bluuebunny/crossref_metadata_2025 huggingface dataset:
Nomenclatural and taxonomic changes in parasitic isopods (Isopoda: Epicaridea), including two new families and note on the questionable association between monogeneans and bopyrids
Authors: BOYKO CHRISTOPHER B. , WILLIAMS JASON D.
Published: March 2023

Several long-standing taxonomic and nomenclatural problems in bopyroid and cryptoniscoid isopods are addressed. Within Bopyroidea we propose five new synonomies, three new combinations, a correction of the spelling of one species and a replacement name for another. In addition, the likely erroneous conclusion that a monogenean is an associate of bopyrids is discussed. Within Cryptoniscoidea, we determined the familial placement of three genera that were previously designated as incertae sedis (Capitoniscus Bourdon, 1972 and Carocryptus Schultz, 1977) or of doubtful affiliation (Cumoechus Hansen, 1916). In total, five species of cryptoniscoids are placed into two new families (Capitoniscidae n. fam. and Cumoechidae n. fam.), each containing at least one species known from both female and cryptoniscus larvae/paedomorphic male stages. Finally, the status of two cryptoniscoid genera is addressed: Gorgoniscus Grygier, 1981 is placed in Hemioniscidae, and Leponiscus Giard, 1887, is synonymized with Hemioniscus Buccholz, 1866.
Capulopsyche keralensis gen. et sp. nov., a new genus and species of the subfamily Taleporiinae (Lepidoptera: Psychidae) from Kerala, India
Authors: UNNIKRISHNAN USHA AYYATH , SOBCZYK THOMAS , JOSE ROBY THEKKUDAN , JOSE JOYCE
Published: March 2023

A new genus and species, Capulopsyche keralensis gen. et sp. nov. from the subfamily Taleporiinae is described from Kerala, India. The new genus has distinct features from other genera of the subfamily. Double-walled larval case architecture is one of the unique characteristics of this genus. Details of life stages, distribution, COI sequencing, and the morphology of adults are described in the paper.
Metabetaeus lapillicola, a new species of alpheid shrimp (Decapoda: Caridea) from Japan, inhabiting unusual pebble beaches
Authors: YAMASHITA RYUNOSUKE , KOMAI TOMOYUKI , KON KOETSU
Published: March 2023

The alpheid shrimp genus Metabetaeus Borradaile, 1899 was previously known from two species associated with anchialine pools and caves, M. minutus (Whitelegge, 1897) and M. lohena Banner & Banner, 1960, and one species inhabiting in coral reef, M. mcphersonae Anker, 2010. In this study, a new species of the genus is described based on fourteen specimens collected from Shizuoka and Mie Prefectures, Honshu, central Japan. Metabetaeus lapillicola n. sp. inhabits interstitial spaces among small pebbles deposited in lower intertidal to upper subtidal zone, representing rather unusual habitat not only for Metabetaeus, but even for carideans. It is distinguished from three congeneric species by the presence of a pterygostomial spine on the carapace, greatly unequal chelipeds with the major one being substantially elongate, and the lack of a distinct distolateral spine on the uropodal endopod. Phylogenetic analyses using the mitochondrial 16S rRNA and COI genes support the recognition of the new species. The generic diagnosis of Metabetaeus is emended to accommodate the new species.
Frequency, Predictors, and Outcomes of the Potential Drug-Drug Interactions in the ICUs of Teaching Hospitals in Ardabil, Northwest of Iran During 2019-2020
Authors: Arab Ali , Sheikh-Germchi Zahra , Habibzadeh Shahram , Sadeghiye-Ahari Saeed , Mostafalou Sara
Published: March 2023

Introduction: Drug-drug interactions (DDIs) can reduce therapeutic efficacy and increase the duration and cost of hospitalization so that patients are sometimes exposed to significant complications and even death. Patients in the intensive care unit (ICU) are at higher risk of DDIs for a variety of reasons, including impaired absorption, decreased metabolism, and renal failure. The main objective of this study was to evaluate frequency, clinical ranking and risk factors of potential DDIs in the ICUs of 3 teaching hospitals in Ardabil. Methods: In this descriptive-analytical cross-sectional study, drug prescriptions 355 patients admitted to the ICUs were studied. Patient information including age, sex, diagnosis, number of prescribers, number of drugs, length of stay, and status of patients’ discharge (recovery or death) were recorded and checked using the online software up to date and the book Drug Interaction Facts. Finally, the data were statistically analyzed using the SPSS software. Results: The number of patients studied was 355. The mean age of the patients were 51.88 ± 23.22 years, and on average, 8.45 drugs had been prescribed for each patient. The total number of DDIs was 1597 among which class X was 1.4%, class D was 26.2%, and class C was 67.7%. Four hundred ninety-seven unique pairs of DDIs were identified. Age, number of prescribed drugs and length of stay in ICU were associated with prevalence of DDIs. Age and number of drugs were also identified as the risk factors of patients’ discharge caused by death. Conclusion: DDIs can complicate health state of patients in ICUs and may increase the length of hospital stay. Setting up computerized systems to alert drug interactions in hospital wards and pharmacotherapeutic intervention by clinical pharmacist can minimize DDIs.
The Impact of Clinical Pharmacy Services on Direct Oral Anticoagulant Medication Selection and Dosing in the Ambulatory Care Setting
Authors: Yates Naomi Y. , Hale Stephanie A. , Clark Nathan P.
Published: March 2023

