bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing the accuracy and utility of ChatGPT responses to patient questions regarding posterior lumbar decompression
Authors: Giakas Alec M. , Narayanan Rajkishen , Ezeonu Teeto , Dalton Jonathan , Lee Yunsoo , Henry Tyler , Mangan John , Schroeder Gregory , Vaccaro Alexander , Kepler Christopher
Published: September 2024

Aim: To examine the clinical accuracy and applicability of ChatGPT answers to commonly asked questions from patients considering posterior lumbar decompression (PLD).

Methods: A literature review was conducted to identify 10 questions that encompass some of the most common questions and concerns patients may have regarding lumbar decompression surgery. The selected questions were then posed to ChatGPT. Initial responses were then recorded, and no follow-up or clarifying questions were permitted. Two attending fellowship-trained spine surgeons then graded each response from the chatbot using a modified Global Quality Scale to evaluate ChatGPT’s accuracy and utility. The surgeons then analyzed each question, providing evidence-based justifications for the scores.

Results: Minimum scores across all ten questions would lead to a total score of 20, whereas a maximum score would be 100. ChatGPT’s responses in this analysis earned a score of 59, just under an average score of 3, when evaluated by two attending spine surgeons. A score of 3 denoted a somewhat useful response of moderate quality, with some important information adequately discussed but some poorly discussed.

Conclusion: ChatGPT has the ability to provide broadly useful responses to common preoperative questions that patients may have when considering undergoing PLD. ChatGPT has excellent utility in providing background information to patients and in helping them become more informed about their pathology in general. However, it often lacks the specific patient context necessary to provide patients with personalized, accurate insights into their prognosis and medical options.
Evaluation of weight loss and quality of life in long-term post-bariatric surgery
Authors: Péres Amanda , Bernhardt Joel , Tibolla Vanessa
Published: September 2024

Aim: Obesity is a chronic disease that can lead to many consequences and is directly related to the development of other non-communicable chronic diseases. Since medical treatment for this comorbidity does not always yield satisfactory results, bariatric surgery ends up being the best option for many cases. Thus, the present study aims to analyze long-term weight loss in patients undergoing bariatric surgery, compare weight loss according to the surgical technique performed, and assess the quality of life of patients in the long-term postoperative period.

Methods: This is a descriptive and cross-sectional study analyzing a pre-existing database along with new data collected through telephone interviews according to the modified Bariatric Analysis and Reporting Outcome System (BAROS) questionnaire. Medical records for those who underwent the procedure within the specified period were analyzed.

Results: Records for a total of 208 patients were analyzed, of whom 181 underwent the Bypass surgical technique and 27 underwent the Sleeve technique. Based on the BAROS score, the majority of patients (64.9%) had a "good" or "very good" outcome. Regarding weight loss, 70.68% of the interviewed patients lost over 50% of weight, with this loss occurring in 74.58% of those who underwent Bypass and 44.44% of those who underwent Sleeve. Additionally, 95.2% of respondents reported feeling “better” or “much better” after surgery.

Conclusion: Our results indicate that bariatric surgery is effective both in long-term weight loss and in improving the quality of life of patients. Meanwhile, our study suggests that the BAROS questionnaire may be insufficient to assess long-term quality of life.
Soft power transformation and growing conflict potential in International Relations
Authors: Rustamova L.
Published: September 2024

At the end of the first quarter of the 21st century, the theoretical understanding of the concept of "soft power" has changed, as well as the application of its tools in practice. Along the liberal democratic countries that have traditionally used “soft power” resources to effectively achieve their foreign policy objectives by spreading their agenda and model of public administration, many non-western states have started to actively employ their educational services, cultural products, and sports diplomacy tools to advance their own geostrategic goals and to limit the monopoly of the West on shaping political agenda and its so-called normative power. With the escalation of the Ukrainian and Palestinian–Israeli conflicts, Western states turned to the use of the so-called sharp power tools, in order to delegitimize the “soft power” of competing countries through the tools of “cancel culture” and, specifically, to limit Russia’s ability to use its humanitarian resources in foreign policy. Reliance on “sharp power” has discredited not just J.Nye’s concept, but also the basic principles of the functioning of the humanitarian sphere at large. Against this background, “soft power” loses its initially positive message that promotes the ideas of growing interdependence as a condition for maintaining long-term partnership relations and mutual benefit. This message is replaced by tools for manipulating public consciousness, as states seek to ensure the conditions for the dominance of their narratives in the shortest possible time. Nevertheless, despite the dominance of “sharp power” at the times of conflict, demand for “soft power” instruments does not disappear completely. This is reflected by the 2022 concept of the humanitarian policy of the Russian Federation abroad which recognizes the important role of “soft power” tools as a means to neutralize anti-Russian sentiments.
Media component of the British “soft power” (analysis of the Chilcot report)
Authors: Kharitonova E.
Published: September 2024

