bluuebunny/crossref_metadata_2025 huggingface dataset:
Heart sounds: Past, present, and future from a technological and clinical perspective – a systematic review
Authors: Azmeen Ayesha , Vakilzadian Hamid , Haider Hani , Mathers Daniel H. , Zimmerman Reid , Bedi Shine , O’Leary Edward L.
Published: May 2023

The high prevalence of cardiac diseases around the world has created a need for quick, easy and cost effective approaches to diagnose heart disease. The auscultation and interpretation of heart sounds using the stethoscope is relatively inexpensive, requires minimal to advanced training, and is widely available and easily carried by healthcare providers working in urban environments or medically underserved rural areas. Since René-Théophile-Hyacinthe Laennec’s simple, monoaural design, the capabilities of modern-day, commercially available stethoscopes and stethoscope systems have radically advanced with the integration of electronic hardware and software tools, however these systems are largely confined to the metropolitan medical centers. The purpose of this paper is to review the history of stethoscopes, compare commercially available stethoscope products and analytical software, and discuss future directions. Our review includes a description of heart sounds and how modern software enables the measurement and analysis of time intervals, teaching auscultation, remote cardiac examination (telemedicine) and, more recently, spectrographic evaluation and electronic storage. The basic methodologies behind modern software algorithms and techniques for heart sound preprocessing, segmentation and classification are described to provide awareness.
Zooming in and Zoning out: Remote Deliberation Impairs Team Decision Quality
Authors: Javalagi Anoop A. , Harris-Watson Alexandra M. , DeChurch Leslie A.
Published: May 2023

The sudden shift to remote work offered a unique opportunity to investigate the effect of meeting modality on team decisions. We present data on classroom teams solving a classic team decision task type, the hidden profile, where members each have unique information that must be combined to arrive at the correct solution. Owing to the COVID-19 pandemic, we collected data on teams solving hidden profiles in-person, over Zoom, and then in-person while wearing face masks. We first demonstrate the efficacy of the decision task, a space-themed hidden profile where team members bring to bear data on exoplanets to choose which of three planets can best support human colonization. Once validated, the task was implemented as part of a team effectiveness course over four years: two years before the COVID-19 pandemic (2018–2020), one year of remote work (2020–2021), and one year of masked in-person work (2021–2022). Students were randomly assigned to teams and roles within each course and deliberated for 30 minutes to choose the best option. Examining the quality of team decisions shows marked differences based on the modality of team deliberations. Teams deliberating in-person had the greatest chance of solving the hidden profile, followed by teams meeting in-person with face masks; teams deliberating over Zoom were least likely to solve the hidden profile. Practical implications of team decision modalities for hybrid work design are discussed.
Metabolomics in acromegaly: a systematic review
Authors: Pînzariu Oana , Georgescu Carmen Emanuela
Published: May 2023

The therapeutic response heterogeneity in acromegaly persists, despite the medical–surgical advances of recent years. Thus, personalized medicine implementation, which focuses on each patient, is justified. Metabolomics would decipher the molecular mechanisms underlying the therapeutic response heterogeneity. Identification of altered metabolic pathways would open new horizons in the therapeutic management of acromegaly. This research aimed to evaluate the metabolomic profile in acromegaly and metabolomics’ contributions to understanding disease pathogenesis. A systematic review was carried out by querying four electronic databases and evaluating patients with acromegaly through metabolomic techniques. In all, 21 studies containing 362 patients were eligible. Choline, the ubiquitous metabolite identified in growth hormone (GH)-secreting pituitary adenomas (Pas) by in vivo magnetic resonance spectroscopy (MRS), negatively correlated with somatostatin receptors type 2 expression and positively correlated with magnetic resonance imaging T2 signal and Ki-67 index. Moreover, elevated choline and choline/creatine ratio differentiated between sparsely and densely granulated GH-secreting PAs. MRS detected low hepatic lipid content in active acromegaly, which increased after disease control. The panel of metabolites of acromegaly deciphered by mass spectrometry (MS)-based techniques mainly included amino acids (especially branched-chain amino acids and taurine), glyceric acid, and lipids. The most altered pathways in acromegaly were the metabolism of glucose (particularly the downregulation of the pentose phosphate pathway), linoleic acid, sphingolipids, glycerophospholipids, arginine/proline, and taurine/hypotaurine. Matrix-assisted laser desorption/ionization coupled with MS imaging confirmed the functional nature of GH-secreting PAs and accurately discriminated PAs from healthy pituitary tissue.
Composite Biomarkers, Behavioral Symptoms, and Comorbidities in Axial Low Back Pain: A Systematic Review
Authors: Saravanan Anitha , Bai Jinbing , Bajaj Prempreet , Sterner Elizabeth , Rajagopal Mahalakshmi , Sanders Sameera , Luckose Anne , Kushnick Michael , Starkweather Angela
Published: May 2023

Purpose

Proinflammatory cytokines play a critical role in chronic inflammation and pain and contribute to behavioral symptoms (depressive symptoms, anxiety, fatigue, sleep disturbance) and comorbidities (diabetes, cardiac diseases, cancer). Evidence is lacking on the specific proinflammatory cytokines associated with these behavioral symptoms/comorbidities co-occurring with axial low back pain (aLBP). This review aimed to systematically analyze the following: (1) specific proinflammatory cytokines associated with aLBP in adults, (2) associations among proinflammatory cytokines and behavioral symptoms in aLBP, and (3) relationships among proinflammatory cytokines and comorbidities in aLBP, to develop a new clinical framework for future diagnostic and intervention targets for patients with aLBP.

