bluuebunny/crossref_metadata_2025 huggingface dataset:
Pregnancy through the Looking-Glass: correlates of disordered eating attitudes among a sample of Lebanese pregnant women
Authors: Gerges Sarah , Obeid Sahar , Hallit Souheil
Published: September 2023

Introduction

Despite the risks of gestational disordered eating for both the mother and fetus, research into this subject is scarce within developing countries, particularly in Lebanon. Our study’s objective was to delve into the predictors of disordered eating attitudes during pregnancy among a sample of Lebanese pregnant women while assessing the potential mediating effect of body dissatisfaction between psychosocial factors and disordered eating attitudes in pregnancy.

Methods

We framed a cross-sectional study, built on self-report measures. Pregnant women of 18 years old and above were recruited from all the Lebanese governorates through an online survey (N = 433).

Results

The results showed that higher pregnancy-specific hassles (Beta = 0.19), media and pregnant celebrities’ influence (Beta = 0.22), and body dissatisfaction (Beta = 0.17) were significantly associated with increased disordered eating attitudes in pregnancy; whereas higher perceived social support (Beta = -0.03), lower socio-economic status (Beta = -0.84), and multigravidity (Beta = -0.96) were significantly associated with less disordered eating attitudes during pregnancy. Body dissatisfaction mediated the association between pregnancy-specific hassles and disordered eating attitudes, and between social appearance concerns and disordered eating attitudes.

Conclusion

Our study highlighted that antenatal care, particularly in Lebanon, should no longer be limited to biological monitoring but rather seek to identify possible eating disorders and mental health threats. Further investigations following longitudinal designs should pursue identifying additional correlates of gestational disordered eating in the clinical context, in furtherance of consolidating screening programs and building targeted treatment strategies.
Validation of the Arabic version of the brief irritability test (Ar-BITe) in non-clinical adolescents
Authors: Fekih-Romdhane Feten , Azzi Vanessa , Hallit Rabih , Malaeb Diana , Dabbous Mariam , Sakr Fouad , Obeid Sahar , Hallit Souheil
Published: September 2023

Background

Despite the substantial clinical relevance of irritability in the development and maintenance of several mental disorders and its negative effects on functioning, no valid and reliable measures are available yet to identify the presence and consequences of irritability as a distinct construct among the Arabic-speaking populations. To bridge this gap, and help advance this field in the under-researched Arab region, we aimed to validate an Arabic-language version of the Brief Irritability Test (BITe).

Methods

Eligible participants were native Arabic-speaking non-clinical adolescents from Lebanon; 527 participants aged 15.73 ± 1.81 years (56% females) completed the survey.

Results

Utilizing the Confirmatory Factor Analysis approach, we found that the five items of the Arabic BITe loaded into a single factor structure. The scale showed excellent reliability, as both Cronbach’s alpha and McDonald’s omega coefficient values were of 0.88. Multi-group analyses showed invariance across sex groups in our sample at the configural, metric, and scalar levels. Female adolescents exhibited higher BITe scores than their male counterparts (14.01 vs. 13.25), but this difference did not reach the statistical significance. Good concurrent validity was supported based on positive correlations between irritability scores and measures of aggression, anger and hostility (r Pearson’s coefficients ranging from 0.35 to 0.42), as well as positive correlations with insomnia symptoms scores.

Conclusion

The present findings allow us to conclude that the Arabic version of the BITe is a unidimensional, reliable, valid, brief, and economic self-report measure of the irritability construct for both male and female Arabic-speakers. Providing an Arabic validated version of the BITe will hopefully foster the research efforts of the Arab scientific community in this area, and promote the implementation of timely, evidence-informed and culturally-sensitive mental health interventions that appropriately address irritability-related problems and consequences among Arab young populations.
Catastrophic health expenditure and its inequality in rural China: based on longitudinal data from 2013 to 2018
Authors: Zhang Weile , Su Min , Li Dongxu , Zhang Tianjiao , Li Wenhui
Published: September 2023

Background

Catastrophic health expenditure (CHE) is an important indicator of measuring health inequality. Previous studies mainly focused on specific vulnerable populations rather than a wider range of vulnerable areas through panel data. Rural China is often associated with an underdeveloped economy and insufficient health resources. This study aims to update the information on the extent of and trends in the incidence and inequality of CHE among the households of rural China through longitudinal survey data.

Methods

Data were obtained from three waves of the China Health and Retirement Longitudinal Study (CHARLS): 2013, 2015, and 2018. In total, 2,575 households were included in the analysis. CHE was defined as household health expenditures exceeding 40% of non-food expenditures. Inequality in CHE was measured using the concentration curve and concentration index. The contribution to CHE inequality was decomposed using the concentration index decomposition method.

Results

The incidence of CHE was 0.2341 (95% CI: 0.22, 0.25) in 2013, 0.2136 (95% CI: 0.20, 0.23) in 2015, and 0.2897 (95% CI: 0.27, 0.31) in 2018 in rural China. The concentration curve lay above the equality line, and the concentration index was negative: −0.1528 (95% CI: −0.1941, −0.1115) in 2013, −0.1010 (95% CI: −0.1442, −0. 0577) in 2015, and −0.0819 (95% CI: −0.1170, −0.0467) in 2018. Economic status, age, and chronic diseases were the main contributors to inequality in CHE.

