bluuebunny/crossref_metadata_2025 huggingface dataset:
Peak oxygen uptake and respiratory muscle performance in patients with chronic obstructive pulmonary disease: Clinical findings and implications
Authors: Choi Hee-Eun , Min Eun-Ho , Kim Hyun-Kuk , Kim Hyo-Jung , Jang Hang-Jea
Published: October 2022

The maximal oxygen uptake (VO2max) is the gold standard measure of aerobic exercise capacity and is an important outcome measure in patients with chronic obstructive pulmonary disease (COPD). And respiratory muscle performance is also an important functional parameter for COPD patients. In addition to the traditional respiratory muscle strength test, the Test of Incremental Respiratory Endurance has recently been introduced and validated in patients with COPD. However, the relationship between VO2 and respiratory muscle performance in COPD is not well understood. Therefore, this study investigated the correlations among VO2 and respiratory muscle performance and other functional markers in COPD. A total of 32 patients with COPD were enrolled. All study participants underwent the following assessments: cardiopulmonary exercise test, pulmonary function test, respiratory muscle strength test, peripheral muscle strength test, and bioelectrical impedance analysis. When comparing VO2peak and respiratory muscle parameters, the sustained maximal inspiratory pressure (SMIP) was the only factor with a significant relationship with VO2peak. Among other functional parameters, the forced expiratory volume in one second (FEV1) showed the strongest correlation with VO2peak. It was followed by phase angle values of lower limbs, leg extension peak torque, age, and total skeletal muscle mass. When comparing respiratory muscle performance with other functional parameters, the SMIP showed the strongest correlation with hand grip strength, followed by peak cough flow, forced vital capacity, maximal inspiratory pressure, and FEV1. The results showed that the SMIP was more significantly correlated with VO2peak than the static measurement of respiratory muscle strength. This suggests that TIRE may be a useful assessment tool for patients with COPD. Additionally, FEV1 and other functional markers were significantly correlated with VO2peak, suggesting that various parameters may be used to evaluate aerobic power indirectly.
Comparison of incidence and prognosis between young and old gastric cancer patient in North-Western China: A retrospective cohort study
Authors: An Juan , Ma Xiaoming , Zhang Chengwu , Zhou Wei , Wang Cheng , Miao Wei , Cai Baojia , Yu Pengjie , Qiao Wenjie , Xu Zhaojun
Published: October 2022

Gastric cancer (GC) is the fourth most common cancer in the world and the second most common cancer in China. In this study, we compared the clinicopathological features and prognosis of GC between young and old patients after curative resection. Six hundred and eighty-six patients with GC resected were divided two groups according to patient age: Younger GC patients ≤40 years of age (YGC, n = 52) and older GC patients >40 years of age (OGC, n = 634). The YGC group had 52 (7.6%) patients in total 686 GC patients. YGC patients was predominant in women (53.8% vs 26.5%) compared with OGC patients. 5-year overall survival exhibited differences in tumor sites, tumor sizes, macroscopic types, T staging, N staging, rate of N staging (rN), tumor node metastasis staging, scope of gastrectomy, radical degree, and lymphatic vascular invasion within each of YGC and OGC group. Univariate analysis of the clinical factors affecting overall survival in YGC group revealed the significant differences in tumor size, macroscopic types (except Borrmann), T staging (except T2), N staging (N3a and N3b), rN, tumor node metastasis staging (III), scope of gastrectomy, radical degree, and lymphatic vascular invasion. Gender, N staging, rN, radical degrees were the independent prognostic factors of younger patients with GC. Similar results were found in the OGC groups. The significant differences in radical degree and lymphatic vascular invasion were found between male and female patients in YGC group. Similar results were found in the OGC groups. Our results showed that YGC patients differ from OGC patients in predominance of women. Gender, N staging, rN, radical degrees were independent risk factors for the prognosis in YGC patients.
Influence of continuous positive airway pressure on lipid profiles of obstructive sleep apnea: A systematic review and meta-analysis
Authors: Xu Yinghua , Wu Haiyan , Lu Xiaoling
Published: October 2022

Background:

To investigate the influence of continuous positive airway pressure (CPAP) on lipid profiles of the patients with obstructive sleep apnea (OSA) in this meta-analysis.

Methods:

Relevant studies reporting the correlation between CPAP and lipid profiles of OSA patients were searched in Pubmed, Cochrane Library and Embase before January 1, 2021. Data of eligible studies were extracted and analyzed using the fixed-effect or random-effect model. Standard mean difference (SMD) and 95% confidence interval (95% CI) were calculated to assess such influence. Subgroup analysis based on CPAP duration was further performed. STATA 12.0 was used in this meta-analysis.

Results:

A total of 12 independent randomized controlled studies involved 1129 OSA patients were recruited in this meta-analysis. The analyzed lipid profiles included total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) and high density lipoprotein (HDL). CPAP was not correlated to TC (SMD = –0.07, 95% CI = –0.33 to 0.19), TG (SMD = –0.01, 95% CI = –0.19 to 0.17), LDL (SMD = –0.01, 95% CI = –0.23 to 0.21) and HDL (SMD = 0.10, 95% CI = –0.03 to 0.22) in OSA patients. Moreover, CPAP duration (=12 weeks; >12 weeks; <12 weeks) also did not influence lipid profiles of OSA patients as well.

