bluuebunny/crossref_metadata_2025 huggingface dataset:
Frequency of cognitive impairment in patients with neuromyelitis optica spectrum disorder in Mexico
Authors: Valdivia-Tangarife Edgar R , Cortés-Enríquez Fernando , Morlett-Paredes Alejandra , Villaseñor-Cabrera Teresita , Gámez-Nava Jorge I , Mireles-Ramírez Mario A , González-López Laura , Macías-Islas Miguel Á
Published: February 2024

Background

Between 29% and 67% of neuromyelitis optica spectrum disorder patients have cognitive alterations.

Objective

To assess the frequency of cognitive impairment in patients with neuromyelitis optica spectrum disorder in Mexico using the Brief International Cognitive Assessment for Multiple Sclerosis.

Methods

We evaluated 40 neuromyelitis optica spectrum disorder patients and 40 healthy controls from Mexico.

Results

28 (70.0%) patients with neuromyelitis optica spectrum disorder had cognitive impairment in two or more cognitive domains. Student´s T test showed statistically poor performance by neuromyelitis optica spectrum disorder patients compared to healthy controls on all three neuropsychological test scores. This significant difference was observed on the Symbols Digit Modalities Test ( t = 8.875; p ≤ 0.001); California Verbal Learning Test-II memory ( t = 10.418; p ≤ 0.001); and Brief Visuospatial Memory Test Revised ( t = 6.123; p ≤ 0.001).

Conclusions

This study showed that 70% of neuromyelitis optica spectrum disorder patients exhibited cognitive impairment in two or more cognitive domains. Determining the frequency of cognitive impairment will guide the decision of Neuropsychologists in planning cognitive rehabilitation across various domains.
Fifth “Jatene Lecture on Surgical Innovation”: Innovation in Congenital Heart Surgery: Contributions From South America
Authors: Juaneda Ignacio , Kreutzer Christian , Jatene Marcelo B.
Published: February 2024

We present the fifth “Jatene Lecture on Surgical Innovation” on Innovation in Congenital Heart Surgery, given at the Eighth Scientific Meeting of the World Society for Pediatric and Congenital Heart Surgery and Eighth World Congress of Pediatric Cardiology and Cardiac Surgery in Washington DC in 2023. We highlight what surgical innovation is and how innovation was accomplished in cardiac surgery and particularly in congenital heart surgery. A brief history of the development of congenital heart surgery across the world is summarized and we finally illustrate the South American contributions to congenital heart surgery, acknowledging the great innovations of Adib Jatene and Guillermo Kreutzer to our field.
Impact of the Rudimentary Chamber on Outcomes in Fontan Patients
Authors: Miwa Koji , Tsumura Sanae , Kanaya Tomomitsu , Kido Takashi , Tominaga Yuji , Kawai Shota , Teguri Yuta
Published: February 2024

Background: We sought to evaluate the influence of the rudimentary ventricle on long-term outcomes after the Fontan operation, focusing on exercise capacity and cardiac performance. Methods: Between 1995 and 2021, 290 patients underwent a total cavopulmonary connection. “Two-ventricle” Fontan circulation was defined as a rudimentary ventricle >30% of the dominant ventricle or >50% of its predicted normal value. This cohort was compared with patients with single-ventricle Fontan circulation. The primary endpoint was Fontan failure, and the secondary endpoints were VO2 and cardiac catheterization data at ten years postoperatively. Results: The median follow-up after the Fontan operation was 7.9 years (interquartile range: 1.9-13.9). No significant difference was found in Fontan failure-free survival between the “two-ventricle” Fontan circulation group and the single-ventricle Fontan circulation group (83/91, 93% vs 156/199, 78%), respectively at 20 years; P = .11). No significant difference was found in VO2 or cardiac performance except cardiac index, with 2.9 (2.3-4.8) versus 2.5 (2.3-4.3) L/min/m2 ( P = .047). Fifty-one patients in the “two-ventricle” Fontan circulation group were followed up for over ten years after the Fontan operation. In the subgroup analysis of this cohort, the rudimentary ventricular end-diastolic volume/dominant ventricular end-diastolic volume ratio showed a significant positive correlation with dominant ventricular end-diastolic pressure (r = 0.58 [95% CI 0.35-0.74], P = .002) and a significant negative correlation with VO2 (r = −0.61 [95% CI −0.80 to −0.28], P = .001). Conclusions: The rudimentary ventricle was not significantly associated with any clinical disadvantages regarding Fontan failure. However, a large rudimentary ventricle was significantly associated with higher end-diastolic pressure and lower exercise capacity.
Factors Associated With a Lateral Ankle Sprain in Young Female Soccer Players: A Prospective Cohort Study
Authors: Taketomi Shuji , Kawaguchi Kohei , Mizutani Yuri , Takei Seira , Yamagami Ryota , Kono Kenichi , Murakami Ryo , Kage Tomofumi , Arakawa Takahiro , Fujiwara Sayaka , Tanaka Sakae , Ogata Toru
Published: February 2024

Background:

Previous studies have attempted to determine if certain risk factors can predict the occurrence of a lateral ankle sprain (LAS) in female soccer players. Unfortunately, there is limited evidence with regard to risk factors associated with an LAS in female soccer players.