Conclusions

The incidence of CHE in rural China displayed an upward trend from 2013 to 2018, although it was not continuous. Furthermore, a strong pro-low-economic inequality in CHE existed in rural China. Mainly economic status, age, and chronic diseases contributed to this pro-low-economic inequality. Health policies to allocate resources and services are needed to satisfy the needs of rural households and provide more accessible and affordable health services. More concern needs to be directed toward households with chronic diseases and older persons to reduce the incidence of CHE and promote health equality.
Promoting healthy sleep in Chinese kindergarteners through a family-based intervention: protocol of the “Healthy Sleep” randomised controlled trial
Authors: Zhang Zhiguang , Li Lin , Li Xiaohua , Okely Anthony
Published: September 2023

Background

Sleep is instrumental for growth and development in children, making it critical to establish healthy sleep habits from the earliest years of life. Many kindergarteners (3–6 years) in China have inadequate and poor sleep, necessitating targeted interventions. This research protocol details the “Healthy Sleep” intervention that was designed to promote healthy sleep among kindergarteners in China.

Methods

The “Healthy Sleep” intervention will be family-based and will support parents as change agents. The development of the intervention is based on evidence regarding correlates of sleep in young children and guided by Bandura’s social cognitive theory. A 12-month randomised controlled trial will be conducted to examine the efficacy of the intervention for promoting healthy sleep in Chinese kindergarteners and the intervention's effects on child development outcomes. A targeted sample of 160 kindergarteners and their parents will be recruited through social media. The intervention group (n = 80) will receive monthly webinars for one year that include multiple intervention components – including educational training, goal setting and planning, as well as follow-up support sessions. The control group (n = 80) will receive videos of the recorded educational sessions after the study end. For primary outcomes, child sleep behaviours will be examined using the Child Sleep Health Questionnaire. For secondary outcomes, communication, fine motor, gross motor, personal-social, and problem-solving development will be examined using the Ages and Stages Questionnaire; executive functions will be examined using the Head, Toes, Knees, and Shoulders Revised tasks. Potential intervention mediators and covariates will be measured using a parental questionnaire. Mixed models will be conducted.

Discussion

This intervention targets sleep behaviours among kindergarteners in China. It has the potential to inform programs to support parents in helping their child establish healthy sleep habits from the earliest years of life. The study will provide high-quality experimental evidence on sleep behaviours in relation to development outcomes in kindergarteners. This evidence will inform family-based strategies to optimise early childhood development and inform national and international updates of the sleep recommendations for young children.

Trial registration

The trial was registered prospectively at Chinese Clinical Trial Registry (ID: ChiCTR2300072105) on 2 June 2023.
Tracheal microbiome and metabolome profiling in iatrogenic subglottic tracheal stenosis
Authors: Fan Zeqin , Zhang Lihui , Wei Li , Huang Xiaoxian , Yang Mei , Xing Xiqian
Published: September 2023

Background

To study the role of microecology and metabolism in iatrogenic tracheal injury and cicatricial stenosis, we investigated the tracheal microbiome and metabolome in patients with tracheal stenosis after endotracheal intubation.

Methods

We collected 16 protected specimen brush (PSB) and 8 broncho-alveolar lavage (BAL) samples from 8 iatrogenic subglottic tracheal stenosis patients, including 8 PSB samples from tracheal scar sites, 8 PSB samples from scar-free sites and 8 BAL samples, by lavaging the subsegmental bronchi of the right-middle lobe. Metagenomic sequencing was performed to characterize the microbiome profiling of 16 PSB and 8 BAL samples. Untargeted metabolomics was performed in 6 PSB samples (3 from tracheal scar PSB and 3 from tracheal scar-free PSB) using high-performance liquid chromatography‒mass spectrometry (LC‒MS).

Results

At the species level, the top four bacterial species were Neisseria subflava, Streptococcus oralis, Capnocytophaga gingivals, and Haemophilus aegyptius. The alpha and beta diversity among tracheal scar PSB, scar-free PSB and BAL samples were compared, and no significant differences were found. Untargeted metabolomics was performed in 6 PSB samples using LC‒MS, and only one statistically significant metabolite, carnitine, was identified. Pathway enrichment analysis of carnitine revealed significant enrichment in fatty acid oxidation.

Conclusion

Our study found that carnitine levels in tracheal scar tissue were significantly lower than those in scar-free tissue, which might be a new target for the prevention and treatment of iatrogenic tracheal stenosis in the future.
“I wanted to know what was hurting so much”: a qualitative study exploring patients’ expectations and experiences with primary care management
Authors: Lowry Véronique , Desmeules François , Zidarov Diana , Lavigne Patrick , Roy Jean-Sébastien , Cormier Audrey-Anne , Tousignant-Laflamme Yannick , Perreault Kadija , Lefèbvre Marie-Claude , Décary Simon , Hudon Anne
Published: September 2023

Background

The management of shoulder pain is challenging for primary care clinicians considering that 40% of affected individuals remain symptomatic one year after initial consultation. Developing tailored knowledge mobilization interventions founded on evidence-based recommendations while also considering patients’ expectations could improve primary care for shoulder pain. The aim of this qualitative study is to explore patients’ expectations and experiences of their primary care consultation for shoulder pain.

