bluuebunny/crossref_metadata_2025 huggingface dataset:
Updated projections of UK heat-related mortality using policy-relevant global warming levels and socio-economic scenarios
Authors: Jenkins Katie , Kennedy-Asser Alan , Andrews Oliver , Lo Y T Eunice
Published: October 2022

High temperatures and heatwaves are associated with significant impacts on human health. With continued global temperature increases, extreme thresholds relevant to health will be exceeded more frequently. This study provides an updated spatial analysis of heat-related mortality for the UK, using the UK Climate Projections (UKCP18) at 1.5 °C–4 °C global warming levels, and embedding population and demographic data from the recently released UK Shared Socioeconomic Pathways (UK-SSPs). Climate change will lead to an increase in heat-related mortality in the future, exacerbated by increased exposure due to increasing population. We find an increase from ∼1400 average annual deaths in the near-past (1990–2019) (95% CI: 1299–1485), to ∼2500 (2304–2794), ∼3700 (3280–4214), ∼8200 (7376–9072) and >18 000 (16 690–20 394) average annual deaths at 1.5 °C, 2 °C, 3 °C and 4 °C respectively (assuming no adaptation). This is considered a high-end estimate due to the assumption of high population growth (UK-SSP5). Older populations are shown to be most vulnerable. A large proportion of heat-related deaths (76% (74%–79%) with 1.5 °C global warming) are attributed to more moderate (1 °C–5 °C) increases above regional temperature thresholds as opposed to extremes. Our results provide a timely update that can serve as a first step to supporting future UK climate policy and risk assessments. Future research considering nonlinearity in the health response to heat exposure is vital.
Increases in China’s wind energy production from the recovery of wind speed since 2012
Authors: Liu Yi , Zeng Zhenzhong , Xu Rongrong , Ziegler Alan D , Jerez Sonia , Chen Deliang , Azorin-Molina Cesar , Zhou Lihong , Yang Xinrong , Xu Haiwei , Li Laurent , Dong Li , Zhou Feng , Cao Renjing , Liu Junguo , Ye Bin , Kuang Xingxing , Yang Xin
Published: October 2022

China has realized a 56-fold increase in installed wind capacity, from 5.9 GW in 2007 to 328 GW in 2021. In addition to increasing installed capacity, plans to substantially increase wind energy production for climate change mitigation also depend on future wind speeds, which strongly influences the efficiencies of installed turbines within individual wind farms. A reversal in globally decreasing wind speeds over several decades has been reported previously. However, subsequent studies using other data sources reported only a slight increase or no reversal in China. These uncertainties regarding China’s wind energy production hamper estimates of wind energy production potential. Here, our analysis of quality-controlled wind speed measurements from in-situ stations shows that the wind speed decline in China reversed significantly since 2012 (P < 0.001), but with substantial spatio-temporal variability. We further estimated the capacity factor (CF) growth and the wind power gain solely associated with the changes in wind speed ranges from 31.6 to 56.5 TWh yr−1 based on the 2019 installed capacity. This estimate explains 22.0%–39.3% of the rapid increase in wind generation CF in China during 2012–2019. The result implies that the site selection of wind farms should consider both current wind situation and future wind speed trends. Further studies are needed to understand the driving factor of wind speed recovery in support of the wind energy industry.
Archetypes of agri-environmental potential: a multi-scale typology for spatial stratification and upscaling in Europe
Authors: Beckmann Michael , Didenko Gregor , Bullock James M , Cord Anna F , Paulus Anne , Ziv Guy , Václavík Tomáš
Published: October 2022

Developing spatially-targeted policies for farmland in the European Union (EU) requires synthesized, spatially-explicit knowledge of agricultural systems and their environmental conditions. Such synthesis needs to be flexible and scalable in a way that allows the generalization of European landscapes and their agricultural potential into spatial units that are informative at any given resolution and extent. In recent years, typologies of agricultural lands have been substantially improved, however, agriculturally relevant aspects have yet to be included. We here provide a spatial classification approach for identifying archetypal patterns of agri-environmental potential in Europe based on machine-learning clustering of 17 variables on bioclimatic conditions, soil characteristics and topographical parameters. We improve existing typologies by (a) including more recent biophysical data (e.g. agriculturally-important soil parameters), (b) employing a fully data-driven approach that reduces subjectivity in identifying archetypal patterns, and (c) providing a scalable approach suitable both for the entire European continent as well as smaller geographical extents. We demonstrate the utility and scalability of our typology by comparing the archetypes with independent data on cropland cover and field size at the European scale and in three regional case studies in Germany, Czechia and Spain. The resulting archetypes can be used to support spatial stratification, upscaling and designation of more spatially-targeted agricultural policies, such as those in the context of the EU’s Common Agricultural Policy post-2020.
Analytic continuation over complex landscapes
Authors: Kent-Dobias Jaron , Kurchan Jorge
Published: October 2022

