bluuebunny/crossref_metadata_2025 huggingface dataset:
Practice Patterns Among Fellowship-Trained Rhinologists: A Survey of Past American Rhinologic Society Fellows
Authors: Tang Dennis M. , Nasrollahi Tasha S. , Vasquez Missael , Borrelli Michela , Sindwani Raj , Wu Arthur W.
Published: April 2024

Background

The goals of this study were to understand the trends in recent and past rhinology fellows concerning their demographics, goals, and experiences.

Methods

An anonymous web-based survey was sent to graduates of the 35 rhinology fellowship programs. The survey included questions regarding the scope of practice, research contribution, societal involvement, fellow satisfaction with training, and current practice patterns. Chi-square testing and logistic regression were used to compare variables across cohorts: 0-5 years versus 6+ years from fellowship graduation, gender, and practice settings.

Results

Based on 171 respondents, we found no significant differences in 0-5 versus 6+ year graduates in their desire for an academic job post-fellowship. However, those who graduated 6+ years ago had significantly more success securing one (74% vs 96%, P = 0.004). Between males and females, there were no differences in goal of obtaining an academic job or success in obtaining an academic career. Females were more likely to report they attend academic society meetings regularly. Female rhinologists also reported less satisfaction with overall work-life balance and decreased satisfaction with clinical practice. Physicians in academic settings have poorer work-life balance.

Conclusions

Our findings suggest that finding an academic job may be more difficult for recent rhinology fellowship graduates, although still very possible for the majority of graduates. Understanding the reason for these changes may provide insight to current rhinology fellowship directors and trainees interested in pursuing fellowship training.
The working conditions of non-professional magistrates and the European concept of ‘worker’
Authors: Maran Emiliano
Published: April 2024

This article provides an overview of the legislation on the status and working conditions of the different categories of non-professional magistrates, as utilised by the judiciary administration of European Member States. In this regard, a distinction is made between ‘lay judges’, non-professional judges cooperating in a judicial process on the basis of their perspective as normal citizens, and ‘honorary judges’, who cooperate in the adjudication with their specialist knowledge and experiences. Through the lens of the CJEU's ruling in UX, the article also provides an insight into whether, on the basis of the reported legislation, any particular category of honorary judges is susceptible of falling within the European concept of ‘worker’.
Influence of approach shape of debris flow on impact load to open Sabo dam in experiment
Authors: Horiguchi Toshiyuki , Miyahara Yuta , Komatsu Yoshiharu
Published: April 2024

Recently, the magnitude of landslide caused by torrential rain and typhoons is increasing in Japan. This high intensity rainfall disaster induces some structural failure of steel pipe open Sabo dams. Thus, current static design loads and impact loads are being considered. To prevent some structural failure of the dam, a new design concept is necessary at the severe load that is exceeding the present design load. However, the influence of debris flow impact load on steel pipe open Sabo dam is not clear to make a design load. The study experimentally approaches a vertical load distribution shape and its time history based on a comparison with a wedge approach shape and a front boulder concentrated shape. The load and moment action of a front boulder concentrated shape debris flow is greater than that of a wedge approach shape. Mechanism making the difference is made clear by observation of vertical detail measurement of impact load.
Stress wave attenuation in ultra-high performance fibre-reinforced concrete during ballistic impact
Authors: Das Nabodyuti , Ramagiri Bhaskar , Nanthagopalan Prakash
Published: April 2024

Depending on material properties and boundary conditions, various waves propagate within the target, during an impact event. Stress wave attenuation during ballistic impact can be expressed in strain profiles regarding time and distance from the impact point. The design of a ballistic-resistant structure thus depends on the stress wave attenuation. This present study focused on stress wave attenuation under projectile impact in ultra-high performance fibre-reinforced concrete (UHPFRC). 3 mm strain gauges were found suitable for such measurements. Two different types (steel fibres) of UHPFRC (Single fibre (S2): 2 % of 6 mm steel fibre and Hybrid fibre combination (S0.5L1.5): 0.5 % of 6 mm + 1.5 % of 13 mm steel fibres) were used for investigation. During the ballistic impact event, strain profiles at specific distances from the point of impact on both the front and rear surfaces of UHPFRC targets were recorded. The scabbing damage due to tension was captured and analysed in this study through stress wave attenuation. The impact performance of hybrid (Short and Long fibres) S0.5L1.5 UHPFRC combinations was much better than S2 (only short fibres) UHPFRC targets. The hybrid steel fibre UHPFRC also shows higher strain attenuation (than short fibre based UHPFRC) in the range of 10-30 µε/mm. It was concluded that the efficiently designed ballistic-resistant UHPFRC should have higher wave attenuation, implying the concrete has enhanced capacity to absorb and localise energy, thereby mitigating the extent of damage inflicted upon the overall concrete slab.
Correlation of oxidative stress and vascular endothelial dysfunction with hippocampal perfusion in atrial fibrillation patients with cognitive impairment
Authors: Ke Hong hong , Li Jinyi , Liang Guicheng , Li Shuhu , Wang Shirong , Zhong Guoqiang
Published: April 2024

Objectives:

To evaluate the correlation of oxidative stress and vascular endothelial dysfunction with hippocampal perfusion in patients with atrial fibrillation and cognitive impairment.

