bluuebunny/crossref_metadata_2025 huggingface dataset:
The Needs of Patients With Chronic Disease in Transitional Care From Hospital to Home in Sudan: A Qualitative Study
Authors: Mohamedsharif Asma , Bastawi Mayada , Gemperli Armin
Published: May 2024

The growing burden of chronic non-communicable diseases demands improved post-discharge care. The Sudanese healthcare system faces challenges in providing coordinated care for patients with chronic conditions after hospital discharge. This qualitative study explored the experiences of patients with chronic disease in transitional care from hospital to home to identify improvement targets. Purposive sampling was used to interview 17 participants from different hospitals in Khartoum, Sudan. Audio recordings were transcribed and analyzed using principles of content analysis to identify themes and the relationship between them. Thematic analysis revealed 4 main themes describing the perceived needs of the patients. These were (1) feeling well-informed about post-discharge care goals and plans; (2) feeling cared for during hospital admission and follow-up visits; (3) feeling safe during the transitional care process; and (4) having access to follow-up services. This study highlights the importance of improving hospital patient education through effective communication to facilitate care transitions.
Surgical Myectomy and Myotomy for Refractory Blepharospasm in Meige Syndrome Patients: A Case Report
Authors: Li Ming-Ming , Cen Zhi-Min , Zhang Huang , Luo Zhong-Ling
Published: May 2024

Meige syndrome is a rare neurological disease characterized by segmental dystonia, specifically blepharospasm and oromandibular dystonia. These symptoms are often accompanied by complex movements of the eyelids, lower facial muscles, mandible, and neck muscles. Bilateral blepharospasm is the most common feature of this disease. In this case report, we present the successful treatment of refractory blepharospasm in a 72-year-old woman with Meige syndrome via 2 incisions resulting from myectomy and in situ surgery.
COVID-19 Implications on Worksite Wellness Programming
Authors: Underwood Renee A. , Wood Angela R. , Wood Ralph J. , Broussard Rylie B. , Broyles Stephanie T.
Published: May 2024

Seven of the top ten leading causes of death in the United States are due to chronic diseases and treating these accounts for 86 percent of our nation's health care costs. The workplace offers an environment to implement chronic disease prevention strategies, such as worksite wellness programs, due to the large amount of time spent at the worksite daily by employees. As a result of COVID-19, many organizations began to change their workdays (i.e., working from home). This research sought to understand what, if any, implications the COVID-19 epidemic had on worksite wellness programming. Semistructured interviews were employed and recorded via Zoom conferencing to gather qualitative data. Four themes were identified: (a) relationship building among remote employees, (b) creativity in how to carry out program components, (c) increased physical activity and work-life balance, and (d) increased knowledge of health issues and mental health resources. Both challenges and successes were reported within themes. The main finding from this research indicates a mostly positive experience for worksite wellness programs during the COVID-19 epidemic. Many organizations have continued nontraditional work environments and the lessons learned from this study can both encourage and provide ideas for how to create and continue a worksite wellness program outside of the normal face-to-face working environment.
When Push Comes to Shove: An Experimental Analysis of Voter Support of a Woman President and the 2024 Nomination
Authors: Tadevich Meagan , Hutson Ashley C. F. , Shufeldt Gregory
Published: May 2024

A woman has not yet shattered the “hardest, highest glass ceiling” of the American presidency. Our research answers two questions: Which groups are more likely to believe electing a woman president to be historically important? (R1), and When a presidential election is at stake, who is likely to support a woman candidate? (R2). Using observational data ( n = 1075), our findings indicate that women, people who recognize sexism within politics, Democrats, and liberals are more likely to view a woman president as historic. Utilizing a list experiment of hypothetical 2024 presidential matchups, few who claimed to view a woman president as historic were willing to cast a vote in their favor. When push came to shove, Democratic women were the group most likely to vote for a woman presidential candidate. As parties look toward the future, this study offers insight into how voters respond to potential nominees and who parties will nominate.
Governance capacity, social justice, social security, and institutionalized political participation in China: A moderated mediation model
Authors: Wang Chenchen , Zhang Xuehe
Published: May 2024

The significance of political participation in social governance and development is increasingly prominent. Citizens’ institutionalized political participation stands as a primary symbol of realizing people’s ownership. Public trust in government, a crucial emotional element of political participation, serves as a bridge for institutionalized political participation. This study formulates a moderated mediation model, encompassing public cognition, emotions, attitudes, and political behaviors. The model aims to elucidate the attributional paths of governmental governance capacity, social justice, and social security on public trust in government and political participation. The findings underscore three pivotal antecedents of public trust in government: citizens perceptions of governance capacity, social justice, and social security foster political participation behavior through public trust in government, subsequently influencing overall political participation. Political efficacy plays a moderating role, influencing the strength of the mediating effect from public trust in government to institutionalized political participation. This addresses a gap in prior research on the intrinsic motivation of citizens’ political engagement. The study emphasizes the role of political efficacy in facilitating and motivating individuals for “orderly political participation,” providing a practical foundation for enhancing the stability of social governance and democratic development.
Supporting healthcare professionals from ethnic minority backgrounds to ‘Step Into’ a clinical academic career
Authors: Bramley Louise , Bond Carmel , Stacey Gemma , Dring Eleanore , Cowley Alison , Booth Vicky , Janiszewski Helen , Cooper Joanne
Published: May 2024

Background:

There is a need to develop research focussed healthcare professionals with the clinical experience and academic skills to meet the needs of a diverse population. Yet, healthcare professionals from ethnic minority backgrounds are often faced with personal, structural or organisational barriers, which prevent them from accessing and applying for development opportunities.

