bluuebunny/crossref_metadata_2025 huggingface dataset:
Survival comparison of first-line treatment regimens in patients with braf-mutated advanced colorectal cancer: a multicenter retrospective study
Authors: Meng Qianhao , Zhao Jian , Yu Yuanyuan , Wang Ke , Ren Jing , Xu Chang , Wang Yusheng , Wang Guangyu
Published: February 2023

Background

Patients with V-Raf murine sarcoma viral oncogene homolog B1 (BRAF) V600E-mutated advanced colorectal cancer (CRC) have a poor prognosis, and treatment options that can improve outcome are still under investigation. The purpose of this study was to discuss the differences of overall survival (OS) and progression-free survival (PFS) between patients with BRAF V600E-mutated advanced CRC who were treated with chemotherapy alone and chemotherapy combined with targeted therapy in advanced first-line therapy.

Methods

Grouping of 61 patients according to first-line treatment regimen (chemotherapy alone/chemotherapy combined with bevacizumab). Kaplan–Meier method and log-rank test were used to compare OS and PFS. Cox proportional hazards regression model was used to measure the risk of first-line medication therapies while correcting for confounding factors that may affect PFS and OS.

Results

There was no significant difference in OS between patients treated with chemotherapy alone and those treated with chemotherapy combined with bevacizumab (P = 0.93; HR, 1.027; 95% CI, 0.555–1.901). Likewise, there was no significant difference in PFS between the two groups (P = 0.29; HR, 0.734; 95% CI, 0.413–1.304). Subgroup analysis showed that OS and PFS of different treatment regimens were not significantly different among subgroups. Multivariate analysis suggested that surgical treatment of primary tumor (P = 0.001; HR, 0.326; 95% CI, 0.169–0.631) and presence of liver metastasis (P = 0.009; HR, 2.399; 95% CI, 1.242–4.635) may serve as independent prognostic indicators in patients with BRAF-mutated advanced CRC. Surgical treatment of the primary tumor (P = 0.041; HR, 0.523; 95% CI, 0.280–0.974) was significantly associated with PFS too.

Conclusion

For patients with BRAF V600E-mutated advanced CRC, chemotherapy alone did not differ significantly in OS and PFS compared with chemotherapy + bevacizumab for advanced first-line therapy. Chemotherapy combined with targeted therapy did not render a survival benefit to these patients, demonstrating that the importance of developing new treatment options for this population.
Construction of a radiogenomic association map of pancreatic ductal adenocarcinoma
Authors: Jamshidi Neema , Senthilvelan Jayasuriya , Dawson David W. , Donahue Timothy R. , Kuo Michael D.
Published: February 2023

Background

Pancreatic adenocarcinoma (PDAC) persists as a malignancy with high morbidity and mortality that can benefit from new means to characterize and detect these tumors, such as radiogenomics. In order to address this gap in the literature, constructed a transcriptomic-CT radiogenomic (RG) map for PDAC.

Methods

In this Institutional Review Board approved study, a cohort of subjects (n = 50) with gene expression profile data paired with histopathologically confirmed resectable or borderline resectable PDAC were identified. Studies with pre-operative contrast–enhanced CT images were independently assessed for a set of 88 predefined imaging features. Microarray gene expression profiling was then carried out on the histopathologically confirmed pancreatic adenocarcinomas and gene networks were constructed using Weighted Gene Correlation Network Analysis (WCGNA) (n = 37). Data were analyzed with bioinformatics analyses, multivariate regression-based methods, and Kaplan-Meier survival analyses.

Results

Survival analyses identified multiple features of interest that were significantly associated with overall survival, including Tumor Height (P = 0.014), Tumor Contour (P = 0.033), Tumor-stroma Interface (P = 0.014), and the Tumor Enhancement Ratio (P = 0.047). Gene networks for these imaging features were then constructed using WCGNA and further annotated according to the Gene Ontology (GO) annotation framework for a biologically coherent interpretation of the imaging trait-associated gene networks, ultimately resulting in a PDAC RG CT-transcriptome map composed of 3 stage-independent imaging traits enriched in metabolic processes, telomerase activity, and podosome assembly (P < 0.05).

Conclusions

A CT-transcriptomic RG map for PDAC composed of semantic and quantitative traits with associated biology processes predictive of overall survival, was constructed, that serves as a reference for further mechanistic studies for non-invasive phenotyping of pancreatic tumors.
The hydroxyapatite modified 3D printed poly L-lactic acid porous screw in reconstruction of anterior cruciate ligament of rabbit knee joint: a histological and biomechanical study
Authors: Wang Yafei , Ren Chengzhen , Bi Fanggang , Li Pengju , Tian Ke
Published: February 2023

Background

3D printing technology has become a research hotspot in the field of scientific research because of its personalized customization, maneuverability and the ability to achieve multiple material fabrications. The focus of this study is to use 3D printing technology to customize personalized poly L-lactic acid (PLLA) porous screws in orthopedic plants and to explore its effect on tendon-bone healing after anterior cruciate ligament (ACL) reconstruction.

