bluuebunny/crossref_metadata_2025 huggingface dataset:
Disparities in eye clinic patient encounters among patients requiring language interpreter services
Authors: Mudie Lucy I. , Patnaik Jennifer L. , Gill Zafar , Wagner Marissa , Christopher Karen L. , Seibold Leonard K. , Ifantides Cristos
Published: March 2023

Background

Communication barriers are a major cause of health disparities for patients with limited English proficiency (LEP). Medical interpreters play an important role in bridging this gap, however the impact of interpreters on outpatient eye center visits has not been studied. We aimed to evaluate the differences in length of eyecare visits between LEP patients self-identifying as requiring a medical interpreter and English speakers at a tertiary, safety-net hospital in the United States.

Methods

A retrospective review of patient encounter metrics collected by our electronic medical record was conducted for all visits between January 1, 2016 and March 13, 2020. Patient demographics, primary language spoken, self-identified need for interpreter and encounter characteristics including new patient status, patient time waiting for providers and time in room were collected. We compared visit times by patient’s self-identification of need for an interpreter, with our main outcomes being time spent with ophthalmic technician, time spent with eyecare provider, and time waiting for eyecare provider. Interpreter services at our hospital are typically remote (via phone or video).

Results

A total of 87,157 patient encounters were analyzed, of which 26,443 (30.3%) involved LEP patients identifying as requiring an interpreter. After adjusting for patient age at visit, new patient status, physician status (attending or resident), and repeated patient visits, there was no difference in the length of time spent with technician or physician, or time spent waiting for physician, between English speakers and patients identifying as needing an interpreter. Patients who self-identified as requiring an interpreter were more likely to have an after-visit summary printed for them, and were also more likely to keep their appointment once it was made when compared to English speakers.

Conclusions

Encounters with LEP patients who identify as requiring an interpreter were expected to be longer than those who did not indicate need for an interpreter, however we found that there was no difference in the length of time spent with technician or physician. This suggests providers may adjust their communication strategy during encounters with LEP patients identifying as needing an interpreter. Eyecare providers must be aware of this to prevent negative impacts on patient care. Equally important, healthcare systems should consider ways to prevent unreimbursed extra time from being a financial disincentive for seeing patients who request interpreter services.
Incidental detection of retinoblastoma from accidental trauma in children
Authors: Fang Yuxin , Li Qiyan , Zhang Chengyue , Zhao Junyang
Published: March 2023

Background

To report a case series of patients who were diagnosed with retinoblastoma (RB), which was preceded by trauma, in a large multicenter cohort and to investigate the incidence, clinical characteristics, and causes of RB misdiagnosis.

Methods

The medical records of consecutive patients with RB between 2006 and 2015 were retrospectively reviewed. Characteristics of trauma patients, including their age at initial trauma, site of trauma, sex, and RB laterality, were analyzed.

Results

Among 3780 patients, 30 (0.8%) experienced systemic or ocular trauma prior to the detection of RB. The median age was 20.7 months, and the median follow-up time was 6 years. There were 2 eyes in stage A, 2 in stage B, 3 in stage C, 12 in stage D, and 15 in stage E. The remaining 2 eyes had extraocular RB. A total of 20 patients experienced ocular trauma, 9 patients experienced head trauma, and 1 patient experienced trauma in other body parts. RB was suspected or detected in 22 patients (73.3%) at the time of primary trauma occurrence, and 8 patients (26.7%) were misdiagnosed with RB during their first visit.

Among them, all experienced blunt ocular trauma, and enucleation was performed in 7 patients in which 1 patient died.

Conclusions

Less than 1% of the patients experienced systemic or ocular trauma before RB was detected. The majority were unilateral and in advanced stages. Differential diagnoses that are not trauma-related must always be considered, and comprehensive examinations must be conducted before diagnostic and therapeutic intraocular procedures are initiated.
Adolescent girls in aquaculture ecozones at risk of nutrient deficiency in Bangladesh development and validation of an integrated metric
Authors: Grieve Eleanor , Mamun Abdullah-Al , de Roos Baukje , Barman Benoy K. , Ara Gulshan , Roos Nanna , Pounds Alexandra , Sneddon Alan A. , Murray Francis , Ahmed Tahmeed , Little David C.
Published: March 2023

Background

This study developed and validated an integrated metric that enhances understanding of linkages between agro-ecological and socio-economic factors that are important for explaining nutritional wellbeing in relation to fish consumption; especially among adolescent girls who are at risk of nutritional deficiency in Bangladesh. Currently, there is no metric that takes account of environmental, cultural and economic contexts when considering fish consumption and dietary health from a policy perspective.

Methods

The study was designed as a bi-seasonal survey, repeated in the same population of adolescent girls recruited during the dry and wet seasons. Sampling was stratified by five settings (four aqua-agroecological zones and one processing plant community), with 60 girls recruited in each. Associations between candidate predictors (salinity, diet diversity, religion, socio-economic status and women’s autonomy score) and dependent variables representing nutritional outcomes (anthropometry, omega-3 index and micronutrient levels) were explored in multivariable regressions. The fitted model with its predictors was validated, and a risk score derived from responses to a few short questions on religion, salinity zone, female autonomy, diet diversity and tilapia consumption.

