bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment for Constipation—An Online Search. Readability and Quality of Online Patient Resources
Authors: Gollapalli Syama , Bresler Richard , Lynch Noel P , Martin Sean T
Published: May 2022

Aim: To evaluate the readability and quality of online patient information regarding treatment for constipation in the English language. Methods: By utilizing the Google © website, the keyword “treatment for chronic constipation” was searched. Each webpage was assessed by 2 authors independently for readability using both the Gunning Fog Index (GFI) and the Flesch Reading Ease Score (FRES). The quality of the information produced on each individual website was assessed using the DISCERN instrument. Other parameters that were recorded included the country of origin, the organization type, and whether or not the website was issued a Health on the Net (HoN) certificate. Results: This study identified a mean GFI score of 13.2 and a mean FRES score of 48.9. This result indicates poor overall readability. A mean DISCERN score of 37.9 was produced, indicating an overall weak quality of online information on this topic. This study indicated that parameters such as website organization type and the presence or absence of HoN certification impacted the quality of the information websites on this topic. Conclusion: This study indicated a poor level of quality and readability of online information on the topic of chronic constipation treatment. Further resources should be directed towards improving website readability and quality. Patients may be advised that if they wish to access online information on this topic, websites that display HoN accreditation will likely produce higher quality information.
Using Standardized Whiteboards to Improve Patient Engagement
Authors: Trojano Max L , Rucker Garrett , McGillen Brian
Published: May 2022

Whiteboards are ubiquitous fixtures in hospital rooms that may represent a ready-made patient engagement tool; yet, their use has only been minimally explored. This study examined the relationship between a standardized whiteboard communication process and patient activation by using the Patient Activation Measure (PAM®). Participants ( N = 172) that were optimally involved in whiteboard communication had significantly higher PAM® scores compared to those who were suboptimally involved. PAM® scores also correlated with self-reported role, with those endorsing active participation scoring higher than passive listeners. Accordingly, this study establishes a positive association between the structured use of whiteboards and patient activation.
Migraine in the emergency department: A retrospective evaluation of the characteristics of attendances in a major city hospital in the United Kingdom
Authors: Logan A-M , Reid I , Yogarajah M , Wang C , Greenwood N , Edwards M , Jarman H , Nirmalananthan N
Published: May 2022

Introduction:

Detailed Emergency Department attendance data for migraine are needed for service redesign.

Methods:

A service evaluation was undertaken, classifying adult emergency department headache attendances using the International Classification of Headache Disorders migraine C-E criteria, evaluating attendance characteristics.

Results:

Migraine/Probable migraine diagnosis was documented in 58% but coded in 24% attendances by ED clinicians. 29% of patients used no analgesia before attending, 43% attended ≥4 days after onset and 19% arrived by ambulance.

Conclusion:

This evaluation highlights sub-optimal acute management and discrepancy between migraine coding and diagnosis contributing to underreporting. We recommend further evaluation of identified cohorts and headache proforma use.
Hepatocellular Carcinoma With a Floating Right Atrial Thrombus and Rupture of the Primary Lesion Causing Right-Sided Hemothorax
Authors: Jose Jomy Vadasseril , Nair Shreetal Rajan , Kayakkal Shajudeen , Thottian Antony George Francis , Rasak Abdul M. M.
Published: May 2022

A 68-year-old gentleman presented to us with a low back ache and paraparesis. Magnetic resonance imaging of the spine revealed vertebral body lesion compressing the spinal cord. As part of the preoperative evaluation for spinal decompression surgery, an echocardiography was done which revealed a normal heart with a floating mass in right atrium extending from the inferior vena cava. On further workup, he was diagnosed to have hepatocellular carcinoma with vertebral metastasis. Subsequently, the primary lesion ruptured leading to massive right-sided hemothorax.
Kozłowskiite, ideally Ca4Fe2+Sn3(Si2O7)2(Si2O6OH)2, a new kristiansenite-type mineral from Szklarska Poręba, Lower Silesia, Poland
Authors: Pieczka Adam , Zelek-Pogudz Sylwia , Gołębiowska Bożena , Stadnicka Katarzyna M. , Evans R. James
Published: May 2022

