bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of fluorocarbon treatment on the adhesion of material extrusion 3D prints on textile
Authors: Sitotaw Dereje B , Muenks Dominik , Kyosev Yordan , Kabish Abera K
Published: November 2022

Three-dimensional (3D) printing has attracted a great deal of attention in recent years in many application fields, for example in the aerospace, construction, industries, art, education, protection, security and medical fields. Some of these application fields of 3D prints depend on the adhesion of imprint polymers on textiles. Adhesion is the tendency of unlike surfaces to cling to one another due to the intermolecular and interatomic interaction of the two surfaces. This study investigated how water and oil resistant treatment of woven fabrics influence on the adhesion strength of 3D prints. The prints were produced from Onyx using Markforged Mark Two 3D printer on Fluorocarbon (FC) treated and untreated woven fabrics. The different printed samples were subjected to a 180° peel test for the full detachment of the prints from the fabric. The result showed that the treatment of the woven fabrics had a significant influence on adhesion force. Further, the results revealed that the treated woven fabric limited the penetration and passage of the melted Onyx through the fabric which gave low adhesion strength between the print and the fabric. The microscopic analysis revealed that the back of the detached 3D prints from the untreated woven fabrics contained many fibers still attached because of the high adhesion strength.
Bedside hip aspiration results in decrease in total general anesthesia time in pediatric patients: A multicenter study
Authors: Braig Zachary V , Pradhan Pratik , Tibbo Meagan E , Padua Horacio , Shaughnessy William J , Stans Anthony A , Larson A Noelle , Shore Benjamin J , Milbrandt Todd A
Published: November 2022

Purpose:

The purpose of this study is to compare pediatric hip aspiration in the operating room under general anesthesia or via bedside aspiration under moderate sedation and delineate the anesthetic time required.

Methods:

A database query conducted at two academic institutions identified all patients under the age of 17 who underwent hip aspiration between 2000 and 2017. At one institution, aspiration was performed in the operating room under general anesthesia. Patients were kept anesthetized until cell count was complete. At the second institution, aspiration was performed in the emergency room at bedside under sedation. The medical record was reviewed for demographic data, hip aspiration results, diagnoses, treatment, and anesthesia time.

Results:

A total of 233 patients (233 hips) with a mean age of 7.2 years were identified. Seventy-five patients underwent aspiration in the operating room, and 158 patients underwent bedside aspiration. Patients with a negative aspiration averaged 87 min under anesthesia when performed in the operating room and 29 min under sedation when performed at bedside. Patients with a negative aspiration performed in the operating room after 5 pm averaged 99 min under anesthesia, and 73 min under anesthesia when performed between 7 am and 5 pm (p < 0.01). Seventy-eight (49%) patients who underwent bedside aspiration did not require operative intervention and therefore avoided general anesthesia.

Conclusion:

Pediatric hip aspiration performed in the operating room results in prolonged anesthesia times while synovial fluid is transported and processed. Anesthesia times are significantly longer after 5 pm. Bedside aspiration resulted in significantly less anesthesia exposure, with half of patients undergoing bedside aspiration avoiding general anesthesia altogether.

Level of evidence:

Level III.
The UBC State Social Connection Scale: Factor Structure, Reliability, and Validity
Authors: Lok Iris , Dunn Elizabeth
Published: November 2022

Social connection plays a central role in people’s everyday lives. Although researchers have traditionally focused on the benefits of experiencing an enduring sense of social connection, recent research has also begun to explore the contextual factors that shape momentary feeling of social connection. To date, however, no psychological scales have been developed to measure state social connection. To address this gap, we developed the 10-item UBC State Social Connection Scale (UBC-SSCS). In Study 1, we generated and refined our initial pool of items and confirmed our hypothesized factor structure in a large university sample. In Studies 2 to 3, we established several forms of validity. We provide foundational evidence that the UBC-SSCS is a reliable and valid instrument for assessing momentary feelings of social connection. Our exploratory findings also suggest that researchers can substantially increase their statistical power using state (vs. trait) measures to capture fluctuations in feelings of social connection.
Natural History of First-Time Anterior Shoulder Dislocation in Patients Older Than 50 Years: A Study of 179 Patients With a Mean Follow-up of 11 Years
Authors: Smartt Anne A. , Wilbur Ryan R. , Song Bryant M. , Krych Aaron J. , Okoroha Kelechi , Barlow Jonathan D. , Camp Christopher L.
Published: November 2022

Background:

There is a dearth of knowledge on anterior shoulder instability in older patients.

Purpose/Hypothesis:

The purposes of this study were to describe the incidence and epidemiology, injury characteristics, and treatment and outcomes in patients ≥50 years old with first-time anterior shoulder instability. We also describe the historical trends in diagnosis and treatment. It was hypothesized that the rates of obtaining a magnetic resonance imaging (MRI) scan and surgical intervention have increased over the past 20 years.

Study Design:

Descriptive epidemiology study.

Methods:

An established geographic database was used to identify 179 patients older than 50 years who experienced new onset anterior shoulder instability between 1994 and 2016. Medical records were reviewed to obtain patient characteristics, imaging characteristics, and surgical treatment and outcomes, including recurrent instability. Comparative analysis was performed to identify differences between age groups. Mean follow-up time was 11 years.