Aim:

To undertake an evaluation of the Step into Clinical Academic Careers’ programme. The programme was designed specifically for nurses, midwives and allied healthcare professionals (NMAHPs) working in NHS organisations, from ethnic minority backgrounds, who had the ambition to pursue a research or clinical academic career.

Methods:

Qualitative individual interviews and online evaluations were conducted to identify the views, perspectives and experiences of participants who undertook the programme. Participants were also followed up after 6 months.

Results:

Participants provided insights into four key areas relating to outcomes of the programme. These were (1) increased confidence, (2) increased motivation, (3) developing networks and (4) inspiring people.

Conclusions:

Organisations must work purposefully and collaboratively to realise equitable support for individuals from ethnic minority backgrounds, through targeted mentoring and leadership development training. Failure to do this will result in a continuation of limited diversity amongst clinical academic and clinical research leaders.
Transgender and gender diverse people with endometriosis: A perspective on affirming gynaecological care
Authors: Jeffrey Sam , Ashton Louis , Ferfolja Tania , Armour Mike
Published: May 2024

Transgender and gender diverse people presumed female at birth experience gynaecological conditions, such as chronic pelvic pain at elevated rates, estimated to impact between 51% and 72% of this population, compared to rates of up to 26.6% in cisgender women. The negative impact of these conditions is likely amplified due to limited access to safe and affirming healthcare. Despite this high prevalence rate, there is limited research investigating the prevalence, presentation or management options for trans and gender diverse people with endometriosis. Cisgender women with endometriosis report barriers to accessing care, with lengthy times to diagnosis and limited treatment options available. However, barriers for trans and gender diverse individuals are enhanced by physician bias and lack of education in gender-affirming care. This is reflected in stories of discrimination and denial of basic healthcare. A healthcare environment built on the presumption that gynaecological patients are women, others trans and gender diverse patients, which can result in avoidance of needed medical care. A lack of knowledge of gender-affirming care alongside healthcare provider bias highlights a need for gender-affirming care and bias reduction training in undergraduate healthcare provider curricula. Research to date assessing current curriculum in Australia and Aotearoa (New Zealand) shows limited inclusion of lesbian, gay, bisexual, trans, queer, intersex, asexual and other related identities content as a whole with gender-affirming care being among the least-frequently addressed topics. This review will detail barriers to accessing gender-affirming healthcare specific to gynaecology, interweaving the experiences of a non-binary individual seeking access to gender-affirming endometriosis care.
Commitment to inclusion: The importance of collaboration in gender equity work
Authors: Lee Jennifer K , Levine Rachel B , Yousem David M , Faraday Nauder , Skarupski Kimberly A , Ishii Masaru , Daugherty Biddison EL , Oliva-Hemker Maria
Published: May 2024

Despite decades of faculty professional development programs created to prepare women for leadership, gender inequities persist in salary, promotion, and leadership roles. Indeed, men still earn more than women, are more likely than women to hold the rank of professor, and hold the vast majority of positions of power in academic medicine. Institutions demonstrate commitment to their faculty’s growth by investing resources, including creating faculty development programs. These programs are essential to help prepare women to lead and navigate the highly matrixed, complex systems of academic medicine. However, data still show that women persistently lag behind men in their career advancement and salary. Clearly, training women to adapt to existing structures and norms alone is not sufficient. To effectively generate organizational change, leaders with power and resources must commit to gender equity. This article describes several efforts by the Office of Faculty in the Johns Hopkins University School of Medicine to broaden inclusivity in collaborative work for gender equity. The authors are women and men leaders in the Office of Faculty, which is within the Johns Hopkins University School of Medicine dean’s office and includes Women in Science and Medicine. Here, we discuss potential methods to advance gender equity using inclusivity based on our institutional experience and on the findings of other studies. Ongoing data collection to evaluate programmatic outcomes in the Johns Hopkins University School of Medicine will be reported in the future.
The Contradictory Nature of Anti-Transgender Rhetoric
Authors: Morgenroth Thekla , Means Kira K. , Mueller Alexandria S. , Sass Kris D.
Published: May 2024

Transgender rights are a polarizing topic. When examining the rhetoric used by those opposed to transgender rights, it often seems like their arguments contradict each other (e.g., claiming that transgender people are a negligible minority but simultaneously “taking over”). One explanation for this contradiction could be that different arguments are endorsed by different people. However, across 4 studies ( N = 2,159), we consistently find a positive relationship between endorsement of contradictory anti-transgenderarguments among the same people, even when they themselves view them as contradictory and when the contradictory nature is made salient. We also examine the strategies opponents of transgender rights employ to resolve these contradictions. Our work contributes to a better understanding of modern anti-transgender beliefs in the United States and has implications for those trying to combat harmful anti-transgender rhetoric.
On presentation of cerebral arteries via cortical openings
Authors: Nowinski Wieslaw L
Published: May 2024

The presentation of cortical arteries is challenging, as most of their course is hidden in the depth of the sulci. Despite that, demonstrating the arteries on the cortical surface is a standard way of their presentation. To keep advantages of surface presentation while lessening its limitation, we propose a novel context-related method of cerebrovasculature presentation by cortical openings consisting in the removal of a selected region from the cortical mantle and exposing underlying structures. We also introduce a reverse than standard vessel-to-context mapping from a gyrus/lobule to vessels supplying it.

