bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of the efficacy of CO2 laser therapy for female stress urinary incontinence
Authors: Hsiao Sheng-Mou , Wu Wen-Yih , Lin Ho-Hsiung
Published: November 2024

Background:

Predictors of the efficacy of a single session of CO2 laser therapy for female stress urinary incontinence are important for pretreatment consultation. Therefore, this study aimed to evaluate these predictors.

Methods:

All consecutive women who underwent vaginal CO2 laser therapy for stress urinary incontinence were prospectively enrolled in the obstetrics and gynecology department of a medical center from October 2018 to December 2021. Women with a global response assessment (GRA) ≤0 during follow-up were considered to have subjective failure. A multivariable backward stepwise Cox proportional hazard model was used to identify factors influencing subjective failure.

Results:

A total of 75 women who underwent single-session vaginal CO2 laser therapy were evaluated. The median duration of subjective improvement (defined as ≥1 on the GRA) was 18.3 (95% CI, 12.1-18.3 months) months. Multivariable analysis revealed that low voided volume (dL, hazard ratio [HR] = 0.707; area under the curve [AUC] = 0.66, cutoff value of voided volume ≤4.0 dL), high postvoid residual volume (dL, HR = 2.714; AUC = 0.60, cutoff value of postvoid residual volume ≥1.0 dL), and low functional profile length (HR = 0.956; AUC = 0.58, cutoff value of functional profile length ≤2.8 cm) were predictors of subjective failure. Logit(p) was found to predict failure (HR = 1.775; AUC = 0.71, cutoff value of logit(p) ≥0.0). Pad weights decreased at 3- and 6-month follow-up visits (e.g., pad weights: 46.9 ± 62.8 g at baseline, 13.1 ± 29.5 g at 3 months, and 21.0 ± 38.2 g at 6 months, p = 0.006). At 6 months, 8 (21%) women were cured (<1 g pad weight), and 16 (42%) women showed improvement (>50% decrease in pad weight). Overactive bladder symptom improved at 3 and 6 months (ie, Overactive Bladder Symptom Score: 3.2 ± 2.7 at baseline, 2.1 ± 2.2 at 3 months, and 2.0 ± 1.2 at 6 months, p < 0.001). However, no significant change in female sexual function was observed from baseline.

Conclusion:

Low voided volume and high postvoid residual volume are significant predictors of subjective failure following a single session of transvaginal CO2 laser therapy. However, the subjective therapeutic effects appear to diminish over a median duration of 18 months.
Analysis of prognosis and medical resource utilization in elderly patients with trauma: A retrospective cohort study in one trauma center
Authors: Kang Lung-Yun , Hua Hu Yu
Published: November 2024

Background:

Trauma is consistently among the top ten causes of death worldwide. The aging population, constituting 15.21% of adults aged over 65 in Taiwan as of November 2019, has significantly impacted healthcare expenditures. This study aimed to explore the prognosis and resource utilization in patients with geriatric trauma.

Methods:

This retrospective analysis included ER admissions between January 2015 and December 2017 at a Level I trauma center in southern Taiwan. Of the 5,185 eligible patients, 1,743 were elderly. Comparisons between the age groups assessed medical resource use, patient characteristics, trauma profiles, and management. Outcomes examined included mortality, complications, length of hospital stay, duration of ICU stay, and costs.

Results:

Elderly patients, predominantly women, exhibit more blunt injuries often resulting from accidental falls. They experienced longer hospital stays and higher medical expenses, as well as increased complication and mortality rates. Mortality predictors included age, GCS score, trauma severity score (≥16), complications, surgery, and initial hypotension. Complications correlated with prolonged length of hospital stay (LOS), early blood transfusion, and mortality, impacting overall expenditure along with trauma severity, ICU days, surgery, and AIS score (≥3).

Conclusion:

Elderly patients had a longer LOS, higher mortality and complication rates, and higher total medical costs. The required medical expenses for elderly trauma cases were relatively higher than those for younger individuals. Relevant authorities should consider patient age when formulating policies for trauma reimbursement. Based on our findings, healthcare resource utilization can be reduced by decreasing the length of hospital stay and mitigating trauma severity. We recommend collecting more detailed data, extending the study period, and engaging in multicenter collaborations to validate our findings and provide a roadmap for further research. We suggested that interventional studies are needed to test strategies aimed at reducing resource utilization and improving outcomes in elderly trauma patients, which would be valuable.
Anatomic versus nonanatomic resection for intrahepatic cholangiocarcinoma: a systematic review and meta-analysis
Authors: Jiang Chuang , Hou Gui-Min , Zhang Zhi-Hong , Qiang Ze-Yuan , Wang Hai-Chuan , Zhou Jin , Zeng Yong
Published: November 2024

Background:

The value of anatomic resection (AR) in intrahepatic cholangiocarcinoma (ICC) remains controversial. This study compares the perioperative safety and long-term outcomes of AR versus nonanatomic resection (NAR) in ICC patients.

Methods:

A systematic search was conducted in PubMed, Medline, Embase, Cochrane Library, China National Knowledge Infrastructure(CNKI), and Wanfang database for prospective or retrospective studies comparing the efficacy of AR and NAR in, ICC published to 1 June 2024. Meta-analyses were performed on surgical factors, perioperative outcomes, and long-term prognosis for both the entire cohort and the propensity score-matched (PSM) cohort. The primary outcome measures were overall survival (OS) and disease-free survival (DFS).

