bluuebunny/crossref_metadata_2025 huggingface dataset:
Hypoxia-altitude simulation test to predict altitude-related adverse health effects in COPD patients
Authors: Bauer Meret , Müller Julian , Schneider Simon R. , Buenzli Simone , Furian Michael , Ulrich Tanja , Carta Arcangelo F. , Bader Patrick R. , Lichtblau Mona , Taalaibekova Ajian , Raimberdiev Madiiar , Champigneulle Benoit , Sooronbaev Talant , Bloch Konrad E. , Ulrich Silvia
Published: December 2022

Background/aims

Amongst numerous travellers to high altitude (HA) are many with the highly prevalent COPD, who are at particular risk for altitude-related adverse health effects (ARAHE). We then investigated the hypoxia-altitude simulation test (HAST) to predict ARAHE in COPD patients travelling to altitude.

Methods

This prospective diagnostic accuracy study included 75 COPD patients: 40 women, age 58±9 years, forced expiratory volume in 1 s (FEV1) 40–80% pred, oxygen saturation measured by pulse oximetry (SpO2) ≥92% and arterial carbon dioxide tension (PaCO2) <6 kPa. Patients underwent baseline evaluation and HAST, breathing normobaric hypoxic air (inspiratory oxygen fraction (FIO2) of 15%) for 15 min, at low altitude (760 m). Cut-off values for a positive HAST were set according to British Thoracic Society (BTS) guidelines (arterial oxygen tension (PaO2) <6.6 kPa and/orSpO2<85%). The following day, patients travelled to HA (3100 m) for two overnight stays where ARAHE development including acute mountain sickness (AMS), Lake Louise Score ≥4 and/or AMS score ≥0.7, severe hypoxaemia (SpO2<80% for >30 min or 75% for >15 min) or intercurrent illness was observed.

Results

ARAHE occurred in 50 (66%) patients and 23 out of 75 (31%) were positive on HAST according toSpO2, and 11 out of 64 (17%) according toPaO2. ForSpO2/PaO2we report a sensitivity of 46/25%, specificity of 84/95%, positive predictive value of 85/92% and negative predictive value of 44/37%.

Conclusion

In COPD patients ascending to HA, ARAHE are common. Despite an acceptable positive predictive value of the HAST to predict ARAHE, its clinical use is limited by its insufficient sensitivity and overall accuracy. Counselling COPD patients before altitude travel remains challenging and best focuses on early recognition and treatment of ARAHE with oxygen and descent.
Evaluation of two-stage designs of Phase 2 single-arm trials in glioblastoma: a systematic review
Authors: Yoo Wonsuk , Kim Seongho , Garcia Michael , Mehta Shwetal , Sanai Nader
Published: December 2022

Background

Due to economical and ethical reasons, the two-stage designs have been widely used for Phase 2 single-arm trials in oncology because the designs allow us to stop the trial early if the proposed treatment is likely to be ineffective. Nonetheless, none has examined the usage for published articles that had applied the two-stage designs in Phase 2 single-arm trials in brain tumor. A complete systematic review and discussions for overcoming design issues might be important to better understand why oncology trials have shown low success rates in early phase trials.

Methods

We systematically reviewed published single-arm two-stage Phase 2 trials for patients with glioblastoma and high-grade gliomas (including newly diagnosed or recurrent). We also sought to understand how these two-stage trials have been implemented and discussed potential design issues which we hope will be helpful for investigators who work with Phase 2 clinical trials in rare and high-risk cancer studies including Neuro-Oncology. The systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)-statement. Searches were conducted using the electronic database of PubMed, Google Scholar and ClinicalTrials.gov for potentially eligible publications from inception by two independent researchers up to May 26, 2022. The followings were key words for the literature search as index terms or free-text words: “phase II trials”, “glioblastoma”, and “two-stage design”. We extracted disease type and setting, population, therapeutic drug, primary endpoint, input parameters and sample size results from two-stage designs, and historical control reference, and study termination status.

Results

Among examined 29 trials, 12 trials (41%) appropriately provided key input parameters and sample size results from two-stage design implementation. Among appropriately implemented 12 trials, discouragingly only 3 trials (10%) explained the reference information of historical control rates. Most trials (90%) used Simon’s two-stage designs. Only three studies have been completed for both stages and two out of the three completed studies had shown the efficacy.

Conclusions

Right implementation for two-stage design and sample size calculation, transparency of historical control and experimental rates, appropriate selection on primary endpoint, potential incorporation of adaptive designs, and utilization of Phase 0 paradigm might help overcoming the challenges on glioblastoma therapeutic trials in Phase 2 trials.
Hyperammonemia in a septic patient with Ureaplasma parvum arthritis: a case report
Authors: Pan Xiaohong , Xu Jiekun , Pan Lei , Wang Caihong , Qiu Junke , Huang Xiaqing , Yan Chenxi , Mao Minjie
Published: December 2022

Background

Septic arthritis requires prompt diagnosis and treatments. Rare pathogens should be considered when patients respond poorly to the initial antibiotic treatments. Ureaplasma parvum is an opportunistic pathogen that commonly resides in the human urogenital tract. Its infection commonly causes hyperammonemia. Hyperammonemia from Ureaplasma parvum septic arthritis has never been reported previously.

