bluuebunny/crossref_metadata_2025 huggingface dataset:
Hidden blood loss and its influencing factors after minimally invasive percutaneous transpedicular screw fixation in thoracolumbar fracture
Authors: Yue Xin , Zhang Jing , Sun Tianze , Zhang Wentao , Yang Ming , Li Zhonghai
Published: November 2022

Background

Minimally invasive percutaneous transpedicular screw fixation (MIPTSF) is generally accepted as a minimally invasive treatment for thoracolumbar fracture. However, hidden blood loss (HBL) caused by this procedure is usually disregarded. This study aimed to investigate the amount of HBL and its influencing factors after MIPTSF in thoracolumbar fracture.

Methods

Between October 2017 and December 2020, a total of 146 patients (106 males and 40 females, age range 21–59 years) were retrospectively examined, and their clinical and radiological data were recorded and analyzed. The Pearson or Spearman correlation analysis was used to investigate an association between patient’s characteristics and HBL. Multivariate linear regression analysis was performed to elucidate the related clinical or radiological factors of HBL.

Results

A substantial amount of HBL (164.00 ± 112.02 ml, 40.65% of total blood loss (TBL)) occurred after transpedicular screw internal fixation. Multivariate linear regression analysis revealed that HBL was positively associated with TBL (p < .001), percentage of vertebral height loss (VHL) (p < .001), percentage of vertebral height restoration (VHR) (p < .001), numbers of fractured vertebrae (P = .013), and numbers of fixed vertebral segments (P = .002).

Conclusion

A large amount of HBL was incurred in patients undergoing MIPTSF in thoracolumbar fracture. More importantly, TBL, percentage of VHL, percentage of VHR, the numbers of fractured vertebrae and fixed vertebral segments were independent risk factors for HBL.
A propensity score matching study on robot-assisted radical cystectomy for older patients: comparison of intracorporeal ileal conduit and cutaneous ureterostomy
Authors: Kadoriku Fumiya , Sasaki Yutaro , Fukuta Kyotaro , Atagi Yuichiro , Shiozaki Keito , Daizumoto Kei , Tomida Ryotaro , Ueno Yoshiteru , Tsuda Megumi , Kusuhara Yoshito , Fukawa Tomoya , Yanagihara Yutaka , Yamaguchi Kunihisa , Yamamoto Yasuyo , Izaki Hirofumi , Takahashi Masayuki , Yamashi Sadamu , Kan Masaharu , Kanayama Hiroomi
Published: November 2022

Background

Robot-assisted radical cystectomy (RARC) and intracorporeal urinary diversion are less invasive than conventional procedures. However, for older patients, cutaneous ureterostomy (CUS) may be preferred because urinary diversion using the intestine has a high incidence of perioperative complications and is highly invasive. The purpose of this study was to demonstrate the safety and efficacy of intracorporeal ileal conduit (ICIC) compared with CUS in patients aged 75 years or older who underwent RARC.

Methods

From October 2014 to December 2021, 82 patients aged 75 years or older who underwent RARC at Tokushima University Hospital, Tokushima Prefectural Central Hospital, or Ehime Prefectural Central Hospital were retrospectively reviewed. Of these, 52 and 25 patients who underwent ICIC and CUS, respectively, were included. After adjusting the patients’ characteristics using propensity score-matching, surgical results and prognoses were retrospectively compared. The propensity score was based on age, Eastern Cooperative Oncology Group Performance Status Scale (ECOG-PS), American Society of Anesthesiologists physical status classification (ASA-PS), clinical tumor stage, and neoadjuvant chemotherapy.

Results

The median age was lower in the ICIC group compared with the CUS group, and the proportion of high-risk cases (ECOG-PS ≥ 2 or ASA-PS ≥ 3) did not differ. The median operation time was longer in the ICIC group, and estimated blood loss was higher, compared with the CUS group. There were no significant differences in the incidence of complications within the first 30 postoperative days, incidence of complications 30–90 days after surgery, 2-year overall survival, 2-year cancer-specific survival, and 2-year recurrence-free survival. The stent-free rate was significantly lower in the CUS group than that in the ICIC group.

Conclusion

In older patients, the ICIC group showed non-inferior surgical and oncological outcomes compared with the CUS group. Urinary diversion following RARC in older patients should be carefully selected by considering not only the age but also the general condition (including comorbidities) of the patient.
Workplace violence and its associated factors among nurses working in public hospitals of eastern Ethiopia: a cross-sectional study
Authors: Legesse Henok , Assefa Nega , Tesfaye Dejene , Birhanu Simon , Tesi Seid , Wondimneh Fenta , Semahegn Agumasie
Published: November 2022

Background

Workplace violence is one of the global health concerns. Although nurses are the backbone of the health care provision, they are highly subjected to workplace violence in healthcare. Nevertheless, there is a paucity of evidence on the extent of workplace violence against nurses in Ethiopia in general and Eastern Ethiopia in particular. Hence, this study aimed to assess the extent of workplace violence against nurses and its associated factors among nurse professionals working at public hospitals in eastern Ethiopia.

Methods

Hospital-based cross-sectional study was conducted among 603 nurses working in public hospitals in eastern Ethiopia. Nurses were recruited using a simple random sampling method at their workplace (health facilities). A pretested self-administered questionnaire was used to collect data. Descriptive, binary and multivariable logistic regression analyses were performed. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to declare significant association.

