bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of staged lateral lumbar interbody fusion combined two-stage posterior screw fixation and two osteotomy strategies for adult degeneration scoliosis: a retrospective comparative study
Authors: Xu Dingli , Gan Kaifeng , Zhao Xuchen , Lian Leidong , Hu Xudong , Luo Ni , Ma Weihu
Published: May 2023

Aims

The commonly used treatments of adult degeneration scoliosis (ADS) were posterior long segment screw fixation with osteotomies. Recently, lateral lumbar intervertebral fusion combined two-stage posterior screw fixation (LLIF + PSF) as a new strategy without osteotomy. Herein, this study aimed to compare the clinical and radiological outcomes among LLIF + PSF and pedicle subtraction osteotomy (PSO), posterior column osteotomies (PCO).

Methods

Totals of 139 ADS patients underwent operation with 2 years longer follow-up visit between January 2013 and January 2018 in Ningbo No.6 Hospital were enrolled into this study. 58 patients were included in PSO group, 45 in PCO group and 36 in LLIF + PSF group, The clinical and radiological data were reviewed from medical records. Baseline characteristic, perioperative radiological data (sagittal vertical axis (SVA), coronal balance (CB), Cobb angle of Mian curve (MC), Lumbar lordosis (LL), pelvic tilt (PT) and pelvic incidence-lumbar lordosis mismatch (PI-LL)), clinical outcomes (VAS of back and leg, Oswestry disability index (ODI) and Scoliosis Research Society 22-question Questionnaire (SRS-22)) and complications were evaluated and compared.

Result

There were no significantly difference in baseline characteristics, preoperative radiological parameters and clinical outcomes among three groups. LLIF + PSF group was significantly shorter in operation time than other two groups (P < 0.05), whereas significant longer hospital stay was observed in LLIF + PSF group (P < 0.05). As for radiological parameters, LLIF + PSF group had significantly improvement in SVA, CB, MC, LL and PI-LL (P < 0.05). Moreover, LLIF + PSF group achieved significantly less correction loss in SVA, CB and PT than PSO and PCO group (1.5 ± 0.7 VS 2.0 ± 0.9 VS 2.2 ± 0.8, P < 0.05; 1.0 ± 0.4 VS 1.3 ± 0.5 VS 1.1 ± 0.7, P < 0.05 and 4.2 ± 2.8 VS 7.2 ± 3.1 VS 6.0 ± 2.8, P < 0.05). Significantly recovery in VAS of back and leg, ODI score and SRS-22 were found among all groups, however, LLIF + PSF shown significant better clinical therapy maintain at follow-up visit than other two groups (P < 0.05). There were no significantly difference in complications among groups (P = 0.66).

Conclusion

Lateral lumbar interbody fusion combined two-stage posterior screw fixation (LLIF + PSF) can achieve comparable clinical therapy for adult degeneration scoliosis as osteotomy strategies. However, furthermore more studies need be taken for verifying the effect of LLIF + PSF in the future.
Association of high kinesiophobia and pain catastrophizing with quality of life in severe hip osteoarthritis: a cross-sectional study
Authors: Hidaka Ryo , Tanaka Takeyuki , Hashikura Kazuaki , Oka Hiroyuki , Matsudaira Ko , Moro Toru , Matsuda Kenta , Kawano Hirotaka , Tanaka Sakae
Published: May 2023

Background

While fear of movement is an important predictor of pain and disability in osteoarthritis (OA), its impact on patients with hip OA remains uncertain. This study aimed to determine whether fear of movement, evaluated by the Tampa Scale for Kinesiophobia (TSK)-11, and pain catastrophizing, evaluated by the Pain Catastrophizing Scale (PCS), were associated with quality of life (QOL) in patients with hip OA.

Methods

This cross-sectional study was conducted between November 2017 and December 2018. Ninety-one consecutively enrolled patients with severe hip OA were scheduled for primary unilateral total hip arthroplasty. The EuroQOL-5 Dimensions questionnaire was used to measure general QOL. The Japanese Orthopedic Association Hip Disease Evaluation Questionnaire was used to assess disease-specific QOL. The covariates included age, sex, body mass index (BMI), pain intensity, high pain catastrophizing (PCS ≥ 30), and high kinesiophobia (TSK-11 ≥ 25). Variables were subjected to multivariate analysis using each QOL scale.

Results

In multiple regression analysis, pain intensity, high pain catastrophizing, and BMI were independently correlated with the disease-specific QOL scale. High pain catastrophizing, pain intensity, and high kinesiophobia were independently correlated with the general QOL scale.

Conclusions

High pain catastrophizing (PCS ≥ 30) was independently associated with disease and general QOL scales. High kinesiophobia (TSK-11 ≥ 25) was independently associated with the general QOL scale in preoperative patients with severe hip OA.
A meta-analysis of risk factors for non-superficial surgical site infection following spinal surgery
Authors: Liu Xiaowen , Hou Yang , Shi Hongyang , Zhao Tianyi , Shi Haoyang , Shi Jiangang , Shi Guodong
Published: May 2023

Background

Surgical site infection (SSI) is the most common complications in spinal surgery. In SSI, non-superficial surgical site infections are more likely to result in poor clinical outcomes. It has been reported that there are multiple factors contributing to postoperative non-superficial SSI, but still remains controversial. Therefore, the aim of this meta-analysis is to investigate the potential risk factors for non-superficial SSI following spinal surgery.

