bluuebunny/crossref_metadata_2025 huggingface dataset:
Experience of Children With Special Education Needs During COVID-19
Authors: Torres Chioma , Schaller Alexandria , Munzer Tiffany , Levitt Kimberley J. , Radesky Jenny S.
Published: June 2024

Objective:

The objective of this study was to examine the unique academic, behavior, and parent mental health challenges for children who qualify for a school individualized education program (IEP) during the COVID-19 pandemic.

Methods:

The authors recruited 302 parents of 5- to 10-year-old children in Michigan (February–March 2021), oversampling children with IEP supports through education-related organizations. Parents completed surveys about school format, child behavior, educational problems, IEP supports, parent stress, and depression symptoms.

Results:

Forty-seven children had an IEP, of whom 36% of parents stated their child was not receiving sufficient IEP services in 2020 to 2021. Reasons included unavailable services (41%), available services but parent unable to bring their child to school (12%), and only virtual services (47%). Compared with children without IEPs, children with IEPs had greater hyperactivity levels (p < 0.0001), more peer problems (p = 0.0003), and behavioral difficulties (p = 0.0002) and their parents had higher depression symptoms (Centers for Epidemiologic Studies Depression Scale score >21, 42.6% vs 27.3%, p = 0.03). Parents of children with IEPs reported lower rates of meeting grade level reading (51.1% vs 77.5%, p = 0.0002), math (54.6% vs 78.9%, p = 0.0006), writing expectations (35.6% vs 67.9%, p < 0.0001), and higher prevalence of medication adjustment for behavior or attention (19.5% vs 4.1%, p = 0.0007) compared with children without an IEP.

Conclusion:

Over one-third of parents of children with IEPs reported their child's learning needs were not met during COVID-19. Lack of access to services may partially explain greater behavioral difficulties and parent depression symptoms in this group. When planning supports during an interruption of in-person instruction, social-emotional needs, behavioral intervention, family support, and academic goals should be addressed.
Evaluation of Virtual Enhanced Child Adult Relationship Enhancement in Primary Care Intervention
Authors: Kiely Jenna , DePaul Emily , Rojas Stefany , Cortes SolRubi , Schilling Samantha , Dougherty Susan , Wood Joanne N.
Published: June 2024

Objective:

Because of COVID-19 pandemic social distancing requirements, the in-person Child Adult Relationship Enhancement in Primary Care (PriCARE) positive parenting intervention was adapted for virtual delivery. Objective was to evaluate the efficacy of the virtual PriCARE program to improve parenting capacity, decrease child behavioral problems, and decrease child maltreatment risk.

Methods:

Caregivers of children 2 to 6 years old recruited from pediatric primary care were randomized to PriCARE (n = 92) or waitlist control (n = 90). Dysfunctional parenting, positive parenting skills, child behaviors, and child maltreatment risk were measured at baseline and 2 to 3 months after intervention using the Parenting Scale (PS), Dyadic Parent-Child Interaction Coding System (DPICS), Eyberg Child Behavior Inventory (ECBI), and Child Abuse Potential Inventory (CAPI). Kruskal-Wallis test compared median change scores from baseline to follow-up by treatment arm.

Results:

Of 182 enrolled caregivers, 92% (168) were mothers and 67% (122) completed study measures at baseline and follow-up. The median decrease (improvement) in total PS score was greater in the PriCARE group compared with the control group (−0.3 [IQR 0.69] vs −0.1 [IQR 0.56], p = 0.028) as was the median decrease (improvement) in ECBI problem score (−3 [IQR 9] vs −1 [IQR 7], p = 0.045) and ECBI intensity score (−9 [IQR 21] vs 0 [IQR 25], p = 0.006). Improvements in 4 positive parenting skills measured by DPICS were greater in the PriCARE group compared with the control group (all p
< 0.003). Median decrease in CAPI abuse score did not differ significantly by study arm (p = 0.055).

Conclusion:

The PriCARE virtual adaptation demonstrated promise in promoting positive parenting and decreasing child behavior problems.
Unbiased transcriptome analysis of human cleft palate reveals evolutionally conserved molecular signatures of development: experimental study
Authors: Jo Taehee , Kim Jeonghoon , Choi Jaehoon , Kim Junhyung , Jeong Woonhyeok
Published: June 2024

Background:

The development of the secondary palate, an essential process for hard palate formation, involves intricate cellular processes. Here, the authors examined the expression patterns of palatal fusion-associated genes in postdevelopmental human palatal tissues.

Methods:

Mucosal samples collected from the anterior fused (control; n=5) and posterior unfused regions (study; n=5) of cleft palate patients were subjected to RNA sequencing. Gene Set Enrichment Analysis (GSEA) was conducted to identify consistent changes in molecular signaling pathways using hallmark (h) gene set collections from the Molecular Signature Database v7.4. The results of RNA sequencing were validated by epithelial-mesenchymal transition (EMT) assays with suppression of target genes, including lrp6, shh, Tgfβ-3 (Bioneer), and negative control siRNA in a human fibroblast cell line (hs68).

Results:

Transcriptome profiling of the cleft mucosa demonstrated that the fully fused anterior mucosa exhibited globally upregulated EMT, Wnt β-catenin, Hedgehog, and TGF-β signaling pathways in gene set enrichment. This strongly indicates the evolutionary conserved similarities in pathways implicated in palatogenesis, as previously shown in murine models. In EMT assays with suppression of Lrp6, Shh, and TGF-β3 in human fibroblast cell lines, suppression of Lrp6 exhibited consistent suppression effects on EMT markers. This indicates a closer association with EMT compared to the other two signals.

