bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility of pair-housing of rats after cranial implant surgery
Authors: Evers Judith , Sridhar Karthik , Lowery Madeleine
Published: October 2022

Rat models employing cranial implants are increasingly employed to facilitate neural stimulation and recording in freely moving animals. Due to possible damage to wound, implant or attached devices, rats with cranial implants are traditionally housed singly, and little information is available on group- or pair-housing. Here we describe a protocol for pair-housing rats following cranial implant surgery and describe our experience with pair-housing during post-surgical recovery and up to 16 weeks following surgery.

Thirty-six adult Wistar rats of both sexes were implanted with deep brain stimulation electrodes. Ten rats were equipped with an additional wireless headstage. Rats were housed in stable pairs before surgery and re-introduced 0–18 h post-surgery. Rat grimace scores did not indicate pain after conclusion of the analgesia protocol, physiological parameters were in the normal range three days post-surgery and weight loss did not exceed 10%. Rats with a cement cap only were pair-housed continuously without damage to the headcap. Rats carrying an additional fragile headstage had to be separated during lights-off periods to prevent headstage damage but could be pair-housed during lights-on periods.

Pair-housing is a feasible and effective method to facilitate the rats’ need for social companionship following cranial implant surgery.
Long-term Care Facility and its Elderly Chronic Diseases in Jishou: Insights into Underdeveloped Area of China
Authors: Xie Fen , Li Jinxiu , Song Wenkai , Liu Quanlong , Jiang Siping , Chen Zheng-ying , Shu Qingxia
Published: October 2022

Insight into the current status of long-term care facilities (LTCFs) and chronic diseases in underdeveloped areas in China is scant. Using a census method to survey older adults ≥60 years old (154 older adult residents) in all LTCFs in Jishou area. The International Resident Assessment Instrument for Long-Term Care Facilities (interRAI-LTCF) was used to collect information and analyze the current status of chronic diseases among older adult residents. There were 62 187 residents ≥60 years old in Jishou area. According to the survey, there were only 154 older adult residents living in the LTCFs of Jishou, with a ratio was 0.3% of all older adult residents, which was much lower than China’s 3.0%. Of respondents (109 older adult residents), the prevalence of chronic diseases was 70.6%. The prevalence increases with age, as well as in the female is higher than in the male. The top 3 chronic diseases were hypertension (41.3%), bone and joint disease (12.8%) and cerebrovascular disease (12.8%). It was found that different age groups and genders lead to differences in the prevalence and the order of chronic diseases. The prevalence of older adults with impaired balance ability, sleep disturbance and swallowing disturbance was higher than that of normal older adults. The results of the one-way analysis of variance showed that the age and balance ability of the older adults with chronic diseases were statistically significant ( P < .05). In addition, the prevalence of chronic diseases in the LTCFs older adult was higher than the home care (HC) older adults in Jishou. The age and the prevalence of chronic diseases of LTCFs in older adults with professional nursing staff were higher than in those without. This study provides a theoretical basis for the healthcare distribution, prevention and treatment of chronic diseases in underdeveloped areas. The undeveloped area has lower LTCFs staying rate and chronic disease prevalence of older adults than relatively developed areas. More public health attention and capital investment are needed to increase the LTCFs number and strengthen disease testing and screening. As well as, the proportion of professional nursing staff and specialist doctors in LTCFs and improve the quality of care and medical treatment for older adults.
Clostridium subterminale infection in a patient with diffuse large B-cell lymphoma and haemophagocytic syndrome: A case report and literature review
Authors: Zhou Ying , Wang Sheng , Weng Xing-bei
Published: October 2022

Although uncommon, infection caused by Clostridium subterminale may be life threatening particularly in immunocompromised patients. We report here a rare presentation of a patient with diffuse large B-cell lymphoma and haemophagocytic syndrome associated with C. subterminale bacteraemia. The management of the patient is described as well as a review of medical literature. Infection by Clostridium species, including C. subterminale, should be considered in a febrile patient with a haematologic malignancy. The case highlights the importance of using gene sequencing for identification of this anaerobic organism.
Chattering-free discrete-time sliding mode control for integrated missile guidance and control system
Authors: Wang Xinming , Wu Di , He Jingang , Zhang Jinpeng , Li Shihua
Published: October 2022

With the development and validation of flight control devices, electronic equipment is widely used in current flight vehicles, which results in a series of control signals in the discrete-time domain. However, many mature integrated guidance and control schemes are designed in the continuous-time domain, and some results of them may not be preserved in the discrete-time domain especially for the sliding mode control. To address this issue, a chattering-free discrete-time sliding mode control scheme is proposed for the integrated guidance and control systems of missiles. By applying the Euler’s discretization method, an approximated discrete-time model with matched and mismatched disturbances is first derived for integrated guidance and control system. Then, the estimates of the disturbances are obtained by using discrete-time generalized proportion integral observers. Integrating the estimated disturbances into the sliding mode variable, a discrete-time sliding mode controller is established by utilizing a modified chattering-free reaching law. The reachability of quasi-sliding mode band, states boundedness, and output convergence performance are analyzed rigorously. Finally, comparative numerical simulations are conducted to verify the effectiveness of the proposed control scheme in the presence of unknown target maneuvers and parameter uncertainties.
Assessment of Nutritional Status Among Children and Adolescents of Juang Tribe in Keonjhar District of Odisha, India
Authors: Kuiti Binoy Kumar , Acharya Subhendu , Satapathy Kanhu Charan , Barik Dillip Kumar , Patra Prasanna Kumar
Published: October 2022

