bluuebunny/crossref_metadata_2025 huggingface dataset:
Concurrent chemotherapy using taxane plus cisplatin versus cisplatin alone in high-risk nasopharyngeal carcinoma patients with suboptimal response to induction chemotherapy
Authors: Zhang Ya-Ni , Chen Yu-Pei , Li Ji-Bin , Lu Tai-Xiang , Han Fei , Chen Chun-Yan
Published: June 2023

Background:

Detectable Epstein–Barr virus (EBV) DNA levels and unsatisfactory tumor response to induction chemotherapy (IC) could be used to guide the risk-adapted treatment strategy of locoregionally advanced nasopharyngeal carcinoma (LANPC) before concurrent chemoradiotherapy. We aim to compare the efficacy and safety of concurrent chemotherapy using taxane plus cisplatin [double-agent concurrent chemotherapy (DACC) group] with those of cisplatin alone [single-agent concurrent chemotherapy (SACC) group] in high-risk LANPC.

Methods:

Overall, 197 LANPC patients with detectable EBV DNA or stable disease (SD) after IC were retrospectively included. Potential confounders between the DACC and SACC groups were adjusted by propensity score matching. Short-term efficacy and long-term survival were assessed in the two groups.

Results:

Although the objective response rate of the DACC group was marginally higher than that of the SACC group, the difference was not significant (92.7% versus 85.3%, p = 0.38). Concerning long-term survival, DACC did not show superiority to SACC after patient matching: 3-year progression-free survival: 87.8% versus 81.7%, p = 0.80; overall survival: 97.6% versus 97.3%, p = 0.48; distant metastasis-free survival: 87.8% versus 90.5%, p = 0.64, and; locoregional relapse-free survival: 92.3% versus 86.9%, p = 0.77. The incidence of grade 1–4 hematological toxicities was significantly higher in the DACC group.

Conclusion:

Due to the small sample size, we do not have sufficient evidence that concurrent chemotherapy using taxane plus cisplatin provides additional survival benefits in LANPC patients with an unfavorable response (detectable EBV DNA levels or SD) after IC. But concurrent taxane and cisplatin chemotherapy is associated with a higher rate of hematologic adverse events. Further clinical trials will be required to establish evidence and identify more effective treatment modalities for high-risk LANPC patients.
The association between pain self-efficacy and patient-reported outcome measures for hand disorders: a cross-sectional study
Authors: Overduin Ilona , Allen Cate , Aret Jomina
Published: June 2023

Introduction

Multiple psychological factors influence the functioning of patients with hand disorders. Pain self-efficacy is a positive psychological factor, which concerns an individual’s confidence to function despite experiencing pain. This study aimed to analyse the association between pain self-efficacy and a patient-reported outcome measure (PROM) for hand and wrist disorders.

Methods

Cross-sectional data from patient records were collected prior to hand therapy to analyse the correlation between pain self-efficacy and a PROM for hand and wrist disorders. The assessment tools consisted of the Dutch translations of the Pain Self-Efficacy Questionnaire Short Form (PSEQ-2) and the Patient Rated Wrist Hand Evaluation (PRWHE).

Results

The findings were reported for the entire sample of 185 respondents (61% women). The PSEQ-2 and the PRWHE were strongly and significantly correlated, which signifies that a higher pain self-efficacy was associated with less pain and disability as measured by the PRWHE. Within a multivariable regression model which accounted for confounding variables, pain self-efficacy independently predicted 28% of the PRWHE scores.

Conclusions

A strong association between the Dutch PSEQ-2 and the PRWHE was found in this sample of hand therapy patients. This study was limited by the use of retrospective data and by the lack of validation of the Dutch PSEQ-2. The findings were consistent with existing research which reported similar correlations between upper extremity PROM scores and pain self-efficacy. The positively worded PSEQ presents a chance to routinely assess pain self-efficacy as a key psychological factor while also affirming a positive coping strategy.
Feasibility and Preliminary Behavioral and Clinical Efficacy of a Diabetes Education Chatbot Pilot Among Adults With Type 2 Diabetes
Authors: Nassar Carine M. , Dunlea Robert , Montero Alex , Tweedt April , Magee Michelle F.
Published: June 2023

Background:

Diabetes self-management education and support (DSMES) improves diabetes outcomes yet remains consistently underutilized. Chatbot technology offers the potential to increase access to and engagement in DSMES. Evidence supporting the case for chatbot uptake and efficacy in people with diabetes (PWD) is needed.

Method:

A diabetes education and support chatbot was deployed in a regional health care system. Adults with type 2 diabetes with an A1C of 8.0% to 8.9% and/or having recently completed a 12-week diabetes care management program were enrolled in a pilot program. Weekly chats included three elements: knowledge assessment, limited self-reporting of blood glucose data and medication taking behaviors, and education content (short videos and printable materials). A clinician facing dashboard identified need for escalation via flags based on participant responses. Data were collected to assess satisfaction, engagement, and preliminary glycemic outcomes.

Results:

Over 16 months, 150 PWD (majority above 50 years of age, female, and African American) were enrolled. The unenrollment rate was 5%. Most escalation flags (N = 128) were for hypoglycemia (41%), hyperglycemia (32%), and medication issues (11%). Overall satisfaction was high for chat content, length, and frequency, and 87% reported increased self-care confidence. Enrollees completing more than one chat had a mean drop in A1C of −1.04%, whereas those completing one chat or less had a mean increase in A1C of +0.09% ( P = .008).

