bluuebunny/crossref_metadata_2025 huggingface dataset:
Self-sacrificial leadership, thriving at work, workplace well-being, and work–family conflict during the COVID-19 crisis: The moderating role of self-leadership
Authors: Huang Danyu , Zhou Hao
Published: October 2023

The COVID-19 crisis has created instability in nurses’ workplace well-being (WWB) and work–family relationships. Exploring effective leadership tailored to the needs in a special context is significant to address these issues. Therefore, we examined how the interaction of self-sacrificial leadership (SSL) and self-leadership (SL)—explaining in the integration of conservation of resources and self-determination theories—related to thriving at work (TAW), WWB, and work–family conflict (WFC). A multi-wave questionnaire was distributed to 405 nurses working at a large hospital in China. The results indicate that (1) SSL brought more WWB and less WFC, (2) TAW mediated the correlations between them, and (3) SL stimulated more TAW than did SSL and weakened the influence of SSL on TAW. Alongside improving the understanding of the role of SSL and SL during the COVID-19 pandemic, we facilitate management interventions to practitioners.

JEL CLASSIFICATION: L200
Intravenous thrombolysis with tenecteplase versus alteplase combined with endovascular treatment of anterior circulation tandem occlusions: A pooled analysis of ETIS and TETRIS
Authors: Marnat Gaultier , Lapergue Bertrand , Gory Benjamin , Kyheng Maeva , Labreuche Julien , Turc Guillaume , Olindo Stephanze , Sibon Igor , Caroff Jildaz , Smadja Didier , Chausson Nicolas , Clarençon Frederic , Seners Pierre , Bourcier Romain , Pop Raoul , Olivot Jean-Marc , Mazighi Mikael , Moulin Solène , Janot Kevin , Cognard Christophe , Alamowitch Sonia , Gerschenfeld Gaspard
Published: October 2023

Background:

Tandem occlusions are a singular large vessel occlusion entity involving specific endovascular and perioperative antithrombotic management. In this context, data on safety and efficacy of prior intravenous thrombolysis (IVT) with tenecteplase is scarce. We aimed to compare IVT with tenecteplase or alteplase in patients with acute tandem occlusions intended for endovascular treatment.

Patients and methods:

A retrospective pooled analysis of two large observational registries (ETIS (Endovascular Treatment of Ischemic Stroke) and TETRIS (Tenecteplase Treatment in Ischemic Stroke)) was performed on consecutive patients presenting with anterior circulation tandem occlusion treated with IVT using either alteplase (ETIS) or tenecteplase (TETRIS) followed by endovascular treatment between January 2015 and June 2022. Sensitivity analyses on atherosclerosis related tandem occlusions and on patient treated with emergent carotid stenting were conducted. Propensity score overlap weighting analyses were performed.

Results:

We analyzed 753 patients: 124 in the tenecteplase and 629 in the alteplase group. The overall odds of favorable outcome (3-month modified Rankin score 0–2) were comparable between both groups (49.4% vs 47.1%; OR = 1.10, 95%CI 0.85–1.41). Early recanalization, final successful recanalization and mortality favored the use of tenecteplase. The occurrence of any intracranial hemorrhage (ICH) was more frequent after tenecteplase use (OR = 2.24; 95%CI 1.75–2.86). However, risks of symptomatic ICH and parenchymal hematoma remained similar. In atherosclerotic tandems, favorable outcome, mortality, parenchymal hematoma, early recanalization, and final successful recanalization favored the tenecteplase group. In the carotid stenting subgroup, PH were less frequent in the tenecteplase group (OR = 0.18; 95%CI 0.05–0.69).

Conclusion:

In patients with tandem occlusions, IVT with tenecteplase seemed reasonably safe in particular with increased early recanalization rates. These findings remain preliminary and should be further confirmed in randomized trials.
Access and use of immunoglobulins in secondary supportive cancer care: A systematic literature review
Authors: Counihan Muireann , Cervenakova Larisa , Misztela Dominika , Van Baelen Maarten , Naughton Bernard D.
Published: October 2023

Background:

Immunoglobulin replacement therapy (IgRT) benefits patients with primary immuno deficiency (PID) originating from the innate or polygenic defects in the immune system. However, evidence supporting their therapeutic role is not as explicit in secondary immuno deficiency (SID) resulting from the treatment of haematological malignancies.

Objectives:

This study aimed to (1) create a dataset of relevant research papers, which explore the use of IgRT in SID for analysis, (2) assess the risk of bias within this dataset and (3) study the characteristics of these papers.

Design:

This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. In addition to the risk of bias, the study characteristics explored in this article included study design, study geographical location and year of publication.

Data Sources and Methods:

To identify studies relevant to the research question, EMBASE and PubMed databases were searched. The Population, Intervention, Comparison and Outcome (PICO) framework was used to assess study quality. Risk of bias and quality of studies were assessed in accordance with the study design. As one model was not appropriate to assess bias in all articles, several tools were used.

Results:

A total of 43 studies were identified from the literature search as relevant to the research objective. The most common study design was a retrospective case–control cohort study ( n = 16/43), and randomised trials were among the least commonly used approaches ( n = 1). Research in this area is occurring around the globe including the United States ( n = 7), Italy ( n = 7), China, India, Japan and throughout Europe. The annual number of papers in this area has varied from 2012 ( n = 1) to 2021 ( n = 7). The studies in this article demonstrated a varied risk of bias, with 9 of the 20 cohort studies scoring less than 5 out of 9 stars.