Methods

A systematic database search of PubMed, Embase, Web of Science, Cochrane Library and Clinical Trials was performed for relevant articles published until September 2022. According to the inclusion and exclusion criteria, two evaluators independently conducted literature screening, data extraction and quality evaluation of the obtained literature. The Newcastle–Ottawa Scale (NOS) score was used for quality evaluation, and meta-analysis was performed by STATA 14.0 software.

Results

A total of 3660 relevant articles were initially identified and 11 articles were finally included in this study for data extraction and meta-analysis. The results of meta-analysis showed that the diabetes mellitus, obesity, using steroids, drainage time and operative time were related to the non-superficial SSI. The OR values (95%CI) of these five factors were 1.527 (1.196, 1.949); 1.314 (1.128, 1.532); 1.687(1.317, 2.162); 1.531(1.313, 1.786) and 4.255(2.612, 6.932) respectively.

Conclusions

Diabetes mellitus, obesity, using steroids, drainage time and operative time are the current risk factors for non-superficial SSI following spinal surgery. In this study, operative time is the most important risk factor resulting in postoperative SSI.
Health consequences of exposure to aircraft contaminated air and fume events: a narrative review and medical protocol for the investigation of exposed aircrew and passengers
Authors: Burdon Jonathan , Budnik Lygia Therese , Baur Xaver , Hageman Gerard , Howard C. Vyvyan , Roig Jordi , Coxon Leonie , Furlong Clement E. , Gee David , Loraine Tristan , Terry Alvin V. , Midavaine John , Petersen Hannes , Bron Denis , Soskolne Colin L. , Michaelis Susan
Published: May 2023

Thermally degraded engine oil and hydraulic fluid fumes contaminating aircraft cabin air conditioning systems have been well documented since the 1950s. Whilst organophosphates have been the main subject of interest, oil and hydraulic fumes in the air supply also contain ultrafine particles, numerous volatile organic hydrocarbons and thermally degraded products. We review the literature on the effects of fume events on aircrew health. Inhalation of these potentially toxic fumes is increasingly recognised to cause acute and long-term neurological, respiratory, cardiological and other symptoms. Cumulative exposure to regular small doses of toxic fumes is potentially damaging to health and may be exacerbated by a single higher-level exposure. Assessment is complex because of the limitations of considering the toxicity of individual substances in complex heated mixtures.

There is a need for a systematic and consistent approach to diagnosis and treatment of persons who have been exposed to toxic fumes in aircraft cabins. The medical protocol presented in this paper has been written by internationally recognised experts and presents a consensus approach to the recognition, investigation and management of persons suffering from the toxic effects of inhaling thermally degraded engine oil and other fluids contaminating the air conditioning systems in aircraft, and includes actions and investigations for in-flight, immediately post-flight and late subsequent follow up.
The application of enhanced recovery after surgery in total gastrectomy: a propensity score-matched analysis
Authors: Yoshikawa Kozo , Shimada Mitsuo , Tokunaga Takuya , Nakao Toshihiro , Nishi Masaaki , Takasu Chie , Kashihara Hideya , Wada Yuma , Yoshimoto Toshiaki
Published: May 2023

Background

This study aimed to investigate the feasibility and safety of our enhanced recovery after surgery protocol including early oral intake and omitting nasogastric tube (NGT) placement after total gastrectomy.

Methods

We analyzed 182 consecutive patients who underwent total gastrectomy. The clinical pathway was changed in 2015, and patients were divided into 2 groups (conventional group and modified group). Postoperative complications, bowel movement, and postoperative hospital stays were compared in the two groups in all cases and propensity score matching (PSM).

Results

Flatus and defecation were significantly earlier in the modified group compared with those in the conventional group (flatus: 2 (1–5) days vs 3 (2–12) days, p = 0.03; defecation: 4 (1–14) days vs 6 (2–12) days p = 0.04). The postoperative hospital stay was 18 (6–90) days in the conventional group and 14 (7–74) days in the modified group (p = 0.009). Days until discharge criteria were met were earlier in the modified group compared with that in the conventional group (10 (7–69) days vs 14 (6–84) days p = 0.01). Overall and severe complications occurred in nine patients (12.6%) and three patients (4.2%) in the conventional group and twelve patients (10.8%) and four patients (3.6%) in the modified group, respectively (p = 0.70 and p = 0.83) in all cases. In PSM, there is no significant difference between the two groups concerning the postoperative complications (overall complication 6 (12.5%) vs 8 (16.7%) p = 0.56, severe complications 1 (2%) vs 2 (4.2%) p = 0.83).

Conclusions

Modified ERAS for total gastrectomy may be feasible and safe.
Quantitative assessment of plantar pressure patterns in relation to foot deformities in people with hereditary motor and sensory neuropathies
Authors: Bloks Bente E. , Wilders Lise M. , Louwerens Jan Willem K. , Geurts Alexander C. , Nonnekes Jorik , Keijsers Noël L.W.
Published: May 2023

Background

Hereditary motor and sensory neuropathies (HMSN), also known as Charcot-Marie-Tooth disease, are characterized by affected peripheral nerves. This often results in foot deformities that can be classified into four categories: (1) plantar flexed first metatarsal, neutral hindfoot, (2) plantar flexed first metatarsal, correctable hindfoot varus, (3) plantar flexed first metatarsal, uncorrectable hindfoot varus, and (4) hindfoot valgus. To improve management and for the evaluation of surgical interventions, a quantitative evaluation of foot function is required. The first aim of this study was to provide insight into plantar pressure of people with HMSN in relation to foot deformities. The second aim was to propose a quantitative outcome measure for the evaluation of surgical interventions based on plantar pressure.

