bluuebunny/crossref_metadata_2025 huggingface dataset:
Biomechanical Analysis of Coracoid Stability After Coracoplasty: How Low Can You Go?
Authors: Heilmann Lukas F. , Sussiek Julia , Raschke Michael J. , Langer Martin F. , Frank Andre , Wermers Jens , Michel Philipp A. , Dyrna Felix , Schliemann Benedikt , Katthagen J. Christoph
Published: February 2022

Background:

Arthroscopic coracoplasty is a procedure for patients affected by subcoracoid impingement. To date, there is no consensus on how much of the coracoid can be resected with an arthroscopic burr without compromising its stability.

Purpose:

To determine the maximum amount of the coracoid that can be resected during arthroscopic coracoplasty without leading to coracoid fracture or avulsion of the conjoint tendon during simulated activities of daily living (ADLs).

Study Design:

Controlled laboratory study.

Methods:

A biomechanical cadaveric study was performed with 24 shoulders (15 male, 9 female; mean age, 81 ± 7.9 years). Specimens were randomized into 3 treatment groups: group A (native coracoid), group B (3-mm coracoplasty), and group C (5-mm coracoplasty). Coracoid anatomic measurements were documented before and after coracoplasty. The scapula was potted, and a traction force was applied through the conjoint tendon. The stiffness and load to failure (LTF) were determined for each specimen.

Results:

The mean coracoid thicknesses in groups A through C were 7.2, 7.7, and 7.8 mm, respectively, and the mean LTFs were 428 ± 127, 284 ± 77, and 159 ± 87 N, respectively. Compared with specimens in group A, a significantly lower LTF was seen in specimens in group B ( P = .022) and group C ( P < .001). Postoperatively, coracoids with a thickness ≥4 mm were able to withstand ADLs.

Conclusion:

While even a 3-mm coracoplasty caused significant weakening of the coracoid, the individual failure loads were higher than those of the predicted ADLs. A critical value of 4 mm of coracoid thickness should be preserved to ensure the stability of the coracoid process.

Clinical Relevance:

In correspondence with the findings of this study, careful preoperative planning should be used to measure the maximum reasonable amount of coracoplasty to be performed. A postoperative coracoid thickness of 4 mm should remain.
Intergenerational Transmission of Trust: A Dyadic Approach
Authors: Wu Cary
Published: February 2022

Trustful parents often have trustful children. Yet it is unclear whether this intergenerational correlation of trust is due to genetic inheritance, shared experiences, or parental socialization. In this article, I suggest that a dyadic approach that differentiates same-sex (mother-daughter and father-son) and cross-sex (mother-son and father-daughter) dyads provides important insights into these potential mechanisms. My analysis of a unique parent-child paired data set created from the Chinese Family Panel Studies (2012–2016) reveals several transmission patterns. First, mothers are generally more influential than fathers in the trust transmission process. Second, there is greater transmission between same-sex generational dyads than between cross-sex pairs. Third, parental homogeneity moderates the transmission process. These patterns are hard to explain with genetic or environmental influences, but they are fully compatible with differential socialization theories. The overall evidence indicates that parental socialization is more likely the primary process underlying how trust is transmitted intergenerationally.
Making space for competition: The rationalities of contemporary regional development
Authors: Öjehag-Pettersson Andreas
Published: February 2022

Taking as its starting premise that we have a politics of space because space is political at the level of ontology, this article investigates how the governing of regional development is guided by a set of prominent political rationalities that revolve around the notions of competition and competitiveness. To this end, I mobilise the Foucauldian framework of governmentality to provide empirical illustrations drawn from a 5-year long research project concerning globalisation in Swedish sub-national regions. These illustrations show how regions are governed through rationalities that stress adaptability, attraction, environment and sustainability as well as leadership in order to prevail in their inevitable competition for vital resources. I argue that as these chains of rationale are put into motion in the contemporary politics of space, they not only promote specific and particular ways of developing regions, but also displace certain practices and objects from the realm of the political to the realm of a natural order. I therefore conclude that current expressions of the politics of space have strong tendencies to deny its own political foundations. Instead, competition and competitiveness are inscribed as naturally occurring features in social relations, thereby elevating their importance in the creation of new sub-national spaces.
Electoral politics, gentrification, and strategic use of contested place identities in Toronto’s Portuguese neighbourhood
Authors: Takahashi Koki
Published: February 2022

This article uses the lens of electoral politics to improve understanding of political dynamics in an ethnic neighbourhood undergoing gentrification, corresponding to Ward 18 and its antecedents in the City of Toronto. This ward has been populated by Portuguese immigrants and their descendants since the 1960s. Since the 1990s, gentrification has corresponded to a decrease in the Portuguese population alongside a proliferating, diverse mix of new arrivals. This article tackles the question of how gentrification affects electoral politics in this traditionally ethnic neighbourhood. In the history of Toronto’s municipal elections, a first-generation Portuguese Canadian candidate first appeared on the ballot in 1978; a decade later, the ward elected another first-generation Portuguese Canadian to the city council. In 2014, the third and most recent of them pursued her candidacy while recognizing the changed demographic and cultural circumstances of the neighbourhood existing as two places within a single urban space. Competing against a candidate with no cultural affiliation to the Portuguese Canadian community, the incumbent won by a narrow margin through appealing to out-group residents, while respecting and cherishing the Portuguese residents, or her robust electoral base. This electoral mirroring of the current condition of this urban space has implications for understanding the relationships between gentrification, urban ethnic minorities, and electoral politics; ethnicity is consolidated through electoral campaigns and mobilized as a useful and handy political tool, and both ethnic-based and non–ethnic-based place identities are strategically utilized for electoral politics in an ethnic neighbourhood undergoing gentrification.
Effects of Slow Deep Breathing on Acute Clinical Pain in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Joseph Amira E. , Moman Rajat N. , Barman Ross A. , Kleppel Donald J. , Eberhart Nathan D. , Gerberi Danielle J. , Murad M. Hassan , Hooten W. Michael
Published: February 2022