Conclusions:

Regardless of the treatment in CPAP duration, it doses does not influence lipid profiles of OSA patients, including TC, TG, LDL and HDL. The results are inconsistent with previous findings, which should be further validated in the multi-center, long-term randomized controlled trials.
Comparative effectiveness of different platelet-rich plasma for arthroscopic rotator cuff repair: A protocol for systematic review and network meta-analysis
Authors: Shen Weiwei , Wang Wei , Xue Yun , Shi Jie , Pu Zhongshu , Gao Qiuming
Published: October 2022

Background:

Rotator cuff tears are one of the most common injuries of the shoulder joint in adults. Arthroscopic rotator cuff repair (ARCR) has become the gold standard for the treatment of rotator cuff injuries, but it still has a high rate of retear. Platelet-rich plasma (PRP) has been widely used as an adjunct to ARCR. However, the comparative efficacy of different PRP for ARCR remain unclear. In order to evaluate the relative efficacy of PRP for individuals with ARCR, we will conduct a systematic review and network meta-analysis of randomized controlled trials.

Methods:

A systematic literature search will be conducted in Embase, PubMed, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Database, and Chinese Biomedical Literature Database will be searched up to October 2022. The primary outcome will focus on the retear rate at the last follow-up. The secondary outcomes include the Visual Analogue Scale for postoperative pain and functional capacity scores. The risk of bias for individual studies will be assessed according to the revised Cochrane risk-of-bias tool for randomized trials (RoB 2.0). Data analysis will be performed using R 4.1.2. Publication bias will be examined using comparison-adjusted funnel plots and Egger’s test using STATA 15.0. The quality of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation approach.

Results:

The results of this study will be submitted to a peer-reviewed journal for publication.

Conclusions:

The review will compare the efficacy of different PRP for patients with ARCR. The result of the study will provide evidence-based medical evidence for ARCR with PRP augmentation.
Investigation report on endoscopic management of esophagogastric variceal bleeding by Chinese endoscopists
Authors: Zhang Wenhui , Wang Yanling , Chu Jindong , Liu Yingdi , LingHu Enqiang
Published: October 2022

Background:

Esophagogastric variceal bleeding (EGVB) is a potentially life-threatening complication of portal hypertension. Endoscopic treatment combined with pharmacotherapy remains the mainstay in the management of acute variceal bleeding.

Aim:

This article intends to highlight the potential differences in the endoscopic management of EGVB in China.

Methods:

A cross-sectional descriptive study was conducted. Endoscopists from 85 hospitals in 62 cities from 26 provinces were contacted by email. The items in questionnaire involved academic experience, screening, esophagogastric varices (EGV) classification, emergency treatment, and primary and secondary prophylaxis of EGVB by endoscopists with different lengths of experience.

Results:

A total of 85 questionnaires were collected. There was no statistical difference in the selection of items (P < .05 indicated statistical significance). The majority of endoscopists (95.29%) offered EGV screening for patients with liver cirrhosis. The location, diameter, and risk factor classification was selected by 82.35% of endoscopists. Endoscopy + medication was preferred (42.35%) for the primary prophylaxis of moderate-to-severe EGVs. There was no statistical difference in emergency intervention time for active EGVB (P > .05). The response “patients receive emergency endoscopic intervention within 12 hours” was selected by 61.2% of the endoscopists. The preferred emergency treatment for EGVB was combination treatment (40%). Tissue adhesive embolization was selected for the treatment of gastric variceal bleeding by 74.12% of endoscopists; transjugular intrahepatic portosystemic stent shunt/percutaneous transhepatic variceal embolization were selected as remedial measures by 48.23% to 52.94% of endoscopists. In addition, 67.06% of endoscopists elected to perform secondary prophylaxis and treatment within 1 week after hemostasis. Endoscopy and endoscopy + medication were selected by 44.71% and 49.41% of endoscopists, respectively, for secondary prophylaxis. The choice of laboratory indicators did not differ with length of experience.

Conclusions:

There was no statistical difference in the endoscopic management of EGVB among Chinese endoscopists. The selection of diagnosis/treatment schemes was mainly based on guidelines and physician experience.
Metformin therapy as a strategy to compensate anti-VEGF resistance in patients with diabetic macular edema
Authors: Uwimana Alexandre , Ma Cong , Chen Shengyao , Ma Xiang
Published: October 2022

Diabetic macular edema (DME) is the complication of diabetic retinopathy, the leading cause of vision loss among diabetic patients. Metformin is the main antidiabetic treatment. It is preferable for its great anti-angiogenic and anti-inflammatory effects. Anti-vascular endothelial growth factor (VEGF) therapy is the preferable treatment for DME despite its lack of convincing results in some patients. To assess whether the combination of metformin and anti-VEGF drugs may decrease the risk of anti-VEGF resistance among DME patients. We included DME patients with a central retinal thickness (CRT) ≥ 250 μm who consecutively underwent at least 3 anti-VEGF therapies from January 1, 2020, to December 30, 2021. Anti-VEGF resistance was defined as persistent macular edema with decreased CRT ≤ 25% after 3 anti-VEGF injections. 109 patients were considered for this research, of whom 65 (59.6%) were resistant to anti-VEGF therapy. The mean CRT of the non-metformin group decreased from 344.88 ± 129.48 to 318.29 ± 123.23 (20.85%) and from 415.64 ± 144.26 to 277.11 ± 99.25 (31.51%) (P = .031) in the metformin group. Moreover, the metformin group had fewer resistant patients than the non-metformin, 24 (45.3%) versus 41 (73.2%). Furthermore, a considerable gain in visual acuity was observed in both groups, with a BCVA gain of 40.41% in the metformin group and 39.9% in the non-metformin group. Metformin may be combined with an anti-VEGF drug to minimize the risk of anti-VEGF resistance among DME patients. Moreover, it can serve to design effective therapeutic deliveries.
Intestinal obstruction caused by small bowel entrapment within a lumbar fracture: A case report
Authors: Lee Jin Suk , Kim Se Heon , Lee Jin Young , Ye Jin Bong , Sul Young Hoon , Seok Junepill , Yoon Su Young , Kim Hong Rye , Choi Jung Hee , Kim Yook
Published: October 2022

