bluuebunny/crossref_metadata_2025 huggingface dataset:
Occurrence and predictors of lifetime suicidality and suicidal ideation in autistic adults
Authors: Bentum J van , Sijbrandij M , Huibers M , Begeer S
Published: February 2024

In the past 40 years, accumulating evidence suggested that autistic individuals are at an increased risk of suicidal thoughts and behaviors. This study examined the occurrence of various potential risk factors for lifetime suicidal behavior and suicidal thoughts in the past month in a Dutch cohort (Netherlands Autism Register) of autistic individuals using the Suicidal Behaviors Questionnaire (SBQ-R) and the Suicidal Ideation Attributes Scale (SIDAS). Our results show that the majority (80%) of the initial sample ( N = 1164) had thought about or attempted suicide in their lifetime, of which 15% had attempted suicide. In the final sample ( n = 421), backward linear regression analyses identified the following predictors for suicidal behavior: psychiatric comorbidity, loneliness, and higher number of autistic traits, F(3, 240) = 21.22, p < 0.001, with R2 of 0.21. For suicidal thoughts in the past month, psychiatric comorbidity and a higher number of autistic traits were significant predictors, F(2, 241) = 20.34, p < 0.001, with R2 of 0.14. In sum, additional risk markers for suicidal thoughts and behaviors in autistic individuals (e.g. number of autistic traits) should be considered when assessing the suicide risk in autistic individuals. Future research should focus on adapting suicide prevention interventions for autistic individuals, such as addressing loneliness as one of the intervention strategies.

Lay Abstract

Over the past few years, more and more research is showing that many autistic people are at an increased risk for suicide. In this study, we asked participants from the Netherlands Autism Register, which is longitudinal register including individuals with autism, about their possible experiences with thoughts and feelings about suicide. Specifically, we looked at whether these thoughts and feelings in their lifetime and in the past month were related to various factors (such as their age, gender, and having psychiatric disorder diagnoses). We found that 80% of the participants had experienced thoughts about or even attempted to take their own life at least once throughout their lifetime. Furthermore, in a subgroup of participants, we found that the presence of a psychiatric disorder diagnosis, feelings of loneliness, and a higher number of autistic traits were associated with experiencing suicidal thoughts and feelings in their lifetime. For those who experienced these suicidal thoughts in the past month, we found that having (multiple) psychiatric disorder diagnoses and a higher number of autistic traits were related to more severe and frequent thoughts about suicide in the past month. Our findings show that additional factors in autistic individuals should be considered when assessing the suicide risk, and it brings us one step closer to understanding why suicide is more common for autistic people.
Suicide risk in transition-aged autistic youth: The link among executive function, depression, and autistic traits
Authors: Cook Michal L , Tomaszewski Brianne , Lamarche Elena , Bowman Karrah , Klein Claire B , Stahl Sara , Klinger Laura G
Published: February 2024

Autistic individuals are at significantly higher risk of suicide than non-autistic individuals, with transition-aged youth at potentially the highest risk. While lower executive function (EF) skills have been significantly associated with suicide risk in other clinical samples, the link between EF and suicidality has not yet been examined for autistic individuals. In this study, 183 transition-aged autistic youths completed routine suicide risk assessments and self- and informant-reports of autistic traits, depression, and EF skills. On the P4 Suicide Screener, approximately one-third of the sample (33.3%) endorsed having thoughts of hurting themselves with the intent to end their lives (i.e., suicidal ideation) in their lifetime. In addition to depressive symptoms, EF impairment independently predicted endorsement of suicidal ideation, indicating that both are crucial intervention goals to target suicidal risk for transition-aged youth on the spectrum. Findings suggest that executive functioning, a prevalent area of difficulty and common intervention target for the autistic community, is an important indicator of suicide risk in this population.

Lay Abstract

Autistic people are more likely to consider suicide than non-autistic people, with transition-aged youth (ages 16–21 years) at potentially the highest risk. Research has also shown that difficulties with executive functioning (e.g., difficulties with organization, sequencing, and decision-making) may heighten suicide risk among non-autistic people, but it is not clear whether this is also true for autistic people. This study explored this question by asking 183 transition-aged autistic youth about their experience with suicidal behavior and examining the relationship between their responses and additional measures of depression, autistic traits, and executive function skills. About one-third of autistic transition-aged youth (33.3%) said that they had experienced thoughts of hurting themselves with the intent to end their lives (i.e., suicidal ideation). Both depression and executive function challenges predicted suicide risk (i.e., participants who experienced depression were more likely to have had suicidal thoughts than those who had not, and participants who had more difficulty with executive function skills were more likely to have had suicidal thoughts than those who had less difficulty). These findings suggest that executive functioning, a common area of difficulty among autistic people, is an important indicator of suicide risk in this population.
An ecological approach to the lexical evolution of Chinese English
Authors: Qin Melissa Xiaohui , Li Xiaoyan
Published: February 2024

Aims and objectives:

Rooted in a contact-oriented stance, this study aims to approach the dynamic evolution of Chinese English lexis from the perspective of language ecology by seeking an ecological explanation of diachronic lexical change. Specifically, it attempts to investigate the division of labor between external and internal ecological factors motivating the evolutionary patterns of Chinese English lexis in the past 60 years.

