bluuebunny/crossref_metadata_2025 huggingface dataset:
Joining Forces: The Spillover Effects of EPA Enforcement Actions and the Role of Socially Responsible Investors
Authors: Dasgupta Sudipto , Huynh Thanh D , Xia Ying
Published: February 2023

We find that firms reduce toxic emissions at their local plants following EPA enforcement actions against nearby plants operated by peer firms that compete in the same product market. These reductions are more pronounced for plants located near socially responsible mutual funds (SRMFs) that hold these plants’ parent firms’ shares. Close proximity to SRMFs is associated with real investment in abatement measures to mitigate emissions. While plants increase emissions again in the long run, such reversals do not occur in plants located near SRMFs. Taken together, our results suggest that local SRMFs complement EPA enforcement in influencing plants’ emissions.

Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Characteristics of patients initiating treatment with baricitinib and outcomes at follow-up: analysis of BSRBR-RA Registry data
Authors: Edwards Christopher J , Mount Julie , Meeks Alexandra , Gulati Tania , Zaremba-Pechmann Liliana , Sheesh Mohamed , Larsson Esbjörn , Dennison Elaine
Published: February 2023

Objectives

To describe selected baseline characteristics, continuation with baricitinib and disease activity over time in patients initiating treatment with baricitinib in a UK real-world rheumatology setting.

Methods

Baseline and follow-up data were analysed from baricitinib-treated patients newly recruited to the British Society for Rheumatology Biologics Registry–RA (BSRBR-RA) baricitinib cohort between 1 January 2018 and 31 March 2020. The primary objective was to evaluate continuation of baricitinib treatment in patients with at least one follow-up. Analyses were performed using the full baricitinib cohort, overall and by patient subgroup: biologic DMARD (bDMARD)/targeted synthetic (ts)DMARD-naive vs -experienced, baricitinib 4 vs 2 mg, age ≥65 vs <65 years, monotherapy vs combination therapy and male vs female.

Results

At baseline, the study cohort (n = 561) was 76.5% female, mean age 60.0 years, had longstanding (mean 13.1 years) and severe RA, and 54.0% had previously received a bDMARD/tsDMARD. Of 265 and 110 patients completing the 6- and 12-month follow-ups with available data, 77.7 and 69.1% remained on baricitinib at each time, respectively. In all Kaplan–Meier analyses, >60% of patients remained on baricitinib at 540 days. Continuation of baricitinib therapy differed between some subgroup pairs (bDMARD/tsDMARD naive/experienced, baricitinib 2 mg/4 mg). Disease activity was lower at both follow-ups than at baseline, overall and in all subgroups.

Conclusion

In the early years of real-world baricitinib use in the UK, a high proportion of patients continued with treatment at both 6 and 12 months, at which times disease activity was lower than at baseline.
Population-representative study reveals cardiovascular and metabolic disease biomarkers associated with misaligned sleep schedules
Authors: Sládek Martin , Klusáček Jan , Hamplová Dana , Sumová Alena
Published: February 2023

Study Objectives

Social jetlag manifests as a difference in sleep timing on workdays and free days. Social jetlag is often associated with shorter, lower-quality sleep, so it is unclear how much the chronic circadian misalignment contributes to observed negative health outcomes. We aimed to (1) investigate associations between social jetlag, chronotype (one of its determinants), and the levels of health markers, (2) describe factors associated with social jetlag, and (3) examine whether working from home can reduce social jetlag.

Methods

Adult respondents participated in a nationally representative longitudinal survey of Czech households (individuals in each wave: n2018/19/20 = 5132/1957/1533), which included Munich ChronoType Questionnaire to evaluate chronotype and social jetlag. A subset provided blood samples (n2019 = 1957) for detection of nine biomarkers and was surveyed in three successive years (social jetlag calculated for n2018/19/20 = 3930/1601/1237). Data were analyzed by nonparametric univariate tests and mixed effects multivariate regression with social jetlag, chronotype, sex, age, body-mass index, and reported diseases as predictors and biomarker levels as outcomes.

Results

Higher social jetlag (≥0.65 h) was significantly associated with increased levels of total cholesterol and low-density lipoprotein cholesterol, particularly in participants older than 50 years (Mann–Whitney, men: pCHL = 0.0005, pLDL = 0.0009; women: pCHL = 0.0079, pLDL = 0.0068). Extreme chronotypes were associated with cardiovascular disease risk markers regardless of social jetlag (Kruskal–Wallis, p < 0.0001). Commuting to work and time stress were identified as important contributors to social jetlag. Individual longitudinal data showed that working from home decreased social jetlag and prolonged sleep.

Conclusions

We report significant associations between sleep phase preference, social jetlag, and cardio-metabolic biomarkers.
ASCs Activate cGAS-Type I IFNs-IL-7 Axis Via Pseudomonas aeruginosa-Derived Outer Membrane Vesicles to Resolve Pneumonia
Authors: Di Caixia , Jiang Yanshan , Li Lulu , Shi Mengmeng , Zhu Yinggang , Zhang Jing , Song Yuanlin , Su Xiao , Qu Jieming
Published: February 2023

