bluuebunny/crossref_metadata_2025 huggingface dataset:
Minimally Invasive Dorsal Cheilectomy and Hallux Metatarsal Phalangeal Joint Arthroscopy for the Treatment of Hallux Rigidus
Authors: Gauthier Chase , Lewis Thomas L. , O'Keefe John , Bakaes Yianni , Vignaraja Vikram , Benjamin Jackson J. , Kaplan Jonathan , Ray Robbie , Gonzalez Tyler
Published: April 2024

Introduction/Purpose:

Minimally invasive dorsal cheilectomy (MIDC) has become a popular alternative to an open approach for treating Hallux Rigidus, although the current literature is divided on its effectiveness regarding complications and patient reported outcomes. To combat a portion of the complications related to the MIDC approach, a first metatarsophalangeal (MTP) joint arthroscopy can often be added to the procedure. The combined procedure has been demonstrated to be effective at improving patient reported outcomes without increasing the complication rate relative to an open procedure. This study looks to examine the effectiveness of the MIDC with first MTP arthroscopy procedure in patients with hallux rigidus with minimum 1 year follow up.

Methods:

This was a multicenter retrospective review was conducted for adult patients treated with MIDC and first MTP arthroscopy between 3/1/2020 and 8/1/2022, with at least one year of postoperative follow-up data. Patient charts were reviewed for demographic information, operative time, pre and postoperative first MTP range of motion (ROM), visual analog scale (VAS), Manchester-Oxford Foot Questionnaire (MOXFQ), and EQ5DLD scores. Continuous data was expressed as a mean and standard deviation, categorical data was expressed as a percentage. Wilcoxon Rank Sum test was used to compare continuous variables. All P < 0.05 was considered significant.

Results:

A total of 31 patients were included in the study with an average follow-up time of 16.5 months (range: 12 to 26.2). There was 1 (3.2%) complication of an underservice EHL tendon tear, 2 (6.5%) patients were converted to a MTP fusion, and 1 (3.2%) patient underwent revision cheilectomy and capsular release for MTP joint contracture. There was a significant improvement in patient’s ROM in dorsiflexion (50 vs 89.6 degrees, P=0.002), but not in plantarflexion (11.3 vs 18.6 degrees, P=0.07). There was a significant improvement in patient’s postoperative VAS pain scores (6.4 vs 2.1, P< 0.001), MOXFQ pain scores (58.1 vs 30.7, P=0.001), MOXFQ Walking/Standing scores (56.6 vs 20.6, P=0.001), MOXFQ Social Interaction scores (47.3 vs 19.36, P=0.002), and MOXFQ Index scores (54.7 vs 22.4, P< 0.001).

Conclusion:

We found that MIDC with first MTP arthroscopy was effective at improving patient reported outcomes, specifically patient’s pain scores, at one year with low complication and revision rates. These results demonstrate MIDC and first MTP arthroscopy’s is an effective treatment for early-stage hallux rigidus and may be considered as an alternative to an open approach.
Surprise Billing in Foot and Ankle Surgery and Its Effect on Patient Satisfaction
Authors: McCahon Joseph , Moncman Tara G. , Radack Tyler , Miller Mark , Parekh Selene , Pedowitz David I. , Daniel Joseph
Published: April 2024

Introduction/Purpose:

Patients undergoing foot and ankle surgery may find themselves facing unexpected medical bills. This is known as surprise billing and has caused financial hardship for many patients, prompting policymakers to pass the “No Surprise Act”. The purpose of this study was to determine the incidence of surprise bills in patient undergoing foot and ankle surgery and the effect of surprise billing on patient satisfaction.

Methods:

This was a retrospective study of patients who underwent a foot and ankle surgery from May 2021 to November 2022 at a large multi-state institution. Patients completed a questionnaire regarding the incidence of surprise bills following their surgery, the details regarding those bills, and how those bills affected the surgical satisfaction.

Results:

Of the 771 responses, 23% of participants received at least one surprise bill following their foot and ankle procedure, with 39% of these bills being greater than $1000. The most common surprise bill came from the surgical facility (46%) followed by anesthesia (42%). Furthermore, the incidence of surprise billing before and after the implementation of the “No Surprise Act” on January 1st, 2022 was not found be significantly different (p=0.134). Patients who received surprise bills reported being significantly less satisfied with their surgery (p < 0.001) and felt their billing experience affected their surgical satisfaction.

Conclusion:

Despite recent legislative efforts, surprise billing in foot and ankle surgery is common and can negatively affect patient surgical satisfaction. Although surgeons may be unable to limit the amount of bills patients receive postoperatively, increased communication and education regarding the perioperative billing process may prove to be beneficial for both patient satisfaction and the doctor-patient relationship.
Total Ankle Replacement with Built-in Antibiotic Spacer: A Paradigm Shift in the Management of Infected Ankles
Authors: Lalli Trapper , Smith Abigail , Strong Reyanne , Koutlas Nathaniel , Sanders James O.
Published: April 2024

Introduction/Purpose:

Infection of an ankle fracture is a devastating complication that can lead to chronic pain, limited motion or amputation. Traditional treatment strategies after infection involve aggressive surgical debridement, implant removal and prolonged antibiotic therapy. Non-anatomic cement spacers for the tibiotalar joint have previously been described with mixed results. Articulating spacers have shown improved outcomes and may be used as definitive treatment. Currently, there are no prefabricated TAR spacers on the market. The use of 3D printing to create custom implants is emerging, however, there is a paucity of literature regarding their use. We present a case of post-infectious ankle arthritis in 14 year old patient treated with a 3D printed total ankle replacement with built in antibiotic spacer (TAR-AS).

