bluuebunny/crossref_metadata_2025 huggingface dataset:
Ocular severe involvement in oculofaciocardiodental syndrome: Description of a case series
Authors: Moleiro Ana Filipa , Oliveira Joana Santos , Grangeia Ana , Faria Pedro , Falcão-Reis Fernando , Magalhães Augusto , Silva Sérgio Estrela
Published: May 2023

Background

Oculofaciocardiodental (OFCD) syndrome is a rare genetic disorder affecting ocular, facial, dental, and cardiac systems, being an X-linked condition caused by pathogenic variants in the BCL-6 corepressor gene ( BCOR). We report a case series of three female patients with OFCD syndrome with severe glaucoma.

Results

Three female patients with OFCD syndrome with different variants involving BCOR gene, in heterozygosity: a seven-years-old girl with an insertion (c.2037_2038dupCT), a nine years-old girl with a microdeletion in the X (p21.2-p11.4)) spanning the BCOR gene; and a 25 years-old female with a deletion (c.3858_3859del). Systemic involvement is variable among patients ranging from one patient mainly with ocular and dental involvement to one with associated intra-auricular and intra-ventricular defects. All the patients presented with congenital cataracts diagnosed in the first days of life. Cataract surgery was performed without incidents between 6 and 16 weeks of age in all the patients. Postoperatively, the three patients developed ocular hypertension and glaucoma with the need for surgical interventions, including trabeculectomy, Ahmed valve implantation, and cyclophotocoagulation.

Conclusion

OFCD syndrome characterizes by a severe ocular involvement with glaucoma as a characteristic feature. Ocular hypertension after cataract surgery in these patients is challenging, almost always needing surgery during childhood. Therefore, we consider BCOR disruption may predispose to a higher incidence of glaucoma due to its aggressiveness and early onset on our case series. The awareness of these complications is crucial to an adequate follow-up of the patients.
Somali parenting in Western contexts: Acculturative stressors and family strengths
Authors: Suleiman Johara , Haight Wendy , Park Sookyoung , Flanagan Shelby
Published: May 2023

This scoping review describes the available research on the experiences of Somali immigrant parents acculturating within Western countries including the U.S., Canada, South Africa, England, and Scandinavia. A total of 19 studies were identified that focused on Somali immigrant families, discussed parenting, and were written in English. Ten were published in peer-reviewed journals including in social work, mental health, and nursing. The other studies were reported in a book chapter and eight graduate-level theses. The studies were qualitative, and identified several themes related to parental strengths and stressors as they acculturated to Western countries. Stressors included conflicts between Western and Islamic values within racist contexts, shifting from communal to nuclear family parenting, and changes in family dynamics. Strengths included strong ties to spirituality, a deep commitment to family, and a strong love of and pride in their cultural identity. Implications for practice, policy, and research are discussed.
Descriptive National Evidence Comparing Hispanic and White Student Graduate Degree Completion Rates
Authors: Solinas-Saunders Monica , Hobson Charles J. , Griffin Andrea , Azemi Yllka , Szostek Jana , Novak John M.
Published: May 2023

Using data from the U.S. Department of Education National Center for Education Statistics Integrated Postsecondary Education Data System (IPEDS), longitudinal trends in graduate degree completion rates for Hispanic and White students were analyzed over a period of 17 years (2002–2019). The results indicated that there was a significant positive linear trend in graduation rates for both Hispanic and White graduate students, with no adverse impact in graduate degree completion rates for Hispanic students when compared to White students.
Associations of gross motor skills with self-regulation and executive function in preschool-aged children
Authors: Veldman Sanne LC , Hammersley Megan L , Howard Steven J , Stanley Rebecca M , Okely Anthony D , Jones Rachel A
Published: May 2023

This study aimed to examine associations between gross motor skills and executive functions (EF) in a large sample of Australian preschool-aged children. Of 566 children (mean age = 3.2 ± 0.4 years, 51.2% girls), locomotor, object control, and total skill competence were significantly associated with visual spatial working memory and inhibition ( p < 0.05). Total skill competence was associated with shifting and locomotor skills were significantly associated with self-regulation ( p < 0.05). Static balance was significantly associated with inhibition and shifting ( p < 0.05). In boys, an association between object control skills and visual spatial working memory was observed. In girls, an association between static balance and visual spatial working memory, phonological working memory, and shifting was observed. The identification of significant associations between gross motor skills and different EFs is an important contribution to the growing evidence on the relationship between motor skills and EFs in early childhood.
Classification of Mental Health Court Participants: Implications for Completion and Recidivism
Authors: Jaggers Jeremiah W. , Prince Kort , Castillo Jason , Walker Allyn
Published: May 2023

The aims of this study were to (a) classify the types of individuals who might be most appropriately served by a mental health court (MHC) and (2) describe the association between class membership on recidivism and MHC completion. Criminal and treatment history data for 350 MHC participants were used. Class memberships were derived using hidden Markov models. Mediation analysis was then used determine the relationship between class, successful MHC completion, and recidivism. Modeling identified a three-class solution and a subsequent path analysis found that those classes associated with lower criminal justice system involvement were more likely to finish MHC successfully and were less likely to recidivate. This study supports research showing patterns of criminal behavior and health/mental health service use is associated with MHC completion and recidivism. The classification of individuals presented here may help court professionals determine to whom MHC should be offered.
Preoperative Dehydration Increases the Risk of Extended Length of Hospital Stay Following Total Ankle Arthroplasty
Authors: Quan Theodore , Magruder Matthew , Chen Frank R. , Tabaie Sean , Best Matthew J. , Aiyer Amiethab
Published: May 2023

Introduction

The effects of preoperative dehydration on outcomes following total ankle arthroplasty (TAA) remain unknown. Therefore, the purpose of this study is to evaluate the association between dehydration and postoperative complications for patients undergoing TAA.

