bluuebunny/crossref_metadata_2025 huggingface dataset:
Comorbid pain and falls among Chinese older adults: the association, healthcare utilization and the role of subjective and objective physical functioning
Authors: Wang Haocen , Yang Rumei , Yang Yang , Meng Yao , Li Sha , Jiang Yun
Published: May 2023

Background

Pain and falls are significant disabling health conditions which cause substantial economic burdens on older adults and their families. Physical functioning (both subjective and objective) might play a significant role in older adults’ pain and falls. In this study we aimed to examine: (1) the relationship between pain and falls among Chinese older adults; (2) pain-fall status (i.e., comorbid pain-fall, pain-only, fall-only, and neither-pain-nor-fall) in relation to healthcare utilization; and (3) whether physical functioning measured either subjectively or objectively would contribute differently to the pain intensity and to the occurrence of falls.

Methods

We used a nationally-representative sample of older adults from the 2011–2012 baseline survey of the China Health and Retirement Longitudinal Study (N = 4,461, aged 60–95 years). Logistic, linear, and negative binomial models adjusted for demographic variables were used in the analysis.

Results

Overall, 36% of older adults reported pain, 20% had fall occurrences, and 11% had comorbid pain and falls. Pain intensity was significantly associated with falls. Individuals in groups of pain-only, fall-only, and comorbid pain-fall reported significantly higher healthcare utilization, that is, more frequent inpatient care and doctor visits than those in the neither-pain-nor-fall group. Subjective, not objective, physical functioning was associated with pain and falls.

Conclusion

Pain and falls are significantly associated with each other, and both can lead to increased healthcare utilization. Compared to objective physical functioning, subjective physical functioning is more likely to correlate with pain and falls, suggesting that self-reported physical status should be considered when designing pain-fall preventive strategies.
Examining the association between functional social support, marital status, and memory: a systematic review
Authors: Haghighi Paniz , Oremus Mark
Published: May 2023

Background

Functional social support (FSS) has been shown to be positively associated with better cognitive function, especially memory, in cross-sectional and longitudinal studies. To better understand this complex association, researchers should consider the impact of additional factors that affect both FSS and memory. Therefore, we conducted a systematic review to examine whether one such factor, marital status or related variables (e.g., FSS from spouses compared to FSS from relatives or friends), affects (e.g., confounds or modifies) the association between FSS and memory in middle-aged and older adults.

Methods

We searched PubMed, PsycINFO, and Scopus from database inception to June 2022. Eligible articles examined the association between FSS and memory, and included marital status or related variables in the analysis. Data were synthesized narratively and reported in accordance with the Synthesis without meta-analysis (SWiM) guidelines; risk of bias was assessed using the Newcastle-Ottawa Scale (NOS).

Results

Four articles were included in the narrative synthesis. All four articles had a low risk of bias. Overall findings suggested some positive associations between FSS from a spouse/partner and memory; however, effect sizes were small and similar to other sources of support, including children, relatives, and friends.

Conclusions

Our review is the first attempt to synthesize the literature on this topic. Despite theoretical support for examining the impact of marital status or related variables on the association between FSS and memory, published studies explored this issue secondarily to other research questions.
Comparing the effectiveness of virtual and semi-attendance Stress Inoculation Training [SIT] techniques in improving the symptoms of anxiety, depression, and stress of pregnant women with psychological distress: a multicenter randomized controlled trial
Authors: Fatemi Atefeh , Nasiri-Amiri Fatemeh , Faramarzi Mahbobeh , Chehrazi Mohammad , Rad Hajar Adib , Pahlavan Zeinab
Published: May 2023

Background

Some studies indicate that more than 10% of pregnant women are affected by psychological problems. The current COVID‐19 pandemic has increased mental health problems in more than half of pregnant women. The present study compared the effectiveness of virtual (VSIT) and semi-attendance Stress Inoculation Training (SIT) techniques on the improvement of the symptoms of anxiety, depression, and stress of pregnant women with psychological distress.

Methods

This study was conducted on 96 pregnant women with psychological distress in a 2-arm parallel-group, randomized control trial between November 2020 and January 2022. The semi-attendance SIT received treatment for six sessions, sessions 1, 3 and 5 as individual face-to-face and sessions 2, 4 and 6 as virtual once a week for 60 min continuously [n = 48], and the virtual SIT received six sessions simultaneously once a week for 60 min (n = 48) in pregnant women of 14–32 weeks’ gestation referred to two selected hospitals. The primary outcome of this study was BSI-18 [Brief Symptom Inventory] and NuPDQ-17 [Prenatal Distress Questionnaire]. The secondary outcomes were the PSS-14 [Cohen’s General Perceived Stress Scale]. Both groups completed questionnaires measuring anxiety, depression, pregnancy-specific stress, and generally perceived stress questionnaires before and after the treatment.

Results

The post-intervention results showed that the stress inoculation training technique in both VSIT and SIT interventions effectively reduced anxiety, depression, psychological distress, pregnancy-specific stress and general perceived stress [P < 0.01]. Also, the SIT interventions on decreasing anxiety [P < 0.001, η2 = 0.40], depression [P < 0.001, η2 = 0.52] and psychological distress [P < 0.001, η2 = 0.41] were more considerable than that of VSIT. However, There was no significant difference between SIT and VSIT intervention in terms of their effects on pregnancy-specific stress [P < 0.38, η2 = 0.01] and general stress [P < 0.42, η2 = 0.008].

