bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic and prognostic value of stress CMR imaging to evaluate stable chest pain: a twenty-year meta-analysis
Authors: Bisaccia G , Ricci F , Khanji M Y , Gallina S , Petersen S E , Bucciarelli-Ducci C
Published: June 2023

Funding Acknowledgements

Type of funding sources: None.

Background

Assessment of inducible ischemia with stress cardiovascular magnetic resonance (CMR) is recommended in patients with chest pain and intermediate or high pre-test probability of coronary artery disease (CAD). We aimed to provide a contemporary quantitative data synthesis on diagnostic accuracy and prognostic value of stress CMR in patients with stable chest pain syndromes.

Methods

We performed a prespecified systematic review and meta-analysis of studies published over the last twenty years on the diagnostic and prognostic value of stress CMR (PROSPERO: CRD42022299275). We measured pooled diagnostic indicators, including diagnostic odds ratio (DOR), sensitivity, specificity, area under the curve (AUC), and summary effect size indicators, including odds ratios (ORs) and cumulative annualized event rates (AERs) for all-cause death, cardiovascular death and major adverse cardiac events (MACE).

Results

We identified 33 diagnostic studies pooling 7,815 individuals (mean age, 62 years, 62% males) and 31 prognostic studies pooling 67,080 patients (mean age, 62 years; 57% males; mean follow-up 3.5 years for a total of 381,357 person-years). Stress CMR yielded a pooled DOR of 26.4 (95%CI:10.6–65.9), a sensitivity of 81% (95%CI:68–89%), a specificity of 86% (95%CI:75–93%), and an AUC of 0.84 (95%CI:0.77–0.89) for the detection of functionally obstructive CAD with fractional flow reserve as the reference test. In subgroup analysis, 3 Tesla imaging yielded higher diagnostic accuracy achieving a DOR of 33.2. Presence of stress-inducible ischemia was associated with higher all-cause mortality (OR:2.0; 95%CI:1.7–2.3), cardiovascular mortality (OR:6.4; 95%CI:4.5–9.1), and increased risk of MACE (OR:5.3; 95%CI:4.0–7.0). AERs for cardiovascular death and MACE were < 1% in patients without stress-inducible ischemia.

Conclusion

Stress CMR yields high diagnostic accuracy and delivers robust prognostication in patients with stable chest pain and known or suspected CAD, particularly with 3 Tesla imaging. While inducible ischemia portends excess mortality and increased risk of MACE, a negative stress CMR indicates a very low risk of future cardiovascular events, with a warranty period of at least 3.5 years.
The generation of the first chromosome-level de novo genome assembly and the development and validation of a 50K SNP array for the St. John River aquaculture strain of North American Atlantic salmon
Authors: Gao Guangtu , Waldbieser Geoffrey C , Youngblood Ramey C , Zhao Dongyan , Pietrak Michael R , Allen Melissa S , Stannard Jason A , Buchanan John T , Long Roseanna L , Milligan Melissa , Burr Gary , Mejía-Guerra Katherine , Sheehan Moira J , Scheffler Brian E , Rexroad Caird E , Peterson Brian C , Palti Yniv
Published: June 2023

Atlantic salmon (Salmo salar) in Northeastern US and Eastern Canada has high economic value for the sport fishing and aquaculture industries. Large differences exist between the genomes of Atlantic salmon of European origin and North American (N.A.) origin. Given the genetic and genomic differences between the 2 lineages, it is crucial to develop unique genomic resources for N.A. Atlantic salmon. Here, we describe the resources that we recently developed for genomic and genetic research in N.A. Atlantic salmon aquaculture. Firstly, a new single nucleotide polymorphism (SNP) database for N.A. Atlantic salmon consisting of 3.1 million putative SNPs was generated using data from whole-genome resequencing of 80 N.A. Atlantic salmon individuals. Secondly, a high-density 50K SNP array enriched for the genic regions of the genome and containing 3 sex determination and 61 putative continent of origin markers was developed and validated. Thirdly, a genetic map composed of 27 linkage groups with 36K SNP markers was generated from 2,512 individuals in 141 full-sib families. Finally, a chromosome-level de novo genome assembly from a male N.A. Atlantic salmon from the St. John River aquaculture strain was generated using PacBio long reads. Information from Hi-C proximity ligation sequences and Bionano optical mapping was used to concatenate the contigs into scaffolds. The assembly contains 1,755 scaffolds and only 1,253 gaps, with a total length of 2.83 Gb and N50 of 17.2 Mb. A BUSCO analysis detected 96.2% of the conserved Actinopterygii genes in the assembly, and the genetic linkage information was used to guide the formation of 27 chromosome sequences. Comparative analysis with the reference genome assembly of the European Atlantic salmon confirmed that the karyotype differences between the 2 lineages are caused by a fission in chromosome Ssa01 and 3 chromosome fusions including the p arm of chromosome Ssa01 with Ssa23, Ssa08 with Ssa29, and Ssa26 with Ssa28. The genomic resources we have generated for Atlantic salmon provide a crucial boost for genetic research and for management of farmed and wild populations in this highly valued species.
The organizational and technological origins of the U.S. shale gas revolution, 1947 to 2012
Authors: Kapoor Rahul , Murmann Johann Peter
Published: June 2023

