bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of non-surgical decompression therapy in addition to routine physical therapy on pain, range of motion, endurance, functional disability and quality of life versus routine physical therapy alone in patients with lumbar radiculopathy; a randomized controlled trial
Authors: Amjad Fareeha , Mohseni-Bandpei Mohammad A. , Gilani Syed Amir , Ahmad Ashfaq , Hanif Asif
Published: March 2022

Background

Lumbar radiculopathy is an extensively common complaint reported by patients of low back pain (LBP), resulting in several impairments. A comparatively novel technique, non-surgical spinal decompression (NSD), is introduced, which uses a sensitive computerized feedback mechanism and decompresses the spinal nerve roots through segmental distraction. The objective of this study was to determine the effects of NSD therapy in addition to routine physical therapy on pain, lumbar range of motion (ROM), functional disability, back muscle endurance (BME), and quality of life (QOL) in patients with lumbar radiculopathy.

Methods

A total of sixty patients with lumbar radiculopathy were randomly allocated into two groups, an experimental (n = 30) and a control (n = 30) group, through a computer-generated random number table. Baseline values were recorded before providing any treatment by using a visual analogue scale (VAS), Urdu version of Oswestry disability index (ODI-U), modified-modified Schober’s test (MMST), prone isometric chest raise test, and Short Form 36-Item Survey (SF-36) for measuring the pain at rest, functional disability, lumbar ROM, BME, and QOL, respectively. All patients received twelve treatment sessions over 4 weeks, and then all outcome measures were again recorded.

Results

By using the ANCOVA test, a statistically significant (p < 0.05) between-group improvement was observed in VAS, ODI-U, BME, lumbar ROM, role physical (RP), and bodily pain (BP) domains of SF-36, which was in favour of NSD therapy group. The between-group difference was 1.07 ± 0.32 cm (p < .001) for VAS, 5.65 ± 1.48 points (p < .001) for ODI-U, 13.93 ± 5.85 s (p = 0.002) for BME, 2.62 ± 0.27 cm (p < .001) for lumbar flexion, 0.96 ± 0.28 (p < .001) for lumbar extension, 5.77 ± 2.39 (p = 0.019) for RP and 6.33 ± 2.52 (p = 0.016) for BP domain of SF-36. For these outcomes, a medium to large effect size (d = 0.61–2.47, 95% CI: 0.09–3.14) was observed.

Conclusion

It was concluded that a combination of non-surgical spinal decompression therapy with routine physical therapy is more effective, statistically and clinically, than routine physical therapy alone in terms of improving pain, lumbar range of motion, back muscle endurance, functional disability, and physical role domain of quality of life, in patients with lumbar radiculopathy, following 4 weeks of treatment.

Trial registration

WHO Iranian registry of clinical trials (IRCT20190717044238N1) Dated: 23.12.2019.
Efficacy of a pharmacist-managed diabetes clinic in high-risk diabetes patients, a randomized controlled trial - “Pharm-MD”
Authors: Halalau Alexandra , Sonmez Melda , Uddin Ahsan , Karabon Patrick , Scherzer Zachary , Keeney Scott
Published: March 2022

Background

Diabetes mellitus affects 13% of American adults. To address the complex care requirements necessary to avoid diabetes-related morbidity, the American Diabetes Association recommends utilization of multidisciplinary teams. Research shows pharmacists have a positive impact on multiple clinical diabetic outcomes.

Methods

Open-label randomized controlled trial with 1:1 assignment that took place in a single institution resident-run outpatient medicine clinic. Patients 18–75 years old with type 2 diabetes mellitus and most recent HbA1c ≥9% were randomized to standard of care (SOC) (continued with routine follow up with their primary provider) or to the SOC + pharmacist-managed diabetes clinic PMDC group (had an additional 6 visits with the pharmacist within 6 months from enrollment). Patients were followed for 12 months after enrollment. Data collected included HbA1c, lipid panel, statin use, blood pressure control, immunization status, and evidence of diabetic complications (retinopathy, nephropathy, neuropathy). Intention-to-treat and per-protocol analysis were performed.

Results

Forty-four patients were enrolled in the SOC + PMDC group and 42 patients in the SOC group. Average decrease in HbA1c for the intervention compared to the control group at 6 months was − 2.85% vs. -1.32%, (p = 0.0051). Additionally, the odds of achieving a goal HbA1c of ≤8% at 6 months was 3.15 (95% CI = 1.18, 8.42, p = 0.0222) in the intervention versus control group. There was no statistically significant difference in the remaining secondary outcomes measured.

Conclusions

Addition of pharmacist managed care for patients with type 2 diabetes mellitus is associated with significant improvements in HbA1c compared with standard of care alone. Missing data during follow up limited the power of secondary outcomes analyses.

Trial registration

ClinicalTrials.gov, ID:NCT03377127; first posted on 19/12/2017.
Antimicrobial activity, in vitro anticancer effect (MCF-7 breast cancer cell line), antiangiogenic and immunomodulatory potentials of Populus nigra L. buds extract
Authors: Kis Brigitta , Pavel Ioana Zinuca , Avram Stefana , Moaca Elena Alina , Herrero San Juan Martina , Schwiebs Anja , Radeke Heinfried H. , Muntean Delia , Diaconeasa Zorita , Minda Daliana , Oprean Camelia , Bojin Florina , Dehelean Cristina Adriana , Soica Codruta , Danciu Corina
Published: March 2022

Purpose

The aim of this study was to evaluate the antioxidant potential, antimicrobial activity, the in vitro anticancer effect (tested on MCF-7 breast cancer cell line), as well as the antiangiogenic and immunomodulatory potential of Populus nigra L. bud (Pg) extract collected from the western part of Romania.

