bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-Term Complete Remission of a Patient With Double-Hit Diffuse Large B-Cell Lymphoma Treated by Chemoimmunotherapy and Chinese Herbal Medicine
Authors: Liang Henry , Guo Jessica , Li Chun Guang
Published: February 2023

Double-hit diffuse large B-cell lymphoma (DHL) is an uncommon subtype of lymphoma which poorly responds to current drug therapies and has low rates of long-term survival in the patients. Herein, we report a case of a 73-year-old Caucasian male who was diagnosed with DHL with double-hit mutations of rearrangement of both c-MYC and BCL2 in November 2013. He commenced the standard R-CHOP-14 chemotherapy (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone) but changed to dose-adjusted DA-EPOCH-R protocol (etoposide, doxorubicin, vincristine, cyclophosphamide, prednisone, and rituximab) in the second and third cycles due to double-hit mutation. Because of intolerance to the intensive therapy, the patient decided to switch to Chinese medicine intervention. From March 2014 to December 2019, he was prescribed with a classical Chinese herbal formula— Sijunzi Decoction plus Prunella vulgaris based prescriptions. After 2 months of the Chinese herbal medicine intervention, the patient felt his right groin mass disappeared. Imaging follow-up showed no residual masses, and no lymphadenopathy was seen. During the period of Chinese herbal medicine treatment, his adherence and tolerability were well maintained with no adverse events. Imaging surveillances afterward found no evidence of lymphoma recurrence. His regular blood tests indicated that the patient’s blood counts were normal and stable; no hematologic toxicity, hepatoxicity, or nephrotoxicity associated with Chinese herbal medicine were found. Follow-up visits until 2020 found that he had been living and enjoying a good quality of life for over 8 years post-diagnosis. This case study illustrates the potential values of Chinese herbal medicine in DHL treatment, alongside chemo-immunotherapy, and in maintaining long-term survival and satisfactory quality of life for DHL patients. The case report provides clinicians with preliminary evidence of the use of Chinese herbal medicine as a therapeutic strategy in the management of DHL.
Fabrication of ecofriendly jute fiber reinforced flexible planar composite as a potential alternative of leather
Authors: Shahid Md Abdus , Miah Md Solaiman , Razzaq Md Abdur
Published: February 2023

Natural fiber reinforced composites are a lightweight, affordable, and environmentally friendly replacement for many problematic applications. These natural fibers could be constructed into flexible planar materials with the aid of composite phenomena that can be used for a variety of applications where flexibility is important like as artificial leather. In this work, nonwoven matt made from spinning wastes of jute fiber was used to reinforce the biodegradable polyvinyl alcohol (PVA) matrix. The percentage of fibers within the PVA matrix was adjusted to develop the flexible planar composites. The nonwoven matt was immerged into the PVA solution casting mold with the aid of the solution evaporation approach. The flexible planar composite was then obtained through heat-induced pressing. Tensile strength, tearing strength, bending modulus, flexing endurance, abrasion resistance, and moisture management profiles of the developed flexible planar composite were assessed. Additionally, studies were performed for Fourier-transform infrared spectroscopy (FTIR) and thermogravimetric (TGA) analysis. The tensile strength has been found 7.78 N/mm2 with 9.84% elongation for a 1.2 mm thick flexible composite. The flexing endurance has been supported by no visible crack formation against 50,000 flexing cycles. The moisture management profile has been ensured by the hydrophobic surface of the composite. Developed flexible planar composite has been shown to have consistent mechanical performance for use as artificial leather, which could be appealing for the fabrication of leather-alternative bags, belts, and wallets.
‘If God is a DJ’: Heritage Rave, the Ageing Raver and the Bodywork of the DJ
Authors: Holmes Helen , Crossley Nick , Park Graeme
Published: February 2023

In this article we explore the revival of rave music in the UK, reporting original research findings and focusing, in particular, upon two emergent themes: (1) the lived experience of the ageing raver, and its embodied and collective nature; and (2) the changing role of the DJ. The article draws upon 15 in-depth interviews with both music professionals and ordinary participants who were part of the rave scene in the 1990s and who are now either returning to rave, after a period away from it, or who, having decreased their involvement, are now stepping it up again in the context of the revival. We explore how rave’s revival constitutes a form of heritage which is crucial to the UK’s creative economy and we illustrate how heritage rave events provide a collective space for ageing ravers to relive times, music and dances of old. However, we find that heritage rave is also a space of contention between advocates of ‘authentic’ and ‘commercialised’ forms of rave respectively. A further finding centres upon the ways in which reviving rave and reframing it in terms of heritage has transformed the position and role of the DJ. Having been a background figure in rave’s first wave, the DJ has become a centralised and revered figure within the heritage rave sector. There is a greater demand for professionalism and therefore sobriety, a demand which often agrees with those of their ageing body, but there are also performance demands which must be reconciled with the limitations of the latter. All DJ’ing involves non-contact bodywork – using music and mixing as a means of eliciting a specific and importantly, collective, bodily response – we argue, but this is heightened in the heritage rave scene.
Report of testicular tumour in a toddler: management beyond the testis
Authors: Sharma Amit , Biswal Deepak , Sharma Satyadeo , Roy Kishore
Published: February 2023

Testicular tumours in prepubertal children tend to be pure yolk sac tumours detected in stage I and have good prognosis. We describe a case of a 2-year old male child with a mixed testicular tumour presenting with stage IIC disease and managed with retroperitoneal lymph node dissection for residual retroperitoneal disease post adjuvant chemotherapy.
Low Preoperative Albumin Associated With Increased Risk of Superficial Surgical Site Infection Following Midfoot, Hindfoot, and Ankle Fusion
Authors: Guareschi Alexander S. , Newton William , Hoch Caroline , Scott Daniel J. , Gross Christopher E.
Published: February 2023

Background

This study investigates the effect of malnutrition, defined by hypoalbuminemia, on rates of complication, readmission, reoperation, and mortality following midfoot, hindfoot, or ankle fusion.

