bluuebunny/crossref_metadata_2025 huggingface dataset:
Almeida Bible—Keeping a Heritage Alive: The Historical Path and Current Challenges of a Seventeenth-Century Translation
Authors: Cavaco Timóteo
Published: April 2023

Until the seventeenth century, no Portuguese person or any other individual had either planned or accomplished a full translation of the Bible into Portuguese. As research has shown, there is a significant quantity of partial Bible texts in Portuguese during the late medieval period, but it was João Ferreira de Almeida (ca. 1628–1691) who undertook the “first common translation … of the Sacred Books.” Since the mid-eighteenth century, the “Almeida Bible” has been published in different versions, first in the Far East—Java and India—and, from the early nineteenth century, in Europe and America. This paper focuses on the historical context in which the Bible translation undertaken by João Ferreira de Almeida emerged and the main characteristics of the translation. It also provides a historical analysis of the revisions that the initial texts underwent in their different chronological and geographical environments, and ends with suggestions for a new revision of the European Portuguese version of the Almeida Bible.
Consultant-Checking Oral Bible Stories: A Case Study
Authors: Komen Erwin R. , Kim Roman
Published: April 2023

Oral Bible Stories (OBS) are retellings of stories that occur in the Bible. They create a bridge between the world of the Bible and the world of the receptor language, incorporating, excluding, and changing parts of stories as found in the Bible by their very design. Our first encounters as consultants with these stories left us wondering about the borders: What sort of changes are to be avoided and what sort are beneficial? Taking as a starting point the case study of an OBS consultant-check of a language in the Caucasus, this paper presents guidelines for omissions and additions.
Recording the ethical provenance of data and automating data stewardship
Authors: Bernier Alexander , Raven-Adams Maili , Zaccagnini Davide , Knoppers Bartha M.
Published: April 2023

Health organisations use numerous different mechanisms to collect biomedical data, to determine the applicable ethical, legal and institutional conditions of use, and to reutilise the data in accordance with the relevant rules. These methods and mechanisms differ from one organisation to another, and involve considerable specialised human labour, including record-keeping functions and decision-making committees. In reutilising data at scale, however, organisations struggle to meet demands for data interoperability and for rapid inter-organisational data exchange due to reliance on legacy paper-based records and on the human-initiated administration of accompanying permissions in data. The adoption of permissions-recording, and permissions-administration tools that can be implemented at scale across numerous organisations is imperative. Further, these must be implemented in a manner that does not compromise the nuanced and contextual adjudicative processes of research ethics committees, data access committees, and biomedical research organisations. The tools required to implement a streamlined system of biomedical data exchange have in great part been developed. Indeed, there remains but a small core of functions that must further be standardised and automated to enable the recording and administration of permissions in biomedical research data with minimal human effort. Recording ethical provenance in this manner would enable biomedical data exchange to be performed at scale, in full respect of the ethical, legal, and institutional rules applicable to different datasets. This despite foundational differences between the distinct legal and normative frameworks is applicable to distinct communities and organisations that share data between one another.
The ‘wrong pocket’ problem as a barrier to the integration of telehealth in health organisations and systems
Authors: Alami Hassane , Shaw Sara E , Fortin Jean-Paul , Savoldelli Mathilde , Fleet Richard , Têtu Bernard
Published: April 2023

The COVID-19 pandemic has accelerated the deployment of telehealth services in many countries around the world. It also revealed many barriers and challenges to the use of digital health technologies in health organisations and systems that have persisted for decades. One of these barriers is what is known as the ‘wrong pocket’ problem – where an organisation or sector makes expenditures and investments to address a given problem, but the benefits (return on investment) are captured by another organisation or sector (the wrong pocket). This problem is the origin of many difficulties in public policies and programmes (e.g. education, environment, justice and public health), especially in terms of sustainability and scaling-up of technology and innovation. In this essay/perspective, we address the wrong pocket problem in the context of a major telehealth project in Canada. We show how the problem of sharing investments and expenses, as well as the redistribution of economies among the different stakeholders involved, may have threatened the sustainability and scaling-up of this project, even though it has demonstrated the clinical utility and contributed to improving the health of populations. In conclusion, the wrong pocket problem may be decisive in the reduced take-up, and potential failure, of certain telehealth programmes and policies. It is not enough for a telehealth service to be clinically relevant and ‘efficient’, it must also be mutually beneficial to the various stakeholders involved, particularly in terms of the equitable sharing of costs and benefits (return on investment) associated with the implementation of this new service model. Finally, the wrong pocket concept offers a helpful lens for studying the success, sustainability, and scale-up of digital transformations in health organisations and systems. This needs to be considered in future research and evaluations in the field.
Risk of Depression in a Suburban Primary Care Setting Before and During the COVID-19 Pandemic
Authors: Whiting Carman H. , Yousefi Pouran , des Bordes Jude K. A. , Rianon Nahid J.
Published: April 2023

Introduction:

Major depression is a common disorder affecting millions of adults each year. Many population-based surveys showed an increase in the number people with symptoms of depression at the onset of the COVID-19 pandemic. Our aim was to determine and compare the prevalence of depression risk in a primary care setting before and during the COVID-19 pandemic.

