bluuebunny/crossref_metadata_2025 huggingface dataset:
Survival status and predictor of mortality among adult stroke patients in Saint Paul’s hospital millennium medical college, Addis Ababa, Ethiopia
Authors: Sahle Adeba Tadesse , Mekonen Hussen , Alemu Tsion , Alate Tamrat , Melis Tamirat
Published: July 2022

Objective:

In Africa, there is up to 316 per 100,000 annual incidence rate of stroke, a prevalence of up to 1460 per 100,000, and a 3-year mortality rate higher than 80%. The incidence of stroke mortality in Ethiopia is 19.2%. Stroke is a major cause of disability and death worldwide. Early mortality in-hospital and deprived functional outcomes are common in acute stroke. This study aims to assess survival status and predictors of mortality among adult stroke patients.

Methods:

Institution-based retrospective cohort was conducted on patients who were admitted to Saint Paul’s Hospital Millennium Medical College. A simple random sampling technique was used. Bivariate and multivariable cox regression analysis were used to identify predictors of stroke mortality. For multivariable cox regression analysis statistically, significance was declared at p-value <0.05 and 95% CI.

Results:

A total of 251 adult stroke patient charts were included in the study. The overall Kaplan–Meier estimate showed that the probability of in-hospital stroke patients’ survival on the 41st day was nearly 50%. In this study, 77 (30.7%) of the study participants died. Decreased Glasgow Coma Scale (GCS) with adjusted hazard ratio (AHR) 4.26 (95% CI: 2.25–8.07) and p-value ⩽ 0.01 and presence of pneumonia with AHR 3.05 (95% CI: 1.29–7.21) and p-value ⩽ 0.01 are the predictor of mortality.

Conclusion:

The probability of survival relatively falls as follow-up time increases. The overall incidence of mortality among adult stroke patients was high. The decreased GCS and the presence of pneumonia are predictors of mortality among adult stroke patients.
Nanofluids modeling and energy transformation under the influence of mixed convection: Role of aluminum and γ-aluminum nanoparticles
Authors: Hamam Haneen , Alhowaity Awatif , Khan Umar , Adnan  , Ullah Basharat , Khan Wahid
Published: July 2022

The analysis of nanofluids under various physical scenarios convinced the researchers and scientists because of their broad range of applications in potential area of the current time like chemical engineering, biomedical engineering and applied thermal engineering etc. To give the final shape of many industrial and engineering processes, enhanced heat transfer desired, therefore, the study of Al2O3-H2O, γAl2O3-H2O, Al2O3-C2H6O2, and γAl2O3- C2H6O2 nanofluids is reported. The model successfully achieved after mathematical operations and by appealing similarity transforms. To examine the behavior of heat transfer, numerical tools utilized and performed the results. It is observed that enhanced heat transfer in Al2O3-H2O, γAl2O3-H2O, Al2O3-C2H6O2, and γAl2O3-C2H6O2 could be attained by setting nanoparticles concentration up to 20%. For Al2O3-H2O, γAl2O3-H2O, optimum heat transfer trends noticed due to their prominent thermophysical values. Also, fewer effects of combined convection on [Formula: see text] examined.
Racialized Organizations in Racialized Space: How Socio-spatial Divisions Activate Symbolic Boundaries in a Charter School and a Public School
Authors: Yazdiha Hajar
Published: July 2022

Much research documents the systems of racism that undergird the rise of school choice policies and charter schools, racialized organizations that reproduce racial logics. While school choice policy gets enacted at the structural level to enable the formation of charter schools, policy also interacts with a localized neighborhood context where space must be allocated to the charter school. As race scholars show, space is itself racialized. How does this localized allocation of racial space shape intra-group dynamics in a predominantly Latinx neighborhood? Evidence for this study comes from two years of ethnographic participant-observation and informal conversations with parents in a traditional public school and a charter school in a large Northeastern city. Findings show how threats to the material boundaries of school space activate symbolic boundaries between parents from each school, drawing from racialized organizational identities of traditional public schools as representing neighborhood loyalty and anti-gentrification resistance positioned against charter schools as representing dominant whiteness, superiority, and social mobility. I conclude with a discussion of implications for broader studies of racialized space and organizations, culture, and collective action.
The Incidence and Burden of Risk Factors for Mild Cognitive Impairment in Older Rural Chinese Persons
Authors: Xue Jiang , Jiao Yongyong , Wang Jiayu , Chen Shulin
Published: July 2022

Objective: The study investigated the prevalence of mild cognitive impairment (MCI), a common cognitive disorder in late life, among rural older residents in China. The associated risk factors were also analyzed. Methods: Two thousand one hundred forty-six older adults aged 60 or more in a rural town of Zhejiang Province, China, were recruited and analyzed. Demographic characteristics were collected by a self-designed questionnaire. Diagnosis of MCI was made by well-trained primary care physicians according to the Petersen criteria. Results: 23.16% of the analyzed sample were diagnosed with MCI, while the prevalence was significantly higher in women, those never married, not employed, and with older age, lower education, diabetes, coronary heart disease and stroke. Stepwise logistic regression indicated that age, education, diabetes, coronary heart disease, and stroke were significant predictive factors of MCI. Conclusion: The prevalence of MCI in rural older residents in China is high, and those with specific demographic characteristics like women, never married, not employed, and with older age, lower education and chronic physical conditions should be more concerned in primary care management. Integrated care approaches managing MCI and comorbid chronic conditions are recommended in future management practices.
Osteoradionecrosis: Experience from the Oral and Maxillofacial Surgery Unit at Christchurch Hospital, New Zealand
Authors: Khor Celine , Graham Danyon O. , Coghlan Peter , Erasmus Jason
Published: July 2022

