bluuebunny/crossref_metadata_2025 huggingface dataset:
Poster 366: EVALUATION OF A DEPRESSION SCREENING PROGRAM IN PEDIATRIC ORTHOPAEDIC SPORTS CLINICS: WHICH PATIENTS ARE IDENTIFIED AS AT RISK?
Authors: Bastrom Tracey , Edmonds Eric , Morillo Reinaldo Colon
Published: August 2023

Objectives:

Universal depression screening of patients ≥12 years of age was instituted at our facility in 2018 in an effort to combat the suicide rate among teenagers. The purpose of this study was to quantify the significance of depression in adolescents being treated within a sports clinic at a pediatric institution and attempt to identify predictors of at risk patients.

Methods:

A retrospective review was performed to identify all patients, ages 12-21 years, who were administered the Patient Health Questionnaire (PHQ-2/PHQ-9) over a 2-year period within our pediatric orthopaedic sports clinics. Patients were grouped into four broad diagnostic categories; knee instability, knee other, other sports related, or shoulder injury. The rate of a positive screen prompting administration of PHQ9 (PHQ2>3), rate of depression risk (PHQ9≥10), and rate of patients indicating self-harm were evaluated. Multivariate binary logistic regression to identify available demographic and diagnosis predictors of risk of self-harm was performed.

Results:

There were 3,298 patients screened in orthopedic sports clinics from 2018-2021. The overall rate of positive screens was 4.2% (n=138), rate of depression risk was 1.9% (n=63), and self-harm was 0.9% (n=29). The distribution of these rates for each diagnostic category are seen in Table 1. Self-harm showed a significant difference in the proportion at risk across the four diagnostic categories (p=0.038), with shoulder and knee instability having the highest rate. Black or African American race (OR 3.8, 95% CI 1.3-11, p=0.02), female gender (OR 3 95%CI 1.3-6.9, p=0.01), public/government insurance (OR 3.8, 95% CI 1.3-11, p=0.02), shoulder diagnosis (OR 3.5 95%CI 1.3-9.4, p=0.016), and knee instability diagnosis (OR 2.8 95%CI 1.2-6.5, p=0.02) were associated with increased risk of self-harm.

Conclusions:

This study demonstrated a 2% rate of depression risk and 1% rate of self-harm risk in this adolescent population being treated within sports clinics. Variability in rate of risk was identified, with the shoulder and knee instability patients having higher risk profiles. Aside from diagnosis groups, gender, race, and insurance were factors that were also independently predictive of patients at risk for depression or self-harm. Knowledge of risk factors can help increase awareness and recognition of potential mental health conditions that may need addressing during the course of treatment for the sports-related injury. [Table: see text]
Poster 393: The Impact of the COVID-19 Lockdown on the Rate of Injuries in the National Basketball Association
Authors: Nguyen Nguyen , Dorsey Harold , Pais Kalaila , Boone Andrew , Wilson Robert , Khanuja Harpal , Singh Sanjum
Published: August 2023

Objectives:

This study aims to assess the impact of the COVID-19 lockdown on injury rates experienced by athletes of the National Basketball Association (NBA). We hypothesized that there would be a change in the incidence rates of sports-related injuries on return to play post-lockdown.

Methods:

We conducted a retrospective analysis utilizing data retrieved from Pro Sports Transactions Archive. This database records all transactions occurring in the NBA, including injuries, trades, signings, and waivings. Information about all injuries to players in the NBA over the last 10 years were collected. All injury descriptions in the dataset were stratified by key anatomical locations and the dataset was shortened to the eight most common. These specific locations were selected due to higher injury rates overall comparatively to the rest of the body. We then compared basketball players who played after the COVID-19 NBA suspension to a propensity score generated control group before the suspension. They were matched for age, body mass index (BMI), regions of the country and positions played. The study outcome variable was the injuries stratified into 4 different groups. Demographics for every player injured (height, weight, years played, and birth dates) were collected from Basketball Reference, in line with publicly available information from the NBA.

Results:

We compared 789 players during the post-suspension to 3,945 match controlled pre- suspension players. The mean age of players was 27.1± 5 years, mean BMI was 25.0± 1.2. The eight most common injuries were knee, ankle, back, hamstring, shoulder, calf, groin, and elbow injuries. Prior to propensity score matching, the rates of the three most common were: knee (pre-suspension: 33.79%; postsuspension: 36.88%), ankle (pre: 27.28%; post: 26.62%), back (pre: 18.52%, post: 14.45%) (p-value: 0.022). Following propensity score matching, the results are as follows: knee (pre-suspension: 29.89%; post-suspension: 36.88%), ankle (pre: 27.10%; post: 26.62%), back (pre: 19.06%, post: 14.45%) (p-value: <0.001).

Conclusions:

Our study concluded that among the three most common injuries, the knee was noted to have a statistically significant increase post the COVID-19 NBA suspension. Moreover, there was a significant decrease in the percentage of players who suffered back and ankle injuries [Table: see text][Table: see text]
Poster 395: Racial Disparities in Utilization and Perioperative Metrics in Rotator Cuff Repair in a US Inpatient Database
Authors: Berlinberg Elyse , Schlacter Jamie , Forlenza Enrico , Mirle Vikranth , Gamsarian Vahram , Cole Brian , Verma Nikhil , Chahla Jorge ,   Forsythe Group
Published: August 2023

Objectives:

Previous studies have shown racial disparities in the utilization and perioperative metrics of orthopedic procedures. However, it remains unclear if similar disparities exist in rotator cuff repair (RCR). The purpose of this study was to examine trends in racial disparities between white and black patients with inpatient RCR in the United States (US).