Conclusions:

Randomised controlled trials are less frequently used to assess access and use of immunoglobulins. More commonly, a retrospective case–control cohort study was used which correlates with the higher risk of bias seen in the studies in this article. Most of the research concerning immunoglobulin use and access occurs in higher-income countries.
Identification of SRS transcription factor family in Solanum lycopersicum, and functional characterization of their responses to hormones and abiotic stresses
Authors: Lu Wang , Wang Yan , Shi Yuan , Liang Qin , Lu Xiangyin , Su Deding , Xu Xin , Pirrello Julien , Gao Ying , Huang Baowen , Li Zhengguo
Published: October 2023

The SHI RELATED SEQUENCE (SRS) family plays a vital role in the development of multiple plant organs such as floral meristem determinacy, organ morphogenesis, and signal transduction. Nevertheless, there is little understanding of the biological significance of tomato SRS family at this point. Our research identified eight SlSRS family members and classified them into three subfamilies based on phylogenetics, conserved motifs, and characteristic domain analysis. The intraspecies and interspecies collinearity analysis revealed clues of SRS family evolution. Many cis-elements related to hormones, stresses, and plant development can be found in the promoter region of SlSRS genes. All of eight SlSRS proteins were located in the nucleus and possessed transcriptional activity, half of which were transcriptional activators, and the other half were transcriptional repressors. Except for SlSRS1, which showed high transcript accumulation in vegetative organs, most SlSRS genes expressed ubiquitously in all flower organs. In addition, all SlSRS genes could significantly respond to at least four different plant hormones. Further, expression of SlSRS genes were regulated by various abiotic stress conditions. In summary, we systematically analyzed and characterized the SlSRS family, reviewed the expression patterns and preliminarily investigated the protein function, and provided essential information for further functional research of the tomato SRS genes in the determination of reproductive floral organs and the development of plants, and possibly other plants.
Halotolerant endophytic bacteria alleviate salinity stress in rice (oryza sativa L.) by modulating ion content, endogenous hormones, the antioxidant system and gene expression
Authors: Asif Saleem , Jan Rahmatullah , Kim Nari , Asaf Sajjad , Lubna  , Khan Muhammad Aaqil , Kim Eun-Gyeong , Jang Yoon-Hee , Bhatta Dibya , Lee In-Jung , Kim Kyung-Min
Published: October 2023

Excessive salinity reduces crop production and negatively impacts agriculture worldwide. We previously isolated endophytic bacterial strains from two halophytic species: Artemisia princeps and Chenopodium ficifolium. We used three bacterial isolates: ART-1 (Lysinibacillus fusiformis), ART-10 (Lysinibacillus sphaericus), and CAL-8 (Brevibacterium pityocampae) to alleviate the impact of salinity stress on rice. The impact of 160 mM NaCl salinity on rice was significantly mitigated following inoculation with these bacterial strains, resulting in increased growth and chlorophyll content. Furthermore, OsNHX1, OsAPX1, OsPIN1 and OsCATA expression was increased, but OsSOS expression was decreased. Inductively coupled plasma mass spectrometry (ICP-MS) revealed reduced K+ and Na+ levels in shoots of bacteria-inoculated plants, whereas that of Mg2+ was increased. Bacterial inoculation reduced the content of total flavonoids in rice leaves. Salinized plants inoculated with bacteria showed reduced levels of endogenous salicylic acid (SA) and abscisic acid (ABA) but increased levels of jasmonic acid (JA). In conclusion, the bacterial isolates ART-1, ART-10, and CAL-8 alleviated the adverse effect of salinity on rice growth, which justifies their use as an eco-friendly agricultural practice.
Piloting an ICU follow-up clinic to improve health-related quality of life in ICU survivors after a prolonged intensive care stay (PINA): feasibility of a pragmatic randomised controlled trial
Authors: Drewitz Karl Philipp , Hasenpusch Claudia , Bernardi Christine , Brandstetter Susanne , Fisser Christoph , Pielmeier Katharina , Rohr Magdalena , Brunnthaler Vreni , Schmidt Konrad , Malfertheiner Maximilian V. , Apfelbacher Christian J.
Published: October 2023

Background

ICU survivors often suffer from prolonged physical and mental impairments resulting in the so called “Post-Intensive Care Syndrome” (PICS). The aftercare of former ICU patients affected by PICS in particular has not been addressed sufficiently in Germany so far. The aim of this study was to evaluate the feasibility of a pragmatic randomised trial (RCT) comparing an intensive care unit (ICU) follow-up clinic intervention to usual care.

Methods

This pilot study in a German university hospital evaluated the feasibility of a pragmatic RCT. Patients were assigned in a 1:1 ratio to an ICU follow-up clinic intervention or to usual care. The concept of this follow-up clinic was previously developed in a participatory process with patients, next of kin, health care professionals and researchers. We performed a process evaluation and determined acceptability, fidelity, completeness of measurement instruments and practicality as feasibility outcomes. The RCT’s primary outcome (health-related quality of life) was assessed six months after ICU discharge by means of the physical component scale of the Short-Form-12 self-report questionnaire.

Results

The pilot study was conducted from June 2020 to May 2021 with 21 and 20 participants in the intervention and control group. Principal findings related to feasibility were 85% consent rate (N = 48), 62% fidelity rate, 34% attrition rate (N = 41) and 77% completeness of outcome measurements. The primary effectiveness outcome (health-related quality of life) could be measured in 93% of participants who completed the study (N = 27). The majority of participants (85%) needed assistance with follow-up questionnaires (practicality). Median length of ICU stay was 13 days and 85% (N = 41) received mechanical ventilation, median Sequential Organ Failure Assessment Score was nine. Six-month follow-up assessment was planned for all study participants and performed for 66% (N = 41) of the participants after 197 days (median).

