bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of allergies on outcomes following shoulder arthroplasty: A national database analysis of 154,478 patients
Authors: Patel Akshar V , Stevens Andrew , Shahzad Hania , Iyer Amogh I , Ragland Dashaun , Cvetanovich Gregory , Bishop Julie Y , Rauck Ryan C
Published: August 2023

Background

The objective of this study is to investigate the effect of allergies on complications following total shoulder arthroplasty (TSA).

Materials and Methods

All data were collected by using the PearlDiver national database to identify patients who had undergone TSA (anatomic or reverse) between 1 January 2010 and 31 October 2021. Patients were stratified into two groups: allergies and no allergies. Comparisons were made regarding complications and revision surgeries. Complications were compared at 30 and 90 days. Revisions were compared at 1, 5 and 10 years postoperatively.

Results

This study identified 28,182 patients with allergies and 126,296 patients without allergies. Patients with allergies were more likely to require revision surgery at all time points analyzed (p < 0.001). Patients with allergies were more likely to have sepsis within 30 (OR 1.53 [1.30–1.80], p < 0.001) and 90 days (1.71 [1.51–1.94], p < 0.001) postoperatively. Patients with allergies were more likely to experience a wound complication within 30 (1.89 [1.58–2.26], p < 0.001) and 90 days (1.81 [1.58–2.08], p < 0.001). The allergy group experienced higher rates of prosthetic joint infections (PJI) (2.14 [1.81–2.54], p < 0.001) and implant complications at 90 days (1.52 [1.42–1.62], p < 0.001).

Discussion

Patients with allergies were more likely to require revision surgery, experience wound complications, sepsis and PJI following TSA.
Multifocal and multicentric glioblastoma: Imaging signature, molecular characterization, patterns of spread, and treatment
Authors: Farhat Maguy , Fuller Gregory N , Wintermark Max , Chung Caroline , Kumar Vinodh A , Chen Melissa
Published: August 2023

Multifocal and multicentric glioblastoma (GBM) or collectively, m-GBM, is an imaging diagnosis present in up to 34% of patients with GBM. Compared to unifocal disease, patients with m-GBM have worse outcomes owing to the enhanced aggressive nature of the disease and its resistance to currently available treatments. To improve the understanding of its complex behavior, many associations have been established between the radiologic findings of m-GBM and its gross histology, genetic composition, and patterns of spread. Additionally, the holistic knowledge of the exact mechanisms of m-GBM genesis and progression is crucial for identifying potential targets permitting enhanced diagnosis and treatment. In this review, we aim to provide a comprehensive summary of the cumulative knowledge of the unique molecular biology and behavior of m-GBM and the association of these features with neuroimaging.
Sudden sensorineural hearing loss after receiving an inactivated viral vaccine, Sinopharm: Two-case report
Authors: Asadi Mahboobe , Naderi Delaram , Jahanshahi Fatemeh
Published: August 2023

The prevalence of Coronavirus Disease 2019 is a global threat. Due to the high mortality rate caused by this disease, the vaccination is mandatory to protect patients against it and reduce the mortality. Rapid development and widespread use of vaccines have raised the possibility of adverse side effects over the course of administration and follow-up. In this study, we investigated an adverse event of sudden sensorineural hearing loss in two patients receiving first dose of Sinopharm, an inactivated viral vaccine. Both patients experienced sudden hearing loss in their left ear some days after receiving the first dose of the Sinopharm and had normal otoscopic examinations in both ears and mild to severe sensorineural hearing loss was reported in the left ear. After imaging evaluation with magnetic resonance imaging which showed no pathologic points. Two patients were treated with prednisolone and valacyclovir. Both patients experienced response and had good prognosis in their follow-up. Our study showed that there is no direct evidence of an association between Coronavirus Disease 2019 vaccination. A viral infection can cause sudden sensorineural hearing loss and should be considered as a possible side effect after vaccination. Although the number of side effects reported in clinical trials has been very low, long-term follow-up of patients is needed to assess the vaccine’s safety, given the incidence of these cases.
The Impact of Digital Disruption: Influences of Digital Media and Social Networks on Forming Digital Natives’ Attitude
Authors: Chang Chin-Wen , Chang Sheng-Hsiung
Published: August 2023

Generation Z, who are prospective customers, are digital natives. As the infrastructure and technology of the internet have developed, this study examines whether digital disruption demonstrates the uniqueness of Generation Z and affects their attitudes toward products they rarely see. Digital media, social network sites, and instant messaging are emphasized due to their relationship to digital disruption. Social networks (e.g., social network sites and instant messaging) encourage interactions and are therefore separate from digital media. The questionnaire in this study was based on a thorough literature review, and reliability and validity were ensured. A total of 505 responses were used for hypothesis testing by the bootstrapping method and ordinary least squares. The results partially comply with the suggestion that Generation Z depends more on information from digital media than previous generations. However, social networks have a greater effect than digital media and do not show generational differences. Although the nature and lifestyle differ across generations, certain circumstances (e.g., working requirements) cause people to not conform to the stereotype of a specific generation. Hence, digital disruption creates generational differences, but these differences can be eliminated through practice. Given the development of digital innovation and its wider systemic effects, this study discusses the disruption of digital technology and the emergence of digital natives. The influences and the interactions identified establish a foundation for empirical practitioners and future researchers.
The Risk Culture Framework: Introducing an Integrative Framework for Holistic Risk Analysis
Authors: Streicher Bernhard , Bielefeld Moritz , Eller Eric
Published: August 2023

