bluuebunny/crossref_metadata_2025 huggingface dataset:
Disclosure of Complementary and Alternative Medicine Use Among Older Adults: A Cross-Sectional Study
Authors: Golden Julia , Kenyon-Pesce Lisa , Robison Julie , Grady James , Guerrera Mary P.
Published: June 2023

Background: Although use of complementary and alternative medicine (CAM) is rising among older adults, many do not discuss these healthcare practices with their primary care practitioners (PCPs). This study sought to determine the prevalence of CAM use and to identify factors associated with CAM disclosure among patients ages 65 and older. Methods: Participants completed an anonymous survey, which evaluated their CAM use over the past year and disclosure of CAM to a PCP. Additional questions queried demographics, patient health, and relationships with one’s PCP. Analyses included descriptive statistics, chi-square tests and logistic regression. Results: One hundred seventy-three participants answered surveys. Sixty percent reported use of at least one form of CAM in the past year. Among those using CAM, 64.4% disclosed use to their PCP. Patients disclosed supplements/herbal products and naturopathy/homeopathy/acupuncture at a higher rate than body work techniques and mind-body practices (71.9% and 66.7% vs. 48% and 50%). The only factor significantly associated with disclosure was trust in one’s PCP (odds ratio = 2.97; confidence interval = 1.01–8.73). Conclusions: Clinicians may improve CAM disclosure rates in older adults by inquiring about all types of CAM and continuing to invest in their patient relationships, specifically by building trust.
Association of Shoulder Dysfunction with Mobility Limitation Among Older Adults in the Baltimore Longitudinal Study of Aging
Authors: Davis Derik L. , Sun Kai , Simonsick Eleanor M.
Published: June 2023

Association between lower extremity dysfunction and mobility limitation in older adults is well-established; whereas, the impact of upper extremity dysfunction on mobility remains unclear. Since lower extremity dysfunction does not explain all mechanisms that contribute to mobility limitation, more holistic hypotheses that explain reduced mobility in older populations are needed. The shoulders facilitate dynamic stability for ambulation, but the impact of shoulder dysfunction on mobility is poorly understood. This study examined the cross-sectional association of restricted shoulder elevation and external rotation range of motion (ROM) with poor lower extremity function and walking endurance capacity among 613 older adults aged 60 years and older in the Baltimore Longitudinal Study of Aging. Results showed that persons with abnormal shoulder elevation or external rotation ROM were 2.5 to 4.5 times more likely to perform poorly on the expanded Short Physical Performance Battery ( p < .050) and the fast-paced 400 m walk test ( p < .050), relative to participants with normal shoulder ROM. These findings provide nascent preliminary evidence that shoulder dysfunction is associated with mobility limitation and suggest that future studies are needed to clarify its impact on mobility and to develop novel interventions to improve prevention or mitigation of age-related declines in mobility.
Cardioprotective Effects of Vitex negundo: A Review of Bioactive Extracts and Compounds
Authors: Nyamweya Boniface , Rukshala Dilani , Fernando Narmada , de Silva Rajiva , Premawansa Sunil , Handunnetti Shiroma
Published: June 2023

There has been accumulating interest in the application of medicinal plants as alternative medicine to treat various diseases and/or to develop modern medicines. Vitex negundo is one of such medicinal plants that has been of interest to many researchers and has been of use in traditional medicine . V. negundo is found in Sri Lanka, Madagascar, Malaysia, India, China, The Philippines and East Africa. Therapeutic properties of V. negundo have previously been reviewed. Different parts, preparations and bioactive components of V. negundo possess potential protective and therapeutic effects against cardiovascular disease and related conditions as demonstrated in previous studies. We review the present state of scientific knowledge on the potential use of V. negundo and some of its bioactive components in protecting against cardiovascular diseases and related pathologies. Previous studies in animal and non-animal experimental models, although limited in number and vary in design, seem to support the cardioprotective effect of V. negundo and some of its active components. However, there is need for further preclinical and clinical studies to validate the use of V. negundo and its active constituents in protection and treatment of cardiovascular diseases. Additionally, since only a few V. negundo compounds have been evaluated, specific cardioprotective effects or mechanisms and possible side effects of other V. negundo compounds need to be extensively evaluated.
Co-created decision-making: From co-production to value co-creation in health care
Authors: Amorim Jason , Ventura Andréa Cardoso
Published: June 2023

Rare diseases are characterized by a wide diversity of signs and symptoms and vary not only from disease to disease but also from person to person, and living with a disease leads patients to peculiar experiences, without limits of time and space, as they extend to various environments and relationships of their lives. Therefore, the objective of this study is the theoretical interaction between value co-creation (VC) and the stakeholder theory (ST) with the shared decision-making (SDM) health care theory, to enable the analysis of the relationships between patients and their stakeholders in the co-creation of value for decision-making focused on the patient’s quality of life. It is configured as a multi-paradigmatic proposal by enabling the analysis of multiple perspectives of different stakeholders in health care. Thus, co-created decision-making (CDM) emerges with emphasis on interactivity of the relationships. As previous studies have already highlighted the importance of holistic care, seeing the patient as a whole and not just the body, studies with CDM will be beneficial for analyses that go beyond the clinical office and doctor–patient relationships, extending to all environments and interactions that add value to the patient’s treatment. It was concluded that the essence of this new theory proposed here is neither in patient-centered care nor in patient self-care, but in co-created relationships with and between stakeholders, including non-health care environments that are important to the patient, such as relationships with friends, family, other patients with the same disease, social media, public policies, and the practice of pleasurable activities.
Exposure-response analysis of alemtuzumab in pediatric allogeneic HSCT for nonmalignant diseases: the ARTIC study
Authors: Achini-Gutzwiller Federica R. , Schilham Marco W. , von Asmuth Erik G. J. , Jansen-Hoogendijk Anja M. , Jol-van der Zijde Cornelia M. , van Tol Maarten J. D. , Bredius Robbert G. M. , Güngör Tayfun , Lankester Arjan C. , Moes Dirk Jan A. R.
Published: June 2023