Methods

The National Surgical Quality Improvement Program (NSQIP) database was queried from 2005 to 2019 to identify 500 patients who underwent midfoot (n = 233), hindfoot (n = 261), or ankle (n = 117) fusion. Patients were stratified into normal (n = 452) or low (n = 48) albumin group, which was defined by preoperative serum albumin level <3.5 g/dL. Demographics, medical comorbidities, hospital length of stay (LOS), and 30-day complication, readmission, and reoperation rates were compared between groups. The mean age of the cohort was 58.7 (range, 21-89) years.

Results

Hypoalbuminemia patients were significantly more likely to have diabetes (P < .001), be on dialysis (P < .001), and be functionally dependent (P < .001). The LOS was significantly greater among the low albumin group (P < .001). The hypoalbuminemia cohort also exhibited a significantly increased likelihood of superficial infection (P = .048). Readmission (P = .389) and reoperation (P = .611) rates did not differ between the groups.

Conclusion

This study shows that malnourished patients have an increased risk of superficial infection following foot and ankle fusions but are not at an increased risk of readmission or reoperation, suggesting that low albumin confers an elevated risk of surgical site infection.

Levels of Evidence:

Level III, Retrospective cohort study
A noisy theory of asking for help that explains why many feel underwhelmed with the help they receive
Authors: Dishop Christopher R. , Awasty Nikhil
Published: February 2023

Employees often feel that the help they receive at work is inadequate. Whereas previous research explains this empirical finding by referencing stereotypes or poor communication, we suggest an alternative that does not rely on biased agents: disappointment with received help may arise due to self-selection and regression to the mean. Before asking for help, employees assess whether their co-workers have the time and ability to respond. Consistent with regression to the mean, extreme beliefs are often followed by less extreme outcomes. However, employees with inflated beliefs are more likely to ask for help than employees with low or modest beliefs. Therefore, the subset of employees who act will have overly optimistic expectations, expectations that are unlikely to be met once co-workers respond. Apart from challenging conventional wisdom, this article also integrates chance and self-selection perspectives into the ongoing dialogue of help-seeking. Implications for future research, theory, and practice are discussed.
Is Intimate Partner Violence More Common Among HIV-Positive Pregnant Women? A Comparative Study in Oyo State, Nigeria
Authors: Ilori Oluwatosin Ruth , Olugbenga-Bello Adenike Iyanuoluwa , Awodutire Phillip Oluwatobi
Published: February 2023

Introduction: Intimate partner violence (IPV) is the most common form of violence against women. Pregnant women are also not exempted from the menace of IPV which has dire consequences for both the mother and child. There is an established link between HIV and IPV and both have a synergistic effect. This study is aimed at comparing the prevalence, pattern, and determinants of IPV among pregnant women living with HIV and HIV-negative pregnant women attending antenatal clinics in Oyo state. Methodology: This is a descriptive cross-sectional study carried out among women attending antenatal clinics in Oyo state using a multistage sampling technique. The study spanned through March and September 2019. The data collection was conducted using a semi-structured questionnaire and the analysis was done using Statistical Package for Social Sciences version 22. The pattern and prevalence of IPV were measured using the Composite Abuse Scale, a 30-item validated interviewer-administered research instrument. It measured 4 dimensions of abuse: physical, emotional, severe, combined, and sexual harassment. A preliminary cut-off score of 7 was used to divide respondents into the presence or absence of IPV. A Chi-square test was used to test for an association between IPV and socio-demographic characteristics and a logistic regression was used at the multivariate level to identify the determinants of IPV. The P-value was set at <.05. Results: Out of the 240 booked pregnant women, 44.2% of HIV-negative respondents and 47.5% of women living with HIV reported being abused in the index pregnancy. Severe combined abuse was the most common type of abuse, 110 (75.1%), followed by emotional abuse, 70 (40.2%), physical abuse, 68 (39.3%), and sexual harassment, 67 (38.1%). Respondents living with HIV reported suffering more physical abuse than their HIV-negative counterparts. Occupation of respondents and duration of marriage determinants of IPV among HIV-positive participants are statistically significant while the duration of marriage was not statistically significant for IPV among HIV-negative respondents. Conclusion: This study recorded a high prevalence of IPV among pregnant women living with HIV and HIV-negative pregnant women with a slight increase in the group living with HIV. It is therefore recommended that IPV screening programs and intervention strategies should be developed for every pregnant woman, irrespective of their HIV status.
Can Entrepreneurship Enable Economic and Social Integration of Refugees? A Comparison of the Economic, Social and Policy Context for Refugee Entrepreneurship in the UK and Germany
Authors: Schmich Marilena , Mitra Jay
Published: February 2023

