bluuebunny/crossref_metadata_2025 huggingface dataset:
Monitored Anesthesia Care Versus General Anesthesia for Transcatheter Aortic Valve Replacement
Authors: Holmes Henry R. , Falasa Matheus , Neal Daniel , Choi Calvin Y. , Park Ki , Bavry Anthony A. , Freeman Kirsten A. , Manning Eddie W. , Stinson Wade W. , Jeng Eric I.
Published: October 2022

Objective:

Monitored anesthesia care (MAC) has been increasingly used in lieu of general anesthesia (GA) for transcatheter aortic valve replacement (TAVR). We sought to compare outcomes and in-hospital costs between MAC and GA for TAVR at a Veterans Affairs Medical Center.

Methods:

A single-center retrospective review was performed of 349 patients who underwent transfemoral TAVR (MAC, n = 244 vs GA, n = 105) from January 2014 to December 2019. Baseline patient characteristics, operating room (OR) time, intensive care unit (ICU) length of stay (LOS), and cost, total LOS, hospital cost, total cost, and complication rates were collected. Propensity matching was performed and resulted in 83 matched pairs.

Results:

In the unmatched TAVR cohort, MAC TAVR was associated with reduced OR time (146 vs 198 min, P < 0.001), ICU LOS (1.4 vs 1.8 days, P < 0.001), total hospital LOS (3.4 vs 5.4 days, P < 0.001), and lower index total cost ($81,300 vs $85,400, P = 0.010). After propensity matching, MAC TAVR patients had reduced OR time (146 vs 196 min, P < 0.05), ICU LOS (1.2 vs 1.7 days, P = 0.006), total LOS (3.5 vs 5.1 days, P = 0.001), and 180-day mortality (2.4% vs 12%, P < 0.03). There was no difference in total hospitalization cost or total cost.

Conclusions:

In propensity-matched groups, TAVR utilizing MAC is associated with improved OR time efficiency, decreased LOS, and a reduction in 180-day mortality but no significant difference in cost.
Volar Transfer of the Lateral Band With Transverse Retinacular Ligament for the Correction of Swan Neck Deformity
Authors: Suzuki Taku , Kimura Hiroo , Matsumura Noboru , Sato Kazuki , Nakamura Masaya , Iwamoto Takuji
Published: October 2022

Background:

This retrospective study was designed to evaluate a surgical treatment for swan neck deformity of the fingers involving the volar transfer of the lateral band using the transverse retinacular ligament.

Methods:

Ten patients who underwent this surgical procedure for swan neck deformity treatment and were followed up for a mean of 26 months (range: 12-65 months) were included in the study. The dorsally located lateral bands were transferred toward the volar aspect of the finger, and their position was maintained using the transverse retinacular ligament. Improvement of the snapping and swan neck deformity was confirmed by intraoperative active motion of the finger. The active range of motion of the affected finger was evaluated pre- and postoperatively.

Results:

Extension of the proximal interphalangeal (PIP) joint averaged 30° (range: 20°-40°) preoperatively and improved to -2° (range: -5°-0°) postoperatively. Extension of the distal interphalangeal (DIP) joint averaged -30° (range: -15° to -70°) preoperatively and improved to -15° (range: 0° to -55°) postoperatively. The mean improvement in range of motion of the DIP joint was 15° (range: 10°-25°). The flexion of both the PIP and DIP joint did not significantly change in any of the patients postoperatively.

Conclusions:

Surgical transfer of the lateral band using the transverse retinacular ligament is effective in correcting mild swan neck deformity. Hyperextension of the PIP joint is corrected well, but the severe extension lag of the DIP joint remains uncorrected postoperatively.
Does size matter? Effects of small versus large pitch small-sided game training on speed and endurance in collegiate soccer players
Authors: Faga Joshua , Bishop Chris , Maloney Sean J
Published: October 2022

The aim of this study was to compare the training effect of small-sided games played using large and small area per player on speed and endurance in college soccer players. Twenty male NCAA division 1 soccer players were randomly assigned to one of two experimental groups: small-sided games using a large area per player ( n = 10), or small-sided games using a small area per player ( n = 10). During the 4-week intervention, both groups performed three sets of 4–8 min of 5 versus 5 small-sided games using either a large (300 m2) or small (75 m2) area per player. Pre- and post-training, players completed linear sprint (20- and 40-m), repeated sprint, and aerobic endurance tests. Following the intervention, both groups exhibited improvements in 20-m, 40-m, and maximum sprinting speed (all p < 0.05, g = 0.04–0.29). No differences or interaction effects in repeat-sprint ability were found for either group ( p > 0.05). A decline in maximal aerobic speed occurred in the small area per player group ( p = 0.010, g = 0.60) whilst no change was reported for the large area per player group. Following the intervention, anaerobic speed reserve was lower for the large area per player group versus the small area per player group ( p = 0.013; g = −0.23). No further between-group differences were reported at either time-point. These results suggest that small-sided games played with a small area per player may not be adequate to maintain aerobic fitness.
Percutaneous transvenous coil embolization of an extrahepatic portosystemic shunt in a cat
Authors: Case J Brad , Solari Francesca P , Vilaplana Grosso Federico
Published: October 2022

Case summary

A 10-month-old male domestic shorthair cat presented for surgical treatment of a congenital portosystemic shunt. The cat had a history of lethargy and ptyalism. Pre- and postprandial bile acids were markedly elevated. CT was performed, which revealed a single, congenital, left gastrophrenic, extrahepatic portosystemic shunt. A minimally invasive surgical approach was considered by transjugular percutaneous coil embolization of the venous shunt, which was performed without complications. Follow-up protein C and serum biochemical analyses were performed at 1, 2 and 5 months postoperatively, and were improved. The cat is alive and clinically normal 11 months postoperatively.