Results

Among the 620 estimated sample, 603(97.3%) of the nurses gave consent and completed the self-administered questionnaire. The prevalence of workplace violence against nurse professionals in the last 12 months was 64.0% (95%CI: 60.2–67.7%). Nurses who were working in surgical (AOR: 2.30, 95%CI: 1.01–5.26), psychiatric (AOR: 3.06, 95%CI: 1.11–8.46), emergency (AOR: 3.62, 95%CI: 1.46–8.98), and medical wards (AOR: 5.20, 95%CI: 2.40–11.27); being worried of workplace violence (AOR: 1.71, 95%CI: 1.09–2.69); witnessed of physical workplace violence (AOR: 5.31, 95%CI: 3.28–8.59); claimed “absence/not-aware” of reporting procedure on workplace violence (AOR: 2.24, 95%CI: 1.45–3.46); and claimed “absence/not-aware” of institutional policies against workplace violence (AOR: 2.68, 95%CI: 1.73–4.13) were factors associated with nurses’ experience of workplace violence in eastern Ethiopia.

Conclusions

Workplace violence against nurses was found to be unacceptably high in the study area (eastern Ethiopia). We suggest that stakeholders could work on early risk identification and management of violent incidents, establish violence reporting and sanction mechanisms using contextual strategies to prevent workplace violence against nurse professionals.
The number of risk factors not at target is associated with cardiovascular risk in a type 2 diabetic population with albuminuria in primary cardiovascular prevention. Post-hoc analysis of the NID-2 trial
Authors: Sasso Ferdinando Carlo , Simeon Vittorio , Galiero Raffaele , Caturano Alfredo , De Nicola Luca , Chiodini Paolo , Rinaldi Luca , Salvatore Teresa , Lettieri Miriam , Nevola Riccardo , Sardu Celestino , Docimo Giovanni , Loffredo Giuseppe , Marfella Raffaele , Adinolfi Luigi Elio , Minutolo Roberto ,   NID-2 study group Investigators, Amelia U , Acierno C , Calatola P , Carbonara O , Conte G , Corigliano G , Corigliano M , D’Urso R , De Matteo A , De Nicola L , De Rosa N , Del Vecchio E , Di Giovanni G , Gatti A , Gentile S , Gesuè L , Improta L , LampitellaJr A , Lampitella A , Lanzilli A , Lascar N , Masi S , Mattei P , Mastrilli V , Memoli P , Minutolo R , Nasti R , Pagano A , Pentangelo M , Pisa E , Rossi E , Sasso F C , Sorrentino S , Torella R , Troise R , Trucillo P , Turco A A , Turco S , Zibella F , Zirpoli L
Published: November 2022

Background

Nephropathy in Diabetes type 2 (NID-2) study is an open-label cluster randomized clinical trial that demonstrated that multifactorial intensive treatment reduces Major Adverse Cardiac Events (MACEs) and overall mortality versus standard of care in type 2 diabetic subjects with albuminuria and no history of cardiovascular disease. Aim of the present post-hoc analysis of NID- 2 study is to evaluate whether the number of risk factors on target associates with patient outcomes.

Methods

Intervention phase lasted four years and subsequent follow up for survival lasted 10 years. To the aim of this post-hoc analysis, the whole population has been divided into 3 risk groups: 0–1 risk factor (absent/low); 2–3 risk factors (intermediate); 4 risk factors (high). Primary endpoint was a composite of fatal and non-fatal MACEs, the secondary endpoint was all-cause death at the end of the follow-up phase.

Results

Absent/low risk group included 166 patients (52.4%), intermediate risk group 128 (40.4%) and high-risk group 23 (7.3%). Cox model showed a significant higher risk of MACE and death in the high-risk group after adjustment for confounding variables, including treatment arm (HR 1.91, 95% CI 1.04–3.52, P = 0.038 and 1.96, 95%CI 1.02–3.8, P = 0,045, respectively, vs absent/low risk group).

Conclusions

This post-hoc analysis of the NID-2 trial indicates that the increase in the number of risk factors at target correlates with better cardiovascular-free survival in patients with type 2 diabetes at high CV risk.

Clinical Trial Registration

ClinicalTrials.gov number, NCT00535925. https://clinicaltrials.gov/ct2/show/NCT00535925
Gender composition and wage gaps in the Canadian health policy research workforce in comparative perspective
Authors: Gupta Neeru , Balcom Sarah Ann , Singh Paramdeep
Published: November 2022

Background

Gendered challenges have been shown to persist among health practitioners in countries at all levels of development. Less is known about non-clinical professionals, that is, those who do not deliver services directly but are essential to health systems performance, such as health policy researchers. This national observational study examined gender occupational segregation and wage gaps in the Canadian health policy research workforce using a cross-domain comparative labour market analysis approach.

Methods

Sourcing data from the 2016 population census, we applied linear regression and Oaxaca–Blinder decomposition techniques to assess wage differentials by sex, traditional human capital measures (e.g., age, education, place of work), and social identity variables intersecting with gender (household head, childcare, migrant status) among health policy researchers aged 25–54. We compared the gender composition and wage gap with seven non-health policy and programme domains, as mapped under the national occupational classification by similarity in the types of work performed.

Results

The health policy research workforce (N = 19 955) was characterized by gender segregation: 74% women, compared with 58% women among non-health policy research occupations (N = 102 555). Women health policy researchers earned on average 4.8% (95% CI 1.5‒8.0%) less than men after adjusting for other professional and personal variables. This gap was wider than among education policy researchers with similar gender composition (75% women; adjusted wage gap of 2.6%). Wages among health policy researchers were 21.1% (95% CI 19.4‒22.8%) lower than their counterparts in the male-dominated economics policy domain, all else being equal. Overall, women’s earnings averaged 3.2% lower than men’s due to factors that remained unexplained by policy domain or other measured predictors.

