bluuebunny/crossref_metadata_2025 huggingface dataset:
The use of identity-related frames in electoral pledges and its effects on Euroscepticism in France and Germany
Authors: Bogado Natalia , Bytzek Evelyn , Steffens Melanie C
Published: February 2023

National identification strength is a key Euroscepticism driver. We examine how politicians’ framing of immigration policies increases the salience of different national identity representations and its relationship with support for the European Union (EU) in a two-waves between-subject survey-experiment using French and German samples. As predicted, exposure to assimilation frames (directly for the French sample or via frame perception for both samples) increased the salience of ethnocultural national identity representations. Additionally, as hypothesised, higher ethnocultural representations salience following assimilation frames exposure was related to higher Euroscepticism. However, feeling emotionally attached to the EU reduced this negative impact of ethnocultural national identity representations on EU attitudes. We discuss the role of ethnocultural nationalism in Euroscepticism and the importance of fostering stronger emotional ties to the EU.
Enhancing work relationships across cultures: The role of energy in cross-cultural work interactions
Authors: McDaniel Sumpter Dana , Gibson Cristina B
Published: February 2023

As culturally different individuals work together, energy may be employed as a resource towards building and sustaining a work relationship. However, current scholarship on energy at work and relational energy fail to take into account cultural considerations. To address this gap, we develop novel theory that distinguishes amongst various forms of energy to explicate how they are differentially interpreted in interactions based on cultural orientation. Integrating theories of interaction rituals and energy at work, our theorizing calls into question common assumptions in prior literature which privilege certain forms of energy expression (such as high intensity) over others (such as calm restraint). We further theorize that energy becomes a resource when culturally-different relationship partners go through a process of discovery as they interact, in which they learn about their partner’s energy contributions and communication preferences. Through adaptation, intercultural partners can then establish an equilibrium, or balanced state, of energy contributions to their interactions. The relational energy gained from reaching this equilibrium replenishes personal resources used in interdependent work with culturally diverse others. We explain how such resource enhancement plays a critical role in sustaining high quality interdependent work in multicultural organizations.
Genetic and Clinical Characteristics of Patients with Philadelphia-Negative Myeloproliferative Neoplasm Carrying Concurrent Mutations in JAK2V617F, CALR, and MPL
Authors: Wang Yan , Ran Fei , Lin Jin , Zhang Jing , Ma Dan
Published: February 2023

Simultaneous mutations in Janus kinase 2 ( JAK2), calreticulin , and myeloproliferative leukemia (MPL) genes are generally not considered for characterizing Philadelphia-negative myeloproliferative neoplasms (MPNs), leading to misdiagnosis. Sanger sequencing and quantitative polymerase chain reaction were used to detect gene mutations in patients with MPN. We retrospectively screened the data of patients with double mutations in our center and from the PubMed database. Two patients tested positive for both JAK2V617F and CALR mutations (2/352 0.57%) in our center, while data of 35 patients from the PubMed database, including 26 patients with essential thrombocythemia (ET), 6 with primary myelofibrosis (PMF), 2 with unexplained thrombosis, and 1 with polycythemia vera were screened for double mutations. Among these mutations, co-mutation of JAKV617F-CALR constituted the majority (80.0%), when compared with JAKV617F-MPL (17.1%) and CALR-MPL (2.9%) mutations. Moreover, patients with concurrent mutational myeloproliferative neoplasm (MPN) were relatively older ( P  =  .010) with significantly higher platelet counts than their counterparts with single gene mutations ( P < .001). The occurrence of palpable splenomegaly ( P < .001) and leukocyte count ( P  =  .041) were also significantly different between patients with single and simultaneous gene mutations. These 4 risk factors also showed significant test effectiveness in the ET and PMF cohorts ( P < .05). In terms of clinical characteristics of patients with ET, those with JAK2V617F- CALR mutation had higher but normal hemoglobin levels ( P  =  .0151) than those carrying JAK2V617F- MPL mutation. From a clinical perspective, patients with multiple mutational MPN are different from those with single gene mutations. The poor treatment response by patients in our center and unfavorable indicators for patients with co-mutations in published literature indicate that customized treatment may be the best choice for patients with MPN carrying co-mutations.
The Course of Diabetic Foot Infection in Elderly Patients: Data of Patients From Turkey
Authors: Ozer Balin Safak , Aşan Mehmet Ali , Ozcan Erhan Cahit , Uğur Kader , Şenol Arzu
Published: February 2023

