bluuebunny/crossref_metadata_2025 huggingface dataset:
Validity and Reliability of the Empowered Veteran Index Among Military Veterans
Authors: McDaniel Justin T. , Rosen Gina , Albright David L. , York Mary , Miller Kyle , Pekios Heather , Kundan Shivam
Published: May 2023

We sought to develop a tool designed to measure psychosocial reintegration outcomes among military veterans. We used a sequential mixed-methods study design for this research project. We conducted semi-structured interviews about veteran reintegration with 30 veteran members of The Mission Continues (TMC). Transcripts were coded/thematized based on three TMC program areas: personal growth (PG), connectedness (C), and community impact (CI). We developed/pilot-tested 65 Likert-scale items across three constructs. We collected survey data ( n = 851) and performed exploratory factor analysis. Cronbach’s alpha was used to measure internal consistency reliability. Results showed that the three-factor model was satisfactory, with eigenvalues of 8.11, 5.50, and 4.92, respectively, on the PG, C, and CI constructs. Model fit indices were also acceptable (RMSEA = 0.06) and Cronbach’s α’s were >.90. This study provided initial validity and reliability evidence for a tool that can be used to assess psychosocial reintegration outcomes among veterans.
Effect of driving pressure on early postoperative lung gas distribution in supratentorial craniotomy: a randomized controlled trial
Authors: Liu Feifei , Zhang Wei , Zhao Zhanqi , Xu Xin , Jian Minyu , Han Ruquan
Published: May 2023

Background

Neurosurgical patients represent a high-risk population for postoperative pulmonary complications (PPCs). A lower intraoperative driving pressure (DP) is related to a reduction in postoperative pulmonary complications. We hypothesized that driving pressure-guided ventilation during supratentorial craniotomy might lead to a more homogeneous gas distribution in the lung postoperatively.

Methods

This was a randomized trial conducted between June 2020 and July 2021 at Beijing Tiantan Hospital. Fifty-three patients undergoing supratentorial craniotomy were randomly divided into the titration group or control group at a ratio of 1 to 1. The control group received 5 cmH2O PEEP, and the titration group received individualized PEEP targeting the lowest DP. The primary outcome was the global inhomogeneity index (GI) immediately after extubation obtained by electrical impedance tomography (EIT). The secondary outcomes were lung ultrasonography scores (LUSs), respiratory system compliance, the ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen (PaO2/FiO2) and PPCs within 3 days postoperatively.

Results

Fifty-one patients were included in the analysis. The median (IQR [range]) DP in the titration group versus the control group was 10 (9–12 [7–13]) cmH2O vs. 11 (10–12 [7–13]) cmH2O, respectively (P = 0.040). The GI tract did not differ between groups immediately after extubation (P = 0.080). The LUSS was significantly lower in the titration group than in the control group immediately after tracheal extubation (1 [0–3] vs. 3 [1–6], P = 0.045). The compliance in the titration group was higher than that in the control group at 1 h after intubation (48 [42–54] vs. 41 [37–46] ml·cmH2O-1, P = 0.011) and at the end of surgery (46 [42–51] vs. 41 [37–44] ml·cmH2O-1, P = 0.029). The PaO2/FiO2 ratio was not significantly different between groups in terms of the ventilation protocol (P = 0.117). At the 3-day follow-up, no postoperative pulmonary complications occurred in either group.

Conclusions

Driving pressure-guided ventilation during supratentorial craniotomy did not contribute to postoperative homogeneous aeration, but it may lead to improved respiratory compliance and lower lung ultrasonography scores.

Clinical trial registration

ClinicalTrials.gov NCT04421976.
Association of albumin levels with the risk of intracranial atherosclerosis
Authors: Lin Xiaoyu , Ke Fangfang , Chen Maohua
Published: May 2023

Objective

Intracranial artery stenosis from atherosclerosis is one of the etiologies of ischemic stroke. There is a correlation between serum albumin level and atherosclerosis. We aimed to investigate whether serum albumin level is related to intracranial atherosclerosis and its significance.

Methods

A retrospective analysis of 150 individuals who underwent cervical cerebral angiography after admission, including clinical data, imaging data, and laboratory data. Since atherosclerosis cannot be used as a good quantitative indicator, we choose the degree of arterial stenosis to reflect atherosclerosis. SPSS 24 software was used for data analysis, and P < .05 was considered statistically significant.

Results

Univariate analysis showed that age, diabetes, and serum albumin level were risk factors for intracranial atherosclerosis (P < .05). Multivariate analysis showed that diabetes and serum albumin levels were independent risk factors for intracranial atherosclerosis (P< 0.05). The average serum albumin level in the non-severe group was 39.80 g/L, and the average serum albumin level in the severe group was 37.60 g/L. The area under the ROC curve of serum albumin was 0.667 (95%CI 0.576–0.758, P = .001), the cutoff value was 0.332176, the sensitivity was 75.9%, and the specificity was 57.3%.

Conclusion

Serum albumin level is an independent risk factor for intracranial atherosclerosis, and provides a new direction for clinical prevention and treatment.
A more than 20-year follow-up of pain and disability after anterior cervical decompression and fusion surgery for degenerative disc disease and comparisons between two surgical techniques
Authors: Hermansen Anna , Hedlund Rune , Zsigmond Peter , Peolsson Anneli
Published: May 2023

Background

Follow-ups more than 20 years after neck surgery are extremely rare. No previous randomized studies have investigated differences in pain and disability more than 20 years after ACDF surgery using different techniques. The purpose of this study was to describe pain and functioning more than 20 years after anterior cervical decompression and fusion surgery, and to compare outcomes between the Cloward Procedure and the carbon fiber fusion cage (CIFC).

