bluuebunny/crossref_metadata_2025 huggingface dataset:
Statistical properties of items and summary scores from the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE®) in a diverse cancer sample
Authors: Mead-Harvey Carolyn , Basch Ethan , Rogak Lauren J , Langlais Blake T , Thanarajasingam Gita , Ginos Brenda F , Lee Minji K , Yee Claire , Mitchell Sandra A , Minasian Lori M , Mendoza Tito R , Bennett Antonia V , Schrag Deborah , Dueck Amylou C , Mazza Gina L
Published: October 2024

Background/Aims:

The Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE®) was developed to capture symptomatic adverse events from the patient perspective. We aim to describe statistical properties of PRO-CTCAE items and summary scores and to provide evidence for recommendations regarding PRO-CTCAE administration and reporting.

Methods:

Using data from the PRO-CTCAE validation study (NCT02158637), prevalence, means, and standard deviations of PRO-CTCAE items, composite scores, and mean and maximum scores across attributes (frequency, severity, and/or interference) of symptomatic adverse events were calculated. For each adverse event, correlations and agreement between attributes, correlations between attributes and composite scores, and correlations between composite, mean, and maximum scores were estimated.

Results:

PRO-CTCAE items were completed by 899 patients with various cancer types. Most patients reported experiencing one or more adverse events, with the most prevalent being fatigue (87.7%), sad/unhappy feelings (66.0%), anxiety (63.6%), pain (63.2%), insomnia (61.8%), and dry mouth (60.0%). Attributes were moderately to strongly correlated within an adverse event ( r = 0.53 to 0.77, all p < 0.001) but not fully concordant (κweighted = 0.26 to 0.60, all p < 0.001), with interference demonstrating lowest mean scores and prevalence among attributes of the same adverse event. Attributes were moderately to strongly correlated with composite scores ( r = 0.67 to 0.97, all p < 0.001). Composite scores were moderately to strongly correlated with mean and maximum scores for the same adverse event ( r = 0.69 to 0.94, all p < 0.001). Correlations between composite scores of different adverse events varied widely ( r = 0.04 to 0.68) but were moderate to strong for conceptually related adverse events.

Conclusions:

Results provide evidence for PRO-CTCAE administration and reporting recommendations that the full complement of attributes be administered for each adverse event, and that attributes as well as summary scores be reported.
Exploring the differences in processing between Chinese emotion and emotion-laden words: A cross-task comparison study
Authors: Zheng Ruiyao , Zhang Meng , Guasch Marc , Ferré Pilar
Published: October 2024

Affective words can be classified into two types: emotion words (EM words, e.g., “happy”) and emotion-laden words (EL words, e.g., “wedding”). Several studies have shown differences in processing between EM and EL words, although results are inconclusive. These two types of words may have representational differences because affective content is an inherent part of the semantic features of EM words (i.e., denotative meaning) but not of EL words, whose affective content is part of their connotative meaning (i.e., these words do not name emotions, but are associated with emotions). In this study, we tested a set of Chinese EM and EL words. Both conditions included positive and negative words. The study involved two tasks, an implicit task, in which emotional content was not relevant (lexical decision task, LDT), and an explicit task, in which the emotional content was relevant (affective categorisation task, ACT). Our results showed that participants responded faster to EM words than to EL words. This advantage was mostly observed in the ACT and with negative words. These results reveal differences in processing between EM and EL words which can be related to the greater relevance of affective content in the meaning of EM words compared with EL words.
Influence of video instruction on soccer kick velocity in young players
Authors: Chinaglia Abel Gonḉalves , Monteiro Rafael Luiz Martins , dos Santos Carlos César Arruda , Tahara Ariany Klein , Santiago Paulo Roberto Pereira
Published: October 2024

Soccer is a sport that necessitates proficiency in motor control and cognitive abilities, with kicking serving as a fundamental action. Improving kicking performance is vital for player advancement, leading to the inquiry: “How can video instruction promptly optimize kicking technique in young players?”. This research aimed to investigate the immediate effects of an instructional video on the kinematic variables of kicking to induce an acute alteration in the movement pattern. A cohort of 26 male youths, aged between 10 and 15 years, partook in the study and were segregated into an instruction group (IG) and a control group (CG). The IG received exposure to a video containing specific kicking instructions, while the CG viewed a video lacking such guidance. Both groups were recorded performing penalty kicks before and after viewing the video. Kinematic analysis was carried out utilizing the OpenPose artificial intelligence neural network for pose detection and subsequent 3D reconstruction. The primary discovery was that the length of the last stride (LS) notably increased in the IG following the instructional video. This outcome indicates that video instructions hold promise in promptly enhancing particular aspects of kicking technique in young soccer players.
Bowel cleansing quality evaluation in colon capsule endoscopy: what is the reference standard?
Authors: Schelde-Olesen Benedicte , Koulaouzidis Anastasios , Deding Ulrik , Toth Ervin , Dabos Konstantinos John , Eliakim Abraham , Carretero Cristina , González-Suárez Begoña , Dray Xavier , de Lange Thomas , Beaumont Hanneke , Rondonotti Emanuele , Kopylov Uri , Ellul Pierre , Pérez-Cuadrado-Robles Enrique , Robertson Alexander , Stenfors Irene , Bojorquez Alejandro , Piccirelli Stefania , Raabe Gitte Grunnet , Margalit-Yehuda Reuma , Barba Isabel , Scardino Giulia , Ouazana Salome , Bjørsum-Meyer Thomas
Published: October 2024

Background:

The diagnostic accuracy of colon capsule endoscopy (CCE) depends on a well-cleansed bowel. Evaluating the cleansing quality can be difficult with a substantial interobserver variation.

