bluuebunny/crossref_metadata_2025 huggingface dataset:
Transcriptomic and metabolic signatures of diatom plasticity to light fluctuations
Authors: Zhou Lu , Gao Shan , Yang Wenting , Wu Songcui , Huan Li , Xie Xiujun , Wang Xulei , Lin Senjie , Wang Guangce
Published: September 2022

Unlike in terrestrial and freshwater ecosystems, light fields in oceans fluctuate due to both horizontal current and vertical mixing. Diatoms thrive and dominate the phytoplankton community in these fluctuating light fields. However, the molecular mechanisms that regulate diatom acclimation and adaptation to light fluctuations are poorly understood. Here, we performed transcriptome sequencing, metabolome profiling, and 13C-tracer labeling on the model diatom Phaeodactylum tricornutum. The diatom acclimated to constant light conditions was transferred to six different light conditions, including constant light (CL5d), short-term (1 h) high light (sHL1h), and short-term (1 h) and long-term (5 days) mild or severe light fluctuation conditions (mFL1h, sFL1h, mFL5d, and sFL5d) that mimicked land and ocean light levels. We identified 2,673 transcripts (25% of the total expressed genes) expressed differentially under different fluctuating light regimes. We also identified 497 transcription factors, 228 not reported previously, which exhibited higher expression under light fluctuations, including 7 with a light-sensitive PAS domain (Per-period circadian protein, Arnt-aryl hydrocarbon receptor nuclear translocator protein, Sim-single-minded protein) and 10 predicted to regulate genes related to light-harvesting complex proteins. Our data showed that prolonged preconditioning in severe light fluctuation enhanced photosynthesis in P. tricornutum under this condition, as evidenced by increased oxygen evolution accompanied by the upregulation of Rubisco and light-harvesting proteins. Furthermore, severe light fluctuation diverted the metabolic flux of assimilated carbon preferentially toward fatty acid storage over sugar and protein. Our results suggest that P. tricornutum use a series of complex and different responsive schemes in photosynthesis and carbon metabolism to optimize their growth under mild and severe light fluctuations. These insights underscore the importance of using more intense conditions when investigating the resilience of phytoplankton to light fluctuations.
Placing Caste: Spatialization, Urban Segregation, and Musical Boundary-Making
Authors: Diwakar Pranathi
Published: September 2022

In the face of India’s enduring caste inequalities, their entrenchment or resistance is central to social and urban navigation. In this article, I locate music as an important site to investigate how caste comes to be spatialized, where place identity comes to symbolize group difference, with the effect of exacerbating social and spatial segregation. I use ethnographic field notes from attending musical events and 103 interviews with members of two live musical worlds situated in the southern city of Chennai: Carnatic music, which is seen as the preserve of Brahmin, or “upper” caste residents of the city; and Gaana music, which is associated with Dalit, or previously “untouchable” caste urban residents. I argue that for caste elites, symbolic power is constructed and maintained through norms and boundary work, thus producing hegemonic place identity and cultural power. For the caste oppressed, caste discrimination is experienced as stigmatized place identity, which is variously managed, reappropriated, or rejected through a range of strategies. The persistence of place-based stigma to devalue caste identity shapes the experience of caste-based urban inequalities that obstruct marginalized communities’ right to the city. In recent years, Gaana musicians are using their music to protest caste-based urban segregation, indexing the rise of a cultural articulation of an anti-caste assertion that challenges the marginalization of urban Dalits. This article advances sociological understandings of the forms that urban segregation can take when layered with caste as an axis of social difference and conceptualizes spatialization of caste as a driver of urban segregation.
A Hospital-based Managed Alcohol Program in a Canadian Setting
Authors: Nolan Seonaid , Fairgrieve Christopher , Dong Huiru , Garrod Emma , van Heukelom Holly , Parappilly Beena P. , McLean Mark , Tsui Judith I. , Samet Jeffrey H.
Published: September 2022

Objectives

A managed alcohol program (MAP) is a harm reduction strategy that provides regularly, witnessed alcohol to individuals with a severe alcohol use disorder. Although community MAPs have positive outcomes, applicability to hospital settings is unknown. This study describes a hospital-based MAP, characterizes its participants, and evaluates outcomes.

Methods

A retrospective chart review of MAP participants was conducted at an academic hospital in Vancouver, Canada, between July 2016 and October 2017. Data included demographics, alcohol/substance use, alcohol withdrawal risk, and MAP indication. Outcomes after MAP initiation included the change in mean daily alcohol consumption and liver enzymes.

Results

Seventeen patients participated in 26 hospital admissions: 76% male, mean age of 54 years, daily consumption prehospitalization of a mean 14 alcohol standard drinks, 59% reported previous nonbeverage alcohol consumption, and 41% participated in a community MAP. Most participants were high risk for severe, complicated alcohol withdrawal and presented in moderate withdrawal. Continuation of community MAP was the most common indication for hospital-based MAP initiation (38%), followed by a history of leaving hospital against medical advice (35%) and hospital illicit alcohol use (15%). Hospital-based MAP resulted in a mean of 5 fewer alcohol standard drinks daily compared with preadmission (P = 0.002; 95% confidence interval, 2–8) and improvement in liver enzymes, with few adverse events.

