bluuebunny/crossref_metadata_2025 huggingface dataset:
The Myth of Men’s Stable, Continuous Labor Force Attachment: Multitrajectories of U.S. Baby Boomer Men’s Employment
Authors: Frech Adrianne , Lankes Jane , Damaske Sarah , Ohler Adrienne
Published: September 2023

Over the past several decades, U.S. men’s paid work has transformed from a state of high stability and continuity to a state of increased instability and precarity. Despite this, full-time employment throughout adulthood remains the presumed standard for modern American men. The authors investigated the diversity of men’s workforce experiences using the National Longitudinal Survey of Youth “National Longitudinal Survey of Youth - 1979 cohort” and identified six multitrajectories of men’s time spent employed, unemployed, and out of the labor force from ages 27 to 49. The authors identified one multitrajectory of steady work, three of increasing unemployment or time out of work, one of increasing steady work, and one of intermittent work. Contrary to conventional assumptions, only 41 percent of men followed a trajectory of continuous, high employment over the duration of their prime earning years. This suggests that most men do not achieve the “ideal worker norm,” raising implications for how research and policy conceptualize men’s work experiences.
Digital expulsions: Refugees’ carcerality and the technological disruptions of asylum
Authors: Tazzioli Martina
Published: September 2023

Introducing the notion of “digital expulsions”, this paper argues that digital technologies in refugee humanitarianism are mainly used for hampering migrants from becoming asylum seekers and getting access to rights. Focusing on Greece, it explores which carceral mechanisms are enforced and sustained through the incorporation of digital technologies in refugee governmentality: it contends that it is key to investigate the specific harms that digital technologies generate on asylum seekers. The article intertwines scholarship on digital technologies in migration governance with carceral geography literature and shows that carceral mechanisms are enacted also through digital technologies. The paper draws attention to how in Greece asylum seekers’ access to the asylum procedure and to financial and humanitarian support is further obstructed due to forced technological intermediations. In the second part, it investigates refugees’ carcerality considering the increasing use of technology in refugee camps and in the asylum procedures: it contends that carceral mechanisms are enforced beyond detention and shows that these work by debilitating and choking refugees’ lives and stealing their lifetime.
Osteotomy of the Femoral Lateral Collateral Ligament Insertion for a Tight Lateral Compartment in Complex Arthroscopic Knee Surgery
Authors: Beel Wouter , Papakostas Emmanouil , Getgood Alan
Published: September 2023

Background:

In cases of complex arthroscopic knee surgery in the lateral compartment, such as performing lateral meniscus repair or transplantation, a tight lateral compartment can jeopardize the best possible care and could lead to iatrogenic cartilage injury. This technique shows a way to increase arthroscopic working space in a tight lateral compartment by performing an osteotomy of the femoral insertion of the lateral collateral ligament (LCL), utilizing a novel adjustable loop refixation technique.

Indication:

The femoral LCL insertion osteotomy can be performed if increased visualization and working space of the lateral compartment are needed during the complex arthroscopic knee surgery.

Technique Description:

After identification of the LCL femoral insertion, a 2-mm drill is passed through the LCL insertion to prepare for an anatomic reduction. The osteotomy is performed by taking a small bone plug together with the complete LCL insertion. Increased visualization and working space in the lateral compartment are obtained without damaging the intrinsic LCL structure. For reinsertion, the bone plug and proximal LCL is whipstitched with a high-strength suture and fixated to an adjustable loop Ultrabutton. The adjustable loop is shuttled through a predrilled 4.5-mm femoral tunnel and flipped on the medial side. The adjustable button is tensioned in 30° of flexion until the bone plug is anatomically reduced.

Results:

We present 1 patient who underwent a femoral LCL osteotomy during arthroscopic lateral meniscus allograft transplantation. The osteotomy healed without any issues, and there was no residual LCL laxity; which was confirmed with varus stress radiographs.

Discussion/Conclusion:

A femoral LCL insertion osteotomy can release a tight lateral compartment without damaging the intrinsic LCL structure. The adjustable loop fixation avoids the use of more traditional screw and washer fixation techniques, which tend to be more prominent and have the potential to back out. An osteotomy is more invasive than the “pie-crusting” technique of the medial collateral ligament for a tight medial compartment. However, it is required due to the poor intrinsic healing capacity of the LCL. Care should be taken to anatomically reduce the bone plug to avoid iatrogenic creation of LCL laxity.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Challenges and Potential of a Diverse Music Teaching Force: A Review of the Literature
Authors: Yi Tammy Sue
Published: September 2023

Current practices of music pedagogy have not been successful at attracting or retaining students of color; as a result, K–12 bands, orchestras, and choirs often reflect the disproportionately White demographics of music performance settings. Practices in the field of music education must adapt to prepare teachers to provide inclusive pedagogy to the racially diverse student populations they will encounter. This includes creating a more diverse teaching force, as well as changes to both teacher preparation practices and the K–12 music curriculum. In this literature review, I examined literature that addresses the question of how to foster inclusivity in music pedagogy.
Site response analysis beneath the Kashmir basin (NW Himalaya) using ambient noise
Authors: Gupta S Vishal , Parvez Imtiyaz A , Khan Prosanta K
Published: September 2023

