bluuebunny/crossref_metadata_2025 huggingface dataset:
A Preliminary Investigation of a Brief Tier 1 Classroom Management Measure
Authors: Gilmour Allison F. , Wehby Joseph H. , Boyle Jessica , Wills Howard P. , Caldarella Paul
Published: June 2023

Multitiered systems for supporting students’ behavior in schools rely on teachers using generally effective classroom management strategies, such as Tier 1 practices. However, few tools exist to easily assess classwide Tier 1 practices. In this brief report, we describe one potential tool, the Classroom Atmosphere Rating Scale–Brief (CARS-B) and assess the properties of the tool using item response theory and multilevel models. We found that most items on the CARS-B had acceptable discriminations and difficulty estimates. Teachers’ CARS-B latent scores were positively associated with student group on-task. We discuss potential changes to the CARS-B and its use in research and practice.
Structural Integrity of the Cerebellar Outflow Tract Predicts Long-Term Motor Function After Middle Cerebral Artery Ischemic Stroke
Authors: Yoo Yeun Jie , Lim Seong Hoon , Kim Youngkook , Kim Joon-Sung , Hong Bo Young , Yoon Mi-Jeong , Rim Hanee , Park Geun-Young
Published: June 2023

Background

The cerebellum plays a crucial role in functional movement by influencing sensorimotor coordination and learning. However, the effects of cortico-cerebellar connectivity on the recovery of upper extremity motor function after stroke have not been investigated. We hypothesized that the integrity of the cortico-cerebellar connections would be reduced in patients with a subacute middle cerebral artery (MCA) stroke, and that this reduction may help to predict chronic upper extremity motor function.

Methods

We retrospectively analyzed the diffusion-tensor imaging of 25 patients with a subacute MCA stroke (mean age: 62.2 ± 2.7 years; 14 females) and 25 age- and sex-matched healthy controls. We evaluated the microstructural integrity of the corticospinal tract (CST), dentatothalamocortical tract (DTCT), and corticopontocerebellar tract (CPCT). Furthermore, we created linear regression models to predict chronic upper extremity motor function based on the structural integrity of each tract.

Results

In stroke patients, the affected DTCT and CST showed significantly impaired structural integrity compared to unaffected tracts and the tracts in controls. When all models were compared, the model that used the fractional anisotropy (FA) asymmetry indices of CST and DTCT as independent variables best predicted chronic upper extremity motor function ( R2 = .506, P = .001). The extent of structural integrity of the CPCT did not significantly differ between hemispheres or groups and was not predictive of motor function.

Conclusions

We found evidence that microstructural integrity of the DTCT in the subacute phase of an MCA stroke helped to predict chronic upper extremity motor function, independent of CST status.
The lethality paradox: Goodhart’s Law and the challenge of measuring lethality
Authors: Biggs Adam T , Hamilton Joseph A , Huffman Greg , Markwald Rachel R
Published: June 2023

Military performance must be evaluated, and one of the most critical concepts to measure involves the lethal capabilities of a military force. However, there are multiple challenges that complicate any accurate performance assessment, including theoretical issues of measurement due to statistical irregularities and practical limitations due to the military context. Here, we describe the lethality paradox, which states that measuring lethality could be a self-defeating exercise despite its necessity. Specifically, the value of any collected metric may be inherently reduced by the act of measurement while, also, creating operational vulnerabilities for a military force. This paradox is conceived as an extension of Goodhart’s Law and incorporates the same challenges of a personnel gaming a set standard rather than developing the skill set supposedly measured by this standard. Our discussion identifies the limitations and applications of Goodhart’s Law to lethality while also concluding with several proposed solutions to different paradoxical challenges.
Opponensplasty for Nerve Palsy: A Systematic Review
Authors: Coulshed Nicholas , Xu Joshua , Graham David , Sivakumar Brahman
Published: June 2023

Opposition is an essential function of the human thumb to enable fine pinch and grip strength. Loss of opposition can be caused by both congenital and acquired pathology resulting in significant disability. This systematic review aims to compare the different techniques available to restore opposition. A systematic review of opponensplasty techniques was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines using PubMed, Embase, Medline, and Web of Science. Studies published in English before April 2021 and that reported on original outcomes of opponensplasty techniques used in the context of neurologic dysfunction were eligible for inclusion. A total of 641 articles were included, of which 42 texts were eligible for inclusion with a total cohort of 873 patients. The most commonly used transfers were palmaris longus (PL), extensor indicis proprius (EIP), and flexor digitorum superficialis (FDS). These transfers all demonstrated an improvement in range of motion, pinch strength, and Kapandji scores. Complication rates of 19% and 12% were reported with FDS and EIP transfers, respectively, predominantly related to donor site morbidity. A complication rate of 6% was observed with PL transfers, which was most commonly related to bowstringing. Heterogeneity of outcomes precluded a direct statistical comparison. There is significant heterogeneity in the literature reporting on opponensplasty techniques. There is limited capacity of direct comparison; however, FDS and EIP appear to demonstrate better functional outcomes, at the cost of higher complication rates. Each technique has specific complications and advantages and importance in patient counseling and discussion. Further prospective comparative studies are warranted.
External Fixation Prior to Fasciectomy Leads to Substantial Improvement of Advanced Dupuytren’s PIP Contractures at Mean Follow-up 15 Months
Authors: Qiu Bowen , Hammert Warren , Wilbur Danielle
Published: June 2023

Background:

The Digit Widget is an external fixation device that can be used to reverse proximal interphalangeal joint (PIPJ) contractures in the hand. Our hypothesis is that usage of the Digit Widget prior to fasciectomy in patients with severe Dupuytren’s proximal interphalangeal (PIP) contractures will result in short-term improvement and maintenance of the PIPJ contracture after fasciectomy.

