bluuebunny/crossref_metadata_2025 huggingface dataset:
Age-to-Glasgow Coma Scale score ratio predicts gastrointestinal bleeding in patients with primary intracerebral hemorrhage
Authors: Qiu Weizhi , Liu Chubin , Ye Jinfu , Wang Gang , Yang Fuxing , Pan Zhigang , Hu Weipeng , Gao Hongzhi
Published: February 2023

Objective

Recent clinical studies have demonstrated that advanced age and low initial Glasgow Coma Scale (GCS) score were independent predictors of gastrointestinal bleeding (GIB) in patients with primary intracerebral hemorrhage (ICH). However, used singly, age and GCS score have their respective shortcomings in predicting the occurrence of GIB. This study aimed to investigate the association between the age-to-initial GCS score ratio (AGR) and the risk of GIB following ICH.

Methods

We conducted a single-center, retrospective observational study of consecutive patients presenting with spontaneous primary ICH at our hospital from January 2017 through January 2021. Patients who fulfilled the inclusion and exclusion criteria were categorized into GIB and non-GIB groups. Univariate and multivariate logistic regression analyses were implemented to identify the independent risk factors for the occurrence of GIB, and a multicollinearity test was performed. Furthermore, one-to-one matching was conducted to balance important patient characteristics by the groups' propensity score matching (PSM) analysis.

Results

A total of 786 consecutive patients fulfilled the inclusion/exclusion criteria for the study, and 64 (8.14%) patients experienced GIB after primary ICH. Univariate analysis revealed that patients with GIB were significantly older [64.0 (55.0–71.75) years vs. 57.0 (51.0–66.0) years, p = 0.001] and had a higher AGR [7.32 (5.24–8.96) vs. 5.40 (4.31–7.11), p < 0.001] and a lower initial GCS score [9.0 (7.0–11.0) vs. 11.0 (8.0–13.0), p < 0.001]. The multicollinearity test revealed that no multicollinearity was observed in the multivariable models. Multivariate analysis showed that the AGR was a significant independent predictor of GIB [odds ratio (OR) 1.155, 95% confidence interval (CI) 1.041–1.281, p = 0.007], as well as prior anticoagulation or antiplatelet therapy (OR 0.388, 95% CI 0.160–0.940, p = 0.036) and MV used >24 h (OR 0.462, 95% CI 0.252–0.848, p = 0.013). Receiver operating curve (ROC) analysis illustrated that the optimal cutoff value for the AGR as a predictor for GIB in patients with primary ICH was 6.759 [the area under the curve (AUC) was 0.713 with a corresponding sensitivity of 60.94% and specificity of 70.5%, 95% CI 0.680–0.745, p < 0.001]. After 1:1 PSM, the matched GIB group had significantly higher AGR levels compared with the matched non-GIB group [7.47(5.38–9.32) vs. 5.24(4.24–6.40), p <0.001]. The ROC analysis indicated an AUC of 0.747 (the sensitivity was 65.62%, and the specificity was 75.0%, 95% CI 0.662–0.819, p < 0.001) for AGR levels as an independent predictor of GIB in patients with ICH. In addition, AGR levels were statistically correlated with unfunctional 90-day outcomes.

Conclusion

A higher AGR was associated with an increased risk of GIB and unfunctional 90-day outcomes in patients with primary ICH.
Application of brain ultrasound in premature infants with brain injury
Authors: Liu Lu
Published: February 2023

Brain injury is the main factor affecting the development and prognosis of the nervous system in premature infants. Early diagnosis and treatment are of great significance in reducing mortality and disability and improving the prognosis of premature infants. Craniocerebral ultrasound has become an important medical imaging method for evaluating the brain structure of premature infants due to its advantages of being non-invasive, cheap, simple, and bedside dynamic monitoring since it was applied to neonatal clinical practice. This article reviews the application of brain ultrasound to common brain injuries in premature infants.
Positive response to niraparib in chemo-refractory patients with metastatic appendiceal mucinous adenocarcinoma harboring ATM mutations: A case report
Authors: Wang Junhui , He Huijuan , Xu Wansu , Chen Jianxin
Published: February 2023

Background

Appendiceal mucinous adenocarcinoma, one kind of specific colorectal cancer, is lowly prevalent and rarely diagnosed in clinical practice. In addition, there have been limited standard treatment strategies established for patients with appendiceal mucinous adenocarcinoma, especially with metastatic disease. The regimens for colorectal cancer, which were adopted in appendiceal mucinous adenocarcinoma, usually resulted in limited effectiveness.

Case presentation

Herein, we presented a case of chemo-refractory patient with metastatic appendiceal mucinous adenocarcinoma harboring ATM pathological mutation of exon 60, c.8734del, p.R2912Efs*26, and who has achieved a persistent response to salvage treatment of niraparib, with disease control time that reached 17 months and still in extension.

Conclusions

We supposed that appendiceal mucinous adenocarcinoma patients harboring ATM pathological mutations may respond to the treatment of niraparib, even without a homologous recombination deficiency (HRD) status; however, it needs further confirmation in a larger cohort.
Associations of novel serum lipid index with epithelial ovarian cancer chemoresistance and prognosis
Authors: Li Yuan , Shang Chunliang , Liang Huamao , Zhang Kun , Wu Yu , Guo Hongyan
Published: February 2023

Purpose

To evaluate the relationship between novel serum lipid index and chemoresistance as well as prognosis of epithelial ovarian cancer (EOC).