Methods

Preparation of PLLA porous screws with good orthogonal pore structure by 3D printer. The hydroxyapatite (HA) was adsorbed on porous screws by electrostatic layer-by-layer self-assembly (ELSA) technology, and PLLA-HA porous screws were prepared. The surface and spatial morphology of the modified screws were observed by scanning electron microscopy (SEM). The porosity of porous screw was measured by liquid displacement method. Thirty New Zealand male white rabbits were divided into two groups according to simple randomization. Autologous tendon was used for right ACL reconstruction, and porous screws were inserted into the femoral tunnel to fix the transplanted tendon. PLLA group was fixed with porous screws, PLLA-HA group was fixed with HA modified porous screws. At 6 weeks and 12 weeks after surgery, 5 animals in each group were sacrificed randomly for histological examination. The remaining 5 animals in each group underwent Micro-CT and biomechanical tests.

Results

The pores of PLLA porous screws prepared by 3D printer were uniformly distributed and connected with each other, which meet the experimental requirements. HA was evenly distributed in the porous screw by ELSA technique. Histology showed that compared with PLLA group, mature bone trabeculae were integrated with grafted tendons in PLLA-HA group. Micro-CT showed that the bone formation index of PLLA-HA group was better than that of PLLA group. The new bone was uniformly distributed in the bone tunnel along the screw channel. Biomechanical experiments showed that the failure load and stiffness of PLLA-HA group were significantly higher than those of PLLA group.

Conclusions

The 3D printed PLLA porous screw modified by HA can not only fix the grafted tendons, but also increase the inductivity of bone, promote bone growth in the bone tunnel and promote bone integration at the tendon-bone interface. The PLLA-HA porous screw is likely to be used in clinic in the future.
High-efficiency production of the antimicrobial peptide pediocin PA-1 in metabolically engineered Corynebacterium glutamicum using a microaerobic process at acidic pH and elevated levels of bivalent calcium ions
Authors: Christmann Jens , Cao Peng , Becker Judith , Desiderato Christian K. , Goldbeck Oliver , Riedel Christian U. , Kohlstedt Michael , Wittmann Christoph
Published: February 2023

Background

Pediocin PA-1 is a bacteriocin of recognized value with applications in food bio-preservation and the medical sector for the prevention of infection. To date, industrial manufacturing of pediocin PA-1 is limited by high cost and low-performance. The recent establishment of the biotechnological workhorse Corynebacterium glutamicum as recombinant host for pediocin PA-1 synthesis displays a promising starting point towards more efficient production.

Results

Here, we optimized the fermentative production process. Following successful simplification of the production medium, we carefully investigated the impact of dissolved oxygen, pH value, and the presence of bivalent calcium ions on pediocin production. It turned out that the formation of the peptide was strongly supported by an acidic pH of 5.7 and microaerobic conditions at a dissolved oxygen level of 2.5%. Furthermore, elevated levels of CaCl2 boosted production. The IPTG-inducible producer C. glutamicum CR099 pXMJ19 Ptac pedACDCg provided 66 mg L−1 of pediocin PA-1 in a two-phase batch process using the optimized set-up. In addition, the novel constitutive strain Ptuf pedACDCg allowed successful production without the need for IPTG.

Conclusions

The achieved pediocin titer surpasses previous efforts in various microbes up to almost seven-fold, providing a valuable step to further explore and develop this important bacteriocin. In addition to its high biosynthetic performance C. glutamicum proved to be highly robust under the demanding producing conditions, suggesting its further use as host for bacteriocin production.
Impact of the COVID-19 lockdown on household diet diversity in rural Bihar, India: a longitudinal survey
Authors: Travasso Sandra M. , Joseph Smitha , Swaminathan Sumathi , John Anjaly Teresa , Makkar Sanchit , Webb Patrick , Kurpad Anura , Thomas Tinku
Published: February 2023

Background

The COVID-19 pandemic disrupted livelihoods and diets across the world. This study aimed to assess changes in household diet diversity and food consumption between the pre-COVID-19 period (December 2019–January 2020) and during the lockdown (March–May 2020), and to identify the socio-economic characteristics that determine these changes in rural Bihar, India.

Methods

Households that had provided their phone numbers in the pre-COVID-19 household survey (n = 1797) were contacted for interviews during the lockdown telephonic survey in a longitudinal survey in two districts (Gaya and Nalanda) in Bihar. In total, 939 households were interviewed. Using data on food consumption from both surveys, 876 households were included in the analysis. Food and Agriculture Organization’s household diet diversity score (HDDS) was used to compare diet diversity between the pre-COVID-19 period and during the lockdown. Logistic regression was used to identify factors affecting household diet diversity and food consumption in the study households.

Results

Low diet diversity increased from 51.6% (95% CI 48.3–54.9) to 75.8% (95% CI 73.0–78.6) from the pre-COVID-19 to the lockdown period. Reduced food consumption was reported across all foods with nearly a quarter of the households reporting reduced consumption of fruits (27%), pulses (25%) and cereals (21%). Nearly 60% and above reported stopping consumption of nutrient-rich foods such as chicken, fish and eggs although the population was predominantly non-vegetarian. Logistic regression analysis revealed that taking a loan from neighbours/relatives (OR = 1.8; 95% CI 1.3–2.5) and belonging to lower social groups (OR = 1.8; 95% CI 1.1–2.9) increased odds of low HDDS. While those possessing ration cards had lower odds of reduced consumption of all food items, it was not associated with stopping consumption of any food item. In an unadjusted analysis, receipt of cash transfer during lockdown was also not associated with diet diversity (OR = 1.2; 95% CI 0.9–1.7).

