bluuebunny/crossref_metadata_2025 huggingface dataset:
How to read biparametric MRI in men with a clinical suspicious of prostate cancer: Pictorial review for beginners with public access to imaging, clinical and histopathological database
Authors: Jambor Ivan , Martini Alberto , Falagario Ugo G , Ettala Otto , Taimen Pekka , Knaapila Juha , Syvänen Kari T , Steiner Aida , Verho Janne , Perez Ileana M , Merisaari Harri , Vainio Paula , Lamminen Tarja , Saunavaara Jani , Carrieri Giuseppe , Boström Peter J , Aronen Hannu J
Published: November 2021

Prostate Magnetic Resonance Imaging (MRI) is increasingly being used in men with a clinical suspicion of prostate cancer (PCa). Performing prostate MRI without the use of an intravenous contrast (IV) agent in men with a clinical suspicion of PCa can lead to reduced MRI scan time. Enabling a large array of different medical providers (from mid-level to specialized radiologists) to evaluate and potentially report prostate MRI in men with a clinical suspicion of PCa with a high accuracy could be one way to enable wide adoption of prostate MRI in men with a clinical suspicion of PCa. The aim of this pictorial review is to provide an insight into acquisition, quality control and reporting of prostate MRI performed without IV contrast agent in men with a clinical suspicion of PCa, aimed specifically at radiologists starting reporting prostate MRI, urologists, urology/radiology residents and mid-level medical providers without experience in reporting prostate MRI. Free public access ( http://petiv.utu.fi/improd/ and http://petiv.utu.fi/multiimprod/ ) to complete datasets of 161 and 338 men is provided. The imaging datasets are accompanied by clinical, laboratory and histopathological findings. Several topics are simplified in order to provide a solid base for the development of skills needed for an unsupervised review and potential reporting of prostate MRI in men with a clinical suspicion of PCa. The current review represents the first step towards enabling a large array of different medical providers to review and report accurately prostate MRI performed without IV contrast agent in men with a clinical suspicion of PCa.
A Moderated Mediation Model of Expectancy-Value Interactions, Engagement, and Foreign Language Performance
Authors: Wu Yajun , Kang Xia
Published: November 2021

Based on the Expectancy-Value Theory (EVT), this study examined the interactive relation between expectancy of success and attainment value, and how they predicate students’ Foreign Language (FL) performance via behavioral engagement. Self-report data were collected from 522 Chinese non-English majors aged 18 to 22 years in their sophomore year. Results of structural equation modeling indicated that expectancy of success and attainment value interacted in predicting Chinese sophomores’ FL performance. The expectancy of success had both direct and indirect effects on FL performance when investigating the mediating role of behavioral engagement. Both theoretical and practical implications are discussed.
Exploring the Effects of Instructional Message Strategies on Risk Perceptions and Behavioral Intentions: The Case of a Substandard Vaccine Incident
Authors: Wang Xiao , Huang Yi-Hui Christine , Wu Qiudi , Fong Ivy Wai-Yin
Published: November 2021

Extending the recent theorizing of the message-centric approach to instructional risk and crisis communication, this study identifies two distinct instructional strategies used by regulatory authorities and adopts a goal-attainment approach to measuring the effectiveness of both strategies in instructing nonscientific publics about impending risks. Specifically, we conducted a quasi-experiment immediately after a substandard vaccine incident in China to examine the differential effects of regulators’ instructional press releases on stakeholders’ risk perceptions and behavioral intentions. We found that the explanation-focused buffering strategy is significantly more effective in both heightening individuals’ cognitive risk perception and reducing their affective risk perception, while the personalization-focused bridging strategy shows more effectiveness in sustaining individuals’ intention to consume and positively evaluate domestic vaccines. Additionally, the findings highlight the need to tailor instructional message strategies to regulatory organizations’ ultimate goals of communication activities. Practical implications for government regulators and risk communicators are also discussed.
Bank Regulation in the Economies in Transition
Authors: Sagatbekovich Kaliyev Kalizhan , Nurmakhanova Mira
Published: November 2021

Given that banking in economies of transition fluctuate heavily, we explore the effect of regulatory norms on performance of banking industry. In particular, we examine the effect of Reserve Requirements, Activity Restrictions, and Capital Stringencies on the overall industry profitability and stability of the financial institutions. We utilize the Generalized Methods of Moments methodology to the panel data regressions over 17 different transitional economies during, and after the crisis period of 2008 through to 2019. Our results show that the Reserve Requirements regulatory norm is the only significant factor that improves the profitability and diminishes the risk of financial instability. The findings are confirmed with our tests over the regional sub-samples. This research sheds the light on the necessities of political and economic reforms in banking for these markets in transition.
Better, Faster, Stronger: The Evolution of Co-authorship in International Management Research Between 1990 and 2016
Authors: Wieczorek Oliver , Eckl Markus , Bausch Madeleine , Radisch Erik , Barmeyer Christoph , Rehbein Malte
Published: November 2021

