bluuebunny/crossref_metadata_2025 huggingface dataset:
Epidemiology of Injury and Illness in North American Professional Men’s Soccer: Comparing COVID-19 Lockdown With Previous Seasons
Authors: Hardin Stacey , Silverman Richard , Brophy Robert , Putukian Margot , Silvers-Granelli Holly
Published: May 2024

Background:

After COVID-19 lockdown, studies across Europe and Asia examined its effect on professional soccer injury rates and severity; however, COVID-19 lockdown influence on injuries in United States men’s professional soccer has not been evaluated.

Hypothesis:

Injury and illness rates during the 2020 season were higher than the previous 2 seasons.

Study Design:

Retrospective observational cohort study.

Level of Evidence:

Level 3.

Methods:

Medical staff from participating Major League Soccer (MLS) clubs entered injuries and athletic exposures during the study period into a league-wide electronic medical record system. Injury rate and severity were analyzed to examine differentials between the 2020 COVID season and historical controls.

Results:

The injury incidence rate per 1000 hours in 2020 was 10.8, ie, higher than 2018 (5.4) and 2019 (5.0) ( P < 0.05). Training injury incidence rate increased in 2020 (8.9) compared with 2018 (2.5) and 2019 (2.6) ( P < 0.05), whereas match injury incidence decreased in 2020 (18.3) compared with 2018 (24.0) and 2019 (22.7) ( P < 0.05). Incidence rates of lower extremity muscle injuries (6.04), anterior cruciate ligament (ACL) injuries (0.17), and concussions (0.49) were also higher in 2020 compared with 2018 (2.5, 0.07, 0.27) and 2019 (2.36, 0.05, 0.22) ( P < 0.05). More injured players in 2020 missed >90 days (17.7%) than in 2018 (10.2%) and 2019 (10.1%) ( P < 0.05). Incidence of all non-COVID-19 illness was higher in 2020 (3.93) than 2018 (1.53) and 2019 (1.32) ( P < 0.05).

Conclusions:

During 2020, there were significant increases in incidence rates of overall injuries, training injuries, lower extremity muscular injuries, ACL injuries, concussions, and non-COVID illness, along with a higher percentage of players missing >90 days compared with the 2 previous seasons.

Clinical Relevance:

These results may help clarify the effects of future MLS inseason work stoppages and periods of restricted training.
Real-world non-interventional post-authorization safety study of long-term use of burosumab in children and adolescents with X-linked hypophosphatemia: first interim analysis
Authors: Boot Annemieke M. , Ariceta Gema , Beck-Nielsen Signe Sparre , Brandi Maria Luisa , Briot Karine , Collantes Carmen de Lucas , Giannini Sandro , Haffner Dieter , Keen Richard , Levtchenko Elena , Mughal M. Zulf , Mӓkitie Outi , Nilsson Ola , Schnabel Dirk , Tripto-Shkolnik Liana , Zillikens M. Carola , Liu Jonathan , Tudor Alina , Emma Francesco
Published: May 2024

Background:

X-linked hypophosphatemia (XLH) is a rare, progressive disorder characterized by excess fibroblast growth factor 23 (FGF23), causing renal phosphate-wasting and impaired active vitamin D synthesis. Burosumab is a recombinant human monoclonal antibody that inhibits FGF23, restoring patient serum phosphate levels. Safety data on long-term burosumab treatment are currently limited.

Objectives:

This post-authorization safety study (PASS) aims to monitor long-term safety outcomes in children and adolescents (1–17 years) treated with burosumab for XLH. This first interim analysis reports the initial PASS safety outcomes.

Design:

A 10-year retrospective and prospective cohort study.

Methods:

This PASS utilizes International XLH Registry (NCT03193476) data, which includes standard diagnostic and monitoring practice data at participating European centers.

Results:

At data cut-off (13 May 2021), 647 participants were included in the International XLH Registry; 367 were receiving burosumab, of which 67 provided consent to be included in the PASS. Mean (SD) follow-up time was 2.2 (1.0) years. Mean (SD) age was 7.3 (4.3) years (range 1.0–17.5 years). Mean duration of burosumab exposure was 29.7 (25.0) months. Overall, 25/67 participants (37.3%) experienced ⩾1 adverse event (AE) during follow-up; 83 AEs were reported. There were no deaths, no AEs leading to treatment withdrawal, nor serious AEs related to treatment. The most frequently reported AEs were classified as ‘musculoskeletal and connective tissue disorders’, with ‘pain in extremity’ most frequently reported, followed by ‘infections and infestations’, with ‘tooth abscess’ the most frequently reported.

Conclusion:

In this first interim analysis of the PASS, covering the initial 2 years of data collection, the safety profile of burosumab is consistent with previously reported safety data. The PASS will provide long-term safety data over its 10-year duration for healthcare providers and participants with XLH that contribute to improvements in the knowledge of burosumab safety.

