bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic value of laboratory markers in patients with acute pulmonary embolism
Authors: Ahmed Yousef Ahmed Yousef , Elfadl Abd-Elazim Ahmed Abo , Houssein Abeer , Abdelrahman Amal Abdallah , Shehata Khaled Mohamed Ali , Omar Amany Omar Mohamed
Published: August 2024

Background
Acute pulmonary embolism (APE) is a serious illness. Identifying prognostic factors for APE may help in the management of those patients. This study's objective was to evaluate the prognostic value of laboratory markers in predicting right ventricular dysfunction (RVD) and 30-day mortality in pulmonary embolism patients.
Methods
Eighty patients with APE were enrolled and followed up for 30-day. Detailed echocardiography was done to evaluate RVD. All patients were subjected to arterial blood gas analysis, complete blood count (CBC), plasma concentration of C-reactive protein (CRP), serum D-dimer level, and serum troponin I level, and the following ratio were calculated: Neutrophil to lymphocytic ratio (NLR), Platelet to lymphocytic ratio (PLR), Red cell distribution width (RDW), Mean platelet volume (MPV) and alveolar to arterial gradient.
Results
Our results analysis revealed significantly elevated levels of median NLR, PLR, CRP, D-dimer, and troponin in both the RVD and non-survivor groups (P value < 0.001). The blood markers that showed the highest predictive ability for right ventricular dysfunction (RVD) and 30-day mortality, as determined by receiver operating characteristic (ROC) analysis and logistic regression, were A-a O2 gradient, serum troponin, CRP, D-dimer, NLR, and PLR (P value < 0.001).
Conclusion
Evaluation of different serum markers including NLR, PLR, RDW, CRP, D-dimer, troponin and A-a O2 gradient are simple and available markers for predicting right ventricular dysfunction (RVD) and 30- day mortality in patients with APE.
Trial registration:
ClinicalTrials.gov ID: NCT04237974.
Identification and Analysis of Autophagy-Related Genes as Diagnostic Markers and Potential Therapeutic Targets for Tuberculosis Through Bioinformatics
Authors: Luo Tingting , Shen Shijie , Sun Yufei , El-Ashram Saeed , Zhang Xia , Liu Keyu , Deng Siqi , Cao Chengzhang , Alajmi Reem Atalla , Wu Jiangdong , Zhang Wanjiang
Published: August 2024

Background: According to the World Health Organization, Mycobacterium tuberculosis (Mtb) infections affect approximately 25% of the world's population. There is mounting evidence linking autophagy and immunological dysregulation to TB, according to many research. As a result, this research set out to discover TB-related autophagy-related biomarkers, gene regulatory networks, and prospective treatment targets.
Methods: We used five autophagy databases to get genes linked to autophagy and GEO databases to get genes connected to TB. Then, functional modules associated with autophagy were obtained by analyzing them using weighted gene coexpression network analysis (WGCNA). Both GO and KEGG were used to examine the ATGs of important modules. Limma, an R tool, was used to identify differentially expressed ATGs, and the external datasets of GSE19435 were used to further confirm their identification. We used DE-ATGs and a protein-protein interaction (PPI) network to search the hub genes. CIBERSORT was used to estimate the kinds and amounts of immune cells. After that, we built a drug-gene interaction network and a network that included messenger RNA, small RNA, DNA, and ceRNA. At last, the differential expression of hub ATGs was confirmed by RT-qPCR, Immunohistochemistry (IHC), and Western blotting (WB). The diagnostic usefulness of hub ATGs was evaluated using receiver operating characteristic (ROC) curve analysis.
Results: Including 508 ATGs, four of the nine modules strongly linked with TB were deemed essential. Three hub genes—IL1B, CAPS1, and STAT1—were identified by intersection out of twenty-two DE-ATGs discovered by differential expression analysis. Research into immune cell infiltration found that TB patients had an increased proportion of plasma cells, CD8 T cells, and M0 macrophages. A competitive endogenous RNA (ceRNA) network utilized 10 long non-coding RNAs (lncRNAs) and 2 miRNAs. Then, the IL1B-targeted drug CANAKINUMAB was assessed using this network. During bioinformatics analysis, three hub genes—IL1B, CAPS1, and STAT1—were validated using WB/RT-qPCR/IHC in mouse and macrophage infection models. In most cases, the new findings corroborated the old ones.
Conclusion: We found that IL1B, CASP1, and STAT1 are important biomarkers for TB. As a result, these crucial hub genes may hold promise as TB treatment targets.
Early withdrawal immunosuppression improved mixed chimerism in hematopoietic stem cell transplantation for pediatric aplastic anemia
Authors: Wang Xinan , Qin Xia , Luo Chengjuan , Luo Changying , Wang Jianmin , Huang Xiaohang , Mi Qiang , Lin Yuchen , Chen Jing
Published: August 2024