Mesenchymal stem cells (MSCs) therapy could efficiently attenuate LPS-induced acute lung injury and Pseudomonas aeruginosa (PA)-induced acute pneumonia. However, the underlying molecular mechanisms are still elusive. Here, we report that PA-derived outer membrane vesicles (OMVs) trigger mouse primary adipose tissue-derived mesenchymal stem cells (ASCs) to upregulate cyclic GMP-AMP synthase (cGAS) for sensing of double-stranded DNA (dsDNA) and the expression of interleukin (IL)-7. Loss of cGAS-interferon (IFN)-β axis abolished the protective function of ASCs to PA-induced acute pneumonia in mice. Mechanistically, OMVs-delivered PA dsDNA primes cGAS-stimulator of interferon genes (STING) signaling pathway and increases the IL-7 production in ASCs via IFN-β signaling. Meanwhile, dsDNA-primed ASCs furthermore amplifies IL-7 expression in primary lung epithelial cells and mouse lung epithelial (MLE)-12 cell line via increased IFN-β. Our findings thus implicate a molecular mechanism that ASCs recognize PA-OMVs-derived dsDNA to secrete IL-7 via activating cGAS, suggesting a potential therapeutic strategy of ASCs transfer for PA-induced lung infection and inflammation.
The Labor-Supply Consequences of Having a Child in China
Authors: Wang Shing-Yi
Published: February 2023

Combining eight years of panel data with an event study approach, this study shows that rural Chinese women’s labor supply falls following the birth of a child. In contrast, men’s labor supply does not fall after birth. Furthermore, a woman’s labor supply falls more following the birth of a son than a daughter. Following the birth of a son relative to a daughter, household cigarette consumption declines, and a mother’s leisure time, her probability of school enrollment, and her participation in decision-making increase. There are no increases in other investments in boys complementary to mothers’ time, such as food expenditures, breastfeeding, or immunizations. These results are consistent with the idea that mothers are rewarded more for having a son, leading them to have more leisure and work less.
Development of a Duplex qPCR System for Detection and Quantification of the Two Canola Blackleg Pathogens Leptosphaeria biglobosa and L. maculans
Authors: Fu Heting , Yang Yalong , Sarkes Alian , Harding Michael W. , Feindel David , Feng Jie
Published: February 2023

Two probe-based qPCR systems, namely P-Lb and P-Lm, specific to the canola blackleg pathogens Leptosphaeria biglobosa and L. maculans, respectively, were developed, and their efficiencies were tested. Each of the two systems targets a single-copy gene exclusively present in the corresponding species. The specificities of the two systems on the species level and their ubiquities on the subspecies level were confirmed by in silico sequence analyses and testing on L. biglobosa (17 strains), L. maculans (10 strains), and other plant pathogens (31 species). For sensitivities, the two systems were tested on synthesized DNA fragments (gBlock) of the targeted regions, from which a standard curve was generated for each system. In addition, standard curves were also generated on gBlocks for duplex qPCR in which the two systems were used in the same reaction. The two systems were further tested in both singleplex and duplex qPCR on DNA samples extracted from fungal spores, inoculated canola cotyledons, and naturally infected canola stubble samples collected from commercial fields. Our data indicated that the two systems are specific to L. biglobosa and L. maculans, respectively, and one reaction could detect as few as 200 spores of either species. When used in duplex qPCR on DNA samples with various origins, the two systems generated similar results as in singleplex qPCR. The duplex qPCR system, along with the sample preparation and DNA extraction specified in this study, constituted a first-reported duplex qPCR protocol for detection and quantification of the two blackleg pathogens from field samples.
The Efficacy of Acceptance and Commitment Therapy for Chronic Pain
Authors: Ma Tsz-Wah , Yuen Ada Siu-Kwan , Yang Zuyao
Published: February 2023

Objectives:

Previous meta-analyses of a small number of trials showed that acceptance and commitment therapy (ACT) might improve chronic pain. Many new trials have been published afterward, and the factors that may impact the efficacy of ACT are less understood. We, therefore, conducted an updated systematic review with meta-analysis to investigate the efficacy of ACT for people with chronic pain.

Methods:

Randomized controlled trials that investigated the efficacy of ACT in clinical or community setting for adult populations with chronic pain were included. The methodological quality of trials was assessed with the Cochrane Risk of Bias tool. Standardized mean differences between ACT and comparison groups in their effects on 6 outcomes (ie, pain acceptance, quality of life, pain-related functioning, pain intensity, anxiety, and depression) were pooled across studies.

Results:

Of the 3171 records identified, 21 trials with 1962 participants were included for analysis. The comparison groups included active treatment and waitlist control/usual care. The standardized mean difference was 0.67 (95% CI: 0.48, 0.87) for pain acceptance, 0.43 (95% CI: 0.29, 0.57) for quality of life, −0.88 (95% CI: −1.14, −0.63) for pain-related functioning, −0.45 (95% CI: −0.62, −0.27) for pain intensity, −0.35 (95% CI: −0.54, −0.15) for anxiety, and −0.74 (95% CI, −0.98, −0.50) for depression, all favoring ACT. Subgroup analyses showed that the effects were statistically significant across almost all subgroups and for some outcomes were greater in the trials conducted in people with a specific diagnosis (as compared with those conducted in people with general chronic pain), the trials with waitlist or usual care control, the trials with a greater number of sessions of ACT, and the trials with a longer ACT intervention.

Discussion:

ACT is effective and comparable to, if not better than, some other available active treatments for chronic pain.
Accuracy of telemedicine for the diagnosis and treatment of patients with shoulder complaints
Authors: Michaelson Evan M. , Wiesel Brent B. , Siedlarz Benjamin , Murthi Anand M. , Sethi Paul M. , Lutton David M. , Nagda Sameer H.
Published: February 2023

Background:

Minimal data is available on the accuracy of diagnoses for orthopaedic shoulder complaints developed via telemedicine consultations. We hypothesize that evaluating surgeons can accurately diagnose and treat shoulder pathology via telemedicine evaluation.

