bluuebunny/crossref_metadata_2025 huggingface dataset:
Efforts to Improve Survival Outcomes of Out-of-Hospital Cardiac Arrest in China: BASIC-OHCA
Authors: Xie Xi , Zheng Jiaqi , Zheng Wen , Pan Chang , Ma Yu , Zhu Yimin , Tan Huiqiong , Han Xiaotong , Yan Shengtao , Zhang Guoqiang , Li Chaoqian , Shao Fei , Wang Chunyi , Zhang Jianbo , Bian Yuan , Ma Jingjing , Cheng Kai , Liu Rugang , Sang Shaowei , Zhang Yongsheng , McNally Bryan , Ong Marcus E.H. , Lv Chuanzhu , Chen Yuguo , Xu Feng ,   on behalf of the BASIC-OHCA Coordinators and Investigators
Published: December 2022

Background:

Establishing registries to collect demographic characteristics, processes of care, and outcomes of patients with out-of-hospital cardiac arrest (OHCA) can better understand epidemiological trends, measure care quality, and identify opportunities for improvement. This study aimed to describe the design, implementation, and scientific significance of a nationwide registry―the BASIC-OHCA (Baseline Investigation of Out-of-Hospital Cardiac Arrest)―in China.

Methods:

BASIC-OHCA was designed as a prospective, multicenter, observational, population-based study. The BASIC-OHCA registry was developed based on Utstein templates. BASIC-OHCA includes all OHCA patients confirmed by emergency medical services (EMS) personnel regardless of age, sex, or cause. Patients declared dead at the scene by EMS personnel for any reasons are also included. To fully characterize an OHCA event, BASIC-OHCA collects data from 3 sources—EMS, the receiving hospital, and patient follow-up—and links them to form a single record. Once data entry is completed and quality is checked, individual identifiers are stripped from the record.

Results:

Currently, 32 EMS agencies in 7 geographic regions contribute data to BASIC-OHCA. They are distributed in the urban and rural areas, covering ≈9% of the population of mainland China. Data collection started on August 1, 2019. By July 31, 2020, a total of 92 913 EMS-assessed OHCA patients were enrolled. Among 28969 (31.18%) EMS-treated OHCAs, the mean age was 65.79±17.36 years, and 68.35% were males. The majority of OHCAs (76.85%) occurred at home or residence. A shockable initial rhythm was reported in 5.43% of patients. Any return of spontaneous circulation, survival to hospital discharge, and favorable neurological outcome at hospital discharge were 5.98%, 1.15%, and 0.83%, respectively.

Conclusions:

BASIC-OHCA is the first nationwide registry on OHCA in China. It can be used as a public health surveillance system and as a platform to produce evidence-based practices to help identify opportunities for improvement.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03926325.
Direct Reprogramming Improves Cardiac Function and Reverses Fibrosis in Chronic Myocardial Infarction
Authors: Tani Hidenori , Sadahiro Taketaro , Yamada Yu , Isomi Mari , Yamakawa Hiroyuki , Fujita Ryo , Abe Yuto , Akiyama Tatsuya , Nakano Koji , Kuze Yuta , Seki Masahide , Suzuki Yutaka , Fujisawa Manabu , Sakata-Yanagimoto Mamiko , Chiba Shigeru , Fukuda Keiichi , Ieda Masaki
Published: December 2022

Background:

Because adult cardiomyocytes have little regenerative capacity, resident cardiac fibroblasts (CFs) synthesize extracellular matrix after myocardial infarction (MI) to form fibrosis, leading to cardiac dysfunction and heart failure. Therapies that can regenerate the myocardium and reverse fibrosis in chronic MI are lacking. The overexpression of cardiac transcription factors, including
Mef2c/Gata4/Tbx5/Hand2
(MGTH), can directly reprogram CFs into induced cardiomyocytes (iCMs) and improve cardiac function under acute MI. However, the ability of in vivo cardiac reprogramming to repair chronic MI with established scars is undetermined.

Methods:

We generated a novel Tcf21
iCre
/reporter/MGTH2A transgenic mouse system in which tamoxifen treatment could induce both MGTH and reporter expression in the resident CFs for cardiac reprogramming and fibroblast lineage tracing. We first tested the efficacy of this transgenic system in vitro and in vivo for acute MI. Next, we analyzed in vivo cardiac reprogramming and fusion events under chronic MI using Tcf21
iCre
/Tomato/MGTH2A and Tcf21
iCre
/mTmG/MGTH2A mice, respectively. Microarray and single-cell RNA sequencing were performed to determine the mechanism of cardiac repair by in vivo reprogramming.

Results:

We confirmed the efficacy of transgenic in vitro and in vivo cardiac reprogramming for acute MI. In chronic MI, in vivo cardiac reprogramming converted ≈2% of resident CFs into iCMs, in which a majority of iCMs were generated by means of bona fide cardiac reprogramming rather than by fusion with cardiomyocytes. Cardiac reprogramming significantly improved myocardial contraction and reduced fibrosis in chronic MI. Microarray analyses revealed that the overexpression of MGTH activated cardiac program and concomitantly suppressed fibroblast and inflammatory signatures in chronic MI. Single-cell RNA sequencing demonstrated that resident CFs consisted of 7 subclusters, in which the profibrotic CF population increased under chronic MI. Cardiac reprogramming suppressed fibroblastic gene expression in chronic MI by means of conversion of profibrotic CFs to a quiescent antifibrotic state. MGTH overexpression induced antifibrotic effects partly by suppression of Meox1, a central regulator of fibroblast activation.