Conclusion:

Our study highlights evolutionarily conserved molecular signatures and provides insights into the importance of the EMT pathway in palatal fusion in humans. Furthermore, intraindividual comparative analysis showed the spatial regulation of gene expression within the same organism. Further research and animal models are needed to explore the complexities of EMT-related palatal fusion.
Innovations in three-dimensional-printed individualized bone prosthesis materials: revolutionizing orthopedic surgery: a review
Authors: Qu Zhigang , Yue Jiaji , Song Ning , Li Shenglong
Published: June 2024

The advent of personalized bone prosthesis materials and their integration into orthopedic surgery has made a profound impact, primarily as a result of the incorporation of three-dimensional (3D) printing technology. By leveraging digital models and additive manufacturing techniques, 3D printing enables the creation of customized, high-precision bone implants tailored to address complex anatomical variabilities and challenging bone defects. In this review, we highlight the significant progress in utilizing 3D-printed prostheses across a wide range of orthopedic procedures, including pelvis, hip, knee, foot, ankle, spine surgeries, and bone tumor resections. The integration of 3D printing in preoperative planning, surgical navigation, and postoperative rehabilitation not only enhances treatment outcomes but also reduces surgical risks, accelerates recovery, and optimizes cost-effectiveness. Emphasizing the potential for personalized care and improved patient outcomes, this review underscores the pivotal role of 3D-printed bone prosthesis materials in advancing orthopedic practice towards precision, efficiency, and patient-centric solutions. The evolving landscape of 3D printing in orthopedic surgery holds promise for revolutionizing treatment approaches, enhancing surgical outcomes, and ultimately improving the quality of care for orthopedic patients.
Left ventricular posterior wall hypertrophy leads to poor prognosis of hypertrophic obstructive cardiomyopathy in children: a cohort study
Authors: Liu Shun , Hua Xiumeng , Zhao Yiqi , Mo Han , Chen Xiao , Wang Weiteng , Li Yijing , Zhao Qian , Yan Jun , Song Jiangping
Published: June 2024

Objective:

The modified Morrow operation for hypertrophic obstructive cardiomyopathy (HOCM) in children has a favorable outcome, but some children still have a poor prognosis after the procedure. In this study, the authors aimed to investigate the application of cardiac computed tomography (CCT) to construct a three-dimensional (3D) model of the left ventricle (LV) and analyze the association between hypertrophy in different parts of the LV and poor prognosis.

Methods:

The authors retrospectively analyzed 57 children with HOCM from April 2015 to October 2022, among whom 16 underwent preoperative CCT examination. All children underwent the modified Morrow surgery in our center. The authors defined heart failure, malignant ventricular arrhythmia, and recurrent left ventricular outflow tract obstruction (LVOTO) as adverse events. The authors performed a retrospective Cox analysis and conducted genetic testing. A 3D model of the LV was built through the standard 17-segment method and analyzing the high-risk factors.

Results:

Seventeen (29.8%) had adverse events during follow-up. Multivariate Cox analysis revealed that genetic mutation (HR: 5.634, 95% CI: 1.663–19.086, P=0.005), Noonan syndrome (HR: 3.770, 95% CI: 1.245–11.419, P=0.019), preoperational systolic anterior motion (HR: 4.596, 95% CI: 1.532–13.792, P=0.007)and mid-ventricular obstruction (HR: 4.763, 95% CI: 1.538–14.754, P=0.007) were high-risk factors, suggesting that the degree of hypertrophy in the LV is associated with poor prognosis. By analyzing the CCT with a 3D model, children with poor prognosis have more hypertrophy in basal-inferior (P=0.014), mid-inferoseptal (P=0.044), and mid-inferior (P=0.017). It suggests that a more hypertrophied posterior left ventricular wall portends a worse prognosis.

Conclusion:

Even after modified Morrow surgery, the prognostic impact of genetic mutation remains significant. Moreover, the degree of hypertrophy of the posterior wall in the LV was also related to the postoperative prognosis through CCT combined with 3D technology. It provides surgeons guiding to evaluate the overall prognosis and the treatment plan before surgery.
Relationships among health promotion behaviors, patient engagement, and the nurse practitioner–patient partnership
Authors: DeCelie Irene , Sturm Bonnie
Published: June 2024

Background:

Individuals adopting health promotion behaviors benefit from improved health and reduced risk of chronic diseases. Patient engagement and a strong provider–patient partnership may play a role in health promotion.

Purpose:

This study examined the relationships between patient engagement, the nurse practitioner–patient partnership and health promotion behaviors among adults in a primary care setting.

Methodology:

A descriptive correlational study using convenience sampling to recruit 85 participants from a nurse practitioner primary care practice. Participants completed questionnaires measuring health promotion behaviors (Health Promoting Lifestyle Profile II), the quality of the nurse practitioner–patient partnership (Patient Reactions Assessment), and a person's capacity to engage in their health care (Person Engagement Index).

Results:

Moderate to strong correlations were found among the main study variables. Multiple regression analysis found a person's capacity to engage in health care significantly predicted health promotion behaviors (R
2 = 0.362, p < .001) and explained 36.2% of the variance in health promotion behaviors.