Objectives:

Our primary aim was to establish a standard of agreement for bowel cleansing in CCE based on evaluations by expert readers. Then, we aimed to investigate the interobserver agreement on bowel cleansing.

Design:

We conducted an interobserver agreement study on bowel cleansing quality.

Methods:

Readers with different experience levels in CCE and colonoscopy evaluated bowel cleansing quality on the Leighton–Rex scale and Colon Capsule CLEansing Assessment and Report (CC-CLEAR), respectively. All evaluations were reported on an image level. A total of 24 readers rated 500 images on each scale.

Results:

An expert opinion-based agreement standard could be set for poor and excellent cleansing but not for the spectrum in between, as the experts agreed on only a limited number of images representing fair and good cleansing. The overall interobserver agreement on the Leighton–Rex full scale was good (intraclass correlation coefficient (ICC) 0.84, 95% CI (0.82–0.85)) and remained good when stratified by experience level. On the full CC-CLEAR scale, the overall agreement was moderate (ICC 0.62, 95% CI (0.59–0.65)) and remained so when stratified by experience level.

Conclusion:

The interobserver agreement was good for the Leighton–Rex scale and moderate for CC-CLEAR, irrespective of the reader’s experience level. It was not possible to establish an expert-opinion standard of agreement for cleansing quality in CCE images. Dedicated training in using the scales may improve agreement and enable future algorithm calibration for artificial intelligence supported cleansing evaluation.

Trial registration:

All included images were derived from the CAREforCOLON 2015 trial (Registered with The Regional Health Research Ethics Committee (Registration number: S-20190100), the Danish data protection agency (Ref. 19/29858), and ClinicalTrials.gov (registration number: NCT04049357)).
Multiobjective design of automated order fulfillment systems: A case study for an existing surgical complex
Authors: Lam Sean Shao Wei , Ge Yao , Cheong Wai Chye , Ho Henry Sun Sien , Ong Marcus Eng Hock
Published: October 2024

We present a case study that introduces a systematic framework for designing an automated guided vehicle (AGV) order fulfillment system. The multi-stage framework integrated discrete event simulation (DES), super-efficiency data envelopment analysis (S-DEA) model, and Design of Experiments (DOE) methodologies for the design of an AGV system in an existing large-scale surgical complex within a comprehensive hospital in Singapore. Performance metrics derived from this model were consolidated into a single relative efficiency score using the S-DEA model. This efficiency score was then utilized in a DOE methodology, combined with a post-hoc model selection process, to robustly identify appropriate models for evaluating alternative system designs. The proposed framework optimizes AGV deployment by first identifying opportunities for AGVs to add value within the surgical system through a value-stream mapping approach. It then derives the optimal system design by balancing cost efficiency, manpower reallocation, and order fulfillment rates, facilitated by the S-DEA model augmented with the DOE approach and post-hoc model selection. Application of this framework to the surgical complex revealed several insights that can significantly enhance AGV efficiency prior to actual deployment. However, a key limitation of this case-study-based approach is its limited generalizability across different systems. Despite this, the methodology provides a robust foundation for AGV system design in similar healthcare environments.
Employee use of social media: Private, public or something else?
Authors: Murto Jari , Korpisaari Päivi
Published: October 2024

This article examines the use of social media at the intersection of work and private life and analyses how employers are permitted to intervene in employees’ social media behaviour. In the article, this phenomenon is described as the hybrid role of an employee. It is created when a person adds work-related information to their personal social media profile and when employers encourage personnel to highlight their expertise and employer-related issues using personal social media accounts. The content of an employee's social media bio and social media postings, as well as an employer's social media policy, create a complex framework spanning the private and public domains. In addition, an employer's intervention in an employee's social media posts constitutes an interference with that employee's freedom of expression and private life, which are fundamental and human rights. Therefore, a compelling reason must exist for an employer to interfere with an employee’s use of social media. Factors that influence this assessment include the employee's position and duties, the closeness of the connection between the social media content and the employer, the (harmful) effect of this content on the employer or its activities, the veracity and public-interest value of the content, the proportionality of the sanction and its compatibility with the employer's social media policy.
Impact of an Adult Congenital Heart Disease Order Set in a Pediatric Cardiac Intensive Care Unit
Authors: Park Ashley , Connor Brynn , Sinha Pranava , Jones Melissa , Munoz Ricardo , Baxter Aminah , Ito Seiji , John Anitha
Published: October 2024