Case presentation

A 65-year-old male presented with fever and left lower leg pain and swelling for more than ten days. Septic arthritis and sepsis were considered after laboratory tests and arthrocentesis. However, he responded poorly to the antibiotic treatments, including cefoperazone-sulbactam, imipenem-cilastatin, and linezolid. His mental status deteriorated rapidly with elevated blood ammonia levels with unremarkable liver function test and sonogram examination results. Despite the treatments with lactulose, L-ornithine L-aspartate, mannitol, and hemodialysis therapy to lower his ammonia level, his blood ammonia level remained persistently high. Finally, metagenomic sequencing of the left knee synovial fluid reported Ureaplasma parvum, which was considered to contribute to his hyperammonemia.

Conclusion

Ureaplasma parvum could cause septic arthritis with hyperammonemia. Genetic tests, such as polymerase chain reaction and next-generation sequencing techniques, could provide a sensitive and fast diagnosis of Ureaplasma parvum.
MRI comparative study of diffuse midline glioma, H3 K27-altered and glioma in the midline without H3 K27-altered
Authors: Zhao Ji-ping , Liu Xue-jun , Lin Hao-zhi , Cui Chun-xiao , Yue Ying-jie , Gao Song , Xu Hong-zhang
Published: December 2022

Purpose

The MRI features of Diffuse midline glioma, H3 K27-altered and glioma in the midline without H3 K27-altered were compared and analyzed, and the changes in the apparent diffusion coefficient (ADC) of the two groups were quantitatively analyzed.

Methods

The MRI images of 35 patients with Diffuse midline gliomas, H3 K27-altered and gliomas in the midline without H3 K27-altered were analyzed retrospectively. The location, edge, signal, peritumoral edema and enhancement characteristics of the lesions were observed, and the changes in ADC values were analyzed.

Results

In the H3 K27-altered group, 85.7% (12/14) of the tumors were located in the thalamus and brainstem compared with 28.6% (6/21) in the no H3 K27-altered group. In the H3 K27-altered group, for tumors only located in the midline area, only 14.3% (1/7) had irregular shapes and unclear boundaries, while for tumors also invaded the extramidline tissues 85.7% (6/7) had irregular shapes and unclear boundaries.The"basilar artery wrapped sign” was found in 6 patients with tumors located in the pons in the H3 K27-altered group, but none in the no H3 K27-altered group had this sign. In the H3 K27-altered group, only 14.3% (1/7) of the tumors confined to the midline area had small cystic degeneration and necrosis, while for tumors also invaded the extramidline tissues, 100% (7/7) of the tumors had cystic degeneration and necrosis, and the cystic degeneration and necrosis only located in the extramidline region of the tumor in 6 cases.A total of 78.6% (11/14) of tumors in the H3 K27-altered group showed mild to moderate enhancement, while 47.6% (10/21) of tumors in the no H3 K27-altered group showed mild to moderate enhancement. The average peritumoral edema index was 1.13 in the H3 K27-altered group and 1.75 in the no H3 K27-altered group. The average ADC value of tumor in the H3 K27-altered group was 7.83 × 10− 4 mm2/s, and the ratio to normal brain tissue was 0.844, while the values in the no H3 K27-altered group were 13.5 × 10− 4 mm2/s and 1.75, respectively.

Conclusion

Compared with gliomas in the midline without H3 K27-altered, The MRI findings and ADC value of Diffuse midline gliomas, H3K27-altered have some characteristics, which can help improve the diagnosis and differential diagnosis.
The acceptability of cervical electrical impedance spectroscopy within a multi-modal preterm birth screening package: a mixed methods study
Authors: Stern Victoria , Jones Georgina L. , Senbeto Sarah , Anumba Dilly
Published: December 2022

Background

Reducing the rate of preterm birth is a cornerstone of global efforts to address child mortality, however existing screening tests offer imperfect prediction. Cervical electrical impedance spectroscopy (EIS) is a novel technique to quantify the ripening changes which precede labour. Mid-trimester EIS measurements have been shown to accurately predict preterm birth in asymptomatic women. This study aimed to comprehensively evaluate the acceptability of cervical EIS to low and high-risk women as part of a package of screening tests performed during a larger prospective trial.

Methods

In this parallel convergent mixed methods study, 40 women completed questionnaires before and after screening tests (EIS, cervical length measurement and fetal fibronectin quantification). Quantitative outcomes were anxiety levels before and after screening (Spielberger State Trait Anxiety Inventory, STAI-6), pain (Short Form McGill Pain Questionnaire) and ratings of EIS device appearance and test acceptability (visual analogue scales). Twenty-one women (11 high-risk, 10 low-risk) also attended a semi-structured qualitative interview. Interviews were recorded and transcribed, then thematic analysis was performed. A convergence coding matrix was constructed to enable triangulation of quantitative and qualitative results.

Results

High risk women demonstrated a significant reduction in anxiety following screening (mean STAI-6 score 34.5 vs. 29.0, p = 0.002). A similar trend was observed among low-risk participants. Ratings of pain, EIS device appearance and procedural acceptability did not differ between groups. Mean pain ratings were low (visual analogue scale 0.97 and 1.01), comparing favourably to published evaluations of conventional screening tests. Qualitative analysis provided insight into both the physical consequences and emotional experiences of screening. Additional determinants of the screening experience included device design, pre-existing perspectives on intimate examination, attitudes to knowledge in pregnancy and interaction with clinical staff. Finally, a range of practical considerations regarding wider use of EIS were identified, with valuable complementary detail regarding acceptability for use in antenatal care.