Purpose:

To identify intrinsic risk factors for an LAS among young female soccer players.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

Participants were 161 young female soccer players in Japan who were evaluated for LAS risk factors during a preseason medical assessment. The assessment included anthropometric, joint laxity, joint range of motion, muscle flexibility, muscle strength, and balance measurements. Each athlete’s history of LASs was also collected. The participants were monitored during a single-yearseason for LASs, as diagnosed by physicians.

Results:

There were 26 instances of an LAS in 25 players (15.5%) during the season. Injured players were significantly more likely to have sustained a previous ankle sprain ( P = .045) and demonstrated significantly worse balance than their peers without an LAS during the double- and single-leg balance tests ( P = .008 for both). Athletes with lower hamstring-to-quadriceps muscle strength ratios were also significantly more likely to sustain an LAS ( P = .02).

Conclusion:

Poor balance, a low hamstring-to-quadriceps ratio, and a history of ankle sprains were associated with an increased risk of LASs in young female soccer players in the current study. These findings may be useful for developing a program to prevent LASs in this population.
Comparison of Conventional Dose Versus Superdose Platelet-Rich Plasma for Knee Osteoarthritis: A Prospective, Triple-Blind, Randomized Clinical Trial
Authors: Patel Sandeep , Gahlaut Shivam , Thami Tarkik , Chouhan Devendra Kumar , Jain Ashish , Dhillon Mandeep Singh
Published: February 2024

Background:

Confusion persists regarding the ideal dosage of platelet-rich plasma (PRP) injection for knee osteoarthritis (OA).

Purpose/Hypothesis:

The purpose of the study was to compare the efficacy of 2 different single-injection PRP dosages in patients with early knee OA—a conventional 4 mL dose and a superdose of 8 mL. It was hypothesized that 8 mL of PRP would be superior to 4 mL of PRP in this patient population.

Study Design:

Randomized clinical trial; Level of evidence, 1.

Methods:

Patients with early knee OA (Kellgren-Lawrence grades 1 and 2) who met the inclusion criteria were randomly divided into 2 groups: Group A (n = 50 knees) received a 4-mL PRP injection, and group B (n = 49 knees) received an 8-mL PRP injection, both prepared using the same procedure. Patients were evaluated at the baseline, 6 weeks, 3 months, and 6 months using the Western Ontario and McMaster Universities Arthritis Index (WOMAC), the WOMAC-Pain subscale, the visual analog scale for pain, the Knee injury and Osteoarthritis Outcome Score, and patient satisfaction, and results were compared between the groups.

Results:

The baseline characteristics of the 2 groups were comparable (group A: mean age, 51.96 ± 6.93 years; group B: mean age, 49.12 ± 9.8 3 years). Leucocyte-depleted PRP with 3.5 times concentration (final product platelet concentration, 706.74 × 103–μL) was injected. The mean absolute platelet count injected was 2.82 ± 0.0012 billion in group A and 5.65 ± 0.0022 billion in group B. All patient-reported outcome scores improved significantly in both groups from the baseline to the final follow-up ( P < .001), with overall trends and results significantly better in group B than in group A ( P < .001). Patient satisfaction at the 6-month follow-up was also better in group B (96%) compared with group A (68%). Short (2 to 7 days) self-limiting complications, such as pain and stiffness, occurred more often in group B ( P < .001).

Conclusion:

Patients with early knee OA had significantly better improvement in pain and function when treated with an 8-mL injection of PRP compared with a 4-mL injection of PRP. The larger dose of PRP had approximately twice the number of platelets.

Registration:

CTRI/2020/02/023403 (Clinical Trials Registry-India identifier).
“Take It to the Lord”: Religion and Responses to Racial Discrimination in the Workplace
Authors: Schneider Rachel C. , Mabute-Louie Bianca , Howard Ecklund Elaine , Daniels Denise
Published: February 2024

Drawing on in-depth interview data from the nationally representative Faith at Work: An Empirical Study, this article contributes to understanding the role of religion in shaping interpretations of and responses to racial discrimination in the workplace. Specifically, it shows how Christians of different racial groups understand the relevance of their faith in coping with perceived racial discrimination in the workplace, and it illuminates the religious frames that respondents employ to “make sense” of perceived racial discrimination at work. We find that Christians of color and White Christians primarily draw on religious frames such as forgiveness and divine sovereignty in response to perceived discrimination but that these frames serve different functions. Some Christians of color also link their faith to a moral conviction to stand up for themselves and others in the workplace. While most studies on the connection between religion and racial discrimination focus on faith as an individual-level coping mechanism and buffering effect, this article also analyzes the implications of religion on racial hierarchies and racial equity efforts in the workplace—including a focus on how religion serves to produce epistemologies of ignorance and support feelings of White victimhood. Our study contributes to the scholarship on racial discrimination and religion by offering new insights into how Christians of different racial groups use faith to cope with perceived racial discrimination at work.
Polyacrylonitrile-based carbon nanofiber electrode fabricated via electrospun for supercapacitor application
Authors: Dubal Sumit , Chavan Sachin , Lohar Gaurav , Lokhande Prasad , Rednam Udayabhaskar , Kumar Deepak
Published: February 2024