Methods:

Patient evaluations for new shoulder complaints via telemedicine were retrospectively reviewed. Records were kept of all new patients seen via telemedicine, and all patients were advised to follow-up for in-person evaluation. All patients with in-person follow-up were included in final analysis. Changes in diagnosis or treatments were noted at time of in-person evaluation.

Results:

Eighty-two patients completed both telemedicine and in-person evaluation. 44 (53.6%) had no changes in diagnosis or treatment, and 22 (26.8%) had no change in diagnosis with advancement in treatment. Sixteen patients (19.5%) had a change in diagnosis or treatment. Of the 16 patients where changes were made, 9 patients were given additional diagnoses, and 7 patients had changes in their diagnosis at time of in-person follow-up. Two (2.4%) patients had a change in treatment resulting from the in-person visit. Fifty-seven patients (69.5%) had imaging (X-ray, MRI, or CT) available during the telemedicine visit.

Conclusions:

Telemedicine was an effective platform for evaluating patients with new shoulder complaints, with only 2.4% of treatments altered after in-person evaluation. There may be specific shoulder pathology that is more difficult to diagnose via telemedicine or without advanced imaging. Further research evaluating patient and surgeon satisfaction with telemedicine is underway.

Level of Evidence:

IV, Retrospective Cohort Study.
Did the centers for medicare & medicaid services’ 2018 policy change removing total knee arthroplasty from the inpatient-only list affect overall patient outcomes in the medicare population?
Authors: Yu Jonathan S. , Zeitlin Jacob , Moore Harold G. , Nocon Allina , Sculco Peter
Published: February 2023

Background:

The 2018 Centers for Medicare & Medicaid Services (CMS) removal of total knee arthroplasty (TKA) from the Inpatient-Only (IPO) list was accompanied by confusion, lack of central guidance on patient selection criteria, payor misinterpretation of the updated policy, and altered payor incentives. The purpose of this study was to assess how the CMS policy change affected overall patient outcomes in the Medicare population after TKA.

Methods:

Using the ACS-NSQIP database, patients 65 years and older who underwent primary, elective, unilateral TKA without any significant medical comorbidity were included. Complication rates before (2014-2017) and after (2018-2019) CMS removal of TKA from the IPO list were compared using interrupted time series analysis to gauge the impact of the policy shift.

Results:

A total 185,294 TKA cases were included in the analysis. Following the CMS removal of TKA from the IPO list in 2018, there were significant decreases in rates of any adverse event (RR 0.90, 95% CI 0.83-0.98, P=0.02), any minor adverse event (RR 0.84, 95% CI 0.73-0.97, P=0.02), and thromboembolic events (RR 0.76, 95% CI 0.64-0.89, P<0.001) significantly decreased There were no significant changes in rates of readmission (RR 0.95, 95% CI 0.87-1.05, P=0.31), reoperation (RR 0.92, 95% CI 0.78-1.09, P=0.33), or any major adverse event (RR 0.92, 95% CI 0.83-1.01, P=0.07).

Conclusions:

Though the CMS removal of TKA from the IPO list in 2018 was accompanied by the emergence of key new issues, the policy change did not adversely affect 30-day postoperative outcomes in the Medicare TKA patient population.

Level of Evidence:

Level IV—retrospective cohort study.
Impact of Preoperative 12-item Short Form Mental Composite Scores on Clinical Outcomes in Cervical Disc Replacement
Authors: Nie James W. , Hartman Timothy J. , Zheng Eileen , MacGregor Keith R. , Oyetayo Omolabake O. , Singh Kern
Published: February 2023

Study Design:

Retrospective cohort study.

Objective:

We aim to examine the effects of preoperative mental health status on demographic, perioperative characteristics, and postoperative outcomes in patients undergoing cervical disc replacement (CDR).

Summary of Background Data:

The effect of preoperative mental health status has not been widely studied in CDR.

Methods:

Patients undergoing primary CDR were retrospectively collected and stratified into 2 cohorts by 12-item Short Form Survey Mental Composite Score (SF-12 MCS) ≥48.9. Patients without preoperative SF-12 MCS scores or diagnosis of infection, malignancy, or trauma were excluded. Demographic information, perioperative characteristic, and patient reported outcome measures (PROMs) were collected. Patient reported outcome measurement information system physical function (PROMIS-PF)/SF-12 Physical Component Score (PCS)/SF-12 MCS/visual analog scale (VAS) neck/VAS leg/neck disability index (NDI) were collected preoperatively and 6 weeks/12 weeks/6 months/1 year postoperatively.

Results:

Eighty-seven patients were included, (47 having SF-12 MCS≥48.9). For PROMs, both cohorts had significant improvement from preoperative baseline, besides SF-12 PCS/MCS at 1 year for the depressed cohort and SF-12 MCS at all time points. The non-depressed cohort demonstrated significantly higher PROMIS-PF preoperatively and at 12 weeks, SF-12 PCS at 12 weeks, SF-12 MCS at all time points, decreased VAS neck at 12 weeks and NDI preoperatively and at 12 weeks, overall minimal clinically important difference (MCID) in most patients in all PROMs besides SF-12 MCS, and higher MCID for PROMIS-PF at 12 weeks. The depressed cohort demonstrated overall MCID in most patients with PROMIS-PF/SF-12 MCS/VAS neck/NDI, and a higher MCID for 6 weeks/12 weeks/6 months postoperatively and overall SF-12 PCS.

