bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-term cancer survivors treated with multiple courses of repeat radiation therapy
Authors: Christ Sebastian M. , Ahmadsei Maiwand , Wilke Lotte , Kühnis Anja , Pavic Matea , Tanadini-Lang Stephanie , Guckenberger Matthias
Published: October 2021

Introduction and background

Through recent advances in cancer care, the number of long-term survivors has continuously increased. As a result, repetitive use of local radiotherapy for curative or palliative indications might have increased as well. This analysis aims to describe patterns of care and outcome of patients treated with multiple courses of repeat radiotherapy.

Materials and methods

All patients treated with radiotherapy between 2011 and 2019 at our department of Radiation Oncology were included into this analysis. A course of radiotherapy was defined as all treatment sessions to one anatomical site under one medical indication. Demographics, cancer and treatment characteristics and overall survival of patients having undergone multiple radiotherapy courses (minimum n = 5) were evaluated.

Results

The proportion of cancer patients treated with a minimum five courses of radiotherapy increased continuously from 0.9% in 2011 to 6.5% in 2019. In the 112 patients treated with a minimum of five radiotherapy courses, the primary tumor was lung in 41.9% (n = 47), malignant melanoma in 8.9% (n = 10) and breast in 8.0% (n = 9) of cases. A median interval of 3 years (maximum 8 years) elapsed between the first and the last radiotherapy course. The maximum number of courses in a single patient were n = 10. Treatment intent was curative or palliative in 46.4% and 53.6% for the first radiotherapy, respectively. The proportion of curative intent decreased to 11.6% at the 5th, and the last radiotherapy course was following a palliative intent in all patients. Five-year overall survival measured from the 1st radiotherapy course was 32.7%. Median overall survival was 3.3, 2.4, 1.3, and 0.6 years when measured from the 1st, the 1st palliative, the 5th and last course of radiotherapy, respectively.

Discussion and conclusion

A continuously increasing number of patients is treated with multiple courses of radiotherapy throughout their long-term cancer survivorship.
Risk factors for secondary fractures to percutaneous vertebroplasty for osteoporotic vertebral compression fractures: a systematic review
Authors: Mao Wei , Dong Fei , Huang Guowei , He Peiliang , Chen Huan , Qin Shengnan , Li Aiguo
Published: October 2021

Background

Osteoporotic vertebral compression fracture (OVCF) is one of the most common fragile fractures, and percutaneous vertebroplasty provides considerable long-term benefits. At the same time, there are many reports of postoperative complications, among which fracture after percutaneous vertebroplasty is one of the complications after vertebroplasty (PVP). Although there are many reports on the risk factors of secondary fracture after PVP at home and abroad, there is no systematic analysis on the related factors of secondary fracture after PVP.

Methods

The databases, such as CNKI, Wan Fang Database and PubMed, were searched for documents on secondary fractures after percutaneous vertebroplasty published at home and abroad from January 2011 to March 2021. After strictly evaluating the quality of the included studies and extracting data, a meta-analysis was conducted by using Revman 5.3 software.

Results

A total of 9 articles were included, involving a total of 1882 patients, 340 of them diagnosed as secondary fractures after percutaneous vertebroplasty.

Conclusion

The additional history of fracture, age, bone mineral density (BMD), bone cement leakage, intravertebral fracture clefts and Cobb Angle might be risk factors related to secondary fractures after percutaneous vertebroplasty for osteoporotic vertebral compression fractures. The height of vertebral anterior and body mass index (BMI) were not correlated.
Identification of circular RNAs hsa_circ_0140271 in peripheral blood mononuclear cells as a novel diagnostic biomarker for female rheumatoid arthritis
Authors: Chen Yufeng , Xu Xianghe , Li Xuegang , Zhong Junlong , Wu Biao , Shang Jie , Jiang Ning , Wang Bin , Zhong Shuping , Lu Huading
Published: October 2021

Background

Rheumatoid arthritis (RA) is a chronic autoimmune disease, which commonly affects women. Accumulating evidence shows that differentially expressed circular RNAs (circRNAs) play crucial roles in the progress of RA. However, the roles of circRNAs in female RA remains unclear. This study explores potential role and diagnostic value of hsa_circ_0140271 from peripheral blood mononuclear cells (PBMC) in female RA.

Methods

Differential expression of circRNAs was determined by RNA-sequencing in PBMC from 4 healthy controls (HC) and 4 RA patients, and we further measured the level of hsa_circ_0140271 in a validation cohort consisting of 47 RA and 47 HC via RT-qPCR. Besides, correlation studies with clinical variables were also examined. What’s more, we performed bioinformatics analysis to predict the potential role of hsa_circ_0140271.

Results

PBMC expression of hsa_circ_0140271 of female RA was significantly higher than that of female HC, and it was positively correlated with antistreptolysin (ASO). Furthermore, the receiver operating characteristic (ROC) curve indicated that hsa_circ_0140271 could distinguish female RA from female HC and female patients with ankylosing spondylitis (AS) or osteoarthritis (OA). Besides, the combined diagnosis anti-cyclic citrullinated peptide (Anti-CCP) + hsa_circ_0140271 could improve diagnostic accuracy with an area under the curve (AUC) of 0.818 to compared with Anti-CCP. Furthermore, KEGG pathway enrichment analysis indicated hsa_circ_0140271 may act as microRNA sponge and participate in fatty acid metabolism pathways.