The article examines the materials from the Report of the Iraq Inquiry, also known as the Chilcot report, that scrutinizes the UK government’s actions in the lead-up to and following the 2003 invasion of Iraq through the 2000s. The article focuses on the British officials’ approaches to the use of “soft power” and to managing public opinion at home and abroad as the UK prepared for employing and employed “hard power” in Iraq. It also explores the specifics of the shaping of the media space at the time that are compared to present approaches to such activities. On the basis of excerpts from the minutes of official meetings and government correspondence cited in the Chilcot report, other documents, and more recent and current UK government publications, the article identifies key characteristics of British strategies for working with partners, media, and wider public in the period covered by the Chilcot report and at the present stage. It is concluded that approaches and strategies developed during the Iraqi campaign remain relevant. The article assesses the impact of public relations strategies employed by the UK during the Iraq campaign on current political situation in Britain and its “soft power” potential.
Iran’s sectarian policy in the Arab countries of the Middle East
Authors: Akhmedov V.
Published: September 2024

The article explores the religious expansion of the Islamic Republic of Iran in the Arab countries of the Middle East. Socio–political precipitants and motives of Iran’s religious policy in the region are addressed through the prism of the Syria crisis. Special attention is paid to a shifting paradigm of armed conflicts in the region as a factor influencing the rise of paramilitary forces (militia) and the choice of instruments of Iran’s humanitarian policy in Syria and Iraq. The history of various Shia militias in Syria and Iraq, their ideological basis and results of their activities are examined. On the basis of comparative analysis, an author’s typology of such groups is proposed. Active spread of the Shia doctrine, the formation of Shia–majority governments, support for non-state groups, and the creation of pro-Iranian militias are explored as strategic guidelines for Iran’s religious expansion in the Middle East. On the one hand, it is concluded that the integration of Shia militias in regular Arab armies along with the spread of the Shia doctrine rooted Iran in Arab social fabric and strengthened its political and military positions in the Middle East. On the other hand, it is shown that Iran’s sectarian policy affected Tehran's relations with key regional, international players in the region in more ways than one. Despite Tehran’s political statements and preferences, Shia militias’ attacks on the U.S. and Israeli targets in the region de facto have made Iran a part in Gaza war and have also affected its rapprochement with the Arab states and its cooperation with international partners in the process of reconciliation in Syria. In view of the significance of the Palestinian–Israeli conflict for Russia’s Middle East policy, the article contributes to the study of the Iranian policy in the region and sheds the light on Iran’s behavioral model in crisis conditions in the Middle East.
RHYTHMEASURE REVISITED. DURATION-NUMBER, MULTI-TIME SCALE THEORY, ETHICS OF DÉMESURE IN BERGSON’S PHILOSOPHY
Authors: Fujita Hisashi
Published: September 2024

Often illustrated with the examples of melody, Bergson’s key concept of durée is best known for its qualitative, heterogeneous, and thus immeasurable multiplicity. However, the examples he gives in Time and Free Will—such as “the regular oscillations of a pendulum” or “the successive strokes of a distant bell”—suggest rather periodic phenomena that would require another perspec­tive in terms of rhythm. When we “get into a rhythm,” we perceive a numerical quality without counting. Rhythm makes glimpse “Otherwise than Measuring”. Focusing on the “rhythmic organization of the whole” within duration could reveal the secret of Bergson’s enigmatic phrase: “this heterogeneity contains number only potentially.” This paper reexamines the theoretical scope of rhyth­measure in two ways. First, it shows how this image médiatrice we forged is going to be renewed by recent studies emphasizing duration-number (Miravete) or multi-time scale theory (Hirai). Second, it explores the ethico-political impli­cations of rhythmeasure. Bergson, in his last book Two Sources of Morality and Religion, multiplies images of “a justice (…) which no longer evokes ideas ofrelativity and proportion, but, on the contrary, of the incommensurable and the absolute”. The very ambiguity of démesuré revitalizes the famous opposition of “the closed/the open”.
Keywords: Duration. Rhythm. Number. Ethics. Démesure.
On the Elimination of Fast Variables from the Langevin Equation
Authors: Bedeaux Dick
Published: September 2024

In a multivariable system there are usually a number of relaxation times. When some of the relaxation times are shorter than others, the corresponding variables will decay to their equilibrium value faster than the others. After the fast variables have decayed, the system can be described with a smaller number of variables. From the theory of nonequilibrium thermodynamics, as formulated by Onsager, we know that the coefficients in the linear flux-force relations satisfy the so-called Onsager symmetry relations. The question we will address in this paper is how to eliminate the fast variables such that the coefficients in the reduced description for the slow variables still satisfy the Onsager relations. As the proof Onsager gave of the symmetry relations does not depend on the choice of the variables, it is equally valid for the subset of slow variables. Elimination procedures that lead to symmetry breaking are possible, but do not consider systems that satisfy the laws of nonequilibrium thermodynamics.
MPO and Its Role in Cancer, Cardiovascular and Neurological Disorders: An Update
Authors: Jannesar Kosar , Soraya Hamid
Published: September 2024

