bluuebunny/crossref_metadata_2025 huggingface dataset:
Brentuximab vedotin plus doxorubicin and dacarbazine in nonbulky limited-stage classical Hodgkin lymphoma
Authors: Abramson Jeremy S. , Bengston Elizabeth , Redd Robert , Barnes Jeffrey A. , Takvorian Tak , Sokol Lubomir , Lansigan Frederick , Armand Philippe , Shah Bijal , Jacobsen Eric , Martignetti Rosalba , Turba Elyce , Metzler Sara , Patterson Victoria , LaCasce Ann S. , Bello Celeste M.
Published: September 2022

ABVD (Adriamycin, bleomycin, vinblastine, dacarbazine) with or without radiation has been the standard treatment for limited-stage Hodgkin lymphoma (HL) but carries risks of bleomycin lung injury and radiation toxicity. Brentuximab vedotin (BV) is approved with AVD for stage III-IV HL, but carries increased risks of peripheral neuropathy (PN) and neutropenic fever, likely due to overlapping toxicity between BV and vinblastine. We therefore evaluated BV in combination with AD for 4 or 6 cycles based on interim positron emission tomography response. Thirty-four patients with nonbulky stage I-II HL were enrolled. Risk was early favorable in 53% and unfavorable in 47%. The overall and complete response rates (CRRs) were 100% and 97%, respectively, with a 5-year progression-free survival (PFS) of 91%. No differences in outcome were observed based on stage (I vs II) or risk status (early favorable vs unfavorable). The most common adverse events were nausea (85%), peripheral sensory neuropathy (59%), and fatigue (56%). There were no cases of grade-4 neutropenia or neutropenic fever, and no patient received granulocyte-colony stimulating factor. Most cases of PN were grade 1, and no patient experienced grade ≥3 PN. BV-AD produced a high CRR and durable PFS with most patients requiring 4 cycles of therapy. Compared with BV-AVD, the toxicity profile appeared improved, with predominantly grade 1 reversible PN and no case of grade 4 neutropenia or neutropenic fever. This regimen warrants further study in HL and may serve as a backbone for the addition of novel agents. This trial is registered on clinicaltrials.gov (NCT02505269).
Adding caplacizumab to standard of care in thrombotic thrombocytopenic purpura: a systematic review and meta-analysis
Authors: Djulbegovic Mia , Tong Jiayi , Xu Alice , Yang Joanna , Chen Yong , Cuker Adam , Pishko Allyson M.
Published: September 2022

Immune thrombotic thrombocytopenic purpura (iTTP) is an acquired, fatal microangiopathy if untreated. Randomized controlled trials (RCTs) demonstrated faster time to response with addition of caplacizumab to standard of care (SOC). However, concerns about RCT selection bias and the high cost of caplacizumab warrant examination of all evidence, including real-world observational studies. In this systematic review and meta-analysis, we searched for comparative studies evaluating SOC with or without caplacizumab for the treatment of iTTP. We assessed risk of bias using the Cochrane risk-of-bias-2 tool (RCTs) and the Newcastle-Ottawa Scale (observational studies). The primary efficacy and safety outcomes were all-cause mortality and treatment-emergent bleeding, respectively. Secondary outcomes included exacerbation and relapse, refractory iTTP, and time to response. We included 2 high-quality RCTs and 3 observational studies at high risk of bias comprising 632 total participants. Compared with SOC, caplacizumab was associated with a nonsignificant reduction in the relative risk [RR] of death in RCTs (RR, 0.21; 95% confidence interval [CI], 0.05-1.74) and observational studies (RR, 0.62; 95% CI, 0.07-4.41). Compared with SOC, caplacizumab was associated with an increased bleeding risk in RCTs (RR, 1.37; 95% CI, 1.06-1.77). In observational studies, bleeding risk was not significantly increased (RR, 7.10; 95% CI, 0.90-56.14). Addition of caplacizumab was associated with a significant reduction in refractory iTTP and exacerbation risks and shortened response time but increased relapse risk. Frontline addition of caplacizumab does not significantly reduce all-cause mortality compared with SOC alone, although it reduces refractory disease risk, shortens time to response, and improves exacerbation rates at the expense of increased relapse and bleeding risk.
TCRvβ-CART therapy mediates high-precision targeting of malignant T-cell clones
Authors: Shaw Lauren C. , Poussin Mathilde , Rodriguez-Garcia Alba , Eggold Joshua , Minutolo Nicholas G. , Wang Jie , Rook Alain H. , Schuster Stephen J. , Powell Daniel J.
Published: September 2022