As a border-transcending discipline, the advancement of international management research depends on collaboration between scholars, universities, and nations to account for the diversity and complexity of management phenomena. Yet, relatively little is known about how international management has evolved as a field of research. We address this gap by examining the evolution of collaboration patterns on three levels of analysis, applying the concepts of cumulative advantage, preferential attachment, and isomorphic behavior in a diachronic network analysis. Based on 6,874 articles published between 1990 and 2016 in eight international management journals, our analysis shows that collaboration is driven by a few key players on each level. Although the US and UK still represent hubs, semi-peripheral actors from Europe and Asia enter the landscape. Nevertheless, non-western actors are still underrepresented. We tie this effect to the expertise-based hegemonic status of American and British business schools and dynamics of cumulative advantage on country-level.
How Do 50-Year-Olds Imagine Their Future: Social Class and Gender Disparities
Authors: Weber Maximilian
Published: November 2021

This paper empirically examines differences in how 50-year-olds imagine their future. It draws on answers to an open-ended survey question in a large British cohort study—the National Child Development Study. Over 6,700 written responses about respondents’ imagined future are examined using text mining methods. Results from a relative frequency analysis and a topic model reveal differences according to gender, occupational class, and educational qualification. The cohort members’ written texts reflect different lifestyles. Men are more likely to mention sport, like golf and football, whereas women are more prone to use words related to family and friends. Respondents with a degree are more likely to write about cultural activities, such as museum or theater visits. Overall, the findings reveal gendered and socially stratified patterns in individual future perceptions, contextualized in relation to leisure, health, and family.
How can social workers be meaningfully involved in palliative care? A scoping review on the prerequisites and how they can be realised in practice
Authors: Taels Brent , Hermans Kirsten , Van Audenhove Chantal , Boesten Nadine , Cohen Joachim , Hermans Koen , Declercq Anja
Published: November 2021

Palliative care is a holistic practice using a multidisciplinary approach in addressing multidimensional needs. Although the social aspects surrounding the end-of-life phase suggest a place for social work in it, the profession is often inadequately involved in daily practice. This contrasts strongly with the potential meaningful contributions of social workers in this field. To date, no comprehensive list of prerequisites for meaningful social work involvement in palliative care exists. This review aims to gain more insight on the prerequisites for meaningful social work involvement in palliative care and how to realise them in practice. It could therefore provide pathways for future intervention development in enhancing the involvement of social workers and maximising their contributions in palliative care. A scoping review methodology was used. A systematic selection of peer-reviewed articles ranged from 2000 to April 2021 – out of the electronic databases Web of Science, Scopus and Pubmed – was conducted. The 170 articles that met the eligibility criteria were analysed for relevant content using open and axial coding processes. The findings are reported according to the PRISMA-ScR checklist. The nine prerequisites listed in this review concern the level of individual social work capacities and the level of contextual factors structuring social work practices. A majority of articles have, however, focused on the level of individual social work capacities in a rather specialist view on palliative care. Future research should further address the contextual level of social work involvement in the broader practice of death, dying and bereavement.
Cardiovascular outcomes in adults with migraine treated with eptinezumab for migraine prevention: pooled data from four randomized, double-blind, placebo-controlled studies
Authors: Smith Timothy R. , Spierings Egilius L. H. , Cady Roger , Hirman Joe , Ettrup Anders , Shen Vivienne
Published: November 2021

Background

Patients with migraine have an increased relative risk of cardio- and cerebrovascular events, and some migraine treatments may exacerbate this risk. The primary objective of this analysis was to determine whether the rate of cardiovascular adverse events was higher for patients with migraine treated with the migraine-preventive eptinezumab, compared with patients receiving placebo.

Methods

Cardiovascular outcomes in patients with migraine were pooled across four clinical trials (phase 1b, phase 2, and two phase 3 trials) for use of eptinezumab as a preventive migraine treatment for up to 1 year. In all studies, treatment-emergent adverse events (TEAEs) that occurred after the first dose of study treatment (eptinezumab 100 mg, 300 mg, 1000 mg, or placebo) and vital signs were recorded through study completion.

Results

Cardiovascular TEAEs were rare across all four clinical trials, and rates were similar between patients receiving eptinezumab and those receiving placebo. Cardiovascular TEAEs that did occur were mild or moderate in severity; there were no serious adverse events as per FDA definition. Vital signs (systolic blood pressure, diastolic blood pressure, and heart rate) were not meaningfully different across treatment groups over the course of 56 weeks, compared to placebo. Treatment with eptinezumab did not result in significant new or changed cardiovascular medications used concomitantly compared to placebo.

Conclusions

In this post hoc analysis of four clinical trials for eptinezumab, doses of 100 mg, 300 mg, and 1000 mg (more than 3 times the highest approved dose) were not associated with clinically relevant changes in vital signs or significant changes in concomitant cardiovascular medication usage, and had low incidences of cardiovascular TEAEs, comparable to placebo.

Trial registration

NCT01772524 (Study 2), 01/21/2013; NCT02275117 (Study 5), 10/27/2014; NCT02559895 (PROMISE-1), 09/25/2017; NCT02974153 (PROMISE-2), 11/28/2016
Molecular Breeding of a Novel PTGMS Line of WDR for Broad-Spectrum Resistance to Blast Using Pi9, Pi5, and Pi54 Genes
Authors: Liu Yi , Zhang Fenyun , Luo Xingxing , Kong Deyan , Zhang Anning , Wang Feiming , Pan Zhongquan , Wang Jiahong , Bi Junguo , Luo Lijun , Liu Guolan , Yu Xinqiao
Published: November 2021

Background

The two-line method based on the photoperiod and thermo-sensitive genic male sterile (PTGMS) lines is more cost-effective, simple, and efficient than the three-line system based on cytoplasmic male-sterility. Blast and drought are the most prevalent biotic and abiotic stress factors hampering rice production. Molecular techniques demonstrate higher efficacy in the pyramiding of disease resistance genes, providing green performance under the background of water-saving and drought-resistance rice.