Risk culture shapes individual, group, organizational, and societal risk perception, and behavior, and, therefore, is a promising concept in risk analysis. Risk culture concepts are popular among practitioners since they have the potential to integrate different research strands and provide practical guidelines. However, such concepts are still ill-defined, and their empirical foundations are limited. We introduce a new framework for risk culture derived from research on organizational culture and risk climate that aims to overcome the shortcomings of current models. The Risk Culture Framework is a 3 × 3 matrix that differentiates three influence domains (i.e., person, social context, and risk situation) and three cultural layers (i.e., observable, non-observable, and implicit factors). The framework can be applied in different contexts and fields of risk research. Each cell of the matrix can be filled with specific, proven factors relevant to the context of interest. The framework aims to enable the integration of different disciplines and approaches, to enlarge the understanding of mechanisms that shape risk perception and behavior, to navigate the conception of research studies, to provide a blueprint for comprehensive risk measures, to guide practical risk analysis, and to facilitate benchmarking for appropriate risk cultures. Considerations for the application of the Risk Culture Framework, as well as its validation through future research, are outlined.
A Rare Case of Infliximab-Induced Small Vessel Vasculitis With Renal Involvement
Authors: Way Anna , Weinstein Elena
Published: August 2023

There are few cases in the literature demonstrating vasculitis induced by tumor necrosis factor–α. There exist even fewer cases of systemic inflammation involving the skin, nerves, and kidneys. Here, we present a novel case of a 27-year-old man with Crohn disease refractory to multiple medications, most recently treated with infliximab. He presented with a 3-week history of non-blanching palpable petechial rash involving his bilateral extremities and right upper extremity as well as lesions with black eschar around his ankles. He was found to have refractory cutaneous small vessel vasculitis, nephrotic range proteinuria, and small fiber neuropathy. This case describes the evaluation and treatment of systemic small vessel vasculitis in the setting of infliximab therapy.
What You See Is Not What You Get: Germ Cell Tumor Mimicking Disseminated Coccidioidomycosis
Authors: Hajeh Haidar , Aboaid Hazem , Fox Kasey , Cobos Everardo , Heidari Arash
Published: August 2023

We present the case of a 30-year-old man with no prior medical history who presented to the hospital with a myriad of symptoms such as shortness of breath, generalized weakness, lower limb weakness, and urinary retention. He was recently diagnosed with “disseminated coccidioidomycosis” by an outside provider on an outpatient basis and started on fluconazole orally. However, due to a lack of improvement and significant symptoms, he was sent to the hospital to initiate liposomal amphotericin B treatment. After a comprehensive workup, an alternative diagnosis was suspected and eventually confirmed as metastatic germ cell carcinoma. Due to the vast dissemination and his poor functional status despite chemotherapy initiation, the patient elected for palliative care and expired shortly after at hospice. This case demonstrates the similarity of clinical findings between disseminated infections and malignancies.
Comparison of the Goutallier Classification of Fatty Infiltration for the Subscapularis With a Novel Modified Classification
Authors: Yoon Tae-Hwan , Kim Sung-Jae , Choi Yun-Rak , Oh Jung-Hyun , Chun Yong-Min
Published: August 2023

Background:

Fatty infiltration in the subscapularis muscle extends to the upper portion of the muscle first and then to the lower portion only after some degree of fatty change has taken place in the upper region. Although the Goutallier classification is the most widely used method to categorize fatty infiltration, how to accurately and reliably determine the extent of infiltration is controversial.

Purpose:

To examine a modified classification that is more reliable in (1) assessing fatty infiltration of the subscapularis muscle and (2) predicting the structural integrity of the repaired tendon by identifying cutoff points for retear.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

This study retrospectively examined the records of 545 patients who underwent arthroscopic repair for a subscapularis tear. Two shoulder surgeons reviewed the preoperative magnetic resonance imaging scans of all enrolled patients and evaluated the fatty infiltration of the subscapularis muscle based on the original Goutallier classification, as well as a novel modified Goutallier classification designed to measure the proportion of fat and muscle in the upper and lower portions of the muscle separately. Intra- and interobserver agreement of the reviewers was calculated using κ statistics. Using receiver operating characteristic curve analysis, we determined the cutoff point for the particular fatty infiltration grade related to the occurrence of retear for each classification scheme.

Results:

The κ values for interobserver reliability were 0.743 and 0.856 for the original and modified Goutallier classifications, respectively, with the modified classification having significantly higher reliability ( Z = 4.064; P < .001). Cutoff points for the fatty infiltration grade associated with retear were 2.5 for the original Goutallier classification (sensitivity, 65.3%; specificity, 95.6%; accuracy, 87.8%) and 3.5 for the modified classification (sensitivity, 52.5%; specificity, 97.8%; accuracy, 89.7%).