The method has the following steps: define a cortical opening, develop a tool to perform them, create cortical openings for gyri and lobules with underlying white matter and intracranial arteries, generate labeled and parcellated images for the created openings, and integrate the cortical opening images with the NOW inBRAIN public repository of 8600 3D neuroimages.

The cortical openings are created for 64 gyri and six lobules for the left and right cerebral hemispheres resulting in 210 images arranged in triples as spatially corresponding non-parcellated and unlabeled, parcellated by color and unlabeled, and parcellated and labeled images.

The cortical opening approach, generally, increases vessel exposure in a higher number of depicted branches, revealing arteries otherwise hidden deep in sulci, a more complete vessel course, and a lower number of required views.

The gyrus/lobule-to-arteries mapping facilitates exploration of a studied region, encapsulates all local arteries, and reduces vascular complexity by decomposing the entire vascular system into smaller sets involved in the studied region.
Effects of flipped listening classroom on undergraduate students’ foreign language listening anxiety and willingness to communicate
Authors: Bolandifar Saeideh , Salehi Nafiseh
Published: May 2024

In a traditional classroom environment, listening comprehension plays a vital role in enabling students to actively participate in the learning process. This is because a significant portion of information is conveyed through the instructor’s explanations and class discussions. Developing strong listening skills can help students effectively understand and participate in classroom activities. The present study aimed to investigate the effects of flipped listening classroom on undergraduate English as a Foreign Language (EFL) students’ foreign language listening anxiety and willingness to communicate. A sample of 46 students at a public university in Iran was chosen to participate in the study using convenience sampling. Implementing a quasi-experimental pretest posttest control group design, two intact classes were randomly assigned to flipped and traditional lecture-based groups. The findings of the study revealed that flipped listening classroom had a positive impact on alleviating foreign language listening anxiety of EFL students and increasing their willingness to communicate. The study has some implications for the material developers, English instructors and students.
Inflammatory polyp of the ileum causing small bowel intussusception: A case report
Authors: Fateemah Suhootoorah , Fauzee Jasmine Nilufer , Manraj Ashok , Ganessen Chinien
Published: May 2024

Adult intussusception is rare, and an underlying benign or malignant aetiology is often found. Inflammatory fibroid polyp, a benign neoplastic polyp that can arise anywhere in the gastrointestinal tract is a rare cause of intussusception of the small bowel. Clinical presentation differs depending on the location of the lesion in the gastrointestinal tract. Diagnosis may be confirmed on a computed tomography scan or ultrasound. Definite diagnosis is based on histopathology and immunocytochemistry. We present the case of a 58-year-old lady with an inflammatory fibroid polyp who presented with microcytic anaemia and chronic abdominal pain due to recurrent intussusception.
Quadricuspid Aortic Valve: Two Asymptomatic Cases of Rare Anomaly
Authors: Mondal Sudipta , Sasikumar Deepa
Published: May 2024

Quadricuspid aortic valve (QAV) is a rare congenital anomaly with <200 cases reported to date. Most patients are asymptomatic. Symptoms depend on the functionality of the valve and associated heart defects, most often presenting as aortic regurgitation followed by aortic stenosis. Management guidelines are ill-defined. We present two cases of QAV with rare associations (ventricular septal defect) and variable clinical presentation.
The importance of translational science within the respiratory field
Authors: Meiners Silke , Reynaert Niki L. , Matthaiou Andreas M. , Rajesh Rishi , Ahmed Engi , Guillamat-Prats Raquel , Heijink Irene H. , Cuevas-Ocaña Sara
Published: May 2024

The Translational Science Working Group at the European Respiratory Society (ERS) aims to bridge the gap between basic and clinical science by providing a platform where scientists, clinicians and experts in the respiratory field can actively shape translational research. For the 2023 Congress, dedicated translational science sessions were created and sessions of interest to many assemblies from the clinical and the scientific point of view were tagged as translational sessions, attracting clinical and scientific experts to the same room to discuss relevant topics and strengthening translational efforts among all ERS assemblies.
lncRNA Oip5-as1 inhibits excessive mitochondrial fission in myocardial ischemia/reperfusion injury by modulating DRP1 phosphorylation
Authors: Niu Xiaowei , Zhang Jingjing , Hu Shuwen , Dang Wenhui , Wang Kaiwen , Bai Ming
Published: May 2024

Background

Aberrant mitochondrial fission, a critical pathological event underlying myocardial ischemia/reperfusion (MI/R) injury, has emerged as a potential therapeutic target. The long non-coding RNA (lncRNA) Oip5-as1 is increasingly recognized for its regulatory roles, particularly in MI/R injury. However, its precise mechanistic role in modulating mitochondrial dynamics remains elusive. This study aims to elucidate the mechanistic role of Oip5-as1 in regulating mitochondrial fission and evaluate its therapeutic potential against MI/R injury.

