bluuebunny/crossref_metadata_2025 huggingface dataset:
Wrist Arthrotomy Saline Load Test
Authors: Scollan Joseph P. , Chughtai Morad , Churchill Jessica L. , Emara Ahmed K. , Brej Ben , Steckler Andrew , Ferre Alexandra , Saluan Paul , Styron Joseph F.
Published: March 2022

Background:

Failure to recognize a potential wrist arthrotomy may lead to missed septic arthritis and devastating sequelae. The saline load test is routinely used to recognize traumatic arthrotomies of other joints; however, there are limited data optimizing this test for the wrist. The purpose of this study was to investigate and perform saline load testing to identify traumatic arthrotomies of the wrist.

Methods:

This was a cadaveric study of 15 wrists. Traumatic arthrotomies were created using a blunt trocar through the 3-4 portal. A 3-mL syringe with 0.1 mL markings was used to inject methylene blue dyed saline into the wrist through the 1-2 portal. Once extravasation was visible from the atherectomized site, the volume was recorded.

Results:

The mean (range) volume injected to identify the arthrotomy of all wrists was 1.22 mL (range, 0.1-3.1 mL). Multivariate regression demonstrated that cadaver age, laterality, and extension range of motion were not significantly associated with the injected saline volume at extravasation ( P > .05, each). Greater joint range of motion was independently associated with higher saline volume load for extravasation (odds ratio: 1.049; 95% confidence interval: 1.024-1.075; P = .003).

Conclusions:

We found that 2.68 and 3.02 mL of methylene blue dyed saline offered 95% and 99% sensitivity, respectively, for diagnosing traumatic wrist arthrotomy. The maximum volume of saline needed to recognize an arthrotomy was 3.1 mL. We recommend this be the minimum volume used to evaluate a traumatic wrist arthrotomy.
An assessment of the World Rugby law application guidelines for the breakdown on sanctioning and player adherence
Authors: Mitchell Scott L. , Tierney Gregory J.
Published: March 2022

World Rugby’s law application guideline for the breakdown was developed to make the breakdown safer, fairer, and simpler to understand. The aim of this study was to use video analysis to assess the impact of these guidelines by comparing player adherence from the 2019 Rugby World Cup (pre-guidelines) to the 2020 Autumn Nations Cup (post-guidelines) as well as the rate of sanctioning by match officials. Contested breakdowns (n = 1444) were individually analysed by coding any infringement that occurred as well as the sanctioning outcome. The chi-square and probability (p) values were calculated to compare proportions before (pre) and after (post) the law application guidelines. No change in the rate of infringements was observed (p = 0.207), though the rate of infringements penalised increased (p = 0.001). Reductions in the rate of infringements of two of the five offences targeted by the guidelines were observed; “offside” (p = 0.008) and “remains on feet” (p <0.001). All dangerous play infringements reduced; “charged in” (p <0.001), “contact above shoulder” (p <0.001), “intentional collapse” (p = 0.023). There are early indications that the guidelines have had a marginal influence on overall player adherence to the breakdown rules but a considerable positive influence on adhering to the rules surrounding dangerous play.
Patient-Flow Analysis for Planning a Focused Hospital Layout: Tampere Heart Hospital Case
Authors: Karvonen Sauli , Eskola Markku , Haukilahti Aki , Porkkala Timo
Published: March 2022

Objective:

The objective of this study is present how a patient movement-based patient-flow analysis is performed for planning the new Heart Hospital of Tampere University Hospital and how patient transfer distances can be shortened by this method.

Background:

The Heart Hospital had served patients as a service line organization for years. However, the Heart Hospital layout rather looked like functional layout instead of service line layout because the units of the Heart Hospital have been spread out around the large university hospital campus.

Method:

The flow routes of patients treated over the course of 1 year were analyzed by information technology systems in the hospital planning phase. Then, the proximity ranking of the main functions of the Heart Hospital was made. Layout planning was performed based on the proximity ranking. Nine months after the opening of the new Heart Hospital, the distances between the various hospital functions were calculated for the old Heart Hospital and the new one.

Results:

In the old Heart Hospital, patients’ transfer distance was 5,654 km (3,513 miles), while the corresponding figure for the new Heart Hospital was 3,797 km (2,359 miles), which means the distance was reduced by 33%.

Conclusion:

The patient-flow analysis works as it generated substantially shorter patient transfer distances in the new Heart Hospital. Shorter distances have supported more fluent patient flows that, in turn, has contributed higher productivity and quality of care.
Congenital hyperinsulinism in a newborn presenting with poor feeding
Authors: Mazloom Kiran , Sanchez-Lara Pedro A , Langston Seth , Grand Katheryn , Schweiger Bahareh
Published: March 2022

Hyperinsulinemic hypoglycemia is a condition linked to several genetic, metabolic, and growth disorders in which there is dysregulated insulin secretion. In infants, an inappropriately persistent hypoglycemic and hypoketotic state can cause severe brain injury leading to epilepsy, cerebral palsy, and neurodevelopmental disabilities due to the lack of glucose and ketone substrate to serve as fuel for the developing brain. The most common cause of persistent hypoglycemia in neonates and children has been found to be congenital hyperinsulinism. Here, we report a child with a unique presentation, found to have a novel genetic variant as the underlying cause of hyperinsulinism. This case study highlights the importance of maintaining a broad differential and considering a diagnosis of congenital hyperinsulinism in a baby with poor feeding in the newborn period. Recognizing and treating congenital hyperinsulinism is essential to prevent potential neurological sequelae from recurrent, severe hypoglycemia.
Pregnant women’s use of a consumer-based meditation mobile app: A descriptive study
Authors: Green Jeni , Neher Taylor , Puzia Megan , Laird Breanne , Huberty Jennifer
Published: March 2022

Objective

The objectives of this study were to explore the satisfaction of pregnant or recently pregnant women with the existing Calm app content (i.e. non-pregnancy) and preferences and recommendations for the types of pregnancy-specific content that would be helpful to pregnant women.