Conclusion:

Whereas both cohorts demonstrated significantly improved PROMs from baseline, the non-depressed cohort demonstrated better physical function, mental health, decreased pain, and disability at various time points, whereas the depressed cohort demonstrated higher mental health MCID achievement at every time point except 1 year. These findings may be useful in managing expectations for patients undergoing cervical surgery.
Driving Pressure, Elastance, and Outcomes in a Real-World Setting: A Bi-Center Analysis of Electronic Health Record Data
Authors: Goodwin Andrew J. , Brinton Daniel L. , Terry Charles , Carter George , Files D. Clark , Kirchoff Katie , Ford Dee W. , Simpson Annie N.
Published: February 2023

OBJECTIVES:

Emerging evidence suggests the potential importance of inspiratory driving pressure (DP) and respiratory system elastance (ERS) on outcomes among patients with the acute respiratory distress syndrome. Their association with outcomes among heterogeneous populations outside of a controlled clinical trial is underexplored. We used electronic health record (EHR) data to characterize the associations of DP and ERS with clinical outcomes in a real-world heterogenous population.

DESIGN:

Observational cohort study.

SETTING:

Fourteen ICUs in two quaternary academic medical centers.

PATIENTS:

Adult patients who received mechanical ventilation for more than 48 hours and less than 30 days.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

EHR data from 4,233 ventilated patients from 2016 to 2018 were extracted, harmonized, and merged. A minority of the analytic cohort (37%) experienced a Pao
2/Fio
2 of less than 300. A time-weighted mean exposure was calculated for ventilatory variables including tidal volume (VT), plateau pressures (PPLAT), DP, and ERS. Lung-protective ventilation adherence was high (94% with VT < 8.5 mL/kg, time-weighted mean VT = 6. 8 mL/kg, 88% with PPLAT ≤ 30 cm H2O). Although time-weighted mean DP (12.2 cm H2O) and ERS (1.9 cm H2O/[mL/kg]) were modest, 29% and 39% of the cohort experienced a DP greater than 15 cm H2O or an ERS greater than 2 cm H2O/(mL/kg), respectively. Regression modeling with adjustment for relevant covariates determined that exposure to time-weighted mean DP (> 15 cm H2O) was associated with increased adjusted risk of mortality and reduced adjusted ventilator-free days independent of adherence to lung-protective ventilation. Similarly, exposure to time-weighted mean ERS greater than 2 cm H2O/(mL/kg) was associated with increased adjusted risk of mortality.

CONCLUSIONS:

Elevated DP and ERS are associated with increased risk of mortality among ventilated patients independent of severity of illness or oxygenation impairment. EHR data can enable assessment of time-weighted ventilator variables and their association with clinical outcomes in a multicenter real-world setting.
Hypertensive Emergencies
Authors: El Hussein Mohamed Toufic , Dolynny Amber
Published: February 2023

Depending on end-organ involvement, hypertensive crisis is classified as hypertensive urgency or hypertensive emergency. The recognition of a hypertensive crisis will lead to the adequate reduction of blood pressure to ameliorate the incidence of end-organ damage. Hypertensive crises result from dysfunction in the renin-angiotensin-aldosterone system and damage to the vascular bed. They occur commonly in the emergency department setting and can lead to increased mortality rates if not treated. Registered nurses play a vital role in assessing patients and administering medications during hypertensive crises. This article will outline the assessment strategies that registered nurses should implement in critical care units while patients are receiving antihypertensive drugs. We will also underscore the significance of monitoring specific laboratory values to mitigate the potential side effects of these drugs and exclude them when contraindicated.
Development of a Shifting and Receiving Performa for ICU Patients
Authors: Kaur Gurleen , Johal Haranjan Kaur , Kalra Shivani
Published: February 2023

Critically ill patients are frequently transported between intensive care units (ICUs) and other sections of hospital, which may cause communication error. The aim of this study was to reduce errors while shifting and receiving of patients in and from the ICU. The present study was aimed to develop a Shifting and Receiving Performa for the patients admitted in the ICU of a tertiary care hospital. A multistage developmental study was conducted in ICUs. Eleven experts were selected by a purposive sampling technique, and the study was conducted in 4 phases. From the pool of items, a preliminary draft of the performa was prepared and the draft was given to experts to evaluate its content and face validity by conducting 2 Delphi rounds. The mean I-CVI of the shifting performa increased from 0.92 to 0.95, S-CVI/AVG exceeded from 0.88 to 0.96, and S-CVI/UA exceeded from 0.48 to 0.7 after Delphi round 2. In the case of the receiving performa, the mean I-CVI and S-CVI/AVG remained the same, that is, 0.98 in Delphi rounds 1 and 2. The mean S-CVI/UA also remained the same (ie, 0.9). The interrater reliability of the performa was found to be 0.95. Almost all the staff nurses found the performa to be beneficial, provided complete information, and reduced communication errors.
Implementing pragmatic clinical trials in hepatology
Authors: Tapper Elliot B. , Serper Marina , Goldberg David S.
Published: February 2023

Patients with chronic liver disease would benefit from pragmatic trial designs. A pragmatic trial seeks to inform clinical decision-making by providing evidence for the adoption of an intervention into real-world clinical practice. A trial’s pragmatism is based on the efficiency by which it identifies, recruits, and follows patients, the degree to which the interventions and design mirror the usual clinical care, and the importance of the outcomes to the patients. We review the promise, trade-offs, and purpose of pragmatic trials in hepatology.
The Relationship Between Emotional Regulation Skills and the Adaptability to the Classes of Children
Authors: Büyüktaşkapu Soydan Sema
Published: February 2023