Conclusion

The semi-attendance SIT group has been a more effective and practical model than the VSIT group, for reducing psychological distress. Therefore, semi-attendance SIT is recommended for pregnant women.
Ophthalmic artery Doppler in the complementary diagnosis of preeclampsia: a systematic review and meta-analysis
Authors: de Melo Pollyanna F. M. Vaz , Roever Leonardo , Mendonça Tânia M. S. , da Silva Costa Fabrício , Rolnik Daniel Lorber , Diniz Angélica L. D.
Published: May 2023

Objective

To evaluate the accuracy of different parameters of the ophthalmic artery Doppler (OAD) in the complementary diagnosis of preeclampsia (PE).

Methods

This meta-analysis adhered to the PRISMA guidelines. To investigate the mean difference in OAD values, peak systolic velocity (PSV), end-diastolic velocity (EDV), second systolic velocity peak (P2), resistance index (RI), pulsatility index (PI), and peak ratio (PR), between PE cases (overall and according to severity) and controls, random-effects meta-analyses were conducted for each Doppler parameter, with overall PE and mild and severe PE subgroups. Diagnostic performance and heterogeneity were evaluated with summary receiver operating characteristic (sROC) curves and 95% confidence intervals obtained with bivariate models.

Results

Eight studies stratified the results into mild and severe or late and early PE, involving 1,425 pregnant women. PR and P2 had better diagnostic performance than the other indexes, with the PR of AUsROC at 0.885, the sensitivity of 84%, and specificity of 92%, with a low false-positive rate of 0.08 and the P2 with AUsROC of 0.926, the sensitivity of 85% and specificity of 88%. RI, PI, and EDV showed good performance and consistency across studies but lower AUsROC values of 0.833, 0.794, and 0.772, respectively.

Conclusion

Ophthalmic artery Doppler is a complementary tool with good performance for the diagnosis of overall and severe preeclampsia, with high and best sensitivity and specificity when using PR and P2 parameters.
Disparities by race/ethnicity in unplanned cesarean birth among healthy nulliparas: a secondary analysis of the nuMoM2b dataset
Authors: Carlson Nicole S. , Carlson Madelyn S. , Erickson Elise N. , Higgins Melinda , Britt Abby J. , Amore Alexis Dunn
Published: May 2023

Background

Racial disparities exist in maternal morbidity and mortality, with most of these events occurring in healthy pregnant people. A known driver of these outcomes is unplanned cesarean birth. Less understood is to what extent maternal presenting race/ethnicity is associated with unplanned cesarean birth in healthy laboring people, and if there are differences by race/ethnicity in intrapartum decision-making prior to cesarean birth.

Methods

This secondary analysis of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b) dataset involved nulliparas with no significant health complications at pregnancy onset who had a trial of labor at ≥ 37 weeks with a singleton, non-anomalous fetus in cephalic presentation (N = 5,095). Logistic regression models were used to examine associations between participant-identified presenting race/ethnicity and unplanned cesarean birth. Participant-identified presenting race/ethnicity was used to capture the influence of racism on participant’s healthcare experiences.

Results

Unplanned cesarean birth occurred in 19.6% of labors. Rates were significantly higher among Black- (24.1%) and Hispanic- (24.7%) compared to white-presenting participants (17.4%). In adjusted models, white participants had 0.57 (97.5% CI [0.45–0.73], p < 0.001) lower odds of unplanned cesarean birth compared to Black-presenting participants, while Hispanic-presenting had similar odds as Black-presenting people. The primary indication for cesarean birth among Black- and Hispanic- compared to white-presenting people was non-reassuring fetal heart rate in the setting of spontaneous labor onset.

Conclusions

Among healthy nulliparas with a trial of labor, white-presenting compared to Black or Hispanic-presenting race/ethnicity was associated with decreased odds of unplanned cesarean birth, even after adjustment for pertinent clinical factors. Future research and interventions should consider how healthcare providers’ perception of maternal race/ethnicity may bias care decisions, leading to increased use of surgical birth in low-risk laboring people and racial disparities in birth outcomes.
Tumor–stroma ratio predicts prognosis and PD-L1 expression in hepatocellular carcinoma
Authors: Wang Dong , Luo Jia , Tao YiMing
Published: May 2023

Background

With the in-depth research on the tumor microenvironment, the tumor stroma is considered to play a leading role in malignant tumor behavior, and PD-L1 is also related to the tumor stroma. The tumor–stroma ratio (TSR) has been regarded as a novel prognostic factor in many cancers. Our study aims to assess the TSR and PD-L1 clinical value in hepatocellular carcinoma (HCC) patients.

Methods

Ninety-five patients who were diagnosed with HCC were included in our study. TSR was estimated on HCC specimen hematoxylin–eosin staining (HE) sections, and the optimal TSR cut-off value was determined by receiver operating characteristic (ROC) curves. The correlation between the TSR and clinicopathologic features was also calculated. Immunohistochemistry (IHC) staining was also carried out to analyze the PD-L1 expression level in HCCs.

