bluuebunny/crossref_metadata_2025 huggingface dataset:
Awareness of caregivers of geriatric deficits among older people—the results of a cross-sectional study in Krakow, Poland
Authors: Pachołek Anna , Piotrowicz Karolina , Gąsowski Jerzy , Tomasik Tomasz
Published: July 2022

Background

It seems that caregivers (CGs) may be a reliable source of information for determining health condition of seniors. This might be important for general practitioners (GPs) and facilitate them conducting comprehensive geriatric assessment (CGA). The objectives of our study were to: compare populations of older patients with and without CGs, characterise the group of CGs, establish whether CGs are aware of patients’ deficiencies in areas of CGA.

Methods

Patients aged at least 65 years underwent CGA using eight tools in GPs’ practices in and around Krakow, Poland. Seniors were divided into two groups: with and without CGs. CGs filled in an authors’ questionnaire on their data and assessed seniors in eight domains corresponding to the tests used in CGA. Patients with and without CGs were also compared in terms of CGA results and basic demographic and medical data. Subjective CGs’ responses were compared with objective CGA results.

Results

We conducted CGA on 438 senior patients. Two hundred fifty eight (59%) of them were classified as patients with CGs. Patients with CGs were older, less educated, more often lived in rural areas and were more frequently in a relationship (as all p < 0.05). In seniors with CGs, the results of frailty (p < 0.008) and insomnia scales (p = 0.049) were significantly worse. Mostly, CGs could properly assess seniors in basic and complex living activities and nutritional status. They were less precise in determining deficits like depressive tendency and insomnia.

Conclusions

CGs’ assessment of older patients can be a valuable source of information about seniors and can be helpful in diagnosing important health issues. CGs have difficulties when asked to properly assess depression and insomnia in the older adults they care for and their answers do not always correspond with the results of CGA. GPs should pay more attention to the needs of CGs themselves and provide them with the necessary knowledge about caring for older people.
Situs inversus totalis with local metastasis of gallbladder carcinoma and variation of the common hepatic artery
Authors: Zhang Cheng , Zhang Bo , Huang Haifeng , Hu Qida , Jin Yibing , Yu Qingsong , Wang Junsen , Zhang Xin , Zhang Yun
Published: July 2022

Background

Situs inversus totalis (SIT) is a rare congenital anomaly characterized by a complete transposition of all the viscera. SIT cases were usually reported because of the presence of tumors, leading to false association between them. Therefore, any research that advances our understanding on SIT is highly required. This study firstly describes a very rare case of SIT with “jumping” metastasis to pancreas of gallbladder carcinoma.

Case presentation

A 69-year-old female patient presented at our hospital with complaints of one month of epigastric pain was studied. She had not sought for treatment prior the visit. Imaging examinations of this patient revealed SIT and a variation of the common hepatic artery with concomitant tumors of gallbladder and pancreas. However, there was no evidence of distant metastases beyond the abdominal cavity. She underwent a combination of radical cholecystectomy, total pancreatectomy, splenectomy and hepatic artery-splenic artery reconstruction. Histological analyses revealed metastasis of the gallbladder carcinoma in to the pancreas. Although the patient opted against chemotherapy, she survived without tumor for 16 months following the surgery. A review of the current literature on association with SIT and tumor occurrence was presented.

Conclusions

It is a great surgical challenge for the resection of multicenter hepatobiliary and pancreatic tumors in such rare SIT anatomical abnormalities with vascular variants. A reliable surgical plan based on detailed preoperative imaging and intraoperative anatomical exploration is crucial to achieving radical resection.
Hearing loss and depressive symptoms in older Chinese: whether social isolation plays a role
Authors: Huang Hao , Wang Jiao , Jiang Chao Qiang , Zhu Feng , Jin Ya Li , Zhu Tong , Zhang Wei Sen , Xu Lin
Published: July 2022

Background

Existing evidence links hearing loss to depressive symptoms, with the extent of association and underlying mechanisms remaining inconclusive. We conducted a cross-sectional study to examine the association of hearing loss with depressive symptoms and explored whether social isolation mediated the association.

Methods

Eight thousand nine hundred sixty-two participants from Guangzhou Biobank Cohort Study were included. Data on self-reported hearing status, the 15-item Geriatric Depression Scale (GDS-15), social isolation and potential confounders were collected by face-to-face interview.

Results

The mean (standard deviation) age of participants was 60.2 (7.8) years. The prevalence of poor and fair hearing was 6.8% and 60.8%, respectively. After adjusting for age, sex, household income, education, occupation, smoking, alcohol use, self-rated health, comorbidities, compared with participants who had normal hearing, those with poor hearing (β = 0.74, 95% confidence interval (CI) 0.54, 0.94) and fair hearing (β = 0.59, 95% CI 0.48, 0.69) had higher scores of GDS-15. After similar adjustment, those with poor hearing (odds ratio (OR) = 2.13, 95% CI 1.65, 2.74) or fair hearing (OR = 1.68, 95% CI 1.43, 1.99) also showed higher odds of depressive symptoms. The association of poor and fair hearing with depressive symptoms attenuated slightly but not substantially after additionally adjusting for social isolation. In the mediation analysis, the adjusted proportion of the association mediated through social isolation was 9% (95% CI: 6%, 22%).