Deep sedimentary valleys entrap and amplify seismic waves, which is further responsible for site-specific amplification over the allied region. Kashmir valley is a deep and active sedimentary basin in the northwest portion of the Himalayan lap. To characterize the site response for the intermountain Kashmir valley for the first time, we acquire single station microtremor measurements using Lennartz (three components/5s seismometer) at 141 sites with a grid of (5 km × 5 km) and two-dimensional (2D) array measurements using seven units of recording station of different geometry pattern at 38 sites across different lithological setup within the basin. We present here (1) a first-order predominant fundamental frequency (0.21–10.19 Hz) and subsequent sedimentary thickness maps for the entire valley, reflecting deep deposition with spatial heterogeneity in the area using the horizontal-to-vertical spectral ratio (HVSR) technique; (2) spatial classification of generated HVSR curves linking subsurface geomorphology and post strong ground-motion scenario in the valley; (3) extraction of the best dispersion characteristics of Rayleigh waves (fundamental mode) from all recorded vertical signals at each array site using frequency–wavenumber (F-K) method with an emphasis on signal synchronicity; and (4) retrieval of one-dimensional (1D) shear wave velocity ( VS) profiles across the valley from the inversion of dispersion curves using the neighborhood algorithm. Distinct model parameterizations were tested for the inversion to achieve the optimal inversion misfit. The collocated 1D VS profiles are consistent with newly drilled borehole logs information. Besides, the presented first-ever ambient noise survey–based site response study meets the objectives of site-specific seismic hazard and risk analysis of the Kashmir valley at the regional scale.
Cognitive, physical and emotional determinants of activities of daily living in nursing home residents—a cross-sectional study within the PROCARE-project
Authors: Wollesen Bettina , Schott Nadja , Klotzbier Thomas , Bischoff Laura Luise , Cordes Thomas , Rudisch Julian , Otto Ann-Kathrin , Zwingmann Katharina , Hildebrand Claudia , Joellenbeck Thomas , Vogt Lutz , Schoene Daniel , Weigelt Matthias , Voelcker-Rehage Claudia
Published: September 2023

Background

Interdependencies of health, fitness, cognition, and emotion can promote or inhibit mobility. This study aimed to analyse pathways and interactions between individual subjective and objective physical performance, cognition, and emotions with activities of daily living (ADLs) as mobility indicators in multimorbid nursing home residents.

Methods

The study included n = 448 (77.1% females, age = 84.1 ± 7.8 years) nursing home residents. To describe the participant's demographics, frailty, number of falls, and participating institutions' socioeconomic status (SES) were assessed. ADLs were measured with the Barthel Index (BI; dependent variable). Independent variables included objective physical performance, subjective physical performance, cognition, and emotions. A structural equation model (SEM) with maximum likelihood estimation was conducted with AMOS. Direct and indirect effects were estimated using standardized coefficients (significance level of 0.05).

Results

Indices showed (Chi2(148) = 217, PCMIN/DF = 1.47; p < .001; Comparative Fit Index = .940; Tucker Lewes Index = .902, RMSEA = .033) that the model fitted the data adequately. While there was no direct association between emotions, subjective physical performance, and ADLs, objective physical performance and cognition predicted higher ADLs (p < .01). Emotions had a strong relationship with subjective physical performance, and cognition had a moderate relationship with objective physical performance.

Discussion and conclusion

Objective performance and cognition predicted higher functional status, as expressed by higher BI scores. ADLs, such as mobility, dressing, or handling tasks, require motor and cognitive performance. Subjective performance is an important predictor of ADLs and is only partly explained by objective performance, but to a large extent also by emotions. Therefore, future interventions for nursing home residents should take a holistic approach that focuses not only on promoting objective physical and cognitive performance but also on emotions and perceived physical performance.

Trial registration

Trial registration number: DRKS00014957.
Diversity and functional prediction of fungal communities in different segments of mongolian horse gastrointestinal tracts
Authors: Zhao Yiping , Ren Xiujuan , Wu Haiqing , Hu He , Cheng Chao , Du Ming , Huang Yao , Zhao Xiaoqing , Wang Liwei , Yi Liuxi , Tao Jinshan , Li Yajing , Lin Yanan , Su Shaofeng , Dugarjaviin Manglai
Published: September 2023

Background

Anaerobic fungi are effective fibre-degrading microorganisms in the digestive tract of horses. However, our understanding of their diversity and community structure is limited, especially in different parts of the gastrointestinal tract.

Results

For the first time, high-throughput sequencing technology was used to analyse and predict fungal microbial diversity in different parts of the gastrointestinal tract of Mongolian horses. The results revealed that the richness and diversity of fungi in the hindgut of Mongolian horses were much higher than those in the foregut. The foregut was dominated by Basidiomycota and Ascomycota, whereas the hindgut was dominated by Neocallimastigomycota and Basidiomycota. At the genus level, the relative abundance of many pathogenic fungi (Cryptococcus, Cladosporium, Alternaria, and Sarocladium) in the foregut was significantly higher than that in the posterior gut, indicating that Mongolian horses have strong disease resistance. The prediction of fungal function also showed significant differences in the fungal flora between the foregut and the hindgut. The fungi in Mongolian horses’ foreguts were mainly pathologically nutritive and contained many animal and plant pathogens, particularly in the small intestine (jejunum and ileum). This indicates that the foregut may be the most important immune site in the digestive system of Mongolian horses, which explains the high disease resistance of Mongolian horses. The number of unassigned functional groups in the posterior gut was significantly higher than that in the anterior gut, indicating that the functions of fungal groups in the posterior gut have not been fully explored, and further studies are required in the future.

