bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcomes and effect of somatic mutations after erythropoiesis stimulating agents in patients with lower-risk myelodysplastic syndromes
Authors: Caballero Juan Carlos , Dávila Julio , López-Pavía María , Such Esperanza , Bernal Teresa , Ramos Fernando , Calabuig Marisa , Hernández Sánchez Jesús María , Pomares Helena , Sánchez Barba Mercedes , Abáigar María , González Bernardo , Merchán Brayan , Sancho-Tello Reyes , Callejas Marta , Muñoz-Novas Carolina , Cerveró Carlos , Sanz Guillermo , Hernández Rivas Jesús María , Díez Campelo; María
Published: January 2024

Background:

Erythropoiesis stimulating agents (ESAs) are the first-line therapy in patients with lower-risk myelodysplastic syndromes (LR-MDS). Some predictive factors for ESAs response have been identified. Type and number of somatic mutations have been associated with prognosis and response to therapies in MDS patients.

Objectives:

The objective was to evaluate the outcomes after ESAs in patients with LR-MDS and to address the potential predictive value of somatic mutations in ESAs-treated patients.

Design:

Multi-center retrospective study of a cohort of 722 patients with LR-MDS included in the SPRESAS (Spanish Registry of Erythropoietic Stimulating Agents Study) study. Retrospective analysis of 65 patients with next generation sequencing (NGS) data from diagnosis.

Methods:

ESAs’ efficacy and safety were evaluated in patients receiving ESAs and best supportive care (BSC). To assess the potential prognostic value of somatic mutations in erythroid response (ER) rate and outcome, NGS was performed in responders and non-responders.

Results:

ER rate for ESAs-treated patients was 65%. Serum erythropoietin (EPO) level <200 U/l was the only variable significantly associated with a higher ER rate (odds ratio, 2.45; p = 0.036). Median overall survival (OS) in patients treated with ESAs was 6.7 versus 3.1 years in patients receiving BSC ( p < 0.001). From 65 patients with NGS data, 57 (87.7%) have at least one mutation. We observed a trend to a higher frequency of ER among patients with a lower number of mutated genes (40.4% in <3 mutated genes versus 22.2% in ⩾3; p = 0.170). The presence of ⩾3 mutated genes was also significantly associated with worse OS (hazard ratio, 2.8; p = 0.015), even in responders. A higher cumulative incidence of acute myeloid leukemia progression at 5 years was also observed in patients with ⩾3 mutated genes versus <3 (33.3% and 10.7%, respectively; p < 0.001).

Conclusion:

This large study confirms the beneficial effect of ESAs and the adverse effect of somatic mutations in patients with LR-MDS.
Modernity, Aesthetics, and Nation Re-branding in Olympics: A Multimodal Discourse Analysis of the Opening Ceremony of the 2022 Beijing Winter Olympic Games
Authors: Wang Yilei , Feng Dezheng (William) , Wang Hua
Published: January 2024

The paper examines the construction of China’s country image in the opening ceremony of the 2022 Beijing Winter Olympic Games. It demonstrates how a country that has no winter sports tradition used the mega-event to showcase its national narrative and to promote winter sports industries. A semiotic framework is developed to model China’s country image as evaluative attributes and to elucidate how they are constructed through linguistic and visual resources in the theater, livestream, and video inserts. The analysis shows that the ceremony was narrated around four major themes—the world’s China, People’s China, the aesthetic China, and the modernized China. Instead of revealing a changeless, nostalgic and mythical China that speaks to a Western orientalistic imagination, these four themes work together to reshape a modern China identity, which brings the contrasting values of globalism, nationalism, Chinese traditional aesthetics, and neoliberalism into a coherent artistic performance. The characteristics of nation branding discourse reflect China’s urban regeneration policies on the one hand, and public diplomacies during the COVID-19 pandemic on the other.
Comparing the Interobserver Reliability of 4 Methods Used to Measure Knee Laxity on Coronal Plane Stress Radiograph
Authors: Schemitsch Geoffrey W. , Hauer Tyler M. , Hoit Graeme , Al Hulaibi Fahad H. , Hu Shu Yang , Etemad-Rezaie Ali , Pinsker Ellie B. , Khan Ryan M. , Coulter Owen , Whelan Daniel B.
Published: January 2024

Background:

Varus and valgus knee stress radiographs provide valuable information in the pre- and postoperative evaluation of joint laxity in patients with multiligament knee injuries (MLKIs).

Purpose:

To review the literature for described techniques of quantifying laxity on coronal stress radiographs of the knee and identify the most reliable method.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

A thorough literature search using the MEDLINE and Embase databases identified 4 studies with distinct methods for objectively measuring laxity on varus and valgus stress radiographs: Heesterbeek et al (2008), Jacobsen (1976), LaPrade et al (2004), and Sawant et al (2004). To compare these methods, 200 coronal plane stress radiographs from 50 patients with MLKIs were retrospectively reviewed from an MLKI database at a single institution. The amount of varus and valgus laxity on each radiograph was measured independently by 4 reviewers using each method. Intraclass correlation coefficients (ICCs) with 95% CIs were calculated to assess the interobserver reliability of each method overall and the varus and valgus measurements individually.