Relevance and novel information

This is the first report of percutaneous transvenous coil embolization for the treatment of an extrahepatic portosystemic shunt in a cat. The outcome was excellent in this patient, with no complications and complete resolution of clinical signs.
Design, implementation, and evaluation of an innovative intelligence information management system for premature infants
Authors: Pahlevanynejad Shahrbanoo , Danaei Navid , Safdari Reza
Published: October 2022

Introduction

Low birth weight is the most important condition of neonatal community health and the main cause of neonates' mortality. Identifying the indexes associated with this condition, and factors to prevent, and managing related data can help reduce the birth of premature infants to reduce the mortality rate due to this condition. The goal of present study was to design, implement and evaluate an innovative intelligence information management system for premature infants.

Material and method

The present study was a multidisciplinary research that was done in 2019 to 2021 in four integrated phases in Iran. The first phase aimed to compare the current status of registration systems of premature infants through a systematic review and semi-structured interviews by using the Delphi model Then the minimum data set was determined and was designed a proposed model based on it. In the second phase, the structure and how the user interacts with the system were determined, and, using Microsoft Visio software, Unified Modeling Language diagrams were drawn to define the logical relationship of data. In the third phase, the system was developed, and finally in the last phase, in three methods, users' views on the usability of the system were evaluated.

Results

The findings of this study included 233 essential data elements that were placed in two main groups of essential data, and the system was approved by end users for 87.73% consent and 67.19% satisfaction for SUMI (Software Usability Measurement Inventory) and 7.97 of 9 in QUIS questionnaire.

Conclusion

This research's results can be beneficial and functional such as a complete sample for design and development of other systems concerned to health systems.
COVID-19 Conspiracy Theories Discussion on Twitter
Authors: Erokhin Dmitry , Yosipof Abraham , Komendantova Nadejda
Published: October 2022

The coronavirus disease 2019 (COVID-19) pandemic was an unexpected event and resulted in catastrophic consequences with long-lasting behavioral effects. People began to seek explanations for different aspects of COVID-19 and resorted to conspiracy narratives. The objective of this article is to analyze the changes on the discussion of different COVID-19 conspiracy theories throughout the pandemic on Twitter. We have collected a data set of 1.269 million tweets associated with the discussion on conspiracy theories between January 2020 and November 2021. The data set includes tweets related to eight conspiracy theories: the 5G, Big Pharma, Bill Gates, biological weapon, exaggeration, FilmYourHospital, genetically modified organism (GMO), and the vaccines conspiracy. The analysis highlights several behaviors in the discussion of conspiracy theories and allows categorizing them into four groups. The first group are conspiracy theories that peaked at the beginning of the pandemic and sharply declined afterwards, including the 5G and FilmYourHospital conspiracies. The second group associated with the Big Pharma and vaccination-related conspiracy whose role increased as the pandemic progressed. The third are conspiracies that remained persistent throughout the pandemic such as exaggeration and Bill Gates conspiracies. The fourth are those that had multiple peaks at different times of the pandemic including the GMO and biological weapon conspiracies. In addition, the number of COVID-19 new cases was found to be a significant predictor for the next week tweet frequency for most of the conspiracies.
Effect of the University’s Environment and Support System on Subjective Social Norms as Precursor of the Entrepreneurial Intention of Students
Authors: Bazan Carlos
Published: October 2022

In this study, we aim to understand the influence of the university’s environment and support system (ESS) on subjective social norms (SSN) as one of the precursors of the entrepreneurial intention (EI) of university students. For this, we applied a customized mathematical model of EI based on the theory of planned behavior to probe whether the university’s ESS can affect SSN and analyze the paths that this influence may follow to form the EI of students. In other words, this study argues that the university plays a critical dual role in shaping the EI of students. First, it can provide support mechanisms to help students translate their ideas into viable business models that may further translate into successful ventures. Second, it can help students gain the support of their families and friends who influence their SSN, thus affecting their EI through the mediating effects of the other two precursors of intention. We collected the data from students in a public university in Atlantic Canada via a structured non-disguised questionnaire to test the hypotheses formulated in this study. We analyzed them through partial least square-structural equation modeling of a second-order mathematical model of EI. Analysis of the data indicates that the mathematical model is appropriate for evaluating the relations among the five constructs of the mathematical model of EI. Results of this study support the hypothesis that the university’s ESS may influence students’ perceptions of the opinions of important reference people regarding their prospects of becoming entrepreneurs. Furthermore, we determined that the university’s ESS influences the EI of students mediated by the more proximal precursors of intention. The effect of the university’s ESS is such that it may positively impact the EI of students, but its importance in the mathematical model of EI is still low. These findings can help universities assess their initiatives to promote innovation and entrepreneurship on campus.
CEO and Chairperson Characteristics and Corporate Environmental Performance: A Study of Cooperatives in Vietnam
Authors: Tran Nhat Minh
Published: October 2022