Conclusions:

These results demonstrate that cardiac reprogramming could repair chronic MI by means of myocardial regeneration and reduction of fibrosis. These findings present opportunities for the development of new therapies for chronic MI and heart failure.
Strategically Managing the Business Model Portfolio Trajectory
Authors: Snihur Yuliya , Thomas Llewellyn D. W. , Burgelman Robert A.
Published: December 2022

This article presents a strategic decision-making tool to assist corporate management in analyzing the trajectory of their business model portfolio. The tool provides a robust means of assessing the trajectory of a business model portfolio through the evolution of inter-business model complementarity and intra-business model complexity. The article illustrates the use of the tool through the example of the radical restructuring of Hewlett Packard’s (HP) business model portfolio in 2015, which resulted in two smaller, more adaptive corporate entities with distinct business models that could pursue redefined growth opportunities after the split.
Does Residential Context Matter? Neighborhood Migrant Concentration and Citizenship Acquisition in the Netherlands
Authors: Leclerc Christophe , Vink Maarten , Schmeets Hans
Published: December 2022

Existing studies analyzing the relation between immigrants’ residential environment and their propensity to naturalize produce contradictory findings. These results are difficult to interpret, as studies typically do not measure residential characteristics at a sufficiently fine-grained scale to test hypotheses about social networks and naturalization, do not model the data's multi-level structure appropriately, and do not account for selection into the residential environment. To address these shortcomings, this article draws on longitudinal micro-data from administrative registers at the neighborhood level in the Netherlands (approximately 1300 residents per neighborhood). We employ a stratified Cox proportional hazard model with shared frailty and inverse probability of treatment weighting to reduce bias due to self-selection into neighborhoods and draw on proxies of social networks in such areas. Our analyses provide support for the ‘migrant enclosure hypothesis,’ as we find that greater migrant concentration in the neighborhood is associated with lower naturalization rates and largely driven by the density of migrant social networks in those residential areas. In the Dutch context, this negative effect of migrant enclosure is especially prevalent among the large, long-settled migrant communities from Morocco and Turkey. We also find support for the ‘naturalization diffusion hypothesis’ and observe that the negative naturalization effect of residing in neighborhoods with higher levels of migrant concentration is offset by the presence of immigrants who have completed the naturalization procedure. Together, these findings reveal a nuanced picture that contrasts with de-contextualized cost-benefit theories of immigrant naturalization and highlights the relevance of the local context of immigrant settlement.
Early literacy and family engagement: A cross-country analysis of caregivers’ perceptions of the public library's role in the digital age in Taiwan, Malaysia, and Vietnam
Authors: Sung Hui-Yun , Abdullah Noorhidawati , Huyen Ngo Thi
Published: December 2022

This study aims to explore caregivers’ perceptions of the public library's role in supporting early literacy and family engagement in the digital age in Asia. Family engagement is important from birth through young adulthood, and public libraries matter for family engagement. However, this topic has been little explored in Asian countries. Structured interviews were conducted with librarians, followed by a survey approach to understand what caregivers of five- to 12-year-old children think about the scope of family engagement practices in public libraries in Taiwan, Malaysia, and Vietnam. In total, 454 valid questionnaires were collected. Findings show that caregivers value the importance of public libraries’ role in promoting family engagement in the digital age in Taiwan, Malaysia, and Vietnam. In order to reap the rewards of family engagement practices, public libraries are suggested to build relationships with families through proactively understanding families’ interests and needs, involving families in the library decision-making process, and engaging families in both print-based and digital literacy programmes.
Prevalence of Dental and Skeletal Malocclusions in Mesaticephalic and Dolichocephalic Dogs—a Retrospective Study (2015–2018)
Authors: Berman Marissa , Soltero-Rivera Maria , Scanlan Amy J Fulton
Published: December 2022

Medical records of dogs with dolico- or mesaticephalic conformation who were presented to a private veterinary referral dental practice with malocclusion of the deciduous or permanent dentition were retrospectively reviewed from a 3-year period (2015–2018). Records were evaluated to determine the type(s) of malocclusions and 198 dogs were evaluated with permanent malocclusions. Of the dogs with deciduous malocclusions, 45 (60%) had variations of a MAL1, 28 (38%) had a MAL2, 13 (17.6%) had a MAL3, and four (5.4%) had a MAL4, with 19 (26%) having more than one type of malocclusion. Poodles, Labrador Retrievers, and Cavalier King Charles Spaniels consisted of 37 (50%) of the dogs with deciduous malocclusions. Fifty-five (74%) dogs proceeded with interceptive orthodontics. Of the dogs with permanent malocclusions, 128 (65%) had a variant of a MAL1, 60 (30%) had a MAL2, 75 (38%) had a MAL3, and 11 (5.6%) had a MAL4, with a MAL1 occurring concurrently with 49 (82%) MAL2 cases. The most common type of MAL1 was linguoversion of one or both mandibular canine teeth in 92 (72%) dogs. The five most commonly affected breeds with permanent malocclusions were Poodles, Labrador Retrievers, Chihuahuas, Pit Bull Terriers, and Cavalier King Charles Spaniels. Overall, 39 (18%) dogs presented with malocclusions observed in this study were associated with the Poodle breed and 20 (9%) dogs were associated with the Labrador Retriever breed. This trend among Poodle mixes and Labrador Retrievers supports a familial pattern to malocclusions.
A Retrospective Study of Ectopic Eruption in 35 Dogs
Authors: Klim Emilia Barbara , Mestrinho Lisa Alexandra , Gawor Jerzy Pawel
Published: December 2022

