bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic value of baseline neutrophil/lymphocyte ratio in HER2-positive metastatic breast cancer: exploratory analysis of data from the CLEOPATRA trial
Authors: Ding Nianhua , Pang Jian , Liu Xuan , He Xiongbin , Zhou Wei , Xie Haiqing , Feng Jianqi , Wang Guo , Tang Jie , Cao Jing , He Liying , He Yingjian , Wang Shouman , Xiao Zhi
Published: January 2024

Purpose

This study aimed to evaluate the prognostic role of the baseline neutrophil/lymphocyte ratio (NLR) in HER2-positive metastatic breast cancer (MBC) patients treated with trastuzumab/pertuzumab.

Experimental design

Data from 780 patients from the CLEOPATRA trial and 248 local patients were collected. Patients were divided into the low and high NLR subgroups by the NLR cutoff value. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) methods were used to control bias. Associations between the NLR and progression-free survival (PFS) and overall survival (OS) were analyzed.

Results

The baseline characteristics of the subgroups were well balanced after PSM and IPTW. A low baseline NLR was associated with better PFS and OS in the trastuzumab and docetaxel (TH) group in the unadjusted, PSM and IPTW models. After IPTW, a low NLR, versus a high NLR, was associated with improved PFS (HR 1.35, 95% CI 1.07–1.70, P = 0.012) and OS (HR 1.47, 95% CI 1.12–1.94, P = 0.006) in the TH group. In patients undergoing treatment with trastuzumab and pertuzumab and docetaxel (THP), a low baseline NLR was also correlated with better PFS but not OS across the three models. After IPTW, a low NLR was associated with better PFS (HR 1.52, 95% CI 1.20–1.93, P = 0.001) than a high NLR in the THP group. Multivariate analyses showed that a low baseline NLR was a predictor for PFS and OS in the TH group and for PFS in the THP group in all three models. In the real-world setting, a low baseline NLR was a predictor of better PFS among patients treated with docetaxel plus trastuzumab without or with pertuzumab in the multivariate model (P = 0.015 and 0.008, respectively).

Conclusions

A low baseline NLR is associated with better survival outcomes among HER2-positive MBC patients receiving docetaxel plus trastuzumab/pertuzumab as first-line therapy.
Delivering COVID-19 vaccine trials at speed: the implementation of a phase IV UK multi-centre randomised controlled trial to determine safety and immunogenicity of COVID-19 vaccines co-administered with seasonal influenza vaccines (ComFluCOV)
Authors: Baos Sarah , Todd Rachel , Thirard Russell , Harris Rosie , Kirwan Jana , Joyce Katherine , Hutton David , Finn Adam , Clout Madeleine , Cappel-Porter Heike , Rogers Chris A , Lazarus Rajeka , Culliford Lucy
Published: January 2024

Background

In February 2021, the UK Department of Health and Social Care sought evidence on the safety and immunogenicity of COVID-19 and influenza vaccine co-administration to inform the 2021/2022 influenza vaccine policy. Co-administration could support vaccine uptake and reduce healthcare appointments. ComFluCOV was a randomised controlled trial designed to provide this evidence. This report outlines the methods used to deliver the trial in 6 months to answer an urgent public health question as part of the COVID-19 pandemic response.

Methods

ComFluCOV was commissioned by the Department of Health and Social Care and was managed by the Bristol Trials Centre, a UK-registered clinical trials unit. It was classed as an Urgent Public Health trial which facilitated fast-track regulatory approvals. Trial materials and databases were developed using in-house templates and those used in other COVID-19 vaccine trials. Participants were recruited by advertising, and via a trial website. Electronic trial systems enabled daily review of participant data. Weekly virtual meetings were held with stakeholders and trial sites.

Results

ComFluCOV was delivered within 6 months from inception to reporting, and trial milestones to inform the Department of Health and Social Care policy were met. Set-up was achieved within 1 month. Regulators provided expedited reviews, with feedback ahead of submission. Recruitment took place at 12 sites. Over 380 site staff were trained. Overall, 679 participants were recruited in two months. The final report to the Department of Health and Social Care was submitted in September 2021, following a preliminary safety report in May 2021. Trial results have been published.

Conclusion

The rapid delivery of ComFluCOV was resource intensive. It was made possible in part due to a unique set of circumstances created by the pandemic situation including measures put in place to support urgent public health research and public support for COVID-19 vaccine research. Elements of the trial could be adopted to increase efficiency in ‘non-pandemic’ situations including working with a clinical trials unit to enable immediate mobilisation of a team of experienced researchers, greater sharing of resources between clinical trials units, use of electronic trial systems and virtual meetings.

Trial registration

ISRCTN14391248, submitted on 17/03/2021. Registered on 30/03/2021.
Gentiopicroside inhibits the progression of gastric cancer through modulating EGFR/PI3K/AKT signaling pathway
Authors: Chen Qishuai , Zhang Tongtong , Li Bingjun , Zhu Zhenguo , Ma Xiaomin , Zhang Yun , Li Linchuan , Zhu Jiankang , Zhang Guangyong
Published: January 2024

Background

This study was designed to clarify the function and potential mechanism of gentiopicroside (GPS) in regulating the malignant progression of gastric cancer (GC) through in vitro cellular experiments and in vivo animal models.