Myeloperoxidase (MPO) is an enzyme that contains a heme group, found mostly in neutrophils and in small amounts in monocytes and plays a major role in their anti-microbial activity. However, excessive levels of MPO have been linked to various disorders and identified as a major cause of tissue destruction. Inhibiting its activity can reduce the severity and extent of tissue damage. Over activity of MPO during chronic inflammation has been shown to be involved in tumorigenesis by inducing a hyper-mutagenic environment through oxidant interaction with DNA, causing DNA modification. Vascular endothelium is one of the most important targets of MPO and high levels have been associated with increased rates of cardiomyopathy, ischemic stroke, heart failure, myocardial infarction, and atrial fibrillation. Therefore, it may be considered a therapeutic target in the treatment of cardiovascular disorders. MPO also participates in the pathogenesis of neurodegenerative diseases. For example, an increase in MPO levels has been observed in the brain tissue of patients with Alzheimer's, Multiple sclerosis (MS), and Parkinson's diseases. In Alzheimer's disease, active MPO is mostly found in the location of beta amyloids and microglia. Therefore, targeting MPO may be a potential treatment and prevention strategy for neurological disorders. This review will discuss MPO's physiological and pathological role in cancer, cardiovascular, and neurological disorders.
Extended Postoperative Antibiotic Prophylaxis Is Associated with No Clinical Value and Higher Projected Cost Following Adult Spinal Surgery
Authors: Awad Mohamed E. , Griffin Nicole A. , Epperson Aaron B. , Alfonso Nicholas A. , Ou-Yang David
Published: September 2024

» We aimed to determine the cost-effectiveness of different protocols of extended postoperative antibiotic prophylaxis (E-PAP) following adult spinal surgery.

» Both stratified (randomized controlled trials only) and nonstratified (all studies) analyses demonstrated that E-PAP has no significant value in reducing the rate of surgical site infection (SSI), deep SSI, or superficial SSI.

» Notably, the E-PAP protocols were associated with a significant increase in the length of hospital stay, resulting in an additional expenditure of $244.4 per episode for the E-PAP 72 hours protocol compared with PAP 24 hours and $309.8 per episode for the E-PAP >48 hours protocol compared with PAP <48 hours.

» E-PAP does not demonstrate any significant reduction in the rate of SSIs following spine surgery. However, these extended protocols were significantly associated with an increase in the length of hospital stay and higher overall projected costs.

Level of Evidence:

Level I. See Instructions for Authors for a complete description of levels of evidence.
The Impact of Social Determinants of Health on the Prognosis of Primary Bone Tumors
Authors: Ebrahimi Alireza , Hosseini Sahar , Shahabi Saeed , Ashkani-Esfahani Soheil , Lozano-Calderon Santiago
Published: September 2024

Background:

Although the prevalence of primary bone tumors (PBTs) was reported to be relatively low, they represent a difficult category of tumors for appropriate prediction, prevention, diagnosis, and treatment. Among different factors contributing to the prognosis and treatment outcomes of patients with these tumors, it is assumed that social determinants of health (SDOH) have not been well investigated nor applied in the process of decision making for these patients.

Methods:

In this systematic review, databases including PubMed, Web of Science, Scopus, Embase, Science Direct, and CINAHL were used. To ensure the quality of the studies and assess them for bias, we used the Methodological Index for Nonrandomized Studies scaling tool. The relevant data were extracted from the included studies and reported.

Results:

Twenty-five studies were included in our review based on the inclusion criteria. Age, socioeconomic status, education, and employment status; place of living and neighborhood; race and ethnicity; and insurance coverage were found to impact the outcomes and prognosis of PBTs.

Conclusion:

Literature has shown correlations of various SDOH with the outcomes of PBTs. SDOH are not independent of each other; including and interpreting them in the process of decision making should be in a multifactorial and intercalated manner. We suggest prospective studies on finding the effect of inventing with SDOH through changes in health care policies, educating patients and care providers, improving socioeconomic conditions, and providing better insurance support, on the outcomes of PBTs.

Level of Evidence:

Level III. See Instructions for Authors for a complete description of levels of evidence.
A geospatial model for identifying stream infrastructure locations
Authors: Vandevort Daniel , Engel Chandler , Stanton Shaun
Published: September 2024

Management of hydraulic infrastructure for flood control, hydropower, navigation, and water supply is a critical component of the Army Dams and Transportation Infrastructure Program (ADTIP). This project provides a tool to locate stream infrastructure using a one-dimensional approach supplemented with geospatial filtering that only needs digital elevation model (DEM) files as primary input. The regions in and around Forts Liberty, Sill, and Cavazos were selected as study areas, and stream networks with corresponding stream elevation profiles were created and searched for elevation changes that met vertical threshold and search window criteria. Recall, Fβ, and a ratio of under to overprediction were used to evaluate performance. The search algorithm generally overpredicts the number of stream infrastructure locations and especially so for large search windows (20 or 25 cells) and small vertical threshold values (5 or 10 m). Overall, it was found that midrange vertical threshold values (2 or 2.5 m with long search windows (20 or 25 cells) with the land cover classification (LCC) check applied yielded results that minimized false negatives and overpredictions. The significance of this tool is that it may reduce costly field investigations, or at least aid in the prioritization of site visits for hydraulic infrastructure managers.
Simple model, complex strata: 2-D numerical forward model analysis of heterogeneity and controls in submarine fan systems
Authors: Mackie Alfie W. , Stevenson Christopher J. , Burgess Peter M.
Published: September 2024

