bluuebunny/crossref_metadata_2025 huggingface dataset:
Machine Learning for Precision Epilepsy Surgery
Authors: Jehi Lara
Published: January 2023

Brain surgery offers the best chance of seizure-freedom for patients with focal drug-resistant epilepsy, but only 50% achieve sustained seizure-freedom. With the explosion of data collected during routine presurgical evaluations and recent advances in computational science, we now have a tremendous potential to achieve precision epilepsy surgery: a data-driven tailoring of surgical planning. This review highlights the clinical need, the relevant computational science focusing on machine learning, and discusses some specific applications in epilepsy surgery.
Axisymmetric frictionless contact between an elastic layer thickness and a circular base under a rigid punch
Authors: Guerrache Fadila , Boutoutaou Hamid , Hachemi Madjid
Published: January 2023

The study presented in this work deals with analytical methods for an axisymmetric problem of an elastic layer partially reposing on a rigid circular base, and is indented along the upper surface with a rigid punch. The contact between the medium and the base is smooth. This boundary value problem is transformed into a system of dual integral equations. In contrast to the classical approach consisting in resolving the corresponding Fredholm equation of the second kind, the latter equations are obtained from an infinite algebraic system of simultaneous equations, where the particular case [Formula: see text] is verified. The results of this system are also obtained numerically. The normal displacement, normal stress, and the stress singularity factor are given analytically and shown graphically with discussion. By comparison with those predicted by the finite element method, the accuracy of the numerical method is approved.
Newborn hearing screening in the UK
Authors: Rova Konstantina , Knight Kathryn , Moss Wendy , Mendis Surangi
Published: January 2023

The newborn hearing screening programme (NHSP) exists to identify permanent childhood hearing impairment (PCHI) in babies born in the UK. Early identification of hearing loss facilitates the provision of hearing aids or a prompt referral for cochlear implantation to ensure children optimise speech, language and communication skills, with the hope that this translates to the best possible educational, mental health, social and quality of life outcomes. Diagnosis of hearing impairment allows aetiological investigations to be offered to look for a potential cause of the PCHI, and given the recent advances in genomic testing, this can facilitate testing for additional family members and future children if a genetic cause is identified. In this article, the authors describe the structure of the NHSP and illustrate referral pathways into the programme from primary care for the few babies that may have been missed or fallen outside the remit of the programme.
Identification of a large intra-exonic deletion in BRCA2 exon 18 in a pancreatic ductal adenocarcinoma
Authors: Debbabi Inès , Vacher Sophie , Neuzillet Cindy , Cros Jérome , Revillon Françoise , Petitalot Ambre , Turpin Anthony , Antonio Samantha , Girard Elodie , Dupain Célia , Kamal Maud , Hammel Pascal , Bièche Ivan , Masliah-Planchon Julien , Caputo Sandrine M.
Published: January 2023

By 2030, pancreatic cancer will become the second leading cause of cancer-related deaths in the United States and in Europe. The management of patients with advanced pancreatic cancer relies on chemotherapy and poly (ADP-ribose) polymerase inhibitors for patients who carry BRCA1/2 inactivating alterations. Some variants, such as large insertion/deletions (Indels), inactivating BRCA1/2 and therefore of clinical relevance can be hard to detect by next-generation sequencing techniques. Here we report a 47-year-old patient presenting with pancreatic cancer whose tumour harbours a large somatic intra-exonic deletion of BRCA2 of 141 bp. This BRCA2 deletion, located in the C-terminal domain, can be considered as pathogenic and consequently affect tumorigenesis because it is involved in the interaction between the DSS1 protein and DNA. Thanks to the optimized bioinformatics algorithm, this intermediate size deletion in BRCA2 was identified, enabling personalized patient management via the inclusion of the patients in a clinical trial.
Hypoxia-tolerant apical-out intestinal organoids to model host-microbiome interactions
Authors: Kakni Panagiota , Jutten Barry , Teixeira Oliveira Carvalho Daniel , Penders John , Truckenmüller Roman , Habibovic Pamela , Giselbrecht Stefan
Published: January 2023

Microbiome is an integral part of the gut and is essential for its proper function. Imbalances of the microbiota can be devastating and have been linked with several gastrointestinal conditions. Current gastrointestinal models do not fully reflect the in vivo situation. Thus, it is important to establish more advanced in vitro models to study host-microbiome/pathogen interactions. Here, we developed for the first time an apical-out human small intestinal organoid model in hypoxia, where the apical surface is directly accessible and exposed to a hypoxic environment. These organoids mimic the intestinal cell composition, structure and functions and provide easy access to the apical surface. Co-cultures with the anaerobic strains Lactobacillus casei and Bifidobacterium longum showed successful colonization and probiotic benefits on the organoids. These novel hypoxia-tolerant apical-out small intestinal organoids will pave the way for unraveling unknown mechanisms related to host-microbiome interactions and serve as a tool to develop microbiome-related probiotics and therapeutics.
Gut-on-a-chip for disease models
Authors: Xian Changxiu , Zhang Jiaxin , Zhao Suqing , Li Xiang-Guang
Published: January 2023

