bluuebunny/crossref_metadata_2025 huggingface dataset:
Lenacapavir: A Novel Long-Acting Capsid Inhibitor for HIV
Authors: Tailor Marylee W. , Chahine Elias B. , Koren David , Sherman Elizabeth M.
Published: May 2023

Objective:

To review the efficacy, safety, and role of lenacapavir (LEN) in the treatment of HIV-1 infection.

Data Sources:

A literature search was performed using PubMed and Google Scholar (through March 2023) with the search term LEN and GS-6207. Other resources included abstracts presented at recent conferences, the manufacturer’s Web site, and prescribing information.

Study Selection and Data Extraction:

All relevant articles, trial updates, and conference abstracts in the English language were included.

Data Synthesis:

Lenacapavir represents a new class of antiretrovirals (ARVs) with a novel mechanism of action as a capsid inhibitor and a unique twice-a-year subcutaneous administration schedule. Lenacapavir when combined with other ARVs has proven to benefit heavily treatment-experienced (HTE) patients with HIV-1 infection in achieving viral suppression and immune restoration.

Relevance to Patient Care and Clinical Practice in Comparison With Existing Drugs:

Lenacapavir is a new treatment option that patients who are HTE can consider adding as part of an ARV regimen.

Conclusions:

Lenacapavir is an effective and well-tolerated option for HTE patients which is a valuable addition to the arsenal of ARVs.
RAF1-rearranged Spindle Cell Mesenchymal Tumor With Calcification and Heterotopic Ossification: A Case Report and Review of Literature
Authors: Cordier Fleur , Loontiens Siebe , Van der Meulen Joni , Lapeire Lore , van Ramshorst Gabrielle H. , Sys Gwen , Van Dorpe Jo , Creytens David
Published: May 2023

We report an exceptional case of a spindle cell mesenchymal tumor with S100 and CD34 co-reactivity, which harbored a SLMAP::RAF1 fusion. To the best of our knowledge, this is the second case of a spindle cell mesenchymal tumor with S100 and CD34 co-reactivity with this specific fusion. Remarkable is the presence of calcification and heterotopic ossification in the center of our lesion, a feature that, to our knowledge, has not been described yet in RAF1-rearranged spindle cell mesenchymal tumors.
No More Building Resiliency: Confronting American Psychology’s White Supremacist Past to Reimagine Its Antiracist Future
Authors: Legha Rupinder K , Martinek Nathalie N.
Published: May 2023

This paper introduces a historically informed antiracist approach to psychological practice aimed at disrupting American psychology’s legacy of racism by first saying “No More” to the whiteness engulfing it. Its end goal is to detour psychological practices away from enduring legacies of oppression, reimagine psychological practice as an antiracist endeavor, and extricate the deep-seated structural whiteness rotting the profession at its core. No more building resiliency takes aim at the White discourses directing people suffering under the weight of White supremacy to bear it instead of compelling mental health professions to dismantle the systems of oppression causing the harm. Seven historical themes reveal how organized psychology has shaped and been shaped by racism and whiteness since its inception. By identifying the language and strategies used to cover up and sustain the racist harm by design, the themes provide starting points for antiracist psychological practices that interrogate and dismantle both forms of oppression. They issue the imperative for a critical, transparent, and transgressive psychology of the future, one that requires not a revision of existing practices, rather a complete redo. The closing section imagines where we go from here by offering immediate action steps for bringing this antiracist future closer within reach.
Responding to Climate Change: Indigenous knowledge lessons from Nigerian root and tuber farmers
Authors: Olaniyan Bolanle Susan , Govender Nadaraj
Published: May 2023

This study espoused lessons learnt from Indigenous root and tuber farmers’ responses to Climate Change in Nigeria. Situated Learning Theory and Participatory Phenomenology framed the study. Data were generated using focus group discussions, in-depth interview and participant observation. An inductive thematic analysis was applied on the data. The experience of Climate Change by the farmers has been change in rainfall pattern and other indicators were identified. The farmers respond to Climate Change using their Indigenous knowledge of water conservation by making mounds, maintain soil fertility by practising crop rotation, use compost made from household wastes and sustainable use of natural resources. The farmers’ preference for adapting to Climate Change using Indigenous knowledge was attributed to Indigenous knowledge being effective, easily accessible and inexpensive along with their apathy to scientific interventions. The study recommended possible ways of including the documented Indigenous knowledge into mainstream adaptation strategies and Agricultural Curriculum in Nigeria.
A co-designed tool to gather data from students with disability about their experiences in tertiary education: Insights from Australia
Authors: Steele Alicia , Banks Robin , Louis Winnifred R
Published: May 2023

A small internal investigation by the University of Queensland (UQ) Union Disability Collective resulted in a student-led project supported by academics across three Australian universities. The project seeks to gain new insights into the experience of students with disabilities studying at Australian universities. Universities conduct disability surveys from time to time, but these tend to be forgotten as time passes and priorities change. This project involved the co-design and development of a survey, using qualitative and quantitative questions, to investigate students’ experiences, including of barriers to education and participation in the Australian tertiary (or post-secondary) sector. This is planned to be the first of several research projects to transparently and accountably track issues faced by disabled tertiary students, and what is working to improve education outcomes and reduce discrimination. The survey has been piloted with UQ students with a view to roll it out to other universities. This paper focuses on the survey instrument and describes the project’s formation and development. It also identifies challenges that have arisen in the process and future directions.
Co-creating public health measures with adolescents in municipalities: Municipal actors’ views on inhibitors and promoters for adolescent involvement
Authors: Sylte Mari , Lillefjell Monica , Anthun Kirsti S.
Published: May 2023

Aim:

To explore what municipal actors consider as inhibiting and promoting adolescents’ involvement in public health measures in municipalities.

