bluuebunny/crossref_metadata_2025 huggingface dataset:
Adverse childhood experiences and prescription opioid use during pregnancy: an analysis of the North and South Dakota PRAMS, 2019–2020
Authors: Testa Alexander , Jacobs Benjamin , Zhang Lixia , Jackson Dylan B. , Ganson Kyle T. , Nagata Jason M.
Published: August 2023

Objectives

This study assesses the association between adverse childhood experiences (ACEs) and prescription opioid use during pregnancy.

Methods

This study uses data on 2,999 individuals from the 2019 and 2020 Pregnancy Risk Assessment Monitoring System (PRAMS) from North Dakota and South Dakota. The relationship between ACEs and prescription opioid use during pregnancy is examined using multiple logistic regression.

Results

The prevalence of prescription opioid use increases alongside more ACE exposure. Compared to those with no ACEs, recent mothers with three or more ACEs have a 2.4 greater odds of prescription opioid use during pregnancy (aOR [adjusted odds ratio] = 2.437; 95% CI [confidence interval] = 1.319, 4.503).

Conclusion

Exposure to three or more ACEs are associated with a higherrisk of prescription opioid use during pregnancy. Additional research is needed better understand the mechanisms that link ACEs and prescription opioid use during pregnancy, as well as how to best support those with ACEs exposure in a trauma-informed manner to reduce the risk of substance use.
Network meta-analysis of first-line immune checkpoint inhibitor therapy in advanced non-squamous non-small cell lung cancer patients with PD-L1 expression ≥ 50%
Authors: Chen Wei , Chen Jiayi , Zhang Lin , Cheng Sheng , Yu Junxian
Published: August 2023

Introduction

The optimal first-line immunotherapy regimen for advanced non-squamous non-small cell lung cancer (NS-NSCLC) patients with programmed cell death ligand 1 (PD-L1) expression ≥ 50% remains unclear. Our aim is to determine the most effective treatment regimen through a network meta-analysis (NMA) comparing these treatments.

Methods

A systematic search was performed in PubMed, Cochrane Library, Web of Science, and Embase databases, and a Bayesian network meta-analysis was conducted. To ensure transparency, the study was registered in the International Prospective Register of Systematic Reviews (CRD42022349712).

Results

The analysis included 11 randomized controlled trials (RCTs) with 2037 patients and 12 immunotherapy combinations. ICI-ICI, ICI alone, and chemotherapy-ICI showed significant advantages over chemotherapy in terms of overall survival (OS) and progression-free survival (PFS). Pembrolizumab plus chemotherapy showed the best OS results compared to chemotherapy. Tislelizumab plus chemotherapy and sintilimab plus chemotherapy provided the best PFS results.

Conclusions

For NS-NSCLC patients with PD-L1 ≥ 50%, pembrolizumab plus chemotherapy, tislelizumab plus chemotherapy, and sintilimab plus chemotherapy are recommended as good treatment options based on the results of this Network meta-analysis (NMA).
Cough-induced chylothorax in a two-year-old boy – case report and review of the literature
Authors: Anger Melanie , Hofmann Julian , Ruf Bettina , Steinborn Marc , Reber Daniela , Warncke Katharina , Rieber Nikolaus
Published: August 2023

Background

Chylothorax is a very rare form of pleural effusion in children, especially after the neonatal period, and predominantly occurs secondary to cardiothoracic surgery. It can lead to significant respiratory distress, immunodeficiency, and malnutrition. Effective treatment strategies are therefore required to reduce morbidity.

Case presentation

A previously healthy two-year old boy was admitted with history of heavy coughing followed by progressive dyspnea. The chest X-ray showed an extensive opacification of the right lung. Ultrasound studies revealed a large pleural effusion of the right hemithorax. Pleural fluid analysis delivered the unusual diagnosis of chylothorax, most likely induced by preceded excessive coughing. After an unsuccessful treatment attempt with a fat-free diet and continuous pleural drainage for two weeks, therapy with octreotide was initiated. This led to complete and permanent resolution of his pleural effusion within 15 days, without any side effects.

Conclusions

Severe cough may be a rare cause of chylothorax in young children. Octreotide seems to be an effective and safe treatment of spontaneous or traumatic chylothorax in children.

There is, however, a lack of comprehensive studies for chylothorax in children and many issues concerning diagnostic strategies and treatment algorithms remain.
Use of electronic devices in leisure time modifies the prevalence and factors associated with sedentary behavior derived exclusively from excessive television viewing among Brazilian adults
Authors: Bertuol Cecília , da Silveira Murilo Henrique Corrêa , Krug Rodrigo de Rosso , Kupske Juliedy Waldow , Mielke Grégore Iven , Del Duca Giovani Firpo
Published: August 2023