Methodology:

A mixed-methods approach was adopted by combining meticulous coding of each lexical item and numerical calculation of the distribution of lexical manifestations on significant linguistic dimensions.

Data collection and analysis:

In terms of data collection, the Chinese English lexis was sourced coherently and longitudinally from Beijing Review (1958–2018). In terms of data analysis, a systematic analytical framework of five parameters (frequency, form, grammar, word formation, and semantics) was created before qualitatively charting the features and quantitatively calculating the statistics for the value of each parameter.

Findings:

Externally, ecological factors bear on lexical trends of all linguistic parameters except lexical forms; internally, system–internal interactions among lexical variants project congruent patterns of alignment among various sets of features of all parameters except grammar.

Originality:

Few studies have approached the Chinese English lexis from the diachronic perspective through the lens of language evolution based on coherently sourced data and systematic analytical procedures.

Significance:

The study is enlightening in providing basic statistics to permit comparisons of lexical evolution in the five linguistic parameters across Expanding Circle ecologies and in extending the evolutionary approach to language change to the lexical realm in the Chinese English context.
What’s so Marxist about Marxist Educational Theory?
Authors: Ford Derek R
Published: February 2024

The antagonism between “class” and “race” have plagued educational theory for decades. As a communist organizer seeking to move Marxist educational theory out of the stagnant waters of theoretical debates, I turn to recent CRT scholarship, which I find much more in line with the communist project. Yet, this literature omits world-historic and ongoing transformations inaugurated particularly since the beginning of the 20th century by erasing, discounting or, denouncing them. I argue the primary factors inhibiting educational researchers: Anticommunism. The global revolutionary era led largely by revolutionary communists contains the most fruitful explanations of those conditions and connections (and the historical legacies accounting for mass movements in the U.S. today, like the historic 2020 uprising against the War on Black America). This rich and dynamic legacy is what can get educational scholarship beyond the cages of academia. After outlining the interconnection between anticommunism and anti-Black racism as the contours of master narratives, I demonstrate how anticommunism continues to hold education’s potential contributions to the struggle back while accounting for the material conditions responsible for the absence of revolutionary theory and practice and the overwhelming surplus of theories critical of revolution in the university today. I demonstrate how anti-Black racism in the U.S. is tethered to anticommunism and how Leninism provides the theoretical and practical link uniting the global struggle of the oppressed and creating the Black and indigenous-led communist movement, contending struggles against white supremacy, capitalism, and imperialism depend on a rejection of anticommunism by turning to Black communist Claudia Jones.
An Anatomic Classification Scheme for Surgical Planning of Renal Artery Aneurysms
Authors: Li Fangda , Li Siting , Cao Zenghan , Zeng Rong , Liu Xiaolong , Liu Changwei , Liu Bao , Chen Yuexin , Ye Wei , Wang Lei , Ni Leng , Zheng Yuehong
Published: February 2024

Purpose:

Renal artery aneurysm (RAA) is a rare disease. This study proposed and evaluated a new classification for RAA to assist in surgical decision-making.

Materials and Methods:

Single-center data of 105 patients with RAAs from the vascular department of vascular surgery were collected retrospectively. A new classification scheme was proposed. Type I aneurysms arise from the main trunk, accessory branch, or first-order branches away from any bifurcation. Type II aneurysms arise from the first bifurcation with narrow necks (defined as dome-to-neck ratio >2) or from intralobular branches. Type III aneurysms with a wide neck arise from the first bifurcation and affect 2 or more branches that cannot be sacrificed without significant infarction of the kidney.

Results:

There was 50 (47.62%) type I, 33 (31.43%) type II, and 22 (20.95%) type III aneurysms. The classification assigned endovascular repair as first-line treatment (for type I or II), while open techniques were conducted if anatomically suitable (for type III). A kappa level of 0.752 was achieved by the classification compared with a level of 0.579 from the classic Rundback classification. Technical primary success was achieved in 100% and 96.05%, and symptoms were completely resolved in 100% and 84.85%, while hypertension was relieved in 84.21% and 72.92% of patients receiving open surgery or endovascular repair, respectively. No significant difference was observed for perioperative or long-term complications among the 3 classification types.

Conclusion:

The new classification proved to be a convenient and effective method for facilitating choice of intervention for RAAs.

Clinical Impact

This study proposed and evaluated a new classification scheme for renal artery aneurysms, which proved to be a convenient and effective method for facilitating surgical decision-making. Coil embolization was the first-line treatment if suitable, while aneurysm resection and reconstruction with vein graft were conducted for some complex lesions. The safety and efficacy of both open and endovascular methods were validated.
Understanding civil servants’ public service motivation, withdrawal behavior, and taking-charge behavior through the lens of self-determination theory
Authors: Guo Shenghao , Wen Bo , Zhu Xiaochun
Published: February 2024