Conclusions

Participation in a hospital-based MAP may be an effective safe approach to reduce harms for some individuals with severe alcohol use disorder. Further study is needed to understand who benefits most from hospital-MAP and potential benefits/harms following hospital discharge.
Complications Are Infrequent After Humeral Shaft Fractures Due to Low-Energy Gunshot Injuries
Authors: Cho Elizabeth , Taylor Aaron , Olson Jeffrey J. , Entezari Vahid , Vallier Heather A.
Published: September 2022

Objective:

To describe humerus shaft fractures after low-energy gunshot wound (GSW) and compare with blunt injuries. We hypothesized that nerve injury, infection, and fracture union would be similar.

Design:

Retrospective.

Setting:

Urban Level 1 trauma center.

Patients/Participants:

Four hundred three patients were treated for a humeral shaft fracture over 18 years. Sixty-two patients sustained injury due to GSW.

Intervention:

Primary open reduction and internal fixation was pursued in 59%, including 32% after GSW.

Main Outcome Measurements:

Rates of nerve injury, infection, and fracture union.

Results:

Patients with GSW were younger with a mean age of 30 years, more likely male (90%), with isolated injuries (84%), and less likely to have simple fractures (84%). Both groups experienced high rates of union (98% of GSW fractures vs. 99% of closed high-energy fractures). Deep infection occurred in 1 patient (1.6%) after GSW. Rates of deep infection in the closed and open blunt trauma fracture groups were similarly low at 1% and 4.5%, respectively. Nerve injury on presentation after GSW was more common than after low-energy and high-energy closed fractures (47% vs. 13% and 27%), but similar to blunt open fracture (52%). Despite higher rates of nerve injury, nerve recovery occurred at similarly high rates after both GSW and blunt injuries (78% vs. 86%).

Conclusions:

Nerve injuries are more common after GSW, but most recover without intervention. Infection is uncommon after GSW, and secondary unplanned operations are rare. Initial nonoperative care of most GSW humerus fractures, even with radial nerve injury at the time of presentation, seems appropriate.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Comparison of Deep Learning and Classical Machine Learning Algorithms to Predict Post-operative Outcomes for Anterior Cervical Discectomy and Fusion Procedures with State-of-the-art Performance
Authors: Rodrigues Adrian J. , Schonfeld Ethan , Varshneya Kunal , Stienen Martin N. , Staartjes Victor E. , Jin Michael C. , Veeravagu Anand
Published: September 2022

Study Design.

Retrospective cohort.

Objective.

Due to Anterior cervical discectomy and fusion (ACDF) popularity, it is important to predict post-operative complications, unfavorable 90-day readmissions, and 2-year re-operations to improve surgical decision making, prognostication and planning.

Summary of Background Data.

Machine learning has been applied to predict post–operative complications for ACDF; however, studies were limited by sample size and model type. These studies achieved

0.70 AUC. Further approaches, not limited to ACDF, focused on specific complication types, and resulted in AUC between 0.70–0.76.

Methods.

The IBM MarketScan Commercial Claims and Encounters Database and Medicare Supplement were queried from 2007-2016 to identify adult patients who underwent an ACDF procedure (N=176,816). Traditional machine learning algorithms, logistic regression, support vector machines, were compared with deep neural networks to predict: 90-day post-operative complications, 90-day readmission, and 2-year reoperation. We further generated random deep learning model architectures and trained them on the 90-day complication task to approximate an upper bound. Lastly, using deep learning, we investigated the importance of each input variable for the prediction of 90-day post-operative complications in ACDF.

Results.

For the prediction of 90-day complication, 90-day readmission, and 2-year reoperation, the deep neural network-based models achieved area under the curve (AUC) of 0.832, 0.713, and 0.671. Logistic regression achieved AUCs of 0.820, 0.712, and 0.671. SVM approaches were significantly lower. The upper bound of deep learning performance was approximated as 0.832. Myelopathy, age, HIV, previous myocardial infarctions, obesity, and documentary weakness were found to be the strongest variable to predict 90-day post-operative complications.

Conclusions.

The deep neural network may be used to predict complications for clinical applications after multi-center validation. The results suggest limited added knowledge exists in interactions between the input variables used for this task. Future work should identify novel variables to increase predictive power.
Effect of Irisin on Human Nucleus Pulposus Cells: New Insights into the Biological Cross-talk Between Muscle and Intervertebral Disk
Authors: Vadalà Gianluca , Di Giacomo Giuseppina , Ambrosio Luca , Cicione Claudia , Tilotta Veronica , Russo Fabrizio , Papalia Rocco , Denaro Vincenzo
Published: September 2022

Study Design.

In vitro study.

Objective.

To investigate the effect of irisin on human nucleus pulposus cells (hNPCs) in vitro.

Summary of Background Data.

Physical exercise (PE) favours weight loss and ameliorates function in patients with low back pain. Although there is no biological evidence that the intervertebral disk (IVD) can respond to PE, recent studies have shown that running is associated with increased IVD hydration and hypertrophy. Irisin, a myokine released upon muscle contraction, has demonstrated anabolic effects on different cell types, including chondrocytes.

Materials and Methods.

hNPCs were exposed to 5, 10, and 25 ng/mL irisin. Cell proliferation, glycosaminoglycan (GAG) content, metabolic activity, gene expression of collagen type II (COL2), matrix metalloproteinase (MMP)-13, tissue inhibitor of matrix metalloproteinase (TIMP)-1 and TIMP-3, aggrecan (ACAN), interleukin (IL)-1β, a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-5 were assessed. In addition, MTT assay and ADAMTS-5, COL2, TIMP-1, and IL-1β gene expression were evaluated following incubation with irisin for 24 hours and subsequent culture with 10 ng/mL IL-1β and vice versa (incubation for 24 hours with IL-1β and subsequent culture with irisin).

