bluuebunny/crossref_metadata_2025 huggingface dataset:
Rates and risk factors of intrapedicular accuracy and cranial facet joint violation among robot-assisted, fluoroscopy-guided percutaneous, and freehand techniques in pedicle screw fixation of thoracolumbar fractures: a comparative cohort study
Authors: Zhang Ren-Jie , Zhou Lu-Ping , Zhang Hua-Qing , Ge Peng , Jia Chong-Yu , Shen Cai-Liang
Published: February 2022

Background

Robot-assisted (RA) technique has been increasingly applied in clinical practice, providing promising outcomes of inserting accuracy and cranial facet joint protection. However, studies comparing this novel method with other assisted methods are rare, and the controversy of the superiority between the insertion techniques remains. Thus, we compare the rates and risk factors of intrapedicular accuracy and cranial facet joint violation (FJV) of RA, fluoroscopy-guided percutaneous (FP), and freehand (FH) techniques in the treatment of thoracolumbar fractures.

Methods

A total of 74 patients with thoracolumbar fractures requiring pedicle screw instruments were retrospectively included and divided into RA, FP, and FH groups from June 2016 to May 2020. The primary outcomes were the intrapedicular accuracy and cranial FJV. The factors that affected the intrapedicular accuracy and cranial FJV were assessed using multivariate analyses.

Results

The optimal intrapedicular accuracy of pedicle screw placement (Grade A) in the RA, FP, and FH groups was 94.3%, 78.2%, and 88.7%, respectively. This finding indicates no significant differences of RA over FH technique (P = 0.062) and FP technique (P = 0.025), but significantly higher accuracies of RA over FP (P < 0.001). In addition, the rates of proximal FJV in RA, FP, and FH groups were 13.9%, 30.8%, and 22.7%, respectively. RA had a significantly greater proportion of intact facet joints than the FP (P = 0.002). However, FP and FH (P = 0.157), as well as RA and FH (P = 0.035) showed significantly similar outcomes with respect to the proximal FJV. The logistic regression analysis showed that FP technique (OR = 3.056) was independently associated with insertion accuracy. Meanwhile, the age (OR = 0.974), pedicle angle (OR = 0.921), moderate facet joint osteoarthritis (OR = 5.584), and severe facet joint osteoarthritis (OR = 11.956) were independently associated with cranial FJV.

Conclusion

RA technique showed a higher rate of intrapedicular accuracy and a lower rate of cranial FJV than FP technique, and similar outcomes to FH technique in terms of intrapedicular accuracy and cranial FJV. RA technique might be a safe method for pedicle screw placement in thoracolumbar surgery.

Level of evidence

3
Clinical results of a lamina with spinous process and an iliac graft as bone grafts in the surgical treatment of single-segment lumbar pyogenic spondylodiscitis: a retrospective cohort study
Authors: Tang Ke , Zhong Weiyang , Wang Xiaolin , Luo Xiaoji , Quan Zhengxue
Published: February 2022

Background

A retrospective study compared the results of a lamina with spinous process (LSP) and an iliac graft (IG) as bone grafts in single-segment lumbar pyogenic spondylodiscitis (LPS) through one-stage-posterior-only approach with radical debridement and instrumentation.

Methods

A LSP was placed in 17 patients (group A), and an IG was implemented in 20 patients (group B). The surgery time, surgery hemorrhage, hospital stay, drainage, and follow-up (FU) were recorded and compared. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, visual analogue scale (VAS), Oswestry Disability Index (ODI), segmental angle, intervertebral height and bony fusion time were compared preoperatively and at the final FU.

Results

All patients were followed-up for a mean of 27.94 ± 2.35 months in group A and 30.29 ± 1.89 months in group B, without a difference. The mean age was younger in group A than in group B (P < 0.05). The surgery time, surgery hemorrhage, and hospitalization cost were lower in group A than in group B (P < 0.05), except for the hospital stay and drainage time. 10 patients in group A had fever and 12 patients in group B. The ESR, CRP level, VAS and ODI scores were significantly decreased, and no significant differences were found between the groups at the final FU. The distribution of bacterial agents in blood culture was 1 case of Aerobacter cloacae, 2 of Staphylococcus aureus, 2 of Escherichia coli, and 1 of Streptococcus viridis in group A and 1 of S. aureus, 1 of Staphylococcus warneri and 2 of Klebsiella pneumoniae in group B. Pyogenic infection was observed in the pathological findings of all patients. No significant difference was found in the mean segmental angle or mean intervertebral height preoperation and at the final FU.

Conclusion

The use of LSP could be an effective bone grafting for surgical management for the LPS while surgery is proposed as a good management strategy for single-segment LPS in carefully selected patients.
Comparative outcomes of pure laparoscopic and open donor right hepatectomy: the first report from a Southeast Asian transplant center
Authors: Lapisatepun Worakitti , Junrungsee Sunhawit , Chotirosniramit Anon , Udomsin Kanya , Lapisatepun Warangkana , Chanthima Phuriphong , Boonsri Settapong , Lorsomradee Suraphong
Published: February 2022

Background

Pure laparoscopic donor right hepatectomy (PLDRH) can provide better operative outcomes for the donor than conventional open donor right hepatectomy (CODRH). However, the complexity of the procedure typically makes transplant teams reluctant to perform it, especially in low-volume transplant centers. We compared the outcomes of PLDRH and CODRH to demonstrate the feasibility of PLDRH in a low-volume transplant program.