Slow deep breathing (SDB) may help patients with acute pain. The primary aim of this systematic review and meta-analysis is to investigate the effects of SDB on acute pain. Secondary aims include investigating the effects of SDB on acute pain-related physical and emotional functioning. An a priori protocol was registered and a database search was conducted by a reference librarian. Randomized controlled trials (RCT) were eligible for inclusion and exclusion criteria included studies of SDB for non-pain indications and studies that applied SDB as a component of an encompassing intervention. The risk or bias was assessed using the Cochrane Collaboration's revised tool for assessing risk of bias in randomized trials. Meta-analysis was conducted using the random effects model. A total of 11 968 studies were screened and seven RCTs met inclusion criteria; five were judged to have low risk of bias. Meta-analysis of post-intervention pain scores demonstrated that SDB was associated with significantly lower pain scores compared with a control group, but with high levels of heterogeneity. Subgroup analyzes demonstrated that trials of burn pain were associated with a larger reduction in pain which partially explains the heterogeneity. Very low certainty evidence suggests that SDB may reduce acute pain intensity. Further research is needed to identify patients who are candidates for SDB and determine the best approach to deliver this therapy.
Clarifying Inaccurate Terminology: The Important Difference Between Dysphagia and Swallowing Dysfunction
Authors: Rameau Anaïs , Katz Philip , Andreadis Katerina , Drenis Sotirios , Joseph Ian Theophilus , Tran Angela , Han Gloria , Sarhadi Kamron Shawn , Kaufman Matthew , Belafsky Peter
Published: February 2022

Background:

Dysphagia refers to the patient’s subjective experience. It is a symptom and should be differentiated from objective signs of swallowing impairment observed by healthcare providers. We hypothesized that there is rampant misuse of the term dysphagia in the medical literature.

Objective:

To evaluate the prevalence of the inaccurate use of the term dysphagia in the medical literature.

Methods:

A comprehensive database search was performed in PubMed, Ovid Embase, and the Cochrane Library to identify all 2019 English articles in the adult medicine literature containing the term dysphagia in the title, abstract and major topic in the medical subject heading. Risk factors for incorrect use of the term dysphagia were evaluated.

Results:

Our search yielded 2427 unique articles, 10% of which was randomly selected, accessed and included in the final analysis. The term dysphagia was misused in 39.1% (95/243) of these articles. The top specialties misusing the term were rehabilitation medicine, speech pathology and neurology. On univariate analysis, only the first author being a speech language pathologist was associated with significant odds of term misuse (OR = 12.2, 95% CI [1.2, 121.5]). Articles from Europe, the U.S.A and Korea had the highest incidence of misuse. Odds of incorrect use of dysphagia were significantly increased in cross-sectional studies (OR = 20.9, 95% CI [2.4-184.1]).

Conclusion:

The inaccurate use of the term dysphagia is widespread in the contemporary medical literature. This confusion undermines the patient’s experience, leads to misapplication of assessment tools, reduces data mining accuracy, and hinders innovation and patient care.
A randomized, placebo-controlled, double-blind trial of canakinumab in children and young adults with sickle cell anemia
Authors: Rees David C. , Kilinc Yurdanur , Unal Selma , Dampier Carlton , Pace Betty S. , Kaya Banu , Trompeter Sara , Odame Isaac , Mahlangu Johnny , Unal Sule , Brent Julie , Grosse Regine , Fuh Beng R. , Inusa Baba P. D. , Koren Ariel , Leblebisatan Goksel , Levin Carina , McNamara Elizabeth , Meiser Karin , Hom Douglas , Oliver Stephen J.
Published: February 2022