Conclusion

The participatory developed intervention of an ICU follow-up clinic and the pragmatic pilot RCT both seem to be feasible. We recommend to start a pragmatic RCT on the effectiveness of the ICU follow-up clinic.

Trial registration

ClinicalTrials.gov US NLM, NCT04186468, Submission: 02/12/2019, Registration: 04/12/2019, https://clinicaltrials.gov/ct2/show/NCT04186468
Effects of ultrasound-guided stellate ganglion block on postoperative sore throat and postoperative sleep disturbance after lumbar spine surgery: a randomized controlled trial
Authors: Luo Decai , Su Yanhong , Pang Yong
Published: October 2023

Background

Postoperative sore throat and sleep disturbance are prevalent among patients undergoing spinal surgery, and these conditions can substantially impact their postoperative satisfaction and quality of life. The present study aimed to examine the impact of ultrasound-guided stellate ganglion block (SGB) on the occurrence of postoperative sore throat (POST) and postoperative sleep disturbance (PSD) in patients who undergo lumbar spine surgery under general anesthesia.

Methods

Sixty patients were randomly assigned to either the experimental group (SGB group) or the control group (CG). Both groups received the same induction and maintenance drugs. However, the SGB group received a right SGB under ultrasound guidance 15 min before anesthesia induction, while the CG did not receive any block anesthesia intervention before anesthesia induction. We monitored the incidence and severity of POST at 1, 6, 24, and 48 h after surgery in both groups. Additionally, we evaluated the deep sleep quality score on the first, second, and fifth days after surgery in both groups.

Results

The incidence of POST at 1 h and 6 h after surgery was significantly lower in the SGB group (10.0% and 13.3%) than in the CG (43.3% and 36.7%) (P < 0.05). The postoperative sore throat scores of the SGB group (0.10 ± 0.31 and 0.17 ± 0.46) at 1 h and 6 h after surgery were lower than those of the CG (0.57 ± 0.73 and 0.50 ± 0.77) (P < 0.05). Moreover, the deep sleep quality score on the first, second, and fifth days after surgery were significantly higher in the CG (5.40 ± 3.37, 4.70 ± 3.19, 4.53 ± 3.44) than in the SGB group (3.87 ± 2.30, 3.13 ± 1.77, 3.03 ± 1.84) (P < 0.05).

Conclusion

Ultrasound-guided SGB can reduce the incidence and severity of POST and improve PSD in patients undergoing lumbar spine surgery.

Trial registration

This study was registered on Chinese Clinical Trial Registry, (ChiCTR2200065279) on 01/11/2022.
Birth preparedness and complications readiness among women in disadvantaged rural districts of Ghana
Authors: Oduro Abraham Rexford , Anyorikeya Maria , Ansah Patrick , Oladokun Samuel , Tei Ernest Maya , Oduro-Ayeh Randy , Welaga Paul , Deh Seli
Published: October 2023

Introduction

Essentially all women and babies irrespective of their economic and social status should reach their full potential for health and well-being. The study assessed the readiness of mothers and their preparedness for birth across three disadvantaged rural districts in Ghana.

Methods

A multi-centre quantitative survey from January to December 2018 using a multistage sampling approach was employed. Using a structured questionnaire data from mothers attending antenatal and postnatal clinics in three main ecological zones of Ghana were collected. Women who provided informed consent were consecutively recruited until the sample size was achieved. For categorical data, summary tables, proportions and percentage are presented. Multivariate logistic regression analysis determined the effect of selected characteristics on birth preparedness. Ethics approval was obtained from the Navrongo Health Research Centre.

Results

A total of 1058 mothers were enrolled: 33.6%, 33.4% and 33.0% respectively from the Ada west, Upper Denkyira west and Builsa south districts. About 94% of the women had prior knowledge of birth preparedness. Approximately 22.6% (95%CI 20.1, 25. 2) of the mothers were assessed to have poor birth preparedness: 8.0% in Builsa south, 27.8% in Ada west and 31.7% in Upper Denkyira west. Prenatal and postnatal data showed no statistically significant difference in poor preparedness (21.9% vs 23.3%; p-value > 0.05). Maternal age, employment status, religious affiliation and parity were not associated with birth preparedness (p-value > 0.05). Area of study (P < 0.001), educational level (P < 0.016), marital status (p < 0.001) and antenatal contacts (< 0.001) were significantly associated with birth preparedness.

Conclusions

As an important safe motherhood strategy woman should plan their pregnancy and birth well to reduce maternal and neonatal mortality. Policy initiatives should take into consideration area of residence, education, marital status and antenatal contacts of women.
Risk factors for poor engagement with a smart pillbox adherence intervention among persons on tuberculosis treatment in Ethiopia
Authors: Tadesse Amare Worku , Cusinato Martina , Weldemichael Gedion Teferra , Abdurhman Tofik , Assefa Demelash , Yazew Hiwot , Gadissa Demekech , Shiferaw Amanuel , Belachew Mahilet , Sahile Mamush , van Rest Job , Bedru Ahmed , Foster Nicola , Jerene Degu , Fielding Katherine Linda
Published: October 2023

Background

Non-adherence to tuberculosis treatment increases the risk of poor treatment outcomes. Digital adherence technologies (DATs), including the smart pillbox (EvriMED), aim to improve treatment adherence and are being widely evaluated. As part of the Adherence Support Coalition to End TB (ASCENT) project we analysed data from a cluster-randomised trial of DATs and differentiated care in Ethiopia to examine individual-factors for poor engagement with the smart pillbox.