Background: Off-label dosing of direct oral anticoagulants (DOACs) is both common and associated with adverse patient outcomes. Evidence describing best practices to support optimal direct oral anticoagulant (DOAC) dosing is limited. Objective: To describe the impact of clinical pharmacist intervention on DOAC prescribing. Methods: This retrospective study was a descriptive analysis conducted within an integrated healthcare system with a centralized, pharmacist-led Anticoagulation Management Service (AMS). Patients prescribed a DOAC between January 1, 2020 and December 31, 2020 were included. Pharmacy dispensing reports were generated for pharmacist review and anticoagulant drug therapy changes were recommended to physicians where appropriate. The primary objective was to describe the number and type of recommendations made. Secondary objectives were to determine the provider acceptance rate based on the intervention type and on clinical vs formulary recommendations. Results: Clinical pharmacists made 147 recommendations for 2331 unique patients included in the analysis. Twenty-three recommendations (16%) were to decrease the dose, 46 (31%) were to increase the dose, 14 (10%) were to change the medication due to clinical scenario, 62 (42%) were to change the medication due to cost, and 2 (1%) were another issue. One hundred twenty-three (84%) recommendations were accepted. The provider acceptance rate was similar for clinical and formulary recommendations (85% and 82% respectively). Conclusion: Implementation of report-driven clinical pharmacist intervention led to an improvement in appropriate DOAC medication selection and dosing.
Depression in systemic lupus erythematosus: A manifestation of microcirculation dysfunction?
Authors: Koletsos Nikolaos , Dipla Konstantina , Triantafyllou Areti , Dolgyras Panagiotis , Aslanidis Spyros , Zafeiridis Andreas , Galanopoulou Vasiliki , Douma Stella , Gkaliagkousi Eugenia
Published: March 2023

Objectives

Depression is highly prevalent among systemic lupus erythematosus (SLE) patients. Brain hypoperfusion in neuropsychiatric SLE patients might be associated with emotional difficulties. However, no previous study examined possible associations of depression with brain oxygenation during a mild physical stress in non-neuropsychiatric SLE patients. Our study aimed to identify possible differences in cerebral oxygenation during exercise in SLE patients with and without depressive symptoms using near-infrared spectroscopy (NIRS) and examine possible underlying mechanisms through evaluation of vascular cell adhesion molecule 1 (VCAM-1) levels.

Methods

SLE patients without a known neuropsychiatric history or treatment with antidepressants or antipsychotic drugs were enrolled. Participants were assigned into groups based on Beck’s Depression Inventory I (BDI-I). Patients with BDI-I score ≥10 comprised the SLE-depression group and those with BDI-I score <9 the SLE-non-depression group. All participants underwent a protocol involving a seated rest, a 3-min handgrip exercise (at 30% of maximal strength), and a 3-min recovery. NIRS was used to monitor changes in cerebral oxygenated hemoglobin (O2Hb), deoxygenated (HHb), and total hemoglobin (tHb). VCAM-1 levels were measured in serum samples.

Results

Twenty-three patients were enrolled. During exercise, the SLE-depression group exhibited a significantly lower increase in cerebral O2Hb [(peak-O2Hb ( p = 0.039); O2Hb-area under the curve, AUC, p = 0.027) vs. SLE-non-depression group. BDI-I score was inversely correlated with AUC (rho = −0.493, p = 0.017) and positively correlated with VCAM-1 levels (rho = 0.501, p = 0.034).

Conclusion

This study suggests a possible association between emotional abnormalities and microvascular impairment (cerebral oxygenation and endothelial dysfunction) in SLE However, larger studies are needed to confirm these results.
Impact of Umbilical Cord Milking and Delayed Cord Clamping on Hematological Parameters in Term Neonates: A Case Control Study
Authors: Prakash Kulkarni Poornima , Masali Balavanthray Dayananda , Kandagal Jasmine , Kulkarni Vijay
Published: March 2023

Introduction

Placental transfusion is additional volume of blood transferred to the baby during birth. A newborn who receives placental transfusion at birth obtains 30% more blood volume than the newborn whose cord is cut immediately. Receiving an adequate blood volume from placental transfusion at birth may be protective for the distressed neonates. It provides sufficient iron reserves for the first 3 to 6 months of life there by preventing or delaying iron deficiency anemia until the use of iron fortified food is implemented. There are 2 ways of placental transfusion, they are delayed cord clamping and umbilical cord milking. Delayed cord clamping (defined as clamping till cessation of pulsations or up to 60-180 s) leads to improvement in levels of hemoglobin and hematocrit at 6 weeks of age. However, universal application is limited due to concerns for the risk of hypothermia, and delay in initiation of resuscitation if required. Umbilical cord milking involves milking the entire contents of the umbilical cord towards the baby with in 20 s. Umbilical cord milking can be used in deliveries where delayed cord clamping is not feasible.

Objective

Comparison of hematological parameters (cord hemoglobin at birth, hemoglobin, hematocrit, and bilirubin levels in term neonates at 48 h with umbilical cord milking and delayed cord clamping).

Methods and Analysis

In this study all the term neonates delivered by vaginal delivery and lower segment caesarean section born to nonanemic mothers were considered eligible. All newborns with no risk factors underwent delayed cord clamping (n = 148) and those term neonates in whom delayed cord clamping was not feasible and/or currently WHO guidelines recommend for immediate cord clamping were allocated for umbilical cord milking (n = 121). Cord hemoglobin at birth, hemoglobin, hematocrit, and bilirubin (direct and indirect) were sent at 48 h. These parameters were compared between 2 groups.

