bluuebunny/crossref_metadata_2025 huggingface dataset:
The Prevalence of Attention Deficit Hyperactivity Disorder in Psychotic Disorders: Systematic Review and Meta-analysis
Authors: Cheng Nicholas , Bryce Shayden , Takagi Michael , Pert Allie , Rattray Audrey , Fisher Evangeline , Lai Marcus , Geljic Mia , Youn Sarah , Wood Stephen J , Allott Kelly
Published: December 2024

Background

Although attention deficit hyperactivity disorder (ADHD) is known to be common in psychotic disorders, reported prevalence rates vary widely, with limited understanding of how different factors (eg, assessment methods, geographical region) may be associated with this variation. The aim was to conduct a systematic review and meta-analysis to determine the prevalence of ADHD in psychotic disorders and factors associated with the variability in reported rates.

Study Design

Searches were conducted in MEDLINE, Embase, PsycINFO, CINAHL, and Scopus in May 2023. Studies were eligible if the frequency of ADHD was reported in psychotic disorder samples. Pooled prevalence meta-analyses were performed. Subgroup analyses and meta-regressions explored whether demographic and study characteristics were associated with reported rates.

Study Results

Thirty-six studies were included, involving 30 726 individuals. The pooled lifetime prevalence of ADHD in psychotic disorders was 18.49% (95% CI 11.78%, 27.83%). The between-study heterogeneity was high (I2 = 98.4% [95% CI 98.2%, 98.6%]). Subgroup analyses revealed higher prevalence rates when using ADHD DSM-IV criteria compared to International Classification of Diseases (ICD)-10. Rates in childhood-onset psychotic disorders were higher than adolescent- and adult-onset psychotic disorder samples. Rates were higher in North America compared to other regions. Meta-regressions indicated a decrease in prevalence rates with publication year.

Conclusions

The prevalence of ADHD in psychotic disorders appears higher than in the general population, highlighting the need for clinical attention and further research into this comorbidity. Reported rates, however, vary significantly. Reasons may include diagnostic criteria, age of psychosis onset, region, study design, and publication year. Future research should investigate these factors using rigorous ADHD assessment protocols.
Is there a mid-career crisis? An investigation of the relationship between age and job satisfaction across occupations based on four large UK datasets
Authors: Zhou Ying , Zou Min , Williams Mark
Published: December 2024

Previous research has yielded mixed evidence on the relationship between age and job satisfaction. While there is broad consensus that job satisfaction tends to increase from midlife into older age, considerable debate persists regarding whether it rises or falls during the early stages of a career. This study examines this relationship in depth by analysing four nationally representative datasets, which include both cross-sectional and longitudinal data from 108 401 workers in the UK covering all industries, occupations and geographical areas. Our findings reveal a distinct U-shaped trajectory of job satisfaction among workers in managerial, professional and associate professional occupations. However, this pattern is not evident among workers in intermediate or lower occupational classes. These results remain consistent even after adjusting for period effects, cohort effects and fixed individual characteristics. The results of this study suggest that commonly cited reasons for the mid-career crisis, such as increased work–family conflicts, are unlikely to fully explain the pattern. Instead, the answer is likely to lie in work-related factors that disproportionately affect highly skilled workers. By highlighting the role of occupational context in shaping how individuals experience their work as they age, this study contributes to resolving a long-standing debate in the job satisfaction literature and lays the groundwork for theoretical advancements in this field.
‘We All of Us Make Mistakes’: Medical Negligence in Interwar General Practice
Authors: Hanley Anne
Published: December 2024

In August 1920, Dr Lysander Maybury began a course of weekly injections into the longitudinal sinus of newborn Leslie Shewry. Although Maybury told Leslie’s parents that he would be giving their son injections, he did not tell them that he had diagnosed congenital syphilis. The precise nature of Leslie’s treatment was also unknown to his parents until many years later when they brought a case for damages against Maybury. They alleged that he had wrongly diagnosed and unnecessarily and improperly treated their son, leaving him permanently disabled. Furthermore, they alleged that he lacked the necessary skills and training to perform such delicate injections and that he was negligent in persisting with treatment when he knew that Leslie suffered convulsions after each injection. Shewry v. Maybury is a microhistory in which the intimate disruptions wrought by one man reveal a great deal about the nature and consequences of medical negligence in interwar Britain.
National Beef Quality Audit-2022: Harvest-floor assessments of hide defects, carcass defects, and offal condemnations that affect value of carcasses and by-products from market cows and bulls
Authors: Borders Sydni E , Schwartz Trent E , Mayer Thachary R , Gehring Kerri B , Griffin Davey B , Kerth Christopher R , Belk Keith E , Edwards-Callaway Lily , Scanga John A , Nair Mahesh N , Morgan J Brad , Douglas Jarrett B , Pfeiffer Morgan M , Mafi Gretchen G , Harr Keayla M , Lawrence Ty E , Tennant Travis C , Lucherk Loni W , O’Quinn Travis G , Beyer Erin S , Bass Phil D , Garcia Lyda G , Bohrer Benjamin M , Pempek Jessica A , Garmyn Andrea J , Maddock Robert J , Carr C Chad , Pringle T Dean , Scheffler Tracy L , Scheffler Jason M , Stelzleni Alexander M , Gonzalez John M , Underwood Keith R , Harsh Bailey N , Waters Crystal M , Savell Jeffrey W
Published: December 2024