Mixed chimerism (MC) occurs frequently with the risk of graft reject (GR) for aplastic anemia (AA) patients undergoing matched sibling donor (MSD) hematopoietic stem cell transplantation (HSCT). So far, no one knows how to adjust immunosuppression (IS) during MC. We retrospectively analyzed 87 consecutive pediatric patients. Early withdrawal (EW) IS and donor lymphocyte infusion (DLI) were attempted to reverse MC. The rate of MC was 26% (n = 23). Low dose cyclophosphamide (CY) (120–150 mg/kg) is an independent risk factor for MC (P = 0.0002) and increase dosage of Fludarabine (FLU) cannot eliminated it. Patients receiving 200 mg/kg CY had the lowest MC rate (8%) and best 3-year graft-versus-host disease (GVHD)/failure free survival (GFFS; 95%). Chimerism in T cells is more sensitive than that in whole blood (P = 0.001). In 17 patients with early-onset MC (ratio of DLI: 83% versus 82%), EW IS strategy is helpful to improving complete chimerism (CC) (63 vs. 295 days, P = 0.008). Our study shows that FLU is necessary to intensify CY + ATG conditioning to maintain the engraftment and 200 mg/kg CY + 150 mg/m2 FLU is recommended as a basic conditioning regimen. EW IS strategy should be considered as an important option to improve donor chimerism in early-onset MC.
Biomarkers to predict the need for renal replacement therapy in severe acute kidney injury: an ancillary analysis of a multicenter randomized controlled trial
Authors: CHAIBI Khalil , PICOD Adrien , BOUBAYA Marouane , Tubiana Sarah , JULLIEN Vincent , MAGREAULT Sophie , Placier Sandrine , Mallet Jérémie , LOUIS Guillaume , Lefevre Laurent Martin , TITECA-BEAUPORT Dimitri , COMBE Béatrice LA , BESSET Sébastien , Badie Julio , Chevrel Guillaume , Chudeau Nicolas , Barbar Saber , Vinsonneau Christophe , Forel Jean-Marie , Thevenin Didier , LACAVE Guillaume , NSEIR Saad , Oziel Johanna , Mayaux Julien , Klouche Kada , Reignier Jean , RICARD Jean-Damien , Quenot Jean-Pierre , Mebazaa Alexandre , Azibani Feriel , Dreyfuss Didier , Gaudry Stephane
Published: August 2024

Introduction
Predicting the need for renal replacement therapy (RRT) in acute kidney injury (AKI) remains challenging. The utility of biomarkers was explored during previous studies which were biased as RRT indications relied on clinician opinion rather than evidence. Those studies preceded trials that clarified RRT initiation criteria. We aimed to assess biomarkers in predicting criteria for RRT initiation in severe AKI patients.
Material and methods
This is an ancillary study of the AKIKI2 trial. Patients with severe AKI (stage 3) receiving invasive mechanical ventilation and/or vasopressors were included. Blood and urine samples were collected within 12 hours after the occurrence of severe AKI. The primary endpoint was the onset of rigorous criteria for RRT initiation within 72 hours after severe AKI. We analyzed routine serum biomarkers (pH, serum potassium, serum creatinine) and novel urinary and serum biomarkers (CCL14, KIM1, nicotinamide and its metabolites, cDPP3, plasma proenkephalin A 119–159).
Results
Among the 256 patients, 101 (39%) met at least one criterion for RRT initiation or died within 72 hours. No biomarker demonstrated satisfactory predictive performance for the primary endpoint. Urinary CCL14 showed potential interest in toxic-induced AKI (AUC 0.74 [0.57–0.90]). No novel biomarker was significantly associated with the occurrence of MAKE60. In multivariate analysis, ‘SAPSIII’ and ‘Serum potassium level at D0’ were significantly associated with the occurrence of MAKE60.
Conclusion
Neither routine nor novel biomarkers demonstrated conclusive predictive accuracy for the need for RRT in severe AKI patients. Given evidence-based criteria for initiating RRT, the tested biomarkers may not effectively guide RRT initiation.
Tesla Autopilot Through Constructions: Investigating the Effect of On-Road Partially-Automated Driving through Construction Zones
Authors: Biondi Francesco , Sahoo Praneet , Jajo Noor
Published: August 2024

Partially-automated driving systems are designed to control the vehicle’s speed and acceleration without input from the human driver on the condition that the driver maintains alertness. These systems are promised to make driving safer especially when driving in road sections exhibiting a higher risk of collisions like construction zones. Despite this, little knowledge is available on how these systems are used in these accident-prone areas and the effect they may have on drivers’ workload and glance allocation. This study aims to fill this gap by having participants drive a Tesla vehicle in Autopilot and manual mode through three road sections: pre-construction, construction, and post-construction. Results show no differences in cognitive workload by driving mode or construction zone. An increase in glances directed away from the forward roadway toward the vehicle’s touchscreen was observed during partially-automated driving in the pre-construction zone, a pattern that, notably, continued on when driving throughout the construction zone. These findings adds to the literature on the human factors of partial automation. More importantly, because drivers failed to increase the amount of time looking at the forward roadway when entering the construction zone, they show the perniciousness of partially-automated driving and the detrimental effect these systems may have on safety.
Assessing Buprenorphine Treatment Utilization and SAMHSA DATA Waiver Provider Distribution in 2021: A Real-World Analysis in California
Authors: Wang Yun , Hu Tao , Roosan Moom , Chang Chih-Hung , Heshmatipour Matthew , Guo Jeff Jianfei , Miotto Karen A.
Published: August 2024