Conclusions

Analysis of high-throughput sequencing results revealed that the fungal composition varied greatly among different gastrointestinal tract segments in Mongolian horses, whose hindgut contains many anaerobic fungi involved in plant cellulose degradation. This provides important basic data for studying fungal diversity in the digestive system of healthy horses, which can be used for the health assessment of horses and provides clues for further research on the disease resistance and digestive capacity of horses, as well as a reference for the early diagnosis of intestinal diseases and innovative treatment methods.
NLG1, encoding a mitochondrial membrane protein, controls leaf and grain development in rice
Authors: Wen Yi , Wu Kaixiong , Chai Bingze , Fang Yunxia , Hu Peng , Tan Yiqing , Wang Yueying , Wu Hao , Wang Junge , Zhu Li , Zhang Guangheng , Gao Zhenyu , Ren Deyong , Zeng Dali , Shen Lan , Dong Guojun , Zhang Qiang , Li Qing , Qian Qian , Hu Jiang
Published: September 2023

Background

Mitochondrion is the key respiratory organ and participate in multiple anabolism and catabolism pathways in eukaryote. However, the underlying mechanism of how mitochondrial membrane proteins regulate leaf and grain development remains to be further elucidated.

Results

Here, a mitochondria-defective mutant narrow leaf and slender grain 1 (nlg1) was identified from an EMS-treated mutant population, which exhibits narrow leaves and slender grains. Moreover, nlg1 also presents abnormal mitochondria structure and was sensitive to the inhibitors of mitochondrial electron transport chain. Map-based cloning and transgenic functional confirmation revealed that NLG1 encodes a mitochondrial import inner membrane translocase containing a subunit Tim21. GUS staining assay and RT-qPCR suggested that NLG1 was mainly expressed in leaves and panicles. The expression level of respiratory function and auxin response related genes were significantly down-regulated in nlg1, which may be responsible for the declination of ATP production and auxin content.

Conclusions

These results suggested that NLG1 plays an important role in the regulation of leaf and grain size development by maintaining mitochondrial homeostasis. Our finding provides a novel insight into the effects of mitochondria development on leaf and grain morphogenesis in rice.
Influence of salinity on the biometric traits of striped catfish (Pangasianodon hypophthalmus) and barley (Hordeum vulgare) cultivated under an integrated aquaculture-agriculture system
Authors: Mugwanya Muziri , Kimera Fahad , Madkour Khaled , Dawood Mahmoud A. O. , Sewilam Hani
Published: September 2023

Background

Soil salinity, soil infertility, and freshwater scarcity are among the major constraints affecting agricultural ecosystems in arid and semi-arid regions of the world. Hence, there is a need to look for salt-tolerant crops and fish that can be successfully cultivated and reared respectively in such harsh environments. The implementation of biosaline integrated aquaculture-agriculture systems (IAAS) utilizing both salt-tolerant crops and fish could improve food and feed production in arid and semi-arid regions. This study, therefore, investigated the influence of salinity on the biometric traits of striped catfish (Pangasianodon hypophthalmus) and barley (Hordeum vulgare) under an IAAS.

Method

The experiment followed a randomized completely block design of three salinity treatments with three replicates namely, T0: Control (freshwater mixed with chemical fertilizers), T1: 5,000 ppm, T2: 10,000 ppm, and T3: 15,000 ppm.

Results

Irrigating barley with saline aquaculture wastewater at different salinities (5,000 ppm, 10,000 ppm, and 15,000 ppm) did not significantly affect the agro-morphological parameters (internode number per plant, stalk diameter, leaf number per plant, leaf area index, and leaf chlorophyll content (SPAD)) of the plants at 90 days after sowing. Moreover, the forage yield and forage quality in terms of fiber fraction, nutrient composition, and in vitro digestibility of the forage biomass were not severely affected by high salinity compared to the control (freshwater and inorganic fertilizers). Our results also showed that rearing striped catfish in saline water not exceeding 10,000 ppm did not negatively impact the growth performance (final weight, body weight gain, feed conversion ratio, specific growth rate, condition factor, and survival) and the health status of the fish.

Conclusions

The integration of striped catfish and barley production in water salinities below 15,000 ppm could be a feasible alternative in safeguarding food and feed security in regions affected by soil salinity, soil infertility, and freshwater scarcity. Moreover, the salinity regime of 5,000 ppm could bring higher economic gains to farmers regarding higher crop yields (fish and forage yield).
Cardiac rehabilitation engagement and associated factors among heart failure patients: a cross-sectional study
Authors: Yu Tianxi , Gao Min , Sun Guozhen , Graffigna Guendalina , Liu Shenxinyu , Wang Jie
Published: September 2023

Background

Chronic Heart Failure (CHF) still affects millions of people worldwide despite great advances in therapeutic approaches in the cardiovascular field. Cardiac rehabilitation (CR) is known to improve disease-related symptoms, quality of life and clinical outcomes, yet implementation is suboptimal, a frequently low engagement in rehabilitation programs has been found globally.