Excessive intravascular release of lysed cellular contents from damaged red blood cells (RBCs) in patients with sickle cell anemia (SCA) can activate the inflammasome, a multiprotein oligomer promoting maturation and secretion of proinflammatory cytokines, including interleukin-1β (IL-1β). We hypothesized that IL-1β blockade by canakinumab in patients with SCA would reduce markers of inflammation and clinical disease activity. In this randomized, double-blind, multicenter phase 2a study, patients aged 8 to 20 years with SCA (HbSS or HbSβ0-thalassemia), history of acute pain episodes, and elevated high-sensitivity C-reactive protein >1.0 mg/L at screening were randomized 1:1 to received 6 monthly treatments with 300 mg subcutaneous canakinumab or placebo. Measured outcomes at baseline and weeks 4, 8, 12, 16, 20, and 24 included electronic patient-reported outcomes, hospitalization rate, and adverse events (AEs) and serious AEs (SAEs). All but 1 of the 49 enrolled patients were receiving stable background hydroxyurea therapy. Although the primary objective (prespecified reduction of pain) was not met, compared with patients in the placebo arm, patients treated with canakinumab had reductions in markers of inflammation, occurrence of SCA-related AEs and SAEs, and number and duration of hospitalizations as well as trends for improvement in pain intensity, fatigue, and absences from school or work. Post hoc analysis revealed treatment effects on weight, restricted to pediatric patients. Canakinumab was well tolerated with no treatment-related SAEs and no new safety signal. These findings demonstrate that the inflammation associated with SCA can be reduced by selective IL-1β blockade by canakinumab with potential for therapeutic benefits. This trial was registered at www.clinicaltrials.gov as #NCT02961218.
Being active with a total hip or knee prosthesis: a systematic review into physical activity and sports recommendations and interventions to improve physical activity behavior
Authors: Mooiweer Yvet , Stevens Martin , van den Akker-Scheek Inge ,   PAIR study group, Barone Giuseppe , Benvenuti Francesco , Berteanu Mihai , Bragonzoni Laura , Ciobanu Ileana , Dallari Dante , Dimitrova Ani , Dimitrov Ivo , Helbostad Jorunn L. , Iliescu Alina , Latessa Pasqualino Maietta , Marin Andreea , Mazzotta Alessandro , Stensdotter Ann-Katrin , Hals Odd M. , Østerås Håvard , Paggetti Cristiano , Pinelli Erika , Shalamanova Nataliya , Shalamanova Rumyana , Stefanelli Claudio , Teodorescu Matei , Todorov Nikolay , Toselli Stefania , Tsvetanova Maya , Unsgaard-Tøndel Monica , Yoncheva Lora , Zinno Raffaele
Published: February 2022

Objectives

Regular physical activity (PA) is considered important after total hip and knee arthroplasty (THA/TKA). Objective was to systematically assess literature on recommendations given by healthcare professionals to persons after THA and TKA and to provide an overview of existing interventions to stimulate PA and sports participation.

Methods

A systematic review with a narrative synthesis including articles published between January 1995 and January 2021 reporting on recommendations and interventions. The PubMed, Embase, CINAHL and PsycInfo databases were systematically searched for original articles reporting on physical activity and sports recommendations given by healthcare professionals to persons after THA and TKA, and articles reporting on interventions/programs to stimulate a physically active lifestyle after rehabilitation or explicitly defined as part of the rehabilitation. Methodological quality was assessed with the Mixed Methods Appraisal Tool (MMAT). The review was registered in Prospero (PROSPERO:CRD42020178556).

Results

Twenty-one articles reported on recommendations. Low-impact activities were allowed. Contact sports, most ball sports, and martial arts were not recommended. One study informed on whether health-enhancing PA recommendations were used to stimulate persons to become physically active. No studies included recommendations on sedentary behavior. Eleven studies reported on interventions. Interventions used guidance from a coach/physiotherapist; feedback on PA behavior from technology; and face-to-face, education, goal-setting, financial incentives and coaching/financial incentives combined, of which feedback and education seem to be most effective. For methodological quality, 18 out of 21 (86%) articles about recommendations and 7 out of 11 (64%) articles about interventions scored yes on more than half of the MMAT questions (0–5 score).

Conclusion

There is general agreement on what kind of sports activities can be recommended by healthcare professionals like orthopedic surgeons and physiotherapists. No attention is given to amount of PA. The same is true for limiting sedentary behavior. The number of interventions is limited and diverse, so no conclusions can be drawn. Interventions including provision of feedback about PA, seem to be effective and feasible.
Effectiveness of the advisory display SmartPilot® view in the assessment of anesthetic depth in low risk gynecological surgery patients: a randomized controlled trial
Authors: Strand Hilde , Elshaug Ann Charlott , Bernersen Øyvind , Ballangrud Randi
Published: February 2022

Background

Assessment of appropriate anesthetic depth is crucial to prevent harm to patients. Unnecessary deep anesthesia can be harmful, potentially causing acute renal failure, myocardial injury, delirium, and an increased mortality rate. Conversely, too light anesthesia combined with muscle relaxants can result in intraoperative patient awareness and lead to serious psychological trauma. This trial aimed to ascertain the effectiveness of the advisory display SmartPilot® View (SPV), as a supplemental measure in the assessment of anesthetic depth in low risk gynecological surgery patients. The hypothesis was that the use of the SPV would increase the precision of assessment, and result in a higher mean arterial pressure.

Methods

This trial used a randomized, controlled, single-blind design with a homogeneous sample. Patients undergoing minor, low risk gynecological surgery were randomly assigned to two groups: a test group wherein current standards were supplemented with the advisory display SPV and a control group assessed using only the current standards. Female patients aged between 18 and 75 years with American Society of Anesthesiologists Physical Status Classification System scores of 1–3 undergoing planned general anesthesia using the total intravenous anesthetic method, combining propofol and remifentanil, were included. The exclusion criteria included a body mass index ≥ 35 kg/m2, a history of alcoholism, drug intake affecting propofol and remifentanil dynamics, and inability to consent. The independent sample t-test and chi-square test or Fisher’s exact test were used to assess the statistical significance of differences between the two groups.

Results

A total of 114 patients were included in the analysis (test group n = 58, control group n = 56). No significant differences in the mean arterial pressure, heart rate, bispectral index, extubation delay, or post-anesthesia care unit stay were found between groups.

Conclusions

The addition of the advisory display SmartPilot® View to current standards in the evaluation of anesthetic depth had no significant effect on the outcome.

