bluuebunny/crossref_metadata_2025 huggingface dataset:
Long COVID and return to work: a qualitative study
Authors: Kohn L , Dauvrin M , Detollenaere J , Primus-de Jong C , Maertens de Noordhout C , Castanares-Zapatero D , Cleemput I , Van den Heede K
Published: December 2022

Background

The COVID-19 pandemic has given rise to an increasing number of patients with ‘long COVID’. Long COVID is the persistence of symptoms for weeks or months after an infection by SARS-CoV-2. It often impacts on the professional life of affected people.

Aims

The aim of this study is to understand the experiences and needs of people with long COVID in relation to their return to work.

Methods

A qualitative study, combining individual interviews and online forum discussions, was performed early 2021, as part of a larger mixed method study on the needs of long COVID patients in Belgium.

Results

One hundred and thirty-four people participated in the study. Participants described various clinical symptoms precluding their return to work. They also face sceptical reactions from employers and colleagues and a lack of support from the social welfare system to facilitate their return to work. These barriers have various impacts, including psychological ones, likely to compromise the professional future of long COVID patients.

Conclusions

While the analysis of patients’ experiences shows variation in long COVID patients’ experiences with return to work, it may help occupational physicians and healthcare practitioners to better take up their crucial role in the return to work of long COVID patients, including raising employers’ and colleagues’ awareness of the specific difficulties related to long COVID.
Beyond transcription: compelling open questions in plant RNA biology
Authors: Manavella Pablo A , Godoy Herz Micaela A , Kornblihtt Alberto R , Sorenson Reed , Sieburth Leslie E , Nakaminami Kentaro , Seki Motoaki , Ding Yiliang , Sun Qianwen , Kang Hunseung , Ariel Federico D , Crespi Martin , Giudicatti Axel J , Cai Qiang , Jin Hailing , Feng Xiaoqi , Qi Yijun , Pikaard Craig S
Published: December 2022

The study of RNAs has become one of the most influential research fields in contemporary biology and biomedicine. In the last few years, new sequencing technologies have produced an explosion of new and exciting discoveries in the field but have also given rise to many open questions. Defining these questions, together with old, long-standing gaps in our knowledge, is the spirit of this article. The breadth of topics within RNA biology research is vast, and every aspect of the biology of these molecules contains countless exciting open questions. Here, we asked 12 groups to discuss their most compelling question among some plant RNA biology topics. The following vignettes cover RNA alternative splicing; RNA dynamics; RNA translation; RNA structures; R-loops; epitranscriptomics; long non-coding RNAs; small RNA production and their functions in crops; small RNAs during gametogenesis and in cross-kingdom RNA interference; and RNA-directed DNA methylation. In each section, we will present the current state-of-the-art in plant RNA biology research before asking the questions that will surely motivate future discoveries in the field. We hope this article will spark a debate about the future perspective on RNA biology and provoke novel reflections in the reader.
Analyses of Cullin1 homologs reveal functional redundancy in S-RNase-based self-incompatibility and evolutionary relationships in eudicots
Authors: Sun Linhan , Cao Shiyun , Zheng Ning , Kao Teh-hui
Published: December 2022

In Petunia (Solanaceae family), self-incompatibility (SI) is regulated by the polymorphic S-locus, which contains the pistil-specific S-RNase and multiple pollen-specific S-Locus F-box (SLF) genes. SLFs assemble into E3 ubiquitin ligase complexes known as Skp1–Cullin1–F-box complexes (SCFSLF). In pollen tubes, these complexes collectively mediate ubiquitination and degradation of all nonself S-RNases, but not self S-RNase, resulting in cross-compatible, but self-incompatible, pollination. Using Petunia inflata, we show that two pollen-expressed Cullin1 (CUL1) proteins, PiCUL1-P and PiCUL1-B, function redundantly in SI. This redundancy is lost in Petunia hybrida, not because of the inability of PhCUL1-B to interact with SSK1, but due to a reduction in the PhCUL1-B transcript level. This is possibly caused by the presence of a DNA transposon in the PhCUL1-B promoter region, which was inherited from Petunia axillaris, one of the parental species of Pe. hybrida. Phylogenetic and syntenic analyses of Cullin genes in various eudicots show that three Solanaceae-specific CUL1 genes share a common origin, with CUL1-P dedicated to S-RNase-related reproductive processes. However, CUL1-B is a dispersed duplicate of CUL1-P present only in Petunia, and not in the other species of the Solanaceae family examined. We suggest that the CUL1s involved (or potentially involved) in the SI response in eudicots share a common origin.
Guidance on research integrity provided by pan-European discipline-specific learned societies: A scoping review
Authors: Hastings Rosie , Labib Krishma , Lechner Iris , Bouter Lex , Widdershoven Guy , Evans Natalie
Published: December 2022

There is little research on the content of research integrity (RI)–related guidance provided by pan-European discipline-specific learned societies, or how this guidance compares with recommendations made in the European Code of Conduct for Research Integrity (ALLEA code). Therefore, we aimed to (1) assess the availability of RI guidance from these learned societies, (2) compare learned societies’ guidance with the ALLEA code, and (3) explore similarities and differences in guidance between learned societies of different disciplines. Using a scoping review, we identified 245 learned societies, from which we identified and conducted a content analysis of fifty-eight guideline documents, developed by forty-six of these learned societies. Less than 25 per cent of learned societies in any discipline provide guidance, and there are notable disciplinary differences. Recommendations made by learned societies, which are not reflected in the ALLEA code, relate primarily to research culture and environment. Medical and Health Sciences societies often focus on regulatory and procedural aspects of research, whereas Natural Sciences societies emphasize the importance of accurate and appropriate dissemination of results. Humanities and Social Sciences societies’ recommendations are more heterogeneous and closely related to the nature of specific subdisciplines. Our results reflect differences in epistemological approaches as well as the specific roles and responsibilities of learned societies. We recommend that learned societies develop, or endorse, appropriate RI guidance.
Causal associations of obstructive sleep apnea with cardiovascular disease: a Mendelian randomization study
Authors: Li Ye , Miao Yuyang , Zhang Qiang
Published: December 2022