Methods

Data were obtained from a cohort of trial participants with drug-sensitive tuberculosis (DS-TB) whose treatment started between 1 December 2020 and 1 May 2022, and who were using the smart pillbox. Poor engagement with the pillbox was defined as (i) > 20% days with no digital confirmation and (ii) the count of days with no digital confirmation, and calculated over a two evaluation periods (56-days and 168-days). Logistic random effects regression was used to model > 20% days with no digital confirmation and negative binomial random effects regression to model counts of days with no digital confirmation, both accounting for clustering of individuals at the facility-level.

Results

Among 1262 participants, 10.8% (133/1262) over 56-days and 15.8% (200/1262) over 168-days had > 20% days with no digital confirmation. The odds of poor engagement was less among participants in the higher stratum of socio-economic position (SEP) over 56-days. Overall, 4,689/67,315 expected doses over 56-days and 18,042/199,133 expected doses over 168-days were not digitally confirmed. Compared to participants in the poorest SEP stratum, participants in the wealthiest stratum had lower rates of days not digitally confirmed over 168-days (adjusted rate ratio [RRa]:0.79; 95% confidence interval [CI]: 0.65, 0.96). In both evaluation periods (56-days and 168-days), HIV-positive status (RRa:1.29; 95%CI: 1.02, 1.63 and RRa:1.28; 95%CI: 1.07, 1.53), single/living independent (RRa:1.31; 95%CI: 1.03, 1.67 and RRa:1.38; 95%CI: 1.16, 1.64) and separated/widowed (RRa:1.40; 95%CI: 1.04, 1.90 and RRa:1.26; 95%CI: 1.00, 1.58) had higher rates of counts of days with no digital confirmation.

Conclusion

Poorest SEP stratum, HIV-positive status, single/living independent and separated/ widowed were associated with poor engagement with smart pillbox among people with DS-TB in Ethiopia. Differentiated care for these sub-groups may reduce risk of non-adherence to TB treatment.
Effects of progressive intensity resistance training on the impact of fibromyalgia: protocol for a blinded randomized controlled trial
Authors: Pontes-Silva André , Dibai-Filho Almir Vieira , de Melo Thayná Soares , Santos Leticia Menegalli , de Souza Marcelo Cardoso , DeSantana Josimari Melo , Avila Mariana Arias
Published: October 2023

Background

Fibromyalgia guidelines indicate that exercise is critical in the management of fibromyalgia, and there is evidence that patients with fibromyalgia can perform resistance training at moderate and high intensities. However, despite the biological plausibility that progression of intensity provides greater benefit to individuals, no studies have compared different intensities (progressive versus constant intensities) of the same exercise in this population.

Objective

To compare the effect of 24 sessions of resistance training (progressive vs. constant intensity) on impact of fibromyalgia, sleep quality, anxiety, depression, pain, walking ability, and musculoskeletal capacity.

Methods

A protocol for a blinded randomized controlled trial. The sample will be randomized into three groups: group 1 (progressive intensity, experimental), group 2 (constant intensity, control A), and group 3 (walking, control B). Group 1 will perform resistance training at moderate intensity (50% of maximum dynamic strength), previously determined by the 1 repetition maximum (1-RM) test in the proposed exercises. The strength of each individual will be reassessed every 4 weeks (by 1-RM) and the intensity of each exercise will be positively adjusted by 20% of the value observed in kg (i.e., first month 50%; second month 70%; third month 90% of the maximum dynamic strength). Group 2 will perform the same procedure, but the intensity will be maintained at 50% of the maximum dynamic strength throughout the treatment (i.e., constant intensity from the first to the third month). Group 3 will perform a 40-minute treadmill walk at low intensity, defined by a walking speed corresponding to 60-70% of the maximum heart rate, which we will control with a heart rate monitor. All groups will receive a 45-minute pain education session prior to the exercise program, covering the pathophysiologic mechanisms of chronic pain, strategies for coping with pain, avoiding hypervigilance, and deconstructing beliefs and myths about chronic pain.

Discussion

The results of the present study may help health care professionals adjust the intensity of resistance training and thus plan the most effective intervention (progressive or constant intensity) to reduce the impact of fibromyalgia on patients’ lives.

Trial registration

Brazilian Registry of Clinical Trials (ReBEC) ID: RBR-9pbq9fg, date of registration: October 06, 2022.
Usefulness of serum sodium levels as a novel marker for predicting acute appendicitis severity: a retrospective cohort study
Authors: Messias Bruno , Cubas Isabella , Oliveira Caio , Hashimoto Flavia , Mocchetti Erica , Ichinose Tania , Waisberg Jaques , Ribeiro Junior Marcelo A. F.
Published: October 2023

Background

Early and accurate preoperative diagnosis of complicated appendicitis mandates the identification of new markers. The aim of this study is to determine whether preoperative serum sodium levels are useful for predicting the severity of acute appendicitis.

Methods

We retrospectively analyzed 475 patients who underwent emergency appendectomies between January 2018 and February 2023 in a general hospital in Brazil. The patients were divided into 2 groups: complicated (n = 254) and uncomplicated (n = 221). Hyponatremia was defined as serum sodium levels < 136 mEq/L. The primary outcome was to evaluate if hyponatremia is associated with complicated appendicitis.

