bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and safety of PEG-rhG-CSF versus rhG-CSF in preventing chemotherapy-induced-neutropenia in early-stage breast cancer patients
Authors: Jiang Yantao , Zhang Ju , Zhong Jianxin , Liao Hao , Zhang Jiayang , Liu Yaxin , Liang Yuehua , Li Huiping
Published: July 2023

Background

To compare the clinical value of recombinant human granulocyte colony-stimulating factor (rhG-CSF) and pegylated rhG-CSF(PEG-rhG-CSF) in early-stage breast cancer (EBC) patients receiving adjuvant chemotherapy, compare the efficacy of PEG-rhG-CSF with different dose and explore the timing of rhG-CSF rescue treatment.

Methods

Patients in two PEG-rhG-CSF subgroups were given 3 mg or 6 mg PEG-rhG-CSF within 24 ~ 48 h after chemotherapy for preventing myelosuppression, while patients in the rhG-CSF group were given rhG-CSF. Observation indicators include the incidence of febrile neutropenia (FN) and grade 3/4 chemotherapy-induced-neutropenia (CIN), the overall levels and nadir values of white blood cells (WBC) and absolute neutrophil count (ANC), comparison of WBC and ANC curves over time, the incidence of CIN-related complications, the incidence of adverse events in each group and the timing of rescue treatment for rhG-CSF.

Results

There was no significant difference in the incidence of FN in the first cycle among the groups (P = 0.203). But the incidence of ≥ 3 grade CIN in two PEG-rhG-CSF subgroups was significantly lower than that in the rhG-CSF group (P < 0.001). The overall WBC and ANC levels in the PEG-rhG-CSF group were significantly higher than those in the rhG-CSF group (P < 0.001). In terms of CIN-related complications, less chemotherapy delay rate (1.1 vs. 7.5%, P = 0.092), less dose reduction rate (6.9 vs. 7.5%, P = 1.000), less antibiotic use rate (3.4 vs. 17.5%, P = 0.011) and less proportion of rhG-CSF rescue therapy (24.1 vs. 85.0%, P < 0.001) in the PEG-rhG-CSF group, and there were no significant differences between PEG-rhG-CSF subgroups. In the incidence of adverse events among the groups, there were no statistical differences. All patients undergoing rhG-CSF rescue treatment were mainly 4 grade (63.6%) and 3 grade (25.5%) CIN, and 10.9% of patients with 1 ~ 2 grade CIN who had high infection risk or had been infected.

Conclusion

PEG-rhG-CSF has better efficacy and equal tolerance compared with rhG-CSF in preventing CIN in EBC patients receiving EC regimen. Moreover, a half-dose 3 mg PEG-rhG-CSF also had good efficacy. Last, patients with ≥ 3 grade CIN and others who have been assessed to be at high risk of infection or have co-infection should consider rhG-CSF or even antibiotic rescue treatment.
Perceived social support and depression among people living with HIV in China: roles of stigma and adherence self-efficacy
Authors: Wang Pengfei , Xiong Jianjing , Zheng Jinlei , Chai Chengliang , Wang Ying
Published: July 2023

Introduction

People living with HIV (PLHIV) are a high-risk group for depression. In particular, the prevalence and burden of depression is higher and more severe among PLHIV in developing and less-developed countries. There is evidence that perceived social support has a positive impact on reducing the occurrence of depression, and high stigma and low adherence self-efficacy are barriers to the effectiveness of social support for depressed PLHIV. However, how these risks affect the effect of social support on depression still needs further identification.

Methods

Between 2017 and 2018, a total of 1139 Chinese PLHIV (74.36% male, mean age = 43.91 years) from three provinces (Shanghai, Zhejiang and Henan) in China were enrolled in the study. Data were analyzed by multiple regression, mediation model, and moderation model.

Results

A total of 43.99% of PLHIV had mild to severe depression. There was a significant negative association between perceived social support and depression (B = -0.049,P < 0.05). Stigma and adherence self-efficacy played a chain mediating role (B = -0.058, 95% CI: -0.078 ~ 0.039) and a moderating role in the effect of perceived social support on depression (stigma: B = -0.003,P < 0.05; adherence self-efficacy: B = 0.004,P < 0.05).

Conclusion

Stigma and adherence self-efficacy indirectly predicted depression, and perceived social support was more effective in reducing depression among PLHIV with high stigma or low adherence self-efficacy. Enhancing multiple social support resources for PLHIV may reduce their risk of depression. Moreover, the need for social support is greater for those with high stigma or low adherence self-efficacy.
Effects of chronic workplace harassment on mental health and alcohol misuse: a long-term follow-up
Authors: Rospenda Kathleen M. , Richman Judith A. , McGinley Meredith , Moilanen Kristin L. , Lin Tracy , Johnson Timothy P. , Cloninger Lea , Shannon Candice A. , Hopkins Thomas
Published: July 2023

Background

Research on the impacts of exposure to workplace harassment (WH) is largely cross-sectional, and existing prospective studies generally are between two and five years of follow-up, with the longest US study being 10 years. However, the effects of exposure to WH may persist longer, particularly if exposure has been chronic. This study fills this gap by examining effects of prior exposure to chronic sexual and generalized WH on psychological distress and alcohol misuse over an approximately 25 year study period.

