bluuebunny/crossref_metadata_2025 huggingface dataset:
Iron increases the profibrotic properties of the senescent peritoneal mesothelial cells
Authors: Breborowicz Andrzej
Published: August 2023

Background:

Treatment of anemia in peritoneal dialysis patients often requires intravenous iron supplementation. Iron diffuses into the peritoneal cavity and is injurious to the peritoneum. We studied how intermittent exposure to iron changes the properties of the senescent peritoneal mesothelial cells (MC).

Methods:

Replicative senescence was induced in MC in control medium (Con) or in control medium with intermittent exposure to iron isomaltoside 15 µg/dL (Con-IIS). After 10 passages properties of MC from both groups were compared to MC not exposed to replicative senescence.

Results:

In senescent MC population doubling time was elongated, intracellular generation of free radicals and staining for β-galactosidase was stronger than in MC not exposed to replicative senescence. All these effects were stronger in MC intermittently exposed to IIS. In these cells intracellular iron content was also higher. Also expression of genes p21 and p53 was stronger in MC intermittently treated with IIS. In senescent cells higher release and expression of IL6 and TGFβ1 was observed and that effect was stronger in MC treated with iron. Senescent MC had reduced fibrinolytic activity, what may predispose to the peritoneal fibrosis. Synthesis of collagen was higher in senescent cells, more in MC treated with iron.

Conclusion:

MC aging results in change of their genotype and phenotype which lead to their profibrotic effect. Exposure to iron enhances these changes.
Examining the Psychometric Properties of the Revised Scale of Economic Abuse among Iranian Women
Authors: Salimi Hadi , Hosseinkhani Ali , Beeble Marisa L. , Samavi S. Abdolvahab
Published: August 2023

Economic abuse, in the context of intimate relationships, is a pervasive form of violence that merits further empirical attention. We know from limited research that the rates of economic abuse appear to be high in Iran; however, there is a lack of culturally appropriate measures that can assess the extent to which women experience economic harm as a result of their partners’ actions. The present study was conducted with the aims of (a) investigating the psychometric properties of the 14-item Revised Scale of Economic Abuse (SEA2) which was translated into Persian for this study and (b) examining the prevalence of economic abuse among a sample of 371 married housewives in Qazvin, Iran. Confirmatory factor analysis supports the two-factor structure of the SEA2, with the exception of one item. Composite reliability and Cronbach’s alpha demonstrated good internal consistency. The average variance extracted method, along with correlations with other financial variables, demonstrated evidence of good convergent validity. Correlations with related, but distinct forms of abuse, support the scale’s discriminant validity. Based on the collective findings, this measure can be used as a reliable and valid tool to study economic abuse among Iranian women which, within our sample, appears to be a common phenomenon. Implications for future research and practice are discussed.
Unraveling the Links among Witnessing Interparental Conflict, Hopelessness, Psychological Dating Violence Victimization, and Adult Depressive Symptoms
Authors: Özkan Hande , Öztemür Gizem , Toplu-Demirtaş Ezgi , Fincham Frank D.
Published: August 2023

Witnessing interparental conflict in childhood predicts psychological dating violence victimization (PDVV) in adulthood. As found in previous studies, PDVV and hopelessness are associated with depression. However, the associations among these four variables have not been explored in detail. The present study, therefore, examined the association between perceived interparental conflict and depression in adulthood and whether PDVV and hopelessness might operate as sequential mechanisms accounting for the association. Participants ( N = 283; Mage = 23.37 years, SD = 4.04 years) in romantic relationships completed measures of perceived interparental conflict, PDVV, hopelessness, and depression. The perceived interparental conflict was related to PDVV and depression but not to hopelessness in adulthood. Moreover, the association between witnessing interparental conflict and depression was serially mediated via PDVV and hopelessness. The results are discussed in regard to previous research, and their implications for future research are presented.
2,5-Tetrahydrofurandimethanol as a sustainable comonomer for modification of polyethylene terephthalate: Liter-level pilot test and non-isothermal crystallization kinetics
Authors: Liu Yang , Zheng Bing , Chen Zhiwei , Pu Xinmin , Zhang Shunhua
Published: August 2023

2,5-tetrahydrofurandimethanol (THFDM), which is an alicyclic diol in products of 5-hydroxymethylfurfural (HMF), is a sustainable monomer to protect environment for replacing the role of isophthalic acid (IPA) and 1,4-cyclohexanedimethanol (CHDM) which were optimized polyethylene terephthalate (PET) performance. By direct esterification method, poly (ethylene-co-tetrahydrofurandimethanol terephthalate) (PETT) was synthesized in 2.5 L reactor. The results showed that the contents of THFDM in copolyester were less than that feeding ratio attributed to its lower reaction reactivity. The color of PETT slightly turned yellow. PETT performed broader processing temperature window, while Tg maintained in good range because of the cyclic structure of THFDM. Especially, the cold crystallization occured in PETT but not in PET after finishing melt crystallization. Otherwise, the thermal stability and crystal structure of PETT remained the same as PET. The crystallization activity of PETT became significantly lower than PET. What proved THFDM was effective in reducing PET crystallinity was that crystallization kinetics using Jeziorny theory and the trend of activation energy of melt crystallization which was calculated by Friedman method. And PETT-2 fibre had comparable mechanical property to PET fibre. In the advancement of green chemistry, THFDM has added a choice of cyclic bio-based comonomers.
Neurologic Examination Facilitated by Reversal of Rocuronium with Sugammadex
Authors: Falksen Jessica A. , Schomer Kendra J.
Published: August 2023

