bluuebunny/crossref_metadata_2025 huggingface dataset:
Combined 3-Dimensional CT and Multidirectional CT Arthrography for Femoroacetabular Impingement and Hip Lesions: A Cross-sectional Study Comparing Imaging and Hip Arthroscopic Surgery Findings
Authors: Chuang Chieh-An , Sheu Huan , Yang Cheng-Pang , Tang Hao-Che , Wu Chen-Te , Fu Chen-Ju , Chan Yi-Sheng
Published: January 2023

Background:

There is limited research investigating the diagnostic strength of 3-dimensional computed tomography (3D-CT) and multidirectional CT arthrography (CTA) for femoroacetabular impingement (FAI) and related hip lesions.

Purpose:

To evaluate the diagnostic strength of combined 3D-CT and CTA in patients with FAI and related hip lesions by comparing it with hip arthroscopic surgery findings.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

This study included patients who were suspected of having FAI and related hip lesions and who underwent a combination of 3D-CT and CTA and subsequent hip arthroscopic surgery between December 2013 and December 2017. The CT and intraoperative arthroscopic findings were recorded and compared. The sensitivity, specificity, and accuracy of 3D-CT for FAI and those of CTA for related hip lesions were calculated.

Results:

A total of 114 patients with 114 hips were included in our study. There were 101 patients with positive findings and 13 patients with negative findings for FAI (including cam, pincer, and combined morphology) according to 3D-CT. The sensitivity, specificity, and accuracy of 3D-CT for FAI were 91.58%, 57.14%, and 89.47%, respectively. The sensitivity, specificity, and accuracy of CTA for labral tears were 94.64%, 100.00%, and 94.73%, respectively. For acetabular cartilage defects, the sensitivity, specificity, and accuracy of CTA were 60.71%, 91.37%, and 76.31%, respectively. For femoral cartilage defects, the sensitivity, specificity, and accuracy of CTA were 82.22%, 76.81%, and 78.94%, respectively.

Conclusion:

The study results indicated that 3D-CT was able to provide excellent accuracy for FAI compared with hip arthroscopic surgery findings. In addition, multidirectional CTA demonstrated promising diagnostic strength for hip lesions such as labral tears and chondral defects.
“I am not a Good Woman?” Exploring the Views and Challenges of Nurses When Discussing HPV Testing and Associated Cervical Screening with Women in Iraq
Authors: Ali Suhailah M. , Lawes Rebecca , Ghalib Ayla Khedher
Published: January 2023

Introduction

Cervical cancer is mostly caused by high-risk Human papillomavirus HPV, with an estimation prevalence of HPV of 99.7% worldwide. The US Food and Drug Administration (FDA) approved an HPV test for primary cervical screening in 2014. An HPV-DNA test, which provides higher protection against invasive cervical carcinomas, is replacing the long-standing Pap smear as the primary method of cervical cancer screening.

Objective

To explore nurses’ experience and knowledge of HPV DNA testing and how screening impacts on women's health through increasing awareness and proposing actions for health education strategies.

Method

A qualitative exploratory study was conducted on a purposeful sample of 25 qualified nurses, who were all employed in regional hospitals within a gynecological department in Kirkuk, Iraq. The nurses were interviewed with a semi-structured topic guide between November 2021 and February 2022. Responses were transcribed verbatim, translated into English and analysed using a content thematic analysis approach.

Results

Four themes with associated sub-themes emerged following coding and peer review. Participants had lack of experience and fragmented knowledge of HPV DNA testing/screening. Culturally sensitive resources for patients and training for nurses was identified key requirements.

Conclusions

Currently, there are no facilities for a HPV testing/screening services available in Iraq. The role of nurses undertaking HPV screening is not established and yet nurses represent the largest sector of health professionals. The dissemination of a collaborative HPV screening training programme to include clinical competence and knowledge for nurses and gynaecologists may improve knowledge, and could also be effective in improving patient awareness and engagement with cervical health.
Aligning Talent and Business: A Key for Sustainable HRM in SMEs
Authors: Kandukuri Vinutha
Published: January 2023

Talent search and its management are ongoing processes that are key to organizational progress. This article reviews the literature on the HR and talent management practices and concepts of larger business firms and small and medium enterprises (SMEs). The challenges faced by the talent acquisition team have been changing invariably throughout industrial development. In this context, the individuals search for stability and recognition in the organization, and the organizations search for talent, retention and consistent performance.

The study attempts to identify the reasons for attrition and importance of sustainable HR practices such as talent management and its business alignment, with particular reference to SMEs. It carries out descriptive and exploratory research. The study highlights the reasons for the increased attrition rate in SMEs compared to the larger firms that follow better, affordable talent management practices. Secondary data from several government websites and survey reports have been used for the study.
Relapsing polychondritis in systemic sclerosis: A rare vasculitic mimic
Authors: Teles Carolina , Liyanage Chiranthi Kongala , Chow Geoffrey , Denton Christopher P , Ong Voon
Published: January 2023

Introduction:

Relapsing polychondritis is a rare, immune-mediated disease characterised by inflammation of cartilaginous structures. Auricular chondritis, sparing the fatty lobule, is the most typical feature, followed by nose and laryngotracheal involvement. Albeit rare, neurologic involvement is reported with relapsing polychondritis. Cranial nerve involvement is the most frequent neurologic manifestation and is probably due to an underlying vasculitic process. Approximately one-third of relapsing polychondritis patients can overlap with other systemic diseases, including other autoimmune connective tissue diseases, but association with systemic sclerosis has very rarely been described.

