bluuebunny/crossref_metadata_2025 huggingface dataset:
A comparative study of respiratory effects of erector spinae plane block versus paravertebral plane block for women undergoing modified radical mastectomy
Authors: Sayed Jehan Ahmed , Hamed Rasha , Abdelraouf Abdelraouf MS , El-hagagy Noha Yahia Mohammd , El dean Mousa Mahmoud Bahaa , Abdel-Wahab Amani H.
Published: July 2024

Background

Inadequate acute postoperative pain control after modified radical mastectomy (MRM) can compromise pulmonary function. This work aimed to assess the postoperative pulmonary effects of a single-shot thoracic paravertebral block (TPVB) and erector spinae plane block (ESPB) in female patients undergoing MRM.

Methods

This prospective, randomized comparative trial was conducted on 40 female American Society of Anesthesiologists (ASA) II-III, aged 18 to 50 years undergoing MRM under general anesthesia (GA). Patients were divided into two equal groups (20 in each group): Group I received ESPB and Group II received TPVB. Each group received a single shot with 20 ml volume of 0.5% bupivacaine.

Results

Respiratory function tests showed a comparable decrease in forced vital capacity (FVC) and forced expiratory volume (FEV1) from the baseline in the two groups. Group I had a lower FEV1/FVC ratio than Group II after 6 h. Both groups were comparable regarding duration for the first postoperative analgesic request (P value = 0.088), comparable postoperative analgesic consumption (P value = 0.855), and stable hemodynamics with no reported side effects.

Conclusion

Both ultrasound guided ESPB and TPVB appeared to be effective in preserving pulmonary function during the first 24 h after MRM. This is thought to be due to their pain-relieving effects, as evidenced by decreased postoperative analgesic consumption and prolonged time to postoperative analgesic request in both groups.

ClinicalTrials.gov ID

NCT03614091 registration date on 13/7/2018.
A novel dual-target Septin9 methylation assay for improved detection of early-stage colorectal cancer and high-grade intraepithelial neoplasia
Authors: Wu Youming , Tong Yongqing , Zhang Haitao , Li Yun , Zhu Xu , Li Ming , Qiu Lili , Liu Wenlan , Mei Siqing , Mao Yu , Cao Yanhua , Su Caiyan , Yu Wentao , Wang Junli , Wang Taizhong , Zhu Zhongyuan , Yu De-Hua
Published: July 2024

Background

Colorectal cancer (CRC) ranks as the third most common malignancies in the world, and periodic examination of the patient is advantageous in reducing the mortality of CRC. The first blood-based Septin9 gene methylation assay which recognized by the US FDA for CRC examination was Epi proColon. However, this assay was not broadly applied in the current clinical guideline because of its relatively lower sensitivity in the detection of early-stage CRC.

Methods

This study aimed at developing a new multiplex Septin9 methylation assay (ColonUSK) which simultaneously evaluates two CpG-rich subregions in the promoter of the Septin9 gene and an internal control in a single reaction. ColonUSK proved increased sensitivity, with a detection limit as low as 12pg of the positive DNA compared with the Septin9 assay targeting one CpG-rich subregion. 1366 subjects were prospectively recruited from four comprehensive hospitals in China in an opportunistic screening study for assessing its value in CRC detection. Blind testing was developed to evaluate ColonUSK in comparison with clinical examination using clinical gold standard such as colonoscopy.

Results

The assay demonstrates clinical sensitivity for diagnosing colorectal cancer (CRC) and advanced adenoma at rates of 77.34% and 25.26%, respectively. Furthermore, ColonUSK exhibits a high degree of specificity for non-CRC cases (95.95%) clinically. Significantly, the detection rate of cases in high-grade intraepithelial neoplasia increased to 54.29%. The value for the assay in the Kappa test was 0.76, showing a high degree of consistency between ColonUSK and clinical gold standard.

Conclusions

ColonUSK indicated moderate diagnostic value and could become a non-invasive detection way for CRC. The implementation of the ColonUSK assay has the capacity to markedly enhance CRC screening practices.
Liraglutide, a glucagon-like peptide-1 receptor agonist, ameliorates inflammation and apoptosis via inhibition of receptor for advanced glycation end products signaling in AGEs induced chondrocytes
Authors: Zhang Xianyu , Jiang Jian , Xu Jiajia , Chen Jian , Gu Yuntao , Wu Guobao
Published: July 2024

Background

This study aimed to investigate functions of GLP-1R agonist by liraglutide (LIRA) and revealing the mechanism related to AGEs/RAGE in chondrocytes.

Methods

To illustrate potential effect of GLP-1R agonist on AGEs induced chondrocytes, chondrocytes were administrated by AGEs with LIRA and GLP-1R inhibitor exendin. Inflammatory factors were assessed using ELISA. Real-time PCR was used to evaluate the catabolic activity MMPs and ADAMTS mRNA level, as well as anabolic activity (aggrecan and collagen II). RAGE expression was investigated by Western blotting. TUNEL, caspase3 activity and immunofluorescence were performed to test the apoptotic activity.

Results

Our results showed that treatment with LIRA at > 100 nM attenuated the AGE-induced chondrocyte viability. Western bolt demonstrated that GLP-1R activation by LIRA treatment reduced RAGE protein expression compared with the AGEs groups. ELISA showed that LIRA hindered the AGEs-induced production of inflammatory cytokines (IL-6, IL-12 and TNF-α) in primary chondrocytes. AGEs induced catabolism levels (MMP-1, -3, -13 and ADAMTS-4, 5) are also attenuated by LIRA, causing the retention of more extracellular matrix (Aggrecan and Collagen II). TUNEL, caspase3 activity and immunofluorescence results indicated that LIRA inhibited the AGEs-induced production of inflammatory cytokines in primary chondrocytes and attenuated the caspase 3 level, leading to the reduced apoptotic activity. All the protective effects are reversed by exendin (GLP-1R blockers).