The National Beef Quality Audit (NBQA)-2022 serves as a benchmark of the current market cow and bull sectors of the U.S. beef industry and allows comparison to previous audits as a method of monitoring industry progress. From September 2021 through May 2022, post-slaughter hide-on animals (n = 6,674), carcasses (n = 5,746), and offal items (heads and tongues: n = 7,282; lungs and hearts: n = 6,708; viscera, kidneys, and livers: n = 6,358) were surveyed at 20 commercial beef processing facilities across the United States. There were 37.8% of cattle with no visible mud contamination. Native (unbranded) hides were observed in 88.3% of cattle. Carcass bruising was observed on 66.7% of cow carcasses and 46.4% of bull carcasses, similar to percentages observed in the 2007 and 2016 audits. Nearly all cattle were free of knots (98.2%) or injection-site lesions (97.1%). Harvest-floor assessments found that 45.0% of livers, 22.2% of viscera, 19.3% of kidneys, 46.6% of lungs, 19.9% of hearts, 11.2% of heads, and 6.4% of tongues were condemned. The leading cause of condemnation for these offal items was contamination, aside from livers with the majority resulting in condemnation from the presence of an abscess. Of the cows surveyed, 25.4% carried a fetus, an 8% increase compared to those observed in 2016, and a 14.8% increase compared to cows surveyed in 2007. Findings from the NBQA-2022 identified areas of improvement and areas that required continued research and producer education to improve market cow and bull welfare, by-product quality, and offal value.
Downregulation of circTLK1 improves the impairments in learning and memory induced by anesthetics via regulating miR-374b-5p expression and reducing neuroinflammation
Authors: Zhu Xiaoli
Published: December 2024

Background: Sevoflurane (Sev) is a common anesthetic used during surgery, but research on its induction of neurotoxicity and learning memory impairment is insufficient. This study aimed to explore the role of Circular RNA tousled like kinase 1 (circTLK1) and its target microRNA (miR)-374b-5p in Sev-induced neurotoxicity and learning memory impairment. Methods: Mouse hippocampal neuronal HT22 cells and SD rats were treated with Sev. Levels of circTLK1 and miR-374b-5p were detected using RT-qPCR. The concentration of inflammatory factors was determined using ELISA. Cell viability and apoptosis were analyzed using CCK-8 and flow cytometry. Targeting relationship between circTLK1 and miR-374b-5p was validated using dual-luciferase reporter assays and RIP experiments. The Morris water maze test was used to assess the learning and spatial memory abilities of rats. Results: The results indicated that Sev treatment stimulated neuroinflammation and oxidative stress while increasing circTLK1 levels and decreasing miR-374b-5p levels in both rats and HT22 cells. Silencing circTLK1 alleviated the decrease in cell viability, increased apoptosis rates, and raised concentrations of inflammatory factors caused by Sev treatment. In in vivo experiments, silencing circTLK1 was also found to counteract the oxidative stress, neuroinflammation, and learning and memory impairment induced by Sev treatment in rats. Additionally, circTLK1 was shown to interact with miR-374b-5p, and inhibiting miR-374b-5p could counteract the neuroprotective effects of si-circTLK1. Conclusion: This research suggested that silencing circTLK1 can mitigate Sev-induced neurotoxicity and learning memory impairment by modulating miR-374b-5p.
O‐GlcNAc transferase promotes vascular smooth muscle calcification through modulating Wnt/β‐catenin signaling
Authors: Xu Lin , Liu Boao , Ma Honghui , Qi Enbo , Ma Jie , Chang Tingmin , Zhang Jinghong , Zhang Wencheng , Chen Weiqian , Cao Xuan , Xiong Xiwen
Published: December 2024

Vascular calcification (VC), associated with high cardiovascular mortality in patients with chronic kidney disease (CKD), involves osteogenic transdifferentiation of vascular smooth muscle cells (VSMCs). O‐GlcNAcylation, a dynamic post‐translational modification, is closely linked to cardiovascular diseases, including VC. However, the exact role and molecular mechanism of O‐GlcNAc signaling in abnormal mineral metabolism‐induced VC remain unclear. In the current study, we found that the levels of O‐GlcNAc transferase (OGT) and global protein O‐GlcNAcylation were significantly upregulated in the artery tissues of mouse calcification models and CKD patients with VC. To further delineate the in vivo role of OGT in VC, we generated Ogt smooth muscle cell‐specific knockout mice and challenged them with 5/6 nephrectomy (5/6 Nx) or high‐dose vitamin D3 to induce VC. Deletion of Ogt in VSMCs led to alleviated VC in response to 5/6 Nx or VD3. Moreover, elevated O‐GlcNAcylation, induced by Thiamet‐G, facilitated osteogenic transdifferentiation in VSMCs in response to phosphate, whereas OSMI‐1, which reduces O‐GlcNAcylation, exhibited an opposite phenotypic effect. Mechanistically, O‐GlcNAc signaling enhanced the osteogenic conversion of VSMCs through regulation of canonical Wnt/β‐catenin pathway. Indeed, β‐catenin was O‐GlcNAcylated by OGT and further increased its transcriptional activity in VSMCs. Furthermore, pharmacological activation of Wnt/β‐catenin signaling largely reversed the diminished aortic calcification caused by Ogt ablation. Our findings demonstrate that smooth muscle O‐GlcNAc signaling plays an important role in regulating hyperphosphatemia‐induced VC and reveal that O‐GlcNAcylation of β‐catenin protein modulates its content and activity in VSMCs.
Program and Institutional Coordinator Well-Being: Results From a National Survey
Authors: Slavin Stuart , Yaghmour Nicholas , Baez-Martinez Aurea , O’Donovan Cormac , Panda Mukta , Carpenter Pamela , Burt Coranita , McLeod Kandice Kaylor
Published: December 2024

Purpose

This study explores the mental health and well-being, overall job satisfaction, likelihood to leave position, and perceptions of job satisfiers and stressors and dissatisfiers in a national sample of program and institutional coordinators in graduate medical education (GME).