Methods

This study was a national cross-sectional survey of subscribers to a meditation mobile app (i.e. Calm). Eligible participants were currently pregnant or recently pregnant (within the past 12 months) and used Calm during their pregnancy. Participants were asked about their Calm usage and perceived benefits of Calm during pregnancy, and interest in pregnancy-specific content. Descriptive statistics were used to characterize the sample.

Results

Participants ( N  =  111) were on average 34 years old (SD  =  5.4) and half of the sample was currently pregnant ( N  =  55). The most common reasons for using the Calm app during pregnancy was for sleep problems (29%; n  =  31) or anxiety (27%; n  =  29). Women reported Calm was most helpful for improving sleep (32%; n  =  32), anxiety (25%; n  =  25), and stress (21%; n  =  21). Nearly all women wanted pregnancy-specific meditation content within the app (98%; n  =  98) and expressed interest in topics including pregnancy-related anxiety (68%; n  =  67), postpartum (50%; n  =  49), pregnancy-related sleep problems (41%; n  =  40), and labor and delivery (38%; n  =  37).

Conclusion

Women who used the Calm app during pregnancy found it helpful for improving sleep, anxiety, and stress but desire pregnancy-specific content. Future meditation mobile app studies should utilize pregnancy-specific content and test the feasibility and efficacy of sleep and mental health in pregnant women.
Urgent Changes to Be Made in Iran’s Primary Education: Voices From Teachers
Authors: Tohidian Iman , Khorsandi Taskoh Ali , Abbaspour Abbas
Published: March 2022

Highlights

One of the main shortcomings of the Iranian educational system is its focus on training students to succeed in different testing/assessment practices. In this regard, primary emphasis is still placed on memorization rather than learning dialogue, collaboration, tolerance, and life expectation for today’s globalized communities. Few voices from Iranian teachers have been heard in international publications. This study collected focus group interviews from 84 Iranian primary school teachers in Tehran, Shiraz, and Yazd. Findings show that the interviewed teachers agreed on the urgent curriculum changes, including English, Law, and Entrepreneurship in the primary teaching. Additionally, the educational focus should be broadened from the current emphasis on assessment from the early years of schooling.
The Uniformization of Think Tanks in Turkey: The Foundation for Political, Economic, and Social Research (SETA) as a Case Study
Authors: Gürpinar Bulut , Aydin Ömür
Published: March 2022

The present study analyzed the role of Turkey’s think tanks as NGOs and conducted a case study on the Foundation for Political, Economic, and Social Research (SETA), an organization that appears to dominate Turkish think thanks’ sphere of activity. Based on the general classifications accepted in the literature on think tanks, the study found that SETA is a “political party affiliation” and “advocacy” think tank. Since its establishment, SETA has been ideologically aligned with the Justice and Development Party (AK Party). It acts as a partner in the design of AK Party policies, provides human resources to the AK Party bureaucracy, and conducts public diplomacy to legitimize these policies in the public eye. According to the Think Tanks and Civil Societies Program’s (TTCSP) data for 2019, 48 think tanks exist in Turkey. The fact that SETA stands out so significantly from its peers suggests that pluralism has been lost in this field and that a monopolization policy is preferred. This study concluded that if a country’s NGOs are weak, this will lead to a democratic deficit. Utilizing Carl Schmitt’s theory of “the total state,” the study analyzed the way in which the post-2016 state-of-emergency regime and the new political regime that emerged following Turkey’s constitutional amendments in 2017 have narrowed the sphere of influence of think tanks and NGOs in Turkey.
Comparative modal analysis on fishing rod made of functionally graded composite material using finite element analysis
Authors: Asiri Saeed
Published: March 2022

The use of smart and advanced composite materials instead of conventional metals is foreseen in material sciences due to the development of novel manufacturing techniques. In this regard, a novel type of composite materials “functionally graded materials (FGM)” has attained great attention owing to their intrinsic mechanical characteristics. FGM have been the focus for researchers for analytical formulation, static structural (large deformation, material nonlinearity) analysis as well as for dynamic analysis on simple beams and on structure having non-uniform tapered rectangular profile considering different boundary conditions. No focus is made to thin structure having non-uniform circular cross-sections. This study aims to deal with analyzing the “dynamic behavior of thin circular non-uniform truncated conical section” which is mostly used for manufacturing of fishing rod. This works primarily compares the static, modal, and harmonic analysis under the application of loads of 50 N acting on fishing rod made up of conventional steel, composite (carbon fiber) steel, and functionally graded material (FGM) with the help of ANSYS®. Firstly, static analysis performed to analyze the structural behavior under the application of static loadings. After that modal analysis performed and first five modes selected for Steel; from 0 to 600 Hz, for Carbon Fiber; from 0 to 850 Hz and for FGM; from 0 to 900 Hz for harmonic analysis. Maximum defection at resonance for steel is 7.94 mm, for composite is 74.4 mm, and for FGM is just 0.032 mm. The comparison of these results clearly depicts that FGM is having excellent vibration suppression performance as compared to other two materials under consideration. This confirms that thin structure (non-uniform circular profile) made of FGM can be used efficiently for the intended applications in future.
The Diagnostic Dilemma of Acute Granulomatous Hepatitis in a Patient With Crohn’s Disease: A Case Report and Review of Literature
Authors: Saad Eltaib , Agab Mohamed , Ozcekirdek Emre Can , Awadelkarim Abdalaziz , Idris Isra
Published: March 2022