Results

The omega-3 index showed the clearest distinction between seasons, by salinity and religion. Higher female autonomy, religion (being Hindu rather than Muslim), geographical location (living in a high or mid-saline area), and a higher dietary diversity were the strongest predictors of whole blood omega-3 index. The c-index for the prognostic model was 0.83 and 0.76 in the wet and dry season respectively, indicating good predictive accuracy. There appeared to be a clear trend in risk scores differentiating between those ‘chronically at risk’ and those ‘never at risk’.

Conclusions

Observational data on different aquaculture-ecozones defined by salinity enabled us to establish linkages between seasonal fish intake, religion, diet diversity, female autonomy and nutritional wellbeing. The purpose of the metric is to reveal these specific linkages in practice. This tool should improve targeting of timely, preventative and cost-effective nutritional interventions to adolescent girls most at-risk from low omega-3 levels in communities where seafood is produced.
What motivated men to start PrEP? A cross-section of men starting PrEP in Buffalo city municipality, South Africa
Authors: Smith Philip John , Daniels Joseph , Bekker Linda-Gail , Medina-Marino Andrew
Published: March 2023

Background

Compared to women, South African men are less likely to know their HIV status (78% vs. 89%), have suppressed viral loads (82% vs. 90%), or access HIV prevention services. To achieve epidemic control where heterosexual sexual behavior drives transmission, interventions to improve the uptake of HIV testing services (HTS) and prevention services must also target cis-gendered, heterosexual men. There is limited understanding of these men’s needs and wants with regards to accessing pre-exposure prophylaxis (PrEP).

Methods

Adult men (≥ 18 years) from a peri-urban community in Buffalo City Municipality were offered community-based HTS. Those who received a negative HIV test result were offered community-based, same-day oral PrEP initiation. Men initiating PrEP were invited to participate in a study exploring men’s HIV prevention needs and reasons for initiating PrEP. An in-depth interview guide, developed using the Network-Individual-Resources model (NIRM), explored men’s perceived HIV acquisition risk, prevention needs, and preferences for PrEP initiation. Interviews were conducted by a trained interviewer in isiXhosa or English, audio-recorded and transcribed. Thematic analysis was used, guided by the NIRM to generate findings.

Results

Twenty-two men (age range 18–57 years) initiated PrEP and consented to study participation. Men reported elevated HIV acquisition risk associated with alcohol use and condom-less sex with multiple partners as facilitators driving PrEP initiation. They anticipated social support from family members, their main sexual partner and close friends for their PrEP use, and discussed other men as important sources of support for PrEP initiation. Nearly all men expressed positive views of people using PrEP. Participants believed HIV testing would be a barrier for men interested in accessing PrEP. Men recommended that access to PrEP be convenient, rapid, and community-based (i.e., not clinic-based).

Discussion

Self-perceived risk for HIV acquisition was a major facilitator for men’s PrEP initiation. Although men expressed positive perceptions of PrEP users, they noted that HIV testing may be a barrier to PrEP initiation. Finally, men recommended convenient access points to facilitate PrEP initiation and sustained use. Gender-responsive interventions tailored to men’s needs, wants, and voices will facilitate their uptake of HIV prevention services, and help to end the HIV epidemic.
Effectiveness of the multi-component intervention ‘Focus’ on reducing smoking among students in the vocational education setting: a cluster randomized controlled trial
Authors: Kjeld Simone G. , Thygesen Lau C. , Danielsen Dina , Jakobsen Gitte S. , Jensen Marie P. , Holmberg Teresa , Bast Lotus S. , Lund Lisbeth , Pisinger Charlotta , Andersen Susan
Published: March 2023

Background

Social inequality in smoking remains an important public health issue. Upper secondary schools offering vocational education and training (VET) comprise more students from lower socioeconomic backgrounds and have higher smoking prevalence than general high schools. This study examined the effects of a school-based multi-component intervention on students’ smoking.

Methods

A cluster randomized controlled trial. Eligible participants were schools offering VET basic courses or preparatory basic education in Denmark, and their students. Schools were stratified by subject area and eight schools were randomly allocated to intervention (1,160 invited students; 844 analyzed) and six schools to control (1,093 invited students; 815 analyzed). The intervention program comprised smoke-free school hours, class-based activities, and access to smoking cessation support. The control group was encouraged to continue with normal practice. Primary outcomes were daily cigarette consumption and daily smoking status at student level. Secondary outcomes were determinants expected to impact smoking behavior. Outcomes were assessed in students at five-month follow-up. Analyses were by intention-to-treat and per protocol (i.e., whether the intervention was delivered as intended), adjusted for covariates measured at baseline. Moreover, subgroup analyses defined by school type, gender, age, and smoking status at baseline were performed. Multilevel regression models were used to account for the cluster design. Missing data were imputed using multiple imputations. Participants and the research team were not blinded to allocation.

Results

Intention-to-treat analyses showed no intervention effect on daily cigarette consumption and daily smoking. Pre-planned subgroup analyses showed statistically significant reduction in daily smoking among girls compared with their counterparts in the control group (OR = 0.39, 95% CI: 0.16, 0.98). Per-protocol analysis suggested that schools with full intervention had higher benefits compared with the control group (daily smoking: OR = 0.44, 95% CI: 0.19, 1.02), while no marked differences were seen among schools with partial intervention.