Methods:

In total, 41 atrial fibrillation patients with cognitive impairment were compared to 45 atrial fibrillation patients without cognitive impairment. Oxidative stress, vascular endothelial dysfunction, hippocampal perfusion, and cognitive function were measured.

Results:

Serum level of oxidized low-density lipoprotein was significantly higher in the atrial fibrillation + cognitive impairment group than in the atrial fibrillation group. Serum levels of intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 were significantly higher, and nitric oxide was lower, in the atrial fibrillation + cognitive impairment group than in the atrial fibrillation group. The regional cerebral blood volume, mean transit time, and time to peak were significantly higher in the atrial fibrillation + cognitive impairment group than in the atrial fibrillation group. Moreover, regional cerebral blood flow was significantly lower in the atrial fibrillation + cognitive impairment group than in the atrial fibrillation group. Age, left atrial diameter, and regional cerebral blood volume were negatively correlated with the cognitive function score in the atrial fibrillation + cognitive impairment group. Serum levels of oxidized low-density lipoprotein, regional cerebral blood volume, regional cerebral blood flow, mean transit time, and time to peak were significantly correlated with cognitive impairment in atrial fibrillation patients after multivariate logistic regression analysis.

Conclusion:

Hippocampal perfusion and oxidative stress were significantly correlated with cognitive impairment in atrial fibrillation patients.
Premarital cohabitation and the gendered division of household labor in China
Authors: Yang Yining Milly
Published: April 2024

Premarital cohabitation has been understudied in China, and its impact on marriages in the region remains largely unexplored. This study examines the implications of premarital cohabitation for gender inequalities in Chinese marriages. The author analyzes how married couples with and without the experience of premarital cohabitation compare in the amounts of time they spend doing housework, whether the differences can be attributed to social and economic factors, and to what extent the experience of cohabitation equalizes the gendered division of housework. Drawing on four waves of data (2010, 2014, 2016, and 2018) from the China Family Panel Studies, this study is one of the first to provide nationally representative evidence on the relationship between premarital cohabitation and housework in China. Propensity score weighting and linear mixed effect models were employed. In contrast to findings from Western contexts, this study finds that in China, premarital cohabitation is not associated with a smaller gender gap in housework time after accounting for factors that affect selection into cohabitation. However, premarital cohabitation was associated with a significant decrease in women's housework time among urban residents and couples married after 1995, while its effect on men's housework time was not significant. Findings from this study highlight a gendered cohabitation effect on housework hours in China and underscore the importance of contextualizing the meanings of cohabitation and housework in non-Western contexts.
Do Sitcom Conversations Fully Depict Those in Natural Settings: A Corpus-Based Lexical Analysis
Authors: Li Min , Xiao Yan
Published: April 2024

An increasing number of studies in pragmatics, second language acquisition, and related fields have opted to use sitcom conversations as a substitute for natural conversations in their analyses. However, few studies have critically examined the validity of this substitution. Taking this into consideration, the present study aims to examine the lexical similarities and differences between sitcom and natural conversations by utilizing the Friends Corpus and the Santa Barbara Corpus of Spoken American English as samples under a synthesized analytic framework of six lexical categories that have been frequently examined in previous research. The findings indicate that there are significant differences between sitcom and natural conversations at the lexical level, particularly in terms of word lengths, keywords, and the use of discourse markers, personal pronouns, vocatives, and religious words. While sitcom conversations tend to be more concise, interactive, evaluative, and involving, natural conversations provide more explanations for their speech acts and refer to their parties who are not present in the conversations. Additionally, sitcom conversations use more intensifiers and vocatives while using fewer tentative modals, expletives, and religious words. Based on these results, it can be concluded that sitcom conversations do not fully depict the conversations in sitcoms, and thus substituting natural conversations with those in sitcoms should be approached with caution in language teaching and research. This study provides insight into the differences in lexical patterns between two types of conversations, and highlights the importance of using natural conversations as a basis for language teaching and research.
The Requirements and Importance of Intercultural Communication Competence in the 21st Century
Authors: Sarwari Abdul Qahar , Adnan Hamedi Mohd , Rahamad Mohamad Saleeh , Abdul Wahab Mohammad Nubli
Published: April 2024

This systematic review assessed the requirements and importance of intercultural communication competence (ICC) in human life in the 21st Century, focusing on its practical aspects and elements. The results reported in the current study are from a review of 45 papers published from 2000 to 2023 in 16 different Web of Science and SCOPUS-indexed journals. To record and select the related and required papers, an online search was done using two key terms, “intercultural competence” and “intercultural communication competence,” and through the use of WoS and SCOPUS databases. A total of 87 items were recorded from the online search, and after a quick review of all records, 45 papers were selected and reviewed thoroughly. Based on the results from the reviewed papers, ICC is one of the main requirements of human life in today’s globalized world, especially in modern education and international business. Findings indicate that the absence of ICC is a crucial reason for failure in many modern professionals. Based on the results, cultural awareness and intercultural sensitivity, language proficiency, empathy, flexibility, and some other traits and skills are among the main components of ICC. The results indicate that staying and studying in multicultural environments, participating in cultural programs, observing felling and emotions, flexibility, and other factors, discussed in the current work, help individuals improve their ICC.
Incidence and Characteristics of Knee Ligament and Meniscal Injuries in Patients With Posterolateral Tibial Plateau Fractures
Authors: Wang Binghao , Zhu Yi , Zhang Binbin , Wang Yukai , Yan Lifeng , Xie Xuetao , Luo Congfeng
Published: April 2024

Background:

Anterior cruciate ligament (ACL) tears are commonly seen with concomitant injuries to the posterolateral tibial plateau, while the occurrence of ACL injuries in posterolateral tibial plateau fractures (PTPFs) remains unclear.