Peripheral T-cell lymphomas (PTCLs) are a heterogeneous group of lymphoid malignancies associated with poor prognosis due to ineffective treatment options and high rates of relapse. The success of chimeric antigen receptor T-cell (CART) therapy for certain hematologic malignancies makes it an attractive treatment option for PTCLs. However, shared expression of potential target antigens by both malignant and healthy T cells poses a challenge. Current prospective CART approaches cause a high degree of on-target, off-tumor activity, resulting in fratricide during CART expansion, depletion of healthy T cells in vivo, and immune compromise in the patient. To limit off-tumor targeting, we sought to develop a CART platform specific for a given T-cell receptor vβ (TCRvβ) family that would endow CAR-modified T cells with the ability to mediate lysis of the clonal malignant population while preserving the majority of healthy T cells. Here, CAR constructs specific for multiple TCRvβ family members were designed and validated. Our results demonstrate that TCRvβ-family–specific CARTs (TCRvβ-CARTs) recognize and kill TCRvβ-expressing target cells. This includes specific self-depletion of the targeted cell subpopulation in the CART product and lysis of cell lines engineered to express a target TCRvβ family. Furthermore, TCRvβ-CARTs eliminated the dominant malignant TCRvβ clone in 2 patient samples. Finally, in immunodeficient mice, TCRvβ-CARTs eradicated malignant cells in a TCRvβ-dependent manner. Importantly, the nontargeted TCRvβ families were spared in all cases. Thus, TCRvβ-CART therapy provides a potential option for high-precision treatment of PTCL with limited healthy T-cell depletion.
Disease- and headache-specific microRNA signatures and their predicted mRNA targets in peripheral blood mononuclear cells in migraineurs: role of inflammatory signalling and oxidative stress
Authors: Aczél Timea , Benczik Bettina , Ágg Bence , Körtési Tamás , Urbán Péter , Bauer Witold , Gyenesei Attila , Tuka Bernadett , Tajti János , Ferdinandy Péter , Vécsei László , Bölcskei Kata , Kun József , Helyes Zsuzsanna
Published: September 2022

Background

Migraine is a primary headache with genetic susceptibility, but the pathophysiological mechanisms are poorly understood, and it remains an unmet medical need. Earlier we demonstrated significant differences in the transcriptome of migraineurs' PBMCs (peripheral blood mononuclear cells), suggesting the role of neuroinflammation and mitochondrial dysfunctions. Post-transcriptional gene expression is regulated by miRNA (microRNA), a group of short non-coding RNAs that are emerging biomarkers, drug targets, or drugs. MiRNAs are emerging biomarkers and therapeutics; however, little is known about the miRNA transcriptome in migraine, and a systematic comparative analysis has not been performed so far in migraine patients.

Methods

We determined miRNA expression of migraineurs’ PBMC during (ictal) and between (interictal) headaches compared to age- and sex-matched healthy volunteers. Small RNA sequencing was performed from the PBMC, and mRNA targets of miRNAs were predicted using a network theoretical approach by miRNAtarget.com™. Predicted miRNA targets were investigated by Gene Ontology enrichment analysis and validated by comparing network metrics to differentially expressed mRNA data.

Results

In the interictal PBMC samples 31 miRNAs were differentially expressed (DE) in comparison to healthy controls, including hsa-miR-5189-3p, hsa-miR-96-5p, hsa-miR-3613-5p, hsa-miR-99a-3p, hsa-miR-542-3p. During headache attacks, the top DE miRNAs as compared to the self-control samples in the interictal phase were hsa-miR-3202, hsa-miR-7855-5p, hsa-miR-6770-3p, hsa-miR-1538, and hsa-miR-409-5p. MiRNA-mRNA target prediction and pathway analysis indicated several mRNAs related to immune and inflammatory responses (toll-like receptor and cytokine receptor signalling), neuroinflammation and oxidative stress, also confirmed by mRNA transcriptomics.

Conclusions

We provide here the first evidence for disease- and headache-specific miRNA signatures in the PBMC of migraineurs, which might help to identify novel targets for both prophylaxis and attack therapy.
Using environmental monitoring data from apex predators for chemicals management: towards better use of monitoring data from apex predators in support of prioritisation and risk assessment of chemicals in Europe
Authors: Treu Gabriele , Slobodnik Jaroslav , Alygizakis Nikiforos , Badry Alexander , Bunke Dirk , Cincinelli Alessandra , Claßen Daniela , Dekker Rene W. R. J. , Göckener Bernd , Gkotsis Georgios , Hanke Georg , Duke Guy , Jartun Morten , Movalli Paola , Nika Maria-Christina , Rüdel Heinz , Tarazona Jose V. , Thomaidis Nikolaos S. , Tornero Victoria , Vorkamp Katrin , Walker Lee A. , Koschorreck Jan , Dulio Valeria
Published: September 2022

A large number of apex predator samples are available in European research collections, environmental specimen banks and natural history museums that could be used in chemical monitoring and regulation. Apex predators bioaccumulate pollutants and integrate contaminant exposure over large spatial and temporal scales, thus providing key information for risk assessments. Still, present assessment practices under the different European chemical legislations hardly use existing chemical monitoring data from top predators. Reasons include the lack of user-specific guidance and the fragmentation of data across time and space. The European LIFE APEX project used existing sample collections and applied state-of-the-art target and non-target screening methods, resulting in the detection of > 4,560 pollutants including legacy compounds. We recommend establishing infrastructures that include apex predators as an early warning system in Europe. Chemical data of apex species from freshwater, marine and terrestrial compartments should become an essential component in future chemical assessment and management across regulations, with the purpose to (1) validate registration data with ‘real world’ measurements and evaluate the predictability of current models; (2) identify and prioritise hazardous chemicals for further assessment; (3) use data on food web magnification as one line of evidence to assess biomagnification; (4) determine the presence of (bio)transformations products and typical chemical mixtures, and (5) evaluate the effectiveness of risk management measures by trend analysis. We highlight the achievements of LIFE APEX with regard to novel trend and mixture analysis tools and prioritisation schemes. The proposed advancements complement current premarketing regulatory assessments and will allow the detection of contaminants of emerging concern at an early stage, trigger risk management measures and evaluations of their effects with the ultimate goal to protect humans and the environment. This is the second policy brief of the LIFE APEX project.
Comparison of antibacterial and antibiofilm activity of bioactive glass compounds S53P4 and 45S5
Authors: Zhou Peng , Garcia Brittny L. , Kotsakis Georgios A.
Published: September 2022