Case description:

A 63-year-old woman presented with acute new-onset severe dysphagia, accompanied by hoarseness and preceded by pain, swelling and erythema of the left pinna, unresponsive to antibiotics. She had a history of long-standing limited cutaneous systemic sclerosis. Cranial nerve examination revealed right-sided palatal palsy, and left vocal cord palsy was found on fibreoptic nasendoscopy. Magnetic resonance imaging of the head and neck showed bilateral enhancement of an extracranial segment of the glossopharyngeal and vagus nerves. Clinical features and imaging findings were consistent with relapsing polychondritis, which successfully responded to high-dose steroids.

Conclusions:

This is a case of relapsing polychondritis mimicking progression of systemic sclerosis, showcasing its challenging features. It emphasises the importance of early diagnosis and prompt management with potential impact on the outcome, while highlighting the complex interplay between these two disease entities and vasculitic mechanisms, which may reflect the shared network of genetic predisposition across autoimmune rheumatic diseases.
Airway responsiveness to adenosine 5' monophosphate following inhalation of hypertonic saline
Authors: O'Hickey SP , Rees PJ , Lee TH
Published: January 2023

We wished to determine whether the refractory period after hypertonic saline (HS) challenge is due to mast cell mediator depletion. Therefore, the airway responsiveness to adenosine 5' monophosphate (AMP), which induces bronchoconstriction via mast cell histamine release, was determined after the inhalation of HS aerosol. Nine asthmatic subjects attended the laboratory on three occasions. On day 1 HS challenge was performed followed one hour later by a second HS challenge. On day 2 an AMP challenge was performed. On day 3 an HS challenge was performed followed one hour later by an AMP challenge. Airway responsiveness (PD35 sGaw) to an initial HS challenge ranged from 12 to 315 l of aerosol (mean 47 l). Airway responsiveness to a second HS challenge ranged from 8 to 800 l (mean 102 l p = 0.035, n = 9). Airway responsiveness to AMP increased from 0.44 to 14.0 mumol (mean 2.37 mumol) at baseline to 0.3 to 15.5 (mean 1.3 mumol) (p = 0.05) after HS challenge. There was a linear correlation between baseline AMP responsiveness and baseline HS responsiveness (r = 0.911, p = 0.001). There was no correlation between the degree of refractoriness and the change in AMP responsiveness (r = 0.1, p = 0.9). Thus airway responsiveness to AMP increased significantly after inhalation of HS aerosol and this increase was independent of refractory behaviour. Our results suggest that the refractory period to HS is not due to mediator depletion.
Absence of circulating products of oxygen derived free radicals in acute severe asthma
Authors: Chilvers ER , Garratt H , Whyte MK , Fink R , Ind PW
Published: January 2023

Oxygen derived free radicals (ODFRs), generated by eosinophils, neutrophils, alveolar macrophages and mast cells, have been proposed as important mediators of inflammatory damage in asthma. We attempted to assess the role of these free radicals in patients with acute asthma by determining serum concentrations of phospholipid-esterified 9, 11 and the parent 9, 12-linoleic acid isomers (9, 11-LA, 9, 12-LA), using HPLC and diode array detection. The diene conjugate, 9, 11-LA, has been shown to be a sensitive and specific marker of free radical activity in other inflammatory conditions. Eight patients (6 female, aged 19-42 years) with acute asthma (mean peak expiratory flow 92 +/- (26) m (SEM) l.min-1, mean PaO2 8.4 (1.0) kPa were studied at 0, 6, 12, 24 and 48 hours after admission to hospital and again 4-6 weeks later. Initial blood samples were taken prior to the administration of oxygen or drug therapy. On admission, mean concentrations of 9, 11-LA and 9, 12-LA were normal at 18.0 (2.8) and 1024 (118) mumol.l-1. All subsequent 9, 11-LA serum concentrations were likewise in the normal range. The serum 9, 11-LA/9, 12-LA ratio was 1.9 (0.4) on admission and 1.6 (0.2) in convalescence (Normal Range 1.0-3.8). These findings in peripheral blood do not support a major role or oxygen derived free radical production in acute asthma, but local airway production cannot be excluded.
Effect of oxygen administration on the breathing pattern during haemodialysis in man
Authors: Heyrman RM , De Backer WA , Van Waeleghem JP , Willemen MJ , Vermeire PA , De Broe ME
Published: January 2023

During haemodialysis (HD), allowing important CO2- unloading, an irregular breathing pattern (BP) is frequently observed. This has been attributed to a decrease in central chemoreceptor firing, with a greater contribution of the peripheral chemoreceptors in the chemical drive to breathe. To provide further evidence for these findings we studied five patients with end-stage renal failure in chronic HD. They underwent HD with a cuprophane membrane and acetate-containing dialysate. Ventilation was measured continuously using respiratory inductance plethysmography. Oxygen was administered for 30 min, using nasal cannulae, at a rate of 6 l.min-1, starting 130 min after the onset of the HD. Blood gases were taken from the arterial line. During the initial air breathing, arterial oxygen tension (PaO2) decreased from 12.3 +/- 1.2 kPa (92.8 +/- 8.9 mmHg) at 0 min to 10.5 +/- 1.8 kPa (79.0 +/- 13.3 mmHg) at 2 h (p less than 0.01) (mean +/- SD). All patients showed irregular breathing with 1.4 +/- 0.6 apnoeas exceeding 10 s per 10 min after 2 h. Minute ventilation decreased from 6.8 +/- 1.9 l.min-1 at 0 min to 5.4 +/- 1.3 l.min-1 at 2 h (p less than 0.05). During the O2 breathing, PaO2 increased to 26.3 +/- 4.0 kPa (197.8 +/- 30.3 mmHg) (p less than 0.001), while arterial carbon dioxide tension (PaCO2) remained unchanged. The irregular BP previously observed vanished completely. The mean number of apnoeas exceeding 10 s per 10 min decreased to 0.08 +/- 0.12 during O2 (p less than 0.002).(ABSTRACT TRUNCATED AT 250 WORDS)
Recent advances in the pathogenesis and clinical assessment of mineral dust pneumoconioses: asbestosis, silicosis and coal pneumoconiosis
Authors: Begin R , Cantin A , Masse S
Published: January 2023