Conclusions

COVID-19 has impacted the consumption of nutrient-rich foods among already low-income rural households in India. Maintaining diet diversity among socio-economically vulnerable households during periods when food consumption is most threatened by shocks such as COVID-19 would need sustained government support in terms of social protection coverage and benefit transfers in rural communities.
Mixed small cell neuroendocrine carcinoma and squamous cell carcinoma covered by tubulovillous adenoma in the rectum: a case report and detailed molecular analyses
Authors: He Fengxia , He Xue , Cui Menghan , Wang Yan
Published: February 2023

Background

Previously, only six cases of mixed neuroendocrine-non-neuroendocrine neoplasm (MiNENs) with squamous cell carcinoma (SCC) component have been described in the colorectum, and the molecular landscape of MiNENs is also poorly understood. Herein, we present a unique case in which the SCC developed as a component of a MiNEN in the rectum.

Case presentation

The patient was firstly diagnosed as rectal small cell neuroendocrine carcinoma (SCNEC) covered by tubulovillous adenoma, and then mixed SCNEC and SCC in the same site 6 months later. Representative samples from the three histologic subtypes were then sent for next-generation sequencing (NGS) separately. Multiple liver metastases occurred in the following month after the last surgery. The patient died of ketoacidosis 1 year after initial diagnosis of the tumor.

Conclusion

This is the first report of this exceedingly rare tumor type to include NGS of the 3 separate morphological entities. Our findings may expedite the understanding of combined tumors in the colorectum.
The effect of growth hormone on the metabolome of follicular fluid in patients with diminished ovarian reserve
Authors: He Fan , Wang Fang , Yang Yang , Yuan Zhi , Sun Chengguang , Zou Heng , Chen Huijia , Yi Hongliang , Gao Shan Hu , Zhang Shen , Hu Lina , Han Ting-li
Published: February 2023

Background

Increasing evidence supports that the co-treatment with growth hormone (GH) enhances ovarian response and oocyte quality during controlled ovarian stimulation (COS) in patients with diminished ovarian reserve (DOR). The composition of follicular fluid (FF) plays an essential role in oocyte development and mirrors the communication occurring between the oocyte and follicular microenvironment. However, the effect of GH on the FF metabolome remains unclear.

Methods

This prospective observational study recruited DOR patients undergoing in vitro fertilization (IVF) cycles with minimal stimulation protocol for COS. Each patient receiving GH co-treatment was matched to a patient without GH co-treatment by propensity score matching. The FF was collected after isolating oocytes and assayed by gas chromatograph-mass spectrometry (GC-MS) metabolomics. The Pearson correlation was performed to evaluate the relationship between the number of oocytes retrieved and the levels of differential metabolites. The KEGG database was used to map differential metabolites onto various metabolic pathways.

Results

One hundred thirty-four FF metabolites were identified by GC-MS metabolomics. Twenty-four metabolites, including glutathione, itaconic acid and S-adenosylmethionin (SAM) showed significant differences between the GH and control groups (p-value < 0.05 and q-value < 0.1). In addition, the number of oocytes retrieved was significantly higher in the GH group compared to the control group (3 vs 2, p = 0.04) and correlated with the levels of five differential metabolites. Among them, the levels of antioxidant metabolite itaconic acid were upregulated by GH administration, while SAM levels were downregulated.

Conclusions

The co-treatment with GH during COS may improve oocyte development by altering FF metabolite profiles in DOR patients. However, given the downregulation of SAM, a regulator of genomic imprinting, the potential risk of imprinting disturbances should not be neglected.
Metformin and long non-coding RNAs in breast cancer
Authors: Gholami Morteza , Klashami Zeynab Nickhah , Ebrahimi Pirooz , Mahboobipour Amir Ali , Farid Amir Salehi , Vahidi Aida , Zoughi Marziyeh , Asadi Mojgan , Amoli Mahsa M.
Published: February 2023

Breast cancer (BC) is the second most common cancer and cause of death in women. In recent years many studies investigated the association of long non-coding RNAs (lncRNAs), as novel genetic factors, on BC risk, survival, clinical and pathological features. Recent studies also investigated the roles of metformin treatment as the firstline treatment for type 2 diabetes (T2D) played in lncRNAs expression/regulation or BC incidence, outcome, mortality and survival, separately. This comprehensive study aimed to review lncRNAs associated with BC features and identify metformin-regulated lncRNAs and their mechanisms of action on BC or other types of cancers. Finally, metformin affects BC by regulating five BC-associated lncRNAs including GAS5, HOTAIR, MALAT1, and H19, by several molecular mechanisms have been described in this review. In addition, metformin action on other types of cancers by regulating ten lncRNAs including AC006160.1, Loc100506691, lncRNA-AF085935, SNHG7, HULC, UCA1, H19, MALAT1, AFAP1-AS1, AC026904.1 is described.
Arbitrary decay for a von Karman system with memory
Authors: Kang Jum-Ran
Published: February 2023

In this paper we study the von Karman plate model with long range memory. By using the assumptions on the relaxation function due to Tatar (J. Math. Phys. 52:013502, 2011), we show an arbitrary rate of decay, which is not necessarily of an exponential or polynomial decay. Our result is obtained without imposing the usual relation between the relaxation function h and its derivative.
On the boundary value conditions of evolutionary $p_{i}$-Laplacian equation
Authors: Zhan Huashui , Si Xin
Published: February 2023

