bluuebunny/crossref_metadata_2025 huggingface dataset:
Occupational stress among farm and ranch operators in the midwestern United States
Authors: Chengane Sabrine , Beseler Cheryl L. , Duysen Ellen G. , Rautiainen Risto H.
Published: November 2021

Background

This study used surveillance data from 2018 and 2020 to test the stability of work-related strain symptoms (high stress, sleep deprivation, exhaustion) with demographic factors, work characteristics, and musculoskeletal symptoms among farm and ranch operators in seven midwestern states of the United States.

Methods

Cross-sectional surveys were conducted among farm and ranch operators in 2018 (n = 4423) and 2020 (n = 3492). Operators were asked whether, in the past 12 months, they experienced extended work periods that resulted in high stress levels, sleep deprivation, exhaustion/fatigue, or other work-related strain symptoms. Covariates included personal and demographic factors, work characteristics, number of injuries, work-related health conditions, and exposures on the operation. Summary statistics were tabulated for explanatory and outcome variables. The classification (decision) tree approach was used to assess what variables would best separate operators with and without reported strain symptoms, based on a set of explanatory variables. Regularized regression was used to generate effect estimates between the work strain variables and explanatory variables.

Results

High stress level, sleep deprivation, and exhaustion were reported more frequently in 2018 than 2020. The classification tree reproduced the 2018 model using 2020 data with approximately 80% accuracy. The mean number of reported MSD symptoms increased slightly from 1.23 in 2018 to 1.41 in 2020. Older age, more time spent in farm work, higher gross farm income (GFI), and MSD symptoms in six body regions (ankles/feet, knees, lower back, neck, shoulders, wrists/hands) were associated with all three work strain symptoms.

Conclusions

Musculoskeletal pain and discomfort was a strong predictor for stress, sleep deprivation, and exhaustion among farmers and ranchers. This finding indicates that reducing MSD pain and discomfort is beneficial for both physical and mental health.
Effect of altitude on COVID-19 mortality in Ecuador: an ecological study
Authors: Campos Adriana , Scheveck Bridget , Parikh Jeegan , Hernandez-Bojorge Santiago , Terán Enrique , Izurieta Ricardo
Published: November 2021

Background

The SARS-CoV-2/COVID-19 pandemic has claimed nearly 900,000 lives worldwide and infected more than 27 million people. Researchers worldwide are studying ways to decrease SARS-CoV-2 transmission and COVID-19 related deaths. Several studies found altitude having a negative association with both COVID-19 incidence and deaths. Ecuadorian data was used to explore the relationship between altitude and COVID-19.

Methods

This is an ecological study examining province-level data. To explore a relationship between altitude and COVID-19, this study utilized publicly available COVID-19 data and population statistics. ANOVA, correlation statistics, and a multivariate linear model explored the relationship between different Ecuadorian altitudes against incidence, mortality, and case-fatality rates. Population statistics attributed to COVID-19 were included in the linear model to control for confounding factors.

Results

Statistically significant differences were observed in the regions of Amazónica, Sierra, Costa of Ecuador for incidence, mortality, and case fatality rates, suggesting an association between altitude and SARS-CoV-2 transmission and COVID-19 disease severity (p-value ≤0.05). In univariate analysis, altitude had a negative association to mortality rate with a 1-unit change in altitude resulting in the decrease of 0.006 units in mortality rate (p-value = 0.03). The multiple linear models adjusted for population statistics showed a statistically significant negative association of altitude with mortality rate (p-value = 0.01) with a 1-unit change in altitude resulting in the decrease in mortality rate by 0.015 units. Overall, the model helped in explaining 50% (R2 = 0.4962) of the variance in mortality rate.

Conclusion

Altitude may have an effect on COVID-19 mortality rates. However, based on our model and R2 value, the relationship between our variables of interest and COVID-19 mortality may be nonlinear. More research is needed to understand why altitude may have a protective effect against COVID-19 mortality and how this may be applicable in a clinical setting.
Predictors of postoperative delirium in elderly patients following total hip and knee arthroplasty: a systematic review and meta-analysis
Authors: Zhou Quan , Zhou Xinfeng , Zhang Yijian , Hou Mingzhuang , Tian Xin , Yang Huilin , He Fan , Chen Xi , Liu Tao
Published: November 2021

Background

Postoperative delirium (POD) is widely reported as a common postoperative complication following total joint arthroplasty (TJA) of the hip and knee in elderly patients, leading to many adverse effects. We sought to investigate predictors of delirium after TJA.

Methods

PubMed, EMBASE, Cochrane Library and Web of Science were searched up to 2020 for studies examining POD following TJA in elderly patients. Pooled odds ratio (OR) and mean difference (MD) of those who experienced delirium compared to those who did not were calculated for each variable. The Newcastle-Ottawa Scale (NOS) was used for the study quality evaluation.

Results

Fifteen studies with 31 potential factors were included. In the primary analysis, 9 factors were associated with POD, comprising advanced age (MD 3.81; 95% confidence interval (CI) 1.80–5.83), dementia (OR 24.85; 95% CI 7.26–85.02), hypertension (OR 2.26; 95% CI 1.31–3.89), diabetes (OR 2.02; 95% CI 1.15–3.55), stroke (OR 14.61; 95% CI 5.26–40.55), psychiatric illness (OR 2.72; 95% CI 1.45–5.08), use of sedative-hypnotics (OR 6.42; 95% CI 2.53–16.27), lower preoperative levels of hemoglobin (MD − 0.56; 95% CI − 0.89−− 0.22), and lower preoperative mini-mental state examination score (MD − 0.40; 95% CI − 0.69−− 0.12). Twelve studies were included in the systematic review, of which 24 factors were additionally correlated with POD using single studies.

