bluuebunny/crossref_metadata_2025 huggingface dataset:
Return to Sport After Pediatric Anterior Cruciate Ligament Reconstruction: A Systematic Review of the Criteria
Authors: Lorange Justin-Pierre , Senécal Laurianne , Moisan Philippe , Nault Marie-Lyne
Published: February 2024

Background:

Postoperative rehabilitation is an important component of recovery after anterior cruciate ligament (ACL) reconstruction (ACLR), facilitating successful return to sport (RTS) by reducing risk factors for repeat injury.

Purpose:

This systematic review aimed to determine the best protocol for RTS after ACLR in children.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

PubMed, Embase, PEDro, SPORTDiscus, and Web of Science databases were searched from October 3, 2014, to November 3, 2022. The inclusion criteria were the pediatric population (<18 years old) after ACLR with clear RTS criteria and/or mean/median time to RTS. Multiligament knee injuries were excluded from this study. The methodologic quality of the included articles was assessed using the methodological index for non-randomized studies (MINORS). The highest possible score was 24 points for comparative studies (ie, a study comparing 2 protocols or more). Noncomparative studies or studies with a single protocol could score a maximum of 16 points as assessed by the MINORS score.

Results:

The search yielded 1816 titles, and 24 were retained based on the inclusion and exclusion criteria. Every study was published between 2015 and 2022. Among the 24 studies included, 13 were retrospective and 11 were prospective. The mean MINORS score for the noncomparative studies was 13 of 16 (n = 23) and 23 of 24 for the comparative study (n = 1). The studies were categorized into unspecified clearance (n = 10), milestone based (n = 13), and combined time and milestone (n = 1). A total of 1978 patients (57% female) were included in the review. The mean age at ACLR was 14.7 years. The most common endpoint used was graft rupture (0% to 35%). In the unspecified group, the quickest RTS was 5.8 months and the longest was 9.6 months. Statistically significant risk factors for ACL reinjury included younger age and earlier RTS. The latter was a significant contributor to graft failure for combined time-based and milestone-based RTS. In the milestone-based group, the most common criteria were ≥90% limb symmetry measured using hamstring strength, quadriceps strength, and/or hop tests. The mean RTS time was 6.8 to 13.5 months.

Conclusion:

RTS should be delayed, when possible, especially in the younger population. A combination of quantitative tests and qualitative tests is also recommended. However, optimal RTS criteria have yet to be determined. Future prospective studies should focus on comparing the different times and milestones currently available.
A Cross-Sectional Study of Nurse Turnover in Residential Care Communities
Authors: Loomer Lacey
Published: February 2024

We examine what facility characteristics are associated with nurse turnover in residential care communities (RCCs). This is a cross-sectional study using the 2018 National Study of Long-term Care Provider Public Use File. There were 3331 RCCs (unweighted n = 272) represented when examining registered nurse (RN) turnover and when examining aide turnover there was a weighted sample of 13,676 RCCs (unweighted n = 68). RN turnover was 72% (95% confidence interval (CI) 59%, 84%), 52% reported 100% turnover. Aide turnover was 48% (95% CI 43%, 53%); 11% reported 100% turnover. We examined ownership and facility type, job design, economic, and working environment factors related to turnover. Using multivariate linear regression, non-profit RCCs had 25 percentage points lower RN turnover (95% CI: −44.46, −4.31) and 9.7 percentage points lower aide turnover (95% CI: 18.8, −0.6) compared to for-profits. We find larger RCCs had lower aide turnover.
A method for evaluating and verifying biochemical methane potential test completion performed with landfilled municipal solid waste
Authors: Casavant Tyler JP , McPhedran Kerry , Fleming Ian R
Published: February 2024

The biochemical methane potential (BMP) test is significant for the landfill industry as it provides a means to evaluate the gas potential, and therefore potential degradability, of both incoming and in-place municipal solid waste (MSW). However, the BMP test is not standardized making comparison of BMP results across sites problematic. For example, the BMP test duration has historically ranged from 20 days to several months with most current BMP tests lasting 60 days. However, the gas generation data can potentially be modelled for any of those durations to produce a prediction of the ultimate BMP value (BMPULT). Currently, the predicted BMPULT values of 23 long-duration (115–150 days) BMP tests were used to determine the required quantity of data (i.e. number of days) needed to produce an accurate BMPULT prediction. Results showed that no single test duration produced both accurate and efficient results, so a novel performance-based endpoint was proposed. The relative change in predicted BMPULT values with respect to time (dBMPULT/d t) was chosen as a potential performance-based completion metric. Results indicate that once the absolute normalized dBMPULT/d t value is within <2.5, <1.5 and <0.6% day−1 that the predicted BMPULT is within 20, 10 and 5% of the true BMPULT, respectively. Overall, the use of performance-based metrics for determining BMP test completion will allow for the collection of partial data sets, reduced experimental times and verification of results.
Tooth surface analysis method based on thermo-mechanical coupling and its application in prediction of gear dry-running bearing capacity
Authors: Xiao Yang , Wang Sanmin , Tang Kexin , Zhang Tao , Guo Zheng , Sun Xiaomei
Published: February 2024

