bluuebunny/crossref_metadata_2025 huggingface dataset:
Learning from implementation of a COVID case management desk guide and training: a pilot study in Sierra Leone
Authors: Witter Sophie , Zou Guanyang , Cheedella Kiran , Walley John , Wurie Haja
Published: September 2023

Background

When the COVID pandemic hit the world, there was need for applied guides and training materials to support frontline health care staff to manage patients effectively and safely and to educate themselves and communities. This article reports on the development and piloting of such a set of materials in Sierra Leone, which were based on international evidence but adapted to the local context. Reflecting on this experience, including community and health system barriers and enablers, is important to prepare for future regional shocks.

Methods

This study, in Bombali district in 2020, piloted user-friendly COVID guides for frontline health workers (the intervention), which was evaluated using facility checklists (pre and post training), routine data analysis and 32 key informant interviews.

Results

Key informants at district, hospital and community health centre levels identified gains from the training and desk guides, including improved diagnosis, triaging, infection prevention and management of patients. They also reported greater confidence to share messages on protection with colleagues and community members, which was needed to encourage continued use of essential services during the pandemic. However, important barriers were also revealed, including the lack of testing facilities, which reduced the sense of urgency, as few cases were identified. Actions based on the Ebola experience, such as setting up testing and isolation centres, which the community avoided, were not appropriate to COVID. Stigma and fear were important factors, although these were reduced with outreach activities. Supplies of essential medicines and personal protective equipment were also lacking.

Conclusion

This pilot study demonstrated the relevance and importance of guides adapted to the context, which were able to improve the confidence of health staff to manage their own and the community’s fears in the face of a new pandemic and improve their skills. Previous epidemics, particularly Ebola, complicated this by both creating structures that could be revitalised but also assumptions and behaviours that were not adapted to the new disease. Our study documents positive adaptations and resilience by health staff but also chronic system weaknesses (particularly for medicines, supplies and equipment) which must be urgently addressed before the next shock arrives.
Genome-wide identification and functional analysis of dysregulated alternative splicing profiles in sepsis
Authors: Tuerdimaimaiti Dilixiati , Abuduaini Buzukela , Kang Shaotao , Jiao Jinliang , Li Mengchen , Madeniyati Wolazihan , Tuerdi Baihetinisha , Aili Gulisitan , Tuerhong Reyila , Kulaxi Ajiguli
Published: September 2023

Background

An increasing body of evidence now shows that the long-term mortality of patients with sepsis are associated with various sepsis-related immune cell defects. Alternative splicing (AS), as a sepsis-related immune cell defect, is considered as a potential immunomodulatory therapy target to improve patient outcomes. However, our understanding of the role AS plays in sepsis is currently insufficient.

Aim

This study investigated possible associations between AS and the gene regulatory networks affecting immune cells. We also investigated apoptosis and AS functionality in sepsis pathophysiology.

Methods

In this study, we assessed publicly available mRNA-seq data that was obtained from the NCBI GEO dataset (GSE154918), which included a healthy group (HLTY), a mild infection group (INF1), asepsis group (Seps), and a septic shock group (Shock). A total of 79 samples (excluding significant outliers) were identified by a poly-A capture method to generate RNA-seq data. The variable splicing events and highly correlated RNA binding protein (RBP) genes in each group were then systematically analyzed.

Results

For the first time, we used systematic RNA-seq analysis of sepsis-related AS and identified 1505 variable AS events that differed significantly (p <= 0.01) across the four groups. In the sepsis group, the genes related to significant AS events, such as, SHISA5 and IFI27, were mostly enriched in the cell apoptosis pathway. Furthermore, we identified differential splicing patterns within each of the four groups. Significant differences in the expression of RNA Binding Protein(RBP) genes were observed between the control group and the sepsis group. RBP gene expression was highly correlated with variant splicing events in sepsis, as determined by co-expression analysis; The expression of DDX24, CBFA2T2, NOP, ILF3, DNMT1, FTO, PPRC1, NOLC1 RBPs were significant reduced in sepsis compared to the healthy group. Finally, we constructed an RBP-AS functional network.

Conclusion

Analysis indicated that the RBP-AS functional network serves as a critical post-transcriptional mechanism that regulates the development of sepsis. AS dysregulation is associated with alterations in the regulatory gene expression network that is involved in sepsis. Therefore, the RBP-AS expression network could be useful in refining biomarker predictions in the development of new therapeutic targets for the pathogenesis of sepsis.
Criterion validity of wrist accelerometry for assessing energy intake via the intake-balance technique
Authors: Hibbing Paul R. , Welk Gregory J. , Ries Daniel , Yeh Hung-Wen , Shook Robin P.
Published: September 2023

Background

Intake-balance assessments measure energy intake (EI) by summing energy expenditure (EE) with concurrent change in energy storage (ΔES). Prior work has not examined the validity of such calculations when EE is estimated via open-source techniques for research-grade accelerometry devices. The purpose of this study was to test the criterion validity of accelerometry-based intake-balance methods for a wrist-worn ActiGraph device.

Methods

Healthy adults (n = 24) completed two 14-day measurement periods while wearing an ActiGraph accelerometer on the non-dominant wrist. During each period, criterion values of EI were determined based on ΔES measured by dual X-ray absorptiometry and EE measured by doubly labeled water. A total of 11 prediction methods were tested, 8 derived from the accelerometer and 3 from non-accelerometry methods (e.g., diet recall; included for comparison). Group-level validity was assessed through mean bias, while individual-level validity was assessed through mean absolute error, mean absolute percentage error, and Bland–Altman analysis.

