bluuebunny/crossref_metadata_2025 huggingface dataset:
Robot-assisted endovascular treatment of hepatic artery aneurysm: A case report
Authors: Wolosker Nelson , Portela Felipe Soares Oliveira , Louzada Andressa Cristina Sposato , Galastri Francisco Leonardo , Affonso Breno Boueri , Nasser Felipe
Published: April 2024

Objective

Robot-assisted endovascular surgery has emerged as a new alternative to interventional procedures, with its application expanding to peripheral and visceral approaches. The objective of this paper is to describe a robot-assisted endovascular treatment in splanchnic arteries.

Methods

A case report of an asymptomatic male patient with an incidental finding of a saccular aneurysm of the proper hepatic artery measuring 3.7 × 2.7 cm and distant 0.6 cm from the origin of the gastroduodenal artery.

Results

Using a robot-assisted endovascular technique (CorPath GRX platform – Siemens), 2 guidewires were advanced in parallel: the first one was placed inside the aneurysm sac, while the second one was placed in the proper hepatic artery distal to the aneurysm; through the first guidewire, a balloon was advanced, positioned distally to the aneurysm, and through the second one, a microcatheter was advanced. Embolization of the aneurysm was performed with the use of coils and Onyx. Control exam performed 120 days after embolization revealed treated aneurysm and preserved distal arterial flow.

Conclusion

Using a robotic platform for navigation in splanchnic territory is safe and effective.
Transcriptomic analysis of differentially alternative splicing patterns in mice with inflammatory and neuropathic pain
Authors: Zhai Mingzhu , Huang Jiabin , Yang Shaomin , Li Na , Zeng Jun , Zheng Yi , Sun Wuping , Wu Benqing
Published: April 2024

Although the molecular mechanisms of chronic pain have been extensively studied, a global picture of alternatively spliced genes and events in the peripheral and central nervous systems of chronic pain is poorly understood. The current study analyzed the changing pattern of alternative splicing (AS) in mouse brain, dorsal root ganglion, and spinal cord tissue under inflammatory and neuropathic pain. In total, we identified 6495 differentially alternatively spliced (DAS) genes. The molecular functions of shared DAS genes between these two models are mainly enriched in calcium signaling pathways, synapse organization, axon regeneration, and neurodegeneration disease. Additionally, we identified 509 DAS in differentially expressed genes (DEGs) shared by these two models, accounting for a small proportion of total DEGs. Our findings supported the hypothesis that the AS has an independent regulation pattern different from transcriptional regulation. Taken together, these findings indicate that AS is one of the important molecular mechanisms of chronic pain in mammals. This study presents a global description of AS profile changes in the full path of neuropathic and inflammatory pain models, providing new insights into the underlying mechanisms of chronic pain and guiding genomic clinical diagnosis methods and rational medication.
Investigating Collective Emotional Structures: Theoretical and Analytical Implications of the ‘Deep Story’ Concept
Authors: Sawicka Maja
Published: April 2024

Since Hochschild proposed the notion of a ‘deep story’ to address a collective emotional structure (particularly resentment) underpinning political attitudes and social divisions in the contemporary USA, this category has been widely embraced across social sciences to reflect upon links between sedimented emotions, motivations, actions and means of social mobilization. Simultaneously, however, criticism of this concept has been articulated which pointed out that Hochschild was inconsistent in her understanding of deep stories and the role this category performs in a sociological investigation. Acknowledging critical addresses presented so far, the article aims at the reconstruction of this concept as an analytical device which can be used to account for collective emotional dynamics accompanying prolonged social transformations. I propose that a deep story can be best understood as a social space in which emotions emerge through an interactional, collaborative process of storytelling. I draw, first, from social-psychological investigations into collective processes of meaning-making to analyse the interplay between the emergence of group-based cognitive categories and their affective implications. Second, I employ narrative theories to account for socio-psychological processes in which group-based, collectively generated cognitive and affective elements are integrated into actual lifeworlds and deployed in sense-making. Finally, I consider the insights pertaining to emotions collectively felt and practised to reflect upon the social dynamic of emotion-sharing. I argue that the notion of a ‘deep story’ is analytically useful only insofar it is embedded in clearly articulated theoretical assertions about cognitive and affective, collective and interpersonal, dynamics of meaning-making.
Anthropometric measures of obesity in patients with knee joint pathology: Body surface area versus body mass index
Authors: Green Alexander , Crow Sam , Al-Dadah Oday
Published: April 2024

Background:

Obesity is quantified using body mass index. Body surface area may provide a superior and more anthropometric method of quantifying obesity in patients with musculoskeletal knee disease. This study compares the effect of weight, height, age and gender on body mass index and body surface area in a population with orthopaedic knee disease.

Methods:

An observational cohort study was conducted of patients presenting with musculoskeletal knee disease. Associations between body mass index, body surface area, age, gender, height, weight and operative versus non-operative management were analysed.