Background and objectives:

Osteoradionecrosis of the jaws (ORN) is a debilitating complication of radiotherapy among head and neck cancer patients. Dentists are critical to the management of patients at risk and may be the first clinicians to encounter new onset ORN. Oral and Maxillofacial Surgical teams are commonly involved in the surgical management of such patients. To the best of our knowledge there have been no studies examining the referral pathways of patients with ORN to Oral and Maxillofacial Surgical Services in New Zealand.

Methods:

A retrospective study was conducted and included all patients with ORN referred to the Oral and Maxillofacial Surgical Service at Christchurch Hospital, New Zealand in the 3-year period 1st January 2018 to 31st December 2020. Clinical records were accessed to collect data endpoints. To illustrate the potential severity of ORN we also present a case report of a patient with mandibular ORN and pathologic fracture that was managed.

Results:

Thirteen patients with ORN were referred to the Oral and Maxillofacial Surgical Service at Christchurch Hospital over the study period. The majority of patients were referred by internal Christchurch Hospital colleagues (Otorhinolaryngology and Hospital Dentists). A wide range of presenting signs/symptoms were found. All patients presented with exposed necrotic bone however no other symptoms were found to be of high sensitivity for ORN. Patients required a range of treatment modalities, from conservative management to resection and fibula free-flap reconstruction.

Conclusions:

Most patients at risk of ORN are being maintained on long-term Hospital based recall lists for clinical review. Given the wide range of presenting signs/symptoms of ORN, oral health practitioners must exercise a high degree of clinical suspicion when encountering these in irradiated patients.
Intergenerational gendered livelihoods: Marriage, matchmaking and Rural-Urban migration in China
Authors: Fan C. Cindy
Published: July 2022

This paper uses marriage as a lens to highlight norms, customs, identities and shared values that shape livelihoods and give meaning to intergenerational and gendered practices at the individual and household level. Drawing on feminist contributions to understanding power differences between women and men and between generations, this paper shows that while livelihood may be seen as involving mainly the economic and material aspects of living, it is equally a matter of how people pursue important goals in life such as marital formation, and how these goals are situated in social, cultural, historical and locational contexts. Based on interviews in Anhui and Sichuan provinces, I highlight how intergenerational livelihoods are influenced by gendered ideology and practice, in particular transactional marriage, parents’ and children’s responsibilities in enabling marital formation and lineage, and the pursuit of rural-urban migration to enhance men’s competitiveness in the marriage market. I foreground the voices and narratives of rural Chinese and rural-urban migrants, who share how they live their lives, resources that they have access to, strategies that they pursue, and their goals and desired outcomes that are situated in relevant social, cultural and spatial contexts. Quotes from interviewees underscore the deep-rooted patriarchy that has manifested itself through marriage, especially the traditions of patrilocal exogamy and transactional matchmaking. Specifically, I draw attention to the roles of house-building and bride price in marital formation, and their implications for rural-urban migration as a long-term household strategy and a way of life. By doing so, this paper emphasizes the social and cultural contexts, in particular gender and intergenerational relations, for research on rural-urban migration.
Fn14 exacerbates acute lung injury by activating the NLRP3 inflammasome in mice
Authors: Guan Xin-Xin , Yang Hui-Hui , Zhong Wen-Jing , Duan Jia-Xi , Zhang Chen-Yu , Jiang Hui-Ling , Xiang Yang , Zhou Yong , Guan Cha-Xiang
Published: July 2022

Background

Uncontrolled inflammation is an important factor in the occurrence and development of acute lung injury (ALI). Fibroblast growth factor-inducible 14 (Fn14), a plasma membrane-anchored receptor, takes part in the pathological process of a variety of acute and chronic inflammatory diseases. However, the role of Fn14 in ALI has not yet been elucidated. This study aimed to investigate whether the activation of Fn14 exacerbated lipopolysaccharide (LPS)-induced ALI in mice.

Methods

In vivo, ALI was induced by intratracheal LPS-challenge combined with/without Fn14 receptor blocker aurintricarboxylic acid (ATA) treatment in C57BL/6J mice. Following LPS administration, the survival rate, lung tissue injury, inflammatory cell infiltration, inflammatory factor secretion, oxidative stress, and NLRP3 inflammasome activation were assessed. In vitro, primary murine macrophages were used to evaluate the underlying mechanism by which Fn14 activated the NLRP3 inflammasome. Lentivirus was used to silence Fn14 to observe its effect on the activation of NLRP3 inflammasome in macrophages.