Conclusions

The present study demonstrates for the first time that LIRA, an agonist for GLP-1R which is commonly used in type 2 diabetes reverses AGEs induced chondrocyte inflammation and apoptosis through suppressing RAGE signaling, contributing to reduced catabolism and retention of more extracellular matrix. The above results indicate the possible effect of GLP-1R agonist on treating OA.
Nurses’ experiences of ethical challenges concerning thirst in dying patients in specialist palliative care: a qualitative study
Authors: Friedrichsen Maria , Lythell Caroline , Milovanovic Micha , Waldréus Nana , Thulesius Hans , Jaarsma Tiny , Jaarsma Pier , Hedman Christel , Schaller Anne Söderlund
Published: July 2024

Aim

To describe nurses’ experiences of ethical challenges in relation to thirst in terminally ill patients in specialist palliative care units.

Research design

A qualitative, reflexive thematic design with an inductive analysis was used.

Participants and research context

Eighteen qualitative interviews with nurses working in six different specialist palliative care units in different hospitals in Sweden were conducted. The interviews were transcribed verbatim and analysed with a reflexive thematic analysis.

Results

This study identified four themes that reflect ethical challenges experienced by nurses in the palliative care regarding thirst: Harmful infusions interfere with peaceful dying; conflict between tradition and personal experience; What is the right intervention to quench thirst? and; Lack of standard procedures, competence and interest among team members.

Conclusion

Palliative care nurses experience a number ethical challenges in relation to thirst in dying patients. The main challenge is the provision of fluids to dying patients via artificial infusions, which nurses struggle with, as they do not want to interfere with a peaceful dying process.
Efficacy of Traditional Chinese Medicine Combined Online Group Psychotherapy (TCM-eRhab) on improving quality of life and relieving psychological burden for colorectal cancer survivors: a study protocol for a phase-II randomized controlled trial
Authors: Yan Yunzi , Liu Jiaxi , Pang Ying , Wang Zixu , Peng Rongyan , Jiang Demei , Yang Yufei , Tang Lili , Sun Lingyun
Published: July 2024

Background

More than 50% of colorectal cancer(CRC) patients experience cancer-related psychological burden after radical surgery, which can seriously affect their physical wellness, quality of life and even survival outcomes. Our research team developed a six-week Traditional Chinese Medicine Combined Online Group Psychotherapy (TCM-eRhab) and proved its efficacy on relieving cancer-related anxiety, depression and fear of cancer recurrence though phase I single arm clinical trial (n = 40). Large sample size randomized controlled clinical trial(RCT) is necessary to further evaluate TCM-eRhab’s role on improving quality of life and survival outcomes among this population.

Methods

We design a phase II RCT study, in which 210 CRC patients who have received radical surgery (stage I-III) will be recruited. Eligible patients will be randomly assigned to TCM-eRhab group or usual care group by 2:1 ratio. Patients in the intervention group will receive the structured TCM-eRhab program for six weeks, while patients in control group will receive usual care only. The primary outcomes are quality of life, severity of anxiety, depression and fear of cancer recurrence. Cancer recurrence rate will also be calculated according to long term follow-up data.

Discussion

As one of the first RCTs to evaluate the impacts of TCM combined psychological therapy to improve CRC patients’ quality of life after surgery, the results from this study will provide innovative knowledge and evidence on integrating TCM into CRC survivorship care and mind–body intervention model.
Prognostic significance of lymphovascular space invasion in early-stage low-grade endometrioid endometrial cancer: a fifteen-year retrospective Chinese cohort study
Authors: Sun Bowen , Zhang Xiaobo , Dong Yangyang , Li Xingchen , Yang Xiao , Zhao Lijun , Wang Jianliu , Cheng Yuan
Published: July 2024

Objective

In 2016, the ESMO-ESGO-ESTRO consensus included LVSI (Lymph-vascular space invasion, LVSI) status as a risk stratification factor for stage I endometrioid endometrial cancer (EEC) patients and as one of the indications for adjuvant therapy. Furthermore, LVSI is included in the new FIGO staging of endometrial cancer (EC) in 2023. However, the data contribution of the Chinese population in this regard is limited. The present study aimed to further comfirm the influence of LVSI on the prognosis of early-stage low-grade EEC in a fifteen-year retrospective Chinese cohort study.

Methods

This retrospective analysis cohort included 702 EEC patients who underwent TAH/BSO surgery, total abdominal hysterectomy, bilateral salpingooophorectomy in Peking University People’s Hospital from 2006 to 2020. Patients were stratified based on LVSI expression status as: LVSI negative group and LVSI positive group. Clinical outcome measures related to LVSI, assessed with a univariate and multivariate Cox proportional hazards regression model.

Results

702 EEC patients with stage I and grade 1–2 were analyzed. 58 patients (8.3%) were LVSI-positive and 14 patients (2.0%) was relapse. Recurrence rates in LVSI-negative and LVSI-positive were 1.6% and 6.9%, respectively. 5-year disease-free survival (DFS) rate in LVSI-negative and LVSI-positive were 98.4% and 93.1%, respectively. These rates for 5-year overall (OS) survival in LVSI-negative were 98.9% while it was 94.8% in LVSI-positive. Multivariate analysis showed that LVSI is an independent risk factor for 5-year DFS (HR = 4.60, p = 0.010). LVSI has a similar result for 5-year OS(HR = 4.39, p = 0.028).