Methods:

Patients who underwent placement of the Digit Widget soft tissue distractor prior to fasciectomy for Dupuytren’s disease were identified between January 2015 and December 2018. Multiple fingers were considered separately. Patient Reported Outcome Measurement Information System (PROMIS) Physical Function (PF), Pain Interference, and Depression scores were collected. Patients treated for contractures from etiologies other than Dupuytren’s were not included. Multiple linear regression was used to compare initial PIP contractures, PF scores, and final contractures.

Results:

There were 28 fingers in 24 patients with average age of 56 ± 12 (30.5-69.9) years. Initial mean PIPJ contracture was 81° (50°-120°), which had corrected to 23° at time of removal. Average time between application and fasciectomy was 58 (28-112) days. At final follow-up, average 449 (58-1641) days, the average contracture was 39° (0°-105°). Contracture immediately following fasciectomy was found to be strongly correlated with the contracture at final follow-up. There was no statistical relationship between final PROMIS PF scores and final change in contracture.

Conclusions:

Digit Widget external fixation is an effective treatment for the correction of advanced PIPJ contractures related to Dupuytren’s disease, with an average of 52% improvement in contracture at 15 months.
Spontaneous Rupture of the Extensor Pollicis Longus Tendon: A Systematic Review
Authors: Lister Rachel C. , Bradford Henry C. , Joo Alex , Carr Catherine W. , Delancy Anna , Naram Aparajit , Rothkopf Douglas M. , Shufflebarger John V.
Published: June 2023

Background:

Extensor pollicis longus (EPL) rupture and tenosynovitis of the third dorsal compartment is often described in association with a history of rheumatoid arthritis or in the setting of a distal radius fracture. However, the literature suggests multiple other potential factors that may lead to a seemingly spontaneous rupture.

Methods:

We performed a systematic review following guidelines set forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The search consisted of headings and keywords related to tendon injuries, tendinopathy, hand surgery, tendon transfer, and injections, as published in reports and studies. Citations were screened by title and abstract against predetermined inclusion and exclusion criteria by 2 independent reviewers, with a third reviewer resolving discrepancies. To be eligible, articles had to meet the following inclusion criterion: describe cases of spontaneous EPL rupture or tenosynovitis of the third dorsal compartment. The exclusion criterion was any history of distal radius fracture or rheumatoid arthritis.

Results:

We identified 29 articles that met the inclusion criterion.

Conclusions:

A myriad of prodromal events or predisposing factors ultimately led to EPL rupture or tenosynovitis of the third compartment. Methods of reconstruction described included primary repair, tendon grafting, and tendon transfer techniques; all with generally good outcomes. These results highlight the inherent fragility of this tendon and support the historical recommendation for early release of the EPL tendon in the setting of tenosynovitis of the third dorsal compartment.
An electroosmotic peristaltic flow of graphene-lubrication oil nanofluid through a symmetric channel
Authors: Kazmi SN , Abbasi FM , Shehzad SA
Published: June 2023

The purpose of this manuscript is to analyze the electroosmotic peristaltic motion of graphene-lubrication oil nanofluid. Rheological characteristics of such fluids are predicted by using the Carreau’s model. Effects of magnetic field, electric field, viscous dissipation, Joule heating, Brownian motion and thermophoresis are also reckoned. Debye-Hückel linearization and lubrication approach are employed in mathematical modeling. Obtained non-linear system of equations are analytically solved by using the builtin command NdSolve and parametric study is carried out to visualize the variation in temperature, velocity, heat transfer rate, concentration profiles, pressure gradient and pressure rise per wavelength. Results unveil that strong electroosmotic parameter enhances both velocity and temperature. Temperature and velocity decline on the enlargement of the Helmholtz-Smoluchowski velocity. Variation in electroosmotic parameter decreases and Helmholtz-Smoluchowski velocity increases mass transfer rate. Pumping region can also be maintained by thickening and thinning the Electric Double Layer (EDL). Present study has useful applications in industries, defect sensor, energy saving, domestic air conditioning, cooling power electronic components and heat extraction and heat transportation.
Considerations for identifying the “right” subgroup in adaptive enrichment trials
Authors: Simon Noah
Published: June 2023

Adaptive Enrichment Trials aim to make efficient use of data in a pivotal trial of a new targeted therapy to both (a) more precisely identify who benefits from that therapy and (b) improve the likelihood of successfully concluding that the drug is effective, while controlling the probability of false positives. There are a number of frameworks for conducting such a trial and decisions that must be made regarding how to identify that target subgroup. Among those decisions, one must choose how aggressively to restrict enrollment criteria based on the accumulating evidence in the trial. In this article, we empirically evaluate the impact of aggressive versus conservative enrollment restrictions on the power of the trial to detect an effect of treatment. We identify that, in some cases, a more aggressive strategy can substantially improve power. This additionally raises an important question regarding label indication: To what degree do we need a formal test of the hypothesis of no treatment effect in the exact population implied by the label indication? We discuss this question and evaluate how our answer for adaptive enrichment trials may relate to the answer implied by current practice for broad eligibility trials.
Partner engagement for planning and development of non-pharmacological care pathways in the AIM-Back trial
Authors: Ballengee Lindsay A , King Heather A , Simon Corey , Lentz Trevor A , Allen Kelli D , Stanwyck Catherine , Gladney Micaela , George Steven Z , Hastings S Nicole
Published: June 2023

Background/Aims

Embedded pragmatic clinical trials are increasingly recommended for non-pharmacological pain care research due to their focus on examining intervention effectiveness within real-world settings. Engagement with patients, health care providers, and other partners is essential, yet there is limited guidance for how to use engagement to meaningfully inform the design of interventions to be tested in pain-related pragmatic clinical trials. This manuscript aims to describe the process and impacts of partner input on the design of two interventions (care pathways) for low back pain currently being tested in an embedded pragmatic trial in the Veterans Affairs health care system.