Results

Mean bias for the three best accelerometry-based methods ranged from -167 to 124 kcal/day, versus -104 to 134 kcal/day for the non-accelerometry-based methods. The same three accelerometry-based methods had mean absolute error of 323–362 kcal/day and mean absolute percentage error of 18.1-19.3%, versus 353–464 kcal/day and 19.5-24.4% for the non-accelerometry-based methods. All 11 methods demonstrated systematic bias in the Bland–Altman analysis.

Conclusions

Accelerometry-based intake-balance methods have promise for advancing EI assessment, but ongoing refinement is necessary. We provide an R package to facilitate implementation and refinement of accelerometry-based methods in future research (see paulhibbing.com/IntakeBalance).
Predictive ability of the Desire to Avoid Pregnancy scale
Authors: Hall Jennifer A. , Barrett Geraldine , Stephenson Judith , Rocca Corinne H. , Edelman Natalie
Published: September 2023

Background

A longstanding gap in the reproductive health field has been the availability of a screening instrument that can reliably predict a person’s likelihood of becoming pregnant. The Desire to Avoid Pregnancy Scale is a new measure; understanding its sensitivity and specificity as a screening tool for pregnancy as well as its predictive ability and how this varies by socio-demographic factors is important to inform its implementation.

Methods

This analysis was conducted on a cohort of 994 non-pregnant participants recruited in October 2018 and followed up for one year. The cohort was recruited using social media as well as advertisements in a university, school, abortion clinic and outreach sexual health service. Almost 90% of eligible participants completed follow-up at 12 months; those lost to follow-up were not significantly different on key socio-demographic factors. We used baseline DAP score and a binary variable of whether participants experienced pregnancy during the study to assess the sensitivity, specificity, area under the ROC curve (AUROC) and positive and negative predictive values (PPV and NPV) of the DAP at a range of cut-points. We also examined how the predictive ability of the DAP varied according to socio-demographic factors and by the time frame considered (e.g., pregnancy within 3, 6, 9 and 12 months).

Results

At a cut-point of 2 on the 0–4 range of the DAP scale, the DAP had a sensitivity of 0.78, a specificity of 0.81 and an excellent AUROC of 0.87. In this sample the cumulative incidence of pregnancy was 16% (95%CI 13%, 18%) making the PPV 43% and the NPV 95% at this cut-point. The DAP score was the factor most strongly associated with pregnancy, even after age and number of children were taken into account. The association between baseline DAP score and pregnancy did not differ across time frames.

Conclusions

This is the first study to assess the DAP scale as a screening tool and shows that its predictive ability is superior to the limited pre-existing pregnancy prediction tools. Based on our findings, the DAP could be used with a cut-point selected according to the purpose.
Supraclavicular nerve sparing versus sacrifice during open reduction internal fixation of acute midshaft clavicle fracture
Authors: Hu Ruei , Su Yu-Jung , Chien Chi-Sheng
Published: September 2023

Background

The branches of the supraclavicular nerve are often sacrificed during open reduction and internal fixation (ORIF) for clavicle fracture. No consensus exists on whether the supraclavicular nerve should be routinely identified and protected during ORIF.

Methods

We developed a simple method to make nerve sparing easier; Wide-Awake Local Anesthesia No Tourniquet (WALANT) solution is locally injected prior to the surgical incision being made. This retrospective study enrolled 340 patients and divided them into supraclavicular-nerve-sparing (n = 45) and supraclavicular-nerve-sacrifice (n = 295) groups. Surgical outcomes—including operative time, estimated blood loss, postoperative pain, union rate, time to union, functional score, paresthesia, complications, implant removal rate, and complication rate—were recorded.

Results

Incisional or anterior chest wall numbness and intraoperative blood loss were significantly less (p < 0.001) in the nerve-sparing group. The operative time was similar in the two groups. No significant differences were discovered in QuickDASH score, postoperative pain score, union rate, time to union, implant removal rate, complication rate, or revision rate.

Conclusions

Our study demonstrated that the outcomes of supraclavicular nerve sparing during ORIF with WALANT can reduce postoperative incisional and anterior chest wall numbness and intraoperative blood loss without increasing the operative time or complication rate.
Ginsenosides: changing the basic hallmarks of cancer cells to achieve the purpose of treating breast cancer
Authors: Jiang Rui-yuan , Fang Zi-ru , Zhang Huan-ping , Xu Jun-yao , Zhu Jia-yu , Chen Ke-yu , Wang Wei , Jiang Xiao , Wang Xiao-jia
Published: September 2023

In 2021, breast cancer accounted for a substantial proportion of cancer cases and represented the second leading cause of cancer deaths among women worldwide. Although tumor cells originate from normal cells in the human body, they possess distinct biological characteristics resulting from changes in gene structure and function of cancer cells in contrast with normal cells. These distinguishing features, known as hallmarks of cancer cells, differ from those of normal cells. The hallmarks primarily include high metabolic activity, mitochondrial dysfunction, and resistance to cell death. Current evidence suggests that the fundamental hallmarks of tumor cells affect the tissue structure, function, and metabolism of tumor cells and their internal and external environment. Therefore, these fundamental hallmarks of tumor cells enable tumor cells to proliferate, invade and avoid apoptosis. Modifying these hallmarks of tumor cells represents a new and potentially promising approach to tumor treatment. The key to breast cancer treatment lies in identifying the optimal therapeutic agent with minimal toxicity to normal cells, considering the specific types of tumor cells in patients. Some herbal medicines contain active ingredients which can precisely achieve this purpose. In this review, we introduce Ginsenoside's mechanism and research significance in achieving the therapeutic effect of breast cancer by changing the functional hallmarks of tumor cells, providing a new perspective for the potential application of Ginsenoside as a therapeutic drug for breast cancer.
Efficient targeting of HIF-1α mediated by YC-1 and PX-12 encapsulated niosomes: potential application in colon cancer therapy
Authors: Bakand Azar , Moghaddam Sevil Vaghefi , Naseroleslami Maryam , André Helder , Mousavi-Niri Neda , Alizadeh Effat
Published: September 2023