Methods:

We conducted a cross-sectional study based on retrospective review of medical records from a large suburban primary care clinic. Records of adults 18 years and older, seen between January 1, 2019 and December 31, 2020 and who had also been screened for depression using the 9-item Patient Health Questionnaire (PHQ-9) were analyzed.

Results:

Adults 18 years and older who completed the PHQ-9 assessment in 2019 and 2020 were 5078 and 4338, respectively. Risk of depression was 18.2% in 2019 and 14.8% in 2020 ( P < .001). In adults under 50 years and those 50 years and older, depression risk was 20.7% versus 15.3% in 2019 ( P < .001) and 17.3% versus 12.6% in 2020 ( P < .001), respectively. In females, depression risk was 20.0% in 2019 and 16.8% in 2020 ( P < .01), and in males, 14.1% in 2019 and 10.6% in 2020 ( P < .01).

Conclusion:

Although our results did not reflect the published literature reporting a higher prevalence of depression during the COVID-19 pandemic, they were consistent with reports of increased risk in females and younger adults.
Outcomes of Fat Grafting in the Active Versus Quiescent Phase of Localized Scleroderma
Authors: Wang Anna , Grünherz Lisanne , De Martini Ilaria V. , Vasella Mauro , Giovanoli Pietro , Lindenblatt Nicole
Published: April 2023

Introduction: Progressive hemifacial atrophy (PHA) and linear scleroderma (LS) are both rare conditions and defined by atrophy and/or sclerosis of the skin and subcutaneous tissue. The ideal timing of reconstructive intervention in these patients is controversial. We compared the outcome and satisfaction of autologous lipofilling performed during active and stable phases of the diseases in adults. Methods: A retrospective chart review was conducted with all patients diagnosed with PHA or LS between 2007 and 2019 in our department. We analysed demographic data, clinical features, and surgical procedures. The changes in symmetry, volume and skin texture were rated by surgeons at 1 week, 3 months and 6 months compared to the preoperative presentation. We compared the outcomes of patients treated during the active and the stable phase of the disease. Additionally, patients were asked to fill out a quality-of-life questionnaire. Results: We found a total of 11 patients diagnosed with PHA and LS, 8 of whom had undergone autologous fat injections to correct facial asymmetry. Of those, 4 patients were treated in their active and 4 in their stable phase. We found similar treatment outcomes in both groups. The social component had the greatest negative effect on patient's quality of life. Conclusion: In this small cohort, autologous fat grafting during the active phase did not appear to be inferior to fat grafting during the stable phase. It could be a safe technique for correction of PHA and LS during the active phase of disease.
Effect of Heading a Soccer Ball as an External Focus During a Drop Vertical Jump Task
Authors: Akbari Hadi , Kuwano Satoshi , Shimokochi Yohei
Published: April 2023

Background:

Research has demonstrated that performing a secondary task during a drop vertical jump (DVJ) may affect landing kinetics and kinematics.

Purpose:

To examine the differences in the trunk and lower extremity biomechanics associated with anterior cruciate ligament (ACL) injury risk factors between a standard DVJ and a DVJ while heading a soccer ball (header DVJ).

Study Design:

Descriptive laboratory study.

Methods:

Participants comprised 24 college-level soccer players (18 female and 6 male; mean ± SD age, 20.04 ± 1.12 years; height, 165.75 ± 7.25 cm; weight, 60.95 ± 8.47 kg). Each participant completed a standard DVJ and a header DVJ, and biomechanics were recorded using an electromagnetic tracking system and force plate. The difference (Δ) in 3-dimensional trunk, hip, knee, and ankle biomechanics between the tasks was analyzed. In addition, for each biomechanical variable, the correlation between the data from the 2 tasks was calculated.

Results:

Compared to the standard DVJ, performing the header DVJ led to significantly reduced peak knee flexion angle (Δ = 5.35°; P = .002), knee flexion displacement (Δ = 3.89°; P = .015), hip flexion angle at initial contact (Δ = −2.84°; P = .001), peak trunk flexion angle (Δ = 13.11°; P = .006), and center of mass vertical displacement (Δ = −0.02m; P = .010), and increased peak anterior tibial shear force (Δ = −0.72 N/kg; P = .020), trunk lateral flexion angle at initial contact (Δ = 1.55°; P < .0001), peak trunk lateral flexion angle (Δ = 1.34°; P = .003), knee joint stiffness (Δ = 0.002 N*m/kg/deg; P = .017), and leg stiffness (Δ = 8.46 N/kg/m; P = .046) compared to those in standard DVJs. In addition, individuals' data for these variables were highly and positively correlated between conditions ( r = 0.632-0.908; P < .001).

Conclusion:

The header DVJ task showed kinetic and kinematic parameters that suggested increased risk of ACL injury as compared with the standard DVJ task.

Clinical Relevance:

Athletes may benefit from acquiring the ability to safely perform header DVJs to prevent ACL injury. To simulate real-time competition situations, coaches and athletic trainers should incorporate such dual tasks in ACL injury prevention programs.
Mortality Rate and Predictors Among Women With Obstructed Labor in a Tertiary Academic Medical Center of Ethiopia: A Retrospective Cohort Study
Authors: Desta Melaku , Ferede Addisu Andualem
Published: April 2023

Introduction

Obstructed labor is one of the most common preventable causes of maternal morbidity and mortality. In Ethiopia, 36% of maternal mortality was due to obstructed labor with uterine rupture. Thus, this study proposed to measure predictors of maternal mortality among women with obstructed labor in a tertiary academic medical center in Southern Ethiopia.