Recent investigations of the fundamental mechanisms of the mineral dust diseases have substantially increased our understanding of the pathogenesis of the pneumoconioses. In all the mineral dust pneumoconioses, the initial early lung lesion is a fibrosing macrophagic alveolitis. The additional contribution of other lung cell populations is currently under investigation and may identify specific processes for each of the pneumoconioses. Clinical investigations have also progressed with new tools such as Gallium-67 lung scanning, bronchoalveolar lavage analyses, and CT scanning of the thorax; their established values are reviewed in this paper, and areas where progress is needed are considered. The clinical progress in the mineral dust diseases is clearly linked to the basic understanding of the mechanisms of these diseases.
Catamenial pleural pain
Authors: Horsfield K
Published: January 2023

A case of recurrent pleural pain without pneumothorax, thought to be due to pulmonary endometriosis, is presented. The pain was associated with the menstrual periods, remitted when the patient was sterilised, recurred when she was given oestrogens, and finally disappeared when the oestrogen was stopped. The presentation of pulmonary endometriosis, with pleural pain but no pneumothorax, should be added to those previously described in the literature.
A Zur-mediated transcriptional regulation of the zinc export system in Pseudomonas aeruginosa
Authors: Ducret Verena , Gonzalez Diego , Leoni Sara , Valentini Martina , Perron Karl
Published: January 2023

The control of cellular zinc (Zn) concentrations by dedicated import and export systems is essential for the survival and virulence of Pseudomonas aeruginosa. The transcription of its many Zn transporters is therefore tightly regulated by a known set of transcription factors involved in either the import or the export of Zn. In this work, we show that the Zur protein, a well-known repressor of Zn import, plays a dual role and functions in both import and export processes. In a situation of Zn excess, Zur represses Zn entry, but also activates the transcription of czcR, a positive regulator of the Zn export system. To achieve this, Zur binds at two sites, located by DNA footprinting in the region downstream the czcR transcription start site. In agreement with this regulation, a delay in induction of the efflux system is observed in the absence of Zur and Zn resistance is reduced. The discovery of this regulation highlights a new role of Zur as global regulator of Zn homeostasis in P. aeruginosa disclosing an important link between Zur and zinc export.
Studies with statistically significant effect estimates are more frequently published compared to non-significant estimates in oral health journals
Authors: Seehra Jadbinder , Khraishi Hadil , Pandis Nikolaos
Published: January 2023

Background

Studies reporting statistically significant effect estimates tend to be more frequently published compared to studies reporting non-significant or equivalent estimates. Consequently, this may lead to distortion of the literature. The aim of this study is to assess the prevalence of reporting statistically significant effect estimates in leading oral health journals and to explore associations between the effect estimates and record characteristics.

Methods

An electronic database search was undertaken of a selection of leading oral health journals including general oral health journals to identify primary oral health records published in 2019. Descriptive statistics and population average GEE logistic regression model was used to assess associations between articles reporting a statistically significant effect estimate and the record characteristics.

Results

In 1335 records, 82.4% records reported a statistically significant effect estimate. All speciality journals compared to general oral health journals were less likely to publish a record with significant effect estimates. Authors based in Asia or other (OR 1.49; 95% CI :1.02,2.19; p = 0.037) were more likely to report significant effect estimates compared to those based in Europe. Interventional (OR 0.35; 0.22,0.58; p < 0.001) and observational (OR 0.56; 0.36, 0.89; p = 0.013) records were less likely to report significant effect estimates compared to in-vitro studies. Registered records were less likely to report significant effect estimates when compared to non-registered studies (OR 0.22; 95% CI :0.14,0.32; p < 0.001).

Conclusion

The publishing of records with significant effect estimates is prevalent within the oral health literature. To reduce dissemination bias and overestimation of effect sizes in systematic reviews, the publishing of studies with non-significant or equivalent effect estimates should be encouraged.
The effects of the coronavirus disease pandemic on intravenous thrombolytic therapy among patients with acute ischemic stroke in Dalian, China
Authors: Pan Xin , Ma Shubei , Sui Xiaowen , Xie Lili , Li Furong , Cheng Zhengping , Cui Li , Zhao Hongling
Published: January 2023

Background

We investigated the influence of the coronavirus disease 2019 (COVID-19) pandemic on the number of patients with acute ischemic stroke who received intravenous thrombolytic therapy (ITT) in Dalian, China, in 2020.

Methods

This retrospective descriptive study, conducted from February 1, 2020, to August 31, 2020, examined 13 hospitals in Dalian that participated in the “stroke emergency map”. To use this “stroke emergency map” of China, patients followed the official “Stroke Map” WeChat account and dialed 120 for emergency medical services. We analyzed the number of patients with acute ischemic stroke who underwent ITT. In particular, we examined the onset-to-door time (ODT), door-to-needle time (DNT), onset-to-needle time (ONT), mode of transportation to the hospital, and National Institutes of Health Stroke Scale (NIHSS) scores before and after ITT. Data were collected for the aforementioned period and compared with the 2021 baseline data from the same time of year. The Mann‒Whitney U test was performed for data analysis.

