bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing standardized speech and language assessment tools in Mandarin Chinese: A context for improving reading and writing
Authors: Jin Lixian , Zhu Hua
Published: September 2023

Discussion to improve reading/writing competences of all students too often assumes ‘normal’ language development, hence it easily omits consideration of language disability and overlooks significant groups of learners – in China, potentially 70 million children and adults with speech and language therapy needs. However, little information is available about practices for language assessments in Chinese and about how language assessment tools are used in kindergartens and schools in China. To address this gap, this study explores the circumstances and provisions for assessing Mandarin-speaking children; through a survey, interviews and observations it ascertains the needs for assessment tools and identifies associated challenges. Specifically, data are analysed through 145 questionnaires gathered from Chinese speech and language therapists (SLTs) to help identify key difficulties in using current language assessment tools. In addition, seven individual interviews with SLTs and two focus-group interviews were conducted to probe the reasons underlying the difficulties and to identify strategies for improvement. The analysis shows a severe shortage of reliable and valid speech and language assessment tools in Chinese. With due training for language teachers and SLTs, these standardized tools could be applied in kindergarten and school contexts. If systematic and affordable pre- and in-service language assessment training programmes are established, they can support teachers in kindergartens and schools to develop reading and writing in Chinese with solid evidence, besides identifying children who may have delays in language development. Without standardized tools to measuring reading and writing abilities accurately, and without early assessment and appropriate intervention, some children with language disabilities will face lifelong disadvantages. In this way, developing Mandarin Chinese assessment tools for SLTs is part of wider literacy development for all.
Development of orientation sensitivity to Chinese characters in preschoolers: Evidence from a longitudinal study
Authors: Zhang Wenfang , Li Su
Published: September 2023

Recent studies have shown that young children’s orientation sensitivity is correlated with their reading ability. However, the development of orientation sensitivity to Chinese characters with different complexities (e.g., simple characters and compound characters) in preschool children is unknown. To fill this gap, the current three-year longitudinal study aimed to investigate the development of orientation sensitivity to Chinese simple characters and compound characters. A total of 50 Chinese children were first tested at their first kindergarten years (T1: mean age = 3.62 years) and then tested annually on a variety of tasks for three years (T2: mean age = 4.63 years; T3: mean age = 5.58 years). Children’s orientation sensitivity to Chinese characters was assessed using two perceptual-matching tasks. The results showed that the inverted and mirrored orientation sensitivity to Chinese characters demonstrated different developmental trajectories. Specifically, children possessed inverted and mirrored orientation knowledge of Chinese simple characters at the age of 4. They also displayed sensitivity to inverted Chinese compound characters at the age of 5. However, mirrored orientation knowledge of Chinese compound characters did not emerge until the age of 5. These results suggest that children’s inverted orientation knowledge of Chinese characters developed earlier. Moreover, the complexity of Chinese characters affected the development of orientation knowledge of Chinese characters.
The difficulty and challenge in Chinese children’s character reading: An analysis based on Chinese curriculum standards and Chinese character reading research
Authors: Liu Baogen , Wang Kaiyue , Wang Wanqin , Wang Lu , Li Feifei
Published: September 2023

Chinese character reading is the focus of Chinese teaching in the lower grades of primary school, and it is also a difficult point and challenging problem in the transition from kindergartens (K3) to primary school. To understand the learning slope of children's Chinese character reading in this transition, this study assessed the requirements of Chinese curriculum standards for compulsory education over the years based on the number of Chinese characters being learned by children in the lower grades of primary school. The results showed that the requirement of 1600 Chinese characters was, is, and will be the “should level” required at this stage of education. Comparing it with the levels achieved by children in kindergartens and primary schools in the empirical research from 2005 to 2021, it was found that the slope of children's Chinese character reading was not in the transition between K3 and Grade 1 but rather between Grades 1 and 2. The study proposed that to alleviate the slope in this transition, we should pay more attention to Chinese character teaching in Grade 2, improve the abilities of Grade 2 students’ Chinese character reading, and help them reach the requirements of the curriculum standards, in order to prevent the pressure of Chinese character reading from Grade 2 flooding back into Grade 1, causing parents to worry about their children's Chinese character reading before entering primary school.
Risk factors in underweight older children with sickle cell anemia: a comparison of low- to high-income countries
Authors: Klein Lauren Jane , Abdullahi Shehu Umar , Gambo Safiya , Stallings Virginia A. , Acra Sari , Rodeghier Mark , DeBaun Michael R.
Published: September 2023