Conclusions

Strategies and interventions should be implemented for the elderly patients receiving TJA surgeries with potential predictors identified in this meta-analysis.
Oral health status among transgender young adults: a cross-sectional study
Authors: Manpreet Kaur , Ajmal Mohammed B. , Raheel Syed Ahmed , Saleem Mohammed C. , Mubeen Khan , Gaballah Kamis , Faden Asmaa , Kujan Omar
Published: November 2021

Background

Transgender and gender nonconforming (TGNC) people are a marginalized set of the population that continues to experience health care inequalities. This study aimed to assess oral health parameters including Candida growth and intensity among TGNC adults.

Methods

This cross-sectional study recruited two subgroups: 40 transgender and 40 control adults. Consented participants were interviewed and clinically examined. Data using the WHO oral health assessment forms were obtained. Samples for Candida growth and intensity analysis were collected from the dorsum surface of the tongue.

Results

27.5% of the transgender group was HIV seropositive. Oral nicotine stomatitis and leukoplakia are reported to be the most prevalent intra-oral lesions showing a prevalence of 27.5% and 20%, respectively. The dental and periodontal health parameters of the transgender group were worse than those of the control group. The intensity of Candida colonies was significantly higher in the test group (p = 0.014).

Conclusion

Poor oral health and significant oral mucosal disorders were reported in transgender adults that have shown a higher rate of behavioral risk factors such as tobacco and alcohol consumption. Further longitudinal studies in different world regions are warranted to understand the barriers to good oral health in transgender adults and how to implement effective prevention and management strategies.
Why is it so difficult to implement a longitudinal clinical reasoning curriculum? A multicenter interview study on the barriers perceived by European health professions educators
Authors: Sudacka Małgorzata , Adler Martin , Durning Steven J. , Edelbring Samuel , Frankowska Ada , Hartmann Daniel , Hege Inga , Huwendiek Sören , Sobočan Monika , Thiessen Nils , Wagner Felicitas L. , Kononowicz Andrzej A.
Published: November 2021

Background

Effective clinical reasoning is a core competency of health professionals that is necessary to assure patients’ safety. Unfortunately, adoption of longitudinal clinical reasoning curricula is still infrequent. This study explores the barriers that hinder the explicit teaching of clinical reasoning from a new international perspective.

Methods

The context of this study was a European project whose aim is to develop a longitudinal clinical reasoning curriculum. We collected data in semi-structured interviews with responders from several European countries who represent various health professions and have different backgrounds, roles and experience. We performed a qualitative content analysis of the gathered data and constructed a coding frame using a combined deductive/inductive approach. The identified themes were validated by parallel coding and in group discussions among project members.

Results

A total of 29 respondents from five European countries participated in the interviews; the majority of them represent medicine and nursing sciences. We grouped the identified barriers into eight general themes: Time, Culture, Motivation, Clinical Reasoning as a Concept, Teaching, Assessment, Infrastructure and Others. Subthemes included issues with discussing errors and providing feedback, awareness of clinical reasoning teaching methods, and tensions between the groups of professionals involved.

Conclusions

This study provides an in-depth analysis of the barriers that hinder the teaching of explicit clinical reasoning. The opinions are presented from the perspective of several European higher education institutions. The identified barriers are complex and should be treated holistically due to the many interconnections between the identified barriers. Progress in implementation is hampered by the presence of reciprocal causal chains that aggravate this situation. Further research could investigate the perceptual differences between health professions regarding the barriers to clinical reasoning. The collected insights on the complexity and diversity of these barriers will help when rolling out a long-term agenda for overcoming the factors that inhibit the implementation of clinical reasoning curricula.
Measuring and monitoring patient safety in hospitals in Saudi Arabia
Authors: Kaud Yazeed , Lydon Sinéad , O’Connor Paul
Published: November 2021

Background

There is much variability in the measurement and monitoring of patient safety across healthcare organizations. With no recognized standardized approach, this study examines how the key components outlined in Vincent et al’s Measuring and Monitoring Safety (MMS) framework can be utilized to critically appraise a healthcare safety surveillance system. The aim of this study is to use the MMS framework to evaluate the Saudi Arabian healthcare safety surveillance system for hospital care.

Methods

This qualitative study consisted of two distinct phases. The first phase used document analysis to review national-level guidance relevant to measuring and monitoring safety in Saudi Arabia. The second phase consisted of semi-structured interviews with key stakeholders between May and August 2020 via a video conference call and focused on exploring their knowledge of how patient safety is measured and monitored in hospitals. The MMS framework was used to support data analysis.

Results

Three documents were included for analysis and 21 semi-structured interviews were conducted with key stakeholders working in the Saudi Arabian healthcare system. A total of 39 unique methods of MMS were identified, with one method of MMS addressing two dimensions. Of these MMS methods: 10 (25 %) were concerned with past harm; 14 (35 %) were concerned with the reliability of safety critical processes, 3 (7.5 %) were concerned with sensitivity to operations, 2 (5 %) were concerned with anticipation and preparedness, and 11 (27.5 %) were concerned with integration and learning.