The initial boundary value problem of the evolutionary $p_{i}$

p
i

-Laplacian equation $$ {u_{t}}=\sum_{i=1}^{N} \frac{\partial}{\partial x_{i}} \bigl(a_{i}(x) \vert u_{x_{i}} \vert ^{p_{i}-2}u_{x_{i}} \bigr) $$

u
t

=

∑

i
=
1

N

∂

∂

x
i

(

a
i

(
x
)
|

u

x
i

|

p
i

−
2

u

x
i

)

is considered, where $a_{i}(x)$

a
i

(
x
)
is nonnegative but is with 0 measure degeneracy. The weak solutions do not belong to $BV_{x}(Q_{T})$
B

V
x

(

Q
T

)
, how to define the trace in a reasonable way? This is the main topic of this paper. A suitable new boundary value condition is quoted and the stability of weak solutions follows naturally.
Exploring multisensory integration of non-naturalistic sounds on body perception in young females with eating disorders symptomatology: a study protocol
Authors: Navas-León Sergio , Morales Márquez Luis , Sánchez-Martín Milagrosa , Crucianelli Laura , Bianchi-Berthouze Nadia , Borda-Mas Mercedes , Tajadura-Jiménez Ana
Published: February 2023

Background

Bodily illusions can be used to investigate the experience of being in a body by manipulating the underlying processes of multisensory integration. Research suggests that people with eating disorders (EDs) may have impairments in visual, interoceptive, proprioceptive, and tactile bodily perception. Furthermore, people with EDs also show abnormalities in integrating multisensory visuo-tactile and visual-auditory signals related to the body, which may contribute to the development of body image disturbances. Visuo-auditory integration abnormalities have been observed also in people with subthreshold ED symptomatology. However, it remains unclear whether these impairments are specific to bodily signals or if they extend to any auditory signals.

Methods

We will recruit 50 participants (aged 18–24; females assigned at birth) with ED symptomatology (subthreshold group) and 50 control participants. The Eating Disorder Examination Questionnaire will be administered to screen for ED symptomatology and divide the sample into two groups accordingly (control and subthreshold group using a clinical cut-off score of 2.8). The strength of both illusions will be measured implicitly with estimations of body part position and size, and explicitly with self-report questionnaires. As a secondary aim, regression analysis will be run to test the predictive role of susceptibility for both illusions on interoceptive body awareness (measured by the Multidimensional Assessment of Interoceptive Awareness Scale) and sensory-processing sensitivity (measured by the Highly Sensitive Person Scale).

Discussion

Our study may contribute to our understanding of the mechanisms underlying body image disturbances. The results may pave the way for novel clinical interventions targeting early symptoms prior to the development of the disorder in young females.
The role of discrimination and adverse childhood experiences in disordered eating
Authors: Nelson Jillian D. , Martin Laura N. , Izquierdo Alyssa , Kornienko Olga , Cuellar Alison E. , Cheskin Lawrence J. , Fischer Sarah
Published: February 2023

Background

In clinical research, there has been a call to move beyond individual psychosocial factors towards identifying cultural and social factors that inform mental health. Similar calls have been made in the eating disorders (ED) field underscoring the need to understand larger sociocultural influences on EDs. Discrimination is a social stressor that may influence mental health in similar ways to traumatic or adverse childhood experiences (ACEs). Given the high rates of EDs and discrimination among marginalized groups, it is vital to understand the role of discrimination and ACEs as predictors of ED symptoms in these populations. The aim of this study is to examine how perceived discrimination predicts ED pathology when statistically adjusting for gender, race, and ACEs.

Methods

The diverse study sample consisted of 331 undergraduate students from a longitudinal cohort study (ages 18–24; 66% female; 35% White/non-Hispanic). Participants completed measures of everyday discrimination, ACEs, and ED pathology.

Results

Following adjustment for multiple statistical comparisons, the frequency of daily discrimination predicted all ED symptoms above and beyond history of ACEs. In follow-up analyses, number of reasons for discrimination predicted cognitive restraint and purging. Differences in ED symptomatology were found based on the reason for discrimination, gender, and race. Specifically, those who experienced weight discrimination endorsed higher scores on all ED symptoms, and those experiencing gender discrimination endorsed higher body dissatisfaction, cognitive restraint, and restriction. People of color endorsed higher restriction, while female participants endorsed higher scores on all ED symptom with the exception of cognitive restraint.

Conclusion

Discrimination is a salient risk factor for ED symptoms even when accounting for individuals’ history of ACEs. Future research should utilize an intersectional approach to examine how perceived discrimination affects ED pathology over time. (Word count: 234).
Successful percutaneous transhepatic lymphangiography and embolization for intractable hepatic lymphorrhea after laparoscopic distal gastrectomy: a case report
Authors: Harigane Kohei , Nemoto Hiroshi , Yoshida Yoshiyuki , Komori Hiromasa , Sarukawa Hideki , Yazawa Naoki , Miyamae Taku
Published: February 2023

Background

Hepatic lymphorrhea is a rare and serious complication of surgery for digestive tract cancers and is thought to occur as a result of lymph node dissection of the hepatoduodenal ligament. This complication results in the accumulation of lymphatic fluid, which may in turn lead to nutritional disorders, immune deficiency, and circulation insufficiency. However, there is currently no standard strategy for treating this condition.