Background: Patients with congenital heart disease (CHD) are increasingly surviving to adulthood. Given their age- and condition-specific needs, the optimal postoperative setting for these patients is not yet determined. This study aims to evaluate the utility of an adult-specific order set in improving clinical outcomes for these patients in a pediatric cardiovascular intensive care unit (ICU). Methods: Adults with CHD (ACHD) admitted to the cardiovascular ICU following cardiac surgery at a pediatric tertiary care center were identified for a retrospective cohort study. Health care delivery metrics and clinical outcomes of participants who received the adult-specific order set were compared with control patients admitted prior to the intervention. Categorical outcomes were compared using the χ2 test of independence or Fisher exact test, and continuous outcomes were assessed using the t test. Results: A total of 130 ACHD patients received the intervention, with no significant differences observed in clinical outcomes when compared with 89 controls. While there was additionally no reduction in hospital-related mortality (2.3% vs 7.8%, RR 0.3; P = .1), clinician ordering behaviors were better aligned with best-practices following the intervention. Among patients with moderate or greater anatomic complexity, a post hoc analysis demonstrated reduced in-hospital mortality from those who received the adult order set. Conclusions: The implementation of an adult-specific order set in a pediatric care setting did not improve clinical outcomes for all ACHD patients. Patients with moderate and greater anatomic complexity did see a mortality benefit, suggestive that targeted electronic tools may most benefit those who have the highest risk.
A Systematic Review of Interventions to Promote Parent-Teacher Relationships in Early Care and Education: Exploring the Social Process Between Parents and Teachers
Authors: Zulauf-McCurdy Courtney A. , McManus Mischa S. , Golez Madison , Fettig Angel
Published: October 2024

Parent-teacher relationships are known to promote positive outcomes for young children in early childhood education; however, parents and teachers face barriers to forming quality relationships. To better understand how to support parents and teachers in forming quality relationships, the present systematic review sought to identify existing interventions designed to promote quality parent-teacher relationships in early childhood education. Systematic search and data extraction identified peer-reviewed manuscripts describing interventions that included components to increase parent-teacher relationships in early childhood education. Each included manuscript was evaluated to answer the following questions: (1) how is the social process between parents and teachers conceptualized?, (2) what strategies were used to improve this social process?, and (3) what outcomes are associated with improving this social process ? Nine out of the 1,992 nonduplicate screened manuscripts met inclusion criteria. Results indicate a small body of research focused solely on interventions designed to improve parent-teacher relationships. Included interventions were limited in their conceptualization of the social process between parents and teachers, strategies to improve it, and associated outcomes assessed. Additional research is needed to understand low-cost and highly feasible interventions that promote quality parent-teacher relationships in early childhood education.
Revisiting building height restriction policy in the historic center of Seoul: Exploring performance-based height management using view shadow simulation
Authors: Lee Jae Min , Lim Justin Heejoon , Heo Jayun
Published: October 2024

This study empirically explores 3D isovists to explore an alternative approach to a 90 m height cap in Seoul’s historic center. We introduced the concept of “view shadow” in the city center to explore potential room for growth: (1) areas hidden by existing buildings and (2) areas visible but not altering the current skyline. The proposed approach integrates the concept of view shadow cast by existing towers to minimize visual impact and preserve iconic and historic views. The simulation findings indicate that a significant portion, approximately 31 sites or 58.5% of the total, can accommodate taller towers than 90 m without compromising the integrity of the historic skyline. The study demonstrates the ability to increase the floor area by 74% and up to 137% from existing conditions to revitalize Seoul’s historic center.
Reduction of production delay cost in underground coal mines: An FMEA-based method study approach
Authors: Reddy G Balakrishna , Samanta Alok Kumar , Kumar K Ratna , Singh Amit Kumar
Published: October 2024

Coal is the backbone of the Indian economy, essential for electricity, steel, cement, and other vital items. Although India aims to be carbon emission-free by 2070, it must rely on coal for a few more decades. In the fiscal year 2021–22, India produced 96 percent of its coal from open-cast (OC) mines, whereas 70 percent of India's total coal reserve is in deep undergrounds. Despite underground (UG) coal mining being eco-friendly and yielding richer coal, its production cost is nearly four times higher than OC mining. Therefore, further research on UG mines is necessary to address these challenges. This study analyzed an underground coal mine production system in India and identified production delays as a major cost driver. Causes of delays were categorized by their association with machine, material, and man. An innovative technique, the Machine Criticality Score (MCS), has been developed to quantify production delay costs and guide management in mitigating them. Additional methods like failure mode and effects analysis (FMEA), standard operating procedure (SOP), inventory management tools, and method study were also used in this study to reduce production delay costs.
Treatment of Complex Multiple Lesions in the Knee With MACI (Autologous Cultured Chondrocytes on Porcine Collagen Membrane)
Authors: Gersoff Wayne
Published: October 2024

Background:

Multiple chondral lesions in the knee are difficult to manage. A few treatment options are available. Considering the number of lesions, size, location, and total surface area, the autologous cultured chondrocytes on porcine collagen membrane (MACI) technique can effectively treat multiple defects simultaneously.

Indications:

The MACI procedure is indicated for multiple chondral lesions in the knee with large surface areas when other technologies are hard to implement or lack sufficient follow-up.

Technique Description:

The chondral defects are debrided to subchondral bone with vertical walls. Concomitant procedures are to be completed before MACI implantation. Each defect is treated as an isolated lesion. Irregular and uncontained lesions require a unique approach. A single membrane can treat multiple lesions; however, careful presurgery analysis is necessary to analyze the requirement of an additional membrane.