Liver involvement is not an uncommon extraintestinal manifestation of inflammatory bowel disease (IBD). IBD-associated liver diseases may have a variety of etiopathogenetic origins (including shared autoimmune pathogenesis, the effect of chronic inflammatory status, and adverse effects of drugs). Nevertheless, acute granulomatous hepatitis in the setting of Crohn’s disease (CD) is a rare clinical entity. It warrants, however, a careful assessment as both clinical and pathological features of Crohn’s-associated granulomatous hepatitis closely mimic extrapulmonary hepatic sarcoidosis, with considerable overlaps between the 2 diseases, which certainly makes a definitive diagnosis quite challenging. It is crucial to exclude infectious etiologies during the evaluation of acute granulomatous hepatitis, as inappropriate immunosuppressive treatment may cause a systemic flare-up of an underlying liver infection. We report a rare case of a 35-year-old female with a history of CD who presented with recurrent fevers, acute abdominal pain, and cholestasis. She was found to have acute hepatitis with noncaseating granulomas on liver biopsy. A comprehensive diagnostic workup did not ultimately prove a specific etiological culprit. The patient was treated with oral corticosteroids, and she demonstrated a positive clinical and laboratory response to the treatment. Our case highlights the diagnostic dilemma of acute granulomatous hepatitis in the setting of co-existent CD with a multisystemic syndrome. Granulomatous hepatitis represents a relatively rare manifestation of both extraintestinal CD and extrapulmonary sarcoidosis, with potential difficulties discriminating between the 2 entities on many occasions. The case also demonstrates the value of an interdisciplinary approach in the context of multisystemic disease to achieve the best outcome.
Using a Patient Hotel: Perceptions of the Quality of Care by Patients Undergoing Analysis for Gastrointestinal Motility Disorders in the Netherlands
Authors: Masclee Gwen MC , Masclee Ad AM , Kruimel Joanna W , Conchillo José M , van Vliet Jedidja , Keszthelyi Daniel
Published: March 2022

There is growing demand to improve healthcare services for patients. Patient hotel models can be applied to allow shorter inpatient stays, however, whether this improves patient satisfaction and quality of care is unknown. All consecutive patients referred for analysis of gastrointestinal (GI) motility disorders at Maastricht UMC, the Netherlands, who stayed overnight in the patient hotel (June 2017–July 2018), were asked to complete a questionnaire on patient satisfaction and quality of care. On a 4-point Likert scale, most patients reported they were largely to absolutely satisfied with the quality of care, regarding coordination, information, courtesy of nurses and staff, and privacy. Cost savings between 48,433 and 74,613 euros for 1 year were achieved, amounting to 613–944 euros per patient. Positive patient satisfaction and perception of quality of care with the patient hotel model were achieved. We show that moving overnight stays from inpatient to an outpatient hotel provides substantial financial savings for hospitals, healthcare providers, and insurance companies.
Kwame Bediako Makes an Offer
Authors: Carpenter Joel
Published: March 2022

This review essay addresses the major themes of Ghanaian theologian Kwame Bediako’s thought, as presented in Tim Hartman, Kwame Bediako: African Theology for a World Christianity. Bediako advocated examining the traditional spirituality of African peoples, studying the Bible in vernacular languages, and asking how the person and work of Jesus Christ engage local cultures. He insisted that Western theology was not central and normative to the Christian faith, and that African theology provided a better model for the development of contextual theologies worldwide.
Four Internal Inconsistencies in Tversky and Kahneman’s (1992) Cumulative Prospect Theory Article: A Case Study in Ambiguous Theoretical Scope and Ambiguous Parsimony
Authors: Regenwetter Michel , Robinson Maria M. , Wang Cihang
Published: March 2022

Scholars heavily rely on theoretical scope as a tool to challenge existing theory. We advocate that scientific discovery could be accelerated if far more effort were invested into also overtly specifying and painstakingly delineating the intended purview of any proposed new theory at the time of its inception. As a case study, we consider Tversky and Kahneman (1992). They motivated their Nobel-Prize-winning cumulative prospect theory with evidence that in each of two studies, roughly half of the participants violated independence, a property required by expected utility theory (EUT). Yet even at the time of inception, new theories may reveal signs of their own limited scope. For example, we show that Tversky and Kahneman’s findings in their own test of loss aversion provide evidence that at least half of their participants violated their theory, in turn, in that study. We highlight a combination of conflicting findings in the original article that make it ambiguous to evaluate both cumulative prospect theory’s scope and its parsimony on the authors’ own evidence. The Tversky and Kahneman article is illustrative of a social and behavioral research culture in which theoretical scope plays an extremely asymmetric role: to call existing theory into question and motivate surrogate proposals.
Error analysis of students with mathematics learning difficulties in Tibet
Authors: Rong Lei , Mononen Riikka
Published: March 2022