Results

The patients had a median age of 22 years, and the median serum sodium level was 137 mEq/L in patients with complicated appendicitis and 139 mEq/L in uncomplicated appendicitis (P < 0.001). The analysis of the receiver operating characteristic curve used as the best cutoff value of serum sodium of 136 mEq/L with a sensitivity of 45.7%, specificity of 86.4%, positive predictive value of 79.5%, and negative predictive value of 58.1% for the diagnosis of complicated AA. Of the 254 patients with complicated appendicitis, 84 (33.1%) had serum sodium levels below 136 mEq/L, while only 12 (5.4%) patients with uncomplicated appendicitis had values ​​below this cutoff. Patients with hyponatremia were 5 times more likely to develop complicated appendicitis. (odds ratio: 5.35; 95% confidence interval: 3.39–8.45)

Conclusions

Preoperative serum sodium levels are a useful tool for predicting the severity of acute appendicitis. Due to its low cost and wide availability, it has become an extremely relevant marker.
One-year healthcare costs after robotic-assisted and laparoscopic partial and radical nephrectomy: a cohort study
Authors: Okhawere Kennedy E. , Milky Gediwon , Razdan Shirin , Shih I-Fan , Li Yanli , Zuluaga Laura , Badani Ketan K.
Published: October 2023

Objective

Despite the wide-spread adoption of robotic-assisted surgery (RAS), the cost–benefit implications for partial (PN) and radical nephrectomy (RN) versus laparoscopic surgery (Lap) is not well established. We sought to examine the trend of adoption and 1-year healthcare expenditure of PN and RN, and compare 1-year expenditures of RAS versus Lap for PN and RN.

Patients and methods

This cohort study used the MerativeTM MarketScan® Databases between 2013 and 2020. A total of 5,353 patients with kidney cancer undergoing PN (2,980, 55.7%) or RN (2,373, 44.3%). We compared open-conversion, length of stay (LOS), index expenditure, 1-year healthcare expenditure and utilization, and missed work-days between RAS and Lap for PN and RN.

Results

Adoption of PN increased overtime (47.0% to 55.8%), mainly driven by robotic PN increase. Among PN, RAS had lower open-conversion, shorter LOS and lower index expenditure than Lap. Among RN, RAS had shorter LOS, and similar open-conversion and index expenditures. During 1-year post-discharge, RAS had lower hospital outpatient visits (IRR = 0.92, 95% CI = 0.85, 0.99, p = 0.029) and office-based visits (IRR = 0.91, 95% CI = 0.86, 0.96, p = 0.002) for PN, translating to a 1-day less (95% CI = 0.25, 1.75, p = 0.008) missed from work for RAS. Following RN, RAS had lower 1-year readmission than Lap (O.R = 0.72, 95% CI = 0.55, 0.94, p = 0.018). RAS and Lap had comparable 1-year post-discharge expenditures for both PN (mean difference, MD = -$475, 95% CI = -$4362, $3412, p = 0.810) and RN (MD = -$4,204, 95% CI = -$13,837, $5430, p = 0.404).

Conclusion

At index surgery, RAS was associated with shorter LOS for both PN and RN, and lower open-conversion and expenditures for PN. RAS and Lap had comparable 1-year total expenditures, despite lower healthcare visits for RAS.
Evaluating potential of leaf reflectance spectra to monitor plant genetic variation
Authors: Li Cheng , Czyż Ewa A. , Halitschke Rayko , Baldwin Ian T. , Schaepman Michael E. , Schuman Meredith C.
Published: October 2023

Remote sensing of vegetation by spectroscopy is increasingly used to characterize trait distributions in plant communities. How leaves interact with electromagnetic radiation is determined by their structure and contents of pigments, water, and abundant dry matter constituents like lignins, phenolics, and proteins. High-resolution (“hyperspectral”) spectroscopy can characterize trait variation at finer scales, and may help to reveal underlying genetic variation—information important for assessing the potential of populations to adapt to global change. Here, we use a set of 360 inbred genotypes of the wild coyote tobacco Nicotiana attenuata: wild accessions, recombinant inbred lines (RILs), and transgenic lines (TLs) with targeted changes to gene expression, to dissect genetic versus non-genetic influences on variation in leaf spectra across three experiments. We calculated leaf reflectance from hand-held field spectroradiometer measurements covering visible to short-wave infrared wavelengths of electromagnetic radiation (400–2500 nm) using a standard radiation source and backgrounds, resulting in a small and quantifiable measurement uncertainty. Plants were grown in more controlled (glasshouse) or more natural (field) environments, and leaves were measured both on- and off-plant with the measurement set-up thus also in more to less controlled environmental conditions. Entire spectra varied across genotypes and environments. We found that the greatest variance in leaf reflectance was explained by between-experiment and non-genetic between-sample differences, with subtler and more specific variation distinguishing groups of genotypes. The visible spectral region was most variable, distinguishing experimental settings as well as groups of genotypes within experiments, whereas parts of the short-wave infrared may vary more specifically with genotype. Overall, more genetically variable plant populations also showed more varied leaf spectra. We highlight key considerations for the application of field spectroscopy to assess genetic variation in plant populations.
Limb salvage and survival after urgent surgical treatment of popliteal artery aneurysm
Authors: Pomatto Sara , Faggioli Gianluca , Pini Rodolfo , Ficarelli Ilaria , Pini Alessia , Angherà Cecilia , Rocchi Cristina , Caputo Stefania , Vacirca Andrea , Ruotolo Carlo , Gargiulo Mauro
Published: October 2023

Background

Popliteal artery aneurysms (PAAs) need urgent treatment in case of acute thrombosis, distal embolization, or rupture. Few data are available in the literature about the treatment results in these scenarios. The aim of the present study was to evaluate an 11-year multicenter experience in the urgent treatment of PAAs.