Assessment of the nutritional status is a major public health concern in India. Thinness (low BMI-for-age) is an important anthropometric measure of undernutrition. In the present scenario, tribal children were facing undernutrition due to lack of income, inadequate food intake, and suffering with various diseases. The objectives of the present study were to determine age groups and sex specific prevalence of thinness among children and adolescents of the Juang tribe of Keonjhar district in Odisha, India. The present cross-sectional study was carried out among 237 (106 male and 131 female) Juang children and adolescents aged 1–17 years. The prevalence of thinness was assessed by using proposed age-sex specific international reference. We used standard statistical technique for comparing the BMI-for-age z-score (BMIZ) means across the educational categories. The overall prevalence among the studied children was 15.61% and educational category wise prevalence of thinness among preschool, school going children, and adolescents were 11.94%, 19.05% and 15.12% respectively. Present scenarios of nutritional health status among Juang children and adolescents have secured a moderate position or have relatively improved. Continuity of the different intervention programs and government undertaking health policies may make a stable situation for good health among Juang children.
Comparison of two Specialized Cleft Palate Feeders
Authors: Penny Cameron , Nugent Kendra-Ann , Gilgan Holly , Bezuhly Michael
Published: October 2022

Objective

To evaluate feeding efficiency and weight gain in infants with cleft palate fed using 1 of the 2 specialty feeders.

Design

Retrospective cohort study.

Setting

Cleft palate clinic in a tertiary pediatric hospital.

Participants

Infants with cleft palate (with or without cleft lip) fed using the Medela SpecialNeeds® Feeder (n = 39) or the Dr. Brown's® Specialty Feeding System (n = 16) and who had documented feeding and growth data available from the time of initial assessment in the first month of life and at subsequent follow-up between 2 and 4 months.

Primary Outcome Measure

Feeding velocity (mL/min).

Secondary Outcomes Measures

Calorie velocity (kcal/min), weight gain, and complications associated with poor feeding.

Results

No statistically significant differences in feeding or calorie velocities were identified between infants with cleft palate fed with the Medela SpecialNeeds® feeder and those fed with the Dr. Brown's® feeder. Mean weight z-scores by month did not differ significantly between the 2 bottle groups at the time of initial assessment (P = .84) and follow-up (P = .20). Mean weight z-scores by month for the infants included in this study fell below the 50th percentile. The proportion of infants who developed otitis media, reflux requiring treatment, or who required hospital admission for nasogastric (NG) feeds did not differ significantly between the 2 groups.

Conclusions

Despite being adequately powered for the primary outcome, no significant differences were identified between infants fed with the Medela or the Dr. Brown's feeders in terms of feeding velocity, calorie velocity, weight gain, or complications.
Porous Polyethylene Versus Autologous Costochondral Reconstruction for Microtia: Incidence and Analysis of Secondary Procedures
Authors: Varagur Kaamya , Zubovic Ema , Skolnick Gary B. , Buss Joanna , Snyder-Warwick Alison , Reinisch John , Patel Kamlesh B.
Published: October 2022

Objective

To examine the frequency of autologous and alloplastic ear reconstructions for patients with microtia in the United States, and describe post-index procedure rates associated with each method.

Design

Retrospective cohort study.

Setting

Claims data from 500 + hospitals from IBM® MarketScan® Commercial and Multi-State Medicaid databases.

Patients/Participants

A total of 649 patients aged 1 to 17 years with International Classification of Diseases, ninth/tenth revision (ICD-9/10) diagnoses for microtia, congenital absence of the ear, or hemifacial microsomia.

Interventions

Alloplastic or autologous ear reconstruction between 2006 and 2018.

Main Outcome Measure

Post-index procedures performed within 1 year following the index repair, analyzed across the study period and separately for each half of the study period (2006-2012, 2012-2018).

Results

A total of 486 (75%) qualifying patients received autologous and 163 (25%) received alloplastic reconstruction. Secondary procedure rates were significantly higher in the autologous group at 90 days ( P = .034), 180 days ( P < .001), and at 365 days ( P < .001). Alloplastic reconstruction accounted for 23.2% of reconstructions in the first half of the study period compared with 26.7% in the second half ( P = .319). One-year secondary procedure rates in the autologous group were not significantly different between both halves of the study period (69.7% vs 67.1%, P = .558), but were significantly lower in the second half for the alloplastic group (44.9% vs 20.2%, P = .001).