This article examines critically the support systems necessary for economic integration of refugees by analysing the economic, social and policy context of refugee entrepreneurship in Germany and the UK. Current economic integration policies in both countries focus primarily on assisting refugees to find employment while appearing to neglect the value of refugee entrepreneurship as a viable option for integrating refugees into the destination country’s economy. Assuming economic integration of refugees is a fundamental socio-economic goal in both countries, our aim was to examine the challenges that could be addressed with regard to future policies for targeting refugee entrepreneurship and augmenting both entrepreneurship development and entrepreneurial policy formulation in host societies. We introduce a theoretical framework building on Wauters and Lambrecht (2008 , Journal of Ethnic and Migration Studies, 34(6), 895–915) and use inductive thematic analysis ( Guest et al., 2013 , Collecting qualitative data: A field manual for applied research) to examine which variables impact refugees. We identify how regulations, measures and policies in different environments affect those variables. We also examine the concept of mixed embeddedness ( Kloosterman et al., 1999 , International Journal of Urban and Regional Research, 23(2), 252–266), and its appropriateness for understanding the emergent entrepreneurial activity of refugees and the support systems that can aid opportunity-based integration. Our findings show that first, the most common challenges refugee entrepreneurs encounter are (a) seed capital, (b) language barriers, (c) location, (d) embeddedness and (e) knowledge about the local market. Second, there are no significant differences in the challenges that refugee entrepreneurs encounter, between the UK and Germany. Third, we also find that the support system for refugee entrepreneurs is larger in Germany than in the UK due to the capacity of government and civil society support. We conclude that combating downward occupational mobility, and fully using the potential and expertise of refugees, refugee entrepreneurship could be considered as a viable option for economic integration because refugee communities offer unique opportunities for potentially expanding the scope and style of entrepreneurship in host countries.
Census-based urban building energy modeling to evaluate the effectiveness of retrofit programs
Authors: Nidam Yael , Irani Ali , Bemis Jamie , Reinhart Christoph
Published: February 2023

Housing retrofits are essential for meeting societal decarbonization goals, alongside addressing energy insecurity, improving public health, and creating new jobs. Yet, despite their multiple benefits and comprehensive government efforts to incentivize retrofits, adoption rates across the world remain low, usually less than 1% per year. Barriers to adoption among homeowners include lack of knowledge of what combination of energy retrofitting upgrades are most cost effective for their situation given available incentive programs. Similarly, cities lack urban-level analysis tools to optimize uptake of and predict carbon emissions reduction from existing incentive programs. To address the latter gap, we present a census-based Urban Building Energy Modeling framework that combines a technical energy saving potential analysis with a socioeconomic model that includes occupant demographics, local building regulations, and incentive eligibility criteria. We use the framework to evaluate the effectiveness of retrofit programs in two Boston neighborhoods with median incomes of $110,00 and $42,000. Results reveal that for the higher income, neighborhood predicted and actual adoption rates between 2014 and 2017 are comparable. In the lower income neighborhood, the proportion of households that would financially benefit from incentive offerings is higher. However, current participation rates do not reflect this difference suggesting that many viable projects do not happen for reasons that are not yet captured by the model. Urban planners, energy policy designers, and community advocates seeking to plan and evaluate energy incentive programs can use this framework to understand the breakdown of opportunities and barriers for different socio-demographic groups and geographic locations.
Quality of Life and Associated Determinants among Female Tea Garden Workers of Indigenous Communities in Sub-Himalayan West Bengal, India: A Cross- Sectional Mixed Methods
Authors: Majumder Suranjan , Chowdhury Indrajit Roy
Published: February 2023

The purpose of this study was to examine the self-perceived quality of life (QOL) using World Health Organization quality of life (WHOQOL-BREF) instrument and associated controlling factors among socio-economically marginalized tribal female tea garden (TG) workers. A cross-sectional mixed-method research design involving both quantitative and qualitative techniques was employed on 378 study samples (18–60 years tribal female TG workers) between February and May 2022 across 10 TGs of Sub-Himalayan north Bengal, India. For the study, both summary statistics (mean, median, mode, standard deviation, and percentage distribution) and inferential statistics (Welch’s ANOVA, independent t-test, paired t-test and multivariate regression) were used to understand the dynamics of QOL and respondents narratives were facilitated to investigate the corresponding phenomenal scenario. Results: Findings indicate the QOL of the tribal female workers variably associated with different socioeconomic conditions and subjective well-being. The findings recommend that female tribal TG workers were perceived to have good ‘overall quality of life’ with a response rate of 33.1%, whereas more than 20% of participants respond that they were poor QOL on ‘overall quality of life’ and ‘general health’ items. The findings show lower summary statistics for most items in the environmental domain. Additionally, the study constructs a multivariate model that identifies several factors including socio-economy, neighbourhood, social relation, and others were significantly control the QOL of the study subjects. These outcomes may have important implications for future studies employing WHOQOL-BREF or similar instruments on different communities with distinctive sociocultural characteristics.
A Novel Click-Through Rate Prediction Model Based on Deep Feature Fusion Network
Authors: Shi Xiujin , Gong Yuan , Zhang Yiwei , Qin Yanxia
Published: February 2023