Conclusions

The document analysis and interviews show an extensive system of MMS is in place in Saudi Arabian hospitals. The assessment of MMS offers a useful framework to help healthcare organizations and researchers to think critically about MMS, and how the data from different methods of MMS can be integrated in individual countries or health systems.
PPARD rs2016520 (T/C) and NOS1AP rs12742393 (A/C) polymorphisms affect therapeutic efficacy of nateglinide in Chinese patients with type 2 diabetes mellitus
Authors: Wang Tao , Song Jin-Fang , Zhou Xue-Yan , Li Cheng-Lin , Yin Xiao-Xing , Lu Qian
Published: November 2021

Background

Genetic polymorphisms in the PPARD and NOS1AP is associated with type 2 diabetes mellitus (T2DM); however, there is no evidence about its impact on the therapeutic efficacy of nateglinide. This study was designed to investigate a potential association of PPARD rs2016520 (T/C) and NOS1AP rs12742393 (A/C) polymorphisms with efficacy of nateglinide in newly diagnosed Chinese patients with type 2 diabetes mellitus (T2DM).

Methods

Sixty patients with newly diagnosed T2DM were enrolled to identify PPARD rs2016520 and NOS1AP rs12742393 genotypes using the polymerase chain reaction-restriction fragment length polymorphism assay (PCR–RFLP). All subjects were treated with nateglinide (360 mg/day) for 8 weeks. Anthropometric measurements, clinical laboratory tests were obtained at baseline and after 8 weeks of nateglinide treatment.

Results

After nateglinide treatment for 8 consecutive weeks, patients with at least one C allele of PPARD rs2016520 showed a smaller decrease in post plasma glucose (PPG), homeostasis model assessment for beta cell function (HOMA-B) than those with the TT genotype did (P < 0.05). In patients with the AA genotype of NOS1AP rs12742393, the drug showed better efficacy with respect to levels of fasting plasma glucose (FPG), fasting serum insulin (FINS), HOMA-B and homeostasis model assessment for insulin resistance (HOMA-IR) than in patients with the AC + CC genotype (P < 0.05). NOS1AP rs12742393 genotype distribution and allele frequency were associated with responsiveness of nateglinide treatment (P < 0.05).

Conclusions

The PPARD rs2016520 and NOS1AP rs12742393 polymorphisms were associated with nateglinide monotherapy efficacy in Chinese patients with newly diagnosed T2DM.

Trial registration

Chinese Clinical Trial Register ChiCTR13003536, date of registration: May 14, 2013.
Prognostic value of characteristics of plaque combined with residual syntax score among patients with STEMI undergoing primary PCI: an intravascular optical coherence tomography study
Authors: Zhao Xiaoxiao , Wang Ying , Chen Runzhen , Li Jiannan , Zhou Jinying , Liu Chen , Zhou Peng , Sheng Zhaoxue , Chen Yi , Song Li , Zhao Hanjun , Yan Hongbing
Published: November 2021

Aim

The present study aimed to explore these characteristics, particularly thin-cap fibroatheroma (TCFA), in relation to residual syntax score (rSS) in patients who presented with acute MI.

Methods and outcomes

A total of 434 consecutive patients with MI aged ≥18 years who had STEMI underwent primary PCI. Notably, compared with other subgroups, the presence of TCFA in culprit lesions and a higher level of rSS, were significantly associated with MACE. When rSS was divided into three groups, high rSS levels were associated with a higher incidence of MACE, in the subgroups of without TCFA (P = 0.005), plaque erosion (P = 0.045), macrophage infiltration (P = 0.026), and calcification (P = 0.002). AUC of ROC curve was 0.794 and 0.816, whereas the AUC of the survival ROC was 0.798 and 0.846.

Conclusion

The results of this study could be used in clinical practice to support risk stratification.

Trial registration

This study was registered at ClinicalTrials.gov as NCT03593928.
Dexmedetomidine inhibits mitochondria damage and apoptosis of enteric glial cells in experimental intestinal ischemia/reperfusion injury via SIRT3-dependent PINK1/HDAC3/p53 pathway
Authors: Zhang Qin , Liu Xiao-Ming , Hu Qian , Liu Zheng-Ren , Liu Zhi-Yi , Zhang Huai-Gen , Huang Yuan-Lu , Chen Qiu-Hong , Wang Wen-Xiang , Zhang Xue-Kang
Published: November 2021

Background

Intestinal ischemia/reperfusion (I/R) injury commonly occurs during perioperative periods, resulting in high morbidity and mortality on a global scale. Dexmedetomidine (Dex) is a selective α2-agonist that is frequently applied during perioperative periods for its analgesia effect; however, its ability to provide protection against intestinal I/R injury and underlying molecular mechanisms remain unclear.

Methods

To fill this gap, the protection of Dex against I/R injury was examined in a rat model of intestinal I/R injury and in an inflammation cell model, which was induced by tumor necrosis factor-alpha (TNF-α) plus interferon-gamma (IFN-γ) stimulation.

Results

Our data demonstrated that Dex had protective effects against intestinal I/R injury in rats. Dex was also found to promote mitophagy and inhibit apoptosis of enteric glial cells (EGCs) in the inflammation cell model. PINK1 downregulated p53 expression by promoting the phosphorylation of HDAC3. Further studies revealed that Dex provided protection against experimentally induced intestinal I/R injury in rats, while enhancing mitophagy, and suppressing apoptosis of EGCs through SIRT3-mediated PINK1/HDAC3/p53 pathway in the inflammation cell model.