Background

Bone loss and deformation due to damage caused by injury or recurrent invasive infections presents a major clinical obstacle. While bone substitute biomaterials promote osseous tissue regeneration, their application in sites complicated by microbial infections such as osteomyelitis, is limited. Bioactive glass biomaterials (Bioglass) have been shown to have efficient mechanisms of repairing the integrity of bone, while inhibiting growth of a range of bacterial strains. There are several commercially available bioactive glass compounds, each with a unique chemical composition. One compound in particular, S53P4, has demonstrated antimicrobial effects in previous studies but the antimicrobial activity of the parent compound 45S5 has not been investigated.

Results

To assess whether antimicrobial activity is common among bioglass compounds, 45S5-the parent compound, was evaluated in comparison to S53P4 for antibacterial and antibiofilm effects against multiple strains of aerobic and anaerobic bacteria associated with various types of osteomyelitis. Experiments of antimicrobial effects in liquid cultures demonstrated that both compounds were antimicrobial against various microbial genera includingS. gordonii,V. parvula,P. aeruginosaand MRSA; particles of the smallest size (32–125 µm) invariably showed the most robust antimicrobial capabilities. When employed against biofilms ecological biofilms grown on hydroxyapatite, 45S5 particles produced a stronger reduction in biofilm mass compared to S53P4 particles when considering small particle ranges.

Conclusion

We found that 45S5 seems to be as effective as S53P4 and possibly even more capable of limiting bacterial infections. The efficacy of bioactive glass was not limited to inhibition of planktonic growth, as it also extended to bacterial biofilms. The increased antibacterial activity of 45S5 compared to S53P4 is true for a variety of size ranges.
Observations on the pollination and breeding systems of two Corybas species (Diurideae; Orchidaceae) by fungus gnats (Mycetophilidae) in southwestern Yunnan, China
Authors: Han Zhou-Dong , Wu You , Bernhardt Peter , Wang Hong , Ren Zong-Xin
Published: September 2022

Modes of floral presentation in some angiosperms attract flies that eat and/or oviposit on seasonal fruiting bodies of fungi. Mushroom mimesis by orchid flowers has been speculated in the geoflorous, Indo-Malaysian-Australasian, genusCorybass.l. for decades but most studies remain fragmentary and are often inconclusive. Here we report the roles of fungus gnats as pollinators ofCorybas geminigibbusandC. shanlinshiensisin southwestern Yunnan, China, combining results of field observations, lab analyses, and manipulative experiments. Hand pollination experiments suggested both species were self-compatible but incapable of mechanical self-pollination, thereby requiring pollinators for fruit production. A female of aPhthiniasp. (Mycetophilidae) carried a pollinarium ofC. geminigibbusdorsally on its thorax. Two females and one male ofExechiasp. (Mycetophilidae) visiting flowers ofC. shanlinshiensiscarried dorsal depositions of pollinaria on their thoraces. Mycetophilid eggs were not found in the flowers of either species. The comparative fragrance analyses of these flowers and three co-fruiting mushroom species did not suggest that either orchid species was a brood-site mimic. This is the first confirmation of the dispersal of pollinaria ofCorybasspecies by fungus gnats in subtropical-temperate Asia.
Investigation of risk factors for tunneled hemodialysis catheters dysfunction: competing risk analysis of a tertiary center data
Authors: Mohazzab Arash , Khavanin Zadeh Morteza , Dehesh Paria , Abdolvand Neda , Rahimi Zhaleh , Rahmani Sahar
Published: September 2022

Background

Hemodialysis tunneled catheters are prone to failure due to infection or thrombosis. Prediction of catheter dysfunction chance and finding the predisposing risk factors might help clinicians to prolong proper catheter function. The multidimensional mechanism of failures following infection or thrombosis needs a multivariable and comprehensive analytic approach.

Methods

A longitudinal cross-sectional study was implemented on 1048 patients admitted for the first hemodialysis tunneled catheterization attempt between 2013 and 2019 in Shahid Hasheminejdad hospital, Tehran, Iran. Patients’ information was extracted from digital and also paper records. Based on their criteria, single and multiple variable analyses were done separately in patients with catheter dysfunction due to thrombosis and infection. T-test and Chi-square test were performed in quantitative and categorical variables, respectively. Competing risk regression was performed under the assumption of proportionality for infection and thrombosis, and the sub-distributional hazard ratios (SHR) were calculated. All statistical inferences were made with a significance level of 0.05.

Results

Four hundred sixty-six patients were enrolled in the analysis based on study criteria. Samples’ mean (SD) age was 54(15.54), and 322 (69.1%) patients were female. Three hundred sixty-five catheter dysfunction cases were observed due to thrombosis 123(26.4%) and infection 242(52%). The Median (range) time to catheter dysfunction event was 243(36–1131) days.