The intestinal tract is a vital organ responsible for digestion and absorption in the human body and plays an essential role in pathogen invasion. Compared with other traditional models, gut-on-a-chip has many unique advantages, and thereby, it can be considered as a novel model for studying intestinal functions and diseases. Based on the chip design, we can replicate the in vivo microenvironment of the intestine and study the effects of individual variables on the experiment. In recent years, it has been used to study several diseases. To better mimic the intestinal microenvironment, the structure and function of gut-on-a-chip are constantly optimised and improved. Owing to the complexity of the disease mechanism, gut-on-a-chip can be used in conjunction with other organ chips. In this review, we summarise the human intestinal structure and function as well as the development and improvement of gut-on-a-chip. Finally, we present and discuss gut-on-a-chip applications in inflammatory bowel disease (IBD), viral infections and phenylketonuria. Further improvement of the simulation and high throughput of gut-on-a-chip and realisation of personalised treatments are the problems that should be solved for gut-on-a-chip as a disease model.
‘Power to the People, to the people’: Training for social prescribers improves support of persistent pain
Authors: Corline Alex , Cole Frances , Trewern Louise , Penlington Chris
Published: January 2023

Introduction

Supported self-management is an important aspect of managing pain, however widely held beliefs about the biomedical nature of pain and limited time availability can make it a tricky concept to introduce to patients. Social prescribers are in an ideal position to support self-management of pain if appropriate training is available to support them. This study aimed to evaluate training for social prescribers and to explore their opinions and experiences about providing self-management support.

Methods

This was a mixed methods study. Repeated measures t-tests were used to compare the reported confidence of attendees in supporting different facets of self-management before and after the training. Thematic analysis of interviews was used to develop a deeper understanding of how participants related the training to their work with patients.

Results

Average confidence improved in all aspects of supporting self-management, and particularly with regard to supporting understanding pain, acceptance, pacing, setting goals, sleep and managing setbacks. Challenges were identified around explaining pain in an accurate and accessible way in order to provide a meaningful rationale for self-management.

Conclusion

Training for social prescribers in self-management support is feasible and leads to improvements in self-reported confidence. Further research is needed to determine the impact on patients and over a longer period of time.
Assessment of distance to primary percutaneous coronary intervention centres in ST-segment elevation myocardial infarction: Overcoming inequalities with process mining tools
Authors: Borges-Rosa João , Oliveira-Santos Manuel , Simões Marco , Carvalho Paulo , Ibanez-Sanchez Gema , Fernandez-Llatas Carlos , Costa Marco , Monteiro Sílvia , Gonçalves Lino ,   on behalf of the Portuguese Registry of Acute Coronary Syndromes
Published: January 2023

Objectives

In ST-segment elevation myocardial infarction (STEMI), time delay between symptom onset and treatment is critical to improve outcome. The expected transport delay between patient location and percutaneous coronary intervention (PCI) centre is paramount for choosing the adequate reperfusion therapy. The “Centro” region of Portugal has heterogeneity in PCI assess due to geographical reasons. We aimed to explore time delays between regions using process mining tools.

Methods

Retrospective observational analysis of patients with STEMI from the Portuguese Registry of Acute Coronary Syndromes. We collected information on geographical area of symptom onset, reperfusion option, and in-hospital mortality. We built a national and a regional patient's flow models by using a process mining methodology based on parallel activity-based log inference algorithm.

Results

Totally, 8956 patients (75% male, 48% from 51 to 70 years) were included in the national model. Most patients (73%) had primary PCI, with the median time between admission and treatment <120 minutes in every region; “Centro” had the longest delay. In the regional model corresponding to the “Centro” region of Portugal divided by districts, only 61% had primary PCI, with “Guarda” (05:04) and “Castelo Branco” (06:50) showing longer delays between diagnosis and reperfusion than “Coimbra” (01:19). For both models, in-hospital mortality was higher for those without reperfusion therapy compared to PCI and fibrinolysis.

Conclusion

Process mining tools help to understand referencing networks visually, easily highlighting its inefficiencies and potential needs for improvement. A new PCI centre in the “Centro” region is critical to offer timely first-line treatment to their population.
More Than Just Numbers: How Engagement Metrics Influence User Intention to Pay for Online Knowledge Products
Authors: Li Wu , Ai Pengya , Ding Annette
Published: January 2023

The online knowledge-sharing market in China has been rapidly growing, with increasing user demand for paid knowledge products. Like in other e-commerce contexts, users must make product evaluations under conditions of information asymmetry. In the age of social media, engagement metrics can be a particularly rich source of product information for users. However, there has been little research on how engagement metrics influence user decision making in online knowledge market. As such, mainly drawing on the Social Impact Theory, this study conducted a 2 (engagement metrics: high vs. low) × 2 (source expertise: high vs. low) between-subject factorial design experiment to explore the impact of engagement metrics on user purchase intention for online knowledge products. Participants consisted of 151 college students who completed measures on purchase intention, trust, demographics, and other individual variables. Results revealed that only when source expertise is high do higher engagement metrics lead to higher consumer trust, in turn resulting in higher purchase intention. Differentiating from findings on the impact of engagement metrics in other online contexts, this study highlights the importance of source expertise for influencing user purchase intention in the knowledge-sharing market.
How Did COVID-19 Change Faculty Members’ Use of Technology?
Authors: Aydın Nurullah , Sayır Muhammed Fatih , Aydeniz Süleyman , Şimşek Tacettin
Published: January 2023