Conclusions

Cervical EIS is well tolerated and acceptable to both low and high-risk women when performed as part of a multi-modal screening package. These results provide useful insights to inform the design of future study and screening protocols.
Minoritised ethnic women’s experiences of inequities and discrimination in maternity services in North-West England: a mixed-methods study
Authors: Thomson Gill , Cook Julie , Crossland Nicola , Balaam Marie-Clare , Byrom Anna , Jassat Raeesa , Gerrard Sabina
Published: December 2022

Background

Minoritised ethnic perinatal women can experience judgemental and stigmatising care due to systemic racism. Discriminatory care contributes to increased risks of poor maternal and infant outcomes, including higher rates of mental ill-health. This study aimed to explore minoritised ethnic women’s experiences of maternity services, including maternity care and mental health support, within a North-West England locality. Here we use an equity lens to report the findings that describe if and how women’s personal, cultural, and spiritual needs were met, their experiences of discriminatory and prejudicial care, and to identify recommendations for service provision.

Methods

A mixed-methods study was undertaken comprising an online survey, interviews, and community consultations. Questions explored access to and experiences of antenatal care and education; information, communication, and choice; experiences of (dis)respect and judgement; mental health needs and support; cultural/religious needs and support; and overall experiences of maternity care. Eligibility criteria were: women, 18+ years, from self-reported minoritised ethnic backgrounds, who had given birth in the previous 2 years and received maternity care in the locality. Surveys were available in seven languages and distributed via social media, mother-baby groups, and community locations. English-speaking survey participants were invited to take part in a follow-up interview. Community staff were approached to collect data on behalf of the study team. Quantitative data were analysed descriptively (n, %) and merged with qualitative data into descriptive themes.

Results

Overall, 104 women provided data; most self-identified as Asian (65.0%) or Black (10.7%) and were aged between 30–34 (32.0%) or 25–29 years (23.3%). Four descriptive themes are reported: ‘accessing care’ details variations and barriers in accessing maternity care; ‘communication needs, and resources’ describes views on adaptions and resources for specific communication needs; ‘meeting religious and cultural needs’ outlines how various religious and cultural needs were met by maternity providers; ‘discriminatory or stigmatising care’ reports on experiences of pejorative and inequitable care.

Conclusions

An equity lens helped identify areas of discriminatory and inequitable care. Key recommendations include cultural safety training for staff; service-user engagement and co-production of research and resources, and appropriate facilities and recording systems to facilitate individualised, needs-based maternity care.
A pan-cancer analysis of the oncogenic role of ERCC6L
Authors: Lu Zhimin , Fei Lihong , Hou Guoxin
Published: December 2022

Background

Excision repair cross-complementation group 6 like (ERCC6L), a polo-like kinase 1 (PLK1)-interacting checkpoint helicase, confers a high risk of cancer and enhances the progression of a variety of cancers. The present investigation aimed to elucidate the pan-cancer expression patterns of ERCC6L and to examine the possibility of using this gene for patient diagnosis and prognosis.

Methods

The expression patterns of ERCC6L in normal and cancer patients at various clinical stages were explored based on TCGA datasets. Subsequently, Bioinformatics techniques were then used to analyze patient’s survival probabilities, Cox multivariate clinical parameters, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) terms related to ERCC6L, the correlation between mRNA expression levels and patient survival, genetic alterations or somatic mutations of ERCC6L, and immune infiltration.

Results

Most cancer types had higher ERCC6L mRNA levels than normal tissue. Higher ERCC6L expression levels were correlated with poor prognosis for cancer patients. Thus, ERCC6L may serve as an effective diagnostic and prognostic marker for multiple cancers. Moreover, ERCC6L expression levels were higher in patients with higher clinical tumor grades and were associated with poor prognoses at these stages. GO and KEGG analyses revealed a correlation between ERCC6L expression levels and chromatin and cell cycle events. We also found that the mRNA expression level of the ERCC6L promoter and a favorable prognosis was negatively correlated with the promoter’s methylation but not with copy number variation. A quantitative analysis of immune infiltration suggested a positive correlation between ERCC6L levels and the infiltration of Th2 immune cells in main cancer types. Finally, we examined the ERCC6L somatic mutations, especially single-nucleotide variants, and ERCC6L expression-related drug sensitivity.

Conclusions

Herein, we reported a comprehensive investigation of the tumor-promoting role of ERCC6L in various cancer types. ERCC6L is a candidate biomarker for diagnosing and unfavorable prognosis of specific cancers.
Mental health among patients with chronic musculoskeletal pain and its relation to number of pain sites and pain intensity, a cross-sectional study among primary health care patients
Authors: Garnæs Kirsti Krohn , Mørkved Siv , Tønne Torgrim , Furan Lars , Vasseljen Ottar , Johannessen Hege Hølmo
Published: December 2022

Background

Chronic musculoskeletal pain (CMP) is characterised by pain related to the muscles or the joints with a duration of three months or more and is associated with high symptomatic burden in patients in primary health care. CMP is commonly associated with impaired mental health, which may affect the rehabilitation process. The primary aim of this study was to compare symptoms of anxiety, depression, fatigue, and insomnia in patients in primary health care with and without CMP. The secondary aim was to assess difference in mental health symptoms related to number of pain sites and pain intensity.

