bluuebunny/crossref_metadata_2025 huggingface dataset:
Choroidal nevus through a broader vision: Retinal imaging acquisition captured with Broad Line Fundus Imaging technology
Authors: Barbosa Gabriel Castilho S , Marback Eduardo F , Novais Eduardo A , Lucatto Luiz FA , Badaró Emmerson , Roisman Luiz , Leitão Guerra Ricardo L
Published: February 2024

Objective

To describe the peculiarities in imaging acquisition of fourteen patients with choroidal nevus using the Broad Line Fundus Imaging (BLFI) technology.

Methods

Single-center, retrospective, cross-sectional analysis.

Results

All images were acquired using the BLFI technology. We have found that choroidal nevus is undetectable in the blue channel (BC) (435–500 nm) and the green channel (GC) (500–585 nm). The only visible changes are related to the drusen, which appeared in BC and GC as light focal dots, correlated to the yellowish foci in the true-color image. On the red channel (RC) (585–640 nm), all lesions revealed the same pattern: a well-defined dark spot, with enhanced contrast, allowing the better visualization, measuring, and characterization of the nevus when compared with the other color channels, including the true-color imaging.

Conclusion

BLFI application in choroidal nevus might be helpful at presentation, refining the diagnostic reliability, and monitoring, as it allows for better detection of alterations in the lesions. The peculiarities of the choroidal nevus are better assessed when using the RC due to its longer wavelength and deeper penetration in the retina and choroid.
Drivers of Rural Non-farm Sector Employment in India, 1983–2019
Authors: Pattayat Shiba Shankar , Parida Jajati Keshari
Published: February 2024

Using the national-level employment and unemployment surveys (NSS and PLFS) and the macro-level data for the period 2005–2019, this article explores the trends and recent growth patterns of rural non-farm sector employment in India. It also examines the micro-level factors determining individuals’ preference towards non-farm sector jobs and the macro-level factors responsible for the growth of non-farm sector employment in rural India. The main findings of the study suggest that although rural non-farm sector employment is rising in absolute terms, its growth rate has slackened in recent years. While the level of education and skill training, market wage rates and socio-cultural setups are among the key micro-level factors determining farm–non-farm employment choices of rural folks, at the macro-level, the growth of investment in capital goods, the number of factories, investment in infrastructure development and the growth of the manufacturing sector are crucial for the growth of non-farm sector jobs in India. Based on these findings, it is argued that the improvement of human capabilities through increased investment in education and skill, and the growth of non-farm sector employment through the development of rural infrastructure and industrialization measures, are necessary to sustain the structural transformation and to harness the demographic dividend in India.

JEL Codes: J01, J21, J43, J64
Interpersonal comparisons of well-being: Increasing convergence
Authors: de Boer Jelle
Published: February 2024

The main question of this paper is how people may agree in their interpersonal comparisons of wellbeing. These comparisons are important in social ethics and for policy purposes. The paper firstly examines grounds for convergence in easy cases. Then comes a more difficult case of low convergence in order to explore a way to increase it. For this, concepts from the empirical subjective well-being literature are used: life satisfaction and vignettes. Ideas of John Harsanyi and Serge Kolm thereby receive a new look.
MobileViT model-based real-time fiber identification method for cashmere and wool
Authors: Lu Kai , Luo Junli , Wang Fei , Fan Zhiwei , Du Genyuan , Zhang Xiangqun , Pei Wenke
Published: February 2024

The physical and morphological characteristics of wool and cashmere fibers exhibit notable similarities, making distinguishing them challenging. In this study, we propose a method based on a lightweight hybrid model called MobileViT, which combines a vision transformer and convolutional neural network, for the real-time identification of fiber categories. After training on a large sample dataset, the model was validated on a test set of 61,095 fiber images belonging to six categories; it took 26.2 s to achieve a recognition accuracy of 97.19%. This paper presents the first attempt to use a hybrid model of Transformer and Convolutional Neural Network (CNN) for the recognition of fiber images. Experimental results demonstrate that the model is capable of effectively extracting features from fibers, and it outperforms pure CNN models in terms of both speed and accuracy.
The prevalent causes of death in patients with peripheral artery disease undergoing revascularisation or amputation
Authors: Telianidis Stacey , Aitken Sarah Joy
Published: February 2024

Objective

Preventing untimely death in patients with peripheral artery disease (PAD) requires a detailed understanding of the predominant causes of death (COD). This literature review aims to describe how short- and long-term COD are reported in patients who had surgery for PAD.

Methods

A literature review was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines for articles reporting specific causes of mortality in patients who had surgery for all stages of PAD. Articles were included if they reported COD after open surgical or endovascular revascularisation, or major or minor amputation for PAD. Critical appraisals were conducted according to included study types, using the Joanna Briggs Institute tools.

Results

Cause of death was reported in 21 publications. Twenty were observational and one was a randomised control trial. Study size ranged from 25 to 10,505 patients. Cardiovascular disease was the most prevalent COD in perioperative periods (42.5% from 13 studies). Long-term follow-up ranged from 1 month and 7 years with 15 studies reporting cardiac related mortality as the most frequent cause of death. However, mortality from neoplasia, respiratory disease (including pneumonia and pulmonary emboli), stroke and sepsis were prevalent. Many studies were low-average quality, with few population-based observational studies.