Methods

AGS and HGC27 cells were divided into control group and GPS treatment groups (50 µM and 100 µM). Then, the cellular proliferation, colony formation, migration, invasion, and apoptosis were detected, respectively. Transmission electron microscope (TEM) was used to observe the mitochondrial changes, and the mitochondrial membrane potential (MMP) was determined using the JC-1 commercial kit. Network pharmacology analysis was utilized to screen the potential molecule that may be related to the GPS activity on GC cells, followed by validation tests using Western blot in the presence of specific activator. In addition, xenografted tumor model was established using BALB/c nude mice via subcutaneous injection of HGC27 cells, along with pulmonary metastasis model. Then, the potential effects of GPS on the tumor growth and metastasis were detected by immunohistochemistry (IHC) and HE staining.

Results

GPS inhibited the proliferation, invasion and migration of GC cell lines in a dose-dependent manner. Besides, it could induce mitochondrial apoptosis. Epidermal growth factor receptor (EGFR) may be a potential target for GPS action in GC by network pharmacological analysis. GPS inhibits activation of the EGFR/PI3K/AKT axis by reducing EGFR expression. In vivo experiments indicated that GPS induced significant decrease in tumor volume, and it also inhibited the pulmonary metastasis. For the safety concerns, GPS caused no obvious toxicities to the heart, liver, spleen, lung and kidney tissues. IHC staining confirmed GPS downregulated the activity of EGFR/PI3K/AKT.

Conclusions

Our investigation demonstrated for the first time that GPS could inhibit GC malignant progression by targeting the EGFR/PI3K/AKT signaling pathway. This study indicated that GPS may be serve as a safe anti-tumor drug for further treatment of GC.
Investigation of the effect of Jacobson’s relaxation technique on the fatigue of family caregivers of hemodialysis patients: a single-blinded randomized controlled trial
Authors: Sajadi Seyedeh Azam , Ravash Farzaneh , Farsi Zahra
Published: January 2024

Background

Caring for hemodialysis patients could be a heavy burden on family caregivers, causing them to become fatigued and decrease their quality of life. This study aimed to investigate whether Jacobson’s relaxation can help alleviate the fatigue of family caregivers of hemodialysis patients.

Methods

This randomized controlled trial was conducted in 2021. Sixty-six family caregivers of hemodialysis patients were recruited by convenience sampling from a referral hospital in Tehran, Iran, and assigned randomly by coin toss to two groups of experimental (n = 32) and control (n = 34). Caregivers in the experimental group performed Jacobson’s relaxation three times a week, each time for 30–45 min, for 30 days. The score and severity of fatigue before, 2 weeks after, and 1 month after the intervention were measured with the Fatigue Severity Scale. Data analysis was performed in the statistics software SPSS using descriptive statistics (frequency, percentage, mean, and standard deviation) and analytic statistics (Independent Samples t-test, Mann–Whitney U test, Chi-Square test, Fisher’s exact test, and RM-ANOVA test). The significance level was less than 0.05.

Results

The fatigue scores of the experimental and control groups were not significantly different before the intervention (4.42 ± 0.42 vs. 4.38 ± 0.42, P = 0.696). However, the experimental group had significantly lower fatigue scores than the control group 2 weeks after the intervention (4.11 ± 0.63 vs. 4.39 ± 0.42, P = 0.036) and 1 month after the intervention (3.5 ± 0.71 vs. 4.4 ± 0.44, P = 0.001). The results also showed a significant drop in the fatigue score of the experimental group after the intervention (P < 0.0001), but no such change in the control group (P = 0.662).

Conclusion

Jacobson’s relaxation technique was effective in alleviating the fatigue of family caregivers of hemodialysis patients. Nurses are therefore recommended to promote the technique as a safe and easy method of fatigue management for family caregivers.
“A bit lost”—Living with attention deficit hyperactivity disorder in the transition between adolescence and adulthood: an exploratory qualitative study
Authors: Rasmussen Inger Lise , Schei Jorun , Ørjasæter Kristin B.
Published: January 2024

Background

Attention deficit hyperactivity disorder (ADHD) begins in childhood and in many cases persists into adulthood. The transition from adolescence to adulthood for young people with ADHD is a vulnerable time and can be associated with comorbid conditions and unfavorable outcomes. Thus, further studies are needed to explore the characteristics of the transition period in emerging adulthood. The overall aim of this study was to gain increased knowledge of emerging adults’ experience of living with ADHD in the transition from adolescence to adulthood. This is a follow-up from a previous qualitative study that examined how young people experience receiving and living with a diagnosis of ADHD.

Method

The study has a qualitative retrospective design. Seven participants were included in this study using a purposive sampling method. We re-invited the same participants who were interviewed in 2015–2016 and conducted in-depth interviews. The data were subjected to Malterud’s systematic text condensation (STC).

Results

Four crosscutting themes were identified from our analysis: (1) low level of knowledge about ADHD and treatment options; (2) barriers to seeking and accessing help; (3) developing self-help strategies; and (4) a preference to discontinued medication use.