Methods

This cross-sectional study was conducted in Trondheim, Norway. All patients aged 21–58 from randomly selected general practitioners (GPs) were invited to participate. Participants were classified into two groups according to presence of CMP. Symptoms of anxiety, depression, fatigue, and insomnia were assessed by the Hospital Anxiety and Depression Scale (HADS), Chalder Fatigue Questionnaire (CFQ), and Insomnia Severity Index (ISI), respectively, using an online survey system.

Results

From the patient lists of six GPs, we included 969 patients. Mean age 46 years (SD: 10.1), and 517 reported CMP. CMP patients reported higher mean symptom score for anxiety (5.4 vs 3.7), depression (3.4 vs 2.0), fatigue (14.2 vs 11.2), and insomnia (8.1 vs 4.4), all p < 0.01 compared to no-CMP patients. Symptoms of impaired mental health increased with increasing number of pain sites and pain intensity (p < 0.001).

Conclusions

Primary health care patients with CMP reported significantly more symptoms of anxiety, depression, fatigue, and insomnia than patients without CMP. The higher number of pain sites and pain intensity, the more mental health symptoms, especially of anxiety. Primary health care personnel have to address mental health issues when treating patients with CMP.

Trial registration

Clinicaltrials.gov (NCT02020772, 25/12/2013).
Evaluation of the clinical value of shear wave elastography for early detection and diagnosis of diabetic peripheral neuropathy: a controlled preliminary prospective clinical study
Authors: Wang Can , Wang Huiqin , Zhou Yi , Zhang Shiqi , Huang Meng
Published: December 2022

Purpose

This study aims to analyze the clinical application value of shear wave elastography (SWE) technique for early diagnosis of diabetic peripheral neuropathy (DPN).

Methods

Diabetic patients hospitalized in the Department of Endocrinology of the First Affiliated Hospital of Anhui Medical University from August 2021 to February 2022 were enrolled as DPN group (n=38) and non-DPN group (n=35) based on the neurophysiological examination results. 30 healthy subjects were recruited as the control group during the same period. Ultrasound examination of the tibial nerve and related laboratory tests were examined and collected for the total 103 study subjects. Statistical analysis of the collected data, and the receiver operating characteristic(ROC) curve for determination of the optimal cut-off values of mean stiffness of tibial nerve to detect DPN, with determination of area under curve (AUC), specificity, sensitivity, and Youden index.P value < 0.05 is considered statistically significant.

Results

Gender, age and BMI differences among three groups were insignificant (P>0.05). The difference of serological indicators between DPN and non-DPN groups was also not found (P>0.05), whereas longer duration of diabetes was observed in DPN group as compared to non-DPN group. As to the ultra-sound relevant parameters, the cross-sectional area and elastic modulus of the tibial nerve in both lower extremities among these three groups were not significantly different (Oneway ANOVA analysis) although the differences were indeed observed if we compared DPN group exclusively with non-DPN group, or compared non-DPN group with healthy group, or compared DPN group with healthy group (t test). Additionally, the mean elasticity (Emean) cut-off value for the diagnosis of DPN was preferably taken as 67.55 kPa.

Conclusion

SWE has unique advantages in early detection and diagnosis of DPN, which deserve further research.
Evaluation of quality of life in endometriosis patients before and after surgical treatment using the EHP30 questionnaire
Authors: Tiringer D. , Pedrini A. S. , Gstoettner M. , Husslein H. , Kuessel L. , Perricos A. , Wenzl R.
Published: December 2022

Backround

Endometriosis is one of the most common gynecological illnesses causing extensive psychological, physical and social impact on patient’s life and exerts negative effects on health-related quality of Life (HRQoL). However, the effects of surgery on the postoperative HRQoL in the different endometriosis subgroups have not been fully evaluated.

Methods

We performed a comparative retrospective study between 2014 and 2018 at the Medical University of Vienna, including all patients with surgically confirmed endometriosis who had completed the standardized Endometriosis Health Profile-30 (EHP-30) questionnaire 1 day after surgery (the questions refer to the 4 weeks preoperatively) and 6–10 weeks postoperatively.

Results

Compared to preoperative values, we found significant benefits, regarding postoperative conditions, in our study group (n = 115) in all five categories, “pain” (HR 0.78, p < 0.001); “self-determination” (HR 0.92, p < 0.001); “emotional health” (HR 0.83, p < 0.001);” social environment” (HR 0.67, p < 0.001); and “self-image” (HR 0.47, p < 0.001). Patients with only peritoneal endometriosis had the lowest preoperative clinical symptoms and there were no significant changes in any of the categories. In the subgroups deep infiltrating endometriosis (DIE) and DIE + ovarian endometrioma, surgical intervention results in a significantly greater improvement in all categories of EHP 30 compared to ovarian endometrioma without DIE or peritoneal endometriosis.

Conclusion

Our study shows, that especially women with DIE—with or without ovarian endometrioma—demonstrate a more pronounced benefit from surgical therapy compared to patients with peritoneal endometriosis or endometrioma without DIE.
Cuscuta epithymum Murr. crude extract pre-conditioning protects C6 cells from L-glutamate-induced neurotoxicity
Authors: Pourhadi Masoumeh , Niknam Zahra , Ghasemi Rasoul , Zomorrod Mina Soufi , Niazi Vahid , Faizi Mehrdad , Zali Hakimeh , Mojab Faraz
Published: December 2022

Background

Cuscuta epithymum Murr. (C. epithymum), as an herbal medicine, has played an anti-cancerous role in various studies; however, its possible neuroprotective effects have been neglected. Here, we aimed to investigate the protective effects of C. epithymum seeds crude extract and different fractions on rat glioblastoma cells (C6) in L-glutamate oxidative condition.