Methods

An institution-based retrospective cohort study was conducted at Hawassa University Specialized Hospital from July 25 to September 30, 2018. Women who had obstructed labor from 2015 to 2017 were recruited. A pretested checklist was used to retrieve data from the woman's chart. A multivariable logistic regression model was employed to identify variables associated with maternal mortality, and variables with a p-value <.05 were considered significant at 95% CI.

Results

With a response rate of 96.3%, 156 moms who experienced labor obstruction were included in the study. Obstructed labor caused the deaths of 14 women, resulting in a maternal mortality rate of 8.9% (95% CI: 7.15, 16.4). Maternal mortality from obstructed labor was reduced in women who received antenatal care visits (AOR = 0.25, 95% CI: 0.13, 0.76) and blood transfusions (AOR =  0.49, 95% CI: 0.03, 0.89). Women who experienced uterine rupture (AOR =  6.25, 95% CI: 5.3, 15.6) and antepartum hemorrhage (AOR = 14, 95% CI: 2.45, 70.5) had a greater risk of maternal mortality than women who did not have the corresponding morbidity.

Conclusions

The center had a higher rate of maternal mortality due to obstructed labor. Early screening and improving the care for women at greatest risk of antenatal and postnatal co-morbidities like uterine rupture and shock were the major priorities and fundamental strategies to decreasing maternal mortality. It also showed that antenatal care visits, early referral, and blood transfusion for women with obstructed labor should be amended in order to lower maternal mortality.
Moral Distress, Health and Intention to Leave: Critical Care Nurses’ Perceptions During COVID-19 Pandemic
Authors: Andersson Maria , Fredholm Angelica , Nordin Anna , Engström Åsa
Published: April 2023

Introduction

Moral distress increases the risk that critical care nurses will lose the ability to provide quality nursing care.

Aims

To describe person-related conditions and perceptions of moral distress, health and intention to leave among critical care nurses in intensive care units, and to examine the relationship between person-related conditions, moral distress, health and intention to leave.

Method

Cross-sectional, with 220 critical care nurses in 15 Swedish ICUs, and data gathered via a self-reported questionnaire.

Results

Highest moral distress scores were reported in futile care and poor teamwork and 21% reported entertaining an intention to leave. Self-reported health was lower than before the COVID-19 pandemic and 4.1% reported pronounced exhaustion disorder. Self-reported health, reduced capacity to tolerate demands under time pressure, emotional instability or irritability, physical weakness, or being more easily fatigued and with decreased well-being were factors that had a relationship with futile care. Sleeping problems and intention to leave had a relationship with poor teamwork.

Conclusions

Different strategies are needed to reduce moral distress and the leadership is crucial for managing crises such as the COVID-19 pandemic.
A navigability entropy model for street networks
Authors: Corcoran Padraig , Lewis Rhyd
Published: April 2023

In this paper, we propose novel local and global models of street network entropy that measure levels of navigability given only limited local directional information. These models are defined for individual locations and entire street networks. Both models are derived using a generalised model of entropy from the field of game theory, which considers a decision-maker attempting to perform a task in the presence of incomplete information. We argue that the proposed models are more interpretable and useful than existing models of street network entropy since they measure the uncertainty of navigation, which is the task street networks are intended to facilitate. We demonstrate this utility by performing an empirical analysis of the entropy properties of UK city street networks.
Adaptation of the collaborative care model to integrate behavioral health care into a low-barrier HIV clinic
Authors: Dombrowski Julia C. , Halliday Scott , Tsui Judith I. , Rao Deepa , Sherr Kenneth , Ramchandani Meena S. , Emerson Ramona , Fleming Mark , Wood Teagan , Chwastiak Lydia
Published: April 2023

Background

The collaborative care management (CoCM) model is an evidence-based intervention for integrating behavioral health care into nonpsychiatric settings. CoCM has been extensively studied in primary care clinics, but implementation in nonconventional clinics, such as those tailored to provide care for high-need, complex patients, has not been well described.

Method

We adapted CoCM for a low-barrier HIV clinic that provides walk-in medical care for a patient population with high levels of mental illness, substance use, and housing instability. The Exploration, Preparation, Implementation, and Sustainment model guided implementation activities and support through the phases of implementing CoCM. The Framework for Reporting Adaptations and Modifications to Evidence-Based Interventions guided our documentation of adaptations to process-of-care elements and structural elements of CoCM. We used a multicomponent strategy to implement the adapted CoCM model. In this article, we describe our experience through the first 6 months of implementation.

Results

The key contextual factors necessitating adaptation of the CoCM model were the clinic team structure, lack of scheduled appointments, high complexity of the patient population, and time constraints with competing priorities for patient care, all of which required substantial flexibility in the model. The process-of-care elements were adapted to improve the fit of the intervention with the context, but the core structural elements of CoCM were maintained.