Purpose:

To (1) explore the incidence of knee ligament (anterior or posterior cruciate ligament, medial or lateral collateral ligament) and medial or lateral meniscus injuries in patients with PTPF and (2) find reliable PTPF-related parameters to predict the risk of knee ligament and meniscal injuries.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Patients diagnosed with PTPF who had computed tomography and magnetic resonance imaging (MRI) data were identified. Morphological parameters of the PTPF were measured on sagittal computed tomography images. Knee ligament and meniscal injuries were assessed using MRI. The association of ACL injuries with meniscal injuries was analyzed. Receiver operating characteristic (ROC) analysis was used to determine the value and cutoff point of the PTPF morphological parameters for diagnosing complete in-substance ACL tears.

Results:

Overall, 113 patients with PTPF were included. ACL injuries were present in 94 (83.2%) patients, including 43 (38.1%) avulsion fractures and 28 (24.8%) complete in-substance tears. Patients with in-substance ACL tears had a higher incidence of lateral meniscus posterior horn tears compared with the other patients ( PBonferroni < .001). ROC analysis revealed that both the fracture depression angle (cutoff point, 25.5°) and the posterior articular surface loss percentage (cutoff point, 37.5%) had a sensitivity >90% and a specificity >80% for the diagnosis of complete in-substance ACL tears.

Conclusion:

ACL injuries were seen in 83.2% of the study patients. Complete in-substance ACL tears were associated with an increased incidence of lateral meniscus posterior horn tears. Among PTPF parameters, fracture depression angle and posterior articular surface loss percentage showed a high predictive value for the presence of complete in-substance ACL tears, thereby reducing delays in diagnosis and treatment.
Nurses’ Attitudes, Practices, and Barriers to Assessing Symptoms of Discomfort in Mechanically Ventilated Patients: A Cross-Sectional Study
Authors: Takahashi Tomohiko , Oyama Yusuke , Sakuramoto Hideaki , Tamoto Mitsuhiro , Sato Tomoo , Nanjo Yuko , Hosoi Sayaka , Unoki Takeshi
Published: April 2024

Introduction

Critically ill patients experience various stressful symptoms of discomfort, including dyspnea, pain, and sleep disruption. Notably, ventilated patients have difficulty self-reporting discomfort symptoms. Nurses need to assess discomfort symptoms to alleviate them, but limited research exists on discomfort symptom assessment and management in critically ill patients.

Objective

To identify the practices, attitudes, and barriers among nurses related to the assessment of discomfort symptoms in mechanically ventilated patients.

Methods

Using a cross-sectional, descriptive study design, a web-based survey was conducted between May and June 2022 with critical care nurses sampled through Japanese academic societies and social networking services. The survey contained questions relative to the above-stated objective. Descriptive statistical analysis was performed without sample size calculation because of the descriptive and exploratory nature of this study.

Results

There were 267 respondents to the questionnaire. The discomfort symptoms that nurses perceived as important to assess were pain (median 100 [interquartile range, IQR 90–100]), insomnia (99 [80–100]), and dyspnea (96.5 [75–100]). Most participants (89.8%) routinely assessed pain in mechanically ventilated patients using a scale; however, other discomfort symptoms were assessed by less than 40% (dyspnea [28.4%], fatigue [8.1%], thirst [13.1%], insomnia [37.3%], and anxiety [13.6%]). Two major barriers to assessing discomfort symptoms were lack of assessment culture within the intensive care unit and lack of knowledge of the relevant evaluation scales.

Conclusions

Nurses were aware of the importance of using scales to assess the discomfort symptoms experienced by mechanically ventilated patients. However, except for pain, most nurses did not routinely use scales to assess discomfort symptoms. Barriers to routine discomfort symptom assessment included the lack of an assessment culture and the lack of knowledge of the assessment scales. Clinicians should be educated regarding the existence of validated rating scales and develop additional rating scales utilizable for minor discomforts in mechanically ventilated patients.
“I Wonder if my Years of Training and Expertise Will be Devalued by Machines”: Concerns About the Replacement of Medical Professionals by Artificial Intelligence
Authors: Rony Moustaq Karim Khan , Parvin Mst. Rina , Wahiduzzaman Md. , Debnath Mitun , Bala Shuvashish Das , Kayesh Ibne
Published: April 2024

Background

The rapid integration of artificial intelligence (AI) into healthcare has raised concerns among healthcare professionals about the potential displacement of human medical professionals by AI technologies. However, the apprehensions and perspectives of healthcare workers regarding the potential substitution of them with AI are unknown.