Methods

In this historic cohort study, plantar pressure measurements of 52 people with HMSN and 586 healthy controls were evaluated. In addition to the evaluation of complete plantar pressure patterns, root mean square deviations (RMSD) of plantar pressure patterns from the mean plantar pressure pattern of healthy controls were calculated as a measure of abnormality. Furthermore, center of pressure trajectories were calculated to investigate temporal characteristics. Additionally, plantar pressure ratios of the lateral foot, toes, first metatarsal head, second/third metatarsal heads, fifth metatarsal head, and midfoot were calculated to measure overloading of foot areas.

Results

Larger RMSD values were found for all foot deformity categories compared to healthy controls (p < 0.001). Evaluation of the complete plantar pressure patterns revealed differences in plantar pressure between people with HMSN and healthy controls underneath the rearfoot, lateral foot, and second/third metatarsal heads. Center of pressure trajectories differed between people with HMSN and healthy controls in the medio-lateral and anterior-posterior direction. The plantar pressure ratios, and especially the fifth metatarsal head pressure ratio, differed between healthy controls and people with HMSN (p < 0.05) and between the four foot deformity categories (p < 0.05).

Conclusions

Spatially and temporally distinct plantar pressure patterns were found for the four foot deformity categories in people with HMSN. We suggest to consider the RMSD in combination with the fifth metatarsal head pressure ratio as outcome measures for the evaluation of surgical interventions in people with HMSN.
circRNA_0001006 predicts prognosis and regulates cellular processes of triple-negative breast cancer via miR-424-5p
Authors: Liu Jiaqi , Kong Linna , Bian Wenqing , Lin Xiaona , Wei Feifei , Chu Jun
Published: May 2023

Background

circular RNAs (circRNAs) have been considered novel biomarker candidates for human cancers, such as triple-negative breast cancer (TNBC). circ_0001006 was identified as a differentially expressed circRNA in metastatic breast cancer, but its significance and function in TNBC were unclear. The significance of circ_0001006 in TNBC was assessed and exploring its potential molecular mechanism to provide a therapeutic target for TNBC.

Results

circ_0001006 showed significant upregulation in TNBC and close association with patients’ histological grade, Ki67 level, and TNM stage. Upregulated circ_0001006 could predict a worse prognosis and high risk of TNBC patients. In TNBC cells, silencing circ_0001006 suppressed cell proliferation, migration, and invasion. In mechanism, circ_0001006 could negatively regulate miR-424-5p, which mediated the inhibition of cellular processes by circ_0001006 knockdown.

Conclusions

Upregulated circ_0001006 in TNBC served as a poor prognosis predictor and tumor promoter via negatively regulating miR-424-5p.
Combination of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio with plasma D-dimer level to improve the diagnosis of deep venous thrombosis (DVT) following ankle fracture
Authors: Gao Zhida , Zhao Kuo , Jin Lin , Lian Xiaodong , Zhang Zhiang , Ma Lijie , Hou Zhiyong
Published: May 2023

Purpose

To investigate the relationship between neutrophil to lymphocyte ratio (NLR)/platelet to lymphocyte ratio (PLR) with deep venous thrombosis (DVT) following ankle fracture and the diagnostic ability of combination model.

Method

This retrospective study included patients with a diagnosis of ankle fracture who had undergone preoperative Duplex ultrasound (DUS) examination for detecting the possible deep venous thrombosis (DVT). The variables of interest, the calculated NLR and PLR and others (demographics, injury, lifestyles and comorbidities) were extracted from the medical records. Two independent multivariate logistics regression models were used to detect the relationship between NLR or PLR and DVT. If any, combination diagnostic model was constructed and its diagnostic ability was evaluated.

Results

There were 1103 patients included, and 92 (8.3%) were found to have preoperative DVT. The NLR and PLR, which had respective optimal cut-off point of 4 and 200, were significantly different between patients with and without DVT either in continuous or categorical variable. After adjustment for covariates, both NLR and PLR were identified as independent risk factors associated with DVT, with odd ratio of 2.16 and 2.84, respectively. The combination diagnostic model, including NLR, PLR and D-dimer, demonstrated to significantly improved the diagnostic performance than any one alone or combined (all P < 0.05), and the area under the curve was 0.729 (95% CI 0.701–0.755).

Conclusion

We concluded the relatively low incidence rate of preoperative DVT after ankle fracture, and both NLR and PLR were independently associated with DVT. The combination diagnostic model can be considered as a useful auxiliary tool for identifying high-risk patients for DUS examination.
Stiff left atrial syndrome with pulmonary veins occlusion after percutaneous radiofrequency ablation: a life-long complication that can lead to heart transplantation
Authors: Kronenberger Rani , Tanaka Kaoru , de Asmundis Carlo , Meir Mark La
Published: May 2023

Background

Stiff left atrial syndrome (SLAS) and pulmonary vein (PV) occlusion are rare yet potentially major life-long complications after radiofrequency ablation for atrial fibrillation. While mostly controlled by medical management, SLAS can progress to refractory congestive heart failure. Treatment of PV stenosis and occlusion remains a challenging problem with ongoing risk for recurrence regardless of techniques employed. Herein we present the case of a now 51-year-old male with acquired PV occlusion and SLAS who, over the course of eleven years, despite multiple interventions, ultimately required heart transplantation.

