bluuebunny/crossref_metadata_2025 huggingface dataset:
Mg–Fe Isotopes Link the Geochemical Complexity of the Coldwell Complex, Midcontinent Rift to Metasomatic Processes in the Mantle
Authors: Brzozowski Matthew J , Good David J , Yan Weihao , Wu Changzhi , An Shichao , Li Weiqiang
Published: August 2022

Mafic intrusions in the Coldwell Complex have previously been interpreted as forming from a metasomatized mantle source. To build upon our understanding of this metasomatism, the Mg–Fe isotope compositions of these rocks have been determined, and variations are assessed with respect to the magmatic processes that could have occurred at different stages of their formation. The mineralized Marathon Series (δ26Mg = −0.28‰ to −0.19‰), associated metabasalt (δ26Mg = −0.24‰ to −0.23‰), and the Geordie Lake gabbro (δ26Mg = −0.31‰ to −0.22‰) are characterized by δ26Mg values that are within the range of mantle values, whereas the unmineralized Layered Series (δ26Mg = −0.2‰ to −0.05‰) is heavier than mantle. In contrast, the δ56Fe values of all the Coldwell basaltic–gabbroic rocks (δ56Fe = 0.07 ± 0.08‰) are heavier than mantle but within the range of terrestrial basalts and mafic–ultramafic layered intrusions. We propose that the Mg–Fe isotope compositions of these rocks was not significantly modified by processes such as partial melting or garnet retention/fractionation in the mantle, fractional crystallization, or contamination during ascent through the crust, as the isotope values do not correlate with proxies for these processes (e.g. La/Sm and La/Yb, Gd/Yb, MgO–CaO–TiO2, and Th/Nb and Th/La, respectively). Their isotope compositions are, therefore, proposed to reflect the compositions of their metasomatized mantle sources. We conclude that metasomatism was not caused by a carbonate melt, subduction-altered oceanic crust and sediments, or an evolved silicate melt, as these processes generate light δ26Mg, variably fractionated δ56Fe, and heavy δ56Fe values, respectively, which are not observed in our dataset for the Coldwell Complex. The agent that metasomatized the mantle beneath the Coldwell Complex was likely slab-derived fluids characterized by isotopically heavy δ26Mg and basaltic δ56Fe values. This scenario can account for the lack of Fe isotope fractionation from basaltic values in all of the Coldwell rocks. The variably heavier δ26Mg of the Layered Series (−0.20 ± 0.01‰ to −0.05 ± 0.05‰) relative to the mantle (−0.25 ± 0.07‰) suggests that the magmas for the Coldwell rocks were derived by tapping of an isotopically heterogeneous mantle source that had undergone variable degrees of metasomatism. The distinctive geochemistry of mafic sequences in the Coldwell and numerous mafic dykes located in the northeast shoulder of the Midcontinent Rift suggests the presence of a variably metasomatized mantle source beneath a large area of the rift.
The Domestic Impact of International Shaming
Authors: Koliev Faradj , Page Douglas , Tallberg Jonas
Published: August 2022

Do international shaming efforts affect citizens’ support for government policies? While it is a frequent claim in the literature that shaming works through domestic politics, we know little about how and when international criticism affects domestic public opinion. We address this question through an originally designed survey experiment in Sweden, which (i) compares the effects of international shaming in two issue areas—human rights and climate change, and (ii) tests whether government responses to criticism moderate the impact of shaming. Our main findings are fourfold. First, we find substantial effects of international shaming on domestic public opinion. These effects hold across both issue areas and irrespective of whether citizens support government parties or not. Second, human rights shaming has a stronger impact on citizens’ support for government policies than climate shaming. Third, shaming is most effective among citizens who are more supportive of climate action, human rights, and international cooperation. Finally, our findings are mixed with respect to the effect of government responses. While government responses do not moderate the effects of human rights shaming, they seem to mitigate the effects of climate shaming.
The footprint of a metrics-based research evaluation system on Spain’s philosophical scholarship: An analysis of researchers’ perceptions
Authors: Feenstra Ramón A , Delgado López-Cózar Emilio
Published: August 2022

The use of bibliometric indicators in research evaluation has a series of complex impacts on academic inquiry. These systems have gradually spread into a wide range of locations and disciplines, including the humanities. The aim of this study is to examine their effects as perceived by philosophy and ethics researchers in Spain, a country where bibliometric indicators have long been used to evaluate research. The study uses a mixed approach combining quantitative and qualitative data from a self-administered questionnaire completed by 201 researchers and from 14 in-depth interviews with researchers selected according to their affiliation, professional category, gender, and area of knowledge. Results show that the evaluation system is widely perceived to affect university researchers in significant ways, particularly related to publication habits (document type and publication language), the transformation of research agendas and the neglect of teaching work, as well as increasing research misconduct and negatively affecting mental health. Although to a lesser extent, other consequences included increased research productivity and enhanced transparency and impartiality in academic selection processes.
Urinary CD163 is a marker of active kidney disease in childhood-onset lupus nephritis
Authors: Inthavong Haleigh , Vanarsa Kamala , Castillo Jessica , Hicks M John , Mohan Chandra , Wenderfer Scott E
Published: August 2022

Objective

The objective of this study was to evaluate the utility of urine CD163 for detecting disease activity in childhood-onset SLE (cSLE) patients.

Methods

Sixty consecutive pediatric patients fulfilling four or more ACR criteria for SLE and 20 healthy controls were recruited for testing of urinary CD163 using ELISA. SLE disease activity was assessed using the SLEDAI-2K.

