bluuebunny/crossref_metadata_2025 huggingface dataset:
Tibiotalocalcaneal Arthrodesis: A Retrospective Comparison Between Nails and Lateral Locking Plate Complications
Authors: Rosemberg Dov Lagus , Macedo Rodrigo Sousa , Sposeto Rafael Barban , Sakaki Marcos Hideyo , Godoy-Santos Alexandre Leme , Fernandes Tulio Diniz
Published: March 2023

Background:

Tibiotalocalcaneal arthrodesis is a well-established procedure to treat some hindfoot diseases. Currently, the most used implants are retrograde intramedullary nails and locking plates combined with lag screws, but there are few articles comparing differences regarding the complications.

Methods:

We have retrospectively analyzed the medical records and the radiographs of patients older than 18 years who underwent this procedure in our service between 2005 and 2019 through retrograde intramedullary nails or lateral locking plates and compression screws with at least 12 months of follow-up and with no history of osteomyelitis in these bones.

Results:

We evaluated a total of 67 patients; of these, 48 received retrograde intramedullary nail implants and 19 received locking plates and compression screws. The overall mean age was 48 years; the median follow-up time was 64.3 months. The complication rate was 60.4% for the intramedullary nail procedure and 52.6% for the locking plate combined with compression screws procedure.

Conclusion:

No significant differences were found in the complication rates between the 2 implants.

Level of Evidence:

Level V, Case series
Cerebral White Matter Demyelination in Vitamin B12 Deficiency: A Case Report
Authors: Kumar Subhash , Mahto Mala
Published: March 2023

Vitamin B12 deficiency has been classically associated with subacute combined degeneration of the cord. It can be readily recognized on magnetic resonance imaging as T2W hyperintensity of the dorsal column. Cerebral changes are being increasingly notified, especially in the elderly population. The authors report the case of a 33-year-old patient and describe the imaging characteristics.
Planning centrality, state-oriented growth, and the spatial evolution of development zones in urban China: The case of Wuhan’s Optics Valley
Authors: Geng Yunming , Jiang Wenwen , Wang Zheng
Published: March 2023

As an important component of China’s efforts at reform and its opening-up policy, China’s development zones have been experiencing rapid development for nearly 40 years and have played a huge role in promoting the country’s economic growth, industrial development, technological innovation and urban construction. This article focuses on the changing priorities and objectives of high-tech development zones and how they have shaped the spatiality of development zones. We also analyse the role of urban planning in delivering these spatial changes thereby expanding on the concept of planning centrality which was introduced by Wu in his 2018 article ‘Planning centrality, market instruments: Governing Chinese urban transformation under state entrepreneurialism’. By drawing on the case of the Optics Valley of China (also known as Wuhan East Lake High-Tech Development Zone), we illustrate how development zones have evolved spatially over 30 years due to the changing needs of the national government as well as the Wuhan municipality. We categorise these changes to the project’s spatial form into three stages: from block to park, from park to urban area, and finally, from urban area to new city. These three stages signify the different priorities of the Chinese state starting from industrial development, to land-based accumulation and now focusing on delivering an ecological civilisation and attracting and retaining a highly skilled workforce. For each corresponding stage, urban planning has played a crucial role whereby the change from a block to park was driven by regulatory and strategic planning whilst for instance the change from an urban area to a new city required planning to focus more on the delivery of high-quality public spaces and amenities through detailed urban design guidance and schemes.
Impact of ground-motion duration on nonlinear structural performance: Part II: site- and building-specific analysis
Authors: Otárola Kenneth , Sousa Luis , Gentile Roberto , Galasso Carmine
Published: March 2023

This study’s Part I proved that ground-motion duration could play an important role when assessing the nonlinear structural performance of case-study inelastic single degree-of-freedom systems. However, quantifying duration effects in many practical/more realistic engineering applications is not trivial, given the difficulties in decoupling duration from other ground-motion characteristics. This study’s Part II, introduced in this article, explores the impact of duration on nonlinear structural performance by numerically simulating the structural response of realistic case-study reinforced concrete bare and infilled building frames. Advanced computational models incorporating structural components’ cyclic and in-cycle strength and stiffness deterioration, and destabilizing [Formula: see text] effects are used. The proposed methodology relies on the generalized conditional intensity measure approach to select ground motions. This allows selecting records consistent with the seismic hazard at a target site, both in terms of spectral shape and duration. Those are employed as input to cloud-based nonlinear structural response analyses. Variance analysis is used to quantify the impact of duration on structural response. Furthermore, vector-valued fragility and vulnerability models alternatively using peak- and cumulative-based engineering demand parameters are derived. Results show that higher damage/loss estimates can be attained as ground-motion duration increases. Relative differences up to 44% are found in fragility median values for a pre-code reinforced concrete infilled frame when comparing scalar and vector-valued fragility models conditioned on average pseudo-spectral acceleration and significant durations up to 35 s.
How I treat unique and difficult to manage cases of CAR T-cell therapy associated neurotoxicity
Authors: Santomasso Bianca D , Gust Juliane , Perna Fabiana
Published: March 2023