In gear transmission, the continuous meshing of the teeth will lead to an increase in their temperature, which will have a certain impact on the working performance of the tooth surface. In order to explore the failure-bearing capacity of gears under dry-running conditions, temperature effects were considered in existing methods for determining tooth surface failure, making it more suitable for high-temperature working conditions caused by a lack of lubrication. The failure situation of gears within 35 min after losing lubrication was analyzed. The results indicate that when the gear loses lubrication, the tooth surface temperature of the gear pair has exceeded the material melting point after working at an input power of 2000 kW for 12 min. But when the power drops to 1000 kW, the instantaneous temperatures of the driving and driven gear tooth surfaces at the end of 35 min reach 1090 and 995°C, respectively, which are lower than the scuffing temperature of the tooth surface. The cumulative wear depths of the driving and driven gear tooth surfaces at the end of 35 min were 239 and 86.6 um, respectively, which were lower than the failure wear depth of the tooth surface; The allowable contact stress of the gear pair within 35 min is greater than its contact stress, meeting the judgment condition of no pitting failure. This indicates that reducing power can appropriately extend the failure time of gear teeth, thereby improving the ultimate working capacity of gears under dry-running conditions. In addition, a gear dry-running experiment was carried out. By comparing the theoretical calculation results with the measured gear failure degree, it shows that the improved method for determining gear surface failure is effective.
The Effectiveness of School-Based Programs on Aggressive Behaviors among Children and Adolescents: A Systematic Review and Meta-Analysis
Authors: Shen Liangqi , Jiang Shan , Tan Shilin
Published: February 2024

Purpose: Present study investigated the effectiveness of school-based intervention programs on reducing aggression among children and adolescents. Method: A thorough search was carried out on 12 electronic databases. Seventeen studies were finalized, and meta-analyses were performed using a random effect model on RevMan software. Results: Findings reveal that existing school-based programs have a significant effect on reducing aggression (standardized mean differences = −0.35, 95% confidence interval [−0.53, −0.18], Z = 3.92, p < .001). Furthermore, subgroup analysis found that interventions with a theoretical basis, using a randomized controlled trial (RCT) design, or having a short duration of each session (below 45 min), were more effective than ones without a theoretical basis, using a quasi-experimental design, or having longer session duration (above 45 min) on reducing aggressive behaviors. Conclusion: This review provided implications to improve school-based interventions by developing designs based on the guidance of theories and RCT design, as well as limiting session duration.
Anthropometric Analysis of the External Ear Using CT Scan Image by Age, Gender, and Side Among the Iranian Population
Authors: Nasiri Mehnoosh , Khabiri Hamid , Halvani Gholam Hossein , MoradiAmin Morteza , Shamsi Farimah , ZangiAbadi Zahra
Published: February 2024

The purpose of this study is to provide an accessible source of anthropometric measurements from the auricle to the tympanic membrane based on age, gender, and ear side, which can be used as a reference for optimizing the fit and comfort of ear-related devices and anthropometric analysis. To do so, in this study, a 3D measurement method based on CT scan imaging was utilized. A new coordinate system was defined to measure 41 linear, angular, and circumference dimensions. The result showed that ergonomic ear-related products should be designed based on the age and gender of the users.
Myopia control efficacy of peripheral defocus soft contact lenses in children and adolescents: A meta-analysis
Authors: Fan Haobo , Zhang Xuemin , Wei Qiumei , Zhong Qiao , Liu Meng , Li Bingqian , Li Shilin , Zhang Renwei , Xie Airui
Published: February 2024

Objectives

To evaluate the effect of peripheral defocus soft contact lenses (PDSCLs) on controlling myopia progression in children and adolescents, and to compare it with orthokeratology (Ortho-K) and single vision lenses (SVLs).

Methods

We conducted a systematic search of PubMed, the Cochrane Library, Medline, CNKI, CBM, VIP, and WanFang Data databases for randomized controlled trials (RCTs) and cohort studies that investigated the effects of PDSCLs on myopia control in children and adolescents. The published languages were limited to English and Chinese. The risk bias tool provided by the Cochrane risk-of-bias tool and Newcastle-Ottawa Scale were used to assess the risk bias of included studies of RCTs and CTs. The published biases of included studies were assessed by Egger`s test.

Results

We included 21 studies, comprising 13 RCTs and 8 cohort studies, with a total of 1337 participants in the PDSCLs group, 428 in the Ortho-K group, and 707 in the SVLs group. The meta-analysis indicated no significant difference between PDSCLs and Ortho-K in controlling the increase of diopter ( MD = 0.01, 95% CI: −0.06, 0.09; P = 0.69) and axial length ( MD = -0.01, 95% CI: −0.02, 0.00; P = 0.28). Compared with SVLs, PDSCLs had a better effect in controlling the increase of diopter ( MD = 0.23, 95% CI: 0.17, 0.28; P < 0.00001) and axial length ( MD = -0.11, 95% CI: −0.12, −0.09; P < 0.00001) in children and adolescents.

