bluuebunny/crossref_metadata_2025 huggingface dataset:
Kommerell’s Diverticulum in a Right-Sided Aortic Arch With an Aberrant Left Subclavian Artery Hybrid Repair
Authors: Solano Antonio , Pizano Alejandro , Azam Jawaher , Gonzalez-Guardiola Gerardo , Siah Michael , Chamseddin Khalil , Prakash Vivek , Kirkwood Melissa L. , Shih Michael
Published: June 2023

Background

Kommerell’s diverticulum (KD) with a right aortic arch (RAA) and aberrant left subclavian artery (aLSCA) is a rare congenital anomaly of the aortic arch. Treatment is not well defined due to its uncommon presentation, with rupture and dissection risk rates of up to 53%.

Case summary

A 54-year-old male with a history of chronic obstructive pulmonary disease (COPD) and hypertension presented with difficulty breathing during exercise without dysphagia. Follow-up computerized tomography angiogram (CTA) revealed the presence of a RAA and aLSCA arising from the descending thoracic aorta with an adjacent 58 × 41-mm KD and tracheal and esophageal displacement. Due to the size of the KD, risk of rupture, unsuitable anatomy for total endovascular aortic repair (EVAR), and high COPD burden, the patient was planned to undergo a hybrid surgical repair. Left common carotid (LCCA) artery to LSCA bypass, full aortic debranching, LSCA embolization and percutaneous thoracic endovascular aortic repair (TEVAR) were performed. Successful device position and exclusion of the diverticulum and aneurysmal aorta were observed after completion thoracic aortogram. 18-month follow-up CTA demonstrated patency of the LSCA to LCCA bypass graft and arch vessel branches, as well as stable exclusion of the KD. Persistence of a type II endoleak originated at the right first posterior intercostal artery has been noted and is being followed conservatively since no sac growth has occurred.

Conclusion

We highlight the presence of a KD with RAA and aberrant subclavian artery, a rare congenital anatomic variation of the aortic arch with complex anatomy. Surgical planning must be individualized according to comorbidities and anatomical variations identified on imaging and 3D reconstructions.
Spontaneous memory strategies in a videogame simulating everyday memory tasks
Authors: Laine Matti , Jylkkä Jussi , Ritakallio Liisa , Eräste Tilda , Kangas Suvi , Hering Alexandra , Zuber Sascha , Kliegel Matthias , Fellman Daniel , Salmi Juha
Published: June 2023

People can use different internal strategies to manage their daily tasks, but systematic research on these strategies and their significance for actual performance is still quite sparse. Here we examined self-reported internal strategy use with a 10-block version of the videogame EPELI (Executive Performance in Everyday LIving) in a group of 202 neurotypical adults of 18–50 years of age. In the game, participants perform lists of everyday tasks from memory while navigating in a virtual apartment. Open-ended strategy reports were collected after each EPELI task block, and for comparison also after an EPELI Instruction Recall task and a Word List Learning task assessing episodic memory. On average, 45% of the participants reported using some strategy in EPELI, the most common types being grouping (e.g., performing the tasks room by room), utilising a familiar action schema, and condensing information (e.g., memorising only keywords). Our pre-registered hypothesis on the beneficial effect of self-initiated strategy use gained support, as strategy users showed better performance on EPELI as compared with no strategy users. One of the strategies, grouping, was identified as a clearly effective strategy type. Block-by-block transitions suggested gradual stabilisation of strategy use over the 10 EPELI blocks. The proneness to use strategies showed a weak but reliable association between EPELI and Word List Learning. Overall, the present results highlight the importance of internal strategy use for understanding individual differences in memory performance, as well as the potential benefit for internal strategy employment when faced with everyday memory tasks.
Options for Translating English Movie Lyrics Into Arabic: A Case study of Netflix Arabic Subtitles of 60 Lyrics
Authors: Abu-Rayyash Hussein , Haider Ahmad S.
Published: June 2023

This study investigates Netflix translation of English movie lyrics into Arabic. It examines and categorizes the subtitles of the movie lyrics based on the translation options proposed by Franzon. Translation options refer to the different methods or approaches a translator can use when translating a song. A parallel corpus of 60 lyrics extracted from 10 musical movies was compiled by aligning the English script and Arabic subtitles. The researchers found that Netflix’s subtitlers employed four options for rendering English lyrics into Arabic. These are neglecting the music in translating the lyric (literal subtitling), which was used in rendering 60% of the investigated lyrics, not translating the lyrics (deletion), which was observed in 17% of the cases, and adapting the music to the translation (esthetic subtitling) was followed in rendering only five lyrics (8%). Finally, incorporating the three previous options (blended subtitling), which was adopted in subtitling 15% of the investigated data. This study recommends further research on the audience reception of the different subtitling options of lyrics. The findings of the current study can be useful for subtitlers and translation students, especially those interested in literary translation and musical movie translation.
Clinical Outcomes After Arthroscopic Microfracture Treatment of Coexisting Talar and Tibial Osteochondral Lesions
Authors: Wei Yu , Yun Xing , Song Jianing , Qi Wei , Li Jia , Liu Yujie , Quan Qi , Wei Min
Published: June 2023

Background:

Despite increased recognition of coexisting tibial and talar osteochondral lesions (OCLs), the risk factors influencing clinical outcomes remain unclear.