Results

Urine CD163 was significantly higher in patients with active LN than inactive SLE patients and healthy controls, with receiver operating characteristics area under the curve values ranging from 0.93 to 0.96. LN was ascertained by kidney biopsy. Levels of CD163 significantly correlated with the SLEDAI, renal SLEDAI, urinary protein excretion and C3 complement levels. Urine CD163 was also associated with high renal pathology activity index and chronicity index, correlating strongly with interstitial inflammation and interstitial fibrosis based on the examination of concurrent kidney biopsies.

Conclusion

Urine CD163 emerges as a promising marker for identifying cSLE patients with active kidney disease. Longitudinal studies are warranted to validate the clinical utility of urine CD163 in tracking kidney disease activity in children with lupus.
Novel welfare state responses in times of crises: the COVID-19 crisis versus the Great Recession
Authors: O’Donoghue Cathal , Sologon Denisa M , Kyzyma Iryna
Published: August 2022

Using microsimulation tools, we explore the social policy responses to the Great Recession and the COVID-19 crisis, and their impact on preserving living standards in Ireland. During the Great Recession, the focus was on cost reduction. By contrast, during the COVID-19 crisis, the focus was on mitigating the impact on household incomes. In addition, an innovation in joint public and private responses emerged through social partnership. We find a stronger policy response during the COVID-19 crisis than the Great Recession. The COVID-19 crisis was more rapid, leaving more individuals out of work, thus family support was weaker. This was compensated by stronger private support through social partnership. Consequently, those with lower incomes had larger disposable incomes at the onset of the crisis; an effect that reduced with policy learning. We find increasing trust in public institutions during the COVID-19 crisis as opposed to a decline during the Great Recession.
Healthcare Use and Case Characteristics of Commercial Sexual Exploitation of Children
Authors: Hornor Gail , Hollar Jessica , Landers Timothy , Sherfield Jennifer
Published: August 2022

Introduction

The overall goal of this study was to provide further information about the characteristics of commercial sexual exploitation of children (CSEC) victims by comparing the characteristics of a known victim pool to high-risk patients identified. The specific objectives of this study were to describe patient demographic characteristics, pediatric healthcare use, familial psychosocial characteristics, and child sexual abuse case characteristics present in youth identified as high risk for CSEC victimization compared with a sample of known victims.

Methods

A retrospective chart review was conducted on patients presenting to the emergency department or Child Advocacy Center for a concern of sexual abuse/assault at a midwestern U.S. academic pediatric medical center. Adolescents aged 12–21 years were included in the study.

Results

In the current study, multiple CSEC risk factors were noted to increase odds for CSEC victimization: homelessness or life on the streets, runaway behavior, living with mother only, placement in a juvenile detention center, placement in a residential treatment center or group home, and number of living arrangements (four or greater). Multiple elements of high-risk sexual behavior increased odds of CSEC victimization: legally age-inappropriate sex, gonorrhea diagnosis, trichomonas diagnosis, other sexually transmitted infection (STI) diagnoses, number of STIs, and chlamydia diagnosis.

Discussion

These findings suggest that age of sexual partners and number and types of STIs are associated with CSEC and should be validated in other groups. In addition, these data suggest that use of cocaine and opiates could serve as an important, yet underrecognized, risk factor.
Utility of Narrow-band Imaging Bronchoscopy in the Diagnosis of Endobronchial Sarcoidosis
Authors: Dhooria Sahajal , Sehgal Inderpaul Singh , Bal Amanjit , Muthu Valliappan , Prasad Kuruswamy Thurai , Gupta Nalini , Ram Babu , Aggarwal Ashutosh N. , Agarwal Ritesh
Published: August 2022

Background:

There are few reports on the utility of bronchoscopic narrow-band imaging (NBI) for visualizing endobronchial abnormalities in sarcoidosis. Our primary objective was to compare the sensitivity of finding endobronchial abnormality using NBI versus white light bronchoscopy (WLB) in patients with sarcoidosis. The secondary aim was to evaluate the sensitivity of NBI in diagnosing endobronchial sarcoidosis against a reference standard of positive endobronchial biopsy (EBB).

Methods:

We retrospectively included subjects with sarcoidosis, where we sequentially recorded WLB and NBI videos to visualize the endobronchial mucosa. We collected data on the demographic findings, sarcoidosis stage, and the histopathological findings of transbronchial needle aspiration, EBB, and transbronchial lung biopsy. Three experienced bronchoscopists viewed the video recordings and noted the abnormalities of the airway mucosa separately on WLB and NBI.

Results:

We included 28 subjects (mean age, 42.9 y; 53.6% men; 14 each, stages 1 and 2) with a final diagnosis of sarcoidosis. Granulomas were detected on EBB in 11 (39.3%) subjects. We identified endobronchial nodules in 10 and 15 subjects on WLB and NBI. The sensitivity of finding endobronchial abnormality using WLB and NBI was 35.7% (10/28) and 53.6% (15/28), respectively (χ2=1.77, df=1, P=0.18). The sensitivity of NBI in diagnosing endobronchial sarcoidosis against a positive EBB was 63.6% (7/11 subjects). There was excellent agreement (Κ=0.86) for detecting nodules on NBI among the 3 observers.

Conclusion:

NBI might allow the identification of additional abnormalities not detected on WLB in sarcoidosis. Larger studies are required to confirm our observations.
Impact of an Endolymphatic Sac Tumor on Subjective and Objective Audiovestibular Function
Authors: Hansen Jonathan Olsgård , West Niels Cramer , Cayé-Thomasen Per
Published: August 2022

Objective

This study reports subjective and objective audiovestibular function in patients diagnosed with an endolymphatic sac tumor (ELST), to evaluate the clinical implication of vestibular testing in ELST patients.