Single variable analysis showed a statistically significant higher proportion of thrombosis in females (OR = 2.66, 95% CI: 1.77–4.00) and younger patients, respectively. Multivariate competing risk regression showed a statistically significant higher risk of thrombosis in females (Sub-distributional hazard (SHR) = 1.81), hypertensive (SHR = 1.82), and more obese patients (BMI SHR = 1.037). A higher risk of infection was calculated in younger (Age SHR = 0.98) and diabetic (SHR = 1.63) patients using the same method.

Conclusion

Female and hypertensive patients are considerably at higher risk of catheter thrombosis, whereas diabetes is the most critical risk factor for infectious catheter dysfunction. Competing risk regression analysis showed a comprehensive result in the assessment of risk factors of catheter dysfunction.
Clinical features, etiology, and prognosis of hand knob stroke: a case series
Authors: Zhang Zhiyong , Sun Xiaoxin , Liu Xinxiu , Wang Lei , Zhu Rui
Published: September 2022

Background

Hand knob stroke is a rare clinical disorder frequently misdiagnosed as peripheral neuropathy. The purpose of this study is to recognize this particular type of stroke by analyzing clinical features, etiology, and prognosis.

Methods

We enrolled 19 patients with acute hand knob stroke in the Department of Neurology of the Beijing Geriatric Hospital from January 2018 to January 2022, and the clinical and imaging data of the patients during hospitalization and follow-up were collected and summarized.

Results

Acute hand knob stroke accounted for 0.9% of all acute stroke, and ischemic stroke (17 cases, 89.5%) was more than hemorrhagic stroke (2 cases, 10.5%). All patients presented sudden contralateral hand paresis, 12 (63.2%) of them had only isolated hand paralysis, and the location of the lesion corresponded to different finger weakness. The cause of hand knob hemorrhage was hypertension, while the causes of hand knob infarction were mainly small-vessel occlusion (SVO) (35.3%) and large-artery atherosclerosis (LAA) (35.3%), and the rare causes include carotid artery dissection and carotid body tumor. After a median follow-up 13.5 months, the prognosis of 94.7% patients was good, and one patient (5.3%) had recurrent stroke.

Conclusions

Hand knob stroke is a rare stroke with a good prognosis and a low stroke recurrence rate. Ischemic stroke is the predominant type and the main clinical manifestation is hand paresis. The cause of hand knob hemorrhage is hypertensive, while SVO and LAA are the main causes of hand knob infarction, but there are some rare etiologies.
“Alcohol intoxication by proxy on a NICU” - a case report
Authors: Wurst Ulrike , Ackermann Benjamin , Kiess Wieland , Thome Ulrich , Gebauer Corinna
Published: September 2022

Background

Ethanol intoxications in newborns are generally due to false preparation of formula with alcoholics or alcohol consumption by the breastfeeding mothers. Rarely, intoxications occur in hospitalized newborns, e.g., from excessive use of alcoholic hand sanitizers. We herein report a strange case of acute ethanol intoxications in our NICU.

Case presentation

An extremely premature infant (23 0/7 weeks gestational age, birthweight 580 g) suffered from repeated life-threatening events with hemodynamic compromise, apnea, and lactic acidosis while being treated in our neonatal intensive care unit (NICU). Symptomatic treatment with intravenous fluids and, if necessary, intubation and catecholamine therapy led to recovery after several hours each time. The episodes eventually turned out to be severe ethanol intoxications brought about by breast milk contaminated with ethanol. The breast milk was supplied by the infant’s mother, who consumed non-trivial amounts of alcohol to build up her strength and make herself produce more milk, which was recommended to her by a family member. Additionally, she supplemented her own mother’s milk with cow’s milk because she was worried her baby was underserved with her milk. The mother admitted to this in intensive conversations with our team and a professional translator.

Conclusions

This unique case underlines how different cultural dynamics can attribute to life-threatening events in the care of premature infants. It is important for us to emphasize that intensive communication and building a confident relationship with the parents of patients is essential to the work on NICUs. Child safeguarding issues and possibilities of intoxications have to stay in mind even in a supposedly safe space like the NICU.
Teacher reports of emotional and behavioral problems in Nepali schoolchildren: to what extent do they agree with parent reports?
Authors: Ma Jasmine , Mahat Pashupati , Brøndbo Per Håkan , Handegård Bjørn H. , Kvernmo Siv , Javo Anne Cecilie
Published: September 2022

Background

Teacher reports of child emotional and behavioral problems (EBPs) are sparse in many low- and middle-income countries, especially when compared to reports from parents. Cross-informant information is pivotal to clinicians when dealing with mentally ill children. In this study from Nepal, we examined teacher reports of child EBPs, the agreement between teacher and parent reports, and how this agreement varied by type of EBP and child gender.

Methods

This cross-sectional, observational study included 3808 schoolchildren aged 6–18 years from 16 districts of Nepal. Teacher and parent reports of EBPs were measured by the Nepali versions of the Teacher Report Form (TRF) and the Child Behavior Checklist (CBCL), respectively. Linear mixed model analysis was used for group comparisons and intraclass correlations. Agreement between TRF and CBCL scale scores were analyzed using Pearson’s correlation coefficient.