Contemporary public management research has focused heavily on the consequences of public service motivation (PSM). However, only a handful of studies have been conducted to develop context-indifferent measurement scales that reflect the nature of this central concept, which ranges along a continuum from controlled to autonomous motivation. This study proposes a new PSM model grounded in self-determination theory (SDT) and empirically validates two behavioral elements for the SDT-based PSM using data from Guangdong Province of China. Specifically, it is found that (1) the withdrawal behavior of public employees is positively influenced by their external PSM, negatively associated with identified and introjected PSM, and independent of intrinsic and integrated PSM; (2) there are positive relationships between introjected-, intrinsic-, identified-PSM, and taking-charge behavior; and (3) integrated and external PSM do not show significant outcome effects. Acknowledging that different motivational dimensions underlying the SDT-based PSM vary in their importance to the stimulation of withdrawal and taking-charge behaviors, the paper concludes with a future agenda for SDT- and PSM-related research that can be furthered in a manner that enriches theory or illuminates practice.
The Black Room
Authors: Thompson Lisa D. , Bazor Barbara P.
Published: February 2024

A simple parent request unveiled a startling revelation: The principal of Bridgforth Elementary School segregated students by race. Her attempt to establish a culturally responsive framework was met with an Office of Civil Rights (OCR) complaint of racial discrimination. This case will examine the principal’s rationale for creating the framework, the parental complaint, the school community response, and two evidence-based options for increasing student outcomes for African American students and other ethnic minorities.
Impact of weave architecture on the mechanical performance of carbon-aramid/PVB hybrid composites
Authors: Shaker Khubab , Abbas Adeel , Nawab Yasir , Umair Muhammad , Khan Muhammad Imran , Zubair Zakariya , Awais Habib
Published: February 2024

Continuous fiber-reinforced thermoplastic composites having superior mechanical properties are preferred for lightweight architectures. Rising demands for enhanced mechanical performance under certain types of loadings have focused researchers toward the hybridization of composite materials. In this study carbon and aramid fibers were employed to produce hybrid fabrics by weaving in two different woven architectures, 1/1 plain and 2/1 twill. Polyvinyl butyral (PVB) matrix was reinforced with these woven fabrics and hybrid composites were fabricated by compression molding. Un-hybrid carbon and aramid composites were fabricated using PVB matrix, as control samples. Tensile characteristics of hybrid composites offered intermediate strain at failures of 0.5% due to the combined rigid and ductile natures of carbon and aramid, respectively. Flexural strength and absorbed impact energy (200 MPa and 97 kJ/m2) were higher for hybrid composites, and quick elastic recoveries were experienced in hybrid composites after impact. Plain woven reinforced hybridization had about 25% and 5% lower tensile and flexural characteristics respectively, as more interlocking zones of warp and weft yarns reduced strength. However, these interlocking zones positively contributed to impact performance by 11.5% higher energy absorption.
Effectiveness in Preventing Hearing Loss: Meta-Analysis of Dietary Consumption Studies
Authors: Gonçalves Laura Faustino , Mary de Paiva Karina , Machado Marcos José , Samelli Alessandra Giannella , Haas Patrícia
Published: February 2024

Objective: The systematic review with meta-analysis aimed to verify the occurrence of a protective effect on hearing loss due to a higher intake of carotenoids, vitamins A, C, E, and folate present in diets. Methods: The search for scientific articles was carried out by 2 independent researchers in electronic databases. Meta-analysis was performed by constructing summary risk measures for each vitamin or antioxidant, combining the risk ratios or adjusted odds ratios (OR) for the various variables observed in the highest categories of vitamin or antioxidant consumption. Results: Five studies involving an estimated 100 549 participants were included in the quantitative synthesis. The summary measures calculated for the highest quartiles/quintiles of the studies were Hazard ratios (HR) .990 for vitamin C; HR 1.07 and OR .925 for vitamin E; HR .921 for folate and OR .906 for vitamin A. Conclusion: Dietary intake of vitamins and antioxidants was inversely associated with the risk of developing hearing loss. Individuals with a higher intake of antioxidants may have better hearing thresholds, especially with the intake of β-carotene.
Citizen empowerment as a police force multiplier: Reproducing social domination through a 21st century personal safety app
Authors: Turner Justin , Milburn Travis
Published: February 2024

Citizen is a digital mapping platform and personal safety app that boasts over 10 million users in the United States. Through the platform, users can report crimes, map safe routes, or rely on the app’s other functions to protect themselves from dangerous situations. Sold on a promise of empowerment, Citizen markets itself as a 21st century technology capable of repairing the ills of our social world. In this article we analyze how Citizen taps into the desire for control and safety and urges its users to actively protect their own communities. As such, we suggest that while surveillant in nature, Citizen revolves around the force inherent to police power, transforming its users via police power by first integrating them into their social platform. Ultimately, Citizen reminds us that police power is not limited to ideological or violent exchanges, but can be a compelling solution to community problems. Rather than a progressive fix to the issues between policing and communities, however, we find that Citizen offers an expansion of police power at the individual scale, reproducing social domination both at the level of capital and the state.
The Colors of the Populist Radical Right: The Strategic Use of Hue and Saturation in Party Logos
Authors: Curini Luigi , Moffitt Benjamin , Zulianello Mattia
Published: February 2024