Turbidite strata stacking patterns are interpreted as products of either allogenic forcing, autogenic processes, or a combination of both. However, the relative influence of each remains difficult to constrain. Here, a simple reduced-complexity 2-D numerical forward model (Lobyte2D) simulates gravity flows passing down a slope, running out, and depositing across a flat basin floor. Flows can erode, bypass, or deposit, cumulatively producing a variety of entirely autogenic retrograding, aggrading, and prograding strata with stratigraphic completeness values ranging from less than 1% to around 40%. Complexity of modeled strata is measured with a spatial entropy metric, and sensitivity analysis indicates that grain-size and flow-acceleration parameters are the key controls on stratal complexity: larger grain sizes are associated with deeper erosion, which makes more rugged topography, and higher values of flow acceleration make flow speeds more sensitive to topography, which triggers localized deposition and/or erosion. Such complexity produced by a simple two-dimensional numerical forward model suggests that even more complex behavior is likely in natural systems, and this should be reflected in outcrop and subsurface interpretations. However, comparison of geometries in chronostratigraphic and cross-section plots of modeled strata shows that, due to a variety of cryptic bypass and erosion surfaces, stacking trends visible in chronostratigraphic plots are much more difficult to detect in outcrop and subsurface cross sections and vertical sections. These insights suggest that many outcrop and subsurface interpretations of submarine-fan strata, particularly sequence stratigraphic interpretations, may be missing substantial complexity, and underestimating the uncertainty inherent in limited data.
Features of Dispersal of Late Anisian Ammonoids of the Boreal Realm
Authors: Konstantinov A.G.
Published: September 2024

—Identifying patterns of geographic differentiation of individual groups of marine invertebrate fauna in the geological past is important for understanding their evolutionary history, solving issues and problems of biostratigraphic division, and correlation of deposits. Paleobiogeographic data is also necessary to identify the development stages of biota and the geological history of marine paleobasins and verify paleogeodynamic reconstructions. In this work, considering the latest data on paleontology and biostratigraphy of the Boreal Triassic, the taxonomic composition and distribution of Upper Anisian ammonoids in various regions of the Boreal realm are revised. A correlation of Upper Anisian deposits of Northeast Asia, British Columbia, Canadian Arctic Archipelago, Svalbard, Franz Josef Land, and Khabarovsk Krai was carried out at the zonal level and a basis was obtained for a comparative analysis of coeval ammonoid faunas. As a result of a qualitative and quantitative comparative analysis of ammonoid assemblages for various phases of the Late Anisian age, it was established that in the Late Anisian age, British Columbia was constantly part of the Canadian province of the Boreal realm, and Northeast Asia was part of the Siberian province. At the end of the Late Anisian age (most of the late part of the Frechites nevadanus or Frechites chischa phases), provincial differences were smoothed out and for the first time, all Boreal regions were included in the Siberian province, except the territory of British Columbia. Analysis of the geographical distribution of some groups of ammonoids in the Late Anisian age and changes in the areas of taxa over time made it possible to identify probable migration routes of Longobarditidae (genus Longobardites) and to introduce significant changes in the ideas about the centers of origin and migration of some Beyrichitidae.
Analysis of Risk factors of anastomotic leakage after minimally invasive esophagectomy with circular cervical anastomosis
Authors: wang cong , li zhenyi , yu yang , lu ming
Published: September 2024

OBJECTIVES Esophagectomy is a high-risk surgical procedure with significant postoperative morbidity and mortality. Anastomotic leakage is still one of the most serious complications after anterior resection for esophageal carcinoma. This study aimed to analyze the risk factors after minimally invasive cervical anastomosis of esophageal cancer and postoperative mortality. METHODS This was a retrospective study of 312 minimally invasive cervical anastomosis of esophageal cancer in a single institute between 2013 and 2016. The anastomotic level and perioperative confounding factors were analyzed by univariate and multivariate logistic regression to identify potential risk factors for postoperative leakage. RESULTS Total 312 patients were evaluated. Overall leak rate was 10.6%. In-hospital or 30-day mortality was 0%. Only 3 patients received intensive care unit due to postoperative complications and mean hospital stay was 14.22(± 7.70) days. Univariate analysis showed that the following variables were related to the incidence of anastomotic leakage: neoadjuvant chemotherapy before operation (p = 0.007); body mass index (BMI) (p = 0.000); diabetes (p = 0.001); operation time (p = 0.006). Multivariable analysis identified diabetes [P = 0.032, odds ratio (OR) 2.637, 95% confidence interval (CI): 1.087–6.393], BMI [P = 0.003, odds ratio (OR) 1.223, 95% confidence interval (CI): 1.070–1.399] and operation time [P = 0.033, odds ratio (OR) 1.012, 95% confidence interval (CI): 1.001–1.024] as the risk factors of anastomotic leakage. CONCLUSIONS Diabetes, operation time and BMI are independent prognostic factors for cervical anastomotic leakage of minimally invasive esophageal cancer. Cervical anastomotic leakage will not affect the short-term survival of the patients.
Developing a novel approach to complex evolution of antimicrobial resistance via mobile genetic elements from a persistent environmental biofilm
Authors: Mathers Amy , Li Thomas , He Qijun , Narendra Sharvari , Stoesser Nicole , Eyre David , Walker Sarah , Barry Katie , Castañeda-Barba Salvador , Huang Fenix Wenda , Parikh Hardik , Kotay Shireen , Crook Derrick , Reidys Christian
Published: September 2024