In this paper we follow up the study of ‘complex complex landscapes’ (Kent-Dobias and Kurchan 2021 Phys. Rev. Res.
3 023064), rugged landscapes of many complex variables. Unlike real landscapes, the classification of saddles by index is trivial. Instead, the spectrum of fluctuations at stationary points determines their topological stability under analytic continuation of the theory. Topological changes, which occur at so-called Stokes points, proliferate among saddles with marginal (flat) directions and are suppressed otherwise. This gives a direct interpretation of the gap or ‘threshold’ energy—which in the real case separates saddles from minima—as the level where the spectrum of the hessian matrix of stationary points develops a gap. This leads to different consequences for the analytic continuation of real landscapes with different structures: the global minima of ‘one step replica-symmetry broken’ landscapes lie beyond a threshold, their hessians are gapped, and are locally protected from Stokes points, whereas those of ‘many step replica-symmetry broken’ have gapless hessians and Stokes points immediately proliferate. A new matrix ensemble is found, playing the role that GOE plays for real landscapes in determining the topological nature of saddles.
Haake–Lewenstein–Wilkens approach to spin-glasses revisited
Authors: Lewenstein Maciej , Cirauqui David , Ángel García-March Miguel , Guigó i Corominas Guillem , Grzybowski Przemysław , Saavedra José R M , Wilkens Martin , Wehr Jan
Published: October 2022

We revisit the Haake–Lewenstein–Wilkens approach to Edwards–Anderson (EA) model of Ising spin glass (SG) (Haake et al 1985 Phys. Rev. Lett.
55 2606). This approach consists in evaluation and analysis of the probability distribution of configurations of two replicas of the system, averaged over quenched disorder. This probability distribution generates squares of thermal copies of spin variables from the two copies of the systems, averaged over disorder, that is the terms that enter the standard definition of the original EA order parameter,

q

EA

. We use saddle point/steepest descent (SPSD) method to calculate the average of the Gaussian disorder in higher dimensions. This approximate result suggest that

q

EA

>
0

at

0
<
T
<

T
c

in 3D and 4D. The case of 2D seems to be a little more subtle, since in the present approach energy increase for a domain wall competes with boundary/edge effects more strongly in 2D; still our approach predicts SG order at sufficiently low temperature. We speculate, how these predictions confirm/contradict widely spread opinions that: (i) There exist only one (up to the spin flip) ground state in EA model in 2D, 3D and 4D; (ii) there is (no) SG transition in 3D and 4D (2D). This paper is dedicated to the memories of Fritz Haake and Marek Cieplak.
Embodied reclamation: how Big Baby Balam and Danza Ocelotl represent the body as a site for decolonization
Authors: Irwin Laura
Published: October 2022

In this article, I investigate how two paintings—Big Baby Balam and Danza Ocelotl—represent the potential for embodied reclamation for Chicanas/os. Through these paintings, the artist Yreina D. Cervántez situates her body as a site for decolonization through a process which I describe as embodied reclamation. In decolonizing her body and situating her body as a site for decolonization, Cervántez represents the body as a physical and material location that was colonized and can be reclaimed. This article extends decolonial theories to discuss embodied reclamation, which reconceptualizes the body as a physical site for reclamation rather than colonization. I am looking at the way these paintings represent a wrestling with embodied identity, and from that I call for more work exploring the “art of identity” as a strategy of self-making in contexts where particular bodies are Othered and brutalized.
A case report on recurrent area postrema syndrome in AQP4-IgG-positive NMOSD
Authors: Shrestha Ramesh , Kharel Ghanshyam
Published: October 2022

Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory condition of the central nervous system caused by severe immune-mediated demyelination and axonal destruction, mainly affecting optic nerves and the spinal cord. We describe a 26-year-old Nepalese woman with recent onset of headache, nausea, vomiting and hiccups indicative of Area Postrema Syndrome (APS). The antibody test for aquaporin-4 was strongly positive. Brain magnetic resonance imaging (MRI) showed a bilateral hyperintense signal in the area postrema (AP). The patient started on methylprednisolone, and then azathioprine was added. However, the patient was readmitted because of tingling in her right upper extremity and sudden onset of tremors. An MRI scan showed an enlarged lesion in AP. Rituximab was started on top of the previous treatment, and a second dose was given after 2 weeks. The patient had been monitored regularly and symptom-free for 5 months. Hence, we emphasize the immediate need for a diagnostic approach for NMOSD management.
Long-term effect of venetoclax therapy in a patient with the transformation of chronic lymphocytic leukemia into Richter’s syndrome
Authors: Tutaeva Victoria Vladimirovna , Ovsannikova Maria Romanovna , Bobin Alexander Nikolaevich , Kuchma Yurii Miroslavovich , Rukavitsin Oleg Anatolievich
Published: October 2022

Richter’s syndrome (RS) is the next step in the progression of chronic lymphocytic leukemia (CLL) progression. It leads to reduced overall patient survival, the necessity of aggressive chemotherapy and a decline in the quality of life. The first line of RS treatment includes traditional chemotherapy such as rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone. However, during the past decade, novel targeted agents added to the therapy dramatically changed the treatment outcome for patients with RS. In our case, we describe a patient with CLL that had progressed to RS and achieved complete remission that lasted > 15 months with venetoclax monotherapy.
Two viruses in a pod: a case series of coinfection of COVID-19 with dengue
Authors: Ravindra Prithvishree , Wilson William , Macharla Aparna , Umakanth Shashikiran , Saravu Kavitha , Gupta Nitin
Published: October 2022