Methods:

Admissions for inpatient RCR in 2008-2012 were queried from the Healthcare Cost and Utilization Project National Inpatient Sample. The primary outcome was utilization rate, defined by the number of RCRs normalized to the US population per race and year. The effect of race on utilization and perioperative metrics was assessed using a regression model correcting for race and year, with a race- year interaction term to approximate temporal trends in disparities (alpha=0.05, 1-beta>0.90).

Results:

Overall, 20,363 patients were included in the final analysis, 18,602 identifying as white (91%) and 1,761 (8.6%) as black. On average, white patients undergoing RCR were older (white median=67 [IQR=58-75] years; black median=60 [IQR=52-68] years, P<0.0001) and more likely on Medicare (white: 59%; black: 44%, P<0.0001). Black race was associated with a 6.6/1,000,000 lower utilization rate compared to white race (P<0.0001). Although the utilization gap narrowed over time, this trend was not significant (Ptrend=0.06). Black patients were 4% less likely to be discharged to a facility (P< 0.0001, Ptrend=0.07) and had a 0.23-day longer average length of stay (P=0.047, Ptrend=0.81). When correcting for baseline age and comorbidities, postoperative complications were not significantly different between white and black patients (beta=-2.4%, 95%CI=-13.0%-+8.3%, P=0.60).

Conclusions:

There is a discrepancy in inpatient RCR utilization between white and black patients. Although this disparity appears to be decreasing over time, this trend was not significant. Further studies are warranted to understand causal factors for these differences, that may serve as targets for future public health interventions. [Table: see text]
The Death of White Sociology and the Academic Awakening of a Ghetto Jew
Authors: Zwerman Gilda
Published: August 2023

Commemorating the 50th anniversary of Joyce Ladner’s ground-breaking text, this essay traverses the border between book review and autobiography. The narrative, written in the first person, begins in Brownsville, Brooklyn in the mid-1960s. The author is a third generation Eastern European Jew who was nurtured by Black activist elders and became a white beneficiary of the educational opportunities created by the civil rights and Black power movements. Her undergraduate path was paved with classics in Black Studies, critical theory and Marxism. But it was Ladner’s seminal text that catapulted her into pursuit of an academic career in sociology. Its opening salvo - that the history of all hitherto American mainstream sociology has been the history of White sociology -held the promise that the color curtain was about to fall and that this profession was about to become an exciting place. The anticipated excitement derived partly from the book’s revelations of the hidden spurious claims underlying the discipline, its scathing criticism of research methods rooted in unproven and racist theories of human nature, and damaging distortions of Black life masquerading as “scientific sociology.” But Ladner’s volume reaches beyond critique: it illuminates the rich history of Black scholarship so long ignored by the discipline’s white gate-keepers; it offers a vision of engaged research conducted by Black scholars and their allies that would begin to remedy the damage, erase the distortions, and fortify the current generation of Black scholars against the tribulations they face in the profession. In doing so the text gives life to the project of creating a distinctive Black sociology.
The Impact and Influence of Hospital Clowns on Hospitalized Children Undergoing Painful Procedures: A Mixed Methods Study
Authors: Kristensen Helle Nygaard , Laugesen Britt , Stinson Jennifer , Haslund-Thomsen Helle
Published: August 2023

Hospital clowns are widely used in pediatric settings. However, the field of pain and pain experience in children is complex and multifaceted. Therefore, the aim of this study was to expand knowledge on the impact and influence of hospital clowns on 4 to 15-year-old children’s experiences of managing painful procedures and conditions. A convergent mixed method study was conducted integrating findings from three individual studies: a prospective non-blinded study and two focused ethnographic studies. The findings illuminated a child—clown interaction characterized by a close relationship evolving during a continuous, mutually focused attention, conceptualized as WE. This WE represent a responsive interaction between child and clown, which supported the child during the procedures, and generated three integrated findings: an age-differentiated approach; understanding the child’s condition; and previous experiences as a part of the child’s history. The WE approach strengthened the child’s competences and ability to manage during painful procedures.
Incorporating Health Policy and Advocacy Curricula Into Undergraduate Medical Education in the United States
Authors: Krishnamurthy Sudarshan , Soltany Kevin Alexander , Montez Kimberly
Published: August 2023

Physicians serve as crucial advocates for their patients. Undergraduate medical education (UME) must move beyond the biomedical model, built upon the perception that health is defined purely in the absence of illness, to also incorporate population health through health policy, advocacy, and community engagement to account for structural and social determinants of health. Currently, the US guidelines for UME lack structured training in health policy or advocacy, leaving trainees ill-equipped to assume their role as physician–advocates or to engage with communities. There is an undeniable need to educate future physicians on legislative advocacy toward improving the social determinants of health through the creation of evidence-based health policy, in addition to training in effective techniques to engage in partnership with the communities in which physicians serve. The authors of this article also present curricular case studies around two programs at their institution that could be used to implement similar programs at other US medical schools.
Unleashing Entrepreneurial Opportunities and Education: Impact of an Innovation Design Lab
Authors: Moore Stephen , Breece Dena D.
Published: August 2023