Conclusion

Whilst cardiovascular COD are the most prevalent reasons for mortality in patients with PAD, the proportion of patients dying from neoplasia and respiratory disease is high. Improved reporting standards for COD in studies examining PAD are needed.
Physician-modified inner-branched endovascular repair with re-intervention
Authors: Tsushima Shingo , Shibata Tsuyoshi , Kawaharada Nobuyoshi
Published: February 2024

Objectives

Treatment of thoracoabdominal aortic aneurysms in high surgical risk patients can be challenging. Reports of physician-modified inner-branched endovascular repair (PMiBEVAR) are increasing. Despite low morbidity and mortality rates, re-interventions for endoleaks with these grafts are serious. There are no reports of additional treatment for PMiBEVAR failure.

Methods/Results

A 75-year-old man presented to our hospital with a Crawford’s type IV thoracoabdominal aortic aneurysm. A PMiBEVAR was performed. Postoperative computed tomographic angiography revealed an endoleak from the inner branch of the right renal artery. A re-intervention was performed with coil embolization of the endoleak. Imaging after re-intervention showed successful obliteration of the endoleak.

Conclusions

We thereby report a successful case of re-intervention for PMiBEVAR failure.
A retrospective assessment of venous recanalization outcomes for oral anticoagulant treatment in deep vein thrombosis
Authors: Guzel Anil , Canbaz Suat
Published: February 2024

Objective

This study aims to provide effective treatment by comparing the venous recanalization responses of oral anticoagulants in deep vein thrombosis therapy.

Methods

From January 2013 to March 2019, a retrospective analysis was conducted on 109 patients who had been diagnosed with deep vein thrombosis and received treatment with apixaban, rivaroxaban, or warfarin within 1 week of symptom onset. Demographic, clinical data, and venous recanalization responses on Doppler ultrasonography of the patients that were followed-up 1 year from the date of diagnosis were evaluated.

Results

At the end of the 1-year follow-up, 21 (19.3%) patients had delayed recanalization, 39 (35.8%) patients had partial recanalization, and 49 (44.9%) patients had complete recanalization. The mean time to complete recanalization was 9.178 months for apixaban, 8.986 months for rivaroxaban, and 10.641 months for warfarin. Rivaroxaban was found to result in earlier completion of recanalization compared to warfarin ( p = .012).

Conclusion

Direct oral anticoagulants might be more effective than vitamin K antagonists in achieving complete recanalization in patients that have deep vein thrombosis. Improving outcomes can be achieved by evaluating current treatment options.
Collaboration, reinvented tools and specialist knowledge: Communication professionals’ experiences of global health crisis management
Authors: Landqvist Mats , Blåsjö Mona
Published: February 2024

Communication professionals have a paramount role in global crisis. What did they learn during the covid pandemic that could be used in future global crisis? The aim of this article is to identify and analyze strategy changes among communicators in municipalities and how their conceptions of communicated knowledge transformed during the pandemic. Retrospective interviews and textual material are analyzed with a framework of Mediated Discourse Analysis in combination with Legitimation Code Theory. The analysis shows that the work of the communicators was characterized by collaboration with other professional groups and the civil society, and that the complexity and important time aspects during this crisis gave birth to semi-new, reinvented, discursive tools in the shape of text genres. The communicators’ conceived relevant knowledge as concept-driven and developed the conception that conveyance of knowledge should be thoroughly planned in a way that takes complexity into account.
Role of alveolar nitric oxide in gastroesophageal reflux-associated cough: prospective observational study
Authors: Zhang Li , Zhang Mengru , Aierken Alimire , Dong Ran , Chen Qiang , Qiu Zhongmin
Published: February 2024

Background:

Fractional exhaled nitric oxide (FeNO) measured at multiple exhalation flow rates can be used as a biomarker to differentiate central and peripheral airway inflammation. However, the role of alveolar nitric oxide (CaNO) indicating peripheral airway inflammation remains unclear in gastroesophageal reflux-associated cough (GERC).

Objectives:

We aimed to characterize the changes in alveolar nitric oxide (CaNO) and determine its clinical implication in GERC.

Design:

This is a single-center prospective observational study.

Methods:

FeNOs at exhalation flow rates of 50 and 200 ml/s were measured in 102 patients with GERC and 134 patients with other causes of chronic cough (non-GERC). CaNO was calculated based on a two-compartment model and the factors associated with CaNO were analyzed. The effect of anti-reflux therapy on CaNO was examined in 26 GERC patients with elevated CaNO.

Results:

CaNO was significantly elevated in GERC compared with that in non-GERC (4.6 ± 4.4 ppb versus 2.8 ± 2.3 ppb, p < 0.001). GERC patients with high CaNO (>5 ppb) had more proximal reflux events (24 ± 15 versus 9 ± 9 episodes, p = 0.001) and a higher level of pepsin (984.8 ± 492.5 versus 634.5 ± 626.4 pg/ml, p = 0.002) in sputum supernatant than those with normal CaNO. More GERC patients with high CaNO required intensified anti-reflux therapy (χ2 = 3.963, p = 0.046), as predicted by a sensitivity of 41.7% and specificity of 83.3%. Cough relief paralleled a significant improvement in CaNO (8.3 ± 3.0 versus 4.8 ± 2.6 ppb, p < 0.001).