Methods

Sequential cohort design for intervention development was followed. Engagement activities were conducted with 25 participants between November 2017 and June 2018. Participants included representatives from multiple groups: clinicians, administrative leadership, patients, and caregivers.

Results

Partner feedback led to several changes in each of the care pathways to improve patient experience and usability. Major changes to the sequenced care pathway included transitioning from telephone-based delivery to a flexible telehealth model, increased specificity about pain modulation activities, and reduction of physical therapy visits. Major changes to the pain navigator pathway included transitioning from a traditional stepped care model to one that offers care in a feedback loop, increased flexibility regarding pain navigator provider type, and increased specificity for patient discharge criteria. Centering patient experience emerged as a key consideration from all partner groups.

Conclusion

Diverse input is important to consider before implementing new interventions in embedded pragmatic trials. Partner engagement can increase acceptability of new care pathways to patients and providers and enhance uptake of effective interventions by health systems.

Trial registration

NCT#04411420. Registered on 2 June 2020.
Robotic-assisted radical prostatectomy is pushing the boundaries: a national survey of frailty using the national surgical quality improvement program
Authors: Abou Heidar Nassib F. , Ayoub Christian Habib , Abou Mrad Anthony , Abdul Khalek Jad , Tamim Hani , El-Hajj Albert
Published: June 2023

Background:

Robotic-assisted radical prostatectomy (RARP) has been found to be comparable and, in some cases, favorable to open surgical approaches, while being used in a frailer population.

Objectives:

We aimed to illustrate the trend in population frailty and compare morbidity and mortality postoperatively in patients who underwent RARP.

Design and Methods:

The National Surgical Quality Improvement Program data set was used to select patients who underwent RARP between the years 2011–2019. Age, frailty indicators, surgical characteristics, and perioperative morbidity and mortality were compared between the years 2011–2019 using the chi-square test (χ2) for categorical variables and the one-way analysis of variance (ANOVA) for continuous variables.

Results:

Our patient population consisted of 66,683 patients who underwent RARP. There was an increase in mean age and frailty indicated by an increase in 5-item frailty score ⩾2, metabolic syndrome index = 3, and American Society of Anesthesiologists’ (ASA) class ⩾3 between the years 2011–2019 ( p < 0.001). Whereas the rate of mortality and morbidity, indicated by postoperative Clavien–Dindo grade ⩾4 and major morbidity, remained the same over the same period ( p > 0.264). Furthermore, operative time and length of stay decreased over the same period ( p < 0.001).

Conclusion:

RARP is being performed on more frail patients, with no added morbidity or mortality.
Surviving Laurel Richardson’s Whirlwinds: “Being With” Loss and Grief
Authors: Ellis Carolyn
Published: June 2023

This essay responds to Laurel Richardson’s book, A Story of a Marriage through Dementia and Beyond: Love in a Whirlwind, and to her poetry, “For Better or Worse,” which is included in this issue of International Review of Qualitative Research. The author describes how she is affected by the poetic and story forms of telling. Through reading and rereading, analyzing and interpreting these texts, she notes parallels between her and Laurel's experiences of loss and how they story their sorrow. Laurel’s descriptions resonate with her, reminding her of her own grief and providing a feeling of companionship--that we are all in this together. She suggests that reading and writing about loss as well as “being with” others in their sorrows can move us to incorporate grief and suffering into our lives without falling into an abyss of sadness, depression, and meaninglessness.
Fractures and dislocations of the foot and ankle in people with diabetes: a literature review
Authors: Johnson Matthew J. , Kandasamy Suganthi , Raspovic Katherine M. , Manchanda Kshitij , Liu George Tye , VanPelt Michael D. , Lavery Lawrence A. , Wukich Dane K.
Published: June 2023