Conclusion:

In assessing fatty infiltration of the subscapularis muscle, the modified Goutallier classification showed higher reliability than the original Goutallier classification. The cutoff point for potential retear (grade 3.5) was at a point where the fatty infiltration extended to the lower portion of the subscapularis muscle.
Injury Rates at an NCAA Division I Institution After the COVID-19 Lockdown: A Descriptive Epidemiological Study
Authors: Angileri Hunter S. , Rosenberg Samuel I. , Tanenbaum Joseph E. , Terry Michael A. , Tjong Vehniah K.
Published: August 2023

Background:

The coronavirus 2019 (COVID-19) pandemic led to frequent schedule changes, abbreviated seasons, and disrupted training at all levels of organized sports.

Purpose/Hypothesis:

The purpose of this study was to investigate the epidemiology of sports-related injuries at a single National Collegiate Athletic Association (NCAA) Division I institution during the 2020 COVID lockdown season when compared with pre-COVID seasons. It was hypothesized that there would be an increase in the overall injury rate and an increase in the number of days missed because of injury during the 2020 season when compared with the previous seasons.

Study Design:

Descriptive epidemiology study.

Methods:

The injury surveillance database at a single NCAA Division I institution was queried for injuries that resulted in time loss (missed game or practice) for a student-athlete or for injuries that persisted >3 days. Injuries were categorized by anatomic area. Days unavailable because of injury were recorded as total days that a student-athlete was listed as “out of activity.” Injury incidence and days unavailable, per 1000 athlete-exposures (AEs), were calculated for 3 pre-COVID seasons (2017-2019) and the 2020 season. The authors calculated the injury rate ratio (IRR) and its associated 95% CI of the 2020 season in comparison with those for the pre-COVID seasons.

Results:

Compared with the pre-COVID seasons, the total injury incidence increased by 10.5% in the 2020 season (68.45 vs 75.65 injuries/1000 AEs; IRR, 1.11 [95% CI, 1.08-1.13]). Total days unavailable decreased by 20.7% in the 2020 season (1374 vs 1089 days/1000 AEs; IRR, 0.79 [95% CI, 0.77-2.26]). Compared with women’s teams, men’s teams had a larger increase in total injury incidence (16.4% vs 6.5%) and larger decrease in days unavailable (23.7% vs 10.75%). There were no clear trends to changes in anatomic distribution of injuries, either by sport or between the sexes.

Conclusion:

Compared with the pre-COVID seasons, the injury incidence was higher and the number of days missed because of injury lower among collegiate student-athletes at a single NCAA Division I school in the season immediately after the COVID-19 lockdown.
Human Papillomavirus Knowledge, Perception, and Willingness to Receive Vaccination Among Female University Students in Addis Ababa University, Ethiopia, 2022: A Cross-Sectional Study
Authors: Regasa Teferi , Sendo Endalew Gemechu , Deressa Jembere Tesfaye
Published: August 2023

Background

Cervical cancer is considered a leading cause of morbidity and mortality among females worldwide. Human papillomavirus is a highly prevalent sexually transmitted infection associated with increased cancer risks. Effective human papillomavirus vaccines are recommended for females in the adolescent years, but uptake has been less than optimal.

Objective

The objective of the study is to assess human papillomavirus knowledge, perception, and willingness to receive vaccination among female students in Addis Ababa University, Addis Ababa, Ethiopia, in 2022.

Methods

Institutional-based cross-sectional study was applied. The data were collected from 7 February to 15 April 2022. A total of 398 female students were recruited, and a multistage sampling technique was used to select the study participants. The data were entered into EpiData version 4.6 and analyzed using SPSS version 25. Bivariate and multivariable logistic regression analyses were used to determine the associations of variables.

Results

In this study, 161 (41%) of the students had good knowledge. About 226 (57.5%) had a more favorable perception regarding human papillomavirus and its vaccine, and 30% of the respondents were willing to receive the vaccine. The year level of study, having a history of sexual intercourse, having a family history of vaccination, and perception toward human papillomavirus and its vaccine were factors associated with students’ willingness to receive the human papillomavirus vaccine.

Conclusion

Educational programs are required to aware female students in Ethiopia considering their poor knowledge of human papillomavirus and its vaccine and the willingness of the students to receive the vaccine and related diseases. The inclusion of the HPV vaccine in the national immunization program that is in line with the World Health Organization’s recommendation should be considered as 118 (30%) of the participants show willingness to be vaccinated worldwide.
Self-Care and Quality of Life Among Adult Patients With Heart Failure: Scoping Review
Authors: Seid Sheka Shemsi , Amendoeira José , Ferreira Maria Regina
Published: August 2023

Introduction

Although self-care has a therapeutic effect on heart failure (HF), patients experience a marked reduction in physical and executive function, resulting in poor quality of life (QoL). A literature review revealed limited evidence regarding the possible relationship between self-care and QoL in HF patients. Therefore, this scoping review aimed to identify scientific evidence that examines the extent of self-care, QoL, and relationship between self-care and QoL in patients with HF.

Methods

Full-text research published from March 23, 2010, to March 23, 2020, written in English, that had content on both self-care and QoL among adult patients with HF was included. A literature search of electronic databases and web searches was conducted for published articles. Four databases were used: MEDLINE, Scopus, Web of Science, and the Cochrane Library. Studies collected from Google and Google Scholar web searches were also included.