Alemtuzumab (anti-CD52 antibody) is frequently prescribed to children with nonmalignant diseases undergoing allogeneic hematopoietic stem cell transplantation (HSCT) to prevent graft failure (GF) and acute graft-versus-host disease (aGVHD). The aim of this multicenter study was the characterization of alemtuzumab population pharmacokinetics to perform a novel model–based exposure-response analysis in 53 children with nonmalignant immunological or hematological disease and a median age of 4.4 years (interquartile range [IQR], 0.8-8.7). The median cumulative alemtuzumab dose was 0.6 mg/kg (IQR, 0.6-1) administered over 2 to 7 days. A 2-compartment population pharmacokinetics model with parallel linear and nonlinear elimination including allometrically scaled bodyweight (median, 17.50 kg; IQR, 8.76-33.00) and lymphocyte count at baseline (mean, 2.24 × 109/L; standard deviation ± 1.87) as significant pharmacokinetic predictors was developed using nonlinear mixed effects modeling. Based on the model–estimated median concentration at day of HSCT (0.77 μg/mL; IQR, 0.33-1.82), patients were grouped into a low- (≤0.77 μg/mL) or high- (>0.77 μg/mL) exposure groups. High alemtuzumab exposure at day of HSCT correlated with delayed CD4+ and CD8+ T-cell reconstitution (P value < .0001) and increased risk of GF (P value = .043). In contrast, alemtuzumab exposure did not significantly influence the incidence of aGVHD grade ≥2, mortality, chimerism at 1 year, viral reactivations, and autoimmunity at a median follow-up of 3.3 years (IQR, 2.5-8.0). In conclusion, this novel population pharmacokinetics model is suitable for individualized intravenous precision dosing to predict alemtuzumab exposure in pediatric allogeneic HSCT for nonmalignant diseases, aiming at the achievement of early T-cell reconstitution and prevention of GF in future prospective studies.
The ‘Ironclad friendship’ of China-Cambodia, lays the first step in the foundation of early diagnosis and treatment of asymptomatic congenital heart Defects- A multi-national screening and intervention project, 2017–2020
Authors: Song Honglin , Li Xi , Lu Jiang , Song Junjie , Wang Teng , Gao Min , Zhang Xingyi , Ma Min , Shi Yi , Fang Jiayu , Fu Hongchen , Wang Huadan , Duo Lin , Tang Mingjing , Pang Linhong
Published: June 2023

Background

Congenital heart disease (CHD) is the leading cause of mortality in childhood worldwide. However, a large number of children with CHD are not diagnosed promptly in low- and middle-income regions, due to limited healthcare resources and lack the ability of prenatal and postnatal ultrasound examinations. The research on asymptomatic CHD in the community is still blank, resulting in a large number of children with asymptomatic CHD can not be found and treated in time. Through the China-Cambodia collaborative health care initiative, the project team conducted research, screened children’s CHD through a sampling survey in China and Cambodia, collected relevant data, and retrospectively analyzed the data of all eligible patients.

Objectives

The project aimed to evaluate the prevalence of asymptomatic CHD in a sample population of 3-18years old and effects on their growth status and treatment outcomes.

Methods

We examined the prevalence of ‘asymptomatic CHD’ among 3-18years old children and adolescents at the township/county levels in the two participating. A total of eight provinces in China and five provinces in Cambodia were analyzed from 2017 to 2020. During 1 year follow-up after treatment, the differences in heights and weights of the treated and control groups were evaluated.

Results

Among the 3,068,075 participants screened from 2017 to 2020, 3967 patients with asymptomatic CHD requiring treatment were identified [0.130%, 95% confidence interval (CI) 0.126 -0.134%]. The prevalence rate of CHD ranged from 0.02 to 0.88%, and was negatively related to local per capita GDP (p = 0.028). The average height of 3310 treated CHD patients were 2.23% (95% CI: -2.51%~-1.9%) lower than that of the standard group and the average weight was − 6.41% (95% CI: -7.17%~-5.65%) lower, the developmental gap widening with advancing age. One year after treatment, the relative height difference remained comparable while that, in weight was reduced by 5.68% (95% CI: 4.27% ~7.09%).

Conclusions

Asymptomatic CHD now is often overlooked and is an emerging public health challenge. Early detection and treatment are essential to lower the potential burden of heart diseases in children and adolescents.
Development of a scoring model based on objective factors to predict gangrenous/perforated appendicitis
Authors: Kobayashi Toshimichi , Hidaka Eiji , Koganezawa Itsuki , Nakagawa Masashi , Yokozuka Kei , Ochiai Shigeto , Gunji Takahiro , Sano Toru , Tomita Koichi , Tabuchi Satoshi , Chiba Naokazu , Kawachi Shigeyuki
Published: June 2023

Background

The mortality rate of gangrenous/perforated appendicitis is higher than that of uncomplicated appendicitis. However, non-operative management of such patients is ineffective. This necessitates their careful exam at presentation to identify gangrenous/perforated appendicitis and aid surgical decision-making. Therefore, this study aimed to develop a new scoring model based on objective findings to predict gangrenous/perforated appendicitis in adults.