Objective

This qualitative research aimed to investigate healthcare workers’ concerns about artificial intelligence replacing medical professionals.

Methods

A descriptive and exploratory research design was employed, drawing upon the Technology Acceptance Model (TAM), Technology Threat Avoidance Theory, and Sociotechnical Systems Theory as theoretical frameworks. Participants were purposively sampled from various healthcare settings, representing a diverse range of roles and backgrounds. Data were collected through individual interviews and focus group discussions, followed by thematic analysis.

Results

The analysis revealed seven key themes reflecting healthcare workers’ concerns, including job security and economic concerns; trust and acceptance of AI; ethical and moral dilemmas; quality of patient care; workforce role redefinition and training; patient–provider relationships; healthcare policy and regulation.

Conclusions

This research underscores the multifaceted concerns of healthcare workers regarding the increasing role of AI in healthcare. Addressing job security, fostering trust, addressing ethical dilemmas, and redefining workforce roles are crucial factors to consider in the successful integration of AI into healthcare. Healthcare policy and regulation must be developed to guide this transformation while maintaining the quality of patient care and preserving patient–provider relationships. The study findings offer insights for policymakers and healthcare institutions to navigate the evolving landscape of AI in healthcare while addressing the concerns of healthcare professionals.
The Decline of Basic Ophthalmology in General Medical Education: A Scoping Review and Recommended Potential Solutions
Authors: Liao Jennifer , Wright Robin Redmon , Vora Gargi K
Published: April 2024

OBJECTIVE

This literature review aims to explore research and conceptual pieces on the state of ophthalmology education and suggest potential ways to address current challenges.

METHODS

A search was conducted in PubMed, ERIC, Web of Science, and Google Scholar with combinations of the following search terms: “ophthalmology education,” “undergraduate medical education,” “medical student,” “United States,” and “Canada.” Eliminating irrelevant articles yielded 47 articles. Three were excluded because of region and focus, leaving 44. After examining the citations, we generated an additional 22 texts for review, totaling 66 articles.

RESULTS

Four primary themes were identified: (1) challenges to ophthalmological education in the U.S. and Canada, (2) potential remedies for optimizing ophthalmology curriculum, (3) technology in ophthalmology education, and (4) innovative ophthalmology teaching approaches. Major challenges included the lack of a standardized curriculum and inadequate clinical exposure and skills training. A number of remedies were proposed, such as standardizing curriculum and furthering faculty involvement, utilizing technology as time-effective learning aids, and employing innovative teaching approaches such as service learning.

CONCLUSION

In light of challenges in ophthalmology education, curriculum designers should consider Cognitive Load Theory (CLT) to assist students to remember meaningful exposures to ophthalmology knowledge and techniques. Based on CLT, we suggest two potential approaches to incorporating ophthalmology curriculum. The first is to embrace interdisciplinary collaborations and place ophthalmology knowledge in varied contexts to facilitate schema construction. The second is to incorporate ophthalmology diagnostics requirements into OSCEs and utilize simulation models for students to gradually increase the fidelity of tasks and devote cognitive resources fully to learning.
The Conundrum and Promise of Intercultural Theology in the Western Academy
Authors: van den Toren Benno
Published: April 2024

Intercultural theology has a dual origin. On the one hand it derives from the development of diverse forms of theologizing in Christianity worldwide, while on the other hand it originates in the North Atlantic university where intercultural theology and world Christianity have developed as particular fields of study. With reference to two examples of spiritual possession and biblical interpretation, this article argues that its location within Western academic institutional settings presents obstacles to the ability of intercultural theologians in the West to do justice to the proper nature of various forms of theologizing in other contexts. In particular, attention is drawn to the fragmentation of theological disciplines, the secularization of academic discourse, the use of cultural analysis, and the power of the Western academy. The article concludes with some proposals regarding how an awareness of this dual origin can help intercultural theologians to be a critical presence within the Western academy beyond their discipline.
Moving Beyond a Missionary Model to Muslims? Considering J. Dudley Woodberry Today
Authors: Lee Alexander S.
Published: April 2024

This article situates J. Dudley Woodberry as an exemplar of scholarly evangelical engagement with Islam while suggesting some limitations of his approach for mission today. After a brief sketch of Woodberry’s earliest steps into scholarship, the article locates his contributions to Islamic Studies against the backdrop of developments in the field with specific attention paid to his engagement with lived Islam. It then interacts with responses to Woodberry’s work and reassesses its relevance for Christian mission among Muslims at present. Finally, this article constructively appropriates Woodberry’s ideas to suggest further steps in Christian-Muslim relations through the practice of comparative theology.
Falls in the hospital: An Italian clinical risk management perspective
Authors: Buongiorno Luigi , Mele Federica , Solarino Biagio , Ferorelli Davide , Zotti Fiorenza , Dell’Erba Alessandro , Carabellese Felice Francesco , Catanesi Roberto , Ferracuti Stefano , Mandarelli Gabriele
Published: April 2024

Background

Hospital falls are a frequent sentinel event worldwide, yet prevention remains challenging. There is a need to standardize hospital fall management in healthcare facilities. This study aimed to analyze policies and procedures used by Italian healthcare facilities to reduce hospital falls.

