bluuebunny/crossref_metadata_2025 huggingface dataset:
Indications and Outcome of Flexible Bronchoscopy at Muhimbili National Hospital in Dar es Salaam: Tanzania
Authors: Lyimo Tito , Kyaruzi Victor Meza , Byomuganyizi Moses , Khamisi Ramadhani Hassan
Published: March 2023

Background:A flexible bronchoscopy is an essential tool that is globally used for the diagnosis and treatment of Broncho-pulmonary diseases. However the indication and outcome of flexible bronchoscopy has not been widely documented in majority of low resource settings.
Objective:To determine the indications and outcome of flexible bronchoscopy (FB) at Muhimbili National Hospital (MNH).
Methodology: A cross sectional analytical study was conducted for a period of 12months. Details involving indications and outcome of flexible bronchoscopy includes; bronchoscopy findings, therapeutic value, diagnostic yield, and early procedural related complications together with their demographic data were documented after each procedure followed by analysis using SPSS version 25.
Results:Among 151 patients underwent flexible bronchoscopy 76(50.3%) were male and 75(49.7%) were female. The median age of 58 years with IQR (43, 65). Among the indications of flexible bronchoscopy, Cough and hemoptysis were the leading by 82.1% and 25.2% respectively. On the other hand hyperemic mucosa (31.1%) and endobronchial mass (21.2%) constituted the majority of the bronchoscopy findings. The overall diagnostic yield was 34.3% and procedural related complications was 18.54%. Among the indications for flexible bronchoscopy, the hemoptysis was associated with procedure related complications by 31.6% (p-value<0.020, OR 2.779). Among sampling technique of flexible bronchoscopy, the endobronchial biopsy and BAL sampling technique were associated with procedure related complications by 39.5 %( p-value<0.001, OR 4.393) and 14.7 %( p-value<0.005, OR 1.870) respectively
Conclusion: We have demonstrated that flexible bronchoscopy is a safe and reliable procedure in diagnosis of respiratory maladies including MTB at Muhimbili National Hospital.
Long-term monitoring of COVID 19 prevalence in raw and treated wastewater in Salvador, a largest capital of Brazilian Northeast
Authors: Rolo Carolina Araújo , Machado Bruna Aparecida Souza , Carmo Matheus , Fernandes Rosângela , Fonseca Maísa Santos , Hodel Saraiva , Silva Jéssica Rebouças , Nunes Danielle Devequi Gomes , Almeida Santos , de Andrade Jailson
Published: March 2023

Wastewater-based epidemiology (WBE) becomes an interesting epidemiological approach to monitoring the prevalence of SARS-CoV-2 broadly and non-invasively. Herein, we employing for the first time WBE, associated or not with the PEG 8000 precipitation method, for detection of SARS-CoV-2 in samples of raw or treated wastewater from 22 municipal wastewater treatment stations (WWTPs) located in Salvador, the fourth most populous city in Brazil. Our results demonstrate the success of the application of WBE for detecting SARS-CoV-2 in both types of evaluated samples, regardless the usage of PEG 8000 concentration procedure. Further, an increase in SARS-CoV-2 positivity rate was observed in samples collected in months that presented the highest number of confirmed COVID-19 cases (May/2021, June/2021 and January/2022). While PEG 8000 concentration step was found to significantly increase the positivity rate in treated wastewater samples (p < 0.005), a strong positive correlation (r: 0.84; p < 0.002) between non-concentrated raw wastewater samples with the number of new cases of COVID-19 (April/2021 – February/2022) was observed. In general, the present results reinforce the efficiency of WBE approach to monitor the presence of SARS-CoV-2 in either low- and high-capacity WWTPs. The successful usage of WBE even in raw wastewater samples makes it an interesting low-cost tool for epidemiological surveillance.
Evaluation of rs10811661 polymorphism in CDKN2A / B in colon and gastric cancer
Authors: Beihaghi Maria , Sahebi Reza , Beihaghi Mohammad Reza , nessiani Raheleh khosravi , Yarasmi Majedeh Ramian , Gholamalizadeh Sajad , Shahabnavaie Fatemeh
Published: March 2023

One of the causes of colon and gastric cancer is the regulation of carcinogenic genes, tumor inhibitors, and micro-RNA. The purpose of this study is to apply rs10811661 polymorphism in CDKN2A /B gene as an effective biomarker of colon cancer and early detection of gastric cancer. As a result,400 blood samples, inclusive of 200 samples from healthy individuals and 200 samples (100 samples from intestinal cancer,100 samples from stomach cancer) from the blood of someone with these cancers, to determine the genotype of genes in healthful and ill people through PCR-RFLP approach and Allelic and genotypic tests of SPSS software. An observe the connection between gastric cancer and bowel cancer risk and genotypes, the t-student test for quantitative variables and Pearson distribution for qualitative variables have been tested and the results have been evaluated using the Chi-square test. The effects confirmed that the highest frequency of TT genotypes is in infected individuals and CC genotype is in healthful individuals. In addition, it confirmed that women were more inclined than men to T3 tumor invasion and most grade II and III colon cancers, and in older sufferers with gastric cancer, the tumor grade tended to be grade I. Among genetic variety and rs10811661, with invasiveness, there is a tumor size and degree in the affected person. In summary, our findings suggest that the rs10811661 polymorphism of the CDKN2A / B gene is strongly associated with the occurrence of intestinal cancer and Stomach is linked to its potential role as a prognostic biomarker for the management of bowel cancer and stomach.
Altered local RAS in the liver increased the risk of NAFLD in male mouse offspring produced by in vitro fertilization
Authors: Bo Le , Wei Lun , Shi Linling , Luo Chao , Gao Shasha , Zhou Anwen , Mao Caiping
Published: March 2023

