bluuebunny/crossref_metadata_2025 huggingface dataset:
Data from Time-dependent prognostic value of serological and measurable residual disease assessments after idecabtagene vicleucel
Authors: Paiva Bruno , Manrique Irene , Rytlewski Julie , Campbell Timothy , Kazanecki Christian C. , Martin Nathan , Anderson Larry D. , Berdeja Jesus G. , Lonial Sagar , Raje Noopur S. , Lin Yi , Moreau Philippe , San-Miguel Jesus F. , Munshi Nikhil C. , Kaiser Shari
Published: September 2023

Abstract
The role of MRD in multiple myeloma patients treated with CAR T cells is uncertain. We analyzed MRD kinetics during the first year after idecabtagene vicleucel (ide-cel) infusion in 125 relapsed/refractory multiple myeloma patients enrolled in KarMMa. At month 1 after ide-cel, there were no differences in progression-free survival (PFS) between patients in less than complete response (CR) vs those in CR; only MRD status was predictive of significantly different PFS at this landmark. In patients with undetectable MRD at 3 months and beyond, PFS was longer in those achieving CR vs
TABLE 2 from Discovery and Characterization of ZL-2201, a Potent, Highly Selective, and Orally Bioavailable Small-molecule DNA-PK Inhibitor
Authors: Lal Shruti , Bhola Neil E. , Sun Bee-Chun , Chen Yuping , Huang Tom , Morton Vivian , Chen Kevin X. , Xia Shanghua , Zhang Haoyu , Parikh Nehal S. , Ye Qiuping , Veiby O. Petter , Bellovin David I. , Ji Yuhua
Published: September 2023

Drug metabolism and pharmacokinetics (DMPK) properties of ZL-2201 in preclinical species
Comparison of the accuracy of linear measurements in CBCT images with different field of views
Authors: Mehdizadeh Mojdeh , Erfani Ali , Soltani Parisa
Published: September 2023

This study sought to investigate the effect of the field of view (FOV) on linear measurements of cone beam computed tomography (CBCT) images. Methods: In this in vitro study, five dry human skulls were used. After using red wax to simulate soft tissue, the skulls were scanned using Galileos CBCT scanner (Sirona, Bensheim, Germany) with exposure parameters of 85 kVp and 21 mAs and voxel size of 0.280 mm; once with FOV of 15 cm × 8 cm and once again with 15 cm × 15 cm. The measured distances were the distance between the center of the bilateral mental foramen in the axial view (MM), the distance between the alveolar crest and the mandibular inferior border in the sagittal view on the midline (CB), and the depth of the socket of the left mandibular central incisor (L1). Descriptive statistics as well as Pearson’s correlation coefficient were used for statistical analysis (α = 0.05) using SPSS software (v. 25, IBM, NY, USA). Results: The measurements obtained with small and large FOV and with the dry skull were not significantly different (p > 0.05). The measurements obtained in small FOV had excellent correlation coefficient when compared with those obtained with the dry skull, with values of 0.890 for MM, 0.954 for CB, and 0.921 for L1 (p < 0.001). The measurements in large FOV also had excellent correlation coefficient when compared with those on the dry skull, with values of 0.894 for MM, 0.949 for CB, and 0.902 for L1 (p < 0.001). Conclusion: According to our findings, linear measurements obtained by CBCT scans in small and large FOVs were not significantly different than those on dry skulls. Since the linear measurements are accurate regardless of FOV size, selection of FOV must be based on patient factors, such as area of interest and radiation dose.
Defining Demographic-specific Coronary Artery Calcium Percentiles in the Population Aged ≥75: The ARIC Study and MESA
Authors: Wang Frances M. , Cainzos-Achirica Miguel , Ballew Shoshana H. , Coresh Josef , Folsom Aaron R. , Howard Candace M. , Post Wendy S. , Wagenknecht Lynne E. , Budoff Matthew J. , Blaha Michael J. , Matsushita Kunihiro
Published: September 2023

BACKGROUND:

Current clinical guidelines recommend a coronary artery calcium (CAC) score of 100 Agatston Units or demographic-specific 75th percentile as high-risk thresholds for guiding atherosclerotic cardiovascular disease preventive therapy. Meanwhile, low CAC can help derisk individuals who may safely defer statin therapy. However, limited data from the early 2000s, including just 208 older Black individuals, inform CAC percentiles for adults aged 75 to 85 years, and none have been established in adults aged ≥85 years. This study aims to characterize the distribution of CAC and establish demographic-specific CAC percentiles in the population aged ≥75 years.

METHODS:

We assessed 2886 participants aged ≥75 years without clinical coronary heart disease from the ARIC study (Atherosclerosis Risk in Communities) visit 7 (2018–2019; n=2217) and the MESA (Multi-Ethnic Study of Atherosclerosis) visit 5 (2010–2011; n=669). Prevalence of any CAC >0 and sex- and race-specific CAC percentiles across age were estimated nonparametrically with locally weighted regression models and pooled residual ranking.

RESULTS:

The median age was 80 (interquartile interval, 77–83) years, and 60% were female. The prevalence of zero CAC was lowest in White males (4%), followed by Black males (13%), White females (14%), and highest in Black females (18%). Regardless of sex and race, most participants had CAC>100 (62.5%). CAC scores increased with age, with CAC identified in ≈95% of participants aged ≥90 years across sex-race subgroups. The 75th percentile corresponded to higher CAC scores for Black older adults (n=741), especially females, than currently used thresholds.

