bluuebunny/crossref_metadata_2025 huggingface dataset:
PS-P14-7: IMPACTS OF CONSTRUCTING AND OPERATING “KARUSHIOH” CERTIFICATION SYSTEM TO PROMOTE DELICIOUS LOW-SALT MEALS ON THE JAPANESE LOW-SALT FOODS MARKET
Authors: Akagawa Eiki , Tanaka Katsuhisa , Takemoto Sayuri , Sato Kaoru , Watanabe Sachie , Watanabe Satomi , Nagao Nobuyuki , Ohtani Misato , Asano Shigehiro , Tatsumi Eisuke , Miyaoto Yoshihiro
Published: January 2023

Objective:

From the viewpoint of preventing and prognosis cardiovascular disease, it was created by National Cerebral and Cardiovascular Center (NCVC) of Japan to create a new concept of low-salt meal that brings out the delicious by using salt lightly under the name of “Karushioh”. As a mechanism for consumers to easily obtain delicious low-salt foods, the “Karushioh” certification system linked to the economic activities of companies, has been promoted by NCVC. Under this system, NCVC examines whether foods meet the certification criteria such as low salt and deliciousness, and permits the labeling of “Karushioh”, which is registered as a trademark for passed foods. Therefore, the purpose of this study was to sort out the current status of this certification and was to verify the spread of “Karushioh” certified foods and their impact on salt reduction.

Design and Methods:

The market size of certified foods was tabulated from the fiscal year 2020 sales performance report submitted by companies that manufactures/sells certified foods in accordance with the trademark license agreement. In addition, the amount of salt reduction associated with the launch of certified foods were estimated from the comparison target products in the “Karushioh” certification examination.

Results:

As an initiative linked to the industry, the market for delicious low-salt foods through the operation of the certification system is expanding, and the market size of the certified foods will exceed 2.1 billion yen in fiscal year 2020, and the number of certifications so far has increased. At the end of 2021, a total of 166 applications were submitted by 52 companies. In addition, the amount of salt reduction in fiscal year 2020 due to the launch of the certified food to the market was estimated to be 51 tons.

Conclusions:

In the several years since the certification system started, it has formed a market of over 2 billion yen, whereas in the market of low-salt foods in Japan, which is estimated to exceed 70 billion yen. With the future development of the certification system, more promotion of salt reduction can be expected.
PS-P14-9: SALT CONTENT IN COMMONLY CONSUMED PROCESSED PACKAGED FOODS AND THEIR CONFORMITY WITH LABEL INFORMATION IN BANGLADESH
Authors: Sobhan Sheikh Mohammad Mahbubus , Mamun Mohammad Abdullah Al , Bahar Nisarga , Sarwar Sneha , Ashraf Md Musharraf , Abedin Md Joynul , Karim Md Rizwanul , Alim Md Abdul , Ahmed Jasimuddin , Shamim Abu Ahmed , Shaheen Nazma , Amin Mohammad Robed , Choudhury Sohel Reza
Published: January 2023

Objective:

Consumption of processed foods is surging in low and middle-income countries and gradually replacing home-cooked meals. Unfortunately, the salt content is usually high in these processed foods which eventually causes hypertension, heart diseases and stroke. As the reduction of overall salt intake serves as a preventive measure for Non-communicable Diseases, so, the present study was undertaken to estimate the content of salt in commonly consumed processed foods in Bangladesh and to assess their conformity with label declaration. Along with salt, total sugar, total fat, saturated fat, trans fat, protein, fiber and energy were also assessed.

Design and Methods:

It was a cross-sectional population-based study. A total of 11 most consumed processed packaged foods were identified from the 8 administrative divisions of Bangladesh through a household survey (n = 480) and a market survey (n = 24) done in 2019. Samples from all the 8 divisions were collected following a list of commonly consumed foods and brands. The foods included for analysis were chips, chanachur, fried peas, pulse, noodles, biscuits, lozenge/lollipop, milk chocolate, chutney, and ice cream. A brand-wise composite sample of each processed food item was prepared by pooling at least 12 samples in the Institute of Nutrition and Food Science. Samples were analyzed by ‘Association of Official Analytical Chemists’ and titrimetric method (IS-1743) method at an accredited lab. The healthiness of the products was evaluated in terms of the Health Star Rating scheme of Australia and the UK traffic light labelling system. Label information was compared with corresponding analytical values and per cent variation was calculated.

Results:

Most of the analyzed foods contained excessive amounts of salt, sugar and saturated fat. Alarmingly, for salt, where WHO labels ‘> 1.5 g/100g’ as ‘High/Excessive’ the products range from 4 g to 0.14 g per 100 g. Among them, 8 out of 11 food items were red marked. None of the brands qualifies for health claims in the star rating scheme and the UK traffic light system due to high content of salt and other critical nutrients. Most of the products misreported the nutrient content on labels.

Conclusions:

For the sake of public health, modification is highly needed in the processing of commonly consumed processed foods to make them healthy and less salt-containing. Study findings strongly advocate the necessity for strict regulations for appropriate user-friendly nutritional labelling. These measures will help in attaining Sustainable Development Goal 3-the health targets.
PS-P15-9: EFFECT OF MINERALOCORTICOID RECEPTOR BLOCKER, ESAXERENONE, ON HOME BLOOD PRESSURE AND CARDIAC HYPERTROPHY IN HYPERTENSIVE PATIENTS WITH LVH (ESES-LVH STUDY)
Authors: Yamamoto Eiichiro , Usuku Hiroki , Sueta Daisuke , Suzuki Satoru , Nakamura Taishi , Matsui Kunihiko , Matsushita Kenichi , Taguchi Takashi , Shiosakai Kazuhito , Sugimoto Kotaro , Tsujita Kenichi
Published: January 2023

Objective:

Cardiac hypertrophy is a prognostic factor in hypertensive patients, and attenuation of the hypertrophy with sustained antihypertensive treatment is important to delay the progression to heart failure. Although most classes of antihypertensive agents have evidence of cardiac hypertrophy regression, there is insufficient evidence for mineralocorticoid receptor blockers (MRB); only one report states that MRB has a more pronounced regressive effect when used in combination with a renin-angiotensin system (RAS) inhibitor. Esaxerenone is a novel selective nonsteroidal MRB which has been recently approved for the treatment of hypertension, to date however, there is little evidence of the effectiveness and safety of esaxerenone in hypertensive patients with cardiac hypertrophy.