Patients and methods

Patients’ serum lipid profiles of 249 cases diagnosed with epithelial ovarian cancer, including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) as well as their ratios, the novel indicators HDL-C/TC and HDL-C/LDL-C, and clinicopathologic characteristics were retrospectively collected and calculated from January 2016 to January 2020 and correlation between serum lipid index and clinicopathological features such as chemoresistance as well as prognosis were evaluated.

Results

249 patients pathologically diagnosed EOC who underwent cytoreductive surgery were included in our cohort. The mean age of these patients was 55.20 ± 11.07 years. Binary logistic regression analyses indicated Federation International of Gynecology and Obstetrics (FIGO(stage and HDL-C/TC ratio had significant association with chemoresistance. Univariate analyses demonstrated pathological type, chemoresistance, FIGO stage, neoadjuvant chemotherapy, maintenance treatment, HDL-C/LDL-C ratio, HDL-C/TC ratio were related to Progression-Free Survival (PFS) and Overall Survival (OS) (P<0. 05). Particularly, multivariate analyses indicated that HDL-C/LDL-C ratio was independent protective factors for both PFS and OS.

Conclusion

The complex serum lipid index HDL-C/TC ratio has a significant correlation with chemoresistance. HDL-C/LDL-C ratio is closely related to the clinicopathological characteristics and prognosis of patients with EOC and is an independent protective factor indicating better outcome.
Predicting survival of NSCLC patients treated with immune checkpoint inhibitors: Impact and timing of immune-related adverse events and prior tyrosine kinase inhibitor therapy
Authors: Sayer Michael R. , Mambetsariev Isa , Lu Kun-Han , Wong Chi Wah , Duche Ashley , Beuttler Richard , Fricke Jeremy , Pharoan Rebecca , Arvanitis Leonidas , Eftekhari Zahra , Amini Arya , Koczywas Marianna , Massarelli Erminia , Roosan Moom Rahman , Salgia Ravi
Published: February 2023

Introduction

Immune checkpoint inhibitors (ICIs) produce a broad spectrum of immune-related adverse events (irAEs) affecting various organ systems. While ICIs are established as a therapeutic option in non-small cell lung cancer (NSCLC) treatment, most patients receiving ICI relapse. Additionally, the role of ICIs on survival in patients receiving prior targeted tyrosine kinase inhibitor (TKI) therapy has not been well-defined.

Objective

To investigate the impact of irAEs, the relative time of occurrence, and prior TKI therapy to predict clinical outcomes in NSCLC patients treated with ICIs.

Methods

A single center retrospective cohort study identified 354 adult patients with NSCLC receiving ICI therapy between 2014 and 2018. Survival analysis utilized overall survival (OS) and real-world progression free survival (rwPFS) outcomes. Model performance matrices for predicting 1-year OS and 6-month rwPFS using linear regression baseline, optimal, and machine learning modeling approaches.

Results

Patients experiencing an irAE were found to have a significantly longer OS and rwPFS compared to patients who did not (median OS 25.1 vs. 11.1 months; hazard ratio [HR] 0.51, confidence interval [CI] 0.39- 0.68, P-value <0.001, median rwPFS 5.7 months vs. 2.3; HR 0.52, CI 0.41- 0.66, P-value <0.001, respectively). Patients who received TKI therapy before initiation of ICI experienced significantly shorter OS than patients without prior TKI therapy (median OS 7.6 months vs. 18.5 months; P-value < 0.01). After adjusting for other variables, irAEs and prior TKI therapy significantly impacted OS and rwPFS. Lastly, the performances of models implementing logistic regression and machine learning approaches were comparable in predicting 1-year OS and 6-month rwPFS.

Conclusion

The occurrence of irAEs, the timing of the events, and prior TKI therapy were significant predictors of survival in NSCLC patients on ICI therapy. Therefore, our study supports future prospective studies to investigate the impact of irAEs, and sequence of therapy on the survival of NSCLC patients taking ICIs.
Lesion-specific 3D-printed moulds for image-guided tissue multi-sampling of ovarian tumours: A prospective pilot study
Authors: Delgado-Ortet Maria , Reinius Marika A. V. , McCague Cathal , Bura Vlad , Woitek Ramona , Rundo Leonardo , Gill Andrew B. , Gehrung Marcel , Ursprung Stephan , Bolton Helen , Haldar Krishnayan , Pathiraja Pubudu , Brenton James D. , Crispin-Ortuzar Mireia , Jimenez-Linan Mercedes , Escudero Sanchez Lorena , Sala Evis
Published: February 2023

Background

High-Grade Serous Ovarian Carcinoma (HGSOC) is the most prevalent and lethal subtype of ovarian cancer, but has a paucity of clinically-actionable biomarkers due to high degrees of multi-level heterogeneity. Radiogenomics markers have the potential to improve prediction of patient outcome and treatment response, but require accurate multimodal spatial registration between radiological imaging and histopathological tissue samples. Previously published co-registration work has not taken into account the anatomical, biological and clinical diversity of ovarian tumours.