Trial registration:

European Union electronic Register of Post-Authorisation Studies: EUPAS32190.
Health anxiety by proxy among parents: Measuring health anxiety for self, child and partner and its associations with family functioning
Authors: Kubb Christian , Foran Heather M
Published: May 2024

Health-related worries can be either self-directed or occur in close relationships by proxy (e.g., among parents, couples, or pet owners). Our aim was to test the feasibility of assessing health anxiety by proxy in parents and to examine the relationship of health anxiety with family well-being. Health anxiety by proxy was measured between parent-child and parent-partner relationships with adapted versions of the modified Short Health Anxiety Inventory. Parents reported significantly higher levels of health anxiety by proxy regarding their child than for themselves, t (585) = −3.61, p < .001. Exploratory factor analysis showed that each health anxiety questionnaire formed a distinct latent factor. Parenting stress and poorer family functioning had small associations with health anxiety towards one’s self, child, and partner ( r = 0.15 to r = 0.20). Further research is needed to determine clinical relevance and its impact on health behaviors and functioning within the family unit.
Impact of the COVID-19 Pandemic on the Revenue of the Catering Industry: Taiwan as an Example
Authors: Wu Hsin-Chieh , Chen Tin-Chih Toly , Wang Syuan Yu
Published: May 2024

Due to the impact of the COVID-19 pandemic, people have reduced eating out, resulting in a severe drop in the revenue of the catering industry. Health risks have become a major factor affecting the revenue of this industry. Predicting the revenue of the catering industry during the COVID-19 pandemic will not only allow practitioners to adjust their business strategies, but also provide a reference for governments to formulate relief measures. To this end, this study proposes a fuzzy big data analytics approach in which random forests, recursive feature elimination, fuzzy c-means, and deep neural networks are jointly applied. First, random forests and recursive feature elimination are used to select the most influential factors. The data is then divided into clusters by fuzzy c-means. Subsequently, a deep neural network is built for each cluster to make predictions. The prediction results of individual clusters are then aggregated to improve prediction accuracy. The proposed methodology has been applied to forecast the revenue of the catering industry in Taiwan. The results of the experiment showed that the impact of new deaths on the revenue of the catering industry was far greater than the number of newly diagnosed COVID-19 cases.
China’s Duty-Free Trade Policy to Bangladeshi Products: A Potential Trade and Economic Effects Analysis Using Partial and Computable General Equilibrium Model
Authors: Islam Mohammad Monirul , Fatema Farha , Akter Asmina
Published: May 2024

China is one of the critical and strategic trading partners of Bangladesh. The Chinese government has declared a zero-tariff facility for 97% of products imported from Bangladesh. The objective of the study is to analyze the effects of the facilitating trade policy on the trade performance of different sectors of Bangladesh. The study applies partial equilibrium SMART simulations, which are accessible in WITS, and the general equilibrium CGE model with GTAP as the methodological tools to quantify the impact of China’s preferential trade policy on trade and the overall economy of Bangladesh. The results of partial equilibrium analysis show that the preferential trade policy substantially positively impacts Bangladesh’s exports to the Chinese market. The results also suggest that the change in total trade under China’s new preferential trade policy is around $58.99 million, with a trade creation of $ 52.16 million and a trade diversion effect of US$ 6.83 million. The CGE analysis results show that China’s new trade policy will have little impact on Bangladesh’s real GDP, and the effects of the policy on exports vary across different sectors. However, the overall effects suggest that Bangladesh will earn a net welfare gain due to China’s new duty-free trade policy in Bangladesh. The findings of the study provide crucial policy suggestions on whether China’s latest tariff facilities will substantially impact the trade and economy of Bangladesh as well as provide foundations for analyzing the effects of future bilateral trade agreements.
Mapping the Degenerative Cervical Myelopathy Research Landscape: Topic Modeling of the Literature
Authors: Karabacak Mert , Jagtiani Pemla , Zipser Carl Moritz , Tetreault Lindsay , Davies Benjamin , Margetis Konstantinos
Published: May 2024

Study Design

Topic modeling of literature.

Objectives

Our study has 2 goals: (i) to clarify key themes in degenerative cervical myelopathy (DCM) research, and (ii) to evaluate the current trends in the popularity or decline of these topics. Additionally, we aim to highlight the potential of natural language processing (NLP) in facilitating research syntheses.

Methods

Documents were retrieved from Scopus, preprocessed, and modeled using BERTopic, an NLP-based topic modeling method. We specified a minimum topic size of 25 documents and 50 words per topic. After the models were trained, they generated a list of topics and corresponding representative documents. We utilized linear regression models to examine trends within the identified topics. In this context, topics exhibiting increasing linear slopes were categorized as “hot topics,” while those with decreasing slopes were categorized as “cold topics”.

Results

Our analysis retrieved 3510 documents that were classified into 21 different topics. The 3 most frequently occurring topics were “OPLL” (ossification of the posterior longitudinal ligament), “Anterior Fusion,” and “Surgical Outcomes.” Trend analysis revealed the hottest topics of the decade to be “Animal Models,” “DCM in the Elderly,” and “Posterior Decompression” while “Morphometric Analyses,” “Questionnaires,” and “MEP and SSEP” were identified as being the coldest topics.