Conclusions

LVSI is an independent predictor of relapse and poor prognosis in early-stage low-grade endometrioid endometrial cancer in the Chinese cohort.
Impact of elevated serum estradiol levels before progesterone administration on pregnancy outcomes in frozen-thawed embryo transfer for hormone replacement therapy
Authors: Shuai Jun , Chen Qiaoli , Wan Siyan , Chen Xingyu , Liu Weiwei , Ye Hong , Huang Guoning
Published: July 2024

Objective

The objective of this retrospective cohort study is to investigate the impact of monitoring serum estradiol (E2) levels before progesterone administration within hormone replacement therapy (HRT) on pregnancy outcomes in women undergoing frozen-thawed embryo transfer (FET).

Methods

Analyzed HRT-FET cycles conducted at a reproductive center from 2017 to 2022. Serum E2 levels were measured prior to progesterone administration. Multivariate stratified and logistic regression analyses were performed on 26,194 patients grouped according to terciles of serum E2 levels before progesterone administration.

Results

The clinical pregnancy rate (CPR) and live birth rate (LBR) exhibited a gradual decline with increasing serum E2 levels across the three E2 groups. Even after controlling for potential confounders, including female age, body mass index, infertility diagnosis, cycle category, number of embryos transferred, fertilization method, indication for infertility, and endometrial thickness, both CPR and LBR persistently showed a gradual decrease as serum E2 levels increased within the three E2 groups. The same results were obtained by multivariate logistic regression analysis.

Conclusions

This large retrospective study indicates that elevated serum E2 levels before progesterone administration during HRT-FET cycles are associated with reduced CPR and LBR post-embryo transfer. Therefore, it is advisable to monitor serum E2 levels and adjust treatment strategies accordingly to maximize patient outcomes.
A prospective cohort study on the effect of lipid accumulation product index on the incidence of cardiovascular diseases
Authors: Tan Yizhen , Wu Yuntao , Ding Xiong , Liang Xueying , Zhao Wenliu , Liu Chunmeng , Lu Xiangfeng , Zhao Dandan , Wu Shouling , Li Yun
Published: July 2024

Background

Cardiovascular disease (CVD) is a chronic disease with a serious prognosis, and obesity is a risk factor for CVD. Lipid accumulation product index (LAP) is a new indicator of obesity, waist circumference, and triglycerides were included in the formula, but its association with CVD is inconsistent. Therefore, this study researched the effect of LAP levels on CVD.

Methods

This prospective cohort study was based on the Kailuan cohort. A total of 95,981 participants who completed the first physical examination in 2006 and had no history of CVD or LAP absence were included. The participants were divided into four groups according to the LAP quartile (Q1 - Q4). Up until December 31, 2022, incidence density was calculated for each group. The hazard ratio (HR) and 95% confidence interval (CI) of CVD in each group were calculated by the Cox proportional hazards model.

Results

During a median follow-up period of 15.95 years, 9925 incident CVD events occurred (2123 myocardial infarction and 8096 stroke). There were differences in potential confounders among the four groups (P < 0.001). The incidence density and 95% CI of CVD in Q1-Q4 groups were 4.76(4.54, 5.00), 6 0.50(6.24, 6.77), 8.13(7.84, 8.44) and 9.34(9.02, 9.67), respectively. There were significant differences in the survival curves among the four groups by log-rank test (P < 0.001). After adjusting for potential confounders, Cox proportional hazards model results showed that compared with the Q1 group, the HR and 95% CI of CVD in the Q2, Q3, and Q4 groups were1.15(1.08, 1.23), 1.29(1.21, 1.38) and 1.39(1.30, 1.49), respectively. The HR and 95%CI of myocardial infarction were 1.28(1.10, 1.49), 1.71(1.47, 1.98) and 1.92(1.64, 2.23), respectively. The HR and 95%CI of stroke were 1.11 (1.03, 1.19), 1.20 (1.12, 1.29) and 1.28 (1.19, 1.38), respectively. After subgroup analysis by gender, there was no significant interaction (P = 0.169), and the relationship between LAP and CVD in different genders was consistent with the main results. After subgroup analysis by age, there was a significant interaction (P = 0.007), and the association between LAP and CVD in different age groups was consistent with the main results. After subgroup analysis by BMI, there was no significant interaction (P = 0.506), and the association between LAP and CVD in different BMI groups was consistent with the main results. The results remained robust after sensitivity analyses. For each unit increase in ln(LAP), the HR and 95%CI of CVD were 4.07 (3.92, 4.23).

Conclusion

This study demonstrated that the risk of CVD increased with the increase of LAP level. The risk of CVD in group Q2 - Q4 was 1.15, 1.29, and 1.39 times higher than that in group Q1, respectively.

Clinical trial registration number

ChiCTR2000029767
Effects of licorice extract in combination with a low-calorie diet on obesity indices, glycemic indices, and lipid profiles in overweight/obese women with polycystic ovary syndrome (PCOS): a randomized, double-blind, placebo-controlled trial
Authors: Hooshmandi Hadis , Ghadiri-Anari Akram , Ranjbar Ali Mohammad , Fallahzadeh Hossein , Hosseinzadeh Mahdieh , Nadjarzadeh Azadeh
Published: July 2024

Background

Polycystic ovary syndrome (PCOS) is the most common ovarian dysfunction. Recent studies showed the effectiveness of licorice on metabolic profiles with inconsistent findings. So, we investigated the effect of licorice on obesity indices, glycemic indices, and lipid profiles in women with PCOS.