Results

Compared with the data from 2020, the number of patients with acute ischemic stroke who underwent ITT increased (from 735 to 1719 cases) in 2021, but the DNT decreased (from 59 to 45 min; P = 0.002). Moreover, 83.9% of patients in 2020 presented to the hospital without ambulance transport, compared to 81.1% of patients in the 2021 non-COVID-19 pandemic period. Patients with NIHSS scores of 6–14 were more likely to call an ambulance for transport to the hospital than to transport themselves to the emergency department.

Conclusions

During the 2020 COVID-19 pandemic, the DNT was prolonged as a result of strengthened fever surveillance. In 2021, the number of patients with acute ischemic stroke who underwent ITT increased compared to the previous year. Notably, the growth in the number of patients with acute ischemic stroke who underwent ITT benefited from both the “stroke emergency map” of China and the “green channel,” a novel treatment approach that focuses on the rational design of the rescue process.

Trial registration.

Our study was a retrospective descriptive study, not a clinical trial, thus we did not have to register for clinical trials.
Cancer incidence in immunocompromised patients: a single-center cohort study
Authors: Ilham Sabrina , Willis Connor , Kim Kibum , Chung Karen C. , Wood Brenda M. , Tan Malinda S. , Tan Chia Jie , Nguyen Danielle T. , Brixner Diana I. , Stenehjem David D.
Published: January 2023

Background

Diminished immune defense plays an important role in cancer development. Cancer risk in immunocompromised patients may differ. Identifying individuals with elevated cancer risk can inform strategies for routine cancer screening. This study aimed to understand and compare cancer incidence and risk in three patient groups: recipients of solid organ transplant (SOT) or hematopoietic stem cell transplant (HSCT); diagnosis of primary or secondary immunodeficiency disorder (PID/SID); and recipients of tumor necrosis factor inhibitor (TNF-i) therapy.

Methods

This retrospective cohort study used the University of Utah Health System database and Huntsman Cancer Institute tumor registry. Patients aged ≥18 years with SOT/HSCT, PID/SID or ≥ 3 months of TNF-i therapy were included. The date of transplant, diagnosis of PID/SID, or 1st TNF-i medication order date was defined as the index date. We calculated cumulative cancer incidence by Kaplan-Meier method. A Cox-proportional hazard regression model with a stepwise variable selection process was used to identify independent risk factors associated with the time to onset of a new primary cancer.

Results

In total, 13,887 patients were included which comprised of 2982 (21%) SOT/HSCT, 7542 (54%) PID/SID and 3363 (24%) patients receiving TNF-i. The mean (SD) age ranged from 46.8 (15) years - 50.4 (18.2) years. The proportion of white patients ranged from 72.3–84.8%. The estimated cumulative cancer incidence was 11.5% in the SOT/HSCT cohort, 14.3% in the PID/SID cohort, and 8.8% in the TNF-i cohort. The multivariable model adjusted for age, benign in-situ disease, Charlson Comorbidity Index, hypertension/cardiovascular disease/end stage renal disease, gender, race/ethnicity, and renal cyst as significant risk factors. The adjusted hazard ratios for cancer development in SOT/HSCT and PID/SID cohorts compared to the TNF-i cohort over the full follow-up period were 1.57 (95% CI: 1.16–2.13) and 2.14 (95% CI: 1.65–2.77), respectively.

Conclusion

A significantly increased risk of cancer was observed in PID/SID patients and SOT/HSCT patients compared to TNF-i patients. Age ≥ 50 years, male gender, and clinical comorbidities were additional factors impacting cancer risk. PID/SID and SOT/HSCT patients may benefit from more intensive cancer screening.
Clinical features and lipid metabolism genes as potential biomarkers in advanced lung cancer
Authors: Merino Salvador María , Fernández Lara Paula , Moreno-Rubio Juan , Colmenarejo Gonzalo , Casado Enrique , Ramírez de Molina Ana , Sereno María
Published: January 2023

Background

Lung cancer is one of the most lethal tumors with a poor survival rate even in those patients receiving new therapies. Metabolism is considered one of the hallmarks in carcinogenesis and lipid metabolism is emerging as a significant contributor to tumor metabolic reprogramming. We previously described a profile of some lipid metabolism related genes with potential prognostic value in advanced lung cancer.

Aim

To analyze clinical and pathological characteristics related to a specific metabolic lipid genomic signature from patients with advanced lung cancer and to define differential outcome.

Methods

Ninety samples from NSCLC (non-small cell lung cancer) and 61 from SCLC (small cell lung cancer) patients were obtained. We performed a survival analysis based on lipid metabolic genes expression and clinical characteristics. The primary end point of the study was the correlation between gene expression, clinical characteristics and survival.

Results

Clinical variables associated with overall survival (OS) in NSCLC patients were clinical stage, adenocarcinoma histology, Eastern Cooperative Oncology Group (ECOG), number and site of metastasis, plasma albumin levels and first-line treatment with platinum. As for SCLC patients, clinical variables that impacted OS were ECOG, number of metastasis locations, second-line treatment administration and Diabetes Mellitus (DM). None of them was associated with gene expression, indicating that alterations in lipid metabolism are independent molecular variables providing complementary information of lung cancer patient outcome.