Results:

For all 4 methods, the overall interobserver reliability was considered at least moderate. The method by Heesterbeek et al proved to have the highest interrater reliability in all domains—overall (ICC, 0.87 [95% CI, 0.85-0.90]), valgus (ICC, 0.83 [95% CI, 0.78-0.88]), and varus (ICC, 0.87 [95% CI, 0.83-0.90])—demonstrating good to excellent reliability both overall and in varus measurements and showing good reliability in valgus measurements. The method by Sawant et al demonstrated good reliability in valgus measurements. All other measures demonstrated moderate reliability.

Conclusion:

Available methods for measuring knee joint laxity on varus and valgus knee stress radiographs in patients with MLKIs demonstrated moderate to good interobserver reliability. The method described by Heesterbeek et al proved to have the highest reliability overall as well as in measurements on varus and valgus views individually.
Meaningful Engagement of People Living With Noncommunicable Diseases: Challenges and Opportunities
Authors: Barone Mark Thomaz Ugliara , Klatman Emma
Published: January 2024

Meaningful engagement of people living with health conditions means actively incorporating them in all stages of health decision-making. Despite efforts by global health agencies and governments towards meaningful engagement of people living with noncommunicable diseases (PLWNCDs), many opportunities for participation are tokenistic. PLWNCDs often report feeling excluded from technical discussions and outnumbered by other stakeholders. Participation in decision-making is a human right, and PLWNCDs must continue advocating for a “nothing about us without us” approach. They should be respected as decision-makers with voice, agency, voting power, rights, and duties. This article highlights four key themes: (1) both tokenistic participation and exclusion of PLWNCDs from technical discussions are still common; (2) the “patient” label implies passivity and can perpetuate limited participation, whereas the identifier of PLWNCDs connotes valuable knowledge associated with lived experience; (3) meaningful participation of PLWNCDs in health decision-making processes should be considered a human right; (4) PLWNCD should be empowered to continue to advocate for inclusion and be respected as decision-makers.
Significance of mixed convective double diffusive MHD stagnation point flow of nanofluid over a vertical surface with heat generation
Authors: Islam Ammara , Mahmood Zafar , Khan Umar
Published: January 2024

The mixed convection double-diffusive MHD flow of boundary layer nanofluids above vertical region is designed. This flow is explained near stagnation point along with heat generation. Using Buongiorno’s model, the properties of Brownian motion, thermophoresis, and diffusion of regular and cross type are included. Using appropriate similarity transformations of the local similarity technique, non-linear unstable PDEs in governing model converted to non-linear ODEs, which were then evaluated numerically by the Keller-box method (KBM) using the computational software MATLAB 2021a. Graphical analysis of possessions of parameters on the boundary layers in profiles of velocity, solute concentration, temperature and nanoparticle concentration is illustrated. The statistics of the reduced Sherwood number and the reduced Nusselt number for solute and nanoparticles in cases of assisting flow and opposing flow are added as well to the results. The fastest rate of heat transfer is achieved in a scenario with a negligible thermophoresis effect. The thermophoresis parameter and the buoyancy parameter of the regular double diffusive appear to rise rather than decrease in the nanoparticles lowered Sherwood number, while the Brownian motion parameter rises. The temperature and layer thickness for heat generation have a quite opposite effect. When the computed numerical findings are compared to earlier published work, it is discovered to be in good percentage. The need for numerous industrial applications and improvements in the efficiency and energy consumption of systems, such as cooling and heating transportation, in water heaters, nuclear reactors, optical devices, turbines, aerodynamics, and electronics, have led to the establishment of this investigation.
Effect of Race and Insurance Status on Treatment and Outcomes in Diabetic Retinopathy: Analysis of 43 274 Eyes Using the IRIS Registry
Authors: Maturi Jay , Maturi Vikas , Scott Adrienne W. , Carson Kathryn A. , Ciulla Thomas , Maturi Raj
Published: January 2024

Purpose: To examine disparities in visual acuity (VA) outcomes 1 year and 2 years after initiation of diabetic retinopathy (DR) or diabetic macular edema (DME) treatment in patients based on race/ethnicity and insurance status, accounting for disease severity. Methods: This retrospective analysis used the IRIS Registry and included DR patients older than 18 years with documented antivascular endothelial growth factor (anti-VEGF) treatment and VA data for at least 2 years. International Classification of Diseases, Tenth Revision, Clinical Modification codes were used to determine the severity of DR and DME presence. VA outcomes were assessed using multivariable linear regressions and anti-VEGF drug use by multivariable logistic regressions, with race and insurance status as independent variables. Main outcome measures comprised the mean VA change at 1 year and 2 years and percentage of patients treated with bevacizumab. Results: The study included 43 274 eyes. White patients presented with a higher mean VA and lower mean DR severity than Black patients and Hispanic patients. Multivariable logistic regression showed Hispanic patients were significantly more likely to be treated with bevacizumab than White patients across all insurance types, controlling for disease severity and VA. After 1 year, the letter improvement was 1.73, 1.33, and 1.13 in White patients, Black patients, and Hispanic patients, respectively. Multivariable linear regression suggested that across races, Medicaid-insured patients had significantly smaller gains in VA than privately insured patients. Conclusions: Race-based and insurance-based differences in 1-year and 2-year outcomes after anti-VEGF treatment for DR and anti-VEGF treatment patterns suggest a need to ensure earlier and more effective treatment of minority and underserved patients in the United States.
Public views of sexual assault, and its prevention, in residential aged care facilities
Authors: Lee Madeline , Moir Emily , McKillop Nadine
Published: January 2024