Diabetes (DM) increases fracture risk, and bone quality depends on type diabetes type, duration, and other comorbidities. Diabetes is associated with a 32% increased relative risk (RR) of total fractures and 24% increased RR of ankle fractures compared with patients without DM. Type 2 DM is associated with a 37% increased RR of foot fractures compared with patients without DM. The incidence of ankle fractures in the general population is 169/100,000 per year, while foot fractures occur less frequently, with an incidence of 142/100,000 per year. Biomechanical properties of bone are negatively impacted by stiff collagen, contributing to the increased risk of fragility fractures in patients with DM. Systemic elevation of proinflammatory cytokines, such as tumor necrosis factor-alpha (TNFα), interleukin-1β (IL-1β), and interleukin 6 (IL-6), impact bone healing in patients with DM. Fractures in patients with DM, can be associated with poorly regulated levels of RANKL (receptor activator of nuclear transcription factor kappa-b ligand) leading to prolonged osteoclastogenesis, and net bone resorption. One of the most salient factors in treating fractures and dislocations of the foot and ankle is to recognize the difference between patients with uncomplicated and complicated DM. Complicated diabetes is defined as ‘end organ damage’, and for the purposes of this review, includes patients with neuropathy, peripheral artery disease (PAD) and/or chronic renal disease. Uncomplicated diabetes is not associated with ‘end organ damage’. Foot and ankle fractures in patients with complicated DM pose challenges, and surgery is associated with increased risks of impaired wound healing, delayed fracture healing, malunion, infection, surgical site infection, and revision surgery. While patients with uncomplicated DM can be treated like patients without DM, patients with complicated DM require close follow-up and robust fixation methods should be considered to withstand the anticipated prolonged healing period. The aims of this review are as follows: (1) to review pertinent aspects of DM bone physiology and fracture healing, (2) to review the recent literature on treatment of foot and ankle fractures in patients with complicated DM, and (3) to provide treatment protocols based on the recent published evidence.
Two-stage revision knee arthroplasty for metallosis in a patient with rheumatoid arthritis: A case report
Authors: Koyama Tomoki , Mori Yu , Kamimura Masayuki , Aki Takashi , Izumiyama Takuya , Mori Naoko , Chiba Daisuke , Hashimoto Ko , Yamamoto Nobuyuki , Aizawa Toshimi
Published: June 2023

We report a successful case of two-stage revision total knee arthroplasty performed for treating painless metallosis after total knee arthroplasty with a metal-backed patella. A 63-year-old woman diagnosed with rheumatoid arthritis underwent left total knee arthroplasty with a metal-backed patella at 32 years of age. The patient did not have knee pain; however, knee joint swelling, a strange noise, and pigmentation were reported 4 years ago. Radiographs showed cloud and metal-line signs anteriorly and posteriorly at the femoral condyle. Therefore, a two-stage surgery was performed for infection prevention and ease of performing posterior synovectomy. The patient underwent initial synovectomy via a posterior approach, followed by anterior synovectomy and revision total knee arthroplasty. Synovectomy was performed well without perioperative infection or failure of wound healing. In cases with metallosis after total knee arthroplasty, the two-stage revision total knee arthroplasty should be considered, depending on the degree of synovial proliferation and the risk of complications.
Successful treatment of severe Pneumocystis Jirovecii pneumonia in a diffuse large B-cell lymphoma patient after R-CHOP chemotherapy: A case report
Authors: Xu Yan , Li Zhaolin , Ouyang Lamei , Su Yinqing , Wang Canmin
Published: June 2023

R-CHOP chemotherapy has been established as the first-line standard treatment for elderly patients diagnosed with diffuse large B-cell lymphoma. However, an increased risk of Pneumocystis jirovecii pneumonia in diffuse large B-cell lymphoma patients after the rituximab-based chemotherapy has been reported. We describe a case who developed intermittent cough, fever and shortness of breath after five cycles of R-CHOP treatment for diffuse large B-cell lymphoma. A rapid deterioration in patient’s respiratory condition prompted us to adopt an aggressive anti- Pneumocystis jirovecii pneumonia strategy that combined the conventional trimethoprim/sulfamethoxazole and another two antimicrobials, caspofungin and clindamycin. This is the first report mentioning the successful treatment of severe Pneumocystis jirovecii pneumonia with a triple-drug regimen in a HIV-uninfected patient. The aim of our report is also to emphasize that early and correct diagnosis of Pneumocystis jirovecii pneumonia in immunocompromised HIV-uninfected patients is very important. Relevant oncologists should be alert to the risk of Pneumocystis jirovecii pneumonia in patients receiving R-CHOP chemotherapy.
International climate targets are achievable, but only in models, not in the real world
Authors: Thompson Roy
Published: June 2023

The article argues that the relationships and historical trends of global temperatures and of fossil-fuel production are now both clear and relatively stable. Hence archival data of past performance allow a ‘speedometer reading’ of current rates of change and enable a direct ‘reality check’ on claims about future climate change. Embedded in a new Hubbert-style resource model the historical rates forecast that surface temperatures remain on course to rise by 4.5°C (6°C over land) by the early 2100s. This unsettling prospect is in close accord with several middle-of-the-road projections in the recent sixth IPCC Assessment Report (2021). Instead, if hoped-for targets of carbon neutrality are to be met and global temperature rises held to well below 2°C, as stipulated in the Paris Agreement, then the current rate of deployment of clean power sources would need to accelerate by an unprecedented 100-fold, to around 50 EJ year−1, within the decade.
Transthoracic Approach to Reoperative Antireflux Surgery
Authors: Schaheen Lara W. , Bremner Ross M.
Published: June 2023

Reoperative antireflux surgery (ARS) is complex and often needs to be customized to the individual patient. A transthoracic approach is preferred in select patients with concomitant esophageal pathologies or a complex surgical history. The clinical presentation and perioperative evaluation of patients who require reoperative ARS as well as surgical options, the role of the transthoracic approach, and Nissen and Belsey Mark IV fundoplication techniques are discussed in detail. Outcomes associated with the transthoracic approach to reoperative ARS are reviewed. Although less invasive laparoscopic approaches have become more common, the transthoracic approach must remain in the foregut surgeon’s armamentarium.
Scientific understanding through big data: From ignorance to insights to understanding
Authors: Martínez-Ordaz María del Rosario
Published: June 2023