A notably high percentage (33%) of students with mathematics learning difficulties (MLD) has been reported in Tibet, which can partly be explained by the current state of mathematics teaching. Less known is what kind of errors these students are making in different types of mathematical tasks. This study investigated the types and frequency of errors made in mathematics tasks by Tibetan seventh-grade students ( n = 30) with MLD, as well as whether gender and school type had any effects on these errors. The novel Mathematics Error Pattern Identification Test (MEPIT) was used to identify the following eight different error types: visual-spatial, comprehension, transformation, relevance, fact, procedural, measurement, and presentation. Students identified as having MLD completed the MEPIT in two sessions due to its length (64 items). Regression analysis and t-tests were used. The most frequent error types were fact and comprehension errors. Compared to the boys in the study, the girls seemed to be more vulnerable to fact and relevance errors. The students in the rural school made more comprehension errors compared to the students in the urban school. Our exploratory study calls for further research on assessing errors that students with MLD make in mathematical tasks. MEPIT was shown to be a promising assessment tool for Tibetan teachers to identify errors that students with MLD may make in mathematics tasks.
CircRbms1 knockdown alleviates hypoxia-induced cardiomyocyte injury via regulating the miR-742-3p/FOXO1 axis
Authors: Liu Bo , Guo Kai
Published: March 2022

Background

Circular RNA (circRNA) has been shown to play an important role in a variety of cardiovascular diseases, including myocardial infarction (MI). However, the role of circRbms1 in MI progression remains unclear.

Methods

An MI mouse model was constructed in vivo, and cardiomyocytes were cultured under hypoxia condition to induce a cardiomyocyte injury model in vitro. The expression levels of circRbms1, microRNA (miR)-742-3p, and forkhead box O1 (FOXO1) were determined by quantitative real-time PCR. Cell viability, migration, invasion, and apoptosis were measured using Cell Counting Kit-8 assay, transwell assay, and flow cytometry. Meanwhile, western blot analysis was used to examine the protein levels of apoptosis markers and FOXO1. Additionally, dual-luciferase reporter assay, RNA pull-down assay, and RIP assay were employed to verify the interactions between miR-742-3p and circRbms1 or FOXO1.

Results

CircRbms1 was upregulated in the heart tissues of MI mice and hypoxia-induced cardiomyocytes. Hypoxia induced cardiomyocyte injury by suppressing cell viability, migration, and invasion, and promoting apoptosis. Function experiments showed that circRbms1 overexpression aggravated hypoxia-induced cardiomyocyte injury, while its silencing relieved cardiomyocyte injury induced by hypoxia. Furthermore, circRbms1 sponged miR-742-3p. MiR-742-3p overexpression alleviated hypoxia-induced cardiomyocyte injury, and its inhibitor reversed the suppressive effect of circRbms1 silencing on hypoxia-induced cardiomyocyte injury. Further experiments showed that FOXO1 was a target of miR-742-3p, and its expression was positively regulated by circRbms1. The inhibitory effect of miR-742-3p on hypoxia-induced cardiomyocyte injury was reversed by FOXO1 overexpression.

Conclusion

CircRbms1 regulated the miR-742-3p/FOXO1 axis to mediate hypoxia-induced cardiomyocyte injury, suggesting that circRbms1 might be an effective target for MI treatment.
Investigating the interaction between inter-locus and intra-locus sexual conflict using hemiclonal analysis in Drosophila melanogaster
Authors: Geeta Arun Manas , Chechi Tejinder Singh , Meena Rakesh , Bhosle Shradha Dattaraya , Srishti  , Prasad Nagaraj Guru
Published: March 2022

Background

Divergence in the evolutionary interests of males and females leads to sexual conflict. Traditionally, sexual conflict has been classified into two types: inter-locus sexual conflict (IeSC) and intra-locus sexual conflict (IaSC). IeSC is modeled as a conflict over outcomes of intersexual reproductive interactions mediated by loci that are sex-limited in their effects. IaSC is thought to be a product of selection acting in opposite directions in males and females on traits with a common underlying genetic basis. While in their canonical formalisms IaSC and IeSC are mutually exclusive, there is growing support for the idea that the two may interact. Empirical evidence for such interactions, however, is limited.

Results

Here, we investigated the interaction between IeSC and IaSC in Drosophila melanogaster. Using hemiclonal analysis, we sampled 39 hemigenomes from a laboratory-adapted population of D. melanogaster. We measured the contribution of each hemigenome to adult male and female fitness at three different intensities of IeSC, obtained by varying the operational sex ratio. Subsequently, we estimated the intensity of IaSC at each sex ratio by calculating the intersexual genetic correlation (rw,g,mf) for fitness and the proportion of sexually antagonistic fitness-variation. We found that the intersexual genetic correlation for fitness was positive at all three sex ratios. Additionally, at male biased and equal sex ratios the rw,g,mf was higher, and the proportion of sexually antagonistic fitness variation lower, relative to the female biased sex ratio, although this trend was not statistically significant.

Conclusion

Our results indicate a statistically non-significant trend suggesting that increasing the strength of IeSC ameliorates IaSC in the population.
Identification and validation of QTLs for kernel number per spike and spike length in two founder genotypes of wheat
Authors: Xu Xin , Li Xiaojun , Zhang Dehua , Zhao Jishun , Jiang Xiaoling , Sun Haili , Ru Zhengang
Published: March 2022

Background

Kernel number per spike (KNS) and spike length (SL) are important spike-related traits in wheat variety improvement. Discovering genetic loci controlling these traits is necessary to elucidate the genetic basis of wheat yield traits and is very important for marker-assisted selection breeding.