With growing indications for Chimeric Antigen Receptor (CAR) T-cell therapy, toxicity profiles are evolving. There is an urgent and unmet need for approaches to optimally manage emerging adverse events that extend beyond the standard paradigm of cytokine release syndrome (CRS) and immune effector cell associated neurotoxicity syndrome (ICANS). While management guidelines exist for ICANS, there is little guidance on how to approach patients with neurologic comorbidities, and how to manage rare neurotoxicity presentations such as CAR T-cell therapy related cerebral edema, severe motor complications or late onset neurotoxicity. Here, we present three scenarios of patients treated with CAR T-cells who develop unique types of neurotoxicity, and we describe an approach to evaluation and management based on experience because objective data are limited. The goal of this manuscript is to develop awareness of emerging and unusual complications, discuss treatment approaches and help institutions and health care providers establish frameworks to navigate how to best address unusual neurotoxicities to ultimately improve patient outcomes.
Impact of allele-level HLA matching on outcomes after double cord blood transplantation in adults with malignancies
Authors: Fatobene Giancarlo , Mariano Livia , Volt Fernanda , Moreira Frederico , Conelissen Jan , Furst Sabine , Daguindau Etienne , Sirvent Anne , Peffault de Latour Régis , Rafii Hanadi , Rivera-Franco Monica M. , Kenzey Chantal , Scigliuolo Graziana Maria , Cappelli Barbara , Ruggeri Annalisa , Gluckman Eliane , Rocha Vanderson
Published: March 2023

In single unrelated cord blood transplantation (UCBT), an increasing number of HLA allele mismatches (MM) has been associated with inferior overall survival (OS) and attributed to higher transplant-related mortality (TRM). Previous studies on the role of allele-level HLA matching after double UCBT (dUCBT) showed conflicting results. In this study, we report the impact of allele-level HLA matching on the outcomes of a large dUCBT cohort. We included 963 adults with hematologic malignancies, with available allele-level HLA matching at HLA-A, -B, -C, and -DRB1, receiving dUCBT between 2006 to 2019. Assignment of donor-recipient HLA match was performed considering the unit with the highest disparity with the recipient. Three hundred ninety-two patients received dUCBT with 0 to 3 MM and 571 with ≥4 allele MM. For recipients of dUCBT with 0 to 3 MM, day-100 and 4-year TRM were 10% and 23%, respectively, compared with 16% and 36% for those with ≥4 MM. A higher degree of allele MM was also associated with the worse neutrophil recovery and lower incidence of relapse; no significant effect on graft-versus-host disease was observed. Patients receiving units with 0 to 3 MM had a 4-year OS of 54% compared with 43% for those receiving units with ≥4 MM. The inferior OS associated with higher HLA disparity was only partially mitigated by increased total nucleated cell doses. Our results confirm that allele-level HLA typing is a significant factor for OS after dUCBT, and units with ≥4 MM (≤4/8 HLA-matched) should be avoided if possible.
What do patients think about palliative care? A national survey of hematopoietic stem cell transplant recipients
Authors: Barata Anna , Abrams Hannah R. , Meyer Christa , Mau Lih-Wen , Mattila Deborah , Burns Linda J. , Ullrich Christina , Murthy Hemant , Wood William A. , Petersdorf Effie , LeBlanc Thomas W. , El-Jawahri Areej
Published: March 2023

Palliative care (PC) benefits patients undergoing hematopoietic stem cell transplantation (HSCT), but it remains underutilized. Although transplant physicians report concerns regarding how patients perceive PC, HSCT recipients’ perceptions about PC remain unaddressed. We conducted a multisite, cross-sectional survey of autologous and allogeneic HSCT recipients 3 to 12 months after transplant to assess their familiarity, knowledge, and perception of PC, as well as their unmet PC needs. We computed a composite score of patients’ perceptions of PC and used a generalized linear regression model to examine factors associated with these perceptions. We enrolled 69.6% (250/359) of potential participants (median age = 58.1; 63.1% autologous HSCT). Overall, 44.3.8% (109/249) reported limited knowledge about PC and 52% (127/245) endorsed familiarity with PC. Most patients felt hopeful (54%) and reassured (50%) when they heard the term PC; 83% saw referral as a sign their doctor cared about what was happening to them. In multivariate analyses, patients who were more knowledgeable about PC were more likely to have positive perceptions of PC (B = 7.54, standard error = 1.61, P < .001). Patients’ demographics, HSCT features, quality of life, and symptom burden were not significantly associated with perceptions of PC. HSCT recipients have positive perceptions of PC, though many have limited knowledge about its role. Patients who were more knowledgeable about PC were more likely to have positive perceptions of PC. These data do not support transplant physicians’ negative concerns about how patients perceive PC and underscore the need to further educate patients and transplant physicians about PC.
Use of statins and risk of myeloproliferative neoplasms: a Danish nationwide case-control study
Authors: Tuyet Kristensen Daniel , Kisbye Øvlisen Andreas , Hjort Kyneb Jakobsen Lasse , Tang Severinsen Marianne , Hannig Louise Hur , Starklint Jørn , Hagemann Hilsøe Morten , Pommer Vallentin Anders , Brabrand Mette , Hasselbalch Hans Carl , El-Galaly Tarec Christoffer , Stidsholt Roug Anne
Published: March 2023