Method

Between August and September 2022, 11,887 program and institutional coordinators and managers with email addresses listed in the Accreditation Council for Graduate Medical Education database were emailed a survey link. The survey queried mental health using the Patient Health Questionnaire 8 depression scale, Generalized Anxiety Disorder 7, and a 2-item burnout scale derived from the Maslach Burnout Inventory; overall satisfaction with work; likelihood to leave work; and drivers of satisfaction and dissatisfaction.

Results

A total of 6,372 coordinators and managers responded to the survey, with 1,367 (23.9%) reporting moderate to severe depression symptoms on the Patient Health Questionnaire 8 and 1,767 (30.4%) reporting moderate to severe anxiety symptoms on the Generalized Anxiety Disorder 7. A total of 2,069 respondents (36.3%) reported feeling burned out at least once per week, 1,288 (20.4%) reported being dissatisfied or very dissatisfied with work, and 1,510 (27.9%) reported being likely or very likely to leave their job in the next year. Positive interactions with administrative staff, residents, fellows, faculty, and program leadership were the highest ranked drivers of job satisfaction. Tracking down residents, fellows, and faculty to complete required tasks, low pay, overall workload, level of detail to manage, time pressure, lack of appreciation by faculty, and sense of entitlement of residents were leading job dissatisfaction drivers.

Conclusions

Coordinators are vitally important members of the GME community who play critical roles in supporting the GME enterprise. This study aims to raise awareness of the challenges and struggles faced by coordinators to lead to improvements in their job satisfaction, mental health, and well-being.
The effect of stand-alone and additional preoperative video education on patients’ knowledge of anaesthesia
Authors: van den Heuvel Sander F. , Jonker Philip , Hoeks Sanne E. , Ismail Sohal Y. , Stolker Robert Jan , Korstanje Jan-Wiebe H.
Published: December 2024

BACKGROUND

Fully digital preoperative information could save valuable time and resources. However, compared with face to face consultations, equivalent levels of safety, patient satisfaction and participation need to be maintained when using other methods to inform patients. This trial compared knowledge retention between preoperative stand-alone video education and face-to-face education by an anaesthesiologist.

OBJECTIVES

To assess if video education, alone or combined with face-to-face education, leads to better knowledge retention more than conventional face-to-face education.

DESIGN

A randomised controlled trial with four arms: Video, Anaesthesiologist, Video & Anaesthesiologist, and Reference for baseline measurements and exploration of a test-enhanced learning effect.

SETTING

A Dutch tertiary care centre from February 2022 to February 2023.

PATIENTS

A total of 767 adult patients undergoing preoperative consultation for elective non-cardiothoracic surgery, with 677 included in the complete case analysis.

INTERVENTION(S)

Stand-alone preoperative video education and video education in combination with face-to-face education in the preoperative outpatient clinic.

MAIN OUTCOME MEASURES

Primary outcome, measured by the Rotterdam Anaesthesia Knowledge Questionnaire, was knowledge retention on day 0. Secondary outcomes included knowledge retention at 14 and 42 days, preoperative anxiety, and the need for additional information using the Amsterdam Preoperative Anxiety and Information Scale. Other outcomes were satisfaction, self-assessed knowledge, and test-enhanced learning effect.

RESULTS

Stand-alone video education led to higher Rotterdam Anaesthesia Knowledge Questionnaire scores than face-to-face education on day 0: median [IQR], 87.5 [81.3 to 93.8] vs. 81.3 [68.8 to 87.5], P < 0.001. Combined education in the “Video & Anaesthesiologist” group led to better knowledge retention compared with both the “Anaesthesiologist” group and the Video group: 93.8 [87.5 to 93.8] vs. 81.3 [68.8 to 87.5], P < 0.001; 93.8 [87.5 to 93.8] vs. 87.5 [81.3 to 93.8], P = 0.01, respectively. No differences in the patients’ preoperative anxiety and satisfaction levels were found.

CONCLUSION

Compared with face-to-face education by an anaesthesiologist, stand-alone video and combined video education improve short-term knowledge retention, without increasing patient anxiety.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT05188547 (https://clinicaltrials.gov/ct2/show/NCT05188547).
Lipotransfer Under Ultrasound-guided Helium Pneumodissection With Closed Lipotransfer Equipment
Authors: Núñez Villar Percy Jesús , Monroy Marbella J.
Published: December 2024

Background:

Gluteal hypoplasia and ptosis reduction are common concerns among patients seeking optimal body contouring in Peru and other countries. Although silicone implants are a traditional solution, they are not suitable for all patients. Fat grafting has emerged as an alternative, with various techniques aimed at enhancing fat graft viability and patient safety.

Methods:

We conducted a study to evaluate the effectiveness and safety of ultrasound-guided helium pneumodissection for gluteal-hip contouring. Between January 2021 and December 2022, 220 patients with varying degrees of gluteal hypoplasia were treated using ultrasound-assisted helium pneumodissection.