Results:

The incidence of first-time anterior shoulder dislocation in our study population was 28.8 per 100,000 person-years, which is higher than previously reported. Full-thickness rotator cuff tears were found in 62% of the 66 patients who underwent MRI scans. Of all patients, 26% progressed to surgery at a mean time of 1.6 years after injury; 57% of all surgical procedures involved a rotator cuff repair, and 17% included anterior labral repair. All patients who underwent a labral repair also underwent concomitant rotator cuff repair. The rate of recurrent instability for the cohort was 15% at a median of 176 days after the initial instability event. There were no instances of recurrent instability after operative intervention. At an average of 7.5 years after the initial instability event, 14% of patients developed radiographic progression of glenohumeral arthritis. The rate of surgical intervention within 1 year of initial dislocation increased from 5.1% in 1994 to 1999 to 52% in 2015 to 2016.

Conclusion:

The incidence of first-time anterior shoulder instability in patients aged ≥50 years was 28.8 per 100,000 person-years. Full-thickness rotator cuff tears (62%) were the most common condition associated with anterior shoulder instability, followed by Hill-Sachs lesions (56%). The rate of recurrent instability for the entire cohort was 15%, with no instances of recurrent instability after operative intervention.
Hydroxyurea for secondary stroke prevention in children with sickle cell anemia in Nigeria: a randomized controlled trial
Authors: Abdullahi Shehu U. , Sunusi Surayya , Abba Mohammed Sani , Sani Saifuddeen , Inuwa Hauwau Aminu , Gambo Safiya , Gambo Awwal , Musa Bilya , Covert Greene Brittany V. , Kassim Adetola A. , Rodeghier Mark , Hussaini Nafiu , Ciobanu Mariana , Aliyu Muktar H. , Jordan Lori C. , DeBaun Michael R.
Published: November 2022

We tested the hypothesis that fixed oral moderate-dose hydroxyurea (20 mg/kg per day) for initial treatment of secondary stroke prevention results in an 80% relative risk reduction of stroke or death when compared with fixed oral low-dose hydroxyurea (10 mg/kg per day) in a phase 3 double-blind, parallel-group, randomized controlled trial in children with sickle cell anemia (SCA) living in Nigeria. A total of 101 participants were randomly allocated to low-dose (n = 49) and moderate-dose (n = 52) hydroxyurea treatment groups. The median participant follow-up was 1.6 years (interquartile range, 1.0-2.3), with a planned minimum follow-up of 3.0 years. A total of 6 recurrent strokes and 2 deaths vs 5 recurrent strokes and 3 deaths occurred in the low- and moderate-dose groups, respectively. The incidence rate ratio (IRR) of the primary outcome measure of stroke or death in the low- and moderate-dose hydroxyurea treatment groups was 0.98 (95% confidence interval [CI], 0.32-3.00; P = .97). The trial was stopped early owing to no clinical difference in the incidence rates of the primary outcome measure. The incidence rates of recurrent strokes were 7.1 and 6.0 per 100 person-years in the low- and moderate-dose groups, respectively, (IRR, 1.18; 95% CI, 0.30-4.88; P = .74). As a measure of adherence to the oral hydroxyurea therapy, the median percent of returned pills was 3.0% and 2.6% in the low- and moderate-dose groups, respectively. No participant had hydroxyurea therapy stopped for myelosuppression. For children with SCA in low-income settings without access to regular blood transfusion therapy, initial low-dose hydroxyurea is a minimum known efficacious dose for secondary stroke prevention.
An economic view on rerouting railway wagons in a single wagonload network to avoid congestion
Authors: Krauth Maurice , Haalboom Daniel
Published: November 2022

It is expected that in the process of meeting the climate policy goals, more transport will take place by rail. Single wagonload transport plays a crucial role as a direct competitor to road-based transport. The aim of this contribution is an evaluation of capacity correlated effects in a railway wagon routing network.

Methods

For this purpose, we developed a mathematical optimisation model. In order to be able to identify the effects and impacts of congestion we created several scenarios and evaluated each of them individually.

Findings

By conducting computational experiments we were able to identify various effects and draw conclusions about the impact. This work contributes to the optimisation of the most costefficient short-term rerouting of railway wagons in single wagonload transport.
Fabrication and application of cisplatin-loaded mesoporous magnetic nanobiocomposite: a novel approach to smart cervical cancer chemotherapy
Authors: Darroudi Mahdieh , Nazari Seyedeh Elnaz , Asgharzadeh Fereshteh , Khalili-Tanha Nima , Khalili-Tanha Ghazaleh , Dehghani Toktam , Karimzadeh Maryam , Maftooh Mina , Fern Gordon A. , Avan Amir , Rezayi Majid , Khazaei Majid
Published: November 2022