Previously, we demonstrated that older children with sickle cell anemia (SCA) living in Nigeria are at increased risk of death if they are underweight (weight-for-age z score < −1). We now conducted a cross-sectional study in low- and high-income settings to determine the risk factors for being underweight a in children aged 5 to 12 years with SCA. The children from low- and high-income settings were eligible participants for the Primary Prevention of Stroke in Children with Sickle Cell Disease in Nigeria (SPRING; N = 928) and the Silent Cerebral Infarct (SIT, North America/Europe; N = 1093) trials, respectively. The median age in the SPRING and SIT cohorts was 8.1 and 8.5 years, respectively (P < .001). A total of 87.9% (n = 816) of participants in the SPRING trial (low-income) met the study criteria for being underweight (weight-for-age z score < −1), and 22.7% (n = 211) for severely underweight (weight-for-age z score < −3), significantly higher than the SIT (high-income) cohort at 25.7% underweight (n = 281) and 0.7% severely underweight (n = 8; P < .001 for both comparisons). In the combined cohort, older age (odds ratio [OR], 1.24; P < .001) and lower hemoglobin level (OR, 0.67; P < .001) were associated with being underweight. Age and hemoglobin level remained statistically significant in separate models for the SPRING and SIT cohorts. Older age and lower hemoglobin levels in children aged 5 to 12 years with SCA are associated with being underweight in low- and high-income settings.
Application of R2-ISS risk stratification to patients with multiple myeloma treated with autologous stem cell transplants at UAMS
Authors: Guo Wancheng , Zhan Anne , Mery David E. , Munshi Manit N. , Makhoul Oussama , Baily Clyde , Zangari Maurizio , Tricot Guido , Peng Hongling , Shaughnessy John D.
Published: September 2023

The Second Revision of the International Staging System (R2-ISS) was published in 2022 and has been validated in several cohorts of patients with multiple myeloma (MM). In this study, we investigated a total of 860 patients with MM who received an upfront autologous stem cell transplantation between 2001 and 2021. The median age of the patients was 60 years, with a median overall survival (OS) of 123 months and median progression-free survival (PFS) of 70 months. We collected the variables included in the ISS, R-ISS, and R2-ISS systems as well as additional standard variables. Our analyses demonstrated that all 3 ISS series systems (ISS, R-ISS, and R2-ISS) exhibited robust discrimination in terms of both OS and PFS among our study cohort. The ISS system effectively stratified patients into 3 risk groups, whereas the R-ISS system accurately identified patients at extremely high or low risk. The R2-ISS system further refined risk stratification by dividing patients into 4 more balanced risk groups. Furthermore, we specifically focused on identifying variables that distinguished patients with OS < 3 years and OS > 10 years within the low-risk R2-ISS stages (I and II) and high-risk R2-ISS stages (III and IV). Our findings revealed that age, hemoglobin, and 1p deletion significantly influenced the classification of patients in the low-risk R2-ISS stage. Additionally, serum light chain, platelet count, age, and the presence of the t(14;16) translocation were found to affect high-risk classification.
Impaired fibrinolysis and increased clot strength are potential risk factors for thrombosis in lymphoma
Authors: Bønløkke Søren Thorgaard , Fenger-Eriksen Christian , Ommen Hans Beier , Hvas Anne-Mette
Published: September 2023

Thrombosis and bleeding are significant contributors to morbidity and mortality in patients with hematological cancer, and the impact of altered fibrinolysis on bleeding and thrombosis risk is poorly understood. In this prospective cohort study, we investigated the dynamics of fibrinolysis in patients with hematological cancer. Fibrinolysis was investigated before treatment and 3 months after treatment initiation. A dynamic clot formation and lysis assay was performed beyond the measurement of plasminogen activator inhibitor 1, tissue- and urokinase-type plasminogen activators (tPA and uPA), plasmin-antiplasmin complexes (PAP), α-2-antiplasmin activity, and plasminogen activity. Clot initiation, clot propagation, and clot strength were assessed using rotational thromboelastometry. A total of 79 patients were enrolled. Patients with lymphoma displayed impaired fibrinolysis with prolonged 50% clot lysis time compared with healthy controls (P = .048). They also displayed decreased clot strength at follow-up compared with at diagnosis (P = .001). A patient with amyloid light-chain amyloidosis having overt bleeding at diagnosis displayed hyperfibrinolysis, indicated by a reduced 50% clot lysis time, α-2-antiplasmin activity, and plasminogen activity, and elevated tPA and uPA. A patient with acute promyelocytic leukemia also displayed marked hyperfibrinolysis with very high PAP, indicating extreme plasmin generation, and clot formation was not measurable, probably because of the extremely fast fibrinolysis. Fibrinolysis returned to normal after treatment in both patients. In conclusion, patients with lymphoma showed signs of impaired fibrinolysis and increased clot strength, whereas hyperfibrinolysis was seen in patients with acute promyelocytic leukemia and light-chain amyloidosis. Thus, investigating fibrinolysis in patients with hematological cancer could have diagnostic value.
Neuropsychiatric events associated with montelukast in patients with asthma: a systematic review
Authors: Lo Chris Wai Hang , Pathadka Swathi , Qin Simon Xiwen , Fung Lydia W.Y. , Yan Vincent Ka Chun , Yiu Hei Hang Edmund , Bloom Chloe I. , Wong Ian Chi Kei , Chan Esther Wai Yin
Published: September 2023

Background:

The United States Food and Drug Administration issued a black box warning on the mental health adverse effects of montelukast in 2020. Age-related effects on the risk of developing specific neuropsychiatric events in montelukast users remain largely unknown.

Objective:

To describe the risk of neuropsychiatric events associated with montelukast in adults and children with asthma.

Methods:

A systematic search of all studies investigating neuropsychiatric events in montelukast users was performed in PubMed, the Cochrane Library and Embase from inception to 7 September 2022. Animal studies and conference abstracts were excluded.