Results

The prevalence of EBPs according to teacher reports was 15.4%, whereas the previous parent reported prevalence was 19.1%. Also, the mean TRF score was significantly lower than mean CBCL score for the 90 common items. Mean TRF scores for Total Problems, Externalizing Problems, and Internalizing Problems were 26.9 (standard deviation, SD 24.5), 6.1 (SD 7.2), and 7.9 (SD 7.3), respectively. Consistent with parent reports, mean TRF scores for Total Problems and Externalizing Problems were higher among boys than girls, whereas no significant gender differences were found for Internalizing Problems. Teacher-parent agreement was moderate (r = .38), and slightly higher for Externalizing Problems than for Internalizing Problems (r = .37 versus r = .34). Moderate to low correlations were found for all syndrome scales, with coefficients ranging from r = .26 (Social Problems) to r = .37 (Attention Problems). The effect of child gender on the teacher-parent agreement was significant for Internalizing Problems only, with a higher agreement for girls than for boys.

Conclusion

Nepali teachers reported fewer child EBPs than parents. Teacher-parent agreement was moderate and varied by type of EBP and child gender. Our findings underscore the importance of obtaining information on child EBPs from both parents and teachers when evaluating and treating children in low- and middle-income countries like Nepal.
Nutritional status of under six years old children in Kalar city, Kurdistan Region, Iraq
Authors: Fateh Hawal Lateef , Nachvak Mostafa , Abdollahzad Hadi , Rezaeian Shahab , Darand Mina , Bagheri Amir
Published: September 2022

Introduction

Nutritional problems in children cause major morbidity and mortality in the world. This study aimed to assess the nutritional status of under six years old children in Kalar city, Kurdistan Region, Iraq.

Methods

In this longitudinal study, data from 403 Iraqi Kurdish children aged 0–72 months and their mothers were extracted from Health Centre in Kalar city undertaken between 2013 and 2019. The children`s growth data were obtained at birth time, 6, 12, 24, and 72 months. Epi Info was used to classify the children of nutritional status by converting the anthropometric measurements into Z-scores. Data were analyzed using SPSS 25 software.

Results

The prevalence of overweight and obesity rose from birth to age 6 years old, from 19.6% and 7.4% to 52.2% and 30.5%, respectively. At 24 month, children had the highest rates of being overweight (56.1%) and obesity (34%). At 6 month, the highest prevalence of wasting exists (9.5%). At 6 month boys and girls had the highest frequency of stunting, 17.2% and 7.2% respectively. Considering the association of all characteristic variables and growth data at birth time, only mothers with academic education had children with significantly higher BMI for age compared to illiterate mothers after adjusting for all potential confounders (β: 0.573, 95% CI: 0.105, 1.04, P: 0.017).

Conclusion

The study suggests that some analysed factors that accounted for malnutrition in Kalar city’s children are preventable. Therefore, to reduce the burden of malnutrition, community-based education and targeted nutritional interventions are required.
Evidence from the Hamburg City Health Study – association between education and periodontitis
Authors: Walther Carolin , Spinler Kristin , Borof Katrin , Kofahl Christopher , Heydecke Guido , Seedorf Udo , Beikler Thomas , Terschüren Claudia , Hajek Andre , Aarabi Ghazal
Published: September 2022

Objective

Large-scale population-based studies regarding the role of education in periodontitis are lacking. Thus, the aim of the current study was to analyze the potential association between education and periodontitis with state of the art measured clinical phenotypes within a large population-based sample from northern Germany.

Material & methods

The Hamburg City Health Study (HCHS) is a population-based cohort study registered at ClinicalTrial.gov (NCT03934957). Oral health was assessed via plaque-index, probing depth, gingival recession and gingival bleeding. Periodontitis was classified according to Eke & Page. Education level was determined using the International Standard Classification of Education (ISCED-97) further categorized in “low, medium or high” education. Analyses for descriptive models were stratified by periodontitis severity. Ordinal logistic regression models were stepwise constructed to test for hypotheses.

Results

Within the first cohort of 10,000 participants, we identified 1,453 with none/mild, 3,580 with moderate, and 1,176 with severe periodontitis. Ordinal regression analyses adjusted for co-variables (age, sex, smoking, diabetes, hypertension and migration) showed that the education level (low vs. high) was significantly associated with periodontitis (OR: 1.33, 95% CI: 1.18;1.47).

Conclusion

In conclusion, the current study revealed a significant association between the education level and periodontitis after adjustments for a set of confounders. Further research is needed to develop strategies to overcome education related deficits in oral and periodontal health.
Participation of patients during arthroscopic partial meniscectomy is conducive to postoperative rehabilitation and satisfaction: a single-center retrospective study
Authors: Ruan Pengfei , Ji RuiQing , Shen Jing , Wang Xiang , Ji Weifeng
Published: September 2022

Purpose

To evaluate the effect of patient participation in arthroscopic partial meniscectomy (APM) on rehabilitation and patient satisfaction.

Methods

A total of 86 patients of traumatic longitudinal vertical meniscus tears, between January 2017 and December 2020 at the First Affiliated Hospital of Zhejiang Chinese Medical University, met the inclusion and exclusion criteria. The patients in the intraoperative participation group (n = 33) were awake and could watch the screen during APM and communicate with the surgeon in the surgery; patients who underwent APM in the traditional mode were classified as the traditional group(n = 53). The differences in exercise adherence, the Knee Injury and Osteoarthritis Outcome Score (KOOS) and satisfaction at follow-up were compared. In the intraoperative participation group, the mean age of the patients was 26.97 ± 5.63 years and the follow-up time was 25.12 ± 6.23 months. In the traditional group, the mean age of the patients was 29.21 ± 5.29 years and the follow-up time was 25.08 ± 6.70 months.