Purpose:

To report clinical follow-up results after arthroscopic microfracture surgery in patients with OCLs of the distal tibial plafond and talus and assess possible factors affecting these clinical outcomes.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 40 patients with coexisting talar and tibial OCLs who underwent arthroscopic microfracture surgery were included. For analysis, the study used the American Orthopaedic Foot & Ankle Society (AOFAS) scale, Karlsson-Peterson scale, and visual analog scale (VAS) for pain for clinical evaluations on the day before surgery, 12 months after surgery, and at the last follow-up. A stepwise regression model and Spearman rank correlation were used to assess possible factors affecting these clinical outcomes.

Results:

The median follow-up time was 34.5 months (interquartile range [IQR], 26.5-54 months). At the final follow-up, the cohort included 40 patients (26 men and 14 women) with a mean age of 38.8 years (range, 19-60 years). The median AOFAS score increased from 57.5 (IQR, 47-65) before surgery to 88 (IQR, 83-92.5) at the final follow-up, the median Karlsson-Peterson score increased from 48 (IQR, 38.5-67) to 82 (IQR, 76-92), and the median VAS score improved from 5 (IQR, 4-6) to 1 (IQR, 0-2). All scale scores showed significant differences between the preoperative and final follow-up evaluations ( P < .001). In the stepwise regression model and Spearman rank correlation analysis, the grade of tibial OCL had a significant independent effect on the final postoperative AOFAS scores of the patients (β = –0.502, P = .001; r = –0.456, P = .003). The size of the tibial lesion also had a significant independent effect on the final postoperative Karlsson-Peterson scores of the patients (β = –0.444, P = .004; r = –0.357, P = .024).

Conclusion:

Arthroscopic microfracture treatment for coexisting talar and tibial OCLs can achieve good short- to midterm clinical outcomes. The grade and size of tibial OCLs are the main risk factors affecting the prognostic functional scores of such patients.
Effect of Gender on French High School Students’ Dream Jobs and Professional Ambition
Authors: Cordonier Laurent , Cafiero Florian , Walzer Nicolas , Bronner Gérald
Published: June 2023

In France, women and men often do not engage in the same occupations, with “feminine” occupations being on average paid less than “masculine” ones. It has been shown that this gender-based occupational segregation is not explained by a difference in professional ambition between female and male students at high school age. In contrast, studies have shown that in France, as well as in many other countries, students’ occupational aspirations are highly gendered. In this visualization, the authors replicate these findings about high school students’ professional ambition and aspirations with new data and indicators, introducing a distinction between their dream jobs and their expected jobs. This research confirms that the persistence of the gender-based occupational segregation has more to do with students’ gender stereotypes than with a difference in ambition between girls and boys.
SBMLKinetics: a tool for annotation-independent classification of reaction kinetics for SBML models
Authors: Xu Jin
Published: June 2023

Background

Reaction networks are widely used as mechanistic models in systems biology to reveal principles of biological systems. Reactions are governed by kinetic laws that describe reaction rates. Selecting the appropriate kinetic laws is difficult for many modelers. There exist tools that attempt to find the correct kinetic laws based on annotations. Here, I developed annotation-independent technologies that assist modelers by focusing on finding kinetic laws commonly used for similar reactions.

Results

Recommending kinetic laws and other analyses of reaction networks can be viewed as a classification problem. Existing approaches to determining similar reactions rely heavily on having good annotations, a condition that is often unsatisfied in model repositories such as BioModels. I developed an annotation-independent approach to find similar reactions via reaction classifications. I proposed a two-dimensional kinetics classification scheme (2DK) that analyzed reactions along the dimensions of kinetics type (K type) and reaction type (R type). I identified approximately ten mutually exclusive K types, including zeroth order, mass action, Michaelis–Menten, Hill kinetics, and others. R types were organized by the number of distinct reactants and the number of distinct products in reactions. I constructed a tool, SBMLKinetics, that inputted a collection of SBML models and then calculated reaction classifications as the probability of each 2DK class. The effectiveness of 2DK was evaluated on BioModels, and the scheme classified over 95% of the reactions.

Conclusions

2DK had many applications. It provided a data-driven annotation-independent approach to recommending kinetic laws by using type common for the kind of models in combination with the R type of the reactions. Alternatively, 2DK could also be used to alert users that a kinetic law was unusual for the K type and R type. Last, 2DK provided a way to analyze groups of models to compare their kinetic laws. I applied 2DK to BioModels to compare the kinetics of signaling networks with the kinetics of metabolic networks and found significant differences in K type distributions.
Evaluating significance of European-associated index SNPs in the East Asian population for 31 complex phenotypes
Authors: Qiao Jiahao , Wu Yuxuan , Zhang Shuo , Xu Yue , Zhang Jinhui , Zeng Ping , Wang Ting
Published: June 2023

Background

Genome-wide association studies (GWASs) have identified many single-nucleotide polymorphisms (SNPs) associated with complex phenotypes in the European (EUR) population; however, the extent to which EUR-associated SNPs can be generalized to other populations such as East Asian (EAS) is not clear.

Results

By leveraging summary statistics of 31 phenotypes in the EUR and EAS populations, we first evaluated the difference in heritability between the two populations and calculated the trans-ethnic genetic correlation. We observed the heritability estimates of some phenotypes varied substantially across populations and 53.3% of trans-ethnic genetic correlations were significantly smaller than one. Next, we examined whether EUR-associated SNPs of these phenotypes could be identified in EAS using the trans-ethnic false discovery rate method while accounting for winner's curse for SNP effect in EUR and difference of sample sizes in EAS. We found on average 54.5% of EUR-associated SNPs were also significant in EAS. Furthermore, we discovered non-significant SNPs had higher effect heterogeneity, and significant SNPs showed more consistent linkage disequilibrium and allele frequency patterns between the two populations. We also demonstrated non-significant SNPs were more likely to undergo natural selection.