Methods

Electronic databases, including PubMed/MEDLINE, ProQuest Nursing & Allied Health Source, and CINAHL Complete (EBSCO) were searched for the period January 2012 to February 2023. Eligible studies included cross-sectional, case-control, longitudinal, and cohort studies in which proinflammatory cytokines were reported in adults above 18 years with aLBP. Intervention studies and randomized controlled trails were excluded. The Joanna Briggs Institute (JBI) criteria were used for quality evaluation.

Results

Findings from 11 studies showed 3 proinflammatory cytokines associated with pain intensity in adult patients with aLBP: C-Reactive Protein (CRP), Tumor Necrosis Factor (TNF-α), and Interleukin (IL-6). Some studies assessed associations between proinflammatory cytokines and depressive symptoms; none explored the association of proinflammatory cytokines with fatigue, anxiety, sleep disturbance, or comorbidities (diabetes, cardiac diseases, and cancer) in aLBP.

Conclusions

Proinflammatory cytokines in aLBP can serve as composite biomarkers for pain, associated symptoms, and comorbidities and may serve as a target for future interventions. There is need for well-designed studies assessing associations among chronic inflammation, behavioral symptoms, and comorbidities.
Influencing Factors and Nomogram for the Development of Epilepsy in Advanced Lung Cancer Patients With Brain Metastases
Authors: Yuan Niu , Lv Zhang-Hong , Tao Ting-Yu , Qian Dan
Published: May 2023

Background

Epilepsy is a prevalent comorbidity in patients with brain metastases (BM) and could result in sudden and accidental damage, as well as increased disease burden due to its rapid onset. Foreseeing the potential for the development of epilepsy may permit timely and efficient measures. This study aimed to analyze the influencing factors of epilepsy in advanced lung cancer (ALC) patients with BM and construct a nomogram model to predict the likelihood of developing epilepsy.

Methods

Socio-demographic and clinical data of ALC patients with BM were retrospectively collected from the First Affiliated Hospital of Zhejiang University School of Medicine between September 2019 and June 2021. Univariate and multivariate logistic regression analyses were applied to determine the influencing factors for epilepsy in ALC patients with BM. Based on the results of the logistic regression analysis, a nomogram was built to represent the contribution of each influencing factor in predicting the probability of epilepsy development in ALC patients with BM. The Hosmer-Lemeshow test and receiver operating characteristic (ROC) curve were utilized to evaluate the goodness of fit and prediction performance of the model.

Results

The incidence of epilepsy among 138 ALC patients with BM was 29.7%. On the multivariate analysis, having a higher number of supratentorial lesions (odds ratio [OR] = 1.727; p = 0.022), hemorrhagic foci (OR = 4.922; p = .021), and a high-grade of peritumoral edema (OR = 2.524; p < .001) were independent risk factors for developing epilepsy, while undergoing gamma knife radiosurgery (OR = .327; p = .019) was an independent protective factor. The p-value of the Hosmer-Lemeshow test was .535 and the area under the ROC curve (AUC) was .852 (95% CI: .807–.897), suggesting the model had a good fit and exhibited strong predictive accuracy.

Conclusion

The nomogram was constructed that can predict the probability of epilepsy development for ALC patients with BM, which is helpful for healthcare professionals to identify high-risk groups early and allows for individualized interventions.
Challenges in empire: Eduards Volters’ ethnography on Lithuania, 1882–1918
Authors: Savoniakaitė Vida
Published: May 2023

This article argues that Eduards Volters (1856–1941), an important ethnographer working in the first part of his career with the Imperial Russian Geographical Society, helped demonstrate the value of first-hand observation, social connection, and social context to ethnography through his research in Lithuania from 1882 to 1918. He did so at a time few of his contemporaries embraced his methods. The article seeks to show Volters’ developing theoretical and political strategies during a period of developing Lithuanian nationalism in an emerging Lithuanian nation—a nationalism with which he was in deep sympathy. I focus on the following questions: the meaning of Volters’ travels to Lithuania Minor and Lithuania; his contributions to what are now called borderland identities studies and his critical methodological and theoretical approach to the ethnography of his day. That critical approach involved ethnography as a part of political activism on the part of both researcher and research subjects. The piece will contribute to the critique of centralization of imperialism studies and will explore by comparison Volters’ relationships with both intellectual predecessors and his contemporaries in Lithuania, Europe, and beyond.
Early childhood leadership well-being: A phenomenological examination of workplace stress and supports
Authors: Bosire Jamlick Peter Ondieki , Gallagher Kathleen Cranley , Garrett Amanda Leigh , Babchuk Wayne
Published: May 2023