Results

Populus nigra L. bud extract presents an important antioxidant activity, due to the rich phytochemical composition. Regarding the biological activity, results have shown that poplar bud extract presents a significant inhibitory activity against Gram-positive bacteria and a dose-dependent decrease of MCF-7 tumor cell viability with an IC50 of 66.26 μg/mL, while not affecting healthy cells. Phenomena of early apoptotic events at the maximum concentration tested (150 μg/mL) were detected by Annexin V-PI double staining. The extract induced G0/G1 phase cell cycle arrest. In addition, Pg extract showed antiangiogenic potential on the chorioallantoic membrane. Also, at the highest concentration (150 μg/mL), good tolerability and no signs of toxicity upon vascular plexus were observed. Moreover, in low concentrations, the Pg extract had immunomodulatory activity on primary human dendritic cells by upregulating IL-12 and IL-23 subunits.

Conclusion

The study concludes that poplar bud extract elicited antioxidant activity, antitumor properties on the breast cancer cell line, followed by an antiangiogenic effect and an immunomodulatory potential on human primary dendritic cells. The biological activity of Populus nigra L. buds extract may open new directions of research on the topic addressed.
Implementing a flipped classroom model in an evidence-based medicine curriculum for pre-clinical medical students: evaluating learning effectiveness through prospective propensity score-matched cohorts
Authors: Tsao Yen-Po , Yeh Wan-Yu , Hsu Teh-Fu , Chow Lok-Hi , Chen Wei-Chih , Yang Ying-Ying , Shulruf Boaz , Chen Chen-Huan , Cheng Hao-Min
Published: March 2022

Background

In a flipped classroom (FC) model, blended learning is used to increase student engagement and learning by having students finish their readings at home and work on problem-solving with tutors during class time. Evidence-based medicine (EBM) integrates clinical experience and patient values with the best evidence-based research to inform clinical decisions. To implement a FC and EBM, students require sufficient information acquisition and problem-solving skills. Therefore, a FC is regarded as an excellent teaching model for tutoring EBM skills. However, the effectiveness of a FC for teaching EBM competency has not been rigorously investigated in pre-clinical educational programs. In this study, we used an innovative FC model in a pre-clinical EBM teaching program.

Methods

FC’s teaching was compared with a traditional teaching model by using an assessment framework of prospective propensity score matching, which reduced the potential difference in basic characteristics between the two groups of students on 1:1 ratio. For the outcome assessments of EBM competency, we used an analysis of covariance and multivariate linear regression analysis to investigate comparative effectiveness between the two teaching models. A total of 90 students were prospectively enrolled and assigned to the experimental or control group using 1:1 propensity matching.

Results

Compared with traditional teaching methods, the FC model was associated with better learning outcomes for the EBM competency categories of Ask, Acquire, Appraise, and Apply for both written and oral tests at the end of the course (allp-values< 0.001). In particular, the “appraise” skill for the written test (6.87 ± 2.20) vs. (1.47 ± 1.74),p < 0.001), and the “apply” skill for the oral test (7.34 ± 0.80 vs. 3.97 ± 1.24,p < 0.001) had the biggest difference between the two groups.

Conclusions

After adjusting for a number of potential confunding factors, our study findings support the effectiveness of applying an FC teaching model to cultivate medical students’ EBM literacy.
Interrater reliability in the assessment of physiotherapy students
Authors: Gittinger Flora P. , Lemos Martin , Neumann Jan L. , Förster Jürgen , Dohmen Daniel , Berke Birgit , Olmeo Anke , Lucas Gisela , Jonas Stephan M.
Published: March 2022

Background

Reliable and objective assessment of psychomotor skills in physiotherapy students’ education is essential for direct feedback and skill improvement. The aim of this study is to determine the interrater reliability in the assessment process of physiotherapy students and to analyse the assessment behaviour of the examiners.

Methods

Physiotherapy teachers from two different schools assessed students from two different schools performing proprioceptive neuromuscular facilitation (PNF) patterns. An evaluation sheet with a 6-point rating scale and 20 evaluation criteria including an overall rating was used for assessment. The interrater reliability was determined calculating an intraclass-correlation coefficient (ICC) and Krippendorff’s alpha. The assessment behaviour of the examiners was further analysed calculating the location parameters and showing the item response distribution over item in form of a Likert plot.

Results

The ICC estimates were mostly below 0.4, indicating poor interrater reliability. This was confirmed by Krippendorff’s alpha. The examiners showed a certain central tendency and intergroup bias.

Discussion and conclusion

The interrater reliability in this assessment format was rather low. No difference between the two physiotherapy schools concerning the interrater reliability could be identified. Despite certain limitations of this study, there is a definite need for improvement of the assessment process in physiotherapy education to provide the students with reliable and objective feedback and ensure a certain level of professional competence in the students.