Conclusion:

Peripheral airway inflammation can be assessed by CaNO measurement in GERC. High CaNO indicates potential micro-aspiration and may predict a necessity for intensified anti-reflux therapy.
Globalization and Liberalization in Social Policy Expansion: Testing the Compensation and Efficiency Hypotheses in Brazil
Authors: Cruz-Martinez Gibran
Published: February 2024

This article examines four potential strategies of the Brazilian welfare system in the face of increasing liberalization and globalization since the 1970s. We test whether liberalization and economic globalization hurt the expansion of social expenditure (the efficiency hypothesis or race to the bottom hypothesis) or whether the welfare system expands as a response to the volatility caused by liberalization and globalization (compensation hypothesis). We employ time-series regression analysis to panel data from 1970 to 2015. We controlled for economic (wealth and GDP growth) and political factors (strength of the left and effective competition of parties in the lower house). We identify different strategies followed by the welfare system through the period analyzed. However, two strategies are dominant in the long run: A neoliberal strategy when the impact of globalization is considered (efficiency hypothesis) and an embedded neoliberal strategy when the effect of liberalization is pondered (compensation hypothesis).
Intimate witnessing: Volunteer testimonies of everyday border violence
Authors: Ramakrishnan Kavita , Stavinoha Luděk
Published: February 2024

In this paper, we center the witnessing repertoires of grassroots volunteers and explore the ways in which they bear witness to and condemn the border violence experienced by illegalized migrants across Europe. Drawing on long-term research of volunteer solidarity structures across Greece and in Paris, our analysis of witnessing uses the ‘intimate’ as a conceptual framing across three intersections of analysis. First, we locate the ‘intimate’ in volunteers’ embodied presence in migrant spaces, where important relations of care between volunteers and migrants emerge based on physical and emotional proximity. Second, we unpack how intimate mourning over migrant incarceration and death are publicly evoked, in the affective and emotive authorship of events to which volunteers bear witness. Finally, we reflect on the multiple political potentialities of intimate witnessing, not only as an alternative to traditional modalities of humanitarian witnessing, but as a radical confrontation against racialized logics that underpin Europe’s bordering apparatus. Bringing together literature on feminist geopolitics, humanitarian witnessing, and volunteer-refugee solidarities, we argue that the distinct repertoires of ‘intimate witnessing’ are paramount to solidarity, whereby volunteers render visible the mundane violence and indignities illegalized migrants face across Europe.
Anesthesia for Maxillofacial Surgery: A Comprehensive Overview
Authors: Singh Manish Kumar , Singh Prem Raj , Chaurasiya Manoj Kumar , Tiwari Tanmay
Published: February 2024

Maxillofacial surgery encompasses a range of procedures on the head and neck, often presenting unique challenges for anesthetists due to the shared airway with surgeons and the common occurrence of difficult airways. This comprehensive overview addresses key aspects of anesthesia for maxillofacial surgery, including pre-assessment, airway management, anesthetic techniques, and postoperative care.
Revision Transtibial Medial Meniscal Root Repair With Concomitant Medial Opening-Wedge Proximal Tibial Osteotomy
Authors: Homan Morgan D. , Tollefson Luke V. , Kennedy Nicholas I. , LaPrade Robert F.
Published: February 2024

Background:

Complete meniscal root tears disrupt dispersion of axial loading forces through hoop stresses. This increases point-loading on tibiofemoral cartilage and leads to chondromalacia and accelerated osteoarthritis (OA). Posterior root tears may be treated successfully with a transtibial pullout repair. Varus malalignment also leads to increased medial compartment pressures, increasing the risk of early OA and putting increased stress on the meniscus and stabilizing knee ligaments. In particular, revision medial meniscal root repairs without correction of varus malalignment are at increased risk of failure. Genu varum may be corrected with a medial opening-wedge proximal tibial osteotomy (OW PTO).

Indications:

Meniscal root repairs are indicated for acute or chronic tears in active patients with healthy cartilage. OW PTO is indicated for varus malalignment in ambulatory patients with healthy cartilage, or who are at risk for failure of meniscal or ligamentous procedures.

Technique Description:

After exposure of the osteotomy site, arthroscopy is performed through the incision and the revision posterior meniscus root repair is performed via a double-tunnel transtibial pullout technique. The positioning of these tunnels is modified superiorly so as to not cross the planned osteotomy site. The osteotomy is then performed by drilling 2 guide pins under fluoroscopy to delineate the plane of the cut. An OW plate is placed, and the root repair is tensioned last.

Results:

Double-tunnel transtibial pullout repairs increase meniscal fixation contact surface and have been shown to be biomechanically superior to all-inside fixation techniques. Medial OW PTO restores knee alignment and reduces supra-anatomic stresses in the medial compartment, additionally decreasing the risk of a revision medial meniscus repair failure.

Discussion:

Biomechanical studies have shown that meniscal root tears are functionally equivalent to complete meniscectomy. Varus malalignment increases the risk of medial meniscal tears, and reduces the risk of a successful long-term repair. We describe a technique for a revision transosseous posterior root repair with concomitant proximal tibial osteotomy, with discussion of surgical pearls and pitfalls. This technique restores anatomic position and native function of the medial meniscus while correcting tibiofemoral malalignment that could jeopardize the repair.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form.
A case report of an accidental iatrogenic dexmedetomidine overdose in an adult
Authors: Tiainen Suvi-Maria , Unga Jonni , Uusalo Panu
Published: February 2024

Background

Dexmedetomidine is a sedative drug with a wide safety margin.