Early childhood center directors need to effectively function in their workplace so that they can provide leadership that supports quality. Their personal and professional well-being may affect how they support other educators. Few studies have investigated work-related well-being from directors’ perspectives. This qualitative study investigated the directors’ common experiences about well-being. Specifically, interpretative phenomenological design was used to explore the directors’ work-related stress, work-related support, and well-being. Four early childhood center directors serving children from low socio-economic backgrounds in Mid-Western State were interviewed individually to understand how they understood work-related well-being, sources of work-related stress, and work-related support. Five themes emerged from the data: understanding of well-being (physical and mental health, salary, relationships, and self-care practice); sources of work-related stress (compassion fatigue, role, and learning); managing work-related stress (self-discipline, mindfulness); sources of support (leadership, staff, self-support, family, and friends); source of inspiration (opportunity and value). Implications include establishing formal support networks, and policy review and provision of resources to effectively support directors from burnout.
A Randomized, Controlled, Parallel-Group, Trial on the Long-term Effects of Melatonin on Fatigue Associated With Breast Cancer and Its Adjuvant Treatments
Authors: Sedighi Pashaki Abdolazim , Sheida Fateme , Moaddab Shoar Leila , Hashem Tahereh , Fazilat-Panah Danial , Nemati Motehaver Alireza , Ghanbari Motlagh Ali , Nikzad Safoora , Bakhtiari Mojtaba , Tapak Leili , Keshtpour Amlashi Zahir , Javadinia Seyed Alireza , Keshtpour Amlashi Zahra
Published: May 2023

Objective:

Cancer related fatigue is a distressing condition and correlated with decrease in quality of life of patients with malignant conditions. In continuation of our previous research, we assessed long term anti-fatigue effects of melatonin in patients with the breast cancer.

Material and methods:

In this clinical trial, 92 breast cancer patients were randomly assigned to receive either melatonin (18 mg/day) or placebo from 1 week before the adjuvant treatments until 2 years after their completion. The levels of fatigue were assessed before and after intervention using Brief Fatigue Inventory (BFI) and were compared at a significance level of P ≤ .05.

Results:

The BFI scores were similar between the 2 groups at the baseline (placebo group: 5.56 ± 1.59 and melatonin group: 5.72 ± 1.68, P = .67). After the intervention, not only the mean fatigue score was significantly lower in melatonin group (2.93 ± 1.04 vs 1.99 ± 1.02, P < .001, P ≤ .05), but also a greater reduction in fatigue score in intervention group was evident over time ( P ≤ .001).

Conclusion:

Long-term usage of melatonin even after completion of adjuvant therapies in women with breast cancer decreased the levels of fatigue associated with the malignant condition and its treatments.

The trial registry name and URL, and registration number:

Iranian Registry of Clinical Trials, https://en.irct.ir/trial/62267 , IRCT20180426039421N3
Examining listeners’ perception of spoken words with different face masks
Authors: Cox Bethany G , Tuft Samantha E , Morich Jessica R , McLennan Conor T
Published: May 2023

The COVID-19 pandemic made face masks part of daily life. While masks protect against the virus, it is important to understand the impact masks have on listeners’ recognition of spoken words. We examined spoken word recognition under three different mask conditions (no mask; cloth mask; Kn95 mask) and in both easy (low density, high phonotactic probability) and hard (high density, low phonotactic probability) words in a lexical decision task. In Experiment 1, participants heard all words and nonwords under all three mask conditions. In Experiment 2, participants heard each word and nonword only once under one of the mask conditions. The reaction time and accuracy results were consistent between Experiments 1 and 2. The pattern of results was such that the no mask condition produced the fastest and most accurate responses followed by the Kn95 mask condition and the cloth mask condition, respectively. Furthermore, there was a trend towards a speed-accuracy trade-off with Word Type. Easy words produced faster but less accurate responses relative to hard words. The finding that cloth masks had a more detrimental impact on spoken word recognition than Kn95 masks is consistent with previous research, and the current results further demonstrate that this effect extends to individual word recognition tasks with only audio presentation.
Why Wait? The Ethics of Disclosing HIV Screening Results
Authors: Aryanpour Zain , Opsteen Skye , Van Gerwen Olivia T. , Muzny Christina A. , Heath Sonya L.
Published: May 2023

Counseling patients on their HIV test results is an important part of undergraduate and graduate medical education. However, many trainees and physicians feel ill prepared to counsel patients on potentially distressing results. We present a case involving early disclosure of a false-positive HIV screening test result to a patient and the downstream effects of this premature disclosure. This case highlights the importance of understanding the various HIV testing options available and the importance of education on effectively counseling patients on screening versus confirmatory HIV test results.
Return to Preinjury-Level Sports After Arthroscopic Latarjet for Recurrent Anterior Shoulder Instability in Professional Athletes
Authors: Brzoska Roman , Laprus Hubert , Malik Shahbaz S. , Solecki Wojciech , Juszczak Barlomiej , Blasiak Adrian
Published: May 2023

Background:

The Latarjet procedure is recommended to treat recurrent anterior shoulder instability with glenoid bone loss. Longer return-to-sport (RTS) times have been reported after the open Latarjet when compared with the arthroscopic Latarjet.

Purpose:

To assess the clinical outcomes and RTS in athletes who underwent an arthroscopic Latarjet.

Study Design:

Case series; Level of evidence, 4.

Methods:

This study included 46 professional athletes with recurrent anterior shoulder instability who underwent an arthroscopic Latarjet between 2010 and 2016. Patients were divided by type of sport: noncollision and nonoverhead (n = 22), collision and martial arts (n = 13), and overhead (n = 11). Sport activity was evaluated with the Kerlan-Jobe Orthopaedic Clinic (KJOC) score, Subjective Patient Outcome for Return to Sports score, and RTS time. Clinical results were evaluated by Constant-Murley score, Walch-Duplay score, and range of external and internal rotation. Complication rates, recurrence of shoulder instability, and number of revision procedures were recorded. Correlation tests were used to assess the relationship between measured parameters.