Here I argue that scientists can achieve some understanding of both the products of big data implementation as well as of the target phenomenon to which they are expected to refer—even when these products were obtained through essentially epistemically opaque processes. The general aim of the paper is to provide a road map for how this is done; going from the use of big data to epistemic opacity (Sec. 2), from epistemic opacity to ignorance (Sec. 3), from ignorance to insights (Sec. 4), and finally, from insights to understanding (Sec. 5, 6)
Oligonucleotide nanoassemblies with allyl bromide scaffold-based small molecules
Authors: Abbas Sk Jahir , Yesmin Sabina , Xia Fangfang , Ali Sk Imran , Xiao Zeyu , Tan Weihong
Published: June 2023

The development of oligonucleotide nanoassemblies with small molecules has shown great potential in bio-medical applications. However, the interaction of negatively charged oligonucleotides with halogenated small molecules represents a scientific challenge. Here, we introduced a distinct allyl bromide halogenated scaffold, which exhibits specific interaction with adenine nucleic bases of the oligonucleotides, thus leading to the formation of self-assembled nanostructures.

Graphical abstract
Population structure and insecticide response of Gammarus spp. in agricultural and upstream forested sites of small streams
Authors: Schneeweiss Anke , Schreiner Verena C. , Liess Matthias , Röder Nina , Schwenk Klaus , Schäfer Ralf B.
Published: June 2023

Exposure to pesticides may cause adaptation not only in agricultural pests and pathogens, but also in non-target organisms. Previous studies mainly searched for adaptations in non-target organisms in pesticide-polluted sites. However, organisms may propagate heritable pesticide effects, such as increased tolerance, to non-exposed populations through gene flow. We examined the pesticide tolerance—as one of the pre-assumptions of local adaptation—of the freshwater crustacean Gammarus spp. (at genus level reflecting the gammarid community). The pesticide tolerance was quantified in acute toxicity tests using the insecticide imidacloprid. Gammarids were sampled at pesticide-polluted agricultural sites (termed agriculture), least impacted upstream sites (termed refuge) and transitional sites (termed edge) in six small streams of south-west Germany. Furthermore, we examined the population genetic structure of Gammarus fossarum and the energy reserves (here lipid content) of G. fossarum as well as of Gammarus spp. at the three site types (i.e. agriculture, edge and refuge). We found significantly lower imidacloprid tolerance of Gammarus spp. from agricultural sites compared to edge and refuge sites, potentially due to higher environmental stress at agricultural sites, as indicated by a slightly lower lipid content per mg gammarid tissue. We found no differences in pesticide tolerance between edge and refuge populations, indicating no propagation of pesticide effects to edges. The genetic structure among G. fossarum populations showed significant differentiation between streams, but not within a stream across the site types. We suggest that high gene flow within each stream hindered population differentiation and resulted in similar (pre)adaptations to local stress levels between site types, although they exhibited different pesticide pollution. Further studies on target genes (e.g., conferring pesticide tolerance), population structure and fitness of different phenotypes in particular among non-target organisms are required for adjacent pristine ecosystems to detect potential propagations of pesticide effects.
A multi-omics analysis reveals CLSPN is associated with prognosis, immune microenvironment and drug resistance in cancers
Authors: Chen Yihong , Wen Haicheng , Li Yin , Han Ying , Tan Jun , Guo Cao , Cai Changjing , Liu Ping , Peng Yinghui , Liu Yihan , Wang Xinwen , Zeng Shan , Feng Ziyang , Shen Hong
Published: June 2023

Background

Immunotherapy is effective only in limited patients. It is urgent to discover a novel biomarker to predict immune cells infiltration status and immunotherapy response of different cancers. CLSPN has been reported to play a pivotal role in various biological processes. However, a comprehensive analysis of CLSPN in cancers has not been conducted.

Methods

To show the whole picture of CLSPN in cancers, a pan-cancer analysis was conducted in 9125 tumor samples across 33 cancer types by integrating transcriptomic, epigenomic and pharmacogenomics data. Moreover, the role of CLSPN in cancer was validated by CCK-8, EDU, colony formation and flow cytometry in vitro and tumor cell derived xenograft model in vivo.

Results

CLSPN expression was generally upregulated in most cancer types and was significantly associated with prognosis in different tumor samples. Moreover, elevated CLSPN expression was closely correlated with immune cells infiltration, TMB (tumor mutational burden), MSI (microsatellite instability), MMR (mismatch repair), DNA methylation and stemness score across 33 cancer types. Enrichment analysis of functional genes revealed that CLSPN participated in the regulation of numerous signaling pathways involved in cell cycle and inflammatory response. The expression of CLSPN in LUAD patients were further analyzed at the single-cell level. Knockdown CLSPN significantly inhibited cancer cell proliferation and cell cycle related cyclin-dependent kinase (CDK) family and Cyclin family expression in LUAD (lung adenocarcinoma) both in vitro and in vivo experiments. Finally, we conducted structure-based virtual screening by modelling the structure of CHK1 kinase domain and Claspin phosphopeptide complex. The top five hit compounds were screened and validated by molecular docking and Connectivity Map (CMap) analysis.

Conclusion

Our multi-omics analysis offers a systematic understanding of the roles of CLSPN in pan-cancer and provides a potential target for future cancer treatment.
Assessment of autoantibodies in paediatric population with primary immunodeficiencies: a pilot study
Authors: Pieniawska-Śmiech Karolina , Lewandowicz-Uszyńska Aleksandra , Zemelka-Wiacek Magdalena , Jutel Marek
Published: June 2023

Background

The correlation between primary immunodeficiencies (PIDs) and autoimmunity shows ethnic and geographical diversity. The aim of our study was to accumulate more data in paediatric PID population.