The prevalence of sexual assaults against older people in Residential Aged Care Facilities (RACFs) is estimated to be more than double the incidents in the community, yet there is a paucity of empirical research focused on this context. Considering significant revelations and community concerns stemming from Australia's recent Royal Commission into Aged Care Quality and Safety, the current study sought to assess public knowledge of sexual assaults in RACFs, specifically, the causes, delegations of responsibility, and possible solutions to limit reoccurrences. Thematic analysis was conducted on 2,398 social media comments made in response to posts concerning sexual assault in RACFs ( n = 27 sources). Results suggest systemic factors frequently contributed to incidents (e.g., staffing insufficiencies, apathetic management, and meagre regulatory requirements), while improved guardianship, sanctions, and regulation were expected to mitigate risk. Notably, the government was frequently blamed for its role in establishing and maintaining conditions that manifest in abuse within RACFs, with responsibility also delegated to family members. Importantly, public opinion strongly coincided with prior empirical prevention recommendations, endorsing the implementation of identified measures to limit sexual victimisation risk in RACFs.
Qualitative Evaluation of Treatment Partners for People With HIV in Botswana: Current Healthcare Provider Practices and Recommendations for Improvement
Authors: Bogart Laura M. , Phaladze Nthabiseng , Kgotlaetsile Keonayang , Goggin Kathy , Mosepele Mosepele
Published: January 2024

Botswana has an adult HIV prevalence of 20.8% and annual incidence of 0.2%. We aimed to evaluate current practices and advance recommendations for treatment partners (informal adherence supporters) for people with HIV in Botswana. In January-February 2020, we conducted seven focus groups with 36 healthcare providers at seven HIV clinics in Gaborone, Botswana. Providers perceived treatment partners to be critical for quality patient care. They shared that in the new era of universal antiretroviral therapy (ART) initiation immediately after diagnosis (“test-and-treat”), providers no longer require patients to select treatment partners at ART initiation. Providers suggested a renewed emphasis on treatment partners. They believed that standard guidance for providers around treatment partner selection would ensure that providers cover similar topics across patients and endorsed implementation of workshops to educate treatment partners on how to support patients. However, streamlined ART initiation policies require innovative strategies, including eHealth interventions, to engage treatment partners.
Teaching mathematics from the lens of social justice in a Pakistani classroom
Authors: Latafat Kashfia
Published: January 2024

In our educational institution, despite significant progress in educational achievements, there is a prevalent issue of mathematics lessons focusing on rote memorization and superficial understanding, leading to learner dissatisfaction. This study presents a research project conducted by a group of five individuals, including myself as a teacher researcher and four other teachers. The project aimed to address this issue by employing a participatory action research approach. Through innovative planning, teaching, and evaluation methods, the research group successfully demonstrated how making mathematics more relevant and meaningful can increase student engagement and agency. The collaborative nature of the group fostered self-awareness among the teacher researchers regarding social justice issues within their mathematics classrooms. The research project highlighted the potential of mathematics as a powerful tool for developing students’ understanding of social justice issues and establishing meaningful connections between these issues and mathematical concepts. Importantly, the project emphasized the significance of student agency, showcasing how collaborative and problem-solving approaches to teaching, coupled with student autonomy in selecting issues to explore and mathematical procedures to apply, can contribute to the development of student agency.
Relationships Between Stigma, Risk Tolerance, and Buprenorphine Dispensing Intentions Among Community-Based Pharmacists: Results From a National Sample
Authors: Light Alysson E. , Green Traci C. , Freeman Patricia R. , Zadeh Paria Sanaty , Burns Anne L. , Hill Lucas G.
Published: January 2024

Background:

Concerns have been raised that pharmacists sometimes act as barriers to patients with opioid use disorder (OUD) accessing buprenorphine treatment. The present research explores how community pharmacists’ endorsement (vs non-endorsement) of stigmatizing beliefs about patients taking buprenorphine relate to intentions, comfort, and decisions regarding dispensing buprenorphine for OUD. In addition, we assessed attitudes toward risk in pharmacy practice as a novel correlate of dispensing intentions and decisions.

Methods:

A sample of 207 active community-based pharmacists practicing in the United States responded to survey items measuring stigma, risk tolerance, and intentions to dispense buprenorphine. The survey included 2 vignettes in which patients presented to the pharmacy with a prescription for buprenorphine, and respondents rated their comfort with dispensing and decisions regarding dispensing in the vignette.

Results:

Results suggest that both stigma toward patients taking buprenorphine to treat OUD and tolerance for risk in pharmacy settings are related to differences in pharmacists’ intentions to and willingness to dispense buprenorphine for OUD.