Ectopic eruption results from a disturbance in tooth development and eruption, leading to an erupted or non-erupted tooth being in an unexpected anatomical location. This retrospective case series describes the location, position, form, and clinical signs associated with ectopic eruption in dogs. Thirty-five dogs (46 teeth) were diagnosed with ectopic eruption at three clinical practices during 2017-2020. The cases were described in terms of the location, the development and eruption status, the clinical signs, the consequences, and the treatment performed. The collected data were statistically analyzed to establish possible ramifications. The results showed that the ectopic eruption in the evaluated cases involved permanent teeth, mainly located in the maxilla, and mostly unerupted. Those located in the mandible were significantly more impacted than those located in the maxilla. This study concluded that tooth crowding and malocclusion (39.1%), facial swelling (8.6%), and periodontal disease (8.6%) were associated with the presence of ectopic eruption, and consequently, treatment was required in the majority (65.2%) of cases.
Design and Xilinx Virtex-field-programmable gate array for hardware in the loop of sensorless second-order sliding mode control and model reference adaptive system–sliding mode observer for direct torque control of induction motor drive
Authors: Krim Saber , Mimouni Mohamed Faouzi
Published: December 2022

This article aims first to propose an improved space vector modulation–direct torque control in order to enhance the induction motor performance using: (1) a super-twisting controller and (2) a novel model reference adaptive system based on a sliding mode observer. Second, due to the complexity of the suggested control algorithm, this article deals also with a hardware implementation on a field-programmable gate array board. Indeed, the field-programmable gate array is mainly chosen to reduce the execution time, thanks to its parallel processing which significantly improves the quality of the control system by reducing the sampling period, and consequently the delays in the control loop. Besides, the super-twisting controller is proposed to enhance the speed regulation loop which is a second-order sliding mode control technique that uses a continuous control law to prevent the chattering phenomenon induced by the first-order sliding mode control technique. Moreover, the high performance control requires information about the rotor speed which can be obtained by a sensor. Generally, the use of the speed sensor increases the system cost and size, and reduces its system reliability. Therefore, a combination between a model reference adaptive system observer and a sliding mode observer is suggested for speed estimation and overcoming the sensitivity of the classical model reference adaptive system observer against uncertainties and stator resistance variations. The performance of the proposed space vector modulation--direct torque control--super-twisting controller with the model reference adaptive system--sliding mode observer algorithm of an induction motor is verified through simulation, hardware co-simulation and experimental validation utilizing a field-programmable gate array Virtex-5-ML507 board. The performance of the suggested sensorless control method is compared also with other recent published schemes.
Antiplatelet Therapy and Bleeding Outcomes With CYP2C19 Genotyping
Authors: Coons James C. , Stevenson James M. , Patel Ami , Smith A. J. Conrad , Prebehalla Linda , Empey Philip E.
Published: December 2022

Purpose:

The impact of antiplatelet therapy with availability of CYP2C19 genotyping on bleeding in a real-world setting has not been extensively studied.

Methods:

Prospective, single-center, cohort study conducted between December 2015 and October 2019 with 1-year follow-up. Patients underwent percutaneous coronary intervention (PCI), CYP2C19 genotyping, and received P2Y12 inhibitor therapy. The primary outcome was time to first bleed of any severity using Bleeding Academic Research Consortium criteria. Secondary outcomes included time to first major bleed and rates of antiplatelet switching.

Results:

The primary outcome occurred in 697 of 2091 (33%) participants at a median of 15 days. Major bleeding occurred in 176 (8%) of patients. Compared to clopidogrel, treatment with ticagrelor or prasugrel was associated with increased risk of any bleeding (adjusted HR [aHR] 2.04, 95% CI 1.69-2.46). For patients without CYP2C19 no function alleles, treatment with prasugrel or ticagrelor was associated with increased risk of any bleeding (aHR 2.31, 95% CI 1.83-2.90). Similar associations were observed for major bleeding. No difference in ischemic events was observed. Among patients discharged on ticagrelor or prasugrel, 199 (36%) were de-escalated to clopidogrel within 1 year. De-escalation was more likely after a bleed if patients did not have a no function allele (35.9% vs 19.1%; P = .02).

Conclusion:

Bleeding is common in post-PCI patients on antiplatelet therapy. Patients on high potency agents had higher bleeding risk in the population at-large and in non-carriers of CYP2C19 no function alleles. Genotype-guided antiplatelet de-escalation should be further explored in prospective studies.
Efficacy and Safety Assessment of Rivaroxaban for the Treatment of Cerebral Venous Sinus Thrombosis in a Chinese Population
Authors: Jiang Yi-ying , Chen Li-jie , Wu Xiao-ju , Zhou Guo-qiu , Mo Dong-can , Li Xiao-ling , Liu Liu-yu , Li Jian-li , Luo Man
Published: December 2022