CONCLUSIONS:

In community-dwelling adults aged ≥75 years free of clinical coronary heart disease, the prevalence of zero CAC was 11%, and CAC >100 as a threshold for high ASCVD risk would categorize most of this older population as high risk. Demographic-specific CAC percentiles from this study are a valuable tool for interpreting CAC in the population aged ≥75 years.
Association of SGLT‐2 Inhibitors With Treatment Satisfaction and Diabetes‐Specific and General Health Status in Adults With Cardiovascular Disease and Type 2 Diabetes
Authors: Ding Qinglan , Spatz Erica S. , Bena James F. , Morrison Shannon L. , Levay Michelle , Lin Haiqun , Grey Margaret , Edwards Nancy E. , Isaacs Diana , West Lucianne , Combs Pamela , Albert Nancy M.
Published: September 2023

Background

It is unknown if initiation of a sodium‐glucose cotransporter‐2 inhibitor (SGLT‐2i) is associated with changes in patient‐reported health status outside of clinical trials.

Methods and Results

Using a prospective observational study design, adults with type 2 diabetes and cardiovascular disease were recruited from 14 US hospitals between November 2019 and December 2021 if they were new users of noninsulin antidiabetic medications. The primary outcome was change in 6‐month diabetes treatment satisfaction. Secondary outcomes included diabetes‐related symptom distress, diabetes‐specific quality of life, and general health status for all patients and based on cardiovascular disease type. Inverse probability of treatment weight using propensity score was performed to compare outcome changes based on medication use. Of 887 patients (SGLT‐2i: n=242) included in the inverse probability of treatment weight analyses, there was no difference in changes in treatment satisfaction in SGLT‐2i users compared with other diabetes medication users (0.99 [95% CI, −0.14 to 2.13] versus 1.54 [1.08 to 2.00],
P
=0.38). Initiating an SGLT‐2i versus other diabetes medications was associated with a greater reduction in ophthalmological symptoms (−3.09 [95% CI, −4.99 to −1.18] versus −0.38 [−1.54 to 0.77],
P
=0.018) but less improvement in hyperglycemia (1.08 [−2.63 to 4.79] versus −3.60 [−5.34 to −1.86],
P
=0.026). In subgroup analyses by cardiovascular disease type, SGLT‐2i use was associated with a greater reduction in total diabetes symptom burden and neurological sensory symptoms in patients with heart failure.

Conclusions

Among patients with type 2 diabetes and cardiovascular disease, initiating an SGLT‐2i was not associated with changes in diabetes treatment satisfaction, total diabetes symptoms, diabetes‐specific quality of life, or general health status.
In Situ Validation of Altimetry and CFOSAT SWIM Measurements in a High Wave Environment
Authors: Hay Andrea , Watson Christopher , Legresy Benoit , King Matt , Beardsley Jack
Published: September 2023

While satellite altimeters have revolutionized ocean science, validation measurements in high wave environments are rare. Using geodetic Global Navigation Satellite System (GNSS) data collected from the Southern Ocean Flux Station (SOFS; −47°S, 142°E) since 2019, as part of the Southern Ocean Time Series (SOTS), we present a validation of satellite missions in this energetic region. Here we show that high rate GNSS observations at SOFS can successfully measure waves in the extreme conditions of the Southern Ocean and obtain robust measurements in all wave regimes [significant wave height (SWH) ranging from 1.5 to 12.6 m]. We find good agreement between the in situ and nadir altimetry SWH (RMSE = 0.16 m, mean bias = 0.04 m, and n = 60). Directional comparisons with the Chinese–French Ocean Satellite (CFOSAT) Surface Waves Investigation and Monitoring (SWIM) instrument also show good agreement, with dominant directions having an RMSE of 9.1° (n = 22), and correlation coefficients between the directional spectra ranging between 0.57 and 0.79. Initial sea level anomaly (SLA) estimates capture eddies propagating through the region. Comparisons show good agreement with daily gridded SLA products (RMSE = 0.03 m, and n = 205), with scope for future improvement. These results demonstrate the utility of high rate geodetic GNSS observations on moored surface platforms in highly energetic regions of the ocean. Such observations are important to maximize the geophysical interpretation from altimeter missions. In particular, the ability to provide collocated directional wave observations and SLA estimates will be useful for the validation of the recently launched Surface Water and Ocean Topography (SWOT) mission where understanding the interactions between sea state and sea surface height poses a major challenge.
Chronic disease diagnosis model based on convolutional neural network and ensemble learning method
Authors: Zhou Huan , Zhang Pei-Ying , Zou Xiao , Liu Jia , Wang Wen-Jie
Published: September 2023

Introduction

Chronic diseases have become one of the main causes of premature death all around the world in recent years. The diagnosis of chronic diseases is time-consuming and costly. Therefore, timely diagnosis and prediction of chronic diseases are very necessary.

Methods

In this paper, a new method for chronic disease diagnosis is proposed by combining convolutional neural network (CNN) and ensemble learning. This method utilizes random forest (RF) as the base classifier to improve classification performance and diagnostic accuracy, and then combines AdaBoost to successfully replace the Softmax layer of CNN to generate multiple accurate base classifiers while determining their optimal attributes, achieving high-quality classification and prediction of chronic diseases.