Methods:

A qualitative study with individual and group interviews was conducted among 15 municipal actors who were central in involving adolescents from five Norwegian municipalities participating in the National Programme for Public Health Work in Municipalities (2017–2027). In addition, participatory observation of project activities was done in two municipalities. A data-driven thematic analysis was applied to analyse data.

Results:

In the analysis, we developed four themes, including both inhibitors and promoters for adolescent involvement: (a) Timeframe challenges in adolescent involvement; (b) Lack of necessary knowledge and awareness among adolescents; (c) Limited competencies and resources in the project groups; and (d) Facilitators’ attitudes on and perceptions of adolescent involvement.

Conclusions:

This study reports factors that are important to consider when facilitating involvement processes with young people. Findings suggest that further work should be done to ensure involvement of adolescents in public health measures in municipalities, and actors involving adolescents must be provided with competence and resources to ensure such participation.
Editorial to Special Issue: Do Actions Speak Louder Than Thoughts? Normative Behaviourism Reconsidered
Authors: Handby Edmund
Published: May 2023

This Editorial introduces the symposium ‘Do Actions Speak Louder Than Thoughts? Normative Behaviourism Reconsidered’, which revisits a contribution to political philosophy methodology, Floyd’s Is Political Philosophy Impossible: Thoughts and Behaviour in Normative Political Theory. I briefly outline each of the contributions, as well as paving the way for Floyd’s response.
The yield of dysplasia and serrated lesions in a single-centre tertiary inflammatory bowel disease cohort
Authors: Yeaman Fiona , Thin Lena
Published: May 2023

Background:

Chromoendoscopy is preferred over high-definition white light endoscopy (HDWLE) for dysplasia surveillance in inflammatory bowel disease (IBD) patients, but is more time-consuming to perform and real-world evidence is limited. The prevalence of sessile serrated lesions (SSLs) in IBD patients is also unknown.

Objective:

To determine the yield of polypoid and non-polypoid dysplasia and SSLs in IBD patients undergoing dysplasia surveillance and the associations for these lesions.

Design:

A retrospective cohort study from a tertiary IBD centre.

Methods:

A keyword search of the colonoscopy reporting system was performed. IBD patients with colonic disease that underwent colonoscopy for surveillance between 1 February 2015 and 1 February 2018 were included. Clinical, endoscopic and histopathological outcomes were extracted for the analysis.

Results:

Of 2114 patients identified, 276 eligible colonoscopies in 126 patients were analysed. The median age at colonoscopy was 51 years (interquartile range: 42–58 years). 71/126 (56%) of colonoscopies were performed in male patients, with 57/126 (45%) having ulcerative colitis, 68/126 (54%) Crohn’s colitis and 1/126 (0.79%) IBD-unspecified. The prevalence for any neoplasia was 75/276 (27%). The prevalence for all serrated lesions was 43/276 (16%). Increased age was a risk factor for finding a neoplastic lesion on both univariate and multivariate analyses. Chromoendoscopy was associated with twice the odds of finding a neoplastic lesion (odds ratio: 1.99, 95% confidence interval: 1.13–3.51, p = 0.02), on multivariate analysis. No factor was associated with an increased risk of finding a serrated lesion.

Conclusion:

Significant neoplastic lesions and serrated lesions were detected in 27% and 16% of colonoscopies performed in IBD patients, respectively, with the highest yield in older patients. Chromoendoscopy significantly increased neoplasia yield compared to HDWLE and still has a robust utility in this pragmatic real-world study.
Impact of the coronavirus disease-2019 pandemic on Veterans Health Administration Sleep Services
Authors: Sico Jason J , Koo Brian B , Perkins Anthony J , Burrone Laura , Sexson Ali , Myers Laura J , Taylor Stanley , Yarbrough W Claibe , Daggy Joanne K , Miech Edward J , Bravata Dawn M
Published: May 2023

Objectives:

To understand the impact of the coronavirus disease-2019 pandemic on sleep services within the United States Department of Veterans Affairs using separate surveys from “pre-COVID” and pandemic periods.

Methods:

Data from a pre-pandemic survey (September to November 2019) were combined with data from a pandemic-period survey (August to November 2020) to Veterans Affairs sleep medicine providers about their local sleep services within 140 Veterans Affairs facilities).

