bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of a home-based palliative heart failure program on quality of life among the elderly: a clinical trial study
Authors: Khajehpoor Mohammad Hossein , shahrbabaki Parvin Mangolian , Nouhi Esmat
Published: September 2023

Introduction

One of the frequent issues that lowers elderly people's quality of life is chronic heart failure, a progressive and life-limiting disease. The purpose of this study was to evaluate the effects of home-based palliative care (HBPC) on the quality of life of elderly patients with heart failure who received discharge orders from hospitals affiliated with Kerman University of Medical Sciences in 2022.

Methods

One hundred heart failure patients were divided into two intervention and control groups for this randomized clinical trial study. The patients were then given the pre-test questionnaires, such as the demographic questionnaire and the Quality of Life Index (QLI) by Ferrans and Powers. The intervention group was given the home care plan. To measure the quality of life one month after the intervention, the quality of life questionnaire was lastly filled out by both groups following the last care session. Software called SPSS 22 was used to enter and analyze the patient data.

Results

The mean age for the elderly in the intervention and in the control groups were 69.46 ± 11.61 and 66.14 ± 12.09 years, respectively. The palliative care program at home made a statistically significant difference in the quality of life and all of its components in the elderly with heart failure in the intervention group immediately after the intervention and one month after the intervention compared to before (P < 0.001). As a result, its scores improved compared to the stage before the intervention. Additionally, a significant difference between the quality of life score and all of its components between the intervention's immediate aftermath and one month later was noted (P < 0.05).

Conclusion

Home-based palliative care has a positive effect on the quality of life for elderly people who have heart failure, making it a worthwhile intervention to enhance their quality of life.

Trial registrations

(IRCT20211213053389N1). Date of registration: (19/02/2022).
Evaluation of factors predicting the benefit from systemic oncological treatment for severely ill hospitalized patients: a retrospective study
Authors: Neves Milena Brachmans Mascarenhas , Neves Yuri Costa Sarno , Bomonetto Juliana Vieira Biason , Matos Priscila Prais Carneiro , Giglio Auro Del , Cubero Daniel de Iracema Gomes
Published: September 2023

Background

Patients with cancer in the disease’s end-stage with poor performance represent a challenging clinical scenario, as they have high chance of a fatal outcome due to clinical conditions, oncological emergencies, and/or metastatic disease. This study examines the factors predicting the potential benefit of “urgent” chemotherapy during hospitalization in this setting, thus addressing a research gap.

Methods

This retrospective observational study was conducted in the largest cancer center in the outskirts of São Paulo. It identified factors predicting the benefit from antineoplastic treatment in severe in-hospital patients admitted during 2019–2020, considering post-chemotherapy survival time as the main dependent variable. Data were retrieved from medical records. All patients aged ≥ 18 years, with an ECOG-PS score ≥ 2, and undergoing non-elective systemic cancer treatment were included.

Results

This study evaluated 204 records, of which 89 were included in the final analysis. A statistically significant association with the worse outcome (death within 30 days of chemotherapy) was found with higher ECOG performance status; chemotherapy dose reduction; lower values of serum albumin, hemoglobin, and creatinine clearance; and higher values of leukocytes, neutrophils, direct bilirubin, urea, and C-reactive protein. In the multivariate analysis, only albumin remained statistically associated with the outcome (hazard ratio = 0.35; confidence interval: 0.14, 0.90; p = 0.034).

Conclusions

Serum albumin and other clinical and laboratory variables might be associated with early post-treatment deaths in patients with cancer. The study data might help guide the decision to administer systemic treatment in this scenario and manage critically ill patients. This study adds to our knowledge of the factors predicting the objective benefits from “heroic” or “urgent” chemotherapy for hospitalized and severely ill patients with cancer.
Effectiveness of mindfulness-based interventions on burnout and self-compassion among critical care nurses caring for patients with COVID-19: a quasi-experimental study
Authors: Othman Sahar Younes , Hassan Nagia I. , Mohamed Alaa Mostafa
Published: September 2023

Background

Workloads in intensive care units (ICUs) have increased and extremely challenging ethical dilemmas were generated by the coronavirus disease 2019 (COVID-19) pandemic. ICU nurses experience high-stress levels and burnout worldwide. Egyptian studies on the effectiveness of mindfulness-based intervention (MBI) among ICU nurses are limited, although MBI has been shown to reduce stress and burnout.

Methods

This quasi-experimental study included 60 nurses working in three hospitals in El-Beheira, Egypt. Participants were randomly allocated to one of the two groups: intervention or control (30 participants per group). The participants in the intervention group (MBI) received 8 MBI sessions, whereas the control group received no intervention. The Maslach Burnout Inventory, the Five-Facet Mindfulness Questionnaire (FFMQ), and the Self-Compassion Scale were used to assess the outcomes. Additionally, demographic and workplace data were collected.

Results

The post-test score of emotional exhaustion after MBI for 8 weeks significantly decreased in the MBI group to 15.47 ± 4.44 compared with the control group with 32.43 ± 8.87 (p < 0.001).

The total Self-Compassion Scale significantly increased because of the mindfulness sessions 94.50 ± 3.83 for the MBI group vs. 79.00 ± 4.57 for the control group (p < 0.001). The post-test score of the FFMQ significantly increased to 137.03 ± 5.93, while the control group’s score decreased to 114.40 ± 7.44, following the MBI sessions (p < 0.001). As determined by Cohen’s d test, the effect size of MBI training is quite large, on the three burnout scale dimensions (emotional exhaustion, depersonalization, and personal achievement), as well as the total score of the mindfulness and self-compassion scales.