Methods

Patients undergoing TAA from 2007 to 2019 were identified in the National Surgical Quality Improvement Program (NSQIP) database. A preoperative serum blood urea nitrogen/creatinine (BUN/Cr) greater than 20 was used to define preoperative dehydration. Patients were stratified into 2 cohorts: patients who were dehydrated (BUN/Cr > 20) and patients without dehydration (BUN/Cr ≤ 20). In this analysis, various postoperative outcomes were assessed with bivariate and multivariate analyses.

Results

In total, 1033 patients underwent TAA and had their serum BUN and Cr values recorded. For both BUN and Cr, the patients in this study had their serum values recorded a mean of 15 days before their surgery. A total of 588 patients (56.9%) did not have dehydration preoperatively and 445 patients (43.1%) were dehydrated. Following adjustment on multivariate analysis, an increased risk of extended length of hospital stay (odds ratio [OR] = 1.457; p = 0.024) was seen in the dehydrated group compared with those who were noted to be well hydrated.

Conclusion

As fluid intake is one modifiable preoperative variable that can be easily monitored during elective procedures, it is important for physicians to be aware of patients who are dehydrated and adjust their fluids appropriately to optimize postoperative outcomes.

Levels of Evidence:

Level III: Retrospective cohort study
Feasibility, acceptance and factors related to the implementation of telemedicine in rural areas: A scoping review protocol
Authors: Aufa Badra Al , Nurfikri Ari , Mardiati Wiwiet , Sancoko Sancoko , Yuliyanto Heri , Nurmansyah Mochamad Iqbal , Arumsari Imas , Koire Ibrahim Isa
Published: May 2023

Background

Telemedicine is a quickly developing service that offers more people the access to effective and high-quality healthcare. Societies residing in rural places tend to travel long distances to receive health care, usually have limited access to health care and/or postpone getting health care until a health emergency occurs. However, for telemedicine services to be accessible, a number of prerequisites including the availability of cutting-edge technology and equipment in rural areas must be present.

Objective

This scoping review aims to collect all available data on the viability, acceptability, challenges and facilitators of telemedicine in rural areas.

Methods

PubMed, Scopus and Medical collection of ProQuest are the databases chosen for an electronic search of the literature. Identification of the title and abstract will be followed by an evaluation of the paper's accuracy and eligibility in a two-fold mode; whereas the identification of papers will be openly and completely described using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) flowchart.

Conclusion

This scoping review would be among the first to offer a thorough evaluation of issues related to the viability, acceptance and implementation of telemedicine in rural areas. In order to improve the conditions of supply, demand and other circumstances relevant to the implementation of telemedicine, the results would be helpful in providing direction and recommendations for future developments in the usage of telemedicine, particularly in rural areas.
Neurodata Tracker: Software for computational assessment of hand motor skills based on optical motion capture in a virtual environment
Authors: López David , Casado-Fernández Laura , Fernández Fernando , Fuentes Blanca , Larraga-García Blanca , Rodríguez-Pardo Jorge , Hernández David , Alonso Elisa , Díez-Tejedor Exuperio , Gutiérrez Álvaro , Alonso de Leciñana María
Published: May 2023

Objectives

Deficits affecting hand motor skills negatively impact the quality of life of patients. The NeuroData Tracker platform has been developed for the objective and precise evaluation of hand motor deficits. We describe the design and development of the platform and analyse the technological feasibility and usability in a relevant clinical setting.

Methods

A software application was developed in Unity (C#) to obtain kinematic data from hand movement tracking by a portable device with two cameras and three infrared sensors (leap motion®). Four exercises were implemented: (a) wrist flexion-extension (b) finger-grip opening-closing (c) finger spread (d) fist opening-closing. The most representative kinematic parameters were selected for each exercise. A script in Python was integrated in the platform to transform real-time kinematic data into relevant information for the clinician. The application was tested in a pilot study comparing the data provided by the tool from ten healthy subjects without any motor impairment and ten patients diagnosed with a stroke with mild to moderate hand motor deficit.

Results

The NeuroData Tracker allowed the parameterization of kinematics of hand movement and the issuance of a report with the results. The comparison of the data obtained suggests the feasibility of the tool for detecting differences between patients and healthy subjects.

Conclusions

This new platform based on optical motion capturing provides objective measurement of hand movement allowing quantification of motor deficits. These findings require further validation of the tool in larger trials to verify its usefulness in the clinical setting.
Development of the information quality scale for health information supply chain type 2 diabetes mellitus management using exploratory factor analysis
Authors: Karimah Rinda Nurul , Kusnanto Hari , Lazuardi Lutfan
Published: May 2023

Background:

Research on the quality scale of the healthcare supply chain is still limited. This study aimed to assess the information quality of the supply chain model with a focus on construct validity. Studies related to information quality measurement generally focus on measuring the dimensions of the completeness of medical records and consumer perspectives. We intended to assess the scale based on doctors needed as care coordinators on type 2 diabetes mellitus or the Non-Insulin-Dependent-Diabetes-Mellitus (NIDDM) program in primary healthcare.