Conclusion

Poor hearing was associated with a higher risk of depressive symptoms, which was only partly mediated by social isolation. Further investigation of the underlying mechanisms is warranted.
Dynamics of gut microbiota during pregnancy in women with TPOAb-positive subclinical hypothyroidism: a prospective cohort study
Authors: Wu Min , Chi Cheng , Yang Yuxi , Guo Shan , Li Tianhe , Gu Muqing , Zhang Tingting , Gao Huimin , Liu Ruixia , Yin Chenghong
Published: July 2022

Background

Anti-thyroid peroxidase antibody (TPOAb) positivity can contribute to inhibit thyroxine synthesis. Gut microbiota can interact with metabolic or immune diseases. However, dynamics of gut microbiota from the second (T2) to the third trimester (T3) in women with TPOAb-positive/negative subclinical hypothyroidism (TPOAb+/TPOAb− SCH) have not been reported. Therefore, we aimed to evaluate whether gut microbiota can be potential therapeutic targets for managing TPOAb+ SCH.

Methods

In this single-center prospective cohort study, we observed gut microbiota dynamics by sequencing 16S rRNA from fecal samples collected in T2 (20–23+ 6 weeks) and T3 (28–33+ 6 weeks). TPOAb+/TPOAb− SCH were stratified depending on whether or not they used levothyroxine (LT4) during the pregnancy (LT4+/LT4−). Microbiome bioinformatics analyses were performed using QIIME2. The linear discriminant analysis effect size (LEfSe) was used for the quantitative analysis of biomarkers. Functional profiling was performed with PICRUSt2.

Results

Distinct gut microbiota dynamics from T2 to T3 were noted in the TPOAb− (n = 68) and TPOAb+ (n = 64) SCH groups. The TPOAb+ LT4− group was characterized by enriched bacterial amplicon sequence variants (ASVs) of Prevotella in T2 and Bacteria, Lachnospirales, Lachnospiraceae, Blautia, and Agathobacter in T3 and by depleted ASVs of Gammaproteobacteria, Enterobacterales, and Enterobacteriaceae in T2 and Actinobacteriota, Coriobacteriia, Actinobacteria, Coriobacteriales, Bifidobacteriales, Bifidobacteriaceae, Bifidobacterium, Dorea formicigenerans, and Bifidobacterium longum in T3. The TPOAb+ LT4+ group was characterized by enriched bacterial ASVs of Blautia, Streptococcus salivarius, and Bifidobacterium longum in T3 and by depleted ASVs of Bacteroidota, Bacteroidia, Bacteroidales, and Prevotella in T2 and Agathobacter in T3. Moreover, we identified 53 kinds of metabolic functions that were mainly involved in sugar, lipid, and amino acid metabolism.

Conclusions

Our results indicated that low dynamics of gut microbiota composition and high dynamics of its metabolic function from T2 to T3 were associated with TPOAb+ SCH. We concluded that gut microbiota could be new targets for treatment of TPOAb+ SCH during pregnancy.

Trial registration

This study was retrospectively registered at the Chinese Clinical Trial Registry (registration number ChiCTR2100047175) on June 10, 2021.
Bilateral posterior scleritis after sequential bilateral cataract surgery: a case report
Authors: Hong Chae-Min , Shin Min-Ho , Kim Seong-Jae , Seo Seong-Wook , Chung Inyoung , Yoo Woong-Sun
Published: July 2022

Background

Posterior scleritis is a rare, inflammatory ophthalmic disease, leading to severe visual impairment if untreated. Posterior scleritis occurring after surgery, unrelated to systemic inflammatory diseases, is even rarer. This report discusses a case of bilateral posterior scleritis, after cataract surgery in both the eyes, treated with high-dose steroids.

Case presentation

A 55-year-old man, who had undergone bilateral sequential cataract surgery one week before, presented with sudden loss of vision and ocular pain in both eyes. The patient had no systemic diseases or neurological symptoms. Serous retinal detachment of the macula with optic disc swelling was observed on fundus examination in both the eyes, and bilateral thickening of choroid and sclera was seen in ultrasonography. Under diagnosis of bilateral posterior scleritis due to the increased signal of sclera in both the eyes on magnetic resonance imaging, high-dose steroid therapy was performed. After treatment, improvement in visual acuity and retinal detachment were observed, and thereafter, it has been maintained without relapse.

Conclusions

With high-dose steroid therapy, we successfully treated a rare case of bilateral posterior scleritis following cataract surgery in both eyes. To our knowledge, this is the first report on posterior scleritis occurring after surgery, unrelated to systemic inflammatory diseases.
Emotional and behavioral problems in Japanese preschool children with subthreshold autistic traits: findings from a community-based sample
Authors: Shirama Aya , Stickley Andrew , Kamio Yoko , Saito Aya , Haraguchi Hideyuki , Wada Ayumu , Sueyoshi Kazuki , Sumiyoshi Tomiki
Published: July 2022

Background

Recently, there has been a growing recognition that autistic traits exist along a continuum beyond diagnostic categories and that even subclinical symptoms may be associated with an increased risk for the psychosocial well-being and mental health of children. However, as yet, there has been little research on whether preschool children with autism spectrum disorder (ASD) symptoms, who do not meet the diagnostic criteria for ASD, are more likely to experience difficulties. To address this deficit this study examined whether young children with subthreshold autistic traits have an increased risk for emotional/behavioral difficulties.