Results

This study employed molecular marker-assisted selection, conventional hybridization, and high-intensity stress screening to integrate three broad-spectrum blast resistance genes Pi9, Pi5, and Pi54 into Huhan 1S. Subsequently, a novel water-saving and drought-resistance rice (WDR) PTGMS line Huhan 74S was developed. The drought resistance of the new PTGMS line Huhan 74S was comparable to that of Huhan 1S. Pathogenicity assays involving the inoculation of 14 blast prevalent isolates in the glasshouse showed that the blast resistance frequency of Huhan 74S was 85.7%. Further evaluation under natural blast epidemic field conditions showed that Huhan 74S and its hybrids were resistant to leaf and neck blast. The critical temperature point of fertility-sterility alteration of Huhan 74S was 23 °C daily mean temperature. The complete male sterility under natural growth conditions in 2017 at Shanghai lasted for 67 days. Also, both the agronomic and grain quality traits met the requirement for two-line hybrid rice production.

Conclusion

These results indicate that the newly bred PTGMS line Huhan 74S can be used to breed high-yielding, good-quality, disease-resistant two-line hybrid water-saving and drought-resistance rice (WDR), hence promoting sustainable rice production in China.
Annual incidence of osteoporotic hip fractures in Iran: a systematic review and meta-analysis
Authors: Tanha Kiarash , Fahimfar Noushin , Nematollahi Shahrzad , Sajjadi-Jazi Sayed Mahmoud , Gharibzadeh Safoora , Sanjari Mahnaz , Khalagi Kazem , Hajivalizedeh Fatemeh , Raeisi Alireza , Larijani Bagher , Ostovar Afshin
Published: November 2021

Background

Osteoporosis (OP) is progressively becoming a global concern with the aging of the world’s populations. Osteoporotic fractures are associated with significantly increased mortality rates and a financial burden to health systems. This Meta-analysis aims to estimate the annual incidence of osteoporotic fractures in Iran.

Methods

A comprehensive systematic literature search was performed through Medline (PubMed), Embase, Scopus, Web of Science, and Google Scholar to identify studies which contain an investigation of the incidence of osteoporotic fractures in Iran up to December 3rd 2020, with no time and language restriction. For the risk of bias assessments of studies, the Joanna Briggs Institute (JBI) critical appraisal checklist for studies reporting prevalence data was used. The pooled estimation of the incidence of osteoporotic fractures in population aged≥50 years was calculated using random-effects meta-analysis, and the heterogeneity of included studies was quantified with the I2 statistic.

Results

In all, 6708 papers were initially retrieved from the electronic databases, among which seven studies were included in the meta-analysis. The pooled standardized annual cumulative incidence of hip fractures was estimated as 138.26 (95% CI: 98.71–193.65) per 100,000 population and 157.52 (95% CI: 124.29–199.64) per 100,000 population in men and women, respectively.

Conclusion

This study showed a high incidence rate of osteoporotic hip fractures in Iran. Early detection and treatment of individuals with higher risks of primary fragility fractures at primary health care as well as implementing fracture liaison services to prevent secondary fractures are highly recommended. The results suffer from the following limitations: first, a low number of studies that were eligible for inclusion; second, the lack of population-based studies; and presence of highly heterogeneous studies despite the use of a random effect model.
Identification of miRNA-mRNA network and immune-related gene signatures in IgA nephropathy by integrated bioinformatics analysis
Authors: Wei Shi-Yao , Guo Shuang , Feng Bei , Ning Shang-Wei , Du Xuan-Yi
Published: November 2021

Background

IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis worldwide, and its diagnosis depends mainly on renal biopsy. However, there is no specific treatment for IgAN. Moreover, its causes and underlying molecular events require further exploration.

Methods

The expression profiles of GSE64306 and GSE93798 were downloaded from the Gene Expression Omnibus (GEO) database and used to identify the differential expression of miRNAs and genes, respectively. The StarBase and TransmiR databases were employed to predict target genes and transcription factors of the differentially expressed miRNAs (DE-miRNAs). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were conducted to predict biological functions. A comprehensive analysis of the miRNA-mRNA regulatory network was constructed, and protein–protein interaction (PPI) networks and hub genes were identified. CIBERSORT was used to examine the immune cells in IgAN, and correlation analyses were performed between the hub genes and infiltrating immune cells.

Results

Four downregulated miRNAs and 16 upregulated miRNAs were identified. Forty-five and twelve target genes were identified for the upregulated and downregulated DE-miRNAs, respectively. CDKN1A, CDC23, EGR1, HIF1A, and TRIM28 were the hub genes with the highest degrees of connectivity. CIBERSORT revealed increases in the numbers of activated NK cells, M1 and M2 macrophages, CD4 naive T cells, and regulatory T cells in IgAN. Additionally, HIF1A, CDC23, TRIM28, and CDKN1A in IgAN patients were associated with immune cell infiltration.