Conclusion

This study provides preliminary evidence that MBI sessions were effective in reducing emotional exhaustion and depersonalization and increasing levels of mindfulness and self-compassion among critical care nurses.
The experiences of Red Crescent relief workers during the COVID-19 pandemic in Iran: a qualitative phenomenological study
Authors: Mohammadkhani Minoo , Tavakoli Sani Mohammad Sadegh , Sarani Arezoo , Khanjani Narges
Published: September 2023

Background

The daily increase of infected individuals and mortalities related to COVID-19 in Iran increased public fear and anxiety and affected the job performance of many health workers, including the Iranian Red Crescent Society, as one of the organizations responding to COVID-19.

Methods

This study aimed to explore the experiences of Red Crescent rescuers, using a qualitative method with an interpretative phenomenological analysis (IPA), and by conducting semi-structured and in-depth interviews with Red Crescent relief workers from Mashhad in September 2020. Participants were selected by purposive sampling.

Results

Rescuers in the Red Crescent Society, had gained different experiences during the COVID-19 pandemic. The experiences were categorized into four main themes. These main themes were: (1) Psychological disorders, (2) Organizational support (3) Mis-management (both structural and human factors), and (4) Opportunities.

Conclusion

The COVID-19 epidemic did create unique opportunities to understand the pitfalls of the Red Crescent aid services. Red Crescent rescue workers suffered from psychological symptoms, and mismanagement was also present. Psychological support and organizational improvements should be implemented.
Long-term care status for the elderly with different levels of physical ability: a cross-sectional survey in first-tier cities of China
Authors: Zhou Mingchao , Zha Fubing , Liu Fang , Zhou Jing , Liu Xiangxiang , Li Jiehui , Yang Qingqing , Zhang Zeyu , Xiong Feng , Hou Dianrui , Weng Hongyun , Wang Yulong
Published: September 2023

Background

Long term care (LTC) services for functionally impaired senior citizens are crucial for addressing the challenges of aging. However, research on eligibility criteria and coverage of LTC in China is lacking. Our objective is to assess the current status of LTC and explore eligibility criteria and coverage for the elderly.

Methods

This is a cross-sectional study conducted in two first-tier cities in China. Residents aged 65 or over were recruited from a nursing home and four primary hospitals. Participants were divided into three groups (bedridden, domestic, and community), then six grades (grade one to six) according to the Longshi Scale, and their functional ability was assessed using the Modified Barthel Index. Information such as diseases, complications, and daily care needs were collected. Nursing staff were invited to indicate patients’ needs for care. A one-way ANOVA test, Kruskal Wallis H test and Mann–Whitney U test were used to explore the differences of variables in three Longshi groups or Longshi grades.

Results

Among all 1157 participants, with an average age of 80.54, 69.3% were in the bedridden group. The most common diagnosis was stroke (71.4%), with the most prevalent complication being pulmonary infection (25.2%). In the nursing assessment, basic health care, disease care, activity care, complication prevention care and psychosocial care were summarized as the five main aspects of LTC for the elderly. Feeding, bathing, drinking, bowel management and bladder management were identified as the basic care which fulfills participants’ basic physical needs in each Longshi group. Mouth care, artificial airway management, and body reposition, which can prevent immobility complications, were highly demanded by bedridden elderly.

Conclusions

The elderly in grade one to three are the ones in need of LTC most. The content of LTC for elderly should include basic care which fulfills their basic physical needs and complication care which can prevent immobility complications. The evidence of this research may contribute to the design of LTC in China.

Trial registration

The study design was registered in the Chinese Clinical Trial Registry (ChiCTR-2000034067, Registered 22 Jun 2020, http://www.chictr.org.cn/showproj.aspx?proj=54770).
Efficacy evaluation of a commercially available MCT enriched therapeutic diet on dogs with idiopathic epilepsy treated with zonisamide: a prospective, randomized, double-blinded, placebo-controlled, crossover dietary preliminary study
Authors: Nakatsuka Kazumasa , Zanghi Brian , Hasegawa Daisuke
Published: September 2023

Background

Idiopathic epilepsy (IE) is a common, chronic brain dysfunction in dogs. Recently, the effect of feeding a diet enriched with medium-chain triglycerides (MCTs) on seizure frequency has been evaluated in several studies in dogs with IE. However, most dogs with IE in previous studies were treated with phenobarbital as the main antiseizure medication (ASM). In Japan, zonisamide (ZNS) is the most prescribed ASM for dogs with IE. The interaction between ZNS and various nutrients including MCTs and the potential effects on treatment efficacy resulting from combining these therapies have not been previously studied. A prospective, randomized, double-blinded, placebo-controlled, crossover dietary study was conducted. Dogs (n = 7) treated with ZNS were fed either a placebo diet (PL) or Purina ProPlan Veterinary Diet NeuroCare (NC) for 3 months, after which treatments were crossed over and continued for another 3 months. Seizure frequency (seizures/month; sz/m), blood tests including concentrations of ZNS and β-hydroxybutyric acid, and owner’s visual analogue scale score were collected from all dogs for both treatment periods.