Results:

Seven studies, including 1801 ICC patients, were analyzed. In both the entire and the PSM cohort, the AR group demonstrated superior OS (HR=0.71, 95% CI=0.57–0.88, P=0.002 and HR=0.70, 95% CI=0.59–0.83, P<0.0001, respectively) and DFS (HR=0.75, 95% CI=0.62–0.91, P=0.004 and HR=0.68, 95% CI=0.58–0.79, P<0.00001, respectively) compared to the NAR group. AR significantly improves 1-year, 3-year, 5-year DFS, and 5-year OS(all P<0.05). In the PSM cohort, AR and NAR groups showed comparable blood loss, operative times, overall complications, and major complications (all P>0.05). Subgroup analysis revealed that among patients with tumor >5 cm, AR achieved better OS and DFS, whereas patients with tumors ≤5 cm did not experience survival benefits from AR.

Conclusion:

This study suggests that AR, compared to NAR, can improve OS and DFS without increasing perioperative risks, particularly in ICC patients with tumors larger than 5 cm.
Apixaban removal during emergency surgery for type A acute aortic dissection: a prospective cohort study
Authors: Røed-Undlien Henriette , Schultz Nina H. , Husebråten Inger M. , Wollmann Birgit M. , Akerkar Rupali R. , Molden Espen , Amundsen Erik K. , Bjørnstad Johannes L.
Published: November 2024

Background:

Acute type A aortic dissection (ATAAD) has a high mortality, and acute aortic repair is the only curative treatment. In patients treated with factor Xa (FXa) inhibitors, the risk of severe disease-related complications such as cardiac tamponade and hemodynamic shock must be balanced against the potential for severe perioperative bleeding. The aim was to study intraoperative changes in plasma levels of the FXa inhibitor apixaban when using hemoadsorption during acute thoracic aortic repair.

Materials and methods:

This is a single-center prospective cohort study. Eight apixaban-treated patients presenting with ATAAD underwent acute thoracic aortic repair with intraoperative hemoadsorption with CytoSorb. Apixaban concentrations were measured at the start of cardiopulmonary bypass (CPB) and after 5, 15, 30, 60, and 90 min of CPB, at CPB weaning, 30 min after CPB weaning and 24 h postoperatively, using ultraperformance liquid chromatography–mass spectrometry (UPLC-MS).

Results:

After 30 min of CPB with hemoadsorption, mean apixaban concentration (±SD) was reduced by 59% from 108 (±69) µg/l to 44 (±20) µg/l (P=0.009). There was a further reduction to 37 (±17) µg/l at CPB weaning (P=0.008). Apixaban concentration displayed an increase to 56 (±29) µg/l 24 h postoperatively (P=0.01). In-hospital mortality was 25%. The mean 24H chest tube drainage volume was 621 (±136) ml.

Conclusion:

Intraoperative hemoadsorption lowers apixaban levels in patients undergoing emergency surgery for ATAAD. Further research is needed to determine its impact on perioperative bleeding complications and mortality.
Risk of High-Grade Cervical Dysplasia in Older Patients With a Positive Human Papilloma Virus Cervical Screening Test
Authors: Preston Marta , Richards Anthony
Published: November 2024

Introduction

The Australian National Cervical Screening Program has mandated management algorithms that are uniform across all age groups, but evidence is emerging that perhaps the risk of high-grade squamous intraepithelial lesion (HSIL) may decrease in the postmenopausal period.

Objective

The aim of the study is to identify if patients ≥50 years of age referred to a tertiary colposcopy service have a different risk of HSIL or greater (+).

Materials and Methods

This is a retrospective cohort study of 3239 referrals to a hospital colposcopy clinic with a positive human papillomavirus (HPV) cervical screening test between December 2017 and May 2023. Patients were included if they were aged 25–74 years, had a cervix, and completed an outpatient colposcopic assessment. Medical records were analyzed to determine the incidence of HSIL+ for each age group and compared them using χ2 and multivariable regression.

Results

The overall incidence of invasive carcinoma was 0.93% and HSIL/adenocarcinoma-in-situ was 20.38%. Patients ≥50 years of age were less likely to have HSIL or greater diagnosed than those <30 (p < .0001) or those 30–49 (p < .0001), even after considering referral HPV subtype and reflex cytology (OR = 0.45, 95% CI = 0.34–0.59). The risk of invasive carcinoma in those aged ≥50 was no different than those aged 30–49 (p = .982).

Conclusions

We observed a lower incidence of HSIL or greater with increasing age even after considering referral HPV subtype and reflex cytology. As further data emerges regarding the risk of high-grade disease in those ≥50 years of age, refinement of the risk-based screening algorithm to account for advanced age may be required.
Formula protein versus human milk protein and the effects on growth in preterm born infants
Authors: Muts Jacqueline , van Keulen Britt J. , van Goudoever Johannes B. , van den Akker Chris H.P.
Published: November 2024

Purpose of review

This review aims to evaluate the latest available evidence on the differences between human milk proteins versus infant formula proteins and its effects on growth and development in preterm infants.

Recent findings

High protein intake supports initial growth in preterm infants, although the long-term benefits remain unclear. Human milk requires adequate fortification to meet nutritional needs of preterm born infants. Formula feeding, with its higher protein content, may accelerate early weight gain but also increases the risk of necrotizing enterocolitis. Current evidence showed no significant advantages of human milk-derived fortifiers over bovine milk-derived fortifiers. Furthermore, studies published during the review period do not provide new evidence that alters the existing understanding of differences in neurodevelopmental outcomes between infants fed human milk and those fed formula.