A number of molecular biofactors have been documented in pathogenesis and poor prognosis of colorectal cancer (CRC). Among them, the Hypoxia-Inducible Factor (HIF-1a) is frequently reported to become over-expressed, and its targeting could restrict and control a variety of essential hallmarks of CRC. Niosomes are innovative drug delivery vehicles with the encapsulating capacity for co-loading both hydrophilic and hydrophobic drugs at the same time. Also, they can enhance the local accumulation while minimizing the dose and side effects of drugs. YC-1 and PX-12 are two inhibitors of HIF-1a. The purpose of this work was to synthesize dual-loaded YC-1 and PX-12 niosomes to efficiently target HIF-1α in CRC, HT-29 cells. The niosomes were prepared by the thin-film hydration method, then the niosomal formulation of YC-1 and PX-12 (NIO/PX-YC) was developed and optimized by the central composition method (CCD) using the Box-Behnken design in terms of size, polydispersity index (PDI), entrapment efficiency (EE). Also, they are characterized by DLS, FESEM, and TEM microscopy, as well as FTIR spectroscopy. Additionally, entrapment efficiency, in vitro drug release kinetics, and stability were assessed. Cytotoxicity, apoptosis, and cell cycle studies were performed after the treatment of HT-29 cells with NIO/PX-YC. The expression of HIF-1αat both mRNA and protein levels were studied after NIO/PX-YC treatment. The prepared NIO/PX-YC showed a mean particle size of 185 nm with a zeta potential of about-7.10 mv and a spherical morphology. Also, PX-12 and YC-1 represented the entrapment efficiency of about %78 and %91, respectively, with a sustainable and controllable release. The greater effect of NIO/PX-YC than the free state of PX-YC on the cell survival rate, cell apoptosis, and HIF-1α gene/protein expression were detected (p < 0.05). In conclusion, dual loading of niosomes with YC-1 and PX-12 enhanced the effect of drugs on HIF-1α inhibition, thus boosting their anticancer effects.

Graphical Abstract
Endoscopic ultrasonography-guided gastroenterostomy versus surgical gastrojejunostomy for palliation of malignant gastric outlet obstruction (ENDURO): study protocol for a randomized controlled trial
Authors: Kastelijn Janine B. , van de Pavert Yorick L. , Besselink Marc G. , Fockens Paul , Voermans Rogier P. , van Wanrooij Roy L. J. , de Wijkerslooth Thomas R. , Curvers Wouter L. , de Hingh Ignace H. J. T. , Bruno Marco J. , Koerkamp Bas Groot , Patijn Gijs A. , Poen Alexander C. , van Hooft Jeanin E. , Inderson Akin , Mieog J. Sven D. , Poley Jan-Werner , Bijlsma Alderina , Lips Daan J. , Venneman Niels G. , Verdonk Robert C. , van Dullemen Hendrik M. , Hoogwater Frederik J. H. , Frederix Geert W. J. , Molenaar I. Quintus , Welsing Paco M. J. , Moons Leon M. G. , van Santvoort Hjalmar C. , Vleggaar Frank P. ,   for the Dutch Pancreatic Cancer Group
Published: September 2023

Background

Malignant gastric outlet obstruction (GOO) is a debilitating condition that frequently occurs in patients with malignancies of the distal stomach and (peri)ampullary region. The standard palliative treatment for patients with a reasonable life expectancy and adequate performance status is a laparoscopic surgical gastrojejunostomy (SGJ). Recently, endoscopic ultrasound-guided gastroenterostomy (EUS-GE) emerged as a promising alternative to the surgical approach. The present study aims to compare these treatment modalities in terms of efficacy, safety, and costs.

Methods

The ENDURO-study is a multicentre, open-label, parallel-group randomized controlled trial. In total, ninety-six patients with gastric outlet obstruction caused by an irresectable or metastasized malignancy will be 1:1 randomized to either SGJ or EUS-GE. The primary endpoint is time to tolerate at least soft solids. The co-primary endpoint is the proportion of patients with persisting or recurring symptoms of gastric outlet obstruction for which a reintervention is required. Secondary endpoints are technical and clinical success, quality of life, gastroenterostomy dysfunction, reinterventions, time to reintervention, adverse events, quality of life, time to start chemotherapy, length of hospital stay, readmissions, weight, survival, and costs.

Discussion

The ENDURO-study assesses whether EUS-GE, as compared to SGJ, results in a faster resumption of solid oral intake and is non-inferior regarding reinterventions for persistent or recurrent obstructive symptoms in patients with malignant GOO. This trial aims to guide future treatment strategies and to improve quality of life in a palliative setting.