Methods

Individuals originally recruited from a university-employed sample in the United States were surveyed at 8 time points from 1996–2007 and again in 2020–2021. A series of hybrid path analyses were tested on a sample of 2352 individuals, regressing recent outcomes on latent classes of harassment derived from earlier survey waves, controlling baseline outcomes and demographics. Model fit was assessed using a variety of fit statistics, and standardized regression coefficients were used to assess significance of individual pathways.

Results

Prior exposure to chronic sexual harassment had significant direct associations with psychological distress, alcohol misuse, and recent stressors at follow-up. Prior exposure to chronic generalized harassment had significant direct associations with lower income and alcohol misuse. Both forms of WH were significantly indirectly associated with psychological distress through recent stressors at follow-up.

Conclusions

Exposure to chronic WH is associated with long-term effects on psychological distress and alcohol misuse in a sample representing a wide variety of job types and racial/ethnic identities. Enforcement of anti-sexual harassment law and policies and enactment of policies and laws to prevent generalized harassment/workplace bullying are imperative for the protection of worker health.
Vacuum sealing drainage to treat Fournier’s gangrene
Authors: Chen Ju-hua , Li Yu-bo , Li De-gang , Zeng Xiao-mei , Yao Qiu-yuan , Fu Jun , Wang Gong-he , Huang Xiao-yan
Published: July 2023

Background

Vacuum sealing drainage (VSD) is widely applied in complex wound repair. We aimed to compare traditional debridement and drainage and VSD in treating Fournier’s gangrene (FG).

Methods

Data of patients surgically treated for FG were retrospectively analyzed.

Results

Of the 36 patients (men: 31, women: 5; mean age: 53.5 ± 11.3 [range: 28–74] years) included in the study, no patients died. Between-group differences regarding sex, age, BMI, time from first debridement to wound healing, number of debridements, FGSI, and shock were not statistically significant (P > 0.05). However, lesion diameter, colostomy, VAS score, dressing changes, analgesic use, length of hospital stay, and wound reconstruction method (χ2 = 5.43, P = 0.04) exhibited statistically significant differences. Tension-relieving sutures (6 vs. 21) and flap transfer (4 vs. 2) were applied in Groups I and II, respectively.

Conclusion

VSD can reduce postoperative dressing changes and analgesic use, and shrunk the wound area, thereby reducing flap transfer in wound reconstruction.
Collecting duct carcinoma with retroperitoneal mass as initial presentation: a rare case report
Authors: Ye Rupei , Liao Yehui , Xia Tian , Zhang Xinfeng , Lu Qiyi , Xiao Xiuli
Published: July 2023

Background

Collecting duct carcinoma (CDC) is a rare renal tumor, originating from the distal collecting duct. CDC rarely presents as a primary tumor outside the renal system.

Case presentation

In this study, we report a rare case of collecting duct carcinoma, with an initial presentation of retroperitoneal lymph node metastasis, and no identifiable primary renal tumor on CT, at the time of diagnosis. The patient was a 64-year-old man presenting with lower back pain. Preoperative CT showed a round, soft tissue mass, measuring 6.7 × 4.4 × 3.3 cm, in the left retroperitoneum with no exact occupying lesion in the left kidney. Clinically, ectopic pheochromocytoma was considered to be a differential diagnosis, and tumor resection was performed. Postoperative pathological results demonstrated that the mass was a fused lymph node, and the tumor cells were destroying the structure. The final diagnosis was lymph node metastatic collecting duct carcinoma, by histology and immunohistochemistry. No further treatment was performed as no space occupying lesion was found in the kidney. Three months later, CT was reexamined, and a mass of 3.6 cm in diameter, was found in the lower left kidney, along with multiple soft tissue masses, in the left renal hilum. Considering recurrence or metastasis, the patient was recommended to undergo surgical treatment, but the patient refused. Four months later, CT was re-examined. The tumor had rapidly progressed but the patient refused treatment again. As per the author’s press release (eleven months after the first discovery), the patient is still alive.

Conclusion

CDC is a rare malignant renal carcinoma, with a high chance of rapid progress, regional lymph nodes involvement and metastasis. It presents diagnostic challenges to clinicians and pathologists, particularly, in the absence of radiographically detectable intrarenal lesions. Definite diagnosis is based on pathological examination combined with immunohistochemical staining.
Association between time in range 70-180 mg/dl in early stage and severity with in patients acute pancreatitis
Authors: Meng Chuchen , Zhang Jie , Wang Ying , Ye Xinhua , Zhuang Shaohua
Published: July 2023

Background

It is not well understood whether glucose control in the early stage of acute pancreatitis(AP) is related to outcome. This study aimed to investigate the association between blood glucose time in range (TIR) of 70–180 mg/dL in the first 72 h(h) on admission and the progression of AP.

Methods

Individuals admitted with AP to the Gastroenterology Department of the Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University between January 2017 and December 2021 were included and retrospectively evaluated. The percentage of TIR between 70 and 180 mg/dL in the first 72 h was calculated. According to the progress of AP at discharge, patients were divided into mild pancreatitis(MAP), and moderately severe acute pancreatitis (MSAP), or severe acute pancreatitis (SAP) groups. We examined the association between TIR or TIR ≥ 70% and AP severity using logistic regression models stratified by a glycosylated hemoglobin (HbA1c) level of 6.5%. Receiver operating characteristic (ROC) curves were generated to assess the ability of the TIR to predict MSAP or SAP.