Study Design

Retrospective cohort study.

Setting

Tertiary referral center/university hospital.

Patients

Five patients diagnosed with unilateral ELST.

Intervention

Subjective and objective audiovestibular tests; pure-tone average; speech discrimination score; the Video Head Impulse Test; the cervical vestibular evoked myogenic potential test; the caloric irrigation test; the Speech, Spatial and Qualities of Hearing Scale; the Tinnitus Handicap Inventory; and the Dizziness Handicap Inventory.

Main Outcome Measure

Findings and characteristics of both subjective and objective audiovestibular functions.

Results

The mean pure-tone average and the mean speech discrimination score were 49 dB HL and 68% on the tumor ear and 13 dB HL and 99% contralaterally. The mean Speech, Spatial and Qualities of Hearing Scale score was 84, and the mean Tinnitus Handicap Inventory score was 64. Caloric testing showed a mean unilateral weakness of 80%. The Video Head Impulse Test of the lateral semicircular canal revealed refixation saccades on all tumor ears and an average gain value of 0.75 on the tumor ear versus 0.94 contralaterally. No cervical vestibular evoked myogenic potentials were elicited on the tumor side, whereas all but one was elicited contralaterally. The average Dizziness Handicap Inventory score was 47.

Conclusion

A characteristic pattern of abnormal caloric findings, refixation saccades, and normal vestibulo-ocular reflex gain alongside sensorineural hearing loss on the tumor ear was identified. Asymmetric sensorineural hearing loss in any patient should lead to objective vestibular evaluation to strengthen not only a targeted tumor surveillance strategy and the indication for imaging, but also the design of vestibular rehabilitation. In addition, vestibular findings may guide the choice of surgical approach.
Impact of Demographics and Clinical Features on Initial Treatment Pathway for Vestibular Schwannoma
Authors: Harvey Erin , Stark Katarina , Friedland David R. , Adams Jazzmyne A. , Harris Michael S. , Tong Ling , Osinksi Kristen , Luo Jake
Published: August 2022

Objective

To identify demographic and clinical features impacting initial treatment pathway for vestibular schwannoma.

Study Design

Retrospective chart review.

Setting

Tertiary care academic medical center.

Patients

Patients diagnosed with vestibular schwannoma between 2009 and 2019.

Interventions

Observation, stereotactic radiosurgery, or microsurgical resection.

Main Outcome Measures

χ2 Test, one-way analysis of variance, and multivariate logistic regression were used to correlate demographic and clinical factors with initial treatment pathway for 197 newly diagnosed vestibular schwannoma patients.

Results

Among 197 patients, 93 (47%) were initially treated with observation, 60 (30%) with stereotactic radiation (Gamma Knife) and 44 (22%) with surgical resection. Age univariately had no statistically significant impact on initial pathway, but those undergoing surgery trended toward a younger demographic (49.1 yr [surgery] versus 57.2 yr [observation] versus 59.0 yr [Gamma Knife]). Men were more likely to be initially observed than women (p = 0.04). Patients initially observed were more likely to have a lower Koos classification (p < 0.001) and have better tumor-ear hearing (p = 0.03). Only 34.4% of patients living outside the local geographic region were initially observed compared with 53.0% living locally (p = 0.055). Surgeon correlated with initial treatment (p = 0.04) but did not maintain significance when adjusting for hearing level or tumor size. A multiple linear regression model found age, maximum tumor diameter, and Koos class to correlate with initial treatment pathway (p < 0.0001, r
2 = 0.42).

Conclusion

Initial treatment pathway for newly diagnosed vestibular schwannoma is impacted by demographic factors such as age, sex, and geographic proximity to the medical center. Clinical features including hearing level and tumor size also correlated with initial treatment modality.
Colorectal Cancer Screening Program in Songjiang district, Shanghai between 2015 and 2017: Evaluation of participation rate and the associated factor
Authors: Wu Yiling , Saito Hiroaki , Ozaki Akihiko , Tanimoto Tetsuya , Jiang Yonggen , Yang Peng , Li Jing , Zhou Zhiming , Zhu Xiuguo , Lu Fei , Kanemoto Yoshiaki , Kurokawa Tomohiro , Tsubokura Masaharu , Zhao Genming
Published: August 2022

Little is known about the participation rate of newly implemented colorectal cancer (CRC) screening programs in China. Our goals were to identify factors associated with nonparticipation for CRC screening in Songjiang District, Shanghai.

We analyzed individuals included in an observational cohort study from 4 towns (Xin Qiao, She Shan, Mao Gang, and Zhong Shan) in Songjiang District. The participation rate was calculated for the CRC screening program based on a fecal immunochemical test and a risk assessment questionnaire between 2015 and 2017 inclusive.

Of the 27,130 individuals eligible for inclusion in this study, 20,863 (76.9%) participated in CRC screening at least once during 2015 and 2017. The factors linked with nonparticipation were; being male (odds ratio [OR] 0.87, 95% confidence interval [CI] 0.82–0.93, P < .01), unmarried (OR 0.71, 95% CI 0.64–0.80, P < .01), having a high education level (middle school, OR 0.82, 95% CI 0.74–0.90, P < .01, high school or above, OR 0.64, 95% CI 0.57–0.73, P < .01), absence of chronic disease (OR 0.90, 95% CI 0.85–0.96, P < .01), and living in 2 out of the 4 towns covered (Xin Qiao, OR 0.72, 95% CI 0.66–0.78, P < .01, Zhong Shan, OR 0.29, 95% CI 0.26–0.31, P < .01).