Previous studies have indicated a possible cancer-protective effect of statins in solid cancers; however, this has never been investigated in myeloproliferative neoplasms (MPNs). We aimed to investigate the association between statin use and the risk of MPNs in a nested nationwide case-control study, using Danish national population registries. Information on statin use was obtained from the Danish National Prescription Registry, and patients diagnosed with MPNs between 2010 and 2018 were identified from the Danish National Chronic Myeloid Neoplasia Registry. The association between statin use and MPNs was estimated using age- and sex-adjusted odds ratios (ORs) and fully adjusted ORs (aORs), adjusting for prespecified confounders. The study population included 3816 cases with MPNs and 19 080 population controls (5:1) matched for age and sex using incidence density sampling. Overall, 34.9% of the cases and 33.5% of the controls ever used statins, resulting in an OR for MPN of 1.07 (95% confidence interval [CI], 0.99-1.16) and an aOR of 0.87 (95% CI, 0.80-0.96), respectively. 17.2% were categorized as long-term users (≥5 years) among the cases compared with 19.0% among controls, yielding an OR for MPN of 0.90 (95% CI, 0.81-1.00) and an aOR of 0.72 (95% CI, 0.64-0.81). Analysis of the effect of the cumulative duration of statin use revealed a dose-dependent response, and the association was consistent for sex, age, and MPN subgroups and across different statin types. Statin users were associated with significantly lower odds of being diagnosed with an MPN, indicating a possible cancer-preventive effect of statins. The retrospective design of this study precludes causal inferences.
Gene regulation network inference using k-nearest neighbor-based mutual information estimation: revisiting an old DREAM
Authors: Shachaf Lior I. , Roberts Elijah , Cahan Patrick , Xiao Jie
Published: March 2023

Background

A cell exhibits a variety of responses to internal and external cues. These responses are possible, in part, due to the presence of an elaborate gene regulatory network (GRN) in every single cell. In the past 20 years, many groups worked on reconstructing the topological structure of GRNs from large-scale gene expression data using a variety of inference algorithms. Insights gained about participating players in GRNs may ultimately lead to therapeutic benefits. Mutual information (MI) is a widely used metric within this inference/reconstruction pipeline as it can detect any correlation (linear and non-linear) between any number of variables (n-dimensions). However, the use of MI with continuous data (for example, normalized fluorescence intensity measurement of gene expression levels) is sensitive to data size, correlation strength and underlying distributions, and often requires laborious and, at times, ad hoc optimization.

Results

In this work, we first show that estimating MI of a bi- and tri-variate Gaussian distribution using k-nearest neighbor (kNN) MI estimation results in significant error reduction as compared to commonly used methods based on fixed binning. Second, we demonstrate that implementing the MI-based kNN Kraskov–Stoögbauer–Grassberger (KSG) algorithm leads to a significant improvement in GRN reconstruction for popular inference algorithms, such as Context Likelihood of Relatedness (CLR). Finally, through extensive in-silico benchmarking we show that a new inference algorithm CMIA (Conditional Mutual Information Augmentation), inspired by CLR, in combination with the KSG-MI estimator, outperforms commonly used methods.

Conclusions

Using three canonical datasets containing 15 synthetic networks, the newly developed method for GRN reconstruction—which combines CMIA, and the KSG-MI estimator—achieves an improvement of 20–35% in precision-recall measures over the current gold standard in the field. This new method will enable researchers to discover new gene interactions or better choose gene candidates for experimental validations.
Establishment of a prognostic signature for lung adenocarcinoma using cuproptosis-related lncRNAs
Authors: Yalimaimaiti Saiyidan , Liang Xiaoqiao , Zhao Haili , Dou Hong , Liu Wei , Yang Ying , Ning Li
Published: March 2023

Objective

To establish a prognostic signature for lung adenocarcinoma (LUAD) based on cuproptosis-related long non-coding RNAs (lncRNAs), and to study the immune-related functions of LUAD.

Methods

First, transcriptome data and clinical data related to LUAD were downloaded from the Cancer Genome Atlas (TCGA), and cuproptosis-related genes were analyzed to identify cuproptosis-related lncRNAs. Univariate COX analysis, least absolute shrinkage and selection operator (LASSO) analysis, and multivariate COX analysis were performed to analyze the cuproptosis-related lncRNAs, and a prognostic signature was established. Second, univariate COX analysis and multivariate COX analysis were performed for independent prognostic analyses. Receiver operating characteristic (ROC) curves, C index, survival curve, nomogram, and principal component analysis (PCA) were performed to evaluate the results of the independent prognostic analyses. Finally, gene enrichment analyses and immune-related function analyses were also carried out.

Results

(1) A total of 1,297 cuproptosis-related lncRNAs were screened. (2) A LUAD prognostic signature containing 13 cuproptosis-related lncRNAs was constructed (NIFK-AS1, AC026355.2, SEPSECS-AS1, AL360270.1, AC010999.2, ABCA9-AS1, AC032011.1, AL162632.3, LINC02518, LINC0059, AL031600.2, AP000346.1, AC012409.4). (3) The area under the multi-indicator ROC curves at 1, 3, and 5 years were AUC1 = 0.742, AUC2 = 0.708, and AUC3 = 0.762, respectively. The risk score of the prognostic signature could be used as an independent prognostic factor that was independent of other clinical indicators. (4) The results of gene enrichment analyses showed that 13 biomarkers were primarily related to amoebiasis, the wnt signaling pathway, hematopoietic cell lineage. The ssGSEA volcano map showed significant differences between high- and low-risk groups in immune-related functions, such as human leukocyte antigen (HLA), Type_II_IFN_Reponse, MHC_class_I, and Parainflammation (P < 0.001).