Results:

59 studies (21 pharmacovigilance studies, four reviews from 172 randomised controlled trials, 20 observational studies, 10 case reports and four case series) evaluating neuropsychiatric events in patients with asthma on montelukast were reviewed. No significant association was shown between montelukast and suicide-related events in six of the observational studies. No association was found for depression as defined by the International Classification of Diseases 10threvision codes in three observational studies and a review of randomised clinical trials. However, findings from four studies using antidepressant prescriptions as the outcome identified significant associations. Consistent with nine pharmacovigilance studies, two large-scale observational studies revealed possible associations of montelukast with anxiety and sleeping disorders in adult patients with asthma, respectively. However, the results were not replicated in two observational studies on children.

Conclusion:

Montelukast is not associated with suicide- and depression-related events in asthma patients. Older adults may be particularly susceptible to anxiety and sleeping disorders.
Factors associated with the status of usual source of care during the COVID-19 pandemic: a nationwide survey in Japan
Authors: Aoki Takuya , Matsushima Masato
Published: September 2023

Background

To ensure that high-quality primary care is available to every individual, increasing the proportion of residents with a usual source of care (USC) is a challenge for each country. However, the status of USC after the spread of COVID-19 and the factors associated with it remain unclear internationally. Therefore, we aimed to explore the associations of sociodemographic and clinical factors with the presence and type of USC (kakaritsukei in Japanese) during the pandemic in Japan.

Methods

We conducted a nationwide cross-sectional survey of a representative sample of the general Japanese adult population in May 2021. The main outcome measures were the presence and type of USC. We assessed sociodemographic and clinical factors, including age, gender, marital status, years of education, employment status, annual household income, social isolation, health literacy, number of chronic conditions, and health-related quality of life.

Results

Of the 1,757 participants, 1,011 (57.5%) had a USC. There were 769 (76.1%) participants who had a USC in a clinic and 227 (22.5%) in a hospital. As a result of multivariable modified Poisson regression analysis, male gender, no chronic condition, lower health literacy, and social isolation were significantly associated with not having a USC. Among participants with a USC, male gender, the presence of one or more chronic conditions, and lower health-related quality of life were associated with having a hospital-based USC.

Conclusions

We identified factors associated with the status of USC during the COVID-19 pandemic, including health literacy and social isolation. These findings provide primary care providers and policymakers with insight into the potential barriers to having a USC in the aftermath of the pandemic.
Biochemical and histopathological evidence for beneficial effects of Empagliflozin pretreatment on acetic acid-induced colitis in rats
Authors: Nazari-Khanamiri Fereshteh , Jafari Abbas , Esmaeilzadeh Zeinab , Ghasemnejad-Berenji Morteza
Published: September 2023

Background

Ulcerative Colitis (UC) is a disorder which oxidative stress plays a critical role in its pathogenesis. Empagliflozin (EMPA) is a sodium-glucose cotransporter-2 (SGLT2) inhibitor that has been shown to have anti-inflammatory and antioxidative effects. The aim of this study was to investigate the protective effects of EMPA on acetic acid (AA) induced colitis in rats.

Methods

A total of twenty-four rats were divided into four groups (six animals in each group) as follows: (1) Control group; (2) acetic acid (AA)-induced colitis group (AA); (3) EMPA treatment group (AA + EMPA); (4) Dexamethasone (Dexa) treatment group (AA + Dexa). Animals in pre-treatment groups received EMPA (10 mg/kg, i.p.) or dexamethasone (4 mg/kg, i.p. as reference drug) for four consecutive days before induction of colitis by intra-rectal acetic acid (4% v/v) administration. Twenty-four hours after AA administration, rats were sacrificed and the colon tissues were removed for histopathological and biochemical evaluations.

Results

Pretreatment with EMPA significantly decreased colon weight/length ratio (81.00 ± 5.28 mg/cm vs. 108.80 ± 5.51 mg/cm) as well as, macroscopic (2.50 ± 0.57 vs. 3.75 ± 0.25) and histological scores (3.3 ± 0.14 vs. 1.98 ± 0.14) compared to the AA-induced colitis group (p < 0.01). Pretreatment with EMPA significantly reduced malondialdehyde (MDA) (324.0 ± 15.93 vs. 476.7 ± 32.26 nmol/mg p < 0.001) and increased glutathione level (117.5 ± 4.48 vs. 94.38 ± 3.950 µmol/mg, p < 0.01) in comparison to the AA-induced colitis group. Furthermore, a significant increase in catalase (44.60 ± 4.02 vs.14.59 ± 2.03 U/mg, P < 0.01), superoxide dismutase (283.9 ± 18.11 vs. 156.4 ± 7.92 U/mg, p < 0.001), and glutathione peroxidase (10.38 ± 1.45 vs. 2.508 ± 0.37, p < 0.01) activities were observed by EMPA pretreatment when compared to the AA-induced colitis group. These results were in line with those of the reference drug.

Conclusions

It is concluded that EMPA could effectively reduce the severity of tissue injury in experimental colitis. This protective effect may be related to the antioxidative effects of EMPA drug.
Spatiotemporal gait parameter fluctuations in older adults affected by mild cognitive impairment: comparisons among three cognitive dual-task tests
Authors: Du Shan , Ma Xiaojuan , Wang Jiachen , Mi Yan , Zhang Jie , Du Chengxue , Li Xiaobo , Tan Huihui , Liang Chen , Yang Tian , Shi Wenzhen , Zhang Gejuan , Tian Ye
Published: September 2023

Backgrounds

Gait disorder is associated with cognitive functional impairment, and this disturbance is more pronouncedly when performing additional cognitive tasks. Our study aimed to characterize gait disorders in mild cognitive impairment (MCI) under three dual tasks and determine the association between gait performance and cognitive function.