Case presentation

A 49-year-old woman with alcoholic liver damage underwent laparoscopic distal gastrectomy with lymph node dissection for early gastric cancer. Abundant ascites persisted postoperatively, and the fluid was suspected to indicate hepatic lymphorrhea. The patient was re-admitted on postoperative day 26 due to the onset of a brain infarction caused by dehydration. Various conservative treatments for hepatic lymphorrhea were ineffective. She underwent percutaneous transhepatic lymphangiography and embolization on postoperative day 81, with obvious effect. Computed tomography images demonstrated complete disappearance of ascites.

Conclusions

Postoperative hepatic lymphorrhea is a rare and serious complication of radical surgery for digestive tract cancers. The current case suggests that percutaneous transhepatic lymphangiography and embolization may be a rational treatment option when conservative treatments fail.
A cross-sectional study of the association between exposure to violence, intelligence, and executive function in Brazilian youths
Authors: Santos Rhaná Carolina , Dalfovo Nicole Prigol , de Freitas Machado Julia , de Azeredo Lucas Araújo , Grassi-Oliveira Rodrigo , Portuguez Mirna Wetters , Buchweitz Augusto
Published: February 2023

We carried out an exploratory study of the association between exposure to violence, intelligence, and executive functions in Brazilian preadolescents. The study included 56 participants (31 males) aged 8 to 14 years old (mean = 11.3, SD = 1.0). We administered neuropsychological tests to evaluate executive functions and the Juvenile Victimization Questionnaire (JVQ) to evaluate exposure to violence. We used the following neuropsychological instruments: Wechsler Abbreviated Scale of Intelligence (WASI), Stroop Color-Word Interference task, digits subtest of the Wechsler Intelligence Scale for Children, and an N-back task. We generated a composite score from neuropsychological test scores and investigated the association of that score, and individual test scores, with exposure to violence and socioeconomic status (SES). Results suggest, first, that exposure to violence is associated with a 0.5-point lower intelligence quotient score for every reported victimization event in the Juvenile Victimization Questionnaire. Results also show that the digits backward subtest scores showed a significant negative correlation with exposure to violence (JVQ; rho = −0.29, p < 0.05); both analyses were adjusted for the level of schooling of parents or guardians, which was also found to be significantly associated with lower intelligence quotient scores. We discuss results in the light of the existing literature on the effects of exposure to violence on adolescent development, and the amounting evidence that suggests an association of exposure to violence, and of victimization, with tests that evaluate constructs of executive functions. The study struggled with low compliance from participants, and we underscore the challenges of carrying out empirical studies aimed at better understanding the development of underrepresented youths, such as those from Central and Latin America.
Public stroke awareness among Gharbia governorate inhabitants: a cross-sectional study
Authors: Elhassanien Mahmoud Ebrahim Mostafa , Ghali Azza Abbas , Shaheen Asmaa Khaled , Ali Dina Abdallah , Sabra Hamdy Khaled , Motawea Sara H. , Ahmed Ali R. , Fahem Michael Maher Mourad , Habash Shimaa Abo Elfotoh , Elbehairy Rola Essam , Abuelsoud Ahmed Galal , Badawy Gehan Ibrahim Mohamed , Bahnasy Wafik Said
Published: February 2023

Background

Stroke is the most common acquired neurological disease in the adult population worldwide with an incidence of 16 million new cases every year responsible for about 6.1 million deaths and 130.6 million disability-adjusted life-years (DALYs). The objectives of this work were to study the level of stroke awareness and the proper response for suspected stroke patients in urban and rural areas of Tanta City, Egypt. The study was conducted on 1869 Egyptian Citizens; 908 and 961 reside in urban and rural areas, respectively, who were submitted to a face-to-face interview using the stroke awareness questionnaire (Arabic version).

Results

Rural participants showed a significant reduction in acute cerebrovascular stroke (CVS) awareness and knowledge including the most affected organ by CVS, what are the risk factors, what are the early stroke symptoms, is there specific treatment for acute ischemic stroke, and what is the proper reaction when confronted with a case of acute CVS?

Conclusion

Urban populations have better recognition of stroke risk factors, early stroke symptoms, and the proper response when confronted with a case of acute CVS when compared with rural people possibly due to better socioeconomic status and higher educational levels.
Study design methodology in neurosurgical research
Authors: Galal Ahmed
Published: February 2023

Background

Medical research has evolved from individual expert-described opinions and techniques to scientifically designed methodology-based studies. There are different study designs, and selecting an appropriate study design is critical to appropriately answer the research question being investigated.

Main body

A research question may be addressed using different approaches that can be descriptive, analytical, or experimental. The choice of study design is influenced by features as that related to exposure (intervention) and disease (outcome); considerations related to time, resources, ethics and gaps in scientific knowledge that remain to be filled. The purpose of this review is to provide an overview of the basic study designs as it is the foundation of neurosurgical research to provide valid scientific evidence.

Conclusion

Quality in scientific research begins with a clear hypothesis and a well-formulated design. This entails a thorough understanding of the different study designs to choose the best suited to answer the investigated research question.
Cannabis use disorder is associated with shorter length of stay and increased home discharge after primary total joint arthroplasty: a propensity-weighted analysis
Authors: Rahmon Dalia , Zalikha Abdul Kareem , Mazur Matthew , Hajj Hussein Inaya , El-Othmani Mouhanad M.
Published: February 2023

Introduction

Increased legalization of cannabis use across the United States has been correlated with increased cannabis use in the clinical setting. However, little is known regarding the characteristics and postoperative outcomes after primary joint arthroplasty (TJA) for patients with cannabis use disorder (CUD).