Conclusions:

Findings support the need for interventions to reduce stigma associated with buprenorphine use among pharmacists and suggest that risk tolerance is an important determinant of pharmacists’ behavior that merits further study.
Flash nanoprecipitation allows easy fabrication of pH-responsive acetalated dextran nanoparticles for intracellular release of payloads
Authors: Hughes Krystal A. , Misra Bishal , Maghareh Maryam , Samart Parinya , Nguyen Ethan , Hussain Salik , Geldenhuys Werner J. , Bobbala Sharan
Published: January 2024

Acetalated dextran (Ac-Dex) nanoparticles are currently of immense interest due to their sharp pH-responsive nature and high biodegradability. Ac-Dex nanoparticles are often formulated through single- or double-emulsion methods utilizing polyvinyl alcohol as the stabilizer. The emulsion methods utilize toxic organic solvents such as dichloromethane or chloroform and require multi-step processing to form stable Ac-Dex nanoparticles. Here, we introduce a simple flash nanoprecipitation (FNP) approach that utilizes a confined impinging jet mixer and a non-toxic solvent, ethanol, to form Ac-Dex nanoparticles rapidly. Ac-Dex nanoparticles were stabilized using nonionic PEGylated surfactants, D-α-Tocopherol polyethylene glycol succinate (TPGS), or Pluronic (F-127). Ac-Dex nanoparticles formed using FNP were highly monodisperse and stably encapsulated a wide range of payloads, including hydrophobic, hydrophilic, and macromolecules. When lyophilized, Ac-Dex TPGS nanoparticles remained stable for at least one year with greater than 80% payload retention. Ac-Dex nanoparticles were non-toxic to cells and achieved intracellular release of payloads into the cytoplasm. In vivo studies demonstrated a predominant biodistribution of Ac-Dex TPGS nanoparticles in the liver, lungs, and spleen after intravenous administration. Taken together, the FNP technique allows easy fabrication and loading of Ac-Dex nanoparticles that can precisely release payloads into intracellular environments for diverse therapeutic applications.

Graphical abstract

pH-responsive Acetalateddextran can be formulated using nonionic surfactants, such as TPGS or F-127, for intracellular release of payloads. Highly monodisperse and stable nanoparticles can be created through the simple, scalable flash nanoprecipitation technique, which utilizes a confined impingement jet mixer.
Fabrication of TPGS decorated Etravirine loaded lipidic nanocarriers as a neoteric oral bioavailability enhancer for lymphatic targeting
Authors: Muheem Abdul , Wasim Mohd. , Aldosari Eman , Baboota Sanjula , Ali Javed
Published: January 2024

Etravirine (ERVN) is a potential NNRTI (non-nucleoside reverse transcriptase inhibitor) in treating HIV infection. It possesses extremely low oral bioavailability. The present research aims to optimize the formulation and characterization of TPGS-enriched ERVN-loaded lipid-based nanocarriers (NLCs) for HIV-infected patients. The formulation, ERVN–TPGS–NLCs, was optimized by central composite rotational design using a modified-solvent emulsification process. Various characterization parameters of NLCs were evaluated, including globule size of 121.56 ± 2.174 nm, PDI of 0.172 ± 0.042, the zeta potential of − 7.32 ± 0.021 mV, %EE of 94.42 ± 8.65% of ERVN and %DL was 8.94 ± 0.759% of ERVN and spherical shape was revealed by TEM. PXRD was also performed to identify the crystallinity of the sample. In-vitro drug release showed % a cumulative drug release of 83.72 ± 8.35% at pH 1.2 and 90.61 ± 9.11% at pH 6.8, respectively, whereas the % cumulative drug release from drug suspension (ERVN-S) was found to be 21.13 ± 2.01% at pH 1.2 and 24.84 ± 2.51 at pH 6.8 at the end of 48 h. Further, the intestinal permeation study and confocal microscope showed approximately three-fold and  two-fold increased permeation in ERVN–TPGS–NLCs and ERVN-NLCs across the gut sac compared to ERVN-S. Hemolysis compatibility and lipolysis studies were performed to predict the in-vivo fate of the formulation. The pharmacokinetic study revealed a 3.13-fold increment in the relative bioavailability, which agrees with the ex-vivo studies, and lymphatic uptake was validated by using cycloheximide along with designed formulation, which showed the impact of lymphatic uptake in AUC. This study ensures that ERVN–TPGS–NLCs take lymphatic uptake to minimize the first-pass metabolism followed by improved oral bioavailability of ERVN. Thus, the enhanced bioavailability of ERVN can reduce the high dose of ERVN to minimize the adverse effects related to dose-related burden.

Graphical abstract
Development of solid lipid nanoparticles-loaded drugs in parasitic diseases
Authors: Nemati Sara , Mottaghi Mahsa , Karami Parisa , Mirjalali Hamed
Published: January 2024

Parasites cause illnesses with broad spectrum of symptoms from mild to severe, and are responsible for a significant number of outbreaks in the world. Current anti-parasitic drugs are toxic and have significant side effects. Nano-carriers are believed to obviate the limitations of conventional drugs via decreasing side effects and increasing target delivery and drug permeability with a controlled prolonged release of a drug. Solid lipid nanoparticles (SLNs) are lipid nanoparticles (LNPs), which have frequently been practiced. Suitable release rate, stability, and target delivery make SLNs a good alternative for colloidal carriers. SLNs are supposed to have great potential to deliver natural products with anti-parasitic properties. Nanoparticles have employed to improve stability and capacity loading of SLNs, during recent years. This review describes development of SLNs, the methods of preparation, characterization, and loaded drugs into SLNs in parasitic diseases. In addition, we summarize recent development in anti-parasitic SLNs-loaded drugs.
Predicting drug–protein interactions by preserving the graph information of multi source data
Authors: Wei Jiahao , Lu Linzhang , Shen Tie
Published: January 2024