Results

In this study, we found that Fn14 expression was significantly increased in the lungs of LPS-induced ALI mice. The inhibition of Fn14 with ATA downregulated the protein expression of Fn14 in the lungs and improved the survival rate of mice receiving a lethal dose of LPS. ATA also attenuated lung tissue damage by decreasing the infiltration of macrophages and neutrophils, reducing inflammation, and suppressing oxidative stress. Importantly, we found that ATA strongly inhibited the activation of NLRP3 inflammasome in the lungs of ALI mice. Furthermore, in vitro, TWEAK, a natural ligand of Fn14, amplified the activation of NLRP3 inflammasome in the primary murine macrophage. By contrast, inhibition of Fn14 with shRNA decreased the expression of Fn14, NLRP3, Caspase-1 p10, and Caspase-1 p20, and the production of IL-1β and IL-18. Furthermore, the activation of Fn14 promoted the production of reactive oxygen species and inhibited the activation of Nrf2-HO-1 in activated macrophages.

Conclusions

Our study first reports that the activation of Fn14 aggravates ALI by amplifying the activation of NLRP3 inflammasome. Therefore, blocking Fn14 may be a potential way to treat ALI.
Current physical therapy practice and implementation factors regarding the evidence-based ‘Rehabilitation of Mobility after Stroke (ReMoS)’ guideline in Germany: a cross-sectional online survey
Authors: Scheffler Bettina , Schimböck Florian , Schöler Almut , Rösner Katrin , Spallek Jacob , Kopkow Christian
Published: July 2022

Background

Evaluation of the current physical therapy practice for German stroke rehabilitation with respect to the ‘Rehabilitation of Mobility after Stroke (ReMoS)’ guideline recommendations and the associated implementation factors.

Methods

A descriptive cross-sectional study employing an online survey was performed among German physical therapists in 2019. The survey consisted of three sections with open and closed questions: 1) self-reported use of ReMoS recommendations, 2) barriers of guideline use and 3) socio-demographic characteristics. The benchmark level for guideline adherent physical therapy was set at > 80%.

Results

Data from 170 questionnaires were eligible for analysis. Participants’ mean age was 41.6 years, 69.4% were female, while 60.1% had no academic degree. The ReMoS guideline was unknown to 52.9% of the responders. Out of all the 46 ReMoS guideline recommendations, only ‘intensive walking training without a treadmill’ was reported to be performed in a guideline adherent manner. Respondents usually denied any personal limitations, such as limited knowledge, or that the ReMoS guideline did not fit their routine practice.

Conclusions

Among German physical therapists, the ReMoS guideline is not well-known and many interventions are not performed as recommended, illustrating the discrepancies between the ReMoS guideline recommendations and current physical therapy practice. Interventions aimed at overcoming this gap should consider both knowledge of existing barriers and facilitators of guideline usage.

Trial registration

The study was retrospectively registered to the German Clinical Trials Register (DRKS00026681).
The impact of dietary diversity and seasonality in food availability on the quantile distribution of birth size among pregnant women in rural Malawi – a cross-sectional study
Authors: Hjertholm Katrine G. , Holmboe-Ottesen Gerd , Mdala Ibrahimu , Shi Zumin , Iversen Per O.
Published: July 2022

Background

Dietary diversity scores can be used as a proxy for dietary intakes and for assessment of nutrient adequacy. Studies from low-resource settings have found maternal dietary diversity scores to be associated with neonatal birth size. We here investigated the relationship between the dietary diversity score among pregnant mothers and birth size of their offspring across quantiles of the birth size variables; birth weight, length, abdominal circumference, and head circumference. We also investigated if seasonality affects birth size across different quantiles.

Methods

Dietary intake and anthropometric data were collected from 190 pregnant women and their neonates in rural Malawi through two agricultural seasons. Dietary data was collected using 24-hour recall interviews and was categorized into the 10-food group dietary diversity score proposed for women by the Food and Agriculture Organization. Neonatal anthropometrics were collected upon delivery at health facilities. Quantile regression analyses were used to investigate associations between dietary diversity scores and birth size, as well as between seasonality and birth size.

Results

We found that neonatal abdominal circumference was 0.9 cm larger during the post-harvest season compared to the pre-harvest season among neonates in the 25th quantile. Birth weight was 281.4 g higher for those born during the post-harvest season in the 90th quantile. For a one-unit increase in maternal dietary diversity score, birth weight increased by 56.7 g among those in the 25th quantile and neonatal head circumference increased by 0.2 cm for those in the 70th quantile. However, these findings did not remain significant when considering the cluster effect of the neonatal anthropometric data.

Conclusions

Our findings indicate that the relationship between seasonality and birth size differs across the distribution of birth size. Investigating the effect of seasonality across the distribution of birth size could be important to identify vulnerable subgroups and develop better, targeted interventions to improve maternal and child nutrition and health.
Treatment retention in opioid agonist therapy: comparison of methadone versus buprenorphine/naloxone by analysis of daily-witnessed dispensed medication in a Canadian Province
Authors: Sadek Joseph , Saunders Joseph
Published: July 2022

Background

The last decade has shown a remarkable increase in the rates of illicit opioid use in Canada and internationally, which is associated with large increases in opioid related morbidity and mortality. While the differences between methadone and buprenorphine/naloxone in terms of retention have been studied outside Canada, the unique location and design of this study, gives it a specific significance.

Objectives

This study aims to describe the relative treatment retention rates for first episode opioid replacement treatment between methadone and buprenorphine/naloxone for patients receiving daily witnessed dispensed medications in Nova Scotia.