Results:

The MACI technique for multiple lesions in the knee has a good response rate and high satisfaction scores over mid- to long-term follow-up.

Discussion/Conclusions:

Multiple chondral lesions of the knee can effectively be treated with MACI, providing patients with additional improved quality of life, increasing level of function, and possibly delaying total knee arthroplasty procedures.

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.
Deuterated water labeling in ibrutinib-treated patients with CLL: leukemia cell kinetics correlate with IGHV, ZAP-70, and MRD
Authors: Kim Ekaterina , Chen Shih-Shih , Sivina Mariela , Hwang Hyunsoo , Huang Xuelin , Ferrajoli Alessandra , Jain Nitin , Wierda William G. , Wodarz Dominik , Chiorazzi Nicholas , Burger Jan A.
Published: October 2024

Deuterated (“heavy”) water labeling in patients with chronic lymphocytic leukemia (CLL) demonstrates that IGHV unmutated and ZAP-70+ patients have higher blood and tissue CLL death rates on ibrutinib therapy, resulting in lower measurable residual disease levels with long-term ibrutinib treatment. This trial was registered at www.clinicaltrials.gov as #NCT01752426.
The long-term effect of the coronavirus pandemic on parkrun participation: an interrupted time series analysis
Authors: Rousham Oscar , Quirk Helen , Goyder Elizabeth , Smith Robert A.
Published: October 2024

Background

The growth of parkrun between 2004 and 2019 has been heralded as a success story for public health as a result of its physical activity and wellbeing benefits for participants. However, parkrun was not immune from the COVID-19 pandemic - with events in mainland England cancelled from March 2020 to July 2021. This study explores the lasting impact of the pandemic on parkrun participation to February 2023, and its implications across the socioeconomic spectrum.

Methods

The study combines aggregated parkrun weekly finisher data from 32,470 Lower Layer Super Output Areas (LSOA) in England from January 2015 to February 2023 with Office of National Statistics (ONS) data on population and deprivation. Interrupted time series analysis using segmented Poisson regression models was used to estimate the immediate change in parkrun participation and the change in the rate of growth following the pandemic. Models were fitted for each Index of Multiple Deprivation (IMD) quintile separately to assess whether this effect differed by socioeconomic deprivation.

Results

Visualisation and interrupted time series analysis showed a significant and long-term decrease in parkrun participation following the reopening of parkrun events. This was consistent across all IMD quintiles, indicating that the inequalities in parkrun participation according to IMD observed prior to the pandemic remained after the pandemic. Between March 2020 and February 2023, almost 13 million fewer parkrun finishes are estimated to have occurred relative to what would have occurred in the absence of the pandemic.

Conclusion

The reduction in parkrun participation during the pandemic and following the reopening of events is likely to have negatively impacted wellbeing in would-be participants. Going forwards, policymakers must make the difficult trade-off between the long-term health and social implications of restricting outdoor physical activity events against the benefits associated with a reduction in infectious disease transmission.
Bridging the gap: a qualitative process evaluation from the perspectives of healthcare professionals of an audit-and-feedback-based intervention to improve transition to adult care for young people living with type 1 diabetes
Authors: Parsons Janet A. , Wigle Jannah , Zenlea Ian , Ivers Noah , Mukerji Geetha , Landry Alanna , Punthakee Zubin , Clarson Cheril L. , Shulman Rayzel
Published: October 2024

Background

The transition from pediatric to adult care is a vulnerable time for young people living with type 1 diabetes (T1D). Bridging the Gap (BTG) is an audit-and-feedback (AF) intervention aimed at improving both transitions-in-care processes and diabetes management in the year following transition. As part of BTG, we conducted a qualitative process evaluation to understand: (a) what was implemented and how; and (b) the contextual factors (micro-, meso- and macro-) that affected implementation, outcomes and study processes.

Methods

Using qualitative descriptive methodology, interviews were conducted with 13 healthcare professionals (HCPs) delivering diabetes care to transitioning youth. Participants were asked about their experiences of BTG study processes and feedback tools, the quality improvement (QI) initiatives implemented at their site, and potential spread and scale. Interviews also explored the impacts of COVID-19 on transition care and study processes and results.

Results

Five key themes were identified. Participants’ reflections on the BTG study design indicated they appreciated its flexible, site-specific approach to QI, which they saw as crucial to the success of their initiatives. Engagement with feedback reports and other study resources provided comparative, site-specific data. Participants described the challenges posed by the COVID-19 pandemic and its impacts on patients, care provision and study implementation. Their site-specific QI initiatives resulted in changes to their transition practices. Finally, participants commented on how BTG and its processes fostered a community of practice (CoP) between sites, resulting in new opportunities to collaborate and share experiences.