The study was aimed to evaluate the effectiveness and safety of esaxerenone in Japanese hypertensive patients with left ventricular hypertrophy (LVH) whose blood pressure (BP) was inadequately controlled with a RAS inhibitor or calcium channel blocker (CCB).

Design and method:

ESES-LVH study (jRCTs071190043) was a multicenter, open-label, interventional study. Main inclusion criteria were hypertensive patients (20 years) with morning and bedtime home BP: 135–159 mmHg systolic BP (SBP) and/or 85–99 mmHg diastolic BP (DBP) taking a RAS inhibitor or CCB, and patients with LVH (diagnosed with echocardiography, ECG, or left ventricular mass index [LVMI]). Over the 24-week study period, the initial dose of esaxerenone was started at 1.25 or 2.5 mg/day, and increased to 5 mg/day at weeks 4 and 8, based on the individual patient's condition. The primary endpoints were change from baseline in morning home BP, and change and %change in LVMI, at the end of treatment (EOT). Secondary endpoints included changes in bedtime home and office BP, proportion of patients achieving target BP, changes in echocardiographic parameters, and safety variables including adverse events, eGFR, and serum potassium levels.

Results:

Baseline characteristics of the 58 enrolled patients were mean age, 64.8 years; male, 70.7%; RAS inhibitor/CCB, 32.8/67.2%; mean morning home SBP/DBP, 142.8/85.0 mmHg; mean LVMI 118.1 g/m2; left ventricular ejection fraction 62.8%; serum potassium level 4.1 mEq/L; and mean eGFRcreat 71.3 mL/min/1.73m2. Mean change from baseline at EOT was -11.5/-4.7 mmHg in the morning home BP, and mean change and % change in LVMI were -9.9 g/m2 and-8.5%, respectively (p < 0.001 each). Detailed effectiveness and safety results will be presented.

Conclusions:

ESES-LVH study will provide the first clinical evidence of not only the antihypertensive and LVH-regressive effects of esaxerenone, but also its safety in Japanese hypertensive patients with cardiac hypertrophy.
PS-P16-4: VALIDATION OF CHO ET AL FORMULA FOR APOLIPOPROTEIN B100 CALCULATION; A POTENTIAL ATHEROSCLEROTIC RISK TOOL IN LIMITED RESOURCES SETTINGS
Authors: Amusat Saheed Oladele
Published: January 2023

Objectives:

Increased atherogenic lipid molecules such as low-density lipoprotein cholesterol (LDL) concentration is associated with increased risk of atherosclerotic, but a substantial risk of cardiovascular disease often remains after LDL and other lipid parameters concentrations have been extensively treated to healthy level. Owning to the lack of assay procedure in the current research geographical area, this study aims to determine the sensitivity and specificity of Apolipoprotein B100 derived from Cho's formula in conjunction with existing routine lipid profile parameters.

Method:

The lipid profile parameters (TC, LDLC, HDLC, Apo B100, TG and non-HDL-C) in the fasting samples of 301 adult patients in the Chemical Pathology Laboratories of the Federal Medical Centre; Birnin Kudu Jigawa State, and Birnin Kebbi, Kebbi State Nigeria. The Apo B100 was calculated using Cho equation (Cho et al., 2012). Receiver Operating Curve (ROC) was employed to determine the sensitivity and reliability of lipid parameters in the assessment of atherosclerotic risk.

Cho^’ s Equation:

ApoB100 = -33.12 + 0.675*LDLc + 11.95*ln(Trig)

Results:

From the table 1, the areas under the curves represent the probability that the lipid assay for a randomly chosen atherosclerotic risk case (sensitivity) will exceed the result for a randomly chosen no risk case (specificity). The asymptotic significance for HDL-C, TC, LDL-C Apo B100 and non-HDL-C were less than 0.05, and AUC greater than 0.7. Furthermore, LDL-C, Apo B100, non-HDL-C, and TC have AUC of 1.00, 0.990, 0.976, and 0.885 respectively. In addition to their high AUC, the specificity of TC, HDL-C, LDL-C Apo B100 and non-HDL-C for ASCVD risk were 74.4, 37.2, 100.0, 94.8 and 88.4 percent respectfully, whereas TG has no significant influence (AUC) on risk of ASCVD. It is worthy to mention that the AUC of HDL-C was statistically significant, but lower than 0.70 (0.429). The serum TC, LDL-C, Apo B100, and non-HDL-C level of greater than 172.1mmg/dl, 106.3 mg/dl, 95.6 mg/dl, and 135.3 mg/dl respectively were associated with a high risk of atherosclerotic as indicated by their specificities and sensitivities.