Methods

In this qualitative study, participants with shoulder pain and having consulted a primary care clinician in the past year were interviewed. All the semi-structured interviews were transcribed verbatim, and inductive thematic analysis was performed to identify themes related to the participants’ expectations and experiences of primary care consultations for shoulder pain.

Results

Thirteen participants with shoulder pain were interviewed (8 women, 5 men; mean age 50 ± 12 years). Eleven of them initially consulted a family physician or an emergency physician, and two participants initially consulted a physiotherapist. Four overarching themes related to patients’ expectations and experiences were identified from our thematic analysis: 1) I can’t sleep because of my shoulder; 2) I need to know what is happening with my shoulder; 3) But… we need to really see what is going on to help me!; and 4) Please take some time with me so I can understand what to do!. Several participants waited until they experienced a high level of shoulder pain before making an appointment since they were not confident about what their family physician could do to manage their condition. Although some participants felt that their physician took the time to listen to their concerns, many were dissatisfied with the limited assessment and education provided by the clinician.

Conclusions

Implementing evidence-based recommendations while considering patients’ expectations is important as it may improve patients’ satisfaction with healthcare. Several participants reported that their expectations were not met, especially when it came to the explanations provided. One unexpected finding that emerged from this study was the waiting period between the onset of shoulder pain and when patients decided to consult their primary care clinician.
Experiences of faculty and students regarding a locally developed framework for implementing interprofessional education during international electives in Sub-Saharan Africa
Authors: Nawagi Faith , Munabi Ian Guyton , Vyt Andre , Kiguli Sarah , Mubuuke Aloysius Gonzaga
Published: September 2023

Background

Given that there are hardly any comprehensive frameworks to guide institutions on approaches to use as they implement interprofessional education and collaborative practice during international electives, we developed and piloted a framework to address this gap. The purpose of this study, therefore, was to explore the experiences of faculty and students regarding the use of the developed interprofessional education and collaborative practice framework during international electives.

Methods

This was an exploratory qualitative study. The study participants included faculty and students from four health training universities in Africa who participated in the pilot of international electives guided by the framework developed. Deductive thematic analysis was used to analyze the data. The codes were categorized as per the major themes.

Results

The major themes regarding the framework included (1) The Strengths, (2) Weaknesses, (3) Opportunities, and (4) Threats. All participants perceived the framework as useful and appropriate to enable the acquisition of interprofessional education and collaborative practice skills objectives set. The framework’s duration of the elective was seen as a weakness with the need for an increment in the duration. The opportunities the framework presented included: acting as a starting point to structure and implement interprofessional education across various training institutions in Africa, advancing research, and networking opportunities to share the best practices. The main threat included siloed training where the current training curriculum of the students does not have opportunities that allow the students to study with, from, and about each other.

Conclusions

The framework developed to guide the implementation of interprofessional education and collaborative practice during international electives is feasible and enabled students to achieve the interprofessional education and collaborative practice objectives set while appreciating the transcultural similarities and differences in another country.
Analysis of factors influencing the organizational capacity of Institutional Review Boards In China: a crisp-set Qualitative Comparative Analysis based on 107 cases
Authors: Lu Lu , Shi Shuwen , Liu Bojing , Liu Chanjuan
Published: September 2023

Background

Institutional Review Boards (IRBs) play a vital role in safeguarding the rights and interests of both research participants and researchers. However, China initiated the establishment of its own IRB system relatively late in comparison to international standards. Despite commendable progress, there is a pressing need to strengthen the organizational capacity building of Chinese IRBs. Hence, this study aims to analyze the key factors driving the enhancement of organizational capacity within these committees.

Method

The cross-sectional survey for this research was conducted from July 2020 to January 2022. Following the statistical grouping based on the "2020 China Health Statistical Yearbook", a systematic investigation of IRBs in various provinces of China was carried out. In-depth interviews and questionnaire surveys were conducted with the chairpersons and administrative executives (or secretaries) of highly cooperative IRBs. Subsequently, data were collected from 107 IRBs. Qualitative Comparative Analysis (QCA) was employed as the method to analyze the factors influencing the organizational capacity of medical ethics committees and explore the diverse combinations of these factors.

Results

Through a singular necessary condition analysis, the variable "protection of rights and interests" emerges as a critical factor contributing to the robust construction of Institutional Review Boards Institutional Review Boards (IRBs). Conversely, the variables of "lack of member ability, absence of review process, and deficiency in the supervision mechanism" collectively constitute a sufficient condition leading to weaker IRB construction. The state analysis uncovers three interpretation modes: member ability-oriented (M1), system process-oriented mode (M2), and resource system-oriented mode (M3).

