bluuebunny/crossref_metadata_2025 huggingface dataset:
Protection of shop stewards in transfers of undertakings: Danish supreme court ruling of 30 january 2024: Transfer of undertakings directive article 6; Danish transfer of undertakings act section 4
Authors: Munkholm Natalie Videbaek
Published: April 2024

A new ruling from the Danish Supreme Court gives perspective to Article 6 of Directive 2001/23/EC (ToU Directive). The ruling concerns the criteria for the continued function and protection of employee representatives under section 4(1) and (2) of the Danish ToU Act and Article 6(1) and (2) of the ToU Directive. At EU level, there is very little case law concerning Article 6 of the ToU Directive. One CJEU ruling was handed down in case C-151/09, in which the Court interpreted the concept of ‘autonomy’ in Article 6(1). The comment on the Danish Supreme Court ruling discusses the interpretation of the criteria for the continued function of shop stewards in a situation where the transferee is not covered by a collective agreement. The Eastern High Court assessment revolved around the lack of collective agreement as the basis for the function of the shop steward. The Supreme Court changed this, and instead reiterated that the criteria for the continued function of the shop steward is the preservation of the ‘autonomy’ or ‘independence’ of the transferred entity. The Danish ruling aligns with the wording of the EU Directive, but the Court did not interpret how to assess whether ‘the independence’ is preserved. In this regard, the CJEU ruling in C-151/09 is still the main source of interpretation. The Danish ruling continues to interpret the scope of the continued employment protection of the shop steward, in the situation where the function is not continued, as protected under Article 6(2) of the ToU Directive. The Supreme Court arrived at a solution whereby the employment protection continues for a period after the cessation of the functions as shop steward, which ceased at the date of transfer, until the end of the individual and extended notice period of the shop steward. Still, quite a number of questions on Article 6(1) and (2) concerning the function and protection of shop stewards in transfers of undertakings remain unanswered.
Chronic spontaneous urticaria preceded by localized insulin reactions: case report
Authors: Momin Zoha K. , Chambliss Jeffrey M.
Published: April 2024

Chronic spontaneous urticaria presents with wheals and/or angioedema for >6 weeks without any specific triggers. The incidence of chronic spontaneous urticaria is increased in patients with comorbid autoimmune conditions. Here, we present a case of chronic spontaneous urticaria in a 9-year-old with type 1 diabetes and autoimmune thyroid disease who first presented with insulin pump site reactions concerning an insulin-related allergy. The patient was successfully treated with antihistamines and later immunosuppression with resumption of insulin pump therapy and remission of chronic spontaneous urticaria symptoms 18 months after onset.
Foundation models are platform models: Prompting and the political economy of AI
Authors: Burkhardt Sarah , Rieder Bernhard
Published: April 2024

A recent innovation in the field of machine learning has been the creation of very large pre-trained models, also referred to as ‘foundation models’, that draw on much larger and broader sets of data than typical deep learning systems and can be applied to a wide variety of tasks. Underpinning text-based systems such as OpenAI's ChatGPT and image generators such as Midjourney, these models have received extraordinary amounts of public attention, in part due to their reliance on prompting as the main technique to direct and apply them. This paper thus uses prompting as an entry point into the critical study of foundation models and their implications. The paper proceeds as follows: In the first section, we introduce foundation models in more detail, outline some of the main critiques, and present our general approach. We then discuss prompting as an algorithmic technique, show how it makes foundation models programmable, and explain how it enables different audiences to use these models as (computational) platforms. In the third section, we link the material properties of the technologies under scrutiny to questions of political economy, discussing, in turn, deep user interactions, reordered cost structures, and centralization and lock-in. We conclude by arguing that foundation models and prompting further strengthen Big Tech's dominance over the field of computing and, through their broad applicability, many other economic sectors, challenging our capacities for critical appraisal and regulatory response.
Nonstandard employment and support for older parents in urban China
Authors: Wang Jia , Ma Mingyue
Published: April 2024

The recent rise of nonstandard employment worldwide has significant implications for intergenerational transfers but has been neglected in existing research on the relationships between adult children's employment experiences and parental support. Utilizing data from the urban sample of the China Family Panel Studies (CFPS), we examine how nonstandard employment is related to adult children's money (financial) and time (instrumental and emotional) support for parents. Our analyses among four groups of adult children reveal complex patterns in the nonstandard employment–parental support relationship by children's gender, coresidence status, and educational attainment. Results suggest nonstandard employment primarily undermines the financial ability to support parents among non-coresident daughters, but nonstandard jobs have little to do with daughters’ time caring for parents regardless of their coresident status. Meanwhile, nonstandard employment appears to be weakly related to help for parents in the short term among all adult sons. Disadvantages associated with nonstandard employment in upstream parental support, such as a “less money, less time” situation, are concentrated among less-educated adult children (mainly daughters) who live apart from their parents.
How Overconfident Financial Knowledge Hinders Retirement Planning? Mediating Analysis and Heterogeneity of Retirement Funding Sources
Authors: Chen Fuzhong , Fan Yingchao , Jiang Guohai , Chen Jinwei
Published: April 2024