Conclusion

Hence, these findings provide evidence supporting the protective effect of Dex against intestinal I/R injury and its underlying mechanism involving the SIRT3/PINK1/HDAC3/p53 axis.
FGD5-AS1 facilitates the osteogenic differentiation of human bone marrow-derived mesenchymal stem cells via targeting the miR-506-3p/BMP7 axis
Authors: Li Jun , Wu Xingbiao , Shi Yaohua , Zhao Hong
Published: November 2021

Background

Osteoporosis is a systemic disease characterized by impaired bone formation, increased bone resorption, and brittle bone fractures. The osteogenic differentiation of human bone marrow-derived mesenchymal stem cells (hBMSCs) is considered to be a vital process for bone formation. Numerous studies have reported that long non-coding RNAs (lncRNAs) are involved in the osteogenic differentiation of hBMSCs. The present study aimed to investigate the effect of FGD5 antisense RNA 1 (FGD5-AS1) on osteogenic differentiation.

Methods

RT-qPCR was performed to detect the expression of FGD5-AS1, miR-506-3p, and osteogenesis-related genes OCN, OPN, OSX, and RUNX2. Western blotting was carried out to detect the protein levels of osteogenesis-related markers. In addition, the regulatory effect of FGD5-AS1 on osteogenic differentiation was detected through alkaline phosphatase (ALP) activity, Alizarin Red S (ARS) staining, and Cell Counting Kit-8 (CCK-8). Bioinformatics analysis and luciferase reporter assay were used to predict and validate the interaction between FGD5-AS1 and miR-506-3p as well as miR-506-3p and bone morphogenetic protein 7 (BMP7).

Results

The RT-qPCR analysis revealed that FGD5-AS1 was upregulated in hBMSCs following induction of osteogenic differentiation. In addition, FGD5-AS1 knockdown attenuated hBMSC viability and osteogenic differentiation. Bioinformatics analysis and luciferase reporter assays verified that FGD5-AS1 could directly interact with microRNA (miR)-506-3p. Furthermore, miR-506-3p could directly target the 3′-untranslated region (3′-UTR) of BMP7. Additionally, functional assays demonstrated that miR-506-3p silencing could restore the suppressive effect of FGD5-AS1 knockdown on osteogenic differentiation and viability of hBMSCs, and miR-506-3p could attenuate osteogenic differentiation via targeting BMP7.

Conclusions

Taken together, the results of the present study suggested that FGD5-AS1 could positively regulate the osteogenic differentiation of hBMSCs via targeting the miR-506-3p/BMP7 axis.
Retraction Note: A positive feedback loop consisting of C12orf59/NF-κB/CDH11 promotes gastric cancer invasion and metastasis
Authors: Jia-Xing Zhang , Wei-Ling He , Zi-Hao Feng , Dong-Liang Chen , Ying Gao , Ying He , Kai Qin , Zhou-San Zheng , Cui Chen , Hui-Wen Weng , Miao Yun , Sheng Ye , Rui-Hua Xu , Dan Xie
Published: November 2021

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s13046-019-1114-2.
Induction of remission in chronic urticaria by immunotherapy using immunoglobulin/histamine complex (Histobulin™): a case report
Authors: Kim Hyuk Soon , Noh Geunwoong
Published: November 2021

Background

Symptom control is a major concern in chronic urticaria. Histobulin™ is a histamine/immunoglobulin complex that has been approved for allergic rhinitis, bronchial asthma and chronic urticaria in some countries. Not only has the immunoglobulin/histamine complex been reported to be effective in allergic diseases, including chronic urticaria, but recently, the possibility of remission induction in chronic urticaria by the immunoglobulin/histamine complex has been reported.

Case presentation

Histobulin™ was administered until remission was induced instead of fixing the number of administrations in four cases of chronic urticaria. Two patients showed an early response and finished treatment with 12 injections of Histobulin™, and the other two patients showed a late response and were injected 43 and 46 times. Remission was induced successfully in all four cases.

Conclusions

Histobulin™ is not only effective but also induces remission in CSU. The Histobulin™ therapy protocol in CSU may be better if the treatment is continued until remission is achieved. Based on the responses of the patients, early responders and late responders were present. The progression of the disease during treatment consisted of a slow improvement phase and a rapid improvement phase. Uniquely, the appropriate allergy laboratory results, including blood eosinophil fraction, total IgE and eosinophil cationic protein level, were normal in all 4 cases. Further studies concerning the mechanisms of Histobulin™ may be needed.
Rhino-orbito-cerebral Mucormycosis: Pictorial Review
Authors: Pai Vivek , Sansi Rima , Kharche Ritesh , Bandili Sridevi Chaitanya , Pai Bhujang
Published: November 2021