Results:

A total of 151 patients were included. Body surface area was more strongly correlated to weight than body mass index (r = 0.98, p < 0.001 versus r = 0.84, p < 0.001). Body surface area also reflects height which body mass index under presents (r = 0.65, p < 0.001 versus r = −0.08, p = 0.35). Body mass index and body surface area were correlated with one another (r = 0.70, p < 0.001). Age was inversely correlated with body surface area (r = −0.20, p = 0.013) but not body mass index (r = 0.05, p = 0.585). Body mass index did not differ between males and females (30.1 versus 30.9, p = 0.37); however, BSA scores were significantly higher in males than females (2.11 versus 1.91, p < 0.001). Neither body surface area nor body mass index scores influenced operative versus non-operative treatment.

Conclusion:

Body surface area could be a useful alternative to body mass index when considering obesity in patients with musculoskeletal knee pathology. Body surface area better reflects the effects of height, weight, age and gender than body mass index.
Evaluation of comorbidity scoring systems in patients undergoing knee arthroplasty
Authors: Green Alexander , Old Jonathan , Al-Dadah Oday
Published: April 2024

Background:

Ageing populations are increasing the demand for knee arthroplasty. Concurrently, the prevalence of medical comorbidities are rising too. The Self-Administered Comorbidity Questionnaire was developed to provide a patient’s assessment of their own comorbidities whereas the American Society of Anesthesiologists grades and the Charlson Comorbidity Index utilise clinical evaluation to objectively measure perioperative morbidity and mortality risk. The primary aim of this study was to compare Self-Administered Comorbidity Questionnaire scores with American Society of Anesthesiologists grades and Charlson Comorbidity Index scores. The secondary aim was to compare Self-Administered Comorbidity Questionnaire scores with knee outcome scores.

Methods:

A single centre observational cohort study of patients with knee osteoarthritis undergoing elective knee arthroplasty. Preoperative evaluation included Self-Administered Comorbidity Questionnaire scores, American Society of Anesthesiologists grades, Charlson Comorbidity Index scores and validated patient-reported outcome measures specific to knee surgery.

Results:

A total of 141 patients were included in this study. Self-Administered Comorbidity Questionnaire scores were directly correlated with American Society of Anesthesiologists grade (rho = 0.37, p < 0.001) and Charlson Comorbidity Index scores (rho = 0.19, p = 0.047). Individual American Society of Anesthesiologists grades had significantly different Self-Administered Comorbidity Questionnaire scores (p = 0.001). Self-Administered Comorbidity Questionnaire scores were specifically associated with hypertension, ischaemic heart disease, chronic obstructive pulmonary disease and the total number of comorbidities, but American Society of Anesthesiologists and Charlson Comorbidity Index scores were associated with more comorbidities. Overall, Self-Administered Comorbidity Questionnaire scores were inversely correlated with patient-reported outcome measure scores.

Conclusion:

Self-Administered Comorbidity Questionnaire scores are associated with increasing comorbidity in patients with symptomatic knee osteoarthritis; however, American Society of Anesthesiologists grades and Charlson Comorbidity Index scores had stronger and more abundant associations with comorbidities and patient-reported outcome measure scores. Self-Administered Comorbidity Questionnaires may complement but not replace current objective assessments of comorbidity when evaluating perioperative risk for knee arthroplasty.
Sonically Speaking: Soundwriting inasthrough Qualitative Research
Authors: Gershon Walter S.
Published: April 2024

This piece considers what it might mean to do something called soundwriting, doing qualitative research in ways that further articulate the sonic rather than reproducing ocularcentric framings that often recreate false binaries or enunciates privileging taxonomies of knowledge and care. To these ends, this article is divided into two overarching sections. The first section attends to questions of what it might mean to theorize processes of qualitative writing in general, what qualitative writing can do and the ethical commitments such writing should likely engage as matters of course. The second section presents the kinds of possibilities and challenges soundwriting can engender. This section underscores connections to fields of sonic study, how sounds can interrupt qualitative research’s often ocularcentric understandings while maintaining continuing discussions of ethical commitments to ecologies and the things that comprise them, including (more than) human animals. Rather than a polemic, this piece seeks to address what soundwriting can do as well as what might be gained for qualitative researchers and our audiences through such intentions, attentions, and expressions.
“I Feel Qatari Today […] I Feel Disabled Today, […] I Feel Like a Migrant Worker Today…”: On Sport, Leadership, and Moral Legitimacy
Authors: Mamo Yoseph Z. , Anagnostopoulos Christos , Chadwick Simon , Andrew Damon P. S.
Published: April 2024

This study examines the public’s perceptions of a speech delivered by FIFA’s president in a press conference one day before the Qatar 2022 FIFA Men’s World Cup. In total, 34,714 publicly available user responses were collected from news media YouTube channels in North America, Europe, and Asia, as well as from Twitter hashtags related to the press conference. This user-generated content was analyzed using sentiment analysis to determine the degree of positivity or negativity, followed by qualitative thematic analysis to identify specific factors influencing public perceptions of Infantino’s speech, including both positive and negative aspects. The results suggested that FIFA’s communication was “debated” due to questions and challenges posed by the public. It is noted, however, that the magnitude of negative and positive evaluations varied according to the medium used and the region. Negative evaluations related to ‘hypocrisy’, ‘lack of transparency’, and ‘diplomatic hedging’, whereas positive evaluations related to ‘symbolic communication’, ‘activist governance’, and ‘cultural appropriateness’. Using the public as a resource for institutional evaluation, this research contributes to the scholarship of sport management by analyzing the impact of communication on an organization’s moral legitimacy.
An acoustic emission based approach for damage pattern recognition in composite using linear discriminant analysis
Authors: Liu Ran , Qiao Shuai , Li Chun-li , Ma Lian-hua , Zhou Wei , Li Qing
Published: April 2024