Case presentation

We present a case of accidental iatrogenic dexmedetomidine overdose in an adult patient during high-intensity focused ultrasound (HIFU) treatment. This is the first case report of an adult patient receiving an intravenous push of dexmedetomidine. Overdose resulted in severe oversedation, but symptoms receded spontaneously over time.

Conclusions

Dexmedetomidine overdoses are infrequent, and they are usually the result of an administration error.
Modeling the effect of grazing on carbon and water use efficiencies in grasslands on the Qinghai–Tibet Plateau
Authors: Huang Xiaotao , Luo Geping , Ma Zhen , Yao Buqing , Du Yangong , Yang Yongsheng
Published: February 2024

Background

Carbon and water use efficiencies (CUE and WUE, respectively) are vital indicators of the adaptability of plants to environmental conditions. However, the effects of grazing and climate change on the spatiotemporal changes in CUE and WUE in Qinghai–Tibet Plateau grasslands (QTPG) are still unclear.

Results

Using the enhanced Biome-BGCMuSo model in combination with observed data, we estimated and analyzed the spatiotemporal variations in CUE and WUE and their responses to grazing in QTPG from 1979 to 2018. The mean annual CUE was 0.7066 in QTPG from 1979 to 2018 under the actual climate scenario. In general, the grassland CUE was low in the southeast and high in the northwest. Grazing generally decreased CUE in QTPG from 1979 to 2018, and there was an increasing trend in the difference in CUE between the grazing and nongrazing scenarios. The difference in CUE was generally greater in the northwest than in the southeast. The mean annual WUE was 0.5591 g C/kg H2O in QTPG from 1979 to 2018 under the actual climate scenario. After 2000, the grassland WUE exhibited a fluctuating upward trend. In general, the grassland WUE was greater in the southeast than in the northwest. Grazing generally decreased WUE in QTPG from 1979 to 2018, and there was an increasing trend in the difference in WUE between the grazing and nongrazing scenarios. The difference in WUE was generally greater in the northwest than in the southeast.

Conclusions

The findings of this study suggested that the spatiotemporal changes in CUE and WUE in QTPG were closely related to changes in the natural environment and grazing management.
RNA sequencing identifies key genes involved in intramuscular fat deposition in chickens at different developmental stages
Authors: Zhu Jinmei , Wang Yongli , Su Yongchun , Zheng Maiqing , Cui Huanxian , Chen Zhiwu
Published: February 2024

Background

Intramuscular fat (IMF) is an important factor in meat quality, and triglyceride (TG) and Phospholipids (PLIP), as the main components of IMF, are of great significance to the improvement of meat quality.

Results

In this study, we used 30 RNA sequences generated from the transcriptome of chicken breast muscle tissues at different developmental stages to construct a gene expression matrix to map RNA sequence reads to the chicken genome and identify the transcript of origin. We used weighted gene co-expression network analysis (WGCNA) and identified 27 co-expression modules, 10 of which were related to TG and PLIP. We identified 150 highly-connected hub genes related to TG and PLIP, respectively, which were found to be mainly enriched in the adipocytokine signaling pathway, MAPK signaling pathway, mTOR signaling pathway, FoxO signaling pathway, and TGF-beta signaling pathway. Additionally, using the BioMart database, we identified 134 and 145 candidate genes related to fat development in the TG-related module and PLIP-related module, respectively. Among them, RPS6KB1, BRCA1, CDK1, RPS3, PPARGC1A, ACSL1, NDUFAB1, NDUFA9, ATP5B and PRKAG2 were identified as candidate genes related to fat development and highly-connected hub genes in the module, suggesting that these ten genes may be important candidate genes affecting IMF deposition.

Conclusions

RPS6KB1, BRCA1, CDK1, RPS3, PPARGC1A, ACSL1, NDUFAB1, NDUFA9, ATP5B and PRKAG2 may be important candidate genes affecting IMF deposition. The purpose of this study was to identify the co-expressed gene modules related to chicken IMF deposition using WGCNA and determine key genes related to IMF deposition, so as to lay a foundation for further research on the molecular regulation mechanism underlying chicken fat deposition.
Subtelomeric plasticity contributes to gene family expansion in the human parasitic flatworm Schistosoma mansoni
Authors: Brann T , Beltramini A , Chaparro C , Berriman M , Doyle SR , Protasio AV
Published: February 2024

Background

The genomic region that lies between the telomere and chromosome body, termed the subtelomere, is heterochromatic, repeat-rich, and frequently undergoes rearrangement. Within this region, large-scale structural changes enable gene diversification, and, as such, large multicopy gene families are often found at the subtelomere. In some parasites, genes associated with proliferation, invasion, and survival are often found in these regions, where they benefit from the subtelomere's highly plastic, rapidly changing nature. The increasing availability of complete (or near complete) parasite genomes provides an opportunity to investigate these typically poorly defined and overlooked genomic regions and potentially reveal relevant gene families necessary for the parasite’s lifestyle.