Conclusions

Our NLP methodology conducted a thorough and detailed analysis of DCM research, uncovering valuable insights into research trends that were otherwise difficult to discern using traditional techniques. The results provide valuable guidance for future research directions, policy considerations, and identification of emerging trends.
Diagnosis of Angioimmunoblastic T Cell Lymphoma After Receiving First Dose of Pfizer/BioNTech (BNT162b2) Vaccine: A Case Report
Authors: Khatri Jai Kumar , Tahboub Ihab , Anwar Khurram , Masoudi Moh’d , Graffeo Vincent , Jamil Muhammad Omer
Published: May 2024

Pfizer/BioNTech (BNT162b2) is a messenger RNA (mRNA) vaccine that is highly effective in preventing the most severe outcomes of COVID-19 infection. Nucleoside-modified severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccines induce effective stimulation of T follicular helper (TFH) cells, leading to a robust germinal center B cell response. Side effects from the BNT162b2 vaccination, including significant lymphadenopathy, have been reported previously. Here, we present a case of angioimmunoblastic lymphoma (AITL), a rare, peripheral T-cell lymphoma with RHOA-G17v-mutated gene developing in a patient following BNT162B2 vaccine with a plausible explanation. A 60-year-old Asian female received her first dose of Pfizer BNT162B2 mRNA vaccine in August 2021. Right after her vaccination, she developed right axillary lymphadenopathy. She received her second vaccine dose in September 2021. Thereafter, she developed lymph node (LN) enlargement in her neck and groin. She underwent left posterior cervical and left groin LN excisional biopsy in April 2022 due to persistent palpable lymphadenopathy. Biopsy results then demonstrated benign follicular hyperplasia. For progressive B symptoms, a right axillary LN biopsy was done, which demonstrated AITL, with molecular studies revealing mutation in TET-2, IDH-2, and RHOA-G17v genes. Progression of AITL following BNT162B2 mRNA vaccine is limited in literature. Our case demonstrates a plausible correlation between the diagnosis of AITL following mRNA vaccination due to the malignant transformation of the TFH cells in patients who have a predisposing mutation of RHOA-17v. Given the rarity of AITL and the heterogeneity of molecular findings, more studies are needed to establish such an association.
Cylindroma of the Breast: A Rare Differential for Breast Cancer on Core Biopsies, Case Report and Review of Literature
Authors: Steinwehr Dre , Ghosh Toshi , Bouton Michael
Published: May 2024

Breast cancers of either ductal or lobular pathology make up the vast majority of breast malignancies. Other cancers occur rarely in the breast. Benign pathology can at times mimic breast cancers on imaging and initial needle biopsies. We report a rare breast pathology of cylindroma. Cylindromas are usually benign, rare dermatologic lesions most commonly associated with head or neck locations. They more commonly occur as sporadic and solitary masses. Less commonly is an autosomal-dominant multi-centric form of this disease. Malignant cylindromas are very rare. We present a patient with findings of a cylindroma of the breast after excision. This was initially felt to be concerning for breast cancer on imaging and core biopsy. Treatment of cylindromas of the breast is excision. Sentinel lymph node dissection is not indicated, nor are adjuvant therapies when identified in the breast. This lesion needs to be included in the differential diagnosis for breast cancer. If cylindromas can be accurately diagnosed preoperatively, this would negate the need for consideration of axillary nodal surgery and adjuvant therapies.
Regional disparities in prehospital delay of acute ischemic stroke: The Korean Stroke Registry
Authors: Lee Eung-Joon , Jeong Han-Yeong , Kim Jayoun , Park Nan Hee , Kang Min Kyoung , Lee Dongwhane , Kim Jinkwon , Jung Yo Han , Yu Sungwook , Kim Wook-Joo , Cho Han-Jin , Lee Kyungbok , Park Tai Hwan , Oh Mi Sun , Lee Ji Sung , Kim Joon-Tae , Yoon Byung-Woo , Park Jong-Moo , Bae Hee-Joon , Jung Keun-Hwa
Published: May 2024

Background:

Late hospital arrival keeps patients with stroke from receiving recanalization therapy and is associated with poor outcomes. This study used a nationwide acute stroke registry to investigate the trends and regional disparities in prehospital delay and analyze the significant factors associated with late arrivals.

Methods:

Patients with acute ischemic stroke or transient ischemic attack between January 2012 and December 2021 were included. The prehospital delay was identified, and its regional disparity was evaluated using the Gini coefficient for nine administrative regions. Multivariate models were used to identify factors significantly associated with prehospital delays of >4.5 h.

Results:

A total of 144,014 patients from 61 hospitals were included. The median prehospital delay was 460 min (interquartile range, 116–1912), and only 36.8% of patients arrived at hospitals within 4.5 h. Long prehospital delays and high regional inequality (Gini coefficient > 0.3) persisted throughout the observation period. After adjusting for confounders, age > 65 years old (adjusted odds ratio [aOR] = 1.23; 95% confidence interval [CI], 1.19–1.27), female sex (aOR = 1.09; 95% CI, 1.05–1.13), hypertension (aOR = 1.12; 95% CI, 1.08–1.16), diabetes mellitus (aOR = 1.38; 95% CI, 1.33–1.43), smoking (aOR = 1.15, 95% CI, 1.11–1.20), premorbid disability (aOR = 1.44; 95% CI, 1.37–1.52), and mild stroke severity (aOR = 1.55; 95% CI, 1.50–1.61) were found to independently predict prehospital delays of >4.5 h.