Results

At birth cord hemoglobin was 15.36 and 15.46 (mean difference = 0.1) in DCC and UCM, respectively. At 48 hours, mean hemoglobin was 18.73 and 18.95 (mean difference = 0.22, P = .3591). Mean hematocrit was 52.22 and 53.28 (mean difference = 1.06, P = .0989), and mean total bilirubin levels was 11.24 and 10.56 (mean difference = 0.69, P = .466).

Conclusion

There were no statistically significant differences in the hematological parameters in full term neonates at 48 h, between delayed cord clamping and umbilical cord milking groups.
Free movement and access to social security in the EU: The challenge of exporting unemployment benefits
Authors: Grabbe Christina
Published: March 2023

The freedom of movement of EU workers and access to national welfare state systems has become a controversial topic among policymakers in recent years. To understand this, the article analyses the positions of Western European states towards the proposal of the European Commission to reform the European social security coordination. The structural problems of this reform and the current Regulation (EC) 883/2004 can be seen in the discussion on the export of unemployment benefits. Although Western European states have similar insurance-based and comprehensive unemployment systems, they have conflicting views on this issue. The article presents a comparative case study of Denmark, the Netherlands and Germany. Data was generated via expert interviews and policy documents and analysed through institutionalist approaches. By tracing the debates on the export of unemployment benefits, the article makes a more general argument about the debate on the free movement of workers and social security in the EU. It explains that policymakers’ main concern is not only the financial burden on their welfare systems, but also that the current Regulation (EC) 883/2004 and the reform proposal are incompatible with national monitoring and enforcement systems, which are designed to work best when the worker is in the Member State of last employment. This incompatibility of the coordination rules with national rules creates opposition among policymakers to the access of EU workers to national welfare systems.
How often does white matter hyperintensity volume regress in cerebral small vessel disease?
Authors: Brown Robin B , Tozer Daniel J , Egle Marco , Tuladhar Anil M , de Leeuw Frank-Erik , Markus Hugh S
Published: March 2023

Background and objectives:

It has been suggested that white matter hyperintensity lesions (WMHs), which typically progress over time, can also regress, and that this might be associated with favorable cognitive performance. We determined the prevalence of WMH regression in patients with cerebral small vessel disease (SVD) and examined which demographic, clinical, and radiological markers were associated with this regression.

Methods:

We used semi-automated lesion marking methods to quantify WMH volume at multiple timepoints in three cohorts with symptomatic SVD; two with moderate-to-severe symptomatic SVD (the SCANS observational cohort and the control arm of the PRESERVE interventional trial) and one with mild-to-moderate SVD (the RUN DMC observational cohort). Mixed-effects ordered logistic regression models were used to test which factors predicted participants to show WMH regression.

Results:

No participants (0/98) in SCANS, 6/42 (14.3%) participants in PRESERVE, and 6/276 (2.2%) in RUN DMC showed WMH regression. On multivariate analysis, only lower WMH volume (OR: 0.36, 95% CI: 0.23–0.56) and better white matter microstructural integrity assessed by fractional anisotropy using diffusion tensor imaging (OR: 1.55, 95% CI: 1.07–2.24) predicted participant classification as regressor versus stable or progressor.

Discussion:

Only a small proportion of participants demonstrated WMH regression across the three cohorts, when a blinded standardized assessment method was used. Subjects who showed regression had less severe imaging markers of disease at baseline. Our results show that lesion regression is uncommon in SVD and unlikely to be a major factor affecting the use of WMH quantification as an outcome for clinical trials.
The path forward for Europe’s green transition
Authors: Pietras Jarosław
Published: March 2023

The EU’s green transition started with the establishment of long-term goals but now requires short-term actions. It is a constant balancing act to achieve these goals while also responding to new problems and challenges. The time frame for reaching the ambitious climate target is short in terms of undertaking a deep transformation but long enough to expect unforeseen events. Europe’s green transformation must include intermediate steps, with the most important short-term deadline being 2030, when CO2 emissions are expected to have been reduced by 55%. This goal cannot be achieved without a thorough industrial and economic transformation. However, the funds available for the transformation are limited and diluted by more pressing immediate needs: Russia’s war against Ukraine has increased global economic uncertainty, value chains have been distorted and EU–US policy divergences are increasing. In other words, Europe needs to reduce its emissions at a time of economic uncertainty, geopolitical tensions and increasing energy pressures.
The Practice of Infant Sleep Position among Mothers in Jimma Town Public Health Institutions, Jimma, Oromia, South West Ethiopia, 2022
Authors: Yetwale Aynalem , Tigstu Bilen , Biyazin Tsegaw , Fenta Belete , Dagnaw Yalemtsehay , Dessalew Yaregal
Published: March 2023

Background

One of the important interventions in the infantile period is the selection of appropriate infant sleeping position. Unsafe infant sleep position is associated with sudden unexpected death in infancy. Yet, little is known about the practice of infant sleep position in Ethiopia. This study aimed to assess the practice of infant sleep position among mothers attending mother and child health service in Jimma town public health institutions, South West Ethiopia, 2022.

Methods

An institutional based cross-sectional study design was conducted on 409 women attending Maternal and child health service in Jimma town public health facilities. The data were collected using a pre-tested and semi- structured questionnaire. Binary Logistic regression was used to analyze the association between the practice infant sleeping positions and explanatory variables. The strength of association was evaluated using an odds ratio at a 95% confidence interval and a P-value ≤ .05 was considered to declare significant associations.