Study Objectives

Obstructive sleep apnea (OSA) had been associated with various cardiovascular diseases (CVDs) in observational studies, but causal inferences have not been confirmed. We used the Mendelian randomization (MR) study to explore the potential causal association between OSA with CVDs in the general population.

Methods

We performed a two-sample MR analysis using five gene-wide significant single-nucleotide polymorphisms associated with OSA at genome-wide significance from the FinnGen study (N = 217 955) and 12 cardiovascular diseases from the UK Biobank and the genetic consortia. The inverse-variance weight was chosen as the primary analysis and was complemented by various sensitivity analyses. The study design applied univariable MR, multivariable MR, and mediation analysis.

Results

MR analyses provide evidence of genetically predicted OSA on the risk of heart failure (odds ratio [OR],1.26; 95% confidence interval [CI],1.08 to 1.47), hypertension (OR,1.24; 95%CI, 1.11 to 1.39) and atrial fibrillation (OR,1.21; 95%CI,1.12 to 1.31). Multivariable MR indicated the adverse effect of OSA on heart failure persisted after adjusting BMI, smoking, drinking, and education (IVW OR,1.13; 95%CI, 1.01 to 1.27). However, the significance of hypertension and atrial fibrillation was dampened. Mediation analyses suggest that the causal association between OSA and heart failure is mediated in part by Apolipoprotein B, with a mediated portion of 9%.

Conclusions

This study suggested that genetically predicted OSA is a potential causal risk factor for heart failure based on a large-scale population. Nevertheless, further studies regarding ancestral diversity are needed to confirm the causal association between OSA and CVDs.
Epidemiological patterns related to deaths caused by visceral leishmaniasis in the southern Amazon region of Brazil
Authors: Carvalho Amanda G , Kuhn André Luiz M , Dias João Victor L , Luz João Gabriel G
Published: December 2022

Background

We analysed the spatial and spatiotemporal patterns of visceral leishmaniasis (VL) mortality at the municipality level in an endemic state in the southern Amazon region of Brazil. Individual-level factors associated with death due to VL were also investigated.

Methods

All VL cases and deaths reported between 2007 and 2018 were included. The global and local bivariate Moran's index assessed the space–time autocorrelation of smoothed triennial VL mortality. Kulldorff's scan statistics investigated spatial and spatiotemporal clusters. A multivariable logistic regression explored sociodemographic, diagnostic and clinical variables associated with death due to VL.

Results

We observed an overall VL mortality and lethality of 0.14 cases/100 000 inhabitants and 11.2%, respectively. A total of 14% of the municipalities registered at least one VL-related death. In the southeastern mesoregion of the state, we detected high-risk spatial (relative risk [RR] 14.14; p<0.001) and spatiotemporal (RR 15.91; p<0.001) clusters for VL mortality. Bivariate Moran's analysis suggested a high space–time autocorrelation of VL mortality. Death by VL was associated with age ≥48 y (odds ratio [OR] 7.2 [95% confidence interval {CI} 3.4 to 15.3]), displacement for notification (OR 3.3 [95% CI 1.5 to 7.2]) and occurrence of oedema (OR 2.8 [95% CI 1.3 to 6.1]) and bleeding (OR 5.8 [95% CI 2.6 to 12.8]).

Conclusions

VL mortality has a heterogeneous spatiotemporal distribution. The death-related factors suggest late diagnosis as an underlying cause of mortality.
Method Matters: The Underreporting of Intimate Partner Violence
Authors: Cullen Claire
Published: December 2022

This paper analyzes the magnitude and predictors of misreporting on intimate partner violence. Women in Nigeria were randomly assigned to answer questions using either an indirect method (list experiment) that gives respondents anonymity, or the standard, direct face-to-face method. Intimate partner violence rates were up to 35 percent greater when measured using the list method than the direct method. Misreporting was associated with indicators often targeted in empowerment and development programs, such as education and vulnerability. These results suggest that standard survey methods may generate significant underestimates of the prevalence of intimate partner violence, and biased correlations and treatment effect estimates.
Combating an Invasive Boxwood Pathogen –Calonectria pseudonaviculata– in the United States by Shifting Production to Less-Susceptible Cultivars
Authors: Omolehin Olanike , Keller John , Gouker Fred , Daughtrey Margery , Luster Douglas , Pscheidt Jay , Hong Chuanxue
Published: December 2022