Conclusion:

Prehospital delays were lengthy and had not improved in Korea, and there was a high regional disparity. To overcome these inequalities, a deeper understanding of regional characteristics and further research is warranted to address the vulnerabilities identified.
Upcoming evidence in clinical practice of two-stage revision arthroplasty for prosthetic joint infection
Authors: Ascione Tiziana , Balato Giovanni , Pagliano Pasquale
Published: May 2024

Total joint arthroplasty is the recommended treatment for patients with end-stage osteoarthritis, as it reduces disability and pain and restores joint function. However, prosthetic joint infection is a serious complication of this procedure, with the two-stage exchange being the most common treatment method. While there is consensus on diagnosing prosthetic joint infection, there is a lack of agreement on the parameters that can guide the surgeon in performing definitive reimplantation in a two-stage procedure. One approach that has been suggested to improve the accuracy of microbiologic investigations before definitive reimplantation is to observe a holiday period from antibiotic therapy to improve the accuracy of cultures from periprosthetic tissues, but these cultures report some degree of aspecificity. Therefore, several pieces of evidence highlight that performing reimplantation using continuous antibiotic therapy should be considered a safe and effective approach, leading to higher cure rates and a shorter period of disability. Dosage of C-reactive protein (CRP), erythrocyte sedimentation rate (ERS) and D-dimer are helpful in diagnosing prosthetic joint infection, but only D-dimer has shown sufficient accuracy in predicting the risk of infection recurrence after a two-stage procedure. Synovial fluid analysis before reimplantation has been shown to be the most accurate in predicting recurrence, and new cutoff values for leukocyte count and neutrophil percentage have shown a useful predictive rule to identify patients at risk of unfavourable outcome. A new scoring system based on a numerical score calculated from the beta coefficient derived through multivariate analysis of D-dimer levels, synovial fluid leukocytes and relative neutrophils percentage has demonstrated high accuracy when it comes to guiding the second step of two-stage procedure. In conclusion, reimplantation may be a suitable option for patients who are on continuous therapy without local symptoms, and with CRP and ERS within the normal range, with low synovial fluid leukocytes (< 952/mL) and a low relative neutrophil percentage (< 52%) and D-dimer below 1100 µg/mL. A numerical score derived from analysing these three parameters can serve as a valuable tool in determining the feasibility of reimplantation in these patients.
Evaluation of a proteomic signature coupled with the kidney failure risk equation in predicting end stage kidney disease in a chronic kidney disease cohort
Authors: Ramírez Medina Carlos Raúl , Ali Ibrahim , Baricevic-Jones Ivona , Saleem Moin A. , Whetton Anthony D. , Kalra Philip A. , Geifman Nophar
Published: May 2024

Background

The early identification of patients at high-risk for end-stage renal disease (ESRD) is essential for providing optimal care and implementing targeted prevention strategies. While the Kidney Failure Risk Equation (KFRE) offers a more accurate prediction of ESRD risk compared to static eGFR-based thresholds, it does not provide insights into the patient-specific biological mechanisms that drive ESRD. This study focused on evaluating the effectiveness of KFRE in a UK-based advanced chronic kidney disease (CKD) cohort and investigating whether the integration of a proteomic signature could enhance 5-year ESRD prediction.

Methods

Using the Salford Kidney Study biobank, a UK-based prospective cohort of over 3000 non-dialysis CKD patients, 433 patients met our inclusion criteria: a minimum of four eGFR measurements over a two-year period and a linear eGFR trajectory. Plasma samples were obtained and analysed for novel proteomic signals using SWATH-Mass-Spectrometry. The 4-variable UK-calibrated KFRE was calculated for each patient based on their baseline clinical characteristics. Boruta machine learning algorithm was used for the selection of proteins most contributing to differentiation between patient groups. Logistic regression was employed for estimation of ESRD prediction by (1) proteomic features; (2) KFRE; and (3) proteomic features alongside KFRE.

Results

SWATH maps with 943 quantified proteins were generated and investigated in tandem with available clinical data to identify potential progression biomarkers. We identified a set of proteins (SPTA1, MYL6 and C6) that, when used alongside the 4-variable UK-KFRE, improved the prediction of 5-year risk of ESRD (AUC = 0.75 vs AUC = 0.70). Functional enrichment analysis revealed Rho GTPases and regulation of the actin cytoskeleton pathways to be statistically significant, inferring their role in kidney function and the pathogenesis of renal disease.

Conclusions

Proteins SPTA1, MYL6 and C6, when used alongside the 4-variable UK-KFRE achieve an improved performance when predicting a 5-year risk of ESRD. Specific pathways implicated in the pathogenesis of podocyte dysfunction were also identified, which could serve as potential therapeutic targets. The findings of our study carry implications for comprehending the involvement of the Rho family GTPases in the pathophysiology of kidney disease, advancing our understanding of the proteomic factors influencing susceptibility to renal damage.
Vitamin D and vitamin K1 as novel inhibitors of biofilm in Gram-negative bacteria
Authors: Lutfi Lekaa L. , Shaaban Mona I. , Elshaer Soha Lotfy
Published: May 2024

Background

The persistent surge in antimicrobial resistance represents a global disaster. The initial attachment and maturation of microbial biofilms are intimately related to antimicrobial resistance, which in turn exacerbates the challenge of eradicating bacterial infections. Consequently, there is a pressing need for novel therapies to be employed either independently or as adjuvants to diminish bacterial virulence and pathogenicity. In this context, we propose a novel approach focusing on vitamin D and vitamin K1 as potential antibiofilm agents that target Gram-negative bacteria which are hazardous to human health.