The current study revealed several associated factors with nonparticipation for the CRC screening in Songjiang district. These findings will help identify target populations that require an individualized approach to increase the participation rate.
Acute right ventricular failure evoked by trauma induced thyroid storm supported by extracorporeal membrane oxygenation: A case report
Authors: Park Soo Jin , Kim Do Jung , Hong You Sun , Lim Sang Hyun , Park Jiye
Published: August 2022

Rationale:

Cardiac arrest due to thyroid storm is a very rare clinical feature with high mortality that presents as multiorgan dysfunction. The mortality rate under this condition is close to 30%, even with appropriate treatment. Most thyroid storms occur in patients with long-standing untreated hyperthyroidism.

Patient concerns:

A 67-year-old woman, who had no specific medical history, was admitted with stupor mentality after a pedestrian traffic accident.

Diagnosis:

The patient had a Burch and Wartofsky score of 80, well beyond the criteria for diagnosis of a thyroid storm (>45 points).

Interventions:

Venoarterial extracorporeal membrane oxygenation (ECMO) was performed due to persistent unstable vital signs and findings of right ventricular dysfunction after return of spontaneous circulation after cardiopulmonary resuscitation. Circulatory assist with ECMO was performed for 8 days using a beta blocker, steroids, thionamide, and Lugol iodine solution.

Outcomes:

Myocardial function and thyroid hormone levels were rapidly normalized. The patient’s mental state recovered, and patient was discharged on day 36 maintaining medication.

Lessons:

Diagnosis of a thyroid storm in patients with multiple trauma is very difficult, because most trauma patients have symptoms of tachycardia, altered mental status, and abdominal pain that appear in thyrotoxic events. However, when unexplained shock without bleeding evidence occurs in patients with multiple trauma, a thyroid function test should be performed to rule out thyroid storm. Moreover, if hyperthyroidism is observed in a trauma patient, even if there is no history of hyperthyroidism, the possibility of a thyroid storm must be considered along with medical support treatment such as ECMO in patient with cardiogenic shock.
Comparing the therapeutic effects of pregabalin and gabapentin after transforaminal epidural nerve block in lumbar radiculopathy
Authors: Kwon Do Yun , Kwak Sang Gyu , Kim Dong Hyuck
Published: August 2022

Lumbar radiculopathy can be presented as low back pain and radiating pain. Transforaminal epidural steroid injection (TFESI) has been used to treat radicular pain, and after the injection, additional medications such as gabapentinoids including pregabalin (PGB) and gabapentin (GBP) can be administered to relieve remnant pain. However, little is known about the effectiveness of gabapentinoids in relieving pain after transforaminal epidural steroid injection.

This study was conducted to compare the effect of pregabalin and gabapentin in lumbar radiculopathy patients who underwent transforaminal epidural steroid injection.

One hundred seven patients who received TFESI and had taken PGB or GBP after the intervention at Daegu Catholic University Medical Center from January 2013 to August 2021 were included in this study. Visual Analogue Scale (VAS) was evaluated in all patients.

Among 107 patients, 57 (53.3%) patients took PGB and 50 (46.7%) patients took GBP after TFESI. The PGB and GBP groups showed reduced VAS scores according to visit (P < .001). However, no statistically significant differences in VAS scores according to the types of medication (P = .811) and change aspects according to visit were observed between the PGB and GBP groups (P = .947).

The study findings suggest that both pregabalin and gabapentin can be equally used to reduce pain in lumbar radiculopathy patients who underwent TFESI. Further studies with larger sample size are needed to generalize the findings of this study.
A review of osteoarthritis signaling intervention using small-molecule inhibitors
Authors: Park Junyong , Lee Sang Yeob
Published: August 2022

Numerous small-molecule inhibitors (SMIs) have been approved as adjuvant or first-line therapies for malignancies. Based on cancer treatment using SMIs, next-generation SMIs that can be used to optimize the therapeutic index, overcome drug resistance, and establish combination therapies are in development. Osteoarthritis (OA) is the most common chronic joint disease with senescence, and there are various approaches to OA treatment; however, the gold standard treatment is controversial. Therefore, in this manuscript, we demonstrated the potential of using SMIs in OA treatment and described the general strategies for using SMIs in OA treatment.
Tolcapone improves outcomes in patients with Parkinson disease treated by levodopa/carbidopa intestinal gel: A pilot study
Authors: Valkovič Peter , Minár Michal , Matejička Peter , Gmitterová Karin , Boleková Veronika , Košutzká Zuzana
Published: August 2022

Background:

Patients with Parkinson disease (PD) treated with levodopa/carbidopa intestinal gel (LCIG) have higher prevalence of hyperhomocysteinemia and peripheral nerves damage.

Objective:

The aim of our study was to test the effect of catechol-O-methyl transferase inhibitor tolcapone—as an add-on therapy to LCIG in patients with PD—on homocysteine (HCY) metabolism and nerve conduction study (NCS) parameters.

Methods:

We evaluated NCS and serum B12, folic acid, and homocysteine in 16 patients with advanced PD on LCIG. Quality of life (QoL) was also assessed. Six subjects were treated with tolcapone add-on therapy (and LCIG dose reduction), 5 with B vitamin supplementation, and 5 without additional treatment.

Results:

The level of HCY increased among patients without treatment (4.95 ± 12.54), and decreased in the vitamin (–17.73 ± 11.82) and tolcapone groups (–8.81 ± 8.36). Patients with tolcapone demonstrated improvement in polyneuropathic symptoms and signs compared with patients treated with vitamins or those without additional treatment (–0.83, d = 0.961). Although the most robust improvement in NCS parameters were observed with tolcapone, the findings were inconsistent to prove the effect of any intervention. Only tolcapone treatment was associated with improvement in QoL (d = 1.089).