Conclusion:

It can be concluded that using the TC, LDL-C, Apo B100 and non-HDL-C for atherosclerotic risk estimation guaranteed significant reliability. It can be concluded that Apo B100 derived using Cho formula showed a high sensitivity and specificity in predicting atherosclerotic risk at a serum level of approximately 96 mg/dl. Therefore, Apo B100 derived from Cho formula may be a useful tool in the management of atherosclerotic cardiovascular disease in limited resources settings.
PS-R06-3: A CASE OF CEREBRAL INFARCTION IN AN ELDERLY HYPERTENSIVE PATIENT WITH 24-HOUR STRICT BLOOD PRESSURE CONTROL
Authors: Nishizawa Masafumi , Hoshide Satoshi , Kario Kazuomi
Published: January 2023

Introduction:

In elderly patients, hypertension is a major risk factor of stroke. Therefore, strict blood pressure (BP) control provides most effective for the prevention of stroke incidence. Here, we report the case of stroke occurred under strict BP control in an elderly patient.

Case:

A 80-year-old Japanese women with the treatment of hypertension and dyslipidemia was admitted to our hospital with suddenly vertigo. Before admission, her BP control was controlled, which her ambulatory BP monitoring performed three months prior to admission showed that 24-hour, daytime and nighttime BP were 107/61 mmHg, 112/64 mmHg and 94/53 mmHg, respectively, and diurnal BP variation showed dipper pattern. On admission, her electrocardiography showed sinus rhythm, and her head magnetic resonance imaging showed the bilateral cerebellum infarction, which is the area dominated by posterior inferior cerebellar artery. The D-dimer level was 1.2 μg/ml. Transesophageal echocardiography was performed to search for an embolic source of stroke and revealed a patent foramen ovale (PFO). Leg vein echocardiography showed the thrombus in the bilateral soleus veins. Based on the above results, we diagnosed a paradoxical cerebral embolism caused by deep vein thrombosis of the lower extremities and PFO.

Conclusion:

The patient had achieved strict BP control assessed by ABPM prior to the onset of the stroke and was considered to be at low risk of stroke. Paradoxical cerebral embolism is a common cause of stroke in younger patients, however, physicians should be also noted as a cause of cerebral infarction even in the elderly patients.
PS-R07-2: A DELAYED DIAGNOSED PRIMARY ALDOSTERONISM
Authors: Hu Zhe , Chen Xin
Published: January 2023

A 52-year-old man with a history of hypertension for more than ten years, hypokalemia (2.9 mmol/L lowest) and left adrenal nodule for four years was admitted to our department. Four years ago, he was hospitalized to screen for primary aldosteronism. Measurements of plasma aldosterone concentration (PAC) showed increases, while plasma renin activity (PRA) was in the normal range. Aldosterone-to-renin ratio (ARR) was less than 30 (pg/ml)/(ng/ml.h−1). The saline infusion test (SIT) was performed and showed the post-infusion PAC > 10 ng/dL while the suppression > 50%. Combined with the ARR, negative was considered and medical treatment was chosen. Four years later, his hypertension became resistant to control. He was admitted again. Before then, he was just diagnosed with obstructive sleep apnea syndrome and began using continuous positive airway pressure. However, the result of the ARR and SIT was similar to the previous, though the PRA was slightly lower. Primary aldosteronism was ultimately diagnosed this time. Adrenal venous sample was performed and showed lateralization was left. He received unilateral adrenalectomy. During the following, his blood pressure had significantly improved, and serum potassium and PAC returned to the normal range. In conclusion, in patients suspected of primary aldosteronism clinically, the concomitant condition should take into consideration.
PS-R07-3: BILATERAL ADRENAL TUMORS IN A PATIENT WITH PRIMARY ALDOSTERONISM CONCURRENT WITH CUSHING'S SYNDROME: A CASE REPORT.
Authors: Otomo Yusuke , Irie Junichiro , Miyashita Kazutoshi , Kobayashi Sakiko , Kinouchi Kenichiro , Nakamura Toshifumi , Kubota Yusuke , Nishimura Takeshi , Itoh Hiroshi
Published: January 2023

Background:

Both primary aldosteronism (PA) and Cushing's syndrome (CS) cause hypertension. It is known that PA can be complicated with CS, but cases with both bilateral PA and unilateral CS are rare.

Case presentation:

A 65-year-old male patient was treated on 10 mg of amlodipine and 2 mg of doxazosin for hypertension from 6 years ago and his blood pressure was about 150/90 mm Hg on average. Because he gained 10 kg of weight over the last 6 months, he visited his primary physician. He had moon face and central obesity, and his blood examination showed the high concentrations of adrenal hormones, i.e., plasma aldosterone concentration (PAC) was 180 pg/mL and plasma renin activity (PRA) was 0.9 ng/mL/h (aldosterone-renin ratio (ARR) was 200.2), cortisol was 11.1 mcg/dL and adrenocorticotropic hormone was undetectable. The twenty-four-hour urine test showed that the greater secretion of adrenal hormones, i.e., aldosterone was 21.4 mcg/day, free cortisol was 148.5 mcg/day (sodium was 190 mEq/day). The computed tomography scan showed bilateral adrenal tumors (37 mm on the left and 8 mm on the right, respectively). The captopril challenge test, the furosemide stress test, and the 1 mg and 8 mg dexamethasone suppression tests were conducted, and he was diagnosed with both PA and CS. By adrenal scintigraphy using 131I-adosterol, high accumulation was detected in the left adrenal gland, whereas there was no accumulation in the right adrenal gland. Hence, the tumor of the left adrenal gland was likely a cortisol-secreting adrenocortical tumor. Furthermore, super-selective adrenal venous sampling indicated autonomous aldosterone secretion from bilateral adrenal glands. The patient underwent laparoscopic left adrenalectomy and the hypercortisolism was corrected. He lost 10 kg of weight 1 year after the surgery. PA remained as indicated by the blood test showing that PRA was 1.2 ng/mL/h, PAC was 347 pg/mL (ARR was 289.2). He is treated with 5 mg of esaxerenone, and his blood pressure is 130/70 mmHg on average.