COVID-19 has caused great changes in education. Routines, practices, and especially the technologies used in teaching have differentiated at all levels of education. The purpose of this study is to determine the technologies used by faculty members for instructional purposes before and during the COVID-19 pandemic and their perspectives on the use of these technologies after the end of pandemic. A close-ended questionnaire was used for gathering data in this survey research study. Participants are150 faculty members from different ages and fields. Findings indicate that, although faculty members experienced various issues (e.g., infrastructure problems, access to technology, and lack of experience in technology) while teaching through technological facilities during the pandemic, they are in favor of using tools such as WhatsApp, Google classroom, Zoom Meeting, Facebook, and e-mail after the end of pandemic due to the different facilities they provide.
Patient Experiences with a Tertiary Care Post-COVID-19 Clinic
Authors: Garg Alpana , Subramain Maran , Barlow Patrick B , Garvin Lauren , Hoth Karin F , Dukes Kimberly , Hoffman Richard M , Comellas Alejandro P
Published: January 2023

Post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PASC) is a complex condition with multisystem involvement. We assessed patients’ experience with a PASC clinic established at University of Iowa in June 2020. A survey was electronically mailed in June 2021 asking about (1) symptoms and their impact on functional domains using the Patient-Reported Outcomes Measurement Information System (PROMIS) measures (Global Health and Cognitive Function Abilities) (2) satisfaction with clinic services, referrals, barriers to care, and recommended support resources. Survey completion rate was 35% (97/277). Majority were women (67%), Caucasian (93%), and were not hospitalized (76%) during acute COVID-19. As many as 50% reported wait time between 1 and 3 months, 40% traveled >1 h for an appointment and referred to various subspecialities. Participants reported high symptom burden-fatigue (77%), “brain fog” (73%), exercise intolerance (73%), anxiety (63%), sleep difficulties (56%) and depression (44%). On PROMIS measures, some patients scored significantly low (≥1.5 SD below mean) in physical (22.7%), mental (15.9%), and cognitive (17.6%) domains. Approximately 61% to 93% of participants were satisfied with clinical services. Qualitative analysis added insight to their experience with healthcare. Participants suggested potential strategies for optimizing recovery, including continuity of care, a co-located multispecialty clinic, and receiving timely information from emerging research. Participants appreciated that physicians validated their symptoms and provided continuity of care and access to specialists.
Aging alters the cell cycle control and mitogenic signaling responses of human hematopoietic stem cells
Authors: Hammond Colin A. , Wu Si Wei , Wang Fangwu , MacAldaz Margarita E. , Eaves Connie J.
Published: January 2023

Human hematopoietic stem cells (HSCs), like their counterparts in mice, comprise a functionally and molecularly heterogeneous population of cells throughout life that collectively maintain required outputs of mature blood cells under homeostatic conditions. In both species, an early developmental change in the HSC population involves a postnatal switch from a state in which most of these cells exist in a rapidly cycling state and maintain a high self-renewal potential to a state in which the majority of cells are in a quiescent state with an overall reduced self-renewal potential. However, despite the well-established growth factor dependence of HSC proliferation, whether and how this mechanism of HSC regulation might be affected by aging has remained poorly understood. To address this knowledge gap, we isolated highly HSC-enriched CD34+CD38−CD45RA−CD90+CD49f+ (CD49f+) cells from cord blood, adult bone marrow, and mobilized peripheral blood samples obtained from normal humans spanning 7 decades of age and then measured their functional and molecular responses to growth factor stimulation in vitro and their regenerative activity in vivo in mice that had undergone transplantation. Initial experiments revealed that advancing donor age was accompanied by a significant and progressively delayed proliferative response but not the altered mature cell outputs seen in normal older individuals. Importantly, subsequent dose-response analyses revealed an age-associated reduction in the growth factor–stimulated proliferation of CD49f+ cells mediated by reduced activation of AKT and altered cell cycle entry and progression. These findings identify a new intrinsic, pervasive, and progressive aging-related alteration in the biological and signaling mechanisms required to drive the proliferation of very primitive, normal human hematopoietic cells.
The essential-use concept: a valuable tool to guide decision-making on applications for authorisation under REACH?
Authors: Figuière Romain , Borchert Flora , Cousins Ian T. , Ågerstrand Marlene
Published: January 2023

Background

In 2020, the European Commission published the Chemical Strategy for Sustainability (CSS) in which it aims to increase the level of protection for human health and the environment from hazardous chemicals. Part of the implementation of the CSS will involve a reform of the REACH authorisation and restriction processes. One option for the reform of the authorisation process is to implement the essential-use concept as a tool to guide decision-making on applications for authorisation to make the process more efficient and to align it with societal needs. The purpose of this study is to investigate whether changes in the legal text that defines the authorisation process, and of the amount and type of information that applicants should provide in an application for authorisation, are needed to enable an implementation of the essential-use concept.

Results

The results suggest that no fundamental changes in the regulatory requirements are needed and that applicants should already provide sufficient and relevant information to the authorities to determine if the use(s) applied for is (are) essential.