Results.

Irisin increased hNPC proliferation, metabolic activity, and GAG content, as well as COL2, ACAN, TIMP-1 and TIMP-3 gene expression, while decreasing MMP-13 and IL-1β mRNA levels. Irisin pretreatment of hNPCs cultured in proinflammatory conditions resulted in a rescue of metabolic activity and a decrease of IL-1β levels. Similarly, incubation of hNPCs with IL-1β and subsequent exposure to irisin led to an increment of metabolic activity, COL2 gene expression, and a reduction of IL-1β and ADAMTS-5 levels.

Conclusions.

Irisin increases hNPC proliferation, GAG content, metabolic activity, and promotes anabolic gene expression while reducing catabolic markers. Irisin may be one of the mediators by which PE and muscle tissues modulate IVD metabolism, suggesting the existence of a biological cross-talk between the muscle and IVD.
Effort-based decision making in response to high-dose androgens: role of dopamine receptors
Authors: Donovan Alexandra , Wood Ruth I.
Published: September 2022

Introduction

Anabolic-androgenic steroids (AAS) are performance-enhancing drugs used by both world-class and rank-and-file athletes. AAS abuse has been linked with risky decision-making, ranging from drunk driving to abusing multiple drugs. Our lab uses operant behavior in rats to test the effects of AAS (testosterone) on decision making. In our previous study, testosterone caused rats to work harder for food reward during an effort discounting (ED) task. ED is sensitive to dopamine in the nucleus accumbens, and AAS alter accumbens dopamine receptor expression. Accordingly, we determined if testosterone increases response to dopamine receptor antagonists during ED.

Methods

Rats were treated chronically with high-dose testosterone (7.5 mg/kg; n = 9) or vehicle (n = 9). We measured baseline preference for the large reward in an ED task, where rats choose between a small easy reward (one lever press for one sugar pellet) and a large difficult reward (2, 5, 10, or 15 presses for three pellets). Preference for the large reward was measured after administration of D1-like (SCH23390, 0.01 mg/kg) or D2-like (eticlopride, 0.06 mg/kg) receptor antagonists.

Results

At baseline, testosterone- and vehicle-treated rats showed similar preference for the large reward lever (FR5, testosterone: 68.6 ± 9.7% and vehicle: 85.7 ± 2.5%). SCH23390 reduced large reward preference significantly in both groups (FR5, testosterone: 41.3 ± 9.2%; vehicle: 49.1 ± 8.2%; F
(1,16) = 17.7; P < 0.05). Eticlopride decreased large reward preference in both groups, but more strongly in testosterone-treated rats (FR5: testosterone: 37.0 ± 9.7%; vehicle: 56.3 ± 7.8%; F
(1,16) = 35.3; P < 0.05).

Conclusion

Testosterone increases response to dopamine D2-like receptor blockade, and this contributes to previously observed changes in decision-making behaviors.
Influence of Specialty Contact Lens Wear on Posterior Corneal Tomography in Keratoconus Subjects
Authors: Deboutte Isabel , Kreps Elke O. , Rozema Jos J. , van Hoey Maarten , Anthonissen Lieselotte , Koppen Carina
Published: September 2022

Objective:

To evaluate the effect of specialty contact lens (CL) wear on posterior corneal tomography in keratoconus subjects.

Methods:

Patients with keratoconus who were wearing specialty CL were included in this retrospective cohort study. Tomographic parameters were evaluated with Scheimpflug imaging (Pentacam HR) before lens fitting and immediately after removal of CLs worn habitually for a period of several months. Subjects were divided into groups, according to type of lens (corneal, scleral, and hybrid) and keratoconus severity based on Belin/Ambrosio D (BAD-D) score, for further analysis.

Results:

Thirty-four eyes of 34 subjects diagnosed with keratoconus were included. Mean duration of habitual CL wear was 7.0±0.3 months. For the entire cohort, a small increase in flat keratometric reading at the anterior corneal surface (K1F; P=0.032) and at the posterior surface (K1B; P=0.041) was found. In the corneal CL group (10 eyes; 29.4%), flattening of the anterior corneal curvature was detected (Kmax; P=0.015). An increase in K1B value was seen in the scleral CL group (15 eyes; 44.1%) (P=0.03). Combined topometric indices showed a small but significant difference in the entire cohort (P<0.05) and in the subgroups of corneal CL wear and of moderate keratoconus (BAD-D score≥7).

Conclusion:

Various types of specialty CLs exert a differential influence on corneal parameters. A small steepening of keratometry at the posterior surface (K1B) was observed in the scleral lens group. Although corneal lens wear flattens the anterior cornea (Kmax), it does not significantly alter the posterior corneal surface.
Ocular Surface in Patients With Obstructive Sleep Apnea Syndrome: Evaluation of Clinical Parameters and Impression Cytology
Authors: Gunes Irem , Oltulu Refik , Oltulu Pembe , Turk Nazlı , Yosunkaya Sebnem
Published: September 2022

Purpose:

To evaluate the effect of obstructive sleep apnea syndrome (OSAS) on the ocular surface and conjunctival cytology and the relationship between the findings and disease severity.