Conclusions

A potential miRNA-mRNA regulatory network contributing to IgAN onset and progression was successfully established. The results of the present study may facilitate the diagnosis and treatment of IgAN by targeting established miRNA-mRNA interaction networks. Infiltrating immune cells may play significant roles in IgAN pathogenesis. Future studies on these immune cells may help guide immunotherapy for IgAN patients.
Patterns and outcomes of immune-related adverse events in solid tumor patients treated with immune checkpoint inhibitors in Thailand: a multicenter analysis
Authors: Ngamphaiboon Nuttapong , Ithimakin Suthinee , Siripoon Teerada , Sintawichai Nattaya , Sriuranpong Virote
Published: November 2021

Background

Most immune-related adverse event (irAE) patterns and treatment guidelines are based on western clinical data. We evaluated the incidence and patterns of irAEs in patients treated with immune-checkpoint inhibitors (ICI) in Thailand.

Methods

All solid tumor patients treated with ICIs were retrospectively reviewed in a multicenter analysis. The study aims to evaluate the incidence of irAEs and their characteristics, treatments, outcomes, and impact on survival. All irAEs were graded using the CTCAE version 4.0. Characteristics of irAEs including time to onset, duration of irAEs, specific treatments, and outcomes of irAEs were reviewed. The Chi-square or Fisher’s exact test was used to compare variables. Overall survival (OS) was estimated by the Kaplan-Meier method, and compared by the log-rank test. A p-value < 0.05 was considered statistically significant.

Results

irAEs of any grade were observed in 98 of 414 patients (24%), whereas grades 3–4 irAEs were observed in 5.6%. The majority of patients (78%) were treated with monotherapy ICI (anti-PD1/PD-L1 92%). The most common all-grade irAEs were hypothyroidism (7.5%), hepatitis (6.5%), and rash (4.8%). Median onset of overall irAEs was 63 days. Pancreatitis and pneumonitis had the earliest onset at 30 and 34 days, respectively. ICIs were rechallenged in 68 of 98 patients with irAE. Eleven of sixty-eight patients (11.2%) with initial irAE had reoccurrence after ICI rechallenge. Based on a multivariate analysis, pre-existing hypothyroidism, ICI used in a clinical trial setting, and combinations of ICI/ICI were independent factors predicting irAE occurrence. Patients with irAE had a statistically significant longer overall survival (OS) when compared to patients without irAE (p = 0.019). A multivariate analysis revealed that occurrence of irAE was an independent prognostic factor for OS (HR 0.70, 95% CI 0.51–0.96; p = 0.028).

Conclusion

irAE was commonly observed in Thai cancer patients treated with ICIs. Most irAEs were low-grade and manageable. Re-occurrence of irAE after re-challenging ICI was not uncommonly observed. Patients who experienced irAEs might have significantly longer OS compared to patients without irAEs. However, OS in this study should be interpreted with caution since it might be affected by various tumor types, treatment settings, dosing schedule, and ICI combinations.
Vitamin D deficiency and depression in obese adults: a comparative observational study
Authors: Kamalzadeh Leila , Saghafi Malihe , Mortazavi Seyede Salehe , Jolfaei Atefeh Ghanbari
Published: November 2021

Background

Amongst the contributing factors of depression, vitamin D deficiency has increasingly drawn attention in recent years. This paper seeks to examine the association between serum vitamin D level and depression in patients with obesity.

Methods

In this comparative observational study, serum 25-hydroxyvitamin D [25(OH)D] levels were compared between obese individuals with depression (n = 174) and those without depression considering the effect of potential confounders. Participants were selected from males and females aged 18 to 60 years old visiting the outpatient obesity clinic of Rasoul-e Akram hospital, Tehran, Iran. The diagnosis of depressive disorder was made based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. Additional clinical and laboratory data were collected from hospital electronic records. Mann–Whitney U test (nonparametric), Student’s t-test (parametric), and Chi-squared test were used to analyze the differences between the two groups. To examine age and gender differences in the relationship between vitamin D deficiency and depression, stratified analyses were conducted by age and gender groups.

Results

The mean 25(OH) D levels were significantly different between depressed and non-depressed groups (20 ± 15 vs. 27 ± 13, P <  0.001). Vitamin D insufficiency/deficiency was detected in 78 and 67% of the depressed and non-depressed groups, respectively, which was significantly different (P = 0.03). The associations between depression and the serum 25(OH) D levels were observed regardless of gender and age. The overall average vitamin D levels were not significantly different between total males and females (22 ± 13 vs. 23 ± 14, P = 0.49). The average level of vitamin D was higher in the older age group (40–60 years) compared to younger participants (18–39 years) (26 ± 15 vs. 21 ± 13, P = 0.004).

Conclusion

The present study provides additional evidence for the hypothesis that low vitamin D serum concentration is associated with depression in obese adults, and highlights the need for further research to determine whether this association is causal.
Physical activity related to mastery and vitality in a Swedish adult population with economic difficulties
Authors: Johansson Lisbeth M. , Lingfors Hans , Golsäter Marie , Kristenson Margareta , Fransson Eleonor I.
Published: November 2021

Background

People with low socio-economic status report lower levels of physical activity (PA). There is insufficient knowledge about the availability of psychological resources for those who are physically active despite having a low socio-economic status. The aim of this study is to investigate the association between PA level and mastery and vitality, respectively, within an adult population with self-reported economic difficulties.