Results

To verify the effectiveness of the proposed method, real-world Electronic Medical Records dataset (C-EMRs) was used for experimental analysis. The results show that compared with other traditional machine learning methods such as CNN, K-Nearest Neighbor, and RF, the proposed method can effectively improve the accuracy of diagnosis and reduce the occurrence of missed diagnosis and misdiagnosis.

Conclusions

This study will provide effective information for the diagnosis of chronic diseases, assist doctors in making clinical decisions, develop targeted intervention measures, and reduce the probability of misdiagnosis.
Narrative Education Combined With Experiential Teaching in the Development of Empathic Competence of Undergraduate Nursing Students: Pre-Test Post-Test Design
Authors: Zhou Zi-Yun , Hu Long-Yi , Wang Ming-Li , Zhou Le-Shan
Published: September 2023

Empathy is a fundamental quality that nursing staff should possess, but the empathy ability of nursing students in China is currently at an intermediate level and requires improvement. This study aimed to explore teaching methods for nursing humanistic education, that can improve the empathy ability of nursing students and cultivate high-quality nursing talents. This study employed narrative education and experiential teaching methods to develop empathic competence in teaching pediatric nursing courses. The empathic ability of nursing students was measured using the JSPE-NS scale before and after teaching and was analyzed to refine the teaching reflection theme words. After teaching, nursing students scored higher on the total empathy scale, perspective-taking dimension, and emotional care dimension than before teaching, with statistically significant differences ( p < 0.05). Five themes were extracted from the teaching reflection, including emotional empathy, pediatric nursing skills, gratitude to parents, reverence for life, and course experience. The results show that the combination of narrative education and experiential teaching methods applied to pediatric nursing courses effectively improved nursing students’ empathy, strengthened their identification with the nursing profession, and promoted the teaching reform of humanistic education in nursing courses. The combination of narrative education and experiential teaching methods can improve the empathic ability of nursing students. This approach is suitable for integrating humanistic education into nursing professional courses and provides a feasible idea for developing humanistic qualities in nurses.
A ‘golden’ alternative for prevention of cisplatin nephrotoxicity in bladder cancer
Authors: Sharon Yoray , Motiei Menachem , Tzror-Azankot Chen , Sadan Tamar , Popovtzer Rachela , Rosenbaum Eli
Published: September 2023

Cisplatin (CP) is the first-line standard of care for bladder cancer. However, a significant percentage of advanced bladder cancer patients are ineligible to receive standard CP treatment, due to the drug’s toxicity, and in particular its nephrotoxicity. These patients currently face suboptimal therapeutic options with lower efficacy. To overcome this limitation, here we designed CP-conjugated gold nanoparticles (GNPs) with specific properties that prevent renal toxicity, and concurrently preserve the therapeutic efficacy of CP. Safety and efficacy of the particles were studied in bladder tumor-bearing mice, using clinically-relevant fractionated or non-fractionated dosing regimens. A non-fractionated high dose of CP-GNP showed long-term intratumoral accumulation, blocked tumor growth, and nullified the lethal effect of CP. Treatment with fractionated lower doses of CP-GNP was also superior to an equivalent treatment with free CP, demonstrating both anti-tumor efficacy and prolonged mouse survival. Moreover, as opposed to free drug, CP-conjugated GNPs did not cause fibrosis or necrosis in kidney. These results indicate that conjugating CP to GNPs can serve as an effective, combined anti-cancer and renoprotective approach, and thus has potential to widen the range of patients eligible for CP-based therapy.
Serum fibrinogen-to-albumin ratio predicts new-onset atrial fibrillation risk during hospitalization in patients with acute myocardial infarction after percutaneous coronary intervention: a retrospective study
Authors: Bao Jiaqi , Gao Zhicheng , Hu Yilan , Liu Wenquan , Ye Lifang , Wang Lihong
Published: September 2023

Background

New-onset atrial fibrillation (NOAF) is a common adverse outcome of percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) and is closely correlated with hospital stay and prognosis. In recent years, serum fibrinogen-to-albumin ratio (FAR), a novel biomarker for inflammation and thrombosis, has been used to predict the severity and prognosis of coronary artery disease. Our study aimed to investigate the relationship between FAR and NOAF during hospitalization after PCI in patients with AMI.

Methods

We retrospectively analyzed the incidence of NOAF during hospitalization and follow-up in 670 patients with AMI after PCI. Data were collected on patient age, sex, body mass index, medical history, current medication, heart failure, laboratory tests, culprit blood vessels, echocardiographic characteristics, and AMI type. The enrolled patients were divided into NOAF and non-NOAF groups. The baseline characteristics of patients in the two groups were compared, and the predictive correlation between FAR and NOAF was evaluated using logistic regression analysis and the receiver operating characteristic curve.

Results

Fifty-three (7.9%) patients developed NOAF during hospitalization. The occurrence of NOAF was found to be independently associated with higher FAR besides older age, higher neutrophil count, greater left atrial size, worse Killip class upon admission, lower body mass index, lower platelet count, lower left ventricle ejection fraction, and target left circumflex artery disease. FAR exhibited a better predictive value for the occurrence of NOAF during hospitalization (area under the curve, 0.732; 95% confidence interval, 0.659–0.808).

