bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification of two novel lipid metabolism-related long non-coding RNAs (SNHG17 and LINC00837) as potential signatures for osteosarcoma prognosis and precise treatment
Authors: Tang Zhifang , Feng Hanzhen , Shu Longjun , Guo Minzheng , Qi Baochuang , Pu Luqiao , Shi Hongxin , Ren Junxiao , Li Chuan
Published: May 2023

Objective

Dysregulated lipid metabolism enhances the development and advancement of many cancers, including osteosarcoma (OS); however, the underlying mechanisms are still largely unknown. Therefore, this investigation aimed to elucidate novel potential lipid metabolism-related long non-coding RNAs (lncRNAs) that regulate OS development and provide novel signatures for its prognosis and precise treatment.

Materials and methods

The GEO datasets (GSE12865 and GSE16091) were downloaded and analyzed using R software packages. Immunohistochemistry (IHC) was used to evaluate protein levels in OS tissues while real-time qPCR was used to measure lncRNA levels, and MTT assays were used to assess OS cell viability.

Results

Two lipid metabolism-associated lncRNAs (LM-lncRNAs), small nucleolar RNA host gene 17 (SNHG17) and LINC00837, were identified as efficient and independent prognostic indicators for OS. In addition, further experiments confirmed that SNHG17 and LINC00837 were significantly elevated in OS tissues and cells than para-cancerous counterparts. Knockdown of SNHG17 and LINC00837 synergistically suppressed the viability of OS cells, whereas overexpression of the two lncRNAs promoted OS cell proliferation. Moreover, bioinformatics analysis was conducted to construct six novel SNHG17-microRNA-mRNA competing endogenous RNA (ceRNA) networks, and three lipid metabolism-associated genes (MIF, VDAC2, and CSNK2A2) were found to be abnormally upregulated in OS tissues, suggesting that they were potential effector genes of SNHG17.

Conclusion

In summary, SNHG17 and LINC00837 were found to promote OS cell malignancy, suggesting their use as ideal biomarkers for OS prognosis and treatment.
International practice patterns of dyslipidemia management in patients with chronic kidney disease under nephrology care: is it time to review guideline recommendations?
Authors: Calice-Silva Viviane , Muenz Daniel , Wong Michelle M. Y. , McCullough Keith , Charytan David , Reichel Helmut , Robinson Bruce , Stengel Benedicte , Massy Ziad A. , Pecoits-Filho Roberto ,   on behalf of CKDopps Investigators, Lopes Antonio , Combe Christian , Jacquelinet Christian , Massy Ziad , Duttlinger Johannes , Fliser Danilo , Lonnemann Gerhard , Wada Takashi , Yamagata Kunihiro , Pisoni Ron , Calice-Silva Viviane , Sesso Ricardo , Speyer Elodie , de Pinho Natalia Alencar , Asahi Koichi , Hoshino Junichi , Narita Ichiei , Perlman Rachel , Port Friedrich , Sukul Nidhi , Wong Michelle , Young Eric , Zee Jarcy
Published: May 2023

Background

In contrast to guidelines related to lipid therapy in other areas, 2012 Kidney Disease Improving Global Outcomes (KDIGO) guidelines recommend conducting a lipid profile upon diagnosis of chronic kidney disease (CKD) and treating all patients older than 50 years without defining a target for lipid levels. We evaluated multinational practice patterns for lipid management in patients with advanced CKD under nephrology care.

Methods

We analyzed lipid-lowering therapy (LLT), LDL- cholesterol (LDL-C) levels, and nephrologist-specified LDL-C goal upper limits in adult patients with eGFR < 60 ml/min from nephrology clinics in Brazil, France, Germany, and the United States (2014–2019). Models were adjusted for CKD stage, country, cardiovascular risk indicators, sex, and age.

Results

LLT treatment differed significantly by country, from 51% in Germany to 61% in the US and France (p = 0.002) for statin monotherapy. For ezetimibe with or without statins, the prevalence was 0.3% in Brazil to 9% in France (< 0.001). Compared with patients not taking lipid-lowering therapy, LDL-C was lower among treated patients (p < 0.0001) and differed significantly by country (p < 0.0001). At the patient level, the LDL-C levels and statin prescription did not vary significantly by CKD stage (p = 0.09 LDL-C and p = 0.24 statin use). Between 7—23% of untreated patients in each country had LDL-C ≥ 160 mg/dL. Only 7–17% of nephrologists believed that LDL-C should be < 70 mg/dL.

Conclusion

There is substantial variation in practice patterns regarding LLT across countries but not across CKD stages. Treated patients appear to benefit from LDL-C lowering, yet a significant proportion of hyperlipidemia patients under nephrologist care are not receiving treatment.
Three-port approach vs conventional laparoscopic radical cystectomy with orthotopic neobladder: a single-center retrospective study
Authors: Dai Shuxin , Liu Chang , Jiang Zhiwei , Teng Xiangyu , Yan Songbai , Xia Dian , Tuo Zhouting , Wang Xin , Wang Qi , Bi Liangkuan
Published: May 2023

Background

This study aimed to compare the clinical outcomes of patients who underwent three-port laparoscopic radical cystectomy (LRC) with orthotopic neobladder (ONB) and traditional five-port method.

Methods

From January 2017 to November 2020, 100 patients underwent LRC + ONB at a third-level grade A hospital.