Methods

We carried out a retrospective study of adult living donor liver transplantation in Chiang Mai University Hospital from January 2015 to March 2021. The patients were divided into a PLDRH group and a CODRH group. Baseline characteristics, operative parameters, and postoperative complications of donors and recipients were compared between the two groups.

Results

Thirty patients underwent donor hepatectomy between the dates selected (9 PLDRH patients and 21 CODRH patients). The baseline characteristics of the 2 groups were not significantly different. The median graft volume of the PLDRH group was 693.8 mL, which was not significantly different from that of the CODRH group (726.5 mL) The PLDRH group had a longer operative time than the CODRH group, but the difference was not statistically significant (487.5 min vs 425.0 min, p = 0.197). The overall complication rate was not significantly different between the two groups (33.3% vs 22.2%, p = 0.555). Additionally, for the recipients, the incidence of major complications was not significantly different between the groups (71.3 vs 55.6%, p = 0.792).

Conclusion

Even in the context of this low-volume transplant program, whose staff have a high level of experience in minimally invasive hepatobiliary surgery, PLDRH showed similar results to CODRH in terms of perioperative outcomes for donors and recipients.
Root coverage of a maxillary lateral incisor with gingival recession, gingival stillman’s cleft, bony exostosis, and denture stomatitis: a case report with 3-year follow-up
Authors: Xie Chengjie , Liu Yeungyeung , Yu Huimin , Mei Jie
Published: February 2022

Background

Coronally advanced flap combined with connective tissue graft is considered as the golden standard of root coverage. Although Miller class I recession is considered to get complete root coverage, there are some uncommon conditions in different cases. This case reported a maxillary lateral incisor with a gingival recession, a stillman’s cleft, a bony exostosis and a denture stomatitis.

Case presentation

A 27-year-old female with a gingival recession, a stillman’s cleft and a bony exostosis was treated by coronally advanced flap combined with connective tissue graft technique, and the complete coverage was achieved. Later a denture stomatitis occurred when an acrylic removable partial denture was used, however the gingival margin was not affected. The denture stomatitis disappeared when a new denture with casting palatal plane was produced. In this case of 3-year follow-up, the gingival contour remained stable and the outcome was satisfactory.

Conclusion

Coronally advanced flap combined with connective tissue graft technique is a classic manner to treat gingival recession especially for a long term stability, even when there is a gingival stillman’s cleft, a bony exostosis and a denture stomatitis.
Developing a framework to describe stigma related to cervical cancer and HPV in western Kenya
Authors: Ginjupalli Ramya , Mundaden Rachel , Choi Yujung , Herfel Emily , Oketch Sandra Yvonne , Watt Melissa H. , Makhulo Breandan , Bukusi Elizabeth Anne , Huchko Megan
Published: February 2022

Background

Despite a high prevalence of human papillomavirus (HPV) and cervical cancer in low and middle-income countries, stigma remains an issue. Addressing HPV and cervical cancer stigma could significantly improve health outcomes for these conditions. The objective of this study was to identify the manifestations of stigma and their potential impacts on health-seeking behavior.

Methods

Twenty-six in-depth interviews were conducted with women living with HIV, HIV-negative women, community health volunteers, and health care providers in Kisumu, Kenya in 2019. The interviews were designed to draw out existing attitudes or experiences related to stigma within the community. We conducted a thematic analysis of the interviews to identify internalized, anticipated, and discriminatory attitudes.

Results

Within internalized attitudes, a prominent observed theme was a fear of death associated with a positive HPV test. This stemmed from a lack of understanding of differences between HPV and cervical cancer and posed a significant barrier for women deciding to seek screening or to continue with treatment. Discriminatory attitudes of community members, including assumptions of promiscuity, infidelity, or HIV status, were perceived to prevent women from accessing screening and treatment opportunities. The interviews also exhibited a limited awareness of HPV in this region, which may have contributed to a lack of enacted stigma towards people living with HPV or cervical cancer.

Conclusion

Stigma has the potential to lead to decreased screening and treatment uptake through its drivers. This includes a decreased perception of personal risk due to a lack of knowledge, which results in increased HPV-risk behaviors. Future research must focus on creating and integrating stigma-reducing interventions, primarily to encourage women to seek out primary and secondary preventative measures.
An ethical analysis of clinical triage protocols and decision-making frameworks: what do the principles of justice, freedom, and a disability rights approach demand of us?
Authors: Zhu Jane , Brenna Connor T. A. , McCoy Liam G. , Atkins Chloë G. K. , Das Sunit
Published: February 2022

Background

The expectation of pandemic-induced severe resource shortages has prompted authorities to draft and update frameworks to guide clinical decision-making and patient triage. While these documents differ in scope, they share a utilitarian focus on the maximization of benefit. This utilitarian view necessarily marginalizes certain groups, in particular individuals with increased medical needs.

Main body

Here, we posit that engagement with the disability critique demands that we broaden our understandings of justice and fairness in clinical decision-making and patient triage. We propose the capabilities theory, which recognizes that justice requires a range of positive capabilities/freedoms conducive to the achievement of meaningful life goals, as a means to do so. Informed by a disability rights critique of the clinical response to the pandemic, we offer direction for the construction of future clinical triage protocols which will avoid ableist biases by incorporating a broader apprehension of what it means to be human.