Methods

This study is a 20 to 24-year follow-up of a randomized controlled trial. Questionnaires were sent to 64 individuals, at least 20 years after ACDF due to cervical radiculopathy. Fifty individuals (mean age 69, 60% women, 55% CIFC) completed questionnaires. Mean time since surgery was 22.4 years (range 20,5–24). Primary outcomes were neck pain and neck disability index (NDI). Secondary outcomes were frequency and intensity of neck and arm pain, headache, dizziness, self-efficacy, health related quality of life or global outcome. Clinically relevant improvements were defined as 30 mm decrease in pain and a decrease in disability of 20 percentage units. Between-group differences over time were analyzed with mixed design ANOVA and relationships between main outcomes and psychosocial factors were analyzed by Spearman´s rho.

Results

Neck pain and NDI score significantly improved over time (p  <  .001), with no group differences in primary or secondary outcomes. Eighty-eight per cent of participants experienced improvements or full recovery, 71% (pain) and 41% (NDI) had clinically relevant improvements. Pain and NDI were correlated with lower self-efficacy and quality of life.

Conclusion

The results from this study do not support the idea that fusion technique affects long-term outcome of ACDF. Pain and disability improved substantially over time, irrespective of surgical technique. However, the majority of participants reported residual disability not to a negligible extent. Pain and disability were correlated to lower self-efficacy and quality of life.
Serum homocysteine concentration as a marker for advanced diabetic nephropathy in a cohort of elderly patients
Authors: Zheng Xulei , Liu Qiaorui , Liu Zhiwen
Published: May 2023

Background

Hyperhomocysteinemia has been linked with chronic kidney disease (CKD). The present study investigated whether homocysteine (Hcy) serum levels might serve as a marker for the advancement of diabetic nephropathy (DN).

Methods

Clinical and laboratory indicators including Hcy, vitamin D (VD), urine protein, estimated glomerular filtration rate (eGFR) and the urinary protein/creatinine ratio in subjects > 65 years with DN (n = 1,845), prediabetes (n = 1,180) and in a non-diabetes (control) group (n = 28,720) were analyzed.

Results

DN patients had elevated Hcy concentrations, decreased VD and higher urinary protein levels, a reduced eGFR and a higher urinary protein/creatinine ratio compared with prediabetic and control subjects. After correcting for urinary protein quantitation, multivariate analysis revealed that both the Hcy concentration (P < 0.010) and urinary protein/creatinine ratio (P < 0.001) were risk factors, while the VD2 + VD3 serum concentration (P < 0.001) was a protective factor for DN. Moreover, Hcy > 12 µmol/L was a cut-off value for predicting advanced DN.

Conclusion

Hcy serum concentration is a potential marker for the advancement of CKD in DN but not prediabetes patients.
Amygdalin-folic acid-nanoparticles inhibit the proliferation of breast cancer and enhance the effect of radiotherapy through the modulation of tumor-promoting factors/ immunosuppressive modulators in vitro
Authors: Askar Mostafa A. , El-Sayyad Gharieb S. , Guida Mona S. , Khalifa Eman , Shabana El Shaimaa , Abdelrahman Ibrahim Y.
Published: May 2023

Introduction

Breast cancer (BC) cells often develop multiple mechanisms of chemo- and radio-resistance during tumor progression, which is the major reason for the failure of breast cancer therapy. Targeted nanomedicines have tremendous therapeutic potential in BC treatment over their free drug counterparts. Searching for chemo- and radio-sensitizers to overcome such resistance is therefore urgently required. The goal of this study is to evaluate and compare the radio-sensitizer efficacy of amygdalin-folic acid nanoparticles (Amy-F) on MCF-7 and MDA-MB-231 cells.

Materials and methods

The effects of Amy-F on MCF-7 and MDA-MB-231 cell proliferation and IC50 were assessed using MTT assay. The expression of proteins involved in several mechanisms induced by Amy-F in MCF-7 and MDA-MB-231 cells, including growth inhibition, apoptosis, tumor growth regulators, immuno-modulators, and radio-sensitizing activities were evaluated via flow cytometry and ELISA assay.

Results

Nanoparticles demonstrated sustained Amy-F release properties and apparent selectivity towards BC cells. Cell-based assays revealed that Amy-F markedly suppresses cancer cell growth and improves radiotherapy (RT) through inducing cell cycle arrest (G1 and sub-G1), and increases apoptosis as well as reduces the proliferation of BC by down-regulating mitogen-activated protein kinases (MAPK/P38), iron level (Fe), nitric oxide (NO), and up-regulating the reactive oxygen species level (ROS). Amy-F has also been shown to suppress the expression of the cluster of differentiation (CD4 and CD80), and interfere with the Transforming growth factor beta (TGF- β)/Interferon-gamma (INF-g)/Interleukin-2 (IL-2)/Interleukin-6 (IL-6)/Vascular endothelial growth factor (VEGF) induced suppression in its signaling hub, while up-regulating natural killer group 2D receptor (NKG2D) and CD8 expression.