With the increasing application of composite components in various industries, the assessment of their structural integrity, the analysis of damage processes, and the identification of damage patterns are becoming increasingly important. The accuracy of the analysis relies heavily on the selection of features. This paper presents a new idea to extract effective damage features from acoustic emission (AE) signals and accurately identify different damages in the failure process of carbon fiber reinforced polymer specimens. The method combines Hilbert–Huang transform (HHT) and Linear Discriminant Analysis (LDA) to analyze the AE signals generated during the damage process of composite specimens. Specifically, the Hilbert marginal energy spectrum of the signals was regarded as frequency domain descriptors. The frequency domain descriptors were subsequently associated with the parametric features after dimensionality reduction by LDA to construct the classification framework named HHT-LDA. The results show that the frequency domain descriptors of the AE signals associated with each damage mode characterized distinctly. The frequency band of energy distribution in the raw waveform for matrix cracking, delamination, and fiber breakage are (100–150 kHz), (150–300 kHz), and (300–350 kHz), respectively. In addition, the three damage patterns mentioned above were successfully detected and recognized from the complex AE waveforms using HHT-LDA with 85% overall classification rate. This research idea will serve as a potential method for future composite damage pattern recognition and provide supporting knowledge for practical applications of AE monitoring.
Reduction of mortality, cardiac damage, and cerebral damage by IL-1 inhibition in a murine model of TTP
Authors: Muller Romain , Cauchois Raphaël , Lagarde Marie , Roffino Sandrine , Genovesio Cécile , Fernandez Samantha , Hache Guillaume , Guillet Benjamin , Kara Yéter , Marlinge Marion , Lenting Peter , Poullin Pascale , Dignat-George Françoise , Tellier Edwige , Kaplanski Gilles
Published: April 2024

Thrombotic thrombocytopenic purpura (TTP), a rare but fatal disease if untreated, is due to alteration in von Willebrand factor cleavage resulting in capillary microthrombus formation and ischemic organ damage. Interleukin-1 (IL-1) has been shown to drive sterile inflammation after ischemia and could play an essential contribution to postischemic organ damage in TTP. Our objectives were to evaluate IL-1 involvement during TTP and to test the efficacy of the recombinant IL-1 receptor antagonist, anakinra, in a murine TTP model. We retrospectively measured plasma IL-1 concentrations in patients with TTP and controls. Patients with TTP exhibited elevated plasma IL-1α and -1β concentrations, which correlated with disease course and survival. In a mouse model of TTP, we administered anakinra (IL-1 inhibitor) or placebo for 5 days and evaluated the efficacy of this treatment. Anakinra significantly reduced mortality of mice (P < .001). Anakinra significantly decreased TTP-induced cardiac damage as assessed by blood troponin concentrations, evaluation of left ventricular function by echocardiography, [18F]fluorodeoxyglucose positron emission tomography of myocardial glucose metabolism, and cardiac histology. Anakinra also significantly reduced brain TTP-induced damage evaluated through blood PS100b concentrations, nuclear imaging, and histology. We finally showed that IL-1α and -1β trigger endothelial degranulation in vitro, leading to the release of von Willebrand factor. In conclusion, anakinra significantly reduced TTP mortality in a preclinical model of the disease by inhibiting both endothelial degranulation and postischemic inflammation, supporting further evaluations in humans.
Haploidentical transplantation in primary refractory/relapsed secondary vs de novo AML: from the ALWP/EBMT
Authors: Nagler Arnon , Labopin Myriam , Tischer Johanna , Raiola Anna Maria , Kunadt Desiree , Vydra Jan , Blaise Didier , Chiusolo Patrizia , Fanin Renato , Winkler Julia , Forcade Edouard , Van Gorkom Gwendolyn , Ciceri Fabio , Mohty Mohamad
Published: April 2024

We compared the outcomes of haploidentical stem cell transplantation (haplo-HSCT) with posttransplant cyclophosphamide (PTCy) in 719 patients with primary refractory (PR) or first relapse (Rel) secondary acute myeloid leukemia (sAML; n = 129) vs those with de novo AML (n = 590), who received HSCT between 2010 and 2022. A higher percentage of patients with sAML vs de novo AML had PR disease (73.6% vs 58.6%; P = .002). In 81.4% of patients with sAML , the antecedent hematological disorder was myelodysplastic syndrome. Engraftment was 83.5% vs 88.4% in sAML and de novo AML, respectively (P = .13). In multivariate analysis, haplo-HSCT outcomes did not differ significantly between the groups: nonrelapse mortality hazard ratio (HR), 1.38 (95% confidence interval [CI], 0.96-1.98; P = .083), relapse incidence HR, 0.68 (95% CI, 0.4.7.-1.00; P = .051). The HRs for leukemia-free survival, overall survival, and graft-versus-host disease (GVHD)–free, and GVHD and relapse–free survival were 0.99 (95% CI, 0.76-1.28; P = .94), 0.99 (95% CI, 0.77-1.29; P = .97), and 0.99 (95% CI, 0.77-1.27; P = .94), respectively. We conclude that outcomes of haplo-HSCT with PTCy are not different for PR/Rel sAML in comparison with PR/Rel de novo AML, a finding of major clinical importance.
Effects of cytochalasin D on relaxation process of skinned taenia cecum and carotid artery from guinea pig
Authors: Mihashi Satoko , Watanabe Masaru
Published: April 2024