This article highlights the development of a university-led, community-based, experiential learning and rural entrepreneurship Innovation Design Lab Farm (Demo Farm) for underserved students and a minority population community. The purpose of this research is to expand upon existing rural entrepreneurship literature by examining the educational effects on institutions, students, and the community while forming a collaborative partnership designed for sharing social and environmental concerns that impact rural farmers (agriculturists) and the community. We propose that this is an inspirational look at one community’s efforts to improve economic development and education in an underserved/minority agricultural region. Based on experiential learning theory, we examine the research question of what the anticipated implications of a demo farm on its stakeholders are. First, we explore the theory of experiential learning and the changing world of education, training, and teaching in rural agriculture. Next, we theorize how experiential agricultural entrepreneurship education is anticipated to positively develop institutions, students, and community participants in one minority rural area. With minimal prior research on experiential learning and innovation design lab rural entrepreneurship, this study adds insight for academic researchers and stakeholders like universities, students, and practitioners (rural farmers/entrepreneurs). Finally, future research is discussed.
Pediatric Knee Arthroscopy: The Basics of Pediatric Knee Arthroscopy from a Collection of Pediatric Sports Medicine Experts
Authors: Kirby Julia , Johnson Benjamin , Millewski Matt , Shea Kevin , Beck Jennifer , Wilson Philip L. , Schmitz Matthew , Milbrandt Todd , Edmonds Eric , Pace Lee , Vandenberg Curt , Tompkins Marc , Gamble James , Yen Yi-Meng , Ganley Ted , Ellis Henry B.
Published: August 2023

Background/Objective:

To share technical pearls of a basic knee arthroscopy in a pediatric patient by presenting tips and tricks used by experienced pediatric arthroscopists.

Indications:

Knee arthroscopy is a common procedure performed by most orthopedic surgeons. However, technical considerations and equipment should be considered before performing this procedure in a pediatric patient. This video provides information on indications, equipment, and patient positioning, as well as outlining a systematic approach to diagnostic arthroscopy and pertinent pediatric anatomy.

Discussion/Conclusion:

This video provides an excellent overview as well as specific pathology-dependent considerations for the inexperienced orthopedic surgeon, or the orthopedic surgeon who rarely performs knee arthroscopy.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Medicines for the People, not the Financial Markets
Authors: Ringger Beat
Published: August 2023

Drug company marketing scandals have often made headlines. However, in recent years, a raft of new pharmaceutical industry transgressions has created crises for health care systems of high-income countries as well as poorer nations. Prices of life-saving drugs are soaring; supply shortfalls of essential medications have become common; development of new antibiotics against resistant organisms is lagging; and inequalities in access to medicines are widening. Policymakers must find new solutions to protect health systems and health.
Lyme borreliosis diagnosis: state of the art of improvements and innovations
Authors: Guérin Mickaël , Shawky Marc , Zedan Ahed , Octave Stéphane , Avalle Bérangère , Maffucci Irene , Padiolleau-Lefèvre Séverine
Published: August 2023

With almost 700 000 estimated cases each year in the United States and Europe, Lyme borreliosis (LB), also called Lyme disease, is the most common tick-borne illness in the world. Transmitted by ticks of the genusIxodesand caused by bacteriaBorrelia burgdorferisensu lato, LB occurs with various symptoms, such as erythema migrans, which is characteristic, whereas others involve blurred clinical features such as fatigue, headaches, arthralgia, and myalgia. The diagnosis of Lyme borreliosis, based on a standard two-tiered serology, is the subject of many debates and controversies, since it relies on an indirect approach which suffers from a low sensitivity depending on the stage of the disease. Above all, early detection of the disease raises some issues. Inappropriate diagnosis of Lyme borreliosis leads to therapeutic wandering, inducing potential chronic infection with a strong antibody response that fails to clear the infection. Early and proper detection of Lyme disease is essential to propose an adequate treatment to patients and avoid the persistence of the pathogen. This review presents the available tests, with an emphasis on the improvements of the current diagnosis, the innovative methods and ideas which, ultimately, will allow more precise detection of LB.
Evaluation of altered starch mutants and identification of candidate genes responsible for starch variation in wheat
Authors: Irshad Ahsan , Guo Huijun , Xiong Hongchun , Xie Yongdun , Jin Hua , Gu Jiayu , Wang Chaojie , Yu Liqun , Wen Xianghui , Zhao Shirong , Liu Luxiang
Published: August 2023

Background

Induction of mutation through chemical mutagenesis is a novel approach for preparing diverse germplasm. Introduction of functional alleles in the starch biosynthetic genes help in the improvement of the quality and yield of cereals.

Results

In the present study, a set of 350 stable mutant lines were used to evaluate dynamic variation of the total starch contents. A megazyme kits were used for measuring the total starch content, resistant starch, amylose, and amylopectin content. Analysis of variance showed significant variation (p < 0.05) in starch content within the population. Furthermore, two high starch mutants (JE0173 and JE0218) and two low starch mutants (JE0089 and JE0418) were selected for studying different traits. A multiple comparison test showed that significant variation in all physiological and morphological traits, with respect to the parent variety (J411) in 2019–2020 and 2020–2021. The quantitative expression of starch metabolic genes revealed that eleven genes of JE0173 and twelve genes of JE0218 had consistent expression in high starch mutant lines. Similarly, in low starch mutant lines, eleven genes of JE0089 and thirteen genes of JE0418 had consistent expression in all stages of seed development. An additional two candidate genes showed over-expression (PHO1, PUL) in the high starch mutant lines, indicating that other starch metabolic genes may also contribute to the starch biosynthesis. The overexpression of SSII, SSIII and SBEI in JE0173 may be due to presence of missense mutations in these genes and SSI also showed overexpression which may be due to 3-primer_UTR variant. These mutations can affect the other starch related genes and help to increase the starch content in this mutant line (JE0173).