Conclusion:

Our study indicates potential of tolcapone add-on therapy in LCIG treated patients in control of homocysteine levels, and improvement of polyneuropathic symptoms, as well as QoL.
A combination of ultrasonic debridement and topical cortex phellodendri compound fluid in patients with diabetic foot ulcers
Authors: Gao Hang , Chen Jiali , Zhao Ziying , Wang Guangyi
Published: August 2022

Objective:

To evaluate the combination of ultrasonic debridement and cortex phellodendri compound fluid (CPCF) in patients with diabetic foot ulcers (DFU).

Patients and methods:

Patients with DFU received the combination of ultrasonic debridement and CPCF in the experimental group and Kangfuxin liquid in the control group for 4 weeks. Patients total clinical efficiency, adverse events, ulcer areas, healing rate, and positive bacterial culture rate were compared.

Results:

The total clinical efficacy was 98% in the treatment group and 68% in the control group (P < .0001). Patients’ adverse events did not show significant difference between 2 groups. Patients who received the combination of ultrasonic debridement and CPCF in the experimental group had smaller ulcer areas (2.88 ± 0.2408 vs 6.912 ± 0.4044), higher healing rate (96.25 ± 0.5263 vs 55 ± 0.8888), and lower positive bacterial culture rate (0 vs 20%) than patients received Kangfuxin liquid in the control group after 4 weeks of treatment.

Conclusions:

In conclusion, patients with DFU receiving the combination of ultrasonic debridement and CPCF had better clinical efficacy, smaller ulcer areas, higher healing rate, and lower positive bacterial culture rate without increasing the adverse events compared to patients receiving Kangfuxin liquid.
Case report of isolated synchronous multiple splenic metastases from rectal cancer: A case report and brief review of the literature
Authors: Zhao Linxian , Sui Mingxiu , Li Jiannan , Zhang Kai
Published: August 2022

Introduction:

Isolated splenic metastasis emanating from colorectal cancer is an extremely rare finding, which usually indicates widely disseminated and multiple metastatic cancer. There have only been 39 cases of isolated splenic metastasis reported in the English literature to date.

Patient concerns:

An 84-year-old female patient presented to our department with dark-red bloody stool that had persisted for 1 month and with an increased serum carcinoembryonic antigen (CEA) level.

Diagnoses:

A colonoscopy showed a rectal mass located 3 cm from the anal margin, which was 45 mm in diameter. The patient was diagnosed with rectal cancer with splenic metastases by abdomen computed tomography.

Interventions:

The patient underwent a radical resection of rectal cancer and splenectomy, and the postoperative histopathology confirmed that the splenic lesions were derived from the adenocarcinoma of the rectum.

Outcomes:

After surgical treatment, the patient recovered well and was recommended for further chemotherapy.

Conclusions:

In addition to revealing a rare case, we also performed a literature review, including a brief discussion about the atypical isolated splenic metastasis from colorectal cancer. Our findings enrich the database of this rare clinical entity and provide experience in the management of splenic metastasis.
Risk factors for suicidal attempt in patients with the melancholic subtype of depressive disorder: Implication for nursing care
Authors: Xu Pengfei , Sun Ying
Published: August 2022

The incidence of suicide in patients with depressive order is much higher than other population. We aimed to evaluate the current status and risk of suicidal attempt in patients with the melancholic subtype of depressive disorder, to provide evidence for the clinical management and nursing care of depressive disorder.

Patients diagnosed as the melancholic subtype of depressive disorder and treated in our hospital from June 1, 2018 to August 31, 2021 were included. The characteristics of included patients were collected and analyzed. Pearson correlation analysis and logistic regression analysis with odd ratio and 95% confidence interval were conducted to analyze the influencing factors of suicidal attempt in patients with the melancholic subtype of depressive disorder.

A total of 446 patients with melancholic subtype of depressive disorder were included, the incidence of suicidal attempt was 18.83%. Pearson correlation analysis indicated that gender (R = 0.611), alcohol drinking (R = 0.719), living situation (R = 0.812), number of previous admission to hospital (R = 0.547), sleep disorder (R = 0.612) and frequent depressive episodes (R = 0.559) were all correlated with the suicidal attempt in patients with melancholic subtype of depressive disorder (all P < 0.05). Logistic regression analysis showed that female (OR 3.115, 95%CI 2.493–3.906), alcohol drinking(OR 1.946, 95%CI 1.684–2.763), living alone (OR 2.401, 95%CI 1.915–3.008), number of previous admission to hospital ≥ 3 (OR 2.342, 95%CI 1.601–2.742), sleep disorder (OR 1.821, 95%CI 1.328–2.215) and frequent depressive episodes (OR 3.128, 95%CI 2.421–3.779) were the independent risk factors of suicidal attempt (all P < 0.05).

Suicidal attempt is common in the patients with melancholic subtype of depressive disorder, and there are many related risk factors for suicidal attempt in patients with the melancholic subtype of depressive disorder.
Radiological patterns and prognosis in elderly patients with acute Klebsiella pneumoniae pneumonia: A retrospective study
Authors: Komiya Kosaku , Yoshikawa Hiroki , Goto Akihiko , Yamamoto Takashi , Yamasue Mari , Johkoh Takeshi , Hiramatsu Kazufumi , Kadota Jun-ichi
Published: August 2022

Although Klebsiella pneumoniae pneumonia is an insidious threat among the elderly, the role of radiological features has not been elucidated. We aimed to evaluate thin-section chest computed tomography (CT) features and assess its associations with disease prognosis in elderly patients with acute K. pneumoniae pneumonia.