Results

A total of 298 individuals were included, of whom 35 developed MSAP or SAP. Logistic regression analyses indicated that TIR was independently associated with the incidence of more serious AP (odds ratio [OR] = 0.962, 95% CI = 0.941–0.983,p = 0.001). This association remained significant in individuals with HbA1c levels ≤ 6.5% (OR = 0.928, 95% CI = 0.888–0.969,p = 0.001). A TIR ≥ 70% was independently associated with reduced severity only in people with well-antecedent controls (OR = 0.238; 95% CI = 0.071–0.802;p = 0.020). TIR was not powerful enough to predict the severity of AP in both patients with poor antecedent glucose control (AUC = 0.641) or with HbA1c < 6.5% (AUC = 0.668).

Conclusions

TIR was independently associated with severity in patients with AP, particularly those with good antecedent glucose control.
Knowledge, attitude, and intended practice of abortion among pharmacy students in Thailand after the amendment of the Thai Abortion Law
Authors: Rongkapich Ratthapong , Poolkumlung Rada , Sinthuchai Natchanika , Limsirorat Phobsan , Chiemchaisri Nattaporn , Santibenchakul Somsook , Jaisamrarn Unnop
Published: July 2023

Background

The recently amended Thai abortion law allows pregnant women to undergo abortions up to the gestational age of 12 weeks. Medical abortion is significant because it has revolutionized access to safe abortion care—abortion medicine can now be safely and effectively administered outside of a healthcare facility to women in early pregnancy. This contribution supports the pharmacists’ role in interprofessional safe abortion teamwork. Adequate knowledge of the current laws regarding safe abortion services will increase pharmacists’ competence in providing services. However, safe abortions as a subject have not been formally incorporated into the curriculum for Thai pharmacy students. Therefore, this study aimed to evaluate the knowledge, attitude, and intended practice of fifth-year pharmacy students at Chulalongkorn University.

Methods

A cross-sectional study was conducted using an electronic self-administered questionnaire adapted from previously published studies to evaluate participants’ knowledge of the recently amended Thai abortion law, attitude toward abortion, and intended practices. The invitations were sent to all fifth-year pharmacy students at Chulalongkorn University.

Results

Among all invitations sent, 104/150 (69.3%) participants responded to the survey. Only a third of the participants (31.7%) had good knowledge scores. Based on five questions regarding the gestational age limit for legal abortion, most participants (52.7%) answered questions incorrectly. Although more than half of the participants (52.5%) disagreed with two pro-choice statements, an overwhelming majority (87.5%) agreed that abortion was a woman’s right. Safe abortion services were mostly agreed upon with serious fetal defects (91.9%), non-HIV maternal health conditions (82.2%), and sexual assaults (77.4%). A positive attitude toward abortion affects the intention to perform an abortion under socioeconomic conditions.

Conclusion

Most participants lacked knowledge on the amended abortion law, especially on the gestational limits of abortion. Participants with favorable attitudes toward abortion tended to be more liberal regarding safe abortion services.
The relationship between teamwork, moral sensitivity, and missed nursing care in intensive care unit nurses
Authors: Nobahar Monir , Ameri Malihe , Goli Shahrbanoo
Published: July 2023

Background

Teamwork, moral sensitivity, and missed nursing care are important healthcare challenges for Intensive Care Unit (ICU) nurses and the existence of a relationship between these variables can be useful for developing better care improvement strategies. This study aimed to determine the relationship between teamwork, moral sensitivity, and missed nursing care in ICU nurses.

Methods

This is a descriptive cross-sectional study conducted on a total of 200 ICU nurses working at teaching hospitals affiliated to Semnan and Shahroud Universities of Medical Sciences, Semnan, Iran in 2022. Sampling was conducted using the census method. Data collection was conducted using a demographic checklist, the TeamSTEPPS Team Perception Questionnaire (T-TPQ), Lützén Moral Sensitivity Questionnaire (L-MSQ), and Kalisch and Williams Missed Nursing Care (MISSCARE) Survey. The examination of the relationship between the three variables was conducted using Pearson’s correlation coefficient and multiple regression analysis.

Results

The mean and standard deviation of teamwork, moral sensitivity, and missed nursing care was 3.47 ± 0.69, 64.19 ± 13.43, and 55.04 ± 34.10, respectively. The variable of teamwork had a significant positive relationship with moral sensitivity (p < .001) and a significant negative relationship with missed nursing care (p < .001). Teamwork was also a positive predictor of moral sensitivity (p < .001) and a negative predictor of missed nursing care (p < .001). The clinical experience of ICU nurses was a positive predictor of teamwork (p = .01) and a negative predictor of missed nursing care (p = .001). The age of ICU nurses was a positive predictor of moral sensitivity (p = .001) and a negative predictor of missed nursing care (p = .008).

Conclusion

The findings showed that a higher level of teamwork was associated with increased moral sensitivity and reduced missed nursing care among ICU nurses. Therefore, focusing on planning interventions on teamwork improvement can lead ICU nurses to improve moral sensitivity, lower missed nursing care, and promote the quality of patient care.
How equitable is utilization of maternal health services in Uganda? Implications for achieving universal health coverage
Authors: Atuhaire Phiona , Kiracho-Ekirapa Elizabeth , Mutenyo John
Published: July 2023

Background

Maternal and neonatal mortality in Uganda remain persistently high. While utilisation of maternal health services has been shown to reduce the risk of maternal death, little is known about the inequalities in utilisation of maternal health services in Uganda. This study examined the inequalities in utilisation of maternal health services between 2006 and 2016 to draw implications for achieving universal health coverage.