Conclusion:

Adrenal venous sampling was able to determine laterality of PA with coexisting CS.
PS-R07-4: EFFICACY OF DOPPLER ULTRASOUND FOR INVESTIGATING THE CAUSE OF WORSENING RENAL FUNCTION AND HYPERTENSION IN A CASE OF RENOVASCULAR HYPERTENSION
Authors: Morikawa Takashi , Nagatsuji Katsushi , Matsuki Aoi , Kadosawa Keita , Sakata Yuko , Yamazaki Daisuke , Hamada Masahiro , Kitabayashi Chizuko , Konishi Yoshio
Published: January 2023

A 72-year-old man visited our hospital after his blood pressure increased from 130/80 to 170/95 mmHg and systemic edema appeared over the past two months. His renal function also deteriorated, with serum creatinine increasing from 2.0 to 4.7 mg/dL. He had developed hypertension aged 40 years and cerebral infarction aged 66 years, and had smoked from 16 to 55 years old. Upon admission, plasma renin activity was 14.8 ng/mL/h, serum aldosterone was 169.4 pg/mL, and he was under treatment with telmisartan 40 mg/day, bisoprolol 5 mg/day, cilnidipine 20 mg/day, and nifedipine 20 mg/day. Computed tomography showed a calcified lesion at the root of the right renal artery and atrophy of the left kidney. There was no postrenal renal failure. On Doppler ultrasound, the right intrarenal artery had no systolic peak wave and the blood flow waveform rose slowly, suggesting renal artery stenosis. Therefore, we suspected that the cause of worsening renal function and hypertension was the deterioration of his one remaining functional (right) kidney, treatment with angiotensin II receptor blocker, and progression of right renal artery stenosis. As this case met the indication criteria for percutaneous transluminal renal angioplasty (PTRA) (resistant to treatment, exacerbated hypertension, and renal artery stenosis in one kidney), we performed angiography and PTRA despite end-stage renal failure. Angiography revealed > 90% stenosis at the root of the right renal artery, and the patient was diagnosed with renovascular hypertension. Following renal artery stenting, the renal stenosis disappeared, blood pressure decreased to 135/75 mmHg, renal function improved to serum creatinine level 2.2 mg/dL, and the edema disappeared. On renal Doppler ultrasound, the waveform of intrarenal blood flow in the right kidney showed a normal pattern. In this case of renovascular hypertension, renal Doppler ultrasound was useful for investigating the cause of worsening renal function and hypertension that occurred over a period of several months.
Additive or synergistic analgesic effect of metamizole on standard pain treatment at home after arthroscopic shoulder surgery
Authors: Stessel Björn , Lambrechts Mathieu , Evers Stefan , Vanderstappen Cedric , Callebaut Ina , Ory Jean-Paul , Herbots Jeroen , Dreesen Inge , Vaninbroukx Michaël , Van de Velde Marc
Published: January 2023

BACKGROUND

There is growing evidence that the analgesic effect of metamizole is mediated at least partly by central mechanisms, including the endocannabinoid/endovanilloid system. Consequently, metamizole may have additive or even synergistic analgesic effects with paracetamol and nonsteroidal anti-inflammatory drugs (NSAID).

OBJECTIVE

This study aimed to assess if triple therapy with metamizole, ibuprofen and paracetamol (MIP) is superior to double therapy with ibuprofen and paracetamol (i.p.) in treating pain at home after ambulatory arthroscopic shoulder surgery.

DESIGN/SETTING/PATIENTS/INTERVENTION

In this double-blind, controlled, high-volume single centre, superiority trial, 110 patients undergoing elective ambulatory arthroscopic shoulder surgery were randomised to receive either MIP (n = 55) or i.p. (n = 55) orally for 4 days between December 2019 and November 2021. Pain intensity at movement and rest, using a numeric rating scale (NRS), perceived pain relief, use of rescue medication and adverse effects of study medication were recorded at the post-anaesthesia care unit (PACU) and on postoperative day (POD) 1 to 4 and 7. Quality of Recovery (QoR) and satisfaction with study medication were measured at POD 7 with telephone follow-up.

MAIN OUTCOME MEASURE

The primary outcome measure was postoperative pain intensity on movement measured by an 11-point NRS (where 0 = no pain and 10 = worst pain imaginable) on POD 1.

RESULTS

For the primary outcome, superiority of MIP in reducing postoperative pain at movement on POD 1 was not confirmed: mean difference NRS [95% confidence interval (CI), −0.08 (−1.00 to 0.84)]. For pain on movement and at rest, no significant differences were found between groups in the PACU nor on POD 1 to 4 or day 7. Nausea was reported significantly more frequently in the metamizole group (22.6 vs. 58.5; P < 0.001). Other adverse effects of study medication, rescue opioid consumption, perceived pain relief, QoR at POD 7, and overall patient satisfaction were similar in both groups.

CONCLUSION

Clinically, triple oral treatment with metamizole, paracetamol and ibuprofen is not superior to oral paracetamol and ibuprofen in multimodal pain treatment at home after ambulatory arthroscopic shoulder surgery.

TRIAL REGISTRATION

European Union Clinical Trials Register 2019-002801-23 and Clinicaltrials.gov NCT04082728.
Targeting VPS72 inhibits ACTL6A/MYC axis activity in HCC progression
Authors: Liu Furong , Liao Zhibin , Qin Lu , Zhang Ze , Zhang Qiaofeng , Han Shenqi , Zeng Weifeng , Zhang Hongwei , Liu Yachong , Song Jia , Chen Wei , Zhu He , Liang Huifang , Chen Xiaoping , Zhang Bixiang , Zhang Zhanguo
Published: January 2023

Background and Aims:

HCC is a highly heterogeneous disease that is caused largely by genomic copy number variations. Herein, the mechanistic and therapeutically targeted role of vacuolar protein sorting 72 homologue (VPS72), a novel copy number variation cis-driven gained gene identified by genome-wide copy number variation and transcriptome analyses in HCC, is not well understood.