Methods

We retrospectively analyzed 151 patients with acute appendicitis who underwent emergency surgery between January 2014 and June 2021. We performed univariate and multivariate analyses to identify independent objective predictors of gangrenous/perforated appendicitis, and a new scoring model was developed based on logistic regression coefficients for independent predictors. Receiver operating characteristic (ROC) curve analysis and the Hosmer–Lemeshow test were performed to assess the discrimination and calibration of the model. Finally, the scores were classified into three categories based on the probability of gangrenous/perforated appendicitis.

Results

Among the 151 patients, 85 and 66 patients were diagnosed with gangrenous/perforated appendicitis and uncomplicated appendicitis, respectively. Using the multivariate analysis, C-reactive protein level, maximal outer diameter of the appendix, and presence of appendiceal fecalith were identified as independent predictors for developing gangrenous/perforated appendicitis. Our novel scoring model was developed based on three independent predictors and ranged from 0 to 3. The area under the ROC curve was 0.792 (95% confidence interval, 0.721—0.863), and the Hosmer–Lemeshow test showed a good calibration of the novel scoring model (P = 0.716). Three risk categories were classified: low, moderate, and high risk with probabilities of 30.9%, 63.8%, and 94.4%, respectively.

Conclusions

Our scoring model can objectively and reproducibly identify gangrenous/perforated appendicitis with good diagnostic accuracy and help in determining the degree of urgency and in making decisions about appendicitis management.
Balancing burdens of infection control: Norwegian district medical officers’ ethical challenges during the COVID-19 pandemic
Authors: Brøderud Linn , Pedersen Reidar , Magelssen Morten
Published: June 2023

Background

In several countries, district medical officers (DMOs) are public health experts with duties including infection control measures. The Norwegian DMOs have been key actors in the local handling of the COVID-19 pandemic.

Methods

The aim of the study was to explore the ethical challenges experienced by Norwegian DMOs during the COVID-19 pandemic, and how the DMOs have handled these challenges. 15 in-depth individual research interviews were performed and analyzed with a manifest approach.

Results

Norwegian DMOs have had to handle a large range of significant ethical problems during the COVID-19 pandemic. Often, a common denominator has been the need to balance burdens of the contagion control measures for different individuals and groups. In another large set of issues, the challenge was to achieve a balance between safety understood as effective contagion prevention on the one hand, and freedom, autonomy and quality of life for the same individuals on the other.

Conclusions

The DMOs have a central role in the municipality’s handling of the pandemic, and they wield significant influence. Thus, there is a need for support in decision-making, both from national authorities and regulations, and from discussions with colleagues.
Long-term outcomes after cytoreductive nephrectomy and thrombectomy of patients with metastatic renal cell carcinoma with venous tumor thrombus: a retrospective study from a large Chinese center
Authors: Chen Kewei , Liu Zhuo , Li Yuxuan , Zhao Xun , Zhang Yu , Bi Hai , Wang Guoliang , Liu Cheng , Tian Xiaojun , Zhang Hongxian , Ma Lulin , Zhang Shudong
Published: June 2023

Background

Targeted therapy combined with immunotherapy is the current first-line treatment for metastatic renal cell carcinoma (mRCC), but patients with tumor thrombus (TT) may suffer from lower limb edema or even sudden cardiac death, so the purpose of this study is to investigate the efficacy and safety of surgical treatment in patients with mRCC and TT and explore worse factors to affect the prognosis in this series of patients.

Patients and methods

A total of 85 mRCC patients with TT who received cytoreductive nephrectomy and thrombectomy at our medical center from 2014 to 2023 are included. All patients received postoperative systemic therapy. Overall survival (OS) is defined as the time from surgery to death due to any reason or the last follow-up. Kaplan–Meier analysis was performed to evaluate OS and differences among groups were tested by log-rank. Multivariable Cox proportional hazards analysis was performed to ascertain independent relationships between clinicopathological factors and OS.

Results

The median age of patients was 58 years old. Eleven patients (12.9%) had no symptoms, 39 patients (45.9%) had local symptoms, 15 patients (17.6%) had systemic symptoms, and 20 patients (23.5%) had both. Mayo grade of TT was 0, 1, 2, 3, and 4 for 12, 27, 31, 7, and 8 patients respectively. Fifty-five patients had lung metastasis, 23 had bone metastasis, 16 had liver metastasis, 13 had adrenal metastasis, and 9 had lymph node metastasis. Of all patients, 17 patients had multiple metastases. The median operation time is 289 min and the median intraoperative hemorrhage is 800 ml. Twenty-eight patients experienced postoperative complications, 8 of which were serious complications of modified Clavien grade III or higher. The median OS of all patients was 33 months and median follow up time was 26 months. In multivariate analysis, systemic symptom (p = 0.00753), pathological type (p = 0.0166), sarcomatous degeneration (p = 0.0334), and perirenal fat infiltration (p = 0.0202) are independent predictors of OS.