Conclusions

Specific clinical features as well as the expression of lipid metabolism-related genes might be potential biomarkers with differential outcomes.
Psychometric properties of the post-traumatic stress disorder checklist for DSM-5 (PCL-5) in Chinese stroke patients
Authors: Jiang Che , Xue Gaici , Yao Shujing , Zhang Xiwu , Chen Wei , Cheng Kuihong , Zhang Yibo , Li Zhensheng , Zhao Gang , Zheng Xifu , Bai Hongmin
Published: January 2023

Background

Stroke is a devastating disease and can be sufficiently traumatic to induce post-traumatic stress disorder (PTSD). Post-stroke PTSD is attracting increasing attention, but there was no study assessing the psychometric properties of the PCL-5 in stroke populations. Our study was conducted to examine the psychometric properties of the PTSD Checklist for DSM-5 (PCL-5) in Chinese stroke patients.

Methods

This was a cross-sectional observational study conducted at our hospital. Three hundred and forty-eight Chinese stroke patients came to our hospital for outpatient service were recruited. They were instructed to complete the PCL-5 scales and were interviewed for PTSD diagnosis with the Clinician Administered PTSD Scale for DSM-5 (CAPS-5). The cutoff scores, reliability and validity of the PCL-5 were analyzed.

Results

PCL-5 scores in our sample were positively skewed, suggesting low levels of PTSD symptoms. The reliability of PCL-5 was good. Exploratory and confirmatory factor analyses indicated acceptable construct validity, and confirmed the multi-dimensionality of the PCL-5. By CFA analysis, the seven-factor hybrid model demonstrated the best model fit. The PCL-5 also showed good convergent validity and discriminant validity. Receiver operating characteristic (ROC) analyses revealed a PCL-5 score of 37 achieved optimal sensitivity and specificity for detecting PTSD.

Conclusions

Our findings supported the use of PCL-5 as a psychometrically adequate measure of post-stroke PTSD in the Chinese patients.
Neurological soft signs and structural network changes: a longitudinal analysis in first-episode schizophrenia
Authors: Kong Li , Herold Christina J. , Bachmann Silke , Schroeder Johannes
Published: January 2023

Background

Neurological soft signs (NSS) are often reported in patients with schizophrenia and may vary with psychopathological symptoms during the course of disease. Many cross-sectional neuroimaging studies have shown that NSS are associated with disturbed network connectivity in schizophrenia. However, it remains unclear how these associations change over time during the course of disorder.

Methods

In present study, 20 patients with first-episode schizophrenia and 20 controls underwent baseline structural magnetic resonance imaging (MRI) scan and at one-year follow-up. Structural network characteristics of patients and controls were analyzed using graph theoretical approach based on MRI data. NSS were assessed using the Heidelberg scale.

Results

At baseline, patients demonstrated significant changes of the local network properties mainly involving regions of the cortical-subcortical-cerebellar circuits compared to healthy controls. For further analysis, the whole patient group was dichotomized into a NSS-persisting and NSS-decreasing subgroup. After one-year follow-up, the NSS-persisting subgroup showed decreased betweenness in right inferior opercular frontal cortex, left superior medial frontal cortex, left superior temporal cortex, right putamen and cerebellum vermis and increased betweenness in right lingual cortex. However, the NSS-decreasing subgroup exhibited only localized changes in right middle temporal cortex, right insula and right fusiform with decreased betweenness, and in left lingual cortex with increased betweenness.

Conclusions

These findings provide evidence for brain network reorganization subsequent to clinical disease manifestation in patients with first-episode schizophrenia, and support the hypothesis that persisting NSS refer to progressive brain network abnormalities in patients with schizophrenia. Therefore, NSS could help to establish a better prognosis in first-episode schizophrenia patients.
Can pre-operative intraarticular injection predict pain relief after total hip arthroplasty?
Authors: Jentzsch Thorsten , Meyer Yann K. , Unterfrauner Ines , Rosskopf Andrea B. , Pfirrmann Christian W. , Zingg Patrick O.
Published: January 2023

Background

To study if pain relief after injection and arthroplasty correlate.

Methods

A retrospective cohort study included consecutive patients (n = 88; median age 64 (interquartile range (IQR) 22) years, 49 (56%) females) that received fluoroscopic-guided intra-articular hip injection with contrast agent, anaesthetic (diagnostic), and corticosteroid (therapeutic) before implantation of primary total hip arthroplasty. Pain scores were assessed pre-injection, post-injection after 15 min (diagnostic phase) at first clinical follow up (therapeutic phase; median 2 (IQR 2) months), and postoperatively (last follow up (median 15 (IQR 5) months)). Responders had reduction in pain score ≥ 20 (numeric rating scale 0–100) points. The primary outcome was the same (or inverse) response to injection and arthroplasty.

Results

The median pain scores were higher pre-injection (68 (IQR 30) points) compared to the diagnostic phase (18 (IQR 40) points; p < 0.001), therapeutic phase (50 (IQR 40) points; p < 0.001), and post-operatively (2 (IQR 15) points; p < 0.001). On the one hand, 69 (78%) cases had the same response in the diagnostic phase and post-operatively (rho = 0.58; p < 0.001; sensitivity 83%); on the other hand 32 (36%) cases had the same response in the therapeutic phase and post-operatively (rho = 0.25; p < 0.001; sensitivity 33%). Furthermore, 57% and 91% of patients had an even better response post-operatively than in the diagnostic and therapeutic phases.