The versatile properties of electrospun carbon nanofibers gaining attention for electrode materials for supercapacitors. The heat treatment process of stabilization played an important role before the carbonization process in electrode fabrication. In the present study, electrospun stabilized polyacrylonitrile nanofiber (St PAN) and carbonized Polyacrylonitrile nanofiber (CNF) at minimum temperature were used as active mass for supercapacitor electrodes. Stabilized CNF nanofiber sample showed a reduction in nanofiber diameter with increased carbon percentage. XRD results showed increased crystallinity in the CNF sample as compared with the Stabilized PAN sample. Electrochemical characterization was performed to measure specific capacitance and to analyze the charge storage mechanism. The proportion of capacitive and diffusion-controlled contributions to energy storage was estimated using Dunn’s model. The results obtained demonstrated that, in comparison to the St PAN electrode, the CNF electrode exhibited a greater capacitive-controlled contribution. The CNF sample has shown an increased capacitive contribution of 82.3% as compared with the St PAN sample. This work provides a method for making electrospun carbon nanofiber-based electrodes as well as a methodical methodology for examining the charge storage process.
Tribological characterization of SAE20W40 lubricant added with surface activated nanoparticles (Al2O3 and SiO2)
Authors: Ramprakaash S. , Muralidharan K. , Vaira Vignesh R. , Senthil Kumar R. , Govindaraju M. , Baghad Abd
Published: February 2024

This research work focuses on the performance characteristics of the standard SAE20W40 lubricant with the addition of nanoparticles (aluminum oxide (Al2O3) and silicon dioxide (SiO2) in equal proportion). The nanoparticles were surface-activated using oleic acid to homogenize the lubricant dispersion. The lubricant was added with 0.1, 0.3, and 0.5 wt% of nanoparticles and subjected to a mechano-thermal process to synthesize nanolubricant. The physio-chemical properties (flash point, fire point, thermal stability, kinematic viscosity, acid value, and iodine value) and tribological characteristics (specific wear rate, friction coefficient, and wear mechanism) of the nanolubricant were determined and correlated with dispersed nanoparticles. Instrumental characterization of SEM, EDS, TEM, FT-IR, and UV-Vis tests were performed to validate the surface-activated nanolubricant. The base lubricant demonstrated favorable tribological characteristics when enhanced with 0.1 wt% additives.
Additive manufacturing in the COVID-19 pandemic: Equipment and challenges?
Authors: Sharma Abhishek , Sharma Vishal S , Gupta Shaman , Sharma Rakesh Chandmal , Palli Srihari , Sharma Neeraj
Published: February 2024

Nowadays, the COVID-19 pandemic spreads all over the world. Every community is helping in the pandemic situation. All communities, like material scientists, medical practitioners, engineers, and healthcare professionals, are collaborating with each other to fight against the pandemic situation. Therefore, manufacturing engineers also play a role in COVID-19. There are a number of medical devices or protection equipment that can be developed by additive manufacturing (AM) to fulfill the shortage of supply. In the present research, an attempt has been made to review the different medical components developed by AM processes. The government’s regulations for different components (development and testing) are also discussed. The challenges associated with the products developed by AM processes are explained. The safety of the developed products is the prime responsibility of manufacturing engineers. This will definitely give the engineers direction to fight against the pandemic situation.
Studying the institutionalisation of urban studies: Fragmentation, the place of disciplines, organisational form
Authors: van Heur Bas
Published: February 2024

In my original paper for Dialogues in Urban Research, I mapped the publication output of a set of multi-disciplinary urban studies centres across the world. The aim was to provide first insights into the (uneven) geographies of urban knowledge production and circulation. In this reply to the five commentaries on my paper, I will develop three observations in some more detail: urban studies as a fragmented field of research, urban studies as a place-based articulation of multiple disciplines and urban studies centres as a contested organisational form within university hierarchies.
Dead people aren’t resilient
Authors: Reitherman Robert
Published: February 2024

Resilience, achieving rapid recovery so that society can bounce back from a disaster, is a desirable goal, but sometimes the focus should be only on safety. The 2023 Turkey/Syria earthquake illustrates the case where limited resources should be prioritized on safety, that is, the collapse prevention performance objective, rather than the significantly more expensive goal of post-earthquake functionality.
An Online Communication Partner Training Program: POWR+ Intervention Results for Teachers, Paraeducators, and Children
Authors: Douglas Sarah N. , Bowles Ryan , Plavnick Joshua , Dunkel-Jackson Sarah M. , Sun Tiantian , Bagawan Atikah
Published: February 2024

Paraeducators frequently support children who use augmentative and alternative communication (AAC) but often lack access to effective training opportunities. Similarly, special education teachers are responsible for supervising paraeducators but often lack effective training on AAC and paraeducator supervision. The POWR+ (Prepare the activity and AAC, Offer opportunities for communication, Wait for the child’s communication, Respond to the child’s communication, + model AAC) intervention provides training to both paraeducators and supervising teachers to support communication for children who use AAC. In this study, a single-case multiple probe design was used to examine the effects of the POWR+ intervention (e.g., communication opportunities, responses to child communication, and plus AAC models provided by paraeducators) for three teacher–paraeducator–child teams. As a result of the POWR+ intervention paraeducator communication opportunities and paraeducator AAC models increased for all paraeducators. Increases were also noted for communication turns for one child and paraeducator responses to child communication for two paraeducators. Results indicate that the POWR+ intervention may be a viable training option for paraeducators and teachers who support children who use AAC.
Harris Poll Migraine Report Card: population-based examination of high-frequency headache/migraine and acute medication overuse
Authors: Starling Amaal J. , Cady Roger , Buse Dawn C. , Buzby Meghan , Spinale Charlie , Steinberg Kathy , Lenaburg Kevin , Kymes Steven
Published: February 2024

Background

Migraine is a disabling neurologic disease that can fluctuate over time in severity, frequency, and acute medication use. Harris Poll Migraine Report Card was a US population-based survey to ascertain quantifiable distinctions amongst individuals with current versus previous high-frequency headache/migraine and acute medication overuse (HFM+AMO). The objective of this report is to compare self-reported experiences in the migraine journey of adults with HFM+AMO to those who previously experienced HFM+AMO but currently have a sustained reduction in headache/migraine frequency and acute medication use.