Conclusions:

Patient engagement is a significant predictor of health promotion behaviors. The interactive care model can serve as a framework for nurse practitioners to build partnerships and facilitate patient engagement. Nurse practitioners can serve as a coach, navigator, collaborator, and trusted health care partner with their patients.

Implications:

Nurse practitioners in primary care may need to restructure the health care encounter to allow for adequate time to communicate, listen, educate, and enlist patients in the shared decision-making process. Nurse practitioners can provide the support patients need to engage in their health care as they accept greater responsibility for their health.
The efficacy of gabapentin supplementation for pain control after lumbar laminectomy and discectomy: A meta-analysis study
Authors: Li Ruhui , Li Wenbin , Yao Xiongbin
Published: June 2024

Background:

Gabapentin supplementation may have some potential in pain control after lumbar laminectomy and discectomy, and this meta-analysis aims to explore the impact of gabapentin supplementation on postoperative pain management for lumbar laminectomy and discectomy.

Methods:

PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched, and we included randomized controlled trials assessing the effect of gabapentin supplementation on the pain control of lumbar laminectomy and discectomy.

Results:

Five randomized controlled trials were finally included in the meta-analysis. Overall, compared with control intervention for lumbar laminectomy and discectomy, gabapentin supplementation was associated with significantly lower pain scores at 2 hours (MD = −2.75; 95% CI = −3.09 to −2.41; P < .00001), pain scores at 4 hours (MD = −2.28; 95% CI = −3.36 to −1.20; P < .0001), pain scores at 24 hours (MD = −0.70; 95% CI = −0.86 to −0.55; P < .00001) and anxiety score compared to control intervention (MD = −1.32; 95% CI = −1.53 to −1.11; P < .00001), but showed no obvious impact on pain scores at 12 hours (MD = −0.58; 95% CI = −1.39 to 0.22; P = .16). In addition, gabapentin supplementation could significantly decrease the incidence of vomiting in relative to control intervention (OR = 0.31; 95% CI = 0.12–0.81; P = .02), but they had similar incidence of nausea (OR = 0.51; 95% CI = 0.15–1.73; P = .28).

Conclusions:

Gabapentin supplementation benefits to pain control after lumbar laminectomy and discectomy.
Development and validation of a prediction model for hypoproteinemia after traumatic spinal cord injury: A multicenter retrospective clinical study
Authors: Tan Xiuwei , Wu Yanlan , Li Fengxin , Wei Qian , Lu Xuefeng , Huang Xiaoxi , He Deshen , Huang Xiaozhen , Deng Shiquan , Hu Linting , Song Fangming , Su Yiji
Published: June 2024

A multicenter retrospective analysis of conventionally collected data. To identify the potential causes of hypoproteinemia after traumatic spinal cord injury (TSCI) and provide a diagnostic model for predicting an individual likelihood of developing hypoproteinemia. Hypoproteinemia is a complication of spinal cord injury (SCI), an independent risk factor for respiratory failure in elderly patients with SCI, and a predictor of outcomes in patients with cervical SCI. Few nomogram-based studies have used clinical indicators to predict the likelihood of hypoproteinemia following TSCI. This multicenter retrospective clinical analysis included patients with TSCI admitted to the First Affiliated Hospital of Guangxi Medical University, Wuzhou GongRen Hospital, and Dahua Yao Autonomous County People Hospital between 2016 and 2020. The data of patients from the First Affiliated Hospital of Guangxi Medical University were used as the training set, and those from the other 2 hospitals were used as the validation set. All patient histories, diagnostic procedures, and imaging findings were recorded. To predict whether patients with TSCI may develop hypoproteinemia, a least absolute shrinkage and selection operator regression analysis was conducted to create a nomogram. The model was validated by analyzing the consequences using decision curve analysis, calibration curves, the C-index, and receiver operating characteristic curves. After excluding patients with missing data, 534 patients were included in this study. Male/female sex, age ≥ 60 years, cervical SCI, pneumonia, pleural effusion, urinary tract infection (UTI), hyponatremia, fever, hypotension, and tracheostomy were identified as independent risk factors of hypoalbuminemia. A simple and easy-to-replicate clinical prediction nomogram was constructed using these factors. The area under the curve was 0.728 in the training set and 0.881 in the validation set. The predictive power of the nomogram was satisfactory. Hypoalbuminemia after TSCI may be predicted using the risk factors of male/female sex, age ≥ 60 years, cervical SCI, pneumonia, pleural effusion, UTI, hyponatremia, fever, hypotension, and tracheostomy.
Assessing drug lag in new drug approvals by the Iran Food and Drug Administration compared to the U.S. FDA, EMA, and PMDA: A 20-year analysis (2001–2021)
Authors: Alipour Sama , Nadimi Parashkouhi Sadra , Mojahedian Mohammadmahdi , Abbasian Hadi
Published: June 2024