Results

There was no significant difference in the seizure frequency between PL (2.95 ± 0.80 sz/m) and NC (1.90 ± 0.57 sz/m) during the 6 months of trial. Three of 7 dogs showed ≥ 50% seizure reduction, and 1 of those 3 dogs achieved seizure freedom in NC period. However, 2 of 7 dogs had no changes in epileptic seizure frequency, 2 of 7 dogs had a deterioration in seizure frequency in the NC period. Feeding the MCT diet concurrent with ZNS showed no apparent adverse effects and did not affect ZNS concentration.

Conclusions

This study indicated that the commercially available MCT-enriched diet (NC) can be safely used concurrently with ZNS for dogs with IE.
Damage-associated molecular patterns and fibrinolysis perturbation are associated with lethal outcomes in traumatic injury
Authors: Shimono Kenshin , Ito Takashi , Kamikokuryo Chinatsu , Niiyama Shuhei , Yamada Shingo , Onishi Hirokazu , Yoshihara Hideaki , Maruyama Ikuro , Kakihana Yasuyuki
Published: September 2023

Background

Upon cellular injury, damage-associated molecular patterns (DAMPs) are released into the extracellular space and evoke proinflammatory and prothrombotic responses in animal models of sterile inflammation. However, in clinical settings, the dynamics of DAMP levels after trauma and links between DAMPs and trauma-associated coagulopathy remain largely undetermined.

Methods

Thirty-one patients with severe trauma, who were transferred to Kagoshima City Hospital between June 2018 and December 2019, were consecutively enrolled in this study. Blood samples were taken at the time of delivery, and 6 and 12 h after the injury, and once daily thereafter. The time-dependent changes of coagulation/fibrinolysis markers, including thrombin-antithrombin complex, α2-plasmin inhibitor (α2-PI), plasmin-α2-PI complex, and plasminogen activator inhibitor-1 (PAI-1), and DAMPs, including high mobility group box 1 and histone H3, were analyzed. The relationship between coagulation/fibrinolysis markers, DAMPs, Injury Severity Score, in-hospital death, and amount of blood transfusion were analyzed.

Results

The activation of coagulation/fibrinolysis pathways was evident at the time of delivery. In contrast, PAI-1 levels remained low at the time of delivery, and then were elevated at 6–12 h after traumatic injury. Histone H3 and high mobility group box 1 levels were elevated at admission, and gradually subsided over time. PAI-1 levels at 6 h were associated with serum histone H3 levels at admission. Increased histone H3 levels and plasmin-α2-PI complex levels were associated with in-hospital mortality. α2-PI levels at admission showed the strongest negative correlation with the amount of blood transfusion.

Conclusion

The elevation of histone H3 levels and fibrinolysis perturbation are associated with fatal outcomes in patients with traumatic injury. Patients with low α2-PI levels at admission tend to require blood transfusion.
Impact of MRI on target volume definition in head and neck cancer patients
Authors: Clasen Kerstin , Nachbar Marcel , Gatidis Sergios , Zips Daniel , Thorwarth Daniela , Welz Stefan
Published: September 2023

Background

Target volume definition for curative radiochemotherapy in head and neck cancer is crucial since the predominant recurrence pattern is local. Additional diagnostic imaging like MRI is increasingly used, yet it is usually hampered by different patient positioning compared to radiotherapy. In this study, we investigated the impact of diagnostic MRI in treatment position for target volume delineation.

Methods

We prospectively analyzed patients who were suitable and agreed to undergo an MRI in treatment position with immobilization devices prior to radiotherapy planning from 2017 to 2019. Target volume delineation for the primary tumor was first performed using all available information except for the MRI and subsequently with additional consideration of the co-registered MRI. The derived volumes were compared by subjective visual judgment and by quantitative mathematical methods.

Results

Sixteen patients were included and underwent the planning CT, MRI and subsequent definitive radiochemotherapy. In 69% of the patients, there were visually relevant changes to the gross tumor volume (GTV) by use of the MRI. In 44%, the GTV_MRI would not have been covered completely by the planning target volume (PTV) of the CT-only contour. Yet, median Hausdorff und DSI values did not reflect these differences. The 3-year local control rate was 94%.

Conclusions

Adding a diagnostic MRI in RT treatment position is feasible and results in relevant changes in target volumes in the majority of patients.
Circ_0001825 promotes osteogenic differentiation in human-derived mesenchymal stem cells via miR-1270/SMAD5 axis
Authors: Zheng Changjun , Ding Lingzhi , Xiang Ziming , Feng Mingxuan , Zhao Fujiang , Zhou Zhaoxin , She Chang
Published: September 2023

Background

The implication of deregulated circular RNAs in osteoporosis (OP) has gradually been proposed. Herein, we aimed to study the function and mechanism of circ_0001825 in OP using osteogenic-induced human-derived mesenchymal stem cells (hMSCs).

Methods

The content of genes and proteins was tested by quantitative real-time polymerase chain reaction and Western blotting. The osteogenic differentiation in hMSCs were evaluated by ALP activity and Alizarin Red staining, as well as the detection of osteogenesis-related markers. Cell viability and apoptosis were measured by CCK-8 assay and flow cytometry. The binding between miR-1270 and circ_0001825 or SMAD5 (SMAD Family Member 5) was confirmed by using dual-luciferase reporter assay and pull-down assay.

Results

Circ_0001825 was lowly expressed in OP patients and osteogenic induced hMSCs. Knockdown of circ_0001825 suppressed hMSC viability and osteogenic differentiation, while circ_0001825 overexpression showed the exact opposite effects. Mechanistically, circ_0001825/miR-1270/SMAD5 formed a feedback loop. MiR-1270 was increased and SMAD5 was decreased in OP patients and osteogenic induced hMSCs. MiR-1270 up-regulation suppressed hMSC viability and osteogenic differentiation, which was reversed by SMAD5 overexpression. Moreover, miR-1270 deficiency abolished the effects of circ_0001825 knockdown on hMSCs.