Qualified clinicians must obtain a practitioner waiver (i.e., “DATA-waiver”) to offer buprenorphine, a medication for opioid use disorder (OUD). However, many counties experience fewer buprenorphine prescriptions due to factors such as “DATA-waiver” providers underutilizing their buprenorphine prescribing ability. Our study aimed to compare the availability of active buprenorphine-prescribing clinicians in California to the Substance Abuse and Mental Health Services Administration (SAMSHA)-listed DATA waived prescribers under each 5-digit ZIP Code. This study utilized the buprenorphine prescription record data in 2021 from California’s Controlled Substance Utilization Review and Evaluation System (CURES). The list of the locators for all X-waiver clinicians was obtained from the SAMHSA webpage. Among 1,600 ZIP Codes where patients resided, 62.1% housed DATA-waived physicians, and 57.8% had active buprenorphine-prescribing clinicians. A disproportional distribution between buprenorphine-prescribing clinicians and DATA-waived physicians was evident. Among physicians listed in the SAMHSA roster, not all were actively prescribing buprenorphine. Significant disparities in access to active prescribers and DATA waiver prescribers persist between rural and urban areas in California. Addressing these issues requires resource allocation and inter-professional collaboration. The 2022 Omnibus bill's policy changes hold promise, necessitating further effort into OUD-based policy changes.
Clinical Application of Hip Joint Anatomical CT Digital Measurement and Correlation Analysis
Authors: Wu Chao , Su Ning , Liu XiaoLin , Chen GuoQiang , Li Wei , Bai XiuXiong , Liu HaiBin , Ou WenJing
Published: August 2024

Purpose
This study employed CT multi-planar reconstruction and cinematic rendering techniques to measure anatomical parameters of the hip joint. It aimed to compare the differences in hip joint anatomical parameters among adults of different age groups and analyze their correlations with baseline data such as height, weight, and BMI.
Methods
A total of 156 cases, comprising 312 hips, were included and divided into six groups based on 10-year age intervals. The following parameters of both hip joints were measured: acetabular anteversion angle, center-edge angle, acetabular coverage rate, acetabular depth, neck shaft angle, femoral offset distance, center-edge angle, anterior and posterior acetabular sector angles, and acetabular anteversion angle. Data were analysed and processed using SPSS statistical software.
Results
When comparing the different age groups, the values of Acetabular coverage, Acetabular depth and other hip parameters were lower in the young adult group than in the older group, but the Sharp angle was greater than in the older group. There was no statistically significant correlation between the innovative and traditional measures of Acetabular coverage and Acetabular depth (r = 0.76, 0.95, P < 0.01). Sharp angle also showed correlation with body mass index and other hip parameter indices.
Conclusion
There are significant differences in hip joint anatomical parameters among different genders and age groups, and significant correlations exist between various anatomical parameters. There is a close relationship between some anatomical parameters and the mechanism of hip arthroplasty, hip dislocation and femoroacetabular impingement, which plays a crucial role in clinical management.
Peripheral blood complement factor C3 as a biomarker of clinical efficacy in patients with first-episode schizophrenia before and after treatment
Authors: Cao Yin , Liang Jun , Dai Biao , Shan Feng , Xia Qingrong
Published: August 2024

Objective
To observe the changes of serum complement factor before and after treatment in patients with first-episode schizophrenia, the main purpose is to find the biomarkers of clinical efficacy based on serum complement factor.
Methods
A total of forty patients with first-episode schizophrenia from Hefei Fourth People's Hospital from July 2022 to December 2023 were selected as the study group after being treated with a single anti-schizophrenia drug aripiprazole for 4 weeks. The study group consisted of a before treatment group and a after treatment group. 40 healthy volunteers in physical examination center were selected as control group. The levels of serum complement factors C1, C2, C3, C4 and CH50 in the study group and the control group were detected. Patients in the study group were evaluated with positive and negative Symptom scales (PANSS). Pearson's correlation test was used to assess the relationships the levels of serum complement factors C1, C2, C3, C4 and CH50 and the reduction rate of PANSS score.
Results
Compared with before treatment group, the PANSS total score, positive symptom score and negative symptom score were decreased after treatment group, and the difference was statistically significant (P < 0.05). The levels of serum C1, C2, C3, C4 and CH50 in control group were lower than those in before treatment group, with statistical significance (P < 0.05). After treatment with aripiprazole, the serum levels of C1, C2, C3 and C4 were significantly lower than those in the before treatment group, but the level of CH50 was significantly increased. Pearson correlation analysis showed that the serum C3 level was negatively correlated with the reduction rate of PANSS total score, the reduction rate of positive symptoms score and the reduction rate of negative symptoms score in the before treatment group (r=-0.467, -0.476, -0.367, all P < 0.05). The change of serum C3 level before and after treatment was negatively correlated with the reduction rate of PANSS total score, the reduction rate of positive symptom score and the reduction rate of negative symptom score (r=-0.458, -0.435, -0.420, all P < 0.05).
Conclusion
The serum levels of C1, C2, C3, C4 and CH50 in patients with first-episode schizophrenia are higher than those in healthy patients. After aripiprazole treatment, the serum levels of C1, C2, C3 and C4 are decreased, and the CH50 level is further increased. Changes in serum C3 levels before and after treatment in patients with first-episode schizophrenia can be used as a biomarker to predict clinical efficacy.
Preliminary Exploration of the Relationship between Tumor Microenvironment in Malignant Ascites and Patient Prognosis
Authors: Wang Qingzhe , Cheng Chong , Wang Rui , Zhang Shuang , Jiang Yong
Published: August 2024