In regions endemic to both COVID-19 and dengue, cases of coinfections are possible. Since they have similar clinical presentations, but management might be different, it is crucial to identify these cases of coinfections. We diagnosed seven cases of dengue–COVID-19 coinfections. Fever, myalgia, rash and thrombocytopenia were found to be the common features. All patients recovered well with supportive treatment. We report this series to highlight the possibility of rare coinfections in endemic areas and the importance of a high index of suspicion, early diagnosis and prompt management.
INDOOR RADON (222RN) MEASUREMENTS AND ESTIMATION OF ANNUAL EFFECTIVE DOSE IN MVANGAN LOCALITY, SOUTH CAMEROON
Authors: Akamba Mbembe Bertrand , Manga André , Mbida Mbembe Serge , Ele Abiama Patrice , Saidou  , Ondo Meye Philippe , Kofane Timoléon Crépin , Ben–Bolie Germain Hubert
Published: October 2022

The present work was aimed at measuring indoor radon activity concentrations in dwellings in Mvangan locality, South Cameroon, in order to assess the extent of measures that may be necessary for controlling public indoor radon exposure in this area. Measurements were carried out using passive solid-state nuclear track detectors (RADONAVA Inc., RadTrak2, Sweden) following ISO 11665-4 standard. Radon concentration ranged between 36 ± 20 and 150 ± 30 Bq m−3 with arithmetic and geometric means values of 64 ± 25 and 60 ± 1 Bq m−3, respectively. These mean values were greater than worldwide values presented by United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), which are, respectively, 40 and 30 Bq m−3. 96% of dwellings that have radon concentrations below the World Health Organization (WHO) reference level of 100 Bq m−3, whereas 4% of dwellings have radon concentrations higher than this level but lower than 300 Bq m−3, the International Commission on Radiological Protection (ICRP) reference level. Annual effective doses due to indoor radon ranged between 0.7 and 2.8 mSv y−1 with an arithmetic mean value of 1.2 ± 0.5 mSv y−1. These values were below the lower limit of the ICRP-recommended action level interval 3–10 mSv y−1. It has been observed that annual effective dose received by residents in cement bricks dwellings were not significantly different (P-value = 0.565) than those received by residents in mud dwellings in Mvangan locality. The mean number of persons expected to be diagnosed with or die from cancer (solid cancers and leukemia) were 162 ± 48 (61 ± 25 for males and 101 ± 41 for females) and 82 ± 24 (33 ± 13 for males and 49 ± 20 for females), respectively. The results obtained in this study prove that the populations of Mvangan locality are exposed to a relatively low potential risk of cancer incidence and mortality.
Differential Colonization of the Plant Vasculature Between Endophytic Versus Pathogenic Fusarium oxysporum Strains
Authors: Martínez-Soto Domingo , Yu Houlin , Allen Kelly S. , Ma Li-Jun
Published: October 2022

Plant xylem colonization is the hallmark of vascular wilt diseases caused by phytopathogens within the Fusarium oxysporum species complex. Recently, xylem colonization has also been reported among endophytic F. oxysporum strains, resulting in some uncertainty. This study compares xylem colonization processes by pathogenic versus endophytic strains in Arabidopsis thaliana and Solanum lycopersicum, using Arabidopsis pathogen Fo5176, tomato pathogen Fol4287, and the endophyte Fo47, which can colonize both plant hosts. We observed that all strains were able to advance from epidermis to endodermis within 3 days postinoculation (dpi) and reached the root xylem at 4 dpi. However, this shared progression was restricted to lateral roots and the elongation zone of the primary root. Only pathogens reached the xylem above the primary-root maturation zone (PMZ). Related to the distinct colonization patterns, we also observed stronger induction of callose at the PMZ and lignin deposition at primary-lateral root junctions by the endophyte in both plants. This observation was further supported by stronger induction of Arabidopsis genes involved in callose and lignin biosynthesis during the endophytic colonization (Fo47) compared with the pathogenic interaction (Fo5176). Moreover, both pathogens encode more plant cell wall–degrading enzymes than the endophyte Fo47. Therefore, observed differences in callose and lignin deposition could be the combination of host production and the subsequent fungal degradation. In summary, this study demonstrates spatial differences between endophytic and pathogenic colonization, strongly suggesting that further investigations of molecular arm-races are needed to understand how plants differentiate friend from foe.

[Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Dynamic Current Focusing Compared to Monopolar Stimulation in a Take-Home Trial of Cochlear Implant Users
Authors: van Groesen Nicolaas Roelof Arnoldus , Briaire Jeroen Johannes , de Jong Monique Anna Maria , Frijns Johannes Hubertus Maria
Published: October 2022

Objectives:

This study compared the performance of a dynamic partial tripolar cochlear implant speech encoding strategy termed dynamic current focusing (DCF) to monopolar stimulation (MP) using spectro-temporal, temporal, and speech-in-noise recognition testing.

Design:

DCF is a strategy that utilizes tripolar or high partial tripolar stimulation at threshold level and increases loudness by slowly widening current spread towards most comfortable level. Thirteen cochlear implant users were fitted with DCF and a non-steered MP matched on pulse rate, pulse width, and active electrodes. Nine participants completed the single-blinded within-subject crossover trial. Repeated testing consisted of four sessions. Strategies were allocated in a DCF-MP-DCF-MP or MP-DCF-MP-DCF design. Three-week adaptation periods ended with a test session in which speech-in-noise recognition (matrix speech-in-noise sentence test), spectro-temporal ripple tests (SMRT and STRIPES) and a temporal amplitude modulation detection test were conducted. All participants recorded their subjective experiences with both strategies using the Speech, Spatial and Qualities of Hearing Scale questionnaire.

