bluuebunny/crossref_metadata_2025 huggingface dataset:
Different roles of the RAAS affect bone metabolism in patients with primary aldosteronism, Gitelman syndrome and Bartter syndrome
Authors: Tang Wangna , Chai Yun , Jia Hongwei , Wang Baoping , Liu Tong , Wang Hao , Dai Chenlin
Published: February 2022

Background

Components of the RAAS may influence bone metabolism. Different roles of the RAAS are found in patients with primary aldosteronism (PA), Gitelman syndrome (GS) and Bartter syndrome (BS). We collected inpatient medical records including 20 patients with Gitelman syndrome (GS group),
17 patients with Bartter syndrome (BS group) and 20 age-matched patients with primary aldosteronism (PA group). We found the following results. (1) PA patients had significantly higher serum magnesium, potassium, plasma aldosterone, serum parathyroid hormone, urinary calcium and BMI (p<0.05) while significantly lower serum calcium and phosphorus (P < 0.05) than GS and BS patients. (2) Total hip and femoral neck bone mineral density (BMD) in PA patients were significantly lower than those in GS and BS patients (P<0.05). (3) GS patients had lower serum magnesium and urinary calcium than BS patients (P < 0.05). (4) Compared with BS patients, the vertebral BMD in GS patients were significantly higher (P < 0.05). So we believe higher aldosterone and PTH levels may be the reason that PA patients have lower hip BMD. Lower urinary calcium and inactivation of the NCC gene (Na-Cl cotransporter) in GS patients may have protective effects on vertebral bone mineral density.

Conclusions

With persistence disordered RAAS, PA patients have lower BMD, especially hip BMD as compared with GS and BS patients. We presumed the lower renin and higher aldosterone level may be the reason. With the same level of renin and aldosterone, BS patients have lower vertebrate BMD than GS patients. Decreased urinary calcium excretion may be the reason.
Interdisciplinary 3D digital treatment simulation before complex esthetic rehabilitation of orthodontic, orthognathic and prosthetic treatment: workflow establishment and primary evaluation
Authors: Lv Longwei , He Wei , Ye Hongqiang , Cheung Kwantong , Tang Lin , Wang Shimin , You Lang , Xun Chunlei , Zhou Yongsheng
Published: February 2022

Background

An interdisciplinary treatment simulation and smile design before a complex esthetic rehabilitation is important for clinicians’ decision-making and patient motivation. Meanwhile, intervention and interaction are necessary for dental specialists in these complex rehabilitations. However, it is difficult to visualize an interdisciplinary treatment plan by using the conventional method, especially when orthognathic surgery is involved, thus hindering communication between dental specialists. This research aims to establish a 3D digital workflow of interdisciplinary treatment simulation to solve this problem.

Methods

An interdisciplinary 3D digital workflow of simulated treatment plan for complex esthetic rehabilitation was established. Eleven patients were enrolled and illustrated with their treatment plans using 3D treatment simulation, as well as 2D digital smile design (DSD) plus wax-up. Visual analogue scales (VAS) were used to rate the intuitiveness, understanding, and satisfaction or help between the two methods by patients and dental specialists.

Results

According to the ratings from the patients, 3D treatment simulation showed obvious advantages in the aspects of intuitiveness (9.7 ± 0.5 vs 6.4 ± 1.4) and treatment understanding (9.1 ± 0.8 vs 6.6 ± 1.5), and the satisfaction rates were also higher (9.0 ± 0.6 vs 7.1 ± 1.8). Dental specialists regarded the 3D digital plans as more intuitive (8.9 ± 0.8 vs 5.9 ± 1.0) and useful to understand the plans from the other specialists (8.9 ± 0.7 vs 6.1 ± 1.0) and helpful to their own treatment plans (8.7 ± 0.9 vs 5.9 ± 1.4).

Conclusions

The interdisciplinary 3D digital treatment simulation helps both patients and dental specialists to improve treatment understanding, and facilitates dental specialists for decision-making before complex esthetic rehabilitation.

Trial registration

This study was registered in the National Clinical Trials Registry under the identification number MR-11-20-002862. This is an observational study in which we did not assign the intervention.
The methods and use of questionnaires for the diagnosis of dental phobia by Japanese dental practitioners specializing in special needs dentistry and dental anesthesiology: a cross-sectional study
Authors: Ogawa Mika , Ayuse Terumi , Fujisawa Toshiaki , Sato Shuntaro , Ayuse Takao
Published: February 2022

Background

Dental phobia is covered by medical insurance; however, the diagnostic methods are not standardized in Japan. Therefore, the aim of this study was to investigate the methods and use of questionnaires for the diagnosis of dental phobia by Japanese dental practitioners specializing in special needs dentistry and dental anesthesiology.

Methods

We conducted an online survey to obtain information from the members of the Japanese Society for Disability and Oral Health (JSDH, n = 5134) and the Japanese Dental Society of Anesthesiology (JDSA, n = 2759). Response items included gender, qualification, affiliation type, methods of diagnosis and management of dental phobia, use of questionnaire, need to establish standardized diagnostic method for dental phobia, and others. The chi-squared test was used to compare answers between the three groups: JSDH only, JDSA only, and both JSDH and JDSA. Multiple logistic regression analysis was conducted to identify factors associated with the use of an assessment questionnaire.