Methods

58 children aged 1–17 and with PID (study group) and 14 age-matched immunocompetent individuals (control group) were included in the study. Serum levels of 17 different specific IgG antibodies against autoantigens were measured by means of a quantitative enzyme immunoassay. Immunoglobulin levels were analysed in relation to a detailed medical examination.

Results

Autoantibodies against one or more antigens were detected in the sera of 24.14% (n = 14) subjects in the study group. The most frequent were anti-thyroid peroxidase (anti-TPO) antibodies (n = 8; 13.8%). Anti-TPO antibody levels were elevated more often in PID patients with a positive family history of autoimmune diseases (p = 0.04). The screening for anti-deamidated gliadin peptide (DGP) and anti-tissue transglutaminase (tTG) antibodies in our series allowed identifying two previously undiagnosed cases of coeliac disease in PID patients. There was no statistically significant difference between the study and the control group in terms of the autoantibodies prevalence.

Conclusions

This study provides data on the prevalence of autoantibodies in paediatric population diagnosed with PID. Selected autoantibodies (i.e. anti-tTG, anti-DGP) might be useful for the screening of PID to avoid the delay of diagnosis of an autoimmune disease.
Opioid-free anesthesia with lidocaine for improved postoperative recovery in hysteroscopy: a randomized controlled trial
Authors: Cha NH , Hu Y , Zhu GH , Long X , Jiang JJ , Gong Yuan
Published: June 2023

Background

Anesthesia with opioids negatively affects patients’ quality of recovery. Opioid-free anesthesia attempts to avoid these effects. This study aimed to evaluate the effect of opioid-free anesthesia on the quality of recovery, using lidocaine on patients undergoing hysteroscopy.

Methods

A parallel-group, randomized, double-blind, controlled trial was conducted in Yichang Central Peoples’ Hospital, Hubei Province, China, from January to April, 2022. We included 90 female patients (age: 18–65 years, American Society of Anesthesiologists Physical Status Class I–II) scheduled for elective hysteroscopy, 45 of whom received lidocaine (Group L), and 45 received sufentanil (Group S). Patients were randomly allocated to receive either lidocaine or sufentanil perioperatively. The primary outcome was the quality of postoperative recovery, which was assessed using the QoR-40 questionnaire (a patient-reported outcome questionnaire measuring the quality of recovery after surgery).

Results

The two groups were similar in age, American Society of Anesthesiology physical status, height, weight, body mass index, and surgical duration. The QoR scores were significantly higher in Group L than Group S. The incidence of postoperative nausea and vomiting, as well as the time to extubation were significantly lower in Group L than Group S.

Conclusion

Opioid-free anesthesia with lidocaine achieves a better quality of recovery, faster recovery, and a shorter time to extubation than general anesthesia with sufentanil.

Trial registration

The trial was registered on January 15, 2022 in the Chinese Clinical Trial Registry (http://www.chictr.org.cn/showprojen.aspx?proj=149386), registration number ChiCTR2200055623.(15/01/2022).
Dexmedetomidine versus haloperidol for sedation of non-intubated patients with hyperactive delirium during the night in a high dependency unit: study protocol for an open-label, parallel-group, randomized controlled trial (DEX-HD trial)
Authors: Minami Takuma , Watanabe Hirotoshi , Kato Takao , Ikeda Kaori , Ueno Kentaro , Matsuyama Ai , Maeda Junya , Sakai Yoji , Harada Hisako , Kuriyama Akira , Yamaji Kyohei , Kitajima Naoki , Kamei Jun , Takatani Yudai , Sato Yuki , Yamashita Yugo , Mizota Toshiyuki , Ohtsuru Shigeru
Published: June 2023

Background

Delirium is common in critically ill patients. Haloperidol has long been used for the treatment of delirium. Dexmedetomidine has recently been used to treat delirium among intubated critically ill patients. However, the efficacy of dexmedetomidine for delirium in non-intubated critically ill patients remains unknown. We hypothesize that dexmedetomidine is superior to haloperidol for sedation of patients with hyperactive delirium, and would reduce the prevalence of delirium among non-intubated patients after administration. We will conduct a randomized controlled trial to compare dexmedetomidine and haloperidol for the treatment of nocturnal hyperactive delirium in non-intubated patients in high dependency units (HDUs).

Methods

This is an open-label, parallel-group, randomized controlled trial to compare the efficacy and safety of dexmedetomidine and haloperidol for nocturnal hyperactive delirium in non-intubated patients at two HDUs of a tertiary hospital. We will recruit consecutive non-intubated patients who are admitted to the HDU from the emergency room, and allocate them in a 1:1 ratio to the dexmedetomidine or haloperidol group in advance. The allocated investigational drug will be administered only when participants develop hyperactive delirium (Richmond Agitation-Sedation Scale [RASS] score ≥1 and a positive score on the Confusion Assessment Method for the ICU between 19:00 and 6:00 the next day) during the night at an HDU. Dexmedetomidine is administered continuously, while haloperidol is administered intermittently. The primary outcome is the proportion of participants who achieve the targeted sedation level (RASS score of between -3 and 0) 2h after the administration of the investigational drug. Secondary outcomes include the sedation level and prevalence of delirium on the day following the administration of the investigational drugs, and safety. We plan to enroll 100 participants who develop nocturnal hyperactive delirium and receive one of the two investigational drugs.