Conclusions

FAR is a robust tool for predicting NOAF risk during hospitalization in patients with AMI after PCI and has a better predictive value than serum fibrin and serum albumin levels alone.
Evaluating the impact of point-of-care HIV viral load assessment on linkage to care in Baltimore, MD: a randomized controlled trial
Authors: Bayan Mohammad Harris , Smalls Travis , Boudreau Alec , Mirza Agha W. , Pasco Courtney , Demko Zoe O , Rothman Richard E. , Hsieh Yu-Hsiang , Eshleman Susan H. , Mostafa Heba H. , Gonzalez-Jimenez Nathalie , Chavez Pollyanna R. , Emerson Brian , Delaney Kevin P. , Daugherty Debra , MacGowan Robin J. , Manabe Yukari C. , Hamill Matthew M.
Published: September 2023

Background

Integration of a sensitive point-of-care (POC) HIV viral load (VL) test into screening algorithms may help detect acute HIV infection earlier, identify people with HIV (PWH) who are not virally suppressed, and facilitate earlier referral to antiretroviral therapy (ART), or evaluation for pre-exposure prophylaxis (PrEP). This report describes a randomized clinical trial sponsored by the Centers for Disease Control and Prevention (CDC): “Ending the HIV Epidemic Through Point-of-Care Technologies” (EHPOC). The study’s primary aim is to evaluate the use of a POC HIV VL test as part of a testing approach and assess the impact on time to linkage to ART or PrEP. The study will recruit people in Baltimore, Maryland, including patients attending a hospital emergency department, patients attending an infectious disease clinic, and people recruited via community outreach. The secondary aim is to evaluate the performance characteristics of two rapid HIV antibody tests approved by the United States Food and Drug Administration (FDA).

Methods

The study will recruit people 18 years or older who have risk factors for HIV acquisition and are not on PrEP, or PWH who are not taking ART. Participants will be randomly assigned to either the control arm or the intervention arm. Participants randomized to the control arm will only receive the standard-of-care (SOC) HIV screening tests. Intervention arm participants will receive a POC HIV VL test in addition to the SOC HIV diagnostic screening tests. Follow up will consist of an interim phone survey conducted at week-4 and an in-person week-12 visit. Demographic and behavioral information, and oral fluid and blood specimens will be collected at enrollment and at week-12. Survey data will be captured in a Research Electronic Data Capture (REDCap) database. Participants in both arms will be referred for either ART or PrEP based on their HIV test results.

Discussion

The EHPOC trial will explore a novel HIV diagnostic technology that can be performed at the POC and provide viral assessment. The study may help inform HIV testing algorithms and contribute to the evidence to support same day ART and PrEP recommendations.

Trial registration

NIH ClinicalTrials.gov NCT04793750. Date: 11 March 2021.
Peripheral neuropathy associated with chronic lymphoproliferative disorders of natural killer cells (CLPD-NK): a case report and literature review
Authors: An Hong , Guo Jiaxiang , Guo Hongliang , Hu Wenli , Lu Ming
Published: September 2023

Background

Chronic lymphoproliferative disorders of natural killer cells (CLPD-NK) is a rare lymphoproliferative disease. Peripheral neuropathy is an unusual symptom of CLPD-NK. We report a case of peripheral neuropathy associated with CLPD-NK and perform a review of literatures.

Case presentation

a 62-year‐old woman presented with progressive numbness and weakness in both extremities. Electrophysiological examinations indicated a sensorimotor polyneuropathy. Peripheral blood examination revealed that the number of white blood cells (WBC) and lymphocytes were significantly increased. Flow cytometry analysis identified that 84% of the lymphocytes are NK cells that mainly expressed CD56, combined with variable expression of CD16, CD2, CD7, CD94, granzyme B, perforin, and CD158 but negative for CD3. Sural nerve biopsy revealed that a plethora of NK cells infiltrated into nerve fascicles. On treatment with combined cyclophosphamide and corticosteroids, her symptoms rapidly improved. Moreover, the absolute lymphocyte count and its proportion recovered to normal range after 3 months’ treatment.

Conclusion

To the best of our knowledge, this is the first case report of peripheral neuropathy associated with CLPD-NK from Chinese. This rare lymphoproliferative disease should be considered if peripheral neuropathy combines with increased WBC or lymphocytes. Immunosuppressive drugs are the major treatment and most patients can achieve a good prognosis.
Cost analysis of an innovative eHealth program in Nigeria: a case study of the vaccine direct delivery system
Authors: Sato Ryoko , Metiboba Loveth , Galadanchi Jamil Aliyu , Adeniran Mohammed-Faosy , Hassan Sadiq Haruna , Akpan David , Odogwu Juliet , Fashoto Busayo
Published: September 2023

Introduction

Vaccine stockout is a severe problem in Africa, including Nigeria, which could have an adverse effect on vaccination coverage and even health outcomes among the population. The Vaccine Direct Delivery (VDD) program was introduced to manage vaccine stockouts using eHealth technology. This study conducts a cost analysis of the VDD program and calculates the incremental costs of reaching an additional child for vaccination through the VDD program.

Methods

We used the expense reports from eHealth Africa, an NGO which implemented the VDD program, to calculate the VDD program’s overall operating costs. We also used the findings from the literature to translate the effect of VDD on the reduction of vaccine stockouts into its effect on the increase in vaccination coverage. We calculated the incremental costs of reaching an additional child for vaccination through the VDD program.

Results

We calculated that implementing the VDD program cost USD10,555 monthly for the 42 months that the VDD program was operating in Bauchi state. This figure translates to an incremental cost of USD20.6 to reach one additional child for vaccination.