Methods

An online survey was available to a general population panel of adults (≥18 years) with migraine per the ID Migraine™ screener. Respondents were classified into “current HFM+AMO” (within the last few months had ≥8 headache days/month and ≥10 days/month of acute medication use; n=440) or “previous HFM+AMO” (previously had HFM+AMO, but within the last few months had ≤7 headache days/month and ≤9 days/month of acute medication use; n=110). Survey questions pertained to demographics, diagnosis, living with migraine, healthcare provider (HCP) communication, and treatment.

Results

Participants in the current HFM+AMO group had 15.2 monthly headache days and 17.4 days of monthly acute medication use in last few months compared to 4.2 and 4.1 days for the previous HFM+AMO group, respectively. Overall, current preventive pharmacologic treatment use was low (15-16%; P>0.1 for current vs previous) in both groups. Previous HFM+AMO respondents reported better current acute treatment optimization. More respondents with current (80%) than previous HFM+AMO (66%) expressed concern with their current health (P<0.05). More than one-third of both groups wished their HCP better understood their mental/emotional health (current 37%, previous 35%; P>0.1 for current vs previous) and 47% (current) to 54% (previous) of respondents worried about asking their HCP too many questions (P>0.1 for current vs previous).

Conclusion

Apart from optimization of acute medication, medical interventions did not significantly differentiate between the current and previous HFM+AMO groups. Use of preventive pharmacological medication was low in both groups. Adults with current HFM+AMO more often had health concerns, yet both groups expressed concerns of disease burden. Optimization of acute and preventive medication and addressing mental/emotional health concerns of patients are areas where migraine care may impact outcomes regardless of their disease burden.

Graphical Abstract
Irrigation expansion has kept pace with the CO2 fertilization effect on vegetation growth in a typical arid region
Authors: Lu Xiaoyao , Zhang Lu , Davies William J. , Zou Minzhong , Niu Jun , Chen Jinliang , Ding Risheng , Li Sien , Kang Shaozhong
Published: February 2024

Dynamics of vegetation in arid areas have drawn worldwide attention. The expansion of irrigated cropland (ICE) in arid regions contributes to increased food security and impacts on the extent and development of regional vegetation. However, the quantitative attribution of vegetation growth variation from ICE and biogeochemical factors (e.g., atmospheric CO2 concentration, climatic factors) is still lacking. Here, we assessed key drivers of vegetation growth in the inland arid region of Northwest China (IANC) from 1982 to 2018, including ICE, increased nitrogen rates, elevated atmospheric CO2 concentration (eCO2) and climate drivers, using normalized difference vegetation index (NDVI) and ecosystem gross primary productivity (GPP) as measures. These variables were quantified through trend decomposition, machine learning algorithms, and a satellite-based model. The results show that vegetation growth was increased in IANC mainly due to eCO2 and ICE. After 1995, as the regional climatic aridity intensified, the CO2 fertilization effect on vegetation growth decreased, as the atmospheric CO2 concentration continued to increase. Meanwhile, irrigated cropland area increased sharply, and ICE-driven GPP variation exceeded that driven by eCO2 in the whole region, while the ICE-driven NDVI variation exceeded that due to eCO2 when the ICE reached 6.38%. The ICE effect on regional vegetation growth rather than the CO2 fertilization effect has mitigated the slowdown of the rate of vegetation growth caused by climate changes. Although the ICE is conducive to food security and continuous greening of arid areas, further reclamation will exacerbate water scarcity. Our results provide research base for identifying the scale of sustainable agricultural development.
Polyploidization of Indotyphlops braminus: evidence from isoform-sequencing
Authors: Zhu Fei , Lu Jing , Sun Ke , Deng Cao , Xu Yu
Published: February 2024

Background

Indotyphlops braminus, the only known triploid parthenogenetic snake, is a compelling species for revealing the mechanism of polyploid emergence in vertebrates.

Methods

In this study, we applied PacBio isoform sequencing technology to generate the first full-length transcriptome of I. braminus, aiming to improve the understanding of the molecular characteristics of this species.

Results

A total of 51,849 nonredundant full-length transcript assemblies (with an N50 length of 2980 bp) from I. braminus were generated and fully annotated using various gene function databases. Our analysis provides preliminary evidence supporting a recent genome duplication event in I. braminus. Phylogenetic analysis indicated that the divergence of I. braminus subgenomes occurred approximately 11.5 ~ 15 million years ago (Mya). The full-length transcript resource generated as part of this research will facilitate transcriptome analysis and genomic evolution studies in the future.
Characterization of sucrose nonfermenting-1-related protein kinase 2 (SnRK2) gene family in Haynaldia villosa demonstrated SnRK2.9-V enhances drought and salt stress tolerance of common wheat
Authors: Liu Jia , Wei Luyang , Wu Yirong , Wang Zongkuan , Wang Haiyan , Xiao Jin , Wang Xiue , Sun Li
Published: February 2024

Background

The sucrose nonfermenting-1-related protein kinase 2 (SnRK2) plays a crucial role in responses to diverse biotic/abiotic stresses. Currently, there are reports on these genes in Haynaldia villosa, a diploid wild relative of wheat.