Methods

A total of 260 participants were enrolled in this cross-sectional study and divided into MCI and cognitively normal control. Spatiotemporal and kinematic gait parameters (31 items) in single task and three dual tasks (serial 100-7, naming animals and words recall) were measured using a wearable sensor. Baseline characteristics of the two groups were balanced using propensity score matching. Important gait features were filtered using random forest method and LASSO regression and further described using logistic analysis.

Results

After matching, 106 participants with MCI and 106 normal controls were recruited. Top 5 gait features in random forest and 4 ~ 6 important features in LASSO regression were selected. Robust variables associating with cognitive function were temporal gait parameters. Participants with MCI exhibited decreased swing time and terminal swing, increased mid stance and variability of stride length compared with normal control. Subjects walked slower when performing an extra dual cognitive task. In the three dual tasks, words recall test exhibited more pronounced impact on gait regularity, velocity, and dual task cost than the other two cognitive tests.

Conclusion

Gait assessment under dual task conditions, particularly in words recall test, using portable sensors could be useful as a complementary strategy for early detection of MCI.
Implication of different frailty criteria in older people with atrial fibrillation: a prospective cohort study
Authors: Liu Junpeng , Chai Ke , Zhu Wanrong , DU Minghui , Meng Chen , Yang Lin , Cui Lingling , Guo Di , Sun Ning , Wang Hua , Yang Jiefu
Published: September 2023

Background

the prevalence of physical and multidimensional frailty and their prognostic impact on clinical outcomes in patients with atrial fibrillation (AF) is unclear.

Objective

to evaluated frailty in a cohort of patients with AF according to different criteria, and studied the prevalence and its prognostic impact on clinical outcomes.

Methods

in this multicenter prospective cohort, 197 inpatients ≥ 65 years old with AF were recruited from September 2018 to April 2019.We used Fried Frailty phenotype (Fried) to assess physical frailty, and comprehensive geriatric assessment-frailty index (CGA-FI) to assess multidimensional frailty. The primary outcome was a composite of all-cause mortality or rehospitalization.

Results

the prevalence of frailty was determined as 34.5% by Fried, 42.6% by CGA-FI. Malnutrition and ≥ 7 medications were independently associated with frailty. Kaplan-Meier survival curve showed that the presence of frailty by CGA-FI had significantly lower all-cause mortality or rehospitalization survival rate (log-rank P = 0.04) within 1 year. Multivariate Cox regression adjusted for age and sex showed that the frailty by CGA-FI was significantly associated with the risk of all-cause mortality or rehospitalization within 1 year (HR 1.79, 95% CI 1.10–2.90). However, those associations were absent with the physical frailty. After broader multivariate adjustment, those associations were no longer statistically significant for both types of frailty.

Conclusions

in older people with AF, Multidimensional frailty is more significantly associated with a composite of all-cause mortality or rehospitalization within 1 year than physical frailty, but these association are attenuated after multivariate adjustment.

Clinical trial registration

ChiCTR1800017204; date of registration: 07/18/2018.
Obstructive sleep apnea: a major risk factor for COVID-19 encephalopathy?
Authors: Breville Gautier , Herrmann François , Adler Dan , Deffert Christine , Bommarito Giulia , Stancu Patrick , Accorroni Alice , Uginet Marjolaine , Assal Frederic , Tamisier Renaud , Lalive Patrice H. , Pepin Jean-Louis , Lövblad Karl-Olof , Allali Gilles
Published: September 2023

Background

This study evaluates the impact of high risk of obstructive sleep apnea (OSA) on coronavirus disease 2019 (COVID-19) acute encephalopathy (AE).

Methods

Between 3/1/2020 and 11/1/2021, 97 consecutive patients were evaluated at the Geneva University Hospitals with a neurological diagnosis of COVID-19 AE. They were divided in two groups depending on the presence or absence of high risk for OSA based on the modified NOSAS score (mNOSAS, respectively ≥ 8 and < 8). We compared patients’ characteristics (clinical, biological, brain MRI, EEG, pulmonary CT). The severity of COVID-19 AE relied on the RASS and CAM scores.

Results

Most COVID-19 AE patients presented with a high mNOSAS, suggesting high risk of OSA (> 80%). Patients with a high mNOSAS had a more severe form of COVID-19 AE (84.8% versus 27.8%), longer mean duration of COVID-19 AE (27.9 versus 16.9 days), higher mRS at discharge (≥ 3 in 58.2% versus 16.7%), and increased prevalence of brain vessels enhancement (98.1% versus 20.0%). High risk of OSA was associated with a 14 fold increased risk of developing a severe COVID-19 AE (OR = 14.52).