Results

Four hundred nine women participated in the study, with a response rate of 97%. The practice of recommended infant sleeping position (supine position) in this study was 33.5% [95% CI (28.9% - 38.6%)]. Being married Adjusted odds ratio (AOR) 2.6; 95% CI (1.04-6.48)), residence (AOR 1.88; 95% CI (1.1-3.31)) multi gravidity (AOR 1.6; 95% CI (1.02-2.59)) and having good knowledge of sleeping position (AOR 1.55; 95% CI (1.01-2.38)) were significantly associated with the practice of infant sleep position

Conclusion

The practice of medically recommended infant sleep position in this study was low. Being married, residence, multi gravidity and having good knowledge of sleeping position were significantly associated with the practice of infant sleep position. Therefore, considering these associated factors during health care provision and disseminating information on safe sleep practices for mothers is needed. Also, different stakeholders, including the federal ministry of health, health professionals, and health institutions at different levels, need to give attention to such problems in addition to the service to reduce infant mortality
Preterm birth and asthma and COPD in adulthood: a nationwide register study from two Nordic countries
Authors: Pulakka Anna , Risnes Kari , Metsälä Johanna , Alenius Suvi , Heikkilä Katriina , Nilsen Sara Marie , Näsänen-Gilmore Pieta , Haaramo Peija , Gissler Mika , Opdahl Signe , Kajantie Eero
Published: March 2023

Background

Preterm birth affects lungs in several ways but few studies have follow-up until adulthood. We investigated the association of the entire spectrum of gestational ages with specialist care episodes for obstructive airway disease (asthma and chronic obstructive pulmonary disease (COPD)) at age 18–50 years.

Methods

We used nationwide registry data on 706 717 people born 1987–1998 in Finland (4.8% preterm) and 1 669 528 born 1967–1999 in Norway (5.0% preterm). Care episodes of asthma and COPD were obtained from specialised healthcare registers, available in Finland for 2005–2016 and in Norway for 2008–2017. We used logistic regression to estimate odds ratios (ORs) for having a care episode with either disease outcome.

Results

Odds of any obstructive airway disease in adulthood for those born at <28 or 28–31 completed weeks were 2–3-fold of those born full term (39–41 completed weeks), persisting after adjustments. For individuals born at 32–33, 34–36 or 37–38 weeks, the odds were 1.1- to 1.5-fold. Associations were similar in the Finnish and the Norwegian data and among people aged 18–29 and 30–50 years. For COPD at age 30–50 years, the OR was 7.44 (95% CI 3.49–15.85) for those born at <28 weeks, 3.18 (95% CI 2.23–4.54) for those born at 28–31 weeks and 2.32 (95% CI 1.72–3.12) for those born at 32–33 weeks. Bronchopulmonary dysplasia in infancy increased the odds further for those born at <28 and 28–31 weeks.

Conclusion

Preterm birth is a risk factor for asthma and COPD in adulthood. The high odds of COPD call for diagnostic vigilance when adults born very preterm present with respiratory symptoms.
Effectiveness and therapeutic validity of physiotherapeutic exercise starting within one year following total and unicompartmental knee arthroplasty for osteoarthritis: a systematic review
Authors: Koster Amarins , Stevens Martin , van Keeken Helco , Westerveld Sanne , Seeber Gesine H.
Published: March 2023

Background

To determine the effectiveness and therapeutic validity of physiotherapeutic exercise after total and unicompartmental knee arthroplasty for osteoarthritis. It was hypothesized that interventions of high therapeutic validity result in superior functional recovery after total and unicompartmental knee arthroplasty versus interventions of low therapeutic validity.

Methods

A systematic review incorporating a comprehensive database search of five major databases relevant to the topic was conducted. Randomized controlled trials were reviewed if they included studies that compared postoperative physiotherapeutic exercise with usual care or compared two types of postoperative physiotherapeutic interventions. All included studies were assessed for risk of bias (using the Cochrane Collaboration’s tool) and therapeutic validity (using the Consensus on Therapeutic Exercise Training scale). The characteristics of the included articles and their results on joint and muscle function, functional performance, and participation were extracted.

Results

Of the 4343 unique records retrieved, 37 articles were included. Six of them showed good therapeutic validity, suggesting low therapeutic validity in 31 studies. Three articles showed a low risk of bias, 15 studies scored some concerns for risk of bias and 19 studies scored high risk of bias. Only one article scored well on both methodological quality and therapeutic validity.

Conclusion

Due to heterogeneity of outcome measures and length of follow-up, as well as limited reporting of details of the physiotherapeutic exercises and control interventions, no clear evidence was found on effectiveness of physiotherapeutic exercises after total and unicompartmental knee arthroplasty. Homogeneity in intervention characteristics and outcome measures would enhance comparability of clinical outcomes between trials. Future studies should incorporate similar methodological approaches and outcome measures. Researchers are encouraged to use the Consensus on Therapeutic Exercise Training scale as a template to prevent insufficient reporting.
Pre-therapeutic lymphocytopenia: a new prognostic factor for failure of endovesical BCG-immunotherapy in non-muscle invasive bladder cancer
Authors: Ziani Idriss , Ibrahimi Ahmed , Bellouki Omar , Elsayegh Hachem , Abouqal Redouane , Nouini Yassine , Bouziane Amal
Published: March 2023

Background

Inflammation plays a key role in the initiation and development of cancers. The prognostic value of inflammation biomarkers is proven in several urological and non-urological cancers. Knowing that the mechanism of action of endovesical BCG-immunotherapy in the treatment of non-muscle-invasive bladder cancer (NMIBC) is based on inflammation; lymphocytes have a key role in this reaction, particularly in the cytotoxic phase and can be predictive biomarkers of the response to BCG-therapy. The main objective of our work is therefore to study the impact of the number of lymphocytes on the response to endovesical BCG-immunotherapy, and more specifically lymphocytopenia (Lp) as a prognostic factor for BCG-failure.