Background: Patients with neurologic injuries often receive neuromuscular blocking agents to facilitate airway management. The urgent nature of intubation may result in paralytic administration prior to neurologic examination, delaying clinical assessment, prognostication, and surgical interventions. Objective: In October 2018, an institutional guideline was implemented to extend institutional sugammadex use to include patients with uncertain neurologic examinations with recent rocuronium administration. The guideline allowed for a dose range of 2 mg/kg to 16 mg/kg. The objective of this continuous quality improvement project was to describe the use of sugammadex after implementation of an institutional guideline. Methods: Patient records between October 2018 and March 2020 were reviewed for guideline adherence and outcomes. Information assessed included patient weight, injury mechanism, the dosage and timing of rocuronium and sugammadex administration, and neurologic examination findings. Descriptive statistics were used to assess outcomes. Results: During the study period, eleven patients received sugammadex to facilitate neurologic examinations. The most common dose of sugammadex was 4 mg/kg with a mean total dose of 498.4 ± 333.5 mg. The mean time between rocuronium and sugammadex administration was 73.9 ± 41 minutes. Most patients (72.7%) had definitive changes in neurologic examination after sugammadex administration. Five patients had neurosurgical interventions offered and performed, with 1 of the patients surviving. Conclusions: This case series suggests that sugammadex is useful for reversing rocuronium induced paralysis to facilitate neurologic examination needed to determine management strategies for patients with a neurologic injury.
Remembering Diana Scully and the Art of a Well-Asked Question
Authors: Campbell Rebecca
Published: August 2023

Professor Diana Scully changed the landscape of sexual violence research with her ground-breaking 1980 study of convicted rapists. Dr. Scully and her colleague, Dr. Joseph Marolla, interviewed 114 imprisoned convicted rapists to understand what rapists gain from sexual aggression and violence. This memorial paper examines this foundational study and its longstanding theoretical and methodological contributions to the field of sexual violence research.
Affective Dynamics and Young Women’s Sexual Subjectivity: The Case Study of the Israeli Practice of “Attacking”
Authors: Herz Rachel Levi , Rozmarin Miri
Published: August 2023

Although young women’s sexual body is often objectified by cultural practices, analysis of their affective responses highlights various possibilities of sexual subjectification. This paper uses the case study of “attacking”—a common Israeli heterosexual practice—to address the emergence of young women’s sexual subjectivity, using affect theory to reveal the gap between affective responses, self-perceptions, and the perceived normativity of the practice. We address vulnerability as an affective pattern of the encounter of bodies with power formations, which also enables transformation. Drawing on interviews with 39 young Israeli women, we demonstrate how “attacking” evokes affective dissonance that illuminates their need to negotiate social meanings and self-perceptions, revealing new forms of collectivity and action that enable sexual expression even when facing vulnerability. This approach challenges the objectification–subjectification dichotomy and expands theorization beyond the focus on autonomy and control of sexual pleasure.
Optimal nonlinear polynomial control of a quarter-vehicle suspension system under harmonic and random road excitations
Authors: Gu Xudong , Zhao Bingxin , Liu Yuhao
Published: August 2023

The present paper proposes an optimal polynomial control strategy for a quarter-vehicle suspension system based on dynamic programming. The optimal control objective is to decrease the responses of sprung mass acceleration, suspension deformation and road excitation, which are reflected in the performance index. The optimal control force is obtained through the principle of dynamic programming, and the form of the optimal control force mainly depends on the form of the cost function. The optimal nonlinear polynomial control (NPC) force is derived by selecting the cost function in polynomial form. The linear feedback matrix and nonlinear feedback matrix in the NPC force are determined by the Riccati equation and Lyapunov equation, respectively. The root mean square (RMS) responses of the sprung mass acceleration, suspension deformation and road load of driving vehicles under deterministic and random road surfaces are calculated. The numerical results showed that the proposed NPC strategy has a better control effect over the traditional linear quadratic regulator (LQR), especially on the peak reduction of sprung mass acceleration. Finally, the optimal control force is divided into active control force and passive control force. The energy input of the optimal control force can be reduced by only inputting the active control force.
Modeling and control of the linear actuator for the lower limb rehabilitation device
Authors: Dao Minh Duc
Published: August 2023

In recent years, the number of stroke patients has increased, which has led to an increased need for motor rehabilitation exercises. The application of automation devices in the rehabilitation of patients is becoming increasingly developed. These devices help reduce the patient training time and workload. Each type of equipment uses different actuators such as electric motors, pneumatic cylinders, and hydraulic cylinders. Different from previous studies, in this paper, a research model of lower extremity rehabilitation devices using a simple actuator which is a linear actuator is presented. The main contribution of this study is that a dynamic model of the linear actuator associated with the action dynamics of the lower extremities of the studied model with three degrees of freedom was established. A mathematical model for this actuator is also presented, simulating the response of the mechanism using the MATLAB/Simulink software. A lower extremity rehabilitation device using a linear actuator was manufactured and tested. The test results for 10 volunteers show that the actuator works and causes miniature angle errors. This experiment demonstrates that the linear actuator can be used in stroke patient rehabilitation equipment and contributes to the diversification of the mechanism in automation equipment.
An Active-Inference Approach to Second-Person Neuroscience
Authors: Lehmann Konrad , Bolis Dimitris , Friston Karl J. , Schilbach Leonhard , Ramstead Maxwell J. D. , Kanske Philipp
Published: August 2023