Results

Our study included 55 patients who underwent three-port LRC and 45 patients who underwent the five-port method. There were no significant differences in perioperative data such as operation time (253.00 ± 43.89 vs. 259.07 ± 52.31 min, P = 0.530), estimated blood loss (EBL)(97.64 ± 59.44 vs. 106.67 ± 55.35 min, P = 0.438), day to flatus (2.25 ± 1.49 vs. 2.76 ± 1.77 days, P = 0.128), day to regular diet (7.07 ± 2.99 vs. 7.96 ± 3.32 days, P = 0.165), day to pelvic drain removal (9.58 ± 3.25 vs. 10.53 ± 3.80 days, P = 0.180), and hospital stay after operation (11.62 ± 3.72 vs. 11.84 ± 4.37 days, P = 0.780) between the two groups. The only significant difference was in the treatment cost (P = 0.035). Similarly, postoperative complications, quality of life, and tumor outcomes were not significantly different between the two groups (P > 0.05).

Conclusions

The three-port method is safe and feasible for patients suitable for traditional five-port LRC with an orthotopic neobladder.
Interactions between carnivore species: limited spatiotemporal partitioning between apex predator and smaller carnivores in a Mediterranean protected area
Authors: Ferretti Francesco , Oliveira Raquel , Rossa Mariana , Belardi Irene , Pacini Giada , Mugnai Sara , Fattorini Niccolò , Lazzeri Lorenzo
Published: May 2023

Background

There is need of information on ecological interactions that keystone species such as apex predators establish in ecosystems recently recolonised. Interactions among carnivore species have the potential to influence community-level processes, with consequences for ecosystem dynamics. Although avoidance of apex predators by smaller carnivores has been reported, there is increasing evidence that the potential for competitive-to-facilitative interactions is context-dependent. In a protected area recently recolonised by the wolf Canis lupus and hosting abundant wild prey (3 ungulate species, 20–30 individuals/km2, together), we used 5-year food habit analyses and 3-year camera trapping to (i) investigate the role of mesocarnivores (4 species) in the wolf diet; (ii) test for temporal, spatial, and fine-scale spatiotemporal association between mesocarnivores and the wolf.

Results

Wolf diet was dominated by large herbivores (86% occurrences, N = 2201 scats), with mesocarnivores occurring in 2% scats. We collected 12,808 carnivore detections over > 19,000 camera trapping days. We found substantial (i.e., generally ≥ 0.75, 0–1 scale) temporal overlap between mesocarnivores—in particular red fox—and the wolf, with no support for negative temporal or spatial associations between mesocarnivore and wolf detection rates. All the species were nocturnal/crepuscular and results suggested a minor role of human activity in modifying interspecific spatiotemporal partitioning.

Conclusions

Results suggest that the local great availability of large prey to wolves limited negative interactions towards smaller carnivores, thus reducing the potential for spatiotemporal avoidance. Our study emphasises that avoidance patterns leading to substantial spatiotemporal partitioning are not ubiquitous in carnivore guilds.
Novel evaluation of upper-limb motor performance after stroke based on normal reaching movement model
Authors: Moon James Hyungsup , Kim Jongbum , Hwang Yeji , Jang Sungho , Kim Jonghyun
Published: May 2023

Background

Upper-limb rehabilitation robots provide repetitive reaching movement training to post-stroke patients. Beyond a pre-determined set of movements, a robot-aided training protocol requires optimization to account for the individuals’ unique motor characteristics. Therefore, an objective evaluation method should consider the pre-stroke motor performance of the affected arm to compare one’s performance relative to normalcy. However, no study has attempted to evaluate performance based on an individual’s normal performance. Herein, we present a novel method for evaluating upper limb motor performance after a stroke based on a normal reaching movement model.

Methods

To represent the normal reaching performance of individuals, we opted for three candidate models: (1) Fitts’ law for the speed-accuracy relationship, (2) the Almanji model for the mouse-pointing task of cerebral palsy, and (3) our proposed model. We first obtained the kinematic data of healthy (n = 12) and post-stroke (n = 7) subjects with a robot to validate the model and evaluation method and conducted a pilot study with a group of post-stroke patients (n = 12) in a clinical setting. Using the models obtained from the reaching performance of the less-affected arm, we predicted the patients’ normal reaching performance to set the standard for evaluating the affected arm.

Results

We verified that the proposed normal reaching model identifies the reaching of all healthy (n = 12) and less-affected arm (n = 19; 16 of them showed an R2 > 0.7) but did not identify erroneous reaching of the affected arm. Furthermore, our evaluation method intuitively and visually demonstrated the unique motor characteristics of the affected arms.

Conclusions

The proposed method can be used to evaluate an individual’s reaching characteristics based on an individuals normal reaching model. It has the potential to provide individualized training by prioritizing a set of reaching movements.
Evolution of the major alcohol companies key global policy vehicle through the prism of tax records 2011–19
Authors: Lesch Matthew , McCambridge Jim
Published: May 2023

Background

Important insights have been generated into the nature of the activities of the International Center for Alcohol Policies (ICAP). Its successor, the International Alliance for Responsible Drinking (IARD) is less well understood. This study aims to rectify evidence limitations on the political activities of the alcohol industry at the global level.

Methods

Internal Revenue Service filings were examined for ICAP and IARD each year between 2011 and 2019. Data were triangulated with other sources to establish what could be gleaned on the internal workings of these organisations.

Results

The stated purposes of ICAP and IARD are near identical. The main declared activities were similar for both organisations and comprised public affairs/policy, corporate social responsibility, science/research and communications. Both organisations work extensively with external actors and it has become possible more recently to identify the main contractors supplying services to IARD.