Trial registration

International Clinical Trials Registry Platform (ICTRP): NL9592. Registered on 07 July 2021.
SND1 aggravates mitochondrial damage, apoptosis and extracellular matrix degradation in IL-1β-stimulated chondrocytes via PINK1/BECN1 pathway
Authors: Lin Shufeng , Guo Huiyang , You Xiaoxuan , Zhang Zefeng , Ye Hui
Published: September 2023

Recently, evidence has suggested a regulatory role for SND1 in osteoarthritis progression. Interestingly, we found that SND1 protein expression was increased, mitochondria were shrunken and decreased in number, mitochondrial membrane potential was decreased, mitochondrial ROS production was increased, and ATP levels were decreased in IL-1β treated mouse chondrocytes, and SND1 silencing removed these changes. Furthermore, IL-1β treatment promoted inflammatory factor secretion in chondrocytes, promoted cell apoptosis, increased MMP13 protein and inhibited collagen II protein expression, and si-SND1 inhibited the IL-1β effects. We validated the association between SND1 and PINK1 and found that PINK1 reversed the inhibitory effects of SND1 silencing on IL-1β-induced mitochondrial damage, inflammatory reaction, apoptosis and extracellular matrix degradation in mouse chondrocytes. Furthermore, we found that PINK1 upregulated BECN1 protein expression and that BECN reversed the inhibitory effects of PINK1 silencing on IL-1β-induced mitochondrial damage, inflammatory reaction, apoptosis and extracellular matrix degradation. Further mechanistic studies revealed that PINK1 inhibited the AMPK/mTOR signaling axis to aggravate IL-1β induced mouse chondrocytes injury by upregulating BECN1 protein expression. In vivo results showed that the damage to cartilage tissue was significantly alleviated in rats with osteoarthritis by knocking down SND1 expression.
Gender gap in STEM pathways: the role of secondary curricula in a highly differentiated school system—the case of Chile
Authors: Sevilla María Paola , Luengo-Aravena Daniela , Farías Mauricio
Published: September 2023

Background

STEM fields are instrumental in increasing the technological and innovative capacity of the economy. As women are underrepresented in the STEM workforce, diverse strategies have been implemented to boost their preparedness and interest in these fields, including early exposure to academic and vocational STEM courses. Using the case of Chile’s highly differentiated school system, this paper examines the role of secondary curricula on students’ enrollment and persistence in STEM programs offered by vocational postsecondary institutions and universities. In doing so, we seek to identify whether exposure to STEM courses within the academic or vocational tracks translates into fewer gender differences in STEM higher education.

Results

Our results reveal that upper-secondary tracks connected to STEM courses are positively associated with enrollment in STEM higher education and, to some degree, persistence. More specifically, exposure to STEM courses in the academic track is the most effective path to boost chances of enrolling in STEM university programs but has no connection to later persistence. In contrast, applied STEM courses within the vocational tracks perform better in the case of STEM programs in postsecondary vocational institutions both in enrollment and persistence. However, this STEM pipeline significantly amplifies gender gaps as males benefit more than women from early exposure to applied STEM courses. We also found that other indirect routes, such as enrolling in STEM university programs from the vocational track with applied STEM courses, boost female participation in these programs, helping reduce gender gaps.

Conclusions

While secondary STEM courses attract more female students to STEM higher education, they alone are insufficient to achieve gender equality in STEM fields as gender gaps widen in the more effective routes. In highly differentiated school systems, policymakers and high school leaders should offer increased support to women interested in STEM studies and careers across all secondary tracks to boost female participation in STEM fields. At the same time, all high school students should be able to select both academic and applied STEM courses as a part of their non-mandatory curriculum.
Identification of active faults and tectonic features through heat flow distribution in the Nankai Trough, Japan, based on high-resolution velocity-estimated bottom-simulating reflector depths
Authors: Takenouchi Shuto , Tsuji Takeshi , Shiraishi Kazuya , Nakamura Yasuyuki , Kodaira Shuichi , Fujie Gou , Mukumoto Kota
Published: September 2023

Estimates of heat flow can contribute to our understanding of geological structures in plate convergent zones that produce great earthquakes. We applied automated velocity analysis to obtain the accurate seismic profiles needed for precise heat flow estimates using six new seismic profiles acquired during R/V Kaimei KM18-10 voyage in 2018. We calculated heat flow values in the accretionary wedge of the Nankai Trough off the Kii Peninsula, Japan, from the positions of widespread bottom-simulating reflectors (BSRs) in seismic reflection profiles. Calculated conductive heat flow values from the depth of the BSR agree with previous studies where a regional trend is observed from ~ 50 mW/m2 to < 40 mW/m2 60 km landward from the deformation front. This trend is caused by thickening of accretionary sediments and the subduction of the Philippines Sea plate. Segments of profiles are marked by anomalous high heat flow values. Such anomalies represent alterations of the shallow crustal thermal structure caused either by a combination of topographic affects, surface erosion of the seafloor, or by fluid flow that transports heat by advection. We interpret heat flow anomalies (~ 100 mW/m2) as indicators of active faulting, which correspond to low seismic velocity zones along faults. Our results also showed relatively high heat flow at the landward end of several survey lines close to the Kii Peninsula, which we interpret to the possible presence of plutonic rocks that underlie the Kii Peninsula and extend offshore and may be the cause of geothermal springs, steep geothermal gradients, and high heat flow.

Graphical abstract
Ulvan and Ulva oligosaccharides: a systematic review of structure, preparation, biological activities and applications
Authors: Li Chen , Tang Tiancheng , Du Yuguang , Jiang Ling , Yao Zhong , Ning Limin , Zhu Benwei
Published: September 2023

Ulva is one of the main green algae causing green tide disasters. Ulvan is the primarily component polysaccharide of the cell wall of Ulva and its complex structure and monosaccharide composition resulted in various biological activities. However, the high-value and effective utilization of extracted ulvan have been obstructed by limitations ranging from large molecular weight and low solubility to poor bioavailability. Ulva oligosaccharide obtained by degrading ulvan can not only ideally retain the various biological activities of ulvan very well but also effectively solve the problems of low solubility and poor bioavailability. The preparation and biological activity studies of ulvan and Ulva oligosaccharides have become a hot spot in the field of marine biological resources development research. At present, the comprehensive reviews of ulvan and Ulva oligosaccharides are still scarce. What are overviewed in this paper are the chemical composition, structure, extraction, and purification of ulvan and Ulva oligosaccharides, where research progress on the biological activities of ulvan and Ulva oligosaccharides is summarized and prospected. A theoretical and practical basis has been provided for further research on ulvan and Ulva oligosaccharides, as well as the high-value development and effective utilization of marine algae resources.