The growing interest in the study of sedentary behavior is justified by its increasing presence in people's daily lives, particularly in leisure time. The aim of this study was to compare the prevalence and factors associated with sedentary behavior derived exclusively from TV time and from its combination with the time spent using other electronic devices among Brazilian adults (n = 52,443). This cross-sectional study used data from the Vigitel survey (2019), which included subjects ≥ 18 years old who resided in the capitals of the 26 Brazilian states and Federal District. High TV time (≥ 4 h/day), and its combination with computer, tablet, or cell phone use (≥ 4 h/day), as well as sociodemographic, behavioral, and health characteristics were self-reported. Adjusted logistic regression was used to estimate odds ratios and 95% confidence intervals (95%CI). The prevalence of high sedentary behavior almost tripled when TV viewing was added to the time spent using other electronic devices (from 12.2%; 95%CI: 11.6; 12.8, to 34.7%; 95%CI: 33.8; 35.6), notably among the youngest (32.0 percentage points). Individuals living without a partner, who smoked, consumed alcohol and processed foods excessively, were physically inactive, and had hypertension were more likely to have both outcomes than their counterparts. Older and less educated individuals were more likely to spend excessive time watching TV and less likely to have high use of other electronic devices in addition to TV viewing than their peers. Including computer, tablet, or cell phone led to an increase in the prevalence of high sedentary behavior. The magnitude and direction of the associations of age and education with high sedentary behavior varied according to the method how high sedentary behavior was defined. Projects, programs, and policies must consider the different indicators of sedentary behavior in monitoring and promoting a healthier lifestyle.
Vitamin D and idiopathic pulmonary fibrosis: a two-sample mendelian randomization study
Authors: Lin Tong , Zhou Fen , Mao Haiyan , Xie Zhenye , Jin Yuhong
Published: August 2023

Background

A prospective study of multiple small samples found that idiopathic pulmonary fibrosis (IPF) is often accompanied by a deficiency in Vitamin D levels. However, the causal relationship between the two remains to be determined. Therefore, our study aims to investigate the causal effect of serum 1,25-hydroxyvitamin D (25(OH)D) on the risk of IPF through a two-sample Mendelian randomization (MR) analysis.

Methods

Through data analysis from two European ancestry-based genome-wide association studies (GWAS), including 401,460 individuals for 25(OH)D levels and 1028 individuals for IPF, we primarily employed inverse-variance weighted (IVW) to assess the causal effect of 25(OH)D levels on IPF risk. MR-Egger regression test was used to determine pleiotropy, and Cochran’s Q test was conducted for heterogeneity testing. Leave-one-out analysis was conducted to examine the robustness of the results.

Results

158 SNPs related to serum 25(OH)D were used as instrumental variables (IVs). The MR analyses revealed no evidence supporting a causal association between the level of circulating 25(OH)D and the risk of IPF. The IVW method [OR 0.891, 95%CI (0.523–1.518), P = 0.670]; There was no significant level of heterogeneity, pleiotropy and bias in IVs. Cochran’s Q test for heterogeneity (MR Egger P = 0.081; IVW P = 0.089); MR-Egger regression for pleiotropy (P = 0.774).

Conclusions

This MR Study suggests that genetically predicted circulating vitamin D concentrations in the general population are not causally related to IPF.
Prevalence and determinants of decision regret in long-term prostate cancer survivors following radical prostatectomy
Authors: Lunger Lukas , Meissner Valentin H. , Kopp Benedikt C. G. , Dinkel Andreas , Schiele Stefan , Ankerst Donna P. , Gschwend Jürgen E. , Herkommer Kathleen
Published: August 2023

Background

Patients with localized prostate cancer (PC) are faced with a wide spectrum of therapeutic options at initial diagnosis. Following radical prostatectomy (RP), PC patients may experience regret regarding their initial choice of treatment, especially when oncological and functional outcomes are poor. Impacts of psychosocial factors on decision regret, especially after long-term follow-up, are not well understood. This study aimed to investigate the prevalence and determinants of decision regret in long-term PC survivors following RP.

Methods

3408 PC survivors (mean age 78.8 years, SD = 6.5) from the multicenter German Familial PC Database returned questionnaires after an average of 16.5 (SD = 3.8) years following RP. The outcome of decision regret concerning the initial choice of RP was assessed with one item from the Decision Regret Scale. Health-related quality of life (HRQoL), PC-anxiety, PSA-anxiety, as well as anxiety and depressive symptoms were considered for independent association with decision regret via multivariable logistic regression.

Results

10.9% (373/3408) of PC survivors reported decision regret. Organ-confined disease at RP (OR 1.39, 95%CI 1.02–1.91), biochemical recurrence (OR 1.34, 1.00-1.80), low HRQoL (OR 1.69,1.28–2.24), depressive symptoms (OR 2.32, 1.52–3.53), and prevalent PSA anxiety (OR 1.88,1.17–3.01) were significantly associated with increased risk of decision regret. Shared decision-making reduced the odds of decision regret by 40% (OR 0.59, 0.41–0.86).

Conclusions

PC survivors may experience decision regret even after 16 years following RP. Promoting shared decision-making in light of both established and novel, potentially less invasive treatments at initial diagnosis may help mitigate long-term regret. Awareness regarding patients showing depressive symptoms or PSA anxiety should be encouraged to identify patients at risk of decision regret in need of additional psychological support.
Anatomical and symptomatic mid-term outcomes of patients with isolated anterior compartment defect repair or stress urinary incontinence
Authors: Gökbel İsmail , Kinci Mehmet Ferdi , Akin Gökbel Deniz , Sivaslioğlu Ahmet Akın
Published: August 2023

Background

An evaluation of preoperative and postoperative 12th month Pelvic Organ Prolapse Quantification (POP-Q) and Lower Urinary Tract Symptoms (LUTS) changes in patients operated for the diagnosis of isolated anterior compartment defect (ACD) or Stress Urinary Incontinence (SUI).

Method

Patients who were diagnosed with isolated ACD or SUI were retrospectively analyzed at urogynecology unit of our tertiary referral center. All pelvic examinations were performed by the same experienced urogynecologist. Pre-operative and post-operative 12th month POP-Q scores and the responses to a detailed LUTS questionnaire in the unit were assessed.