Discussion

This study sheds light on the political activities of the alcohol industry at the global level. It suggests that the evolution of ICAP into IARD has not been accompanied by shifts in the organisation and activities of the collaborative efforts of the major alcohol companies.

Conclusion

Alcohol and global health research and policy agendas should give careful attention to the sophisticated nature of industry political activities.
Capacity building through comprehensive implementation research training and mentorship: an approach for translating knowledge into practice
Authors: Asampong Emmanuel , Kamau Edward Mberu , Teg-Nefaah Tabong Philip , Glozah Franklin , Nwameme Adanna , Opoku-Mensah Kwabena , Amankwa Belynda , Dako-Gyeke Phyllis
Published: May 2023

Background

Implementation research (IR) is increasingly gaining popularity as the act of carrying an intention into effect. It is thus an important approach to addressing individual practices, policies, programmes and other technologies to solving public health problems. Low- and middle-income countries (LMICs) continue to experience public health problems which could be addressed using implementation research. These countries however fall behind prioritizing implementation research due to the disorganized approach used to providing knowledge about the value and scope of implementation research. This paper seeks to explain steps taken to resolve this by capacity strengthening activities through a comprehensive implementation research training and mentorship programme which was informed by needs assessment.

Methods

The roll-out of the comprehensive implementation research training and mentorship was done in phases, including engaging the implementation research community through TDR Global, competency building for programme officers and ethical review board/committee members, and practical guidance to develop an implementation research proposal. The Bloom taxonomy guided the training whilst the Kirkpatrick Model was used for the evaluation of the effectiveness of the capacity building.

Results

The findings identified critical areas of mentors and how mentorship should be structured and the most effective ways of delivering mentorship. These findings were used to develop a mentorship guide in IR. The mentorship guidance is to be used as a check-tool for mentoring participants during trainings as part of the package of resources in implementation research. It is also to be used in equipping review board members with knowledge on ethical issues in implementation research.

Conclusion

The approach for providing comprehensive implementation research training and mentorship for programme personnel has provided an opportunity for both potential mentors and mentees to make inputs into developing a mentorship guidance for LMICs. This guidance would help address mentorship initiation and implementation challenges in IR.
Ornamental plants associated with Buddhist figures in China
Authors: Xu Xiaodan , Yan Chengmin , Ma Zhiying , Wang Qi , Zhao Jie , Zhang Rui , He Luyao , Zheng Wei
Published: May 2023

Background

In China, many ornamental plants associated with Buddhist figures, including the Sakyamuni, Bodhisattva, and Arhat, were grown and worshiped because of their cultural and religious significance. However, the systematic collation and ethnobotanical information about these culturally important plants have yet to be fully understood.

Methods

Online information was collected from 93 e-commercial platforms for ornamental plants all over China. Field sampling was conducted in 16 ornamental markets and 163 Buddhist temples using key informant interviews and participatory observation with traders, tourists, and local disciples. The types, distributions, and associated characteristics of the screened plants were summarized and the evolving characteristics of these ornamental plants were analyzed.

Results

A total of 60 ornamental plants, including six varieties and one subspecies, were screened, of which 43 species were associated with Sakyamuni, 13 with Bodhisattva, and four with Arhat. Among the 60 species, three were regarded as the Asoka tree related to Buddha's birth, ten as the Bodhi tree connected to Buddha's enlightenment, three as the Sal tree associated with Buddha's nirvana, nine were related to Buddha’s head, belly, or hand, and 18 were connected with Buddha as lotus throne, bamboo monastery, or Bodhi beads. The evolving characteristics of these ornamental plants primarily constituted the substitution of the original plants by similar native plant species, followed by the introduced species with comparable morphology to the Buddhist figures.

Conclusions

People grow ornamental plants associated with Buddhist figures to reflect their love and praise for plants and Buddha. The association between the ornamental plants and Buddhist figures will aid the inheritance of Buddhist culture and promote ornamental plants in the commercial market. Thus, the ethnobotany of ornamental plants associated with Buddhist figures can serve as a basis for future investigation of modern Buddhist culture.
“UFO procedure” for massive aortic and mitral annular calcification involving left atrial and ventricular myocardium: a potential radical solution
Authors: Wert Leonhard , Pasic Miralem , Heck Roland , Van Praet Karel M. , Kempfert Jörg , Jacobs Stephan , Falk Volkmar
Published: May 2023

Background

The “UFO procedure” was initially developed as a surgical option to enlarge the aortic annulus in patients requiring valve replacement. This technique can be employed to treat extensive endocarditis located in the intervalvular fibrous body (IVFB). One of the indications for a "UFO procedure" is massive aortic and mitral valve calcification. It is a challenging surgical procedure with a high risk of intraoperative complications.

Case summary

We present a 76-year-old male patient with massive aortic and mitral valve calcification involving the left atrium, the left ventricle and the left ventricular outflow tract. Both valves exhibited severe stenosis and moderate to severe regurgitation. The left ventricle was hypertrophic and the left ventricular ejection fraction was > 55%. The patient was prediagnosed with persistent atrial fibrillation. The risk of death following heart surgery (EuroSCORE II) was calculated as 9.21%. We successfully performed a so-called “UFO procedure” including replacement of both valves without annular decalcification to avoid atrioventricular dehiscence. We enlarged the IVFB and replaced the non-coronary sinus of Valsalva with doubled bovine pericardium. The left ventricular outflow tract was decalcified. The patient was transferred to a local hospital on the 13th postoperative day.