Conclusion:

This diabetes education chatbot pilot demonstrated PWD acceptability, satisfaction, and engagement plus preliminary evidence of self-care confidence and A1C improvement. Further efforts are needed to validate these promising early findings.
Exercise Intensity and Activity Energy Expenditure of Professional Golf Players in Official Competitive Setting
Authors: Scalise Filippo , Cavanna Ferruccio , Godio Chiara , Beretta Egidio P.
Published: June 2023

Background:

Research regarding the physical needs of professional golf players is lacking. With advances in wearable technology, it has become easier to analyze physiological responses such as heart rate (HR) to determine activity energy expenditure (AEE). The purpose of the study was to evaluate exercise intensity (EI) and AEE during 4 consecutive tournament’s golf rounds using a popular wrist-based HR monitoring.

Hypothesis:

Wearable systems for HR monitoring can be used to provide an accurate estimate of energy expenditure.

Study Design:

Cross-sectional study.

Level of Evidence:

Level 3.

Methods:

A total of 20 male professional golfers participated in the study. Each player was monitored during an official tournament consisting of 4 rounds of 18 holes. EI and AEE were determined using HR wrist monitoring (Whoop Strap 2.0). We calculated the percentage of HRmax (%HRmax) and the percentage of HRres (%HRres) and the AEE in kcal/min using Keytel’s formula.

Results:

The calculated mean %HRmax and %HRres for the study population were 56.4% ± 1.8% and 40.5% ± 2.6%, respectively. Considering American College of Sports Medicine guidelines, these average percentages correspond to a moderate EI. The average caloric expenditure was 5.4 ± 0.4 kcal/min and 1555.8 ± 157.8 kcal per round considering an average golf round duration of 288.3 ± 19.5 minutes.

Conclusion:

A professional player’s golf round is moderate physical activity. The AEE of this activity was equal to 5.4 cal/min, which is moderate energy consumption.

Clinical Relevance:

These data could help golf coaches and conditioning coaches to have a better understanding of the load placed on golfers during tournaments.
Flattening the Curve and Cutting Corners—Pearls and Pitfalls Facial Gender Affirming Surgery
Authors: Gunther Sven , Carboy Jourdan , Jedrzejewski Breanna , Berli Jens
Published: June 2023

Study Design

This is an experiential article based on the past 6 years experience of providing facial gender confirmation surgery (fGAS) at an academic medical center.

Objective

While trainees are getting increasing exposure to aspects of facial gender affirming surgery (fGAS), the gap between trained providers and patients who can access care is currently still widening. A handful of fellowships across the country have emerged that include fGAS in their curriculum, but it will take another decade before the principles of affirming care and surgeries are systematically taught. Fortunately, the surgical principles and techniques required to perform fGAS are part of the skill set of any specialty surgeon trained in adult craniofacial trauma and esthetic facial surgery/rhinoplasty. It is the aim of this article to provide directly applicable knowledge with the goal to assist surgeons who consider offering fGAS in flattening the learning curve and hopefully contribute to increasing the quality of care provided for the transgender and gender diverse population. We hope to provide the reader with a very tangible article with the aims to 1) provide a simple systematic framework for an affirming consultation and preoperative assessment and 2) provide translatable surgical pearls and pitfalls for forehead feminization and gonial angle resection. The frontal sinus set back and gonial angle resection in our opinion are the most unique aspect to fGAS as rhinoplasty, genioplasty and other associated procedures (e.g., fat grafting) follow well established principles. We hope that the value of this article lies in the translatability of the presented principle to any practice setting without the need for VSP, special surgical instruments or technology beyond basic craniofacial tools.

Methods

This is an experiential article based on the senior authors 6 year experience offering fGAS in an academic setting. The article is structured to outline both pearls and pittfalls and is supplemented by photographs and a surgical video.

Results

A total of 19 pearls and pitfalls are outlined in the article.

Conclusions

Facial gender affirming surgery mostly follows established craniofacial and esthetic surgery principles. Forehead feminization and gonial angle feminization are the 2 components that diverge most from established surgical techniques and this article hopefully provides guidance to shorten the learning curve of surgeons.
Predialysis trajectories of estimated GFR and concurrent trends of Chronic Kidney Disease-relevant biomarkers
Authors: Tsao Hsiao-Mei , Lai Tai-Shuan , Chou Yu-Hsiang , Lin Shuei-Liong , Chen Yung-Ming
Published: June 2023

Background:

The glomerular filtration rate (GFR) decline varies in patients with advanced chronic kidney disease (CKD), and the concurrent changes in CKD-related biomarkers are unclear.

Objectives:

This study aimed to examine the changes in CKD-related biomarkers along with the kidney function decline in various GFR trajectory groups.

Design:

This study was a longitudinal cohort study originated from the pre-end-stage renal disease (pre-ESRD) care program in a single tertiary center between 2006 and 2019.