Methods:

One hundred six eyes of 106 patients (77 patients with OSAS and 29 control subjects) were included in the study. Twenty-three patients with an apnea–hypopnea index (AHI) of 5 to 15 were classified as mild OSAS (group 1), 27 patients with an AHI of 15 to 30 were classified as moderate OSAS (group 2), and 27 patients with an AHI≥30 were classified as severe OSAS (group 3). The following tests were used to evaluate the ocular surface: tear break-up time (TBUT), Schirmer I test, ocular surface disease index (OSDI), and conjunctival impression cytology (CIC). The results obtained from the tests were analyzed and compared between the groups.

Results:

The mean value of the Schirmer I test was 15.03±10.16 (1–35) mm in the control group, whereas it was found as 13.39±8.80 (3–35) mm, 9.85±7.81 (1–30) mm, and 9.41±7.53 (2–35) mm in the mild, moderate, and severe OSAS groups, respectively, and the difference between the groups was significant (P=0.002). Although the mean TBUT score was 9.83±5.03 (3–23) seconds in the control group, it was 11.04±6.22 (3–20), 6.26±3.48 (1–16), and 5.44±3.09 (1–10) in the mild, moderate, and severe OSAS groups, respectively, and the difference between the groups was significant (P<0.001). Although the mean OSDI score was 12.76±14.84 (range, 0–41.65) in the control group, it was 11.52±12.95 (range, 0–44.40), 25.06±19.45 (range, 0–75), and 20.31±19.87 (range, 0–77.70) in the mild, moderate, and severe OSAS groups, respectively, and the difference between the groups was significant (P=0.015). Although the mean CIC stage was 0.47±0.60 (0–2) in the control group, it was 0.89±0.74 (0–2), 1.52±0.75 (0–3), and 1.83±0.69 (1–3) in the mild, moderate, and severe OSAS groups, respectively, and the difference between groups was significant (P<0.001).

Conclusion:

In addition to decreased tear production and TBUT, cytological changes including squamous metaplasia were detected between patients with OSAS and the control group.
Patient preferences in the treatment of chronic musculoskeletal pain: a systematic review of discrete choice experiments
Authors: Zhu Mengting , Dong Dong , Lo Hermione Hin-Man , Wong Samuel Yeung-Shan , Mo Phoenix Kit-Han , Sit Regina Wing-Shan
Published: September 2022

Chronic musculoskeletal pain (CMP) is a preference-sensitive condition for which numerous treatment options are available, each with benefits and risks. Thus, patient preferences play a critical role in decision making. This study summarized evidence from discrete choice experiments (DCEs) to quantify patient preferences for CMP treatment and identified important treatment attributes. A systematic review of DCEs on patient preferences for CMP treatment was conducted. Studies were included if they used DCE to determine patient preferences for CMP. A previously described methodological assessment tool was used to assess the risk of bias. The treatment attributes were summarized and sorted according to the frequency of citation and relative weight. Subgroup analyses were conducted to explore the intervention-specific attributes. A total of 15 eligible studies with 4065 participants were included. We identified “capacity to realize daily life activities,” “risk of adverse events,” “effectiveness in pain reduction,” and “out-of-pocket cost” as important attributes. Although “treatment frequency” and “onset of treatment efficacy” were less frequently mentioned, they were also important attributes. The attribute of “risk of adverse events” was especially important for drug treatment. The “out-of-pocket cost” and “treatment location and mode” were important attributes of exercise therapy. The attributes identified in this review will inform the design of future DCE studies, facilitate the translation of measurement-based care to value-based care, and provide the rationale to promote shared decision making and patient-centered care.
Medical school grades may predict future clinical competence
Authors: Wu Jr-Wei , Cheng Hao-Min , Huang Shiau-Shian , Liang Jen-Feng , Huang Chia-Chang , Shulruf Boaz , Yang Ying-Ying , Chen Chen-Huan , Hou Ming-Chih , Huey-Herng Sheu Wayne
Published: September 2022

Background:

In real-world medical education, there is a lack of reliable predictors of future clinical competencies. Hence, we aim to identify the factors associated with clinical competencies and construct a prediction model to identify “improvement required” trainees.

Methods:

We analyzed data from medical students who graduated from National Yang-Ming University with clerkship training and participated in the postgraduate year (PGY) interview at Taipei Veterans General Hospital. Clinical competencies were evaluated using grades of national objective structured clinical examination (OSCEs). This study used data from medical students who graduated in July 2018 as the derivation cohort (N = 50) and those who graduated in July 2020 (n = 56) for validation.

Results:

Medical school grades were associated with the performance of national OSCEs (Pearson r = 0.34, p = 0.017), but the grades of the structured PGY interviews were marginally associated with the national OSCE (Pearson r = 0.268, p = 0.06). A prediction model was constructed to identify “improvement required” trainees, defined: trainees with the lowest 25% of scores in the national OSCEs. According to this model, trainees with the lowest 25% medical school grades predicted a higher risk of the “improvement required” clinical performance (Q1–Q3 vs Q4 = 15% vs 60%, odds ratio = 8.5 [95% confidence interval = 1.8-39.4], p = 0.029). In the validation cohort, our prediction model could accurately classify 76.7% “improvement required” and “nonimprovement required” students.