Results

The optimal TSR cut-off value was 0.525. The median OS of the stroma-high and stroma-low groups was 27 and 36 months, respectively. The median RFS of the stroma-high and stroma-low groups was 14.5 and 27 months, respectively. In the Cox multivariate analysis, the TSR was an independent prognostic factor for HCC overall survival (OS) and recurrence-free survival (RFS) in patients who underwent liver resection. IHC staining revealed TSR-high HCC samples with high PD-L1-positive cell expression.

Conclusions

Our results suggest that the TSR can predict the prognosis of HCC patients who underwent liver resection. The TSR is related to PD-L1 expression and may be a therapeutic target that can dramatically improve HCC patients’ clinical outcomes.
Prognostic value of preoperative hematological markers in patients with glioblastoma multiforme and construction of random survival forest model
Authors: Duan Xiaozong , Yang Bo , Zhao Chengbin , Tie Boran , Cao Lei , Gao Yuyuan
Published: May 2023

Objective

In recent years, an increasing number of studies have revealed that patients’ preoperative inflammatory response, coagulation function, and nutritional status are all linked to the occurrence, development, angiogenesis, and metastasis of various malignant tumors. The goal of this study is to determine the relationship between preoperative peripheral blood neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), systemic immune-inflammatory index (SII), platelet to lymphocyte ratio (PLR), and platelet to fibrinogen ratio (FPR). Prognostic nutritional index (PNI) and the prognosis of glioblastoma multiforme (GBM) patients, as well as establish a forest prediction model that includes preoperative hematological markers to predict the individual GBM patient’s 3-year survival status after treatment.

Methods

The clinical and hematological data of 281 GBM patients were analyzed retrospectively; overall survival (OS) was the primary endpoint. X-Tile software was used to determine the best cut-off values for NLR, SII, and PLR, and the survival analysis was carried out by the Kaplan–Meier method as well as univariate and multivariate COX regression. Afterward, we created a random forest model that predicts the individual GBM patient’s 3-year survival status after treatment, and the area under the curve (AUC) is used to validate the model’s effectiveness.

Results

The best cut-off values for NLR, SII, and PLR in GBM patients’ preoperative peripheral blood were 2.12, 537.50, and 93.5 respectively. The Kaplan–Meier method revealed that preoperative GBM patients with high SII, high NLR, and high PLR had shorter overall survival, and the difference was statistically significant. In addition to clinical and pathological factors. Univariate Cox showed NLR (HR = 1.456, 95% CI: 1.286 ~ 1.649, P < 0.001) MLR (HR = 1.272, 95% CI: 1.120 ~ 1.649, P < 0.001), FPR (HR = 1.183,95% CI: 1.049 ~ 1.333, P < 0.001), SII (HR = 0.218,95% CI: 1.645 ~ 2.127, P < 0.001) is related to the prognosis and overall survival of GBM. Multivariate Cox proportional hazard regression showed that SII (HR = 1.641, 95% CI: 1.430 ~ 1.884, P < 0.001) is also related to the overall survival of patients with GBM. In the random forest prognostic model with preoperative hematologic markers, the AUC in the test set and the validation set was 0.907 and 0.900, respectively.

Conclusion

High levels of NLR, MLR, PLR, FPR, and SII before surgery are prognostic risk factors for GBM patients. A high preoperative SII level is an independent risk factor for GBM prognosis. The random forest model that includes preoperative hematological markers has the potential to predict the individual GBM patient’s 3-year survival status after treatment,and assist the clinicians for making a good clinical decision.
A serial mediation model of social media addiction and college students’ academic engagement: the role of sleep quality and fatigue
Authors: Zhuang Jie , Mou Qiaoxing , Zheng Tong , Gao Fei , Zhong Yaqin , Lu Qingyun , Gao Yuexia , Zhao Miaomiao
Published: May 2023

Background

It has been documented that social media addiction (SMA) has a detrimental effect on college students’ academic engagement. However, the mechanisms underlying this association are not well understood. This study aimed to determine the serial mediation effects of sleep quality and fatigue on the relationship between SMA and academic engagement among college students.

Methods

A cross-sectional survey was conducted with 2661 college students (43.3% males, mean age = 19.97 years). The participants completed the Bergen Social Media Addiction Scale, the Utrecht Student Work Engagement Scale for Students, the Pittsburgh Sleep Quality Index, and the Fatigue Assessment Scale. The serial mediation effects were examined using Model 6 in the Hayes’ PROCESS macro for SPSS.

Results

The results showed that SMA among college students had a direct negative relationship with their academic engagement (Effect = − 0.051, 95% CI: −0.087 to − 0.015). In addition, sleep quality and fatigue mediated the relationship between SMA and academic engagement both independent and serially, with the independent mediation effect of sleep quality being − 0.031 (95% CI: −0.048 to − 0.016), the independent mediation effect of fatigue being − 0.109 (95% CI: −0.133 to − 0.088), and the serial mediation effect of sleep quality and fatigue being − 0.080 (95% CI: −0.095 to − 0.066). The total indirect effect of the three mediation paths was 80.9%.