Methods:

We adopted a group-based trajectory model to categorize CKD patients into three trajectories according to estimated glomerular filtration rate (eGFR) changes. A repeated-measures linear mixed model was used to estimate the concurrent biomarker trends in a 2-year period before dialysis and to examine the differences among trajectory groups. A total of 15 biomarkers were analyzed, including urine protein, serum uric acid, albumin, lipid, electrolytes, and hematologic markers.

Results:

Using longitudinal data from 2 years before dialysis initiation, 1758 CKD patients were included. We identified three distinct eGFR trajectories: persistently low eGFR levels, progressive loss of eGFR, and accelerated loss of eGFR. Eight of the 15 biomarkers showed distinct patterns among the trajectory groups. Compared with the group with persistently low eGFR values, the other two groups were associated with a more rapid increase in the blood urea nitrogen (BUN) level and urine protein–creatinine ratio (UPCR), especially in the year before dialysis initiation, and a more rapid decline in hemoglobin and platelet counts. A rapid eGFR decline was associated with lower levels of albumin and potassium, and higher levels of mean corpuscular hemoglobin concentration (MCHC) and white blood cell (WBC). The albumin level in the group with an accelerated loss of eGFR was below the normal range.

Conclusion:

Using longitudinal data, we delineated the changes in CKD biomarkers with disease progression. The results provide information to clinicians and clues to elucidate the mechanism of CKD progression.
Fertility preservation options for transgender and nonbinary individuals
Authors: Reckhow Jensen , Kula Hakan , Babayev Samir
Published: June 2023

Transgender and nonbinary individuals are historically underserved by healthcare systems. A crucial area for improvement is fertility preservation counseling and service delivery, as gender-affirming hormone therapy and gender-affirming surgery may negatively affect future fertility. The methods available for fertility preservation depend on the patient’s pubertal status and utilization of gender-affirming therapies, and counseling and delivery of these services are complex and require a multidisciplinary approach. Further research is needed to identify pertinent stakeholders in managing the care of these patients, as well as to better understand the optimal frameworks for delivering integrated and comprehensive care to this patient population. Fertility preservation is an active and exciting area of scientific discovery and offers a wealth of opportunities to improve the care of transgender and nonbinary individuals.
Geographies of the impossible
Authors: Pohl Lucas
Published: June 2023

In this commentary, I trace the potential of ‘the impossible’ as a spatio-temporal category for geographical research. I proceed from the assumption that the impossible takes on an ever more prominent role in the contemporary zeitgeist, especially in light of current crisis dynamics, such as pandemics, climate change, or the threat of nuclear warfare. When the impossible ‘takes place’, it receives a geography, or means the end of geography. Geographies of the impossible suspend taken-for-granted facts, pave the way for new actors, function according to their own logic, and create spaces for extraordinary encounters. Studying these geographies encourages scholars to engage with dystopian and apocalyptic but also utopian and revolutionary spatialities as well as follow the desire to make possible tomorrow what is impossible today.
Exploring patient participation during video consultations: A qualitative study
Authors: Bavngaard Martin Vinther , Lüchau Elle Christine , Hvidt Elisabeth Assing , Grønning Anette
Published: June 2023

Objective

Video consultations enable a digital point of contact between the general practitioner and patient. With their medium-specific characteristics, video consultations may create novel conditions for the enactment of patient participation during consultations. Although numerous studies have explored patients’ experiences of video consultations, research explicitly investigating patient participation within this new consultation setting remains sparse. This qualitative study explores how patients participate during interactions with their general practitioner by drawing on the affordances of video consultations.

Methods

The data corpus comprises eight recorded video consultations (59 minutes and 19 seconds in total) between patients and their general practitioner, all subjected to reflexive thematic analysis yielding three themes illustrating concrete participatory use cases.

Results

We find that video consultations provide an accessible format for patients otherwise unable to attend a physical consultation due to physical and mental barriers. Moreover, patients participate by drawing on resources situated in their spatial setting to settle health-related questions of doubt arising during the consultation. Lastly, we posit that patients enact participation by visually communicating their impromptu engagement in decision-making and reporting to their general practitioner by making use of the qualities of their smartphone during their consultation.

Conclusions

Our findings illustrate how video consultations provide a communicative context in which patients may enact distinct forms of participation by drawing on its technologically contingent affordances during interactions with their general practitioner. More research is needed to explore the participatory opportunities of video consultations in telemedical healthcare services for different patient groups.
Multi-Level Analysis of Factors on Teacher Job Satisfaction Across Japan and South Korea: Evidence From TALIS 2018
Authors: Niu Jinpeng , Fan Chunhong , Wang Zhongxing , Chen Yonghuan
Published: June 2023

Teacher job satisfaction has been investigated as a critical influence on teacher turnout and the development of high-quality schools. Employing hierarchical linear modeling (HLM), the present study examined the effects of both teacher- and school-level factors on teacher job satisfaction in Japan and South Korea. Education in both countries is rooted in an East Asian cultural setting, and a comparison across the two countries will contribute to the discovery of underlying factors that affect teacher job satisfaction. The current study, based on the 2018 Teaching and Learning International Survey, showed that gender, teaching experience, social utility motivation to teach, self-efficacy, teacher-student relations, professional development, and team innovativeness exerted a crucial influence on teacher job satisfaction at teacher-level for Japan and South Korea. Furthermore, school sector, school delinquency and violence, and lack of special needs personnel were distinctive factors at school-level related to teacher job satisfaction for the two countries. The findings were discussed within the East Asian cultural context as well as comparatively, regarding East Asian versus Western cultures.
A Comparative Evaluation of Drug Information Leaflets of Over-the-Counter Medicines in Palestine
Authors: Koni Amer , Snobar Anas , Ahmed Ahmad , Jawabreh Abed Al-rahman , Al-Jabi Samah W. , Zyoud Sa’ed H.
Published: June 2023