Conclusion

The participants emphasized a need for more information about ADHD in transition phases and support, both from professionals and peers, about finding ways to live meaningful lives. The treatment they had been offered was particularly linked to symptom reduction and medication use. A more appropriate focus would have been linked to how they, as citizens, could gain knowledge and skills to live meaningful lives with ADHD.
The analysis of marking reliability through the approach of gauge repeatability and reproducibility (GR&R) study: a case of English-speaking test
Authors: Sureeyatanapas Pornphan , Sureeyatanapas Panitas , Panitanarak Uthumporn , Kraisriwattana Jittima , Sarootyanapat Patchanan , O’Connell Daniel
Published: January 2024

Ensuring consistent and reliable scoring is paramount in education, especially in performance-based assessments. This study delves into the critical issue of marking consistency, focusing on speaking proficiency tests in English language learning, which often face greater reliability challenges. While existing literature has explored various methods for assessing marking reliability, this study is the first of its kind to introduce an alternative statistical tool, namely the gauge repeatability and reproducibility (GR&R) approach, to the educational context. The study encompasses both intra- and inter-rater reliabilities, with additional validation using the intraclass correlation coefficient (ICC). Using a case study approach involving three examiners evaluating 30 recordings of a speaking proficiency test, the GR&R method demonstrates its effectiveness in detecting reliability issues over the ICC approach. Furthermore, this research identifies key factors influencing scoring inconsistencies, including group performance estimation, work presentation order, rubric complexity and clarity, the student’s chosen topic, accent familiarity, and recording quality. Importantly, it not only pinpoints these root causes but also suggests practical solutions, thereby enhancing the precision of the measurement system. The GR&R method can offer significant contributions to stakeholders in language proficiency assessment, including educational institutions, test developers and policymakers. It is also applicable to other cases of performance-based assessments. By addressing reliability issues, this study provides insights to enhance the fairness and accuracy of subjective judgements, ultimately benefiting overall performance comparisons and decision making.
Advances in nanobiosensors during the COVID-19 pandemic and future perspectives for the post-COVID era
Authors: Kim Young Jun , Min Junhong
Published: January 2024

The unprecedented threat of the highly contagious virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes exponentially increased infections of coronavirus disease 2019 (COVID-19), highlights the weak spots of the current diagnostic toolbox. In the midst of catastrophe, nanobiosensors offer a new opportunity as an alternative tool to fill a gap among molecular tests, rapid antigen tests, and serological tests. Nanobiosensors surpass the potential of antigen tests because of their enhanced sensitivity, thus enabling us to see antigens as stable and easy-to-access targets. During the first three years of the COVID-19 pandemic, a substantial number of studies have reported nanobiosensors for the detection of SARS-CoV-2 antigens. The number of articles on nanobiosensors and SARS-CoV-2 exceeds the amount of nanobiosensor research on detecting previous infectious diseases, from influenza to SARS-CoV and MERS-CoV. This unprecedented publishing pace also implies the significance of SARS-CoV-2 and the present pandemic. In this review, 158 studies reporting nanobiosensors for detecting SARS-CoV-2 antigens are collected to discuss the current challenges of nanobiosensors using the criteria of point-of-care (POC) diagnostics along with COVID-specific issues. These advances and lessons during the pandemic pave the way for preparing for the post-COVID era and potential upcoming infectious diseases.

Graphical Abstract
Correlating food and nutritional patterns with cancers in the pediatric oncology population at two specialized hospitals in Tanzania
Authors: Monko Dafrosa Joseph , Martin Haikael David , Mpolya Emmanuel Abraham
Published: January 2024

Background

This study of nutritional patterns in relation to cancers among pediatric oncology population in Tanzania was motivated by the lack of up-to-date information about the nutritional practices, the controversy around the importance of nutritional support and the lack of consistent nutritional criteria among pediatric oncology populations.

Methods

A survey study in two cancer referral hospitals of children diagnosed with any cancers, aged between 1 and 17 years inclusive and being eligible for enteral feeding included 131 children. Their demographic, nutritional, feeding and cancer profiles were analyzed descriptively through mapping and other approaches as well as inferentially using multinomial regression models to understand different aspects of nutrition for children suffering from cancers.

Results

The majority (15% or higher) of pediatric oncology population originated from the lake zone. Between 7 and 12% of pediatric oncology population originated from the Western zone. The top-three cancers with their percentages in the brackets were: Wilms Tumor (32%), Acute Lymphoblastic Leukemia (26%) and Retinoblastoma (13%). About 69% of the pediatric oncology population ate foods that are rich in energy but poor in protein such as rice (21.5%), porridge (19.3%), banana (11.7%) and potatoes (10.2%). On the other hand, only 17.5% ate foods that are generally protein-rich such as meat (8.0%), fish (5.3%) and chicken (4.2%); and 12.7% ate milk (4.2%), beans (3.4%), vegetables (2.7%), eggs (1.9%) and fruits (1.5%). Cancers impacted food intake in about 60% of all children with cancers and affected appetite in 18.3% of them. Cancers caused vomiting in 16% and diarrhea in 6.1% of children. The majority of children with cancers (61.8%) took at least one meal while 34.4% took just snacks (p < 0.001).