Conclusions

Collectively, the novel Amy-F either alone or in combination with RT abrogated BC proliferation.
Comparing the effectiveness of asynchronous e-modules and didactic lectures to teach electrocardiogram interpretation to first year US medical students
Authors: Olvet Doreen M. , Sadigh Kaveh
Published: May 2023

Background

Medical students are expected to be competent in interpreting electrocardiograms (ECGs) by the time they graduate, but many are unable to master this skill. Studies suggest that e-modules are an effective way to teach ECG interpretation, however they are typically evaluated for use during clinical clerkships. We sought to determine if an e-module could replace a didactic lecture to teach ECG interpretation during a preclinical cardiology course.

Methods

We developed an asynchronous, interactive e-module that consisted of narrated videos, pop-up questions and quizzes with feedback. Participants were first year medical students who were either taught ECG interpretation during a 2-hour didactic lecture (control group) or were given unlimited access to the e-module (e-module group). First-year internal medicine residents (PGY1 group) were included to benchmark where ECG interpretation skills should be at graduation. At three time-points (pre-course, post-course, and 1-year follow-up), participants were evaluated for ECG knowledge and confidence. A mixed-ANOVA was used to compare groups over time. Students were also asked to describe what additional resources they used to learn ECG interpretation throughout the study.

Results

Data was available for 73 (54%) students in the control group, 112 (81%) in the e-module group and 47 (71%) in the PGY1 group. Pre-course scores did not differ between the control and e-module groups (39% vs. 38%, respectively). However, the e-module group performed significantly better than the control group on the post-course test (78% vs. 66%). In a subsample with 1-year follow-up data, the e-module group’s performance decreased, and the control group remained the same. The PGY1 groups’ knowledge scores were stable over time. Confidence in both medical student groups increased by the end of the course, however only pre-course knowledge and confidence were significantly correlated. Most students relied on textbooks and course materials for learning ECG, however online resources were also utilized.

Conclusions

An asynchronous, interactive e-module was more effective than a didactic lecture for teaching ECG interpretation, however continued practice is needed regardless of how students learn to interpret ECGs. Various ECG resources are available to students to support their self-regulated learning.
Classification of imbalanced data using machine learning algorithms to predict the risk of renal graft failures in Ethiopia
Authors: Mulugeta Getahun , Zewotir Temesgen , Tegegne Awoke Seyoum , Juhar Leja Hamza , Muleta Mahteme Bekele
Published: May 2023

Introduction

The prevalence of end-stage renal disease has raised the need for renal replacement therapy over recent decades. Even though a kidney transplant offers an improved quality of life and lower cost of care than dialysis, graft failure is possible after transplantation. Hence, this study aimed to predict the risk of graft failure among post-transplant recipients in Ethiopia using the selected machine learning prediction models.

Methodology

The data was extracted from the retrospective cohort of kidney transplant recipients at the Ethiopian National Kidney Transplantation Center from September 2015 to February 2022. In response to the imbalanced nature of the data, we performed hyperparameter tuning, probability threshold moving, tree-based ensemble learning, stacking ensemble learning, and probability calibrations to improve the prediction results. Merit-based selected probabilistic (logistic regression, naive Bayes, and artificial neural network) and tree-based ensemble (random forest, bagged tree, and stochastic gradient boosting) models were applied. Model comparison was performed in terms of discrimination and calibration performance. The best-performing model was then used to predict the risk of graft failure.

Results

A total of 278 completed cases were analyzed, with 21 graft failures and 3 events per predictor. Of these, 74.8% are male, and 25.2% are female, with a median age of 37. From the comparison of models at the individual level, the bagged tree and random forest have top and equal discrimination performance (AUC-ROC = 0.84). In contrast, the random forest has the best calibration performance (brier score = 0.045). Under testing the individual model as a meta-learner for stacking ensemble learning, the result of stochastic gradient boosting as a meta-learner has the top discrimination (AUC-ROC = 0.88) and calibration (brier score = 0.048) performance. Regarding feature importance, chronic rejection, blood urea nitrogen, number of post-transplant admissions, phosphorus level, acute rejection, and urological complications are the top predictors of graft failure.

Conclusions

Bagging, boosting, and stacking, with probability calibration, are good choices for clinical risk predictions working on imbalanced data. The data-driven probability threshold is more beneficial than the natural threshold of 0.5 to improve the prediction result from imbalanced data. Integrating various techniques in a systematic framework is a smart strategy to improve prediction results from imbalanced data. It is recommended for clinical experts in kidney transplantation to use the final calibrated model as a decision support system to predict the risk of graft failure for individual patients.
Fruit, vegetable, and fruit juice consumption and risk of gestational diabetes mellitus: a systematic review and meta-analysis
Authors: Liao Yan-Ping , Zheng Qing-Xiang , Jiang Xiu-Min , Chen Xiao-Qian , Gao Xiao-Xia , Pan Yu-Qing
Published: May 2023

Background

Fruit, vegetable, and fruit juice intake is associated with the risk of gestational diabetes mellitus (GDM). However, the conclusion is limited and conflicted. The purpose of this systematic review and meta-analysis is to investigate the association between fruit, vegetable, and fruit juice consumption and the risk of GDM.

Methods

To find relevant studies, we searched PubMed, The Cochrane Library, Web of Science, Embase, ScienceDirect, PsycINFO, CINAHL, Ovid, EBSCO, CBM, CNKI, Wanfang Data, and VIP for the report on prospective cohort studies published from inception to April 8, 2022. Summary relative risks (RR) and 95% confidence intervals (Cis) were estimated using a random-effects model.