Graphical Abstract
Dietary trends among young adults during the COVID-19 lockdown: socioeconomic and gender disparities
Authors: Parker Jennifer , Kaur Simranpreet , Medalla John Marlo , Imbert-Sanchez Anairobi , Bautista Jeanette
Published: September 2023

Background

Healthy eating is vital to well-being and during the COVID-19 pandemic, it was especially important for boosting immunity and protecting against viral infections. Yet, by many accounts, keeping a nutritious diet was a casualty of the pandemic rather than a means to fight it. Young adults experienced disproportionate pandemic-related disruptions during a formative stage of development while little is still known about dietary outcomes.

Methods

We employed a cross-sectional design to examine dietary disparities targeting young adults (ages 18–28) during the COVID-19 lockdown period. Participants (N = 254) responded to a 15–20-min online survey with questions related to food composition and sources of food, perceptions of healthy eating, weight change, physical activity, and food insecurity. Comparisons were made by household income and gender. Multiple regression analyses were conducted to investigate factors that predicted perceptions of healthy eating behaviors while controlling for other sociodemographic factors.

Results

A clear overall trend toward unhealthy behaviors was found while positive changes were also identified. Consumption of junk food significantly increased (+ 3%), 40% gained weight, a third were less active, and 5–8% were food insecure on a regular basis. Meanwhile, eating food from restaurants declined and, for some, home-based cooking increased. Lower income participants were overly represented in unhealthy changes and higher income participants were disproportionately represented in healthy changes. Males reported more changes in dietary composition while females reported more fluctuation in weight. Reduced activity, weight gain, and food insecurity predicted unhealthy eating behaviors. Living with friend(s)/roommate(s) predicted healthier eating, but only among lower income participants.

Conclusions

It is recommended that pandemic minded public health interventions account for negative dietary trends with particular attention to low-income young adults. Solutions should be geared toward reshaping fiscal, social and physical environments, rather than relying solely on behavioral interventions.
Multimodality imaging of transient perivascular inflammation of carotid artery (TIPIC) syndrome: a case report
Authors: Ganesan Prakash , Durai Indira
Published: September 2023

Background

Transient Perivascular Inflammation of Carotid artery syndrome is a rare clinicoradiological entity characterized by inflammation of the carotid artery wall with surrounding perivascular inflammatory changes. This is a self-limiting condition and necessitates awareness and high degree of suspicion to differentiate from other serious pathologies involving the carotid artery.

Case presentation

A middle aged asian male patient presented with acute onset of intense pain in the right lateral aspect of neck. Ultrasonography and Magnetic Resonance Imaging showed wall thickening of the common carotid artery and carotid bulb with surrounding inflammation in the perivascular soft tissues. He was treated with brief course of oral anti-inflammatory medications. The patient’s symptoms improved and imaging findings resolved in 2 weeks.

Conclusions

Being infrequently encountered in clinical practice, recognition of transient perivascular inflammation of carotid artery syndrome by the physician is of prime importance. Prompt radiological investigation and follow-up imaging are crucial for accurate diagnosis, thereby leading to appropriate treatment.
Outcomes of tricuspid valve regurgitation after heart transplantation; a single center retrospective cohort study
Authors: Laimoud Mohamed , Fouly Mohamed
Published: September 2023

Background

Tricuspid valve regurgitation (TR) of the donor's heart is a common problem that can develop immediately after cardiac transplantation. There is still little data about its impact on clinical outcomes. We aimed to evaluate the short-term and 1-year effects of significant TR after heart transplantation. We retrospectively analyzed 120 patients who underwent elective orthotopic heart transplantation between 2011 and 2022. According to the postoperative TR, the patients were divided into insignificant (n= 106) and significant (n= 14) TR groups.

Results

Patients with significant TR were younger [median age: 38 (Q1- Q3: 36- 39) vs. 49 (35- 55) years, p=0.037] and had a higher prevalence of nonischemic cardiomyopathy (85.71% vs. 42.45%, p=0.003) and donor female gender (35.7% vs. 19.8%,p=0.021). The patients with significant TR had a longer ICU stay [19 (14-27) vs. 11 (9-14) days, p=0.001], more frequent acute kidney injury (57.14% vs. 32.08%, p=0.023), and continuous renal replacement therapy (14.3% vs. 5.66%, p=0.031), with higher 30-day mortality (7.14% vs. 1.9%, p=0.046) and 1-year mortality (14.3% vs. 2.8%, p=0.022) compared to patients with insignificant TR. The degree of TR significantly decreased during the follow-up [β: -0.18 (95% CI: -0.25 to -0.10); p<0.001]. All patients with TR were managed medically without surgical interventions. Logistic multivariable regression revealed that nonischemic heart disease (OR: 3.41,95% CI: 1.31-41.2, p=0.024) and female donor (OR:1.56, 95%CI: 1.13-25.3, p=0.013) independently predicted significant postoperative TR.