Conclusions

The majority of pediatric oncology population had erratic nutritional patterns and took foods high in energy and poor in proteins. There is a two-way interaction between cancers and nutrition in which cancers affect general nutritional intake which could affect the cancer treatment outcomes in return. Therefore, it is important to consider these interactions while managing pediatric oncology populations in this and similar settings.
Targeting the molecular web of Alzheimer’s disease: unveiling pathways for effective pharmacotherapy
Authors: Jadhav Devika , Saraswat Nikita , Vyawahare Neeraj , Shirode Devendra
Published: January 2024

Introduction

Alzheimer’s disease is a neurocognitive disorder that affects elderly people by slowly impaired cognition, dementia, and gets worse with age. It slowly impacts the quality of life. Clinically, it is distinguished by a transition from episodic memory to a gradual reduction in cognitive ability leading to cognitive dysfunction. Neurofibrillary tangles and amyloid plaques are unique structures that are thought to have a role in the pathogenesis of Alzheimer's disease. In this review, we focus our attention on the risk factors, pathophysiology, etiology, epidemiology, stages, diagnosis, treatment, mechanisms, pathways, ongoing clinical trials data and risks potentially associated with the development of Alzheimer's disease.

Short summary

This review aims to extrapolate the information about Alzheimer's disease. Preliminary research was done by selecting reviews on PubMed, Elsevier, and Google open-access publications using the keywords like “Alzheimer, dementia, neurodegenerative, memory, amyloid β, mechanism of action, pathways”.

Conclusion

Here we show the discussion and interpretation of several signaling pathways in the pathogenesis of Alzheimer's disease such as amyloid β plaque cleavage, Metal ion hypothesis, amyloid β degradation, initiation of amyloidogenic and non-amyloidogenic pathway, oxidative stress hypothesis, Metabolic syndrome, insulin resistance and tau phosphorylation associated apolipoprotein- cholesterol, neurofibrillary tangles accumulation, and insulin resistance which are significant for better understanding of the disease initiation and progression. On studying the ongoing clinical trials, it was found that current drugs being tested are crenezumab, gantenerumab and sodium oligonucleotide.

Graphical Abstract
Cerebral venous sinus thrombosis manifesting as chronic spontaneous subdural hematoma: case report and review of the literature
Authors: Laouar Fares , Brahmia Yasser , Boublata Lotfi
Published: January 2024

Background

Cerebral venous sinus thrombosis (CVST) is a rare form of stroke that is mainly seen in young women. It is frequently associated with hemorrhagic venous infarction and subarachnoid hemorrhage. There are few reports of CVST associated with chronic non-traumatic subdural hematoma (SDH). The diagnosis of CVST with spontaneous SDH is difficult because of the variability of its clinical features. The management of SDH associated with CVST is controversial and not well-established.

Case presentation

We report a 26-year-old woman with positive COVID-19 serology who presented with superior longitudinal sinus thrombosis associated with chronic spontaneous SDH. She was managed conservatively and treated with anticoagulation and corticosteroids. A follow-up angioscan 1 month after treatment showed regression of the SDH volume with partial repermeabilisation of the thrombosed sinus. Three months later, the follow-up angioscan showed complete resolution of the chronic SDH and superior longitudinal sinus thrombosis with restoration of venous flow.

Conclusions

CVST can also present with spontaneous chronic SDH. The management of SDH concomitant with CVST remains controversial due to the rarity of its presentation and the risks associated with the use of anticoagulation.
Having chronic back pain did not impact COVID-19 outcome in a low-income population – a retrospective observational study
Authors: de Castro Alcantara Antônia Celia , Rocha Hermano Alexandre Lima , de Oliveira Jobson Lopes , Baraliakos Xenofon , Rocha Francisco Airton Castro
Published: January 2024

Introduction

Chronic back pain (CBP) is a major cause of years lived with disability. Social inequalities increase the prevalence and burden of CBP. Management of CBP was affected by restricted access to non-pharmacological treatments and outdoor activities during COVID-19 pandemic.

Objective

To determine the prevalence of CBP among patients with COVID-19 as well as the impact of having CBP in COVID-19 outcome in our low-income population.

Methods

Retrospective cohort of individuals with confirmed COVID diagnosis from May 2020 - March 2021, at Hospital Regional UNIMED (HRU) in Fortaleza, Ceará, Brazil. Data included comorbidities and household income.

Results

Among 1,487 patients, 600 (40.3%) were classified as having CBP. Mean age as well as income were similar in CBP and non-CBP groups, with more women in the CBP group. Hypertension and asthma, but not diabetes, were more prevalent in those with CBP. Need for emergency care, hospitalization, and admission to intensive care unit were similar regardless of having CBP. Dyspnea was more common in CBP vs. non-CBP groups, with 48.8% vs. 39.4% percentages, respectively (p = 0.0004).