Methods

This randomized, double-blind, placebo-controlled trial was performed on 66 overweight/obese women with PCOS. The participants were randomly assigned to receive either 1.5 gr/day licorice extract plus a low-calorie diet (n = 33) or placebo plus a low-calorie diet (n = 33) for 8 weeks. Participants’ anthropometric indices and body composition were assessed using standard protocols. Fasting blood sugar (FBS), insulin levels, low-density lipoprotein-cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG), and high-density lipoprotein-cholesterol (HDL-C) were measured using enzymatic kits. The homeostasis model assessment-insulin resistance (HOMA-IR) and HOMA of β-cell function (HOMA-B) were calculated using valid formulas.

Results

Between-group comparisons demonstrated significant differences between the groups in terms of obesity indices (body weight, BMI, and body fat), lipid profiles (TG, TC, LDL-C, and HDL-C), FBS and insulin levels, HOMA-IR, and HOMA-B at the end of the study (P < 0.05). Supplementation with licorice plus a low-calorie diet was also more effective in improving all parameters than a low-calorie diet alone after adjusting for confounders (baseline values, age, weight changes, and physical activity changes) (P < 0.05).

Conclusion

The findings showed that licorice consumption leads to improvements in obesity indices, glucose homeostasis, and lipid profiles compared to placebo. Due to possible limitations of the study, further research is needed to confirm these findings.
Lung transplant list withdrawal in a liver transplant patient thanks to elexacaftor-tezacaftor-ivacaftor: a case report
Authors: Traunero Arianna , Galletti Anna , Ghirardo Sergio , Barbi Egidio , Maschio Massimo
Published: July 2024

Background

Elexacaftor-tezacaftor-ivacaftor (ETI) is a transmembrane conductance regulator modulator that significantly improves lung function in patients affected by cystic fibrosis (CF). This triple drug is currently not indicated in liver transplant patients, as clinical trials including subjects with previous solid organ transplantation are lacking.

Case presentation

We report on a liver transplant girl with CF-related advanced pulmonary disease meeting clinical criteria for lung transplant, who started the triple modulator because she could not get on the lung transplant waiting list due to psycho-social motivations. Since initiation of ETI therapy, she has experienced a significant improvement in respiratory function and quality of life, without adverse effects.

Conclusions

This case shows that ETI therapy can represent a lifesaving drug for individuals without alternatives, even in liver transplant patients. The clinical benefits of the modulator overcome risks, which may be limited with a close drug monitoring of immunosuppressants serum levels and functional liver tests.
A preoperative radiogenomic model based on quantitative heterogeneity for predicting outcomes in triple-negative breast cancer patients who underwent neoadjuvant chemotherapy
Authors: Zhou Jiayin , Bai Yansong , Zhang Ying , Wang Zezhou , Sun Shiyun , Lin Luyi , Gu Yajia , You Chao
Published: July 2024

Background

Triple-negative breast cancer (TNBC) is highly heterogeneous, resulting in different responses to neoadjuvant chemotherapy (NAC) and prognoses among patients. This study sought to characterize the heterogeneity of TNBC on MRI and develop a radiogenomic model for predicting both pathological complete response (pCR) and prognosis.

Materials and methods

In this retrospective study, TNBC patients who underwent neoadjuvant chemotherapy at Fudan University Shanghai Cancer Center were enrolled as the radiomic development cohort (n = 315); among these patients, those whose genetic data were available were enrolled as the radiogenomic development cohort (n = 98). The study population of the two cohorts was randomly divided into a training set and a validation set at a ratio of 7:3. The external validation cohort (n = 77) included patients from the DUKE and I-SPY 1 databases. Spatial heterogeneity was characterized using features from the intratumoral subregions and peritumoral region. Hemodynamic heterogeneity was characterized by kinetic features from the tumor body. Three radiomics models were developed by logistic regression after selecting features. Model 1 included subregional and peritumoral features, Model 2 included kinetic features, and Model 3 integrated the features of Model 1 and Model 2. Two fusion models were developed by further integrating pathological and genomic features (PRM: pathology-radiomics model; GPRM: genomics-pathology-radiomics model). Model performance was assessed with the AUC and decision curve analysis. Prognostic implications were assessed with Kaplan‒Meier curves and multivariate Cox regression.

Results

Among the radiomic models, the multiregional model representing multiscale heterogeneity (Model 3) exhibited better pCR prediction, with AUCs of 0.87, 0.79, and 0.78 in the training, internal validation, and external validation sets, respectively. The GPRM showed the best performance for predicting pCR in the training (AUC = 0.97, P = 0.015) and validation sets (AUC = 0.93, P = 0.019). Model 3, PRM and GPRM could stratify patients by disease-free survival, and a predicted nonpCR was associated with poor prognosis (P = 0.034, 0.001 and 0.019, respectively).

Conclusion

Multiscale heterogeneity characterized by DCE-MRI could effectively predict the pCR and prognosis of TNBC patients. The radiogenomic model could serve as a valuable biomarker to improve the prediction performance.
Great leap forward famine exposure and urban-rural migration convolute the modern prevalence of diabetes in China
Authors: Luo Dian , Kuo Wan-chin
Published: July 2024

Background

Although evidence from birth cohort analysis has indicated the metabolic risk of early-life exposure to the Great Leap Forward Famine (GLFF) in China, three confounding effects, including the exposure windows, aging, and geographical variations in famine severity, have been brought to debates for a decade. This study aimed to address these confounding effects and extensively examine how GLFF exposure is associated with diabetes risk in mid-to-late life and its interaction with urban-rural migration.

Methods

Data from the China Health and Retirement Longitudinal Study (CHARLS) were analyzed with age-stratification and stepped wedge approaches. Weighted prevalence and multivariable logistic regression were used to investigate the effects of GLFF exposure and urban-rural migration on mid-to-late life diabetes risk and the interaction between GLFF exposure and urban-rural migration. Birth provinces were controlled as a fixed effect to account for variations in famine severity across provinces.