Methods

We used the Uganda Demographic Health Survey 2006, 2011 and 2016 to analyse inequalities in utilisation of antenatal care (ANC4+), skilled birth attendance (SBA), postnatal care (PNC) and a package of maternal health services. Equity ratios, concentration curves, concentration indices and regression analysis were used in the estimations.

Results

Inequalities in utilization of single and a package of maternal health services reduced between 2005 and 2016, but remained pro-rich. Inequalities in utilisation of package of maternal health services were greater than for a single service. Women from the richest quintile were 4 times more likely to receive a package of care compared to the poorest women, but were just 1.5 times more likely to receive ANC4 + than those in the poorest quintile. In 2006 women in urban areas were 2.6 times more likely to receive a package of all three maternal health services than their rural counterpart and they had a relative advantage of 23.4% to utilize skilled birth delivery than the poorest women. Each additional year of schooling and living in urban areas was associated with 1.2 and 1.6% point increase in utilisation of a package of care respectively. Wealth, education and living in urban areas were positively associated with utilisation of all maternal healthcare.

Conclusion

Declining inequalities in utilisation of maternal healthcare reflect a move towards achieving universal health coverage in Uganda. Pro-rich, education and urban-biased inequalities, imply the need for targeted interventions for the poor, less educated and rural women. Targeted voucher schemes, free distribution of birth kits for poorer and rural women, community-level mobilization to improve uptake of postnatal care, and promoting women’s education and incomes are feasible interventions to improve utilisation of maternal health services and equity.
The impact of the stress hyperglycemia ratio on mortality and rehospitalization rate in patients with acute decompensated heart failure and diabetes
Authors: Zhou Qing , Yang Jie , Wang Wenyao , Shao Chunli , Hua Xinwei , Tang Yi-Da
Published: July 2023

Background

The relationship between stress hyperglycemia and long-term prognosis in acute decompensated heart failure (ADHF) patients is unknown. This study investigated the associations of stress hyperglycemia with mortality and rehospitalization rates among ADHF patients with diabetes.

Methods

We consecutively enrolled 1904 ADHF patients. Among them, 780 were with diabetes. Stress hyperglycemia was estimated using the stress hyperglycemia ratio (SHR), which was calculated by the following formula: SHR = admission blood glucose/[(28.7 × HbA1c%) – 46.7]. All diabetic ADHF subjects were divided into quintiles according to the SHR. The primary endpoint was all-cause death at the 3-year follow-up. The secondary endpoints were cardiovascular (CV) death and heart failure (HF) rehospitalization at the 3-year follow-up. A Cox proportional hazards model and restricted cubic spline analysis were used to elucidate the relationship between the SHR and the endpoints in diabetic ADHF patients. Further analyses were performed to examine the relationships between SHR and the outcomes in heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF).

Results

A total of 169 all-cause deaths were recorded during a median follow-up of 3.24 years. Restricted cubic spline analysis suggested a U-shaped association between the SHR and the mortality and rehospitalization rates. Kaplan–Meier survival analysis showed the lowest mortality in the 2nd quintile (P = 0.0028). Patients categorized in the highest range (5th quintile) of SHR, compared to those in the 2nd quintile, exhibited the greatest susceptibility to all-cause death (with a hazard ratio [HR] of 2.76 and a 95% confidence interval [CI] of 1.63–4.68), CV death (HR 2.81 [95% CI 1.66–4.75]) and the highest rate of HF rehospitalization (HR 1.54 [95% CI 1.03–2.32]). Similarly, patients in the lowest range (1st quintile) of SHR also exhibited significantly increased risks of all-cause death (HR 2.33, 95% CI 1.35–4.02) and CV death (HR 2.32, 95% CI 1.35–4.00). Further analyses indicated that the U-shape association between the SHR and mortality remained significant in both HFpEF and HFrEF patients.

Conclusion

Both elevated and reduced SHRs indicate an unfavorable long-term prognosis in patients with ADHF and diabetes.
Construction of a system for head and neck tumor traceless resection with non-inflatable transaxillary total endoscopic surgery
Authors: Sun Ronghao , Wang Xu , Malouta Michelle Z. , Zhou Yuqiu , Cai Yongcong , Shui Chunyan , Jiang Jian , Sheng Jianfeng , Zheng Chuanming , Tian Wen , Li Chao
Published: July 2023

Radical cure and functional preservation of tumors are the fundamental goals of surgical treatment of head and neck tumors, and the preservation of good aesthetics is a higher pursuit on this basis. Fully hiding the surgical incision and reducing the visibility of scars are important goals of cosmetic surgery. Using complete endoscopy for the head and neck is an effective method. CO2-free transaxillary total endoscopic surgery is a method with many advantages, which has been widely used in the resection of thyroid tumors, but for other parts and types of tumors in the head and neck, this surgical method is rarely used. The research team expanded its application scope and applied it to submandibular gland tumor resection and other head and neck surgeries for the first time. Through this exploration, it improved traction devices such as retractors, strictly limited the surgical indications, analyzed and summarized the key points, steps and methods of surgery, and built a treatment system for head and neck tumor surgery under complete endoscopy using the non-inflatable transaxillary approach. In this article, we introduce the system and select typical cases to share.
A novel immunohistochemical score predicts the postoperative prognosis of gastric cancer patients
Authors: Liu Feng , Wu Xiaoyang , Wang Weiping , Chang Jun
Published: July 2023

Background and aim

Immunohistochemistry indicators are increasingly being used to predict the survival prognosis of cancer patients after surgery. This study aimed to combine some markers to establish an immunohistochemical score (MSI-P53-Ki-67[MPK]) and stratify postoperative patients with gastric cancer according to the score.