Methods

To simulate in vitro MI/R injury, HL-1 cardiomyocytes were subjected to hypoxia/reoxygenation (H/R). Lentiviral vectors were employed to achieve overexpression or knockdown of Oip5-as1 in HL-1 cells by expressing Oip5-as1 or shRNA targeting Oip5-as1, respectively. The impact of Oip5-as1 on mitochondrial dynamics in HL-1 cells was assessed using CCK-8 assay, flow cytometry, immunofluorescence staining, and biochemical assays. MI/R injury was induced in mice by ligating the left anterior descending coronary artery. Conditional knockout mice for Oip5-as1 were generated using the CRISPR/Cas9 genome editing technology, while overexpression of Oip5-as1 in mice was achieved via intramyocardial administration of AAV9 vectors. In mice, the role of Oip5-as1 was evaluated through echocardiographic assessment, histopathological staining, and transmission electron microscopy. Furthermore, Western blotting, RNA pull-down, RNA immunoprecipitation, and co-immunoprecipitation assays were conducted to investigate Oip5-as1’s underlying mechanisms.

Results

The expression levels of Oip5-as1 are significantly decreased in MI/R-injured HL-1 cells and myocardium. In HL-1 cells undergoing H/R injury, overexpression of Oip5-as1 attenuated excessive mitochondrial fission, preserved mitochondrial functionality, and reduced cellular apoptosis, while knockdown of Oip5-as1 exhibited the opposite effects. Furthermore, in a mouse model of MI/R injury, overexpression of Oip5-as1 diminished mitochondrial fission, myocardial infarct size and improved cardiac function. However, knockout of Oip5-as1 exacerbated myocardial injury and cardiac dysfunction, which were significantly reversed by treatment with a mitochondrial division inhibitor-1 (Mdivi-1). Mechanistically, Oip5-as1 selectively interacts with AKAP1 and CaN proteins, inhibiting CaN activation and subsequent DRP1 dephosphorylation at Ser637, thereby constraining DRP1’s translocation to the mitochondria and its involvement in mitochondrial fission.

Conclusions

Our study underscores the pivotal role of Oip5-as1 in mitigating excessive mitochondrial fission during MI/R injury. The findings not only enhance our comprehension of the molecular mechanisms underlying MI/R injury but also identify Oip5-as1 as a potential therapeutic target for ameliorating MI/R injury.

Graphical Abstract
Genome-wide identification and expression analysis of the Eriobotrya japonica TIFY gene family reveals its functional diversity under abiotic stress conditions
Authors: Li Xulin , Wen Ke , Zhu Ling , Chen Chaoying , Yin Tuo , Yang Xiuyao , Zhao Ke , Zi Yinqiang , Zhang Huiyun , Luo Xinping , Zhang Hanyao
Published: May 2024

Background

Plant-specific TIFY proteins are widely found in terrestrial plants and play important roles in plant adversity responses. Although the genome of loquat at the chromosome level has been published, studies on the TIFY family in loquat are lacking. Therefore, the EjTIFY gene family was bioinformatically analyzed by constructing a phylogenetic tree, chromosomal localization, gene structure, and adversity expression profiling in this study.

Results

Twenty-six EjTIFY genes were identified and categorized into four subfamilies (ZML, JAZ, PPD, and TIFY) based on their structural domains. Twenty-four EjTIFY genes were irregularly distributed on 11 of the 17 chromosomes, and the remaining two genes were distributed in fragments. We identified 15 covariate TIFY gene pairs in the loquat genome, 13 of which were involved in large-scale interchromosomal segmental duplication events, and two of which were involved in tandem duplication events. Many abiotic stress cis-elements were widely present in the promoter region. Analysis of the Ka/Ks ratio showed that the paralogous homologs of the EjTIFY family were mainly subjected to purifying selection. Analysis of the RNA-seq data revealed that a total of five differentially expressed genes (DEGs) were expressed in the shoots under gibberellin treatment, whereas only one gene was significantly differentially expressed in the leaves; under both low-temperature and high-temperature stresses, there were significantly differentially expressed genes, and the EjJAZ15 gene was significantly upregulated under both low- and high-temperature stress. RNA-seq and qRT-PCR expression analysis under salt stress conditions revealed that EjJAZ2, EjJAZ4, and EjJAZ9 responded to salt stress in loquat plants, which promoted resistance to salt stress through the JA pathway. The response model of the TIFY genes in the jasmonic acid pathway under salt stress in loquat was systematically summarized.

Conclusions

These results provide a theoretical basis for exploring the characteristics and functions of additional EjTIFY genes in the future. This study also provides a theoretical basis for further research on breeding for salt stress resistance in loquat. RT-qPCR analysis revealed that the expression of one of the three EjTIFY genes increased and the expression of two decreased under salt stress conditions, suggesting that EjTIFY exhibited different expression patterns under salt stress conditions.
Identification of novel single nucleotide variants in the drug resistance mechanism of Mycobacterium tuberculosis isolates by whole-genome analysis
Authors: Qian Weiye , Ma Nan , Zeng Xi , Shi Mai , Wang Mingqiang , Yang Zhiyuan , Tsui Stephen Kwok-Wing
Published: May 2024

Background

Tuberculosis (TB) represents a major global health challenge. Drug resistance in Mycobacterium tuberculosis (MTB) poses a substantial obstacle to effective TB treatment. Identifying genomic mutations in MTB isolates holds promise for unraveling the underlying mechanisms of drug resistance in this bacterium.