The pharmaceutical industry is vital for healthcare advancement through innovative medications, improving lives. A substantial challenge is “Drug lag,” hindering patient access and increasing disease adjusted life years burdens. We aim to examine drug lag for Iran Food and Drug Administration (IFDA) approved drugs versus US Food & Drug Administration (FDA), European Medicines Agency (EMA), and Pharmaceuticals and Medical Devices Agency (PMDA) over 2001 to 2021. We reviewed new molecular entities within this period, using descriptive statistics in Excel 2019. Drug lag is assessed from relative and absolute perspectives, considering approval gaps and annual rates. Among 710 FDA-approved drugs, 410 received EMA approval, 344 from PMDA, and 148 from IFDA. For 148 IFDA and FDA-approved drugs, the maximum drug lag was 237 months. The mean relative drug lag was 65.18 ± 61.56 months. Compared to EMA (112 drugs), the maximum lag was 257 months, with a mean relative lag of 70.29 ± 53.67 months. With PMDA (127 drugs), the maximum lag was 253 months, with a mean relative lag of 38.23 ± 60.57 months. Iran faces significant drug lag compared to developed countries’ regulatory bodies, limiting patient access to innovative treatments. Addressing this issue is crucial for timely drug access, reducing disease burdens. Further research and policy interventions are needed to mitigate drug lag’s impact on Iran healthcare landscape.
Therapeutic efficacy of recombinant human growth hormone in children with different etiologies of dwarfism from a pharmacoeconomic point of view
Authors: Ma Yanxia , Sheng Jianping , Wang Lijie , Zhang Yanan , Liu Lin
Published: June 2024

Treatment outcomes for different causes of childhood dwarfism vary widely, and there are no studies on the economic burden of treatment in relation to outcomes. This paper compared the efficacy and healthcare costs per unit height of recombinant human growth hormone (rhGH) for the treatment of growth hormone deficiency (GHD) and idiopathic short stature (ISS) with a view to providing a more cost-effective treatment option for children. We retrospectively analyzed 117 cases (66 cases of GHD and 51 cases of ISS) of short-stature children who first visited Weifang People’s Hospital between 2019.1 and 2022.1 and were treated with rhGH for 1 to 3 years to track the treatment effect and statistically analyzed by using paired t tests, non-parametric tests, and chi-square tests, to evaluate the efficacy of rhGH treatment for GHD and ISS children and the medicinal cost. The annual growth velocity (GV) of children with GHD and ISS increased the fastest during 3 to 6 months after treatment and then gradually slowed down. The GV of the GHD group was higher than that of the ISS group from 0 to 36 months after treatment (P < .05 at 3, 6, 9, and 12 months); the height standard deviation scores (HtSDS) of the children in the GHD and ISS groups increased gradually with the increase of the treatment time, and the changes in the height standard deviation scores (ΔHtSDS) of the GHD group were more significant than those of the ISS group (P < .05 at 3, 6, 9, and 12 months). (2) The medical costs in the pubertal group for a 1-cm increase in height were higher than those of children in the pre-pubertal group at the same stage (3 to 24 months P < .05). The longer the treatment time within the same group, the higher the medical cost of increasing 1cm height. RhGH is effective in treating children with dwarfism to promote height growth, and the effect on children with GHD is better than that of children with ISS; the earlier the treatment time, the lower the medical cost and the higher the comprehensive benefit.
The postoperative clinical effects of utilizing 3D printed (Ti6Al4V) interbody fusion cages in posterior lumbar fusion: A retrospective cohort study
Authors: Wang Zi , Zhang Dongzhe , Zhang Zepei , Miao Jun
Published: June 2024

Background:

The research focused on the postoperative effect of using interbody fusion cage in lumbar posterior lamina decompression and interbody fusion with pedicle screw by comparing the postoperative effect of using 3D printing (Ti6Al4V) and PEEK material interbody fusion cage.

Methods:

Ninety-one patients with lumbar degenerative diseases from the Department of Spine Surgery of Tianjin Hospital were included in the study cohort. They were divided into 3D group (n = 39) and PEEK group (n = 52) according to the use of interbody fusion cage. The imaging data of the patients were collected and the postoperative data of the 2 groups were compared to evaluate patients’ health status and the recovery of lumbar structure and function after operation.

Results:

Combined with the degree of fusion, the clinical effect of 3D printing titanium alloy interbody fusion cage was comprehensively judged. At the last follow-up, the JOA score, ODI index, VAS, prolo function score, and SF-36 scale of the 2 groups showed that the clinical symptoms were better than those before operation (P< .05). The height of intervertebral disc, the area of intervertebral foramen and the physiological curvature of lumbar vertebrae increased in varying degrees after operation (P< .05). At the last follow-up, the vertebral cage fusion rates were as high as 89.13% and 90.91% in the 3D and PEEK groups, with collapse rates of 6.5% and 4.5%, respectively. There were 10 cases of cage displacement in 3D group and 7 cases of cage displacement in PEEK group. There was no significant difference between the 2 groups (P> .05).

Conclusions:

In conclusion, 3D printed (Ti6Al4V) interbody fusion cage can obtain good clinical effect in the surgical treatment of lumbar degenerative diseases. Posterior lumbar lamina decompression, bilateral pedicle screw fixation combined with 3D printed cage interbody fusion is excellent in rebuilding the stability of lumbar vertebrae. 3D printed interbody fusion cage can be an ideal substitute material for intervertebral bone grafting. The stable fusion time of interbody fusion cage after lumbar fusion is mostly from 3 months to half a year after operation.
Mendelian randomization analysis elucidates the causal relationship between celiac disease and the risk of thyroid dysfunction
Authors: Liu Ming , Zhao Yueping , Jiang Lianxue
Published: June 2024