Results

Of the 90 patients with isolated ACD or SUI, midurethral sling with mini-sling and retropubic transobturator tape methods was applied in 24, iliococcygeal fixation in 28, trapezoid repair in 9 patients, anterior bridge operation in 14, and plication of pubocervicovaginal fascia to the cervical ring in 15. We compared the POP-Q score and pre and post-operative 12th month LUTS. Between pre and post-operative 12th month, there was a statistically significant difference at Aa and Ba points (p < 0.00, 0.001). Comparative LUTS questionnaire showed statistically significant differences in stress urinary incontinence, frequency, urgency, abnormal emptying, nocturia, pelvic pain (p: <0.001, p < 0.001, p: <0.001, p:0.001, p:<0.001, p:0.003, respectively).

Conclusion

Anatomical and symptomatic recovery is achieved with appropriate surgical intervention in women with isolated ACD or SUI. When LUTS were evaluated in terms of symptomatic recovery, they were found to be related not only to symptoms involving the anterior compartment, but also to symptoms involving other compartments.
Evaluation of psychological distress is essential for patients with locally advanced breast cancer prior to neoadjuvant chemotherapy: baseline findings from cohort study
Authors: Omari Majid , Amaadour Lamiae , Zarrouq Btissame , Al-Sheikh Yazeed A. , El Asri Achraf , Kriya Salima , Nadi Sara , Benbrahim Zineb , Mellas Nawfel , Rhazi Karima El , Ragala Mohammed El Amine , Hilaly Jaouad El , Giesy John P. , Aboul-Soud Mourad A.M. , Halim Karima
Published: August 2023

Background

patients with locally advanced breast cancer (LABC) are often treated by neoadjuvant chemotherapy (NACT). This study aims to determine the prevalence of psychological distress and their sociodemographic and clinical factors in patients recently diagnosed with LABC and before NACT. Methods: A total of 209 LABC patients without metastatic localization were recruited between 2021 and 2022 in the oncology hospital at Fez. A structured questionnaire and the Hospital Anxiety and Depression Scale were used. A descriptive analysis and linear model were performed. Results: a mean age of participants was 47.43 ± 9.45 years. The prevalence of depression, anxiety and psychological distress among participants was 59.62% (95% CI: 52.61–33.34), 47.85% (95% CI: 40.91–54.85), and 65.07 (95% CI: 58.19–71.52) respectively. Depression was associated to age (< 50 years) (AOR = 2.19; 95% CI = 1.13–4.23) and health insurance (AOR = 3.64; 95% CI: 1.18–11.26). Anxiety was associated to age (< 50) (AOR = 2.21; 95% CI: 1.18–4.13) and right breast cancer (AOA = 2.01; 95% CI: 1.11–3.65). Psychological distress was associated to chronic illness (AOR = 2.78; 95% CI: 1.32–5.85) and lymph node status (AOR = 2.39; 95% CI: 1.26–4.57). Conclusions: Based on the high prevalence of depression and anxiety it appears opportune to treat psychological distress among LABC patient candidates for NACT. Each psychological intervention should take into account sociodemographic and clinical factors found associated in our study. Psychological therapeutic interventions are crucial for LABC patients as early as the time of diagnosis and through subsequent steps in NACT to improve their overall mental health.
Primary care provider perspectives on the role of community pharmacy in colorectal cancer screening: a qualitative study
Authors: Brenner Alison T. , Rohweder Catherine L. , Wangen Mary , Atkins Dana L. , Ceballos Rachel M. , Correa Sara , Ferrari Renée M. , Issaka Rachel B. , Ittes Annika , Odebunmi Olufeyisayo O. , Reuland Daniel S. , Waters Austin R. , Wheeler Stephanie B. , Shah Parth D.
Published: August 2023

Background

The United States Preventive Services Task Force (USPSTF) lists 32 grade A or B recommended preventive services for non-pregnant United States (US) adults, including colorectal cancer screening (CRC). Little guidance is given on how to implement these services with consistency and fidelity in primary care. Given limited patient visit time and competing demands, primary care providers (PCPs) tend to prioritize a small subset of these recommendations. Completion rates of some of these services, including CRC screening, are suboptimal. Expanding delivery of preventive services to other healthcare providers, where possible, can improve access and uptake, particularly in medically underserved areas or populations. Fecal immunochemical testing (FIT) (at-home, stool-based testing) for CRC screening can be distributed and resulted without PCP involvement. Pharmacists have long delivered preventive services (e.g., influenza vaccination) and may be a good option for expanding CRC screening delivery using FIT, but it is not clear how PCPs would perceive this expansion.

Methods

We used semi-structured interviews with PCPs in North Carolina and Washington state to assess perceptions and recommendations for a potential pharmacy-based FIT distribution program (PharmFIT™). Transcripts were coded and analyzed using a hybrid inductive-deductive content analysis guided by the Consolidated Framework for Implementation Research (CFIR) to elucidate potential multi-level facilitators of and barriers to implementation of PharmFIT™.

Results

We completed 30 interviews with PCPs in North Carolina (N = 12) and Washington state (N = 18). PCPs in both states were largely accepting of PharmFIT™, with several important considerations. First, PCPs felt that pharmacists should receive appropriate training for identifying patients eligible and due for FIT screening. Second, a clear understanding of responsibility for tracking tests, communication, and, particularly, follow-up of positive test results should be established and followed. Finally, clear electronic workflows should be established for relay of test result information between the pharmacy and the primary care clinic.