We aimed to investigate the efficacy and safety of rivaroxaban for acute and long-term management of cerebral venous sinus thrombosis (CVST). This study reviewed CVST-diagnosed patients admitted to the First Affiliated Hospital of Guangxi Medical University from January 2015 to December 2020. The primary outcome was a composite of recurrent thrombosis or major bleeding events. The secondary efficacy outcomes included a disease recovery time (DRT) presenting the time from admission to the endpoint as recovery (the modified Rankin scale [mRS] score [0-1]) within 30 and 90 days, and length of hospital stay (LHS). Patients treated with rivaroxaban (38) and warfarin (45) were enrolled in the final analysis. The primary outcome had no significant difference (5.3% vs 11.1%, P = .576) between the 2 groups. The secondary efficacy outcome regarding the median 30-d DRT was 17 days (95% confidence interval [CI], 14.6-19.4) in the rivaroxaban group, compared with 26.0 days (95% CI, 16.8-35.2) in the warfarin group (hazard ratio, 1.806; 95% CI, 1.051-3.103; log-rank P = .026). Two groups have a significant difference in LHS ( P = .041). Patients with cerebral edema, intracerebral hemorrhage, and mild/moderate disability (admission mRS score [2-3]) treated with rivaroxaban recovered faster than those with warfarin (log-rank P < .05). Patients with cerebral edema, intracerebral hemorrhage, and mild/moderate disability treated with rivaroxaban had a shorter recovery time than those treated with warfarin within 1 month from admission, indicating that rivaroxaban a promising convenient therapy for CVST, helping them speedily restore social functions.
Refractive error after combined phaco-vitrectomy: A multicentric study
Authors: Kilian Raphael , Crincoli Emanuele , Rizzo Clara , Ripa Matteo , Faraldi Francesco , Lavia Carlo , Tartaro Ruggero , Ceruti Piero , Casini Giamberto , Rizzo Stanislao , Savastano Alfonso
Published: December 2022

Purpose

To study the post-operative refractive error (RE) of patients undergoing combined phaco-vitrectomy and to find out which intraocular lens (IOL)-power formula had the best refractive outcomes.

Methods

In this retrospective multicentric study we compared the preoperative expected target with the postoperative RE of patients undergoing combined phaco-vitrectomy due to vitreomacular traction, macular pucker, full thickness macular hole or lamellar macular hole. A multinomial logistic regression was performed to compare the postoperative REs and the differences between expected and postoperative REs among the SRK-T, Olsen's and Holladay-2 formulas. The correlation between the difference in REs and IOL-power was also studied.

Results

Sixty-seven eyes with a mean axial length of 23.73 ± 1.21 mm were included. Forty-two (63%), 14 (21%) and 11 (16%) eyes were implanted with an IOL that was calculated respectively with SRK-T, Olsen's and the Holladay-2 formula. The mean preoperative expected- and post-operative REs were −0.16 ± 0.12D and −0.48 ± 0.17, respectively ( p = 0.045). SRK-T and Holladay-2 formulas led to a significant myopic shift whereas Olsen's caused a significant hyperopic error, independently from the IOL power.

Conclusion

Independently from the IOL power, none of the analyzed formulas is precise at calculating the post-operative RE.
An optimized irradiation strategy and layout configuration in laser forming of copper/aluminum bi-metal sheets with a functional thickness
Authors: Ghoreishi S Reza , Mahmoodi Masoud
Published: December 2022

Laser forming process is a type of thermo-mechanical forming process in which a laser beam irradiation on a specific scan path is used to create a bending angle in a sheet. In this work, the forming behavior of copper/aluminum bi-metal sheets with a functional thickness is investigated using the laser forming process. For that, numerical simulations are performed with an implementation of DFLUX subroutine to have more realistic process circumstances. The process parameters were defined as follows: laser beam radius of 2 mm and scan velocity of 1000 mm/min with three different laser power to activate the temperature gradient mechanism. A detailed discussion has been done on an optimized selection of bi-metal sheet layout (i.e. the selection of the material from copper and aluminum as the top layer to increase the formability of the sheet under the same process conditions). Furthermore, the laser forming process of bi-metal sheets with a functional thickness as well as single-layered uniform sheets have been studied and the differences between these two are specified. An irradiation strategy was also presented to eliminate/reduce edge effects on bi-metal sheets. Hence, by adding an auxiliary laser path perpendicular to the main scan path, the uniformity of the final product would be improved. Numerical simulations were fully validated with the corresponding experimental tests. Finally, aluminum was determined as the ideal option to choose as a top layer due to having a higher thermal expansion coefficient and lower thermal conductivity.
The development of a multidimensional meaning of tax: From unfair tax to fair
Authors: Hilling Axel , Sandell Niklas , Sonnerfeldt Amanda , Vilhelmsson Anders
Published: December 2022

Historically, companies have communicated taxes as a burden, as the benefits provided by governments are not perceived to be in proportion to their payments. With sustainable development becoming central in many policy areas, new discourses including ‘fair’ or ‘sustainable’ tax have become omnipresent in public talk on taxes. This paper analyzes tax discourses in corporate annual reports within this changing context to examine the use of language in the construction of the meaning of tax. By analyzing tax reporting by a state-owned multinational company over two decades, we observe that the communication of taxes increased in both number and types of discourses. Importantly, this highlights the shift in tax discourses from one dominated by codified accounting discourse reinforcing the monolithic representation of tax as an unfair expense, to one where tax is given a multidimensional meaning within a broader discursive context, where tax is a meaningful corporate responsibility to society.
Pharmacokinetic boosting to enable a once-daily reduced dose of tofacitinib in patients with rheumatoid arthritis and psoriatic arthritis (the PRACTICAL study)
Authors: van der Togt Céleste J.T. , Verhoef Lise M. , van den Bemt Bart J.F. , den Broeder Nathan , ter Heine Rob , den Broeder Alfons A.
Published: December 2022

Background:

Tofacitinib is a Janus Kinase (JAK) inhibitor used for the treatment of rheumatoid arthritis (RA) and psoriatic arthritis (PsA), dosed as 5 mg twice daily (BID). It is primarily metabolized by the cytochrome P-3A (CYP3A) enzyme, and therefore, the manufacturer recommends to halve the dose when using CYP3A-inhibiting co-medication. Combining half-dose tofacitinib with a registered CYP3A inhibitor (cobicistat) could reduce costs and improve patient experience.