Methods

Data were analyzed from 1057 Japanese preschool children aged 5-years old collected during the first wave of the Tama Children’s Survey (TCS) cohort study. Parent-reported autistic traits were assessed with the Social Responsiveness Scale (SRS), while they provided information on their child’s emotional/behavioral problems using the Strengths and Difficulties Questionnaire (SDQ). Logistic regression analysis was used to examine associations.

Results

Preschool children with mild-to-moderate autistic traits, corresponding to subclinical autism were significantly more likely to score above the clinical thresholds for emotional/behavioral problems compared to children with fewer autistic traits. Follow-up diagnostic assessments and analyses of 72 children from the cohort confirmed these findings and showed that these children with subthreshold autistic traits also had a significantly lower intelligence quotient (IQ) as measured by the Wechsler Preschool and Primary Scale of Intelligence (WPPSI).

Conclusions

Although subthreshold autistic traits are difficult to define due to the sometimes vague border between typical and atypical development, there may be a large number of preschool children with subthreshold autistic traits, who may have an increased risk for a variety of different emotional/behavioral difficulties as well as lower cognitive functioning.
The extent and nature of television food and non-alcoholic beverage advertising to children during chinese New Year in Beijing, China
Authors: Lei Nan , Liu Zechen , Xiang Lin , Ye Lihong , Zhang Juan
Published: July 2022

Background

Exposure to food and non-alcoholic beverage advertisements (F&B ads) on television, which can affect children’s nutrition knowledge, food consumption, diet quality, and purchasing preferences, is one aspect of the obesogenic environment. This aspect has been well-studied and assessed in many countries. In China, however, only few studies have been done in earlier years and all of them were focus on regular days. This study aimed to assess the extent and nature of F&B ads on television (TV) during the public holiday directed towards children aged 4–14 years in Beijing.

Method

Top 3 channels viewed by children aged 4–14 years in Beijing were selected by TV viewership data, survey, and expert consultation. Each channel was recorded for 7 days (24 h) during the public holiday of the Chinese New Year in 2019. F&B ads were coded and analyzed following the adapted food promotion module of INFORMAS protocol. Three nutrient profile models were used to classify F&B ads as healthy or unhealthy F&B ads.

Results

Of the 10,082 ads in 504-hour recorded programs, 42.9% were F&B ads. The hourly average ads and F&B ads per channel were 19.8 (SD 15.32) and 8.6 (SD 9.84), while that was higher on the national children’s channel (17.15, SD 12.25) than other channels (p < 0.05). Of F&B ads classified with the three nutrient profile models, more than 55% were unhealthy for children. The categories most frequently advertised were savory snacks, milk drinks, nonpermitted milk drinks, cakes/sweet biscuits, and beverages. Unhealthy F&B ads were more likely to use promotional characters, brand benefit claims, and health claims than permitted F&B ads (p < 0.05).

Conclusions

Children in Beijing were exposed to a high proportion of unhealthy F&B ads during the Chinese New Year holiday. Our findings support the need to assess and regulate TV F&B ads marketing for children.
Kinesiophobia could affect shoulder function after repair of rotator cuff tears
Authors: Wang Huihui , Hu Fangning , Lyu Xiaolong , Jia Honglei , Wang Bomin , Liu Fanxiao , Yang Yongliang
Published: July 2022

Purpose

Kinesiophobia (fear of movement) is a major limiting factor in the return to pre-injury sport level after surgery of rotator cuff tears. The study aims to gain insights into how kinesiophobia affects shoulder pain and function after the repair of full-thickness rotator cuff tears.

Methods

A prospective study was conducted to evaluate patients who underwent rotator cuff repair between January 2019 and December 2019 in our institution. The patients were divided into a trial group with a high kinesiophobia (Tampa Scale for Kinesiophobia [TSK], TSK > 37) and a control group with a low kinesiophobia (TSK ≤ 37). The indicators of interest included the Constant-Murley scores, numerical rating scale (NRS), visual analogue scale (VAS), Oxford Shoulder Score (OSS), and the American shoulder and elbow score (ASES), shoulder function and strength, and range of motion (ROM) at 3 days, 6 weeks, and 12 months after repair of full-thickness rotator cuff tears.

Results

In total, 49 patients who underwent repair of full-thickness rotator cuff tears were enrolled, which was divided into a trial group involving 26 patients (mean TSK 52.54) and a control group involving 23 patients (mean TSK 33.43). There were no statistically significant differences in basic information such as age, gender, and length of stay in the two groups. The preoperative and early postoperative functional scores and the Tampa Scale for Kinesiophobia were statistically significant differences between the two groups. However, long-term postoperative follow-up showed no statistically significant difference in ASES, and Constant-Murley scores, OSS, and VAS scores between the two groups as the kinesiophobia changed from positive to negative.

Conclusion

Degree of kinesiophobia reduced during post-operative rehabilitation of rotator cuff repair patients, but high kinesiophobia is still present in a large portion of the patients after rotator cuff repair. Patients after rotator cuff repair will benefit from early recognition and prevention of kinesiophobia.
Effect of vitamin K2 administration on depression status in patients with polycystic ovary syndrome: a randomized clinical trial
Authors: Tarkesh Firoozeh , Namavar Jahromi Bahia , Hejazi Najmeh , Hoseini Golazin
Published: July 2022

Background

Patients with Polycystic ovary syndrome (PCOS) are predisposed to the development of several mental comorbidities such as depression. According to several studies, PCOS can be managed by improving insulin sensitivity. The insulin-sensitizing effect of vitamin K has been reported in recent studies. Therefore, in the current trial, we assessed the effect of administrating vitamin K2 (Menaquinone-7) on depression status in women afflicted with PCOS.