Methods:

Sixty-four primary healthcare doctors with an age range of 24–51 years were involved in this research. The scale obtained was formed from the assessment of the point of view of a panel of experts through the content validity index (CVI). The exploratory factor analysis (EFA) method was used to explore the scale of information quality in the information supply chain model for the NIDDM chronic disease management program.

Result:

The data analysis results indicated three main factors that affected the quality of the information supply chain model of NIDDM, namely accessibility, safety, and efficiency of information related to NIDDM. The results of the validity and reliability of the data showed that the scale used in this research was valid and reliable with a Cronbach alpha coefficient of 0.861.

Conclusion:

The scale developed in this research could be used to explore the quality of the information supply chain of NIDDM management in primary healthcare. Each item on the scale could explain the variables according to their respective groups.
Heterogeneity of treatment effects by risk in pulmonary arterial hypertension
Authors: Pan Hao-Min , McClelland Robyn L. , Moutchia Jude , Appleby Dina H. , Fritz Jason S. , Holmes John H. , Minhas Jasleen , Palevsky Harold I. , Urbanowicz Ryan J. , Kawut Steven M. , Al-Naamani Nadine
Published: May 2023

Background

It is currently unknown if disease severity modifies response to therapy in pulmonary arterial hypertension (PAH). We aimed to explore if disease severity, as defined by established risk-prediction algorithms, modified response to therapy in randomised clinical trials in PAH.

Methods

We performed a meta-analysis using individual participant data from 18 randomised clinical trials of therapy for PAH submitted to the United States Food and Drug Administration to determine if predicted risk of 1-year mortality at randomisation modified the treatment effect on three outcomes: change in 6-min walk distance (6MWD), clinical worsening at 12 weeks and time to clinical worsening.

Results

Of 6561 patients with a baseline US Registry to Evaluate Early and Long-Term PAH Disease Management (REVEAL 2.0) score, we found that individuals with higher baseline risk had higher probabilities of clinical worsening but no difference in change in 6MWD. We detected a significant interaction of REVEAL 2.0 risk and treatment assignment on change in 6MWD. For every 3-point increase in REVEAL 2.0 score, there was a 12.49 m (95% CI 5.86–19.12 m; p=0.001) greater treatment effect in change in 6MWD. We did not detect a significant risk by treatment interaction on clinical worsening with most of the risk-prediction algorithms.

Conclusions

We found that predicted risk of 1-year mortality in PAH modified treatment effect as measured by 6MWD, but not clinical worsening. Our findings highlight the importance of identifying sources of treatment heterogeneity by predicted risk to tailor studies to patients most likely to have the greatest treatment response.
Pre-excited atrial fibrillation revealed at a very delayed age: case report
Authors: Diallo Thierno Hamidou , Faraj Raid , Hilal Safae , Lahraoui Myriam , Kisra Oualid , Benmessaoud Fatima-Azzahra , Doghmi Nawal , Fellat Ibtissam , Cherti Mohamed
Published: May 2023

Background

Wolff-Parkinson-White (WPW) syndrome is a condition characterized by the persistence of an accessory pathway responsible for ventricular pre-excitation that can lead to symptomatic and potentially severe arrhythmias. Coexistence with atrial fibrillation is well known and not uncommon, exposing to potential degenerescence into ventricular fibrillation when atrial impulses are transmitted along the accessory pathway. WPW syndrome is most prevalent in younger patients and cases revealed after an advanced age have rarely been described in the literature.

Case presentation

Here, we report a case of atrial pre-excitation first diagnosed at the age of 72 years that required external electrical cardioversion with a favorable outcome. The diagnosis was based on clinical and electrographic findings.

Conclusions

WPW syndrome is a relatively rare cardiac disorder that can be a cause of sudden death, especially when combined with atrial fibrillation. Therefore, cardiologists have to consider this diagnosis in patients presenting clinical signs of arrhythmia with an electrical pattern of WPW.
BPTF in bone marrow provides a potential progression biomarker regulated by TFAP4 through the PI3K/AKT pathway in neuroblastoma
Authors: Jiang Chiyi , Yang Yeran , He Sidou , Yue Zhixia , Xing Tianyu , Chu Ping , Yang Wenfa , Chen Hui , Zhao Xiaoxi , Yu Yongbo , Zhang Xuan , Su Yan , Guo Yongli , Ma Xiaoli
Published: May 2023

Background

Neuroblastoma (NB) is the most common extracranial malignant solid tumor in children, which is highly prone to bone marrow (BM) metastasis. BM can monitor early signs of mild disease and metastasis. Existing biomarkers are insufficient for the diagnosis and treatment of NB. Bromodomain PHD finger transcription factor (BPTF) is an important subunit of the chromatin-remodeling complex that is closely associated with tumors. Here, we evaluated whether BPTF in BM plays an important role in predicting NB progression, and explore the molecular mechanism of BPTF in NB.

Methods

The clinical relevance of the BPTF was predicted in the GEO (GSE62564) and TARGET database. The biological function of BPTF in NB was investigated by constructing cell lines and employing BPTF inhibitor AU1. Western blot was used to determine the changes of BPTF, TFAP4, PI3K/AKT signaling and Epithelial-mesenchymal transition (EMT) related markers. A total of 109 children with newly diagnosed NB in Beijing Children's Hospital from January 2018 to March 2021 were included in this study. RT-PCR was used to measure the BPTF and TFAP4 expression in BM. The cut-off level was set at the median value of BPTF expression levels.