Kozłowskiite, ideally Ca4(Fe2+Sn3)(Si2O7)2(Si2O6OH)2, is a new mineral isostructural with kristiansenite and silesiaite, found as a band in the core of a zoned silesiaite–kristiansenite crystal from the granitic pegmatite at Szklarska Poręba, Lower Silesia, Poland. In tiny pieces kozłowskiite is pale brownish, with a calculated density of 3.775 g⋅cm–3 and a mean refractive index ~1.727. The triclinic crystal structure was determined with space-group symmetry C1: a = 10.0183(2), b = 8.3861(1), c = 13.3395(2) Å, α = 89.956(1), β = 109.039(2), γ = 89.979(1)° and V = 1059.40(3) Å3, although, similarly to kristiansenite, it is metrically monoclinic (Laue group 2/m) with α and γ angles equal to 90° and a = 10.0170(3), b = 8.3860(2), c = 13.3421(4) Å, β = 109.050(3)° and V = 1059.40(5) Å3. The seven strongest reflections in the calculated powder X-ray diffraction pattern are [d in Å (I) hkl]: 5.190 (73.2) 111, 1$\bar{1}$1; 4.569 (30.0) $\bar{2}$02; 3.153 (64.7) 004; 3.094 (28.1) $\bar{3}$11, $\bar{3}\bar{1}$1; 3.089 (100) $\bar{2}\bar{2}$2, $\bar{2}$22; 2.595 (27.2) 2$\bar{2}$2, 222; and 2.141 (30.6) $\bar{3}$31, $\bar{3}\bar{3}$1. Electron microprobe analysis gave (in wt.%) SiO2 39.46, ZrO2 0.35, SnO2 31.13, Al2O3 0.35, Sc2O3 2.65, total Fe as Fe2O3 5.06 (= Fe2O3calc. 2.26; FeOcalc. 2.52), MnO 0.71, CaO 18.42 and H2Ocalc. 1.48, sum 99.33. The empirical formula on the basis of 26O + 2(OH) and 16 cations (Z = 2) is Ca4.00(Sn2.52Sc0.47Fe2+0.43Fe3+0.34Mn2+0.12Al0.08Zr0.03)Σ4.00(Si2.00O7)2(Si2.00O6OH)2. The crystal structure of kozłowskiite was refined to an R1 = 2.12% for 4887 reflections with Io>2σI. The Ca and Si sites are occupied solely by Ca and Si, respectively, and three of four M sites: M2, M3 and M4, are dominated by Sn. Four hydrogen atoms present in the kozłowskiite unit cell are shared among the O17–O27 and O47–O37 oxygen atoms where O17 and O47 are OH groups forming relatively strong hydrogen bonds.
Leukotriene receptor antagonists and risk of neuropsychiatric events in children, adolescents and young adults: a self-controlled case series
Authors: Park Ji Soo , Cho Yoo Jung , Yun Je-Yeon , Lee Hye Jin , Yu Jinho , Yang Hyeon-Jong , Suh Dong In
Published: May 2022

Background

Leukotriene receptor antagonists (LTRAs) are widely used for asthma and allergic rhinitis (AR), but concerns about the risk of neuropsychiatric events (NPEs) have been raised since the first Drug Safety Communication by the US Food and Drug Administration in 2008. This study evaluates the association between LTRA use and NPEs in children, adolescents and young adults with asthma or AR.

Methods

A self-controlled case series study was conducted using the Korean National Health Insurance Service claims database from two 3-year observation periods (observation period 1 (Obs1): 2005–2007; observation period 2 (Obs2): 2016–2018). Asthma or AR patients aged 3–30 years who were prescribed LTRAs and diagnosed with NPEs were included. The incidence rate ratios (IRRs) for the exposed period and risk periods (1–3, 4–7, 8–14, 15–30, 31–90 and >90 days from initiation of LTRA) compared with unexposed periods were calculated using conditional Poisson regression. Subgroup analysis according to age group, type of NPEs and indication of LTRA was performed.

Results

Among 17 001 included patients, the risk of NPEs increased in Obs2 (IRR 1.11, 95% CI 1.00–1.22), but did not increase in Obs1. Risk was increased during risk periods 4–7 days (IRR 2.36, 95% CI 1.99–2.76) and 8–14 days (IRR 1.78, 95% CI 1.46–2.15) after initiation of LTRA, particularly in adolescents (IRR 1.28, 95% CI 1.05–1.55) and young adults (IRR 1.14, 95% CI 1.02–1.28), while risk was decreased in children (3–11 years). Risk was not increased for any single type of NPE. AR patients were at increased risk (IRR 1.19, 95% CI 1.01–1.39), but not those with asthma.

Conclusions

Overall, risk of NPEs with LTRA use differed between risk periods and subgroups. Physicians should prescribe LTRAs according to indications and inform patients about possible NPEs.
The paradox of immune checkpoint inhibition re-activating tuberculosis
Authors: Ahmed Mohamed , Tezera Liku B. , Elkington Paul T. , Leslie Alasdair J.
Published: May 2022

By attenuating T-cell activation, immune checkpoints (ICs) limit optimal anti-tumour responses and IC inhibition (ICI) has emerged as a new therapy for a broad range of cancers. T-cell responses are indispensable to tuberculosis (TB) immunity in humans. However, boosting T-cell immunity in cancer patients by blocking the programmed cell death 1/programmed cell death ligand 1 (PD-1/PD-L1) axis can trigger re-activation of latent TB. This phenomenon appears to contradict the prevailing thought that enhancing T-cell immunity toMycobacterium tuberculosiswill improve immune control of this pathogen. In support of this anecdotal human data, several murine studies have shown that PD-1 deficiency leads to severe TB disease and rapid death. These observations warrant a serious reconsideration of what constitutes effective TB immunity and how ICs contribute to it. Through restraining T-cell responses, ICs are critical to preventing excessive tissue damage and maintaining a range of effector functions. Bolstering this notion, inhibitory receptors limit pathology in respiratory infections such as influenza, where loss of negative immune regulation resulted in progressive immunopathology. In this review, we analyse the mechanisms of ICs in general and their role in TB in particular. We conclude with a reflection on the emerging paradigm and avenues for future research.
Pulmonologists’ work and clinical life during the COVID-19 pandemic: a society-led survey
Authors: Pietersen Pia Iben , Konge Lars , Jørgensen Rasmus , Stolz Daiana , Farr Amy , Laursen Christian B.
Published: May 2022

The continuous and ongoing coronavirus disease 2019 (COVID-19) pandemic has highly affected pulmonologists and pulmonology residents worldwide. To identify where additional work and resources must be focused, it is important to explore on what parameters the pulmonologists and residents are challenged. We present the results of a society-led survey on pulmonologists’ and pulmonology residents’ work and clinical life during the pandemic.