Methods

Initially, the total phenolic content of C. epithymum crude extract and the fractions (all produced by maceration method) was determined. Subsequently, C6 cells were pre-treated with the various concentrations of crude extract and fractions 24 h before L-glutamate exposure. Likewise, C6 cells were treated with the same concentrations of crude extract and fractions 24 h after exposure to L-glutamate. The cell viability and morphology were compared in crude extract and fractions groups, then superoxide dismutase (SODs) activity, reactive oxygen species (ROS), and malondialdehyde (MDA) levels were measured. The flow cytometry test was used to study C. epithymum crude extract's effects on the cell cycle and also to quantify the apoptosis, necrosis, and live cells population in different groups.

Results

C. epithymum crude extract and fractions (hexanoic, dichloromethanolic, and methanolic) had concentration-dependent cytotoxicity (IC50:126.47, 2101.96, 140.97, and 218.96 µg/ml, respectively). The crude extract and methanolic fraction contained phenolic compounds (55.99 ± 2.795 and 50.80 ± 2.969 mg gallic acid/g extract), while in hexanoic and dichloromethanolic fractions, the phenolic content was undetectable. In the cell viability assay, in comparison to fractions, the crude extract showed a more protective effect against glutamate-induced oxidative condition (P < 0.0001). The crude extract increased the SODs activity (P < 0.001) and decreased MDA and ROS levels (P < 0.0001) in comparison to the glutamate group. The crude extract significantly increased the population of cells in G1 (from 63.04 to 76.29) and decreased the percentage of cells in G2 (from 11.56 to 6.7) and S phase (from 25.4 to 17.01). In addition, it decreased the apoptotic and necrotic cell populations (from 34 to 17.1) and also increased the percentage of live cells (from 66.8 to 83.4 percent) in the flow cytometry test.

Conclusion

C. epithymum crude extract plays a neuroprotective role by activating the defense mechanisms in cell against the oxidative condition.
Influence of the implementation of strengths-based nursing and healthcare on early childhood nurses’ competencies: a mixed-method study
Authors: Thentz Camille , Durgnat-Sciboz Christine , Macé Sylvie , Béguin Marie-Catherine , Falcy Vincent , Schobinger Elisabeth , Da Rocha Gora
Published: December 2022

Background

The scope of practice for nurses caring for families has evolved to meet the challenges presented by societal changes and increasing needs. In 2015, early childhood nurses from a Swiss region decided to implement a new model of care to guide their practice. The aim of this study was to explore the changes to early childhood nurses’ practices following the implementation of the strengths-based nursing and healthcare (SBNH) approach to care.

Methods

This study of early childhood nurses’ (N = 61) practices used a pre-post intervention design and a mixed-method approach. Nurses’ competencies and changes in practice were measured using the Nurse Competence Scale (NCS). The quantitative data were analysed using descriptive statistics, Kruskal Wallis tests and logistic regression. Thematic analysis was used to derive themes from the qualitative data.

Results

After the intervention, frequency of competency use increased in all domains of the NCS except the “teaching-coaching” domain; perceived levels of competencies also increased in all areas except “helping role” and “diagnostic functions”. Age and length of employment at the current post hindered improvement in the “teaching-coaching” competency. Interviews revealed themes related to the implementation process: “adaptability”, “implementation process”, “ambivalence” and “engagement to change”. Other themes were related to practice changes: “developing a disciplinary identity”, “path with families” and “strengths”.

Conclusion

This study showed that the use of perceived competencies changed over time after the introduction of SBNH into practice. Nurses questioned and adapted their routines based on SBNH. Nurse’s vision of care also changed; they felt that their care was congruent with their values. For families, this approach allowed a change of vision with a resource-centred approach. Implementation of models of care such as the SBNH in the early childhood context is innovative, as little research in the literature addresses the early childhood community home-visiting context is still modest. This research underlines the added value of this approach on early childhood nurses’ competencies.
Risk factors and potential predictors of pulmonary embolism in cancer patients undergoing thoracic and abdominopelvic surgery: a case control study
Authors: Li Yi , Liu Zhenjun , Chen Chen , Li Dan , Peng Huan , Zhao Pei , Wang Jiuhui
Published: December 2022

Background

Postoperative pulmonary embolism (PE) is a severe complication leading to death and poor prognosis. The present study investigated the risk factors and potential predictors of PE in cancer patients undergoing thoracic and abdominopelvic surgery.

Methods

A retrospective study was conducted on the patients with cancer who underwent thoracic and abdominopelvic surgery in Sichuan Cancer Hospital from December 2016 to January 2022. A total of 189 patients were included, in which 63 patients diagnosed PE after operation were collected as PE group, and 126 patients matched by age, type of cancer and cancer location were enrolled as control group. Conditional logistic regression was conducted to analyze the association between PE and risk factors. Predictive values of key factors were compared by the area under the curve (AUC) in receiver operating characteristic curve (ROC) curve.

Results

Conditional multivariate logistic regression showed that BMI (odds ratio [OR] 4.065, 95% confidence interval [CI] 1.138–14.527;p = 0.031), intraoperative hypotension time (OR 4.095, 95% CI 1.367–12.266;p = 0.009), same day fluid balance (OR 0.245, 95% CI 0.061–0.684;p = 0.048), and postoperative D-Dimer (OR 1.693, 95% CI 1.098–2.611;p = 0.017) were significantly related to the occurrence of postoperative PE. Postoperative D-Dimer had the maximal AUC value 0.8014 (95% CI: 0.7260–0.8770) for predicting PE, with a cutoff value of 1.505 μg/ml.