Methods

This retrospective cohort study used data from the National Inpatient Sample of patients undergoing primary TJA between 2006 to 2015. Patients were grouped based on presence of concomitant CUD. Patient demographic characteristics and outcome data between groups were analyzed. Propensity score methodology was used to compare immediate in-hospital complications and economic outcomes.

Results

A total of 8,740,798 TJAs were included. The prevalence of CUD increased nearly five-fold from 0.05% to 0.26% during this time (P < 0.0001). CUD patients were significantly younger, more likely to be male, most frequently of non-Hispanic Black race, and had higher rates of Medicaid insurance. Patients with CUD had a significantly shorter length of hospital stay (3.04 vs. 3.24 days, P = 0.0297), while incurring significantly higher daily ($22,614 vs. $17,955, P < 0.0001) and total charges during admission ($58,507 vs. $50,924, P < 0.0001), compared to patients without CUD. When compared with the control group, CUD was associated with significantly greater odds of home discharge (odds ratio (OR): 1.45, P = 0.0007), and significantly lower odds of rehab discharge (OR: 0.70, P = 0.0013). There were no differences in overall complication profile or in the vast majority of individual in-hospital complications between groups.

Conclusion

While CUD is correlated to shorter length of stay and increased home discharge after TJA, it does not show a strong effect on complications in an inpatient postoperative setting. It is important for clinicians to appreciate the demographic profile and expected clinical and economic outcomes for patients with CUD undergoing TJA, particularly in the context of evolving laws surrounding cannabis use.
A partnership between Māori healing and psychiatry in Aotearoa New Zealand
Authors: NiaNia Wiremu , Bush Allister
Published: February 2023

This paper describes an example of Māori healing and psychiatry working together in an Indigenous mental health context in Aotearoa (New Zealand). Each author outlines their perspectives on the context and the partnership. The case of a Māori teenager with pseudo-seizures and voice-hearing is described to illustrate the partnership in action.
Assessing the Increased Variability in Individual Lesion Kinetics During Immunotherapy: Does It Exist, and Does It Matter?
Authors: Kerioui Marion , Bertrand Julie , Desmée Solène , Le Tourneau Christophe , Mercier François , Bruno René , Guedj Jérémie
Published: February 2023

PURPOSE

Several studies have raised the hypothesis that immunotherapy may exacerbate the variability in individual lesions, increasing the risk of observing divergent kinetic profiles within the same patient. This questions the use of the sum of the longest diameter to follow the response to immunotherapy. Here, we aimed to study this hypothesis by developing a model that estimates the different sources of variability in lesion kinetics, and we used this model to evaluate the impact of this variability on survival.

METHODS

We relied on a semimechanistic model to follow the nonlinear kinetics of lesions and their impact on the risk of death, adjusted on organ location. The model incorporated two levels of random effects to characterize both between- and within-patient variability in response to treatment. The model was estimated on 900 patients from a phase III randomized trial evaluating programmed death-ligand 1 checkpoint inhibitor atezolizumab versus chemotherapy in patients with second-line metastatic urothelial carcinoma (IMvigor211).

RESULTS

The within-patient variability in the four parameters that characterize individual lesion kinetics represented between 12% and 78% of the total variability during chemotherapy. Similar results were obtained during atezolizumab, except for the durability of the treatment effects, for which the within-patient variability was markedly larger than during chemotherapy (40% v 12%, respectively). Accordingly, the occurrence of divergent profile consistently increased over time in patients treated with atezolizumab and was equal to about 20% after 1 year of treatment. Finally, we show that accounting for the within-patient variability provided a better prediction of most at-risk patients than a model relying solely on the sum of the longest diameter.

CONCLUSION

Within-patient variability provides valuable information for the assessment of treatment efficacy and the detection of at-risk patients.
Systematic analysis of the pp collisions at LHC energies with Tsallis function
Authors: Badshah Murad , Waqas Muhammad , Khubrani Ahmed M. , Ajaz Muhammad
Published: February 2023

This work focuses on the study of identified (

,

, p, and

), strange hadrons (

, Λ,

), recorded by CMS, and light nuclei and their anti-nuclei (d,

, t,

, 3He and

), recorded by ALICE, at

, 2.76 TeV, 7 TeV and 13 TeV in pp collision at mid rapidities. The p

T
distributions of these particles are analyzed using the Tsallis model, which fits the experimental data very well. Several important parameters for studying the characteristics of the medium produced during such collisions are extracted. The effective temperature (T) increases monotonically with increasing particle mass and also with increasing collision energy. The non-extensivity parameter (q) decreases with the mass of the particle. For heavier particles, greater T and smaller q mean that they decouple early from the system and attain equilibrium quickly compared to lighter ones. Furthermore, with an increase in collision energy, the multiplicity parameter N
0 increases.
Two Cases of External Auditory Canal Osteonecrosis in Patients on Antiresorptive Therapy for Osteoporosis
Authors: Kumar Shejil , Diamond Terrence , Walton Joanna
Published: February 2023