Conclusions

Decreased academic engagement caused by SMA can be aggravated by poor sleep quality and fatigue. Strengthening supervision and intervention in social media use among college students, supplemented by attention to psychosomatic health, including sleep quality and fatigue could promote their engagement in academic work.
Initial programme theory for community-based ART delivery for key populations in Benue State, Nigeria: a realist evaluation study
Authors: Ibiloye Olujuwon , Decroo Tom , van Olmen Josefien , Masquillier Caroline , Okonkwo Prosper , Lynen Lutgarde , Jwanle Plang , Van Belle Sara
Published: May 2023

Background

The community-based antiretroviral therapy delivery (CBART) model was implemented in Benue State in Nigeria to increase access of key populations living with HIV (KPLHIV) to antiretroviral treatment. Key populations (KP) are female sex workers, men who have sex with men, persons who inject drugs, and transgender people. Evidence shows that the CBART model for KP (KP-CBART) can improve HIV outcomes along the cascade of HIV care and treatment in sub-Saharan Africa. However, how KP-CBART works, for whom, why, and under what circumstances it generates specific outcomes are not yet clear. Therefore, the aim of this study is to identify the initial programme theory (IPT) of the KP-CBART in Benue State using a realist approach.

Method

The study design is exploratory and qualitative, exploring the implementation of KP-CBART. We reviewed the intervention logic framework & guidelines for the KP-CBART in Nigeria, conducted a desk review of KP-CBART in Sub-Saharan Africa (SSA) and interviewed programme managers in the Benue HIV programme between November 2021 and April 2022. Findings were synthesized using the Context-Mechanism-Outcome (CMO) heuristic tool to explain the relationship between the different types of CBART models, contextual factors, actors, mechanisms and outcomes. Using a generative causality logic (retroduction and abduction), we developed, following a realist approach, CMO configurations (CMOc), summarized as an empirically testable IPT.

Result

We developed 7 CMOc and an IPT of the KP-CBART. Where KPLHIV receive ART in a safe place while living in a setting of punitive laws, harassment, stigma and discrimination, KP will adhere to treatment and be retained in care because they feel safe and trust the healthcare providers. Where KPLHIV are involved in the design, planning and implementation of HIV services; medication adherence and retention in care will improve because KP clients perceive HIV services to be KP-friendly and participate in KP-CBART.

Conclusion

Implementation of CBART model where KPLHIV feel safe, trust healthcare providers, and participate in HIV service delivery can improve medication adherence and retention in care. This programme hypothesis will be tested and refined in the next phase of the realist evaluation of KP-CBART.
Association between radical versus conservative surgery and short-term outcomes of hepatic cystic echinococcosis in Nyingchi, China: a retrospective cohort study
Authors: Huang Liangping , Zheng Benrong , Aduo  , Ouzhulamu  , Li Xi , Yao Jianchun
Published: May 2023

Background

Radical or conservative surgical treatment for hepatic Cystic Echinococcosis (hepatic CE) is controversial. We aimed to measure the association between radical surgery (RS) versus conservative surgery (CS) and short-term outcomes in our cohort.

Methods

Medical records of hepatic CE patients’ demographic, clinical, radiological, operative and postoperative details who underwent surgical treatment between January 3, 2017 and January 3, 2018 at the Department of General Surgery, Nyingchi People's Hospital, Nyingchi, China, were retrieved and analyzed. The primary outcome was overall morbidity. The secondary outcomes included: (i) bile leakage; (ii) complications of lung, pleura, heart, liver, pancreas and biliary tract; (iii) incision infection and residual cavity abscess formation; (iv) anaphylactic reaction and shock; (v) tear of surrounding tissues; (vi) hospital and post-operative length of stay (LOS); (vii) length of surgery; (viii) blood loss during surgery. Multivariable logistic/linear regression models with various adjustment strategies for confounders were performed to evaluate the association.

Results

A total of 128 hepatic CE patients were included with 82 (64.1%) and 46 (35.9%) receiving CS and RS, respectively. After fully adjusted, RS was associated with 60% lower risk of overall complication (aOR 0.4; 95%CI, 0.2–0.9) and 0.6-h shorter surgical time (aβ 0.4; 95%CI,-0.0–0.8) comparing to CS. However, RS was associated with more blood loss during surgery (aβ 179.3; 95%CI, 54.2–304.5).

Conclusion

To conclude, RS was associated with a 60% reduction in developing overall complication in the short term, but may result in more blood loss during surgery than CS.
Diet quality and anthropometric indices of patients undergone bariatric surgery: the prospective Tehran obesity treatment study
Authors: Hosseini-Esfahani Firoozeh , Kazemi-Aliakbar Mona , koochakpoor Glareh , Barzin Maryam , Khalaj Alireza , Valizadeh Majid , Mirmiran Parvin
Published: May 2023

Background

Patients undergone bariatric surgery (BS) has long-term risks including decrease in diet quality, nutritional deficiencies and weight regain. This study focus on assessing dietary quality and food group components in patients one year after BS, the relationship between dietary quality score and anthropometric indices, and also evaluating the trend of body mass index (BMI) of these patients three years after BS.

Methods

A total of 160 obese patients (BMI ≥ 35 kg/m2) were undergone sleeve gastrectomy (SG) (n = 108) or gastric bypass (GB) (n = 52), participated in this study. They were assessed for dietary intakes using three 24-hour dietary recalls one year after surgery. Dietary quality was assessed using food pyramid for post BS patients and healthy eating index (HEI). Anthropometric measurements were taken pre-surgery and 1, 2 and 3 years after operation.