A total of 579 pulmonologists and pulmonology residents completed the survey (5.9% of the European Respiratory Society's physician members) and most respondents answered that they have had sufficient training on how to handle patients with COVID-19 (e.g.how to handle patients to prevent virus spread). However, more than a third of the respondents (n=210, 36.3%) had performed procedures they did not feel competent in due to the pandemic and, for example, relocation to COVID-19 units.

We must strive for investment in research on medical education and potentially simulation-based training in technical procedures to ensure competence and decrease the insecurity about new procedures, especially in the setting of worldwide pandemics or acute critical situations.
A novel model to predict severe COVID-19 and mortality using an artificial intelligence algorithm to interpret chest radiographs and clinical variables
Authors: Munera Nicolás , Garcia-Gallo Esteban , Gonzalez Álvaro , Zea José , Fuentes Yuli V. , Serrano Cristian , Ruiz-Cuartas Alejandra , Rodriguez Alejandro , Reyes Luis F.
Published: May 2022

Background

Patients with coronavirus disease 2019 (COVID-19) could develop severe disease requiring admission to the intensive care unit (ICU). This article presents a novel method that predicts whether a patient will need admission to the ICU and assesses the risk of in-hospital mortality by training a deep-learning model that combines a set of clinical variables and features in chest radiographs.

Methods

This was a prospective diagnostic test study. Patients with confirmed severe acute respiratory syndrome coronavirus 2 infection between March 2020 and January 2021 were included. This study was designed to build predictive models obtained by training convolutional neural networks for chest radiograph images using an artificial intelligence (AI) tool and a random forest analysis to identify critical clinical variables. Then, both architectures were connected and fine-tuned to provide combined models.

Results

2552 patients were included in the clinical cohort. The variables independently associated with ICU admission were age, fraction of inspired oxygen (FiO2) on admission, dyspnoea on admission and obesity. Moreover, the variables associated with hospital mortality were age,FiO2on admission and dyspnoea. When implementing the AI model to interpret the chest radiographs and the clinical variables identified by random forest, we developed a model that accurately predicts ICU admission (area under the curve (AUC) 0.92±0.04) and hospital mortality (AUC 0.81±0.06) in patients with confirmed COVID-19.

Conclusions

This automated chest radiograph interpretation algorithm, along with clinical variables, is a reliable alternative to identify patients at risk of developing severe COVID-19 who might require admission to the ICU.
“The whole of humanity has lungs, doesn't it? We are not all the same sort of people”: patient preferences and choices for an online, self-guided chronic breathlessness supportive intervention: SELF-BREATHE
Authors: Reilly Charles C. , Bristowe Katherine , Roach Anna , Chalder Trudie , Maddocks Matthew , Higginson Irene J.
Published: May 2022

Introduction

The burden of chronic breathlessness on individuals, family, society and health systems is significant and set to increase exponentially with an ageing population with complex multimorbidity, yet there is a lack of services. This has been further amplified by the coronavirus disease 2019 pandemic. Online breathlessness interventions have been proposed to fill this gap, but need development and evaluation based on patient preferences and choices. This study aimed to explore the preferences and choices of patients regarding the content of an online self-guided chronic breathlessness supportive intervention (SELF-BREATHE).

Methods

Semi-structured telephone interviews were conducted with adults living with advanced malignant and nonmalignant disease and chronic breathlessness (July to November 2020). Interviews were analysed using conventional and summative content analysis.

Results

25 patients with advanced disease and chronic breathlessness (COPD n=13, lung cancer n=8, interstitial lung disease n=3, bronchiectasis n=1; 17 male; median (range) age 70 (47–86) years; median (range) Medical Research Council dyspnoea score 3 (2−5)) were interviewed. Individuals highlighted strong preferences for focused education, methods to increase self-motivation and engagement, interventions targeting breathing and physical function, software capability to personalise the content of SELF-BREATHE to make it more meaningful to the user, and aesthetically designed content using various communication methods including written, video and audio content. Furthermore, they identified the need to address motivation as a key potential determinant of the success of SELF-BREATHE.

Conclusion

Our findings provide an essential foundation for future digital intervention development (SELF-BREATHE) and scaled research.
Telemedicine and virtual respiratory care in the era of COVID-19
Authors: Pinnock Hilary , Murphie Phyllis , Vogiatzis Ioannis , Poberezhets Vitalii
Published: May 2022

The World Health Organization defines telemedicine as “an interaction between a healthcare provider and a patient when the two are separated by distance”. The coronavirus disease 2019 (COVID-19) pandemic has forced a dramatic shift to telephone and video consulting for follow-up and routine ambulatory care for reasons of infection control. Short message service (“text”) messaging has proved a useful adjunct to remote consulting, allowing the transfer of photographs and documents. Maintaining the care of noncommunicable diseases is a core component of pandemic preparedness and telemedicine has developed to enable (for example) remote monitoring of sleep apnoea, telemonitoring of COPD, digital support for asthma self-management and remote delivery of pulmonary rehabilitation. There are multiple exemplars of telehealth instigated rapidly to provide care for people with COVID-19, to manage the spread of the pandemic or to maintain safe routine diagnostic or treatment services.