Methods

Our study is a monocentric retrospective cohort carried for prognostic purposes, including 200 patients neodiagnosed with non-muscle-invasive bladder cancer (Ta -T1 stages), who required adjuvant treatment to TURB by BCG-immunotherapy, over a period of 5 years from January 2012 to December 2016. The cutoff value chosen was 1.67 × 109/L using maximized Log-Rank test. Survival analysis was studied using a Kaplan–Meier model. The comparison between the thresholds (L ≤ Vs > 1.67 × 109/L) concerning the recurrence and progression rates was carried out using the Log-Rank test. The association between lymphocytopenia and BCG-therapy failure was assessed in univariate and multivariate analysis by the Cox model. Statistical analysis was performed using Jamovi statistical software.

Results

One hundred and eight patients had a lymphocyte count > 1.67 × 109/L while 92 had a lymphocyte count ≤ 1.67 × 109/L. The median lymphocyte value was 1.64 (1.19; 2.4). The median survival without failure of BCG treatment was significantly better in the high lymphocyte-count group, with median of 22 months in the > 1.67 × 109/L group versus 11 months until failure in the ≤ 1.67 × 109/L group. A lymphocyte count ≤ 1.67 × 109/L was associated with failure of BCG-therapy in univariate (HR = 4.80, P ≤ 0.001) and multivariate (HR = 1.88, P = 0.025) studies. Other factors associated in the univariate study were found: T1 stage (P = 0.001), high-grade urothelial carcinoma (P = 0.001), multifocal tumor (P = 0.001), tumor size > 3 cm (P = 0.001), concomitant carcinoma in situ (Cis) (P = 0.001) and vascular emboli (P = 0.001). Multivariate study showed significant factors that are, in addition to lymphocytopenia, the presence of T1 stage (P = 0.011) and vascular emboli (P = 0.013).

Conclusion

Our study has shown an association between lymphocytes count and NMIBC progression. Patients with lymphocytopenia carry an increased risk of endovesical BCG-immunotherapy failure. These results should be further validated.
Effects of gentle mechanical skin stimulation on subjective symptoms and joint range of motions in people with chronic neck and shoulder discomfort
Authors: Watanabe Nobuhiro , Nara Marina , Suzuki Shihoko , Sugie Masamitsu , Yamamoto Takao , Hotta Harumi
Published: March 2023

This study aimed to examine the efficacy of a 2-week self-administered gentle mechanical skin stimulation on chronic neck and shoulder discomfort. In participants (n = 12) with chronic neck and shoulder discomfort, subjective measures of pain sensation, discomfort, and difficulty in moving using a visual analog scale (VAS, 0–10) and objective measures of 12 different joint range of motions (ROMs) for the cervical and shoulder regions, using a digital goniometer, were collected before and after self-care with contact acupuncture, called microcones. The self-care for 2 weeks significantly (p < 0.001) decreased all VAS scores to 2.2–2.3 from baseline values of 6.0–7.4. Of the 12 ROMs tested, 8 were significantly increased (p < 0.013). This open-label study suggests the use of self-care with microcones in improving subjective symptoms and joint ROMs in people suffering from chronic neck and shoulder discomfort. However, a randomized, double-blind, controlled clinical trial is needed to further investigate the efficacy and safety of microcones.
A novel prognostic signature for clear cell renal cell carcinoma constructed using necroptosis-related miRNAs
Authors: Yu Zuhu , Lu Chong , Lu Bin , Gao Hong , Liang Rongfang , Xiang Wuxing
Published: March 2023

Background

This work aims to analyze the relationship between necroptosis-related microRNAs (miRNAs) and the prognosis of clear cell renal cell carcinoma (ccRCC).

Methods

The miRNAs expression profiles of ccRCC and normal renal tissues from The Cancer Genome Atlas (TCGA) database were used to construct a matrix of the 13 necroptosis-related miRNAs. Cox regression analysis was used to construct a signature to predict the overall survival of ccRCC patients. The genes targeted by the necroptosis-related miRNAs in the prognostic signature were predicted using miRNA databases. Gene Ontology (Go) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were used to investigate the genes targeted by the necroptosis-related miRNAs. The expression levels of selected miRNAs in 15 paired samples (of ccRCC tissues and adjacent normal renal tissues) were investigated using reverse transcriptase quantitative polymerase chain reaction (RT-qPCR).

Results

Six necroptosis-related miRNAs were found to differentially expressed between ccRCC and normal renal tissues. A prognostic signature consisting of miR-223-3p, miR-200a-5p, and miR-500a-3p was constructed using Cox regression analysis and risk scores were calculated. Multivariate Cox regression analysis showed that the hazard ratio was 2.0315 (1.2627–3.2685, P = 0.0035), indicating that the risk score of the signature was an independent risk factor. The receiver operating characteristic (ROC) curve showed that the signature has a favorable predictive capacity and the Kaplan-Meier survival analysis indicated that ccRCC patients with higher risk scores had worse prognoses (P < 0.001). The results of the RT-qPCR verified that all three miRNAs used in the signature were differentially expressed between ccRCC and normal tissues (P < 0.05).