Existing click-through rate prediction models employ both a shallow model and a deep neural model for better feature interaction. The former shallow model aims to extract explainable explicit features and the latter deep neural model aims to learn efficient implicit features. Deep neural network is a commonly used deep neural model, which can yield better performance with more neural layers. However, increasing the number of neural layers would lead to problems such as gradient vanishing, gradient explosion, and excessive parameters. In addition, the performance of a deep neural network will also decrease rapidly when it becomes too deep. In this article, we propose a novel click-through rate prediction model by improving the deep neural model part to alleviate the above problems of deep neural network-based models. This article proposes to utilize a dense deep neural network model to strengthen feature propagation, which takes the outputs of all previous layers as the input of the current layer, instead of only one previous layer being used in the deep neural network. In addition, we also utilize an advanced shallow model FmFM for better explicit features in this article, and explicit and implicit features are interacted in our model. Experiments on two data sets (Criteo and Avazu) show that the proposed click-through rate prediction model significantly outperforms existing classical models such as DeepFM, xDeepFM, and DeepLight models.
Developing an evidence-Informed decolonising curriculum wheel – A reflective piece
Authors: Ahmed-Landeryou Musharrat
Published: February 2023

Decolonising the curriculum is not a fad (Moosavi, 2020) nor a metaphor (Tuck and Yang, 2012). It is the deep interrogation of curriculum with Black and minoritised students, to expose how the colonialist patriarchal epistemological worldview has shaped the curriculum, the results of which are seen in the different educational outcomes for these groups compared to their white peers. Thus, this approach to curriculum transformation decentres the hegemony disadvantaging and harming Black and minoritised students. Decolonising the curriculum reinserts knowledges and authors that are pushed to the margins/devalued, so that Black and minoritised students can be represented in the curriculum, representation leads to belonging, a contributor for student success (Pedler et al., 2022). This paper reflects on the development of an evidence informed ‘decolonising the curriculum wheel – a reflection framework’, as a method to support and guide engagement and continuous evaluation of decolonising curricula activity/ies across a higher education institution, to potentially improve belonging for Black and minoritised students. The article shares how through a scoping literature review and thematic analysis of reports from student focus groups, components for a decolonising method were identified. The article also lays bare the challenges that occurred in this journey towards developing the wheel.
Perinatal characteristics and neonatal outcomes of singletons and twins in Chinese very preterm infants: a cohort study
Authors: Yang Min , Fang Lingyu , Wang Yanchen , Li Xiaoying , Cao Yun , Sun Jianhua , Ting Joseph , Chen Xiafang , Fan Xiaobo , Dai Jiale , Tong Xiaomei , Chen Dongmei , Wang Jimei ,   the Chinese Neonatal Network, Lee Shoo K. , Chen Chao , Du Lizhong , Zhou Wenhao , Xu Falin , Tian Xiuying , Zhang Huayan , Ji Yong , Li Zhankui , Shi Jingyun , Xue Xindong , Yang Chuanzhong , Wang Sannan , Liu Ling , Gao Xirong , Wu Hui , Yang Changyi , Han Shuping , Shan Ruobing , Jiang Hong , Qiu Gang , Wei Qiufen , Cheng Rui , Kang Wenqing , Li Mingxia , Dai Yiheng , Wang Lili , Liu Jiangqin , Lin Zhenlang , Shi Yuan , Cheng Xiuyong , Pan Jiahua , Zhang Qin , Feng Xing , Zhou Qin , Li Long , Chen Pingyang , Yang Ling , Zhuang Deyi , Zhang Yongjun , Feng Jinxing , Li Li , Lin Xinzhu , Qiu Yinping , Liang Kun , Ma Li , Chen Liping , Zhang Liyan , Song Hongxia , Yin Zhaoqing , Hei Mingyan , Huang Huiwen , Yang Jie , Li Dong , Ding Guofang , Zhang Qianshen , Ma Xiaolu
Published: February 2023

Background

The prevalence of preterm birth has been rising, and there is a paucity of nationwide data on the perinatal characteristics and neonatal outcomes of twin deliveries of very preterm infants (VPIs) in China. This study compared the perinatal characteristics and outcomes of singletons and twins admitted to neonatal intensive care units (NICUs) in China.

Methods

The study population comprised all infants born before 32 weeks in the Chinese Neonatal Network (CHNN) between January 2019 and December 2019. Three-level and population-average generalized estimating equation (GEE)/alternating logistic regression (ALR) models were used to determine the association of twins with neonatal morbidities and the use of NICU resources.

Results

During the study period, there were 6634 (71.2%) singletons and 2680 (28.8%) twins, with mean birth weights of 1333.70 g and 1294.63 g, respectively. Twins were significantly more likely to be delivered by caesarean section (p < 0.01), have antenatal steroid usage (p = 0.048), have been conceived by assisted reproductive technology (ART) (p < 0.01), have a higher prevalence of maternal diabetes (p < 0.01) and be inborn (p < 0.01) than singletons. In addition, twins had a lower prevalence of small for gestational age, maternal hypertension, and primigravida mothers than singletons (allp < 0.01). After adjusting for potential confounders, twins had higher mortality rates (adjusted odds ratio [AOR] 1.28, 95% confidence interval [CI] 1.10–1.49), higher incidences of short-term composite outcomes (AOR 1.28, 95% CI 1.09–1.50), respiratory distress syndrome (RDS) (AOR 1.30, 95% CI 1.12–1.50), and bronchopulmonary dysplasia (BPD) (AOR 1.10, 95% CI 1.01–1.21), more surfactant usage (AOR 1.22, 95% CI 1.05–1.41) and prolonged hospital stays (adjusted mean ratio 1.03, 95% CI 1.00–1.06), compared to singletons.