This research aims to examine the influence of chairperson/CEO demographic characteristics on the level of cooperatives’ the environmental performance of Vietnamese cooperatives, based on Upper Echelon Theory. To measure environmental performance levels, this study uses energy consumption levels (electricity) to test the hypotheses. A sample of 1,508 cooperatives (from 2014 to 2016) has been used to carry out the OLS regression model, controlling for year and industry fixed effects. This study shows that the relationship between a chairperson’s educational level and electricity consumption is negative and significant (decreasing energy consumption). A similar finding is also found with CEO duality, which supports the negative nexus with electricity used. In addition, no significant association was found between chairperson/CEO gender and energy consumption level, whereas the relationship with a chairpersons’ age is positive. Drawing from Upper Echelon Theory, the current research provides novel insights into the relationships between chairpersons/CEOs’ characteristics and the cooperatives’ environmental performance. From practical implication, since cooperatives are a relatively common type of business in the rural areas of Vietnam and environmental protection is quite essential, it is necessary for cooperatives to choose suitable chairpersons/CEO based on their demographic characteristics.

JEL: G30, K32, M14
Nurse Anesthesia Diversion Prevention: A Knowledge and Needs Gap Analysis
Authors: Ades Joshua , Sims Christopher , Polancich Shea , Hammond Stephanie
Published: October 2022

Background:

Substance misuse is an occupational health problem for anesthesia providers (APs). More than 10% of nurse anesthetists misuse and divert medications. No standard exists for addressing AP drug diversion. The purpose of this quality improvement project was to evaluate the use of a knowledge and needs assessment to inform the development of a successful drug diversion prevention program for certified registered nurse anesthetists (CRNAs) and student registered nurse anesthetists (SRNAs).

Methods:

A 28-item questionnaire, using the health belief model (HBM) and the risk perception attitude (RPA) framework, was developed to assess knowledge, beliefs, and practices of substance misuse and diversion. RPA groups were determined by level of belief in self-risk and perceived efficacy of prevention strategies. The survey was emailed to 100 CRNAs and over 100 SRNAs. Survey results were organized using the RPA framework.

Findings:

One hundred twelve surveys were completed. The RPA avoidant category (high-risk belief and low perceived efficacy of preventive interventions) comprised 52.5% of CRNAs; SRNAs were divided primarily among the RPA responsive category with high perceived risk and high-efficacy beliefs (38.9%) and the indifferent category of low-risk beliefs and low perceived efficacy (31.9%).

Conclusions/Applications to Practice:

Anesthesia providers have varying beliefs regarding drug misuse and diversion risks and perceptions of their ability to be successful with preventive strategies. Failure to address nurse anesthesia needs-based diversion prevention may result in missed opportunities to educate this group. Implementation of RPA-tailored interventions by health care organizations may produce effective, long-term outcomes for drug diversion within the profession.
Fund-based Activity of Indian Small Finance Banks: A Fuzzy DEA Approach
Authors: Konar Pulak , Sinha Ram Pratap , Ghosh Samriddhi , Guha Banhi
Published: October 2022

The objective of this article is to promote financial inclusion in the niche market for the less privileged class of the society by allowing small finance banks that are specialized in terms of activity with a regional focus and the target population. The present study makes an efficiency evaluation of the small finance banks operating in India for the period 2017–2020. In view of the smallness of the sample size, the study estimates efficiency, not by the conventional data envelopment analysis (DEA)-based point estimates. Instead, it estimates efficiency by applying the Guo–Tanaka fuzzy DEA model. In the second stage, efficiency is explained in terms of three contextual variables: return on asset, capital adequacy and net non-performing asset ratio.

JEL Classifications: C61, D21, G21
Spontaneous Resolution of Drug-Resistant Epilepsy in Patients with Sturge-Weber Syndrome
Authors: Alawadhi Abdulla , Poulin Chantal
Published: October 2022

Introduction: Sturge-Weber syndrome (SWS) is often associated with drug resistant epilepsy. The literature is unclear as to how often these patients can be weaned off of antiepileptic drugs (AEDs) to become seizure-free. Case Description: We describe two patients with SWS. After initial treatment with various AEDs, breakthrough seizures still occurred. However, after periods with no seizure activity, they were weaned off of their medications. They have been off for 4 and 3 years and seizure-free for 13 and 12 years, respectively. No surgical procedure was necessary. Conclusion: We hypothesize that spontaneous involution or pathological disconnection of the vascular malformations might underly the patients’ recovery. The initial aggressive therapy, close follow-up, choice of AEDs, or natural evolution of the disease may have played a role in their recovery. Therefore, in patients with SWS and lesional structural epilepsy, medication freedom is possible and invasive management options including surgery should be discussed carefully.
Community Social Paediatrics Approach, an Innovative Healthcare Intervention: Implementation Fidelity in Atlantic Canada
Authors: Doucet Danielle , Dubé Anik , Corriveau Hélène , Blaney Sonia , Iancu Penelopia , Morin Sylvie , Plourde Vickie
Published: October 2022