Results

Using the latest chromosome-scale genome assembly and hallmark repeat richness observed at chromosome termini, we have identified and characterised the subtelomeres of Schistosoma mansoni, a metazoan parasitic flatworm that infects over 250 million people worldwide. Approximately 12% of the S. mansoni genome is classified as subtelomeric, and, in line with other organisms, we find these regions to be gene-poor but rich in transposable elements. We find that S. mansoni subtelomeres have undergone extensive interchromosomal recombination and that these sites disproportionately contribute to the 2.3% of the genome derived from segmental duplications. This recombination has led to the expansion of subtelomeric gene clusters containing 103 genes, including the immunomodulatory annexins and other gene families with unknown roles. The largest of these is a 49-copy plexin domain-containing protein cluster, exclusively expressed in the tegument—the tissue located at the host-parasite physical interface—of intramolluscan life stages.

Conclusions

We propose that subtelomeric regions act as a genomic playground for trial-and-error of gene duplication and subsequent divergence. Owing to the importance of subtelomeric genes in other parasites, gene families implicated in this subtelomeric expansion within S. mansoni warrant further characterisation for a potential role in parasitism.
A preliminary study of the miRNA restitution effect on CNV-induced miRNA downregulation in CAKUT
Authors: Mitrovic Kristina , Zivotic Ivan , Kolic Ivana , Zakula Jelena , Zivkovic Maja , Stankovic Aleksandra , Jovanovic Ivan
Published: February 2024

Background

The majority of CAKUT-associated CNVs overlap at least one miRNA gene, thus affecting the cellular levels of the corresponding miRNA. We aimed to investigate the potency of restitution of CNV-affected miRNA levels to remediate the dysregulated expression of target genes involved in kidney physiology and development in vitro.

Methods

HeterozygousMIR484knockout HEK293 and homozygousMIR185knockout HEK293 cell lines were used as models depicting the deletion of the frequently affected miRNA genes by CAKUT-associated CNVs. After treatment with the corresponding miRNA mimics, the levels of the target genes have been compared to the non-targeting control treatment. For both investigated miRNAs,MDM2andPKD1were evaluated as common targets, while additional 3 genes were investigated as targets of each individual miRNA (NOTCH3,FIS1andAPAF1as hsa-miR-484 targets andRHOA,ATF6andCDC42as hsa-miR-185-5p targets).

Results

Restitution of the corresponding miRNA levels in both knockout cell lines has induced a change in the mRNA levels of certain candidate target genes, thus confirming the potential to alleviate the CNV effect on miRNA expression. Intriguingly, HEK293 WT treatment with investigated miRNA mimics has triggered a more pronounced effect, thus suggesting the importance of miRNA interplay in different genomic contexts.

Conclusions

Dysregulation of multiple mRNA targets mediated by CNV-affected miRNAs could represent the underlying mechanism behind the unresolved CAKUT occurrence and phenotypic variability observed in CAKUT patients. Characterizing miRNAs located in CNVs and their potential to become molecular targets could eventually help in understanding and improving the management of CAKUT.
Intraoperative mechanical power and postoperative pulmonary complications in low-risk surgical patients: a prospective observational cohort study
Authors: El-Khatib Mohamad , Zeeni Carine , Shebbo Fadia M. , Karam Cynthia , Safi Bilal , Toukhtarian Aline , Nafeh Nancy Abou , Mkhayel Samar , Shadid Carol Abi , Chalhoub Sana , Beresian Jean
Published: February 2024

Background

Inadequate intraoperative mechanical ventilation (MV) can lead to ventilator-induced lung injury and increased risk for postoperative pulmonary complications (PPCs). Mechanical power (MP) was shown to be a valuable indicator for MV outcomes in critical care patients. The aim of this study is to assess the association between intraoperative MP in low-risk surgical patients undergoing general anesthesia and PPCs.

Methods

Two-hundred eighteen low-risk surgical patients undergoing general anesthesia for elective surgery were included in the study. Intraoperative mechanical ventilatory support parameters were collected for all patients. Postoperatively, patients were followed throughout their hospital stay and up to seven days post discharge for the occurrence of any PPCs.

Results

Out of 218 patients, 35% exhibited PPCs. The average body mass index, tidal volume per ideal body weight, peak inspiratory pressure, and MP were significantly higher in the patients with PPCs than in the patients without PPCs (30.3 ± 8.1 kg/m2 vs. 26.8 ± 4.9 kg.m2, p < 0.001; 9.1 ± 1.9 ml/kg vs. 8.6 ± 1.4 ml/kg, p = 0.02; 20 ± 4.9 cmH2O vs. 18 ± 3.7 cmH2O, p = 0.001; 12.9 ± 4.5 J/min vs. 11.1 ± 3.7 J/min, p = 0.002). A multivariable regression analysis revealed MP as the sole significant predictor for the risk of postoperative pulmonary complications [OR 1.1 (95% CI 1.0–1.2, p = 0.036].

Conclusions

High intraoperative mechanical power is a risk factor for developing postoperative pulmonary complications. Furthermore, intraoperative mechanical power is superior to other traditional mechanical ventilation variables in identifying surgical patients who are at risk for developing postoperative pulmonary complications.

Clinical trial registration

NCT03551899; 24/02/2017.
Effect of age and gender on ventricular-arterial coupling estimated using a non-invasive technique
Authors: Obata Yurie , Matsuki Yuka , Okafuji Kazuhiro , Shigemi Kenji
Published: February 2024

Background

Left ventricular-arterial coupling is assessed as the ratio of left ventricular end-systolic elastance (Ees) to arterial elastance (Ea). Previous studies have introduced non-invasive estimations of Ees/Ea. It requires only four variables, namely pre-ejection period, ejection time, end-systolic pressure and diastolic pressure. The aims of the present study were to clarify the reference values of Ees/Ea estimated using the noninvasive technique, and to investigate the effects of age and gender on Ees/Ea in healthy subjects.