Conclusion

Our work suggests that twins have a greater risk of mortality, a higher incidence of RDS and BPD, more surfactant usage, and longer NICU stays than singletons among VPIs in China.
Association between retinol intake and periodontal health in US adults
Authors: Zhou Shenyue , Chen Juan , Cao Ruoyan
Published: February 2023

Background

Inflammation and oxidative stress are two hallmarks of periodontitis. Retinol is an antioxidant and suppresses expression of pro-inflammatory factors. However, the evidence for an association between retinol intake and periodontitis is limited. Thus, the aim of this study is to assess the association between retinol intake and periodontal health.

Methods

Data used in this cross-sectional study from the National Health and Nutrition Examination Survey (NHANES) 2009–2014 (n = 9081). Dietary intake of retinol was measured based on two 24-h dietary recall interviews. The category of periodontitis was defined by the CDC/AAP according to clinical periodontal parameters. Univariate and multivariate logistic regression analyses were applied to investigate the relationship between retinol intake and the risk of periodontitis.

Results

Compared with the lowest tertile, individuals in the highest tertile of retinol intake were less likely to be periodontitis (ORtertile3vs1 = 0.79, 95% CI: 0.65–0.96). The association was still significant in populations who were less than 60 years old (ORtertile3vs1 = 0.80, 95% CI: 0.65–0.97), non-Hispanic black (ORtertile3vs1 = 0.62, 95% CI: 0.42–0.94), PI ≤ 1.3 (ORtertile3vs1 = 0.72, 95% CI: 0.55–0.93), 1.3 < PI ≤ 3.5 (ORtertile3vs1 = 0.70, 95% CI: 0.55–0.89), non-smoker (ORtertile3vs1 = 0.63, 95% CI: 0.48–0.81), obesity (ORtertile3vs1 = 0.68, 95% CI: 0.49–0.94) and who had not diabetes mellitus (ORtertile3vs1 = 0.79, 95% CI: 0.65–0.95) or had hypertension (ORtertile3vs1 = 0.63, 95% CI: 0.47–0.84).

Conclusion

Retinol intake is inversely associated with poor periodontal health in US adults.
Determinants of induced abortion among women of reproductive age: evidence from the 2013 and 2019 Sierra Leone Demographic and Health Survey
Authors: Sesay Foday Robert , Anaba Emmanuel Anongeba , Manu Adom , Maya Ernest , Torpey Kwasi , Adanu Richard M. K.
Published: February 2023

Background

Worldwide, pregnancy termination due to unintended pregnancy is crucial in maternal health, particularly in settings where abortion laws are restrictive. Presently, there is a paucity of literature on determinants of induced abortion among women of reproductive age in Sierra Leone. The study findings could be used to improve the country's maternal mortality indices and inform health programs and reproductive health policies geared toward tackling induced abortion.

Methods

We analyzed secondary data from the 2013 and 2019 Sierra Leone Demographic and Health Surveys. The surveys were nationally representative, with weighted samples comprising 16,658 (2013) and 15,574 (2019) women of reproductive age. Descriptive statistics, including frequencies and percentages, were computed, while Chi-square and Binomial Logistics Regression were employed to identify correlates of induced abortion.

Results

The results showed that a minority (9%) of the participants had induced abortion in both surveys. Abortion was significantly associated with age, marital status, employment status, education, parity, and frequency of listening to the radio and watching television (p < 0.05). For instance, women aged 45–49 years (AOR = 7.91; 95% CI: 5.76–10.87), married women (AOR = 2.52; 95% CI: 1.95–3.26), and working women (AOR = 1.65; 95% CI: 1.45–1.87) had a higher likelihood of induced abortion compared to their counterparts. Moreover, women with primary education (AOR = 1.27; 95% CI:1.11–1.46) and those who watch television once a week (AOR = 1.29; 95% CI: 1.11–1.49) were more likely to terminate a pregnancy. Women with six or more children (AOR = 0.40; 95% CI: 0.31–0.52) were less likely to terminate a pregnancy compared to those with no child.

Conclusion

The study revealed that a minority of the women had induced abortions. The prevalence of induced abortion did not change over time. Induced abortion was influenced by age, marital status, employment status, education, parity, and exposure to mass media. Therefore, policies and programs to reduce unwanted pregnancies should focus on increasing access to modern contraceptives among women of lower socio-economic status.
Development and evaluation of a portable and soft 3D-printed cast for laparoscopic choledochojejunostomy model in surgical training
Authors: Xia Jianfu , Mao Jinlei , Chen Hao , Xu Xiaodong , Zhang Jing , Yang Jin , Wang Zhifei
Published: February 2023

Background

Laparoscopic choledochojejunostomy (LCJ) is an essential basic skill for biliary surgeons. Therefore, we established a convenient and effective LCJ 3D printing model to evaluate whether the model could simulate the actual operation situation and determine its effectiveness and validity in surgical training.

Methods

A 3D printing dry laboratory model was established to simulate LCJ. The face and content validity of the model were evaluated by six experienced biliary surgeons based on 5-point Likert scale questionnaires. A total of 15 surgeons with different levels of experience performed LCJ on the model and evaluated the structural validity of the model using the objective structured assessment of technical skills (OSATS). Simultaneously, the operation time of each surgery was also recorded. A study was also performed to further evaluate the learning curve of residents.