Conclusions

BTG resulted in a CoP among practitioners delivering transition care to youth with T1D, which could be scaled up to promote a learning health system in pediatric diabetes care. Qualitative process evaluation is a useful tool for understanding how contextual factors affect the implementation and outcomes of complex QI interventions.
The renoprotective efficacy and safety of genetically-engineered human bone marrow-derived mesenchymal stromal cells expressing anti-fibrotic cargo
Authors: Li Yifang , Hunter Alex , Wakeel Miqdad M. , Sun Guizhi , Lau Ricky W. K. , Broughton Brad R. S. , Pino Ivan E. Oyarce , Deng Zihao , Zhang Tingfang , Murthi Padma , Del Borgo Mark P. , Widdop Robert E. , Polo Jose M. , Ricardo Sharon D. , Samuel Chrishan S.
Published: October 2024

Background

Kidney fibrosis is a hallmark of chronic kidney disease (CKD) and compromises the viability of transplanted human bone marrow-derived mesenchymal stromal cells (BM-MSCs). Hence, BM-MSCs were genetically-engineered to express the anti-fibrotic and renoprotective hormone, human relaxin-2 (RLX) and green fluorescent protein (BM-MSCs-eRLX + GFP), which enabled BM-MSCs-eRLX + GFP delivery via a single intravenous injection.

Methods

BM-MSCs were lentiviral-transduced with human relaxin-2 cDNA and GFP, under a eukaryotic translation elongation factor-1α promoter (BM-MSCs-eRLX + GFP) or GFP alone (BM-MSCs-eGFP). The ability of BM-MSCs-eRLX + GFP to differentiate, proliferate, migrate, produce RLX and cytokines was evaluated in vitro, whilst BM-MSC-eRLX + GFP vs BM-MSCs-eGFP homing to the injured kidney and renoprotective effects were evaluated in preclinical models of ischemia reperfusion injury (IRI) and high salt (HS)-induced hypertensive CKD in vivo. The long-term safety of BM-MSCs-RLX + GFP was also determined 9-months after treatment cessation in vivo.

Results

When cultured for 3- or 7-days in vitro, 1 × 106 BM-MSCs-eRLX + GFP produced therapeutic RLX levels, and secreted an enhanced but finely-tuned cytokine profile without compromising their proliferation or differentiation capacity compared to naïve BM-MSCs. BM-MSCs-eRLX + GFP were identified in the kidney 2-weeks post-administration and retained the therapeutic effects of RLX in vivo. 1–2 × 106 BM-MSCs-eRLX + GFP attenuated the IRI- or therapeutically abrogated the HS-induced tubular epithelial damage and interstitial fibrosis, and significantly reduced the HS-induced hypertension, glomerulosclerosis and proteinuria. This was to an equivalent extent as RLX and BM-MSCs administered separately but to a broader extent than BM-MSCs-eGFP or the angiotensin-converting enzyme inhibitor, perindopril. Additionally, these renoprotective effects of BM-MSCs-eRLX + GFP were maintained in the presence of perindopril co-treatment, highlighting their suitability as adjunct therapies to ACE inhibition. Importantly, no major long-term adverse effects of BM-MSCs-eRLX + GFP were observed.

Conclusions

BM-MSCs-eRLX + GFP produced greater renoprotective and therapeutic efficacy over that of BM-MSCs-eGFP or ACE inhibition, and may represent a novel and safe treatment option for acute kidney injury and hypertensive CKD.
Empirical challenges in assessing the “leaky STEM pipeline”: how the research design affects the measurement of women’s underrepresentation in STEM
Authors: Stefani Antje , Minor Ralf , Leuze Kathrin , Strauss Susanne
Published: October 2024

Background

Despite a well-documented underrepresentation of women in STEM majors and occupations, empirical evidence on whether there really is a “leaky STEM pipeline” is mixed due to a lack of methodological consistency. Studies vary by (1) the definition of STEM, (2) the decision to measure choices alone or to also include aspirations, and (3) the use of longitudinal or cross-sectional data.

Results

In order to analyze how variations in the research design affect the measurement of women’s underrepresentation in the field of STEM, we critically reviewed relevant literature on the “leaky pipeline” and identified three central features in the designs of existing empirical studies. We illustrate how the variation of these affects the results by applying them to the German context. Our results support the “leakage” perspective for Germany only during the transition to the labor market. Changes in STEM aspirations between grades 9 and 12 do not follow a clear pattern. Indeed, a comparison of grade 12 aspirations to actual college major choices even shows an increasing share of women in STEM.

Conclusion

Germany does not exhibit a significant “leaky STEM pipeline”. Due to more men choosing STEM, gender gaps widen in higher education, while the pipeline remains stable. Therefore, we challenge the “leaky pipeline” metaphor, advocating a life-course perspective to better understand STEM trajectories. We call for refined measurement standards, emphasizing official STEM definitions, long-term observations from aspirations to career entry, and the use of longitudinal data.
An aggressive gastric CIC-DUX4 sarcoma surgically resected with multivisceral organs: a case report
Authors: Koba Mizuki , Takeno Atsushi , Hasegawa Hiroko , Sakamori Ryotaro , Higashiura Rei , Yamamoto Masaaki , Tokuyama Shinji , Toshiyama Reishi , Kawai Kenji , Takahashi Yusuke , Sakai Kenji , Hama Naoki , Gotoh Kunihito , Kato Takeshi , Hirose Yumiko , Mori Kiyoshi , Mano Masayuki , Hirao Motohiro
Published: October 2024

Background

Capicua transcriptional repressor-double homeobox 4 sarcoma (CDS) is a rare and aggressive malignant soft tissue tumor that typically arises within the soft tissues. We report an exceptionally rare case of a gastric CDS successfully resected despite its extensive invasion into surrounding organs.