Objectives:

Primary: bioequivalence of tofacitinib 5 mg combined with cobicistat once daily (QD; intervention) to tofacitinib 5 mg BID (control). Secondary: safety, patient preference (7-point Likert scale at study end) and predicted differences in disease activity (DAS28-CRP and probability of ACR20 response) using a validated exposure-response model.

Design:

Open-label, cross-over pharmacokinetic study.

Methods:

We included patients with RA or PsA, treated with tofacitinib 5 mg BID for ⩾14 days without co-medication affected by CYP3A inhibition. Pharmacokinetic sampling was performed at baseline and after 2–6 weeks of intervention treatment. Bioequivalence was defined as 90% CI of the average tofacitinib concentration (Cavg,ss; intervention to control) falling between 80% and 125%, assessed by non-linear mixed-effects modelling.

Results:

Between 16 September 2019 and 15 January 2021, 30 patients were included, of whom 25 completed both PK measurements. The tofacitinib Cavg,ss was 85% (90% CI: 75–96%). No serious adverse events occurred. Patient preference was 56% for intervention versus 18% for control. No relevant differences in median predicted disease activity were found (DAS28-CRP: 0.03, 95% CI: −0.16 to 0.22; ACR20: −0.01, −0.07 to 0.05).

Conclusion:

Due to slightly lower tofacitinib concentrations during intervention treatment, pharmacokinetic bioequivalence could not formally be established. However, pharmacokinetic boosting may be an attractive strategy for cost reduction of tofacitinib because of its safety, similar predicted pharmacodynamics and patient preference.

Registration:

This study was registered on 29 May 2019 in the Netherlands Trial Register (register number: NL7766).
ED Patient Experience: Does Day of the Week or Time of the Day Matter?
Authors: Badr Samer , Nyce Andrew , Al Soueidy Amine , Freeze Brian , Bosire Joshua , Jovin Franziska , Kupersmith Eric , Mazzarelli Anthony , Rachoin Jean-Sebastien
Published: December 2022

The effect of the arrival day of the week, arrival time of the day, or discharge time of the day on emergency department (ED) patient experience (PE) scores has not been well studied. We performed a retrospective analysis of ED patients between July 1st, 2018 through March 31st, 2021. We recorded demographics, PE scores, arrival day, arrival and discharge times, and total ED and perceived ED times. We performed univariate and multivariable analyses. We sent 49,849 surveys and received back 2423 that we included in our study. The responding patients’ median age was 52, with a majority of female gender (62%) and white race (57%). The average arrival time was 1:40 PM, and the average discharge time 2:38 PM. The average total ED time was 261 minutes, while the average perceived ED time was 540 minutes. We found a statistical association between worse PE scores and longer actual ED time but not longer perceived time. A later arrival time was significantly associated with worse PE scores on 4 out of 6 domains of the PE questionnaire. The discharge time and the day of the week were not significantly associated with PE scores. Conclusion: Actual longer ED time was significantly associated with worse PE scores, but not perceived time. Later arrival time was associated with worse PE scores, but not later discharge time. The arrival day of the week was not statistically associated with differences in PE. Further studies are needed to confirm these findings.
Clustering of pediatric onset inflammatory bowel disease in Finland: a nationwide register-based study
Authors: Nikkilä Atte , Auvinen Anssi , Kolho Kaija-Leena
Published: December 2022

Background

The incidence of pediatric inflammatory bowel disease (PIBD) has increased dramatically during the past decades. This implies involvement of environmental factors in etiology but lends no clues about specific agents. We evaluated clustering in time and place of residence at PIBD onset using a case-control setting with comprehensive nationwide register data.

Methods

We included all PIBD cases diagnosed at ages < 18 years during 1992–2017 (3748 cases; median age of 14.6; 2316 (58%) with ulcerative colitis (UC), 1432 with Crohn’s, and 18,740 age- and sex-matched controls) and constructed complete residential histories (including coordinates) from the national database until the date of the diagnosis of the case assigned as index date for the controls. Using the coordinates of the addresses of the subjects and the diagnosis/index dates, we evaluated clustering in time and place using the Knox test. Four temporal (2, 4, 6, 12 months) and four distance (0.25, 0.5, 1, 5 km) thresholds were used, and results were calculated separately for Crohn´s disease and UC. Similar analyses were conducted using the addresses at birth and the addresses five years before the diagnosis or index date. Based on the threshold values displaying the most clustering in the Knox test, logistic regression models were built to identify whether sex, age at diagnosis or the year of diagnosis affected the probability of belonging to a cluster. To analyze clustering in time and place throughout the residential histories, we used Jacquez’s Q with an open-access python program pyjacqQ.

Results

The mean number of residencies until the index date was 2.91 for cases and 3.05 for controls (p = 0.0003). Knox test indicated residential clustering for UC with thresholds of 500 m between locations and time-period of four months (p = 0.004). In the regression analysis, sex, age at diagnosis or year of UC diagnosis did not show differences between the clustered and other cases. Jacquez Q analyses showed higher than expected frequency of clustered cases throughout residential histories (p < 10− 8).