Our study aims to conduct an evaluation and comparison between the leaflets of local and imported oral solid over-the-counter medications (OTC) found in the Palestinian markets. Forty-nine leaflets were evaluated using a scoring method and depending on the appearance of 31 headings, along with the use of manual word counting to assess the amount of information within 23 topics of all 31. None of the evaluated PIs, local or imported, completed all 31 criteria. Remarkably, the imported product leaflets achieved higher scores than their local leaflets in 19 out of 31 topics, whereas the local products achieved better scores than the imported agents in only 2 items, and 10 criteria were equally scored between them. None of the PIs mentioned pharmacokinetic information, instructions for converting tablets or capsules into liquid forms, or shelf life. In general, imported leaflets give more detailed information than their local counterparts. The lowest value of the fold difference in mean rank was 0.85 times for the direction of use, and the highest value was 2.43-fold for adverse drug reactions. The results showed a deficiency in the information provided in the local package inserts compared to the imported versions of oral solid OTC medications available in Palestine. These findings encourage the Palestinian Ministry of Health to provide full criteria for pharmaceutical companies to ensure that the leaflets contain sufficient and updated information and ensure that the patients use their drugs safely and effectively.
Do Symptom Severity, Individual Socioeconomic Status, and Neighborhood Socioeconomic Status Explain Differences in Daily Functioning in Non-Latinx Black, Non-Latinx White, and Latinx People With Serious Mental Illnesses?
Authors: Nagendra Arundati , Liu Chih-Wei Joshua , Mueser Kim T. , Harvey Philip D. , Depp Colin A. , Moore Raeanne C. , Davis Beshaun , Pinkham Amy E.
Published: June 2023

In this study, we examined ethno-racial differences in daily functioning in 66 non-Latinx White participants, 83 non-Latinx Black participants, and 60 Latinx participants ( N = 209) diagnosed with serious mental illnesses, and the extent to which individual socioeconomic status (SES), neighborhood SES, and symptom severity accounted for observed differences. Participants completed ecological momentary assessments of what they were doing, who they were with, and where they were three times daily for 30 days. Black participants more frequently reported being alone or engaged in passive leisure (e.g., watching TV) than White participants and Latinx participants, less frequently reported vocational activity than Latinx participants, and less frequently reported home-based active leisure than White participants. Although some findings were accounted for by neighborhood SES, individual SES, or symptoms, there is also a need to explore sociocultural and racism-related explanatory factors. Clinical implications (e.g., providing vocational services to Black clients) and future research directions are discussed.
Trump and Modi and the ideological, political and economic underpinnings of the India–United States trade dispute
Authors: Verma Raj
Published: June 2023

This article seeks to provide answers to questions: why did India and the United States have a trade dispute under Trump and Modi administrations, and why were the two countries unable to resolve the trade dispute under Trump and Modi administrations? The article asserts that the primary reason for the trade dispute/disagreements between the two countries is the domestic economic and political environment and ideological considerations in the Trump and Modi administrations. This has manifested itself in a clash between Trump's ‘America first’ stance with the aim of ‘Making America great again’ and Modi's ‘Make in India’ initiative which envisions creating India as a manufacturing powerhouse and increasing the economic prosperity of Indian citizens. The article highlights each country's concerns and grievances regarding the other side's trade policies and what kind of trade access India wants from the United States and vice-versa.
Pars Plana Vitrectomy for Vitreomacular Traction Resulting in Persistent Postoperative Loculated Foveal Subretinal Fluid
Authors: Wilson Darcie S. , Pinto Ashlyn M. , Gupta R. Rishi
Published: June 2023

Purpose: To describe a case of postoperative persistent loculated subretinal fluid (SRF) that developed after pars plana vitrectomy (PPV) for vitreomacular traction (VMT) syndrome. Methods: A case was analyzed and a literature review performed. Results: A healthy 64-year-old man with no significant ocular history presented with persistent, symptomatic VMT. Combined phacoemulsification and PPV, epiretinal membrane and internal limiting membrane peeling, and gas–fluid exchange were performed. Postoperative spectral-domain optical coherence tomography imaging showed loculated foveal SRF. The SRF persisted for 8 months, with minimal change in size and little best-corrected visual acuity improvement. Conclusions: Although persistent loculated SRF has been reported after vitrectomy for rhegmatogenous retinal detachment (RD) in high myopia and tractional RD in diabetes, it has not yet been reported postoperatively after PPV for VMT. Studies of the pathophysiology and long-term course of persistent SRF after PPV for VMT are needed to inform management decisions for this rare complication.
Hospitals on Park Road
Authors: Shajahan Althaf , Mukherji Arnab , Chirammal Shedha
Published: June 2023