Methods

A longitudinal retrospective descriptive study analyzing secondary data from the Nova Scotia Prescription Monitoring Program on patients 18 years of age and older who started first episode opioid agonist therapy with methadone or buprenorphine/naloxone for opioid use disorder in Nova Scotia between 2014 and 2018. Treatment episode was defined as date of initial opioid agonist prescription until there is a gap of greater than 6 days without receiving opioid agonist medication at a pharmacy.

Results

One thousand eight hundred sixty-seven of whom were analyzed as they had at least 1 day in treatment. There was significant treatment dropout within the first 2 weeks of treatment, which did not show a significant difference between OAT medication (23.4% of buprenorphine/naloxone; 22.2% methadone). Median duration of retention in treatment was 58 days for those treated with buprenorphine/naloxone and 101 days for patients treated with methadone.

Multivariate cox proportional hazards model showed that buprenorphine/naloxone use as compared to methadone lead to increased hazard of treatment dropout by 62% (HR = 1.62).

Hazard rate of treatment dropout for patients below 25 years of age was calculated. (HR 1.53).

Median duration of retention in treatment for this subgroup of patients younger than age 25 was 37.5 days for patients treated with buprenorphine/naloxone and 69 days for patients treated with methadone.

Conclusions

Our data suggests that methadone is a numerically superior medication for opioid use disorder when the metric of treatment retention is viewed in isolation, for our population in Nova Scotia. However, the results should be interpreted carefully considering the number of limitations of this study. There are social/accessibility, pharmacologic/safety, and patient preference factors which are also key in decision making when prescribing opioid agonist therapy. These must all be considered when deciding on which medication to initiate for a patient beginning a new treatment episode with OAT for opioid use disorder. This study should stimulate further research into this important area in addiction medicine.
Weight loss outcomes achieved by adults accessing an online programme offered as part of Public Health England’s ‘Better Health’ campaign
Authors: Toon Josef , Geneva Martina , Sharpe Paul , Lavin Jacquie , Bennett Sarah , Avery Amanda
Published: July 2022

Effective use of health technology may offer a scalable solution to the obesity pandemic. Online digital programmes provide a convenient and flexible way for more people to access regular support. This service evaluation aims to determine whether adults accessing an online weight management programme via a national campaign are successful in losing weight.

Data was analysed for adults registering with Slimming World’s online programme using a discounted membership offered as part of PHE’s ‘Better Health’ campaign between July and December 2020. Last-weight carried forward was used to calculate weight outcomes for participants who had the opportunity to complete 12-weeks and recorded ≥ one weight besides baseline. Engagement was determined using number of online weekly weights recorded with high engagers having weight data for ≥ 9 occasions. Socioeconomic status was assessed using postcode data. Resubscription and uploaded weight data were used to determine numbers who continued beyond the offer period.

Twenty-seven thousand two hundred forty-eight adults (5.3% males) with mean age 41.0 ± 11.4 years met inclusion criteria. Mean baseline BMI was 33.4 ± 6.8 kg/m2(29.2% 30–34.9, 18.3% 35–39.9 and 15.1% > 40 kg/m2). Mean weight loss at 12 weeks was 2.7 (± 3) kg representing a mean loss of 3% (± 3.1) body weight with 42.3% achieving ≥ 3% and 22.1% weight loss ≥ 5%. Median number of weigh-ins was six. Men had greater weight losses compared to women (p < 0.001). High engagers, both men and women, achieved greater weight losses (p < 0.001). Absolute weight loss was associated with joining BMI (rs = -0.15,p < 0.001) but for % weight change only small differences were seen (max effect size = 0.03) with no differences in weight change for high engagers between different baseline BMI categories (p > 0.05). 30.9% were in the lowest two IMD quintiles and absolute and percentage weight change did not differ across deprivation quintiles (p > 0.05). 34.9% continued to access the online support after the offer period.

This service evaluation shows that an online programme, offered as part of a national campaign, can offer effective support to a large number of people with different starting BMIs and from different socioeconomic backgrounds. An increased level of engagement leads to better weight losses.
Experience with open schools and preschools in periods of high community transmission of COVID-19 in Norway during the academic year of 2020/2021
Authors: Stebbings Sara , Rotevatn Torill Alise , Larsen Vilde Bergstad , Surén Pål , Elstrøm Petter , Greve-Isdahl Margrethe , Johansen Tone Bjordal , Astrup Elisabeth
Published: July 2022

Background

Schools and preschools have largely remained open in Norway throughout the pandemic, with flexible mitigation measures in place. This contrasts with many other high-income countries that closed schools for long periods of time. Here we describe cases and outbreaks of COVID-19 in schools and preschools during the academic year 2020/2021, to evaluate the strategy of keeping these open with infection prevention control measures in place.

Methods

In this descriptive study, the Norwegian Institute of Public Health initiated systematic surveillance for COVID-19 cases and outbreaks in schools and preschools in October 2020. Data was compiled from the national outbreak alert system VESUV, municipality websites, and media scanning combined with the national emergency preparedness register Beredt C-19. An outbreak was defined as ≥ 2 cases among pupils or staff within 14 days at the same educational setting. Settings were categorized as preschool (1–5-years), primary school (6–12-years), lower secondary school (13–15-years) and upper secondary school (16–18- years). We reported the incidence rate among preschool and school-aged pupils and gave a descriptive overview of outbreaks and included cases per educational setting.