Conclusions

Thirteen cuproptosis-related lncRNAs may be clinical molecular biomarkers for the prognosis of LUAD.
INSnet: a method for detecting insertions based on deep learning network
Authors: Gao Runtian , Luo Junwei , Ding Hongyu , Zhai Haixia
Published: March 2023

Background

Many studies have shown that structural variations (SVs) strongly impact human disease. As a common type of SV, insertions are usually associated with genetic diseases. Therefore, accurately detecting insertions is of great significance. Although many methods for detecting insertions have been proposed, these methods often generate some errors and miss some variants. Hence, accurately detecting insertions remains a challenging task.

Results

In this paper, we propose a method named INSnet to detect insertions using a deep learning network. First, INSnet divides the reference genome into continuous sub-regions and takes five features for each locus through alignments between long reads and the reference genome. Next, INSnet uses a depthwise separable convolutional network. The convolution operation extracts informative features through spatial information and channel information. INSnet uses two attention mechanisms, the convolutional block attention module (CBAM) and efficient channel attention (ECA) to extract key alignment features in each sub-region. In order to capture the relationship between adjacent subregions, INSnet uses a gated recurrent unit (GRU) network to further extract more important SV signatures. After predicting whether a sub-region contains an insertion through the previous steps, INSnet determines the precise site and length of the insertion. The source code is available from GitHub at https://github.com/eioyuou/INSnet.

Conclusion

Experimental results show that INSnet can achieve better performance than other methods in terms of F1 score on real datasets.
A key gene for the climatic adaptation of Apis cerana populations in China according to selective sweep analysis
Authors: Zhang Yi , Xu Hao , Wang Zhi , Jie Haoliang , Gao Fuchao , Cai Minqi , Wang Kang , Chen Dafu , Guo Rui , Lin Zheguang , Niu Qingsheng , Ji Ting
Published: March 2023

Background

Apis cerana is widely distributed in China and, prior to the introduction of western honeybees, was the only bee species kept in China. During the long-term natural evolutionary process, many unique phenotypic variations have occurred among A. cerana populations in different geographical regions under varied climates. Understanding the molecular genetic basis and the effects of climate change on the adaptive evolution of A. cerana can promote A. cerana conservation in face of climate change and allow for the effective utilization of its genetic resources.

Result

To investigate the genetic basis of phenotypic variations and the impact of climate change on adaptive evolution, A. cerana workers from 100 colonies located at similar geographical latitudes or longitudes were analyzed. Our results revealed an important relationship between climate types and the genetic variation of A. cerana in China, and a greater influence of latitude compared with longitude was observed. Upon selection and morphometry analyses combination for populations under different climate types, we identified a key gene RAPTOR, which was deeply involved in developmental processes and influenced the body size.

Conclusion

The selection of RAPTOR at the genomic level during adaptive evolution could allow A. cerana to actively regulate its metabolism, thereby fine-tuning body sizes in response to harsh conditions caused by climate change, such as food shortages and extreme temperatures, which may partially elucidate the size differences of A. cerana populations. This study provides crucial support for the molecular genetic basis of the expansion and evolution of naturally distributed honeybee populations.
Hypervirulent R20291 Clostridioides difficile spores show disinfection resilience to sodium hypochlorite despite structural changes
Authors: Malyshev Dmitry , Jones Imogen Anne , McKracken Matthew , Öberg Rasmus , Harper Glenn M. , Joshi Lovleen Tina , Andersson Magnus
Published: March 2023

Background

Clostridioides difficile is a spore forming bacterial species and the major causative agent of nosocomial gastrointestinal infections. C. difficile spores are highly resilient to disinfection methods and to prevent infection, common cleaning protocols use sodium hypochlorite solutions to decontaminate hospital surfaces and equipment. However, there is a balance between minimising the use of harmful chemicals to the environment and patients as well as the need to eliminate spores, which can have varying resistance properties between strains. In this work, we employ TEM imaging and Raman spectroscopy to analyse changes in spore physiology in response to sodium hypochlorite. We characterize different C. difficile clinical isolates and assess the chemical’s impact on spores’ biochemical composition. Changes in the biochemical composition can, in turn, change spores’ vibrational spectroscopic fingerprints, which can impact the possibility of detecting spores in a hospital using Raman based methods.

Results

We found that the isolates show significantly different susceptibility to hypochlorite, with the R20291 strain, in particular, showing less than 1 log reduction in viability for a 0.5% hypochlorite treatment, far below typically reported values for C. difficile. While TEM and Raman spectra analysis of hypochlorite-treated spores revealed that some hypochlorite-exposed spores remained intact and not distinguishable from controls, most spores showed structural changes. These changes were prominent in B. thuringiensis spores than C. difficile spores.

Conclusion

This study highlights the ability of certain C. difficile spores to survive practical disinfection exposure and the related changes in spore Raman spectra that can be seen after exposure. These findings are important to consider when designing practical disinfection protocols and vibrational-based detection methods to avoid a false-positive response when screening decontaminated areas.