Results:

A total of 67 (47.9%) facilities responded to the pandemic online survey. In-lab diagnostic and titration sleep studies were stopped at 91.1% of facilities during the pandemic; 76.5% of facilities resumed diagnostic studies and 60.8% resumed titration studies by the time of the second survey. Half of the facilities suspended home sleep testing; all facilities resumed these services. In-person positive airway pressure clinics were stopped at 76.3% of facilities; 46.7% resumed these clinics. Video telehealth was either available or in development at 86.6% of facilities and was considered a lasting addition to sleep services. Coronavirus disease-2019 transmission precautions occurred at high rates. Sleep personnel experienced high levels of stress, anxiety, fear, and burnout because of the pandemic and in response to unexpected changes in sleep medicine care delivery.

Conclusions:

Sleep medicine services within the Veterans Affairs evolved during the pandemic with many key services being interrupted, including in-lab studies and in-person positive airway pressure clinics. Expansion and initiation of telehealth sleep services occurred commonly. The pandemic adversely affected sleep medicine personnel as they sought to maintain access to care.
Malnutrition in hospitalized cancer patients: A single-center, cross-sectional study in Southern Vietnam
Authors: Van Tap Nguyen , Bang Ho Tat , Huong Duong Thi , Chi Pham Cong , Anh Le Thi Ngoc
Published: May 2023

Objectives:

Malnutrition in cancer patients reduces response to chemotherapy, increases the hospitalization costs, hospital infections, and deaths. The aim of this study was to determine the prevalence, level of malnutrition, and its related factors in cancer patients at a local hospital in Southern Vietnam.

Methods:

A descriptive cross-sectional study was performed on all 118 cancer patients who were undergoing inpatient treatment at Long An General Hospital, Vietnam from May to September 2020. Data were collected from patients by face-to-face interviewing using a subjective global assessment (SGA) and from medical records. Malnutrition is divided into three groups: SGA-A (normal), SGA-B (mild/moderate/suspected malnutrition), SGA-C (severe malnutrition). Multivariable logistic regression is used to identify factors related to malnutrition with statistical significance p < 0.05.

Results:

Out of 118 participants, 72 (61.0%) were males and 84 (71.2%) aged ⩾60 years. The prevalence of malnutrition in cancer patients was 84.7% (100/118), in which 33% (39/118) were severe (SGA-C) and 51.7% (61/118) were mild–moderate (SGA-B). Pancreatic and lung cancers are the most malnourished. The results of multivariate logistic regression analysis showed that the factors related to malnutrition in cancer patients were gastrointestinal symptoms lasting 2 weeks (odds ratio: 6.10, 95% confidence interval: 1.12–33.35), patients with decreased motor function (odds ratio: 13.73, 95% confidence interval: 2.56–73.86), blood albumin <35 g/l (odds ratio: 6.42, 95% confidence interval: 1.54–26.82), and blood lymphocyte ⩽ 1700 cells/mm3 (odds ratio: 5.36, 95% confidence interval: 1.31–21.97).

Conclusions:

There was a high proportion of malnutrition in cancer patients. Therefore, it is necessary to strengthen nutrition counseling and intervention for these patients, especially those that have prolonged gastrointestinal symptoms, reduced motor function, and low blood albumin or low blood lymphocytes.
The Impact of the Affordable Care Act Medicaid Expansion on Acute Diabetes Complications Among Community Health Center Patients
Authors: Huguet Nathalie , Dinh Dang , Hwang Jun , Marino Miguel , Larson Annie E. , Suchocki Andrew , DeVoe Jennifer E.
Published: May 2023

Objective:

This study evaluates whether patients residing in expansion states have a greater increase in outpatient diagnoses of acute diabetes complications than those living in non-expansion states following the implementation of the Affordable Care Act (ACA).

Methods:

This retrospective cohort study uses electronic health records (EHR) from 10,665 non-pregnant patients, aged 19 to 64 years old who were diagnosed with diabetes in 2012 or 2013 from 347 community health centers (CHCs) across 16 states (11 expansion and 5 non-expansion states). Patients included had ≥1 outpatient ambulatory visit in each of these periods: pre-ACA: 2012 to 2013, post-ACA: 2014 to 2016, and post-ACA: 2017 to 2019. Acute diabetes-related complications were identified using International Classification Diseases (ICD-9-CM and ICD-10-CM) codes classification and could occur on or after diagnosis of diabetes. We performed difference-in-differences (DID) analysis using a generalized estimating equation to compare the change in rates of acute diabetes complications by year and by Medicaid expansion status.

Results:

There was a greater increase after year 2015 in visits related to abnormal blood glucose among patient living in Medicaid expansion states than in non-expansion states (2017 DID = 0.041, 95% CI = 0.027-0.056). Although both visits due to any acute diabetes complications and infection-related diabetes complications were higher among patients living in Medicaid expansion states, there was no difference in the trend overtime between expansion and non-expansion states.