Conclusion

If the conditions are met regarding pharmacist training, follow-up for positive FITs, and transfer of documentation, PCPs are likely to support PharmFIT™ as a way for their patients to obtain and complete CRC screening using FIT.
Emergence and influence of sequence bias in evolutionarily malleable, mammalian tandem arrays
Authors: Brovkina Margarita V. , Chapman Margaret A. , Holding Matthew L. , Clowney E. Josephine
Published: August 2023

Background

The radiation of mammals at the extinction of the dinosaurs produced a plethora of new forms—as diverse as bats, dolphins, and elephants—in only 10–20 million years. Behind the scenes, adaptation to new niches is accompanied by extensive innovation in large families of genes that allow animals to contact the environment, including chemosensors, xenobiotic enzymes, and immune and barrier proteins. Genes in these “outward-looking” families are allelically diverse among humans and exhibit tissue-specific and sometimes stochastic expression.

Results

Here, we show that these tandem arrays of outward-looking genes occupy AT-biased isochores and comprise the “tissue-specific” gene class that lack CpG islands in their promoters. Models of mammalian genome evolution have not incorporated the sharply different functions and transcriptional patterns of genes in AT- versus GC-biased regions. To examine the relationship between gene family expansion, sequence content, and allelic diversity, we use population genetic data and comparative analysis. First, we find that AT bias can emerge during evolutionary expansion of gene families in cis. Second, human genes in AT-biased isochores or with GC-poor promoters experience relatively low rates of de novo point mutation today but are enriched for non-synonymous variants. Finally, we find that isochores containing gene clusters exhibit low rates of recombination.

Conclusions

Our analyses suggest that tolerance of non-synonymous variation and low recombination are two forces that have produced the depletion of GC bases in outward-facing gene arrays. In turn, high AT content exerts a profound effect on their chromatin organization and transcriptional regulation.
A link between mitochondrial damage and the immune microenvironment of delayed onset muscle soreness
Authors: Li Zheng , Peng Lina , Sun Lili , Si Juncheng
Published: August 2023

Background

Delayed onset muscle soreness (DOMS) is a self-healing muscle pain disorder. Inflammatory pain is the main feature of DOMS. More and more researchers have realized that changes in mitochondrial morphology are related to pain. However, the role of mitochondria in the pathogenesis of DOMS and the abnormal immune microenvironment is still unknown.

Methods

Mitochondria-related genes and gene expression data were obtained from MitoCarta3.0 and NCBI GEO databases. The network of mitochondrial function and the immune microenvironment of DOMS was constructed by computer algorithm. Subsequently, the skeletal muscle of DOMS rats was subjected to qPCR to verify the bioinformatics results. DOMS and non-DOMS histological samples were further studied by staining and transmission electron microscopy.

Results

Bioinformatics results showed that expression of mitochondria-related genes was changed in DOMS. The results of qPCR showed that four hub genes (AMPK, PGC1-α, SLC25A25, and ARMCX1) were differentially expressed in DOMS. These hub genes are related to the degree of skeletal muscle immune cell infiltration, mitochondrial respiratory chain complex, DAMPs, the TCA cycle, and mitochondrial metabolism. Bayesian network inference showed that IL-6 and PGC1-α may be the main regulatory genes of mitochondrial damage in DOMS. Transmission electron microscopy revealed swelling of skeletal muscle mitochondria and disorganization of myofilaments.

Conclusions

Our study found that skeletal muscle mitochondrial damage is one of the causes of inflammatory factor accumulation in DOMS. According to the screened-out hub genes, this study provides a reference for follow-up clinical application.
Therapeutic efficacy of artesunate–amodiaquine and artemether–lumefantrine for the treatment of uncomplicated falciparum malaria in Chad: clinical and genetic surveillance
Authors: Issa Mahamat Souleymane , Warsame Marian , Mahamat Moussa Hassane Taisso , Saleh Issakha Diar Mahamat , Boulotigam Kodbsse , Djimrassengar Honoré , Issa Ali Haggar , Abdelkader Ousmane , Hassoumi Manah , Djimadoum Mbanga , Doderer-Lang Cécile , Ndihiokubwayo Jean Bosco , Rasmussen Charlotte , Menard Didier
Published: August 2023

Background

Artesunate–amodiaquine (AS–AQ) and artemether–lumefantrine (AL) are the currently recommended first-and second-line therapies for uncomplicated Plasmodium falciparum infections in Chad. This study assessed the efficacy of these artemisinin-based combinations, proportion of day 3 positive patients, proportions of molecular markers associated with P. falciparum resistance to anti-malarial drugs and variable performance of HRP2-based malaria rapid diagnostic tests (RDTs).

Methods

A single-arm prospective study assessing the efficacy of AS–AQ and AL at three sites (Doba, Kelo and Koyom) was conducted between November 2020 to January 2021. Febrile children aged 6 to 59 months with confirmed uncomplicated P. falciparum infection were enrolled sequentially first to AS–AQ and then AL at each site and followed up for 28 days. The primary endpoint was PCR-adjusted adequate clinical and parasitological response (ACPR). Samples collected on day 0 were analysed for mutations in pfkelch13, pfcrt, pfmdr-1, pfdhfr, pfdhps genes and deletions in pfhrp2/pfhrp3 genes.

Results

By the end of 28-day follow-up, per-protocol PCR corrected ACPR of 97.8% (CI 95% 88.2–100) in Kelo and 100% in Doba and Kayoma were observed among AL treated patients. For ASAQ, 100% ACPR was found in all sites. All, but one patient, did not have parasites detected on day 3. Out of the 215 day 0 samples, 96.7% showed pfkelch13 wild type allele. Seven isolates carried nonsynonymous mutations not known to be associated artemisinin partial resistance (ART-R). Most of samples had a pfcrt wild type allele (79% to 89%). The most prevalent pfmdr-1 allele detected was the single mutant 184F (51.2%). For pfdhfr and pfdhps mutations, the quintuple mutant allele N51I/C59R/S108N + G437A/540E responsible for SP treatment failures in adults and children was not detected. Single deletion in the pfhrp2 and pfhrp3 gene were detected in 10/215 (4.7%) and 2/215 (0.9%), respectively. Dual pfhrp2/pfhrp3 deletions, potentially threatening the efficacy of HRP2-based RDTs, were observed in 5/215 (2.3%) isolates.