Case presentation

After undergoing three radiofrequency catheter procedures for paroxysmal atrial fibrillation (AF), a hybrid ablation was planned due to reappearance of symptomatic AF. Preoperative echocardiography and chest computed tomography (CT) revealed an occlusion of both left PVs. Furthermore, left atrial dysfunction, high pulmonary artery and pulmonary wedge pressures were diagnosed as well as an important reduction of the left atrial volume. The diagnosis of stiff left atrial syndrome was made. Primary surgical repair of the left-sided PVs was performed using a pericardial patch as a tubular neo-vein, combined with cryoablation in the left and right atrium to treat the patient’s arrhythmia. Initial results were favorable, however, after two years the patient experienced progressive restenosis with hemoptysis. Therefore, stenting of the common left PV was performed. Over the years, progressive right heart failure with severe tricuspid regurgitation developed, despite maximal medical therapy, which led to the need for heart transplantation.

Conclusion

The impact of PV occlusion and SLAS after percutaneous radiofrequency ablation can be lifelong and devastating for the clinical course of the patient. Since the presence of a small left atrium could be an important predictor for SLAS in case of redo ablation, preprocedural imaging should guide the operator to an algorithm of a decision-making containing lesion set, energy source, and safety of re-ablation.
Hereditary angioedema with an acute attack resolved after bone marrow transplantation for acute myeloid leukemia: a case report
Authors: Honda Daisuke , Ohsawa Isao , Aizawa Masashi , Tomino Yasuhiko , Asanuma Katsuhiko
Published: May 2023

Background

Hereditary angioedema (HAE), which is caused by C1-inhibitor (C1-INH) deficiency or dysfunction, is a rare and potentially life-threatening disease. In patients with HAE, excess production of bradykinin causes acute unpredictable recurrent attacks of angioedema in localized regions, including the larynx and intestines. Given the fact that HAE is an autosomal dominant disease, C1-INH produced in patients with HAE is 50% of that produced in healthy individuals. However, most patients with HAE present plasma C1-INH function of < 25% owing to the chronic consumption of C1-INH by kallikrein–kinin, contact, complement, coagulation, and fibrinolysis cascades. Recently, several therapeutic options have been developed for acute attacks and prophylaxis in the treatment of HAE; however, currently, there is no curative therapy for HAE.

Case presentation

Here we report the case of a 48-year-old male patient who presented with a long-standing history of HAE and underwent bone marrow transplantation (BMT) for acute myeloid leukemia (AML) at the age of 39 years and has been in complete remission of AML and HAE thereafter. Notably, after BMT, his C1-INH function gradually increased as follows: < 25%, 29%, 37%, and 45.6%. Since his 20 s, he intermittently presented with an acute attack of HAE once every 3 months from the initial attack. Further, after undergoing BMT, the number of acute attacks decreased to twice within 4 years until the age of 45 years, and subsequently, the patient has been free of acute attacks. C1-INH is mainly synthesized by hepatocytes, but it is known to be partially produced and secreted from peripheral blood monocytes, macrophages, endothelial cells, and fibroblasts. We speculate that the C1-INH function may be increased by extrahepatic production of C1-INH, possibly synthesized by differentiated cells derived from hematopoietic and mesenchymal stem cells after BMT.

Conclusions

This case report supports efforts to focus on extrahepatic production of C1-INH in the next strategy of new treatment development for HAE.
One Health: navigating plague in Madagascar amidst COVID-19
Authors: Agrawal Ritik , Murmu Jogesh , Pattnaik Sweta , Kanungo Srikanta , Pati Sanghamitra
Published: May 2023

Background

Africa sees the surge of plague cases in recent decades, with hotspots in the Democratic Republic of Congo, Madagascar, and Peru. A rodent-borne scourge, the bacterial infection known as plague is transmitted to humans via the sneaky bites of fleas, caused by Yersinia pestis. Bubonic plague has a case fatality rate of 20.8% with treatment, but in places such as Madagascar the mortality rate can increase to 40–70% without treatment.

Main text

Tragedy strikes in the Ambohidratrimo district as three lives are claimed by the plague outbreak and three more fight for survival in the hospitals, including one man in critical condition, from the Ambohimiadana, Antsaharasty, and Ampanotokana communes, bringing the total plague victims in the area to a grim to five. Presently, the biggest concern is the potential plague spread among humans during the ongoing COVID-19 pandemic. Effective disease control can be achieved through training and empowering local leaders and healthcare providers in rural areas, implementing strategies to reduce human–rodent interactions, promoting water, sanitation and hygiene practices (WASH) practices, and carrying out robust vector, reservoir and pest control, diversified animal surveillance along with human surveillance should be done to more extensively to fill the lacunae of knowledge regarding the animal to human transmission. The lack of diagnostic laboratories equipped represents a major hurdle in the early detection of plague in rural areas. To effectively combat plague, these tests must be made more widely available. Additionally, raising awareness among the general population through various means such as campaigns, posters and social media about the signs, symptoms, prevention, and infection control during funerals would greatly decrease the number of cases. Furthermore, healthcare professionals should be trained on the latest methods of identifying cases, controlling infections and protecting themselves from the disease.