The link between celiac disease (CeD) and thyroid dysfunction has been investigated. However, it is uncertain if CeD is causally linked to thyroid dysfunction. A 2-sample Mendelian randomization study was conducted to ascertain the causal connection between CeD and thyroid dysfunction. Using data from the FinnGen Consortium, a 2-sample Mendelian randomization study was conducted to look at the connection between thyroid dysfunction and CeD. Another replication of the data from the UK Biobank was subsequently performed to confirm our findings. Furthermore, a sequence of sensitivity analyses was performed. The inverse variance weighting technique demonstrates that genetically determined CeD is substantially linked with hypothyroidism, thyrotoxicosis, Graves’ disease, and free thyroxine. However, no significant associations were found between CeD and thyroid-stimulating hormone or thyroiditis. Moreover, we achieve the same results in duplicate datasets, which increases the reliability of our findings. This study suggests that CeD and thyroid dysfunction are linked, and it gives theoretical support and new ways of thinking about how to diagnose and treat both conditions.
Potential of digital chest radiography-based deep learning in screening and diagnosing pneumoconiosis: An observational study
Authors: Zhang Yajuan , Zheng Bowen , Zeng Fengxia , Cheng Xiaoke , Wu Tianqiong , Peng Yuli , Zhang Yonliang , Xie Yuanlin , Yi Wei , Chen Weiguo , Wu Jiefang , Li Long
Published: June 2024

The diagnosis of pneumoconiosis is complex and subjective, leading to inevitable variability in readings. This is especially true for inexperienced doctors. To improve accuracy, a computer-assisted diagnosis system is used for more effective pneumoconiosis diagnoses. Three models (Resnet50, Resnet101, and DenseNet) were used for pneumoconiosis classification based on 1250 chest X-ray images. Three experienced and highly qualified physicians read the collected digital radiography images and classified them from category 0 to category III in a double-blinded manner. The results of the 3 physicians in agreement were considered the relative gold standards. Subsequently, 3 models were used to train and test these images and their performance was evaluated using multi-class classification metrics. We used kappa values and accuracy to evaluate the consistency and reliability of the optimal model with clinical typing. The results showed that ResNet101 was the optimal model among the 3 convolutional neural networks. The AUC of ResNet101 was 1.0, 0.9, 0.89, and 0.94 for detecting pneumoconiosis categories 0, I, II, and III, respectively. The micro-average and macro-average mean AUC values were 0.93 and 0.94, respectively. The accuracy and Kappa values of ResNet101 were 0.72 and 0.7111 for quadruple classification and 0.98 and 0.955 for dichotomous classification, respectively, compared with the relative standard classification of the clinic. This study develops a deep learning based model for screening and staging of pneumoconiosis is using chest radiographs. The ResNet101 model performed relatively better in classifying pneumoconiosis than radiologists. The dichotomous classification displayed outstanding performance, thereby indicating the feasibility of deep learning techniques in pneumoconiosis screening.
Combination of 2 test methods, single-picture optotype visual acuity chart and spot™ vision screener, in the eye health screening program for 3-year-old children in Tokyo: A retrospective, observational study
Authors: Kumanomido Takashi , Murasugi Hiroko , Miyaji Atsuko , Sunohara Daisuke , Suzuki Mari , Uno Shinji , Watanabe Hitoshi
Published: June 2024

To evaluate the usefulness of the Tokyo Metropolitan Government’s Eye Health Screening Program for 3-year-old children, which combines the Single-Picture Optotype Visual Acuity Chart (SPVAC) and Spot™ Vision Screener (SVS) tests. This was a retrospective, observational, matched study. Patients who underwent the eye health screening program and had abnormalities were classified into 3 groups according to the outcomes of the SPVAC (SPVAC-passed, SPVAC-P; SPVAC-failed, SPVAC-F) and SVS (SVS-passed, SVS-P; SVS-failed, SVS-F) tests as follows: SPVAC-P/SVS-F, SPVAC-F/SVS-P, and SPVAC-F/SVS-F. We evaluated the age at examination, SPVAC and SVS test success rates, and SVS refractive power. Additionally, the rates of refractive error, amblyopia, and strabismus were compared among the 3 groups. The SPVAC-P/SVS-F, SPVAC-F/SVS-P, and SPVAC-F/SVS-F groups comprised 158, 28, and 74 eyes, respectively. The mean age was 37.4 months. The success rates of the SPVAC and SVS tests were 69.8% and 96.2%, respectively. The mean SVS hyperopia value in the SPVAC-F/SVS-F group (2.71 ± 1.50 D) was significantly higher than that of the SPVAC-P/SVS-F group. The mean SVS astigmatism and myopia values were −2.21 diopter (D) ± 1.09 D and −3.40 ± 1.82 D, respectively; they did not differ significantly from that of the SPVAC-P/SVS-F group. Significant differences were observed in the refractive error, amblyopia, and strabismus rates among the 3 groups. Regarding disease determination, no significant difference was observed among participants who passed and failed the SPVAC test, regardless of the outcome of the other test. However, a significant difference was observed between those passing and failing the SVS tests. The SPVAC method used to screen 3-year-old children should be modified to commence at 42 months of age or be replaced with a single Landolt C test. The SVS test is useful for screening younger patients. Furthermore, the SVS test showed that the degree of hyperopia was higher in patients who did not pass the SPVAC test.
A study on the safety and efficacy of endoscopic thyroidectomy via axillary approach for the treatment of thyroid cancer
Authors: Wang Song , Zhang Fangjie , Wang Jingjing , Ao Yazhou
Published: June 2024