Under the background of general financial knowledge confidence and insufficient retirement planning, this study investigates the relationship between overconfident financial knowledge and consumer retirement planning. Using data from the National Financial Capability Study, this study employs probit regressions and finds that consumers with overconfident financial knowledge are less likely to have retirement planning, that is, contribute to retirement accounts regularly. This study further explores the mediators in this relationship and concludes that consumers who are overconfident in their financial knowledge tend to be more preference to risk, fail to make ends meet, and do not care about their financial situation, therefore are less likely to plan for retirement. Furthermore, compared to retirement accounts such as 401(k) that are through an employer, consumers with overconfident financial knowledge are more willing to engage in those such as IRA that are not through an employer. This study also finds that underconfident financial knowledge, another type of incorrect subjective evaluation of financial knowledge, is positively associated with retirement planning. Based on these findings, this study recommends policymakers reduce financial knowledge overconfidence, guide individuals to regularly pay attention to their financial situation, and encourage employers to actively participate in retirement plans.

JEL Classification: D12, N30, D80, D91.
Investigating the Transition Upgrading Paths of Manufacturing Enterprises From an Energy Source Perspective
Authors: Xu Xiaowei , Qi Liangqun , Wang Xueyuan , Sun Jianyu , Xu Yingying
Published: April 2024

As the manufacturing industry is the foundation of the national economy, many countries have made concerted efforts to promote the transition upgrading of manufacturing enterprises from political, industrial, and academic circles. This study employed content analysis to explore the transition upgrading factors for manufacturing enterprises from an energy source perspective. With the help of FsQCA (Fuzzy-sets qualitative comparative analysis), which can mine multivariate combination relationships using a small number of samples, this study quantitatively calculated the transition paths and energy source combinations of manufacturing enterprises. Three transition upgrading paths were proposed, including an innovation-oriented path, a business-oriented path, and an efficiency-oriented path. The results indicate that manufacturing enterprises can realize transition upgrading based on three key methods, including innovation resources and innovation activities, strategic layout, and production operation + network relationship (peripheral). Such a finding validated the rationality of the theoretical path design and improved the research depth and precision. Multiple case analyses of Huawei, Haier, and Lenovo reveal that manufacturing enterprises used three ways to promote transition upgrading: the joint action of innovation activities and innovation resources; the uni-directional causal effect of strategic layout adjustment to increase market value; and the coordination and matching role of network relations dominated by production and operation. We conclude that this study provides an effective decision-making basis and management reference for manufacturing enterprises, so that enterprises can choose an appropriate energy accumulation method and scientifically realize the transition upgrading.
Assessing the Vitality of a Local Chinese Community Language: Cantonese in Ipoh, Malaysia
Authors: Zhou Wei , Ang Lay Hoon
Published: April 2024

Malaysia is a multilingual and multiethnic country with a substantial population of ethnic Chinese, who use standardized languages such as Malay, English, and Mandarin, as well as various Chinese dialects in their daily lives within and beyond Chinese communities. Cantonese is a community language that significantly impacts the lives of local Chinese in the city of Ipoh, Malaysia. This study aims to examine the vitality of Cantonese in Ipoh using the language vitality and endangerment (LVE) tool developed by UNESCO. Nine LVE-proposed factors reflecting the degree of endangerment were investigated. Using a survey method, 377 participants from various groups were randomly selected from the Chinese community in Ipoh, Malaysia during January 6 to February 5, 2022. The result shows that Cantonese in Ipoh is rated as “Unsafe,” indicating that measures should be taken to prevent its further decline. The result suggests that further research is needed to gain a clearer understanding of the factors affecting language shift and maintenance, as well as the potential and challenges of linguistic and cultural diversity in the contemporary world.
A Rare Case of Small Bowel Obstruction due to Migration of a Percutaneous Biliary Stent
Authors: Ghirardelli Luca , Beneduce Aldo Alberto , Gusmini Simone
Published: April 2024

Biliary endoprostheses are widely used in the treatment of biliary lithiasis, malignant and benign strictures, and occasionally in long-lasting biliary fistulas. They can be placed endoscopically during endoscopic retrograde cholangiopancreatography and radiologically (percutaneous) when the endoscopic route is not feasible. Complications associated with the endoscopic placement of biliary endoprostheses are well described in the literature, with migration being the most common. Intestinal obstruction is a rare complication associated with the migration of these devices. There are no reports in the literature of this complication occurring after percutaneous placement. We present a case of a patient who arrived at the emergency department with ileal obstruction secondary to the migration and concurrent embedding of a covered stent placed radiologically to treat a biliary leak after surgery. The patient underwent diagnostic laparoscopic and ileal resection, revealing a lithiasic concretion at the tip of the stent, causing the small bowel obstruction.
A reinforcement learning approach for selecting infill drilling locations considering long-term production planning in mining complexes with supply uncertainty
Authors: Levinson Zachary , Dimitrakopoulos Roussos
Published: April 2024