Case presentation

A 48-year-old male presented with a progressively enlarging abdominal mass. Upper gastrointestinal endoscopy revealed a large ulcerative tumor on the posterior gastric wall. Biopsy results initially suggested a neuroendocrine cell carcinoma. Contrast-enhanced computed tomography showed a 20 cm tumor protruding from the posterior stomach wall, directly invading the pancreas and colon. We performed a multivisceral resection (stomach, pancreatic tail, spleen, and transverse colon) achieving an R0 resection. Pathological examination of the permanent specimen revealed small round cells with high nuclear-to-cytoplasmic ratios. Immunohistochemical staining confirmed the diagnosis of CDS. The patient recovered well and was discharged on postoperative day 33.

Conclusions

This case report describes the first detailed account of a surgically resected aggressive CDS originating from the stomach.
Ruptured solitary fibrous tumor of the pleura with hemothorax: a case report
Authors: Komatsu Hiroaki , Furukawa Nao , Imamoto Kosuke , Okabe Kazunori
Published: October 2024

Background

The majority of the patients with a solitary fibrous tumor (SFT) of the pleura are asymptomatic, and rupture of an SFT with hemothorax is rare.

Case presentation

A 48-year-old man was taken by ambulance to our hospital because of sudden onset of left chest pain. Two months before the referral, a tumor was detected in the left upper lobe of the lung by screening computed tomography at another hospital, and further observation was recommended, because the tumor was suspected to be benign. Our contrast-enhanced computed tomography analysis of the chest revealed a solid tumor (5 cm in diameter) with an irregular enhancement effect close to the pericardium and pleural effusion in the left thoracic cavity. Pleural effusion was not detected in the previous imaging analysis. CT number of the pleural effusion was 40 HU, and the pleural effusion was suspected to be hematogenous. Therefore, rupture of the tumor with bleeding was suspected as the cause of the effusion because of the sudden onset. Preoperative diagnosis was a mediastinal tumor, such as a teratoma, because the tumor was close to the pericardium. Thoracoscopic surgery was performed with the patient in the right lateral decubitus position; bloody pleural effusion was observed and drained. The tumor originated from the visceral pleura of the left upper lobe of the lung and was resected with a surgical stapler. Macroscopic analyses of the resected tumor indicated that bleeding were caused by the rupture of the tumor at the defect of the capsule wall. The operation took 63 min. The postoperative pathological diagnosis was a benign SFT. Hemorrhage was observed just under the capsule wall of the tumor. The postoperative course of the patient was uneventful, and he was discharged 2 days after surgery.

Conclusions

Even when an SFT is neither huge nor malignant, rupture can occur, and resection should be considered regardless of the size or malignant characteristics. After an SFT rupture, careful follow-up is needed to monitor for the intrathoracic recurrence or dissemination of the tumor.
Fine Tuning ECG Interpretation for Young Athletes: ECG Screening Using Z-score-based Analysis
Authors: Park Jihyun , Kimata Chieko , Young Justin , Perry James C. , Bratincsak Andras
Published: October 2024

Background

Electrocardiograms (ECGs) in athletes commonly reveal findings related to physiologic adaptations to exercise, that may be difficult to discern from true underlying cardiovascular abnormalities. North American and European societies have published consensus statements for normal, borderline, and abnormal ECG findings for athletes, but these criteria are not based on established correlation with disease states. Additionally, data comparing ECG findings in athletes to non-athlete control subjects are lacking. Our objective was to compare the ECGs of collegiate athletes and non-athlete controls using Z-scores for digital ECG variables to better identify significant differences between the groups and to evaluate the ECG variables in athletes falling outside the normal range.

Methods

Values for 102 digital ECG variables on 7206 subjects aged 17–22 years, including 672 athletes, from Hawaii Pacific Health, University of Hawaii, and Rady Children’s Hospital San Diego were obtained through retrospective review. Age and sex-specific Z-scores for ECG variables were derived from normal subjects and used to assess the range of values for specific ECG variables in young athletes. Athletes with abnormal ECGs were referred to cardiology consultation and/or echocardiogram.

Results

Athletes had slower heart rate, longer PR interval, more rightward QRS axis, longer QRS duration but shorter QTc duration, larger amplitude and area of T waves, prevalent R’ waves in V1, and higher values of variables traditionally associated with left ventricular hypertrophy (LVH): amplitudes of S waves (leads V1-V2), Q waves (V6, III) and R waves (II, V5, V6). Z-scores of these ECG variables in 558 (83%) of the athletes fell within − 2.5 and 2.5 range derived from the normal population dataset, and 60 (8.9%) athletes had a Z-score outside the − 3 to 3 range. While 191 (28.4%) athletes met traditional voltage criteria for diagnosis of LVH on ECG, only 53 athletes (7.9%) had Z-scores outside the range of -2.5 to 2.5 for both S amplitude in leads V1-V2 and R amplitude in leads V5-6. Only one athlete was diagnosed with hypertrophic cardiomyopathy with a Z-score of R wave in V6 of 2.34 and T wave in V6 of -5.94.