Methods:

A CT scan was performed in accordance with computer aided design (CAD) parameters. Bilateral lower extremities were scanned to allow the unaffected side to be mirrored and be the basis for implant design. Slice spacing less than 1.25mm with pixel size of 0.5mm. The studies were in DICOM files and within a timeframe where no significant change in patient anatomy had occurred. The implants were fabricated by selective laser melting (SLM) of cobalt chrome alloy (CoCrMo) by Restor3d (Durham, NC). Our design incorporated a stacked gyroid component to facilitate antibiotic cement impregnation. In terms of surgical technique, the custom TAR-AS followed a similar approach to a patient specific TAR procedure. Prior to implantation, the gyroid component of the TAR-AS was filled with Simplex bone cement with tobramycin (Stryker).

Results:

At six months postoperatively, our patient reported no limitation in activities. AOFAS scores improved from 46/100 preoperatively to 83/100 at six months postoperatively. Radiographic parameters showed no signs of implant failure, loosening or change in alignment. Intraoperative cultures remained negative.

Conclusion:

We present a case demonstrating the utilization of 3D generated prostheses for treatment of post-infection ankle arthritis. The TAR-AS represents a significant advancement in the management of ankle infections. This innovative approach combines the benefits of joint replacement and continued antibiotic elution. With further research and continued technological advancements, the TAR-AS has the potential to become the gold standard for the treatment of infected TAR. Despite the promising results, challenges remain in the implementation of TAR-AS. Long term follow up studies are needed to evaluate the durability and longevity of the implant. Total ankle with built in antibiotic spacer Superior view of tibial tray with antibiotic cement packed in gyroid
Simulation-Based Power Analyses for the Smallest Effect Size of Interest: A Confidence-Interval Approach for Minimum-Effect and Equivalence Testing
Authors: Riesthuis Paul
Published: April 2024

Effect sizes are often used in psychology because they are crucial when determining the required sample size of a study and when interpreting the implications of a result. Recently, researchers have been encouraged to contextualize their effect sizes and determine what the smallest effect size is that yields theoretical or practical implications, also known as the “smallest effect size of interest” (SESOI). Having a SESOI will allow researchers to have more specific hypotheses, such as whether their findings are truly meaningful (i.e., minimum-effect testing) or whether no meaningful effect exists (i.e., equivalence testing). These types of hypotheses should be reflected in power analyses to accurately determine the required sample size. Through a confidence-interval-focused approach and simulations, I show how to conduct power analyses for minimum-effect and equivalence testing. Moreover, I show that conducting a power analysis for the SESOI might result in inconclusive results. This confidence-interval-focused simulation-based power analysis can be easily adopted to different types of research areas and designs. Last, I provide recommendations on how to conduct such simulation-based power analyses.
Connecting Students With Significant Support Needs to Employment: A Tool to Structure Employment Planning Meetings
Authors: Awsumb Jessica , Hrvatin Justine , Travers Hilary , Carter Erik W. , Guest Laura
Published: April 2024

One powerful way to prepare students with significant support needs for employment in adulthood is to ensure they experience employment during high school. To assist students with significant support needs in developing their employment goals and connecting to and sustaining a job, we developed a person-centered planning meeting focused centrally on employment—the Employment Planning Meeting. During the meeting, an Employment Planning Meeting Tool (The Tool) is used to guide and provide structure and organization for a team supporting a student. It serves as a living document of the student’s interests, needs, and goals as they relate to employment during and after high school. This article describes each step of the meeting and how to use the Tool with students and their support team members. In addition, we share the experiences of professionals who organized and facilitated Employment Planning Meetings with a student with significant support needs and their families.
Mineralogical zoning of the PGE–Cu–Ni orebodies in the central part of the Oktyabr'sky Deposit, Norilsk District, Russia
Authors: Tolstykh Nadezhda D. , Krivolutskaya Nadezhda A. , Canhimbue Lyudmila S. , Gongalsky Bronislav I. , Kuzmin Ivan A.
Published: April 2024