Conclusions

Children and adolescents wearing PDSCLs can achieve better myopia control than those wearing SVLs, and their effect is comparable to that of Ortho-K.
Advances in the long-term treatment of neuromyelitis optica spectrum disorder
Authors: Anderson Monique , Levy Michael
Published: February 2024

Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune neuroinflammatory disorder with a prevalence of 1-5/100,000 globally, characterized by attacks of the central nervous system including but not limited to optic neuritis, transverse myelitis and brainstem lesions, including area postrema lesions. These autoimmune attacks can lead to irreversible damage if left untreated, therefore strategies have been developed to prevent relapses. Initial off-label treatments have achieved variable levels of success in relapse prevention, but improved relapse prevention and quality of life remain a goal in the field. A better understanding of the underlying pathophysiology of NMOSD over the last 10 years has led to newer, more specific approaches in treatment, culminating in the first FDA approved treatments in the disease. In this review, we will discuss the seminal trials of PREVENT or Eculizumab in the treatment of aquaporin-4 (AQP4)-IgG positive NMOSD, N-Momentum or Inebilizumab in the study of NMOSD (both AQP4-IgG positive and negative) and SAkura Sky and SAkuraStar which studied satralizumab in AQP4-IgG seropositive and seronegative NMOSD patients. We will also discuss the extension trials of each of these medications and what lead to their approval in AQP4-IgG seropositive NMOSD patients. We will then examine treatments in the pipeline for adult and pediatric NMOSD patients and conclude with discussions on treatment considerations in pregnant patients and how to approach treatment of NMOSD patients during COVID.
Linear growth behaviour of intermetallic compound layer in electronic interconnections
Authors: Bakar Maria Abu , Jalar Azman , Alias Anuar
Published: February 2024

We observed a linear behaviour of intermetallic compound (IMC) layer growth in electronic metallurgical interconnections, although the time required was twice that of commercial reliability standards for electronic packaging. This finding contradicts the classical parabolic growth law, which is widely reported to represent growth behaviour. We suggest that the parabolic growth law may be inadequate to thoroughly explain the IMC layer's growth by considering (a) one-directional growth and (b) reactions between elements for formation and growth. Further analysis has been carried out to analyse the logical judgment of the parabolic growth law and support our finding over linear IMC layer growth behavior.
Automated analysis of trapeziometacarpal joint kinematics using four-dimensional computed tomography
Authors: Van Royen Kjell , Keelson Benyameen , Jager Tjeerd , Buls Nico , Scheerlinck Thierry , Cattrysse Erik
Published: February 2024

The aim of this study was to develop an automated approach model to define in vivo kinematics of the trapeziometacarpal (TMC) joint using four-dimensional computed tomography. A total of 15 healthy volunteers were included and their TMC joint kinematics were studied during a retropulsion-opposition-retropulsion movement. We used cardan angles estimated from transformation matrices using a ZYX-decomposition and analysed the motion of the thumb metacarpal relative to the trapezium, the thumb metacarpal relative to the index metacarpal, and the trapezium relative to the index metacarpal. The study also included an analysis of the joint hysteresis effect and a joint proximity model that estimated the joint contact area during a retropulsion-opposition-retropulsion movement. The automated approach significantly decreased the time needed to analyse each case and makes this model applicable for further research on TMC kinematics.
Higher modified frailty index score is associated with 30-day postoperative complications following revision total shoulder arthroplasty
Authors: Seibold Bruce Tanner , Quan Theodore , Zhao Amy Y , Parel Philip M , Mikula Jacob D , Mun Frederick , Srikumaran Umasuthan , Zimmer Zachary R
Published: February 2024

Background

Previous studies have shown that increased 5-item modified frailty index (mFI-5) scores are associated with poor surgical outcomes. This study seeks to determine whether the comorbidities comprising the mFI-5 were correlated with poor outcomes following revision total shoulder arthroplasty (TSA).

Methods

Utilizing the National Surgical Quality Improvement Program database, a mFI-5 score was calculated for all patients 50 years and older who underwent revision TSA between 2013 and 2019. Pearson's Chi-squared tests and multivariable regression analysis were used to evaluate the association of the mFI score with various postoperative complications.

Results

Patients with a mFI-5 score of 2+ had significantly increased risk of readmission (OR 2.58), bleeding requiring transfusion (OR 3.66), extended length of stay (OR 2.43), and discharge to a non-home destination (OR 3.22) compared to patients with a mFI-5 score of 0. Relative to patients with a score of 1, those with a mFI-5 score of 2+ had an increased risk of postoperative transfusion (OR 2.46), extended length of stay (OR 2.16), and discharge to a non-home location (OR 2.84).

Discussion

The mFI-5 is a valuable tool that can stratify patients based on risk for postoperative complications following revision TSA.
Type I Brugada Pattern in a Febrile Patient Following COVID-19 Vaccination Booster
Authors: Cacdac Robert , Lim Anthony , Ghazaleh Jonathan , Salmasi Shiva , Poursadrolah Sayna , Jordan Monica , Rubin Andrew
Published: February 2024

There have been studies published regarding the association between developing Brugada syndrome after an acute COVID-19 infection. In this case, we present a patient who presented with a syncopal episode and subsequently found to have Type I Brugada pattern on electrocardiogram. The patient underwent placement of a single chamber defibrillator. Genetic analysis demonstrated SCN5A variant which is associated with cardiac conditions including Brugada syndrome.
Rapid Start of Antiretroviral Therapy in a Large Urban Clinic in the US South: Impact on HIV Care Continuum Outcomes and Medication Adherence
Authors: Chow Jeremy Y. , Gao Ang , Ahn Chul , Nijhawan Ank E.
Published: February 2024