Trial registration

The trial was registered on January 16th 2019 with ClinicalTrials.gov (ref: NCT03807271).
Validity and reliability of the Thai version of the simple frailty questionnaire (T-FRAIL) with modifications to improve its diagnostic properties in the preoperative setting
Authors: T.Sriwong Warut , Mahavisessin Waroonkarn , Srinonprasert Varalak , Siriussawakul Arunotai , Aekplakorn Wichai , Limpawattana Panita , Suraarunsumrit Patumporn , Ramlee Rachaneekorn , Wongviriyawong Titima
Published: February 2022

Background

Several methods are available for identifying frailty, but limited tools have been validated in Thai context. Our objective was to evaluate the validity and reliability of the Thai version of the Simple Frailty Questionnaire (T- FRAIL) compared to the Thai Frailty Index (TFI) and to explore modifications to improve its diagnostic properties.

Methods

The T-FRAIL was translated with permission using a standardized protocol, that included forward and back-translation. Content validity analysis was performed using input from 5 geriatricians. Test-retest reliability, concurrent validity, diagnostic properties, and options to increase the sensitivity of the questionnaire were explored. A cross-sectional study for evaluation validity and reliability was carried out among 3 hundred patients aged 60 or more undergoing elective surgery at a university hospital.

Results

The item content validity index (I-CVI) showed 1.0 for each questionnaire item. Test-retest reliability within a 7-day interval was done in 30 patients with a good intraclass correlation coefficient of 0.880. Compared with the TFI, the T-FRAIL yielded an excellent accuracy (area under the curve = 0.882). The identification of frailty using a score of 2 points or more provided the best Youden’s index at 63.1 with a sensitivity of 77.5% (95% CI 69.0–84.6) and a specificity of 85.6% (95% CI 79.6–90.3). A cutoff point of 1 out of 5 items for original T-FRAIL provided a sensitivity of 93.3% and a specificity of 61.1%. The modified T-FRAIL (T-FRAIL_M1), by reducing the “illnesses” criterion to 4 or more diseases, at a cutoff point at 1 had a sensitivity of 94.2% and a specificity of 57.8%. Another modified T-FRAIL (T-FRAIL_M2), by combining three components, at a cutoff point at 1 yielded a sensitivity of 85.8% and a specificity of 80.6%.

Conclusion

The T-FRAIL and its modification demonstrated satisfactory validity and reliability to identify frailty in elderly patients. The cutoff score of 1 point from 5 items from the original version of T-FRAIL and T-FRAIL_M1 provides a highly sensitive screening tool. T-FRAIL_M1 with a cutoff point of 2 and T-FRAIL_M2 yields reasonable sensitivity and specificity for practical use.
Perceptions, motivations, and beliefs about HIV risk and pre-exposure prophylaxis (PrEP) among participants in a nurse-led PrEP service (PrEP-RN)
Authors: Orser Lauren , O’Byrne Patrick , Holmes Dave
Published: February 2022

Background

While HIV pre-exposure prophylaxis (PrEP) has become more readily available in Canada, its uptake among HIV priority populations continues to be affected by system-level and individual factors. Such impediments relate to challenges by healthcare providers in assessing HIV-related risk and variability in patients’ motivations for PrEP initiation and continued engagement in care.

Methods

In Ottawa, Canada, a group of researchers implemented Canada’s first nurse-led HIV prevention program, known as PrEP-RN. As part of this pilot, qualitative interviews were completed with fourteen patients who had accessed PrEP-RN. The purpose of these interviews was to understand participants’ perspectives related to HIV prevention and experiences accessing care through a nurse-led service. Interviews were analyzed using thematic analysis, which were organized into the two major themes of (1) motivations for PrEP initiation and (2) beliefs about the benefits of PrEP.

Results

Findings revealed participants’ motivations for PrEP differed from healthcare provider’s views of risk, which were influenced by external life factors and personal perceptions of risk. In addition, participants discussed the benefits of PrEP in terms of its ability to manage their potential mistrust of sexual partners, control their sexual health, and liberate fears and anxieties related to HIV.

Conclusions

Based on these findings, health and allied providers should consider incorporating individual motivations and beliefs into patient education and counselling about PrEP to better target HIV prevention care at persons are at elevated risk of HIV. These perspectives could also be used to re-structure web and social media campaigns to increase PrEP uptake among HIV priority populations.
Central venous pressure and acute kidney injury in critically ill patients with multiple comorbidities: a large retrospective cohort study
Authors: Sun Runlu , Guo Qi , Wang Junjie , Zou Yaoyao , Chen Zhiteng , Wang Jingfeng , Zhang Yuling
Published: February 2022

Background

Given the traditional acceptance of higher central venous pressure (CVP) levels, clinicians ignore the incidence of acute kidney injury (AKI). The objective of this study was to assess whether elevated CVP is associated with increased AKI in critically ill patients with multiple comorbidities.

Methods

This was a retrospective observational cohort study using data collected from the Medical Information Mart for Intensive Care (MIMIC)-III open-source clinical database (version 1.4). Critically ill adult patients with CVP and serum creatinine measurement records were included. Linear and multivariable logistic regression were performed to determine the association between elevated CVP and AKI.

Results

A total of 11,135 patients were enrolled in our study. Critically ill patients in higher quartiles of mean CVP presented greater KDIGO AKI severity stages at 2 and 7 days. Linear regression showed that the CVP quartile was positively correlated with the incidence of AKI within 2 (R2 = 0.991,P = 0.004) and 7 days (R2 = 0.990,P = 0.005). Furthermore, patients in the highest quartile of mean CVP exhibited an increased risk of AKI at 7 days than those in the lowest quartile of mean CVP with an odds ratio of 2.80 (95% confidence interval: 2.32–3.37) after adjusting for demographics, treatments and comorbidities. The adjusted odds of AKI were 1.10 (95% confidence interval: 1.08–1.12) per 1 mmHg increase in mean CVP.