Methods

Eighty-four PCOS women were allocated into the intervention and comparison groups; the intervention group (n = 42) administered 90 µg/day Menaquinone-7, and the comparison group (n = 42) consumed placebo capsules (containing avesil) for 8 weeks. In this randomized, double blind, placebo-controlled clinical trial, depression status was measured by BECK depression inventory-II (BDI-II) before and after 8 weeks of intervention.

Results

Consumption of Menaquinone-7 in comparison with the placebo capsules significantly improved depression status (P = 0.012).

Conclusion

This clinical study reported the advantageous effect of Menaquinone-7 administration on depression status in PCOS patients.

Trial registration The present study was registered at http://www.IRCT.ir on 06/06/2018 (registration number: IRCT20170916036204N5).
Adult patient communication experiences with nurses in cancer care settings: a qualitative study
Authors: Alshammari Mukhlid , Duff Jed , Guilhermino Michelle
Published: July 2022

Background

The patient communication experience is an important outcome measure that guides quality improvements in healthcare settings specifically in cancer care. Therefore, this study aimed to explore the patient’s communication experiences with nurses in cancer care settings.

Methods

Semi-structured face to face interviews were conducted with 21 participants who received cancer care at two Saudi Arabian tertiary healthcare facilities between Aug 2019 to Dec 2019. The study used a qualitative descriptive design. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to analyse the data using six stages of Braun and Clarke.

Results

Four major themes were identified and a total of eleven sub-themes. The major themes were; (1) The importance of patient-nurse relationships, (2) Providing appropriate information to patients, (3) Responding to patients emotional needs and (4) Verbal communication between nurses and cancer patients.

Conclusions

Some participants felt that their communication with nurses was limited, but generally, most felt that communication was acceptable irrespective of barriers such as language, culture, religion, gender, workload and healthcare preferences. Participants drew a comparison between Saudi and non-Saudi nurses as well as between nurses and doctors communication skills. They felt that Saudi nurses had good communication skills, but non-Saudi nurses were more competent in some aspects such as kindness, politeness, respectful and non-verbal communication. They also felt that doctors were more accurate in their information than nurses.
Aligned electrospun poly(l-lactide) nanofibers facilitate wound healing by inhibiting macrophage M1 polarization via the JAK-STAT and NF-κB pathways
Authors: Xie Jian , Wu Xiaowei , Zheng Shang , Lin Kaili , Su Jiansheng
Published: July 2022

Delayed wound healing remains a challenge, and macrophages play an important role in the inflammatory process of wound healing. Morphological changes in macrophages can affect their phenotype, but little is known about the underlying mechanism. Aligned electrospun nanofibers have natural advantages in modulating cell morphology. Therefore, the current study constructed aligned electrospun nanofibers that could transform macrophages into elongated shapes. Our results demonstrated that aligned nanofibers without exogenous cytokines could downregulate the proinflammatory M1 phenotype and upregulate the prohealing M2 phenotype in an inflammatory environment. Importantly, our study revealed that aligned electrospun nanofibers could inhibit macrophage M1 polarization via the JAK-STAT and NF-κB pathways. Furthermore, the conditioned medium from macrophages cultured on aligned nanofibers could encourage fibroblast migration, proliferation and collagen secretion. In vivo, aligned nanofibers alleviated the inflammatory microenvironment, promoted angiogenesis and accelerated wound healing in mouse skin defects by modulating macrophage phenotypes. Collectively, aligned electrospun nanofibers can influence macrophage polarization via the JAK-STAT and NF-κB pathways and attenuate the local inflammatory response in skin wounds. This study provides a potential strategy to modulate macrophage polarization and promote wound healing by controlling the topology of biomaterials and offers a new perspective for the application of nanotechnology in wound healing.
Prognostic factors and related complications/sequalae of squamous cell carcinoma located in the gingivobuccal complex
Authors: Zhu Yunhao , Li Bo , Liu Huan , Li Delong , Cheng Aoming , Wang Chong , Han Zhengxue , Feng Zhien
Published: July 2022

Background

Gingivobuccal complex (GBC) was a relatively new concept of oral subsite that was comprises of the upper and/or lower gingiva, gingival buccal sulcus, and adjacent buccal mucosa. Squamous cell carcinoma (SCC) of the GBC had a poor prognosis, with few studies analyzing this particular entity. The objective of this study was to analyze the risk factors affecting the prognosis and complications/sequalae of gingivobuccal complex cancer.

Methods

Between December 2014 and August 2019, a total of 122 patients diagnosed with primary gingivobuccal complex cancer in Beijing Stomatological Hospital, Capital Medical University were enrolled in the study. Through outpatient reviewed and telephone followed-up for 2-5 years postoperatively, postoperative relapse and complications/sequalae were assessed. The primary outcome parameter was 2-year disease-free survival.

