bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimization-based biomechanical lifting models for manual material handling: A comprehensive review
Authors: Zaman Rahid , Arefeen Asif , Quarnstrom Joel , Barman Shuvrodeb , Yang James , Xiang Yujiang
Published: July 2022

Lifting is a main task for manual material handling (MMH), and it is also associated with lower back pain. There are many studies in the literature on predicting lifting strategies, optimizing lifting motions, and reducing lower back injury risks. This survey focuses on optimization-based biomechanical lifting models for MMH. The models can be classified as two-dimensional and three-dimensional models, as well as skeletal and musculoskeletal models. The optimization formulations for lifting simulations with various cost functions and constraints are reviewed. The corresponding equations of motion and sensitivity analysis are briefly summarized. Different optimization algorithms are utilized to solve the lifting optimization problem, such as sequential quadratic programming, genetic algorithm, and particle swarm optimization. Finally, the applications of the optimization-based lifting models to digital human modeling which refers to modeling and simulation of humans in a virtual environment, back injury prevention, and ergonomic safety design are summarized.
The Japanese translation of the Gold-MSI: Adaptation and validation of the self-report questionnaire of musical sophistication
Authors: Sadakata Makiko , Yamaguchi Yasumasa , Ohsawa Chie , Matsubara Masaki , Terasawa Hiroko , von Schnehen Andres , Müllensiefen Daniel , Sekiyama Kaoru
Published: July 2022

This study presents a Japanese translation of the Goldsmiths Musical Sophistication Index (Gold-MSI). The index consists of 38 self-report questions and provides a general sophistication score as well as subscale scores for Active Engagement, Perceptual Abilities, Musical Training, Singing Abilities, and Emotions. The validation of the translation with 689 native Japanese speakers indicated excellent internal consistency and test–retest reliability. Confirmatory factor analysis revealed that the bifactor model structure formulated by the original study of Gold-MSI is maintained reasonably in our data. The strengths of the Gold-MSI self-report inventory are (1) it offers a multifaceted view of musical sophistication, (2) a subset of five subscales can be used to measure different aspects of musical sophistication independently, and (3) the ease of administration as it is a self-report questionnaire. In view of the fact that this inventory and its translations increasingly contribute to research on musical expertise, skills, and abilities, having a Japanese translation may enhance future research in these areas even further.
A Rare Case of Cleft Palate Associated With Tongue Hamartoma: A Case Report and Systematic Review
Authors: Dash Suvashis , Chauhan Shashank , Sennimalai Karthik , Kharbanda Om Prakash , Singhal Maneesh
Published: July 2022

Introduction

Palate development involves a genetic regulation through a complex molecular mechanism that may be disrupted by environmental factors, resulting in impaired fusion and cleft palate formation. An encounter with a case of cleft palate due to dorsal tongue hamartoma prompted us to perform this systematic review.

Objective

To review the clinical profile and management approach for a case with cleft palate and tongue hamartoma.

Design

A systematic literature search was conducted using keywords related to cleft palate and tongue hamartoma in PubMed, Scopus, MEDLINE, and Scielo databases through December 2021, with no time or language restrictions.

Patients, Participants

Studies reporting patients with cleft palate and tongue hamartoma were included.

Main outcome measure(s)

Information related to clinical profile, diagnostic tests, histopathology, management, and outcomes were extracted.

Fourteen relevant publications were identified with 16 cases reported so far. Among them, thirteen patients were females (81.25%), and 3 were males (18.75%). The age of presentation varied from birth to 19 years. Oral-facial-digital syndrome (type II) was the most commonly associated syndrome.

Congenital tongue hamartoma with cleft palate is a rare presentation, which can present as an isolated entity or part of a syndrome. Genetic evaluation is warranted, particularly for multiple hamartomatous lesions. The preferred treatment is immediate excision of hamartoma while following a standard timeline for palatoplasty.
Work and wellbeing in remote Australia: Moving beyond punitive ‘workfare’
Authors: Staines Zoe
Published: July 2022

Australia's remote-focused ‘workfare’ program (Community Development Program, CDP) has produced overwhelmingly negative impacts, most of which have been borne by its ∼80% Aboriginal and Torres Strait Islander participants. The Australian government has announced that CDP will end in 2023, though a replacement policy/program is not yet decided. Here, I bring three public proposals for replacement policies (wage subsidy, Job Guarantee, Liveable Income Guarantee) into conversation with one another, and compare these to the possibilities offered by a basic income. Drawing on documentary evidence, I discuss potential advantages and disadvantages of these alternatives, asking whether they might improve wellbeing and alleviate the harms experienced under CDP-style workfare.
The Lnc-RNA APPAT Suppresses Human Aortic Smooth Muscle Cell Proliferation and Migration by Interacting With MiR-647 and FGF5 in Atherosclerosis
Authors: Meng Fanming , Han Luyang , Liang Qin , Lu Shanshan , Huang Yanqing , Liu Junwen
Published: July 2022

Purpose:

LncRNA-Atherosclerotic plaque pathogenesis-associated transcript ( APPAT) could be detected in circulating blood and has been demonstrated to correlate with the development of atherosclerosis in our previous work. It could be a potential noninvasive biomarker for earlier diagnoses of clinical cardiovascular disease. Moreover, the expression of miR-647 increased in ox-LDL-treated vascular smooth muscle cells and peripheral blood of patients with coronary heart disease. A negative correlation between APPAT and miR-647 was confirmed, and FGF5 was screened as molecular target of miR-647. However, it is largely unclear how APPAT, miR-647, and FGF5 interact and function in disease development. Here, we aim to explore the underlying molecular mechanism in this progression.