Conclusions

Elevated CVP is associated with an increased risk of AKI in critically ill patients with multiple comorbidities. The optimal CVP should be personalized and maintained at a low level to avoid AKI in critical care settings.
Should pregnant women know their individual risk of future pelvic floor dysfunction? A qualitative study
Authors: Bugge Carol , Strachan Heather , Pringle Stewart , Hagen Suzanne , Cheyne Helen , Wilson Don
Published: February 2022

Background

The study aimed to explore:

• pregnant women’s and healthcare professionals’ perspectives on provision of individual risk scores for future Pelvic Floor Dysfunction (PFD),

• the feasibility of providing this during routine maternity care,

• actions women might take as a result of knowing their PFD risk.

Methods

Qualitative study. Setting: UK NHS Health Board. Participants: Pregnant women (n = 14), obstetricians (n = 6), midwives (n = 8) and physiotherapists (n = 3). A purposive sample of pregnant women and obstetric healthcare professionals were introduced to the UR-CHOICE calculator, which estimates a woman’s PFD risk, and were shown examples of low, medium and high-risk women. Data were collected in 2019 by semi-structured interview and focus group and analysed using the Framework Approach.

Results

Women’s PFD knowledge was limited, meaning they were unlikely to raise PFD risk with healthcare professionals. Women believed it was important to know their individual PFD risk and that knowledge would motivate them to undertake preventative activities. Healthcare professionals believed it was important to discuss PFD risk, however limited time and concerns over increased caesarean section rates prevented this in all but high-risk women or those that expressed concerns.

Conclusion

Women want to know their PFD risk. As part of an intervention based within a pregnant woman/ maternity healthcare professional consultation, the UR-CHOICE calculator could support discussion to consider preventative PFD activities and to enable women to be more prepared should PFD occur. A randomised controlled trial is needed to test the effectiveness of an intervention which includes the UR-CHOICE calculator in reducing PFD.
Abundant expression of ferroptosis-related SAT1 is related to unfavorable outcome and immune cell infiltration in low-grade glioma
Authors: Mou Yanhua , Zhang Lu , Liu Zhantao , Song Xiujun
Published: February 2022

Background

Low-grade glioma (LGG) is susceptible to ferroptosis, which is involved in TMZ resistance. Ferroptosis induction can enhance the sensitivity to TMZ and synergistically kill glioma cells. T cell-promoted tumor ferroptosis is a vital anti-tumor mechanism of immune checkpoint inhibitors. The SAT1 activation is closely related to ferroptosis upon ROS induction due to the upregulation of arachidonate 15-lipoxygenase (ALOX15) expression.

Methods

The expression of SAT1 in pan-cancer and corresponding normal tissue from the TCGA data portal was primarily explored. The landscape of SAT1 and immune cell infiltration and their corresponding gene marker sets in different tissues were further explored. Additionally, we evaluated the relationships between SAT1 and the clinicopathologic parameters of LGG, and the disease-specific survival (DSS), progression-free interval (PFI), and overall survival (OS) were also assessed using KM survival curves and multivariate analysis in LGG. Meanwhile, the Gene Set Enrichment Analysis (GSEA) was also implemented to determine the potential effect of the SAT1 gene in LGG. Furthermore, the predictive power of SAT1 was validated using an independent LGG cohort from the Chinese Glioma Genome Atlas (CGGA) data.

Results

In general, the expression of SAT1 is different between most tumors and their adjacent normal tissues. The results demonstrated that SAT1 expression is positively associated with TMB in LGG, BRCA, and THYM. The results displayed that the expression level of SAT1 is obviously correlated with the level of infiltrating macrophages and CD8 + T cells, and the levels of most immune gene sets were associated with the SAT1 expression in LGG. Interestingly, univariate and multivariate models significantly indicated that the OS and PFI of patients with LGG with high SAT1 levels were poorer than those with low SAT1 expression in the TCGA LGG cohort. GSEA showed that SAT1 was involved in immune regulation and multiple signaling pathways. Finally, our analysis demonstrated that SAT1 was closely associated with IDH mutation, 1p19q codeletion, chemoradiotherapy resistance and disease recurrence.

Conclusions

Abundant expression of SAT1 was related to poor disease prognosis and abundant immune cell infiltration in LGG.
Pancreaticobiliary maljunction and pancreas divisum accompanied with intestinal malrotation: a case report
Authors: Lei Waiun , Yan Jiayu , Zhang Tingchong , Liu Lu , Chen Yajun
Published: February 2022

Background

Pancreaticobiliary maljunction is a congenital anatomical abnorma l junction of the pancreatic duct and bile duct into a common channel outside the duodenal wall. Pancreas divisum is also a congenital anatomical abnormality characterized by unfused pancreatic ducts. Intestinal malrotation is caused by the failure of bowel rotation and fixation. We reported an optimal surgical intervention for the rare case of pancreaticobiliary maljunction and pancreas divisum accompanied intestinal malrotation.

Case presentation

A 2-year-old female presented with fever and jaundice. Abdominal ultrasound showed dilated common bile duct and intrahepatic bile ducts; MRCP showed pancreaticobiliary maljunction, pancreas divisum, and dilated biliary system; Abdominal contrast-enhanced CT showed a reversed relationship between the superior mesenteric artery and the superior mesenteric vein. An operation of laparoscopic resection of the extrahepatic bile duct, Roux-en-Y hepaticojejunostomy, and Ladd’s procedure was performed after the inflammation of the biliary system was treated. The post-operative follow-up period was uneventful.