Discussion

These observations suggest an association between high risk of OSA and COVID-19 AE severity. High risk of OSA could be a predisposing factor leading to severe COVID-19 AE and consecutive long-term sequalae.
Factors affecting practices of recently delivered women on maternal and neonatal health care in selected rural areas of Bangladesh
Authors: Jannat Zerin , Ali Md. Wazed , Alam Nurul , Uddin Md. Jasim
Published: September 2023

Bangladesh has made laudable progress in maternal and child health (MCH). Maternal and child mortalities have reduced substantially accompanied by stellar rise in immunization and contraceptive prevalence rate (CPR). However, such success is distributed unevenly throughout and the country is among one of the top ten countries with highest number of neonatal and under-five children mortalities. Rural Bangladesh is home to more than half of the country’s total population. Yet, disparity in access to healthcare services and information are overt in these areas. Utilization of maternal health services (MHS) is low whereas maternal and child mortalities are high in the rural areas. Thus, this cluster randomized cross sectional study was conducted with the aim to observe the practices that rural women followed in regards to maternal and child health and factors that affected these practices. Primary data was collected from 550 respondents using a structured questionnaire within the time period September—October 2019. All our participants were recently delivered women (RDW), defined in our study as women of reproductive age (15–49 years) who had delivered a child recently, i.e. 12 months prior (September 2018 – August 2019) the data collection. We conducted logistic regression and multivariate analysis to analyze data. Results from this study depict that while 96.3% of RDW opted for ANC visits and 99.1% fed colostrum to their newborn, fewer have had institutional deliveries and the number of RDW who had PNC was only 64.7%. Education was found to be the most prominent factor that affected practices employed by RDW. The more educated a respondent was, the greater the chance was of her engaging in appropriate maternal and child health practices. The RDW preferred and visited private facilities the most to obtain healthcare services with private medical doctors being one of the prime sources of healthcare information for the respondents. On the contrary, monthly expenditure exerted no statistically significant impact on the aforementioned practices. Thus, results of our study imply that interventions enhancing education and health knowledge of women and engaging private sector be designed for improving maternal and neonatal health care in rural areas of Bangladesh.
The effects of the COVID-19 lockdowns on motor skill development of 6- and 7-year old children in the Netherlands: a longitudinal study
Authors: den Uil Anne R. , van Doorn Hemke , Schweitzer Mandy , Janssen Mirka , Scholte Ron H. J. , Busch Vincent
Published: September 2023

Background

The closing of schools and sports clubs during the COVID-19 lockdown raised questions about the possible impact on children’s motor skill development. Therefore, we compared motor skill development over a one-year period among four different cohorts of primary school children of which two experienced no lockdowns during the study period (control cohorts) and two cohorts experienced one or two lockdowns during the study period (lockdown cohorts).

Methods

A total of 992 children from 9 primary schools in Amsterdam (the Netherlands) participated in this study (age 5 – 7; 47.5% boys, 52.5% girls). Their motor skill competence was assessed twice, first in grade 3 (T1) and thereafter in grade 4 (T2). Children in control group 1 and lockdown group 1 were assessed a third time after two years (T3). Motor skill competence was assessed using the 4-Skills Test, which includes 4 components of motor skill: jumping force (locomotion), jumping coordination (coordination), bouncing ball (object control) and standing still (stability). Mixed factorial ANOVA’s were used to analyse our data.

Results

No significant differences in motor skill development over the study period between the lockdown groups and control groups (p > 0.05) were found, but a difference was found between the two lockdown groups: lockdown group 2 developed significantly better than lockdown group 1 (p = 0.008). While socioeconomic status was an effect modifier, sex and motor ability did not modify the effects of the lockdowns.

Conclusions

The COVID-19 lockdowns in the Netherlands did not negatively affect motor skill development of young children in our study. Due to the complexity of the factors related to the pandemic lockdowns and the dynamic systems involved in motor skill development of children, caution must be taken with drawing general conclusions. Therefore, children’s motor skill development should be closely monitored in the upcoming years and attention should be paid to individual differences.
Association between lumbar endplate damage and bone mineral density in patients with degenerative disc disease
Authors: Huang Shan , Lu Ke , Shi Hui-juan , Shi Qin , Gong Ya-qin , Wang Jian-liang , Li Chong
Published: September 2023

Background

To explore the independent association between lumbar endplate damage and bone mineral density (BMD) in patients with degenerative disc disease (DDD).

Methods

This retrospective investigation was based out of a prospectively collected database from the Affiliated Kunshan Hospital of Jiangsu University. Data from 192 DDD patients, collected between December 2018 and January 2022, were chosen for the final analysis. The average total endplate score (TEPS) of lumbar(L) 1-L4 was assessed by magnetic resonance imaging (MRI), and represents the extent of endplate damage. Osteoporosis severity was assessed via the L1-L4 BMD evidenced by dual-energy x-ray absorptiometry (DXA). Other analyzed information included gender, age, body mass index (BMI), and osteophyte score (OSTS). Uni- and multivariate linear regression analyses were employed to evaluate the association between average TEPS and BMD of L1-L4. Moreover, the generalized additive model (GAM) was employed for non-linear association analysis.

Results

Upon gender, age, BMI, and OSTS adjustments, a strong independent inverse relationship was observed between average TEPS and BMD (β, -0.021; 95% CI, -0.035 to -0.007, P-value = 0.00449). In addition, the gender stratification analysis revealed a linear relationship in males, and a non-linear relationship in females. Specifically, there was a significantly stronger negative relationship between average TEPS and BMD in females, when the average TEPS was < 3.75 (β, -0.063; 95% CI, -0.114 to -0.013; P-value = 0.0157). However, at an average TEPS > 3.75, the relationship did not reach significance (β, 0.007; 95% CI, -0.012 to 0.027; P-value = 0.4592).