Results

To understand the evolution of SnRK2-V family genes and their roles in various stress conditions, we performed genome-wide identification of the SnRK2-V gene family in H. villosa. Ten SnRK2-V genes were identified and characterized for their structures, functions and spatial expressions. Analysis of gene exon/intron structure further revealed the presence of evolutionary paths and replication events of SnRK2-V gene family in the H. villosa. In addition, the features of gene structure, the chromosomal location, subcellular localization of the gene family were investigated and the phylogenetic relationship were determined using computational approaches. Analysis of cis-regulatory elements of SnRK2-V gene members revealed their close correlation with different phytohormone signals. The expression profiling revealed that ten SnRK2-V genes expressed at least one tissue (leave, stem, root, or grain), or in response to at least one of the biotic (stripe rust or powdery mildew) or abiotic (drought or salt) stresses. Moreover, SnRK2.9-V was up-regulated in H. villosa under the drought and salt stress and overexpressing of SnRK2.9-V in wheat enhanced drought and salt tolerances via enhancing the genes expression of antioxidant enzymes, revealing a potential value of SnRK2.9-V in wheat improvement for salt tolerance.

Conclusion

Our present study provides a basic genome-wide overview of SnRK2-V genes in H. villosa and demonstrates the potential use of SnRK2.9-V in enhancing the drought and salt tolerances in common wheat.
Transcriptomic divergence of the Rheum palmatum complex derived from top-geoherb and non-geoherb areas provides the insights into geoherbalism properties of rhubarb
Authors: Zhou Tao , Tang Yadi , Zhou Lipan , Liu Jie , Pu Yang , Jiang Fan , Wang Jian , Wang Xumei
Published: February 2024

Geoherb usually represents high-quality medicinal herbs with better clinical therapeutic effects, and elucidating the geoherbalism is essential for the quality improvement of traditional Chinese Medicine. However, few researches were conducted to clarify the geoherbalism based on a large scale of transcriptomics. In the present study, we compared the transcriptomes of Rheum palmatum complex derived from top-geoherb and non-geoherb areas to show the geoherbalism properties of rhubarb. A total of 412.32 Gb clean reads were obtained with unigene numbers of 100,615 after assembly. Based on the obtained transcriptome datasets, key enzyme-encoding genes involved in the anthraquinones biosynthesis were also obtained. We also found that 21 anthraquinone-related unigenes were differentially expressed between two different groups, and some of these DEGs were correlated to the content accumulation of five free anthraquinones, indicating that the gene expression profiles may promote the geoherbalism formation of rhubarb. In addition, the selective pressure analyses indicated that most paired orthologous genes between these two groups were subject to negative selection, and only a low proportion of orthologs under positive selection were detected. Functional annotation analyses indicated that these positive-selected genes related to the functions such as gene expression, substance transport, stress response and metabolism, indicating that discrepant environment also enhanced the formation of geoherbalism. Our study not only provided insights for the genetic mechanism of geoherbalism of rhubarb, but also laid more genetic cues for the future rhubarb germplasms improvement and utilization.
Intrathecal morphine delivery at prepontine cistern to control refractory cancer-related pain: a case report of extensive metastatic and refractory cancer pain
Authors: Li Qing , Long Yan-ling , He Yun-wu , Long Hui , Xiao Zhen-ping , Li Yong-lin , Yang Wu-zhou , Jiang Li-ping , Gao Wei , Zou Cong
Published: February 2024

Background

Extensive metastatic and refractory cancer pain is common, and exhibits a dissatisfactory response to the conventional intrathecal infusion of opioid analgesics.

Case Presentation

The present study reports a case of an extensive metastatic esophageal cancer patient with severe intractable pain, who underwent translumbar subarachnoid puncture with intrathecal catheterization to the prepontine cistern. After continuous infusion of low-dose morphine, the pain was well-controlled with a decrease in the numeric rating scale (NRS) of pain score from 9 to 0, and the few adverse reactions to the treatment disappeared at a low dose of morphine.

Conclusions

The patient achieved a good quality of life during the one-month follow-up period.
Mass intraoperative endothelial glycocalyx shedding affects postoperative systemic inflammation response
Authors: Wang JiaWan , Wu Yan
Published: February 2024

Bacground

Off-pump coronary artery bypass graft (OPCABG) has a high incidence of postoperative systemic inflammation response syndrome (SIRS), and perioperative endothelial glycocalyx layer (EGL) disruption can be one of the predisposing factors. We hypothesized that EGL shedding happened earlier in OPCABG which can influence on postoperative SIRS, and sevoflurane might preserve EGL better than propofol.

Methods

We randomly allocated 50 patients undergoing OPCABG to receive either sevoflurane-sufentanil or propofol-sufentanil anesthesia. Plasma syndecan-1, heparan sulfate (HS), atrial natriuretic peptide (ANP), IL-6, and cardiac troponin I (cTnI) were measured. Blood samples were collected at 6 timepoints: induction (T1), before grafting (T2), after grafting(T3), surgery done (T4), postoperative day1 (POD1,T5) and POD2 (T6). SIRS criteria and sequential organ failure assessment (SOFA) score were examined.