Both fortified human milk and preterm formula support growth in preterm infants, but human milk offers additional protective benefits, such as reducing the risk of necrotizing enterocolitis, making it the preferred option. Balancing immediate growth needs with potential long-term developmental outcomes remains crucial, highlighting the need for further research to determine the optimal protein intake for preterm infants.
From Acute Pancreatitis to Diabetes
Authors: Saad Michelle , Hornung Lindsey , Abu-El-Haija Maisam
Published: November 2024

Objectives

This study aimed to identify the risk profile for postpancreatitis diabetes mellitus (PPDM) in children after a single acute pancreatitis (AP) episode and to investigate the association between episode severity and complications, length of stay (LOS), and intensive care unit (ICU) needs.

Methods

This cross-sectional study used the Pediatric Health Information System database for patients ≤19 years old with index AP admissions (2011–2020). A query (2012–2021) was performed for diabetes mellitus (DM). Patients with prior DM or pancreatic surgery before AP or DM diagnoses were excluded.

Results

Out of 12,822 patients with index AP admissions (median age, 13.4 years; 54% female), 686 (5.4%) developed PPDM, with 320 (2.5%) during and 366 (2.9%) at a later admission. The median time to PPDM was 1.9 months (interquartile range: 0–20.8 months). Patients with PPDM experienced extended LOS, heightened ICU needs, and increased complications such as sepsis, pancreatic necrosis, and cyst formation, along with higher rates of organ dysfunction and comorbidities.

Conclusions

Children face DM risks during or after AP episodes. Enhanced DM screening and close outpatient follow-up within 3 to 6 months post-discharge are recommended.
Markers of Collagen Formation and Degradation in Serum and Pancreatic Fluid Collections in Patients With Acute and Chronic Pancreatitis
Authors: Prahm August Pilegaard , Nissen Neel Ingemann , Werge Mikkel Parsberg , Hadi Amer , Willumsen Nicholas , Karsdal Morten Asser , Gluud Lise-Lotte , Olesen Søren Schou , Karstensen John Gásdal , Novovic Srdan
Published: November 2024

Objectives

Current knowledge on the fibro-inflammatory process underlying chronic pancreatitis originates from animal studies or human studies based on circulating biomarkers. To provide new insight into the underlying fibro-inflammatory processes, we simultaneously assessed fibrosis biomarkers in pancreatic fluid collections and the systemic circulation.

Materials and Methods

This prospective observational cross-sectional study included patients with acute and chronic pancreatitis undergoing drainage of pancreatic fluid collections, as well as 20 healthy controls (only serum levels). PRO-C3, PRO-C11 and PRO-C19 (markers of collagen formation), and C3M and C4M (markers of collagen degradation) were evaluated for both compartments (serum and fluid collection).

Results

Forty-three patients were included: 26 with walled-off necrosis and 17 with pseudocyst. Serum levels of all 5 fibrosis biomarkers were elevated in patients as compared to controls (all P < 0.001). PRO-C3 levels were significantly higher in pancreatic fluid vs serum (280.6 vs 20.8 ng/mL, P < 0.001). In contrast, levels of C3M (20.5 vs 13.1 ng/mL, P = 0.003), PRO-C19 (64.9 vs 14.3 nM, P < 0.001), and C4M (55.6 vs 20.4 ng/mL, P < 0.001) were significantly higher in serum vs pancreatic fluid.

Conclusions

The high serum levels in patients suggest increased overall fibrotic activity in pancreatitis patients as compared to healthy controls. PRO-C3 elicited higher levels in the pancreatic fluid, indicating localized fibrotic activity.
Usefulness of Semiautomated 3D Volumetric Assessment of Liver Tumor Burden for Patients With Unresectable Pancreatic Neuroendocrine Tumor
Authors: Fujimori Nao , Fujita Nobuhiro , Murakami Masatoshi , Ohno Akihisa , Matsumoto Kazuhide , Teramatsu Katsuhito , Ueda Keijiro , Wada Noriaki , Takao Seiichiro , Okamoto Daisuke , Ishigami Kousei , Ito Tetsuhide , Ogawa Yoshihiro
Published: November 2024

Objectives

In patients with metastatic pancreatic neuroendocrine tumors (PanNETs), the Ki-67 index is objectively assessed by pathologists; however, liver tumor burden (LTB) depends on the subjective judgment of physicians. This study aimed to elucidate the usefulness of the semi-automated 3D volumetric assessment of LTB in patients with PanNET.

Materials and Methods

We retrospectively reviewed 29 patients (40 computed tomographies [CTs]) with metastatic PanNETs. LTB was measured using a semiautomated 3D volumetric software program (volumetric assessment) or evaluated independently by 6 clinicians using CT imaging (visual assessment). The treatment map was classified into 3 groups based on LTB and Ki-67 index.

Results

Visual and volumetric assessments of the LTB were well correlated. The LTB was significantly higher on visual assessment than volumetric assessment (P < 0.01). Categorization on the map was consistent between the visual and volumetric evaluations in 23 patients (equal group). The remaining 6 patients were overestimated by visual assessment (overestimated group). Progression-free survival was significantly longer in patients in the ‘equal group’ than the ‘overestimated group’ (981 vs 366 days, P < 0.01).