Conclusion

Hsa_circ_0140271 was likely to be used as a promising diagnostic biomarker for female RA; it may act as microRNA sponge to regulate fatty acid metabolism pathways in RA.
Factors influencing early and long-term survival following hip fracture among nonagenarians
Authors: Weinberg Laurence , Ou Yang Bobby , Cosic Luka , Klink Sarah , Le Peter , Li Jasun Kai , Koshy Anoop Ninan , Jones Daryl , Bellomo Rinaldo , Tan Chong Oon , Lee Dong-Kyu
Published: October 2021

Background

The outcomes of nonagenarian patients undergoing orthopaedic surgery are not well understood. We investigated the 30-day mortality after surgical treatment of unilateral hip fracture. The relationship between postoperative complications and mortality was evaluated.

Methods

We performed a single-centre retrospective cohort study of nonagenarian patients undergoing hip fracture surgery over a 6-year period. Postoperative complications were graded according to the Clavien–Dindo classification. Correlation analyses were performed to evaluate the relationship between mortality and pre-specified mortality risk predictors. Survival analyses were assessed using Cox proportional hazards regression modelling.

Results

The study included 537 patients. The 30-day mortality rate was 7.4%. The mortality rate over a median follow-up period of 30 months was 18.2%. Postoperative complications were observed in 459 (85.5%) patients. Both the number and severity of complications were related to mortality (p < 0.001). Compared to patients who survived, deceased patients were more frail (p = 0.034), were at higher ASA risk (p = 0.010) and were more likely to have preoperative congestive heart failure (p < 0.001). The adjusted hazard ratio for mortality according to the number of complications was 1.3 (95% CI 1.1, 1.5; p = 0.003). Up to 21 days from admission, any increase in complication severity was associated significantly greater mortality [adjusted hazard ratio: 3.0 (95% CI 2.4, 3.6; p < 0.001)].

Conclusion

In a nonagenarian cohort of patients undergoing hip fracture surgery, 30-day mortality was 7.4%, but 30-month mortality rates approached one in five patients. Postoperative complications were independently associated with a higher mortality, particularly when occurring early.
Totally endoscopic aortic valve replacement with concomitant trans-aortic mitral valve repair for mitral regurgitation
Authors: Pitsis Antonios , Tsotsolis Nikolaos , Boudoulas Harisios , Boudoulas Konstantinos Dean
Published: October 2021

Background

Minimally invasive aortic valve procedures through a hemi-sternotomy or a right anterior mini-thoracotomy have gained popularity over the last several years. Totally endoscopic aortic valve replacement (TEAVR) is an innovative and a less invasive (incision-wise) surgical aortic valve replacement technique. The operative steps of TEAVR have been reported previously from our group. Mitral regurgitation (MR) frequently accompanies aortic valve disease that at times may also require repair. Totally endoscopic surgery in such cases has not been tested.

Presentation of the technique

We present a surgical technique for a totally endoscopic approach to aortic valve replacement and concomitant mitral valve repair for primary and secondary MR. An aortotomy incision was used avoiding an atriotomy, which results in an increase in cross-clamp (XC) and cardiopulmonary bypass (CPB) times that could be associated with higher mortality and morbidity. Neochords (artificial chordae tendineae) were used for primary MR and an edge-to-edge approach for secondary MR.

Conclusion

TEAVR and concomitant mitral valve repair can be performed successfully with reasonable XC and CPB times with excellent short-term results.
Strategies to evaluate outcomes in long-COVID-19 and post-COVID survivors
Authors: Crispo Anna , Bimonte Sabrina , Porciello Giuseppe , Forte Cira Antonietta , Cuomo Gaia , Montagnese Concetta , Prete Melania , Grimaldi Maria , Celentano Egidio , Amore Alfonso , de Blasio Elvio , Pentimalli Francesca , Giordano Antonio , Botti Gerardo , Baglio Giovanni , Sileri Pierpaolo , Cascella Marco , Cuomo Arturo
Published: October 2021

SARS-CoV-2 infection can impact the physical, cognitive, mental health of patients, especially in those recovered in intensive care units. Moreover, it was proved that the effects of the virus may persist for weeks or months. The term long-COVID or post-COVID syndrome is commonly used for indicating a variety of physical and psychological symptoms that continue after the resolution of the acute phase. This narrative review is aimed at providing an updated overview of the impact of physical, cognitive, and psychological health disorders in COVID-19 survivors, by summarizing the data already published in literature in the last year. Studies cited were found through PubMed searches. We also presented an overview of the post-COVID-19 health consequences on three important aspects: nutritional status, neurological disorders, and physical health. Moreover, to activate a correct health planning policy, a multidisciplinary approach for addressing the post- COVID-19 issue, has been proposed. Finally, the involvement of health professionals is necessary even after the pandemic, to reduce expected post-pandemic psychosocial responses and mental health disorders.
Concurrent ibrutinib plus venetoclax in relapsed/refractory mantle cell lymphoma: the safety run-in of the phase 3 SYMPATICO study
Authors: Wang Michael , Ramchandren Radhakrishnan , Chen Robert , Karlin Lionel , Chong Geoffrey , Jurczak Wojciech , Wu Ka Lung , Bishton Mark , Collins Graham P. , Eliadis Paul , Peyrade Frédéric , Lee Yihua , Eckert Karl , Neuenburg Jutta K. , Tam Constantine S.
Published: October 2021