Conclusions

Pre-operative intraarticular injection can predict pain relief after primary total hip arthroplasty. A positive response to hip arthroplasty may be better predicted by the response to local anaesthetic (diagnostic phase) than corticosteroids. Most patients (91%) with osteoarthritis may expect better pain relief after arthroplasty compared to the therapeutic phase after injection.
Anti-colorectal cancer of Ardisia gigantifolia Stapf. and targets prediction via network pharmacology and molecular docking study
Authors: Dai Weibo , Yang Jing , Liu Xin , Mei Quanxi , Peng Weijie , Hu Xianjing
Published: January 2023

Background

Ardisia gigantifolia Stapf. (AGS), a Chinese folk medicine widely grows in the south of China and several studies reported that AGS could inhibit the proliferation of breast cancer, liver cancer, and bladder cancer cell lines. However, little is known about its anti-colorectal cancer (CRC) efficiency.

Methods

In the present study, a combination of MTT assay, network pharmacological analysis, bioinformatics, molecular docking, and molecular dynamics simulation study was used to investigate the active ingredients, and targets of AGS against CRC, as well as the potential mechanism.

Results

MTT assay showed that three kinds of fractions from AGS, including the n-butanol extract (NBAGS), ethyl acetate fraction (EAAGS), and petroleum ether fraction (PEAGS) significantly inhibited the proliferation of CRC cells, with the IC50 values of 197.24, 264.85, 15.45 µg/mL on HCT116 cells, and 523.6, 323.59, 150.31 µg/mL on SW620 cells, respectively. Eleven active ingredients, including, 11-O-galloylbergenin, 11-O-protocatechuoylbergenin, 11-O-syringylbergenin, ardisiacrispin B, bergenin, epicatechin-3-gallate, gallic acid, quercetin, stigmasterol, stigmasterol-3-o-β-D-glucopyranoside were identified. A total of 173 targets related to the bioactive components and 21,572 targets related to CRC were picked out through database searching. Based on the crossover targets of AGS and CRC, a protein-protein interaction network was built up by the String database, from which it was concluded that the core targets would be SRC, MAPK1, ESR1, HSP90AA1, MAPK8. Besides, GO analysis showed that the numbers of biological process, cellular component, and molecular function of AGS against CRC were 1079, 44, and 132, respectively, and KEGG pathway enrichment indicated that 96 signaling pathways in all would probably be involved in AGS against CRC, among which MAPK signaling pathway, lipid, and atherosclerosis, proteoglycans in cancer, prostate cancer, adherens junction would probably be the major pathways. The docking study verified that AGS had multiple ingredients and multiple targets against CRC. Molecular dynamics (MD) simulation analysis showed that the binding would be stable via forming hydrogen bonds.

Conclusion

Our study showed that AGS had good anti-CRC potency with the characteristics of multi-ingredients, -targets, and -signaling pathways.
Exploration of the mechanism by which Huangqi Guizhi Wuwu decoction inhibits Lps-induced inflammation by regulating macrophage polarization based on network pharmacology
Authors: Wang Sutong , Ji Tianshu , Wang Lin , Qu Yiwei , Wang Xinhui , Wang Wenting , Lv Mujie , Wang Yongcheng , Li Xiao , Jiang Ping
Published: January 2023

Background

Huangqi Guizhi Wuwu decoction (HQGZWWD) is a traditional Chinese herbal medicine formulation with significant anti-inflammatory activity. However, its underlying mechanism remains unknown. Through network pharmacology and experimental validation, this study aimed to examine the potential mechanism of HQGZWWD in regulating macrophage polarization and inflammation.

Methods

The active components were obtained from the Traditional Chinese Medicine Systems Pharmacology database and Analysis Platform (TCMSP), whereas the corresponding targets were obtained from the TCMSP and Swiss Target Prediction database. The GeneCards database identified targets associated with macrophage polarization and inflammation. Multiple networks were developed to identify the key compounds, principal biological processes, and pathways of HQGZWWD that regulate macrophage polarization and inflammation. Autodock Vina is utilized to assess the binding ability between targets and active compounds. Finally, confirm the experiment’s central hypothesis. Human histiocytic lymphoma (U-937) cells were transformed into M1 macrophages following stimulation with Lipopolysaccharide (LPS) to evaluate the effect of HQGZWWD drug-containing mouse serum (HQGZWWD serum) on regulating macrophage polarization and inflammation.

Results

A total of 54 active components and 859 HQGZWWD targets were obtained. There were 9972 targets associated with macrophage polarization and 11,109 targets associated with inflammation. After screening, 34 overlapping targets were identified, of which 5 were identified as central targets confirmed by experiments, including the α7 nicotinic acetylcholine receptor (α7 nAchR), interleukin 6 (IL-6), Interleukin-1 beta (IL-1β), interleukin 10 (IL-10) and growth factor beta (TGF-β1). Pathway enrichment analysis revealed that 34 overlapping targets were enriched in multiple pathways associated with macrophage polarization and inflammation, including the TGF beta signaling pathway, NF-kappa B signaling pathway, JAK-STAT signaling pathway, and TNF signaling pathway. Molecular docking confirmed that the majority of HQGZWWD’s compounds can bind to the target. In vitro experiments, HQGZWWD serum was shown to up-regulate the expression of α7 nAchR, reduce the number of M1 macrophages, stimulate the production of M2 macrophages, inhibit the expression of pro-inflammatory cytokines IL-6 and IL1-β, and increase the expression of anti-inflammatory cytokines IL-10 and TGF-β1.