Mucormycosis (MCR) is a fulminant, potentially lethal, opportunistic fungal infection. Diabetes, immunocompromised states and elevated serum iron levels are the most important risk factors for contracting MCR infection. Recently, MCR co-infections have been observed in patients with COVID-19 disease owing to a complex interplay of metabolic factors and corticosteroid therapy. Rhino-orbito-cerebral mucormycosis (ROCM) is the most common clinical form of MCR infection and refers to infection of the nasal cavities, paranasal sinuses, neck spaces, orbits and intracranial structures. Sinonasal inoculation is typically the primary site of infection; the necrotising and angioinvasive properties of the fungus facilitate its spread into adjacent structures. In this review, we discuss the pertinent mycology and risk factors of MCR infection. The review also aims to acquaint the reader with the cross-sectional imaging appearances of ROCM and its complications. All the cases discussed in this pictorial essay are microbiologically and/or histopathologically proven cases of ROCM with concomitant COVID-19 infection.
CT imaging of peritoneal carcinomatosis with surgical correlation: a pictorial review
Authors: Panagiotopoulou Panagiota Berta , Courcoutsakis Nikos , Tentes Apostolos , Prassopoulos Panos
Published: November 2021

Cytoreductive surgery in combination with hyperthermic intraperitoneal chemotherapy has revolutionized the survival and the quality of life in selected patients with peritoneal carcinomatosis. Preoperative CT is important for the selection of patients that may benefit from cytoreductive surgery and is useful for surgical planning. There are several tasks for the radiologist during CT interpretation: to describe cancerous implants on a “site-by-site” basis in the peritoneum, ligaments, mesenteries and visceral surfaces, to analyze patterns of involvement and to estimate the disease burden. Knowledge of the correlation between the CT and the surgical findings enhances the understanding of the disease and facilitates the communication between radiologists and surgeons.
Route of infectious bronchitis virus vaccination determines the type and magnitude of immune responses in table egg laying hens
Authors: Al-Rasheed Mohammed , Ball Christopher , Ganapathy Kannan
Published: November 2021

Chicken immune responses to infectious bronchitis virus (IBV) vaccination can depend on route of administration, vaccine strain and bird age. Typically for layer chickens, IBV vaccinations are administered by spray in the hatchery at day-old and boosted at intervals with live vaccines via drinking water (DW). Knowledge of live attenuated IBV vaccine virus kinetics and the immune response in egg-laying hens is exceptionally limited. Here, we demonstrated dissemination of vaccine viruses and differences in hen innate, mucosal, cellular and humoral immune responses following vaccination with Massachusetts or 793B strains, administered by DW or oculonasal (ON) routes. Detection of IBV in the Mass-vaccinated groups was greater during early time-points, however, 793B was detected more frequently at later timepoints. Viral RNA loads in the Harderian gland and turbinate tissues were significantly higher for ON-Mass compared to all other vaccinated groups. Lachrymal fluid IgY levels were significantly greater than the control at 14 days post-vaccination (dpv) for both vaccine serotypes, and IgA mRNA levels were significantly greater in ON-vaccinated groups compared to DW-vaccinated groups, demonstrating robust mucosal immune responses. Cell mediated immune gene transcripts (CD8-α and CD8-β) were up-regulated in turbinate and trachea tissues. For both vaccines, dissemination and vaccine virus clearance was slower when given by DW compared to the ON route. For ON administration, both vaccines induced comparable levels of mucosal immunity. The Mass vaccine induced cellular immunity to similar levels regardless of vaccination method. When given either by ON or DW, 793B vaccination induced significantly higher levels of humoral immunity.
The properties of the solution for a class of switched systems with internally forced switching
Authors: Li Huanting , Chen Xiankang
Published: November 2021

In this paper, the dynamic behavior of a class of switched systems with internally forced switching (IFS) is investigated. By introducing the definitions of continuous dependence and differentiability, the continuous dependence and differentiability of the solution relative to the control function are obtained. In the past studies, the optimal control problem given by IFS mainly focused on a special class of controlled systems (the piece affine system). Our results lay a good foundation for studying the more general internally forced switching problem.
EANM dosimetry committee series on standard operational procedures: a unified methodology for 99mTc-MAA pre- and 90Y peri-therapy dosimetry in liver radioembolization with 90Y microspheres
Authors: Chiesa Carlo , Sjogreen-Gleisner Katarina , Walrand Stephan , Strigari Lidia , Flux Glenn , Gear Jonathan , Stokke Caroline , Gabina Pablo Minguez , Bernhardt Peter , Konijnenberg Mark
Published: November 2021

The aim of this standard operational procedure is to standardize the methodology employed for the evaluation of pre- and post-treatment absorbed dose calculations in 90Y microsphere liver radioembolization. Basic assumptions include the permanent trapping of microspheres, the local energy deposition method for voxel dosimetry, and the patient–relative calibration method for activity quantification.The identity of 99mTc albumin macro-aggregates (MAA) and 90Y microsphere biodistribution is also assumed. The large observed discrepancies in some patients between 99mTc-MAA predictions and actual 90Y microsphere distributions for lesions is discussed. Absorbed dose predictions to whole non-tumoural liver are considered more reliable and the basic predictors of toxicity. Treatment planning based on mean absorbed dose delivered to the whole non-tumoural liver is advised, except in super-selective treatments.

Given the potential mismatch between MAA simulation and actual therapy, absorbed doses should be calculated both pre- and post-therapy. Distinct evaluation between target tumours and non-tumoural tissue, including lungs in cases of lung shunt, are vital for proper optimization of therapy. Dosimetry should be performed first according to a mean absorbed dose approach, with an optional, but important, voxel level evaluation. Fully corrected 99mTc-MAA Single Photon Emission Computed Tomography (SPECT)/computed tomography (CT) and 90Y TOF PET/CT are regarded as optimal acquisition methodologies, but, for institutes where SPECT/CT is not available, non-attenuation corrected 99mTc-MAA SPECT may be used. This offers better planning quality than non dosimetric methods such as Body Surface Area (BSA) or mono-compartmental dosimetry. Quantitative 90Y bremsstrahlung SPECT can be used if dedicated correction methods are available.