Results

Databases suggested that BPTF expression was higher in NB and was significantly associated with stage and grade. Proliferation and migration of NB cells were slowed down when BPTF was silenced. Mechanistically, TFAP4 could positively regulate BPTF and promotes EMT process through activating the PI3K/AKT signaling pathway. Moreover, detection of the newly diagnosed BM specimens showed that BPTF expression was significantly higher in high-risk group, stage IV group and BM metastasis group. Children with high BPTF at initial diagnosis were considered to have high risk for disease progression and recurrence. BPTF is an independent risk factor for predicting NB progression.

Conclusions

A novel and convenient BPTF-targeted humoral detection that can prompt minimal residual and predict NB progression in the early stages of the disease were identified. BPTF inhibitor AU1 is expected to become a new targeted drug for NB therapy. It’s also reveal previously unknown mechanisms of BPTF in NB cell proliferation and metastasis through TFAP4 and PI3K/AKT pathways.
Specific Streptomyces strain enhances the growth, defensive mechanism, and fruit quality of cucumber by minimizing its fertilizer consumption
Authors: Orouji Elham , Fathi Ghare baba Mohammad , Sadeghi Akram , Gharanjik Shahrokh , Koobaz Parisa
Published: May 2023

Background

The required amounts of chemical fertilizers (NPK) are determined by plant yield, and product quality is given less consideration. The use of PGPRs is an environmentally friendly approach that, in addition to increasing yield, also improves fruit quality. This study examined the role of specificStreptomycesstrains in aiding cucumber plants to 1) use fewer NPK fertilizers in the same quantity 2) improve the quality of cucumber fruit, and 3) promote growth and defense system.

Results

In this study, the effect of 17Streptomycesstrains on the vegetative traits of cucumber seedlings of the Sultan cultivar was evaluated as the first test. Four strains ofStreptomyceswith the highest root and shoot dry weight were selected from the strains. This experiment was performed to determine the interaction effect of selected strains and different amounts of NPK on cucumber yield, quality, physiological and biochemical responses of plants. The first experiment’s results revealed that strains IC6, Y7, SS12, and SS14 increased significantly in all traits compared to the control, while the other strains dramatically improved several characteristics. Analysis of variance (ANOVA) revealed significant differences between the effect of strains, NPK concentrations, and their interactions on plant traits. The treatments containing 75% NPK + SS12, yielded the most fruit (40% more than the inoculated control). Antioxidant enzymes assay showed that SS12 substantially increased the activity of POX, PPO, and the expression of the genes related to these two enzymes. Hormone assay utilizing HPLC analysis revealed that various strains employ a specific mechanism to improve the immune system of plants.

Conclusions

Treatment with strain SS12 led to the production of cucumbers with the highest quality by reducing the amount of nitrate, and soluble sugars and increasing the amount of antioxidants and firmness compared to other treatments. A specificStreptomycesstrain could reduce 25% of NPK fertilizer during the vegetative and reproductive growth period. Moreover, this strain protected plants against possible pathogens and adverse environmental factors through the ISR and SAR systems.
The m6A/m5C/m1A regulator genes signature reveals the prognosis and is related with immune microenvironment for hepatocellular carcinoma
Authors: Liu Ting , Sun Lei , Li Zhi-zhao , Yang Kun , Chen Jia-min , Han Xiao-yi , Qi Li-ming , Zhou Xin-gang , Wang Peng
Published: May 2023

Background

RNA methylation is a crucial in many biological functions, and its aberrant regulation is associated with cancer progression. N6-Methyladenosine (m6A), 5-Methylcytosine (m5C), N1-methyladenosine (m1A) are common modifications of RNA methylation. However, the effect of methylation of m6A/m5C/m1A in hepatocellular carcinoma (HCC) remains unclear.

Method

The transcriptome datasets, clinic information, and mutational data of 48 m6A/m5C/m1A regulator genes were acquired from the TCGA database, and the prognostic hazard model was established by univariate and Least absolute shrinkage and selection operator (Lasso) regression. The multivariate regression was performed to determine whether the risk score was an independent prognostic indicator. Kaplan–Meier survival analysis and ROC curve analysis were used to evaluate the predictive ability of the risk model. Decision curve analysis（DCA）analysis was conducted to estimate the clinical utility of the risk model. We further analyzed the association between risk score and functional enrichment, tumor immune microenvironment, and somatic mutation.

Result

The four-gene (YTHDF1, YBX1, TRMT10C, TRMT61A) risk signature was constructed. The high-risk group had shorter overall survival (OS) than the low-risk group. Univariate and multivariate regression analysis indicated that risk score was an independent prognostic indicator. Risk scores in male group, T3 + T4 group and Stage III + IV group were higher in female group, T1 + T2 group and stage I + II group. The AUC values for 1-, 2-, and 3-year OS in the TCGA dataset were 0.764, 0.693, and 0.689, respectively. DCA analysis showed that the risk score had a higher clinical net benefit in 1- and 2-year OS than other clinical features.The risk score was positively related to some immune cell infiltration and most immune checkpoints.