Conclusion

This study was among the first to test whether a complex, multicomponent intervention could reduce smoking in schools with high smoking risk. Results showed no overall effects. There is a great need to develop programs for this target group and it is important that they are fully implemented if an effect is to be achieved.

Trial registration

https://www.isrctn.com/ISRCTN16455577, date of registration 14/06/2018.
Evaluation of the effect of physical therapy on pain and dysfunction of knee osteoarthritis based on fNIRS: a randomized controlled trial protocol
Authors: Wang Xiao-yi , Bao Chun-cha , An Ran , Wu Tao , Wang Dun , Zhang Yu-jia , He Cheng-qi
Published: March 2023

Background

Knee osteoarthritis (KOA) is a chronic musculoskeletal disease that can cause joint pain and dysfunction, affecting the quality of life of patients. Nonsurgical treatment is the conventional treatment of KOA, among which physical therapy is widely used because of its simplicity, convenience and effectiveness. The functional biomarker will add to the clinical fidelity and diagnostic accuracy. Therefore, our study chose a more objective evaluation indicator, functional near-infrared spectroscopy (fNIRS), to identify between healthy people and KOA patients, and to detect the pain change before and after treatment of KOA patients.

Methods

The study will be conducted in the Rehabilitation Medical Center of West China Hospital of Sichuan University and divided into 2 stages. In the first stage, we will compare and determine the differences in baseline data between healthy volunteers and KOA patients. In the second stage, 72 KOA patients will be randomly divided into two groups: the drug therapy group (DT) and the combination therapy group (CT) for 10 treatments. Outcome measures will be measured at baseline and on the 5th and 10th days after the intervention, including the numerical rating scale (NRS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), pain catastrophizing scale (PCS), the association of pain severity with task-state functional connectivity fNIRS and association of pain severity with task-activated fNIRS.

Discussion

By analyzing the fNIRS data of healthy volunteers and KOA patients, our study will be determined whether fNIRS can be used as a new indicator to reflect the severity of pain in KOA patients. Subsequently, the same fNIRS data for KOA patients before and after the intervention will be collected to provide an accurate evaluation criterion for the effect of physical therapy on KOA.

Trial registration

The study was registered on the Chinese Registry website (registered in ChiCTR.org with the identifiers ChiCTR2200064175 and 29/09/2022).
Exploring expectations of Chinese patients for total knee arthroplasty: once the medicine is taken, the symptoms vanish
Authors: Yang Lin , Yang Zhi-Ying , Li Hui-Wu , Xu Yi-Min , Bian Wei-Wei , Ruan Hong
Published: March 2023

Background

Preoperative expectations of total knee arthroplasty (TKA) outcomes are important determinants of patient satisfaction. However, expectations of patients in different countries are affected by cultural background. The general goal of this study was to describe Chinese TKA patients’ expectations.

Methods

Patients scheduled for TKA were recruited in a quantitative study(n = 198). The Hospital for Special Surgery Total Knee Replacement Expectations Survey Questionnaire was used for survey TKA patients’ expectations. Descriptive phenomenological design was used for the qualitative research. Semi-structured interviews were conducted with 15 TKA patients. Colaizzi’s method was used for interview data analysis.

Results

The mean expectation score of Chinese TKA patients was 89.17 points. The 4 highest score items were walk short distance, remove the need for walker, relieve pain and make knee or leg straight. The 2 lowest score items were employed for monetary reimbursement and sexual activity. Five main themes and 12 sub-themes emerged from the interview data, including multiple factors raised expectations, expectations of physical comfort, expect various activities back to normal, hope for a long joint lifespan, and expect a better mood.

Conclusions

Chinese TKA patients reported a relatively high level of expectations, and differences across cultures result in different expectation points than other national populations, requiring adjustment of items when using assessment tools across cultures. Strategies for expectation management should be further developed.

Level of evidence

Level IV.
The safety and prognosis of radical surgery in colorectal cancer patients over 80 years old
Authors: Zhao Fu-Qiang , Jiang Yu-Juan , Xing Wei , Pei Wei , Liang Jian-Wei
Published: March 2023

Objective

The purpose of this study was to assess the safety and feasibility of radical surgery and to investigate prognostic factors influencing in colorectal cancer (CRC) patients over the age of 80.

Methods

Between January 2010 and December 2020, 372 elderly CRC patients who underwent curative resection at the National Cancer Center were enrolled in the study. Preoperative clinical characteristics, perioperative outcomes, and postoperative pathological features were all collected.

Results

A total of 372 elderly patients with colorectal cancer were included in the study, including 226 (60.8%) men and 146 (39.2%) women. A total of 219 (58.9%) patients had a BMI < 24 kg/m2, and 153 (41.1%) patients had a BMI ≥ 24 kg/m2. The mean operation time and intraoperative blood loss were 152.3 ± 58.1 min and 67.6 ± 35.4 ml, respectively. The incidence of overall postoperative complications was 28.2% (105/372), and the incidence of grade 3–4 complications was 14.7% (55/372). In the multivariable Cox regression analysis, BMI ≥ 24 kg/m2 (HR, 2.30, 95% CI, 1.27–4.17; P = 0.006) and N1-N2 stage (HR: 2.97; 95% CI, 1.48–5.97; P = 0.002) correlated with worse CSS.