Results

There were neither differences of syndecan-1, HS, IL-6 nor of SIRS criteria or SOFA score between the sevoflurane and propofol groups. All patients were pooled as a single group for further statistical analyses, plasma syndecan-1 (P < 0.001) and IL-6 (P < 0.001) increased significantly as a function of time; syndecan-1 increasing correlated significantly with the duration of coronary graft anastomosis (r = 0.329, P = 0.026). Syndecan-1(T3) correlated significantly with ANP(T3) (r = 0.0.354, P = 0.016) and IL-6 (T5) (r = 0.570, P < 0.001). The maximum value of IL-6 correlated significantly with SIRS (r = 0.378, P = 0.010), the maximum value of SOFA score (r = 0.399, P = 0.006) and ICU days (r = 0.306, P = 0.039). The maximum value of SOFA score correlated significantly with the occurrence of SIRS (r = 0.568, P < 0.001) and ICU days (r = 0.338, P = 0.022).

Conclusions

OPCABG intraoperative early EGL shedding caused of grafts anastomosis greatly affected postoperative SIRS and SOFA score, sevoflurane did not clinically preserve EGL better.

Trial registration

ChiCTR-IOR-17012535. Registered on 01/09/2017.
The impact of Karnofsky performance status on prognosis of patients with hepatocellular carcinoma in liver transplantation
Authors: Zhou Jie , Ye Danni , Zhang Siyao , Ding Jiawei , Zhang Tao , Chen Zheng , Xu Fangshen , Ren Shenli , Hu Zhenhua
Published: February 2024

Background

Functional performance as measured by the Karnofsky Performance Status (KPS) scale has been linked to the outcomes of liver transplant patients; however, the effect of KPS on the outcomes of the hepatocellular carcinoma (HCC) liver transplant population has not been fully elucidated. We aimed to investigate the association between pre-transplant KPS score and long-term outcomes in HCC patients listed for liver transplantation.

Methods

Adult HCC candidates listed on the Scientific Registry of Transplant Recipients (SRTR) database from January 1, 2011 to December 31, 2017 were grouped into group I (KPS 80–100%, n = 8,379), group II (KPS 50–70%, n = 8,091), and group III (KPS 10–40%, n = 1,256) based on percentage KPS score at listing. Survival was compared and multivariable analysis was performed to identify independent predictors.

Results

Patients with low KPS score had a higher risk of removal from the waiting list. The 5-year intent-to-treat survival was 57.7% in group I, 53.2% in group II and 46.7% in group III (P < 0.001). The corresponding overall survival was 77.6%, 73.7% and 66.3% in three groups, respectively (P < 0.001). Multivariable analysis demonstrated that KPS was an independent predictor of intent-to-treat survival (P < 0.001, reference group I; HR 1.19 [95%CI 1.07–1.31] for group II, P = 0.001; HR 1.63 [95%CI 1.34–1.99] for group III, P < 0.001) and overall survival(P < 0.001, reference group I; HR 1.16 [95%CI 1.05–1.28] for group II, P = 0.004; HR 1.53 [95%CI 1.26–1.87] for group III, P < 0.001). The cumulative 5-year recurrence rates was higher in group III patients (7.4%), compared with 5.2% in group I and 5.5% in group II (P = 0.037). However, this was not significant in the competing regression analysis.

Conclusions

Low pre-transplant KPS score is associated with inferior long-term survival in liver transplant HCC patients, but is not significantly associated with post-transplant tumor recurrence.
Predicting the incidence of infectious diarrhea with symptom surveillance data using a stacking-based ensembled model
Authors: Wang Pengyu , Zhang Wangjian , Wang Hui , Shi Congxing , Li Zhiqiang , Wang Dahu , Luo Lei , Du Zhicheng , Hao Yuantao
Published: February 2024

Background

Infectious diarrhea remains a major public health problem worldwide. This study used stacking ensemble to developed a predictive model for the incidence of infectious diarrhea, aiming to achieve better prediction performance.

Methods

Based on the surveillance data of infectious diarrhea cases, relevant symptoms and meteorological factors of Guangzhou from 2016 to 2021, we developed four base prediction models using artificial neural networks (ANN), Long Short-Term Memory networks (LSTM), support vector regression (SVR) and extreme gradient boosting regression trees (XGBoost), which were then ensembled using stacking to obtain the final prediction model. All the models were evaluated with three metrics: mean absolute percentage error (MAPE), root mean square error (RMSE), and mean absolute error (MAE).

Results

Base models that incorporated symptom surveillance data and weekly number of infectious diarrhea cases were able to achieve lower RMSEs, MAEs, and MAPEs than models that added meteorological data and weekly number of infectious diarrhea cases. The LSTM had the best prediction performance among the four base models, and its RMSE, MAE, and MAPE were: 84.85, 57.50 and 15.92%, respectively. The stacking ensembled model outperformed the four base models, whose RMSE, MAE, and MAPE were 75.82, 55.93, and 15.70%, respectively.