Conclusions

This study screened a large scale of mutant population and identified mutants, could provide useful genetic resources for the study of starch biosynthesis and genetic improvement of wheat in the future. Further study will help to understand new genes which are responsible for the fluctuation of total starch.
‘Walking epidural’: comparison of the analgesic efficacy of levobupivacaine 0.0625% + fentanyl 2mcg/mL versus ropivacaine 0.075% + fentanyl 2mcg/mL
Authors: Mingote Álvaro , Zamora Moreno Eloísa , García Díaz Andrés , Chiara Graciani Guillermo , Elbal Sánchez Carlos , Guadalix Sánchez Cristina , Gutiérrez Martínez Diego , García - Fernández Javier , Fornet Ruiz Inocencia
Published: August 2023

Introduction

Epidural infusion with low local anesthetic concentrations with opiates decrease the severity of the motor blockade associated. The present study aims to compare the analgesic efficacy and the motor blockade between two local anesthetic epidural infusions: levobupivacaine 0.0625% + fentanyl 2mcg/mL versus ropivacaine 0.075% + fentanyl 2mcg/mL.

Materials and methods

In a single-blind prospective randomized study, 60 laboring parturient had continuous epidural analgesia as follows: 30 of them received levobupivacaine 0.0625% + fentanyl 2mcg/mL and 30 of them received ropivacaine 0.075% + fentanyl 2mcg/mL and rates of infusion were adjusted to the height. Analgesic, motor blockade and satisfaction records were collected as well as maternal and neonate adverse events.

Results

After 2 h of the catheter placement, patients who received levobupivacaine showed a mean VAS of 3.2 [1.8–4.6] versus 1.8 [1.2–2.5] (p = 0.05) in patients who received ropivacaine. In addition, patients who received levobupivacaine showed a punctuation in Bromage scale of 0.0 [0.0–1.0] versus 0.0 [0.0–0.0] (p = 0.04) in patients who received ropivacaine. Finally, the parturient who received levobupivacaine scored a mean satisfaction index of 8.1 [7.3–8.9] versus 9.3 [8.7–9.8] (p = 0.02) in those who received ropivacaine. We did not register maternal nor neonate adverse events.

Conclusion

Both infusions (levobupivacaine 0.0625% + fentanyl 2mcg/mL and ropivacaine 0.075% + fentanyl 2mcg/mL) are effective for labor analgesia. However, ropivacaine would present a better pharmacodynamic profile with less motor blockade and decreased need for analgesic rescue hence improving patient’s satisfaction.
Ultrasound-guided scalp nerve block in anesthesia of children receiving cranial suture reconstruction
Authors: Zou Tianxiao , Yu Shenghua , Ding Guili , Wei Rong
Published: August 2023

Objective

Analgesia is very important for children with craniosynostosis who are undergoing cranial suture reconstruction. This study investigated the effectiveness and safety of an analgesic technique based on scalp nerve block combined with general anesthesia versus general anesthesia alone.

Methods

This was a single-center, prospective, randomized, controlled study. A total of 60 children aged 6-24 months who underwent cranial suture reconstruction were randomly divided into two groups: Group A (general anesthesia combined with scalp nerve block) and Group N (general anesthesia). The hemodynamics were recorded preoperatively, at 5 min after incision and at 1, 6 and 12 h after surgery; the pain was scored at 1, 6 and 12 h after surgery, and blood glucose was detected at 1 h after surgery.

Results

The mean arterial pressure and heart rate at 5 min after incision and 1 h after surgery in Group N were higher than those in Group A; the blood glucose and FLACC score in Group N were higher than those in Group A; and the number of postoperative analgesic pump presses were also significantly increased in Group N.

Conclusion

Preoperative scalp nerve block can reduce hemodynamic fluctuation and postoperative pain in children undergoing cranial suture reconstruction for craniosynostosis. Thus, it can be safely and effectively applied in the anesthesia of these children.
Early Vascular Ageing in adolescents with migraine with aura: a community-based study
Authors: Bernar Benoît , Gande Nina , Stock Anna Katharina , Staudt Anna , Pechlaner Raimund , Hochmayr Christoph , Kaltseis Katharina , Winder Bernhard , Kiechl Sophia Julia J. , Broessner Gregor , Geiger Ralf , Kiechl Stefan ,   Early Vascular Ageing (EVA) Tyrol Study Group, Anliker Markus , Asare Mandy , Bock-Bartl Manuela , Bohl Maximilian , Griesmacher Andrea , Klingenschmid Julia , Kothmayer Martina , Marxer Julia , Pircher Maximilian , Reiter Carmen , Schreiner Christina , Kiechl-Kohlendorfer Ursula , Knoflach Michael
Published: August 2023

Background

Migraine with aura is associated with an increased risk of cardiovascular disease, yet the pathophysiology is unknown. Suggested underlying mechanisms of aura formation point into the direction of an abnormal vasoreactivity that also extends to the extracranial vasculature.