Results

Compared to those who were never exposed to GLFF, fetal GLFF exposure was associated with a higher risk of adult-onset diabetes after controlling for provinces, demographics, and health statuses. Yet, after adding the proxy of childhood growth environments into the model, fetal exposure to GLFF was not significantly associated with adult-onset diabetes risk (OR = 1.22, p = 0.10), compared to those who were never exposed to GLFF. Across the three age-stratification groups, static urban residents, in general, had a higher risk of diabetes compared to static rural residents. Interaction effects between GLFF exposure and urban-rural migration were insignificant across all three age-stratification groups.

Conclusion

Fetal exposure to GLFF might have a traceable effect on adult-onset diabetes risk. Yet, the growth environment and urban lifestyle outweigh and further confound the impact of GLFF exposure on adult-onset diabetes risk.
Trends in antimicrobial resistance in Enterobacterales isolated from children: data from the China Antimicrobial Surveillance Network (CHINET) from 2015–2021
Authors: Pan Fen , Wang Chun , Yang Yang , Guo Yan , Zhu Demei , Zhang Hong , Jiang Xiaofei , Xu Yingchun , Zhang Xiaojiang , Zhang Zhaoxia , Ji Ping , Kang Mei , He Chao , Wang Chuanqing , He Leiyan , Xu Yuanhong , Huang Ying , Chen Zhongju , Sun Ziyong , Ni Yuxing , Sun Jingyong , Chu Yunzhuo , Tian Sufei , Hu Zhidong , Li Jin , Yu Yunsong , Lin Jie , Shan Bin , Du Yan , Guo Sufang , Wang Yanyan , Wei Lianhua , Wang Xin , Zhuo Chao , Su Danhong , Wang Ruizhong , Fang Hua , Yu Bixia , Gong Ping , Song Miao , Guo Dawen , Zhao Jinying , Liu Wen’en , Li Yanming , Jin Yan , Wang Yueling , Weng Kaizhen , Zhang Yirong , Xu Xuesong , Yan Chao , Huang Xiangning , Yu Hua , Li Yi , Wang Shanmei , Zhang Lixia , Ma Juan , Zhou Shuping , Ke Jiangwei , Zhu Lei , Meng Jinhua , Shen Han , Zhou Wanqing , Li Gang , Jia Wei , Wu Jinsong , Lu Yuemei , Li Jihong , Liu Jiangshan , Liao Longfeng , Gu Hongqin , Jiang Lin , He Wen , Xue Shunhong , Feng Jiao , Dou Rui , Yue Chunlei , Guo Ruyi , Jin Yan , Ma Xiaobo , Zheng Yanping , Hu Fangfang , Chen Yunsheng , Meng Qing ,   China Antimicrobial Surveillance Network (CHINET) Study Group
Published: July 2024

Antimicrobial resistance poses a significant threat to global public health, especially for Enterobacterales. In this study, we investigated the distribution and antimicrobial resistance of Enterobacterales in children in the China Antimicrobial Surveillance Network (CHINET) in 2015–2021. In total, 81,681 strains isolated from children were collected in this period, accounting for 50.1% of Gram-negative organisms. The most frequently isolated Enterobacterales were Escherichia coli, Klebsiella spp., Salmonella spp., and Enterobacter spp. The main sources of the isolates were urine and the respiratory tract, accounting for 29.3% and 27.7% of isolates, respectively. The proportions of E. coli, Klebsiella pneumoniae, and Proteus mirabilis expressing extended-spectrum β-lactamase were 48.8%–57.6%, 49.3%–66.7%, and 23.1%–33.8%, respectively. The prevalence of carbapenem-resistant Enterobacterales was 5.7%–9.5%, which showed a decreasing trend from 2015 to 2021. The detection rates of carbapenem-resistant Klebsiella spp., carbapenem-resistant Enterobacter spp., and carbapenem-resistant E. coli were 14.1%–22.6%, 7.1%–15.7% and 2.0%–3.4%, respectively. In Enterobacterales, the resistance rates to ciprofloxacin were higher than to levofloxacin. However, the Enterobacterales strains were highly susceptible to amikacin, polymyxin B, and tigecycline. The resistance rate of Salmonella spp. to ampicillin was > 70%, whereas their resistance rate to ceftriaxone was < 30%. These findings indicate that the resistant rates of some Enterobacterales isolates in children to common antimicrobial agents show decreasing trends. Continuous monitoring of bacterial resistance should be strengthened to prevent and control the spread of drug-resistant bacteria.
Effect of behavioural activation for individuals with post-stroke depression: systematic review and meta-analysis
Authors: Yisma Engida , Walsh Sandra , Hillier Susan , Gillam Marianne , Gray Richard , Jones Martin
Published: July 2024

Background

Previous research showed that behavioural activation is as effective as cognitive–behavioural therapy for general depression. However, it remains unclear if it leads to greater improvement in depressive symptoms when compared with standard treatment for post-stroke depression.

Aims

To compare the effectiveness of behavioural activation against control conditions in reducing depression symptoms in individuals with post-stroke depression.

Method

This review searched five databases from inception until 13 July 2021 (updated 15 September 2023) for randomised controlled trials comparing behavioural activation and any control conditions for post-stroke depression. Risk of bias was assessed with the Cochrane Collaboration's Risk-of-Bias 2 tool. The primary outcome was improvement in depressive symptoms in individuals with post-stroke depression. We calculated a random-effects, inverse variance weighting meta-analysis.