Methods

In this work, we developed a research pathway and an automated computational pipeline to produce lesion-specific three-dimensional (3D) printed moulds based on preoperative cross-sectional CT or MRI of pelvic lesions. Moulds were designed to allow tumour slicing in the anatomical axial plane to facilitate detailed spatial correlation of imaging and tissue-derived data. Code and design adaptations were made following each pilot case through an iterative refinement process.

Results

Five patients with confirmed or suspected HGSOC who underwent debulking surgery between April and December 2021 were included in this prospective study. Tumour moulds were designed and 3D-printed for seven pelvic lesions, covering a range of tumour volumes (7 to 133 cm3) and compositions (cystic and solid proportions). The pilot cases informed innovations to improve specimen and subsequent slice orientation, through the use of 3D-printed tumour replicas and incorporation of a slice orientation slit in the mould design, respectively. The overall research pathway was compatible with implementation within the clinically determined timeframe and treatment pathway for each case, involving multidisciplinary clinical professionals from Radiology, Surgery, Oncology and Histopathology Departments.

Conclusions

We developed and refined a computational pipeline that can model lesion-specific 3D-printed moulds from preoperative imaging for a variety of pelvic tumours. This framework can be used to guide comprehensive multi-sampling of tumour resection specimens.
Endoscopic far-lateral supracerebellar infratentorial approach for resection of posterior clinoid meningioma: Case report and literature review
Authors: Bai Yang , Han Song , Sun Xiaoyu , Liu Xuantong , Li Xinning , Feng Sizhe , Liang Guobiao
Published: February 2023

Introduction

The surgery of posterior clinoid meningioma (PCM) remains one of the most formidable challenges for neurosurgeons because of its location at great depth in the cranium and proximity to vital neurovascular structures. Herein, we aim to describe the technique and feasibility of a novel approach, the purely endoscopic far-lateral supracerebellar infratentorial approach (EF-SCITA), for resection of this extremely rare entity.

Case description

A 67-year-old women presented with gradually deteriorating vision in right eye for 6 months. Imaging examinations revealed a right-sided PCM, and the EF-SCITA approach was attempted for tumor resection. Tentorium incision allowed a working corridor toward the PCM in the ambient cistern through the supracerebellar space. During surgery, the infratentorial part of the tumor was found to compress the CN III and posterior cerebral artery medially and encase the CN IV laterally. Following debulking of the infratentorial tumor, the supratentorial part could be exposed and then excised, which had dense adhesions to the ICA and the initial part of the basal vein in front. After total tumor removal, its dural attachment was detected at the right posterior clinoid process and then coagulated under direct vision. The patient on follow-up at 1 month had improvement in visual acuity in right eye, with no restriction of extra-ocular movements.

Discussion

EF-SCITA approach combines advantages of the posterolateral approach and endoscopic technique, allowing access to PCMs with seemingly low risks of postoperative morbidity. It would be a safe and effective alternative for resection of lesions in the retrosellar space.
Prediction of CD3 T cells and CD8 T cells expression levels in non-small cell lung cancer based on radiomic features of CT images
Authors: Chen Lujiao , Chen Lulin , Ni Hongxia , Shen Liyijing , Wei Jianguo , Xia Yang , Yang Jianfeng , Yang Minxia , Zhao Zhenhua
Published: February 2023

Background

In this work, radiomics characteristics based on CT scans were used to build a model for preoperative evaluation of CD3 and CD8 T cells expression levels in patients with non-small cell lung cancer (NSCLC).

Methods

Two radiomics models for evaluating tumor-infiltrating CD3 and CD8 T cells were created and validated using computed tomography (CT) images and pathology information from NSCLC patients. From January 2020 to December 2021, 105 NSCLC patients with surgical and histological confirmation underwent this retrospective analysis. Immunohistochemistry (IHC) was used to determine CD3 and CD8 T cells expression, and all patients were classified into groups with high and low CD3 T cells expression and high and low CD8 T cells expression. The CT area of interest had 1316 radiomic characteristics that were retrieved. The minimal absolute shrinkage and selection operator (Lasso) technique was used to choose components from the IHC data, and two radiomics models based on CD3 and CD8 T cells abundance were created. Receiver operating characteristic (ROC), calibration curve, and decision curve analyses were used to examine the models’ ability to discriminate and their clinical relevance (DCA).

Results

A CD3 T cells radiomics model with 10 radiological characteristics and a CD8 T cells radiomics model with 6 radiological features that we created both demonstrated strong discrimination in the training and validation cohorts. The CD3 radiomics model has an area under the curve (AUC) of 0.943 (95% CI 0.886-1), sensitivities, specificities, and accuracy of 96%, 89%, and 93%, respectively, in the validation cohort. The AUC of the CD8 radiomics model was 0.837 (95% CI 0.745-0.930) in the validation cohort, with sensitivity, specificity, and accuracy values of 70%, 93%, and 80%, respectively. Patients with high levels of CD3 and CD8 expression had better radiographic results than patients with low levels of expression in both cohorts (p<0.05). Both radiomic models were therapeutically useful, as demonstrated by DCA.