Methods

In this study, we investigated the roles of single nucleotide variants (SNVs) in MTB isolates resistant to four antibiotics (moxifloxacin, ofloxacin, amikacin, and capreomycin) through whole-genome analysis. We identified the drug-resistance-associated SNVs by comparing the genomes of MTB isolates with reference genomes using the MuMmer4 tool.

Results

We observed a strikingly high proportion (94.2%) of MTB isolates resistant to ofloxacin, underscoring the current prevalence of drug resistance in MTB. An average of 3529 SNVs were detected in a single ofloxacin-resistant isolate, indicating a mutation rate of approximately 0.08% under the selective pressure of ofloxacin exposure. We identified a set of 60 SNVs associated with extensively drug-resistant tuberculosis (XDR-TB), among which 42 SNVs were non-synonymous mutations located in the coding regions of nine key genes (ctpI, desA3, mce1R, moeB1, ndhA, PE_PGRS4, PPE18, rpsA, secF). Protein structure modeling revealed that SNVs of three genes (PE_PGRS4, desA3, secF) are close to the critical catalytic active sites in the three-dimensional structure of the coding proteins.

Conclusion

This comprehensive study elucidates novel resistance mechanisms in MTB against antibiotics, paving the way for future design and development of anti-tuberculosis drugs.
Genomic identification and expression analysis of acid invertase (AINV) gene family in Dendrobium officinale Kimura et Migo
Authors: Liu Yujia , Liu Boting , Luo Kefa , Yu Baiyin , Li Xiang , Zeng Jian , Chen Jie , Xia Rui , Xu Jing , Liu Yuanlong
Published: May 2024

Background

Dendrobium officinale Kimura et Migo, a renowned traditional Chinese orchid herb esteemed for its significant horticultural and medicinal value, thrives in adverse habitats and contends with various abiotic or biotic stresses. Acid invertases (AINV) are widely considered enzymes involved in regulating sucrose metabolism and have been revealed to participate in plant responses to environmental stress. Although members of AINV gene family have been identified and characterized in multiple plant genomes, detailed information regarding this gene family and its expression patterns remains unknown in D. officinale, despite their significance in polysaccharide biosynthesis.

Results

This study systematically analyzed the D. officinale genome and identified four DoAINV genes, which were classified into two subfamilies based on subcellular prediction and phylogenetic analysis. Comparison of gene structures and conserved motifs in DoAINV genes indicated a high-level conservation during their evolution history. The conserved amino acids and domains of DoAINV proteins were identified as pivotal for their functional roles. Additionally, cis-elements associated with responses to abiotic and biotic stress were found to be the most prevalent motif in all DoAINV genes, indicating their responsiveness to stress. Furthermore, bioinformatics analysis of transcriptome data, validated by quantitative real-time reverse transcription PCR (qRT-PCR), revealed distinct organ-specific expression patterns of DoAINV genes across various tissues and in response to abiotic stress. Examination of soluble sugar content and interaction networks provided insights into stress release and sucrose metabolism.

Conclusions

DoAINV genes are implicated in various activities including growth and development, stress response, and polysaccharide biosynthesis. These findings provide valuable insights into the AINV gene amily of D. officinale and will aid in further elucidating the functions of DoAINV genes.
Serum levels of lipoprotein-associated phospholipase A2 are associated with coronary atherosclerotic plaque progression in diabetic and non-diabetic patients
Authors: Zhang Shudong , Wang Jiangang , Chen Shuai , Zhang Ying , He Ruming , Wang Xiaoqun , Ding Fenghua , Hu Wenbo , Dai Yang , Lu Lin , Zhang Ruiyan , Ni Jingwei , Chen Qiujing
Published: May 2024

Background

Lp-PLA2 is linked to cardiovascular diseases and poor outcomes, especially in diabetes, as it functions as a pro-inflammatory and oxidative mediator.

Objectives

This research aimed to explore if there is a connection between the serum levels of Lp-PLA2 and the progression of coronary plaques (PP) in individuals with type 2 diabetes mellitus (T2DM) and those without the condition.

Materials and methods

Serum Lp-PLA2 levels were measured in 137 T2DM patients with PP and 137 T2DM patients with no PP, and in 205 non-diabetic patients with PP and 205 non-diabetic patients with no PP. These individuals met the criteria for eligibility and underwent quantitative coronary angiography at the outset and again after about one year of follow-up. The attributes and parameters of the participants at the outset were recorded.

Results

Increased serum levels of Lp-PLA2 were closely associated with coronary artery PP, and also significantly correlated with change of MLD, change of diameter stenosis and change of cumulative coronary obstruction in both diabetic and non-diabetic groups, with higher correlation coefficients in diabetic patients as compared with non-diabetic patients. Moreover, multivariate logistic regression analysis showed that serum Lp-PLA2 level was an independent determinant of PP in both groups, with OR values more significant in diabetic patients than in non-diabetic patients.