Background: Assisted reproductive technology (ART) is associated with an increased risk of adverse metabolic health in offspring, and these findings have been demonstrated in animal models without parental infertility issues. However, it is unclear what changes lead to abnormal metabolism. The activation of the renin-angiotensin system (RAS) has been related to various aspects of metabolic syndrome. Thus, we focused on the local RAS of the liver, which is the central organ for glucose and lipid metabolism in offspring conceived by in vitro fertilization (IVF), and studied the role of local liver RAS in metabolic diseases.
Methods: Male C57BL/6 mouse offspring obtained by natural pregnancy and IVF were fed a standard chow diet or a high-fat diet (HFD) from 4 weeks of age through 16 weeks of age. We assessed glucose and lipid metabolism, hepatic histopathology, and the gene and protein expression of key RAS components. In addition, the blocker losartan was used from 4 weeks of age through 16 weeks of age to investigate the regulatory mechanisms of abnormal local RAS on metabolic activity in the IVF offspring liver.
Results: The growth trajectories of IVF offspring body and liver weights were different from those of naturally pregnant offspring. Impaired glucose tolerance (IGT) and insulin resistance (IR) occurred in IVF-conceived male offspring. After continuous HFD feeding, male offspring in the IVF group underwent earlier and more severe IR. Furthermore, there was a trend of lipid accumulation in the livers of chow-fed IVF offspring. Hepatic steatosis was also more serious in the IVF offspring after HFD treatment. Type 1 receptor (AT1R), which is the primary receptor mediating the action of angiotensin (Ang) II, has been confirmed to be upregulated in IVF offspring livers. Losartan reduced or even eliminated most of the significant differences between the IVF and NC groups after HFD consumption.
Conclusions: The upregulation of AT1R expression in the liver increased the activity of the local RAS, resulting in abnormal glucose and lipid metabolism and lipid accumulation in the liver, significantly increasing the risk of nonalcoholic fatty liver disease (NAFLD) in IVF offspring.
MiR-128-3p inhibits vascular smooth muscle cell proliferation of spontaneously hypertensive rats via targeting KLF4
Authors: Xie Liang , Weng Qing , Zhu Ying , Li Shanshan , Liu Niannian
Published: March 2023

Background Hypertension as a refractory disease has always been a major clinical problem. The proliferation of vascular smooth muscle cells (VSMCs) plays core roles in vascular remodeling of hypertension. MicroRNAs are a type of small noncoding RNA that modulate gene expression via binding different target genes.
Methods and results In this study, we investigated that miR-128-3p inhibited the proliferation of SHR-VSMCs via targeting KLF4. Firstly, we found that the expression levels of miR-128-3p were significantly reduced in SHR aorta and VSMCs compared with WKY. Overexpression of miR-128-3p arrested the function of proliferation in VSMCs. Furthermore, we confirmed that KLF4 was a direct target gene of miR-128-3p, and knockdown of KLF4 suppressed the proliferation.
Conclusions Our findings indicated that overexpression of miR-128-3p in SHR attenuates vascular remodeling and hypertension.
An analysis of racial inequities in emergency department triage among patients with stroke symptoms in the United States.
Authors: Neves Gabriel , DeToledo John , Morris James , Xu K. Tom
Published: March 2023

Background
Racial inequities exist in treatment and outcomes in patients with acute stroke.
Objectives
Our objective was to determine if racial inequities exist in time-lapse between patient presentation and provider assessment in patients with stroke symptoms in Emergency Departments (ED) across the U.S.
Methods
This was a retrospective, observational study of the National Hospital Ambulatory Medical Care Survey (NHAMCS) 2014–2018. We identified visits with stroke symptoms and stratified the proportion of door-to-provider (DTP) times by racial groups. We used broad and narrow definitions of stroke symptoms. We performed bivariate and multivariate analyses using race, DTP times, and clinical and demographic characteristics as covariates.
Results
Between 2014–2018, there were an average of 138.58 million total annual ED visits. Of the total ED visits, 0.36–7.39% of the ED visits presented with stroke symptoms, the average DTP time ranged from 39 to 49 minutes, and the proportion of the visits with a triage level of 1 (immediate) or 2 (emergent) ranged from 16.03–23.27% for stroke symptoms. No statistically significant racial disparities were found in DTP or ED triage level, except that when compared to non-Hispanic whites with atypical stroke symptoms, significantly longer DTP times were found in blacks (by 15.88 minutes, 95% CI: 4.29–27.48) and Hispanics (by 14.77 minutes, 95% CI: 3.37–26.16). Non-Hispanic whites were significantly more frequently diagnosed with a stroke/TIA than racial minority groups (p = 0.045) for atypical stroke symptoms.
Conclusion
In our population-based analysis, we did not identify consistently significant racial disparities in the DTP times or ED triage level at ED triage for stroke symptoms.
Growth differentiation factor-15 as predictor of periodontal treatment effects in patients with periodontitis: a randomized-controlled clinical trial
Authors: Isola Gaetano , Tartaglia Gianluca Martino , Santonocito Simona , Chaurasia Akhilanand , Marya Anand , Giudice Antonino La
Published: March 2023