Conclusion

The use of Z-scores derived from a normal population may provide more precise screening to define cardiac abnormalities in young athletes and reduce unnecessary secondary testing, restrictions and concern.
Assessing the impact of migration on the happiness of household women left behind: evidence from Punjab, Pakistan
Authors: Aziz Noshaba , Raza Ali , Yang Shaoxiong , Zhou Jin
Published: October 2024

The concept of happiness is becoming an increasingly significant area of focus in the evaluation of overall quality of life. This research examines the impact of migration on the well-being of women who remain in their place of residence following the migration of their family members. The study employs data from the Multiple Indicators Cluster Survey (2017–2018) in Punjab, Pakistan, and addresses sample selection bias through Propensity Score Matching (PSM). Moreover, as the dependent variable is ordinal, the study employed ordered logistic regression to examine the correlation between migration and happiness, taking into account migration status and other variables. The findings indicate that women from migrant backgrounds tend to benefit from migrating, primarily in terms of enhanced financial resources. In order to gain insight into the varying effects of migration on women’s happiness, the study employed heterogeneity analysis, which revealed that the influence of migration on women’s happiness differs across various areas. In conclusion, the combination of propensity score matching (PSM) with ordered logistic regression and heterogeneity analysis represents a robust methodology for evaluating the impact of migration on women’s perceptions of happiness. The study demonstrates that migration has the potential to improve the quality of life of women who remain in their home countries, particularly those residing in financially disadvantaged households.
A community-centric model for conference co-creation: the world conference on CDG for patients, families and professionals
Authors: Francisco Rita , Pascoal Carlota , Granjo Pedro , de Freitas Claudia , Videira Paula A. , dos Reis Ferreira Vanessa
Published: October 2024

Background

Patient and public co-creation and involvement in health initiatives have been witnessing great expansion in recent years. From healthcare to research settings, collaborative approaches are becoming increasingly prevalent and diverse, especially in the field of rare diseases which faces complex challenges. Conference development and implementation, however, have been primarily guided by passive, information-sharing models. There is a need for conferences to evolve towards more inclusive, interactive, collaborative, and problem-solving platforms. Here, we aimed to report on a pioneer model, emphasizing a community partnership approach to conference co-creation that takes the World Conference on Congenital Glycosylation Disorders (CDG) as an exemplary case.

Methods

To answer the need to overcome the lack of access to high-quality information which limits CDG diagnosis, research and treatment options, the World CDG Organization has been refining a community-centric model for conference co-creation. Focusing on the 5th edition of the conference, data on stakeholders’ preferences was collected using an online survey and a poll to define the conference agenda, guide its development and select optimal dates for an all-stakeholder inclusive, relevant and participatory event.

Results

We describe the complexities of the community-centric conference co-creation model, detailing its refined methodology and the outcomes achieved. The model is grounded on a participative approach to promote people-centered research and care for CDG patients. The involvement of the public in the conference co-creation and in participatory methods allowed the generation of knowledge on community needs and preferences.

Conclusion

This paper describes a reliable, highly adaptable conference co-creation model that fosters community-building, disseminates understandable information, and serves as a borderless platform to incentivize multiple stakeholder collaborations towards CDG research and drug development. We argue this is a reproducible model that can be endorsed and more widely adopted by other disease communities and events.
Gochujang, a Korean traditional fermented soybean product: history, preparation and functionality
Authors: Jung Su-Jin , Shin Dong-Hwa
Published: October 2024

Korean food has garnered global interest, especially after COVID-19, with a significant increase in demand for K-Food staples like bulgogi, tteokbokki, bibimbap, kimchi, and galbi, as well as related YouTube content. A key ingredient that enhances the deliciousness of Korean cuisine is Gochujang. Gochujang, with its unique taste and aroma, is an unparalleled fermented spice seasoning, adding spiciness and a special flavor to a variety of dishes. Made from ingredients such as Meju, glutinous rice, red pepper powder, malt, and salt, Gochujang has a rich history spanning thousands of years and is celebrated for its spicy and sweet flavor. Gochujang is differentiated by commercial and traditional manufacturing methods. Traditional Gochujang is produced through natural fermentation using glutinous rice, malt, Meju powder, salt, and red pepper powder. Conversely, commercial production blends traditional methods with modern industrial techniques, utilizing pure microbial cultures like Aspergillus oryzae and Bacillus subtilis as starters to meet mass production demands. Beyond its culinary uses, Gochujang is recognized globally for its nutritional value and health benefits. Fermentation enhances its health functionality by creating new substances or converting fermentation metabolites. Notable compounds synthesized during fermentation include capsaicin from red pepper powder and non-glycoside isoflavones from Meju, which are linked to antiobesity, antidiabetic, antiatherosclerosis, and anticancer effects. Gochujang also helps restore intestinal microbial balance, promoting gut health. This review aims to explore the historical background of Gochujang, its production methods, flavor characteristics, nutritional composition, health benefits, and the expansion of culinary research involving Gochujang.
Prevalence and associated factors of suicide-related behaviors in Iranian students: a large sample cross-sectional study
Authors: Yaghubi Hamid , Soleimani Leila , Abedi Yarandi Mohammad Saeed , Mollaei Aghil , Mahdavinoor Seyyed Muhammad Mahdi
Published: October 2024

Background

Admission to the university changes life conditions and thereby increases mental pressure. If the students cannot bear the psychological pressure of being a student, that may lead to suicide among the vulnerable persons. Therefore, in this research, we would like to investigate the prevalence and associated factors of suicide-related behaviors in Iranian students.