Results

Data were obtained from 614 practitioners (JSDH only, n = 329; JDSA only, n = 195; both JSDH and JDSA: n = 90, response rate: 7.8% [614/7,893], men: n = 364 [58.5%]). Only 9.7% of practitioners used questionnaires to quantify the level of dental anxiety. The members of both JSDH and JDSA group used questionnaires more frequently than members of the JSDH only (19% and 7.1%, respectively; Bonferroni corrected p < 0.01). Most practitioners (89.1%) diagnosed dental phobia based on patient complaints of fear of treatment. Furthermore, majority of the participants (73.3%) felt the need to establish standardized diagnostic method for “dental phobia.” Multiple logistic regression analysis showed that membership of the JSDH only was negatively related (odds ratio [OR] 0.28, 95% confidence interval [CI] 0.13–0.60), and use of behavioral therapy was positively related (OR 2.34, 95% CI 1.18–4.84) to the use of a questionnaire.

Conclusions

The results of this study showed that the use of questionnaires was very low, patients’ subjective opinions were commonly used to diagnose dental phobia, and a standardized diagnostic criterion was thus needed among practitioners. Therefore, it is necessary to establish diagnostic criteria for dental phobia in line with the Japanese clinical system and to educate dentists about them.
Medically-oriented design for explainable AI for stress prediction from physiological measurements
Authors: Jaber Dalia , Hajj Hazem , Maalouf Fadi , El-Hajj Wassim
Published: February 2022

Background

In the last decade, a lot of attention has been given to develop artificial intelligence (AI) solutions for mental health using machine learning. To build trust in AI applications, it is crucial for AI systems to provide for practitioners and patients the reasons behind the AI decisions. This is referred to as Explainable AI. While there has been significant progress in developing stress prediction models, little work has been done to develop explainable AI for mental health.

Methods

In this work, we address this gap by designing an explanatory AI report for stress prediction from wearable sensors. Because medical practitioners and patients are likely to be familiar with blood test reports, we modeled the look and feel of the explanatory AI on those of a standard blood test report. The report includes stress prediction and the physiological signals related to stressful episodes. In addition to the new design for explaining AI in mental health, the work includes the following contributions: Methods to automatically generate different components of the report, an approach for evaluating and validating the accuracies of the explanations, and a collection of ground truth of relationships between physiological measurements and stress prediction.

Results

Test results showed that the explanations were consistent with ground truth. The reference intervals for stress versus non-stress were quite distinctive with little variation. In addition to the quantitative evaluations, a qualitative survey, conducted by three expert psychiatrists confirmed the usefulness of the explanation report in understanding the different aspects of the AI system.

Conclusion

In this work, we have provided a new design for explainable AI used in stress prediction based on physiological measurements. Based on the report, users and medical practitioners can determine what biological features have the most impact on the prediction of stress in addition to any health-related abnormalities. The effectiveness of the explainable AI report was evaluated using a quantitative and a qualitative assessment. The stress prediction accuracy was shown to be comparable to state-of-the-art. The contributions of each physiological signal to the stress prediction was shown to correlate with ground truth. In addition to these quantitative evaluations, a qualitative survey with psychiatrists confirmed the confidence and effectiveness of the explanation report in the stress made by the AI system. Future work includes the addition of more explanatory features related to other emotional states of the patient, such as sadness, relaxation, anxiousness, or happiness.
Access to healthcare for street sex workers in the UK: perspectives and best practice guidance from a national cross-sectional survey of frontline workers
Authors: Potter Lucy C. , Horwood Jeremy , Feder Gene
Published: February 2022

Background

Street sex workers (SSWs) are a highly marginalised and stigmatised group who carry an extremely high burden of unmet health need. They experience multiple and interdependent health and social problems and extreme health inequality. Despite high levels of chronic physical and mental ill-health, there is little evidence of effective healthcare provision for this group. They are often considered ‘hard to reach’, but many individuals and organisations have extensive experience of working with this group.

Methods

We conducted a cross-sectional survey of professionals who work with SSWs in the UK on their perspectives on their access to primary care, mental health, sexual health and drug and alcohol services, how well these services met the needs of SSWs and suggestions of best practice.

Results

50 professionals mostly from England, responded. Mainstream general practice and mental health services were found to be largely inaccessible to SSWs. Sexual health, drug and alcohol services and homeless health services better met their needs; this was mostly attributed to flexible services and collaborations with organisations who work closely with SSWs. The main challenges in providing healthcare to SSWs were services being inflexible, under-resourced services and services not being trauma-informed. Best practice in providing healthcare to SSWs includes- seamless partnership working between agencies with case worker support; peer-involvement in service development and engagement, a range of health provision including outreach, presence in community spaces and fast-track access into mainstream services; trauma-informed, gender-sensitive health services in a welcoming environment with flexible, responsive appointment and drop-in systems and consistent clinicians with specialist knowledge of substance misuse, mental health, domestic violence and homelessness.

Conclusions

Access to healthcare for SSWs in the UK is highly variable but largely inadequate with regards to primary care and mental health provision. The examples of positive healthcare provision and partnership working presented here demonstrate the feasibility of accessible healthcare that meets the needs of SSWs. These need to be systematically implemented and evaluated to understand their impact and implications. As we build back from COVID-19 there is an urgent need to make accessible healthcare provision for marginalised groups the norm, not the exception.
c-MET/VEGFR-2 co-localisation impacts on survival following bevacizumab therapy in epithelial ovarian cancer: an exploratory biomarker study of the phase 3 ICON7 trial
Authors: Morgan Robert D. , Ferreras Cristina , Peset Isabel , Avizienyte Egle , Renehan Andrew G. , Edmondson Richard J. , Murphy Alexander D. , Nicum Shibani , Van Brussel Thomas , Clamp Andrew R. , Lambrechts Diether , Zhou Cong , Jayson Gordon C.
Published: February 2022

Introduction

Bevacizumab improves survival outcomes in women diagnosed with epithelial ovarian cancer (EOC). Pre-clinical data showed that the c-MET/VEGFR-2 heterocomplex negates VEGF inhibition through activation of c-MET signalling, leading to a more invasive and metastatic phenotype. We evaluated the clinical significance of c-MET and VEGFR-2 co-localisation and its association with VEGF pathway-related single nucleotide polymorphisms (SNPs) in women participating in the phase 3 trial, ICON7 (ClinicalTrials.gov identifier: NCT00262847).