Background: It has been shown that periodontal treatment could potentially decrease the risk of developing cardiovascular disease (CVD) and that growth differentiation factor 15 (GDF-15) is a valuable biomarker of early CVD risk. This study evaluated the efficacy of periodontal treatment on growth differentiation factor 15 (GDF-15) and related circulating systemic risk biomarkers such as glutathione peroxidase 1 (GPx-1), c-reactive protein (hs-CRP), and surfactant protein D (SP-D) and explored whether patients with high GDF-15 at baseline showed increased clinical benefits with two non-surgical treatments protocols at 6-months follow-up.
Methods: Patients with periodontitis were randomized to receive quadrant (Q-SRP, n=23) or full-mouth disinfection (FMD, n=23) protocols. Clinical and periodontal parameters were recorded in all enrolled patients. Serum concentrations of GDF-15, GPx-1, hs-CRP, and SP-D concentrations were assessed at baseline and 30, 90, and 180-days follow-up through enzyme-linked immunosorbent assay (ELISA) and nephelometric assay techniques.
Results: Q-SRP was more effective than FMD in lowering periodontal parameters, and the mean proportions of GDF-15 (p=0.005), GPx-1 (p=0.025), hs-CRP (p<0.001), and SP-D (p=0.042) after 6 months of treatment. Periodontal parameters were significantly associated with concentrations of GDF-15, GPx-1, hs-CRP, and SP-D at 6-months follow-up. Furthermore, the ANOVA analysis revealed that Q-SRP significantly influenced the upregulation of GPx-1 and on downregulation of GDF-15, and SP-D and substantially impacted the effectiveness of periodontal therapy at 6 months follow-up.
Conclusion: The results evidenced that, in comparison with FMD, Q-SRP was more effective at reducing periodontal variables and positively impacting GDF-15, GPx-1, hs-CRP, and SP-D concentrations, although patients who exhibited higher GDF-15 and SP-D and lowered GPx-1 at baseline, more benefited the effects of periodontal treatment at 6-month follow-up.
Could a risk prediction model based on patient record data improve our understanding of carotid stenosis?
Authors: Hervik Kjersti , Wilsgaard Tom , Myrmel Truls , Kjørstad Knut Eivind
Published: March 2023

Digitalised patient records represent a large potential source of real-world data. Nevertheless, confidentiality and data protection has made big data extraction from patient records impossible in the past. Future options for artificial intelligence in free text reading might enable data extraction while maintaining confidentiality. In turn this could enable improvement in risk prediction for several disease groups. Still, it is not known if free text record data provides an appropriate data source for this purpose. In this project we have analysed a pilot dataset of patients with carotid stenosis in order to estimate the stroke risk in relation to treatment, and by that to assess the individual risk profile. The pilot dataset is applied to design a statistical model suitable for patient record data analysis. In this article a detailed description of the data set, and the methods behind our model choice will be presented.
Genetic mapping and identification of Rht8-B1 that regulates plant height in wheat
Authors: Zhou Chunyun , Xiong Hongchun , Fu Meiyu , Guo Huijun , Zhao Linshu , Xie Yongdun , Gu Jiayu , Zhao Shirong , Ding Yuping , Li Yuting , Li Xuejun , Liu Luxiang
Published: March 2023

Background
Plant Height (PH) and Spike Compactness (SC) are important agronomic traits that affect yield improvement in wheat crops. The identification of the loci or genes responsible for these traits is thus of great importance for marker-assisted selection in wheat breeding.
Results
In this study, we used a RIL population with 139 lines derived from crossing between the mutant Rht8-2 and the local wheat variety NongDa5181 (ND5181) to construct a high-density genetic linkage map by applying the Wheat 40K Panel. We identified 7 stable QTLs for PH (3) and SC (4) under two environments using the RIL population, and found that Rht8-B1 is the causal gene of qPH2B.1 by further genetic mapping, gene cloning and gene editing analyses. Our results further showed that two natural variants from GC to TT in the coding region of Rht8-B1 resulted in an amino acid change from G (ND5181) to V (Rht8-2) at the 175th position, reducing PH by 3.6%~6.2% in the RIL population. Moreover, gene editing analysis suggested that the height of T2 generation in Rht8-B1 edited plants was reduced by 5.6%, and that the impact of Rht8-B1 on PH was significantly lower than Rht8-D1. Additionally, distribution analysis of Rht8-B1 in various wheat resources suggested that Rht8-B1b have not been widely utilized in modern wheat breeding
Conclusions
The combination of Rht8-B1b with other favorable Rht genes might be an alternative approach for developing lodging-resistant crops. Our study brings important information for marker-assisted selection in wheat breeding.
Developing a Turbulence-Inspired Zonal Combustion Modeling Approach, Implementing the CRNs in Turbulent Diffusion Flames
Authors: Modarres MohammadReza
Published: March 2023