Conclusion

The findings of this study showed that radical resection for CRC is safe and feasible for patients over the age of 80. After radical resection, BMI and N stage were independent prognostic factors for elderly CRC patients.
Machine learning and network analysis for diagnosis and prediction in disorders of consciousness
Authors: Narayanan Ajit , Magee Wendy L. , Siegert Richard J.
Published: March 2023

Background

Prolonged Disorders of Consciousness (PDOC) resulting from severe acquired brain injury can lead to complex disabilities that make diagnosis challenging. The role of machine learning (ML) in diagnosing PDOC states and identifying intervention strategies is relatively under-explored, having focused on predicting mortality and poor outcome. This study aims to: (a) apply ML techniques to predict PDOC diagnostic states from variables obtained from two non-invasive neurobehavior assessment tools; and (b) apply network analysis for guiding possible intervention strategies.

Methods

The Coma Recovery Scale-Revised (CRS-R) is a well-established tool for assessing patients with PDOC. More recently, music has been found to be a useful medium for assessment of coma patients, leading to the standardization of a music-based assessment of awareness: Music Therapy Assessment Tool for Awareness in Disorders of Consciousness (MATADOC). CRS-R and MATADOC data were collected from 74 PDOC patients aged 16–70 years at three specialist centers in the USA, UK and Ireland. The data were analyzed by three ML techniques (neural networks, decision trees and cluster analysis) as well as modelled through system-level network analysis.

Results

PDOC diagnostic state can be predicted to a relatively high level of accuracy that sets a benchmark for future ML analysis using neurobehavioral data only. The outcomes of this study may also have implications for understanding the role of music therapy in interdisciplinary rehabilitation to help patients move from one coma state to another.

Conclusions

This study has shown how ML can derive rules for diagnosis of PDOC with data from two neurobehavioral tools without the need to harvest large clinical and imaging datasets. Network analysis using the measures obtained from these two non-invasive tools provides novel, system-level ways of interpreting possible transitions between PDOC states, leading to possible use in novel, next-generation decision-support systems for PDOC.
Socio-economic and education related inequities in use of modern contraceptive in seven sub-regions in Uganda
Authors: Makumbi Fredrick E , Nabukeera Sarah , Tumwesigye Nazarius Mbona , Namanda Cissie , Atuyambe Lynn , Mukose Aggrey , Ssali Sarah , Ssenyonga Ronald , Tweheyo Ritah , Gidudu Andrew , Sekimpi Carole , Hashim Catherine Verde , Nicholson Martha , Ddungu Peter
Published: March 2023

Background

Advocacy for equity in health service utilization and access, including Family Planning (FP) continues to be a cornerstone in increasing universal health coverage. Inequities in Family planning are highlighted by the differences in reproductive health outcomes or in the distribution of resources among different population groups. In this study we examine inequities in use of modern contraceptives with respect to Socio-economic and Education dimensions in seven sub-regions in Uganda.

Methods

The data were obtained from a baseline cross-sectional study in seven statistical regions where a program entitled “Reducing High Fertility Rates and Improving Sexual Reproductive Health Outcomes in Uganda, (RISE)” is implemented in Uganda. There was a total of 3,607 respondents, half of whom were women of reproductive age (15-49 years) and the other half men (18-54 years). Equity in family planning utilization was assessed by geography, wealth/economic and social-demographics. The use of modern family planning was measured as; using or not using modern FP. Concentration indices were used to measure the degree of Inequality in the use of modern contraceptives. Prevalence Ratios to compare use of modern FP were computed using modified Poisson regression run in STATA V15.

Results

Three-quarters (75.6%) of the participants in rural areas were married compared to only 63% in the urban. Overall use of modern contraceptives was 34.2% [CI:30.9, 37.6], without significant variation by rural/urban settings. Women in the higher socio-economic status (SES) were more advantaged in use of modern contraceptives compared to lower SES women. The overall Erreygers Concentration Index, as a measure of inequity, was 0.172, p<0.001. Overall, inequity in use of modern contraceptives by education was highest in favor of women with higher education (ECI=0.146, p=0.0001), and the concentration of use of modern contraceptives in women with higher education was significant in the rural but not urban areas

Conclusion

Inequities in the use of modern contraceptives still exist in favor of women with more education or higher socio-economic status, mainly in the rural settings. Focused programmatic interventions in rural settings should be delivered if universal Family Planning uptake is to be improved.
Advances in transport and toxicity of nanoparticles in plants
Authors: Gao Mingyang , Chang Jia , Wang Zhongtang , Zhang Hongyan , Wang Tian
Published: March 2023

In recent years, the rapid development of nanotechnology has made significant impacts on the industry. With the wide application of nanotechnology, nanoparticles (NPs) are inevitably released into the environment, and their fate, behavior and toxicity are indeterminate. Studies have indicated that NPs can be absorbed, transported and accumulated by terrestrial plants. The presence of NPs in certain edible plants may decrease harvests and threaten human health. Understanding the transport and toxicity of NPs in plants is the basis for risk assessment. In this review, we summarize the transportation of four types of NPs in terrestrial plants, and the phytotoxicity induced by NPs, including their impacts on plant growth and cell structure, and the underlying mechanisms such as inducing oxidative stress response, and causing genotoxic damage. We expect to provide reference for future research on the effects of NPs on plants.