Conclusion

HQGZWWD can regulate the number of M1/M2 macrophages and the level of inflammatory cytokines, and the underlying mechanism may be related to the up-regulation of α7 nAchR expression.
Anxiolytic-like effect of Suanzaoren–Wuweizi herb-pair and evidence for the involvement of the monoaminergic system in mice based on network pharmacology
Authors: Liu Jie , Shi Jin-Li , Guo Jian-You , Chen Yi , Ma Xiao-Jie , Wang Sheng-Nan , Zheng Zhi-Quan , Lin Ming-Xuan , He Shuai
Published: January 2023

Background

Suanzaoren-Wuweizi herb-pair (SWHP), composed of Zizyphi Spinosi Semen (Suanzaoren in Chinese) and Schisandrae Chinensis Fructus (Wuweizi in Chinese), is a traditional herbal formula that has been extensively used for the treatment of insomnia. The study aimed to explore the targets and signal pathways of Suanzaoren-Wuweizi (S-W) in the treatment of anxiety by network pharmacology, and to verify the pharmacodynamics and key targets of SWHP in mice.

Methods

The Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) as well as literature mining were used to obtain the main chemical ingredients of Suanzaoren and Wuweizi. The SwissTargetPrediction platform was used to predict drug-related targets. The GeneCards, TTD, DisGeNET and OMIM databases were used to obtain potential targets for the treatment of anxiety with the chemical components of S-W. Drug-disease intersection genes were selected, and a protein-protein interaction (PPI) network was constructed using STRING. The core targets of S-W in the treatment of anxiety were selected according to the topological parameters, and GO functional enrichment as well as KEGG pathways enrichment analyses were performed for potential targets. The relationship network of the “drug-active ingredient-disease-target-pathway” was constructed through Cytoscape 3.8.0. The pharmacodynamics of SWHP in the treatment of anxiety was evaluated by the elevated plus maze (EPM), the light/dark box test (LDB) and the open field test (OFT). The mechanisms were examined by measuring monoamine neurotransmitters in brain of mice.

Results

The results showed that there were 13 active ingredients for the treatment of anxiety in the network. This includes sanjoinenine, swertisin, daucosterol, schizandrer B, wuweizisu C and gomisin-A. Additionally, there were 148 targets, such as AKT1, TNF, SLC6A4, SLC6A3, EGFR, ESR1, HSP90AA1, CCND1, and DRD2, mainly involved in neuroactive ligand-receptor interactions, the Serotonergic synapse pathway and the cAMP signaling pathway. After 1 week of treatment, SWHP (2 and 3 g/kg) induced a significant increase on the percentage of entries into and time spent on the open arms of the EPM. In the LDB test, SWHP exerted anxiolytic-like effect at 2 g/kg. In the open-field test, SWHP (2 g/kg) increased the number of central entries and time spent in central areas. The levels of brain monoamines (5-HT and DA) and their metabolites (5-HIAA, DOPAC) were decreased after SWHP treatment.

Conclusions

The anti-anxiety effect of SWHP may be mediated by regulating 5-HT, DA and other signaling pathways. These findings demonstrated that SWHP produced an anxiolytic-like effect and the mechanism of action involves the serotonergic and dopaminergic systems, although underlying mechanism remains to be further elucidated.
A systematic scoping review of reflective writing in medical education
Authors: Lim Jia Yin , Ong Simon Yew Kuang , Ng Chester Yan Hao , Chan Karis Li En , Wu Song Yi Elizabeth Anne , So Wei Zheng , Tey Glenn Jin Chong , Lam Yun Xiu , Gao Nicholas Lu Xin , Lim Yun Xue , Tay Ryan Yong Kiat , Leong Ian Tze Yong , Rahman Nur Diana Abdul , Chiam Min , Lim Crystal , Phua Gillian Li Gek , Murugam Vengadasalam , Ong Eng Koon , Krishna Lalit Kumar Radha
Published: January 2023

Background

Reflective writing (RW) allows physicians to step back, review their thoughts, goals and actions and recognise how their perspectives, motives and emotions impact their conduct. RW also helps physicians consolidate their learning and boosts their professional and personal development. In the absence of a consistent approach and amidst growing threats to RW’s place in medical training, a review of theories of RW in medical education and a review to map regnant practices, programs and assessment methods are proposed.

Methods

A Systematic Evidence-Based Approach guided Systematic Scoping Review (SSR in SEBA) was adopted to guide and structure the two concurrent reviews. Independent searches were carried out on publications featured between 1st January 2000 and 30th June 2022 in PubMed, Embase, PsychINFO, CINAHL, ERIC, ASSIA, Scopus, Google Scholar, OpenGrey, GreyLit and ProQuest. The Split Approach saw the included articles analysed separately using thematic and content analysis. Like pieces of a jigsaw puzzle, the Jigsaw Perspective combined the themes and categories identified from both reviews. The Funnelling Process saw the themes/categories created compared with the tabulated summaries. The final domains which emerged structured the discussion that followed.

Results

A total of 33,076 abstracts were reviewed, 1826 full-text articles were appraised and 199 articles were included and analysed. The domains identified were theories and models, current methods, benefits and shortcomings, and recommendations.