Conclusion

Cytoreductive nephrectomy and thrombectomy is relatively safe and effective for patients with mRCC accompanied by TT. In this series of patients, the worse prognosis is associated with systemic symptoms, non-clear cell carcinoma, sarcomatous degeneration and perirenal fat infiltration.
Novel mutations in a second primary gastric cancer in a patient treated for primary colon cancer
Authors: Purwar Roli , Tripathi Madhumita , Rajput Monika , Pal Manjusha , Pandey Manoj
Published: June 2023

A 60-year-old man presented with complaints of abdominal pain and melena. Patient had a history of colon cancer 16 years back and had undergone right hemi colectomy for microsatellite instability (MSI) negative, mismatch repair (MMR) stable, T2N0 disease with no mutations on next-generation sequencing (NGS). Investigations revealed a second primary in stomach (intestinal type of adenocarcinoma) with no recurrent lesions in colon or distant metastasis. He was started on CapOx with Bevacizumab and developed gastric outlet obstruction. Total gastrectomy with D2 lymphadenectomy and Roux-en-Y oesophageao-jejunal pouch anastomosis was done. The histopathology showed intestinal type of adenocarcinoma with pT3N2 disease. NGS showed 3 novel mutations in KMT2A, LTK, and MST1R gene. The pathway enrichment analysis and Gene Ontology were carried out, followed by the construction of protein–protein interaction network to discover associations among the genes. The results suggested that these mutations have not been reported in gastric cancer earlier and despite not having a direct pathway of carcinogenesis they probably act through modulation of host of miRNA’s. Further studies are needed to investigate the role of KMT2A, LTK, and MST1R gene in gastric carcinogenesis.
tsRNA-04002 alleviates intervertebral disk degeneration by targeting PRKCA to inhibit apoptosis of nucleus pulposus cells
Authors: Pan Jie , Liu Zhonghan , Shen Bin , Xu Jin , Dai Gonghua , Xu Wen , Wang Jianjie , Li Lijun , Cheng Liming
Published: June 2023

Background

Intervertebral disk degeneration (IDD) is a degenerative disease that underlies various musculoskeletal and spinal disorders and is positively correlated with age. tRNA-derived small RNAs (tsRNA), as a new small noncoding RNAs, its function in IDD is unclear. Herein, our goal was to find the key tsRNA that affects IDD independently of age and explore the underlying mechanisms.

Methods

Small RNA sequencing was performed in nucleus pulposus (NP) tissues of traumatic lumbar fracture individuals, young IDD (IDDY) patients, and old IDD (IDDO) patients. The biological functions of tsRNA-04002 in NP cells (NPCs) were investigated by qRT-PCR, western blot, and flow cytometry analysis. The molecular mechanism of tsRNA-04002 was demonstrated by luciferase assays and rescue experiments. Furthermore, the therapeutic effects of tsRNA-04002 on IDD rat model were used and evaluated in vivo.

Results

Compared with fresh traumatic lumbar fracture patients, a total of 695 disordered tsRNAs is obtained (398 down-regulated tsRNAs and 297 up-regulated tsRNAs). These disordered tsRNAs were mainly involved in Wnt signaling pathway and MAPK signaling pathway. tsRNA-04002 was an age-independent key target in IDD, which was both lower expressed in IDDY and IDDO groups than control group. Overexpression of tsRNA-04002 restrained inflammatory cytokines IL-1β and TNF-α expression, increased the COL2A1, and inhibited the NPCs apoptosis. Furthermore, we determined that PRKCA was the target gene of tsRNA-04002 and was negatively regulated by tsRNA-04002. The rescue experiment results suggested that the high expression of PRKCA reversed the inhibitory effect of tsRNA-04002 mimics on NPCs inflammation and apoptosis, and promotive effect of COL2A1. Moreover, tsRNA-04002 treatment dramatically ameliorated the IDD process in the puncture-induced rat model, together with the blockade of PRKCA in vivo.

Conclusion

Collectively, our results substantiated that tsRNA-04002 could alleviate IDD by targeting PRKCA to inhibit apoptosis of NPCs. tsRNA-04002 may be a novel therapeutic target of IDD progression.
Classical versus chemometrics tools for spectrophotometric determination of fluocinolone acetonide, ciprofloxacin HCl and ciprofloxacin impurity-A in their ternary mixture
Authors: Tantawy Mahmoud A. , Wahba Israa A. , Saad Samah S. , Ramadan Nesrin K.
Published: June 2023

Green, simple, accurate and robust univariate and chemometrics assisted UV spectrophotometric approaches have been adopted and validated for concurrent quantification of fluocinolone acetonide (FLU), ciprofloxacin HCl (CIP) together with ciprofloxacin impurity-A (CIP imp-A) in their ternary mixture. Double-divisor ratio spectra derivative (DDRD) method has been used for determination of FLU. On the other hand, the first (D1) and second (D2) derivative approaches have been applied for the quantification of CIP and CIP imp-A, respectively. For the ratio difference (RD), derivative ratio (DR), and mean centering of ratio spectra (MC) methods, CIP and its impurity A have been simultaneously determined. The acquired calibration plots were linear over the concentration range of 0.6–20.0 μg/mL, 1.0–40.0 μg/mL and 1.0–40.0 μg/mL for fluocinolone acetonide, ciprofloxacin HCl, and ciprofloxacin impurity-A, respectively. The chemometrics methods namely; partial least squares (PLS) and artificial neural networks (ANN) were used for the concurrent determination of the three adopted components via using twenty-five mixtures as calibration set and fifteen mixtures as validation one. The investigated approaches were validated in accordance with International Council for Harmonisation (ICH) guidelines, and statistically compared with the official ones. The proposed methods were acceptably applied to the examination of FLU and CIP in their pure powders and pharmaceutical ear drops.
Role of high-temperature requirement serine protease A 2 in rheumatoid inflammation
Authors: Jeong Gi Heon , Nam Min-Kyung , Hur Wonhee , Heo Seolhee , Lee Saseong , Choi Eunbyeol , Park Jae Hyung , Park Youngjae , Kim Wan-Uk , Rhim Hyangshuk , Yoo Seung-Ah
Published: June 2023

Background

High-temperature requirement serine protease A 2 (HtrA2) is known to be involved in growth, unfolded protein response to stress, apoptosis, and autophagy. However, whether HtrA2 controls inflammation and immune response remains elusive.