Conclusion

Our findings suggest that the incidence of PIBD, especially of UC, exhibits clustering in locations of residencies over time. For the clustered cases, environmental triggers warrant future studies.
Drug-induced liver injury following the use of tocilizumab or sarilumab in patients with coronavirus disease 2019
Authors: Gao Qian , Yin Xuedong , Tan Boyu , Wang Junshi , Chen Jiayan , Zhao Bin , Yang Qiaoling , Li Zhiling
Published: December 2022

Backgrounds

Interleukin-6 (IL-6) blockers including tocilizumab and sarilumab were approved by the U.S. Food and Drug Administration (FDA) in June 2021 for the treatment of patients with moderate to severe COVID-19. The use of sarilumab or tocilizumab in COVID-19 patients has been related to a reduction in mortality compared to standard care. Recent evidence has emerged concerning drug-induced liver injury (DILI) after sarilumab or tocilizumab applications in COVID-19 patients.

Aims

The study aimed to estimate DILI associated with sarilumab or tocilizumab in treating moderate to severe patients infected with SARS-Cov-2.

Methods

We conducted a retrospective pharmacovigilance study by data mining of the FDA’s adverse event reporting systems (FAERS) database from the first quarter of 2004 to the fourth quarter of 2021 in confirmed COVID-19 patients. We analyzed DILI cases associated with tocilizumab or sarilumab in treating COVID-19 patients from the FAERS during this period. Disproportionality analysis and Bayesian analysis of COVID-19 patients were utilized for case analysis, and we also next compared the onset time and fatality rates of DILI following tocilizumab or sarilumab.

Results

A total of 275 cases of TCZ or SAR-related DILI reports were extracted. A total of 192 AEs cases were related to tocilizumab (TCZ), and 83 were related to sarilumab (SAR). In patients treated with TCZ, most were < 75 years old (51.57%), with more male than female (46.35% vs. 13.02%). The correlation between IL-6 receptor antagonists and DILI was stronger in SAR (ROR = 12.94; 95%CI 9.6–17.44) than in TCZ (ROR = 1.33; 95%CI 1.14–1.55). The onset time of DILI was different between TCZ and SAR, and a significant difference was observed in TCZ than SAR (P < 0.0001). A significant difference was observed in the mortality rate of TCZ and SAR (P = 0.0009). DILI associated with COVID-19 patients treated with TCZ appeared to have earlier onset-time (1(0–46) day) VS. SAR (3.5(0–27) day).

Conclusion

This study shows strict monitor ought to be paid for TCZ or SAR when used for COVID-19 patients with poor liver function.
Robot-assisted subretinal injection system: development and preliminary verification
Authors: Yang Kunkun , Jin Xin , Wang Zhaodong , Fang Yifan , Li Zhao , Yang Zhe , Cong Jinju , Yang Yang , Huang Yifei , Wang Liqiang
Published: December 2022

Background

To design and develop a surgical robot capable of assisting subretinal injection.

Methods

A remote center of motion (RCM) mechanical design and a master-slave teleoperation were used to develop and manufacture the assisted subretinal surgery robot (RASR). Ten fresh isolated porcine eyes were divided into the Robot Manipulation (RM) group and Manual Manipulation (MM) group (5 eyes for each group), and subretinal injections were performed by the robot and manual manipulation methods, respectively. A preliminary verification of the robot was performed by comparing the advantages and disadvantages of the robot manipulation and manual manipulation by using optical coherent tomography (OCT), fundus photography, and video motion capture analysis after the surgery.

Results

Both the robot and the manual manipulation were able to perform subretinal injections with a 100% success rate. The OCT results showed that the average subretinal area was 1.548 mm2and 1.461 mm2in the RM and MM groups, respectively (P > 0.05). Meanwhile the volume of subretinal fluid obtained using the retinal map mode built in OCT was not statistically different between the RM and MM groups (P > 0.05). By analyzing the surgical video using Kinovea, a motion capture and analysis software, the results suggest that the mean tremor amplitude of the RM group was 0.3681 pixels (x direction), which was significantly reduced compared to 18.8779 pixels (x direction) in the MM group (P < 0.0001).

Conclusion

Robot-assisted subretinal injection system (RASR) is able to finish subretinal injection surgery with better stability and less fatigue than manual manipulation.
Effects of the areas of worklife on job embeddedness: a national cross-sectional study among Egyptian nurses
Authors: El-Gazar Heba E. , Abdelhafez Shymaa , Zoromba Mohamed A
Published: December 2022

Aim

This study aimed to examine the effects of a person–job match in the six areas of worklife on Egyptian nurses’ job embeddedness.

Background

Healthcare organizations struggle to embed nurses in their job. However, the antecedents of nurses’ job embeddedness are not fully known, especially those related to organizational factors. This study is an initiative to contribute in this field.

Methods

A national cross-sectional study that enrolled 1003 Egyptian licensed nurses was conducted. Data were collected using an online-based version of the Areas of Worklife Scale and the Global Job Embeddedness Scale and analyzed using the descriptive statistics, Pearson correlation, and regression analysis.

Results

Nurses reported a moderate level of job embeddedness with a person–job match in control, reward, and community. Regression analysis showed four of six areas of worklife (value, fairness, community, and control) contributing to nurses’ job embeddedness.

Conclusion

Nurses who experience a person–job match in the value, fairness, community, and control areas of worklife are more likely to embed in their job. A match in the value area has the great potentials for nurses to embed in their job.