Results:

Participants’ SMRT thresholds improved 0.40 ripples per octave (p = 0.02, Bonferroni-corrected: p = 0.1) with DCF over MP at 65 dB SPL. No significant differences between the strategies were found on speech-in-noise recognition at conversational (65 dB SPL) and soft (45 dB SPL) loudness levels, temporal testing, STRIPES, or the SMRT at 45 dB SPL. After Bonferroni correction, a learning effect remained on the matrix speech-in-noise sentence test at both loudness levels (65 dB SPL: p = 0.01; 45 dB SPL: p = 0.02). There was no difference in learning effects over time between DCF and MP. Similarly, no significant differences were found in subjective experience on the Speech, Spatial and Qualities of Hearing Scale questionnaire. DCF reduced average battery life by 48% (5.1 hours) (p < 0.001) compared to MP.

Conclusions:

DCF may improve spectral resolution over MP at comfortable loudness (65 dB SPL) in cochlear implant users. However, the evidence collected in this study was weak and the significant result disappeared after Bonferroni correction. Also, not all spectral tests revealed this improvement. As expected, battery life was reduced for DCF. Although the current study is limited by its small sample size, considering previous studies, DCF does not consistently improve speech recognition in noise over MP strategies.
To Do One and To Get More: Part II. Diabetes and metabolic dysfunction-associated fatty liver diseases
Authors: Lee Wen-Ling , Wang Peng-Hui , Yang Szu-Ting , Liu Chia-Hao , Chang Wen-Hsun , Lee Fa-Kung
Published: October 2022

Type 2 diabetes mellitus (DM) is characterized by inability of faulty pancreatic β-cells to secret a normal amount of insulin to maintain normal body consumption, and/or peripheral tissue has a decreased susceptibility to insulin, resulting in hyperglycemia and insulin resistance. Similar to other chronic systemic inflammatory diseases, DM is a result from dysregulated interactions between ethnic, genetic, epigenetic, immunoregulatory, hormonal and environmental factors. Therefore, it is rational to suppose the concept as “To do one and to get more”, while using anti-diabetic agents (ADA), a main pharmacologic agent for the treatment of DM, can provide an extra-glycemia effect on co-morbidities or concomittent co-morbidities to DM. In this review, based on the much strong correlation between DM and metabolic dysfunction-associated fatty liver diseases (MAFLD) shown by similar pathophysiological mechanisms and a high prevalence of DM in MAFLD and its vice versa (a high prevalence of MAFLD in DM), it is possible to use the strategy to target both diseases simultaneously. We focus on a new classification of ADA, such as glucagon-like peptide 1 receptor (GLP1R) agonist and sodium-glucose cotransporter-2 (SGLT-2) inhibitors to show the potential benefits of extra-glycemic effect on MAFLD. We conclude that the management of DM patients, especially for those who need ADA as adjuvant therapy should include healthy lifestyle modification to overcome the metabolic syndrome, contributing to the urgent need of an effective weight reduction strategy. GLP1R agonist is one of effective body weight-lowering medications, which may be a better choice for DM complicated with MAFLD or its-associated severe form as MASH, although the role of SGLT-2 inhibitors are also impressive. The prescription of these two classes of ADA may satisfy the concept “To do one and to get more”, based on successful sugar-lowering effect for controlling DM and extra-glycemia benefits of hepatoprotective activity in DM patients.
50% effective concentration of sevoflurane for immobility in cerebral palsy children undergoing botulinum toxin injection
Authors: Kim Kanghui , Lee Eunhee , Jung Sung Mee , Baek Jongyoon
Published: October 2022

Background:

This prospective study aimed to determine the optimum end-tidal sevoflurane concentration required for immobility during botulinum toxin injection in spontaneously breathing children with cerebral palsy (CP).

Methods:

Twenty-three children with spastic CP, aged 3 to 12 years, with American Society of Anesthesiologists (ASA) physical status I and II, scheduled to receive botulinum toxin type A injection were enrolled in the study. After induction of deep sedation using pre-filled 8% sevoflurane in oxygen and maintenance of the predetermined end-tidal sevoflurane concentration, the botulinum toxin was injected in spontaneously breathing children. The response to the botulinum toxin injection was classified as “movement” or “no movement” by an independent investigator who was blinded to the predetermined end-tidal sevoflurane concentration and bispectral index (BIS) value. The end-tidal sevoflurane concentration was predetermined, initiating at 2.0% with 0.2% as a step size in the next patient depending on the previous patient’s response using the modified Dixon’s up-and-down method.

Results:

Of 21 children, 12 (57.1%) showed “no movement” in response to the botulinum toxin injection. By Dixon’s up-and-down method, the 50% effective end-tidal concentration (EC50) of sevoflurane for successful botulinum toxin injection was 1.76 ± 0.15% (95% CI 1.62–1.90). Based on the dose‐response curve using probit analysis, the predicted EC50 and 95% effective end-tidal concentrations (EC95) of sevoflurane without movement were 1.77% (95% CI 1.59–2.35) and 2.09% (95% CI 1.89–5.80), respectively.