Conclusions

The CoCM model can be adapted for a setting that requires more flexibility than the usual primary care clinic while maintaining the core elements of the intervention.
Investigating algorithm-oriented flexibility and structure-informed flexibility in mathematics learning
Authors: Wang Haoyi , Star Jon R.
Published: April 2023

Procedural flexibility is a crucial element of deep procedural knowledge involving the selection of “the most appropriate strategy.” However, there exists unavoidable nuance when one attempts to define “the most appropriate” strategy, which leads to two types of procedural flexibility: (a) structure-informed flexibility (Struct-Flex), which refers to a preference for situationally appropriate strategies; (b) algorithm-oriented flexibility (Algo-Flex), which refers to a preference for standard algorithms. The current study investigated the distinction between these two flexibility types and tested potential predictors for both types of flexibility. The study data were collected from 412 Grade 9 through 12 students from 19 math classrooms in the southeastern region of the U.S. Chi-squared tests and regression models revealed that: (a) problem type was strongly correlated to and predictive of a preference for using algorithms in algebra; (b) students’ current high school math course grade was associated with preference for standard algorithms; (c) students’ current high school math course level and their classroom assignment were related to preference for situationally appropriate strategies. The results suggest that, in this sample, Algo-Flex was as prevalent as Struct-Flex, and the two flexibility types had different predictors. This paper can advance our practical knowledge of U.S. students’ strategy choices. The identified predictors of Algo-Flex and Struct-Flex can also inform the design of relevant educational interventions. Future studies may explore longitudinal datasets to untangle the relationship between course level, age, and flexibility, as well as examine flexibility in Asia in comparison to Europe and North America.
Surgical Treatment of the Cranial Basis Teratoma in a Newborn and Palatal Reconstruction With Tongue Flap a 17-Years Follow-Up: A Case Report
Authors: Costa De-Moraes Sylvio Luiz , Fares Raissa Dias , Maurity de Paula Afonso Alexandre , Mattos Ricardo Pereira , Gomes dos Santos Roberto , Pereira Rayssa Lima , Ribeiro da Silva Jonathan
Published: April 2023

Epignathus or Tessier fissure 0-14 is a rare teratoma composed of the three embryonic germ layers. Clinically, it appears as a mass covered with skin and mucosa, originating from pluripotential stem cells. According to the latest classification by the World Health Organization teratoma represents the main benign Germ cell tumors of the sinus region and presents similar histological aspects with its counterparts in the gonads and other extragonadal sites. The purpose of this study is to present a case of epignathus originating from the base of the skull in a Caucasian female patient with a cleft palate after the incisive foramen, not affecting the nasal floor. During physical examination, via intraoral route, in the region below the base of the skull, an extensive solid mass, covered by mucosa and with the presence of hair. Computed tomography confirmed the lesion, in the region corresponding to the base of the patient’s skull. The first surgical approach of resection occurred at the 40th day of the patient’s life, under general anesthesia and subsequent primary closure of the palatal defect. The second surgery was performed 10 months later, when tissue expanders were used on the palate to increase the mucosal surface. At the age of 5, the patient underwent surgery with a tongue flap, from the lingual dorsum, with an anterior pedicle. The patient was kept under sedation and relaxation for a period of 10 days for flap autonomy. After this period, the section of the flap and the reconstruction of the tongue dorsum were performed. The patient had a good evolution and was maintained under outpatient treatment. Pediatricians and pediatric dentists should be aware of the importance of prenatal exams and soon after birth, to identify possible deformities in neonatal patients, which favors the diagnosis. The 17-year postoperative follow-up of complete surgical removal of the teratoma and reconstruction of the cleft palate, combining the use of a tissue expander on the palate and a flap on the dorsum of the tongue, proved to be a viable resource for improving the patient’s quality of life.
Inequalities and Effect of Non-Biological Factors on Perinatal Mortality in Uttar Pradesh
Authors: Chauhan Bal Govind , Kumar Pradeep , Kundu Sampurna
Published: April 2023

Approximately 6 million neonatal deaths occur globally, with approximately 99 percent of them occurring in developing countries. This study is an attempt to examine the prevalence and influence of non-biological factors on perinatal mortality in India. National Family Health Survey (2015-2016) data and bivariate and multivariate techniques have been used to fulfill the aforesaid objectives. Findings suggest that approximately 47 perinatal deaths occurred per 1,000 pregnancies lasting seven or more months during the last five years preceding the survey in Uttar Pradesh. Parental education, wealth status, variables related to pregnancy and delivery, mother's demographic factors, mother's height, and child characteristics have shown significant impact on perinatal mortality. For a policy point of view, more emphasis is needed on quality of care of National Health Mission (NHM) strategy at times of greater risk—that is, birth and the first few days of life—which could be the way forward for reducing high perinatal deaths.
Modelling charring of timber exposed to natural fire
Authors: Pečenko Robert , Hozjan Tomaž , Huč Sabina
Published: April 2023