Conclusions

This pilot study revealed a good correlation between visual and volumetric assessments, and visual assessment overestimated LTB, compared to volumetric assessment.
The Significant Impact of Fibrinogen–C-Reactive Protein–Albumin Ratio on the Long-Term Outcomes After Pancreatic Resection for Pancreatic Cancer
Authors: Tanji Yoshiaki , Haruki Koichiro , Igarashi Yosuke , Yanagaki Mitsuru , Shirai Yoshihiro , Taniai Tomohiko , Furukawa Kenei , Onda Shinji , Sakamoto Taro , Ikegami Toru
Published: November 2024

Objectives

This study aimed to assess the prognostic significance of a novel biomarker, the fibrinogen–C-reactive protein–albumin ratio (F-CAR), in pancreatic cancer patients undergoing pancreatectomy.

Method

We retrospectively analyzed 163 patients undergoing pancreatectomy for pancreatic cancer. The relationship between F-CAR, calculated from preoperative serum fibrinogen, albumin, and C-reactive protein levels, and long-term outcomes following pancreatectomy was examined.

Results

Multivariate analysis revealed that several factors, including age (P < 0.01), high serum carbohydrate antigen 19-9 (CA19-9) level (P < 0.01), high serum carcinoembryonic antigen level (P = 0.049), pT3 or pT4 (UICC) (P < 0.01), pN1 or pN2 (P < 0.01), and high F-CAR (hazards ratio, 1.51; 95% confidence interval, 1.03–2.22; P = 0.04), were independent and significant predictors of disease-free survival. Moreover, factors such as age (P = 0.02), high serum carcinoembryonic antigen level (P < 0.01), preoperative biliary drainage (P = 0.02), preoperative chemotherapy (P = 0.04), lymph node metastasis (P < 0.01), adjuvant chemotherapy (P = 0.046), and high F-CAR (hazards ratio, 1.55; 95% confidence interval, 1.03–2.35; P = 0.04) were found to be independent and significant predictors of overall survival.

Conclusions

F-CAR is a useful prognostic factor for disease-free survival and overall survival after pancreatectomy in pancreatic cancer patients.
Hyperplasia of Fat-Containing Cells With Mature Adipocyte Marker Is Associated With Pancreatic Fat Enlargement
Authors: Fujita Yukari , Kozawa Junji , Horii Tomomi , Kawata Satoshi , Ishibashi Chisaki , Y. Baden Megu , Eguchi Hidetoshi , Shimomura Iichiro
Published: November 2024

Objectives

To elucidate the specific characteristics of fat-containing cells in the pancreas and the mechanism of intrapancreatic fat deposition in humans.

Materials and Methods

Fifteen Japanese patients who had undergone pancreatic resection were enrolled, and the normal region from each samples was examined. Immunostaining for adiponectin and perilipin 1 was performed, and the relationships between the pancreatic fat-cell area or clinical parameters and the density or the diameter of the fat cells were analyzed.

Results

The expression of adiponectin in the cytoplasm and perilipin 1 along the plasma membrane was observed in fat-containing cells in the pancreas. The fat-containing cell area had a significant positive correlation with cell density. In addition, fat-containing cell density was significantly positively correlated with homeostasis model assessment insulin resistance. The diameter of fat-containing cells had significant positive correlations with BMI, fasting immunoreactive insulin, and homeostasis model assessment insulin resistance. Of all fat-containing cells, 10.4% were intralobular cells, and the diameter of intralobular cells showed a tendency for positive correlation with age.

Conclusions

The characteristics of fat-containing cells in the pancreas indicate that some of them may be mature adipocytes, and fat volume may be increased by hyperplasia of fat-containing cells associated with insulin resistance.
Ethical Considerations Regarding Digital Health Services in Home-Based Palliative Care
Authors: Steindal Simen A. , Klarare Anna , Sørensen Benedicte Strøm , Holmen Heidi , Nes Andrea A. G. , Winger Anette , Godskesen Tove
Published: November 2024

Historically, in-person contact between patients and nurses in home-based care has been pivotal in palliative care and hospice care. The provision of home-based palliative care services could be challenged by the projected increase in patients who need palliative care and by the expected shortage of nurses. Digital health services could constitute one measure for delivering high-quality palliative care, enabling patients to stay home. Nurses often follow up these patients remotely. Because digital health services are increasingly implemented in home-based palliative care, it is imperative that nurses consider the ethical concerns regarding such service delivery. Neglecting ethical concerns could result in unintended consequences for patients and nurses and inhibit care delivery. The aim of this article was to explore ethical concerns of digital health services in home-based palliative care through the lens of the 4 biomedical principles: autonomy, beneficence, nonmaleficence, and justice. This study utilized a bottom-up methodology conducting a subanalysis of the results of 2 previous reviews.
Content comparison of multidimensional functional outcome measures in rehabilitation and the ICF clinical functioning information tool: A scoping literature review
Authors: Amatya Bhasker , Mukaino Masahiko , Stucki Gerold , Selb Melissa , Khan Fary
Published: November 2024

Background:

The ICF-based Clinical Functioning Information Tool (ClinFIT) was developed as a standardized tool to facilitate the assessment of functioning in clinical and, research settings.

Objective:

This review describes the contents of commonly used multidimensional outcome measures that describe functioning in rehabilitation settings and maps these measures to ICF categories covered by the ClinFIT to identify commonalities and discrepancies in the content.