Conclusions

This investigation found that the gender inequalities already widely seen among clinical practitioners are replicated among health policy researchers, potentially hindering the competitiveness of the health sector for attracting and retaining talent. Our findings suggest intersectoral actions are necessary to tackle wage gaps and devaluation of female-dominated health professions. Accountability for gender equity in health must extend to the professionals tasked with conducting equity-informative health policy research.
Using the WHO-INTEGRATE evidence-to-decision framework to develop recommendations for induction of labour
Authors: Murano Melissa , Chou Doris , Costa Maria Laura , Turner Tari
Published: November 2022

Background

In 2019, WHO prioritized updating recommendations relating to three labour induction topics: labour induction at or beyond term, mechanical methods for labour induction, and outpatient labour induction. As part of this process, we aimed to review the evidence addressing factors beyond clinical effectiveness (values, human rights and sociocultural acceptability, health equity, and economic and feasibility considerations) to inform WHO Guideline Development Group decision-making using the WHO-INTEGRATE evidence-to-decision framework, and to reflect on how methods for identifying, synthesizing and integrating this evidence could be improved.

Methods

We adapted the framework to consider the key criteria and sub-criteria relevant to our intervention. We searched for qualitative and other evidence across a variety of sources and mapped the eligible evidence to country income setting and perspective. Eligibility assessment and quality appraisal of qualitative evidence syntheses was undertaken using a two-step process informed by the ENTREQ statement. We adopted an iterative approach to interpret the evidence and provided both summary and detailed findings to the decision-makers. We also undertook a review to reflect on opportunities to improve the process of applying the framework and identifying the evidence.

Results

Using the WHO-INTEGRATE framework allowed us to explore health rights and equity in a systematic and transparent way. We identified a lack of qualitative and other evidence from low- and middle-income settings and in populations that are most impacted by structural inequities or traditionally excluded from research. Our process review highlighted opportunities for future improvement, including adopting more systematic evidence mapping methods and working with social science researchers to strengthen theoretical understanding, methods and interpretation of the evidence.

Conclusions

Using the WHO-INTEGRATE evidence-to-decision framework to inform decision-making in a global guideline for induction of labour, we identified both challenges and opportunities relating to the lack of evidence in populations and settings of need and interest; the theoretical approach informing the development and application of WHO-INTEGRATE; and interpretation of the evidence. We hope these insights will be useful for primary researchers as well as the evidence synthesis and health decision-making communities, and ultimately contribute to a reduction in health inequities.
Endoplasmic reticulum stress targeted therapy for breast cancer
Authors: Xu Di , Liu Zhen , Liang Ming-Xing , Fei Yin-Jiao , Zhang Wei , Wu Yang , Tang Jin-Hai
Published: November 2022

Recurrence, metastasis, and drug resistance are still big challenges in breast cancer therapy. Internal and external stresses have been proven to substantially facilitate breast cancer progression through molecular and systemic mechanisms. For example, endoplasmic reticulum stress (ERS) results in activation of the unfolded protein response (UPR), which are considered an important cellular stress response. More and more reports indicate its key role in protein homeostasis and other diverse functions involved in the process of breast cancer progression. Therefore, therapies targeting the activation of ERS and its downstream signaling pathways are potentially helpful and novel tools to counteract and fight breast cancer. However, recent advances in our understanding of ERS are focused on characterizing and modulating ERS between healthy and disease states, and so little attention has been paid to studying the role and clinical application of targeting ERS in a certain cancer. In this review, we summarize the function and main mechanisms of ERS in different molecular types of breast cancer, and focus on the development of agents targeting ERS to provide new treatment strategies for breast cancer.
Magnetique: an interactive web application to explore transcriptome signatures of heart failure
Authors: Britto-Borges Thiago , Ludt Annekathrin , Boileau Etienne , Gjerga Enio , Marini Federico , Dieterich Christoph
Published: November 2022

Background

Despite a recent increase in the number of RNA-seq datasets investigating heart failure (HF), accessibility and usability remain critical issues for medical researchers. We address the need for an intuitive and interactive web application to explore the transcriptional signatures of heart failure with this work.

Methods

We reanalysed the Myocardial Applied Genomics Network RNA-seq dataset, one of the largest publicly available datasets of left ventricular RNA-seq samples from patients with dilated (DCM) or hypertrophic (HCM) cardiomyopathy, as well as unmatched non-failing hearts (NFD) from organ donors and patient characteristics that allowed us to model confounding factors. We analyse differential gene expression, associated pathway signatures and reconstruct signaling networks based on inferred transcription factor activities through integer linear programming. We additionally focus, for the first time, on differential RNA transcript isoform usage (DTU) changes and predict RNA-binding protein (RBP) to target transcript interactions using a Global test approach. We report results for all pairwise comparisons (DCM, HCM, NFD).