Materials and Methods:

APPAT, miR-647, and FGF5 expression levels were detected by quantitative reverse transcription polymerase chain reaction; cell proliferation was detected by EdU incorporation assay; cell migration was detected by wound-healing assay; the molecular interaction of APPAT/FGF5 with miR-647 was verified by dual-luciferase reporter assay; the western blot was performed to determine the gene expression at protein levels; subcellular localizations of APPAT and miR-647 were observed by fluorescence in situ hybridization; cytosolic and nucleus fractionation assay was performed to further detect the distribution of miR-647.

Results:

APPAT and miR-647 have inverse effects on human aortic smooth muscle cells’ (HASMCs) proliferation and migration. APPAT negatively regulated the cell activity, whereas miR-647 did it in a positive way (p<0.05). Three pairs of molecular interplay were found: mutual negative regulation between APPAT and miR-647, APPAT downregulated FGF5, miR-647 regulation on FGF5 (p<0.05). Subcellular location assay confirmed the molecular interaction of APPAT and miR-647.

Conclusions:

APPAT could suppress the migration and proliferation of ox-LDL-treated HASMCs via interacting with miR-647 and FGF5. We revealed a nontypical competing endogenous RNA mechanism of long noncoding RNA in the progression of atherosclerosis.
A Nomogram Combining Neutrophil-to-Lymphocyte Ratio and D-Dimer Predicts Chemosensitivity of Oxaliplatin-Based First-Line Chemotherapy in Patients with Unresectable Advanced Gastric Cancer
Authors: Shen Hao , Wu Shusheng , Su Rixin , Chen Yaolin , He Yifu
Published: July 2022

Introduction: No effective peripheral blood predictors have been establoshed for first-line chemotherapy in patients with advanced gastric cancer. In this study, a nomogram combining the neutrophil-to-lymphocyte ratio/D-dimer with gender, number of metastases, and histological grade was established to predict progression-free survival in patients with unresectable advanced gastric cancer. Methods: We retrospectively collected baseline clinical characteristics and blood parameters from 153 patients diagnosed with advanced gastric cancer that underwent oxaliplatin-based first-line chemotherapy. Kaplan–Meier analysis and Cox regression analysis were used to determine the factors associated with progression-free survival. The concordance index (C-index) and calibration curve were used to determine the prediction accuracy and discriminative ability of the nomogram as a visual complement to the prognostic score system. Results: Determined by the X-tile software, the optimal cut-off points for the neutrophil-to-lymphocyte ratio and D-dimer were 3.18 and 0.56 mg/L, respectively. Multivariate analysis identified four independent prognostic factors: two or more metastatic organs (HR: 1.562, 95% CI: 1.009-2.418, P = .046), poor differentiation (HR: 0.308, 95% CI: 0.194-0.487, P < .001), neutrophil-to-lymphocyte ratio >3.18 (HR: 1.427, 95% CI: 1.024-1.989, P = .036), and D-dimer >0.56 mg/L (HR: 1.811, 95% CI: 1.183-2.773, P = .006). Receiver operating characteristic curves showed that the combination of the neutrophil-to-lymphocyte ratio and D-dimer in the prediction model exhibited the highest predictive performance (area under the curve, 0.800). The prognostic nomogram yielded a C-index of 0.800. Decision curve analysis demonstrated that the prognostic nomogram was clinically useful. A nomogram-based risk classification system was also constructed to facilitate risk stratification of advanced gastric cancer for optimal clinical management. Conclusion: We identified the neutrophil-to-lymphocyte ratio and D-dimer level as independent prognostic factors for advanced gastric cancer. The prognostic nomogram combining the neutrophil-to-lymphocyte ratio and D-dimer level can be applied in the individualized prediction of treatment outcome in patients with advanced gastric cancer.
Connected and automated vehicle control at unsignalized intersection based on deep reinforcement learning in vehicle-to-infrastructure environment
Authors: Chen Juan , Sugumaran Vijayan , Qu Peiyan
Published: July 2022

In order to reduce the number of vehicle collisions and average travel time when vehicles pass through an unsignalized intersection with connected and automated vehicle, an improved Double Dueling Deep Q Network method with Convolutional Neutral Network and Long Short-Term Memory is presented in this article. This method designs a multi-step reward and penalty method to alleviate the sparse reward problem using positive and negative reward experience replay buffer. The proposed method is validated in a simulation environment with different traffic flow and market penetration under the mixed traffic conditions of automated vehicles and human-driving vehicles. The results show that compared with traditional signal control methods, the proposed method can effectively improve the convergence and stability of the algorithm, reduce the number of collisions, and reduce the average travel time under different traffic conditions.
Impact of teriparatide therapy in Indian postmenopausal women with osteoporosis with regard to DXA-derived parameters
Authors: Sandeep Nandipati Venkata , Joseph Aneez , Cherian Kripa Elizabeth , Kapoor Nitin , Paul Thomas V
Published: July 2022

Background:

There is paucity of literature on the impact of teriparatide on hip geometry and bone microarchitecture globally and none from the Indian subcontinent. This study examined the outcome of teriparatide therapy on vertebral fractures, bone mineral density (BMD), hip structural analysis (HSA), and trabecular bone score (TBS) in Indian postmenopausal women with severe osteoporosis.