Discussion

This is the first randomized controlled trial to compare the efficacy and safety of dexmedetomidine and haloperidol for sedation of non-intubated critically ill patients with hyperactive delirium in HDUs. The results of this study may confirm whether dexmedetomidine could be another option to sedate patients with hyperactive delirium.

Trial registration

Japan Registry of Clinical Trials, jRCT1051220015, registered on 21 April 2022.
AT1R gene rs389566 polymorphism contributes to MACCEs in hypertension patients
Authors: Luo Jun-Yi , Du Guo-Li , Hao Yang-Min , Liu Fen , Zhang Tong , Fang Bin-Bin , Li Xiao-Mei , Gao Xiao-Ming , Yang Yi-Ning
Published: June 2023

Objective

To investigate the possible association between AT1R gene polymorphisms and major adverse cardiovascular and cerebrovascular events (MACCEs) in hypertension patients combined with or without coronary artery disease (CAD) in Xinjiang.

Methods

374 CAD patients and 341 non-CAD individuals were enrolled as study participants and all of them have a hypertension diagnosis. AT1R gene polymorphisms were genotyped by SNPscan™ typing assays. During the follow-up in the clinic or by telephone interview, MACCEs were recorded. Kaplan–Meier curves and Cox survival analyses were used to explore the association between AT1R gene polymorphisms and the occurrence of MACCEs.

Results

AT1R gene rs389566 was associated with MACCEs. The TT genotype of the AT1R gene rs389566 had a significantly higher probability of MACCEs than the AA + AT genotype (75.2% vs. 24.8%, P = 0.033). Older age (OR = 1.028, 95% CI: 1.009–1.0047, P = 0.003) and TT genotype of rs389566 (OR = 1.770, 95% CI: 1.148–2.729, P = 0.01) were risk factors of MACCEs. AT1R gene rs389566 TT genotype may be a predisposing factor for the occurrence of MACCEs in hypertensive patients.

Conclusion

We should also pay more attention to the prevent of MACCEs in hypertension patients combined with CAD. Especially those elderly hypertensive patients carrying AT1R rs389566 TT genotype requires avoidance of unhealthy lifestyle, better management of blood pressure control and reduce the occurrence of MACCEs.
Meta-analysis of differences in neutrophil to lymphocyte ratio between hypertensive and non-hypertensive individuals
Authors: Sarejloo Shirin , Dehesh Moein , Fathi Mobina , Khanzadeh Monireh , Lucke-Wold Brandon , Ghaedi Arshin , Khanzadeh Shokoufeh
Published: June 2023

This study systematically reviewed the evidence regarding differences in the neutrophil to lymphocyte ratio (NLR) level between hypertensive and normotensive individuals as well as between patients with dipper and non-dipper hypertension (HTN). PubMed, Scopus, and Web of Science databases were systematically searched up to 20 December 2021. This was done without any limitation with regard to date, publication, or language. Pooled weighted mean differences (WMD) with 95% confidence intervals (95% CI) were reported. We assessed the quality of studies based on the Newcastle–Ottawa Scale (NOS). In total, 21 studies were included in our study. There was a significant increase in NLR levels for the hypertensive group in comparison to the control group (WMD = 0.40, 95%CI = 0.22–0.57, P < 0.0001). In addition, the NLR levels were higher in the non-dipper than in the dipper group (WMD = 0.58, 95%CI = 0.19–0.97, P = 0.003). Our findings showed that hypertensive patients had higher level of NLR than normotensive individuals.
His-Purkinje system pacing versus biventricular pacing in clinical efficacy: a systematic review and meta-analysis
Authors: Wang Ya , Liu Fangchao , Liu Mengyao , Wang Zefeng , Lu Xiangfeng , Huang Jianfeng , Gu Dongfeng
Published: June 2023

Background

His-Purkinje system pacing (HPSP), including his-bundle pacing (HBP) and left bundle branch area pacing (LBBaP), imitates the natural conduction of the heart as an alternative to biventricular pacing (BVP) in cardiac resynchronization therapy (CRT). However, the feasibility and efficacy of HPSP were currently only evidenced by studies with a limited sample size, so this study aimed to provide a comprehensive assessment through a systematic review and meta-analysis.

Methods

In order to compare the clinical outcomes associated with HPSP and BVP in patients for CRT, PubMed, EMBASE, Cochrane Library and Web of Science database were searched from inception to April 10, 2023. Clinical outcomes of interest including QRS duration (QRSd), left ventricular (LV) function and New York Heart Association (NYHA) functional classification, pacing threshold, echocardiographic and clinical response, hospitalization rate of HF and all-cause mortality were also extracted and summarized for meta-analysis.