The Community Social Paediatrics approach (CSPA) is a comprehensive and personalized approach to care that is becoming more widely used throughout Canada. However, data on its implementation fidelity remain scarce. The purpose of this research was to assess the implementation fidelity of a CSPA established in 2017 in Canada. Data were collected through focus group interviews with the CSPA team using an implementation fidelity grid based on the Dr. Julien Foundation standard accreditation criteria. Results showed that on one hand, administrative and financial management and governance were among those domains with lower ratings. On the other hand, assessment/orientation and follow-up/support had high levels of fidelity of implementation. This research helps to better understand which factors are contributing to varying levels of fidelity of implementation. To reach an increased level of fidelity of implementation, it is recommended that adequate resources be in place.
Neck Dissection Timing in Transoral Robotic or Laser Microsurgery in Oropharyngeal Cancer: A Systematic Review
Authors: Ramchandani Jai Parkash , Brunet Aina , Skalidi Nikoleta , Faulkner Jack , Rovira Aleix , Simo Ricard , Jeannon Jean‐Pierre , Arora Asit
Published: October 2022

Objective

This review assesses the effect on intra‐ and postoperative patient outcomes of the timing of neck dissection in relation to transoral surgery. Outcome measures include postoperative bleeding, intra‐ and postoperative fistula formation, and disease‐specific and overall survival.

Data Sources

A search was conducted across the MEDLINE, Embase, US National Library of Medicine, and Cochrane databases with search terms in July 2021.

Review Methods

Articles that conformed with specified inclusion criteria were included. Included articles were scanned for bias with the ROBINS‐I tool.

Results

Nineteen articles were selected for qualitative analysis, including 546 patients who had neck dissection in conjunction with transoral robotic surgery/transoral laser microsurgery (TORS/TLM). Seventy‐one (18%) patients had neck dissection prior to TORS/TLM, 39 (10%) had neck dissection performed after TORS/TLM, and 281 (72%) had concurrent procedures. In patients with neck dissection before TORS/TLM, 3% experienced major postoperative bleeding, and fistula rates were 0%. In the cohort with neck dissection after TORS/TLM, 3% experienced minor postoperative hemorrhage, and 8% had intraoperative fistulae. In the concurrent cohort of patients, 1% had major postoperative bleeds and 0.3% had minor bleeds, while 4% developed intraoperative fistulas and 0.3% developed postoperative fistulas.

Conclusion

Current evidence indicated that there appears to be no correlation between timing of neck dissection and complications. This systematic review found insufficient data to comment on whether the timing of neck dissection in relation to TORS/TLM affects the outcomes of patients.
Intravitreal Rituximab-Associated Retinal Occlusive Vasculitis
Authors: McAllister Mark A. , Moore Spencer M. , Harris April E.
Published: October 2022

Purpose:

To describe a 90-year-old patient who was referred to a private retina specialist with gradually worsening vision and floaters in the left eye.

Methods:

A retrospective case report is presented.

Results:

The patient was treated with intravitreal rituximab injections for intraocular lymphoma with resulting vision loss to the level of hand motions from severe granulomatous uveitis and retinal occlusive vasculitis.

Conclusions:

Retinal occlusive vasculopathy secondary to rituximab intravitreal injections is a rare clinical entity with only a single previous case reported in the literature. However, there are reports of systemic vasculitis after systemic administration of rituximab. Clinicians should be aware of the possibility of ocular hypertension, granulomatous anterior uveitis, and/or retinal occlusive vasculitis after intravitreal rituximab use. Consideration should be given to the inflammatory risk of rituximab intravitreal injections to reduce the potential for treatment-induced vision loss.
Revising the Diabetes Distress Scale for Use Among Adults in the Dominican Republic: Findings From Cognitive Interviews
Authors: Wallace Deshira D. , Núñez Ivania , Barrington Clare
Published: October 2022

Purpose:

The purpose of this study is to assess the content validity of the Diabetes Distress Scale (DDS) among adults with type 2 diabetes mellitus (T2DM) living in rural Dominican Republic communities.

Methods:

Researchers conducted cognitive interviews with 20 adults with T2DM to assess how they answered a Spanish version of the 17-item DDS, a commonly used scale to measure diabetes distress. Interviews were done iteratively to allow for revisions and testing of those revisions with the participants. Analysis involved field notes, text summaries, and cognitive coding.

Results:

The sample was 55% women, had a mean age of 55 years, and came from 10 rural communities. The cognitive interviews highlighted needed changes across comprehension, judgment (clarity), recall, response process, and logical/structural issue domains. Participants generally understood the DDS; however, 4 items, the introduction, and response options were revised to improve participant response. The items were revised using wording from the participants themselves. By changing certain terms and splitting a couple of items, these items improved comprehension and judgment. The introduction was simplified from 2 paragraphs to 1 to reduce structural issues (ie, scale’s features), and the response options were reduced from 6 options to 5 options to improve the response process.