Results

The operating space score of the model was 4.83 ± 0.41 points. The impression score of bile duct and intestinal canal was 4.33 ± 0.52 and 4.17 ± 0.41 points, respectively. The tactile sensation score of bile duct suture and intestinal canal suture was 4.00 ± 0.63 and 3.83 ± 0.41points, respectively. The OSATS score for model operation in the attending group was 29.20 ± 0.45 points, which was significantly higher than that in the fellow group (26.80 ± 1.10,P = 0.007) and the resident group (19.80 ± 1.30,P < 0.001). In addition, there was a statistical difference in operation time among surgeons of different experience levels (P < 0.05). Residents could significantly improve the surgical score and shorten the time of LCJ through repeated training.

Conclusions

The 3D printing LCJ model can simulate the real operation scenes and distinguish surgeons with different levels of experience. The model is expected to be one of the training methods for biliary tract surgery in the future.
Polycystic ovary syndrome preceding the diagnosis of acromegaly: a retrospective study in 97 reproductive-aged women
Authors: Khiyami Anamil M. , Jokar Tahereh Orouji , Abdallah Hussein M. , Gardner Paul A. , Zenonos Georgios A. , Styer Aaron K. , Fazeli Pouneh K.
Published: February 2023

Background

Acromegaly is a disease of growth hormone excess that results in enlargement of extremities, abnormal glucose and lipid metabolism, and gonadal disruption. Manifestations of the disease are insidious and typically lead to a diagnostic delay of 7–10 years. Classically the polycystic ovary syndrome (PCOS) phenotype is described in women with irregular menses, clinical or biochemical evidence of androgen excess, and/or multiple ovarian follicles on pelvic ultrasonography. Women with acromegaly may present with some or all of these symptoms. Our objective was to evaluate the prevalence of PCOS in patients with acromegaly and to determine if diagnosis of PCOS results in a delay in diagnosing acromegaly.

Methods

Using patient databases at two academic health centers, we identified 97 premenopausal women aged 18–49 years old presenting with acromegaly. Data were collected regarding pelvic sonography and reproductive history, including the diagnosis of PCOS. Patients carrying the diagnosis of PCOS before their diagnosis of acromegaly were identified and the remaining patients were screened using the Rotterdam criteria to identify additional patients meeting the criteria for PCOS prior to their diagnosis of acromegaly.

Results

Mean age of the population (n = 97) at the time of diagnosis of acromegaly was 33.4 ± 7.5 years (SD). Thirty-three percent of patients (n = 32) either carried a diagnosis of PCOS or met diagnostic criteria for PCOS before their diagnosis of acromegaly. In the subset of patients in whom data on symptom onset were available, those who met criteria for PCOS were diagnosed with acromegaly a median of 5 years [4, 9] after the onset of symptoms compared to 2 years [0.92, 3] (p =  0.006) in the patients who did not meet criteria for PCOS.

Conclusions

Our data demonstrate a high prevalence of signs and symptoms of PCOS in reproductive-aged women with acromegaly and a longer time to diagnosis in women who meet the clinical criteria for PCOS. As screening for acromegaly is relatively simple and done with measurement of a random, non-fasting IGF-1 level that can be drawn at any time during the menstrual cycle, screening patients with PCOS for acromegaly may lessen the delay in diagnosis for reproductive-aged women with this disease.
Microbiota composition in the lower respiratory tract is associated with severity in patients with acute respiratory distress by influenza
Authors: Hernández-Terán Alejandra , Vega-Sánchez Angel E. , Mejía-Nepomuceno Fidencio , Serna-Muñoz Ricardo , Rodríguez-Llamazares Sebastián , Salido-Guadarrama Iván , Romero-Espinoza Jose A. , Guadarrama-Pérez Cristobal , Sandoval-Gutierrez Jose L. , Campos Fernando , Mondragón-Rivero Erika N. , Ramírez-Venegas Alejandra , Castillejos-López Manuel , Téllez-Navarrete Norma A. , Pérez-Padilla Rogelio , Vázquez-Pérez Joel A.
Published: February 2023

Several factors are associated with the severity of the respiratory disease caused by the influenza virus. Although viral factors are one of the most studied, in recent years the role of the microbiota and co-infections in severe and fatal outcomes has been recognized. However, most of the work has focused on the microbiota of the upper respiratory tract (URT), hindering potential insights from the lower respiratory tract (LRT) that may help to understand the role of the microbiota in Influenza disease. In this work, we characterized the microbiota of the LRT of patients with Influenza A using 16S rRNA sequencing. We tested if patients with different outcomes (deceased/recovered) and use of antibiotics differ in their microbial community composition. We found important differences in the diversity and composition of the microbiota between deceased and recovered patients. In particular, we detected a high abundance of opportunistic pathogens such as Granulicatella, in patients either deceased or with antibiotic treatment. Also, we found antibiotic treatment correlated with lower diversity of microbial communities and with lower probability of survival in Influenza A patients. Altogether, the loss of microbial diversity could generate a disequilibrium in the community, potentially compromising the immune response increasing viral infectivity, promoting the growth of potentially pathogenic bacteria that, together with altered biochemical parameters, can be leading to severe forms of the disease. Overall, the present study gives one of the first characterizations of the diversity and composition of microbial communities in the LRT of Influenza patients and its relationship with clinical variables and disease severity.
Long-term administration of CU06-1004 ameliorates cerebrovascular aging and BBB injury in aging mouse model
Authors: Kim Hyejeong , Noh Minyoung , Zhang Haiying , Kim Yeomyeong , Park Songyi , Park Jeongeun , Kwon Young-Guen
Published: February 2023