Conclusions

Although the REACH authorisation already provides a legal and practical basis for an implementation of the essential-use concept, the feasibility of the essentiality assessment and its potential to make the decision-making on applications more efficient are highly dependent on the quality of the information provided and the clearness of decision criteria. However, if an applicant successfully demonstrates that the risk related to the use(s) applied for is adequately controlled, it could not be legally justified for the European Commission to refuse an authorisation by arguing that the use(s) applied for is (are) non-essential.
Agreement between Capillary Refill Time measured at Finger and Earlobe sites in different positions: a pilot prospective study on healthy volunteers
Authors: La Via Luigi , Sanfilippo Filippo , Continella Carlotta , Triolo Tania , Messina Antonio , Robba Chiara , Astuto Marinella , Hernandez Glenn , Noto Alberto
Published: January 2023

Background

Capillary Refill Time (CRT) is a marker of peripheral perfusion usually performed at fingertip; however, its evaluation at other sites/position may be advantageous. Moreover, arm position during CRT assessment has not been fully standardized.

Methods

We performed a pilot prospective observational study in 82 healthy volunteers. CRT was assessed: a) in standard position with participants in semi-recumbent position; b) at 30° forearm elevation, c and d) at earlobe site in semi-recumbent and supine position. Bland–Altman analysis was performed to calculate bias and limits of agreement (LoA). Correlation was investigated with Pearson test.

Results

Standard finger CRT values (1.04 s [0.80;1.39]) were similar to the earlobe semi-recumbent ones (1.10 s [0.90;1.26]; p = 0.52), with Bias 0.02 ± 0.18 s (LoA -0.33;0.37); correlation was weak but significant (r = 0.28 [0.7;0.47]; p = 0.01). Conversely, standard finger CRT was significantly longer than earlobe supine CRT (0.88 s [0.75;1.06]; p < 0.001) with Bias 0.22 ± 0.4 s (LoA -0.56;1.0), and no correlation (r = 0,12 [-0,09;0,33]; p = 0.27]. As compared with standard finger CRT, measurement with 30° forearm elevation was significantly longer (1.17 s [0.93;1.41] p = 0.03), with Bias -0.07 ± 0.3 s (LoA -0.61;0.47) and with a significant correlation of moderate degree (r = 0.67 [0.53;0.77]; p < 0.001).

Conclusions

In healthy volunteers, the elevation of the forearm significantly prolongs CRT values. CRT measured at the earlobe in semi-recumbent position may represent a valid surrogate when access to the finger is not feasible, whilst earlobe CRT measured in supine position yields different results. Research is needed in critically ill patients to evaluate accuracy and precision at different sites/positions.
The impact of intrahepatic cholestasis on pregnancy outcomes: a retrospective cohort study
Authors: Chen Yiming , Zhang Huimin , Ning Wenwen , Chen Yijie , Wen Caihe
Published: January 2023

Background

This study analyzed the pregnancy outcomes of patients with intrahepatic cholestasis of pregnancy (ICP) in Hangzhou, China.

Methods

Cases of pregnant women monitored by antepartum testing at Hangzhou Women’s Hospital from January 2018 to December 2020 were reviewed. Subjects were classified into two groups according to whether they had ICP: 688 cases of ICP were assigned to an exposure group while 38,556 cases of non-ICP were assigned to a non-exposed group. Univariate analysis was performed on qualitative or quantitative data using the Chi-Squared test or Mann–WhitneyUtest, and the adjusted odds ratio (aOR) and 95% confidence interval (CI) of the two groups of related variables were calculated by multivariate binary logistic regression analysis.

Results

The incidence rate of ICP was 1.75%. Pregnant women with hepatitis B virus were correlated with ICP. Hepatitis B carriers (aOR = 3.873), preeclampsia (PE, aOR = 3.712), thrombocytopenia (aOR = 1.992), gestational hypertension (GH, aOR = 1.627), hyperlipidemia (aOR = 1.602) and gestational diabetes mellitus (GDM, aOR = 1.265) were all risk factors for ICP. In contrast, Body Mass Index (BMI) ≥ 30 kg/m2(aOR = 0.446), 25 m2< maternal BMI < 29.9 kg/m2(aOR = 0.699) and parity ≥ 1 (aOR = 0.722) were protective factors for ICP. Pregnant women in the ICP group had an increased risk of gestation days < 259 days (aOR = 4.574) and cesarean delivery (aOR = 1.930) after ICP, and a decreased risk of longer gestational days (aOR = 0.105), premature rupture of membranes (aOR = 0.384) and fetal macrosomia (aOR = 0.551).

Conclusions

By analyzing a Chinese population with ICP, we identified that pregnant women who are hepatitis B carriers or with PE, thrombocytopenia, GH, hyperlipidemia, and GDM are at higher risk of ICP. Moreover, ICP is associated with adverse pregnancy outcomes; in particular, ICP may increase the incidence of shorter gestational days and non-vaginal delivery methods such as cesarean section but reduce the incidence of premature rupture of membranes and fetal macrosomia.
A high neutrophil-to-platelet ratio is associated with hematoma expansion in patients with spontaneous intracerebral hemorrhage: a retrospective study
Authors: Li Yujian , Yang Xiang , Zhou Huiqing , Hui Xuhui , Li Hao , Zheng Jun
Published: January 2023

Background

Early hematoma expansion (HE) occurs in 20 to 40% of spontaneous intracerebral hemorrhage (ICH) patients and is a primary determinant of early deterioration and poor prognosis. Previous studies have shown that inflammation is a major pathological feature of ICH, and the neutrophil-to-platelet ratio (NPR) is a marker of systemic inflammation. Therefore, we aimed to assess the association between the NPR and HE in ICH patients.