Objective

To quantify diverse CR-engaged processes and elucidate associated factors of the various levels of CR engagement in CHF patients.

Methods

Discharged patients admitted from cardiology departments between May 2022 to July 2022 were enrolled by mobile phone text messaging, CHF patients from same department between August 2022 to December 2022 were enrolled by face-to-face. Individuals who met the inclusion criteria filled the questionnaires, including the generalized anxiety disorders scale, patient health questionnaire, cardiac rehabilitation inventory, patient activation measure, Tampa scale for kinesiophobia heart, social frailty, Patient Health Engagement Scale (PHE-s®). We obtained sociodemographic characteristics and clinical data from medical records. Chi-square tests and multivariable logistic regression analyses were performed to examine the factors associated with CR engagement phases.

Results

A total of 684 patients were included in the study. 52.49% patients were in the Adhesion phase. At the multivariate level, compared with the blackout phase process anxiety, monthly income (RMB yuan) equal to or more than 5,000 were the most important factor impacting CHF patients CR engagement. Compared with the Blackout phase, regular exercise or not, severe depression, previous cardiac-related hospitalizations 1 or 2 times, Age influenced patient CR engagement in the Arousal phase. Besides, compared with the Blackout phase, outcome anxiety and activation level were independent factors in the Eudaimonic Project phase.

Conclusion

This study characterized CR engagement, and explored demographic, medical, and psychological factors—with the most important being process anxiety, monthly income, patient activation, severe depression, and previous cardiac-related hospitalizations. The associated factors of CR engagement were not identical among different phases. Our findings suggested that factors could potentially be targeted in clinical practice to identify low CR engagement patients, and strategies implemented to strengthen or overcome these associations to address low CR engagement in CHF patients.
Discrepancy between two invasive blood pressure measurements in patients receiving intra-aortic balloon pump therapy
Authors: Lu Lijuan , Zhang Shiyi , Zhang Yu , Zhao Xiaoyan
Published: September 2023

Background

Hemodynamic monitoring is imperative for patients with cardiogenic shock undergoing Intra-aortic Balloon Pump (IABP) therapy. Blood pressure monitoring encompasses non-invasive, invasive peripheral arterial pressure (IPAP), and invasive central aortic pressure (ICAP) methods. However, marked disparities exist between IPAP and ICAP. This study examined the discrepancies between IPAP and ICAP and their clinical significance.

Methods

A retrospective analysis was conducted on cardiogenic shock patients who underwent IABP therapy and were admitted to the Coronary Care Unit (CCU) of a tertiary hospital in China from March 2017 to November 2022. The Bland–Altman plot illustrated the discrepancy between IPAP and ICAP. A clinically significant difference between ICAP and IPAP measurements was defined as ≥ 10 mmHg, which could necessitate alterations in blood pressure management according to current guidelines that recommend maintaining a mean arterial pressure (MAP) ≥ 70 mmHg.

Results

In total, 162 patients were included in the final analysis. In patients without vasopressors, the difference between ICAP and IPAP was 5.73 mmHg (95% limits of agreement [LOA], -16.98 to 28.44), whereas, in patients with vasopressors, it was 4.36 mmHg (95% LOA, -17.31 to 26.03). ICAP measurements exceeded IPAP in patients undergoing IABP therapy. However, the difference was not statistically significant between the two groups. Multivariate logistic regression revealed that higher serum lactate levels (Odds ratio [OR], 1.14; 95% confidence interval [CI], 1.03–1.27; p = 0.013) and age ≥ 60 years (OR, 13.20; 95% CI, 1.50–115.51; p = 0.020) were associated with an increased likelihood of a clinically significant MAP discrepancy. Conversely, a history of coronary heart disease was associated with a decreased likelihood (OR, 0.34; 95% CI, 0.13–0.90; p = 0.031).

Conclusions

Notable discrepancies between ICAP and IPAP measurements exist in cardiogenic shock patients undergoing IABP therapy. ICAP exceeds IPAP, and factors such as age ≥ 60 years, elevated lactic acid levels, and absence of coronary heart disease contribute to this discrepancy. Enhanced vigilance is warranted for these patients, and the consideration of peripheral invasive monitoring in conjunction with IABP therapy is advised.
Identifying populations with chronic pain in primary care: developing an algorithm and logic rules applied to coded primary care diagnostic and medication data
Authors: Hafezparast Nasrin , Bragan Turner Ellie , Dunbar-Rees Rupert , Vusirikala Amoolya , Vodden Alice , de La Morinière Victoria , Yeo Katy , Dodhia Hiten , Durbaba Stevo , Shetty Siddesh , Ashworth Mark
Published: September 2023

Background

Estimates of chronic pain prevalence using coded primary care data are likely to be substantially lower than estimates derived from community surveys. Most primary care studies have estimated chronic pain prevalence using data searches confined to analgesic medication prescriptions. Increasingly, following recent NICE guideline recommendations, patients and doctors opt for non-drug treatment of chronic pain thus excluding these patients from prevalence estimates based on medication codes. We aimed to develop and test an algorithm combining medication codes with selected diagnostic codes to estimate chronic pain prevalence using coded primary care data.