Conclusion

The three necroptosis-related-miRNAs used in this study could be a valuable signature for the prognosis of ccRCC patients. Necroptosis-related miRNAs should be further explored as prognostic indicators for ccRCC.
95% effective volume of ropivacaine for ultrasound‑guided supra‑inguinal fascia iliaca compartment block
Authors: Zhang Can , Dai Wei , He Kaihua
Published: March 2023

Background

Hip arthroplasty is effective in treating hip diseases, such as osteoarthritis and hip fracture, but it often brings severe trauma and pain. In recent years, ultrasound-guided supra-inguinal fascia iliaca compartment block(S-FICB) has become a widely used nerve block method for analgesia in hip arthroplasty.

Methods

Fifty-three patients preparing for hip arthroplasty were prospectively enrolled. S-FICB was performed under ultrasound guidance, and inject 0.33% ropivacaine into the space. Using the biased-coin design (BCD) sequential allocation method. The initial volume of 0.33% ropivacaine was 30ml. In case of failure, the next patient received a higher volume (defined as the previous volume with an increment of 1.2 mL). If the previous patient had a successful block, the next patient was randomized to a lower volume (defined as the previous volume with a decrement of 1.2 mL), with a probability of b = 0.05, or the same volume, with a probability of 1 − b = 0.95. The study was stopped when 45 successful blocks were achieved.

Results

Forty-five patients (84.9%) were blocked successfully. The 95% effective volume (EV95) was 34.06ml (95%CI 33.35 ~ 36.28ml). There were 31 patients with non-fracture in this study. The quadriceps muscle strength decreased in only two patients. Moreover, they both received 34.8ml of ropivacaine for S-FICB. Twenty-two patients had hip fractures. There were 3 patients (14%) with failed blocks and 19 patients (86%) with successful blocks. However, all fracture patients experienced less pain after S-FICB.

Conclusion

EV95 of 0.33% ropivacaine for ultrasound-guided S-FICB was 34.06ml.

Trial registration

The trial was registered at the Chinese Clinical Trial Registry (registration number: ChiCTR2100052214, registration date: 2021 October 22).
Laryngeal edema following remimazolam-induced anaphylaxis: a rare clinical manifestation
Authors: Hu Xiawei , Tang Yaning , Fang Xiangming
Published: March 2023

Background

Remimazolam is an ultra-short-acting intravenous benzodiazepine, which has been used as sedative/anesthetic in procedural sedation and anesthesia. Although peri-operative anaphylaxis due to remimazolam has been reported recently, the spectrum of the allergic reactions is still not fully known.

Case presentation

We describe a case of anaphylaxis following remimazolam administration in a male patient undergoing colonoscopy under procedural sedation. The patient presented complex clinical signs including airway changes, skin symptoms, gastrointestinal manifestations and hemodynamic fluctuations. Different from other reported cases, laryngeal edema was the initial and main clinical feature of remimiazolam-induced anaphylaxis.

Conclusions

Remimazolam-induced anaphylaxis has a rapid onset and complex clinical features. This case reminds anesthesiologists should be particularly alert to the unknown adverse reactions of new anesthetics.
Effectiveness of dual antiplatelet de-escalation therapy on the prognosis of patients with ST segment elevation myocardial infarction undergoing percutaneous coronary intervention
Authors: Zhao Zhigang , Wang Jingyao , Lei Mengjie , Li Yachao , Yang Yanli , An Lei , Sun Xue , Li Cairong , Xue Zengming
Published: March 2023

Aim

To investigate the effectiveness of de-escalation of ticagrelor (from ticagrelor 90 mg to clopidogrel 75 mg or ticagrelor 60 mg) on the prognosis of patients with ST segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) after 3 months of oral dual antiplatelet therapy (DAPT).

Methods

From March 2017 to August 2021, 1056 patients with STEMI in a single centre, through retrospective investigation and analysis, were divided into intensive (ticagrelor 90 mg), standard (clopidogrel 75 mg after PCI) and de-escalation groups (clopidogrel 75 mg or ticagrelor 60 mg after 3 months of treatment with 90 mg ticagrelor) based on the type and dose of P2Y12 inhibitor 3 months after PCI, and the patients had a ≥ 12-month history of oral DAPT. The primary end point was major adverse cardiovascular and cerebrovascular events (MACCEs) during the 12-month follow-up period, including composite end points of cardiac death, myocardial infarction, ischaemia-driven revascularization and stroke. The major safety endpoint was bleeding events.

Results

The results showed that during the follow-up period, there was no statistically significant difference in the incidence of MACCEs between the intensive and de-escalation groups (P > 0.05). The incidence of MACCEs in the standard treatment group was higher than that in the intensive treatment group (P = 0.014), but the incidence of bleeding events in the de-escalation group was significantly lower than that in the standard group (9.3% vs. 18.4%, χ²=7.191, P = 0.027). The Cox regression analysis showed that increases in haemoglobin (HGB) (HR = 0.986) and estimated glomerular filtration rate (eGFR) (HR = 0.983) could reduce the incidence of MACCEs, while old myocardial infarction (OMI) (P = 0.023) and hypertension (P = 0.013) were independent predictors of MACCEs.