Trial registration

The study was approved by the ethics committee of the Medical Faculty RWTH Aachen University (EK 340/16).
Transformative learning through participation: experiences at a rural clinical training site in South Africa
Authors: Müller Jana , Reardon Cameron , Coetzee Francois , Bester Juanita , Dube Kopano , Hanekom Susan , du Plessis Elmarize , Couper Ian
Published: March 2022

Background

Distributed training has been cited as an opportunity that offers transformative learning experiences in preparing a future workforce to address local needs. For this reason, rural and longitudinal placements are increasingly being adopted by medical schools across the world. Place, participation and person are considered integral in the process of transformation of medical students into responsive graduates on the distributed platform. This article aims to explore the experiences and perceptions of student learning on a rural training platform in South Africa while considering the interrelation between person, place and participation as a process of transformation to becoming a health care professional. The research forms part of a 5-year longitudinal case study, initiated in 2019 to explore a university-rural hospital collaboration on students, staff and the local health care system.

Methods

Data was collected using interviews and surveys from 63 purposively selected and consenting participants between January and November of 2019. All qualitative data were inductively analysed using an interpretivist approach to thematic analysis for the purposes of this article. All quantitative data was analysed descriptively using Microsoft Excel. Ethics and permission for this research was granted by the Stellenbosch University Human Research Ethics Committee, the Undergraduate Students Programme Committee and the Northern Cape Department of Health, South Africa.

Findings

Four themes, namely: authenticity of context; participation in a community of practice and social activities; supervision and reflection; and distance support were extracted from the data. These findings contribute to the theory of transformative learning on the distributed platform by expanding on the interrelationship of person, place and participation, specifically as it relates to participation within various communities and practices. The value of active participation in reflection and supervision, distance academic support and social support systems are explored.

Conclusions

The three dimensions and interrelationship of person, place and participation in the process of transformative learning on the rural training platform can be further unpacked by exploring the types of participation that have facilitated student learning in this research context. Participation in interprofessional teams; supervision, reflection and distance support appear to be the most crucial elements during this transformative learning process.
The impact of 3D printed models on spatial orientation in echocardiography teaching
Authors: Salewski Christoph , Nemeth Attila , Sandoval Boburg Rodrigo , Berger Rafal , Hamdoun Hasan , Frenz Hannes , Spintzyk Sebastian , Hahn Julia Kelley , Schlensak Christian , Krüger Tobias
Published: March 2022

Purpose

During our transthoracic echocardiography (TTE) courses, medical students showed difficulty in spatial orientation. We implemented the use of 3D printed cardiac models of standard TTE views PLAX, PSAX, and A4C and assessed their efficacy in TTE-teaching.

Methods

One hundred fifty-three participants were split into two groups. A pre-test-retest of anatomy, 2D -, and 3D orientation was conducted. The intervention group (n = 77) was taught using 3D models; the control group (n = 76) without. Both were comparable with respect to baseline parameters. Besides test-scores, a Likert scale recorded experiences, difficulties, and evaluation of teaching instruments.

Results

From the 153 students evaluated, 123 improved, 20 did worse, and ten achieved the same result after the course. The median overall pre-test score was 29 of 41 points, and the retest score was 35 (p < 0.001). However, the intervention group taught with the 3D models, scored significantly better overall (p = 0.016), and in 2D-thinking (p = 0.002) and visual thinking (p = 0.006) subtests. A backward multivariate linear regression model revealed that the 3D models are a strong individual predictor of an excellent visual thinking score. In addition, our study showed that students with difficulty in visual thinking benefited considerably from the 3D models.

Conclusion

Students taught using the 3D models significantly improved when compared with conventional teaching. Students regarded the provided models as most helpful in their learning process. We advocate the implementation of 3D-printed heart models featuring the standard views for teaching echocardiography. These findings may be transferable to other evidence based medical and surgical teaching interventions.
Implementability of collecting patient-reported outcome data in stroke unit care – a qualitative study
Authors: Lebherz Lisa , Fraune Elisa , Thomalla Götz , Frese Marc , Appelbohm Hannes , Rimmele David Leander , Härter Martin , Kriston Levente
Published: March 2022

Background

Patient-reported outcome measures (PROMs) assess patient-relevant effects of medical treatments. We aimed to evaluate the implementation of the International Consortium for Health Outcomes Measurement Standard Set for Stroke (ICHOM-SSS) into routine inpatient care of a stroke unit.

Methods

The ICHOM-SSS was administered in a certified stroke unit during and after inpatient care. Semi-structured interviews with medical staff (n = 5) and patients or their proxies (n = 19) about their experience were audio-recorded and analysed using thematic analyses. Implementation outcomes were chosen in advance and adhered to current standards of implementation science.

Results

Patients perceived the ICHOM-SSS to be relevant and feasible. They reported limited understanding of why the assessment was introduced. The overall acceptance of using PROMs was high. While medical staff, too, perceived the assessment to be appropriate and relevant, their appraisal of feasibility, sustainability, and their acceptance of the implementation were low.

Conclusions

For a sustainable implementation of PROMs in clinical practice, IT resources need to be adapted, medical care needs to be reorganized, and additional clinical resources are required. Future research should investigate benefits of the ICHOM-SSS and a simpler, automated implementation in stroke care.