Conclusion

Having CBP prior to COVID did not impact the acute clinical outcome of COVID individuals of a low-income population.
Interdisciplinary network care collaboration in Parkinson’s disease: a baseline evaluation in Germany
Authors: Lummer Carina , Eggers Carsten , Becker Andreas , Demandt Fenja , Warnecke Tobias ,   Parkinson Netzwerke Deutschland e.V.
Published: January 2024

Background

The strengthening of interdisciplinary care collaboration in Parkinson's disease is taking on increasing importance in daily medical routine. Therefore, care providers worldwide are organizing themselves in disease-specific regional network structures. However, the existing networks are heterogeneous, and the driving key players are yet unidentified.

Objectives

To systematically identify key factors of the composition of health care professionals, who are initially interested in the development of a Parkinson network for interdisciplinary care collaboration, their motivation, and expectations, we conducted a basic evaluation in three different German regions covering a total number of 23,405 people with Parkinson’s.

Methods

A specially developed semi-open questionnaire focusing on socio-demographic information, ways of contact, interdisciplinary collaboration, and connectedness was used. Statistical analyses were performed based on a predesigned codebook.

Results

The most crucial professions were outpatient therapists (physio-, occupational-, speech therapists) (36.7%), average case load of 10.1 patients/3 months and inpatient movement disorder specialists (21.1%), average case load of 197.4 patients/3 months. Before implementation of PD networks, 48.9% of outpatient therapists did not have any contact with neurologists. 58.9% of caregivers considered the current frequency of collaboration to be insufficient. The lack of political support as well as a lack of time were identified as main hurdles to increased collaboration.

Conclusion

The identified driving forces in strengthened care collaboration are assigned to different healthcare sectors. This makes networks which provide tools for specialized education and interdisciplinary, cross-sectoral communication indispensable. For an areawide rollout, a rethinking of political frameworks towards network care is strongly necessary.
Members’ experiences and perceptions of participating in an Australian Regional One Health Network
Authors: Thompson Kirrilly , Taylor Joanne , Massey Peter D. , Durrheim David N.
Published: January 2024

Background

The One Health framework is intended to optimise the interdependent health of humans, animals and ecosystems. It relies on effective collaborations across disciplines, sectors and communities. One Health networks have become increasingly important platforms for encouraging, creating and supporting collaborations. Their success is usually judged by evaluations of their outputs. However, there is also a need to understand member experiences and perceptions of the networks in which they participate. To that end, we undertook the first membership survey of a One Health network that was established in Australia in 2005.

Methods

An online membership survey was created, comprising closed and open-ended questions.

Results

Around one third of the Regional One Health Partnership (‘the Network’) participated in the study (33 members). Participants contributed a combined total of 170 years of experience in the Network and 414 years of combined experience working in/on One Health. The Network has provided excellent opportunities for cross sectoral collaboration that would otherwise not have been possible. Findings also highlighted the intangible benefits of membership such as the creation of a collaborative support group for emerging and established One Health practitioners.

Conclusions

The Network plays an important role in One Health collaborations in New South Wales and further afield. Commensurate with the literature on One Health collaborations globally, we identified a need for greater diversity amongst members, especially from First Nations people, local communities, non-government organisations and wildlife/environment experts, as well as concerted attempts to identify policy implications. Our membership survey tool could be adapted for future One Health Network membership surveys in Australia and internationally.
Dimensional changes of Hoffa’s fat pad related to aging: evaluation by MRI
Authors: Testini Valentina , Veronese Nicola , Ricatti Giovanni , Paparella Maria Teresa , Guglielmi Giuseppe
Published: January 2024

Background

Hoffa's fat pad is an intra-capsular extra-sinovial structure of the knee joint that has a significant biomechanical and metabolic role, minimizing the influence of stresses created by loading and generating cytokines. Changes in its size can lead to variations in the homeostasis of the knee in elderly patients. This work intends to assess the dimensional variations of Hoffa's fat pad associated to aging in both sexes, using MRI sagittal sequences acquired from the OAI (Osteoarthritis Initiative) database.

Methods

We examined the Hoffa's fat pad sagittal thickness in 217 men and women with knee osteoarthritis who were grouped into four age groups for the study: 40–49; 50–59; 60–69; and 70–80. 3T sagittal IW 2D TSE Fat-suppressed MRI sequences, taken from the OAI (Osteoarthritis Initiative) database, were examined.

Results

Hoffa’s fat pad thickness was shown to differ significantly between groups in both men and women, decreasing in the older individuals' groups (R = − 0.46; p 0.0001). By dividing the patients into ten-year age groups and by sex, the thickness of both the right knee and the left knee was examined. In fact, the average thickness of Hoffa's fat pad of the right knee was reported to be, in males, 33.6+/− 3 mm in subjects aged between 40 and 49 years, 31+/− 2.4 mm for patients aged between 50 and 59, 30.3 ± 1.8 mm in the group between 60 and 69 years and 28.7+/− 1.8 mm between 70 and 80 years. In women the values obtained were the following: 29+/− 1.6 mm between 40 and 49 years; 28.9+/− 2.6 mm in the group between 50 and 59 years, 25.3+/− 1.9 mm for patients aged 60 and 69 years and 26+/− 2 mm between 70 and 80 years. Similar results were obtained for the left knee.