Results:

The mean ± SD patient age was 27.1 ± 7.3 years, and the mean follow-up was 50.7 ± 18 months. Overall, 44 patients (95.7%) returned to their previously practiced sports, and 40 (87%) returned to their preinjury levels. The RTS time was 5 ± 1.4 months, with no significant difference among sport types. KJOC and Subjective Patient Outcome for Return to Sports scores were 95.2 ± 5.6 and 9.5 ± 1, respectively. Significant pre- to postoperative improvement was seen on the Constant-Murley score (from 54.3 ± 9.4 to 87.9 ± 8.2; P = .001) and Walch-Duplay score (from 53.7 ± 7.3 to 88.1 ± 10.7; P = .001). Mean postoperative external and internal rotation was 72.8° ± 18.6° and 81.3° ± 11.3°. Procedure-related complications occurred in 10 patients (21.7%); recurrence of shoulder instability was observed in 4 (8.7%); and 4 (8.7%) underwent revision surgery. A worse Walch-Duplay score was significantly associated with longer RTS time ( r = –0.39; P = .019) and lower KJOC score ( r = 0.29; P = .03).

Conclusion:

There was a 95.7% RTS rate after the arthroscopic Latarjet procedure, although the procedure was not free from complications.
Nursing and Health Sciences Students' Perspective on the Functions of Academic Advising
Authors: Aljohani Khalid A. , Almarwani Abdulaziz Mofdy , Tubaishat Ahmad , Gracia Paul Reinald B. , Natividad Maria Jocelyn B. , Gamboa Helen M. , Aljohani Mohammed S.
Published: May 2023

Introduction

Nursing and allied health students represent a significant percentage of undergraduate students. Academic advising is integral to students’ success.

Objective

This study aimed to identify nursing and allied-health science students’ perspectives on academic advising functions and identify the demographic factors associated with these perspectives.

Methods

A cross-sectional, correlational study was conducted with 252 students who completed a survey on students’ perspectives on academic advising functions. Students were recruited from a large public university in western Saudi Arabia.

Results

The results revealed that 97.6% of students reported knowing their academic advisor and 80.8% reported meeting with their advisor at least once over the past year. Overall, students perceived academic advising as important ( M = 4.0, SD ± 0.86). The social role of academic advising was perceived as its most important function ( M = 4.1, SD ± 0.85), followed by the academic role ( M = 4.0, SD ± 0.87) and the personal role ( M = 3.9, SD ± 0.87). The results showed that junior students perceived academic advising as more important than their counterparts. There was a weak significant correlation between students’ perception of academic advising functions and the number of meetings held with their advisors.

Conclusion

Faculty should improve students’ understanding of the academic advisor's role in academic progress. Students understanding of their academic advisor's role in supporting their academic progress should be emphasized, especially among senior students.
Non-Covalent Bonding of Green Synthesized Copper Nanoparticles to Enhance Physicochemical Behavior of Sulfur-Dyed Cotton Fabric
Authors: Amir Muhammad , Ahmed Kashif , Hasany Syed Farhan , Butt Rizwan Aslam
Published: May 2023

Cotton fabric samples were treated with copper acetate mordant, in addition to green synthesized copper nanoparticles extracted from the Conocarpus erectus leaves, with two different concentrations of 10% and 20%, respectively. Two dyeing techniques, continuous dyeing and exhaust dyeing, were employed. X-ray diffraction confirmed the synthesis of copper nanoparticles with an approximate size of 30 nm. Scanning electron microscopy showed copper nanocrystals with a size range of 30–70 nm. The tensile strength showed an approximately 60% rise in the warp direction and an approximately 20% rise in the weft direction for both continuous and exhaust dyeing techniques. The color strength (ratio of absorption co-efficient (K) and scattering coefficient (S); K/S) showed an improvement of 100% and 20% for the exhaust and continuous dyeing techniques, respectively. Both the dyeing techniques showed a rising trend in color fastness to wash and color fastness to rubbing with an increment up to grade 5. The light fastness showed an improvement up to grade 6 for both the techniques. Fastness to rubbing showed an increment from 1 to 5 for both techniques.
Methodological challenges of researching an emerging scene: Experimental electronic music in contemporary Manchester
Authors: Taylor Steven
Published: May 2023

The process of researching a music scene retrospectively, even one which has recently formed, rests on a relatively simple ontological foundation; that the scene is broadly agreed – by both participants and observers – to already exist and to be available as an object for study, whether that proceeds on a musicological, sociological or geographical basis. But what if the scene is merely purported, suspected or intuited to be in the process of formation; to be, in some sense, imminent rather that existent? What methods are appropriate to investigating a music scene under such conditions? What constitutes, if not ‘evidence’, then sufficiently persuasive indications that a scene is emerging? These considerations are explored in this article, in the context of the author's early-stage fieldwork into a putative new underground electronic music scene in Manchester, UK, along with reflexive observations on the researcher's insertion into a potential process of scene-formation.
Role of Knowledge Sharing Culture and Knowledge Management on the Corporate Performance: A Theoretical Discussion
Authors: Goyal D.P. , Kiran Ravi , Hakhu Rahul
Published: May 2023