Discussion/Conclusions

Our study is one of the first to conduct a cost analysis of eHealth technology in Africa. The incremental cost of USD20.6 was within the range of other interventions that intended to increase vaccine uptake in low- and middle-income countries. The VDD program is a promising technology to substantially reduce vaccine stockout, leading to a reduction of over 55% at a reasonable cost, representing 26% of the total budget for routine immunization activities in Bauchi state. However, there is no comparable costing study that evaluates the cost of a supply chain strengthening intervention. Future studies should investigate further the feasibility of eHealth technology, as well as how to minimize its costs of implementation while keeping the efficacy of the program.
Is gambling like a virus?: A conceptual framework and proposals based on empirical data for the prevention of gambling addiction
Authors: Chóliz Mariano
Published: September 2023

Objective

The objective of this study is to present a conceptual framework for the prevention of gambling disorder and try to corroborate some of its postulates. The assumption of gambling as if it were acting like a virus may have important considerations in terms of preventing gambling disorder in society and, therefore, it could be a relevant public health issue.

Background

Like COVID-19, gambling disorder is a disease which is caused by the action of an external agent. The external agent was already in existence, but certain environmental conditions (absence of regulatory measures based on the prevention of gambling disorder) favored its propagation. Regarding immunization, for SARS-CoV-2, it is obtained through vaccination and prevention of exposure. However, it is unlikely that immunization can be developed for any gambling addiction prevention program to immunize everyone who is exposed to the “gambling virus”. So, in the case of gambling disorder, preventive strategies should rather prevent gambling from affecting most people by limiting availability (supply) and accessibility (ease of access) to gambling.

Study design

This research is a quasi-experimental investigation aimed to evaluate the effects of anti-COVID measures on the frequency of gambling and evolution of gambling disorder. The present study analyzed gambling patterns and the problems caused by gambling in 2,903 people, including those who were at-risk gamblers or had a gambling disorder.

Results

In general terms, restrictive measures to combat COVID-19 worked to prevent the consolidation of gambling habits and the appearance of gambling disorder, but they did not seem to be sufficient for people who already had this disorder. The most affected games were electronic games machines (EGMs) that took place in public places (gambling halls, bars and restaurants, etc.).

Conclusions

The findings of this work support the hypothesis that, just as the SAR-CoV-2 virus is responsible for the global pandemic of COVID-19, which can only be stopped with vaccines and social distancing, in the case of gambling, the absence of an effective vaccine for "gambling virus" can lead to an epidemic of gambling disorders in societies, if the environmental conditions that are favorable for the spread of such virus are not modified. Some preventive strategies that can be useful from a public health frame of reference are suggested.
Long term adherence to continuous positive Airway pressure in mild obstructive sleep apnea
Authors: Qiao Min , Xie Yiyu , Wolff Armand , Kwon Jeff
Published: September 2023

Background

Studies have shown that a significant percentage of patients with obstructive sleep apnea (OSA) do not tolerate continuous positive airway pressure (CPAP) therapy and long-term use may be as low as 30%. Given the lower levels of symptoms and health-related risks, patients with mild sleep apnea may be at even higher risk for non-adherence to long term CPAP. The purpose of our study was to investigate the prevalence and associations of long-term CPAP adherence in first time users with mild sleep apnea diagnosed by home sleep apnea testing (HSAT).

Methods

We identified all the patients who were diagnosed with mild sleep apnea (5 = < AHI < 15) by home sleep apnea testing from 01/2013 to 06/2019 at a large, combined community and hospital-based sleep practice. Only first time CPAP users were included. Compliance was defined as CPAP usage ≥ 4 h per night on ≥ 70% of nights over 30 consecutive days. We defined long term adherence as compliance on the 12th month following CPAP set up. Patient demographics, comorbidities, and CPAP compliance at 1st, 3rd, 6th, 9th and 12th month after therapy initiation were collected. We compared and identified the factors that had significant difference (P < 0.1) between compliant and non-compliant groups at the 12th month.

Results

222 patients were included in the analysis. 57 (25.7%) patients were adherent with long term CPAP treatment. The following factors were associated with a greater likelihood for long-term CPAP adherence: older age, lower body mass index (BMI), presence of a bed partner, non-smoker, presence of Diabetes Mellitus (DM), presence of Heart Failure (CHF), lack of depression, and compliance at 1st, 3rd, 6th and 9th month.

Conclusions

Long term CPAP compliance in mild sleep apnea patients is low. Long term adherence to CPAP can be predicted based on CPAP adherence during the first three months.
Mutation status analysis of 58 patients with advanced ALK fusion gene positive non small cell lung cancer
Authors: Yang Yuan , Lu Baohua , Hu Mingming , Wang Qunhui , Jiang Mei , Zhang Tongmei , Liu Zhe
Published: September 2023

Purpose

To analyze the characteristics and prognostic values of Anaplastic Lymphoma Kinase (ALK) fusion gene partner, gene subtype and abundance in tumor tissues of advanced Non Small Cell Lung Cancer (NSCLC) patients with positive ALK fusion gene and to explore the best treatment mode of ALK-Tyrosine Kinase Inhibitors(TKIs).

Methods

Cases of advanced NSCLC patients with ALK positive confirmed by both Next Generation Sequencing (NGS) and immunohistochemistry were retrospectively collected. The relationships of Overall Survival (OS)/Progression Free Survival (PFS) between different mutation subtypes, mutation abundance, clinicopathological features were analyzed. OS/PFS between different treatment mode of ALK inhibitors were compared.