Conclusion:

Botulinum toxin injection can be successfully accomplished at an end-tidal sevoflurane concentration of 1.76 ± 0.15% in 50% of spontaneously breathing children with CP aged 3–12 years.
Association between conscientiousness and team emotional intelligence: A moderated mediation model
Authors: Zhou Xuefei , Sun Xueqin , Wang Zhao , Jiang Tao
Published: October 2022

To investigate the influence of interpersonal emotion regulation and conscientiousness on team emotional intelligence. A total of 1369 college students were investigated with the conscientiousness subscale of Big Five Personality Questionnaire, Team Emotional Intelligence Scale and Leadership Positive Emotional Operation Questionnaire. Variance analysis, Pearson product difference correlation analysis, multiple regression analysis and path analysis were used. In order to avoid the possible skew problem, the bootstrap method was used to calculate the structural equation model. SPSS 22.0, Amos 24, R software were used for statistical analysis. A total of 1600 questionnaires were sent out and 1369 effective questionnaires were recovered. The total score of College Students’ team emotional intelligence was 5.07 ± 0.70, with 4.88 ± 0.87, 5.38 ± 0.79, 4.74 ± 0.91, 4.71 ± 0.83, 5.23 ± 1.00, and 5.46 ± 0.91 for interpersonal understanding, asking for feedback, emotional management, organizational cognition, relationship building and problem-solving ability, respectively. Conscientiousness significantly predicted team emotional intelligence, and leadership’s positive emotional operation. Furthermore, conscientiousness could predict team emotional intelligence through mediating individual emotional intelligence. Interpersonal positive emotion regulation played a part of mediating role between conscientiousness and team emotional intelligence.
Discussion on the molecular mechanism of Duhuo Jisheng decoction in treating osteoarthritis based on network pharmacology and molecular docking
Authors: Yang Liu , Zheng Senwang , Hou Ajiao , Wang Song , Zhang Jiaxu , Yu Huan , Wang Xuejiao , Lan Wei
Published: October 2022

In this study, network pharmacology and molecular docking technology were used to explore the molecular mechanisms of the Duhuo Jisheng decoction in the treatment of osteoarthritis (OA). The chemical composition of the prescriptions was obtained from the traditional Chinese medicine systems pharmacology database and analysis platform (TCMSP) database and the retrieved literature. Targets for the active ingredients were obtained using TCMSP and the Swiss Target Prediction Database. Disease targets were obtained from GeneCards and DisGeNET databases. The online tool, Venny, was used to obtain common targets for drugs and diseases. Protein-protein interactions (PPI) between common targets were analyzed using the search tool for the retrieval of interacting genes/proteins (STRING) database. Common targets were analyzed for gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment using the database for annotation, visualization and integrated discovery (DAVID) database. Molecular docking of the first 10 targets and first 10 components was verified using AutoDock Tools software, and the docking diagram was visualized using PyMOL software. After screening, 210 chemical components of the Duhuo Jisheng decoction (DHJSD) were identified. The 253 common targets of drugs and diseases were combined by eliminating repeat values. Based on PPI network analysis, the top ten targets were SRC, STAT3, MAPK3, MAPK1, RELA, PIK3R1, HSP90AA1, TP53, EP300, and AKT1. KEGG analysis showed that DHJSD could regulate the HIF-1, PI3K-Akt, and JAK-STAT signaling pathways. The biological processes involved include inflammatory reactions, the negative regulation of apoptosis, and the positive regulation of cell proliferation. Molecular docking results showed that all targets, except the RELA protein, showed good binding to the compounds, indicating that the 10 components might exert therapeutic effects by binding to the above targets. DHJSD can treat OA by regulating the HIF-1, PI3K-Akt, and JAK-STAT signaling pathways. The proteins involved were SRC, STAT3, MAPK3, MAPK1, and PIK3R1. In this study, network pharmacology was used to predict the mechanism of DHJSD in OA treatment, which was verified by molecular docking to provide experimental research ideas and scientific basis for OA treatment.
Trans-catheter closure of ASD and abnormal connection of left pulmonary vein to vertical vein: A case report
Authors: Shabestari Mahmoud Mohamadzadeh , Kerachian Abdollah , Poorzand Hoorak , Eshraghi Ali , Keihanian Faeze
Published: October 2022

Rationale:

Partial anomalous pulmonary venous connection is a rare congenital anomaly in which one or more pulmonary veins are connected to the venous circulation leading to left to right heart shunt. Although correction of anomalous pulmonary venous connection is achieved through surgery, there are rare instances where the abnormal pulmonary vein has dual connection to both left atrium and the major systemic veins. Under these circumstances, catheter-based treatment might become a feasible option.

Patient concerns:

A 22-year-old female presented with exertional dyspnea, holo-systolic murmur in left sternal border, and fixed splitting of S2 in examination.

Diagnosis:

The patient was diagnosed with secundum type atrial septal defect (ASD) and dual drainage of left upper pulmonary vein.

Interventions:

The patient was candidate for device closure. Under TEE guidance, occluder devices were deployed in the upper part of vertical vein and subsequently in place of ASD.

Outcomes:

Echocardiogram in the next day showed complete occlusion of flow through the vertical vein and ASD. Dual antiplatelet was prescribed on discharge. Follow-up echocardiography after 3 months showed obvious improvement in RV size. Due to suspicion for clot formation, TEE was done and thrombosis with approximate length of extension of 15 mm was detected back to the device. The patient is following for 5 years. Repeated TEE after 2 years did not show any change in the burden of clot.