Methods

This online, cross-sectional survey was performed from March 18 to April 15, 2023, in Iran. The questionnaires were completed by 2181 students. In this study, Perceived Stress Scale (PSS-4), Meaning in Life Questionnaire (MLQ), Generalized Anxiety Disorder Scale (GAD-7), and Suicidal Behaviors Questionnaire-Revised (SBQ-R), and Oslo Social Support Scale (OSSS-3) were used. Finally, we identified the factors associated with suicide-related behaviors using univariate and multiple regression.

Results

The prevalence of suicidal behaviors in students was 57.95%. According to the results, male gender, marriage, having meaning in life, occasional smoking, sleeping after 1 a.m., and having social support were associated with a reduced risk of suicide. In addition, a history of sexual abuse, more anxiety, and higher perceived stress were associated with an increased risk of suicide.

Conclusions

The prevalence of suicide-related behaviors in Iranian students was higher than expected. Urgent interventions should be considered to prevent students from committing suicide. Helping students find meaning in life, as well as eliminating the causes of students’ anxiety and stress, may be effective in this respect. Additionally, teaching students how to control anxiety and stress may be helpful.
Elevated 1-hour Post Load Glucose as a Predictor for Telomere Attrition: A Study Based on a Chinese Community Population
Authors: Gao Qi , Yu Jie , Liu Yiwen , Xing Baodi , Ping Fan , Xu Lingling , Li Wei , Zhang Huabing , Li Yuxiu
Published: October 2024

Context

One-hour post-load glucose (1h-PG) detects dysglycemia-related disorders more effectively than traditional glycemic parameters. Hyperglycemia accelerates aging, but whether 1h-PG outperforms in predicting aging remains unclear.

Objective

To compare the effectiveness of 1h-PG with other glycemic parameters in identifying and predicting telomere attrition.

Methods

We conducted a cross-sectional and longitudinal study based on a Chinese community cohort. Multivariate linear regression and logistic regression were used to analyze the associations between glycemic parameters and telomere length. The area under the receiver operating characteristic (AUROC) curve were used to compare the differentiating and predictive ability. Populations were regrouped by glucose tolerance status and 1h-PG to compare telomere length. Analyses were separately conducted in nondiabetic and diabetic populations.

Results

The cross-sectional study included 715 participants. Only 1h-PG was significantly negatively associated with relative telomere length in both nondiabetic [β = −.106, 95% confidence interval (CI) −0.068 to −0.007, P = .017] [odds ratio (OR) = 1.151, 95% CI 1.069 to 1.239, P = .005] and diabetic (β = −.222, 95% CI −0.032 to −0.007, P = .002) (OR = 1.144, 95% CI 1.041 to 1.258, P = .035) populations. The longitudinal study recruited 437 populations and 112 remained in 7-years follow-up. 1h-PG was associated with telomere shortening in the nondiabetic group (β = −.314, 95% CI −0.276 to −0.032, P = .016) (OR = 2.659, 95% CI 1.158 to 6.274, P = .021). AUROC analysis showed that 1h-PG outperformed other glycemic parameters in identifying and predicting telomere attrition. Reclassification revealed that normal glucose tolerance and prediabetic individuals with elevated 1h-PG had telomere lengths comparable to prediabetic and diabetic populations, respectively.

Conclusion

1h-PG outperforms other glycemic parameters in predicting telomere attrition and can be a valuable marker for early aging detection.
Hypogonadotropic Hypogonadism as First Presentation of the Severe Neuroendocrine Disorder Caused by RNF216
Authors: Rochtus Anne , Asscherickx Willeke , Timmers Marijke , Vermeer Sascha , Antonio Leen
Published: October 2024

Biallelic pathogenic variants in RNF216 cause a syndrome characterized by hypogonadotropic hypogonadism, cerebellar ataxia, chorea, and cognitive impairment, a combination first described as Gordon Holmes syndrome (MIM 212840). We report 2 siblings who were referred due to absent or delayed puberty. The older sibling, a 17-year-old male, presented with absence of secondary sexual characteristics and a high-pitched voice. He had normal cognitive development and no anosmia. Clinical examination revealed Tanner stage P1/G1 and bilateral gynecomastia. Blood tests showed low gonadotropin and morning testosterone levels. His 15-year-old sister was referred due to primary amenorrhea. She had spontaneous thelarche and presented with Tanner stage P3/B3. Pituitary magnetic resonance imaging was performed on the brother due to suspicion of Kallmann syndrome, revealing a normal anterior pituitary, a hypoplastic posterior pituitary, and an extensive supratentorial leuko-encephalopathy. Whole-exome sequencing revealed a homozygous pathogenic variant in RNF216 in both affected siblings. Both parents were heterozygous carriers. RNF216 pathogenic variants cause a disorder characterized by combined neurodegeneration and reproductive dysfunction. Although neurological symptoms are typically recognized first, they often seem to follow the onset of hypogonadism. This highlights the need for awareness, as hypogonadotropic hypogonadism may be the initial manifestation of this severe neuroendocrine disorder, especially in males.