This study aims to determine the regulatory role of teachers' social interaction practices in the relationship between children's emotional regulating skills and their classroom adaptation. Using a random cluster sampling method, the sample of the study consists of 250 children and 50 preschool teachers who attended preschool educational institutions on the central districts of the province of Konya, Turkey, in the 2020–2021 academic year. The research data were collected using the Teacher Observation of Classroom Adaptation—Checklist, Social Interaction Practices for the Preschool Years (SIPPY), and Emotional Regulation Checklist. The results demonstrate that emotional regulation skills and intensive strategies have a direct effect on classroom adaptation and that the negative effect of emotional regulation skills on classroom adaptation decreases when intensive strategies applied by the teacher increase. So, in other words, teachers' practices of more intensive social interaction in the classroom have been associated with higher class adjustment for all children in the classroom, regardless of the risk in emotional regulation. In view of these findings, it can be said that increasing the frequency of applying the teacher's intensive strategies in the classroom reduces the negative effect of emotional regulation skills on the classroom adaptation; by this way, classroom adaptation of children increases.
Pharmacological Treatment of Disinhibition in Acquired Brain Injury
Authors: Song Grace , Koro Mira , Berzen Leon , Tung Anthony , Ryan Andrew , Tham Joseph Chun Wearn
Published: February 2023

Purpose/Background

Traumatic brain injury is a major universal public health concern and results in chronic neurobehavioral sequelae including disinhibition. Objectives of this study were to review the literature on pharmacological treatment of disinhibition post–acquired brain injury (ABI), describe a snapshot of pharmacotherapy used in ABI at a tertiary neuropsychiatric unit in British Columbia, Canada, and share expert opinion.

Methods/Procedures

A retrospective chart review of 11 patients from October to December 2021 was conducted based on exclusion criteria: age greater than 18 years, primary neurodegenerative conditions, or aphasia. Patient demographics, behavioral and cognitive test results, and disinhibition treatment were recorded. A brief review of the literature was conducted to find the best available evidence of pharmacological interventions to treat disinhibition post-ABI.

Findings/Results

In ABI, there was a high utilization of antipsychotics and benzodiazepines, at 91% and 64% respectively, in patients with severe cognitive deficit and disinhibition. Mood stabilizers and nonselective β-blockers were less prescribed in this population at 73% and 18%. At the point of data collection, all the patients had responded well to treatment and were in the maintenance phase of their pharmacological treatment.

Implications/Conclusions

A limited number of studies with weak methodology suggest that mood stabilizers and β-blockers should be first line for disinhibition treatment. Our findings are complementary to the literature describing treatment of severe disinhibition. The choice of treatment for disinhibition depends on factors including nature and severity of target symptoms, level of drug evidence, patient-tailored objectives, concurrent psychiatric diagnoses, clinical experience of clinicians, adverse drug reactions, and treatment acuity.
Integrated analysis of RNA-seq in hepatocellular carcinoma reveals competing endogenous RNA network composed of circRNA, lncRNA, and mRNA
Authors: Zhou Fuyin , Kang Qingsong , Ma Junbo , Cai Jie , Chen Ying , Qu Kai , Li Feibo
Published: February 2023

Background:

Circular RNAs (circRNAs) and long non-coding RNAs (lncRNAs) have been hypothesized to have important roles in the etiology of hepatocellular carcinoma (HCC). However, the synergistic effect of circRNA and lncRNA in the pathogenesis of HCC has rarely been studied.

Methods:

In this study, the Gene Expression Omnibus database was used to get the expression profiles of circRNAs, micro RNAs (miRNAs), lncRNAs, and messenger RNAs (mRNAs) in HCC tissues and normal tissues. The accession numbers for this database are GSE101728, GSE155949, and GSE108724. We found 291 differentially overexpressed lncRNAs and 541 differentially overexpressed mRNA in GSE101728, 30 differentially overexpressed circRNA in GSE155949, and 48 significantly downregulated miRNA in GSE198724. Meanwhile, based on Pearson correlation test, we established lncRNA–mRNA networks. We constructed lncRNA/circRNA–miRNA pairs through Starbase database prediction and identified the common miRNAs. The intersection of co-predicted miRNAs and the 48 significantly low expression miRNAs in GSE198724 were included in the following study. miRDB, Targetscan, miRwalk, and lncRNA-related mRNA jointly determined the miRNA–mRNA portion of the circRNA/lncRNA–miRNA–mRNA co-expression network. And, among 55 differentially expressed mRNA in circRNA/lncRNA–miRNA–mRNA network, CPEB3, EFNB3, FATA4, growth hormone receptor, GSTZ1, KLF8, MFAP4, PAIP2B, PHACTR3, PITPNM3, RPS6KA6, RSPO3, SLITRK6, SMOC1, STEAP4, SYT1, TMEM132E, TSPAN11, and ZFPM2 were intimately related to the prognosis of HCC patients in Kaplan–Meier plotter analysis (P < .05).

Conclusion:

We have discovered that the prognosis-related lncRNAs/circRNAs–miRNA–mRNA network plays a significant role in the pathogenesis of HCC. These findings may offer fresh perspectives for further research into the pathogenesis of HCC and the search for novel treatments for HCC.
Assessment of macular and peripapillary choroidal thickness in non-arteritic anterior ischemic optic neuropathy: A meta-analysis
Authors: Li Xuejiao , Chen Haoliang , Dang Yalong
Published: February 2023

Background:

Non-arteritic anterior ischemic optic neuropathy (NAION) is the most common optic neuropathy in adults aged ≥ 50 years. Transient non-perfusion or hypoperfusion of the optic nerve head circulation is believed to be the underlying cause of NAION. It has been suggested that peripapillary choroidal thickness (PCT) is altered after ischemic disorders of the optic nerve head, but the results have not always been consistent. To address this issue and provide evidence for the pathogenesis of NAION, we performed a meta-analysis to systematically evaluate macular choroidal thickness (MCT) and PCT in patients with NAION.