Lessons:

For comprehensive evaluation of patients with ASD, assessment of pulmonic veins is crucial and in the presence of a vertical vein, the dual drainage of pulmonic veins should be considered.
Opioid prescribing practices in trauma patients at discharge: An exploratory retrospective chart analysis
Authors: Premachandran Priyanka , Nippak Pria , Begum Housne , Meyer Julien , McFarlan Amanda
Published: October 2022

This study examined the opioid prescribing patterns at discharge in the trauma center of a major Canadian hospital and compared them to the guidelines provided by the Illinois surgical quality improvement collaborative (ISQIC), a framework that has been recognized as being associated with reduced risk.

This was a retrospective chart review of patient data from the trauma registry between January 1, 2018, and October 31, 2019. A total of 268 discharge charts of naïve opioid patients were included in the analysis. A Morphine Milligram Equivalents per day (MME/day) was computed for each patient who was prescribed opioids and compared with standard practice guidelines.

About 75% of patients were prescribed opioids. More males (75%) than females (25%) were prescribed opioids to patients below 65 years old (91%). Best practice guidelines were followed in most cases. Only 16.6% of patients were prescribed over 50 mg MME/day, the majority (80.9%) were prescribed opioids for =<3 days and only 1% for >7 days. Only 7.5% were prescribed extended-release opioids and none were strong like fentanyl. Patients received a multimodal approach with alternatives to opioids in 88.9% of cases and 82.9% had a plan for opioid discontinuation. However, only 23.6% received an acute pain service referral.

The majority of the prescriptions provided adhered to the best practice guidelines outlined by the ISQIC framework. These results are encouraging with respect to the feasibility of implementing opioid prescription guidelines effectively. However, routine monitoring is necessary to ensure that adherence is maintained.
Analysis of the epidemiological characteristics between 2004 and 2017 and prediction of the changing pattern of other infectious diarrhea (OID) under COVID-19 in China
Authors: Ge Yujie , Wang Kai , Liu Jun , Xu Lingzhong
Published: October 2022

The study describes epidemiological features and transmission of other infectious diarrhea (OID) before and during the epidemic of COVID-19 in China, which lays a foundation for OID prevention and control. Incidence rate and mortality data of OID containing detailed epidemiological information such as date, age and region from 2004 to 2017, and total OID case number from 2018 to 2020 were obtained from the Data Center of China’s Public Health Science and the National Bureau of Statistics’ statistical yearbook. The Joinpoint regression model and Z test was used to analyze, while R language and ArcGIS 10.5 for drawing. The autoregressive integrated moving average model was used to predict the influence of COVID-19 on OID. The OID incidence rate increased from 31.69/10 million in 2004 to 92.42/10 million in 2017, and the mortality rate decreased from 1.82/10,000 to 0.14/10,000. The male to female incidence ratio was 1.39:1 (P < .001). The patients’ age showed a decreased trend with age (P < .001). The scattered children devoted the most OID incidence rate. The bimodal distribution of OID incidence was summer peak in northern China, 2 apparent peaks in central and eastern, and winter peak in southern. The autoregressive integrated moving average model predicted 1,406,557 in 2020, comparing the actual OID cases in 2020 to 1,062,277. Affected by the epidemic control measures of COVID-19, the number of OID cases declined by 32.4% (Absolute percentage error = 32.4%). The OID incidence rate in China continuously increased and showed a bimodal distribution in summer and winter with inconspicuous regional characteristics, gender and age susceptibility differences, and occupational differences. Meanwhile, COVID-19 significantly reduced OID incidence in 2020. The discoveries might bring a beneficial effect on OID prevention and control policies.
Mining TCGA and GEO databases for the prediction of poor prognosis in lung adenocarcinoma based on up-regulated expression of TNS4
Authors: Liu Feng , Gao Xinliang , Liu Wei , Xue Wujun
Published: October 2022

To investigate the clinical significance of Tensin4 (TNS4) in human cancers, particularly lung cancer, we mined the Cancer Genome Atlas database for lung adenocarcinoma (TCGA-LUAD) and the Gene Expression Omnibus database to predict poor prognosis based on the up-regulated expression of TNS4 in LUAD. The correlation between the clinical pathologic features of patients and TNS4 gene expression was analyzed using the Wilcoxon signed-rank test. Cox regression analysis was used to evaluate the association of clinicopathologic characteristics with the overall survival (OS) of cancer patients using TCGA data. The relationship between TNS4 expression and cancer patient survival was evaluated with Kaplan–Meier survival curves and meta-analyses. GO and KEGG were also included in the data mining methods. The expression level of TNS4 in LUAD tissue was higher than that in adjacent normal tissue (P < .001). According to the Kaplan–Meier survival curve, LUAD patients with high TNS4 expression had worse prognosis than those with low TNS4 expression (P < .001 for OS; P = .028 for progression-free survival). A positive correlation between TNS4 expression and poor OS was found with both univariate and multivariate analyses. Increased TNS4 expression in LUAD was closely correlated with a higher disease stage (P = .007), positive lymph nodes (P = .005), and larger tumor size (P = .002). Moreover, meta-analysis including seven independent datasets showed LUAD patients with higher TNS4 had poorer OS (combined hazard ratio = 1.27, 95% confidence interval 1.16–1.39). In the high-TNS4 population, regulation of the actin cytoskeleton, extracellular matrix receptor interactions, and focal adhesion were differentially enriched. Integrin α6β4 and laminin-5 genes were also associated with TNS4. TNS4 expression may be a potential biomarker for predicting poor survival in LUAD. Moreover, the correlation between TNS4 and integrin α6β4 may be attributed to the role of TNS4 in LUAD.
Follow-up care of 12 months of patients with bladder cancer in Spain: A multicenter prospective cohort study
Authors: Bonfill Xavier , Martinez-Zapata María José , Barrionuevo-Rosas Leslie , Vernooij Robin WM , Sánchez María José , Morales-Suárez-Varela María , De la Cruz Javier , Emparanza José Ignacio , Ferrer Montserrat , Pijoan José Ignacio , Palou Joan , Frances Albert , Madrid Eva , Coscia Claudia , Zamora Javier
Published: October 2022