Results

During the whole academic year, a total of 1203 outbreaks in preschools and school settings were identified, out of a total of 8311 preschools and schools nationwide. The incidence of COVID-19 in preschool- and school-aged children and the rates of outbreaks in these settings largely followed the community trend. Most of the outbreaks occurred in primary schools (40%) and preschools (25%). Outbreaks across all settings were mostly small (median 3 cases, range 2 to 72), however, 40 outbreaks (3% of total) included 20 or more cases. The larger outbreaks were predominantly seen in primary schools (43%).

Conclusions

We observed few large outbreaks in open schools and preschools in Norway during the academic year of 2020/2021, also when the Alpha variant was predominant. This illustrates that it is possible to keep schools and preschools open even during periods of high community transmission of COVID-19. Adherence to targeted IPC measures adaptable to the local situation has been essential to keep educational settings open, and thus reduce the total burden on children and adolescents.
Distribution and clinical significance of circulating CD8+CD28− regulatory T cells in the peripheral blood of patients with pulmonary tuberculosis
Authors: Yu Xin , Lin Yao , Chen Hui , Wu Min-Juan , Huang Li-Na , Song Yi-Yan , Gu Bin-Bin , Ye Zhi-Jian , Xu Ping , Zhang Jian-Ping , Xu Jun-Chi
Published: July 2022

Background

Regulatory T cells (Treg cells) in the peripheral blood of patients with pulmonary tuberculosis (PTB) may be closely related to the progression of PTB. In this study, the distribution characteristics and clinical importance of CD8+CD28− Treg cells in patients with tuberculosis were systematically analyzed, and the role and importance of CD8+CD28− Treg cells in influencing the immune response and progression of tuberculosis were discussed, which will provide immunological indices and reference values for the clinical diagnosis of tuberculosis.

Methods

Flow cytometry, sputum smears and computed tomography imaging were used to analyze the distribution characteristics of CD8+CD28− Treg cells in the peripheral blood of patients with PTB and the correlation between CD8+CD28−Treg cells and clinical and immune indices.

Results

The percentages of CD4+CD25high and CD8+CD28− Treg cells in the peripheral blood of patients with PTB were significantly higher than those in the healthy control (HC) group. Further analysis showed that the percentage of CD4+CD25highTreg cells in the Stage II group was significantly higher than that in the HC group. The percentages of CD4+CD25high and CD8+CD28− Treg cells increased significantly in patients in the Stage II group. The proportion of CD8+CD28− Treg cells was directly proportional to the degree of positivity in sputum smears, while CD4+CD25highTreg cells did not exhibit this trend.

The correlations between the percentage of CD4+CD25high and CD8+CD28− Treg cells and the percentage of lymphocyte subsets were examined. The percentage of CD8+CD28− Treg cells was negatively correlated with the percentage of CD4+T cells and positively correlated with the CD8+T cell percentage in the HC and PTB groups. The percentage of CD4 + CD25highTreg cells was positively correlated with the percentage of CD4+T cells only in the PTB group.

Conclusions

This study was the first to show that the proportion of CD8+CD28− Treg cells in the peripheral blood of patients with PTB was significantly increased, and the increase in CD8+CD28− Treg cells was related to the progression of PTB, which may affect the proportion of immune cell subsets by inhibiting the immune response, resulting in the progression of PTB.
Impact of preoperative biopsy on tumor spread through air spaces in stage I non-small cell lung cancer: a propensity score-matched study
Authors: Ding Yun , Li Jiuzhen , Li Xin , Xu Meilin , Geng Hua , Sun Daqiang
Published: July 2022

Background

Percutaneous needle biopsy (PNB) and bronchoscopic biopsy (BB) are widely used in the preoperative diagnosis of pulmonary nodules, but whether PNB or BB may cause tumor spread through air spaces (STAS) has not been reported.

Methods

433 postoperative patients with pathological stage I non-small cell lung cancer (NSCLC) from January 2015 to December 2018 at our hospital were enrolled and divided into PNB group (n = 40), BB group (n = 48) and non-biopsy group (n = 345). The PNB and BB groups were matched using propensity score matched (PSM) separately from the non-biopsy group, after which the effects of PNB and BB on STAS, recurrence-free survival (RFS) and overall survival (OS) were assessed.

Results

After PSM for 9 confounding factors (gender, age, smoking history, tumor site, scope of surgery, pathology type, stage, maximum tumor diameter and postoperative treatment), 38 cases in the PNB group were successfully matched with 38 cases in the non-biopsy group and 28 cases in the BB group were successfully matched with 28 cases in the non-biopsy group. After PSM, there was no significant difference in the incidence of STAS between the PNB and non-biopsy groups (42.1% vs. 34.2%, P > 0.05) and between the BB and non-biopsy groups (42.9% vs. 46.4%, P > 0.05). The results after PSM showed no significant effect of both PNB and BB on RFS and OS after radical surgery (P > 0.05).

Conclusion

Preoperative biopsy in patients with stage I NSCLC has not been shown to increase the occurrence of STAS, nor postoperative recurrence and death.
Outcomes of active cervical therapeutic exercise on dynamic intervertebral foramen changes in neck pain patients with disc herniation
Authors: Wu Shyi-Kuen , Chen Han-Yu , You Jia-Yuan , Bau Jian-Guo , Lin Yu-Chen , Kuo Li-Chieh
Published: July 2022

Background

To better understand biomechanical factors that affect intervertebral alignment throughout active therapeutic exercise, it is necessary to determine spinal kinematics when subjects perform spinal exercises. This study aims to investigate the outcomes of active cervical therapeutic exercise on intervertebral foramen changes in neck pain patients with disc herniation.