Results

Of 922 initial studies, five randomised controlled trials with 425 participants met the inclusion criteria. Meta-analysis showed that behavioural activation was associated with reduced depressive symptoms in individuals with post-stroke depression at 6-month follow-up (Hedges’ g −0.39; 95% CI −0.64 to −0.14). The risk of bias was low for two (40%) of five trials, and the remaining three (60%) trials were rated as having a high risk of bias. Heterogeneity was low, with no indication of inconsistency.

Conclusions

Evidence from this review was too little to confirm the effectiveness of behavioural activation as a useful treatment for post-stroke depression when compared with control conditions. Further high-quality studies are needed to conclusively establish the efficacy of behavioural activation as a treatment option for post-stroke depression.
Novel Biomarkers Reveal Mismatch Between Tissue and Serum Thyroid Hormone Status in Amiodarone-Induced Hyperthyroidism
Authors: Sinkó Richárd , Katkó Mónika , Tóth Géza , Kovács Gábor László , Dohán Orsolya , Fülöp Tibor , Costa Patrício , Dorogházi Beáta , Kővári Dóra , Nagy Endre V , Fekete Csaba , Gereben Balázs
Published: July 2024

Context

Serum thyrotropin and thyroid hormone (TH) levels are routine markers of thyroid function. However, their diagnostic performance is limited under special conditions, such as in amiodarone-induced hyperthyroidism (AIH). Such cases would require the assessment of tissue TH action, which is currently unfeasible.

Objective

Development of an approach that determines how well serum parameters are reflected in tissue TH action of patients.

Methods

TH-responsive marker genes were identified from human hair follicles (HFs) with next-generation sequencing, validated by quantitative polymerase chain reaction. A classification model was built with these markers to assess tissue TH action and was deployed on amiodarone-treated patients. The impact of amiodarone on tissue TH action was also studied in thyroid hormone action indicator (THAI) mice.

Results

The classification model was validated and shown to predict tissue TH status of subjects with good performance. Serum- and HF-based TH statuses were concordant in hypothyroid and euthyroid amiodarone-treated patients. In contrast, amiodarone decreased the coincidence of serum-based and HF-based TH statuses in patients with hyperthyroidism, indicating that AIH is not unequivocally associated with tissue hyperthyroidism. This was confirmed in the THAI model, where amiodarone prevented tissue hyperthyroidism in THAI mice despite high serum free thyroxine.

Conclusion

We developed a minimally invasive approach using HF markers to assess tissue TH economy that could complement routine diagnostics in controversial cases. We observed that a substantial proportion of patients with AIH do not develop tissue hyperthyroidism, indicating that amiodarone protects tissues from thyrotoxicosis. Assessing tissue TH action in patients with AIH may be warranted for treatment decisions.
ASSIMETRIA REGULATÓRIA ENTRE PORTOS PÚBLICOS E TERMINAIS DE USO PRIVADO – CASE DO PORTO DE PARANAGUÁ
Authors: Freitas dos Santos Marcus Vinicius
Published: July 2024

Este artigo contém um estudo de caso, a partir das situações observadas nos portos paranaenses, em relação ao procedimento para obtenção da delegação de competências, bem como para realização de procedimentos licitatórios para arrendamento de áreas operacionais, frente ao arcabouço legal que rege a matéria e aos percalços enfrentados ao longo dos procedimentos que serviram de parâmetro para o estudo. Ao final, traçou-se um paralelo com a sistemática aplicável aos Terminais de Uso Privado, para demonstrar a polarização incidente no mesmo setor (portuário).
Recursos estratégicos e internacionalização nos Programas de Pós-Graduação stricto sensu da Área de Administração, Ciências Contábeis e Turismo do Brasil
Authors: Ribeiro Henrique César Melo
Published: July 2024

O objetivo deste estudo foi identificar e analisar os recursos estratégicos mapeados e assimilados pelos programas de pós-graduação (PPGs) stricto sensu para um processo de internacionalização. Utilizou-se da análise fatorial, regressão linear e anova. Vislumbram quatro grupos de fatores que alicerçam e norteiam os recursos estratégicos importantes e decisivos para o processo de internacionalização dos PPGs: inovação e RH; pesquisa científica; experiência e parceria internacional; e marketing e marca. Os recursos estratégicos identificados e analisados nesta pesquisa, contribuem para que os PPGs possam ter uma maior ciência de quais recursos competitivos podem ser proeminentes para o processo de internacionalização.
The Bright Side of Price Volatility in Global Commodity Procurement
Authors: Xing Wei , Liu Liming , Zhang Fuqiang , Zhao Qian
Published: July 2024

This paper studies two competing firms’ choices between the contingent-price contract (CPC) and fixed-price contract (FPC) in global commodity procurement. The FPC price is determined when signing the contract, whereas the CPC price is pegged to an underlying index and remains open until the delivery date. Under both contracts, each firm determines its order quantity based on the updated belief about the market demand. The unrealized CPC price correlates with the market demand, allowing a firm to update its belief about the CPC price using demand information, thereby generating a price-learning effect. We find that, contrary to conventional wisdom, a larger price volatility could benefit the firms, and, under differentiated contracts, a firm might benefit from the improvement of forecast accuracy at its rival. We further show that the price-learning effect plays a critical role in the firms’ contract choices. First, significant price volatility forces the firms to pursue the responsiveness of the CPC. Second, the firms may adopt differentiated contracts to enhance their responses to market changes and dampen competition, and a higher competition intensity more likely leads to contract differentiation. Third, the firms in a small market seek responsiveness and contract differentiation rather than cost efficiency. This study reveals the bright side of price volatility and takes a step toward understanding the effect of two-dimensional information updating.

This paper was accepted by Jeannette Song, operations management.

Funding: This work was supported in part by the National Natural Science Foundation of China [W. Xing was supported by Grant 72071210, L. Liu was supported by Grant 72371122, and F. Zhang was supported by Grants 71929201 and 72131004].

Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2023.00304 .
A case of atypical scleroderma renal crisis
Authors: Lalwani Ayushi , Amin Shefali , Yousaf Zohaib , Riaz Gondal Muhammad Umer , Al Ampnti Sami , Pajak Andrew , Reggio Christopher
Published: July 2024

We present the case of a 63-year-old female diagnosed with atypical SSc in the setting of acute SRC. She was undergoing work-up for progressive dyspnoea in the outpatient setting when she was found to have newly diagnosed restrictive lung pathology and worsening renal function, thus prompting acute hospital admission. Given multisystem involvement of the pulmonary and renal systems, the differential diagnosis included autoimmune and connective tissue disorders. Although serologies were non-specific, renal biopsy confirmed scleroderma renal disease, and she was started on treatment with captopril. This case highlights the importance of clinical judgment and timely diagnosis, even when laboratory data might indicate otherwise.
Sizing of Energy Storage Systems in Electric Vehicles based on Battery-Supercapacitor Technology
Authors: Alfani Denny
Published: July 2024

The purpose of this research is to determine the ideal hybrid energy storage system (HESS) size with the goal to improve the effectiveness and efficiency of combined battery and supercapacitor energy storage in electric vehicles. The research uses Mixed Integer Linear Programming (MILP) to determine the most suitable configurations using simulation data from a modeled electric vehicle. The results show that MILP works at identifying the specific capacity needs of the storage system, which change based on the vehicle's power and energy capacity. The innovation provides a paradigm for the development of sustainable and highly efficient electric vehicles in the future, while also enhancing the functionality of current electric vehicles.
The impact of an anomalous third segment of the vertebral artery on bypass surgery: a case report and literature review
Authors: Zhao Yike , Liu Fangzhou , Shen Fazheng , Liang Jianing , Zhao Xinli
Published: July 2024

The horizontal part of the third segment (V3) of the vertebral artery (VA) is a critical anastomotic site for bypass procedures involving either donor or recipient vessels. It is rare for the V3 segment to deviate from its typical course of passing through the atlanto-transverse foramen. V3 anomaly encountered in occipital artery (OA)-V3 bypass surgery has not been previously reported. Here, we present a case involving a patient undergoing bypass surgery due to recurrent post-stent occlusion at the first segment (V1) of the left VA. During the operation, it was noted that the V3 horizontal segment could not be identified within the left VA groove, leading to initial suspicion of left V3 disuse atrophy attributed to prolonged chronic ischaemia. Consequently, there was a need to modify the operative method and to transition from an OA-V3 bypass to an OA-posterior inferior cerebellar artery bypass. Post-operative computed tomography angiography confirmed that indeed, the left V3 did not traverse through the transverse foramen of the atlas and instead entered the dural membrane between the first cervical vertebra (C1) and the second cervical vertebra (C2).
Material Culture in Vernacular/Semi−Vernacular Arabic from Medieval Tunisia: A Preliminary Inventory of Lexical Data in the Kitāb Riyāḍ al-Nufūs fī Ṭabaqāt ʽUlamāʼ al-Qayrawān wa-Ifrīqiya by Abū Bakr al-Qayrawānī al-Mālikī (dead after 464/1072)
Authors: Meouak Mohamed
Published: July 2024

Abstract: This short paper presents lexical data in vernacular Arabic collected in a text by the Medieval Tunisian writer Abū Bakr al-Qayrawānī al-Mālikī. After a presentation of the author, it is reminded the interest there would be in studying the material in vernacular Arabic from Tunisia in order to contribute to a better knowledge of the social history of linguistic habits. The textual material is exposed in Arabic script and divided into four main sections. The textual Arabic information is translated and sometimes, we add explanations on the significance of some words. Lastly, in a provisional conclusion, maybe the reader can appreciate how is necessary going on with this kind of research which tries to reassess the need to take into account the vernacular Arabic data compiled in written sources and the notion of language contact in Medieval Tunisia, mainly between Arabic, Berber, and Latin/Romance languages.
Lybyer on Democracy and Despotism in the Time of Suleiman the Magnificent
Authors: Daglier Üner
Published: July 2024

Abstract: In The Government of the Ottoman Empire in the Time of Suleiman the Magnificent , Albert Howe Lybyer controversially maintained that Ottoman government was composed of two distinctly separate institutions. These were the ruling institution and the Moslem institution, and their rivalry was exacerbated by the fact that the ruling institution was almost exclusively manned by Christian renegades, who had been levied as tribute boys from the Christian subjects of the empire or otherwise enslaved. For Lybyer, the renegades’ superb education, advancement on the basis on merit, and access to privilege was a unique case of democracy in the sixteenth century.
Representation and positioning of post-socialist identities in Jurica Pavičić’s short stories
Authors: Pulišelić Eldi Grubišić
Published: July 2024

Abstract: The contemporary Croatian writer Jurica Pavičić deals with different aspects of the Croatian transitional society through the representation and positioning of post-socialist identities. Some of his characters experience a tragic fate because they are unable to fit into the post-socialist and post-war reality, some deliberately opt for the outcast position completely convinced of the rightness of their ways, whereas some accept the illusion of transitional prosperity. They are all connected by their deep-seated solitude and exposure to the anomalies of the transitional society while they attempt to self-actualise within a culturally specific Dalmatian region where they live. In this paper, we have focused on the presentation and positioning of post-socialist identities in Jurica Pavičić’s short stories The Buried Dog , The Guardian Angel and Two Tenors .
Photonic sampling of microwave signals with adjustable sampling frequencies using an optical frequency comb
Authors: Yang Rui , Vercesi Valeria , Seeds Alwyn , Liu Chin-Pang
Published: July 2024