Methods

Following a scoping review 4 criteria were developed to identify cohorts of people with chronic pain. These were (1) people with one of 12 (‘tier 1’) conditions that almost always results in the individual having chronic pain (2) people with one of 20 (‘tier 2’) conditions included when there are also 3 or more prescription-only analgesics issued in the last 12 months (3) chronic neuropathic pain, or (4) 4 or more prescription-only analgesics issued in the last 12 months. These were translated into 8 logic rules which included 1,932 SNOMED CT codes.

Results

The algorithm was run on primary care data from 41 GP Practices in Lambeth. The total population consisted of 386,238 GP registered adults ≥ 18 years as of the 31st March 2021. 64,135 (16.6%) were identified as people with chronic pain. This definition demonstrated notably high rates in Black ethnicity females, and higher rates in the most deprived, and older population.

Conclusions

Estimates of chronic pain prevalence using structured healthcare data have previously shown lower prevalence estimates for chronic pain than reported in community surveys. This has limited the ability of researchers and clinicians to fully understand and address the complex multifactorial nature of chronic pain. Our study demonstrates that it may be possible to establish more representative prevalence estimates using structured data than previously possible. Use of logic rules offers the potential to move systematic identification and population-based management of chronic pain into mainstream clinical practice at scale and support improved management of symptom burden for people experiencing chronic pain.
Recent functional decline and outpatient follow-up after hospital discharge: a cohort study
Authors: Bogler Orly , Kirkwood David , Austin Peter C. , Jones Aaron , Sinn Chi-Ling Joanna , Okrainec Karen , Costa Andrew , Lapointe-Shaw Lauren
Published: September 2023

Background

Functional decline is common following acute hospitalization and is associated with hospital readmission, institutionalization, and mortality. People with functional decline may have difficulty accessing post-discharge medical care, even though early physician follow-up has the potential to prevent poor outcomes and is integral to high-quality transitional care. We sought to determine whether recent functional decline was associated with lower rates of post-discharge physician follow-up, and whether this association changed during the COVID-19 pandemic, given that both functional decline and COVID-19 may affect access to post-discharge care.

Method

We conducted a retrospective cohort study using health administrative data from Ontario, Canada. We included patients over 65 who were discharged from an acute care facility during March 1st, 2019 – January 31st, 2020 (pre-COVID-19 period), and March 1st, 2020 – January 31st, 2021 (COVID-19 period), and who were assessed for home care while in hospital. Patients with and without functional decline were compared. Our primary outcome was any physician follow-up visit within 7 days of discharge. We used propensity score weighting to compare outcomes between those with and without functional decline.

Results

Our study included 21,771 (pre-COVID) and 17,248 (COVID) hospitalized patients, of whom 15,637 (71.8%) and 12,965 (75.2%) had recent functional decline. Pre-COVID, there was no difference in physician follow-up within 7 days of discharge (Functional decline 45.0% vs. No functional decline 44.0%; RR = 1.02, 95% CI 0.98–1.06). These results did not change in the COVID-19 period (Functional decline 51.1% vs. No functional decline 49.4%; RR = 1.03, 95% CI 0.99–1.08, Z-test for interaction p = 0.72). In the COVID-19 cohort, functional decline was associated with having a 7-day physician virtual visit (RR 1.15; 95% CI 1.08–1.24) and a 7-day physician home visit (RR 1.64; 95% CI 1.10–2.43).

Conclusions

Functional decline was not associated with reduced 7-day post-discharge physician follow-up in either the pre-COVID-19 or COVID-19 periods. In the COVID-19 period, functional decline was positively associated with 7-day virtual and home-visit follow-up.
Effect of statin treatment on mortality in elderly patients with type 2 diabetes mellitus patients: a retrospective cohort study
Authors: Fan Yao , Wang Juan , Wu Haidi , Dai Lingli , Wang Lan , Gu Liubao
Published: September 2023

Background

The effects of statins on the reduction of mortality in individuals aged 75 years or older remain controversial. We conducted this study to investigate whether there is an association between statin therapy and mortality in patients with type 2 diabetes mellitus (T2DM) who are over the age of 75 years.

Methods

The present study used data from the Staged Diabetes Targeting Management Study, which began in 2005. A total of 518 T2DM patients older than 75 years were included. Cox regression analyses were used to evaluate the association between statins and specific causes of death in patients with T2DM.

Results

After a follow-up period of 6.09 years (interquartile range 3.94–8.81 years), 111 out of 518 patients died. The results of Cox regression analyses showed that there was no significant association between statin use and all-cause mortality (HR 0.75; 95% CI 0.47, 1.19) after adjustment for all potential confounders. Subgroup analysis indicated that statins had no association with the risk of all-cause mortality or deaths caused by ischemic cardiovascular diseases in T2DM patients with or without coronary heart disease.