Methods

In the Early Vascular Ageing Tyrol study, a community-based non-randomized controlled trial conducted in 45 schools and companies in Tyrol (Austria) and South-Tyrol (Italy) between May 2015 and September 2018 aiming to increase cardiovascular health in adolescents, headache syndromes were classified according to the International Classification of Headache Disorders in a face-to-face interview. Carotid-femoral pulse-wave-velocity was measured by applanation tonometry and carotid intima-media-thickness by high-resolution ultrasound of the distal common carotid arteries. Differences in pulse-wave-velocity and carotid intima-media-thickness in youngsters with migraine with aura were compared respectively to those without headache and with other headaches by multivariable linear regression analysis.

Results

Of the 2102 study participants 1589 were aged 14 to 19 (mean 16.8) years and had complete data. 43 (2.7%) reported migraine with aura and 737 (46.4%) other headaches. Mean pulse-wave-velocity was 6.17 m/s (± 0.85) for migraine with aura, 6.06 m/s (± 0.82) for all other headaches and 6.15 (0.95) m/s for participants without headaches. Carotid intima-media-thickness was 411.3 µm (± 43.5) for migraine with aura, 410.9 µm (± 46.0) for all other headaches and 421.6 µm (± 48.4) for participants without headaches. In multivariable linear regression analysis, we found no differences in carotid-femoral pulse-wave-velocity or carotid intima-media-thickness in young subjects with migraine with aura, all other headaches, or no headaches.

Conclusions

In line with previous large-scale studies in adults, we could not demonstrate relevant associations of migraine with aura with markers of arterial stiffness or subclinical atherosclerosis making early vascular ageing an unlikely pathophysiological link between migraine with aura and cardiovascular diseases.

Trial registration

First registered on ClinicalTrials.gov 29/04/2019 (NCT03929692).
Incidence of hospital-acquired acute kidney injury and trajectories of glomerular filtration rate in older adults
Authors: Ebert Natalie , Schneider Alice , Huscher Doerte , Mielke Nina , Balabanova Yanina , Brobert Gunnar , Lakenbrink Carla , Kuhlmann Martin , Fietz Anne-Katrin , van der Giet Markus , Wenning Volker , Schaeffner Elke
Published: August 2023

Background

In older adults, epidemiological data on incidence rates (IR) of hospital-acquired acute kidney injury (AKI) are scarce. Also, little is known about trajectories of kidney function before hospitalization with AKI.

Methods

We used data from biennial face-to-face study visits from the prospective Berlin Initiative Study (BIS) including community-dwelling participants aged 70+ with repeat estimated glomerular filtration rate (eGFR) based on serum creatinine and cystatin C. Primary outcome was first incident of hospital-acquired AKI assessed through linked insurance claims data. In a nested case-control study, kidney function decline prior to hospitalization with and without AKI was investigated using eGFR trajectories estimated with mixed-effects models adjusted for traditional cardiovascular comorbidities.

Results

Out of 2020 study participants (52.9% women; mean age 80.4 years) without prior AKI, 383 developed a first incident AKI, 1518 were hospitalized without AKI, and 119 were never hospitalized during a median follow-up of 8.8 years. IR per 1000 person years for hospital-acquired AKI was 26.8 (95% confidence interval (CI): 24.1–29.6); higher for men than women (33.9 (29.5–38.7) vs. 21.2 (18.1–24.6)). IR (CI) were lowest for persons aged 70–75 (13.1; 10.0-16.8) and highest for ≥ 90 years (54.6; 40.0-72.9). eGFR trajectories declined more steeply in men and women with AKI compared to men and women without AKI years before hospitalization. These differences in eGFR trajectories remained after adjustment for traditional comorbidities.

Conclusion

AKI is a frequent in-hospital complication in individuals aged 70 + showing a striking increase of IR with age. eGFR decline was steeper in elderly patients with AKI compared to elderly patients without AKI years prior to hospitalization emphasising the need for long-term kidney function monitoring pre-admission to improve risk stratification.
Validation and comparison of the stroke prognosis instrument (SPI-II) and the essen stroke risk score (ESRS) in predicting stroke recurrence in Asian population
Authors: Kongwatcharapong Junporn , Sornkhamphan Akaporn , Kaveeta Chitapa , Nathisuwan Surakit
Published: August 2023

Background

Currently, there are limited data on the accuracy of available risk scores to predict stroke recurrence in the Asian population.

Method

A single-center, retrospective cohort study was conducted among patients with acute ischemic stroke during January 2014 - December 2018. Longitudinal data with three years of follow-up among these patients were collected and validated through both electronic and manual chart review. The area under the receiver-operating curve (AUROC) method or C-statistic and calibration plot were used to evaluate and compare the Stroke Prognosis Instrument II (SPI-II) and the Essen Stroke Risk Score (ESRS) in predicting the long-term risk of recurrent ischemic stroke. The predictive performances of the two scores were compared using DeLong’s method.