This case adopts a dialectical method to illustrate firm-level strategies and competition in the Indian for-profit hospital sector. The case clearly contextualizes its setting within the developing country scenario and against a backdrop of under-provision in healthcare delivery. We compare growth models, horizontal and vertical integration strategies, mergers and acquisitions plans, geographical expansion patterns and physician engagement models of two leading hospital chains in the Indian hospital sector anonymizing them and masking them as the ‘Hospitals on Park Road’.
Spectral matching RotD100: Effects on bidirectional lateral demand of reinforced concrete frame buildings
Authors: Rivera-Figueroa Alan , Montejo Luis A , Grant Damian N
Published: June 2023

Different approaches are used to generate ground motion sets compatible with a target RotD100 spectrum following current ASCE7 requirements. The sets are used as input to perform bidirectional nonlinear response history analyses and evaluate the imposed deformation and energy demands. The structures studied are multistory buildings comprised of space frames designed to resist both gravity and earthquake forces. The influence of reinforcement detailing is explored by varying the ratios between the nominal moment capacities of beams and columns. A wide range of inelastic demands is investigated by scaling the intensity of the input motions. It was found that the marked disparities between the demands exhibited by the various sets can be explained by the differences in the spectral amplitudes along the expected periods of vibration. The traditional approach of spectral matching each horizontal component separately to the target RotD100 spectrum generates records with disproportionate intensities causing unrealistic large inelastic demands when compared to the results expected from amplitude-scaled records. On the other hand, the sets generated by simultaneous modification of the horizontal components to directly match the target RotD100 spectrum exhibited the tightest match to the target and the closest ground motion characteristics (Arias Intensity, significant duration, directionality, and spectral dispersion) to the amplitude-scaled sets. These sets also imposed the mean peak drift and mean total energy demands closest to the imposed by the amplitude-scale sets; however, the mean peak drift demand was slightly but consistently below the expected from amplitude-scaled sets. This unconservative bias vanished when the same approach was implemented using 110% the target spectrum to comply with the ASCE7 minimum spectral amplitude requirement for spectrally matched records.
Sonographic Reference Values for Median Nerve Cross-sectional Area: A Meta-analysis of Data From Healthy Individuals
Authors: Roll Shawn C. , Takata Sandy C. , Yao Buwen , Kysh Lynn , Mack Wendy J.
Published: June 2023

Objective:

Establish median nerve cross-sectional area (CSA) reference values and identify patient-level factors impacting diagnostic thresholds.

Materials and Methods:

Studies were identified through a robust search of multiple databases, and quality assessment was conducted using a modified version of the National Institute of Health Study Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. A meta-analysis was performed to identify normative values stratified by anatomic location. A meta-regression was conducted to examine heterogeneity effects of age, sex, and laterality.

Results:

The meta-analysis included 73 studies; 41 (56.2%) were high quality. The median nerve CSA [95% confidence interval, CI] was 6.46 mm2 [6.09–6.84], 8.68 mm2 [8.22–9.13], and 8.60 mm2 [8.23–8.97] at the proximal forearm, the carpal tunnel inlet, and the proximal carpal tunnel, respectively. Age was positively associated with CSA at the level of proximal carpal tunnel (β = 0.03 mm2, P = .047). Men (9.42 mm2 [8.06–10.78]) had statistically larger proximal tunnel CSA ( P = .03) as compared with women (7.71 mm2 [7.01–8.42]). No difference was noted in laterality.

Conclusion:

A reference value for median nerve CSA in the carpal tunnel is 8.60 mm2. Adjustments may be required in pediatrics or older adults. The diagnostic threshold of 10.0 mm2 for male patients should be cautiously applied as the upper limit of normative averages surpasses this threshold.
The pre-conception maternal exposure to Sofosbuvir affects the mitochondrial biogenesis in prenatal fetal tissues: Experimental study on rats
Authors: Mahmoud Shimaa A. , Abdel-Aziz Maryam M. , Khafaga Rana H. M. , Hafez Hala A. , Kamel Maher A. , Shaker Sara A.
Published: June 2023

Background

 Hepatitis C virus (HCV) infection is a global public health problem and Egypt has the highest HCV prevalence worldwide. Hence, global efforts target to eliminate HCV by 2030. Sofosbuvir is a nucleotide analogue inhibitor of HCV polymerase essential for viral replication. Animal studies prove that Sofosbuvir metabolites cross the placenta and are excreted in the milk of nursing animals. We aimed to investigate the possible effects of preconception maternal exposure to Sofosbuvir on mitochondrial biogenesis in prenatal fetal liver, skeletal muscle, and placental tissues.

Methods

 The study was conducted on 20 female albino rats divided into a control group receiving a placebo and an exposed group receiving 4 mg/kg orally/day for 3 months of Sofosbuvir. At the end of the treatment period, pregnancy was induced in both groups by mating with healthy male rats overnight. At gestational day 17, all pregnant female rats were sacrificed. Each fetus was dissected to obtain the fetal liver, skeletal muscle, and placental tissues.