Methods

We used 245 patients who underwent surgery at one center as the training cohort and 111 patients from another center as the validation cohort. All patients were treated between January 2012 and June 2018. The training cohort was screened for prognostic factors, and MPK scores were established using univariate and multifactorial COX risk proportional models. Patients were prognostically stratified according to the MPK score after gastrectomy for gastric cancer. Overall survival (OS) and recurrence-free survival (RFS) rates were compared among low-, intermediate-, and high-risk groups using the Kaplan–Meier method, and survival curves were plotted. Finally, the MPK score was validated using the validation cohort.

Results

In the training group, there were statistically significant differences in OS and RFS in the low, medium, and high-risk groups (P < 0.001). Thirty patients were in the high-risk group (12.2%). The median survival times of the three groups were 64.0, 44.0, and 23.0, respectively, and median times to recurrence were 54.0, 35.0, and 16.0 months, respectively. In the validation group, the prognosis in the three risk groups remained significantly different (P < 0.001).

Conclusions

The novel MPK score could effectively predict the postoperative OS and RFS of gastric cancer patients, risk-stratify postoperative patients, and identify postoperative high-risk patients for refined management.
Radiotherapy-induced diffuse myocardial fibrosis in early-stage breast cancer patients – multimodality imaging study with six-year follow-up
Authors: Moisander Mikko , Skyttä Tanja , Kivistö Sari , Huhtala Heini , Nikus Kjell , Virtanen Vesa , Kellokumpu-Lehtinen Pirkko-Liisa , Raatikainen Pekka , Tuohinen Suvi
Published: July 2023

Background

Breast radiotherapy (RT) induces diffuse myocardial changes, which may increase the incidence of heart failure with preserved ejection fraction. This study aimed to evaluate the early signs of diffuse fibrosis after RT and their evolution during a six-year follow-up.

Methods

Thirty patients with early-stage left-sided breast cancer were studied with echocardiography and electrocardiography (ECG) at baseline, after RT, and at three-year and six-year follow-up visits. Echocardiography analysis included an off-line analysis of integrated backscatter (IBS). ECG was analysed for fragmented QRS (fQRS). In addition, cardiac magnetic resonance (CMR) imaging was performed at the six-year control. The left ventricle 16-segment model was used in cardiac imaging, and respective local radiation doses were analysed.

Results

Regional myocardial reflectivity in inferoseptal segments increased by 2.02 (4.53) dB (p = 0.026) and the percentage of leads with fQRS increased from 9.2 to 16.4% (p = 0.002) during the follow-up. In CMR imaging, abnormal extracellular volume (ECV) and T1 mapping values were found with anteroseptal and apical localization in a median of 3.5 (1.00–5.75) and 3 (1.25–4.00) segments, respectively. A higher left ventricle radiation dose was associated with an increased likelihood of having changes simultaneously in CMR and echocardiography (OR 1.26, 95% Cl. 1.00–1.59, p = 0.047).

Conclusions

After radiotherapy, progressive changes in markers of diffuse myocardial fibrosis were observed in a multimodal manner in ECG and echocardiography. Changes in echocardiography and abnormal values in CMR were localized in the septal and apical regions, and multiple changes were associated with higher radiation doses.
The relationship between the use of GLP-1 receptor agonists and the incidence of respiratory illness: a meta-analysis of randomized controlled trials
Authors: Yu Meixin , Wang Ruxin , Pei Ling , Zhang Xiaofang , Wei Jinjing , Wen Yun , Liu Han , Ye Haowen , Wang Jinghao , Wang Lihong
Published: July 2023

Aim

We aimed to assess the association between the use of Glucagon-like peptide-1 receptor agonists and the risk of 12 respiratory diseases in patients with type 2 diabetes, obesity, or overweight.

Method

The PubMed (MEDLINE), EMBASE, Cochrane Library, and ClinicalTrials.gov databases were searched from the establishment of the database to December 24, 2022. Dichotomous outcomes were analyzed using RR and 95% CI calculated from fixed-effects models.

Results

Twenty-eight RCTs were ultimately included for analysis, involving a total of 77,485 participants. Compared to controls, patients with GLP-1RAs have a 14% lower risk of respiratory disease (RR 0.86, 95% CI 0.81–0.93 p < 0.0001), with Semaglutid (RR 0.82, 95% CI 0.68–0.97, p = 0.02), Liraglutide (RR 0.86. 95% CI 0.75–0.98, p = 0.03), Dulaglutide (RR 0.82, 95% CI 0.70–0.96, p = 0.02), Albiglutide (RR 0.93,95% CI 0.79–1.10, p = 0.40), Exenatide (RR 0.93, 95% CI 0.74–1.18, p = 0.55), Lixisenatide (RR 0.83, 95% CI 0.62–1.12, p = 0.22), and Efpeglenatide (RR 0.76, 95% CI 0.46–1.24, p = 0.27). Semaglutide, Liraglutide and Dulaglutide reduce the risk of respiratory diseases by 18%, 14% and 18%, respectively.Trial duration, control type, and indication were not associated with the impact of GLP-1 receptor agonists on overall respiratory disease. Among secondary outcomes, the risk of Pulmonary edema (RR 0.66, 95% CI 0.44–0.98, p = 0.04), and Bronchitis (RR 0.86, 95% CI 0.74–1.00, p = 0.04) was reduced.