Conclusions

This study demonstrated the independent negative association between average TEPS and BMD values of L1-L4. Upon gender stratification, a linear relationship was observed in males, and a non-linear association in females. The findings reveal that patients with osteoporosis or endplate damage require more detailed examinations and treatment regimen.
A simple and effective technique for laparoscopic gastrorrhaphy: modified Graham’s patch with barbed suture
Authors: Chou Ta-Chun , Lee Chun-Hui , Soong Ruey-Shyang , Chen Yi-Chan
Published: September 2023

Introduction

Peptic ulcers are caused by unbalanced acid production, and proton pump inhibitors (PPIs) in recent decades have helped to treat peptic ulcers effectively. Meanwhile, the incidence of perforated peptic ulcer (PPU) persists and has a high mortality rate if there is no adequate management. Primary closure with a modified Graham’s patch was well performed in early detected PPU with a small size < 2 cm. A laparoscopic approach for PPU was prescribed for decades with proven feasibility and safety. We introduced an effective technique combined with barbed suture and modified Graham’s patch, which can significantly reduce the surgical time without significantly increasing morbidity and mortality compared with traditional interrupted suture.

Patients and method

We retrospectively collected data from January 2014 to December 2020 in Keelung Change Gung Memorial Hospital, and a total of 154 patients receiving laparoscopic repair of PPU were included. There were 59 patients in the V-loc group (V group) and 95 patients in the laparoscopic primary repair group (P group).

Results

The V group had a significantly shorter operation time than the P group (96.93 ± 22.14 min vs. 123.97 ± 42.14, P < 0.001). Ten patients suffered from morbidity greater than the Clavien‒Dindo classification 4 (5 from V group, and 5 from P group). Three patients with leakage were reported. Two patients were in the V group, and one patient was in the P group (p = 0.432).

Conclusion

Laparoscopic repair with barbed suture and modified Graham’s patch provides a simple and effective technique in the management of acute abdomen. This technique can be easily performed by experienced surgeons and trainees in minimally invasive surgery without affecting patient safety.
Oral manifestations of COVID-19 in unvaccinated patients: a cross-sectional study
Authors: Fernandes Tatiana Jorge , Ogrzewalska Maria , Martins Ezequias Batista , de Siqueira Marilda Agudo Mendonça Teixeira , Brasil Patrícia , Calvet Guilherme Amaral
Published: September 2023

Background

Early studies have highlighted the possible development of dysgeusia and anosmia in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and these manifestations should be considered a potential indication of coronavirus disease 19 (COVID-19). As potential contributors to these symptoms, dentists should perform careful oral and oropharyngeal examinations and document suspicious oral lesions in patients with COVID-19, especially in those who complain of loss of taste and smell. The study’s objective was to assess the prevalence of oral manifestations among ambulatory unvaccinated symptomatic patients with suspected COVID-19 during the acute phase of the disease.

Methods

This cross-sectional study evaluated oral manifestations in adults (aged ≥ 18 years) with suspected and confirmed SARS-CoV-2 infection. Chi-square and Fisher’s exact tests were used to compare data between the groups (rRT-PCR-positive and rRT-PCR-negative patients).

Results

One hundred thirty-six participants were included. Most were female (n = 79; 58.1%), with a mean age of 39.53 (± 14.17) years. Of these, 54 (39.7%) had a positive rRT-PCR test, and 82 (60.3%) had negative rRT-PCR results. Oral manifestations were observed in 40 participants (74.1%) in the rRT-PCR-positive group and 67 participants (81.7%) in the rRT-PCR-negative group. The most common oral manifestations were xerostomia (n = 85; 62.5%) and dysgeusia/ageusia (n = 57; 41.9%). Different rates of gingivitis (n = 12; 22.2% vs. n = 5; 6.1%; p = 0.005) and halitosis (n = 7; 13.0% vs. n = 1; 1.2%; p = 0.007) were observed between the rRT-PCR-positive and -negative groups, respectively. Mouth ulcers, glossitis, tongue coating, and petechiae were reported in both groups without significant differences.

Conclusions

A high prevalence of oral manifestations was observed in symptomatic patients with suspected or confirmed COVID-19.

Clinical Relevance

This study highlights the importance of routine oral examinations by dentists as part of the multidisciplinary care of COVID-19 patients.
Impact of the COVID-19 pandemic crisis on turnover intention among nurses in emergency departments in Thailand: a cross sectional study
Authors: Sungbun Songwut , Naknoi Siripan , Somboon Panjasilpa , Thosingha Orapan
Published: September 2023

Background

During the COVID-19 pandemic in Thailand, a large volume of COVID-19 patients were referred to hospital emergency departments (EDs). This increased job demand and job strain among ED nurses, resulting in a high risk of intention to leave their organization.

Aims

To investigate turnover intention during the COVID-19 pandemic among ED nurses and examine the effect of organizational resources, maladaptive regulation, and job burnout on nurses’ turnover intention.

Method

This cross-sectional study investigated 322 ED nurses. We divided participants into two groups: dark-red zone areas (pandemic crisis areas) and non-red zone areas (non-pandemic crisis areas). Descriptive statistics, Pearson’s correlation analysis, and multiple linear regression (forward stepwise method) were used to analyze factors that predicted turnover intention.