Results

Fifty-eight patients were enrolled. There were diverse fusion partners. Five subtypes of Echinoderm Microtubule-associated protein-Like 4 gene (EML4)-ALK fusion mutation were detected: V1,V2,V3,V5 and V7. The mutation abundance ranged from 0.13 to 27.77%, with a median of 5.34%. The abundance of V2 and V5 was higher than V1 and V3 respectively. There was no difference in OS between the low abundance group(≤ 5.34%) and the high abundance group(>5.34%) (P = 0.434). PFS of second-generation ALK inhibitors as first-line treatment was longer than that of Crizotinib as first-line (P<0.001). Never smokers had longer OS than current smokers(P = 0.001).

Conclusions

There are differences in abundance between different fusion partners and subtypes in advanced NSCLC with positive ALK. OS is not associated with subtypes, mutation abundance and first line treatment option of either generation of ALK inhibitors. Smoking is a poor prognostic factor.
Association between admission hyperglycemia and postoperative pneumonia in geriatric patients with hip fractures
Authors: Tang Wanyun , Yao Wei , Wang Wei , Lv Qiaomei , Ding Wenbo
Published: September 2023

Background

Admission hyperglycemia is a common phenomenon in the early stages of injury. This study aimed to determine the relationship between admission hyperglycemia and postoperative pneumonia in geriatric patients with hip fractures.

Methods

A total of 600 geriatric patients admitted to Dandong Central Hospital with hip fractures were included. Patients were divided into four groups based on quartiles of admission blood glucose levels: Q1- Q4. Multivariable logistic regression and propensity score-matched analyses were conducted to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for postoperative pneumonia. Receiver operating characteristic (ROC) curves were used to determine the cut-off value of admission hyperglycemia for predicting postoperative pneumonia.

Results

The incidence of postoperative pneumonia was significantly higher among hyperglycemic patients than those with normal glucose levels (OR = 2.090, 95% CI: 1.135–3.846, p = 0.016). Admission hyperglycemia showed moderate predictive power, with an area under the ROC curve of 0.803. Furthermore, propensity score-matched analyses demonstrated that patients in the Q3 (OR = 4.250, 95% CI: 1.361–13.272, p = 0.013) and Q4 (OR = 4.667, 95% CI: 1.251–17.405, p = 0.022) quartiles had a significantly higher risk of postoperative pneumonia compared to patients in the Q1 quartile.

Conclusions

Admission hyperglycemia in elderly hip fracture patients increases the risk of postoperative pneumonia. This biomarker can aid clinical assessment and perioperative management.
Single knotless-anchor with two ethicon 2# for Ellman grade III bursal-side partial thickness rotator cuff tears: a cadaveric biomechanical study and short-term clinical evaluation
Authors: su-Bao Ding , Zhang Baolu- , luo Hong- , liu Yang- , chen-Li Rui , Zou Yiyuan- , qiang-Zeng Sheng , Fu Shijie- , Liu Gang
Published: September 2023

Background

Several surgical techniques are used to treat bursal-side partial thickness rotator cuff tears (PTRCTs). However, use of single knotless-anchor with two Ethicon 2# repair technique for PTRCTs has not been reported.

Materials and methods

Bursal-side PTRCTs (Ellman grade III, 75% thickness of tears) were created in the supraspinatus tendon in 16 fresh-frozen cadaveric shoulders. The specimens were randomly assigned to two equal groups: (1) Group A (Transtendon repair), a single knotless-anchor repair with two Ethicon 2#; (2) Group B, Conversion repair (Double-row, DR). Post-repair, each specimen was subjected to cyclic loading test from 5 to 100 N (50 cycles), followed by an ultimate failure test. The displacement of greater tuberosity (mm) and ultimate (N) were recorded. In the clinical study, 12 patients diagnosed with Ellman grade III Bursal-side PTRCTs (using a single knotless anchor with two Ethicon 2# repair techniques) were operated on and analyzed. Visual analog scale (VAS), American Shoulder and Elbow Surgeons Score (ASES), Constant-Murley Score (CMS), and range of motion (ROM) were assessed before surgery and at final minimum follow-up (>1year).

Results

There was no significant between-group difference with respect to load-to-failure test (Group A, 359.25 ± 17.91 N; Group B, 374.38 ± 13.75 N, P > 0.05). There were no significant differences with respect to rotator cuff displacement of 10 mm (Group A, 190.50 ± 8.52 N; Group B, 197.25 ± 6.84 N, P > 0.05) and 15 mm (Group A, 282.25 ± 12.20 N; Group B, 291.13 ± 14.74 N, P > 0.05). However, there was significant between-group difference with respect to displacement of 3 and 5 mm (P < 0.05). In the clinical trial, all patients were followed up for an average of 20.4 months (12–29 months). At the last follow-up after surgery(minimum>1year), the VAS score was 0.50 ± 0.67 (0–2), the ASES score was 86.50 ± 3.96 (79–92), the CMS score was 85.08 ± 5.65 (74–93), the mean Forward flexion ROM was 154.00°± 12.48° (131°-169°), and the abduction ROM was 165.00°±13.26° (138°-173°). There was a statistically significant difference between the results of the preoperative and the last postoperative follow-up. The results of the last postoperative follow-up were statistically different from those of the preoperative follow-up (P < 0.05). Regarding complications, stiffness (2 cases) and shoulder impingement (1 case) occurred in 3 cases (25%).

Conclusion

A single knotless anchor with two Ethicon 2# may provide a biomechanically and clinically feasible option for the treatment of bursal-side Ellman grade III PTRCTs, particularly in resource-constrained settings.