Conclusions

This SSR in SEBA suggests that a structured approach to RW shapes the physician’s belief system, guides their practice and nurtures their professional identity formation. In advancing a theoretical concept of RW, this SSR in SEBA proffers new insight into the process of RW, and the need for longitudinal, personalised feedback and support.
Exploring what is reasonable: uncovering moral reasoning of vascular surgeons in daily practice
Authors: Heidenreich Kaja , Svantesson Mia , Karlsson Marit , Bremer Anders
Published: January 2023

Background

Vascular surgery offers a range of treatments to relieve pain and ulcerations, and to prevent sudden death by rupture of blood vessels. The surgical procedures involve risk of injury and harm, which increases with age and frailty leading to complex decision-making processes that raise ethical questions. However, how vascular surgeons negotiate these questions is scarcely studied. The aim was therefore to explore vascular surgeons’ moral reasoning of what ought to be done for the patient.

Methods

Qualitative, semi-structured interviews were conducted with 19 vascular surgeons working at three Swedish university hospitals. Data were analysed according to systematic text condensation.

Results

The surgeons’ moral reasoning about what ought to be done comprised a quest to relieve suffering and avoid harm by exploring what is reasonable to do for the patient. Exploring reasonableness included to shift one´s perspective from the vessels to the whole person, to balance patient’s conflicting needs and to place responsibility for right decision on one´s shoulders. The shift from blood vessels to the whole person implied gaining holistic knowledge in pondering of what is best, struggling with one´s authority for surgery through dialogue, and building relationship for mutual security. To balance patient’s conflicting needs implied weighing the patient’s independence and a sense of being whole against ease of suffering, respecting the patient’s will against protecting life and well-being, and weighing longer life against protecting the present well-being. Finally, to place responsibility on one´s shoulders was conveyed as an urge to remind oneself of the risk of complications, withholding one’s power of proficiency, and managing time during the illness course.

Conclusions

This study contributes to uncovering how moral reasoning is embodied in the vascular surgeons’ everyday clinical discourse as a tangible part of their patient care. The results underpin the significance of moral considerations in the assemblage of medical knowledge and technical skills to further understand vascular surgeons’ clinical practice. The clinical application of these results is the need of forums with sufficient possibilities for articulating these important moral considerations in everyday care.
Expert consensus on the management of systemic sclerosis-associated interstitial lung disease
Authors: Rahaghi Franck F. , Hsu Vivien M. , Kaner Robert J. , Mayes Maureen D. , Rosas Ivan O. , Saggar Rajan , Steen Virginia D. , Strek Mary E. , Bernstein Elana J. , Bhatt Nitin , Castelino Flavia V. , Chung Lorinda , Domsic Robyn T. , Flaherty Kevin R. , Gupta Nishant , Kahaleh Bashar , Martinez Fernando J. , Morrow Lee E. , Moua Teng , Patel Nina , Shlobin Oksana A. , Southern Brian D. , Volkmann Elizabeth R. , Khanna Dinesh
Published: January 2023

Background

Systemic sclerosis (SSc) is a rare, complex, connective tissue disorder. Interstitial lung disease (ILD) is common in SSc, occurring in 35–52% of patients and accounting for 20–40% of mortality. Evolution of therapeutic options has resulted in a lack of consensus on how to manage this condition. This Delphi study was initiated to develop consensus recommendations based on expert physician insights regarding screening, progression, treatment criteria, monitoring of response, and the role of recent therapeutic advances with antifibrotics and immunosuppressants in patients with SSc-ILD.

Methods

A modified Delphi process was completed by pulmonologists (n = 13) and rheumatologists (n = 12) with expertise in the management of patients with SSc-ILD. Panelists rated their agreement with each statement on a Likert scale from − 5 (complete disagreement) to + 5 (complete agreement). Consensus was predefined as a mean Likert scale score of ≤  − 2.5 or ≥  + 2.5 with a standard deviation not crossing zero.

Results

Panelists recommended that all patients with SSc be screened for ILD by chest auscultation, spirometry with diffusing capacity of the lungs for carbon monoxide, high-resolution computed tomography (HRCT), and/or autoantibody testing. Treatment decisions were influenced by baseline and changes in pulmonary function tests, extent of ILD on HRCT, duration and degree of dyspnea, presence of pulmonary hypertension, and potential contribution of reflux. Treatment success was defined as stabilization or improvement of signs or symptoms of ILD and functional status. Mycophenolate mofetil was identified as the initial treatment of choice. Experts considered nintedanib a therapeutic option in patients with progressive fibrotic ILD despite immunosuppressive therapy or patients contraindicated/unable to tolerate immunotherapy. Concomitant use of nintedanib with MMF/cyclophosphamide can be considered in patients with advanced disease at initial presentation, aggressive ILD, or significant disease progression. Although limited consensus was achieved on the use of tocilizumab, the experts considered it a therapeutic option for patients with early SSc and ILD with elevated acute-phase reactants.

Conclusions

This modified Delphi study generated consensus recommendations for management of patients with SSc-ILD in a real-world setting. Findings from this study provide a management algorithm that will be helpful for treating patients with SSc-ILD and addresses a significant unmet need.
Ghost messages: cell death signals spread
Authors: Zhang Mingming , Lin Yuan , Chen Ruijing , Yu Haikuan , Li Yi , Chen Ming , Dou Ce , Yin Pengbin , Zhang Licheng , Tang Peifu
Published: January 2023

Cell death is a mystery in various forms. Whichever type of cell death, this is always accompanied by active or passive molecules release. The recent years marked the renaissance of the study of these molecules showing they can signal to and communicate with recipient cells and regulate physio- or pathological events. This review summarizes the defined forms of messages cells could spread while dying, the effects of these signals on the target tissue/cells, and how these types of communications regulate physio- or pathological processes. By doing so, this review hopes to identify major unresolved questions in the field, formulate new hypothesis worthy of further investigation, and when possible, provide references for the search of novel diagnostic/therapeutics agents.