We explore the origins and the development of hydraulic fracking technology that made possible United States’ unexpected rise as a top producer of oil and gas. As hydraulic fracking was first used extensively to produce shale gas and only later to produce shale oil, we focus on analyzing what is often referred to as the “shale gas revolution.” We trace how the shale gas ecosystem evolved, what role different actors played in the unexpected shale gas revolution, and how the strategies and knowledge bases of the different actors differed and evolved over time.
Analysis of thermoelectric effect of wet spun graphene fiber composites
Authors: Dlimi Said , Elmourabit Fahd , Ouissaaden Fatima Id , Khoukh Abdelaziz , Limouny Lhoussine , Baghaz Elhadi , El kaaouachi Abdelhamid
Published: June 2023

In this manuscript, we have theoretically reanalyzed data prepared and already published by Foroughi et al. (RSC Adv 2016;6:46427–32). These data concern the thermal energy dependence of the electrical conductivity of the samples: graphene fiber, graphene/poly(3,4-ethylenedioxythiophene) (graphene/PEDOT), graphene/carbon nanotube (graphene/CNT) and graphene/carbon nonotube/poly(3,4-ethylenedioxythiophene) (graphene/CNT/PEDOT) composite fibers. We investigate the behavior of the thermal conductivity for these four samples. These samples are considered as thermoelectric materials or green energy conversion materials using the Seebeck effect to transform heat into electrical energy and vice versa. In this context, the optimization of the merit factor ZT remains a challenge for the scientific community. The objective of this investigation is to evaluate and characterize the thermoelectric efficiency of the above-mentioned samples. We confront the experimental data with the existing theoretical models. The thermoelectric efficiency is generally characterized by the merit factor ZT. The maximum ZT of about 1,2 is obtained in the graphene fiber and between 0,1 and 0,2 in the others samples. The performance of the material depends on ZT; indeed a high ZT ($\mathrm{ZT}\ge 1$) corresponds to a better optimization of the composite.
Effect of increasing dietary fermentable fiber on diet nutrient digestibility and estimation of endogenous phosphorus losses in growing pigs
Authors: Heyer Charlotte M E , Wang Li Fang , Beltranena Eduardo , Rodehutscord Markus , Zijlstra Ruurd T
Published: June 2023

Fermentable fiber may increase endogenous losses of phosphorus (EPL) and amino acids (AA), thereby reducing apparent nutrient digestibility. Acacia gum with medium-to-high fermentability and low viscosity was increasingly included in diets to investigate its effect on apparent ileal digestibility (AID) and apparent total tract digestibility (ATTD) of nutrients, gross energy (GE), and standardized total tract digestibility (STTD) of P in growing pigs. A control diet (49% cornstarch; 18% bovine plasma protein) was formulated to measure basal EPL. Three additional diets were formulated to include 2.5%, 5.0%, or 7.5% acacia gum at the expense of cornstarch. Diets contained 16.1% to 17.4% CP and 0.31% to 0.33% total P (DM-basis). The four diets were fed to eight ileal-cannulated barrows (initial BW, 54.6 kg) for four 9 d periods in a double 4 × 4 Latin square. Apparent hindgut fermentation (AHF) was calculated as ATTD minus AID. Feeding increasing acacia gum quadratically affected (P < 0.05) AID of DM, GE, linearly decreased (P < 0.05) ATTD of DM, crude protein (CP), GE, digestible (DE) and predicted net energy (NE) value of diets, and linearly increased (P < 0.001) AHF of DM and GE. Increasing acacia gum did not affect AID and standardized ileal digestibility (SID) of CP and AA. Basal EPL was 377 mg/kg DM intake (DMI) and increasing acacia gum linearly increased (P < 0.05) total tract EPL. Increasing acacia gum linearly decreased (P < 0.05) diet ATTD of P, and STTD of P based on either the calculated EPL or NRC (2012) recommended value (190 mg P/kg DMI). Increasing acacia gum did not affect AID and ATTD of Ca of diets. In conclusion, feeding increasing dietary fermentable, low-viscous acacia gum decreased diet AID and ATTD of DM and GE, but did not affect AID or SID of CP and AA. Increasing acacia gum decreased ATTD of P, which might have been due to increased specific endogenous losses of P in the total tract of growing pigs.
Perifascial Areolar Tissue Transplantation for Covering Exposed Proximal Interphalangeal Joint After Electric Burn
Authors: Oshima Junya , Sasaki Masahiro , Sasaki Kaoru , Sekido Mitsuru
Published: June 2023

Soft tissue damage in electric burn injuries is often deep and may expose tendons, bones, or joints in the hand. Here, we present the case of a 76-year-old man treated using perifascial areolar tissue (PAT) transplantation for covering the proximal interphalangeal joint of the middle finger, which had been exposed because of an electric burn. Following ointment therapy, surgery was performed on day 34 postinjury when a deep ulcer with opening of the proximal interphalangeal joint was observed on the dorsum of the right middle finger. After resecting the cartilage of the proximal interphalangeal articular surface, two Kirschner wires were inserted, and arthrodesis was performed. PAT was harvested from the left inguinal region and applied to the joint exposed wound of the middle finger. Full-thickness skin graft was applied over it. Three months after surgery, the preserved middle finger could be used as a functional finger. PAT transplantation does not require microsurgery techniques, is simple and minimally invasive, and has a short treatment period, so it may be an effective option for treating wounds in which exposed ischemic tissue is present. Soft tissue damage in electric burn injuries is often deep and may expose tendons, bones, and joints in the hand, which is the most common affected site. Here, we report a case treated using perifascial areolar tissue (PAT) transplantation for covering the proximal interphalangeal joint of the middle finger, which had been exposed because of an electric burn.
Barriers and facilitators to implementation of healthy food and drink policies in public sector workplaces: a systematic literature review
Authors: Rosin Magda , Mackay Sally , Gerritsen Sarah , Te Morenga Lisa , Terry Gareth , Ni Mhurchu Cliona
Published: June 2023

Context

Many countries and institutions have adopted policies to promote healthier food and drink availability in various settings, including public sector workplaces.