Results

Of 1,537 papers identified by the search, 12 were included. The reviewed studies included 3,127 patients. Ten articles used a cross-sectional study design, whereas the remaining articles used a longitudinal and quasi-experimental design. This review found that the extent of self-care practices among patients with HF was inadequate, a significant proportion of patients enrolled in the reviewed studies had a moderate QoL, and higher self-care practices were associated with a better QoL. Self-care behavior and QoL were affected by social support, sex, age, educational level, place of residence, illness knowledge, presence of comorbidities, and functional classification of HF.

Conclusion

Self-care behavior was positively correlated with QoL in patients with HF. Self-care and QoL in these patients have been reported to be affected by several factors. Further research with a rigorous study design is recommended to investigate the influence of self-care practices on QoL in patients with HF.
Secondary prevention by structured semi-interactive stroke prevention package in INDIA (SPRINT INDIA): Findings from the process evaluation of a randomized controlled trial
Authors: Verma Shweta Jain , Gulati Puja , Injety Ranjit J , Arora Deepti , Dhasan Aneesh , Singhania Anusha , Khatter Himani , Sharma Meenakshi , Sylaja Padmavathyamma Narayanapillai , Pandian Jeyaraj Durai
Published: August 2023

Introduction:

Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in INDIA Trial delivered secondary stroke awareness intervention to sub-acute stroke patients in form of workbook, videos and SMS across 31 centres in 12 languages. Trial was stopped for futility due to fewer vascular outcomes than anticipated. Trial results indicated that trial intervention, did not lead to reduction in vascular events. We carried out process evaluation, to evaluate trial implementation and participant’s perspectives, to comprehend the trial’s futile outcomes.

Materials and Methods:

Using mixed methods approach, qualitative interviews and quantitative data from case report forms, workbooks and questionnaires were analysed to measure intervention fidelity and contamination. Using purposive sampling, 115 interviews of patient-caregiver dyads and health professionals at 11 centres and 2 focus group discussions were held.

Results and discussion:

Iterative thematic analysis of qualitative data was done with RE-AIM and realist models. There was good fidelity to intervention and adherence to protocol; however, there was dilution of inclusion criteria by randomly enrolling uneducated and caregiver-dependent patients. Centre coordinators provided counselling to both arms, not specified by protocol, causing bias. Coordinators found it difficult to keep patients motivated to view intervention which was corroborated by fidelity questionnaire showing decreased viewing of intervention for a year. Cardiovascular protection improved in routine care by virtue of participating in trial. No contamination of intervention was reported.

Conclusion:

The intervention was acceptable by patients and caregivers, which could be made a community-based programme. Reasons identified for decreased viewing were repetitive content and non-availability of personal cellular device.
Gut microbiota diversity before allogeneic hematopoietic stem cell transplantation as a predictor of mortality in children
Authors: Masetti Riccardo , Leardini Davide , Muratore Edoardo , Fabbrini Marco , D’Amico Federica , Zama Daniele , Baccelli Francesco , Gottardi Francesca , Belotti Tamara , Ussowicz Marek , Fraczkiewicz Jowita , Cesaro Simone , Zecca Marco , Merli Pietro , Candela Marco , Pession Andrea , Locatelli Franco , Prete Arcangelo , Brigidi Patrizia , Turroni Silvia
Published: August 2023

The correlation existing between gut microbiota diversity and survival after allogeneic hematopoietic stem cell transplantation (allo-HSCT) has so far been studied in adults. Pediatric studies question whether this association applies to children as well. Stool samples from a multicenter cohort of 90 pediatric allo-HSCT recipients were analyzed using 16S ribosomal RNA amplicon sequencing to profile the gut microbiota and estimate diversity with the Shannon index. A global-to-local networking approach was used to characterize the ecological structure of the gut microbiota. Patients were stratified into higher- and lower-diversity groups at 2 time points: before transplantation and at neutrophil engraftment. The higher-diversity group before transplantation exhibited a higher probability of overall survival (88.9% ± 5.7% standard error [SE] vs 62.7% ± 8.2% SE; P = .011) and lower incidence of grade 2 to 4 and grade 3 to 4 acute graft-versus-host disease (aGVHD). No significant difference in relapse-free survival was observed between the 2 groups (80.0% ± 6.0% SE vs 55.4% ± 10.8% SE; P = .091). The higher-diversity group was characterized by higher relative abundances of potentially health-related microbial families, such as Ruminococcaceae and Oscillospiraceae. In contrast, the lower-diversity group showed an overabundance of Enterococcaceae and Enterobacteriaceae. Network analysis detected short-chain fatty acid producers, such as Blautia, Faecalibacterium, Roseburia, and Bacteroides, as keystones in the higher-diversity group. Enterococcus, Escherichia-Shigella, and Enterobacter were instead the keystones detected in the lower-diversity group. These results indicate that gut microbiota diversity and composition before transplantation correlate with survival and with the likelihood of developing aGVHD.
CARD11 gain of function upregulates BCL2A1 expression and promotes resistance to targeted therapies combination in B-cell lymphoma
Authors: Decombis Salomé , Bellanger Celine , Le Bris Yannick , Madiot Candice , Jardine Jane , Santos Juliana Carvalho , Boulet Delphine , Dousset Christelle , Menard Audrey , Kervoelen Charlotte , Douillard Elise , Moreau Philippe , Minvielle Stephane , Moreau-Aubry Agnes , Tessoulin Benoit , Roue Gael , Bidère Nicolas , Le Gouill Steven , Pellat-Deceunynck Catherine , Chiron David
Published: August 2023