Methodology:

Ambulatory postmenopausal women above the age of 50 years with either severe osteoporosis or vertebral fractures, or both, were recruited. All patients received cholecalciferol (2000 IU/day), calcium carbonate (elemental calcium 1 g/day), and teriparatide (20 mcg subcutaneously/day) for 24 months. Baseline bone biochemistry, BMD, TBS, and HSA were assessed and repeated after 24 months of therapy. Incident vertebral and nonvertebral fractures were also studied.

Results:

A total of 51 postmenopausal women with mean (SD) age of 65.7(8.6) years, and mean (SD) body mass index of 22.7 (3.5) kg/m2 were recruited in this study. Vertebral fractures were present in 74.5% (38/51) at baseline. Following teriparatide therapy, significant improvement was observed in the BMD (g/cm2) at both the lumbar spine (0.706–0.758: p < 0.001) and femoral neck (0.551–0.579: p = 0.047) as well as the TBS (1.160–1.271: p < 0.001). Most indices of proximal hip geometry also showed significant improvement following teriparatide therapy at 24 months. Incident vertebral fractures were noted in only 7.8% (4/51) of participants, while 92% (47/51) of participants did not develop any new vertebral fractures on follow-up.

Conclusion:

In South Indian postmenopausal women with either severe osteoporosis or vertebral fractures, or both, teriparatide was effective in improving the bone mineral parameters and bone quality.
Association of Serum Phosphate Derangement With Mortality in Patients on Continuous Renal Replacement Therapy
Authors: Thongprayoon Charat , Radhakrishnan Yeshwanter , Cheungpasitporn Wisit , Petnak Tananchai , Qureshi Fawad , Mao Michael A. , Kashani Kianoush B.
Published: July 2022

Background:

There is limited evidence on the association of serum phosphate with mortality in patients receiving continuous renal replacement therapy (CRRT).

Objective:

To assess the association of serum phosphate with mortality in critically ill patients requiring CRRT for acute kidney injury (AKI).

Design:

A cohort study.

Setting:

A tertiary referral hospital in the United States.

Patients:

Acute kidney injury patients receiving CRRT from 2006 through 2015 in intensive care units.

Measurements:

(1) Serum phosphate before CRRT and (2) mean serum phosphate during CRRT were categorized into 3 groups; ≤2.4 (hypophosphatemia), 2.5 to 4.5 (normal serum phosphate group), and ≥4.6 (hyperphosphatemia) mg/dL.

Methods:

Multivariable logistic regression was used to assess the association between serum phosphate and 90-day mortality.

Results:

A total of 1108 patients were included in this study. Of these, 55% died within 90 days after CRRT initiation. Before CRRT, 3%, 30%, and 66% had hypophosphatemia, normophosphatemia, and hyperphosphatemia, respectively. Before CRRT, both hypophosphatemia and hyperphosphatemia were significantly associated with higher 90-day mortality with the adjusted odds ratio (OR) of 2.22 (95% confidence interval [CI]: [1.03, 4.78]) and 1.62 (95% CI: [1.21, 2.18]), respectively. During CRRT, 3%, 85%, and 12% had mean serum phosphate in hypophosphatemia, normophosphatemia, and hyperphosphatemia range. During CRRT, hyperphosphatemia was significantly associated with higher 90-day mortality with adjusted OR of 2.22 (95% CI: [1.45, 3.38]).

Limitations:

Single center, observational design, lack of information regarding causes of serum phosphate derangement.

Conclusion:

Most CRRT patients had hyperphosphatemia before CRRT initiation but maintain normal serum phosphate during CRRT. Before CRRT, hypo- and hyperphosphatemia, and during CRRT, hyperphosphatemia predicted higher mortality.

Trial registration:

Not registered.
Machine Learning for Predicting Lower Extremity Muscle Strain in National Basketball Association Athletes
Authors: Lu Yining , Pareek Ayoosh , Lavoie-Gagne Ophelie Z. , Forlenza Enrico M. , Patel Bhavik H. , Reinholz Anna K. , Forsythe Brian , Camp Christopher L.
Published: July 2022

Background:

In professional sports, injuries resulting in loss of playing time have serious implications for both the athlete and the organization. Efforts to quantify injury probability utilizing machine learning have been met with renewed interest, and the development of effective models has the potential to supplement the decision-making process of team physicians.

Purpose/Hypothesis:

The purpose of this study was to (1) characterize the epidemiology of time-loss lower extremity muscle strains (LEMSs) in the National Basketball Association (NBA) from 1999 to 2019 and (2) determine the validity of a machine-learning model in predicting injury risk. It was hypothesized that time-loss LEMSs would be infrequent in this cohort and that a machine-learning model would outperform conventional methods in the prediction of injury risk.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

Performance data and rates of the 4 major muscle strain injury types (hamstring, quadriceps, calf, and groin) were compiled from the 1999 to 2019 NBA seasons. Injuries included all publicly reported injuries that resulted in lost playing time. Models to predict the occurrence of a LEMS were generated using random forest, extreme gradient boosting (XGBoost), neural network, support vector machines, elastic net penalized logistic regression, and generalized logistic regression. Performance was compared utilizing discrimination, calibration, decision curve analysis, and the Brier score.