With the aging population, it is expected that diabetes and related complications will increase rapidly. The aim of this study was to examine the signs and symptoms of diabetic foot infection in elderly individuals. Patients with diabetic foot infection were grouped as mild, moderate, and severe. Patients aged <65 years and those who did not meet the diagnosis of diabetic foot infection were excluded from the study. Only the first applications of patients who applied to the hospital multiple times with diabetic foot infection diagnosis were evaluated. 314 patients were included in the study. The mean age of the patients was 71.5 (±12). The number of patients aged 75 and over was 125 (39.8%). Of the patients, 25.7% had mild, 61.7% moderate, and 12.4% severe clinical forms. 131 (41.7%) of the patients had osteomyelitis. Amputation was performed in 112 of the patients. Antibiotic treatment was given to 102 patients only. While 89 patients died, a significant correlation was found between all groups between amputation rate and mortality frequency and clinical severity of diabetic foot infection ( P < .001). In our study, it was observed that the clinical severity of diabetic foot infection was more severe and the overall mortality rate was higher in geriatric patients. In light of all these data, it can be concluded that an early and comprehensive roadmap should be followed in geriatric patients with diabetic foot infection who have an increased risk of morbidity and mortality.
Specialty Balloons for Vessel Preparation During Infrainguinal Endovascular Revascularization Procedures: A Review of Literature
Authors: Giannopoulos Stefanos , Volteas Panagiotis , Virvilis Dimitrios
Published: February 2023

Balloon angioplasty with/without utilizing drug eluting technology or stenting constitutes the treatment of choice for a significant percentage of patients with peripheral artery disease requiring an intervention. However, in cases of diffuse disease and plaque complexity, angioplasty may lead to dissection, recoil, and/or early restenosis, making vessel preparation a key component for successful and durable endovascular revascularization outcome. This review of literature aims to present contemporary data for several commercially available specialty balloons that have been designed to minimize the arterial wall stress of conventional balloon angioplasty and facilitate technical success, as well as long-term patency.
Pharmacological and metabolic effects of drospirenone as a progestin-only pill compared to combined formulations with estrogen
Authors: Regidor Pedro-Antonio , Mueller Anna , Mayr Manuela
Published: February 2023

The spironolactone derivative drospirenone is combined with ethinylestradiol or estetrol in combined oral contraceptives. Formulations with 17-β-estradiol are used to treat climacteric symptoms. A drospirenone-only formulation has been introduced for contraception. Here, the pharmacological properties of drospirenone, the impact of the different formulations on metabolic and laboratory parameters, and the resulting clinical implications are reviewed. Ethinylestradiol, an inhibitor of CYP metabolic enzymes, changes the pharmacokinetics of drospirenone, leading to a higher drospirenone exposure with ethinylestradiol/drospirenone compared to the drospirenone-only preparation. In addition, several metabolic alterations have been described. The impact of estetrol is less pronounced, and for 17-β-estradiol/drospirenone and drospirenone-only, decreased triglyceride and cholesterol levels were observed. Ethinylestradiol induces various pro-coagulatory factors, leading to hypercoagulability. The effect is significantly reduced with estetrol, and no influence was observed with the drospirenone-only preparation. The anti-mineralocorticoid activity of drospirenone seems to positively counteract the renin-angiotensin-aldosterone-system-activating action of ethinylestradiol. There is no influence on blood pressure with ethinylestradiol/drospirenone and estetrol/drospirenone formulations, while in clinical trials, a reduction has been observed with 17-β-estradiol/drospirenone and drospirenone-only. Anti-aldosterone activity via non-renal mineralocorticoid receptors is associated with cardiovascular health, while interactions with parathyroid hormone signaling impact bone structure and vascular calcification. Though the clinical relevance is unclear for drospirenone, data in this context are reviewed. To sum up, the advantages of drospirenone in hormonal contraception and treatment of menopausal symptoms have been demonstrated for all the formulations described here. Combination with estrogen confers benefits and risks, which must be considered.
Inaccuracy in the Scientific Record and Open Postpublication Critique
Authors: Brewin Chris R.
Published: February 2023

There is growing evidence that the published psychological literature is marred by multiple errors and inaccuracies and often fails to reflect the changing nature of the knowledge base. At least four types of error are common—citation error, methodological error, statistical error, and interpretation error. In the face of the apparent inevitability of these inaccuracies, core scientific values such as openness and transparency require that correction mechanisms are readily available. In this article, I reviewed standard mechanisms in psychology journals and found them to have limitations. The effects of more widely enabling open postpublication critique in the same journal in addition to conventional peer review are considered. This mechanism is well established in medicine and the life sciences but rare in psychology and may assist psychological science to correct itself.
Prefiguring the argument: Bain’s Anarchical Society
Authors: Navari Cornelia
Published: February 2023

Some of the themes found in William Bain’s book, Political Theolog of International Order, were prefigured in his chapter on Hedley Bull’s The Anarchical Society. This article looks back to that earlier chapter and draws on some of the themes while providing a critical reading of them and Bain’s larger project.
Axillary chest wall solid-papillary carcinoma: A case report on presentation and management
Authors: Niver Harper E. , Strom Priscilla
Published: February 2023

Papillary breast carcinomas comprise <1% of all breast cancers. They are notorious among surgical pathologists for posing diagnostic difficulty, especially with small sample sizes, such as a core-needle biopsy and carry potential for overtreatment. Solid-papillary carcinoma is a subtype of papillary breast carcinomas that affects elderly females and generally has a favorable diagnosis in its in-situ form. This report focuses on the unique and clinically aggressive presentation and treatment of invasive solid-papillary carcinoma that was discovered along the axillary chest wall after an ipsilateral mastectomy for multifocal ductal carcinoma in situ.
Child Protection in Indian Programme and Legislative Framework: A Critical Analysis
Authors: Jain Bhavya
Published: February 2023