Conclusions

In these databases, autologous reconstruction is more common than alloplastic reconstruction. Autologous reconstruction is staged, with most undergoing a secondary procedure between 3 months and 1 year postoperatively. Secondary procedure rates decreased over time in patients undergoing alloplastic reconstruction.
Promoting L2 writing development via a concept-based approach to teaching genre: A sociocultural intervention study in Chinese EFL writing classrooms
Authors: Fu Zhuxia , Liu Yongcan
Published: October 2022

This article investigates the effect of concept-based instruction (CBI), a pedagogy based on Vygotsky’s sociocultural theory, on second language (L2) learners’ writing development. A quasi-experimental intervention lasting 16 weeks was conducted involving 88 first-year Chinese university students of English. The participants were assigned to three conditions: Full CBI (F-CBI) treatment, Partial CBI (P-CBI) treatment (i.e. CBI without peer–peer talk) and control. A definition task and two writing tasks (a narrative and an argumentative task) were used to measure students’ knowledge and understanding of genre and their writing performance, respectively. The results indicated that the F-CBI intervention generated significantly larger gains in learners’ understanding of genre as well as their overall writing performance than did the control group. In addition, a significant difference was also observed between the F-CBI group and the P-CBI group in the definition task and the argumentative task, which further suggests that peer–peer talk plays a crucial role in enhancing learners’ conceptual development. This study highlights the feasibility and effectiveness of integrating CBI in L2 writing instruction and the importance of engaging learners to talk through their understanding and use of concepts in the classroom. Theoretical contributions to Vygotsky’s sociocultural theory of mind are also discussed.
In search of a cool identity: how young people negotiate religious and ethnic boundaries in a superdiverse context
Authors: Driezen Ariadne , Clycq Noel , Verschraegen Gert
Published: October 2022

In this paper, we aim to study how young people navigate a super-diverse majority-minority context, and how they negotiate bright religious and ethnic symbolic boundaries. Our study is based on 40 in-depth interviews with young people from various ethnic, social and religious backgrounds in the super-diverse city of Antwerp. Our analysis shows that young people generally draw on a cultural repertoire of commonplace diversity to navigate various peer relations and present diversity as a normal element of everyday life. However, our analysis also shows how ethnic minority youth experience bright ethnic and religious boundaries and need to navigate social exclusion processes. While minority youth rework bright boundaries by inverting their othered position and redefining coolness through a repertoire of ethnic hybridity, white majority youth face new challenges as their previously taken-for-granted dominant position becomes questioned and contested within a super-diverse setting. Our analysis shows how white majority youth manage their changing social position by drawing upon cultural repertoires of ethnic purity and ‘normal’ youthfulness, yet this also raises the question of whether they can draw on cultural repertoires, which do not imply nativist white identity politics.
Construction and Validation of Prognosis Nomogram for Metastatic Lung Squamous Cell Carcinoma: A Population-Based Study
Authors: Liu Yuting , Sun Min , Xiong Ying , Gu Xinyue , Zhang Kai , Liu Li
Published: October 2022

Purpose: This study aimed to establish a nomogram to predict overall survival in lung squamous cell carcinoma patients with metastasis for clinical decision-making. Methods: We investigated lung squamous cell carcinoma patients diagnosed with stage M1 in the Surveillance, Epidemiology, and Final Results database between 2010 and 2015. They were divided into training cohort and validation cohort. In the training cohort, statistically significant prognostic factors were identified using univariate and multivariate Cox regression analysis, and an individualized nomogram model was developed. The model was evaluated by C-index, area under the curve, calibration plot, decision curve analysis, and risk group stratification. Results: In total, 9910 patients were included in our study, including 6937 in the training cohort and 2937 in the validation cohort. Factors containing age, T stage, N stage, bone metastasis, brain metastasis, liver metastasis, surgery, chemotherapy, and radiotherapy were independent prognostic factors for overall survival and were used in the construction of the nomogram. The C-index in the training cohort and validation cohort were 0.711 (95% confidenc interval: 0.705-0.717) and 0.707 (95% confidenc interval: 0.697-0.717), respectively. The time-dependent area under the curve of both groups was higher than 0.7 within 5 years. Calibration plots indicated that the nomogram-predicted survival was consistent with the recorded 6-month, 1-year, and 2-year prognoses. Furthermore, decision curve analysis revealed that the nomogram was clinically useful and had a better discriminative ability to recognize patients at high risk than the TNM criteria-based tumor staging. And then we developed an overall survival risk classification system based on the nomogram total points for each patient, which divided all patients into a high-risk group and a low-risk group. Finally, we implemented this nomogram in a free online tool. Conclusion: We constructed a nomogram and a corresponding risk classification system predicting the overall survival of lung squamous cell carcinoma patients with metastasis. These tools can assist in patients’ counseling and guide treatment decision-making.
Feasibility of a tailored and virtually supported home exercise program for people with multiple myeloma using a novel eHealth application
Authors: Purdy Graeme M. , Venner Chris P. , Tandon Puneeta , McNeely Margaret L.
Published: October 2022

Introduction

eHealth exercise interventions have the unique ability to leverage the benefits of in-person programming (tailoring and supervision) with the benefits of home programming (flexibility). There may be a role for eHealth-delivered exercise for people with multiple myeloma (MM), as exercise tailoring and supervision are critical for successful outcomes due to the significant impacts/risks of myeloma-related side effects. The purpose of this study was to determine the safety, feasibility, and preliminary efficacy of a 12-week virtually supported eHealth exercise program.