Results:

A total of 736 LEMSs resulting in lost playing time occurred among 2103 athletes. Important variables for predicting LEMS included previous number of lower extremity injuries; age; recent history of injuries to the ankle, hamstring, or groin; and recent history of concussion as well as 3-point attempt rate and free throw attempt rate. The XGBoost machine achieved the best performance based on discrimination assessed via internal validation (area under the receiver operating characteristic curve, 0.840), calibration, and decision curve analysis.

Conclusion:

Machine learning algorithms such as XGBoost outperformed logistic regression in the prediction of a LEMS that will result in lost time. Several variables increased the risk of LEMS, including a history of various lower extremity injuries, recent concussion, and total number of previous injuries.
Gist Representations and Decision-Making Processes Affecting Antibiotic Prescribing for Children with Acute Otitis Media
Authors: Marti Deniz , Hamdy Rana F. , Broniatowski David A.
Published: July 2022

Objective. To test the predictions of fuzzy-trace theory regarding pediatric clinicians’ decision-making processes and risk perceptions about antibiotics for children with acute otitis media (AOM). Methods. We conducted an online survey experiment administered to a sample of 260 pediatric clinicians. We measured their risk perceptions and prescribing decisions across 3 hypothetical AOM treatment scenarios. Participants were asked to choose among the following options: prescribe antibiotics immediately, watchful waiting (“hedging”), or not prescribing antibiotics. Results. We identified 4 gists based on prior literature: 1) “why not take a risk?” 2) “antibiotics might not help but can hurt,” 3) “antibiotics do not have harmful side effects,” and 4) “antibiotics might have harmful side effects.” All 4 gists predicted risky choice ( P < 0.001), and gist endorsements varied significantly between scenarios when antibiotics were indicated, F(2, 255) = 8.53, P < 0.001; F(2, 255) = 5.14, P < .01; and F(2, 255) = 3.56, P < 0.05 for the first 3 factors, respectively. In a logistic regression, more experienced clinicians were less likely to hedge ( B = −0.05; P < 0.01). Conclusion. As predicted by fuzzy-trace theory, pediatric clinicians’ prescription decisions are associated with gist representations, which are distinct from verbatim risk estimates. Implications. Antibiotic stewardship programs can benefit by communicating the appropriate gists to clinicians who prescribe antibiotics for pediatric patients.

Highlights

We found clinicians’ antibiotic prescription decisions were driven by gist representations of antibiotic risks for a given hypothetical patient scenario, and clinicians’ gist representations and verbatim risk estimates about antibiotic-related risks were distinct from each other. We showed that the effect of patient scenarios on clinicians’ antibiotic prescription decisions was mediated by clinicians’ gist representations. Less experienced clinicians tend to “hedge” in their antibiotic prescription decisions compared with more experienced clinicians. The broader impact of our study is that antibiotic stewardship programs can benefit by communicating the appropriate gists to clinicians who prescribe antibiotics for pediatric patients, rather than solely focusing on closing potential knowledge deficits of the clinicians.
Parenteral NSAIDs for acute treatment of migraine: Adherence to the IHS guidelines for controlled trials
Authors: Curran John G , Waters John , Yuan Hsiangkuo
Published: July 2022

Background:

Parenteral non-steroidal anti-inflammatory drugs (NSAIDs) are important alternatives to oral NSAIDs, especially in patients with severe migraine who have emesis or gastroparesis. With increasing research on using parenteral NSAIDs for acute migraine, it is critical to examine the quality of these studies. Our goal was to assess the adherence of these trials to the International Headache Society (IHS) controlled trial guidelines for acute treatment of migraine.

Methods:

We queried PubMed for clinical trials investigating parenteral NSAIDs for acute treatment of migraine in adult patients. We developed a 14-point scoring system based on the essential components of the IHS guidelines. To date, four versions of the IHS’s Guidelines for controlled trials of acute treatment of migraine attacks have been published. Each trial was evaluated with the appropriate edition of the guidelines.

Results:

We identified 216 studies and assessed 27 eligible clinical trials. The mean score was 6.7 ± 2.1 (2–11). Most trials followed the IHS migraine diagnosis criteria (85.2%), but only six (22.2%) selected patients based on the recommended headache frequency. Most trials were randomized (88.8%), but fewer were double-blinded (74.1%) or placebo-controlled (11.1%). Almost every trial clearly explained the pain scale (96.3%), and three-quarters (77.8%) assessed headache-associated symptoms. However, no trial utilized the recommended primary endpoint: pain-freedom at 2-hours.

Conclusions:

Most clinical trials on parenteral NSAIDs for acute migraine did not fully adhere to the IHS recommendations. Future studies should pay special attention to the IHS guideline to improve the quality of clinical trials for the acute treatment of migraine.
Daridorexant: A New Dual Orexin Receptor Antagonist for Insomnia
Authors: Onge Erin St. , Phillips Bradley , Rowe Casey
Published: July 2022