Actin linked regulatory mechanisms are known to contribute contraction/relaxation in smooth muscle. In order to clarify whether modulation of polymerization/depolymerization of actin filaments affects relaxation process, we examined the effects of cytochalasin D on relaxation process by Ca2+ removal after Ca2+-induced contraction of β-escin skinned (cell membrane permeabilized) taenia cecum and carotid artery preparations from guinea pigs. Cytochalasin D, an inhibitor of actin polymerization, significantly suppressed the force during relaxation both in skinned taenia cecum and carotid artery. The data fitting analysis of the relaxation processes indicates that cytochalasin D accelerates slow (latch-like) bridge dissociation. Cytochalasin D seems to directly disrupts actin filament organization or its length, resulting in modulation of actin filament structure that prevents myosin binding.
A chromosome-level genome reveals genome evolution and molecular basis of anthraquinone biosynthesis in Rheum palmatum
Authors: Zhang Tianyi , Zhou Lipan , Pu Yang , Tang Yadi , Liu Jie , Yang Li , Zhou Tao , Feng Li , Wang Xumei
Published: April 2024

Background

Rhubarb is one of common traditional Chinese medicine with a diverse array of therapeutic efficacies. Despite its widespread use, molecular research into rhubarb remains limited, constraining our comprehension of the geoherbalism.

Results

We assembled the genome of Rheum palmatum L., one of the source plants of rhubarb, to elucidate its genome evolution and unpack the biosynthetic pathways of its bioactive compounds using a combination of PacBio HiFi, Oxford Nanopore, Illumina, and Hi-C scaffolding approaches. Around 2.8 Gb genome was obtained after assembly with more than 99.9% sequences anchored to 11 pseudochromosomes (scaffold N50 = 259.19 Mb). Transposable elements (TE) with a continuous expansion of long terminal repeat retrotransposons (LTRs) is predominant in genome size, contributing to the genome expansion of R. palmatum. Totally 30,480 genes were predicted to be protein-coding genes with 473 significantly expanded gene families enriched in diverse pathways associated with high-altitude adaptation for this species. Two successive rounds of whole genome duplication event (WGD) shared by Fagopyrum tataricum and R. palmatum were confirmed. We also identified 54 genes involved in anthraquinone biosynthesis and other 97 genes entangled in flavonoid biosynthesis. Notably, RpALS emerged as a compelling candidate gene for the octaketide biosynthesis after the key residual screening.

Conclusion

Overall, our findings offer not only an enhanced understanding of this remarkable medicinal plant but also pave the way for future innovations in its genetic breeding, molecular design, and functional genomic studies.
The burden and natural history of cardiac pathology at TB diagnosis in a high-HIV prevalence district in Zambia: protocol for the TB-Heart study
Authors: Scopazzini Marcello S. , Chansa Pamela , Majonga Edith D. , Bual Nina , Schaap Albertus , Mateyo Kondwelani J. , Musukuma Remmy , Mweemba Veronica , Cheeba Maina , Mwila Chipili C. , Sigande Lucheka , Banda Isabel , Ngulube Joseph , Shanaube Kwame , Zenner Dominik , Ayles Helen , Shah Anoop S. V.
Published: April 2024

Background

Tuberculosis (TB) continues to be a major cause of death across sub-Saharan Africa (SSA). In parallel, non-communicable disease and especially cardiovascular disease (CVD) burden has increased substantially in the region. Cardiac manifestations of TB are well-recognised but the extent to which they co-exist with pulmonary TB (PTB) has not been systematically evaluated. The aim of this study is to improve understanding of the burden of cardiac pathology in PTB in those living with and without HIV in a high-burden setting.

Methods

This is a cross-sectional and natural history study to evaluate the burden and natural history of cardiac pathology in participants with PTB in Lusaka, Zambia, a high burden setting for TB and HIV. Participants with PTB, with and without HIV will be consecutively recruited alongside age- and sex-matched TB-uninfected comparators on a 2:1 basis. Participants will undergo baseline assessments to collect clinical, socio-demographic, functional, laboratory and TB disease impact data followed by point-of-care and standard echocardiography. Participants with PTB will undergo further repeat clinical and functional examination at two- and six months follow-up. Those with cardiac pathology at baseline will undergo repeat echocardiography at six months.