Conclusion

Circ_0001825 promoted hMSC viability and osteogenic differentiation via miR-1270/SMAD5 axis, suggesting the potential involvement of circ_0001825 in osteoporosis.
Schisandrin protects against ulcerative colitis by inhibiting the SGK1/NLRP3 signaling pathway and reshaping gut microbiota in mice
Authors: Wang Xiaohu , Shen Chaozhuang , Wang Xingwen , Tang Jin , Wu Zijing , Huang Yunzhe , Shao Wenxin , Geng Kuo , Xie Haitang , Pu Zhichen
Published: September 2023

Background

According to the Chinese Pharmacopoeia, the fruit of Schisandra chinensis (Turcz.) Baill. (SC) is an important traditional Chinese medicine that can be used to treat diarrhea. Despite the increasing research on the anti-inflammatory and anti-oxidant aspects of SC, the studies on the anti-ulcerative colitis of Schisandrin (SCH), the main constituent of SC, are relatively few.

Methods

The mice used in the study were randomly distributed into 6 groups: control, model, 5-ASA, and SCH (20, 40, 80 mg/kg/d). The mice in the model group were administered 3% (w/v) dextran sulfate sodium (DSS) through drinking water for 7 days, and the various parameters of disease activity index (DAI) such as body weight loss, stool consistency, and gross blood were measured. ELISA was used to detect inflammatory factors, and bioinformatics combined with transcriptome analysis was done to screen and verify relevant targets. 16S rDNA high-throughput sequencing was used to analyze the composition of the gut microbiota(GM), while mass spectrometry was done to analyze the changes in the content of bile acids (BAs) in the intestine.

Results

Mice treated with SCH experienced significant weight gain, effectively alleviating the severity of colitis, and decreasing the levels of inflammatory factors such as TNF-α, IL-1β, IL-18, IL-6, and other related proteins (NLRP3, Caspase-1, SGK1) in UC mice. Furthermore, the analysis of GM and BAs in mice revealed that SCH increased the relative abundance of Lactobacilli spp, reduced the relative abundance of Bacteroides, and promoted the conversion of primary BAs to secondary BAs. These effects contributed to a significant improvement in the DSS-induced GM imbalance and the maintenance of intestinal homeostasis.

Conclusion

It seems that there is a close relationship between the SCH mechanism and the regulation of SGK1/NLRP3 pathway and the restoration of GM balance. Therefore, it can be concluded that SCH could be a potential drug for the treatment of UC.
Analysis of the accuracy and reliability of vertical jump evaluation using a low-cost acquisition system
Authors: Caseiro-Filho Luis C. , Girasol Carlos E. , Rinaldi Mateus L. , Lemos Tenysson W. , Guirro Rinaldo R. J.
Published: September 2023

Background

The vertical jump can be analyzed based on the flight time achieved by the individual. This measurement can be obtained using a force platform or a three-dimensional infrared camera system, but such equipment is expensive and requires training for data collection and processing. Thus, this study aimed to evaluate the accuracy and reliability of using a smartphone and the Kinovea software compared with a force platform as a method of vertical jump analysis.

Methods

For this purpose, two independent evaluators analyzed videos of bipodal and unipodal vertical jumps by counting the variables among participants. The participants performed three consecutive jumps in bipodal and unipodal conditions with the dominant and non-dominant legs.

Results

The intra-rater analysis for bipodal jumps was found to have excellent reproducibility (ICC = 0.903 to 0.934), whereas for unipodal jumps, the reproducibility was moderate to excellent (ICC = 0.713 to 0.902). The inter-rater analysis showed that for bipodal jumps, the reproducibility is substantial to excellent (ICC = 0.823 to 0.926), while for unipodal jumps, it is moderate (ICC = 0.554 to 0.702).

Conclusions

Therefore, it can be concluded that the vertical jump evaluation can be performed using the smartphone-Kinovea system. However, the same evaluator should carry out the evaluation to maintain reliable indices.
Seed nutrient is more stable than leaf in response to changing multiple resources in an alpine meadow
Authors: Li Jiapu , Tian Dashuan , Yu Kailiang , Guo Hongbo , Zhang Ruiyang , Wang Jinsong , Zhou Qingping , Niu Shuli
Published: September 2023

Background

It has been long thought that nitrogen (N), phosphorus (P) concentrations and their ratios (N:P) in metabolically active or functional organs (i.e., leaves) are less responsive to environmental changes. Little attention, however, has been paid to the reproductive organs—seeds, while seeds may maintain their nutrients more stable for the evolutionary fitness of next generation.

Methods

Here, we conducted a field experiment of N, P addition and drought in an alpine meadow, aiming to compare the difference of leaf and seed nutrients and stoichiometric ratios in response to these resource treatments and their interactions. Four dominant species were selected among grass and forb functional groups, including Elymus nutans, Deschampsia caespitosa, Artemisia roxburghiana and Polygonum viviparum.

Results

Under natural conditions, leaf N and P concentrations were consistently lower than seed among species. However, leaf nutrients were much more sensitive than seed nutrients to N and P addition. Specifically, N or P addition accordingly increased leaf N or P concentration by 22.20–44.24% and 85.54–93.61%, while only enhanced seed N or P concentration by 5.15–17.20% and 15.17–32.72%, respectively. Leaf N or P concentration was significantly reduced by P or N addition, but seed nutrients remained unchanged. In contrast, drought did not change both organ nutrients. Similarly, nutrient addition and drought had synergistic interactions on leaf nutrients, but not on seed nutrients.