Conclusions

When making judgments on therapeutic immunotherapy, CT-based radiomic models can be utilized as a non-invasive way to evaluate the expression of tumor-infiltrating CD3 and CD8 T cells in NSCLC patients.
Current comprehensive understanding of denosumab (the RANKL neutralizing antibody) in the treatment of bone metastasis of malignant tumors, including pharmacological mechanism and clinical trials
Authors: Lu Junjie , Hu Desheng , Zhang Yan , Ma Chen , Shen Lin , Shuai Bo
Published: February 2023

Denosumab, a fully humanized monoclonal neutralizing antibody, inhibits activation of the RANK/RANKL/OPG signaling pathway through competitive binding with RANKL, thereby inhibiting osteoclast-mediated bone resorption. Denosumab inhibits bone loss; therefore, it is used to treat metabolic bone diseases (including postmenopausal osteoporosis, male osteoporosis, and glucocorticoid-induced osteoporosis), in clinical practice. Since then, multiple effects of denosumab have been discovered. A growing body of evidence suggests that denosumab has a variety of pharmacological activities and broad potential in clinical diseases such as osteoarthritis, bone tumors, and other autoimmune diseases. Currently, Denosumab is emerging as a treatment for patients with malignancy bone metastases, and it also shows direct or indirect anti-tumor effects in preclinical models and clinical applications. However, as an innovative drug, its clinical use for bone metastasis of malignant tumors is still insufficient, and its mechanism of action needs to be further investigated. This review systematically summarizes the pharmacological mechanism of action of denosumab and the current understanding and clinical practice of the use of denosumab for bone metastasis of malignant tumors to help clinicians and researchers deepen their understanding of denosumab.
Safety of nurse-directed triage intranasal fentanyl protocol for acute pain management in a European pediatric emergency department: A retrospective observational analysis
Authors: Romano F. , Wendelspiess M. , Mansour R. , Abplanalp-Marti O. , Starvaggi C. , Holzner F. , Steiner I. , Keitel K.
Published: February 2023

Background

Nurse-directed pain protocols for intranasal fentanyl administration are not widely implemented in European (EU) pediatric emergency departments (PED). Barriers include perceived safety concerns for intranasal (IN) fentanyl. The aim of this study is to describe our experience with a nurse-directed triage IN fentanyl protocol with a focus on safety in a tertiary EU PED.

Methods

We conducted a retrospective analysis of patient records of children aged 0–16 years who received nurse-directed IN fentanyl between January 2019 and December 2021 at the PED of the University Children's Hospital of Bern, Switzerland. Extracted data points included demographics, presenting complaint, pain score, IN fentanyl dosage, concomitant pain medication use, and adverse events.

Results

A total of 314 patients were identified with ages ranging from 9 months to 15 years. The main indication for nurse-directed fentanyl administration was musculoskeletal pain due to trauma (n = 284, 90%). Mild adverse events (vertigo) were reported in two patients (0.6%), without a correlation to concomitant pain medication or protocol violation. The only reported severe adverse event of syncope and hypoxia in a 14-year-old adolescent occurred in a setting where the institutional nurse-directed protocol was violated.

Conclusion

In accordance with previous studies outside of Europe, our data support the case that when appropriately used, nurse-directed IN fentanyl is a safe potent opioid analgesic for pediatric acute pain management. We strongly encourage the introduction of nurse-directed triage fentanyl protocols Europe-wide in order to provide effective and adequate acute pain management in children.
Inpatient medical management of severe pediatric obesity: Literature review and case reports
Authors: Goldman Victoria E. , Espinoza Juan C. , Vidmar Alaina P.
Published: February 2023

Pediatric obesity rates continue to rise steeply with significant adverse effects on health outcomes across the lifespan. Significant obesity can affect the efficacy, side effects, and ability to use certain treatment, medication, or imaging modalities needed in the evaluation and management of acute pediatric conditions. Inpatient settings are rarely used as an opportunity for weight counseling and thus there is a paucity of clinical guidelines on how to manage severe obesity in the inpatient setting. We present a literature review and three patient cases with single-center protocol for non-surgical management of severe obesity in children admitted for other acute medical reasons. We performed a PubMed review from January 2002 to February 2022 utilizing keywords: “inpatient,” “obesity,” and “intervention.” For our cases, we identified three patients with severe obesity acutely impacting their health while admitted for medical treatment who concurrently underwent acute, inpatient, weight loss regimens at a single children's hospital. The literature search yielded 33 articles describing inpatient weight loss treatments. Three patients met case criteria, all three of which demonstrated a decrease in their weight in excess percent of the 95th percentile after inpatient weight-management protocol implementation (% reduction BMIp95: 16%–30%). This highlights obesity acutely limits or impacts specific medical care required during inpatient admissions in pediatric patients. It also suggests that implementation of an inpatient weight-management protocol during admission may provide an opportune setting to support acute weight loss and overall improved health outcomes in this high-risk cohort.
Adverse events of tumor necrosis factor alpha inhibitors for the treatment of ankylosing spondylitis: A meta-analysis of randomized, placebo-controlled trials
Authors: Feng Haihuan , Zhao Ying , Kuang Weihong , Dai Yanping , Cen Xiaobo , Qin Feng
Published: February 2023

Objective: Tumor necrosis factor alpha inhibitors (TNFi) have shown substantial efficacy in alleviating and treating ankylosing spondylitis (AS). However, the heightened interest is accompanied by concerns over adverse events. In this meta-analysis, we analyzed both serious and common adverse events in patients treated with tumor necrosis factor alpha inhibitors compared with those in the placebo group.