The Indian Judicial System lags in addressing child trafficking, as it does not yet have a dedicated Act or law to address the issue of either human or child trafficking. The Trafficking of Persons (Prevention, Protection and Rehabilitation) Bill of 2018 still awaits a nod from the Upper House of the Parliament, the Rajya Sabha, to be implemented. However, a network of other laws, policies and schemes sets out measures to provide some preventive and rehabilitative services for children who are vulnerable to trafficking or have been trafficked. These include children who have lost one or both parents, live on streets, belong to low socio-economic background and have been abused, among others. Some of the laws and policies regarding safeguarding of children include the Juvenile Justice (Care and Protection of Children) Act, 2015; Mission Vatsalya, 2022 and Child and Adolescent Labour (Prohibition and Regulation) Act, 1986. The mentioned laws and policies have set up key mechanisms for child protection by the government in the Indian context.

This article looks to identify such provisions across the Indian legislative and programmatic landscape that are instrumental in keeping children in the care of family as far as possible and providing them safe out-of-home care where family care cannot be provided. It also reviews how these provisions set up, or fail to set up, a safety net around children to protect them from trafficking. The article undertakes a critical analysis of child protection measures set up by the government in India to identify good practices as well as gaps in the judicial and policy landscape of child protection and trafficking. It analyses the Guidelines on Mission Vatsalya, Juvenile Justice (Care and Protection of Children) Act, 2015 and Child and Adolescent Labour (Prohibition and Regulation) Act, 1986.
Examining the contribution of motivation in the job search of youth with developmental language disorder
Authors: Dubois Pascale , Guay Frédéric , St-Pierre Marie-Catherine
Published: February 2023

Background & aims

Youth with developmental language disorder (DLD) are at risk of experiencing challenges during their job search. It is thus crucial to promote efficient job search behaviors in terms of effort, intensity, and self-regulation. Based on self-determination theory (SDT), we verified the role of autonomous and controlled motivations in enhancing these behaviors.

Methods

Study 1 included 37 young adults with DLD who have finished school, and Study 2 included 52 youth with DLD transitioning from school to work. They completed a questionnaire examining their job search behaviors and their motivation toward their job search.

Results

Autonomous motivation positively predicted job search effort, intensity, and self-regulation. Small to moderate relations were observed in Study 1, and moderate to strong ones in Study 2. Controlled motivation was unrelated to the three behaviors.

Conclusions

In line with SDT, autonomous motivation is an important foundation for positive job search behaviors among youth with DLD.

Implications

Supporting the development of autonomous motivation is thus encouraged in transition services for this population.
Youthful culture: Immaterial labour, co-optation and the space between IRL young people and their conceptual doppelgangers
Authors: Threadgold Steven
Published: February 2023

DIY and alternate cultures are important social spaces to study because they are where young people can find themselves when they feel like they do not fit in and where they can find like-minded peers with whom to work, make and play. DIY and alternative cultures are also key objects of co-optation and value creation, where resistive and creative practices are denuded of their artistry, politics and emotional authenticity, repurposed through immaterial labour, and resold as aesthetics and affects. Beginning by situating the analysis in wider conceptualisations about late capitalism's business ontology, this article contributes to unpacking these processes firstly by making a theoretical/methodological distinction between ‘youth’ and ‘young people’. I then develop the affects of ‘youthful culture’ not only to conceptually rethink how youth cultures still play a role in the lives of young people in terms of identity formation and everyday forms of escape and creativity, but also to highlight processes of co-optation, commercial culture and how figurative distortions of youth create value in late capitalism. As ‘youth’ is conceptually cut loose from age brackets, it becomes an affect operationalised for an array of vested interests. Importantly, what is often left out of considering co-optation are the actual physical bodies and everyday emotions of living, breathing young people from whom these affects are extracted. This article will discuss these aspects using empirical examples from research on punk and hospitality showing how the immaterial labour that ‘youth’ enacts in these spaces is exploited from backs of the physical and creative labour performed by young people themselves, aspects of which they are sometimes reflexively aware and are attempting to negotiate.
Preparation and characterization of the myricetin-loaded solid lipid nanoparticles decorated with folic acid-bound chitosan and evaluation of its antitumor and anti-angiogenic activities in vitro and in vivo in mice bearing tumor models
Authors: Khatamian Niloufar , Motavalizadehkakhky Alireza , Homayouni Tabrizi Masoud , Mehrzad Jamshid , Zhiani Rahele
Published: February 2023