Results

The intraoperative participation group reported a better result in exercise adherence (78.79% VS 50.94%, p = 0.012). As secondary outcomes, Patients in the intraoperative participation group demonstrated better scores on the KOOS domains of pain (79.80 ± 6.38 VS 76.26 ± 5.33, p = 0.007), Symptoms (59.41 ± 5.27 VS 56.74 ± 5.97, p = 0.038), and QOL (65.91 ± 10.72 VS 60.26 ± 9.34, p = 0.012), as compared to these in the traditional group. There were no significant differences in the KOOS domains of Sport (72.88 ± 8.20 VS 72.64 ± 7.70, P = 0.892), and ADL (89.47 ± 3.50 VS 87.87 ± 4.50 p = 0.085). what’s more, in the intraoperative participation group, the results of satisfaction (96.97% VS 81.13%, p = 0.025) were also significantly better.

Conclusion

The mode of participation of patients during APM can improve patients’ exercise adherence, reduce pain, improve symptoms and improve patients’ satisfaction as well as the quality of life. More work is needed to develop this mode further.
Prevalence of chronic pelvic pain and primary dysmenorrhea in women of reproductive age in Ecuador
Authors: de Las Mercedes Villa Rosero Carmen Yolanda , Mazin Suleimy Cristina , Nogueira Antonio Alberto , Vargas-Costales José Antonio , Rosa-e-Silva Julio Cesar , Candido-dos-Reis Francisco José , Poli-Neto Omero Benedicto
Published: September 2022

Background

Chronic pelvic pain (CPP) and primary dysmenorrhoea are debilitating conditions that can impair the quality of life of affected women. These conditions are frequently neglected, delaying proper diagnosis and healthcare provision. This study aimed to estimate the prevalence of CPP and primary dysmenorrhoea in Ecuador and identify potential variables associated with their occurrence.

Methods

We conducted a cross-sectional survey in an urban neighbourhood of Quito, the capital of Ecuador. A total of 2397 participants of 14–49 years of age were included. The data were collected through questionnaires administered by trained interviewers.The crude and adjusted prevalence ratios were calculated using a log-binomial regression model. The correlation between pain intensity catastrophising of symptoms were statistically analysed.

Results

The prevalence of CPP and primary dysmenorrhoea was 9.8% and 8.9%, respectively. Irritative urinary symptoms, primary dysmenorrhoea, and underlying mental disorders were associated with CPP, while smoking, irritable bowel syndrome, sleep disturbance, dyspareunia, and mental disorders were associated with primary dysmenorrhoea.

Conclusions

The prevalence of CPP and primary dysmenorrhoea in Ecuador was similar to that in other Latin American countries. Primary dysmenorrhoea is a risk factor of CPP, and less than a quarter of women are undergoing treatment for the condition. Our findings reinforce the importance of healthcare interventions in anticipating the diagnosis of these conditions in women of reproductive age.
Effects of plant-based medicinal food on postoperative recurrence and lung metastasis of gastric cancer regulated by Wnt/β-catenin-EMT signaling pathway and VEGF-C/D-VEGFR-3 cascade in a mouse model
Authors: Tian Lin , Chen Xuxi , Cao Li , Zhang Lishi , Chen Jinyao
Published: September 2022

Background

The plant-based medicinal food (PBMF) is a functional compound extracted from 6 medicinal and edible plants: Coix seed, L. edodes, A. officinalis L., H. cordata, Dandelion, and G. frondosa. Our previous studies have confirmed that the PBMF possesses anti-tumor properties in a subcutaneous xenograft model of nude mice. This study aims to further investigate the effects and potential molecular mechanisms of the PBMF on the recurrence and metastasis of gastric cancer (GC).

Methods

Postoperative recurrence and metastasis model of GC was successfully established in inbred 615 mice inoculated with mouse forestomach carcinoma (MFC) cells. After tumorectomy, 63 GC mice were randomly divided into five groups and respectively subject to different treatments for 15 days as below: model control group, 5-Fu group, and three doses of PBMF (43.22, 86.44, 172.88 g/kg PBMF in diet respectively). The inhibition rate (IR) of recurrence tumor weights and organ coefficients were calculated. Meanwhile, histopathological changes were examined and the metastasis IR in lungs and lymph node tissues was computed. The mRNA expressions related to the canonical Wnt/β-catenin signaling pathway, epithelial-mesenchymal transition (EMT) and lymphangiogenesis were detected by RT-qPCR in recurrence tumors and/or lung tissues. Protein expressions of β-catenin, p-β-catenin (Ser33/37/Thr41), GSK-3β, p-GSK-3β (Ser9), E-cadherin, and Vimentin in recurrence tumors were determined by Western Blot. LYVE-1, VEGF-C/D, and VEGFR-3 levels in recurrence tumors and/or lung tissues were determined by immunohistochemistry staining.