Methods

This retrospective study utilized data from healthy, 30-79-year-old subjects. We recorded electrocardiogram, phonocardiogram, and brachial arterial pulse waves simultaneously using the vascular screening system, and used the observed variables to calculate Ees/Ea. We separated subjects into five groups according to their age and compared Ees/Ea among the different age groups.

Results

The study included 2114 males and 2292 females. Ees/Ea ranged from 1.87 to 2.04 in males, and 1.98 to 2.32 in females. We observed no age-related differences in Ees/Ea in males (p = 0.10), and significant differences in females (p < 0.001). Ees/Ea in males was not different compared to those in females in 60-69-year-old group (p = 0.92). Whereas Ees/Ea was higher in females compared to those in males in the other age groups. The differences between medians of Ees/Ea in males and those in females were 0.45 (p < 0.001), 0.24 (p < 0.001), 0.13 (p = 0.01), and 0.13 (p = 0.03) in 30–39, 40–49, 50–59, and 70-79-year-old age groups, respectively.

Conclusions

We clarified the reference values of Ees/Ea in healthy subjects. The effect of age on Ees/Ea is different in males and females, although Ees/Ea is maintained within a relatively narrow range in all subjects.
Influence of a chronic beta-blocker therapy on perioperative opioid consumption – a post hoc secondary analysis
Authors: Trauzeddel Ralf F. , Rothe Luisa M. , Nordine Michael , Dehé Lukas , Scholtz Kathrin , Spies Claudia , Hadzidiakos Daniel , Winterer Georg , Borchers Friedrich , Kruppa Jochen , Treskatsch Sascha
Published: February 2024

Background

Beta-blocker (BB) therapy plays a central role in the treatment of cardiovascular diseases. An increasing number of patients with cardiovascular diseases undergoe noncardiac surgery, where opioids are an integral part of the anesthesiological management. There is evidence to suggest that short-term intravenous BB therapy may influence perioperative opioid requirements due to an assumed cross-talk between G-protein coupled beta-adrenergic and opioid receptors. Whether chronic BB therapy could also have an influence on perioperative opioid requirements is unclear.

Methods

A post hoc analysis of prospectively collected data from a multicenter observational (BioCog) study was performed. Inclusion criteria consisted of elderly patients (≥ 65 years) undergoing elective noncardiac surgery as well as total intravenous general anesthesia without the use of regional anesthesia and duration of anesthesia ≥ 60 min. Two groups were defined: patients with and without BB in their regular preopreative medication. The administered opioids were converted to their respective morphine equivalent doses. Multiple regression analysis was performed using the morphine-index to identify independent predictors.

Results

A total of 747 patients were included in the BioCog study in the study center Berlin. 106 patients fulfilled the inclusion criteria. Of these, 37 were on chronic BB. The latter were preoperatively significantly more likely to have arterial hypertension (94.6%), chronic renal failure (27%) and hyperlipoproteinemia (51.4%) compared to patients without BB. Both groups did not differ in terms of cumulative perioperative morphine equivalent dose (230.9 (BB group) vs. 214.8 mg (Non-BB group)). Predictive factors for increased morphine-index were older age, male sex, longer duration of anesthesia and surgery of the trunk. In a model with logarithmised morphine index, only gender (female) and duration of anesthesia remained predictive factors.

Conclusions

Chronic BB therapy was not associated with a reduced perioperative opioid consumption.

Trial registration

This study was registered at ClinicalTrials.gov (NCT02265263) on the 15.10.2014 with the principal investigator being Univ.-Prof. Dr. med. Claudia Spies.
Effects of neighborhood built environment on cognitive function in older adults: a systematic review
Authors: Song Yiling , Liu Yunxi , Bai Xiaotian , Yu Hongjun
Published: February 2024

Background

In the background of an aging population, the risk of cognitive impairment in the older population is prominent. Exposure to complex neighborhood built environments may be beneficial to the cognitive health of older adults, and the purpose of this study was to systematically review the scientific evidence on the effects of neighborhood built environments on cognitive function in older adults.

Methods

Keywords and references were searched in Web of Science, Pubmed, PsycINFO, and MEDLINE. Studies examining the relationship between the built environment and cognitive function in older adults were included. The neighborhood built environment as an independent variable was classified according to seven aspects: density, design, diversity, destination accessibility, public transportation distance, blue/green space, and built environment quality. The cognitive function as the dependent variable was classified according to overall cognitive function, domain-specific cognitive function, and incidence of dementia. The quality of the included literature was assessed using the National Institutes of Health's Observational Cohort and Cross-Sectional Study Quality Assessment Tool.

Results

A total of 56 studies were included that met the inclusion criteria, including 31 cross-sectional studies, 23 longitudinal studies, 1 cross-sectional study design combined with a case-control design, and 1 longitudinal study design combined with a case-control design. Most of the studies reviewed indicate that the built environment factors that were positively associated with cognitive function in older adults were population density, street connectivity, walkability, number of public transportation stops around the residence, land use mix, neighborhood resources, green space, and quality of the neighborhood built environment. Built environment factors that were negatively associated with cognitive function in older adults were street integration, distance from residence to main road. The relationship between residential density, destination accessibility, and blue space with cognitive function in older adults needs to be further explored.