Populist radical right (PRR) parties tend to stress their differences from other parties. Yet at the same time, PRR parties have increasingly sought to integrate into party systems across the globe. In seeking to understand the way that PRR parties negotiate this paradoxical situation, the literature tends to focus on their policy offerings or discourse. We, on the contrary, investigate an underestimated aspect of their political communication: their visuals. Namely, we focus on the question of if and how PRR parties communicate their similarities or differences from other parties via the color profiles of their logos, given that color is a key way that political parties can signal (a) their ideological commitments (via hue) and (b) their approach to “valence” considerations (via saturation). We expect PRR parties’ attempts to signal their integration into party systems to be mainly sought via saturation, as a proxy for valence perceptions related to parties’ seriousness and competence, while we expect them to signal their difference from other parties via hue, given the incentive for PRR parties to communicate their ideological distance from non-populist parties as a marker of distinctiveness in the political market. We test our research questions by analyzing parties’ logos across 35 democracies in recent elections. Results largely confirm our expectations, demonstrating the utility of focusing on the visual aspects of PRR parties’ political communication. Interestingly, the results do not replicate if we focus on populist parties beyond the PRR party family.
Influence of fibre orientation parallel to impact direction on the impact response of unidirectional glass/epoxy composite: Experimental investigation on confinement and hybridisation
Authors: Ramagiri Bhaskar , Yerramalli Chandra Sekher , Das Nabodyuti
Published: February 2024

In a high-velocity impact phenomenon, the damage is localised, and for thick composite laminates, most of the projectile’s kinetic energy is absorbed through out-of-plane compression and shear mechanisms. In conventional composite laminate, as the fibre orientations are in the in-plane of laminate, the out-of-plane compression and out-of-plane shear of laminate are utilised. In composites, the out-of-plane compressive strength is significantly lower than the in-plane (fibre direction) strength. The present study investigates the impact response of unidirectional (UD) glass/epoxy composite targets with fibres oriented parallel to the impact direction. The lack of research on the impact behaviour of unidirectional glass/epoxy composites with fibre orientation parallel to the impact direction demands further experimentation and understanding of failure mechanisms. In this study, firstly, the impact response of UD glass/epoxy composites with fibres oriented parallel to the impact direction (GFID) was investigated and compared with conventional cross-ply (GFCP) and quasi-isotropic (GFQI) glass/epoxy laminates. Secondly, to address the issues of GFID splitting on impact, GFID was confined in both the hoop and normal-to-binder directions. Thirdly, the impact response of various hybrid GFID with and without confinement with GFCP as backing was evaluated. GFID under out-of-plane punch load fails by splitting, and its compressive participation depends on the impact velocity. GFID under the hoop and normal-to-binder direction confinement showed better specific impact energy absorption relative to pure GFID. The experimental results show that GFID wounds with carbon fibre used as a facing with GFCP as a backing provide better impact resistance at HVI conditions than conventional laminates of the same thickness. These findings suggest that the combination of GFID and GFCP targets can be used to have better impact resistance in various applications.
The Mental Health of Essential Workers During the COVID-19 Pandemic: The Role of U.S. State-Level Policies
Authors: Donnelly Rachel , Schoenbachler Adam K.
Published: February 2024

Emerging research documents concerning mental health outcomes among essential workers at the start of the COVID-19 pandemic. However, mental health outcomes may have varied across states in the United States, as state-level policies differed. Questions also remain about the mental health of workers during the second year of the pandemic. Using nationally representative data from the U.S. Household Pulse Survey (April–July 2021), we documented the mental health of essential workers and tested whether state-level policies (e.g., mask mandates) reduced mental health disparities for essential workers. Results show that food and beverage essential workers experienced heightened anxiety and depression relative to nonessential workers. Moreover, for food and beverage workers, disparities in mental health were smaller in states with mask mandates, expanded paid leave, and higher minimum wage compared to states without these policies. The present study points to the potential for state-level policies to protect the mental health of essential workers.
A Corpus-Based Study of Metaphor of Modalization in English Academic Writing
Authors: Chen Chunmei , He Qingshun
Published: February 2024

Metaphor of modality in the Hallidayan linguistic framework is manifested through a transition from implicit modal expressions to explicit modal expressions, encompassing metaphor of modalization and metaphor of modulation. This article conducts a corpus-based investigation to examine the prevalence of metaphors of modalization in English academic writing. The study, which relies on data from the British National Corpus (BNC), reveals that modal expressions are more frequently used in less technical texts (i.e., in spoken texts rather than in written texts with regard to mode, in fiction texts rather than in academic texts with regard to genre, and in hard science texts rather than in soft science texts with regard to discipline). Furthermore, explicit subjective and explicit objective modal expressions exhibit opposite distribution patterns across modes, genres, and academic disciplines. Based on this general distribution pattern, this study then examines three distinct groups of PhD dissertations. It becomes evident that Chinese English as a Foreign Language (EFL) writers employ significantly fewer subjective projecting clauses compared to proficient native English writers in their academic writing. This difference arises from the rigorous training Chinese EFL learners receive, emphasizing the avoidance of authorial identity in academic writing. This study hereby concludes that while English academic writing may be becoming less formal, author involvement should not be encouraged in relatively more technical academic texts.
The elephant in the room in greenhouse gases emissions: rethinking healthcare systems to face climate change. A rapid scoping review
Authors: Cristiano Walter , De Marchi Chiara , di Domenico Kevin , Punzo Ornella , Mancini Aurora , Mancini Laura
Published: February 2024