Trial registration

ClinicalTrials.gov Identifier: NCT03795948, retrospectively registered on 8 January 2019.
‘If we don’t assess the patient’s vision, we risk starting at the wrong end’: a qualitative evaluation of a stroke service knowledge translation project
Authors: Mathisen Torgeir S. , Eilertsen Grethe , Ormstad Heidi , Falkenberg Helle K.
Published: March 2022

Background

Visual impairments (VIs) affect 60% of stroke survivors and have negative consequences for rehabilitation and quality of life poststroke. Symptoms of VIs post stroke are difficult to identify for stroke survivors and health care professionals without using a structured vision assessment. In this study, we qualitatively evaluate the implementation outcomes after implementing a structured visual assessment with the Competence, Rehabilitation of Sight after Stroke Vision (KROSS) assessment tool in stroke care services.

Methods

This is a qualitative study comprising four focus group interviews. The health care personnel (HCP) involved in the implementation or with experience using the KROSS assessment tool in practice were invited to participate. We used Proctor et al.’s definitions of implementation outcomes as a framework, which informed the interview guide and analysis. We used a deductive - inductive content analysis, as described by Elo and Kyngäs.

Results

The participants found the structured vision assessment with the KROSS tool as being acceptable; they expressed a motivation and intention to use the new routine in practice. They believed it was important to assess their patient’s visual function because it influenced other rehabilitation activities and activities of daily living. Most of the participants reported having adopted the vision assessment in their practice, except for those participants from the home care services who experienced that they have few stroke survivors to follow up on. The assessment was believed to be more appropriate to perform within the rehabilitation services where there is more of a focus on functional assessments. Although vision assessment was new to all the participants, they felt that they improved their vision assessment skills by regularly using the assessment tool. Together with sufficient instructions and supervision, they believed that vison assessment was feasible for their practise. Including the vison assessment in the existing routines and systems was important to promote sustainable implementation.

Conclusion

Implementing a structured vision assessment with the KROSS tool in health care services was experienced as acceptable and feasible. The new routine led to increased attention towards poststroke VIs and increased collaboration with vision experts. Tailoring the routine to each practice and how they organise their work can support the integration of a vision assessment in their routines. To promote better vision care poststroke vision assessment and follow up should be included in the stroke care pathways.
RETRACTED ARTICLE: LncRNA PTCSC3 is upregulated in osteoporosis and negatively regulates osteoblast apoptosis
Authors: Liu Xingchao , Chen Mingliang , Liu Qinghe , Li Gang , Yang Pei , Zhang Guodong
Published: March 2022

Background

It is known that long non-coding RNA (lncRNA) PTCSC3 is involved in thyroid cancer and glioma, but its function in osteoporosis is unknown. The aim of our study was to investigate the role of lncRNA PTCSC3 in osteoporosis.

Methods

A total of 80 patients with osteoporosis (4 clinical stages) and four corresponding groups of healthy controls were enrolled. Plasma PTCSC3 levels in the 80 osteoporosis patients and 80 healthy volunteers were measured using RT-qPCR. The diagnostic potential of plasma PTCSC3 for osteoporosis was evaluated by ROC curve analysis with healthy volunteers as the true negative cases and corresponding osteoporosis patients as the true positive cases.

Results

PTCSC3 was upregulated in osteoporosis patients compared with healthy controls. PTCSC3 levels increased with osteoporosis stages increasing, but not with healthy controls aging. PTCSC3 overexpression separated each stage of osteoporosis from corresponding controls. PTCSC3 overexpression promoted while PTCSC3 silencing inhibited osteoblast apoptosis. However, PTCSC3 overexpression and silencing showed no significant effect on osteoclast apoptosis. LncRNA PTCSC3 was upregulated in osteoporosis and negatively regulated osteoblast apoptosis.

Conclusion

LncRNA PTCSC3 may serve as a potential therapeutic target for osteoporosis.
Novel compound heterozygous variants in the PCCB gene causing adult-onset propionic acidemia presenting with neuropsychiatric symptoms: a case report and literature review
Authors: Li Yingxuan , Wang Miaomiao , Huang Zhaoyang , Ye Jing , Wang Yuping
Published: March 2022

Background

Propionic acidemia (PA) is a rare autosomal recessive disorder of metabolism caused by mutations in the PCCA or PCCB gene, leading to propionyl CoA carboxylase (PCC) enzyme deficiencies. Most PA patients present variable clinical phenotypes and severity in the neonatal or infant period, with only a few developing symptoms after infancy. This report describes a PA patient with an adult-onset phenotype and a novel compound heterozygous mutation in the PCCB gene. To further explore the genotype–phenotype correlations in late-onset PA, we performed a literature review focusing on and summarizing 11 patients with PCC gene mutations who had the first onset and/or the definite diagnosis after infancy.

Case presentation

A 21-year-old PA patient presented with weakness of four limbs, gait abnormalities, two episodes of seizures, mental and behavior disorders after severe vomiting. Magnetic Resonance Imaging (MRI) demonstrated sustained bilateral caudate head and putamen symmetrical hyperintensity. Biochemical investigations revealed plasma amino and urine values correlating with a PA profile. Genetic analysis confirmed novel compound heterozygous variants in PCCB, with a newly-found pathogenic mutation (c.467T>C) and the c.1316A>G mutation associated with pathogenicity.