Conclusion:

We found a significantly greater rate of visits for abnormal blood glucose in patients receiving care in expansion states relative to patients in CHCs in non-expansion states starting in 2015. Additional resources for these clinics, such as the ability to provide blood glucose monitoring devices or mailed/delivered medications, could substantially benefit patients with diabetes.
Breaking the Shackles: Uncovering the Entrepreneurial Intention Among Women A Study Based in North India
Authors: Fayaz Naira , Khandai Sujata , Zupic Ivan
Published: May 2023

The present research explores the factors stimulating entrepreneurial potential among women based in India and how it eventually results in an intention to start their own business. The study is using the theory of planned behavior (TPB) and the entrepreneurial event model to identify the antecedents of entrepreneurial potential among women entrepreneurs in India. The study also attempts to understand whether entrepreneurial potential results in an intention to take up a business venture. A survey questionnaire is used to gather the data, and it is conducted both online and offline. The study used 214 responses in total. The data is analyzed using validated procedures and techniques, such as exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and then path analysis in AMOS (20). The study found that entrepreneurial potential was significantly affected by perceived desirability, followed by perceived feasibility and it also found that perceived risk negatively affects entrepreneurial potential. The second finding shows that the developed potential does turn into an intention to start an entrepreneurial venture, backed by perceived desirability and perceived feasibility. The results can be used to design training programs and help incubators create a methodical strategy to ensure the promotion of women entrepreneurs.
An Investment in Knowledge: Personal Finance Education for Medical Students
Authors: Wu Scott A , Neuville Alexander J , Bigach Stephen D , Kalainov David M , Patel Alpesh A
Published: May 2023

The financial burden of pursuing a medical education continues to grow, with the average medical student now owing over $240,000 in total student loan debt by the time they graduate. This burden peaks at a time when trainees are making some of the most consequential decisions of their careers. Additionally, many students are simultaneously making important financial decisions related to personal aspirations, all before a drastic change in earning potential once they begin practicing as attending physicians. Medical trainees’ financial stress is linked to specialty choice, mental quality of life, and physician burnout, with additional implications of such stress for patient health and safety. 1 – 3 Despite these issues, there are few examples of medical schools providing direct personal finance education to their students. Given the lack of personal finance education opportunities for medical students, the authors designed and implemented a medical student–specific personal finance curriculum at their home institution in conjunction with the Association of American Medical Colleges’ (AAMC) Financial Information, Resources, Services, and Tools program. The curriculum, which is primarily delivered through interactive lectures, covers topics ranging from the basics of saving and investment to clinicians’ potential future roles as administrators and innovators. The authors (1) present details regarding the creation of their personal finance education program; (2) invite fellow medical trainees and their respective institutions to start their own personal finance education programs or add similar curriculum to their health sciences coursework; and (3) call for recommendations by the American Medical Association (AMA) and AAMC in support of formal personal finance instruction for medical students on a national level.
Life and times of data access: Regarding Native Lands
Authors: Brewer Joseph P , Carroll Stephanie Russo , Bartecchi David , Chesnais Aude K , Johnson Michael Kotutwa
Published: May 2023

It is challenging to understand the full and detailed story of Native People’s lands in the United States. In this article, we contend that reliable and accessible data regarding Native People’s lands complicate and perpetuate those challenges. Stemming from the implications of colonial ideologies, such as the General Allotment Act of 1887, Native Peoples’ land-based data are difficult to access for Tribal Nations and researchers. Land data have been and continue to be obscured by U.S. federal processes and are dependent on unreliable systems of outdated and exclusive practices that consistently marginalize Native Peoples. Therefore, those data do not adequately inform Tribal land planning initiatives. In this article we recommend new processes that strengthen Tribal data sovereignty as the fundamental underpinnings to an inclusive and protected data in the future.
Impact of Foreign Direct Investment and Merchandise and Services Trade on the Economic growth in India: An Empirical Study
Authors: Bhattacharyya Jita , Bhattacharya Mousumi
Published: May 2023

This paper attempts to study the possible link among FDI inflow, economic growth, merchandise trade and services trade of India during the post-liberalisation period 1998–99: Ql to 2008–09: Q3. The long-term relationships among the variables are analysed using the Johansen and Juselius multivariate co integration approach. Short and long run dynamics are captured through vector error correction models. To further investigate the interaction between the variables, the study uses impulse response function (IRFs) besides the above mentioned time series technique. Regression analysis is also done for the same time period. To test the parameter stability of the variables involved in the study, CUSUMSQ test is also performed. The study found the evidence of co integration among the variables, indicating diat a long-term relationship exists among diem. Bi-directional causality is observed between merchandise trade and economic growth, services trade and economic growth. Unidirectional causality is observed from FDI to economic growth and FDI to merchandise trade. A unidirectional causality is also observed from merchandise trade to services trade.
Identification of cuproptosis-related lncRNAs to predict prognosis and immune infiltration characteristics in alimentary tract malignancies
Authors: Xie Yangyang , Song Xue , Du Danwei , Ni Zhongkai , Huang Hai
Published: May 2023

Background

Alimentary tract malignancies (ATM) caused nearly one-third of all tumor-related death. Cuproptosis is a newly identified cell death pattern. The role of cuproptosis-associated lncRNAs in ATM is unknown.