Results

Out of 130 Gram-negative bacterial isolates, 117 were confirmed to be A. baumannii (21 isolates, 17.9%), K. pneumoniae (40 isolates, 34.2%) and P. aeruginosa (56 isolates, 47.9%). The majority of the isolates were obtained from blood and wound specimens (27.4% each). Most of the isolates exhibited high resistance rates to β-lactams (60.7–100%), ciprofloxacin (62.5–100%), amikacin (53.6–76.2%) and gentamicin (65-71.4%). Approximately 93.2% of the isolates were biofilm producers, with 6.8% categorized as weak, 42.7% as moderate, and 50.4% as strong biofilm producers. The minimum inhibitory concentrations (MICs) of vitamin D and vitamin K1 were 625–1250 µg mL-1 and 2500–5000 µg mL-1, respectively, against A. baumannii (A5, A20 and A21), K. pneumoniae (K25, K27 and K28), and P. aeruginosa (P8, P16, P24 and P27) clinical isolates and standard strains A. baumannii (ATCC 19606 and ATCC 17978), K. pneumoniae (ATCC 51503) and P. aeruginosa PAO1 and PAO14. Both vitamins significantly decreased bacterial attachment and significantly eradicated mature biofilms developed by the selected standard and clinical Gram-negative isolates. The anti-biofilm effects of both supplements were confirmed by a notable decrease in the relative expression of the biofilm-encoding genes cusD, bssS and pelA in A. baumannii A5, K. pneumoniae K28 and P. aeruginosa P16, respectively.

Conclusion

This study highlights the anti-biofilm activity of vitamins D and K1 against the tested Gram-negative strains, which emphasizes the potential of these vitamins for use as adjuvant therapies to increase the efficacy of treatment for infections caused by multidrug-resistant (MDR) strains and biofilm-forming phenotypes. However, further validation through in vivo studies is needed to confirm these promising results.
Hydrogen sulfide-mitigated salinity stress impact in sunflower seedlings was associated with improved photosynthesis performance and osmoregulation
Authors: Younis Abeer Abdelrazk , Mansour Mohamed Magdy Fahim
Published: May 2024

Background

Salinity is one major abiotic stress affecting photosynthesis, plant growth, and development, resulting in low-input crops. Although photosynthesis underlies the substantial productivity and biomass storage of crop yield, the response of the sunflower photosynthetic machinery to salinity imposition and how H2S mitigates the salinity-induced photosynthetic injury remains largely unclear. Seed priming with 0.5 mM NaHS, as a donor of H2S, was adopted to analyze this issue under NaCl stress. Primed and nonprime seeds were established in nonsaline soil irrigated with tape water for 14 d, and then the seedlings were exposed to 150 mM NaCl for 7 d under controlled growth conditions.

Results

Salinity stress significantly harmed plant growth, photosynthetic parameters, the structural integrity of chloroplasts, and mesophyll cells. H2S priming improved the growth parameters, relative water content, stomatal density and aperture, photosynthetic pigments, photochemical efficiency of PSII, photosynthetic performance, soluble sugar as well as soluble protein contents while reducing proline and ABA under salinity. H2S also boosted the transcriptional level of ribulose 1,5-bisphosphate carboxylase small subunit gene (HaRBCS). Further, the transmission electron microscope showed that under H2S priming and salinity stress, mesophyll cells maintained their cell membrane integrity and integrated chloroplasts with well-developed thylakoid membranes.

Conclusion

The results underscore the importance of H2S priming in maintaining photochemical efficiency, Rubisco activity, and preserving the chloroplast structure which participates in salinity stress adaptation, and possibly sunflower productivity under salinity imposition. This underpins retaining and minimizing the injury to the photosynthetic machinery to be a crucial trait in response of sunflower to salinity stress.
The role of hemoadsorption in cardiac surgery – a systematic review
Authors: Matejic-Spasic Marijana , Lindstedt Sandra , Lebreton Guillaume , Dzemali Omer , Suwalski Piotr , Folliguet Thierry , Geidel Stephan , Klautz Robert J. M. , Baufreton Christophe , Livi Ugolino , Gunaydin Serdar , Deliargyris Efthymios N. , Wendt Daniel , Thielmann Matthias
Published: May 2024

Background

Extracorporeal blood purification has been widely used in intensive care medicine, nephrology, toxicology, and other fields. During the last decade, with the emergence of new adsorptive blood purification devices, hemoadsorption has been increasingly applied during CPB in cardiac surgery, for patients at different inflammatory risks, or for postoperative complications. Clinical evidence so far has not provided definite answers concerning this adjunctive treatment. The current systematic review aimed to critically assess the role of perioperative hemoadsorption in cardiac surgery, by summarizing the current knowledge in this clinical setting.