Conclusions

Our study revealed the extent to which EUR-associated SNPs could be significant in the EAS population and offered deep insights into the similarity and diversity of genetic architectures underlying phenotypes in distinct ancestral groups.
Assessment of the first presentations of common variable immunodeficiency in a large cohort of patients
Authors: Esmaeilzadeh Hossein , Jokar-Derisi Armita , Hassani Amir Hossein , Yazdani Reza , Delavari Samaneh , Abolhassani Hassan , Mortazavi Negar , Askarisarvestani Aida
Published: June 2023

Background

Common Variable Immunodeficiency (CVID) is a primary immunodeficiency syndrome resulting in recurrent infections, autoimmunity, and granulomatous manifestations.

Methods and materials

This retrospective study was conducted on an Iranian national registry of immunodeficient patients from 2010 to 2021. The frequency of first presentations of CVID and its association with sex, age of onset, and family history of CVID was evaluated.

Results

A total of 383 patients entered the study, 164 of whom were female, and the rest were male. The mean age of the patients was 25.3 ± 14.5 years. The most frequent first presentations of CVID were pneumonia (36.8%) and diarrhea (19.1%). Patient sex, age of onset, and family history did not make significant differences in first presentations of this disease.

Conclusion

pneumonia is the most common first presentation of CVID. Family history of CVID, the age of symptom onset, and sex made no differences in the first presentations of CVID.
Effect of regional versus general anesthesia on recurrence of non-muscle invasive bladder cancer: a systematic review and meta-analysis of eight retrospective cohort studies
Authors: Wang Yulong , Song Yuxuan , Qin Caipeng , Zhang Chunlong , Du Yiqing , Xu Tao
Published: June 2023

Background

Regional anesthesia appears to reduce cancer recurrence, but the optimal anesthesia modality for non-muscle invasive bladder cancer (NMIBC) were still under debate. Therefore, we sought to assess the effect of regional and GA only upon the recurrence and long-term prognosis of NMIBC through this meta-analysis.

Methods

We performed an extensive literature search of PubMed, Embase, Web of Science, the Cochrane Library and China National Knowledge Infrastructure (up to October 30, 2022) to identify eligible articles on the possible impact of different anesthetic modalities for the recurrence rate of NMIBC.

Results

Eight studies comprising 3764 participants, including 2117 subjects with RA and 1647 with GA, were finally enrolled. Cancer recurrence rate was significantly lower in subjects with RA than those with GA (RR 0.84, 95%CI 0.72–0.98, P = 0.03). We didn’t detect the differences between GA and RA in the time of recurrence (SMD 2.07, 95% CI -0.49–4.63, P = 0.11) and cancer progression (RR 1.14, 95%CI 0.71–1.84, P = 0.59). Results from subgroup analysis demonstrated that spinal anesthesia could significantly decrease the incidence of cancer recurrence in comparison with general anesthesia (RR 0.80, 95%CI 0.72–0.88, P < 0.001) and high-risk NMIBC patients who received RA tended to have less recurrence (HR 0.55, 95%CI 0.39–0.79, P = 0.001) than those receiving GA.

Conclusions

RA, especially spinal anesthesia, may be effective in reducing the recurrence rate after transurethral resection of NMIBC. More prospective experimental and clinical studies are needed to validate our findings.

Trial registration

INPLASY registration INPLASY2022110097.
Circadian rhythm disturbance and delirium in ICU patients: a prospective cohort study
Authors: Li Jingjing , Cai Shining , Liu Xiao , Mei Jinghua , Pan Wenyan , Zhong Ming , Zhang Yuxia
Published: June 2023

Background

Patients treated in the intensive care unit (ICU) may experience a reversal of day and night. The circadian rhythm in ICU patients can be disturbed.

Methods

To explore the relationship between ICU delirium and the circadian rhythms of melatonin, cortisol and sleep. A prospective cohort study was carried out in a surgical ICU of a tertiary teaching hospital. Patients who were conscious during the ICU stay after surgery and were scheduled to stay in the ICU for more than 24 h were enrolled. Serum melatonin and plasma cortisol levels were measured three times a day by drawing arterial blood on the first three days after ICU admission. Daily sleep quality was assessed by the Richard-Campbell Sleep Questionnaire (RCSQ). The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) was performed twice a day to screen for ICU delirium.

Results

A total of 76 patients were included in this study, and 17 patients developed delirium during their ICU stay. Melatonin levels were different at 8:00 (p = 0.048) on day 1, at 3:00 (p = 0.002) and at 8:00 (p = 0.009) on day 2, and at all three time points on day 3 (p = 0.032, 0.014, 0.047) between delirium and non-delirium patients. The plasma cortisol level in the delirium patients was significantly lower than that in the non-delirium patients at 16:00 on day 1 (p = 0.025). The changes in melatonin and cortisol secretion levels exhibited obvious biological rhythmicity in non-delirium patients (p < 0.001 for melatonin,p = 0.026 for cortisol), while no rhythmicity was found in melatonin and cortisol secretion levels in the delirium group (p = 0.064 for melatonin,p = 0.454 for cortisol). There was no significant difference in RCSQ scores in the first three days between the two groups.