Conclusion

The results of this study confirm that AS–AQ and AL treatments are highly efficacious in study areas in Chad. The absence of known pfkelch13 mutations in the study sites and the high parasite clearance rate at day 3 suggest the absence of ART-R. The absence of pfdhfr/pfdhps quintuple or sextuple (quintuple + 581G) mutant supports the continued use of SP for IPTp during pregnancy. The presence of parasites with dual pfhrp2/pfhrp3 deletions, potentially threatening the efficacy of HRP2-based RDTs, warrants the continued surveillance.

Trial registration ACTRN12622001476729
A swift expanding trend of extracellular vesicles in spinal cord injury research: a bibliometric analysis
Authors: Zhiguo Fan , Ji Wu , Shenyuan Chen , Guoyou Zhang , Chen Kai , Hui Qian , Wenrong Xu , Zhai Xiao
Published: August 2023

Extracellular vesicles (EVs) in the field of spinal cord injury (SCI) have garnered significant attention for their potential applications in diagnosis and therapy. However, no bibliometric assessment has been conducted to evaluate the scientific progress in this area. A search of articles in Web of Science (WoS) from January 1, 1991, to May 1, 2023, yielded 359 papers that were analyzed using various online analysis tools. These articles have been cited 10,842 times with 30.2 times per paper. The number of publications experienced explosive growth starting in 2015. China and the United States led this research initiative. Keywords were divided into 3 clusters, including “Pathophysiology of SCI”, “Bioactive components of EVs”, and “Therapeutic effects of EVs in SCI”. By integrating the average appearing year (AAY) of keywords in VoSviewer with the time zone map of the Citation Explosion in CiteSpace, the focal point of research has undergone a transformative shift. The emphasis has moved away from pathophysiological factors such as “axon”, “vesicle”, and “glial cell” to more mechanistic and applied domains such as “activation”, “pathways”, “hydrogels” and “therapy”. In conclusions, institutions are expected to allocate more resources towards EVs-loaded hydrogel therapy and the utilization of innovative materials for injury mitigation.
Valuing Chinese medicine quality of life-11 dimensions (CQ-11D) health states using a discrete choice experiment with survival duration (DCETTO)
Authors: Zhu Wentao , Zhang Mengpei , Pan Jie , Shi Lizheng , Gao Hailiang , Xie Shitong
Published: August 2023

Objective

To explore generating a health utility value set for the Chinese medicine Quality of life-11 Dimensions (CQ-11D), a utility instrument designed to assess patients’ health status while receiving TCM treatment, among the Chinese population.

Methods

The study was designed to recruit at least 2400 respondents across mainland China to complete one-to-one, face-to-face interviews. Respondents completed ten discrete choice experiment with survival duration (DCETTO) tasks during interviews. The conditional logit models were used to generate the health utility value set for the CQ-11D using the DCETTO data.

Results

A total of 2,586 respondents were invited to participate in the survey and 2498 valid interviews were completed (a completion rate of 96.60%). The modified conditional logit model with combing logically inconsistent levels was ultimately selected to construct the health utility value set for the CQ-11D instrument. The range of the measurable health utility value was -0.868 ~ 1.

Conclusion

The study provides the first utility value set for the CQ-11D among the Chinese population. The CQ-11D and corresponding utility value set can be used to measure the health utility values of patients undergoing traditional Chinese medicine interventions, and further facilitate relevant cost-utility analyses. The application of the CQ-11D can support TCM resource allocation in China.
A quality improvement project to increase breast milk feeding of hospitalized late preterm infants in China
Authors: Quan Meiying , Li Zhenghong , Ward Laura Placke , Feng Shuju , Jing Yalin , Wang Lin , Yuan Jing
Published: August 2023

Background

The breastfeeding rates of late preterm infants are lower than both term and extremely preterm infants. To explore the interventions of increasing full breast milk feeding rate of hospitalized late preterm infants on the 7th day after birth (D7) and evaluate the effect of these quality improvement (QI) interventions.

Methods

The full breast milk feeding (amount of enteral breast milk reached 120ml/kg/d on D7) rate of hospitalized late preterm infants during May 2017 and November 2017 was set as the baseline before intervention, and the specific aim of promoting breast milk feeding was put forward. The Pareto Chart was used to analyze the factors that affect breast milk feeding process, as well as the discussion of multidisciplinary experts. Key drivers were constructed, including informational materials and education about breast milk feeding, consultations and support on optimal breast milk initiation, initiating breast milk expression within one hour after birth, accurate measurement and recording of expressed breast milk, stimulating continuous and effective lactation, proper breast pump selection in and out of hospital and sending and preserving of expressed milk to NICU. Control chart was used to monitor the monthly change of full breast milk feeding rate until the aim was achieved and sustained.

Results

The baseline of full breast milk feeding rate of late preterm infants was 10%, and the aim of QI was to increase the rate to 60% within a two-year period. Control chart dynamically showed the full breast milk feeding rate increased to 80% with the implementation of the interventions, achieved and made the aim of QI sustained.