Approach and Results:

First, overexpression of VPS72 enhanced the initiation and progression of HCC in vitro and in vivo. Mechanistically, VPS72 interacted with the oncoproteins MYC and actin-like 6A (ACTL6A) and promoted the formation of the ACTL6A/MYC complex. Furthermore, ACTL6A regulated VPS72 protein stability by weakening the interaction between tripartite motif containing 21 (TRIM21) and VPS72. Thus, the interaction between VPS72 and ACTL6A enhanced the affinity of MYC for its target gene promoters and promoted their transcription, thereby contributing to HCC progression, which was inhibited by adeno-associated virus serotype 8 (AAV8)-mediated short hairpin RNA (shRNA) against VPS72.

Conclusions:

This study reveals the molecular mechanism of ACTL6A/VPS72/MYC in HCC, providing a theoretical basis and therapeutic target for this malignancy.
It Takes Two to Tango: High Rates of Injury and Concussion in Ball Carriers and Tacklers in High School Boys' Rugby
Authors: West Stephen W. , Shill Isla J. , Sick Stacy , Schneider Kathryn J. , WIley James Preston , Hagel Brent E. , Emery Carolyn A. , Black Amanda M.
Published: January 2023

Objective:

To examine injury and concussion rates, mechanisms, locations, and types of injury in Canadian high school male rugby.

Design:

Prospective cohort study.

Setting:

High school male rugby.

Participants:

A total of 429 high school players (2018: n = 225, 2019: n = 256) were recruited from 12 teams in 7 schools in Calgary, Canada.

Interventions:

None.

Main Outcome Measures:

Injury surveillance included baseline questionnaires, weekly exposure, and injury reports. Injuries included those requiring medical attention, resulted in time loss and/or inability to complete a session. Concussion was defined as per the fifth Consensus on Concussion in Sport, and all players with a suspected concussion were referred to a study sport medicine physician.

Results:

A total of 134 injuries were captured, leading to an injury incidence rate (IR) of 57.9/1000 hours [95% confidence intervals (CIs): 45.4-73.8]. Median time loss was 6 days (range: 0-90). Injuries to the head were the most common (40%), followed by shoulder (12%) and ankle (10%). The concussion IR was 22.0/1000 hours (95% CIs: 15.9-30.4), which was the most common injury type (38%), followed by sprain (20%) and strain (15%). Sixty-five percent of injuries occurred in the tackle (ball carrier 35%, tackler 30%) and 76% of concussions (ball carrier 41%, tackler 35%).

Conclusions:

The rate of injury and concussion in Canadian youth high school male rugby is high, with tackle-related injuries and concussions the most common. Given this, there is a critical need for implementation of prevention strategies, in particular targeting concussion and the tackle event (eg, neuromuscular, tackle training, and law changes).
Frailty Screening in Geriatric Trauma: A Pilot Feasibility Study
Authors: Keiser Megan , Buterakos Roxanne , Gillespie Samantha , Musil Stephanie , Herek Jessica S. , Sachwani-Daswani Gul
Published: January 2023

Background:

Frailty in older adult trauma patients is associated with increased complications and worsened outcomes. Frailty screening can help guide care. Yet, trauma center assessment of frailty is relatively new, can be challenging to implement, and is not yet standard practice.

Objectives:

The purpose of this pilot feasibility study is to assess the impact of implementing frailty screening for older adult trauma patients and to evaluate the effect of frailty screening on palliative care consultation, inhospital complications, hospital length of stay, and discharge disposition.

Methods:

We conducted a 3-month (July 2019 to September 2019) prospective observational pilot feasibility study of geriatric trauma patients 65 years and older presenting to a Level I trauma center. The Trauma-Specific Frailty Index score was completed within 24 hr of patient admission. Inferential statistics were used to assess the relationships.

Results:

Fifty subjects were included. Between frail and nonfrail patient groups, there was no significant correlation between mean Trauma-Specific Frailty Index score and palliative care consultation, χ2
(1,

N

=50) = 2.32, p = .149; inpatient complications, χ2
(1,

N

=50) = 0.000, p = 1.000; hospital length of stay, t
(48) = 0.95, p = .345; or discharge disposition (receiver operating characteristic curve, p = .337). There was a significant negative relationship between Trauma-Specific Frailty Index Scores and Injury Severity Scores, t
(15) = 2.33, p = .035.

Conclusion:

This pilot study demonstrates that frailty screening can be implemented to help guide older adult trauma care but is not without challenges. Barriers to frailty screening should be addressed to ensure trauma team engagement. Additional research with a larger sample size is warranted to explore the benefits of frailty screening in guiding care.
Developing a Trauma Intermediate Care Unit
Authors: Krause Morgan A. , Mantooth Jessica L. , Gibson Jesse E.
Published: January 2023

Background:

Trauma-specific nursing units are integral to providing quality trauma care. Yet, little has been published on intermediate care units for the trauma population.

Objective:

This article aims to describe one trauma center's journey to develop and implement a trauma intermediate care unit.

Methods:

The need for a trauma intermediate care unit was identified during the review of patient care at a Level II trauma center. An interdisciplinary team was created and met weekly for 6 months to plan the implementation of a trauma intermediate care unit. Education plans, training, equipment procurement, and staffing were evaluated throughout the process.

Results:

Positive results were noted from the implementation of the intermediate care unit through the first year following implementation. The average length of stay for patients in the surgical trauma intensive care unit was reduced, resulting in cost savings for the organization. In addition, this collaborative work positively impacted patient safety, staff engagement, and finances.