Examining potential drug–target interactions (DTIs) is a pivotal component of drug discovery and repurposing. Recently, there has been a significant rise in the use of computational techniques to predict DTIs. Nevertheless, previous investigations have predominantly concentrated on assessing either the connections between nodes or the consistency of the network’s topological structure in isolation. Such one-sided approaches could severely hinder the accuracy of DTI predictions. In this study, we propose a novel method called TTGCN, which combines heterogeneous graph convolutional neural networks (GCN) and graph attention networks (GAT) to address the task of DTI prediction. TTGCN employs a two-tiered feature learning strategy, utilizing GAT and residual GCN (R-GCN) to extract drug and target embeddings from the diverse network, respectively. These drug and target embeddings are then fused through a mean-pooling layer. Finally, we employ an inductive matrix completion technique to forecast DTIs while preserving the network’s node connectivity and topological structure. Our approach demonstrates superior performance in terms of area under the curve and area under the precision–recall curve in experimental comparisons, highlighting its significant advantages in predicting DTIs. Furthermore, case studies provide additional evidence of its ability to identify potential DTIs.
High-resolution anorectal manometry for diagnosing obstructed defecation syndrome associated with moderate rectocele compared to healthy individuals
Authors: Geng Hong Zhi , Zhang Yi , Xu Chen , Cong Jiying , Li Yuwei
Published: January 2024

Background

Few studies have investigated healthy female individuals (HFI) and those with obstructed defecation syndrome associated with moderate rectocele in women (MRW), identified using three-dimensional high-resolution anorectal manometry (3D HRAM) parameters that correlate with age stratification.

Objective

We aimed to explore the clinical diagnostic values of the MRW and HFI groups using 3D HRAM parameters related to age stratification.

Methods

A prospective non-randomized controlled trial involving 128 cases from the MRW (treatment group, 68 cases) and HFI (control group, 60 cases) groups was conducted using 3D HRAM parameters at Tianjin Union Medical Center between January 2017 and June 2022, and patients were divided into two subgroups based on their ages: the ≥50 and < 50 years subgroups.

Results

Multivariate binary logistic regression analysis showed that age (P = 0.024) and rectoanal inhibitory reflex (P = 0.001) were independent factors affecting the disease in the MRW group. Compared to the HFI group, the receiver operating characteristic (ROC) curve demonstrated that the 3D HRAM parameters exhibited a higher diagnostic value for age (Youden index = 0.31), urge to defecate (Youden index = 0.24), and rectoanal pressure differential (Youden index = 0.21) in the MRW group.

Conclusions

Compared to the HFI group, the ROC curve of the 3D HRAM parameters suggests that age, urge to defecate, and rectoanal pressure differential in the MRW group have a significant diagnostic value. Because the Youden index is lower, 3D HRAM cannot be considered the gold standard method for diagnosing MRW.
Prevalence and risk factors for subclinical hypothyroidism in older patients with major depressive disorder
Authors: Li Min , Wang Xiu-Wen , Wang Xiao-Qian , Zhang Jian-Jun , Zhang Xiang-Yang
Published: January 2024

Background

Subclinical hypothyroidism (SCH) is highly correlated with major depressive disorder (MDD). However, the prevalence and risk factors for SCH in older patients with MDD have rarely been reported in China.

Methods

This cross-sectional study included 266 older MDD patients with SCH was performed. Clinical and anthropometric, biochemical, and thyroid function data were collected. Depression, anxiety, and psychotic symptoms were assessed using the Hamilton Depression Scale, the Hamilton Anxiety Scale, and the Positive and Negative Syndrome Scale positive subscale, respectively.

Results

Among older patients with MDD, the prevalence of SCH was 64.7% (172/266). Compared to patients without SCH, older MDD patients with SCH had a longer disease course and higher TSH, A-TG, A-TPO, HDL-C, LDL-C, TC, FPG, and systolic pressure levels (all P ≤ 0.002). Furthermore, disease progression (OR 1.082, 95% CI 1.020–1.147, P = 0.009), A-TG (OR 1.005, 95% CI 1.001–1.009, P = 0.017), TC (OR 2.024, 95% CI 1.213–3.377, P = 0.007), FPG (OR 2.916, 95% CI 1.637–5.194, P < 0.001), systolic pressure (OR 1.053, 95% CI 1.008–1.100, P = 0.022) were independently associated with SCH, in older patients with MDD.

Conclusions

Our findings suggest a high prevalence of SCH in older patients with MDD. Several demographic and clinical variables were independently associated with SCH in older patients with MDD.
Associations between resting heart rate and cognitive decline in Chinese oldest old individuals: a longitudinal cohort study
Authors: Ma Zhaoyin , Qu Yanlin , Ma Haibo , Zhang Yuanyuan , Wang Min , Huang Nana , Li Xiaohong
Published: January 2024

Background

The trajectories of cognitive function in the oldest old individuals is unclear, and the relationship between resting heart rate (RHR) and cognitive decline is controversial.

Methods

3300 participants who had cognitive function repeatedly measured 4 ~ 8 times were included, and latent class growth mixed models were used to identified the cognitive function trajectories. Cognitive decline was defined by the trajectory shapes, considering level and slope. After excluding individuals with sinus rhythm abnormal, 3109 subjects were remained and were divided into five groups by their RHR. Logistic regression models were used to estimate the relationship between RHR and cognitive decline.