Methods

All symptomatic PAAs surgically treated in two vascular centers between 2010 and 2021 were retrospectively analyzed. In the postoperative period periodical clinical and Duplex-Ultrasound evaluation were performed. The evaluated endpoint was the outcome of urgent PAAs treatment according to their clinical presentation. Statistical analysis was performed by Kaplan-Meier log-rank evaluation and multivariable Cox regression tests.

Results

Sixty-six PAAs needed an urgent repair. Twelve (18%) patients had a PAA rupture and 54 (82%) had an acute limb ischemia (ALI) due to either distal embolization or acute thrombosis. Patients with ALI underwent bypass surgery in 51 (95%) cases, which was associated with preoperative thrombolysis in 18 (31%) cases. A primary major amputation was performed in 3 (5%) cases. The mean follow-up was 52 ± 21 months with an overall 5-year limb salvage of 83 ± 6%. Limb salvage was influenced only by the number of patent tibial arteries (pTA) [5-years limb salvage 0%, 86 ± 10%, 92 ± 8% and 100% in case of 0, 1, 2 or 3 pTA, respectively (P = .001)]. An independent association of number of pTA and limb loss was found [hazard ratio (HR): 0.14 (95% confidence interval (CI) 0.03–0.6), P = .001]. Overall 5-year survival was 71 ± 7%. Ruptured PAAs were associated with lower 5-year survival compared with the ALI group (48 ± 2% vs. 79 ± 7%, P = .001). The number of pTA (33 ± 20%, 65 ± 10%, 84 ± 10% and 80 ± 10% for 0, 1, 2 and 3 pTA, respectively, P = .001) and the thrombolysis (94 ± 6% vs. 62 ± 10%, P = .03) were associated with higher survival in patients with ALI. There was an independent association of number of pTA and long-term survival [HR 0.15 (95% CI 0.03–0.8), P = .03].

Conclusions

PAA rupture is the cause of urgent PAA treatment in almost one fifth of cases, and it is associated with lower long-term survival. ALI can benefit from thrombolysis, and long-term limb salvage and survival are associated with the number of pTA.
Correlation between admission hypoalbuminemia and postoperative urinary tract infections in elderly hip fracture patients
Authors: Yao Wei , Tang Wanyun , Wang Wei , Lv Qiaomei , Ding Wenbo
Published: October 2023

Purpose

This study aimed to evaluate the correlation between hypoalbuminemia upon admission and the incidence of postoperative urinary tract infections (UTIs) in elderly patients with hip fractures.

Methods

A retrospective analysis was performed on the medical records of elderly patients who underwent surgical treatment for hip fractures at a level I trauma center from 2013 to 2023. Serum albumin levels were measured upon admission, and hypoalbuminemia was defined as a total albumin level < 35 g/L. Multivariable logistic regression and propensity score matching analysis were utilized to control and reduce potential confounding factors, aiming to obtain adjusted odds ratios (ORs) and 95% confidence intervals (CI) for UTIs to determine the strength of the association.

Results

This observational cohort study included 1279 patients, among whom 298 (23.3%) developed UTIs. Patients with albumin levels < 35 g/L had significantly greater odds of developing UTIs compared to those with albumin levels ≥ 35 g/L (OR 1.86, 95% CI 1.28–2.70). Further analysis, dividing albumin levels into quartiles, demonstrated that patients in the Q2 group (38.0–40.9 g/L; OR 1.38, 95% CI 0.88–2.17), Q3 group (35.0–37.9 g/L; OR 1.69, 95% CI 1.06–2.71), and Q4 group (15.3–34.9 g/L; OR 2.67, 95% CI 1.61–4.43) had notably higher odds of developing UTIs compared to those in the Q1 group (41.0–52.0 g/L).

Conclusions

The presence of hypoalbuminemia upon admission in elderly patients undergoing hip fracture surgery is strongly correlated with the occurrence of postoperative UTIs. Furthermore, this association exhibits a clear dose–response relationship.
Application progress of artificial intelligence and augmented reality in orthopaedic arthroscopy surgery
Authors: Chen Haojie
Published: October 2023

In today's rapidly developing technological era, the technological revolution triggered by the rapid iteration of artificial intelligence and augmented reality has provided brand-new digital intelligent empowerment for orthopaedic clinical operation. Although traditional arthroscopy has been widely promoted globally due to its advantages such as minimally invasive, safety and early functional exercise, it still has deficiencies in precision and personalization. The assistance of artificial intelligence and augmented reality enables precise positioning and navigation in arthroscopic surgery, as well as personalized operations based on patient conditions, which lifts the objective limitations of traditional sports medicine surgery. The integration of artificial intelligence and augmented reality with orthopaedic arthroscopy surgery is still in infancy, even though there are still some insufficient to be solved, but its prospect is bright.
Surgical treatment of severe benign tracheal stenosis
Authors: Feng Yong-Geng , Tao Shao-Lin , Mei Long-Yong , Dai Fu-Qiang , Tan Qun-You , Wang Ru-Wen , Zhou Jing-Hai , Deng Bo
Published: October 2023

Objective

To present clinical experiences regarding surgical treatment of patients with severe cicatricial tracheal stenosis.