Materials and methods

Patients had FIGO stage I-IIA grade 3/poorly differentiated or clear cell carcinoma or stage IIB-IV epithelial ovarian, primary peritoneal or fallopian tube cancer. Immunofluorescence staining for co-localised c-MET and VEGFR-2 on tissue microarrays and genotyping of germline DNA from peripheral blood leukocytes for VEGFA and VEGFR-2 SNPs was performed. The significance of these biomarkers was assessed against survival.

Results

Tissue microarrays from 178 women underwent immunofluorescence staining. Multivariable analysis showed that greater c-MET/VEGFR-2 co-localisation predicted worse OS in patients treated with bevacizumab after adjusting for FIGO stage and debulking surgery outcome (hazard ratio [HR] 1.034, 95% confidence interval [95%CI] 1.010–1.059). Women in the c-MET/VEGFR-2HIGH group treated with bevacizumab demonstrated significantly reduced OS (39.3 versus > 60 months; HR 2.00, 95%CI 1.08–3.72). Germline DNA from 449 women underwent genotyping. In the bevacizumab group, those women with the VEGFR-2 rs2305945 G/G variant had a trend towards shorter PFS compared with G/T or T/T variants (18.3 versus 23.0 months; HR 0.74, 95%CI 0.53–1.03).

Conclusions

In bevacizumab-treated women diagnosed with EOC, high c-MET/VEGFR-2 co-localisation on tumour tissue and the VEGFR-2 rs2305945 G/G variant, which may be biologically related, were associated with worse survival outcomes.
Stochastic integrated model-based protocol for volume-controlled ventilation setting
Authors: Lee Jay Wing Wai , Chiew Yeong Shiong , Wang Xin , Mat Nor Mohd Basri , Chase J. Geoffrey , Desaive Thomas
Published: February 2022

Background and objective

Mechanical ventilation (MV) is the primary form of care for respiratory failure patients. MV settings are based on general clinical guidelines, intuition, and experience. This approach is not patient-specific and patients may thus experience suboptimal, potentially harmful MV care. This study presents the Stochastic integrated VENT (SiVENT) protocol which combines model-based approaches of the VENT protocol from previous works, with stochastic modelling to take the variation of patient respiratory elastance over time into consideration.

Methods

A stochastic model of Ers is integrated into the VENT protocol from previous works to develop the SiVENT protocol, to account for both intra- and inter-patient variability. A cohort of 20 virtual MV patients based on retrospective patient data are used to validate the performance of this method for volume-controlled (VC) ventilation. A performance evaluation was conducted where the SiVENT and VENT protocols were implemented in 1080 instances each to compare the two protocols and evaluate the difference in reduction of possible MV settings achieved by each.

Results

From an initial number of 189,000 possible MV setting combinations, the VENT protocol reduced this number to a median of 10,612, achieving a reduction of 94.4% across the cohort. With the integration of the stochastic model component, the SiVENT protocol reduced this number from 189,000 to a median of 9329, achieving a reduction of 95.1% across the cohort. The SiVENT protocol reduces the number of possible combinations provided to the user by more than 1000 combinations as compared to the VENT protocol.

Conclusions

Adding a stochastic model component into a model-based approach to selecting MV settings improves the ability of a decision support system to recommend patient-specific MV settings. It specifically considers inter- and intra-patient variability in respiratory elastance and eliminates potentially harmful settings based on clinically recommended pressure thresholds. Clinical input and local protocols can further reduce the number of safe setting combinations. The results for the SiVENT protocol justify further investigation of its prediction accuracy and clinical validation trials.
Pan-cancer quantitation of epithelial-mesenchymal transition dynamics using parallel reaction monitoring-based targeted proteomics approach
Authors: Jain Ankit P. , Sambath Janani , Sathe Gajanan , George Irene A. , Pandey Akhilesh , Thompson Erik W. , Kumar Prashant
Published: February 2022

Epithelial–mesenchymal transition (EMT) is a dynamic and complex cellular process that is known to be hijacked by cancer cells to facilitate invasion, metastasis and therapeutic resistance. Several quantitative measures to assess the interplay between EMT and cancer progression are available, based on large scale genome and transcriptome data. However, these large scale multi-omics studies have repeatedly illustrated a lack of correlation in mRNA and protein abundances that may be influenced by diverse post-translational regulation. Hence, it is imperative to understand how changes in the EMT proteome are associated with the process of oncogenic transformation. To this effect, we developed a parallel reaction monitoring-based targeted proteomics method for quantifying abundances of EMT-associated proteins across cancer cell lines. Our study revealed that quantitative measurement of EMT proteome which enabled a more accurate assessment than transcriptomics data and revealed specific discrepancies against a backdrop of generally strong concordance between proteomic and transcriptomic data. We further demonstrated that changes in our EMT proteome panel might play a role in tumor transformation across cancer types. In future, this EMT panel assay has the potential to be used for clinical samples to guide treatment choices and to congregate functional information for the development and advancing novel therapeutics.
The role of S100B/RAGE-enhanced ADAM17 activation in endothelial glycocalyx shedding after traumatic brain injury
Authors: Zou Zhimin , Li Li , Li Qin , Zhao Peng , Zhang Kun , Liu Chengyong , Cai Daozhang , Maegele Marc , Gu Zhengtao , Huang Qiaobing
Published: February 2022

Background

Traumatic brain injury (TBI) remains one of the main causes for disability and death worldwide. While the primary mechanical injury cannot be avoided, the prevention of secondary injury is the focus of TBI research. Present study aimed to elucidate the effects and mechanisms of S100B and its receptor RAGE on mediating secondary injury after TBI.