Objective

The objective of this review was to systematically synthesize evidence on barriers and facilitators to implementation of and compliance with healthy food and drink policies aimed at the general adult population in public sector workplaces.

Data Sources

Nine scientific databases, 9 grey literature sources, and government websites in key English-speaking countries along with reference lists.

Data Extraction

All identified records (N = 8559) were assessed for eligibility. Studies reporting on barriers and facilitators were included irrespective of study design and methods used but were excluded if they were published before 2000 or in a non-English language.

Data Analysis

Forty-one studies were eligible for inclusion, mainly from Australia, the United States, and Canada. The most common workplace settings were healthcare facilities, sports and recreation centers, and government agencies. Interviews and surveys were the predominant methods of data collection. Methodological aspects were assessed with the Critical Appraisal Skills Program Qualitative Studies Checklist. Generally, there was poor reporting of data collection and analysis methods. Thematic synthesis identified 4 themes: (1) a ratified policy as the foundation of a successful implementation plan; (2) food providers’ acceptance of implementation is rooted in positive stakeholder relationships, recognizing opportunities, and taking ownership; (3) creating customer demand for healthier options may relieve tension between policy objectives and business goals; and (4) food supply may limit the ability of food providers to implement the policy.

Conclusions

Findings suggest that although vendors encounter challenges, there are also factors that support healthy food and drink policy implementation in public sector workplaces. Understanding barriers and facilitators to successful policy implementation will significantly benefit stakeholders interested or engaging in healthy food and drink policy development and implementation.

Systematic Review Registration

PROSPERO registration no. CRD42021246340.
Local Social Vulnerability as a Predictor for Cancer-Related Mortality Among US Counties
Authors: Chen Krista Y , Blackford Amanda L , Sedhom Ramy , Gupta Arjun , Hussaini S M Qasim
Published: June 2023

Substantial gaps in national healthcare spending and disparities in cancer mortality rates are noted across counties in the US. In this cross-sectional analysis, we investigated whether differences in local county-level social vulnerability impacts cancer-related mortality. We linked county-level age-adjusted mortality rates (AAMR) from the Centers for Disease Control and Prevention (CDC) Wide-ranging Online Data for Epidemiologic Research database, to county-level Social Vulnerability Index (SVI) from the CDC Agency for Toxic Substances and Disease Registry. SVI is a metric comprising 15 social factors including socioeconomic status, household composition and disability, minority status and language, and housing type and transportation. AAMRs were compared between least and most vulnerable counties using robust linear regression models. There were 4 107 273 deaths with an overall AAMR of 173 per 100 000 individuals. Highest AAMRs were noted in older adults, men, non-Hispanic Black individuals, and rural and Southern counties. Highest mortality risk increases between least and most vulnerable counties were noted in Southern and rural counties, individuals aged 45-65, and lung and colorectal cancers, suggesting that these groups may face highest risk for health inequity. These findings inform ongoing deliberations in public health policy at the state and federal level and encourage increased investment into socially disadvantaged counties.
Plant-specific BLISTER interacts with kinase BIN2 and BRASSINAZOLE RESISTANT1 during skotomorphogenesis
Authors: Yang Ruizhen , Liu Pan , Zhang Tianren , Dong Huixue , Jing Yexing , Yang Ziyi , Tang Sha , Zhang Yu , Lv Mingjie , Liu Jun , Zhang Yunwei , Qiao Weihua , Liu Jie , Sun Jiaqiang
Published: June 2023

Brassinosteroids play an essential role in promoting skotomorphogenesis, yet the underlying mechanisms remain unknown. Here we report that a plant-specific BLISTER (BLI) protein functions as a positive regulator of both BR signaling and skotomorphogenesis in Arabidopsis (Arabidopsis thaliana). We found that the glycogen synthase kinase 3 (GSK3)-like kinase BRASSINOSTEROID INSENSITIVE2 interacts with and phosphorylates BLI at 4 phosphorylation sites (Ser70, Ser146, Thr256, and Ser267) for degradation; in turn, BR inhibits degradation of BLI. Specifically, BLI cooperates with the BRASSINAZOLE RESISTANT1 (BZR1) transcription factor to facilitate the transcriptional activation of BR-responsive genes. Genetic analyses indicated that BLI is essentially required for BZR1-mediated hypocotyl elongation in the dark. Intriguingly, we reveal that BLI and BZR1 orchestrate the transcriptional expression of gibberellin (GA) biosynthetic genes to promote the production of bioactive GAs. Our results demonstrate that BLI acts as an essential regulator of Arabidopsis skotomorphogenesis by promoting BR signaling and GA biosynthesis.
Brazilian Air Force acquisition policies: observing absorptive capacity and contingent factors in aeronautical beneficiary companies
Authors: Caliari Thiago , Bovo Mayara , Urbina Lígia Maria Soto , Scarpel Rodrigo Arnaldo
Published: June 2023