Methods

Expression of HtrA2 in the synovial tissue of patients was examined using immunohistochemistry and immunofluorescence staining. Enzyme-linked immunosorbent assay was used to determine the concentrations of HtrA2, interleukin-6 (IL-6), interleukin-8 (IL-8), chemokine (C-C motif) ligand 2 (CCL2), and tumor necrosis factor α (TNFα). Synoviocyte survival was assessed by MTT assay. For the downregulation of HtrA2 transcripts, cells were transfected with HtrA2 siRNA.

Results

We found that the concentration of HtrA2 was elevated in rheumatoid arthritis (RA) synovial fluid (SF) than in osteoarthritis (OA) SF, and its concentrations were correlated with the number of immune cells in the RA SF. Interestingly, HtrA2 levels in the SF of RA patients were elevated in proportion to synovitis severity and correlated with the expression of proinflammation cytokines and chemokines, such as IL-6, IL-8, and CCL2. In addition, HtrA2 was highly expressed in RA synovium and primary synoviocytes. RA synoviocytes released HtrA2 when stimulated with ER stress inducers. Knockdown of HtrA2 inhibited the IL1β-, TNFα-, and LPS-induced release of proinflammatory cytokines and chemokines by RA synoviocytes.

Conclusion

HtrA2 is a novel inflammatory mediator and a potential target for the development of an anti-inflammation therapy for RA.
Doppler flow morphology characteristics of epiaortic arteries in aortic valve pathologies: a retrospective study on a cohort of patients with ischemic stroke
Authors: Meyer Stefanie , Wilde Lara , Wolf Frieder , Liman Jan , Bähr Mathias , Maier Ilko L.
Published: June 2023

Background and aims

Neurovascular ultrasound (nvUS) of the epiaortic arteries is an integral part of the etiologic workup in patients with ischemic stroke. Aortic valve disease shares similar vascular risk profiles and therefore not only presents a common comorbidity, but also an etiologic entity. The aim of this study is to investigate the predictive value of specific Doppler curve flow characteristics in epiaortic arteries and the presence of aortic valve disease.

Methods

Retrospective, single-center analysis of ischemic stroke patients, both receiving full nvUS of the extracranial common- (CCA), internal- (ICA) and external carotid artery (ECA) and echocardiography (TTE/TEE) during their inpatient stay. A rater blinded for the TTE/TEE results investigated Doppler flow curves for the following characteristics: ‘pulsus tardus et parvus’ for aortic valve stenosis (AS) and ‘bisferious pulse’, ‘diastolic reversal’, ‘zero diastole’ and ‘no dicrotic notch’ for aortic valve regurgitation (AR). Predictive value of these Doppler flow characteristics was investigated using multivariate logistic regression models.

Results

Of 1320 patients with complete examination of Doppler flow curves and TTE/TEE, 75 (5.7%) showed an AS and 482 (36.5%) showed an AR. Sixty-one (4.6%) patients at least showed a moderate-to-severe AS and 100 (7.6%) at least showed a moderate-to-severe AR. After adjustment for age, coronary artery disease, arterial hypertension, diabetes mellitus, smoking, peripheral arterial disease, renal failure and atrial fibrillation, the following flow pattern predicted aortic valve disease: ‘pulsus tardus et parvus’ in the CCA and ICA was highly predictive for a moderate-to-severe AS (OR 1158.5, 95% CI 364.2–3684.8, p < 0.001). ‘No dicrotic notch’ (OR 102.1, 95% CI 12.4–839.4, p < 0.001), a ‘bisferious pulse’ (OR 10.8, 95% CI 3.2–33.9, p < 0.001) and a ‘diastolic reversal’ (OR 15.4, 95% CI 3.2–74.6, p < 0.001) in the CCA and ICA predicted a moderate-to-severe AR. The inclusion of Doppler flow characteristics of the ECA did not increase predictive value.

Conclusions

Well defined, qualitative Doppler flow characteristics detectable in the CCA and ICA are highly predictive for aortic valve disease. The consideration of these flow characteristics can be useful to streamline diagnostic and therapeutic measures, especially in the outpatient setting.
Effect of antioxidant and anti-inflammatory on bioactive components of carrot (Daucus carota L.) leaves from Jeju Island
Authors: Kim Ji Soo , Lim Ji Hee , Cho Somi Kim
Published: June 2023