Results

Focusing on the DCM versus HCM contrast (DCMvsHCM), we identified 201 differentially expressed genes, some of which can be clearly associated with changes in ERK1 and ERK2 signaling. Interestingly, the signs of the predicted activity for these two kinases have been inferred to be opposite to each other: In the DCMvsHCM contrast, we predict ERK1 to be consistently less activated in DCM while ERK2 was more activated in DCM. In the DCMvsHCM contrast, we identified 149 differently used transcripts. One of the top candidates is the O-linked N-acetylglucosamine (GlcNAc) transferase (OGT), which catalyzes a common post-translational modification known for its role in heart arrhythmias and heart hypertrophy. Moreover, we reconstruct RBP – target interaction networks and showcase the examples of CPEB1, which is differentially expressed in the DCMvsHCM contrast.

Conclusion

Magnetique (https://shiny.dieterichlab.org/app/magnetique) is the first online application to provide an interactive view of the HF transcriptome at the RNA isoform level and to include transcription factor signaling and RBP:RNA interaction networks. The source code for both the analyses (https://github.com/dieterich-lab/magnetiqueCode2022) and the web application (https://github.com/AnnekathrinSilvia/magnetique) is available to the public. We hope that our application will help users to uncover the molecular basis of heart failure.
Influence of COVID-19 on the 10-year carbon footprint of the Nagoya University Hospital and medical research centre
Authors: Morooka Hikaru , Yamamoto Takanori , Tanaka Akihito , Furuhashi Kazuhiro , Miyagawa Yasuhiro , Maruyama Shoichi
Published: November 2022

Background:

Amidst the climate crisis, a key goal of the medical sector is to reduce its large carbon footprint. Although the Coronavirus disease 2019 (COVID-19) pandemic greatly impacted the medical sector, its influence on carbon footprints remains unknown. Therefore, the aim of this study was to evaluate changes in the carbon footprint of a university hospital with a medical research centre over the past 10 years.

Methods:

Data on electricity, gas, and water usage, pharmaceutical and medical supply costs, and waste amounts were recorded for Nagoya University Hospital from April 2010 to March 2021. The relevant emission factors were obtained from the Japanese government and the overall monthly carbon footprint was reported according to the Greenhouse Gas Protocol. The effect of the COVID-19 pandemic on the carbon footprint was then compared for three types of emission sources. Moreover, a regression model was used to plot quadratic functions as approximate functions using monthly carbon emissions and monthly average external temperatures. Finally, the monthly carbon footprint was calculated per hospital admission.

Results:

The overall carbon footprint of the hospital was 73,546 tCO2e in 2020, revealing an increase of 26.60% over the last 10 years. Carbon emissions from electricity consumption represented 26% of total emissions. The individual carbon footprints of pharmaceuticals, medical supplies, waste, and water usage also increased from 2010 to 2020. The overall monthly carbon footprint was positively correlated with the average monthly temperature (R2 = 0.7566, p < 0.001). Compared with 2019, the overall carbon footprint decreased by 2.19% in 2020. Moreover, the monthly carbon footprint per hospital admission increased significantly between 2018 (0.24 tCO2e/admission) and 2020 (0.26 tCO2e/admission) (p = 0.002).

Conclusion:

The overall carbon footprint of the hospital generally increased over the last decade. During the COVID-19 epidemic in 2020, the carbon footprint decreased slightly, likely because of the reduced number of patients. However, the carbon footprint per admission increased, which was attributed to more complicated patient backgrounds because of the ageing population. Therefore, evaluation of carbon emissions in the medical sector is urgently required in order to act on the climate crisis as soon as possible.
Radiation dose escalation for locally advanced nasopharyngeal carcinoma patients with local and/or regional residual lesions after standard chemoradiotherapy: a non-randomized, observational study
Authors: Jin Ting , Liu Nan-Fang , Jin Qi-Feng , Hua Yong-Hong , Chen Xiao-Zhong
Published: November 2022

Background

To assess the effectiveness and toxicity of radiation dose escalation for locally advanced nasopharyngeal carcinoma (LA-NPC) in patients with local and/or regional residual lesion(s) after standard treatment.

Methods

From November 2011 to November 2020, 259 LA-NPC patients who had local and/or regional residual lesion(s) after induction chemotherapy followed by concurrent chemoradiotherapy (IC + CCRT) from our hospital were included. The total dose of primary radiotherapy (RT) was 68.1–74.25 Gy (median, 70.4 Gy). The boost doses were 4.0–18.0 Gy (median, 9 Gy), 1.8–2.0 Gy/fraction.

Results

For all patients, the 5-year local relapse-free survival was 90.2%, regional relapse-free survival was 89.1%, locoregional relapse-free survival (LRRFS) was 79.5%, distant metastasis-free survival (DMFS) was 87.9%, failure-free survival (FFS) was 69.0%, and overall survival (OS) was 86.3%. LRRFS, DMFS, FFS, and OS in patients with age ≤ 65 versus > 65, plasma Epstein-Barr virus-deoxyribonucleic acid  ≤ 500 versus > 500, T1–2 versus T3–4, N0–1 versus N2–3, and stage III versus stage IV showed no statistically significant differences. The interval between primary RT and boost was not a prognostic factor for LRRFS, DMFS, FFS, and OS. Males had a lower 3-year FFS rate than females (72.9% vs. 83.7%, P = 0.024). LA-NPCs with locally and regionally residual lesion(s) had the worst 3-year DMFS and OS rates compared with locally or regionally residual lesion(s) (77.7% vs. 98.8% vs. 87.4%, P = 0.014; 75.9% vs. 94.5% vs. 82.4%, P = 0.002).

Conclusion

Boost radiation was an option for LA-NPCs with locally and/or regionally residual lesions after receiving IC + CCRT. It warrants further prospective study.