Mineralogical features of two orebodies, lenses (C-3 and C-4), at the central part of the Oktyabr'sky deposit have been investigated. Multidirectional mineralogical zoning in the northern and southern orebodies is shown, confirming the hypothesis of their formation from various magmatic flows, which have individual features and their own modes of formation. The southern C-3 and northern C-4 orebodies differ in their mineralogical associations: C-3 is characterised by a high-sulfur association of sulfides; and C-4 contains minerals with a sulfur deficit (talnakhite, sugakiite). Variations in Fe and Ni ratios in pentlandite are controlled by the volatility of sulfur during ore crystallisation. Direct crystallisation zoning is observed in the disseminated ores of the C-4 orebody (borehole RT-107), where the fugacity of sulfur ($f_{S_2}$) increases from bottom to top. In contrast in orebody C-3 (borehole RT-30) $f_{S_2}$ decreases in the same direction. This reverse zoning coincides with the vectors of the evolution of ore systems in various blocks of the Main Ore Body of the Oktyabr'sky deposit. The difference in typomorphic features of disseminated ores of the southern and northern orebodies is confirmed by differences in the associations of platinum-group element minerals (PGMs). Disseminated ores in picritic gabbro-dolerites and massive pyrrhotite ores in the exocontact of the intrusion within the southern orebody differ in the specialisation of PGMs: the former is characterised by minerals of the Pd–Bi–Sb–Te system, the latter by only Pt minerals. The similarity of these types of ores lies in the similar reverse mineralogical and geochemical zoning from top to bottom along the sections, caused by the evolution of the sulfide melt in this direction. The formation of reverse zoning of disseminated ores (zones of ‘marginal reversion’) is probably due to the action of a mechanism of repeated influx of a melt of an increasingly primitive composition into the upper parts of the crystallising flow. Unidirectional trends in massive and disseminated ores are more likely to be due to the action of the same type of mechanism.
Unscheduled health care interactions in patients with multiple myeloma receiving T-cell redirection therapies
Authors: Howard Anna J. , Concepcion Isabel , Wang Alice X. , Hamadeh Issam S. , Hultcrantz Malin , Mailankody Sham , Tan Carlyn , Korde Neha , Lesokhin Alexander M. , Hassoun Hani , Shah Urvi A. , Maclachlan Kylee H. , Rajeeve Sridevi , Landau Heather J. , Scordo Michael , Shah Gunjan L. , Lahoud Oscar B. , Chung David J. , Giralt Sergio , Usmani Saad Z. , Firestone Ross S.
Published: April 2024

Outcomes for patients with relapsed/refractory multiple myeloma (R/RMM) have dramatically improved after the development and now growing utilization of B-cell maturation antigen–targeted chimeric antigen receptor (CAR) T-cell therapy and bispecific antibody (BsAb) therapy. However, health care utilization as a quality-of-life metric in these growing populations has not been thoroughly evaluated. We performed a retrospective cohort study evaluating the frequency and cause of unscheduled health care interactions (UHIs) among patients with R/RMM responding to B-cell maturation antigen–targeted BsAb and CAR T-cell therapies (N = 46). This included the analysis of remote UHIs including calls to physicians’ offices and messages sent through an online patient portal. Our results showed that nearly all patients with R/RMM (89%) receiving these therapies required a UHI during the first 125 days of treatment, with a mean of 3.7 UHIs per patient. Patients with R/RMM responding to BsAbs were significantly more likely to remotely contact their physicians’ offices (1.8-fold increase; P = .038) or visit an urgent care center (more than threefold increase; P = .012) than patients with R/RMM responding to CAR T-cell therapies. This was largely due to increased reports of mild upper respiratory tract infections in BsAb patients. Our results underscore the need to develop preemptive management strategies for commonly reported symptoms that patients with R/RMM experience while receiving CAR T-cell or BsAb therapies. This preemptive management may significantly reduce unnecessary health care utilization in this vulnerable patient population.
Phytonano silver for cosmetic formulation- synthesis, characterization, and assessment of antimicrobial and antityrosinase potential
Authors: George Neethu , Devi D. Gayathri
Published: April 2024

Novel formulations of silver nanoparticles remain exciting if it is applicable for cosmetic purposes. This study proposes a value-added brand-new nanomaterial for improving skin complexion by inhibiting melanin development. This work aims to develop cost effective, efficient, natural silver nanoparticles phytomediated by aqueous extract of leaf sheath scales of Cocos nucifera (Cn-AgNPs) having potential as tyrosinase inhibitors hindering melanin synthesis. The formation of Cn-AgNPs was assessed spectrophotometrically and confirmed by the sharp SPR spectrum at 425 nm. The chemical composition profiling was characterized by X-ray diffraction (XRD) and Fourier Transform Infrared (FTIR) spectroscopy. The morphology was confirmed by Field Emission Scanning Electron Microscopy (FESEM) and the thermal stability was assessed by Thermogravimetric analysis (TGA). Pharmacological application studies supported the materialization of Cn-AgNPs with significant antityrosinase potential and considerably improved antibacterial and antioxidant properties. Cn-AgNPs showed potential antibacterial effects against gram-positive and negative strains, including prominent infectious agents of the skin. Antioxidant capacity was confirmed with an IC50 of 57.8 μg/mL by DPPH radical scavenging assay. Furthermore, in vitro melanin content determination was performed using SK-MEL cells. Cell line studies proved that Cn-AgNPs decrease the melanin content of cells. The IC50 value obtained was 84.82 μg/mL. Hence Cn-AgNPs is proposed to be acting as a whitening agent through lessening cellular melanin content and as a significant inhibitor of tyrosinase activity. The antioxidant properties and antibacterial effects can contribute to skin rejuvenation and can prevent skin infections as well. This evidence proposes the development of a new nanostructured pharmaceutical and cosmetic formulation from Cocos nucifera leaf sheath scales.
Two synergistic types of muscles were detected during forearm rotation exercise by T2 cumulative frequency curves using 0.2 T magnetic resonance imaging
Authors: Takamori Masayoshi , Akiyama Sumikazu , Seo Yoshiteru , Mizushima Takashi
Published: April 2024