The present study evaluated the potential of carrot (Daucus carota L.) leaf, a non-edible part of carrots, which are among the most consumed vegetables worldwide. The antioxidant activities of 70% ethanol extract (EEC) and hot water extract (HEC) of carrot leaves were compared. The results revealed that the total polyphenol content, total flavonoid content, and DPPH and ABTS radical scavenging activities were higher in EEC than in HEC. Both extracts protected the cells against H2O2-induced toxicity and markedly reduced the levels of reactive oxygen species in RAW 264.7 cells. Moreover, pretreatment of RAW 264.7 cells with EEC and HEC prior to H2O2 (500 μM) exposure increased superoxide dismutase and glutathione peroxidase activities in these cells. Notably, EEC and HEC increased intracellular catalase activity by 36.77 and 6.39 times, respectively. Compared to HEC, EEC remarkably inhibited the production of lipopolysaccharide-induced nitric oxide and reduced the gene expression of IL-6, IL-1β, iNOS, COX-2, and TNF-α. Comparative analysis of the composition of the extracts using HPLC–UV suggested notably higher contents of catechin, chlorogenic acid, caffeic acid, rutin, quercetin, and cynaroside in EEC than in HEC. Collectively, these results imply that carrot leaves are a potentially beneficial natural source of antioxidants and anti-inflammatory compounds in functional foods.
Does trait mindfulness mediate the relationship between borderline personality symptoms and emotion dysregulation?
Authors: Roberts Alison , de Visser Richard , Rosten Claire , Startup Helen , Strauss Clara
Published: June 2023

Background

Emotion dysregulation is core to many biopsychosocial models of Borderline Personality Disorder (BPD) and is often targeted as part of their associated psychological therapies. Several distinct specialist psychotherapies are thought to be effective for people diagnosed with BPD but it is unclear whether they share common change mechanisms. Some evidence suggests that Mindfulness Based Interventions improve competency in emotion regulation as well as trait mindfulness, which are both plausibly associated with good treatment outcomes. It is unclear whether the association between the severity of BPD symptoms and emotion dysregulation is mediated by trait mindfulness. Would improvement in trait mindfulness mediate an association between lower severity of BPD symptoms and fewer problems of emotion dysregulation?

Methods

One thousand and twelve participants completed online, single time-point, self-report questionnaires.

Results

As predicted, the severity of BPD symptoms was significantly and positively associated with emotion dysregulation with a large effect size (r = .77). Trait mindfulness mediated this relationship as the 95% confidence interval for the indirect effect did not cross zero (size of direct effect = .48 and size of indirect effect = .29 [.25, .33].

Conclusions

The relationship between the severity of BPD symptoms and emotion dysregulation was confirmed in this dataset. As hypothesised, this relationship was mediated by trait mindfulness. Process measures of emotion dysregulation and mindfulness should be included in intervention studies for people diagnosed with BPD to understand if improvements in these factors are a universal occurrence with good response to treatment. Other process measures should also be explored to identify other factors involved in the relationship between BPD symptoms and emotion dysregulation.
Uniqueness, complexities, and research issues of logistics and trade facilitation in Greater Bay Area of China
Authors: Wu Edmund Y. , Ho Danny C. K. , Ng Stephen C. H. , Leung Lawrence C.
Published: June 2023

The Greater Bay Area (GBA) is to become a major innovation and technology hub of global impact. Such a transformation is to take place in the midst of a policy-driven economy in GBA’s Mainland region and a market-driven economy in Hong Kong and Macau. In this paper, we examine the uniqueness and complexities of logistics and trade facilitation in GBA. This study establishes a discourse in GBA’s logistics and trade facilitation between government and non-government stakeholders. Based on the discourse, we provide a conceptual context on the unique aspects of GBA, pinpointing critical issues such as the coexistence of differing institutional systems and interplay between state planning and market economy. A major objective of the paper is to identify and conceptualize unique logistics and trade features of GBA development, and to highlight opportunities for academic and policy research.
Deep learning for predicting future lesion emergence in high-risk breast MRI screening: a feasibility study
Authors: Burger Bianca , Bernathova Maria , Seeböck Philipp , Singer Christian F. , Helbich Thomas H. , Langs Georg
Published: June 2023

Background

International societies have issued guidelines for high-risk breast cancer (BC) screening, recommending contrast-enhanced magnetic resonance imaging (CE-MRI) of the breast as a supplemental diagnostic tool. In our study, we tested the applicability of deep learning-based anomaly detection to identify anomalous changes in negative breast CE-MRI screens associated with future lesion emergence.

Methods

In this prospective study, we trained a generative adversarial network on dynamic CE-MRI of 33 high-risk women who participated in a screening program but did not develop BC. We defined an anomaly score as the deviation of an observed CE-MRI scan from the model of normal breast tissue variability. We evaluated the anomaly score’s association with future lesion emergence on the level of local image patches (104,531 normal patches, 455 patches of future lesion location) and entire CE-MRI exams (21 normal, 20 with future lesion). Associations were analyzed by receiver operating characteristic (ROC) curves on the patch level and logistic regression on the examination level.

Results

The local anomaly score on image patches was a good predictor for future lesion emergence (area under the ROC curve 0.804). An exam-level summary score was significantly associated with the emergence of lesions at any location at a later time point (p = 0.045).

Conclusions

Breast cancer lesions are associated with anomalous appearance changes in breast CE-MRI occurring before the lesion emerges in high-risk women. These early image signatures are detectable and may be a basis for adjusting individual BC risk and personalized screening.

Relevance statement

Anomalies in screening MRI preceding lesion emergence in women at high-risk of breast cancer may inform individualized screening and intervention strategies.

Key points

• Breast lesions are associated with preceding anomalies in CE-MRI of high-risk women.

• Deep learning-based anomaly detection can help to adjust risk assessment for future lesions.

• An appearance anomaly score may be used for adjusting screening interval times.