Ibrutinib plus venetoclax, given with an ibrutinib lead-in, has shown encouraging clinical activity in early phase studies in mantle cell lymphoma (MCL). The ongoing phase 3 SYMPATICO study evaluates the safety and efficacy of concurrently administered, once-daily, all-oral ibrutinib plus venetoclax in patients with relapsed/refractory MCL. A safety run-in (SRI) cohort was conducted to inform whether an ibrutinib lead-in should be implemented for the randomized portion. Patients received concurrent ibrutinib 560 mg continuously plus venetoclax in a 5-week ramp-up to venetoclax 400 mg for up to 2 years. The primary endpoint was occurrence of tumor lysis syndrome (TLS) and dose-limiting toxicities (DLTs). The SRI cohort enrolled 21 patients; six and 15 were in low- or increased-risk categories for TLS, respectively. During the 5-week venetoclax ramp-up, three patients had DLTs, and one patient at increased risk for TLS had a laboratory TLS; no additional TLS events occurred during follow-up. With a median follow-up of 31 months, the overall response rate was 81% (17/21); 62% (13/21) of patients had a complete response. SRI data informed that the randomized portion should proceed with concurrent ibrutinib plus venetoclax, with no ibrutinib lead-in. Ibrutinib plus venetoclax demonstrated promising efficacy; no new safety signals were observed.

Trial registration: ClinicalTrials.gov, NCT03112174. Registered 13 April 2017, https://clinicaltrials.gov/ct2/show/NCT03112174.
Dysregulated tumor-associated macrophages in carcinogenesis, progression and targeted therapy of gynecological and breast cancers
Authors: Xu Tianhan , Yu Sihui , Zhang Jiawen , Wu Sufang
Published: October 2021

Gynecological and breast cancers are a group of heterogeneous malignant tumors. Although existing treatment strategies have ameliorated the clinical outcomes of patients, the overall survival rate of advanced diseases remains unsatisfactory. Increasing evidence has indicated that the development and prognosis of tumors are closely related to the tumor microenvironment (TME), which restricts the immune response and provokes malignant progression. Tumor-associated macrophages (TAMs) are the main component of TME and act as a key regulator in tumor metastasis, immunosuppression and therapeutic resistance. Several preclinical trials have studied potential drugs that target TAMs to achieve potent anticancer therapy. This review focuses on the various functions of TAMs and how they influence the carcinogenesis of gynecological and breast cancers through regulating cancer cell proliferation, tumor angiogenesis and tumor-related immunosuppression. Besides, we also discuss the potential application of disabling TAMs signaling as a part of cancer therapeutic strategies, as well as CAR macrophages, TAMs-based vaccines and TAMs nanobiotechnology. These research advances support that targeting TAMs combined with conventional therapy might be used as effective therapeutics for gynecological and breast cancers in the future.
High class filtering facepiece (FFP) are fundamental and effective in protection of emergency health care workers: an observational cohort study in a German community
Authors: Lier Martin , Nessler Stefan , Stadelmann Christine , Pressler Meike , Saager Leif , Moerer Onnen , Roessler Markus , Meissner Konrad , Winkler Martin S.
Published: October 2021

Background

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a highly contagious airborne virus inducing pandemic coronavirus disease 2019 (COVID-19). This is most relevant for medical staff working under harmful conditions in emergencies often dealing with patients and an undefined SARS-CoV-2 status. We aimed to measure the effect of high-class filtering facepieces (FFP) in emergency medical service (EMS) staff by analyzing seroprevalence and history of positive polymerase chain reaction (PCR) for SARS-CoV-2.

Method

This observational cohort study included workers in EMS, who were compared with hospital staff (HS) and staff, which was not directly involved in patient care (NPC). All direct patient contacts of EMS workers were protected by FFP2/N95 (filtering face piece protection class 2/non-oil-based particulates filter efficiency 95%) masks, whereas HS was protected by FFP2/N95 exclusively when a patient had a proven or suspected SARS-CoV-2 infection. NPC was not protected by higher FFP. The seroprevalence of SARS-CoV-2 antibodies was analyzed by immunoassay by end of 12/2020 together with the history of a positive PCR. In addition, a self-assessment was performed regarding the quantity of SARS-CoV-2 positive contacts, about flu symptoms and personal belief of previous COVID-19 infections.

Results

The period in which contact to SARS-CoV-2 positive patients has been possible was 10 months (March to December 2020)—with 54,681 patient contacts documented for EMS—either emergencies (n = 33,241) or transportation services (n = 21,440). Seven hundred-thirty (n = 730) participants were included into the study (n = EMS: 325, HS: 322 and NPC: 83). The analysis of the survey showed that the exposure to patients with an unknown and consecutive positive SARS-CoV-2 result was significantly higher for EMS when compared to HS (EMS 55% vs. HS 30%, p = 0.01). The incidence of a SARS-CoV-2 infection in our cohort was 1.2% (EMS), 2.2% (HS) and 2.4% (NPC) within the three groups (ns) and lowest in EMS. Furthermore, the belief of previous COVID-19 was significant higher in EMS (19% vs. 10%),

Conclusion

The consistent use of FFP2/N95 in EMS is able to prevent work-related SARS-CoV-2 infections in emergency situations. The significance of physical airway protection in exposed medical staff is still relevant especially under the aspect of new viral variants and unclear effectiveness of new vaccines.