Charring of timber structural elements in fire is one of the most fundamental phenomena that affect the fire resistance of these elements. For an accurate and safe design of structural fire resistance, it is important to consider charring of timber in natural fire exposures, since determining charring for standard fire exposure, which is a common practice, is outdated and in some cases unsafe, due to the fact that some natural fires can be much more severe. Currently, the prescriptive approach and simplified design methods fail to give information about charring of timber elements exposed to natural fire and thus, a performance-based design is needed. Therefore, this paper presents an upgrade and extension of a recently developed heat-mass-pyrolysis model named PYCIF. Originally, PYCIF model was developed only for standard fire conditions. In the present paper, several studies and analyses are performed to extend model application to natural fire conditions. Firstly, the sensitivity study is performed, where the impact of model parameters on the charring development is investigated. It is discovered, that the kinetic parameters for the reaction rate of the active cellulose production, namely activation energy E1 and pre-exponential factor A1, are the most influential. In the next analyses the model calibration for small-scale cone calorimeter tests and large-scale natural fire tests of cross-laminated timber (CLT) floor system is performed. A robust nature of the model is identified since minor parameter calibration is required for an accurate prediction of the charring depth and temperatures in timber elements exposed to various fire conditions. Furthermore, a strong connection between the heating rate of fire and kinetic parameters is discovered. In cases of faster heating rate, the kinetic parameters govern slower reaction rate of active cellulose.
Optimization study of the adsorption of malachite green removal by MgO nano-composite, nano-bentonite and fungal immobilization on active carbon using response surface methodology and kinetic study
Authors: Hussien Hamad Mohammed Taha Moustafa
Published: April 2023

Malachite green a typical organic dye containing triarylmethane, is discharged in wastewater by textile and leather manufacturing plants. MG can pollute the environment, and it represents a major hazard to humans and various living organisms. We have thus worked toward developing the optimum dye-absorptive material, which should possess the following characteristics: excellent adsorption capacity, good selectivity, favorable recycling and reuse potential, and ease and quickness of adsorption. In this study, nano-bentonite, novel hybrid MgO-impregnated clay, and fungal composites were synthesized for Malachite green removal from aqueous solution. Response surface methodology (RSM) was used for the optimization of the synthesis of adsorbents to achieve simultaneous maximum malachite green removal. The composites were characterized by Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and X-ray diffraction (XRD). According to the obtained results, MgO-impregnated clay exhibits a exhibited a higher adsorption capacity of MG than nano-bentonite and pure bentonite. The malachite green adsorption isotherm on MgO-impregnated clay corresponded with the Freundlich isotherm. However, the Langmuir adsorption isotherm was a superior fit for nano-bentonite. The adsorption activities of nano-bentonite and MgO-impregnated clay were fitted into a pseudo-second-order kinetic model. Based on the root-mean-square error, bias, and accuracy, statistical research has shown that the Halden model has optimal accuracy. In addition, despite being recycled numerous times, the adsorbent maintained its high structural stability and removal effectiveness for nano-bentonite (94.5–86%) and MgO-impregnated clay (92–83%).
Aptamer modified Ti3C2 nanosheets application in smart targeted photothermal therapy for cancer
Authors: Bai Zhiqiang , Zhao Lu , Feng Haidi , Xin Zhihui , Wang Chaoyu , Liu Zhixiong , Tian Maozhong , Zhang Haifei , Bai Yunfeng , Feng Feng
Published: April 2023

Background

Ti3C2 is a type of transition metal carbides and nitrides (MXenes) with high light-to-heat conversion efficiency property, which has been widely used in cancer treatment recently. In fact, active targeting delivery of MXenes nanomaterials with targeting molecule could enhance the therapeutic efficacy. However, targeted therapy of MXenes has not been further studied in the past. Aptamers (Apt) with excellent affinity and high specificity properties have been widely used as targeting tools. Predictably, the incorporation of Apt into Ti3C2 nanomaterials will offer an unprecedented opportunity in the research fields of cancer targeted therapy.

Results

Transmembrane glycoprotein mucin 1 (MUC1) is overexpressed on the surface of MCF-7 cells, and MUC1 Apt (Apt-M) could target MCF-7 cells with high affinity and specificity. Here, a smart targeting nanotherapeutic system Ti3C2/Apt-M was fabricated, which could specifically recognize and enter in MCF-7 cells. Benefitting from the desirable targeted performance of Apt-M, MCF-7 cells completed the ingestion process of Ti3C2/Apt-Mf nanosheets within 4 h, and Apt-M facilitated the entry of the Ti3C2/Apt-Mf nanosheets into MCF-7 cells. Besides, Ti3C2/Apt-M nanosheets exhibited the potential as an outstanding photothermal agent (PTA) because of the photothermal performance inherited from wrapped Ti3C2 nanosheets. As demonstrated, upon 808 nm laser irradiation, the Ti3C2/Apt-M nanotherapeutic system displayed a satisfactory antitumor effect by targeted photothermal therapy both in vitro and in vivo.

Conclusion

This study provides a new idea for the development of MXenes nanotherapeutic system with high active targeting performance.