Objective: To review the safety, efficacy, and tolerability of daridorexant in treating insomnia characterized by difficulties with sleep onset and/or sleep maintenance in adult patients. Data Sources: A literature search was performed through PubMed using the following key terms: daridorexant, ACT-541468, orexin, insomnia, and sleep. Study Selection and Data Extraction: Selected articles included those which described clinical studies of the pharmacokinetics, efficacy, safety, or tolerability of daridorexant. Data Synthesis: Daridorexant works through antagonism of the dual orexin receptor. It is the third agent in this class of medications approved by the U.S. Food and Drug Administration (FDA). Daridorexant, at a dose of 25 mg to 50 mg, was shown to be effective in improving sleep parameters in phase 3 clinical studies and was well tolerated. Adverse event rates from phase 2 and 3 clinical trials were low with fatigue, nasopharyngitis, gait disturbance, somnolence, diarrhea, and headache most commonly reported. Conclusions: All currently available agents for treating insomnia have received a “weak” recommendation in the clinical practice guidelines, including the dual orexin receptor antagonist class of medications. Initial data suggest that with routine use daridorexant does not impair next day functioning, a common issue with other agents used to treat insomnia. In addition, daridorexant appears to be as safe and effective in treating insomnia in patients of all ages including those ≥65 years of age.
d-Borneol enhances cisplatin sensitivity via p21/p27-mediated S-phase arrest and cell apoptosis in non-small cell lung cancer cells and a murine xenograft model
Authors: Li Jinxiu , Yuan Jianmei , Li Yong , Wang Jian , Gong Daoyin , Xie Qian , Ma Rong , Wang Jiajun , Ren Mihong , Lu Danni , Xu Zhuo
Published: July 2022

Background

Cisplatin (CDDP) is commonly used to treat non-small cell lung cancer (NSCLC), but the appearance of drug resistance greatly hinders its efficacy. Borneol may promote drug absorption; however, synergism between borneol and CDDP in suppressing NSCLC is not clearly understood. Hence, we investigated borneol as a novel chemosensitizer to support chemotherapeutic efficacy and reduce side effects.

Methods

We compared viability after exposure to d-borneol, l-borneol, and synthetic borneol in two NSCLC cell lines, A549 and H460, and selected the most sensitive cells. We then assessed synergy between borneol forms and CDDP in cisplatin-resistant NSCLC cells, H460/CDDP. Next, we identified effective concentrations and exposure times. Subsequently, we evaluated cell migration via wound healing and cell proliferation via clone formation assay. Then, we focused on P-glycoprotein (P-gp) function, cell cycle, apoptosis, and RNA sequencing to elucidate underlying molecular mechanisms for synergy. Finally, we used an H460/CDDP xenograft tumor model to verify antitumor activity and safety in vivo. Data were examined using one-way analysis of variance (ANOVA) for multiple datasets or t-test for comparisons between two variables.

Results

d-Borneol was more effective in H460 than A549 cells. d-Borneol combined with CDDP showed greater inhibition of cell proliferation, migration, and clone formation in H460/CDDP cells than CDDP alone. RNA sequencing (RNA-seq) analysis identified differentially expressed genes enriched in cell cycle pathways. The impact of d-borneol on CDDP chemosensitivity involved arrest of the cell cycle at S phase via p27/p21-mediated cyclinA2/D3-CDK2/6 signaling and activation of intrinsic apoptosis via p21-mediated Bax/Bcl-2/caspase3 signaling. Further, d-borneol ameliorated drug resistance by suppressing levels and activity of P-gp. Cotreatment with d-borneol and CDDP inhibited tumor growth in vivo and reduced CDDP-caused liver and kidney toxicity.

Conclusions

d-Borneol increased the efficacy of cisplatin and reduced its toxicity. This compound has the potential to become a useful chemosensitizer for drug-resistance NSCLC.
Systematic study of single-cell isolation from musculoskeletal tissues for single-sell sequencing
Authors: Gao Manman , Guo Peng , Liu Xizhe , Zhang Penghui , He Zhongyuan , Wen Liru , Liu Shaoyu , Zhou Zhiyu , Zhu Weimin
Published: July 2022

Background

The single-cell platform provided revolutionary way to study cellular biology. Technologically, a sophistic protocol of isolating qualified single cells would be key to deliver to single-cell platform, which requires high cell viability, high cell yield and low content of cell aggregates or doublets. For musculoskeletal tissues, like bone, cartilage, nucleus pulposus and tendons, as well as their pathological state, which are tense and dense, it’s full of challenge to efficiently and rapidly prepare qualified single-cell suspension. Conventionally, enzymatic dissociation methods were wildly used but lack of quality control. In the present study, we designed the rapid cycling enzymatic processing method using tissue-specific enzyme cocktail to treat different human pathological musculoskeletal tissues, including degenerated nucleus pulposus (NP), ossifying posterior longitudinal ligament (OPLL) and knee articular cartilage (AC) with osteoarthritis aiming to rapidly and efficiently harvest qualified single-cell suspensions for single-cell RNA-sequencing (scRNA-seq).

Results

We harvested highly qualified single-cell suspensions from NP and OPLL with sufficient cell numbers and high cell viability using the rapid cycling enzymatic processing method, which significantly increased the cell viability compared with the conventional long-time continuous digestion group (P <0.05). Bioanalyzer trace showed expected cDNA size distribution of the scRNA-seq library and a clear separation of cellular barcodes from background partitions were verified by the barcode-rank plot after sequencing. T-SNE visualization revealed highly heterogeneous cell subsets in NP and OPLL. Unfortunately, we failed to obtain eligible samples from articular cartilage due to low cell viability and excessive cell aggregates and doublets.