We retrospectively included elderly patients, admitted for acute K. pneumoniae pneumonia, and investigated thin-section CT findings to determine whether bronchopneumonia or lobar pneumonia was present. The association between the radiological pattern of pneumonia and in-hospital mortality was analyzed.

Eighty-six patients with acute K. pneumoniae pneumonia were included, and among them, the bronchopneumonia pattern was observed in 70 (81%) patients. Twenty-five (29%) patients died in hospital, and they had a greater incidence of lobar pneumonia pattern (40% in nonsurvivors vs 10% in survivors; P = .008), low albumin level (2.7 g/dL, range, 1.6–3.8 in nonsurvivors vs 3.0 g/dL, range, 1.7–4.2 in survivors; P = .026) and higher levels of aspartate aminotransferase (30 U/L, range, 11–186 in nonsurvivors vs 23 U/L, range, 11–102 in survivors, P = .017) and C-reactive protein (8.0 mg/dL, range, 0.9–26.5 in nonsurvivors vs 4.7 mg/dL, range, 0.0–24.0 in survivors; P = .047) on admission. Multivariate analysis showed that lobar pneumonia pattern was independently associated with increased in-hospital mortality (adjusted hazard ratio, 3.906; 95% CI, 1.513–10.079; P = .005).

In elderly patients with acute K. pneumoniae pneumonia, the lobar pneumonia pattern may be less commonly observed, and this pattern could relate to poor prognosis.
Adenoma detection rate using narrow-band imaging is inferior to high-definition white light colonoscopy in screening and surveillance colonoscopies in daily clinical care: A randomized controlled trial
Authors: Bürger Martin , Weber Marko , Petersen Iver , Stallmach Andreas , Schmidt Carsten
Published: August 2022

Background:

Despite recent advances in endoscopic technology adenoma miss rate still is up to 20% contributing to interval cancers. Improved imaging modalities have been introduced to increase adenoma detection rate (ADR). Recently, narrow-band imaging (NBI) (Exera II series, Olympus Corporation) was not significantly better than high-definition white light colonoscopy (HD-WLC). An improved second generation of NBI (190-NBI) is characterized by better illumination of the bowel lumen and may be associated with a higher ADR.

Methods:

We performed a prospective randomized study on patients referred to the Jena University Hospital for screening or surveillance colonoscopy between January 2015 and April 2017. Participating endoscopists were divided into 2 subgroups depending on their individual experience. Colonoscopy was performed by use of HD-WLC or 190-NBI upon withdrawal.

Results:

Five hundred fifty-three patients participated in the study. Eighty patients were excluded (insufficient bowel cleansing [n = 34], anticoagulation precluding polypectomy [n=15], partial colonic resection [n=9], other reasons [n = 22]). Mean age was 66.9 years (standard deviation 10.3 years), and 253 patients were male (53.5%). Bowel preparation and withdrawal time were not different. ADR among all subgroups was 39.4% using HD-WLC, but only 29.1% were using 190-NBI (P = .02). Number of polyps per patient was lower using 190-NBI than with HD-WLC (0.58 vs 0.86; P = .02). Subgroup analysis revealed that 190-NBI was inferior to HD-WLC only in unexperienced endoscopists.

Conclusion:

In our stud,y ADR was lower by use of 190-NBI. These differences persisted only in unexperienced investigators. 190-NBI seems to be more challenging regarding ADR, requiring more intensive training prior to implementing this technology in daily clinical care.

Registration:

ClinicalTrials.gov (identifier: NCT03081975).
Exploration of the advantages of minimally invasive surgery for clinical T4 colorectal cancer compared with open surgery: A matched-pair analysis
Authors: Imaizumi Ken , Homma Shigenori , Miyaoka Yoichi , Matsui Hiroki , Ichikawa Nobuki , Yoshida Tadashi , Takahashi Norihiko , Taketomi Akinobu
Published: August 2022

The indications of minimally invasive surgery (MIS) for T4 colorectal cancer are controversial because the advantages of MIS are unclear. Therefore, we compared overall survival (OS) and recurrence-free survival (RFS) as the primary endpoint, and short-term outcome, alteration in perioperative laboratory data, and the interval of postoperative chemotherapy from operation as secondary endpoints, between MIS and open surgery (OPEN) using a matched-pair analysis. We explored the advantages of MIS for T4 colorectal cancer.

In this retrospective single-institution study, we included 125 patients with clinical T4 colorectal cancer who underwent curative-intent surgery of the primary tumor between October 2010 and September 2019. Conversion cases were excluded. MIS patients were matched to OPEN patients (ratio of 1:2) according to tumor location, clinical T stage, and preoperative treatment.

We identified 25 and 50 patients who underwent OPEN and MIS, respectively, including 31 with distant metastasis. Both groups had similar background characteristics. The rate of major morbidities (Clavien-Dindo grade > III) was comparable between the 2 groups (P = .597), and there was no mortality in either group. MIS tended to result in shorter postoperative hospitalization than OPEN (P = .073). Perioperative alterations in laboratory data revealed that MIS suppressed surgical invasiveness better compared to OPEN. Postoperative chemotherapy, especially for patients with distant metastasis who underwent primary tumor resection, tended to be started earlier in the MIS group than in the OPEN group (P = .075). OS and RFS were comparable between the 2 groups (P = .996 and .870, respectively). In the multivariate analyses, MIS was not a significant prognostic factor for poor OS and RFS.