The offset agreement (OA) of the Brazilian Air Force (FAB) is a demand-side policy aiming to improve innovative capacities. However, it may be constrained by companies’ absorptive capacities, relationship features, and sectoral specificities. This study examines these issues in a small but representative sample of domestic beneficiary firms from the FAB’s OA. The model in the study by Zahra and George, along with contingent factors such as power relationship and social integration mechanisms, inspired the design of the research tools. The results point to similar and high firms’ absorptive capacities, regardless of the origins of capital. However, results show distinct benefit perceptions given by contingent factors, companies’ strategies, and sectoral specificities, which may denote distinct possibilities on cumulativeness and appropriability from technology transfer. We expect that these findings may improve the planning, monitoring, evaluation, and adjustments of this demand-side policy, attracting attention to new studies on the theme.
Standards of Care in Social Work: Ethical and Risk Management Implications
Authors: Reamer Frederic G
Published: June 2023

Social workers are sometimes named as defendants in malpractice lawsuits. These lawsuits allege negligence, specifically that social work defendants owed a duty to the plaintiff, breached this duty, and the defendant’s actions caused harm. Plaintiffs in litigation cases typically allege that social workers violated or failed to meet prevailing standards of care in the profession. It is essential that social workers understand the legal concept of standard of care and its implications for professional practice. This article reviews the concept of standard of care; discusses the ways in which social work ethics standards, federal and state laws, national practice standards, expert witness testimony, and professional literature determine the standard of care; and presents practical steps social workers can take to comply with prevailing standards of care, protect clients, and protect themselves. The author focuses especially on complex cases where social workers may not agree on relevant standards of care.
Pediatric Complex Regional Pain Syndrome With and Without a History of Prior Physical Trauma at Onset
Authors: Sherry David D. , Mondal Antara , McGill Mackenzie , Gmuca Sabrina
Published: June 2023

Objective:

To determine if differences exist between children with complex regional pain syndrome (CRPS) who identify an inciting physical traumatic event (Group T) versus those without such history (Group NT).

Methods:

We performed a single center, retrospective study of children diagnosed with CRPS ≤18 years old presenting between April 2008 and March 2021 and enrolled in a patient registry. Abstracted data included clinical characteristics, pain symptoms, functional disability inventory, psychological history, pain catastrophizing scale for children (PCS-C). Charts were reviewed for outcome data.

Results:

We identified 301 children with CRPS, 95 (64%) reported a prior physical trauma. There was no difference between the groups regarding age, sex, duration, pain level, function, psychological symptoms, and scores on the PCS-C. However, those in group T were more likely to have had a cast (43% vs. 23%, P<0.001). Those in group T were less likely to experience complete resolution of symptoms (64% vs. 76%, P=0.036). There were no other outcome differences between the groups.

Discussion:

We found minimal differences in children with CRPS who report a prior history of physical trauma to those who do not. Physical trauma may not play as significant a role as does immobility, such as casting. The groups mostly had similar psychological backgrounds and outcomes.
Cuticular Poroma: A Rare Poroma Variant Simulating a Malignant Neoplasm That Often Harbors YAP1::NUTM1 Fusions Similar to Their Conventional Counterparts
Authors: Kolm Isabel , Konstantinova Anastasia M. , Kutzner Heinz , Barghorn Andre , Vanecek Tomas , Mangana Joanna , Kazakov Dmitry V.
Published: June 2023

Cuticular poroma is a rare variant of poroma composed of exclusively or predominantly cuticular cells, namely of large cells with ample eosinophilic cytoplasm. We report 7 cases of this rare tumor identified among 426 neoplasms diagnosed as poroma or porocarcinoma. The patients were 4 males and 3 females, ranging in age from 18 to 88 years. All presented with a solitary asymptomatic nodule. The location included knee (2 cases), shoulder, thigh, shin, lower arm, and neck (each 1). All lesions were surgically removed. No evidence of disease was observed in 5 patients with available follow-up (range 12–124 months).

Microscopically, all neoplasms were composed of variably sized, focally closed packed, or interconnecting nodules constituted mostly of cuticular cells. Small poroid cells were a focal feature in 5 tumors, whereas in the remaining 2 cases, poroid cells with conspicuous but still in minority. Five neoplasms were somewhat asymmetric, with irregular outlines. Ductal differentiation and intracytoplasmic vacuoles were seen in 6 tumors. Other features variably encountered were conspicuous intranuclear pseudoinclusions, cystic change, occasional multinucleated cells, increased mitoses, and stromal desmoplasia. Four of the 5 tumors analyzed with next-generation sequencing yielded YAP1::NUTM1 fusions. In addition, various mutations, mostly of unknown significance were identified in one neoplasm.
Application of finite element analysis in maxillofacial surgery biomechanics
Authors: Zhou Weihao , Guo Ziwei , El Akkawi Mariya Mohamad , Qi Xiangdong
Published: June 2023

Finite element analysis method is one of the important tools in biomechanics research, which has the characteristics of high efficiency, convenience, accuracy, low resource consumption, individuation, and repeatability. At present, it is widely used in maxillofacial surgery, such as the biomechanics of normal jaw, the mechanical research of temporomandibular joint disease, and the surgical effect of jaw fracture and of orthognathic surgery. In this paper, the application of finite element analysis in maxillofacial surgery is summarized by combining the principle of finite element analysis, and the shortcomings of finite element analysis in clinical application are explained to provide suggestions for future research.
A cone-beam computed tomography study of supernumerary teeth
Authors: Guo Jing , Jumatai Sakendeke , Dai Yonggang , Sun Jingwen , Gong Zhongcheng
Published: June 2023

Objectives:

The objective was to study the position and morphological characteristics of supernumerary teeth (ST) based on the cone beam computed tomography (CBCT) data to provide a reference for clinical diagnosis and treatment.