Conclusion

We developed a novel m6A/m5C/m1A regulator genes' prognostic model, which could be applied as a latent prognostic tool for HCC and might guide the choice of immunotherapies.
Sick leave and disability pension among TMD patients with musculoskeletal diseases, mental and behavioural disorders – a SWEREG-TMD population-based cohort study
Authors: Salinas Fredricson Adrian , Krüger Weiner Carina , Adami Johanna , Rosén Annika , Lund Bodil , Hedenberg-Magnusson Britt , Fredriksson Lars , Svedberg Pia , Naimi-Akbar Aron
Published: May 2023

Background

Temporomandibular disorders (TMD) are associated with musculoskeletal diseases (MSD), mental and behavioural disorders (MBD), and patients with TMD have been shown to have 2–3 times more days of sick leave (SL) and disability pension (DP) than the general population. MSD and MBD are two of the most common causes for SL and DP, and the association between TMD and the influence of comorbidities on the need for SL and DP among TMD patients need further clarification. This study investigates the impact of MSD and MBD comorbidity on SL and DP among TMD patients diagnosed in a hospital setting and/or surgically treated.

Methods

All incident TMD patients diagnosed or treated in a hospital setting between 1998 and 2016 and aged 23–59 were included. A non-exposed comparison cohort was collected from the general population. The cohorts were grouped based on the presence of comorbidity: No comorbidity (Group I); MSD comorbidity (Group II); MBD comorbidity (Group III); and combined MSD and MBD comorbidity (Group IV). Main outcomes were mean annual days of SL and DP, and statistical analysis was conducted using generalized estimated equations.

Results

TMD subjects with no comorbidities (Group I) and with MSD/MBD comorbidity (Group II and III) were 2–3 times more often on SL and DP than the corresponding groups from the general population. However, in the group with both MSD and MBD comorbidity (Group IV), the difference between the TMD subjects and the general population was diminishing, suggesting an additive effect.

Conclusion

TMD patients are more dependent on SL and DP benefits compared to general population and the difference remains even after considering MSD and MBD comorbidity. In individuals with combined MSD and MBD comorbidity, concurrent TMD has less impact on the need for social insurance benefits. The results accentuate the impact TMD has on the patients’ impaired ability to return to work and why TMD should be recognized as having a substantial impact on individual and economic suffering as well as on societal costs, with emphasis on the influence of comorbidities on patient suffering.
A novel biplanar positioning technique to guide iliosacral screw insertion: a retrospective study
Authors: Zhao Yangyang , Cui Pengju , Xiong Zhenggang , Zheng Jiachun , Xing Deguo
Published: May 2023

Purpose

To evaluate the safety and benefits of the biplanar position technique on operative time, radiation exposure, and screw placement accuracy.

Methods

In this study, we retrospectively evaluated the records of 64 patients with pelvic fractures (Tile B and C) between October 2020 and September 2021. According to the surgical methods selected by the patients, the patients were divided into a biplanar positioning technique group (biplanar group), a Ti-robot navigation group (Ti-robot group), and a traditional fluoroscopy-guided technique group (traditional group). Length of operation, blood loss, intra-operative radiation exposure fracture reduction, and the quality of screw positioning were compared among the three groups.

Results

One hundred three screws were implanted in 64 patients (biplanar group 22, Ti-robot group 21, traditional group 21). The average operation time was significantly less in the biplanar group (26.32 ± 6.32 min) than in the traditional group (79.24 ± 11.31 min), but significantly more than in the Ti-robot group (15.81 ± 3.9 min). The radiation exposure was similar in the biplanar group (740.53 ± 185.91 cGy/cm2) and Ti-robot group (678.44 ± 127.16 cGy/cm2), both of which were significantly more than in the traditional group (2034.58 ± 494.54 cGy/cm2). The intra-operative blooding loss was similar in the biplanar group (12.76 ± 3.77 mL) and the Ti-robot group (11.92 ± 4.67 mL), both of which were significantly less than in the traditional group (29.7 ± 8.01 mL). The Screw perforation was slightly lower in the biplanar group (94.1%) than in the Ti-robot group (97.2%) but was significantly higher than in the traditional group (75.7%).

Conclusions

The biplanar positioning technique is as accurate and safe as computer-navigated systems for percutaneous iliosacral screw insertion, associated with shorter surgical time, lower intra-operative radiation exposure, and more accuracy compared to traditional fluoroscopy.
Serum concentrations of IL-16 and its genetic polymorphism rs4778889 affect the susceptibility and severity of endometriosis in Nigerian women
Authors: Babah Ochuwa Adiketu , Ojewunmi Oyesola Oyewole , Onwuamah Chika Kingsley , Udenze Ifeoma Christiana , Osuntoki Akinniyi Adediran , Afolabi Bosede Bukola
Published: May 2023

Background

Endometriosis is the presence of active ectopic endometrial glands and stroma at other sites outside the uterine cavity. It is a common cause of chronic pelvic pain which is sometimes debilitating, and inflammation is one of the known triggers of endometriosis. Interleukins 6 and 16 (IL-6 and IL-16) are proinflammatory cytokines which play essential roles in inflammatory diseases. We therefore investigated the relationship between genetic polymorphisms of interleukins 6 and 16, and the development of endometriosis in Nigerian women.

Method

One hundred and thirty (130) consenting women were consecutively enrolled, sixty-five (65) of whom had endometriosis and 65 age-matched women as reference group, surgically confirmed as not having endometriosis. Spectrophotometric determination of serum concentrations of Interleukins 6 and 16 was carried out and the genotyping of IL-6 (rs1800795) and IL-16 (rs4778889, rs11556218, rs4072111) genes were performed using TaqMan assays.