The purpose of this study was the detection and characterization of synergistic muscle activity. Using T2-map MRI, T2values for 10 forearm muscles in 11 healthy adult volunteers were obtained in the resting state and after isotonic forearm supination and pronation exercises with the elbow extended. T2was normalized by Z = (T2e–T2r)/SDr, where T2ewas T2after exercise, while T2rand SDrwere the reference values of 34 ms and 3 ms, respectively. Using the cumulative frequency curves of Z values (CFZ), we detected 2 and 3 synergistic muscles for supination and pronation, respectively, and divided these into 2 types, one activated by exercise strength dependently, and the other, independent of exercise strength, activated by only a smaller fraction of the participants. We also detected co-contraction for the supination. Thus, CFZ is a useful visualization tool to detect and characterize not only synergistic muscle, but also co-contraction muscle.
Fine scale diversity in the lava: genetic and phenotypic diversity in small populations of Arctic charr Salvelinus alpinus
Authors: Leblanc Camille A. , Räsänen Katja , Morrissey Michael , Skúlason Skúli , Ferguson Moira , Kristjánsson Bjarni K.
Published: April 2024

Background

A major goal in evolutionary biology is to understand the processes underlying phenotypic variation in nature. Commonly, studies have focused on large interconnected populations or populations found along strong environmental gradients. However, studies on small fragmented populations can give strong insight into evolutionary processes in relation to discrete ecological factors. Evolution in small populations is believed to be dominated by stochastic processes, but recent work shows that small populations can also display adaptive phenotypic variation, through for example plasticity and rapid adaptive evolution. Such evolution takes place even though there are strong signs of historical bottlenecks and genetic drift. Here we studied 24 small populations of the freshwater fish Arctic charr (Salvelinus alpinus) found in groundwater filled lava caves. Those populations were found within a few km2-area with no apparent water connections between them. We studied the relative contribution of neutral versus non-neutral evolutionary processes in shaping phenotypic divergence, by contrasting patterns of phenotypic and neutral genetic divergence across populations in relation to environmental measurements. This allowed us to model the proportion of phenotypic variance explained by the environment, taking in to account the observed neutral genetic structure.

Results

These populations originated from the nearby Lake Mývatn, and showed small population sizes with low genetic diversity. Phenotypic variation was mostly correlated with neutral genetic diversity with only a small environmental effect.

Conclusions

Phenotypic diversity in these cave populations appears to be largely the product of neutral processes, fitting the classical evolutionary expectations. However, the fact that neutral processes did not explain fully the phenotypic patterns suggests that further studies can increase our understanding on how neutral evolutionary processes can interact with other forces of selection at early stages of divergence. The accessibility of these populations has provided the opportunity for long-term monitoring of individual fish, allowing tracking how the environment can influence phenotypic and genetic divergence for shaping and maintaining diversity in small populations. Such studies are important, especially in freshwater, as habitat alteration is commonly breaking populations into smaller units, which may or may not be viable.
The effect of white grub (Maladera Verticalis) larvae feeding on rhizosphere microbial characterization of aerobic rice (Oryza sativa L.) in Puer City, Yunnan Province, China
Authors: Wang Guang , Li Zhengfei , Yang Baoyun , Yang Huquan , Zhang Yujie , Zeng Qingping , Yan Chaojianping , He Yanyan , Peng Yuejin , Wang Wenqian , Chen Bin , Du Guangzu
Published: April 2024

Background

Rhizosphere microorganisms are vital in plants’ growth and development and these beneficial microbes are recruited to the root-zone soil when experiencing various environmental stresses. However, the effect of white grub (Maladera verticalis) larvae feeding on the structure and function of rhizosphere microbial communities of aerobic rice (Oryza sativa L.) is unclear.

Results

In this study, we compared physicochemical properties, enzyme activities, and microbial communities using 18 samples under healthy and M. verticalis larvae-feeding aerobic rice rhizosphere soils at the Yunnan of China. 16 S rRNA and ITS amplicons were sequenced using Illumina high throughput sequencing. M. verticalis larvae feeding on aerobic rice can influence rhizosphere soil physicochemical properties and enzyme activities, which also change rhizosphere microbial communities. The healthy and M. verticalis larvae-feeding aerobic rice rhizosphere soil microorganisms had distinct genus signatures, such as possible_genus_04 and Knoellia genera in healthy aerobic rice rhizosphere soils and norank_f__SC − I−84 and norank_f__Roseiflexaceae genera in M. verticalis larvae-feeding aerobic rice rhizosphere soils. The pathway of the metabolism of terpenoids and polyketides and carbohydrate metabolism in rhizosphere bacteria were significantly decreased after M. verticalis larvae feeding. Fungal parasite–wood saprotroph and fungal parasites were significantly decreased after M. verticalis larvae feeding, and plant pathogen–wood saprotroph and animal pathogen–undefined saprotroph were increased after larvae feeding. Additionally, the relative abundance of Bradyrhizobium and Talaromyces genera gradually increased with the elevation of the larvae density. Bacterial and fungal communities significantly correlated with soil physicochemical properties and enzyme activities, respectively.