There are significant challenges in developing drug carriers for therapeutic perspective. We have investigated a novel nanocarrier system, based on combining functionalized magnetic nanocomposite with Metal–Organic Frameworks (MOFs). Magnetic nanoparticles modified using biocompatible copolymers may be suitable for delivering hydrophobic drugs, such as cisplatin. Furthermore, compared to polymeric nanocarriers, nanocomposite constructed from zeolitic imidazolate framework-8 (ZIF-8) have demonstrated better drug loading capacity, as well as excellent pH-triggered drug release. Cisplatin-encapsulated Fe3O4@SiO2-ZIF-8@N-Chit-FA has been evaluated to determine the antitumor effects of free cisplatin enhancement in cervical cancer cells. In order to increase the stability of the proposed nanocarrier in aqueous solutions, in addition to the density of functional groups, a nano-chitosan layer was coated on top of the magnetic nanocomposite. It was then added with cisplatin onto the surface of Fe3O4@SiO2-ZIF-8@N-Chit-FA to deliver anticancer treatment that could be targeted using a magnetic field. A mouse isograft model of TC1 cells was used to evaluate the in vivo tumor growth inhibition. In tumor-bearing mice, Fe3O4@SiO2-ZIF-8@N-Chit-FA-cisplatin was injected intraperitoneally, and the targeted delivery was amplified by an external magnet (10 mm by 10 mm, surface field strength 0.4 T) fixed over the tumor site. Based on in vivo results, cisplatin-Loaded Mesoporous Magnetic Nanobiocomposite inhibited the growth of cervical tumors (P < 0.001) through the induction of tumor necrosis (P < 0.05) when compared to cisplatin alone. With the application of an external magnetic field, the drug was demonstrated to be able to induce its effects on specific target areas. In summary, Fe3O4@ SiO2-ZIF-8 @ N-Chit-FA nanocomposites have the potential to be implemented in targeted nanomedicine to deliver bio-functional molecules.
A multilayer dynamic perturbation analysis method for predicting ligand–protein interactions
Authors: Gu Lin , Li Bin , Ming Dengming
Published: November 2022

Background

Ligand–protein interactions play a key role in defining protein function, and detecting natural ligands for a given protein is thus a very important bioengineering task. In particular, with the rapid development of AI-based structure prediction algorithms, batch structural models with high reliability and accuracy can be obtained at low cost, giving rise to the urgent requirement for the prediction of natural ligands based on protein structures. In recent years, although several structure-based methods have been developed to predict ligand-binding pockets and ligand-binding sites, accurate and rapid methods are still lacking, especially for the prediction of ligand-binding regions and the spatial extension of ligands in the pockets.

Results

In this paper, we proposed a multilayer dynamics perturbation analysis (MDPA) method for predicting ligand-binding regions based solely on protein structure, which is an extended version of our previously developed fast dynamic perturbation analysis (FDPA) method. In MDPA/FDPA, ligand binding tends to occur in regions that cause large changes in protein conformational dynamics. MDPA, examined using a standard validation dataset of ligand-protein complexes, yielded an averaged ligand-binding site prediction Matthews coefficient of 0.40, with a prediction precision of at least 50% for 71% of the cases. In particular, for 80% of the cases, the predicted ligand-binding region overlaps the natural ligand by at least 50%. The method was also compared with other state-of-the-art structure-based methods.

Conclusions

MDPA is a structure-based method to detect ligand-binding regions on protein surface. Our calculations suggested that a range of spaces inside the protein pockets has subtle interactions with the protein, which can significantly impact on the overall dynamics of the protein. This work provides a valuable tool as a starting point upon which further docking and analysis methods can be used for natural ligand detection in protein functional annotation. The source code of MDPA method is freely available at:https://github.com/mingdengming/mdpa.
Mitochondrial genomic analyses provide new insights into the “missing” atp8 and adaptive evolution of Mytilidae
Authors: Zhao Baojun , Gao Shengtao , Zhao Mingyang , Lv Hongyu , Song Jingyu , Wang Hao , Zeng Qifan , Liu Jing
Published: November 2022

Background

Mytilidae, also known as marine mussels, are widely distributed in the oceans worldwide. Members of Mytilidae show a tremendous range of ecological adaptions, from the species distributed in freshwater to those that inhabit in deep-sea. Mitochondria play an important role in energy metabolism, which might contribute to the adaptation of Mytilidae to different environments. In addition, some bivalve species are thought to lack the mitochondrial protein-coding gene ATP synthase F0 subunit 8. Increasing studies indicated that the absence of atp8 may be caused by annotation difficulties for atp8 gene is characterized by highly divergent, variable length.

Results

In this study, the complete mitochondrial genomes of three marine mussels (Xenostrobus securis, Bathymodiolus puteoserpentis, Gigantidas vrijenhoeki) were newly assembled, with the lengths of 14,972 bp, 20,482, and 17,786 bp, respectively. We annotated atp8 in the sequences that we assembled and the sequences lacking atp8. The newly annotated atp8 sequences all have one predicted transmembrane domain, a similar hydropathy profile, as well as the C-terminal region with positively charged amino acids. Furthermore, we reconstructed the phylogenetic trees and performed positive selection analysis. The results showed that the deep-sea bathymodiolines experienced more relaxed evolutionary constraints. And signatures of positive selection were detected in nad4 of Limnoperna fortunei, which may contribute to the survival and/or thriving of this species in freshwater.

Conclusions

Our analysis supported that atp8 may not be missing in the Mytilidae. And our results provided evidence that the mitochondrial genes may contribute to the adaptation of Mytilidae to different environments.
Immunomodulatory effects of β-defensin 2 on macrophages induced immuno-upregulation and their antitumor function in breast cancer
Authors: Agarwal Sonam , Chauhan Anita , Singh Khushwant , Kumar Kunal , Kaur Rupinder , Masih Marilyn , Gautam Pramod Kumar
Published: November 2022

Background

Macrophages are mononuclear CD34+ antigen-presenting cells of defense mechanism and play dual roles in tumor burden. The immunomodulatory and their antitumor function of β-defensin 2 is still unclear, despite the accumulating evidence of the response in infection. So, the aim of present study is to elucidate the role of β-defensin 2 on the level of ROS, cytokines, chemokine expression in macrophages and antitumor function in breast cancer.