Myricetin is a flavonoid with anticancer properties. This study aimed to formulate myricetin in the form of solid lipid nanoparticles (SLN), decorated with chitosan (CS) and active-targeted with folic acid (FA). After characterization, the in vitro release, cytotoxicity, antioxidant, and ability of the formulation to induce apoptosis using flow cytometry, fluorescent microscopy, and real-time qPCR were examined. Then in vivo anti-angiogenesis on chick chorioallantoic membrane (CAM) and antitumor activities on mice bearing tumor models were investigated. The present study showed that the size of 310 nm and zeta potential of + 30 mV were acceptable for oral administration. The Michaelis–Menten model fitted the drug release pattern with lag during 144 h of the study. The cytotoxicity assay showed that myricetin-SLN-CS-FA significantly killed cancer cells at the concentrations of 6.25, 12.5, 25, 50 and 100 µg/mL (*p < 0.05, **p < 0.01, and ***p < 0.001). The highest level of apoptosis was shown at the concentration of 45 µg/ml in flow cytometry, and fluorescent studies. These results showed the anticancer properties of myricetin-SLN-CS-FA in a dose-dependent manner. The real-time results also indicated that the formulation exerted its cytotoxic effect by activating apoptosis genes. The DPPH, ABTS, and FRAP studies also demonstrated the significant antioxidant properties of the myricetin-SLN-CS-FA (*p < 0.05, **p < 0.01, and ***p < 0.001). The anti-angiogenic activities of the formulations depicted in the CAM assay significantly decrease the number and length of the vessels (*p < 0.05, **p < 0.01, and ***p < 0.001), and also affect VEGF and VEGFR, genes involved in angiogenesis (**p < 0.01, and ***p < 0.001). The antitumor studies indicated the statistically significant effects of myricetin-SLN-CS-FA on reducing tumor volume (*p < 0.05 and ***p < 0.001). The H&E staining of the liver and monitoring of the animal weights also indicated the safety of the formulation. The analysis of mRNA expression in liver and tumor demonstrated that myricetin-SLN-CS-FA exerts its antitumor activities by modulating the inflammatory and oxidative responses in the tissues.
The dual role of Nrf2 in melanoma: a systematic review
Authors: Malakoutikhah Zahra , Mohajeri Zahra , Dana Nasim , Haghjooy Javanmard Shaghayegh
Published: February 2023

Melanoma is the most lethal type of skin cancer that originates from the malignant transformation of melanocytes. Although novel treatments have improved patient survival in melanoma, the overall prognosis remains poor. To improve current therapies and patients outcome, it is necessary to identify the influential elements in the development and progression of melanoma.

Due to UV exposure and melanin synthesis, the melanocytic lineage seems to have a higher rate of ROS (reactive oxygen species) formation. Melanoma has been linked to an increased oxidative state, and all facets of melanoma pathophysiology rely on redox biology. Several redox-modulating pathways have arisen to resist oxidative stress. One of which, the Nrf2 (nuclear factor erythroid 2-related factor 2), has been recognized as a master regulator of cellular response to oxidative or electrophilic challenges. The activation of Nrf2 signaling causes a wide range of antioxidant and detoxification enzyme genes to be expressed. As a result, this transcription factor has lately received a lot of interest as a possible cancer treatment target.

On the other hand, Nrf2 has been found to have a variety of activities in addition to its antioxidant abilities, constant Nrf2 activation in malignant cells may accelerate metastasis and chemoresistance. Hence, based on the cell type and context, Nrf2 has different roles in either preventing or promoting cancer. In this study, we aimed to systematically review all the studies discussing the function of Nrf2 in melanoma and the factors determining its alteration.
The empirical estimate of the survival and variance using a weighted composite endpoint
Authors: Nabipoor Majid , Westerhout Cynthia M. , Rathwell Sarah , Bakal Jeffrey A.
Published: February 2023

Background

Composite endpoints for estimating treatment efficacy are routinely used in several therapeutic areas and have become complex in the number and types of component outcomes included. It is assumed that its components are of similar asperity and chronology between both treatment arms as well as uniform in magnitude of the treatment effect. However, these assumptions are rarely satisfied. Understanding this heterogeneity is important in developing a meaningful assessment of the treatment effect.

Methods

We developed the Weighted Composite Endpoint (WCE) method which uses weights derived from stakeholder values for each event type in the composite endpoint. The derivation for the product limit estimator and the variance of the estimate are presented. The method was then tested using data simulated from parameters based on a large cardiovascular trial. Variances from the estimated and traditional approach are compared through increasing sample size.

Results

The WCE method used all of the events through follow-up and generated a multiple recurrent event survival. The treatment effect was measured as the difference in mean survivals between two treatment arms and corresponding 95% confidence interval, providing a less conservative estimate of survival and variance, giving a higher survival with a narrower confidence interval compared to the traditional time-to-first-event analysis.

Conclusions

The WCE method embraces the clinical texture of events types by incorporating stakeholder values as well as all events during follow-up. While the effective number of events is lower in the WCE analysis, the reduction in variance enhances the ability to detect a treatment effect in clinical trials.
The effectiveness and cost of integrating pharmacists within general practice to optimize prescribing and health outcomes in primary care patients with polypharmacy: a systematic review
Authors: Croke Aisling , Cardwell Karen , Clyne Barbara , Moriarty Frank , McCullagh Laura , Smith Susan M.
Published: February 2023

Background

Polypharmacy and associated potentially inappropriate prescribing (PIP) place a considerable burden on patients and represent a challenge for general practitioners (GPs). Integration of pharmacists within general practice (herein ‘pharmacist integration’) may improve medications management and patient outcomes. This systematic review assessed the effectiveness and costs of pharmacist integration.