Conclusions

Based on the results we provide new insight for understanding the adaptation of aerobic rice to M. verticalis larvae feeding via regulating the rhizosphere environment, which would allow us to facilitate translation to more effective measures.
Exploring the knowledge and skills for effective family caregiving in elderly home care: a qualitative study
Authors: Hailu Gebrezabher Niguse , Abdelkader Muntaha , Asfaw Feven , Meles Hailemariam Atsbeha
Published: April 2024

Background

Family caregivers play a crucial role in providing physical, emotional, and social support to the elderly, allowing them to maintain their independence and stay in their preferred living environment. However, family caregivers face numerous challenges and require specific knowledge and skills to provide effective care. Therefore, understanding the knowledge and skills required for effective family caregiving in elderly home care is vital to support both the caregivers and the elderly recipients.

Methods

The research was carried out in Mekelle City, Ethiopia, utilizing the phenomenology study design and purposive sampling technique. A total of twenty-two in-depth interviews were conducted. Individuals with experience in providing care for elderly people in their homes were targeted. Data was gathered through the use of an open-ended guide, transcribed word-for-word, inputted into ATLAS.ti8 software, and translated. Codes and themes were then extracted from the transcribed data, and a thematic analysis was performed. To minimize personal biases, the collected data were coded independently by the data collection assistants and the PI. The analysis was carried out by authors who were not involved in the data collection process. The interviews were conducted in a quiet place.

Results

A total of 22 in-depth interviews were conducted as part of this research. The results indicated that although the participants had knowledge about common health problems experienced by older people, they were uninformed about how to manage these conditions at home and were unaware of specialized healthcare resources for the elderly. Furthermore, they had limited knowledge about suitable exercise routines, strategies to prevent falls, and home healthcare practices for older individuals. On the other hand, they exhibited a solid comprehension and awareness of abusive behaviors specifically directed at older adults.

Conclusion

The results emphasized the importance of enhancing education and training for family caregivers in handling elderly health issues, raising awareness about specialized healthcare services catered to the elderly, improving understanding of activities of daily living (ADLs) and fall prevention, and offering inclusive training in healthcare tasks related to elder care.

Recommendation

Participants should receive comprehensive education and training programs to enhance their knowledge and skills in managing these conditions. Efforts should also be made to raise awareness about the availability of geriatric hospitals or specialized nurses for the elderly. Participants need to be educated about suitable exercise routines for the elderly and fall prevention strategies. Healthcare skills training is also necessary for participants, focusing on activities such as wound dressing, vital sign monitoring, and establishing a specific schedule for changing positions.
Targeted metabolomic profiles of serum amino acids are independently correlated with malnutrition in older adults
Authors: Zhao Xianghui , Meng Li , Wang Daguang , Shi Jing , Wu Wenbin , Fan Guoqing , Shi Hong , Dong Jun , Yu Pulin , Yang Ruiyue
Published: April 2024

Background

Malnutrition is a common geriatric syndrome that is closely associated with adverse clinical outcomes and poses significant harm to older adults. Early assessment of nutritional status plays a crucial role in preventing and intervening in cases of malnutrition. However, there is currently a lack of measurable methods and biomarkers to evaluate malnutrition in older adults accurately. The aim of this study is to investigate the independent correlation between serum levels of amino acids and malnutrition in older adults, and to identify effective metabolomics biomarkers that can aid in the early detection of geriatric malnutrition.

Methods

A total of 254 geriatric medical examination participants from Beijing Hospital were included in the study, consisting of 182 individuals with normal nutritional status (Normal group) and 72 patients at risk of malnutrition or already malnourished (MN group). Malnutrition was assessed using the Mini-Nutritional Assessment Short-Form (MNA-SF). Demographic data were collected, and muscle-related and lipid indexes were determined. Serum amino acid concentrations were measured using isotope dilution liquid chromatography-tandem mass spectrometry (LC-MS/MS). The correlation between serum amino acid levels and malnutrition was analyzed using non-parametric tests, partial correlation analysis, linear regression, and logistic regression.

Results

The geriatric MN group exhibited significantly lower serum aromatic amino acid levels (P < 0.05) compared to the normal group. A positive correlation was observed between serum aromatic amino acid levels and the MNA-SF score (P = 0.002), as well as with known biomarkers of malnutrition such as body mass index (BMI) (P < 0.001) and hemoglobin (HGB) (P = 0.005). Multivariable logistic or linear regression analyses showed that aromatic amino acid levels were negatively correlated with MN and positively correlated with the MNA-SF score, after adjusting for some confounding factors, such as age, gender, BMI, smoking status, history of dyslipidemia, diabetes mellitus and frailty. Stratified analyses revealed that these trends were more pronounced in individuals without a history of frailty compared to those with a history of frailty, and there was an interaction between aromatic amino acid levels and frailty history (P = 0.004).