Results

A total of 12 studies with 32,794 participants were included in the meta-analysis. Total fruit consumption was associated with a lower risk of GDM (RR = 0.92, 95% CI = 0.86–0.99). Whereas an increasing the consumption of vegetable, including all vegetable (RR = 0.95, 95% CI = 0.87–1.03), starchy vegetable (RR = 1.01, 95% CI = 0.82–1.26), and fruit juice (RR = 0.97, 95% CI = 0.91–1.04) was not associated with a reduction in the risk of GDM. In a dose‒response analysis of eight studies, a 3% reduction in risk of GDM for a 100 g/d increase in fruit consumption (RR = 0.97, 95% CI = 0.96–0.99).

Conclusions

The findings suggest that higher fruit consumption may reduce the risk of GDM, with a 3% reduction in the risk of GDM for every 100 g/d increase in fruit intake. Higher-quality prospective studies or randomized clinical trials are required to validate the effect of different variations of fruits, vegetables, and fruit juice consumption on the risk of GDM.
Respiratory muscle training: a bibliometric analysis of 60 years’ multidisciplinary journey
Authors: Ramli Muhammad Imran , Hamzaid Nur Azah , Engkasan Julia Patrick , Usman Juliana
Published: May 2023

Background

Over the decades, many publications have established respiratory muscle training (RMT) as an effective way in improving respiratory dysfunction in multiple populations. The aim of the paper is to determine the trend of research and multidisciplinary collaboration in publications related to RMT over the last 6 decades. The authors also sought to chart the advancement of RMT among people with spinal cord injury (SCI) over the last 60 years.

Methods

Bibliometric analysis was made, including the publications’ profiles, citation analysis and research trends of the relevant literature over the last 60 years. Publications from all time frames were retrieved from Scopus database. A subgroup analysis of publications pertinent to people with SCI was also made.

Results

Research on RMT has been steadily increasing over the last 6 decades and across geographical locations. While medicine continues to dominate the research on RMT, this topic also continues to attract researchers and publications from other areas such as engineering, computer science and social science over the last 10 years. Research collaboration between authors in different backgrounds was observed since 2006. Source titles from non-medical backgrounds have also published articles pertinent to RMT. Among people with SCI, researchers utilised a wide range of technology from simple spirometers to electromyography in both intervention and outcome measures. With various types of interventions implemented, RMT generally improves pulmonary function and respiratory muscle strength among people with SCI.

Conclusions

While research on RMT has been steadily increasing over the last 6 decades, more collaborations are encouraged in the future to produce more impactful and beneficial research on people who suffer from respiratory disorders.
Lactobacillus paracasei L9 affects disease progression in experimental autoimmune neuritis by regulating intestinal flora structure and arginine metabolism
Authors: Meng Yuting , Qiu Xiangjie , Tang Zhongxiang , Mao Yu , Tan Yurong
Published: May 2023

Background

Autoimmune neuropathies are common peripheral nervous system (PNS) disorders. Environmental influences and dietary components are known to affect the course of autoimmune diseases. Intestinal microorganisms can be dynamically regulated through diet, and this study combines intestinal microorganisms with diseases to open up new therapeutic ideas.

Methods

In Lewis rats, a model of EAN was established with P0 peptide, Lactobacillus were used as treatment, serum T-cell ratio, inflammatory factors, sciatic neuropathological changes, and pathological inflammatory effects on intestinal mucosa were detected, and fecal metabolomics and 16 s microbiome analysis were performed to further explore the mechanism.

Results

In the EAN rat model, Lactobacillus paracasei L9 (LP) could dynamically regulate the CD4+/CD8+T balance in serum, reduce serum IL-1, IL-6 and TNF-α expression levels, improve sciatic nerve demyelination and inflammatory infiltration, and reduce nervous system score. In the rat model of EAN, intestinal mucosa was damaged. Occludin and ZO-1 were downregulated. IL-1, TNF-α and Reg3γ were upregulated. LP gavage induced intestinal mucosa recovery; occludin and ZO-1 upregulation; IL-1, TNF-α and Reg3γ downregulation. Finally, metabolomics and 16 s microbiome analysis were performed, and differential metabolites were enriched with an important metabolic pathway, arginine and proline metabolism.

Conclusion

LP improved EAN in rats by influencing intestinal community and the lysine and proline metabolism.
Characteristics and impact of interventions to support healthcare providers’ compliance with guideline recommendations for breast cancer: a systematic literature review
Authors: Ricci-Cabello Ignacio , Carvallo-Castañeda Darla , Vásquez-Mejía Adrián , Alonso-Coello Pablo , Saz-Parkinson Zuleika , Parmelli Elena , Morgano Gian Paolo , Rigau David , Solà Ivan , Neamtiu Luciana , Niño-de-Guzmán Ena
Published: May 2023

Background

Breast cancer clinical practice guidelines (CPGs) offer evidence-based recommendations to improve quality of healthcare for patients. Suboptimal compliance with breast cancer guideline recommendations remains frequent, and has been associated with a decreased survival. The aim of this systematic review was to characterize and determine the impact of available interventions to support healthcare providers’ compliance with CPGs recommendations in breast cancer healthcare.