Conclusion

Successful surgical treatment to this extent was demonstrated for the first time. Due to the high perioperative mortality, the surgical treatment of patients with this constellation would be refused in most cases. In our patient, the preoperative imaging showed extreme calcification of both valves and the surrounding myocardium. Excellent preoperative planning and a highly experienced surgical team is necessary.
Integrated proteogenomic characterization reveals an imbalanced hepatocellular carcinoma microenvironment after incomplete radiofrequency ablation
Authors: Shi Zheng-Rong , Duan Yu-Xin , Cui Fang , Wu Zhong-Jun , Li Mao-Ping , Song Pei-Pei , Peng Qi-Ling , Ye Wen-Tao , Yin Kun-Li , Kang Mei-Qing , Yu Yan-Xi , Yang Jian , Tang Wei , Liao Rui
Published: May 2023

Background

Efforts to precisely assess tumor-specific T-cell immune responses still face major challenges, and the potential molecular mechanisms mediating hepatocellular carcinoma (HCC) microenvironment imbalance after incomplete radiofrequency ablation (iRFA) are unclear. This study aimed to provide further insight into the integrated transcriptomic and proteogenomic landscape and identify a new target involved in HCC progression following iRFA.

Methods

Peripheral blood and matched tissue samples were collected from 10 RFA-treated HCC patients. Multiplex immunostaining and flow cytometry were used to assess local and systemic immune responses. Differentially expressed genes (DEGs) and differentially expressed proteins (DEPs) were explored via transcriptomic and proteogenomic analyses. Proteinase-3 (PRTN3) was identified in these analyses. And then, the ability of PRTN3 to predict overall survival (OS) was assessed in 70 HCC patients with early recurrence after RFA. In vitro CCK-8, wound healing and transwell assays were conducted to observe interactions between Kupffer cells (KCs) and HCC cells induced by PRTN3. The protein levels of multiple oncogenic factors and signaling pathway components were detected by western blotting. A xenograft mouse model was built to observe the tumorigenic effect of PRTN3 overexpression on HCC.

Results

Multiplex immunostaining revealed no immediate significant change in local immune cell counts in periablational tumor tissues after 30 min of iRFA. Flow cytometry showed significantly increased levels of CD4+ T cells, CD4+CD8+ T cells, and CD4+CD25+CD127− Tregs and significantly decreased the levels of CD16+CD56+ natural killer cells on day 5 after cRFA (p < 0.05). Transcriptomics and proteomics revealed 389 DEGs and 20 DEPs. Pathway analysis showed that the DEP-DEGs were mainly enriched in the immunoinflammatory response, cancer progression and metabolic processes. Among the DEP-DEGs, PRTN3 was persistently upregulated and closely associated with the OS of patients with early recurrent HCC following RFA. PRTN3 expressed in KCs may affect the migration and invasion of heat stress-treated HCC cells. PRTN3 promotes tumor growth via multiple oncogenic factors and the PI3K/AKT and P38/ERK signaling pathways.

Conclusions

This study provides a comprehensive overview of the immune response and transcriptomic and proteogenomic landscapes of the HCC milieu induced by iRFA, revealing that PRTN3 promotes HCC progression after iRFA.

Trial registration

ChiCTR2200055606, http://www.chictr.org.cn/showproj.aspx?proj=32588.
Prevalence and risk factors of significant persistent pain symptoms after critical care illness: a prospective multicentric study
Authors: Bourdiol Alexandre , Legros Vincent , Vardon-Bounes Fanny , Rimmele Thomas , Abraham Paul , Hoffmann Clément , Dahyot-Fizelier Claire , Jonas Maud , Bouju Pierre , Cirenei Cédric , Launey Yoann , Le Gac Gregoire , Boubeche Samia , Lamarche Edouard , Huet Olivier , Bezu Lucillia , Darrieussecq Julie , Szczot Magdalena , Delbove Agathe , Schmitt Johan , Lasocki Sigismond , Auchabie Johann , Petit Ludivine , Kuhn-Bougouin Emmanuelle , Asehnoune Karim , Ingles Hugo , Roquilly Antoine , Cinotti Raphaël ,   the ALGO-RÉA study group,   the Atlanréa Group, Yavchitz Amélie , Sigault Stéphanie , Mazereaud Aurélien , Bezu Lucilia , Léger Maxime , Evain Jean-Noël ,   the Société Française d’Anesthésie-Réanimation–SFAR Research Network
Published: May 2023

Background

Prevalence, risk factors and medical management of persistent pain symptoms after critical care illness have not been thoroughly investigated.

Methods

We performed a prospective multicentric study in patients with an intensive care unit (ICU) length of stay ≥ 48 h. The primary outcome was the prevalence of significant persistent pain, defined as a numeric rating scale (NRS) ≥ 3, 3 months after admission. Secondary outcomes were the prevalence of symptoms compatible with neuropathic pain (ID-pain score > 3) and the risk factors of persistent pain.

Results

Eight hundred fourteen patients were included over a 10-month period in 26 centers. Patients had a mean age of 57 (± 17) years with a SAPS 2 score of 32 (± 16) (mean ± SD). The median ICU length of stay was 6 [4–12] days (median [interquartile]). At 3 months, the median intensity of pain symptoms was 2 [1–5] in the entire population, and 388 (47.7%) patients had significant pain. In this group, 34 (8.7%) patients had symptoms compatible with neuropathic pain. Female (Odds Ratio 1.5 95% CI [1.1–2.1]), prior use of anti-depressive agents (OR 2.2 95% CI [1.3–4]), prone positioning (OR 3 95% CI [1.4–6.4]) and the presence of pain symptoms on ICU discharge (NRS ≥ 3) (OR 2.4 95% CI [1.7–3.4]) were risk factors of persistent pain. Compared with sepsis, patients admitted for trauma (non neuro) (OR 3.5 95% CI [2.1–6]) were particularly at risk of persistent pain. Only 35 (11.3%) patients had specialist pain management by 3 months.