Conclusions

Hoffa’s fat pad gradually thins with aging in both male and female patients with knee osteoarthritis, and this can be detected by evaluating the thickness of the fat pad on sagittal MRI sequences.
Appropriate timing of veno-arterial extracorporeal membrane oxygenation initiation after cardiac surgery
Authors: Laimoud Mohamed , Hakami Emad , Machado Patricia , Lo Michelle Gretchen , Maghirang Mary Jane
Published: January 2024

Background

Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) can be initiated during cardiac surgery or later in ICU according to the hemodynamic profile and organ perfusion. Our aim was to study the appropriate timing of post-cardiotomy ECMO (PC-ECMO) initiation. We retrospectively analyzed 152 adult patients supported with PC-ECMO in our cardiac center between 2016 and 2022. The patients were divided into two groups: the intra-operative ECMO and the postoperative ECMO groups. The primary outcome was all-and-on-ECMO hospital mortality. The secondary outcomes included ECMO duration, new need for dialysis, cerebrovascular stroke, and length of ICU stay.

Results

Our cohort analysis revealed that 81(53.3%) patients were intra-operatively supported with VA-ECMO while 71(46.7%) patients were postoperatively supported in ICU. The postoperative ECMO group had significantly lesser SAVE score (p = 0.001), higher SAVE risk classes (p < 0.001), and higher SOFA score (p = 0.008) compared to the intra-operative ECMO group. The postoperative ECMO group had significantly more frequent hospital mortality (p = 0.003), on-ECMO mortality (p = 0.006), cerebrovascular stroke (p = 0.034), acute renal failure requiring dialysis (p < 0.001), and lesser lactate clearance at 12 h (p = 0.016) and at 24 h (p = 0.023) compared to the intra-operative group. There were statistically insignificant differences between the two groups regarding post-ECMO hospital mortality, cerebral bleeding, limb ischemia, ECMO, and ICU duration. Postponed postoperative ECMO insertion was associated with an increased risk of death (HR 1.628, 95%CI 1.102–2.403, p =0.014) with cox-proportional hazard regression. Logistic multivariable regression showed that atrial fibrillation (OR 6.2, 95% CI 2.71–61.84, p = 0.002), initial SOFA score (OR 1.46, 95% CI 1.041–3.83, p = 0.001), and postoperative ECMO insertion (OR 1.93, 95% CI 1.04–8.73, p = 0.031) were the predictors of hospital mortality.

Conclusions

Postponed ECMO insertion in critically sick patients was associated with increased mortality after cardiac surgery. Early intra-operative initiation of PC-ECMO may have the potential to improve outcomes after cardiac surgeries.
Does corporate governance spur bank intellectual capital in an emerging economy? A system GMM analysis from Ethiopia
Authors: Assfaw Abdu Mohammed , Sharma Dhiraj
Published: January 2024

Purpose

The current study aims to explore the impact of corporate governance (CG) mechanisms, as measured by board size, board meeting frequency, board gender diversity, number of board subcommittees, board remuneration, size of audit committee, and audit committee meeting frequency, on bank intellectual capital (as calculated by the modified value-added intellectual coefficient (M-VAIC) and its components (human capital efficiency (HCE), structural capital efficiency (SCE), and relational capital efficiency (SCE)).

Design/methodology/approach

Panel data is extracted from the financial and other internal reports of 14 commercial banks and the National Bank of Ethiopia for the period 2011–2022. A two-step system generalized method of moments (2SYS-GMM) was used to account for the unobserved endogeneity and heteroscedasticity problems.

Findings

The empirical findings suggest that board size and board meeting frequency have a negative and significant impact on all IC performance measures. Besides, audit committee size has a negative and significant effect on HCE, SCE, and M-VAIC of the banking industry in Ethiopia. Moreover, board remuneration has a significant positive relationship with IC efficiency (HCE, SCE, and M-VAIC). Also, audit committee meeting frequency has a positive and significant effect on the HCE of banks. However, board gender diversity and the number of board subcommittees have not made statistically significant contributions to IC performance.

Research limitation/implication

The study is limited in its use of seven dimensions of CG and future studies can use other alternative accounts for CG variables. Next, this study applies only to commercial banks; hence, future studies can include other financial as well as non-financial organizations such as insurance companies, microfinance institutions, manufacturing, and other sectors.

Practical implications

This study contributes to helping the regulators and practitioners of the banking industry improve the existing standards and guidelines for CG practices to strengthen their IC performance. The findings may also give input for policymakers to integrate the intellectual capital in the decision-making process for policy formulation and implementation for the establishment of a robust banking sector.

Originality/value

Considering the modified value-added IC coefficient (M-VAIC) and 2SYS-GMM models, this research is the first study to analyze the relationships between CG and banks’ IC in Ethiopia.
What will others think of me? The longitudinal association between trauma-related shame and guilt and psychopathology after a terror attack
Authors: Glad Kristin Alve , Aakvaag Helene Flood , Wentzel-Larsen Tore , Dyb Grete , Thoresen Siri
Published: January 2024

Background

Trauma-related shame and guilt have been identified as important factors for mental health following interpersonal trauma. For survivors of terror and disasters, however, the role of shame and guilt remains largely unknown.