Social neuroscience has often been criticized for approaching the investigation of the neural processes that enable social interaction and cognition from a passive, detached, third-person perspective, without involving any real-time social interaction. With the emergence of second-person neuroscience, investigators have uncovered the unique complexity of neural-activation patterns in actual, real-time interaction. Social cognition that occurs during social interaction is fundamentally different from that unfolding during social observation. However, it remains unclear how the neural correlates of social interaction are to be interpreted. Here, we leverage the active-inference framework to shed light on the mechanisms at play during social interaction in second-person neuroscience studies. Specifically, we show how counterfactually rich mutual predictions, real-time bodily adaptation, and policy selection explain activation in components of the default mode, salience, and frontoparietal networks of the brain, as well as in the basal ganglia. We further argue that these processes constitute the crucial neural processes that underwrite bona fide social interaction. By placing the experimental approach of second-person neuroscience on the theoretical foundation of the active-inference framework, we inform the field of social neuroscience about the mechanisms of real-life interactions. We thereby contribute to the theoretical foundations of empirical second-person neuroscience.
A complex network analysis of local and non-local tourist flows in Beijing through mobile phone data
Authors: Xiao Yang , Wang Hang , Miao Siyu , Xie Bo
Published: August 2023

Tourism flow is the foundation of tourism development, and studying tourist flows is one of the most important aspects of tourism research. This paper examines tourist flows among A-level scenic spots in Beijing, focusing on local and non-local tourists, utilizing mobile phone data received from Unicom. The research comprises tourist flow distribution characteristics, centrality analysis, community detection, and analysis of affecting factors. The key findings of the study are that tourist distribution is unequal between scenic spots, with non-local tourists having a more concentrated distribution than local tourists. The impact of transport and scenic spot category and level are assessed and tourism links between scenic spots frequented by local tourists and non-local tourists are shown to require different tourism management approaches.
Corporate Governance in Family Firms: A Bibliometric Analysis
Authors: Duhoon Anshu , Singh Mohinder
Published: August 2023

Like other business forms, corporate governance is a matter of concern for family firms as well. The objective of the work is to study the corporate governance practices of family-owned firms using bibliometric analysis of existing literature. With the help of VOSviewer & Biblioshiny Software, an attempt has been made to develop the visualization patterns based on academic publications growth, most influential authors, country, keyword occurrences, thematic map and co-authorship network. Based on 435 studies conducted during the selected period, the study found the maximum work has been done in the USA followed by Italy, Spain, China and UK, and Anderson and Reeb (2003) is the most cited work in this area. The main focus of prominent studies was on assessing the impact of family ownership on a firm’s performance, and there is unanimity that family firms’ CEOs devote more time and effort to preserve socio-economic wealth, have fewer forecasting errors and perform better. Though ‘corporate strategy’ and ‘governance approach’ are key concepts in family businesses yet it is a less explored areas. Thiss article provides an overview of how the literature on corporate governance and family firms has evolved and a synopsis of the most influential authors, most productive countries, co-word analysis and themes clustering. This study provides a thorough coverage of the existing literature on family governance mechanisms and is helpful for new researchers who want to understand this concept and also for those who are looking to explore new directions in the same field.
Comparison of the effects of one-level and bi-level pre-incisional erector spinae plane block on postoperative acute pain in video-assisted thoracoscopic surgery; a prospective, randomized, double-blind trial
Authors: Zengin Emine Nilgün , Zengin Musa , Yiğit Hülya , Sazak Hilal , Şekerci Sumru , Alagöz Ali
Published: August 2023

Background

This prospective, randomized, double-blind trial aimed to compare the postoperative analgesic efficacy of One-Level pre-incisional erector spinae plane block (ESPB) and Bi-Level pre-incisional ESPB in patients undergoing video-assisted thoracic surgery (VATS).

Methods

This pilot trial was conducted between April 2022 and February 2023 with sixty patients. The patients were randomly divided into two groups. In One-Level ESPB Group (n = 30) block was performed at the thoracal(T)5 level with the 30 ml 0.25% bupivacaine. In the Bi-Level ESPB Group (n = 30) block was performed at T4 and T6 levels by using 15 ml of 0.25% bupivacaine for each level. In the postoperative period, 50 mg dexketoprofen every 12 h and 1 g paracetamol every 8 h were given intravenously (IV). Patient-controlled analgesia (PCA) prepared with morphine was applied to the patients. 0.5 mg/kg of tramadol was administered via IV for rescue analgesia. Visual analog scale (VAS) scores were recorded in the postoperative 1st, 2nd, 4th, 12th, 24th, and 48th -hours. The need for additional analgesics and side effects were recorded. In two groups, patients’ demographics and postoperative hemodynamic data were recorded.