Conclusions

The disturbance of the circadian rhythm of melatonin and cortisol secretion was associated with the development of delirium in ICU patients. Clinical staff should pay more attention to the importance of maintaining patients’ normal circadian rhythms in the ICU.

Trial registration

The study was registered with the US National Institutes of Health ClinicalTrials.gov(NCT05342987) (25/04/2022).
Association between cardiopulmonary resuscitation audit results with in-situ simulation and in-hospital cardiac arrest outcomes and key performance indicators
Authors: Ruangsomboon Onlak , Surabenjawongse Usapan , Jantataeme Pongthorn , Chawaruechai Thanawin , Wangtawesap Khemchat , Chakorn Tipa
Published: June 2023

Introduction

In-situ simulation (ISS) is a method to evaluate the performance of hospital units in performing cardiopulmonary resuscitation (CPR). It is conducted by placing a high-fidelity mannequin at hospital units with simulated scenarios and having each unit’s performance evaluated. However, little is known about its impact on actual patient outcomes. Therefore, we aimed to evaluate the association between the ISS results and actual outcomes of patients with in-hospital cardiac arrest (IHCA).

Methods

This retrospective study was conducted by reviewing Siriraj Hospital’s CPR ISS results in association with the data of IHCA patients between January 2012 and January 2019. Actual outcomes were determined by patients’ outcomes (sustained return of spontaneous circulation (ROSC) and survival to hospital discharge) and arrest performance indicators (time-to-first-epinephrine and time-to-defibrillation). These outcomes were investigated for association with the ISS scores in multilevel regression models with hospital units as clusters.

Results

There were 2146 cardiac arrests included with sustained ROSC rate of 65.3% and survival to hospital discharge rate of 12.9%. Higher ISS scores were significantly associated with improved sustained ROSC rate (adjusted odds ratio 1.32 (95%CI 1.04, 1.67); p = 0.01) and a decrease in time-to-defibrillation (-0.42 (95%CI -0.73, -0.11); p = 0.009). Although higher scores were also associated with better survival to hospital discharge and a decrease in time-to-first-epinephrine, most models for these outcomes failed to reach statistical significance.

Conclusion

CPR ISS results were associated with some important patient outcomes and arrest performance indicators. Therefore, it may be an appropriate performance evaluation method that can guide the direction of improvement.
Clinical significance of reactive thrombocytosis in the course of acute pancreatitis
Authors: Chiba Nobutaka , Sugita Atsunori , Mizuochi Minori , Sato Jun , Saito Takeshi , Sakurai Atsushi , Kinoshita Kosaku
Published: June 2023

Background

Reactive thrombocytosis occurs secondary to systemic infections, inflammatory, and other conditions. The relationship between thrombocytosis and acute pancreatitis (AP) in inflammatory diseases is uncertain. This study aimed to evaluate the clinical significance of thrombocytosis in AP patients during hospitalization.

Methods

Subjects within 48 h of AP onset were consecutively enrolled over 6 years. Platelet counts of ≥ 450,000/µL were defined as thrombocytosis, < 100,000/µL as thrombocytopenia, and other counts as normal. We compared clinical characteristics, including the rate of severe AP (SAP) assessed by the Japanese Severity Score; blood markers, including hematologic and inflammatory factors and pancreatic enzymes during hospitalization; and pancreatic complications and outcomes in the three groups.

Results

A total of 108 patients were enrolled. Although, SAP was more common in patients with thrombocytosis and thrombocytopenia (87.9% and 100%, respectively), the differences in lymphocytes and C-reactive protein, lactase dehydrogenase, and antithrombin levels, which are factors of the systemic inflammatory response, and the mean platelet volume, an indicator of platelet activation, were observed among patients with thrombocytosis and thrombocytopenia during hospitalization. Regarding pancreatic complications and outcomes, patients with thrombocytosis and thrombocytopenia had higher acute necrotic collection (ANC), pancreatic necrosis, intestinal paralysis, respiratory dysfunction, and pancreatic-related infection levels than patients with normal platelet levels. The relationship between pancreatic complications and thrombocytosis was assessed by multivariate logistic regression; the odds ratios for development of ANC, pancreatic necrosis and pancreatic-related infections were 7.360, 3.735 and 9.815, respectively.

Conclusions

Thrombocytosis during hospitalization for AP suggests development of local pancreatic complications and pancreatic-related infections.
The CHASIT study: sequential chemo-immunotherapy in patients with locally advanced urothelial cancer – a non-randomized phase II clinical trial
Authors: Rutten V. C. , Salhi Y. , Robbrecht G. J. , de Wit R. , van Leenders G. J.L.H. , Zuiverloon T. C.M. , Boormans J. L.
Published: June 2023

Background

Patients with locally advanced irresectable or clinically node positive urothelial cancer (UC) have a poor outcome. Currently, these patients can only be cured by receiving induction chemotherapy and, if an adequate radiological response is obtained, radical surgical resection. Long-term survival, however, strongly depends on the absence of residual tumor in the surgical resection specimen, i.e. a pathological complete response (pCR). The reported pCR rate following induction chemotherapy in locally advanced or clinically node-positive UC is 15%. The 5-year overall survival rate for patients achieving a pCR is 70–80% versus 20% for patients who have residual disease or nodal metastases. This clearly demonstrates the unmet need to improve clinical outcome of these patients. Recently, the JAVELIN Bladder 100 study demonstrated an overall survival benefit of sequential chemo-immunotherapy in patients with metastatic UC. The CHASIT study aims to translate these findings to the induction setting by assessing the efficacy and safety of sequential chemo-immunotherapy in patients with locally advanced or clinically node-positive UC. In addition, patient biomaterials are collected to investigate biological mechanisms of response and resistance to chemo-immunotherapy.