In this paper, an attempt has been made to illustrate the significance of Knowledge Sharing Culture (KSC) and Knowledge Management (KM) on the performance of a company. Besides, the various issues pertaining to KSC and KM in a corporate organisation have dieoretically been discussed in detail by reviewing some of the important case studies. The management of knowledge and developing a sound KSC assume a very significant role in die corporate structure in accomplishing numerous objectives of a firm, namely, competitive advantage, performance, profit, lower transaction cost, agency cost etc., in the post 1990s era. Developing a sound KSC dirough KM brings about lot of advantages in a company in terms of revenue, marketing and cost of production. However, the development of KSC depends largely on die organisational, technical, managerial and technical cultures/environments of a company. These cultures are to be nurtured and developed in order to improve and install a sustainable KSC for accomplishing the corporate objectives in the highly competitive world economy in the long run. The focus of die managers should be on the various components of corporate cultures and factors before embarking on in installing and improving a sound KSC to enhance the overall performance of a company.
Single-nucleus chromatin accessibility identifies a critical role for TWIST1 in idiopathic pulmonary fibrosis myofibroblast activity
Authors: Valenzi Eleanor , Bahudhanapati Harinath , Tan Jiangning , Tabib Tracy , Sullivan Daniel I. , Nouraie Mehdi , Sembrat John , Fan Li , Chen Kong , Liu Silvia , Rojas Mauricio , Lafargue Audrey , Felsher Dean W. , Tran Phuoc T. , Kass Daniel J. , Lafyatis Robert
Published: May 2023

Background

In idiopathic pulmonary fibrosis (IPF), myofibroblasts are key effectors of fibrosis and architectural distortion by excessive deposition of extracellular matrix and their acquired contractile capacity. Single-cell RNA-sequencing (scRNA-seq) has precisely defined the IPF myofibroblast transcriptome, but identifying critical transcription factor activity by this approach is imprecise.

Methods

We performed single-nucleus assay for transposase-accessible chromatin sequencing on explanted lungs from patients with IPF (n=3) and donor controls (n=2) and integrated this with a larger scRNA-seq dataset (10 IPF, eight controls) to identify differentially accessible chromatin regions and enriched transcription factor motifs within lung cell populations. We performed RNA-sequencing on pulmonary fibroblasts of bleomycin-injuredTwist1-overexpressing COL1A2 Cre-ER mice to examine alterations in fibrosis-relevant pathways followingTwist1overexpression in collagen-producing cells.

Results

TWIST1, and other E-box transcription factor motifs, were significantly enriched in open chromatin of IPF myofibroblasts compared to both IPF nonmyogenic (log2fold change (FC) 8.909, adjusted p-value 1.82×10−35) and control fibroblasts (log2FC 8.975, adjusted p-value 3.72×10−28).TWIST1expression was selectively upregulated in IPF myofibroblasts (log2FC 3.136, adjusted p-value 1.41×10−24), with two regions ofTWIST1having significantly increased accessibility in IPF myofibroblasts. Overexpression of Twist1 in COL1A2-expressing fibroblasts of bleomycin-injured mice resulted in increased collagen synthesis and upregulation of genes with enriched chromatin accessibility in IPF myofibroblasts.

Conclusions

Our studies utilising human multiomic single-cell analyses combined within vivomurine disease models confirm a critical regulatory function for TWIST1 in IPF myofibroblast activity in the fibrotic lung. Understanding the global process of opening TWIST1 and other E-box transcription factor motifs that govern myofibroblast differentiation may identify new therapeutic interventions for fibrotic pulmonary diseases.
Pan-cancer analysis revealed H3K4me1 at bivalent promoters premarks DNA hypermethylation during tumor development and identified the regulatory role of DNA methylation in relation to histone modifications
Authors: Lu Yang , Cao Qiang , Yu Yue , Sun Yazhou , Jiang Xuan , Li Xin
Published: May 2023

Background

DNA hypermethylation at promoter CpG islands (CGIs) is a hallmark of cancers and could lead to dysregulation of gene expression in the development of cancers, however, its dynamics and regulatory mechanisms remain elusive. Bivalent genes, that direct development and differentiation of stem cells, are found to be frequent targets of hypermethylation in cancers.

Results

Here we performed comprehensive analysis across multiple cancer types and identified that the decrease in H3K4me1 levels coincides with DNA hypermethylation at the bivalent promoter CGIs during tumorigenesis. Removal of DNA hypermethylation leads to increment of H3K4me1 at promoter CGIs with preference for bivalent genes. Nevertheless, the alteration of H3K4me1 by overexpressing or knockout LSD1, the demethylase of H3K4, doesn’t change the level or pattern of DNA methylation. Moreover, LSD1 was found to regulate the expression of a bivalent gene OVOL2 to promote tumorigenesis. Knockdown of OVOL2 in LSD1 knockout HCT116 cells restored the cancer cell phenotype.