Conclusions

Our study found no significant association between all-cause mortality and statin use in T2DM patients over the age of 75 years. More evidence is needed to support the use of statins in the elderly T2DM patients.
Differences between CEUS LI-RADS and CECT LI-RADS in the diagnosis of focal liver lesions in patients at risk for HCC
Authors: Wen Rong , Huang Weiche , Song Rui , Qin Lanhui , Wu Yuquan , Peng Yuting , Huang Xiongyan , He Yun , Yang Hong
Published: September 2023

Objectives

To compare the inter-modality consistency and diagnostic performances of the contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) and contrast-enhanced computed tomography (CECT) LI-RADS in patients at risk for hepatocellular carcinoma (HCC), so as to help clinicians to select a more appropriate modality to follow the focal liver lesions (FLLs).

Methods

This retrospective study included untreated 277 FLLs from 247 patients who underwent both CEUS and CECT within 1 month. The ultrasound contrast medium used was SonoVue. FLL categories were independently assigned by two ultrasound physicians and two radiologists using CEUS LI-RADS v2017 and CECT LI-RADS v2018, respectively. The diagnostic performances of CEUS and CECT LI-RADS were evaluated using sensitivity, specificity, positive predictive value (PPV), and negative predictive value. Cohen’s Kappa was employed to evaluate the concordance of the LI-RADS category.

Results

The inter-modality consistency for CEUS and CECT LI-RADS was 0.31 (p < 0.001). HCC was more frequently observed in CECT LR-3 and LR-4 hepatic lesions than in CEUS (7.3% vs. 19.5%, p < 0.001). The specificity and PPV of CEUS and CECT LR-5 for the diagnosis of HCC were 89.5%, 95.0%, and 82.5%, 94.4%, respectively. The sensitivity of CEUS LR-5 + LR-M for the diagnosis of hepatic malignancies was higher than that of CECT (93.7% vs. 82.7%, p < 0.001). The specificity and PPV of CEUS LR-M for the diagnosis of non-HCC malignancies were lower than those of CECT (59.7% vs. 95.5%, p < 0.001; 23.4% vs. 70.3%, p < 0.001).

Conclusions

The inter-modality consistency between the CEUS and CECT LI-RADS categories is fair. CEUS LI-RADS was more sensitive than CECT LI-RADS in terms of identifying hepatic malignancies, but weaker in terms of separating HCC from non-HCC malignancies.
Effective automatic detection of anterior cruciate ligament injury using convolutional neural network with two attention mechanism modules
Authors: Liang Chen , Li Xiang , Qin Yong , Li Minglei , Ma Yingkai , Wang Ren , Xu Xiangning , Yu Jinping , Lv Songcen , Luo Hao
Published: September 2023

Background

To develop a fully automated CNN detection system based on magnetic resonance imaging (MRI) for ACL injury, and to explore the feasibility of CNN for ACL injury detection on MRI images.

Methods

Including 313 patients aged 16 – 65 years old, the raw data are 368 pieces with injured ACL and 100 pieces with intact ACL. By adding flipping, rotation, scaling and other methods to expand the data, the final data set is 630 pieces including 355 pieces of injured ACL and 275 pieces of intact ACL. Using the proposed CNN model with two attention mechanism modules, data sets are trained and tested with fivefold cross-validation.

Results

The performance is evaluated using accuracy, precision, sensitivity, specificity and F1 score of our proposed CNN model, with results of 0.8063, 0.7741, 0.9268, 0.6509 and 0.8436. The average accuracy in the fivefold cross-validation is 0.8064. For our model, the average area under curves (AUC) for detecting injured ACL has results of 0.8886.

Conclusion

We propose an effective and automatic CNN model to detect ACL injury from MRI of human knees. This model can effectively help clinicians diagnose ACL injury, improving diagnostic efficiency and reducing misdiagnosis and missed diagnosis.
Integrated profiling identifies CACNG3 as a prognostic biomarker for patients with glioma
Authors: Shan Enfang , Cao Yi-nan , Zhang Yang , Chen Wen , Ren Xurui , Zhu Shanjie , Xi Xueru , Mu Shuai , Ma Mian , Zhi Tongle , Li Xianwen
Published: September 2023

Gliomas are the most common malignant primary brain tumors in adults with poor prognoses. The purpose of this study is to explore CACNG3 as a prognostic factor that is closely related to the progression and survival outcome of gliomas and to provide a potential new molecular target for the diagnosis and treatment of glioma patients. CACNG3 expression and related clinical data were collected from three major databases of The Chinese Glioma Genome Atlas (CGGA), The Cancer Genome Atlas (TCGA), and Gene Expression Omnibus (GEO). The CGGA dataset was used as a training set, and TCGA and GEO datasets obtained from the GEO database were used for validation. CACNG3 was expressed at low levels in the tumor group, and the overall survival (OS) in patients with low CACNG3 expression is shorter. Furthermore, CACNG3 expression was negatively associated with glioma grades, which was confirmed in the IHC results of clinical samples. The expression level of CACNG3 in the IDH1 wide-type group, 1p/19q non-codel group, and mesenchymal subtype group was significantly reduced, and the results showed that CACNG3 could serve as a biomarker for the mesenchymal molecular subtype. In addition, the univariate and multivariate analysis verified the prognostic value of CACNG3 in predicting the OS of gliomas of all grades. The results of functional annotation and pathway enrichment analysis of differently expressed genes(DEGs), showed that CACNG3 might affect the development of glioma by interfering with synaptic transmission. Moreover, temozolomide (TMZ), commonly used in the treatment of glioma, increased CACNG3 expression in a dose and time-dependent manner. Therefore, CACNG3 plays a vital role in the occurrence and development of gliomas and can serve as a potential biomarker for targeted therapy and further investigation in the future.
Increased TCP11 gene expression can inhibit the proliferation, migration and promote apoptosis of cervical cancer cells
Authors: Wang Fang , Song Shuyan , Guo Bingxuan , Li Yangyang , Wang Huijuan , Fu Shaowei , Wang Luyue , Zhe Xiangyi , Li Hongtao , Li Dongmei , Shao Renfu , Pan Zemin
Published: September 2023