Methods

This multicenter, prospective phase II clinical trial includes patients with stage cT4NxM0 or cTxN1-N3M0 UC of the bladder, upper urinary tract or urethra. Patients who do not experience disease progression after 3 or 4 cycles of platinum-based chemotherapy are eligible for inclusion. Included patients receive 3 cycles of anti-PD-1 immunotherapy with avelumab followed by radical surgery. Primary endpoint is the pCR rate. It is hypothesized that sequential chemo-immunotherapy results in a pCR rate of ≥ 30%. To obtain a power of 80%, 64 patients are screened and 58 patients are included in the efficacy analysis. Secondary endpoints are toxicity, postoperative surgical complications, progression-free, cancer-specific and overall survival at 24 months.

Discussion

This is the first study to assess the potential benefit of sequential chemo-immunotherapy in patients with locally advanced or node positive UC. If the primary endpoint of the CHASIT study is met, i.e. a pCR rate of ≥ 30%, a randomized controlled trial is foreseen to compare this new treatment regimen to standard care.

Trial registration

NCT05600127 at Clinicaltrials gov, registered on 31/10/2022.
Childhood socioeconomic position and cardiometabolic risk in young adulthood- the impact of mental health
Authors: Kempel Mia Klinkvort , Winding Trine Nøhr , Böttcher Morten , Hansen Stefan Nygaard , Andersen Johan Hviid
Published: June 2023

Background

Low socioeconomic position in childhood is associated with greater cardiometabolic disease risk later in life. The aim of the current study is to examine the mediating impact of mental health on the association between childhood socioeconomic position and cardiometabolic disease risk in young adulthood.

Methods

We used a combination of national registers, longitudinal questionnaire-data and clinical measurements from a sub-sample (N = 259) of a Danish youth cohort. Childhood socioeconomic position was indicated by the educational level of the mother and the father at age 14. Mental health was measured by four different symptom scales at four age-points (age 15, 18, 21 and 28), and combined into one global score. Cardiometabolic disease risk was measured by nine biomarkers at age 28–30 and combined into one global score by sample-specific z-scores. We conducted analyses within the causal inference framework and evaluated the associations using nested counterfactuals.

Results

We found an inverse association between childhood socioeconomic position and cardiometabolic disease risk in young adulthood. The proportion of the association which was mediated by mental health was 10 (95% CI: -4; 24) % and 12 (95% CI: -4; 28) % using educational level of the mother and the father as indicator, respectively.

Conclusions

Accumulated poorer mental health in childhood, youth and early adulthood partially explained the association between low childhood socioeconomic position and increased cardiometabolic disease risk in young adulthood. The results of the causal inference analyses rely on the underlying assumptions and correct depiction of the DAG. Since these are not all testable, we cannot exclude violations that potentially could bias the estimates. If the findings can be replicated, this would support a causal relationship and direct potentials for intervention. However, the findings point to a potential for intervention in young age in order to impede the translation of childhood social stratification into later cardiometabolic disease risk disparities.
The meaning of sedentary behavior among older adults: a phenomenological hermeneutic study
Authors: Niklasson Joakim , Fagerström Cecilia , Bergman Patrick , Lindberg Terese , Backåberg Sofia
Published: June 2023

Background

A sedentary lifestyle has implications for health and well-being. For healthy ageing, it is recommended to interrupt prolonged sitting; however, little is known about the meaning of sedentary behavior among older adults. The aim of this study was to understand the meaning of sedentary behavior among older adults with initial support from community care.

Methods

A phenomenological hermeneutics approach was used, and individual interviews were conducted with sixteen older adults aged 70 to 97 years, by phone and face to face. The older adults lived in ordinary housing in southern Sweden and received initial support from community care.

Results

The interviews yielded three key themes: Being sedentary is an unnatural part of life, having an ageing body means unwanted frailty, and having a sedentary lifestyle is based on conscious choices.

Conclusion

Being sedentary means having a lack of physical activity and social interactions, resulting in wanting to be more physically active than sometimes possible. Clinical practitioners should bear in mind that becoming more sedentary is inevitable with an ageing body, but that older adults may have an innate desire to be as physically active as possible. A lifelong exposure to physical activity, the possibility of well-being found in sedentary activities and the impact of social networks should not be overlooked when creating clinical interventions to break unhealthy sedentary behavior among older adults. To increase the understanding of sedentary behavior among older adults, future research could focus on the impact of physical impairment on sedentary behavior and the relationship between sedentary behavior and physical activity throughout life.
Research on anterior minimally invasive approach in the treatment of children with developmental dysplasia of the hip
Authors: Hu Xiongke , Tan Qian , Mei Haibo , Mo Shasha , Liu Kun
Published: June 2023

Objectives

To investigate the clinical efficacy and safety of open reduction through anterior minimally invasive approach in the treatment of children with developmental dysplasia of the hip.