Conclusion:

Our study suggests that interventions for students with unsatisfactory medical school grades are warranted to improve their clinical competencies.
Functional Abdominal Cramping Pain
Authors: Müller-Lissner Stefan , Andresen Viola , Corsetti Maura , Bustos Fernández Luis , Forestier Sylvie , Pace Fabio , Valdovinos Miguel A.
Published: September 2022

Functional abdominal cramping pain (FACP) is a common complaint, which may present either on its own or in association with a functional gastrointestinal disorder. It is likely caused by a variety of, probably partly unknown, etiologies. Effective management of FACP can be challenging owing to the lack of usable diagnostic tools and the availability of a diverse range of treatment approaches. Practical guidance for their selection and use is limited. The objective of this article is to present a working definition of FACP based on expert consensus, and to propose practical strategies for the diagnosis and management of this condition for physicians, pharmacists, and patients. A panel of experts on functional gastrointestinal disorders was convened to participate in workshop activities aimed at defining FACP and agreeing upon a recommended sequence of diagnostic criteria and management recommendations. The key principles forming the foundation of the definition of FACP and suggested management algorithms include the primacy of cramping pain as the distinguishing symptom; the importance of recognizing and acting upon alarm signals of potential structural disease; the recognition of known causes that might be addressed through lifestyle adjustment; and the central role of antispasmodics in the treatment of FACP. The proposed algorithm is intended to assist physicians in reaching a meaningful diagnostic endpoint based on patient-reported symptoms of FACP. We also discuss how this algorithm may be adapted for use by pharmacists and patients.
The S-100B level, intracranial pressure, body temperature, and transcranial blood flow velocities predict the outcome of the treatment of severe brain injury
Authors: Dzierzęcki Sebastian , Ząbek Mirosław , Zapolska Gabriela , Tomasiuk Ryszard
Published: September 2022

This study evaluates the applicability of S100B levels, mean maximum velocity (V
mean) over time, pulsatility index (PI), intracranial pressure (ICP), and body temperature (T) for the prediction of the treatment of patients with traumatic brain injury (TBI). Sixty patients defined by the Glasgow Coma Scale score ≤ 8 were stratified using the Glasgow Coma Scale into 2 groups: favorable (FG: Glasgow Outcome Scale ≥ 4) and unfavorable (UG: Glasgow Outcome Scale < 4). The S100B concentration was at the time of hospital admission. V
mean was measured using transcranial Doppler. PI was derived from a transcranial Doppler examination. T was measured in the temporal artery. The differences in mean between FG and UG were tested using a bootstrap test of 10,000 repetitions with replacement. Changes in S100B, V
mean, PI, ICP, and T levels stratified by the group were calculated using the one-way aligned rank transform for nonparametric factorial analysis of variance. The reference ranges for the levels of S100B, V
mean, and PI were 0.05 to 0.23 µg/L, 30.8 to 73.17 cm/s, and 0.62 to 1.13, respectively. Both groups were defined by an increase in V
mean, a decrease in S100B, PI, and ICP levels; and a virtually constant T. The unfavorable outcome is defined by significantly higher levels of all parameters, except T. A favorable outcome is defined by S100B < 3 mg/L, PI < 2.86, ICP > 25 mm Hg, and V
mean > 40 cm/s. The relationships provided may serve as indicators of the results of the TBI treatment.
Application strategy and effect analysis of nutritional support nursing for critically ill patients in intensive care units
Authors: Li Yunting , Liu Haitang
Published: September 2022

We investigate nutritional support and nursing status of critical patients in intensive care units (ICUs) to understand the latest nutritional support guidelines’ implementation by clinical medical staff; identify problems in nutritional support and nursing for these patients, analyze causes, and present suggestions; and provide a clinical/theoretical bases to improve nutritional support implementation and nursing strategies for them. Clinical case information of 304 critically ill ICU patients admitted from July 2017 to July 2021 was analyzed. They were divided into the experimental (nutritional support) and control (no nutritional support) groups to compare their laboratory indicators, 28-day case fatality rate, and infection incidence. Least significant difference was used for postanalysis of statistically significant items to obtain pairwise comparisons. Nutrition support strategies for ICU patients are consistent with guidelines but have an implementation gap. No statistically significant differences were found in hemoglobin (HB), total serum protein (TP), serum albumin (ALB), transferrin (TF), prealbumin (PA), and total lymphocyte count (TLC) in experimental group patients compared with the control group within 24 hours (before nutritional support, P > .05). No statistically significant differences were also found in HB, TP, TLC, and ALB between the enteral nutrition + parenteral nutrition (EN + PN), total EN (TEN), total PN (TPN), and control groups on admission day 7 (after nutritional support, P > .05), while statistically significant differences existed between PA and TF (P < .05). TF of patients supported by TEN was higher (statistically significant difference, P < .05). PA in patients receiving TEN and EN + PN support was higher than in control group patients (statistically significant difference, P < .05). Compared with the control group, in experimental group patients, infection incidence was significantly lower (40.2% vs 62.9%, P < .05); incidence of complications was lower, but not statistically significant (40.2% vs 57.1%, P > .05); and 28-day mortalities were significantly lower (26.7% vs 45.7%, P < .05). Nutritional support can reduce hospitalization complications and 28-day mortality in critical patients, but its implementation must be standardized. Especially for patients with gastrointestinal dysfunction, personalized/standardized nutrition strategies and nursing procedures are needed when PN support is applied, and training of clinical medical staff should be strengthened to improve nutrition support’s efficiency.
Cardiovascular disease in women: A review of spontaneous coronary artery dissection
Authors: Khiatah Bashar , Jazayeri Sam , Yamamoto Naofumi , Burt Tristen , Frugoli Amanda , Brooks Dennis L
Published: September 2022