The therapeutic approach of bladder cancer strongly determines its prognosis. We describe the treatments and outcomes for a Spanish cohort of patients with bladder cancer for the first 12 months after diagnosis and identify the factors that influenced the decision to undergo the treatment received. We conducted a multicenter, prospective, cohort study including primary bladder cancer patients during the first 12 months after diagnosis. The clinical outcomes were performance status (ECOG), adverse events and any cause of mortality. We stratified the analysis by factors that might influence the treatments received. We conducted univariate and multivariable logistic regression models to assess which patient and tumor characteristics were associated with receiving adjuvant treatment in the subgroup of noninvasive bladder cancer patients. In total, 314 patients were included (85% men; 53.8% >70 years) in 7 tertiary Spanish hospitals; 82.2% had a noninvasive urothelial bladder cancer (NMIBC). Patients received mostly surgery plus adjuvant therapy (67.7%). BCG (32.8% patients) was the most frequently administered adjuvant therapy, followed by intravesical chemotherapy (17.8% patients) and radiotherapy (10.8%). The variability of administered treatments among hospitals was low. Patients with NMIBC were more likely to receive adjuvant therapy if they had a higher educational level, some comorbidities and a high-grade tumor. The number of fully active patients (ECOG 0) significantly decreased during the first year of follow-up from 58% to 36 % (OR: 2.41, 95%CI 1.82–3.20); at 12-month follow-up 10.8% patients had died from any cause. In conclusion, most of the patients had a NMIBC. Surgery alone or plus adjuvant therapy were the commonest curative options of bladder cancer. BCG therapy was the adjuvant therapy most frequently administered. Higher educational level, presence of comorbidities and a high-grade tumor were associated with adjuvant therapy. Patient performance status was worsening over time. Almost 1 of 10 patients died during the first year of follow-up.
Studies on Kyphoplasty over 20 years by science mapping method: Kyphoplasty by science mapping method
Authors: Comert Serhat
Published: October 2022

Design:

This is a bibliometric analysis. Performed by Scientific Mapping technique. The purpose of the study is to analyze articles on Kyphoplasty. Kyphoplasty is a minimally invasive surgical method. Bibliometrics is the mathematical and statistical quantitative analysis of works. One of the primary uses of bibliometric analysis is scientific mapping.

Method:

To conduct the bibliometric analysis of the subject of Kyphoplasty, the Web of Science Core Collection database was preferred. After the selection of the data set, the data were filtered; as a result, the study was carried out on 2236 articles. Researchers, journals, articles, institutions, and the studies’ countries were analyzed.

Results:

According to the number of articles published in Kyphoplasty, China, USA, Germany, Korea, and Italy are among the leading countries. According to the analysis, the authors with the highest h-index value are Yang HL and Hirsch JA. The European Spine Journal and the Spine are the most impactful journals.

Conclusions:

Our study was carried out with the Science Mapping technique using Bibliometrics software. This type of work has become popular in recent years. Such studies are not common in the field of neurosurgery.
Mobile application for home exercise adherence in patients with knee osteoarthritis: A pilot study
Authors: Yamamoto Yohei , Murata Yasuaki , Tanaka Naofumi , Shigemura Tomonori , Maruyama Juntaro , Nakane Ryo , Wada Yuichi
Published: October 2022

Background:

The adherence to home exercise is generally low despite its well-known effect on knee osteoarthritis. Therefore, we developed a home exercise application, LongLifeSupport, to provide patients with daily basic exercise videos and an automatic recording calendar. We hypothesized that this application would encourage patients to exercise and help maintain their motivation; this pilot study aimed to determine their exercise adherence rates. Using outcome measures, we also aimed to determine the effect of home exercise using this application and the factors for its continuation.

Methods:

Twenty patients with knee osteoarthritis were included. The participants exercised for 12 weeks. Using pre- and post-tests, we examined their satisfaction with continuation (only in the post-test), Japanese knee osteoarthritis measure score, short physical performance battery score, bilateral knee extension muscle strength, and short test battery for locomotive syndrome. Furthermore, we investigated correlations between adherence rates and pretest scores of Japanese knee osteoarthritis measure and short test battery and between pretest scores and variations in Japanese knee osteoarthritis measure and short test battery.

Results:

The mean adherence rate was 82.4%. The participants showed ease of continuation (100%) and significant improvements in the degree of knee pain, pain, and stiffness, and daily life conditions using the Japanese knee osteoarthritis measure score, total score, walk seconds, and chair stand seconds of the short physical performance battery, as well as the extension muscle strength of the right- and pain-side knee. No significant correlations were identified between the adherence rate and the pretest or variation.