Healthcare systems (HSs) provide essential services to populations yet require a large amount of energy to perform duties and tasks. Specifically, 4.4% of global net carbon emissions can be attributed precisely to the activities of HSs. Therefore, it seems unlikely that the targets of zero carbon dioxide (CO2) emissions by 2050, set by the Paris Agreement, will be met without rethinking the role and impact of HSs towards climate change. Here we summarize the available literature on CO2 emissions depending on direct and indirect Hss activities. We show that the number of studies addressing this topic is still very limited and that most of the emissions derive from the supply chain HSs rely on to perform their tasks. Furthermore, we highlight how this topic is addressed unevenly among countries. Indeed, we found that less economically developed countries are less represented in the literature on this topic and that, even in economically developed countries, most of the studies come from English-speaking countries. In the discussion, we stress that health workers and policymakers should pay more attention to this issue in order to tackle climate change and related health issues, following the example of few virtuous countries. Finally, some potential impact mitigation strategies are discussed.
CTC together with Shh and Nrf2 are prospective diagnostic markers for HNSCC
Authors: Rahman Md. Mizanur , Hossain Muhammad Mosaraf , Islam Shafiqul , Ahmed Ridwan , Majumder Mohit , Dey Shantu , Kawser Md. , Sarkar Bishu , Himu Md. Ejajur Rahman , Chowdhury Ali Asgar , Ahmed Shakera , Biswas Supran , Anwar Mostafa Mahfuzul , Hussain Mohammad Jamal , Kumar Shil Rajib , Baidya Sunanda , Parial Ramendu , Islam Mohammed Moinul , Bharde Atul , Jayant Sreeja , Aland Gourishankar , Khandare Jayant , Uddin Shaikh Bokhtear , Noman Abu Shadat Mohammod
Published: February 2024

Background

The lack of appropriate prognostic biomarkers remains a significant obstacle in the early detection of Head and Neck Squamous Cell Carcinoma (HNSCC), a cancer type with a high mortality rate. Despite considerable advancements in treatment, the success in diagnosing HNSCC at an early stage still needs to be improved. Nuclear factor erythroid 2-related factor 2 (Nrf2) and Sonic Hedgehog (Shh) are overexpressed in various cancers, including HNSCC, and have recently been proposed as possible therapeutic targets for HNSCC. Circulating Tumor Cell (CTC) is a novel concept used for the early detection of cancers, and studies have suggested that a higher CTC count is associated with the aggressiveness of HNSCC and poor survival rates. Therefore, we aimed to establish molecular markers for the early diagnosis of HNSCC considering Shh/Nrf2 overexpression in the background. In addition, the relation between Shh/Nrf2 and CTCs is still unexplored in HNSCC patients.

Methods

In the present study, we selected a cohort of 151 HNSCC patients and categorized them as CTC positive or negative based on the presence or absence of CTCs in their peripheral blood. Data on demographic and clinicopathological features with the survival of the patients were analyzed to select the patient cohort to study Shh/Nrf2 expression. Shh and Nrf2 expression was measured by qRT-PCR.

Results

Considering significant demographic [smoking, betel leaf (p-value < 0.0001)] and clinicopathological risk factors [RBC count (p < 0.05), Platelet count (p < 0.05), Neutrophil count (p < 0.005), MCV (p < 0.0001), NLR (p < 0.05), MLR (p < 0.05)], patients who tested positive for CTC also exhibited significant overexpression of Shh/Nrf2 in both blood and tissue compared to CTC-negative patients. A strong association exists between CTCs and tumor grade. Following chemotherapy (a combination of Cisplatin, 5FU, and Paclitaxel), the frequency of CTCs was significantly decreased in patients with HNSCC who had tested positive for CTCs. The Kaplan–Meier plot illustrated that a higher number of CTCs is associated with poorer overall survival (OS) in patients with HNSCC.

Conclusions

Detecting CTCs, and higher expression of Shh and Nrf2 in HNSCC patients’ blood, can be a promising tool for diagnosing and prognosticating HNSCC.
Metabolic acidemia due to saline absorption during transurethral and transcervical surgery: a report of 2 cases
Authors: Nakamura Mizuyuki , Ikeda Kohei , Uezono Shoichi
Published: February 2024

Background

The development of endoscopic systems that include bipolar electrocautery has enabled the use of normal saline irrigation in transurethral or transcervical endoscopic surgery. However, excessive saline absorption can cause hyperchloremic metabolic acidosis.