Conclusions

The incorporation of symptom surveillance data could improve the predictive accuracy of infectious diarrhea prediction models, and symptom surveillance data was more effective than meteorological data in enhancing model performance. Using stacking to combine multiple prediction models were able to alleviate the difficulty in selecting the optimal model, and could obtain a model with better performance than base models.
Quantification of preexisting lung ground glass opacities on CT for predicting checkpoint inhibitor pneumonitis in advanced non-small cell lung cancer patients
Authors: Wang Xinyue , Zhao Jinkun , Mei Ting , Liu Wenting , Chen Xiuqiong , Wang Jingya , Jiang Richeng , Ye Zhaoxiang , Huang Dingzhi
Published: February 2024

Background

Immune checkpoint inhibitors (ICIs) can lead to life-threatening pneumonitis, and pre-existing interstitial lung abnormalities (ILAs) are a risk factor for checkpoint inhibitor pneumonitis (CIP). However, the subjective assessment of ILA and the lack of standardized methods restrict its clinical utility as a predictive factor. This study aims to identify non-small cell lung cancer (NSCLC) patients at high risk of CIP using quantitative imaging.

Methods

This cohort study involved 206 cases in the training set and 111 cases in the validation set. It included locally advanced or metastatic NSCLC patients who underwent ICI therapy. A deep learning algorithm labeled the interstitial lesions and computed their volume. Two predictive models were developed to predict the probability of grade ≥ 2 CIP or severe CIP (grade ≥ 3). Cox proportional hazard models were employed to analyze predictors of progression-free survival (PFS).

Results

In a training cohort of 206 patients, 21.4% experienced CIP. Two models were developed to predict the probability of CIP based on different predictors. Model 1 utilized age, histology, and preexisting ground glass opacity (GGO) percentage of the whole lung to predict grade ≥ 2 CIP, while Model 2 used histology and GGO percentage in the right lower lung to predict grade ≥ 3 CIP. These models were validated, and their accuracy was assessed. In another exploratory analysis, the presence of GGOs involving more than one lobe on pretreatment CT scans was identified as a risk factor for progression-free survival.

Conclusions

The assessment of GGO volume and distribution on pre-treatment CT scans could assist in monitoring and manage the risk of CIP in NSCLC patients receiving ICI therapy.

Clinical relevance statement

This study’s quantitative imaging and computational analysis can help identify NSCLC patients at high risk of CIP, allowing for better risk management and potentially improved outcomes in those receivingICI treatment.
CT-guided radioactive 125I seeds brachytherapy for lung oligometastases from colorectal cancer: initial results
Authors: Song Mengyao , Zhou Xueliang , Hou Rongna , Sigdel Milan , Liu Yiming , Zhang Chengzhi , Xu Kaihao , Han Xinwei , Jiao Dechao
Published: February 2024

Objectives

To evaluate the safety and effectiveness of computed tomography (CT)-guided radioactive 125I seeds brachytherapy (RISB) for lung oligometastases (LO) from colorectal cancer (CRC).

Methods

Data for 144 LOs from 70 CRC patients who underwent CT-guided RISB were retrospectively analyzed. The primary endpoints were progression-free survival (PFS) and overall survival (OS), and the secondary endpoints were technical success, local control rate (LCR), and complications. Kaplan–Meier method was used for survival analysis. Cox model was used to identify the independent predictors of poor prognosis.

Results

The RISB procedures were successfully performed in all patients, and the success rate was 100%. The median follow-up was 27.8 months. The median PFS was 10.0 months (95% CI: 8.9–11.1) and the 1- and 2-year PFS rates were 32.9% and 5.9%, respectively. On multivariate analysis, serum carcinoembryonic antigen (CEA) ≤ 15 ng/ml (P = 0.048), middle-high differentiated pathological classification (P = 0.015), primary TNM stages I-III (P = 0.001), LO number ≤ 2 (P < 0.001) and cumulative gross tumor volume (GTV) ≤ 40 cm3 (P < 0.001) showed superior PFS. The median OS was 30.8 months (95% CI: 27.1–34.4) and the 1-, 2-, and 3-year OS rates were 95.7%, 67.4%, and 42.5%, respectively. On multivariate analysis, serum CEA ≤ 15 ng/ml (P = 0.004), middle-high differentiated pathological classification (P < 0.001), primary TNM stages I-III (P < 0.001), LO number ≤ 2 (P < 0.001), cumulative GTV ≤ 40 cm3 (P < 0.001) and system treatments combined with chemotherapy and target therapy (P < 0.001) showed superior OS. The LCR for 3, 6, and 12 months was 97.9%, 91.0%, and 83.6%, respectively. There were 4 cases of pneumothorax at 5.7% that required drainage.

Conclusions

RISB for LO from CRC is safe and effective, and serum CEA, TNM stage, LO number, cumulative GTV, and system treatments should be emphasized for long OS.
The relationship between cumulative ecological risk and health risk behaviors among Chinese adolescents
Authors: Wang Jiaojiao , Xie Yang , Zhang Yi , Xu Huiqiong , Zhang Xianglin , Wan Yuhui , Tao Fangbiao
Published: February 2024

Objectives

To explore the relationship between cumulative ecological risk and individual risky behavior and multiple forms of aggregated behaviors among adolescents, and examine the gender differences.

Methods

A large-scale, nationally representative, and students-based investigation was conducted in rural and urban areas of eight provinces in China from October to December 2021. A total of 22 868 adolescents with an average age of 14.64 years completely standardized questionnaire in which the sociodemographic characteristics, socio-ecological risk factors and risky behaviors were used to analyze.