Conclusions

BMI, intraoperative hypotension time, lower same day fluid balance and postoperative D-dimer are independent risk factors associated with PE in cancer patients undergoing thoracic and abdominopelvic surgery. Postoperative D-Dimer seems to be a good indicator to predict postoperative PE for cancer patients.
Bacterial ribosomal RNA detection in cerebrospinal fluid using a viromics approach
Authors: Kinsella Cormac M. , Edridge Arthur W. D. , van Zeggeren Ingeborg E. , Deijs Martin , van de Beek Diederik , Brouwer Matthijs C. , van der Hoek Lia
Published: December 2022

Background

In patients with central nervous system (CNS) infections identification of the causative pathogen is important for treatment. Metagenomic next-generation sequencing techniques are increasingly being applied to identify causes of CNS infections, as they can detect any pathogen nucleic acid sequences present. Viromic techniques that enrich samples for virus particles prior to sequencing may simultaneously enrich ribosomes from bacterial pathogens, which are similar in size to small viruses.

Methods

We studied the performance of a viromic library preparation technique (VIDISCA) combined with low-depth IonTorrent sequencing (median ~ 25,000 reads per sample) for detection of ribosomal RNA from common pathogens, analyzing 89 cerebrospinal fluid samples from patients with culture proven bacterial meningitis.

Results

Sensitivity and specificity to Streptococcus pneumoniae (n = 24) before and after optimizing threshold parameters were 79% and 52%, then 88% and 90%. Corresponding values for Neisseria meningitidis (n = 22) were 73% and 93%, then 67% and 100%, Listeria monocytogenes (n = 24) 21% and 100%, then 27% and 100%, and Haemophilus influenzae (n = 18) 56% and 100%, then 71% and 100%. A higher total sequencing depth, no antibiotic treatment prior to lumbar puncture, increased disease severity, and higher c-reactive protein levels were associated with pathogen detection.

Conclusion

We provide proof of principle that a viromic approach can be used to correctly identify bacterial ribosomal RNA in patients with bacterial meningitis. Further work should focus on increasing assay sensitivity, especially for problematic species (e.g. L. monocytogenes), as well as profiling additional pathogens. The technique is most suited to research settings and examination of idiopathic cases, rather than an acute clinical setting.
Assessment of the correlation between clinical and radiological outcomes in patients suffering from mild to moderate cervical spine dysfunction symptoms: a prospective study
Authors: Niu Xiao-ping , Zhu Wei-Hua , Wang Lu , Zhao Gao-nian , Liu Ji-tao , Huang Ai-bing
Published: December 2022

Background

Neck pain and cervical disc degeneration (CDD) are common findings. Valid data on correlation between clinical scores and radiological grade of CDD in patients with mild to moderate clinical disability are not available. The study has been designed to investigate the correlation between clinical and radiological outcomes in these patients.

Methods

A cohort of 150 patients who suffered from mild to moderate cervical spine dysfunction symptoms from September 2020 to May 2021 was enrolled. We evaluated functional status using Japanese Orthopaedic Association scores (JOA), the visual analog scale, and the Neck Disability Index. We assessed the CDD with magnetic resonance imaging-based grading systems. We analyzed relationships between radiological grades of CDD and clinical symptoms along with demographic data.

Results

One hundred thirteen patients [mean age 44.78, 78 (69%) females] were finally included. CDD occurred most at the C5–C6 level, with 56.93% of higher grade III from Miyazaki. The grades of Miyazaki (P < 0.05) and the scores of Nakashima (P < 0.05) were positively correlated with the duration of symptoms, and the severity of the CDD increased with aging (P < 0.01). Moreover, we correlated patients’ JOA scores with the current scoring and grading systems, especially the grades of Miyazaki (P < 0.01) and the scores of Nakashima (P < 0.01).

Conclusion

Increasing grades of CDD paralleled decreasing JOA scores in the population studied.
Ground-glass opacity in a patient with right aortic arch and no left pulmonary artery
Authors: Yang Guang , Zeng Chenxi , Tu Dehao , Fu Xiangning , Xiong Jing , Liu Changyu , Cai Yixin
Published: December 2022

Background

Here we report a case of patients with mixed ground glass opacity in the left lung combined with congenital right aortic arch, which is only present in 0.01–0.1% of adults.

Case presentation

A 60-year-old woman was referred to our department with a mixed ground-glass opacity (GGO) in the upper lobe of her left lung. She had congenital right aortic arch, and the left pulmonary artery was absent. Enhanced chest computed tomography, pulmonary perfusion imaging, and three-dimensional reconstruction were performed to confirm the blood supply in the left lung and the exact location of the GGO. Because of the unusual left pulmonary vascular structure, wedge resection was performed to prevent massive hemorrhage. The final pathological examination revealed that the mixed GGO was a well-differentiated pulmonary adenocarcinoma.