Methods: We searched for clinical trials in PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, and VIP Data. Studies were selected based on strict inclusion and exclusion criteria. Only randomized, placebo-controlled trials were included in the final analysis. RevMan 5.4 software was used for performing meta-analyses.

Results: A total of 18 randomized controlled trials recruiting 3,564 patients with ankylosing spondylitis were included, with overall moderate to high methodological quality. Compared with the placebo group, the incidences showed no difference and were only slightly increased numerically for serious adverse events, serious infections, upper respiratory tract infection, and malignancies in patients treated with tumor necrosis factor alpha inhibitors. However, tumor necrosis factor alpha inhibitor treatment significantly increased the incidence of overall adverse events, nasopharyngitis, headache, and injection-site reactions in ankylosing spondylitis patients when compared with placebo.

Conclusion: The available data indicated that ankylosing spondylitis patients who received tumor necrosis factor alpha inhibitors had no significantly increased risks of serious adverse events when compared with the placebo group. However, tumor necrosis factor alpha inhibitors significantly increased the incidence rate of common adverse events, including nasopharyngitis, headache, and injection-site reactions. Large-scale and long-term follow-up clinical trials are still necessary to further investigate the safety of tumor necrosis factor alpha inhibitors in ankylosing spondylitis treatment.
CTH/MPST double ablation results in enhanced vasorelaxation and reduced blood pressure via upregulation of the eNOS/sGC pathway
Authors: Katsouda Antonia , Markou Maria , Zampas Paraskevas , Varela Aimilia , Davos Constantinos H. , Vellecco Valentina , Cirino Giuseppe , Bucci Mariarosaria , Papapetropoulos Andreas
Published: February 2023

Hydrogen sulfide (H2S), a gasotransmitter with protective effects in the cardiovascular system, is endogenously generated by three main enzymatic pathways: cystathionine gamma lyase (CTH), cystathionine beta synthase (CBS) and 3-mercaptopyruvate sulfurtransferase (MPST) enzymes. CTH and MPST are the predominant sources of H2S in the heart and blood vessels, exhibiting distinct effects in the cardiovascular system. To better understand the impact of H2S in cardiovascular homeostasis, we generated a double Cth/Mpst knockout (Cth/Mpst−/−) mouse and characterized its cardiovascular phenotype. CTH/MPST-deficient mice were viable, fertile and exhibited no gross abnormalities. Lack of both CTH and MPST did not affect the levels of CBS and H2S-degrading enzymes in the heart and the aorta. Cth/Mpst−/− mice also exhibited reduced systolic, diastolic and mean arterial blood pressure, and presented normal left ventricular structure and fraction. Aortic ring relaxation in response to exogenously applied H2S was similar between the two genotypes. Interestingly, an enhanced endothelium-dependent relaxation to acetylcholine was observed in mice in which both enzymes were deleted. This paradoxical change was associated with upregulated levels of endothelial nitric oxide synthase (eNOS) and soluble guanylate cyclase (sGC) α1 and β1 subunits and increased NO-donor-induced vasorelaxation. Administration of a NOS-inhibitor, increased mean arterial blood pressure to a similar extent in wild-type and Cth/Mpst−/− mice. We conclude that chronic elimination of the two major H2S sources in the cardiovascular system, leads to an adaptive upregulation of eNOS/sGC signaling, revealing novel ways through which H2S affects the NO/cGMP pathway.
Renin–angiotensin–aldosterone pathway modulators in chronic kidney disease: A comparative review
Authors: Alshahrani Saeed
Published: February 2023

Chronic kidney disease presents a health challenge that has a complex underlying pathophysiology, both acquired and inherited. The pharmacotherapeutic treatment options available today lower the progression of the disease and improve the quality of life but cannot completely cure it. This poses a challenge to the healthcare provider to choose, from the available options, the best way to manage the disease as per the presentation of the patient. As of now, the recommended first line of treatment to control the blood pressure in chronic kidney disease is the administration of renin–angiotensin–aldosterone system modulators. These are represented mainly by the direct renin inhibitor, angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers. These modulators are varied in their structure and mechanisms of action, hence showing varying treatment outcomes. The choice of administration of these modulators is determined by the presentation and the co-morbidities of the patient, the availability and affordability of the treatment option, and the expertise of the healthcare provider. A direct head-to-head comparison between these significant renin–angiotensin–aldosterone system modulators is lacking, which can benefit healthcare providers and researchers. In this review, a comparison has been drawn between the direct renin inhibitor (aliskiren), angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers. This can be of significance for healthcare providers and researchers to find the particular loci of interest, either in structure or mechanism, and to intervene as per the case presentation to obtain the best possible treatment option.
Trehalose-6-phosphate synthase regulates chitin synthesis in Mythimna separata
Authors: Yang Hong-Jia , Cui Meng-Yao , Zhao Xiao-Hui , Zhang Chun-Yu , Hu Yu-Shuo , Fan Dong
Published: February 2023