Conclusions:

Based on iterative study findings, the researchers propose expanding the 17-item DDS to 19 items to improve participant response. Revising the DDS to account for cultural and structural changes will improve clinical and public health understanding of the role of diabetes distress on T2DM management among Dominican adults.
Novel six-gene prognostic signature based on colon adenocarcinoma immune-related genes
Authors: Zhou Rui , Gao Zhuowei , Ju Yongle
Published: October 2022

Background

Colon adenocarcinoma (COAD) is one of the most common gastrointestinal tumors worldwide, and immunotherapy is one of the most promising treatments for it. Identifying immune genes involved in the development and maintenance of cancer is key to the use of tumor immunotherapy. This study aimed to determine the prognostic value of immune genes in patients with COAD and to establish an immune-related gene signature. Differentially expressed genes, immune-related genes (DEIGs), and transcription factors (DETFs) were screened using the following databases: Cistrome, The Cancer Genome Atlas (TCGA), the Immunology Database and Analysis Portal, and InnateDB. We constructed a network showing the regulation of DEIGs by DETFs. Using weighted gene co-expression network analysis, we prepared 5 co-expressed gene modules; 6 hub genes (CD1A, CD1B, FGF9, GRP, SERPINE1, and F2RL2) obtained using univariate and multivariate regression analysis were used to construct a risk model. Patients from TCGA database were divided into high- and low-risk groups based on whether their risk score was greater or less than the mean; the public dataset GSE40967, which contains gene expression profiles of 566 colon cancer patients, was used for validation.

Results

Survival analysis, somatic gene mutations, and tumor-infiltrating immune cells differed significantly between the high- and low-risk groups.

Conclusions

This immune-related gene signature could play an important role in guiding treatment, making prognoses, and potentially developing future clinical applications.
The long non-coding RNA lncMYOZ2 mediates an AHCY/MYOZ2 axis to promote adipogenic differentiation in porcine preadipocytes
Authors: Yang Yang , Wu Yiqi , Ji Mengting , Rong Xiaoyin , Zhang Yanwei , Yang Shuai , Lu Chang , Cai Chunbo , Gao Pengfei , Guo Xiaohong , Li Bugao , Cao Guoqing
Published: October 2022

Long non-coding RNAs (lncRNAs) play a vital role in regulating adipogenesis. However, the associated regulatory mechanisms have yet to be described in detail in pig. In this study, we demonstrate a critical role for lncMYOZ2 in adipogenesis from porcine preadipocytes. Specifically, lncMYOZ2 was more abundant in the adipose tissue of Mashen (fat-type) pigs than for Large White (lean-type) pigs, and knockdown of this lncRNA significantly inhibited the differentiation of porcine preadipocytes into adipocytes. Mechanistically, we used RNA pull-down and RIP assays to establish that lncMYOZ2 interacts with adenosylhomocysteinase (AHCY). Moreover, lncMYOZ2 knockdown increased promoter methylation of the target gene MYOZ2 and lowered its expression. Finally, we describe a positive regulatory role for MYOZ2 in adipogenesis. Collectively, these findings establish lncMYOZ2 as an important epigenetic regulator of adipogenesis via the aforementioned AHCY/MYOZ2 pathway, and provide insights into the role of lncRNAs in porcine adipose development.
Influencing factors on instrumental activities of daily living functioning in people with mild cognitive disorder – a secondary investigation of cross-sectional data
Authors: Bruderer-Hofstetter Marina , Gorus Ellen , Cornelis Elise , Meichtry André , De Vriendt Patricia
Published: October 2022

Background

Finding a strategy to reduce the impact of cognitive decline on everyday functioning in persons suffering from cognitive impairment is a public health priority. Instrumental activities of daily living (IADL) are key to everyday functioning. Hence, it is essential to understand the influencing factors on IADL to develop specific interventions to improve everyday functioning in persons with mild cognitive disorder. Therefore, this study aimed to 1) explore different influencing factors on IADL functioning considering all domains of the International Classification of Functioning, disability, and health and 2) rank these factors.

Methods

We performed a secondary analysis of a cohort including participants with amnestic mild cognitive impairment (a-MCI) or mild Alzheimer’s Dementia (mild AD). The IADL functioning model was used as a starting point to estimate the effects of cognitive and physical function factors and personal and environmental factors on IADL functioning using multiple linear regression analysis, including subgroup analysis in persons with a-MCI. We used standardized coefficient estimates to relate the size of the predictor effects in the final model.

Results

We included 105 participants (64 a-MCI, 41 mild AD); the mean age was 81.9 years (SD 4.9), with 70% females. Based on a multi-step approach and model fit, the final model included IADL functioning as the response variable and memory, attention, executive function, vision and hearing, mobility, balance, education, and social support as predictors. The final model explained 75% of the variability. The significant predictors in the model were mobility, balance, attention, and education, and were the predictors with the most considerable effects based on standardized coefficient estimates. The subgroup analysis, including only a-MCI participants, revealed a similar pattern.

Conclusion

Our results confirm that IADL functioning in people with mild cognitive disorder is influenced by cognitive and physical function and personal factors. The study provides further insight into understanding IADL functioning impairments in persons with mild impaired cognition and may be used to develop specific non-pharmacological interventions.
The synergistic effect of depression and moderate chronic kidney disease on the all-cause and cardiovascular disease mortality among adults: a retrospective cohort study
Authors: Meng Fanchao , Qi Yanjie , Chen Xu , Yan Xiuping , Huang Huanhuan , He Fan
Published: October 2022

Background

The relationship between the coexistence of depression and moderate chronic kidney disease (CKD) and mortality is unclear. We aimed to investigate whether there is a synergistic effect of depression and moderate CKD on the all-cause and cardiovascular disease (CVD) mortality among adults.