Methods

The Italian hospitals’ public procedures on patients’ falls issued between November 2011 and June 2022 were retrieved by a web search using the Google search engine and further evaluated according to their compliance with the 2011 Italian Ministerial recommendation for the prevention of patients’ falls.

Results

We found 37 official online procedures, of which 45.6% showed full compliance with the 2011 Ministerial recommendation. All the documents explicitly addressed the issue of identifying patient-related fall risk profiles, whereas 28 set appropriate environmental risk factors. More than 80% of the retrieved procedures used the Conley scale. Forty-three percent of the procedures did not provide for national monitoring and reporting of patient falls.

Conclusions

Public procedures for preventing patient falls in Italian hospitals are scarcely compliant with the 2011 Ministerial recommendation. Local monitoring, compliance, and reporting of hospital falls are needed to improve patient outcomes and reduce the risk of litigation for staff and organizations. Additionally, standardized tools for evaluating the risk of falls, healthcare professionals’ training, and implementing environmental prevention strategies are needed to contrast this issue.
Recurrent Adamantinoma With Fibrous Dysplasia-like Feature
Authors: Petaros Anja , Šantić Veljko , Vuković Anita Savić , Perić Petar , Jonjić Nives
Published: April 2024

Adamantinoma (AD) is a rare, slow-growing primary malignant bone tumor characterized by a biphasic morphology of clusters of epithelial cells and spindle cell osteofibrous components. A strong relationship between AD and osteofibrous dysplasia (OFD) has been proposed, while fibrous dysplasia (FD) has been rarely associated with AD. We present an AD case that was followed and histologically evaluated 3 times over 6 years with different morphological patterns. The tumor in the primary biopsy and after complete resection showed classical features of AD and osteofibrous-like pattern, while the recurrent lesion presented with exclusively spindle cell morphology and was thus diagnosed as FD. However, the extensive immunohistochemical analysis in all 3 lesions revealed strong reactivity for pancytokeratin, vimentin, p63, and podoplanin, which are characteristic for AD. Although, in the FD-like section of the tumor from the first recurrence the positivity of podoplanin was stronger than pancitokeratin, which was variably positive on spindle cells. The present case highlights the problem of diagnosing AD based on a single biopsy with one tumor’s component predominating over the other, and at the same time emphasizes the importance of using immunohistochemical staining for keratin and podoplanin when the histopathological features of (osteo)fibrous lesion can be linked to AD.
Dietary inflammatory index in relation to the progression of hepatic steatosis and liver fibrosis: evaluation by elastography/Fibroscan
Authors: Miryan Mahsa , Rashid Sameeah Abdulrahman , Navashenaq Jamshid Gholizadeh , Soleimani Davood , Nematy Mohsen , Moludi Jalal
Published: April 2024

One of the proposed mechanisms by which nutrition influences the progression of hepatic steatosis to fibrosis is inflammation. The study investigated how the inflammatory potential of the diet affects the risk of liver damage in patients with nonalcoholic fatty liver disease (NAFLD), a condition where fat accumulates in the liver. This cross-sectional study included 170 outpatients with newly diagnosed NAFLD. This study used a device called Fibroscan® to measure the degree of liver fibrosis, which is the scarring of the liver tissue due to chronic inflammation. The study also used a tool called the Dietary Inflammatory Index (DII) to measure the inflammatory potential of the diet based on the intake of different foods and nutrients. In the findings of the study, patients with more severe fat accumulation in the liver (hepatic steatosis) had higher DII scores, meaning they had more inflammatory diets. The study also found that higher DII scores were associated with higher weight and body mass index (BMI). One standard deviation (SD) increase in DII scores was associated with a 0.29 kilopascal (95% CI: 0.10–0.44; P-value 0.001) increase in the mean liver stiffness, an indicator of liver fibrosis. The study concluded that patients with higher DII scores had a higher risk of developing liver fibrosis than those with lower DII scores, even after adjusting for confounding factors (odds ratio: 5.89; P-value: 0.001). The study suggested that eating less inflammatory foods may help prevent or slow down the progression of hepatic steatosis and liver in patients with NAFLD.
Evaluation of models to predict prognosis in patients with advanced hepatocellular carcinoma treated with TACE combined with apatinib
Authors: Sun Fang , Liu Kai-Cai , Ul Ain Qurat , Lu Dong , Zhou Chun-Ze , Xiao Jing-Kun , Zhang Xing-Ming , Zhang Zheng-Feng , Cheng Deng-Lei , He Yu-Sheng , Lv Wei-Fu
Published: April 2024

Background

The HAP, Six-and-Twelve, Up to Seven, and ALBI scores have been substantiated as reliable prognostic markers in patients presenting with intermediate and advanced hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE) treatment. Given this premise, our research aims to assess the predictive efficacy of these models in patients with intermediate and advanced HCC receiving a combination of TACE and Apatinib. Additionally, we have conducted a meticulous comparative analysis of these four scoring systems to discern their respective predictive capacities and efficacies in combined therapy.