Conclusions

Despite being endemic to Madagascar, the outbreak’s pace is unparalleled, and it may spread to non-endemic areas. The utilization of a One Health strategy that encompasses various disciplines is crucial for minimizing catastrophe risk, antibiotic resistance, and outbreak readiness. Collaboration across sectors and proper planning ensures efficient and consistent communication, risk management, and credibility during disease outbreaks.

Graphical Abstract
Climate change and infectious disease: a review of evidence and research trends
Authors: Van de Vuurst Paige , Escobar Luis E.
Published: May 2023

Background

Climate change presents an imminent threat to almost all biological systems across the globe. In recent years there have been a series of studies showing how changes in climate can impact infectious disease transmission. Many of these publications focus on simulations based on in silico data, shadowing empirical research based on field and laboratory data. A synthesis work of empirical climate change and infectious disease research is still lacking.

Methods

We conducted a systemic review of research from 2015 to 2020 period on climate change and infectious diseases to identify major trends and current gaps of research. Literature was sourced from Web of Science and PubMed literary repositories using a key word search, and was reviewed using a delineated inclusion criteria by a team of reviewers.

Results

Our review revealed that both taxonomic and geographic biases are present in climate and infectious disease research, specifically with regard to types of disease transmission and localities studied. Empirical investigations on vector-borne diseases associated with mosquitoes comprised the majority of research on the climate change and infectious disease literature. Furthermore, demographic trends in the institutions and individuals published revealed research bias towards research conducted across temperate, high-income countries. We also identified key trends in funding sources for most resent literature and a discrepancy in the gender identities of publishing authors which may reflect current systemic inequities in the scientific field.

Conclusions

Future research lines on climate change and infectious diseases should considered diseases of direct transmission (non-vector-borne) and more research effort in the tropics. Inclusion of local research in low- and middle-income countries was generally neglected. Research on climate change and infectious disease has failed to be socially inclusive, geographically balanced, and broad in terms of the disease systems studied, limiting our capacities to better understand the actual effects of climate change on health.

Graphical abstract
Bortezomib induced peripheral neuropathy and single nucleotide polymorphisms in PKNOX1
Authors: Zhou Xiang , Han Seungbin , Cebulla Nadine , Haertle Larissa , Steinhardt Maximilian J. , Schirmer Daniel , Runau Eva , Flamm Leon , Terhorst Calvin , Jähnel Laura , Vogt Cornelia , Nerreter Silvia , Teufel Eva , Stanojkovska Emilia , Mersi Julia , Munawar Umair , Schindehütte Magnus , Blum Robert , Reinhold Ann-Kristin , Scherf-Clavel Oliver , Rittner Heike L. , Pham Mirko , Rasche Leo , Einsele Hermann , Sommer Claudia , Kortüm K. Martin
Published: May 2023

We analyzed single nucleotide polymorphisms (SNPs) in PKNOX1 (rs2839629) and in the intergenic region between PKNOX1 and CBS (rs915854) by Sanger sequencing in 88 patients with multiple myeloma treated with bortezomib. All patients (n = 13) harboring a homozygous mutation in PKNOX1 (rs2839629) also had a homozygous mutated rs915854 genotype. Homozygous mutated genotypes of rs2839629 and rs915854 were significantly enriched in patients with painful peripheral neuropathy (PNP) (P < 0.0001), and homozygous mutated rs2839629 genotype was significantly enriched in patients with pain compared to patients with no pain (P = 0.04). In summary, both SNPs rs2839629 and/or rs915854 may be potential biomarkers predicting an increased risk to develop painful PNP under bortezomib.
Simulation of horizontal sporadic E layer movement driven by atmospheric tides
Authors: Andoh Satoshi , Saito Akinori , Shinagawa Hiroyuki
Published: May 2023

The present study aims to reveal horizontal sporadic E (Es) movements driven by atmospheric diurnal/semi-diurnal tides using a three-dimensional (3D) ionospheric model. Horizontal Es movements have been investigated since the mid-twentieth century, using a variety of 1D/2D observational techniques. However, there are no comprehensive studies that explain the different results asserted by the observations. Herein, we performed 3D Es simulations at mid- and low-latitudes. This is the first study to investigate horizontal Es movements from a 3D perspective. We found that the Es layers are constrained at the zonal-wind shear nodes above $$\sim$$
∼
110 km, but transported by horizontal winds below $$\sim$$
∼
110 km. The Es layers that descend with the downward tidal phases move southward. The descending Es layers move westward as they lag behind the zonal-wind shear nodes. The Es layers that stagnate at $$\sim$$
∼
100 km are transported by the semi-diurnal tides. In general, the descending and stagnating Es layers do not move eastward. This is because the Es layers diffuse vertically in the eastward/northward wind region or in the early stage of formation in the eastward/southward wind region. The horizontal Es movement tendency in the simulations agreed with and provided a general explanation for previous observations.

Graphic Abstract
The effect of remote fitting technology on hearing aid satisfaction
Authors: Çelikgün Bahtiyar , Büyükkal Furkan
Published: May 2023

Background

Telemedicine is a method of providing remote healthcare services and consultations to patients using communication technology. Tele-audiology is a sub-branch of telemedicine. It refers to providing audiology services using telehealth strategies. This study aims to compare the satisfaction of patients who come to the hearing aid center and receive device fitting service and patients who have hearing aid fitting using tele-audiology service. For this purpose, hearing aid users were divided into two groups. The study group consisted of 17 participants (10 male, 7 females; mean age 65.17 ± 13.88) who continued fitting appointments remotely after the first clinic application, while the control group consisted of 23 participants (10 males, 13 females; mean age 62.17 ± 18.32) who had all hearing aid fittings performed face-to-face in the clinic. The participant’s satisfaction was assessed with The International Outcome Inventory for Hearing Aids Turkiye (IOI-HA-TR) questionnaire because it is practical and can be administered over the phone.