Graphical Abstract
The predictive value of weight evolution in screening for malnutrition in community-dwelling older persons (70+) in Antwerp
Authors: Van Offenwert Evelien , Schoenmakers Birgitte
Published: March 2023

Background

Experience and research show that screening for malnutrition in primary care mainly takes place by monitoring the weight parameter and that validated screening instruments are hardly used. In this study we examined the effectiveness and predictive value of weight evolution in screening for (risk of) malnutrition in older people living at home, in comparison with a validated screening tool, namely the Mini Nutritional Assessment Short Form (MNA-SF).

Methods

This project was a prospective, longitudinal study with quantitative data that took place in the province of Antwerp (Belgium) from December 2020 until June 2021. The target group of this study consisted of people over 70 living at home who were visited by a home nurse on a regular basis (at least once a month). The outcome measure was the weight evolution over six months compared with the score on the MNA-SF at month six. Weight was measured and recorded once a month during 6 months. At the last weight measurement, the MNA-SF was administered. In order to assess their own nutritional state, three additional questions were asked after taking the MNA-SF.

Results

A total of 143 patients gave consent to participate, of which 89 were women and 54 men. The mean age was 83.7 years (SD6.62) with a range of 70 to 100 years. Based on the MNA-SF score measured after six months, 53.1% (76/143) of participants had a normal nutritional status, 37.8% (54/143) scored risk of malnutrition and 4.9% (7/ 143) was malnourished. In order to detect people with (risk of) malnutrition, a PPV of 78.6%, a NPV of 60.7%, a sensitivity of 19.3% and a specificity of 96.0% were established with a weight evolution of ≥ 5% weight loss at six months. To detect malnutrition, our results showed respectively 33.3%, 98.4%, 71.4% and 92.3%.

Conclusion

In this study, weight evolution has a low sensitivity in screening for (risk of) malnutrition in people over 70 living at home compared to the MNA-SF. However, in order to detect people with malnutrition, this study demonstrated a sensitivity of 71.4% and a specificity of 92.3% for a weight loss of ≥ 5% at six months.
Psychometric properties of the Alzheimer’s Disease Cooperative Study – Activities of Daily Living for Mild Cognitive Impairment (ADCS-MCI-ADL) scale: a post hoc analysis of the ADCS ADC-008 trial
Authors: Potashman Michele , Pang Menglan , Tahir Muna , Shahraz Saeid , Dichter Sascha , Perneczky Robert , Nolte Sandra
Published: March 2023

Background

The Alzheimer's Disease Cooperative Study – Activities of Daily Living Scale for use in Mild Cognitive Impairment (MCI), the ADCS-ADL-MCI, is an evaluation scale with information provided by an informant/caregiver to describe the functional impairment of patients with MCI. As the ADCS-ADL-MCI has yet to undergo a full psychometric evaluation, this study aimed to evaluate the measurement properties of the ADCS-ADL-MCI in subjects with amnestic MCI.

Methods

Measurement properties, including item-level analysis, internal consistency reliability, test–retest reliability, construct validity (convergent/discriminant, known-groups validity), and responsiveness were evaluated using data from the ADCS ADC-008 trial, a 36-month, multicenter, placebo-controlled study in 769 subjects with amnestic MCI (defined by clinical criteria and a global clinical dementia rating, CDR, score of 0.5). Due to most subjects' mild condition at baseline and resulting low variance in scores, psychometric properties were assessed using both baseline and 36-month data.

Results

Ceiling effects were not apparent at the total score level, with 3% of the cohort reaching the maximum score of 53, despite most subjects having a relatively high score at baseline (mean score = 46.0 [standard deviation = 4.8]). Item-total correlations were overall weak at baseline, most likely due to low variability in responses; however, at month 36, good item homogeneity was found. Cronbach's alpha values ranged from acceptable (0.64 at baseline) to good (0.87 at month 36), indicating overall very good internal consistency reliability. Further, moderate to good test–retest reliability was found (intraclass correlation coefficients ranging from 0.62–0.73). The analyses also largely supported convergent/discriminant validity, especially at month 36. Finally, the ADCS-ADL-MCI discriminated well between groups showing good known-groups validity, and was responsive in patients who indicated a longitudinal change in other instruments.

Conclusions

This study provides a comprehensive psychometric evaluation of the ADCS-ADL-MCI. Findings suggest that the ADCS-ADL-MCI is a reliable, valid and responsive measure capable of capturing functional abilities in patients with amnestic MCI.

Trial registration

ClinicalTrials.gov Identifier: NCT00000173.
The impact of stroke on the ability to live an independent life at old age: a community-based cohort study of Swedish men
Authors: Lindvall Elias , Franzon Kristin , Lundström Erik , Kilander Lena
Published: March 2023

Introduction

Few studies with controls from the same cohort have investigated the impact of stroke on the ability to live an independent life at old age. We aimed to analyze how great an impact being a stroke survivor would have on cognition and disability. We also analyzed the predictive value of baseline cardiovascular risk factors.

Methods

We included 1147 men, free from stroke, dementia, and disability, from the Uppsala Longitudinal Study of Adult Men, between 69–74 years of age. Follow-up data were collected between the ages of 85–89 years and were available for 481 of all 509 survivors. Data on stroke diagnosis were obtained through national registries. Dementia was diagnosed through a systematic review of medical charts and in accordance with the current diagnostic criteria. The primary outcome, preserved functions, was a composite outcome comprising four criteria: no dementia, independent in personal activities of daily living, ability to walk outside unassisted, and not living in an institution.