Background

Age-related changes in the cerebrovasculature, including blood–brain barrier (BBB) disruption and vascular dementia, are emerging as potential risks for many neurodegenerative diseases. Therefore, the endothelial cells that constitute the cerebrovasculature may play key roles in preventing brain injury. Our previous study showed that CU06-1004, an endothelial cell dysfunction blocker, prevented vascular leakage, enhanced vascular integrity in ischemic reperfusion injury, and promoted the normalization of tumor vasculature. Here, we evaluated the effects of CU06-1004 on age-related cerebrovascular functional decline in the aged mouse brain.

Results

In this study, we investigated the protective effects of CU06-1004 against oxidative stress–induced damage in human brain microvascular endothelial cells (HBMECs). HBMECs were treated with hydrogen peroxide (H2O2) to establish an oxidative stress–induced model of cellular injury. Compared with H2O2 treatment alone, pretreatment of HBMECs with CU06-1004 considerably reduced oxidative stress–induced cytotoxicity, reactive oxygen species generation, senescence-associated β-galactosidase activity, senescence marker expression, and the expression levels of inflammatory proteins. Based on the observed cytoprotective effects of CU06-1004 in HBMECs, we examined whether CU06-1004 displayed protective effects against cerebrovascular aging in mice. Long-term administration of CU06-1004 alleviated age-associated cerebral microvascular rarefaction and cerebrovascular senescence in the aged mouse brain. CU06-1004 supplementation also reduced the extravasation of plasma IgG by improving BBB integrity in the aged mouse brain, associated with reductions in neuronal injury. A series of behavioral tests also revealed improved motor and cognitive functions in aged mice that received long-term CU06-1004 administration.

Conclusions

These findings suggest that CU06-1004 may represent a promising therapeutic approach for delaying age-related cerebrovascular impairment and improving cognitive function in old age.
Digital marketing of commercial breastmilk substitutes and baby foods: strategies, and recommendations for its regulation in Mexico
Authors: Mota-Castillo Pedro Javier , Unar-Munguía Mishel , Santos-Guzmán Andrea , Ceballos-Rasgado Marena , Tolentino-Mayo Lizbeth , Barquera Simón , Sachse Aguilera Matthias , Armijo Fernanda Cobo , Bonvecchio Anabelle
Published: February 2023

Background

Parents are exposed to breastmilk substitutes and baby foods marketing on the internet and social media, which hinders adequate breastfeeding and complementary feeding. This study identifies digital marketing strategies for breastmilk substitutes, specifically commercial milk formula and baby foods used by the industry to influence infant and young children’s feeding practices in Mexico and proposes regulatory recommendations that can be useful for similar countries.

Methods

Qualitative study based on the CLICK monitoring framework developed by the World Health Organization, adapted for digital marketing of commercial milk formula and baby foods. Semi-structured interviews (n = 53) with key actors were conducted between November 2020 and March 2021, and used grounded theory for the analysis and interpretation with the MAXQDA 20 software.

Results

Commercial milk formula and baby food companies use digital media to contact and persuade parents to use their products by sending electronic newsletters with advertising. Companies hire influencers to market their products because there is no regulation prohibiting the advertisement of breastmilk substitutes on social media, and promote formula among health professionals inviting them to participate in sponsored webinars on infant nutrition, ignoring conflict of interest and the International Code of Marketing of Breastmilk Substitutes. Parents trust formula and baby food advertisements, which use emotional messages and health and nutrition claims to encourage their consumption. Health professionals consider that claims contribute to the indiscriminate use of formula, and some actors propose the use of plain packaging for these products.

Conclusions

Breastmilk substitutes companies promote their products in digital media using unethical strategies that fail to comply with the International Code of Marketing of Breastmilk Substitutes. They generate strong conflicts of interest with health professionals, taking advantage of legal framework gaps and the lack of monitoring and effective sanctions for non-compliers. Updating the legal framework and monitoring compliance, including digital media, is urgently needed to protect children’s right to breastfeeding, healthy nutrition and life, and the rights of women to health and informed decision-making.
Comparison effects of two muscle relaxant strategies on postoperative pulmonary complications in transapical transcatheter aortic valve implantation: a propensity score-matched analysis
Authors: Yu Hong , Zuo Yiding , Xu Zhao , Zhao Dailiang , Yue Jianming , Liu Lulu , Guo Yingqiang , Huang Jiapeng , Deng Xiaoqian , Liang Peng
Published: February 2023

Background

Prior studies have reported conflicting results on the effect of sugammadex on postoperative pulmonary complications (PPCs) and research on this topic in transapical-transcatheter aortic valve implantation (TA-TAVI) was sparse. The current study aimed to investigate whether there were differences in the incidence of PPCs between two muscle relaxant strategies (rocuronium/sugammadex vs. cisatracurium/neostigmine) in patients undergoing TA-TAVI.