The proposed methodology is feasible with standard camera software and a spreadsheet. Available commercial or free software can help facilitate the process and improve calculation time.
Establishment and validation of a logistic regression model for prediction of septic shock severity in children
Authors: Han Yujie , Kang Lili , Liu Xianghong , Zhuang Yuanhua , Chen Xiao , Li Xiaoying
Published: November 2021

Background

Septic shock is the most severe complication of sepsis, and is a major cause of childhood mortality, constituting a heavy public health burden.

Methods

We analyzed the gene expression profiles of septic shock and control samples from the Gene Expression Omnibus (GEO). Four differentially expressed genes (DEGs) from survivor and control groups, non-survivor and control groups, and survivor and non-survivor groups were selected. We used data about these genes to establish a logistic regression model for predicting the survival of septic shock patients.

Results

Leave-one-out cross validation and receiver operating characteristic (ROC) analysis indicated that this model had good accuracy. Differential expression and Gene Set Enrichment Analysis (GSEA) between septic shock patients stratified by prediction score indicated that the systemic lupus erythematosus pathway was activated, while the limonene and pinene degradation pathways were inactivated in the high score group.

Conclusions

Our study provides a novel approach for the prediction of the severity of pathology in septic shock patients, which are significant for personalized treatment as well as prognostic assessment.
No increased risk of Alzheimer’s disease among people with immune-mediated inflammatory diseases: findings from a longitudinal cohort study of U.S. older adults
Authors: Booth Michael J. , Kobayashi Lindsay C. , Janevic Mary R. , Clauw Daniel , Piette John D.
Published: November 2021

Objective

Immune-mediated inflammatory diseases (IMID) are characterized by systemic inflammation affecting the joints and bodily organs. Studies examining the association between individual IMIDs and the risk of Alzheimer’s disease (AD) have yielded inconsistent findings. This study examines AD risk across a group of IMIDs in a large population-based sample of older adults.

Methods

Data on a national sample of US adults over age 50 was drawn from the Health and Retirement Study (HRS) and linked Medicare claims from 2006 to 2014. IMIDs include rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn’s disease, ulcerative colitis, and related conditions. We identified IMIDs from 2006 to 2009 Medicare claims using International Classification of Diseases (ICD9-CM) codes. The date of incident AD was derived from Chronic Conditions Warehouse (CCW) identifiers. We examined the risk of AD from 2009 to 2014 using Cox proportional hazards models, both unadjusted and adjusted for age, gender, education, race, and the genetic risk factor APOE-e4.

Results

One hundred seventy-one (6.02%) of the 2842 total HRS respondents with Medicare coverage and genetic data were classified with IMIDs. Over the subsequent 6 years, 9.36% of IMID patients developed AD compared to 8.57% of controls (unadjusted hazard ratio (HR): 1.09, 95% CI .66–1.81, p = 0.74). Adjusted HR 1.27 (95% CI 0.76–2.12, p = 0.35). Age (HR for 10-year increment 3.56, p < .001), less than high school education (HR 1.70, p = .007), and APOE-e4 (HR 2.61, p < .001 for one or two copies), were also statistically significant predictors of AD.

Conclusion

HRS respondents with common IMIDs do not have increased risk of Alzheimer’s disease over a 6-year period.
Simultaneous radio-ulnar cannulation: shifting gears from ‘feasibility’ to ‘applicability’
Authors: Sahu Ankit Kumar , Prajapati Sudesh , Kazmi Danish Hasan
Published: November 2021

Conventionally, routes of vascular access commonly include femoral and radial arteries with brachial, ulnar and subclavian arteries being rarely used for coronary interventions. Non-femoral arterial access is being increasingly preferred to minimise groin puncture site complications, prolonged immobilization and duration of hospital stay. However, radial artery cannulation is also fraught with fears of tortuosity, loops, vascular spasm, perforation, pseudoaneurysm formation, arm hematoma and arterial occlusion. In contemporary practice when most of the coronary procedures are being done via transradial access, encountering one of the above-mentioned hurdles often forces the operator to switchover to femoral access. Here, we explore the rationale, feasibility, operational logistics, clinical implications and future directions for using simultaneous radio-ulnar arterial access in the same extremity.
Teaching the Tough Topics: Fostering Ideological Awareness through the Inclusion of Societally Impactful Topics in Introductory Biology
Authors: Beatty Abby E. , Driessen Emily P. , Gusler Taylor , Ewell Sharday , Grilliot Amy , Ballen Cissy J.
Published: November 2021

Development and integration of ideological awareness curriculum enhances students’ ability to apply traditional biology learning objectives to societally relevant topics by understanding the biases, stereotypes, and assumptions that shape the world around them.
Receiver grouping strategies for hybrid geometric-mean reverse time migration
Authors: Bai Tong , Lyu Bin , Williamson Paul , Nakata Nori
Published: November 2021