Malignant ascites (MA) is a common complication of tumors which related to poor prognosis. With the deepening of the research on tumor microenvironment (TME), the influence of TME on prognosis is gradually understood. As a special TME, the relationship between MA and prognosis of patients need to be explored. 39 samples of MA in West China Hospital from 2018 to 2022 were collected for immunohistochemical (IHC) staining of CD4, CD8, CD11b, CD11c, CD16, CD19, CD163 and FOXP3. Through analyzing the relationship between the proportion of positive cells and the ascites-specific survival (ASS) of patients, immune cells infiltration score (ICIS) related to immune cell infiltration was established. Based on Kruskal-Wallis H test, the expression of CD8 in MA of different tumor types was significantly different (P = 0.014), the proportion of CD8 positive cells in biliary tract tumors is significantly higher than that in gastrointestinal (GI) tract tumors (P = 0.032). According to the multivariate cox regression analysis, only whether to receive chemotherapy was an independent prognostic risk factor. ICIS 1 (CD4, CD8, CD163, FOXP3) and ICIS2 (CD4, CD8, CD11b, CD11c, CD16, CD19, CD163, FOXP3) constructed according to immune cell infiltration can effectively predict the ASS of patients (ICIS1: High expression vs low expression, HR, 0.43, 95%CI (0.22–0.84), P = 0.0065; ICIS2: high vs. low expression, HR, 0.36, 95%CI (0.16–0.79), P = 0.0007). In general, the immune cells in MA are related to the survival of patients. The distribution model of immune cells based on TME has a good predictive value for the survival of patients.
Tracing gender variation in traditional knowledge: participatory tools to promote conservation in a Quilombola community in Brazil
Authors: Cantelli Daniele , Gonçalves Maiara Cristina , Silva Vilson Omar da , Silva Dirceu Nunes da , Hanazaki Natalia
Published: August 2024

Background
Based on participatory research tools and analysis with a gender focus, we aim to identify the knowledge associated with native plants of the Atlantic Forest in a Quilombola community whose territory is juxtaposed with a protected area, in South Brazil.
Methods
Through the perception of the local residents of the Quilombola community of São Roque, we classified the availability, harvesting intensity, abundance and importance of fourteen plants native to the Atlantic Forest found in their territory. A participatory workshop was built with the community to collect data through three activities: four-cell tool, environment matrix, and importance matrix. In order to identify the diversity of intracultural knowledge, all activities were separated into two groups based on the gender of the participants and researchers.
Results
The species Pau-pra-tudo (Picrasma crenata), Quina (Coutarea hexandra) and Cipó-milome (Aristolochia triangularis) were similarly classified as important by both groups, which indicates the cultural and environmental relevance associated with them disregarding gender. The perception of other species were expressed in different ways between the groups, showing the variance of the ecological knowledge and the relationship between the socio-cultural contexts of gender with the knowledge manifested. The final part of the workshop was a lecture given by two community experts about herbal medicines based on forest species found in the territory.
Conclusions
Based on the plural results recorded in the workshops, we discuss the demand of traditional communities inclusion in land management plans of environmental agencies, highlighting how individual characteristics, such as gender, can fill gaps in data about local biodiversity.
Transcultural Adaptation and Validation of the Eating Self-Efficacy Brief Scale (ESEBS): The Brazilian version
Authors: Feoli Ana Maria Pandolfo , Silva Tainá Lopes da , Urbanetto Janete de Souza , D'Amico Monica , Cerolini Silvia , Lombardo Caterina
Published: August 2024

Purpose
This study aimed to develop and validate the Brief Eating Self-Efficacy Scale (ESEBS-BR) in Brazilian Portuguese, addressing the lack of tools to assess eating self-efficacy beliefs in Portuguese-speaking populations.
Method
The study sought to cross-culturally adapt the scale, evaluate its internal structure, validate its reliability and validity, and explore potential associations between eating self-efficacy and eating behaviors. The cross-cultural adaptation process followed guidelines proposed by Beaton et al. (2007), involving translation and back-translation, expert committees, and pre-testing. Scale validation was conducted with 228 participants, including reliability analyses, confirmatory factor analysis, and correlations with established measures of eating behavior.
Results
The ESEBS-BR, maintaining all 8 original items, demonstrated high reliability, with a two-factor structure model confirmed by confirmatory factor analysis. Significant correlations were found between ESEBS-BR scores and measures of binge eating and eating behaviors, validating its criterion validity.
Conclusions
The development and validation of the ESEBS-BR represent a significant contribution to the assessment of eating self-efficacy in the Brazilian population. The scale proved to be sensitive, reliable, and valid, offering an important tool for research and clinical interventions related to eating behavior.
Level of evidence
V, descriptive cross sectional study
Impact of Exon 1 Polymorphism in the MBL2 Gene on MBL Serum Levels and Infection Susceptibility in Acute Lymphoid Leukemia
Authors: Oliveira Leonardo Calheiros , Barbosa Anderson Nogueira , Mineiro Luma Silva , de Souza Paulo Henrique Rodrigues , Pontes Gemilson Soares
Published: August 2024

Polymorphisms in the MBL2 gene exon 1 can decrease serum levels of mannose-binding lectin (MBL), increasing the risk of infection in immunocompromised individuals. This study evaluated the association between the polymorphism in exon 1 of the MBL2 gene, genotypes, serum MBL levels, and infection in 122 patients with acute lymphoid leukemia (ALL). The MBL*A allele exhibited the highest frequency (0.37) within the study population. The MBL*D (0.32) was the predominant variant. The combined frequency of O polymorphic alleles (either B or D) was 0.63. The frequencies of the A/A, A/O and O/O genotypes were 0.13, 0.49 and 0.38, respectively. All patients exhibited consistently low levels of serum MBL, irrespective of their exon 1 genotype. Parasitic infections (n = 103), bacterial (n = 69) and viral (n = 48). A/O genotype (0.49) had higher infection rates, A/A (0.13) had lower rates, and O/O showed increased viral susceptibility (OR: 0.37; 95% CI 0.13–1.06; p = 0.05). Our findings demonstrated that the study population were MBL-deficient, regardless of their MLB2 genotype. Individuals with the A/O genotype had more infections, while those with the O/O genotype appeared more susceptible to viral infections. These findings highlight the impact of MBL levels and genetic variants on infection susceptibility in ALL patients.
Natal factors influencing newborn’s oral microbiome diversity: beyond mother-to-newborn microbial transmission
Authors: Kim Yoon-Hee , Lee Tae yang , Kim Hyun-Yi , Jeong Su Jin , Han Jung Ho , Shin Jeong Eun , Lee Jae-Ho , Kang Chung-Min
Published: August 2024