Method

Data from a cross-sectional, population-based study (n = 817) were used. Linear regression was used to estimate the unstandardised regression coefficient (β) with 95% confidence intervals (95% CI), describing associations between PA levels (independent variable) and scale scores of psychological resources in terms of mastery and vitality (outcome variables). Three models were constructed: Model I unadjusted; Model II adjusted for sex and age; and Model III adjusted for sex, age, smoking and food quality.

Result

After adjusting for sex, age, smoking and food quality and using low-level PA as the reference, high-level PA, but not intermediate-level PA, was related to higher scale scores of mastery (β = 0.72 [95% CI 0.08 to 1.37]). For vitality, both high-level PA and intermediate-level PA were related to higher scale scores (β = 9.30 [95% CI 5.20 to 13.40] and β = 6.70 [95% CI 1.40 to 12.00] respectively).

Conclusion

In an adult population with self-reported economic difficulties, higher levels of physical activity were related to higher mastery and vitality. Our results support that the association between physical activity and psychological resources in terms of mastery and vitality should be considered in the context of targeted health dialogues.

Trial registration number

Not applicable.
Factors associated with an interruption in treatment of people living with HIV in USAID-supported states in Nigeria: a retrospective study from 2000–2020
Authors: Tomescu Silviu , Crompton Thomas , Adebayo Jonathan , Kinge Constance Wose , Akpan Francis , Rennick Marcus , Chasela Charles , Ondura Evans , Dauda Dauda Sulaiman , Pisa Pedro T.
Published: November 2021

Background

Patient interruption of antiretroviral therapy (ART) continues to limit HIV programs’ progress toward epidemic control. Multiple factors have been associated with client interruption in treatment (IIT)— including age, gender, CD4 count, and education level. In this paper, we explore the factors associated with IIT in people living with HIV (PLHIV) in United States Agency for International Development (USAID)-supported facilities under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) program in Nigeria.

Methods

We conducted cross-sectional analyses on data obtained from Nigeria’s National Data Repository (NDR), representing a summarized record of 573 630 ART clients that received care at 484 PEPFAR/USAID-supported facilities in 16 states from 2000–2020. IIT was defined as no clinical contact for 28 days or more after the last expected clinical contact. Univariate and multivariate logistic regression models were computed to explore the factors associated with IIT. The variables included in the analysis were sex, age group, zone, facility level, regimen line, multi-month dispensing (MMD), and viral load category.

Results

Of the 573 630 clients analysed in this study, 32% have been recorded as having interrupted treatment. Of the clients investigated, 66% were female (32% had interrupted treatment), 39% were aged 25–34 at their last ART pick-up date (with 32% of them interrupted treatment), 59% received care at secondary level facilities (37% interrupted treatment) and 38% were last receiving between three- to five-month MMD (with 10% of these interrupted treatment). Those less likely to interrupt ART were males (aOR = 0.91), clients on six-month MMD (aOR = 0.01), adults on 2nd line regimen (aOR = 0.09), and paediatrics on salvage regimen (aOR = 0.02). Clients most likely to interrupt ART were located in the South West Zone (aOR = 1.99), received treatment at a tertiary level (aOR = 12.34) or secondary level facilities (aOR = 4.01), and had no viral load (VL) on record (aOR =10.02). Age group was not significantly associated with IIT.

Conclusions

Sex, zone, facility level, regimen line, MMD, and VL were significantly associated with IIT. MMD of three months and longer (especially six months) had better retention on ART than those on shorter MMD. Not having a VL on record was associated with a considerable risk of IIT.
The role of femoral obliquity angle and T1 pelvic angle in predicting quality of life after spinal surgery in adult spinal deformities
Authors: Perna Andrea , Proietti Luca , Smakaj Amarildo , Velluto Calogero , Meluzio Maria Concetta , Rovere Giuseppe , Florio Daniela , Zirio Gianfranco , Tamburrelli Francesco Ciro
Published: November 2021

Background

Adult spinal deformities (ASD) represent a growing clinical condition related to chronic pain, disability and reduction in quality of life (QoL). A strong correlation among spinal alignment, spinopelvic parameters and QoL after spinal fusion surgery in ASD patients was thoroughly investigated over the last decade, However, only few studies focused on the relationship between lumbo-pelvic-femoral parameters - such as Femoral Obliquity Angle (FOA), T1 Pelvic Angle (TPA) and QoL.

Methods

Radiological and clinical data from 43 patients surgically treated with thoracolumbar posterior spinal fusion for ASD between 2015 and 2018 were retrospectively analyzed. The primary outcomes were the correlation between preoperative spino-pelvic-femoral parameters and postoperative clinical, functional outcomes and QoL. Secondary outcomes were: changes in sagittal radiographic parameters spino-pelvic-femoral, clinical and functional outcomes and the rate of complications after surgery.

Results

Using Spearman’s rank correlation coefficients, spinopelvic femoral parameters (FOA, TPA, pre and post-operative) are directly statistically correlated to the quality of life (ODI, SRS-22, pre and post-operative; > 0,6 strong correlation, p <  0.05). Stratifying the patients according pre preoperative FOA value (High FOA ≥ 10 and Normal/Low FOA <  10), those belonging to the first group showed worse clinical (VAS: 5.2 +/− 1.4 vs 2.9 +/− 0.8) and functional outcomes (ODI: 35.6+/− 6.8 vs 23.2 +/− 6.5) after 2 years of follow-up and a greater number of mechanical complications (57.9% vs 8.3% p <  0.0021).