Conclusion:

The adherence rate to the application was over 80%. Participants with knee osteoarthritis showed almost full satisfaction, reduced pain, and improved physical ability. Therefore, the use of this application provided a safe exercise program and maintained the exercise motivation of participants. Thus, it may be useful for unsupervised home exercise.
Effectiveness of aftercare program for suicide ideators: Real-world evidence from National Suicide Surveillance System in Taiwan
Authors: Siu Wing Hin Stanford , Juang Yeong-Yuh , Huang Tsuei-Mi , Lin Sheue-Rong , Chung Chia-Chi , Tu Hui-Tzu , Chen Wei-Min , Wang Bi-Hwa , See Lai-Chu
Published: October 2022

Aftercare programs’ effectiveness for suicide ideators has seldom been reported. This study assessed rates and factors related to the recurrence of suicide-related episodes after the index suicidal ideation episode, index cases, and family members receiving aftercare. This is a secondary data analysis of 1787 suicidal ideation episodes from 1557 individuals reported to the National Suicide Surveillance System in New Taipei City, Taiwan, from January 2012 to June 2013 and followed up until September 2013. Among 1787 index suicidal ideations, 19.1% had recurrences of suicide-related episodes, including suicidal ideation (11.9%), attempt (6.7%), and death (0.5%) within 2 years after index ideation. These recurrences were significantly reduced after the index cases received aftercare twice, three, and four or higher. Family members receiving aftercare twice or more were associated with reduced suicidality in the index cases. Receiving aftercare among index cases was associated with being a woman, suicide due to occupation/finance, and reporting from suicide hotlines. Receiving aftercare among family members was associated with the index cases aged ≤ 19 years old, suicide reasons related to school, occupation/finance, and reporting from schools and hospitals. Aftercare programs for suicide ideators and family members of adolescent suicide ideators (aged ≤ 19 years old) decreased subsequent episodes of suicidal behavior.
Effective and enduring surgical treatment for targeted therapy-related paronychia: A retrospective study
Authors: Liu Ting-Hsuan , Wu Shu-Yu , Tsai Sheng-Lin , Wu Chien-Wei , Hou Chih-Chun , Lai Chung-Yu , Tzeng Yuan-Sheng
Published: October 2022

The development of targeted therapy has improved treatment outcomes for patients with non-small cell lung cancer (NSCLC). However, paronychia, a common adverse effect of targeted therapy, remains burdensome. Although conservative treatments for paronychia have been well reported in the literature, studies on the efficacy of surgical partial matricectomy for paronychia, are scarce. This study aimed to evaluate the effect of surgical partial matricectomy in targeted therapy-induced paronychia in patients with NSCLC. This retrospective cohort study included 11 patients with a total of 18 lesions on the big toes. Data on lung cancer stages, types and duration of targeted therapy, onset of paronychia, pain scale scores, conservative treatments, course of matricectomy, paronychia-free interval after matricectomy, and wound condition were collected from medical records. The Wilcoxon signed-rank test was used for analysis. The mean pain scale score after matricectomy was significantly lower than that after conservative treatments (1.00 ± 0.00 vs 2.94 ± 0.87; P < .001) and before treatment (1.00 ± 0.00 vs 3.06 ± 0.80; P < .001). The mean duration of matricectomy was significantly shorter than that of conservative treatments (3.22 ± 1.00 vs 56.56 ± 52.29 weeks; P < .001). Surgical partial matricectomy is an effective and enduring intervention for targeted therapy-related paronychia. It provides a shorter course of treatment, reduced pain, and improved appearance of the healed wound. Furthermore, surgical partial matricectomy could result in a better quality of life during targeted therapy than that of conservative treatments.
Compound heterozygous protein C deficiency with pulmonary embolism caused by a novel PROC gene mutation: Case report and literature review
Authors: Zhang Zhaorui , Yang Zhen , Chen Mei , Li Yuzhu
Published: October 2022

Rationale:

Protein C is an anticoagulation agent, and protein C deficiency results in vascular thrombosis disease. Hereditary protein C deficiency is a risk factor for pulmonary embolism in adults. Pathogenic variants of the Protein C, Inactivator Of Coagulation Factors Va And VIIIa (PROC) gene which encodes protein C have been identified as a cause of protein C deficiency.

Patient concerns:

We describe a patient with a novel mutation in the PROC gene who was diagnosed with pulmonary embolism in a Chinese family.

Diagnosis:

According to the results of the pulmonary computed tomography angiography (CTA) and the level of blood protein C, the patient was diagnosed with pulmonary embolism caused by protein C deficiency.

Interventions:

Whole-exome sequencing (WES) was performed for the molecular analysis.

Outcome:

The results of patient’s deoxyribonucleic acid revealed a heterozygous mutation (c.237 + 5G > A) in intron 3 of the PROC gene. His father also harbored the same mutation in the PROC gene. We also reviewed the protein C deficiencies caused by PROC gene mutations in cases.

Lessons:

A novel mutation in intron 3 of PROC gene has not been previously reported in patients with pulmonary embolism caused by protein C deficiency. After anticoagulation therapy, the patient recovered, and CT showed resolution of the thrombosis. Pulmonary embolism may be caused by protein C deficiency and the rare compound heterozygous mutation in intron 3 of the PROC gene could cause protein C deficiency via impairment of the secretory activity of protein C.