Geometric-mean reverse time migration (GmRTM), a powerful crosscorrelation-based imaging method, generates higher resolution source images and is more robust to noise compared with conventional time-reversal imaging. The price to pay is the higher computational costs. Alternatively, we can adopt hybrid strategies by dividing the receivers into different groups. Conventional time reversal (i.e., wavefield summation) is performed inside each group, followed by the application of crosscorrelation imaging condition among different groups. Such hybrid strategies can retain the advantages of GmRTM and time reversal and are often more practical than pure GmRTM. Yet, designing appropriate grouping strategy is not trivial. Here, we have developed two grouping strategies (adjacent and scattered) and used synthetic and field-data examples to evaluate their performance with various group numbers. In addition to the spatial resolution of the source image, robustness to random noise is another important assessment criterion, for which we consider two distribution patterns, such as concentrated and scattered, of traces contaminated with strong random noise. We also evaluated their effectiveness to visualize events (in the image domain) that are not completely recorded by all receivers. Our comprehensive tests illustrate the respective advantages of the two grouping strategies.
Comments on: “Imaging the Aquistore reservoir after 36 kilotonnes of CO2 injection using distributed acoustic sensing” (K. Harris, D. J. White, and C. Samson, 2017, Geophysics, 82, no. 6, M81–M96) and “Initial 4D seismic results after CO2 injection start-up at the Aquistore storage site” (L. A. N. Roach, D. J. White, B. Roberts, and D. Angus, 2017, Geophysics, 82, no. 3, B95–B107)
Authors: Nemeth Balazs , Escalante Christian
Published: November 2021

Two papers published in Geophysics use the normalized root-mean-square (Nrms) calculation in a sliding window to compare traces and to create a “difference Nrms′” volume. The authors use the derived difference volume to indicate the presence of apparent time-lapse anomaly between two seismic surveys. In this discussion, we point out that the used methodology does not allow a robust comparison of seismic traces. We recommend the use of simple amplitude difference calculation between volumes to show the presence of time-lapse anomalies, instead of the used methodology.
Use of online cultural content for mental health and well-being during COVID-19 restrictions: cross-sectional survey
Authors: Syed Sheriff Rebecca J. , Adams Helen , Riga Evgenia , Przybylski Andrew K. , Bonsaver Laura , Bergin Laura , O'Dell Bessie , McCormack Susan , Creswell Cathy , Cipriani Andrea , Geddes John R.
Published: November 2021

Aims and method

To gain a deeper understanding of the use of online culture and its potential benefits to mental health and well-being, sociodemographic characteristics and self-reported data on usage, perceived mental health benefits and health status were collected in an online cross-sectional survey during COVID-19 restrictions in the UK in June–July 2020.

Results

In total, 1056 people completed the survey. A high proportion of participants reported finding online culture helpful for mental health; all but one of the benefits were associated with regular use and some with age. Reported benefits were wide-ranging and interconnected. Those aged under 25 years were less likely to be regular users of online culture or to have increased their use during lockdown.

Clinical implications

There may be benefits in targeting cultural resources for mental health to vulnerable groups such as young adults.
Effects of an Oncology Nurse-Led, Primary Palliative Care Intervention (CONNECT) on Illness Expectations Among Patients With Advanced Cancer
Authors: Sigler Lauren E. , Althouse Andrew D. , Thomas Teresa H. , Arnold Robert M. , White Douglas , Smith Thomas J. , Chu Edward , Rosenzweig Margaret , Smith Kenneth J. , Schenker Yael
Published: November 2021

PURPOSE:

Patients with advanced cancer often have unrealistic expectations about prognosis and treatment. This study assessed the effect of an oncology nurse-led primary palliative care intervention on illness expectations among patients with advanced cancer.

METHODS:

This study is a secondary analysis of a cluster-randomized trial of primary palliative care conducted at 17 oncology clinics. Adult patients with advanced solid tumors for whom the oncologist would not be surprised if died within 1 year were enrolled. Monthly visits were designed to foster realistic illness expectations by eliciting patient concerns and goals for their medical care and empowering patients and families to engage in discussions with oncologists about treatment options and preferences. Baseline and 3-month questionnaires included questions about life expectancy, treatment intent, and terminal illness acknowledgment. Odds of realistic illness expectations at 3 months were adjusted for baseline responses, patient demographic and clinical characteristics, and intervention dose.

RESULTS:

Among 457 primarily White patients, there was little difference in realistic illness expectations at 3 months between intervention and standard care groups: 12.8% v 11.4% for life expectancy (adjusted odds ratio [aOR] = 1.15; 95% CI, 0.59 to 2.22; P = .684); 24.6% v 33.3% for treatment intent (aOR = 0.76; 95% CI, 0.44 to 1.27; P = .290); 53.6% v 44.7% for terminal illness acknowledgment (aOR = 1.28; 95% CI, 0.81 to 2.00; P = .288). Results did not differ when accounting for variation in clinic sites or intervention dose.