Results

VAS scores at resting were statistically significantly higher at the 1st (p: 0.002) and 4th -hour (p: 0.001) in the One-Level ESPB. When the groups were evaluated in terms of VAS coughing scores, the 4th -hour (p: 0.001) VAS coughing scores results were found to be statistically significantly higher in the One-Level ESPB group. In terms of VAS values evaluated during follow-up, the rates of VAS coughing score > 3 values were found to be statistically significantly lower in the Bi-Level ESPB group (p: 0.011). There was no statistically significant difference between the groups in terms of side effects, morphine consumption, and additional analgesic use (p > 0.05).

Conclusions

Adequate analgesia was achieved in the early postoperative period in the group treated with Bi-Level ESPB with similar morphine consumption and side effects. This may be an advantage, especially in the early postoperative period when the pain is quite intense.
Lifeday coverage of oral anticoagulants and one-year relative survival in patients with atrial fibrillation: a population-based study in Estonia
Authors: Pauklin Priit , Marandi Toomas , Kals Mart , Ainla Tiia , Martinson Katrin , Eha Jaan , Kampus Priit
Published: August 2023

Background

Routine oral anticoagulation (OAC) is recommended for almost all high-risk patients with atrial fibrillation, yet registries show that OACs are still underused. Our aim was to study the lifeday coverage (LDC) of OAC prescriptions and its relationship with one-year mortality rates of AF patients aged ≥ 65 in Estonia for the years 2019 and 2020.

Methods

Medical data for AF patients aged ≥ 65 years from 2018 and alive as of 01.01.2019 (cohort I) and new AF documentation from 2019 and alive as of 01.01.2020 (cohort II) was obtained from the Health Insurance Fund’s electronic database. The data was linked to the nationwide Estonian Medical Prescription Centre’s database of prescribed OACs. For LDC analysis, daily doses of guideline-recommended OACs were used. The patients were categorized into three LDC groups: 0%, 1–79%, and ≥ 80%. The data was linked to the Estonian Causes of Death Registry to establish the date of death and mortality rate for the whole Estonian population aged ≥ 65.

Results

There were 34,018 patients in cohort I and 9,175 patients with new AF documentation (cohort II), previously not included in cohort I. Of the patients, 77.7% and 68.6% had at least one prescription of OAC in cohorts I and II respectively. 57.4% in cohort I and 44.5% in cohort II had an LDC of ≥ 80%. The relative survival estimates at 1 year for LDC lifeday coverage groups 0%, 1–79%, and ≥ 80% were 91.2%, 98.2%, and 98.5% (cohort I), and 91.9%, 95.2%, and 97.6% (cohort II), respectively.

Conclusions

Despite clear indications for OAC use, LDC is still insufficient and anticoagulation is underused for stroke prevention in Estonia. Further education of the medical community and patients is needed to achieve higher lifeday coverage of prescribed OACs.
Genetically predicted effects of physical activity and sedentary behavior on myasthenia gravis: evidence from mendelian randomization study
Authors: Li Jiao , Wang Fei , Zhang Chen , Li Zhen , Gao Juan , Liu Haijie
Published: August 2023

Background

Myasthenia gravis (MG) is an autoimmune disorder affecting the neuromuscular junction. Despite the potential benefits of higher physical activity and lower sedentary behavior in MG patients, evidence from observational studies for the effect of physical activity on the risk of MG is limited and inconclusive.

Methods

We employed linkage disequilibrium score (LDSC) regression, two-sample Mendelian randomization (MR), and its multivariable extension analyses (MVMR) to assess the relationship between leisure screen time (LST), moderate-to-vigorous intensity physical activity during leisure time (MVPA) and the risk of MG using genome-wide association studies (GWAS) summary datasets. MR analyses were performed using the inverse-variance-weighted (IVW), weighted-median, and MR-Egger regression. Sensitivity analyses were further performed using alternative instruments to test the robustness of our findings.

Results

We found evidence of genetic overlap between LST (rg = 0.113, P = 0.023) and MG, as well as between MVPA (rg=-0.220, P = 0.0001) and MG, using LDSC method. The results of the MR suggested an association between genetic liability to LST and increased risk of MG (IVW OR = 1.609, 95% CI = 1.153 to 2.244; P = 0.005). This association was particularly notable for late-onset MG (IVW OR = 1.698, 95% CI = 1.145 to 2.518; P = 0.008), but not for early-onset MG. Consistent findings were obtained in the MVMR analysis using BMI as covariate (IVW OR = 1.593, 95% CI 1.167 to 2.173, P = 0.003). However, the MR analysis does not support a substantial causal effect of MVPA on the risk of MG.

Conclusion

Our findings support a causal effect of sedentary behavior as measured by LST on MG, indicating that lack of exercise may play a role in the development of MG. Longitudinal and interventional studies of this association are warranted.
The “island sign” on diffusion-weighted imaging predicts early neurological deterioration in penetrating artery territory infarctions: a retrospective study
Authors: Yang Yang , Si Zhihua , Wang Dawei , Dong Dong , Liu Rutao , Yu Xianwen , Tang Jiyou , Wang Aihua
Published: August 2023

Background

Early neurological deterioration (END) sometimes occurs in patients with penetrating artery territory infarction (PATI) and leads to poor prognosis. In this study, we analyzed clinical and neuroimaging characteristics of PATI, and focused on the infarct patterns on diffusion-weighted imaging (DWI). We tried to investigate whether the “island sign” pattern is associated with END.