Graphical Abstract
How do contextual factors influence naloxone distribution from syringe service programs in the USA: a cross-sectional study
Authors: Lambdin Barrot H. , Wenger Lynn , Bluthenthal Ricky , Bartholomew Tyler S. , Tookes Hansel E. , LaKosky Paul , O’Neill Savannah , Kral Alex H.
Published: March 2023

Background

Naloxone is a medication that can quickly reverse an opioid overdose. Syringe service programs (SSPs) are community-based prevention programs that provide a range of evidence-based interventions in the USA, including naloxone distribution. Attributes of SSPs make them ideal settings for naloxone distribution—they have staff and delivery models that are designed to reach people who use drugs where they are. We assessed which outer and inner setting factors of SSPs were associated with naloxone distribution in the USA.

Methods

We surveyed SSPs in the USA known to the North American Syringe Exchange Network in 2019. Using the exploration, preparation, implementation and maintenance framework, we assessed inner and outer contextual factors associated with naloxone distribution among SSPs (n = 263 or 77% of SSPs). We utilized negative binomial regression to assess which factors were associated with the number of naloxone doses distributed and people receiving naloxone.

Results

SSPs reported distributing 710,232 naloxone doses to 230,506 people in the prior year. Regarding outer setting, SSPs located in areas with high levels of community support had a higher level of naloxone distribution (aIRR = 3.07; 95% confidence interval (CI): 2.09–4.51; p < 0.001) and 110% (p = 0.022) higher rate of people receiving naloxone (aIRR = 2.10; 95% CI 1.46–3.02; p < 0.001) in the past 12 months. The legal status of SSPs and the level of need was not significantly associated with naloxone distribution. Regarding inner setting, SSPs with proactive refill systems (aIRR = 2.08; 95% CI 1.27–3.41; p = 0.004), greater number of distribution days (aIRR = 1.09 per day; 95% CI 1.06–1.11; p < 0.001) and older programs (aIRR = 1.06 per year; 95% CI 1.02–1.11; p = 0.004) were associated with higher levels of naloxone distribution. Also, SSPs with proactive refill systems (aIRR = 2.23; 95% CI 1.38–3.58; p = 0.001); greater number of distribution days (aIRR = 1.04; 95% CI 1.02–1.07; p < 0.001) and older programs (aIRR = 1.11; 95% CI 1.05–1.17; p < 0.001) were associated with a higher number of people receiving naloxone.

Conclusion

We identified outer and inner setting factors of SSPs that were associated with greater naloxone distribution. It is critical to ensure SSPs are adequately resourced to build community support for services and develop service delivery models that maximize naloxone distribution to address the nation’s opioid overdose crisis.
First case report of ensartinib in a patient with metastatic ALK rearranged lung cancer with ALK I1171N mutation: a case report
Authors: Yang Shuang , Feng Weineng , Deng Yanming , Liang Jianmiao
Published: March 2023

Background

The acquired resistance to ALK tyrosine kinase inhibitors (TKIs) in ALK-rearranged NSCLC is associated with poor survival outcomes and poses distinct clinical challenges. It is essential to develop potential therapeutic strategies for overcoming resistance.

Case presentation

Here, we first report a female lung adenocarcinoma patient with an acquired ALK resistance mutation (ALK 11171N) who was treated with ensartinib. Her symptoms significantly improved after only 20 days, and with a side effect of mild rash. Follow-up images observed no further brain metastases after 3 months.

Conclusions

This treatment may provide a new therapeutic strategy for ALK TKIs resistant patients, especially in position 1171 of ALK exon20.
KCNJ2/HIF1α positive-feedback loop promotes the metastasis of osteosarcoma
Authors: Shen Mao , Pan Runsang , Lei Shan , Zhang Lu , Zhou Changhua , Zeng Zhirui , Nie Yingjie , Tian Xiaobin
Published: March 2023

Background

Early metastasis is a hallmark of osteosarcoma (OS), a highly common type of malignant tumor. Members of the potassium inwardly rectifying channel family exert oncogenic effects in various cancers. However, the role of the potassium inwardly rectifying channel subfamily J member 2 (KCNJ2) in OS is unclear.

Methods

The expression of KCNJ2 in OS tissues and cell lines was measured using bioinformatic analysis, immunohistochemistry, and western blotting. Wound-healing assays, Transwell assays, and lung metastasis models were used to analyze the effects of KCNJ2 on mobility of OS cells. The molecular mechanisms linking KCNJ2 and HIF1α in OS were explored by mass spectrometry analysis, immunoprecipitation, ubiquitination detection, and chromatin-immunoprecipitation quantitative real-time polymerase chain reaction.

Results

KCNJ2 was found to be overexpressed in advanced-stage OS tissues, as well as in cells with high metastatic potential. High expression of KCNJ2 was associated with a shorter survival rate of OS patients. KCNJ2-inhibition repressed the metastasis of OS cells, whereas KCNJ2-elevation induced the opposite effects. Mechanistically, KCNJ2 binds to HIF1α and inhibits its ubiquitination, thus increasing the expression of HIF1α. Interestingly, HIF1α binds directly to the KCNJ2 promoter and increases its transcription under hypoxic conditions.