Bisphosphonates and denosumab have demonstrated overwhelmingly favorable skeletal benefit/risk profile in managing postmenopausal osteoporosis. External auditory canal osteonecrosis is a rare skeletal complication of antiresorptives previously described in 11 patients with bisphosphonate exposure and 1 bisphosphonate-naïve patient on denosumab. We present 2 patients who developed external auditory canal osteonecrosis while taking antiresorptives for postmenopausal osteoporosis; a 79-year-old asymptomatic bisphosphonate-naïve woman with 2-year exposure to denosumab, and a 64-year-old woman with otalgia after 5 years of risedronate and 5 years of denosumab treatment. Neither patient had previous exposure to glucocorticoids or local radiotherapy. Otoscopy performed by an ear/nose/throat (ENT) surgeon revealed exposed areas of bone in external auditory canal in both patients. Computed tomography of temporal bones found no evidence of bone erosion. Bone turnover markers were suppressed. Both patients ceased denosumab and were managed conservatively, with stable external auditory canal findings after 12 months. Although external auditory canal osteonecrosis is a rare skeletal complication of antiresorptive use, development of localizing symptoms in the ear should alert physicians to this rare clinical entity and prompt ENT surgical referral for early diagnosis and initiation of management.
Politics of Recognition: The National Campaign for the Right to Legal, Safe, and Free Abortion in Argentina
Authors: Gutiérrez María Alicia
Published: February 2023

This article charts the arguments, strategies, and struggles of the abortion rights movement in Argentina, with special attention to the National Campaign for the Right to Legal, Safe, and Free Abortion. This heterogeneous coalition—widely recognized by its green kerchief—played a key role leading the impressive activist process that culminated with abortion legalization. The law approved by the Argentine Congress in December of 2020 provides for the right to voluntary abortion during the first fourteen weeks of pregnancy and allows for specific legal grounds for abortion after that period (rape or risk to the health or life of the pregnant person). Importantly, before legal reform was achieved, activists had patiently worked to advance the “social decriminalization” of abortion.
Transforaminal Lumbar Interbody Fusion Versus Posterolateral Fusion Alone in the Treatment of Grade 1 Degenerative Spondylolisthesis
Authors: Tang Alan R. , Chanbour Hani , Steinle Anthony M. , Jonzzon Soren , Roth Steven G. , Gardocki Raymond J. , Stephens Byron F. , Abtahi Amir M. , Zuckerman Scott L.
Published: February 2023

BACKGROUND:

Transforaminal lumbar interbody fusion (TLIF) and posterolateral fusion (PLF) alone are two operations performed to treat degenerative lumbar spondylolisthesis. To date, it is unclear which operation leads to better outcomes.

OBJECTIVE:

To compare TLIF vs PLF alone regarding long-term reoperation rates, complications, and patient-reported outcome measures (PROMs) in patients with degenerative grade 1 spondylolisthesis.

METHODS:

A retrospective cohort study using prospectively collected data between October 2010 and May 2021 was undertaken. Inclusion criteria were patients aged 18 years or older with grade 1 degenerative spondylolisthesis undergoing elective, single-level, open posterior lumbar decompression and instrumented fusion with ≥1-year follow-up. The primary exposure was presence of TLIF vs PLF without interbody fusion. The primary outcome was reoperation. Secondary outcomes included complications, readmission, discharge disposition, return to work, and PROMs at 3 and 12 months postoperatively, including Numeric Rating Scale-Back/Leg and Oswestry Disability Index. Minimum clinically important difference of PROMs was set at 30% improvement from baseline.

RESULTS:

Of 546 patients, 373 (68.3%) underwent TLIF and 173 underwent (31.7%) PLF. Median follow-up was 6.1 years (IQR = 3.6-9.0), with 339 (62.1%) >5-year follow-up. Multivariable logistic regression showed that patients undergoing TLIF had a lower odds of reoperation compared with PLF alone (odds ratio = 0.23, 95% CI = 0.54-0.99, P = .048). Among patients with >5-year follow-up, the same trend was seen (odds ratio = 0.15, 95% CI = 0.03-0.95, P = .045). No differences were observed in 90-day complications (P = .487) and readmission rates (P = .230) or minimum clinically important difference PROMs.

CONCLUSION:

In a retrospective cohort study from a prospectively maintained registry, patients with grade 1 degenerative spondylolisthesis undergoing TLIF had significantly lower long-term reoperation rates than those undergoing PLF.
Transradial Access Failures During Neuroangiography for Patients With Moyamoya
Authors: Luther Evan , McCarthy David , Hect Jasmine , Burks Joshua , Lu Victor M. , Govindarajan Vaidya , Ramsay Ian A. , King Hunter , Silva Michael A. , Abdelsalam Ahmed , Yavagal Dileep , Peterson Eric , Starke Robert M. , Morcos Jacques
Published: February 2023

BACKGROUND:

Despite studies continuing to demonstrate the utility of transradial access (TRA) in neuroangiography, minimal data exist regarding predictors of TRA failure. Furthermore, although many patients with moyamoya disease/syndrome will require life-long angiographic evaluation, even less has been reported on the usage of TRA in this population.

OBJECTIVE:

To perform a matched analysis at our high-volume moyamoya center to determine predictors of TRA failure in these patients.

METHODS:

A total of 636 patients undergoing TRA for neuroangiography were identified from 2018 to 2020. Demographic and angiographic characteristics including radial artery spasm (RAS), radial anomalies, and access site conversion were compared between patients with moyamoya and the rest of the cohort. A 4:1 matched analysis, based on age and sex, was also performed to eliminate confounding variables.