The early microbiota of neonates is crucial for developing the postnatal immune system and establishing normal physiological, metabolic, and neurological functions. This study investigates the pattern of mother-to-newborn microbial transmission and identify factors influencing the diversity of the neonatal oral microbiome. The study includes a prospective cohort comprising 73 mothers and 87 neonates and a retrospective cohort comprising 991 mothers and 1,121 neonates. Samples from the maternal cervix and neonatal gastric, bronchial, and oral cavities were analyzed using culture-based methods. 16S rRNA gene sequencing using oral swab samples to characterize microbial diversity and composition. Similar genera were detected in the neonatal gastric, bronchial, and oral samples, and the neonatal gastric culture was the most similar to the maternal cervical culture. In addition to mother-to-newborn transmission of microbes, various natal factors including birth type, birth weight, delivery mode, maternal chorioamnionitis, maternal diabetes and the presence of microbes in other sites influenced the diversity of the neonatal oral microbiome. Among these factors, the birth type was the most significant. The composition of the oral microbiome differed significantly according to the birth type, and preterm neonates exhibited decreased oral microbiome diversity, with fewer beneficial bacteria and more pathogens.
Posterior inclinatory approach for degenerative foraminal stenosis with the biportal endoscopic technique: clinical and radiological outcomes
Authors: Xu Zhengyu , Hu Qingfeng , Zhong Zhuolin , Jing Xiaowei
Published: August 2024

Background
Although there are several surgical applications to treat foraminal stenosis, difficulties in some cases need novel access to decompression and preserve normal structure simultaneously. Biportal endoscopic spine surgery (BESS) presents a multitude of advantages, including enhanced flexibility, improved magnification, and an expanded field of view. We introduce a novel posterior inclinatory access in BESS (PIA-BESS) that is specifically designed to treat some specific degenerative foraminal stenosis and evaluate its clinical and radiological outcomes.
Methods
Between March 2021 and July 2023, 19 patients presenting with symptomatic nerve root involvement due to foraminal stenosis underwent the PIA-BESS surgical procedure. Preoperative and postoperative assessments involved magnetic resonance imaging (MRI) and computed tomography (CT) scans to measure changes in the cross-sectional area of the spinal canal and intervertebral foramen. Clinical outcomes were evaluated using the Oswestry Disability Index (ODI) scores and the visual analog scale (VAS) scores for buttock and radicular pain. The dynamic intervertebral angle (IVA) and vertebral slip rate, as determined from preoperative and postoperative X-rays, were employed to evaluate post-surgical vertebral stability.
Results
The intervertebral foraminal area increased significantly from the initial measurement of 32.26 ± 13.49 mm2 to 79.95 ± 19.78 mm2 (P<0.05). Similarly, the spinal canal area also showed a significant increase, from 105.37 ± 21.66 mm2 to 145.63 ± 17.86 mm2 (P<0.05). ODI scores reduced significantly from 73.27 ± 13.21 to 9.26 ± 7.65 (P<0.05), and VAS scores reduced significantly from 5.79 ± 1.08 to 0.84 ± 0.90 (P<0.05). Notably, there were significant differences between the pre-operation and post-operation measurements. However, no significant changes were observed in the dynamic IVA and vertebral slip rate.
Conclusions
The PIA-BESS approach is an effective and low-complication method for addressing stenosis in the lumbar foraminal region. It provides effective decompression for bony stenosis or extruded and sequestered discs in the foraminal region, while preserving the normal structure to maintain the spine stability.
Transferring Health Personnel's Human Factor Skills to competency in clinical practice: Key Findings from a Qualitative Investigation
Authors: Abildgren Lotte , Lebahn-Hadidi Malte , Mogensen Christian Backer , Toft Palle , Steffensen Sune Vork , Hounsgaard Lise
Published: August 2024

Background: Research shows that simulation-based training can increase knowledge and skills among pregraduate healthcare students, that simulation-based training of technical skills places the participants higher on the learning curve in practice, and that simulation-based training can improve participants’ human factor skills. Nevertheless, how cognitive and social knowledge and skills are transferred into clinical practice competency remains unknown. This study aims to explore qualified in-hospital health personnel’s transfer of human factor skills from a simulation-based training course to competency in everyday clinical practice.
Method: A qualitative phenomenological-hermeneutic methodology and an ethnographic study investigate qualified health personnel’s transfer of human factor skills before, during, and after a simulation-based training course. The data collection comprises three phases: a clinical phase, a simulation-based training phase and a transfer phase; each phase is based on a subsequent analysis of the previous phase. Data consist of approximately 107 hours of video recordings, field notes and reflections within the research team. Data are analysed with RICEA, a qualitative hybrid method of a Ricɶur-Inspired Analysis and Cognitive Event Analysis.
Findings: The analysis reveals three key themes: Individual transfer of learning, Intercollegiate transfer of learning and Organisational transfer of learning. The findings imply that transfer of human factor skills happens on an individual and intercollegiate level. Still, transfer needs to be scaffolded on an organisational level so that cognitive and social knowledge becomes competency in clinical practice. Further, the findings imply that transferring human factor skills needs another focus than transferring technical skills. Transfer, internalisation and retention of human factor skills are inadequate because of insufficient organisational focus on transferring human factor skills.
Conclusion: Findings suggest a need for a broader and more profound focus on transferring human factor skills to competency in clinical practice. Involving local ambassadors and increased collaboration between simulation centres and organisations around the transfer phase could optimise the transfer of human factor skills. However, further research is needed in this area.
Trial registration: N/A
Vessel Wall Enhancement and High-Sensitivity CRP as Prognostic Markers in Non-Cardioembolic Ischemic Stroke: A Prospective Cohort Study
Authors: Na Seunghee , Kim Taewon , Koo Jaseong , Hong Yun Jeong , Kim Seong-Hoon
Published: August 2024