Trial registration: Retrospectively registered.
The implementation of physicians assistant in a surgical ward improves continuity in daily clinical work and increases comprehensibility of nurses and physicians
Authors: Halvachizadeh Sascha , Goezmen Sarper , Schuster Sibylle , Teuben Michel , Baechtold Matthias , Probst Pascal , Hauswirth Fabian , Muller Markus K.
Published: November 2022

Introduction

Physician Assistant (PA) have been deployed to increase the capacity of a team, supporting continuity and medical cover. The goal of this study was to assess the implementation of PAs on continuity of surgical rounds, on the collaboration of nurses and physicians and on support of administrative work.

Methods

This cross-sectional survey was performed on nurses and physicians who work full-time at a surgical ward in a Swiss reference center. PAs were introduced in our institution in 2019. Participants answered a self-developed questionnaire 6 and 12 months after the implementation of PAs. Administrative work, teamwork, improvement of workflow, and training of physicians has been assessed. Participants answered questions on a 5-point Likert scale and were stratified according to profession (nurse, physician).

Results

Participants (n = 53) reported a positive effect on the regular conduct of rounds (2.9, SD 1.1 points after 6 weeks and 3.5, SD 1.1 points after 12 weeks, p = 0.05). A significant improvement of nurse-doctor collaboration has been reported (3.6, SD 1.0 and 4.2, SD 0.8, p = 0.05). Nurses (n = 28, 52.8%) reported the that PAs are integrated in the physicians team rather than the nurses team (4.0, SD 0.0 points and 4.4, SD 0.7 points, p = 0.266) and a significant beneficial effect on the surgical clinic (3.7, SD 1.0 points and 4.4, SD 0.8 points, p = 0.043). Improved overall management of surgical cases was reported by the physicians (n = 25, 47.2%) (4.8, SD 0.4 and 4.3, SD 0.6, p = 0.046).

Conclusion

The implementation of PA has improved the collaboration of physicians and nurses substantially. Continuity of rounds has improved and the administrative workload for residents decreased substantially. Overall, the implementation of PA was reported to be beneficial for the surgical clinic.
A universal predictive and mechanistic urinary peptide signature in acute kidney injury
Authors: Piedrafita Alexis , Siwy Justyna , Klein Julie , Akkari Amal , Amaya-garrido Ana , Mebazaa Alexandre , Sanz Anna Belen , Breuil Benjamin , Montero Herrero Laura , Marcheix Bertrand , Depret François , Fernandez Lucie , Tardif Elsa , Minville Vincent , Alves Melinda , Metzger Jochen ,   Kidney Attack Study Group, Grunenwald Etienne , Feuillet Guylène , Buléon Marie , Brunet Manon , Mayeur Nicolas , Casemayou Audrey , Labaste François , Grossac Julia , Mischak Harald , Ortiz Alberto , Gazut Stéphane , Schanstra Joost P. , Faguer Stanislas
Published: November 2022

Background

The delayed diagnosis of acute kidney injury (AKI) episodes and the lack of specificity of current single AKI biomarkers hamper its management. Urinary peptidome analysis may help to identify early molecular changes in AKI and grasp its complexity to identify potential targetable molecular pathways.

Methods

In derivation and validation cohorts totalizing 1170 major cardiac bypass surgery patients and in an external cohort of 1569 intensive care unit (ICU) patients, a peptide-based score predictive of AKI (7-day KDIGO classification) was developed, validated, and compared to the reference biomarker urinary NGAL and NephroCheck and clinical scores.

Results

A set of 204 urinary peptides derived from 48 proteins related to hemolysis, inflammation, immune cells trafficking, innate immunity, and cell growth and survival was identified and validated for the early discrimination (< 4 h) of patients according to their risk to develop AKI (OR 6.13 [3.96–9.59], p < 0.001) outperforming reference biomarkers (urinary NGAL and [IGFBP7].[TIMP2] product) and clinical scores. In an external cohort of 1569 ICU patients, performances of the signature were similar (OR 5.92 [4.73–7.45], p < 0.001), and it was also associated with the in-hospital mortality (OR 2.62 [2.05–3.38], p < 0.001).

Conclusions

An overarching AKI physiopathology-driven urinary peptide signature shows significant promise for identifying, at an early stage, patients who will progress to AKI and thus to develop tailored treatments for this frequent and life-threatening condition. Performance of the urine peptide signature is as high as or higher than that of single biomarkers but adds mechanistic information that may help to discriminate sub-phenotypes of AKI offering new therapeutic avenues.
Subjective knee apprehension is not associated to physical parameters 6–12 months after anterior cruciate ligament reconstruction
Authors: Gauthier Morgan , Lê Thanh Nam , Wehn Antonia , Joseph Samuel , Tscholl Philippe M.
Published: November 2022

Purpose

Anterior cruciate ligament (ACL) rupture is a common injury and psychological parameters measured at 6–8 months are said to be almost more predictive for return to sport (RTS) than physiological. Purpose was 1) to evaluate the correlation between knee apprehension using ACL-RSI and physical factors after ACL reconstruction (ACLR), 2) to assess the correlation between ACL-RSI and patient parameters (age, pivot-sport, BMI), and 3) to evaluate ACL-RSI over time.

Methods

Patients with ACLR with or without meniscal repair between 2013 and 2020 were retrospectively analyzed. Including criteria were RTS testing battery, assessed at least 6 months after surgery, including physical parameters (strength, triple hop test, side hop test, and bilateral knee stability) and psychological parameters (ACL-RSI). 5 subgroups were analyzed to assessed factors such as age, BMI, pivot sport, time interval between two RTS testing battery.