RESULTS:

Patients with moyamoya were younger (40 vs 57 years, P < .0001), had smaller radial diameters (1.9 vs 2.6 mm, P < .0001), more commonly had a high brachial bifurcation (25.9% vs 8.5%, P = .008), more frequently experienced clinically significant RAS (40% vs 8.4%, P < .0001), and more often required access site conversion (26.7% vs 7.8%, P = .002). Increasing age was associated with less TRA failures in patients with moyamoya (odds ratio = 0.918) but more failures in the rest of the cohort (odds ratio = 1.034). In the matched analysis, patients with moyamoya continued to experience more radial anomalies, RAS, and access site conversions.

CONCLUSION:

Patients with moyamoya, when controlling for age and sex, have higher rates of TRA failure during neuroangiography. Increasing age in Moyamoya is inversely correlated with TRA failures suggesting that younger patients with moyamoya are at higher risk of extracranial arteriopathy.
Foxm1 regulates cardiomyocyte proliferation in adult zebrafish after cardiac injury
Authors: Zuppo Daniel A. , Missinato Maria A. , Santana-Santos Lucas , Li Guang , Benos Panayiotis V. , Tsang Michael
Published: February 2023

The regenerative capacity of the mammalian heart is poor, with one potential reason being that adult cardiomyocytes cannot proliferate at sufficient levels to replace lost tissue. During development and neonatal stages, cardiomyocytes can successfully divide under injury conditions; however, as these cells mature their ability to proliferate is lost. Therefore, understanding the regulatory programs that can induce post-mitotic cardiomyocytes into a proliferative state is essential to enhance cardiac regeneration. Here, we report that the forkhead transcription factor Foxm1 is required for cardiomyocyte proliferation after injury through transcriptional regulation of cell cycle genes. Transcriptomic analysis of injured zebrafish hearts revealed that foxm1 expression is increased in border zone cardiomyocytes. Decreased cardiomyocyte proliferation and expression of cell cycle genes in foxm1 mutant hearts was observed, suggesting it is required for cell cycle checkpoints. Subsequent analysis of a candidate Foxm1 target gene, cenpf, revealed that this microtubule and kinetochore binding protein is also required for cardiac regeneration. Moreover, cenpf mutants show increased cardiomyocyte binucleation. Thus, foxm1 and cenpf are required for cardiomyocytes to complete mitosis during zebrafish cardiac regeneration.
Criteria and Indicators of Economic Efficiency of Municipal Programs
Authors: Suslova A. , Basovskiy Leonid
Published: February 2023

An approach to assessing the economic efficiency of municipal programs is proposed. The approach is based on a combination of market and sociological cost estimates of the results of the implementation of activities included in the municipal programs. As indicators characterizing the economic efficiency of municipal programs, it is proposed to use the ratio of the value of benefits and resources provided as result of the implementation of the program to the amount of costs for the implementation of the program.

The valuation of the value of the benefits and resources provided as result of the implementation of the program are determined by the market price of the benefits, resources provided as result of the implementation of the program. Benefits and resources that do not have a market valuation are evaluated the basis of surveys, questionnaire surveys of respondents — users of the good, resource, the possibility of using which arises as a result of the implementation of the program.
Application of Accounting Instruments for the Purposes of Financial Planning of Corporations
Authors: Zinov'eva Yu.
Published: February 2023

Objective: to identify similar elements and tasks of accounting and financial planning systems and to justify the need for the development of mechanisms for integrating the tools of these systems on the example of the largest complex structured corporation JSC “Russian Railways”. Procedure and methods: the organizational features of the corporation and the specifics of accounting and analytical business processes are analyzed, the risks of the financial planning system as objects that can be leveled by accounting policy instruments. Results: based on the results of the study, the general principles of the formation of accounting and financial planning systems were identified, accounting tools were proposed that allow to level the risks of financial planning, the expediency of bringing the two systems under study closer in order to improve the quality of information and reduce the cost of accounting and analytical work was justified. Practical significance: proposals are formulated to improve the interaction of the accounting system through the accounting policy of an economic entity with financial planning on the example of the JSC “Russian Railways” corporation, which can be applied in practice not only by the railway corporation, but also by other enterprises and organizations.
La politique territoriale du roi Sahourê à la lumière de récentes découvertes
Authors: Martinet Émilie
Published: February 2023

The territorial organisation in the early Fifth Dynasty remains little known compared to the Sixth Dynasty, for which the data are more numerous. However, in recent years, there have been several discoveries concerning the reign of Sahure (c. 2487–2475 BCE). This latest information, combined with a re-examination of the textual and material sources known for a long time, shed new light on the policy of territorial organisation of Sahure by enabling us to answer the following questions: To which provinces did this king give his attention? What are the characteristics and the motivations of this territorial policy? Sahure carried out a huge policy of development in Lower Egypt, in particular in the south-east of the Delta, and in the south of Upper Egypt. By using a global approach, analysis of all the data allows identification of three main reasons explaining this territorial policy: to facilitate the recovery of valuable resources at the margins of the country and abroad, to support the increase in the number of officials and to carry out the construction projects of the monarchy. Moreover, a new theory is proposed about the creation of the 8th nome in the south-east of the Delta.