Conclusions

The results of this study are effectively explicable using the "Triangular Force" model proposed for the hypothesis of IRBs' organizational capacity, which provides a solid foundation for the development of organizational capabilities in IRBs. To enhance the organizational capacity of IRBs in China, it is imperative to elevate the competence of committee members and strengthen team development. This can be achieved by establishing a comprehensive regulatory framework and refining procedural protocols. Moreover, clarifying the organizational structure and optimizing resource allocation are essential steps in bolstering the overall organizational capabilities of these committees.
The voice of the profession: how the ethical demand is professionally refracted in the work of general practitioners
Authors: Johnsson Linus , Höglund Anna T. , Nordgren Lena
Published: September 2023

Background

Among the myriad voices advocating diverging ideas of what general practice ought to be, none seem to adequately capture its ethical core. There is a paucity of attempts to integrate moral theory with empirical accounts of the embodied moral knowledge of GPs in order to inform a general normative theory of good general practice. In this article, we present an empirically grounded model of the professional morality of GPs, and discuss its implications in relation to ethical theories to see whether it might be sustainable as a general practice ethic.

Methods

We observed and interviewed sixteen GPs and GP residents working in health care centres in four Swedish regions between 2015–2017. In keeping with Straussian Grounded Theory, sampling was initially purposeful and later theoretically guided, and data generation, analysis and theoretical integration proceeded in parallel. The focal concept of this article was refined through multidimensional property supplementation.

Results

The voice of the profession is one of four concepts in our emerging theory that attempt to capture various motives that affect GPs’ everyday moral decisionmaking. It reflects how GPs appreciate the situation by passing three professional–moral judgments: Shall I see what is before me, or take a bird’s-eye view? Shall I intervene, or stay my hand? And do I need to speak up, or should I rather shut up? By thus framing the problem, the GP narrows down the range of considerations, allowing them to focus on its morally most pertinent aspects. This process is best understood as a way of heeding Løgstrup’s ethical demand. Refracted through the lens of the GP’s professional understanding of life, the ethical demand gives rise to specific moral imperatives that may stand in opposition to the express wishes of the other, social norms, or the GP’s self-interest.

Conclusions

The voice of the profession makes sense of how GPs frame problematic situations in moral terms. It is coherent enough to be sustainable as a general practice ethic, and might be helpful in explaining why ethical decisions that GPs intuitively understand as justified, but for which social support is lacking, can nevertheless be legitimate.
Exploring physician engagement in health care organizations: a scoping review
Authors: Prenestini Anna , Palumbo Rocco , Grilli Roberto , Lega Federico
Published: September 2023

Rationale

Enhancing health system effectiveness, efficiency, and appropriateness is a management priority in most world countries. Scholars and practitioners have focused on physician engagement to facilitate such outcomes.

Objectives

Our research was intended to: 1) unravel the definition of physician engagement; 2) understand the factors that promote or impede it; 3) shed light on the implications of physician engagement on organizational performance, quality, and safety; and 4) discuss the tools to measure physician engagement.

Method

A scoping review was undertaken. Items were collected through electronic databases search and snowball technique. The PRISMA extension for Scoping Reviews (PRISMA-ScR) statement and checklist was followed to enhance the study replicability.

Results

The search yielded 16,062 records. After an initial screening, 300 were selected for potential inclusion in this literature review. After removing duplicates and records not meeting the inclusion criteria, full-text analysis of 261 records was performed, yielding a total of 174 records.

Discussion

Agreement on the conceptualization of physician engagement is thin; furthermore, scholars disagree on the techniques and approaches used to assess its implementation and implications. Proposals have been made to overcome the barriers to its adoption, but empirical evidence about implementing physician engagement is still scarce.

Conclusions

Our scoping review highlights the limitations of the extant literature about physician engagement. Physician engagement is a relatively ill-defined concept: developing an evidence base for its actual implementation is necessitated to provide reliable guidance on how the governance of health care organizations could be improved. Although we did not assess the quality or the robustness of current empirical research, our findings call for further research to: 1) identify potential drivers of physician engagement, 2) develop dependable assessment tools providing health care organizations with guidance on how to foster physician engagement, and 3) evaluate engagement’s actual impact on health care organizations’ performance.
Long intergenic non-coding RNA DIO3OS promotes osteosarcoma metastasis via activation of the TGF-β signaling pathway: a potential diagnostic and immunotherapeutic target for osteosarcoma
Authors: Yuan Jinghong , Jia Jingyu , Wu Tianlong , Du Zhi , Chen Qi , Zhang Jian , Wu Zhiwen , Yuan Zhao , Zhao Xiaokun , Liu Jiahao , Guo Jia , Cheng Xigao
Published: September 2023

Background

The aim of this study was to determine the underlying potential mechanisms and function of DIO3OS, a lincRNA in osteosarcoma and clarify that DIO3OS can be used as a potential diagnostic biomarker and immunotherapeutic target.