Conclusion

Our study suggests that serum aromatic amino acids are independently associated with malnutrition in older adults. These results have important implications for identifying potential biomarkers to predict geriatric malnutrition or monitor its progression and severity, as malnutrition can result in poor clinical outcomes.
A systematic review and meta-analysis of circulating serum and plasma microRNAs in TB diagnosis
Authors: Gunasekaran Harinisri , Sampath Pavithra , Thiruvengadam Kannan , Malaisamy Muniyandi , Ramasamy Rathinasabapati , Ranganathan Uma Devi , Bethunaickan Ramalingam
Published: April 2024

Background

Tuberculosis (TB) ranks as the second leading cause of death globally among all infectious diseases. This problem is likely due to the lack of biomarkers to differentiate the heterogeneous spectrum of infection. Therefore, the first step in solving this problem is to identify biomarkers to distinguish the different disease states of an individual and treat them accordingly. Circulating microRNA (miRNA) biomarkers are promising candidates for various diseases. In fact, we are yet to conceptualize how miRNA expression influences and predicts TB disease outcomes. Thus, this systematic review and meta-analysis aimed to assess the diagnostic efficacy of circulating miRNAs in Latent TB (LTB) and Active Pulmonary TB (PTB).

Methods

Literature published between 2012 and 2021 was retrieved from PubMed, Web of Science, Cochrane, Scopus, Embase, and Google Scholar. Articles were screened based on inclusion and exclusion criteria, and their quality was assessed using the QUADAS-2 tool. Funnel plots and forest plots were generated to assess the likelihood of study bias and heterogeneity, respectively.

Results

After the screening process, seven articles were selected for qualitative analysis. The study groups, which consisted of Healthy Control (HC) vs. TB and LTB vs. TB, exhibited an overall sensitivity of 81.9% (95% CI: 74.2, 87.7) and specificity of 68.3% (95% CI: 57.8, 77.2), respectively. However, our meta-analysis results highlighted two potentially valuable miRNA candidates, miR-197 and miR-144, for discriminating TB from HC. The miRNA signature model (miR197-3p, miR-let-7e-5p, and miR-223-3p) has also been shown to diagnose DR-TB with a sensitivity of 100%, but with a compromised specificity of only 75%.

Conclusion

miRNA biomarkers show a promising future for TB diagnostics. Further multicentre studies without biases are required to identify clinically valid biomarkers for different states of the TB disease spectrum.

Systematic review registration

PROSPERO (CRD42022302729).
Ultrasound-based deep learning radiomics model for differentiating benign, borderline, and malignant ovarian tumours: a multi-class classification exploratory study
Authors: Du Yangchun , Guo Wenwen , Xiao Yanju , Chen Haining , Yao Jinxiu , Wu Ji
Published: April 2024

Background

Accurate preoperative identification of ovarian tumour subtypes is imperative for patients as it enables physicians to custom-tailor precise and individualized management strategies. So, we have developed an ultrasound (US)-based multiclass prediction algorithm for differentiating between benign, borderline, and malignant ovarian tumours.

Methods

We randomised data from 849 patients with ovarian tumours into training and testing sets in a ratio of 8:2. The regions of interest on the US images were segmented and handcrafted radiomics features were extracted and screened. We applied the one-versus-rest method in multiclass classification. We inputted the best features into machine learning (ML) models and constructed a radiomic signature (Rad_Sig). US images of the maximum trimmed ovarian tumour sections were inputted into a pre-trained convolutional neural network (CNN) model. After internal enhancement and complex algorithms, each sample’s predicted probability, known as the deep transfer learning signature (DTL_Sig), was generated. Clinical baseline data were analysed. Statistically significant clinical parameters and US semantic features in the training set were used to construct clinical signatures (Clinic_Sig). The prediction results of Rad_Sig, DTL_Sig, and Clinic_Sig for each sample were fused as new feature sets, to build the combined model, namely, the deep learning radiomic signature (DLR_Sig). We used the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) to estimate the performance of the multiclass classification model.

Results

The training set included 440 benign, 44 borderline, and 196 malignant ovarian tumours. The testing set included 109 benign, 11 borderline, and 49 malignant ovarian tumours. DLR_Sig three-class prediction model had the best overall and class-specific classification performance, with micro- and macro-average AUC of 0.90 and 0.84, respectively, on the testing set. Categories of identification AUC were 0.84, 0.85, and 0.83 for benign, borderline, and malignant ovarian tumours, respectively. In the confusion matrix, the classifier models of Clinic_Sig and Rad_Sig could not recognise borderline ovarian tumours. However, the proportions of borderline and malignant ovarian tumours identified by DLR_Sig were the highest at 54.55% and 63.27%, respectively.

Conclusions

The three-class prediction model of US-based DLR_Sig can discriminate between benign, borderline, and malignant ovarian tumours. Therefore, it may guide clinicians in determining the differential management of patients with ovarian tumours.
Designing and validating of a questionnaire measuring perceived self-care ability (PSCA) in chronic stroke patients at home
Authors: Jafari-golestan Nasrin , Dalvandi Asghar , Hosseini Mohammadali , Fallahi-Khoshknab Masoud , Ebadi Abbas , Rahgozar Mahdi , Souraya Sidani
Published: April 2024

Background

Patients with a stroke often cannot care for themselves after hospital discharge. Assessment of their self-care ability is the first step in planning post-discharge home care. This study aimed to design and validate a measure of perceived self-care ability (PSCA) in stroke patients.