Conclusions

Persistent pain symptoms were frequent in critical illness survivors and specialized management remained infrequent. Innovative approaches must be developed in the ICU to minimize the consequences of pain.

Trial registration. NCT04817696. Registered March 26, 2021.
Diagnostic accuracy of point-of-care ultrasound for shock: a systematic review and meta-analysis
Authors: Yoshida Takuo , Yoshida Takuya , Noma Hisashi , Nomura Takeshi , Suzuki Akihiro , Mihara Takahiro
Published: May 2023

Background

 Circulatory failure is classified into four types of shock (obstructive, cardiogenic, distributive, and hypovolemic) that must be distinguished as each requires a different treatment. Point-of-care ultrasound (POCUS) is widely used in clinical practice for acute conditions, and several diagnostic protocols using POCUS for shock have been developed. This study aimed to evaluate the diagnostic accuracy of POCUS in identifying the etiology of shock.

Methods

We conducted a systematic literature search of MEDLINE, Cochrane Central Register of Controlled Trials, Embase, Web of Science, Clinicaltrial.gov, European Union Clinical Trials Register, WHO International Clinical Trials Registry Platform, and University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) until June 15, 2022. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and assessed study quality using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Meta-analysis was conducted to pool the diagnostic accuracy of POCUS for each type of shock. The study protocol was prospectively registered in UMIN-CTR (UMIN 000048025).

Results

Of the 1553 studies identified, 36 studies were full-text reviewed, and 12 studies with 1132 patients were included in the meta-analysis. Pooled sensitivity and specificity were 0.82 [95% confidence interval (CI) 0.68–0.91] and 0.98 [95% CI 0.92–0.99] for obstructive shock, 0.78 [95% CI 0.56–0.91] and 0.96 [95% CI 0.92–0.98] for cardiogenic shock, 0.90 [95% CI 0.84–0.94] and 0.92 [95% CI 0.88–0.95] for hypovolemic shock, and 0.79 [95% CI 0.71–0.85] and 0.96 [95% CI 0.91–0.98] for distributive shock, respectively. The area under the receiver operating characteristic curve for each type of shock was approximately 0.95. The positive likelihood ratios for each type of shock were all greater than 10, especially 40 [95% CI 11–105] for obstructive shock. The negative likelihood ratio for each type of shock was approximately 0.2.

Conclusions

 The identification of the etiology for each type of shock using POCUS was characterized by high sensitivity and positive likelihood ratios, especially for obstructive shock.
HELP — Heidelberg decision aid for lung cancer patients: a randomized controlled clinical trial
Authors: Deis Nicole , Unsöld Laura , Siegle Anja , Krisam Johannes , Thomas Michael , Villalobos Matthias
Published: May 2023

Background

Shared decision-making (SDM), which increases the patient’s well-being, adherence, and success of treatment, is becoming increasingly important in medicine and especially in oncology. To empower patients to participate more actively in consultations with their physicians decision aids have been developed. In non-curative settings, such as the treatment of advanced lung cancer, decisions differ substantially from the curative setting, as uncertain gains in terms of survival outcomes and quality of life have to be weighed against the severe side effects of treatment regimens. There is still a lack of tools developed and implemented for such specific settings in cancer therapy that support shared decision-making. The aim of our study is to evaluate the effectiveness of the HELP decision aid.

Methods

The HELP-study is designed as a randomized, controlled, open monocenter trial with two parallel groups. The intervention consists of the use of the HELP decision aid brochure, accompanied by a decision coaching session. The primary endpoint is clarity of personal attitude as operationalized by the Decisional Conflict Scale (DCS) after the decision coaching. Randomization will be performed as stratified block randomization according to the characteristic of preferred decision-making at baseline with a 1:1 allocation.

The participants in the control group get usual care, i.e., the doctor-patient conversation takes place without preliminary coaching and deliberation about their preferences and goals.

Discussion

Developing decision aids (DA) for (lung) cancer patients with limited prognosis should empower patients to address these aspects and include information about “Best Supportive Care” as a treatment option. Using and implementing the decision aid HELP can not only give patients the possibility to include their personal wishes and values in the decision-making process, but also raise the awareness of shared decision-making itself among these patients and their physicians.

Trial registration

German Clinical Trial Register DRKS00028023. Registered on 8 February 2022.
Ultrasound detected increase in optic disk height to identify elevated intracranial pressure: a systematic review
Authors: Ghanem Ghadi , Haase David , Brzezinski Agatha , Ogawa Rikke , Asachi Parsa , Chiem Alan
Published: May 2023

Background

Elevated intracranial pressure (eICP) is a serious medical emergency that requires prompt identification and monitoring. The current gold standards of eICP detection require patient transportation, radiation, and can be invasive. Ocular ultrasound has emerged as a rapid, non-invasive, bedside tool to measure correlates of eICP. This systematic review seeks to explore the utility of ultrasound detected optic disc elevation (ODE) as an ultrasonographic finding of eICP and to study its sensitivity and specificity as a marker of eICP.