Results

The most common central site of the tumor was the buccal mucosa (45.1%), followed by the lower gingiva (36.9%). The most diseases were pT4a (45.1%) and there was lymph node invasion (pN+) in 41.8% of patients. Moderate differentiated squamous carcinoma (77.9%) accounted for the vast majority of the histopathological differentiation. A total of 62.3% of tumors invaded the bone, while, 5.7% invaded the skin layer. Survival analysis found that 44.3% of patients experienced relapse within two years postoperatively and the mortality rate after relapse was 75.9%. Almost 60.0% of the tumors involving the maxilla and/or mandible developed relapse. Cox proportional hazards model found that pN stage (p= 0.002) and bone invasion (p= 0.007) were significant independent predictors of 2-year disease-free survival. Importantly, 63.1% of patients had postoperative (and postradiotherapy) complications/sequalae. It was noteworthy that 18 of 43 patients (41.9%) who implanted with titanium plates had hardware-related complications/sequalae, and the most of them were titanium plate exposure (61.1%).

Conclusions

Squamous cell carcinoma of the gingivobuccal complex cancer, as a new subsite worthy of attention in oral cancer, has a high complication/sequalae rate, high relapse rate and poor prognosis.

Trial registration

Prospective, Observational, Real-world Oral Malignant Tumors Study (clinicaltrials.gov identifier: NCT02395367). The approval of the Institutional Review Board of the Beijing Stomatological Hospital of Capital Medical University (Approval number: CMUSH-IRB-KJPJ-2015-08)
An argument for pandemic risk management using a multidisciplinary One Health approach to governance: an Australian case study
Authors: Woolaston Katie , Nay Zoe , Baker Michelle L. , Brockett Callum , Bruce Mieghan , Degeling Chris , Gilbert Joshua , Jackson Bethany , Johnson Hope , Peel Alison , Sahibzada Shafi , Oskam Charlotte , Hewitt Chad L.
Published: July 2022

The emergence of SARS-CoV-2 and the subsequent COVID-19 pandemic has resulted in significant global impact. However, COVID-19 is just one of several high-impact infectious diseases that emerged from wildlife and are linked to the human relationship with nature. The rate of emergence of new zoonoses (diseases of animal origin) is increasing, driven by human-induced environmental changes that threaten biodiversity on a global scale. This increase is directly linked to environmental drivers including biodiversity loss, climate change and unsustainable resource extraction. Australia is a biodiversity hotspot and is subject to sustained and significant environmental change, increasing the risk of it being a location for pandemic origin. Moreover, the global integration of markets means that consumption trends in Australia contributes to the risk of disease spill-over in our regional neighbours in Asia-Pacific, and beyond. Despite the clear causal link between anthropogenic pressures on the environment and increasing pandemic risks, Australia’s response to the COVID-19 pandemic, like most of the world, has centred largely on public health strategies, with a clear focus on reactive management. Yet, the span of expertise and evidence relevant to the governance of pandemic risk management is much wider than public health and epidemiology. It involves animal/wildlife health, biosecurity, conservation sciences, social sciences, behavioural psychology, law, policy and economic analyses to name just a few.

The authors are a team of multidisciplinary practitioners and researchers who have worked together to analyse, synthesise, and harmonise the links between pandemic risk management approaches and issues in different disciplines to provide a holistic overview of current practice, and conclude the need for reform in Australia. We discuss the adoption of a comprehensive and interdisciplinary ‘One Health’ approach to pandemic risk management in Australia. A key goal of the One Health approach is to be proactive in countering threats of emerging infectious diseases and zoonoses through a recognition of the interdependence between human, animal, and environmental health. Developing ways to implement a One Health approach to pandemic prevention would not only reduce the risk of future pandemics emerging in or entering Australia, but also provide a model for prevention strategies around the world.
Retrospective study of hypofractionated stereotactic radiotherapy combined with whole brain radiotherapy for patients with brain metastases
Authors: Xie Xue-Yi , Peng Hong-Hua , Zhang Xi , Pan Yu-Liang , Zhang Zhen , Cao Pei-Guo
Published: July 2022

Background and purpose

To evaluate the clinical outcomes of hypofractionated stereotactic radiotherapy (HFSRT) combined with whole brain radiotherapy (WBRT) in patients with brain metastases (BMs).

Materials and methods

From May 2018 to July 2020, 50 patients (111 lesions) received HFSRT (18 Gy/3F) + WBRT (40 Gy/20F). The RECIST 1.1 and RANO-BM criteria were used to evaluate treatment efficacy. Five prognostic indexes (RPA, GPA, SIR, BS-BM, and GGS) were applied. The primary endpoint was intracranial local control (iLC). Secondary endpoints were overall survival (OS) and the safety of treatment.

Results

Intracranial objective response rates (iORR) using the RECIST 1.1 and RANO-BM criteria were 62.1% and 58.6%, respectively. The iLC rate was 93.1%, the 6- and 12-month iLC rates were 90.8% and 57.4%, respectively. The median intracranial progression-free survival (iPFS) was not reached (range 0–23 months). The 6-, 12-, and 24-month OS rates were 74.2%, 58.2%, and 22.9%, respectively. The KPS score showed statistical significance in univariate analysis of survival. The 6, 12, and 24 month OS rates for patients with KPS ≥ 70 were 83.8%, 70.5%, and 29.7%, respectively. The median survival time (MST) for all patients and for patients with KPS ≥ 70 were 13.6 and 16.5 months, respectively. Sex, KPS score, and gross tumor volume were significant factors in the multivariate analysis of survival. OS was significantly associated with RPA, SIR, BS-BM, and GGS classes. No acute toxicities of grade 3 or higher were noted.