Conclusion

Taken together, our results indicated that a KCNJ2/HIF1α positive feedback loop exists in OS tissues, which significantly promotes OS cell metastasis. This evidence may contribute to the diagnosis and treatment of OS.
Landscape analysis of m6A modification regulators related biological functions and immune characteristics in myasthenia gravis
Authors: Li Shuang , Liu Hui , Ruan Zhe , Guo Rongjing , Sun Chao , Tang Yonglan , Huang Xiaoxi , Gao Ting , Hao Sijia , Li Huanhuan , Song Na , Su Yue , Ning Fan , Li Zhuyi , Chang Ting
Published: March 2023

Background

N6-methyladenosine (m6A) modification has been recognized to play fundamental roles in the development of autoimmune diseases. However, the implication of m6A modification in myasthenia gravis (MG) remains largely unknown. Thus, we aimed to systematically explore the potential functions and related immune characteristics of m6A regulators in MG.

Methods

The GSE85452 dataset with MG and healthy samples was downloaded from Gene Expression Omnibus (GEO) database. m6A modification regulators were manually curated. The targets of m6A regulators were obtained from m6A2Target database. The differential expressed m6A regulators in GSE85452 dataset were identified by “limma” package and were validated by RT-PCR. Function enrichment analysis of dysregulated m6A regulators was performed using “clusterProfiler” package. Correlation analysis was applied for analyzing the relationships between m6A regulators and immune characteristics. Unsupervised clustering analysis was used to identify distinct m6A modification subtypes. The differences between subtypes were analyzed, including the expression level of all genes and the enrichment degree of immune characteristics. Weighted gene co-expression network analysis (WGCNA) was conducted to obtain modules associated with m6A modification subtypes.

Results

We found that CBLL1, RBM15 and YTHDF1 were upregulated in MG samples of GSE85452 dataset, and the results were verified by RT-PCR in blood samples from19 MG patients and 19 controls. The targeted genes common modified by CBLL1, RBM15, and YTHDF1 were mainly enriched in histone modification and Wnt signaling pathway. Correlation analysis showed that three dysregulated m6A regulators were closely associated with immune characteristics. Among them, RBM15 possessed the strongest correlation with immune characteristics, including CD56dim natural killer cell (r = 0.77, P = 0.0023), T follicular helper cell (r = − 0.86, P = 0.0002), Interferon Receptor (r = 0.78, P = 0.0017), and HLA-DOA (r = 0.64, P = 0.0200). Further two distinct m6A modification patterns mediated by three dysregulated m6A regulators was identified. Bioinformatics analysis found that there were 3029 differentially expressed genes and different immune characteristics between two m6A modification patterns. Finally, WGCNA analysis obtained a total of 12 modules and yellow module was the most positively correlated to subtype-2.

Conclusion

Our findings suggested that m6A RNA modification had an important effect on immunity molecular mechanism of MG and provided a new perspective into understanding the pathogenesis of MG.
Religious hallucinations in Lebanese patients with schizophrenia and their association with religious coping
Authors: Fares Rabih , Rabil Jean-Marc , Haddad Chadia , Helwe Sami , Khalil Joe , Kasrine Al Halabi Carina , Abi Antoun Tiffany , Haddad Georges , Hallit Souheil
Published: March 2023

Purpose

to evaluate the relationship between religious hallucinations and religious coping among Lebanese patients with schizophrenia.

Methods

We have studied the prevalence of religious hallucinations (RH) among 148 hospitalized Lebanese patients suffering from schizophrenia or schizoaffective disorder in November 2021 exhibiting religious delusions (RD), and their relationship with religious coping using the brief Religious Coping Scale (RCOPE). The PANSS scale was used to evaluate psychotic symptoms.

Results

After adjustment over all variables, more psychotic symptoms (higher total PANSS scores) (aOR = 1.02) and more religious negative coping (aOR = 1.11) were significantly associated with higher odds of having religious hallucinations, whereas watching religious programs (aOR = 0.34) was significantly associated with lower odds of having religious hallucinations.

Conclusion

This paper highlights the important role of religiosity that has to play in the formation of religious hallucinations in schizophrenia. Significant association was found between negative religious coping and the emergence of religious hallucinations.
Adenosquamous carcinoma coexisting with intraductal papillary mucinous neoplasm of the pancreas: a case report
Authors: Sawai Hirozumi , Kiriyama Yuka , Kuzuya Hiromasa , Fujii Yoshiaki , Ueno Shuhei , Koide Shuji , Kurimoto Masaaki , Yamao Kenji , Matsuo Yoichi , Morimoto Mamoru , Koide Hajime , Kamiya Atsushi
Published: March 2023

Background

Adenosquamous carcinoma of the pancreas is a rare variant, with a worse prognosis than pancreatic ductal adenocarcinoma; moreover, it has characteristic clinical and histopathological features. Studies have mentioned the differentiation of intraductal papillary mucinous neoplasms into mucinous/tubular adenocarcinomas; however, their transdifferentiation into adenosquamous carcinoma remains unclear.