Discussion

The outcomes of the study are to a) determine the burden of cardiac pathology at TB diagnosis, b) describe its association with patient-defining risk factors and biochemical markers of cardiac injury and stretch and c) describe the natural history of cardiac pathology during the course of TB treatment.
Remote sensing image information extraction based on Compensated Fuzzy Neural Network and big data analytics
Authors: Sun Rui , Zhang Zhengyin , Liu Yajun , Niu Xiaohang , Yuan Jie
Published: April 2024

Medical imaging AI systems and big data analytics have attracted much attention from researchers of industry and academia. The application of medical imaging AI systems and big data analytics play an important role in the technology of content based remote sensing (CBRS) development. Environmental data, information, and analysis have been produced promptly using remote sensing (RS). The method for creating a useful digital map from an image data set is called image information extraction. Image information extraction depends on target recognition (shape and color). For low-level image attributes like texture, Classifier-based Retrieval(CR) techniques are ineffective since they categorize the input images and only return images from the determined classes of RS. The issues mentioned earlier cannot be handled by the existing expertise based on a keyword/metadata remote sensing data service model. To get over these restrictions, Fuzzy Class Membership-based Image Extraction (FCMIE), a technology developed for Content-Based Remote Sensing (CBRS), is suggested. The compensation fuzzy neural network (CFNN) is used to calculate the category label and fuzzy category membership of the query image. Use a basic and balanced weighted distance metric. Feature information extraction (FIE) enhances remote sensing image processing and autonomous information retrieval of visual content based on time-frequency meaning, such as color, texture and shape attributes of images. Hierarchical nested structure and cyclic similarity measure produce faster queries when searching. The experiment’s findings indicate that applying the proposed model can have favorable outcomes for assessment measures, including Ratio of Coverage, average means precision, recall, and efficiency retrieval that are attained more effectively than the existing CR model. In the areas of feature tracking, climate forecasting, background noise reduction, and simulating nonlinear functional behaviors, CFNN has a wide range of RS applications. The proposed method CFNN-FCMIE achieves a minimum range of 4–5% for all three feature vectors, sample mean and comparison precision-recall ratio, which gives better results than the existing classifier-based retrieval model. This work provides an important reference for medical imaging artificial intelligence system and big data analysis.
Elucidating the role of EPPK1 in lung adenocarcinoma development
Authors: Arimura Ken , Kammer Michael , Rahman S. M. Jamshedur , Sheau-Chiann Chen , Zhao Shilin , Heidi Chen , Eisenberg Rosana , Zou Yong , Antic Sanja , Richmond Bradley , Tagaya Etsuko , Grogan Eric , Massion Pierre , Maldonado Fabien
Published: April 2024

Background

We recently found that epiplakin 1 (EPPK1) alterations were present in 12% of lung adenocarcinoma (LUAD) cases and were associated with a poor prognosis in early-stage LUAD when combined with other molecular alterations. This study aimed to identify a probable crucial role for EPPK1 in cancer development.

Methods

EPPK1 mRNA and protein expression was analyzed with clinical variables. Normal bronchial epithelial cell lines were exposed to cigarette smoke for 16 weeks to determine whether EPPK1 protein expression was altered after exposure. Further, we used CRISPR-Cas9 to knock out (KO) EPPK1 in LUAD cell lines and observed how the cancer cells were altered functionally and genetically.

Results

EPPK1 protein expression was associated with smoking and poor prognosis in early-stage LUAD. Moreover, a consequential mesenchymal-to-epithelial transition was observed, subsequently resulting in diminished cell proliferation and invasion after EPPK1 KO. RNA sequencing revealed that EPPK1 KO induced downregulation of 11 oncogenes, 75 anti-apoptosis, and 22 angiogenesis genes while upregulating 8 tumor suppressors and 12 anti-cell growth genes. We also observed the downregulation of MYC and upregulation of p53 expression at both protein and RNA levels following EPPK1 KO. Gene ontology enrichment analysis of molecular functions highlighted the correlation of EPPK1 with the regulation of mesenchymal cell proliferation, mesenchymal differentiation, angiogenesis, and cell growth after EPPK1 KO.

Conclusions

Our data suggest that EPPK1 is linked to smoking, epithelial to mesenchymal transition, and the regulation of cancer progression, indicating its potential as a therapeutic target for LUAD.
Bilateral multifocal chorioretinitis as the only presentation of acute West Nile virus infection: a case report
Authors: Valsecchi Nicola , Veronese Chiara , Roda Matilde , Ciardella Antonio Pasquale , Fontana Luigi
Published: April 2024

Background

To describe a case of bilateral multifocal chorioretinitis as the only presentation of acute West Nile virus (WNV) infection in the absence of neurological involvement.

Case presentation

A 78-year-old Italian woman was admitted to our emergency department because she noticed blurry vision in both eyes. She did not report fever, fatigue, or neurological symptoms in the last few days. Multimodal imaging showed the presence of bilateral hyperfluorescent lesions with a linear distribution, that corresponded to hypocyanescent spots on indocyanine green angiography. Antibody serology showed the presence of IgM antibodies, IgG antibodies, and ribonucleic acid (RNA) for WNV. Magnetic resonance imaging (MRI) of the brain ruled out central nervous system involvement. Three months later, the patient reported spontaneous resolution of her symptoms and remission of the chorioretinal infiltrates.