Simultaneous stochastic optimisation frameworks provide a method for optimising long-term production schedules in mining complexes that aim to maximise net present value and manage risk related to supply uncertainty. The uncertainty and local variability related to the quality and quantity of material in the mineral deposits are modelled with a set of stochastic orebody simulations, an input into the simultaneous stochastic optimisation framework. Infill drilling provides opportunities to collect additional information associated with the mineral deposits, which can inform future production scheduling decisions. A framework is developed for optimising infill drilling locations with a criterion that seeks areas that directly affect long-term planning decisions and requires the use of geostatistical simulations. Actor-critic reinforcement learning is applied to identify infill drilling locations in a copper mining complex using this criterion. The case study demonstrates that adapting production scheduling decisions given additional information has the potential to improve the associated production and financial forecasts and identifies a stable area for infill drilling.
Testing for t(3;8) in MYC/BCL6-rearranged large B-cell lymphoma identifies a high-risk subgroup with inferior survival
Authors: Maybury Bernard D. , James Lisa , Phillips Neil , Venkatadasari Indrani , Qureshi Iman , Riley James , Talbot Georgina , Moosai Shivir , Giles Hannah , Chadderton Nicola , Dowds James , Rakesh Pallav , Crosland Henry , Haslam Aidan , Lane Sarah , Vega Gonzalez Monica , Davies David , Cherian George , Shenouda Amir , Kaudlay Praveen , Starczynski Jane , Rudzki Zbigniew , Chaganti Sridhar
Published: April 2024

A reciprocal t(3;8) BCL6::MYC fusion is common in large B-cell lymphoma (LBCL) with MYC and BCL6 disruption. These pseudo–double-hit cases are not adverse, whereas t(3;8)−MYC/BCL6 lymphoma has an inferior prognosis relative to other MYC-rearranged LBCL.
Development of a performance-based toolkit of the treatable traits of functioning in hospitalised patients with exacerbation of COPD: a survey-based study protocol
Authors: Leonardi Naiara Tais , Kawakami Débora Mayumi Oliveira , Cruz Joana , Burtin Chris , Borghi-Silva Audrey , Mendes Renata Gonçalves
Published: April 2024

Background

The management of COPD has been based on the premise of identifying problems that guide personalised treatment based on a multidimensional assessment, known as treatable traits. Exacerbation of COPD (ECOPD) results in physical and functional impairments, limitation of daily activities and negative impact on patients’ quality of life and prognosis. In this context, identifying treatable traits in patients with ECOPD is essential to properly guide individualised patient care. There is a need to develop a performance-based toolkit to identify the main treatable traits of functioning in hospitalised patients with ECOPD.

Methods and analysis

This is a study protocol of a survey method observational study to develop a performance-based toolkit. The study will include the following steps: 1) definition of treatable traits by both physiotherapists who provide or have provided care to hospitalised patients with ECOPD on a regular basis, and patients who have experienced at least one ECOPD which required hospitalisation; 2) selection of the most appropriate measures (markers) for each treatable trait based on established criteria and a previous systematic review; and 3) implementation of the toolkit in a pilot/feasibility study with hospitalised patients with ECOPD.

Conclusion

The development of a feasible performance-based toolkit with the best markers for each key treatable trait of functioning in hospitalised patients with ECOPD will make it possible to create individualised patient care for the specific demands of these patients.
Diagnostic utility of capnography in emergency department triage for screening acidemia: a pilot study
Authors: Peng Paul , Manini Alex F.
Published: April 2024

Background

Capnography is a quantitative and reliable method of determining the ventilatory status of patients. We describe the test characteristics of capnography obtained during Emergency Department triage for screening acidemia.

Results

We performed an observational, pilot study of adult patients presenting to Emergency Department (ED) triage. The primary outcome was acidemia, as determined by the basic metabolic panel and/or blood gas during the ED visit. Secondary outcomes include comparison of estimated and measured respiratory rates (RR), relationships between end-tidal CO2 (EtCO2) and venous partial pressure of CO2, admission disposition, in-hospital mortality during admission, and capnogram waveform analysis. A total of 100 adult ED encounters were included in the study and acidemia ($$ \left[HC{O}_{3}^{-}\right]\le 22 \text{mEq/L}$$ or $$ pH< 7.35$$) was identified in 28 patients. The measured respiratory rate (20.3 ± 6.4 breaths/min) was significantly different from the estimated rate (18.4 ± 1.6 breaths/min), and its area under the receiver operating curve (c-statistic) to predict acidemia was only 0.60 (95% CI 0.51–0.75, p = 0.03). A low end-tidal CO2 (EtCO2 < 32 mmHg) had positive (LR+) and negative (LR−) likelihood ratios of 4.68 (95% CI 2.59–8.45) and 0.34 (95% CI 0.19–0.61) for acidemia, respectively—corresponding to sensitivity 71.4% (95% CI 51.3–86.8) and specificity 84.7% (95% CI 74.3–92.1). The c-statistic for EtCO2 was 0.849 (95% CI 0.76–0.94, p = 0.00). Waveform analysis further revealed characteristically abnormal capnograms that were associated with underlying pathophysiology.

Conclusions

Capnography is a quantitative method of screening acidemia in patients and can be implemented feasibly in Emergency Department triage as an adjunct to vital signs. While it was shown to have only modest ability to predict acidemia, triage capnography has wide generalizability to screen other life-threatening disease processes such as sepsis or can serve as an early indicator of clinical deterioration.
SynGenes: a Python class for standardizing nomenclatures of mitochondrial and chloroplast genes and a web form for enhancing searches for evolutionary analyses
Authors: Rabelo Luan Pinto , Sodré Davidson , de Sousa Rodrigo Petry Corrêa , Watanabe Luciana , Gomes Grazielle , Sampaio Iracilda , Vallinoto Marcelo
Published: April 2024

Background

The reconstruction of the evolutionary history of organisms has been greatly influenced by the advent of molecular techniques, leading to a significant increase in studies utilizing genomic data from different species. However, the lack of standardization in gene nomenclature poses a challenge in database searches and evolutionary analyses, impacting the accuracy of results obtained.