Research has demonstrated the disproportionate quality of care for women with cardiovascular disease. These findings have prompted a renewed focus on cardiovascular disease awareness and disease prevention in women. Spontaneous coronary artery dissection (SCAD) is a significant cause of myocardial infarction (MI) and sudden death that primarily affects women. ongoing research has led to improved diagnostic capabilities and changes in approaches to initial and long-term management most importantly this research has provided evidence that SCAD is more common than previously thought and must be evaluated and treated differently from atherosclerotic MI. The difference between SCAD and atherosclerotic MI is highlighted in high rates of recurrent disease, gender distribution, association with exogenous hormones, pregnancy, migraine, physical and emotional stress triggers, concurrent systemic arteriopathies, and connective tissue disease. In this review, we provide updated insights and a summary of the epidemiology, risk factors, clinical presentation, diagnosis, treatment options, prognosis, and recurrence prevention of SCAD. We aim to provide a review of SCAD as a focus on cardiovascular disease awareness and disease prevention in women.
The half-painted picture: Reviewing the mental health impacts of cancer screening
Authors: Wadsworth Lauren P. , Wessman Inga , Björnsson Andri Steinþór , Jonsdottir Gudbjorg , Kristinsson Sigurður Yngvi
Published: September 2022

Cancer screening is recommended for select cancers worldwide. Cancer screening has become increasingly effective and accessible and often increases overall survival. However, the mental health effects of cancer screening, such as its impact on depression, anxiety, and post-traumatic stress disorder, are largely unknown. Conflicting available literature indicates the negative, neutral, and positive mental health effects of cancer screening across cancer types. There are a limited number of randomized controlled trials measuring the mental health effects of cancer screening. Overall, the more negative and life-threatening the screening results, the greater the mental health effects. Screening for cancer without a known precursor, for example, due to family history, can have positive impacts such as decreased worry and increased quality of life. However, receiving a cancer diagnosis often has negative mental effects that increase with the life-threatening potential of malignancy. In this study, we review the existing literature and provide recommendations for future research to determine if and when cancer screening is the best practice.
Impaired brain networks functional connectivity after acute mild hypoxia
Authors: Liu Jie , Li Shujian , Liu Mingxi , Xu Xianrong , Zhang Yong , Cheng Jingliang , Zhang Wanshi
Published: September 2022

This study aimed to analyze the changes in brain networks functional connectivity of pilots exposed to simulated hypoxia using resting-state functional magnetic resonance imaging (fMRI). A total of 35 healthy male pilots exposed to 14.5% oxygen concentration (corresponding to an altitude of 3000 m) underwent resting-state fMRI scans. The independent component analysis (ICA) approach was used to analyze changes in the resting-state brain networks functional connectivity of pilots after hypoxic exposure, and 9 common components in brain functional networks were identified. In the functional connections that showed significant group differences, linear regression was used to examine the association between functional connectivity and clinical characteristics. The brain networks functional connectivity after hypoxia exposure decreased significantly, including the left frontoparietal network and visual network 1-area, left frontoparietal network and visual network 2-area, right frontoparietal network and visual network 2-area, dorsal attention network and ventral attention network, dorsal attention network and auditory network, and ventral attention network and visual network 1-area. We found no correlation between the altered functional connectivity and arterial oxygen saturation level. Our findings provide insights into the mechanisms underlying hypoxia-induced cognitive impairment in pilots.
Psychomotor development and seizure features in idiopathic myoclonic epilepsy in infancy
Authors: Jiang Yongning , Zhou Xiangqin
Published: September 2022

Myoclonic epilepsy in infancy (MEI) is a rare syndrome characterized by generalized myoclonic seizures (MS) that occur within the first 3 years of life. In the present study, the form of onset, and clinical and electroencephalogram (EEG) features were analyzed. A retrospective chart review was conducted for 16 MEI patients between March 2009 and July 2022 in Peking Union Medical College. The clinical and video EEG (VEEG) characteristics, treatment strategy, and follow-up information were analyzed. Four cases presented with afebrile generalized tonic-clonic seizures (GTCS) at the onset of MEI (GTCS at onset or atypical MEI), while 12 cases presented with MS at onset (MS at onset or typical MEI). The 24-hour VEEG revealed a generalized discharge of polyspike (or spike)-and-wave complexes that lasted for 1–3 seconds in the ictal phase. All patients were treated with valproic acid monotherapy, and none of the patients experienced seizure recurrence. Furthermore, all patients had normal psychomotor development at the end of the follow up period. Typical MEI (MS at onset) and atypical MEI (GTCS at onset) were described in the present study. These 2 groups differed in form of onset, but there were no significant differences in clinical or EEG features.
Bioinformatics algorithm for lung adenocarcinoma based on macropinocytosis-related long noncoding RNAs as a reliable indicator for predicting survival outcomes and selecting suitable anti-tumor drugs
Authors: Chen Hang , Xu Shuguang , Hu Zeyang , Wei Yiqing , Zhu Youjie , Fang Shenzhe , Pan Qiaoling , Liu Kaitai , Li Ni , Zhu Linwen , Xu Guodong
Published: September 2022