Objective
Eccentric vessel wall enhancement (EVWE) and high-sensitivity C-reactive protein (hs-CRP) are inflammatory biomarkers associated with atherosclerotic disease. We investigated their prognostic value in patients with acute ischemic stroke receiving guideline-adherent medical treatment.
Methods
In this prospective observational cohort study, patients with acute non-cardioembolic ischemic stroke underwent vessel wall MRI and hs-CRP testing. The primary outcome was subsequent ischemic stroke during the follow-up period. The median follow-up duration was 21 months. Kaplan-Meier survival and Cox regression analysis was used to determine the associations between EVWE, hs-CRP levels, and subsequent ischemic stroke.
Results
Among 191 patients, 81 (42.4%) had EVWE. EVWE positivity showed a trend towards a lower risk of subsequent ischemic stroke compared to EVWE negativity (HR 0.32, 95% CI 0.12–0.87; P = 0.061). Hs-CRP levels were not significantly associated with recurrent stroke risk. The combination of EVWE positivity and low hs-CRP levels (< 1.25 mg/L) was associated with the most favorable outcome, while EVWE negativity and high hs-CRP levels (≥ 1.25 mg/L) were associated with the worst outcome (HR 0.143, 95% CI 0.04–0.50; P = 0.031).
Conclusions
In patients with acute ischemic stroke receiving optimal medical therapy, EVWE positivity may paradoxically indicate a lower risk of recurrent stroke. The combination of EVWE and hs-CRP status provides prognostic information, with EVWE positivity and low hs-CRP levels associated with the most favorable outcome. These findings highlight the potential role of integrating imaging and serum inflammatory biomarkers in risk stratification and management of acute ischemic stroke patients.
Mental health and psychosocial support in the context of peacebuilding: lessons learned from Somalia
Authors: Ibrahim Mohamed , Malik Mamunur Rahman , Noor Zeynab , Ndithia James , Salad Abdulwahab
Published: August 2024

Conflict tends to break down health systems by damaging health care infrastructure, forcing health care workers to flee from dangerous work environments, and causing an upsurge in displacement, starvation and recurrent epidemics. In Somalia, three decades of conflict and ongoing humanitarian crises have profoundly impacted the physical and psychological well-being of the people. As part of the World Health Organization’s Health and Peace Initiative, the Government of Somalia, WHO and partners have implemented a project to integrate mental health and psychosocial support in the context of peacebuilding, the first of its kind in Somalia. The project encompassed training of health workers on mental health, provision of services, awareness and addressing the stigma and discrimination. Drawing on the project evaluation as well as primary research conducted as part of the project to understand the epidemiology of mental health and substance use issues in the project sites, valuable lessons have been learned from this multi-agency project implemented in a challenging context during the COVID-19 pandemic and an ongoing complex conflict and humanitarian crisis in South Central Somalia. This case study provides an overview of the project, delving into its conceptual framework, activities and outcomes. It highlights the challenges, lessons learned and recommendations. The lessons discussed below are derived from the implementation process, project outcomes, research findings, training and evaluation reports. The case study considered every aspect of the project to enable us to capture the process as well as outcomes.
Impact of arterial system alterations due to amputation on arterial stiffness and hemodynamics: a numerical study
Authors: Hasan OBEID , BIKIA Vasiliki , Patrick SEGERS , PARE Mathilde , Pierre BOUTOUYRIE , Nikos STERGIOPULOS , Mohsen AGHARAZII
Published: August 2024

Subjects with amputation of the lower limbs are at increased risk of cardiovascular mortality and morbidity. We hypothesize that amputation-induced alterations in the arterial tree negatively impact arterial biomechanics, blood pressure and flow behavior. These changes may interact with other biological factors, potentially increasing cardiovascular risk. To evaluate this hypothesis regarding the purely mechanical impact of amputation on the arterial tree, we used a simulation computer model including a detailed one-dimensional (1D) arterial network model (143 arterial segments) coupled with a zero-dimensional (0D) model of the left ventricle. Our simulations included five settings of the arterial network: 1) 4-limbs control, 2) unilateral amputee (right lower limb), 3) bilateral amputee (both lower limbs), 4) trilateral amputee (lower-limbs and right upper-limb), and 5) quadrilateral amputee (lower and upper limbs). Analysis of regional stiffness, as calculated by pulse wave velocity (PWV) for large-, medium- and small-sized arteries, showed that, while aortic stiffness did not change with increasing degree of amputation, stiffness of medium and smaller-sized arteries increased with greater amputation severity. Despite a staged decrease in cardiac output, the systolic and diastolic blood pressure values increased, resulting in an increase in both central and peripheral pulse pressures but with an attenuation of pulse pressure amplification. The most significant increase in peak systolic pressure and decrease in peak systolic blood flow was observed at the site of the abdominal aorta. Wave separation analysis indicated no changes in the shape of the forward and backward wave components. However, the results from wave intensity analysis showed that with extended amputation, there was an increase in peak forward wave intensity and a rise in the inverse peak of the backward wave intensity, suggesting potential alterations in cardiac hemodynamic load. In conclusion, this simulation study showed that biomechanical and hemodynamic changes in the arterial network geometry could interact with additional risk factors to increase the cardiovascular risk in patients with amputations.
Investigating the Psychological and Physiological Effects of Igusa (Juncus effusus L. var. decipiens “Suzukaze”) Scent： A Pilot Study Using Igusa Water
Authors: Goto Seiko , Hamano Hiroshi , Nakajima Taisuke , Kishida Fumi , Isa Akiko , Zennifa Fadilla , Xu Yanli , Shimizu Kuniyoshi
Published: August 2024