Methods

We retrospectively collected and analyzed data from ICH patients who received treatment at our institution from January 2018 to November 2019. The NPR was calculated from the admission blood test. Brain computed tomography (CT) scans were performed at admission and repeated within 24 h. Hematoma growth was defined as relative growth > 33% or absolute growth > 6 ml.

Results

A total of 317 patients were enrolled in our study. Multivariate logistic regression analysis indicated that the NPR was an independent predictor of HE [odds ratio (OR) = 1.742; 95% CI: 1.508–2.012, p < 0.001]. Receiver operating characteristic (ROC) curve analysis revealed that the NPR could predict HE, with an area under the curve of 0.838 (95% CI, 0.788–0.888, p < 0.001). The best predictive cut-off of the NPR for HE was 5.47 (sensitivity, 75.3%; specificity, 77.6%).

Conclusions

A high NPR was associated with an increased risk of HE in patients with ICH.
DUPAN-II normalisation as a biological indicator during preoperative chemoradiation therapy for resectable and borderline resectable pancreatic cancer
Authors: Hasegawa Shinichiro , Takahashi Hidenori , Akita Hirofumi , Mukai Yosuke , Mikamori Manabu , Asukai Kei , Yamada Daisaku , Wada Hiroshi , Fujii Yoshiaki , Sugase Takahito , Yamamoto Masaaki , Takeoka Tomohira , Shinno Naoki , Hara Hisashi , Kanemura Takashi , Haraguchi Naotsugu , Nishimura Junichi , Matsuda Chu , Yasui Masayoshi , Omori Takeshi , Miyata Hiroshi , Ohue Masayuki , Ishikawa Osamu , Sakon Masato
Published: January 2023

Background

Duke pancreatic mono-clonal antigen type 2 (DUPAN-II) is a famous tumour maker for pancreatic cancer (PC) as well as carbohydrate antigen 19–9 (CA19-9). We evaluated the clinical implications of DUPAN-II levels as a biological indicator for PC during preoperative chemoradiation therapy (CRT).

Methods

This retrospective analysis included data from 221 consecutive patients with resectable and borderline resectable PC at diagnosis who underwent preoperative CRT between 2008 and 2017. We focused on 73 patients with elevated pre-CRT DUPAN-II levels (> 230 U/mL; more than 1.5 times the cut-off value for the normal range). Pre- and post-CRT DUPAN-II levels and the changes in DUPAN-II ratio were measured.

Results

Univariate analysis identified normalisation of DUPAN-II levels after CRT as a significant prognostic factor (hazard ratio [HR] = 2.06, confidence interval [CI] = 1.03–4.24, p = 0.042). Total normalisation ratio was 49% (n = 36). Overall survival (OS) in patients with normalised DUPAN-II levels was significantly longer than that in 73 patients with elevated levels (5-year survival, 55% vs. 21%, p = 0.032) and in 60 patients who underwent tumour resection (5-year survival, 59% vs. 26%, p = 0.039).

Conclusion

Normalisation of DUPAN-II levels during preoperative CRT was a significant prognostic factor and could be an indicator to monitor treatment efficacy and predict patient prognosis.
Instability of emotional relationships and suicide among youth: a qualitative study
Authors: Fallahi-Khoshknab Masoud , Amirian Zainab , Maddah Sadat Seyed Bagher , Khankeh Hamid Reza , Dalvandi Asghar
Published: January 2023

Background

Interpersonal problems are one of the factors for understanding the complex issues that result in suicide attempts and self-injury by poisoning. The quality of familial relationships is a predictor of the occurrence and outcome of suicide attempts. This study aimed to explore motives for self-poisoning suicide attempts amongst young adults.

Method

This research was a qualitative study conducted using semi-structured interviews in 2019 in Kermanshah Province, Iran. Eighteen participants who had attempted suicide by self-poisoning were interviewed, and information was collected until data saturation was achieved. The interviews were recorded and transcribed, and the data were analyzed through content analysis.

Results

The results included the category of instability in emotional relationships with the three sub-categories of 1- Emotional failure, 2- Emotional trauma, and 3- Loss of emotional resilience (caused by emotional failure and emotional trauma within the previous few months). Instability in emotional relationships creates feelings of disgrace, humiliation, burdensomeness, worthlessness, and insignificance, which increases the chances of attempting suicide.