MIS was surgically safe and showed similar oncological outcomes to OPEN—with the potential of reduced invasiveness and enhanced recovery from surgery. Therefore, patients undergoing MIS might receive subsequent postoperative treatments earlier.
Study on the association between the polymorphism of MCP-1 rs1024611 and the genetic susceptibility of type 2 diabetes with sepsis
Authors: Li Yan , He Junbing , Shao Yi-ming , Chen Lanchun , Li Ming , Tang Donghui , Shi Zhizhou , Liao Qinghui , Guo Zhongqiu , Wang Juan , Zheng Qiaoan , Zhao Yanni , Chen Yuhua
Published: August 2022

Monocyte chemoattractant protein-1 (MCP-1) rs1024611 (-2518 A > G) polymorphism are associated with inflammatory diseases. In this study, we investigate the relationship between MCP-1 rs1024611 polymorphism and genetic susceptibility of type 2 diabetes mellitus (T2DM) with sepsis.

Two hundred eighty-five patients with T2DM are divided into the diabetes with sepsis group (combined group, 113 cases) and the diabetes group (172 cases). Blood samples and corresponding clinical data were collected. MCP-1 rs1024611 polymorphism in blood samples was detected by pyrosequencing. Meanwhile, the expressions of MCP-1, tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1β, and IL-6 in blood samples were detected by real-time quantitative polymerase chain reaction and enzyme-linked immunosorbent assay, respectively. The relationship between different genotypes of MCP-1 rs1024611 polymorphic locus and T2DM with sepsis was analyzed by combining with the clinical data of the patients.

The frequencies of rs1024611 AG/GG genotypes and G allele in T2DM with sepsis group were significantly higher than those in T2DM patients without sepsis (P = .004 for AG/GG vs AA genotypes; P = .037 for G allele vs A allele). Subgroup analysis showed that the rs1024611 G allele frequency in the septic shock group was significantly higher than the general sepsis group (P = .02). The expressions of MCP-1 and TNF-α in GG genotypes in T2DM with sepsis group were significantly higher than AA or GA genotypes (P < .05).

This study preliminarily showed that the rs1024611 A > G polymorphism within the promoter region of MCP-1 gene can upregulate the expression of MCP-1 gene and proinflammatory cytokine TNF-α, which ultimately contributed to the predisposition and progression of T2DM with sepsis.
Which factor can predict the effect of indirect decompression using oblique lumbar interbody fusion?
Authors: Woo Joon-Bum , Son Dong-Wuk , Lee Su-Hun , Lee Jun-Seok , Lee Sang Weon , Song Geun Sung
Published: August 2022

The aim of this study was to investigate the association between various factors of indirect decompression. Previous studies have demonstrated the effectiveness of indirect decompression. There is no consensus regarding the predictive factors for indirect decompression. Facet joint gap (FJG) and bulging disc thickness (BDT) have never been considered as factors in other studies.

We retrospectively reviewed 62 patients who underwent OLIF L4/5 between April 2018 and September 2020. The relationships between cross-sectional area (CSA) change, CSA change ratio, spinal stenosis grade, and various factors were studied. Various factors related to indirect decompression, such as ligament flavum thickness (LFT), foraminal area (FA), disc height (DH), bulging disc thickness(BDT), and facet joint gap (FJG), were measured.

CSA increased from 69.72 mm2 preoperatively to 115.95 mm2 postoperatively (P < .001). BDT decreased from 4.97 mm preoperatively to 2.56 mm postoperatively (P < .001). FJG (Right) increased from 2.99 mm preoperatively to 4.38 mm postoperatively (P < .001). FJG (Left) increased from 2.95 mm preoperatively to 4.52 mm postoperatively (P < .001). The improvement of spinal stenosis grade was as follows: 1 point up group, 38 patients; 2 point up groups, 19 patients; and 3 point up groups, 3 patients. The correlation factors were prespinal stenosis grade (0.723, P < .00), CSA change (0.490, P < .00), and FJG change ratio (left, 0.336, P < .008).

FJG showed statistical significance with indirect decompression. Indirect decompression principles might be utilized in patients with severe spinal canal stenosis (even grade 4).
Early gastric neoplasms are significant risk factor for colorectal adenoma: A prospective case-control study
Authors: Kim Seong-Jung , Lee Jun , Baek Dae Youb , Lee Jun Hyung , Hong Ran
Published: August 2022

Although gastric cancer patients have a high incidence and risk of colorectal cancer, evidence is lacking regarding whether early gastric neoplasms (EGNs), such as gastric adenomas and early gastric cancer, are risk factors for colorectal adenoma. This study aimed to investigate the incidence of colorectal adenomas in patients with EGN.

This prospective study was conducted between January 2015 and December 2016. Of the 307 patients who underwent gastric endoscopic submucosal dissection for EGN, 110 patients were enrolled in the EGN group, and 110 age- and sex-matched healthy persons from the screening population were included in the control group in a 1:1 ratio. Demographic factors and results of colonoscopy, including quality assessment, were collected, and analyzed.

No significant differences in the quality of colonoscopy, including bowel preparation, cecal intubation rate, and withdrawal time between the 2 groups, were observed. The incidence of colorectal adenoma was significantly higher in the EGN group than in the control group (55.5% vs 26.4%, P = .001). Multivariate analysis confirmed that old age (odds ratio: 1.04, 95% confidence interval: 1.01–1.08, P = .005) and a history of EGN (odds ratio: 4.99, 95% confidence interval: 2.60–9.57, P = .001) were independent risk factors for colorectal adenoma.