Background
Tatami mats, an integral part of traditional Japanese architecture, are renowned for their distinctive scent primarily derived from rush (Juncus effusus L. var. decipiens) or igusa in Japanese. Although the aroma of tatami is deeply ingrained in Japanese culture, its potential psychological and physiological effects remain underexplored.
Methods
This study investigated the effects of igusa scent on mood, cognitive function, and behavior. The experiment was conducted in three stages to clarify its effects; 1. on brain activity when individuals inhaled a scent released from an inhaler in a small closed room, 2. on healthy subjects’ moods in a normal living environment with a scent emitted by a diffuser, and 3. on the well-being of elderly individuals in a normal living environment using scents emitted by a diffuser. EEG monitor, visual stimuli tests, POMS mood test, 100 square calculation tests, and questionnaire were used for healthy individuals. MMSE test, DBD test, and CMAI test were used for individuals with dementia.
Results
Subsequent experiments involving healthy individuals and elderly participants in nursing homes revealed that igusa scent enhanced cognitive function, improved mood, and reduced behavioral symptoms, especially among elderly individuals with dementia.
Conclusions
The scent of igusa water demonstrated its effects regardless of preference. It can also be expected to have an effect through long-term exposure, even for those who do not perceive the scent.
Peer-led intervention for individuals with major depression: study protocol for a randomized controlled trial (SUPEERMood)
Authors: Gonzalez-Garcia Xandra , Moreno-Sancho M. Lucia , Roa-Díez Patricia , Caceres-Tejeiro Yolanda , Flowers Sarah-Louise Auvergne , Montes Concha Gómez , Bennasar-Veny Miquel , García-Toro Mauro , Yañez Aina M.
Published: August 2024

Background: Major Depressive Disorder (MDD) is one of the most disabling mental health problems worldwide. The Recovery Model emphasizes peer support to empower individuals with MDD, improve self-management, and patients' quality of life. Despite the demonstrated efficacy of peer-led interventions, further research is needed due to methodological limitations and variability in interventions across studies. Therefore, the objective of this trial is to evaluate the effectiveness of an adjuvant peer-led intervention for the reduction of depressive symptoms in individuals diagnosed with MDD attended in primary care mental health units.
Methods: A controlled, parallel, randomized clinical trial will be conducted. The intervention group (n=35) will receive 6 weeks of peer-led sessions based on a peer support program drive whilst supervised by nurses, while the control group (n=35) will use a mobile Health (mHealth) application for emotional wellness based on CBT for 6 weeks. Measurements will be collected at baseline, at 6 weeks, at 6 and 12 months after the intervention to evaluate post-intervention effects. The primary outcome is the reduction of depressive symptoms through the Beck Depression Inventory (BDI-II) after the intervention. Secondary outcomes will involve measures such as adherence to psychiatric treatment, quality of life, adherence to mediterranean diet, alcohol consumption and physical activity.
Discussion: We hypothesize that this peer-led intervention, in contrast to the mHealth, will show improvement in BDI-II score reduction of 6 points after six weeks, 6 and 12 months. Standardized peer-led programs can benefit patients and professionals in terms of efficacy and feasibility of clinical treatment of depression, healthy habits, self-care and quality of life. In addition, they can provide recovery and relapse reduction, improved psychosocial support, minimization of intensive care use, and support for patient autonomy through self-management.
Trial registration: The trial protocol is prospectively registered with ClinicalTrials.gov under protocol registration number NCT06398561. Date of registration: May 01, 2024. Recruitment is ongoing.
The explanation of electrical properties changes under NH3 and H2 containing atmospheres in risen temperatures of ceria- and zirconia-based solid electrolytes by means of electrochemical impedance spectroscopy
Authors: Dziubaniuk Małgorzata
Published: August 2024

In the presented research, commercial powders of nominal compositions: Ce0.8Gd0.2O1.9, Sc0.1Ce0.01Zr0.89O1.95, Sc0.09Yb0.01Zr0.9O1.95 structural and electrochemical properties were investigated. The X-ray diffraction of the specimens at room temperature showed a cubic phase. Electrical properties studies over a wide range of frequencies (0.1 Hz to 32 MHz) and temperature (200–600 °C) were analyzed using impedance spectroscopic technique in different atmospheres (synthetic air, 3000 ppm NH3 in argon, 10% H2 in argon). The impedance plane plot shows semicircle arcs at different temperatures and electrical equivalent circuit have been proposed to analyze the impedance results. Basing on comparison of the spectra in different atmospheres the reactions on the three-phase boundaries were proposed as well as the conduction mechanisms of the electrolytes were described. The material based on ceria is mixed ionic-electronic conductor, while in zirconia-based materials electrical conduction is realized by oxygen ion carriers. The electrochemical properties of the powders were compared from the applicative point of view as a candidate for element in fuel cells and gas sensors.
Human Papillomavirus Vaccine Uptake among Adolescent Survivors of Hematopoietic Stem Cell Transplant
Authors: Morrison Aimee , Myers Kasiani , Streich-Tilles Tara
Published: August 2024