Conclusions

This study highlights that seed nutrient concentrations could be more stable than metabolically active leaf organ when facing multidimensional resource changes. This complements the traditional view on the ‘Stable Leaf Nutrient Hypothesis’ with the involvement of reproductive organs. The less responsiveness of seed nutrients suggests the adaptive strategy to ensure the success of next generations and long-term plant demographic stability.
Alexithymia characteristics are associated with salience network activity in healthy participants: an arterial spin labeling study
Authors: Motomura Yuki , Fukuzaki Ayaka , Eto Sanami , Hirabayashi Naoki , Gondo Motoharu , Izuno Satoshi , Togao Osamu , Yamashita Koji , Kikuchi Kazufumi , Sudo Nobuyuki , Yoshihara Kazufumi
Published: September 2023

Background

Alexithymia, a personality trait characterized by difficulties in identifying and expressing their emotions despite having a range of emotional experiences, can impact individuals’ stress coping mechanisms. While many studies have investigated brain functions associated with specific tasks in relation to emotion processing, research focusing on resting-state brain functions has been limited. Thus, the aim of this study was to investigate the relationship between alexithymia and brain function by analyzing arterial spin labeling (ASL) data obtained during the resting state.

Methods

A brain structural and functional imaging study was conducted on 42 healthy adult men and women using ASL and the 20-item Toronto Alexithymia Scale (TAS-20) questionnaire survey. Cerebral blood flow and functional connectivity values were calculated for regions of interest in the default mode network, saliency network, and central executive network from the ASL data. Correlation analysis was performed with TAS20 scores, and partial correlation analysis was conducted to control for anxiety and depression.

Results

The functional connectivity analysis revealed a negative correlation between the functional connectivity of the right insular cortex and left anterior cingulate cortex and the total score of TAS, as well as difficulty identifying feelings and difficulty describing feeling subscores, indicating that the higher the scores, the weaker the functional connectivity between these regions (T = -3.830, p = 0.0013, R = -0.5180). This correlation remained significant even after controlling for anxiety and depression using partial correlation analysis.

Conclusion

The present study revealed differences in the activity of the Saliency Network at rest as measured by ASL, which were independent of anxiety and depression, and varied depending on the severity of alexithymia. This functional change may underlie the neural basis of decreased emotional processing observed in alexithymia. These findings may contribute to the elucidation of the neural mechanisms of alexithymia, which can lead to social impairments, and suggest the usefulness of ASL measurement as a biomarker of alexithymia.
Antipsychotic effects on anthropometric outcomes in anorexia nervosa: a retrospective chart review of hospitalized children and adolescents
Authors: Frank Bettina , Arnold Sabine , Jaite Charlotte , Correll Christoph U.
Published: September 2023

Background

Off-label antipsychotic use is not uncommon in youth with anorexia nervosa (AN), aiming to enhance suboptimal weight restoration, yet its efficacy remains debated, especially in youth.

Methods

Retrospective chart review of consecutively admitted inpatients (ages 8–18 years) with restricting/binge-purge AN, comparing youth with versus without antipsychotic treatment regarding baseline factors, treatment, and anthropometric outcome characteristics including all patients and matched subgroups. Matched subsamples were also compared regarding faster versus slower weight change (median split). Furthermore, within-subject analyses compared weight gain trajectories before versus after antipsychotic use in antipsychotic-treated youth. These results were then compared in a pre-/post design with the matched control group without antipsychotic treatment, using the mean duration until antipsychotic use in the antipsychotic-treated group as the dividing timeline, controlling for a potential order effect, in that later rather than earlier antipsychotic treatment for AN may be more successful.

Results

Of 294 youth with AN (median age = 15.2 (interquartile range = 14.0, 16.6) years, females = 96.6%, restricting subtype = 81.0%, hospitalization duration = 98.2 ± 43.2 days), 44 (15.0%) underwent 52 antipsychotic trials (olanzapine = 63.5%). In multivariable analyses, antipsychotic use was independently associated with younger age, childhood physical abuse history, comorbid borderline personality traits, and lower pre-antipsychotic weight gain (p < 0.0001). In unmatched groups, antipsychotic-treated versus non-treated youth had significantly lower discharge anthropometric parameters, longer inpatient treatment, and lower weight change/week (p < 0.001–p = 0.005), without significant differences between olanzapine and non-olanzapine antipsychotics (p = 0.27–0.44). Non-significant antipsychotic effects on weight outcomes were confirmed in (1) matched subgroups of antipsychotic-treated versus non-treated youth (n = 43 each), (2) youth with faster versus slower weight gain (n = 21 vs. n = 22), and (3) antipsychotic-treated youth when comparing weight change before versus after antipsychotic use (n = 31). Moreover, in antipsychotic-treated youth, weight change/week remained significantly lower versus matched non-antipsychotic-treated youth (n = 31) both before (p = 0.053) and after (p = 0.006) the median time (5 weeks) until antipsychotic use.