Conclusion:

With leadership support, the proper key stakeholders, clear deliverables, and a well-defined development plan, the implementation of this intermediate care unit was successful.
Competency-based evaluation: Collaboration and consistency from academia to practice
Authors: Jenkins-Weintaub Edith , Goodwin Michal , Fingerhood Marianne
Published: January 2023

Competency-based evaluation is not a new concept in nursing education. The Essentials: Core Competencies for Professional Nursing Education (AACN Essentials), published in 2021, and the NONPF Nurse practitioner Role Core Competencies (2022) have provided us with the most recent roadmap for curriculum development and student evaluation. Using these two national guidelines and the Standards for Quality Nurse practitioner Education (2022), we examined ways to unify curriculum and competency in clinical practice. Through a review of the available literature, the lack of standardization in evaluating competency in clinical practice was evident. A framework for evaluation was developed including concepts from other health care discipline competency models. This article presents the resulting evaluation of a tool across academia and practice. Clinical preceptors are an extension of the faculty and play a significant role in developing practice competencies in advanced practice nursing students. Providing preceptors with a comprehensive framework we derived from the already existing PRIME model, and which we use with simulated patients, allows for the evaluation of clinical competencies in a variety of clinical settings. Consistency of evaluation across settings assures the attainment of the competencies necessary to perform safely and effectively in the practice environment.
Short-term effects of transcatheter aortic valve replacement on blood pressure and cardiac function in elderly patients with severe aortic stenosis
Authors: Aoyama Rie , Takeda Kazuhiro , Ishikawa Joji , Harada Kazumasa
Published: January 2023

Background

Transcatheter aortic valve replacement (TAVR) is a standard treatment for elderly and high-risk patients with aortic valve stenosis (AS); however, its short-term effects on blood pressure (BP) and cardiac function are not clear. Therefore, we aimed to determine the short-term effects of TAVR in elderly patients (>75 years), who reflect the clinical situation in Japan.

Method and results

Twenty-eight consecutive elderly patients with severe AS and hypertension who underwent TAVR under general anesthesia were retrospectively investigated. All patients had hypertension that was well controlled with antihypertensive drugs. Serum brain natriuretic peptide level and peak velocity in the aortic valve were significantly reduced. TAVR induces an increase in BP that requires additional antihypertensive agents. There was no correlation between the change rate of SBP and stroke volume index (SVI), but there was a positive correlation between the rate of change in pulse pressure (PP) and SVI. This tendency was particularly observed in patients with low brachial-ankle pulse wave velocity (baPWV).

Conclusion

We observed post-TAVR hypertension and required additional antihypertensive drugs. The increases in SVI and PP after TAVR resulted in post-TAVR hypertension. Moreover, post-TAVR hypertension is less likely to occur in elderly patients with a high baPWV, which indicates advanced arteriosclerosis.
The relationship between hyperhomocysteinemia and total coronary artery occlusion: a cross-sectional study from Southwest China
Authors: Xiao Kaiyong , Chen Yuxiong , Xiao Lian , Sun Hua , He Zhongwei , Huang Guan , Chen Lvhong , Xv Lei , Peng Ling , Li Juan , Xv Yuling , Wang Jianping
Published: January 2023

Background

Increasing evidence points to hyperhomocysteinemia as an independent risk factor for coronary artery disease in addition to traditional cardiovascular risks, but few have studied the association between hyperhomocysteinemia and total coronary artery occlusion (TCAO). To understand the risk factors for TCAO, we investigated the potential relationship between hyperhomocysteinemia and TCAO, and the interactions between cardiovascular risk factors and hyperhomocysteinemia.

Methods

A total of 890 adult patients from Southwest China participated in this cross-sectional study between February 2018 and February 2021. TCAO was defined as complete occlusion of more than one of the 15 coronary segments. Hyperhomocysteinemia was defined as serum homocysteine levels ≥15 μmol/L. Multivariable logistic regression models were used to determine the relationship between hyperhomocysteinemia and TCAO. The relationship between homocysteine as a continuous variable and TCAO was also analyzed. Subgroup analyses by sex, age, weight, smoking, hypertension, diabetes, and dyslipidemia were done, and interactions between subgroup variables and hyperhomocysteinemia were performed.

Results

Individuals with hyperhomocysteinemia showed an increased risk for TCAO. The adjusted odds ratio for TCAO in individuals with hyperhomocysteinemia was 1.74 (95% confidence interval, 1.28–2.36). When analyzed as a continuous variable, homocysteine was associated with an increased risk for TCAO. Subgroup analysis showed that the association between hyperhomocysteinemia and TCAO was statistically significant in men, elderly, overweight, smokers, and non-diabetic people. Interaction analysis showed no significant interactions between hyperhomocysteinemia and group variables.

Conclusions

In Southwest China, hyperhomocysteinemia was significantly associated with TCAO. This association was particularly significant in men, elderly, overweight, smokers, and non-diabetic people.
Efficacy and Safety of Radiofrequency Ablation Plus Stent Versus Stent-alone Treatments for Malignant Biliary Strictures
Authors: Khizar Hayat , Hu Yufei , Wu Yanhua , Ali Kamran , Iqbal Junaid , Zulqarnain Muhammad , Yang Jianfeng
Published: January 2023

Background/Aims:

Malignant biliary strictures (MBS) are very aggressive and cannot be diagnosed in the early stages due to their asymptomatic nature. Stenting the stricture area of the biliary tree is palliative treatment but has poor survival time. Radiofrequency ablation plus stent (RFA+S) have been recently used to improve the survival and stent patency time in patients with MBS. In this systematic review and meta-analysis, we tried to evaluate the efficacy and safety of radiofrequency ablation.