Results

The study cohort consisted of 543 patients, including 181 and 362 patients with and without recurrent events. There were no significant differences in mean age and gender between the two groups. Recurrence cases tended to have significant more risk factors compared to those without events. Among cases with recurrent events, 134 (74.03%) and 65.74% (119) cases were classified as high-risk based on SPI-II and ESRS, respectively. The AUROC curve of the SPI-II and ESRS score was 0.646 (95% CI, 0.594–0.697) and 0.614 (95%CI, 0.563–0.665), respectively (p = 0.394). Based on the calibration plot, the SPI-II and ESRS scores showed similar moderate predictive performance on recurrence stroke with a C statistic (95% CI) of 0.655 (95% CI: 0.603–0.707) and 0.631 (95% CI 0.579–0.684), respectively.

Conclusion

Both ESRS and SPI-II scores had moderate predictive performance in Thai population.
Risk factors for the development of postpartum depression in individuals who screened positive for antenatal depression
Authors: Yu Jingjing , Zhang Zhiyin , Deng Yuanyuan , Zhang Lijun , He Chuncao , Wu Yinyin , Xu Xianrong , Yang Jun
Published: August 2023

Background

Women with antenatal depression often have a higher risk of developing postpartum depression (PPD) after delivery. A number of factors associated with the PDD in those previously reporting antenatal depression have been suggested, but further research is needed. This study aimed to investigate factors associated with developing subsequent postnatal depression in women who had screened positive for antenatal depression.

Methods

This study was carried out in Hangzhou women’s Hospital. 578 women who experienced antenatal depression from this cohort were enrolled in this study. The sociodemographic and clinical characteristics of the participants were collected and tabulated against the incidence of postnatal depression. Binary logistic regression was used to estimate the effects of the principal underlying variables. The Chinese-version Edinburgh Postnatal Depression Scale (EPDS) was used to screen for PPD. Antenatal screening for depression was conducted at 28–34 weeks during pregnancy and postpartum depressive symptoms were assessed at 6 weeks after childbirth in the women. Path Analysis of Structural Equation Model (SEM) was employed to explore the direct, indirect, and total effects of risk factors of PPD.

Results

57.6% (n = 333) of the participants subsequently developed PPD in our study. The results of the logistic analysis indicated that ages ≤ 35 years old (OR = 1.852; 95%CI: 1.002–3.423), non-one-child families (OR = 1.518; 95%CI: 1.047-2.200), and rare care from partner during pregnancy (OR = 2.801; 95%CI: 1.038–7.562), the antenatal EPDS score (OR = 1.128; 95%CI: 1.052–1.209), pyrexia during pregnancy (OR = 2.43; 95%CI: 1.358–4.345), fairly good (OR = 1.836; 95%CI: 1.009–3.340), fairly bad (OR = 3.919; 95%CI:2.072–7.414) and very bad postpartum sleep quality (OR = 9.18; 95%CI: 2.335–36.241) were associated with increased risk of PPD (compared to very good postpartum sleep quality). In path analysis model, antenatal EPDS score (standardized total β = 0.173) and pyrexia during pregnancy (standardized total β = 0.132) had both direct and indirect effects (the impact on outcome variables needs to be determined through other variables) on PPD. Sleep quality after delivery (standardized β = 0.226) and one-child family (standardized β = 0.088) had direct effects only on PPD.

Conclusion

The results from our study indicated that more than 50% of the women who experienced antepartum depression would subsequently develop PPD. Depressive symptoms and pyrexia during pregnancy increase PPD scores, and these effects were in part mediated via poor sleep quality during the postpartum period.
Stressors in university life and anxiety symptoms among international students: a sequential mediation model
Authors: Wang Yue , Wang Xiaobin , Wang Xuehang , Guo Xiaoxi , Yuan Lulu , Gao Yuqin , Pan Bochen
Published: August 2023

Background

Anxiety is a common mental health problem among university students, and identification of its risk or associated factors and revelation of the underlying mechanism will be useful for making proper intervention strategies. The aim of our study is to test the sequential mediation of self-efficacy and perceived stress in the association between stressors in university life and anxiety symptoms.

Methods

A cross-sectional study design was adopted and a sample of 512 international students from a medical university of China completed the survey with measurements of stressors in university life, self-efficacy, perceived stress and anxiety symptoms.

Results

We found that 28.71% of the international students had anxiety symptoms, and stressors in university life were positively associated with anxiety symptoms (β = 0.23, t = 5.83, p < 0.01). Moreover, sequential mediating role of self-efficacy and perceived stress in the association between the stressors and anxiety symptoms was revealed.

Conclusions

Our study provided a new perspective on how to maintain the mental health, which suggested that self-efficacy improvement and stress reduction strategies should be incorporated in the training programs to support students.
A three-dimensional measurement study of fracture displacement in Garden I femoral neck fracture: a retrospective study
Authors: Wang Ying , Ma Jianxiong , Bai Haohao , Zhan Hongqi , Lu Bin , Sun Lei , Jin Hongzhen , Zhao Xingwen , Wu Yanfei , Chen Jiahui , Ma Xinlong
Published: August 2023

Background

Garden I femoral neck fractures are nondisplaced femoral neck fractures. Nonoperative treatment and in situ fixation are the preferred treatments. However, the postoperative outcome is not satisfactory and the incidence of complications remains high, which raises doubts about the accuracy of the diagnosis of nondisplaced Garden I fractures. Recently, three-dimensional (3D) reconstruction has been reported as a mature technology for reconstructing the bone structure of patients. We further extended this technique in the measurement of the fracture spatial displacement to verify the accuracy of Garden I femoral neck fractures.