Methods

Participants with MM completed a 12-week virtually supported home exercise program involving virtually supervised group workouts, independent workouts, and aerobic exercise. Tailoring was facilitated by the functionality of HEAL-Me, a novel eHealth app. Participants completed virtual fitness assessments and questionnaires at baseline and week 12.

Results

Twenty-nine participants consented, 26 completed all follow-up testing (90%). Exercise adherence was 90% (group), 83% (independent), and 90% (aerobic). No serious adverse events (grade ≥3) occurred. Significant improvements were found for quality of life and physical fitness. There was a high level of program/app satisfaction: 96% of participants agreed or strongly agreed that the exercise program was beneficial, 93% found it enjoyable, 89% were satisfied or very satisfied with delivery through the HEAL-Me app, and 48% felt that the eHealth program helped them manage cancer-related symptoms and side-effects.

Conclusion

An eHealth intervention that is individually tailored and includes virtual supervision and active support from the healthcare team is feasible and acceptable to people with MM. The findings from this study warrant investigation using a large-scale randomized controlled trial.
Patterns of Head and Neck Injuries in Urban India: A Multicenter Study
Authors: Kim Eric K. , Suri Deepak , Mahajan Anshul , Bhandarkar Prashant , Khajanchi Monty , Gadgil Anita , Ranganathan Kavitha , Gerdin Warnberg Martin , Roy Nobhojit , Raykar Nakul P.
Published: October 2022

Objective

The pattern of head and neck injuries has been well studied in high‐income countries, but the data are limited in low‐ and middle‐income countries, which are disproportionately affected by trauma. We examined a prospective multicenter database to describe patterns and outcomes of head and neck injuries in urban India.

Study Design

Retrospective review of trauma registry.

Setting

Four tertiary public hospitals in Mumbai, Delhi, Kolkata.

Methods

We identified patients with isolated head and neck injuries using International Classification of Diseases, 10th Revision (ICD‐10) codes and excluded those with traumatic brain and/or ophthalmic injuries and injuries in other body regions.

Results

Our cohort included 171 patients. Most were males (80.7%) and adults aged 18 to 55 years (60.2%). Falls (36.8%) and road traffic accidents (36.3%) were the 2 predominant mechanisms of injury. Overall, 35.7% required intensive care unit (ICU) admission, and 11.7% died. More than 20% of patients were diagnosed with “unspecified injury of neck.” Those with the diagnosis had a higher ICU admission rate (51.4% vs 31.3%, P =. 025) and mortality rate (27.0% vs 7.5%, P =. 001) than those without the diagnosis.

Conclusion

Isolated head and neck injuries are not highly prevalent among Indian trauma patients admitted to urban tertiary hospitals but are associated with high mortality. Over a fifth of patients were diagnosed with “unspecified injury of neck,” which is associated with more severe clinical outcomes. Exactly what this diagnosis entails and encompasses remains unclear.
LncRNA SNHG16 promotes development of oesophageal squamous cell carcinoma by interacting with EIF4A3 and modulating RhoU mRNA stability
Authors: Ren Lihua , Fang Xin , Shrestha Sachin Mulmi , Ji Qinghua , Ye Hui , Liang Yan , Liu Yang , Feng Yadong , Dong Jingwu , Shi Ruihua
Published: October 2022

Background

Numerous studies have revealed that long noncoding RNAs (lncRNAs) are closely related to the development of many diseases and carcinogenesis. However, their specific biological function and molecular mechanism in oesophageal squamous cell carcinoma (ESCC) remains unclear.

Methods

RNA-Seq was performed to determine the differential expressions of lncRNAs in ESCC, and the level of SNHG16 expression was detected in ESCC and intraepithelial neoplasia (IEN) samples. In vitro and in vivo experiments were performed to explore the role of SNHG16 and the interaction of EIF4A3 and Ras homologue family member U (RhoU) signalling.

Results

One hundred and seventy-five upregulated and 134 downregulated lncRNAs were identified by RNA-Seq. SNHG16 was highly expressed in ESCC and intraepithelial neoplasia (IEN) samples, and its expression level was correlated with tumour differentiation and T stage. Overexpression of SNHG16 can facilitate ESCC cell proliferation and metastasis. Mechanistically, we noticed that SNHG16 could bind RNA binding protein (RBP)-eukaryotic translation initiation factor (EIF4A3) and interact with it to form a complex. Importantly, the coalition of SNHG16 and EIF4A3 ultimately regulated Ras homologue family member U (RhoU). SNHG16 modulated RhoU expression by recruiting EIF4A3 to regulate the stability of RhoU mRNA. Knockdown of RhoU further alleviated the effect of the SNHG16 oncogene in ESCC cells.