Mobile genetic elements are key to the global emergence of antibiotic resistance. We successfully reconstructed the complete bacterial genome and plasmid assemblies of isolates sharing the same blaKPC carbapenemase gene to understand evolution over time in six confined hospital drain biofilms over five years. From 82 isolates we identified 14 unique strains from 10 species with 113 blaKPC−carrying plasmids across 16 distinct replicon types. To assess dynamic gene movement, we introduced the 'Composite-Sample Complex', a novel mathematical approach to using probability to capture the directional movement of antimicrobial resistance genes accounting for the co-occurrence of both plasmids and chromosomes within an isolate, and highlighting likely donors and recipients. From the validated model, we demonstrate frequent transposition events of blaKPC from plasmids to other plasmids, as well as integration into the bacterial chromosome within specific drain biofilms. We present a novel approach to estimate the directional movement of antimicrobial resistance via gene mobilization.
Comparison of side-to-side anastomosis vs. end-to-end anastomosis in NOSES operation for left colon cancer: a retrospective study
Authors: Huang Jintuan , Wu Jianchao , Fang Sifu , Huang Jinmei , Chen Weili , Shi Zhimin
Published: September 2024

Objective: To analyze and compare the application and efficacy of side-to-side anastomosis and end-to-end anastomosis in NOSES operation for left colon cancer.
Methods: A retrospective analysis of 69 patients in our hospital from February 2018 to February 2022 who underwent natural orifice specimen extraction surgery (NOSES) for left colon tumors. The observation group was performed with side-to-side anastomosis (Overlap). For digestive tract reconstruction, the control group was anastomosed by end-to-end anastomosis; the intraoperative and postoperative conditions and complications were compared between the two groups.
Results: There was no significant difference in operation time and intraoperative blood loss between the two groups (P>0.05). However, the intraoperative anastomosis time in the observation group was significantly shorter than that in the control group (P<0.001). Additionally, there was no significant difference in the time of first exhaustion, defecation time, degree of patency of defecation, frequency of defecation, postoperative hospital stays and postoperative pain between the two groups (P>0.05). Furthermore, the overall incidence of postoperative complications did not show a significant difference (P>0.05).
Conclusions: In the NOSES surgery of left colon cancer, both side-to-side anastomosis (Overlap) and end-to-end anastomosis yield comparable radical outcomes., but the side-to-side anastomosis (Overlap) method is operationally simpler and has a shorter intraoperative anastomosis time. As such, this method is the preferred anastomosis method when NOSES for colorectal cancer is carried out in primary hospitals.
Trial registration number ChiCTR1900026104 (2019-09-21)
Device that safely closes the incisions made with trocars in laparoscopic surgery
Authors: Padilla Luis , Montoya-Ramírez Jesús , Aguilar-Soto Oscar , Herran-Motta Fanny Stella , Landero-Yoshioka Takeshi , López-Gutiérrez Javier , Carranza-Castro Carranza-Castro , Nuño-Lámbarri Natalia , Ortega-Salgado José Arturo , Ortiz-Fernández Moisés , Silvio Mauricio Di , Montalvo-Javé Eduardo Esteban
Published: September 2024

Objective:
To describe and demonstrate the safety and efficacy of an OcluPad (OP) that closes surgical incisions in the abdominal wall, made with trocars in laparoscopic surgery in obese patients, avoiding hernias.
Material and methods:
After preclinical studies in rats and pigs, we obtained authorization from the Research, Ethics, and Biosafety commissions of the "20 de Noviembre" National Medical Center to develop a clinical trial and apply the OP device to 40 of the 80 patients subjected to Gastric bypass or gastric sleeve surgery as a surgical treatment for morbid obesity. The patients were divided into two groups: Group I, 40 patients with three OP devices applied to close the trocar holes, and Group II, 40 patients without surgical closure of the three trocar holes.
Results:
The groups were evaluated two years after the bariatric surgery procedure using abdominal tomography. Obtaining zero hernias in group I and 14 hernias in group II generated a 35% prevalence. (p = 0.001) (OR = 0.04) CI = 0.005–0.38.
Conclusions:
OP is a device that prevents the formation of trocar hernias in obese patients. It is efficient, simple, quick to apply, economical, and meets the concept of safety and effectiveness since it has excellent biocompatibility; generating a layer of neo-mesothelium induces minimal adhesions.
POEMS syndrome combined with anti-Caspri1 antibody-mediated autoimmune nodo-paranodopathy: a case report
Authors: Zou xuan , Hong Yan , Zhou Guanen
Published: September 2024