Methods

We enrolled consecutive patients admitted with acute PATI within 48 h after onset from May 2020 to July 2022. They were divided into with and without the “island sign” pattern on DWI. According to infarct location, all the patients were classified into two groups: the territories of the lenticulostriate arteries (LSA) and paramedian pontine arteries (PPA). The patients in each group were further divided into two groups according to whether they developed END or not. Through analyzing the clinical and neuroimaging characteristics of the patients, we tried to identify the factors that might associated with the “island sign” pattern and the potential predictors of END within the LSA and PPA groups.

Results

Out of the 113 patients enrolled in this study, END was found in 17 patients (27.9%) in the LSA group and 20 patients (38.5%) in the PPA group. The “island sign” was found in 26 (23%) patients. In the multivariate analysis, the independent predictors of END in the LSA group were the “island sign” (OR 4.88 95% CI 1.03–23.2 P = 0.045) and high initial National Institute of Health Stroke Scale (NIHSS) (OR 1.79 95% CI 1.08–2.98 P = 0.024) and in the PPA group was the presence of lesions extending to the ventral pontine surface (OR 7.53 95% CI 1.75–32.37 P = 0.007).

Conclusions

The predictive factors for END were different in the LSA and PPA groups. The “island sign” was particularly associated with END in the LSA group.
Acceptability of prehabilitation for cancer surgery: a multi-perspective qualitative investigation of patient and ‘clinician’ experiences
Authors: Powell Rachael , Davies Amy , Rowlinson-Groves Kirsty , French David P , Moore John , Merchant Zoe
Published: August 2023

Background

‘Prehabilitation’ interventions aim to enhance individuals’ physical fitness prior to cancer treatment, typically involve exercise training as a key component, and may continue to support physical activity, strength, and fitness during or after treatment. However, uptake of prehabilitation is variable. This study investigated how patients from diverse socio-economic status groups perceived an exemplar prehabilitation and recovery programme, aiming to understand factors impacting acceptability, engagement and referral.

Methods

This research was conducted in the context of the Prehab4Cancer and Recovery Programme, a prehabilitation and recovery programme available across Greater Manchester, UK. Qualitative, semi-structured phone/video-call interviews were conducted with 18 adult patient participants referred to the programme (16 ‘engagers’, 2 ‘non-engagers’; half the sample lived in localities with low socio-economic status scores). An online questionnaire with free-response and categorical-response questions was completed by 24 ‘clinician’ participants involved in referral (nurses, doctors and other staff roles). An inductive, multi-perspective, thematic analysis was performed, structured using the Framework approach.

Results

Discussing and referring patients to prehabilitation can be challenging due to large quantities of information for staff to cover, and for patients to absorb, around the time of diagnosis. The programme was highly valued by both participant groups; the belief that participation would improve recovery seemed a major motivator for engagement, and some ‘clinicians’ felt that prehabilitation should be treated as a routine part of treatment, or extended to support other patient groups. Engagers seemed to appreciate a supportive approach where they did not feel forced to do any activity and tailoring of the programme to meet individual needs and abilities was appreciated. Initial engagement could be daunting, but gaining experience with the programme seemed to increase confidence.

Conclusions

The prehabilitation programme was highly valued by engagers. Introducing prehabilitation at a challenging time means that personalised approaches might be needed to support engagement, or participation could be encouraged at a later time. Strategies to support individuals lacking in confidence, such as buddying, may be valuable.

Study registration

The study protocol was uploaded onto the Open Science Framework 24 September 2020 (https://osf.io/347qj/).
A real-world disproportionality analysis of Rucaparib: Post-marketing Pharmacovigilance Data
Authors: Zhang Qilin , Ding Yiling , Shu Yamin , Chen Jing
Published: August 2023

Background

Rucaparib has been approved for the maintenance treatment of adult patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer. However, the long-term safety of rucaparib in large sample population was unknown. The presented study aimed to evaluate rucaparib-associated adverse events (AEs) according to the real-world pharmacovigilance database.

Methods

Disproportionality analysis was conducted to assess the association between rucaparib and its AEs. Data were collected from the international pharmacovigilance database of US FDA Adverse Event Reporting System (FAERS) between January 2017 and June 2022. The characteristics of rucaparib-related AEs, and the onset time were further analyzed.

Results

A total of 9,296,694 AE reports were recorded in the FAERS during the study period, among which 7,087 reports were associated with rucaparib. About 135 rucaparib-related AE signals in 15 system organ class (SOCs) were identified. The most common AEs included anaemia, thrombocytopenia, nausea, vomiting, fatigue, blood creatinine increase, alanine aminotransferase increase, and aspartate aminotransferase increase, which were listed in the label for rucaparib. Of note, 21 new and unexpected significant AEs that off-label were also found in our study, such as preferred term (PTs) of intestinal obstruction, gastrooesophageal reflux disease, blood iron decreased, dehydration, and hypersomnia. The median onset time of rucaparib-related AEs was 12 days (interquartile range [IQR] 1–62 days), and had early failure types.