Results

In the present study, we used a recombinant inbred line population with 248 lines derived from the two founder genotypes of wheat, Bima4 and BainongAK58, to construct a high-density genetic map using wheat 55 K genotyping assay. The final genetic linkage map consists of 2356 bin markers (14,812 SNPs) representing all 21 wheat chromosomes, and the entire map spanned 4141.24 cM. A total of 7 and 18 QTLs were identified for KNS and SL, respectively, and they were distributed on 11 chromosomes. The allele effects of the flanking markers for 12 stable QTLs, including four QTLs for KNS and eight QTLs for SL, were estimated based on phenotyping data collected from 15 environments in a diverse wheat panel including 384 elite cultivars and breeding lines. The positive alleles at seven loci, namely, QKns.his-7D2–1, QKns.his-7D2–2, QSl.his-4A-1, QSl.his-5D1, QSl.his-4D2–2, QSl.his-5B and QSl.his-5A-2, significantly increased KNS or SL in the diverse panel, suggesting they are more universal in their effects and are valuable for gene pyramiding in breeding programs. The transmission of Bima4 allele indicated that the favorite alleles at five loci (QKns.his-7D2–1, QSl.his-5A-2, QSl.his-2D1–1, QSl.his-3A-2 and QSl.his-3B) showed a relatively high frequency or an upward trend following the continuity of generations, suggesting that they underwent rigorous selection during breeding. At two loci (QKns.his-7D2–1 and QSl.his-5A-2) that the positive effects of the Bima4 alleles have been validated in the diverse panel, two and one kompetitive allele-specific PCR (KASP) markers were further developed, respectively, and they are valuable for marker-assisted selection breeding.

Conclusion

Important chromosome regions controlling KNS and SL were identified in the founder parents. Our results are useful for knowing the molecular mechanisms of founder parents and future molecular breeding in wheat.
Comparison of oscillometric, non-invasive and invasive arterial pressure monitoring in patients undergoing laparoscopic bariatric surgery – a secondary analysis of a prospective observational study
Authors: Hansen Jonathan , Pohlmann Markus , Beckmann Jan H. , Klose Phil , Gruenewald Matthias , Renner Jochen , Lorenzen Ulf , Elke Gunnar
Published: March 2022

Background

Oscillometric, non-invasive blood pressure measurement (NIBP) is the first choice of blood pressure monitoring in the majority of low and moderate risk surgeries. In patients with morbid obesity, however, it is subject to several limitations. The aim was to compare arterial pressure monitoring by NIBP and a non-invasive finger-cuff technology (Nexfin®) with the gold-standard invasive arterial pressure (IAP).

Methods

In this secondary analysis of a prospective observational, single centre cohort study, systolic (SAP), diastolic (DAP) and mean arterial pressure (MAP) were measured at 16 defined perioperative time points including posture changes, fluid bolus administration and pneumoperitoneum (PP) in patients undergoing laparoscopic bariatric surgery. Absolute arterial pressures by NIBP, Nexfin® and IAP were compared using correlation and Bland Altman analyses. Interchangeability was defined by a mean difference ≤ 5 mmHg (SD ≤8 mmHg). Percentage error (PE) was calculated as an additional statistical estimate. For hemodynamic trending, concordance rates were analysed according to the Critchley criterion.

Results

Sixty patients (mean body mass index of 49.2 kg/m2) were enrolled and data from 56 finally analysed. Pooled blood pressure values of all time points showed a significant positive correlation for both NIPB and Nexfin® versus IAP. Pooled PE for NIBP versus IAP was 37% (SAP), 35% (DAP) and 30% (MAP), for Nexfin versus IAP 23% (SAP), 26% (DAP) and 22% (MAP). Correlation of MAP was best and PE lowest before induction of anesthesia for NIBP versus IAP (r = 0.72; PE 24%) and after intraoperative fluid bolus administration for Nexfin® versus IAP (r = 0.88; PE: 17.2%). Concordance of MAP trending was 90% (SAP 85%, DAP 89%) for NIBP and 91% (SAP 90%, DAP 86%) for Nexfin®. MAP trending was best during intraoperative ATP positioning for NIBP (97%) and at induction of anesthesia for Nexfin® (97%).

Conclusion

As compared with IAP, interchangeability of absolute pressure values could neither be shown for NIBP nor Nexfin®, however, NIBP showed poorer overall correlation and precision. Overall trending ability was generally high with Nexfin® surpassing NIBP. Nexfin® may likely render individualized decision-making in the management of different hemodynamic stresses during laparoscopic bariatric surgery, particularly where NIBP cannot be reliably established.