Conclusion

We identified a novel compound heterozygous mutation in the PCCB gene causing late-onset PA. Patients carrying mutations in the PCCB gene tend to develop late-onset PA and present neuropsychiatric symptoms and/or signs. Further molecular biological research is needed to explore the genotype–phenotype correlations of PA.
Comorbidities in unclassifiable interstitial lung disease
Authors: Prior Thomas Skovhus , Hyldgaard Charlotte , Torrisi Sebastiano Emanuele , Kronborg-White Sissel , Ganter Claudia , Bendstrup Elisabeth , Kreuter Michael
Published: March 2022

Background

Comorbidities are common in interstitial lung diseases (ILD) and have an important association with survival, but the frequency and prognostic impact of comorbidities in unclassifiable interstitial lung disease (uILD) remains elusive. We aimed to describe the prevalence of comorbidities and assess the impact on survival in patients with uILD. Furthermore, we aimed to identify and characterize potential phenotypes based on clusters of comorbidities and examine their association with disease progression and survival.

Methods

Incident patients diagnosed with uILD were identified at two ILD referral centers in Denmark and Germany from 2003 to 2018. The diagnosis uILD was based on multidisciplinary team meetings. Clinical characteristics and comorbidities were extracted from ILD registries and patient case files. Survival analyses were performed using Cox regression analyses, disease progression was analyzed by linear mixed effects models, and clusters of comorbidities were analyzed using self-organizing maps.

Results

A total of 249 patients with uILD were identified. The cohort was dominated by males (60%), former (49%) or current (15%) smokers, median age was 70 years, mean FVC was 75.9% predicted, and mean DLCO was 49.9% predicted. One-year survival was 89% and three-year survival was 73%. Eighty-five percent of the patients had ≥ 1 comorbidities, 33% had ≥ 3 comorbidities and 9% had ≥ 5 comorbidities. The only comorbidity associated with excess mortality was dyslipidemia. No association between survival and number of comorbidities or the Charlson comorbidity index was observed. Three clusters with different comorbidities profiles and clinical characteristics were identified. A significant annual decline in FVC and DLCO % predicted was observed in cluster 1 and 2, but not in cluster 3. No difference in mortality was observed between the clusters.

Conclusions

The comorbidity burden in uILD is lower than reported in other types of ILD and the impact of comorbidities on mortality needs further clarification. Three clusters with distinct comorbidity profiles were identified and could represent specific phenotypes. No difference in mortality was observed between clusters, but slower disease progression was observed in cluster 3. Better understanding of disease behavior and mortality will require further studies of subgroups of uILD with longer observation time.
A population-based predictive model to identify patients with signet ring cell carcinoma of the stomach who are most suitable for primary tumor resection
Authors: Hu Biao , Zou Run-Pu , Gan Yin-Wen , Zhu Yi-Hao , Ren Si-Min , Hou Wei-Zhong , Xie Zhi-Xin , Wang Ru , Yang Wen-Ting , Lin Peng-Ji , Feng Jun-Tao , Gao Zi-Min , Guo Xu-Guang
Published: March 2022

Background

Though the survival benefit of primary tumor operation for patients with signet ring cell carcinoma of the stomach is known, the specific characteristics of those patients who would profit from the operation are yet to be determined. To this end, a predictive model was developed to identify the conjecture that the survival profit from primary tumor operation would only be obtained by patients.

Method

The clinical data of the patients with signet ring cell carcinoma of the stomach were obtained from the Surveillance, Epidemiology, and End Results database, and then divided into operation and no-operation groups based on whether the patients underwent the primary tumor operation. To remove the confounding factors, propensity score matching was employed, and it was hypothesized that the patients who had been operated on and lived a longer life than the median cancer-specific survival time of those who hadn’t must have profited from the surgery. To discuss the independent factors of cancer-specific survival time in the beneficial group and the non-beneficial group, the Cox model was used, and based on the various vital predictive factors, a nomogram was drawn using logistic regression.

Result

The number of eligible patients was 12,484, with 43.9% (5483) of them having received surgery. After employing propensity score matching, the cancer-specific survival time of the operation group was found to be apparently longer (median: 21 vs. 5 months; p < 0.001) than the no-operation group. In the operation group, 4757 (86.7%) of the patients lived longer than five months (beneficial group). The six indexes (beneficial and non-beneficial group) included gender, age, Tumor Node Metastasis stage, histologic type, differentiation grade, and tumor position, and were used as predictors to draw the nomogram. The nomogram was used to divide the patients who had taken operations into two groups: the beneficial operation group and the non-beneficial operation group. The beneficial operation group, it was found, survived longer than the non-beneficial operation group (median cancer-specific survival time: 28 vs. 3 months, p < 0.001). Moreover, there was we could tell little difference in survival between the two groups (median cancer-specific survival time: 3 vs. 5 months).

Conclusions

The predictive model created to select suitable candidates for surgical treatment from patients with signet ring carcinoma of the stomach could be adopted to identify certain patients benefiting from the primary tumor operation.
Comparison of laboratory-based and non-laboratory-based WHO cardiovascular disease risk charts: a population-based study
Authors: Rezaei Fatemeh , Seif Mozhgan , Gandomkar Abdullah , Fattahi Mohammad Reza , Malekzadeh Fatemeh , Sepanlou Sadaf G. , Hasanzadeh Jafar
Published: March 2022

Background

Determining the risk of Cardiovascular Disease (CVD) is a necessity for timely preventive interventions in high-risk groups. However, laboratory testing may be impractical in countries with limited resources. This study aimed at comparison and assessment of the agreement between laboratory-based and non-laboratory-based WHO risk charts models.