Case presentation

An 80-year-old Japanese woman was referred to our hospital for further examination of multiple pancreatic cysts. Enhanced computed tomography after close follow-up for 6 years revealed a new nodule with poor enhancement on the pancreatic body. Distal pancreatectomy and splenectomy were performed. Histopathological examination revealed an adenosquamous carcinoma with coexisting intraductal papillary mucinous neoplasms; moreover, the intraductal papillary mucinous neoplasms lacked continuity with the adenosquamous carcinoma. Immunohistochemical analysis revealed squamous cell carcinoma and differentiation from adenocarcinoma to squamous cell carcinoma. Gene mutation analysis revealed KRASG12D and KRASG12R mutations in adenosquamous carcinoma components and intraductal papillary mucinous neoplasm lesions, respectively, with none showing the mutation of GNAS codon 201. The final histopathological diagnosis was adenosquamous carcinoma with coexisting intraductal papillary mucinous neoplasms of the pancreas.

Conclusions

This is the rare case of adenosquamous carcinoma with coexisting intraductal papillary mucinous neoplasms of the pancreas. To investigate the underlying transdifferentiation pathway of intraductal papillary mucinous neoplasms into this rare subtype of pancreatic cancer, we explored gene mutation differences as a clinicopathological parameter.
An inventory of adjuvants used for vaccination in horses: the past, the present and the future
Authors: Carnet Flora , Perrin-Cocon Laure , Paillot Romain , Lotteau Vincent , Pronost Stéphane , Vidalain Pierre-Olivier
Published: March 2023

Vaccination is one of the most widely used strategies to protect horses against pathogens. However, available equine vaccines often have limitations, as they do not always provide effective, long-term protection and booster injections are often required. In addition, research efforts are needed to develop effective vaccines against emerging equine pathogens. In this review, we provide an inventory of approved adjuvants for equine vaccines worldwide, and discuss their composition and mode of action when available. A wide range of adjuvants are used in marketed vaccines for horses, the main families being aluminium salts, emulsions, polymers, saponins and ISCOMs. We also present veterinary adjuvants that are already used for vaccination in other species and are currently evaluated in horses to improve equine vaccination and to meet the expected level of protection against pathogens in the equine industry. Finally, we discuss new adjuvants such as liposomes, polylactic acid polymers, inulin, poly-ε-caprolactone nanoparticles and co-polymers that are in development. Our objective is to help professionals in the horse industry understand the composition of marketed equine vaccines in a context of mistrust towards vaccines. Besides, this review provides researchers with a list of adjuvants, either approved or at least evaluated in horses, that could be used either alone or in combination to develop new vaccines.
The effect of internal forced displacement on small and medium enterprises in the host community, in case of Amhara region, Ethiopia
Authors: Dagnachew Tefera Getachew
Published: March 2023

Ethiopia is highly challenged by the growing ethnicity-based conflict and large numbers of people are forcibly displaced from their origin. This study examines the effect of growing internal forced displacements on small and medium enterprises in the Amhara region, Ethiopia. The study used firm-level data for the years between 2015 and 2021. To analyze the effect of IDPs, the study used a panel-instrumental approach. The estimated result finds that large forced IDPs affect enterprises' production. Small enterprises are highly affected by IDPs compared to medium enterprises, and this is due to the greater influence of the informal sector on small enterprises.
Prevention of radiotherapy-related oral mucositis with zinc and polyherbal mouthwash: a double-blind, randomized clinical trial
Authors: Sahebnasagh Marzieh , Aksi Vahideh , Eslami Fatemeh , Lashkardoost Hossein , Kasaian Jamal , Golmohammadzadeh Shiva , Parkam Bahareh , Negarandeh Reza , Saghafi Fatemeh , Sahebnasagh Adeleh
Published: March 2023

Background

A significant percentage of head and neck cancer (HNCs) patients receiving RT experience oral mucositis (OM). This study aimed to evaluate the effect of the polyherbal (containing chamomile, peppermint oil, Aloe vera, and honey) and zinc mouthwashes in comparison to the control (chlorhexidine) and placebo groups for prevention of radiation-induced OM.

Methods

This study was a double-blinded randomized clinical trial, conducted on 67 patients with HNCs undergoing radiotherapy. The eligible participants were randomized to receive either one of the following; zinc sulfate, polyherbal, chlorhexidine (Vi-one 0.2% CHX), or placebo mouthwash for 6 weeks. Follow-up evaluation of oral hygiene and the checklists of OM and the intensity of pain were filled out according to WHO assessment tool, Oral Mucositis Assessment Scale (OMAS), and Visual Analog Scale (VAS) in all the participants weekly for seven consecutive weeks.

Results

The results of present clinical trial demonstrated that the use of either zinc sulfate or polyherbal mouthwash significantly reduced the scores of OM and the severity of pain during weeks 2 to 7 after consumption compared with the CHX or placebo mouthwashes (P < 0.05). According to the post hoc analysis and compared with the placebo, a significantly better result was reported for zinc sulfate and polyherbal mouthwashes at weeks 2 to 7, but not for the CHX mouthwash.

Conclusion

This study showed that the use of zinc sulfate or polyherbal mouthwashes is effective in prevention of both OM severity scores and pain related to OM intensity at weeks 2 to 7 following consumption in HNCs patients.