Results

The mean age of patients was 39.9 ± 11 years (79% female). The mean ± SD percentage of excess weight loss was 76.6 ± 21.0 one year after surgery. Intake patterns are generally (up to 60%) not consistent with the food pyramid. The mean total HEI score was 64 ± 12 out of 100. More than %60 of participants is exceeding the recommendations for saturated fat and sodium. The HEI score did not show significant relationship with anthropometric indices. The mean of BMI in SG group increased over three years of follow up, while in GB group, there were no significant differences in BMI during three years of follow up.

Conclusions

These findings showed that patients had not healthy pattern intake one year after BS. Diet quality did not show significant relationship with anthropometric indices. The trend of BMI three years after surgery was different based on surgery types.
Sociodemographic structure and health care-related outcomes of community-dwelling dementia caregiving dyads: a latent class replication study
Authors: Wiegelmann Henrik , Wolf-Ostermann Karin , Janssen Niels , van Hout Hein , Vroomen Janet L. MacNeil , Arzideh Farhad
Published: May 2023

Background

The identification of dyadic subgroups of individuals living with dementia and their informal caregivers can help to design effective tailored support. In a previous German study, we identified six dementia dyad subgroups by applying Latent Class Analysis (LCA). Results showed sociodemographic heterogeneity as well as differences in health care outcomes (i.e., quality of life, health status, caregiver burden) between subgroups. The objective of this study is to determine if the dyad subgroups from the previous analysis can be replicated in a similar but distinct Dutch sample.

Methods

A LCA 3-step procedure was applied to baseline data from the COMPAS study, a prospective cohort study. LCA is a statistical approach used to identify heterogeneous subgroups within populations based on their pattern of answers on a set of categorical variables. Data comprises 509 community-living individuals with predominantly mild to moderate dementia and their informal caregivers. A narrative analysis was used to compare latent class structures of the original versus the replication study.

Results

Six distinct dementia dyad subgroups were identified: A subgroup of “adult–child-parent relation with younger informal caregiver” (31.8%), a “couple with female informal caregiver of older age” group (23.1%), an “adult–child-parent relation with middle-aged informal caregiver” group (14.2%), a “couple with middle-aged female informal caregiver” group (12.4%), a “couple with older male informal caregiver” group (11.2%) and a “couple with middle-aged male informal caregiver” group (7.4%). Quality of life of individuals with dementia was rated better in couples than in adult–child-relationships. Worst health for caregivers was reported by subgroups with female informal caregivers living together with male individuals with dementia in couple relationships. A subgroup with older female informal caregivers in couple relationships report the most severe burden on physical and mental health. In both studies, a model with six subgroups fitted the data best. Although substantive similarities between the subgroups of both studies appeared, considerable differences are also evident.

Conclusion

This replication study confirmed the existence of informal dementia dyad subgroups. The observed differences between the subgroups provide useful contributions for a more tailored health care services for informal caregivers and individuals living with dementia. Furthermore, it underlines the relevance of dyadic perspectives. To facilitate replication studies and increase the validity of evidence, a standardization of collected data across studies would be beneficial.
Virtual visits at the Helsinki Head and Neck Center during the COVID-19 pandemic: patient safety incidents and the experiences of patients and staff
Authors: Tolvi Morag , Oksanen Lotta-Maria , Lehtonen Lasse , Geneid Ahmed , Männikkö Pia , Ruokonen Hellevi , Majander Anna , Arminen Susan , Aaltonen Leena-Maija
Published: May 2023

Background

During the COVID-19 pandemic, health care had to find new ways to care for patients while reducing infection transmission. The role of telemedicine role has grown exponentially.

Methods

A questionnaire on experiences and satisfaction was sent to the staff of the Head and Neck Center of Helsinki University Hospital and to otorhinolaryngology patients treated remotely between March and June 2020. Additionally, patient safety incident reports were examined for incidents involving virtual visits.

Results

Staff (response rate 30.6%, (n = 116)) opinions seemed to be quite polarized. In general, staff felt virtual visits were useful for select groups of patients and certain situations, and beneficial in addition to face-to-face visits, not instead of them. Patients (response rate 11.7%, (n = 77)) gave positive feedback on virtual visits, with savings in time (average 89 min), distance travelled (average 31.4 km) and travel expenses (average 13.84€).

Conclusions

While telemedicine was implemented during the COVID-19 pandemic to ensure patient treatment, its usefulness after the pandemic must be examined. Evaluation of treatment pathways is critical to ensure that quality of care is upheld while new treatment protocols are introduced. Telemedicine offers the opportunity to save environmental, temporal, and monetary resources. Nonetheless, the appropriate use of telemedicine is essential, and clinicians must be offered the option to examine and treat patients face-to-face.
Accuracy of minimal residual disease detection by circulating tumor DNA profiling in lung cancer: a meta-analysis
Authors: Zhong Ran , Gao Rui , Fu Wenhai , Li Caichen , Huo Zhenyu , Gao Yuewen , Lu Yi , Li Feng , Ge Fan , Tu Hengjia , You Zhixuan , He Jianxing , Liang Wenhua
Published: May 2023

Background

The sensitivity and specificity of minimal residual disease detected by circulating tumor DNA profiling (ctDNA MRD) in lung cancer, with particular attention to the distinction between landmark strategy and surveillance strategy, for predicting relapse in lung cancer patients after definitive therapy has yet to be determined.