Graphical Abstract
Preparation of hospitals for mass casualty incidents in Bavaria, Germany: care capacities for penetrating injuries and explosions in TerrorMASCALs
Authors: Thies Nina , Zech Alexandra , Kohlmann Thorsten , Biberthaler Peter , Bayeff-Filloff Michael , Kanz Karl-Georg , Prückner Stephan
Published: October 2021

Background

In a terror attack mass casualty incident (TerrorMASCAL), compared to a “normal” MASCAL, there is a dynamic course that can extend over several hours. The injury patterns are penetrating and perforating injuries. This article addresses the provision of material and personnel for the care of special injuries of severely injured persons that may occur in the context of a TerrorMASCAL.

Methods

To answer the research question about the preparation of hospitals for the care of severely injured persons in a TerrorMASCAL, a survey of trauma surgery departments in Bavaria (Germany) was conducted using a questionnaire, which was prepared in three defined steps based on an expert consensus. The survey is divided into a general, neurosurgical, thoracic, vascular and trauma surgery section. In the specialized sections, the questions relate to the implementation of and material and personnel requirements for special interventions that are required, particularly for injury patterns following gunshot and explosion injuries, such as trepanation, thoracotomy and balloon occlusion of the aorta.

Results

In the general section, it was noted that only a few clinics have an automated system to notify off-duty staff. When evaluating the data from the neurosurgical section, the following could be established with regard to the performance of trepanation: the regional trauma centers do not perform trepanation but nevertheless have the required material and personnel available. A similar result was recorded for local trauma centers. In the thoracic surgery section, it could be determined that almost all trauma centers that do not perform thoracotomy have the required material available. This group of trauma centers also stated that they have staff who can perform thoracotomy independently. The retrograde endovascular aortic occlusion procedure is possible in 88% of supraregional, 64% of regional and 10% of local trauma centers. Pelvic clamps and external fixators are available at all trauma centers.

Conclusion

The results of the survey show potential for optimization both in the area of framework conditions and in the care of patients. Consistent and specific training measures, for example, could improve the nationwide performance of these special interventions. Likewise, it must be discussed whether the abovementioned special procedures should be reserved for higher-level trauma centers.
Determinant factors of under-five mortality in Southern Nations, Nationalities and People’s region (SNNPR), Ethiopia
Authors: Gobebo Gizachew
Published: October 2021

Background

Child mortality is a key indicator of the performance of the health system of a nation. Impressive progress in the reduction of under-five mortality has been made in Ethiopia. However, still there are some regions where the under-five mortality rates are high. Southern Nations, Nationalities, and Peoples’ Region (SNNPR) is among those regions in Ethiopia with high under-five mortality rates. This study aimed to identify the determinant factors of under-five mortality in SNNPR.

Methods

Data used for the study were drawn from the 2016 EDHS. A total of 1277 under-five children were included in the study. A multivariable logistic regression model was fitted to identify determinant factors associated with under-five mortality.

Results

Children with second or third birth order (OR = 1.316, 95% CI: (1.097, 2.343)), fourth or fifth birth order (OR = 1.934, 95% CI: (1.678, 3.822)), sixth or above birth order (OR = 3.980, 95% CI: (2.352, 6.734)) were significantly associated with increased risk of under-five mortality as compared to those with first birth order. Increased risk of under-five mortality was also significantly associated with a family size of five or more (OR = 3.397, 95% CI: (1.702, 6.782)) as compared to the family size of less than five; smaller size at birth (OR = 1.714, 95% CI: (1.120, 2.623)) as compared to larger size at birth; multiple births (OR = 1.472, 95% CI: (1.289, 2.746)) as compared to singletons. On the other hand, female children (OR = 0.552, 95% CI: (0.327, 0.932)), children born at health institutions (OR = 0.449, 95% CI: (0.228, 0.681)) and children who were breastfed (OR = 0.657, 95% CI: (0.393, 0.864)) were significantly associated with decreased risk of under-five mortality as compared to male children, those born at home and those who were not breastfed respectively.

Conclusions

Sex of a child, birth order, size of a child at birth, place of delivery, birth type, breastfeeding status, and family size were significant factors associated with under-five mortality in SNNPR, Ethiopia. Thus, planning and implementing relevant strategies that focus on those identified determinant factors of under-five mortality is required for the improvement of child survival in SNNPR, Ethiopia.
Adjuvant SOX chemotherapy versus concurrent chemoradiotherapy after D2 radical resection of locally advanced esophagogastric junction (EGJ) adenocarcinoma: study protocol for a randomized phase III trial (ARTEG)
Authors: Shen Jinwen , Zhu Xiu , Du Yian , Zhu Yuan , Yu Pengfei , Yang Litao , Xu Zhiyuan , Huang Ling , Zhang Yunli , Zhang Yanqiang , Liu Luying , Cheng Xiangdong
Published: October 2021

Background

Survival benefit of adjuvant radiotherapy for locally advanced gastric cancer following gastrectomy plus D2 lymphadenectomy has always been controversial. Esophagogastric junction (EGJ) adenocarcinoma, which is usually classified as gastric cancer in East Asia, often has a higher locoregional recurrence rate after operation because of its special anatomical characteristics. The aim of this study is to determine whether adjuvant radiotherapy can improve survival of locally advanced EGJ adenocarcinoma after D2 radical resection.