Method

A total of 23 patients (25 hips) less than 2 years with developmental dysplasia of the hip treated by open reduction through anterior minimally invasive approach were treated in our hospital from August 2016 to March 2019. Through the anterior minimally invasive approach, we enter from the gap between sartorius muscle and tensor fasciae lata without cutting off rectus femoris muscle, which can effectively expose the joint capsule and reduce the damage to medial blood vessels and nerves. The operation time, incision length, intraoperative bleeding, hospital stay and surgical complications were observed. The progression of developmental dysplasia of the hip and avascular necrosis of the femoral head were evaluated by imaging examination.

Result

All patients were performed with follow-up visit for an average of 22 months. The average incision length was 2.5 cm, the average operation time was 26 min, the average intraoperative bleeding was 12ml, and the average hospital stay was 4.9 days. All patients received concentric reduction immediately after operation, and no re-dislocation occurred. At the last follow-up visit, the acetabular index was (25.8 ± 6.4°). During the follow-up visit, X-ray showed avascular necrosis of the femoral head in 4 hips (16%).

Conclusion

open reduction through anterior minimally invasive approach can achieve good clinical effect in the treatment of infantile developmental dysplasia of the hip.
Cubitus varus after pediatric lateral condylar fracture: true or pseudo?
Authors: Kim Kyungil , Yoon Chiyoung , Lee Han Yong
Published: June 2023

Purpose

Common complications of lateral condylar fractures are lateral condylar overgrowth, lateral bony spur and cubitus varus. Lateral condylar overgrowth or lateral bony spur may appear as cubitus varus on gross examination. Such gross cubitus varus without actual angulation is pseudo-cubitus varus, while a difference of more than 5° in varus angulation on X-ray is true cubitus varus. This study aimed to compare true and pseudo-cubitus varus.

Methods

One hundred ninety-two children treated for unilateral lateral condylar fracture with a follow-up period of over six months were included. The Baumann angle, humerus-elbow-wrist angle and interepicondylar width of both side were compared. More than 5° in varus angulation on X-ray was considered cubitus varus. Increase in interepicondylar width was considered lateral condylar overgrowth or a lateral bony spur. The risk factors that could predict the development of a true cubitus varus were analyzed.

Results

True cubitus varus was 32.8%, measured by Baumann angle and 29.2%, measured by humerus-elbow-wrist angle. A total of 94.8% of patients showed an increased interepicondylar width. The predicted cut-off value for 5° varus angulation on the Baumann angle was a 3.675 mm increase in interepicondylar width by ROC curve analysis. The risk of cubitus varus in stage 3, 4, and 5 fractures according to Song’s classification was 2.88 times higher than that in stage 1 and 2 fractures on multivariable logistic regression analysis.

Conclusion

Pseudo-cubitus varus is more prevalent than true cubitus varus. A 3.7 mm increase in interepicondylar width could simply predict true cubitus varus. The risk of cubitus varus increased in Song’s classification stages 3, 4, and 5.
1 year mortality after hip fracture in an Irish urban trauma centre
Authors: Ferris Helena , Merron Georgia , Coughlan Tara
Published: June 2023

Background

Hip fracture accounts for a considerable burden of disease in older adults, yet there is a paucity of data pertaining to longer-term outcomes in the Irish Hip Fracture population. Understanding the factors that influence longer-term survival would allow care pathways to be refined to optimise patient outcomes. In Ireland, there is no linkage to death registration at a national or regional level, nor are longer-term outcomes captured by the Irish Hip Fracture Database. This study aimed to quantify 1-year mortality in an Irish hip fracture cohort and identify factors that influence survival at 1 year.

Methods

A retrospective review of hip fracture cases in an Irish urban trauma centre over a 5-year period was conducted. Mortality status was obtained via the Inpatient Management System and correlated with the Irish Death Events Register. A range of routinely collected patient and care process variables were analysed using logistic regression.

Results

A total of 833 patients were included. Within 1 year of sustaining a hip fracture, 20.5% (171/833) had died. On multivariate analysis, female gender (OR 0.36, p < 0.001, 95% CI 0.23–0.57), independent mobility pre-fracture (OR 0.24, p < 0.001, 95% CI 0.14–0.41) and early mobilisation on the day of or after surgery (OR 0.48, p < 0.001, 95% CI 0.30–0.77) reduced the likelihood of dying within 1 year (AUC 0.78).

Conclusion

Of the variables examined, early postoperative mobilisation was the only modifiable factor identified that conferred a longer-term survival benefit. This underscores the importance of adhering to international best practice standards for early postoperative mobilisation.
Epidemiology of distal radius fracture: a regional population-based study in Japan
Authors: Ando Jiro , Takahashi Tsuneari , Ae Ryusuke , Ajiki Takashi , Matsumura Tomohiro , Sasao Wataru , Abe Masahiko , Takeshita Katsushi
Published: June 2023

Background

Distal radius fracture (DRF) is very common worldwide. In particular, aging countries have numerous patients with DRF, resulting in an urgent need for active preventive measures. As few epidemiological studies have investigated DRF in Japan, we aimed to identify the epidemiological characteristics of patients of all ages with DRF in Japan.

Methods

This descriptive epidemiologic study analyzed data obtained from clinical information of patients diagnosed with DRF from January 1, 2011, to December 31, 2020, at a prefectural hospital in Hokkaido, Japan. We calculated the crude and age-adjusted annual incidences of DRF and described the age-specific incidence, injury characteristics (injury location and cause, seasonal differences, and fracture classification), and 1- and 5-year mortality rates.