Methods

We searched for systematic reviews and primary studies in PubMed and Embase (from inception to May 2021). We included experimental and observational studies reporting on the use of interventions to support compliance with breast cancer CPGs. Eligibility assessment, data extraction and critical appraisal was conducted by one reviewer, and cross-checked by a second reviewer. Using the same approach, we synthesized the characteristics and the effects of the interventions by type of intervention (according to the EPOC taxonomy), and applied the GRADE framework to assess the certainty of evidence.

Results

We identified 35 primary studies reporting on 24 different interventions. Most frequently described interventions consisted in computerized decision support systems (12 studies); educational interventions (seven), audit and feedback (two), and multifaceted interventions (nine). There is low quality evidence that educational interventions targeted to healthcare professionals may improve compliance with recommendations concerning breast cancer screening, diagnosis and treatment. There is moderate quality evidence that reminder systems for healthcare professionals improve compliance with recommendations concerning breast cancer screening. There is low quality evidence that multifaceted interventions may improve compliance with recommendations concerning breast cancer screening. The effectiveness of the remaining types of interventions identified have not been evaluated with appropriate study designs for such purpose. There is very limited data on the costs of implementing these interventions.

Conclusions

Different types of interventions to support compliance with breast cancer CPGs recommendations are available, and most of them show positive effects. More robust trials are needed to strengthen the available evidence base concerning their efficacy. Gathering data on the costs of implementing the proposed interventions is needed to inform decisions about their widespread implementation.

Trial registration

CRD42018092884 (PROSPERO)
Cancer cachexia: molecular mechanisms and treatment strategies
Authors: Setiawan Tania , Sari Ita Novita , Wijaya Yoseph Toni , Julianto Nadya Marcelina , Muhammad Jabir Aliyu , Lee Hyeok , Chae Ji Heon , Kwon Hyog Young
Published: May 2023

Muscle wasting is a consequence of physiological changes or a pathology characterized by increased catabolic activity that leads to progressive loss of skeletal muscle mass and strength. Numerous diseases, including cancer, organ failure, infection, and aging-associated diseases, are associated with muscle wasting. Cancer cachexia is a multifactorial syndrome characterized by loss of skeletal muscle mass, with or without the loss of fat mass, resulting in functional impairment and reduced quality of life. It is caused by the upregulation of systemic inflammation and catabolic stimuli, leading to inhibition of protein synthesis and enhancement of muscle catabolism. Here, we summarize the complex molecular networks that regulate muscle mass and function. Moreover, we describe complex multi-organ roles in cancer cachexia. Although cachexia is one of the main causes of cancer-related deaths, there are still no approved drugs for cancer cachexia. Thus, we compiled recent ongoing pre-clinical and clinical trials and further discussed potential therapeutic approaches for cancer cachexia.
The applications of CRISPR/Cas-mediated genome editing in genetic hearing loss
Authors: Wu Junhao , Tao Yong , Deng Di , Meng Zhaoli , Zhao Yu
Published: May 2023

Hearing loss (HL) can be caused by a number of different genetic factors. Non-syndromic HL refers that HL occurs as an isolated symptom in an individual, whereas syndromic HL refers that HL is associated with other symptoms or abnormalities. To date, more than 140 genes have been identified as being associated with non-syndromic HL, and approximately 400 genetic syndromes can include HL as one of the clinical symptoms. However, no gene therapeutic approaches are currently available to restore or improve hearing. Therefore, there is an urgent necessity to elucidate the possible pathogenesis of specific mutations in HL-associated genes and to investigate the promising therapeutic strategies for genetic HL. The development of the CRISPR/Cas system has revolutionized the field of genome engineering, which has become an efficacious and cost-effective tool to foster genetic HL research. Moreover, several in vivo studies have demonstrated the therapeutic efficacy of the CRISPR/Cas-mediated treatments for specific genetic HL. In this review, we briefly introduce the progress in CRISPR/Cas technique as well as the understanding of genetic HL, and then we detail the recent achievements of CRISPR/Cas technique in disease modeling and therapeutic strategies for genetic HL. Furthermore, we discuss the challenges for the application of CRISPR/Cas technique in future clinical treatments.
Fear of progression among postoperative patients with newly diagnosed lung cancer: a cross-sectional survey in China
Authors: Chen Ruiyun , Yang Hui , Zhang Hongmei , Chen Jingru , Liu Saisai , Wei Li
Published: May 2023

Background

More lung cancer cases are becoming diagnosed earlier in recent years. The diagnosis is often accompanied by fear of progression (FoP). There is a clear research gap in the existing literature on FoP and the most frequent concerns in newly diagnosed lung cancer patients.

Objective

To identify the status and factors related to FoP in newly diagnosed Chinese lung cancer patients undergoing thoracoscopic lung cancer resection.

Methods

A cross-sectional design with convenience sampling was used in this study. Participants (N = 188) with newly diagnosed lung cancer (≤ 6 months) at one hospital in Zhengzhou were recruited. A demographic questionnaire, Fear of Progression Questionnaire-Short Form, Social Support Rating Scale (SSRS), Simplified Coping Style Questionnaire, and Brief Illness Perception Questionnaire were used to assess characteristics, FoP, social support, coping style, and patient illness perceptions. Multivariable logistic regression analysis was used to identify factors associated with FoP.