Conclusion

QI interventions including breast milk feeding education, early postpartum breast milk pumping, kangaroo care to stimulate breast milk secretion, and convenient way of transporting breast milk to NICU, could significantly improve the full breast milk feeding rate of hospitalized late preterm infants.
Biochemical characterization of type I-E anti-CRISPR proteins, AcrIE2 and AcrIE4
Authors: Koo Jasung , Lee Gyujin , Ka Donghyun , Park Changkon , Suh Jeong-Yong , Bae Euiyoung
Published: August 2023

In bacteria and archaea, CRISPRs and Cas proteins constitute an adaptive immune system against invading foreign genetic materials, such as bacteriophages and plasmids. To counteract CRISPR-mediated immunity, bacteriophages encode anti-CRISPR (Acr) proteins that neutralize the host CRISPR–Cas systems. Several Acr proteins that act against type I-E CRISPR–Cas systems have been identified. Here, we describe the biochemical characterization of two type I-E Acr proteins, AcrIE2 and AcrIE4. We determined the crystal structure of AcrIE2 using single-wavelength anomalous diffraction and performed a structural comparison with the previously reported AcrIE2 structures solved by different techniques. Binding assays with type I-E Cas proteins were carried out for the target identification of AcrIE2. We also analyzed the interaction between AcrIE4 and its target Cas component using biochemical methods. Our findings corroborate and expand the knowledge on type I-E Acr proteins, illuminating diverse molecular mechanisms of inhibiting CRISPR-mediated prokaryotic anti-phage defense.
Crohn’s disease-related anal fistula cancer diagnosed by examination under anesthesia: a case report
Authors: Kaneshiro Daisuke , Sanechika Yuusuke , Kishi Kazuki , Sakai Daichi , Iwamoto Kazuya , Takeda Mitsunobu , Nakahara Yujiro , Ohashi Tomofumi , Naito Atsushi , Furukawa Kenta , Moon Jeongho , Imasato Mitsunobu , Asaoka Tadafumi , Mizushima Tsunekazu
Published: August 2023

Background

As the number of patients with inflammatory bowel disease (IBD) increases, the incidence of IBD-related colorectal cancer (CRC) is also on the rise. Crohn’s disease (CD)-related CRC has been reported to have a poorer prognosis than sporadic CRC, and the early detection of CD-related CRC is difficult. Japanese patients with CD are reported to have a higher frequency of anorectal cancer than the Western population; however, methods for early diagnosis have not yet been established because of perianal pain during the examination.

Case presentation

We report a case of CD-related anal fistula cancer that was detected early by surveillance examination under anesthesia (EUA). The patient was a 37-year-old man, diagnosed with CD at the age of 15 years and started medical treatment. However, due to poor disease control, the intestinal tract remained highly inflamed and the patient continued to have over 10 bowel movements per day. He was referred to our hospital for surgical treatment after a colonoscopy (CS), which revealed multiple active ulcers and stenoses. Since three perianal seton drainage tubes had been placed around his anus since the age of 33 years, we decided to perform an EUA to rule out cancer coexistence in the anorectal region. After a random biopsy of the rectum by CS under general anesthesia, we resected and curetted multiple perianal fistulas as much as possible and reinserted the seton drainage tubes. Pathological examination of the fistula tract revealed adenocarcinoma in one tract, indicating the coexistence of anal fistula cancer. Based on the diagnosis of multiple intestinal stenoses and anal fistula cancer due to CD, we performed hand-assisted laparoscopic total colectomy, rectal amputation, extensive perineal resection, and reconstruction using a left rectus abdominis flap.

Conclusion

In a long-term CD patient with anorectal lesions, we performed an EUA to diagnose the coexistence of anal fistula cancer at an early stage, and surgical resection was achieved. EUA is effective for the early detection and treatment of CD-related CRC and may contribute to an improved prognosis.
Nurturing child social-emotional development: evaluation of a pre-post and 2-month follow-up uncontrolled pilot training for caregivers and educators
Authors: Speidel Ruth , Wong Tracy K. Y. , Al-Janaideh Redab , Colasante Tyler , Malti Tina
Published: August 2023

Background

Social-emotional capacities contribute to children’s mental health by helping them navigate their own and others’ emotional states and forge healthy relationships. Caregivers and educators are critical socialization agents in early and middle childhood, but gaps remain in the systematic integration of social-emotional research into caregiver and educator trainings. The aim of this pilot study was to test the feasibility and preliminary efficacy of a social-emotional training designed to promote caregivers’ and educators’ capacities to support social-emotional development in children ages 3–8 years.

Methods

Fifty adults (n = 24 caregivers of children ages 3–8 years, n = 26 educators working with children ages 3–8 years) participated in a virtual training over 3 weeks. Participants completed pre-training, post-training, and 2-month follow-up questionnaires evaluating their knowledge of social-emotional concepts, use of training strategies, mental health, and satisfaction with the training. Caregivers also reported children’s social-emotional capacities and mental health.

Results

On average, caregivers and educators completed 83% of the virtual training sessions and reported high satisfaction with the training. Further, preliminary evidence indicated that caregivers’ and educators’ knowledge of social-emotional concepts increased pre- to post-training and was maintained at the 2-month follow-up. Increases in caregivers’ and educators’ knowledge and greater use of training strategies were associated with improvements in children’s social-emotional capacities and caregivers’ and educators’ own mental health.