Method

Swiss albino mice were used to harvest PEC macrophages and C127i breast cancer cells line for tumor model was used in this study. Macrophages were harvested and characterized by flow-cytometry using F4/80 and CD11c antibodies. MTT was performed to estimate cytotoxicity and dose optimization of β-defensin 2. Oxidative stress was analyzed by H2O2 and NO estimation followed by iNOS quantified by q-PCR. Cytokines and chemokines estimation was done using q-PCR. Co-culture experiment was performed to study anti-tumor function using PI for cell cycle, Annexin –V and CFSE analysis for cell proliferation.

Results

PEC harvested macrophages were characterized by flow-cytometry using F4/80 and CD11c antibodies with the purity of 8% pure population of macrophages. It was found that 99% of cells viable at the maximum dose of 100 ng/ml of β-defensin 2 in MTT. Levels of NO and H2O2 were found to be decreased in β-defensin 2 as compared to control. Expression of cytokines of IFN-γ, IL-1α, TNF-α, TGF-βwas found to be increased while IL-3 was decreased in β-defensin 2 group as compared to control. Levels of chemokines CXCL-1, CXCL-5 and CCL5 increased in treated macrophages while CCL24 and CXCL-15 expression decreased. Adhesion receptor (CD32) and fusion receptor (CD204) were decreased in the β-defensin 2 group as compared to control. Anti-tumor experiment was performed using co-culture experiment apoptosis (Annexin-V) was induced, cell cycle arrest in phage and cell proliferation of C127i cells was decreased.

Conclusion

This is the first report of β-defensin 2 modulates macrophage immunomodulatory and their antitumor function in breast cancer. β-defensin 2 as a new therapeutic target for immunotherapy as an adjuvant in vaccines.
Role of bilirubin in the prognosis of coronary artery disease and its relationship with cardiovascular risk factors: a meta-analysis
Authors: Li Xiao-ling , Zhao Cun-rui , Pan Chen-liang , Jiang Gaxue , Zhang Bo
Published: November 2022

Background

Bilirubin is a heme catabolism product with antioxidant, anti-inflammatory, and anti-apoptotic properties and is implicated in the prognosis of several diseases. This study evaluates the prognostic role of bilirubin in coronary artery disease (CAD) patients.

Methods

After identifying studies from the literature, meta-analyses were performed to achieve a) overall estimates of serum total bilirubin levels in patients with myocardial infarction (MI), non-MI CAD and healthy individuals; b) odds ratios (OR) of adverse outcomes between higher and lower total bilirubin levels; c) standardized mean difference (SMD) in total bilirubin levels in patients with high vs low CAD severity; and d) correlation between disease severity and total bilirubin. Metaregression analyses were performed to examine the relationship between cardiovascular risk factors and increasing quantiles of total bilirubin levels.

Results

Forty-three studies were identified. Pooled serum total bilirubin levels were 0.72 mg/dl [95% confidence interval (CI): 0.60, 0.83] in MI patients; 0.65 mg/dl [95% CI: 0.60, 0.69] in non-MI CAD patients; and 0.66 mg/dl [95% CI: 0.56, 0.75] in healthy individuals. Higher total bilirubin levels were associated with greater odds of adverse outcomes in MI patients (OR: 1.08 [95% CI: 0.99, 1.18]) but lower odds in non-MI CAD patients (OR: 0.80 [95%CI: 0.73, 0.88]). Compared to non-severe cases, total bilirubin levels were higher in patients with severe MI (SMD 0.96 [95% CI: − 0.10, 2.01]; p = 0.074) but were lower in severe non-MI CAD patients (SMD − 0.30 [95%CI: − 0.56, − 0.03]; p = 0.02). Total bilirubin levels correlated positively with MI severity (r = 0.41 [95% CI: 0.24, 0.59]; p < 0.01) but correlated negatively with non-MI CAD severity (r =  − 0.17 [95% CI: − 0.48, 0.14]; p = 0.28). Female sex was inversely associated with increasing quantiles of bilirubin (meta-regression coefficient: − 8.164 [− 14.531, − 1.769]; p = 0.016) in MI patients.

Conclusion

Prognostic role of bilirubin for CAD appears complicated, as different odds are observed for MI and non-MI CAD patients which weakens the case of causal involvement of bilirubin in CAD etiology or prognosis.
Aberrant cytokeratin 7 expression by hepatocytes can predict the ductopenia grade in primary biliary cholangitis
Authors: Liu Hong-Li , Yang An-Yin , Xiong Qing-Fang , Zhong Yan-Dan , Liu Du-Xian , Huang Ping , Feng Xiao-Ning , Zhang Yu , Yang Yong-Feng
Published: November 2022

Background

Aberrant cytokeratin 7 expression by hepatocytes (CK7+Hs) is the hallmark characteristic of cholestasis diseases, especially in ductopenia diseases such as primary biliary cholangitis (PBC). This study attempted to evaluate the differences and relationships between the clinical and histological features of aberrant cytokeratin 7 (CK7) expression by hepatocytes in PBC patients.

Methods

The clinicopathological data of patients diagnosed with PBC at the Second Hospital of Nanjing between January 2016 and September 2018 were analysed with SPSS 20.0.