Materials and Methods:

CBCT imaging data and patient characteristics of 113 patients visiting our institution between January 2020 and January 2021 were collected and analyzed. The Chi square test was used to compare enumeration data between different groups, while the Student's t-test was used for measurement data.

Results:

Overall, 156 ST were found in 113 patients (82 men and 31 women). Among them, 73 patients had 1 ST, 37 had 2, and 3 had 3. The supernumeraries were maxillary and mandibular in 103 and 10 patients, respectively. A total of 136 teeth were found in the anterior area, of which 30 were in the midline region. Three teeth were in the premolar and molar regions. The teeth were mainly conical (118 teeth), followed by supplementary (24 teeth), tuberculate (10 teeth), and odontomatous (4 teeth), including 2 compound odontomas and 2 complex odontomas; 66 teeth were normally oriented, 62 were inverted, and 28 were transverse. There was a statistically significant relationship in ST between shape and arch, location and shape, and morphology and sagittal position and orientations (P < 0.05).

Conclusion:

CBCT is an essential tool for diagnosis, and it provides valuable information about the position and morphology of teeth, especially the relationship of teeth to adjacent structures objectively, stereoscopically, and comprehensively.
Chronic exposure to fine particles (PM2.5) and mortality: Evidence from Chile
Authors: Busch Pablo , Cifuentes Luis Abdón , Cabrera Camila
Published: June 2023

Background:

Many Chilean cities suffer from high air pollution from industrial, mobile, and residential wood-burning sources. Several studies have linked PM2.5 air pollution exposure to higher mortality risk from cardiovascular, pulmonary, and lung cancer causes. In recent years, Chile has developed an extensive air pollution monitoring network to enforce air quality standards for PM2.5, allowing the study of the medium-term association between PM2.5 and mortality.

Methods:

A negative binomial regression model was used to study the association between 3-year average PM2.5 concentrations and age-adjusted mortality rates for 105 of the 345 municipalities in Chile. Models were fitted for all (ICD10 A to Q codes), cardiopulmonary (I and J), cardiovascular (I), pulmonary (J), cancer (C), and lung cancer (C33-C34) causes; controlling for meteorological, socioeconomic, and demographic characteristics.

Results:

A significant association of PM2.5 exposure with cardiopulmonary (relative risk for 10 µg/m3 PM2.5: 1.06; 95% confidence interval = 1.00, 1.13) and pulmonary (1.11; 1.02, 1.20) age-adjusted mortality rates was found. Cardiovascular (1.06; 0.99, 1.13) and all causes (1.02; 0.98, 1.07) were positive, but not significant. No significant association was found between cancer and lung cancer. The positive associations remained even when controlling for multiple confounding factors, model specifications, and when considering different methods for exposure characterization. These estimates are in line with results from cohort studies from the United States and European studies.

Conclusion:

Three-year average PM2.5 exposure is positively associated with the age-adjusted mortality rate for cardiopulmonary and cardiovascular causes in Chile. This provides evidence of the medium-term exposure effect of fine particles on long-term mortality rates.
Eight-and-a-half syndrome in a patient with hypertensive emergencies
Authors: Taheri Sogand , Eshgabadi Amin , Fatuyi Michael , Rahima Kinan , Heil Jason
Published: June 2023

An 88-year-old white female was admitted with a hypertensive emergency and a sudden onset of abnormal extraocular movements and facial (cranial nerve VII) palsy. This article presents a case of the eight-and-a-half syndrome and discusses its underlying clinicopathology, including a review of the neuroanatomy related to the lesion causing the eight-and-a-half syndrome in this patient.
The association between brachial-ankle pulse-wave velocity and adverse cardiovascular events in 5719 community participants a prospective cohort study
Authors: Wang Yuhan , Liu Hongzhou , Wang Jincheng , Hu Xiaodong , Wang Anping , Chen Kang , Wang Anning , Zang Li , Cheng Yu , Gu Weijun , Dou Jingtao , Mu Yiming , Du Jin , Lyu Zhaohui
Published: June 2023

Background:

The brachial-ankle pulse-wave velocity (baPWV) is regarded as the gold standard in the evaluation of arterial stiffness. Its prognostic significance for major adverse cardiovascular events (MACE) has been demonstrated. However, the factors influencing the association between baPWV and MACE risk have not been determined. In this study, we investigated the association of baPWV and MACE risk and whether it is affected by the risk factors for different cardiovascular diseases (CVDs).

Methods:

This was a prospective cohort study that initially enrolled 6850 participants from 12 communities in Beijing. The participants were divided into three subgroups according to their baPWV values. The primary outcome was the first occurrence of MACE, defined as hospitalization from cardiovascular diseases, first occurrence of a nonfatal myocardial infarction, or nonfatal stroke. Cox proportional hazards regression and restricted cubic spline analyses were used to examine the association between baPWV and MACE. The effect of CVD risk factors on the relationship between baPWV and MACE was explored in subgroup analyses.

Results:

The final study population consisted of 5719 participants. During a median follow-up of 34.73 months, MACE occurred in 169 participants. The restricted cubic spline analysis indicated a positive linear relationship between baPWV and MACE risk. After adjustment for cardiovascular risk factors, the hazard ratio (HR) for MACE risk per SD increase in baPWV was 1.272 [95% confidence interval (CI): 1.149–1.407, P < 0.001], and the HR for MACE in the high-baPWV vs. the low-baPWV group was 1.965 (95% CI: 1.296–2.979, P = 0.001). Adding baPWV to the conventional cardiovascular risk factors significantly improved the model's prediction performance and the net reclassification (NRI) [NRI: 0.379 (95% CI: 0.072–0.710), P = 0.025] in MACE discrimination. However, in the subgroup analysis, two CVD risk factors, stable coronary heart disease and hypertension, showed significant interaction effects (P
interaction both < 0.05). This result indicated that the effect of CVD risk factors must be taken into account when assessing the relationship between baPWV and MACE.