Rapid start of antiretroviral therapy (ART) has been associated with improvement in several HIV-related outcomes in clinical trials as well as demonstration projects, but how regional and contextual differences may affect the effectiveness of this intervention necessitates further study. In this study of a large, urban, Southern US clinic-based retrospective cohort, we identified 544 patients with a new diagnosis of HIV during 2016 to 2019 and compared HIV care continuum outcomes for the first 12 months of care before and after rapid start implementation. Kaplan-Meier time-to-event curves were used to summarize time to virologic suppression, and stepwise Cox, linear, and logistic regression models were used to create multivariate models to evaluate the association between rapid start and time to virologic suppression, medication adherence, and retention in care and sustained virologic suppression, respectively. We found that rapid start was significantly associated with improved medication adherence scores (+15.37 points, 95% confidence interval [CI] 9.36-21.39, P < .01) and retention in care (adjusted odds ratio = 1.51, 95% CI 1.05-2.19, P = .03). Time to virologic suppression (median 2.46 months before, 2.56 months after rapid start) and sustained virologic suppression were not associated with rapid start in our setting. Though rapid start was associated with improved medication adherence and retention in care, more support may be needed to achieve the same outcomes seen in other studies and sustained over the entire HIV care continuum, especially in settings with significant patient and systemic barriers to care such as unstable housing, lack of Medicaid expansion, and frequent coverage interruptions.
Mercury Induced Autoimmunity: A Case of CASPR2/LGI1 Autoimmune Encephalitis in a 14-Month-old
Authors: Heller Ariel , Nolan Krystal , Rametta Salvatore
Published: February 2024

Contactin-associated protein-like 2 (CASPR2) autoantibodies are among those associated with several syndromes with effects on both the central and peripheral nervous systems including neuropathy and encephalitis and is most commonly seen in middle-aged to elderly males. We present a case of autoimmune encephalitis in a 14-month-old female presenting with altered mental status, refusal to bear weight, and hypertension in the setting of mercury exposure. This is the youngest reported case of CASPR2/LGI1/VGKC antibody associated autoimmune encephalitis stimulated by mercury exposure.
Authoritarian neoliberalism debates: A critical review of the literature in central and eastern Europe
Authors: Mexhuani Fitim , Mexhuani Burim
Published: February 2024

Since communism’s collapse, Central and Eastern Europe adopted neoliberal reforms for democratization and market integration. However, democratic institutions in many countries have backslid. Scholars debate neoliberalism’s impacts and the rise of oligarchs concentrating wealth and distorting democracy. This review analyzes 50 sources from 1990-2020 through meta-analysis. Literature is assessed regarding neoliberalization’s mechanisms and effects. Privatization concentrated assets in politically-connected oligarchs, enabling state capture constraining competition. Deregulation empowered economic elites with disproportionate political influence, distorting representation toward oligarchic over public interests. Evidence partially supports the hypothesis that neoliberalism benefiting oligarchs distorted democracy, contributing to backsliding. However, grassroots resistance offers alternatives. Further research could integrate local case studies and frameworks focused on equitable distribution rather than growth alone.
Lipid metabolism-related genes are involved in the occurrence of asthma and regulate the immune microenvironment
Authors: Jia Yuanmin , Wang Haixia , Ma Bin , Zhang Zeyi , Wang Jingjing , Wang Jin , Chen Ou
Published: February 2024

Background

Lipid metabolism plays a pivotal role in asthma pathogenesis. However, a comprehensive analysis of the importance of lipid metabolism-related genes (LMRGs) in regulating the immune microenvironment in asthma remains lacking. The transcriptome matrix was downloaded from the Gene Expression Omnibus (GEO) dataset. Differentially expressed analysis and weighted gene coexpression network analysis (WGCNA) were conducted on the GSE74986 dataset to select hub LMRGs, and gene set enrichment analysis (GSEA) was conducted to explore their biological functions. The CIBERSORT algorithm was used to determine immune infiltration in the asthma and control groups, and the correlation of diagnostic biomarkers and immune cells was performed via Spearman correlation analysis. Subsequently, a competitive endogenous RNA (ceRNA) network was constructed to investigate the hidden molecular mechanism of asthma. The expression levels of the hub genes were further validated in the GSE143192 dataset, and RT‒qPCR and immunofluorescence were performed to verify the reliability of the results in the OVA asthma model. Lastly, the ceRNA network was confirmed by qRT-PCR and RNAi experiments in the characteristic cytokine (IL-13)-induced asthma cellular model.

Results

ASAH1,ACER3andSGPP1were identified as hub LMRGs and were mainly involved in protein secretion, mTORC1 signaling, and fatty acid metabolism. We found more infiltration of CD8+T cells, activated NK cells, and monocytes and less M0 macrophage infiltration in the asthma group than in the healthy control group. In addition,ASAH1,ACER3, andSGPP1were negatively correlated with CD8+T cells and activated NK cells, but positively correlated with M0 macrophages. Within the ceRNA network,SNHG9-hsa-miR-615-3p-ACER3,hsa-miR-212-5pandhsa-miR-5682may play crucial roles in asthma pathogenesis. The low expression ofASAH1andSGPP1in asthma was also validated in the GSE74075 dataset. AfterSNHG9knockdown,miR-615-3pexpression was significantly upregulated, while that ofACER3was significantly downregulated.