Materials and Methods:

Study search up to December 2021 was performed in different medical databases such as PubMed, Web of Science, and Cochrane library, etc. We selected eligible studies reporting survival time, stent patency time, and adverse events in patients with MBS. We compare the outcomes of RFA+S and stent-alone treatment groups.

Results:

A total of 15 studies (6 randomized controlled trials and 9 observational studies) with 1815 patients were included for meta-analysis of which 701 patients were in RFA+S group and 1114 patients in the stent-alone group. Pooled mean difference of survival time was 2.88 months (95% CI: 1.78-3.97) and pooled mean difference of stent patency time was 2.11 months (95% CI: 0.91-3.30) and clinical success risk ratio was 1.05 (95% CI: 1.01–1.09). Risk ratios for adverse events are given; Bleeding 0.84 (95% CI: 0.34-2.11), abdominal pain 1.06 (95% CI: 0.79-1.40), pancreatitis 0.93 (95% CI: 0.43-2.01), cholangitis 1.07 (95% CI: 0.72-1.59), and stent dysfunction 0.87 (95% CI: 0.70-1.07).

Conclusions:

Radiofrequency ablation is involved in increased survival and stent patency time for MBS patients. With the help of better techniques, adverse events can be limited.
Efficacy of acupuncture for generalized anxiety disorder: A PRISMA-compliant systematic review and meta-analysis
Authors: Li Meichen , Liu Xin , Ye Xinyi , Zhuang Lixing
Published: January 2023

Background:

Generalized anxiety disorder (GAD) tightly traps modern people. Its incidence shows an increased peak during the 2019 novel coronavirus (COVID-19) epidemic. Acupuncture is regarded as an effective way to relieve anxiety symptoms. However, there are still controversies. This study aimed to systematically evaluate the clinical efficacy of acupuncture in patients with GAD.

Methods:

Four English and 3 Chinese databases were searched from their inception to January 2022. Only randomized controlled trials (RCTs) in which acupuncture was the main intervention were included. The literature was independently screened and extracted by two investigators. The Cochrane Bias Risk Assessment Tool was used for quality evaluation. Analyses were conducted by RevMan 5.3.0 and STATA 15.0 software. The primary outcome was the Hamilton Anxiety Scale (HAMA). The secondary indicators were the total effective rate, the Self-Rating Anxiety Scale (SAS), and the Treatment Emergent Symptom Scale (TESS).

Results:

Twenty-seven studies were included with a total of 1782 participants. The risk of performance bias or reporting bias for most of the included trials was unclear. Combined results showed the acupuncture group had better outcomes in the HAMA score [MD = −0.78, 95%CI (−1.09, −0.46)], the total effective rate [RR = 1.14, 95%CI (1.09, 1.19)], the SAS score [MD = −2.55, 95%CI (−3.31, −1.80)] compared with the control group. Regarding the number of adverse events, the acupuncture group was safer than the control group and scored less grade in the TESS score [MD = −1.54, 95%CI (−1.92, −1.17)].

Conclusions:

Acupuncture can effectively relieve the anxiety symptoms of generalized anxiety disorder patients with fewer side effects, but randomized controlled trials with large sample size and high quality are also required to support the result.
Prognostic value of metformin in cancers: An updated meta-analysis based on 80 cohort studies
Authors: Yang Jing , Yang Hang , Cao Ling , Yin Yuzhen , Shen Ying , Zhu Wei
Published: January 2023

Background:

Experiments have shown that metformin can inhibit cancer cell growth, but clinical observations have been inconsistent, so we pooled the currently available data to evaluate the impact of metformin on cancer survival and progression.

Methods:

PubMed, web of science, Embase, and Cochrane databases were searched. Pooled hazard ratios (HRs) were identified using a random-effects model to estimate the strength of the association between metformin and survival and progression in cancer patients.

Results:

We incorporated 80 articles published from all databases which satisfied the inclusion criterion. It showed that metformin was associated with better overall survival (hazard ratio [HR] = 0. 81; 95% confidence interval [CI]: [0.77–0.85]) and cancer-specific survival (HR = 0.79; 95% CI: [0.73–0.86]), and metformin was associated with progression-free survival (HR = 0.76; 95% CI: [0.66–0.87]). In patients with diabetes mellitus, the HR of overall survival was 0.79(95% CI: [0.75–0.83]), progression-free survival was 0.72(95% CI: [0.60–0.85]), and the cancer-specific survival was 0.76(95% CI: [0.68–0.86]). It was proposed that metformin can improve the prognosis of cancer patients with diabetes mellitus.

Conclusion:

Based on cohort studies, metformin therapy has potential survival benefits for patients with malignancy, especially with the greatest benefits seen in breast cancer on overall survival, progression-free survival, and cancer-specific survival. And metformin also showed potential benefits in cancer-specific survival in colorectal and prostate cancer.
Expression and prognosis analyses of the fibronectin type-III domain-containing (FNDC) protein family in human cancers: A Review
Authors: Jiang Hui , Chu Bo Ling , He Jiao , Liu Zhi , Yang Ling
Published: January 2023