Results

 The results of our study indicated that the exposure of young female rats to Sofosbuvir affects pregnancy outcomes. Fetal liver and muscle showed lower mitochondrial DNA-copy number (mtDNA-CN) by about 24% and 29% respectively, peroxisome proliferator-activated receptor-gamma coactivator-1 alpha and its downstream targets; nuclear respiratory factor-1 and mitochondrial transcription factor A. While the placental tissues showed different patterns, particularly elevated in mtDNA-CN by about 43%.

Conclusions

 The study provides preliminary evidence of the detrimental effects of Sofosbuvir on the pregnancy outcomes of the exposed females and may impair the placental and fetal organs’ development. These effects may be mediated through modulating mitochondrial homeostasis and functions.
Mitochondrial reprogramming in peripheral blood mononuclear cells of patients with glycogen storage disease type Ia
Authors: Rossi Alessandro , Assunto Antonia , Rosano Carmen , Tucci Sara , Ruoppolo Margherita , Caterino Marianna , Pirozzi Francesca , Strisciuglio Pietro , Parenti Giancarlo , Melis Daniela
Published: June 2023

Background

Glycogen storage disease type Ia (GSDIa) is an inborn metabolic disorder caused by the deficiency of glucose-6-phospatase-α (G6Pase-α) leading to mitochondrial dysfunction. It remains unclear whether mitochondrial dysfunction is present in patients’ peripheral blood mononuclear cells (PBMC) and whether dietary treatment can play a role. The aim of this study was to investigate mitochondrial function in PBMC of GSDIa patients.

Methods

Ten GSDIa patients and 10 age-, sex- and fasting-time matched controls were enrolled. Expression of genes involved in mitochondrial function and activity of key fatty acid oxidation (FAO) and Krebs cycle proteins were assessed in PBMC. Targeted metabolomics and assessment of metabolic control markers were also performed.

Results

Adult GSDIa patients showed increased CPT1A, SDHB, TFAM, mTOR expression (p < 0.05) and increased VLCAD, CPT2 and citrate synthase activity in PBMC (p < 0.05). VLCAD activity directly correlated with WC (p < 0.01), BMI (p < 0.05), serum malonycarnitine levels (p < 0.05). CPT2 activity directly correlated with BMI (p < 0.05).

Conclusion

Mitochondrial reprogramming is detectable in PBMC of GSDIa patients. This feature may develop as an adaptation to the liver enzyme defect and may be triggered by dietary (over)treatment in the frame of G6Pase-α deficiency. PBMC can represent an adequate mean to assess (diet-induced) metabolic disturbances in GSDIa.
Preferences for policy measures to regulate urban vehicle access for climate change mitigation
Authors: Ogunkunbi Gabriel Ayobami , Meszaros Ferenc
Published: June 2023

In cognisance of the urgent need to decarbonise the transport sector to limit its impact on climate change and to internalise other negative transport externalities, regulating vehicle access in urban areas is essential. However, urban areas often struggle to implement these regulations due to concerns relating to social acceptability, heterogeneity of citizen preferences, lack of information on preferred measure attributes, and other factors that can boost the acceptance of urban vehicle access regulations. This study explores the acceptability and willingness to support Urban Vehicle Access Regulations (UVAR) in Budapest, Hungary to reduce transportation emissions and promote sustainable urban mobility. Using a structured questionnaire, which includes a choice-based conjoint exercise, the study finds that 42% of respondents were willing to support a car-free policy measure. Results were analysed to elicit preferences for specific UVAR measure attributes, identify population subgroups, and assess factors influencing willingness to support UVAR implementation. Access fee and proportion of revenue earmarked for transport development were the most important attributes to respondents. The study also identified three distinct subgroups of respondents with differing preferences, which could be characterised based on access to passenger cars, age, and employment status. The findings suggest that for effective UVAR, access fees for non-compliant vehicles should be excluded from measure designs, and the attribute preference approach highlights the importance of considering the heterogeneity of residents’ preferences in UVAR measure planning.
Seasonal fluctuations and diversity of Ingoldian mycobiota in two water bodies receiving different effluents at Assiut Governorate (Upper Egypt)
Authors: Khallil Abdel-Raouf M. , Ali Essam H. , Ibrahim Sabreen S. , Hassan Elhagag Ahmed
Published: June 2023

In the current study, fifty-eight Ingoldain fungal species assignable to forty-one genera were recovered from two water bodies receiving the treated sewage and the effluents of oils and soaps factory at Assiut Governorate (Upper Egypt), of which Anguillospora, Amniculicola, Flagellospora, and Mycocentrospora were the most prevalent genera. The most widespread identified species were Anguillospora furtive, Amniculicola longissima and Flagellospora fusarioides. Forty-three species were identified for the first time in Egypt. The most Ingoldain taxa were estimated for El-Zinnar canal, with the highest recorded taxa in winter. Whereas, the highest dominance of Ingoldian fungi was estimated for the El-Ibrahimia canal. The highest Simpson and Shannon diversity indexes were estimated for El-Zinnar canal samples recording 0.9683 and 3.741, respectively. The poorest water sites with Ingoldian fungi were those exposed directly to either treated sewage or industrial effluents, with which relatively higher values of water conductivity, cations and anions. Water temperature was the main abiotic factor driving the seasonal occurrence of Ingoldian fungi. It is interesting to isolate some Ingoldian fungal species from the stressful water sites receiving the effluents which provide valuable insights regarding their adaptation, predictive and putative role as bioindicators and their potentiality in pollutants degradation, organic decomposition, and transformation of xenobiotic compounds.
Acceptance of diagnosis and management satisfaction of patients with “suspected Lyme borreliosis” after 12 months in a multidisciplinary reference center: a prospective cohort study
Authors: Raffetin Alice , Chahour Amal , Schemoul Julien , Paoletti Giulia , He Zhuoruo , Baux Elisabeth , Patrat-Delon Solène , Nguala Steve , Caraux-Paz Pauline , Puppo Costanza , Arias Pauline , Madec Yoann , Gallien Sébastien , Rivière Julie
Published: June 2023