A strategy combining targeted therapies is effective in B-cell lymphomas (BCL), such as mantle cell lymphoma (MCL), but acquired resistances remain a recurrent issue. In this study, we performed integrative longitudinal genomic and single-cell RNA-sequencing analyses of patients with MCL who were treated with targeted therapies against CD20, BCL2, and Bruton tyrosine kinase (OAsIs trial). We revealed the emergence of subclones with a selective advantage against OAsIs combination in vivo and showed that resistant cells were characterized by B-cell receptor (BCR)–independent overexpression of NF-κB1 target genes, especially owing to CARD11 mutations. Functional studies demonstrated that CARD11 gain of function not only resulted in BCR independence but also directly increased the transcription of the antiapoptotic BCL2A1, leading to resistance against venetoclax and OAsIs combination. Based on the transcriptional profile of OAsIs-resistant subclones, we designed a 16-gene resistance signature that was also predictive for patients with MCL who were treated with conventional chemotherapy, underlying a common escape mechanism. Among druggable strategies to inhibit CARD11-dependent NF-κB1 transduction, we evaluated the selective inhibition of its essential partner MALT1. We demonstrated that MALT1 protease inhibition led to a reduction in the expression of genes involved in OAsIs resistance, including BCL2A1. Consequently, MALT1 inhibition induced synergistic cell death in combination with BCL2 inhibition, irrespective of CARD11 mutational status, both in vitro and in vivo. Taken together, our study identified mechanisms of resistance to targeted therapies and provided a novel strategy to overcome resistance in aggressive BCL. The OAsIs trial was registered at www.clinicaltrials.gov #NCT02558816.
Necessary and Sufficient Conditions for Feasible Neighbourhood Solutions in the Local Search of the Job-Shop Scheduling Problem
Authors: Gui Lin , Li Xinyu , Gao Liang , Wang Cuiyu
Published: August 2023

The meta-heuristic algorithm with local search is an excellent choice for the job-shop scheduling problem (JSP). However, due to the unique nature of the JSP, local search may generate infeasible neighbourhood solutions. In the existing literature, although some domain knowledge of the JSP can be used to avoid infeasible solutions, the constraint conditions in this domain knowledge are sufficient but not necessary. It may lose many feasible solutions and make the local search inadequate. By analysing the causes of infeasible neighbourhood solutions, this paper further explores the domain knowledge contained in the JSP and proposes the sufficient and necessary constraint conditions to find all feasible neighbourhood solutions, allowing the local search to be carried out thoroughly. With the proposed conditions, a new neighbourhood structure is designed in this paper. Then, a fast calculation method for all feasible neighbourhood solutions is provided, significantly reducing the calculation time compared with ordinary methods. A set of standard benchmark instances is used to evaluate the performance of the proposed neighbourhood structure and calculation method. The experimental results show that the calculation method is effective, and the new neighbourhood structure has more reliability and superiority than the other famous and influential neighbourhood structures, where 90% of the results are the best compared with three other well-known neighbourhood structures. Finally, the result from a tabu search algorithm with the new neighbourhood structure is compared with the current best results, demonstrating the superiority of the proposed neighbourhood structure.
Effect of thermal modification on the stress relaxation behavior and microstructure of the cell wall
Authors: Murata Koji , Utsumi Mayumi , Hirata Tomoya , Nakamura Masashi
Published: August 2023

The stress relaxation behavior and cell wall microstructure of sugi were evaluated after thermal modification. Stress relaxation is observed and has a broad relaxation spectrum, implying various relaxation mechanisms. The relaxation was analyzed using a stretched exponential function, namely, the Kohlrausch–Williams–Watts (KWW) function, which contains two parameters. Moreover, the structure of the amorphous phase in the cell wall was examined by small-angle X-ray scattering (SAXS) analysis using the mass fractal dimension. The variation in the relaxation spectrum reduced, and the specific relaxation time increased by thermal modification at 220 °C. The mass fractal dimension in SAXS increased owing to modification, indicating that the structure of the cell wall includes some defects between cellulose microfibrils. The mass fractal dimension was related to the relaxation parameter of the KWW function. Considering the change in crystallinity, the amorphous phase in the cell wall decomposed and condensed by thermal decomposition, which caused a longer relaxation time. Thus, the KWW function may be used to evaluate the stress relaxation behavior of wood, and the mass fractal dimension in SAXS can indicate the amorphous structure in the cell wall.
Integrating bioinformatic resources to identify characteristics of rheumatoid arthritis-related usual interstitial pneumonia
Authors: Qiu Yulu , Liu Chang , Shi Yumeng , Hao Nannan , Tan Wenfeng , Wang Fang
Published: August 2023

Background

Rheumatoid arthritis (RA) is often accompanied by a common extra-articular manifestation known as RA-related usual interstitial pneumonia (RA-UIP), which is associated with a poor prognosis. However, the mechanism remains unclear. To identify potential mechanisms, we conducted bioinformatics analysis based on high-throughput sequencing of the Gene Expression Omnibus (GEO) database.