Methods

A literature search of PubMed, Cochrane library, and the database provided by CytoSorbents was conducted on June 1st, 2023. The search terms were chosen by applying neutral search keywords to perform a non-biased systematic search, including language variations of terms “cardiac surgery” and “hemoadsorption”. The screening and selection process followed scientific principles (PRISMA statement). Abstracts were considered for inclusion if they were written in English and published within the last ten years. Publications were eligible for assessment if reporting on original data from any type of study (excluding case reports) in which a hemoadsorption device was investigated during or after cardiac surgery. Results were summarized according to sub-fields and presented in a tabular view.

Results

The search resulted in 29 publications with a total of 1,057 patients who were treated with hemoadsorption and 988 control patients. Articles were grouped and descriptively analyzed due to the remarkable variability in study designs, however, all reported exclusively on CytoSorb® therapy. A total of 62% (18/29) of the included articles reported on safety and no unanticipated adverse events have been observed. The most frequently reported clinical outcome associated with hemoadsorption was reduced vasopressor demand resulting in better hemodynamic stability.

Conclusions

The role of hemoadsorption in cardiac surgery seems to be justified in selected high-risk cases in infective endocarditis, aortic surgery, heart transplantation, and emergency surgery in patients under antithrombotic therapy, as well as in those who develop a dysregulated inflammatory response, vasoplegia, or septic shock postoperatively. Future large randomized controlled trials are needed to better define proper patient selection, dosing, and timing of the therapy.
Lactate dynamics in paediatric patients with severe sepsis: insights from a prospective cohort study
Authors: Abdelaziz Tarek A. , Karam Nehad Ahmed , Ismail Weaam Ibrahim , Askary Nahed Mohamed Ali , Baz Eman Gamal
Published: May 2024

Background

Sepsis is an infection-related systemic inflammatory response that often leads to elevated lactate levels. Monitoring lactate levels during severe sepsis is vital for influencing clinical outcomes. The aim of this study was to assess the association between plasma lactate levels and mortality in children with severe sepsis or septic shock.

Methods

The current prospective study was conducted in the PICU of University Children’s Hospital. The International Paediatric Sepsis Consensus Conference criteria for Definitions of Sepsis and Organ Failure in 2005 were used to diagnose patients with sepsis. We measured plasma lactate levels upon admission (Lac H0) and 6 h later (Lac H6). The static indices included the absolute lactate values (Lac H0 and Lac H6), while the dynamic indices included the delta-lactate level (ΔLac) and the 6-hour lactate clearance. The 6-hour lactate clearance was calculated using the following formula: [(Lac H0–Lac H6)100/Lac H0]. ΔLac was calculated as the difference between the Lac H0 and Lac H6 levels. Patient survival or death after a PICU stay was the primary outcome.

Results

A total of 46 patients were included in this study: 25 had septic shock, and 21 had severe sepsis. The mortality rate was 54.3%. The Lac H0 did not significantly differ between survivors and nonsurvivors. In contrast, the survivors had significantly lower Lac H6 levels, higher ΔLac levels, and higher 6-hour lactate clearance rates than nonsurvivors. Lactate clearance rates below 10%, 20%, and 30% were significantly associated with mortality. The best cut-off values for the lactate clearance rate and Lac H6 for the prediction of mortality in the PICU were < 10% and ≥ 4 mmol/L, respectively. Patients with higher Lac H6 levels and lower lactate clearance rates had significantly higher PICU mortality based on Kaplan–Meier survival curve analysis.

Conclusions

This study highlights the significance of lactate level trends over time for the prediction of mortality in the PICU in patients with severe sepsis or septic shock. Elevated lactate levels and decreased lactate clearance six hours after hospitalisation are associated with a higher mortality rate.
A randomized controlled trial to compare the effects of time-restricted eating versus Mediterranean diet on symptoms and quality of life in bipolar disorder
Authors: Johnson Sheri L. , Murray Greg , Kriegsfeld Lance J. , Manoogian Emily N.C. , Mason Liam , Allen J. D. , Berk Michael , Panda Satchidanda , Rajgopal Nandini A. , Gibson Jake C. , Joyner Keanan J. , Villanueva Robert , Michalak Erin E.
Published: May 2024

Background

The primary objective of this randomized controlled trial (RCT) is to establish the effectiveness of time-restricted eating (TRE) compared with the Mediterranean diet for people with bipolar disorder (BD) who have symptoms of sleep disorders or circadian rhythm sleep–wake disruption. This work builds on the growing evidence that TRE has benefits for improving circadian rhythms. TRE and Mediterranean diet guidance will be offered remotely using self-help materials and an app, with coaching support.

Methods

This study is an international RCT to compare the effectiveness of TRE and the Mediterranean diet. Three hundred participants will be recruited primarily via social media. Main inclusion criteria are: receiving treatment for a diagnosis of BD I or II (confirmed via DIAMOND structured diagnostic interview), endorsement of sleep or circadian problems, self-reported eating window of ≥ 12 h, and no current mood episode, acute suicidality, eating disorder, psychosis, alcohol or substance use disorder, or other health conditions that would interfere with or limit the safety of following the dietary guidance. Participants will be asked to complete baseline daily food logging for two weeks and then will be randomly allocated to follow TRE or the Mediterranean diet for 8 weeks, during which time, they will continue to complete daily food logging. Intervention content will be delivered via an app. Symptom severity interviews will be conducted at baseline; mid-intervention (4 weeks after the intervention begins); end of intervention; and at 6, 9, and 15 months post-baseline by phone or videoconference. Self-rated symptom severity and quality of life data will be gathered at those timepoints, as well as at 16 weeks post baseline. To provide a more refined index of whether TRE successfully decreases emotional lability and improves sleep, participants will be asked to complete a sleep diary (core CSD) each morning and complete six mood assessments per day for eight days at baseline and again at mid-intervention.