Computational modeling of the combustion systems not only depends on the flow field typology but also requires well considering the turbulence-reaction interactions. Complex combustion chambers can increase numerical costs dramatically. This paper addresses a novel CFD-based chemical reactor network (CFD-CRN) integrated approach to predict combustion byproducts with high accuracy. This methodology uses turbulence intensity as a determining factor to generate clusters of reactors. The CFD simulations were performed with fine grids using the GRI-Mech 2.11 methane-air combustion mechanism with 277 elementary reactions of 49 species. The GRI-Mech 3.0 including NO formation and reburn chemistry, with 53 species and 325 reactions, is used for the CRN analysis. Implementing the CFD-based CRN, the authors found that the rate of production of NOx from the prompt, thermal, and N2O pathways are calculated as 47.37%, 22.18%, 30.45%, and 40.24%, 29.13%, and 30.63% for the Sandia flames D and E, respectively. The computational fluid dynamics reports for those pathways are predicted as 50.39%, 19.78%, 29.83%, and about 43.58%, 28.45%, and 27.97% entire the Sandia flames D and E, in order. It is deduced that the application of the hybrid CFD-CRN in combustion systems is not only reliable for its high accuracy but also is noticeably efficient for fewer CPU requirements and numerical costs, especially in industrial combustion systems.
Moisture control of tropical cyclones in high-resolution simulations of paleoclimate and future climate
Authors: Raavi Pavan Harika , Chu Jung-Eun , Timmermann Axel , Lee Sun-Seon , Walsh Kevin
Published: March 2023

The intensity of tropical cyclones (TCs) is expected to increase in response to greenhouse warming. However, how future climate change will affect TC frequencies and tracks is still under debate. To further elucidate the underlying sensitivities, we study TCs response to different past and future climate forcings. Using a high-resolution TC-resolving global Earth system model with 1/4o atmosphere and 1/10o ocean resolution we conducted a series of paleo-snapshot and future greenhouse warming simulations targeting the last interglacial (Marine Isotope Stage (MIS) 5e, 125 ka), glacial sub-stage MIS5d (115 ka), present-day (PD), and CO2 doubling (2×CO2) conditions. Our analysis reveals that precessional forcing creates an interhemispheric difference in simulated TC densities, whereas future CO2 forcing impacts both hemispheres in the same direction. In both cases, we find that TC genesis frequency, density, and intensity are primarily controlled by changes in tropospheric thermal and moisture structure, with warmer hemispheres exhibiting a reduction in TC density.
Teaser
Precessional and CO2 effects on tropical cyclone formation are primarily controlled by moisture-related processes.
Chemoembolization Combined Radiofrequency Ablation vs. Chemoembolization Alone for Treatment of beyond the Milan Criteria viable Hepatocellular Carcinoma (CERFA): Study protocol for a randomized controlled trial
Authors: Lee Soon Kyu , Yang Hyun , Kwon Jung Hyun , Shim Dong Jae , Kim Doyoung , Nam Soon Woo , Yoo Sun Hong , Bae Si Hyun , Lee Ahlim , Lee Young Joon , Jeon Changho , Jang Jeong Won , Sung Pil Soo , Chun Ho Jong , Kim Su Ho , Choi Joon-Il , Oh Jung Suk , Yang Yun-Jung
Published: March 2023

• Background

Many previous studies evaluated a combination of transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) for treating early hepatocellular carcinoma (HCC); however, studies evaluating combination therapy for beyond-the-Milan criteria HCC are scarce.

• Methods

A total of 120 patients with beyond-the-Milan criteria HCC who have viable tumour after first TACE will be enrolled in this multi-institutional, parallel, pragmatic, randomized controlled trial. Patients with metastasis, vascular invasion, or a sum of tumour diameter > 8 cm will be excluded. Eligible patients will be randomly assigned to combination TACE and RFA therapy or TACE monotherapy groups. Patients in the combination therapy group will receive a second TACE and subsequent RFA at the viable tumour. Patients in the TACE monotherapy group will receive only second TACE. Patients in both groups will undergo magnetic resonance imaging 4–6 weeks after second TACE. The primary endpoint is 1-month tumour response, and secondary endpoints are progression-free survival, overall response rate, number of treatments until CR, overall survival, and change in liver function.

• Discussion

Although TACE can be used to treat intermediate-stage HCC, it is difficult to achieve CR by first TACE in most intermediate-stage patients. Recent studies show a survival advantage of combination therapy over monotherapy. However, most studies evaluating combination therapy included patients with a single tumour sized < 5 cm, and no studies included patients with intermediate-stage but more advanced (i.e., beyond-the-Milan criteria) HCC. This study will evaluate the efficacy of combined TACE and RFA therapy for patients with advanced HCC within the intermediate stage.

Trial registration:

Clinical Research Information Service (CRiS) KCT0006483
Hoarseness as the first symptom in a patient with acute suppurative thyroiditis secondary to a pyriform sinus fistula: A case report
Authors: Otsuki Toshifumi , Onuma Ryoichi , Tonsho Kohei , Saito Dai , Sakai Hideyuki , Kamimura Miki , Watanabe Yohei , Kurihara Noriko , Ishida Eiichi , Kumaki Satoru
Published: March 2023

Background

Pyriform sinus fistulas (PSFs) are rare congenital anomalies of the third or fourth brachial clefts. Dyspnea is reportedly secondary to compression by a neck mass. However, hoarseness, as the first symptom of PSF, has not yet been reported.

Case presentation

This report describes an eleven-year-old girl presenting with hoarseness as the first symptom of PSF. Hoarseness occurred 2 days prior to admission. On admission, she had fever, hoarseness, and an elastic soft mass on her left anterior neck. Contrast-enhanced computed tomography of the cervical region demonstrated an abscess partially infiltrating the thyroid gland and an air pocket near the pyriform sinus. Pharyngoscopy revealed swelling of the left arytenoid region, with purulent retention. The left vocal cord was swollen but not paralyzed. Additionally, the laboratory data indicated thyrotoxicosis. Suspecting a PSF infection, parenteral treatment with cefotaxime and dexamethasone was initiated. On the following day, the hoarseness disappeared, and the fever resolved. Four weeks after onset, the thyroid hormone levels returned to the normal range, and a barium esophagogram revealed residual contrast in the left pyriform sinus, leading to a diagnosis of PSF.