Conclusion

The clinical pandemic response, codified across triage protocols, should embrace a form of justice which incorporates a vision of pluralistic human capabilities and a valuing of positive freedoms.
Productivity analysis of regional-level hospital care in the Czech republic and Slovak Republic
Authors: Vaňková Ivana , Vrabková Iveta
Published: February 2022

Background

Providing hospital care is an essential objective of national health policies. The countries that share common history, when they emerged from the same health system and similar conditions in the early 1990s, after the division of Czechoslovakia, became the objects of evaluation of the development of technical efficiency of hospital care. The subsequent development of their health care system also was very similar, but no longer entirely identical. The article aims to identify the trends and disparities in the productivity of the capacities of hospital care on the regional level (NUTS III.) in the Czech Republic and the Slovak Republic in 2009–2018 before the COVID-19 pandemic using the multi-criteria decision methods.

Methods

The window analysis as a dynamic DEA method based on moving averages and also the Malmquist Index, that allows the evaluation of changes in relative efficiency and of changes in the production possibilities frontier have become the key methods for evaluating the over time efficiency evolution. To model technical efficiency, an output-oriented method assuming constant returns to scale was chosen. Aggregated input and output parameters for each region were the object of study.

Results

The results showed that differences in the efficiency trends in terms of the examined parameters among the individual regions are slightly greater in the Czech Republic than in the Slovak Republic. The least efficient regions are those where capital cities are located. Furthermore, the analysis showed that in 2018 all of the Slovak Republic regions improved its productivity compared to 2009 and that technological conditions had a significant impact on this improvement. The results of the Czech Republic regions show productivity improvement in 57% of the regions that, on the contrary, was due to changes in technical efficiency.

Conclusions

It should be recommended to the state- and regional-level governments to refrain from unilaterally preferring the orientation of public policies on the efficiency of the provision of hospital care, and rather focus on increasing the quality and availability of hospital care, especially in smaller, rural, and border regions, in the interest of population safety during pandemics and other emergencies.
Comprehensive analysis of N6-methyladenosine regulators with the tumor immune landscape and correlation between the insulin-like growth factor 2 mRNA-binding protein 3 and programmed death ligand 1 in bladder cancer
Authors: Cui Jianfeng , Zhu Yaofeng , Liu Xiaochen , Wang Wenfu , Jiang Xuewen , Xia Yangyang , Zhou Guanwen , Chen Shouzhen , Shi Benkang
Published: February 2022

Background

N6-methyladenosine (m6A) is one of the most abundant post-transcriptional modifications of RNA. However, there is limited information about the potential roles of m6A regulators in tumor immunity. Therefore, in this study, we aimed to testify the functions of m6A regulators in bladder cancer as well as their association with the tumor immune landscape.

Methods

We reported the variation and expression levels of m6A regulators in the TCGA database and GTEx database of bladder cancer. Clusters, risk score patterns, and nomograms were constructed to evaluate the function and prognostic value of m6A regulators. Furthermore, we constructed nomogram to evaluate the prognosis of the individual patients. The correlation between insulin-like growth factor 2 mRNA-binding protein 3 (IGF2BP3) and programmed cell death ligand 1 (PD-L1) was evaluated both in vitro and in vivo.

Results

We found that the tumor grade and DNA damage pathways were strongly correlated with distinct clusters. Furthermore, two risk score groups with six m6A regulators were identified using the least absolute shrinkage and selection operator (LASSO) and multivariable Cox regression analysis, which could be regarded as independent prognostic markers in patients with bladder cancer. The risk score pattern was linked to the tumor immune landscape, indicating a correlation between immune checkpoints and m6A regulators. Moreover, an m6A regulator, IGF2BP3, was found to be highly expressed in the tumor samples, regulating both the total and membrane-bound PD-L1 expression levels.

Conclusions

The results of this study revealed that the m6A clusters and patterns play crucial roles in the regulation of tumor immunity, which may be used to develop comprehensive treatment strategies for the management of bladder cancer.
Best interests and low thresholds: legal and ethical issues relating to needle and syringe services for under 18s in Sweden
Authors: Barrett Damon , Petersson Frida , Turner Russell
Published: February 2022

Access for legal minors to needle and syringe programmes raises a number of practical, legal and ethical challenges that traverse clinical practice, child protection and child rights. This article addresses the current legal age restriction on access to needle and syringe programmes (NSPs) in Sweden. Based on legislation and legislative preparatory works, it traces the rationale for retaining an age restriction in the context of a policy priority to improve access for people who inject drugs. Building on threshold theory and child rights literature, the article unpacks the apparent tension between protecting the low threshold nature of service provision, child protection duties of healthcare staff, and the best interests of the child. It explores whether this tension could be alleviated through replacing a legal age restriction for all with best interests assessments for each individual, and discusses the potential ethical and practical challenges involved in such a change.
Scavenger receptor CD36 governs recruitment of myeloid cells to the blood–CSF barrier after stroke in neonatal mice
Authors: Rayasam Aditya , Mottahedin Amin , Faustino Joel , Mallard Carina , Vexler Zinaida S.
Published: February 2022

Background

Ischemic stroke induces the activation and recruitment of peripheral leukocytes to the injured brain. These cells can infiltrate the brain through multiple routes, either by penetrating blood–brain barrier or via blood–CSF barriers at the meninges or the choroid plexus (CP). We previously showed that myeloid cell trafficking via the CP occurs early after neonatal arterial stroke and modulates injury. CD36 is a receptor that mediates function of endothelial cells and cells of the monocyte lineage under various neurodegenerative conditions and can influence brain injury after neonatal stroke. Here we asked whether CD36 impacts injury by altering leukocyte trafficking through the CP in neonatal mice subjected to transient middle cerebral artery occlusion (tMCAO).