Results

Three hundred three patients (212 male, 91 female) presenting ACLR were included. Mean age at surgery was 27 (± 8) years. 258 patients practiced pivot-sport activity and 45 non-pivot-sport activity. The mean interval between ACL rupture and surgery was 6.5 (± 4.5) months. RTS testing battery were performed at 8 (± 7) months after ACLR.

Mean ACL-RSI was 58 (± 28). 1) ACL-RSI was not influenced by muscle strength, coordination and stability of the knee. 2) ACL-RSI was significantly better in lower BMI and non-pivot-sport activities. No correlation was found between graft type, age, sex, and ACL-RSI assessment. 3) For patients who performed two RTS testing battery at 8 and 12 months, ACL-RSI did not significantly increase over time (56 to 64 points, p = 0.22) in spite of significant increased quadriceps (127 to 151 Nm/kg, p = 0.005) and hamstring (93 to 105 Nm/kg, p = 0.05) strength.

Conclusions

Psychological readiness before RTS, measured upon ACL-RSI does not correlate with any physical parameter at 8–12 months postoperatively. Although quadriceps and hamstring strength increased significantly over time, ACL-RSI does not and must therefore be routinely assessed.
“My guitar is my rifle”: Mexican migrants mobilising unconventionally through arts
Authors: Lara-Guerrero Larisa , Rojon Sebastien
Published: November 2022

Diasporas can create, transform, and exploit transnational networks to engage in political movements in their homeland and in their hostland, engaging in both electoral and non-electoral politics through political parties, political campaigns, and hometown organisations. However, the individual processes of subjectivation and its relationship with arts as a form of political engagement have been under-explored especially in contexts of violence and insecurity. This ethnographic paper sheds light on the micro-level of diaspora mobilisation by introducing the concept of “subjectivity” as a key term to analyse the transnational and unconventional political practices organised by migrants. As a result, this research aims to answer the following questions: (1) How are Mexican migrants becoming diasporic political subjects and creating spaces of transnational political activism in reaction to the context of violence in their homeland? (2) What makes them resort to art as a repertoire of contention against violence in their home towns? The paper introduces empirical examples collected in Brussels during 19 months of fieldwork with members of the Mexican diaspora, including semi-structured interviews with key informants and participant observation at political demonstrations, music rehearsals, charity concerts, gastronomic and artistic festivals, and political debates.
Synchronization clusters located on epileptic onset zones in neocortical epilepsy
Authors: Sun Yanping , Song Yuqiang , Ren Hongjin , Zhu Haifang , Wang Yanning , Li Xiaoli , Yan Wenjing , Wang Yuping
Published: November 2022

Background

Brain function is thought to rely on complex interactions of dynamic neural systems, which depend on the integrity of structural and functional networks. Focal epilepsy is considered to result from excessive focal synchronization in the network. Synchronization analysis of multichannel electrocorticography (ECoG) contributes to the understanding of and orientation of epilepsy. The aim of this study was to explore the synchronization in multichannel ECoG recordings from patients with neocortical epilepsy and characterize neural activity inside and outside the onset zone.

Methods

Four patients with neocortical epilepsy, who became seizure-free for more than 1 year after surgery guided by ECoG monitoring, were included in this study. ECoG data recorded during pre-surgical evaluation were analyzed. Synchronizations in phase and amplitude of different frequency bands between ECoG channels was analyzed using MATLAB. We generated 100 surrogate data from the original ECoG data using Amplitude Adjusted Fourier Transform to calculate the enhanced synchronization. The relationship between synchronization characteristics and seizure onset zone was analyzed.

Results

We found synchronization clusters in the 14–30 Hz and 30–80 Hz bands around the onset areas during both interictal and the beginning of ictal periods in all four patients.

Conclusions

The enhanced-synchronization clusters play a central role in epilepsy, and may activate the onset areas and contribute to the spreading of epileptiform activity.
Leptomeningeal carcinomatosis in a patient with recurrent unresectable squamous cell carcinoma of the retromolar trigone—a brief report
Authors: Pattanaik Jhansi , Goel Varshu , Sehrawat Priyanka , Rathore Ruchi , Singh Rajesh Kumar , Garg Ajay , Biswas Ahitagni
Published: November 2022

Background

The reported incidence of leptomeningeal carcinomatosis is 3–8% in patients with solid tumours. More commonly, it has been described in the setting of advanced cancers of the lung, breast and malignant melanoma.

Case presentation

A 50-year-old diabetic patient with recurrent unresectable squamous cell carcinoma (SCC) of the right retromolar trigone (rT4bN0M0) presented with severe low backache and weakness in bilateral lower limbs 20 days after the completion of concurrent chemoradiotherapy. Contrast-enhanced MRI of the spine showed multiple nodular enhancing leptomeningeal lesions at the lumbar level and an intramedullary T2/FLAIR-hyperintense longitudinal lesion involving the central cord from C2 to C7 vertebral levels, suggestive of leptomeningeal metastases. Cerebrospinal fluid (CSF) analysis revealed pleocytosis, elevated protein and markedly decreased glucose. The CSF cytology revealed scattered large atypical cells, suspicious for metastasis. Non-contrast MRI of the brain showed a T2/FLAIR-hyperintense lesion involving the right caudate nucleus suggestive of either an acute infarct with haemorrhagic transformation or a haemorrhagic brain metastasis. During assessment, he had high-grade fever and was started on empirical intravenous antibiotics (ceftriaxone, vancomycin and subsequently meropenem) in line with the management for acute bacterial meningitis. Gram staining of CSF did not demonstrate the presence of any bacteria and the specimen was sterile on culture. He did not respond to empirical antibiotics, had a progressive downhill course and eventually died due to aspiration pneumonia.