Conclusion

ASAH1,ACER3andSGPP1might be diagnostic biomarkers for asthma, and are associated with increased immune system activation. In addition,SNHG9-hsa-miR-615-3p-ACER3may be viewed as effective therapeutic targets for asthma. Our findings might provide a novel perspective for future research on asthma.
Effect of esketamine on postoperative analgesia and postoperative delirium in elderly patients undergoing gastrointestinal surgery
Authors: Liu Jing , Wang TingTing , Song Jian , Cao Li
Published: February 2024

Objective

To investigate the analgesic effect of esketamine combined with low-dose sufentanil in elderly patients after gastrointestinal surgery, and whether the anti-inflammatory effect of esketamine is involved in the mechanism of postoperative delirium.

Method

We enrolled sixty elderly patients (age ≥ 65 years old, American Society of Anesthesiologists (ASA) grade I-III) who underwent gastrointestinal surgery. Patients were randomly assigned to Group C (control group) who received sufentanil 2 ug/kg, and Group E (experimental group) who received sufentanil 1.5 ug/kg + esketamine 1 mg/kg, with 30 patients in each group. All patients underwent total intravenous anesthesia during the surgery and were connected to a patient-controlled intravenous analgesia (PCIA) pump after surgery. The primary outcome was the evaluation of pain at 4, 24, 48 h after surgery which was evaluated by NRS scores. In secondary outcomes, inflammation was assessed by measuring IL-6 levels using ELISA. The postoperative delirium and the occurrence of adverse reactions were observed on the 1st and 3rd day after surgery.

Results

The NRS scores at 4, 24, and 48 h after surgery in the experimental group [(4.53 ± 1.22), (3.46 ± 0.73), (1.37 ± 0.99)] were lower than that in the control group [(5.23 ± 1.16), (4.46 ± 0.77), (2.13 ± 0.78)] (P < 0.05). The concentration of serum IL-6 in the experimental group at 24 and 48 h after operation [(15.96 ± 4.65), (11.8 ± 3.24)] were lower than that in the control group [(23.07 ± 4.86), (15.41 ± 4.01)] (P < 0.05); the incidence of postoperative delirium in the experimental group was less than that in the control group (P < 0.05); there was no significant difference in the incidence of postoperative nausea and vomiting between the two groups (P > 0.05), and neither group had nightmares or delirium.

Conclusion

Esketamine may enhance postoperative pain management compare with sufentanil, and esketamine has anti-inflammatory effects that reduce the incidence of postoperative delirium.

Trial registration

Full name of the registry: Chinese Clinical Trial Registry. Trial registration number: ChiCTR2300072374. Date of registration:2023/06/12
Effectiveness of bevacizumab in the treatment of metastatic colorectal cancer: a systematic review and meta-analysis
Authors: Song Yu , Mao Qianqian , Zhou Manling , Liu Cheng-Jiang , Kong Li , Hu Ting
Published: February 2024

Objective

To evaluate the benefit of bevacizumab under the comprehensive treatment strategy and its advantages over other drugs, so as to provide reference for the formulation of clinical plans.

Methods

As of October 1, 2022, the randomized controlled clinical trials of bevacizumab in combination with metastatic colorectal cancer published in PubMed, Cochrane Library and Medline databases were searched. The odds ratio (OR) and its 95% confidence interval (CI) were used to evaluate the short-term disease control effect and long-term survival of the treatment strategy.

Results

21 RCTs (6665 patients; 3356 patients in the experimental group and 3309 patients in the control group; average age, 55–75 years) were treated with bevacizumab as the experimental group for metastatic colorectal cancer. BEV has stronger anti-tumor activity than the single treatment scheme (OR = 1.30, 95% CI: 1.11–1.52). And Benefits of the BEV group were 0.73 (0.55, 0.96), 1.26 (0.71, 2.24), 1.63 (0.92, 2.87) and 0.07 (0.02, 0.25) compared with CET, VAN, CED and PAN respectively. The disease control of BEV combined therapy was better (OR = 1.36, 95% CI: 1.04–1.78). The same as compared with cediranib (OR = 1.94, 95% CI: 1.06–3.55). However, the long-term prognosis of BEV, including the overall survival (HRs = 0.98, 95% CI: 0.84–1.15) and progression-free survival (HRs = 1.05,95% CI: 0.97–1.13) were not prolonged. The survival benefits of cetuximab and panitumumab were not reflected.

Conclusion

The addition of BEV can enhance the anti-tumor ability and disease control, while cetuximab and panitumumab may have stronger ability. However, it did not effectively improve the survival of patients. A more reasonable and effective treatment plan needs more clinical experimental support.
Identification of differentially methylated regions associated with both liver fibrosis and hepatocellular carcinoma
Authors: Kurokawa Suguru , Kobori Takuro , Yoneda Masato , Ogawa Yuji , Honda Yasushi , Kessoku Takaomi , Imajo Kento , Saito Satoru , Nakajima Atsushi , Hotta Kikuko
Published: February 2024

Background

Liver fibrosis is a major risk factor for hepatocellular carcinoma (HCC). We have previously reported that differentially methylated regions (DMRs) are correlated with the fibrosis stages of metabolic dysfunction-associated steatotic liver disease (MASLD). In this study, the methylation levels of those DMRs in liver fibrosis and subsequent HCC were examined.

Methods

The methylation levels of DMRs were investigated using alcoholic cirrhosis and HCC (GSE60753). The data of hepatitis C virus-infected cirrhosis and HCC (GSE60753), and two datasets (GSE56588 and GSE89852) were used for replication analyses. The transcriptional analyses were performed using GSE114564, GSE94660, and GSE142530.