This is the first prospective study to reflect the quality indicator of colonoscopy and confirmed that old age and a history of EGN are significant risk factors for colorectal adenomas. Therefore, more stringent colonoscopy surveillance should be considered in elderly patients with EGN.
Association between body mass index and fecal calprotectin levels in children and adolescents with irritable bowel syndrome
Authors: Kim Jun Hwan , Yi Dae Yong , Lee Yoo Min , Choi You Jin , Kim Ju Young , Hong Yong Hee , Park Ji Young , Kim Su Yeong , Lee Na Mi , Yun Sin Weon , Chae Soo Ahn , Lim In Seok , Choi Eung Sang , Jeong In Sook
Published: August 2022

Irritable bowel syndrome (IBS) is a common pediatric functional gastrointestinal disorder. It is characterized by recurrent abdominal pain and changes in bowel habits and is more prevalent in obese patients. We investigated the association between obesity and IBS in pediatric patients through fecal calprotectin testing.

Patients under 18 years of age with IBS who underwent fecal calprotectin testing from January 2015 through April 2020 were retrospectively investigated. The patients were divided into groups based on body mass index (BMI): group I (BMI < 85th percentile) and group II (BMI ≥ 85th percentile). Group II was divided into group IIa, overweight (85th percentile ≤ BMI < 95th percentile), and group IIb, obese (BMI ≥ 95th percentile).

Among 277 included patients, 202 (72.9%) were in group I, and 75 (27.1%) were in group II (mean calprotectin levels, 75.60 ± 103.48 vs 45.89 ± 66.57 µg/g, respectively; P = .006). There were significant differences in mean calprotectin levels between groups I and IIa (75.60 ± 103.48 vs 45.45 ± 63.38 µg/g, respectively; P = .028) and groups I and IIb (75.60 ± 103.48 vs 46.22 ± 69.59 µg/g, respectively; P = .025). There was a significant difference in mean calprotectin levels between groups I and II (85.69 ± 142.13 vs 32.04 ± 28.17 µg/g, respectively; P = .029) among patients between 6 and 12 years of age but not among adolescents aged between 12 and 18 years (P = .139). Fecal calprotectin was lower when moderate-to-severe fatty livers were observed by ultrasound compared with normal livers (68.52 ± 97.22 vs 18.53 ± 18.56 µg/g, respectively; P = .017).

Fecal calprotectin levels were higher in normal-weight pediatric IBS patients than in their obese counterparts, and this difference was more prominent in younger patients. In young children, IBS symptoms are thought to be influenced more by factors other than intestinal inflammation.
Association between chronic pain with presarcopenia and central sensitization in Japanese community-dwelling older adults: A cross-sectional study
Authors: Imai Ryota , Imaoka Masakazu , Nakao Hidetoshi , Hida Mitsumasa , Tazaki Fumie , Inoue Takao , Orui Junya , Nakamura Misa
Published: August 2022

Older people with chronic pain are at higher risk of developing sarcopenia. Central sensitization (CS) has been implicated in chronic pain among community-dwelling older adults. However, a relationship between CS and chronic pain with sarcopenia has not been established. This cross-sectional study aimed to clarify the relationship between chronic pain with sarcopenia or presarcopenia and CS among community-dwelling older adults. We assessed chronic pain and sarcopenia in 104 older adults participating in community health checks. We defined sarcopenia using the Asian Working Group for Sarcopenia (AWGS) consensus recommendations based on the following outcomes: low muscle mass, low muscle strength, and slow gait speed. Pain-related assessments included pain intensity, the Pain Catastrophizing Scale, the CS Inventory-9, the pressure pain threshold, the Tampa Scale of Kinesiophobia-11, and the EuroQol 5-dimension 5-level (EQ5D-5L). Chronic pain was defined by related symptoms within the month prior to the health check that had continued for ≥ 3 months and corresponded to a numerical rating scale score of ≥ 1 at the site of maximum pain. The prevalence of chronic pain was 43.3%. In addition, the prevalence of chronic pain with sarcopenia or presarcopenia was 29.8%. A logistic regression analysis revealed that the pressure pain threshold (odds ratio: 0.82, 95% CI: 0.95–1.02) and the EQ5D-5L (odds ratio: 0.58, 95% CI: 0.36–0.76) were significantly associated with the presence of chronic pain with sarcopenia or presarcopenia. Chronic pain with sarcopenia or presarcopenia was affected by central sensitization. Therefore, CS should be evaluated in the elderly.
Biological mechanisms and applied prospects of mesenchymal stem cells in premature ovarian failure
Authors: Shi Lan , Zhang Zhifen , Deng Miao , Zheng Fangyuan , Liu Wenhua , Ye Shujin
Published: August 2022

Premature ovarian failure (POF), also known as primary ovarian insufficiency (POI), refers to the loss of ovarian function in women after puberty and before the age of 40 characterized by high serum gonadotropins and low estrogen, irregular menstruation, amenorrhea, and decreased fertility. However, the specific pathogenesis of POF is unexplained, and there is no effective therapy for its damaged ovarian tissue structure and reduced reserve function. Mesenchymal stem cells (MSCs), with multidirectional differentiation potential and self-renewal ability, as well as the cytokines and exosomes they secrete, have been studied and tested to play an active therapeutic role in a variety of degenerative pathologies, and MSCs are the most widely used stem cells in regenerative medicine. MSCs can reverse POI and enhance ovarian reserve function through differentiation into granulosa cells (GCs), immune regulation, secretion of cytokines and other nutritional factors, reduction of GCs apoptosis, and promotion of GCs regeneration. Many studies have proved that MSCs may have a restorative effect on the structure and fertility of injured ovarian tissues and turn to be a useful clinical approach to the treatment of patients with POF in recent years. We intend to use MSCs-based therapy to completely reverse POI in the future.