Results

Three distinct cognitive function trajectory groups were identified: high-stable (n = 1226), medium-decreasing (n = 1526), and rapid-decreasing (n = 357). Individuals of medium/rapid-decreasing group were defined as cognitive decline. Adjusting for covariates, the odds ratios (95% confidence intervals) of RHR sub-groups were 1.19 (0.69, 2.05), 1.27 (1.03, 1.56), 1.30 (1.01, 1.67) and 1.62 (1.07, 2.47) for those RHR < 60 bpm, 70 ~ 79 bpm, 80 ~ 89 bpm and > 90 bpm respectively, compared with those RHR 60 ~ 69 bpm. The interaction effect between RHR and physical activity (PA) on cognitive decline was found, and stratification analysis was presented that higher RHR would only show risk effects on cognitive decline in those with physical inactivity (P < 0.05 for all).

Conclusions

Our study demonstrates RHR more than 70 bpm present significant risk effect on cognitive decline, and this relationship is modified by PA. Elder population with physical inactivity and higher RHR should be paid more attention to prevent cognitive decline.
Preoperative prognostic nutritional index value as a predictive factor for postoperative delirium in older adult patients with hip fractures: a secondary analysis
Authors: Mi Xinning , Jia Yunyang , Song Yanan , Liu Kaixi , Liu Taotao , Han Dengyang , Yang Ning , Wang Geng , Guo Xiangyang , Yuan Yi , Li Zhengqian
Published: January 2024

Background

Malnutrition is a common geriatric syndrome and can be targeted preoperatively to decrease the risk of postoperative delirium (POD) in older adult patients. To analyze the value of the prognostic nutritional index (PNI) to predict the incidence of POD in older adult patients with hip fractures.

Methods

This was a prospective, observational, cohort study of older adult patients with hip fractures. Preoperative PNI was calculated as 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (/μL) using preoperative laboratory results. Patients were divided into POD and non-POD groups using the Confusion Assessment Method (CAM). The risk factors associated with POD as well as the relationship between PNI values and the incidence of POD were analyzed using univariate and multivariate logistic regression analyses. The predictive value of PNI for POD was assessed using receiver operating characteristic curve analysis.

Results

In this cohort of 369 patients who underwent hip fracture surgery, 67 patients (18.2%) were diagnosed with POD by the CAM results. Low PNI increased the risk of POD (odds ratio (OR) = 0.928, 95% confidence interval (CI): 0.864–0.997). General anesthesia (OR = 2.307, 95% CI: 1.279–4.162) and Mini-Mental State Examination (MMSE) score (OR = 0.956, 95% CI: 0.920–0.994) were also identified as risk factors for POD. Receiver operating characteristic curve analysis suggested that PNI combined with the anesthetic method and MMSE score may be used as a potential predictive indicator of POD after hip fracture surgery.

Conclusion

Preoperative PNI value is related to POD in older adult patients with hip fractures.

Trial registration

This secondary analysis study was approved by the Peking University Third Hospital Medical Science Research Ethics Committee (approval No. M2022578) and registered in the Chinese Clinical Trial Registry (ChiCTR2300070569).
Muscle ultrasound to diagnose sarcopenia in chronic kidney disease: a systematic review and bayesian bivariate meta-analysis
Authors: Yang Qinbo , Zhang Chen , Zhang Zhuyun , Su Baihai
Published: January 2024

Objective

The aim of this systematic review was to assess the diagnostic test accuracy of muscle ultrasound for sarcopenia among chronic kidney disease (CKD) populations.

Background

Sarcopenia has become a worldwide health issue, especially for CKD patients. Conventional techniques of muscle mass assessment often prove limited, thus prompts increasing interest in ultrasound suitability.

Methods

We searched the Cochrane Library, PubMed and Embase for literature published up to June 2023. Ultrasound diagnosis of sarcopenia in CKD patients was included. Two independent investigators used the Quality Assessment Tool for Diagnosis Accuracy Studies (QUADAS-2) to assess the quality. We extracted valuable information from eligible studies. Using a Bayesian bivariate model, we pooled sensitivity and specificity values and summary receiver operating characteristic (SROC) curves.

Results

Five articles, involving 428 participants at various stages of CKD were included. Three studies diagnosed by the cross-sectional area (CSA) of the rectus femoris, while two others by muscle thickness (MT) and shear wave elastography (SWE) from the same muscle, separately. Overall, CSA or SWE had a pooled sensitivity of 0.95 (95% CrI, 0.80, 1.00), and the specificity was 0.73 (95% CrI, 0.55, 0.88) for diagnosing sarcopenia in CKD patients.

Conclusions

Ultrasound measurements of CSA and SWE were more sensitive for diagnosing sarcopenia in the CKD population than in the general population. Ultrasound assessment from a single peripheral skeletal muscle site may serve as a rapid screening tool for identifying sarcopenic individuals within the CKD population, if a specific cut-off value could be determined.
Monocyte to high-density lipoprotein cholesterol ratio is associated with cerebral small vessel diseases
Authors: Nam Ki-Woong , Kwon Hyung-Min , Jeong Han-Yeong , Park Jin-Ho , Min Kyungha
Published: January 2024

Background

Inflammation is a major pathological mechanism underlying cerebrovascular disease. Recently, a new inflammatory marker based on the ratio between monocyte count and high-density lipoprotein (HDL) cholesterol has been proposed. In this study, we evaluated the relationship between monocyte-to-HDL cholesterol ratio (MHR) and cerebral small vessel disease (cSVD) lesions in health check-up participants.