Patients and methods

From January 2008 to March 2020, 14 patients underwent tracheal resection and reconstruction under general anesthesia. Nine cases had cervical tracheal stenosis and five cases had thoracic tracheal stenosis. The mean diameter and length of strictured trachea was 0 − 8 mm with a mean of 4.5 ± 2.4 mm and 1 − 3 cm with a mean of 1.67 ± 0.63 cm, respectively. General anesthesia and mechanical ventilation were performed in ten cases and four patients underwent femoral arteriovenous bypass surgery due to severe stenosis. End-to-end anastomosis of trachea was performed in 13 cases and the anastomosis between trachea and cricothyroid membrane was performed in one case. Absorbable and unabsorbable sutures were used for the anterior and posterior anastomoses, respectively. Postoperative neck anteflexion was maintained by a suture between the chin and superior chest wall. The relevant data of the 14 patients were retrospectively reviewed, and the operation time, blood loss, postoperative hospital stay, postoperative complications and follow-up were retrieved.

Results

There was no intraoperative death. The length of resected trachea ranged from 1.5 to 4.5 cm with a mean of 1.67 ± 0.63 cm. Operation time ranged from 50 − 450 min with a mean of 142.8 ± 96.6 min and intraoperative hemorrhage ranged from 10 − 300 ml with a mean of 87.8 ± 83.6 ml. Follow-up period ranged from 5 to 43 months with a mean of 17.9 ± 10.6 months. None of the patients had recurrent laryngeal nerve paralysis during postoperative follow-up. Ten cases were discharged uneventfully. Anastomosis stenosis occurred in three cases who received interventional therapies. Bronchopleurocutaneous fistula occurred in one patient after 6 days postoperatively and further treatment was declined.

Conclusion

The strategies of anesthesia, mechanical ventilation, identification of stenosis lesion, the “hybrid” sutures and postoperative anteflexion are critical to be optimized for successful postoperative recovery.
Clinical characteristics of child and adolescent psychiatric outpatients engaging in fireplay or arson: a case–control study
Authors: Sasaki Yoshinori , Hakosima Yuki , Inazaki Kumi , Mizumoto Yuki , Okada Takayuki , Mikami Katsunaka , Tsujii Noa , Usami Masahide
Published: October 2023

Background

Fireplay and arson incidents among children and adolescents have gained attention because of their potentially severe consequences and societal impacts. Understanding the underlying psychiatric characteristics of individuals engaging in fireplay or arson is crucial for early identification and targeted intervention. However, there is a lack of research conducted in clinical psychiatric populations in this context. This study compared the clinical characteristics of child and adolescent psychiatric outpatients who engaged in fireplay or arson with those without such behaviors.

Methods

A retrospective case–control study was conducted using data collected from patients who visited the Department of Child and Adolescent Psychiatry at Kohnodai Hospital, National Center for Global Health and Medicine in Japan, between April 2014 and March 2022. Medical records were checked to see if the patient had practically committed behaviors that corresponded to fireplay or arson. The case group was identified using this process. After identifying the case and control groups, sex, diagnosis, antisocial behavior, abuse history, and children-to-parent violence were assessed and compared by careful review of medical records.

Results

The study identified 64 patients who engaged in fireplay or arson, representing approximately 1.1% of the total 5,587 patients (case group). The median age of the patients’ first fire-related behavior was 13 years (range, 6–18 years). In the case group, 14.1% of the cases involved arson, resulting in substantial damage. Of the remaining 5523 patients, 2268 patients had datasets for the first consultation (control group). The most prevalent diagnosis in the case group was attention-deficit hyperactivity disorder (ADHD), present in 57.8% of the cases. The study revealed a significant association between fire-related behaviors and ADHD as well as antisocial behavior. Gender differences were observed, with boys being more likely to engage in fireplay or arson than girls.

Conclusions

This study suggests that clinicians and mental health professionals should closely consider male sex, ADHD, and antisocial behaviors as potential risk factors for fire-related behaviors. Monitoring the case group for the development of psychiatric disorders, including the use of illegal drugs, is recommended to prevent future arson incidents.
Dataset for vaginal human papillomavirus infection among adolescent and early adult girls in Jos, Nigeria
Authors: Cosmas Nanma T. , Nimzing Lohya , Egah Daniel Z. , Famooto Oluranti A. , Adebamowo Sally N. , Adebamowo Clement A.
Published: October 2023

Objectives

To assess risk factors for HPV infection, determine knowledge about HPV vaccines, assess willingness to receive the HPV vaccine among adolescent and early adult girls in Nigeria, we administered a structured questionnaire. We also collected samples to determine the prevalence and patterns of HPV infections.

Data description

The dataset contains the responses of 205 participants from 10 randomly selected public and private secondary schools in Jos, Nigeria. The data includes information on risk factors for HPV infections such as sexual behaviours, knowledge about HPV vaccine and willingness to receive the vaccine. This is valuable information that can be compared to data from studies in other environments or to determine changes in the pattern of risk factors and HPV prevalence in this population over time.
Independent effect of Aβ burden on cognitive impairment in patients with small subcortical infarction
Authors: Kang Sung Hoon , Kang Minwoong , Han Jung Hoon , Lee Eun Seong , Lee Keon-Joo , Chung Su Jin , Suh Sang-Il , Koh Seong-Beom , Eo Jae Seon , Kim Chi Kyung , Oh Kyungmi
Published: October 2023

Background

The effect of amyloid-β (Aβ) on cognitive impairment in patients with small subcortical infarction remains controversial, although a growing body of evidence shows a substantial overlap between Alzheimer’s disease (AD) and subcortical ischemic vascular dementia, another form of cerebral small vessel disease (cSVD). Therefore, we investigated the relationships between Aβ positivity and the development of post-stroke cognitive impairment (PSCI) in patients with small subcortical infarction.