Results

The mean score of FoP was 35.39 ± 8.03. There are 56.4% of the patients (scores ≥ 34) have a clinically dysfunctional level of FoP. FoP was higher in young (18–39 years) than middle-aged patients (40–59 years) and elderly patients (≧60 years) (P = 0.004). Patients aged 40–59 years showed significantly higher fear of family-related concerns (P < 0.001), a fear of potential harm from medications (P = 0.001); Patients aged 18–39 years and 40–59 years showed significantly higher fears of work-related concerns (P = 0.012). Multiple logistic regression analyses showed that patients’ age, the time from surgery and SSRS score were found to be independently associated with higher FoP.

Conclusions

High FoP is a frequently reported problem among newly diagnosed lung cancer patients, especially those less than 60 years old. Professional psychoeducation, psychological interventions, and personalized support are needed for patients with a high FoP.
Impact of nutritional and educational support on home enteral nutrition
Authors: Madrid-Paredes Adela , Leyva-Martínez Socorro , Ávila-Rubio Verónica , Molina-Soria Juan Bautista , Sorribes-Carrera Patricia , Yeste-Doblas Carmen , López-Medina José Antonio , Luna-López Victoria Eugenia , Fernández-Soto María Luisa
Published: May 2023

Background

Home Enteral Nutrition (HEN) is used to prevent or correct malnutrition in outpatients. Due to the complexity of this process, the indication, follow-up, and results of an educational program of HEN patients was evaluated.

Methods

A prospective, observational, real-life, multicenter study was performed in 21 Spanish Hospital. Patients receiving HEN by nasogastric tube or ostomy were included. The following variables were collected: age, gender, HEN indication, type of formula, nutritional requirements, laboratory variables, complications, and quality standards of the educational program. To calculate the energy and protein requirements, the FAO/WHO/UNU formula was used considering the adjusted weight of the patients. All data were analyzed using SPSS.24.

Results

414 patients were included. Most conditions diagnosed were neurodegenerative diseases (64.8%). 100 (25.3%) were diabetic. The mean weight was 59.3 ± 10.4 kg and BMI 22.6 ± 3.2. Moderate protein-calorie malnutrition was predominant at baseline (46.4%). Improvement in nutritional status at six months was recorded in more than 75% of patients (p < 0.05). Tolerance problems, diarrhea and abdominal distension fell between the 3- and 6-month visits (p < 0.05). Patients who received intermittent EN had fewer tolerance-related effects (OR 0.042; 95% CI 0.006–0.279) and less diarrhoea (OR 0.042; 95% CI 0.006–0.279). At the baseline and 6-month visits, compliance with the educational measures proposed by the prescriber was ≥ 99%.

Conclusion

The nutritional assessment to prescribe individualized HEN to each patient, together with educational measures and training in the proper use of this treatment for both patients and trainers, improves nutritional status and reduces the onset of adverse events.
An evaluation of the governance structure of marine services in South Africa’s ports system
Authors: Mthembu Sphiwe Eugene , Chasomeris Mihalis
Published: May 2023

Port governance structures are a vital factor impacting port investments, efficiencies, effectiveness and productivity. An important determining factor is the port management and whether it is centralized under the national government as a State-Owned Enterprise (SOE), decentralized to the municipal level, or alternatively privatized. Reforms in port management indicate that ports either subscribe to a public service port, tool port, landlord port or private port approach. Several inefficiencies exist in the governance, pricing and performance of marine services in South Africa. This study aims to evaluate the governance structure of marine services in South Africa’s ports. The research methodology included observations, a focus group with six participants and semi-structured interviews with twenty participants that included port managers, harbour masters, port experts, port agents, terminal operators, and cargo owners. The main findings confirmed the need for the participation of private service providers in the provision of marine services in South Africa’s ports and additional regulations on marine services to advance investment, performance and protection of port users. Although there is a need for private sector participation in the provision of marine services in South Africa’s ports, participation should enhance the country’s economic and developmental agenda, including job creation, investment in infrastructure, improved service provision and transforming the ports system.
Potential of parasitoids to control Diaspis echinocacti (Bouché) (Hemiptera: Diaspididae) on Opuntia spp. cactus pear
Authors: El Aalaoui Mohamed , Sbaghi Mohamed
Published: May 2023

Background

Diaspis echinocacti (Bouché) is a major pest of cactus pear species worldwide. Over the past three years, this scale insect has seen increasing interest regarding its spread and importance, as well as the efficacy of its primary parasitoids Aphytis debachi Azim, and Plagiomerus diaspidis Crawford, as biocontrol agents. Infestation of cactus pear plants by D. echinocacti and parasitism rates of its two parasitoids were evaluated in fields in Zemamra-Morocco, for three years (2020–2022). Infested cladodes were collected and incubated in the laboratory (27 ± 1 °C) for parasitism study.

Results

Infestation of cactus pear plants by the cochineal increased continuously during the study period to reach 66% in 2022. Parasitism rates were lowest in 2020 and increased thereafter to 74.10 and 38.38% in 2022 for P. diaspidis, and A. debachi, respectively. The most abundant parasitoid was P. diaspidis. The functional response and mutual interference of P. diaspidis and A. debachi attacking D. echinocacti second instar nymphs were studied in the laboratory. Logistic regression for both parasitoids tested had a negative linear parameter indicating a type II functional response. Attack rates were 0.73 and 0.60 and handling times were 0.09 and 0.06 h for P. diaspidis and A. debachi, respectively, were estimated using Holling's disk equation. Search efficiency decreased significantly from 0.060 to 0.002 for P. diaspidis and from 0.067 to 0.003 for A. debachi when the parasitoids density increased from 1 to 8.