Methods

This systematic review followed the preferred reporting items for systematic reviews and meta-analyses guidelines. We systematically searched PubMed, EMBASE, and Cochrane Central for English articles published before April 2023; yielding 1,919 total citations. After eliminating duplicates, and screening the records, we identified 29 articles that addressed ultrasonographically detected ODE.

Results

The 29 articles included a total of 1249 adult and pediatric participants. In patients with papilledema, the mean ODE ranged between 0.6 mm and 1.2 mm. Proposed cutoff values for ODE ranged between 0.3 mm and 1 mm. The majority of studies reported a sensitivity between 70 and 90%, and specificity ranged from 69 to 100%, with a majority of studies reporting a specificity of 100%.

Conclusions

ODE and ultrasonographic characteristics of the optic disc may aid in differentiating papilledema from other conditions. Further research on ODE elevation and its correlation with other ultrasonographic signs is warranted as a means to increase the diagnostic accuracy of ultrasound in the setting of eICP.
Imaging quality of an artificial intelligence denoising algorithm: validation in 68Ga PSMA-11 PET for patients with biochemical recurrence of prostate cancer
Authors: Margail Charles , Merlin Charles , Billoux Tommy , Wallaert Maxence , Otman Hosameldin , Sas Nicolas , Molnar Ioana , Guillemin Florent , Boyer Louis , Guy Laurent , Tempier Marion , Levesque Sophie , Revy Alban , Cachin Florent , Chanchou Marion
Published: May 2023

Background

68 Ga-PSMA PET is the leading prostate cancer imaging technique, but the image quality remains noisy and could be further improved using an artificial intelligence-based denoising algorithm. To address this issue, we analyzed the overall quality of reprocessed images compared to standard reconstructions. We also analyzed the diagnostic performances of the different sequences and the impact of the algorithm on lesion intensity and background measures.

Methods

We retrospectively included 30 patients with biochemical recurrence of prostate cancer who had undergone 68 Ga-PSMA-11 PET-CT. We simulated images produced using only a quarter, half, three-quarters, or all of the acquired data material reprocessed using the SubtlePET® denoising algorithm. Three physicians with different levels of experience blindly analyzed every sequence and then used a 5-level Likert scale to assess the series. The binary criterion of lesion detectability was compared between series. We also compared lesion SUV, background uptake, and diagnostic performances of the series (sensitivity, specificity, accuracy).

Results

VPFX-derived series were classified differently but better than standard reconstructions (p < 0.001) using half the data. Q.Clear series were not classified differently using half the signal. Some series were noisy but had no significant effect on lesion detectability (p > 0.05). The SubtlePET® algorithm significantly decreased lesion SUV (p < 0.005) and increased liver background (p < 0.005) and had no substantial effect on the diagnostic performance of each reader.

Conclusion

We show that the SubtlePET® can be used for 68 Ga-PSMA scans using half the signal with similar image quality to Q.Clear series and superior quality to VPFX series. However, it significantly modifies quantitative measurements and should not be used for comparative examinations if standard algorithm is applied during follow-up.
How to improve the efficiency and the safety of real-time ultrasound-guided central venous catheterization in 2023: a narrative review
Authors: Boulet Nicolas , Muller Laurent , Rickard Claire M , Lefrant Jean-Yves , Roger Claire
Published: May 2023

Central venous catheterization (CVC) is a frequent procedure, practiced by intensivists, anesthesiologists and advanced practice nurses in intensive care units and operative rooms. To reduce CVC-associated morbidity, it is essential to strive for best practices, based on the latest evidence. This narrative review aims to synthesize current knowledge on evidence-based best practices for CVC that improve the use and feasibility of real-time ultrasound-guided insertion procedures. Optimization of the vein puncture technique and the development of new technologies are discussed to reinforce the use of the subclavian vein catheterization as first choice. The search for alternative site of insertions, without increasing infectious and thrombotic risks, deserves further research.
Global prevalence of drug-resistant tuberculosis: a systematic review and meta-analysis
Authors: Salari Nader , Kanjoori Amir Hossein , Hosseinian-Far Amin , Hasheminezhad Razie , Mansouri Kamran , Mohammadi Masoud
Published: May 2023

Background

Tuberculosis is a bacterial infectious disease, which affects different parts of a human body, mainly lungs and can lead to the patient’s death. The aim of this study is to investigate the global prevalence of drug-resistant tuberculosis using a systematic review and meta-analysis.

Methods

In this study, the PubMed, Scopus, Web of Science, Embase, ScienceDirect and Google Scholar repositories were systematically searched to find studies reporting the global prevalence of drug-resistant tuberculosis. The search did not entail a lower time limit, and articles published up until August 2022 were considered. Random effects model was used to perform the analysis. The heterogeneity of the studies was examined with the I2 test. Data analysis was conducted within the Comprehensive Meta-Analysis software.

Results

In the review of 148 studies with a sample size of 318,430 people, the I2 index showed high heterogeneity (I2 = 99.6), and accordingly random effects method was used to analyze the results. Publication bias was also examined using the Begg and Mazumdar correlation test which indicated the existence of publication bias in the studies (P = 0.008). According to our meta-analysis, the global pooled prevalence of multi-drug resistant TB is 11.6% (95% CI: 9.1–14.5%).