Methods

The prognostic value of ctDNA MRD by landmark strategy and surveillance strategy was evaluated in a large cohort of patients with lung cancer who received definitive therapy using a systemic literature review and meta-analysis. Recurrence status stratified by ctDNA MRD result (positive or negative) was extracted as the clinical endpoint. We calculated the area under the summary receiver operating characteristic curves, and pooled sensitivities and specificities. Subgroup analyses were conducted based on histological type and stage of lung cancer, types of definitive therapy, and ctDNA MRD detection methods (detection technology and strategy such as tumor-informed or tumor-agnostic).

Results

This systematic review and meta-analysis of 16 unique studies includes 1251 patients with lung cancer treated with definitive therapy. The specificity of ctDNA MRD in predicting recurrence is high (0.86–0.95) with moderate sensitivity (0.41–0.76), whether shortly after treatment or during the surveillance. The landmark strategy appears to be more specific but less sensitive than the surveillance strategy.

Conclusions

Our study suggests that ctDNA MRD is a relatively promising biomarker for relapse prediction among lung cancer patients after definitive therapy, with a high specificity but suboptimal sensitivity, whether in landmark strategy or surveillance strategy. Although surveillance ctDNA MRD analysis decreases specificity compared with the landmark strategy, the decrease is minimal compared to the increase in sensitivity for relapse prediction of lung cancer.
Post-malarial neurological syndrome in a Gambian adult residing in the Gambia: a case report and a review of literature
Authors: Ekeh Bertha C. , Bah Ebrima , Jobe Ya Fatou B M , Daboer Aji F. , Gomez Mariama , Lanlokun Ridhwan A.
Published: May 2023

Background

Post malarial neurological syndrome (PMNS) occurs as a sequel of cerebral malaria which is the most deadly form of severe malaria. In holo-endemic regions (areas of high malarial transmission) all forms of severe malaria as well as cerebral malaria usually occur in children and those who are semi or non-immune like pregnant women, migrants as well as tourists. It also occurs in hypo-endemic regions (areas of limited malarial transmission with low immunity) and malaria- free zones. Survivors however may have neurologic complications after recovery. PMNS has been reported in many parts of the world. Being a sequel to cerebral malaria, it is uncommon in adults who were born and reside in a holo-endemic region all their lives.

Case report

This is the case of an 18 year old Gambian who has lived in The Gambia all his life that had PMNS five days after recovery from cerebral malaria.

Methods

This was a predominantly web based literature search. The search comprise all case reports, original articles and reviews on PMNS or neurological deficits associated with malaria or noted after malaria infection. The search engines used were Google, Yahoo and Google scholar.

Results

A total of 62 papers were found. These were used for this review of the literature.

Conclusion

Cerebral malaria also occurs in adults in holo-endemic areas though rare and some of the survivors may develop PMNS. It is commoner in the youth age group. There is need for further studies since the youth may be a possible new ‘vulnerable group’ in holoendemic areas. This may lead to the widening the targeted group for malaria control in the regions of high malarial transmission.
Radio-resistance of hypoxic tumors: exploring the effects of oxygen and X-ray radiation on non-small lung cancer cell lines
Authors: Hanley Rachel , Pagliari Francesca , Garcia-Calderón Daniel , Fernandes Guerreiro Joana , Genard Géraldine , Jansen Jeannette , Nisticò Clelia , Marafioti Maria Grazia , Tirinato Luca , Seco Joao
Published: May 2023

Background

Solid tumors are often riddled with hypoxic areas, which develops as a result of high proliferation. Cancer cells willingly adapt and thrive in hypoxia by activating complex changes which contributes to survival and enhanced resistance to treatments, such as photon radiation. Photon radiation primarily relies on oxygen for the production of reactive oxygen species to induce DNA damage. The present in-vitro study aimed at investigating the biochemical responses of hypoxic non-small cell lung cancer (NSCLC) cells, particularly the effects on the DNA damage repair systems contributing to more radioresistant phenotypes and their pro- and anti-oxidant potential, within the first 24 h post-IR.

Methods

NSCLC cell lines (H460, A549, Calu-1) were irradiated using varying X-ray doses under normoxia (21% O2) and hypoxia (0.1% O2). The overall cell survival was assessed by clonogenic assays. The extent of irradiation (IR)-induced DNA damage was evaluated by analyzing γ-H2AX foci induction and the altered expression of repair genes involved in non-homologous end joining and homologous recombination pathways. Moreover, cell-altered responses were investigated, including the nuclear and cytosolic hydrogen peroxide (H2O2) production, as well as the associated anti-oxidant potential, in particular some components related to the glutathione system.

Results

Analysis of clonogenic survival revealed an enhanced radioresistance of the hypoxic NSCLC cells associated with reduced DNA damage and a downregulation of DNA repair genes. Moreover, nuclear H2O2 levels were IR-induced in a dose-dependent manner only under normoxia, and directly correlated with the DNA double-strand breaks. However, the observed nuclear H2O2 reduction in hypoxia appeared to be unaffected by IR, thus highlighting a possible reason for the enhanced radioresistance of the hypoxic NSCLC cells. The cellular antioxidant capacity was upregulated by IR in both oxygen conditions most likely helping to counteract the radiation effect on the cytosolic H2O2.