Background

Cervical cancer is a common gynecological malignancy. Gene microarray found that TCP11 gene was highly expressed in cervical cancer. However, the effect of TCP11 gene on the proliferation, apoptosis and migration of cervical cancer cells and its underlying molecular mechanisms are unclear.

Methods

GEPIA database, tissue microarray, western blot and qRT-PCR were used to analyze the expression of TCP11 gene in cervical cancer tissues and cells and its relationship with patients’ survival rate. The cell cycle and apoptosis were detected by flow cytometry, and the expressions of cell cycle and apoptosis related molecules and EMT-related molecules were detected by Western blot and qRT-PCR.

Results

The results showed that TCP11 gene was highly expressed in cervical cancer tissues and cells compared with normal cervical tissues and cells, and its expression was positively correlated with patients’ survival rate. The results of proliferation and migration assays showed that TCP11 overexpression inhibited the proliferation and migration of HeLa and SiHa cells. The results showed that TCP11 overexpression blocked the cell cycle of HeLa and SiHa cells, decreased the expression of CDK1 and Cyclin B1, and increased the apoptosis and the expression of caspase-3, cleaved-caspase-3 and cleaved-PARP. TCP11 overexpression increased the protein and mRNA expression of EMT-related molecules ZO-1 and E-cadherin. Conversely, TCP11 knockdown promoted the proliferation of HeLa and SiHa cells and the migration of HeLa cells.

Conclusions

TCP11 overexpression significantly inhibited the occurrence and development of cervical cancer cells, it may be a potentially beneficial biomarker for cervical cancer.
German mammography screening program: program sensitivity between 2010 and 2016 estimated based on German health claims data
Authors: Heinze Franziska , Czwikla Jonas , Heinig Miriam , Langner Ingo , Haug Ulrike
Published: September 2023

Background

Program sensitivity is a key quality indicator for mammography screening programs (MSP). Estimating program sensitivity usually requires a linkage of screening and cancer registry data. For the German MSP, such data linkage-based estimates have only been reported for two out of 16 federal states. We aimed to explore the potential of estimating program sensitivity for the German MSP based on information available in health claims data.

Methods

We used data from the second-largest statutory health insurance fund in Germany, BARMER (~ 9 million members all over Germany). We included women aged 50 to 69 years with a non-initial screening mammography between 2010 and 2016 and followed them up for two years. We estimated the rate of screen-detected and interval cancers as well as program sensitivity.

Results

Per year, we included 212,400 to 303,667 women (mean age: 60–61 years). Overall, 1,992,287 non-initial MSP screening examinations conducted in these women between 2010 and 2016 were considered for the analyses. Age-standardized program sensitivity ranged between 69.9% [95% CI: 67.3–72.0%] and 71.7% [95% CI: 69.5-73.9%] during the study period. Per 1,000 non-initial screening examinations, the rate of screen-detected breast cancer ranged between 4.6 and 5.3, and the rate of interval breast cancer rates ranged between 0.6 and 0.8 for the first and between 1.3 and 1.4 for the second year after screening.

Conclusions

Our results were plausible and consistent with quality indicators estimated for the German MSP based on data linkage and thus support the value of German health claims data in this regard. The quality indicators estimated in our study are in line with levels expected according to European Guidelines.
Causal associations between gut microbiota and urological tumors: a two-sample mendelian randomization study
Authors: Mingdong Wang , Xiang Gao , Yongjun Quan , Mingshuai Wang , Hao Ping
Published: September 2023

Background

Dysbiosis of gut microbiota has been linked to numerous diseases, including cancer. The unique role of gut microbiota in urological tumors is gaining prominence. However, it is still controversial whether the dysbiosis of gut microbiota should be one of the etiological factors of bladder cancer (BCa), prostate cancer (PCa) or kidney cancer (KCa).

Materials and methods

The microbiome genome-wide association study (GWAS) from the MiBioGen consortium (18,340 samples of 24 population-based cohorts) was utilized as the exposure data. Additionally, outcomes data (951 BCa cases and 307,092 controls; 1,631 KCa cases and 238,678 controls; 79,148 PCa cases and 61,106 controls) were extracted from the GWAS of the FinnGen and PRACTICAL consortia. To detect the potential causative bacterial traits for BCa, PCa, and KCa, a two-sample Mendelian randomization (MR) analysis was performed, employing the inverse-variance weighted or Wald ratio method. Sensitivity analyses were subsequently conducted to explore the robustness of the primary results. Finally, the reverse MR analysis was undertaken to mitigate the reverse causation.