Conclusion

The surgical options should be evaluated carefully in view of the complications and the prognosis of the patient, when ground glass opacity is combined with congenital cardiovascular anomalies.
The efficacy and safety of thermal ablation for patients with lung malignancy: a meta-analysis of 12 studies in China
Authors: Liu Rongxing , Shen Qiurong , Lu Hongjun
Published: December 2022

Background

Thermal ablation has been increasingly used in the treatment of lung cancer in recent years. This meta-analysis aims to investigate the therapeutic effect and safety of thermal ablation plus chemotherapy as compared with chemotherapy alone in treating patients with lung malignancy in China based on current evidence.

Methods

Databases including PubMed, Web of Science, Embase and the Cochrane Library were searched for clinical reports. Additional literature search was also performed by searching the reference list of included studies and latest reviews. Raw data including objective response rate, disease control rate, progression-free survival, overall survival and the incidence of major complication were extracted and pooled.

Results

A total of 12 studies in China including 1282 patients with lung malignancy were included in this meta-analysis. The number of studies that reported data of objective response rate, disease control rate, progression-free survival, overall survival and major complication was 8, 7, 7, 6 and 7, respectively. The combination therapy of thermal ablation plus chemotherapy showed a significantly better efficacy in improving objective response rate (odds ratio = 2.73; P < 0.001) and disease control rate (odds ratio = 2.43; P < 0.001) as compared with chemotherapy alone. Thermal ablation was also a significant protective factor for progression-free survival (hazard ratio = 0.43; P < 0.001) and overall survival (hazard ratio = 0.49; P < 0.001). Besides, thermal ablation did not increase the risk of major complication (odds ratio = 0.75; P = 0.252).

Conclusion

The present meta-analysis based on these studies in China suggested that thermal ablation is a promising technique to provide better disease response and survival outcomes for patients with lung malignancy. Thermal ablation is worth further promotion in treating lung malignancy and application in clinical practice.
A neuroendocrine tumor within an anterior mediastinal mature teratoma: a case report
Authors: Sato Daisuke , Izu Asami , Sakakibara Masashi , Hayashi Sohei , Kawachi Riken , Shimamura Mie , Masuda Shinobu , Sakurai Hiroyuki
Published: December 2022

Background

Mature teratomas are benign germ cell tumors. On rare occasions, they have been associated with somatic malignancies and are termed rare germ cell tumors with a somatic-type malignancy (GCTSM). Mature teratomas commonly comprise adenocarcinomas; only seven previous cases of mature teratomas with neuroendocrine tumors have been reported to date. Here, we report a patient with a neuroendocrine tumor whithin a mature teratoma.

Case presentation

A 26-year-old man visited our department complaining of chest tightness. Contrast-enhanced computed tomography (CT) scans showed a strongly enhanced lesion within a 10-cm encapsulated cystic lesion in the anterior mediastinum. Positron emission tomography (PET) scans showed no areas of significant 18F-fluorodeoxyglucose (18F-FDG) accumulation. He underwent complete tumor resection via the transsternal approach. Histopathological examination of the specimen indicated a neuroendocrine tumor contained within a mature teratoma.

Conclusions

In this case, a neuroendocrine tumor was contained within a mature teratoma. Our patient had no specific symptoms and his serum markers were within the normal range. Although PET is beneficial for diagnosing other GCTSM, it is not useful in detecting a neuroendocrine tumor. Therefore, the preoperative diagnosis of neuroendocrine tumors contained within mature teratomas remains challenging. However, GCTSM should be suspected in patients exhibiting CT findings of a mediastinal tumor, measuring ≥ 6 cm, in addition to characteristic GCTSM findings. Moreover, surgery should be performed carefully in such cases.
A faster iterative method for solving nonlinear third-order BVPs based on Green’s function
Authors: Okeke Godwin Amechi , Ofem Austine Efut , Işık Hüseyin
Published: December 2022

In this article, we propose an iterative method, called the GA iterative method, to approximate the fixed points of generalized α-nonexpansive mappings in uniformly convex Banach spaces. Further, we obtain some convergence results of the new iterative method. Also, we provide a nontrivial example of a generalized α-nonexpansive mapping and with the example, we carry out a numeral experiment to show that our new iterative algorithm is more efficient than some existing iterative methods. Again, we present an interesting strategy based on the GA iterative method to solve nonlinear third-order boundary value problems (BVPs). For this, we derive a sequence named the GA–Green iterative method and show that the sequence converges strongly to the fixed point of an integral operator. Finally, the approximation of the solution for a nonlinear integrodifferential equation via our new iterative method is considered. We present some illustrative examples to validate our main results in the application sections of this article. Our results are a generalization and an extension of several prominent results of many well-known authors in the literature.
Influence of pyrolysis temperature on the physicochemical properties of biochars obtained from herbaceous and woody plants
Authors: Tu Panfeng , Zhang Guanlin , Wei Guoqiang , Li Juan , Li Yongquan , Deng Lifang , Yuan Haoran
Published: December 2022

This work aimed to investigate the effect of pyrolysis temperature on the yield and properties of biochars synthesized from herbaceous and woody plants. Four typical materials, including two herbaceous plants (rice straw, corn straw) and two woody plants (camellia oleifera shells, garden waste), were used in the experiments under five operating temperatures (from 300 °C to 700 °C, with an interval of 100 °C). The results showed biochar derived from herbaceous plants had a significantly higher pH (from 7.68 to 11.29 for RS), electrical conductivity (EC, from 6.5 Ms cm−1 to 13.2 mS cm−1 for RS), cation exchange conductivity (CEC, from 27.81 cmol kg−1 to 21.69 cmol kg−1 for RS), and ash content (from 21.79% to 32.71% for RS) than the biochar from woody plants, but the volatile matter (VM, from 42.23% to 11.77% for OT) and specific surface area (BET, from 2.88 m2 g−1 to 301.67 m2 g−1 for OT) in the woody plant-derived biochar were higher. Except for CEC and VM, all the previously referred physicochemical characteristics in the as-prepared biochars increased with the increasing pyrolysis temperature, the H/C and O/C values of herbaceous and woody plant-derived biochar were lower than 0.9 and 0.3, respectively, confirming their potential as the material for carbon sequestration. The results revealed that biochar made from herbaceous plants was more suitable for acidic soil amendments. In contrast, woody plant-derived biochar were recommended to remove heavy metals in environmental remediation and water treatment.