Results

Among 481 survivors with outcome data, 64 (13%) suffered a stroke during the follow-up. Only 31% of stroke cases, compared to 72% of non-stroke cases (adjusted OR 0.20 [95% CI 0.11–0.37]), had preserved functions. The chance of being free of dementia was 60% lower in the stroke group, OR 0.40 [95% CI 0.22–0.72]. No cardiovascular risk factors were independently able to predict preserved functions among stroke cases.

Conclusion

Stroke has long lasting consequences for many aspects of disability at very high age.
Sarcopenia negatively affects postoperative short-term outcomes of patients with non-cirrhosis liver cancer
Authors: Yang Jinhuan , Wang Daojie , Ma Lei , An Xuewen , Hu Zijing , Zhu Huili , Zhang Wanqian , Chen Kaiwen , Ma Jun , Yang Yan , Wu Lijun , Chen Gang , Wang Yi
Published: March 2023

Background

Literature review have shown that sarcopenia substantially alters the postoperative outcomes after liver resection for malignant tumors. However, these retrospective studies do not distinguish cirrhotic and non-cirrhotic liver cancer patients, nor combine the assessment of muscle strength in addition to muscle mass. The purpose of this study is to study the relationship between sarcopenia and short-term outcomes after hepatectomy in patients with non-cirrhotic liver cancer.

Methods

From December 2020 to October 2021, 431 consecutive inpatients were prospectively enrolled in this study. Muscle strength and mass were assessed by handgrip strength and the skeletal muscle index (SMI) on preoperative computed tomographic scans, respectively. Based on the SMI and the handgrip strength, patients were divided into four groups: group A (low muscle mass and strength), group B (low muscle mass and normal muscle strength), group C (low muscle strength and normal muscle mass), and group D (normal muscle mass and strength). The main outcome was major complications and the secondary outcome was 90-d Readmission rate.

Results

After strictly exclusion, 171 non-cirrhosis patients (median age, 59.00 [IQR, 50.00–67.00] years; 72 females [42.1%]) were selected in the final analysis. Patients in group A had a statistically significantly higher incidence of major postoperative complications (Clavien–Dindo classification ≥ III) (26.1%, p = 0.032), blood transfusion rate (65.2%, p < 0.001), 90-day readmission rate (21.7%, p = 0.037) and hospitalization expenses (60,842.00 [IQR, 35,563.10–87,575.30], p < 0.001) than other groups. Sarcopenia (hazard ratio, 4.21; 95% CI, 1.44–9.48; p = 0.025) and open approach (hazard ratio, 2.56; 95% CI, 1.01–6.49; p = 0.004) were independent risk factors associated with major postoperative complications.

Conclusions

Sarcopenia is closely related to poor short-term postoperative outcomes in non-cirrhosis liver cancer patients and the assessment that combines muscle strength and muscle mass can simply and comprehensively identify it.

Trial registration

ClinicalTrials.gov identifiers NCT04637048. (19/11/2020).
Early-stage corneal toxicity secondary to high-dose systemic cytarabine: a case report
Authors: Mito Tsuyoshi , Takeda Shun , Miyashita Hisanori , Sasaki Hiroshi
Published: March 2023

Background

High-dose systemic cytarabine chemotherapy may cause fine corneal opacities and refractile microcysts, which are densely distributed in the center of the cornea. Most previous case reports on microcysts have been those following complaints of subjective symptoms, and the findings at the initial stage of development and time-course changes are still unknown. This report aims to clarify the time-course changes of microcysts using slit-lamp photomicrographs.

Case presentation

A 35-year-old woman who was treated with high-dose systemic cytarabine therapy (3 courses of 2 g/m2 every 12 h for 5 days) for acute myeloid leukemia and presented with subjective symptoms, such as bilateral conjunctival injection, photophobia, and blurred vision, on the 7th day of treatment in both the first two courses. Anterior segment findings by slit-lamp microscopy revealed microcysts densely distributed in the central region of the corneal epithelium. In both courses, microcysts disappeared within 2–3 weeks upon prophylactic steroid instillation. In the 3rd course, daily ophthalmic examinations were conducted from the start of the treatment, and on the 5th day without subjective symptoms, the microcysts in the corneal epithelium appeared evenly and sparsely distributed throughout the cornea except for the corneal limbus. Thereafter, the microcysts accumulated towards the center of the cornea and disappeared gradually. The change from low-dose to full-strength steroid instillation immediately following the occurrence of microcysts in the 3rd course resulted in the peak finding being the mildest compared to that in the past two courses.

Conclusions

Our case report revealed that microcysts appeared scattered throughout the cornea before the appearance of subjective symptoms and then accumulated in the center and disappeared. A detailed examination is necessary to detect early changes in microcyst development resulting in prompt and appropriate treatment.
Pattern, barriers, and predictors of mental health care utilization among Egyptian undergraduates: a cross-sectional multi-centre study
Authors: Baklola Mohamed , Terra Mohamed , Elzayat Mohamed A. , Abdelhady Doaa , El-Gilany Abdel-Hady , collaborators ARO team of
Published: March 2023

Background

Mental health disorders are a major public health concern especially among undergraduates, globally and within Egypt. Most individuals suffering from mental illnesses either do not seek care at all or seek it only after a large delay. It is therefore critical to identify the barriers that prevent them from seeking professional help to solve the problem from its roots. Thus, the objectives of the study were to assess the prevalence of psychological distress, the need for professional mental health care, and the barriers to seeking available services among undergraduate students in Egypt.