Methods

This study was performed using the baseline data of 8138 participants in the pars cohort study who had no history of CVD and stroke. The updated 2019 WHO model was used to determine the 10-year fatal and non-fatal CVD risks. In general, there are two types of new WHO risk prediction models for CVD. The scores were determined based on age, sex, smoking status, diabetes, Systolic Blood Pressure (SBP), and total cholesterol for the laboratory-based model and age, sex, smoking status, SBP, and Body Mass Index (BMI) for the non-laboratory-based model. The agreement of these two models was determined via kappa statistics for the classified risk (low: < 10%, moderate: 10–< 20%, high: ≥ 20%). Correlation coefficients (r) and scatter plots was used for correlation between scores.

Results

The results revealed very strong correlation coefficients for all sex and age groups (r = 0.84 for males < 60 years old, 0.93 for males ≥ 60 years old, 0.85 for females < 60 years old, and 0.88 for females ≥ 60 years old). In the laboratory-based model, low, moderate, and high risks were 76.10%, 18.17%, and 5.73%, respectively. These measures were respectively obtained as 77.00%, 18.08%, and 4.92% in the non-laboratory-based model. Based on risk classification, the agreement was substantial for males < 60 years old and for both males and females aged ≥ 60 years (kappa values: 0.79 for males < 60 years old, 0.65 for males ≥ 60 years old, and 0.66 for females ≥ 60 years old) and moderate for females < 60 years old (kappa = 0.46).

Conclusions

The non-laboratory-based risk prediction model, which is simple, inexpensive, and non-invasive, classifies individuals almost identically to the laboratory-based model. Therefore, in countries with limited resources, these two models can be used interchangeably.
Study effect of probiotics and prebiotics on treatment of OVA-LPS-induced of allergic asthma inflammation and pneumonia by regulating the TLR4/NF-kB signaling pathway
Authors: Wu Zhiwei , Mehrabi Nasab Entezar , Arora Poonam , Athari Seyyed Shamsadin
Published: March 2022

Asthma is a common respiratory disease, and immune system dysregulation has direct relevance to asthma pathogenesis. Probiotics and prebiotics have immunomodulatory effects and can regulate immune responses and may attenuate allergic reactions. Therefore, in this study, we explored the role of probiotics and prebiotics in regulating acute airway inflammation and the TLR4/NF-kB pathway. Allergic asthma model of BALB/c mice was produced and treated with probiotics (LA-5, GG, and BB-12) and prebiotics (FOS and GOS). Then AHR, BALF cells count, EPO activity, IL-4, 5, 13, 17, 25, 33, as well as IFN-γ, total and OVA-specific IgE, IgG1, Cys-LT, LTB4, LTC4, and TSLP levels were measured. Also, the GTP/GOT assay was performed and gene expression of Akt, NLR3, NF-kB, PI3K, MyD88, TLR4, CCL11, CCL24, MUC5a, Eotaxin, IL-38, and IL-8 were determined. Finally, lung histopathological features were evaluated. Treatment with probiotics could control AHR, eosinophil infiltration to the BALF and reduce the levels of immunoglobulins, IL-17, GTP and also decrease mucus secretion, goblet cell hyperplasia, peribronchial and perivascular inflammation and also, EPO activity. It could reduce gene expression of TLR4 and CCL11. On the other hand, IL-38 gene expression was increased by both probiotic and prebiotic treatment. Treatment with probiotics and prebiotics could control levels of IL-4, 5, 13, 25, 33, leukotrienes, the gene expression of AKT, NLR3, NF-κB, MyD88, MUC5a. The prebiotic treatment could control peribronchial inflammation and PI3K gene expression. Both of the treatments had no significant effect on the GOT, TSLP and IL-8, eotaxin and CCL24 gene expression. Probiotics and prebiotics could induce tolerance in allegro-inflammatory reactions and alter immune responses in allergic conditions. Probiotics could also modulate cellular and humoral immune responses and prevent allergic disorders.
Maximal isokinetic elbow and knee flexor–extensor strength measures in combat sports athletes: the role of movement velocity and limb side
Authors: El-Ashker Said , Chaabene Helmi , Prieske Olaf
Published: March 2022

Background

Maximal isokinetic strength ratios of joint flexors and extensors are important parameters to indicate the level of muscular balance at the joint. Further, in combat sports athletes, upper and lower limb muscle strength is affected by the type of sport. Thus, this study aimed to examine the differences in maximal isokinetic strength of the flexors and extensors and the corresponding flexor–extensor strength ratios of the elbows and knees in combat sports athletes.

Method

Forty male participants (age = 22.3 ± 2.5 years) from four different combat sports (amateur boxing, taekwondo, karate, and judo; n = 10 per sport) were tested for eccentric peak torque of the elbow/knee flexors (EF/KF) and concentric peak torque of the elbow/knee extensors (EE/KE) at three different angular velocities (60, 120, and 180°/s) on the dominant and non-dominant side using an isokinetic device.

Results

Analyses revealed significant, large-sized group × velocity × limb interactions for EF, EE, and EF–EE ratio, KF, KE, and KF–KE ratio (p ≤ 0.03; 0.91 ≤ d ≤ 1.75). Post-hoc analyses indicated that amateur boxers displayed the largest EE strength values on the non-dominant side at ≤ 120°/s and the dominant side at ≥ 120°/s (p < 0.03; 1.21 ≤ d ≤ 1.59). The largest EF–EE strength ratios were observed on amateur boxers’ and judokas’ non-dominant side at ≥ 120°/s (p < 0.04; 1.36 ≤ d ≤ 2.44). Further, we found lower KF–KE strength measures in karate (p < 0.04; 1.12 ≤ d ≤ 6.22) and judo athletes (p ≤ 0.03; 1.60 ≤ d ≤ 5.31) particularly on the non-dominant side.