Results

Hypomethylated DMR and increased transcriptional level of zinc finger and BTB domain containing 38 (ZBTB38) were observed in HCC. Hypermethylated DMRs, and increased transcriptional levels of forkhead box K1 (FOXK1) and zinc finger CCCH-type containing 3 (ZC3H3) were observed in HCC. The methylation levels of DMR of kazrin, periplakin interacting protein (KAZN) and its expression levels were gradually decreased as cirrhosis progressed to HCC.

Conclusions

Changes in the methylation and transcriptional levels of ZBTB38, ZC3H3, FOXK1, and KAZN are important for the development of fibrosis and HCC; and are therefore potential therapeutic targets and diagnostic tools for cirrhosis and HCC.
Combined effects of vitamin D deficiency and systemic inflammation on all-cause mortality and cause-specific mortality in older adults
Authors: Zhang Chi , Cui Ju , Li Shaojie , Shen Ji , Luo Xuanmei , Yao Yao , Shi Hong
Published: February 2024

Background

Vitamin D deficiency and systemic inflammation share common pathological mechanisms in muscle loss, cardio-pulmonary function decline, and abnormal metabolism, which are linked to chronic conditions, senescence, and early mortality. However, their combined effect on mortality in older adults has not been well established. This study longitudinal aimed to explore the independent and combined associations of serum 25-hydroxyvitamin D [25(OH)D] and high sensitivity C-reactive protein (hs-CRP) with mortality risk in Chinese community-based older people.

Methods

3072 older adults (86.07 ± 11.87 years, 54.52% female) from the Chinese Longitudinal Healthy Longevity Survey (2012–2018) were enrolled. Baseline 25(OH)D and hs-CRP levels were collected, and survival information was recorded in the 2014 and 2018 follow-up waves. Cox proportional hazard regressions were conducted to explore the associations between 25(OH)D, hs-CRP, and mortality. Demographic characteristics, health behaviors, and chronic disease biomarkers were adjusted.

Results

During 10,622.3 person-years of follow-up (median: 3.51 years), 1321 older adults died, including 448 deaths due to cardiovascular disease (CVD). Increased mortality risk was associated with lower 25(OH)D and higher hs-CRP quantiles, even after adjusting for each other and multiple covariates (all P-trend < 0.05). In combined analyses, the highest all-cause mortality (HR: 2.18, 95% CI: 1.73 ~ 2.56), CVD mortality (HR: 2.30, 95% CI: 1.64 ~ 3.21), and non-CVD mortality (HR: 2.19, 95% CI: 1.79 ~ 2.49) were obtained in participants with both 25(OH)D deficiency (< 50 nmol/L) and high hs-CRP (≥ 3.0 mg/L), respectively. We observed significant additive interactions of 25(OH)D and hs-CRP on all-cause mortality and non-CVD mortality (RERIS>0).

Conclusions

Low 25(OH)D and high hs-CRP, both independently and jointly, increase mortality risk in Chinese community-dwelling older adults. Thus, priority should be given to early detection and appropriate intervention in older individuals with combined vitamin D deficiency and systemic inflammation. Molecular mechanisms of related adverse health effect are worthy of further investigation.
Empyema necessitans caused by methicillin-resistant Staphylococcus aureus: a case report and literature review
Authors: Nakamura Tomoaki , Ishikawa Kazuhiro , Murata Naoki , Sato Kuniko , Kitamura Atsushi , Mori Nobuyoshi , Jinta Torahiko
Published: February 2024

Background

Empyema necessitans (EN) is a rare condition characterized by pleural infection with pus spreading into adjacent soft tissues. Although Mycobacterium tuberculosis and Actinomyces israelii are common causative agents, methicillin-resistant Staphylococcus aureus (MRSA) is relatively rare, but it is associated with high mortality in empyema cases. We aimed to report a unique case of EN caused by MRSA and present a literature review to better understand this rare condition.

Case presentation

A 69-year-old man with a history of right ureteral stone presented with fever and left anterior thoracic pain. A physical examination revealed redness and swelling in the left thoracic region. Imaging studies confirmed EN with fluid accumulation around the sternocostal joint of the left first rib. MRSA was identified from blood and pleural fluid cultures. The patient received antimicrobial therapy, and a chest tube was inserted for drainage. Despite initial improvement, vertebral osteomyelitis was diagnosed on day 17. The antimicrobials were subsequently terminated after 6 weeks, but vertebral osteomyelitis recurred, and treatment was resumed and completed on day 215.

Conclusion

EN caused by MRSA is rare, and the literature review revealed 14 cases from human sources. Positive blood cultures were observed in 40% of cases, and metastatic infections were present in 30% of cases. Osteomyelitis was the most common type of metastatic lesion. All the patients underwent drainage. Patients with MRSA-associated EN frequently develop disseminated lesions and should therefore be carefully examined. Moreover, appropriate treatment with antibiotics and drainage is necessary for a good prognosis. Although the prognosis appeared to be favorable in our review, publication bias and treatment challenges for metastatic infections should be considered.
Should non-invasive prenatal testing be recommended for patients who achieve pregnancy with PGT?
Authors: Liang Yunhao , Li Meiyi , Fei Jia , Chen Zhiheng
Published: February 2024

Objective

To determine whether non-invasive prenatal testing is an alternative testing option to preimplantation genetic testing (PGT) in pregnant patients.