Methods

Thirty diagnosed C4/5 and/or C5/6 disc-herniated patients receiving an 8-week cervical therapeutic exercise program were followed up with videofluoroscopic images. The dynamic changes in the foramen were computed at different timepoints, including the neutral position, end-range positions in cervical flexion-extension, protrusion-retraction, and lateral flexion movements.

Results

The results showed that the active cervical flexion, retraction, and lateral flexion away from the affected side movements increased the area of the patients’ intervertebral foramen; while the active extension, protrusion, and lateral flexion toward the affected side reduced the areas of intervertebral foramen before treatment. After the treatment, the active cervical flexion significantly increased the C2/3, C3/4, and C6/7 foramen area by 5.02–8.67% (p = 0.001 ~ 0.029), and the extension exercise significantly reduced the C2/3 and C4/5 area by 5.12–9.18% (p = 0.001 ~ 0.006) compared to the baseline. Active retraction movement significantly increased the foramen area from C2/3 to C6/7 by 3.82–8.66% (p = 0.002 ~ 0.036 with exception of C5/6). Active lateral flexion away from the affected side significantly increased the foramen by 3.71–6.78% (p = 0.007 ~ 0.046 with exception of C6/7).

Conclusions

The 8-week therapeutic exercises including repeated cervical retraction, extension, and lateral flexion movements to the lesion led to significant changes and improvements in intervertebral foramen areas of the patients with disc herniation.

Trial registration

ISRCTN61539024
Informational content of two-dimensional panoramic radiographs and lateral cephalometric radiographs with respect to the bone volume of intraoral donor regions considering CBCT imaging
Authors: Brockmeyer Phillipp , Wiechens Bernhard , Sevinc Tayhan , Schliephake Henning , Hahn Wolfram
Published: July 2022

Background

To test the hypothesis that cephalometric parameters in two-dimensional routine dental radiographs correlate with the bone volume of intraoral bone donor sites.

Methods

One-hundred and eight radiographs [36 panoramic radiographs (PRs), 36 lateral cephalometric radiographs (LCRs), and 36 cone-beam computed tomography scans (CBCT)] of 36 patients (all three imaging techniques applied according to the needs of treatment planning), were analyzed individually. Cephalometric parameters (PR and LCR) were correlated with the bone volume measurement in three-dimensional CBCT scans in three intraoral donor sites (chin, mandibular retromolar region, and zygomatic alveolar crest).

Results

The mean bone volumes measured for the chin were (3.10 ± 1.11 cm³ SD), the mandibular retromolar region (1.66 ± 0.54 cm³ SD), and the zygomatic alveolar crest (0.17 ± 0.04 cm³ SD). Cephalometric parameters were significantly correlated (allp-values < 0.05) with the bone volume in the chin and the mandibular retromolar region. The bone volume of the zygomatic alveolar crest exhibited no correlations (p > 0.05) with cephalometric parameters. However, it was significantly correlated (p < 0.01) with the mandibular retromolar bone volume. No gender-specific differences (p > 0.05) were observed concerning bone volumes in all bone harvesting regions. Nevertheless, the male population’s interforaminal distance in the chin region was significantly higher (p = 0.001).

Conclusions

PRs and LCRs can be used at the initial stage of peri-implant augmentation planning to deduce conclusions about the bone volume in different intraoral bone donor sites. It can help describe indications and justify additional diagnostic options, such as three-dimensional radiologic techniques.
Visual-spatial dimension integration in digital pathology education enhances anatomical pathology learning
Authors: Wan Ken Lee , Sen Arkendu , Selvaratnam Lakshmi , Naing Mohd Imran Mohd , Khoo Joon Joon , Rajadurai Pathmanathan
Published: July 2022

Literature review demonstrated a surprising lack of publications on digital e-learning pathology resources for senior medical undergraduates and interns. An interactive Digital Pathology Repository (iDPR) integrating two- and three-dimensional (2D, 3D) high-resolution anatomical pathology images with correlated digital histopathology was developed. The novel iDPR was rigorously evaluated using mixed methods to assess pathology knowledge gains (pre- and post-tests), quality impact analysis (questionnaire), user feedback (focus group discussions) and user visual behaviour (eye gaze tracking analysis of 2D/ 3D images).

Exposure to iDPR appeared to improve user pathology knowledge, as observed by significantly increased test scores on topic-related quizzes (n = 69,p < 0.001). In addition, most users were highly satisfied with the key design elements of the iDPR tool. Focus group discussion revealed the iDPR was regarded as a relevant online learning resource, although some minor technical issues were also noted. Interestingly, visual behaviour trends indicated that specific diagnostic pathological lesions could be correctly identified faster in 3D images, when compared to 2D images.