Method

Data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases were used to identify prognostic lncRNAs by Cox regression and LASSO. Then a predictive nomogram was constructed based on seven prognostic lncRNAs. In addition, the prognostic potential of the seven-lncRNA signature was verified via survival analysis, the receiver operating characteristic (ROC) curve, calibration curve, and clinicopathologic characteristics correlation analysis. Furthermore, we explored the associations between the signature risk score and immune landscape, and somatic gene mutation.

Results

We identified 1211 cuproptosis-related lncRNAs and seven survival-related lncRNAs. Patients were categorized into high-risk and low-risk groups with significantly different prognoses. ROC and calibration curve confirmed the good prediction capability of the risk model and nomogram. Somatic mutations between the two groups were compared. We also found that patients in the two groups responded differently to immune checkpoint inhibitors and immunotherapy.

Conclusion

The proposed novel seven lncRNAs nomogram could predict prognosis and guide treatment of ATM. Further research was required to validate the nomogram.
Identification of SPRYD4 as a tumour suppressor predicts prognosis and correlates with immune infiltration in cholangiocarcinoma
Authors: Ma Zuyi , Xie Tiange , Sun Jia , Yu Jianchun , Huang Shanzhou , Zhou Qi , Li Binglu
Published: May 2023

Cholangiocarcinoma (CCA) is an aggressive solid tumour with a 5-year survival rate ranging from 7% to 20%. It is, therefore, urgent to identify novel biomarkers and therapeutic targets to improve the outcomes of patients with CCA. SPRY-domain containing protein 4 (SPRYD4) contains SPRY domains that modulate protein–protein interaction in various biological processes; however, its role in cancer development is insufficiently explored. This study is the first to identify that SPRYD4 is downregulated in CCA tissues using multiple public datasets and a CCA cohort. Furthermore, the low expression of SPRYD4 was significantly associated with unfavourable clinicopathological characteristics and poor prognosis in patients with CCA, indicating that SPRYD4 could be a prognosis indicator of CCA. In vitro experiments revealed that SPRYD4 overexpression inhibited CCA cells proliferation and migration, whereas the proliferative and migratory capacity of CCA cells was enhanced after SPRYD4 deletion. Moreover, flow cytometry showed that SPRYD4 overexpression triggered the S/G2 cell phase arrest and promoted apoptosis in CCA cells. Furthermore, the tumour-inhibitory effect of SPRYD4 was validated in vivo using xenograft mouse models. SPRYD4 also showed a close association with tumour-infiltrating lymphocytes and important immune checkpoints including PD1, PD-L1 and CTLA4 in CCA. In conclusion, this study elucidated the role of SPRYD4 during CCA development and highlighted SPRYD4 as a novel biomarker and tumour suppressor in CCA.
An implementation evaluation of the physical activity counseling for in-patients with major depressive disorder (PACINPAT) intervention: a randomized controlled trial
Authors: Cody Robyn , Kreppke Jan-Niklas , Fischer Xenia , Faude Oliver , Beck Johannes , Brand Serge , Hatzinger Martin , Imboden Christian , Kügerl Nadine , Lang Undine E. , Mans Sarah , Maurer Reto , Mikoteit Thorsten , Oswald Anja , Rhodius Lilja-Sophie , Schweinfurth Nina , Wechsler Laura , Gerber Markus
Published: May 2023

Background

The physical activity counseling for in-patients with major depression (PACINPAT) randomized controlled trial was launched to tackle physical inactivity for in-patients with major depressive disorder. Evidence shows that despite potential treatment effects, physical inactivity is prevalent in this population. To contribute to the assessment of how this in-person and remote, theory-based, individually tailored intervention was designed, received and effected behavior, the aim of this study was to evaluate its implementation.

Methods

This implementation evaluation was conducted within a multi-center randomized controlled trial according to the Process Evaluation Framework by the Medical Research Council including the analysis of reach, dose, fidelity and adaptation. Data were collected from the implementers and the participants randomized to the intervention group of the trial.

Results

The study sample comprised 95 physically inactive in-patients (mean age: 42 years, 53% women) with diagnosed major depressive disorder. The intervention reached the intended population (N = 95 in-patients enrolled in the study). The intervention dose varied between early dropouts (counseling sessions, M = 1.67) and study completers with some participants receiving a low dose (counseling sessions, M = 10.05) and high dose (counseling sessions, M = 25.37). Differences in the attendance groups were recognizable in the first two counseling sessions (duration of counseling session about 45 min in early dropouts versus 60 min for study completers). Fidelity of the in-person counseling content was partly achieved and adapted, whereas that of the remote counseling content was well achieved. Participants (86% at follow up) reported satisfaction with the implementers of the intervention. Adaptations were made to content, delivery mode and dose.

Conclusion

The PACINPAT trial was implemented in the intended population, in varying doses and with adaptations made to in-person counseling content and remote counseling dose. These findings are key to understanding outcome analyses within the PACINPAT trial, further developing interventions and contributing to implementation research among in-patients with depressive disorders.