Graphical Abstract
Widespread presentation of brown tumors mimicking multiple myeloma
Authors: Duyck Julien , Spincemaille Katrien , Verfaillie Jan , Meert Caressa , Muylle Kristoff
Published: June 2023

Brown tumors or osteitis fibrosa cystica has become a rare presentation of primary hyperparathyroidism in up-to-date clinical practice. Here, we describe a case of longstanding untreated hyperparathyroidism presenting itself with brown tumors in a 65-year-old patient. During the diagnostic work-up of this patient, bone SPECT/CT and 18F-FDG-PET/CT revealed multiple widespread osteolytic lesions. Differentiating from other bone tumors such as multiple myeloma is challenging. In this case, the final diagnosis was made by integrating the medical history, biochemical diagnosis of primary hyperparathyroidism, pathological findings and medical imaging.
Technical considerations of endovascular management of true visceral artery aneurysms
Authors: Khairallah M. K. , Morgan R. A. , Das R.
Published: June 2023

Background

True visceral artery aneurysms are potentially complex to treat but with advances in technology and increasing interventional radiology expertise over the past decade are now increasingly the domain of the interventional radiologist.

Body

The interventional approach is based on localization of the aneurysm and identification of the anatomical determinants to treat these lesions to prevent aneurysm rupture. Several different endovascular techniques are available and should be selected carefully, dependent on the aneurysm morphology. Standard endovascular treatment options include stent-graft placement and trans-arterial embolisation.

Different strategies are divided into parent artery preservation and parent artery sacrifice techniques.

Endovascular device innovations now include multilayer flow-diverting stents, double-layer micromesh stents, double-lumen balloons and microvascular plugs and are also associated with high rates of technical success.

Conclusion

Complex techniques such as stent-assisted coiling and balloon-remodeling techniques are useful techniques and require advanced embolisation skills and are further described.
The reintroduction of hemp in the USA: a content analysis of state and tribal hemp production plans
Authors: Falkner Amanda , Kolodinsky Jane , Mark Tyler , Snell William , Hill Rebecca , Luke Amelia , Shepherd Jonathan , Lacasse Hannah
Published: June 2023

Background

The reintroduction of Cannabis sativa L. in the form of hemp (< 0.3% THC by dry weight) into the US agricultural sector has been complex and remains confounded by its association with cannabis (> 0.3% THC by dry weight). This has been further exacerbated by inconsistent hemp regulations in the US since the 2014 Farm Bill’s reintroduction.

Methods

A content analysis was performed to analyze the terms and definitions presented by state and tribal hemp production plans, the USDA Hemp producer license, and the 2014 state pilot plans. A total of 69 hemp production plans were analyzed.

Results

Results suggest significant discrepancies between hemp production plans, which have been exacerbated by extending the 2014 Farm Bill language into the 2018 Farm Bill timeframe.

Conclusions

Findings from this study point to areas in need of uniformity and consistency as the regulatory framework is modified and provides a starting point for change for federal policymakers. The results may also be useful to companies attempting to market products across state boundaries. Suggestions for how to mitigate these inconsistencies are provided based on the content analysis findings.
Physiological effects of resistant starch and its applications in food: a review
Authors: Han Jun , Wu Jirong , Liu Xin , Shi Jianrong , Xu Jianhong
Published: June 2023

Starch,as the main source of carbohydrates in the diet, provides energy for various activities of the body. Different types and structures of starch lead to variations in digestion and absorption, thereby affecting blood glucose levels and lipid metabolism in the body. Resistant starch (RS) has gained much attention because of its unique properties; it is not digested in the small intestine but ferments in the large intestine and produces short-chain fatty acids. RS has been found to play a crucial role in glucose homeostasis, fat metabolism, cholesterol levels and mineral absorption. Furthermore, RS has a high thermal stability, white color and low water holding capacity, making it useful in a wide range of  food industry applications. This review aims to provide an update on the physiological effects of RS under physiological and pathological conditions, to provide information on the applications of RS in the food industry, and to assess whether dietary strategies to improve RS could have potential prevention and therapeutic effects for metabolic disorders associated with diabetes, obesity, and hyperlipidemia.

Graphical Abstract
Risk factors of sudden cardiac death in Egyptian patients younger than 40 years
Authors: Ali Ahmed Nabil , Abdeltawab Hend Ali , Eldamanhoury Hayam , Aboulmaaty Mervat
Published: June 2023

Background

Sudden cardiac death in young people is a major problem. The causes are well known; however, they may not be discovered before the episode of sudden death. A challenge for the future is identifying patients at risk before an episode of sudden cardiac death. Development of preventive and educational programs is required to identify sudden cardiac death/sudden cardiac arrest (SCD/SCA) risk factors, causes and characteristics. We aimed to study the characteristics of SCD/SCA in a cohort of young Egyptian population. Our retrospective cohort study included 246 patients of SCD/SCA who were collected from 5000 records of arrhythmia patients from January 2010 till January 2020. The records of the specialized arrhythmia clinic were reviewed to collect the families of SCD/SCA. All patients and/or their first-degree relatives were subjected to thorough history taking and clinical evaluation and investigations. Comparisons were done regarding age group and presence of positive family history of SCD.

Results

Males constituted 56.9% of the study population. Mean age was 26.6 ± 12.73 years. Positive family history was present in 202 (82.1%) cases. Sixty-one percent of the cases had history of syncopal attacks. SCD/SCA during non-exertion or sleep occurred in 50.4% of cases. Hypertrophic cardiomyopathy was the most common cause of SCD/SCA (20.3%), followed by dilated cardiomyopathy (19.1%), long QT Syndrome (11.4%), complete heart block (8.5%), and Brugada syndrome (6.8%). In the older age group of 18–40 years, hypertrophic cardiomyopathy was responsible for SCD in 44 patients (25.3%) versus 6 patients (8.3%) in younger age group (p-value: 0.003). DCM was also dominant in older age group (42 patients; 24.1%) versus 5 patients (6.9%) in younger age group. Hypertrophic cardiomyopathy was more prevalent in positive family history group (46 patients; 22.8%) versus 4 patients (9.1%) in negative family history group (p-value: 0.041).