The iDPR offers promise and potential in pathology education for senior clinical students and interns, gauging from both qualitative and quantitative positive user feedback. With incorporation of image annotations and interactive functionality, and with further technology development, this would prove a useful tool for diagnostic pathology and telepathology. As images with added visual-spatial dimension can provide enhanced detail and aid more rapid diagnosis, future applications of the iDPR could include virtual reality or holographic images of anatomical pathology specimens.
Hospitals during economic crisis: a systematic review based on resilience system capacities framework
Authors: Foroughi Zeynab , Ebrahimi Parvin , Aryankhesal Aidin , Maleki Mohammadreza , Yazdani Shahram
Published: July 2022

Background

Hospitals are the biggest users of the health system budgets. Policymakers are interested in improving hospital efficiency while maintaining their performance during the economic crisis. This study aims at analysing the hospitals’ policy solutions during the economic crisis using the resilience system capacities framework.

Method

This study is a systematic review. The search strategy was implemented on the Web of Science, PubMed, Embase, Scopus databases, and Econbiz search portal. Data were extracted and analysed through the comparative table of resilience system capacities framework and the World Health Organization (WHO) health system’s six building blocks (i.e., leadership and governance, service delivery, health workforce, health systems financing, health information systems, and medicines and equipment).

Findings

After the screening, 78 studies across 36 countries were reviewed. The economic crisis and adopted policies had a destructive effect on hospital contribution in achieving Universal Health Coverage (UHC). The short-term absorptive capacity policies were the most frequent policies against the economic crisis. Moreover, the least frequent and most effective policies were adaptive policies. Transformative policies mainly focused on moving from hospital-based to integrated and community-based services. The strength of primary care and community-based services, types and combination of hospital financing systems, hospital performance before the crisis, hospital managers’ competencies, and regional, specialties, and ownership differences between hospitals can affect the nature and success of adopted policies.

Conclusion

The focus of countries on short-term policies and undermining necessary contextual factors, prioritizing efficiency over quality, and ignoring the interrelation of policies compromised hospital contribution in UHC.
PO2RDF: representation of real-world data for precision oncology using resource description framework
Authors: Zhao Yiqing , Dimou Anastasios , Shen Feichen , Zong Nansu , Davila Jaime I. , Liu Hongfang , Wang Chen
Published: July 2022

Background

Next-generation sequencing provides comprehensive information about individuals’ genetic makeup and is commonplace in precision oncology practice. Due to the heterogeneity of individual patient’s disease conditions and treatment journeys, not all targeted therapies were initiated despite actionable mutations. To better understand and support the clinical decision-making process in precision oncology, there is a need to examine real-world associations between patients’ genetic information and treatment choices.

Methods

To fill the gap of insufficient use of real-world data (RWD) in electronic health records (EHRs), we generated a single Resource Description Framework (RDF) resource, called PO2RDF (precision oncology to RDF), by integrating information regarding genes, variants, diseases, and drugs from genetic reports and EHRs.

Results

There are a total 2,309,014 triples contained in the PO2RDF. Among them, 32,815 triples are related to Gene, 34,695 triples are related to Variant, 8,787 triples are related to Disease, 26,154 triples are related to Drug. We performed two use case analyses to demonstrate the usability of the PO2RDF: (1) we examined real-world associations between EGFR mutations and targeted therapies to confirm existing knowledge and detect off-label use. (2) We examined differences in prognosis for lung cancer patients with/without TP53 mutations.

Conclusions

In conclusion, our work proposed to use RDF to organize and distribute clinical RWD that is otherwise inaccessible externally. Our work serves as a pilot study that will lead to new clinical applications and could ultimately stimulate progress in the field of precision oncology.
Differences in the characteristics and pulmonary toxicity of nano- and micron-sized respirable coal dust
Authors: Zhang Yinci , Li Amin , Gao Jiafeng , Liang Jiaojiao , Cao Niandie , Zhou Shuping , Tang Xiaolong
Published: July 2022

Background

The characteristics of coal dust (CD) particles affect the inhalation of CD, which causes coal worker’s pneumoconiosis (CWP). CD nanoparticles (CD-NPs, < 500 nm) and micron particles (CD-MPs, < 5 μm) are components of the respirable CD. However, the differences in physicochemical properties and pulmonary toxicity between CD-NPs and CD-MPs remain unclear.

Methods

CD was analyzed by scanning electron microscopy, Malvern nanoparticle size potentiometer, energy dispersive spectroscopy, infrared spectroscopy, and electron paramagnetic resonance spectroscopy. CCK-8 assay, ELISA, transmission electron microscope, JC-1 staining, reactive oxygen species activity probe, calcium ion fluorescent probe, AO/EB staining, flow cytometry, and western blot were used to determine the differences between CD-NPs and CD-MPs on acute pulmonary toxicity. CCK-8, scratch healing and Transwell assay, hematoxylin–eosin and Masson staining, immunohistochemistry, immunofluorescence, and western blot were applied to examine the effects of CD-NPs and CD-MPs on pneumoconiosis.

Results

Analysis of the size distribution of CD revealed that the samples had been size segregated. The carbon content of CD-NPs was greater than that of CD-MPs, and the oxygen, aluminum, and silicon contents were less. In in vitro experiments with A549 and BEAS-2B cells, CD-NPs, compared with CD-MPs, had more inflammatory vacuoles, release of pro-inflammatory cytokines (IL-6, IL-1β, TNFα) and profibrotic cytokines (CXCL2, TGFβ1), mitochondrial damage (reactive oxygen species and Ca2+ levels and decreased mitochondrial membrane potential), and cell death (apoptosis, pyroptosis, and necrosis). CD-NPs-induced fibrosis model cells had stronger proliferation, migration, and invasion than did CD-MPs. In in vivo experiments, lung coefficient, alveolar inflammation score, and lung tissue fibrosis score (mean: 1.1%, 1.33, 1.33) of CD-NPs were higher than those of CD-MPs (mean: 1.3%, 2.67, 2.67). CD-NPs accelerated the progression of pulmonary fibrosis by upregulating the expression of pro-fibrotic proteins and promoting epithelial–mesenchymal transition. The regulatory molecules involved were E-cadherin, N-cadherin, COL-1, COL-3, ZO-1, ZEB1, Slug, α-SMA, TGFβ1, and Vimentin.