Methods

Performing a retrospective analysis on the clinical data from 200 patients with intermediate and advanced HCC, we studied those who received TACE combined with Apatinib at the First Affiliated Hospital of the University of Science and Technology of China between June 2018 and December 2022. To identify the factors affecting survival, the study performed univariate and multivariate Cox regression analyses, with calculations of four different scores: HAP, Six-and-Twelve, Up to Seven, and ALBI. Lastly, Harrell’s C-index was employed to compare the prognostic abilities of these scores.

Results

Cox proportional hazards model results revealed that the ALBI score, presence of portal vein tumor thrombus (PVTT, )and tumor size are independent determinants of prognostic survival. The Kaplan-Meier analyses showed significant differences in survival rates among patients classified by the HAP, Six-and-Twelve, Up to Seven, and ALBI scoring methods. Of the evaluated systems, the HAP scoring demonstrated greater prognostic precision, with a Harrell’s C-index of 0.742, surpassing the alternative models (P < 0.05). In addition, an analysis of the area under the AU-ROC curve confirms the remarkable superiority of the HAP score in predicting short-term survival outcomes.

Conclusion

Our study confirms the predictive value of HAP, Six-and-Twelve, Up to Seven, and ALBI scores in intermediate to advanced Hepatocellular Carcinoma (HCC) patients receiving combined Transarterial Chemoembolization (TACE) and Apatinib therapy. Notably, the HAP model excels in predicting outcomes for this specific HCC subgroup.
Bacteremia caused by Nocardia farcinica: a case report and literature review
Authors: Wang Di , Hu Meng-Ting , Liu Wen-Jing , Zhao Ying , Xu Ying-Chun
Published: April 2024

Background

Nocardia farcinica is one of the most common Nocardia species causing human infections. It is an opportunistic pathogen that often infects people with compromised immune systems. It could invade human body through respiratory tract or skin wounds, cause local infection, and affect other organs via hematogenous dissemination. However, N. farcinica-caused bacteremia is uncommon. In this study, we report a case of bacteremia caused by N. farcinica in China.

Case presentation

An 80-year-old woman was admitted to Peking Union Medical College Hospital with recurrent fever, right abdominal pain for one and a half month, and right adrenal gland occupation. N. farcinica was identified as the causative pathogen using blood culture and plasma metagenomics next-generation sequencing (mNGS). The clinical considerations included bacteremia and adrenal gland abscess caused by Nocardia infection. As the patient was allergic to sulfanilamide, imipenem/cilastatin and linezolid were empirically administered. Unfortunately, the patient eventually died less than a month after the initiation of anti-infection treatment.

Conclusion

N. farcinica bacteremia is rare and its clinical manifestations are not specific. Its diagnosis depends on etiological examination, which can be confirmed using techniques such as Sanger sequencing and mNGS. In this report, we have reviewed cases of Nocardia bloodstream infection reported in the past decade, hoping to improve clinicians’ understanding of Nocardia bloodstream infection and help in its early diagnosis and timely treatment.
A systematic review on antibiotic therapy of cutaneous bacillary angiomatosis not related to major immunocompromising conditions: from pathogenesis to treatment
Authors: Rotundo Salvatore , Tassone Maria Teresa , Marascio Nadia , Morrone Helen Linda , Gigliotti Simona , Quirino Angela , Russo Alessandro , Matera Giovanni , Trecarichi Enrico Maria , Torti Carlo
Published: April 2024

Background

Cutaneous bacillary angiomatosis (cBA) is a vascular proliferative disorder due to Bartonella spp. that mostly affects people living with HIV (PLWH), transplanted patients and those taking immunosuppressive drugs. Since cBA is mostly related to these major immunocompromising conditions (i.e., T-cell count impairment), it is considered rare in relatively immunocompetent patients and could be underdiagnosed in them. Moreover, antimicrobial treatment in this population has not been previously investigated.

Methods

We searched the databases PubMed, Google Scholar, Scopus, OpenAIRE and ScienceDirect by screening articles whose title included the keywords “bacillary” AND “angiomatosis” and included case reports about patients not suffering from major immunocompromising conditions to provide insights about antibiotic treatments and their duration.

Results

Twenty-two cases of cBA not related to major immunocompromising conditions were retrieved. Antibiotic treatment duration was shorter in patients with single cBA lesion than in patients with multiple lesions, including in most cases macrolides and tetracyclines.

Conclusions

cBA is an emerging manifestation of Bartonella spp. infection in people not suffering from major immunocompromising conditions. Until evidence-based guidelines are available, molecular tests together with severity and extension of the disease can be useful to personalize the type of treatment and its duration.
A meta-analysis of risk factors for a Dacron-cuffed catheter related infection in hemodialysis
Authors: Chen Wen , Wang Zaoju , Wang Guoping , Cao Chunyu , Hong Bo , Liu Jinying , Xie Fuhua , Wang Runxiu
Published: April 2024

Objective

To provide theoretical basis for prevention of a Dacron-cuffed catheter related infection (CRI), the risk factors of CRI in hemodialysis patients were systematically evaluated.

Methods

Eight databases, including PubMed, Cochrane library, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Database (CBM), Wanfang Database and Chinese Scientific Journal Database (VIP), were searched to screen out literatures related to the risk factors of long-term indwelling a Dacron-cuffed CRI in hemodialysis. Meta-analysis of risk factors for a Dacron-cuffed CRI in hemodialysis and publication bias test were performed using RevMan 5.4 software.