Conclusion

HFSRT combined with WBRT is a safe and effective local treatment modality for BM patients.
Does cervical curvature affect neurological outcome after incomplete spinal cord injury without radiographic abnormality (SCIWORA): 1-year follow-up
Authors: Qi Can , Cao Junming , Xia Hehuan , Miao Dechao , Liu Yaming , Guo Junfei , Li Zequn , Hou Zhiyong
Published: July 2022

Background

At present, surgery is the primary clinical treatment for SCIWORA patients, but conservative treatment still plays an important role in patients with incomplete spinal cord injury. As an important index of cervical spine degeneration, cervical curvature has an impact on the prognosis of spinal cord injury patients. This paper studied the prognosis of conservatively treated patients with SCIWORA and the correlation between cervical curvature and neurological prognosis.

Methods

A retrospective study was conducted in all the patients with SCI admitted to the Third Affiliated Hospital of Hebei Medical University between January 2017 and June 2020. Data were recorded in 106 eligible patients, including sex, age, injury factors, Cobb angle, CCI, CSA, and ASIA motor and sensory scores. The Wilcoxon sign rank sum test was used to analyze the data postinjury and at the 1-year follow-up. Pearson correlation analysis was performed for the Cobb angle, CCI and CSA. Simple linear regression analysis and multiple linear regression analysis were performed for each group of variables.

Results

The Wilcoxon signed rank sum test confirmed that the Cobb angle, the CCI and the CSA of the patients were not significantly different at the 1-year follow-up when compared with the postinjury values, and the ASIA motor and sensory scores were significantly improved. The Pearson correlation analysis showed correlations among the Cobb angle, the CCI and the CSA. Simple linear regression analysis and multiple linear regression analysis showed that the nerve recovery rate was negatively correlated with age and was positively correlated with the Cobb angle.

Conclusion

Conservative treatment of incomplete SCIWORA can achieve a good prognosis.
There is a clear correlation between the Cobb angle, CCI and CSA, and the Cobb angle, as an important influencing factor, needs to be considered. For SCIWORA patients undergoing nonsurgical treatment, improving cervical curvature is beneficial to the prognosis of patients. Age negatively affects the neurological prognosis.
Extrathyroidal extension and cervical node infiltration are associated with recurrences and shorter recurrence-free survival in differentiated thyroid cancer: a cohort study
Authors: Anwar Sumadi Lukman , Cahyono Roby , Suwardjo Suwardjo , Hardiyanto Herjuna
Published: July 2022

Background

Differentiated thyroid cancer has excellent overall survival. However, around 20% of patients experience recurrent diseases after a certain time of follow-up. Therefore, identification of risk factors for recurrence is necessary to adjust treatment and surveillance planning.

Methods

A retrospective study was conducted of 312 patients with differentiated thyroid cancer who received surgery with and without adjuvant treatment. Clinical and pathological risk factors were analyzed for recurrences.

Results

After median follow-up of 57 months, 109 of 312 patients (34.9%) developed recurrences. Extrathyroidal extension and positive cervical nodes were significantly associated with recurrences (OR = 2.449, 95%CI:1.260–4.760, P = 0.008 and OR = 3.511, 95%CI:1.860–6.626, P < 0.001; respectively). Lympho-vascular invasion (LVI) and tumor multifocality were also associated with increased risk of recurrence (OR = 2.577, 95%CI:1.380–4.812, P = 0.003 and OR = 1.602, 95%CI:1.001–2.495, P = 0.050; respectively). Using multivariable regression, only older age and tumor infiltration to the lymph nodes were significantly associated with recurrences (OR = 2.227, 95%CI:1.037–4.782, P = 0.040 and OR = 2.966, 95%CI:1.470–5.986, P = 0.002; respectively). In addition, T4, cervical lymph node infiltration, older age, and LVI were associated with shorter recurrence-free survival.

Conclusion

Recurrence rates in our study population are relatively high. Extrathyroidal extension, positive neck lymph node, and older age were associated with recurrence risks of well differentiated thyroid cancers.
Investigation of the association between coffee and risk of RA—results from the Swedish EIRA study
Authors: Westerlind Helga , Dukuzimana Justine , Lu Xiaomin , Alfredsson Lars , Klareskog Lars , Di Giuseppe Daniela
Published: July 2022

Background

Studies on the association between coffee, a modifiable lifestyle factor, and rheumatoid arthritis (RA), a chronic autoimmune disease primarily affecting the joints, have been conflicting. The aim of the present study was to study the association between coffee consumption and risk of RA in the context of different lifestyle factors.

Methods

We included 2184 cases (72% women, mean age 55 years) newly diagnosed with RA during 2005–2018 in Sweden and 4201 controls matched on age, sex, and residential area. Data on coffee consumption was collected through a food frequency questionnaire and categorized into < 2 (reference), 2–< 4, 4–< 6, and ≥ 6 cups/day. We calculated odds ratios (OR) with 95% confidence intervals (CI) for coffee consumption and risk of RA, in a crude model (taking matching factors into account), and then adjusted first for smoking and further for BMI, educational level, alcohol consumption, and physical activity. We also stratified analyses on sex, smoking, rheumatoid factor, and anti-CCP2 status.