Implications for nursing management

Actions aimed at embedding nurses should prioritize on optimizing a person–job match in value, fairness, community, and control.
International recruitment of mental health nurses to the national health service: a challenge for the UK
Authors: Phiri Peter , Sajid Sana , Baykoca Ardic , Shetty Suchith , Mudoni Daisy , Rathod Shanaya , Delanerolle Gayathri
Published: December 2022

The UK’s National Health Service (NHS) has been dealing with a shortage in the nursing workforce for the past few decades. With the ongoing COVID-19 pandemic and post-Brexit effects, it is important now more than ever to concentrate on recruiting new staff and retaining current staff in the National Health Service. The increasing demand for mental health services stresses the importance of prioritising recruitment of mental health nurses. One of the main strategies being implemented to combat this shortage is the recruitment of internationally trained mental health nurses. Whilst this is a favourable solution, the multiple challenges this proposal brings makes it hard for the National Health Service to practically implement this to increase staff numbers. In this discursive position paper, we consider the difficulties the National Health Service is currently facing in terms of recruiting mental health nurses and then discuss the importance of and need for international recruitment including the strategies that are currently being implemented. The challenges and obstacles associated with this proposed resolution will also be addressed.
An ecological study regarding the association between paraquat exposure and end stage renal disease
Authors: McGwin Gerald , Griffin Russell L.
Published: December 2022

Background

Persons who experience paraquat poisoning rapidly develop damage to a variety of organ systems including acute kidney injury (AKI), the occurrence of which is associated with an increased risk of death. However, little is known about the effects of chronic paraquat exposure on renal function and the onset of chronic renal disease. The objective of the current study is to assess the association between paraquat exposure and the incidence of end stage renal disease (ESRD) in the United States.

Methods

Data on the incidence of ESRD for the period 2010 through 2017 and kilograms of paraquat use per square mile for each county in the conterminous United States was obtained from the United States Renal Data System (USRDS) and the National Water Quality Assessment (NAWQA) Program, respectively. Negative binomial regression was used to estimate rate ratios (RRs) and 95% confidence intervals (CIs) for the association between quartiles of paraquat exposure and the incidence of ESRD.

Results

The incidence of ESRD increased with increasing paraquat density. Based on a 20-year exposure lag, those in the highest paraquat density quartile had a 21% higher rate of ESRD compared to the lowest quartile whereas for a 15-year lag the increase was 26%. Adjusted associations were attenuated though still followed an increasing linear trend across quintiles.

Conclusions

The results of this study are consistent with a large number of studies documenting a high incidence of AKI and a small number of studies chronic renal disease following acute and chronic paraquat exposure, respectively. While the pathophysiological mechanisms underlying kidney injury following paraquat poisoning are well understood, more research is necessary to understand the natural history of chronic kidney disease due to chronic paraquat exposure.
A liquid biopsy signature of circulating exosome-derived mRNAs, miRNAs and lncRNAs predict therapeutic efficacy to neoadjuvant chemotherapy in patients with advanced gastric cancer
Authors: Guo Ting , Tang Xiao-Huan , Gao Xiang-Yu , Zhou Yuan , Jin Bo , Deng Zi-Qian , Hu Ying , Xing Xiao-Fang , Li Zi-Yu , Ji Jia-Fu
Published: December 2022

At present, there is no validated marker to identify the subpopulation of patients with advanced gastric cancer (AGC) who might benefit from neoadjuvant chemotherapy (NACT). In view of this clinical challenge, the identification of non-invasive biomarkers for efficacy prediction of NACT in patients with AGC is imperative. Herein, we aimed to develop a non-invasive, liquid-biopsy-based assay by using an exosome-derived RNAs model based on multi-omics characteristics of RNAs. We firstly used a multi-omics strategy to characterize the mRNAs, microRNAs (miRNAs) and long non-coding RNAs (lncRNAs) profiles of circulating exosome enriched fractions in responders to NACT paired with non-responders, using RNA sequencing. Finally, numerous miRNAs, mRNAs and lncRNAs were identified to be associated with the response to NACT in patients with AGC, and it was validated in an independent cohort with promising AUC values. Furthermore, we established a 6-exosome-RNA panel that could robustly identified responders from non-responders treated with fluorouracil-based neoadjuvant chemotherapy.
Prognostic value of elastic lamina staining in patients with stage III colon cancer
Authors: Bi Feifei , Li Xiaoyan , Zhang Yong , Wang Zekun , Dong Qian , Zhang Jingdong , Sun Deyu
Published: December 2022

Objective

The objectives of this study were to analyze the difference between the preoperative radiological and postoperative pathological stages of colorectal cancer (CRC) and explore the feasibility of elastic lamina invasion (ELI) as a prognostic marker for patients with stage III colon cancer.

Methods

A total of 105 consecutive patients underwent radical surgery (R0 resection) for stage III colon cancer at the Cancer Hospital of China Medical University between January 2015 and December 2017. Clinicopathological features, including radiological stage and elastic lamina staining, were analyzed for prognostic significance in stage III colon cancer.

Results

A total of 105 patients with stage III colon cancer who met the criteria and had complete data available were included. The median follow-up period of survivors was 41 months. During the follow-up period, 33 (31.4%) patients experienced recurrence after radical resection, and the 3-year disease-free survival (DFS) rate was 64.8%. The consistency between preoperative radiological and postoperative pathological staging was poor (κ = 0.232, P < 0.001). The accuracy of ≤ T2 stage diagnoses was 97.1% (102/105), that of T3 stage was 60.9% (64/105), that of T4a stage was 68.6% (72/105) and that of T4b stage was 91.4% (96/105). The DFS rate of T3 ELI (+) patients was significantly lower than that of both T3 ELI (−) patients (P = 0.000) and pT4a patients (P = 0.013). The DFS rate of T3 ELI (−) patients was significantly higher than that of pT4b patients (P=0.018). T3 ELI (+) (HR (Hazard ratio), 8.444 [95% CI, 1.736–41.067]; P = 0.008), T4b (HR, 57.727[95% CI, 5.547-600.754]; P = 0.001), N2 stage (HR, 10.629 [95% CI, 3.858–29.286]; P < 0.001), stage III (HR, 0.136 [95% CI, 0.31–0.589]; P = 0.008) and perineural invasion (PNI) (HR, 8.393 [95% CI, 2.094–33.637]; P = 0.003) were independent risk factors for postoperative recurrence of stage III colon cancer.