Methods

The expression matrix data and clinical information were obtained from XENA platform of UCSC and GEO database as the test cohorts. The external validation cohort was collected from our hospital. Bioinformatics analysis was used to annotate the biological function of DIO3OS. Immune infiltration and immune checkpoint analysis were applied to evaluate whether DIO3OS can be used as an immunotherapeutic target. ROC curves and AUC were established to assess the diagnostic value of DIO3OS for differentiating patients from other subtypes sarcoma. The expression analysis was detected by qRT-PCR, western blot, and immunohistochemical. Wound healing assay and Transwell assay were applied to determine the migration and invasion function of DIO3OS in osteosarcoma cell lines. The tail vein injection osteosarcoma cells metastases model was used in this research.

Results

High expression of DIO3OS was identified as a risk lincRNA for predicting overall survival of osteosarcoma in test cohort. The outcomes of experiments in vitro and in vivo showed that low expression of DIO3OS limited osteosarcoma tumor metastasis with inhibiting TGF-β signaling pathway. Immune checkpoint genes (CD200 and TNFRSF25) expressions were inhibited in the low DIO3OS expression group. The DIO3OS expression can be applied to reliably distinguish osteosarcoma from lipomatous neoplasms, myomatous neoplasms, nerve sheath tumors, and synovial-like neoplasms. This result was further validated in the validation cohort.

Conclusions

In conclusion, our outcomes indicated that DIO3OS is a potential diagnostic and prognostic biomarker of osteosarcoma, emphasizing its potential as a target of immunotherapy to improve the treatment of osteosarcoma through TGF-β signaling pathway.

Trial registration number: The present retrospectively study was approved by the Ethics Committee of The Second Affiliated Hospital of Nanchang University [Review (2020) No. (115)].
Barriers and facilitators to seeking and accessing mental health support in primary care and the community among female migrants in Europe: a “feminisms” systematic review
Authors: Nyikavaranda Patrick , Pantelic Marija , Jones Christina J , Paudyal Priyamvada , Tunks Alice , Llewellyn Carrie D
Published: September 2023

Background

Recent years have seen record levels of migration to Europe. Female migrants are at heightened risk of developing mental health disorders, yet they face barriers to accessing mental health services in their host countries. This systematic review aims to summarise the barriers and facilitators to accessing mental health support for female migrants in Europe.

Methods

The review follows PRISMA guidelines, and the protocol was pre-published on PROSPERO. Six electronic databases were searched: CINAHL, Global Health Database, Medline, PsycARTICLES, PsycINFO and Web of Science. Thematic analysis was undertaken on the identified studies. A feminist quality appraisal tool was applied.

Results

Eight qualitative, six quantitative and five mixed methods studies were identified. Barriers included a lack of information, stigma, religious and cultural practices and beliefs, and a lack of consideration of gender-specific needs within the health system. Gender-sensitive services, supportive general practitioners and religious leaders facilitated access.

Conclusions

The design of mental health research, services, policies, and commissioning of support for migrants must consider female migrant needs. Mental health support services must be culturally aware and gender sensitive.

Registration

The review protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO, registration number CRD42021235571.
Association of remnant cholesterol with hypertension, type 2 diabetes, and their coexistence: the mediating role of inflammation-related indicators
Authors: Wu Yuxuan , Wei Qinfei , Li Husheng , Yang Han , Wu Yuying , Yu Yiming , Chen Qiansi , He Baochang , Chen Fa
Published: September 2023

Purpose

Cholesterol metabolism is a risk factor for cardiovascular disease, and recent studies have shown that cholesterol metabolism poses a residual risk of cardiovascular disease even when conventional lipid risk factors are in the optimal range. The association between remnant cholesterol (RC) and cardiovascular disease has been demonstrated; however, its association with hypertension, type 2 diabetes mellitus (T2DM), and the concomitance of the two diseases requires further study. This study aimed to evaluate the association of RC with hypertension, T2DM, and both in a large sample of the U.S. population, and to further explore the potential mechanisms involved.

Methods

This cross-sectional study used data from the 2005—2018 cycles of the National Health and Nutrition Examination Survey (N = 17,749). Univariable and multivariable logistic regression analyses were performed to explore the relationships of RC with hypertension, T2DM, and both comorbidities. A restricted cubic spline regression model was used to reveal the dose effect. Mediation analyses were performed to explore the potential mediating roles of inflammation-related indicators in these associations.

Results

Of the 17,749 participants included (mean [SD] age: 41.57 [0.23] years; women: 8983 (50.6%), men: 8766 (49.4%)), the prevalence of hypertension, T2DM, and their co-occurrence was 32.6%, 16.1%, and 11.0%, respectively. Higher RC concentrations were associated with an increased risk of hypertension, T2DM, and their co-occurrence (adjusted odds ratios for per unit increase in RC were 1.068, 2.259, and 2.362, and 95% confidence intervals were 1.063–1.073, 1.797–2.838, and 1.834–3.041, respectively), with a linear dose–response relationship. Even when conventional lipids were present at normal levels, positive associations were observed. Inflammation-related indicators (leukocytes, lymphocytes, monocytes, and neutrophils) partially mediated these associations. Among these, leukocytes had the greatest mediating effect (10.8%, 14.5%, and 14.0%, respectively).