Trial registration

The non-interventional, observational study was registered retrospectively at (NCT03184285) on June 12, 2017.
Preoperative acute lung injury and oxygenation impairment occurred in the patients with acute aortic dissection
Authors: Zhao Xuemin , Bie Mengjun
Published: March 2022

Acute lung injury (ALI) and oxygenation impairment (OI) frequently occur in the patients with acute aortic dissection (AAD), which may necessitate mechanical ventilation and result in adverse outcomes. This paper aims to increase clinicians’ awareness of the severe respiratory complications in the patients with AAD, and provide the overview of the epidemiology, adverse outcomes, pathogenesis, predictive markers and therapeutic modalities of the concurrent conditions. Currently, it is considered that inflammatory response plays a great role in the pathogenesis of ALI and OI in the patients with AAD, but the definite pathogenesis remains unclear. Given the great importance of the prediction of the occurrence of the severe respiratory complication at a very early stage, some inflammatory biomarkers have been investigated to predict the occurrence of ALI and OI in several studies. C-reactive protein was found to have a significant predictive effect for the development of ALI and OI. Early use of beta-blockers and the use of bindarit could prevent the occurrence of OI and ALI. Ulinastatin could also improve oxygenation in the patients with type-A AAD. Prevention and management of ALI and OI in AAD remain a great challenge. The definite pathogenesis should be clearly clarified and further studies should be performed to look for potential effective way to predict and manage the severe respiratory conditions.
Pain management of nalbuphine and sufentanil in patients admitted intensive care unit of different ages
Authors: Ji Kaiqiang , Gong Xiaoying , Luan Ting , Gao Xiaopeng , Zang Bin
Published: March 2022

Background

Pain relief for patients in the intensive care unit (ICU) can improve treatment outcomes and reduce the burden on doctors and nurses. This study aims to report the clinical analgesic and sedative effects of nalbuphine and sufentanil on ICU patients.

Methods

This study retrospectively analyzed the medical records of 87 critically ill patients who received nalbuphine or sufentanil infusion in the ICU, including demographic data, diagnosis, Acute Physiology and Chronic Health Evaluation (APACHE) II, Critical Care Pain Observation Tool (CPOT), Richmond Agitation-Sedation Scale (RASS), systolic and diastolic blood pressure, heart rate and blood oxygen saturation (SpO2). The primary outcomes of this study were CPOT and RASS scores. The secondary outcomes were hemodynamic changes, including systolic blood pressure, diastolic blood pressure, heart rate, and SpO2. The adverse events recorded during pain management, such as hypoxemia, respiration depression and bradycardia, were also collected and analyzed.

Results

None of the patients in both groups experienced episode of hypoxemia, respiration depression and bradycardia. However, age-stratified analyses showed that nalbuphine has a better analgesic effect than sufentanil for patients aged ≤ 60 (P < 0.05). In contrast, sufentanil showed a better analgesic effect than nalbuphine for patients aged > 60 ( P < 0.05). Furthermore, nalbuphine has a significantly better sedative effect than sufentanil for patients aged ≤ 60 (P < 0.05).

Conclusion

ICU patients of different age groups may be suitable for different analgesics. For patients under the age of 60, nalbuphine has better analgesia and sedation than sufentanil, and does not cause respiratory depression and drastic hemodynamic changes.
The effect of missing data and imputation on the detection of bias in cognitive testing using differential item functioning methods
Authors: Nichols E. , Deal J. A. , Swenor B. K. , Abraham A. G. , Armstrong N. M. , Bandeen-Roche K. , Carlson M. C. , Griswold M. , Lin F. R. , Mosley T. H. , Ramulu P. Y. , Reed N. S. , Sharrett A. R. , Gross A. L.
Published: March 2022

Background

Item response theory (IRT) methods for addressing differential item functioning (DIF) can detect group differences in responses to individual items (e.g., bias). IRT and DIF-detection methods have been used increasingly often to identify bias in cognitive test performance by characteristics (DIF grouping variables) such as hearing impairment, race, and educational attainment. Previous analyses have not considered the effect of missing data on inferences, although levels of missing cognitive data can be substantial in epidemiologic studies.

Methods

We used data from Visit 6 (2016–2017) of the Atherosclerosis Risk in Communities Neurocognitive Study (N = 3,580) to explicate the effect of artificially imposed missing data patterns and imputation on DIF detection.

Results

When missing data was imposed among individuals in a specific DIF group but was unrelated to cognitive test performance, there was no systematic error. However, when missing data was related to cognitive test performance and DIF group membership, there was systematic error in DIF detection. Given this missing data pattern, the median DIF detection error associated with 10%, 30%, and 50% missingness was -0.03, -0.08, and -0.14 standard deviation (SD) units without imputation, but this decreased to -0.02, -0.04, and -0.08 SD units with multiple imputation.

Conclusions

Incorrect inferences in DIF testing have downstream consequences for the use of cognitive tests in research. It is therefore crucial to consider the effect and reasons behind missing data when evaluating bias in cognitive testing.
Prophylactic clip closure for mucosal defects is associated with reduced adverse events after colorectal endoscopic submucosal dissection: a propensity-score matching analysis
Authors: Omori Jun , Goto Osamu , Habu Tsugumi , Ishikawa Yumiko , Kirita Kumiko , Koizumi Eriko , Noda Hiroto , Higuchi Kazutoshi , Onda Takeshi , Akimoto Teppei , Akimoto Naohiko , Itokawa Norio , Kaise Mitsuru , Iwakiri Katsuhiko
Published: March 2022

Background

It is unclear whether prophylactic endoscopic closure after colorectal endoscopic submucosal dissection (ESD) reduces the risk of postoperative adverse events due to variability in lesion characteristics. Therefore, we conducted a retrospective study using propensity score matching to evaluate the efficacy of prophylactic clip closure in preventing postoperative adverse events after colorectal ESD.

Methods

This single-center retrospective cohort study included 219 colorectal neoplasms which were removed by ESD. The patients were allocated into the closure and non-closure groups, which were compared before and after propensity-score matching. Post-ESD adverse events including major and minor bleeding and delayed perforation were compared between the two groups.