Conclusions

Levels of serum Lp-PLA2 show a significant association with the progression of coronary atherosclerotic plaque in patients with T2DM and those without, especially among individuals with diabetes.
Long-term prognosis after endoscopic submucosal dissection for esophageal cancer in older adult patients
Authors: Konishi Hirona , Urabe Yuji , Nakamura Takeo , Ishibashi Kazuki , Mizuno Junichi , Fukuhara Motomitsu , Takasago Takeshi , Tanaka Hidenori , Tsuboi Akiyoshi , Yamashita Ken , Hiyama Yuichi , Takigawa Hidehiko , Kotachi Takahiro , Yuge Ryo , Ishikawa Akira , Oka Shiro
Published: May 2024

Background

The validity of endoscopic submucosal dissection (ESD) for esophageal squamous cell carcinoma (ESCC) in older individuals with comorbidities remains unclear. Therefore, this study evaluated the safety and efficacy of ESD and additional treatment for ESCC in older adult patients.

Methods

The clinicopathological characteristics and clinical outcomes of 398 consecutive older adult patients (≥ 65 years) with 505 lesions who underwent ESD for ESCC at the Hiroshima University Hospital between September 2007 and December 2019 were retrospectively evaluated. Additionally, the prognoses of 381 patients who were followed up for > 3 years were assessed.

Results

The mean patient age and procedure time were 73.1 ± 5.8 years and 77.1 ± 43.5 min, respectively. The histological en bloc resection rate was 98% (496/505). Postoperative stenosis, perforation, pneumonia, and delayed bleeding were conservatively treated in 82 (16%), 19 (4%), 15 (3%), and 5 (1%) patients, respectively. The 5-year overall and disease-specific survival rates were 78.9% and 98.0%, respectively (mean follow-up time: 71.1 ± 37.3 months). Multivariate analysis showed that age and the American Society of Anesthesiologists classification of physical status class ≥III (hazard ratio: 1.27; 95% confidence interval: 1.01–1.59, p = 0.0392) were independently associated with overall survival. A significantly lower overall survival rate was observed in the high-risk follow-up group than in the low-risk follow-up and high-risk additional treatment groups (p < 0.01). However, no significant difference in disease-specific survival was observed among the three groups.

Conclusions

ESD is safe for ESCC treatment in patients aged ≥ 65 years. However, additional treatments should be considered based on the patient’s general condition.
Diagnostic accuracy of cognitive screening tools validated for older adults in Iran: a systematic review and meta-analysis
Authors: Kamalzadeh Leila , Tayyebi Gooya , Shariati Behnam , Shati Mohsen , Saeedi Vahid , Malakouti Seyed Kazem
Published: May 2024

Background

This systematic review aims to comprehensively assess the diagnostic accuracy of cognitive screening tools validated for older adults in Iran, providing evidence-based recommendations for clinicians and researchers.

Methods

A comprehensive search in March 2023 across Web of Science, PubMed, Scopus, ScienceDirect, SID, IranMedex, and IranDoc, enhanced by hand-searching references and Google Scholar, identified cross-sectional studies on cognitive screening in Iranian seniors. We assessed diagnostic accuracy, cognitive domains, and test strengths and weaknesses. A bivariate random-effects meta-analysis provided summary estimates and 95% confidence intervals, illustrated in forest plots.

Results

Our review, derived from an initial screening of 38 articles, focused on 17 studies involving 14 cognitive screening tools and participant counts from 60 to 350, mostly from specialized clinics. The MMSE was the only tool examined in at least three studies, prompting a meta-analysis revealing its sensitivity at 0.89 and specificity at 0.77 for dementia detection, albeit amidst significant heterogeneity (I^2 > 80%). ACE-III demonstrated the highest diagnostic accuracy for MCI and dementia, while MoCA’s performance was deemed adequate for MCI and excellent for dementia. High bias risk in studies limits interpretation.

Conclusion

This review identifies key cognitive tools for dementia and MCI in Iranian older adults, tailored to educational levels for use in primary and specialized care. It emphasizes the need for further validation to enhance diagnostic precision across diverse settings, within a concise framework prioritizing brevity and accuracy for clinical applicability.
Association of serum total IgE and allergen-specific IgE with insulin resistance in adolescents: an analysis of the NHANES database
Authors: Liu Yaping , Wang Xiaoxia , Liu Yong
Published: May 2024

Background

Recent studies have found that total immunoglobulin E (IgE) and allergen-specific IgE were associated with some metabolic diseases. However, the role of IgE in metabolism among adolescents is still unclear. Herein, this study aims to investigate the associations of serum total IgE and allergen-specific IgE with insulin resistance (IR) in adolescents, in order to provide some reference for the prevention and treatment of metabolic diseases in a young age.

Methods

Data of 870 adolescents were extracted from the National Health and Nutrition Examination Survey (NHANES) database in 2005–2006 in this cross-sectional study. Weighted univariate and multivariate logistic regression analyses were utilized to screen covariates and explore the relationships of serum total IgE and allergen-specific IgE with IR. The evaluation indexes were odds ratios (ORs) and 95% confidence intervals (CIs). In addition, these relationships were also assessed in subgroups of allergy history, asthma history, and number of allergens.