Methods

We studied 24,412 participants from the National Health and Nutrition Examination Survey 2005–2014 with a mortality follow-up assessment in 2015. Four groups were created based on depression and CKD status: Group 1, no depression and no CKD; Group 2, depression present and no CKD; Group 3: no depression and CKD present; Group 4: depression present and CKD present. Moderate CKD was defined as an estimated glomerular filtration rate of 15–59 mL/min/1.73 m2 (Stage 3–4) or one-time urine albumin-to-creatinine ratio ≥ 30 mg/g. Depression was defined as the 9-item Patient Health Questionnaire score of 10 or more. Cox proportional hazards regression models were used to calculate the multivariate-adjusted hazard ratios (HRs) of death for Group 4 with other groups.

Results

Over a mean follow-up of 5.8 years, 1783 deaths were documented, including 338 deaths from CVD. The HR for all-cause mortality in Group 4 was 3.62 (95% CI: 2.69–4.87), 2.99 (1.92–4.66), and 1.75 (1.29–2.37) when compared with Group 1, 2, and 3, respectively. The HR for CVD mortality in Group 4 was 3.89 (1.68–9.00), 1.90 (0.86–4.21), and 1.97 (1.17–3.32) when compared with Group 1, 2, and 3, respectively.

Conclusions

There might be a synergistic effect of depression and moderate CKD on all-cause mortality. Moreover, depression might increase the risk of CVD mortality in individuals with moderate CKD.
Reliability and validity of the Japanese treatment self-regulation questionnaire for Japanese workers
Authors: Ishii Kayoko , Morita Kumiko , Sumita Hiroko
Published: October 2022

Background

Motivational interventions are used as preventive measures in occupational health. However, existing studies primarily focus on motivation methods and not the stage of motivation—the process from extrinsic to intrinsic motivation. The treatment self-regulation questionnaire (TSRQ) can predict workers’ health at each motivational stage. Accordingly, this study examined the reliability and validity of the Japanese version of the TSRQ (Diet and Exercise) in occupational health settings.

Methods

Responses of 912 workers were analyzed. In this study, the Cronbach’s alphas were 0.85 for Diet and 0.84 for Exercise after excluding items with low Item-Total correlations. Regarding convergent validity, there was a weak correlation between behavior modification stages and the TSRQ. Regarding structural validity, confirmatory factor analysis was performed assuming a four-factor structure.

Results

The goodness-of-fit indices were: Comparative Fit Index (CFI) = 0.94, Tucker Lewis Index (TLI) = 0.92, and Root Mean Square Error of Approximation (RMSEA) = 0.07 for Diet and CFI = 0.92, TLI = 0.91, and RMSEA = 0.08 for Exercise.

Conclusion

The Japanese version of the TSRQ has a certain degree of reliability and validity. It can measure motivation for Diet and health-related behaviors in occupational health settings. The findings of this study may serve as a basis for promoting primary and secondary prevention.
The clinical elective course and its effects on medical students and graduates of Jordanian medical schools
Authors: Al-Taher Raed , Al-Ani Ruba , Al-Ani Abdullah , Rashdan Mohammad , Al Manasra Abdel rahman A. , Aborajooh Emad , Al-Balas Hamzeh , Al-Balas Hasan , Al-Balas Mahmoud , Attiyat Maymoona , Qasem Nuha
Published: October 2022

Background

The elective course is part of the 6th-year medical school curriculum in Jordan. Students choose the specialty in which they wish to spend 8 weeks and choose their location even if it is outside their university’s affiliated hospitals. In this study, we try to understand student choices regarding the country of elective, chosen specialty, type of placement (observership/clerkship), and elective general value from participants' perspectives.

Methods

This paper used a cross-sectional study. The survey was distributed through social media platforms (mainly Facebook and WhatsApp) targeting 6th-year medical students and doctors who graduated from one of the 5 Jordanian medical schools (the University of Jordan, Jordan University of Science and Technology, Mutah University, Yarmouk University, and Hashemite University).

Results

The majority of participants had an international elective (69.6%), mainly in the USA, followed by the UK. Internal medicine was the primary field of interest for 14.8%, followed by general surgery. Of these, 241 (62.6%) actively participated in work at their chosen hospitals as they had a clerkship/hands-on experience. In contrast, 142 (36.9%) were observers. The majority indicated that the elective is worth the time, money, and effort. Moreover, they had adequate supervision throughout the course and could achieve their preset objectives.

Conclusions

The elective course gives a unique experience to our students. General satisfaction is an indicator of the success of the course in actively exposing medical students to clinical practice.
Left ventricular non-compaction cardiomyopathy associated with the PRKAG2 mutation
Authors: Zhang Jing , Han Xiu , Lu Qun , Feng Yunfei , Ma Aiqun , Wang Tingzhong
Published: October 2022

Left ventricular non-compaction cardiomyopathy (LVNC) is one of the most common inherited cardiovascular diseases. The genetic backgrounds of most LVNC patients are not fully understood. We collected clinical data, family histories, and blood samples and performed genetic analysis using next-generation sequencing (NGS) from a Chinese family of 15 subjects. Clinically LVNC affected subjects showed marked cardiac phenotype heterogeneity. We found that these subjects with LVNC carried a missense heterozygous genetic mutation c.905G>A (p.R302Q) in γ2 subunit of AMP-activated protein kinase (PRKAG2) gene through NGS. Individuals without this mutation showed no symptoms or cardiac structural abnormalities related to LVNC. One subject was the victim of sudden cardiac death. To sum up, PRKAG2 mutation c.905G>A (p.R302Q) caused familial LVNC. Our results described a potentially pathogenic mutation associated with LVNC, which may further extend the spectrum of LVNC phenotypes related to PRKAG2 gene mutations.
Association between triglyceride glucose index and atherosclerotic plaques and Burden: findings from a community-based study
Authors: Wang Mengxing , Mei Lerong , Jin Aoming , Cai Xueli , Jing Jing , Wang Suying , Meng Xia , Li Shan , Wei Tiemin , Wang Yongjun , Pan Yuesong
Published: October 2022