Methods:

A scoping review included a systematic search of PubMed, Embase, Cochrane Library, and other resources. Twelve outcome measures were selected, and their meaningful concepts were linked to the ClinFIT by 2 authors using established ICF linking rules. Content density, bandwidth, and content diversity indices were calculated for each measure.

Results:

A total of 369 meaningful concepts from the 292 items from 12 measures were selected. Of these, 293 (79.4%) concepts were linked to the ClinFIT categories, with a majority (80.5%) linked to “activities and participation”; however, 76 (20.6%) meaningful concepts could not be linked to any ClinFIT categories. The extent of content coverage varied significantly between measures, reflecting the differences in the scope of each measure. The “activity and participation” categories had the highest bandwidth for all measures (range: 28.6%–71.4%), while the “body function” category was less represented (range: 0%–33.3%).

Conclusions:

ClinFIT can be the useful outcome measure for functional assessment in rehabilitation settings, as it covers wider concepts, considered important in rehabilitation settings, compared with other common functional outcome measures. It can establish comparability of a minimal data set on functional outcomes across various medical conditions and settings.
An Overview of Medical, Surgical, and Rehabilitation Outcome Measures Used in Randomized Controlled Trials of Moderate to Severe Traumatic Brain Injury
Authors: Flores-Sandoval Cecilia , Bateman Emma A. , MacKenzie Heather M. , Sequeira Keith , Janzen Shannon , Teasell Robert
Published: November 2024

Optimal reporting of outcomes is critical for the interpretation of research findings. This review aimed to examine the utilization of outcome measures (OMs) in randomized controlled trials (RCTs) of moderate to severe TBI (MSTBI). Systematic searches were conducted up to December 2022 in MEDLINE, PubMed, Scopus, CINAHL, EMBASE and PsycINFO, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RCTs were included if the population studied had ≥18 years and ≥ 50% had MSTBI. 662 met inclusion criteria. There was a total of 839 unique OMs across all included RCTs. Of these, only 195 (23.2%) were used in ≥4 RCTs. On average, RCTs included 1.26 OMs (range 1 to 23). A total of 495 (59%) of OMs were classified in the recovery and rehabilitation category, and 344 (41%) in the medical and surgical measures category. There was a more equal representation of OMs in high income countries (HICs) compared to low to middle income countries (LMICs), with the latter using fewer recovery and rehabilitation OMs. OMs used in RCTs of MSTBI have significant heterogeneity and variable clinical relevance, which limits the impact and generalizability of research in MSTBI, and the ability to compare across studies.
Effects of Vibration Therapy on Muscle Strength, Shoulder Range of Motion, and Muscle Biomechanical Properties in Patients with Breast Cancer Undergoing Radiotherapy: A Randomized Controlled Trial
Authors: Feyzioğlu Özlem , Dinçer Selvi , Yılmaz Binnur Dönmez , Saldıran Tülay Çevik , Öztürk Özgül
Published: November 2024

Objective

To investigate the effects of vibration therapy to home-based exercises on shoulder muscle strength, range of motion (ROM), pain-related disability, and muscles viscoelastic properties of shoulder and neck in patients with breast cancer undergoing radiotherapy.

Design

In this randomized controlled superiority trial was conducted with 38 participants who underwent breast cancer surgery. All patients were randomized into two groups: control group (CG) and vibration group (VG). Both groups performed home-based exercises for 5 days a week for 6 weeks. VG recived additional vibration therapy for 2 days a week for 6 weeks. Shoulder ROM, muscle strength, pain, disability, grip stength, and viscoelastic properties of the pectoralis major, upper trapezius, and sternocleidomastoid were compared pre- and post-intervention.

Results

VG demonstrated better improvement in shoulder ROM, muscle strength and pain-related disability (p < 0.05), except for internal rotation ROM. Only tone of pectoralis major was significantly higher in VG according to group x time interaction (p < 0.05), no differences were detected in terms of muscle viscoelastic properties in the CG patients (p > 0.05).

Conclusion

Vibration therapy provided superior improvements in muscle strength, ROM, and pain-related disability compared to home-based exercises alone in patients with breast cancer undergoing radiotherapy in the early postoperative phase.
Brief Report: Effect of Improved Provider Communication and Adherence to Guidelines on PrEP Initiation in Kisumu Kenya
Authors: Vera Melissa , Sila Joseph , Richardson Barbra A. , Otieno Felix , Owiti George , Kemunto Valarie , Kinuthia John , Beima-Sofie Kristin , Larsen Anna , Dettinger Julia C. , Pintye Jillian , John-Stewart Grace , Kohler Pamela
Published: November 2024

Introduction:

Adolescent girls and young women (AGYW) in Kenya have low pre-exposure prophylaxis (PrEP) initiation rates in part because of stigmatizing interactions with health care providers. Our recent randomized clinical trial of a standardized patient actor (SP) training intervention for providers found higher quality PrEP delivery at intervention sites; however, it was unclear whether improved service quality improved PrEP initiation.

Methods:

This analysis used routine records from facilities participating in the randomized trial that aimed to improve provider communication and adherence to Kenyan guidelines when offering PrEP to AGYW. We used facility-level PrEP registers from May to December 2019 as the baseline period and December 2020 to June 2021 as the postintervention period. We used linear regression with percentage initiating as the outcome, intervention and baseline initiation levels as covariates, and the number eligible postintervention at each facility as frequency weights.