Methods

A systematic search of ten databases from inception to January 2021 was conducted. Studies that evaluated the effectiveness or cost of pharmacist integration were included. Eligible interventions were those that targeted medications optimization compared to usual GP care without pharmacist integration (herein ‘usual care’). Primary outcomes were PIP (as measured by PIP screening tools) and number of prescribed medications. Secondary outcomes included health-related quality of life, health service utilization, clinical outcomes, and costs. Randomised controlled trials (RCTs), non-RCTs, interrupted-time-series, controlled before-after trials and health-economic studies were included.

Screening and risk of bias using Cochrane EPOC criteria were conducted by two reviewers independently. A narrative synthesis and meta-analysis of outcomes where possible, were conducted; the certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation approach.

Results

In total, 23 studies (28 full text articles) met the inclusion criteria. In ten of 11 studies, pharmacist integration probably reduced PIP in comparison to usual care (moderate certainty evidence). A meta-analysis of number of medications in seven studies reported a mean difference of -0.80 [-1.17, -0.43], which indicated pharmacist integration probably reduced number of medicines (moderate certainty evidence). It was uncertain whether pharmacist integration improved health-related quality of life because the certainty of evidence was very low. Twelve health-economic studies were included; three investigated cost effectiveness. The outcome measured differed across studies limiting comparisons and making it difficult to make conclusions on cost effectiveness.

Conclusions

Pharmacist integration probably reduced PIP and number of medications however, there was no clear effect on other patient outcomes; and while interventions in a small number of studies appeared to be cost-effective, further robust, well-designed cluster RCTs with economic evaluations are required to determine cost-effectiveness of pharmacist integration.

Trial registration

CRD42019139679.
Lower serum FT3 within the reference range is associated with mortality for older adults over 80 years of age with sarcopenia
Authors: Zhang Li , Tu You-Yi , Zhao Zhe , Jin Jun , Tao Jun , Zhang Xiao-Yan
Published: February 2023

Objective

Thyroid hormones stimulate myogenesis and muscle contraction and regulate skeletal muscle cell metabolism. However, the association between thyroid hormone levels and mortality in sarcopenic older adults remains elusive. The aim of this study was to investigate the relationship between thyroid hormones and all-cause mortality in people over 80 years of age with sarcopenia.

Methods

This study was performed on 264 sarcopenic patients aged 80 years and older. Serum levels of thyroid hormone, including free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) were tested to evaluate thyroid status. Sarcopenia was defined using the criteria of the European Working Group on Sarcopenia in Older People. Mortality data were available for up to 38 months of follow-up. The correlation between FT3 and calf circumference (CC) or handgrip strength (HGS) was determined by Pearson correlation analysis. Kaplan-Meier analysis was used to compare the differences between FT3 tertile groups. Cox regression was used to analyze the mortality risk ratio of patients with different FT3 tertiles.

Results

During the follow-up period, 88 older adults died. Non-Survivors had lower serum FT3 levels (3.7 ± 0.5 vs. 3.9 ± 0.7, P = 0.001) than the Survivor. Serum FT3 was positively associated with CC and HGS (r = 0.29, P < 0.001, r = 0.21, P = 0.002, respectively). The Kaplan-Meier curve analysis demonstrated a difference in mortality among the FT3 tertile groups (log-rank test, χ2 = 11.83, P = 0.003). The high FT3 group had lower mortality compared with the low FT3 group (the adjusted HRs were 0.63 (95%CI: 0.41–0.96 P = 0.031).

Conclusion

Lower FT3 within the reference range is associated with higher mortality in adults over 80 years with sarcopenia and euthyroid. Routine assessment of FT3 may be an easy way to identify high-risk older adults with sarcopenia.
Clinical significance of dynamic variation of low cholesterol and its prognostic value in patients with pyogenic liver abscesses: a retrospective study
Authors: Feng Tiantong , Zhang Wen , Hou Xiaoxue , Yuan Hui , Cai Jinyuan , Jiang Zhengyi , Hu Pingping , Yue Ming , Li Wenting , Zhu Chuanlong , Li Yuwen
Published: February 2023

Background

Serum lipids variations are closely related to the sepsis progression; however, their value for patients with pyogenic liver abscesses (PLA) has rarely been studied. We investigated the serum lipid level variations in patients with PLA and its predictive value to the disease.

Methods

The study included 328 patients with PLA hospitalized in the First Affiliated Hospital of Nanjing Medical University from January 2017 to December 2021; 35 (10.67%) in the severe group (SG) and 293 (89.33%) in the non-severe group (nSG). Their clinical records were analyzed retrospectively, and dynamic curves were drawn to clarify the changes in different indicators during the course of the disease.