Conclusion

PSF presenting with hoarseness as the first symptom in patients should be considered.
The impact of eHealth on relationships and trust in primary care: A review of reviews
Authors: Ramachandran Meena , Brinton Christopher , Wiljer David , Upshur Ross , Gray Carolyn Steele
Published: March 2023

Background: Given the increasing integration of digital health technologies in team-based primary care, this review aimed at understanding the impact of eHealth on patient-provider and provider-provider relationships.
Methods: A review of reviews was conducted on three databases to identify papers published in English from 2008 onwards. The impact of different types of eHealth on relationships and trust and the factors influencing the impact were thematically analyzed.
Results:A total of 79 reviews were included. Patient-provider relationships were discussed more frequently as compared to provider-provider relationships. Communication systems like telemedicine were the most discussed type of technology. eHealth was found to have both positive and negative impacts on relationships and/or trust. This impact was influenced by a range of patient-related, provider-related, technology-related, and organizational factors, such as patient sociodemographics, provider communication skills, technology design, and organizational technology implementation, respectively.
Conclusions:Recommendations are provided for effective and equitable technology selection, application, and training to optimize the impact of eHealth on relationships and trust. The review findings can inform providers’ and policymakers’ decision-making around the use of eHealth in primary care delivery to facilitate relationship-building.
The effect of fibrinoid necrosis on the clinical features and outcomes of primary IgA nephropathy
Authors: Chen Hongshan , Liu Youxia , Wei Li , Wang He , Zheng Zhenfeng , Yan Tiekun , Jia Junya , Li Dong
Published: March 2023

Background: To explore the clinicopathologic features and outcomes of IgAN patients who presented with fibrinoid necrosis (FN) lesions or not and the effect of immunosuppressive (IS) treatment in IgAN patients with FN lesions as well.
Methods: This was a retrospective cohort study with 720 patients diagnosed with primary IgAN from January 2010 to December 2020 in Tianjin Medical University General Hospital and having detailed baseline and follow-up characteristics. Explore the difference of clinicopathological characteristics in different group IgAN patients. Compare the survival from a composite endpoint rate in different group IgAN patients by Kaplan-Meier survival curve as well. The univariate and multivariate Cox models were used to establish the basic model for renal outcomes in patients with FN lesions.
Results:(1) A total of 233 patients (35.04%) were found FN lesions in all participants. Patients with FN lesions suffered more severe hematuria than those without. On the hand of pathological characteristic, patients with FN lesions showed higher proportions of M1, E1, C1/C2 and T1/T2 lesions compared with those without FN lesions. (2) The 1-year, 3-year, and 5-year survival of the composite endpoint were lower in the FN1 group than FN0 group. By contrast, patients showed no statistical significance on the survival of the composite kidney endpoint between patients with or without FN lesions after IS treatment. (3) After adjusting for clinicopathological variables, the presence of FN lesions was a significantly independent risk factor for composite endpoint. By using multivariate Cox regression analyses, we also found when the fraction of FN lesions exceeded 10%, the risk of progression into composite endpoint increased 3.927 times.
Conclusion: Fibrinoid necrosis of capillary loops is an independent risk factor of poor renal outcomes. More effective treatment like IS treatment should be considered for those who had FN lesions.
Lower rates of return to sport in patients with generalised joint hypermobility two years after ACL reconstruction: a prospective cohort study
Authors: Lindskog Jakob , Piussi Ramana , Simonson Rebecca , Högberg Johan , Samuelsson Kristian , Thomeé Roland , Sundemo David , Senorski Eric Hamrin
Published: March 2023

Background

Generalised joint hypermobility (GJH) is associated with an increased risk of suffering an anterior cruciate ligament (ACL) injury. Patients with GJH exhibit lower muscle strength and poorer scores for patient-reported outcomes after ACL reconstruction, compared with patients without GJH. The aim of this study was to examine differences in the percentages of patients who return to sport (RTS) or pre-injury level of activity (RTP), muscle function and patient-reported outcomes at the time of RTS or RTP, as well as the time of RTS or RTP in patients with GJH compared with patients without GJH in the first two years after ACL reconstruction.

Methods

This prospective study used data from a rehabilitation-specific register. A total of 1,198 patients aged between 16 and 50, who had an ACL injury treated with reconstruction, were included. Data up to two years after ACL reconstruction were used and consisted of results in isokinetic muscle function tests for knee extension and flexion and patient-reported outcomes (Knee Self-Efficacy Scale, Knee injury and Osteoarthritis Outcome Score and ACL-Return to Sport after Injury scale) at the time of RTS, as well as the time of RTP. A Beighton Score of ≥ 5/9 was used to define GJH. A Tegner Activity Scale of ≥ 6 was used to define RTS, while a Tegner equal to or above pre-injury level was used to define RTP.

Results

A smaller proportion of patients with GJH achieved RTS compared with patients without GJH (49.2% vs 57.3%). Furthermore, patients with GJH were marginally less symmetrical on the knee extension strength test, expressed as a Limb Symmetry Index, at the time of RTP compared with patients without GJH (87.3 ± 13.5 vs 91.7 ± 14.3). No further differences were found between groups regarding any muscle function tests or patient-reported outcomes.