Conclusion

The study results provided an in-depth understanding of romantic, and unstable familial relationships as a significant factor in suicide attempts, demonstrating the role of emotional stress in attempting suicide. The present study provided information on the risk factors and warning signs for psychiatrists and nurses dealing with suicidal patients to take effective measures to prevent suicide through social support.
Suicidal ideation in men during COVID-19: an examination of protective factors
Authors: Seidler Zac E. , Wilson Michael J. , Oliffe John L. , Fisher Krista , O’Connor Rory , Pirkis Jane , Rice Simon M.
Published: January 2023

Background

Men account for three-quarters of all suicide deaths in many Western nations including Australia. Whilst extensive research has examined risk factors for suicidal ideation and behaviour in men, protective factors remain underexplored, particularly social support, resilience and coping behaviours. Such factors are important to examine particularly in the context of COVID-19, where enforced isolation (among other negative lifestyle effects) has created widespread risk for the development of suicidal ideation. This mixed-methods study aimed to examine associations of various protective factors with suicidal ideation in men, using data from an online survey conducted during the COVID-19 pandemic. In addition, we aimed to qualitatively investigate men’s self-reported protective strategies when experiencing suicidal thoughts and behaviour.

Methods

A convenience sample of 700 men (age M = 50.3 years; SD = 15.2 years) responded to an online survey including quantitative measures of suicidal ideation, planning and attempt, alongside employment and relationship status, coping, social support, resilience, and a qualitative free-text item gauging men’s self-reported protective strategies. Multinomial logistic regression was applied to compare odds of sub-categories of suicide risk (ideation; planning) according to protective factors. Qualitative responses were analysed via thematic analysis.

Results

Men in a relationship, and those lower in emotion-focused and avoidant coping reported lower odds of suicidal ideation. Maintaining employment throughout the pandemic was protective against suicidal ideation and planning; as was greater perceived social support from friends. Greater self-reported resilience was protective against suicidal ideation and planning. Qualitative analyses led to the development of two themes: coping and connecting, reflecting men’s intra- and interpersonal management strategies; and sustaining selflessness, where men’s imaginings of the collateral damage of their suicidal behaviour was protective against action on suicidal thoughts or plans.

Conclusions

Findings of this study speak to the nuanced roles of interpersonal connections, resilience and coping behaviours in protecting against suicidal ideation and planning in men. In addition, qualitative insights further cement men’s identification with familial protector and/or provider roles as protective against suicidal action.
Participative epidemiology and prevention pathway of health risks associated with artisanal mines in Luhihi area, DR Congo
Authors: Irenge Christian Ahadi , Bushenyula Parfait Kaningu , Irenge Emmannuel Bayubasire , Coppieters Yves
Published: January 2023

Background

Health issues are associated with artisanal mining in the DR Congo. The scenario is worst when artisanal mining is done informally or with limited material and technical resources.

This paper argues that the adoption of healthy practices by artisanal miners might be limited given that it involves unrealistic socio-economic, and administrative aspects and access to health risk prevention means.

Making a conceptual framework on the feasibility of revolutionizing artisanal mining practices linked to health risks in the DR Congo requires trans-disciplinary interventions and researches. This case study aims at co-analyzing with actors in the Luhihi artisanal gold mine, the epidemiology of health issues. It also aims at describing the dynamics of resources that mining actors mobilize or think they can mobilize in order to prevent health risks.

Methods

A “socio-anthropological” qualitative study with “transdisciplinary methods” was carried out the Luhihi artisanal mining. Data collection tools and methods included an exploratory survey, semi-structured interviews. Focus groups (FG) mixed with proportional piling were used to support the open-ended interview discussions. The actors interviewed were selected by “convenience sampling” and the saturation principle indicated the size of the sampling. In total, 67 persons were interviewed and 5 FG each consisting of 5 to 10 mining actors were organized. Data were triangulated among respondents to ensure their veracity and an “inductive thematic data analysis” was applied.

Results

Key findings are the role of actors involved the organization system at the Luhihi artisanal mining site; a description of a participative epidemiology and determinants of health issues; presentation of the importance of health risks as perceived by mining actors; the constraints in the common illenesses treatment; and opportunities of collective actions for gathering resources required for the organization of healthcare services.

Conclusion

The results are translated into a grid of powers and interests in relation to the mobilization of resources for the prevention and treatment of health issues. The dialogue for change regarding the ignorance of the actors to exposure to chemical risks such as to exposure mercury, silica, carbon monoxide, and cyanide also entailed the translation of the results. In addition, an analysis of the ability of artisanal mining actors to implement health risk prevention services was made.
Relationship of sleep duration with incident cardiovascular outcomes: a prospective study of 33,883 adults in a general population
Authors: Cui Hui , Xu Rong , Wan Yiming , Ling Yong , Jiang Yonggen , Wu Yiling , Guan Ying , Zhao Qi , Zhao Genming , Zaid Maryam
Published: January 2023

Background

Studies on the effect of sleep duration on cardiovascular health have contradictory findings. Underlying health issues may have led to inconsistent results and warrant consideration. We aim to assess the relationship of night sleep duration with incident cardiovascular disease (CVD) in a general population, taking into consideration underlying chronic diseases.

Methods

Data from Shanghai Suburban Adult Cohort and Biobank with a median follow-up of 5.1 years was used, including 33,883 adults aged 20–74 years old. Incident CVD cases were reported and recorded by the Center for Disease Prevention and Control in Songjiang, Shanghai. We used Cox proportional hazard regression models and restricted cubic spline (RCS) analysis to explore the relationship between different sleep groups and sleep duration with incident CVD outcomes, through stratification by gender and age, as well as different health conditions, with adjustments for potential confounders.