Conclusion

In conclusion, GLP-1RAs were linked to a lower risk of overall respiratory diseases, especially Pulmonary edema and Bronchitis. In the future, physicians should pay attention to the relationship between GLP-1 RA and the risk of respiratory diseases and evaluate the efficacy of GLP-1RAs in the primary and secondary prevention of respiratory diseases.

Trial registration CRD42023396138.

Graphical Abstract
Altered brain metabolism in frontotemporal dementia and psychiatric disorders: involvement of the anterior cingulate cortex
Authors: van Engelen Marie-Paule E. , Verfaillie Sander C. J. , Dols Annemieke , Oudega Mardien L. , Boellaard Ronald , Golla Sandeep S. V. , den Hollander Marijke , Ossenkoppele Rik , Scheltens Philip , van Berckel Bart N. M. , Pijnenburg Yolande A. L. , Vijverberg Everard G. B.
Published: July 2023

Background

Behavioural symptoms and frontotemporal hypometabolism overlap between behavioural variant of frontotemporal dementia (bvFTD) and primary psychiatric disorders (PPD), hampering diagnostic distinction. Voxel-wise comparisons of brain metabolism might identify specific frontotemporal-(hypo)metabolic regions between bvFTD and PPD. We investigated brain metabolism in bvFTD and PPD and its relationship with behavioural symptoms, social cognition, severity of depressive symptoms and cognitive functioning.

Results

Compared to controls, bvFTD showed decreased metabolism in the dorsal anterior cingulate cortex (dACC) (p < 0.001), orbitofrontal cortex (OFC), temporal pole, dorsolateral prefrontal cortex (dlPFC) and caudate, whereas PPD showed no hypometabolism. Compared to PPD, bvFTD showed decreased metabolism in the dACC (p < 0.001, p < 0.05FWE), insula, Broca’s area, caudate, thalamus, OFC and temporal cortex (p < 0.001), whereas PPD showed decreased metabolism in the motor cortex (p < 0.001). Across bvFTD and PPD, decreased metabolism in the temporal cortex (p < 0.001, p < 0.05FWE), dACC and frontal cortex was associated with worse social cognition. Decreased metabolism in the dlPFC was associated with compulsiveness (p < 0.001). Across bvFTD, PPD and controls, decreased metabolism in the PFC and motor cortex was associated with executive dysfunctioning (p < 0.001).

Conclusions

Our findings indicate subtle but distinct metabolic patterns in bvFTD and PPD, most strongly in the dACC. The degree of frontotemporal and cingulate hypometabolism was related to impaired social cognition, compulsiveness and executive dysfunctioning. Our findings suggest that the dACC might be an important region to differentiate between bvFTD and PPD but needs further validation.
A DeepONet multi-fidelity approach for residual learning in reduced order modeling
Authors: Demo Nicola , Tezzele Marco , Rozza Gianluigi
Published: July 2023

In the present work, we introduce a novel approach to enhance the precision of reduced order models by exploiting a multi-fidelity perspective and DeepONets. Reduced models provide a real-time numerical approximation by simplifying the original model. The error introduced by the such operation is usually neglected and sacrificed in order to reach a fast computation. We propose to couple the model reduction to a machine learning residual learning, such that the above-mentioned error can be learned by a neural network and inferred for new predictions. We emphasize that the framework maximizes the exploitation of high-fidelity information, using it for building the reduced order model and for learning the residual. In this work, we explore the integration of proper orthogonal decomposition (POD), and gappy POD for sensors data, with the recent DeepONet architecture. Numerical investigations for a parametric benchmark function and a nonlinear parametric Navier-Stokes problem are presented.
Prognostic factors in transnasal endoscopic surgery for paediatric patients with ossifying fibroma of the paranasal sinuses and skull base
Authors: Ma Jingying , Zhou Bing , Huang Qian , Cui Shunjiu , Cao Dingfang
Published: July 2023

Background

Ossifying fibroma of the paranasal sinuses and skull base in paediatric patients is difficult to operate and can recur easily after surgery. This study aimed to analyse factors associated with recurrence after transnasal endoscopic resection of ossifying fibroma in paediatric patients.

Methods

This retrospective observational study included 34 patients under 17 years of age who underwent transnasal endoscopic resection of ossifying fibroma of the paranasal sinuses and skull base from 2005 to 2021 at a single tertiary medical centre. Clinical indicators such as age; surgical history; pathological type; intraoperative bleeding; and orbit, anterior skull base, sphenoid bone, sella turcica, clivus, or frontal sinus involvement were subjected to univariate analysis using the χ2 test, to investigate whether any of these factors affected recurrence.

Results

All 34 patients underwent transnasal endoscopic resection. The follow-up period was 6–120 months (mean: 48.0 months). Five patients experienced local recurrence during the follow-up period (14.7%). Results of χ2 tests indicated that a history of previous surgery, the amount of intraoperative bleeding, and sphenoid and/or sella turcica and clivus involvement were significantly associated with recurrence ( P < 0.05). Age; pathological stage; and orbit, anterior skull base, and frontal sinus involvement were not associated with recurrence ( P > 0.05).