Background

Insulin resistance is an important cause of cardiovascular events and cerebral infarction development. We aimed to investigate the association of the triglyceride glucose (TyG) index with atherosclerotic burden and plaques in coronary, intra- and extracranial arteries in participants with non-diabetes, and compared the results with that of the homeostasis model assessment of insulin resistance (HOMA-IR).

Methods

Participants without diabetes in the PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events (PRECISE) study were included. We categorized participants by tertiles of the TyG index and the concordance/discordance of the TyG index and HOMA-IR. Discordance was defined as a TyG index equal to or greater than the median and HOMA-IR less than the median, or vice versa. The atherosclerosis plaques and burden in coronary, intra- and extracranial arteries were evaluated. The association of HOMA-IR and TyG index with the presence of atherosclerotic plaques and atherosclerotic burden was assessed by binary and ordinal logistic regression models, respectively.

Results

Among 2,719 included participants, the average age was 60.9 (± 6.6) years, and 53.0% were female. Both TyG index and HOMA-IR were associated with increased odds of coronary/intra- and extracranial atherosclerotic plaques and burden after adjustment for age, sex, currenting smoking and drinking (all P < 0.05). However, the association between HOMA-IR and intracranial atherosclerosis was not statistically significant after adjustment for all potential confounders. Discordantly high TyG index with HOMA-IR had a higher odd of extracranial plaque (odds ratio [OR]: 1.34, 95% confidence interval [CI]: 1.04–1.71), extracranial atherosclerotic burden (common odds ratio [cOR]: 1.35, 95% CI 1.06–1.71), coronary plaque (OR: 1.30, 95% CI 1.01–1.68) and segment stenosis score (cOR: 1.39, 95% CI 1.09–1.78) as compared with concordantly low TyG index with HOMA-IR. The TyG index had a better net reclassification improvement ability than HOMA-IR for atherosclerotic plaques when adding to baseline model.

Conclusion

Elevated TyG index was associated with increased odds of atherosclerosis in coronary/intra- and extracranial arteries. Compared with HOMA-IR, the TyG index was more strongly associated with intracranial atherosclerosis. Moreover, discordantly high TyG index with HOMA-IR was also important for atherosclerosis identification.
Effects of virtual reality erotica on ejaculate quality of sperm donors: a balanced and randomized controlled cross-over within-subjects trial
Authors: Rosenkjær Daniel , Pacey Allan , Montgomerie Robert , Skytte Anne-Bine
Published: October 2022

Background

Previous research has shown that the type and duration of erotic material that men have access to during masturbation can influence semen parameters. To our knowledge, the use of virtual reality (VR) headsets to present erotica has not previously been studied. We reasoned that, because VR can provide a more immersive experience to the user, semen parameters of masturbatory ejaculates may be altered.

Methods

This study had a balanced and randomized controlled cross-over within-subjects design. 504 ejaculates were collected from 63 sperm donors at 4 locations in Denmark. During masturbation each donor was instructed to observe erotic material either on a touch screen monitor or using a VR headset. The order of each pair of within-subject treatments was randomized by the throw of a dice. Anonymized data were analysed with linear mixed and piecewise structural equation models.

Results

Both abstinence period and VR-use influenced the total number of motile spermatozoa ejaculated. For short abstinence periods, VR-use increased the number of motile sperm in the ejaculate. However, the difference between VR and non-VR ejaculates decreased as abstinence period increased such that there was no difference at the mean abstinence period of 58 h. For longer abstinence periods, total motile sperm counts were lower, on average, when men used VR compared to those that did not.

Conclusion

The use of VR headsets to view erotica had a strong positive effect on the number of motile sperm in an ejaculate when the donor’s abstinence time was short (< 24 h). VR-use could improve the ejaculate quality of men who are asked to provide samples after a short period of abstinence, such as men in infertile partnerships producing samples for ART or cancer patients depositing sperm before treatment.

Trial registration

Trial retrospectively registered on 13 July 2022 at ClinicalTrials.gov. Identifier: NCT05457764.
Early effects of LPS-induced neuroinflammation on the rat hippocampal glycolytic pathway
Authors: Vizuete Adriana Fernanda K. , Fróes Fernanda , Seady Marina , Zanotto Caroline , Bobermin Larissa Daniele , Roginski Ana Cristina , Wajner Moacir , Quincozes-Santos André , Gonçalves Carlos Alberto
Published: October 2022