Conclusions

These pilot results support the feasibility of infusing evidence-based social-emotional content into caregiver and educator training initiatives aimed at nurturing child social-emotional development and mental health. The results inform future evaluation of the short- and long-term benefits of this training with a full-scale randomized controlled trial design.
The feasibility of using a digital tool to enhance mobilisation following abdominal cancer surgery—a non-randomised controlled trial
Authors: Karlsson Patrik , Nygren-Bonnier Malin , Henningsohn Lars , Rydwik Elisabeth , Hagströmer Maria
Published: August 2023

Background

Early mobilisation is strongly recommended following abdominal cancer surgery, but evidence on how to structure early mobilisation to improve outcomes and support patient adherence is lacking. Pedatim® (Phystec) is a novel digital tool designed to support mobilisation in hospital settings using prescribed activities and goals on a tablet. The aim of this study was to evaluate the feasibility of the Pedatim tablet to enhance mobilisation following abdominal cancer surgery.

Methods

In a non-randomised feasibility trial design, participants were recruited between January and May 2022 at Karolinska University Hospital, Sweden. Participants used a Pedatim tablet from postoperative day 1 (POD 1) until hospital discharge. The primary objective was to evaluate process feasibility, regarding recruitment, compliance, and acceptability. Recruitment was measured by percentage of available patients included, eligibility criteria sufficiency, and number of dropouts. Compliance was measured by number of patients using versus not using the board. Acceptability was measured using the System Usability Scale. The secondary objective was to evaluate scientific feasibility, defined as an indication of treatment effects where physical activity was assessed using an activPAL accelerometer. Unforeseen events relating to the tablet were also registered.

Results

Based on predetermined feasibility criteria, the overall study design was determined to be feasible regarding recruitment as 69% accepted participation (n = 20), compliance was 95%, and the acceptability mean score was high (77/100). Eligibility criteria were not feasible as 79% (n = 108) of available patients were excluded. The intervention was determined to be scientifically feasible, mean steps per day increased from 623 (SD 766) to 1823 (SD 1446), and mean sit-to-stand transitions per day increased from 11 (SD 8) to 29 (SD 12) POD 1–4. Technical issues emerged, highlighting the need for available technical support and “user champions” among healthcare professionals on the ward.

Conclusions

Using the Pedatim tablet to enhance mobilisation following abdominal cancer surgery was deemed feasible, but a randomised controlled trial is needed to determine the tool’s effectiveness. The study process was determined to be feasible with revisions of the eligibility criteria needed before a future trial. Involving healthcare professionals and providing available technical support are important for future implementation.
Age-of-information-aware PI controller for load frequency control
Authors: Jiao Dan , Shao Changzheng , Hu Bo , Xie Kaigui , Lin Chengrong , Ju Zhuoxuan
Published: August 2023

Open communication system in modern power systems brings concern about information staleness which may cause power system frequency instability. The information staleness is often characterized by communication delay. However, communication delay is a packet-centered metric and cannot reflect the requirement of information freshness for load frequency control (LFC). This paper introduces the age of information (AoI), which is more comprehensive and informative than the conventional communication delay modeling method. An LFC controller and communication are integrated into the design for LFC performance improvement. An AoI-aware LFC model is formulated first, and considering each allowable update period of the smart sensor, different AoI-aware PI controllers are then designed according to the exponential decay rate. The right AoI-aware controller and update period are selected according to the degree of frequency fluctuation of the power system. Case studies are carried out on one-area and two-area power systems. The results show the superior performance of the AoI-aware controllers in comparison to the delay-dependent controllers.
Combination tanning mechanism inspired environmentally benign catalyst for efficient degradation of tetracycline
Authors: Xiao Meng , Liu Shuangmei , Qi Wenqian , Peng Yu , Yan Qingyu , Mao Hui
Published: August 2023

The utilization of chelation reaction between metals and tannins is a common tanning method in leather chemistry. Herein, a novel combination tanning mechanism inspired environmentally benign catalyst (CMBT-Fe0) was synthesized by immobilizing Fe nanoparticles onto bayberry tannin (BT) grafted chitosan microfibers (CM). The obtained catalyst featured a well-defined microfibrous structure, on which Fe0 nanoparticles were highly dispersed to exhibit exceptional catalytic activity for the degradation of tetracycline (TC). The catalytic activity of CMBT-Fe0 was 1.72 times higher than that of the commercial Fe0 nanoparticles without immobilization, with 95.03% of TC degraded within 90.0 min. The CMBT-Fe0 catalysts were recycled 6 times, with the removal rate of TC maintained at 82.56%. Furthermore, a possible mechanism responsible for the catalytic removal of TC was provided by analyzing the catalytic degradation products via liquid chromatography-mass spectrometry. Therefore, our investigation successfully developed efficient catalysts to address the concerned environmental issue of antibiotic pollution.

Graphical Abstract
Positron emission tomography rubidium-82 myocardial perfusion imaging in diagnosing uncommon paediatric acute coronary syndrome: a case report
Authors: Abd Razak Nadiah , Md. Yusof Ahmad Khairuddin , Abdul Hamid Khadijah , Khor Phay Phay
Published: August 2023

Background

Acute coronary syndrome (ACS) is uncommon among the paediatric population with no guideline in the management in this age group up to this date. This case report aims to introduce the Positron Emission Tomography Rubidium-82 (PET Rb-82 MPI) as one of the non-invasive diagnostic tools in paediatric acute coronary syndrome.