Results

In this present study, 97 and 122 lesions were allocated to the closure and non-closure groups, respectively, and propensity score matching created 61 matched pairs. The rate of adverse events was significantly lower in the closure group than in the non-closure group (8% vs. 28%, P = 0.008). Delayed perforation occurred in two patients in the non-closure group, whereas no patient in the closure group developed delayed perforation. In contrast, there were no significant differences in other postoperative events including the rate of abdominal pain; fever, white blood cell count, and C-reactive protein; and appetite loss between the two groups.

Conclusions

Propensity score matching analysis demonstrated that prophylactic closure was associated with a significantly reduced rate of adverse events after colorectal ESD. When technically feasible, mucosal defect closure after colorectal ESD may result in a favorable postoperative course.
MiR-1-3p targets CENPF to repress tumor-relevant functions of gastric cancer cells
Authors: Zhou Shenkang , Han Hui , Yang Leilei , Lin Hui
Published: March 2022

Here we noted significantly downregulated miR-1-3p in gastric cancer (GC) tissue compared with adjacent normal tissue through qRT-PCR. Lowly expressed miR-1-3p correlated GC progression. Overexpressing miR-1-3p could restrain tumor-relevant cell behaviors in GC, while miR-1-3p inhibitor treatment triggered the opposite results. Moreover, dual-luciferase reporter gene detection identified specific binding sites of miR-1-3p in CENPF 3’untranslated region. Upregulating miR-1-3p constrained cell progression of GC via CENPF downregulation. Western blot, qRT-PCR and dual-luciferase detections manifested that miR-1-3p negatively mediated CENPF expression in GC cells. Thus, we demonstrated that miR-1-3p negatively mediated CENPF to hamper GC progression. CENPF may be an underlying target for GC therapy.
RIP3 knockdown inhibits necroptosis of human intestinal epithelial cells via TLR4/MyD88/NF-κB signaling and ameliorates murine colitis
Authors: Duan Chaoqin , Xu Xi , Lu Xiaoyi , Wang Ling , Lu Zhongkai
Published: March 2022

Background

Ulcerative colitis (UC) is a common inflammatory bowel disease, during which cell necroptosis plays key roles in driving inflammation initiation and aggravation. Previous studies reported Receptor Interacting Protein Kinase 3 (RIP3)-mediated necroptosis in multiple diseases, and RIP3 protein in Paneth cells significantly enriched in the intestines of both humans and mice. Therefore, we hypothesized targeting RIP3 to inhibit necroptosis may depress UC.

Methods

We classified clinical UC samples according to the modified Truelove & Witts criterion. The expression of RIP3 was measured by western blot and immunohistochemistry. Cell proliferation and apoptosis were analyzed by MTT assay and flow cytometry. ROS production and the secretion of inflammatory cytokines were measured by DCFH-DA probe and ELISA assay. TLR4/MyD88/NF-κB signaling pathway was analyzed by western blot. We established experimental colitis model in RIP3 knockout and wild-type mice and disease activity index (DAI) score was calculated. The expression and distribution of tight junction protein were analyzed by immunofluorescence. The ratio of CD4+Foxp3+ T cells in the spleen was detected by flow cytometry. Oxidative damage of mouse colon was assessed by detecting the levels of SOD, MDA and MPO. Data were analyzed by one-way ANOVA or student’s t test.

Results

The expression of RIP3 in human colon is positively associated with the severity of UC. RIP3 inhibitor GSK872 or RIP3 knockdown reverses the inhibitory effect of TNF-α on proliferation and the promoting effect of TNF-α on apoptosis and necrosis in human intestinal epithelial cells. In addition, RIP3 deficiency inhibits the secretion of inflammatory cytokines (IL-16, IL-17 and IFN-γ) and ROS production induced by TNF-α. In vivo, RIP3 inhibitor Nec-1 effectively improves DSS-induced colitis in mice. In mechanism, RIP3 depression could upregulate the proportion of CD4+Foxp3+ immunosuppressive Treg cells in the spleen while suppressed TLR4/MyD88/NF-κB signaling pathway and ROS generation, and all these anti-inflammation factors together suppress the secretion of inflammatory cytokines and necroptosis of intestinal epithelial cells.

Conclusions

This study preliminarily explored the regulating mechanism of RIP3 on UC, and Nec-1 may be a promising drug to alleviate the inflammation and necroptosis of the colon in UC patients.
Comparative effectiveness of second-line biological therapies for ulcerative colitis and Crohn’s disease in patients with prior failure of anti-tumour necrosis factor treatment
Authors: Hyun Hye Kyung , Zhang Hyun-Soo , Yu Jongwook , Kang Eun Ae , Park Jihye , Park Soo Jung , Park Jae Jun , Kim Tae Il , Kim Won Ho , Cheon Jae Hee
Published: March 2022

Background

Therapeutic options for inflammatory bowel disease (IBD) have increased since the introduction of tumour necrosis factor (TNF) inhibitors a few decades ago. However, direct comparisons of the effectiveness of second-line biological agents in patients with ulcerative colitis (UC) and Crohn’s disease (CD) are lacking.

Methods

Patients with UC or CD who experienced anti-TNF treatment failure and subsequently used vedolizumab, ustekinumab, or tofacitinib as a second-line drug were retrospectively recruited. The primary outcomes were the clinical remission rate at week 16 and the cumulative relapse rate 48 weeks after receiving induction therapy.