Conclusions

The newly identified SNHG16–EIF4A3–RhoU signalling pathway directly coordinates the response in ESCC pathogenesis and suggests that SNHG16 is a promising target for potential ESCC treatment.
The utility of diffusion-weighted imaging in patients with spinal cord infarction: difference from the findings of neuromyelitis optica spectrum disorder
Authors: Kobayashi Makoto
Published: October 2022

Background

Magnetic resonance imaging (MRI) plays a crucial role in diagnosing spinal cord infarction (SCI). However, the findings are often indistinguishable from those of other intramedullary diseases, such as neuromyelitis optica spectrum disorder (NMOSD). Although diffusion-weighted imaging (DWI) is a promising technique, the utility for discriminating SCI from NMOSD remains unclear because the DWI findings of acute NMOSD lesions have not been investigated in detail.

Methods

Clinical and MRI findings were retrospectively evaluated in 15 and 12 patients with acute SCI and NMOSD, respectively. First, clinical characteristics were compared between the SCI and NMOSD groups. Second, MRI abnormalities were examined to find differences between these groups. Third, in the SCI group, factors influencing T2 and DWI abnormalities were analyzed using the mixed-effects logistic regression analysis.

Results

The proportion of female patients was higher in the NMOSD group (92%) than in the SCI (40%). The time from symptom onset to nadir was smaller in the SCI group (median [interquartile range]; 4 [0.1–8.3] hours) than in the NMOSD (252 [162–576]). On T2-weighted images, SCI lesions had smaller length than NMOSD (2 [1–2] and 5 [2–7] vertebral segments, respectively). Focal lesions within the T9–L2 level were found only in patients with SCI. DWI hyperintensity was observed both in the SCI (frequency, 100%) and NMOSD (60%) groups. On apparent diffusion coefficient (ADC) maps, the hyperintensities of SCI had corresponding hypointensities, whereas those of NMOSD were isointense and a large portion of NMOSD lesions had hyperintense signals. Owl’s eyes sign and pencil-like hyperintensity, typically reported as T2 findings suggestive of SCI, were also found on DWI. Posterior linear hyperintensity was frequently detected on DWI in patients with posterior spinal artery infarction. The presence of MRI abnormality revealing SCI was modeled with the time from symptom onset, imaging sequence and plane, and affected vascular territory.

Conclusions

DWI and ADC maps help distinguish SCI from NMOSD. The time from symptom onset, imaging sequence, and imaging plane should be considered when MRI findings are interpreted in patients with suspected SCI.
Examining relationships between perceived neighborhood social cohesion and ideal cardiovascular health and whether psychosocial stressors modify observed relationships among JHS, MESA, and MASALA participants
Authors: Dulin Akilah J. , Park Jee Won , Scarpaci Matthew M. , Dionne Laura A. , Sims Mario , Needham Belinda L. , Fava Joseph L. , Eaton Charles B. , Kanaya Alka M. , Kandula Namratha R. , Loucks Eric B. , Howe Chanelle J.
Published: October 2022

Background

Psychosocial stressors increase the risks for cardiovascular disease across diverse populations. However, neighborhood level resilience resources may protect against poor cardiovascular health (CVH). This study used data from three CVH cohorts to examine longitudinally the associations of a resilience resource, perceived neighborhood social cohesion (hereafter referred to as neighborhood social cohesion), with the American Heart Association’s Life’s Simple 7 (LS7), and whether psychosocial stressors modify observed relationships.

Methods

We examined neighborhood social cohesion (measured in tertiles) and LS7 in the Jackson Heart Study, Multi-Ethnic Study of Atherosclerosis, and Mediators of Atherosclerosis in South Asians Living in America study. We used repeated-measures, modified Poisson regression models to estimate the relationship between neighborhood social cohesion and LS7 (primary analysis, n = 6,086) and four biological metrics (body mass index, blood pressure, cholesterol, blood glucose; secondary analysis, n = 7,291). We assessed effect measure modification by each psychosocial stressor (e.g., low educational attainment, discrimination).

Results

In primary analyses, adjusted prevalence ratios (aPR) and 95% confidence intervals (CIs) for ideal/intermediate versus poor CVH among high or medium (versus low) neighborhood social cohesion were 1.01 (0.97–1.05) and 1.02 (0.98–1.06), respectively. The psychosocial stressors, low education and discrimination, functioned as effect modifiers. Secondary analyses showed similar findings. Also, in the secondary analyses, there was evidence for effect modification by income.

Conclusion

We did not find much support for an association between neighborhood social cohesion and LS7, but did find evidence of effect modification. Some of the effect modification results operated in unexpected directions. Future studies should examine neighborhood social cohesion more comprehensively and assess for effect modification by psychosocial stressors.
Corpus luteum hemorrhage with acquired hemophilia A: a case report and literature review
Authors: Xie Xiaofei , Jiang Shaoru
Published: October 2022

Background

The rupture of the corpus luteum (CL) may occur at all stages of a woman’s reproductive life. Bleeding of the ruptured CL varies from self-limiting hemorrhage to massive hemoperitoneum, causing the shock and subsequent emergency surgery. But hemoperitoneum secondary to ruptured CL is a rare complication and situation for women with bleeding disorders.

Case presentation

We here describe a case of severe CL hemorrhage with factor VIII deficiency. We chose conservative management instead of surgery for the abnormal hemostatic condition. With blood product and factor concentrate support, conservative management was successful in avoiding surgery in the episode of bleeding.