Introduction:

Intestinal obstruction associated with traumatic vertebral fracture is extremely rare. We report a case of obstructive small bowel injury caused by entrapment of the small intestine at the fracture site of the 5th lumbar vertebra due to trauma.

Case presentation:

A 55-year-old man fell from a height of 4 m and visited the emergency room of a local hospital with complain of back pain. During the examination, a 5th lumbar vertebral body fracture and left psoas muscle hematoma were observed, and the patient was admitted to the neurosurgery department for conservative treatment. The patient received conservative treatment for 2 days, but new symptoms of intestinal obstruction and fever occurred. A neurosurgeon at the hospital suspected duodenal perforation and transferred the patient to the regional trauma center for treatment. Our medical staff reviewed the patient’s symptoms and imaging data and decided to perform an emergency operation because of small bowel entrapment in the 5th lumbar vertebrae fracture and perforation of the small intestine. We found that the small bowel, approximately 160 cm below the ligament of Treitz, was incarcerated at the 5th lumbar vertebral fracture site. After careful manual reduction of the entrapment of the small intestine, a small bowel resection of 25 cm, including the injury site, was performed with anastomosis.

Conclusion:

If symptoms of intestinal obstruction are observed in patients with traumatic spinal injury, medical staff must consider the exceedingly rare possibility of bowel entrapment.
Huangqi Guizhi Wuwu decoction in peripheral neurotoxicity treatment using network pharmacology and molecular docking
Authors: Chen Tingting , Shi Yabo , Shi Wenchuan
Published: October 2022

In this study, we predicted the core active compounds of Huangqi Guizhi Wuwu decoction in treatment of oxaliplatin-induced peripheral neuropathy and the related potential mechanism. Corresponding database was used to complete the interaction (PPI) network of key targets and the enrichment analysis of corresponding genmes. Molecular docking of key targets and key compounds was carried out using relevant software. The 60 chemical components corresponding to the oral absorption of Huangqi Guizhi Wuwu decoction correspond to 157 unique targets, and the 233 chemical components corresponding to percutaneous absorption in vitro correspond to 155 unique targets. There were 1074 unique targets for chemotherapy-induced peripheral neuropathy. Finally, three common key targets (SLC6A2, SLC6A3, and SLC6A4) and two key compounds (6-Gingerol and nuciferin) were screened according to the above three target datasets. The results showed that The PPI network of common key targets involved 23 associated proteins. In the related GO enrichment results, there were 33 items related to biological processes, 13 items related to cell composition, 21 items related to molecular function, and four KEGG pathway enrichments. L1000 kinase and GPCR perturbation analysis showed that the associated protein had an effect on the expression of multiple groups of kinase genes. HPA revealed that the enrichment of three common key targets was tissue-specific. The docking results showed that the 6 groups were structurally stable. The oral and topical use of Huangqi Guizhi Wuwu decoction can prevent and control peripheral neurotoxicity. The prevention and control effects may be related to its participation in the regulation of neurotransmitter transport, sympathetic activity, and transport. The histological parts of the mechanism are mainly distributed in the adrenal gland, placenta, brain, intestine, and lung, the blood is not specific. According to the prediction results of molecular docking, 6-Gingerol and nuciferin can closely bind to three common key targets.
Humoral immune response against BNT162b2 mRNA COVID-19 vaccine in patients with rheumatic disease undergoing immunosuppressive therapy: A Japanese monocentric study
Authors: Sugihara Koichi , Wakiya Risa , Kameda Tomohiro , Shimada Hiromi , Nakashima Shusaku , Kato Mikiya , Miyagi Taichi , Ushio Yusuke , Mizusaki Mao , Mino Rina , Chujo Kanako , Nomura Yumi , Inoo Masayuki , Kadowaki Norimitsu , Dobashi Hiroaki
Published: October 2022