Results

Eighty-nine PBC patients who underwent liver biopsy were enrolled in this study, and 15, 29 and 45 patients had aberrant CK7 expression by hepatocytes (CK7+Hs (2 +), CK7+Hs (1 +), and CK7−Hs, respectively). There were significant differences in TB, DB, ALP, TA, IgM, interface activity, and ductopenia grade between patients with CK7−Hs and CK7+Hs (2 +) (P < 0.05). The ductopenia grade was also significantly different between patients with CK7+Hs (2 +) and CK7+Hs (1 +) according to sex (P < 0.05). Upon merging the data of CK7+Hs (2 +) and CK7+Hs (1 +) into CK7+Hs, we found significant differences in AMA, AMA-M2, anti-gp210, TB, DB, ALP, TA, IgM, fibrosis, and ductopenia grade between CK7+Hs and CK7−Hs (P < 0.05). The odds ratios (ORs) (and 95% confidence intervals (CIs)) of CK7+Hs according to anti-gp210, ductopenia grade, and interface activity were 6.413 (95% CI 1.363–30.162), 4.145 (95% CI 1.898–9.052) and 3.247 (95% CI 1.556–6.775), respectively (P < 0.05). Spearman's rank correlation according to interface activity and ductopenia grade in patients with CK7+Hs (2 + , 1 + , 0) wasr = 0.359 (P = 0.001) andr = 0.396 (P < 0.001), respectively.

Conclusion

CK7+Hs serves as a cholestasis index of PBC and are associated with the ductopenia grade and interface activity. Aberrant cytokeratin 7 expression by hepatocytes can predict the ductopenia grade in primary biliary cholangitis.
Incidence and predictors of acute kidney injury among women with severe pre-eclampsia at Mbarara Regional Referral Hospital
Authors: Hassan Mariam , Mayanja Roland , Ssalongo Wasswa G.M , Robert Natumanya , Mark Lugobe Henry , Samson Okello , Muhindo Rose
Published: November 2022

Background

The presence of acute kidney injury (AKI) in pre-eclampsia complicates treatment including; increasing length of hospital stay and a need to access services like dialysis which are largely expensive in resource-limited settings. We aimed to determine incidence and predictors of acute kidney injury among women with severe pre-eclampsia at Mbarara Regional Referral Hospital in southwestern Uganda.

Methods

We carried out a hospital-based prospective cohort study from 16 November  2018 to 18 April 2019, among pregnant women with severe pre-eclampsia followed up in the hospital. We enrolled 70 mothers with severe pre-eclampsia and eclampsia; we excluded patients with a history of chronic kidney disease, chronic hypertension, and gestational hypertension. Data on socio-demographics, laboratory parameters, health system, obstetric and medical factors were collected. Baseline serum creatinine, complete blood count, and CD4 T-cell count were all done at admission (0-hour). A second serum creatinine was done at 48-hours to determine the presence of AKI and AKI was defined as a relative change of serum creatinine value at least 1.5 times the baseline (i.e., at admission) within 48 h. The proportion of women diagnosed with acute kidney injury among the total number of women with severe pre-eclampsia was reported as incidence proportion. Univariate and multivariate logistic regression was used to establish the association between acute kidney injury and severe pre-eclampsia.

Results

Incidence of acute kidney injury was high (42.86%) among women with severe pre-eclampsia. Antenatal care attendance was protective with an odds ratio of 0.14 (0.03, 0.73), p-value 0.020 at bivariate analysis but had no statistical significance at multivariate analysis. Eclampsia was an independent risk factor for acute kidney injury. (aOR 5.89 (1.51, 38.88), p-value 0.014.

Conclusion

The incidence of acute kidney injury in patients with severe pre-eclampsia is high. Eclampsia is an independent risk factor of acute kidney injury. The findings of this study highlight the urgent need for more research and better perinatal care for these women.
Cerebral blood flow abnormalities with central sparing on arterial spin labeling in mild encephalopathy associated with excitotoxicity: a case report
Authors: Nakajima Yuki , Kobayashi Shinya , Tanoue Hideki , Ishihara Sayaka , Kamiya Ayako , Kawata Nanako , Asakura Mari , Suzuki Daichi , Obana Natsuko , Hayashi Kenta , Kawaguchi Takahiro , Noda Masahiro , Oba Kunihiro , Katori Tatsuo , Kageyama Tsutomu , Ogasawara Masashi
Published: November 2022

Background

Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) and mild encephalopathy associated with excitotoxicity (MEEX) are the most frequent acute encephalopathies in pediatric patients in Japan. AESD typically presents with biphasic seizures and delayed reduced diffusion in the subcortical area, called bright tree appearance (BTA), on radiological examination. In patients with AESD, arterial spin labeling (ASL) shows decreased cerebral blood flow (CBF) in the hyperacute stage and increased CBF in the acute stage, suggesting the usefulness of ASL for the early diagnosis of AESD. Additionally, proton magnetic resonance spectroscopy (MRS) shows elevated glutamate (Glu) and glutamine (Gln) in AESD. MEEX is a group of mild encephalopathies with transient elevation of Gln on MRS similar to that in AESD; however, MEEX does not include any clinical biphasic course or abnormalities, including BTA on diffusion-weighted imaging. Although the usefulness of ASL for AESD has been reported, there are no reports for patients with MEEX. In this study, we report our experience with a 4-year-old girl diagnosed with MEEX who showed unique findings on ASL.