Conclusion

Based on our results, preoperative FOA and TPA could be important prognostic parameters for predicting disability and quality of life after spinal surgery in ASD patients and early indicators of possible spinal sagittal malalignment. FOA and TPA, like other and better known spinopelvic parameters, should always be considered when planning corrective surgery in ASD patients.
Gender disparities among medical students choosing to pursue careers in medical research: a secondary cross-sectional cohort analysis
Authors: Snyder Austin , Xiang David , Smith Alison , Esswein Shannon , Toubat Omar , Di Capua John , Kwan Jennifer M. , Daye Dania
Published: November 2021

Background

Though the proportion of women in medical schools has increased, gender disparities among those who pursue research careers still exists. In this study, we seek to better understand the main factors contributing to the existing gender disparities among medical students choosing to pursue careers in medical research.

Methods

A secondary cross-sectional cohort analysis of previously published data was conducted using a 70-item survey that was sent to 16,418 medical students at 32 academic medical centers, and was IRB exempt from the need for ethical approval at the University of Illinois at Chicago and the University of Pennsylvania. Data was collected from September 2012 to December 2014. Survey results were analyzed using chi-square tests and Cramer’s V to determine gender differences in demographic characteristics (training stage, race/ethnicity, marital status, parental status, financial support, and parental career background), career sector choice, career content choice, specialty choice, foreseeable career obstacles, and perceptions about medical research careers.

Results

Female respondents were more likely to be enrolled in MD-only programs, while male respondents were more likely to be enrolled in MD/PhD programs. More male students selected academia as their first-choice career sector, while more female respondents selected hospitalist as their first-choice career sector. More female respondents identified patient care and opportunities for community service as their top career selection factors, while more male respondents identified research and teaching as their top career selection factors. Student loan burden, future compensation, and work/life balance were the most reported obstacles to pursuing a career in medical research.

Conclusions

There are many factors from a medical student’s perspective that may contribute to the existing gender disparities in pursuing a career in medical research. While much progress has been made in attracting nearly equal numbers of men and women to the field of medicine, active efforts to bridge the gap between men and women in medical research careers are needed.
Mitochondria-targeted accumulation of oxygen-irrelevant free radicals for enhanced synergistic low-temperature photothermal and thermodynamic therapy
Authors: Hu Hongzhi , Deng Xiangtian , Song Qingcheng , Yang Wenbo , Zhang Yiran , Liu Weijian , Wang Shangyu , Liang Zihui , Xing Xin , Zhu Jian , Zhang Junzhe , Shao Zengwu , Wang Baichuan , Zhang Yingze
Published: November 2021

Background

Although lower temperature (< 45 °C) photothermal therapy (LPTT) have attracted enormous attention in cancer therapy, the therapeutic effect is still unsatisfying when applying LPTT alone. Therefore, combining with other therapies is urgently needed to improve the therapeutic effect of LPTT. Recently reported oxygen-irrelevant free radicals based thermodynamic therapy (TDT) exhibit promising potential for hypoxic tumor treatment. However, overexpression of glutathione (GSH) in cancer cells would potently scavenge the free radicals before their arrival to the specific site and dramatically diminish the therapeutic efficacy.

Methods and results

In this work, a core–shell nanoplatform with an appropriate size composed of arginine–glycine–aspartate (RGD) functioned polydopamine (PDA) as a shell and a triphenylphosphonium (TPP) modified hollow mesoporous manganese dioxide (H-mMnO2) as a core was designed and fabricated for the first time. This nanostructure endows a size-controllable hollow cavity mMnO2 and thickness-tunable PDA layers, which effectively prevented the pre-matured release of encapsulated azo initiator 2,2′-azobis[2-(2-imidazolin-2-yl) propane] dihydrochloride (AIBI) and revealed pH/NIR dual-responsive release performance. With the mitochondria-targeting ability of TPP, the smart nanocomposites (AIBI@H-mMnO2-TPP@PDA-RGD, AHTPR) could efficiently induce mitochondrial associated apoptosis in cancer cells at relatively low temperatures (< 45 °C) via selectively releasing oxygen-irrelevant free radicals in mitochondria and facilitating the depletion of intracellular GSH, exhibiting the advantages of mitochondria-targeted LPTT/TDT. More importantly, remarkable inhibition of tumor growth was observed in a subcutaneous xenograft model of osteosarcoma (OS) with negligible side effects.

Conclusions

The synergistic therapy efficacy was confirmed by effectively inducing cancer cell death in vitro and completely eradicating the tumors in vivo. Additionally, the excellent biosafety and biocompatibility of the nanoplatforms were confirmed both in vitro and in vivo. Taken together, the current study provides a novel paradigm toward oxygen-independent free-radical-based cancer therapy, especially for the treatment of hypoxic solid tumors.

Graphical Abstract
Deep venous thrombosis in an individual with statin-exposed anti-SRP myopathy: case report and review of literature
Authors: Li Jiali , Yan Mingming , Qin Jiao , He Lingyan , Dai Cao , Wen Rui
Published: November 2021

Background

Immune-mediated necrotizing myopathy (IMNM) is characterized by proximal muscle weakness, elvated serum muscle enzyme levels, myopathic electromyography findings, and necrotic muscle fiber with few inflammatory cell infiltration in muscle biopsies. Statins, the first line drug to lower triglyceride and cholesterol level in blood, have been reported to be associated with statins-induced necrotizing autoimmune myopathy (SINAM). Although anti-3-hydroxy-3-methylglutarylcoenzyme-A reductase (anti-HMGCR) myopathy is considered as the leading myopathy related to the statins medication, anti-signal recognition particle (SRP) myopathy were also identified in several cases with statin exposure. The risk of deep venous thrombosis (DVT) is substantially high in individuals with autoimmune inflammatory diseases. But few studies have reported the occurrence and recommendation for treatment of DVT in patients with anti-SRP myopathy. Here, we reported a statin-exposed anti-SRP myopathy individual developed DVT who was successfully treated with catheter-directed thrombolysis (CDT) and systemic anticoagulants therapy.