Despite advancements in early detection and treatment, cancer continues to pose a threat to human health and is the leading cause of death worldwide. According to recent research, the fibronectin type-III domain-containing (FNDC) protein family has been implicated in several different human disorders. However, little is known regarding their expression and prognostic significance in most human malignancies. We carried out a thorough cancer vs. normal expression study using the Oncomine and Tumor Immune Estimation Resource (TIMER) databases, as well as a prognostic evaluation using the Kaplan-Meier (KM) plotter and PrognoScan databases. Oncomine revealed that the mRNA expression levels of FNDC1, FNDC3A, and FNDC3B were higher in most malignancies than in normal tissues, but the mRNA expression levels of FNDC4, FNDC5, FNDC7, and FNDC8 were downregulated in most cancers when compared with normal tissues. In survival analyses based on KM Plotter and PrognoScan, all members of the FNDC family displayed significant correlations with survival outcomes in breast, gastric, and ovarian cancers. Furthermore, the whole FNDC family, except for FNDC7 and FNDC8, was found to have substantial predictive effects in lung adenocarcinoma, but not in squamous cell lung cancer. In addition, potential connections between several FNDC family members and survival results in liver and colorectal malignancies were discovered in this study. One or more members of the FNDC family demonstrated statistically significant differences in expression between cancer and normal tissues, suggesting that they could be used as prognostic biomarkers for specific cancers.
Effects of LncRNA GAS5/miR-137 general anesthesia on cognitive function by TCF4 inflammatory bodies in patients undergoing lumbar spinal canal decompression
Authors: Zhang Chunli , Chen Dingzhong , Gu Yuntao , Wang Tao , Wang Cong
Published: January 2023

Lumbar spinal stenosis is a common orthopedic disease in clinical practice at present. Postoperative cognitive dysfunction (POCD) refers to the phenomenon of impaired memory. However, whether long noncoding RNA (LncRNA) GAS5 contributes to the mechanism of cognitive function in undergoing lumbar spinal canal decompression remains unknown. Thus, the present study investigated the precise details of LncRNA GAS5 involvement in Postoperative cognitive dysfunction of patients undergoing lumbar spinal canal decompression. Patients undergoing lumbar spinal canal decompression with cognitive function and Normal healthy volunteers were obtained. C57BL/6 mice were maintained with a 2% concentration of sevoflurane in 100% oxygen at a flow rate of 2 L minute-1 for 4 hours. LncRNA GAS5 gene expression were up-regulated in patients undergoing lumbar spinal canal decompression. In mice model, LncRNA GAS5 gene expression also increased. LncRNA GAS5 promoted neuroinflammation in vitro model. LncRNA GAS5 raised cognitive impairment and increased neuroinflammation in mice model. LncRNA GAS5 suppressed miR-137 in vitro model. MiR-137 reduced neuroinflammation in vitro model. MiR-137 suppressed TCF4 protein expression in vitro model. Transcription factor TCF4 activates the expression of bHLH. Taking together, this experiment provide the first experimental and clinical evidence that LncRNA GAS5/miR-137 promoted anesthesia-induced cognitive function to increase inflammatory bodies in patients undergoing lumbar spinal canal decompression, suggesting it may be a biomarker of POCD and a potential therapeutic target for POCD.
Comparison of the conventional Henry approach and trans-flexor carpi radialis approach for the treatment of distal radius fracture: A retrospective cohort study
Authors: Shim Bum-Jin , Kim Do-Young , Lee Sang-Soo , Cho Min-Soo , Hwang Jung-Taek
Published: January 2023

Few studies have compared the clinical outcomes of the conventional Henry approach and trans-flexor carpi radialis (FCR) approach. The purpose of this study was to compare the clinical and radiologic outcomes of the conventional Henry approach and trans-FCR approach for the treatment of distal radius fractures. We compared 20 wrists that underwent the conventional Henry approach with 20 wrists that underwent the trans-FCR approach for open reduction and internal fixation of distal radius fracture. The clinical and radiological parameters were checked at 3 months, 6 months, and 1 year after surgery. A visual analogue scale score, the modified Mayo wrist score, range of motion, and grip strength were collected. In addition, tenderness in the area of the FCR tendon were assessed. Regarding radiologic evaluations, the radial inclination, radial height, volar tilt, and ulna variance were measured. In the trans-FCR approach group, 15 patients complained of tenderness in the area of the FCR tendon at 3 months after surgery, which was significantly higher than those of conventional Henry approach group (P < .05). In the conventional Henry approach group, the tenderness had resolved spontaneously by 1 year after surgery in 19 patients. The trans-FCR approach can cause discomfort such as tenderness to the area of the FCR tendon compared to the conventional Henry approach, but there is no significant difference in the final clinical and radiologic outcomes.
Role of serum cystatin C in the prediction of acute kidney injury following pediatric cardiac surgeries: A single center experience
Authors: Zakaria Marwa , Hassan Tamer , Refaat Ali , Fathy Manar , Hashem Mustafa I.A. , Khalifa Naglaa , Ali Ahmed A. , Elhewala Ahmed , Ramadan Ahmed , Nafea Alaa
Published: January 2023

Intense contemporary research is directed towards validating novel biomarkers to predict acute kidney injury (AKI) in children undergoing cardiothoracic surgeries. We aimed to evaluate the role of cystatin C in early prediction of AKI following cardiac surgery in children with congenital heart disease. Prospective observational cohort study was conducted on 40 children with congenital heart disease undergoing cardiac surgery. 40 healthy children with matched age and sex were enrolled as a control group. Children were subjected to physical examination, routine blood tests, echocardiography, and measurement of plasma cystatin C level on different occasions. The median age of the patients was 3.65 years, a range from 1 to 5 years with no significant difference regarding the age and sex of cases and control groups. The mean serum cystatin C level in patients was 0.75 ± 0.15, 1.35 ± 0.34 and 1.21 ± 0.38 mg/dL (preoperative, at 6 h and at 24 h postoperative, respectively) with statistically significant difference P < .05. 30% of the patients developed postoperative AKI with significantly higher serum cystatin C at 6 hours postoperative >1.33 mg/dL compared to preoperative level p P < .05. Serum cystatin C level was positively correlated with cardiac bypass time, ischemic time and length of hospital stay at 6 hours postoperative. Serum cystatin C is a sensitive marker for early detection of AKI following cardiac surgery in children with congenital heart disease and it was positively correlated with cardiac bypass time, ischemic time and length of hospital stay.