Results

High-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and lipoprotein(a) (Lp(a)) in the SG were significantly lower than those in nSG (P < 0.001). Total cholesterol (TC) at baseline (OR = 0.184, P < 0.001) was an independent risk factor for severe patients and had the highest predictive value, with an area under the curve of 0.859 and a cut-off value of 2.70 mmol/L (sensitivity = 94.3%, specificity = 63.5%). For patients who met the criteria for drainage surgery, TC, HDL-C and LDL-C levels continued to decrease with antibiotic therapy alone before drainage and began to increase after the surgery.

Conclusions

Low TC level on admission is an independent risk factor for the progression of severe illness in PLA patients, with the highest predictive value surpassing other routine clinical indices. Abscess drainage should be performed as soon as possible for patients whose TC continues to decline after medical treatment.
Evaluate prognostic accuracy of SOFA component score for mortality among adults with sepsis by machine learning method
Authors: Pan Xiaobin , Xie Jinbao , Zhang Lihui , Wang Xincai , Zhang Shujuan , Zhuang Yingfeng , Lin Xingsheng , Shi Songjing , Shi Songchang , Lin Wei
Published: February 2023

Introduction

Sepsis has the characteristics of high incidence, high mortality of ICU patients. Early assessment of disease severity and risk stratification of death in patients with sepsis, and further targeted intervention are very important. The purpose of this study was to develop machine learning models based on sequential organ failure assessment (SOFA) components to early predict in-hospital mortality in ICU patients with sepsis and evaluate model performance.

Methods

Patients admitted to ICU with sepsis diagnosis were extracted from MIMIC-IV database for retrospective analysis, and were randomly divided into training set and test set in accordance with 2:1. Six variables were included in this study, all of which were from the scores of 6 organ systems in SOFA score. The machine learning model was trained in the training set and evaluated in the validation set. Six machine learning methods including linear regression analysis, least absolute shrinkage and selection operator (LASSO), Logistic regression analysis (LR), Gaussian Naive Bayes (GNB) and support vector machines (SVM) were used to construct the death risk prediction models, and the accuracy, area under the receiver operating characteristic curve (AUROC), Decision Curve Analysis (DCA) and K-fold cross-validation were used to evaluate the prediction performance of developed models.

Result

A total of 23,889 patients with sepsis were enrolled, of whom 3659 died in hospital. Three feature variables including renal system score, central nervous system score and cardio vascular system score were used to establish prediction models. The accuracy of the LR, GNB, SVM were 0.851, 0.844 and 0.862, respectively, which were better than linear regression analysis (0.123) and LASSO (0.130). The AUROCs of LR, GNB and SVM were 0.76, 0.76 and 0.67, respectively. K-fold cross validation showed that the average AUROCs of LR, GNB and SVM were 0.757 ± 0.005, 0.762 ± 0.006, 0.630 ± 0.013, respectively. For the probability threshold of 5–50%, LY and GNB models both showed positive net benefits.

Conclusion

The two machine learning-based models (LR and GNB models) based on SOFA components can be used to predict in-hospital mortality of septic patients admitted to ICU.
Choroidal structural changes following vitrectomy performed with phacoemulsification in unilateral idiopathic epiretinal membrane
Authors: Liu Yan , Zhang Jia Ying , Ding Xia , He Fang Lin , Lu Lin Na , Fu Yao
Published: February 2023

Background

This study aims to determine the influence of vitrectomy combined with macular epiretinal membrane dissection and internal limiting membrane (ILM) peeling and phacoemulsification on choroidal vasculature in patients with unilateral idiopathic epiretinal membrane (IERM) and concurrent cataract using optical coherence tomography (OCT).

Methods

This retrospective study included 26 eyes of 26 patients (8 males and 18 females) with unilateral IERM without vitreomacular traction (VMT) (group 1) and the patients’ fellow eyes (n = 26, group 2). Three-port 25-G pars plana vitrectomy (PPV) combined with macular epiretinal membrane dissection and ILM peeling and phacoemulsification was performed on all patients. The comprehensive ophthalmologic examinations of all patients involved OCT measurements at every visit before and after surgery, and the choroidal thickness (CT), central macular thickness (CMT) and choroidal vascularity index (CVI) were calculated.

Results

The mean age of the IERM patients was 66.58 ± 7.06 years. Postoperatively, best corrected visual acuity (BCVA) was significantly greater than baseline (P = 0.023). The CVI of the IERM eyes was significantly lower (P < 0.01) than that of the fellow eyes at baseline. The subfoveal CT in the IERM eyes was lower than that in the fellow eyes (P = 0.023), but there was, no significant difference in the average CT between the two groups at baseline (P = 0.071). In eyes with IERM, the CVI significantly increased at 1 week, 1 month (P < 0.001), and 3 months (P = 0.049) postoperatively, the subfoveal CT was markedly thickened 1 month after surgery (P = 0.001), the temporal 3 mm and nasal CT significantly increased at 1 week and 1 month postoperatively (P = 0.041, P = 0.022 for temporal 3 mm; P < 0.001, P = 0.047 for nasal 1.5 mm; P = 0.01, P = 0.001 for nasal 3 mm), and only the temporal 3 mm CT increased significantly at 3 months postoperatively (P = 0.017). The baseline CMT of the IERM eyes was significantly thicker than that of the fellow eyes (P < 0.001). CMT significantly decreased at 3 months postoperatively in IERM eyes(P = 0.033).