Results

Long sleep duration (> 9 h) compared to > 7 to ≤ 8 h was associated with overall incident CVD in participants aged ≥ 50 years old: HR(95%CI) = 2.07 (1.15, 3.74) for 50-59y and 1.43 (1.04, 1.93) for 60-74y. RCS analysis showed a J-shaped relationship between sleep and CVD risk in those ≥ 50y, which was confirmed only in those with a chronic health condition. Non-linear relationships between sleep and CVD risk factors, such as BMI, blood glucose and glycated haemoglobin, were observed.

Conclusions

Long sleep duration is associated with increased risk of CVD in people ≥ 50y. However, CVD risk factors and underlying health conditions such as hypertension, and diabetes, may play a driving role in the relationship.
Empirical validation of the information-motivation-behavioral skills model of gestational weight management behavior: a framework for intervention
Authors: You Hua , Wang Yuan-Yuan , Zhang Chi , Walker Anita Nyarkoa , Ge Jin-Jin , Zhao Shi-Qi , Peng Xue-Qing
Published: January 2023

Background

Unhealthy gestational weight gain is a modifiable risk factor for adverse maternal and child health. Appropriate and effective intervention strategies that focus on behavioral change or maintenance are critical in weight management during pregnancy. Our aim was to uncover the influencing factors and psychosocial mechanisms of gestational weight control behavior, and to construct a behavioral model suitable for intervention based on Information-Motivation-Behavioral skills (IMB) model.

Methods

A sample of 559 pregnant women from a municipal maternal and child healthcare facility in Jiangsu Province, China was enrolled in this cross-sectional empirical study. Partial least square structural equation modelling was used to verify the hypothesized model, and post hoc analyses was used to test the effect of parity and pre-pregnancy BMI on the model.

Results

The IMB model elements can predict gestational weight management (GWM) behavior well, with information being the most influential factor. As predicted, information affects GWM directly (β = 0.325, p < 0.05) and indirectly (β = 0.054, p < 0.05) through behavioral skills. Likewise, motivation has direct (β = 0.461, p < 0.05) effects on GWM, and has indirect (β = 0.071, p < 0.05) effects through behavioral skills. Behavioral skills have a direct impact (β = 0.154, p < 0.05). The model had a goodness of fit (GOF = 0.421) and was robust when tested in subgroups of different parity or pre-pregnancy BMI.

Conclusion

Findings from this study supported the predictions of the IMB model for GWM behavior, and identified its modifiable determinants. The tested behavior model for GWM can serve as a new validated intervention strategy in weight management among pregnant women.
Cyanoacrylate glue foreign body after CT-guided localization of a pulmonary nodule during video-assisted thoracoscopic surgery: a case report
Authors: Deng Jingdan , Zeng Zhiwen , Liao Yilin , Zhong Haihui , Zhang Huanrong
Published: January 2023

Background

A tracheal foreign body is a common airway aspiration that creates an emergency, which often causes unobserved respiratory problems and requires management. Iatrogenic tracheal foreign bodies are rarely observed, which results in tracheal obstruction. If the foreign body were removed from the tracheobronchial system, it would save lives. A similar case of a tracheal foreign body was focused on, which was caused by medical glue used during preoperative computed tomography localization of pulmonary nodules.

Case presentation

The foreign body was deposited in the right upper bronchi, accidentally discovered after anesthesia when a double-lumen tube was located by fiber bronchoscopy. Following a video-assisted thoracoscopic surgery, the foreign body was removed using a respiratory endoscopy without subsequent adverse consequences for the patient.

Conclusions

There is a risk of complications from iatrogenic airway foreign bodies for preoperative localization of pulmonary nodules by injecting cyanoacrylate glue.
Pulmonary veno-occlusive disease in Sjogren's syndrome: a case report
Authors: Zeng Xiaofang , Liu Qiong , Rathinasabapathy Anandharajan , Zha Lihuang , Liu Dongliang , Tang Yiyang , Sun Jing , Luo Hui , Yu Zaixin
Published: January 2023

Background

Pulmonary arterial hypertension (PAH) associated with connective tissue disease (CTD) belongs to Group 1 pulmonary hypertension. Pulmonary veno-occlusive disease (PVOD), which is characterized by venous system aberrations, has been previously reported in CTD-PAH; however, it has rarely been observed in Sjogren’s syndrome (SS).

Case presentation

Our 28-year-old female patient was admitted to the hospital with recurrent shortness of breath even after minimal physical activity. Her chest high-resolution CT scan demonstrated pulmonary artery dilatation and bilateral ground-glass nodules. A subsequent right heart catheterization confirmed pulmonary hypertension because her mean pulmonary arterial pressure was 62 mmHg. Our inquisitive genomic assessment identified a novel EIF2AK4 mutation at c.1021 C > T (p. Gln341*), the dominant causal gene of PVOD. Histological examination demonstrated stenosis and occlusions in the pulmonary veins. Because she presented with features such as dry eyes and Raynaud's phenomenon, we performed a biopsy on the labial salivary gland, which confirmed SS. Her treatment regimen included PAH-targeted therapies (tadalafil and macitentan) in combination with hydroxychloroquine. Although she was hospitalized several times due to acute exacerbation of PAH, her disease progression was under control, and she did not demonstrate any signs of pulmonary edema even after a three-year treatment period.