Methods

This study established TBI animal model by fluid percussion injury in rats, cell model by stretch-injured in astrocytes, and endothelial injury model with conditioned medium stimulation. Pharmacological intervention was applied to interfere the activities of S100B/RAGE/ADAM17 signaling pathway, respectively. The expressions or contents of S100B, RAGE, syndecan-1 and ADAM17 in brain and serum, as well as in cultured cells and medium, were detected by western blot. The distribution of relative molecules was observed with immunofluorescence.

Results

We found that TBI could activate the release of S100B, mostly from astrocytes, and S100B and RAGE could mutually regulate their expression and activation. Most importantly, present study revealed an obvious increase of syndecan-1 in rat serum or in endothelial cultured medium after injury, and a significant decrease in tissue and in cultured endothelial cells, indicating TBI-induced shedding of endothelial glycocalyx. The data further proved that the activation of S100B/RAGE signaling could promote the shedding of endothelial glycocalyx by enhancing the expression, translocation and activity of ADAM17, an important sheddase, in endothelial cells. The damage of endothelial glycocalyx consequently aggravated blood brain barrier (BBB) dysfunction and systemic vascular hyper-permeability, overall resulting in secondary brain and lung injury.

Conclusions

TBI triggers the activation of S100B/RAGE signal pathway. The regulation S100B/RAGE on ADAM17 expression, translocation and activation further promotes the shedding of endothelial glycocalyx, aggravates the dysfunction of BBB, and increases the vascular permeability, leading to secondary brain and lung injury. Present study may open a new corridor for the more in-depth understanding of the molecular processes responsible for cerebral and systemic vascular barrier impairment and secondary injury after TBI.
Clinical outcomes after IL-6 blockade in patients with COVID-19 and HIV: a case series
Authors: Minkove Samuel J. , Geiger Grant , Llibre Josep M. , Montgomery Mary W. , West Natalie E. , Chida Natasha M. , Antar Annukka A. R. , Dandachi Dima , Weld Ethel D. ,   HIV-COVID-19 Consortium, Karmen-Tuohy Savannah , Carlucci Philip M. , Zacharioudakis Ioannis M. , Rahimian Joseph , Zervou Fainareti N. , Rebick Gabriel , Stachel Anna , Tang Shini , Ding Dan , Jones Joyce L. , Farley Jason E. , Dooley Kelly E. , Wilgus Barbara E. , Sanchez Michael , Chow Jeremy , Kitchell Ellen , Koh Shannon , Maxwell Daniel , Lau Abby , Brooks Shamika , Chu Jessica , Estrada Joshua , Lazarte Susana M. , Arinze Folasade , Francis Adero , Paranjape Neha , Sax Paul E. , Wanjalla Celestine N. , Kheshti Asghar N. , Bailin Samuel , Koethe John , Kelly Sean G. , Raffanti Stephen P. , Patel Shital M. , Xu Teena Huan , Goebel Melanie , Santiago Alberto Díaz-De , Ray Manoj , Slim Jihad , Kratz Ann Marie Porreca , Koren David E. , Hiryak Kayla , Hill Brannon , Dare Ryan K. , Bordelon Stacie , Bailey Brett , Baddley John W. , Matthew Shoemaker D. , Rodriguez-Nava Guillermo , Shweta F. N. U. , Chu Carolyn , Pearson Catherine , Treakle Amy , Furin Jennifer J. , Bogorodskaya Milana , Desai Samit , Osterholzer Danielle , Arquiette Jered , Ford Emily S. , Ching Patrick R. , Sun Louisa , Buggy Brian P. , Tirmizi Amir , Argentine Sarah , Desai Balaji , Swartz Talia H. , Latimer Dusty , Camazine Maraya
Published: February 2022

Background

In hospitalized people with HIV (PWH) there is an increased risk of mortality from COVID-19 among hospitalized PWH as compared to HIV-negative individuals. Evidence suggests that tocilizumab—a humanized monoclonal interleukin (IL)-6 receptor inhibitor (IL-6ri) antibody—has a modest mortality benefit when combined with corticosteroids in select hospitalized COVID-19 patients who are severely ill. Data on clinical outcomes after tocilizumab use in PWH with severe COVID-19 are lacking.

Case presentation

We present a multinational case series of 18 PWH with COVID-19 who were treated with IL-6ri’s during the period from April to June 2020. Four patients received tocilizumab, six sarilumab, and eight received an undocumented IL-6ri. Of the 18 patients in the series, 4 (22%) had CD4 counts < 200 cells/mm3; 14 (82%) had a suppressed HIV viral load. Eight patients (44%), all admitted to ICU, were treated for secondary infection; 5 had a confirmed organism. Of the four patients with CD4 counts < 200 cells/mm3, three were treated for secondary infection, with 2 confirmed organisms. Overall outcomes were poor—12 patients (67%) were admitted to the ICU, 11 (61%) required mechanical ventilation, and 7 (39%) died.