Graphical Abstract
Quantitative CT screening improved lumbar BMD evaluation in older patients compared to dual-energy X-ray absorptiometry
Authors: Lin Wentao , He Chaoqin , Xie Faqin , Chen Tao , Zheng Guanghao , Yin Houjie , Chen Haixiong , Wang Zhiyun
Published: April 2023

Background

Robust evidence on whether diagnostic discordance exists between lumbar osteoporosis detected by quantitative computed tomography (QCT) vs. dual-energy X-ray absorptiometry (DXA) is still lacking. In this study involving a relatively large prospective cohort of older men (aged > 60 years) and postmenopausal women, we assessed lumbar QCT-derived volumetric bone mineral density (vBMD) and DXA-derived area BMD and evaluated their predictive performance for prevalent vertebral fracture (VF).

Methods

A total of 501 patients who underwent spinal surgery from September 2020 to September 2022 were enrolled. The criteria recommended by the American College of Radiology and the World Health Organization were used for lumbar osteoporosis diagnosis. The osteoporosis detection rates between QCT and DXA were compared. QCT-vBMD was plotted against the DXA T score, and the line of best fit was calculated based on linear regression. Multivariate logistic regression was used to analyze the associations between risk factors and VF. Receiver operating characteristic curve analysis was performed, and the corresponding area under the curve (AUC) was calculated.

Results

QCT screening showed that 60.7% of patients had osteoporosis, whereas DXA screening showed that 50.7% of patients had osteoporosis. Diagnoses were concordant for 325 (64.9%) patients. In all, 205 patients suffered a VF of at least one anatomic level. Of these, 84.4% (173/205) were diagnosed with osteoporosis by QCT, while only 73.2% (150/205) were diagnosed by DXA. Multivariate logistic regression showed that osteoporosis detected by QCT exhibited a stronger relationship with VF than that detected by DXA (unadjusted OR, 6.81 vs. 5.04; adjusted OR, 3.44 vs. 2.66). For discrimination between patients with and without VF, QCT-vBMD (AUC = 0.802) showed better performance than DXA T score (AUC = 0.76).

Conclusion

In older patients undergoing spinal surgery, QCT-vBMD is more helpful than DXA in terms of osteoporosis detection rate and prediction of patients with prevalent VFs.
HIV matters when diagnosing TB in young children: an ancillary analysis in children enrolled in the INPUT stepped wedge cluster randomized study
Authors: Powell L , Denoeud-Ndam L , Herrera N , Masaba R , Tchounga B , Siamba S , Ouma M , Petnga SJ , Machekano R , Pamen B , Okomo G , Simo L , Casenghi M , Rakhmanina N , Tiam A
Published: April 2023

Background

Children under age five years, particularly those living with HIV (CLHIV), are at risk for rapid progression of tuberculosis (TB). We aimed to describe TB clinical presentations, diagnostic pathways and treatment outcomes in CLHIV compared to children without HIV in Cameroon and Kenya.

Methods

This sub-analysis of a cluster-randomized trial evaluating the integration of pediatric TB services from May 2019 to March 2021 enrolled children age < 5 years with TB. We estimated the HIV infection rate with 95% confidence interval (CI). We compared TB clinical presentations, diagnostic pathways and treatment outcomes in CLHIV and children without HIV. Finally, we investigated whether HIV infection was associated with a shorter time to TB diagnosis (≤ 3 months from symptoms onset) after adjusting for covariates. Univariable and multivariable logistic regression analysis were performed with adjusted odds ratios (AORs) presented as measures of the association of covariates with HIV status and with shorter time to TB diagnosis.

Results

We enrolled 157 children with TB (mean age was 1.5 years) and 22/157 (14.0% [9.0-20.4%]) were co-infected with HIV. CLHIV were more likely to initially present with acute malnutrition (AOR 3.16 [1.14–8.71], p = 0.027). Most TB diagnoses (140/157, 89%) were made clinically with pulmonary TB being the most common presentation; however, there was weak evidence of more frequent bacteriologic confirmation of TB in CLHIV, 18% vs. 9% (p = 0.067), due to the contribution of lateral-flow urine lipoarabinomannan to the diagnosis. HIV positivity (AOR: 6.10 [1.32–28.17], p = 0.021) was independently associated with a shorter time to TB diagnosis as well as fatigue (AOR: 6.58 [2.28–18.96], p = 0.0005), and existence of a household contact diagnosed with TB (AOR: 5.60 [1.58–19.83], p = 0.0075), whereas older age (AOR: 0.35 [0.15–0.85], p = 0.020 for age 2–5 years), night sweats (AOR: 0.24 [0.10–0.60], p = 0.0022) and acute malnutrition (AOR: 0.36 [0.14–0.92], p = 0.034) were associated with a delayed diagnosis. The case fatality rate was 9% (2/22) in CLHIV and 4% (6/135) in children without HIV, p = 0.31.

Conclusions

These results altogether advocate for better integration of TB services into all pediatric entry points with a special focus on nutrition services, and illustrate the importance of non-sputum-based TB diagnostics especially in CLHIV.

Trial registration

NCT03862261, first registration 05/03/2019.
Chidamide enhances cytotoxicity of doxorubicin by promoting autophagy and apoptosis in breast cancer
Authors: Li Jieqing
Published: April 2023

Background

Breast cancer (BC) is a prevalent disease that harms women's health, and in-depth investigations of the pathogenesis, treatment, and prevention of BC are the focus of many research programs. Chidamide (CHI) is a histone deacetylase suppressor that depresses histone deacetylase functions, thereby influencing cell growth through an epigenetic mechanism. However, CHI effects upon BC are largely unknown. Present research aimed to confirm the possibility of using CHI combined with chemotherapy drug doxorubicin (DOX) to prevent chemotherapeutic BC resistance in vivo and in vitro.