Results

Serum IL-16 concentration was significantly higher in women with severe chronic pelvic pain compared to those with mild pain (p = 0.023). The C allele of rs4778889 was associated with endometriosis (OR: 1.80, 95% CI: 1.08 – 3.02, p = 0.024).

Conclusion

Serum IL-16 and IL-16 rs4778889 may be important markers for endometriosis in Nigerian, and by extension, African women. Multicentre African studies would clarify this.
Is it too complex? A survey of pediatric residency program’s educational approach for the care of children with medical complexity
Authors: Sieplinga Kira , Kruger Christopher , Goodwin Emily
Published: May 2023

Background

Although Entrustable Professional Activities (EPAs) regarding pediatric training in care for children with medical complexity (CMC) exist, it is unknown what US pediatric training programs provide for education related to care of CMC and whether educators perceive that pediatric residents are prepared to care for CMC upon graduation.

Methods

From June, 2021 through March 2022, we surveyed US pediatric residency program delegates about practice settings, current educational offerings, perception of resident preparedness regarding care of CMC, and likelihood to implement CMC education in the future.

Results

Response rate was 29% (56 /195). A third of responding programs (34%, n = 19) provide a specific educational CMC offering including combinations of traditional didactics (84%, n = 16), asynchronous modules/reading (63%, n = 12), experiential learning (58%, n = 11), and simulation-based didactics (26%, n = 5). The majority (93%, n = 52) of respondents agreed residents should be competent in providing primary care for CMC upon graduation and CMC should receive primary care from a resident (84%, n = 47). A total of 49% (n = 27) of respondents reported their residents are very or extremely well prepared to care for CMC after graduation. A total of 33% (n = 18) of programs reported CMC receive primary care from residents. Respondent average perception of resident preparedness was significantly higher in programs with educational offerings in five of eleven EPAs (nutrition and weight, transitions, feeding tubes, advocacy, and care coordination). The majority (78%, n = 29) of programs without educational offerings are at least somewhat likely to implement CMC curricula in the next three years.

Conclusion

Pediatric residency programs report residents should be competent in care for CMC upon graduation. Pediatric residents are exposed to a wide variety of clinical care models for CMC. The minority of responding programs have intentional CMC educational offerings. Of those programs that provide CMC education, the offerings are variable and are associated with a perception of improved preparedness to care for CMC upon graduation.
Clinicians’ satisfaction with laboratory services and associated factors at public health facilities in Northeast Ethiopia
Authors: Abebe Daniel Dagne , Temesgen Minwuyelet Maru , Abozin Addisu Tesfie
Published: May 2023

Background

Satisfaction has become a key measure of quality and an important tool for improvement. Laboratories are increasingly required to regularly assess satisfaction of their customers. This study aimed to assess clinicians’ satisfaction with laboratory services and associated factors at public health facilities.

Methods

A facility-based cross-sectional study was conducted in Northeast Ethiopia from May to June 2019. Eight hospitals and 24 health centres were first selected using a stratified sampling method, and a total of 224 randomly selected clinicians were included. Satisfaction with multiple aspects of laboratory services was assessed using a self-administered questionnaire, on a rating scale of 1 (very dissatisfied) to 5 points (very satisfied). Laboratory quality assessment was performed using WHO-AFRO’s stepwise accreditation checklist. Multivariable logistic regression model was fitted to determine the association between independent variables and clinicians’ overall satisfaction level using STATA ver14.1. A p-value < 0.05 was considered significant.

Results

Overall, 72.8% of the clinicians were satisfied. Lowest mean ratings were obtained for the helpfulness of the laboratory handbook (3.3), provision of STAT/urgent services (3.7), and adequacy of tests provided (3.8). The clinicians’ timely receipt of results (AOR = 2.3, 95% CI = 1.1–5.0), notification of panic results (AOR = 2.5, 95% CI = 1.1–5.6), perceived quality/reliability of test results (AOR = 3.1, 95% CI = 1.5–6.3), and the laboratories’ rate of concordant malaria microscopy results (AOR = 4.1, 95% CI = 1.8–9.3), were significantly associated with satisfaction.

Conclusions

Nearly one-third of clinicians were not satisfied with the laboratory services. Laboratory managers should emphasize the timely communication of STAT/urgent and panic results, and the reliability of test results, to improve users’ satisfaction and overall quality of care.
Gastric cancer cell-originated small extracellular vesicle induces metabolic reprogramming of BM-MSCs through ERK-PPARγ-CPT1A signaling to potentiate lymphatic metastasis
Authors: Huang Jiaying , Wang Xiang , Wen Jing , Zhao Xinxin , Wu Chen , Wang Lin , Cao Xiaoli , Dong Haibo , Xu Xuejing , Huang Feng , Zhu Wei , Wang Mei
Published: May 2023