Introduction

Because patients with a “suspicion of Lyme borreliosis (LB)” may experience medical wandering and difficult care paths, often due to misinformation, multidisciplinary care centers were started all over Europe a few years ago. The aim of our study was to prospectively identify the factors associated with the acceptance of diagnosis and management satisfaction of patients, and to assess the concordance of the medical health assessment between physicians and patients 12 months after their management at our multidisciplinary center.

Methods

We included all adults who were admitted to the Tick-Borne Diseases Reference Center of Paris and the Northern Region (TBD-RC) (2017–2020). A telephone satisfaction survey was conducted 12 months after their first consultation. It consisted of 5 domains and 13 items rated between 0 (lowest) and 10 (highest grade): (1)Reception; (2)Care and quality of management; (3)Information/explanations given to the patients; (4)Current medical condition and acceptance of the final diagnosis; (5)Overall appreciation. Factors associated with diagnosis acceptance and management satisfaction at 12 months were identified using logistic regression models. The concordance of the health status as assessed by doctors and patients was calculated using a Cohen’s kappa test.

Results

Of the 569 patients who consulted, 349 (61.3%) answered the questionnaire. Overall appreciation had a median rating of 9 [8;10] and 280/349 (80.2%) accepted their diagnoses. Patients who were “very satisfied” with their care paths at TBD-RC (OR = 4.64;CI95%[1.52–14.16]) had higher odds of diagnosis acceptance. Well-delivered information was strongly associated with better satisfaction with the management (OR = 23.39;CI95%[3.52–155.54]). The concordance between patients and physicians to assess their health status 12 months after their management at TBD-RC was almost perfect in the groups of those with confirmed and possible LB (κ = 0.99), and moderate in the group with other diagnoses (κ = 0.43).

Conclusion

Patients seemed to approve of this multidisciplinary care organization for suspected LB. It helped them to accept their final diagnoses and enabled a high level of satisfaction with the information given by the doctors, confirming the importance of shared medical decisions, which may help to reduce health misinformation. This type of structure may be useful for any disease with a complex and controversial diagnosis.
Steroid responsive idiopathic calcitriol induced hypercalcemia: a case report and review of the literature
Authors: Fadel Omar El , Kenkare Anshel , Zhang Jingjing
Published: June 2023

Background

Idiopathic Calcitriol Induced Hypercalcemia is a rare cause of a common condition of hypercalcemia. Hypercalcemia is most commonly the result of hyperparathyroidism and together with hypercalcemia of malignancy accounts for over 95% of cases. Idiopathic Calcitriol Induced Hypercalcemia can mimic hypercalcemia secondary to granulomatous diseases like sarcoidosis, but with apparent absences of both imaging and physical exam findings consistent with the disease. We report here a 51-year-old man who presented with recurrent nephrolithiasis, hypercalcemia, and acute kidney injury.

Case presentation

A 51-year-old man presented with severe back pain and mild hematuria. He had a history of recurrent nephrolithiasis over the course of a 15-year period. On presentation his calcium was elevated at 13.4 mg/dL, creatinine was 3.1 mg/dL (from baseline of 1.2), and his PTH was reduced at 5 pg/mL. CT abdomen and pelvis showed acute nephrolithiasis which was managed medically. Work up for the hypercalcemia included an SPEP which was normal, Vit D,1,25 (OH)2 was elevated at 80.4 pg/mL, CT chest showed no evidence of sarcoidosis. Management with 10 mg prednisone showed marked improvement in the hypercalcemia and he no longer had any symptoms of hypercalcemia.

Conclusion

Idiopathic Calcitriol Induced Hypercalcemia is a rare cause of hypercalcemia. All reported cases benefit from more intensive long-term immunosuppression. This report helps consolidate the diagnosis of Idiopathic Calcitriol Induced Hypercalcemia and encourages researchers to better investigate its underlying pathogenesis.
Prevalence and predictors of chronic kidney disease of undetermined causes (CKDu) in Western Kenya’s “sugar belt”: a cross-sectional study
Authors: H. Hathaway Michelle , L. Patil Crystal , Odhiambo Aloyce , Onyango Dickens , Dorevitch Samuel
Published: June 2023

Background

Epidemics of chronic kidney disease of undetermined causes (CKDu) among young male agricultural workers have been observed in many tropical regions. Western Kenya has similar climatic and occupational characteristics as many of those areas. The study objectives were to characterize prevalence and predictors of CKDu, such as, HIV, a known cause of CKD, in a sugarcane growing region of Kenya; and to estimate prevalence of CKDu across occupational categories and evaluate if physically demanding work or sugarcane work are associated with reduced eGFR.