Discussion

The planned research will provide novel and important information on whether TRE is more beneficial than the Mediterranean diet for reducing mood symptoms and improving quality of life in individuals with BD who also experience sleep or circadian problems.

Trial registration

ClinicalTrials.gov ID NCT06188754.
Factors facilitating and hindering South Asian immigrant adults from engaging in exercise and physical activity – a qualitative systematic review
Authors: Maricar Nasimah , Khan Behram , David Trixy , Hyrich Kimme L , Barton Anne
Published: May 2024

Background

Exercise and physical activity are key components of management in patients with rheumatic musculoskeletal diseases (RMD), but people of the South Asian communities have a lower level of engagement with these activities compared to their Caucasian counterparts. The aim of this qualitative systematic review was to determine the barriers and facilitators of exercise and physical activity in South Asian communities who have migrated and live in western countries, particularly in those who have RMD.

Methods

Qualitative studies, published in English between 1999 and 2021 and including evaluation of barriers and/or facilitators to exercise or physical activity behaviour in people of South Asian adult communities who have migrated and/or lived in western countries were identified from Embase, MEDLINE, CINAHL, PsycINFO, Google Scholar and manual searches. The studies were appraised using the CASP checklist. Inductive thematic synthesis was used to identify common and global themes.

Results

A total of 32 studies that discussed barriers and facilitators of physical activity in South Asian communities who have migrated and lived in western countries were used for this review but there were no studies identified that focussed specifically on those with RMD. Following appraisal of the reporting of the studies, 30 studies were included in the pooling of the results. The facilitators and barriers to physical activities were broadly categorized into ‘extrinsic’ and ‘intrinsic’ factors. Extrinsic factors such as ‘opportunity’ included environmental factors such as weather and safety; socioeconomic factors such as education, language and literacy, and support in the form of social, psychological and resources. Intrinsic factors included cultural factors, such as life stages and family influence, beliefs and knowledge, which impacted attitudes and skills.

Conclusions

This review has synthesised evidence of barriers or facilitators and identified potentially modifiable factors influencing physical activity and exercise engagement, which could form the basis of evidence-based interventions to promote participation in healthy behaviour change. Provision of a safe, comfortable and culturally acceptable environment together with culturally-aligned cognitive strategies to facilitate acquisition of exercise-efficacy skills could help engagement.

Registration

The systematic review was registered on PROSPERO, registration no. 289,235.
Cognition as mediator of pulmonary function and risk of sarcopenia among older adults
Authors: Hu Zhao , Tang Lu , Zhan Yiqiang
Published: May 2024

Background

The relationship between lung function and sarcopenia remains ambiguous. The primary aim of this study was to investigate the potential association between lung function and sarcopenia in the older adults, as well as to examine the mediating role of cognitive function in this relationship.

Methods

The participants were selected from a nationally representative population-based cohort in China. The peak expiratory flow (PEF) measurement was used to evaluate the lung function in older persons. The sarcopenia was diagnosed using the guidelines of the Asian Working Group for Sarcopenia (AWGS) in 2019. The Cox proportional hazard model was utilized to perform primary analyses of the relationship between PEF and sarcopenia. The mediating effect of cognitive function was evaluated using the counterfactual mediation method.

Results

This cohort study included 4,011 older adults (average age, 66.6 years; 53.3% males). During a follow-up period of 3.86 years, 349 individuals were diagnosed with sarcopenia. After adjusting for potential confounders, each one-standard-deviation increase in PEF was associated with a 28% reduction in the risk of sarcopenia (hazard ratio [HR]: 0.72; 95% confidence interval [CI]: 0.63, 0.80). There was a significant mediation of cognition for the association between PEF and incident sarcopenia, and the proportion mediated was 12.2% (95% CI: 4.5%, 23.1%).

Conclusions

Older adults with impaired lung function are more likely to develop sarcopenia. Nevertheless, cognition can explain only a small portion of this association. Thus, other potential pathways between lung function and sarcopenia must be elucidated.
Physical activity has decreased in Finnish children and adolescents from 2016 to 2022
Authors: Husu Pauliina , Tokola Kari , Vähä-Ypyä Henri , Sievänen Harri , Kokko Sami , Villberg Jari , Vasankari Tommi
Published: May 2024

Background

Varying trends in children’s and adolescents’ physical activity (PA) have been reported during the last 10–20 years. Trends in sedentary behavior (SB) have been studied only rarely. The purpose of the present study was to describe population-based trends in accelerometer-measured PA, standing and SB, among Finnish 7-15-year-old children and adolescents, and to evaluate the potential influence of the COVID-19 pandemic on these behaviors.

Method

A cross-sectional population-based Finnish school-aged physical activity Study (FSPA) measured daily steps, vigorous (VPA), moderate (MPA), moderate-to-vigorous (MVPA), light physical activity (LPA), standing, and SB by an accelerometer for seven consecutive days in 2016, 2018, and 2022 (n = 7.080, 57% girls). The data was analyzed by multivariate regression analysis.