Methods

A proportionate allocation technique was used to recruit 3240 undergraduates from 21 universities. Symptoms of psychological distress were evaluated using the Arabic General Health Questionnaire (AGHQ-28) and a score of above nine was used to identify positive cases. The pattern for utilization of mental health care was assessed using a multi-choice question and barriers to mental health care were assessed using the Barriers to Access to Care Evaluation (BACE- 30) tool. Logistic regression was adopted to identify the predictors of psychological distress and seeking professional health care.

Results

The prevalence of psychological distress was 64.7% and the need for professional mental health care was 90.3% of those with psychological distress. The top barrier to receiving professional mental health services was wanting to solve the problem on their own. Logistic regression revealed that female sex, living away from family and positive family history of mental disorders were independent predictors of psychological distress. Students from urban backgrounds were more likely to seek help than students from rural ones. While age above 20 and positive family history of mental disorders were independent predictors for seeking professional help. There is no significant difference between medical and non-medical students in terms of psychological distress.

Conclusion

The findings of the study showed there is a high prevalence of psychological distress and a lot of instrumental and attitudinal related barriers to seeking mental health care and highlighted the urgent need to develop interventions and preventive strategies to address the mental health of university students.
Utilisation of rehabilitation due to mental disorders during the SARS-CoV-2 pandemic: a difference-in-differences analysis
Authors: Bethge Matthias , Fauser David , Zollmann Pia , Streibelt Marco
Published: March 2023

Background

Our analyses examined the extent to which the use of rehabilitation for patients with mental disorders decreased due to the COVID-19 pandemic in Germany.

Methods

We used monthly cross-sectional administrative data on rehabilitation utilisation due to mental disorders in 2019 and 2020 and estimated a difference-in-differences model to determine the reduction in rehabilitation utilisation attributable to the pandemic.

Results

We included 151,775 rehabilitations in 2019 and 123,229 rehabilitations in 2020 in our analysis. The number of rehabilitations decreased from April to December by 14.2% due to the pandemic (March to December: 21.8%). The decline was more pronounced for women than for men and varied regionally. Temporal and regional differences in utilisation were moderately associated with the decrease in mobility in the pandemic year. In the first phase of the pandemic, i.e., March and April 2020, the decline was strongly associated with the regional incidence of SARS-CoV-2 infection.

Conclusion

Due to the pandemic, significantly fewer rehabilitations due to mental disorders occurred in Germany in 2020 than in 2019. The likely increasing need for rehabilitation for people with mental disorders should be addressed by making rehabilitation access and delivery more flexible.
Problematic social media use and alcohol expectancies in early adolescents
Authors: Nagata Jason M. , Smith Natalia , Zamora Gabriel , Sajjad Omar M. , Ganson Kyle T. , Testa Alexander , Jackson Dylan B.
Published: March 2023

Background

Alcohol expectancies are beliefs regarding positive (e.g., tension reduction) or negative (e.g., loss of motor coordination) effects of alcohol. Based on Social Learning Theory, social media can influence alcohol expectancies in adolescents. In particular, problematic social media use – which can reflect elements of addiction, including mood modification, tolerance, withdrawal, conflict, and relapse – could be linked to alcohol expectancies. We aimed to determine the associations between problematic social media use and alcohol expectancies in a national (U.S.) cohort of 10-14-year-old early adolescents.

Methods

We analyzed cross-sectional data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 9,008) at the Year 2 assessment (2018–2020). Unadjusted and adjusted linear regression analyses were conducted to examine the associations between problematic social media use and alcohol expectancies (positive and negative), adjusting for race/ethnicity, sex, household income, parent education, sexual orientation, parental marital status, and study site. Furthermore, we computed marginal predicted probabilities to aid in interpreting findings.

Results

The sample was 48.7% female and racially and ethnically diverse (43.0% non-White), with a mean age of 12.02 ± 0.66 years old. In models adjusted for confounders including both time spent on social media and problematic social media use, time spent on social media was not associated with positive or negative alcohol expectancies, but higher problematic social media use score was associated with higher positive (B = 0.045, 95% confidence interval [CI] 0.020–0.069) and negative (B = 0.072, 95% CI 0.043–0.101) alcohol expectancies scores.

Conclusion

Problematic social media use was associated with both positive and negative alcohol expectancies in a demographically diverse national sample of early adolescents in the U.S. Given the small effect sizes of the current study, future studies should further examine these relationships prospectively, as well as the mechanisms linking problematic social media use to alcohol expectancies and alcohol consumption. Because alcohol expectancies are modifiable and linked with alcohol initiation, they could be a target for future prevention efforts.
The risk of an incident hospital contact with a musculoskeletal disorder in Danish occupational fishers: a register-based study
Authors: Remmen Line Nørgaard , Christiansen David Høyrup , Herttua Kimmo , Klakk Heidi , Berg-Beckhoff Gabriele
Published: March 2023

Background

The prevalence of musculoskeletal disorders (MSDs) among occupational fishers is high, yet knowledge of the risk factors is scarce and inconsistent. The aim of this study was to investigate the risk from various work-related characteristics on incident hospital contact due to a musculoskeletal disorders and other pain disorders among Danish occupational fishers.