Conclusions

The increase in the CVI in the IERM eyes without VMT after combined PPV with ILM peeling and phacoemulsification persists for at least 3 months.
Action status and willingness to change health-promoting behaviors during the COVID-19 pandemic among elementary school children: a study based on Prochaska’s stages of behavior change theory (TTM)
Authors: Kamran Aziz , Aliakbari Parviz , Nasimi Doost Azgomi Ramin , Naeim Mahdi
Published: February 2023

Background & aim:

COVID-19 pandemic has significant effects on lifestyle and health-promoting behaviors and adolescence is a very critical period due to the importance of identity formation and individual behaviors. Therefore, the aim of this study was to determine the status of health- promoting behaviors in the sixth grade male students attending elementary schools in Ardabil city based on Prochaska ‘s stages of behavior change (TTM).

Materials & methods:

This analytical cross-sectional study was conducted on the 619 sixth grade male students attending elementary schools during 2021. The data were collected using two instruments (a researcher-made questionnaire and Health Promoting Lifestyle Profile-II (HPLP-II) questionnaire). The data were analyzed using SPSS version 22 and one-way analysis of variance.

Results:

The majority of students in physical activity and healthy eating behaviors were in the pre-contemplation stage, 29.6% (183 people) and 33.1% (205 people), respectively. All dimensions of health-promoting behaviors were observed to have a significant relationship with the stages of Prochaska’s theory behavior change in students, their decision-making balance and self-efficacy scores (P < 0.001).

Conclusion:

The health of students is under serious threat due to the poor state of health-promoting behaviors and the weak desire to change behavior. By planning in educating the students, significant changes can be made in changing their behavior and improving their health.
Normative values for hand grip and pinch strength for 6 to 18 year-olds in Saudi Arabia
Authors: Alqahtani Bader A. , Alenazi Aqeel M. , Elnaggar Ragab K. , Alshehri Mohammed M. , Alhowimel Ahmed , Najmi Ayat A. , Alasraj Muneera , Alghadeir Mshari
Published: February 2023

Background

Normative values for hand grip and pinch strength among children in Saudi Arabia has not been well established. Therefore, the main aim of this study is to establish normative values for hand grip and pinch strength in children aged 6 to 18 years in Saudi Arabia.

Methods

A cross-sectional study was conducted from different 5 regions in Saudi Arabia. Participants between the age of 6 years and 18 years old were recruited through different primary and secondary schools in Saudi Arabia. Data for age, gender, Body Mass Index, and preferred hand were collected. Hand grip strength was measured using digital hand dynamometer and the tip pinch, palmar pinch, and key pinch strength were measured using the hydraulic pinch gauge.

Results

A total of 616 participants included in this study (318 boys and 298 girls). Participants were stratified into 5 chronological age groups of 6–7 years, 8–9, 10–11, 12–13, 14–15, 16–17, and 18 years. The results showed an overall trend of increasing hand grip strength and pinch strength with age regardless of hand preference. Boys had significantly higher grip strength than girls in all age groups (P < 0.05).

Conclusion

This study established normative values for hand grip and pinch strength in the healthy Saudi pediatric and adolescent population, using boys and girls aged 6 to 18. The outcomes of this study also demonstrated that gender, age, and hand preference can all have an impact on how strong a handgrip develops.
Effects of Baduanjin exercise on the physical function of middle-aged and elderly people: a systematic review and meta-analysis of randomized controlled trials
Authors: Lin Huiying , Wan Mingyue , Ye Yu , Zheng Guohua
Published: February 2023

Background and purpose

Chinese mind–body exercise-Baduanjin has received increasing attention for health promotion among middle-aged and older adults in China, but there is a lack of high-quality evidence on its effectiveness. This systematic review and meta-analysis was conducted to investigate the effects of Baduanjin on physical function in middle-aged and older adults.

Methods

Seven electronic databases were searched for articles published before 22 June 2021 with the keywords Baduanjin exercise combined with physical-function-related outcomes. Risk of bias was assessed in the included studies, and data were analyzed using Review Manager software V5.3.

Results

Fifteen articles, including 14 randomized controlled trials, were included in this study. The results of the meta-analysis showed that Baduanjin significantly improved muscle strength (grip strength: SMD = 0.63, 95% CI 0.22 to 1.04, p = 0.003), balance ability (timed up-and-go test score: MD = -2.21, 95% CI -3.91 to -0.51, p = 0.01; one-leg stand test score: MD = 3.75, 95% CI 1.96 to 5.55, p < 0.0001; Berg balance scale score: MD = 4.16, 95% CI 2.49 to 5.83, p < 0.00001; strengthening Romberg’s test result: SMD = 1.02, 95% CI 0.17 to 1.86, p = 0.02); and cardiorespiratory fitness (diastolic blood pressure: MD = -3.62, 95% CI -3.95 to -3.30, p < 0.00001; resting heart rate: MD = -1.30, 95% CI -1.57 to -1.03, p < 0.00001; step test: MD = 4.25, 95% CI 0.76 to 7.74, p = 0.02). No adverse events were reported.