Case presentation

Patient is an 11-year-old boy with underlying Nephrotic syndrome who was referred to our hospital with the chief complaint of chest pain. This was associated with raised cardiac enzyme and S–T depression on the posterior leads of electrocardiogram. On his arrival, we noted raised lipid profile as well as proteinuria and hypoalbuminaemia. He had frequent relapse of Nephrotic syndrome with the latest episode was three months ago. He has a strong family history of ischaemic heart disease whom his father had an episode of myocardial infarction at the age of 40 as well as a strong family history of hypercholesterolaemia. His father and paternal uncle were diagnosed with hypercholesterolaemia at their early age. He was arranged for Coronary Computed Tomography Angiography which subsequently followed by PET Rb-82 MPI. The PET Rb-82 MPI demonstrated a large area of stress induced ischaemia in the left anterior descending, left circumflex and right coronary artery territories. The left ventricular size is normal with good systolic function and normal wall motion. Global coronary flow reserve was still preserved at 2.07. Following the multi-disciplinary meeting, diagnosis of ACS was established. Patient was treated with dual anti-platelets, and he was then arranged for coronary angiography. The coronary angiography showed complete occlusion of the left circumflex artery from the proximal segment. There was a mild disease at mid segment of the diagonal artery with myocardial bridging. There was also a moderate disease from proximal segment of the dominant right coronary artery. Paclitaxel drug coated balloons were inserted into the diagonal and left circumflex arteries.

Conclusions

This rare case report on paediatric ACS highlights the diagnostic value of PET Rb-82 MPI as one of the non-invasive imaging tools in diagnosing paediatric acute coronary syndrome.
Bioanalytical method development, validation and quantification of flutamide in spiked rat plasma by using high-performance liquid chromatography
Authors: Sabale Vidya , Jiwankar Manasi , Sabale Prafulla
Published: August 2023

Background

A quick, low cost and precise method was developed and validated for flutamide in the rat plasma using a high-performance liquid chromatography. Acetanilide was used as internal standard in the study. Flutamide was extracted from rat plasma using methanol. The chromatographic analysis was carried out on Cromasil C18 column at 227 nm using methanol–water mixture as the mobile phase and flow rate of 0.8 ml/min.

Results

The developed method demonstrated good linearity over the 100–1000 ng/ml concentration range with a regression coefficient of 0.9947. The accuracy of the developed method was found to be 97–101%, while its precision was found to be less than 5%. Limits of detection and quantitation were determined to be 2.52 ng/ml and 7.66 ng/ml, respectively. Flutamide showed recovery of about 96–100% and the developed method was further used to investigate the pharmacokinetics of flutamide in the marketed formulation.

Conclusions

From the results, it can be concluded that the developed method has the potential to successfully determine flutamide in rat plasma and establish the pharmacokinetic parameters of other flutamide-containing formulations.
Uptake of Genetic Research Results and Patient-Reported Outcomes With Return of Results Incorporating Web-Based Predisclosure Education
Authors: Kilbride Madison , Egleston Brian L. , Chung Wendy K. , Olopade Olufunmilayo , Maxwell Kara N. , Shah Payal , Churpek Jane E. , Fleisher Linda , Terry Mary Beth , Fetzer Dominique , Gaieski Jill Bennett , Bulafka Jessica , Espinal Aileen , Karpink Kelsey , Walser Sarah , Singleton Davone , Palese Monica , Siljander Ilona , Brandt Amanda , Clark Dana , Koval Carrie , Wynn Julia , Long Jessica M. , McKenna Danielle , Powers Jacquelyn , Nielsen Sarah , Domchek Susan M. , Nathanson Katherine L. , Bradbury Angela R.
Published: August 2023

Web-based predisclosure education for genetic research results is a viable alternative
Risk Factors Associated with Incident Vertebral Fractures in Steroid-treated Males with Duchenne Muscular Dystrophy
Authors: Phung Kim , McAdam Laura , Ma Jinhui , McMillan Hugh J , Jackowski Stefan , Scharke Maya , Matzinger Mary-Ann , Shenouda Nazih , Koujok Khaldoun , Jaremko Jacob L , Wilson Nagwa , Walker Scott , Hartigan Colleen , Khan Nasrin , Page Marika , Robinson Marie-Eve , Saleh David S , Smit Kevin , Rauch Frank , Siminoski Kerry , Ward Leanne M
Published: August 2023

Purpose

Prevention of fractures is an unmet need in glucocorticoid (GC)-treated Duchenne muscular dystrophy. This study explored factors associated with incident vertebral fractures (VFs) to inform future fracture prevention efforts.

Methods

VFs were evaluated prospectively at study baseline and 12 months on lateral spine radiographs in participants aged 4 to 25 years with Duchenne muscular dystrophy. Clinical factors were analyzed for their association with the change in Spinal Deformity Index (sum of the Genant-defined VF grades from T4 to L4) between baseline and 12 months.

Results

Thirty-eight males were evaluated (mean ± SD age at baseline 11.0 ± 3.6 years; mean ± SD GC duration at baseline 4.1 ± 3.1 years; 74% ambulatory). Nine of 38 participants (24%) had 17 incident VFs, of which 3/17 VFs (18%) were moderate/severe. Participants with 12-month incident VF had lower mean ± SD baseline lumbar spine areal bone mineral density Z-scores (−2.9 ± 1.0 vs −1.9 ± 1.1; P = .049) and lower total body less head areal bone mineral density Z-scores (−3.1 ± 1.2 vs −1.6 ± 1.7; P = .036). Multivariable linear regression showed that at least 1 VF at baseline (P < .001), a higher number of antecedent non-VF (P < .001), and greater bone age delay at baseline (P = .027) were significant predictors of an increase in the Spinal Deformity Index from baseline to 12 months.

Conclusion

The observation that ≥ 1 prevalent VF and/or non-VF were the strongest predictors of incident VFs at 12 months supports the need for prevention of first fractures in this high-risk setting. Bone age delay, a marker of GC exposure, may assist in the prioritization of patients in efforts to prevent first fractures.