Results

Most participants were female and the mean age was 34.54 years. During COVID-19 pandemic crisis, 72.8% of ED nurses in dark-red zone areas desired to leave their organization. The factors of motivation, exhaustion, and cognitive impairment positively influenced turnover intention among ED nurses in dark-red zone areas. Low availability of organizational resources was associated with an increase in the turnover intention rate. Maladaptive regulation, exhaustion, and cognitive impairment positively influenced turnover intention among ED nurses in non-red zone areas.

Conclusion

Exhaustion and cognitive impairment stand as significant facets of burnout linked to the intention of turnover among ED nurses. To address this, we recommend fostering secure workplace settings and implementing interventions that alleviate job demands and strains for ED nurses, potentially reducing turnover intentions.
Decreased serum 4-Hydroxynonenal level as a biomarker for the progression of steroid-induced osteonecrosis of the femoral head
Authors: Xiao Fangjun , Wei Tengfei , Xiao Huan , He Wei , Wei Qiushi
Published: September 2023

Background

Osteonecrosis of the femoral head (ONFH) is becoming a prevalent global health problem. 4-Hydroxynonenal (4-HNE) serves as a common marker of oxidative stress. This study aims to study the potential role of 4-HNE in the progression of steroid-induced osteonecrosis of the femoral head (SIONFH).

Method

Between April 2021 and December 2021, 64 subjects were enrolled in this cross-sectional case‒control study. Thirty-six patients were grouped based on the Association Research Circulation Osseous (ARCO) classification, and 28 healthy volunteers without hip pain or any lesions shown in anteroposterior and frog-leg lateral pelvic radiographs served as the normal control group. Bone hematoxylin–eosin (HE) staining, microcomputed tomography (micro-CT), immunohistochemistry, and levels of plasma 4-HNE were evaluated.

Results

The 4-HNE level was higher in the SIONFH group than in the normal control group (P < 0.001), and 4-HNE levels were significantly higher in SIONFH patients in the early stage of disease (stage II). The 4-HNE level was negatively correlated with ARCO stage (r = − 0.6875, P < 0.001). Immunohistochemistry revealed the presence of 4-HNE in the trabecular bone, osteocytes, and bone marrow.

Conclusion

The 4-HNE level is negatively associated with ARCO stages. Lower levels of 4-HNE may serve as a critical biomarker for the progression of SIONFH.
RET/PTC rearrangement in papillary thyroid carcinoma arising in malignant struma ovarii with abdominal wall metastasis and cervical thyroid gland: a case report and review of the literature
Authors: Kabootari Maryam , Habibi Tirtashi Reza , Zadeh-Vakili Azita , Zarkesh Maryam , Samadanifard Hossein , Haghighi Shirin , Azizi Fereidoun , Amouzegar Atieh
Published: September 2023

Background

Struma ovarii refers to rare mature cystic teratomas containing at least 50% of thyroid tissue, and malignant transformation is known to be even rarer. The synchronous development of malignant struma ovarii and cervical thyroid carcinoma are also scarce and poorly understood due to limited data about molecular features. Here, we present the first report of RET/PTC 1 rearrangement in synchronous metastatic malignant struma ovarii to the abdominal wall and cervical thyroid cancer.

Case presentation

We described a 47-year-old multigravida woman with bilateral adnexal and lower abdominal wall masses detected during the evaluation of abnormal uterine bleeding. The patient underwent a hysterectomy, bilateral salpingo-oophorectomy, and surgical removal of abdominal wall mass. Then, the pathological evaluation revealed papillary thyroid carcinoma (PTC) within struma ovarii and metastatic PTC in the abdominal wall fibro adipose tissue. Further, cervical thyroid gland physical examination and ultrasound illustrated a nodule within the left lobe. Subsequently, a total thyroidectomy was performed, and a histological examination revealed PTC. Furthermore, all affected tissue, i.e., struma ovarii, abdominal wall metastasis, and cervical thyroid gland tested for BRAF and RAS mutations and RET/PTC 1 rearrangement. RET/PTC 1 rearrangement was identified among all three different sites. Finally, after six years of follow-up, the patient had no evidence of recurrence or distant metastasis.

Conclusions

In light of these findings, malignant struma ovarii might yield a clue to cervical thyroid carcinoma, and the molecular analysis could provide valuable information for understanding the underlying mechanism, tumor clinicopathological behaviors, and prognosis.
Modelling Innovation competence profiles: the empowering roles of self-monitoring and resilience
Authors: Ojo Kolawole Shola , Volkova Natalia V.
Published: September 2023

Background

Innovation competence has been found to constitute distinct innovative abilities that must be analyzed together to get a more comprehensive picture of their effectiveness in various targeted groups. Drawn from the componential theory of creativity, such personal traits as individual resilience and self-monitoring play a critical role in developing innovation competence across students. This research aims to investigate the innovation competence profiles of students from various educational levels and study the role of individual resilience and self-monitoring in predicting the memberships of these profiles.