Methods

In neonatal mice with intact or globally disrupted CD36 signalling (CD36 KO), we characterized the phenotypes of myeloid cells by flow cytometry and the underlying gene expression signatures in the CPs contralateral and ipsilateral to tMCAO by RNA sequencing analyses, focussing on early post-reperfusion time window.

Results

Flow cytometry in the isolated CPs revealed that CD36 mediates stepwise recruitment of myeloid cells to the CP ipsilateral to tMCAO early after reperfusion, with a predominant increase first in inflammatory monocyte subsets and neutrophils followed by patrolling monocytes. RNA sequencing analyses demonstrated marked changes in gene expression in the CP ipsilateral compared to the CP contralateral to tMCAO in wild type mice. Changes were further modified by lack of CD36, including distinction in several clusters of genes involved in inflammatory, metabolic and extracellular matrix signalling in the CP ipsilateral to tMCAO.

Conclusion

Altogether, our data suggest cooperation between blood–CSF–brain interface via the CP through CD36-mediated signalling following neonatal stroke with a key role for inflammatory monocytes and neutrophils.
Copper-catalyzed dicarbonyl stress in NAFLD mice: protective effects of Oleuropein treatment on liver damage
Authors: Santini Silvano Junior , Tarantino Giovanni , Iezzi Antonella , Alisi Anna , Balsano Clara
Published: February 2022

Background

Nonalcoholic fatty liver disease (NAFLD) or more appropriately, metabolic associated fatty liver disease (MAFLD), is the hepatic manifestation of metabolic syndrome. An imbalance of copper homeostasis has been described in the progression of NAFLD/MAFLD toward NASH/MASH. We were interested in understanding whether the chelating activity of Oleuropein (Ole) was able to improve the copper accumulation and the related pro-oxidant and glycative damage in the liver of mice fed HFD.

Methods

Twelve C57BL/6J mice fed normal diet (ND) or high-fat diet (HFD) for 16 weeks and then thirty two female and male mice fed ND or HFD for 8 weeks adding Ole for the following 8 weeks were studied.

Results

Altered expression of copper-trafficking genes and proteins (CTR1, CTR2, ATP7B, COX17, CCS, and ATOX1) induced imbalance of copper homeostasis combined with an increase in dicarbonyl stress in the liver of HFD fed mice. Interestingly enough, glyoxalase system was improved by Ole administration and the Ole related protective effects differ in the two sexes of mice.

Conclusions

Our study highlights the role of the dicarbonyl stress in the pathogenesis of NAFLD and suggests Ole as a natural copper chelator to prevent the liver damage induced by methyglyoxal pathway derangement.
Lipid metabolism contribute to the pathogenesis of IgA Vasculitis
Authors: Liu Ying , Wen Min , He Qingnan , Dang Xiqiang , Feng Shipin , Liu Taohua , Ding Xuewei , Li Xiaoyan , He Xiaojie
Published: February 2022

Background and objectives

The underlying mechanism of IgA vasculitis (IgAV) and IgA vasculitis with nephritis (IgAVN) remains unclear. Therefore, there are no accurate diagnostic methods. Lipid metabolism is related to many immune related diseases, so this study set out to explore the relationship of lipids and IgAV and IgAVN.

Methods

Fifty-eighth patients with IgAV and 28 healthy controls were recruited, which were divided into six separate pools to investigate the alterations of serum lipids according to the clinical characteristics: healthy controls group (HCs) and IgAV group (IgAVs), IgAVN group (IgAV-N) and IgAV without nephritis group (IgAV-C), initial IgAV group (IgAV0) and IgAV in treatment with glucocorticoids group (IgAV1).

Results

31 identified lipid ions significantly changed in IgAVs with p < 0.05, variable importance of the projection (VIP) > 1 and fold change (FC) > 1.5. All these 31 lipid ions belong to 6 classes: triacylglycerols (TG), phosphatidylethanolamine (PE), phosphatidylcholine (PC), phosphatidylserine, ceramide, and lysophosphatidylcholine. TG (16:0/18:1/22:6) +NH4 over 888875609.05, PC (32:1) +H over 905307459.90 and PE (21:4)-H less than 32236196.59 increased the risk of IgAV significantly (OR>1). PC (38:6) +H was significantly decreased (p < 0.05, VIP>1 and FC>1.5) in IgAVN. PC (38:6) less than 4469726623 conferred greater risks of IgAV (OR=45.833, 95%CI: 6.689~341.070).

Conclusion

We suggest that lipid metabolism may affect the pathogenesis of IgAV via cardiovascular disease, insulin resistance, cell apoptosis, and inflammation. The increase of TG(16:0/18:1/22:6) + NH4, and PC(32:1) + H as well as PE (21:4)-H allow a good prediction of IgAV. PE-to-PC conversion may participate in the damage of kidney in IgAV. PC (38:6) + H may be a potential biomarker for IgAVN.
Colorectal cancer development is affected by the ECM molecule EMILIN-2 hinging on macrophage polarization via the TLR-4/MyD88 pathway
Authors: Andreuzzi Eva , Fejza Albina , Polano Maurizio , Poletto Evelina , Camicia Lucrezia , Carobolante Greta , Tarticchio Giulia , Todaro Federico , Di Carlo Emma , Scarpa Melania , Scarpa Marco , Paulitti Alice , Capuano Alessandra , Canzonieri Vincenzo , Maiero Stefania , Fornasarig Mara , Cannizzaro Renato , Doliana Roberto , Colombatti Alfonso , Spessotto Paola , Mongiat Maurizio
Published: February 2022

Background

Colorectal cancer is one of the most frequent and deadly tumors. Among the key regulators of CRC growth and progression, the microenvironment has emerged as a crucial player and as a possible route for the development of new therapeutic opportunities. More specifically, the extracellular matrix acts directly on cancer cells and indirectly affecting the behavior of stromal and inflammatory cells, as well as the bioavailability of growth factors. Among the ECM molecules, EMILIN-2 is frequently down-regulated by methylation in CRC and the purpose of this study was to verify the impact of EMILIN-2 loss in CRC development and its possible value as a prognostic biomarker.