Results

This study suggested that Bifidobacterium (p = 0.030), Actinobacteria (p = 0.037 for phylum, 0.041 for class), and Ruminococcustorques group (p = 0.018), exhibited an association with an increased risk of BCa using either the inverse-variance weighted or Wald ratio method. By utilizing the Wald ratio method, Allisonella (p = 0.004, p = 0.038) was associated with a decreased risk of BCa and PCa, respectively. Furthermore, Ruminococcustorques group (p = 0.028) and Erysipelatoclostridium (p = 0.048) were causally linked to an elevated risk of KCa.

Conclusions

This MR study supports that genetically predicted gut microbiota is causally related to BCa, PCa and KCa. Additionally, distinct bacterial traits are identified in relation to each tumor type.
Painted playgrounds for preschoolers’ physical activity and fundamental motor skill improvement: a randomized controlled pilot trial of effectiveness
Authors: Webster E. Kipling , Kepper Maura M. , Saha Sanjoy , Beyl Robbie A. , Kracht Chelsea L. , Romain Jessica St. , Staiano Amanda E.
Published: September 2023

Background

Preschool children are not meeting recommended levels of physical activity (PA) nor are they proficient in fundamental motor skills (FMS), which are the foundation for PA. As such, interventions are needed to increase PA and FMS in young children. This trial examined the effects of an environmental (“painted playgrounds”) and capacity-building (written toolkit) intervention on child FMS, PA, and sedentary behavior at early childhood education (ECE) centers and examined feasibility.

Methods

In a randomized controlled trial, four ECE centers were randomly assigned to an intervention group or wait-list control. For intervention centers, stencils were spray painted adjacent to playgrounds and teachers were provided material for using stencils for FMS practice. Follow-up assessments were conducted six to eight weeks after baseline. Time spent in PA and sedentary behavior was assessed via accelerometry and FMS were evaluated using the Test of Gross Motor Development (TGMD-3) at baseline and follow-up. A repeated measures linear model was performed to test the effects of the painted playgrounds on the primary outcomes of interest. Feasibility was measured by stencil engagement via direct observation and satisfaction surveys.

Results

A total of 51 preschoolers completed baseline assessments (4.3±0.6 years; 43.1% male). There were no significant changes in PA or sedentary behavior (all confidence intervals contain 0) between control and intervention groups. Intervention children significantly improved ball skill, locomotor, and overall TGMD-3 percentile scores at follow-up (all (all confidence intervals contain 0), which was not observed in control group. However, there was no significant change in FMS between the control and intervention groups (confidence intervals contain 0). For stencil use, boys and girls interacted with different stencils during their free play. Directors and teachers reported children incorporated academic concepts and initiated games, and teachers prompted more PA opportunities on the playground.

Conclusions

This intervention did not show statistically significant changes in children’s PA, FMS, or sedentary behavior compared to a control group; however, small FMS improvements for the intervention group were found from baseline to follow-up. Further work should examine intervention fidelity as well as inexpensive supplies, teacher training, or other strategies to increase preschool children’s PA and improve FMS at ECE centers.
Safe use of the ketogenic diet in an infant with microcephaly, epilepsy, and diabetes syndrome: a case report
Authors: Zegarra Walter A. , Gallentine William B. , Ruzhnikov Maura R. , McAndrews Catherine A. , Gloyn Anna L. , Addala Ananta
Published: September 2023

Background

Microcephaly, epilepsy, and diabetes syndrome (MEDS) is a rare syndromic form of monogenic diabetes caused by bi-allelic loss of function mutations in IER3IP1. In vitro studies have shown that loss of IER31P leads to apoptosis in both neurons and pancreatic β-cells. Simultaneous management of seizures and diabetes is challenging in patients with MEDS. We present the challenges and successes in the use of ketogenic diet in an infant with insulinopenic diabetes.

Case presentation

Our term female proband presented at 2 months of age with new onset multifocal seizures followed by the onset of infantile spasms (IS) at 4 months of age. An epilepsy gene panel identified bi-allelic variants, c.239T > G (p.Leu80*) and c.2T > A (initiator codon), in IER3IP1 that were subsequently shown to be inherited in trans. Following initiation of steroid therapy for IS, the patient developed clinically apparent insulin requiring diabetes. Her epilepsy was ultimately refractory to multiple antiseizure medications, thus the ketogenic diet (KD) was initiated. We were able to successfully titrate to a therapeutic KD ratio of 3:1 and maintain a ketotic state without diabetic ketoacidosis (DKA). With intercurrent illnesses, however, the patient had rapid decompensation and mild DKA due to delays in treatment, and for this reason, KD was discontinued after 5 months.

Conclusions

We report two novel IER31P1 mutations in a patient with MEDS and the successful management of the cooccurring conditions of IS and insulinopenic diabetes with the KD. Our experience underscores the importance of careful monitoring during KD as our patient had DKA more easily when on the KD.