Conclusion

A smaller proportion of patients with GJH achieved RTS compared with patients without GJH. Patients with GJH display less symmetrical knee extension strength at the time of RTP compared with patients without GJH.
Characteristics of distal radius fractures in east China-an observational cohort study of 1954 individual fractures
Authors: Luo Zhenyu , Zhu Wei , Jiang Chao , He Wei , Zuo Hua
Published: March 2023

OBJECTIVE: To investigate the epidemiological characteristics and changing trends of distal radius fractures during 5 years, which gains insight into the incidence of the disease in the region.
METHODS: Utilizing the medical imaging computer system (PACS), 1954 clinical records of radial radius fractures from patients treated at the affiliated hospital of Jiangsu University from January 2017 to December 2021 were collected and analyzed for age, gender, side, osteoporosis status, and incidence of the season.
RESULTS: there were a total of 1954 distal radius fractures, with 731 (37.4%) being male and 1223 (62.6%) being female (ratio 0.59:1), and the highest proportion was female. The median age was 56 years (range 1-102 years) with an average of 50.48 years, 1033 (52.7%) on the left side, 885 (45.1%) on the right side, and 36 (1.8%) on both sides, the left side being the highest. The age distribution was highest in the 61-70 year old group (23.9%, 467/1954), and the highest proportion in males was in the 11-20 year old group (23.8%, 174/731), and in females was in the 61-70 year old group (30.83%, 377/1223). In the 50 years and older group, there were 276 males and 991 females (ratio 1:3.59), with osteoporosis in 536 cases, accounting for 42.03% of the older fractures. The seasonal distribution was highest in summer and autumn (55.1%, 1076/1954).
CONCLUSION: In east China, distal radius fractures were predominantly female and left-sided, with the highest proportion in the age group of 61-70 years and in summer and autumn（rainy season）.
Preoperative fasting blood glucose combined with age-adjusted D-dimer levels as a predictive score to assess postoperative prognosis of early-stage cervical cancer patients: a retrospective cohort study
Authors: Zhu Chunyu , Zhang Li , Chen Xinyi , Jin Beibei , Ding Xiaoyin , Wei Qinru , Du Hongxiang , Wu Xirong , Zhang Yuquan , Peng Chen , Yang Xiaoqing
Published: March 2023

Background. There is a lack of methods to predict the prognosis of early-stage cervical cancer patients undergoing radical hysterectomy at present. In this study, a nomogram was constructed using commonly clinical data to evaluate the prognostic value.
Methods. Retrospective, double-center analysis of the biochemical parameters and clinicopathological factors was performed in 381 patients. Area under the curve (AUC) was used to evaluate the prognostic efficacy of FBG, D-dimer, age-adjusted D-dimer, and their combination in early-stage cervical cancer patients undergoing radical hysterectomy. Multivariable analysis of both progression-free survival (PFS) and overall survival (OS) was performed with Cox proportional hazards regression models.
Results. A new calculation formula for age-adjusted D-dimer was established. Kaplan-Meier survival analysis and AUC showed that FBG, D-dimer, and age-adjusted D-dimer had a good predictive ability for OS and PFS. A new score was established based on the cut-off values for FBG and age-adjusted D-dimer [5.45 mmol/L, 0.184 mg/L (fibrinogen equivalent units)]. Score2 for high FBG level (FBG≥5.45) and high age-adjusted D-dimer level [D-D(a)≥0.184], score1 for abnormalities in only one of the biochemical indices, and score0 for no abnormalities in both biochemical indices [FBG<5.45 and D-D(a)<0.184]. Multivariate Cox regression analysis showed that tumor size, deep stromal invasion, and score2 were independent prognostic factors for PFS and OS. These factors were used to build a nomogram for predicting OS in early-stage cervical cancer patients undergoing radical hysterectomy.
Conclusions. The score2 model combining FBG and age-adjusted D-dimer can effectively predict the prognosis of early-stage cervical cancer patients undergoing radical hysterectomy.
Savoring Life During The Pandemic: An online intervention to promote well-being in emerging adults
Authors: Villani Daniela , Pancini Elisa , Pesce Francesca , Scuzzarella Lucia
Published: March 2023

Background: Savoring, that is the ability to create and increase positive emotions, represents a promising approach to enhance subjective well-being (SWB) in emerging adults in times of the COVID-19 pandemic. This study aims to investigate the preliminary effects of a self-help e-savoring intervention on increasing savoring beliefs and strategies and SWB in emerging adult participants. It also examines the user experience and the perceived usefulness of the intervention.
Methods: Forty-nine participants were involved, and the experimental group (N = 23) completed six online exercises (two exercises per week for three weeks) while the control group (N = 26) did not follow the intervention. Both groups filled out online questionnaires before and after the intervention.
Results: A repeated measures ANOVA revealed a significant increase for the experimental group in savoring beliefs (especially toward the present and the future) and in positive emotions compared to the control group. The perspicuity, attractiveness, and efficiency of the online platform were very positively evaluated, and most participants rated the intervention as useful.
Conclusions: The results of this preliminary study are promising and indicate its potential for promoting savoring and positive emotions in emerging adults. Future research could evaluate its long-term effects and verify its results with other age groups.
Association between vascular access types and mortality in hemodialysis patients: A systematic review and meta-analysis
Authors: Peimin Gan , Huang Qingxiu , Xu Juan , ruan Shaowei , Pan Yurong , Liu Linna , Li Yanlin
Published: March 2023