Conclusion

This brief report highlights the importance of awareness of leptomeningeal carcinomatosis as a possible cause of backache with sensorimotor deficit and autonomic dysfunction in a previously treated case of head and neck SCC.
Treating Smoking in Cancer Patients: An Essential Component of Cancer Care—The New National Cancer Institute Tobacco Control Monograph
Authors: Lowy Douglas R. , Fiore Michael C. , Willis Gordon , Mangold Kristen N. , Bloch Michele H. , Baker Timothy B.
Published: November 2022

PURPOSE:

Continued smoking after the diagnosis of cancer can markedly worsen oncology treatment side effects, cancer outcomes, cancer mortality, and all-cause mortality. Conversely, mounting evidence demonstrates that smoking cessation by patients with cancer improves outcomes. A cancer diagnosis often serves as a teachable moment, characterized by high motivation to quit. However, too few patients with cancer who smoke are offered evidence-based smoking cessation treatment, and too few engage in such treatment.

METHODS AND MATERIALS:

The National Cancer Institute commissioned Tobacco Control Monograph 23, Treating Smoking in Cancer Patients: An Essential Component of Cancer Care, to review and synthesize the evidence that clarifies the need to intervene with smoking in cancer care.

RESULTS:

Although many patients with newly diagnosed cancer who smoke make quit attempts, many of these are unsuccessful, and among those who successfully quit, relapse is common. Indeed, an estimated 12.2% of adults ever diagnosed with cancer reported they currently smoked (National Health Interview Survey, 2020). Patients with cancer who smoke are likely to benefit from smoking cessation treatments, including counseling and US Food and Drug Administration–approved medications, and there are many effective strategies to increase delivery of smoking cessation treatment in cancer care settings.

CONCLUSION:

Smoking cessation is among the most effective treatment options for improving the likelihood of survival, quality of life, and overall health of patients with cancer who smoke. It is important for cancer care clinicians and patients to realize that it is never too late to quit smoking and that there are clear benefits to doing so, regardless of cancer type.
A 12-lead ECG correlation network model exploring the inter-lead relationships
Authors: Zhang Chuanzhe , Li Jiahao , Pang Shaopeng , Xu Fangzhou , Zhou Shuwang
Published: November 2022

The 12-lead electrocardiogram (ECG) is widely used for automatic diagnosis of arrhythmia based on deep neural networks (DNN). In this paper, we use the 12-lead ECG dataset provided by the China Physiological Signal Challenge 2018 (CPSC2018), which contains 6877 samples and each sample contains 12-lead ECG records and corresponding reference labels. First, by statistical analysis of the results of 90 DNN models with F
1 > 0.6 published by CPSC2018, we found that almost all DNN models had high accuracy in identifying the left bundle branch block (LBBB) even when the number of training samples for LBBB is severely insufficient. Second, through ablation studies, we found that the absence of the 7th lead V1 severely affected the diagnostic accuracy of many DNN models, where ablation studies were used to quantify the effect of the disappearance of a single lead on the F
1 of the DNN model. We aim to explain the above two special phenomena using complex network theory. A 12-lead ECG correlation network based on the inter-lead Pearson correlation coefficient is proposed, which allows us to observe the correlation between a single lead and others, and quantify the correlation strength of each lead through a projection process. We used the covariance method to quantify the consistency of the change trend for the average correlation strength of 12 leads between any two categories, and found that the mean values of the covariance for LBBB under the positive and negative 12-lead ECG correlation network were 0.01 and 0.07, respectively, much smaller than other categories. This uniqueness may explain from the perspective of complex networks why LBBB can be diagnosed accurately by almost all DNN models when its number of samples used for training is severely insufficient. Furthermore, we found that the correlation between the lead V1 and other leads was close to 0. This low correlation may make the information of the lead V1 significantly different from other leads, resulting in its important role in the automatic diagnosis of arrhythmia.
The neutrino pair annihilation

around a massive source with an f(R) global monopole
Authors: Shi Yuxuan , Cheng Hongbo
Published: November 2022

In this work we investigate the neutrino pair annihilation around a gravitational object involving an f(R) global monopole. We derive and calculate the ratio

meaning that the energy deposition per unit time is over that in the Newtonian case. It is found that the greater influence from f(R) theory leads more energy to set free from the annihilation with greater ratio value. It is important that the existence of global monopole makes a sharp increase in the ratio

, causing heavier gamma-ray burst. We also discuss the derivative

as a function of radius r of the star to show the similar features, that is the considerable modification of Einstein's gravity and the global monopole with unified theory order will raise the amount of

more greatly. The stellar body with f(R) global monopole can be well qualified as a source of gamma-ray bursts. Moreover, we can select the factor

to be comparable with the accelerating universe while regulating the parameter η for the global monopole in order to make the ratio curves coincide with the results from astronomy. It is possible to probe the monopole from astrophysical observations.
Sticky, stickier and stickiest – a comparison of adhesive performance in clingfish, lumpsuckers and snailfish
Authors: Huie Jonathan M. , Wainwright Dylan K. , Summers Adam P. , Cohen Karly E.
Published: November 2022