Methods:

A comprehensive literature search of PubMed, Embase, Cochrane Library, and Web of Science databases was performed until August 31, 2022. The main inclusion criterion was a case-control study in which MCT and PCT were measured using optical coherence tomography in patients with NAION. Mean difference (MD) and 95% confidence interval were calculated for continuous estimates. The Review Manager (V5.40) was used for the analysis.

Results:

Nine studies comprising 663 eyes (283 NAION eyes and 380 healthy control eyes) were included (Newcastle-Ottawa Scale score ≥ 5). MCT and PCT were higher in eyes with chronic NAION (MD = 19.16, P = .04; MD = 35.36, P < .00001) and NAION fellow eyes (MD = 30.35, P = .0006; MD = 29.86, P = .04) than in healthy controls. No difference was noted in the MCT between eyes with acute NAION and healthy controls (MD = 2.99, P = .87).

Conclusion:

Increased MCT and PCT may be important anatomical and physiological features of the eyes in patients with NAION.
Characteristics of Chest HRCT and pulmonary function tests in elderly-onset primary Sjögren syndrome with interstitial lung disease
Authors: Dong Xin , Gao Yanli , Li Man , Wang Dong , Li Jifeng , Zhang Yongfeng
Published: February 2023

To investigate the characteristics of elderly-onset primary Sjögren syndrome (pSS) using chest high-resolution computed tomography and pulmonary function tests (PFTs). The data of 102 patients with pSS with interstitial lung disease were retrospectively analyzed. The chest high-resolution computed tomography, PFTs, and clinical and laboratory data were evaluated based on the age of onset: elderly-onset pSS (EopSS) (≥65 years) versus adult-onset pSS (AopSS) (<65 years). Among the 102 patients with pSS-interstitial lung disease, there were 34 of EopSS and 68 of AopSS. EopSS patients presented a significantly higher incidence of usual interstitial pneumonia (EopSS [38.2%] vs AopSS [11.8%], P = .005) and a significantly lower incidence of nonspecific interstitial pneumonia (EopSS [8.8%] vs AopSS [25%], P = .042). Unlike the AopSS group, the significant decreases in the vital capacity (VC) (the percentage of the predicted value of each parameter [%pred]) and the forced VC (%pred), PFTs showed that VC (%pred) and forced VC (%pred) were >80% in the EopSS group. Forced expiratory volume in 1 second significantly decreased and residual volume significantly increased in the EopSS group (P = .001). The percentage of small airway disease was significantly higher in the EopSS group (P = .021). Diffusing capacity of the lung for carbon monoxide/alveolar volume (%pred) was <80% in both groups with a lower percentage in the AopSS group. Usual interstitial pneumonia is more common in the EopSS group. Although there is no significant difference in ventilation dysfunction between the EopSS and AopSS groups, small airway disease is more common in the EopSS group, while restrictive ventilatory dysfunction is more common in the AopSS group. Therefore, the EopSS group has its own characteristics and it is worth studying and noting.
Effect of audiovisual media-based nursing information on environmental stress, anxiety, and uncertainty in patients undergoing open-heart surgery
Authors: Jeon Jeong-Yeong , Kim Dong-Hee , Kang Kyoungrim
Published: February 2023

Patients with heart disease often feel helpless and anxious because of illnesses in their vital organs. Unfamiliar environment of the intensive care unit is another factor that increases patient anxiety. This study developed audiovisual media-based information on nursing after open-heart surgery and evaluated its effect on patients’ post-surgery, with the aim of reducing patients’ environmental stress, anxiety, and uncertainty. This quasi-experimental study was conducted using a nonequivalent control group and non-synchronized pretest-posttest design to investigate the effect of audiovisual media-based nursing information provided prior to surgery on environmental stress, anxiety, and uncertainty in patients admitted to the cardiovascular intensive care unit after open-heart surgery. This study included 147 patients with heart disease who underwent open-heart surgery at a university hospital in South Korea. Dropouts in each group were caused by the following: for the control group, 2 were due to death, 9 discontinued, and 5 lost consciousness; for the experimental group, 2 were due to death, 6 discontinued, and 2 lost consciousness. The final number of participants investigated was 121 to 65 in the experimental group and 56 in the control group. Prior to surgery, the experimental group was provided with audio-visual information about nursing, whereas the control group was provided with written information about nursing. The environmental stress score was lower in the experimental group, 1.95 ± 0.51 points compared to 2.31 ± 0.51 points in the control group (t = 3.38, P < .001). There was a significant difference in anxiety between the mean pretest-posttest scores, with 0.39 ± 0.35 points in the experimental group, and −0.05 ± 0.58 points in the control group (t = 5.165, P < .001). On the other hand, there was a significant difference in uncertainty between the mean pretest-posttest scores, with 0.39 ± 0.4 points in the experimental group, and 0.24 ± 0.48 points in the control group (t = 4.541, P < .001). This finding indicates that providing audiovisual information regarding nursing before open-heart surgery is effective in reducing environmental stress, anxiety, and uncertainty in patients.
The efficacy and safety of hydrotherapy in patients with knee osteoarthritis: A protocol for systematic review and meta-analysis
Authors: Zhang Xu , Xue Tianle , Hou Desheng , Lu Cheng
Published: February 2023

Background:

Knee osteoarthritis (OA) is a common clinical degenerative disease of the joints, which is prone to occur in middle-aged and elderly people. At present, the disease cannot be cured, it is mostly treated with drugs to relieve symptoms, improve joint function, protect cartilage, such as glucosamine, anti-inflammatory and analgesic drugs, and but the efficacy is not lasting and the recurrence rate is high. Hydrotherapy has become a long-term alternative therapy in China and is receiving increasing attention. We perform a protocol for systematic review and meta-analysis to determine the efficacy and safety of a hydrotherapy program in individuals living with knee OA.