Conclusions

In this case series of hospitalized PWH with COVID-19 and given IL-6ri prior to the common use of corticosteroids, there are reports of secondary or co-infection in severely ill patients. Comprehensive studies in PWH, particularly with CD4 counts < 200 cells, are warranted to assess infectious and other outcomes after IL-6ri use, particularly in the context of co-administered corticosteroids.
The diagnostic levels of evidence of instrumented devices for measuring viscoelastic joint properties and spasticity; a systematic review
Authors: van der Velden Levinia Lara , de Koff Maaike Anna Catharina , Ribbers Gerard Maria , Selles Ruud Willem
Published: February 2022

Background

Many diagnostic robotic devices have been developed to quantify viscoelastic properties and spasticity of patients with upper motor neuron lesions. However, in clinical practice, subjective and nonvalid clinical scales are still commonly used. To understand the limited use of diagnostic robotic devices assessing viscoelastic joint properties and spasticity in clinical practice, we evaluate the diagnostic level of evidence of studies on these devices.

Method

A systematic literature review was performed using multiple databases. Two of the authors independently screened all articles. Studies investigating human subjects diagnosed with stroke or cerebral palsy, measured with a mechanical device to assess viscoelastic joint properties and/or spasticity of an extremity. All articles were assigned a diagnostic level of evidence, which was established with a classification strategy based on the number of participants and the design of the study, from a Level 0 (less than 10 subjects) to a Level IV, reporting the long-term clinical consequences in daily care.

Results

Fifty-nine articles were included. Most studies measured the upper limb (64%) in stroke patients (81%). The highest level of evidence found was Level IIa (53%); these studies correlated the test values of the robotic device with a clinical test or within subgroups. Level 0 (30%) and Level I (17%; determining the range of values of the robotic test) were also common. None of the studies tested their device for diagnostic accuracy (Level III), clinical added value (Level IV).

Conclusion

The diagnostic evidence needed for implementing robotic devices in clinical practice is lacking. Our findings indicate that more effort should be invested in studying diagnostic accuracy (Level III) or added value for clinical care (Level IV); only these studies can provide clinicians with evidence that robotic devices have added value above the currently-used clinical scales.
Problematic Internet Use, health behaviors, depression and eating disorders: a cross-sectional study among Polish medical school students
Authors: Kożybska Marta , Kurpisz Jacek , Radlińska Iwona , Skwirczyńska Edyta , Serwin Natalia , Zabielska Paulina , Kotwas Artur , Karakiewicz Beata , Lebiecka Zofia , Samochowiec Jerzy , Flaga-Gieruszyńska Kinga
Published: February 2022

Background

Problematic Internet Use is defined as a use of the Internet which leads to various difficulties. The aim of this study was to check whether Problematic Internet Use is associated with health risks, such as: anti-health behaviors, depressive symptoms, abnormal body weight or eating disorders.

Methods

This cross-sectional study included 540 medical school students of Polish descent (83.5% females; 16.5% males), whose mean age was 22.49 years (SD = 5.20). The participants were asked to complete a questionnaire set, including the Problematic Internet Use Test, Juczyński’s Health-Related Behavior Inventory, the Beck Depression Inventory, the Eating Attitudes Test and a self-designed demographic survey.

Results

Increased Problematic Internet Use scores were observed in male, full-time students, persons who use the Internet on the computer (compared to those who mostly use it on the phone), and those who go online mainly for entertainment purposes (compared to those who indicated another main purpose of using the Internet). 47.6% of the sample reported poor health behaviors, while 27.1% met the criteria of a depressive episode and 6.9% of an eating disorder. High risk of Problematic Internet Use was observed in 2.8% of the sample, particularly those who reported having more free time during the day, engaged in fewer health protective behaviors, manifested more severe depressive symptoms and scored higher on the Eating Attitudes Test.

Conclusion

Such results indicate that students with Problematic Internet Use lead an unhealthy lifestyle and more often show symptoms of depression and eating disorders than students without Problematic Internet Use.
Relationship between time of emergency department admission and adherence to the Surviving Sepsis Campaign bundle in patients with septic shock
Authors: You Je Sung , Park Yoo Seok , Chung Sung Phil , Lee Hye Sun , Jeon Soyoung , Kim Won Young , Shin Tae Gun , Jo You Hwan , Kang Gu Hyun , Choi Sung Hyuk , Suh Gil Joon , Ko Byuk Sung , Han Kap Su , Shin Jong Hwan , Kong Taeyoung ,   Korean Shock Society (KoSS) Investigators, Kim Won Young , Ryoo Seung Mok , Shin Tae Gun , Hwang Sung Yeon , Jo You Hwan , Chung Sung Phil , Hwang Yoon Jung , Beom Jin Ho , Park Yoo Seok , Kang Gu Hyun , Choi Sung-Hyuk , Yoon Young-Hoon , Suh Gil Joon , Lim Tae Ho , Ko Byuk Sung , Han Kap Su , Shin Jong Hwan , Lee Hui Jai , You Kyoung Min
Published: February 2022

Background

Nighttime hospital admission is often associated with increased mortality risk in various diseases. This study investigated compliance rates with the Surviving Sepsis Campaign (SSC) 3-h bundle for daytime and nighttime emergency department (ED) admissions and the clinical impact of compliance on mortality in patients with septic shock.

Methods

We conducted an observational study using data from a prospective, multicenter registry for septic shock provided by the Korean Shock Society from 11 institutions from November 2015 to December 2017. The outcome was the compliance rate with the SSC 3-h bundle according to the time of arrival in the ED.