Despite many positive examples of equivalent functionality and safety, there remain questions about the impact of remote delivery of care on rapport and the longer term impact on patient/professional relationships. Although telehealth has the potential to contribute to universal health coverage by providing cost-effective accessible care, there is a risk of increasing social health inequalities if the “digital divide” excludes those most in need of care. As we emerge from the pandemic, the balance of remoteversusface-to-face consulting, and the specific role of digital health in different clinical and healthcare contexts will evolve. What is clear is that telemedicine in one form or another will be part of the “new norm”.
The impact of endoscopic lung volume reduction on physical activity coaching in patients with severe emphysema
Authors: Blondeel Astrid , Demeyer Heleen , Ceulemans Laurens J. , Coolen Johan , Everaerts Stephanie , Geysen Hannelore , Verleden Geert M. , Van Raemdonck Dirk , Dooms Christophe , Troosters Thierry , Janssens Wim
Published: May 2022

Introduction

Endoscopic lung volume reduction (ELVR) aims to improve pulmonary function in severe emphysema. Physical activity (PA) coaching is expected to improve daily life PA. When improving ventilatory constrains in severe COPD, a better response to PA coaching is expected. The present study investigated the impact of PA coaching in addition to ELVR in severe emphysema.

Methods

Patients allocated, based on fissure integrity, in the ELVR or no-ELVR cohort, received the PA coaching intervention with a step counter and smartphone application from 3 to 6 months follow-up. The primary end-point of this research question was the change in daily step count from baseline to 6 months follow-up compared between the ELVR and no-ELVR cohort. The secondary end-points were time spent in moderate to vigorous PA, movement intensity and patient-reported experience with PA between ELVR and no-ELVR.

Results

At 6 months, PA in both ELVR+coaching (1479±460 steps·day−1; p=0.001) and no-ELVR+coaching (1910±663 steps·day−1; p=0.004) improved within group, without significant between-group differences (−405±781 steps·day−1; p=0.60). Patients in the ELVR group tended to experience less difficulty with PA compared to no-ELVR+coaching (7±4 points, p=0.08).

Conclusion

We found that PA coaching is feasible and can help to enhance PA in patients with severe emphysema. Improving the ventilatory capacity through ELVR is not a prerequisite for a successful coaching intervention to increase objectively measured PA, although it alleviates patients’ experienced difficulty with PA in those with severe COPD.
Challenges of delivering TOD in low-density contexts: the Swedish experience of barriers and enablers
Authors: Hrelja Robert , Olsson Lina , Pettersson-Löfstedt Fredrik , Rye Tom
Published: May 2022

Background

Transit Oriented Development (TOD) is key to the success of public transport and for sustainable urban and regional development. Previous research has often focused on delivering TOD in urban areas with high population and building densities. This highlights the need to broaden the scope of TOD approaches to also include less densely populated areas located outside the immediate urban cores as a key concern for policy.

Purpose

The aim of this paper is to increase the knowledge of how to deliver TOD in such low-density contexts.

Methods

Three case studies of attempts at delivering TOD in sparsely populated areas in three Swedish city-regions are made. The data for the case studies consist of planning documents and 13 interviews with key stakeholders involved in the planning processes of the three cases.

Results

The results show that many of the barriers and enablers are rather similar to those identified in research on TOD in much more urban contexts in other parts of the world, but the relationships between them are differently nuanced in low-density contexts. The lack of clear quantified definitions of what TOD is (or is not) allows a more flexible, site-specific understanding of TOD to emerge in this context.

Results

It is important that a shared vision of TOD in each location is developed by the organizations involved—and such a shared vision appears to be crucial for the development to have a good chance of being delivered. Informal definitions, and individual perceptions (including those of the public) are important; and in locations that are quite “marginal” for TOD, all enablers must interact together positively for the development to have the maximum likelihood of going ahead as planned.
Diverse functions associate with non-coding polymorphisms shared between humans and chimpanzees
Authors: Velazquez-Arcelay Keila , Benton Mary Lauren , Capra John A.
Published: May 2022

Background

Long-term balancing selection (LTBS) can maintain allelic variation at a locus over millions of years and through speciation events. Variants shared between species in the state of identity-by-descent, hereafter “trans-species polymorphisms”, can result from LTBS, often due to host–pathogen interactions. For instance, the major histocompatibility complex (MHC) locus contains TSPs present across primates. Several hundred candidate LTBS regions have been identified in humans and chimpanzees; however, because many are in non-protein-coding regions of the genome, the functions and potential adaptive roles for most remain unknown.

Results

We integrated diverse genomic annotations to explore the functions of 60 previously identified regions with multiple shared polymorphisms (SPs) between humans and chimpanzees, including 19 with strong evidence of LTBS. We analyzed genome-wide functional assays, expression quantitative trait loci (eQTL), genome-wide association studies (GWAS), and phenome-wide association studies (PheWAS) for all the regions. We identify functional annotations for 59 regions, including 58 with evidence of gene regulatory function from GTEx or functional genomics data and 19 with evidence of trait association from GWAS or PheWAS. As expected, the SPs associate in humans with many immune system phenotypes, including response to pathogens, but we also find associations with a range of other phenotypes, including body size, alcohol intake, cognitive performance, risk-taking behavior, and urate levels.