Conclusion

For STEMI patients undergoing PCI, the de-escalation scheme of ticagrelor to clopidogrel 75 mg or ticagrelor 60 mg at 3 months after PCI was related to the reduction of bleeding events, especially minor bleeding events, without an increase in ischaemic events.
Identification of potential serum biomarkers for congenital heart disease children with pulmonary arterial hypertension by metabonomics
Authors: Jin Nan , Yu Mengjie , Du Xiaoyue , Wu Zhiguo , Zhai Changlin , Pan Haihua , Gu Jinping , Xie Baogang
Published: March 2023

Background

Pulmonary arterial hypertension is a common complication in patients with congenital heart disease. In the absence of early diagnosis and treatment, pediatric patients with PAH has a poor survival rate. Here, we explore serum biomarkers for distinguishing children with pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD) from CHD.

Methods

Samples were analyzed by nuclear magnetic resonance spectroscopy-based metabolomics and 22 metabolites were further quantified by ultra-high-performance liquid chromatography–tandem mass spectroscopy.

Results

Serum levels of betaine, choline, S-Adenosyl methionine (SAM), acetylcholine, xanthosine, guanosine, inosine and guanine were significantly altered between CHD and PAH-CHD. Logistic regression analysis showed that combination of serum SAM, guanine and N-terminal pro-brain natriuretic peptide (NT-proBNP), yielded the predictive accuracy of 157 cases was 92.70% with area under the curve of the receiver operating characteristic curve value of 0.9455.

Conclusion

We demonstrated that a panel of serum SAM, guanine and NT-proBNP is potential serum biomarkers for screening PAH-CHD from CHD.
Correlation between Heart rate recovery and Left Atrial phasic functions evaluated by 2D speckle-tracking Echocardiography after Acute Myocardial infarction
Authors: Mashayekhi Behruz , Mohseni-Badalabadi Reza , Hosseinsabet Ali , Ahmadian Tahereh
Published: March 2023

Background

Heart rate recovery (HRR) in the exercise test is the index of cardiac autonomic system function and sympathovagal balance impaired in patients with myocardial infarction (MI). An instance is left atrial (LA) phasic function, which is impaired in such patients. In this study, we investigated the role of HRR in predicting LA phasic functions in patients with MI.

Methods

The present study recruited 144 consecutive patients with ST-elevation MI. A symptom-limited exercise test was performed about 5 weeks after MI, with echocardiography conducted just before the exercise test. The patients were divided into abnormal and normal HRR at 60 s (HRR60) and again into abnormal and normal HRR at 120 s (HRR120) after the exercise test. LA phasic functions, evaluated by 2D speckle-tracking echocardiography, were compared between the 2 groups.

Results

Patients with abnormal HRR120 had lower LA strain values and strain rates during the reservoir, conduit, and contraction phases, while those with abnormal HRR60 had lower LA strain values and strain rates during the reservoir and conduit phases. The differences were lost after adjustments for possible confounders, except for LA strain and strain rate during the conduit phase, in patients with abnormal HRR120.

Conclusions

Abnormal HRR120 in the exercise test can independently predict decreased LA conduit function in patients with ST-elevation MI.
Application of a preoperative pain management mode based on instant messaging software in elderly hip fracture patients: a randomized controlled trial
Authors: Shen Yang , Liu Wei , Zhu Zhe , Liu Shuangmei , Cao Yanyan , Yan Lei , Chen Liang
Published: March 2023

Background

Preoperative analgesia of hip fracture in elderly patients is important, but it is also lacking. In particular, nerve block was not provided in time. In order to provide more effective analgesia, we designed a multimodal pain management mode based on instant messaging software.

Methods

From May to September 2022, a total of 100 patients with unilateral hip fracture aged over 65 were randomly divided into the test group and the control group. Finally, 44 patients in each group completed the result analysis. A new pain management mode was used in the test group. This mode focuses on the full information exchange between medical personnel in different departments, early fascia iliaca compartment block (FICB), and closed-loop pain management. Outcomes include the time when FICB is completed for the first time; The number of cases of FICB completed by emergency doctors; Patients' pain score, pain duration.

Results

The time for patients in the test group to complete FICB for the first time was 3.0 [1.925–3.475] h, which was less than the time for patients in the control group (4.0 [3.300–5.275] h). The difference was statistically significant (P < 0.001). Compared with 16 patients in the control group, 24 patients in the test group completed FICB by emergency doctors, and there was no statistical difference between the two groups (P = 0.087). The test group was superior to the control group in the highest NRS score (4.00 [3.00–4.00] vs 5.00 [4.00–5.75]), the duration of the highest NRS score (20.00 [20.00–25.00] mins vs 40.00 [30.00–48.75] mins), and the NRS > 3 time (35.00 [20.00–45.00] mins vs 72.50 [60.00–45.00] mins). The analgesic satisfaction of patients in the test group (5.00 [4.00–5.00]) was also significantly higher than that of the control group (3.00 [3.00–4.00]). The above four indexes were different between the two groups (P < 0.001).

Conclusions

Using instant messaging software, the new model of pain management can enable patients to receive FICB as soon as possible and improve the timeliness and effectiveness of analgesia.