Case presentation

Patient 1: A 76-year-old man was scheduled for transurethral resection of the prostate with saline irrigation. Approximately 140 min after the surgery, abdominal distension and cervical edema were observed. Abdominal ultrasound examination indicated a subhepatic hypoechoic lesion, which suggested extravasation of saline. Arterial blood gas analysis revealed hyperchloremic metabolic acidosis. The patient was extubated 2 h after the operation with no subsequent airway problems, and the electrolyte imbalance was gradually corrected. Patient 2: A 43-year-old woman was scheduled for transcervical resection of a uterine fibroid with saline irrigation. When the drape was removed after the operation was finished, notable upper extremity edema was observed. Arterial blood gas analysis revealed hyperchloremic metabolic acidosis. The patient’s acidemia, electrolyte imbalance, and neck edema gradually resolved, and the patient was extubated 16 h after the operation without subsequent airway problems.

Conclusions

Anesthesiologists should be aware of acidemia, cardiopulmonary complications, and airway obstruction caused by excessive saline absorption after saline irrigation in endoscopic surgery.
Feasibility study of Syngo iFlow in predicting hemodynamic improvement post-endovascular procedure in peripheral artery disease
Authors: Tang Ming , Zeng Fanyi , Chang Xindong , He Mingfei , Fang Qingqing , Xue Lele , Luo Xinyi , Yin Shiwu
Published: February 2024

Objective

This study endeavors to examine the feasibility of predicting the clinical outcomes of patients suffering from peripheral artery disease (PAD) who undergo endovascular intervention, by employing the Syngo iFlow technology.

Methods

Retrospectively enrolling 76 patients from December 2021 to May 2023, yielding a total of 77 affected limbs, this study employs clinical outcomes (improvement or otherwise) as the gold standard. Two physicians conducted visual assessments on both DSA and iFlow images to gauge patient improvement and assessed inter-observer consistency for each image modality. The Time to Peak (TTP) of regions of interest (ROI) at the femoral head, knee joint, and ankle joint was measured. Differences in pre- and post-procedure TTP were juxtaposed, and statistically significant parameter cutoff values were identified via ROC analysis. Employing these cutoffs for TTP classification, multivariate logistic regression and the C-statistic were utilized to assess the predictive value of distinct parameters for clinical success.

Results

Endovascular procedure exhibited technical and clinical success rates of 82.58 and 75.32%, respectively. Diagnostic performance of iFlow image visual assessment surpassed that of DSA images. Inter-observer agreement for iFlow and DSA image evaluations was equivalent (κ = 0.48 vs 0.50). Post-classification using cutoff values, multivariate logistic regression demonstrated the statistical significance of ankle joint TTP in post-procedure iFlow images of the endovascular procedure for clinical success evaluation (OR 7.21; 95% CI 1.68, 35.21; P = 0.010), with a C-statistic of 0.612.

Conclusion

Syngo iFlow color-encoded imagery holds practical value in assessing the technical success of post-endovascular procedures, offering comprehensive lower limb arterial perfusion visualization. Its quantifiable parameters exhibit promising potential for prognosticating clinical success.
Brain activation during standing balance control in dual-task paradigm and its correlation among older adults with mild cognitive impairment: a fNIRS study
Authors: Xu Guocai , Zhou Mian , Chen Yan , Song Qipeng , Sun Wei , Wang Jiangna
Published: February 2024

Background

This study aimed to compare the balance ability and functional brain oxygenation in the prefrontal cortex (PFC) among older adults with mild cognitive impairment (MCI) under single and dual tasks, and also investigate their relationship. Neural regulatory mechanisms of the brain in the MCI were shed light on in balance control conditions.

Methods

21 older adults with MCI (female = 12, age: 71.19 ± 3.36 years) were recruited as the experimental group and 19 healthy older adults (female = 9, age: 70.16 ± 4.54 years) as the control group. Participants completed balance control of single task and dual task respectively. Functional near-infrared spectroscopy (fNIRS) and force measuring platform are used to collect hemodynamic signals of the PFC and center of pressure (COP) data during the balance task, respectively.

Results

The significant Group*Task interaction effect was found in maximal displacement of the COP in the medial-lateral (ML) direction (D-ml), 95% confidence ellipse area (95%AREA), root mean square (RMS), the RMS in the ML direction (RMS-ml), the RMS in the anterior-posterior (AP) direction (RMS-ap), sway path (SP), the sway path in the ML direction (SP-ml), and the sway path in the AP direction (SP-ap). The significant group effect was detected for five regions of interest (ROI), namely the left Brodmann area (BA) 45 (L45), the right BA45 (R45), the right BA10 (R10), the left BA46 (L46), and the right BA11 (R11). Under single task, maximal displacement of the COP in the AP direction (D-ap), RMS, and RMS-ap were significantly negatively correlated with R45, L45, and R11 respectively. Under dual task, both RMS and 95%AREA were correlated positively with L45, and both L10 and R10 were positively correlated with RMS-ap.

Conclusion

The MCI demonstrated worse balance control ability as compared to healthy older adults. The greater activation of PFC under dual tasks in MCI may be considered a compensatory strategy for maintaining the standing balance. The brain activation was negatively correlated with balance ability under single task, and positively under dual task.

Trial registration

ChiCTR2100044221, 12/03/2021.
Cognitive function and quantitative electroencephalogram analysis in subjects recovered from COVID-19 infection
Authors: Gaber Manal M. , Hosny Hanan , Hussein Mona , Ashmawy Mona A. , Magdy Rehab
Published: February 2024

Background & Objectives

Objective assessment of post-COVID-19 cognitive dysfunction is highly warranted. This study aimed to evaluate the cognitive dysfunction of COVID-19 survivors with cognitive complaints, both clinically and neurophysiologically, using Quantitative Electroencephalogram (QEEG).