Methods:

This protocol will be designed in accordance with the preferred reporting items for systematic reviews and meta-analysis protocols. It is registered on the international prospective register of systematic reviews (No. CRD42022365564). We will search the following databases: The Cochrane Skin Group Trials Register, MEDLINE, EMBASE, The Cochrane central register of controlled trials, Chinese biomedical literature database, Chinese medical current content and China national knowledge infrastructure. The risk of bias of the included studies will be appraised using the Cochrane collaboration tool. Statistical analysis will be performed using IBM SPSS Statistics (Armonk, NY).

Results:

This systematic review will summarize the short- and long-term clinical outcomes of hydrotherapy for knee OA.

Conclusion:

The findings from this review will establish the quality of currently available evidence, which will determine the need for further studies to establish the true effect size of hydrotherapy in knee OA.
Predictive factors of postendoscopic retrograde cholangiopancreatography pancreatitis for biliary complications in living-donor liver transplantation recipients
Authors: Shehta Ahmed , Elshobari Mohamed , Salah Tarek , Sultan Ahmad M. , Yasen Amr , Elsadany Mohamed , Elsarraf Waleed Rifat , Abdel-Khalek Ehab E. , Shiha Usama , Elebidy Gamal , Abdel Wahab Mohamed , Samy Mohamed
Published: February 2023

Objectives

Endoscopic retrograde cholangiopancreatography (ERCP) has shown great safety and efficacy in the management of post-living-donor liver transplantation (LDLT) biliary complications. Pancreatitis is the most commonest and the most feared complication after ERCP.

Methods

We reviewed the data of liver transplant recipients who underwent ERCP for biliary complications after LDLT between 2011 and 2022.

Results

In total 63 patients underwent ERCP after LDLT. They were targeted to 134 set of ERCP. Pancreatitis occurred in 52 sets (38.8%). We subclassified the patients into two groups, without pancreatitis: 31 patients (49.2%) and with pancreatitis 32 patients (50.8%). A higher incidence of pancreatitis was noticed with the first ERCP set (P = 0.04). Biliary strictures were more noted in the pancreatitis group (P = 0.025). Difficult cannulation requiring precut was more observed in the pancreatitis group (P = 0.007). Also, more frequent sphincterotomy was observed in the pancreatitis group (P = 0.003). Longer hospital stay, more fever, abdominal pain and vomiting were noted in the pancreatitis group (P = 0.001). Higher post-ERCP serum amylase (P = 0.001) and creatinine (P = 0.021), while lower serum calcium (P = 0.21) were noticed in the pancreatitis group. On multivariate analysis, preoperative diabetes, number of biliary anastomoses (single/multiple) and difficult cannulation requiring precut were significant predictors of post-ERCP pancreatitis.

Conclusion

Patient-related risk factors and bedside procedure-related risk factors play an essential role in the development of pancreatitis after ERCP for LDLT recipients. Endoscopists should be mindful by those high-risk patients during ERCP to apply appropriate techniques to prevent the development of this serious complication.
Utility of pre-treatment 18F-fluorodeoxyglucose PET radiomic analysis in assessing nodal involvement in cervical cancer
Authors: Chan Kit Chi , Perucho Jose A.U. , Subramaniam Rathan M. , Lee Elaine Y.P.
Published: February 2023

Objective

Intratumor heterogeneity has prognostic value in cervical cancer, which can be depicted on 18F-fluorodeoxyglucose (18F-FDG) PET/computed tomography (PET/CT) and then quantitatively characterized by texture features. This study aimed to evaluate the discriminative performance and predictive ability of the texture features in determining lymph node involvement in cervical cancer.

Methods

A total of 101 patients with newly diagnosed cervical cancer, who underwent pre-treatment whole-body 18F-FDG PET/CT imaging were retrospectively recruited. Patients were categorized based on their nodal status. Thirty-five radiomic features together with the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of the primary cervical tumors were extracted. Conventional indices were used to build logistic regression model and texture features were used to build random forest model. The performances for differentiating nodal status were assessed by receiver operating characteristic analysis.

Results

Conventional PET indices were significantly higher in patients with nodal involvement compared to those without: SUVmax = 14.22 vs. 10.05; MTV = 57.02 vs. 28.73; TLG = 492.8 vs. 188.8 (P < 0.05). Nineteen radiomic features describing regional heterogeneity were significantly different between nodal involvements. Area under the curves of the models with conventional indices and PET texture features for discriminating nodal status were 0.72 and 0.76, respectively.

Conclusion

PET-derived radiomic features had moderate performance in discriminating nodal involvement in cervical cancer; and they did not outperform model based on conventional indices.
Nurse Staffing and Veteran Outcomes in the Veterans Health Administration's Community Living Centers
Authors: Brown Lana M. , Gauss C. Heath , Billings Pamela , Minor Lisa , Moore Jade T. , Sawyer Linda M. , Sparks Diane , Sullivan Sheila Cox
Published: February 2023

Background:

The demand for nursing care is rising in the long-term care setting. Nurse staffing is a crucial measure linked to health care quality measure outcomes.