Results

A total of 13 studies (ten observational studies and three randomized studies) involving 1,121 patients were finally included. The patients were followed up for 6–27 months. Compared with BVP, CRT patients treated by HPSP presented shorter QRSd [mean difference (MD): -26.23 ms, 95% confidence interval (CI): -34.54 to -17.92, P < 0.001, I2 = 91%], greater LV functional improvement with increased left ventricular ejection fraction (LVEF) (MD: 6.01, 95% CI: 4.81 to 7.22, P < 0.001, I2 = 0%), decreased left ventricular end-diastolic dimension (LVEDD) (MD: -2.91, 95% CI: -4.86 to -0.95, P = 0.004, I2 = 35%), and more improved NYHA functional classification (MD: -0.45, 95% CI: -0.67 to -0.23, P < 0.001, I2 = 70%). In addition, HPSP was more likely to have higher echocardiographic [odds ratio (OR): 2.76, 95% CI: 1.74 to 4.39, P < 0.001, I2 = 0%], clinical (OR: 2.10, 95% CI: 1.16 to 3.80, P = 0.01, I2 = 0%) and super clinical (OR: 3.17, 95% CI: 2.09 to 4.79, P < 0.001, I2 = 0%) responses than BVP, and a lower hospitalization rate of HF (OR: 0.34, 95% CI: 0.22 to 0.51, P < 0.001, I2 = 0%), while presented no difference (OR: 0.68, 95% CI: 0.44 to 1.06, P = 0.09, I2 = 0%) in all-cause mortality compared with BVP. With threshold change taking into account, BVP was less stable than LBBaP (MD: -0.12 V, 95% CI: -0.22 to -0.03, P = 0.01, I2 = 57%), but had no difference with HBP (MD: 0.11 V, 95% CI: -0.09 to 0.31, P = 0.28, I2 = 0%).

Conclusion

The present findings suggested that HPSP was associated with greater improvement of cardiac function in patients with indication for CRT and was a potential alternative to BVP to achieve physiological pacing through native his-purkinje system.

Graphical Abstract
Comparison of the feasibility and safety between distal transradial access and conventional transradial access in patients with acute chest pain: a single-center cohort study using propensity score matching
Authors: Li Wenhua , Wang Juan , Liang Xiaofang , Wang Qiang , Chen Tao , Song Yanbin , Shi Ganwei , Li Feng , Li Yong , Xiao Jianqiang , Cai Gaojun
Published: June 2023

Background

Distal transradial access (dTRA) has been suggested to have great advantages over cTRA. However, there is a lack of preliminary data on dTRA in patients undergoing emergency coronary angiography (CAG) or percutaneous coronary intervention (PCI). To explore the feasibility and safety of distal transradial access in patients with acute chest pain.

Methods

A total of 1269 patients complaining of acute chest pain in our emergency department from January 2020 to February 2022 were retrospectively included. The patients who met the inclusion criteria were divided into the conventional transradial access (cTRA) group (n = 238) and the dTRA group (n = 158). Propensity score matching was used to minimize the baseline differences.

Results

The cannulation success rate in the dTRA group was significantly lower than that in the cTRA group (87.41% vs. 94.81%, p < 0.05). No significant differences in the puncture time and total procedure time were noted between the two groups (p > 0.05). Compared with the cTRA group, the hemostasis duration was significantly shorter [4(4, 4) h vs. 10(8, 10) h, p < 0.001) and the incidence of minor bleeding (BARC Type I and II) was significantly lower in the dTRA group than that in the cTRA group (0.85% vs. 5.48%, p = 0.045). Asymptomatic radial artery occlusion was observed in six patients (5.83%) in the cTRA group and one patient (1.14%) in the dTRA group (p = 0.126). The subgroup analysis of ST-elevation myocardial infarction (STEMI) showed no significant differences in the puncture time, D-to-B time or total procedure time between the two groups.

Conclusions

The dTRA for emergency CAG or PCI has an acceptable success rate and puncture time, a shorter hemostasis time, and a downward trend in RAO rate compared to the cTRA. The dTRA did not increase the D-to-B time in emergency coronary interventions in STEMI patients. On the contrary, a low incidence of RAO by the dTRA created an opportunity for future coronary interventions in non-culprit vessels in the same access.

Trial registration

Retrospectively registered in Chinese Clinical Trial Registry (registry number: ChiCTR2200061104, date of registration: June 15, 2022).
Declining incidence rate of tuberculosis among close contacts in five years post-exposure: a systematic review and meta-analysis
Authors: Du Ying , He Yijun , Zhang Haoran , Shen Fei , Guan Ling , Xin Henan , He Yongpeng , Cao Xuefang , Feng Boxuan , Quan Zhusheng , Liu Jianmin , Gao Lei
Published: June 2023

Background

Individuals in close contact with active pulmonary tuberculosis (TB) patients showed a high risk of recent infection and, once infected, higher risk of developing active TB in the following years post-exposure. But the peak time of active disease onset is unclear. This study aims to estimate post exposure TB incidence risk among close contacts to provide reference for clinical and public health strategies.

Methods

We searched PubMed, Web of Science, and EMBASE for articles published until December 1, 2022. The incidence rates were quantitatively summarized by means of meta-analysis using the random-effect model.

Results

Of the 5616 studies, 31 studies included in our analysis. For baseline close contacts results, the summarized prevalence of Mycobacterium tuberculosis (MTB) infection and active TB was found to be 46.30% (95% CI: 37.18%-55.41%) and 2.68% (95% CI: 2.02%-3.35%), respectively. During the follow-up, the 1-year, 2-year and 5-year cumulative incidence of TB in close contacts were 2.15% (95% CI: 1.51%-2.80%), 1.21% (95% CI: 0.93%-1.49%) and 1.11% (95% CI: 0.64%-1.58%), respectively. Individuals with a positive result of MTB infection testing at baseline showed significantly higher cumulative TB incidence as compared to those negatives (3.80% vs. 0.82%, p < 0.001).

Conclusions

Individuals with close contact to active pulmonary TB patients are bearing significant risk of developing active TB, particularly within the first-year post-exposure. Population with recent infections should be an important priority for active case finding and preventive intervention worldwide.