Conclusions

Significant TR was associated with early mortality and morbidities with prolonged hospitalization. The degree of TR significantly decreased during the first year after transplantation.
Prophylactic Radiation Therapy Versus Standard of Care for Patients With High-Risk Asymptomatic Bone Metastases: A Multicenter, Randomized Phase II Clinical Trial
Authors: Gillespie Erin F. , Yang Joanna C. , Mathis Noah J. , Marine Catherine B. , White Charlie , Zhang Zhigang , Barker Christopher A. , Kotecha Rupesh , McIntosh Alyson , Vaynrub Max , Bartelstein Meredith K. , Mitchell Aaron , Guttmann David M. , Yerramilli Divya , Higginson Daniel S. , Yamada Yoshida J. , Kohutek Zachary A. , Powell Simon N. , Tsai Jillian , Yang Jonathan T.
Published: September 2023

In a multicenter RCT (n = 78), radiation to high-risk asymptomatic bone metastases ⬇ skeletal-related events and prolonged OS.
Prevalence of Adverse Event Reporting in Adolescents and Young Adults Enrolled in Cancer Clinical Trials
Authors: Wayant Cole , Fitzgerald Kyle , Hemmerich Christian , Geng Yimin , Freyer David , Roth Michael
Published: September 2023

Adverse event reporting for AYAs with cancer was poor in a new study by @ColeWayant, et al.
Outcomes of Patients With Graves Disease 25 Years After Initiating Antithyroid Drug Therapy
Authors: Meling Stokland Ann-Elin , Austdal Marie , Nedrebø Bjørn Gunnar , Carlsen Siri , Hetland Hanne Brit , Breivik Lars , Ueland Hans Olav , Watt Torquil , Cramon Per Karkov , Løvås Kristian , Husebye Eystein Sverre , Ueland Grethe Åstrøm
Published: September 2023

Context

Graves disease (GD) is a leading cause of hyperthyroidism. Detailed investigations and predictors of long-term outcomes are missing.

Objective

This work aimed to investigate the outcomes in GD 25 years after initiating antithyroid drug treatment, including disease course, clinical and biochemical predictors of relapse, and quality of life.

Methods

A retrospective follow-up was conducted of GD patients that participated in a randomized trial from 1997 to 2001. Demographic and clinical data were obtained from medical records and questionnaires. Biobank samples were analyzed for inflammatory biomarkers and compared with age- and sex-matched healthy individuals.

Results

We included 83% (182/218) of the patients from the original study. At the end of follow-up, normal thyroid function was achieved in 34%. The remaining had either active disease (1%), spontaneous hypothyroidism (13%), or had undergone ablative treatment with radioiodine (40%) or thyroidectomy (13%). Age younger than or equal to 40 years, thyroid eye disease (TED), smoking, and elevated levels of interleukin 6 and tumor necrosis factor receptor superfamily member 9 (TNFRS9) increased the risk of relapsing disease (odds ratio 3.22; 2.26; 2.21; 1.99; 2.36). At the end of treatment, CD40 was lower in patients who maintained normal thyroid function (P = .04). At the end of follow-up, 47% had one or more autoimmune diseases, including vitamin B12 deficiency (26%) and rheumatoid arthritis (5%). GD patients who developed hypothyroidism had reduced quality of life.

Conclusion

Careful lifelong monitoring is indicated to detect recurrence, hypothyroidism, and other autoimmune diseases. Long-term ATD treatment emerges as a beneficial first-line treatment option, especially in patients with young age at onset or presence of TED.
Clival Ectopic Pituitary Adenoma Causing Cushing Syndrome
Authors: Karthik Subramaniam , Krishna Tharun , Johnson Jai Richo , Karikkanthra Jyothi
Published: September 2023

The development of adenohypophysis by differentiating and detaching from the pharyngeal roof results in formation of a functional ectopic pituitary tissue around the Sella turcica. Of the ectopic sites in which pituitary adenoma occurs, clival adenomas are rare and the majority secrete prolactin. We report a case of ACTH-dependent Cushing syndrome. Magnetic resonance imaging revealed a clival mass with sphenoid sinus infiltration and 68Gallium (Ga) Dodecane tetra acetic acid—NaI3—octreotide positron emission tomography-computed tomography showed intense uptake in the region. Postoperative immunohistochemistry revealed ACTH and T-box Protein in T-cell positivity. With literature review, we found 5 reported cases of clival ectopic pituitary adenoma with Cushing syndrome. Clinical characteristics, imaging features, histology, and management of such masses have been discussed. In conclusion, ACTH-producing clival ectopic pituitary adenomas are rare, require differentiation from neuroendocrine tumors, and remit by multimodal therapy.
Automated Preoperative and Postoperative Volume Estimates Risk of Retreatment in Chronic Subdural Hematoma: A Retrospective, Multicenter Study
Authors: Vargas Jan , Pease Matthew , Snyder M. Harrison , Blalock Jonathan , Wu Shandong , Nwachuku Enyinna , Mittal Aditya , Okonkwo David O. , Kellogg Ryan T.
Published: September 2023

BACKGROUND AND OBJECTIVES:

Several neurosurgical pathologies, ranging from glioblastoma to hemorrhagic stroke, use volume thresholds to guide treatment decisions. For chronic subdural hematoma (cSDH), with a risk of retreatment of 10%–30%, the relationship between preoperative and postoperative cSDH volume and retreatment is not well understood. We investigated the potential link between preoperative and postoperative cSDH volumes and retreatment.