Conclusions

The increased risk of recurrence after transnasal endoscopic resection of nasal–skull base ossifying fibroma should be considered during endoscopic surgery in paediatric patients with a history of previous surgery, intraoperative bleeding tendency, and sphenoid and/or sella turcica and clivus involvement. These patients require careful postoperative follow-up.
Implementation of interactive control of a crane ship model in MATLAB/Simulink environment
Authors: Makarov Oleg , Yase Hayato , Harada Takashi
Published: July 2023

The increased demand for performing crane ship modeling has led to the necessity for fast and accurate numerical experiments. This paper presents an approach for creating a numerical model of a crane vessel with a suspended load that allows for real-time control of crane parts. The model is developed in the MATLAB/Simulink environment, which makes it possible to extend it further to the user's needs. The authors describe the approach to the calculation of wave-induced ship motions, presents the Simulink block model and describes the features encountered during the simulation process. The possibility of real-time control of the position of crane parts is also shown, keeping the calculation speed of the ship hydrodynamics.
Perspectives of eFootball Players and Staff Members Regarding the Effects of Esports on Health: A Qualitative Study
Authors: Monteiro Pereira Ana , Bolling Caroline , Birch Phil , Figueiredo Pedro , Verhagen Evert , Brito João
Published: July 2023

Background

Recently, esports have been argued to impact esports players' health, particularly for those competing at higher levels. Esports are a relatively new phenomenon, and an inside perspective regarding esports players’ needs and experiences is essential to promote adequate health support for this population. Thus, in this qualitative study, we explored the perspectives of elite esports players and staff members regarding the effects of esports participation on health. Ten semi-structured interviews were performed with members of the Portuguese FIFA (i.e. FIFA EA Sports®) eFootball National team (i.e. five elite electronic football players, one world-class electronic football player, two national team coaches, and two members of the esports department). Data analysis was undertaken following the principles of thematic analysis.

Results

We identified four major superordinate themes: health definition (1), factors of esports that impact mental (2) and mental health (3), and strategies to improve esports players’ health (4). Esports-related factors such as gaming, competition, and performance were said to impact mental health, while equipment, facilities, and esports-related sitting time affect physical health. To minimise those risks, four main strategies were suggested: optimising and scheduling esports training, improving lifestyle habits with an emphasis on physical health, enhancing facilities and equipment, and improving health support, particularly with a mental health professional.

Conclusion

Esports players and staff members are concerned and aware of esports’ mental and physical demands. Understanding what esports players need and perceive about their health, complemented with the view of staff members, and their proposed strategies for health promotion might help define and prioritise healthcare needs, which could help players and the broad esports community.
Determining the benefits and drawbacks of parents using personal connections and social networks for recruitment in research projects: a qualitative study
Authors: Kim Laesa , Costello Carrie , Golding Michael A. , Janse van Rensburg Chloé , Protudjer Jennifer L. P. , Wittmeier Kristy
Published: July 2023

Background

It is becoming more common for parents of children with chronic conditions to join research teams as partners. Parent partnerships can help align research with what is relevant and important to families. It is also common for parent partners to be asked to share information about a study through their personal networks, which supports study recruitment. In this parent-led study, we explored parents' experiences when working together with researchers in patient-oriented research studies, in relation to study recruitment.

Methods

Demographic data were collected through a brief online survey (SurveyMonkey®) and analysed descriptively (n, %, median (interquartile range; IQR)). Qualitative data were collected through focus groups and interviews (July to October 2021), transcribed verbatim, and analysed thematically. Parent co-leads were involved in every stage of the study, including study design, recruitment, data collection, analysis, interpretation, and knowledge mobilization.

Results

Fifteen parents (n = 14 women) who had research partnership experience participated in this study. Most (n = 13) participants self-identified as White or of European descent. The majority (n = 10) had partnered in 1–3 research projects, while five participants had partnered in 4 + projects. Parents had a median of 3 years (IQR: 5) of partnership experience. We identified the following three themes: motivations, authentic partnerships, and learned decision making. Each theme included reflections about recruitment, and about research partnership in general. Motivations included a personal connection to the research topic, a connection to the community impacted by the research topic, and a desire to create change. Authentic partnerships were important for a meaningful experience, and enhanced participant’s willingness and ability to share study materials. Learned decision making reflected parents’ evolving decisions and practices related to sharing study information or personal information to support research. We provide a summary of participants’ recommendations for researchers who work with parent partners, and recommendations for parents as they approach research partnerships.

Conclusions

Experiences shared by parents who have partnered in research provide valuable information to inform recruitment methods and improve team functioning. Parent partners expressed a willingness to support recruitment and valued a strong research team working together for a common outcome. This study yields a set of recommendations guiding future research that engages parents as team members.
Diet, physical activity, and UV protection comprehensively influenced vitamin D status in college students: a cross-section study from China
Authors: Luo Yingyi , Qu Chunbo , Zhang Rui , Zhang Jingyi , Han Dan , Zhang Qingwen , Li Jiaxing , Na Lixin
Published: July 2023

Background

Vitamin D deficiency is one of the most prevalent health problems worldwide in all age groups, whereas vitamin D status of Chinese college students was seldom studied in China. The purpose of this study was to explore the vitamin D status in Chinese college freshmen and its influencing factors, providing evidence for nutrition strategy application.

Methods

Information including demographic status, diet habit, physical activity, and ultraviolet ray (UV) protection was collected by online questionnaire. Serum 25(OH)D3 concentrations were measured using a liquid chromatograph mass spectrometer. Multivariate linear regression analyses were used to explore the comprehensive influence of diet, physical activity and UV protection on serum 25(OH)D3 levels.