Background POEMS syndrome is a rare paraneoplastic syndrome caused by abnormal proliferation of plasma cells. It can cause multiple peripheral neuropathy, but the specific mechanism is still unclear. we describe a case of POEMS syndrome combined with anti-Caspri1 antibody-mediated autoimmune nodo-paranodopathy.Case presentation A 66-year-old male patient developed flaccid paralysis of the limbs after diarrhea two months ago. He was diagnosed with POEMS syndrome 4 years ago. The titer of the IgG antibody against contact associated protein1 (Caspr1) in the patient's serum was 1:100, and the IgG and IgM antibodies against GM1 were weakly positive. Brain MRI shows left paraventricular infarction, accompanied by cerebrovascular stenosis, severe heart failure, and pleural effusion. The patient's condition improved after receiving plasma exchange (PE) and methylprednisolone treatment.Conclusion There is report of POEMS syndrome combined with anti-GM1 antibody1, but there has been no report of POEMS syndrome combined with anti-Caspr1 antibody. Abnormal plasma cell proliferation in POEMS syndrome may be the culprit behind the production of antibodies.
Estimates of non-communicable disease expenditure by disease phase, sex, and age group for all OECD countries
Authors: Grimshaw Samantha , Bourke Emily , Blakely Tony
Published: September 2024

Background:
Across OECD member countries, non-communicable diseases (NCDs) accounted for nearly 90% of deaths and over half of disability-adjusted life years lost. NCD health expenditure estimates are necessary to estimate future health expenditure trajectories for different prevention and treatment policies. However, no dataset of comparable estimates exists across OECD countries.
This study generates disease expenditure estimates in all 38 OECD member countries in 2019, for 80 major NCDs by disease phase, sex, and age group – filling a critical information gap in global health data.
Methods:
Health expenditure per person with disease by sex and age group was taken from a comprehensive Australian disease expenditure study and disaggregated by disease phase (first year of diagnosis, last year of life if dying of disease, otherwise prevalent) using Global Burden of Disease data and New Zealand estimates of relative expenditure ratios by phase. These estimates were applied to case numbers in each OECD country and scaled to each country’s total health system expenditure to estimate total NCD expenditure in 2019 United States dollars by disease phase. Estimates were compared with pre-existing disease expenditure estimates for Norway, Switzerland, and the United States of America.
Results:
Average health expenditure on NCDs across OECD countries was US$207 million per 100,000 population. Pooled across countries, musculoskeletal disorders contributed to the highest proportion of total health expenditure (17.4%), followed by cancer and other neoplasms (9.4%), and CVD (9.1%). The highest proportion expenditure conditions for females were musculoskeletal disorders (56.1%), mental and substance use disorders (55.8%), and neurological conditions (54.8%). For males it was kidney and urinary diseases (63.8%), cancer and other neoplasms (58.3%), and cardiovascular diseases (50.7%). The first year of diagnosis represented on average 36.8% of total NCD expenditure, while last year of life expenditure attributable to disease causing death accounted for 2.6%.
Similarities and differences were observed between our estimates and pre-existing country-specific estimates.
Conclusions:
Our estimates represent a starting point for understanding the impact of NCDs on health system expenditure. We recommend evolving our paper’s methods to include multiple country-level studies as inputs – augmented by covariates (e.g. GDP, public/private split) to better predict disease expenditure.
Phase Angle and Body Composition in Long-term Type 1 Diabetes in Adults: A comparative study in a Brazilian Public Reference Outpatient Clinic
Authors: Pena Natália Fenner , Fajardo Virginia Capistrano , Froes Lívia , Carvalho Paulo Augusto Miranda , Lauria Márcio Weissheimer , Torres Henrique Oswaldo da Gama
Published: September 2024

Introduction: Type 1 Diabetes Mellitus (DM1) is a disease that affects a small percentage of the population. Nevertheless prevalence is currently growing, with alarming data on lack of control. The importance of body composition and Phase Angle (PA) as assessed by Bioelectrical Impedance (BIA) in long term DM1 patients lies in the fact that alterations in cellular integrity and body compartments may affect risk profiles and metabolic control. The objective of this study was to compare different PA and body composition parameters in a sample of adults with DM1, with healthy controls.
Methods: A comparative study was carried out in a state public university outpatient clinic, including a cohort of adult patients of both sexes, diagnosed with DM1, and a control group matched by age and sex, in a 2:1 ratio. Anthropometric measurements included weight, height and BMI. From the raw bioelectrical impedance data of Resistance and Reactance, Fat-Free Mass (FFM), Fat Mass (FM), Fat-Free Mass Index (FFMI), Fat Mass Index (FMI), PA and standardized PA (SPA) were calculated. Means or medians were compared. Regression models were used to show distinguishing characteristics of both groups or to disclose associations within the diabetic group (HbA1c, disease duration, presence of microvascular complications, capillary blood glucose, BMI and FMI).
Results: 88 patients with Type 1 Diabetes and 46 healthy controls were evaluated. PA was lower in diabetics (6.05 vs 6.85, p = 0.000), as well as SPA (-1.47 vs -1.36, p = 0.000). Diabetics displayed higher adiposity (%FM = 29.6 vs 27.6, p = 0.016; FMI = 7.00 vs 6.33, p= 0.016) and lower %FFM. Most of the differences were maintained after sex stratification and diabetic man disclose a lower FFMI than male controls (18.2 vs20.16, p = 0.029).
Conclusion:Patients with DM1 present greater nutritional risk and worse cell membrane integrity when assessed by PA. Significant body composition differences among groups and between sexes were highlighted, with data showing greater adiposity in diabetic women and diabetic men displaying lower muscle mass. These findings suggest the importance including PA and body composition evaluation in the multidisciplinary clinical outpatient follow-up of patients with Type 1 Diabetes, in an attempt to obtain better metabolic control and consequently, a better prognosis.
The Relationship Between Gratitude and Coping Strategies: A Mediation Analysis Based on Longitudinal Cross-sectional Data
Authors: ZHANG Jun , YIN Zhimin , DENG Ping , YANG Jieying
Published: September 2024