Neuroinflammation is a common feature during the development of neurological disorders and neurodegenerative diseases, where glial cells, such as microglia and astrocytes, play key roles in the activation and maintenance of inflammatory responses in the central nervous system. Neuroinflammation is now known to involve a neurometabolic shift, in addition to an increase in energy consumption. We used two approaches (in vivo and ex vivo) to evaluate the effects of lipopolysaccharide (LPS)-induced neuroinflammation on neurometabolic reprogramming, and on the modulation of the glycolytic pathway during the neuroinflammatory response. For this, we investigated inflammatory cytokines and receptors in the rat hippocampus, as well as markers of glial reactivity. Mitochondrial respirometry and the glycolytic pathway were evaluated by multiple parameters, including enzymatic activity, gene expression and regulation by protein kinases. Metabolic (e.g., metformin, 3PO, oxamic acid, fluorocitrate) and inflammatory (e.g., minocycline, MCC950, arundic acid) inhibitors were used in ex vivo hippocampal slices. The induction of early inflammatory changes by LPS (both in vivo and ex vivo) enhanced glycolytic parameters, such as glucose uptake, PFK1 activity and lactate release. This increased glucose consumption was independent of the energy expenditure for glutamate uptake, which was in fact diverted for the maintenance of the immune response. Accordingly, inhibitors of the glycolytic pathway and Krebs cycle reverted neuroinflammation (reducing IL-1β and S100B) and the changes in glycolytic parameters induced by LPS in acute hippocampal slices. Moreover, the inhibition of S100B, a protein predominantly synthesized and secreted by astrocytes, inhibition of microglia activation and abrogation of NLRP3 inflammasome assembly confirmed the role of neuroinflammation in the upregulation of glycolysis in the hippocampus. Our data indicate a neurometabolic glycolytic shift, induced by inflammatory activation, as well as a central and integrative role of astrocytes, and suggest that interference in the control of neurometabolism may be a promising strategy for downregulating neuroinflammation and consequently for diminishing negative neurological outcomes.
Rendezvous between ambulances and prehospital physicians in the Capital Region of Denmark: a descriptive study
Authors: Oelrich Roselil , Kjoelbye Julie Samsoee , Rosenkrantz Oscar , Barfod Charlotte
Published: October 2022

Background

In a two-tier Emergency Medical Services response system with ambulances and physician-staffed rapid response vehicles, both units are ideally dispatched simultaneously when a physician is needed. However, when advanced resources are dispatched secondarily, a meeting point (rendezvous) is established to reduce time to advanced care. This study aims to assess the extent of rendezvous tasks, patient groups involved and physician contribution when rendezvous is activated between the primary ambulances and rapid response vehicles in the Capital Region of Denmark.

Methods

We analysed prehospital electronic patient record data from all rendezvous cases in the Capital Region of Denmark in 2018. Variables included the number of times rendezvous was activated, patient demographics, dispatch criteria, on-scene diagnosis, and prehospital treatment.

Result

Ambulances requested rendezvous 2340 times, corresponding to 1.3% of all ambulance tasks and 10.7% of all rapid response vehicle dispatches. The most frequently used dispatch criterion was unclear problem n = 561 (28.8%), followed by cardiovascular n = 439 (22.5%) and neurological n = 392 (20.1%). The physician contributed with technical skills like medication n = 760 (39.0%) and advanced airway management n = 161 (8.3%), as well as non-technical skills like team leading during advanced life support n = 152 (7.8%) and decision to end futile treatment and death certificate issuance n = 73 (3.7%).

Conclusion

Rendezvous between ambulances and physician-staffed rapid response vehicles was activated in 1.3% of all ambulance cases corresponding to 10.7% of all RRV dispatches in 2018. The three largest patient groups in rendezvous presented cardiovascular, neurological, and respiratory problems. The prehospital physician contributed with technical skills like medication and advanced airway management as well as non-technical skills like team leading during advanced life support and ending futile treatment. The high percentage of dispatch criterion unclear problem illustrates the challenge of precise dispatch and optimal use of prehospital resources. Therefore, it seems necessary to have a safe and rapid rendezvous procedure to cope with this uncertainty.
Intimin (eae) and virulence membrane protein pagC genes are associated with biofilm formation and multidrug resistance in Escherichia coli and Salmonella enterica isolates from calves with diarrhea
Authors: Hasson Shaimaa O. , Judi Hawraa K. , Salih Hawazen H. , Al-Khaykan Ameer , Akrami Sousan , Sabahi Sahar , Saki Morteza , Al-Rubaie Zahraa A.
Published: October 2022

Objectives

This study aimed to evaluate the association of the intimin (eae) and pagC genes with biofilm formation and multidrug resistance (MDR) phenotype in Escherichia coli and Salmonella enterica collected from calves with diarrhea.

Results

Fecal samples (n: 150) were collected from calves with diarrhea. Of 150 fecal samples, 122 (81.3%) were culture positive and 115/122 (94.2%) were Gram-negative bacteria. Among them, E. coli (n = 64/115, 55.6%) was the most common isolate followed by S. enterica (n = 41/115, 35.6%). Also, 10 (8.6%) isolates were other Enterobacteriaceae bacteria including Klebsiella and Proteus species. Eighty-nine isolates (77.4%) from calf diarrhea, including 52 (81.3%) E. coli and 37 (90.2%) S. enterica were MDR. The eae and pagC genes were detected in 33 (51.5%) E. coli and 28 (68.3%) S. enterica isolates, respectively. There was a strong association between these genes and biofilm formation and MDR phenotype (P-value = 0.000). All E. coli isolates carrying the eae gene were biofilm producers and MDR. Also, all pagC-positive S. enterica isolates were MDR and 25 (89.3%) isolates of them produced biofilm.