CONCLUSION:

Illness expectations are difficult to change among patients with advanced cancer. Additional work is needed to identify approaches within oncology practices that foster realistic illness expectations to improve patient decision making.
Precursor types predict the stability of neuronal branches
Authors: Fuchs Joachim , Eickholt Britta J.
Published: November 2021

Branches are critical for neuron function, generating the morphological complexity required for functional networks. They emerge from different, well-described, cytoskeletal precursor structures that elongate to branches. While branches are thought to be maintained by shared cytoskeletal regulators, our data from mouse hippocampal neurons indicate that the precursor structures trigger alternative branch maintenance mechanisms with differing stabilities. Whereas branches originating from lamellipodia or growth cone splitting events collapse soon after formation, branches emerging from filopodia persist. Furthermore, compared to other developing neurites, axons stabilise all branches and preferentially initiate branches from filopodia. These differences explain the altered stability of branches we observe in neurons lacking the plasma membrane protein phospholipid phosphatase-related protein 3 (PLPPR3, also known as PRG2) and in neurons treated with netrin-1. Rather than altering branch stability directly, PLPPR3 and netrin-1 boost a ‘filopodia branch programme’ on axons, thereby indirectly initiating more long-lived branches. In summary, we propose that studies on branching should distinguish overall stabilising effects from effects on precursor types, ideally using multifactorial statistical models, as exemplified in this study.
Oportunidades para startups
Authors: França Mota Guilherme , Carneiro Jorge
Published: November 2021

Com um ecossistema empreendedor dinâmico de tecnologia, a Índia oferece caminhos para negócios de empresas brasileiras, como as fintechs.
Em busca da sustentabilidade
Authors: Vilasboas Calixto Casnici Cyntia , Carlo Butske Jean , Luís de Vasconcellos Sílvio
Published: November 2021

Com uma ousada agenda para transformar sua matriz energética, a Índia oferece oportunidades para empresas brasileiras.
As empresas familiares diante da Covid-19
Authors: Mendonça Carlos , Aidar Marcelo
Published: November 2021

Negócios brasileiros controlados por famílias foram buscar inspiração em seus valores para enfrentar a pandemia com resiliência, embora ainda precisem avançar no âmbito da profissionalização.
O combate ao estresse no trabalho
Authors: Amad  Costa Sérgio
Published: November 2021

Hoje, infelizmente, ainda há companhias que são ambientes produtores de doenças para vários de seus profissionais.
Risk factors and Compliance of surviving sepsis campaign: A retrospective cohort study at tertiary care hospital
Authors: Yousuf Farheen , Malik Ayesha , Saba Ayesha , Sheikh Sana
Published: November 2021

Background and Objective: Sepsis is one of the leading causes of direct maternal mortality in Pakistan. It is recommended that the first three hours after the presentation are crucial. During this time implementation of surviving sepsis campaign resuscitation bundles reduces maternal mortality. Our objective was to assess the factors contributing to puerperal sepsis and the compliance of “surviving sepsis campaign resuscitation bundles in puerperal sepsis” for the management of puerperal sepsis.

Methods: This was a retrospective record review for five years from January 2011-December 2015. All women who fulfilled the inclusion criteria of puerperal sepsis were included and data from their files were collected and entered in SPSS version 19.0. Mean and standard deviations were calculated for continuous variables while for categorical variable proportion and percentages were used.

Results: This retrospective record review in five years showed the 396 patients had P-sepsis, among them 44 patients had severe sepsis with organ dysfunction. The culture was positive in 26(59%) with trend of E-coli in 9(20%) Among them 12(27%) had serum lactate more than ≥4mmol/L. Central venous pressure monitoring with fluid resuscitation was done as per protocol of survival bundle given to all 12(100%), Vasopressin was needed in half of these patients 6(50%). Amid 44 patients of severe sepsis 29(66%) were admitted to special care, while 15(34%) required intensive care admissions. Our 7(16%) patients failed to survive. All of them had multi-organ failure.

Conclusion: There was moderate adherence of modified surviving sepsis campaign resuscitation bundles. Further improvement in compliance is warranted.

doi: https://doi.org/10.12669/pjms.38.1.3992

How to cite this:Yousuf F, Malik A, Saba A, Sheikh S. Risk factors and Compliance of surviving sepsis campaign: A retrospective cohort study at tertiary care hospital. Pak J Med Sci. 2022;38(1):90-94. doi: https://doi.org/10.12669/pjms.38.1.3992

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Postoperative Visual Outcome: Sling procedure with prolene sutures in children with simple congenital ptosis
Authors: Shamim Nida , Hayat Nausheen , Cheema Alyscia
Published: November 2021

Objective: To assess the visual outcome after sling procedure using prolene sutures in children with simple congenital ptosis.

Methods: A descriptive case series study was performed in the Department of Ophthalmology of Jinnah Post Graduate Medical Centre, for a duration of six months in which 20 patients aged 3-10 years were selected with either unilateral or bilateral congenital ptosis. They were thoroughly examined and visual acuity and degree of ptosis were measured pre-operatively. Frontalis sling surgery was performed using prolene sutures on all patients after which their visual acuity and degree of ptosis were measured once again after three months post-operatively. Data were analyzed using SPSS version 20.0. For qualitative variables, frequency and percentages were calculated. Mean and Standard deviation was commutated for the quantitative variable.

Results: The mean age of the patients was 8.15±1.75. 11 (55%) male and 9 (45%) female participants were included in the study. Visual acuity improved in all the patients with all the patients attaining a visual acuity of 6/6 (n=12, 60%), 6/9 (n=7, 35%), and 6/12 (n=1, 5%). The degree of ptosis post-operatively was not found in any patient either.

Conclusion: Sling procedure helped in eliminating ptosis and improved visual acuity in patients with simple congenital ptosis.

doi: https://doi.org/10.12669/pjms.38.1.4359

How to cite this:Shamim N, Hayat N, Cheema A. Postoperative Visual Outcome: Sling procedure with prolene sutures in children with simple congenital ptosis. Pak J Med Sci. 2022;38(1):232-236. doi: https://doi.org/10.12669/pjms.38.1.4359

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.