Conclusions

The consistency between preoperative radiological and postoperative pathological staging was poor, especially for tumors located in the ascending colon and descending colon. Elastic lamina staining is expected to become a stratified indicator of recurrence risk for patients with stage III colon cancer and a guide for individualized adjuvant chemotherapy, thus improving patient prognosis.
Comparative single-center study between modified laparoscopic radical hysterectomy and open radical hysterectomy for early-stage cervical cancer
Authors: Li Xuqing , Pei Xueting , Li Hongyan , Wang Yan , Zhou Youwei , Wei Zhaolian , Yin Zongzhi
Published: December 2022

Background

Since the release of the LACC trial results in 2018, the safety of laparoscopic radical hysterectomy (LRH) for cervical cancer has received huge attention and heated discussion. We developed modified laparoscopic radical hysterectomy (MLRH) incorporating a series of measures to prevent tumor spillage, which has been performed in our center since 2015.

Objective

Present study retrospectively analyzed relevant indicators of MLRH and evaluated disease-free survival (DFS) primarily in the treatment of early cervical cancer compared with open surgery.

Methods

Patients with 2014 International Federation of Gynecology and Obstetrics clinical stages 1B1 and 2A1 cervical cancer who underwent radical hysterectomy in the gynecological department of our hospital from October 2015 to June 2018 were enrolled retrospectively in this study. Patients were divided into two groups based on the surgical procedure: open radical hysterectomy (ORH) group (n = 336) and MLRH group (n = 302). Clinical characteristics, surgical indices, and survival prognosis were analyzed, including 2.5-year overall survival (OS) rate, 2.5-year DFS rate, recurrence rate, and recurrence pattern.

Results

Compared to the ORH group, the MLRH group exhibited a longer operative time, longer normal bladder function recovery time, less intraoperative blood loss volume, and more harvested pelvic lymph nodes (P < 0.05). No significant differences were observed in postoperative complications, the 2.5-year OS, 2.5-year DFS, and recurrence rate between the two groups (P > 0.05); however, the recurrence pattern was significantly different (P < 0.05). The MLRH group mainly exhibited local single metastasis (7/11), whereas the ORH group mainly exhibited distant multiple metastases (14/16). Stratified analysis revealed that overall survival rate was higher in the MLRH group than in the ORH group in patients with stage 1B1 and middle invasion (P < 0.05).

Conclusion

MLRH does not show a survival disadvantage in the treatment of early-stage cervical cancer when compared with open surgery. In addition, MLRH shows a survival advantage in patients with stage 1B1 and middle 1/3 invasion. Considering this is a retrospective study, further prospective study is necessary for more sufficient data support.

Trial registration

Present research is a retrospective study. The study had retrospectively registered on Chinese Clinical Trial Registry (http://www.chictr.org.cn/), and the registered number is ChiCTR1900026306.
Association between physical activity and cancer risk among Chinese adults: a 10-year prospective study
Authors: Su Jian , Jiang Yuchen , Fan Xikang , Tao Ran , Wu Ming , Lu Yan , Hua Yujie , Jin Jianrong , Guo Yu , Lv Jun , Pei Pei , Chen Zhengming , Li Liming , Zhou Jinyi
Published: December 2022

Background

In China, the quantity of physical activity differs from that in Western countries. Substantial uncertainty remains about the relevance of physical activity for cancer subtypes among Chinese adults.

Objective

This study aimed to investigate the association between total daily physical activity and the incidence of common types of cancer.

Methods

A total of 53,269 participants aged 30–79 years were derived from the Wuzhong subcohort of the China Kadoorie Biobank study during 2004–2008. We included 52,938 cancer-free participants in the final analysis. Incident cancers were identified through linkage with the health insurance system and death registries. Cox proportional hazard models were introduced to assess the associations of total daily physical activity with the incidence of 6 common types of cancer.

Results

During a follow-up of 10.1 years, 3,674 cases of cancer were identified, including 794 (21.6%) from stomach cancer, 722 (19.7%) from lung cancer, 458 (12.5%) from colorectal cancer, 338 (9.2%) from liver cancer, 250 (6.8%) from breast cancer, and 231 (6.3%) from oesophageal cancer. Compared to the participants in the lowest quartile of physical activity levels, those in the highest quartile had an 11% lower risk for total cancer incidence (hazard ratio [HR]: 0.89, 95% confidence interval [CI]: 0.81–0.99), 25% lower risk for lung cancer incidence (HR: 0.75, 95% CI: 0.60–0.94), and 26% lower risk for colorectal cancer incidence (HR: 0.74, 95% CI: 0.55–1.00). There were significant interactions of physical activity with sex and smoking on total cancer (both P for interaction < 0.005), showing a lower risk for females and never smokers (HR: 0.92, 95% CI: 0.87–0.98 and HR: 0.93, 95% CI: 0.87–0.98, respectively).

Conclusions

Higher physical activity levels are associated with a reduced risk of total, lung, and colorectal cancer.