Graphical Abstract
Intravenous thrombolysis for acute ischemic stroke associated with known left ventricular thrombus: safe or not?
Authors: Kitmeridou Sofia , Tsiptsios Dimitrios , Tsalkidis Dimos , Psatha Evlampia A. , Iliopoulos Ioannis , Aggelousis Nikolaos , Vadikolias Konstantinos
Published: December 2022

Safety and efficacy data on intravenous thrombolysis (IVT) for acute ischemic stroke (AIS) in case of known left ventricular thrombus (LVT) are lacking. We present the case of a 35-year-old male with disabling AIS and known LVT that was treated successfully with intravenous alteplase. Apart from neurological improvement, post-procedural full thrombus lysis was also evident. Even though performing IVT in similar instances constitutes a difficult decision for physicians, it may be reasonable in the context of acute disabling stroke.
Unfolding Political Emergence: The Knowledge of Visual Artworks in Peter Weiss’sThe Aesthetics of Resistance
Authors: Jonsson Stefan
Published: December 2022

Starting out from the interpretation of Picasso’s Guernica in Peter Weiss’s The Aesthetics of Resistance, this essay discusses how, why, and for what purposes Weiss inserted extensive discussions of classical and contemporary artworks in his novel. More specifically, and by introducing the two notions of the foldout and political emergence, the essay investigates how the visual artworks in Weiss’s narrative reconfigure understandings of temporality, collectivity, and realism. A central question concerns the novel’s way of transforming representations of objective oppression, and even death itself, into figures of emancipatory subjective agency. Analyses of the novel’s interpretive engagement with visual artworks such as Guernica demonstrate how these sections of the novelistic text interrupt historical temporality, establish a transhistorical collectivity, and superimpose the experience of the victim with the perspective of the witness. In this way, it is argued, Weiss’s narrative enables an identification with the mute experience of destruction while converting that experience into a future-oriented political force: the emergence and continuation of collective struggle.
For Future Reference: A Twenty-First-Century Reading of Peter Weiss’s Poetics of Parataxis and Scenes of Walking
Authors: Kaakinen Kaisa
Published: December 2022

This article analyzes how paratactic and multisensory narrative strategies in Peter Weiss’s novel Die Ästhetik des Widerstands (1975–81) contribute to the novel’s project of an aesthetics of resistance for future reference. The narrative mode of the novel emphasizes situated and embodied future acts of reading that generate new historical linkages and orientations across temporal, geographic, and medial gaps. Weiss’s novel mediates twentieth-century history of antifascist resistance with a perspective attuned to multiple possibilities inherent in historical instances. Furthermore, by sensitizing its recipients to differentiated ways of engaging with textual gaps, the novel presents itself as a medium of historical orientation toward futures not articulated in the text itself. The novel’s implied future readers share the novel’s concern with emancipation of the oppressed, but the protocols of reading suggested in the novel also imply that these future readers may interrupt overly rigid historical narratives that may prevent emancipation in specific contexts. The novel remains relevant because of both its historical material and its sophisticated form, which explores aesthetic mediation of experience and relational narrative strategies without losing the sense of historical materiality and without subsuming experience within a concept of a self-enclosed subject.
Renewing Resistance at Sea and on Isles: Peter Weiss’s The Aesthetics of Resistance, Volume 2, for the Twenty-First Century
Authors: Miller Matthew D.
Published: December 2022

Eroding the value of human life and obscuring the discernibility of shared futures, the twenty-first century’s unabating civilizational calamities compel desperate attempts to advance individual and social renewal in the navigation of dark times. Mindful of such need, this article examines the transhistorical resourcefulness of Peter Weiss’s Die Ästhetik des Widerstands (The Aesthetics of Resistance) with regard to contemporary challenges. Schooled in antifascism’s failures of the 1930s and 1940s, The Aesthetics abounds in detailed engagements with literary and visual works of art as well as pivotal chapters of European political history to model processes of resistance formation. Weiss’s extensive remediation of Théodore Géricault’s painting The Raft of the Medusa in the transition from volume 1 to volume 2 and the political debate that The Aesthetics’ narrator stages between the Swedish figures Ström and Rogeby near the end of the second volume feature the imagination as a force of aesthetic and political resistance respectively: whereas the narrator’s engagement with Géricault’s Raft yields a vision of common plight and solidarity in defiance of colonialist and fascist catastrophes, his artful modulation of Ström and Rogeby’s exchanges sets a course for the expansion of resistance’s scope. The combined analysis of these segments reveals how The Aesthetics’ interrelation of struggles across historical, geographic, racial, and economic divides proves instructive for new articulations and formations of resistance amid the twenty-first century’s health, social, political and refugee crises.