Trial registration

ISRCTN, ISRCTN10469580, registered on 3rd September 2018.
Comparison of healthspan-related indicators between adults with and without HIV infection aged 18–59 in the United States: a secondary analysis of NAHNES 1999–March 2020
Authors: Chen Chen , Cao Xingqi , Xu Jie , Jiang Zhen , Liu Zuyun , McGoogan Jennifer , Wu Zunyou
Published: May 2023

Background

As persons with HIV (PWH) live longer they may experience a heightened burden of poor health. However, few studies have characterized the multi-dimentional health of PWH. Thus, we aimed to identify the extent and pattern of health disparities, both within HIV infection status and across age (or sex) specific groups.

Methods

We used cross-sectional data from the US National Health and Nutrition Examination Survey, 1999–March 2020. The adjusted prevalence of six healthspan-related indicators—physical frailty, activities of daily living (ADL) disability, mobility disability, depression, multimorbidity, and all-cause death—was evaluated. Logistic regression and Cox proportional hazards analyses were used to investigate associations between HIV status and healthspan-related indicators, with adjustment for individual-level demographic characteristics and risk behaviors.

Results

The analytic sample consisted of 33 200 adults (170 (0.51%) were PWH) aged 18–59 years in the United States. The mean (interquartile range) age was 35.1 (25.0–44.0) years, and 49.4% were male. PWH had higher adjusted prevalences for all of the 6 healthspan-related indicators, as compared to those without HIV, ranged from 17.4% (95% CI: 17.4%, 17.5%) vs. 2.7% (95%CI: 2.7%, 2.7%) for all-cause mortality, to 84.3% (95% CI: 84.0%, 84.5%) vs. 69.8% (95%CI: 69.7%, 69.8%) for mobility disability. While the prevalence difference was largest in ADL disability (23.4% (95% CI: 23.2%, 23.7%); P < 0.001), and least in multimorbidity (6.9% (95% CI: 6.8%, 7.0%); P < 0.001). Generally, the differences in prevalence by HIV status were greater in 50–59 years group than those in 18–29 group. Males with HIV suffered higher prevalence of depression and multimorbidity, while females with HIV were more vulnerable to functional limitation and disabilities. HIV infection was associated with higher odds for 3 of the 6 healthspan-related indicators after fully adjusted, such as physical frailty and depression. Sensitivity analyses did not change the health differences between adults with and without HIV infection.

Conclusions

In a large sample of U.S. community-dwelling adults, by identifying the extent and pattern of health disparities, we characterized the multi-dimentional health of PWHs, providing important public health implications for public policy that aims to improve health of persons with HIV and further reduce these disparities.
Interplay of gestational parent exposure to ambient air pollution and diet characteristics on preterm birth
Authors: Jardel Hanna , Martin Chantel L , Hoyo Cathrine , Rappazzo Kristen M
Published: May 2023

Background

Despite many efforts, preterm birth (PTB) is poorly understood and remains a major public health problem in the United States. Toxicological work suggests gestational parent (GP) diet may modify the effect of ambient pollutants on birth outcomes. We assessed risk of PTB in humans in relation to fine particulate matter (PM2.5), ozone (O3), and nitrogen dioxide (NO2) and variation by diet.

Methods

684 GP-singleton infant pairs in the Newborn Epigenetics Study prospective birth cohort were attributed ambient air pollutant exposures for each trimester based on residence. Total energy intake, percent of energy intake from saturated fat, and percent of energy intake from total fat were dichotomized at the 75th percentile. >We used log binomial regressions to estimate risk ratios (RR (95%CI)) for PTB by pollutant interquartile ranges, adjusting for GP age, pre-pregnancy body mass index, GP race/ethnicity, GP education, season of conception, household income, and each diet factor. We assessed departure from additivity using interaction contrast ratios (ICRs). We addressed missing covariate data with multiple imputation.

Results

Point estimates suggest that O3 may be inversely associated with PTB when exposure occurs in trimester 2 (min RR: 0.77, 95% CI: 0.39, 1.49), but may be harmful when exposure occurs in trimester 3 (max RR: 1.51, 95% CI: 0.62, 3.64). Additionally, PM2.5 may be inversely associated with PTB when considered with total fat and saturated fat in trimester 2. Imprecise ICRs suggest departure from additivity (evidence of modification) with some pollutant-diet combinations.

Conclusions

While confidence intervals are wide, we observed potential modification of pollutant associations by dietary factors. It is imperative that large cohorts collect the required data to examine this topic, as more power is necessary to investigate the nuances suggested by this work.
Association between early ambulation exercise and short-term postoperative recovery after open transforaminal lumbar interbody fusion: a single center retrospective analysis
Authors: Liao Jingwen , Qi Zhou , Chen Biying , Lei Purun
Published: May 2023

Background

Early ambulation in patients undergoing transforaminal lumbar interbody fusion (TLIF) surgery is recommended, however, the precise time interval after open surgery has never been specified. Current retrospective analysis was conducted aiming to clarify an accurate time interval.