Conclusion

The results of this study provide evidence that RC is associated with the risk of hypertension, T2DM, and their co-occurrence, possibly mediated by an inflammatory response.
Prevalence, one-year-incidence and predictors of carcinoid heart disease
Authors: Mattig Isabel , Franke Maximilian Richard , Pschowski Rene , Brand Anna , Stangl Karl , Knebel Fabian , Dreger Henryk
Published: September 2023

Background

Carcinoid heart disease (CHD) caused by neuroendocrine tumours (NET) is associated with an increased morbidity and mortality due to valvular dysfunction and right sided heart failure. The present study aimed to assess the prevalence and one-year-incidence of CHD in NET patients. Tumour characteristics, laboratory measurements, and echocardiographic findings were evaluated to identify predictors of CHD manifestation.

Methods

The study was an investigator-initiated, monocentric, prospective trial. Patients with NET without previously diagnosed CHD were included and underwent comprehensive gastroenterological and oncological diagnostics. Echocardiographic examinations were performed at baseline and after one year.

Results

Forty-seven NET patients were enrolled into the study, 64% of them showed clinical features of a carcinoid syndrome (CS). Three patients presented with CHD at baseline and three patients developed cardiac involvement during the follow-up period corresponding to a prevalence of 6% at baseline and an incidence of 6.8% within one year. Hydroxyindoleacetic acid (5-HIAA) was identified to predict the occurrence of CHD (OR, 1.004; 95% CI, 1.001–1.006 for increase of 5-HIAA), while chromogranin A (CgA), and Kiel antigen 67 (Ki 67%) had no predictive value. Six patients with CHD at twelve-month follow-up revealed a tendency for larger right heart diameters and increased values of myocardial performance index (MPEI) at baseline compared to NET patients.

Conclusion

The prevalence at baseline and one-year-incidence of CHD was 6–7%. 5-HIAA was identified as the only marker which predict the development of CHD.

Graphical Abstract
Development of an Elliptical Perturbation System that provides unexpected perturbations during elliptical walking (the EPES system)
Authors: Sade Shoval , Pickholz Hodaya , Melzer Itshak , Shapiro Amir
Published: September 2023

Background

‘Perturbation-based balance training’ (PBBT) is a training method that was developed to improve balance reactive responses to unexpected balance loss. This training method is more effective in reducing fall rates than traditional balance training methods. Many PBBTs are performed during standing or treadmill walking which targeted specifically step reactive responses, we however, aimed to develop and build a mechatronic system that can provide unexpected perturbation during elliptical walking the Elliptical Perturbation System (the EPES system), with the aim of improving specifically the trunk and upper limbs balance reactive control.

Methods

This paper describes the development, and building of the EPES system, using a stationary Elliptical Exercise device, which allows training of trunk and upper limbs balance reactive responses in older adults.

Results

The EPES system provides 3-dimensional small, controlled, and unpredictable sudden perturbations during stationary elliptical walking. We developed software that can identify a trainee’s trunk and arms reactive balance responses using a stereo camera. After identifying an effective trunk and arms reactive balance response, the software controls the EPES system motors to return the system to its horizontal baseline position after the perturbation. The system thus provides closed-loop feedback for a person’s counterbalancing trunk and arm responses, helping to implement implicit motor learning for the trainee. The pilot results show that the EPES software can successfully identify balance reactive responses among participants who are exposed to a sudden unexpected perturbation during elliptical walking on the EPES system.

Conclusions

EPES trigger reactive balance responses involving counter-rotation action of body segments and simultaneously evoke arms, and trunk reactive response, thus reactive training effects should be expected.
Bibliometric and visualized analysis of arthroscopic treatment of acromioclavicular joint injury
Authors: Zhang Jian , Li Mingjun , Yang Yuxia , Liu Wenkang , Meng Xiangji , Fei Wenyong , Wang Jingcheng
Published: September 2023

Background

Since arthroscopy was discovered to treat acromioclavicular joint injury, people have had great interest and attention to this beautiful and minimally invasive operation, and related research has been increasing worldwide. At present, there is no bibliometric and visualized analysis in this field. The purpose of this study is to explore the research hotspots and trends of arthroscopic treatment of acromioclavicular joint injury through bibliometric and visualized analysis and look forward to the future development direction of clinical practice.

Methods

The publications on arthroscopic treatment of acromioclavicular joint injury diseases from its establishment to April 2023 were obtained from the Web of Science (WOS) Core Collection database. CiteSpace, VOSviewer, Scimago graphica and Origin were used for bibliometric and visualized analysis.

Results

This study included a total of 330 publications. The number of publications tends to increase every year. The USA has the most significant number of publications and citations. Imhoff AB is the most relevant scholar with the largest number of publications in this field, and the scholar with the highest citation and average citations is Mazzocca AD. Tech Univ Munich, Rush University and Charite are the three institutions with the greatest contribution. Tech Univ Munich, Rush University and Charite are the three institutions with the greatest contribution. In addition, “Arthroscopy-the Journal of Arthroscopic and Related Surgery” and “American Journal of Sports Medicine” are the institutions with the most significant number of publications and average citations, respectively. The most common keywords are “acromioclavicular joint dislocation,” “arthroscopic resection,” “arthroscopic reconstruction” and “coracoclavicular ligament.”