Conclusion

In summary, our work identified a universal indicator that can pre-mark DNA hypermethylation in cancer cells, and dissected the interplay between H3K4me1 and DNA hypermethylation in detail. Current study also reveals a novel mechanism underlying the oncogenic role of LSD1, providing clues for cancer therapies.
Development and validation of a nomogram for postoperative sleep disturbance in adults: a prospective survey of 640 patients undergoing spinal surgery
Authors: Du Jin , Zhang Honggang , Ding Zhe , Wu Xiaobin , Chen Hua , Ma Weibin , Qiu Canjin , Zhu Shengmei , Kang Xianhui
Published: May 2023

Background

Postoperative sleep disturbance (PSD) is a prevalent clinical complication that may arise due to various factors. The purpose of this investigation is to identify the risk factors for PSD in spinal surgery and establish a risk prediction nomogram.

Methods

The clinical records of individuals who underwent spinal surgery from January 2020 to January 2021 were gathered prospectively. The least absolute shrinkage and selection operator (LASSO) regression, along with multivariate logistic regression analysis, was employed to establish independent risk factors. A nomogram prediction model was devised based on these factors. The nomogram’s effectiveness was evaluated and verified via the receiver operating characteristic (ROC) curve, calibration plot, and decision curve analysis (DCA).

Results

A total of 640 patients who underwent spinal surgery were analyzed in this investigation, among which 393 patients experienced PSD with an incidence rate of 61.4%. After conducting LASSO regression and logistic regression analyses using R software on the variables in training set, 8 independent risk factors associated to PSD were identified, including female, preoperative sleep disorder, high preoperative anxiety score, high intraoperative bleeding volume, high postoperative pain score, dissatisfaction with ward sleep environment, non-use of dexmedetomidine and non-use of erector spinae plane block (ESPB). The nomogram and online dynamic nomogram were constructed after incorporating these variables. In the training and validation sets, the area under the curve (AUC) in the receiver operating characteristic (ROC) curves were 0.806 (0.768–0.844) and 0.755 (0.667–0.844), respectively. The calibration plots indicated that the mean absolute error (MAE) values in both sets were respectively 1.2% and 1.7%. The decision curve analysis demonstrated the model had a substantial net benefit within the range of threshold probabilities between 20% and 90%.

Conclusions

The nomogram model proposed in this study included eight frequently observed clinical factors and exhibited favorable accuracy and calibration.

Trial registration

The study was retrospectively registered with the Chinese Clinical Trial Registry (ChiCTR2200061257, 18/06/2022).
Pulmonary recruitment maneuver reduces the intensity of post-laparoscopic shoulder pain: a systematic review and meta-analysis
Authors: Deng Xiao , Li Hao , Wan Yantong , Lin Xuemei
Published: May 2023

Background

Post-laparoscopic shoulder pain (PLSP) is a common complication following laparoscopic surgeries. This meta-analysis aimed to investigate whether pulmonary recruitment maneuver (PRM) was beneficial to alleviated shoulder pain after laparoscopic procedures.

Methods

We reviewed existing literature in the electronic database from the date of inception to January 31, 2022. The relevant RCTs were independently selected by two authors, after which data extraction, assessment of the risk of bias, and comparison of results.

Results

This meta-analysis included 14 studies involving 1504 patients, among which 607 patients were offered pulmonary recruitment maneuver (PRM) alone or in combination with intraperitoneal saline instillation (IPSI), while 573 patients were treated with passive abdominal compression. The administration of PRM significantly decreased the post-laparoscopic shoulder pain score at 12 h (MD (95%CI) − 1.12(–1.57, − 0.66), n = 801, P < 0.001, I2 = 88%); 24 h (MD (95%CI) − 1.45(–1.74, − 1.16), n = 1180, P < 0.001, I2 = 78%) and at 48 h (MD (95%CI) − 0.97(–1.57, − 0.36), n = 780, P < 0.001, I2 = 85%). We observed high heterogeneity in the study and analyzed the sensitivity but failed to identify the cause of the heterogeneity, which may have resulted from the different methodologies and clinical factors in the included studies.

Conclusion

This systematic review and meta-analysis indicate that PRM can reduce the intensity of PLSP. More studies may be needed to explore the usefulness of PRM in more laparoscopic operations besides gynecological surgeries and determine the optimal pressure of PRM or its appropriate combination with other measures. The results of this meta-analysis should be interpreted with caution owing to the high heterogeneity between the analyzed studies.
Sarcopenia provides extra value outside the PULP score for predicting mortality in older patients with perforated peptic ulcers
Authors: Wang Yu-Hao , Tee Yu-San , Wu Yu-Tung , Cheng Chi-Tung , Fu Chih-Yuan , Liao Chien-Hung , Hsieh Chi-Hsun , Wang Stewart C.
Published: May 2023

Background

Perforated peptic ulcer (PPU) remains challenging surgically due to its high mortality, especially in older individuals. Computed tomography (CT)-measured skeletal muscle mass is a effective predictor of the surgical outcomes in older patients with abdominal emergencies. The purpose of this study is to assess whether a low CT-measured skeletal muscle mass can provide extra value in predicting PPU mortality.

Methods

This retrospective study enrolled older (aged ≥ 65 years) patients who underwent PPU surgery. Cross-sectional skeletal muscle areas and densities were measured by CT at L3 and patient-height adjusted to obtain the L3 skeletal muscle gauge (SMG). Thirty-day mortality was determined with univariate, multivariate and Kaplan–Meier analysis.