Conclusions

Baduanjin exercise may be an effective intervention to improve physical function in the middle-aged and elderly population. However, more RCTs with larger sample sizes and more rigorous research designs are needed in the future to confirm the results.
The benefits of using atypical presentations and rare diseases in problem-based learning in undergraduate medical education
Authors: Bai Suyun , Zhang Limin , Ye Zhen , Yang Duxiao , Wang Tao , Zhang Yuanying
Published: February 2023

Background

The nature of student learning in problem-based learning (PBL) largely depends on the quality of the case scenarios presented to them. The effect of case scenarios with higher challenge degree, especially common disease with atypical symptoms (CDAS)- and rare disease (RD)-based case scenarios, on undergraduate medical students remains unclear. This study compared the impact of all scenarios pertaining to common disease with typical symptoms (CDTS) case scenarios, CDTS interspersed with CDAS case scenarios, and CDTS interspersed with RD case scenarios on perceptions of undergraduate students studying organ/system integration curriculum via PBL.

Methods

After finishing four CDTS case scenarios, 294 third-year medical students were randomly allocated into three groups: CDTS, CDAS and RD, studying via CDTS, CDAS and RD case scenarios, respectively. A questionnaire with 15 items was conducted to evaluate the students’ perceptions. The students’ responses were scored using a 4-point rating scale. The data were analysed using the Kruskal–Wallis test.

Results

Among the three PBL conditions, the ones with a higher degree of challenge were rated higher by the students, which included the quality of the case scenarios and the overall performances of the students. The CDAS and RD cases were more effective in developing students’ self-directed learning skills, stimulating them to acquire more knowledge required for future work. The satisfaction percentage of RD case scenario sessions was higher.

Conclusions

Of all the three kinds of case scenarios, both CDTS interspersed with CDAS and RD case scenarios had more positive effects on the self-evaluated performance of students. Increasing the challenge and variety of case scenarios by the inclusion of CDAS and RD especially RD might be an effective stimulus in improving students’ performance in PBL sessions.
Differential treatment responses to immune checkpoint inhibitor (ICI) therapy in a case of multiple primary malignancies: the programmed death ligand-1 (PD-L1) negative ureteral and lung metastasis from a clear cell renal cell carcinoma appearing after robotic-assisted partial nephrectomy progressed after ICI therapy, while synchronous PD-L1-positive primary lung squamous cell carcinoma responded very well to ICI therapy: a case report
Authors: Urushibara Masayasu , Ishizaka Kazuhiro , Matsutani Noriyuki , Takahashi Mikiko , Nagata Masakazu , Okumura Taisuke , Matsumoto Yuuki , Tatsuoka Shinichiro , Nenohi Tsunehiro , Amemiya Takumasa , Shimizu Yohei , Shirakawa Takeshi , Kato Daisuke
Published: February 2023

Background

Renal cell carcinoma (RCC) and non-small cell lung cancer (NSCLC) are representative malignancies that respond well to immune checkpoint inhibitors (ICIs). Research has been conducted to identify biomarkers, such as programmed death ligand-1 (PD-L1), that would allow the response to ICI therapy to be predicted; however, the complex tumor immune system consisting of both host and tumor factors may also exert an influence.

Case presentation

Computed tomographic imaging (CT) incidentally revealed a left renal mass, and a left pulmonary nodule with multiple lymph node metastases (LNMs). Firstly, video-assisted thoracic surgery revealed a lung tumor invading the chest wall. Histologically, the findings of the tumor were consistent with squamous cell carcinoma (SCC), and immunohistochemistry (IHC) showed positive PD-L1 expression. The renal tumor was excised by robotic-assisted partial nephrectomy (RAPN). Histologically, the renal tumor showed the features of clear cell carcinoma (CCC). Four months after the RAPN, CT revealed left hydronephrosis caused by an enhancing ureteral tumor. Then, multiple right lung metastases appeared, and the left lung tumor increased. Following treatment including atezolizumab, the primary lung SCC and the multiple LNMs almost disappeared completely, while the ureteral and right lung metastases showed progression. The ureteral metastasis was resected by left open nephroureterectomy. Histology of the ureteral tumor revealed features consistent with CCC. Histological examination of the multiple right lung metastases that were resected by partial lobectomy via a small thoracic incision also revealed features consistent with CCC. Two months after nephroureterectomy, a solitary left lung metastasis was treated by nivolumab and ipilimumab. Six months after nephroureterectomy, the patient died of RCC. Further studies of specimens revealed that the tumor cells in the primary RCC and the ureteral and lung metastases showed negative results of IHC for PD-L1.

Conclusions

The responses to ICI therapy of concomitant RCC and NSCLC were quite different. The PD-L1 expression status in individual tumors in cases of multiple primary malignancies (MPMs) may directly predict the response of each malignancy to ICI therapy, because the host immune system, which may affect the response to ICI therapy, could be the same in MPMs.