We investigated serum total antibody titers against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein receptor-binding domain after BNT162b2 mRNA vaccination against coronavirus disease 2019 (COVID-19) in Japanese patients taking various immunosuppressive medications for rheumatic disease. In 212 outpatients with rheumatic diseases at Kagawa University Hospital and 43 healthy volunteers (controls), all of whom had received 2 doses of BNT162b2 vaccine, serum antibody titers of SARS-CoV-2 spike protein were analyzed at least 14 days after the second dose. Many of the patients were taking immunosuppressive agents to manage their rheumatic disease. The antibody titers against SARS-CoV-2 spike protein in these patients were significantly lower than those in controls. The analysis of therapeutic agents revealed that the antibody titers in patients treated with rituximab were much lower than those in controls. In patients treated with tacrolimus, baricitinib, azathioprine, mycophenolate mofetil, abatacept, tumor necrosis factor inhibitors, cyclosporine, interleukin-6 inhibitors, methotrexate, or glucocorticoids, antibody titers were moderately lower than those of controls. Interleukin-17 and interleukin-23 inhibitors did not impair the humoral response. In addition, the combination of methotrexate with various immunosuppressive agents reduced titers, although not significantly. In Japanese patients with rheumatic disease, many immunosuppressants impaired the immune response to the BNT162b2 vaccine. The degree of decline in antibody titers differed according to immunosuppressant. When used concomitantly with other immunosuppressants, methotrexate may impair the immune response to the BNT162b2 vaccine. However, immunomodulatory treatments such as interleukin-17 and -23 inhibitors may not attenuate this response in patients with rheumatic disease.
Vitamin A in children’s pneumonia for a COVID-19 perspective: A systematic review and meta-analysis of 15 trials
Authors: Li Ruoxi , Zhao Wenli , Wang Hongwu , Toshiyoshi Maeda , Zhao Ye , Bu Huaien
Published: October 2022

Background:

To systematically review and meta-analyze the efficacy of vitamin A as an adjuvant therapy for pneumonia in children.

Methods:

We searched in PubMed, the Cochrane Library, Chinese National Knowledge Infrastructure, WanFang Database and Chongqing VIP information network from libraries building to March 2022, screening randomized controlled trials (RCT) about vitamin A combined with conventional therapy for pneumonia in children. Two researchers used the Cochrane risk of bias tool to assess the quality of included studies dependently. Data analysis was conducted in the RevMan 5.3.

Results:

15 trials involving 3496 patients (treated group: 1898; control group: 1598) were analyzed in this study. The Meta-analysis showed that vitamin A combined with conventional therapy improved clinical efficacy (P < .05), shortened the duration of fever and cough, negative time of chest X-ray, and the hospitalization, lung rale disappearance, choking milk disappearance, shortness of breath disappearance and perilabial cyanosis disappearance (P < .05). However, vitamin A combined with conventional therapy did not reduce the mortality of pneumonia in children (P > .05).

Conclusion:

Vitamin A contributes to relieve the clinical symptoms and signs, and also shorten the hospitalization.
Identification and verification of a 4-gene signature predicting the overall survival of cervical cancer
Authors: Yuan Lu , Lu Zijun , Sun Guoqiang , Cao Dongmei
Published: October 2022

Cervical cancer (CC) is one of the most common gynecological malignancies, ranking fourth in both incidence and mortality in women worldwide. Early screening and treatment are of great significance in reducing the incidence and mortality of CC. Due to the complex molecular mechanisms of tumor progression, the predictive power of traditional clinical information is limited. In this study, an effective molecular model is established to assess prognosis of patients with CC and guide clinical treatment so as to improve their survival rate. Three high quality datasets (GSE138080, GSE52904, GSE67522) of expression profiling were obtained from gene expression omnibus (GEO) database. Another mRNA expression and clinicopathological data of CC were obtained from The Cancer Genome Atlas (TCGA) dataset. The bioinformatic analyses such as univariate analysis, multivariate Cox proportional-hazards model (Cox) analysis and lasso regression analysis were conducted to select survival-related differentially expressed genes (DEGs) and further establish a prognostic gene signature. Moreover, the performance of prognostic gene signature was evaluated based on Kaplan–Meier curve and receiver operating characteristic (ROC) curve. Gene set enrichment analysis (GSEA) and tumor immunity analysis were carried out to elucidate the molecular mechanisms and immune relevance. A 4-gene signature comprising procollagen-lysine, 2-oxoglutarate 5-dioxygenase 2 (PLOD2), spondin1 (SPON1), secreted phosphoprotein 1 (SPP1), ribonuclease H2 subunit A (RNASEH2A) was established to predict overall survival (OS) of CC. The ROC curve indicated good performance of the 4-gene signature in predicting OS of CC based on the TCGA dataset. The 4-gene signature classified the patients into high-risk and low-risk groups with distinct OS rates of CC. Univariate analysis and multivariate Cox regression analysis revealed that the 4-gene signature was an independent factor affecting the prognosis of patients with CC. Our study developed a 4-gene signature capable of predicting the OS of CC. The findings may be beneficial to individualized clinical treatment and timely follow-up for patients with CC.
Clinicopathological characteristics and prognosis of colon cancer with lung metastasis without liver metastasis: A large population-based analysis
Authors: Wang Xiao , Qi Ruihua , Xu Ying , Lu Xingang , Shi Qing , Wang Ya , Wang Da , Wang Chunliang
Published: October 2022