Results

From 2011 to 2016, 141 older patients were included; 54.8% had sarcopenia. They were further categorized into the PULP score ≤ 7 (n=64) or PULP score > 7 group (n=82). In the former, there was no significant difference in 30-day mortality between sarcopenic (2.9%) and nonsarcopenic patients (0%; p=1.000). However, in the PULP score > 7 group, sarcopenic patients had a significantly higher 30-day mortality (25.5% vs. 3.2%, p=0.009) and serious complication rate (37.3% vs. 12.9%, p=0.017) than nonsarcopenic patients. Multivariate analysis showed that sarcopenia was an independent risk factor for 30-day mortality in patients in the PULP score > 7 group (OR: 11.05, CI: 1.03-118.7).

Conclusion

CT scans can diagnose PPU and provide physiological measurements. Sarcopenia, defined as a low CT-measured SMG, provides extra value in predicting mortality in older PPU patients.
Incidence, risk factors and outcomes of acute kidney injury in surgical intensive care unit octogenarians at the Jordan University Hospital
Authors: Bani Hani Amjad , Abu Abeeleh Mahmoud , Al-Najjar Sondos , Alzibdeh Abdulla , Mansour Shahd , Bsisu Isam , Awamleh Nour , Farah Randa
Published: May 2023

Background

Acute kidney damage (AKI) is among the most severe consequences observed in surgical intensive care units (SICUs). We aim to observe the incidence, risk factors, and outcomes of acute kidney injury in SICU octogenarians.

Methods

A cross-sectional retrospective study was conducted at the SICU of Jordan University Hospital (JUH), a tertiary teaching hospital in a developing country, between January 2018 and December 2019. Patients who were 80 years or older at the time of data collection were included. The definition of AKI was based on Kidney Disease Improving Global Outcomes (KDIGO) criteria. Demographic, clinical, and laboratory data were reviewed.

Results

A total number of 168 patients were included. The mean age was 84.0 ± 3.8 years, and 54.8% of the participants were women. Of those, 115 (68.5%) had surgery before or during ICU stay, and 28.7% of the patients’ surgeries were an emergency surgery. Also, 47.8% of surgeries were considered by anesthesia to be high-risk surgeries. A total of 55 patients (32.7%) developed AKI during their SICU stay. The factors that were significantly associated with AKI in the ICU patients included use of beta blocker [AOR: 3.7; 95% CI: 1.2–11.8; p = 0.025], and inotropes [AOR:4.0; 95% CI: 1.2–13.3; p = 0.03]. The factors that were significantly associated with mortality in the ICU included using mechanical ventilation [AOR:18.7; 95% CI: 2.4-141.9; p = 0.005] and inotropes use [AOR: 12.3; 95% CI: 1.2-120.7; p = 0.031].

Conclusions

The incidence of AKI during SICU stay in this study was 32.7% and it was significantly associated with the use of beta blockers, mechanical ventilation, and inotropes. The mortality rate among octogenarians who developed AKI during SICU stay was 36.4%. Further studies are needed globally to assess the incidence of AKI in octogenarian surgical patients and identify risk factors to provide preventative measurements and strategies.
Dural arteriovenous fistula presenting with stroke-like symptoms and regional cerebral hyperperfusion: a case report
Authors: Chen Hanfeng , Wei Ruili , Xu Ziqi
Published: May 2023

Background

Non-hemorrhagic focal neurological deficit is one of the clinical manifestations of intracranial dural arteriovenous fistulas (DAVF). When symptoms appear suddenly, it is difficult to distinguish it from ischemic stroke in certain circumstances, which might easily lead to misdiagnosis. Here, we report a rare case of DAVF with sudden onset sensory aphasia mimicking hyperacute stroke but presented with unexpected regional hyperperfusion on the site corresponding to its symptoms.

Case presentation

A 76-year-old male with histories of atrial fibrillation and hypertension was admitted to the emergency department due to sudden sensory aphasia. The diagnosis of ischemic stroke was made based on clinical experience after non-contrast CT excluding hemorrhage. As in the absence of clear contraindication, the patient received intravenous thrombolysis. On the cerebral CT perfusion, the left temporal lobe, where the sensory speech center is located, was manifested as regional hyperperfusion. Thrombolysis was subsequently halted, but scheduled cranial imaging indicated hemorrhagic transformation. According to the radiological hint from cranial MRI, the patient was suspected of having DAVF, which was finally confirmed by cerebral digital subtraction angiography.

Conclusion

When DAVF is presented as sudden onset focal neurological deficit, cranial CT perfusion at an early stage might reveal an abnormal hyperperfusion pattern. Clinicians should be aware of the diagnostic possibility of DAVF in this situation and double-review the CT angiography image to reduce missed diagnoses.
Effects of two different types of luteal support on pregnancy outcomes following antagonist fresh embryo transfer: a retrospective study
Authors: De Minji , Chen Lixue , Zeng Lin , Wang Yang , Yang Rui , Li Rong , Chi Hongbin
Published: May 2023

Background

Only a small number of studies have reported the use of progesterone vaginal gel in combination with dydrogesterone as part of the antagonist protocol for fresh embryo transfer. Therefore, this study aimed to compare the effects of two types of luteal support on pregnancy outcomes following the antagonist protocol for fresh embryo transfer.