Methods

In this study, CCK8 (a plate colony formation assay) was applied to detect cell proliferation. Flow cytometry detection showed the apoptotic cell death of both T47D and MCF-7 cells. Nude mouse xenografts were used to detect tumor growth and pulmonary metastasis. High-throughput sequencing was used to detect expression of different genes.

Results

Our data showed that CHI treatment reduced BC cell proliferation, tumor growth, and cell invasion. CHI treatments stimulated BC cell apoptosis by promoting ULK2-mediated autophagy and increasing MCF-7 cell sensitivity to DOX, resulting in decreased tumor growth.

Conclusion

Collectively, our results illustrated that CHI enhanced DOX cytotoxicity by promoting apoptosis and autophagy in BC cells, which advised that CHI could be a candidate drug for BC patient treatments.
Overall survival in patients with advanced non-small cell lung cancer with KRAS G12C mutation with or without STK11 and/or KEAP1 mutations in a real-world setting
Authors: Julian Cristina , Pal Navdeep , Gershon Anda , Evangelista Marie , Purkey Hans , Lambert Peter , Shi Zhen , Zhang Qing
Published: April 2023

Background

KRAS mutations occur frequently in advanced non-small cell lung cancer (aNSCLC); the G12C mutation is the most prevalent. Alterations in STK11 or KEAP1 commonly co-occur with KRAS mutations in aNSCLC. Using real-world data, we assessed the effect of KRAS G12C mutation with or without STK11 and/or KEAP1 mutations on overall survival (OS) in patients with aNSCLC receiving cancer immunotherapy (CIT), chemotherapy, or both in first line (1L) and second line (2L).

Methods

Patients diagnosed with aNSCLC between January 2011 and March 2020 in a clinico-genomic database were included. Cox proportional hazards models adjusted for left truncation, baseline demographics and clinical characteristics were used to analyze the effect of STK11 and/or KEAP1 co-mutational status on OS in patients with KRAS wild-type (WT) or G12C mutation.

Results

Of 2715 patients with aNSCLC without other actionable driver mutations, 1344 (49.5%) had KRAS WT cancer, and 454 (16.7%) had KRAS G12C–positive cancer. At 1L treatment start, significantly more patients with KRAS G12C–positive cancer were female, smokers, and had non-squamous histology, a higher prevalence of metastasis and programmed death-ligand 1 positivity than those with KRAS WT cancer. Median OS was comparable between patients with KRAS G12C–positive and KRAS WT cancer when receiving chemotherapy or combination CIT and chemotherapy in the 1L or 2L. Median OS was numerically longer in patients with KRAS G12C vs KRAS WT cancer treated with 1L CIT (30.2 vs 10.6 months, respectively) or 2L CIT (11.3 vs 7.6 months, respectively). Co-mutation of STK11 and KEAP1 was associated with significantly shorter OS in patients receiving any type of 1L therapy, regardless of KRAS G12C mutational status.

Conclusions

This real-world study showed that patients with KRAS G12C–positive or KRAS WT cancer have similar OS in the 1L or 2L when treated with chemotherapy or combination CIT and chemotherapy. In contrast to aNSCLC patients with EGFR or ALK driver mutations, patients with KRAS G12C–positive cancer may benefit from CIT monotherapy. Co-mutation of STK11 and KEAP1 was associated with significantly shorter survival, independent of KRAS G12C mutational status, reflecting the poor prognosis and high unmet need in this patient population.
Clinical outcomes of bilateral implantation of new generation monofocal IOL enhanced for intermediate distance and conventional monofocal IOL in a Korean population
Authors: Choi Wan Kyu , Han Hyo Ji , Son Hyeck-Soo , Khoramnia Ramin , Auffarth Gerd U. , Choi Chul Young
Published: April 2023

Background

To compare the clinical outcomes of bilateral implantation of enhanced intermediate function intraocular lenses (IOLs) and standard monofocal IOLs.

Methods

In this prospective, randomized, comparative controlled study, we compared the visual outcomes of patients who underwent bilateral cataract surgery at the Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, with either enhanced monofocal IOLs (Tecnis Eyhance, ICB00, Johnson and Johnson Vision Care, Inc) (Group 1) or standard monofocal IOLs (Tecnis, ZCB00, Johnson and Johnson Vision Care, Inc) (Group 2). The assessment included monocular and binocular uncorrected distance visual acuity (UDVA), uncorrected intermediate (UIVA at 60 cm) and near (UNVA at 40 cm) visual acuity, uncorrected defocus curves, contrast sensitivity testing (CST), and reading speed test using Quality of vision was evaluated using the Visual Function Questionnaire (VFQ-25).