Conclusions

The present findings indicated combat sport-specific differences in maximal isokinetic strength measures of EF, EE, KF, and KE particularly in favor of amateur boxers on the non-dominant side.

Trial registration: This study does not report results related to health care interventions using human participants and therefore it was not prospectively registered.
Post-mortem computed tomography in forensic shooting distance estimation: a porcine cadaver study
Authors: Junno Juho-Antti , Kotiaho Antti , Oura Petteri
Published: March 2022

Objectives

Gunshot wounds are frequently studied using computed tomography (CT) to examine tissue damage. In this study, we aimed to test the potential of post-mortem CT (PMCT) in shooting distance estimation at distances 0–100 cm. We hypothesized that in addition to the wound channel, we could also potentially detect tissue damage caused by muzzle pressure on PMCT.

Results

A total of 59 gunshot wounds (23 contact shots, 21 close-range shots, 15 distant shots) were inflicted on eight piglet carcasses with a .22 Long Rifle handgun. PMCT scans were obtained using clinical equipment, and they were evaluated for wound characteristics by visual inspection and numeric measurements. In our data, contact shots could be clearly distinguished from close-range and distant shots by a hyperdense ring-shaped area surrounding the outermost part of the wound channel. Close-range and distant shot wounds did not have this feature and were difficult to distinguish from each other. The mean wound channel diameter ranged from 3.4 to 5.4 mm, being smallest in contact shots and largest in distant shots. These preliminary findings suggest that PMCT may aid the estimation of shooting distance. As this study only addressed low velocity gunshot wounds in carcasses, further studies are warranted.
Prolonged coma due to amitriptyline overdose and genetic polymorphism: a case report
Authors: van de Wint Tijs , de Vries Schultink Aurelia H. M. , Meinders Arend Jan , Harmsze Ankie , Bruins Peter
Published: March 2022

Background

Reduced consciousness has a wide variety of possible causes, not infrequently being toxic in nature. An intoxication might be obvious, but in this paper an unexpected case with a tricyclic antidepressant is presented.

Case presentation

A 76-year-old caucasian female was found unconscious. Primary diagnostic evaluation, including a negative drugs of abuse test, did not give direction to any clear cause. Yet an intraventricular conductive disorder with widening of the QRS complex and electroencephalogram abnormalities did suggest a possible drug effect. Heteroanamnestic information led to the suspicion of an amitriptyline intoxication, which was confirmed by further laboratory analysis. The patient remained comatose for several days. High concentrations of amitriptyline indicated a large overdose of amitriptyline and, in combination with a cytochrome P450 2D6 poor metabolizer status, could explain the long persistence of her comatose state.

Conclusion

We present a tricyclic antidepressant intoxication, where the patient is thought to have taken a large amount of amitriptyline at once, which, in combination with a cytochrome P450 2D6 poor metabolizer status, led to an unusual long persistence of her coma.
Caenorhabditis elegans as a powerful tool in natural product bioactivity research
Authors: Ha Ngoc Minh , Tran Son Hung , Shim Yhong-Hee , Kang Kyungsu
Published: March 2022

In addition to synthetic and semisynthetic compounds, natural products have received much attention as prolific sources of lead compounds with therapeutic effects on various diseases. In the process of screening the bioactivities of potential candidates, an in vivo assay is very important for providing meaningful insight into the efficacy, adverse effects, and modes of action that are relevant to humans. Among the many experimental models,Caenorhabditis elegansis particularly efficient due to its advantages in morphology, behavior, and genetic aspects. This review summarizes some basic and useful techniques commonly used in screening the bioactivities of natural products. Recent studies of naturally occurring extracts as well as bioactive compounds in various areas, namely, anti-aging, anti-neurodegeneration, anti-obesity, anti-infection, and gut health, are reviewed as examples of the applicability of theC. elegansmodel. Technological developments that incorporateC. elegansin other fields, such as instrumental analysis and emerging methods, are also discussed in this paper.
The translation and psychometric assessment of the SCOFF eating disorder screening questionnaire: the Persian version
Authors: Bazzazian Shahin , Ozgoli Giti , Kariman Nourossadat , Nasiri Malihe , Mokhtaryan-Gilani Tahereh , Hajiesmaello Maryam
Published: March 2022

Background

Eating Disorders (EDs) are defined by abnormal eating habits. The SCOFF (Sick-Control-One stone-Fat-Food) is a simple screening questionnaire for EDs. This study was conducted to translate and evaluate the psychometric properties of the SCOFF questionnaire in Iranian university students.

Methods

A total of 310 Iranian students of the Shahid Beheshti University of Medical Sciences completed a test battery of questionnaires including the well-known screener of eating disorder symptoms, the SCOFF. All measures were presented to the participants in Persian. The 5-item SCOFF questionnaire was translated to Persian using the forward–backward method. The face, content, criterion, and construct validity of the Persian version of the SCOFF were assessed. The validity and reliability of the Persian version of the SCOFF was assessed and factor analysis was conducted.