Conclusion

Here, we report the case of an SS-PAH patient with PVOD who carried a novel biallelic EIF2AK4 mutation, and PAH-targeted therapies were well tolerated by our patient.
Core decompression with β-tri-calcium phosphate grafts in combination with platelet-rich plasma for the treatment of avascular necrosis of femoral head
Authors: Lyu Jinyang , Ma Tiancong , Huang Xin , Shi Jingsheng , Huang Gangyong , Chen Feiyan , Wei Yibing , Wang Siqun , Xia Jun , Zhao Guanglei , Chen Jie
Published: January 2023

Background

This study was aimed to investigate whether the application of platelet-rich plasma (PRP) combined with β-tri-calcium phosphate (β-TCP) grafts after core decompression (CD) could improve the clinical outcomes of early stage of avascular necrosis of femoral head.

Methods

Forty-five (54 hips) patients with Ficat-Arlet classification stage I-II treated by CD with β-TCP grafts with or without the application of PRP from July 2015 to October 2020 were reviewed. Group A (CD + β-TCP grafts) included 24 patients (29 hips), while group B (CD + β-TCP grafts + PRP) included 21 patients (25 hips). Visual analogue scale (VAS) score, Harris hip score (HHS), change in modified Kerboul angle and the hip joint survival were evaluated and compared between the groups. Patients had a mean follow-up period of 62.1 ± 17.2 months and 59.3 ± 14.8 months in group A and group B, respectively.

Results

The mean VAS scores in group A was significantly higher than group B at the 6 months (2.9 ± 0.7 vs 1.9 ± 0.6, p < 0.01) and final follow up postoperative (2.8 ± 1.2 vs 2.2 ± 0.7, p = 0.04). The mean HHS in group A was significantly lower than group B at the 6 months (80.5 ± 13.8 vs 89.8 ± 12.8, p = 0.02). However, at the final follow up, there is no significant difference between the groups (77.0 ± 12.4 vs 83.1 ± 9.3, p = 0.07). The mean change in modified Kerboul angle was -7.4 ± 10.6 in group A and -19.9 ± 13.9 in group B which is statistically significant (p < 0.01). Survivorship from total hip arthroplasty were 86.2%/84% (p = 0.86) at the final follow up, which was not statistically significant. No serious complications were found in both groups.

Conclusions

A single dose of PRP combined with CD and β-TCP grafts provided significant pain relief, better functional outcomes, and delayed progression in the short term compared to CD combined with β-TCP grafts. However, the prognosis of the femoral head did not improve significantly in the long term. In the future, designing new implants to achieve multiple PRP injections may improve the hip preservation rate.
Is the anterior cervical dynamic plate fixation better than the anterior static plate fixation: a retrospective review with over 5 years follow-up
Authors: Li Chao , He Qing , Zhu Yue , Wang Zuqiang
Published: January 2023

Background

To compare the clinical and radiologic outcomes after anterior cervical dynamic or static plate fixation for short segment cervical degenerative disc diseases (DDD) for more than 5 years.

Methods

Sixty-four patients who underwent anterior cervical one level discectomy or corpectomy with an anterior cervical plate system were followed for an average of 6.8 years for clinical and radiographic outcomes. Among the sixty-four patients, thirty-eight patients were fixed with a static plate (ORION and CSLP plate system) and the other twenty-six patients were fixed with a dynamic plate (ABC plate). Radiographic data were collected included the global sagittal alignment of the cervical spine (C2–C7), the local height and angle of the operated level pre-operatively, postoperatively and at last follow-up. A clinical assessment was performed at pre-operatively, three months postoperatively and final follow-up using the Japanese Orthopedic Association (JOA) /Visual Analogue Score(VAS)/ Neck Disablility Index(NDI) scoring system.

Results

The mean follow-up time was 6.8 years. At final review, there were two cases of suspicious pseudarthrosis which were from ABC plate fixation group while the other cases all gained solid fusion. The height of fusion segment gained significantly improvement for both dynamic and static plate group post-operation, and all groups demonstrated a significant loss in height postoperatively. Generally, for the one level ACDF group, the height decrease was 0.5 mm for static plate and 1.6 mm for dynamic group which was significantly different(p < 0.05). And for one level ACCF group, this type of difference was not seen in which decreasing was 1.7 mm for static group and 1.8 mm for dynamic group. Segmental lordosis of the fusion segments was increased significantly both post-operation and final follow-up than before-operation for both one and two segments fusion. Global cervical lordosis from C2–C7 was increased in the early postoperative period in all groups, and at final follow-up the total lordosis was still getting better compared with early postoperative period, but this increase was not statistically significant. Clinical assessment of JOA/NDI showed that there was significantly improvement 3-month post-operation compared with pre-operation, and the score could get a slight further improvement at the final follow-up.

Conclusion

Our study demonstrated a statistically similar fusion rate between dynamic and static cervical plate fixation. However, the height gained with static plate fixation for single segment disease was maintained better than with dynamic plate fixation and there was no difference between JOA outcome scores between groups. Despite the reported improved biomechanics of dynamic plate fixation, further research needs to be done to show the clinical advantage of dynamic plate fixation.