Results

Weighted gene co-expression network analysis (WGCNA) analysis identified 2 RA-positive related modules and 4 idiopathic pulmonary fibrosis (IPF)-positive related modules. A total of 553 overlapped differentially expressed genes (DEG) were obtained, of which 144 in the above modules were further analyzed. The biological process of “oxidative phosphorylation” was found to be the most relevant with both RA and IPF. Additionally, 498 up-regulated genes in lung tissues of RA-UIP were screened out and enriched by 7 clusters, of which 3 were closely related to immune regulation. The analysis of immune infiltration showed a characteristic distribution of peripheral immune cells in RA-UIP, compared with IPF-UIP in lung tissues.

Conclusions

These results describe the complex molecular and functional landscape of RA-UIP, which will help illustrate the molecular pathological mechanism of RA-UIP and identify new biomarkers and therapeutic targets for RA-UIP in the future.
Variation in the morphology and effector profiles of Exserohilum turcicum isolates associated with the Northern Corn Leaf Blight of maize in Nigeria
Authors: Bankole Faith A. , Badu-Apraku Baffour , Salami Abiodun O. , Falade Titilayo D.O. , Bandyopadhyay Ranajit , Ortega-Beltran Alejandro
Published: August 2023

Background

Maize production in lowland agro-ecologies in West and Central Africa is constrained by the fungus Exserohilum turcicum, causal agent of Northern Corn Leaf Blight (NCLB). Breeding for resistance to NCLB is considered the most effective management strategy. The strategy would be even more effective if there is adequate knowledge of the characteristics of E. turcicum in a target region. Maize leaves showing NCLB symptoms were collected during field surveys in three major maize growing areas in Nigeria: Ikenne, Ile-Ife, and Zaria during 2018/2019 and 2019/2020 growing seasons to characterize E. turcicum populations interacting with maize using morphological and molecular criteria.

Results

A total of 217 E. turcicum isolates were recovered. Most of the isolates (47%) were recovered from the Ikenne samples while the least were obtained from Zaria. All isolates were morphologically characterized. A subset of 124 isolates was analyzed for virulence effector profiles using three primers: SIX13-like, SIX5-like, and Ecp6. Inter- and intra-location variations among isolates was found in sporulation, growth patterns, and presence of the effectors. Candidate effector genes that condition pathogenicity and virulence in E. turcicum were found but not all isolates expressed the three effectors.

Conclusion

Morphological and genetic variation among E. turcicum isolates was found within and across locations. The variability observed suggests that breeding for resistance to NCLB in Nigeria requires selection for quantitative resistance to sustain the breeding efforts.
Prognostic Nutritional Index (PNI) as a potential predictor and intervention target for perioperative ischemic stroke: a retrospective cohort study
Authors: Liu Min , Sun Miao , Zhang Ting , Li Peng , Liu Jin , Liu Yanhong , Song Yuxiang , Liu Siyuan , Yang Huikai , Zhou Zhikang , Chang Dandan , Wang Guyan , Mi Weidong , Ma Yulong
Published: August 2023

Background

The prognostic nutritional index (PNI) is a nutritional indicator and predictor of various diseases. However it is unclear whether PNI can be a predictor of perioperative ischemic stroke. This study aims to evaluate the association of the preoperative PNI and ischemic stroke in patients undergoing non-cardiac surgery.

Methods

The retrospective cohort study included patients who underwent noncardiac surgery between January 2008 and August 2019. The patients were divided into PNI ≥ 38.8 and PNI < 38.8 groups according to the cut-off value of PNI. Univariate and multivariate logistic regression analyses were performed to explore the association between PNI and perioperative ischemic stroke. Subsequently, propensity score matching (PSM) analysis was performed to eliminate the confounding factors of covariates and further validate the results. Subgroup analyses were completed to assess the predictive utility of PNI for perioperative ischemic stroke in different groups.

Results

Amongst 221,542 hospitalized patients enrolled, 485 (0.22%) experienced an ischemic stroke within 30 days of the surgery, 22.1% of patients were malnourished according to PNI < 38.8, and the occurrence of perioperative ischemic stroke was 0.34% (169/49055) in the PNI < 38.8 group. PNI < 38.8 was significantly associated with an increased incidence of perioperative ischemic stroke whether in univariate logistic regression analysis (OR = 1.884, 95% CI: 1.559—2.267, P < 0.001) or multivariate logistic regression analysis (OR = 1.306, 95% CI: 1.061—1.602, P = 0.011). After PSM analysis, the ORs of PNI < 38.8 group were 1.250 (95% CI: 1.000–1.556, P = 0.050) and 1.357 (95% CI: 1.077–1.704, P = 0.009) in univariate logistic regression analysis and multivariate logistic regression analysis respectively. The subgroup analysis indicated that reduced PNI was significantly associated to an increased risk of perioperative ischemic stroke in patients over 65 years old, ASA II, not taking aspirin before surgery, without a history of stroke, who had neurosurgery, non-emergency surgery, and were admitted to ICU after surgery.