Conclusions

The management of pancreas divisum can be conservative. We present an optimal pattern of Roux-en-Y hepaticojejunostomy to deal with pancreaticobiliary maljunction associated with intestinal malrotation.
Stakeholder dialogue on dilemmas at work as a workplace health promotion intervention including employees with a low SEP: a Responsive Evaluation
Authors: van Heijster Hanneke , van Berkel Jantien , Boot Cécile R. L. , Abma Tineke , de Vet Emely
Published: February 2022

Background

The aim of this study was to evaluate the perceived changes of an innovative workplace health promotion intervention and evaluation. In this study, a bottom-up approach was taken to define the central themes and relevant outcomes of an intervention. These central themes and relevant outcomes of the intervention were defined together with stakeholders, including employees with a low socioeconomic position.

Methods

The intervention consisted of a series of structured stakeholder dialogues in which dilemmas around the – by employees defined —health themes were discussed. The intervention was implemented in a harbor service provider with approximately 400 employees. Over a two-year period, 57 participants engaged in eight dialogues of one hour. 15 interviews and six participant observations took place for the evaluation of the intervention.

Results

Together with the stakeholders, high workload and mental health were defined as central themes for the dialogue intervention in the male-dominated workplace. The dialogue intervention contributed to changes, on different levels: individual, team, and organization. Overall, the stakeholder dialogues advanced the understanding of factors contributing to high workload and mental health. In reply to this, several actions were taken on a organizational level.

Conclusions

Taking a bottom-up approach in WHP allows to understand the health issues that are important in the daily reality of employees with a low socioeconomic position. Through this understanding, workplace health promotion can become more suitable and relevant for employees with a low socioeconomic position.

Trial registration

Netherlands Trial Register (NRT): NL8051. Registration date: 28/09/2019, Retrospectively registered https://www.trialregister.nl
Use of the 95-degree angled blade plate with biological and mechanical augmentation to treat proximal femur non-unions: a case series
Authors: Vicenti Giovanni , Solarino Giuseppe , Bizzoca Davide , Simone Filippo , Maccagnano Giuseppe , Zavattini Giacomo , Ottaviani Guglielmo , Carrozzo Massimiliano , Buono Claudio , Zaccari Domenico , Moretti Biagio
Published: February 2022

Background

Intertrochanteric and subtrochanteric non-union are rare but challenging complications. In the present study, we investigate the use of a 95° blade, in association with biological and mechanical augmentation, in the management of intertrochanteric and subtrochanteric femoral non-unions.

Methods

Between October 2015 and February 2021, a retrospective cohort study was conducted at our institution to investigate the use of a 95° blade, in association with biological and mechanical augmentation, in the management of intertrochanteric and subtrochanteric femoral non-unions, following the mechanical failure of the first device. All the patients underwent a clinical and radiographic follow-up at 6 weeks, 3, 6, 9, 12 and 18 months; at each follow-up, a plain radiograph of the femur was performed and patients were assessed using Harris Hip Score (HHS) and the Short Form-12 (SF-12) questionnaire.

Results

From October 2015 and February 2021, 40 proximal femur non-unions were managed at our Institution. Fifteen patients out of forty (37.5%) met the inclusion criteria. The main data of the study are summarized in Table 1; patients’ mean was 57 years old (range 19–83); 10 males and 5 females were included in the study. All the patients completely healed clinically and radiologically at an average of 6.1 months (range 4–13). All these patients returned to their pre-injury mobility status. During an average follow-up period of 25 months (range 8–60), the observed complications included wound dehiscence, which was treated with a superficial surgical debridement, a below-the-knee deep vein thrombosis, and a blade plate failure 3 months after the first revision surgery.

Conclusions

This study shows the treatment of inter-and sub-trochanteric non-unions with a 95° blade plate, medial strut allograft, and bone autograft obtained with RIA system, together with a varus malalignment correction, leads to a high percentage of bone healing, with a low incidence of complications and good clinical outcome.
The relationship between S1 screw loosening and postoperative outcome in patients with degenerative lumbar scoliosis
Authors: Xu Fei , Zhou Siyu , Zou Da , Li Weishi , Sun Zhuoran , Jiang Shuai
Published: February 2022

Background

When choosing S1 as the lowest level of instrumentation, there are many complications may come out such as S1 screw loosening. Facing this problem, there has been various techniques for the protection of S1 screw including sacropelvic fixation, bicortical or tricortical insertion of S1 screw.

Objective

This study aimed to explore the risk factors for the S1 screw loosening, then to demonstrate the relationship between S1 screw loosening and postoperative outcome for patients with degenerative lumbar scoliosis (DLS).

Methods

Patients who underwent lumbosacral fixation for DLS were evaluated retrospectively. They were divided into two groups according to the S1 pedicle screw at the follow-up. Age, gender, bone mineral density, body mass index, history of smoking, the number of instrumented levels, comorbidities, complications and radiological parameters were collected. We established logistic regression analysis to determine independent risk factors for S1 screw loosening and multiple linear regression to identify whether S1 screw loosening would influence postoperative clinical outcome.