Results:

The amount of fat grafted ranged from 200 to 1500 mL per buttock, with most patients receiving 701–800 mL. The integration of color Doppler ultrasound allowed for precise visualization throughout the procedure and safe placement of fat grafts. Helium pneumodissection facilitated efficient fat graft injection with reduced resistance at the recipient site. Mild complications included temporary hyperthermia in 4.5% of patients and one instance of retraction in the lower quadrant of the right buttock.

Conclusions:

Ultrasound-guided helium pneumodissection for gluteal-hip contouring demonstrates significant advantages in patient safety, fat graft viability, and overall satisfaction. This advanced technique allows for efficient fat injection with reduced resistance in the subcutaneous plane, minimizing the risk of deep plane injections into the muscle. Although occasional mild complications were observed, they were manageable and did not compromise the overall safety of the technique.
Skin Stretching Techniques: A Review of Clinical Application in Wound Repair
Authors: Yang Tian , Tan Zhixiang , Chen Xuejie , Wang Fang , Tao Rui , Tong Yilan , Wang Xiaoli , Fan Huajun , Yu Mosheng , Zhu Zhanyong
Published: December 2024

Background:

The repair of skin defect wounds is a long-term goal of clinical pursuit. Currently, free or pedicled skin flap transplantation is commonly used to repair skin defects. However, these methods may lead to complications such as flap necrosis, thrombosis, scarring, diminished sensation, and pigmentation in both the donor and recipient areas. Since its introduction in 1976, skin stretching techniques were widely used for minor skin and soft-tissue defects in the surgical field.

Methods:

A narrative review was conducted to identify relevant articles about the skin stretching techniques for promoting wound healing. We searched the Web of Science and PubMed databases for all articles containing different combinations of “skin stretch techniques” and “wound repair,” “skin defects,” and “tissue expansion.”

Results:

Through the screening of 500 articles, 84 representative and persuasive articles were selected in this review. These studies collectively demonstrate the technique’s effectiveness in reducing wound size, facilitating primary closure, and improving cosmetic outcomes. Reported complications were generally minor, including transient erythema and mild discomfort, with rare instances of skin necrosis.

Conclusions:

Skin stretch techniques emerge as a promising approach for managing large-area wounds, offering the advantage of achieving primary healing without compromising surrounding healthy tissue. However, to optimize its clinical application, further research is warranted, particularly in addressing challenges related to precise stretching and infection management.
Limb Salvage via Surgical Soft-tissue Reconstruction With Ovine Forestomach Matrix Grafts: A Prospective Study
Authors: Lawlor John , Bosque Brandon A. , Frampton Christopher , Young D. Adam , Martyka Patrick
Published: December 2024

Background:

Complex and chronic lower extremity defects present a surgical challenge and can progress to eventual amputation if closure is not achieved. In addition to morbidity and mortality, these defects have a significant impact on patient quality of life and represent a substantial cost burden to the healthcare system. Ovine forestomach matrix (OFM) grafts are an advanced tissue scaffold option to supplement the surgical reconstruction ladder and may augment limb preservation in cases of complex lower extremity defects.

Methods:

A prospective observational study enrolled 130 complex lower extremity reconstructions that received OFM as part of surgical management. Granulation tissue formation, defect closure, and postoperative complications were assessed up to 1 year postoperatively to evaluate the outcome of OFM grafts for limb salvage via surgical reconstruction.

Results:

Participant demographics and defect characteristics were reflective of a real-world inpatient population with complex and chronic defects. Despite complexity of the defects, no postoperative infections or major amputations were reported. The median time to complete granulation tissue coverage and fill was 30.0 days (95% confidence interval, 26.9–33.1) and the median time to complete defect closure was 127.0 days (95% confidence interval, 110.5–143.5). At 180 days, a 62% incidence of healing was achieved with a median product application of 1.0 (interquartile range, 1.0–1.0).

Conclusions:

OFM-based grafts supported successful coverage of lower extremity defects in a real-world cohort with known risk-factors for amputation. Achieving successful closure with minimal complications, and often in a single application, suggests utility of OFM as a cost-effective adjunct in lower extremity reconstruction.
Efficacy, Safety, and Recurrence in Older Thyroid Eye Disease Patients Undergoing Teprotumumab Treatment
Authors: Chen Kaylie , Lelli Gary J.
Published: December 2024

Increasing life expectancy and an aging population have preserved quality of life decisions into older adulthood, defined by some clinical standards as greater than 75 years of age. While teprotumumab may represent a breakthrough in the treatment of thyroid eye disease, the teprotumumab phase III trial included only 2 patients aged over 75. Four female patients between the ages of 78 and 86—of whom 3 completed 8 infusions and 1 completed 7 infusions before discontinuation—were included in our study with a mean initial Clinical Activity Score score of 5.5, subjective diplopia, and proptosis. All patients experienced reduction in Clinical Activity Score with teprotumumab treatment. Two patients were subjective diplopia responders. Of the 6 eyes with collected measurements, all demonstrated a ≥2 mm reduction in post-treatment Hertel measurements. Most common adverse events were hyperglycemia, dysgeusia, fatigue, and alopecia. One patient with diabetes experienced an A1C rise requiring insulin. One patient had recurrence with increasing proptosis and recurrence of diplopia.
Racial disparities in patients with hidradenitis suppurativa: effects on diagnosis and quality of life
Authors: Olaoye Ibukunoluwa , Casado Amber
Published: December 2024