Methods

In this phase III, randomized, open label, controlled trial, we plan to recruit 378 patients with Siewert type II and III adenocarcinoma of EGJ, who had undergone transabdominal radical surgery and D2 lymphadenectomy, and were divided into pathological stage IIB to IIIC. All patients will be randomized 1:1 to receive either adjuvant chemotherapy alone (control group) or adjuvant chemotherapy plus chemoradiotherapy (experimental group). Patients allocated to control group will receive eight cycles of S-1 plus oxaliplatin (SOX), while the experimental group will receive two cycles of SOX followed by 45-Gy RT combined with S-1 and four additional cycles of SOX. The primary endpoint is 3-year disease-free survival rate (DFS). The secondary endpoints are 3-year overall survival rate (OS), 3-year locoregional recurrence-free survival rate (LRFS), 3-year distant metastasis-free survival rate (DMFS), and quality of life (QoL).

Discussion

In the past, the adjuvant treatment of EGJ adenocarcinoma needs to draw on the experience of esophageal adenocarcinoma or gastric adenocarcinoma. In this study, EGJ adenocarcinoma is considered as an independent disease, and the conclusion will provide evidence for optimal adjuvant therapy of locally advanced EGJ adenocarcinoma after D2 radical resection.

Trial registration

ClinicalTrials.govNCT03973008. Registered on 1 June 2019 (retrospectively registered), URL: https://clinicaltrials.gov/ct2/show/NCT03973008?term=NCT03973008&draw=2&rank=1
Efficacy and safety of thread embedding acupuncture for facial expression muscles atrophy after peripheral facial paralysis: study protocol for a randomized controlled trial
Authors: Yu Binyan , Xuan Lihua , Jin Yutong , Chen Shan , Liu Shan , Wan Yijia
Published: November 2021

Background

Facial expression muscles atrophy is one kind of sequelae after peripheral facial paralysis. It causes critical problems in facial appearance of patient as well as social and psychological problems. This study aims to evaluate the efficacy and safety of Thread-embedding acupuncture (TEA) for the management of facial expression muscles atrophy after peripheral facial paralysis.

Methods

This is a patient-assessor blinded, randomized, sham-controlled trial. A total of fifty-six eligible patients will be randomly divided into TEA (n=28) and sham TEA (STEA) (n=28) groups. Both groups will receive TEA or STEA treatment at the frontal muscle and the depressor anguli oris muscle, at one predefined points once a week for eight weeks. Additionally, both groups will receive traditional acupuncture treatment at ten acupoints (GB20, LI4, LR3, GB12, ST7, SI18, LI20, BL2, SJ23, ST4) twice a week for eight weeks as a concurrent treatment. B-mode ultrasonography will be used to assess the changes in facial expression muscle thickness ratio of the affected/healthy side at baseline and at 10 weeks after screening, as the primary outcome. House-Brackmann Grade and lip mobility score will be measured and analyzed at baseline and 4, 8, 10, and 12 weeks after screening, as secondary outcomes.

Discussion

The study will compare TEA with sham TEA to explore the feasibility for TEA in improving facial expression muscles atrophy after peripheral facial paralysis.

Trial registration

Chinese Clinical Trial Registry, ChiCTR1900027170. Registered on 3 November 2019,http://www.chictr.org.cn/edit.aspx?pid=45173&htm=4
Is antibiotic treatment effective in the management of chronic low back pain with disc herniation? Study protocol for a randomised controlled trial
Authors: Urquhart Donna M. , Rosenfeld Jeffrey V. , van Tulder Maurits , Wluka Anita E. , Leder Karin , Cheng Allen C. , Forbes Andrew B. , Chan Patrick , O’Sullivan Richard , Liew Susan , Cicuttini Flavia M.
Published: October 2021

Background

There has been immense interest and debate regarding the effectiveness of antibiotic treatment for chronic low back pain. Two randomised controlled trials have examined the efficacy of antibiotics for chronic low back pain with disc herniation and Modic changes, but have reported conflicting results. The aim of this double-blind, randomised, placebo-controlled trial is to determine the efficacy of antibiotic treatment in a broader patient subgroup of chronic low back pain with disc herniation and investigate whether the presence of Modic changes predicts response to antibiotic therapy.

Methods

One hundred and seventy individuals with chronic low back pain will be recruited through hospital and private medical and allied health clinics; advertising in national, community and social media; and posting of flyers in community locations. They will be randomly allocated to receive either amoxicillin-clavulanate (500 mg/125 mg) twice per day for 90 days or placebo. The primary outcome measure of pain intensity will be assessed using the Low Back Pain Rating scale and a 100-mm visual analogue scale at 12 months. Secondary measures of self-reported low back disability and work absence and hindrance will also be examined, and an economic analysis will be conducted. Intention-to-treat analyses will be performed.

Discussion

There is uncertainty about whether antibiotic treatment is effective for chronic low back pain and, if effective, which patient subgroup is most likely to respond. We will conduct a clinical trial to investigate the efficacy of antibiotics compared with placebo in individuals with chronic low back pain and a disc herniation. Our findings will provide high-quality evidence to assist in answering these questions.