Conclusions

In this naturalistic study, clinician's antipsychotic choice, given to a more severely ill subgroup of adolescents with AN, did not significantly improve overall worse weight change trajectories during inpatient treatment, even in matched subgroups. Randomized trials in individuals reflecting real-world samples are needed to evaluate the utility of antipsychotic treatment in youth with AN.
Slow slip event in the focal area of the 1975 Kurile tsunami earthquake inferred from unusual long-term seismic quiescence
Authors: Katsumata Kei
Published: September 2023

In subduction zones, slow slip events (SSEs) have been observed in the portion deeper than the downdip edge of seismogenic zone. However, since it is far offshore from geodetic networks on land, shallow SSEs near the trench axis are hardly observed. Despite of less quantitative than seafloor geodetic observations, a method for inferring the shallow SSEs based on seismic quiescence was presented in this study. Unusual decrease in occurrence rate of M ≥ 5.0 earthquakes was found in the southwestern Kurile Islands. The occurrence rate was ∼1.3 events/year between 1977 and around 2004 and no earthquake was observed during 16 years after 2004. The spatial pattern of the seismic quiescence can be explained qualitatively by the Coulomb failure stress change due to shallow SSE and its fault plane is on the upper boundary of the subducting Pacific plate in the focal area of the 1975 tsunami earthquake.
Modeling geomagnetic spikes: the Levantine Iron Age anomaly
Authors: Rivera Pablo , Pavón-Carrasco F. Javier , Osete María Luisa
Published: September 2023

The Levantine Iron Age anomaly (LIAA) is a regional short-decadal geomagnetic strength field variation located at the Levantine region characterized by high intensities with maximum virtual axial dipole moments around 190 ZAm2. It has been constrained by archeomagnetic data coming from Eastern Europe and Western Asia between 1050 and 700 BC. The LIAA can be related to a fast and spatially localized geomagnetic positive anomaly (spike) at the Earth’s surface. In this study, we model the LIAA by using a Fisher–von Mises function that fits the most recent archeomagnetic intensity database in the region. A spherical harmonic analysis is implemented for this spike function to perturb a base model in order to build a global reconstruction (perturbed-model) that reproduces the spatial and temporal characteristics of the LIAA. Our results show the importance of harmonic degrees from n = 3–4 to n = 20 to reconstruct the anomaly extension suggested by the database. Two maxima linked with the LIAA are reproduced by our global perturbed-model at the Levantine region at 950 BC and 750 BC. A third maxima in intensity around 500 BC is also observed, affecting the whole Europe.

Graphical Abstract
Malignant peripheral nerve sheath tumor in the pelvis: a case report
Authors: Ono Rika , Tominaga Tetsuro , Nonaka Takashi , Takamura Yuma , Oishi Kaido , Shiraishi Toshio , Hashimoto Shintaro , Noda Keisuke , Sawai Terumitsu , Nagayasu Takeshi
Published: September 2023

Background

Malignant peripheral nerve sheath tumors (MPNSTs) are malignancies that arise or differentiate from or infiltrate peripheral nerves and account for approximately 5% of soft-tissue malignancies. Approximately half of MPNSTs develop in patients with neurofibromatosis type 1 (NF1), a hereditary disease. MPNSTs occur mainly in the trunk, proximal extremities, and neck, but can on rare occasion arise in or near the gastrointestinal tract, and intestinal complications have been reported. We describe herein a case with resection of an MPNST arising in the pelvic region.

Case presentation

A 51-year-old woman had undergone repeated resections for systemic neurofibrosis associated with NF1. This time, a pelvic tumor was noted on follow-up positron emission tomography computed tomography (CT). She presented with slowly progressive radiating pain in the lower extremities and was referred to our hospital for tumor resection. Contrast-enhanced CT showed a 75 × 58-mm mass in the right greater sciatic foramen directly below a 24 × 28-mm mass. Open pelvic tumor resection was performed for pelvic neurofibroma. The obturator nerve was identified lateral to the main tumor and the sciatic nerve was identified dorsally, then dissection was performed. The closed nerve was spared, while the sciatic nerve was partially dissected and the two tumors were removed. Both tumors were elastic and hard. Pathologic findings were MPNST for the large specimen and neurofibroma with atypia for the small specimen. The patient developed temporary postoperative ileus, but is generally doing well and is currently free of recurrence or radiating pain. The patient is at high risk of recurrence and close monitoring should be continued.

Conclusions

We encountered a rare case of MPNST. Due to the high risk of recurrence, surgery with adequate margins was performed, with a requirement for appropriate follow-up.
Use of patient-specific guides and 3D model in scapula osteotomy for symptomatic malunion
Authors: Cattaneo Stefano , Domenicucci Marco , Galante Claudio , Biancardi Elena , Casiraghi Alessandro , Milano Giuseppe
Published: September 2023

Background

Scapular osteotomy for malunion can lead to resolution of pain and functional improvement in scapula fracture sequelae. Understanding three-dimensional bone morphology and analysing post-traumatic deformity is the main step of planning and the key to success of the procedure. 3D models and patient-specific guides are a growing technology to enhance accuracy of planning and to assist during surgery.

Case presentation

We report the case of a 50 years old male, complaining of pain and limited function after a malunited scapular body fracture. Clinical assessment showed a severe impairment of shoulder function with active and passive forward flexion limited to 80°, absent external rotation, and internal rotation limited to the buttock. X-rays and CT scan showed an excessive lateral border offset of 53 mm and complete displacement of the glenoid segment anteriorly and medially to the scapular body, with impingement between the lateral most prominent scapular bone spur and humeral shaft. Glenopolar angle was 19°, scapular body angulation on the sagittal plane was 12°. Corrective osteotomy was planned on a virtual interactive rendering and on 3D printed models. Patient-specific guides were developed to perform a body-spine osteotomy with removal of a bone wedge, and a glenoid-spine osteotomy; a patient-specific wedge spacer was used to hold the reduction during plate fixation. Follow-up up to 12 months after surgery demonstrated improvement in scapula anatomy, shoulder girdle function, and patient-reported outcomes.