Methods

This was a retrospective study of the clinical outcomes of patients who underwent PGT and invasive or non-invasive pregnancy testing after euploid blastocyst transfer at our IVF centre between January 2017 and December 2022.

Results

In total, 321 patients were enrolled in this study, 138 (43.0%) received invasive pregnancy testing, and 183 (57.0%) patients underwent non-invasive testing. The mean age of the patients in Group 2 was higher than that of the patients in Group 1 (35.64 ± 4.74 vs. 31.04 ± 4.15 years, P < 0.001). The basal LH and AMH levels were higher in Group 1 than in Group 2 (4.30 ± 2.68 vs. 3.40 ± 1.88, P = 0.003; 5.55 ± 11.22 vs. 4.09 ± 3.55, P = 0.012), but the clinical outcomes were not significantly different. Furthermore, the clinical outcomes of patients undergoing invasive testing were similar to those of patients undergoing non-invasive testing with the same PGT indication.

Conclusion

Our results suggest that non-invasive pregnancy testing is a suitable alternative option for detecting the foetal chromosomal status in a PGT cycle. However, the usefulness of non-invasive testing in PGT-M patients is still limited.
The diagnostic potential of miR-196a-1 in colorectal cancer
Authors: Mehrjoei Bayan , Haghnazari Lida , Bashiri Homayoon , Rezvani Nayebali
Published: February 2024

Background

Colorectal cancer (CRC) is a common malignancy worldwide. MicroRNAs (miRNAs) are important epigenetic alterations that notably impact various physiological and pathological processes by acting as negative regulators of gene expression. Furthermore, they have a vital function in different types of cancers, including CRC. In this research, we evaluated, for the very first time, the expression levels of miR-196a-1 in the tissue and plasma of patients with CRC and also homeobox D8 (HOXD8) as the target gene.

Materials and methods

This study included a collection of 220 plasma and tissue samples from 55 patients diagnosed with CRC, as well as 55 healthy individuals matched by age and sex. Total RNA was extracted from plasma and tissue samples, and then polyadenylation and cDNA synthesis were performed. The expression levels of miR-196a-1 and HOXD8 as target gene was evaluated by quantitative RT-PCR (qRT-PCR) assay. We compared the diagnostic value of plasma miR-196a-1 with that of the circulating tumor markers CA19-9 and CEA using a Receiver Operating Characteristics (ROC) analysis. The association of miR-196a-1 with clinicopathological characteristics was assessed in tissue and plasma samples from patients with CRC.

Results

Our data demonstrated that the expression levels of miR-196a-1 in the tissue and plasma samples of CRC patients were 11.426- and 11.655-fold higher, respectively than those in adjacent normal tissue and plasma samples from normal subjects (p < 0.001). Through ROC curve analysis, it was identified that the sensitivity and specificity of miR-196a-1 for tissue samples, with an AUC of 0.925, were 89% and 98%, respectively. In addition, the sensitivity and specificity for plasma samples with an AUC of 0.801 were 70% and 98%, respectively. These findings reveal that miR-196a-1 is a useful biomarker for discriminating cases from controls. Furthermore, the expression of HOXD8 was not significantly altered in tumor tissue samples compared to adjacent normal tissues (P > 0.05).

Conclusions

These results show that miR-196a-1 has an oncogenic impact and plays a significant role in CRC development. The results also indicate that miR-196a-1 could serve as a novel noninvasive biomarker for the detection of CRC.
Psychological pathway to emotional exhaustion among nurses and midwives who provide perinatal bereavement care in China: a path analysis
Authors: Qian Jialu , Wu Gaoyan , Jevitt Cecilia , Sun Shiwen , Wang Man , Sun Xiangyu , Yu Xiaoyan
Published: February 2024

Background

A lack of confidence in perinatal bereavement care (PBC) and the psychological trauma experienced by nurses and midwives during bereavement care leads to their strong need for sufficient organisational support. The current study intended to test a hypothesised model of the specific impact paths among organisational support, confidence in PBC, secondary traumatic stress, and emotional exhaustion among nurses and midwives.

Methods

A descriptive, cross-sectional survey was conducted in sixteen maternity hospitals in Zhejiang Province, China, from August to October 2021. The sample (n = 779) consisted of obstetric nurses and midwives. A path analysis was used to test the relationships among study variables and assess model fit.

Results

Organisational support directly and positively predicted confidence in PBC and demonstrated a direct, negative, and significant association with secondary traumatic stress and emotional exhaustion. Confidence in PBC had a positive direct effect on secondary traumatic stress and a positive indirect effect on emotional exhaustion via secondary traumatic stress. Secondary traumatic stress exhibited a significant, direct effect on emotional exhaustion.