Conclusion

Family history of SCD was the most common risk factor of SCD. The most common cause of SCD in young Egyptian patients below 40 years was hypertrophic cardiomyopathy, followed by dilated cardiomyopathy. Both diseases were more common in the age group between 18 and 40 years. Hypertrophic cardiomyopathy was more common in patients with positive family history of SCD/SCA.
Diagnostic utility of contrast-enhanced FLAIR MRI in imaging of demyelinating and infectious brain lesions
Authors: Gad Mona , Elsorogy Lamiaa Galal , Moustafa Sherif Abdel Fattah
Published: June 2023

Background

Contrast-enhanced MRI is frequently used as a baseline modality and indispensable tool for early diagnosis and follow-up of different brain lesions. Herein, we aimed to evaluate the diagnostic impact of contrast-enhanced FLAIR compared to the widely used post-contrast T1W sequence in terms of demyelinating and infectious brain lesions detection in clinical practice and explore its value in monitoring disease activity for selecting appropriate therapy. MR Imaging was performed using 1.5 Tesla device. Both T1W and FLAIR sequences were obtained prior to and after administration of intravenous gadolinium-based contrast agent. Both qualitative and quantitative approaches were used for image analysis by two independent radiologists.

Results

Sixty patients were prospectively enrolled in this study. Our participants were subdivided into two categories, either demyelinating (45 multiple sclerosis) or infectious lesions (13 meningitis/meningoencephalitis and 2 pyogenic abscess). By comparing the two post-contrast sequences, CE-FLAIR revealed greater enhancement in 38 cases (63.34%), equal enhancement in 17 cases (28.33%) and less enhancement in 5 cases (8.33%). For lesion conspicuity: good delineation observed in (61.67%), fair delineation in (25%) and no delineation in (13.33%). Lesion-to-background contrast ratio was statistically significant in CE-FLAIR with excellent inter-class correlation.

Conclusion

CE-FLAIR should be added in conjunction with or as a superior alternative to conventional CE-T1W sequence to optimize lesion detection and improve diagnostic reliability particularly in demyelinating and infectious lesions.
Work-related risk factors and the prevalence of low back pain among low-income industrial workers in Bangladesh: results from a cross-sectional study
Authors: Chowdhury Md. Omar Sharif Ahmmed , Huda Nurul , Alam Md. Mohsin , Hossain Sayed Imran , Hossain Shohal , Islam Shahana , Khatun Most. Rumpa
Published: June 2023

Objectives

Industrial workers are exposed to various musculoskeletal problems especially in tasks related to production. Low back pain is the main problem in most musculoskeletal disorders. Therefore, our study aims to identify the prevalence of work-related low back pain and its risk factors among industrial workers in Bangladesh.

Materials and methods

A sample of 384 industrial workers aged 18–55 years in Bangladesh was selected to conduct this cross-sectional study to assess low back pain prevalence and identify its risk factors. Regression analysis was performed regarding socioeconomic status and risk factor related to LBP through interviews and questionnaires.

Results

Data analysis showed that the prevalence of LBP in industrial workers in Dhaka City was 238 (62%). Low back pain was associated with increasing age (odd ratio = 1.05). Other significant risks for pain in the low back were being a permanent employee (OR 3.15) and working more than 8 h (OR = 1.99). Also, LBP was associated with incorrect body mechanics use, repetitive bending, and continuous long-time sitting risk was higher than others.

Conclusion

The results of this investigation highlight a high proportion of LBP and its risk factors among industrial workers in Dhaka City. Age, type of employment, working hours, use of incorrect body mechanics, repeated bending or twisting, and prolonged sitting were among the risk factors for back pain. Therefore, exercising, providing adequate training for properly maintaining body mechanics, and avoiding bad positions may be among the most powerful steps needed to avoid or prevent development of back pain.
Real time full-color imaging in a Meta-optical fiber endoscope
Authors: Fröch Johannes E. , Huang Luocheng , Tanguy Quentin A.A. , Colburn Shane , Zhan Alan , Ravagli Andrea , Seibel Eric J. , Böhringer Karl F. , Majumdar Arka
Published: June 2023

Endoscopes are an important component for the development of minimally invasive surgeries. Their size is one of the most critical aspects, because smaller and less rigid endoscopes enable higher agility, facilitate larger accessibility, and induce less stress on the surrounding tissue. In all existing endoscopes, the size of the optics poses a major limitation in miniaturization of the imaging system. Not only is making small optics difficult, but their performance also degrades with downscaling. Meta-optics have recently emerged as a promising candidate to drastically miniaturize optics while achieving similar functionalities with significantly reduced size. Herein, we report an inverse-designed meta-optic, which combined with a coherent fiber bundle enables a 33% reduction in the rigid tip length over traditional gradient-index (GRIN) lenses. We use the meta-optic fiber endoscope (MOFIE) to demonstrate real-time video capture in full visible color, the spatial resolution of which is primarily limited by the fiber itself. Our work shows the potential of meta-optics for integration and miniaturization of biomedical devices towards minimally invasive surgery.