Results

A total of 258 patients with DRF were identified, of which 190 (73.6%) were female and the mean age (standard deviation) was 67.0 (21.5) years. The crude annual incidence of DRF ranged from 158.0 to 272.6 per 100,000 population/year, and the age-adjusted incidence among female patients demonstrated a significant decreasing trend during 2011–2020 (Poisson regression analysis; p = 0.043). The age-specific incidence differed by sex, with peaks at 10–14 years for males and 75–79 years for females. The most common cause of injury was a simple fall in patients > 15 year of age and sports injuries in patients ≤ 15 years of age. DRFs were most frequently sustained outdoors and were more common in the winter season. In patients > 15 years of age, the proportions of AO/OTA fracture types A, B, and C were 78.7% (184/234), 1.7% (4/234), and 19.6% (46/234), respectively, and 29.1% (68/234) of patients received surgical treatment for DRF. The 1- and 5-year mortality rates were 2.8% and 11.9%, respectively.

Conclusions

Our findings were mostly consistent with previous global studies. Although the crude annual incidence of DRF was relatively high because of recent population aging, the age-adjusted annual incidence among female patients showed a significant decreasing trend during this decade.
Gut microbiota combined with fecal metabolomics reveals the effects of FuFang Runzaoling on the microbial and metabolic profiles in NOD mouse model of Sjögren’s syndrome
Authors: Chen Changming , Zeng Ping , Yao Xueming , Huang Zhaowei , Ling Yi , Huang Ying , Hou Lei , Li Hufan , Zhu Dan , Ma Wukai
Published: June 2023

Objective

Sjögren’s syndrome (SS) is an inflammatory autoimmune disease characterized by high levels of chronic lymphocyte infiltration. Differences and dysfunction in the gut microbiota and metabolites may be closely related to the pathogenesis of SS. The purpose of this study was to reveal the relationship between the gut microbiota and metabolome in NOD mice as a model of SS and the role of FuFang Runzaoling (FRZ), which is a clinically effective in treating SS.

Methods

NOD mice were gavaged with FRZ for 10 weeks. The ingested volume of drinking water, submandibular gland index, pathologic changes of the submandibular glands, and serum cytokines interleukin (IL)-6, IL-10, IL-17 A, and tumor necrosis factor-alpha (TNF-α) were determined. The roles of FRZ on gut microbiota and fecal metabolites were explored by 16 S rRNA gene sequencing and liquid chromatography-mass spectrometry (LC-MC), respectively. The correlation between them was determined by Pearson correlation analysis.

Results

Compared with the model group, the drinking water volume of NOD mice treated with FRZ increased and the submandibular gland index decreased. FRZ effectively ameliorated lymphocyte infiltration in the small submandibular glands in mice. Serum levels of IL-6, TNF-α, and IL-17 A decreased, and IL-10 increased. The Firmicutes/Bacteroidetes ratio in the FRZ treatment group was higher. FRZ significantly downregulated the relative abundance of the family Bacteroidaceae and genus Bacteroides, and significantly upregulated the relative abundance of genus Lachnospiraceae_UCG-001. Orthogonal projections to latent structures discriminant analysis (OPLS-DA) revealed the significant change in fecal metabolites after FRZ treatment. Based on criteria of OPLS-DA variable influence on projection > 1, P < 0.05, and fragmentation score > 50, a total of 109 metabolites in the FRZ-H group were differentially regulated (47 downregulated and 62 upregulated) compared to their expressions in the model group. Kyoto Encyclopedia of Genes and Genomes pathway analysis revealed enriched metabolic of sphingolipid metabolism, retrograde endocannabinoid signaling, GABAergic synapse, necroptosis, arginine biosynthesis, and metabolism of histidine, alanine, aspartate, and glutamate. Correlation analysis between gut microbiota and fecal metabolites suggested that the enriched bacteria were related to many key metabolites.

Conclusions

Taken together, we found FRZ could reduce the inflammatory responses in NOD mice by regulating the gut microbiota, fecal metabolites, and their correlation to emerge a therapeutic effect on mice with SS. This will lay the foundation for the further studies and applications of FRZ, and the use of gut microbiotas as drug targets to treat SS.

Graphical Abstract
Effects of exercise interventions on cancer-related fatigue and quality of life among cancer patients: a meta-analysis
Authors: Chen Xiaoli , Li Juejin , Chen Chongcheng , Zhang Yalin , Zhang Shu , Zhang Yun , Zhou Lin , Hu Xiaolin
Published: June 2023

Purpose

In this study, exercise interventions were evaluated for their effects on cancer-related fatigue (CRF) and quality of life (QoL) among cancer patients.

Design

A meta-analysis was performed.

Methods

We systematically searched the PubMed/Medline, Web of Science, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, and CINAHL databases, and gray literature sources including the Virginia Henderson International Nursing Library and Google Scholar. This study only included randomized controlled trials (RCTs) examining how exercise interventions affect CRF and QoL among cancer patients. Based on the Cochrane Risk-of-Bias Assessment Tool, version 2 (RoB 2) and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, the methodological quality of the included studies was evaluated. In addition, standardized mean differences (SMDs) and 95% confidence intervals (CIs) were applied to assess the intervention effect with respect to CRF and QoL. Data analysis was performed using Review Manager (version 5.4).