Conclusions

For the first time in scapula malunion surgery, patient-specific osteotomy guides were succesfully used during surgery to perform osteotomies and to assist in reduction maneuvers.
Turbulent far wake of a body of arbitrary shape
Authors: Le Berre M. , Pomeau Y.
Published: September 2023

Using a recently proposed closure for the Boussinesq-Reynolds turbulent stress we re-derive Prandtl's result for the turbulent wake width behind blunt bodies. We show that it is valid for a body of arbitrary shape, but only for wakes due to a drag oriented parallel to the incoming flow. If the geometry of the body resisting the flow lacks symmetries forbidding it, the force on the body has also a component orthogonal to the incoming velocity, called lift, that allows, for instance, planes to fly. Using our closure theory we show that this lift generates a wake wider than the drag, with a width growing like the one-half power of the distance to the body, instead of the one-third in the case of drag only. This has important consequences as it leads to a change of structure of the wake that remains turbulent all the way to infinity.
Thyroid Hormone Levels Correlate With the Maturation of Implanted Pancreatic Endoderm Cells in Patients With Type 1 Diabetes
Authors: Ramzy Adam , Saber Nelly , Bruin Jennifer E , Thompson David M , Kim Peter T W , Warnock Garth L , Kieffer Timothy J
Published: September 2023

Background

Macroencapsulated pancreatic endoderm cells (PECs) can reverse diabetes in rodents and preclinical studies revealed that thyroid hormones in vitro and in vivo bias PECs to differentiate into insulin-producing cells. In an ongoing clinical trial, PECs implanted in macroencapsulation devices into patients with type 1 diabetes were safe but yielded heterogeneous outcomes. Though most patients developed meal responsive C-peptide, levels were heterogeneous and explanted grafts had variable numbers of surviving cells with variable distribution of endocrine cells.

Methods

We measured circulating triiodothyronine and thyroxine levels in all patients treated at 1 of the 7 sites of the ongoing clinical trial and determined if thyroid hormone levels were associated with the C-peptide or glucagon levels and cell fate of implanted PECs.

Results

Both triiodothyronine and thyroxine levels were significantly associated with the proportion of cells that adopted an insulin-producing fate with a mature phenotype. Thyroid hormone levels were inversely correlated to circulating glucagon levels after implantation, suggesting that thyroid hormones lead PECs to favor an insulin-producing fate over a glucagon-producing fate. In mice, hyperthyroidism led to more rapid maturation of PECs into insulin-producing cells similar in phenotype to PECs in euthyroid mice.

Conclusion

These data highlight the relevance of thyroid hormones in the context of PEC therapy in patients with type 1 diabetes and suggest that a thyroid hormone adjuvant therapy may optimize cell outcomes in some PEC recipients.
Hyperoxia Increases Kidney Injury During Renal Ischemia and Reperfusion in Mice
Authors: Kimlinger Melissa J. , No Tom J. , Mace Eric H. , Delgado Rachel D. , Lopez Marcos G. , de Caestecker Mark P. , Billings Frederic T.
Published: September 2023

BACKGROUND:

Renal ischemia and reperfusion (IR) contribute to perioperative acute kidney injury, and oxygen is a key regulator of this process. We hypothesized that oxygen administration during surgery and renal IR would impact postoperative kidney function and injury in mice.

METHODS:

Mice were anesthetized, intubated, and mechanically ventilated with a fraction of inspired oxygen (Fio
2) 0.10 (hypoxia), 0.21 (normoxia), 0.60 (moderate hyperoxia), or 1.00 (severe hyperoxia) during 67 minutes of renal IR or sham IR surgery. Additional mice were treated before IR or sham IR surgery with 50 mg/kg tempol, a superoxide scavenger. At 24 hours, mice were sacrificed, and blood and kidney collected. We assessed and compared kidney function and injury across groups by measuring blood urea nitrogen (BUN, primary end point), renal histological injury, renal expression of neutrophil gelatinase–associated lipocalin (NGAL), and renal heme oxygenase 1 (Ho-1), peroxisome proliferator–activated receptor gamma coactivator 1-α (Pgc1-α), and glutathione peroxidase 4 (Gpx-4) transcripts, to explore potential mechanisms of any effect of oxygen.

RESULTS:

Hyperoxia and hypoxia during renal IR surgery decreased renal function and increased kidney injury compared to normoxia. Baseline median (interquartile range) BUN was 22.2 mg/dL (18.4–26.0), and 24 hours after IR surgery, BUN was 17.5 mg/dL (95% confidence interval [CI], 1.3–38.4; P = .034) higher in moderate hyperoxia–treated animals, 51.8 mg/dL (95% CI, 24.9–74.8; P < .001) higher in severe hyperoxia–treated animals, and 64.9 mg/dL (95% CI, 41.2–80.3; P < .001) higher in hypoxia-treated animals compared to animals treated with normoxia (P < .001, overall effect of hyperoxia). Hyperoxia-induced injury, but not hypoxia-induced injury, was attenuated by pretreatment with tempol. Histological injury scores, renal NGAL staining, and renal transcription of Ho-1 and suppression of Pgc1-α
followed the same pattern as BUN, in relation to the effects of oxygen treatment.