Tumor microenvironment and metabolic reprogramming are critical for tumor metastasis. Bone marrow-derived mesenchymal stem cells (BM-MSCs) are widely involved in the formation of tumor microenvironment and present oncogenic phenotypes to facilitate lymph node metastasis (LNM) in response to small extracellular vesicles (sEV) released by gastric cancer (GC) cells. However, whether metabolic reprograming mediates transformation of BM-MSCs remains elusive. Herein, we revealed that the capacity of LNM-GC-sEV educating BM-MSCs was positively correlated with the LNM capacity of GC cells themselves. Fatty acid oxidation (FAO) metabolic reprogramming was indispensable for this process. Mechanistically, CD44 was identified as a critical cargo for LNM-GC-sEV enhancing FAO via ERK/PPARγ/CPT1A signaling. ATP was shown to activate STAT3 and NF-κB signaling to induce IL-8 and STC1 secretion by BM-MSCs, thereby in turn facilitating GC cells metastasis and increasing CD44 levels in GC cells and sEV to form a persistent positive feedback loop between GC cells and BM-MSCs. The critical molecules were abnormally expressed in GC tissues, sera and stroma, and correlated with the prognosis and LNM of GC patients. Together, our findings uncover the role of metabolic reprogramming mediated BM-MSCs education by LNM-GC-sEV, which presents a novel insight into the mechanism underlying LNM and provides candidate targets for GC detection and therapy.
Geographic and urban–rural disparities in dietary energy and macronutrient composition among women of childbearing age: findings from the China health and nutrition survey,1991–2015
Authors: Zhao Jian , Zuo Lijun , Sun Jian , Su Chang , Wang Huijun
Published: May 2023

Background

Understanding nutritional status among women of childbearing age (WCA) is of increasing concern, as nutrient intakes may affect the health of WCA and well-being of their offspring. This study aimed to investigate secular trends of dietary energy and macronutrients intakes and access longitudinally the urban-rural and geographic disparities among Chinese WCA.

Methods

A total of 10,219 participants were involved in three rounds of the Chinese Health and Nutrition Survey (CHNS:1991, 2004, and 2015). Average macronutrients intakes were compared against the Chinese Dietary Reference Intakes Standard (DRIs) to better assess adequacy. Mixed effect models were used to estimate the secular trends of dietary intake.

Results

A total of 10,219 participants were involved. Dietary fat, the percentage of energy (%E) from fat, and the proportion with more than 30% of energy from fat and less than 50% from carbohydrates increased notably over time (p < 0.001). In 2015, urban western WCA had the most dietary fat (89.5 g/d), %E from fat (41.4%), with the highest proportion of energy from fat (81.7%) and carbohydrate (72.1%) out the range of DRIs. From 1991 to 2015, the average urban-rural differences in dietary fat decreased from 15.7 g/d to 3.2 g/d among eastern WCA. However, it increased to 16.4 g/d and 6.3 g/d among central and western WCA, respectively.

Conclusion

WCA was experiencing a rapid transformation to a high-fat diet. Temporal variation with obvious urban-rural and geographic disparities in dietary. energy and macronutrient composition persistently existed among Chinese WCA.These findings have implications of future public strategies to strengthen the nutrition propaganda and education of balanced diet for WCA to help them to improve their nutritional status, especially for those living in western China.
Crosstalk between macrophages and cardiac cells after myocardial infarction
Authors: Jian Yuhong , Zhou Xiao , Shan Wenju , Chen Cheng , Ge Wei , Cui Jun , Yi Wei , Sun Yang
Published: May 2023

Cardiovascular diseases, such as myocardial infarction (MI), are a leading cause of death worldwide. Acute MI (AMI) inflicts massive injury to the coronary microcirculation, causing large-scale cardiomyocyte death due to ischemia and hypoxia. Inflammatory cells such as monocytes and macrophages migrate to the damaged area to clear away dead cells post-MI. Macrophages are pleiotropic cells of the innate immune system, which play an essential role in the initial inflammatory response that occurs following MI, inducing subsequent damage and facilitating recovery. Besides their recognized role within the immune response, macrophages participate in crosstalk with other cells (including cardiomyocytes, fibroblasts, immune cells, and vascular endothelial cells) to coordinate post-MI processes within cardiac tissue. Macrophage-secreted exosomes have recently attracted increasing attention, which has led to a more elaborate understanding of macrophage function. Currently, the functional roles of macrophages in the microenvironment of the infarcted heart, particularly with regard to their interaction with surrounding cells, remain unclear. Understanding the specific mechanisms that mediate this crosstalk is essential in treating MI. In this review, we discuss the origin of macrophages, changes in their distribution post-MI, phenotypic and functional plasticity, as well as the specific signaling pathways involved, with a focus on the crosstalk with other cells in the heart. Thus, we provide a new perspective on the treatment of MI. Further in-depth research is required to elucidate the mechanisms underlying crosstalk between macrophages and other cells within cardiac tissue for the identification of potential therapeutic targets.
Efficacy comparison of vascularized iliac crest bone flap and Ilizarov bone transport in the treatment of traumatic bone defects of the tibia combined with large soft tissue defects
Authors: Cao Zhe-ming , Sui Xin-lei , Xiao Yu , Qing Li-ming , Wu Pan-feng , Tang Ju-yu
Published: May 2023

Background

Traumatic tibial defect complicated with soft tissue defect is a difficult problem in clinic. Vascularized iliac crest bone flap (VIBF) and Ilizarov bone transport are effective methods to treat tibial defects with limited defect length, which most need to be explored accordingly.

Methods

In this study, a total of 68 patients with traumatic tibial defect (ranging from 4 to 10 cm) and large soft tissue defect were collected retrospectively. The soft tissue defects were repaired by latissimus dorsal musculocutaneous flap (LD), anterolateral thigh flap (ALTF) or both. Thirty-three cases were treated with vascularized iliac crest bone flap transplantation and 35 cases were treated with Ilizarov bone transport. Intraoperative and postoperative follow-up data (including operation time, blood loss, bone union time, external fixation time, external fixation index, complication rate, reoperation rate, and functional evaluation) were recorded, and comparative analysis was performed.