Conclusions

The diversity of traits associated with non-coding regions with multiple SPs support previous hypotheses that functions beyond the immune system are likely subject to LTBS. Furthermore, several of these trait associations provide support and candidate genetic loci for previous hypothesis about behavioral diversity in human and chimpanzee populations, such as the importance of variation in risk sensitivity.
Identification of sex determination locus in sea cucumber Apostichopus japonicus using genome-wide association study
Authors: Wang Yixin , Yang Yujia , Li Yulong , Chen Muyan
Published: May 2022

Background

Sex determination mechanisms are complicated and diverse across taxonomic categories. Sea cucumber Apostichopus japonicus is a benthic echinoderm, which is the closest group of invertebrates to chordate, and important economic and ecologically aquaculture species in China. A. japonicus is dioecious, and no phenotypic differences between males and females can be detected before sexual maturation. Identification of sex determination locus will broaden knowledge about sex-determination mechanism in echinoderms, which allows for the identification of sex-linked markers and increases the efficiency of sea cucumber breeding industry.

Results

Here, we integrated assembly of a novel chromosome-level genome and resequencing of female and male populations to investigate the sex determination mechanisms of A. japonicus. We built a chromosome-level genome assembly AJH1.0 using Hi-C technology. The assembly AJH1.0 consists of 23 chromosomes ranging from 22.4 to 60.4 Mb. To identify the sex-determination locus of A. japonicus, we conducted genome-wide association study (GWAS) and analyses of distribution characteristics of sex-specific SNPs and fixation index FST. The GWAS analysis showed that multiple sex-associated loci were located on several chromosomes, including chromosome 4 (24.8%), followed by chromosome 9 (10.7%), chromosome 17 (10.4%), and chromosome 18 (14.1%). Furthermore, analyzing the homozygous and heterozygous genotypes of plenty of sex-specific SNPs in females and males confirmed that A. japonicus might have a XX/XY sex determination system. As a physical region of 10 Mb on chromosome 4 included the highest number of sex-specific SNPs and higher FST values, this region was considered as the candidate sex determination region (SDR) in A. japonicus.

Conclusions

In the present study, we integrated genome-wide association study and analyses of sex-specific variations to investigate sex determination mechanisms. This will bring novel insights into gene regulation during primitive gonadogenesis and differentiation and identification of master sex determination gene in sea cucumber. In the sea cucumber industry, investigation of molecular mechanisms of sex determination will be helpful for artificial fertilization and precise breeding.
Intracranial pressure and optic disc changes in a rat model of obstructive hydrocephalus
Authors: Hagen Snorre Malm , Eftekhari Sajedeh , Hamann Steffen , Juhler Marianne , Jensen Rigmor H.
Published: May 2022

Background

The kaolin induced obstructive hydrocephalus (OHC) model is well known for its ability to increase intracranial pressure (ICP) in experimental animals. Papilledema (PE) which is a predominant hallmark of elevated ICP in the clinic has not yet been studied in this model using high-resolution digital fundus microscopy. Further, the long-term effect on ICP and optic nerve head changes have not been fully demonstrated. In this study we aimed to monitor epidural ICP after induction of OHC and to examine changes in the optic disc. In addition, we validated epidural ICP to intraventricular ICP in this disease model.

Method

Thirteen male Sprague-Dawley rats received an injection into the cisterna magna containing either kaolin-Ringer’s lactate suspension (n = 8) or an equal amount of Ringer’s lactate solution (n = 5). Epidural ICP was recorded post-operatively, and then continuously overnight and followed up after 1 week. The final epidural ICP value after 1 week was confirmed with simultaneous ventricular ICP measurement. Optic disc photos (ODP) were obtained preoperatively at baseline and after one week and were assessed for papilledema.

Results

All animals injected with kaolin developed OHC and had significant higher epidural ICP (15.49 ± 2.47 mmHg) compared to control animals (5.81 ± 1.33 mmHg) on day 1 (p < 0.0001). After 1 week, the epidural ICP values were subsided to normal range in hydrocephalus animals and there was no significant difference in epidural ICP between the groups. Epidural ICP after 1 week correlated with the ventricular ICP with a Pearson’s r = 0.89 (p < 0.0001). ODPs from both groups showed no signs of acute papilledema, but 5 out of 8 (62.5%) of the hydrocephalus animals were identified with peripapillary changes.

Conclusions

We demonstrated that the raised ICP at day 1 in the hydrocephalus animals was completely normalized within 1 week and that epidural ICP measurements are valid method in this model. No acute papilledema was identified in the hydrocephalus animals, but the peripapillary changes indicate a potential gliosis formation or an early state of a growing papilledema in the context of lateral ventricle dilation and increased ICP.
Patients with gastroenteric tumor after upper abdominal surgery were more likely to require rescue analgesia than lower abdominal surgery
Authors: Li Ting-Ting , Chang Quan-Yuan , Xiong Liu-Lin , Chen Yan-Jun , Li Qi-Jun , Liu Fei , Wang Ting-Hua
Published: May 2022

Objectives

To find out the reasons why patients still need to use rescue analgesics frequently after gastrointestinal tumor surgery under the patient-controlled intravenous analgesia (IV-PCA), and the different abdominal surgery patients using the difference of analgesics.