Results

To address this issue, a Python class for standardizing gene nomenclatures, SynGenes, has been developed. It automatically recognizes and converts different nomenclature variations into a standardized form, facilitating comprehensive and accurate searches. Additionally, SynGenes offers a web form for individual searches using different names associated with the same gene. The SynGenes database contains a total of 545 gene name variations for mitochondrial and 2485 for chloroplasts genes, providing a valuable resource for researchers.

Conclusions

The SynGenes platform offers a solution for standardizing gene nomenclatures of mitochondrial and chloroplast genes and providing a standardized search solution for specific markers in GenBank. Evaluation of SynGenes effectiveness through research conducted on GenBank and PubMedCentral demonstrated its ability to yield a greater number of outcomes compared to conventional searches, ensuring more comprehensive and accurate results. This tool is crucial for accurate database searches, and consequently, evolutionary analyses, addressing the challenges posed by non-standardized gene nomenclature.

Graphical abstract
Metabolomics and proteomics insights into subacute ruminal acidosis etiology and inhibition of proliferation of yak rumen epithelial cells in vitro
Authors: Wang JunMei , Shi Liyuan , Zhang Xiaohong , Hu Rui , Yue Ziqi , Zou Huawei , Peng Quanhui , Jiang Yahui , Wang Zhisheng
Published: April 2024

Background

Untargeted metabolomics and proteomics were employed to investigate the intracellular response of yak rumen epithelial cells (YRECs) to conditions mimicking subacute rumen acidosis (SARA) etiology, including exposure to short-chain fatty acids (SCFA), low pH5.5 (Acid), and lipopolysaccharide (LPS) exposure for 24 h.

Results

These treatments significantly altered the cellular morphology of YRECs. Metabolomic analysis identified significant perturbations with SCFA, Acid and LPS treatment affecting 259, 245 and 196 metabolites (VIP > 1,P < 0.05, and fold change (FC) ≥ 1.5 or FC ≤ 0.667). Proteomic analysis revealed that treatment with SCFA, Acid, and LPS resulted in differential expression of 1251, 1396, and 242 proteins, respectively (FC ≥ 1.2 or ≤ 0.83,P < 0.05, FDR < 1%). Treatment with SCFA induced elevated levels of metabolites involved in purine metabolism, glutathione metabolism, and arginine biosynthesis, and dysregulated proteins associated with actin cytoskeleton organization and ribosome pathways. Furthermore, SCFA reduced the number, morphology, and functionality of mitochondria, leading to oxidative damage and inhibition of cell survival. Gene expression analysis revealed a decrease the genes expression of the cytoskeleton and cell cycle, while the genes expression associated with inflammation and autophagy increased (P < 0.05). Acid exposure altered metabolites related to purine metabolism, and affected proteins associated with complement and coagulation cascades and RNA degradation. Acid also leads to mitochondrial dysfunction, alterations in mitochondrial integrity, and reduced ATP generation. It also causes actin filaments to change from filamentous to punctate, affecting cellular cytoskeletal function, and increases inflammation-related molecules, indicating the promotion of inflammatory responses and cellular damage (P < 0.05). LPS treatment induced differential expression of proteins involved in the TNF signaling pathway and cytokine-cytokine receptor interaction, accompanied by alterations in metabolites associated with arachidonic acid metabolism and MAPK signaling (P < 0.05). The inflammatory response and activation of signaling pathways induced by LPS treatment were also confirmed through protein interaction network analysis. The integrated analysis reveals co-enrichment of proteins and metabolites in cellular signaling and metabolic pathways.

Conclusions

In summary, this study contributes to a comprehensive understanding of the detrimental effects of SARA-associated factors on YRECs, elucidating their molecular mechanisms and providing potential therapeutic targets for mitigating SARA.
Genetic and phenotypic analysis of 225 Chinese children with developmental delay and/or intellectual disability using whole-exome sequencing
Authors: Ma Heqian , Zhu Lina , Yang Xiao , Ao Meng , Zhang Shunxiang , Guo Meizhen , Dai Xuelin , Ma Xiuwei , Zhang Xiaoying
Published: April 2024