This study aims to evaluate the safety and efficacy of endoscopic thyroid cancer treatment using an axillary approach. Participants were allocated into 2 groups: one undergoing transaxillary endoscopic surgery and the other, traditional open surgery. We compared intraoperative and postoperative conditions, focusing on parameters such as intraoperative blood loss, duration of surgery, length of postoperative hospitalization, volume of postoperative drainage, number of lymph nodes cleared in the central region, neck pain scores, neck injury indices, cosmetic satisfaction, postoperative complications, and total hospitalization duration. Patients in the endoscopic treatment (ET) group experienced longer surgical times, less intraoperative bleeding, and increased postoperative drainage. These indicators showed significant differences between the groups (P < .05). For the group undergoing endoscopic surgery via the axillary approach, there was a lower neck pain score on the third postoperative day and higher cosmetic satisfaction at 3 months. However, there were no significant differences between the groups in terms of the number of lymph nodes cleared in the central area, and the incidence of complications such as difficulty breathing, difficulty swallowing, hoarseness, and subcutaneous hematoma (P > .05). The axillary approach endoscopic surgery group also showed significantly prolonged surgery times and postoperative hospital stays, with a significant increase in postoperative drainage fluid (P < .05). Concurrently, this technique involved smaller surgical incisions and effectively concealed scars in the armpit, leading to better outcomes in terms of intraoperative bleeding, neck pain scores, and postoperative cosmetic satisfaction. Non-inflatable ET via the axillary approach for treating thyroid cancer demonstrates promising efficacy and safety. It offers additional benefits of minimal pain and enhanced cosmetic outcomes, making it a viable option for clinical adoption and application.
Relationship between preoperative hemoglobin levels and length of stay in elderly patients with hip fractures: A retrospective cohort study
Authors: Zhang Ning , Zhang Daxue , Ren Shuqun , Gao Yan , Sun Weichao , Yang Shiwei
Published: June 2024

Globally, hip fractures in elderly individuals are a prevalent and serious issue. Patients typically have a longer length of stay (LOS), which increases the risk of complications and increases hospitalization costs. Hemoglobin (Hb) is a routine blood test that is associated with disease prognosis. This study aimed to investigate the relationship between preoperative Hb and LOS in elderly hip fracture patients and to determine a reliable transfusion threshold. The clinical data of hip fracture patients (aged ≥ 60 years) admitted to the Department of Orthopaedics, Shenzhen Second People’s Hospital, between January 2012 and December 2021 were retrospectively analyzed. Multiple linear regression analysis was used to assess the linear relationship between preoperative Hb and LOS. Smooth curve fitting was performed to investigate potential nonlinear relationships. In the case of discovering nonlinear relationships, a weighted two-piecewise linear regression model was built, and the inflection points were determined using a recursive algorithm. Subgroup analyses were conducted based on age and gender. A total of 1444 patients with an average age of (77.54 ± 8.73) years were enrolled. After adjusting for covariates, a nonlinear relationship was found between preoperative Hb and LOS. The two-piecewise linear regression model revealed an inflection point of 10 g/dL. On the left of the inflection point (Hb < 10 g/dL), the LOS was reduced by 0.735 days for every 1 g/dL increase in Hb (β = ‐0.735, 95% confidence interval: ‐1.346 to ‐0.124, P = .019). On the right side of the inflection point (Hb > 10 g/dL), the relationship was not statistically significant (β = 0.001, 95% confidence interval: ‐0.293 to 0.296, P = .992). In elderly hip fracture patients, there is a nonlinear association between preoperative Hb and LOS. However, when Hb levels were <10 g/dL, there was a negative correlation with the LOS. No correlation was observed when Hb levels were >10 g/dL. These findings underscore the importance of timely intervention to manage Hb levels in elderly patients with hip fractures, potentially reducing hospitalization durations and associated complications.
Therapeutic analysis of laser moxibustion for different KL graded knee osteoarthritis
Authors: Yan Yuming , Lin Lin , Cheng Ke , Deng Haiping , Qin Meng , Shen Xueyong , Zhao Ling
Published: June 2024

Background:

Our previous studies showed that laser moxibustion may be effective in alleviating the symptoms of knee osteoarthritis. However, the therapeutic effect in patients with different Kellgren-Lawrence (KL) grades is still unclear. We aimed to compare the efficacy of laser moxibustion in the treatment of knee osteoarthritis with different KL grades.

Methods:

A total of 392 symptomatic KOA patients with different KL grades were randomly assigned to the laser treatment or sham laser control group (1:1). The patients received laser moxibustion treatment or sham treatment 3 times a week for 4 weeks. Outcomes were measured using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores and Visual Analog Scale (VAS) scores, and the primary outcome measurement was the change in WOMAC pain scores from baseline to week 4.

Results:

Among 392 randomized participants, 364 (92.86%) completed the trial. Participants with KL grades 2, 3, and 4 had significantly higher pain, functional, and total WOMAC scores than those with KL grade 1. Spearman correlation test results showed a positive correlation between KL grade and WOMAC pain, function, stiffness scores, and WOMAC total scores. That is, the higher the KL grade, the higher the WOMAC pain, function, stiffness, and WOMAC total scores. After 4 weeks of treatment, patients with KL grades 2 and 3 had significantly higher improvement scores in pain, function, and total scores than those with KL grade 1, whereas those with KL grade 2 had significantly higher improvement scores in stiffness than those with KL grade 1. Patients with KL grade 4 showed no significant effects after laser moxibustion treatment.