Results

In the crude model, high coffee consumption was associated with increased risk of RA (OR = 1.50, 95% CI 1.20–1.88 for ≥ 6 cups/day compared to < 2 cups). After adjusting for smoking, the OR decreased and was no longer statistically significant (OR = 1.16, 95% CI 0.92–1.46) and decreased further in the full model (OR = 1.14 95% CI 0.89–1.45). This pattern held true in all strata.

Conclusion

The findings from this large, population-based case-control study did not support a significant association between coffee consumption and risk of RA as a whole nor within different subgroups.
A study on benthic molluscs and stable isotopes from Kutch, western India reveals early Eocene hyperthermals and pronounced transgression during ETM2 and H2 events
Authors: Mitra Aniket , Dutta Rakhi , Halder Kalyan
Published: July 2022

The early Eocene greenhouse Earth experienced several transient global warming events, indicated by sharp negative excursions in the stable isotope ratios of carbon and oxygen. A huge amount of CO2, enriched with12C, was released in the ocean–atmosphere system leading to warming. The Paleocene–Eocene boundary is demarcated by the most significant and well-known hyperthermal event, Paleocene–Eocene thermal maximum (PETM). The PETM is documented to be accompanied by a transgression. The later hyperthermals are relatively less studied. Information on the hyperthermals from the palaeo-tropical basins are relatively few. Here, we present a high-resolution litho-, bio- and isotope–stratigraphic analysis of the early Eocene succession from the Kutch Basin, western India. Stable isotopes of carbon and oxygen were analysed from sediments (δ13Corg) and mollusc shells (δ13Ccarband δ18Ocarb). The succession, prevailingly with lignite, along with carbonaceous black shale and plenty of fossil plant remains, is primarily a product of terrestrial environment. A pronounced marine transgression, characterised by marine mollusc bearing glauconitic shale in the middle of the succession, indicates a coastal transitional setting between the ocean and land. The δ13C curve of organic carbon reveals five negative excursions, which are identified as the PETM, Eocene thermal maximum 2 (ETM2)/H1, H2, I1 and I2 in ascending order. The hyperthermal pair of ETM2–H2 corresponds with the marine interval. δ13Ccarband δ18Ocarbfrom the middle part of the succession reveal concomitant negative excursions. The association between these hyperthermals and transgression appears to be regionally and globally valid, which strongly suggests a causal link between them.
Multivariate meta-analysis of multiple outcomes: characteristics and predictors of borrowing of strength from Cochrane reviews
Authors: Hattle Miriam , Burke Danielle L. , Trikalinos Thomas , Schmid Christopher H. , Chen Yong , Jackson Dan , Riley Richard D.
Published: July 2022

Objectives

Multivariate meta-analysis allows the joint synthesis of multiple outcomes accounting for their correlation. This enables borrowing of strength (BoS) across outcomes, which may lead to greater efficiency and even different conclusions compared to separate univariate meta-analyses. However, multivariate meta-analysis is complex to apply, so guidance is needed to flag (in advance of analysis) when the approach is most useful.

Study design and setting

We use 43 Cochrane intervention reviews to empirically investigate the characteristics of meta-analysis datasets that are associated with a larger BoS statistic (from 0 to 100%) when applying a bivariate meta-analysis of binary outcomes.

Results

Four characteristics were identified as strongly associated with BoS: the total number of studies, the number of studies with the outcome of interest, the percentage of studies missing the outcome of interest, and the largest absolute within-study correlation. Using these characteristics, we then develop a model for predicting BoS in a new dataset, which is shown to have good performance (an adjusted R2 of 50%). Applied examples are used to illustrate the use of the BoS prediction model.

Conclusions

Cochrane reviewers mainly use univariate meta-analysis methods, but the identified characteristics associated with BoS and our subsequent prediction model for BoS help to flag when a multivariate meta-analysis may also be beneficial in Cochrane reviews with multiple binary outcomes. Extension to non-Cochrane reviews and other outcome types is still required.
Exploring patterns and consequences of land consumption in a coastal city-region
Authors: Dadashpoor Hashem , Hasankhani Zahra
Published: July 2022

Background

The rapid expansion of built-up areas and land consumption with unsustainable spatial patterns in coastal urban areas has become a global major concern due to its far-reaching consequences for human daily life, environmental sustainability, and living organisms. However, the research on this phenomenon in these areas has received less attention. To fill this gap, we conducted a study to explore the spatial patterns of land consumption at both micro- and macro-levels and to evaluate its consequences in terms of sustainable development in a coastal city-region of Mazandaran Province in northern Iran. To achieve these two goals, we combined two methods of urban land density function and landscape expansion index (LEI) to explore spatial patterns of land consumption and also evaluated the sustainability of the region with two methods of the hierarchical analytical process (AHP) and urban sustainability index (USI).

Results

The spatial patterns of land consumption in the city-region of Mazandaran from 1996 to 2016 at the macro-level changed from a decentralized-sprawl to a centralized-sprawl pattern. At the micro-level, the dominant spatial pattern of land consumption in the city-region changed gradually from the outlying pattern towards the edge expansion and infilling patterns. Also, the spatial pattern of the built-up patches in the majority of the urban areas had conformity with the dominant pattern of the region. Besides, the spatial patterns of land consumption in the region were in an unsustainable state and were changing towards more unsustainability. The absence of urban containment policies and plans could lead to further destruction of the natural environment and increase its unsustainability.