Conclusions

Stimulation with CD-NPs resulted in more pronounced acute and chronic lung toxicity than did stimulation with CD-MPs. These effects included acute inflammatory response, mitochondrial damage, pyroptosis, and necrosis, and more pulmonary fibrosis induced by epithelial–mesenchymal transition.
Mechanism research and treatment progress of NAD pathway related molecules in tumor immune microenvironment
Authors: Xu QinChen , Liu Xiaoyan , Mohseni Ghazal , Hao Xiaodong , Ren Yidan , Xu Yiwei , Gao Huiru , Wang Qin , Wang Yunshan
Published: July 2022

Nicotinamide adenine dinucleotide (NAD) is the core of cellular energy metabolism. NAMPT, Sirtuins, PARP, CD38, and other molecules in this classic metabolic pathway affect many key cellular functions and are closely related to the occurrence and development of many diseases. In recent years, several studies have found that these molecules can regulate cell energy metabolism, promote the release of related cytokines, induce the expression of neoantigens, change the tumor immune microenvironment (TIME), and then play an anticancer role. Drugs targeting these molecules are under development or approved for clinical use. Although there are some side effects and drug resistance, the discovery of novel drugs, the development of combination therapies, and the application of new technologies provide solutions to these challenges and improve efficacy. This review presents the mechanisms of action of NAD  pathway-related molecules in tumor immunity, advances in drug research, combination therapies, and some new technology-related therapies.
The relationship between animal flesh foods consumption and rheumatoid arthritis: a case-control study
Authors: Hatami Elahe , Aghajani Mobina , Pourmasoumi Makan , Haeri Farahnaz , Boozari Behnoosh , Nezamoleslami Saeed , Clark Cain C. T. , Nezamoleslami Shokufeh , Ghiasvand Reza
Published: July 2022

Background

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory, and debilitating autoimmune illness. The objective of the present study was to evaluate the relationship between animal flesh foods consumption and rheumatoid arthritis.

Methods

Meat consumption was assessed by using a semi-quantitative Food Frequency Questionnaire (168 items) in a case-control study of 297 subjects (100 newly diagnosed cases and 197 healthy controls). An expert rheumatologist diagnosed patients based on the American College of Rheumatology definitions, 2010. Multivariate logistic regression, adjusted for lifestyle and nutritional confounders, was used to evaluate the relationship between dairy consumption and rheumatoid arthritis.

Results

Participants with greater consumption of fish and seafood were less likely to have RA (OR 0.52; 95% CI 0.27–0.98). Conversely, a higher processed meat intake was associated with increased odds of RA (OR 3.45; 95% CI 1.78–6.68). However, no significant association was found between red meats and poultry consumption and the risk of RA in the fully adjusted model.

Conclusions

The present study suggests an inverse association between fish and seafood consumption and the risk of RA. On the contrary, a higher amount of processed meat intake was associated with increased odds of RA. However, further studies are warranted to confirm the veracity of our findings.
Effect of soy isoflavones supplementation on migraine characteristics, mental status and calcitonin gene-related peptide (CGRP) levels in women with migraine: results of randomised controlled trial
Authors: Babapour Maedeh , Khorvash Fariborz , Rouhani Mohammad Hossein , Ghavami Abed , Ghasemi‐Tehrani Hatav , Heidari Zahra , Karbasi Mojtaba , Moradi Fatemeh , Askari Gholamreza
Published: July 2022

Background

Literature suggests a relationship between estrogen levels and migraine headache pathogenesis. However, the effect of soy isoflavones on migraine characteristic remains unclear. This study aimed to investigate the effect of soy isoflavones on migraine characteristics and calcitonin gene-related peptide (CGRP) levels in women with migraine.

Methods

Eighty-three participants completed a randomized double-blind controlled trial, receiving 50 mg per day soy isoflavones or placebo supplementation for 8 weeks. Migraine severity, migraine days per month, frequency and duration of attacks, mental status, quality of life and serum CGRP levels were measured at baseline and the end of the intervention. Bivariate comparison and intention-to-treat (ITT) were used for analysis.

Results

Soy isoflavones intake resulted in a significant decrease in mean frequency (-2.36 vs -0.43, P < 0.001), duration (-2.50 vs -0.02, P < 0.001) of migraine attacks and CGRP level (-12.18 ng/l vs -8.62, P = 0.002) in compared to placebo group. Also, a significant improvement was found in quality of life (16.76 vs 2.52, P < 0.001). Although, reduction in the migraine severity and mental status did not reach a statistically significant level (P > 0.05).

Conclusion

soy isoflavones supplementation may be considered as a complementary treatment for women with migraine to improve migraine characteristics and reduce the burden of disease.