Methods

The AOM/DSS CRC protocol was applied to Emilin-2 null and wild type mice. Tumor development was monitored by endoscopy, the molecular analyses performed by IHC, IF and WB and the immune subpopulations characterized by flow cytometry. Ex vivo cultures of monocyte/macrophages from the murine models were used to verify the molecular pathways. Publicly available datasets were exploited to determine the CRC patients’ expression profile; Spearman’s correlation analyses and Cox regression were applied to evaluate the association with the inflammatory response; the clinical outcome was predicted by Kaplan-Meier survival curves. Pearson correlation analyses were also applied to a cohort of patients enrolled in our Institute.

Results

In preclinical settings, loss of EMILIN-2 associated with an increased number of tumor lesions upon AOM/DSS treatment. In addition, in the early stages of the disease, the Emilin-2 knockout mice displayed a myeloid-derived suppressor cells-rich infiltrate. Instead, in the late stages, lack of EMILIN-2 associated with a decreased number of M1 macrophages, resulting in a higher percentage of the tumor-promoting M2 macrophages. Mechanistically, EMILIN-2 triggered the activation of the Toll-like Receptor 4/MyD88/NF-κB pathway, instrumental for the polarization of macrophages towards the M1 phenotype. Accordingly, dataset and immunofluorescence analyses indicated that low EMILIN-2 expression levels correlated with an increased M2/M1 ratio and with poor CRC patients’ prognosis.

Conclusions

These novel results indicate that EMILIN-2 is a key regulator of the tumor-associated inflammatory environment and may represent a promising prognostic biomarker for CRC patients.
Somatic mutational profiles and germline polygenic risk scores in human cancer
Authors: Liu Yuxi , Gusev Alexander , Heng Yujing J. , Alexandrov Ludmil B. , Kraft Peter
Published: February 2022

Background

The mutational profile of cancer reflects the activity of the mutagenic processes which have been operative throughout the lineage of the cancer cell. These processes leave characteristic profiles of somatic mutations called mutational signatures. Mutational signatures, including single-base substitution (SBS) signatures, may reflect the effects of exogenous or endogenous exposures.

Methods

We used polygenic risk scores (PRS) to summarize common germline variation associated with cancer risk and other cancer-related traits and examined the association between somatic mutational profiles and germline PRS in 12 cancer types from The Cancer Genome Atlas. Somatic mutational profiles were constructed from whole-exome sequencing data of primary tumors. PRS were calculated for the 12 selected cancer types and 9 non-cancer traits, including cancer risk determinants, hormonal factors, and immune-mediated inflammatory diseases, using germline genetic data and published summary statistics from genome-wide association studies.

Results

We found 17 statistically significant associations between somatic mutational profiles and germline PRS after Bonferroni correction (p < 3.15 × 10−5), including positive associations between germline inflammatory bowel disease PRS and number of somatic mutations attributed to signature SBS1 in prostate cancer and APOBEC-related signatures in breast cancer. Positive associations were also found between age at menarche PRS and mutation counts of SBS1 in overall and estrogen receptor-positive breast cancer. Consistent with prior studies that found an inverse association between the pubertal development PRS and risk of prostate cancer, likely reflecting hormone-related mechanisms, we found an inverse association between age at menarche PRS and mutation counts of SBS1 in prostate cancer. Inverse associations were also found between several cancer PRS and tumor mutation counts.

Conclusions

Our analysis suggests that there are robust associations between tumor somatic mutational profiles and germline PRS. These may reflect the mechanisms through hormone regulation and immune responses that contribute to cancer etiology and drive cancer progression.
Personality traits and quality of life among Lebanese medical students: any mediating effect of emotional intelligence? A path analysis approach
Authors: Maalouf Elise , Hallit Souheil , Obeid Sahar
Published: February 2022

Background

Medicine is an incredibly demanding career that appears to leave many medical students at risk of fatigue, anxiety, depression and burnout. Since adaptation and lifestyle changes are important, quality of life (QOL) of students during medical school could be impaired. Personality traits and emotional intelligence (EI) facets may be both linked to medical student’s QOL. To our knowledge, no studies have been done on the concurrent and prospective relationship between QOL-related personality traits and EI in Lebanese medical students. This study aimed to investigate the role of EI as a mediator between personality traits and QOL among a sample of Lebanese medical students.

Methods

This research is a descriptive cross-sectional survey study involving 293 Lebanese medical students recruited from all 7 Faculties of Medicine in Lebanon (June–December 2019). Structural equation modeling (SEM) was performed using SPSS AMOS v.24 to examine the structural relationship between each personality trait taken as independent variables, QOL as the dependent variable, and emotional intelligence as the mediator, among university students. The relative Chi-square (χ2/df), root mean square error of approximation (RMSEA) statistic, Tucker Lewis Index (TFI) and the comparative fit index (CFI) were used to evaluate the goodness-of-fit of the model.