Methods

A sequential-exploratory mixed method was conducted in Tehran, Iran, in 2020–2021. The qualitative phase involved in-depth semi-structured interviews with 12 participants. Transcripts were content analyzed. The results guided the development of 81 items. psychometric properties such as face validity (Impact Score > 1.5), content validity ratio (CVR > 0.63), content validity index (Item Content Validity Index: ICVI > 0.78, Scale Content Validity Index/Average: SCVI/Ave > 0.8) and Kappa value (Kappa > 0.7), internal consistency (Cronbach’s alpha > 0.7), relative reliability (ICC: inter class correlation coefficient), absolute reliability (Standard Error of Measurement: SEM and Minimal Detectable Changes: MDC), convergent validity (Correlation Coefficient between 0.4–0.7), interpretability, responsiveness, feasibility, and ceiling and floor effects were assessed.

Results

Content analysis of the qualitative interviews yielded 5 major categories and 9 subcategories that reflected "Perceptual stability", "Cognitive fluctuations", "Sensory, Motor and Physical health",” The subjective nature" and "The dynamic nature” of PSCA. Results of face and content validity reduced the number of items to 32, capturing three dimensions of PSCA in chronic stroke patients; these dimensions included perceptual ability, threatened health status, and sensory, motor, and cognitive ability. The findings supported the reliability and validity of the measure.

Conclusions

The PSCA questionnaire was developed and validated within the Iranian culture. It is useful in assessing the self-care of patients with stroke and in informing practice.
Astragaloside IV-PESV inhibits prostate cancer tumor growth by restoring gut microbiota and microbial metabolic homeostasis via the AGE-RAGE pathway
Authors: You Xujun , Qiu Junfeng , Li Qixin , Zhang Qing , Sheng Wen , Cao Yiguo , Fu Wei
Published: April 2024

Background

Prostate cancer (PCa) is becoming the most common malignancy in men worldwide. We investigated the effect of astragaloside IV combined with PESV on the gut microbiota and metabolite of PCa mice and the process of treating PCa.

Methods

Nude mice were genetically modified to develop tumors characteristic of PCa. The treatment of PCa mice involved the administration of a combination of astragaloside IV and peptides derived from scorpion venom (PESV). Feces were collected for both 16 S rDNA and metabolic analysis. Fecal supernatant was extracted and used for fecal transplantation in PCa mice. Tumor development was observed in both PCa mice and nude mice. Tumor histopathology was examined, and the expression of inflammatory factors and the AGE-RAGE axis in PCa tissues were analyzed.

Results

PCa mice treated with Astragaloside IV in combination with PESV showed a significant reduction in tumor volume and weight, and stabilization of gut microbiota and metabolites. At the Genus level, significant differences were observed in Porphyromonas, Corynebacterium, Arthromitus and Blautia, and the differential metabolites were PA16_016_0, Astragaloside+, Vitamin A acid, Nardosinone, a-Nortestoster, D-Pantethine, Hypoxanthine, Pregnenolone, cinnamic acid, Pyridoxa, Cirtruline and Xanthurenate. There was a correlation between gut microbiota and metabolites. After the fecal transplantation, tumor growth was effectively suppressed in the PCa mice. Notably, both the mRNA and protein levels of the receptor for advanced glycation end products (RAGE) were significantly decreased. Furthermore, the expression of inflammatory factors, namely NF-κB, TNF-α, and IL-6, in the tumor tissues was significantly attenuated. Conversely, upregulation of RAGE led to increased inflammation and reversed tumor growth in the mice.

Conclusion

Astragaloside IV combined with PESV could treat PCa by intervening in gut microbiota composition and metabolite by targeting RAGE.
Correlation between socioeconomic indices and epidemiological indices of thyroid cancer from 1990 to 2019 year: a global ecologic study
Authors: Maleki Zahra , Hassanzadeh Jafar , Ghaem Haleh
Published: April 2024

Background

The incidence of thyroid cancer as the most common type of endocrine gland malignancy has risen more significantly than any malignancies in recent years. Estimated new cases of thyroid cancer in the United States in 2024 were 12,500 and 31,520 for men and women, respectively, and estimated deaths were 1,180 for women and 990 for men. Indices of socio-economic have been commonly used to measure the development of countries. Therefore, this study aimed to examine the correlation between indices of socioeconomic status and epidemiological indices of thyroid cancer throughout the world. In addition, this study has compared two indices of human development and a socio-demographic index.

Method

This worldwide ecological study used data on thyroid cancer incidence, mortality, human development index (HDI), and sociodemographic index (SDI) between 1990 and 2019 from the Global Burden of Disease (GBD). We evaluated the correlation between incidence and mortality rates with socioeconomic indices by using Pearson’s correlation coefficient. Furthermore, for the first time, the generalized additive model (GAM) was employed for modeling. The statistical software R, version 4.2.2, was used to conduct all statistical analyses.