Trial registration

Australian New Zealand Clinical Trials Registry ACTRN12615000958583. Registered on 11 September 2015
Insulin-like growth factor-1 in articular cartilage repair for osteoarthritis treatment
Authors: Wen Caining , Xu Limei , Xu Xiao , Wang Daping , Liang Yujie , Duan Li
Published: October 2021

Articular cartilage repair is a critical issue in osteoarthritis (OA) treatment. The insulin-like growth factor (IGF) signaling pathway has been implicated in articular cartilage repair. IGF-1 is a member of a family of growth factors that are structurally closely related to pro-insulin and can promote chondrocyte proliferation, enhance matrix production, and inhibit chondrocyte apoptosis. Here, we reviewed the role of IGF-1 in cartilage anabolism and catabolism. Moreover, we discussed the potential role of IGF-1 in OA treatment. Of note, we summarized the recent progress on IGF delivery systems. Optimization of IGF delivery systems will facilitate treatment application in cartilage repair and improve OA treatment efficacy.
Effect of the internet combined with exercise-based individualized nursing intervention in patients with gestational diabetes mellitus
Authors: Chen Yaer , Qiu Chunbo , Chen Jie , Li Lu , Xu Jichao , Sheng Zhiren
Published: October 2021

Background

Gestational diabetes mellitus (GDM) is the most frequent medical complication of pregnancy. This condition is manifested by glucose intolerance resulting in hyperglycemia of variable severity during pregnancy. One of the most important clinical tools for efficiently regulating maternal blood glucose is strictly monitoring blood glucose levels. However, due to a lack of appropriate intervention tools, managing the occurrence of GDM is still unfeasible. This study aimed to determine clinical efficacy of the internet combined with exercise-based individualized nursing intervention in patients with gestational diabetes mellitus (GDM).

Methods

In total, 139 patients with GDM were divided into two groups, with 79 patients in the observation group (internet combined with exercise-based individualized nursing intervention) and 60 patients in the control group (routine nursing intervention only). The two groups were given specified nursing intervention for 8 weeks and then compared for changes in their blood glucose, blood lipids, blood pressure, insulin resistance (IR), and rate of adverse pregnancy outcomes. Additionally, the psychological state was analyzed, and their nursing satisfaction with the care from nurses that they received was investigated before and after the nursing intervention.

Results

Compared with the control group, the following indices of the observation group were lowered: blood glucose-related indices (FBG and 2 h PG), blood lipids and blood pressure associated indices (TG, TC, and HbA1c, DBP, SBP, and MAP), and IR-related indices (FINS, 2 h INS, and HOMA -IR) (all P < 0.05). The observation group also showed a lower rate of adverse pregnancy outcomes than the control group (7.59% vs. 20.00%; P < 0.05). In addition, SAS and SDS scores of the observation group were both lower than the control group (P < 0.05). Accordingly, the nursing satisfaction score also displayed that the observation group (93.67%) had a higher satisfaction outcome than the control group (76.67%; P < 0.05).

Conclusions

Internet combined with exercise-based individualized nursing intervention in GDM patients can effectively improve their blood glucose, IR, and psychological status, thus significantly improving their pregnancy outcomes and mental condition.
Global, regional, and national prevalence of diabetes mellitus in patients with pulmonary tuberculosis: a systematic review and meta-analysis
Authors: Li Minmin , Chen Tao , Hua Zhongqiu , Yan Hong , Wang Duolao , Li Zhaoqing , Kang Yijun , Zhu Ni , Li Chao
Published: October 2021

Background

Both pulmonary tuberculosis (PTB) and diabetes mellitus (DM) are major global public health problems. We estimated the global, regional, and national prevalence of diabetes mellitus in a population with PTB.

Methods

We searched for observational studies of DM in people with PTB using the PubMed and Embase electronic bibliographic databases, focusing on articles published in the English language from database inception until March 31, 2021. We included original research that reported the prevalence of DM in PTB or those that had sufficient data to compute these estimates. Studies were excluded if they did not provide primary data or were case studies or reviews. Two authors independently extracted the articles and collected detailed information using a predefined questionnaire. A country-specific random-effects meta-analysis was used for countries with two or more available studies, and a fractional response regression model was employed to predict the prevalence of DM in PTB for countries with one or no study. The study was registered with the International Prospective Register of Systematic Reviews, using the registration number CRD42018101989.

Results

We identified 22,658 studies, and 153, across 51 countries, were retained for data extraction. The global prevalence of DM among patients with PTB was estimated to be 13.73% (95% confidence interval [CI] 12.51–14.95). The prevalence rates were 19.32% (95% CI 13.18–25.46) in the region of the Americas, 17.31% (95% CI 12.48–22.14) in the European region, 14.62% (95% CI 12.05–17.18) in Southeast Asia, 13.59% (95% CI 7.24–19.95) in the western Pacific region, 9.61% (95% CI 4.55–14.68) in the eastern Mediterranean region, and 9.30% (95% CI 2.83–15.76) in the African region. The country with the highest estimated prevalence was the Marshall Islands (50.12%; 95% CI 4.28–95.76).

Conclusion

Comorbid PTB and DM remain prevalent worldwide.
Single cell Raman spectroscopy to identify different stages of proliferating human hepatocytes for cell therapy
Authors: Ma Chen , Zhang Ludi , He Ting , Cao Huiying , Ren Xiongzhao , Ma Chenhui , Yang Jiale , Huang Ruimin , Pan Guoyu
Published: October 2021

Background

Cell therapy provides hope for treatment of advanced liver failure. Proliferating human hepatocytes (ProliHHs) were derived from primary human hepatocytes (PHH) and as potential alternative for cell therapy in liver diseases. Due to the continuous decline of mature hepatic genes and increase of progenitor like genes during ProliHHs expanding, it is challenge to monitor the critical changes of the whole process. Raman microspectroscopy is a noninvasive, label free analytical technique with high sensitivity capacity. In this study, we evaluated the potential and feasibility to identify ProliHHs from PHH with Raman spectroscopy.