Developmental delay (DD), or intellectual disability (ID) is a very large group of early onset disorders that affects 1–2% of children worldwide, which have diverse genetic causes that should be identified. Genetic studies can elucidate the pathogenesis underlying DD/ID. In this study, whole-exome sequencing (WES) was performed on 225 Chinese DD/ID children (208 cases were sequenced as proband-parent trio) who were classified into seven phenotype subgroups. The phenotype and genomic data of patients with DD/ID were further retrospectively analyzed. There were 96/225 (42.67%; 95% confidence interval [CI] 36.15–49.18%) patients were found to have causative single nucleotide variants (SNVs) and small insertions/deletions (Indels) associated with DD/ID based on WES data. The diagnostic yields among the seven subgroups ranged from 31.25 to 71.43%. Three specific clinical features, hearing loss, visual loss, and facial dysmorphism, can significantly increase the diagnostic yield of WES in patients with DD/ID (P = 0.005, P = 0.005, and P = 0.039, respectively). Of note, hearing loss (odds ratio [OR] = 1.86%; 95% CI = 1.00-3.46, P = 0.046) or abnormal brainstem auditory evoked potential (BAEP) (OR = 1.91, 95% CI = 1.02–3.50, P = 0.042) was independently associated with causative genetic variants in DD/ID children. Our findings enrich the variation spectrums of SNVs/Indels associated with DD/ID, highlight the value genetic testing for DD/ID children, stress the importance of BAEP screen in DD/ID children, and help to facilitate early diagnose, clinical management and reproductive decisions, improve therapeutic response to medical treatment.
Effect of converting from propofol to remimazolam with flumazenil reversal on recovery from anesthesia in outpatients with mental disabilities: a randomized controlled trial
Authors: Jeon Sooyoung , Kim Jieun , Karm Myong-Hwan , Kim Jin-Tae
Published: April 2024

Background

General anesthesia is often necessary for dental treatment of outpatients with mental disabilities. Rapid recovery and effective management of postoperative nausea and vomiting (PONV) are critical for outpatients. This study aimed to investigate the effect of transitioning from propofol to remimazolam with flumazenil reversal administered toward the end of surgery during propofol-based total intravenous anesthesia (TIVA) on recovery.

Methods

Adults with mental disabilities scheduled to undergo dental treatment were randomly assigned to receive either propofol-based TIVA (Group P) or propofol-remimazolam-based TIVA with flumazenil reversal (Group PR). Propofol was replaced with remimazolam 1 h before the end of surgery in Group PR; moreover, 0.5 mg of flumazenil was administered after the neuromuscular blockade reversal agent. The primary outcome was the duration of stay in the post-anesthesia care unit (PACU). The secondary outcomes included time to eye-opening, time to extubation, occurrence of PONV, and quality of recovery.

Results

Fifty-four patients were included in this study. The duration of stay in the PACU in Group PR was significantly shorter than that in Group P (mean difference, 8.7 min; confidence interval [95% CI], 3.3–14.2; P = 0.002). Group PR exhibited a shorter time to eye opening (mean difference, 5.4 min; 95% CI, 3.3–8.1; P < 0.001) and time to extubation (mean difference, 5.5 min; 95% CI, 3.6–7.9; P < 0.001) than Group P. Neither group required the administration of rescue analgesics, and the incidence of PONV was not reported.

Conclusions

Transitioning from propofol to remimazolam 1 h before the end of surgery followed by flumazenil reversal reduced the duration of stay in the PACU and the time to eye opening and extubation without affecting the incidence of PONV and quality of recovery.

Trial registration number

Clinical Research Information Service (KCT0007794), Clinical trial first registration date: 12/10/2022.
Regional analgesia using ultrasound-guided intermediate cervical plexus block versus cervical erector spinae block for anterior cervical spine surgery: a randomized trial
Authors: Kamel Alshaimaa Abdel Fattah , Fahmy Ahmed M. , Fathi Heba M. , Elmesallamy Wael Abd Elrahman Ali , Khalifa Osama Yehia A.
Published: April 2024

Background

Regional analgesia techniques are crucial for pain management after cervical spine surgeries. Anesthesiologists strive to select the most effective and least hazardous regional analgesia technique for the cervical region. Our hypothesis is that an intermediate cervical plexus (IC) block can provide adequate postoperative analgesia compared to a cervical erector spinae (ES) block in patients undergoing anterior cervical spine surgery.

Methods

In this double-blind prospective trial, 58 patients were randomly assigned into two equal groups prior to the administration of general anesthesia. Patients in the IC group (n = 29) underwent ultrasound-guided bilateral intermediate cervical plexus block with 15 ml of bupivacaine 0.25% administered to each side. The ES group (n = 29) underwent ultrasound-guided bilateral cervical erector spinae plane blocks with 15 ml of 0.25% bupivacaine administered to each side at the C6 level. The primary outcome was to record the time to the first call for rescue analgesia (nalbuphine), and the secondary outcomes were to measure the performance time, the onset of the sensory block, the intraoperative fentanyl consumption, postoperative pain intensity using VAS, the postoperative total nalbuphine consumption, and postoperative complications such as nausea, vomiting, hypotension, and bradycardia.

Results

The performance and onset of sensory block times were significantly shorter in the IC group compared to the ES group. The time to first call for nalbuphine was significantly shorter in the IC group (7.31 ± 1.34 h) compared to the ES group (11.10 ± 1.82 h). The mean postoperative VAS scores were comparable between the two groups at the measured time points, except at 8 h, where it was significantly higher in the IC group, and at 12 h, where it was significantly higher in the ES group. The total nalbuphine consumption was significantly higher in the IC group (33.1 ± 10.13 mg) compared to the ES group (22.76 ± 8.62 mg).

Conclusions

For patients undergoing anterior cervical spine surgery, the intermediate cervical plexus block does not provide better postoperative regional analgesia compared to the cervical erector spinae block. Performance time and onset time were shorter in the IC group, whereas nalbuphine consumption was lower in the ES group.