Aims

To explore the long-term occurrence of trauma-related shame and guilt among survivors of a terror attack, and the potential importance of these emotions for mental health.

Method

A total of 347 survivors (48.7% female, mean age at the time of the attack: 19.25 years, s.d. = 4.40) of the 2011 massacre on Utøya island, Norway, participated in face-to-face, semi-structured interviews. Trauma-related shame and guilt were measured with items from the Shame and Guilt After Trauma Scale at 2.5 and 8.5 years post-terror attack. Post-traumatic reactions and anxiety/depression at 8.5 years post-terror attack were measured with the University of California at Los Angeles PTSD Reaction Index and the Hopkins Symptom Checklist-25, respectively. Associations between trauma-related shame/guilt and post-trauma psychopathology were analysed by multiple linear regressions.

Results

Trauma-related shame and guilt were prevalent among survivors at both 2.5 and 8.5 years post-terror attack. In unadjusted analyses, shame and guilt, at both time points, were significantly associated with post-traumatic stress reactions and anxiety/depression. Shame remained significantly associated with mental health when adjusted for guilt. Both earlier and current shame were uniquely related to mental health.

Conclusions

Trauma-related shame and guilt may be prevalent in survivors of mass trauma several years after the event. Shame, in particular, may play an important role for long-term mental health. Clinicians may find it helpful to explicitly address shame in treatment of mass trauma survivors.
Global prevalence of psychosocial assessment following hospital-treated self-harm: systematic review and meta-analysis
Authors: Witt Katrina , McGill Katie , Leckning Bernard , Hill Nicole T. M. , Davies Benjamin M. , Robinson Jo , Carter Gregory
Published: January 2024

Background

Hospital-treated self-harm is common, costly and associated with repeated self-harm and suicide. Providing a comprehensive psychosocial assessment following self-harm is recommended by professional bodies and may improve outcomes.

Aims

To review the provision of psychosocial assessments after hospital-presenting self-harm and the extent to which macro-level factors indicative of service provision explain variability in these estimates.

Method

We searched five electronic databases to 3 January 2023 for studies reporting data on the proportion of patients and/or events that were provided a psychosocial assessment. Pooled weighted prevalence estimates were calculated with the random-effects model. Random-effects meta-regression was used to investigate between-study variability.

Results

119 publications (69 unique samples) were included. Across ages, two-thirds of patients had a psychosocial assessment (0.67, 95% CI 0.58–0.76). The proportion was higher for young people and older adults (0.75, 95% CI 0.36–0.99 and 0.83, 95% CI 0.48–1.00, respectively) compared with adults (0.64, 95% CI 0.54–0.73). For events, around half of all presentations had these assessments across the age range. No macro-level factor explained between-study heterogeneity.

Conclusions

There is room for improvement in the universal provision of psychosocial assessments for self-harm. This represents a missed opportunity to review and tailor aftercare supports for those at risk. Given the marked unexplained heterogeneity between studies, the person- and system-level factors that influence provision of psychosocial assessments after self-harm should be studied further.
Severe depression and all-cause and cause-specific mortality in Scotland: 20 year national cohort study
Authors: Alotaibi Raied , Halbesma Nynke , Wild Sarah H. , Jackson Caroline A.
Published: January 2024

Background

Understanding cause of death in people with depression could inform approaches to reducing premature mortality.

Aim

To describe all-cause and cause-specific mortality for people with severe depression in Scotland, by sex, relative to the general population.

Method

We performed a retrospective cohort study, using psychiatric hospital admission data linked to death data, to identify adults (≥18 years old) with severe depression and ascertain cause-specific deaths, during 2000–2019. We estimated relative all-cause and cause-specific mortality for people with severe depression using standardised mortality ratios (SMRs), stratified by sex using the whole Scottish population as the standard.

Results

Of 28 808 people with severe depression, 7903 (27.4%) died during a median follow-up of 8.7 years. All-cause relative mortality was over three times higher than expected (SMR, both sexes combined: 3.26, 95% CI 3.19–3.34). Circulatory disease was the leading cause of death, and, among natural causes of death, excess relative mortality was highest for circulatory diseases (SMR 2.51, 2.40–2.66), respiratory diseases (SMR 3.79, 3.56–4.01) and ‘other’ causes (SMR 4.10, 3.89–4.30). Among circulatory disease subtypes, excess death was highest for cerebrovascular disease. Both males and females with severe depression had higher all-cause and cause-specific mortality than the general population. Suicide had the highest SMR among both males (SMR 12.44, 95% CI 11.33–13.54) and females (22.86, 95% CI 20.35–25.36).