Boxwood blight (BB) caused by Calonectria pseudonaviculata (Cps), an economically devastating disease affecting everyone in the supply chain from growers to gardeners, was first officially documented in the United States in 2011. This disease has taken a heavy toll on boxwood, an iconic landscape plant and the number one evergreen nursery crop. Instead of abandoning boxwood production and switching to other evergreens, growers in the United States, informed by the latest research, have elected to combat this disease. One of the strategies employed has been to shift boxwood production from highly susceptible to less-susceptible cultivars. The objective of this study was to investigate the ongoing shift by comparing boxwood sales of 17 selected nurseries from seven states across the country in 2011, 2016, and 2021. Results revealed an additional 21.24% (from 38.58 to 60.04%) in sales of less-susceptible boxwood cultivars in 2021 compared with 2016. The less-susceptible cultivars responsible for increased boxwood sales are ‘Winter Gem’, ‘Wintergreen’, ‘SB 300’ (Freedom), ‘SB 108’ (Independence), and ‘Little Missy’. The potential for long-term positive impact on sustainable boxwood production and plantings in the United States through the use of less-susceptible cultivars is discussed. This shift in boxwood choices builds crop health into new plantings of this landmark plant and sustains growth in demand for boxwood. This sets a new example of sustainable protection for a crop that is under serious pressure from an invasive pathogen.
Accuracy of International Classification of Diseases, 10th Revision Codes for Identifying Sepsis: A Systematic Review and Meta-Analysis
Authors: Liu Bonnie , Hadzi-Tosev Milena , Liu Yang , Lucier Kayla J. , Garg Anchit , Li Sophie , Heddle Nancy M. , Rochwerg Bram , Ning Shuoyan
Published: December 2022

OBJECTIVES:

Administrative databases are increasingly used in research studies to capture clinical outcomes such as sepsis. This systematic review and meta-analysis examines the accuracy of International Classification of Diseases, 10th revision (ICD-10), codes for identifying sepsis in adult and pediatric patients.

DATA SOURCES:

We searched MEDLINE, EMBASE, Web of Science, CENTRAL, Epistemonikos, and McMaster Superfilters from inception to September 7, 2021.

STUDY SELECTION:

We included studies that validated the accuracy of sepsis ICD-10 codes against any reference standard.

DATA EXTRACTION:

Three authors, working in duplicate, independently extracted data. We conducted meta-analysis using a random effects model to pool sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). We evaluated individual study risk of bias using the Quality Assessment of Diagnostic Accuracy Studies tool and assessed certainty in pooled diagnostic effect measures using the Grading of Recommendations Assessment, Development, and Evaluation framework.

DATA SYNTHESIS:

Thirteen eligible studies were included in the qualitative synthesis and the meta-analysis. Eleven studies used manual chart review as the reference standard, and four studies used registry databases. Only one study evaluated pediatric patients exclusively. Compared with the reference standard of detailed chart review and/or registry databases, the pooled sensitivity for sepsis ICD-10 codes was 35% (95% CI, 22–48, low certainty), whereas the pooled specificity was 98% (95% CI: 98–99, low certainty). The PPV for ICD-10 codes ranged from 9.8% to 100% (median, 72.0%; interquartile range [IQR], 50.0–84.7%). NPV ranged from 54.7% to 99.1% (median, 95.9%; interquartile range, 85.5–98.3%).

CONCLUSIONS:

Sepsis is undercoded in administrative databases. Future research is needed to explore if greater consistency in ICD-10 code definitions and enhanced quality measures for ICD-10 coders can improve the coding accuracy of sepsis in large databases.
Fluid Overload Mechanically Ventilated Days: A Novel Fluid Exposure Measure in Critically Ill Children With Acute Respiratory Failure
Authors: Barhight Matthew F. , Sanchez-Pinto L. Nelson , Basu Rajit K.
Published: December 2022

We propose a novel metric evaluating the impact an exposure to a large positive fluid balance over time has on clinical outcomes in children with respiratory failure, termed “fluid overload mechanically ventilated” (FOMV) days. We performed a retrospective cohort study of mechanically ventilated children. Using multivariable regression analyses, each FOMV day was associated with a 5% decreased likelihood of having a ventilator-free day (adjusted incidence rate ratio [aIRR], 0.95; 95% CI, 0.95–0.96), a 5% increased likelihood of having an additional day of stay (aIRR, 1.05; 95% CI 1.05–1.06), and a 6% increased relative risk of death (aRR, 1.06; 95% CI, 1.01–1.11). FOMV is a novel exposure measure in children with acute respiratory failure associated with poor outcomes paralleling published data demonstrating dose-dependent exposure to a positive fluid balance is associated with worse outcomes. FOMV is a targetable exposure metric for future use in quality improvement initiatives and research studies that may help to determine the efficacy of interventions.
Stereotactic Partial Breast Irradiation
Authors: Montalvo Steven K. , Collins Brian , Vicini Frank , Rahimi Asal
Published: December 2022

Breast irradiation has evolved significantly over the last several decades. Accelerated partial breast and stereotactic breast irradiation have evolved as strategies to reduce irradiated volumes, preserve appropriate oncologic control, and improve cosmetic outcome. The sequencing and/or combination of stereotactic partial breast irradiation with novel systemic agents is of great interest to the oncologic community. Here we explore the landscape of modern trials and opine on the future of partial breast irradiation.
Development and Evaluation of a Cervical Cancer Screening Training Program for Midwives in Japan
Authors: Oishi Tokiko , Miyauchi Akito , Yamada Manabu , Nakane Naoko , Manome Yuko , Kajihara Yoko , Hanley Sharon J.B. , Nishioka Emiko , Mikami Yumiko
Published: December 2022

Background:

In Japan, cervical cancer incidence has increased over the last decade and screening coverage is extremely low (35.8%). In 2016, the Japanese government allowed nursing professionals to perform cervical screening for the first time if instructed to do so by a gynecologist. Following this, a training program was developed for midwives to perform cervical screening.