Results

A total of 2049 patients were enrolled. Compared with daytime admission, nighttime admission was associated with higher compliance with the administration of antibiotics within 3 h (adjusted odds ratio (adjOR), 1.326; 95% confidence interval (95% CI), 1.088–1.617, p = 0.005) and with the complete SSC bundle (adjOR, 1.368; 95% CI, 1.115–1.678; p = 0.003), likely to result from the increased volume of all patients and sepsis patients admitted during daytime hours. The hazard ratios of the completion of SSC bundle for 28-day mortality and in-hospital mortality were 0.750 (95% CI 0.590–0.952, p = 0.018) and 0.714 (95% CI 0.564–0.904, p = 0.005), respectively.

Conclusion

Septic shock patients admitted to the ED during the daytime exhibited lower sepsis bundle compliance than those admitted at night. Both the higher number of admitted patients and the higher patients to medical staff ratio during daytime may be factors that are responsible for lowering the compliance.
Infectious sacroiliitis due to group A streptococcus infection during pregnancy: a case report
Authors: Nagashima Mikako , Watanabe Norikazu , Okui Yosuke , Fukase Mika , Takahashi Kanako , Ohta Tsuyoshi , Tsutsumi Seiji , Takakubo Yuya , Takagi Michiaki , Nagase Satoru
Published: February 2022

Background

Group A streptococcus infection during pregnancy can be concerning. It may cause toxic shock syndrome, which can be fatal. Here, we report a rare case of a pregnant woman who developed infectious sacroiliitis due to group A streptococcus infection. To the best of our knowledge, this case is the first of its kind to be reported.

Case presentation

A 32-year-old multiparous Japanese woman presented with fever and right buttock pain at 28 weeks of gestation. Based on our clinical findings and investigations, she was diagnosed with group A streptococcus bacteremia and infectious sacroiliitis caused by group A streptococcus. A cardiotocography performed to assess the fetal status showed fetal tachycardia. To prevent the patient from progressing to toxic shock syndrome caused by group A streptococcus, we performed an emergency cesarean section. The patient and her infant had a good course after the cesarean section.

Conclusion

A pregnant woman diagnosed with group A streptococcus infection needs to be monitored closely because a timely decision to deliver the fetus before rapid deterioration to toxic shock syndrome is crucial.
Application of stem cells in the repair of intervertebral disc degeneration
Authors: Zhang Wentao , Sun Tianze , Li Ying , Yang Ming , Zhao Yantao , Liu Jing , Li Zhonghai
Published: February 2022

Intervertebral disc degeneration (IDD) is a common disease that increases with age, and its occurrence is stressful both psychologically and financially. Stem cell therapy for IDD is emerging. For this therapy, stem cells from different sources have been proven in vitro, in vivo, and in clinical trials to relieve pain and symptoms, reverse the degeneration cascade, delay the aging process, maintain the spine shape, and retain mechanical function. However, further research is needed to explain how stem cells play these roles and what effects they produce in IDD treatment. This review aims to summarize and objectively analyse the current evidence on stem cell therapy for IDD.
Incidence, demographic, biochemical, and clinicopathological profile of primary IgAN in a tertiary care center from Northern India
Authors: Bhat Mohammad Ashraf , Sofi Imran Sultan , Sheikh Rayees Yousuf , Wani Imtiyaz
Published: February 2022

Background

Primary IgA nephropathy (IgAN) has variable distribution and clinicopathological spectrum throughout the world. We report the incidence, demographic, and clinicopathological profile of primary IgAN from a tertiary care center in Northern India.

Methods

This is a single-center, prospective, observational study conducted at Sheri- Kashmir Institute of Medical Sciences, J&K, India, from January 2015 to December 2018. The study was approved by the hospital ethical committee.

Results

A total of 106 patients were included in this study, accounting for 19% (106/558) of all native kidney biopsies done during the period from January 2015 till December 2018. Males and females accounted for 60.4% (64/106) and 39.6% (42/106), respectively, with a ratio of 1.5:1. The mean age was 31.37±11.60 years. Edema and hypertension were the most common presenting symptoms and signs, seen in 69 (65.1%) and 72 (67.9%) patients, respectively. The baseline 24-h urine protein excretion was 2.32 ±1.34 g, Nephrotic range proteinuria (≥3.5g/day) was seen in 23/106 (21.7%). Average serum creatinine was 1.6±0.80 mg/dl and estimated glomerular filtration rate using CKD-EPI was <60 ml/min/1.73 m2in 48.1% of patients (51/106). In patients with < 1 g proteinuria, 36.8% had E1, 78.9% had S1, 36.8% had T1, and 42.1% had T2 lesions.

Conclusions

IgAN is common in North India and has a more severe histopathological presentation, characterized by extensive sclerosis and tubulointerstitial fibrosis. Renal dysfunction and nephrotic range proteinuria are common. Hypertension, low eGFR, and proteinuria correlate with the presence of segmental scarring, endocapillary hypercellularity, and IFTA. Screening of asymptomatic individuals might help in early diagnosis and long-term preservation of renal function.
Impaired long-term outcomes of patients with schizophrenia spectrum disorder after coronary artery bypass surgery: nationwide case–control study
Authors: Kallio Mika , Korkeila Jyrki , Malmberg Markus , Gunn Jarmo , Rautava Päivi , Korhonen Päivi , Kytö Ville
Published: February 2022

Background

Patients with schizophrenia spectrum disorder have increased risk of coronary artery disease.