Distant metastasis explains the high mortality rate of colon cancer, in which lung metastasis without liver metastasis (LuM) is a rare subtype. This study is aimed to identify risk factors of LuM and LLM (lung metastasis with liver metastasis) from colon cancer, and to analyze the prognosis of patients with LuM by creating a nomogram. Patients’ information were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Multivariable logistic regression analysis was used to determine the risk factors for LuM and LLM. Prognostic factors for cancer-specific survival (CSS) and overall survival (OS) were identified by multivariate Cox proportional hazards regression and nomogram models were established to predict CSS and OS. Multivariate logistic regression analysis showed that blacks, splenic flexure of colon tumor, tumor size >5 cm, T4, N3, and higher lymph node positive rate were associated with the occurrence of LuM. Meanwhile, age >65 years old, female, splenic flexure of colon, higher lymph node positive rate, and brain metastasis were independent risk factors for CSS. The C-index of the prediction model for CSS was 0.719 (95% CI: 0.691–0.747). In addition, age, primary site, tumor size, differentiation grade, N stage, and bone metastasis were significantly different between LuM and LLM. The nomograms we created were effective in predicting the survival of individuals. Furthermore, patients with LuM and LLM from colon cancer might require different follow-up intervals and examinations.
How to survive a periviable birth baby with birth weight of 450g: A case report
Authors: Tang Binzhi , Ling Qiying , Yang Qian , Li Maojun , Shi Wei , Wu Qing
Published: October 2022

Rationale:

An increasing number of periviable birth newborns (PVBs) have emerged with concurrent growing high-risk pregnancy. To date, postnatal management of PVBs remains one of the most challenging issues and limited studies have been reported.

Patient concerns:

A female baby born at 230/7 weeks of gestation with birth weight of 450g.

Diagnosis:

PVB baby, respiratory distress syndrome (RDS), ventilator associated pneumonia (VAP), intraventricular hemorrhage (IVH), metabolic bone disease of prematurity (MBDP), transient hypothyroxinemia of prematurity (THOP), bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP).

Interventions:

Individualized treatment and intensive care, including neonatal resuscitation, effective respiratory and circulatory support, venous access and nutrition, prevention and treatment of infection, management of endocrine and metabolic problems, individualized nursing such as developmental supportive care, integrated oral motor interventions, skin care, family-integrated-care, etc were performed according to existing literature.

Outcomes:

The baby was discharged home after 138 days of hospitalization with body weight of 2700 g, a full oral feed achieved, and without any requirement of respiratory support or oxygen supply. Now she is 38-month-old, with no significant long-term adverse sequelae.

Lessons:

Our case expands the experience and knowledges of individualized and intensive management of PVB babies in their early life days, which increase PVBs’ survival and improves their prognosis.
Dog Ears in Wound Closure
Authors: Perez Megan M. , Stoehr Jenna R. , Chwa Emily , Connor Lauren , Gosain Arun Kumar
Published: October 2022

Conical deformities found at the apices of incisions after wound closure represent tissue redundancy, commonly known as “dog ears.” The amount of tissue excess is related to the geometry of the incision, surrounding skin elasticity, and tension of closure. Experience with tissue handling shows that some dog ears do “settle” or resolve with time; such cases occur when local tissue has high skin elasticity, the dog ears are small in height, and tension on the line of closure is low. Dog ears that do not fall into this category can be troublesome to surgeon and patient alike as they can poorly impact aesthetic outcomes and lead to secondary revision procedures. Therefore, we present a pertinent review of the mechanisms behind dog-ear formation and the variety of surgical techniques used to minimize and correct their formation.
Prepectoral Breast Reconstruction Reduces Opioid Consumption and Pain After Mastectomy
Authors: Holland Michael , Su Paul , Piper Merisa , Withers Jacquelyn , Harbell Monica W. , Bokoch Michael P. , Sbitany Hani
Published: October 2022

Background

Acute pain after mastectomy is increased with concurrent breast reconstruction. One postulated advantage of prepectoral breast reconstruction is less postoperative pain; however, no comparisons to partial submuscular reconstruction have been made to date. Here, we examined the postoperative pain experienced between patients with prepectoral and subpectoral breast reconstruction after mastectomy.

Methods

We performed a retrospective chart review of all patients undergoing immediate breast reconstruction with tissue expanders from 2012 to 2019 by a single plastic surgeon. Patient demographics, surgical details, and anesthetic techniques were evaluated, and our primary outcome compared postoperative opioid usage between prepectoral and subpectoral reconstructions. Our secondary outcome compared pain scores between techniques.

Results

A total of 211 subpectoral and 117 prepectoral reconstruction patients were included for analysis. Patients with subpectoral reconstructions had higher postoperative opioid usage (80.0 vs 45.0 oral morphine equivalents, P < 0.001). Subpectoral patients also recorded higher maximum pain scores compared with prepectoral reconstructions while admitted (7 of 10 vs 5 of 10, P < 0.004). Multivariable linear regression suggests that mastectomy type and subpectoral reconstruction were significant contributors to postoperative opioid use (P < 0.05).

Conclusions

Prepectoral breast reconstruction was associated with less postoperative opioid consumption and lower postoperative pain scores as compared with subpectoral reconstruction, when controlling for other surgical and anesthesia factors. Future randomized controlled trials are warranted to study how postoperative pain and chronic pain are influenced by the location of prosthesis placement in implant-based postmastectomy breast reconstruction.
An analysis of the meta-analysis of board characteristics and demand for audit quality
Authors: Yang Zhifeng
Published: October 2022

Purpose

The purpose of this study is to discuss Kalia, Basu and Kundu's (KBK’s) paper's motivation, findings and contributions and suggest further development.

Design/methodology/approach

This paper is to discuss the meta-analysis of board characteristics and demand for audit Quqality by KBK.

Findings

KBK paper is well motivated and makes new contributions to the literature. Future research can expand the sample and examine the moderating effects of institutional factors such as ownership structure, regulatory reforms and country-level investor protection and legal enforcement.