Objective
To compare the mortality of different vascular access types in hemodialysis patients by using systematic review and meta-analysis of observational research.
Methods
Through a systematic literature search in PubMed and Embase databases, the English publications that directly compared the mortality of vascular access types in hemodialysis patients from 2000 to 2022 were determined. The outcomes of this study are based on the mortality hazard ratio (HR) of vascular access types. Moreover, using a random-effects model to calculate the pooled HR [95% CI] and I2 to show the heterogeneity among the included studies.
Results
Of the 4,802 studies screened, 19 studies involving 575,109 patients met the inclusion criteria and were included in the analysis. Meta-analyses revealed the significant difference for the adjusted HR of death among various vascular access types. The results of meta-analysis showed that the mortality of using central venous catheter (CVC) for hemodialysis patients was higher than using arteriovenous fistula (AVF) (pooled HR = 1.85; 95% CI, 1.55–2.22). Further, the mortality of patients with arteriovenous graft (AVG) was higher than patients with AVF (pooled HR = 1.24; 95% CI, 1.12–1.36), while the mortality have no statistically significant difference between CVC use and AVG use was found (pooled HR = 1.41; 95% CI, 1.31–1.52; P > 0.05).
Conclusions
The mortality of patients with CVC was higher than those with AVF for hemodialysis, while patients using AVG had higher mortality than those using AVF.
Facile preparation of black electrochromic ink using a copper oxide nanoparticle suspension
Authors: Jeong Chan Yang , Watanabe Hiroshi , Tajima Kazuki
Published: March 2023

Electrochromic (EC) materials for smart windows must exhibit a dark colour and block visible light (wavelength = 380–780 nm) to reduce environmental impact. Many researchers have attempted to use organic materials like polymers to produce these dark tones. However, their fabrication methods are complicated, expensive, and may even use hazardous substances; moreover, they are often not sufficiently durable, such as upon exposure to ultraviolet light. Therefore, herein we focused on using copper oxide (CuO) to develop an ecofriendly, inexpensive dark inorganic EC thin film by printing ink prepared using our nanoparticle (NP) dispersion technology. Specifically, we dispersed CuO NPs, synthesised by simply heating basic copper carbonate, in easily purified water using citric acid to adjust the pH. This research will enable the creation of EC smart windows using existing inorganic materials and methods, such as printing technology, and is the first step towards developing environment-friendly, cost-effective, and functional dark inorganic materials.
Micro- and nanochamber array system for single enzyme assays
Authors: Iijima Kazuki , Kaji Noritada , Tokeshi Manabu , Baba Yoshinobu
Published: March 2023

Arrays of small reaction containers, ranging from 624 femtoliters (10-15 L) to 270 attoliters (10-18 L), for capturing a single enzyme molecule and measuring the activity were developed together with a new reversible sealing system based on a pneumatic valve actuator made of polydimethylsiloxane (PDMS). The valve was actuated by PBS solution, effectively preventing evaporation of the solution from the micro- and nanochambers and allowing the assay to be carried out over a long period of time. The hydrolysis rates of β-D-galactosidase (β-gal), kcat, were decreased according to the chamber size decrease, and the overall tendency seems to be symmetrical relationship to the specific surface area of the chambers even under the prevented condition of non-specific adsorption. The spatial localisation of the protons in the chambers, which might could affect the dissociation state of the proteins, was also investigated to explain the decrease in the hydrolysis rate. The developed chamber system developed here may be useful for artificially reproducing the confined intracellular environments and molecular crowding conditions.
A COM-B analysis of facilitators of and barriers to smoking cessation among Chinese smokers——a qualitative study
Authors: Xie Xiaoyun , Nan Yi , Lin Bingliang , Chen Tianqi , Zhang Luge , Xiao Lin
Published: March 2023

Introduction: Despite the Chinese government’s efforts, smoking prevalence remains high and motivation to quit stays at a low level in China. However, few studies have examined the perceptions, behaviors, and attitudes related to quitting smoking specifically, especially in a theory-based deductive manner. This study deployed the COM-B model as a framework to explore smoking cessation among Chinese smokers.
Methods: Forty 30-minute individual in-depth interviews were conducted with a semi-structured moderator guide. Participants (N = 40) were current smokers and ex-smokers aged 18 years or older. A directed content analysis approach was utilized for examining interview data.
Results: Smokers’ motivation to stop smoking was influenced by their beliefs about the health consequence. Regarding smoking as a personal choice and habit and overemphasis on willpower both impeded smokers’ motivation to quit. The positive social climate change improved smokers’ opportunity for cessation, but the insufficient and underused smoking cessation services and family support were detrimental to their opportunity. Incapability to handle invitations from others and deal with negativity and inadequate knowledge about smoking and cessation represented smokers’ insufficient capability to quit smoking.
Conclusions: The barriers impeding Chinese smokers’ quitting attempts as well as the facilitators promoting their cessation were determined from three perspectives: motivation, opportunity, and capability. Publicity and education campaigns should target smokers’ misconception that smoking is a symbol of personal freedom, correct their misplaced overemphasis on willpower, promote the existing smoking cessation services wildly, and most importantly shape the social norm into a more anti-smoking way. Using real story to demonstrate the health consequences of smoking, disseminating information about smoking cessation services in the maternity center, enriching the existing smoking cessation services by embracing mobile health, and empowering family support may better facilitate smoking cessation in China.
Implications: The present study has both practical and theoretical significance. These barriers and facilitators presented in this study could inform future smoking cessation programs. Besides, the deployment of the COM-B model in the analysis of smoking cessation could boost its use in other fields in China.
Psychometric Properties of the Arabic Version of the Fertility Quality of Life (FertiQoL) Questionnaire Tested on Infertile Couples in Jordan
Authors: Obeisat Salwa Al , Hayajneh Audai A. , Hweidi Issa M. , Abujilban Sanaa , Mrayan Lina , Alfar Rana , Nashwan Abdulqadir J. , Hweidi Lama I
Published: March 2023