Aims

To investigate long-term outcomes of patients with schizophrenia spectrum disorder and coronary artery disease after coronary artery bypass grafting surgery (CABG).

Method

Data from patients with schizophrenia spectrum disorder (n = 126) were retrospectively compared with propensity-matched (1:20) control patients without schizophrenia spectrum disorder (n = 2520) in a multicentre study in Finland. All patients were treated with CABG. The median follow-up was 7.1 years. The primary outcome was all-cause mortality.

Results

Patients with diagnosed schizophrenia spectrum disorder had an elevated risk of 10-year mortality after CABG, compared with control patients (42.7 v. 30.3%; hazard ratio 1.56; 95% CI 1.13–2.17; P = 0.008). Schizophrenia spectrum diagnosis was associated with a higher risk of major adverse cardiovascular events during follow-up (49.9 v. 32.6%, subdistribution hazard ratio 1.59; 95% CI 1.18–2.15; P = 0.003). Myocardial infarction (subdistribution hazard ratio 1.86; P = 0.003) and cardiovascular mortality (subdistribution hazard ratio 1.65; P = 0.017) were more frequent in patients with versus those without schizophrenia spectrum disorder, but there was no difference for stroke. Psychiatric ward admission, antipsychotic medication, antidepressant use and benzodiazepine use before CABG were not associated with outcome differences. After CABG, patients with schizophrenia spectrum disorder received statin therapy less often and had lower doses; the use of other cardiovascular medications was similar between schizophrenia spectrum and control groups.

Conclusions

Patients with schizophrenia spectrum disorder have higher long-term risks of death and major adverse cardiovascular events after CABG. The results underline the vulnerability of these patients and highlight the importance of intensive secondary prevention and risk factor optimisation.
Anxiety and depression among children and young people involved in family justice court proceedings: longitudinal national data linkage study
Authors: Griffiths Lucy Jane , Mcgregor Joanna , Pouliou Theodora , Johnson Rhodri D. , Broadhurst Karen , Cusworth Linda , North Laura , Ford David V. , John Ann
Published: February 2022

Background

Little is known about mental health problems of children and young people (CYP) involved with public and private law family court proceedings, and how these CYP fare compared to those not involved in these significant disruptions to family life.

Aims

This study examined records of depression/anxiety in CYP involved in public and private law proceedings using linked population-level data across Wales.

Method

Retrospective e-cohort study. We calculated the incidence of primary-care-recorded depression/anxiety among CYP involved in these proceedings and in a comparison group, using Poisson regression. Depression/anxiety outcomes following proceedings were evaluated using pairwise Cox regression, with age- and gender-matched controls of CYP who had no involvement with the courts.

Results

CYP in the public group had twice the risk of depression (adjusted incidence rate ratio aIRR = 2.2; 95% CI 1.9–2.6) and 20% higher risk of anxiety (aIRR = 1.2; 95% CI 1.0–1.5) relative to the comparison group. The private group had 60% higher risk of depression (aIRR = 1.6; 95% CI 1.4–1.7) and 30% higher risk of anxiety (aIRR = 1.3; 95% CI 1.2–1.4). Following private law proceedings, CYP were more likely to have depression (hazard ratio HR = 1.9; 95% CI 1.7–2.1), and anxiety (HR = 1.4; 95% CI 1.2–1.6) than the control group. Following public proceedings, CYP were more likely to have depression (HR = 2.1; 95% CI 1.7–2.5). Incidence of anxiety or depression following court proceedings was around 4%.

Conclusions

Findings highlight the vulnerability of CYP involved in family court proceedings and increased risk of depression and anxiety. Schools, health professionals, social and family support workers have a role to play in identifying needs and ensuring CYP receive appropriate support before, during and after proceedings.
Ambulatory Blood Pressure Monitoring in Children and Adults Prenatally Exposed to Dexamethasone Treatment
Authors: Karlsson Leif , Wallensteen Lena , Nordenström Anna , Krmar Rafael T , Lajic Svetlana
Published: February 2022

Context

The clinical use of dexamethasone (DEX) prenatally to reduce virilization of external genitalia in female fetuses with congenital adrenal hyperplasia (CAH) is efficient but still controversial. It remains challenging to prevent the excessive exposure of DEX in unborn healthy babies during the first trimester of pregnancy.

Objective

Since endogenous glucocorticoids contribute to the maintenance of blood pressure (BP) and since events during fetal life may program the fetus and affect future metabolic health, the aim of this study was to analyze ambulatory BP measurements in CAH-unaffected children and adults that were prenatally exposed to DEX treatment.

Methods

Ambulatory BP measurements were analyzed in 33 (16 female) DEX-treated participants aged 5.1 to 26.3 years (19 participants aged ≤ 18 years) and in 54 (28 female) age- and sex-matched apparently healthy controls aged 5.5 to 25.3 years (27 participants aged ≤ 18 years) with ambulatory normotension.

Results

Participants’ age, height, weight, and body mass index were similar between the DEX-treated group and the control group. Heart rate, 24-hour BP, pulse pressure, and nighttime dipping did not statistically significantly differ between DEX-treated participants and controls.