Methods

This register-based study comprised data from the Danish Occupational Cohort with eXposure (DOC*X) for all persons registered as occupational fishers between 1994 and 2017. Time-to-event analysis with Cox regression model was used with age as the time scale.

Results

Among the 15,739 fishers, 40% (n = 5,669 cases) had an incident hospital contact with an MSD during follow-up. Back disorders were the dominant complaint. Male fishers working less than 5 years or more than 15 years had higher risks of MSD (HR 2.40 (95% CI: 2.06, 2.80), HR: 2.04 (95% CI: 1.76, 2.35), respectively, than those working for over 20 years. Period effects confounded and reduced the risk from occupational seniority.

Conclusion

Fishers occupational seniority vary in risk of MSDs across working life. Results showed a nonlinear relationship between the highest risk for fishers working less than 5 years and the lowest risk working more than 20 years as occupational fisher. More years in the workforce, a captain education, and primarily working part time significantly reduced the risk of experiencing a first MSDs for men. Healthy worker effect was documented.
Cefcapene pivoxil-induced hypocarnitinemic hypoglycemia in elderly man with subclinical ACTH deficiency: a case report
Authors: Takahashi Yoshihiro , Murayama Masanori , Noda Kaoru , Yamakawa Kengo , Koide Yuya , Yamada Rie , Hayashi Makoto , Yasuda Keigo
Published: March 2023

Background

Drug-induced hypocarnitinemia has been noted as a cause of hypoglycemia in children. However, adult cases are extremely rare and pre-existing conditions (including endocrine disorders and frailty) have been suggested to be involved. Hypoglycemia due to drug-induced hypocarnitinemia is quite rare, and there were few reports of pivoxil-containing cephalosporin (PCC)-induced hypocarnitinemia in adults.

Case presentation

We present a case of an 87-year-old man with malnutrition, and frailty. He developed severe hypoglycemia with unconsciousness after taking cefcapene pivoxil hydrochloride, one of PCC, and hypocarnitinemia was diagnosed. Despite levocarnitine administration, asymptomatic mild hypoglycemia had persisted. Subsequent investigation revealed subclinical ACTH deficiency due to empty sella, which played a key role to maintain mild hypoglycemia as underlying disorder, and PCC-induced hypocarnitinemia triggered severe hypoglycemia. The patient responded to hydrocortisone therapy.

Conclusions

We need to be aware of the facts that PCC can induce severe hypocarnitinemic hypoglycemia in elderly adults associated with frailty, malnutrition, and subclinical ACTH syndrome.
Reply to ‘Response to “The opinion of French pulmonologists and palliative care physicians on non-invasive ventilation during palliative sedation at end of life: a nationwide survey’’ ’
Authors: Guastella V. , Greil A. , Lambert C. , Lautrette A.
Published: March 2023

We read with interest the letter by Twycross and al on our article recently published in BMC Palliative Care. The authors suggest that the term palliative sedation has been used inappropriately and they consider that in the situation described the sedation was a procedural one rather than a continuous deep sedation. We strongly disagree with this point of view. In an end-of-life situation, the priorities are the patient’s comfort, pain and anxiety. This type of sedation does not have the characteristics of procedural sedation described in anaesthesia. The French Clayes Leonetti law makes it possible to clarify the intention of the sedation in end-of-life situations.
Protective effects of baicalin magnesium on non-alcoholic steatohepatitis rats are based on inhibiting NLRP3/Caspase-1/IL-1β signaling pathway
Authors: Guan Xiulu , Shen Shiyuan , Liu Jinxia , Song Hongru , Chang Jinhua , Mao Xiaoxia , Song Jingyu , Zhang Lin , Liu Cuizhe
Published: March 2023

Baicalin magnesium is a water-soluble compound isolated from the aqueous solution by Scutellaria baicalensis Georgi. Preliminary experiments have demonstrated that baicalin magnesium can exert protective effects against acute liver injury in rats induced by carbon tetrachloride or lipopolysaccharide combined with d-galactose by regulating lipid peroxidation and oxidative stress. The aim of this study was to investigate the protective effect of baicalin magnesium on non-alcoholic steatohepatitis (NASH) in rats and to elucidate the underlying mechanisms. NASH was induced through a high-fat diet (HFD) for 8 weeks, and Sprague-Dawley rats were intravenously injected with baicalin magnesium, baicalin, and magnesium sulfate for 2 weeks, respectively. Serum was obtained for biochemical analyses and the determination of oxidative stress indicators. Liver tissues were collected for use in liver index assessment, histopathological examination, inflammatory factor analysis, and protein and gene expression analysis. The results revealed that baicalin magnesium markedly improved HFD-induced lipid deposition, inflammatory response, oxidative stress, and histopathological impairments. And baicalin magnesium may exert a protective effect on NASH rats by inhibiting the NLR family pyrin domain involving the 3 (NLRP3)/caspase-1/interleukin (IL)-1β inflammatory pathway. Additionally, the effect of baicalin magnesium was remarkably superior to that of equimolar baicalin and magnesium sulfate in regard to ameliorating NASH symptoms. In conclusion, the findings suggested that baicalin magnesium may represent a potential drug for the treatment of NASH.