Case presentation

The patient was a 4-year-old girl admitted to the emergency room with febrile status epilepticus. Considering the possibility of AESD, vitamin therapy was initiated. ASL-MR imaging (MRI) of the brain performed on the second day showed increased blood flow in the frontal, temporal, and occipital regions with spared central sulcus, which indicated AESD with central sparing. The patient was diagnosed with AESD, and the treatment included pulse steroid therapy and immunoglobulin therapy from day 3. The patient remained mildly unconscious but gradually became conscious by day 7 with no seizures. Brain MRI performed on day 8 did not show any characteristic AESD findings, such as BTA. Furthermore, MRS showed elevated Gln, which, along with the clinical course, led to the diagnosis of MEEX. The patient was discharged on day 16 without obvious sequelae.

Conclusions

ASL may be useful in the early diagnosis of MEEX as well as AESD, facilitating early intervention.
Severe intrahepatic cholestasis of pregnancy due to a Sertoli-Leydig cell tumour in a woman with polycystic ovary syndrome: a case report
Authors: Yun Feng , Fu Leyi , Xu Dong , Qu Fan , Wang Fangfang
Published: November 2022

Background

Intrahepatic cholestasis of pregnancy (ICP) is a common gestational complication characterized by pruritus and elevated bile acids, usually occurring in the third trimester when the serum estrogen and progesterone levels are highest. Hyperandrogenism during pregnancy is a pathological state that is mostly induced by polycystic ovary syndrome (PCOS) but rarely by concomitant androgen-secreting ovarian tumours. To date, no correlation has been drawn between ICP and hyperandrogenism.

Case presentation

Here, we present a rare case of early-onset severe ICP in a PCOS patient conceived via in vitro fertilization-embryo transfer, with worsening hirsutism and acne due to high levels of testosterone and dehydroepiandrosterone sulphate, both of which were produced by a fast-growing ovarian Sertoli–Leydig cell tumour. Her serum estradiol was also very high, which was speculated to be converted from the circulating androgens by the placenta. She had preterm premature rupture of membranes and delivered at 30 weeks, followed by a rapid remission of ICP as her serum estradiol dropped. However, the excessive androgens did not retreat until the large ovarian tumour was surgically removed.

Conclusion

This unusual case highlights the concurrence of original hyperandrogenism and subsequent hyperestrogenism during pregnancy and the resultant confounding manifestations. Obstetricians should be aware of the potential association between androgen excess and ICP via placental aromatization.
Conservative surgery with microwave ablation for recurrent bone tumor in the extremities: a single-center study
Authors: Zheng Kai , Yu Xiu-chun , Xu Ming , Wang Jing-ming
Published: November 2022

Background

Surgical treatment for recurrent bone tumors in the extremities still presents a challenge. This study was designed to evaluate the clinical value of microwave ablation in the treatment of recurrent bone tumors.

Methods

We present 15 patients who underwent microwave ablation for recurrent bone tumors during the last 7 years. The following parameters were analyzed for outcome evaluation: general condition, surgical complications, local disease control, overall survival, and functional score measured using the Musculoskeletal Tumor Society (MSTS) 93 scoring system.

Results

Percutaneous microwave ablation in one patient with osteoid osteoma and another with bone metastasis resulted in postoperative pain relief. Thirteen patients received intraoperative microwave ablation before curettage or resection, including those with giant cell tumors of bone (6), chondroblastoma (2), osteosarcoma (2), undifferentiated sarcoma (1), and bone metastases (2). All patients achieved reasonable local tumor control in the mean follow-up of 29.9 months. The functional score was 24.1 for the 15 patients 6 months after the operation. Four patients had tumor metastasis and died, whereas 3 patients with tumors survived, and the remaining 8 patients without the disease survived.

Conclusions

Microwave ablation represents an optional method for local control in treating recurrent bone tumors in the extremities.
Snacking for a reason: detangling effects of socio-economic position and stress on snacking behaviour
Authors: Gillebaart Marleen , Schlinkert Caroline , Poelman Maartje P. , Benjamins Jeroen S. , De Ridder Denise T.D.
Published: November 2022

Background

As snacking can be considered a cornerstone of an unhealthy diet, investigating psychological drivers of snacking behaviour is urgent, and therefore the purpose of this study. Socio-economic position (SEP) and stress are known to affect many behaviours and outcomes, and were therefore focal points in the study.

Methods

In a cross-sectional survey study, we examined whether Socio-economic position (SEP) would amplify associations between heightened stress levels and self-reported negative-affect related reasons for snacking. Next, we investigated whether Socio-economic position (SEP) predicted frequency of snacking behaviour, and how stress and other reasons for snacking could explain this association. Outcome measures were reasons people indicated for snacking, and frequency of snacking behaviour.

Results

Analyses revealed that people seem to find more reasons to snack when they are stressed, and that this association was more pronounced for people with a high compared to low socio-economic position. Furthermore, a higher socio-economic position was associated with a higher frequency of snacking, and both snacking to reward oneself and snacking because of the opportunity to do so remained significant mediators.