Results

Higher conscientiousness was significantly associated with more EI (Beta = 0.38; p < 0.001) and lower QOL (Beta = − 0.14; p = 0.025). The indirect relationships between conscientiousness, EI and QOL showed that EI mediated the association between conscientiousness and QOL (Beta = 0.17; 95% CI − 0.73 to − 0.004; p = 0.037). The fit indices of this model were adequate for χ2/df, RMSEA and CFI but not TLI. Higher openness to experience was significantly associated with more EI (Beta = 0.48; p < 0.001) and lower QOL (Beta = − 0.38; p < 0.001). The indirect relationships between openness to experience, EI and QOL showed that EI mediated the association between openness to experience and QOL (Beta = 0.30; 95% CI − 1.11 to − 0.03; p = 0.04). The fit indices were adequate for χ2/df and CFI but not RMSEA and TLI. EI did not mediate the association between the other three personality traits (extroversion, agreeableness and neuroticism) and QOL.

Conclusion

This current research has shed considerable light on the nexus of associations between EI, personality traits and well-being, nonetheless, led to the creation of more puzzling questions. On the whole, it seems that EI and its components can be used as an evaluation instrument in relates with Lebanese medical students’ personality profile as a means of future training to improve quality of life during medical education.
Self and suffering in Indian thought: implications for clinicians
Authors: Singh Swaran P.
Published: February 2022

The four main Indian religions – Hinduism, Buddhism, Jainism and Sikhism – have several shared concepts about self and suffering, which are salient to the world-view of the followers of these faiths. Understanding the concepts of mind, self and suffering in these faiths can help clinicians build better rapport and gain deeper understanding of the inner world of patients of these faiths. This article highlights the broad cultural and religious beliefs of these groups, with the hope that increased knowledge among clinicians might lead to better therapeutic engagement.
Endoscopic Transcortical-Transventricular Approach in Treating Third Ventricular Craniopharyngiomas—Case Series With Technical Note and Literature Review
Authors: Shoubash Loay I. , El Refaee Ehab , Al Menabbawy Ahmed , Refaat Mohamed I. , Fathalla Hussein , Schroeder Henry W. S.
Published: February 2022

BACKGROUND:

A paradigm shift toward less radicality in the treatment of craniopharyngioma (CP) has increasingly gained recognition. In selected patients, a less invasive approach aiming at cyst decompression may be suitable.

OBJECTIVE:

To present our experience with the endoscopic transcortical-transventricular approach (ETTA) for the treatment of CP located in the third ventricle, describe our surgical technique, and explore the results reported in the literature.

METHODS:

Data for third ventricular CPs treated using ETTA in 2 tertiary medical centers between 2006 and 2020 were retrospectively reviewed. Cystic, mixed lesion, new, and recurrent cases were included. ETTA aimed at cyst fenestration, subtotal or partial tumor resection, managing the hydrocephalus, or a combination of these modalities. Fractionated radiotherapy (RT) was performed (54 Gy in 30 fractions).

RESULTS:

The described approach was performed in 13 patients with a mean age of 30.2 years. Tumor excision was attempted in 10 patients. Cystic fenestration alone was conducted in 3 patients, followed by intracystic catheter implantation in 2 patients. Permanent diabetes insipidus developed in 3 patients, and 1 patient experienced a surgical site infection. The recurrence rate for ETTA + RT (pre-ETTA in 33.3%) was 2/9 (22.2%) after a mean follow-up of 21.3 months. Four patients did not undergo RT after ETTA, and all these patients experienced recurrences after a mean follow-up of 15.5 months. Hydrocephalus resolved in all 6 patients who presented with accompanying hydrocephalus.

CONCLUSION:

ETTA combined with adjuvant RT is a safe and effective option in the management of cystic or predominantly cystic CP extending into the third ventricle. This procedure also effectively treats the accompanying hydrocephalus.
Magnetic Resonance-Guided Focused Ultrasound Thalamotomy for Essential Tremor Under General Anesthesia: Technical Note
Authors: Mensah-Brown Kobina G. , Yang Andrew I. , Hitti Frederick L. , Henry Lenora , Heman-Ackah Sabrina M. , Chaibainou Hanane , Baltuch Gordon H.
Published: February 2022

BACKGROUND:

Magnetic resonance–guided focused ultrasound (MRgFUS) thalamotomy is an incisionless therapy for the treatment of medication-resistant essential tremor. Although its safety and efficacy has been demonstrated, MRgFUS is typically performed with the patient awake, with intraprocedural neurological assessments to guide lesioning.

OBJECTIVE:

To report the first case of MRgFUS thalamotomy under general anesthesia in a patient whose medical comorbidities prohibit him from being in a supine position without a secured airway.

METHODS:

The dentatorubrothalamic tract was directly targeted. Two sonications reaching lesional temperatures (≥54°C) were delivered without any complications.

RESULTS:

Lesioning was confirmed on intraoperative magnetic resonance imaging, and the patient experienced 89% improvement in his tremor postoperatively.