Results

All five items of the translated questionnaire were approved after face validity. Content validity ratio was 0.73 (range 0.66–0.83) and content validity index was 0.96 (range 0.91–1), so all items were approved. Exploratory factor analysis revealed a 2-factor structure, which explained 52.47% of the variance. Confirmatory factor analysis showed a very good goodness-of-fit for the 2-factor model. 2-factor and 1-factor models indicate a very good goodness-of-fit in females and adequate goodness-of-fit in males. Criterion validity showed an acceptable correlation between the SCOFF and the EDE-Q. Reliability was acceptable based on the stability [ICC = 0.905(95% CI .760–.962 p < 0.001)] and the internal consistency (KR20 = 0.4).

Conclusion

Appropriate psychometric properties of the 5-item Persian version of the SCOFF (both models) were confirmed, suggesting its use as a valid questionnaire in EDs screening.
The role of mindfulness and attachment security in facilitating resilience
Authors: Yang Fan , Oka Takashi
Published: March 2022

Background

In recent years, there has been growing interest in exploring ways to facilitate positive psychological dispositions, including resilience. The goal of the present study was to explore the possibility that trait mindfulness facilitates attachment security and thus enhances resilience.

Methods

We conducted two studies based on cross-sectional surveys. In Study 1, data of 207 students studying in Japan was collected. In Study 2, we used a different sample of 203 participants and different measurements to replicate the findings of Study 1.

Results

The results of Study 1 revealed that mindfulness positively predicted resilience, while attachment anxiety and avoidance were mediators between mindfulness and resilience. The results of Study 2 showed that mindfulness positively predicted resilience, and the mediating effect of attachment avoidance was significant, but the mediating effect of attachment anxiety was not significant.

Conclusions

It is possible to facilitate attachment security through cultivating trait mindfulness, and in this way, resilience could be enhanced. The effect of different components of mindfulness on attachment and resilience requires further studies.
Systematic strategies for degradation kinetic study of pharmaceuticals: an issue of utmost importance concerning current stability analysis practices
Authors: Bhangare Dhiraj , Rajput Niraj , Jadav Tarang , Sahu Amit Kumar , Tekade Rakesh K. , Sengupta Pinaki
Published: March 2022

Degradation kinetic study ascertains the shelf life of drugs under different environmental conditions. It can facilitate the prediction of specific critical factors that can affect the quality of pharmaceuticals during storage. To date, general systematic strategies for performing degradation kinetics of drugs have not been discussed in any literature. Moreover, no regulatory guideline is available on the degradation kinetic study of pharmaceuticals. Owing to this, the kinetic behavior of drugs is not being analyzed uniformly. This article provides a detailed insight into degradation kinetic approaches including criticality in selecting different variables for the study. Factors that can affect the quality of degradation kinetic study data have been critically discussed. In addition, a systematic strategy to perform degradation kinetic study with advanced degradation models has been discussed. This article will be helpful for the researcher working in the field of stability analysis and guide to select a logical path for determining the kinetic behavior of drugs. High-quality degradation kinetic data through the properly designed study will help to establish accurate storage conditions of pharmaceuticals. This article is unique and novel of its kind and would have a significant contribution to the field of stability analysis.
Deep learning for Dixon MRI-based attenuation correction in PET/MRI of head and neck cancer patients
Authors: Olin Anders B. , Hansen Adam E. , Rasmussen Jacob H. , Jakoby Björn , Berthelsen Anne K. , Ladefoged Claes N. , Kjær Andreas , Fischer Barbara M. , Andersen Flemming L.
Published: March 2022

Background

Quantitative whole-body PET/MRI relies on accurate patient-specific MRI-based attenuation correction (AC) of PET, which is a non-trivial challenge, especially for the anatomically complex head and neck region. We used a deep learning model developed for dose planning in radiation oncology to derive MRI-based attenuation maps of head and neck cancer patients and evaluated its performance on PET AC.

Methods

Eleven head and neck cancer patients, referred for radiotherapy, underwent CT followed by PET/MRI with acquisition of Dixon MRI. Both scans were performed in radiotherapy position. PET AC was performed with three different patient-specific attenuation maps derived from: (1) Dixon MRI using a deep learning network (PETDeep). (2) Dixon MRI using the vendor-provided atlas-based method (PETAtlas). (3) CT, serving as reference (PETCT). We analyzed the effect of the MRI-based AC methods on PET quantification by assessing the average voxelwise error within the entire body, and the error as a function of distance to bone/air. The error in mean uptake within anatomical regions of interest and the tumor was also assessed.

Results

The average (± standard deviation) PET voxel error was 0.0 ± 11.4% for PETDeep and −1.3 ± 21.8% for PETAtlas. The error in mean PET uptake in bone/air was much lower for PETDeep (−4%/12%) than for PETAtlas (−15%/84%) and PETDeep also demonstrated a more rapidly decreasing error with distance to bone/air affecting only the immediate surroundings (less than 1 cm). The regions with the largest error in mean uptake were those containing bone (mandible) and air (larynx) for both methods, and the error in tumor mean uptake was −0.6 ± 2.0% for PETDeep and −3.5 ± 4.6% for PETAtlas.

Conclusion

The deep learning network for deriving MRI-based attenuation maps of head and neck cancer patients demonstrated accurate AC and exceeded the performance of the vendor-provided atlas-based method both overall, on a lesion-level, and in vicinity of challenging regions such as bone and air.