Conclusions

Our results indicate that the urban areas of the coastal Mazandaran have the same behavior in the spatial pattern of land consumption at the macro- and micro-levels and all are in the same direction and follow the dominant pattern of the region.
Impact of collaborative physician-pharmacist stewardship strategies on prophylactic antibiotic practices: a quasi-experimental study
Authors: Pardo Antonelle , Ntabaza Vianney , Rivolta Mathieu , Goulard Aline , Sténuit Serge , Demeester Remy , Milas Sandrine , Duez Pierre , Patris Stéphanie , Joris Marc , Dony Philippe , Cherifi Soraya
Published: July 2022

Background

An effective use of surgical antibiotic prophylaxis (SAP) appears essential to prevent the development of infections linked to surgery while inappropriate and excessive prescriptions of prophylactic antibiotics increase the risk of adverse effects, bacterial resistance and Clostridium difficile infections. In this study, we aimed to analyze SAP practices in an acute secondary hospital in Belgium during the years 2016–2021 in order to evaluate the impacts of combined stewardship interventions, implemented thanks to a physician-pharmacist collaboration.

Methods

A quasi-experimental study on SAP practices was conducted during 5 years (2016–2021) in a Belgian University Hospital. We first performed a retrospective observational transversal study on a baseline group (2016.1–2016.4). Then, we constituted a group of patients (2017.1–2017.4) to test a combined intervention strategy of stewardship which integrated the central role of a pharmacist in antibiotic stewardship team and in the pre-operative delivery of nominative kits of antibiotics adapted to patient factors. After this test, we collected patient data (2018.1–2018.4) to evaluate the sustained effects of stewardship interventions. Furthermore, we evaluated SAP practices (2019.1–2019.4) after the diffusion of a computerized decision support system. Finally, we analyzed SAP practices in the context of the COVID-19 pandemic (2020.1–2020.4 and 2021.1–2021.4). The groups were compared from year to year in terms of compliance to institutional guidelines, as evaluated from seven criteria (χ2 test).

Results

In total, 760 surgical interventions were recorded. The observational study within the baseline group showed that true penicillin allergy, certain types of surgery and certain practitioners were associated with non-compliance (p < 0.05). Compared with the baseline group, the compliance was significantly increased in the test group for all seven criteria assessed (p < 0.05). However, the effects were not fully sustained after discontinuation of the active interventions. Following the diffusion of the computerized decision support system, the compliance to guidelines was not significantly improved. Finally, the COVID-19 pandemic did not appear to affect the practices in terms of compliance to guidelines.

Conclusions

This study shows that optimization of SAP practices is achievable within a proactive multidisciplinary approach including real-time pharmaceutical interventions in the operating area and in the care units practicing SAP.
The prevalence of obstructive sleep apnoea risk factors in individuals with cognitive impairment: south London cross-sectional study
Authors: Kirsh Leiah , Cox Rebecca , Mongue-Din Heloise , Lawrence Robert
Published: July 2022

Aims and Method

We aimed to determine the prevalence of risk factors for obstructive sleep apnoea (OSA) in patients with mild cognitive impairment (MCI) or dementia. Using patient records across a 5 year period, we identified 16 855 patients with dementia or MCI. We gave scores for keywords relating to each modified STOP BANG parameter in patient progress notes. Based on individual scores, we stratified the population into groups with low, intermediate and high risk of OSA.

Results

Our population had a high prevalence of risk factors and consequently high risk scores for OSA (18.21% high risk). Parameters directly related to sleep had a low prevalence.

Clinical implications

The risk of developing or having OSA is high among patients with MCI and dementia. Low sleep parameter frequency probably suggests poor documentation of sleep rather than true prevalence. Our findings support the implementation of the STOP BANG or a similar screening tool as a standardised method to identify OSA risk in memory clinics.
First Trimester Dexamethasone Treatment Is Not Associated With Alteration in Resting-state Connectivity at Adolescent or Adult Age
Authors: Messina Valeria , van’t Westeinde Annelies , Padilla Nelly , Lajic Svetlana
Published: July 2022

Context

Prenatal treatment with dexamethasone (DEX) has been used to prevent virilization in females at risk of congenital adrenal hyperplasia (CAH). Both affected and unaffected girls, as well boys, are treated until the genotype and sex of the fetus is known (gestational weeks 10-12). After that, only affected girls are treated until term. Exposure to a high synthetic glucocorticoid dosage may alter the developmental trajectory of the brain, with alterations in resting-state functional connectivity of the brain at adult age.

Objective

To investigate resting-state functional connectivity in subjects at risk of having CAH, exposed to DEX treatment during the first trimester of fetal life, both in the whole brain and in 3 regions of interest (amygdala, hippocampus, and superior frontal gyrus).

Design, Setting, and Participants

Eighteen participants (8 females) at risk of having CAH, exposed to DEX treatment, and 38 controls (24 females), age range 16 to 26 years, from a single research institute, underwent functional magnetic resonance imaging of the brain during rest. We used 2 different approaches: an exploratory whole-brain analysis and seed-based analysis. For seed-based analysis, we chose 3 different brain regions (amygdala, hippocampus, and superior frontal gyrus) based on our previous findings and literature evidence.

Results

We did not observe any differences in functional connectivity during rest, either in the whole brain nor in seed-based connectivity analyses at this adolescent and young adult age.

Conclusions

Our results are reassuring; however, future studies on larger samples and with more sensitive methodologies are needed to confirm these findings.