Conclusion

Our study demonstrated potential new AEs of rucaparib, and further studies were expected to confirm the results.
Prevalence of lower back pain and its associations with lifestyle behaviors among college students in Saudi Arabia
Authors: Alshehri Mohammed M , Alqhtani Amjad M , Gharawi Shahd H , Sharahily Raghad A , Fathi Wajd A , Alnamy Shahad G , Alothman Shaima A , Alshehri Yasir S. , Alhowimel Ahmed S. , Alqahtani Bader A. , Alenazi Aqeel M.
Published: August 2023

Background

Lower back pain (LBP) is a common musculoskeletal disorder that may affect students’ daily lives. Recent psychological research showed a relevant connection between LBP and multidimensional health. However, the association between LBP and lifestyle behavior has not been established, and improving knowledge in this area may help develop preventive strategies and optimize college students’ quality of life.

Methods

A cross-sectional study of 1420 college students in Saudi Arabia was conducted, and participants who attended Saudi Universities were recruited from May 2021 to November 2021. An established validated online survey assessed LBP, sleep quality, time spent sedentary (sedentary duration), health responsibility, physical activity, nutrition, spiritual growth, interpersonal relationships, and stress management. Generalized Linear Regression was used to assess the associations between LBP severity and lifestyle behaviors after controlling for covariates.

Results

LBP was prevalent among college students from Saudi Arabia. Most of the sample were young (23.81 ± 6.02), and female (83.7%). There were significant differences between students with and without LBP regarding age, BMI, sex, marital status, pain severity, overall lifestyle behavior, health responsibility, physical activity, nutrition, stress management, and global sleep quality. After controlling for age, BMI, sex, and marital status, there were significant associations between pain severity and global sleep quality (ß=0.2, p < .001, CI: 16 to 0.24), and sedentary duration (ß=0.03, p = .01, CI:0.009 to 0.06).

Conclusions

This study helped define the prevalence of LBP in college students in Saudi Arabia and evaluated the association between LBP and lifestyle behaviors. The findings showed that students with higher levels of poor sleep quality or sedentary behavior had higher levels of pain. Promoting sleep quality and reducing sedentary behavior may help establish preventive strategies for LBP in college students.
Folate deficiency may increase the risk for elevated TSH in patients with type 2 diabetes mellitus
Authors: Lin Lin , Du Yushan , Niu Guanyu , Xia Shuangbo , Liu Jufen
Published: August 2023

Background

Type 2 diabetes mellitus (T2DM) and thyroid dysfunction (TD) are two common chronic endocrine disorders that often coexist. Folate deficiency has been reported to be related with the onset and development of T2DM. However, the relationship between folate deficiency and TD remains unclear. This study aims to investigate the association of serum folate with TD in patients with T2DM.

Methods

The study used data on 268 inpatients with T2DM in the Beijing Chao-yang Hospital, Capital Medical University from October 2020 to February 2021. Thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), and serum folate were measured with chemiluminescence immunoassay (CLIA), and folate deficiency was defined as a serum folate concentration < 4.4 ng/mL. Ordinary least squares regression models were used to assess the association of serum folate with TSH concentration. Multivariable logistic regression models were performed to explore the correlation of folate deficiency and the risk for elevated TSH.

Results

15.3% of T2DM patients had TD. Among those patients with TD, 80.5% had elevated TSH. Compared with the normal-TSH and low-TSH groups, the prevalence of folate deficiency was significantly higher in the elevated-TSH group (P < 0.001). Serum folate level was negatively associated with TSH (β=-0.062, 95%CI: -0.112, -0.012). Folate deficiency was associated with the higher risk for elevated TSH in patients with T2DM (OR = 8.562, 95%CI: 3.108, 23.588).

Conclusions

A low serum folate concentration was significantly associated with a higher risk for elevated TSH among T2DM patients.
Understanding competency of nursing students in the course of case-based learning in Cambodia: a convergent mixed method study
Authors: Koto-Shimada Kyoko , Carandang Rogie Royce , Shibanuma Akira , Kiriya Junko , Ong Ken Ing Cherng , Touch Sokneang , Koy Virya , Jimba Masamine
Published: August 2023

Background

In the last decade, nursing education has begun to reform to competency-based education worldwide, including in low-and middle-income countries. Case-Based Learning (CBL), an approach to delivering competency-based education, contributes to acquiring critical thinking competency, problem-solving, higher knowledge, professional value and attitude. However, it needs to be taught in a culturally appropriate manner. In Cambodia, CBL was initiated in a classroom and clinical practicum by faculty and preceptors who graduated from the upgrading course. This study examined the factors associated with the competency level of nursing students, explored the practice and perceptions of teaching–learning activities among students, faculty members and preceptors and assessed the coherence of qualitative and quantitative findings.

Methods

This was a convergent, mixed methods study. Data were collected from eight educational institutions for quantitative and qualitative studies and seven hospitals for qualitative studies. From June to September 2019, a cross-sectional survey of nursing students in the third year of the three-year programme (n = 719), eight focus group discussions (FGDs; n = 55) with 6–8 members and 15 FGDs with faculty (n = 38) and clinical preceptors (n = 37) with 4–7 members were conducted to elicit the teaching–learning experience and perceptions. Multiple linear regression was performed to investigate the factors associated with student competency. Moreover, the study conducted thematic content analysis on the qualitative data. The integrated analysis was presented as side-by-side joint displays.