Originality/value

Based on the review of KBK’ spaper, this study suggests that future research should expand the sample and examine the moderating effects of institutional factors such as ownership structure, regulatory reforms and country-level investor protection and legal enforcement.
Extrinsic and intrinsic motives: panic buying and impulsive buying during a pandemic
Authors: Lavuri Rambabu , Jaiswal Deepak , Thaichon Park
Published: October 2022

Purpose

The present study operationalizes and tests the impact of extrinsic (store environment, promotional activities) and intrinsic (hedonism, materialism) variables on impulsive buying during the COVID-19 period. It also considers the dual-factor approach (panic and impulsive buying tendency) using the “Stimulus-Organism-Response” approach and “Dual-Factor Theory”.

Design/methodology/approach

Purposive sampling was used to obtain data from 362 responses from retail shoppers and analyzed by path analysis. The moderation of novel constructs (scarcity and COVID-19 pandemic) examines the backdrop of retail impulse shopping.

Findings

The store environment has a detrimental effect on panic and impulsive buying. Promotional activities have a beneficial effect on impulsive buying tendency. Similarly, hedonism and materialism have a substantial positive effect on panic and impulsive buying tendencies. Between stimulus (intrinsic and extrinsic) and response variables, organism factors (panic and impulsive buying inclinations) influenced positively (impulsive buying); in terms of moderation, scarcity and the COVID-19 pandemic exhibit substantial moderation between organism and response.

Originality/value

The results contribute substantially to the existing domain of customers’ panic and impulsive purchasing behavior for the scarcity of essential items during the COVID-19 epidemic. Research in this field is limited, varied and inconclusive. New insights were obtained as this research blends the “Stimulus-Organism-Response” and Dual factor theories.
Workplace loneliness, ego depletion and cyberloafing: can leader problem-focused interpersonal emotion management help?
Authors: Yang Hongling , Lin Zhibin , Chen Xiao , Peng Jian
Published: October 2022

Purpose

This study aims to explore whether and how workplace loneliness leads to cyberloafing and the role of leader problem-focused interpersonal emotion management in buffering this relationship.

Design/methodology/approach

Drawing on ego depletion theory, the authors propose that employees' workplace loneliness leads to cyberloafing via ego depletion, while leader interpersonal emotion management (i.e. leadership behavior targeted at managing employees' negative emotions) can help to alleviate the situation. To test this study’s predictions, the authors collected multisource data at three time points from a sample of 219 employee–colleague dyads.

Findings

The results show that workplace loneliness is positively related to cyberloafing and that ego depletion mediates this relationship. Leader problem-focused interpersonal emotion management weakens the relationship between workplace loneliness and ego depletion and the indirect relationship between workplace loneliness and cyberloafing via ego depletion such that the above relationships are weak (versus strong) when leader problem-focused interpersonal emotion management is high (versus low).

Originality/value

The study results suggest that workplace loneliness is an important hidden danger that leads to cyberloafing because lonely employees suffer more from ego depletion. Leaders' interpersonal emotion management strategy serves as a potential buffer for such a negative effect.
Popping the “bubble” metaphor: separation and integration of expatriate communities
Authors: Miao Chengcheng , Gaggiotti Hugo , Brewster Chris
Published: October 2022

Purpose

This paper aims to discuss multiple uses of the concept of “bubble” as a metaphor to refer to different experiences of foreign working communities and suggests a more flexible and comprehensive approach.

Design/methodology/approach

Based on ethnographic fieldwork conducted at different locations, the authors propose changing the use of the bubble metaphor from an analogy of living in isolation to a way of conceptualising the changing contexts and characteristics that impact the porosity and permeability of communities.

Findings

The paper suggests that when using the metaphor as a concept, the following considerations need to be taken into account: (1) the conventional thinking that “expat-bubbles” are isolated places, (2) any simplistic notion that different internationally mobile workers will be less or more immersed in the local community and (3) the use of the bubble metaphor without a careful delineation and reference to its permeability and porosity.

Originality/value

The paper helps to visualise a different dimension of the traditional taken-for-granted representation of the bubble. The bubble emerges as a rich analogical concept not to explain binomial representations of integration-separation. Rather than a simple “open” or “closed”, bubbles became more or less porous and permeable depending on the experiences of foreign working communities.
Dielectric spectroscopy‐based characterisation of different types of Paneer (Indian cottage cheese) in terms of texture, microstructure and functional groups
Authors: Kumari Khushbu , Chakraborty Subir Kumar , Sudhakar Anjali , Kishore Anand
Published: October 2022

Different variants of Paneer were prepared with cow milk (CM), buffalo milk (BM), skimmed milk powder (SMP) and blends (40:60, 50:50, 60:40) of SMP with CM/BM. The Paneer composition, texture, microstructure and spread of functional groups were correlated with the dielectric capacitance values. Results depicted a strong correlation (R2 > 0.95) between milk used for Paneer making and its proximate composition in terms of the capacitance value, and it was highest for CM followed by BM; 100% SMP Paneer recorded lowest values. Paneer made from blends of SMP and liquid milk had the lowest transmittance value, indicating higher total protein content.
An exploration of LAF‐bTMB as a predictor for the efficacy of immunotherapy combined with chemotherapy in non—small cell lung cancer
Authors: Zhang Shuyang , Yang Lu , Yang Yaning , Xin Ying , Wang Yan
Published: October 2022

Background

Immune checkpoint inhibitor (ICI) combined with chemotherapy is one of the standards of care for advanced non–small cell lung cancer (NSCLC) without driver mutations. However, the biomarker of combination therapy is still unknown. Although previous studies have confirmed that low allele frequency adjusted blood‐based tumor mutational burden (LAF‐bTMB) is associated with the efficacy of ICI monotherapy, there has been no report on the correlation between the efficacy of LAF‐bTMB and ICI combined chemotherapy. This study aimed to explore whether LAF‐bTMB can be used as a predictive biomarker for the efficacy of immunotherapy combined with chemotherapy in advanced NSCLC.