Objective:

To evaluate a training program for Japanese midwives to perform cervical screening.

Methods:

Eight experienced midwives participated at 1 medical center in November 2019. After a lecture, skills-lab and 3-week practice using a manikin, midwives who passed the skills-check proceeded to the practicum for routine screening. After passing the practicum, each midwife took 20 samples under indirect supervision. Evaluations by supervising gynecologists and 160 screened women, as well as midwives’ self-reports were analyzed.

Results:

The pass rate was 86%. In 21 (13%) of 160 cases, midwives needed assistance from a gynecologist to locate the cervix, including 5 cases which were taken over by a gynecologist. None of the samples were unsatisfactory. Women’s evaluation of midwives as screeners was both positive and high.

Conclusions:

This training program enabled experienced Japanese midwives to take adequate samples while methods of evaluation should be elaborated. Women were highly satisfied with midwives performing cervical screening.

Implications for Practice:

Task shifting to midwives may be an important policy approach to improving cervical screening coverage.

Foundational:

This study was the first in Japan to give foundation to task shifting of cervical screening from physicians to midwives.
Exercise increases arterial stiffness independent of blood pressure in older Veterans
Authors: Pewowaruk Ryan J. , Hein Amy J. , Hansen Kristin M. , Barnes Jill N. , Chesler Naomi C. , Korcarz Claudia E. , Gepner Adam D.
Published: December 2022

Background:

Exercise-induced changes in arterial function could contribute to a hypertensive response to exercise (HRE) in older individuals. We performed the present analysis to define the acute arterial stiffness response to exercise in ambulatory older adults.

Methods:

Thirty-nine Veterans (>60 years old), without known cardiovascular disease, participated in this study, including 19 Veterans who were hypertensive (70.8 ± 6.8 years, 53% women) and 20 Veterans who were normotensive (72.0 ± 9.3 years, 40% women). Arterial stiffness parameters were measured locally with carotid artery ultrasound and regionally with carotid–femoral pulse wave velocity (cfPWV) before and during the 10 min after participants performed a Balke maximal exercise treadmill stress test.

Results:

The arterial stiffness response to exercise was similar for control and hypertensive participants. At 6 min postexercise, cfPWV was significantly increased (Δ1.5 ± 1.9 m/s, P = 0.004) despite mean blood pressure (BP) having returned to its baseline value (Δ1 ± 8 mmHg, P = 0.79). Arterial mechanics modeling also showed BP-independent increases in arterial stiffness with exercise (P < 0.05). Postexercise cfPWV was correlated with postexercise SBP (r = 0.50, P = 0.004) while baseline cfPWV (r = 0.13, P = 1.00), and postexercise total peripheral resistance (r = −0.18, P = 1.00) were not.

Conclusion:

In older Veterans, exercise increases arterial stiffness independently of BP and the arterial stiffness increase with exercise is associated with increased postexercise SBP. BP-independent increases in arterial stiffness with exercise could contribute to a HRE in older adults.
Immune Biomarkers in the Peripheral Blood and Tumor Microenvironment of Classical Hodgkin Lymphoma Patients in Relation to Tumor Burden and Response to Treatment
Authors: Mulder Tom A. , Andersson Maria L. , Peña-Pérez Lucía , Heimersson Kia , Xagoraris Ioanna , Wahlin Björn E. , Månsson Robert , Hansson Lotta , Rassidakis Georgios , Palma Marzia
Published: December 2022

In classical Hodgkin lymphoma (cHL), the malignant cells represent only a small fraction of the tumor. Yet, they orchestrate a lymphocyte-dominated tumor microenvironment (TME) that supports their survival and growth. The systemic effects of this local immunomodulation are not fully elucidated. Here, we aimed at characterizing circulating lymphocytes and plasma proteins in relation to clinical parameters and treatment effect. Peripheral blood (PB) samples were obtained from 48 consecutive patients at diagnosis and at 2 time points after successful primary treatment. Single-cell suspensions were prepared from lymph node (LN) biopsies obtained for routine diagnostic purposes. Twenty healthy individuals were included as controls. Cells from PB and LN were analyzed by flow cytometry, and plasma proteins by Proximity Extension Assay. We found that the frequencies of T and B cells positively correlated between the LN and the PB compartments. Compared to controls, cHL patients had higher frequencies of proliferating T cells as well as higher expression of programmed death (PD)-1 and cytotoxic T lymphocyte antigen (CTLA)-4 in circulating T cells, and lower naive T-cell frequencies. Advanced-stage patients had fewer NK cells with a functionally impaired phenotype. Differences in the immune profile were observed in patients with a high tumor burden and with high inflammation, respectively. Most of these deviations disappeared after standard first-line treatment. Patients who received radiotherapy involving the mediastinum had low T-cell counts for a prolonged period. Our findings suggest that the immunomodulation of lymphocytes in the TME of cHL might affect immune biomarkers in the PB.
Changes in platelet levels and prognosis in patients with acute liver failure and late-onset hepatic failure
Authors: Hayashi Manabu , Fujita Masashi , Abe Kazumichi , Takahashi Atsushi , Ohira Hiromasa
Published: December 2022