Conclusion

Preliminary evidence suggests an association between the neighborhood built environment and cognitive function in older adults. The causal relationship between the built environment and cognitive function can be further explored in the future using standardized and combined subjective and objective assessment methods, and longitudinal or quasi-experimental study designs. For public health interventions on the cognitive health of older adults, it is recommended that relevant authorities include the neighborhood built environment in their intervention programs.
Risk factors for short-term all-cause mortality in patients with end stage renal disease: a scoping review
Authors: Yip Wanfen , Ng Sheryl Hui Xian , Kaur Palvinder , George Pradeep Paul , Guan Jennifer Huey Chen , Lee Guozhang , Koh Timothy Jee Kam , Tan Woan Shin , Hum Allyn Yin Mei
Published: February 2024

Objectives

There is a lack of prognostic information to guide the prediction of short-term all-cause mortality in patients with end-stage renal disease (ESRD). The aim was to review the risk factors that influenced the risk of short-term all-cause mortality in patients with ESRD.

Methods

MEDLINE, Embase, PubMed, CINAHL, the Cochrane Library and Web of Science databases were searched for articles published between 2000 and 2020. Articles describing risk factors predicting short-term mortality (≤ 3 years) in patients with ESRD were included. Four reviewers independently performed title, abstract, full text screening and data extraction. Assessment of risk of bias was assessed using the Quality In Prognosis Studies (QUIPS) tool checklist.

Results

20,840 articles were identified and 113 papers were included for this review. Of the 113 papers, 6.2% included only peritoneal dialysis (PD) patients, 67.3% included only hemodialysis (HD) patients, 20.4% included both PD and HD patients, with the remaining papers featuring patients on conservative management or awaiting renal transplant. Risk factors were categorised into 13 domains: 1)demographics/ lifestyle, 2) comorbidities 3)intradialytic blood pressure, 4)biomarkers, 5)cardiovascular measurements, 6)frailty status, 7)medications, 8)treatment related indicators, 9)renal related parameters, 10)health status, 11)cause of ESRD, 12)access to healthcare care/ information and, 13)proxy measures for poor health. C-reactive protein(CRP), age, and functional status were observed to have higher percentage of instances of being significantly associated with all-cause mortality.

Conclusion

Commonly examined risk factors observed from this review may be used to build a general prognostic model for patients with ESRD, with specific treatment related risk factors added on to enhance the accuracy of the models.
ITGAM-mediated macrophages contribute to basement membrane damage in diabetic nephropathy and atherosclerosis
Authors: Lou Yude , Li Peng Hui , Liu Xiao Qi , Wang Tian Xiang , Liu Yi Lan , Chen Chen Chen , Ma Kun Ling
Published: February 2024

Background

Diabetic nephropathy (DN) and atherosclerosis (AS) are prevalent and severe complications associated with diabetes, exhibiting lesions in the basement membrane, an essential component found within the glomerulus, tubules, and arteries. These lesions contribute significantly to the progression of both diseases, however, the precise underlying mechanisms, as well as any potential shared pathogenic processes between them, remain elusive.

Methods

Our study analyzed transcriptomic profiles from DN and AS patients, sourced from the Gene Expression Omnibus database. A combination of integrated bioinformatics approaches and machine learning models were deployed to identify crucial genes connected to basement membrane lesions in both conditions. The role of integrin subunit alpha M (ITGAM) was further explored using immune infiltration analysis and genetic correlation studies. Single-cell sequencing analysis was employed to delineate the expression of ITGAM across different cell types within DN and AS tissues.

Results

Our analyses identified ITGAM as a key gene involved in basement membrane alterations and revealed its primary expression within macrophages in both DN and AS. ITGAM was significantly correlated with tissue immune infiltration within these diseases. Furthermore, the expression of genes encoding core components of the basement membrane was influenced by the expression level of ITGAM.

Conclusion

Our findings suggest that macrophages may contribute to basement membrane lesions in DN and AS through the action of ITGAM. Moreover, therapeutic strategies that target ITGAM may offer potential avenues to mitigate basement membrane lesions in these two diabetes-related complications.
Investigation of alterations in retrobulbar hemodynamics and their correlation with choroidal thickness after strabismus surgery
Authors: Uzun Aslihan , Altas Hilal , Sahin Asena Keles
Published: February 2024

Background

To evaluate the changes in retrobulbar circulation after strabismus surgery and to assess the relationship of these changes with choroidal thickness (CT).

Methods

This prospective study included 26 eyes of 26 patients who underwent strabismus surgery and 15 eyes of 15 healthy individuals as control group. The patients who had single horizontal muscle surgery were included in Group 1 (n = 14); and those who had surgery on both horizontal muscles were included in Group 2 (n = 12). Peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index (RI) and pulsatility index (PI) of ophthalmic artery (OA), posterior ciliary artery (PCA), and central retinal artery (CRA) were measured using Color Doppler Ultrasonography. Subfoveal CT was measured via Optical Coherence Tomography. All measurements were obtained preoperatively, at 1st week and 1st month after surgery.

Results

There were no differences regarding preoperative blood flow velocity parameters among the groups. OA RI increased significantly at 1st week and 1st month after surgery in Group 1 and 2 (P = 0.029 and P = 0.045, respectively). There was a significant increase in PCA PSV at 1st week in Group 1 (P = 0.002). There was no difference between the mean preoperative and postoperative CT among the 3 groups. A negative correlation between the percentage changes of CT and CRA EDV was found in Group 2 (P = 0.011).