Conclusions

The global prevalence of drug-resistant tuberculosis was found to be very high, thus health authorities should consider ways to control and manage the disease to prevent a wider spread of tuberculosis and potentially subsequent deaths.
Promoting self-regulated learning, autonomy, and self-efficacy of EFL learners through authentic assessment in EFL classrooms
Authors: Ismail Sayed M. , Nikpoo Iman , Prasad K. D. V.
Published: May 2023

The present research tried to prompt self-regulated learning, autonomy, and self-efficacy of EFL learners through authentic assessment in Iranian EFL classrooms. To do so, 57 Iranian EFL learners were chosen and assigned to two equal groups; the Experimental Group (CG) and the Control Group (CG). Then, three questionnaires were administered to assess the respondents’ self-regulated learning, autonomy, and self-efficacy before doing the treatment. After that, the EG received the treatment via using authentic assessments whereas the CG received the instruction through non-authentic assessments. After teaching 15 English passages to both groups, three post-tests were administered to them to determine the effects of the treatment on their self-regulated learning, autonomy, and self-efficacy. Lastly, the attitude questionnaire was given to the EG students to assess their attitudes toward implementing authentic assessments in EFL classes. The outcomes of ANCOVA revealed that there were significant differences between the post-tests of the EG and the CG. The results displayed that the EG noticeably outdid the CG in self-regulated learning, autonomy, and self-efficacy post-tests. In addition, the results showed that the EG held a positive attitude toward using authentic assessment in EFL classes. It can be concluded that applying authentic assessment in EFL classes can bring about constructive impacts for EFL learners. The findings of this investigation can be extremely valuable for EFL teachers and material designers to consider the impacts of authentic assessments and invest more in using these sorts of assessments.
Sucrose metabolism analysis in a high sucrose sugarcane mutant clone at a mature stage in contrast to low sucrose parental clone through the transcriptomic approach
Authors: Khan Qaisar , Qin Ying , Guo Dao-Jun , Chen Jiao-Yun , Zeng Xu-Peng , Mahmood Amir , Yang Li-Tao , Liang Qiang , Song Xiu-Peng , Xing Yong-Xiu , Li Yang-Rui
Published: May 2023

Background

The significance of sugarcane as a major crop is due to the production of sucrose and a significant source of ethanol. Sucrose phosphate synthase (SPS), Sucrose synthase (SuSy), and cell wall invertase (CWIN) genes regulate sucrose metabolism and accumulation in high sucrose sugarcane; such genes are significant for manipulating sucrose content. The current study explored the genes associated with sucrose metabolism and accumulation in a high sucrose sugarcane mutant clone GXB9 compared to its low sucrose parental clone B9.

Results

A total of 100, 262 differentially expressed genes were obtained, and 69, 637 (69.46%) got annotation in public databases COG, GO, KEGG, KOG, Pfam, eggNOG, NR, and Swiss-Prot. The SPS5 gene was significantly up-regulated in the maturing internodes of GXB9 and downregulated in B9. The SuSy and CWIN genes were up-regulated in the immature internodes; however, no expression was found in the maturing internodes of GXB9. The genes involved in trehalose synthesis were downregulated in GXB9 while up-regulated in B9. The cellulose synthase (CeS) genes were significantly up-regulated in the immature internodes than in maturing internodes of GXB9.

Conclusions

The key finding of this research suggests that the SPS5 gene has a predominant role in enhancing the sucrose accumulation ability of GXB9. No expression of SuSy and CWIN genes in maturing internodes and downregulation of trehalose genes in GXB9 may also have contributed to the higher sucrose accumulation in the stalk of high sucrose mutant. The current finding is a source for sugarcane breeding, particularly improving sucrose content.

Graphical Abstract
A systematic review and meta-analysis on the radiation dose of computed tomography in hybrid nuclear medicine imaging
Authors: Verfaillie Gwenny , Franck Caro , De Crop An , Beels Laurence , D’Asseler Yves , Bacher Klaus
Published: May 2023

Background

While diagnostic reference levels (DRLs) are well-established for the radiopharmaceutical part, published DRLs for the CT component of positron emission tomography/computed tomography (PET/CT) and single photon emission computed tomography/computed tomography (SPECT/CT) are limited. This systematic review and meta-analysis provides an overview of the different objectives of CT in hybrid imaging and summarizes reported CT dose values for the most common PET/CT and SPECT/CT examinations. Also, an overview of already proposed national DRLs is given.

Methods

A systematic literature search was performed to identify original articles reporting CT dose index volume (CTDIvol), dose-length product (DLP) and/or national DRLs for the most frequently performed PET/CT and/or SPECT/CT examinations. Data were grouped according to the clinical objective: diagnostic (D-CT), anatomical localisation (AL-CT) or attenuation correction (AC-CT) CT. Random-effects meta-analyses were conducted.

Results

Twenty-seven articles were identified of which twelve reported national DRLs. For brain and tumour PET/CT imaging, CTDIvol and DLP values were higher for a D-CT (brain: 26.7 mGy, 483 mGy cm; tumour: 8.8 mGy, 697 mGy cm) than for an AC/AL-CT (brain: 11.3 mGy, 216 mGy cm; tumour: 4.3 mGy, 419 mGy cm). Similar conclusions were found for bone and parathyroid SPECT/CT studies: D-CT (bone: 6.5 mGy, 339 mGy cm; parathyroid: 15.1 mGy, 347 mGy cm) results in higher doses than AL-CT (bone: 3.8 mGy, 156 mGy cm; parathyroid: 4.9 mGy, 166 mGy cm). For cardiac (AC-CT), mIBG/octreotide, thyroid and post-thyroid ablation (AC/AL-CT) SPECT/CT pooled mean CTDIvol (DLP) values were 1.8 mGy (33 mGy cm), 4.6 mGy (208 mGy cm), 3.1 mGy (105 mGy cm) and 4.6 mGy (145 mGy cm), respectively. For all examinations, high variability in nuclear medicine practice was observed.