Purpose This study evaluated the potential relationship between gratitude and coping strategies, examining the mediating effects of perceived social support and self-esteem between gratitude and coping strategies. Methods Starting from January 2023, our research team conducted three longitudinal surveys on 2018 high school students, using Mplus software to construct a structural equation model to explore the relationships between gratitude, coping strategies, perceived social support, and self-esteem. Results Gratitude can significantly predict coping strategies directly and indirectly through perceived social support and self-esteem. Conclusion Gratitude can significantly and positively predict coping strategies both directly and indirectly. This study delves into the complex relationship between gratitude and coping strategies, deepening our understanding of this dynamic. Schools and families should prioritize strengthening children's gratitude education and nurturing their confidence and self-esteem to help them cultivate a positive mindset and engage in positive prosocial behaviors.
A 26 years old primigravida woman presented with Abdominal cutaneous entrapment syndrome: a case report
Authors: Berhanu Melaku Tsediew , Kebede Molla Asnake , Tessfaw Adamu Tigabu , Tekle Alemayehu Beharu , Birhanu Anteneh Messele , Deresa Meron Teka
Published: September 2024

Background: Abdominal cutaneous nerve entrapment syndrome (ACNES) is characterized by severe, mostly refractory, chronic pain due to the entrapment of the cutaneous branches of the lower torso intercostal nerves at the lower edge of the rectus abdominis muscle. ACNES is rare compared to other pregnancy-related peripheral neuropathies and is often overlooked as a differential diagnosis for abdominal pain, despite the diagnosis relying primarily on patient history and physical examination. Emergency physicians and other medical personnel's lack of exposure to such cases results in unnecessary laboratory requests, repeated visits, and increased fear and tension for the patient.
Case presentation: A 26-year-old primigravida woman on her second trimester of pregnancy presented to our Emergency department with persistent localized right upper quadrant abdominal pain. Despite repeated visit to the nearby hospital, no diagnosis was settled and the pain persisted. At our ED after a thorough history, physical examination and diagnostic test no abnormality was found. Finally Abdominal cutaneous nerve entrapment syndrome (ACNES) was considered and a mixture of 1 ml 2% lidocaine with adrenaline and 1 ml dexamethasone (4 mg) was infiltrated into the fascial plane in a fanning fashion into the most tender area using a modified technique and the patient reported significant improvement in pain.
Conclusion: Abdominal cutaneous nerve entrapment syndrome (ACNES) is a cause of abdominal pain in pregnancy that is often overlooked. The objective of this study is to describe a rare case of ACNES in a 26-year-old primigravida woman who presented to a low-resource emergency department to assist patient management.
Clinical efficacy of arthroscopic calcium sulfate loaded with vancomycin and implanted to treat postoperative infection after anterior cruciate ligament reconstruction
Authors: Zhou Peng , Zhao ZhengRong , Liu Yang , Zhao MaoSheng , Li ZhiGang , Li ShenSong , Zhang Peng
Published: September 2024