Trial registration

The trial was registered at clinicaltrials.gov. (NCT05577559, and the date of registration: 13–10-2022).
The relationship between relational continuity and family physician follow-up after an antidepressant prescription in older adults: a retrospective cohort study
Authors: Rudoler David , Lane Natasha , Grudniewicz Agnes , Ling Vicki , Snadden David , Stukel Therese A
Published: April 2024

Background

Side effects can occur within hours to days of starting antidepressant medications, whereas full therapeutic benefit for mood typically takes up to four weeks. This mismatch between time to harm and lag to benefit often leads to premature discontinuation of antidepressants, a phenomenon that can be partially reversed through early doctor-patient communication and follow-up. We investigated the relationship between relational continuity of care – the number of years family physicians have cared for older adult patients – and early follow-up care for patients prescribed antidepressants.

Methods

A retrospective cohort study was conducted on residents of Ontario, Canada aged 66 years or older who were dispensed their first antidepressant prescription through the provincial drug insurance program between April 1, 2016, and March 31, 2019. The study utilized multivariable regression to estimate the relationship between relational continuity and 30-day follow-up with the prescribing family physician. Separate estimates were generated for older adults living in urban, non-major urban, and rural communities.

Results

The study found a small positive relationship between relational continuity of care and follow-up care by the prescribing family physician for patients dispensed a first antidepressant prescription (RRR = 1.005; 95% CI = 1.004, 1.006). The relationship was moderated by the patients’ location of dwelling, where the effect was stronger for older adults residing in non-major urban (RRR = 1.009; 95% CI = 1.007, 1.012) and rural communities (RRR = 1.006; 95% CI = 1.002, 1.011).

Conclusions

Our findings do not provide strong evidence of a relationship between relational continuity of care and higher quality management of antidepressant prescriptions. However, the relationship is slightly more pronounced in rural communities where access to continuous primary care and specialized mental health services is more limited. This may support the ongoing need for the recruitment and retention of primary care providers in rural communities.
Clinicopathologic and endoscopic characteristics of ten patients with gastric hamartomatous inverted polyp: a single center case series
Authors: Dong Ningning , Meng Fandong , Yue Bing , Hou Junzhen
Published: April 2024

Background

Gastric hamartomatous inverted polyps (GHIPs) are not well characterized and remain diagnostically challenging due to rarity. Therefore, this study aims to investigate the clinicopathologic and endoscopic characteristics of patients with GHIP.

Methods

We retrospectively reviewed clinicopathologic and endoscopic features of ten patients with GHIP who were admitted to Beijing Friendship Hospital from March 2013 to July 2022. All patients were treated successfully by endoscopic resection.

Results

GHIPs were usually asymptomatic and found incidentally during gastroscopic examination. They may be sessile or pedunculated, with diffuse or local surface redness or erosion. On endoscopic ultrasonography, the sessile submucosal tumor-type GHIP demonstrated a heterogeneous lesion with cystic areas in the third layer of the gastric wall. Histologically, GHIPs were characterized by a submucosal inverted proliferation of cystically dilated hyperplastic gastric glands accompanied by a branching proliferation of smooth muscle bundles. Inflammatory cells infiltration was observed in the stroma, whereas only one patient was complicated with glandular low-grade dysplasia. Assessment of the surrounding mucosa demonstrated that six patients (60%) had atrophic gastritis or Helicobacter pylori–associated gastritis, and four patients (40%) had non-specific gastritis. Endoscopic resection was safe and effective.

Conclusions

GHIPs often arise from the background of abnormal mucosa, such as atrophic or H.pylori-associated gastritis. We make the hypothesis that acquired inflammation might lead to the development of GHIPs. We recommend to make a full assessment of the background mucosa and H. pylori infection status for evaluation of underlying gastric mucosal abnormalities, which may be the preneoplastic condition of the stomach.
Characteristics and outcomes of COVID-19 patients presumed to be treated with sotrovimab in NHS hospitals in England
Authors: Patel Vishal , Levick Bethany , Boult Stephen , Gibbons Daniel C. , Drysdale Myriam , Lloyd Emily J. , Singh Moushmi , Birch Helen J.
Published: April 2024

Background

The impact of the constantly evolving severe acute respiratory syndrome coronavirus 2 on the effectiveness of early coronavirus disease 2019 (COVID-19) treatments is unclear. Here, we report characteristics and acute clinical outcomes of patients with COVID-19 treated with a monoclonal antibody (mAb; presumed to be sotrovimab) across six distinct periods covering the emergence and predominance of Omicron subvariants (BA.1, BA.2, and BA.5) in England.

Methods

Retrospective cohort study using data from the Hospital Episode Statistics database from January 1–July 31, 2022. Included patients received a mAb delivered by a National Health Service (NHS) hospital as a day-case, for which the primary diagnosis was COVID-19. Patients were presumed to have received sotrovimab based on NHS data showing that 99.98% of COVID-19-mAb-treated individuals received sotrovimab during the study period. COVID-19-attributable hospitalizations were reported overall and across six distinct periods of Omicron subvariant prevalence. Subgroup analyses were conducted in patients with severe renal disease and active cancer.