Results

The correlation between the incidence of thyroid cancer and the HDI was significant and positive (r = 0.47, p-value < 0.001). While the correlation between thyroid cancer mortality and HDI was not statistically significant (r = 0.01, p-value = 0.076). Besides, the incidence of thyroid cancer was significantly positively correlated with SDI (r = 0.48, p-value < 0.001). The multiple GAM showed that for one unit increase in HDI, the risk of thyroid cancer was increased by 2.1 times (RR = 2.1, 95%CI = 2.04 to 2.19), and for one unit increase in SDI, the risk of thyroid cancer was shown to increase by 2.2 times. (RR = 2.2, 95%CI = 2.19 to 2.35).

Conclusion

It has been evident that countries with higher incidence of thyroid cancer display higher socioeconomic indices. While, countries with higher socioeconomic indices, report lower mortality rates. However, based on the modeling results, it can be concluded that the SDI is slightly more useful in this regard. Therefore, examining the epidemiological indices of thyroid cancer by socio-economic indices can be useful to reflect a clear image of the distribution of this cancer in each country, and can be used for planning cancer prevention strategies.
Clinical characteristics and surgical outcomes of transcutaneous versus transconjunctival excision of Wolfring gland ductal cysts
Authors: Diab Mostafa Mohamed , Allen Richard C. , Mohammed Khaled Kotb , Saif Ahmed T.S.
Published: April 2024

Purpose

To analyze the clinicopathological characteristics and surgical outcomes of patients with Wolfring gland ductal cysts (WGDCs).

Methods

A retrospective, consecutive, interventional comparative case series was performed over a period of 7 years. Data on demographic and clinical characteristics, pathological findings and outcomes of surgically excised cysts were collected. A comparison between the transconjunctival and transcutaneous approaches was also assessed.

Results

Forty-eight patients (48 eyelids) were included in the final analysis. The most common presenting symptom was painless eyelid swelling (81.3%). The median symptom duration was 11.5 months (IQR, 18.25). The upper eyelid was involved in 31 (64.6%) patients, 29/31 of whom had cysts in a medial or centromedial location. Forty-five (93.8%) cysts were bluish gray and transilluminable with clear contents on lid eversion and a median largest dimension of 22 mm (IQR, 8). A transverse conjunctival fibrotic band was observed along the proximal tarsal border in the cyst area in all patients. Signs of chronic trachoma were noted in 38 (79.2%) patients. Preoperative significant ptosis was present in 28/31 (90.3%) of the upper eyelid cysts. Thirty cysts (62.5%) were excised through the skin, and 18 cysts (37.5%) were excised transconjunctivally. Intraoperative cyst rupture, the need for conjunctival grafting and postoperative residual upper lid ptosis were significantly greater in the transconjunctival group (p = 0.009, p < 0.001, and p = 0.016, respectively).

Conclusion

The present study highlights the clinicopathological characteristics of a relatively large series of surgically excised WGDCs. Transcutaneous excision of WGDCs has proven to be an effective treatment with fewer adverse sequelae than the transconjunctival approach.
Impulsivity mediates the association between narcissism and substance-related problems beyond the degree of substance use: a longitudinal observational study
Authors: Hildebrandt Malin K. , Noack Josepha , Wuellhorst Raoul , Endrass Tanja , Jauk Emanuel
Published: April 2024

Background

Narcissism has been implied as a putative risk factor for substance use disorders (SUDs). However, previous research did not disentangle the degree of substance use from substance-related problems, the symptoms of SUDs. This preregistered study addressed the open question whether grandiose and vulnerable narcissism and their constituent traits convey specific SUD risk, that is, explain substance-related problems beyond the degree of use. Furthermore, we tested whether impulsivity or substance use motives linked to narcissistic self-regulation mediate this association.

Methods

Narcissism, impulsivity, substance use motives, past-year substance use, and substance-related problems were assessed in 139 (poly-)substance users, 121 of whom completed a one-year follow-up. For significant longitudinal associations between narcissism factors and substance-related problems controlled for the degree of use, we tested impulsivity and substance use motives as mediators.

Results

Grandiose narcissism (r =.24, p =.007) and its constituent factors antagonistic (r =.27, p =.003) and agentic narcissism (r =.18, p =.050), but not vulnerable narcissism, prospectively predicted substance-related problems beyond the degree of substance use. Associations of grandiose narcissism and antagonistic narcissism with substance-related problems were fully mediated by impulsivity, but not substance use motives. Impulsivity explained roughly one third of the association of both grandiose (P̂M = 0.30) and antagonistic narcissism (P̂M = 0.26) with substance-related problems.

Discussion

We demonstrate that grandiose narcissism– particularly antagonistic but also agentic narcissism– is specifically linked to substance-related problems beyond the degree of substance use. The mediating effect of impulsivity but not substance use motives suggests that impulsivity may be a more important mechanism than narcissistic self-regulation in promoting SUD in narcissism. However, future studies may use more targeted measures than substance use motives to further probe the role of self-regulation. Similar result patterns for alcohol compared to all substances together indicate that mechanisms may be alike across substances. In conclusion, narcissistic individuals may not use substances more but have a higher SUD risk, informing prevention and treatment.