Results

There were no significant differences in hearing aid satisfaction between those who came to the hearing center and filled out the IOI-HA-TR questionnaire personally and those who completed it through the Remote Care application (p < 0.05). In addition, most of the participants stated that using Remote Care solved their problems (35% very good, 24% good) and they were satisfied with the fitting of their hearing aids with this application (35% good, 29% very good). In addition, 13 out of 17 participants stated that they would pay attention to the “remote fitting” feature when purchasing a new hearing aid (76% very good). Moreover, they would like to continue the fitting using the Remote Care application (65% yes).

Conclusion

Remote fitting technology via smartphone applications can facilitate the lives of hearing aid users and improve their quality of life in cases of risky conditions such as pandemics, various diseases, and physical limitations.
Comparison of the therapeutic efficacy between systemic chemotherapy with and without radiofrequency ablation for colorectal cancer liver metastases: A propensity score matching study
Authors: Hao Wu , Jun Zhou , Yan Li , Zhong-yi Zhang , Bin-bin Jiang , Gui-ju Liu , Wei Yang , Lin Shen , Kun Yan
Published: May 2023

Objective:

To compare therapeutic efficacy between systemic chemotherapy (SC) alone and preoperative SC followed by radiofrequency ablation (SC+RFA) in patients with colorectal cancer liver metastases (CRLM).

Methods:

This study identified a cohort of patients with CRLM after treatment between 2010 and 2016. Patients who received SC+RFA were compared with SC patients by propensity score matching. Overall survival (OS) and intrahepatic progression-free survival (PFS) were compared using stratified log-rank test. The outcomes after SC and SC+RFA were also assessed in patient subgroups.

Results:

This study identified 338 patients with CRLM who had underwent SC and had different response to chemotherapy, including non-progressive disease (non-PD) or progressive disease (PD). Of this cohort, 64 patients in SC+RFA group were matched by propensity score to 64 patients who received SC alone. Compared with SC cohort, the SC+RFA cohort yielded better OS (HR, 0.403; 95% CI, 0.271–0.601) and PFS (HR, 0.190; 95% CI, 0.113–0.320). The estimated OS rates at 1, 3 and 5 years were 93.8%, 51.6% and 15.6% for SC+RFA group and 81.3%, 26.6% and 10.9% for SC group (p＜0.001). The cumulative PFS rates at 1, 3, and 5 years were 43.8 %, 14.1% and 3.1% for the SC+RFA group and 1.6%, 0 and 0% for SC group (p＜0.0001). In subgroup analysis, compared with patients with PD response, patients with non-PD response could gain better PFS (HR, 0.207; 95% CI, 0.121–0.354) and OS (HR, 0.390; 95% CI, 0.246–0.617).

Conclusions:

RFA was associated with improved OS and intrahepatic PFS in CRLM patients with preoperative SC,especially in non-PD response subgroup after SC.

Advances in knowledge:

The addition of RFA was advocated for CRLM patients with preoperative SC. This study will provide important reference and evidence to better perform the management of unresectable CRLM.
The role of artificial intelligence in hastening time to recruitment in clinical trials
Authors: Ismail Abdalah , Al-Zoubi Talha , El Naqa Issam , Saeed Hina
Published: May 2023

Novel and developing artificial intelligence (AI) systems can be integrated into healthcare settings in numerous ways. For example, in the case of automated image classification and natural language processing, AI systems are beginning to demonstrate near expert level performance in detecting abnormalities such as seizure activity. This paper, however, focuses on AI integration into clinical trials. During the clinical trial recruitment process, considerable labor and time is spent sifting through electronic health record and interviewing patients. With the advancement of deep learning techniques such as natural language processing, intricate electronic health record data can be efficiently processed. This provides utility to workflows such as recruitment for clinical trials. Studies are starting to show promise in shortening the time to recruitment and reducing workload for those involved in clinical trial design. Additionally, numerous guidelines are being constructed to encourage integration of AI into the healthcare setting with meaningful impact. The goal would be to improve the clinical trial process by reducing bias in patient composition, improving retention of participants, and lowering costs and labor.
Conservation Measures for Changing Exhibition Environments: Development of Support in Open Storage
Authors: Kim Young Mok , Kwon Hee Hong
Published: May 2023

The number of domestic art museums and museums that have introduced it to take advantage of the good points of an open storage type exhibition is increasing. Therefore, there is a concern that the collection will be damaged by visitors and the open storage environment. The work “Flowers of tomorrow” by Choi Jeonghwa which is on display in the open storage of the National Museum of Modern and Contemporary Art, was physically damaged due to the storage environment, contact with visitors, and structural instability. This study attempted to develop and produce supports that can minimize damage in an open storage environment and do not heterogeneous during viewing when the work is displayed again after the conservation treatment is completed. The support was made in a shape suitable for vulnerable parts using 3D scanner and 3D printer. The load bearing capacity according to the length and thickness of the support was measured, and conditions suitable for the wind strength flowing inside the open storage were selected. Based on the results of the experiment, the support was produced, and the color was matched so that there was no heterogeneity from the color of the work in the applied parts, and it was currently being displayed in open storage while being attached to the work.
Adherence with standard guidelines among doctors involved in aerosol generating procedures to control COVID-19 transmission
Authors: Hassan Madeeha , Waqar S H , Shahzad Fatima , Siraj Minhaj us
Published: May 2023

Objectives: To review the strategies for controlling COVID-19 transmission among doctors involved in aerosol generating procedures.