Conclusions

In conclusion, our data provide insight into the adaptive behavior of radiation-resistant hypoxic NSCLC cells, in particular their DNA repair and oxidative stress responses, which could contribute to lower DNA damage and higher cell survival rates following X-ray exposure. These findings may therefore help to identify potential targets for improving cancer treatment outcomes.
Exons 1–3 deletion in FLCN is associated with increased risk of pneumothorax in Chinese patients with Birt-Hogg-Dubé syndrome
Authors: Wang Yue , Cai Mengru , Jiang Xianliang , Lv Guangyu , Hu Daiju , Zhang Guofeng , Liu Jinli , Wei Wei , Xiao Jun , Shen Bing , Ryu Jay H. , Hu Xiaowen
Published: May 2023

Background

The pathogenic variants responsible for Birt-Hogg-Dubé syndrome (BHDS) in folliculin (FLCN) gene mostly consist of point mutations. Although large intragenic deletions/duplications have been reported in several case reports, the relationship between large intragenic deletions/duplications and phenotype in BHDS remains unclear.

Methods

We retrospectively identified and reviewed patients with a large intragenic deletion spanning exons 1–3 and analyzed their phenotypic features to compare with those of point mutation carriers in our hospital from January 1, 2017 to August 31, 2022.

Results

Twenty unique point mutations (including 4 novel mutations) were detected in 62 patients from 45 families (90%). Exons 1–3 deletion were identified in 8 patients from 5 families (10%) that resided in the same region, Feidong County of Anhui Province, China. Breakpoint analysis indicated that all the deletion breakpoints were flanked by Alu repeats. The prevalence of exons 1–3 deletion carriers in Feidong County was 8.1-times higher than that for BHDS in Anhui Province, suggesting a clustered phenomenon of exons 1–3 deletion. Significantly increased risk of pneumothorax was observed in those with exons 1–3 deletion compared with point mutations (91% vs. 58%, p value 0.047). The risk of renal cancer may be higher in those with exons 1–3 deletion than for those with point mutations (18% vs. 4%, p > 0.05).

Conclusions

Large intragenic deletion of exons 1–3 in FLCN was identified as a local aggregation phenomenon in Feidong County, China, and was associated with a significantly higher risk of pneumothorax compared to those with point mutations.
Exploring circular MET RNA as a potential biomarker in tumors exhibiting high MET activity
Authors: Bersani Francesca , Picca Francesca , Morena Deborah , Righi Luisella , Napoli Francesca , Russo Mariangela , Oddo Daniele , Rospo Giuseppe , Negrino Carola , Castella Barbara , Volante Marco , Listì Angela , Zambelli Vanessa , Benso Federica , Tabbò Fabrizio , Bironzo Paolo , Monteleone Emanuele , Poli Valeria , Pietrantonio Filippo , Di Nicolantonio Federica , Bardelli Alberto , Ponzetto Carola , Novello Silvia , Scagliotti Giorgio V. , Taulli Riccardo
Published: May 2023

Background

MET-driven acquired resistance is emerging with unanticipated frequency in patients relapsing upon molecular therapy treatments. However, the determination of MET amplification remains challenging using both standard and next-generation sequencing-based methodologies. Liquid biopsy is an effective, non-invasive approach to define cancer genomic profiles, track tumor evolution over time, monitor treatment response and detect molecular resistance in advance. Circular RNAs (circRNAs), a family of RNA molecules that originate from a process of back-splicing, are attracting growing interest as potential novel biomarkers for their stability in body fluids.

Methods

We identified a circRNA encoded by the MET gene (circMET) and exploited blood-derived cell-free RNA (cfRNA) and matched tumor tissues to identify, stratify and monitor advanced cancer patients molecularly characterized by high MET activity, generally associated with genomic amplification.

Results

Using publicly available bioinformatic tools, we discovered that the MET locus transcribes several circRNA molecules, but only one candidate, circMET, was particularly abundant. Deeper molecular analysis revealed that circMET levels positively correlated with MET expression and activity, especially in MET-amplified cells. We developed a circMET-detection strategy and, in parallel, we performed standard FISH and IHC analyses in the same specimens to assess whether circMET quantification could identify patients displaying high MET activity. Longitudinal monitoring of circMET levels in the plasma of selected patients revealed the early emergence of MET amplification as a mechanism of acquired resistance to molecular therapies.

Conclusions

We found that measurement of circMET levels allows identification and tracking of patients characterized by high MET activity. Circulating circMET (ccMET) detection and analysis could be a simple, cost-effective, non-invasive approach to better implement patient stratification based on MET expression, as well as to dynamically monitor over time both therapy response and clonal evolution during treatment.
Predicting the outcome of plantar heel pain in adults: a systematic review of prognostic factors
Authors: Gulle Halime , Morrissey Dylan , Tan Xiang Li , Cotchett Matthew , Miller Stuart Charles , Jeffrey Aleksandra Birn , Prior Trevor
Published: May 2023

Background

Plantar Heel Pain (PHP) is a common disorder with many treatment pathways and is not self‐limiting, hence prognostic information concerning recovery or recalcitrance is needed to guide practice. In this systematic review, we investigate which prognostic factors are associated with favourable or unfavourable PHP outcomes.