Conclusion

Gynecologist should be alert for the patients with abnormal hemostatic condition. Selective patients presenting with CL hemoperitoneum association with bleeding disorders may undergo conservative management and avoid the risk of surgery.
Complementary medicine usage in surgery: a cross-sectional survey in Germany
Authors: Lederer Ann-Kathrin , Samstag Yvonne , Simmet Thomas , Syrovets Tatiana , Huber Roman
Published: October 2022

Background

Complementary medicine (CM) is frequently used by patients, but little is known about the usage of CM in surgical patients. The study aimed to elucidate the relevance of CM in surgery.

Methods

This cross-sectional, multi-center survey utilized a paper-based questionnaire consisting of 21 questions to capture CM usage and interest as well as CM communication in visceral and thoracic surgical patients being hospitalized at the corresponding departments of surgery at the University Medical Centers in Freiburg, Heidelberg und Ulm, Germany.

Results

Overall, 151 patients consented to the survey. On average, current CM usage was stated by 44% of patients. Most frequently used CM approaches were physical exercise (63%), nutritional supplements (59%) and herbal medicine (56%). Strong interest in CM counselling was stated by 51% of patients. Almost 80% of patients wanted to be treated in a holistic manner and desired for reliable information about CM as well as CM informed physicians. Only 12% of patients communicated CM usage and interest with their attending physician. Review of literature revealed similar results showing an overall CM usage of 43%, preferring nutritional supplements and herbal medicine.

Conclusion

The results of our cross-sectional study indicate a high percentage of CM users and a strong interest in CM among surgical patients. Indeed, the current communication about CM between patients and surgeons is poor. With respect to safety and quality reasons, but also to pay attention to patients’ demands, physicians should be aware of patients’ CM usage in surgery.

Trial registration

German Clinical Trial register (DRKS00015445).
Multiomics surface receptor profiling of the NCI-60 tumor cell panel uncovers novel theranostics for cancer immunotherapy
Authors: Heumos Simon , Dehn Sandra , Bräutigam Konstantin , Codrea Marius C. , Schürch Christian M. , Lauer Ulrich M. , Nahnsen Sven , Schindler Michael
Published: October 2022

Background

Immunotherapy with immune checkpoint inhibitors (ICI) has revolutionized cancer therapy. However, therapeutic targeting of inhibitory T cell receptors such as PD-1 not only initiates a broad immune response against tumors, but also causes severe adverse effects. An ideal future stratified immunotherapy would interfere with cancer-specific cell surface receptors only.

Methods

To identify such candidates, we profiled the surface receptors of the NCI-60 tumor cell panel via flow cytometry. The resulting surface receptor expression data were integrated into proteomic and transcriptomic NCI-60 datasets applying a sophisticated multiomics multiple co-inertia analysis (MCIA). This allowed us to identify surface profiles for skin, brain, colon, kidney, and bone marrow derived cell lines and cancer entity-specific cell surface receptor biomarkers for colon and renal cancer.

Results

For colon cancer, identified biomarkers are CD15, CD104, CD324, CD326, CD49f, and for renal cancer, CD24, CD26, CD106 (VCAM1), EGFR, SSEA-3 (B3GALT5), SSEA-4 (TMCC1), TIM1 (HAVCR1), and TRA-1-60R (PODXL). Further data mining revealed that CD106 (VCAM1) in particular is a promising novel immunotherapeutic target for the treatment of renal cancer.

Conclusion

Altogether, our innovative multiomics analysis of the NCI-60 panel represents a highly valuable resource for uncovering surface receptors that could be further exploited for diagnostic and therapeutic purposes in the context of cancer immunotherapy.
Glyphosate exposure in early pregnancy and reduced fetal growth: a prospective observational study of high-risk pregnancies
Authors: Gerona Roy R. , Reiter Jill L. , Zakharevich Igor , Proctor Cathy , Ying Jun , Mesnage Robin , Antoniou Michael , Winchester Paul D.
Published: October 2022

Background

Prenatal glyphosate (GLY) exposure is associated with adverse reproductive outcomes in animal studies. Little is known about the effects of GLY exposure during pregnancy in the human population. This study aims to establish baseline urine GLY levels in a high-risk and racially diverse pregnancy cohort and to assess the relationship between prenatal GLY exposure and fetal development and birth outcomes.

Methods

Random first trimester urine specimens were collected from high risk pregnant women between 2013 and 2016 as part of the Indiana Pregnancy Environmental Exposures Study (PEES). Demographic and clinical data were abstracted from mother and infant medical records. Urine glyphosate levels were measured as a proxy for GLY exposure and quantified using liquid chromatography-tandem mass spectrometry. Primary outcome variables included gestation-adjusted birth weight percentile (BWT%ile) and neonatal intensive care unit (NICU) admission. Relationships between primary outcome variables and GLY exposure were assessed using univariate and multivariate linear and logistic regression models.