Hidradenitis suppurativa (HS), a chronic autoinflammatory disease affecting the skin, poses significant challenges in diagnosis, treatment, and quality of life (QOL), with a disproportionate impact on different racial and ethnic groups. This review explores the epidemiology, risk factors, diagnostic delays, treatment modalities, and the varying quality of life experiences of patients with HS, focusing on the substantial disparities faced by Black individuals. Despite a worldwide prevalence of ∼1%, HS exhibits a higher occurrence in Black patients in the United States, leading to more severe disease states, delayed diagnoses, decreased QOL, and increased health care resource utilization. The article delves into the complexity of HS diagnosis, emphasizing the importance of early detection to prevent disease progression and the role of dermatology clinicians in accurate diagnosis compared with nondermatology settings. Treatment options, including antibiotics, biologics, and surgical interventions, are discussed with a focus on the need for diverse representation in clinical trials. The impact of HS on QOL is profound, affecting various aspects such as mental health, sexual well-being, and daily functioning. Notably, this review highlights the underrepresentation of people of color in HS research, contributing to a limited understanding of racial and ethnic influences on the disease. The article highlights the need to advocate for increased access to dermatologic care, community outreach, and further research involving diverse populations to address the existing disparities in HS diagnosis, treatment, and outcomes.
What Are Consumers Looking for With Boric Acid?
Authors: Stockdale Colleen K. , Bartolo-Costello Abigail A. , Vieira-Baptista Pedro
Published: December 2024

Two separate online surveys were presented to women who were confirmed to have purchased a boric acid vaginal suppository product in the previous year for themselves March 2020 (study 1) and July 2023 (study 2) to understand consumer expectations concerning the use of vaginal boric acid. Study 1 found that repeat purchasers are more likely to buy boric acid products to prevent symptoms, especially bacterial vaginosis. Study 2 confirmed boric acid was more likely to be purchased for prevention than treatment, especially odor/bacterial vaginosis, with 83% reporting they were satisfied and 40% reporting they were extremely satisfied. While boric acid has been used for decades as an alternative treatment for vaginitis, it has recently become commercially available (for vaginal application) with high levels of satisfaction.
Exosomal long non-coding RNAs in lung cancer: A review
Authors: Jiang Jingyuan , Lin Fengwu , Wu Wenqi , Zhang Zhe , Zhang Chen , Qin Dongliang , Xu Zhenan
Published: December 2024

Lung cancer is one of the most threatening malignancies among the different kinds of tumors. The incidence and mortality rate are increasing especially in male. Advances in diagnosis and treatment have been achieve in recent years. However, the lung tumor cells also developing chemo- and radio-resistance. Novel approaches and new treatments are stilled needed to develop for early diagnosis and treatment. Recently, long non-coding RNAs (lncRNAs) original exosomes were proved different expression in lung tumor, which mediate multiple biological processes and is responsible for tumor proliferation and metastasis. In this review, we focus on the emerging roles of both lncRNAs and exosomal lncRNAs in lung cancer and their roles on angiogenesis, metastasis, diagnosis, drug resistance, and immune regulation of lung cancer. Exosome lncRNAs were proved to serve as regulatory factors for gene expression, mediating intercellular communication, and participating in the occurrence and development of various diseases. In addition, exosomes lnc RNA has advantages on the early diagnosis of lung cancer, tumor cell metastasis, drug resistance, and immune regulation. Exosome lncRNAs an provide some unique ideas on how to improve the efficiency of diagnosis and treatment of lung cancer in the future.
The prognostic value of vascular endothelial growth factor in endometrial cancer: A protocol for systematic review and meta-analysis
Authors: Qiang Bao , Kang YiFan , Yang JiaoLin , Su HuanCheng , Wang Zhe , Zhang ChunMei , Zhang SanYuan
Published: December 2024

Background:

A large number of studies have shown that high expression of vascular endothelial growth factor (VEGF) in cancer tissues is associated with poor prognosis of various cancers. However, this finding in endometrial cancer is controversial. Therefore, this meta-analysis aimed to explore the effects of VEGF on survival in patients with endometrial cancer.

Methods:

Four databases of PubMed, Medline, Web of Science, and China National Knowledge Infrastructure were searched to collect literature that met the inclusion criteria. The association between high VEGF expression and survival outcomes and clinicopathological features of patients with cancer was evaluated by calculating the combined hazard ratio (HR), odds ratio (OR), and 95% confidence interval (CI). The Begg test was used to assess publication bias.

Results:

A total of 11 studies were included, involving 1251 patients. The results showed that compared with low VEGF expression, high VEGF expression was significantly associated with shorter overall survival (HR = 2.44, 95% CI = 1.15–5.16, I2 = 80%, P = .02) and disease-specific survival (HR = 7.87, 95% CI = 1.70–36.44, I2 = 64%, P = .008) but not with disease-free survival (HR = 1.45, 95% CI = 0.70–3.02, I2 = 68%, P = .32). In addition, VEGF expression is higher in patients with advanced stage (OR = 3.70, 95% CI = 2.22–6.19, P < .001), lower histological differentiation (OR = 2.08, 95% CI = 1.22–3.55, P = .007), and lymph node metastasis (OR = 5.42, 95% CI = 2.35–5.11, P < .001).