METHODS:

We performed a retrospective chart review of patients operated for unilateral cSDH from 4 level 1 trauma centers, February 2009–August 2021. We used a 3-dimensional deep learning, automated segmentation pipeline to calculate preoperative and postoperative cSDH volumes. To identify volume thresholds, we constructed a receiver operating curve with preoperative and postoperative volumes to predict cSDH retreatment rates and selected the threshold with the highest Youden index. Then, we developed a light gradient boosting machine to predict the risk of cSDH recurrence.

RESULTS:

We identified 538 patients with unilateral cSDH, of whom 62 (12%) underwent surgical retreatment within 6 months of the index surgery. cSDH retreatment was associated with higher preoperative (122 vs 103 mL; P < .001) and postoperative (62 vs 35 mL; P < .001) volumes. Patients with >140 mL preoperative volume had nearly triple the risk of cSDH recurrence compared with those below 140 mL, while a postoperative volume >46 mL led to an increased risk for retreatment (22% vs 6%; P < .001). On multivariate modeling, our model had an area under the receiver operating curve of 0.76 (95% CI: 0.60-0.93) for predicting retreatment. The most important features were preoperative and postoperative volume, platelet count, and age.

CONCLUSION:

Larger preoperative and postoperative cSDH volumes increase the risk of retreatment. Volume thresholds may allow identification of patients at high risk of cSDH retreatment who would benefit from adjunct treatments. Machine learning algorithm can quickly provide accurate estimates of preoperative and postoperative volumes.
Anatomy of the Frontal Sinus Drainage Pathway Evaluated in 247 Cadavers to Prevent Cerebrospinal Fluid Leakage After Frontobasal Craniotomy
Authors: Kodera Toshiaki , Isozaki Makoto , Akazawa Ayumi , Oiwa Mizuki , Yamauchi Takahiro , Yamada Shintaro , Tai Katsuhide , Kawajiri Satoshi , Kidoguchi Masamune , Higashino Yoshifumi , Hashimoto Norichika , Arishima Hidetaka , Iino Satoshi , Kikuta Ken-ichiro
Published: September 2023

BACKGROUND AND OBJECTIVES:

The frontal sinus (FS) drainage pathway (FSDP) may be a conduit for cerebrospinal fluid leakage after frontobasal craniotomy. In this cadaveric study, we aimed to evaluate the anatomy of the FSDP.

METHODS:

The FSs and FSDPs of 247 cadavers were investigated. We counted the number of FSs and FSDPs in each half-head, verified the presence of a narrowing section in each FSDP, and evaluated the depth, shape, and size of each narrowing FSDP section.

RESULTS:

We investigated 494 sides and 472 FSDPs of 247 cadavers. FSs were unilaterally undeveloped in 13 of 247 cadavers (5.3%) and bilaterally in 8 (3.2%). FSs were unilaterally duplicated in 7 of 247 cadavers (2.8%), and no FSs were bilaterally duplicated or triplicated. No FSs had 2 or more FSDPs, and all 472 investigated FSDPs were invariably narrowed at various depths. The narrowing FSDP sections were elliptical (78.6%), circular (18.1%), triangular (1.8%), or crescent-shaped (1.4%) and of varying thickness and orientation. Although FSDPs were asymmetric in 92.2% of cadavers and narrowing FSDP sections were located deep (8.9 ± 4.4 mm from the anterior skull base), the narrowing FSDP sections were typically small (area: 5.9 ± 3.3 mm2) or thin (short diameter: 2.1 ± 0.7 mm).

CONCLUSION:

Each FS had only one FSDP, all FSDPs were invariably narrowed at various depths, and the narrowing FSDP sections were sufficiently small or thin to allow local closure, facilitating prevention of cerebrospinal fluid leakage after frontobasal craniotomy.
A plea for more careful scholarship in reviewing evidence: the case of mammographic screening
Authors: Duffy Stephen W. , Tabar Laszlo , Chen Tony H.H. , Yen Amy M.F. , Dean Peter B. , Smith Robert A.
Published: September 2023

Objectives:

To identify issues of principle and practice giving rise to misunderstandings in reviewing evidence, to illustrate these by reference to the Nordic Cochrane Review (NCR) and its interpretation of two trials of mammographic screening, and to draw lessons for future reviewing of published results.

Methods:

A narrative review of the publications of the Nordic Cochrane Review of mammographic screening (NCR), the Swedish Two-County Trial (S2C) and the Canadian National Breast Screening Study 1 and 2 (CNBSS-1 and CNBSS-2).

Results:

The NCR concluded that the S2C was unreliable, despite the review’s complaints being shown to be mistaken, by direct reference to the original primary publications of the S2C. Repeated concerns were expressed by others about potential subversion of randomisation in CNBSS-1 and CNBSS-2; however, the NCR continued to rely heavily on the results of these trials. Since 2022, however, eyewitness evidence of such subversion has been in the public domain.

Conclusions:

An over-reliance on nominal satisfaction of checklists of criteria in systematic reviewing can lead to erroneous conclusions. This occurred in the case of the NCR, which concluded that mammographic screening was ineffective or minimally effective. Broader and more even-handed reviews of the evidence show that screening confers a substantial reduction in breast cancer mortality.