Methods

This study enrolled patients diagnosed with advanced NSCLC and who received ICI combined with chemotherapy for first‐line therapy from May 2020 to December 2021 at Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. Clinical information, treatment information, survival data, and peripheral blood samples of every patient before treatment were collected. Next‐generation sequencing was performed on plasma samples to estimate bTMB and LAF‐bTMB.

Results

A total of 42 patients with NSCLC were enrolled. In this cohort, 19 patients achieved partial response (PR), and the objective response rate (ORR) was 45.2%. The median progression‐free survival (PFS) of all patients was 13.4 months (95% CI, 7.49–19.72). Both PFS and the overall survival (OS) were significantly longer in the responder (R) group than in the non‐responder (NR) group (median PFS, 16.4 months vs. 7.2 months, p = 0.028; median OS, NE vs. 9.3 months, p = 0.016). There was no significant difference in bTMB and LAF‐BTMB between the R and NR group. The ORR of patients with LAF‐bTMB≤8muts/Mb was significantly higher than that of patients with LAF‐bTMB >8muts/Mb (ORR, 61% vs. 26%, respectively, p = 0.033). When LAF‐bTMB ≤8muts/Mb or > 20muts/Mb, ORR was significantly higher than that of patients with LAF‐bTMB between 8 and 20muts/Mb (ORR were 57% and 21%, p = 0.047). No correlation has been found between LAF‐bTMB and PFS or OS.

Conclusions

This study confirmed that neither bTMB nor LAF‐bTMB is feasible as a potential predictor of first‐line immunochemotherapy for advanced NSCLC. More suitable biomarkers need to be explored to screen patients with better efficacy of immunotherapy combined with chemotherapy in the future.
Investigation of poor predictive factors in extensive stage small cell lung cancer under etoposide‐platinum‐atezolizumab treatment
Authors: Lim Jeong Uk , Kang Hye Seon , Shin Ah. Young , Yeo Chang Dong , Kim Sung Kyoung , Kim Jin Woo , Kim Seung Joon , Lee Sang Haak
Published: October 2022

Background

The phase III trial IMpower133 showed that platinum and etoposide plus atezolizumab was associated with improved overall survival (OS) and progression free‐survival (PFS) when compared to the placebo group in treatment‐naïve extensive stage (ES) small cell lung cancer (SCLC). Due to superiority in clinical outcomes, combination immunotherapy plus chemotherapy have become mainstay treatment modalities as first‐line treatment in ES‐SCLC. Nevertheless, real‐world data are still lacking and the search for potential biomarkers is essential. This study aimed to evaluate potential predictive biomarkers applicable in ES‐SCLC under combination therapy.

Methods

Patients with ES‐SCLC under etoposide‐platinum‐atezolizumab enrolled from seven university hospitals affiliated to the Catholic University of Korea were evaluated. Pretreatment clinical parameters were evaluated for association with OS and PFS. Adverse events (AEs) during induction and maintenance phases were also evaluated. p‐values below 0.05 were considered statistically significant.

Results

A total of 41 patients were evaluated. Six‐month survival was 68.6%. As best response to treatment, 26 (63.4%) showed partial response, nine (22.0%) showed stable disease, and four (9.8%) showed progressive disease. During the induction phase, grade I–II AEs occurred in 22 (53.7%) patients, and grade III–IV AEs occurred in 26 (63.4%) patients. During the maintenance phase, nine out of 25 (36.0%) patients experienced any grade AEs. In multivariate analysis for OS, lactate dehydrogenase (LDH), c‐reactive protein (CRP), and forced vital capacity (%) were significant factors. In multivariate analysis for PFS, sex, and LDH were significant.

Conclusion

In ES‐SCLC under etoposide‐platinum‐atezolizumab, pretreatment CRP, LDH and FVC (%) were independent predictive factors.
An analysis of silybin meglumine tablets in the treatment of drug‐induced liver injury as assessed for causality with the updated Roussel Uclaf Causality Assessment Method using a nationwide database
Authors: Zhang Bo , Jiang Guosheng , Wang Li , Li Xia , Zhao Chuan , Tan Qiliang , Kang Weiwei , Feng Yuxia , Han Xian , Raza Hafiz Khuram , Mao Yimin
Published: October 2022

Aim

Drug‐induced liver injury (DILI) poses significant challenges to clinical practice. Currently, there is no recommended therapy to treat DILI; therefore, it is vital to explore new therapeutic agents. This study aimed to investigate the efficacy and safety of silybin meglumine tablets in treating DILI.