Conclusion

Whereas low socio-economic position was associated with higher stress levels, this did not translate into increased snacking. Contrarily, those with higher socio-economic position could be more prone to using ‘reasons to snack’, which may result in justification of unhealthy snacking behaviour.
Air pollution and refraining from visiting health facilities: a cross-sectional study of domestic migrants in China
Authors: Liu Zhixin , Liu Chaojie , Cui Yu , Liu Junping , Zhang Huanyu , Feng Yajie , Wang Nan , Jiao Mingli , Kang Zheng , Xu Xiaoxue , Zhao Juan , Wang Chen , Zou Dandan , Liang Libo , Wu Qunhong , Hao Yanhua
Published: November 2022

Background

Local environmental factors are associated with health and healthcare-seeking behaviors. However, there is a paucity in the literature documenting the link between air pollution and healthcare-seeking behaviors. This study aimed to address the gap in the literature through a cross-sectional study of domestic migrants in China.

Methods

Data were extracted from the 2017 China Migrants Dynamic Survey (n = 10,051) and linked to the official air pollution indicators measured by particulate matter (PM2.5 and PM10) and air quality index (AQI) in the residential municipalities (n = 310) of the study participants over the survey period. Probit regression models were established to determine the association between air pollution and refraining from visiting health facilities after adjustment for variations in the predisposing, enabling and needs factors. Thermal inversion intensity was adopted as an instrumental variable to overcome potential endogeneity.

Results

One unit (µg/m3) increase in monthly average PM2.5 was associated with 1.8% increase in the probability of refraining from visiting health facilities. The direction and significance of the link remained unchanged when PM2.5 was replaced by AQI or PM10. Higher probability of refraining from visiting health facilities was also associated with overwork (β = 0.066, p = 0.041) and good self-related health (β = 0.171, p = 0.006); whereas, lower probability of refraining from visiting health facilities was associated with short-distance (inter-county) migration (β=-0.085, p = 0.048), exposure to health education (β=-0.142, p < 0.001), a high sense of local belonging (β=-0.082, p = 0.018), and having hypertension/diabetes (β=-0.169, p = 0.005).

Conclusion

Air pollution is a significant predictor of refraining from visiting health facilities in domestic migrants in China.
Health behaviours and well-being among older adults with a Surinamese migration background in the Netherlands
Authors: Jagroep Warsha , Cramm Jane M. , Denktaş Semiha , Nieboer Anna P.
Published: November 2022

Background

This study aims to identify the relationships between health behaviours (healthy diet, physical activity, not smoking and social activity) and well-being among older adults with a Surinamese background.

Methods

Community-dwelling older adults (≥ 70 years) with a Surinamese background living in Rotterdam, the Netherlands, were identified by the municipal register. A survey study was conducted to assess background information, health behaviours (healthy diet, physical activity, not smoking and social activity) and well-being. Multiple regression analyses were performed to assess the relationships of health behaviours with well-being while controlling for background characteristics.

Results

Average age of participants was 76.2 (4.9) years, slightly more than half of them were female (54.2%). Almost half of the participants had a low-income level (49.6%). More than half of the participants met the Dutch guidelines of fruit intake (63.0%) and vegetable intake (62.8%). Less than half of the participants met the guidelines of fish intake (40.9%) and physical activity (39.8%). The majority of the participants were non-smokers (87.9%). Most of the participants had daily contact with family/friends (90.9%) and slightly more than half of the participants visited family/friends often (53.6%). Looking at the health behaviours, a positive relationship was found between eating enough fruit (β = .109; p ≤ 0.05) and vegetables (β = .135; p ≤ 0.01), physical activity (β = .164; p ≤ 0.001) and often visiting family/friends (β = .158; p ≤ 0.001) with well-being.

Conclusion

This study suggests that next to traditional health behaviours also social activity is an essential health behaviour for the well-being of older Surinamese adults. Research about health promotion should expand its focus by including social activity as health behaviour.
“You’re damned if you do, you’re damned if you don’t”: a qualitative exploration of parent motives for provision of mobile screen devices in early childhood
Authors: Mallawaarachchi Sumudu R. , Hooley Merrilyn , Sutherland-Smith Wendy , Horwood Sharon
Published: November 2022

Background

Exploring parental motives for providing smartphones and tablets to young children is important to better understand ways to optimise healthy use of mobile screens in early childhood. To date, no study has qualitatively examined the factors underpinning parental motives of providing mobile screens to young children, using a theoretically driven approach.

Methods

We conducted 45 in-depth, semi structured online interviews with primary caregivers of toddlers and pre-schoolers from diverse family backgrounds who participated in a large online survey in Australia. Themes were generated from the transcribed interviews using template thematic analysis. The coding was completed deductively using the Theory of Planned Behaviour (TPB) and data-driven induction.

Results

Participants consistently reported a spectrum of attitudes, subjective norms and perceived behavioural control aspects which drove their decision to provide or not provide a mobile screen device to their child. Five main descriptive themes were generated, guided by the TPB: (1) Convenience, connection, and non-traditional learning experience; (2) Negative behavioural consequences and potential activity displacement through mobile screens; (3) Influences of society and resources; (4) Managing and achieving a balance; (5) External challenges.

Conclusions

Overall, the findings demonstrated that parents experienced cognitive dissonance between their attitudes and behaviour, primarily from perceived behavioural control and subjective norms negating the influence of attitudes on their motives to provide a device. These insights offer important avenues for public health messaging and resources to better involve and support parents in decision-making relating to mobile screens in everyday lives of young children.
Incidence and risk factors of postoperative medial shoulder imbalance in Lenke Type 2 adolescent idiopathic scoliosis with lateral shoulder balance
Authors: Deng Zhipeng , Wang Liang , Wang Linnan , Yang Xi , Wang Lei , Liu Limin , Song Yueming
Published: November 2022

Background

In clinical practice, there are a significant percentage of Lenke 2 AIS patients suffered from medial shoulder imbalance (MSI) despite achieving good lateral shoulder balance (LSB) following surgery. However, there are few studies evaluating the features of the medial shoulder. The objective of this study was to determine the incidence and independent risk factors of MSI with LSB after Lenke 2 AIS corrective surgery.