Results

Among eligible adolescents, 168 had IR. No significant association between serum total IgE level and IR was found. However, adolescents with higher level of allergen-specific IgE to rye grass [OR = 0.47, 95%CI: (0.25–0.91)], white oak [OR = 0.57, 95%CI: (0.37–0.88)], or peanut [OR = 0.38, 95%CI: (0.15–0.97)] seemed to have lower odds of IR, whereas those had higher level of shrimp-specific IgE [OR = 2.65, 95%CI: (1.21–5.84)] have increased odds of IR. In addition, these associations between allergen-specific IgE and IR were also discovered in adolescents who had allergy history or asthma history, or had different numbers of allergens.

Conclusion

Paying attention to different allergens in adolescents may be important in the early identification of IR among this high-risk population. The study results relatively provided some reference for further exploration on IR prevention.
Knowledge and attitude towards home quarantine instructions and associations with history of Covid-19 infection in Malaysia
Authors: Choo Shea Jiun , Chang Chee Tao , Chan Huan-Keat , Abu Hassan Muhammad Radzi , Hamdan Muhammad Hazmi , Cheong Ai Ting , Mat Noh Fatin Nadhirah , Uzma Mustafa Nur Syahmina
Published: May 2024

Introduction

Although COVID-19 has entered the endemic phase, individuals infected with COVID-19 are required to adhere to home quarantine measures. By exploring the public’s knowledge and attitude towards recommended home quarantine measures, their readiness in containing potential COVID-19 outbreak can be determined. This study aimed to assess the public knowledge and attitude towards home quarantine instructions and their association with history of COVID-19 infections.

Methods

This was a web-based cross-sectional study conducted among the public in Malaysia between August to October 2022. All Malaysian adults over 18 years of age were included. Knowledge on home quarantine instructions and COVID-19 warning signs were measured using “True,” “False,” or “I’m not sure”, while attitude towards home quarantine instructions was measured using a five-point Likert Scale. The questionnaire was initially constructed in English and then translated into the national language, Bahasa Malaysia. Face and content validation were performed. The internal consistency of the questionnaire was found to be satisfactory.

Results

1,036 respondents were analyzed, comprised mostly of females (743, 71.6%) with a history of COVID-19 (673, 64.9%). In the knowledge domain, more than 80% of the respondents answered 9 out of 11 home quarantine instructions statements correctly. 457 (44.1%) were unaware or unsure about the minimum distance of the infected individual’s bed from the rest of the occupants in a shared bedroom. The respondents reported relatively weaker knowledge in identifying uncommon warning signs of COVID-19 deterioration, including anuria (162, 44.5%), ingestion problems (191, 52.5%), and immobility (195, 53.6%). In the attitude domain, more than 90% of respondents answered correctly in 8 out of 9 questions. Respondents with a previous history of COVID-19 infections had better knowledge than COVID-19 infection-naïve individuals towards both home quarantine instructions and COVID-19 warning signs.

Conclusion

Most respondents had good knowledge and attitude towards home quarantine instructions, with those previously infected with COVID-19 showing greater awareness of uncommon warning signs. However, there was a notable lack of awareness regarding physical distancing within shared rooms, appropriate disinfectant use and mobility limitation within the household. This study highlights the knowledge gaps to be improved in future educational campaigns.
Analysis of the relationship between shorter sleep duration and wrist fractures: based on NHANES
Authors: Wu Lang , Han Shaoyu , Cui Bingjun , Wang Chuangong , Zhang Zhenqing , Chen Zhixiang
Published: May 2024

Background

Wrist fracture is one of the common limb fractures. Its incidence rate increases with age and osteoporosis. Nowadays, Sleep health is increasingly valued, but the relationship between wrist fractures and sleep time is not yet clear.

Methods

Data in this study were collected and screened from the NHANES from 2005 to 2010 and 2013 to 2014. The variables were extracted from interviews and compared between the wrist fractures and the sleep duration. The data was analyzed by weighted multivariate logistic regression.

Results

After excluding individuals who were not eligible and had invalid data, we finally identified 1835 participants for inclusion in this study. We found a negative association between the sleep duration and the fractured of the wrist (OR = 1.027,95% CI (1.027, 1.028), P < 0.00001).

Conclusion

This study demons that the association between the sleep duration and the fractures of the wrist is significant. Our findings provide a better understanding of the relationship between sleep duration and wrist fractures. This study may help us reducing the incidence of wrist fractures in the population based on healthy sleep management in the future, and improve the quality of life of middle-aged and elderly patients. Provide evidence for clinical patients to manage healthy sleep.
Incidence and risk factors of postoperative delirium following hepatic resection: a retrospective national inpatient sample database study
Authors: Liu Rui , Liu Ningyuan , Suo Shanlian , Yang Qinfeng , Deng Zhen , Fu Wei , Wang Min
Published: May 2024

Background

Postoperative delirium (POD) is a common complication after major surgery and can cause a variety of adverse effects. However, no large-scale national database was used to assess the occurrence and factors associated with postoperative delirium (POD) following hepatic resection.

Methods

Patients who underwent hepatic resection from 2015 to 2019 were screened using the International Classification of Diseases (ICD) 10th edition clinical modification code from the National Inpatient Sample (NIS) Database. Peri-operative factors associated with delirium were screened and underwent statistical analysis to identify independent predictors for delirium following hepatic resection.