Methods

This case–control study was conducted on 50 recovered subjects from COVID-19 infection with cognitive complaints and 50 age, sex, and educational-matched healthy controls. Both groups were subjected to the following neurocognitive tests: Paired associate learning Test (PALT) and Paced Auditory Serial Addition Test (PASAT). The neurophysiological assessment was also done for both groups using QEEG.

Results

COVID-19 survivors had significantly lower PALT scores than controls (P < 0.001). QEEG analysis found significantly higher levels of Theta / Beta ratio in both central and parietal areas in patients than in the controls (P < 0.001 for each). The interhemispheric coherence for the frontal, central, and parietal regions was also significantly lower in patients than in the control group regarding alpha and beta bands. There were statistically significant lower scores of PALT and PASAT among cases with severe COVID-19 infection (P = 0.011, 0.005, respectively) and those who needed oxygen support (P = 0.04, 0.01, respectively). On the other hand, a statistically significantly lower mean of frontal alpha inter-hemispheric coherence among patients with severe COVID-19 infection (P = 0.01) and those needing mechanical ventilation support (P = 0.04).

Conclusion

Episodic memory deficit is evident in COVID-19 survivors with subjective cognitive complaints accompanied by lower inter-hemispheric coherence in frontal regions. These clinical and neurophysiological changes are associated with hypoxia and COVID-19 severity.
Systematic review of the patient burden of generalised myasthenia gravis in Europe, the Middle East, and Africa
Authors: McCallion J , Borsi A , Noel W , Lee J , Karmous W , Sattler S , Boggia GM , Hardy EJ , Mitchell CR , Mitchell SA , Gilhus Nils Erik
Published: February 2024

Background

Myasthenia gravis (MG) is a rare autoimmune disease characterised by muscle weakness, and progression from ocular (oMG) to generalised (gMG) symptoms results in a substantial negative impact on quality of life (QoL). This systematic review aimed to provide an overview of the patient burden experienced by people living with gMG.

Methods

Electronic database searches (conducted March 2022), supplemented by interrogation of grey literature, were conducted to identify studies reporting patient burden outcomes in patients with gMG in Europe, the Middle East and Africa. Results were synthesised narratively due to the heterogeneity across trials.

Results

In total, 39 patient burden publications (representing 38 unique studies) were identified as relevant for inclusion in the systematic review, consisting of 37 publications reporting formal patient-reported outcome measures (PROMs), and two publications describing alternative qualitative assessments of patient experience. The studies included a variety of measures including generic and disease-specific PROMs, as well as symptom-specific PROMs focusing on key comorbidities including depression, anxiety, fatigue and sleep disturbance. The findings showed some variation across studies and PROMs; however, in general there was evidence for worse QoL in patients with gMG than in healthy controls or in patients with oMG, and a trend for worsening QoL with increasing MG severity.

Conclusions

This review highlights the importance of considering patient QoL when developing and assessing treatment and management plans for patients with gMG. However, the heterogeneity identified across studies illustrates the need for further representative and well-powered studies in large cohorts administering consistent, validated questionnaires.

Trial registration

The protocol for this systematic review was registered in PROSPERO: CRD42022328444.
Spontaneous regression of a giant uterine leiomyoma after delivery: a case report and literature review
Authors: Zhu-ge Lifang , Bei Qiaoli , Pan Weiping , Ni Xiaojun
Published: February 2024

Background

Uterine leiomyomas are hormone-dependent benign tumors and often begin to shrink after menopause due to the reduction in ovarian steroids. The influence of pregnancy on uterine leiomyomas size remains unclear. Here, we present a case of spontaneous regression of a giant uterine leiomyoma after delivery.

Case presentation

A 40-year-old woman presented with multiple uterine leiomyomas, one of which is a giant uterine leiomyomas (approximately 8 cm in diameter) that gradually shrinked after delivery. At over two months postpartum, the large myometrial leiomyoma had transformed into a submucosal leiomyoma, and over 3 years postpartum, both the submucosal leiomyoma and multiple intramural leiomyomas completely regressed.

Conclusion

Spontaneous regression of a giant uterine leiomyom is rare after delivery. Considering uterine leiomyoma regression until over 3 year postpartum,we need to observe the regression of uterine fibroid for a longer time postpartum in the absence of fibroid related complications. In addition, it will provide new insights for treatment options of uterine leiomyomas in the future.
The association of TMPRSS6 gene polymorphism with iron status in Egyptian children (a pilot study)
Authors: Hamed Hanan M. , Bostany Eman El , Motawie Ayat A. , Abd Al-Aziz Amany M. , Mourad Abbass A. , Salama Hassan M. , Kamel Solaf , Hassan Eman M. , Helmy Neveen A. , El-saeed Gamila S. , Elghoroury Eman A.
Published: February 2024

Several studies have shown association of single nucleotide polymorphisms (SNPs) of hepcidin regulatory pathways genes with impaired iron status. The most common is in the TMPRSS6 gene. In Africa, very few studies have been reported. We aimed to investigate the correlation between the common SNPs in the transmembrane protease, serine 6 (TMPRSS6) gene and iron indicators in a sample of Egyptian children for identifying the suitable candidate for iron supplementation.