Conclusion

People with severe depression have markedly higher all-cause mortality than the general population in Scotland, with relative mortality varying by cause of death. Effective interventions are needed to reduce premature mortality for people with severe depression.
The Landscape of Pediatric Radiation Oncology in Nigeria
Authors: Joseph Adedayo , Akinsete Adeseye M. , Lasebikan Nwamaka N. , Adeneye Samuel , Awofeso Opeyemi M. , Oladipo Aishat T. , Ajose Azeezat O. , Ojo Oluwatimileyin , Merrell Kenneth , Ngwa Wilfred , Puthoff David S. , Onitilo Adedayo A.
Published: January 2024

Radiation therapy (RT) is an essential part of the multidisciplinary treatment of pediatric cancer. Over the past five decades, significant advances have been made in the delivery of RT, with better dose delivery to disease targets while minimizing exposure to nearby organs at risk. These advances have led to improved treatment outcomes, increased survival, and reduced treatment-related toxicities. Advanced treatment techniques, however, require significant investment in infrastructural and personnel resources. This review documents what is currently available regarding expertise and infrastructure for pediatric radiation oncology practice in Nigeria. It was performed to serve as a foundation for the creation and design of tailored solutions (initiatives and policies) to increase pediatric radiation availability, accessibility, and equity in Nigeria and ultimately improve pediatric cancer treatment outcomes in the region.
Modifiable Risk Factors and Risk of Colorectal and Endometrial Cancers in Lynch Syndrome: A Systematic Review and Meta-Analysis
Authors: Power Robert F. , Doherty Damien E. , Parker Imelda , Gallagher David J. , Lowery Maeve A. , Cadoo Karen A.
Published: January 2024

PURPOSE

Lynch syndrome is the most common hereditary cause of colorectal and endometrial cancers. Modifiable risk factors, including obesity, physical activity, alcohol intake, and smoking, are well-established in sporadic cancers but are less studied in Lynch syndrome.

METHODS

Searches were conducted on MEDLINE, Embase, and Web of Science for cohort studies that investigated the association between modifiable risk factors and the risk of colorectal or endometrial cancer in people with Lynch syndrome. Adjusted hazard ratios (HRs) and 95% CIs for colorectal and endometrial cancers were pooled using a random effects model. The protocol was prospectively registered on PROSPERO (CRD 42022378462), and the meta-analysis was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-Analysis of Observational Studies in Epidemiology reporting guidelines.

RESULTS

A total of 770 citations were reviewed. Eighteen studies were identified for qualitative synthesis, with seven colorectal cancer (CRC) studies eligible for meta-analysis. Obesity (HR, 2.38 [95% CI, 1.52 to 3.73]) was associated with increased CRC risk. There was no increased CRC risk associated with smoking (HR, 1.04 [95% CI, 0.82 to 1.32]) or alcohol intake (HR, 1.32 [95% CI, 0.97 to 1.81]). Type 2 diabetes mellitus (T2DM) and some dietary factors might increase risk of CRC although more studies are needed. In a qualitative synthesis of three endometrial cancer cohort studies, female hormonal risk factors and T2DM may affect the risk of endometrial cancer, but obesity was not associated with an increased risk.

CONCLUSION

Lifestyle recommendations related to weight and physical activity may also be relevant to cancer prevention for individuals with Lynch syndrome. Further high-quality prospective cohort studies, in particular, including endometrial cancer as an end point, are needed to inform evidence-based cancer prevention strategies in this high-risk population.
Chemicals Used in Plastic Materials: An Estimate of the Attributable Disease Burden and Costs in the United States
Authors: Trasande Leonardo , Krithivasan Roopa , Park Kevin , Obsekov Vladislav , Belliveau Michael
Published: January 2024

Context

Chemicals used in plastics have been described to contribute to disease and disability, but attributable fractions have not been quantified to assess specific contributions. Without this information, interventions proposed as part of the Global Plastics Treaty cannot be evaluated for potential benefits.

Objective

To accurately inform the tradeoffs involved in the ongoing reliance on plastic production as a source of economic productivity in the United States, we calculated the attributable disease burden and cost due to chemicals used in plastic materials in 2018.

Methods

We first analyzed the existing literature to identify plastic-related fractions (PRF) of disease and disability for specific polybrominated diphenylethers (PBDE), phthalates, bisphenols, and polyfluoroalkyl substances and perfluoroalkyl substances (PFAS). We then updated previously published disease burden and cost estimates for these chemicals in the United States to 2018. By uniting these data, we computed estimates of attributable disease burden and costs due to plastics in the United States.

Results

We identified PRFs of 97.5% for bisphenol A (96.25-98.75% for sensitivity analysis), 98% (96%-99%) for di-2-ethylhexylphthalate, 100% (71%-100%) for butyl phthalates and benzyl phthalates, 98% (97%-99%) for PBDE-47, and 93% (16%-96%) for PFAS. In total, we estimate $249 billion (sensitivity analysis: $226 billion-$289 billion) in plastic-attributable disease burden in 2018. The majority of these costs arose as a result of PBDE exposure, though $66.7 billion ($64.7 billion-67.3 billion) was due to phthalate exposure and $22.4 billion was due to PFAS exposure (sensitivity analysis: $3.85-$60.1 billion).

Conclusion

Plastics contribute substantially to disease and associated social costs in the United States, accounting for 1.22% of the gross domestic product. The costs of plastic pollution will continue to accumulate as long as exposures continue at current levels. Actions through the Global Plastics Treaty and other policy initiatives will reduce these costs in proportion to the actual reductions in chemical exposures achieved.