Methods

A total of 970 patients underwent abdominal operation for gastrointestinal tumors were included. According whether patients used dezocine frequently for rescue analgesics within 2 days after surgery, they assigned into two groups: RAN group (Patients who did not frequently use rescue analgesia, 406 cases) and RAY group (Patients who frequently used rescue analgesia, 564 cases). The data collected included patient’s characteristics, postoperative visual analogue scale (VAS), nausea and vomiting (PONV), and postoperative activity recovery time.

Results

No differences were observed in the baseline characteristics. Compared with the RAN group, patients in the RAY group had a higher proportion of open surgery, upper abdominal surgery, VAS score at rest on the first 2 days after surgery and PONV, and a slower recovery of most postoperative activities. Under the current use of IV-PCA background, the proportion of rescue analgesics used by patients undergoing laparotomy and upper abdominal surgery was as high as 64.33% and 72.8%, respectively. Regression analysis showed that open surgery (vs laparoscopic surgery: OR: 2.288, 95% CI: 1.650–3.172) and the location of the tumor in the upper abdomen (vs lower abdominal tumor: OR: 2.738, 95% CI: 2.034–3.686) were influential factors for frequent salvage administration.

Conclusions

In our patient population, with our IV-PCA prescription for postoperative pain control, patient who underwent open upper abdominal surgery required more rescue postoperative analgesia.
Preoperative fibrinogen-to-albumin ratio predicts the prognosis of patients with hepatocellular carcinoma subjected to hepatectomy
Authors: Mai Rong-yun , Bai Tao , Luo Xiao-ling , Wu Guo-bin
Published: May 2022

Background

Systemic inflammatory response (SIR) plays a crucial role in every step of tumorigenesis and development. More recently, the fibrinogen-to-albumin ratio (FAR), an inflammation-based model, was suggested as a prognostic maker for various cancer patients. This research aimed to estimate the prognostic abilities of FAR, neutrophil–lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), platelet– lymphocyte ratio (PLR), and systemic immune–inflammation index (SII) in patients with hepatocellular carcinoma (HCC) subjected to curative hepatectomy.

Methods

A total of 1,502 cases who underwent hepatectomy for HCC were included. The predictive performances of FAR, NLR, MLR, PLR and SII were assessed with regards to overall survival (OS) and disease-free survival (DFS). The area under the time-dependent receiver operating characteristic curve was used to compare prognostic performances.

Results

Data revealed that FAR had higher predictive accuracy than other inflammation-based models and alpha-fetoprotein (AFP) in assessing OS and DFS. Indeed, the OS and DFS of patients with high FAR (> 8.9), differentiated by the optimal cut-off value of FAR, were remarkably reduced (p < 0.05 for OS and DFS). Multivariate Cox regression analyses identified that AFP, FAR, clinically significant portal hypertension, tumor size, Barcelona Clinical Liver Cancer staging system, major resection and blood loss were independent indicators for predicting OS and DFS. Furthermore, these patients could be classified according to their FAR into significantly different subgroups, regardless of AFP levels (p < 0.05 for DFS and OS). Similar results were obtained in other inflammation-based prognostic models.

Conclusions

Compared with NLR, MLR, PLR, SII and AFP, FAR showed significant advantages in predicting survival of HCC patients subjected to liver resection.
Effect of different interventions for latent tuberculosis infections in China: a model-based study
Authors: Wen Zexuan , Li Tao , Zhu Wenlong , Chen Wei , Zhang Hui , Wang Weibing
Published: May 2022

Background

Tuberculosis (TB) has a serious impact on people’s health. China is one of 30 countries that has a high TB burden. As the currently decreasing speed of the incidence of TB, the WHO’s goal of “End TB Strategy” is hard to achieve by 2035. As a result, a SEIR model that determines the impact of different tuberculosis preventive treatments (TPTs) in different age groups, and the effect of different interventions on latent TB infections (LTBIs) in China is developed.

Methods

A Susceptible-Exposed-Infectious-Recovered (SEIR) model was established. Goodness-of-fit tests were used to assess model performance. Predictive analysis was used to assess the effect of different interventions on LTBIs and achieving the goals of the “End TB Strategy”.

Results

The Chi-square test indicated the model provided a good statistical fit to previous data on the incidence of TB (χ2 = 0.3085, p > 0.999). The 1HP treatment regimen (daily rifapentine + isoniazid for 4 weeks) was most effective in reducing the number of TB cases by 2035. The model indicated that several strategies could achieve the 2035 target of the “End TB Strategy”: completion of active case finding (ACF) for LTBI and TPT nation-wide within 5 years; completion of ACF for LTBIs and TPT within 2 years in high-incidence areas; completion of TPT in the elderly within 2 years; or introduction of a new vaccine in which the product of annual doses and vaccine efficiency in the three age groups above 14 years old reached 10.5 million.

Conclusion

The incidence of TB in China declined gradually from 2005 to 2019. Implementation of ACF for LTBIs and TPT nation-wide or in areas with high incidence, in the elderly, or administration of a new and effective vaccine could greatly reduce the number of TB cases and achieve the 2035 target of the “End TB Strategy” in China.
Extracellular vesicle biomarkers for pancreatic cancer diagnosis: a systematic review and meta-analysis
Authors: Jia Erna , Ren Na , Shi Xianquan , Zhang Rongkui , Yu Haixin , Yu Fan , Qin Shaoyou , Xue Jinru
Published: May 2022

Background

Extracellular vesicle (EV) biomarkers have promising diagnosis and screening capacity for several cancers, but the diagnostic value for pancreatic cancer (PC) is controversial. The aim of our study was to review the diagnostic performance of EV biomarkers for PC.