Results

A total of 80,070 patients underwent hepatic resection over a five-year period from 2015 to 2019. The overall occurrence of POD after hepatic resection was 1.46% (1039 cases), with a slight upward trend every year. The incidence of elective admission was 6.66% lower (88.60% vs. 81.94%) than that of patients without POD after hepatic resection and 2.34% (45.53% vs. 43.19%) higher than that of patients without POD in teaching hospitals (P < 0.001). In addition, POD patients were 6 years older (67 vs. 61 years) and comprised 9.27% (56.69% vs. 47.42%) more male patients (P < 0.001) compared to the unaffected population. In addition, the occurrence of POD was associated with longer hospitalization duration (13 vs. 5 days; P < 0.001), higher total cost ($1,481,89 vs. $683,90; P < 0.001), and higher in-hospital mortality (12.61% vs. 4.11%; P < 0.001). Multivariate logistic regression identified hepatic resection-independent risk factors for POD, including non-elective hospital admission, teaching hospital, older age, male sex, depression, fluid and electrolyte disorders, coagulopathy, other neurological disorders, psychoses, and weight loss. In addition, the POD after hepatic resection has been associated with sepsis, dementia, urinary retention, gastrointestinal complications, acute renal failure, pneumonia, continuous invasive mechanical ventilation, blood transfusion, respiratory failure, and wound dehiscence / non-healing.

Conclusion

Although the occurrence of POD after hepatic resection is relatively low, it is beneficial to investigate factors predisposing to POD to allow optimal care management and improve the outcomes of this patient population.
Risk factors for postoperative pulmonary complications in elderly patients undergoing video-assisted thoracoscopic surgery lobectomy under general anesthesia: a retrospective study
Authors: Feng Guang , Jia Yitong , Zhao Guanxu , Meng Fanqi , Wang Tianlong
Published: May 2024

Background

The objective of this study is to identify and evaluate the risk factors associated with the development of postoperative pulmonary complications (PPCs) in elderly patients undergoing video-assisted thoracoscopic surgery lobectomy under general anesthesia.

Methods

The retrospective study consecutively included elderly patients (≥ 70 years old) who underwent thoracoscopic lobectomy at Xuanwu Hospital of Capital Medical University from January 1, 2018 to August 31, 2023. The demographic characteristics, the preoperative, intraoperative and postoperative parameters were collected and analyzed using multivariate logistic regression to identify the prediction of risk factors for PPCs.

Results

322 patients were included for analysis, and 115 patients (35.7%) developed PPCs. Multifactorial regression analysis showed that ASA ≥ III (P = 0.006, 95% CI: 1.230 ∼ 3.532), duration of one-lung ventilation (P = 0.033, 95% CI: 1.069 ∼ 4.867), smoking (P = 0.027, 95% CI: 1.072 ∼ 3.194) and COPD (P = 0.015, 95% CI: 1.332 ∼ 13.716) are independent risk factors for PPCs after thoracoscopic lobectomy in elderly patients.

Conclusion

Risk factors for PPCs are ASA ≥ III, duration of one-lung ventilation, smoking and COPD in elderly patients over 70 years old undergoing thoracoscopic lobectomy. It is necessary to pay special attention to these patients to help optimize the allocation of resources and enhance preventive efforts.
Analysis of prefabricated myofunctional appliances with different overjet and bumper designs: a three-dimensional finite element analysis
Authors: Xiaowei Wu , Haoran Lv , Xuehui Chen , Xiaogang Pan
Published: May 2024

Background

Prefabricated myofunctional appliance can guide tooth eruption, improve dentition alignment, correct myofunctional disorders and harmful oral habits. However, its application to skeletal discrepancy may result in unsatisfactory tooth inclination. This study aimed to construct a novel appliance with overjet design to avoid this side effect and investigated its shape and mechanical changes under occlusion using three-dimensional finite element method.

Methods

We established three samples of prefabricated myofunctional appliances. The first one was edge to edge without overjet, and the outer shield of both jaws were flattened. The second one was 3 mm overjet with stepped the outer shield. The last one was 3 mm overjet, and the outer shield of both jaws were flatted, which meant the front wall of lower jaw was strengthened with bumper, termed as lower bumper. A complete dentition model was applied to the study. 150 N occlusal force was applied to each type of appliance and the deformation displacement and the changes in stress was recorded.

Results

The deformation was significant in the incisors regions, especially in the vertical and lateral dimensions. The maximum displacements of 3 mm overjet with step shield group were 7.08 mm (vertical), 3.99 mm (lateral), and 2.90 mm (sagittal), while it decreased to 3.92 mm(vertical), 1.94 mm (lateral), and 1.55 mm (sagittal) in overjet with bumper group. Moreover, the upper molar regions exhibited higher vertical and sagittal displacement in 3 mm overjet with step shield group, which were 3.03 mm (vertical) and 1.99 mm (sagittal), and the bumper design could decrease the maximum displacement to 1.72 mm (vertical) and 0.72 mm (sagittal). In addition, the Von Mises stress of appliances was analyzed, and results indicated that 3 mm overjet with step shield generated higher stress than other groups, with the maximum Von Mises stress was 0.9387 MP, which were 0.5858 and 0.5657 MP in edge to edge group and 3 mm overjet with lower bumper group, respectively.

Conclusion

The prefabricated myofunctional appliances may cause deformation during occlusion. Compared to step shield group, the application of lower bumper exhibited better resistance to occlusal force.