Conclusions

Our study indicates that low preoperative PNI is significantly associated with a higher incidence of ischemic stroke in patients undergoing non-cardiac surgery. Preoperative PNI, as a preoperative nutritional status evaluation index, is an independent risk factor useful to predict perioperative ischemic stroke risk, which could be used as an intervenable preoperative clinical biochemical index to reduce the incidence of perioperative ischemic stroke.
A nomogram based on CT texture features to predict the response of patients with advanced pancreatic cancer treated with chemotherapy
Authors: Li Jingjing , Du Jiadi , Li Yuying , Meng Mingzhu , Hang Junjie , Shi Haifeng
Published: August 2023

Objective

This study aimed to evaluate the predictive value of computed tomography (CT) texture features in the treatment response of patients with advanced pancreatic cancer (APC) receiving palliative chemotherapy.

Methods

This study enrolled 84 patients with APC treated with first-line chemotherapy and conducted texture analysis on primary pancreatic tumors. 59 patients and 25 were randomly assigned to the training and validation cohorts at a ratio of 7:3. The treatment response to chemotherapy was evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST1.1). The patients were divided into progressive and non-progressive groups. The least absolute shrinkage selection operator (LASSO) was applied for feature selection in the training cohort and a radiomics signature (RS) was calculated. A nomogram was developed based on a multivariate logistic regression model incorporating the RS and carbohydrate antigen 19-9 (CA19-9), and was internally validated using the C-index and calibration plot. We performed the decision curve analysis (DCA) and clinical impact curve analysis to reflect the clinical utility of the nomogram. The nomogram was further externally confirmed in the validation cohort.

Results

The multivariate logistic regression analysis indicated that the RS and CA19-9 were independent predictors (P < 0.05), and a trend was found for chemotherapy between progressive and non-progressive groups. The nomogram incorporating RS, CA19-9 and chemotherapy showed favorable discriminative ability in the training (C-index = 0.802) and validation (C-index = 0.920) cohorts. The nomogram demonstrated favorable clinical utility.

Conclusion

The RS of significant texture features was significantly associated with the early treatment effect of patients with APC treated with chemotherapy. Based on the RS, CA19-9 and chemotherapy, the nomogram provided a promising way to predict chemotherapeutic effects for APC patients.
Differential effects of lifestyle activities on disability incidence based on neighborhood amenities
Authors: Katayama Osamu , Lee Sangyoon , Bae Seongryu , Makino Keitaro , Chiba Ippei , Harada Kenji , Shinkai Yohei , Shimada Hiroyuki
Published: August 2023

Background

This study examined the effect of neighborhood amenities on disability risk among community-dwelling older adults in Japan, based on lifestyle activities.

Method

This was an observational prospective cohort study. Participants comprised 13,258 older adults from the National Center for Geriatrics and Gerontology–Study of Geriatric Syndromes. We calculated participants’ Walk Score using their home addresses and divided them into three groups: “car-dependent,” “somewhat walkable,” and “very walkable.” We then calculated the average value of lifestyle activities. We divided the neighborhood amenity groups into two groups, “fewer lifestyle activities” and “more lifestyle activities,” for a total of six groups. After identifying interactions between neighborhood amenities and lifestyle activities, Cox proportional hazard models to calculate hazard ratios for incident disability risk, based on neighborhood amenities and lifestyle activities.

Results

An interaction occurred between neighborhood amenities and lifestyle activities (p < 0.05). Survival probabilities for incident disability based on lifestyle activities were estimated for each neighborhood amenity group: car-dependent, 1.62 (95% CI 1.07 to 2.46); somewhat walkable, 1.08 (95% CI 0.84 to 1.40); and very walkable, 1.05 (95% CI 0.87 to 1.27). Those with fewer lifestyle activities in the car-dependent group exhibited the highest risk of incident disability in the unadjusted and adjusted models.

Conclusion

Given that the aging population is increasing steadily, considering older adults’ neighborhood amenities and lifestyle activities in their day-to-day lives can help clinicians to deliver more older adult-centered care. Incorporating the lifestyle activities and neighborhood amenities of older adults into care planning will lead to the design and development of integrated clinical and community screening programs.
Change of sexual behavior among men who have sex with men before, during and after COVID-19 pandemic in China: a cross-sectional study
Authors: Wang Shi , Yang Jie , Niu Dandan , Hou Yushan , Fei Liping , Zhao Hehe , Chen Fangfang , Lv Fan
Published: August 2023

Introduction

The COVID-19 epidemic control and prevention strategies affected people’s sexual activities and behaviors. Little was known about long-term effects of COVID-19 prevention and control strategies on sexual behaviors among men who have sex with men (MSM). This study aimed to examine changes in risky sexual behaviors of MSM before and after the local epidemic.

Methods

An online survey was conducted nationwide from June 1 to June 10, 2022. MSM aged 16 years and above, residing in China were recruited through convenience sampling. A generalized estimating equation model with modified Poisson regression was used to analyze changes in multiple sexual partners, unprotected sex, mobility for sexual activity, and recreational substance use before and after the local epidemic.