Case presentation

A 56-year-old Chinese female came to the outpatient room with gradually progressive bilateral lower-extremity weakness. Magnetic resonance imaging revealed myopathy in bilateral thighs. Serum anti-SRP antibody was positive. She was diagnosed with anti-SRP myopathy. When treated with corticosteroids and immunosuppressants, the patient developed mild edema and pain of left lower extremity. Angiography and ultrasound revealed diffuse venous thrombosis of left lower extremity. Therapy was initiated with CDT and lower molecular weight heparin, then switched to once daily oral rivaroxaban. Meanwhile, steroids combined with tacrolimus were also carried on while simvastatin was discontinued. One month later, patient’s symptoms were resolved and only partial thrombosis in left femoral vein was remained.

Conclusion

The prevalence of DVT in patient with anti-SRP myopathy was rare. No well-established treatment strategy is available to manage the IMNM and DVT at the same time. The systemic anticoagulants therapy combined CDT can be an effective therapeutic approach to address extensive DVT in patient with anti-SRP myopathy.
Chromium removal from tannery effluents by adsorption process via activated carbon chat stems (Catha edulis) using response surface methodology
Authors: Bayisa Yigezu Mekonnen , Bullo Tafere Aga , Akuma Desalegn Abdissa
Published: November 2021

Objective

In tannery processing, water consumption is high, which generates wastewater as a by-product and numerous pollutants such as chromium heavy metals that make adverse effects of water bodies and the surrounding environment. This study analyzed, chromium (VI) removal from wastewater through activated carbon chat stem was investigated. Adsorption is a common treatment method via activated carbon due to its cost-effective, profitable, and removal efficiency of these heavy metals.

Results

The proximate analysis of moisture content of chat stem has 6%, activated carbon ash content of 17.35%, volatile materials of 20.12%, and fixed carbon contents of 56.53%, which are well-matched the standards quality of activated carbon. As the process parameter varies, the increment of the chromium removal efficiency was from 62.5 to 97.03%. The maximum adsorption efficiency was observed at 30 g/L dosage of the adsorbent, at pH 4, and contact time at 180 min of activated carbon from chat stem waste was found 97.03%. FTIR was used to characterize the surface of the chat stem before and after adsorption. Langmuir and Freundlich are used for short contact time’s adsorption isotherm 0.9839 and 0.9995 respectively, which conformed, no visible change in the corrosion state.
Assessment of autonomic function by long-term heart rate variability: beyond the classical framework of LF and HF measurements
Authors: Hayano Junichiro , Yuda Emi
Published: November 2021

In the assessment of autonomic function by heart rate variability (HRV), the framework that the power of high-frequency component or its surrogate indices reflects parasympathetic activity, while the power of low-frequency component or LF/HF reflects sympathetic activity has been used as the theoretical basis for the interpretation of HRV. Although this classical framework has contributed greatly to the widespread use of HRV for the assessment of autonomic function, it was obtained from studies of short-term HRV (typically 5‑10 min) under tightly controlled conditions. If it is applied to long-term HRV (typically 24 h) under free-running conditions in daily life, erroneous conclusions could be drawn. Also, long-term HRV could contain untapped useful information that is not revealed in the classical framework. In this review, we discuss the limitations of the classical framework and present studies that extracted autonomic function indicators and other useful biomedical information from long-term HRV using novel approaches beyond the classical framework. Those methods include non-Gaussianity index, HRV sleep index, heart rate turbulence, and the frequency and amplitude of cyclic variation of heart rate.
Cognitive behavioral therapy for irritable bowel syndrome induces bidirectional alterations in the brain-gut-microbiome axis associated with gastrointestinal symptom improvement
Authors: Jacobs Jonathan P. , Gupta Arpana , Bhatt Ravi R. , Brawer Jacob , Gao Kan , Tillisch Kirsten , Lagishetty Venu , Firth Rebecca , Gudleski Gregory D. , Ellingson Benjamin M. , Labus Jennifer S. , Naliboff Bruce D. , Lackner Jeffrey M. , Mayer Emeran A.
Published: November 2021

Background

There is growing recognition that bidirectional signaling between the digestive tract and the brain contributes to irritable bowel syndrome (IBS). We recently showed in a large randomized controlled trial that cognitive behavioral therapy (CBT) reduces IBS symptom severity. This study investigated whether baseline brain and gut microbiome parameters predict CBT response and whether response is associated with changes in the brain-gut-microbiome (BGM) axis.

Methods

Eighty-four Rome III-diagnosed IBS patients receiving CBT were drawn from the Irritable Bowel Syndrome Outcome Study (IBSOS; ClinicalTrials.gov NCT00738920) for multimodal brain imaging and psychological assessments at baseline and after study completion. Fecal samples were collected at baseline and post-treatment from 34 CBT recipients for 16S rRNA gene sequencing, untargeted metabolomics, and measurement of short-chain fatty acids. Clinical measures, brain functional connectivity and microstructure, and microbiome features associated with CBT response were identified by multivariate linear and negative binomial models.