Methods

This study was a retrospective cross-sectional study based on a registry that prospectively collected health check-up participants between 2006 and 2013. Three cSVD subtypes were measured on brain magnetic resonance imaging. White matter hyperintensity (WMH) volume, and lacunes and cerebral microbleeds (CMBs) were quantitatively and qualitatively measured, respectively. The MHR was calculated according to the following formula: MHR = monocyte counts (× 103/μL) / HDL cholesterol (mmol/L).

Results

In total, 3,144 participants were evaluated (mean age: 56 years, male sex: 53.9%). In multivariable analyzes adjusting for confounders, MHR was significantly associated with WMH volume [β = 0.099, 95% confidence interval (CI) = 0.025 to 0.174], lacune [adjusted odds ratio (aOR) = 1.43, 95% CI = 1.07–1.91], and CMB (aOR = 1.51, 95% CI = 1.03–2.19). In addition, MHR showed a positive quantitative relationship with cSVD burden across all three subtypes: WMH (P < 0.001), lacunes (P < 0.001), and CMBs (P < 0.001).

Conclusions

High MHR was closely associated with cSVD in health check-up participants. Because these associations appear across all cSVD subtypes, inflammation appears to be a major pathological mechanism in the development of various cSVDs.
Regular use of paracetamol and risk of liver cancer: a prospective cohort study
Authors: Tian Liang , Mi Ningning , Wang Leiqing , Huang Chongfei , Fu Wenkang , Bai Mingzhen , Gao Long , Ma Haidong , Zhang Chao , Lu Yawen , Zhao Jinyu , Zhang Xianzhuo , Jiang Ningzu , Lin Yanyan , Yue Ping , Xia Bin , He Qiangsheng , Yuan Jinqiu , Meng Wenbo
Published: January 2024

Background

Paracetamol induces hepatotoxicity and subsequent liver injury, which may increase the risk of liver cancer, but epidemiological evidence remains unclear. We conducted this study to evaluate the association between paracetamol use and the risk of liver cancer.

Methods

This prospective study included 464,244 participants free of cancer diagnosis from the UK Biobank. Incident liver cancer was identified through linkage to cancer and death registries and the National Health Service Central Register using the International Classification of Diseases (ICD)-10 codes (C22). An overlap-weighted Cox proportional hazards model was utilized to calculate the hazard ratio (HR) and 95% confidence interval (CI) for the risk of liver cancer associated with paracetamol use. The number needed to harm (NNH) was calculated at 10 years of follow-up.

Results

During a median of 12.6 years of follow-up, 627 cases of liver cancer were identified. Paracetamol users had a 28% higher risk of liver cancer than nonusers (HR 1.28, 95% CI 1.06–1.54). This association was robust in several sensitivity analyses and subgroup analyses, and the quantitative bias analysis indicated that the result remains sturdy to unmeasured confounding factors (E-value 1.88, lower 95% CI 1.31). The NNH was 1106.4 at the 10 years of follow-up.

Conclusion

The regular use of paracetamol was associated with a higher risk of liver cancer. Physicians should be cautious when prescribing paracetamol, and it is recommended to assess the potential risk of liver cancer to personalize the use of paracetamol.
Radial keratotomy: background and how to manage these patients nowadays
Authors: Colombo-Barboza Guilherme Novoa , Rodrigues Pablo Felipe , Colombo-Barboza Fernanda Daroz Paulo , Moscovici Bernardo Kaplan , Colombo-Barboza Luiz Roberto , Colombo-Barboza Marcello Novoa , Nose Walton
Published: January 2024

In this review, we presented the principles of radial keratotomy (RK), its evolution, enhancement, and complications, and strategies to manage the consequences of RK in the present day. It is essential to understand the RK procedure f, the theoretical background that supported this surgery, the current effect on the cornea, and how to approach patients needing vision improvement. These patients are developing cataracts that need to be handled well, from the IOL calculation to the surgical procedure. Guided keratorefractive surgery is the most accurate procedure to improve these patient's vision and life. Nevertheless, some patients may need other approaches, such as sutures, penetrating keratoplasty, corneal rings, and pinhole implants, depending on the degree of irregularity of the cornea, ablation depth for guided surgery or if the sutures are open.
Which rehabilitation initiatives can effectively improve participation in an educational setting for visually impaired and blind adolescents? A systematic review
Authors: Milde Nina , Schmidt Diana Chabané , Larsen Anders , Kessel Line
Published: January 2024

Background

Visually impaired and blind adolescents fare poorly in educational attainment compared to adolescents without vision impairment. Rehabilitation holds the potential to compensate for the hindrances that the impairment causes. Many rehabilitation initiatives exist. However, the efficacy of these initiatives remains uncertain. This systematic review assessed which rehabilitation initiatives improve participation in an educational setting for visually impaired and blind adolescents.