Methods: A cross-sectional study was conducted in Pakistan Institute of Medical Sciences, Islamabad from September to November 2020, using a 21-itemed initially piloted self-administered questionnaire designed on Google forms. It was shared with doctors involved in Aerosol generating medical procedures (AGMPs) by using social media applications. After the data was collected, it was analyzed using SPSS version 21.

Results: A total of 136 doctors participated in the study that included 59 female and 77 male participants. Our 67 (49.3%) participants screened their patients for signs and symptoms of COVID-19 before a routine checkup. The most common disinfectant used for reusable medical equipment by 62 (45.6%) respondents was alcohol swab, 57 (41.9%) did not disinfect reusable equipment and 17 (12.5%) used Dettol water spray.

Conclusion: Majority of the doctors involved in AGMPS are not following the guidelines provided by international and national bodies. As such adherence to guidelines can help prevent COVID19 transmission in frontline doctors especially those involved in aerosol generating procedures.

doi: https://doi.org/10.12669/pjms.39.4.3971

How to cite this: Hassan M, Waqar SH, Shahzad F, Minhaj us Siraj. Adherence with standard guidelines among doctors involved in aerosol generating procedures to control COVID-19 transmission. Pak J Med Sci. 2023;39(4):---------. doi: https://doi.org/10.12669/pjms.39.4.3971

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Photo-induced photoacoustic streaming and pineapple peel extract as final irrigant on extrusion bond strength of root filling material to canal wall
Authors: Saeed Alghamdi AbdulRehman , Alotaibi Badi , Alsalhi Hanin , Aljuailan Roqayah Ibrahim , Barakat Ali
Published: May 2023

Objective: Photon-induced photoacoustic streaming (PIPS) with pineapple peel extract (PPE) and ethylenediaminetetraacetic acid (EDTA) as a final endodontic irrigant on the push-out bond strength (PBS) of root filling material to conventional irrigation NaOCl with EDTA.

Methods: An in vitro study at Dar Al Uloom University was conducted over three months. Root canal preparation was performed. Based on final irrigation, all the specimens were divided randomly into four groups (n=10) Group 1: 2.25% NaOCl+ 17% EDTA (control), Group-2: 2.25% NaOCl+PIPS + 6.25% PPE, Group-3: 2.25% NaOCl+PIPS + 17% EDTA, Group-4: 2.25% NaOCl + 6.25% PPE. Canals were obturated and sealed with AH Plus sealer. Root sectioning was performed at 1mm thickness and PBS testing was performed using the universal testing machine. The debonded samples were analyzed for failure mode. ANOVA compared the means and standard deviations (SD) of all investigated group. Assessment of multiple comparisons was performed using Tukey’s post hoc test.

Results: The maximum PBS was demonstrated by the coronal section of Group-2 (2.25%NaOCl +PIPS+6.25%PPE) specimens (8.21±0.81MPa). The apical section of Group-1 (2.25% NaOCl+17% EDTA) specimens demonstrated minimum bond strength (2.80±0.18 MPa). The intergroup comparison revealed that Group-3 (2.25% NaOCl +PIPS +17% EDTA) and Group-2 demonstrated comparable outcomes (p>0.05). Group-4 (2.25% NaOCl +6.25% PPE) specimens established significantly lower values than Group-3 and Group-4 (p<0.05).

Conclusion: Photon-induced photoacoustic streaming with pineapple peel extract and EDTA demonstrated better bond strength of root canal sealer and have the potential to be used as the final irrigant.

doi: https://doi.org/10.12669/pjms.39.4.7370

How to cite this: AlGhamdi ARS, Alotaibi B, Alsalhi H, Aljuailan RI, Barakat A. Photo-induced photoacoustic streaming and pineapple peel extract as final irrigant on extrusion bond strength of root filling material to canal wall . Pak J Med Sci. 2023;39(4):---------.  doi: https://doi.org/10.12669/pjms.39.4.7370

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Lipoid Proteinosis: Identification of a Novel Nonsense Mutation c.1246C>T:p.R416X in ECM1 gene from Bangladesh
Authors: Khan Md. Azraf Hossain , Reza Md. Abu , Sharaf Ibrahim Md. , Alam Md. Jahangir , Rahman Md. Mostafizur , Chandra Pampa , Anwar Kazi Selim , Salam Md. Abdus
Published: May 2023

Lipoid proteinosis is a rare multisystem genodermatosis inherited as autosomal recessive trait. We report a case of lipoid proteinosis in a 10-year-old boy born to first-degree consanguineous parents presented with marked hoarseness of voice, accelerated photoaging appearance, enlarged and erythematous tongue with restricted movement and widespread dermatoses. Biopsy of oral mucosa revealed Periodic acid-Schiff (PAS)-positive amorphous eosinophilic hyaline deposits. Mutational analysis revealed a homozygous nonsense mutation with C to T substitution at nucleotide position 1246(c.1246C>T) in exon-8 of the extracellular matrix protein 1 gene leading to a stop codon. Both the parents were unaffected heterozygous carriers. To our knowledge, this is the first case report of lipoid proteinosis with evidence of a novel nonsense genetic mutation from Bangladesh.