Conclusions

This study shows that nurses' and midwives' confidence in PBC and mental health were leadingly influenced by organisational support in perinatal bereavement practice. It is worth noting that higher confidence in PBC may lead to more serious psychological trauma symptoms in nurses and midwives. Secondary traumatic stress plays an essential role in contributing to emotional exhaustion. The findings suggest that support from organisations and self-care interventions were required to improve confidence in PBC and reduce negative psychological outcomes among those providing PBC. The development of objective measures for assessing competence in PBC and organizational support are essential.
An experimental game to assess hunter’s participation in zoonotic diseases surveillance
Authors: Pouliquen Aude , Mapeyi Gilles Aurélien Boupana , Vanthomme Hadrien , Olive Marie-Marie , Maganga Gaël Darren , Cornelis Daniel , Lebel Sébastien , Peyre Marisa , Delabouglise Alexis
Published: February 2024

Background

Strengthening the surveillance of zoonotic diseases emergence in the wild meat value chains is a critical component of the prevention of future health crises. Community hunters could act as first-line observers in zoonotic pathogens surveillance systems in wildlife, by reporting early signs of the possible presence of a disease in the game animals they observe and manipulate on a regular basis.

Methods

An experimental game was developed and implemented in a forested area of Gabon, in central Africa. Our objective was to improve our understanding of community hunters' decision-making when finding signs of zoonotic diseases in game animals: would they report or dissimulate these findings to a health agency? 88 hunters, divided into 9 groups of 5 to 13 participants, participated in the game, which was run over 21 rounds. In each round the players participated in a simulated hunting trip during which they had a chance of capturing a wild animal displaying clinical signs of a zoonotic disease. When signs were visible, players had to decide whether to sell/consume the animal or to report it. The last option implied a lowered revenue from the hunt but an increased probability of early detection of zoonotic diseases with benefits for the entire group of hunters.

Results

The results showed that false alerts—i.e. a suspect case not caused by a zoonotic disease—led to a decrease in the number of reports in the next round (Odds Ratio [OR]: 0.46, 95% Confidence Interval [CI]: 0.36–0.8, p < 0.01). Hunters who had an agricultural activity in addition to hunting reported suspect cases more often than others (OR: 2.05, 95% CI: 1.09–3.88, p < 0.03). The number of suspect case reports increased with the rank of the game round (Incremental OR: 1.11, CI: 1.06–1.17, p < 0.01) suggesting an increase in participants’ inclination to report throughout the game.

Conclusion

Using experimental games presents an added value for improving the understanding of people’s decisions to participate in health surveillance systems.
Perceptions of barriers to and facilitators of exercise rehabilitation in adults with lung transplantation: a qualitative study in China
Authors: Yang Hui , Liu Saisai , Chen Jingru , Qiao Yaxin , Wang Chengcheng , Zhang Wenping , Wei Li , Chen Ruiyun
Published: February 2024

Background

Exercise is crucial for pulmonary rehabilitation and improving the prognosis of lung transplantation (LTx) patients. However, many LTx patients in China have low exercise tolerance and compliance, and the reasons behind these challenges have not been fully elucidated. Therefore, this qualitative research aims to identify the barriers to and facilitators of exercise rehabilitation in LTx patients.

Methods

From January to July 2023, 15 stable LTx patients were recruited and participated in in-depth, semi-structured, face-to-face interviews at Henan Provincial People’s Hospital. The interview transcripts were analyzed using the COM-B model and the Theoretical Domains Framework (TDF).

Results

Six general themes including 19 barriers and 14 facilitators for the exercise rehabilitation of LTx patients were identified based on the COM-B model and TDF. The barriers to exercise included physical limitations, insufficient exercise endurance, lack of knowledge, and lack of motivation. The facilitators of exercise included motivation, self-efficacy, perceived significance of exercise rehabilitation, and social support.

Conclusion

The study offers detailed insight into the development and implementation of exercise rehabilitation intervention strategies for LTx patients. By combining COM-B model and TDF, the study provides strong evidence that active behavior change strategies are required for LTx patients to promote their participation in exercise rehabilitation. Professional support, pulmonary rehabilitation training, behavior change technology, and digital health tools are essential for strengthening the evidence system for reporting exercise efficacy and effectiveness.
Gender influences resident physicians’ perception of an employee-to-employee recognition program: a mixed methods study
Authors: Tischendorf Jessica S. , Krecko Laura K. , Filipiak Rachel , Osman Fauzia , Zelenski Amy B.
Published: February 2024

Background

Burnout is prevalent in medical training. While some institutions have implemented employee-to-employee recognition programs to promote wellness, it is not known how such programs are perceived by resident physicians, or if the experience differs among residents of different genders.

Methods

We used convergent mixed methods to characterize how residents in internal medicine (IM), pediatrics, and general surgery programs experience our employee-to-employee recognition ("Hi-5″) program. We collected Hi-5s received by residents in these programs from January 1, 2021–December 31, 2021 and coded them for recipient discipline, sex, and PGY level and sender discipline and professional role. We conducted virtual focus groups with residents in each training program.

Main measures and approach

We compared Hi-5 receipt between male and female residents; overall and from individual professions. We submitted focus group transcripts to content analysis with codes generated iteratively and emergent themes identified through consensus coding.

Results

Over a 12-month period, residents received 382 Hi-5s. There was no significant difference in receipt of Hi-5s by male and female residents.

Five IM, 3 surgery, and 12 pediatric residents participated in focus groups. Residents felt Hi-5s were useful for interprofessional feedback and to mitigate burnout. Residents who identified as women shared concerns about differing expectations of professional behavior and communication based on gender, a fear of backlash when behavior does not align with gender stereotypes, and professional misidentification.

Conclusions

The “Hi-5” program is valuable for interprofessional feedback and promotion of well-being but is experienced differently by men and women residents. This limitation of employee-to-employee recognition should be considered when designing equitable programming to promote well-being and recognition.