Conclusion:

baPWV is a potential marker to improve the identification of MACE risk in the general population. A positive linear correlation was firstly determined between baPWV and MACE risk, but it may not be valid in participants with stable coronary heart disease and hypertension.
The Impact of Loving-Kindness Meditation on Compassion Fatigue of Nurses Working in the Neonatal Intensive Care Unit
Authors: Asadollah Fatemeh , Nikfarid Lida , Sabery Mahdieh , Varzeshnejad Maryam , Hashemi Fatemeh
Published: June 2023

Compassion fatigue is a common complication in nurses, which can lead to burnout, job dissatisfaction, and a decline in the quality of patient care. This study aimed to investigate the impact of loving-kindness meditation on compassion fatigue of nurses working in the neonatal intensive care unit (NICU). This cluster-blinded randomized clinical trial study was conducted on 66 NICU nurses in 2 educational hospitals selected. The intervention group received a 1-month online program for daily training and practice of loving-kindness meditation. The control group received miscellaneous files on mental health during the COVID-19 pandemic period. The Nursing Compassion Fatigue Inventory (NCFI) was filled out by the 2 groups, before and after the intervention. The results showed that the mean scores of the NCFI in the intervention group decreased significantly compared with before the intervention (P = .002). In comparison with the control group, there was a significant difference between the mean scores of the 2 groups after the intervention (P = .034). Among nurses working in NICU, loving-kindness meditation significantly reduces compassion fatigue after 1 month. These findings support the use of this intervention for nurses.
Mild Traumatic Brain Injury Does Not Significantly Affect Midlife Cognitive Functioning Within the General Population: Findings From a Prospective Longitudinal Birth Cohort Study
Authors: Theadom Alice , Barker-Collo Suzanne , Parag Varsha , Caspi Avshalom , Moffitt Terri E. , Hogan Sean , Ramrakha Sandhya , Poulton Richie
Published: June 2023

Objective:

To determine whether differences exist in mid-adulthood cognitive functioning in people with and without history of mild traumatic brain injury (mTBI).

Setting:

Community-based study.

Participants:

People born between April 1, 1972, and March 31, 1973, recruited into the Dunedin Multidisciplinary Health and Development Longitudinal Study, who completed neuropsychological assessments in mid-adulthood. Participants who had experienced a moderate or severe TBI or mTBI in the past 12 months were excluded.

Design:

Longitudinal, prospective, observational study.

Main Measures:

Data were collected on sociodemographic characteristics, medical history, childhood cognition (between 7 and 11 years), and alcohol and substance dependence (from 21 years of age). mTBI history was determined from accident and medical records (from birth to 45 years of age). Participants were classified as having 1 mTBI and more in their lifetime or no mTBI. The Wechsler Adult Intelligence Scale (WAIS-IV) and Trail Making Tests A and B (between 38 and 45 years of age) were used to assess cognitive functioning. T tests and effect sizes were used to identify any differences on cognitive functioning domains between the mTBI and no mTBI groups. Regression models explored the relative contribution of number of mTBIs and age of first mTBI and sociodemographic/lifestyle variables on cognitive functioning.

Results:

Of the 885 participants, 518 (58.5%) had experienced at least 1 mTBI over their lifetime, with a mean number of 2.5 mTBIs. The mTBI group had significantly slower processing speed (P < .01, d = 0.23) in mid-adulthood than the no TBI controls, with a medium effect size. However, the relationship no longer remained significant after controlling for childhood cognition, sociodemographic and lifestyle factors. No significant differences were observed for overall intelligence, verbal comprehension, perceptual reasoning, working memory, attention, or cognitive flexibility. Childhood cognition was not linked to likelihood of sustaining mTBI later in life.

Conclusion:

mTBI histories in the general population were not associated with lower cognitive functioning in mid-adulthood once sociodemographic and lifestyle factors were taken into account.
Characterization of the Immediate and Delayed Biomechanical Response to UV-A Crosslinking of Human Corneas
Authors: Ross Andrea K. M. , Schlunck Günther , Böhringer Daniel , Maier Philip , Eberwein Philipp , Reinhard Thomas , Lang Stefan Johann
Published: June 2023

Purpose:

Keratoconus leads to visual deterioration due to irregular astigmatism and corneal thinning. Riboflavin-based corneal UV-A crosslinking (CXL) induces novel intramolecular and intermolecular links resulting in corneal tissue stiffening, thereby halting disease progression. The purpose of this study was to analyze the immediate and delayed biomechanical responses of human donor corneas to CXL.

Methods:

CXL was performed according to the Dresden protocol to corneas not suitable for transplantation. Biomechanical properties were subsequently monitored by measuring the Young modulus using nanoindentation. The immediate tissue response was determined after 0, 1, 15, and 30 minutes of irradiation. Delayed biomechanical effects were investigated with follow-up measurements immediately and 1, 3, and 7 days after CXL.