Trial registration IRCT20190123042475N1 and IRCT20190123042475N2. Registration date: 2019-06-09, 2019-07-26.
Development and psychometric study of the scale of the positive relationship PRIM + 19 in peruvian university students
Authors: Vilca Lindsey W. , Aquino-Hidalgo Jannia M. , Esteban-Brañes Jhaleri , Caycho-Rodríguez Tomás
Published: March 2023

Background

Positive relationships are one of the most important components within the PERMA model since they facilitate the development of the other components. However, in the scientific literature, few instruments have been identified with solid psychometric properties that measure positive relationships in university students and adequately represent the construct. Therefore, the study aims to develop and study the psychometric properties of the PRI + 19 positive relationships scale through Confirmatory Factor Analysis, factorial invariance, and relationship-based validity with other variables.

Method

A pilot sample of 201 university students (43.8% men and 56.2 women) between the ages of 18 and 34 (M = 20.9; SD = 2.74) was collected. The confirmatory sample consisted of 450 university students of both sexes (30.2% men and 69.8 women) between the ages of 18 and 35 years (M = 21.9; SD = 3.15). Along with the PRI + scale, other instruments were applied to measure satisfaction with life and psychological well-being.

Results

In the pilot study, the Exploratory Factor Analysis showed the presence of three factors that could explain 54.5% of the items. In the confirmatory study, the Confirmatory Factor Analysis showed that the model of three dimensions related to 19 items presents the best adjustment indexes compared to other models (χ2 = 541.61; df = 149; CFI = 0.97; TLI = 0.97; RMSEA = 0.077 [IC90% 0.070 ‒ 0.084]). The scale also showed evidence of being strictly invariant for the groups of men and women. Finally, it was shown that the development of the positive bonds dimension positively predicts psychological well-being (0.35) and life satisfaction (0.20). The positive relationship management dimension positively predicts psychological well-being (0.28) and life satisfaction (0.29). Similarly, the integration dimension positively predicts psychological well-being (0.48) and life satisfaction (0.52).

Conclusion

This study suggests that the PRIM + 19 scale is a useful tool from which valid and reliable interpretations of positive relationships in Peruvian university students can be obtained.
Patient experiences with patient-reported outcome measures: an interview study of patients undergoing total hip– and knee arthroplasty
Authors: Mikkelsen Laura Bjerg , Wedderkopp Niels , Mose Louise Schlosser
Published: March 2023

Background

Internationally, patient-reported outcome measures are increasingly applied in clinical settings to patients undergoing total knee arthroplasty (TKA) and total hip arthroplasty (THA). Current literature does not provide an understanding of the patient experience with these tools, as remarkably few studies are published investigating patient perspectives on completing PROMs. Thus, the aim of this study was to investigate patient experiences, perspectives, and understanding with usage of PROMs for total hip and total knee arthroplasty in a Danish orthopedic clinic.

Methods

Patients who were scheduled for, or recently had, a THA or TKA for primary osteoarthritis were recruited to participate in individual interviews, which were audio-recorded and transcribed verbatim. The analysis was based on qualitative content analysis.

Results

In total, 33 adult patients (18 female) were interviewed. Average age was 70.15 (range 52–86). The following themes were derived from the analysis: a) motivation and demotivation for completion, b) to complete a PROM questionnaire, c) environment for completion, and d) suggestions for use of PROMs.

Conclusion

The majority of participants scheduled for TKA/THA were not fully aware of the purpose of completing PROMs. Motivation to do so arose from a desire to help others. Demotivation was affected by inabilities to use electronic technology. In terms of completing PROMs, participants expressed varied ease of use, and some perceived technical challenges. The participants expressed satisfaction with the flexibility of completing PROMs in outpatient clinics or at home; nevertheless, some did not manage completion on their own. Help was of great importance for completion, especially for participants with limited electronic capabilities.
Characteristic changes of the palatal rugae following orthodontic treatment
Authors: Ziar Nazanin , Pakshir Hamid Reza , Alamdarloo Yasaman , Ajami Shabnam
Published: March 2023

Background

Because of the individuality of the palatal rugae, they are applicable for human identification purposes the same as the fingerprints. Therefore, it is important to assess the effect of different factors on rugae characteristics. We assessed the characteristic changes of the palatal rugae following extraction and expansion during orthodontic treatments. Before and after orthodontic treatment dental casts of 30 patients were scanned by 3Shape Trios 3D intraoral scanner, and superimposed in Geomagic X 2018 software. Displacement of 13 reference points was analyzed in three dimensions. The length of the palatal rugae was also measured. SPSS version 22.0 was applied for data analysis, using independent t test, sample t test, and chi-square test.

Results

The alterations in the mean palatal rugae length were significant in the first right and third right ridges after extraction, and right and left second ridges after expansion treatment (P < 0.05). Changes in coordinates in the X, Y, and Z axes were significant at 8 points on the rugae after extraction, and 5 points after expansion treatment (P < 0.05). The changes in the sum of means of displacements were significant at all 13 points after extraction and expansion treatments (P < 0.05).

Conclusions

The palatal rugae do not remain stable during expansion and extraction orthodontic treatments. Some changes occurred in length, and the most medial and most lateral points on each ridge were displaced. The length of the incisive papilla did not change during treatment; thus, it can serve as a stable landmark. If we consider palatal rugae as an individual landmark, we can refer the patients after orthodontic treatment for scanning of their palatal rugae to document their post treatment pattern; but it should be noted that treatment relapse may change it again.