Results

The mRNA, as well as protein expression of GSK-3β were up-regulated and the mRNA expression of β-catenin was down-regulated after PBMF treatment. Meanwhile, the ratio of p-β-catenin (Ser33/37/Thr41) to β-catenin protein was increased significantly and the p-GSK-3β (Ser9) protein level was decreased. And PMBF could effectively decrease the mRNA and protein levels of Vimentin while increasing those of E-cadherin. Furthermore, PBMF markedly reduced lymphatic vessel density (LVD) (labeled by LYVE-1) in recurrence tumor tissues, and mRNA levels of VEGF-C/D, VEGFR-2/3 of recurrence tumors were all significantly lower in the high-dose group.

Conclusions

PBMF had a significant inhibitory effect on recurrence and lung metastasis of GC. The potential mechanism may involve reversing EMT by inhabiting the Wnt/β-catenin signaling pathway. Lymphatic metastasis was also inhibited by PBMF via down-regulating the activation of the VEGF-C/D-VEGFR-2/3 signaling cascade.
Early transcriptional responses of bronchial epithelial cells to whole cigarette smoke mirror those of in-vivo exposed human bronchial mucosa
Authors: van der Does Anne M. , Mahbub Rashad M. , Ninaber Dennis K. , Rathnayake Senani N. H. , Timens Wim , van den Berge Maarten , Aliee Hananeh , Theis Fabian J. , Nawijn Martijn C. , Hiemstra Pieter S. , Faiz Alen
Published: September 2022

Background

Despite the well-known detrimental effects of cigarette smoke (CS), little is known about the complex gene expression dynamics in the early stages after exposure. This study aims to investigate early transcriptomic responses following CS exposure of airway epithelial cells in culture and compare these to those found in human CS exposure studies.

Methods

Primary bronchial epithelial cells (PBEC) were differentiated at the air–liquid interface (ALI) and exposed to whole CS. Bulk RNA-sequencing was performed at 1 h, 4 h, and 24 h hereafter, followed by differential gene expression analysis. Results were additionally compared to data retrieved from human CS studies.

Results

ALI-PBEC gene expression in response to CS was most significantly changed at 4 h after exposure. Early transcriptomic changes (1 h, 4 h post CS exposure) were related to oxidative stress, xenobiotic metabolism, higher expression of immediate early genes and pro-inflammatory pathways (i.e., Nrf2, AP-1, AhR). At 24 h, ferroptosis-associated genes were significantly increased, whereas PRKN, involved in removing dysfunctional mitochondria, was downregulated. Importantly, the transcriptome dynamics of the current study mirrored in-vivo human studies of acute CS exposure, chronic smokers, and inversely mirrored smoking cessation.

Conclusion

These findings show that early after CS exposure xenobiotic metabolism and pro-inflammatory pathways were activated, followed by activation of the ferroptosis-related cell death pathway. Moreover, significant overlap between these transcriptomic responses in the in-vitro model and human in-vivo studies was found, with an early response of ciliated cells. These results provide validation for the use of ALI-PBEC cultures to study the human lung epithelial response to inhaled toxicants.
Mixed methods systematic review of the literature base exploring working alliance in the chiropractic profession
Authors: Ivanova Dima , Bishop Felicity L. , Newell Dave , Field Jonathan , Walsh Madeleine
Published: September 2022

Background

The construct of working alliance has been used to operationalise the patient–clinician relationship. Research evidence from the rehabilitation literature has established an association between the construct and several patient outcomes. The aim of this systematic literature review was to study working alliance in the chiropractic discipline.

Method

This review followed a mixed method systematic review methodology: EBSCO (The Allied and Complementary Medicine Database), EBSCO (MEDLINE), EBSCO PsycINFO, Web of Science Core Collection, Chiro index, and grey literature were searched for quantitative, qualitative, and mixed methods studies on 17th March 2021. Qualitative appraisal was conducted using the Mixed Methods Appraisal Tool, version 2018. The qualitative component was synthesised via thematic synthesis and explored patients’ and chiropractors’ perceptions of the nature and role of working alliance. The quantitative component was synthesised via narrative synthesis to examine how the construct has been measured in research and what its effect on clinical outcomes and patient satisfaction is. The findings were integrated in the discussion section.

Results

Thirty studies were included. The qualitative component found that both patients and chiropractors consider working alliance as a key factor in the treatment journey. The findings illustrated that the construct includes the bond between a patient and a chiropractor which is underpinned by trust and attentiveness to patients’ needs, values and preferences. Qualitative data also suggested that strong working alliance has the potential to improve patients’ adherence to treatment and that it is characterised by ongoing negotiation of expectations about the goals of care and the tasks involved in the treatment plan. The quantitative component highlighted that even though working alliance is relevant to the chiropractic discipline, very few studies have quantitatively measured the construct and its effect.

Conclusion

The findings of this review emphasise the subjective importance of working alliance in the chiropractic clinical encounter. However, there were not enough homogenous studies measuring the effect of working alliance on clinical outcomes and patient satisfaction to conduct a meta-analysis. Future research should focus on evaluating potential direct and mediated effects on patient outcomes.
Efficacy and safety of Jin-shui Huan-xian granule for idiopathic pulmonary fibrosis: study protocol for a multicenter, randomized, double-blind, placebo-controlled trial
Authors: Yang Shu-guang , Yu Xue-qing , Li Jian-sheng , Xie Yang , Zhang Wei , Ban Chengjun , Feng Jihong , Wu Lei , Lu Xuechao , Zhao Limin , Meng Yong , Zhou Miao , He Yong , Luo Weixian
Published: September 2022

Background and rationale

Idiopathic pulmonary fibrosis is a critical disease with a poor prognosis. Although different studies have been conducted for the treatment of idiopathic pulmonary fibrosis, limited treatments are available. Jin-shui Huan-xian granule (JHG), which is a Chinese medicine herbal compound, has shown promising efficacy in reducing frequencies of acute exacerbations, improving exercise capacity the quality of life of patients with idiopathic pulmonary fibrosis. This study is to evaluate the efficacy and safety of JHG for IPF.