Results

A total of 94 patients with UC or CD experienced anti-TNF treatment failure and received vedolizumab (UC: 37; CD: 28), ustekinumab (CD: 16), or tofacitinib (UC: 13). The clinical remission rates were not significantly different between the vedolizumab and tofacitinib groups in UC patients (56.8% vs. 46.2%, p = 0.509). In CD patients, the clinical remission rates were not significantly different between the vedolizumab and ustekinumab groups (53.6% vs. 50.0%, p = 0.820). Moreover, the cumulative rates of clinical relapse were not significantly different between the vedolizumab and tofacitinib groups in UC patients and between the vedolizumab and ustekinumab groups in CD patients (p = 0.396 and p = 0.692, respectively). Safety profiles were also similar among the treatment groups in both UC and CD patients.

Conclusions

After prior anti-TNF therapy failure, vedolizumab and tofacitinib in UC patients and vedolizumab and ustekinumab in CD patients were not significantly different in terms of the efficacy in inducing and maintaining a clinical response.
Lack of relationship between PROX1 expression and clinicopathological parameters and prognosis in gastric cancer patients: a meta-analysis and TCGA analysis
Authors: Jia Zirui , Wang Yuhang , Gao Jiacheng , Zu Guo
Published: March 2022

Background

The relationship between PROX1 expression and clinicopathological characteristics and prognosis in patients with gastric cancer (GC) remain controversial. The aim of this study is to determine the clinicopathological and prognostic significance of PROX1 expression in patients with GC.

Methods

A systematic literature search and meta-analysis were performed. Odds ratio (OR) and confidence interval (CI) were used to evaluated the relationship between PROX1 expression and clinicopathological characteristics and overall survival (OS) of GC patients. Additionally, the Cancer Genome Atlas (TCGA) and the Genotype-Tissue Expression (GTEx) datasets were utilized to examine the relationship between PROX1 expression and clinicopathological significance and OS in GC patients.

Results

A total of 8 studies pooling 1289 GC patients were included in the assessment. In GC patients, PROX1 expression was not related to gender (OR: 1.234, 95% CI 0.958–1.590, P = 0.104), depth of tumor invasion (OR: 0.742, 95% CI 0.428–1.287, P = 0.289), lymph node metastasis (OR: 2.161, 95% CI 0.808–5.779, P = 0.125), TNM stage (OR: 1.324, 95% CI 0.572–3.066, P = 0.513), tumor size (OR: 0.889, 95% CI 0.502–1.576, P = 0.687), distant metastasis (OR: 1.096, 95% CI 0.470–2.555, P = 0.763). In addition, we also found that PROX1 expression was not associated with 1-year OS (OR: 0.908, 95% CI 0.631–1.306, P = 0.602), 3-year OS (OR: 1.234, 95% CI 0.482–3.160, P = 0.661) and 5-year OS (OR: 0.853, 95% CI 0.266–2.736, P = 0.790). According to TCGA, in comparison with high and low PROX1 expression in GC patients, the OS did not differ statistically (p = 0.119).

Conclusion

The expression of PROX1 was shown to lack a significant relationship to gender, TNM stage, depth of invasion, tumor size, stage, distant metastasis, or lymph node metastasis in statistically. The expression of PROX1 was not related to OS and it failed to be a meaningful biomarker to prevent and diagnose GC.
Long-term outcomes of refractory esophageal strictures after endoscopic submucosal dissection of superficial esophageal neoplasms
Authors: Lu Qing , Wang Jin , Lv Xiuhe , Xi Mingjia , Lei Tiantian , Wang Zijing , Yang Li , Yang Jinlin
Published: March 2022

Background

Many studies have focused on prophylactic therapy for post-endoscopic submucosal dissection (ESD) of esophageal strictures. However, various strategies cannot prevent the occurrence of postoperative strictures after extensive ESD. Postoperative strictures often inevitably occur, and endoscopic dilation is still a temporarily effective therapy.

Methods

This study included patients with post-ESD refractory esophageal strictures (RESs) from January 2014 to November 2019. Clinical effectiveness was assessed using univariate analysis and multivariate logistic regression. Hierarchical linear models were used to identify factors that predicted the dysphagia-free period.

Results

A total of 50 patients fulfilled the inclusion criteria and entered the study. Twenty-seven (54%) patients had a history of prophylactic oral steroid therapy. Forty-six patients (92%) underwent ≥ 75% circumferential resection, including 32 (64%) cases involving entire circumferential ESD. The mean dysphagia-free period of 50 patients was 2.9 months (95% CI 2.3–3.5). The dysphagia-free period had a linear growth trend over time, increasing by 6.9 days per endoscopic therapy, and the estimated last dysphagia-free period was 85.9 days. Old and female patients had shorter dysphagia-free periods compared with young and male patients. Endoscopic therapy success was achieved in 30 (60%) patients. Multivariate analysis revealed that circumferential lesions (OR 6.106, 95% CI 1.013–36.785, P = 0.048) were significant predictive factors for poor clinical outcome.

Conclusion

Endoscopic dilation seemed effective in patients with post-ESD RESs by increasing the dysphagia-free period. After approximately 10 continuous dilations, 60% of patients achieved endoscopic success, and the remission rate of obstruction was increased. Prophylactic oral steroid therapy could reduce the occurrence of RESs. However, once a RES had occurred, prophylactic steroid therapy could not reduce the frequency of dilations or change the long-term outcomes.

Trial registration: This study was prospectively registered and approved by the Ethics Committee of West China Hospital of Sichuan University (IRB number: ChiCTR-ONN-17012382) on 2015.