Results:

Young's modulus indicated a linear trend in direct response to increasing irradiation times (mean values: total 61.31 kPa [SD 25.53], 0 minutes 48.82 kPa [SD 19.73], 1 minute 53.44 kPa [SD 25.95], 15 minutes 63.56 kPa [SD 20.99], and 30 minutes 76.76 kPa [SD 24.92]). The linear mixed model for the elastic response of corneal tissue was 49.82 kPa + (0.91 kPa/min × time [minutes]); P < 0.001. The follow-up measurements showed no significant delayed changes in the Young modulus (mean values: total 55,28 kPa [SD 15.95], immediately after CXL 56,83 kPa [SD 18.74], day 1 50.28 kPa [SD 14.15], day 3 57.08 kPa [SD 14.98], and day 7 56.83 kPa [SD 15.07]).

Conclusions:

This study suggests a linear increase of corneal Young modulus as a function of CXL timing. No significant short-term delayed biomechanical changes posttreatment were observed.
Efficacy of vaginal natural orifice transluminal endoscopic sentinel lymph node biopsy for endometrial cancer: a prospective multicenter cohort study
Authors: Deng Li , Liu Yi , Yao Yuanyan , Deng Yuan , Tang Shuai , Sun Li , Wang Yanzhou
Published: June 2023

Introduction:

Natural-orifice transluminal endoscopic surgery (NOTES) is performed increasingly often despite the lack of high-quality evidence confirming its safety, especially for malignant diseases. The aim of this prospective study is to verify that vaginal NOTES (vNOTES) can be performed safely and effectively in early endometrial cancer staging surgery.

Materials:

This prospective study was conducted in two tertiary hospitals in southern China from January 2021 to May 2022. A total of 120 patients with stage I endometrial cancer were included. vNOTES or multiport laparoscopic staging surgery was selected according to each patient’s wishes. The primary outcome was the sentinel lymph node (SLN) detection rate, analyzed by a noninferiority test. The secondary outcomes were perioperative outcomes.

Results:

Among the 120 patients enrolled, 57 underwent vNOTES, and 63 underwent multiport laparoscopy. The patient-specific detection rates of SLNs were 94.73% and 96.82% in the vNOTES and laparoscopy groups, respectively. Additionally, the bilateral detection rates were 82.46% and 84.13%, and the side-specific detection rates were 88.60% and 90.48% in these two groups, respectively. All three detection rates in the vNOTES group were noninferior to those of laparoscopy group at a noninferiority cutoff of -15%. The median operation times of the vNOTES and laparoscopy groups were 132.35 and 138.73 minutes (P=0.362), and the median estimated blood loss were 75 and 50 ml (P=0.096), respectively. No intraoperative complications occurred in either group. The pain scores on the Numerical Rating Scale (NRS) at both 12 hours and 24 hours after operation were significantly lower in the vNOTES group (P<0.001) and the median postoperative hospital stay was significantly shorter in the vNOTES group (P=0.001).

Conclusion:

This study illustrates the potential applicability of vNOTES in gynecological malignancy surgery by demonstrating its safety and effectiveness in endometrial cancer staging. However, its long-term survival outcomes require further exploration.
Glyceryl trinitrate-induced blood pressure variability decrease during head-up tilt test predicts vasovagal response
Authors: Meglič Bernard , Danieli Aljoša
Published: June 2023

Purpose

Glyceryl trinitrate (GTN) provoked cardioinhibitory syncope during the head-up tilt test is preceded by a period of disrupted blood pressure variability (BPV). Endogenous nitric oxide (NO) attenuates BPV independently of blood pressure (BP). We hypothesized that exogenous NO donor GTN might decrease BPV during the presyncope period. A decrease in BPV may predict the tilt outcome.

Methods

We analyzed 29 tilt test recordings of subjects with GTN-induced cardioinhibitory syncope and 30 recordings of negative subjects. A recursive autoregressive model of BPV after GTN was performed; powers of the respiratory (0.15–0.45 Hz) and nonrespiratory frequency (0.01–0.15 Hz) bands were calculated for each of the 20 normalized time periods. The post-GTN relative changes in heart rate, BP, and BPV were calculated.

Results

In the syncope group, spectral power of nonrespiratory frequency systolic and diastolic BPV progressively felt for 30% after GTN application and stabilized after 180 s. BP started to fall 240 s after the GTN application. Decrease in nonrespiratory frequency power of diastolic BPV 20 s after GTN administration predicted cardioinhibitory syncope (area under the curve 0.811; 77% sensitivity; 70% specificity; cutoff value > 7%).

Conclusion

GTN application during the tilt test attenuates systolic and diastolic nonrespiratory frequency BPV during the presyncope period, independent of BP. A decrease in nonrespiratory frequency diastolic BPV 20 s after GTN application predicts cardioinhibitory syncope with good sensitivity and moderate specificity.
Development of saliva-based cardiac troponin I point-of-care test using alpha-amylase depletion: a feasibility study
Authors: Westreich Roi , Tsaban Gal , Neumann Yoav , Abu Salman Amjad , Braver Omri , Braiman Dana , Zamed Tali , Neuhaus Zipora Feiga , Deutsch Omer , Palmon Aaron , Maimon Nimrod , Zahger Doron , Abramowitz Yigal
Published: June 2023

Introduction:

Cardiac troponin (cTn) is the biomarker of choice for detection of myocardial injury. There is a great need for simple point-of-care (POC) troponin testing among patients with chest pain, mainly in the prehospital setting. The purpose of this study was to evaluate the presence of cardiac troponin I (cTnI) in saliva of patients with myocardial injury using alpha-amylase depletion technique.