Conclusion:

Laser moxibustion is effective for pain reduction and functional improvement in the treatment of KOA with KL grades 2 and 3.
Efficacy and safety of albiglutide, a once-weekly glucagon-like peptide-1 receptor agonist, in patients with type 2 diabetes: A systematic review and meta-analysis
Authors: Kamrul-Hasan A.B.M. , Dutta Deep , Nagendra Lakshmi , Bhattacharya Saptarshi , Singla Rajiv , Kalra Sanjay
Published: June 2024

Background:

No meta-analysis has holistically analyzed and summarized the therapeutic efficacy and safety of albiglutide in type 2 diabetes (T2D). This meta-analysis addresses this knowledge gap.

Methods:

Randomized controlled trials involving patients with T2D receiving albiglutide in the intervention arm and either a placebo or an active comparator in the control arm were searched through electronic databases. The primary outcome was the change from baseline (CFB) in glycated hemoglobin (HbA1c); secondary outcomes included CFB in fasting plasma glucose, body weight, and adverse events (AE).

Results:

From 443 initially screened articles, data from 12 randomized controlled trials involving 6423 subjects were analyzed. Albiglutide, at both doses, outperformed placebo in terms of HbA1c reductions (for albiglutide 30 mg: mean differences −1.04%, 95% confidence interval [CI] [−1.37–−0.72], P < .00001, I
2 = 89%; and for albiglutide 50 mg: mean differences −1.10%, 95% CI [−1.45–−0.75], P < .00001, I
2 = 90%). Higher proportions of subjects achieved HbA1c < 7% in the albiglutide arm than in placebo (for albiglutide 30 mg: odds ratio 6.26, 95% CI [2.50–15.70], P < .0001, I
2 = 82%; and for albiglutide 50 mg: odds ratio 5.57, 95% CI [2.25–13.80], P = .0002, I
2 = 84%). Albiglutide had glycemic efficacy comparable to other glucose-lowering drugs. CFB in body weight was similar with albiglutide and placebo. AE profile, including gastrointestinal AE, was identical with albiglutide and placebo, except for higher drug-related AE and injection-site reaction with albiglutide.

Conclusion:

Albiglutide provides reassuring data on good glycemic efficacy, tolerability, and safety over an extended period of clinical use in patients with T2D. Albiglutide 30 mg has comparable efficacy and safety profiles to albiglutide 50 mg.
Association between color value of tongue and T2DM based on dose-response analyses using restricted cubic splines in China: A cross-sectional study
Authors: Tian Zhikui , Sun Xuan , Wang Dongjun , Wang Hongwu
Published: June 2024

This study aimed to explore the relationship between international commission on illumination (CIE) L*a*b* color value of tongue and type 2 diabetes mellitus (T2DM). We used restricted cubic spline method and logistic regression method to assess the relationship between CIE L*a*b* color value of tongue and T2DM. A total of 2439 participants (991 T2DM and 1448 healthy) were included. A questionnaire survey and tongue images obtained with tongue diagnosis analysis-1 were analyzed. As required, chi-square andttests were applied to compare the T2DM and healthy categories. Our findings suggest the 95% confidence interval and odds ratio for body mass index, hypertension, and age were 0.670 (0.531–0.845), 13.461 (10.663–16.993), and 2.595 (2.324–2.897), respectively, when compared to the healthy group. A linear dose-response relationship with an inverse U-shape was determined between CIE L* and CIE a* values and T2DM (P < .001 for overall andP < .001 for nonlinear). Furthermore, U-shaped and linear dose-response associations were identified between T2DM and CIE b* values (P = .0160 for nonlinear). Additionally, in adults, the CIE L*a*b* color value had a correlation with T2DM. This novel perspective provides a multidimensional understanding of traditional Chinese medicine tongue color, elucidating the potential of CIE L*a*b* color values of tongue in the diagnosis of T2DM.
Assessing quality of life and depression in non-metastatic breast cancer patients following surgical treatment: A cross-sectional study in Lebanon
Authors: Nahle Ali Alakbar , Hamdar Hussein , Awada Rim , Kaddour Ziad , Rammal Zeina , Abbas Rim , Jalloul Sarah Ibrahim , Ismail Nathalie Haidar
Published: June 2024

Breast cancer is a global health concern that significantly impacts the quality of life (QOL) of individuals. This study aims to comprehensively examine the interplay between QOL and depression among nonmetastatic breast cancer patients in Lebanon, a region with limited research in this context. A cross-sectional study was conducted at Hammoud Hospital-University Medical Center from January 2018 to January 2023. Data was collected through a self-administered questionnaire distributed as Google Forms via WhatsApp. A total of 193 patients had non-metastatic breast cancer. Out of these, 81 valid responses were obtained. The Patient Health Questionnaire and Quality of Life Scale were used to assess depression and QOL, respectively. A total of 81 patients were included with mean age 54.4 years. Results revealed that 77.8% of patients experienced provisional depression, with 35.8% meeting criteria for major depressive disorder. Financial status and chronic diseases were associated with the likelihood of developing major depressive disorder. The mean QOL score was 81.14, lower than the average for healthy individuals. Educational level and presence of chronic diseases were significant factors influencing QOL. Postsurgical depression prevalence is substantial, underscoring the importance of integrating mental health care. Economic status and comorbidities are influential factors, necessitating targeted interventions. Breast cancer’s impact on QOL is profound, falling below that of other chronic conditions. Education empowers coping, while comorbidities impact QOL. Our findings emphasize the multidimensional nature of breast cancer care, advocating for holistic support and addressing emotional well-being.
Role of flibanserin in managing hypoactive sexual desire disorder in women: A systematic review and meta-analysis
Authors: Kamrul-Hasan A.B.M. , Hannan Mohammad Abdul , Alam Muhammad Shah , Aalpona Fatema Tuz Zahura , Nagendra Lakshmi , Selim Shahjada , Dutta Deep
Published: June 2024