CONCLUSION:

This demonstrates the safety and feasibility of MRgFUS thalamotomy under general anesthesia without the benefit of intraprocedural neurological assessments.
Tcf12 and NeuroD1 cooperatively drive neuronal migration during cortical development
Authors: Singh Aditi , Mahesh Arun , Noack Florian , Cardoso de Toledo Beatriz , Calegari Federico , Tiwari Vijay K.
Published: February 2022

Corticogenesis consists of a series of synchronised events, including fate transition of cortical progenitors, neuronal migration, specification and connectivity. NeuroD1, a basic helix-loop-helix (bHLH) transcription factor (TF), contributes to all of these events, but how it coordinates these independently is still unknown. Here, we demonstrate that NeuroD1 expression is accompanied by a gain of active chromatin at a large number of genomic loci. Interestingly, transcriptional activation of these loci relied on a high local density of adjacent bHLH TFs motifs, including, predominantly, Tcf12. We found that activity and expression levels of Tcf12 were high in cells with induced levels of NeuroD1 that spanned the transition of cortical progenitors from proliferative to neurogenic divisions. Moreover, Tcf12 forms a complex with NeuroD1 and co-occupies a subset of NeuroD1 target loci. This Tcf12-NeuroD1 cooperativity is essential for gaining active chromatin and targeted expression of genes involved in cell migration. By functional manipulation in vivo, we further show that Tcf12 is essential during cortical development for the correct migration of newborn neurons and, hence, for proper cortical lamination.
LMBR1L regulates the proliferation and migration of endothelial cells through Norrin/β-catenin signaling
Authors: Liu Wenjing , Jiang Xiaoyan , Li Xiao , Sun Kuanxiang , Yang Yeming , Yang Mu , Li Shujin , Zhu Xianjun
Published: February 2022

Precise Norrin and β-catenin (Norrin/β-catenin; encoded by NDP and CTNNB1, respectively) signaling is critical for proper angiogenesis. Dysregulation of this signaling leads to various diseases, of which retinal exudative vitreoretinopathy is the most prevalent. Here, we used a global knockout mouse model to show that limb development membrane protein 1 like (LMBR1L), a transmembrane protein of unknown function in angiogenesis, is essential for retinal vascular development. In vitro experiments revealed that LMBR1L depletion results in aberrant activation of the Norrin/β-catenin signaling pathway via decreased ubiquitylation of FZD4 and increased Norrin co-receptor LRP5 and p-GSK3β-Ser9 expression levels, which cause accumulation of β-catenin. Moreover, inhibition of LMBR1L in human retinal microvascular endothelial cells (HRECs) caused increased proliferation ability and defective cell migration, which might have occurred as a result of upregulated expression levels of the apical junction components. Treatment with p-GSK3β-Ser9 inhibitor AR-A014418 restored the phenotypes in LMBR1L-null HRECs, which further demonstrated the important regulatory role of LMBR1L in the Norrin/β-catenin signaling pathway. Taken together, our data reveal an essential role for LMBR1L in angiogenesis.

This article has an associated First Person interview with the first author of the paper.
Επιχειρηματικά δίκτυα και οικογενειακές στρατηγικές στον Πειραιά
Authors: Μπαφούνη Ευαγγελία
Published: February 2022

Η παρούσα διδακτορική διατριβή μελετά την πορεία του κυθήριου Ευστάθιου Δηλαβέρη, ο οποίος μεταναστεύει οικογενειακά στον Πειραιά τη δεκαετία του 1870. Μελετάται η ενασχόληση του με την οικοδομή, το πέρασμα του από το εμπόριο και στη συνέχεια τη βιομηχανία, με την ίδρυση μιας αποθήκης οικοδομικών υλών στην αρχή, την ίδρυση ενός εργοστασίου μωσαϊκών πλακών για να καταλήξει να δημιουργήσει το πρώτο και σημαντικότερο εργοστάσιο γαλλικών κεράμων και διάτρητων τούβλων στην Λεύκα του Πειραιά. Παράλληλα ερευνάται ο κόσμος της κεραμοποιϊας στην περιοχή των Καμινίων του Πειραιά την περίοδο που αρχίζει την δραστηριοποίηση του ο ίδιος ο Ευστάθιος και τις επιπτώσεις που προκαλεί η ίδρυση της κεραμοποιϊας του. Συγχρόνως προσπαθεί να αποκωδικοποιήσει τις συμπεριφορές του τόσο στο επαγγελματικό όσο και στο οικογενειακό του περιβάλλον και τα δίκτυα καθώς επίσης και τις στρατηγικές που υιοθετεί για να επιτύχει το στόχο του.
Οι σκοποί και το περιεχόμενο των αναλυτικών προγραμμάτων τεχνολογίας για την Πρωτοβάθμια Εκπαίδευση
Authors: Πριμεράκης Γεώργιος
Published: February 2022