Subjects and methods

This is a multicenter, randomized, double-blind, placebo-controlled clinical trial. A total of 312 idiopathic pulmonary fibrosis patients will be enrolled and randomly allocated to one of the two groups with 1:1. After a 2-week washout period, 52-week treatment will also be performed for all the patients. Patients in the experimental group and the control group will be given JHG and JHG placebo, respectively. Outcome measures including acute exacerbations, pulmonary function, dyspnea, exercise capacity, and quality of life will be evaluated in this study.

Discussion

Based on our previous study, it is hypothesized that JHG will reduce acute exacerbations; improve exercise capacity, pulmonary function, and quality of life; and delay the disease progression-free. High-level evidence-based support for TCM in IPF will also be obtained in this study.

Trial registration

ClinicalTrials.gov NCT04187690. Register on December 11, 2019
An overview of Internal Medicine Point-of-Care Ultrasound rotations in Canada
Authors: Gaudreau-Simard Mathilde , Wiskar Katie , Kilabuk Elaine , Walsh Michael H. , Sattin Michael , Wong Jonathan , Burhani Zain , Arishenkoff Shane , Yu Jeffrey , Lam Ada W. , Ma Irene W. Y.
Published: September 2022

Background

Point-of-care ultrasound (POCUS) is a growing part of internal medicine training programs. Dedicated POCUS rotations are emerging as a particularly effective tool in POCUS training, allowing for longitudinal learning and emphasizing both psychomotor skills and the nuances of clinical integration. In this descriptive paper, we set out to review the state of POCUS rotations in Canadian Internal Medicine training programs.

Results

We identify five programs currently offering a POCUS rotation. These rotations are offered over two to thirteen blocks each year, run over one to four weeks and support one to four learners. Across all programs, these rotations are set up as a consultative service that offers POCUS consultation to general internal medicine inpatients, with some extension of scope to the hospitalist service or surgical subspecialties. The funding model for the preceptors of these rotations is predominantly fee-for-service using consultation codes, in addition to concomitant clinical work to supplement income. All but one program has access to hospital-based archiving of POCUS exams. Preceptors dedicate ten to fifty hours to the rotation each week and ensure that all trainee exams are reviewed and documented in the patient’s medical records in the form of a consultation note. Two of the five programs also support a POCUS fellowship. Only two out of five programs have established learner policies. All programs rely on In-Training Evaluation Reports to provide trainee feedback on their performance during the rotation.

Conclusions

We describe the different elements of the POCUS rotations currently offered in Canadian Internal Medicine training programs. We share some lessons learned around the elements necessary for a sustainable rotation that meets high educational standards. We also identify areas for future growth, which include the expansion of learner policies, as well as the evolution of trainee assessment in the era of competency-based medical education. Our results will help educators that are endeavoring setting up POCUS rotations achieve success.
The effects of technological and traditional feedback on back squat performance in untrained women
Authors: Stien N. , Andersen V. , Engelsrud G. H. , Solstad T. E. J. , Saeterbakken A. H.
Published: September 2022

Background

Recently, a novel method for improving movement quality called open-ended augmented feedback has been introduced. However, the effects of using such feedback in a training intervention have not yet been examined. The aim of this study was to assess the changes in performance and movement quality following a five-week resistance-training program with either (1) technological feedback or (2) traditional, verbal feedback from an experienced trainer.

Methods

Nineteen untrained females (age: 21.84 ± 2.24 years, height: 169.95 ± 5.92 cm, body mass: 65.05 ± 7.93 kg) randomly allocated to one of the two conditions completed five weeks of training with two weekly sessions. Pre- and post-intervention, participants were tested for physical performance (i.e., back squat and isometric mid-thigh pull strength) and movement quality parameters (weight distribution, center of gravity variation, and subjective rating of the back squat technique).

Results

Both groups similarly increased the training resistance throughout the intervention (p < 0.01), as well as strength in the back squat (technological feedback group: effect size (ES) = 1.31, p = 0.002; traditional feedback group: ES = 1.48, p = 0.002). Only the traditional feedback group increased isometric mid-thigh pull strength (ES = 1.11, p = 0.008) and subjectively rated lifting technique at the same load (p = 0.046). No changes in force distribution (p = 0.062–0.993) or center of gravity variation (p = 0.160–0.969) occurred in either group when lifting the same absolute loads at post-test. However, both groups displayed a greater variation in center of gravity when lifting the same relative load at post-test (technological feedback group: p < 0.001; traditional feedback group: p = 0.006). No differences were found between the groups for any of the observed changes (p = 0.205–0.401).

Conclusions

Five weeks of back-squat training with verbal feedback increased isometric mid-thigh pull strength and subjectively rated lifting technique from pre- to post-test, whereas technological feedback did not. Both methods improved back squat strength and training resistance. For resistance-training beginners, the choice between feedback methods should be based on the desired outcomes and the availability of expertise and equipment.