Conclusions

In conclusion, using the rapid cycling enzymatic processing method, we provided thorough protocols for preparing single-cell suspensions from human musculoskeletal tissues, which was timesaving, efficient and protective to cell viability. The strategy would greatly guarantee the cell heterogeneity, which is critical for scRNA-seq data analysis. The protocol to treat human OA articular cartilage should be further improved.
Total intravenous anesthesia induced and maintained by a combination of remimazolam and remifentanil without a neuromuscular blocking agent: a prospective, observational pilot study
Authors: Park Insun , Cho Mincheul , Nam Sun Woo , Hwang Jung-Won , Do Sang-Hwan , Na Hyo-Seok
Published: July 2022

Background

A novel short-acting benzodiazepine, Remimazolam, has recently been approved for general anesthesia and sedation. Hence, we investigated the feasibility and safety of remimazolam during the induction and maintenance of general anesthesia without using a neuromuscular blocking agent (NMBA) in patients undergoing hysteroscopic surgery.

Methods

This prospective observational study included 38 patients undergoing hysteroscopic surgery. Remimazolam and remifentanil were the main anesthetic agents without an NMBA, and a supraglottic airway was inserted to protect the airway. The induction time, amount of each anesthetic agent used during anesthesia, intraoperative bispectral index (BIS) hemodynamic parameters, and recovery profiles were measured.

Results

General anesthesia was successfully administered to 37 patients using remimazolam and remifentanil without NMBA. The induction doses of remimazolam and remifentanil were 0.4 mg/kg (interquartile range [IQR] 0.34–0.47 mg/kg) and 1.07 μg/kg (IQR, 0.90–1.29 μg/kg), respectively. Additionally, the maintenance doses of remimazolam and remifentanil were 1.14 mg/kg/h (IQR, 0.88–1.55 mg/kg/h) and 0.06 μg/kg/min (IQR, 0.04–0.08 μg/kg/min), respectively. Intraoperative BIS values had risen temporarily > 60 in eight patients (21.6%) despite administration of 2 mg/kg/h of remimazolam; thus, they were treated with supplementary midazolam. The median recovery time was 7 min (IQR, 5–8 min) after 40 min (IQR, 40.0–57.5 min) of total mean anesthesia time. There was no correlation between the infusion dose of remimazolam and recovery profiles, such as recovery time, final BIS of anesthesia, modified observer assessment of alertness/sedation (OAA/S) scale or post-anesthesia recovery (PAR) score when arriving at the PACU, and length of stay in the PACU (all P > 0.05).

Conclusion

Remimazolam can be combined with remifentanil without an NMBA in female patients who undergo hysteroscopic surgery, during which a supraglottic airway is a feasible method to protect the airway.

Trial registration

The study protocol was registered at ClinicalTrials.gov (NCT05025410) on 27/08/2021.
Enhancing opportunistic recruitment and retention in primary care trials: lessons learned from a qualitative study embedded in the Cranberry for Urinary Tract Infection (CUTI) feasibility trial
Authors: Gbinigie Oghenekome A. , Boylan Anne-Marie , Butler Christopher C. , Heneghan Carl J. , Tonkin-Crine Sarah
Published: July 2022

Background

Opportunistic recruitment in primary care is challenging due to the inherent unpredictability of incident conditions, and workload and time pressures. Many clinical trials do not recruit to target, leading to equivocal answers to research questions. Learning from the experiences of patients and recruiters to trials of incident conditions has the potential to improve recruitment and retention to future trials, thereby enhancing the quality and impact of research findings. The aim of this research was to learn from the trial experiences of UTI patients and recruiters to the Cranberry for UTI (CUTI) trial, to help plan an adequately powered trial of similar design.

Methods

One-to-one semi-structured interviews were embedded within the CUTI feasibility trial, an open-label, randomised feasibility trial of cranberry extract for symptoms of acute, uncomplicated Urinary Tract Infection (UTI) in primary care. Interviews were conducted with a sample of: CUTI trial participants; non-CUTI trial UTI patients; and, recruiters to the CUTI trial. Verbatim transcripts were analysed thematically.

Results

Twenty-six patients with UTI and eight recruiters (nurses and GPs) to the CUTI trial were interviewed. Three themes were developed around: reasons for participating in research; barriers to opportunistic recruitment; and, UTI patients’ experiences of trial procedures. Recruiters found that targeted electronic prompts directed at healthcare practitioners based in clinics where patients with incident conditions were likely to present (e.g. minor illness clinic) were more effective than generic prompts (e.g. desk prompts) at filtering patients from their usual clinical pathway to research clinics. Using a script to explain the delayed antibiotic trial group to patients was found to be helpful, and may have served to boost recruitment. For UTI patients, using an electronic diary to rate their symptoms was considered an acceptable medium, and often preferable to using a paper diary or mobile phone application.

Conclusions

The use of targeted prompts directed at clinicians, a script to explain trial groups that may be deemed less desirable, and an appropriate diary format for patient-reported outcomes, may help to improve trial recruitment and retention.
The effect of subjective social status on health-related quality of life decline in urban Chinese older adults: a four-year longitudinal study from Hong Kong
Authors: Sumerlin Timothy S. , Kwok Timothy C. Y. , Goggins William B. , Yuan Jinqiu , Kwong Elizabeth M. S. , Leung Jason , Kim Jean H.
Published: July 2022

Background

Improving health-related quality of life (HRQOL) is becoming a major focus of old age care and social policy. Researchers have been increasingly examining subjective social status (SSS), one’s self-perceived social position, as a predictor of various health conditions. SSS encompasses not only concrete socio-economic (SES) factors but also intangible aspects of status. This study’s main objective was to examine the association between SSS and long-term change in HRQOL in older Chinese adults.