Methods

This study analysed 34 296 DILI cases assessed by the updated RUCAM from a nationwide database. A total of 301 patients with RUCAM scores ≥6 were directly enrolled in this study, while an additional 340 patients with RUCAM scores <6 who were adjudged as probable DILI by a panel of three hepatologists were also included in the analysis. The enrolled patients were divided into the silybin meglumine group and the control group. The propensity score matching (PSM) method was used to obtain comparable characteristics between the two groups.

Results

There were 129 cases in the silybin meglumine group and 512 cases in the control group. After applying PSM, 129 matched pairs were obtained. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) resumption rates in the silybin meglumine group were significantly higher than the control group (58.91% vs. 20.93%, P ≤ .0001 and 63.49% vs. 37.50%, P ≤ .0001). The univariate and multivariate logistic regression analysis revealed that grouping factor (odds raio [OR], 5.42; 95% confidenxe interval [CI], 3.12–9.39; P < .0001 and OR, 6.10; 95% CI, 2.98–12.48; P < .0001) and ALT levels (OR, 0.95; 95% CI, 0.93–0.98; P = .0015 and OR, 0.95; 95% CI, 0.92–0.99; P = .0157) were essential influencing factors for ALT normalization.

Conclusions

Silybin meglumine tablets are safe and effective in DILI treatment. Large‐scale and randomized controlled trials are required to further confirm their efficacy.
Sex disparities in medication prescribing amongst patients with type 2 diabetes mellitus managed in primary care
Authors: Ambrož Martina , Geelink Marit , Smits Kirsten P.J. , de Vries Sieta T. , Denig Petra
Published: October 2022

Background

Sex differences in clinical outcomes have been observed for patients with type 2 diabetes mellitus (T2DM). These could be related to sex disparities in treatment.

Objectives

To determine whether there are sex disparities in medication prescribing amongst patients with T2DM.

Methods

A cohort study was conducted using the Groningen Initiative to ANalyze Type 2 diabetes Treatment (GIANTT) database, which includes data from primary care patients with T2DM from the north of the Netherlands. Data on demographics, physical examinations, laboratory measurements and prescribing were extracted. A set of validated prescribing quality indicators assessing the prevalence, start, intensification and safety of glucose‐, lipid‐, blood pressure‐ and albuminuria‐lowering medication was applied for the calendar year 2019. Univariate logistic regression analyses were conducted.

Results

We included 10,456 patients (47% females). Females were less often treated with metformin (81.7% vs. 86.5%; OR 0.70, 95% CI 0.61–0.80), and were less often prescribed a renin‐angiotensin‐aldosterone inhibitor (RAAS‐i) when treated with multiple blood pressure‐lowering medicines (81.9% vs. 89.3%; OR 0.55, 95% CI 0.46–0.64) or when having albuminuria (74.7% vs. 82.1%; OR 0.64, 95% CI 0.49–0.85) than males. Statin treatment was less frequently started (19.7% vs. 24.7%; OR 0.75, 95% CI 0.58–0.96) and prescribed (58.7% vs. 63.9%; OR 0.80, 95% CI 0.73–0.89) in females. There were no differences in starting and intensifying glucose‐, blood pressure‐ and albuminuria‐lowering medication.

Conclusions

Sex disparities in medication prescribing amongst T2DM patients were seen, including less starting with statins and potential undertreatment with RAAS‐i in females. Such disparities may partly explain higher excess risks for cardiovascular and renal complications associated with diabetes observed in females.
Coordination of photosynthetic traits across soil and climate gradients
Authors: Westerband Andrea C. , Wright Ian J. , Maire Vincent , Paillassa Jennifer , Prentice Iain Colin , Atkin Owen K. , Bloomfield Keith J. , Cernusak Lucas A. , Dong Ning , Gleason Sean M. , Guilherme Pereira Caio , Lambers Hans , Leishman Michelle R. , Malhi Yadvinder , Nolan Rachael H.
Published: October 2022

“Least‐cost theory” posits that C3 plants should balance rates of photosynthetic water loss and carboxylation in relation to the relative acquisition and maintenance costs of resources required for these activities. Here we investigated the dependency of photosynthetic traits on climate and soil properties using a new Australia‐wide trait dataset spanning 528 species from 67 sites. We tested the hypotheses that plants on relatively cold or dry sites, or on relatively more fertile sites, would typically operate at greater CO2 drawdown (lower ratio of leaf internal to ambient CO2, Ci:Ca) during light‐saturated photosynthesis, and at higher leaf N per area (Narea) and higher carboxylation capacity (Vcmax 25) for a given rate of stomatal conductance to water vapour, gsw. These results would be indicative of plants having relatively higher water costs than nutrient costs. In general, our hypotheses were supported. Soil total phosphorus (P) concentration and (more weakly) soil pH exerted positive effects on the Narea–gsw and Vcmax 25–gsw slopes, and negative effects on Ci:Ca. The P effect strengthened when the effect of climate was removed via partial regression. We observed similar trends with increasing soil cation exchange capacity and clay content, which affect soil nutrient availability, and found that soil properties explained similar amounts of variation in the focal traits as climate did. Although climate typically explained more trait variation than soil did, together they explained up to 52% of variation in the slope relationships and soil properties explained up to 30% of the variation in individual traits. Soils influenced photosynthetic traits as well as their coordination. In particular, the influence of soil P likely reflects the Australia's geologically ancient low‐relief landscapes with highly leached soils. Least‐cost theory provides a valuable framework for understanding trade‐offs between resource costs and use in plants, including limiting soil nutrients.