Methods

Raman spectra were collected at least 600 single spectrum for PHH and ProliHHs at different stages (Passage 1 to Passage 4). Linear discriminant analysis and a two-layer machine learning model were used to analyze the Raman spectroscopy data. Significant differences in Raman bands were validated by the associated conventional kits.

Results

Linear discriminant analysis successfully classified ProliHHs at different stages and PHH. A two-layer machine learning model was established and the overall accuracy was at 84.6%. Significant differences in Raman bands have been found within different ProliHHs cell groups, especially changes at 1003 cm−1, 1206 cm−1 and 1440 cm−1. These changes were linked with reactive oxygen species, hydroxyproline and triglyceride levels in ProliHHs, and the hypothesis were consistent with the corresponding assay results.

Conclusions

In brief, Raman spectroscopy was successfully employed to identify different stages of ProliHHs during dedifferentiation process. The approach can simultaneously trace multiple changes of cellular components from somatic cells to progenitor cells.
Stem cell-based therapy for ameliorating intrauterine adhesion and endometrium injury
Authors: Song Yu-Ting , Liu Peng-Cheng , Tan Jie , Zou Chen-Yu , Li Qian-Jin , Li-Ling Jesse , Xie Hui-Qi
Published: October 2021

Intrauterine adhesion refers to endometrial repair disorders which are usually caused by uterine injury and may lead to a series of complications such as abnormal menstrual bleeding, recurrent abortion and secondary infertility. At present, therapeutic approaches to intrauterine adhesion are limited due to the lack of effective methods to promote regeneration following severe endometrial injury. Therefore, to develop new methods to prevent endometrial injury and intrauterine adhesion has become an urgent need. For severely damaged endometrium, the loss of stem cells in the endometrium may affect its regeneration. This article aimed to discuss the characteristics of various stem cells and their applications for uterine tissue regeneration.
Mesenchymal stem cells-derived exosomes for drug delivery
Authors: Sun Yao , Liu Guoliang , Zhang Kai , Cao Qian , Liu Tongjun , Li Jiannan
Published: October 2021

Exosomes are extracellular vesicles secreted by various cells, mainly composed of lipid bilayers without organelles. In recent years, an increasing number of researchers have focused on the use of exosomes for drug delivery. Targeted drug delivery in the body is a promising method for treating many refractory diseases such as tumors and Alzheimer's disease (AD). Finding a suitable drug delivery carrier in the body has become a popular research today. In various drug delivery studies, the exosomes secreted by mesenchymal stem cells (MSC-EXOs) have been broadly researched due to their immune properties, tumor-homing properties, and elastic properties. While MSC-EXOs have apparent advantages, some unresolved problems also exist. This article reviews the studies on MSC-EXOs for drug delivery, summarizes the characteristics of MSC-EXOs, and introduces the primary production and purification methods and drug loading methods to provide solutions for existing problems and suggestions for future studies.
srBERT: automatic article classification model for systematic review using BERT
Authors: Aum Sungmin , Choe Seon
Published: October 2021

Background

Systematic reviews (SRs) are recognized as reliable evidence, which enables evidence-based medicine to be applied to clinical practice. However, owing to the significant efforts required for an SR, its creation is time-consuming, which often leads to out-of-date results. To support SR tasks, tools for automating these SR tasks have been considered; however, applying a general natural language processing model to domain-specific articles and insufficient text data for training poses challenges.

Methods

The research objective is to automate the classification of included articles using the Bidirectional Encoder Representations from Transformers (BERT) algorithm. In particular, srBERT models based on the BERT algorithm are pre-trained using abstracts of articles from two types of datasets, and the resulting model is then fine-tuned using the article titles. The performances of our proposed models are compared with those of existing general machine-learning models.

Results

Our results indicate that the proposed srBERTmymodel, pre-trained with abstracts of articles and a generated vocabulary, achieved state-of-the-art performance in both classification and relation-extraction tasks; for the first task, it achieved an accuracy of 94.35% (89.38%), F1 score of 66.12 (78.64), and area under the receiver operating characteristic curve of 0.77 (0.9) on the original and (generated) datasets, respectively. In the second task, the model achieved an accuracy of 93.5% with a loss of 27%, thereby outperforming the other evaluated models, including the original BERT model.

Conclusions

Our research shows the possibility of automatic article classification using machine-learning approaches to support SR tasks and its broad applicability. However, because the performance of our model depends on the size and class ratio of the training dataset, it is important to secure a dataset of sufficient quality, which may pose challenges.
The worldwide prevalence of burnout syndrome among bank employees: a systematic review and meta-analysis protocol
Authors: Tehrani Sharareh Azedi , Keshtkar Abbasali , Ramasamy Akilesh , Fadaei Majid
Published: October 2021

Background

Burnout is a syndrome caused by chronic stress in the workplace that has not been successfully managed. Although prevalence of burnout is well documented in different fields, little is known about this syndrome in the context of banking work. The objective of this review will be to assess worldwide pooled prevalence of burnout syndrome among bank employees.

Methods

This is a study protocol for a systematic review. We will search the following electronic databases (from their inception onwards): PubMed/MEDLINE, SCOPUS, Web of Science, PsycINFO, ERIC, EBSCOhost, Emerald Insight, and Google Scholar. Grey literature will be identified through searching SCOPUS, Google Scholar, ProQuest databases, and websites of related organizations. We will consider studies that include any type of employee in the banking industry and report extractable prevalence estimates of burnout. Two reviewers will independently screen all citations, full-text articles, and abstract data. The study methodological quality (or bias) will be appraised using an appropriate tool. If feasible, we will conduct random effect meta-analysis of prevalence data. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g., setting, sex, burnout assessment method, country, and work hours).