doi: https://doi.org/10.12669/pjms.39.4.7437

How to cite this: Khan MAH, Reza MA, Sharaf IM, Alam MJ, Rahman MM, Chandra P, et al. Lipoid Proteinosis: Identification of a Novel Nonsense Mutation c.1246C>T:p.R416X in ECM1 gene from Bangladesh. Pak J Med Sci. 2023;39(4):---------. doi: https://doi.org/10.12669/pjms.39.4.7437

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Effects of vaccination against COVID-19 on the emotional health of older adults
Authors: Alarcon-Ruiz Christoper A. , Romero-Albino Zoila , Soto-Becerra Percy , Huarcaya-Victoria Jeff , Runzer-Colmenares Fernando M. , Romani-Huacani Elisa , Villarreal-Zegarra David , Maguiña Jorge L. , Apolaya-Segura Moises , Cuba-Fuentes Sofía
Published: May 2023

Background:The COVID-19 pandemic significantly impacted the mental and emotional health of the elderly, especially those from low to middle-income countries. However, COVID-19 vaccination may reduce this influence. Therefore, we aimed to estimate the effect of vaccination against COVID-19 on the emotional health of older adults.

Methods:We selected a national, random, and stratified sample of non-hospitalized adults aged 60 to 79 years from Peru who intended to receive or had already received the COVID-19 vaccine during recruitment. During June and July 2021, the assessed outcomes were fear, anxiety, and worry about COVID-19, general anxiety, and depression at baseline and after a month. We estimated the adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) for each altered emotional health outcome in those who had one and two doses, compared with those who were not vaccinated using multilevel logistic regression with mixed effects.

Results:We recruited 861 older adults with 20.8% of loss to follow-up. At baseline, 43.9% had received only one dose of the vaccine, and 49.1% had two doses. In the analysis during follow-up, those who had two doses had less fear (aOR: 0.19; CI 95%: 0.07 to 0.51) and anxiety to COVID-19 (aOR: 0.45; CI 95%: 0.22 to 0.89), compared to unvaccinated. Also, those with two doses were significantly less likely to have fear of COVID-19 (aOR: 0.35; CI 95%: 0.21 to 0.59), anxiety about COVID-19 (aOR: 0.48; CI 95%: 0.34 to 0.68), and worry about COVID-19 (aOR: 0.58; CI 95%: 0.37 to 0.94), compared to those who had only one dose. We observed no effects in those with only one dose compared to unvaccinated.

Conclusions:Two doses of COVID-19 vaccination in older adults improves their perception of COVID-19 infection consequences. This information could be integrated into the vaccination campaign as an additional beneficial effect.
Measuring linguistics of the wokototen chart made inductively by deciphering kunten materials
Authors: Tsutsumi Tomoaki , Tajima Koji , Kosukegawa Teiji , Takada Tomokazu
Published: May 2023

In this paper, we focus on wokototen markings, which are a system of kunten annotations used to facilitate the reading of classical Chinese documents by Japanese readers. Using digitized data, we performed basic measurements of wokototen by using a chart that summarizes the wokototen markings of actual kunten materials described by Hiroshi Tsukishima, and we quantitatively clarified their characteristics. Kunten materials are classical Chinese books with annotations, called kunten, on the Chinese text. The wokototen is a type of kunten. In ancient East Asian countries, kunten systems were developed as a way of directly annotating Chinese documents so that they could be read and understood by non-native readers. For this reason, kunten materials and kunten are treated as historical sources for linguistic and historical research. The shape and position of a wokototen marking determines what kind of reading it indicates. The results of our basic survey quantitatively show that almost all the wokototen charts in actual kunten materials contain particles represented by “te”, “ni”, and “wo”, the most common shapes of wokototen are dots and shapes that can be written with a single stroke, such as ｜, ─, and ＼, and that the most common places to find these markings are to the right of characters in the horizontal direction and below characters in the vertical direction.
Academic entrepreneurial engagement for frugal innovation in higher education institutions: a systematic literature review
Authors: Toyin Ojo Oluwayomi , Dorasamy Magiswary , W. Migin Melissa , Jayabalan Jayamalathi , R Rajeswari , Tung Soon Seng
Published: May 2023

Higher education institutions (HEI) are faced with increasing challenges related to shrinking resources, high operation costs, the COVID-19 pandemic, decreasing student enrolment rates, and pressure to contribute to regional development and economic growth. To overcome such challenges, academics must move beyond their traditional functions of research and teaching and engage in entrepreneurial activities. Through engagement in entrepreneurial activities, academics can contribute to frugal innovation (FI) in private HEI (PHEI). The literature in this context emphasizes that academic entrepreneurial engagement (AEE) will lead to innovation, the identification of opportunities for new business ventures, financial rewards for institutions and academics, an impact on the economy, and the enhancement of social welfare. This study presents a systematic review of the literature and adopts the Transfield five-phase strategy to review the literature on AEE from the past two decades (2000–2020). A total of 1,067 papers on FI are obtained, only five of which focus on AEE. Moreover, papers related to AEE for FI are few. The study presents the research gaps, challenges, and potential factors for further research in this context. We conclude that FI for AEE in PHEI can be a game-changer for future sustainability. Moreover, we believe that the outcome of this review warrants further research.