Conclusions

In endemic areas, it is important to think of acute WNV infection as an explanatory etiology in cases of multifocal chorioretinitis, even without neurological involvement.
Decomposition analysis on the equity of health examination utilization for the middle-aged and elderly people in China: based on longitudinal CHARLS data from 2011 to 2018
Authors: Su Min , Zhang Tianjiao , Zhang Weile , Li Zhengrong , Fan Xiaojing
Published: April 2024

Background

This study aimed to investigate the utilization rate and equity of health examination service among the middle-aged and elderly population in China from 2011 to 2018. The contribution of various determinants to the inequity in health examination service utilization was also examined.

Methods

Data from the China Health and Retirement Longitudinal Survey (CHARLS) were analyzed to assess the health examination service utilization rate among the middle-aged and elderly population. A concentration curve and concentration index were employed to measure the equity of health examination service utilization and decomposed into its determining factors. Horizontal inequity index was applied to evaluate the trends in equity of health examination service.

Results

The health examination service utilization rates among the middle-aged and elderly population were 29.45%, 20.69%, 25.40%, and 32.05% in 2011, 2013, 2015, and 2018, respectively. The concentration indexes for health examination service utilization were 0.0080 (95% CI: − 0.0084, 0.0244), 0.0155 (95% CI: − 0.0054, 0.0363), 0.0095 (95% CI: − 0.0088, 0.0277), and − 0.0100 (95% CI: − 0.0254, 0.0054) from 2011 to 2018, respectively. The horizontal inequity index was positive from 2011 to 2018, evidencing a pro-rich inequity trend. Age, residence, education, region, and economic status were the major identified contributors influencing the equity of health examination service utilization.

Conclusions

A pro-rich inequity existed in health examination service utilization among the middle-aged and elderly population in China. Reducing the wealth and regional gap, providing equal educational opportunities, and strengthening the capacity for chronic disease prevention and control are crucial for reducing the inequity in health examination service utilization.
A systematic review and meta-analysis of hybrid vs. cemented stems – which method is more optimal for revision total knee arthroplasty?
Authors: Thever Yogen , James Loh Sir Young , Raghavan Raghuraman , Toh Rong Chuin , Moo Ing How
Published: April 2024

Introduction

The number of primary and revision Total Knee Arthroplasty (TKA) cases are expected to increase in future. There are various advantages and disadvantage to employing either of the two main types of stem fixation methods – cemented or hybrid technique. This review aimed to study the most optimal fixation method for revision TKAs by comparing radiological outcomes and re-revision rates.

Methods

A systematic review and meta-analysis was performed using PubMed and Cochrane Library from 2010 to identify studies explicitly comparing outcomes between cemented against hybrid fixation revision TKA techniques, with a minimum follow up of at least 24 months. A total of 8 studies was included in this review. Egger’s test and visual inspection of the funnel plot did not reveal publication bias.

Results

There was no statistically significant difference in radiological failure and loosening (OR 0.79, CI 0.37–1.66, I2 = 29%, p = 0.22), all causes of re-revision (OR 1.03, CI 0.73–1.44, I2 = 0%, p = 0.56) and aseptic revision (OR 0.74, CI 0.27–2.02, I2 = 0%, p = 0.41) between cemented and hybrid techniques. Functional and pain outcomes compared between the two fixation techniques were largely similar across the studies included in this meta-analysis.

Conclusion

Despite a trend favouring hybrid stems in revision TKA, current evidence revealed that radiological outcomes and re-revision rates are largely similar between cemented and hybrid fixation techniques.
Assessment of oral hypofunction and its association with age among Korean community-dwelling older adults
Authors: Park Hye-Jin , Jung Eun-Ha , Kim Soo-Min , Park Seong-Chan , Jo Min-Ji , Lee Yun-Seon , Kim Sung-Hoon , Han Sun-Young
Published: April 2024

Background

Due to the increasing proportion of older adults in Korea and growing interest in aging, the concepts of oral aging and oral hypofunction have recently been introduced. Thus, it is necessary to investigate the age-specific oral function levels of Korean older adults and develop expert intervention methods for healthy aging.

Methods

Dysphagia, independence of daily living, and oral hypofunction were assessed in 206 older adults living in Wonju, Gangwon State, South Korea. Subjective dysphagia was assessed through self-report questionnaires using the Dysphagia Handicap Index (DHI), the Korean version of Eating Assessment Tool-10, and the Korean version of the Modified Barthel Index. In addition, the oral hypofunction assessment items included decreased chewing ability, occlusal pressure, tongue pressure, oral dryness, and oral cleanliness.

Results

DHI increased significantly with age, with those in their 80 s reporting the most difficulty swallowing. Oral function in terms of chewing ability (maximum occlusal pressure and number of remaining teeth), maximum occlusal pressure, and maximum tongue pressure also declined with increasing age. While there was no significant difference in oral dryness by age, those in their 80 s had dry mouth according to the criteria of the oral moisture checking device.

Conclusions

In an assessment of oral function in community-dwelling, independent Korean older adults, the number of items that were assessed as oral hypofunction increased with age. The findings can be used to standardize the oral hypofunction assessment item and develop age-based individualized intervention plans for the early management of oral health and individual oral myofunctional rehabilitation in Korean community-dwelling older adults.
Dynamics of caste and early childbearing in India: a perspective of three decades
Authors: Pradhan Manas Ranjan , Mondal Sourav , Saikia Daisy , Mudi Prasanna Kumar
Published: April 2024

Background

Early childbearing disrupts girls’ otherwise healthy growth into adulthood and adversely affects their education, livelihood, and health. Individual, sociocultural, economic, environmental, and health service-related factors contribute to childbearing among young females. In India, caste affects health outcomes despite several affirmative policies aimed at improving the health and welfare of the backward castes/tribes. However, there is a dearth of empirical evidence about the impact of caste on early childbearing, more specifically, regarding the trajectory of inter-caste disparities in early childbearing.