Methods

A longitudinal Hong Kong study recruited 2934 community-dwelling adults (age > 65 years). Participants completed SF-12 physical health (PCS) and mental health (MCS) HRQOL scales. This study analyzed baseline SSS-Society (self-perceived social status within Hong Kong) and SSS-Community (self-perceived status within one’s own social network) as predictors of long-term HRQOL decline. After stratifying for sex, multiple-linear-regression was performed on 4-year follow-up SF-12 PCS and MCS scores after adjusting for baseline SF-12 scores, traditional SES indicators, demographic variables, clinical conditions, and lifestyle variables.

Results

In the multivariable analyses, lower SSS-Society was associated with declines in MCS in males (βstandardized = 0.08,p = 0.001) and declines in PCS (βstandardized = 0.07,p = 0.006) and MCS (βstandardized = 0.12,p < 0.001) in females.

SSS-Community was associated with declines in PCS in males (βstandardized = 0.07,p = 0.005) and MCS in females (βstandardized = 0.14,p < 0.001).

Conclusions

SSS may be a useful supplementary tool for predicting risk of long-term HRQOL decline in older Chinese adults. Strategies to reduce perceived social inequalities may improve HRQOL in older adults.
A retrospective cross sectional study assessing factors associated with retention and non-viral suppression among HIV positive FSWs receiving antiretroviral therapy from primary health care facilities in Kampala, Uganda
Authors: Atuhaire Lydia , Shumba Constance S. , Mapahla Lovemore , Nyasulu Peter S.
Published: July 2022

Background

Patient retention in care and sustained viral load suppression are a cornerstone to improved health and quality of life, among people living with HIV. However, challenges of retention on ART remain among female sex workers (FSWs). We report lost to follow up (LTFU), viral load suppression, and the associated factors among FSWs that access HIV treatment at primary health care facilities in Kampala.

Methods

We retrospectively abstracted and analysed patient management data of HIV positive FSWs who enrolled in care between January 2018 to December 2020. LTFU was defined as failure of a FSW to return for treatment at least 90 days from the date of their last clinic appointment. We defined viral suppression as having a last viral load of ≤ 1000 copies/ml preceding data abstraction. Data were analysed using Stata 15.1 software.

Results

A total of 275 FSWs were included in our study sample. We found low retention of 85.1% (n = 234) at six months, corresponding to LTFU of 14.9 (n = 41) within the same period. Retention decreased with duration of being in care up to 73.5% (n = 202) at 24 months, and this translates to LTFU of 26.5% (n = 73). Viral load testing coverage was 62% (n = 132) and of these, 90.9% (n = 120) were virally suppressed. Factors associated with LTFU in univariable logistic regression; and viral load suppression in multivariable logistic regression models were; having a telephone contact (OR: 0.3, 95% CI: 0.1–0.9 p = 0.031), having enrolled in HIV care aged ≥ 35 years (OR: 0.5, 95% CI: 0.2–1.0 p = 0.048), (OR:0.03, 95%CI: 0.00–0.5, p = 0.016); and having good ART adherence (OR: 0.2, 95% CI: 0.1–0.5 p = 0.001), (OR:24.0, 95% CI: 3.7–153.4 p = 0.001) respectively. Having good ART adherence remained statistically significant (OR: 0.2, 95% CI: 0.08–0.53 p = 0.001) in multivariable logistic regression for LTFU.

Conclusion

This study found low retention among HIV diagnosed FSWs in care. Viral load suppression was acceptable and comparable to that of the general population, however viral load coverage was low. Strategies that increase retention in care and access to viral load testing such as individual client centred care models are vital to improve retention and viral load coverage among FSWs.
Prevalence of ocular trauma in 6–12-year-old children living in Shahroud, Iran
Authors: Hashemi Hassan , Pakzad Reza , Khabazkhoob Mehdi , Yekta Abbasali , Emamian Mohammad Hassan , Fotouhi Akbar
Published: July 2022

Aim

To determine the prevalence of ocular trauma in Iranian children aged 6–12 years.

Methods

This population-based cross-sectional study, comprised the first phase of the Shahroud Schoolchildren Eye Cohort Study on primary school children using cluster sampling in urban areas and census in rural areas. The students underwent the measurement of uncorrected and corrected visual acuity as well as non-cycloplegic, cycloplegic, and subjective refraction. The history of trauma, hospitalization, and surgery due to trauma was collected from parents using a questionnaire.

Results

The data of the trauma history was recorded for 5267 out of 5620 students. The mean age of the students was 9.7 ± 1.7 years (range: 6–12 years), 53.7% of them were boys, and 79.3% were from urban areas. A positive history of ocular trauma was found in 285 participants, and the lifetime prevalence of ocular injury (95% CI) was 5.2% (4.6–5.9). Blunt trauma was the most common ocular injury with a prevalence of 66.2%. There was a significant positive assocation between ocular trauma and living in rural areas (OR: 1.49, p: 0.012), older age (OR: 1.17, p < 0.001), and male sex (OR: 1.62, p: 0.002). Furthermore, 9.3% and 4.7% of the traumas required hospitalization and surgical intervention, respectively.

Conclusion

This study found a marked prevalence of ocular trauma compared to previous studies. Male sex, older age, and living in rural areas were associated with ocular trauma, which could be due to differences in lifestyle preference, outdoor exposure, and dangerous situations. Educational programs and safety instructions should be encouraged.
Effect of different surgical positions on intraocular pressure: a cross-sectional study
Authors: Sun Yuhong , Wang Juan , Wang Wei , Fan Guohui , Wu Sinan , Zhao Fei , Lu Yi , Liu Di , Li Yan , Hu Jin , Yang Lin , Bai Yu , Zhao Tong , Zhao Ying
Published: July 2022

Background

Intraoperative intraocular pressure (IOP) elevation is a risk factor for postoperative blindness. Surgical position is associated with intraoperative IOP elevation. In China, there are few studies on the effect of various surgical positions on intraoperative IOP. This study was conducted to explore IOP change and its related factors in four common surgical positions in China.