Conclusion

The large variation in CT dose values and national DRLs highlights the need for optimisation in hybrid imaging and justifies the clinical implementation for nuclear medicine specific DRLs.
Bones and all: a new critically endangered Pantepui species of Stefania (Anura: Hemiphractidae) and a new osteological synapomorphy for the genus
Authors: Kok Philippe J. R.
Published: May 2023

The hemiphractid frog genusStefaniais one of the many ancient (near-) endemic lineages of vertebrates inhabiting the biodiverse Pantepui biogeographical region in the Guiana Shield Highlands of northern South America—the famous “Lost World” of Arthur Conan Doyle. Previous molecular analyses of the genusStefaniahave indicated that species boundaries and phylogenetic relationships are often incongruent with morphological traits in that clade. A substantial number of “taxonomically cryptic” species, often microendemic, remain to be described. This is notably the case for an isolated population from the summit of Wei-Assipu-tepui, a small table-top mountain at the border between Guyana and Brazil. That population was previously known asStefaniasp. 6 and belongs to theS. riveroiclade. The new species is phylogenetically distinct, but phenotypically extremely similar toS. riveroi, a taxon found only on the summit of Yuruaní-tepui in Venezuela and recovered as sister to all the other known species in theS. riveroiclade. The new taxon is described based on morphology and osteology. Data about genetic divergences within theS. riveroiclade are provided. A new synapomorphy for the genusStefaniais proposed: the presence of a distal process on the third metacarpal. Amended definitions are offered for the three other species in theS. riveroiclade (S. ayangannae,S. coxi,S. riveroi). The new species should be listed as Critically Endangered according to IUCN criteria.
Bone regeneration in inflammation with aging and cell-based immunomodulatory therapy
Authors: Kushioka Junichi , Chow Simon Kwoon-Ho , Toya Masakazu , Tsubosaka Masanori , Shen Huaishuang , Gao Qi , Li Xueping , Zhang Ning , Goodman Stuart B.
Published: May 2023

Aging of the global population increases the incidence of osteoporosis and associated fragility fractures, significantly impacting patient quality of life and healthcare costs. The acute inflammatory reaction is essential to initiate healing after injury. However, aging is associated with “inflammaging”, referring to the presence of systemic low-level chronic inflammation. Chronic inflammation impairs the initiation of bone regeneration in elderly patients. This review examines current knowledge of the bone regeneration process and potential immunomodulatory therapies to facilitate bone healing in inflammaging.

Aged macrophages show increased sensitivity and responsiveness to inflammatory signals. While M1 macrophages are activated during the acute inflammatory response, proper resolution of the inflammatory phase involves repolarizing pro-inflammatory M1 macrophages to an anti-inflammatory M2 phenotype associated with tissue regeneration. In aging, persistent chronic inflammation resulting from the failure of M1 to M2 repolarization leads to increased osteoclast activation and decreased osteoblast formation, thus increasing bone resorption and decreasing bone formation during healing.

Inflammaging can impair the ability of stem cells to support bone regeneration and contributes to the decline in bone mass and strength that occurs with aging. Therefore, modulating inflammaging is a promising approach for improving bone health in the aging population. Mesenchymal stem cells (MSCs) possess immunomodulatory properties that may benefit bone regeneration in inflammation. Preconditioning MSCs with pro-inflammatory cytokines affects MSCs’ secretory profile and osteogenic ability. MSCs cultured under hypoxic conditions show increased proliferation rates and secretion of growth factors. Resolution of inflammation via local delivery of anti-inflammatory cytokines is also a potential therapy for bone regeneration in inflammaging. Scaffolds containing anti-inflammatory cytokines, unaltered MSCs, and genetically modified MSCs can also have therapeutic potential. MSC exosomes can increase the migration of MSCs to the fracture site and enhance osteogenic differentiation and angiogenesis.

In conclusion, inflammaging can impair the proper initiation of bone regeneration in the elderly. Modulating inflammaging is a promising approach for improving compromised bone healing in the aging population.
Advances in the Management of Menopausal Symptoms, Fertility Preservation, and Bone Health for Women With Breast Cancer on Endocrine Therapy
Authors: Lambertini Matteo , Arecco Luca , Woodard Terri Lynn , Messelt Audrey , Rojas Kristin E.
Published: May 2023

In patients with hormone receptor–positive early-stage breast cancer, adjuvant endocrine treatment administered for up to 5-10 years after diagnosis significantly reduces the risk of recurrence and death. However, this benefit comes with the cost of short- and long-term side effects that may negatively affect patients' quality of life (QoL) and treatment adherence. Among them, the prolonged estrogen suppression associated with the use of adjuvant endocrine therapy in both premenopausal and postmenopausal women can induce life-altering menopausal symptoms, including sexual dysfunction. Moreover, a decrease in bone mineral density and an increased risk of fractures should be carefully considered and prevented whenever indicated. For young women diagnosed with hormone receptor–positive breast cancer with unfulfilled childbearing plans, several challenges should be addressed to manage their fertility and pregnancy-related concerns. Proper counseling and proactive management of these issues are critical components of survivorship and should be pursued from diagnosis through the breast cancer care continuum. This study aims to provide an updated overview of the available approaches for improving the QoL of patients with breast cancer receiving estrogen deprivation therapy, focusing on advances in the management of menopausal symptoms, including sexual dysfunction, fertility preservation, and bone health.