Methods

We performed a systematic review of PubMed, Medline, and Web Of Science databases from inception to 18 Feb 2022. We identified studies reporting the diagnostic performance of EV biomarkers for PC and summarized the information of sensitivity, specificity, area under the curve (AUC), or receiver operator characteristic (ROC) curve) in according to a pre-designed data collection form. Pooled sensitivity and specificity was calculated using a random-effect model.

Results

We identified 39 studies, including 2037 PC patients and 1632 noncancerous, seven of which were conducted independent validation tests. Seventeen studies emphasized on EV RNAs, sixteen on EV proteins, and sixteen on biomarker panels. MiR-10b, miR-21, and GPC1 were the most frequently reported RNA and protein for PC diagnosis. For individual RNAs and proteins, the pooled sensitivity and specificity were 79% (95% CI: 77–81%) and 87% (95% CI: 85–89%), 72% (95% CI: 69–74%) and 77% (95% CI: 74–80%), respectively. the pooled sensitivity and specificity of EV RNA combined with protein panels were 84% (95% CI: 81–86%) and 89% (95% CI: 86–91%), respectively. Surprisingly, for early stage (stage I and II) PC EV biomarkers showed excellent diagnostic performance with the sensitivity of 90% (95% CI: 87–93%) and the specificity of 94% (95% CI: 92–95%). Both in sensitivity and subgroup analyses, we did not observe notable difference in pooled sensitivity and specificity. Studies might be limited by the isolation and detection techniques of EVs to a certain extent.

Conclusions

EV biomarkers showed appealing diagnostic preference for PC, especially for early stage PC. Solving the deficiency of technologies of isolation and detection EVs has important implications for application these novel noninvasive biomarkers in clinical practice.
Construction and validation of a two-gene signature based on SUMOylation regulatory genes in non-small cell lung cancer patients
Authors: Sheng Hongxu , Hao Zhexue , Zhu Linhai , Zeng Yuan , He Jianxing
Published: May 2022

Background

Post-translational modification plays an important role in the occurrence and development of various tumors. However, few researches were focusing on the SUMOylation regulatory genes as tumor biomarkers to predict the survival for specific patients. Here, we constructed and validated a two-gene signature to predict the overall survival (OS) of non-small cell lung cancer (NSCLC) patients.

Methods

The datasets analyzed in this study were downloaded from TCGA and GEO databases. The least absolute shrinkage and selection operator (LASSO) Cox regression was used to construct the two-gene signature. Gene set enrichment analysis (GSEA) and Gene Ontology (GO) was used to identify hub pathways associated with risk genes. The CCK-8 assay, cell cycle analysis, and transwell assay was used to validate the function of risk genes in NSCLC cell lines.

Results

Firstly, most of the SUMOylation regulatory genes were highly expressed in various tumors through the R package ‘limma’ in the TCGA database. Secondly, our study found that the two gene signature constructed by LASSO regression analysis, as an independent prognostic factor, could predict the OS in both the TCGA training cohort and GEO validation cohorts (GSE68465, GSE37745, and GSE30219). Furthermore, functional enrichment analysis suggests that high-risk patients defined by the risk score system were associated with the malignant phenomenon, such as DNA replication, cell cycle regulation, p53 signaling pathway. Finally, the results of the CCK-8 assay, cell cycle analysis, and transwell assay demonstrated that the two risk genes,SAE1andUBA2, could promote proliferation and migration in non-small cell lung cancer cells.

Conclusions

The two-gene signature constructed in our study could predict the OS and may provide valuable clinical guidance for the treatment of NSCLC patients.
Clinical outcomes of single-step transepithelial photorefractive keratectomy and off-flap epipolis-laser in situ keratomileusis in moderate to high myopia: 12-month follow-up
Authors: Zhang Yunjie , Li Tiankun , Li Zhangliang , Dai Mali , Wang Qinmei , Xu Chenchen
Published: May 2022

Background

To compare the quantitative and qualitative optical outcomes of single-step transepithelial photorefractive keratectomy (TPRK) and off-flap epipolis-laser in situ keratomileusis (Epi-LASIK) in moderate to high myopia.

Methods

In this prospective self-control study, we included patients with moderate to high myopia who were randomized to undergo TPRK in one eye and Epi-LASIK in the other eye. Twelve-month follow-up results for visual acuity, refraction, ocular high-order aberrations, contrast sensitivity, postoperative pain, epithelial healing, and haze grade were assessed.

Results

A total of 64 eyes (32 patients) were enrolled in the study. More eyes completed re-epithelialization in the TPRK group than in the Off-flap Epi-LASIK group 3–4 days postoperatively, while all eyes completed re-epithelialization by 7 days. More eyes achieved a visual acuity (both UDVA and CDVA) of better than 20/20 in the TPRK group than in the Off-flap Epi-LASIK group. The ±0.50 D predictability for correction of the spherical equivalent (SE) was higher in the eyes of the TPRK group (91%) than in those of the off-flap Epi-LASIK group (80%) 12 months after surgery. No significant differences in ocular aberrations, including coma, spherical, and trefoil, were found between the two groups at 12 months. There were also no significant differences in visual acuity, contrast sensitivity, pain, and haze grading between the two groups.