Results

At 3-months postoperatively, monocular and binocular outcomes of UIVA and UNVA were statistically significantly better in Group 1 (P < 0.05). The binocular uncorrected defocus curve of Group 1 showed statistically significantly better outcomes at vergence ranges of -1.5 to -4.0 D (P < 0.05). Significantly higher reading speed test was also observed in Group 1 in all ranges tested (1.0 to 0.1 LogMAR) (P < 0.05). There were no statistically significant differences in CST between groups.

Conclusions

Bilateral implantation of enhanced monofocal IOLs provided better vision at intermediate and near distances compared to standard monofocal IOLs, while maintaining good distance vision and contrast sensitivity.
An investigation of the relationships between suicidal ideation, psychache, and meaning in life using network analysis
Authors: Li Yijun , Guo Zhihua , Tian Wenqing , Wang Xiuchao , Dou Weijia , Chen Yanfeng , Huang Shen , Ni Shengdong , Wang Hui , Wang Chaoxian , Liu Xufeng , Zhu Xia , Wu Shengjun
Published: April 2023

Background

Previous studies have investigated the relationships between psychache or meaning in life and suicidal ideation based on sum score of corresponding scale. However, this practice has hampered the fine-grained understanding of their relationships. This network analysis study aimed to conduct a dimension-level analysis of these constructs and the relationships among them in a joint framework, and identify potential intervention targets to address suicidal ideation.

Methods

Suicidal ideation, psychache, and meaning in life were measured using self-rating scales among 738 adults. A network of suicidal ideation, psychache, and meaning in life was constructed to investigate the connections between dimensions and calculate the expected influence and bridge expected influence of each node.

Results

“Psychache” was positively linked to “sleep” and “despair”, while “presence of meaning in life” had negative associations with “psychache”, “despair”, and “pessimism”. The most important central nodes were “sleep” and “despair”, and the critical bridge nodes were “presence of meaning in life” and “psychache”.

Conclusion

These preliminary findings uncover the pathological pathways underlying the relationships between psychache, meaning in life, and suicidal ideation. The central nodes and bridge nodes identified may be potential targets for effectively preventing and intervening against the development and maintenance of suicidal ideation.
Association of remnant cholesterol with depression among US adults
Authors: Wang Yang , Shen Ruhua
Published: April 2023

Background

Remnant cholesterol is receiving increasing attention because of its association with various diseases. However, there have been no studies on remnant cholesterol levels and depression.

Methods

A cross-sectional analysis was performed based on the National Health and Nutrition Examination Survey (NHANES) 2005–2016. Depression was assessed using a Patient Health Questionnaire (PHQ-9). Fasting remnant cholesterol was calculated as the total cholesterol minus high-density lipoprotein cholesterol (HDL-C) minus low-density lipoprotein cholesterol (LDL-C). Logistic regression analysis with sampling weights was used to examine the association between remnant cholesterol concentration and depression.

Results

Among 8,263 adults enrolled in this study (weighted mean age, 45.65 years), 5.88% (weighted percentage) had depression. Compared to the participants without depression, those with depression had higher concentration of remnant cholesterol (weighted mean, 26.13 vs. 23.05, P < 0.001). There was a significant positive relationship between remnant cholesterol concentration and depression and multivariable-adjusted OR with 95% CI was 1.49 (1.02–2.17). Among the subgroup analyses, remnant cholesterol concentration was positively associated with depression among participants less than 60 years (OR, 1.62; 95% CI, 1.09–2.42), male (OR, 2.02; 95% CI, 1.01–4.05), BMI under 30 (OR, 1.83; 95% CI, 1.14–2.96), and those with diabetes (OR, 3.88; 95% CI, 1.43–10.49).

Conclusions

Remnant cholesterol concentration positively correlated with depression, suggesting that a focus on remnant cholesterol may be useful in the study of depression.
Interaction between blood cadmium and lead concentration and physical activity on hypertension from the Korean national health and nutrition examination survey in 2008–2013
Authors: Kwon Jeoung A , Kim Byungmi , Kim Eunji , Kwon Kisung
Published: April 2023

Background

Previous studies have suggested that blood Cd, Pb exposure, and physical activity levels may influence the development of hypertension. This study aimed to investigate the relationship between blood Cd, Pb levels, and hypertension by the level of physical activity in Korean adults using The Korea National Health and Nutrition Examination Survey (KNHANES).

Methods

We used data from the KNHANES (2008–2013), a nationally representative, cross-sectional, population-based study. We included 8,510 participants who had records of blood Cd, Pb and, blood pressure measurements. Multiple logistic regression was used to examine the association between blood Cd and Pb exposure and the development of hypertension, as well as the modifying effects of physical activity levels. Additive interaction was estimated using relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (S).

Results

Following covariates adjustments, we found significant associations of blood Cd and Pb with higher hypertension prevalence. This association was more apparent in low physical activity while blood Cd and Pb concentrations were not significantly associated with hypertension in participants with more activity. Additionally, there was a significant interaction between blood Cd and physical activity on hypertension risk (RERI = 0.17, 95% CI: -0.36–0.7; AP = 0.12, 95% CI: -0.28–0.52; S = 1.75, 95% CI:1.36–2.14).

Conclusions

Our results suggest that low physical activity may substantially amplify the adverse effects of blood Pb and Cd exposure on hypertension risk. However, interactions were only found for Cd. Further studies are needed to confirm these findings.