The therapeutic strategies for acute liver failure (ALF) and late-onset hepatic failure (LOHF) still have room for improvement. Recent studies have reported an association between platelets and the pathophysiology of ALF. In this study, we investigated changes in platelet levels and clinical findings in ALF and LOHF patients. We retrospectively investigated the clinical data of 62 patients with ALF and LOHF. We analyzed the association between changes in platelet levels for 7 days after admission and the prognosis in patients with ALF and LOHF. The factors associated with changes in platelet levels were also analyzed. The platelet levels on days 1, 3, and 7 were significantly lower in the patients who died or underwent liver transplantation than in the spontaneous survivors. Administration of recombinant thrombomodulin was associated with spontaneous survival. The platelet levels in patients who met the King’s College Hospital Criteria or the Japanese scoring system (JSS) for ALF ≥ 4 were significantly decreased 7 days after admission. The area under the receiver operating characteristic curve (AUROC) of a JSS score of 3 for predicting low platelet levels on day 7 was 0.903. Decreased platelet levels were associated with poor prognosis in patients with ALF and LOHF. The patients with low platelet levels and JSS scores on admission showed a high AUROC for predicting low platelet levels on day 7. Decreased platelet levels after admission may be a simple prognostic marker in ALF and LOHF patients.
Application of state-target application of painful arthritis liver and kidney deficiency: A review
Authors: Zhou Rui , Jia Yuyan , Wang Ying , Wang Xukai , Leng Xiangyang
Published: December 2022

In recent years, with the progress and development of the times, our eating habits and lifestyle changes have led to an increase in gouty arthritis annually, with the main use of nonsteroidal anti-inflammatory drugs and other drugs. These drugs are highly dependent, resulting in an unresponsive state, which is easy to recur. Therefore, more and more patients choose traditional Chinese medicine (TCM) to treat them. After years of continuous exploration and rich clinical experience accumulation, Academician TongXiaolin put forward the dialectical strategy of “combination of state and target” in TCM. He believed that the deficiency of liver and kidney is transformed into a state, with uric acid as the target. Through the target prescription Simiao decoction to clever heat and moisture, replenishing liver and kidney, the target medicine Bixie (Dioscorea Tokoro Makino) to rheumatism, Shujin;Tufuling (Rhizoma Smilacis Glabrae) for detoxification, dehydration gas, Weilingxian (Radix et Rhizoma Clematidis) to rheumatism, pass meridians, and the combination of the condition and target achieves a good clinical effect.
Efficacy of exercise in patients with pulmonary fibrosis: A systematic review and meta-analysis
Authors: Gao Yan , Zhao Lijing , Yang Zhaoyun , He Kang , Zhang Tingyu , Yi Jiang
Published: December 2022

Background:

Pulmonary fibrosis (PF) is easily caused by a variety of factors, resulting in dyspnea, exertion and movement intolerance. This systematic review aims to synthesize evidence on exercise training during rehabilitation for PF in order to improve patients’ exercise capacity, quality of life, and lung function.

Methods:

Retrieved from the Cochrane Library, Web of Science, PubMed, Scopus and Embase from inception until April 2022. Participants: patients with PF; Intervention measures: exercise training; Results: exercise ability, quality of life, lung function and cardiopulmonary endurance. Two reviewers independently screen the title, abstract and full text. Finally, quality evaluation and meta-analysis were conducted.

Results:

In this study, 13 randomized controlled studies from 1468 articles were selected. A total of 456 patients with PF were enrolled. Compared with usual care in the control group, the 6-minute walking distance, predicted forced vital capacity, predicted forced expiratory volume at 1 second and maximal rate of oxygen consumption were increased significantly after exercise training, while there was no significant change in quality of life and predicted diffusing capacity of the lung for carbon monoxide.

Conclusion:

Exercise training can significantly improve the exercise capacity, lung function and cardiopulmonary endurance of patients with PF, but has no effect on the quality of life. Exercise training is an effective rehabilitation strategy for PF.
An overview of lumbar anatomy with an emphasis on unilateral biportal endoscopic techniques: A review
Authors: Zhang Qiang , Wei Yongan , Wen Li , Tan Chang , Li Xinzhi , Li Bo
Published: December 2022

Unilateral biportal endoscopy (UBE) is a major surgical technique used to treat degenerative lumbar diseases. The UBE technique has the advantages of flexible operation, high efficiency, and a large observation and operation space. However, as a typical representative of minimally invasive techniques, UBE still needs to complete a wide range of decompression and tissue resection in a narrow working space, resulting in many surgery-associated injuries. Therefore, it is necessary to reduce complications by familiarity with the anatomy of the lumbar spine. Based on the UBE technique, this review article provides historical and current information on the anatomical structures of the lumbar vertebrae, such as the articular process, pedicle, lamina, ligamentum flavum, nerve root, intervertebral disc, and artery supply.
Endoscopic treatment for duodenal perforation due to biliary stent dislocation: A case report and brief review of the literature
Authors: Fujii Yuki , Matsumoto Kazuyuki , Miyamoto Kazuya , Matsumi Akihiro , Morimoto Kosaku , Terasawa Hiroyuki , Yamazaki Tatsuhiro , Horiguchi Shigeru , Tsutsumi Koichiro , Kato Hironari
Published: December 2022

Rationale:

Duodenal wall perforation by a dislocated biliary stent placed for biliary structure is rare but can be life-threatening. There are few reports on the management of stent-related duodenal perforation.

Patient concerns:

Three cases included in this study had undergone endoscopic retrograde cholangiopancreatography with placement of a plastic stent for biliary stricture. Two cases had symptoms (fever or abdominal pain), while other case showed no symptom after biliary stent placement.