Trehalose is a substrate for the chitin synthesis pathway in insects. Thus, it directly affects chitin synthesis and metabolism. Trehalose-6-phosphate synthase (TPS) is a crucial enzyme in the trehalose synthesis pathway in insects, but its functions in Mythimna separata remain unclear. In this study, a TPS-encoding sequence in M. separata (MsTPS) was cloned and characterized. Its expression patterns at different developmental stages and in diverse tissues were investigated. The results indicated that MsTPS was expressed at all analyzed developmental stages, with peak expression levels in the pupal stage. Moreover, MsTPS was expressed in the foregut, midgut, hindgut, fat body, salivary gland, Malpighian tubules, and integument, with the highest expression levels in the fat body. The inhibition of MsTPS expression via RNA interference (RNAi) resulted in significant decreases in the trehalose content and TPS activity. It also resulted in significant changes in Chitin synthase (MsCHSA and MsCHSB) expression, and significantly decrease the chitin content in the midgut and integument of M. separata. Additionally, the silencing of MsTPS was associated with a significant decrease in M. separata weight, larval feed intake, and ability to utilize food. It also induced abnormal phenotypic changes and increased the M. separata mortality and malformation rates. Hence, MsTPS is important for M. separata chitin synthesis. The results of this study also suggest RNAi technology may be useful for enhancing the methods used to control M. separata infestations.
A bibliometric analysis of the studies in high-altitude induced sleep disturbances and cognitive impairment research
Authors: Zhang Jiexin , Tang Songyuan , Chen Chao , Jiang Hezhong , Liao Hai , Liu Huawei , Wang Li , Chen Xin
Published: February 2023

Background: The two main symptoms at high altitude, sleep abnormalities and cognitive impairments, interact with each other. These two dysfunctions are also closely related to systemic multisystem diseases, including cerebrovascular diseases, psychiatric disorders, and immune regulatory diseases.

Purpose: To systematically analyze and visualize research on sleep disturbances and cognitive impairment at high altitudes using a bibliometrics method, and to determine future research directions by analyzing research trends and the latest hotspots.

Methods: Publications from 1990 to 2022 on sleep disturbances and cognitive impairment at high altitudes were retrieved from the Web of Science. Using the R Bibliometrix software and Microsoft Excel, all data were examined statistically and qualitatively. For network visualization, the data were later exported into VOSviewer 1.6.17 and CiteSpace 6.1.R6.

Results: A total of 487 articles in this area were published from 1990 to 2022. In this period, there was an overall increase in the number of publications. The United States has shown considerable importance in this sector. Bloch Konrad E was the most prolific and valuable author. The most prolific journal was High Altitude Medicine & Biology, and it has been the first choice for publishing in this field in recent years. Analysis of keyword co-occurrences suggested that research interest in the clinical manifestations of sleep disturbances and cognitive impairment caused by altitude hypoxia was mainly focused on “acute mountain-sickness,” “insomnia,” “apnea syndrome,” “depression,” “anxiety,” “Cheyne-strokes respiration,” and “pulmonary hypertension.” The mechanisms of disease development related to “oxidative stress,” “inflammation,” “hippocampus,” “prefrontal cortex,” “neurodegeneration,” and “spatial memory” in the brain have been the focus of recent research. According to burst detection analysis, “mood” and “memory impairment,” as terms with high strength, are expected to remain hot topics in the coming years. High-altitude-induced pulmonary hypertension is also in the emerging stage of research, and the treatments will continue to receive attention in the future.

Conclusion: More attention is being focused on sleep disturbances and cognitive impairment at high altitudes. This work will serve as a useful reference for the clinical development of treatments for sleep disturbances and cognitive impairment induced by hypobaric hypoxia at high altitudes.
Fading boundaries between the physical and the social world: Insights and novel techniques from the intersection of these two fields
Authors: Dapor Cecilia , Sperandio Irene , Meconi Federica
Published: February 2023

This review focuses on the subtle interactions between sensory input and social cognition in visual perception. We suggest that body indices, such as gait and posture, can mediate such interactions. Recent trends in cognitive research are trying to overcome approaches that define perception as stimulus-centered and are pointing toward a more embodied agent-dependent perspective. According to this view, perception is a constructive process in which sensory inputs and motivational systems contribute to building an image of the external world. A key notion emerging from new theories on perception is that the body plays a critical role in shaping our perception. Depending on our arm’s length, height and capacity of movement, we create our own image of the world based on a continuous compromise between sensory inputs and expected behavior. We use our bodies as natural “rulers” to measure both the physical and the social world around us. We point out the necessity of an integrative approach in cognitive research that takes into account the interplay between social and perceptual dimensions. To this end, we review long-established and novel techniques aimed at measuring bodily states and movements, and their perception, with the assumption that only by combining the study of visual perception and social cognition can we deepen our understanding of both fields.
The role of hormones in attraction and visual attention to facial masculinity
Authors: Garza Ray , Byrd-Craven Jennifer
Published: February 2023