Results

The median follow-up time was 32 months. Compared with Ilizarov group, the VIBF group exhibited statistically faster bone union time (6.3 ± 1.0 vs. 18.2 ± 3.0 months). Moreover, the VIBF group showed shorter EFT (7.3 ± 1.0 vs. 19.2 ± 3.0 months) and a better EFI (34.8 ± 9.2 vs. 84.2 ± 23.7 days/cm). The excellent and good rate of lower limb appearance evaluation in VIBP group was significantly better than that in Ilizarov group. The complication rate and reoperation rate were significantly higher in Ilizarov group.

Conclusion

In summary, compared with Ilizarov bone transport, VIBP has the advantages of faster healing, shorter external fixation time, lower complication and reoperation rate, and better appearance within the limited defect length. Ilizarov bone transport is still preferred when the defect length exceeds the maximum repair length of the iliac flap. The daily handling required by bone transport process is painful.

Level of evidence

III, Case–control study.
Bushen-Yizhi formula ameliorates mitochondrial dysfunction and oxidative stress via AMPK/Sirt1 signaling pathway in D-gal-induced aging rats
Authors: Liao Yanfang , Lai Yiyi , Xu Huilin , Gao Li , Fu Xiaomei , Wang Xue , Wang Qi , Shen Jiangang , Fang Jiansong , Fang Shuhuan
Published: May 2023

Background

As a major risk factor for neurodegenerative diseases, aging has become a heavy health care burden worldwide. Age-related decline in mitochondrial function and oxidative stress is strongly associated with neurodegeneration. The previous study demonstrated that Bushen-Yizhi formula (BSYZ), a traditional Chinese medicine formula, is effective in reducing neurodegeneration.

Methods

This study is the first to investigate the effect of BSYZ on D-gal-induced learning memory in rats. Secondly, the potential metabolic mechanism of BSYZ was explored by 1H-NMR metabolomics analysis. Then based on the comparison of differential metabolites implied that BSYZ ameliorated mitochondrial dysfunction through choline metabolic pathway in D-gal-treated rats. Finally, pharmacological validation was conducted to explore the effects of BSYZ on D-gal-induced oxidative stress, neuroinflammation, and neuronal apoptosis.

Results

Our data showed that BSYZ increased aspartate and betaine levels, while decreasing choline levels. Furthermore, BSYZ also increased the proteins level of CHDH and BHMT to regulate choline metabolic pathway. Meanwhile, BSYZ alleviated mitochondrial damage and oxidative stress, including enhanced ATP production and the ratio of NAD+/NADH, reduced the level of MDA, enhanced GSH and SOD activity, upregulated the expressions of p-AMPK, SIRT1 proteins. In addition, BSYZ downregulated the levels of inflammatory cytokines, such as TNF-α, IL-1β and IL-6, as well as suppressed Bcl-2 proteins family dependent apoptosis.

Conclusion

BSYZ treatment effectively rescues neurobehavioral impairment by improving mitochondrial dysfunction, oxidative stress, neuroinflammation and neuroapoptosis via AMPK/SIRT1 pathway in D-gal-induced aging.
IMPOWER: a national patient-generated registry for intestinal malrotation exploring diagnosis, treatment, and surgical outcomes
Authors: Martinez Sydney A. , Fligor Scott C. , Tsikis Savas , Short Meagan , Corcoran Katie E. , Rogers Amy , Gura Kathleen M. , Puder Mark
Published: May 2023

Background

Intestinal malrotation is a rare congenital condition with potentially devastating consequences due to potential volvulus and massive intestinal necrosis. Diagnosis is often delayed and long-term symptoms following surgical correction are poorly characterized. We developed theIntestinal Malrotation Patient Outcomes and WEllness Registry (IMPOWER), a national patient-generated registry (PGR), to capture data related to presenting symptoms, testing, diagnosis, treatment, and follow-up of individuals diagnosed with malrotation. IMPOWER captures patient-reported information from adult patients and parents/caregivers of children diagnosed with malrotation at the time of enrollment and at ongoing 6-month intervals. We present baseline characteristics of patients enrolled during the first two months of the registry.

Results

Within the first two months, 354 patients with malrotation enrolled in IMPOWER, and 191 (53.9%) completed all baseline assessments. Nearly 90% of the 119 pediatric participants and 37.7% of the 72 adult participants experienced symptoms prior to diagnosis. Vomiting was the predominant symptom for pediatric participants compared to abdominal pain in adults. Yellow bilious emesis was more commonly reported than green, and volvulus at diagnosis occurred in 70% of pediatric and 27% of adult participants. One-third of pediatric participants had a bowel resection as part of their initial surgical procedure, resulting in 23.4% with diagnosed short bowel syndrome. More than 60% of pediatric and 80% of adult registrants reported gastrointestinal symptoms that persisted throughout the first year following their initial operation. Approximately 25% of registrants reported visiting four or more gastroenterologists for management of ongoing symptoms.

Conclusions

Fewer than half of pediatric patients presented with the “classic” presentation of green bilious colored emesis. Yellow bilious emesis was more commonly reported, and chronic gastrointestinal symptoms (i.e., abdominal pain, reflux, constipation, diarrhea) and feeding intolerance were common following surgical procedures for malrotation. This novel PGR highlights the need for a multicenter prospective registry to characterize the natural history and develop consistent standards of care related to the diagnosis, treatment, and long-term care for patients with malrotation.