Advances in knowledge:

Those carrying out systematic reviews should be aware of the dangers of over-reliance on checklists and guidelines. Readers of systematic reviews should be aware that a systematic review is just another study, with the capability that all studies have of coming to incorrect conclusions. When a review seems to overturn the current position, it is essential to revisit the publications of the primary research.
A prática do kitesurf e as lesões relacionadas: uma revisão narrativa da literatura
Authors: Lima Daniel Souza , Condori Jaqueline Mamani , Chavez Elizabet Diaz , De Araújo Gabriel Rocha Pinon Teixeira , Augusto João Pedro Andrade , Barreto Victor Leonardo
Published: September 2023

Objetivo: realizar uma revisão na literatura para caracterizar o perfil epidemiológico das lesões traumáticas provocadas pela prática dessa modalidade. Metodologia: realizou-se uma revisão narrativa da literatura acerca das lesões decorrentes da prática esportiva do kitesurf na base de dados da Scielo, Ovid MEDLINE e Google Scholar de artigos de janeiro de 2000 a dezembro de 2022. Resultados: foram eleitos 14 artigos que se ajustaram aos objetivos dessa revisão. Mediante análise dos artigos, foram encontradas discussões que direcionam os principais mecanismos de trauma, riscos de lesões, estruturas mais frequentemente acometidas e propostas para minimizar os danos e a recuperação. Conclusão: as lesões que podem acometer os praticantes deste esporte aquático, em sua maioria, são leves e principalmente nos membros inferiores; entretanto, podem ser letais, o que desperta a necessidade de maior investigação epidemiológica e clínica dos casos atendidos, bem como a adoção de medidas de prevenção.
ENTRE O CUIDAR E O ADOECER: A SÍNDROME DE BURNOUT NOS AGENTES COMUNITÁRIOS DE SAÚDE DURANTE A PANDEMIA DE COVID-19
Authors: Borges José Luiz Nobre , Sousa Juliana Carvalho de , Menezes Edivaldo Rabelo de , Rego Sidneia Maia de Oliveira , Lima Joyce Silva Soares de
Published: September 2023

O presente estudo tem como objetivo analisar a Síndrome de Burnout em Agentes Comunitários de Saúde durante o período pandêmico do COVID-19. A pesquisa é um estudo descritivo, qualitativo, que utiliza a técnica análise de conteúdo, realizado em um município do Rio Grande do Norte com sete agentes comunitários de saúde do município, onde os dados foram coletados por meio de entrevista semiestruturada baseada na escala MBI - Maslach Burnout Inventory. Com base nos dados analisados, seis dos sete entrevistados apresentavam sinais de esgotamento emocional, dois apresentavam sinais de despersonalização, e nenhum deles apresentava mau desempenho profissional. Porém, considerando que o Burnout é uma relação sistêmica entre essas três dimensões, não se pode dizer que eles tendem a desenvolver a síndrome. Ademais, este estudo contribui para realçar os cuidados necessários, para evitar o desenvolvimento do burnout nos ACS, pois o adoecimento dos colaboradores interfere diretamente em suas relações de trabalho.
SUCESSO DA EQUIPE DE PROJETO: UM ESTUDO SOBRE VARIÁVEIS PREDITORAS
Authors: Melo Antony Bento
Published: September 2023

A presente pesquisa objetivou entender como o suporte da alta gestão, as habilidades da equipe de projeto e os escritórios de gestão de projetos podem influenciar o sucesso da equipe de projeto. Desse modo, efetivou-se uma survey, com 87 líderes de equipe de projeto, para posterior modelagem de equações estruturais, no software PLS 3.0. Os resultados reafirmam o apontado pela literatura, no que diz respeito à indispensabilidade de se considerar ambas as Habilidades da Equipe, Hard e Soft, na gestão de projetos e, consequentemente, quanto ao Sucesso da Equipe.
LEADERSHIP AND ELDERLY CAREGIVERS IN LTC’s: A BIBLIOMETRIC ANALYSIS
Authors: Etges Miriam Teresa
Published: September 2023

We conducted a bibliometric analysis on leadership research in formal caregivers within geriatric environments, examining the association between these professionals and leadership. Our study aimed to identify trends and indicators by examining articles published on the Web of Science (WoS) platform from 1990 to 2022. Data from the WoS platform were collected and analyzed using Boolean operators to identify articles that met the following criteria: publication before 2022 and focus on the relationship between "leadership", "formal caregiver" and "elderly", "elderly", or "patients". The investigations primarily focused on nursing, with 53% of the publications originating from the administrative sciences. North American research accounts for 38% of the scientific production in this field. The relationship between leadership and elderly caregivers has received little attention from a managerial perspective. Based on a content analysis of recent publications, potential research opportunities in this field are presented, providing clues for a future investigation agenda.
ANÁLISE DAS EXPECTATIVAS DOS CONSUMIDORES DE COMPANHIAS AÉREAS BRASILEIRAS DURANTE A PANDEMIA DE COVID-19 POR MEIO DA ANÁLISE FATORIAL
Authors: Ramos Pamela Adelino , Pereira Felipe Araujo
Published: September 2023

Transporte aéreo é um importante elo logístico no mundo, promovendo rapidez e segurança no transporte de cargas e passageiros, sendo importantíssimo para o desenvolvimento de qualquer país. Devido à pandemia do novo coronavírus, iniciada em 2020, setores como o transporte aéreo foram bastante afetados. Nesse sentido, os setores responsáveis pelos transportes aéreos precisaram adaptar o serviço mesmo em um momento de adversidade. Para isso, houve investimento em higienização, atendendo às exigências dos órgãos reguladores. Este estudo objetiva analisar as expectativas de qualidade sob a ótica dos consumidores do serviço aéreo, baseando-se nas mudanças de protocolos. A Análise Fatorial Exploratória constatou que os consumidores esperam um serviço aéreo seguro, garantindo a higienização e a comunicação efetiva com seu público. Esta pesquisa é relevante por permitir compreender o comportamento do consumidor do transporte aéreo no Brasil e o que se espera das companhias aéreas no que diz respeito a um serviço de qualidade.