Σκοπός της εργασίας μας είναι η διερεύνηση της πορείας διαμόρφωσης των αναλυτικών προγραμμάτων τεχνολογίας για την υποχρεωτική εκπαίδευση στο Ηνωμένο Βασίλειο και ειδικά στην Αγγλία. Μελετήθηκε γενικότερα η εκπαίδευση στο Ηνωμένο Βασίλειο από τα πρώτα της βήματα, καθώς και οι διάφορες εκφράσεις της μέχρι πρόσφατα. Περιεγραφήκαν και αναλύθηκαν τα ιστορικά γεγονότα και οι κοινωνικές, οικονομικές και πολιτικές συνθήκες που γέννησαν την ανάγκη δημιουργίας κρατικού συστήματος εκπαίδευσης, της εισαγωγής του μαθήματος της τεχνολογίας στο Ηνωμένο Βασίλειο και τη διαμόρφωση του αντίστοιχου αναλυτικού προγράμματος και την σχέση του με τις φυσικές επιστήμες. Στη συνέχεια περιεγράφηκαν και αναλύθηκαν οι σκοποί και το περιεχόμενο αυτών των αναλυτικών προγραμμάτων τεχνολογίας για την υποχρεωτική εκπαίδευση υπό το φως των οικονομικών, κοινωνικών και πολιτικών ιστορικών συνθηκών. Με βάση την ανάλυση που προηγήθηκε, ισχυριστήκαμε ότι η ανάπτυξη και η αναθεώρηση των αναλυτικών προγραμμάτων στην τεχνολογική εκπαίδευση ως μέρος της γενικής εκπαίδευσης προωθείται σε περιόδους οικονομικής ύφεσης. Το παράδειγμα του Ηνωμένου Βασιλείου και ειδικά της Αγγλίας δείχνει ότι υπάρχει σαφής συσχέτιση μεταξύ αφενός των οικονομικών κρίσεων και των επακόλουθων υφέσεων των δεκαετιών του 1860, του 1930 και του 1970 και αφετέρου των σημαντικών εξελίξεων στην κοινωνία, στην πολιτική, στην εκπαίδευση και ιδιαίτερα στην εκπαίδευση στην τεχνολογία.
The Use of Creative Works of Younger Schoolchildren to Improve the Success of Their Educational Activities
Authors: Nikitina E.
Published: February 2022

The article proposes for consideration the problem of using creative works as an effective way to implement an individually differentiated approach in teaching successful younger schoolchildren. The author relies on the idea that difficulties in the learning process can occur in children who demonstrate different levels of educational activity, in particular, also in excellent schoolchildren and "good schoolchildren", therefore, providing them with different levels of creative tasks allows for the successful prospective intellectual and creative development of such schoolchildren. Examples of the use of differentiated creative tasks in the lessons of the Russian language and literary reading are given.
Methodological Support of the Updated Federal State Educational Standard of Primary General Education
Authors: Vinogradova Natalya
Published: February 2022

The article discusses scientific and methodological approaches and characterizes the updated version of the Federal State Educational Standard for Primary General Education (FSES PGE) adopted by the Ministry of Education of the Russian Federation in May 2021. The structure of the Approximate educational program and its most important part - exemplary work programs of primary school subjects are considered. On the example of the work program on the subject "World around", a description of the goals, content, planned learning outcomes is given, accompanied by comments for the teacher.
Current state of knowledge and concerns regarding cardiopulmonary resuscitation performed in the setting of out-of-hospital sudden cardiac arrest among adult, non-medical rural residents
Authors: Budzyńska Julia , Kozioł Ilona , Leśniewska Magdalena , Szaniawska Monika , Szast Konrad
Published: February 2022

INTRODUCTION Every year in Poland 56,000 outside the hospital there is a sudden cardiac arrest.

OBJECTIVES The aim of the study was to determine the level of knowledge of basic life support undertaken in prehospital management in rural areas. The second objective of the study was to assess needs for cardiopulmonary resuscitation(CPR) training among adults in rural areas.

MATERIAL AND METHODS The study was carried out with the use of an original questionnaire based on the review of literature and guidelines of the European Resuscitation Council. The questionnaire was shared by social media. The questionnaire consisted of the following parts: metric, experience of previous CPR, knowledge about CPR, assessment of demand and interest in expanding knowledge and skills in CPR. A total of 501 responses were collected, of which 316 from adult, non-medical rural residents were analyzed.

RESULTS Over 85% of respondents knew how to assess consciousness of the victim, 95% of respondents knew when to start CPR. About 33% of the respondents did not know the correct location of  chest compressions. Moreover 65% of them could not identify the correct frequency of compressions. Although rib fracture was one of the most commonly cited concerns, it was a potential reason to discontinue CPR only for 4.5% of respondents. 

CONCLUSIONS It was observed that there is a need for additional CPR training among rural adult residents. The information collected in this study may allow for the planning of appropriate educational activities to increase the level of knowledge about CPR in heart accidents.
Integrated Stochastic Optimal Self-Scheduling for Two-Settlement Electricity Markets
Authors: Pan Kai , Guan Yongpei
Published: February 2022

The complexity of current electricity wholesale markets and the increased volatility of electricity prices because of the intermittent nature of renewable generation make independent power producers (IPPs) face significant challenges to submit offers. This challenge increases for those owning traditional coal-fired thermal generators and renewable generation. In this paper, an integrated stochastic optimal strategy is proposed for an IPP using the self-scheduling approach through its participation in both day-ahead and real-time markets (i.e., two-settlement electricity markets) as a price taker. In the proposed approach, the IPP submits an offer for all periods to the day-ahead market for which a multistage stochastic programming setting is explored for providing real-time market offers for each period as a recourse. This strategy has the advantage of achieving overall maximum profits for both markets in the given operational time horizon. Such a strategy is theoretically proved to be more profitable than alternative self-scheduling strategies as it takes advantage of the continuously realized scenario information of the renewable energy output and real-time prices over time. To improve computational efficiency, we explore polyhedral structures to derive strong valid inequalities, including convex hull descriptions for certain special cases, thus strengthening the formulation of our proposed model. Polynomial-time separation algorithms are then established for the derived exponential-sized inequalities to speed up the branch-and-cut process. Finally, both numerical and real case studies demonstrate the potential of the proposed strategy.

Summary of Contribution: This paper develops innovative models and methods to study a family of practically important problems via the interactions of operations research and computing. Specifically, this paper provides in-depth analyses of innovative stochastic optimization modeling approaches and develops computationally efficient polyhedral results. The paper also verifies the effectiveness of proposed analyses via extensive computing experiments.