Conclusion

The number of publications shows a steady upward trend as a whole. However, there is still a lack of cooperation among countries, institutions and scholars around the world, so various countries, institutions and scholars need to strengthen academic exchanges and expand the field of cooperation, so as to promote further research and development in related fields. However, minimally invasive methods such as arthroscopy are still the hotspots and frontiers in the treatment of acromioclavicular joint injury in the future.
Management of anomalous origin of right coronary artery from left coronary sinus
Authors: Mangel Tobin , Divya Aabha , De Silva Ravi
Published: September 2023

Aberrant origin of coronary artery is a rare congenital anomaly associated with increased risk of myocardial ischemia and sudden death, with the highest risk lesions being those arising from the opposite sinus of Valsalva. We report a case with an aberrant right coronary artery arising superior to the left coronary cusp, with a slit-like ostium, having an inter-arterial and intramural course through the aortic root, that underwent repositioning of the right coronary artery. We believe such cases warrant surgical correction and reimplantation is a safe, effective and reproducible technique.
Usage of chitosan from Hermetia illucens as a preservative for fresh Prunus species fruits: a preliminary analysis
Authors: Triunfo Micaela , Tafi Elena , Guarnieri Anna , Ianniciello Dolores , Scieuzo Carmen , Salvia Rosanna , Hahn Thomas , Zibek Susanne , Falabella Patrizia
Published: September 2023

Background

Fruit and vegetables are highly perishable. In an era where reducing food waste is absolutely essential, packaging is important for maintaining the postharvest quality of these fresh products. Research is working to reduce the use of synthetic materials, not safe for the environment and human health. In this perspective, chitosan emerges as a viable solution for this purpose, as it is biodegradable, biocompatible and also safe for food application. The growing interest in using insects as a source of chitin has allowed for increased exploitation of insect-based waste products to recover valuable materials, such as biopolymers. The black soldier fly (Hermetia illucens L.) is the most widely reared species in Europe for feed production and waste management.

Results

In this work, fresh mature apricots (Prunus armeniaca L.), nectarines (Prunus persica vulgaris Mill.) and yellow peaches (Prunus persica var. laevis Gray) were coated with 0.5% and 1% chitosan from the pupal exuviae of Hermetia illucens, applied by spraying and stored at room temperature or 4 °C until they decay. Then, to validate the effectiveness of chitosan as a polymer for fruit preservation, several parameters including pH, TSS and weight loss were evaluated.

Conclusions

The results showed that chitosan derived from the black soldier fly is as effective as or better than the commercially available crustacean chitosan in maintaining more stable some storage parameters in fresh apricots, nectarines and peaches. Thus, insects, especially Hermetia illucens, are confirmed as a viable alternative source of the polymer.

Graphical Abstract
Management of left traumatic diaphragmatic hernia complicated by traumatic Stanford type B aortic dissection
Authors: Matsubayashi Yuta , Takanashi Yusuke , Sekihara Keigo , Hayakawa Takamitsu , Mizuno Kiyomichi , Kawase Akikazu , Sato Masanori , Shiiya Norihiko , Funai Kazuhito
Published: September 2023

Background

Traumatic diaphragmatic hernias are frequently associated with multiple organ injuries caused by high-energy trauma. Herein, we report a case of left traumatic diaphragmatic hernia complicated by traumatic Stanford type B aortic dissection, in which we considered surgical strategies for the timing and approach of diaphragmatic hernia repair.

Case presentation

A 65-year-old man was transported to our hospital following a traffic accident. He was diagnosed with left traumatic diaphragmatic hernia, traumatic Stanford type B aortic dissection, multiple fractures of the left ribs, hemothorax, and pulmonary contusion. Because acute surgery for hernia repair might exacerbate aortic dissection, we initiated conservative treatment for aortic dissection. Respiratory status and ischemia of the herniated organs were monitored carefully. On the day 6, when the aortic dissection was considered stable, we performed diaphragmatic hernia repair. A large surgical field secured by thoracolaparotomy enabled safe surgical techniques for visualization of the aortic wall. Postoperatively, there was no diaphragmatic hernia recurrence, and the aortic dissection remained stable with conservative treatment.

Conclusions

In traumatic diaphragmatic hernia complicated by traumatic Stanford type B aortic dissection, elective surgery via the trans-thoracoabdominal approach may be safe after stabilization of aortic dissection, provided the respiratory condition can be kept stable.
Tucatinib and Trastuzumab for Previously Treated Human Epidermal Growth Factor Receptor 2–Positive Metastatic Biliary Tract Cancer (SGNTUC-019): A Phase II Basket Study
Authors: Nakamura Yoshiaki , Mizuno Nobumasa , Sunakawa Yu , Canon Jean-Luc , Galsky Matthew D. , Hamilton Erika , Hayashi Hidetoshi , Jerusalem Guy , Kim Seung Tae , Lee Keun-Wook , Kankeu Fonkoua Lionel Aurelien , Monk Bradley J. , Nguyen Danny , Oh Do-Youn , Okines Alicia , O'Malley David M. , Pohlmann Paula , Reck Martin , Shin Sang Joon , Sudo Kazuki , Takahashi Shunji , Van Marcke Cedric , Yu Evan Y. , Groisberg Roman , Ramos Jorge , Tan Sherry , Stinchcombe Thomas E. , Bekaii-Saab Tanios
Published: September 2023

PURPOSE

To evaluate the efficacy and safety of tucatinib and trastuzumab in patients with previously treated human epidermal growth factor receptor 2–positive (HER2+) metastatic biliary tract cancer (mBTC).