Results

S1 screw loosening rate was up to 41.0% (32/78). Patients were older in the S1 screw loosening group than those in the control group (P < 0.05). Compared with the control group, the rate of osteoporosis was higher in screw loosening group than that in the control group (P < 0.05). Older age and osteoporosis were independent risk factors for S1 screw loosening (P < 0.05). In the screw loosening group, the rate of hypertension was higher than that in the control group (P < 0.05). The relationship of S1 screw loosening and ODI was not significant in the multiple linear regression (P > 0.05). The clinical outcome was similar in the S1 screw loosening group and control group (P > 0.05).

Conclusion

Older age and osteoporosis are independent risk factors for the S1 screw loosening. Patients with complication of S1 screw loosening are not always along with worse clinical outcome. We should consider potential benefit, complications and medical cost when choosing the lowest instrumented vertebrae for patients with DLS.
Extract of Corallodiscus flabellata attenuates renal fibrosis in SAMP8 mice via the Wnt/β-catenin/RAS signaling pathway
Authors: Cao Bing , Zeng Mengnan , Si Yanpo , Zhang Beibei , Wang Yangyang , Xu Ruiqi , Huang Yanjie , Feng Weisheng , Zheng Xiaoke
Published: February 2022

Background

Fibrosis is one of the most common pathological features of the aging process of the kidney, and fibrosis in aging kidneys also aggravates the process of chronic kidney disease (CKD). Corallodiscus flabellata B. L. Burtt (C. flabellata, CF) is a commonly used botanical drug in Chinese folklore. However, few studies have reported its pharmacological effects. This study aimed to explore the effect of CF ethanol extract on renal fibrosis in SAMP8 mice and identify potentially active compounds.

Methods

Senescence-accelerated mouse-prone 8 (SAMP8) were used as animal models, and different doses of CF were given by gavage for one month. To observe the degree of renal aging in mice using β-galactosidase staining. Masson staining and the expression levels of Col-I, α-SMA, and FN were used to evaluate the renal fibrosis in mice. The protein expression levels of Nrf2 pathway and Wnt/β-catenin/RAS pathway in the kidney were measured. And β-galactosidase (β-gal) induced NRK-52E cells as an in vitro model to screen the active components of CF.

Results

The CF ethanol extract significantly inhibited the activity of renal β-galactosidase and the expression levels of Col-I, α-SMA, and FN in SAMP8 mice, and improved Masson staining in SAMP8 mice. CF remarkably reduced urinary protein, creatinine, urea nitrogen and serum levels of TNF-α and IL-1β in SAMP8 mice, and significantly increased the levels of SOD and GSH-Px. Moreover, CF activated the Nrf2 pathway and blocked the Wnt/β-catenin/RAS pathway in the kidneys of mice. Besides, 3,4-dihydroxyphenylethanol (SDC-0-14, 16) and (3,4-dihydroxyphenylethanol-8-O-[4-O-trans-caffeoyl-β-D-apiofuranosyl-(1→3)-β-D-glucopyranosyl (1→6)]-β-D-glucopyranoside (SDC-1-8) were isolated from CF, which reduced the senescence of NRK-52E cells, and maybe the active ingredients of CF playing the anti-aging role.

Conclusions

Our experiments illuminated that CF ethanol extract may ameliorate renal fibrosis in SAMP8 mice via the Wnt/β-catenin/RAS pathway. And SDC-0-14,16 and SDC-1-8 may be the material basis for CF to exert anti-renal senescence-related effects.
Cost-effectiveness of comprehensive preventive measures for coal workers’ pneumoconiosis in China
Authors: Ge Xiaoyan , Cui Kai , Ma Honglin , Zhao Siqi , Meng Weihan , Wang Wenbo
Published: February 2022

Background

Coal workers’ pneumoconiosis (CWP) remains one of the most severe occupational diseases in China. Despite the implementation of CWP comprehensive preventive measures, the unreasonable allocation of investment by coal enterprises limits the effect of preventing CWP, especially when the health resources are inadequate. This study aims to evaluate the cost-effectiveness of comprehensive measures for CWP from the perspective of coal enterprises.

Methods

Comprehensive measures and two primary interventions (engineering controls and individual protective equipment) were selected. A time-dependent Markov model was developed to evaluate cost and quality-adjusted life-years (QALYs). The input data were collected from the survey and literature. A hypothetical null situation, in which the currently implemented interventions were eliminated, was used as a comparator based on the generalised cost-effectiveness analysis (GCEA) recommended by the World Health Organization (WHO). The primary outcomes of the model were reported in terms of incremental cost-effectiveness ratios (ICERs). Uncertainty was verified using one-way and probabilistic sensitivity analyses.

Results

The QALYs of the comprehensive measures, engineering controls, and individual protective equipment were 17.60, 17.50, and 16.85 years, respectively. Compared with null, the ICERs of the interventions were 65,044.73, 30,865.15, and 86,952.41 RMB/QALY, respectively. Individual protective equipment was dominated by an ICER of -11,416.02 RMB/QALY compared to engineering controls. Sensitivity analysis suggested the robustness of the results.

Conclusions

The comprehensive preventive measures for CWP that are currently implemented in Chinese state-owned mines are cost-effective. In comprehensive measures, engineering controls are more cost-effective than individual protective equipment. Investment in engineering controls should be increased to improve the cost-effectiveness of preventing CWP.
Risk/benefit tradeoff of habitual physical activity and air pollution on chronic pulmonary obstructive disease: findings from a large prospective cohort study
Authors: Chen Lan , Cai Miao , Li Haitao , Wang Xiaojie , Tian Fei , Wu Yinglin , Zhang Zilong , Lin Hualiang
Published: February 2022

Background

The combined health impact of physical activity (PA) and air pollution on chronic obstructive pulmonary disease (COPD) remains unclear. We investigated the joint effects of habitual PA and long-term fine particulate matter (PM2.5) exposure on COPD incidence in a prospective population-based cohort.