Results

Totally 1667 freshmen from 26 provinces, autonomous districts or municipalities, were recruited, with a mean age of 18.6 ± 0.9 years. The mean serum 25(OH)D3 levels were 18.1 ± 6.3 ng/mL and the proportion of vitamin D deficiency and insufficiency was 67.5% and 27.8%, respectively. Multivariate linear regression indicated that higher intake of milk and yogurt, calcium or vitamin D supplementation, and longer time of outdoor activity were positively linked to higher serum 25(OH)D3, while higher intake of candy and higher UV protection index were negatively associated with serum 25(OH)D3, after adjusted for age, gender, region of original residence, latitudes, longitude and BMI.

Conclusions

Vitamin D deficiency is very common in Chinese college students. Milk and yogurt intake and outdoor activity should be encouraged while candy intake should be limited for preventing vitamin D deficiency. Public health policies should focus on these changeable lifestyles and consider well-balanced guidelines on UV protection and vitamin D supplementation.
Neutrophils form extracellular traps in response to Opisthorchis viverrini crude antigens, which are elevated in neutrophils from opisthorchiasis patients with hepatobiliary abnormalities
Authors: Watakulsin Krongkarn , Chuenchom Chalida , Thapphan Chakrit , Thai Tran Duong , Chareonsudjai Sorutsiri , Faksri Kiatichai , Suttiprapa Sutas , Tangkawatana Sirikachorn , Sripa Banchob , Edwards Steven W. , Salao Kanin
Published: July 2023

Opisthorchis viverrini (Ov) infection can cause several disease conditions of the bile duct including hepatobiliary abnormalities (HBAs) and the most severe, cholangiocarcinoma (CCA). Fibrosis occurs when tissues are damaged and normal wound-healing responses are dysregulated. Neutrophils are the first cells to migrate to an infection site to protect the host from intruding extracellular pathogens through a wide range of effector mechanisms such as phagocytosis, production of reactive oxygen species, proteases, or release of neutrophil extracellular traps (NETs). In this work, we used confocal microscopy to assess whether Ov crude antigens can cause release of NETs from neutrophils from Ov-free individuals. We demonstrated for the first time that these antigens could induce release of NETs ex vivo in a dose-dependent manner from neutrophils isolated from Ov-free individuals. Intriguingly, when we measured NETs from neutrophils isolated from Ov-infected patients, we found increased spontaneous production of NETs in patients with HBAs. Interestingly, exposure to Ov crude antigens lowered the level of NETs released by neutrophils from patients with active Ov infection regardless of HBA status. We propose that in the case of acute Ov infection, even when concentration of Ov antigens is relatively low, neutrophils can form NETs. However, when this infection becomes chronic, manifesting as a definite HBA, the levels of NET production are reduced when treated with Ov crude antigens. Excessive production of proinflammatory mediators from these NETs might have effects on the parasites, but may also lead to excessive injury of surrounding tissues resulting in HBAs and may lead eventually to the most severe complications such as CCA.
Information Spillover in Multi-Good Adverse Selection
Authors: Huangfu Bingchao , Liu Heng
Published: July 2023

This paper analyzes information spillover in a multi-good adverse selection model in which a privately informed seller trades two different goods in two different markets. Buyers learn the seller’s information from both the market they participate in and the trading outcomes in the other market. We identify a sufficient negative correlation condition under which information spillover reduces efficiency loss. We also discover a novel type of coordination friction that leads to multiple equilibria, which can be welfare-ranked by the number of initial no-trade periods. When the sufficient negative correlation condition fails, the efficiency loss is the same as in the case without information spillover. (JEL D82, D83, L15)
Judicial Mechanism Design
Authors: Siegel Ron , Strulovici Bruno
Published: July 2023

This paper proposes a mechanism-design approach to study criminal justice systems. We derive properties of optimal mechanisms for two notions of welfare distinguished by their treatment of deterrence. These properties provide insights into the effects of defendants’ private information about their guilt; highlight forces that may underlie certain features of existing systems, such as plea bargaining and binary verdicts and the separation of fact-finding and sentencing; and indicate directions for possible improvements of criminal trials, such as varying the standard for conviction across crimes. (JEL D82, K41, K42)
Material Characteristics and Manufacturing Techniques Interpretation for the Casting Molds from the Silla Urban Site of Hwangnyongsa in Gyeongju, Korea
Authors: Jin Hong Ju , Jang Sungyoon , Kim Han Seul , Lee Myeong Seong
Published: July 2023

This study investigates the material characteristics of casting molds found at the Silla urban site of Hwangnyongsa in Gyeongju to interpret manufacturing techniques of casting mold for bronze used in the Unified Silla period. The casting molds appear to be earthen molds for bronze-making, with a thick ceramic wall and are classified into inner and outer mold types. The molds show a layered structure, with a silt layer thinly applied to the earthen mold surface. This layer comes into contact with melted metal during bronze manufacturing and is located on the outside of inner molds and inside of outer molds. The paste layer exhibits fine-grained texture with a bimodal structure. Thin section analysis reveals planar voids in the paste, which were made by the carbonization of rice husks used as a temper during the firing process. The silt layer is mainly composed of very fine-grained quartz and feldspars without clay and plant tempers. It is estimated that the casting molds were made by mixing soil with tempers of minerals and rice husks, applying a silt layer to the surface of the molds, and experiencing temperatures below 1,000℃. Overall, the selection of different raw materials for each layer of the molds is connected with efficiency to ensure the permeability and thermal resistance during the casting process and easy release of the bronze object from the molds.