Results

There were a total of 1573 participants in the 28 included articles. According to the meta-analysis, CRF (SMD = -0.35, 95% CI: -0.63 to -0.07, p = 0.01) and QoL (SMD = 0.36, 95% CI: 0.20 to 0.53, p < 0.01) were positively affected by exercise interventions. Subgroup analyses revealed considerable improvements in CRF (SMD = -0.54, 95% CI: -1.00 to -0.09, p = 0.02) and QoL (SMD = 0.38, 95% CI: 0.16 to 0.59, p < 0.01) from aerobic exercise. An intervention duration less than 12 weeks had a better effect on CRF (SMD = -0.80, 95% CI: -1.43 to -0.17, p = 0.01) and QoL (SMD = 0.53, 95% CI: 0.21 to 0.85, p < 0.01), and three times per week was the most effective frequency in improving QoL (SMD = 0.69, 95% CI: 0.28 to 1.11, p < 0.01). Exercise intervention was more successful in improving CRF (SMD = -0.66, 95% CI: -1.10 to -0.21, p < 0.01) and QoL (SMD=-0.50, 95% CI: 0.23 to 0.78, p < 0.01) in female cancer patients. Sensitivity analyses showed that the pooled outcomes were reliable and stable.

Conclusion

Exercise interventions are a workable approach to improve CRF and QoL among cancer patients. An aerobic exercise intervention of less than 12 weeks might be most effective in improving CRF and QoL, and three times per week might be the most appropriate frequency. Exercise might have a more positive effect on improving CRF and QoL in female cancer patients. Additionally, a larger number of high-quality RCTs should be conducted to further confirm the efficacy of exercise interventions on CRF and QoL among cancer patients.

Registration number

CRD42022351137.
Association of Medicaid expansion with dental emergency department visits overall and by states’ Medicaid dental benefits provision
Authors: Giannouchos Theodoros V. , Reynolds Julie , Damiano Peter , Wright Brad
Published: June 2023

Background

Evidence on the association of Medicaid expansion with dental emergency department (ED) utilization is limited, while even less is known on policy-related changes in dental ED visits by Medicaid programs’ dental benefits generosity. The objective of this study was to estimate the association of Medicaid expansion with changes in dental ED visits overall and by states’ benefits generosity.

Methods

We used the Healthcare Cost and Utilization Project’s Fast Stats Database from 2010 to 2015 for non-elderly adults (19 to 64 years of age) across 23 States, 11 of which expanded Medicaid in January 2014 while 12 did not. Difference-in-differences regression models were used to estimate changes in dental-related ED visits overall and further stratified by states’ dental benefit coverage in Medicaid between expansion and non-expansion States.

Results

After 2014, dental ED visits declined by 10.9 [95% confidence intervals (CI): -18.5 to -3.4] visits per 100,000 population quarterly in states that expanded Medicaid compared to non-expansion states. However, the overall decline was concentrated in Medicaid expansion states with dental benefits. In particular, among expansion states, dental ED visits per 100,000 population declined by 11.4 visits (95% CI: -17.9 to -4.9) quarterly in states with dental benefits in Medicaid compared to states with emergency-only or no dental benefits. Significant differences between non-expansion states by Medicaid’s dental benefits generosity were not observed [6.3 visits (95% CI: -22.3 to 34.9)].

Conclusions

Our findings suggest the need to strengthen public health insurance programs with more generous dental benefits to curtail costly dental ED visits.
Tibialis anterior rerouting combined with calcaneal lengthening osteotomy as a single-stage reconstruction of symptomatic flexible flatfoot in children and adolescents
Authors: Sakr Samy Abdel-Hady , Zayda Ahmed Ibrahim , Mesregah Mohamed Kamal , Abosalem Ahmed Abdelazim
Published: June 2023

Background

Symptomatic flexible flatfoot in children and adolescents should be surgically managed only if conservative measures have failed. The aim of this study was to assess functional and radiological results of tibialis anterior rerouting combined with calcaneal lengthening osteotomy as s single-stage reconstruction of symptomatic flexible flatfoot.

Methods

The current study was a prospective study of patients with symptomatic flexible flatfoot treated by single-stage reconstruction in the form of tibialis anterior tendon rerouting combined with calcaneal lengthening osteotomy. The American Orthopaedic Foot and Ankle Society score (AOFAS) was utilized to evaluate the functional outcomes. The evaluated radiological parameters included the standing anteroposterior (AP) and lateral talo-first metatarsal angle, talar head coverage angle, and calcaneal pitch angle.

Results

 The current study included 16 patients (28 feet) with a mean age of 11.6 ± 2.1 years. There was a statistically significant improvement in the mean AOFAS score from 51.6 ± 5.5 preoperatively to 85.3 ± 10.2 at final follow-up. Postoperatively, there was a statistically significant reduction in the mean AP talar head coverage angle from 13.6 ± 4.4° to 3.9 ± 3°, the mean AP talo-first metatarsal angle from 16.9 ± 4.4° to 4.5 ± 3.6°, and the mean lateral talo-first metatarsal angle from 19.2 ± 4.9° to 4.6 ± 3.2°, P < 0.001. Additionally, the mean calcaneal pitch angle increased significantly from 9.6 ± 1.9° to 23.8 ± 4.8°, P < 0.001. Superficial wound infection occurred in three feet and was treated adequately by dressing and antibiotics.

Conclusion

 Symptomatic flexible flatfoot in children and adolescents can be treated with combined lateral column lengthening and tibialis anterior rerouting with satisfactory radiological and clinical outcomes.

Level of evidence Level IV.