Method

This study used data from all five rounds of the National Family Health Survey (NFHS) in India to assess the association between caste and early childbearing over the last three decades. All women aged 20–24 [NFHS-1 (n = 17,218), NFHS-2 (n = 15,973), NFHS-3 (n = 22,807), NFHS-4 (n = 122,955) and NFHS-5 (n = 118,700)] were considered to create a pooled data set (n = 297,653) for analysis. Bivariate analysis and binary logistic regression were conducted using Stata (v17). ArcMap (v10.8) presented the caste-wise prevalence of early childbearing among the states and Union Territories (UTs).

Results

Many women continue to have early childbearing despite a considerable reduction over the last three decades from 47% in 1992-93 to 15% in 2019-21. Compared to NFHS-1, the odds of early childbearing increased by 15% in NFHS-2 and, after that, declined by 42% in NFHS-3 and 64% in NFHS-4 and NFHS-5. The inter-caste disparity in early childbearing persists, albeit with a narrowing gap, with the Scheduled castes (SC) remaining the most vulnerable group. Adjusting the effects of socio-demographic and economic characteristics, SC women had significantly higher odds of early childbearing (OR = 1.07, CI = 1.04–1.11) than those from the General caste.

Conclusion

To decrease early childbirth, a focus on adolescent marriage prevention and increasing contraceptive use among young SC women is necessary. Strengthening ongoing programs and policies targeting educational and economic empowerment of the socially weaker castes/tribes will help in reducing early childbearing. Efforts to prevent early childbearing will accelerate the achievement of the Sustainable Development Goals (SDGs)-especially those related to health, poverty, nutrition, education, and general wellbeing, in addition to protecting women’s reproductive rights.
A systematic scoping review of group reflection in medical education
Authors: Phua Gillian Li Gek , Owyong Jasmine Lerk Juan , Leong Ian Tze Yong , Goh Suzanne , Somasundaram Nagavalli , Poon Eileen Yi Ling , Chowdhury Anupama Roy , Ong Simon Yew Kuang , Lim Crystal , Murugam Vengadasalam , Ong Eng Koon , Mason Stephen , Hill Ruaridh , Krishna Lalit Kumar Radha
Published: April 2024

Background

Reviewing experiences and recognizing the impact of personal and professional views and emotions upon conduct shapes a physician’s professional and personal development, molding their professional identity formation (PIF). Poor appreciation on the role of reflection, shortages in trained tutors and inadequate ‘protected time’ for reflections in packed medical curricula has hindered its integration into medical education. Group reflection could be a viable alternative to individual reflections; however, this nascent practice requires further study.

Methods

A Systematic Evidence Based Approach guided Systematic Scoping Review (SSR in SEBA) was adopted to guide and structure a review of group reflections in medical education. Independent searches of articles published between 1st January 2000 and 30th June 2022 in bibliographic and grey literature databases were carried out. Included articles were analysed separately using thematic and content analysis, and combined into categories and themes. The themes/categories created were compared with the tabulated summaries of included articles to create domains that framed the synthesis of the discussion.

Results

1141 abstracts were reviewed, 193 full-text articles were appraised and 66 articles were included and the domains identified were theories; indications; types; structure; and benefits and challenges of group reflections.

Conclusions

Scaffolded by current approaches to individual reflections and theories and inculcated with nuanced adaptations from other medical practices, this SSR in SEBA suggests that structured group reflections may fill current gaps in training. However, design and assessment of the evidence-based structuring of group reflections proposed here must be the focus of future study.
Sociocultural adjustment and social support as predictors for international medical sciences students’ anxiety during COVID-19
Authors: Razgulin Jevgenij , Argustaitė-Zailskienė Gita , Petrolienė Raimonda , Šmigelskas Kastytis
Published: April 2024

Background

The prevalence of anxiety is high among international medical sciences students and it increased even more during the COVID-19 pandemic due to different restrictions and social isolation. Successful sociocultural adjustment and social support could be important factors in overcoming those challenges, however, there is a lack of studies which would investigate the role of those factors among inter- national medical students. This study aimed to assess the role of sociocultural adjustment and social support as predictors for international medical students’ anxiety during COVID-19.

Methods

Two measurements were conducted via self-reported questionnaires which consisted of three scales - SCAS, MSPSS and GAD-7. In total, 82 international medical students participated in both measurements in this longitudinal study.

Results

The findings indicated that 37% of international students had symptoms of moderate or severe anxiety during their first year of studies at university. In the second year, during the COVID-19 pandemic and an official lockdown, 35% of international students had symptoms of moderate or severe anxiety. In addition, this study showed that gender and sociocultural adjustment did not play a role as predictors of students’ anxiety during the second year of studies. However, this study revealed that social support provided by family during the first year of studies, as well as having friends or family members who had been ill with COVID-19 predicted higher levels of anxiety at second measurement, while sociocultural adjustment was an even stronger predictor of anxiety in the second year of studies of international medical students.