As a highly conserved endocytic mechanism during evolution, macropinocytosis is enhanced in several malignant tumors, which promotes tumor growth by ingesting extracellular nutrients. Recent research has emphasized the crucial role of macropinocytosis in tumor immunity. In the present study, we established a new macropinocytosis-related algorithm comprising molecular subtypes and a prognostic signature, in which patients with lung adenocarcinoma (LUAD) were classified into different clusters and risk groups based on the expression of 16 macropinocytosis-related long noncoding RNAs. According to the molecular subtypes, we discovered that patients with LUAD in cluster1 had a higher content of stromal cells and immune cells, stronger intensity of immune activities, higher expression of PD1, PDL1, and HAVCR2, and a higher tumor mutational burden, while patients in cluster2 exhibited better survival advantages. Furthermore, the constructed prognostic signature revealed that low-risk patients showed better survival outcomes, earlier tumor stage, higher abundance of stromal cells and immune cells, higher immune activities, higher expression of PD1, PDL1, CTLA4, and HAVCR2, and more sensitivity to Paclitaxel and Erlotinib. By contrast, patients with high scores were more suitable for Gefitinib treatment. In conclusion, the novel algorithm that divided patients with LUAD into different groups according to their clusters and risk groups, which could provide theoretical support for predicting their survival outcomes and selecting drugs for chemotherapy, targeted therapy, and immunotherapy.
Are plain radiographic measurements still consistent with a diagnosis of basilar invagination in the era of cross-sectional images?
Authors: Park Jong-Hyeok , Kim Jong Tae , Kim Il Sup , Hong Jae Taek
Published: September 2022

Retrospective cross-sectional study To evaluate the validity and obtain optimal cutoff values of 3 radiologic measurements for the diagnosis of basilar invagination (BI). Two hundred seventy-six patients (46 patients who underwent atlantoaxial fusion for BI and 230 patients who were treated for minor cervical trauma) seen in a single institution from January 2010 to December 2016 were included in this study. Age, sex, and body mass index were adjusted for the patients. The Ranawat index (RI), modified Ranawat method (MRM), and Redlund-Johnell method (RJM) were used to diagnose BI on plain radiographs. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and diagnostic odds ratio of 3 radiologic measurements were compared. We also calculated the optimized cutoff values of 3 radiologic measurements using the receiver operating characteristic curve in our patients. The mean age of the 130 women and 146 men was 58.3 ± 14.5 years. The mean values of RI, MRM, and RJM in the BI group were 12.5 ± 3.3, 23.1 ± 3.8, and 27.3 ± 3.6 in women and 13.6 ± 2.6, 26.8 ± 4.2, and 34.7 ± 5.1 in men. There was a significant difference between the sexes (P < .05). The accuracies of RI, MRM, and RJM were 95%, 89.6%, and 92.3% in women and 93%, 68.2%, and 85.4% in men, respectively. The optimized cutoff values of RI, MRM, and RJM were 14, 26, and 32 mm in women and 15, 29, and 38 mm in men. Three radiologic measurements (RI, MRM, and RJM) are reliable for the diagnosis of BI even in the era of cross-sectional images. The validity of these measurements depends on sex and particular radiologic measurement. The optimized cutoff values of RI, MRM, and RJM were 14, 26, and 32 mm in women and 15, 29, and 37 mm in men. These cutoff values showed high validity when compared to the CT and MRI findings.
Korean nurses’ perception and performance on communication with physicians in clinical deterioration
Authors: Jin Bo-Gyeong , Kang Kyoungrim , Cho Hyun-Jin
Published: September 2022

Effective communication between nurses and physicians is necessary for prompt and accurate responses in clinical deterioration. This study aimed to examine nurses’ perception and performance of communication with physicians in clinical deterioration situations in the ward. A descriptive research design with a survey of 250 ward nurses working in 2 tertiary hospitals was used. Regarding communication with the physician, nurses’ perception was highest for timeliness, followed by accuracy, understanding, satisfaction, and openness, and their performance was highest for preparation, followed by situation, background, assessment, and recommendation. It is suggested that proactive activities for improving openness, accuracy, satisfaction, and mutual understanding between physicians and nurses are required for patient safety. Additionally, the performance for assessment and recommendations should be improved. Education programs for nurses and physicians should be developed and applied to clinical practice to promote understanding and trust in interprofessional communication.
Sorsby fundus dystrophy (SFD): A narrative review
Authors: Tsokolas Georgios
Published: September 2022

Sorsby fundus dystrophy (SFD) is a rare autosomal dominant disorder with complete penetrance affecting the macula. This is caused by a mutation in the TIMP-3. This objective narrative review aims to provide an overview of the pathophysiology, current treatment modalities, and future perspectives. A literature search was performed using “PubMed,” “Web of Science,” “Scopus,” “ScienceDirect,” “Google Scholar,” “medRxiv,” and “bioRxiv.” The molecular mechanisms underlying SFD are not completely understood. Novel advancements in cell culture techniques, including induced pluripotent stem cells, may enable more reliable modeling of SFD. These cell culture techniques aim to shed more light on the pathophysiology of SFD, and hopefully, this may lead to the future development of treatment strategies for SFD. Currently, no gene therapy is available. The main treatment is the use of anti-vascular endothelial growth factors (anti-VEGF) to treat secondary choroidal neovascular membrane (CNV), which is a major complication observed in this condition. If CNV is detected and treated promptly, patients with SFD have a good chance of maintaining a functional central vision. Other treatment modalities have been tried but have shown limited benefit, and therefore, have not managed to be more widely accepted. In summary, although there is no definitive cure yet, the use of anti-VEGF treatment for secondary CNV has provided the opportunity to maintain functional vision in individuals with SFD, provided CNV is detected and treated early.
YouTube as a source of information and education on endometriosis
Authors: Lee Kyong-No , Tak Hyun-Jin , Park So-Yoon , Park Sung Taek , Park Sung-Ho
Published: September 2022