Methods

PubMed, Embase, Scopus, Cinahl, and Cochrane library databases were searched. Only primary studies as randomized controlled trial (parallel group or crossover), cohort studies, case-control studies, qualitative studies, and case-studies were included. Data on the study characteristics, visual impairment, type of intervention, research question, main findings, and implications for practice were extracted from the papers. Critical appraisal was performed using the Critical Appraisal Checklist for Qualitative Research and the Checklist for Quasi-Experimental Studies both from the Joanna Briggs Institute. The data extraction and the critical appraisal were performed independently by two reviewers.

Results

A total of 10 studies with visually impaired and blind adolescents were considered eligible, from an original search result of 3210 studies. In the thematic analysis we identified a heightened focus on different means for studying by making the curriculum content more accessible by applying different audio, tactile, or electronic devices (n = 8). A minor focus in the identified studies (n = 2) was placed on the impact of support from the environment on the development of literacy, for example the support from teachers or parents. Outcome parameters representing more diverse rehabilitation initiatives have not been adequately investigated in the literature. The scientific evidence that we identified was based on few publications with contradictory results and some studies were of questionable quality, limiting the applicability of their findings.

Conclusions

Overall, the review identified a gap in the evidence regarding rehabilitation initiatives for visually impaired and blind adolescents that enables participation in an educational setting. The overall quality assessment of the 10 studies identified several risks of bias, for which reason the current scientific evidence does not qualify as a basis for decision making, leaving the adolescents in a heightened risk to fall even further behind in the educational system. Further high quality randomized controlled trials are required to establish high-quality evidence.
Information needs of ethnically diverse, vaccine-hesitant parents during decision-making about the HPV vaccine for their adolescent child: a qualitative study
Authors: Fisher Harriet , Denford Sarah , Audrey Suzanne , Finn Adam , Hajinur Huda , Hickman Matthew , Mounier-jack Sandra , Mohamed Asha , Roderick Marion , Tucker Leanne , Yates Julie , Chantler Tracey
Published: January 2024

Background

The English schools-based human papillomavirus (HPV) vaccination programme has the potential to eliminate HPV-related cancers if high uptake is achieved. However, unmet information needs among some parents may contribute to persisting lower uptake among minority ethnic groups. Through this study we aimed to understand the information needs of vaccine-hesitant, ethnically diverse parents during decision-making about the HPV vaccine for their adolescent child, to inform the future development of tailored communication materials.

Methods

Recruitment was facilitated thorough healthcare and community organisations within London and the South West of England. Semi-structured interviews took place between April and August 2023. Thematic analysis was undertaken, assisted by NVivo software.

Results

Of the 29 parents interviewed, the majority were mothers (79%), belonged to a minority ethnic group (88%), and had an adolescent child unvaccinated against HPV (72%). Five of the interviews were undertaken in the participants’ primary language with translation support. Most parents interviewed had limited knowledge about the HPV vaccine and appeared conflicted as to whether vaccines could offer benefits to health. Misunderstanding around the potential of developing serious side-effects (e.g. fertility issues, developing cancer) were factors that could negatively impact decision-making by parents. Stigma associated with the sexual transmissibility of HPV did not always negatively impact decision-making. However, some parents chose not to vaccinate on the basis of perceptions of low risk and a preference to provide education about sexual behaviours to their adolescent child.

Conclusions

Tailoring communication materials to address misunderstandings could support informed decision-making by vaccine hesitant parents for their adolescent children to be vaccinated against HPV. Future communication materials about the HPV vaccine should highlight the benefits of protection against cancer to increase parents’ motivation for protect their adolescent child; provide accurate convincing information in relation to the excellent safety profile; and emphasise the importance of providing HPV vaccine at the recommended age, all alongside communicating the universality and commonality of HPV infection.

Trial registration

N/A.
Association between depressive symptoms and employment type of Korean workers: the Fifth Korean Working Conditions Survey
Authors: Yang Yun-Jung , Lee Jihye
Published: January 2024

Background

This study analyzed the association between depressive symptoms and employment type, by considering both socioeconomic status and job stress factors.

Methods

We analyzed 27,369 participants (13,134 men and 14,235 women) using data from the fifth Korean Working Conditions Survey. The participants were divided into regular and precarious workers. Depressive symptoms were defined using the World Health Organization-5 Well-Being Index. A multivariate logistic regression analysis was performed to assess the association between depressive symptoms and employment type.

Results

Of the participants, 71.53% (N = 19578) were regular workers and 28.47% (N = 7791) were precarious workers. The weighted frequencies of participants with depressive symptoms (42.50%) were significantly higher than those of precarious workers (32.54%, p < 0.001). In the univariate and multivariate analyses, precarious workers had a significantly higher risk of depressive symptoms than regular workers (odds ratio [OR] 1.53, 95% confidence interval [CI] 1.42–1.64; OR 1.16, 95% CI 1.07–1.26, respectively). The significant association between depressive symptoms and precarious workers has also been reflected in propensity score matched participants through crude and multivariate analysis (OR 1.54 [95% CI 1.43–1.66] and OR 1.15 [95% CI 1.04–1.26], respectively).

Conclusions

The findings suggest that precarious workers may have a higher risk of depressive symptoms than regular workers. However, this is only a cross-sectional study. Therefore, further study is required to investigate the relevance association between depressive symptoms and employment types.