The coastal waters of the North Pacific are home to the northern clingfish (Gobiesox maeandricus), Pacific spiny lumpsucker (Eumicrotremus orbis) and marbled snailfish (Liparis dennyi) – three fishes that have evolved ventral adhesive discs. Clingfish adhesive performance has been studied extensively, but relatively little is known about the performance of other sticky fishes. Here, we compared the peak adhesive forces and work to detachment of clingfish, lumpsuckers and snailfish on surfaces of varying roughness and over ontogeny. We also investigated the morphology of their adhesive discs through micro-computed tomography scanning and scanning electron microscopy. We found evidence that adhesive performance is tied to the intensity and variability of flow regimes in the fishes' habitats. The northern clingfish generates the highest adhesive forces and lives in the rocky intertidal zone where it must resist exposure to crashing waves. Lumpsuckers and snailfish both generate only a fraction of the clingfish's adhesive force, but live more subtidal where currents are slower and less variable. However, lumpsuckers generate more adhesive force relative to their body weight than snailfish, which we attribute to their higher-drag body shape and frequent bouts into the intertidal zone. Even so, the performance and morphology data suggest that snailfish adhesive discs are stiffer and built more efficiently than lumpsucker discs. Future studies should focus on sampling additional diversity and designing more ecologically relevant experiments when investigating differences in adhesive performance.
Yoga Impacts Cognitive Health: Neurophysiological Changes and Stress-regulation Mechanisms
Authors: Voss Stephanie , Cerna Jonathan , Gothe Neha P.
Published: November 2022

Yoga, a physical and contemplative practice, offers the practitioner a unique mind-body exercise experience demonstrating preliminary efficacy in improving cognitive health. We examine the evidence for underlying mechanisms that explain the yoga-cognition relationship in healthy older adults. The cognitive benefits of yoga may be the result of improved stress regulation and neurocognitive resource efficiency that facilitate bi-directional brain-body communication.
An Unusual Case of Arm Pain in a Young Soccer Player: Herpes Zoster in the Pediatric Athlete
Authors: MacDonald James , Mosser-Goldfarb Joy , Souverbielle Cristina Tomatis , Cuff Steven
Published: November 2022

Herpes zoster (HZ), shingles, is caused by the varicella-zoster virus (VZV). HZ develops as a reactivation of latent VZV and is characterized by a painful, vesicular rash typically manifesting in a dermatomal distribution on the arms, trunk or face. HZ occurs in individuals who had primary VZV disease (chickenpox) as a child or in those who have received live, attenuated VZV vaccine. HZ is common in the elderly and the immunocompromised, with age being the single greatest risk factor. The incidence of HZ in children is 74/100,000 person years for the unvaccinated and 38/100,000 person years for the vaccinated. We discuss the case of a 12-year-old soccer player with HZ who presented with right arm pain after a putative traumatic event. Diagnosis was made after two emergency department visits where the condition was not identified. HZ should be considered in the clinician's differential even in immunocompetent, vaccinated children.
Clinical Practice Patterns of Isthmic Spondylolysis in Young Athletes: A Survey of Pediatric Research in Sports Medicine Members
Authors: Hollabaugh William L. , Foley Davelaar Cassidy M. , McHorse Kevin J. , Achar Suraj A. , MacDonald James P. , Riederer Mark F.
Published: November 2022

Isthmic spondylolysis is a common cause of back pain in young athletes. The condition presents to numerous medical providers who employ a variety of different practices in diagnosis and management. The purpose of this study was twofold: to review the literature of diagnosis and management of the young athlete with isthmic spondylolysis and to survey Pediatric Research in Sports Medicine (PRiSM) members during the 2021 PRiSM Annual Meeting on practice patterns of diagnosis and management of the young athlete with isthmic spondylolysis. The response rate was 27%. Per respondents: 24% obtain oblique radiographs; 90% use magnetic resonance imaging as the advanced imaging modality; 60% treat with bracing; 57% recommend rest prior to physical therapy (PT); 53% prescribe return to sport activity restrictions. Although there are similarities in the diagnosis of isthmic spondylolysis in young athletes, this survey confirmed variability in management, especially bracing, timing of PT and return to sport activity restrictions.
Comparison of 2D and 3D semantic segmentation in urban areas using fused hyperspectral and lidar data
Authors: Kuras Agnieszka , Jenul Anna , Brell Maximilian , Burud Ingunn
Published: November 2022

Multisensor data fusion has become a hot topic in the remote sensing research community. This is thanks to significant technological advances and the ability to extract information that would have been challenging with a single sensor. However, sensory enhancement requires advanced analysis that enables deep learning. A framework is designed to effectively fuse hyperspectral and lidar data for semantic segmentation in the urban environment. Our work proposes a method of reducing dimensions by exploring the most representative features from hyperspectral and lidar data and using them for supervised semantic segmentation. In addition, we chose to compare segmentation models based on 2D and 3D convolutional operations with two different model architectures, such as U-Net and ResU-Net. All algorithms have been tested with three loss functions: standard Categorical Cross-Entropy, Focal Loss and a combination of Focal Loss and Jaccard Distance—Focal–Jaccard Loss. Experimental results demonstrated that the 3D segmentation of U-Net and ResU-Net with Focal and Focal–Jaccard Loss functions had significantly improved performance compared to the standard Categorical Cross-Entropy models. The results show a high accuracy score and reflect reality by preserving the complex geometry of the objects.