Purpose
To evaluate the efficacy of vancomycin-loaded calcium sulfate for treating postoperative infection after anterior cruciate ligament (ACL) reconstruction, provide a foundation for early diagnosis and treatment of postoperative infection of the anterior cruciate ligament.
Methods
Between September 2015 and September 2021, 34 patients with postoperative ACL infection received treatment. The infected patients were divided into calcium sulfate group and arthroscopic cleaning group. The blood routine chemistry, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were followed up at 1, 2, and 3 weeks postsurgically; knee mobility and visual analog scale (VAS) scores were evaluated at 6 weeks postsurgically; and the knee stability (KT-2000), Lysholm scores, the International Knee Documentation Committee (IKDC) scores, and Tegner scores were followed up at 2 years postsurgically.
Results
The knee range of motion and VAS score of both groups of patients improved significantly at 6 weeks postsurgically compared to presurgically (P < 0.05). Seven patients in the arthroscopic cleaning group still did not achieve the normal knee range of motion after 6 weeks, and four of them underwent manual release surgery under general anesthesia again. There was a significant improvement in knee joint stability, Lysholm scores, IKDC scores, and Tegner scores between the two groups of patients at the 2-year follow-up (P < 0.05). The Lysholm score and IKDC score of the calcium sulfate group were better than those of the arthroscopic cleaning group, and the differences between the groups were statistically significant (P < 0.05). Between the two groups, there was no significant difference in knee joint stability or Tegner score (P > 0.05).
Conclusions
Arthroscopic debridement combined with vancomycin-loaded calcium sulfate antibacterial particles in intra-articular filling can reduce the incidence of knee joint adhesion in ACL reconstruction patients with infections and has good therapeutic efficacy, making it worthy of clinical application.
Level of evidence:
Level III.
Synthesis of Polyacrylamide Nanomicrospheres Modified with a Reactive Carbamate Surfactant for Efficient Profile Control and Plugging
Authors: Yang Wenwen , Lai Xiaojuan , Wang Lei , Shi Huaqiang , Li Haibin , Chen Jiali , Wen Xin , Li Yulong , Song Xiaojiang , Wang Wenfei
Published: September 2024

A carbamate surfactant was synthesized using octadecanol polyoxyethylene ether(AEO) and isocyanatoethyl methacrylate(IEM) as functional monomers. Subsequently, active-carbamate-surfactant-modified PER nanomicrospheres were prepared through two-phase aqueous dispersion polymerization, utilizing acrylamide (AM), 2-acrylamido-2-methylpropanesulfonic acid (AMPS), and ethylene glycol dimethacrylate (EGDMA) as raw materials. The microstructures and properties of the nanomicrospheres were characterized and examined using infrared spectroscopy, nanolaser particle size analysis, thermogravimetric analysis, scanning electron microscopy, rheometry, rotating drop ultra-low interfacial tensiometry, and core-driven experiments. The results revealed that the synthesized PER nanomicrospheres exhibit a uniform particle size distribution, with an average particle size of 336 nm. Furthermore, the nanomicrospheres exhibit a thermal decomposition temperature of 278℃, demonstrating good thermal stability. The nanomicrospheres also exhibit favorable expansion and viscoelastic properties. Upon the injection of 3wt.% of the PER nanomicrospheres into a non-homogeneous core, the blocking rate (η) reaches 90.32%, while the recovery rate increases by 30.2%. This improvement is attributed to the unique structural design of the nanomicrospheres, allowing them to form a thin film at the three-phase oil-water-rock interface and promoting oil emulsification and stripping. Overall, the PER nanomicrospheres effectively control fluid dynamics within reservoirs, mitigate the loss of oil and gas resources, enhance the economic benefits of oil and gas fields, and thus demonstrate good application prospects.
Association between human blood metabolome and risk of myocarditis: a Mendelian randomization study
Authors: Wang Ziyi , Tian Haonan , Wang Jun
Published: September 2024

Objective
Myocarditis is a common disease of the cardiovascular and immune systems, but the relationship between relevant metabolites in the blood and the risk of myocarditis has not been established. To identify biometabolic markers in myocarditis blood, we performed a two-sample MR study.
Methods
MR preliminary analysis: based mainly on the results of IVW, supplemented by MR-Egger, weighted median, and weighted mode for FDR multiple correction; removal of confounders: screened on the GWAS Catalog website; sensitivity analyses: Cochrane Q-test, Egger regression, MR- PRESSO, scatterplot, funnel plot, forest plot; Genetic and directional analysis: co-localization analysis, steiger test; Replicative and Meta-analysis: meta-analysis by extracting the same ending GWAS from another database.
Results
MR analysis identified significant correlations after FDR for 5 metabolic biomarkers (P < 0.05). Four known metabolites: kynurenine, 1-stearoyl-GPE (18:0), Deoxycarnitine, 5-acetylamino-6-formylamino-3-methyluracil with one unknown metabolite: X-25422. Among them, kynurenine (OR = 1.441, 95%CI = 1.089–1.906, P = 0.018) and 1-stearoyl-GPE (18:0) (OR = 1.263, 95%CI = 1.029–1.550, P = 0.029) were risk factors for myocarditis, Deoxycarnitine (OR = 0.813, 95%CI = 0.676–0.979, P = 0.029), 5-acetylamino-6-formylamino-3-methyluracil (OR = 0.864, 95%CI = 0.775–0.962, P = 0.018) and X-25422 (OR = 0.721, 95%CI = 0.587–0.886, P = 0.009) were protective factors against myocarditis. There was no heterogeneity, horizontal pleiotropy, or sensitivity (P < 0.05), no shared genetic factors between exposure and outcome, and the causality was in the right direction. Meta-analysis results again identified five metabolites causally related to myocarditis (I2 < 50%, P < 0.05).
Conclusion
This study identified a causal relationship between five circulating metabolites and myocarditis, and Kynurenine, 1-stearoyl-GPE (18:0), Deoxycarnitine, X-25422, and 5-acetylamino-6-formylamino-3-methyluracil may be as potential drug targets for myocarditis, providing a theoretical basis for the prevention, diagnosis, and treatment of myocarditis.