Conclusion

Single and double horizontal rectus muscle surgery have a measurable effect on retrobulbar hemodynamics but these changes do not correlate with CT.
Artificial intelligence-based model for predicting pulmonary arterial hypertension on chest x-ray images
Authors: Imai Shun , Sakao Seiichiro , Nagata Jun , Naito Akira , Sekine Ayumi , Sugiura Toshihiko , Shigeta Ayako , Nishiyama Akira , Yokota Hajime , Shimizu Norihiro , Sugawara Takeshi , Nomi Toshiaki , Honda Seiwa , Ogaki Keisuke , Tanabe Nobuhiro , Baba Takayuki , Suzuki Takuji
Published: February 2024

Background

Pulmonary arterial hypertension is a serious medical condition. However, the condition is often misdiagnosed or a rather long delay occurs from symptom onset to diagnosis, associated with decreased 5-year survival. In this study, we developed and tested a deep-learning algorithm to detect pulmonary arterial hypertension using chest X-ray (CXR) images.

Methods

From the image archive of Chiba University Hospital, 259 CXR images from 145 patients with pulmonary arterial hypertension and 260 CXR images from 260 control patients were identified; of which 418 were used for training and 101 were used for testing. Using the testing dataset for each image, the algorithm outputted a numerical value from 0 to 1 (the probability of the pulmonary arterial hypertension score). The training process employed a binary cross-entropy loss function with stochastic gradient descent optimization (learning rate parameter, α = 0.01). In addition, using the same testing dataset, the algorithm’s ability to identify pulmonary arterial hypertension was compared with that of experienced doctors.

Results

The area under the curve (AUC) of the receiver operating characteristic curve for the detection ability of the algorithm was 0.988. Using an AUC threshold of 0.69, the sensitivity and specificity of the algorithm were 0.933 and 0.982, respectively. The AUC of the algorithm’s detection ability was superior to that of the doctors.

Conclusion

The CXR image-derived deep-learning algorithm had superior pulmonary arterial hypertension detection capability compared with that of experienced doctors.
Improving the diagnosis of active tuberculosis: a novel approach using magnetic particle-based chemiluminescence LAM assay
Authors: Li Yan , Ru Zhiwei , Wei Hongxia , Wu Ming , Xie Guihua , Lou Jianrong , Yang Xiang , Zhang Xilin
Published: February 2024

Objectives

Tuberculosis (TB) is a significant global health concern, given its high rates of morbidity and mortality. The diagnosis using urine lipoarabinomannan (LAM) primarily benefits HIV co-infected TB patients with low CD4 counts. The focus of this study was to develop an ultra-sensitive LAM assay intended for diagnosing tuberculosis across a wider spectrum of TB patients.

Design & Methods

To heighten the sensitivity of the LAM assay, we employed high-affinity rabbit monoclonal antibodies and selected a highly sensitive chemiluminescence LAM assay (CLIA-LAM) for development. The clinical diagnostic criteria for active TB (ATB) were used as a control. A two-step sample collection process was implemented, with the cutoff determined initially through a ROC curve. Subsequently, additional clinical samples were utilized for the validation of the assay.

Results

In the assay validation phase, a total of 87 confirmed active TB patients, 19 latent TB infection (LTBI) patients, and 104 healthy control samples were included. Applying a cutoff of 1.043 (pg/mL), the CLIA-LAM assay demonstrated a sensitivity of 55.2% [95%CI (44.13%~65.85%)], and a specificity of 100% [95%CI (96.52%~100.00%)], validated against clinical diagnostic results using the Mann-Whitney U test. Among 11 hematogenous disseminated TB patients, the positive rate was 81.8%. Importantly, the CLIA-LAM assay consistently yielded negative results in the 19 LTBI patients.

Conclusion

Overall, the combination of high-affinity antibodies and the CLIA method significantly improved the sensitivity and specificity of the LAM assay. It can be used for the diagnosis of active TB, particularly hematogenous disseminated TB.
A possible correlation between facet orientation and development of degenerative cervical spinal stenosis
Authors: Abudouaini Haimiti , Yang Junsong , Lin Kaiyuan , Meng Yibing , Zhang Hong , Wang Sibo
Published: February 2024

Background

Previous studies have demonstrated the relationship between sagittal facet orientation and cervical degenerative spondylolisthesis. However, the associations between facet orientation and cervical spinal stenosis (CSS) have rarely been studied.

Methods

One hundred twenty patients with CSS (CSS group) and 120 healthy participants (control group) were consecutively enrolled. The cervical facet angles and anteroposterior diameter (A-P diameter) of spinal canal at each subaxial cervical levels were measured using axial magnetic resonance imaging. The intersection angle of the midsagittal line of the vertebra to the facet line represents the orientation of the facet joint.

Results

The facet angles on the right side at C2- C3 and C3-C4 in CSS group and at C2- C3 in control group had significantly higher values than those of the other sides. Besides, the facet angles and A-P diameter of spinal canal in CSS group were significantly smaller than those in control group at all levels (p < 0.05).

Conclusions

Our study demonstrated that patients with CSS have smaller axial cervical facet joint angles compared to the healthy individuals. Further studies are needed to elicit the specific underlying mechanism between sagittalization of the cervical facet joints and the pathology of CSS.