Methods

The Disadvantaged Populations eGFR Epidemiology Study (DEGREE) protocol was followed in a cross-sectional study conducted in Kisumu County, Western Kenya. Multivariate logistic regression was performed to identify predictors of reduced eGFR.

Results

Among 782 adults the prevalence of eGFR < 90 was 9.85%. Among the 612 participants without diabetes, hypertension, and heavy proteinuria the prevalence of eGFR < 90 was 8.99% (95%CI 6.8%, 11.5%) and 0.33% (95%CI 0.04%, 1.2%) had eGFR < 60. Among the 508 participants without known risk factors for reduced eGFR (including HIV), the prevalence of eGFR < 90 was 5.12% (95%CI 3.4%, 7.4%); none had eGFR < 60. Significant risk factors for reduced eGFR were sublocation, age, body mass index, and HIV. No association was found between reduced eGFR and work in the sugarcane industry, as a cane cutter, or in physically demanding occupations.

Conclusion

CKDu is not a common public health problem in this population, and possibly this region. We recommend that future studies should consider HIV to be a known cause of reduced eGFR. Factors other than equatorial climate and work in agriculture may be important determinants of CKDu epidemics.
I-PREGNO – prevention of unhealthy weight gain and psychosocial stress in families during pregnancy and postpartum using an mHealth enhanced intervention: a study protocol of two cluster randomized controlled trials
Authors: Vogel Lea , Färber Tanja , Hölzl Ingrid , Deliens Tom , Henning Carmen , Liel Christoph , Löchner Johanna , Lux Ulrike , Opitz Ansgar , Seiferth Caroline , Versele Vicka , Wolstein Jörg , van Poppel Mireille N. M.
Published: June 2023

Background

The transition to parenthood represents a critical life period with psychosocial, and behavioral changes and challenges for parents. This often increases stress and leads to unhealthy weight gain in families, especially in psychosocially burdened families. Although universal and selective prevention programs are offered to families, specific support often fails to reach psychosocially burdened families. Digital technologies are a chance to overcome this problem by enabling a low-threshold access for parents in need. However, there is currently a lack of smartphone-based interventions that are tailored to the needs of psychosocially burdened families.

Aims

The research project I-PREGNO aims to develop and evaluate a self-guided, smartphone-based intervention in combination with face-to-face counseling delivered by healthcare professionals for the prevention of unhealthy weight gain and psychosocial problems. The intervention is specifically tailored to the needs of psychosocially burdened families during the pregnancy and postpartum period.

Methods

In two cluster randomized controlled trials in Germany and Austria (N = 400) psychosocially burdened families will be recruited and randomized to i) treatment as usual (TAU), or ii) I-PREGNO intervention (self-guided I-PREGNO app with counseling sessions) and TAU. We expect higher acceptance and better outcomes on parental weight gain and psychosocial stress in the intervention group.

Discussion

The intervention offers a low cost and low-threshold intervention and considers the life situation of psychosocially burdened families who are a neglected group in traditional prevention programs. After positive evaluation, the intervention may easily be implemented in existing perinatal care structures in European countries such as Germany and Austria.

Trial registration

Both trials were registered prospectively at the German Clinical Trials Register (Germany: DRKS00029673; Austria: DRKS00029934) in July and August 2022.
Effect of preoperative prophylactic intravenous tranexamic acid on perioperative blood loss control in patients undergoing cesarean delivery: a systematic review and meta-analysis
Authors: Yang Fan , Wang Han , Shen Mengdie
Published: June 2023

Background

Postpartum hemorrhage (PPH) is one of the important risk factors leading to maternal mortality and intervention is essential. Oxytocin therapy is widely used clinically, but the effect is unsatisfactory. The efficacy of tranexamic acid (TXA) in hemostasis is notable, whereas its use in preventing PPH warrants exploration.

Aims

To evaluate the effect of prophylactic administration of TXA on perioperative blood loss in women undergoing cesarean section by systematic review and meta-analysis of published studies.

Methods

Bibliographic databases were screened from their inception to December 2022 to retrieve relevant studies. Study outcomes including blood loss during cesarean section, 2-h postpartum blood loss, total blood loss (during cesarean section and 2-h postpartum), and 6-h postpartum, as well as hemoglobin changes were extracted and compared.

Results

A total of 21 studies, nine randomized clinical trials and 12 cohort studies, involving 1896 patients given TXA prophylactically and 1909 patients given placebo or no treatment, were analyzed. Compared with the control group, the preoperative prophylactic intravenous administration of TXA significantly reduced the intraoperative (RCT: P < 0.00001, cohort studies: P < 0.00001), 2-h postpartum (RCT: P = 0.02, cohort studies: P < 0.00001) and total blood loss (RCT: P < 0.00001, cohort studies: P = 0.0002), and reduced the decline in hemoglobin (RCT: P < 0.00001, cohort studies: P = 0.0001), but did not significantly affect blood loss at 6-h postpartum (P = 0.05).

Conclusion

Prophylactic intravenous TXA before cesarean section is helpful in preventing perioperative bleeding in women.

Trial registration

http://www.crd.york.ac.uk/PROSPERO, identifier: CRD 42022363450.