Methods

MEDLINE, Web of Science, EMBASE, Scopus and PubMed electronic bibliographic databases were searched for studies evaluating baseline patient characteristics associated with outcomes in prospective longitudinal cohorts or after specific interventions. Cohort, clinical prediction rule derivation and single arms of randomised controlled trials were included. Risk of bias was evaluated with method‐specific tools and evidence certainty with GRADE.

Results

The review included five studies which evaluated 98 variables in 811 participants. Prognostic factors could be categorised as demographics, pain, physical and activity‐related. Three factors including sex and bilateral symptoms (HR: 0.49[0.30–0.80], 0.33[0.15–0.72], respectively) were associated with a poor outcome in a single cohort study. The remaining four studies reported twenty factors associated with a favourable outcome following shockwave therapy, anti‐pronation taping and orthoses. Heel spur (AUC = 0.88[0.82–0.93]), ankle plantar‐flexor strength (Likelihood ratio (LR): 2.17[1.20–3.95]) and response to taping (LR = 2.17[1.19–3.90]) were the strongest factors predicting medium‐term improvement. Overall, the study quality was low. A gap map analysis revealed an absence of research that included psychosocial factors.

Conclusions

A limited number of biomedical factors predict favourable or unfavourable PHP outcomes. High quality, adequately powered, prospective studies are required to better understand PHP recovery and should evaluate the prognostic value of a wide range of variables, including psychosocial factors.
Citicoline in hypoxic ischemic encephalopathy in neonates: a randomized controlled trial
Authors: Salamah Abeer , El Amrousy Doaa , Elsheikh Mai , Mehrez Mostafa
Published: May 2023

Background

Hypoxic-ischemic encephalopathy (HIE) is one of the major complications that can lead to death or disability in neonates. We assessed the effect of citicoline as a neuroprotector in neonates with moderate and severe HIE.

Methods

This clinical trial was carried on 80 neonates with moderate to severe HIE who were not candidates for therapeutic cooling. They were subdivided randomly into two groups; citicoline treatment group which included 40 neonates who received citicoline 10 mg / kg /12 h IV for 4 weeks plus other supportive measures and the control group which included 40 neonates who were managed with placebo and the same supportive measures. All patients were evaluated for duration of mechanical ventilation (MV), need for inotropes, seizures (type, frequency, and duration), and duration of NICU. Cranial ultrasounds and brain magnetic resonance image (MRI) were performed for all included neonates after 4 weeks of treatment. Follow- ups of all neonates for the neurodevelopmental outcomes were done at 3, 6, 9, and 12 months.

Results

There was a significant reduction in the number of neonates having seizures after discharge in the citicoline-treated group (2 neonates) compared to the control group (11 neonates). Cranial ultrasound and MRI findings at 4 weeks were significantly better in the treatment group compared to the control group. Moreover, neurodevelopmental outcome showed significant improvement at 9 and 12 months in the citicoline treated neonates compared to the control group. There was statistically significant reduction in the duration of seizures, NICU stay, inotrope use, and MV in the treatment group compared to the control group. Citicoline was well tolerated with no remarkable side effects.

Conclusion

Citicoline could be a promising neuroprotector drug in neonates with HIE.

Trial registration

The study was registered at ClinicalTrials.gov (NCT03949049). Registered at 14 May 2019, https://clinicaltrials.gov/ct2/show/NCT03949049
Central venous stenosis after subclavian versus internal jugular dialysis catheter insertion (CITES) in adults in need of a temporary central dialysis catheter: study protocol for a two-arm, parallel-group, non-inferiority randomised controlled trial
Authors: Borgquist Ola , Naddi Leila , Božović Gracijela , Hellberg Matthias , Annborn Martin , Sjövall Fredrik , Adrian Maria , Hettinger Eva , Sjöberg Pia , Kander Thomas
Published: May 2023

Background

The right internal jugular vein is currently recommended for temporary central dialysis catheters (tCDC) based on results from previous studies showing a lower incidence of central vein stenosis compared to the subclavian vein. Data is however conflicting, and there are several advantages when the subclavian route is used for tCDCs. This prospective, controlled, randomised, non-inferiority study aims to compare the incidence of post-catheterisation central vein stenosis between the right subclavian and the right internal jugular routes.

Methods

Adult patients needing a tCDC will be included from several hospitals and randomised to either subclavian or internal jugular vein catheterisation with a silicone tCDC. Inclusion continues until 50 patients in each group have undergone a follow-up CT venography. The primary outcome is the incidence of post-catheterisation central vein stenosis detected by a CT venography performed 1.5 to 3 months after removal of the tCDC. Secondary outcomes include between-group comparisons of (I) the patients’ experience of discomfort and pain, (II) any dysfunction of the tCDC during use, (III) catheterisation success rate and (IV) the number of mechanical complications. Furthermore, the ability to detect central vein stenosis by a focused ultrasound examination will be evaluated using the CT venography as golden standard.

Discussion

The use of the subclavian route for tCDC placement has largely been abandoned due to older studies with various methodological issues. However, the subclavian route offers several advantages for the patient. This trial is designed to provide robust data on the incidence of central vein stenosis after silicone tCDC insertion in the era of ultrasound-guided catheterisations.

Trial registration

Clinicaltrials.gov; NCT04871568. Prospectively registered on May 4, 2021.