Methods

This was a retrospective study of patients with Garden I femoral neck fractures from January 2013 to December 2018 at our institution, who were included according to specified criteria. A bilateral proximal femur model of each patient was established based on computed tomography (CT) data. The displacement of the deepest portion of the femoral head fovea, the displacement of the center of the femoral head and the rotation of the femoral head were measured in the bilateral model.

Results

A total of 102 patients diagnosed with Garden I fractures were included in this study. The cohort included 32 men and 70 women, with an average age of 55.88 ± 15.32 years. In these patients, the average displacement of the deepest portion of the femoral head fovea was 16.43 ± 7.69 mm. The minimum and maximum displacement was 3.58 and 44.32 mm, respectively. The average displacement of the center of the femoral head was 10.39 ± 5.47 mm and ranged from 2.16 to 34.42 mm. The rotational angle was 23.81 ± 10.15 ° and ranged from 3.71 ° to 61.19 °.

Conclusions

Garden I fractures have large spatial displacement and cannot be considered incomplete or nondisplaced fractures. Therefore, we suggest that anatomical reduction should be considered during treatment.
Encouraging outpatients in an acute hospital for the relief of cancer-related pain: a qualitative study
Authors: Hinata Miwa , Miyazaki Kikuko , Nakayama Takeo , Tokunaga Megumi , Watanabe Toru , Nawata Shuichi
Published: August 2023

Purpose

To identify the processes of cancer-related pain relief and exacerbation faced by outpatients in an acute care hospital and to examine the support needed for outpatient pain control.

Methods

We conducted semi-structured, in-depth interviews with patients from the outpatient department of Showa University Northern Yokohama Hospital in Kanagawa Prefecture, Japan. Participants were recruited by purposive sampling. From the recorded data, verbatim transcripts were made and used as textual data for analysis by consistent comparative method.

Results

Between April 2018 and April 2022, interviews were conducted with 30 participants. Analysis of the verbatim transcripts generated 13 categories from 27 concepts. Category relationships were examined, and a conceptual framework was developed. Outpatients went from being in a state of hesitation towards consultation with medical professionals to receiving individual consistent follow-ups by medical professionals in the hospital and community pharmacies, which led to patient teleconsultations when their physical condition changed, leading to an improvement of pain.

Conclusion

The process of relief and exacerbation of cancer-related pain experienced by outpatients in the acute care hospital reveals that the provision of consistent follow-up through remote or in-person interviews has an important role to play in pain management, as it helps to build relationships between patients and medical professionals. Alternatively, when outpatients exhibited endurance, their pain worsened, and they fell into a negative cycle of poor pain control.
Colonic stem cells from normal tissues adjacent to tumor drive inflammation and fibrosis in colorectal cancer
Authors: Zhao Yuanyuan , Guo Mengmeng , Zhao Fuqiang , Liu Qian , Wang Xia
Published: August 2023

Background

In colorectal cancer (CRC), the normal tissue adjacent to tumor (NAT) communicates actively with the tumor. Adult stem cells from the colon play a crucial role in the development of the colonic epithelium. In the tumor microenvironment, however, it is unclear what changes have occurred in colonic stem cells derived from NAT.

Methods

Using an intestinal stem cell culture system, we cultured colonic cells from NAT and paired CRC tissue, as well as cells from healthy tissue (HLT). Clonogenicity and differentiation ability were used to compare the function of clones from NAT, HLT and CRC tissues. RNA high-throughput sequencing of these clones was used to identify the molecular characteristics of NAT-derived clones. Coculture of clones from HLT and CRC was used to assess molecular changes.

Results

We found that the morphological characteristics, clonogenic ability, and differentiation ability of NAT-derived clones were consistent with those of HLT-derived clones. However, NAT-derived clones changed at the molecular level. A number of genes were specifically activated in NAT. NAT-derived clones enriched pathways related to inflammation and fibrosis, including epithelial mesenchymal transition (EMT) pathway and TGF-beta signaling pathway. Our results also confirmed that NAT-derived clones could recruit fibroblasts in mice. In addition, HLT-derived clones showed high expression of FOSB when cocultured with tumor cells.

Conclusions

Our results demonstrate that colonic stem cells from NAT in the tumor microenvironment undergo changes at the molecular level, and these molecular characteristics can be maintained in vitro, which can induce fibrosis and an inflammatory response.
Static mechanical analysis of the vertebral body after modified anterior cervical discectomy and fusion (partial vertebral osteotomy): a finite element model
Authors: Xue Huo-huo , Tang Dian , Zhao Wen-han , Chen Liang , Liao Zhong , Xue Jing-lai
Published: August 2023

Background

Modified anterior cervical discectomy and fusion (Mod ACDF) can effectively address ossification of the posterior longitudinal ligament (OPLL), which is difficult to remove directly from the posterior edge of the vertebral body, with considerably lesser damage as compared to anterior cervical corpectomy and fusion (ACCF). We compared the static mechanics of different anterior approaches by using an ideal finite element model.

Methods

A complete finite element model was established and classified into the following three surgical models according to different model cutting operations: ACDF, ACCF, and Mod ACDF. Three different bone volume situations (normal bone mineral density, osteopenia, and osteoporosis) were simulated. After fixing the lower surface of C5 or C6, a load was applied to the upper surface of C4, and the stress distribution and displacement of the upper surface of C5 or C6 were observed and the related values were recorded.