Conclusion

Our study suggests that prenatal DEX treatment in CAH-unaffected children and adults does not appear to adversely affect ambulatory BP later in life. Our observations need to be confirmed in larger studies.
5-Aminolevulinic Acid-Guided Resection in Grade III Tumors—A Comparative Cohort Study
Authors: Baig Mirza Asfand , Lavrador Jose Pedro , Christodoulides Ioannis , Boardman Timothy Martyn , Vastani Amisha , Al Banna Qusai , Ahmed Razna , Norman Irena C. F. , Murphy Christopher , Devi Sharmila , Giamouriadis Anastasios , Vergani Francesco , Gullan Richard , Bhangoo Ranjeev , Ashkan Keyoumars
Published: February 2022

BACKGROUND:

The benefits of using 5-aminolevulinic acid (5-ALA) in resection of grade IV tumors have been extensively researched. However, few studies have investigated the use of 5-ALA in grade III gliomas.

OBJECTIVE:

To discover whether 5-ALA provides significant benefit in assisting resection of grade III gliomas.

METHODS:

A single-center, retrospective cohort study between January 2013 and January 2019 of adult patients with grade III gliomas. Patients were separated into a 5-ALA–guided surgery group (5-ALA-GS) and non–5-ALA-guided surgery group (non–5-ALA-GS). Primary outcome was overall survival (OS); secondary outcomes were both postoperative and 6-month performance status (PS6m), and extent of resection (EoR).

RESULTS:

Sixty-nine patients with grade III gliomas were included (39 and 30 patients in the 5-ALA-GS group and non–5-ALA-GS group, respectively). There was no significant difference in tumor characteristics between the groups. No significant difference was observed in OS (P= .072) and EoR (P= .609) between both the groups. In a subgroup of the 5-ALA-GS where gross total resection (GTR) was achieved, there was a better OS (P= .043). Significantly worse outcomes were seen postoperatively (P= .044) and at PS6m (P= .041) in the 5-ALA-GS group, mainly because of the poorer outcome in the subtotal resection subgroup.

CONCLUSION:

Despite the benefits of 5-ALA in grade IV glioma surgery, these benefits are limited to a smaller group of patients with grade III tumors where there is sufficient fluorescence to allow GTR. In this cohort of patients, 5-ALA use may result in worse neurological outcomes particularly when GTR is not feasible and therefore caution is warranted.
Scaling-Up Adolescent High-Intensity Interval Training Programs for Population Health
Authors: Lubans David R. , Eather Narelle , Smith Jordan J. , Beets Michael W. , Harris Nigel K.
Published: February 2022

High-intensity interval training (HIIT) has become a polarizing form of exercise. In this article, we argue that adolescent HIIT programs can have population health impact if they are (i) integrated into existing opportunities, (ii) designed to develop physical literacy, (iii) delivered in an engaging manner, and (iv) guided and supported by an implementation framework that addresses relevant barriers and facilitators.
The challenge of knowledge management in small and medium enterprises (SMEs)
Authors: Ανδρονίκου Δημήτριος
Published: February 2022

Αυτή η μελέτη διερευνά με ποιο τρόπο και σε τι βαθμό οι υποκειμενικές, κοινωνικές και πολιτικές διαστάσεις του οργανισμού καθορίζουν τις αντιλήψεις και την εφαρμογή της διαχείρισης γνώσης στις μικρομεσαίες επιχειρήσεις. Η επισκόπηση της βιβλιογραφίας έδειξε ότι η ΔΓ στις μικρομεσαίες επιχειρήσεις δεν έχει αναγνωριστεί ως προτεραιότητα στην ατζέντα τους και στις περισσότερες περιπτώσεις, εφαρμόζουν άτυπα τη ΔΓ. Δηλαδή, χωρίς να το κατονομάζουν ως ΔΓ και χωρίς πρωτοβουλίες όπως στρατηγικές, πολιτικές και σχέδια δράσης καθοδηγούμενα από τις σχετικές έννοιες και την ειδική ορολογία. Στο πλαίσιο της μελέτης διαπιστώθηκε ότι η ΔΓ εφαρμόζεται ως επί το πλείστον περιστασιακά και ανεπίσημα σαν ξεχωριστά κομμάτια των εργαλείων της Τεχνολογίας των Πληροφοριών και των δραστηριοτήτων που συμβάλλουν στην οργανωσιακή λειτουργία. Ο τρόπος με τον οποίο διαχειρίζονται την γνώση τους αυτοί οι οργανισμοί εξαρτάται κυρίως από τον Ιδιοκτήτη-Διευθυντή και την προσωπική του τοποθέτηση (νοητικά μοντέλα και ποιότητα της πρακτικής σοφίας-φρόνησης) σε σχέση με άλλους κοινωνικούς, πολιτικούς και συγκυριακούς παράγοντες. Η ετερογένεια των ΜΜΕ, όσον αφορά την ιδιοκτησία (οικογενειακή και μη-οικογενειακή επιχείρηση), το μέγεθος, τον τομέα, βασιζόμενες στην ένταση της γνώσης και βασιζόμενες στην ένταση του εργατικού δυναμικού, δικαιολογεί τον τρόπο που οι εμπλεκόμενοι κατανοούν και εφαρμόζουν τη ΔΓ στους οργανισμούς. Πρόσφατα, μία νέα προοπτική διαφαίνεται με την αναγνώριση της ΔΓ και την ενσωμάτωση της οργανωσιακής γνώσης στην αναθεωρημένη έκδοση ISO 9001:2015 ‘Διαχείριση Ποιότητας Συστήματα – Απαιτήσεις’ (ISO, 2015). Ωστόσο, μέχρι στιγμής αυτή η αλλαγή στο πρότυπο έχει περάσει σχεδόν απαρατήρητη από πολλούς οργανισμούς και ως εκ τούτου είναι ακόμα άγνωστο πως αυτό εφεξής θα επηρεάσει την εφαρμογή της ΔΓ.