MeSH keywords

Bursal-side Ellman Grade III; Single Knotless-anchor; Double-row repair; Biomechanical study; Short-term clinical evaluation.
Trans-pacific multicenter collaborative study of minimally invasive proximal versus total gastrectomy for proximal gastric and gastroesophageal junction cancers
Authors: Ikoma Naruhiko , Grotz Travis , Kawakubo Hirofumi , Kim Hyoung-Il , Matsuda Satoru , Hirata Yuki , Nakao Atsushi , Williams Loretta A. , Wang Xin Shelley , Mendoza Tito , Wang Xuemei , Badgwell Brian D. , Mansfield Paul F. , Hyung Woo-Jin , Strong Vivian E. , Kitagawa Yuko
Published: September 2023

Background

The current standard operation for proximal gastric and gastroesophageal junction (P/GEJ) cancers with limited esophageal extension is total gastrectomy (TG). TG is associated with impaired appetite and weight loss due to the loss of gastric functions such as production of ghrelin and with anemia due to intrinsic factor loss and vitamin B12 malabsorption. Theoretically, proximal gastrectomy (PG) can mitigate these problems by preserving gastric function. However, PG with direct esophagogastric reconstruction is associated with severe postoperative reflux, delayed gastric emptying, and poor quality of life (QoL). Minimally invasive PG (MIPG) with antireflux techniques has been increasingly performed by experts but is technically demanding owing to its complexity. Moreover, the actual advantages of MIPG over minimally invasive TG (MITG) with regards to postoperative QoL are unknown. Our overall objective of this study is to determine the short-term QoL benefits of MIPG. Our central hypotheses are that MIPG is safe and that patients have improved appetite after MIPG with effective antireflux techniques, which leads to an overall QoL improvement when compared with MITG.

Methods

Enrollment of a total of 60 patients in this prospective survey-collection study is expected. Procedures (MITG versus MIPG, antireflux techniques for MIPG [double-tract reconstruction versus the double-flap technique]) will be chosen based on surgeon and/or patient preference. Randomization is not considered feasible because patients often have strong preferences regarding MITG and MIPG. The primary outcome is appetite level (reported on a 0-10 scale) at 3 months after surgery. With an expected 30 patients per cohort (MITG versus MIPG), this study will have 80% power to detect a one-point difference in appetite level. Patient-reported outcomes will be longitudinally collected (including questions about appetite and reflux), and specific QoL items, body weight, body mass index and ghrelin, albumin, and hemoglobin levels will be compared.

Discussion

Surgeons from the US, Japan, and South Korea formed this collaboration with the agreement that the surgical approach to P/GEJ cancers is an internationally important but controversial topic that requires immediate action. At the completion of the proposed research, our expected outcome is the establishment of the benefit and safety of MIPG.

Trial registration

This trial was registered with Clinical Trials Reporting Program Registration under the registration number NCI-2022–00267 on January 11, 2022, as well as with ClinicalTrials.gov under the registration number NCT05205343 on January 11, 2022.
Reconstruction of the temporomandibular joint using a vascularized medial femoral condyle osteocartilaginous flap: an experimental investigation in miniature pigs
Authors: Lin Tianyi , Chen Shuo , Xia Long , Jie Bimeng , Zhang Yi , He Yang
Published: September 2023

Background

Reconstruction of the temporomandibular joint (TMJ) is a significant challenge in maxillofacial surgery. A vascularized medial femoral condyle (MFC) osteocartilaginous flap is a good choice for TMJ reconstruction. In this study, we evaluated the radiographic and histological changes of MFC after TMJ reconstruction.

Methods

A ramus-condyle unit (RCU) defect was created unilaterally in five adult male Bama miniature pigs. The ipsilateral vascularized MFC osteocartilaginous flap was used to reconstruct the TMJ, and the non-operative sides served as controls. Multislice spiral computed tomography (CT) was performed preoperatively, immediately postoperatively, and at two weeks, three months, and six months postoperatively. Three animals were euthanized at 6 months postoperatively. Their reconstructed condyles, natural condyles and the MFCs on the opposite side were collected and subjected to µCT and histological evaluation.

Results

In the miniature pigs, the vascularized MFC osteocartilaginous flap was fused to the mandible, thus restoring the structure and function of the RCU. The postoperative radiographic changes and histological results showed that the reconstructed condyle was remodeled toward the natural condyle, forming a similar structure, which was significantly different from the MFC.

Conclusions

In miniature pigs, the RCU can be successfully reconstructed by vascularized osteocartilaginous MFC flap. The reconstructed condyle had almost the same appearance and histological characteristics as the natural condyle.
Clinical and epidemiological features of high-risk human papillomavirus infection in patients with cervical intraepithelial lesions
Authors: Ding Yu-Qin , Yu Jie , Wang Run-Qiu , Sang Lin
Published: September 2023

Objective

In this study, we analyzed the clinical and epidemiological features of high-risk human papillomavirus (HR-HPV) infection in patients with cervical intraepithelial lesions.

Methods

Retrospective analysis was performed on the clinical data of 240 cases of histologically confirmed cervical squamous intraepithelial lesions to determine any correlation between HPV infection characteristics, age distribution, and cervical epithelial lesions.