Conclusions

Parasitism potential, functional response and mutual interference of P. diaspidis and A. debachi attacking D. echinocacti were reported. The results of this investigation suggest that both P. diaspidis and A. debachi had the potential to effectively control infestations of D. echinocacti on cactus pear plantations.
Creutzfeldt–Jakob disease in a post-COVID-19 patient: did SARS-CoV-2 accelerate the neurodegeneration?
Authors: Alloush Taha K. , Alloush Adel T. , Abdelazeem Yaser , Shokri Hossam M. , Abdulghani Khaled O. , Elzoghby Ahmed
Published: May 2023

Background

Creutzfeldt–Jakob disease (CJD) is a rare, fatal neurodegenerative disorder, with few months as a usual duration from onset to death.

Case presentation

In this case report, a patient of Sporadic CJD (sCJD) who presented one month after severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The diagnosis of this case was established after confirming findings from clinical, neurophysiology, radiological, and laboratory features of this disease.

Conclusion

Putting in mind all the updated data on the pathogenesis of CJD and the immune responses to SARS-CoV-2, we can suggest that COVID-19 can lead to accelerated pathogenesis and exaggerated manifestations of this fatal neurodegenerative disease.
Neurosurgical sports injury (an established unit)
Authors: Abouhashem Safwat
Published: May 2023

Management of Sports-related injuries have long been recognized and reported to improve medical care for sports-related injuries as well as improve athletes’ health, fitness, safety, and well-being. Various anatomical regions are affected by sports activities involving the head and spine, which account for 9.4% and 8–15% of total sports injuries, respectively. Furthermore, sports-related brain injuries have been associated with a 3% mortality rate following hospitalization. Neurosurgery is the medical discipline with the greatest experience in dealing with brain and spinal damage, as all patients who report to the emergency room with head injuries are treated by neurosurgeons. There are also numerous cases of acute and chronic spinal abnormalities that are common in athletes of all ages and ability levels. The frequency of sports-related spinal and brain injuries is expected to rise as the number of individuals participating in sports activities, whether professionally or recreationally, grows. As a result, the neurosurgeon's role is projected to grow over time, covering not only hospital treatment and management of sports-related head, spine, and peripheral nerve injuries but also on-field assessment and sideline medical team, as well as participation in sports injury research. Sport neurosurgeons have more to contribute in both clinical care and research to the field of sports medicine. This role could include not only hospital care and management of sports-related head, spine, and peripheral nerve injuries, but also on-field assessment and sideline care of athletes, as well as a significant role in sports injury research. The purpose of this literature is to provide an overview of sport-specific neurosurgical injuries and treatment, and outcomes and to identify who is a sports neurosurgeons and why do they exist? Traumatic brain injuries, spinal injuries, peripheral nerve injuries, and neurological diseases that are more likely to get worse during sports seem to be examples of sports-related neurosurgical injuries. Neurosurgeons and the neurosurgical community should be concerned about the growing knowledge and evolution in the field of sports medicine, and they should embrace significant advances in our understanding of sports-related neurological syndromes, as well as sports neurosurgery should be considered as an individualized aspect of neurological surgery.
Dynamic contrast-enhanced MRI and Apparent diffusion coefficient mapping in the characterization of Palpable breast lesions: A prospective observational study
Authors: Boruah Deb K. , Konwar Nitashree , Gogoi Bidyut B. , Hazarika Karuna , Ahmed Halimuddin
Published: May 2023

Background

Breast MRI is the imaging modality of choice in patients with palpable breast lesions unequivocal on mammography and ultrasonography. This study aims to evaluate the role of dynamic contrast-enhanced MRI (DCE-MRI) and apparent diffusion coefficient mapping in the characterization and differentiation of various palpable breast lesions. This prospective observational study was conducted in a tertiary care hospital between July 2019 and June 2021. Sixty-six patients with palpable breast lesions were undergone MRI scans of the breasts. The various palpable breast lesions were categorized according to the 5th edition BI-RADS lexicon. The sensitivity of ADC mapping and DCE-MRI was determined for differentiation of various palpable breast lesions according to the BI-RADS category and gold standard histopathological findings.

Results

Of 66 patients with palpable breast lesions, 36 patients (54.5%) were benign and 30 patients (45.5%) were malignant lesions. Malignant palpable breast lesions had a mean ADC value of 0.939 ± 0.166[SD] × 10−3 mm2/s, and benign lesions had 1.891 ± 0.524[SD] × 10−3 mm2/s where unpaired Student t-test showed statistically significant difference of P value 0.0005. BI-RADS 2 lesions had a mean ADC value of 2.056 ± 0.471[SD] × 10−3 mm2/s, BI-RADS 3 had 1.314 ± 0.151[SD] × 10−3 mm2/s, BI-RADS 4 had 0.935 ± 0.119[SD] × 10−3 mm2/s, and BI-RADS 5 had 0.930 ± 0.943[SD] × 10−3 mm2/s. BI-RADS 2 category showed optimal cutoff mean ADC of 1.508 × 10−3 mm2/s with a sensitivity of 85.7% and specificity of 94.7%, BI-RADS 3 lesions had 1.208 × 10−3 mm2/s with a sensitivity of 75% and specificity of 55.2%, BI-RADS 4 lesions had 1.064 × 10−3 mm2/s with a sensitivity 80% and specificity of 67.9%, and BI-RADS 5 lesions had 1.013 × 10−3 mm2/s with a sensitivity of 80% and specificity of 82.6%.