Results

In 2016, participants took on average 10.305 steps per day, and spent 0:15 (h: min) in VPA, 1:37 in MPA, 1:52 in MVPA, 3:48 in LPA, 0:55 in standing and 7:52 in SB. From 2016 to 2018, daily steps, MPA, LPA, and standing increased [229 steps (95% Confidence Interval, CI 70–387), 0:03 (CI 0:01 − 0:04), 0:11 (CI 0:09 − 0:14), and 0:07 (CI 0:05 − 0:08), respectively], while VPA and SB decreased [0:01 (CI 0:00–0:02) and 0:20 (CI 0:16 − 0:24), respectively]. From 2018 to 2022, daily PA and standing declined [751 steps (CI 562–939), VPA 0:02 (CI 0:01 − 0:03), MPA 0:09 (CI 0:07 − 0:11), MVPA 0:11 (CI 0:09 − 0:14), LPA 0:08 (CI 0:05 − 0:11), and standing 0:01 (CI 0:01 − 0:03)] while SB increased 0:21 (CI 0:16 − 0:25) indicating potential influence of the pandemic.

Conclusions

Children and adolescents became physically less active from 2016 to 2022. The potential effects of the COVID-19 were seen as declined PA and increased sedentariness from 2018 to 2022.
Supporting post-pandemic recovery: a qualitative study of the capabilities, opportunities and motivations to deliver oral health behaviour change messages to parents of young children in community settings
Authors: Goldthorpe Joanna , Kilbee Lauren , Pretty Iain , Cotterill Sarah , Hart Jo , Peters Sarah
Published: May 2024

Background

The COVID-19 pandemic exacerbated vulnerabilities and inequalities in children’s oral health, and treatment activity virtually ceased during periods of lockdown. Primary care dentistry is still in the post-pandemic recovery phase, and it may be some years before normal service is resumed in NHS dentistry. However, opportunities to support the dental workforce through offering some preventative care in outreach settings may exist. This has the additional benefit of potentially reaching children who do not routinely see a dentist. The aim of this research was therefore to explore views around upskilling practitioners working in early years educational and care settings to support families of pre-school aged children to adopt and maintain preventative oral health behaviours.

Methods

Using the Capability, Opportunity and Motivation model of behaviour (COM-B) to structure our data collection and analysis, we conducted semi-structured interviews with 16 practitioners (dental and non-dental) and analysed the data using deductive framework analysis.

Results

The data were a good fit with the COM-B model, and further themes were developed within each construct, representing insights from the data.

Conclusion

Early years practitioners can reach vulnerable children who are not usually brought to see a dentist, and have the capability, opportunity and motivation to support the oral health behaviours of families of children in their care. Further research is needed to identify training needs (oral health and behaviour change knowledge and skills), acceptability to parents, and supporting dental practice teams to work in partnership with early years settings.
Co-designing strategies to improve advance care planning among people from culturally and linguistically diverse backgrounds with cancer: iCanCarePlan study protocol
Authors: Chauhan Ashfaq , Chitkara Upma , Walsan Ramya , Sansom-Daly Ursula M. , Manias Elizabeth , Seah Davinia , Dalli Angie , El-Kabbout Nadine , Tieu Thit , Sarwar Mashreka , Faiz Misbah , Huang Nancy , Rocha Vitor Moraes , Pal Abhijit , Harrison Reema
Published: May 2024

Background

Advance care planning (ACP) describes the process of supporting individuals at any age or stage of health to consider and share their personal values, life goals, and preferences regarding future health care. Engaging in ACP is associated with better-quality of care in which people receive care in lines with their wishes, values and preferences. Direct translations of ACP guides and resources do not attend to the considerable inter- and intra-ethnic variations in cultural and religious or spiritual beliefs that shape preferences among people from culturally and linguistically diverse (CALD) backgrounds. ICanCarePlan is a three-year project that aims to determine the prevalence of ACP documentation among people from CALD backgrounds with cancer, identify resources available and their use to support ACP among CALD communities, identify barriers and facilitators of person-centred ACP, and to develop, through co-design with consumers and clinicians, approaches that enhance the process ACP for people from CALD backgrounds.

Method

A mixed-method sequential approach will be used comprising of four studies. Study one is retrospective medical record review of approximately 1500 medical records to establish the prevalence of ACP documentation among CALD patient records in cancer services. Study two is a document analysis synthesising the resources available in the Australian health system to support ACP. Study three is a qualitative study with healthcare staff and consumers to explore barriers and enablers of person-centred ACP. Evidence generated from studies one to three will inform the conduct of co-design with stakeholders to develop approaches to improve ACP processes among CALD communities. Language, technical and financial support for meaningful involvement with consumers from CALD backgrounds throughout this project is outlined. A plan for distress management is also made due to sensitive nature of the topic. The research project has also established a project steering group consisting of three consumer members who are from CALD backgrounds.

Discussion

The project will address a national priority issue for a growing population of CALD communities in Australia. The project will provide novel evidence of ACP among CALD communities and novel strategies developed with stakeholders to enhance uptake and experiences of ACP.