Results

Urine GLY levels above the limit of detection (0.1 ng/mL) were found in 186 of 187 (99%) pregnant women. Further analyses were limited to 155 pregnant women with singleton live births. The mean age of participants was 29 years, and the majority were non-Hispanic white (70%) or non-Hispanic Black (21%). The mean (± SD) urine GLY level was 3.33 ± 1.67 ng/mL. Newborn BWT%iles were negatively related to GLY (adjusted slope ± SE = -0.032 + 0.014, p = 0.023). Infants born to women living outside of Indiana’s large central metropolitan area were more likely to have a lower BWT%ile associated with mother’s first trimester GLY levels (slope ± SE = -0.064 ± 0.024, p = 0.007). The adjusted odds ratio for NICU admission and maternal GLY levels was 1.16 (95% CI: 0.90, 1.67, p = 0.233).

Conclusion

GLY was found in 99% of pregnant women in this Midwestern cohort. Higher maternal GLY levels in the first trimester were associated with lower BWT%iles and higher NICU admission risk. The results warrant further investigation on the effects of GLY exposure in human pregnancies in larger population studies.
Managing clustering effects and learning effects in the design and analysis of randomised surgical trials: a review of existing guidance
Authors: Conroy Elizabeth J. , Blazeby Jane M. , Burnside Girvan , Cook Jonathan A. , Gamble Carrol
Published: October 2022

Background

The complexities associated with delivering randomised surgical trials, such as clustering effects, by centre or surgeon, and surgical learning, are well known. Despite this, approaches used to manage these complexities, and opinions on these, vary. Guidance documents have been developed to support clinical trial design and reporting. This work aimed to identify and examine existing guidance and consider its relevance to clustering effects and learning curves within surgical trials.

Methods

A review of existing guidelines, developed to inform the design and analysis of randomised controlled trials, is undertaken. Guidelines were identified using an electronic search, within the Equator Network, and by a targeted search of those endorsed by leading UK funding bodies, regulators, and medical journals. Eligible documents were compared against pre-specified key criteria to identify gaps or inconsistencies in recommendations.

Results

Twenty-eight documents were eligible (12 Equator Network; 16 targeted search). Twice the number of guidance documents targeted design (n/N=20/28, 71%) than analysis (n/N=10/28, 36%). Managing clustering by centre through design was well documented. Clustering by surgeon had less coverage and contained some inconsistencies. Managing the surgical learning curve, or changes in delivery over time, through design was contained within several documents (n/N=8/28, 29%), of which one provided guidance on reporting this and restricted to early phase studies only. Methods to analyse clustering effects and learning were provided in five and four documents respectively (N=28).

Conclusions

To our knowledge, this is the first review as to the extent to which existing guidance for designing and analysing randomised surgical trials covers the management of clustering, by centre or surgeon, and the surgical learning curve. Twice the number of identified documents targeted design aspects than analysis. Most notably, no single document exists for use when designing these studies, which may lead to inconsistencies in practice. The development of a single document, with agreed principles to guide trial design and analysis across a range of realistic clinical scenarios, is needed.
Cross-watershed distribution pattern challenging the elimination of Oncomelania hupensis, the intermediate host of Schistosoma japonicum, in Sichuan province, China
Authors: Chen Shen , Lu Ding , Duan Lei , Ma Ben , Lv Chao , Li Yin-long , Lu Shen-ning , Li Lan-hua , Xu Liang , Wu Zi-song , Xia Shang , Xu Jing , Liu Yang , Lv Shan
Published: October 2022

Background

Snail control is critical to schistosomiasis control efforts in China. However, re-emergence ofOncomelania hupensisis challenging the achievements of schistosomiasis control. The present study aimed to test whether the amphibious snails can spread across watersheds using a combination of population genetics and geographic statistics.

Methods

The digital maps and attributes of snail habitats were obtained from the national survey onO. hupensis. Snail sampling was performed in 45 counties of Sichuan Province. Thecox1 gene of specimens was characterized by sequencing. Unique haplotypes were found for phylogenetic inference and mapped in a geographical information system (GIS). Barriers of gene flow were identified by Monmonier’s maximum difference algorithm. The watercourses and watersheds in the study area were determined based on a digital elevation model (DEM). Plain areas were defined by a threshold of slope. The slope of snail habitats was characterized and the nearest distance to watercourses was calculated using a GIS platform. Spatial dynamics of high-density distributions were observed by density analysis of snail habitats.

Results

A total of 422cox1 sequences ofO. hupensisspecimens from 45 sampling sites were obtained and collapsed into 128 unique haplotypes or 10 clades. Higher haplotype diversity in the north of the study area was observed. Four barriers to gene flow, leading to five sub-regions, were found across the study area. Four sub-regions ran across major watersheds, while high-density distributions were confined within watersheds. The result indicated that snails were able to disperse across low-density areas. A total of 63.48% habitats or 43.29% accumulated infested areas were distributed in the plain areas where the overall slope was < 0.94°. Approximately 90% of snail habitats were closer to smaller watercourses. Historically, high-density areas were mainly located in the plains, but now more were distributed in hilly region.

Conclusions

Our study showed the cross-watershed distribution ofOncomelaniasnails at a large scale. Natural cross-watershed spread in plains and long-distance dispersal by humans and animals might be the main driver of the observed patterns. We recommend cross-watershed joint control strategies for snail and schistosomiasis control.