Methods

A retrospective analysis of eligible patients was conducted using the databases of the Bone Surgery Department, Third Affiliated Hospital of Sun Yat-sen University from 2016 to 2021. Data pertaining to postoperative hospital stay length, expenses, incidence of complications were extracted and compared using Pearson’s χ2 or Student’s t-tests. A multivariate linear regression model was conducted to identify the relationship between length of hospital stay (LOS) and other outcomes of interest. A propensity analysis was conducted to minimize bias and to evaluate the reliability of results.

Results

A total of 303 patients met the criteria and were included for the data analysis. Multivariate linear regression results demonstrated that a high ASA grade (p = 0.016), increased blood loss (p = 0.003), cardiac disease (p < 0.001), occurrence of postoperative complications(p < 0.001) and longer ambulatory interval (p < 0.001) was significantly associated with an increased LOS. The cut-off analysis manifested that patients should start mobilization within 3 days after open TLIF surgery (B = 2.843, [1.395–4.292], p = 0.0001). Further comparative analysis indicated that patients who start ambulatory exercise within 3 days have shorter LOS (8.52 ± 3.28d vs 12.24 ± 5.88d, p < 0.001), total expenses ( 9398.12 ± 2790.82vs 10701.03 ± 2994.03 [USD], p = 0.002). Propensity analysis revealed such superiority was stable along with lower incidence of postoperative complications (2/61 vs 8/61, p = 0.0048).

Conclusions

The current analysis suggested that ambulatory exercise within 3 days for patients who underwent open TLIF surgery was significantly associated with reduced LOS, total hospital expenses, and postoperative complications. Further causal relationship would be confirmed by future randomized controlled trials.
Contributions of musculoskeletal rehabilitation in patients after chikungunya fever: a systematic review
Authors: Sales Weslley Barbosa , Leite Djavan Gomes , Truta Ramalho Caroline Sousa , Macêdo Sabrina Gabrielle Gomes Fernandes , de Souza Gérson Fonseca , Cavalcanti Maciel Álvaro Campos
Published: May 2023

Introduction

Chikungunya fever is an infection transmitted by the Chikungunya virus (CHIKV), which is an arbovirus that is transmitted by the mosquitoes Aedes aegypti and Aedes albopictus. The most common sequelae caused by CHIKV are chronic musculoskeletal pain, nerve damage, joint deformation and functional impairment.

Objective

To systematically identify the literature on the contributions of physiotherapy in the treatment of patients with CHIKV sequelae.

Materials and methods

Systematic review of the literature, guided by the recommendations of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). The databases used were PUBMED, LILACS, Scielo and PEDro. Experimental studies and/or full case studies published without language restriction or publication data were included, in which they stood out as contributions of musculoskeletal functional rehabilitation in the treatment of patients with the condition in question. Analytical observational studies, editorial letters, review protocols, reflective studies, literature reviews and articles that do not have an abstract and/or full text available online were excluded.

Results

The search in the databases was carried out between July and August 2022. A total of 4,782 articles were found on the platforms used and 10 articles from the gray literature search. After the duplicate analysis, 2,027 studies were excluded, leaving 2,755 articles that had their titles and abstracts read, of which 600 articles were selected for full reading. After this step, a final sample of 13 articles was eligible for this review.

Final considerations

The most consolidated approaches used in the literature demonstrate that kinesiotherapy, associated or not with electrothermophototherapy, the pilates method and auriculotherapy are useful resources in the treatment of these individuals, significantly inspired by pain relief, improved quality of life and of functionality.
Application of 3D-printed pulmonary segment specimens in experimental teaching of sectional anatomy
Authors: Miao Huachun , Ding Jian , Gong Xin , Zhao Jian , Li Huaibin , Xiong Kepin , Zhou Xiang , Liu Wenhui , Wu Feng
Published: May 2023

Background

Lung cross-section is one of the emphases and challenges in sectional anatomy. Identification of the complex arrangement of intrapulmonary tubes such as bronchi, arteries, and veins in the lungs requires the spatial imagination of students. Three-dimensional (3D) printing has become increasingly used in anatomy education. This study aimed to analyze the effectiveness of 3D-printed specimens used for the experimental teaching of sectional anatomy.

Methods

A digital thoracic dataset was obtained and input into a 3D printer to print multicolor specimens of the pulmonary segment after software processing. As research subjects, 119 undergraduate students majoring in medical imaging from classes 5–8 in the second-year were chosen. In the lung cross-section experiment course, 59 students utilized 3D printed specimens in conjunction with traditional instruction as the study group, while 60 students received traditional teaching as the control group. Preclass and postclass tests, course grading, and questionnaire surveys were used to assess instructional efficacy.

Results

We obtained a set of pulmonary segment specimens for teaching. The students in the study group scored better in the postclass test than those in the control group (P < 0.05), and the students in the study group scored higher in satisfaction with the teaching content and spatial thinking for sectional anatomy than those in the control group (P < 0.05). The course grades and excellence rates in the study group exceeded those in the control group (P < 0.05).