Results:

Overall, 1375 AGYW presented to study sites, were eligible for PrEP, and were included in analyses (baseline: n = 706, postintervention: n = 669). Among 669 PrEP-eligible AGYW in the postintervention period (intervention: n = 360, control: n = 309), 591 (88.3%) initiated PrEP (intervention: n = 335, control: n = 256). PrEP initiation was 93.1% at intervention sites (range: 0%–100%) and 82.8% at control sites (range: 0%–100%). Adjusted for baseline initiation rates, initiation was 12.1% higher at intervention sites than at control sites (P < 0.001, [95% CI: 0.09 to 0.15]).

Conclusions:

Our study found significant improvement in PrEP initiation among AGYW who presented to intervention facilities. SP training interventions that improve quality of service delivery for AGYW could lead to higher population-level PrEP coverage.
Metastasis Detection Using True and Artificial T1-Weighted Postcontrast Images in Brain MRI
Authors: Haase Robert , Pinetz Thomas , Kobler Erich , Bendella Zeynep , Paech Daniel , Clauberg Ralf , Foltyn-Dumitru Martha , Wagner Verena , Schlamp Kai , Heussel Gudula , Heussel Claus Peter , Vahlensieck Martin , Luetkens Julian A. , Schlemmer Heinz-Peter , Specht-Riemenschneider Louisa , Radbruch Alexander , Effland Alexander , Deike Katerina
Published: November 2024

Objectives

Small lesions are the limiting factor for reducing gadolinium-based contrast agents in brain magnetic resonance imaging (MRI). The purpose of this study was to compare the sensitivity and precision in metastasis detection on true contrast-enhanced T1-weighted (T1w) images and artificial images synthesized by a deep learning method using low-dose images.

Materials and Methods

In this prospective, multicenter study (5 centers, 12 scanners), 917 participants underwent brain MRI between October 2021 and March 2023 including T1w low-dose (0.033 mmol/kg) and full-dose (0.1 mmol/kg) images. Forty participants with metastases or unremarkable brain findings were evaluated in a reading (mean age ± SD, 54.3 ± 15.1 years; 24 men). True and artificial T1w images were assessed for metastases in random order with 4 weeks between readings by 2 neuroradiologists. A reference reader reviewed all data to confirm metastases. Performances were compared using mid-P McNemar tests for sensitivity and Wilcoxon signed rank tests for false-positive findings.

Results

The reference reader identified 97 metastases. The sensitivity of reader 1 did not differ significantly between sequences (sensitivity [precision]: true, 66.0% [98.5%]; artificial, 61.9% [98.4%]; P = 0.38). With a lower precision than reader 1, reader 2 found significantly more metastases using true images (sensitivity [precision]: true, 78.4% [87.4%]; artificial, 60.8% [80.8%]; P < 0.001). There was no significant difference in sensitivity for metastases ≥5 mm. The number of false-positive findings did not differ significantly between sequences.

Conclusions

One reader showed a significantly higher overall sensitivity using true images. The similar detection performance for metastases ≥5 mm is promising for applying low-dose imaging in less challenging diagnostic tasks than metastasis detection.
Application of Submandibular Intubation as Alternative to Elective Short-Term Tracheotomy for Particular Cases of Oral and Maxillofacial Tumors Resection and Defects Reconstruction
Authors: Paka Lubamba Grace , Bao Mingzhe , Yang Jiajin , Cao Yubin , Li Honglin , Ma Zhongkai , Lin Jie , Zhao Guile , Hua Yufei , Zhang Gaowei , Huang Guangzhao , Gao Ning , Zhu Guiquan , Li Chunjie
Published: November 2024

Objective:

To describe the cases of oral and maxillofacial tumors (OMFT) resection and defects reconstruction under submandibular intubation (SMI) performed in our institution; secondly, to systematically review and analyze the characteristics of studies about SMI in oral and maxillofacial surgery to estimate the incidence rate of complication.

Method:

Data related to all 6 patients included in this study were prospectively collected from November 2016 to November 2023. The tract for endotracheal tube was created by bluntly dissection from the submandibular area to the floor of mouth. We performed an exhaustive search for studies about SMI using Pubmed, Embase, Proquest, and Chinese Biomedical Literature Database. Meta-analysis of the incidence rate of complication and infection was performed using STATA 14.1.

Results:

There was a male predominance (87.3%); the mean age was 47.8±16.8 years; squamous cell carcinoma (SCC) was the most frequent diagnosis (33.3%); the mean time of the operation was 237.0±65.2 minutes; the SMI procedure mean time was 5.5±0.9 minutes; and the mean time to extubation 133.3±12.5 minutes. No accident or complication was observed intraoperatively and postoperatively. The systematic review included 22 out of 234 studies screened. The meta-analysis showed an overall complication rate and superficial infection rate of 5.7% and 3.7% in the last 15 years versus 20.2% and 10.6% in over 15 years ago.

Conclusion:

Submandibular intubation was found technically easy, safe, and effective alternative of elective short-term tracheotomy, orotracheal and nasotracheal intubations in our series of OMFT resection and defects reconstruction.
The Impact of Language-Discordant Care Upon the Patient Family Experience in Pediatric Plastic Surgery
Authors: Yau Alice , Lentskevich Marina A. , Figueroa Ariel E. , Gutowski Kristof S. , Bajaj Anitesh , Donaldson Rachel , Herbener Cara E. , Gosain Arun K.
Published: November 2024

Background:

Patient satisfaction surveys usually overlook differences in patient family experience (PFE) for families whose spoken language is different from that of the treating physician. This study examines the relationship between language-discordant care and patient experience.