Background: The Fertility Quality of Life (FertiQoL) questionnaire assesses the quality of life of people with fertility problems. The present study aimed to assess the psychometric properties of the Arabic version of the FertiQoL in infertile couples in Jordan.
Methods: This study used a cross-sectional design among 212 participants with infertility problems. An exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) were conducted to investigate the underlying structure of the novel Arabic version of the FertiQoL tool.
Results: The Cronbach’s alpha values for the FertiQoL core domain, the FertiQoL treatment domain, and the total FertiQoL scale were 0.93, 0.74, and 0.92, respectively. The EFA indicated a two-domain model, with the first factor having 24 items and measuring "Core QoL". The second factor has 10 items and measures "Treatment QoL" in the context of infertility. The EFA and the CFA supported a two-factor model whereby the two factors explained 48% of the shared covariance between the analyzed quality of life indicators. The indices of goodness-of-fit of the model showed acceptable fit as follows: the chi-squared test (χ2) = 7.943, the comparative fit index (CFI) = 0.999, the root mean square error of approximation (RMSEA) = 0.001, and the Tucker-Lewis index (TLI) = 0.989.
Conclusion: The study's findings demonstrated the reliability and validity of the Arabic version of the FertiQoL for assessing the quality of life of infertile couples or those in Jordan with no pregnancy or childlessness.
Global Research Status and Trends in Orthopaedic Surgical Robotics: a Bibliometric and Visualization Analysis Study
Authors: Guo Xinmeng , Wang Daofeng , Li Jiantao , Zhang Hao
Published: March 2023

Purpose
This study aimed to investigate and summarise the current state of research and trends in orthopaedic surgical robots.
Methods
Data on publicly available publications related to orthopaedic surgical robots were extracted by abstract searches of the Web of Science Core Collection database. A bibliometric analysis and detailed reading of the publications were then carried out and the information was visualised using co-authorship analysis, coupling analysis, co-citation analysis and co-occurrence analysis in VOSviewer.
Results
With 436 publications included in the study from 1993 to 2022, the overall contribution of publications to the world showed an increasing trend year by year, with a particularly pronounced after 2017, and a geographical trend of predominantly East Asia, North America, and Western Europe. Of these, China was the largest contributor (n = 128). Overall the UK affiliates and their scholars were leaders in the field, with a high number of publications, total citations, average citations per article and H-index. The most published institutions and authors were Imperial College London(n = 21) and Professor Fares Sahi Haddad of University College London(n = 12), respectively. Journals with a high overall impact on robotic orthopaedic surgery were the Journal of Arthroplasty, Bone Joint Journal, International Journal of Medical Robotics and Computer Assisted Surgery. Keyword co-occurrence network analysis revealed four main clusters: robot-assisted knee, hip arthroplasty, spine surgery, and robotic technology research and development. The top three most common sites for robot-assisted surgery use were the knee, hip and spine. The most used robot types were the knee and spine, with Mako and Arobot being the most used robots for the knee and TiRobot for the spine.
Conclusion
This study comprehensively reveals the current status and trends of global research on orthopaedic surgical robots, covering countries, institutions, authors, journals, research hotspots, robot types and surgical sites, providing directional guidance and research ideas for further research on the technological development and clinical evaluation of orthopaedic surgical robots.
Feasibility and acceptability of using biometric fingerprinting to track migrations and support retention in HIV prevention research in fishing population in East Africa
Authors: Abaasa Andrew , Mee Paul , Nanyonjo Agnes , Easton Sue , Asiki Gershim
Published: March 2023

Introduction

Fishing populations constitute suitable key population amongst which to conduct HIV prevention trials due to very high HIV prevalence and incidence, however, these are highly mobile populations. We determined the feasibility and acceptability of using fingerprinting and geographical positioning systems to describe mobility patterns and retention among fisherfolks on the shoreline of Lake Victoria in Southwestern Uganda.

Methods

Between August 2015 and January 2017, two serial cross-sectional surveys were conducted during which fingerprinting of all residents aged 18–30 years on the shoreline of Lake Victoria was done. A mapper moving ahead of the survey team, produced village maps and took coordinates of every household. These were accessed by the survey team that assigned household and individual unique identifiers (ID) and collected demographic data. Using the assigned IDs, individuals were enrolled and their fingerprints scanned. The fingerprinting was repeated 6 months later in order to determine the participant’s current household. If different from the baseline, a new household ID was assigned which was used to map migrations both within and between villages.

Results

At both rounds, over 99% accepted fingerprinting. No fingerprint faults were recorded initially and less than 1% at the second round. Over 80% of the participants were seen at round two and of these 16.3% had moved to a new location, the majority (85%) within the same village. Movements between villages were mainly observed in large villages. Those who did not consider the fishing village to be their permanent home were less likely to be migrants than permanent residents adjusted odds ratio = 0.37, 95%CI:0.15–0.94.

Conclusion

Use of fingerprinting in fishing populations is feasible and acceptable. It is possible to track this mobile population for clinical trials or health services using this technology since most movements could be traced within and between villages.