Background:

Flibanserin, approved for the treatment of hypoactive sexual desire disorder (HSDD) in females, has demonstrated diverse therapeutic and adverse effect (AE) prospects in the extant randomized controlled trials (RCTs). This meta-analysis aimed to characterize the outcomes of flibanserin use in these patients comprehensively.

Methods:

RCTs involving women with HSDD receiving flibanserin in the intervention arm and placebo in the control arm were sought after throughout the electronic databases. The primary outcomes were the changes from baseline in satisfying sexual events (SSE) per month and sexual desire score per month measured using an electronic diary (eDiary).

Results:

From 478 initially screened articles, data from 8 RCTs involving 7906 women with HSDD were analyzed. In premenopausal women, flibanserin 100 mg was superior to placebo in improving the number of SSE per month (mean difference, MD 0.69, 95% CI [0.39, 0.99]), eDiary sexual desire score (MD 1.71, 95% CI [0.43, 2.98]), Female Sexual Function Index (FSFI) desire domain (FSFI-d) score (MD 0.30, 95% CI [0.29, 0.31]), FSFI total score (MD 2.51, 95% CI [1.47, 3.55]), Female Sexual Distress Scale-Revised (FSDS-R) Item 13 score (MD −0.30, 95% CI [−0.31, −0.29]), and FSDS-R total score (MD −3.30, 95% CI [−3.37, −3.23]). Compared to placebo, a higher number of premenopausal women using flibanserin 100 mg achieved improvements in the Patient’s Global Impression of Improvement score (OR 1.93, 95% CI [1.58, 2.36], P < .00001) and responded positively at Patient Benefit Evaluation (PBE) (odds ratio, OR 1.76, 95% CI [1.34, 2.31], P < .0001). Postmenopausal women receiving flibanserin 100 mg also benefited in terms of the number of SSE per month, FSFI-d and total scores, FSDS-R Item 13 and total scores, and PBE response. Although flibanserin use was associated with higher risks of dizziness, fatigue, nausea, somnolence, and insomnia, these adverse events were mild in nature; the serious AEs and severe AEs were comparable between the flibanserin and placebo groups.

Conclusion:

While flibanserin has demonstrated efficacy in the treatment of HSDD in both pre- and postmenopausal women, its therapeutic advantages may be overshadowed by the higher likelihood of AEs.
Global research trends and future directions in diabetic macular edema research: A bibliometric and visualized analysis
Authors: Li Yuanyuan , Jie Chuanhong , Wang Jianwei , Zhang Weiqiong , Wang Jingying , Deng Yu , Liu Ziqiang , Hou Xiaoyu , Bi Xuqi
Published: June 2024

Background:

Diabetic Macular Edema (DME) significantly impairs vision in diabetics, with varied patient responses to current treatments like anti-vascular endothelial growth factor (VEGF) therapy underscoring the necessity for continued research into more effective strategies. This study aims to evaluate global research trends and identify emerging frontiers in DME to guide future research and clinical management.

Methods:

A qualitative and quantitative analysis of publications related to diabetic macular edema retrieved from the Web of Science Core Collection (WoSCC) between its inception and September 4, 2023, was conducted. Microsoft Excel, CiteSpace, VOSviewer, Bibliometrix Package, and Tableau were used for the bibliometric analysis and visualization. This encompasses an examination of the overall distribution of annual output, major countries, regions, institutions, authors, core journals, co-cited references, and keyword analyses.

Results:

Overall, 5624 publications were analyzed, indicating an increasing trend in DME research. The United States was identified as the leading country in DME research, with the highest h-index of 135 and 91,841 citations. Francesco Bandello emerged as the most prolific author with 97 publications. Neil M. Bressler has the highest h-index and highest total citation count of 46 and 9692, respectively. The journals “Retina – the Journal of Retinal and Vitreous Diseases” and “Ophthalmology” were highlighted as the most prominent in this field. “Retina” leads with 354 publications, a citation count of 11,872, and an h-index of 59. Meanwhile, “Ophthalmology” stands out with the highest overall citation count of 31,558 and the highest h-index of 90. The primary research focal points in diabetic macular edema included “prevalence and risk factors,” “pathological mechanisms,” “imaging modalities,” “treatment strategies,” and “clinical trials.” Emerging research areas encompassed “deep learning and artificial intelligence,” “novel treatment modalities,” and “biomarkers.”

Conclusion:

Our bibliometric analysis delineates the leading role of the United States in DME research. We identified current research hotspots, including epidemiological studies, pathophysiological mechanisms, imaging advancements, and treatment innovations. Emerging trends, such as the integration of artificial intelligence and novel therapeutic approaches, highlight future directions. These insights underscore the importance of collaborative and interdisciplinary approaches in advancing DME research and clinical management.