Methods

We performed a retrospective analysis of clinical data from infertile patients who underwent fresh embryo transfer via the antagonist protocol (2785 cycles) between February and July 2019 and between February and July 2021 at the Peking University Third Hospital Reproductive Medicine Centre. According to the luteal support received, the cycle groups were divided into the progesterone vaginal gel group (single medication or VP group; 1170 cycles) and the progesterone vaginal gel plus dydrogesterone group (combination medication or DYD + VP group; 1615 cycles). After propensity score matching, the clinical pregnancy, ongoing pregnancy, early miscarriage, and ectopic pregnancy rates were compared between the two groups.

Results

In total, 1057 pairs of cycles were successfully matched via propensity scores. The clinical and ongoing pregnancy rates in the combination medication group were significantly higher than those in the single medication group (P < 0.05), whereas no significant differences were noted in the early miscarriage and ectopic pregnancy rates between the two groups (both P > 0.05).

Conclusions

Combined luteal support after the antagonist protocol is preferred for patients undergoing fresh cycle embryo transfer.
Using Andersen’s behavioral model of health care use for intermittent preventive treatment of malaria in pregnancy in Nigeria
Authors: Solanke Bola Lukman , Yinusa Rasheed Adebayo , Oyeleye Olaoye James , Oluwatope Omolayo Bukola , Ilesanmi Benjamin Bukky , Oni Tosin Olajide
Published: May 2023

Background

Studies in Nigeria and elsewhere in sub-Saharan Africa (sSA) have explored factors influencing usage of intermittent preventive treatment of malaria in pregnancy (IPTp). Most studies, however, are not model or theory-based, which provides less satisfactory guidance to malaria control programming. This study fills the knowledge gap by adapting Andersen’s behavioral model of health care use to IPTp usage in Nigeria.

Methods

This study adopted a cross-sectional design that utilized secondary data extracted from the 2018 Nigeria Demographic and Health Survey (NDHS). A weighted sample of 4,772 women who had given birth in the past year preceding the survey, was analyzed. Outcome variable was usage of IPTp, dichotomized into optimal or otherwise. Explanatory variables cut across individual and community levels and were divided into predisposing, enabling and need factors in line with the theoretical constructs of the Andersen model. Two multilevel mixed-effects logistic regression models were fitted to identify factors which influenced optimal usage of IPTp. Analyses were performed using STATA 14. Statistical significance was set at 5%.

Results

Realised level of optimal IPTp usage was 21.8%. Factors that either predispose or enable pregnant women to take optimal doses of IPTp were maternal education, being employed, being autonomous in their own healthcare, health insurance enrolment, partner education, receiving antenatal care in public health facilities, rural residence, being resident in northern geo-political zones, community literacy level and community perception of the consequences of malaria. Two significant need factors affecting optimal usage of IPTp were timing of the first antenatal care visit and sleeping under mosquito bed nets.

Conclusion

Optimal usage of IPTp is low among pregnant women in Nigeria. There is a need to devise additional public health educational programs promoting IPTp usage through the formation of Advocacy, Communication and Social Mobilisation (ACSM) in every ward in all local government areas, particularly in the rural and northern parts of the country. In addition, health planners should adopt the Andersen model for assessing key determinants of IPTp usage among childbearing women in Nigeria.
Tissue proteome analysis for profiling proteins associated with lymph node metastasis in gallbladder cancer
Authors: Jain Vaishali , Akhtar Javed , Priya Ratna , Sakhuja Puja , Goyal Surbhi , Agarwal Anil Kumar , Ghose Vivek , Polisetty Ravindra Varma , Sirdeshmukh Ravi , Siraj Fouzia , Gautam Poonam
Published: May 2023

Lymph node (LN) metastasis is the earliest sign of metastatic spread and an established predictor of poor outcome in gallbladder cancer (GBC). Patients with LN positive GBC have a significantly worse survival (median survival- 7 months) than patients with LN negative disease (median survival- ~ 23 months) in spite of standard treatment which includes extended surgery followed by chemotherapy, radiotherapy and targeted therapy. This study aims at understanding the underlying molecular processes associated with LN metastasis in GBC. Here, we used iTRAQ-based quantitative proteomic analysis using tissue cohort comprising of primary tumor of LN negative GBC (n = 3), LN positive GBC (n = 4) and non-tumor controls (Gallstone disease, n = 4), to identify proteins associated with LN metastasis. A total of 58 differentially expressed proteins (DEPs) were found to be specifically associated with LN positive GBC based on the criteria of p value ≤ 0.05, fold change ≥ 2 and unique peptides ≥ 2. These include the cytoskeleton and associated proteins such as keratin, type II cytoskeletal 7 (KRT7), keratin type I cytoskeletal 19 (KRT19), vimentin (VIM), sorcin (SRI) and nuclear proteins such as nucleophosmin Isoform 1 (NPM1), heterogeneous nuclear ribonucleoproteins A2/B1 isoform X1 (HNRNPA2B1). Some of them are reported to be involved in promoting cell invasion and metastasis. Bioinformatic analysis of the deregulated proteins in LN positive GBC using STRING database identified ‘neutrophil degranulation’ and ‘HIF1 activation’ to be among the top deregulated pathways. Western blot and IHC analysis showed a significant overexpression of KRT7 and SRI in LN positive GBC in comparison to LN negative GBC. KRT7, SRI and other proteins may be further explored for their diagnostics and therapeutic applications in LN positive GBC.