Conclusion:

High VEGF expression can predict poor prognosis and poor clinicopathological features in patients with endometrial cancer, and it may be a valuable new indicator to evaluate the prognosis of patients with endometrial cancer.
Patient Reported Outcomes for SB5, an adalimumab biosIMILAR, in patients with rheumatoid arthritis and ankylosing spondylitis (PRO-SIMILAR): Study protocol for a phase IV, single-arm, open-label trial
Authors: Lee Jisoo , Kim Sung-Soo , Lee Sang-Il , Kim Tae-Hwan , Hong Seung-Jae , Lee Hye-Soon , Lee Jaejoon , Park Yong-Wook , Lee Sung Won , Noh Joungyoun , Park Seong Nam , Lee Bokyung , Choe Jung-Yoon
Published: December 2024

Introduction:

Biosimilars are increasing selected as a cost-effective treatment option in the management of immune-mediated inflammatory diseases. Despite equivalent efficacy of biosimilars was demonstrated compared with the originators in randomized controlled trials, biosimilar uptake is often impacted by lack of confidence in these products by the patients. The Patient Reported Outcomes for SB5, an adalimumab biosIMILAR, in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) (PRO-SIMILAR) study was designed to evaluate the efficacy of SB5, from the perspectives of the patients in real world settings.

Methods and analysis:

PRO-SIMILAR is an ongoing phase IV, single-arm, open-label trial conducted in 35 hospitals across Korea. The study is designed for 1000 adult patients with RA and AS (at least ≥300 in each group) treated in routine clinical practice. Participants are treated with SB-5 40 mg every other week for 52 weeks. The primary efficacy endpoint is European quality of life-5 dimensions-5 level index score at week 52 compared to baseline. The secondary efficacy endpoints are changes in disease activity index scores, proportion of patients achieving remission and clinical response, and rate of SB5 persistence. The safety and exploratory endpoints are include assessments of adverse events, immunogenicity, and pen/syringe preference. Data are collected at baseline, 12, 24 (for RA), 36 (for AS), and 52 weeks.
Primary juvenile Sjögren’s syndrome in a 4-year-old female patient: a Palestinian case report
Authors: Janem Abdelrhman Muwafaq , Jobran Afnan W.M. , Shtaya Marwan Hani , Abu Alrob Rand Mashhour , Halahlah Aysha Ahmad , Iwaiwi Haya Sameer , Hanifa Hamdah , Abunejma Fawzy Mazen
Published: December 2024

Introduction and clinical significance:

Primary Sjögren’s syndrome (PSS) is a rare disease in the pediatric age group, with not enough data regarding these patients. In addition, to date only few papers emphasizing uveitis as a finding of PSS have been published.

Case presentation:

We describe a case of a 4-year-old Palestinian girl with bilateral parotid gland enlargement, dry eyes and mouth, eyelids swelling, arthralgia, dysphagia, and fatigue for 2 months duration. The patient was diagnosed with uveitis. Investigations showed elevated CPR and erythrocyte sedimentation rate. ANA was initially negative on the enzyme-linked immunosorbent assay, but elevated on the immunofluorescence assay 6 weeks after the initial test. She was diagnosed with PSS according to the clinical findings, ultrasonography, and salivary – gland biopsy results.

Clinical discussion:

Uveitis is a rare manifestation of PSS and has not yet been reported in the literature as a manifestation of pediatric PSS. Because uveitis is usually asymptomatic in this age group, case-regular ophthalmologic follow-up is recommended in all patients with PSS, as a delay in diagnosis and management may cause permanent vision loss.

Conclusion:

PSS is rare in the pediatric population, with onset between 10 and 14 years old. Salivary gland ultrasound and minor salivary gland biopsy are essential tools for the diagnosis of PSS in childhood. Treatment options for PSS in children are limited, but medications like methotrexate and prednisolone can help improve systemic symptoms and reduce parotid swelling. Pilocarpine can be added for dryness, and steroid eye drops and artificial tears for dry eyes. Further research is needed to establish management protocols specifically for the pediatric age group.
Advancements in high-intensity focused ultrasound for urological tumor research and application
Authors: Liu Jun , Feng You-Gang , Zhang Cai , Chen Wen-Zhi
Published: December 2024

High-intensity focused ultrasound (HIFU), a non-invasive therapeutic approach, has made significant inroads in urological oncology, notably for kidney, bladder, and prostate cancers. Its advantages in treating prostate cancer are particularly pronounced, offering less invasive treatment with faster recovery and superior organ function preservation compared to traditional methods. HIFU is an advantageous option for patients with localized prostate cancer who prefer nonsurgical treatments or have a high demand for quality of life. Despite its benefits, HIFU faces limitations requiring further research and clinical validation to ensure safety and effectiveness. This paper provides a concise review of HIFU’s current application in urological tumor treatment, highlighting its role in prostate cancer therapy and exploring its potential in the adjuvant treatment of advanced prostate cancer, offering insights for its future role in urological oncology.
Takotsubo syndrome
Authors: Zaloom Joan M.
Published: December 2024

Takotsubo syndrome causes sudden weakening of the heart muscle, often triggered by intense physical or emotional stress. Because its symptoms closely mimic those of acute coronary syndrome, the healthcare team must recognize the signs and provide appropriate care.
Does Hospital Accreditation or Certification Impact Patient Outcomes? Findings From a Scoping Review for Healthcare Industry Leaders
Authors: Connor Linda , Dufour Karey , Zadvinskis Inga M. , Waddell Ashley , Powell Nancy , Gorsuch Penelope F. , Brown Roy , Melnyk Bernadette Mazurek , Gallagher-Ford Lynn
Published: December 2024

OBJECTIVE

This scoping review describes findings from published literature, evaluates the association between hospital accreditation or certification and patient outcomes, and identifies gaps.