Purpose:

To assess for associations between nursing hours per patient day (NHPPD) and outcome measures in the Veterans Health Administration Community Living Centers.

Methods:

A retrospective data review of NHPPD and quality measures for 134 community living centers was conducted. Linear regression was used to assess for linear associations between average total NHPPD and 6 quality measures.

Results:

A significant linear association was found between average total NHPPD and falls with major injury (P = .02) and help with activities of daily living (P = .01). No associations were found between nurse staffing and 4 other quality measures.

Conclusions:

This study adds to the body of literature regarding the impact of nurse staffing on quality measures.
Pulse Oximetry and Arterial Saturation Difference in Pediatric COVID-19 Patients: Retrospective Analysis by Race*
Authors: Savorgnan Fabio , Hassan Adel , Borges Nirica , Acosta Sebastian
Published: February 2023

Objectives:

Pulse oximetry (Spo
2) may overestimate arterial oxygen saturation (Sao
2) in blood laboratory testing. This study aimed to assess Spo
2–Sao
2 difference in relation to race (i.e., patient self-reporting as Black or White), occult hypoxemia, and length of stay (LOS) in pediatric patients with COVID-19.

Design:

Single-center retrospective study in pediatric COVID-19 patients. We used multivariable linear regressions to examine the association between race and oximetry measurements and between occult hypoxemia and LOS. Oximetry bias was defined using Spo
2 and Sao
2 data according to approved comparisons. Occult hypoxemia was defined as Spo
2 greater than 92% and Sao
2 less than 88%.

Setting:

Quaternary pediatric hospital.

Patients:

Pediatric COVID-19 patients admitted to Texas Children’s Hospital between May 2020 and December 2021.

Interventions:

None.

Measurements and Main Results:

There were 2713 patients with complete physiological data in the analysis. Of the total, 61% were Black, and 39% were White. Oximetry bias was greater in Black compared with White patients (p < 0.001), and this bias increased as the oxygen saturations decreased (p < 0.001). Black and White patients had a 12% and 4% prevalence of occult hypoxemia, respectively (p < 0.001). LOS was not associated with oximetry bias or occult hypoxemia once controlled for the level of support (intensive care, respiratory, circulatory).

Conclusions:

We found an oximetry bias in the measurement of Spo
2 with respect to Sao
2 in symptomatic hospitalized pediatric patients with the diagnosis of COVID-19. Furthermore, race is related to an increased oximetry bias. However, we did not find a relationship between oximetry bias and the LOS in the hospital in this cohort of patients.
Müller’s Muscle-Conjunctival Resection for Treatment of Contralateral Ptosis Following Unilateral External Levator Advancement
Authors: Mangan Mehmet Serhat , Tekcan Hatice , Yurttaser Ocak Serap , Ozcelik Kose Alev , Balci Sevcan , Ercalik Nimet Yesim , Imamoglu Serhat
Published: February 2023

Background:

One of the main causes of unsatisfactory outcomes after unilateral blepharoptosis surgery is asymmetry of the upper eyelid height, which occurs as a result of a contralateral eyelid droop. Therefore, we evaluated the efficacy of Müller’s muscle-conjunctival resection (MMCR) for the treatment of contralateral ptosis following unilateral external levator advancement (ELA).

Methods:

This study analyzed 26 eyelids of 26 patients with upper eyelid height asymmetry following unilateral ELA who underwent contralateral MMCR retrospectively. The phenylephrine test was performed before ELA and before MMCR. The main outcome measures were symmetry outcomes and clinical outcomes.

Results:

The mean patient age was 55.81 ± 7.98 years (range, 44–70 years); 15 were (57.7%) female. Hering’s dependency was observed in 13 (50%) of the patients before ELA. An adequate response to phenylephrine was observed before MMCR but not before ELA. Symmetry outcomes after MMCR were perfect (<0.5 mm), good (≥0.5 mm, <1 mm), and fair (≥1 mm) in 7, 17, and 2 patients, respectively. An optimal upper eyelid height was noted in 47 of the 52 eyelids after the MMCR, while three of the 52 eyelids had minimal overcorrection, and two eyelids had undercorrection. The mean change in MRD1 of the contralateral eyelid droop was greater for patients with than without Hering dependency (p < .0001) after ELA but not after MMCR. Two patients (7.6%) underwent revisional ELA surgery.

Conclusions:

MMCR and use of the phenylephrine test to predict the eyelid position may represent an alternative approach in patients who require management of contralateral ptosis following unilateral ELA.
Secondary Facial Gender Surgery: Causes of Poor Outcomes and Strategies for Avoidance and Correction
Authors: Simon Daniel , Capitán Luis , Coon Devin , Gutiérrez-Santamaría Javier , Bailón Carlos , Bellinga Raúl J. , Pérez de Perceval Tara Miguel , Tenório Thiago , Capitán-Cañadas Fermín
Published: February 2023

Facial feminization surgery covers a broad spectrum of procedures across both hard and soft tissues. Despite the fact that this is a decidedly predictable surgery, because of the high demand for the procedures, a growing number of patients are requiring revision surgery, whether to correct unexpected results or to treat mid- to long-term functional and aesthetic complications. This Special Topic categorizes unsatisfactory outcomes encountered after forehead surgery, lower jaw surgery, and thyroid chondroplasty, key steps to avoid these pitfalls, and strategies for structured analysis and operative planning in revision cases.