Results

After screening, 13 literatures involving a Dacron-cuffed CRI were included, with a total of 625 patients, and the infection rate was 11.7%. The combined OR value and 95% confidence interval (CI) of all factors were: Combined with Diabetes (1.94, 1.51 ~ 2.50), Hb (1.82, 1.35 ~ 2.44), age (2.38, 1.06 ~ 5.34), catheter indwelling time (1.79, 1.21 ~ 2.66), serum albumin (2.26, 1.25 ~ 4.08), catheter indwelling site (3.29, 1.74 ~ 6.23) and the number of tube placement (5.40, 2.65 ~ 11.02).

Conclusions

The main risk factors for a Dacron-cuffed CRI in hemodialysis were combined with diabetes, hemoglobin level, age, catheter indwelling time, serum albumin level, femoral vein catheter indwelling and catheterization times. In other words, hemodialysis patients are at higher risk of CRI if they have diabetes, or if they have a lower hemoglobin level, or if they are older, or if they have a longer duration of catheterization, or if they have a lower serum albumin level, or if they have a femoral vein catheter, or if they have more catheters.
Improving emotion perception in cochlear implant users: insights from machine learning analysis of EEG signals
Authors: Paquette Sebastien , Gouin Samir , Lehmann Alexandre
Published: April 2024

Background

Although cochlear implants can restore auditory inputs to deafferented auditory cortices, the quality of the sound signal transmitted to the brain is severely degraded, limiting functional outcomes in terms of speech perception and emotion perception. The latter deficit negatively impacts cochlear implant users’ social integration and quality of life; however, emotion perception is not currently part of rehabilitation. Developing rehabilitation programs incorporating emotional cognition requires a deeper understanding of cochlear implant users’ residual emotion perception abilities.

Methods

To identify the neural underpinnings of these residual abilities, we investigated whether machine learning techniques could be used to identify emotion-specific patterns of neural activity in cochlear implant users. Using existing electroencephalography data from 22 cochlear implant users, we employed a random forest classifier to establish if we could model and subsequently predict from participants’ brain responses the auditory emotions (vocal and musical) presented to them.

Results

Our findings suggest that consistent emotion-specific biomarkers exist in cochlear implant users, which could be used to develop effective rehabilitation programs incorporating emotion perception training.

Conclusions

This study highlights the potential of machine learning techniques to improve outcomes for cochlear implant users, particularly in terms of emotion perception.
Using part of the initial analgesic dose as the epidural test dose did not delay the onset of labor analgesia: a randomized controlled clinical trial
Authors: Chen Jianxiao , Chen Sumeng , Lv Hao , Lv Peijun , Yu Xinhua , Huang Shaoqiang
Published: April 2024

Background

Epidural test dose for labor analgesia is controversial and varies widely in clinical practice. It is currently unclear whether using a portion of the initial dose for analgesia as the test dose delays the onset time of analgesia, compared to the traditional test dose.

Methods

One hundred and twenty-six parturients who chose epidural analgesia during labor were randomly assigned to two groups. The first dose in group L was 3 ml 1.5% lidocaine, and in the RF group was 10 ml 0.1% ropivacaine combined with 2 μg/ml fentanyl. After 3 min of observation, both groups received 8 ml 0.1% ropivacaine combined with 2 μg/ml fentanyl. The onset time of analgesia, motor and sensory blockade level, numerical pain rating scale, patient satisfaction score, and side effects were recorded.

Results

The onset time of analgesia in group RF was similar to that in group L (group RF vs group L, 7.0 [5.0–9.0] minutes vs 8.0 [5.0–11.0] minutes, p = 0.197). The incidence of foot numbness (group RF vs group L, 34.9% vs 57.1%, p = 0.020) and foot warming (group RF vs group L, 15.9% vs 47.6%, p < 0.001) in group RF was significantly lower than that in group L. There was no difference between the two groups on other outcomes.

Conclusions

Compared with 1.5% lidocaine 3 ml, 0.1% ropivacaine 10 ml combined with 2 μg/ml fentanyl as an epidural test dose did not delay the onset of labor analgesia, and the side effects were slightly reduced.

Clinical trial registration

http://www.chictr.org.cn (ChiCTR2100043071).
Development and implementation of a worksite-based intervention to improve mothers’ knowledge, attitudes, and skills in sharing information with their adolescent daughters on preventing sexual violence: lessons learned in a developing setting, Sri Lanka
Authors: Mataraarachchi Dilini , Buddhika Mahesh P.K. , Pathirana T.E.A. , Vithana P.V.S.C.
Published: April 2024

Background

Sexual violence among adolescents has become a major public health concern in Sri Lanka. Lack of sexual awareness is a major reason for adverse sexual health outcomes among adolescents in Sri Lanka. This study was intended to explore the effectiveness of a worksite-based parent-targeted intervention to improve mothers’ knowledge, and attitudes on preventing sexual violence among their adolescent female offspring and to improve mother-daughter communication of sexual violence prevention with the family.