BACKGROUND

Healthcare accreditation and certification organizations set standards and evaluate whether the standards are met. Despite the extensive efforts of both parties to improve healthcare delivery, poor patient health outcomes still exist in the United States.

METHODS

A comprehensive search of published peer-reviewed literature in English, utilizing the databases OVID MEDLINE, EMBASE, and CINAHL, addressing hospital accreditation or certification and patient outcomes, was conducted.

RESULTS

There was inconclusive evidence to support a relationship between hospital accreditation and outcomes in US hospitals, except for bariatric accreditation and stroke specialty certification studies for mortality and length of stay. The heterogeneous reporting of measures made it difficult to draw meaningful conclusions.

CONCLUSION

Understanding the extent to which accreditation is associated with patient outcomes is required. Future research is needed to establish scientific connections between hospital accreditations or certifications and patient outcomes.
Femoral intramedullary nail extraction using the kissing nail technique when primary measures fail
Authors: Brenner Joseph , Joiner Jonathan , Schweller Eric , Ren Emily , Nasr Kerellos , Vaidya Rahul
Published: December 2024

Introduction:

Intramedullary femoral nails (IMFNs) need to be removed for subsequent joint replacement, refracture, nonunion, or infection. The tools used to extract newer IMFNs may not be suited for removal of older implants, especially if broken. The purpose of this study was to describe a novel technique in femoral nail extraction when primary measures fail and a report on 6 cases where it was used.

Technical Procedure:

The technique is used after standard techniques including the Winquist set fail. A guide rod is passed through the center of the incarcerated nail (IN) to the distal end or to the proximal end if it is a retrograde nail. The femur is approached through a separate incision either through the knee for an antegrade nail or through the proximal femur for a retrograde nail. The guide rod is delivered through the opposite end by either hitting it through the end of the bone or breaching the end with a starting wire and starting reamer. The guide rod is then delivered into the field. Using flexible reamers over the delivered guide rod, the femur is reamed up to the IN. A second IMN slightly smaller in diameter is chosen and passed to touch the distal end of the IN, guided by the guide rod to keep the nails aligned. The second nail is impacted, which pushes the IN out its insertion point.

Discussion:

Hardware extraction is difficult for any surgeon, and extraction of older or broken nails with lower grade material poses even greater challenges. This technique is meant as an extra tool for avoidance of corticotomy when primary means for nail extraction have failed. We present 6 cases with 5 successful results.
Refrigeration reduces instillation discomfort of a 0.09% cyclosporine A solution
Authors: Ngo William , Nagaarudkumaran Nijani , Huynh Cassandra Bonnie
Published: December 2024

SIGNIFICANCE

Topical cyclosporine A (CsA) for the treatment of dry eye disease is often associated with instillation discomfort, which may negatively influence patient adherence to therapy. This study found that refrigerating topical CsA reduced instillation discomfort compared with instillation of warm CsA. Thus, refrigerating CsA prior to instillation may improve patient experience when using CsA to manage dry eye disease.

PURPOSE

This study aimed to quantify instillation discomfort associated with cold or warm instillation of a 0.09% CsA.

METHODS

Forty participants with symptomatic aqueous deficient dry eye were enrolled. A drop of cold (4°C) CsA was instilled in one eye, and a drop of warm (23°C) CsA was instilled in the other eye. The order and eye receiving the cold drop were randomized. Participants rated the discomfort of each eye (0, no discomfort; 10, maximal discomfort) prior to drop instillation, immediately post-instillation, and at each subsequent minute for 10 minutes. Area under the curve was used to quantify cumulative discomfort.

RESULTS

Forty participants (39.6 ± 18.9 years old, 82% female) completed the study. A majority of participants (n = 24, 60%) experienced reduced cumulative discomfort with cold CsA, whereas the remainder experienced minimal difference (n = 10, 25%) or increased cumulative discomfort (n = 6, 15%). For those with reduced discomfort (n = 24), cumulative discomfort associated with cold instillation (median, 11.5 [2.2, 20.0]) was significantly lower (p<0.01) than cumulative discomfort associated with warm instillation (median, 17.5 [11.2, 32.2]). Cold instillation was associated with a median reduction of 1 discomfort point immediately post-instillation and at all subsequent time points (all p≤0.04, but not significant at t = 10), compared with warm instillation.

CONCLUSIONS

Up to 60% of participants found that cold instillation of CsA solution induced less discomfort than warm instillation, lasting up to 9 minutes post-instillation. In contrast, although 15% of participants found reduced discomfort with warm instillation, the magnitude of discomfort associated with warm instillation was not significantly different than cold instillation.
Relations Between Suicide Risk and Patient Safety Attitudes Among the Nursing Team in a Brazilian Context
Authors: Corrêa Kariciele Cristina , Araújo Lúcio Borges de , Alves Helenitta Melo da Silva , Ferreira Liz Marina Corrêa , Miranda Frank José Silveira , Junqueira Marcelle Aparecida de Barros
Published: December 2024

Objectives:

To analyze the aspects of suicide risks and their relation to patient safety attitudes among the nursing staff of a large public university hospital in Brazil.

Methods:

A cross-sectional and descriptive study with 226 nursing workers from a large public university hospital in Brazil. Socioprofessional information, health conditions, and family history related to suicide risk were collected through the Mini International Neuropsychiatric Interview Plus and the Safety Attitudes Questionnaire. A 95% CI was considered, and statistical tests such as the Student t test, χ2, analysis of variance, and multiple linear regression were used.