Results

First, the quantitative and qualitative findings confirmed each other ’s CBL learning experiences. Students had higher levels of nursing competencies if they had CBL experiences, both in the classroom and clinical practicum, both in a group manner. Next, the quantitative and qualitative findings complemented students’ academic satisfaction with the teaching by faculty members and preceptors. Finally, the quantitative and qualitative findings were expanded to explain students’ academic satisfaction with the programme.

Conclusions

The finding of CBL experiences in a group and students’ satisfaction with faculty members’ and preceptors’ teaching improved nursing students’ competency development. Meanwhile, students’ satisfaction with the design and delivery of the educational programme provides implications for policy level to narrow the theory and practice gaps in low- and middle-income countries.
Training the healthcare workforce to support task-shifting and viral hepatitis elimination: a global review of English language online trainings and in-person workshops for management of hepatitis B and C infection
Authors: Corcorran Maria A. , Scott John D. , Naveira Marcelo , Easterbrook Philippa
Published: August 2023

Background

Achieving World Health Organization (WHO) targets for viral hepatitis elimination will require simplification and decentralisation of care, supported through task-shifting and training of non-specialist frontline healthcare workers. To inform development of national health worker trainings in viral hepatitis, we review and summarise available online and workshop trainings for management of hepatitis B virus (HBV) and hepatitis C virus (HCV).

Methods

We performed a systematic search of PubMed, Embase, Web of Science, conference abstracts, and grey literature using Google to identify online and in-person workshop trainings for health workers focused on HBV and/or HCV. Additional trainings were identified through a WHO regional network. We included online trainings written in English and in-person workshops developed for low-and-middle-income countries (LMICs). Available curricula are summarised together with key operational features (e.g. training length, year developed/updated, developing institution) and programmatic features (e.g. content, mechanism for self-assessment, use of clinical case studies).

Results

A total of 30 trainings met our inclusion criteria (10 online trainings; 20 in-person workshops). 50% covered both HBV and HCV, 13% HBV alone and 37% HCV alone. Among online trainings, only 2 (20%) were specifically developed or adapted for LMICs; 70% covered all aspects of hepatitis care, including prevention, assessment, and treatment; 9 (90%) included guidance on when to refer to specialists, and 6 (60%) included modules on management in specific populations (e.g., people who inject drugs [PWID], prisoners, and children). Online trainings used different formats including text-based modules, narrated slide-sets, and interactive web-based modules. Most workshops (95%) were targeted towards non-specialty providers, and 50% were an integral part of a national strategy for viral hepatitis elimination. Workshop length ranged from several hours to multiple sessions over the course of months, and many were part of a blended educational model, which included other opportunities for ongoing learning (e.g., telementorship).

Conclusion

This compendium of online and in-person workshop trainings for HBV and HCV is a useful resource for national hepatitis programmes developing training curricula for non-specialists. Additional online training curricula are needed for use in LMICs, and additional materials are needed to address management challenges in key populations, such as PWID.
Prediction of nonsentinel lymph node metastasis in breast cancer patients based on machine learning
Authors: Xiu Yuting , Jiang Cong , Zhang Shiyuan , Yu Xiao , Qiao Kun , Huang Yuanxi
Published: August 2023

Background

Develop the best machine learning (ML) model to predict nonsentinel lymph node metastases (NSLNM) in breast cancer patients.

Methods

From June 2016 to August 2022, 1005 breast cancer patients were included in this retrospective study. Univariate and multivariate analyses were performed using logistic regression. Six ML models were introduced, and their performance was compared.

Results

NSLNM occurred in 338 (33.6%) of 1005 patients. The best ML model was XGBoost, whose average area under the curve (AUC) based on 10-fold cross-verification was 0.722. It performed better than the nomogram, which was based on logistic regression (AUC: 0.764 vs. 0.706).

Conclusions

The ML model XGBoost can well predict NSLNM in breast cancer patients.
Radiation dose is associated with improved local control for large, but not small, hepatocellular carcinomas
Authors: Amit Uri , Mohiuddin Jahan J , Wojcieszynski Andrzej P , Harton Joanna , Williams Graeme , Manjunath Shwetha , Grandhi Nikhil , Doucette Abigail , Plastaras John P , Metz James M , Ben-Josef Edgar
Published: August 2023

Background

With advances in understanding liver tolerance, conformal techniques, image guidance, and motion management, dose-escalated radiotherapy has become a potential treatment for inoperable hepatocellular carcinoma (HCC). We aimed to evaluate the possible impact of biologically effective dose (BED) on local control and toxicity among patients with HCC.

Methods and materials

Patients treated at our institution from 2009 to 2018 were included in this retrospective analysis if they received definitive-intent radiotherapy with a nominal BED of at least 60 Gy. Patients were stratified into small and large tumors using a cutoff of 5 cm, based on our clinical practice. Toxicity was assessed using ALBI scores and rates of clinical liver function deterioration.

Results

One hundred and twenty-eight patients were included, with a mean follow-up of 16 months. The majority of patients (90.5%) had a good performance status (ECOG 0–1), with Child-Pugh A (66.4%) and ALBI Grade 2 liver function at baseline (55.4%). Twenty (15.6%) patients had a local recurrence in the irradiated field during the follow-up period. Univariate and multivariate Cox proportional hazard analyses showed that only BED significantly predicted local tumor recurrence. Higher BED was associated with improved local control in tumors with equivalent diameters over 5 cm but not in smaller tumors. There was no difference in liver toxicity between the low and high-dose groups.