The current study investigated the ovulatory shift hypothesis, which suggests that women prefer more masculine traits when estradiol is high, and progesterone is low (E/P ratio). The current study used an eye tracking paradigm to measure women’s visual attention to facial masculinity across the menstrual cycle. Estradiol (E) and progesterone (P) were collected to determine if salivary biomarkers were associated with visual attention to masculine faces in a short- and long-term mating context. Women (N = 81) provided saliva samples at three time points throughout their menstrual cycle and were asked to rate and view men’s faces that had been manipulated to appear feminine and masculine. Overall, masculine faces were viewed longer compared to feminine faces and this was moderated by mating context, where women viewed masculine faces longer for a long-term relationship. There was not any evidence suggesting that E/P ratio was associated with preferences for facial masculinity, but there was evidence to suggest that hormones were associated with visual attention to men in general. In line with sexual strategies theory, there was evidence to suggest that mating context and facial masculinity are important in mate choice; however, there was no evidence to suggest that women’s mate choice was associated with shifts across the menstrual cycle.
Neuroscience-based psychotherapy: A position paper
Authors: Cammisuli Davide Maria , Castelnuovo Gianluca
Published: February 2023

In the recent years, discoveries in neuroscience have greatly impacted upon the need to modify therapeutic practice starting from the evidence showing some cerebral mechanisms capable of coping with mental health crisis and traumatic events of the individual's life history by redesigning the narrative plot and the person's sense of the Self. The emerging dialogue between neuroscience and psychotherapy is increasingly intense and modern psychotherapy cannot ignore the heritage deriving from studies about neuropsychological modification of memory traces, neurobiology of attachment theory, cognitive mechanisms involved in psychopathology, neurophysiology of human empathy, neuroimaging evidence about psychotherapeutic treatment, and somatoform disorders connecting the brain and the body. In the present article, we critically examined sectorial literature and claimed that psychotherapy has to referred to a neuroscience-based approach in order to adopt the most tailored interventions for specific groups of patients or therapy settings. We also provided recommendations for care implementation in clinical practice and illustrated challenges of future research.
Predictors of post-stroke depression: Validation of established risk factors and introduction of a dynamic perspective in two longitudinal studies
Authors: Ladwig Simon , Werheid Katja , Südmeyer Martin , Volz Matthias
Published: February 2023

Introduction

Cerebral insults lead in many cases not only to cognitive impairment but also to disturbed emotionality. After stroke, one in three survivors develops a depression which impacts quality of life and rehabilitation. Meta-analyses have identified five main predictors of post-stroke depression (PSD): history of mental disorder, stroke severity, physical disability, cognitive impairment, and social support. However, these five established variables have never been conjointly investigated in a sample of stroke survivors. Therefore, their independent predictive values remain unclear. Moreover, predictors are most often used as time-invariant factors (status scores), neglecting the intraindividual dynamics after stroke.

Methods

Our study analyses the data of two prospective longitudinal studies, investigating stroke survivors from two rehabilitation hospitals (N1 = 273) and one acute care hospital (N2 = 226). Baseline assessments included the five established predictors and depressive symptoms. After 6 months, depressive symptoms were reassessed in both studies (n1 = 176, n2 = 183), and physical disability and social support were reassessed in study 2. The predictivity of the five predictors and the additional predictivity of intraindividual dynamics for PSD were examined in multiple linear regression analyses.

Results

History of mental disorder was a risk factor for depressive symptoms after stroke at all measurement times (B = 3.32 to 3.97; p < 0.01). Physical disability was a risk factor at all measurement times (B = −0.09 to −0.03; p < 0.05) except 6 months after rehabilitation. Social support was a protective factor (B = −2.69 to −1.91; p < 0.01) outside the acute phase (R2 = 0.15–0.39). Intraindividual changes in physical disability and perceived social support were independent predictors of PSD 6 months after the acute phase (B = −0.08/−0.14; p < 0.01), in addition to status scores on established variables (ΔR2 = 0.08, p < 0.001).

Discussion

History of mental disorder, physical disability, and social support are independent predictors of depressive symptoms in the first year post-stroke, also when considered conjointly. Future studies should control for these variables when investigating new predictors of PSD. In addition, intraindividual changes in known predictors after stroke play a relevant role in the pathogenesis of PSD and should be considered in clinical practice and future research.
Satisfaction with the life of Polish women experiencing domestic violence
Authors: Pawłowska-Muc Agnieszka Konstancja , Pilewska-Kozak Anna Bogusława , Stadnicka Grażyna , Kęsik Jan Jakub , Dobrowolska Beata
Published: February 2023

Introduction

Domestic violence against a woman, inflicted by her husband/partner, disrupts the socially recognized model of partnership and family life and endangers the health and life of the victim. The aim of the study was to assess the level of satisfaction with the life of Polish women experiencing domestic violence and compare it to results of women not experiencing domestic violence.

Methods

A cross-sectional study was conducted on a convenience sample of 610 Polish women divided in two groups: victims of domestic violence (Group 1, n = 305) and women not experiencing domestic violence (Group 2, n = 305).