Methods

This retrospective observational study enrolled 245 adult patients underwent TA-TAVI between October 2018 and January 2021. The patients were grouped according to the type of muscle relaxant strategies (115 with rocuronium/sugammadex in the R/S group and 130 with cisatracurium/neostigmine in the C/N group, respectively). Pre- and intraoperative variables were managed by propensity score match (PSM) at a 1:2 ratio. PPCs (i.e., respiratory infection, pleural effusion, pneumothorax, atelectasis, respiratory failure, bronchospasm and aspiration pneumonitis) were evaluated from the radiological and laboratory findings.

Results

After PSM, 91 patients in the R/S group were selected and matched to 112 patients in the C/N group. Patients in the R/S group showed lower PPCs rate (45.1% vs. 61.6%, p = 0.019) compared to the C/N group. In addition, the R/S group showed significant shorter extubation time (7.2 ± 6.2 vs. 10.3 ± 8.2 min, p = 0.003) and length of hospital stay (6.9 ± 3.3 vs. 8.0 ± 4.0 days, p = 0.034).

Conclusion

The rocuronium/sugammadex muscle relaxant strategy decreases the incidence of PPCs in patients undergoing TA-TAVI when compared to cisatracurium/neostigmine strategy.

Trial registration ChiCTR, ChiCTR2100044269. Registered March 14, 2021-Prospectively registered, http://www.Chictr.org.cn.
Inhibitory effect and mechanism of Lactobacillus crispatus on cervical precancerous cells Ect1/E6E7 and screening of early warning factors
Authors: Wan B. , Wei L. J. , Tan T. M. , Qin L. , Wang H.
Published: February 2023

Objective

To study the potential mechanism of Lactobacillus crispatus inhibiting cervical squamous intraepithelial lesion (SIL) and screen the early warning factors of SIL.

Methods

The effects of Lactobacillus crispatus on the proliferation, apoptosis, cross pore migration and invasion and cytokines of cervical precancerous cells Ect1/E6E7 were detected respectively. The effect of Lactobacillus crispatus on the expression of differential proteins screened in Ect1/E6E7 cells were detected by Western blot.

Results

Lactobacillus crispatus significantly inhibited the proliferation, induced apoptosis and inhibited cell migration of Ect1/E6E7 cells in a time-dependent manner (P < 0.05), but had no significant effect on cell invasion. Lactobacillus crispatus significantly promoted the secretion of Th1 cytokines and inhibited the secretion of Th2 cytokines by Ect1/E6E7 cells (P < 0.05). In addition, compared with SiHa cells in the control group, the expression of differential proteins PCNA, ATM, LIG1 and HMGB1 in Ect1/E6E7cells decreased significantly, while the expression of TDG and OGG1 proteins increased significantly (P < 0.05). ABCG2 protein in Ect1/E6E7 cells was slightly higher than that in SiHa cells, but the difference was not statistically significant. What is interesting is that Lactobacillus crispatus significantly inhibited the expression of ABCG2, PCNA, ATM, LIG1, OGG1 and HMGB1 proteins in Ect1/E6E7 cells, and promoted the expression of TDG protein.

Conclusions

Lactobacillus crispatus may inhibit the function of Ect1/E6E7 cells through multiple pathways and exert the potential to reverse the progression of SIL.
VSELs and OSCs together sustain oogenesis in adult ovaries and their dysfunction results in age-related senescence, PCOS, POI and cancer
Authors: Bhartiya Deepa , Sharma Diksha
Published: February 2023

Multiple studies using single-cell RNA sequencing (scRNAseq) have failed to detect stem cells in adult ovaries. We have maintained that two populations of ovarian stem cells including pluripotent, very small embryonic-like stem cells (VSELs) and tissue-committed ‘progenitors’ termed ovarian stem cells (OSCs) can easily be detected in Hematoxylin and Eosin-stained ovary surface epithelial (OSE) cells smears prepared from both mice and human ovaries. Most likely the stem cells never get subjected to scRNAseq since they pellet down only by centrifuging cells suspension at 1000 g while cells for scRNAseq were invariably prepared by centrifuging at 200-400 g. A recent article provided further explanation for the failure of scRNAseq to detect ovarian stem cells. Extensive reanalysis of data (generated by scRNAseq) using an advanced software successfully detected OSCs and meiotic markers supporting neo-oogenesis in adult human ovaries. But this article remained critical on the biological relevance of VSELs and their relationship with OSCs. By carefully studying the OSE cells smears (which hold VSELs, OSCs and germ cell nests GCNs), prepared by partial trypsin digestion of intact mice ovaries during different stages of estrus cycle, we have successfully delineated novel functions of VSELs/OSCs in vivo under physiological conditions. VSELs undergo asymmetrical divisions to self-renew and give rise to slightly bigger OSCs which in turn undergo symmetrical divisions and clonal expansion to form GCNs, regular neo-oogenesis and follicle assembly. GCNs have been earlier described in fetal ovaries and during OSE cells culture (from adult ovaries) in response to FSH treatment. Dysfunction of VSELs/OSCs (which express ERα, ERβ, FSHR) due to neonatal exposure to endocrine disruption results in ovarian insufficiency and polycystic ovaries. VSELs have also been implicated in ovarian cancer. Age-related ovarian senescence/menopause is also due to dysfunction and blocked differentiation of VSELs/OSCs. These novel findings in vivo along with abundant in vitro and lineage tracing studies data in published literature provides huge scope for further research, offers novel avenues to manage ovarian pathologies and calls for re-writing of textbooks.