Methods:

A retrospective review of deidentified pediatric plastic surgery PFE survey responses from 2018 to 2021 was performed with permission from Lurie Children’s Hospital’s PFE Team.

Results:

A total of 443 pediatric plastic surgery patients were included. The race breakdown was White (49%), Other (23.9%), Black (8.8%), and Asian (5.9%). Ethnic distribution included “Not Hispanic/Latino” (58.2%) and “Hispanic/Latino” (31.4%). Languages spoken were English (80.4%), Spanish (18.1%), and Other (2.3%). Eighty-seven (19.64%) patients were language-discordant with their providers; out of this group, 68 (78.2%) preferred interpreter services. Methods of interpreter services included in-person (54.4%), over-the-phone (27.9%), video (1.5%), and no services (16.2%). The language-discordant group was less likely to give the highest ranking to “provider courtesy and respect” [odds ratio (OR)=0.200, P<0.001], “provider listened carefully” (OR=0.202, P<0.001), and “knowing what to do with subsequent questions following visit” (OR=0.435, P<0.01). No differences in PFE ratings existed for: “enough information provided,” overall provider rating, and whether they would recommend the facility. There were no significant differences in provider ratings by interpreter service method.

Conclusions:

Patient/provider language discordance results in significantly lower PFE ratings in areas involving patient teaching and perceptions of provider respect, courtesy, and careful listening. This underscores the importance of providers better accommodating families with limited English proficiency.
De Novo Missense Mutation in FREM1 Identified in a Chinese Patient with Comorbid Congenital Microtia and Pulmonary Hypoplasia
Authors: Chen Xinyuan , Meng Xiaolu , Si Nuo , Jiang Haiyue
Published: November 2024

Cases of microtia combined with pulmonary hypoplasia are occasionally in clinics, and its genetic etiology has so far proved inconclusive. Here, aiming to contribute to a better understanding of microtia-related comorbid respiratory anomalies, the authors provide a clinical and genetic description of a rare trio family of which the son suffers combined deformities of right microtia, left pulmonary hypoplasia, and dextrocardia using whole-genome sequence (WGS). A novel potential pathologic compound heterozygosity in the FREM1 gene was identified and validated by the trio and bioinformatics analysis. This case expands the FREM1 mutation genotype and phenotype spectrum, sheds light on the congenital deformities of microtia and pulmonary hypoplasia, and emphasizes the importance of the FREM1 gene in pulmonary and craniofacial development.
Whole genome sequencing assisted outbreak investigation of Salmonella enteritidis, at a hospital in South Africa, September 2022
Authors: Brümmer Brian , Smith Anthony Marius , Modise Motshabi , Thomas Juno , Mdose Hetani , Mokoena Ramasedi , Baleni Dikeledi
Published: November 2024

Health authorities were notified of a suspected outbreak of foodborne disease in a hospital in South Africa, where staff and patients reported acute onset of abdominal cramps, diarrhoea, fever and rigours after eating a chicken pasta meal. The aim of this report is to discuss the use of whole genome sequencing (WGS) analysis of bacterial isolates to support an epidemiological investigation. An epidemiological investigation led by the Infection Control Manager of the hospital and supported by an outbreak response team was conducted. Standard microbiological procedures were used to process stool samples and culture/identify diarrhoeal pathogens. Bacterial cultures were investigated using WGS performed using Illumina NextSeq technology, and WGS data were analysed using multiple bioinformatics tools, including those available at the Center for Genomic Epidemiology and EnteroBase. Core genome multilocus sequence typing (cgMLST) was used to investigate the phylogeny of isolates. Forty-nine cases were identified, with stool samples collected from 21 cases, and nontyphoidal Salmonella isolated from 19 out of 21 (90%) of the samples. All isolates were identified as Salmonella enterica serovar Enteritidis and differed from each other by ≤2 allele differences on cgMLST, indicating that isolates are highly genetically related. Delays in testing of food retention samples rendered the negative test results of limited value. A case–control study was conducted; eating chicken pasta was strongly associated with developing gastroenteritis (odds ratio (OR) = 15.4, Chi-Square test with Yates correction p value = 0.02). The epidemiological evidence suggests that the chicken pasta was the likely vehicle of transmission in this outbreak, although the source of S. enterica serovar Enteritidis remains unknown.
Development and validation of novel proliferation-related gene signature for MSS colorectal cancer prognosis
Authors: Wang Sen , Yu Zhiyu , Xu Peng , Zhang Cheng
Published: November 2024

Colorectal cancer (CRC) is classified into microsatellite instability (MSI) and microsatellite stabilized (MSS) based on the differences in DNA repair mechanisms. In recent years, many studies have proved that some emerging therapeutic approaches have good therapeutic effects on MSI as a subtype but are ineffective for MSS as a subtype. This paper aims to start with the molecular mechanism of MSS and try to find the characteristic target genes of MSS as a subtype. We used bioinformatics techniques and machine learning to find GTF2IRD1. The gene GTF2IRD1 is highly expressed in MSS-type CRC but is stable in MSI. Subsequently, we verified its expression and function with relevant experiments. We demonstrated that GTF2IRD1 can promote the proliferation of MSS-type colorectal cancer and correlate with the poor prognosis of MSS-type colorectal cancer patients, which may provide a potential target gene for the clinical treatment of MSS-type colorectal cancer.
Prey movement shapes the acquisition of predator expertise in a virtual bi-trophic system
Authors: Fraser Franco Maxime , Santostefano Francesca , Martin Julien G. A. , Kelly Clint D. , Montiglio Pierre-Olivier
Published: November 2024