Results

Patients between the ages of 31 and 40 with cervical intraepithelial lesions were more likely to have high-grade squamous intraepithelial lesions (HSIL; 40.7%) than low-grade squamous intraepithelial lesions (LSIL; 31.3%) (P < 0.05). In patients with HSIL, HR-HPV16, HR-HPV33, and HR-HPV52 were the most common types of HPV infection, while in patients with LSIL, HR-HPV16, HR-HPV52, and HR-HPV58 were the most common types of HPV infection. The highest percentage of single infections occurred in the HSIL group (69.6%), followed by the LSIL group (68.8%). HSIL was present in a significant number of patients (28.6%) aged 30 years and above who tested positive for 12 HPV types but negative for TCT.

Conclusion

The prevalence of HSIL is greatest in younger patients. Patients with cervical epithelial lesions typically have a single infection of a high-risk HPV genotype—HR-HPV16, HR-HPV33, HR-HPV52, or HR-HPV58. Patients aged 30 years and above who test positive for one of 12 types of HPV but negative for TCT are at increased risk for developing HSIL. In order to detect cervical lesions early and begin treatment without delay, colposcopy should be performed regardless of whether or not a high-risk HPV infection is present.
Associations between domestic violence and poor pregnancy outcomes in taiwanese women: a nested case–control study
Authors: Lin Chia-Ling , Sun Jui-Chiung , Lin Chun-Ping , Chung Chi-Hsiang , Chien Wu-Chien
Published: September 2023

Background and aims

Domestic violence (DV) are one of the important risk factors for women’s health outcomes. The aim of this study was explored the risk of DV association with the poor pregnancy outcomes (PPOs), including premature delivery, abortion, and stillbirth.

Methods

A nested case–control study was applied. Data from the Taiwan National Health Insurance Research Database were collected from 2000 to 2015. A total of 41,730 participants were included in this study, including 8,346 participants in the case group and 33,384 age- and index year-matched control group. Assessments of DA and PPOs were determined according to the International Classification of Diseases, 9th Revision. We conducted a conditional logistic regression analysis to estimate the effect of DV on PPOs.

Results

The mean age was 35.53 in the 41,730 female participants. The overall incidence rate of PPOs of the participants, who had experienced DV, was 84.05 per 100,000 person-years. which was significantly higher than that for the controls (18.19 per 100,000 person-years). The risk of PPOs was higher in the participants who had experienced DV than in the controls (adjusted odds ratio [AOR] = 3.31; 95% confidence interval [CI] [95% CI]: 2.83–3.86), including for premature delivery (AOR = 3.57; 95% CI: 3.05–4.17), abortion (AOR = 3.31; 95% CI: 2.83–3.86) and stillbirth (AOR = 2.98; 95% CI: 2.55–3.47). The results showed that the longer a participant has been suffering DV, the risk of PPOs was higher.

Conclusions

Present results reaved the risk of PPOs associated with DV. Especially, the longer a woman has been experiencing DV, the risk of PPOs was higher, showed a dose–response effect.
Herbal melanin modulates PGE2 and IL-6 gastroprotective markers through COX-2 and TLR4 signaling in the gastric cancer cell line AGS
Authors: El-Obeid Adila , Maashi Yahya , AlRoshody Rehab , Alatar Ghada , Aljudayi Modhi , Al-Eidi Hamad , AlGaith Nouf , Khan Altaf Husain , Hassib Adil , Matou-Nasri Sabine
Published: September 2023

We reported a gastric anti-ulcerogenic effect of the Nigella sativa (L.)-derived herbal melanin (HM) using rat models. However, the molecular mechanisms underlying this HM gastroprotective effect remain unknown. Cyclooxygenase-2 (COX-2)-catalyzed prostaglandin E2 (PGE2) and toll-like receptor 4 (TLR4)-mediated interleukin-6 (IL-6) production and secretion play major roles in gastric mucosal protection. In the current study, the human gastric carcinoma epithelial cell line AGS was used as a model to investigate the effect of HM on TLR4, COX-2, glycoprotein mucin 4 protein and gene expression using immuno-cyto-fluorescence staining, Western blot technology, and reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Gastroprotective markers PGE2 and IL-6 production and secretion were also assessed using an enzyme-linked immunosorbent assay (ELISA). Bacterial lipopolysaccharides (LPS), well-known inducers of TLR4, COX-2, PGE2 and IL-6 expression, were used as a positive control. We showed that HM upregulated its main receptor TLR4 gene and protein expression in AGS cells. HM increased, in a dose- and time-dependent manner, the secretion of PGE2 and the expression of COX-2 mRNA and protein, which was detected in the nucleus, cytoplasm and predominantly at the intercellular junctions of the AGS cells. In addition, HM enhanced IL-6 production and secretion, and upregulated the mucin 4 gene expression, the hallmarks of gastroprotection. To check whether HM-induced PGE2 and IL-6 through TLR4 signaling and COX-2 generated, AGS cells were pre-treated with a TLR4 signaling inhibitor TAK242 and the COX-2 inhibitor NS-398. A loss of the stimulatory effects of HM on COX-2, PGE2 and IL-6 production and secretion was observed in TAK242 and NS-398-pre-treated AGS cells, confirming the role of TLR4 signaling and COX-2 generated in the HM gastroprotective effects. In conclusion, our results showed that HM enhances TLR4/COX-2-mediated secretion of gastroprotective markers PGE2 and IL-6, and upregulates mucin 4 gene expression in the human gastric epithelial cell line AGS, which may contribute to the promising beneficial gastroprotective effect of HM for human gastric prevention and treatment.