Methods

This was a cross-sectional observational study. A total of 325 surgical patients who had non-ocular surgery from January 2019 to December 2019 in the hospital, were enrolled in this study. During their surgeries for general anesthesia, these participants were placed in lithotomy position/lateral position/prone position/supine position according to their surgery requirement. IOP was measured by icareTA03 handheld portable tonometer at 9 different time points from admission to exiting the operation room. And general information, postural position, and surgery information were collected through a uniform questionnaire. Multivariate analysis was performed to explore the related factors of IOP change.

Results

IOP of both eyes on lithotomy position, lateral position, and supine position showed statistical differences by ANOVA test at each time point (p < 0.05). IOP of both eyes in the prone position before exit from the operating room was significantly higher than IOP 10-min after anesthesia (p < 0.01). IOP under different postural angles showed statistical differences (F value = 4.85, P < 0.05), and the larger the head-down angle, the higher the IOP. IOP on the compressed side in the lateral position was higher than that on the non-compressed side (p < 0.01). In the multivariate linear regression analysis adjusted by other factors, postural position and baseline IOP were associated with IOP difference between before and after surgery (p < 0.01).

Conclusion

IOP in the four surgical positions showed different change patterns with the surgical process and position change. Nurses should assist the surgeon to reduce the head-down angle without interfering with the surgical operation and strengthen the inspection of IOP on patients with long-time surgery, to avoid intraoperative rapid IOP changes.
Serum neurofilament light reflects cognitive dysfunctions in children with obstructive sleep apnea
Authors: Shi Yewen , Feng Yani , Chen Xi , Ma Lina , Cao Zine , Shang Lei , Zhao Bingjie , She Ningning , Zhang Yitong , Si Chao , Liu Haiqin , Zhao Junjie , Ren Xiaoyong
Published: July 2022

Background

In children, obstructive sleep apnea (OSA) can cause cognitive dysfunctions. Amyloid-beta and tau are elevated in OSA. Neurofilament light (NfL) is a marker of neuro-axonal damage, but there are no reports of NfL for OSA. The objective was to investigate the serum levels of NfL and tau in children with or without OSA and explore their relationship with cognitive dysfunctions caused by OSA.

Methods

This retrospective case–control study included children diagnosed with adenoid tonsil hypertrophy from July 2017 to September 2019 at the Second Affiliated Hospital of Xi’an Jiaotong University. Correlations between cognitive scores and tau and NfL were examined.

Results

Fifty-six OSA and 49 non-OSA children were included. The serum NfL levels were higher in the OSA group (31.68 (27.29–36.07) pg/ml) than in the non-OSA group (19.13 (17.32–20.95) pg/ml) (P < 0.001). Moreover, NfL was correlated with the course of the disease, apnea–hypopnea index (AHI), obstructive apnea index (OAI), obstructive apnea–hypopnea index (OAHI), average oxygen saturation (SaO2), respiratory arousal index (RAI), and cognitive dysfunctions evaluated by the Chinese Wechsler Intelligence Scale for Children (C-WISC) (allP < 0.05). The area under the receiver operating characteristics curve (AUC) of NfL was 0.816 (95%CI: 0.736–0.897). Multiple regression analysis revealed that NfL was significantly associated with verbal intelligence quotient (VIQ), performance intelligence quotient (PIQ) and full-scale intelligence quotient (FIQ) (P < 0.001, respectively).

Conclusions

Serum NfL levels are associated with the severity of cognitive dysfunctions in children diagnosed with adenoid tonsil hypertrophy and might be a candidate noninvasive, objective marker to identify cognitive dysfunctions in children with OSA.
Association between migration and oral health-related quality of life: results from a nationally representative online survey
Authors: Aarabi Ghazal , Walther Carolin , Kretzler Benedikt , Zwar Larissa , König Hans-Helmut , Hajek André
Published: July 2022

Purpose

To analyze the link between individuals with and without migration background and oral health-related quality of life (also stratified by sex).

Methods

Data in this cross-sectional study were taken from a nationally representative survey (n = 3075, August/September 2021). The Oral Health Impact Profile (OHIP-G5) was used to measure oral health-related quality of life. Two-part models were calculated, adjusting for various covariates.

Results

Individuals with migration background had lower oral health-related quality of life (total sample, Cohen’s d = − 0.30; in men, d =− 0.44; in women, d =− 0.22). Two-part models also revealed that the migration background was associated with a higher likelihood of OHIP-G5 scores of one or higher (total sample and in both sexes). Moreover, migration background was positively associated with the extent of oral health-related quality of life (conditional on OHIP-G5 scores of one or higher; total sample and in men). Furthermore, regressions showed that migration background was associated with lower oral health-related quality of life (total sample and in both sexes).

Conclusions

Our study emphasized the link between having a migration background and lower oral health-related quality of life among both women and men. Maintaining oral health among individuals with a migration background is a key challenge. Culturally and socially sensitive actions should provide easy accessible oral health information and preventive measures in order to lower access barriers in dental care for individuals with migration background.