Methods

One hundred and twenty Lenke 2 AIS patients with LSB at the last follow-up were reviewed from 2009 to 2018. Preoperative, and 3-month and the last postoperative follow-up radiographs were measured using a number of specific measurements. At the last follow-up, patients were divided into medial shoulder balance (MSB) group and the MSI group according to whether the T1 tilt was greater than 3°. A stepwise multiple linear regression analysis was used to examine the independent risk factors for MSI. Scoliosis Research Society (SRS)-30 questionnaire was used to assess clinical outcomes.

Results

Up to 69.2% of patients suffered from MSI with LSB after Lenke Type 2 AIS corrective surgery. Multiple regression showed that postoperative upper instrumented vertebra tilt (UIVt), proximal thoracic curve (PTC), the ratio of PTC and main thoracic curves (PTC/MTC) and T2 vertebra rotation ratio (T2-VR) were significant predictors for MSI (UIVt: b = 0.398, p < 0.001; PTC/MTC: b = 2.085, p < 0.001; PTC: b = 0.155, p < 0.001; T2-VR: b = 3.536, p = 0.008; adjusted R2 = 0.711). 72 patients completed the SRS-30 questionnaire survey, and the MSB group were scored the higher (p ≤ 0.001) in self-image domain (4.18 ± 0.43 vs. 3.70 ± 0.35), satisfaction domain (4.39 ± 0.54 vs. 3.95 ± 0.46) and total average (4.31 ± 0.23 vs. 4.11 ± 0.19).

Conclusion

Although the patients with Lenke 2 AIS achieve LSB after corrective surgery, up to 69.2% of them suffered from MSI. Postoperative UIVt, PTC, PTC/MTC and T2-VR were significant predictors for MSI. Sufficient correction of these variables may facilitate the achievement of MSB.
The outcomes and prognostic factors of patients who underwent reoperation for persistent/recurrent papillary thyroid carcinoma
Authors: Sun Wenyu , Di Lu , Chen Lili , Li Duanshu , Wu Yi , Xiang Jun , Zhou Shichong , Sun Tuanqi
Published: November 2022

Background

While the most suitable approach for treating persistent/recurrent papillary thyroid carcinoma (PTC) remains controversial, reoperation may be considered an effective method. The efficacy of reoperation in patients with locoregional persistent/recurrent PTC, especially those with unsatisfactory radioactive iodine (RAI) ablation results, is still uncertain. This study aimed to clarify the clinical management strategies for locoregional persistent/recurrent PTC and to explore factors that may affect long-term patient outcomes after reoperation.

Methods

In total, 124 patients who initially underwent thyroidectomy and variable extents of RAI therapy and finally received reoperation for locoregionally persistent/recurrent PTC were included. The parameters associated with recurrence-free survival (RFS) were analysed using a Cox proportional hazards model.

Results

Overall, 124 patients presented with structural disease after initial therapy and underwent secondary surgical resection, of whom 32 patients developed further structural disease during follow-up after reoperation. At the time of reoperation, metastatic lymph nodes with extranodal extension (P = 0.023) and high unstimulated thyroglobulin (unstim-Tg) levels after reoperation (post-reop) (P = 0.001) were independent prognostic factors for RFS. Neither RAI avidity nor the frequency and dose of RAI therapies before reoperation affected RFS.

Conclusions

Reoperation is an ideal clinical treatment strategy for structural locoregional persistent/recurrent PTC, and repeated empirical RAI therapies performed prior to reoperation may not contribute to the long-term outcomes of persistent/recurrent PTC patients. Metastatic lymph nodes with extranodal extension and post-reop unstim-Tg > 10.1 ng/mL may predict a poor prognosis.
Personality and oral health-related quality of life. Results from an online survey
Authors: Hajek André , König Hans-Helmut
Published: November 2022

Background

To investigate the association between personality factors and oral health-related quality of life.

Methods

Data were taken from an online survey (representative for the general adult population in Germany in terms of region, sex and age group; n = 3,075) performed in late summer 2021. The well-established Oral Health Impact Profile (OHIP-G5) was used to measure oral health-related quality of life. Moreover, the established 10 Item Big Five Inventory (BFI-10) was used to quantify personality factors (in terms of agreeableness, conscientiousness, extraversion, neuroticism, and openness to experience). Sex, age, family status, educational level, smoking status, alcohol consumption, sports activities, presence of chronic diseases and self-rated health were adjusted for in multiple linear regression analysis.

Results

Pearson correlations between oral health-related quality of life and personality factors ranged from r =- 0.17 (conscientiousness) to r = 0.17 (neuroticism). Regressions revealed that low oral health-related quality of life is associated with higher neuroticism (β = 0.39, p < 0.001) and lower conscientiousness (β=-0.51, p < 0.001).

Conclusion

This study revealed an association between personality factors (higher neuroticism and lower conscientiousness) and low oral health-related quality of life. Before dental treatment, it may be helpful to measure personality traits of patients in order to predict the expectations of patients, as well as their responses to intended treatments. This may support the identification of the most appropriate method of treatment.