CONCLUSIONS:

In this controlled preclinical study of oxygen treatment during renal IR surgery, hyperoxia and hypoxia impaired renal function, increased renal injury, and impacted expression of genes that affect mitochondrial biogenesis and antioxidant response. These results might have implications for patients during surgery when high concentrations of oxygen are frequently administered, especially in cases involving renal IR.
Live-imaging studies reveal how microclots and the associated inflammatory response enhance cancer cell extravasation
Authors: Ward Juma , Martin Paul
Published: September 2023

Previous clinical studies and work in mouse models have indicated that platelets and microclots might enable the recruitment of immune cells to the pre-metastatic cancer niche, leading to efficacious extravasation of cancer cells through the vessel wall. Here, we investigated the interaction between platelets, endothelial cells, inflammatory cells, and engrafted human and zebrafish cancer cells by live-imaging studies in translucent zebrafish larvae, and show how clotting (and clot resolution) act as foci and as triggers for extravasation. Fluorescent tagging in each lineage revealed their dynamic behaviour and potential roles in these events, and we tested function by genetic and drug knockdown of the contributing players. Morpholino knockdown of fibrinogen subunit α (fga) and warfarin treatment to inhibit clotting both abrogated extravasation of cancer cells. The inflammatory phenotype appeared fundamental, and we show that forcing a pro-inflammatory, tnfa-positive phenotype is inhibitory to extravasation of cancer cells.
Weaver ants regulate the rate of prey delivery during collective vertical transport
Authors: Burchill Andrew T. , Pavlic Theodore P. , Pratt Stephen C. , Reid Chris R.
Published: September 2023

The collective transport of massive food items by ant teams is a striking example of biological cooperation, but it remains unclear how these decentralized teams coordinate to overcome the various challenges associated with transport. Previous research has focused on transport across horizontal surfaces and very shallow inclines, disregarding the complexity of natural foraging environments. In the ant Oecophylla smaragdina, prey are routinely carried up tree trunks to arboreal nests. Using this species, we induced collective transport over a variety of angled surfaces with varying prey masses to investigate how ants respond to inclines. We found that weight and incline pose qualitatively different challenges during transport. Prey were carried over vertical and inclined surfaces faster than across horizontal surfaces, even though inclines were associated with longer routes and a higher probability of dropping the load. This additional speed was associated with more transporters being allocated to loads on steeper inclines and not with the persistence of individual ants. Ant teams also regulated a stable prey delivery rate (rate of return per transporter) across all treatments. Our proposed constrained optimization model suggests a possible explanation for these results; theoretically, prey intake rate at the colony level is maximized when the allocation of transporters yields a similar prey delivery rate across loads.
Implementation of a Multi-Disciplinary Team and Quality of Goals of Care Discussions in Palliative Surgical Oncology Patients
Authors: Soon Joel J. Y. , Juan Darryl W. K. , Ong Whee S. , Bek Schin , Neo Patricia S. H. , Salazar Ennaliza , Da Zhuang Kun , Tan Yee Pin , Seo Chin Jin , Ong Johnny C. A. , Chia Claramae S. , Wong Jolene S. M.
Published: September 2023

Background

Palliative surgical oncology patients represent a unique group with complex needs who often require multidisciplinary input for the provision of timely and holistic care. The authors assembled a multi-disciplinary palliative intervention team and evaluated its association with the quality of discussions on goals of care (GOC) among advanced cancer patients undergoing palliative interventions.

Methods

This prospective cohort study analyzed advanced cancer patients undergoing palliative interventions at a single urban academic center from October 2019 to March 2022. In January 2021, a multi-disciplinary palliative surgical intervention (MD-PALS) team was assembled. All palliative surgical oncology patients were discussed at multi-disciplinary meetings and managed by members of the MD-PALS team. An interrupted time series (ITS) model was built to evaluate the association of MD-PALS implementation and the quality of GOC discussions as measured by a consensus-derived four-point GOC discussion quality score.

Results

The study recruited 126 palliative surgical oncology patients: 44 in the pre-MD-PALS group and 82 in the post-MD-PALS group. The two groups did not differ significantly in baseline demographics, treatment, or postoperative and survival outcomes. Compared with the pre-MD-PALS group, the post-MD-PALS group had a significantly higher mean GOC discussion quality score (1.34 vs 2.61; p < 0.001). Based on the ITS model, the average quarterly GOC discussion quality score increased significantly among patients after implementation of the MD-PALS team (change = 1.93; 95 % confidence interval, 0.96–2.90; P = 0.003).

Conclusion

The implementation of an MD-PALS team was associated with improvements in the quality of GOC discussions among palliative surgical oncology patients.
Frozen Shoulder: Diagnosis and Management
Authors: Wise Sean R. , Seales Paul , Houser Alex P. , Weber Chase B.
Published: September 2023

Frozen shoulder is a common condition that causes pain and restriction of movement of the shoulder unrelated to secondary causes. It has three classic phases (freezing, frozen, and thawing), and is resolved in most cases within 1 to 2 years. Diagnosis is clinical based on global motion restriction and pain. Imaging plays an ancillary role to narrow the differential diagnosis. Physical therapy, nonsteroidal anti-inflammatories, and injection therapies are standard treatments, although none have been shown to alter the long-term course of the condition. Ultrasound guidance is recommended for injection-based therapy, although not required. Further study should focus on long-term outcomes and treatments that significantly alter the natural course of the disease.