Many patients seek information online, including on social media, regarding various health topics. This study aimed to investigate whether YouTube videos on endometriosis could be a useful source for the general population, surgical trainees, and specialists. A YouTube search was conducted on December 26, 2021, using the search terms “endometriosis,” “endometrioma,” and “endometriotic cyst.” Videos were sorted by view count, and the 100 videos with the highest view counts were chosen. After excluding 48 videos for various reasons, 52 were included in the final analysis. The number of views, duration, likes and dislikes, content type, and source of each video were recorded. We referred to a previous study to evaluate video quality. The 52 videos related to endometriosis had a total of 35,220,141 views (median 233,688, range 48,874–10,452,366). Based on authorship, the videos were categorized into videos uploaded by the medical group and the nonmedical group. The medical group mainly uploaded videos directly related to endometriosis, such as explanations or detailed surgical procedures for endometriosis (26/27, 96%), whereas the nonmedical group mainly uploaded videos about personal experiences and others (24/25, 96%; P <.001). Evaluating the score by each type of content, videos containing personal experiences (median score 6, range 3–10) scored significantly lower than videos containing other content such as explanations of the disease (median score 14, range 7–18; P < .001) and surgical procedures (median score 9, range 5–17; P < .001). Analysis according to the source, the number of views and video power index was significantly higher in the videos uploaded by the nonmedical group (P < .05). YouTube is currently not an appropriate source for patients to gain information on endometriosis. Credible videos with accurate information and clear, high-quality operative clips with proper scientific commentary should be uploaded by medical professionals and medical institutions to critically and rapidly appraise the quality of online video-disseminated information on endometriosis. In addition, advanced filtering using categories by YouTube’s staff appears to be necessary.
Regional block anesthesia for adult patients with inguinal hernia repair: A systematic review
Authors: Lv Jie , Zhang Qi , Zeng Ting , Li Xue-Feng , Cui Yang
Published: September 2022

Background:

Inguinal hernia repair (IHR) is a common surgical technique performed under regional block anesthesia (RBA). Although previous clinical trials have explored the effectiveness and safety of RBA for IHR, no systematic review has investigated its effectiveness and safety in adult patients with IHR.

Methods:

This systematic review searched electronic databases (PubMed, Embase, Cochrane Library, CNKI, Wangfang, and VIP) from their inception to July 1, 2022. We included all potential randomized controlled trials that focused on the effects and safety of RBA in adult patients with IHR. Outcomes included operative time, total rescue analgesics, numerical rating scale at 24 hours, occurrence rate of nausea and vomiting, and occurrence rate of urinary retention (ORUCR).

Results:

Five randomized controlled trials, involving 347 patients with IHR, were included in this study. Meta-analysis results showed that no significant differences were identified on operative time (MD = −0.20; fixed 95% confidence interval [CI], −3.87, 3.47; P = .92; I² = 0%), total rescue analgesics (MD = −8.90; fixed 95% CI, −20.36, 2.56; P = .13; I² = 28%), and occurrence rate of nausea and vomiting (MD = 0.39; fixed 95% CI, 0.13, 1.16; P = .09; I² = 0%) between 2 types of anesthesias. However, significant differences were detected in the numerical rating scale at 24 hours (MD = −1.53; random 95% CI, −2.35, −0.71; P < .001; I² = 75%) and ORUCR (MD = 0.20; fixed 95% CI, 0.05, 0.80; P = .02; I² = 0%) between the 2 management groups.

Conclusion:

The results of this study demonstrated that IHR patients with RBA benefit more from post-surgery pain relief at 24h and a decrease in the ORUCR than those with CSA.
Cytoreductive radical prostatectomy or radiation therapy for metastases prostate cancer: Evidence from meta-analysis
Authors: Peng Zhixiong , Huang Andong
Published: September 2022

Background:

Cytoreductive radical prostatectomy (RP), transurethral resection of the prostate, and radiation therapy were the main local treatments for oligometastatic prostate cancer (PCa). An optimal local treatment for metastases PCa was not consensus. The purpose of this study was to evaluate the effect on these local treatments for patients with metastases PCa.

Methods:

All relevant studies were systematically searched through PubMed, Web of Science through November 1, 2021. Studies were screened by inclusion and exclusion criteria. Progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS) were evaluated by this meta-analysis.

Results:

Eleven studies were identified that met the inclusion criteria. 644 patients received cytoreductive surgery, 8556 patients received no surgery or radiation therapy (RT), and 461 patients received RP + androgen deprivation therapy compared with 746 patients who received RT. Pooled data indicated that cytoreductive surgery significantly prolonged the PFS (OR = 0.65, 95% CI 0.53–0.80, P < .0001), CSS and OS (OR = 0.49, 95% CI 0.43–0.56, P < .00001; and OR = 0.80, 95% CI 0.72–0.88, P < .00001; respectively). Comparing cytoreductive surgery with RT, CSS, and OS were similar (OR = 0.82, 95% CI 0.67–1.01, P = .06; and OR = 0.93, 95% CI 0.79–1.09, P = .39; respectively).

Conclusions:

Cytoreductive radical prostatectomy significantly prolonged the PFS for metastatic PCa. Although OS was considered a-not-so significant difference between cytoreductive surgery and non-local therapy, non-local treatment was not recommended.