Conclusions

Both TPRK and off-flap Epi-LASIK are safe, effective, and predictable treatments for moderate to high myopia with comparable surgical outcomes.

Trial registration

This study was retrospectively registered on ClinicalTrial.gov (NCT05060094, 17/09/2021).
Time trends in social contacts before and during the COVID-19 pandemic: the CONNECT study
Authors: Drolet Mélanie , Godbout Aurélie , Mondor Myrto , Béraud Guillaume , Drolet-Roy Léa , Lemieux-Mellouki Philippe , Bureau Alexandre , Demers Éric , Boily Marie-Claude , Sauvageau Chantal , De Serres Gaston , Hens Niel , Beutels Philippe , Dervaux Benoit , Brisson Marc
Published: May 2022

Background

Since the beginning of the COVID-19 pandemic, many countries, including Canada, have adopted unprecedented physical distancing measures such as closure of schools and non-essential businesses, and restrictions on gatherings and household visits. We described time trends in social contacts for the pre-pandemic and pandemic periods in Quebec, Canada.

Methods

CONNECT is a population-based study of social contacts conducted shortly before (2018/2019) and during the COVID-19 pandemic (April 2020 – February 2021), using the same methodology for both periods. We recruited participants by random digit dialing and collected data by self-administered web-based questionnaires. Questionnaires documented socio-demographic characteristics and social contacts for two assigned days. A contact was defined as a two-way conversation at a distance ≤ 2 m or as a physical contact, irrespective of masking. We used weighted generalized linear models with a Poisson distribution and robust variance (taking possible overdispersion into account) to compare the mean number of social contacts over time and by socio-demographic characteristics.

Results

A total of 1291 and 5516 Quebecers completed the study before and during the pandemic, respectively. Contacts significantly decreased from a mean of 8 contacts/day prior to the pandemic to 3 contacts/day during the spring 2020 lockdown. Contacts remained lower than the pre-COVID period thereafter (lowest = 3 contacts/day during the Christmas 2020/2021 holidays, highest = 5 in September 2020). Contacts at work, during leisure activities/in other locations, and at home with visitors showed the greatest decreases since the beginning of the pandemic. All sociodemographic subgroups showed significant decreases of contacts since the beginning of the pandemic. The mixing matrices illustrated the impact of public health measures (e.g. school closure, gathering restrictions) with fewer contacts between children/teenagers and fewer contacts outside of the three main diagonals of contacts between same-age partners/siblings and between children and their parents.

Conclusion

Physical distancing measures in Quebec significantly decreased social contacts, which most likely mitigated the spread of COVID-19.
Empathy and burnout in medical staff: mediating role of job satisfaction and job commitment
Authors: Yue Zongpu , Qin Yang , Li Ying , Wang Jian , Nicholas Stephen , Maitland Elizabeth , Liu Cai
Published: May 2022

Background

Burnout is a growing problem among medical staff worldwide and empathy has been described as an essential competence to attenuate burnout. Previous studies found job satisfaction and job commitment were affected by the empathy and associated with burnout. This study explores the effect and mechanism of empathy on burnout on medical staff and investigates the mediating role of job satisfaction and job commitment in the relationship between empathy and burnout among medical staff.

Methods

Based on a self-administered questionnaire which included the Maslach Burnout Inventory (MBI) to measure burnout, 335 responses from medical staff in Tianjin City, China, yielded data on socio-demographic characteristics, empathy, burnout, job satisfaction and job commitment. Bivariate correlation and structured equation modeling (SEM) analyzed the relationships between empathy, job satisfaction, job commitment and burnout multi-group invariant analysis was used to evaluate whether the model was consistent across different type and level of hospitals and different job and employment type subgroups.

Results

A total of 202 (60.3%) medical staff had low level burnout, 115 (34.3%) staff had the moderate level and 18 (5.4%) staff had the high level burnout. The results of the SEM showed that empathy not only had a direct negative effect on burnout ($$\beta =-0.401, P<0.001)$$

β
=
-
0.401
,
P
<
0.001
)

, but also had an indirect impact through job satisfaction ($$\beta =-0.373, P<0.001)$$

β
=
-
0.373
,
P
<
0.001
)

and job commitment ($$\beta =0.489, P<0.001)$$

β
=
0.489
,
P
<
0.001
)

. Job commitment was negatively associated burnout ($$\beta =-0.513, P<0.001),$$

β
=
-
0.513
,
P
<
0.001
)
,

but, unexpectedly, job satisfaction was positively associated with burnout ($$\beta =0.177, P<0.001)$$

β
=
0.177
,
P
<
0.001
)

. The results also indicated the model was consistent across employment type ($$\Delta {\chi }^{2}$$

Δ

χ

2

= 5.904, p > 0.05) and hospital type ($$\Delta {\chi }^{2}$$

Δ

χ

2

= 7.748, p > 0.05), but was inconsistent across hospital level ($$\Delta {\chi }^{2}$$

Δ

χ

2

= 42.930, p < 0.05) and job type ($$\Delta {\chi }^{2}$$

Δ

χ

2

= 52.912, p < 0.05).

Conclusions

Our results pointed out the important role that empathy plays in addressing burnout and revealed that managing job satisfaction and increasing the job commitment attenuated burnout. We recommend that the government should accelerate the reform of the resourcing of different hospital levels; facilitate hospital managers to implement additional training; and support hospitals to strengthen psychological testing and counseling to reduce medical staff burnout.