Diagnoses:

Dislocation of plastic stents was revealed on computed tomography or endoscopic images. Two patients were diagnosed with duodenal perforation due to distal migration of long stents with a straight shape on the distal side. One patient was diagnosed with fistula formation between the intrahepatic bile duct and duodenum due to perforation of a pigtail stent.

Interventions:

All cases could successfully be managed endoscopically with closure by hemoclips or stent replacement.

Outcomes:

All 3 cases were improved after endoscopic treatment without any subsequent intervention.

Lessons:

Longer stents with a straight distal side are associated with a higher risk of duodenal perforation. Endoscopic management is appropriate as a first-line approach for a clinically stable patient. At the time of stent placement, we should pay attention to the length and type of stent.
Clinical usefulness of biomarkers for diagnosis and prediction of prognosis in sepsis and septic shock
Authors: Lee Jae Ha , Kim Seong-Ho , Jang Ji Hoon , Park Jin Han , Jo Kyung Min , No Tae-Hoon , Jang Hang-Jea , Lee Hyun-Kyung
Published: December 2022

Sepsis is a life-threatening condition and remains a major cause of mortality. The aim of this study was to evaluate the role of biomarkers in the diagnosis of sepsis and septic shock in patients admitted to the emergency department (ED). Medical records of patients who underwent measurement of serum biomarkers including lactic acid, C-reactive protein, procalcitonin (PCT), and presepsin in the ED between May 2019 and May 2020 were retrospectively reviewed. Patients were subdivided into 3 groups; non-sepsis, sepsis, and septic shock according to the new definition using the sequential organ failure assessment score. The mean age was 69.3 years, and 55.8% of the study population was female. Of 249 subjects, 98 patients confined to sepsis group, and 35.7% of them were septic shock. In the multivariable analysis, a high level of PCT was an independent predictor of sepsis (odds ratio [OR], 1.028; 95% confidence interval [CI], 1.006–1.051; P = .011) along with a simplified acute physiology score III (SAPS III) (OR, 1.082; 95% CI, 1.062–1.103, P < .001). PCT was also an independent risk factor for septic shock (OR, 1.043; 95% CI, 1.016–1.071, P = .02). In the receiver operating characteristic curve analysis, the area under the curve of PCT to predict sepsis and septic shock were 0.691 (P < .001) and 0.734 (P < .001), respectively. The overall 30-days mortality rate was 8.8%, and the mortality rate was significantly higher in the sepsis group (sepsis vs non-sepsis, 15.3% vs 4.6%; P = .004). In the multivariate Cox analysis, a higher level of lactic acid (hazard ratio [HR], 1.328; 95% CI, 1.061–1.663, P = .013), predisposing chronic pulmonary diseases (HR, 7.035; 95% CI, 1.687–29.341, P = .007), and a high SAPSIII value (HR, 1.046; 95% CI, 1.015–1.078, P = .003) were independent risk factors for mortality in sepsis patients. PCT was a useful biomarker for predicting sepsis and septic shock in the ED. A higher level of lactic acid, predisposing chronic pulmonary diseases, and a high SAPS III score were associated with a greater mortality risk in patients with sepsis.
Prevalence and risk factors of loneliness among patients with hematological malignancies
Authors: Yu Junye , Song Huanhuan
Published: December 2022

To identify independent factors for predicting loneliness in patients with hematological malignancies. It is an observational cross-sectional study. 157 patients with hematologic malignancies were enrolled between March 2020 and May 2020. The sociodemographic characteristics and psychometric properties (coping styles, self-esteem, big 5 personality traits, and hope) were tested for correlation with loneliness. Multivariate hierarchical regression analysis was then utilized to identify independent risk factors for loneliness. The patients exhibited a mean global score of 36.25 that corresponded to a moderate degree of loneliness. The sociodemographic factors, including occupation, family earning, living areas, times of hospitalization, were significantly related to loneliness. In addition, the coping styles, levels of self-esteem, the big 5 personality traits, and levels of hope were significantly correlated with the degrees of loneliness. Furthermore, sociodemographic factors (occupation) and psychometric properties (coping styles and hope) were identified as independent predictors for loneliness in patients with hematological malignancies. Loneliness is highly prevalent in patients with hematological malignancies. Notably, occupation, times of hospitalization, family earning, coping styles, self-esteem, big 5 personality traits, and hope are all independent risk factors for loneliness.
Analgesic effect of butorphanol tartrate combined with hydromorphone on patients with cesarean section: A prospective cohort study
Authors: Zhang Ying , Xie Shixuan , Zhang Guanglei , Gong Xun
Published: December 2022

To evaluate the analgesic effect of butorphanol tartrate combined with hydromorphone on the patients with cesarean section, we conducted a prospective cohort study. A total of 90 patients were given patient-controlled intravenous analgesia (PCIA) with hydromorphone for 24 hours after the cesarean section. After stopping PCIA, they were divided into 2 groups randomly. The cases treated with butorphanol tartrate intravenous drip were evaluated as the butorphanol group (n = 45) and the cases treated with saline were evaluated as the control group (n = 45). We compared the vital signs, analgesic effect, adverse reactions, the bladder and gastrointestinal function recovery, and neonatal jaundice between the 2 groups. The visual analog score in butorphanol group was significantly lower than that of control group at 3 and 4 hours after stopping PCIA (P < .05), but there was no significant difference in visual analog score at 6 and 12 hours after stopping PCIA. The first time of getting out of bed and urination in butorphanol group was significantly later than that in control group while there was no significant difference in the first anal ventilation and the neonatal jaundice index between the 2 groups. We should pay attention to the pain of patients with cesarean section after stopping PCIA. The combination of butorphanol tartrate and hydromorphone play a good effect to relieve the pain while nursing care should be strengthened to urge patients to take early activities to reduce the occurrence of urinary retention.
Comparison of ultrasound with computed tomography to measure skeletal muscle mass in critically ill patients: A prospective study protocol
Authors: Peres Leandro Moreira , Luis-Silva Fabio , Menegueti Mayra Gonçalves , Sato Lucas , Basile-Filho Anibal , Suen Vivian Marques Miguel , Martins-Filho Olindo Assis , Auxiliadora-Martins Maria
Published: December 2022