Results

Among a total of 10,096 patients, 1.0% (n = 96) had a COVID-19-attributable hospitalization, 4.6% (n = 465) had a hospital visit due to any cause, and 0.3% (n = 27) died due to any cause during the acute period. COVID-19-attributable hospitalization rates were consistent among subgroups, and no significant differences were observed across periods of Omicron subvariant predominance.

Conclusions

Levels of COVID-19-attributable hospitalizations and deaths were low in mAb-treated patients and among subgroups. Similar hospitalization rates were observed whilst Omicron BA.1, BA.2, and BA.5 were predominant, despite reported reductions in in vitro neutralization activity of sotrovimab against BA.2 and BA.5.
Comparison of vestibular aqueduct visualization on computed tomography and magnetic resonance imaging in patients with Ménière’s disease
Authors: Xia Kaijun , Lei Ping , Liu Yingzhao , Chen Cen , Pan Hui , Leng Yangming , Liu Bo
Published: April 2024

Background

The vestibular aqueduct (VA) serves an essential role in homeostasis of the inner ear and pathogenesis of Ménière’s disease (MD). The bony VA can be clearly depicted by high-resolution computed tomography (HRCT), whereas the optimal sequences and parameters for magnetic resonance imaging (MRI) are not yet established. We investigated VA characteristics and potential factors influencing MRI-VA visibility in unilateral MD patients.

Methods

One hundred patients with unilateral MD underwent MRI with three-dimensional sampling perfection with application optimized contrasts using different flip angle evolutions (3D-SPACE) sequence and HRCT evaluation. The imaging variables included MRI-VA and CT-VA visibility, CT-VA morphology and CT-peri-VA pneumatization.

Results

The most frequent type of MRI-VA and CT-VA visualization was invisible VA and continuous VA, respectively. The MRI-VA visibility was significantly lower than CT-VA visibility. MRI-VA visibility had a weak positive correlation with ipsilateral CT-VA visualization. For the affected side, the MRI-VA visualization was negatively correlated with the incidence of obliterated-shaped CT-VA and positively with that of tubular-shaped CT-VA. MRI-VA visualization was not affected by CT-peri-VA pneumatization.

Conclusion

In patients with MD, the VA visualization on 3D-SPACE MRI is poorer than that observed on CT and may be affected by its osseous configuration. These findings may provide a basis for further characterization of VA demonstrated by MRI and its clinical significance.
Clinical significance of urinary inflammatory biomarkers in patients with IgA nephropathy
Authors: Yoon Soo-Young , Kim Jin Sug , Jung Su Woong , Kim Yang Gyun , Moon Ju-Young , Lee Sang-Ho , Yim Sung-Vin , Hwang Hyeon Seok , Jeong Kyunghwan
Published: April 2024

Background

IgA nephropathy (IgAN) is the most common type of primary glomerulonephritis, although the definitive markers are unknown. We aimed to investigate the clinical significance of urinary cytokines in patients with IgAN.

Methods

From 2009 to 2018, the patients were divided into three groups: IgAN (n = 191), disease control (n = 53), and normal control (n = 76). We used a multiplex enzyme-linked immunosorbent assay to measure 16 selected urinary inflammatory cytokines, evaluated the correlation between clinical and pathological features following regression analysis on progression.

Results

The IgAN group exhibited significantly different levels of urinary cytokines compared to the normal control and disease control groups. Urinary levels of B-cell-activating factor, vascular endothelial growth factor receptor-2, monocyte chemoattractant protein-1, C–X–C motif chemokine 10, C–X–C motif ligand 16, epidermal growth factor (EGF), endocan, endostatin, growth/differentiation factor-15 (GDF-15), interleukin-6 (IL-6), mannose-binding lectin, transferrin receptor, and kidney injury molecule-1 were significantly correlated with both the estimated glomerular filtration rate and urine protein–creatinine ratio. In a multivariate Cox regression analysis, urinary EGF (hazard ratio [HR] 0.40, 95% confidence interval [CI] 0.17–0.95, P = 0.04), GDF-15 (HR 2.45, 95% CI 1.01–5.94, P = 0.048), and IL-6 (HR 3.02, 95% CI 1.05–8.64, P = 0.04) were associated with progression in IgAN.

Conclusions

Urinary inflammatory biomarkers may serve as alternative predictive biomarkers in patients with IgAN. Further studies are needed to elucidate the physiological mechanisms and confirm the results.
25-hydroxycholesterol promotes proliferation and metastasis of lung adenocarcinoma cells by regulating ERβ/TNFRSF17 axis
Authors: He Mengting , Jiang Wenbo , Li Xingkai , Liu Hongjin , Ren Hongsheng , Lin Yanliang
Published: April 2024