Methods

“My mother is my best friend” is an intervention designed based on previous research and behavioral theories, to help parents to improve their sexual communication skills with their adolescent daughters. A quasi-experimental study was conducted from August 2020 to March 2023 in randomly selected two Medical Officer of Health (MOH)areas in Kalutara district, Sri Lanka. Pre and post-assessments were conducted among a sample of 135 mothers of adolescent girls aged 14–19 years in both intervention and control areas.

Results

Out of the 135 mothers who participated in the baseline survey, 127 mothers (94.1%) from the intervention area (IA) physically participated in at least one session of the intervention. The worksite-based intervention was effective in improving mothers’ knowledge about adolescent sexual abuse prevention (Difference in percentage difference of pre and post intervention scores in IA and CA = 4.3%, p = 0.004), mother’s attitudes in communicating sexual abuse prevention with adolescent girls (Difference in percentage difference of pre and post intervention scores in IA and CA = 5.9%, p = 0.005), and the content of mother-daughter sexual communication (Difference in percentage difference of pre and post intervention scores in IA and CA = 27.1%, p < 0.001).

Conclusions and recommendations

Worksite-based parenting program was effective in improving mothers’ knowledge about sexual abuse prevention among adolescent daughters and in improving the content of mother-daughter communication about sexual abuse prevention. Developing appropriate sexual health programs for mothers of different ethnicities, and cultures using different settings is important. Conduction of need assessment programs to identify the different needs of mothers is recommended.
Physical activity and lung function association in a healthy community-dwelling European population
Authors: Collaud Sybile , Touilloux Brice , von Garnier Christophe , Marques-Vidal Pedro , Kraege Vanessa
Published: April 2024

Background

The association of physical activity (PA) and lung function (LF) varies from no measurable effect to delayed LF decline. We assessed the association between accelerometery-assessed PA and LF in a sample of apparently healthy, community-dwelling subjects.

Methods

We included two cross-sectional studies using data from the PneumoLaus study (2014–17 and 2018–21), conducted in Lausanne, Switzerland. PA was assessed by accelerometry and categorised as inactivity, light, moderate or vigorous. Forced expiratory volume in 1 second (FEV1), forced volume capacity (FVC) and maximal mid-expiratory flow (MMEF) were measured by spirometry and expressed in percentage of predicted value (PV).

Results

Overall, 1′910 (54.7% women, 62.0 ± 9.7 years) and 1′174 (53.4% women, 65.8 ± 9.5 years) participants were included in the first and the second surveys, respectively. In both surveys, moderate and vigorous PA showed a weak but significant correlation with FEV1 in percentage (PV) (R = 0.106 and 0.132 for the first and 0.111 and 0.125 for the second surveys, p < 0.001). Similar correlations with FVC (p < 0.001) were found. Associations held irrespective of smoking status and remained after multivariable adjustment. Fewer associations were detected between LF and light PA or between MMEF and PA.

Conclusion

Moderate and vigorous intensity PA are associated with increased LF regardless of smoking status in apparently healthy community-dwelling European population. These associations are statistically but not clinically significant due to the small correlation coefficients (R < 0.30), corresponding to a weak association.
Machine learning pipeline to analyze clinical and proteomics data: experiences on a prostate cancer case
Authors: Vizza Patrizia , Aracri Federica , Guzzi Pietro Hiram , Gaspari Marco , Veltri Pierangelo , Tradigo Giuseppe
Published: April 2024

Proteomic-based analysis is used to identify biomarkers in blood samples and tissues. Data produced by devices such as mass spectrometry requires platforms to identify and quantify proteins (or peptides). Clinical information can be related to mass spectrometry data to identify diseases at an early stage. Machine learning techniques can be used to support physicians and biologists in studying and classifying pathologies. We present the application of machine learning techniques to define a pipeline aimed at studying and classifying proteomics data enriched using clinical information. The pipeline allows users to relate established blood biomarkers with clinical parameters and proteomics data. The proposed pipeline entails three main phases: (i) feature selection, (ii) models training, and (iii) models ensembling. We report the experience of applying such a pipeline to prostate-related diseases. Models have been trained on several biological datasets. We report experimental results about two datasets that result from the integration of clinical and mass spectrometry-based data in the contexts of serum and urine analysis. The pipeline receives input data from blood analytes, tissue samples, proteomic analysis, and urine biomarkers. It then trains different models for feature selection, classification and voting. The presented pipeline has been applied on two datasets obtained in a 2 years research project which aimed to extract hidden information from mass spectrometry, serum, and urine samples from hundreds of patients. We report results on analyzing prostate datasets serum with 143 samples, including 79 PCa and 84 BPH patients, and an urine dataset with 121 samples, including 67 PCa and 54 BPH patients. As results pipeline allowed to identify interesting peptides in the two datasets, 6 for the first one and 2 for the second one. The best model for both serum (AUC=0.87, Accuracy=0.83, F1=0.81, Sensitivity=0.84, Specificity=0.81) and urine (AUC=0.88, Accuracy=0.83, F1=0.83, Sensitivity=0.85, Specificity=0.80) datasets showed good predictive performances. We made the pipeline code available on GitHub and we are confident that it will be successfully adopted in similar clinical setups.