Discussion

This systematic review will assess the worldwide prevalence of burnout syndrome among bank employees. The results of this study will be published in a peer-reviewed journal. As it presents an analysis of published literature, the study does not require ethical approval.

Systematic review registration

PROSPERO CRD42020213565
Paper 3: Selecting rapid review methods for complex questions related to health policy and system issues
Authors: Wilson Michael G. , Oliver Sandy , Melendez-Torres G. J. , Lavis John N. , Waddell Kerry , Dickson Kelly
Published: October 2021

Approaches for rapid reviews that focus on streamlining systematic review methods are not always suitable for exploring complex policy questions, as developing and testing theories to explain these complexities requires configuring diverse qualitative, quantitative, and mixed methods studies. Our objective was therefore to provide a guide to selecting approaches for rapidly (i.e., within days to months) addressing complex questions related to health policy and system issues.

We provide a two-stage, transdisciplinary collaborative process to select a rapid review approach to address complex policy questions, which consists of scoping the breadth and depth of the literature and then selecting an optimal approach to synthesis. The first stage (scoping the literature) begins with a discussion with the stakeholders requesting evidence to identify and refine the question for the review, which is then used to conduct preliminary searches and conceptually map the documents identified. In the second stage (selection of an optimal approach), further stakeholder consultation is required to refine and tailor the question and approach to identifying relevant documents to include. The approach to synthesizing the included documents is then guided by the final question, the breadth and depth of the literature, and the time available and can include a static or evolving conceptual framework to code and analyze a range of evidence. For areas already covered extensively by existing systematic reviews, the focus can be on summarizing and integrating the review findings, resynthesizing the primary studies, or updating the search and reanalyzing one or more of the systematic reviews.

The choice of approaches for conducting rapid reviews is intertwined with decisions about how to manage projects, the amount of work to be done, and the knowledge already available, and our guide offers support to help make these strategic decisions.
On new generalized quantum integrals and related Hermite–Hadamard inequalities
Authors: Kara Hasan , Budak Hüseyin , Alp Necmettin , Kalsoom Humaira , Sarikaya Mehmet Zeki
Published: October 2021

In this article, we introduce a new concept of quantum integrals which is called ${}^{\kappa _{2}}T_{q}$

T
q

κ
2

-integral. Then we prove several properties of this concept of quantum integrals. Moreover, we present several Hermite–Hadamard type inequalities for ${}^{\kappa _{2}}T_{q}$

T
q

κ
2

-integral by utilizing differentiable convex functions. The results presented in this article are unification and generalization of the comparable results in the literature.
Characteristic estimation of differential polynomials
Authors: Chen Min-Feng , Huang Zhi-Bo
Published: October 2021

In this paper, we give the characteristic estimation of a meromorphic function f with the differential polynomials $f^{l}(f^{(k)})^{n}$

f
l

(

f

(
k
)

)

n

and obtain that $$\begin{aligned} T(r,f)\leq M\overline{N} \biggl(r,\frac{1}{f^{l}(f^{(k)})^{n}-a} \biggr)+S(r,f) \end{aligned}$$
T
(
r
,
f
)
≤
M

N
‾

(
r
,

1

f
l

(

f

(
k
)

)

n

−
a

)

+
S
(
r
,
f
)
holds for $M=\min \{\frac{1}{l-2},6\}$
M
=
min
{

1

l
−
2

,
6
}
, integers $l(\geq 2)$
l
(
≥
2
)
, $n(\geq 1)$
n
(
≥
1
)
, $k(\geq 1)$
k
(
≥
1
)
, and a non-zero constant a. This quantitative estimate is an interesting and complete extension of earlier results. The value distribution of a differential monomial of meromorphic functions is also investigated.
Wave propagation in a diffusive SEIR epidemic model with nonlocal transmission and a general nonlinear incidence rate
Authors: Wu Xin , Ma Zhaohai
Published: October 2021

We introduce a diffusive SEIR model with nonlocal delayed transmission between the infected subpopulation and the susceptible subpopulation with a general nonlinear incidence. We show that our results on existence and nonexistence of traveling wave solutions are determined by the basic reproduction number $R_{0}=\partial _{I}F(S_{0},0)/\gamma $

R
0

=

∂
I

F
(

S
0

,
0
)
/
γ
of the corresponding ordinary differential equations and the minimal wave speed $c^{*}$

c
∗

. The main difficulties lie in the fact that the semiflow generated here does not admit the order-preserving property. In the present paper, we overcome these difficulties to obtain the threshold dynamics. In view of the numerical simulations, we also obtain that the minimal wave speed is explicitly determined by the time delay and nonlocality in disease transmission and by the spatial movement pattern of the exposed and infected individuals.
Hyers–Ulam stability of impulsive Volterra delay integro-differential equations
Authors: Refaai D. A. , El-Sheikh M. M. A. , Ismail Gamal A. F. , Abdalla Bahaaeldin , Abdeljawad Thabet
Published: October 2021

This paper discusses different types of Ulam stability of first-order nonlinear Volterra delay integro-differential equations with impulses. Such types of equations allow the presence of two kinds of memory effects represented by the delay and the kernel of the used fractional integral operator. Our analysis is based on Pachpatte’s inequality and the fixed point approach represented by the Picard operators. Applications are provided to illustrate the stability results obtained in the case of a finite interval.