Introduction:

Therapy and nutritional status directly interfere in the clinical evolution of critically ill patients, in reducing morbidity and mortality, by maintaining the functional integrity of the gastrointestinal tract, decreasing the catabolic response, besides contributing to the reduction of hospitalization time resulting in less treatment cost. Critical patients and trauma victims suffer early changes in the quantity and quality of muscle mass. Tools to identify the groups most susceptible to these complications are necessary so that interventions can minimize the deleterious effects of malnutrition in critically ill patients.

Methods and analysis:

The aim of the present study is to measure muscle mass loss by measuring the thickness of the rectus femoris muscle by bedside ultrasound in critically ill patients admitted to the Intensive Care Unit (ICU) of a university hospital. Information will be collected regarding the length of hospital and ICU stay, the reason for admission, anthropometric data at admission and during hospitalization, energy needs, nutritional therapy used, and fasting time. This is a prospective, observational study that will be carried out in a single center in an ICU of a tertiary university hospital. The study population will undergo 3 tomographic images and 3 ultrasounds of the rectus femoris of each patient at different times. We propose, unprecedentedly, performing a validation study of ultrasound with the gold standard Computed tomography to evaluate the musculature of critically ill patients victims of traumatic brain injury. The results got will texto be fundamental for the development of new fields of investigation and certainly contribute to the discovery of a new approach to treat sarcopenia in critically ill patients. The Research Ethics Committee approved the study and all patients included will sign an informed consent form. (Clinical Record: RBR-2bzspnz).
Pembrolizumab versus paclitaxel for previously treated, advanced gastro-esophageal junction cancer: A systematic review and meta-analysis of randomized clinical trials
Authors: Swed Sarya , Shaheen Nour , Hafez Wael , Elsayed Talat Nesreen , Rozan Samah S. , Diab Rehab , Nashwan Abdulqadir J. , Motawea Karam R. , Alibrahim Hidar , Albuni Mhd Kutaiba , Battikh Elias , Sawaf Bisher , Shoib Sheikh
Published: December 2022

Background:

This paper aims to compare the effectiveness and safety of pembrolizumab and paclitaxel as a second line for patients with locally advanced gastroesophageal cancer.

Methods:

By searching PubMed, Scopus, Web of Science, and Ovid, any randomized clinical study comparing the effectiveness of paclitaxel and pembrolizumab as second-line therapy for advanced gastroesophageal cancer met the inclusion criteria. Only 3 of the 23 eligible studies that were fully reviewed were eligible for meta-analysis.

Results:

The total number of patients included in the meta-analysis was 635 in the pembrolizumab group and 596 in the paclitaxel group. In terms of objective response rate, there was no statistically significant difference between pembrolizumab and paclitaxel (relative risk = 1.10, 95% CI = 0.80–1.50, P = .57). Furthermore, Pembrolizumab and paclitaxel did not differ in terms of the rate of partial response statistically significantly from one another, according to the overall analysis (relative risk = 0.93, 95% CI = 0.57–1.52, P-value = .78).

Conclusion:

There is no difference between pembrolizumab and paclitaxel in objective response rate. The objective response rate shows that doctors may consider either treatment for patients with advanced gastroesophageal cancer, given the time to response is comparable across therapies.
“MURAL” model to predict bleeding from mural-based lesions in potential small bowel bleeding may improve diagnostic capability and decrease cost
Authors: Limsrivilai Julajak , Chaemsupaphan Thanaboon , Khamplod Sipawath , Srisajjakul Sitthipong , Kositamongkol Chayanis , Phisalprapa Pochamana , Maipang Kochakon , Kaosombatwattana Uayporn , Pausawasdi Nonthalee , Charatcharoenwitthaya Phunchai , Leelakusolvong Somchai , Pongprasobchai Supot
Published: December 2022

In potential small bowel bleeding, video capsule endoscopy (VCE) is excellent to detect mucosal lesions, while mural-based lesions are better detected by computed tomography enterography (CTE). A predictive tool to identify mural-based lesions should guide selecting investigations. In this retrospective study, we developed and validated the “MURAL” model based on logistic regression to predicts bleeding from mural-based lesions. Cost-effectiveness analysis comparing diagnostic strategy among VCE, CTE, and MURAL model was performed. Of 296 patients, 196 and 100 patients were randomly included in the derivative and validation cohorts, respectively. The MURAL model comprises 5 parameters: age, presence of atherosclerosis, chronic kidney disease, antiplatelet use, and serum albumin level. The area under the receiver operating characteristic curve was 0.778 and 0.821 for the derivative and validation cohorts, respectively. At a cutoff value of 24.2%, the model identified mural-based lesions with 70% sensitivity and 83% specificity in the validation cohort. Cost-effectiveness analysis revealed that application of the MURAL model demonstrated a comparable missed lesion rate but had a lower missed tumor rate, and lower cost compared to VCE strategy. The model for predicting mural-based lesions provide some guidance in investigative decision-making, which may improve diagnostic efficiency and reduce costs.
Association of low-density lipoprotein cholesterol levels with the risk of mortality and cardiovascular events: A meta-analysis of cohort studies with 1,232,694 participants
Authors: Peng Ke , Li Xingyue , Wang Zhen , Li Meiling , Yang Yongjian
Published: December 2022

Background:

Lowering elevated low-density lipoprotein cholesterol (LDL-C) is an important strategy to prevent cardiovascular disease (CVD), while some studies report low LDL-C increases all-cause mortality. Our study aimed to explore the appropriate low LDL-C level with the lower CVD risk but with no excess risk for all-cause mortality.