Results

The average Von Mises Stress and displacement levels of Mod ACDF were between those of ACDF and ACCF; with the peak Von Mises Stress occurring on the posterior side of the vertebral body (Points 1–4). The change in Von Mises Stress of the vertebral body is not significant during bone loss. However, the degree of displacement of the vertebral body surface and risk of vertebral collapse are increased (100 N: 13.91 vs. 19.47 vs. 21.62 μm; 150 N: 19.60 vs. 29.30 vs. 31.64 μm; 200 N: 28.53 vs. 38.65 vs. 44.83 μm).

Conclusions

The static biomechanical effects caused by Mod ACDF are intermediate between ACDF and ACCF, and the risk of vertebral body collapse is lower than that by ACCF. Therefore, Mod ACDF may be an effective solution when targeting OPLL with poorly positioned posterior vertebral body edges.
Effective methods for bulk RNA-seq deconvolution using scnRNA-seq transcriptomes
Authors: Cobos Francisco Avila , Panah Mohammad Javad Najaf , Epps Jessica , Long Xiaochen , Man Tsz-Kwong , Chiu Hua-Sheng , Chomsky Elad , Kiner Evgeny , Krueger Michael J. , di Bernardo Diego , Voloch Luis , Molenaar Jan , van Hooff Sander R. , Westermann Frank , Jansky Selina , Redell Michele L. , Mestdagh Pieter , Sumazin Pavel
Published: August 2023

Background

RNA profiling technologies at single-cell resolutions, including single-cell and single-nuclei RNA sequencing (scRNA-seq and snRNA-seq, scnRNA-seq for short), can help characterize the composition of tissues and reveal cells that influence key functions in both healthy and disease tissues. However, the use of these technologies is operationally challenging because of high costs and stringent sample-collection requirements. Computational deconvolution methods that infer the composition of bulk-profiled samples using scnRNA-seq-characterized cell types can broaden scnRNA-seq applications, but their effectiveness remains controversial.

Results

We produced the first systematic evaluation of deconvolution methods on datasets with either known or scnRNA-seq-estimated compositions. Our analyses revealed biases that are common to scnRNA-seq 10X Genomics assays and illustrated the importance of accurate and properly controlled data preprocessing and method selection and optimization. Moreover, our results suggested that concurrent RNA-seq and scnRNA-seq profiles can help improve the accuracy of both scnRNA-seq preprocessing and the deconvolution methods that employ them. Indeed, our proposed method, Single-cell RNA Quantity Informed Deconvolution (SQUID), which combines RNA-seq transformation and dampened weighted least-squares deconvolution approaches, consistently outperformed other methods in predicting the composition of cell mixtures and tissue samples.

Conclusions

We showed that analysis of concurrent RNA-seq and scnRNA-seq profiles with SQUID can produce accurate cell-type abundance estimates and that this accuracy improvement was necessary for identifying outcomes-predictive cancer cell subclones in pediatric acute myeloid leukemia and neuroblastoma datasets. These results suggest that deconvolution accuracy improvements are vital to enabling its applications in the life sciences.
Cross-species single-cell transcriptomic analysis of animal gastric antrum reveals intense porcine mucosal immunity
Authors: Wang Xiaodan , Hong Fan , Li Haonan , Wang Yalong , Zhang Mengxian , Lin Shibo , Liang Hui , Zhou Hongwen , Liu Yuan , Chen Ye-Guang
Published: August 2023

As an important part of the stomach, gastric antrum secretes gastrin which can regulate acid secretion and gastric emptying. Although most cell types in the gastric antrum are identified, the comparison of cell composition and gene expression in the gastric antrum among different species are not explored. In this study, we collected antrum epithelial tissues from human, pig, rat and mouse for scRNA-seq and compared cell types and gene expression among species. In pig antral epithelium, we identified a novel cell cluster, which is marked by high expression of AQP5, F3, CLCA1 and RRAD. We also discovered that the porcine antral epithelium has stronger immune function than the other species. Further analysis revealed that this may be due to the insufficient function of porcine immune cells. Together, our results replenish the information of multiple species of gastric antral epithelium at the single cell level and provide resources for understanding the homeostasis maintenance and regeneration of gastric antrum epithelium.
Multiclass objects detection algorithm using DarkNet-53 and DenseNet for intelligent vehicles
Authors: Yang Lina , Chen Gang , Ci Wenyan
Published: August 2023

Intelligent vehicles should not only be able to detect various obstacles, but also identify their categories so as to take an appropriate protection and intervention. However, the scenarios of object detection are usually complex and changeable, so how to balance the relationship between accuracy and speed is a difficult task of object detection. This paper proposes a multi-object detection algorithm using DarkNet-53 and dense convolution network (DenseNet) to further ensure maximum information flow between layers. Three 8-layer dense blocks are used to replace the last three downsampling layers in DarkNet-53 structure, so that the network can make full use of multi-layer convolution features before prediction. The loss function of coordinate prediction error in YOLOv3 is further improved to improve the detection accuracy. Extensive experiments are conducted on the public KITTI and Pascal VOC datasets, and the results demonstrate that the proposed algorithm has better robustness, and the network model is more suitable for the traffic scene in the real driving environment and has better adaptability to the objects with long distance, small size and partial occlusion.