METHODS

SGNTUC-019 (ClinicalTrials.gov identifier: NCT04579380 ) is an open-label phase II basket study evaluating the efficacy and safety of tucatinib and trastuzumab in patients with HER2-altered solid tumors. In the biliary tract cancer cohort, patients had previously treated HER2 overexpressing or amplified (HER2+) tumors (identified with local testing) with no prior HER2-directed therapy. The primary end point was confirmed objective response rate (cORR) per investigator assessment. Patients were treated on a 21-day cycle with tucatinib (300 mg orally twice daily) and trastuzumab (8 mg/kg intravenously followed by 6 mg/kg every 3 weeks).

RESULTS

Thirty patients were enrolled. As of data cutoff (January 30, 2023), the median duration of follow-up was 10.8 months. The cORR was 46.7% (90% CI, 30.8 to 63.0), with a disease control rate of 76.7% (90% CI, 60.6 to 88.5). The median duration of response and progression-free survival were 6.0 months (90% CI, 5.5 to 6.9) and 5.5 months (90% CI, 3.9 to 8.1), respectively. At data cutoff, 15 patients (50.0%) had died, and the estimated 12-month overall survival rate was 53.6% (90% CI, 36.8 to 67.8). The two most common treatment-emergent adverse events (TEAEs) were pyrexia (43.3%) and diarrhea (40.0%). Grade ≥3 TEAEs were reported in 18 patients (60.0%), with the most common being cholangitis, decreased appetite, and nausea (all 10.0%), which were generally not treatment related. TEAEs led to treatment regimen discontinuation in one patient, and there were no deaths due to TEAEs.

CONCLUSION

Tucatinib combined with trastuzumab had clinically significant antitumor activity and was well tolerated in patients with previously treated HER2+ mBTC.
Active smelling in the American cockroach
Authors: Hoffmann Antoine , Couzin-Fuchs Einat
Published: September 2023

Motion plays an essential role in sensory acquisition. From changing the position in which information can be acquired to fine-scale probing and active sensing, animals actively control the way they interact with the environment. In olfaction, movement impacts the time and location of odour sampling as well as the flow of odour molecules around the olfactory organs. Employing a detailed spatiotemporal analysis, we investigated how insect antennae interact with the olfactory environment in a species with a well-studied olfactory system – the American cockroach. Cockroaches were tested in a wind-tunnel setup during the presentation of odours with different attractivity levels: colony extract, butanol and linalool. Our analysis revealed significant changes in antennal kinematics when odours were presented, including a shift towards the stream position, an increase in vertical movement and high-frequency local oscillations. Nevertheless, the antennal shifting occurred predominantly in a single antenna while the overall range covered by both antennae was maintained throughout. These findings hold true for both static and moving stimuli and were more pronounced for attractive odours. Furthermore, we found that upon odour encounter, there was an increase in the occurrence of high-frequency antennal sweeps and vertical strokes, which were shown to impact the olfactory environment's statistics directly. Our study lays out a tractable system for exploring the tight coupling between sensing and movement, in which antennal sweeps, in parallel to mammalian sniffing, are actively involved in facilitating odour capture and transport, generating odour intermittency in environments with low air movement where cockroaches dwell.
UK Consortium for Autonomous Hydrogen HGV
Authors: Wade Andrew
Published: September 2023

A new UK consortium including ASDA has been awarded £6.6m of government funds to develop a hydrogen-powered self-driving HGV for the logistics industry.
Evolve Project Shows 70GW of Untapped European Marine Power
Authors: Wade Andrew
Published: September 2023

The pan-European EVOLVE project has uncovered 70GW of potential wave and tidal stream energy, around half of which is in British waters.
Soft Pedestrian 360 ADDS Realism to Pedestrian Target Testing
Authors: Ford Jason
Published: September 2023

AB Dynamics and sister company Dynamic Research, Inc. (DRI) have launched Soft Pedestrian 360, a next-generation pedestrian ADAS (Advanced driver assistance systems) target.
Innovative Solutions to Grand Challenges
Authors: Drake Richard
Published: September 2023

Dr Richard Drake, Chief Technology Officer at Babcock International Group comments on the collaborative projects and disruptive trends uncovered by The Engineer's seventh annual Collaborate To Innovate (C2I) awards
Opening Up for Autonomy
Authors: Hughes Dave
Published: September 2023

Digital flight offers a way for different types of airspace users to self-separate within a single integrated airspace
The Dream Departure
Authors: Sampson Ben
Published: September 2023

10 years ago the Boeing 787-9 Dreamliner made its maiden flight after years of planning