The acquisition of expertise is crucial for predators to be successful hunters. To achieve this, predators must hone their skills and gain knowledge through repeated and extensive practice. On the other hand, prey may hinder the acquisition of predator expertise by employing antipredator tactics to evade detection and pursuit. However, empirical evidence on how predators acquire expertise through repeated encounters with their prey remains limited, largely due to the challenges of monitoring direct interactions in the wild. Here, we use a virtual predator-prey system (the gameDead by Daylight) to investigate how experience shapes individual and population hunting success in human predators across repeated interactions with their prey. We show that predators optimized prey consumption as they gained experience, indicating that they acquired expertise through extensive practice. At the population-level, we found that faster prey impaired the acquisition of expertise by reducing hunting success. Prey speed was also an important mediator of this relationship at the individual level, driving differences among predators in the acquisition of expertise. Our study outlines how prey antipredator behaviour can mediate the acquisition of expertise in predator populations.
Oncogene-induced senescence and senescence-associated secretory phenotype (SASP) determine the efficacy of palbociclib in PIK3CA mutated colorectal cancer
Authors: Cao Pingping , Zhou Xiaohui , Yang Suisui , Shen Tianqi , Wang Shuai , Yu Hanyang , Liu Xiaorong , Gong Yeqing , Wang WenHong , Wang Haiyang , Zhou Tingting , Wang Jing , Fan Zhining , Huang Mingde , Qian Xu , Wang Xiuxing , Wang Qianghu , Yang Liu , Zhang Yingjian , Lin Fan
Published: November 2024

Palbociclib is an excellent CDK4/6 inhibitor, but its clinical application is mainly limited to the treatment of advanced ER+/HR+and HER2−breast cancer. Its efficacy in colorectal cancer (CRC) is evaluated in multiple trials and so far remains undetermined. We found that the PIK3CA-mutant CRC cells were insensitive to palbociclib treatment compared with the PIK3CA wild-type counterparts, and they were in an OIS (oncogene-induced senescence) state which was predisposed to a strong senescence-associated secretory phenotype (SASP) upon treatment. These senescent cells excessively secreted various SASP factors LCN2, and ultimately caused palbociclib-resistance via upregulation of EGFR in the non-senescent CRC cells. Importantly, a drug combination screen identified that erlotinib could synergize with palbociclib to overcome the SASP-induced resistance. Overall, we found that PIK3CA mutation-induced senescence compromised the efficacy of palbociclib treatment in CRC but co-targeting EGFR could minimize the OIS-associated side effects while preserving the beneficial effects.
CellPatch: a Highly Efficient Foundation Model for Single-Cell Transcriptomics with Heuristic Patching
Authors: Zhu Hanwen , Yuan Yushun , Yang Jiyuan , Cai Kangwen , Wei Nana , Zhang Senxin , Wang Lu , Jiang Wen-Jie , Sun YuanChen , Liu An , Lai Futing , Wang Yu-Juan , Ma Zeyu , Zheng Xiaoqi , Wu Hua-Jun
Published: November 2024

The rapid advancement of foundation models has significantly enhanced the analysis of single-cell omics data, enabling researchers to gain deeper insights into the complex interactions between cells and genes across diverse tissues. However, existing foundation models often exhibit excessive complexity, hindering their practical utility for downstream tasks. Here, we present CellPatch, a lightweight foundation model that leverages the strengths of the cross-attention mechanism and patch tokenization to reduce model complexity while extracting efficient biological representations. Comprehensive evaluations conducted on single-cell RNA-sequencing datasets across multiple organs and tissue states demonstrate that CellPatch achieves state-of-the-art performance in downstream analytical tasks while maintaining ultra-low computational costs during both pretraining and finetuning phases. Moreover, the flexibility and scalability of CellPatch allow it to serve as a general framework that can be incorporated with other well established single-cell analysis software, thereby enhancing their performance through transfer learning on diverse downstream tasks.
MICROPLASTICS IN THE MOUNT TERMINILLO SNOW’S (RIETI, ITALY)
Authors: Pietrelli Loris , Menegoni Patrizia , Millesimi Ines , Sighicelli Maria , Baldi Marina , Schirone Bartolomeo
Published: November 2024

Microplastics (MPs) concentrations in atmospheric fallout is a growing environmental concern, this paper reports data regarding the MPs pollution determined using snow samples collected in wintertime and in 6 different areas on Mount Terminillo (2216 m a.s.l.) a typical Apennines massif located north of Rome. Assessment results show that the maximum average concentration found un snow is 74.69 MPsL-1of melted snow. The results of the characterization show that the most common MPs form was microfibers having dimensions <5mm. The largest MPs were characterized by Fourier Transformed IR (FTIR) analysis, among the polymer materials, the most abundant were polyamide (PA, 25.93%), polyethylene terephthalate (PET, 22,23%), polyester (PES, 17.28%) polypropylene (PP, 8.64%) and polyethylene (PE, 7.40%). The presence of PTFE fibers and a fragment of ABS, typical materials of technical clothing, shows that MPs contamination is also due to recreational activities as well as atmospheric deposits. The Carbonyl Index values indicated that some MPs (PE, PP) are degraded.