Purpose
To characterize the rate of human papillomavirus (HPV) vaccine uptake in the adolescents after hematopoietic stem cell transplant (HSCT).
Methods
This retrospective study evaluated the vaccine history of adolescent HSCT patients ≥ 11 years of age transplanted between 2015 and 2022 at a tertiary care medical center. Logistic regression was used to examine bivariate associations between HPV vaccine uptake and covariates including demographic factors, indication for and type of HSCT, receipt of HPV vaccine prior to transplant, and receipt of other vaccines after transplant.
Results
Among 119 (n = 53 female; n = 66 male) eligible patients, 66 (55.5%) received ≥ one dose of the HPV vaccine after HSCT. Among those who initiated vaccination, 45/66 (68.2%) completed two or more doses. Of 69 patients who were eligible to receive the vaccine prior to HSCT, 19/36 (52%) were vaccinated both before and after HSCT, compared to 14/33 (42%) who did not receive the vaccine before HSCT but chose to be vaccinated after HSCT. No statistically significant difference was identified between those who did and did not initiate HPV vaccination after HSCT among covariates examined.
Conclusions
Rate of HPV vaccine uptake after HSCT was lower compared to the general U.S. adolescent population and lower than the rate of other recommended vaccines. Receiving HPV vaccine prior to HSCT was not associated with HPV re-uptake after HSCT.
Implications for Cancer Survivors: HPV vaccination continues to be suboptimal in HSCT survivorship and should be a targeted goal for improvement in preventing secondary malignancy in this high-risk population.
Inflammation patterns in early postoperative cholangitis predict long-term outcomes in biliary atresia: A potential role of non-suppurative cholangitis
Authors: Harumatsu Toshio , Muraji Toshihiro , Masuya Ryuta , Tsuruno Yudai , Iwamoto Yumiko , Ogata Masato , Takada Lynne , Kedoin Chihiro , Nagano Ayaka , Murakami Masakazu , Sugita Koshiro , Yano Keisuke , Onishi Shun , Kawano Takafumi , Muto Mitsuru , Kaji Tatsuru , Ieiri Satoshi
Published: August 2024

Purpose
Frequent postoperative cholangitis in biliary atresia (BA) affects the long-term native liver survival. This study assessed the characteristics of early cholangitis and their influence on the prognosis.
Methods
Forty-three patients with BA who underwent surgery between 2000 and 2020 were analyzed for routine inflammatory markers. Early cholangitis characteristics were compared between native liver survivor (NLS) and living donor liver transplant (LDLT) patients.
Results
Among the 43 patients, 30 (69.8%) experienced 130 episodes of cholangitis. In the area under the receiver operating characteristics curve (AUROC) analysis, the cutoff value of the total cholangitis episodes was 3, with an area under the AUROC curve of 0.695 (95% confidence interval: 0.522–0.868). Before 3 years old, 113 episodes (86.9%) of cholangitis were observed. The white blood cell, C-reactive protein, and alanine aminotransferase values at cholangitis onset did not markedly differ between the LDLT and NLS groups. Conversely, the neutrophil-to-lymphocyte ratio in the NLS group was significantly lower than in the LDLT group (0.85 vs. 1.63, p < 0.001).
Conclusions
Cholangitis in the NLS group was lymphocyte-dominant and atypical in its pathogenesis. Lymphocyte-dominant cholangitis is non-suppurative, and future research should clarify its pathogenesis to improve the treatment and prognosis of BA.
An ultrasound-guided supraclavicular approach for tunneled central venous catheter insertion can be safely performed by junior residents
Authors: Iwamoto Yumiko , Onishi Shun , Sugita Koshiro , Nakame Kazuhiko , Kaji Tatsuru , Yano Keisuke , Ogata Masato , Takada Lynne , Kedoin Chihiro , Nagano Ayaka , Murakami Masakazu , Harumatsu Toshio , Yamada Koji , Yamada Waka , Masuya Ryuta , Kawano Takafumi , Muto Mitsuru , Ieiri Satoshi
Published: August 2024

Purpose
Ultrasound-guided supraclavicular catheterization (UGSC) of the brachiocephalic vein (BCV) for long-term tunneled central venous catheter (tCVC) insertion may be safer than the internal jugular vein approach due to its superior field of view. We examined the clinical outcomes of tCVC insertions performed by junior residents through UGSC of the BCV.
Patients and Methods:
From January 2018 to December 2023, we assessed clinical outcomes and compared the experience levels of surgeons conducting tCVC insertions. Surgeons were categorized into three groups: junior residency (JR), senior residency (SR), and board-certified pediatric surgeons (BCPS).
Results
177 tCVC insertions were done on 146 patients. Intraoperative complications included 6 cases of arterial puncture, 1 case of pneumothorax, 1 case of over insertion of catheter tip, and 1 case of suspected hemothorax. Distribution across groups was as follows: 28 cases (15.8%) in JR group, 92 (52.0%) in SR group, and 57 (32.2%) in BCPS group. Although the JR group exhibited longer operation times than the BCPS group, no significant differences in intraoperative complications were noted.
Conclusion
Junior residents can safely perform UGSC for tCVC insertion. However, careful consideration of complications such as arterial or thoracic puncture is essential, and case selection should be based on experience.