Methods:

PubMed, Embase, Cochrane Library, and Web of Science were searched until April 7, 2021. Twenty cohort studies with 1232,694 adults were obtained. Effect size index was evaluated using pooled relative risk (RR) with 95% confidence interval (CI). Heterogeneity was assessed using the Cochran’s Q test and I
2 statistic, and heterogeneity sources was investigated using meta-regression. Publication bias was assessed and sensitivity analysis was performed.

Results:

The risks of all-cause mortality (RR: 1.34, 95%CI: 1.00–1.80), CVD death (RR: 1.79, 95%CI: 1.26–2.54), CHD death (RR: 2.03, 95%CI: 1.36–3.03) were higher in LDL-C ≥ 160 mg/dL than LDL-C of 70–129 mg/dL. Both LDL-C of 130–159 mg/dL and ≥ 160 mg/dL were associated with higher CVD risk than LDL-C of 70–129 mg/dL, with RR of 1.26 (95%CI: 1.08–1.47) and 1.70 (95%CI: 1.35–2.14), respectively. Compared to LDL-C of 70–129 mg/dL, no association was found between LDL < 70 mg/dL and all-cause mortality and CVD events.

Conclusion:

Our results found LDL-C ≥ 130 mg/dL was associated with the higher risk of all-cause mortality and CVD risk, indicating that adults with high LDL-C should take interventions to regulate the LDL-C level lower than 130 mg/dL.
Effectiveness and safety of Baduanjin for schizophrenia: A protocol for systematic review and meta-analysis
Authors: Wu Haiyuan , Xue Kaiyuan , Peng Aineng , Chai Jianbo , Zhao Yonghou
Published: December 2022

Background:

The cause of schizophrenia is still unknown, the course of the disease is long and its onset is thought to be related to neurodevelopmental, genetic, and oxidative stress factors and so on. There is no means of cure. Typical drug therapy is effective in treating the acute stage of schizophrenia, while the impaired social and life functions of patients are often neglected. Baduanjin is a traditional Chinese physical and breathing exercise that not only strengthens the muscles, and moves the joints, but also exercises the will. Many studies have been reported in the study on the application of Baduanjin to schizophrenic patients to promote recovery, but no research systematically evaluates the therapeutic effects and safety of Baduanjin for schizophrenic patients. This study aims to systematically investigate the efficacy and safety of Baduanjin in the treatment of schizophrenic patients.

Methods:

Reports of randomized controlled trials (RCTs) on Baduanjin for schizophrenia will be searched in the following data sources, including 3 English databases（PubMed, EMBASE, Cochrane Library）and 4 Chinese databases（China National Knowledge Infrastructure, Chinese Biomedical Literature, Wanfang, and China Clinical Trials Registry Database）, and their publication time is restricted from the establishment of the database to October 1, 2022. Two reviewers will independently perform study selection, data extraction, and quality assessment. RevMan V.5.4 software will be used for meta-analysis. The protocol will be performed according to preferred reporting items for systematic reviews and meta-analysis protocols (PRISMA-P) guidelines.

Results:

The results will provide a systematic overview of the current evidence on the use of Baduanjin to treat schizophrenia.

Conclusion:

The conclusions of this study will help clarify whether Baduanjin is effective and safe for treating schizophrenia.
Sleep quality among different classes of heart failure patients in Jordan: A STROBE compliant cross-sectional study
Authors: Gharaibeh Besher , Al-Absi Ilham , Abuhammad Sawsan , Gharaibeh Monther , Jarrah Mohamad
Published: December 2022

Many researchers emphasize the importance of studying sleep quality among patients with heart failure (HF). Because of the importance of this topic, many studies have been conducted to address the different aspects of sleep-in various populations of patients with HF. The purposes of our study were: to assess the types of disturbances in sleep within the different classes of HF, and to assess whether there were differences in the levels of sleep quality and types of disturbances in sleep within the different classes in non-hospitalized Jordan patients with HF. Data were gathered from 2 cardiac clinics and 2 medical clinics at 3 Jordan hospitals. A minimum sample of 200 people was recruited to participate in this study based on these criteria and factors. The prevalence of low sleep quality and types of disturbances in sleep were increased with the increase in New York Heart Association class. Nearly 3 quarters of the study sample had poor sleep quality 73.5% (n = 147). Using a score of 5 as a cut point, 147 patients with HF in our study sample had poor sleep quality. The most common types in all classes were waking up for urination, waking in the middle of the night or early morning, waking up due to coughing and snoring, and difficulty falling asleep within 30 minutes. However, waking up due to feeling cold or hot were rarely reported in all classes of patients with HF. Poor sleep quality negatively affects the quality of life in patients with HF by decreasing physical cognitive and psychosocial performance in those patients. This is the first study in literature study sleep quality in the different New York Heart Association functional classes.