Results

At baseline, CBT responders had increased fecal serotonin levels, and increased Clostridiales and decreased Bacteroides compared to non-responders. A random forests classifier containing 11 microbial genera predicted CBT response with high accuracy (AUROC 0.96). Following treatment, CBT responders demonstrated reduced functional connectivity in regions of the sensorimotor, brainstem, salience, and default mode networks and changes in white matter in the basal ganglia and other structures. Brain changes correlated with microbiome shifts including Bacteroides expansion in responders.

Conclusions

Pre-treatment intestinal microbiota and serotonin levels were associated with CBT response, suggesting that peripheral signals from the microbiota can modulate central processes affected by CBT that generate abdominal symptoms in IBS. CBT response is characterized by co-correlated shifts in brain networks and gut microbiome that may reflect top-down effects of the brain on the microbiome during CBT.
Prevalence of depression, anxiety and stress during the COVID-19 pandemic: a cross-sectional study among Palestinian students (10–18 years)
Authors: Radwan Eqbal , Radwan Afnan , Radwan Walaa , Pandey Digvijay
Published: November 2021

Background

The COVID-19 pandemic considers a threat to students’ well-being and mental health. The current descriptive cross-sectional study aims to identify psychological distress among school students during the lockdown period.

Methods

This study was carried out in a sample of 420 primary and secondary school students from June 10 to July 13, 2020, in the Gaza Strip in Palestine. Data was collected using an online questionnaire that included informed consent, socio-demographic questions, and a psychometric scale (DASS-21).

Results

The results revealed that most students experienced moderate to severe levels of anxiety (89.1%) and depression (72.1%), whereas less than half of them (35.7%) experienced moderate to severe stress. Stress, anxiety and depression scores were significantly different across gender, age groups, family size, and family's economic status. The results showed that gender (β = -0.174,p < 0.001), age (β = −0.155,p = 0.001) and economic level of family (β = −0.147,p = 0.002) were negative predictors correlated with stress. Family size (β = 0.156,p = 0.001) played a positive role in stress. It was found that gender (β = −0.105,p = 0.031), age (β = −0.135,p = 0.006) and economic level of family (β = −0.136,p = 0.005) were negative predictors correlated with anxiety, whereas family size (β = 0.139,p = 0.004) played a positive role in anxiety. For depression, gender (β = −0.162,p = 0.001), age (β = −0.160,p = 0.001) and economic level of family (β = −0.131,p = 0.007) were negative predictors correlated with depression, whereas family size (β = −0.133,p = 0.006) was found to be a positive predictor. Concerns about the influence of COVID-19 on economic, education, and daily life were positively correlated to the levels of depression, anxiety and stress, whereas the availability of social support was negatively correlated.

Conclusion

The development of a health protocol for influenced students is urgently needed to maintain them remain resilient during dangerous times.
The use of autologous platelet-rich fibrin matrix combined with meniscal repair in the treatment of parameniscal cyst: clinical results and cyst recurrence after 2-year of follow up
Authors: Screpis Daniele , Piovan Gianluca , Natali Simone , Pasqualotto Stefano , Magnanelli Stefano , Iacono Venanzio , Farinelli Luca , Grassi Marco , Zorzi Claudio
Published: November 2021

Purpose

Parameniscal cysts are associate with horizontal meniscal tears. Arthroscopic meniscal repair and the excision of the cyst by mini-open approach represent a valid treatment. However, the recurrence of cyst is still a current issue. Therefore, biological factors may be considered to promote the biological repair and avoid recurrence. The aim of the present study was to report the clinical results and the rate of recurrence of the cyst after minimum 2-year of follow up in a cohort of patients treated by meniscal repair and autologous platelet-rich fibrin matrix augment.

Methods

Patients with lateral parameniscal cyst undergoing arthroscopic meniscal repair and autologous platelet-rich fibrin matrix augment between 2016 and 2019 were retrospectively reviewed in March 2021. Inclusion criteria were absence of prior surgery on the affected knee with minimum 2-year of follow-up. Exclusion criteria were concomitant ligament lesions, rheumatic diseases and knee osteoarthritis. After reviewing the database, each selected patient was contacted and asked to participate in the study; at the follow-up evaluation all patient signed an informed consent. Tegner-Lysholm knee score, IKDC and NRS were collected before surgery and at follow-up.

Results

This study included 15 patients (8 male) with mean age of 32.8 years old. No recurrence of the cysts was observed. The Tegner-Lysholm knee score and IKDC subjective scores increased respectively from 41.3 ± 5.4 and 37.6 ± 5.1 at baseline to 92.3 ± 4.6 and 89.4 ± 2.6 at the final follow up. Concerning pain relief, the Numeric Pain Rating Scale (NRS) displayed a significant improvement reaching at the follow up a score of 1,3 ± 1.1 in comparison to 6.8 ± 0.9 at the baseline.

Conclusion

Surgical management of symptomatic lateral parameniscal cyst with cyst excision, autologous PRP membrane application and meniscus repair demonstrated excellent subjective clinical outcome with any cyst reoccurrence.

Level of evidence

III, retrospective cohort study.