Methods

A cross-sectional survey was conducted among university and college students, studying in a metropolitan area of the North-West region. The sampling scheme was stratified by the level of education and age. The questionnaire included items on the participants’ demographics, including gender, age, and level of education, measures of innovative abilities, individual resilience, and self-monitoring. This study sought to create innovation competence profiles in the student population using latent profile analysis. Multinomial logistic regression was employed to identify the impact of individual resilience and self-monitoring on innovation competence profile membership.

Results

A sample of 638 university and college students was analyzed. The latent profile analysis classified students into three different innovation competence profiles - strong, moderate, and weak - with college and female students being identified as the typical members of the weak profile. Individual resilience increases the odds of membership into the strong profile than to moderate and weak profiles. High self-monitors have higher chances of being profiled into the strong profile than the weak and moderate profiles compared to the low self-monitors.

Conclusions

Training investment aimed at boosting the innovative abilities of employees should consider the innovation competence profile of the beneficiaries to inform decisions about the appropriate level of intervention required. Likewise, educators could enrich their courses devoted to improving the innovative abilities of students with content that aims to improve their level of resilience accompanied by social support. Theoretical and practical implications are also discussed.
Investigation of LIG-based pressure sensors with various silicon-based elastomeric encapsulation layers
Authors: Shin Yoo-Kyum , Kim Ki-Hoon , Seo Min-Ho
Published: September 2023

Laser-induced graphene (LIG) has attracted significant interest in the field of pressure sensors owing to the high sensitivity associated with its inherent three-dimensional porous structure. However, the brittleness of fabricated LIG poses a critical challenge in terms of durability. To address this issue, current research on LIG-based pressure sensors has focused on the utilization of Si-elastomer encapsulation layers. Despite the importance of the mechanical properties of Si elastomers for the performance of physical sensors, few studies have been conducted on the characterization of pressure sensors based on the encapsulation layer. In this study, we investigated the electromechanical characteristics of LIG-based pressure sensors encapsulated in various Si-based elastomers. For an unbiased evaluation, we first introduce a simple and reliable fabrication process for LIG-based pressure sensors with different Si-elastomer encapsulation layers. Subsequently, the electromechanical responses of the sensors were characterized using an automated pressure machine, demonstrating that sensors with encapsulation layers with a lower Young’s modulus exhibited increased resistance changes and extended response times. Finally, an in-depth exploration of the environmental stability of the pressure sensors was conducted for various encapsulation materials, ultimately confirming negligible performance variations based on the encapsulation materials.
Preparation and sustained-release study of Litsea cubeba essential oil inclusion complex with γ-cyclodextrin-metal–organic frameworks
Authors: Zheng Wenxi , Zhang Sheng , Chen Jie
Published: September 2023

Background

Litsea cubeba essential oil (LCEO) is a food additive that requires encapsulation to delay its release due to its irritating nature. To identify an appropriate inclusion material, gamma (γ)-cyclodextrin (CD)-metal organic frameworks (MOF) were prepared, and the sustained release of the inclusion complex (IC) was studied.

Results

The γ-CD-MOF was formed using γ-CD, potassium hydroxide (KOH), cetyltrimethylammonium bromide (CTAB), and silane coupling agents through the vapor diffusion method. The highest encapsulated rate achieved was 26.02%, with a temperature of 50 °C, a stirring time of 2.5 h, and an LCEO to γ-CD dosage ratio of 1:8. During the adsorption test, the amount of LCEO gradually increased within the first 180 min. However, after this time, there was no significant change in the adsorption amount of LCEO, indicating that the γ-CD-MOF had reached adsorption equilibrium. The average release rate of the IC reached 9.76% at 11 h. By comparison, the average release rate of the IC with γ-CD was 9.30% at 10 min, resulting in a diffusion index of 0.349. Under ultraviolet (UV) scanning, the sustained-release solution of the IC exhibited a strong characteristic citral absorption peak at 238 nm. Moreover, under infrared spectroscopy scanning, the absorption peak intensity of the IC was 1.19 times higher than that of blank γ-CD-MOF at 1676 cm−1. The IC, as observed through a scanning electron microscope, exhibited round pellets with a diameter of 40–60 μm. Energy dispersive spectroscopy images showed uniform distribution of potassium and sulfur elements. In X-Ray diffraction, the diffraction peaks of the IC were found at 5.27°, 7.45°, 10.54°, 12.08°, 14.20°, 14.92°, 15.84°, 16.68°, 19.24°, 21.80°, and 23.69°, with no significant change in the adsorption amount of LCEO. The Brunauer–Emmett–Teller (BET) testing revealed that the surface area of γ-CD-MOF was 5.089 m2/g, and the pore diameter was 3.409 nm by the Barrett–Joyner–Halenda (BJH) method.

Conclusion

These data demonstrated that the sustained effect of the γ-CD-MOF was superior to that of γ-CD. The adsorption kinetics curve followed the Quasi-primary kinetics model, while the release curve adhered to the Ritger–Peppas model. Furthermore, the release behavior was primarily governed by the Fick diffusion mechanism, which was advantageous for achieving the sustained release of LCEO. The UV spectrum, infrared spectroscopy (IR), scanning electron microscopy–energy dispersive spectroscopy (SEM–EDS), X-ray diffraction (XRD), and BET techniques confirmed the successful formation of the IC of LCEO with γ-CD-MOF. This study offers a promising technical solution for delaying the release and improving the sustained-release product of LCEO.

Graphical Abstract