Graphical Abstract
Evaluation of relationship between maximum SUV measured on 18F-FDG PET/CT with tumor pathological types, size, lymph node metastasis and distant metastasis in non-small cell lung cancer
Authors: Shalaby Sherif Mohsen Ibraheem Yousef , Abdel-Aziz Amany M. R. , Mansour Mohamed G. , Darwish Eman A. F.
Published: October 2022

Background

Lung cancer is the most commonly diagnosed cancer, of which the non-small cell lung cancer (NSCLC) accounts for approximately 80% of the newly diagnosed lung cancer. The prognosis of lung tumors depends on early and accurate staging as well as the histopathological type of the tumor. It is suggested that NSCLC with different histopathological types and primary tumor sizes can elicit variable max.SUV values on 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG) PET/CT with different lymph nodes and distant metastatic potential. In this study, we aim to evaluate the relationship between the maximum SUV measured on (18F-FDG) PET/CT with tumor pathological type, primary tumor size, lymph node metastasis, and distant metastasis in NSCLC.

Results

This is a cross-sectional analysis of the (FDG-PET/CT) findings of 40 patients with NSCLC. Statistical analysis is used to determine correlation between max.SUV and tumor size, with each pathological type, nodal (N) staging and distant metastasis (M) staging. The primary lung tumors histopathological types were 25 (62.5%) adenocarcinomas, 12 (30%) squamous cell carcinomas and 3 (7.5%) large cell carcinomas. The max.SUV and tumor size of the squamous cell carcinoma group were significantly higher than max.SUV of adenocarcinoma and large cell cancer groups (P = 0.000009). A significant positive correlation was found between the primary tumor max.SUV and tumoral size. Neither lymph node nor distant metastases involvement was correlated with tumor max.SUV.

Conclusions

The tumor size and histologic subtype both strongly influence FDG uptake in lung cancer. Nonetheless, max.SUV cannot be regarded as a predictive of metastases or lymph node involvement.
Integrated approaches to delivering cancer screenings to address disparities: lessons learned from the evaluation of CDC’s Colorectal Cancer Control Program
Authors: Subramanian Sujha , Tangka Florence K. L. , DeGroff Amy , Richardson Lisa C.
Published: October 2022

Background

The Centers for Disease Control and Prevention launched the Colorectal Cancer Control Program to increase colorectal cancer screening among groups with low screening uptake. This engagement has enabled the health systems participating in the program to enhance infrastructure, systems, and process to implement interventions for colorectal cancer screening. These improvements have enabled other health promotion innovations such as the delivery of integrated interventions and supporting activities (referred to as integrated approaches) for multiple cancers. Using implementation science frameworks, the program evaluation team has examined these integrated approaches to capture the experiences of the awardees, health systems, and clinics.

Methods and results

The findings from this comprehensive evaluation are presented in a series of 3 manuscripts. The first manuscript provides a conceptual framework for integrated approaches for cancer screening to support comprehensive evaluations and offers recommendations for future research. The second manuscript presents findings on key factors that support readiness for implementing integrated approaches based on qualitative interviews guided by implementation science constructs. The final manuscript reports on the challenges and benefits of integrated approaches to increase cancer screening in primary care facilities based on lessons learned from three real-world implementation case studies.

Conclusion

Integrated models for implementing cancer screening could offer cost-effective approaches to reduce healthcare disparities. Additional implementation science-based systematic evaluations are needed to ensure integrated approaches are optimized, and cost-efficient models are scaled up.
Health professionals’ experience of treatment of patients whose community treatment order was revoked under new capacity-based mental health legislation in Norway: qualitative study
Authors: Wergeland Nina Camilla , Fause Åshild , Weber Astrid Karine , Fause Anett Beatrix Osnes , Riley Henriette
Published: October 2022

Background

Norway introduced capacity-based legislation in mental healthcare on 1 September 2017 with the aim of increasing patient autonomy and legal protection and reducing the use of coercion. The new legislation was expected to be particularly important for patients under community treatment orders (CTOs).

Aims

To explore health professionals’ experiences of how capacity-based legislation affects healthcare services for patients whose compulsory treatment order was revoked as a result of being assessed as having capacity to consent.

Method

Nine health professionals responsible for treatment and care of patients whose CTO was revoked owing to the new legislation were interviewed in depth from September 2019 to March 2020. We used a hermeneutic approach to the interviews and analysis of the transcripts.

Results

The participants found that capacity-based legislation raised their awareness of their responsibility for patient autonomy and involvement in treatment and care. They also felt a need for more frequent assessments of patients’ condition and capacity to consent and more flexibility between levels of care.

Conclusions

The study shows that health professionals found that capacity-based legislation raised their awareness of their responsibility for patient autonomy and involvement in treatment and care. They sought closer dialogue with patients, providing information and advice, and more frequently assessing patients’ condition to adjust treatment and care to enable them to retain their capacity to consent. This could be challenging and required competence, continuity and close collaboration between personnel in different healthcare services at primary and specialist level.