Methods

We prospectively recruited 37 patients aged ≥ 50 years, with first-ever small subcortical infarction, who underwent amyloid positron emission tomography, 3 months after stroke at Korea University Guro Hospital. We also enrolled CU participants matched for age and sex with stroke patients for comparison of Aβ positivity. Patients were followed up at 3 and 12 months after the stroke to assess cognitive decline. Logistic and linear mixed-effect regression analyses were performed to identify the effect of Aβ positivity on PSCI development and long-term cognitive trajectories.

Results

At 3 months after stroke, 12/37 (32.4%) patients developed PSCI, and 11/37 (29.7%) patients had Aβ deposition. Aβ positivity (odds ratio [OR] = 72.2, p = 0.024) was predictive of PSCI development regardless of cSVD burden. Aβ positivity (β = 0.846, p = 0.014) was also associated with poor cognitive trajectory, assessed by the Clinical Dementia Rating-Sum of Box, for 1 year after stroke.

Conclusions

Our findings highlight that Aβ positivity is an important predictor for PSCI development and cognitive decline over 1 year. Furthermore, our results provide evidence that anti-AD medications may be a strategy for preventing cognitive decline in patients with small subcortical infarctions.
Cost-effectiveness analysis of biologics for the treatment of chronic rhinosinusitis with nasal polyps in Canada
Authors: Yong Michael , Kirubalingam Keshinisuthan , Desrosiers Martin Y. , Kilty Shaun J. , Thamboo Andrew
Published: October 2023

Background

Dupilumab, omalizumab, and mepolizumab are the three biologics currently approved for use in CRSwNP in Canada. Despite evidence of efficacy, their cost-effectiveness, which is a key factor influencing prescribing patterns, has not yet been compared to each other.

Methods

A cost-effectiveness model using quality-adjusted life years (QALYs) was constructed using a Decision Tree Markov analysis. A third-party healthcare payer perspective and a 10-year time horizon was used. A willingness-to-pay (WTP) threshold of 50,000 Canadian dollars (CAD) per QALY was used to determine cost-effectiveness. Dupilumab, omalizumab, and mepolizumab were each compared to each other.

Results

Omalizumab was the most cost-effective biologic using current estimates of cost and efficacy in CRSwNP. Using omalizumab as a baseline, dupilumab had an ICER of $235,305/QALY. Mepolizumab was dominated by omalizumab and dupilumab at the current drug prices and estimates of efficacy. Sensitivity analyses determined that when increasing the WTP threshold to $150,000/QALY, dupilumab became cost-effective compared to omalizumab in 22.5% of simulation scenarios. Additionally, altering dosing frequency had a significant effect on cost-effectiveness.

Conclusion

When comparing the relative cost-effectiveness of biologics in recalcitrant CRSwNP, omalizumab currently appears to be the most cost-effective option. Future reductions in drug prices, adjustments to currently approved dosing regimens, better patient selection, and improvements in sinus surgery outcomes will challenge the current cost-effectiveness models and necessitate reassessment as treatments for CRSwNP continue to evolve.
c-Jun as a one-way valve at the naive to primed interface
Authors: Li Dongwei , Luo Ling , Guo Lin , Wu Chuman , Zhang Ran , Peng Yuling , Wu Menghua , Kuang Junqi , Li Yan , Zhang Yudan , Xie Jun , Xie Wenxiu , Mao Rui , Ma Gang , Fu Xiuling , Chen Jiekai , Hutchins Andrew P. , Pei Duanqing
Published: October 2023

Background

c-Jun is a proto-oncogene functioning as a transcription factor to activate gene expression under many physiological and pathological conditions, particularly in somatic cells. However, its role in early embryonic development remains unknown.

Results

Here, we show that c-Jun acts as a one-way valve to preserve the primed state and impair reversion to the naïve state. c-Jun is induced during the naive to primed transition, and it works to stabilize the chromatin structure and inhibit the reverse transition. Loss of c-Jun has surprisingly little effect on the naïve to primed transition, and no phenotypic effect on primed cells, however, in primed cells the loss of c-Jun leads to a failure to correctly close naïve-specific enhancers. When the primed cells are induced to reprogram to a naïve state, these enhancers are more rapidly activated when c-Jun is lost or impaired, and the conversion is more efficient.

Conclusions

The results of this study indicate that c-Jun can function as a chromatin stabilizer in primed EpiSCs, to maintain the epigenetic cell type state and act as a one-way valve for cell fate conversions.
AI-enabled legacy data integration with privacy protection: a case study on regional cloud arbitration court
Authors: Song Jie , Fu Haifei , Jiao Tianzhe , Wang Dongqi
Published: October 2023

This paper presents an interesting case study on Legacy Data Integration (LDI for short) for a Regional Cloud Arbitration Court. Due to the inconsistent structure and presentation, legacy arbitration cases can hardly integrate into the Cloud Court unless processed manually. In this study, we propose an AI-enabled LDI method to replace the costly manual approach and ensure privacy protection during the process. We trained AI models to replace tasks such as reading and understanding legacy cases, removing privacy information, composing new case records, and inputting them through the system interfaces. Our approach employs Optical Character Recognition (OCR), text classification, and Named Entity Recognition (NER) to transform legacy data into a system format. We applied our method to a Cloud Arbitration Court in Liaoning Province, China, and achieved a comparable privacy filtering effect while retaining the maximum amount of information. Our method demonstrated similar effectiveness as the manual LDI, but with greater efficiency, saving 90% of the workforce and achieving a 60%-70% information extraction rate compared to manual work. With the increasing development of informationalization and intelligentization in judgment and arbitration, many courts are adopting ABC technologies, namely Artificial intelligence, Big data, and Cloud computing, to build the court system. Our method provides a practical reference for integrating legal data into the system.