Results:

Most of the safety attitudes were below the average score considered positive (mean Safety Attitudes Questionnaire value >0.75), and 41 (18.1%) workers were considered to have any degree of suicide risk. Participants with parents or siblings who had attempted suicide were 3.44 times more likely to have moderate or high suicide risk. Negative safety attitudes were associated with health conditions and family history, considered suicide risk factors. Participants with moderate or high suicide risk were 2.83 times more likely to have worse patient safety attitudes concerning job satisfaction.

Conclusions:

This study reveals significant associations between patient safety attitudes and the mental health of nursing workers, expanding the view of worker health management actions and, consequently, patient safety culture.
Brief Report: Pancreatic Cancer in People With HIV: A Case–Control Study
Authors: Chawki Sylvain , Hamet Gwenn , Brun Alexandre , Lourenco Nelson , Bouchaud Olivier , Bottero Julie , Sellier Pierre , Molina Jean-Michel ,   and the COREVIH le de France Est Study Group
Published: December 2024

Background:

We aimed to estimate the incidence and to assess the risk factors associated with pancreatic cancer (PC) in people with HIV (PWH).

Setting:

We used electronic medical record data from 2009 to 2020 available in the COREVIH Ile-de-France-Est database of PWH treated in Paris public hospitals.

Methods:

We analyzed data on patient demographics, treatment history, and immunovirologic status. A case–control study was designed; each case (PWH and PC) was matched on age, gender, and duration of HIV infection to 4 controls (PWH without PC).

Results:

Twenty-four cases were identified from the database, with an incidence of PC estimated at 28 cases (95% confidence interval: 19 to 43) per 100,000 person-years. The median age was 57 years [interquartile range (IQR) 51–68] at cancer diagnosis. Twenty-one cases (88%) were male. The median CD4+ T-cell count at PC diagnosis was 587/mm3 (IQR 317–748), and the nadir CD4+ T-cell count was 194 (IQR 98–380). Twenty cases (91%) had a suppressed HIV replication at PC diagnosis. Twelve patients (50%) had metastasis on diagnosis. The median time to death after cancer diagnosis was 11 months (IQR 1–19). Twenty-two cases were matched with 88 controls. There were no statistically significant risk factors of PC identified in our analysis.

Conclusion:

PC remains rare in PWH and is associated with a severe prognosis at a relatively young age. Further studies are needed to identify risk factors associated with PC development in PWH.
Tuberculosis molecular bacterial load assay in the management of tuberculosis
Authors: Gillespie Stephen H. , Sabiiti Wilber
Published: December 2024

Purpose of review

Treatment monitoring remains a challenge in tuberculosis. The development of the tuberculosis molecular bacterial load assay (TB-MBLA) opens the possibility of real-time treatment monitoring. This review summarizes recent TB-MBLA research and outlines a future research agenda.

Recent findings

Recent studies show that TB-MBLA can be applied a wide range of specimens to make a quantitative assessment of the number live M. tuberculosis organisms rapidly. This allows real-time monitoring of treatment response that simplifies patient management and facilitates comparison of different treatment regimens.

The ability to measure the number of live organisms in real-time could improve treatment outcome. The TB-MBLA should revolutionize our understanding of the pathology of tuberculosis with significant implications for clinical practice and research.
The association between blastocyst quality and perinatal outcomes during a single frozen-thawed blastocyst transfer cycles: a propensity score-matched study
Authors: Wu Jing , Yang Chen , Zheng Wei , Cao Meng-Yi , Li Meng-Na , Kuang Yi-Hui , Ren Bing-Nan , Zu Ruo-Wen , Shen Ran , Han Jing-Yi , Li Pei-Xin , Guan Yi-Chun
Published: December 2024

Objective:

With the increasing acceptance of blastocyst transfer technologies, more attention is being paid to the selection of blastocysts during the transplant cycle. However, few studies have investigated the relationship between blastocyst quality and perinatal outcomes in single frozen-thawed blastocyst transfer (SFBT) cycles. The aim of this study was to focus solely on the blastocyst and investigate the association between embryo morphological grading and perinatal outcomes in an SFBT cycle.

Methods:

In this retrospective cohort study, we divided patients into the good-quality blastocyst transfer group and the poor-quality blastocyst transfer group based on the morphological grading of the blastocysts. To control for potential confounding factors, propensity score matching (PSM) was used to match variables such as male age, secondary infertility, primiparity, the developmental day of the transferred blastocysts, and endometrial thickness on the transfer day. Patients who received single vitrified-warmed high-quality blastocysts were matched with patients who received single poor-quality blastocysts at a 1:1 ratio. Logistic and linear regression analyses were performed to assess perioperative outcomes between the two groups, with adjusted odds ratios reported along with 95% confidence intervals. Two-tailed P-values < 0.05 were considered statistically significant.

Results:

Both before and after using PSM, there were no statistically significant differences in obstetric outcomes, including the incidence of gestational hypertension, gestational diabetes, or cesarean delivery, among women receiving SFBT with different blastocyst qualities. There were also no significant differences in neonatal outcomes between the two groups regarding newborn birth weight or the occurrence of birth defects.

Conclusion:

The quality of blastocysts did not affect the perinatal outcomes of SFBT cycles. Thus, it is a viable option to select a single poor-quality blastocyst for transfer in SFBT cycles when high-quality blastocysts are not available.