Methods

A prospective cohort study was conducted using data from the UK Biobank. Incidence of COPD was ascertained through linkage to the UK National Health Services register. Annual mean PM2.5 concentration was obtained using land use regression model. PA was measured by questionnaire and wrist-worn accelerometer. Cox proportional hazard models were applied to examine the associations between PM2.5, PA, and COPD. Additive and multiplicative interactions were examined.

Results

A total of 266,280 participants free of COPD at baseline were included in data analysis with an average follow-up of 10.64 years, contributing to around 2.8 million person-years. Compared with participants with low level of PA, those with higher PA levels had lower risks of COPD incidence [hazard ratio (HR): 0.769, 95% CI: 0.720, 0.820 for moderate level; HR: 0.726, 95% CI: 0.679, 0.776 for high level]. By contrast, PM2.5 was associated with increased risk of COPD (HR per interquartile range increment: 1.065, 95% CI: 1.032, 1.099). Limited evidence of interaction between habitual PA and PM2.5 exposure was found. Similar results were found for accelerometer-measured PA.

Conclusions

Our study suggests that habitual PA could reduce risk of COPD incidence, and such protective effects were not affected by ambient PM2.5 pollution exposure.
Splicing factor derived circular RNA circCAMSAP1 accelerates nasopharyngeal carcinoma tumorigenesis via a SERPINH1/c-Myc positive feedback loop
Authors: Wang Yian , Yan Qijia , Mo Yongzhen , Liu Yuhang , Wang Yumin , Zhang Shanshan , Guo Can , Wang Fuyan , Li Guiyuan , Zeng Zhaoyang , Xiong Wei
Published: February 2022

Background

Circular RNAs play an important role in tumor genesis and progression, but they have not been sufficiently studied in patients with nasopharyngeal carcinoma (NPC).

Methods

The circular RNA,circCAMSAP1,was screened in NPC cells by RNA sequencing analysis. The expression ofcircCAMSAP1in NPC tissues was examined by real-time quantitative polymerase chain reaction (RT-qPCR) and in situ hybridization. Wound-healing, transwell, MTT and flow cytometry assays, and nude mouse tumor models were used to explore the effect ofcircCAMSAP1on proliferation and metastasis of NPC in vitro or in vivo. The downstream proteins regulated bycircCAMSAP1were screened using mass spectrometry. The interaction betweencircCAMSAP1and theSERPINH1mRNA was identified using the circular RNA immunoprecipitation method and the luciferase reporter assay. The interaction between SERPINH1 and transcription factor c-Myc was verified through Co-immunoprecipitation (Co-IP) and immunofluorescence. The effect of c-Myc on the generation ofcircCAMSAP1was examined through RT-qPCR and chromatin immunoprecipitation. Finally, the splicing factors that promote the production ofcircCAMSAP1were explored by RT-qPCR and RNA immunoprecipitation (RIP).

Results

We found thatcircCAMSAP1was highly expressed in NPC tissues and promoted NPC proliferation and metastasis. Additionally,circCAMSAP1promoted SERPINH1 expression through improvedSERPINH1mRNA stability by binding to the 3′-untranslated region (3’UTR) ofSERPINH1. Highly expressed SERPINH1 reduced the ubiquitination-degradation rate of c-Myc, causing increased tumorigenesis. Meanwhile, c-Myc, cooperating with splicing factor 10 (SRSF10), could also promoteCAMSAP1pre-mRNA transcription and back-splicing, forming a positive feedback ofcircCAMSAP1production, resulting in the proliferation and metastasis of NPC.

Conclusions

Our findings revealed thatcircCAMSAP1promotes NPC proliferation and metastasis by binding to the 3’UTR ofSERPINH1, suggesting that the positive feedback ofcircCAMSAP1-SERPINH1-c-Myc may serve as a prognostic biomarker or therapeutic target in patients with NPC.
The neurovascular unit in leukodystrophies: towards solving the puzzle
Authors: Zarekiani Parand , Nogueira Pinto Henrique , Hol Elly M. , Bugiani Marianna , de Vries Helga E.
Published: February 2022

The neurovascular unit (NVU) is a highly organized multicellular system localized in the brain, formed by neuronal, glial (astrocytes, oligodendrocytes, and microglia) and vascular (endothelial cells and pericytes) cells. The blood–brain barrier, a complex and dynamic endothelial cell barrier in the brain microvasculature that separates the blood from the brain parenchyma, is a component of the NVU. In a variety of neurological disorders, including Alzheimer’s disease, multiple sclerosis, and stroke, dysfunctions of the NVU occurs. There is, however, a lack of knowledge regarding the NVU function in leukodystrophies, which are rare monogenic disorders that primarily affect the white matter. Since leukodystrophies are rare diseases, human brain tissue availability is scarce and representative animal models that significantly recapitulate the disease are difficult to develop. The introduction of human induced pluripotent stem cells (hiPSC) now makes it possible to surpass these limitations while maintaining the ability to work in a biologically relevant human context and safeguarding the genetic background of the patient. This review aims to provide further insights into the NVU functioning in leukodystrophies, with a special focus on iPSC-derived models that can be used to dissect neurovascular pathophysiology in these diseases.