We propose and demonstrate what we believe to be a novel photonic sampling technique using an agile optical frequency comb generator achieving flexible sampling frequencies. Several comb lines are carved into sampling pulses which are then time-dispersed along a single-mode optical fiber as a function of the electronically adjusted comb line spacing and the number of comb lines selected. Successful sampling and demodulation of QAM signals up to a 17 GHz carrier frequency with a sampling rate of up to 50 GSa/s have been demonstrated. A minimum of 1.5% EVM at 3 GHz and a maximum 4.4 bits (ENOB) at 2.1 GHz were also measured.
Suppression of efficiency roll-off in solution-processed OLEDs using pyrimidine-based iridium complexes modified with sterically hindered groups
Authors: Chen Man , Wang Pengxiang , Liang Guijie , Ye Shanghui
Published: July 2024

Three bis-cyclometalated iridium complexes Ir1-Ir3 were successfully synthesized through mild reaction conditions. All complexes exhibit emission peaks at 507-509 nm, with excellent photoluminescence quantum efficiencies (PLQY) ranging from 69% to 97%. Self-quenching is significantly reduced because the steric spacers lead to minimum bimolecular interactions. Accordingly, the electroluminescence device based on complex Ir3 exhibits a maximum luminous efficiency of 39.6 cd A−1, a high EQE of 13.1% with an efficiency roll-off of 4.2% at 1000 cd m−2, which is much smaller than that (10.8%) of the Ir1-based device. Moreover, its devices exhibit excellent stability even at elevated doping concentrations, suggesting a notable reduction in intermolecular interactions caused by the steric pinene spacer.
Effect of automated versus conventional ventilation on mechanical power of ventilation—A randomized crossover clinical trial
Authors: Buiteman-Kruizinga Laura A. , Serpa Neto Ary , Botta Michela , List Stephanie S. , de Boer Ben H. , van Velzen Patricia , Bühler Philipp Karl , Wendel Garcia Pedro D. , Schultz Marcus J. , van der Heiden Pim L. J. , Paulus Frederique ,   for the INTELLiPOWER–investigators
Published: July 2024

Introduction

Mechanical power of ventilation, a summary parameter reflecting the energy transferred from the ventilator to the respiratory system, has associations with outcomes. INTELLiVENT–Adaptive Support Ventilation is an automated ventilation mode that changes ventilator settings according to algorithms that target a low work–and force of breathing. The study aims to compare mechanical power between automated ventilation by means of INTELLiVENT–Adaptive Support Ventilation and conventional ventilation in critically ill patients.

Materials and methods

International, multicenter, randomized crossover clinical trial in patients that were expected to need invasive ventilation > 24 hours. Patients were randomly assigned to start with a 3–hour period of automated ventilation or conventional ventilation after which the alternate ventilation mode was selected. The primary outcome was mechanical power in passive and active patients; secondary outcomes included key ventilator settings and ventilatory parameters that affect mechanical power.

Results

A total of 96 patients were randomized. Median mechanical power was not different between automated and conventional ventilation (15.8 [11.5–21.0] versus 16.1 [10.9–22.6] J/min; mean difference –0.44 (95%–CI –1.17 to 0.29) J/min; P = 0.24). Subgroup analyses showed that mechanical power was lower with automated ventilation in passive patients, 16.9 [12.5–22.1] versus 19.0 [14.1–25.0] J/min; mean difference –1.76 (95%–CI –2.47 to –10.34J/min; P < 0.01), and not in active patients (14.6 [11.0–20.3] vs 14.1 [10.1–21.3] J/min; mean difference 0.81 (95%–CI –2.13 to 0.49) J/min; P = 0.23).

Conclusions

In this cohort of unselected critically ill invasively ventilated patients, automated ventilation by means of INTELLiVENT–Adaptive Support Ventilation did not reduce mechanical power. A reduction in mechanical power was only seen in passive patients.

Study registration

Clinicaltrials.gov (study identifier NCT04827927), April 1, 2021

URL of trial registry record

https://clinicaltrials.gov/study/NCT04827927?term=intellipower&rank=1
Influence of biceps-triceps ratio on golf swing performance
Authors: Zou Yue , MacFarlane Niall
Published: July 2024

Objective

This study examines how maintaining a straight leading arm affects the muscle strength balance between the biceps and triceps in golfers and its influence on golf performance.

Methods

We recruited 20 male participants aged 18–45, including 10 golfers and 10 non-golfers. The participants’ average age was 25.6±6.2 years, height 1.8±0.07 m, and weight 75.6±10.2 kg. We measured isometric and isokinetic muscle strength using the Primus RS Dynamometer (BTE Technologies, Hanover, MD, USA) and assessed golf swing performance with the Optishot 2 Golf Simulator (Optishot, Brighton, MI, USA).

Results

Golfers exhibited significantly greater triceps strength (P = 0.02) and a lower biceps-to-triceps strength ratio (P = 0.002) than non-golfers. Low-handicap golfers showed more centered and consistent ball impacts compared to mid-handicap golfers. There were no significant differences in swing path and face angles between low- and mid-handicap golfers. Muscle strength and the biceps-to-triceps strength ratio correlated with driving distance, as well as the frequencies of specific swing paths, face angles, and ball impact points, highlighting the complex interplay between muscle balance and swing performance.

Conclusion

Greater triceps strength and a lower biceps-to-triceps strength ratio are key for maintaining a straight leading arm, especially in skilled golfers. While increased muscle strength tends to enhance driving distance, it does not necessarily improve accuracy. Consistent ball impact points may indicate higher skill levels. Future research should involve a larger, more diverse participant pool to validate these findings and further explore the complex nature of golf swing performance.