Conclusions

Higher radiotherapy dose is associated with improved local control in large tumors but not in tumors smaller than 5 cm in diameter. High-dose radiotherapy was not associated with increased liver toxicity.
In primary total hip arthroplasty, the direct anterior approach leads to higher levels of creatine kinase and lower levels of C-reactive protein compared to the posterolateral approach: a propensity score matching analysis of short-term follow-up data
Authors: De Berardinis Luca , Senarighi Marco , Farinelli Luca , Qordja Fjorela , Gallo Alberto , Spezia Marco , Gigante Antonio Pompilio
Published: August 2023

Background

This retrospective study compares the invasiveness of the direct anterior approach (DAA) and the posterolateral approach (PLA) in total hip arthroplasty (THA) by assessing three widely used inflammation-related serum markers in the first ten post-operative days.

Methods

The database of our institution was mined for primary THAs conducted by the DAA or the PLA from February 2020 to June 2022. Demographics and creatine kinase (CK), C-reactive protein (CRP), and white blood cells were compared. Propensity Score Matching (PSM) analysis (1:1 ratio) was conducted based on multiple variables.

Results

PSM analysis yielded 44 pairs of DAA and PLA patients. CK was significantly higher (p < 0.001) in the DAA than in the PLA group on postoperative day (POD) 2, 5 and 10. The POD2, POD5 and POD10 CK/preoperative CK ratio was 12.9, 5.0 and 0.8 in DAA and 8.8, 3.3 and 0.6 in PLA (p = 0.017, p = 0.012 and p = 0.025, respectively). The POD2, POD5 and POD10 CRP/preoperative CRP ratio was 95.1, 65.6 and 22.8 in PLA and 34.7, 23.3 and 8.9 in DAA (p < 0.001, p = 0.002 and p < 0.001, respectively).

Conclusion

PSM analysis of early postoperative CK and CRP values demonstrated that the DAA should be considered as a less stressful approach, not as a muscle-sparing or a minimally invasive THA approach.
Comparative analysis of diabetes risk in patients with obstructive sleep apnea undergoing different treatment approaches
Authors: Shih Nai-Chen , Wei James Cheng-Chung
Published: August 2023

The bidirectional relationship between obstructive sleep apnea (OSA) and diabetes mellitus (DM) has been explored in several studies. O'Connor-Reina et al., published a paper entitled: “Risk of diabetes in patients with sleep apnea: comparison of surgery versus CPAP in a long-term follow-up study” to examine a cohort study comparing the effects of surgery and continuous positive airway pressure (CPAP) on the risk of diabetes in patients with OSA. The study findings suggest that both therapies offer protection against diabetes, with upper airway surgery demonstrating better preventive efficacy than CPAP. However, potential biases and confounding variables should be considered, such as race, ethnicity, socioeconomic factors, BMI, glucose levels, HbA1c values, medication use and healthy dietary habits. Besides using International Classification of Diseases codes, the definition of DM as an outcome can also incorporate specific laboratory indicators and the use of diabetes treatment medications. Furthermore, subgroups analysis defined by demographic variables, such as age, sex, and race is recommended. The limitations of the study also include potentially data omissions due to reliance on electronic medical records from specific healthcare institutions. To enhance research comprehensiveness, alternative data sources and collaborations with additional healthcare institutions are suggested for future investigations.
Functional analysis of 3′-UTR hairpins supports a two-tiered model for posttranscriptional regulation ofMAT2Aby METTL16
Authors: Hunter Olga V. , Ruiz Julio C. , Flaherty Juliana N. , Conrad Nicholas K.
Published: August 2023

S-adenosylmethionine (SAM) is the methyl donor for nearly all cellular methylation events, so cells need to carefully control SAM levels.MAT2Aencodes the only SAM synthetase expressed in the majority of human cells, and its 3′-UTR has six conserved regulatory hairpins (hp1–6) that can be methylated by the N6-methyladenosine methyltransferase METTL16. Hp1 begins 8 nt from the stop codon, whereas hp2–6 are clustered further downstream (∼800 nt). These hairpins have been proposed to regulateMAT2AmRNA levels in response to intracellular SAM levels by regulating intron detention of the last intron ofMAT2Aand by modulating the stability of the fully spliced mRNA. However, a dissection of these two posttranscriptional mechanisms has not been previously reported. Using a modular reporter system, we show that hp1 functions primarily when the detained intron is included in the reporter and when that intron has a suboptimal polypyrimidine tract. In contrast, the hp2–6 cluster modulates mRNA stability independent of the detained intron, although hp1 may make a minor contribution to the regulation of decay as well. Taken with previously published reports, these data support a two-tiered model forMAT2Aposttranscriptional regulation by METTL16 through its interactions with hp1 and hp2–6. In the upstream tier, hp1 and METTL16 controlMAT2Aintron detention, whereas the second tier involves METTL16-dependent methylation of hp2–6 to controlMAT2AmRNA stability. Thus, cells use a similar set of molecular factors to achieve considerable complexity in the posttranscriptional regulation of SAM homeostasis.