Trial registration

Chinese Clinical Registry Center, ChiCTR2200059013, 23/04/2022.
Excess mortality and associated factors among people living with HIV initiating highly active antiretroviral therapy in Luzhou, China 2006–2020
Authors: Niu Dandan , Xiao Ticheng , Chen Yuanyi , Tang Houlin , Chen Fangfang , Cai Chang , Qin Qianqian , Zhao Decai , Jin Yichen , Wang Shi , Hou Yushan , Lu Zhen , Yang Luoyao , Liu Hong , Xie Dongqin , Zou Huachun , Lyu Fan
Published: March 2023

Background

To estimate crude mortality, excess mortality, and standardized mortality rates (SMR) among people living with HIV (PLHIV) initiating highly active antiretroviral therapy (HAART) in Luzhou, China 2006–2020, and assess associated factors.

Methods

PLHIV initiating HAART in the HIV/AIDS Comprehensive Response Information Management System (CRIMS) in Luzhou, China 2006–2020 were included in the retrospective cohort study. The crude mortality, excess mortality, and SMR were estimated. Multivariable Poisson regression model was used for analyzing risk factors associated with excess mortality rates.

Results

The median age among 11,468 PLHIV initiating HAART was 54.5 years (IQR:43.1–65.2). The excess mortality rate decreased from 1.8 deaths/100 person-years (95% confidence interval [CI]:1.4–2.4) in 2006–2011 to 0.8 deaths/100 person-years (95%CI:0.7–0.9) in 2016–2020. SMR decreased from 5.4 deaths/100 person-years (95%CI:4.3–6.8) to 1.7 deaths/100 person-years (95%CI:1.5–1.8). Males had greater excess mortality with the eHR of 1.6 (95%CI:1.2–2.1) than females. PLHIV with CD4 counts ≥ 500 cells/μL had the eHR of 0.3 (95%CI:0.2–0.5) in comparison to those with CD4 counts < 200 cells/μL. PLHIV with WHO clinical stages III/IV had greater excess mortality with the eHR of 1.4 (95%CI:1.1–1.8). PLHIV with time from diagnosis to HAART initiation ≤ 3 months had the eHR of 0.7 (95%CI:0.5–0.9) compared to those with time ≥ 12 months. PLHIV with initial HAART regimens unchanged and viral suppression had the eHR of 1.9 (95%CI:1.4–2.6) and 0.1 (95%CI:0.0–0.1), respectively.

Conclusions

The excess mortality and SMR among PLHIV initiating HAART in Luzhou, China decreased substantially from 2006 to 2020, but the mortality rate among PLHIV was still higher than general population. PLHIV who were male, with baseline CD4 counts less than 200 cells/μL, WHO clinical stages III/IV, time from diagnosis to HAART initiation ≥ 12 months, initial HAART regimens unchanged, and virological failure had a greater risk of excess deaths. Early and efficient HAART would be significant in reducing excess mortality among PLHIV.
Machine learning-based radiomics model to predict benign and malignant PI-RADS v2.1 category 3 lesions: a retrospective multi-center study
Authors: Jin Pengfei , Shen Junkang , Yang Liqin , Zhang Ji , Shen Ao , Bao Jie , Wang Ximing
Published: March 2023

Purpose

To develop machine learning-based radiomics models derive from different MRI sequences for distinction between benign and malignant PI-RADS 3 lesions before intervention, and to cross-institution validate the generalization ability of the models.

Methods

The pre-biopsy MRI datas of 463 patients classified as PI-RADS 3 lesions were collected from 4 medical institutions retrospectively. 2347 radiomics features were extracted from the VOI of T2WI, DWI and ADC images. The ANOVA feature ranking method and support vector machine classifier were used to construct 3 single-sequence models and 1 integrated model combined with the features of three sequences. All the models were established in the training set and independently verified in the internal test and external validation set. The AUC was used to compared the predictive performance of PSAD with each model. Hosmer–lemeshow test was used to evaluate the degree of fitting between prediction probability and pathological results. Non-inferiority test was used to check generalization performance of the integrated model.

Results

The difference of PSAD between PCa and benign lesions was statistically significant (P = 0.006), with the mean AUC of 0.701 for predicting clinically significant prostate cancer (internal test AUC = 0.709 vs. external validation AUC = 0.692, P = 0.013) and 0.630 for predicting all cancer (internal test AUC = 0.637 vs. external validation AUC = 0.623, P = 0.036). T2WI-model with the mean AUC of 0.717 for predicting csPCa (internal test AUC = 0.738 vs. external validation AUC = 0.695, P = 0.264) and 0.634 for predicting all cancer (internal test AUC = 0.678 vs. external validation AUC = 0.589, P = 0.547). DWI-model with the mean AUC of 0.658 for predicting csPCa (internal test AUC = 0.635 vs. external validation AUC = 0.681, P = 0.086) and 0.655 for predicting all cancer (internal test AUC = 0.712 vs. external validation AUC = 0.598, P = 0.437). ADC-model with the mean AUC of 0.746 for predicting csPCa (internal test AUC = 0.767 vs. external validation AUC = 0.724, P = 0.269) and 0.645 for predicting all cancer (internal test AUC = 0.650 vs. external validation AUC = 0.640, P = 0.848). Integrated model with the mean AUC of 0.803 for predicting csPCa (internal test AUC = 0.804 vs. external validation AUC = 0.801, P = 0.019) and 0.778 for predicting all cancer (internal test AUC = 0.801 vs. external validation AUC = 0.754, P = 0.047).

Conclusions

The radiomics model based on machine learning has the potential to be a non-invasive tool to distinguish cancerous, noncancerous and csPCa in PI-RADS 3 lesions, and has relatively high generalization ability between different date set.