Methods:

Saliva samples were collected from 40 patients with myocardial injury who were tested positive for conventional high-sensitivity cardiac troponin T (cTnT) blood tests, and from 66 healthy volunteers. Saliva samples were treated for the removal of salivary alpha-amylase. Treated and untreated samples were tested with blood cTnI Rapid Diagnostic Test. Salivary cTnI levels were compared to blood cTnT levels.

Results:

Thirty-six of 40 patients with positive blood cTnT had positive salivary samples for cTnI following alpha-amylase depletion treatment (90.00% sensitivity). Moreover, three of the four negative saliva samples were obtained from patients with relatively low blood cTnT levels of 100 ng/L or less (96.88% sensitivity for 100 ng/L and above). The negative predictive value was 93.65% and rose up to 98.33% considering the 100 ng/L cutoff. Positive predictive values were 83.72% and 81.58%, respectively. Among 66 healthy volunteers and 7 samples yielded positive results (89.39% specificity).

Conclusion:

In this preliminary work, the presence of cTnI in saliva was demonstrated for the first time to be feasibly identified by a POC oriented assay. The specific salivary alpha-amylase depletion technique was shown to be crucial for the suggested assay.
Effect of incretins on skeletal health
Authors: Starup-Linde Jakob , Hygum Katrine , Langdahl Bente
Published: June 2023

Purpose of review

The incretin hormones, glucagon like peptide-1 (GLP-1) and gastric inhibitory peptide (GIP), have been shown to decrease bone resorption in humans. The aim of this review is to collate evidence and current advances in the research within the last year on the effect of incretins on skeletal health.

Recent findings

Preclinical studies show potential direct beneficial effects on bone by GLP-1 and GIP, however real world epidemiological data show no effects of GLP-1 receptor analogues on fracture risk. This may be due to the weight loss accompanied by GLP-1 treatment which may have detrimental effects on bone. GIP is shown to reduce bone resorption and increase bone formation. Further evidence suggests an additive effect of GIP and glucagon like peptide-2, which could affect bone by different mechanisms.

GIP and GLP-1 based therapies are more widespread used and may have potential beneficial effects on bone, possibly counterbalanced by weight loss. Long-term effects and side-effects of GIP or GIP/ GLP-2 co-administration remain to be elucidated, and longer term treatment trials are needed.
Quick nic: novel smokeless nicotine products and pediatric trends
Authors: Dubrosa Fiona , Sangiuolo Kara , Franco Julian , Milanaik Ruth L.
Published: June 2023

Purpose of review

The development and marketing of smokeless nicotine products in recent years have become increasingly popular among adolescents. In addition to well known conventional inhaled nicotine products, noninhaled products, such as nicotine toothpicks, orbs, lozenges, strips, and more, have dangerously captivated a new youth audience. Although smokeless nicotine products may seem to be less threatening than conventional inhaled nicotine products, there are significant risks associated with the use of these products, including addiction and severe health issues. The purpose of this review is to provide up-to-date information about alternative nicotine products currently on the market that may appeal to youth, and the dangers of nicotine use for pediatric populations.

Recent findings

Smokeless nicotine products appeal to minors with their varying flavors and discrete packaging. These products may lead to nicotine toxicity as well as severe health problems, such as cancer, issues with reproduction, and heart attacks. Nicotine is extremely dangerous for young children; in fact, using nicotine products before the age of 18 years can lead to addiction and is linked to an increased likelihood of experimenting with stronger nicotine products or illicit drugs. The development of inconspicuous nicotine packaging has led to increasing concerns for accidental nicotine exposure and overdose in youth.

Greater knowledge regarding current nicotine products on the market, specifically smokeless nicotine products, will help clinicians be more aware of the dangers associated with these products. Clinicians will be better able to provide their patients and families with proper guidance to avoid nicotine addiction, further drug use, and detrimental health issues. Caregivers and medical professionals must recognize novel and inconspicuous nicotine products commonly used among youth, understand the signs of nicotine abuse and dependence, and take measures to address possible nicotine-related health risks.
Which items of the modified Barthel Index can predict functional independence at discharge from inpatient rehabilitation? A secondary analysis retrospective cohort study
Authors: Pournajaf Sanaz , Pellicciari Leonardo , Proietti Stefania , Agostini Francesco , Gabbani Debora , Goffredo Michela , Damiani Carlo , Franceschini Marco
Published: June 2023

The modified Barthel Index (mBI) is a well-established patient-centered outcome measure commonly administrated in rehabilitation settings to evaluate the functional status of patients at admission and discharge. This study aimed to detect which mBI items collected on admission can predict the total mBI at discharge from first inpatient rehabilitation in large cohorts of orthopedic (n = 1864) and neurological (n = 1684) patients. Demographic and clinical data (time since the acute event 11.8 ± 17.2 days) at patients’ admission and mBI at discharge were collected. Univariate and multiple binary logistic regressions were performed to study the associations between independent and dependent variables for each cohort separately. In neurological patients, the shorter time between the acute event and rehabilitation admission, shorter length of stay, and being independent with feeding, personal hygiene, bladder, and transfers were independently associated with higher total mBI at discharge (R2 = 0.636). In orthopedic patients, age, the shorter time between the acute event and rehabilitation admission, shorter length of stay, and being independent with personal hygiene, dressing, and bladder were independently associated with higher total mBI at discharge (R2 = 0.622). Our results showed that different activities in neurological (i.e. feeding, personal hygiene, bladder, and transfer) and orthopedic sample (i.e. personal hygiene, dressing, and bladder) are positively associated with better function (measured by mBI) at the discharge. Clinicians have to take into account these predictors of functionality when they plan an appropriate rehabilitation treatment.