Lung adenocarcinoma is the main type of lung cancer in women. Our previous findings have evidenced that 25-hydroxycholesterol (25-HC) promotes migration and invasion of lung adenocarcinoma cells (LAC), during which LXR as a 25-HC receptor plays an important role. Estrogen receptor beta (ERβ) is a receptor of 27-hydroxycholesterol that is structurally analogous to 25-HC, but its role in the functional actions of 25-HC remained largely unknown. In this study, we demonstrated that 25-HC treatment triggered ERβ expression in LAC. Knockdown of ERβ inhibited 25-HC-mediated proliferation, migration and invasion, and reduced 25-HC-induced LAC metastasis in vivo. Further investigation revealed that ERβ knockdown restrained the expression of TNFRSF17 (BCMA). In vivo experiments also confirmed that ERβ knockdown blocked 25-HC-induced TNFRSF17 expression. TNFRSF17 knockdown also restrained 25-HC-induced proliferation, migration and invasion. Bioinformatic analysis showed that the levels of ERβ and TNFRSF17 were elevated in lung adenocarcinoma, and were closely related to tumor stages and nodal metastasis status. These results suggested that 25-HC promoted the proliferation and metastasis of LAC by regulating ERβ/TNFRSF17 axis.
m1A regulator-mediated methylation modification patterns correlated with autophagy to predict the prognosis of hepatocellular carcinoma
Authors: Wu Yingmin , Li Lian , Wang Long , Zhang Shenjie , zeng Zhirui , Lu Jieyu , Wang Zhi , Zhang Yewei , Zhang Shilong , Li Haiyang , Chen Tengxiang
Published: April 2024

Background

N1-methyladenosine (m1A), among the most common internal modifications on RNAs, has a crucial role to play in cancer development. The purpose of this study were systematically investigate the modification characteristics of m1A in hepatocellular carcinoma (HCC) to unveil its potential as an anticancer target and to develop a model related to m1A modification characteristics with biological functions. This model could predict the prognosis for patients with HCC.

Methods

An integrated analysis of the TCGA-LIHC database was performed to explore the gene signatures and clinical relevance of 10 m1A regulators. Furthermore, the biological pathways regulated by m1A modification patterns were investigated. The risk model was established using the genes that showed differential expression (DEGs) between various m1A modification patterns and autophagy clusters. These in vitro experiments were subsequently designed to validate the role of m1A in HCC cell growth and autophagy. Immunohistochemistry was employed to assess m1A levels and the expression of DEGs from the risk model in HCC tissues and paracancer tissues using tissue microarray.

Results

The risk model, constructed from five DEGs (CDK5R2, TRIM36, DCAF8L, CYP26B, and PAGE1), exhibited significant prognostic value in predicting survival rates among individuals with HCC. Moreover, HCC tissues showed decreased levels of m1A compared to paracancer tissues. Furthermore, the low m1A level group indicated a poorer clinical outcome for patients with HCC. Additionally, m1A modification may positively influence autophagy regulation, thereby inhibiting HCC cells proliferation under nutrient deficiency conditions.

Conclusions

The risk model, comprising m1A regulators correlated with autophagy and constructed from five DEGs, could be instrumental in predicting HCC prognosis. The reduced level of m1A may represent a potential target for anti-HCC strategies.
Management of macula-on giant retinal tear detachments– outcome of pars-plana-vitrectomy with silicone oil versus gas tamponade
Authors: Barth Teresa , Radeck Viola , Gamulescu Maria-Andreea , Helbig Horst , Märker David
Published: April 2024

Background

To compare the outcome of eyes with a macula-on giant retinal tear (GRT) detachment treated with pars-plana-vitrectomy (PPV) depending on the used endotamponade.

Methods

All consecutive cases with a macula-on GRT-associated rhegmatogenous retinal detachment (RRD) managed with PPV between 2007 and 2022 were retrospectively assessed depending on the selected endotamponade. By reviewing medical charts and surgical protocols the pre- and intraoperative parameters were analysed in detail. The number of vitreoretinal (VR) procedures needed for reattachment, the redetachment rate and the functional outcome were evaluated. Eyes treated with primary silicone oil (SO) tamponade were compared to eyes with primary gas tamponade. Cases with pre-existing conditions affecting outcome e.g. macula-off situation, history of trauma, status after complicated cataract surgery, former VR surgery or proliferative vitreoretinopathy grade C or higher were excluded.

Results

Overall, 51 eyes of 45 patients with a macula-on GRT detachment were treated with PPV and SO (n = 32; 63%) or gas (n = 19; 37%) endotamponade in the observed period. Eyes with primary SO tamponade underwent on average 2.3 (SD 0.8) VR procedures and had a redetachment rate of 13% (n = 4). Eyes with gas tamponade showed a higher redetachment rate of 32% (n = 6) with a mean number of 1.6 (SD 1.0) PPV procedures. Postoperative best-corrected visual acuity (BCVA) was significantly better in eyes with primary gas tamponade (mean logMAR BCVA 0.32; SD 0.30) compared to eyes with SO (mean logMAR BCVA 0.60; SD 0.42; p = 0.008).

Conclusions

Surgical management of GRT-associated RRDs is complex. In clinical routine often SO is used as endotamponade. Because of known disadvantages (second procedure necessary for SO removal, unexplained SO-related visual loss, secondary glaucoma, SO emulsification) some VR surgeons prefer a gas tamponade. In our cohort, eyes with a gas compared to SO tamponade showed higher redetachment rates. However, the final postoperative BCVA was significantly better in eyes with gas compared to SO tamponade.

Trial registration

The trial protocol was approved by the local ethics committee on 25th of November 2022 (Ethikkommission der Universität Regensburg, Votum 22-3166-104).