Patients and methods One hundred and sixty children aged 5–13 years were included & classified into iron deficient, iron deficient anemia and normal healthy controls. All were subjected to assessment of serum iron, serum ferritin, total iron binding capacity, complete blood count, reticulocyte count, serum soluble transferrin receptor and serum hepcidin. Molecular study of TMPRSS6 genotyping polymorphisms (rs4820268, rs855791 and rs11704654) were also evaluated.

Results There was an association of iron deficiency with AG of rs855791 SNP, (P = 0.01). The minor allele frequency for included children were 0.43, 0.45 & 0.17 for rs4820268, rs855791 & rs11704654 respectively. Genotype GG of rs4820268 expressed the highest hepcidin gene expression fold, the lowest serum ferroportin & iron store compared to AA and AG genotypes (p = 0.05, p = 0.05, p = 0.03 respectively). GG of rs855791 had lower serum ferritin than AA (p = 0.04), lowest iron store & highest serum hepcidin compared to AA and AG genotypes (p = 0.04, p = 0.01 respectively). Children having CC of rs11704654 had lower level of hemoglobin, serum ferritin and serum hepcidin compared with CT genotype (p = 0.01, p = 0.01, p = 0.02) respectively.

Conclusion Possible contribution of SNPs (rs855791, rs4820268 and rs11704654) to low iron status.
Age- and cause-specific contributions to increase in life expectancy at birth in Korea, 2000–2019: a descriptive study
Authors: Kim Ikhan , Bae Hyeona
Published: February 2024

Background

Korea’s life expectancy at birth has consistently increased in the 21st century. This study compared the age and cause-specific contribution to the increase in life expectancy at birth in Korea before and after 2010.

Methods

The population and death numbers by year, sex, 5-year age group, and cause of death from 2000 to 2019 were acquired. Life expectancy at birth was calculated using an abridged life table by sex and year. The annual age-standardized and age-specific mortality by cause of death was also estimated. Lastly, the age and cause-specific contribution to the increase in life expectancy at birth in the two periods were compared using a stepwise replacement algorithm.

Results

Life expectancy at birth in Korea increased consistently from 2010 to 2019, though slightly slower than from 2000 to 2009. The cause-specific mortality and life expectancy decomposition analysis showed a significant decrease in mortality in chronic diseases, such as neoplasms and diseases of the circulatory system, in the middle and old-aged groups. External causes, such as transport injuries and suicide, mortality in younger age groups also increased life expectancy. However, mortality from diseases of the respiratory system increased in the very old age group during 2010–2019.

Conclusions

Life expectancy at birth in Korea continued to increase mainly due to decreased mortality from chronic diseases and external causes during the study period. However, the aging of the population structure increased vulnerability to respiratory diseases. The factors behind the higher death rate from respiratory disease should be studied in the future.
Higher sclerostin is associated with pulmonary hypertension in pre-dialysis end-stage kidney disease patients: a cross-sectional prospective observational cohort study
Authors: Lee Jonghyun , Cho Dong-Hyuk , Min Hyeon-Jin , Son Young-Bin , Kim Tae Bum , Oh Se Won , Kim Myung-Gyu , Cho Won Yong , Jo Sang-Kyung , Yang Jihyun
Published: February 2024

Background

Pulmonary hypertension (PH) is a complication of chronic kidney disease (CKD) that contributes to mortality. Sclerostin, a SOST gene product that reduces osteoblastic bone formation by inhibiting Wnt/β-catenin signaling, is involved in arterial stiffness and CKD-bone mineral disease, but scanty evidence to PH. This study explored the relationship between sclerostin and PH in CKD 5, pre-dialysis end-stage kidney disease (ESKD) patients.

Methods

This cross-sectional prospective observational cohort study included 44 pre-dialysis ESKD patients between May 2011 and May 2015. Circulating sclerostin levels were measured using an enzyme-linked immunosorbent assay. PH was defined as an estimated pulmonary artery systolic pressure > 35 mmHg on echocardiography.

Results

Patients with higher sclerostin levels ≥ 218.18pmol/L had echocardiographic structural cardiac abnormalities, especially PH (P < 0.01). On multivariate logistic analysis, sclerostin over 218.19pmol/L was significantly associated with PH (odds ratio [OR], 41.14; 95% confidence interval [CI], 4.53-373.89, P < 0.01), but multivariate Cox regression analysis showed the systemic vascular calcification score over 1 point (Hazard ratio [HR] 11.49 95% CI 2.48–53.14, P = 0.002) and PH ([HR] 5.47, 95% CI 1.30-23.06, P = 0.02) were risk factors for all-cause mortality in pre-dialysis ESKD patients.

Conclusions

Serum sclerostin and PH have a positive correlation in predialysis ESKD patients. The higher systemic vascular calcification score and PH have an association to increase all-cause mortality in pre-dialysis ESKD patients.