Results and Conclusions

Most Polish women experiencing domestic violence are characterized by low life satisfaction. The mean value of life satisfaction in Group 1 was 13.78, SD = 4.88, significantly lower when compared to Group 2 (M = 21.04, SD = 5.61). Their satisfaction with life is related, among other things, to the form of violence inflicted upon them by their husband/partner. Abused women with low life satisfaction are most often victims of psychological violence. The most common cause is the perpetrator's addiction to alcohol and/or drugs. Assessment of their life satisfaction is unrelated to help-seeking and to the occurrence of violence in their family home in the past.
Exploring the needs and barriers for death education in China: Getting answers from heart transplant recipients' inner experience of death
Authors: Shu Wan , Miao QunFang , Feng JieHui , Liang GuanMian , Zhang Jing , Zhang Jinsheng
Published: February 2023

Background

Promoting reflection about death may support better living, and how to carry out death education is an important issue to be addressed across the world. The purpose of the current study was to explore the attitude of heart transplant recipients toward death and their inner real experience to provide information for the development of death education strategies.

Methods

A phenomenological qualitative study was conducted using a snowball method. A total of 11 patients who had undergone heart transplantation more than 1-year ago were recruited for the current study for semi-structured interviews.

Results

A total of five themes were identified: “Not avoid talking about death,” “Feeling fear about the pain in the process of death”, “Wanting a good death at the end of life,” “The richness of feelings during near-death is surprising,” and “Being close to death makes people more receptive to death.”

Conclusion

Heart transplant recipients have a positive attitude toward death and wish for “good death” at the end of life. These patients' near-death experiences and positive attitudes toward death during the course of their illness provided evidence of the need for death education in China and supported the experiential approach to death education.
Low limb prostheses and complex human prosthetic interaction: A systematic literature review
Authors: Domínguez-Ruiz Adan , López-Caudana Edgar Omar , Lugo-González Esther , Espinosa-García Francisco Javier , Ambrocio-Delgado Rocío , García Ulises D. , López-Gutiérrez Ricardo , Alfaro-Ponce Mariel , Ponce Pedro
Published: February 2023

A few years ago, powered prostheses triggered new technological advances in diverse areas such as mobility, comfort, and design, which have been essential to improving the quality of life of individuals with lower limb disability. The human body is a complex system involving mental and physical health, meaning a dependant relationship between its organs and lifestyle. The elements used in the design of these prostheses are critical and related to lower limb amputation level, user morphology and human-prosthetic interaction. Hence, several technologies have been employed to accomplish the end user’s needs, for example, advanced materials, control systems, electronics, energy management, signal processing, and artificial intelligence. This paper presents a systematic literature review on such technologies, to identify the latest advances, challenges, and opportunities in developing lower limb prostheses with the analysis on the most significant papers. Powered prostheses for walking in different terrains were illustrated and examined, with the kind of movement the device should perform by considering the electronics, automatic control, and energy efficiency. Results show a lack of a specific and generalised structure to be followed by new developments, gaps in energy management and improved smoother patient interaction. Additionally, Human Prosthetic Interaction (HPI) is a term introduced in this paper since no other research has integrated this interaction in communication between the artificial limb and the end-user. The main goal of this paper is to provide, with the found evidence, a set of steps and components to be followed by new researchers and experts looking to improve knowledge in this field.
Prevalence and predictors of gender-based violence among Wolkite University female students, southwest Ethiopia, 2021: Cross-sectional study
Authors: Workye Haile , Mekonnen Zebene , Wedaje Wesen , Sitot Aregash
Published: February 2023

Background

Gender-based violence is an important topic that needs to be taken into account when identifying gender-related gaps and disadvantages that a person might face because of their gender. Violence against women could result in psychological and physical adverse outcomes. Therefore, this study aims to assess the prevalence and predictors of gender-based violence among female students at Wolkite University, southwest Ethiopia, 2021.

Method

An institutional-based cross-sectional study was conducted among 393 female students and the students were selected by using a systematic sampling method. Data were checked for completeness and entered into EpiData version 3.1 and then exported to SPSS version 23 for further analysis. Binary and multivariable logistic regressions were employed to determine the prevalence and predictors of gender-based violence. The adjusted odds ratio (AOR) with its 95% confidence interval (CI) at a p-value of ≤0.05 was used to check statistical association.

Result

In this study, the overall prevalence of gender-based violence among female students was 46.2%. The prevalence of physical violence and sexual violence was 56.1% and 47.0%, respectively. Factors that were significantly associated with gender-based violence among female university students were: being a 2nd-year student or having a lower educational level [AOR = 2.56 (95% CI, 1.06–6.17)], being married or living with a male partner [AOR = 3.35 (95% CI, 1.07–10.5], having a father with no formal education [AOR = 15.46 (95% CI, 5.204–45.39)], having a drinking habit [AOR = 2.53 (95% CI, 1.21–6.30)] and not being able to freely discuss issues with their families [AOR = 2.48 (95% CI, 1.27–4.84)]

Conclusions and recommendations

The result of this study showed that more than one-third of the participants were exposed to gender-based violence. Thus, gender-based violence is an important topic deserving of more consideration; further investigations are important to decrease gender-based violence among university students.