Results

Of included students, 48.4% encountered the high level of social-ecological risk. The prevalence of breakfast intake not daily, alcohol use (AU), smoking, physical inactivity, prolonged screen time (ST) on weekdays and weekends, suicidal ideation, suicidal plan, suicidal attempt, and non-suicidal self-injury (NSSI) was 41.0%, 11.9%, 3.4%, 61.9%, 15.1%, 51.1%, 27.7%, 13.9%, 6.5% and 27.0% respectively. 22.2% of participants engaged in high-risk behaviors. All were significantly influences of increased cumulative ecological risk on individual behavior and low-risk clustering behaviors separately. The odds ratio of breakfast intake not daily, AU, smoking, physical inactivity, prolonged ST in weekday and weekend, suicidal ideation, suicidal plan, suicidal attempt, and NSSI for the adjusted model in low versus high level of cumulative ecological risk was respectively significant in both boy and girls, and the ratio of odds ratios (ROR) was separately 0.95 (p = 0.228), 0.67 (p < 0.001), 0.44 (p < 0.001), 0.60 (p < 0.001), 0.78 (p = 0.001), 0.83 (p = 0.001), 0.80 (p = 0.001), 0.83 (p = 0.022), 0.71 (p = 0.005), 0.75 (p = 0.001). Girls encountering a high level of cumulative ecological risk were more likely to engage in multiple forms of clustering risky behaviors than boys (RORs: 0.77, p = 0.001).

Conclusions

Research and effective inventions at the social-ecological environment, based on the view of cumulative risk, are needed to promote the healthy development of behaviors in adolescence, and pay more attention to decreasing the occurrence of risky behaviours in girls than boys.
Barriers to healthcare utilization among married women in Afghanistan: the role of asset ownership and women’s autonomy
Authors: Malik Manzoor Ahmad , Sinha Ratnesh , Priya Angelin , Rahman Mohammad Hifz Ur
Published: February 2024

Women face multiple socio-economic, cultural, contextual, and perceived barriers in health service utilization. Moreover, poor autonomy and financial constraints act as crucial factors to their healthcare accessibility. Therefore, the objective of the present study is to study the association between health care utilization barriers and women empowerment, including asset ownership among currently married women in Afghanistan. Data of 28,661 currently married women from Afghanistan demographic health survey (2015) was used to carry out this study. Barriers to access healthcare were computed based on problems related to permission, money, distance, and companionship, whereas women empowerment and asset ownership were computed as potential covariates along with other socio-economic risk factors. Bivariate and logistic analysis was carried out to study the association and odds of explanatory variables. Our results confirm the significant and strong association between the barriers to access healthcare and various explanatory variables. Women having any decision-making autonomy are less likely to face any odds [(AOR = 0.56, p < 0.001), CI: 0.51–0.61] among the currently married women than those who don’t have any decision-making authority. Similarly, women who justify their beating for some specific reasons face the greater difficulty of accessing health care [(AOR = 1.76, p < 0.001), CI: 1.61–1.93]. In terms of asset ownership, women having any asset ownership (land or household) are less likely to face any barriers in health services utilization given the lower odds [(AOR = 0.91, p < 0.001), CI: 0.90–0.98]. Accessing maternal health is a crucial policy challenge in Afghanistan. A substantial proportion of women face barriers related to approval, money, distance, and companionship while accessing the health services utilization in Afghanistan. Similarly, women empowerment and asset ownership are significantly associated with health service accessibility. This paper therefore suggests for some policy interventions to strengthen the healthcare needs of women and ensure healthcare accessibility by scaling down these potential barriers like poor autonomy, asset ownership and domestic violence.
Social marketing and mass media interventions to increase sexually transmissible infections (STIs) testing among young people: social marketing and visual design component analysis
Authors: Riddell Julie , Cleary Anne , Dean Judith A. , Flowers Paul , Heard Emma , Inch Zeb , Mutch Allyson , Fitzgerald Lisa , McDaid Lisa
Published: February 2024

Introduction

Globally, sexually transmissible infections (STIs) continue to disproportionately affect young people. Regular STI testing is an important public health strategy but remains low among this age group. Raising awareness of testing is an essential step and requires effective interventions designed for young people. To inform the development of effective interventions that promote STI testing among young people, we conducted a systematic literature review to describe the social marketing and visual design components commonly found in STI testing interventions and explore associations of these components with intervention effectiveness.

Methods

We used a systemic review methodology to identify peer-reviewed articles that met pre-defined inclusion criteria. Social marketing and visual component analyses were conducted using structured data extraction tools and coding schemes, based on the eight key social marketing principles and 28 descriptive dimensions for visual analysis.

Results

18 studies focusing on 13 separate interventions met the inclusion criteria. Most interventions used photograph-based images, using conventionally attractive actors, positioned centrally and making direct eye contact to engage the viewer. The majority of interventions featured text sparingly and drew on a range of tones (e.g. serious, humorous, positive, reassuring, empowering and informative) and three interventions used sexualised content. Four articles explicitly stated that the interventions was informed by social marketing principles, with two explicitly referencing all eight principles. Around half of the articles reported using a formal theoretical framework, but most were considered to have theoretical constructs implicit in interventions materials. Four articles provided detailed information regarding developmental consumer research or pre-testing. All articles suggested segmentation and development of materials specifically for young people. Explicit consideration of motivation and competition was lacking across all articles. This study found that there were some design elements common to interventions which were considered more effective. High social marketing complexity (where interventions met at least seven of the 11 criteria for complexity) seemed to be associated with more effective interventions.

Conclusions

Our findings suggest that the incorporation of social marketing principles, could be more important for intervention effectiveness than specific elements of visual design. Effective and systematic use of social marketing principles may help to inform future evidence-informed and theoretically based interventions and should be employed within sexual health improvement efforts.