Conclusions

Breast MRI is superior to the other imaging modalities for the characterization and differentiation of various palpable breast lesions. The combined use of ADC mapping and DCE-MRI had more sensitivity than conventional MRI, ADC mapping or DCE-MRI alone.
OLD ENGLISH LEXEME ÆÐELING IN THE GLOSSARIES AND IN THE TEXT OF THE POEM BEOWULF
Authors: Krupina Ekaterina A.
Published: May 2023

Background. The Old English poem Beowulf is one of the samples of the Anglo-Saxon poetic tradition and the culture. This work keeps secrets that attract attention of culture experts, historians, linguists, including lexicographers. The 19th century became a starting point for making dictionaries to this poem. Both dictionaries as the text can be a valuable source of information about semantic scope of lexical items.

Purpose. The article considers the semantic scope and the shades of the meaning of the Old English æðeling.

Materials and methods. The research material comprises the text of the Old English poem Beowulf, unindependent glossaries by J. Kemble 1837, B. Thorpe 1855, W.J. Sedgefield 1913, F. Klaeber 1950, A. Wyatt 1898, the glossaries to online projects Beowulf on Steorarume, Gutenberg. The continuous sampling, contextual analysis, dictionary criticism methods were used.

Results. The article considers the etymology of the Old English lexeme æðeling, and its etymological parallel lines. On the basis of the text examples the meaning of the noun and the shades of the meaning were determined. They are “king”, “noble man”, “warrior”, “descendants of noble and glorious”, “weak man”, “bold man”, “noble kinsman”. The analysis of the dictionary entries proves the wide semantic meaning and the shades of the meaning of the noun. The dynamics of the development of the definition in the dictionaries of the 19-21th centuries is also fixed.

Practical implications. The results of the research can be used in teaching students History of the English Language. Also, they can be used for replenishing the dictionaries to the Old English poem Beowulf.
China’s economic challenge to Europe/Europa y el desafío económico de China
Authors: Wihtol Robert
Published: May 2023

China es el mayor desafío económico de Europa. La aspiración de China por el dominio geopolítico, económico y tecnológico está tensionando gravemente sus relaciones con Europa, que se encuentran en una clara trayectoria descendente. Las posiciones se han endurecido por ambas partes, con China volviéndose económicamente hacia adentro y la Unión Europea etiquetando a China como un competidor total, con limitadas áreas para el compromiso. El enfoque de China es a largo plazo y estratégico, explotando las divisiones internas de la UE y la débil cooperación transatlántica con Estados Unidos. A China le gustaría tener acceso a tecnologías avanzadas con posibles aplicaciones militares, y ha adquirido puertos europeos y otras infraestructuras estratégicas. A través de la Iniciativa de la Franja y la Ruta, se ha convertido en el mayor acreedor bilateral del mundo. En último término, China busca revisar la arquitectura económica internacional y “reescribir las reglas del juego”. La respuesta de Europa no ha estado bien coordinada, ha sido a corto plazo y fragmentaria, lo que refleja las divisiones internas en la Unión. Para responder eficazmente al desafío de China, Europa necesita superar los intereses nacionales, cooperar con sus aliados y actuar más estratégicamente.
El espacio ultraterrestre. Necesidad de una estrategia de defensa
Authors: Martínez Cortés José M.
Published: May 2023

La tecnología espacial y sus productos derivados se han convertido en un elemento fundamental para la vida y para la supervivencia y prosperidad de las sociedades desarrolladas y poseen un peso creciente en aquellas otras que están en vías de desarrollo. Esta dependencia del espacio irá, además, reforzándose progresivamente en los próximos años. Esta realidad, unida a los riesgos y desafíos asociados a fenómenos naturales, accidentes no provocados, o bien, a acciones intencionadas realizadas por otros actores en el espacio, trae como consecuencia la necesidad de protección de nuestras actividades en el espacio para garantizar un acceso continuado; de no hacerlo, el impacto en el normal desarrollo de nuestras vidas y en el planeamiento y conducción de operaciones militares sería muy significativo. En general, las Fuerzas Armadas españolas disponen de un nivel muy aceptable de capacidades espaciales para afrontar los entornos operativos del presente. Sin embargo, el espacio ultraterrestre se encuentra cada vez más congestionado y disputado y, en este contexto, no existe la misma disponibilidad de capacidades necesarias para implementar un control efectivo del espacio que permita contrarrestar actividades maliciosas de potenciales adversarios, aspecto en el que resulta imprescindible avanzar.
Inteligencia Artificial en el Espacio Ultraterrestre: ¿Un nuevo desafío para la OTAN?
Authors: Montes Toscano Borja
Published: May 2023

El Espacio Ultraterrestre está cobrando más importancia que nunca no solamente como dominio operacional, sino también por sus vulnerabilidades intrínsecas. La OTAN no busca una confrontación directa en el Espacio Ultraterrestre, sino garantizar el acceso a las capacidades espaciales necesarias para que pueda seguir cumpliendo con el mandato encomendado por sus Estados Miembros. Para ello, tanto el fomento de la interoperabilidad como de la arquitectura jurídica de la Alianza serán fundamentales. La Inteligencia Artificial supone un desafío importante en el marco de las relaciones internacionales no solamente por la posible asimetría entre Estados, sino también por el riesgo de impunidad y falta de atribución de posibles comportamientos “autónomos” que puedan resultar perjudiciales tanto en objetos como personas.