Results

Compared to the pre-pandemic (36.5%), the prevalence of multiple sexual partners (11.5%) significantly decreased during the local epidemic and then increased after the local epidemic (25.2%) but remained lower than pre-pandemic, as did the prevalence of unprotected sex (31.1%, 19.4%, and 26.1%), mobility for sexual activity (7.5%, 2.8%, and 4.1%) and recreational substance use (47.7%, 27.2%, and 39.5%). Compared to the pre-pandemic, higher declines in the prevalence of risky sexual behaviors during the local epidemic existed among MSM living without a regular partner (44% decrease in unprotected sex and 46% in recreational substance use), with a bachelor’s degree and above (70% decrease in multiple sex partners, 39% in unprotected sex, 67% in mobility for sexual activity and 44% in recreational substance use), higher incomes (70% decrease in multiple sex partners), self-identified gay or bisexual/unsure (38-71%), and HIV infection (49-83% decrease respectively in these four indicators). After the local epidemic, the declines in the above indicators compared to the pre-pandemic were correspondingly. And higher declines existed among MSM living without a regular partner (8% decrease in unprotected sex and 13% in recreational substance use), with a bachelor’s degree and above (33% decrease in multiple sex partners), higher incomes (55% decrease in mobility for sexual activity), self-identified gay (51% decrease in mobility for sexual activity), and HIV infection (32%, 68%, 24% decrease respectively in unprotected sex, mobility for sexual activity and recreational substance use).

Conclusions

Risky sexual behaviors reduced considerably during the local epidemic, then seemed rebounded after the outbreak but wouldn’t return to pre-pandemic levels. More attention should be paid to vulnerable people with lower socio-economic status, HIV-positive, and sexual minorities for sustained HIV and COVID-19 prevention.
Intractable hiccups after VNS implantation: a case report
Authors: Recio Susan Zhang , Abdennadher Myriam
Published: August 2023

Background

Hiccups (medically termed, “singultus”), when intractable, can cause significant medical consequences such as aspiration, malnutrition, and depression, leading to poor quality of life. Several case reports have shown that vagus nerve stimulator (VNS) implantation can help treat central idiopathic intractable hiccups. However, we present a contrary case of a patient who developed intractable singultus following VNS placement for medically refractory epilepsy.

Case presentation

We report a 71-year-old male patient with drug-resistant epilepsy who underwent VNS implantation and developed intractable hiccups shortly thereafter. The hiccups were severe and persistent, such that the patient developed a Mallory-Weiss tear, which required intensive care, invasive intubation and mechanical ventilation, and a prolonged rehabilitation course. Despite multiple therapies including phrenic nerve block and Nissen fundoplication, the patient’s hiccups persisted and only stopped once the VNS was permanently deactivated.

Conclusions

Little is known about the incidence of hiccups after VNS implantation. We present one case of hiccups as a direct consequence of VNS implantation. The clinical impact of this report is significant given the relative unfamiliarity of hiccups as an adverse effect of VNS implantation. Neurologists and epileptologists, who present VNS implantation as a surgical option for seizure control to their patients, should be aware of the possibility of singultus development and its significant physical and emotional ramifications.
Ultrasound for diagnosis of postpartum retained products of conception—How accurate we are?
Authors: Yagur Yael , Jurman Liron , Weitzner Omer , Arbib Nissim , Markovitch Ofer , Klein Zvi , Daykan Yair , Schonman Ron
Published: August 2023

Objective

Postpartum retained products of conception (RPOC) can cause short- and long-term complications. Diagnosis is based on ultrasound examination and treated with hysteroscopy. This study evaluated the size of RPOC that can be related to a positive pathology result for residua.

Materials and methods

This retrospective cohort study included women who underwent hysteroscopy for postpartum RPOC diagnosed by ultrasound, 4/2014–4/2022. Demographics, intrapartum, sonographic, intraoperative, and post-operative data were retrieved. We generated a ROC curve and found 7 mm was the statistically sonographic value for positive pathology for RPOC. Data between women with sonographic RPOC ≤ 7 mm and > 7 mm were compared. Positive and negative predictive values were calculated for RPOC pathology proved which was measured by ultrasound.

Results

Among 212 patients who underwent hysteroscopy due to suspected RPOC on ultrasound, 20 (9.4%) women had residua ≤ 7 mm and 192 (90.6%) had residua > 7 mm. The most common complaint was vaginal bleeding in 128 cases (60.4%); more so in the residua > 7 mm group (62.5% vs. 40%, p = .05). Among women with residua ≤ 7 mm, the interval from delivery to hysteroscopy was longer (117.4 ± 74.7 days vs. 78.8 ± 68.8 days, respectively; p = .02). Positive pathology was more frequent when residua was > 7 mm. PPV for diagnosis of 7 mm RPOC during pathology examination was 75.3% and NPV 50%.

Conclusions

Sonographic evaluation after RPOC showed that residua > 7 mm was statistically correlated with positive RPOC in pathology and PPV of 75% and NPV of 50%. Due to the high NPV and low complication rate of office hysteroscopy, clinicians should consider intervention when any RPOC are measured during sonographic examination to reduce known long-term complications.