Conclusion

The application of high-precision multicolor 3D-printed specimens of lung segments in experimental teaching of sectional anatomy can improve teaching effectiveness and is worth adopting and promoting in sectional anatomy courses.
Concurrent IgG4-related hypophysitis and clinically nonfunctioning gonadotroph pituitary neuroendocrine tumor
Authors: Tahara Shigeyuki , Osamura Robert Yoshiyuki , Hattori Yujiro , Ishisaka Eitaro , Inomoto Chie , Sugihara Hitoshi , Teramoto Akira , Morita Akio
Published: May 2023

Background

Some patients develop immunoglobulin G4 (IgG4)-related hypophysitis associated with systemic diseases. More than 30 cases of IgG4-related hypophysitis have been reported. However, biopsy has rarely been performed in these patients, and none have had an associated pituitary neuroendocrine tumor (PitNET). We present a case of concurrent IgG4-related hypophysitis and PitNET.

Case presentation

A 56-year-old Japanese man arrived at the hospital with visual impairment, bitemporal hemianopia, and right abducens nerve palsy. Magnetic resonance imaging revealed pituitary body and stalk swelling as well as a small poorly enhanced right anterior lobe mass. Laboratory and loading test results suggested hypopituitarism. Because IgG4 level was elevated, a systemic examination was performed; multiple nodules were found in both lung fields. The diagnosis was based on an endoscopic transnasal biopsy of the pituitary gland. A histopathological examination revealed a marked infiltration of plasma cells into the pituitary gland, which was strongly positive for IgG4. The histological features of the resected tumor were consistent with those of gonadotroph PitNET, which was immunohistochemically positive for follicle-stimulating hormone-β and steroidogenic factor-1, and no plasma cell infiltration was observed. Based on the histopathological examination results, steroid therapy was initiated, which reduced pituitary gland size and serum IgG4 levels.

Discussion and Conclusions

This is the first reported case of IgG4-related hypophysitis with PitNET. Although no pathological findings indicating a relationship between the two conditions were found, we were able to preoperatively differentiate multiple lesions via detailed diagnostic imaging.
Real-time estimation of the remaining surgery duration for cataract surgery using deep convolutional neural networks and long short-term memory
Authors: Wang Bowen , Li Liangzhi , Nakashima Yuta , Kawasaki Ryo , Nagahara Hajime
Published: May 2023

Purpose

Estimating the surgery length has the potential to be utilized as skill assessment, surgical training, or efficient surgical facility utilization especially if it is done in real-time as a remaining surgery duration (RSD). Surgical length reflects a certain level of efficiency and mastery of the surgeon in a well-standardized surgery such as cataract surgery. In this paper, we design and develop a real-time RSD estimation method for cataract surgery that does not require manual labeling and is transferable with minimum fine-tuning.

Methods

A regression method consisting of convolutional neural networks (CNNs) and long short-term memory (LSTM) is designed for RSD estimation. The model is firstly trained and evaluated for the single main surgeon with a large number of surgeries. Then, the fine-tuning strategy is used to transfer the model to the data of the other two surgeons. Mean Absolute Error (MAE in seconds) was used to evaluate the performance of the RSD estimation. The proposed method is compared with the naïve method which is based on the statistic of the historical data. A transferability experiment is also set to demonstrate the generalizability of the method.

Result

The mean surgical time for the sample videos was 318.7 s (s) (standard deviation 83.4 s) for the main surgeon for the initial training. In our experiments, the lowest MAE of 19.4 s (equal to about 6.4% of the mean surgical time) is achieved by our best-trained model for the independent test data of the main target surgeon. It reduces the MAE by 35.5 s (-10.2%) compared to the naïve method. The fine-tuning strategy transfers the model trained for the main target to the data of other surgeons with only a small number of training data (20% of the pre-training). The MAEs for the other two surgeons are 28.3 s and 30.6 s with the fine-tuning model, which decreased by -8.1 s and -7.5 s than the Per-surgeon model (average declining of -7.8 s and 1.3% of video duration). External validation study with Cataract-101 outperformed 3 reported methods of TimeLSTM, RSDNet, and CataNet.

Conclusion

An approach to build a pre-trained model for estimating RSD estimation based on a single surgeon and then transfer to other surgeons demonstrated both low prediction error and good transferability with minimum fine-tuning videos.
Combination therapies for cancer: challenges and opportunities
Authors: Zhou Zhijun , Edil Barish H. , Li Min
Published: May 2023

Background

Gastrointestinal cancers represent a major challenge to public health. Pancreatic cancer is the most lethal cancer among all gastrointestinal cancers. Most patients cannot meet the criteria of resection at diagnosis, indicating these patients will have dismal prognosis.

Main text

Neoadjuvant chemotherapy helps some patients regain the opportunity of radical resection. An optimal regimen of chemotherapy is one that maximizes the anti-tumor efficacy while maintaining a relatively manageable safety profile. The development of surgical procedures further improves the outcomes of these patients.

Conclusions

Combination therapies in a multidisciplinary manner that involves modified chemotherapy regimen, radical resection, and intestine auto-transplantation may provide the currently best possible care to patients with locally advanced pancreatic cancer.