Conclusions

This knowledge can help to better understand how international medical students felt during the COVID-19 pandemic and what role the above- mentioned factors played in the students’ anxiety. As the anxiety level is quite high among international medical students, universities and mental health service providers should take it into consideration and help them to overcome those challenges.
Development of a validated assessment tool for medical students using simulated patients: an 8-year panel survey
Authors: Haruta Junji , Nakajima Rika , Monkawa Toshiaki
Published: April 2024

Background

The use of simulated patients (SPs) to assess medical students’ clinical performance is gaining prominence, underscored by patient safety perspective. However, few reports have investigated the validity of such assessment. Here, we examined the validity and reliability of an assessment tool that serves as a standardized tool for SPs to assess medical students’ medical interview.

Methods

This longitudinal survey was conducted at Keio University School of Medicine in Japan from 2014 to 2021. To establish content validity, the simulated patient assessment tool (SPAT) was developed by several medical education specialists from 2008 to 2013. A cohort of 36 SPs assessed the performance of 831 medical students in clinical practice medical interview sessions from April 2014 to December 2021. The assessment’s internal structure was analyzed using descriptive statistics (maximum, minimum, median, mean, and standard deviation) for the SPAT’s 13 item total scores. Structural validity was examined with exploratory factor analysis, and internal consistency with Cronbach’s alpha coefficients. The mean SPAT total scores across different SPs and scenarios were compared using one way analysis of variance (ANOVA). Convergent validity was determined by correlating SPAT with the post-clinical clerkship obstructive structured clinical examination (post-CC OSCE) total scores using Pearson’s correlation coefficient.

Results

Of the 831 assessment sheets, 36 with missing values were excluded, leaving 795 for analysis. Thirty-five SPs, excluding one SP who quit in 2014, completed 795 assessments, for a response rate of 95.6%. Exploratory factor analysis revealed two factors, communication and physician performance. The overall Cronbach’s alpha coefficient was 0.929. Significant differences in SPAT total scores were observed across SPs and scenarios via one-way ANOVA. A moderate correlation (r =.212, p <.05) was found between SPAT and post-CC OSCE total scores, indicating convergent validity.

Conclusions

Evidence for the validity of SPAT was examined. These findings may be useful in the standardization of SP assessment of the scenario-based clinical performance of medical students.
Factors influencing hospitalization or emergency department visits and mortality in type 2 diabetes following the onset of new cardiovascular diagnoses in a population-based study
Authors: Agvall Björn , Jonasson Junmei Miao , Galozy Alexander , Halling Anders
Published: April 2024

Background

Individuals with type 2 diabetes (T2D) are at increased risk of developing cardiovascular disease (CVD) which necessitates monitoring of risk factors and appropriate pharmacotherapy. This study aimed to identify factors predicting emergency department visits, hospitalizations, and mortality among T2D patients after being newly diagnosed with CVD.

Methods

In a retrospective observational study conducted in Region Halland, individuals aged > 40 years with T2D diagnosed between 2011 and 2019, and a new diagnosis of CVD between 2016 and 2019, were followed for one year from the date of CVD diagnosis. The first encounter for CVD diagnosis was categorized as inpatient-, outpatient-, primary-, or emergency department care. Follow-up included laboratory tests, blood pressure, pharmacotherapies, and healthcare utilization. Hazard ratios (HR) in two Cox regression analyses determined relative risks for emergency visits/hospitalization and mortality, adjusting for age, sex, glucose regulation, lipid levels, kidney function, blood pressure, pharmacotherapy, and healthcare utilization.

Results

The study included a total of 1759 T2D individuals who received a new CVD diagnosis, with 67% diagnosed during inpatient care. The average hospitalization stay was 6.5 days, and primary care follow-up averaged 10.1 visits. Patients with CVD diagnosed in primary care had a HR 0.52 (confidence interval [CI] 0.35–0.77) for emergency department visits/hospitalization, but age had a HR 1.02 (CI 1.00-1.03). Pharmacotherapy with insulin, DPP4-inhibitors, aldosterone antagonists, and beta-blockers had a raised HR. Highest mortality risk was observed when CVD was diagnosed inpatient care, systolic blood pressure < 100 mm Hg and elevated HbA1c. Age had a HR 1.05 (CI 1.03–1.08), eGFR < 30 ml/min HR 1.46 (CI 1.01–2.11), and LDL-Cholesterol > 2,5 h 1.46 (CI 1.01–2.11) and associated with increased mortality risk. Pharmacotherapy with metformin had a HR 0.41 (CI 0.28–0.62), statins a HR 0.39 (CI 0.27–0.57), and a primary care follow-up < 30 days a HR 0.53 (CI 0.37–0.77) and associated with lower mortality risk.

Conclusions

T2D individuals who had a new diagnosis of CVD were predominantly diagnosed when hospitalized, while follow-up typically occurred in primary care. Identifying factors that predict risks of mortality and hospitalization should be a focus of follow-up care, underscoring the critical role of primary care in the effective management of T2D and CVD.