bluuebunny/crossref_metadata_2025 huggingface dataset:
Activity outcomes after hip arthroplasty: an information tool based on patients’ experience captured in a hospital registry
Authors: Cole Sophie , Fabiano Gianluca , Barea Christophe , Cullati Stéphane , Agoritsas Thomas , Gutacker Nils , Silman Alan , Hannouche Didier , Lübbeke Anne , Pinedo-Villanueva Rafael
Published: July 2024

Background and purpose
Patients receiving total hip arthroplasty (THA) have different expectations and concerns about their health outcomes after surgery. In this study we developed a tool based on registry data to inform patients and their clinicians about activity outcomes after THA.
Methods
We used data from the Geneva Arthroplasty Registry (GAR) on patients receiving a primary elective THA between 1996 and 2019. The information tool was developed around five activity outcomes: getting in/out of the car, getting dressed autonomously, independence in weekly tasks, interference in social activities, and activity levels. Clusters of patients with homogeneous activity outcomes were identified based on baseline predictors at one, five and 10 years after surgery using Conditional Inference Trees (CITs).
Results
In total, 14 CITs were generated based on 6,836 operations included in the tool. Overall, activity outcomes substantially improved at all three times points after surgery, with 1-year values mostly being the highest. While before surgery only about 10% of patients had none/slight limitations in activities of daily living there were about 70% 1 year after surgery. The SF12 mental component score (MCS), SF12 self-rated health (SRH), BMI, ASA score, and comorbidity count were the most recurring predictors of activity outcomes.
Predictors and their relative importance changed at different time points for the same outcome. For example, for ability to get in/out the car, whilst clusters at year 1 were generated based on WOMAC function, SRH, mental health, WOMAC difficulty walking, and SF12 physical interference, at year 5, ASA score, BMI, SF12 physical & mental health, activity level, and socio-economic status were significant. Outcome profiles varied by clusters.
Conclusion
Distinct activity outcomes clusters based on baseline patient characteristics were identified and knowing this can help inform patients’ expectation and meaningful discussions with clinicians about treatment decisions.
Endocardial suture occlusion of the left atrial appendage during minimally invasive cardiac surgery
Authors: huang chengfeng , huang jiawen , shen si , li yongheng , Zhang yanlin , Zhang xiaoshen , Lu Hua
Published: July 2024

Background
Most thrombi originate from the left atrial appendage (LAA), and preventing thromboembolic stroke is an important aspect of stroke prevention. Previous studies have found that LAA closure is beneficial for preventing thrombosis. Currently, surgical procedures can achieve LAA closure by closing the endocardium or epicardium. Among them, only the LAA endocardial suture technique can be applied to both median thoracotomy and right minimally invasive cardiac surgery.
Aims
This study aims to evaluate the efficacy of LAAC with MICS.
Methods
A total of 74 patients who underwent LAAC during valve operation between 2017 to 2021 were included in this study. Of these, 42 patients underwent MICS. 32 patients who underwent valve surgery during full sternotomy were compared. LAAC uses a continuous suture from the insides. Patients underwent cardiac computed tomography (CT) and transthoracic echocardiography (TTE) follow-up approximately 18 months after surgery. Complete occlusion of the LAA after LAAO was defined as a radiodensity of < 100 HU, contrast opacification of < 25% of the left atrium, and LAAC without any leak.
Results
The LAA closure procedure was successful in 26 cases (81%) in the median thoracotomy group and 20 cases (48%) in the right minimally invasive group. Residual shunting (failed LAA closure) was more common in the right minimally invasive group (P: 0.003), and no correlation was found between residual shunting and left atrial (LA), left ventricular end-diastolic diameter (LVDD), and left ventricular ejection fraction (LVEF).
Conclusions
Compared with median thoracotomy, residual shunting after MICS was more common. CT imaging analysis of 22 patients with failed closure in the MICS group showed that residual shunting was mainly concentrated on margins of the suture (anterior superior and posterior inferior) (86%), with a middle area accounting for 3 (14%).
Differences in fine-scale spatial genetic structure of European beech populations along elevational gradients
Authors: Budde Katharina , Zormpa Ourania Grigoriadou , Wilhelmi Selina , Vucetic Boban , Müller Markus , Gailing Oliver , Ciocîrlan Mihnea-Ioan-Cezar , Ciocîrlan Elena , Curtu Alexandru Lucian , Targem Mehdi , Wildhagen Henning
Published: July 2024

Limited gene dispersal via pollen and seeds typically leads to clustering of related individuals within populations, known as fine-scale spatial genetic structure (FSGS). It reflects microevolutionary processes at the local scale and can inform forest management practices for conservation and restoration purposes. The strength of FSGS varies widely between species with different life history traits but also between populations of the same species.
Here, we investigated the FSGS, genetic diversity and spring phenology (bud burst) of five European beech (Fagus sylvaticaL.) populations along an elevational gradient, ranging from about 550 m to 1400 m a.s.l. in the Romanian Carpathians.
Using microsatellite and genome-wide single nucleotide polymorphism (SNP) markers, we showed that FSGS was most pronounced in lower elevation populations. While FSGS results based on both marker types showed similar trends, significant differences were detected mainly based on SNPs, highlighting the higher resolution of genome-wide markers. Spring phenology started earlier at low elevations and appeared more synchronized compared to high elevations, which may contribute to differences in FSGS. We also observed a slight decrease in genetic diversity with increasing elevation.
These differences in FSGS and genetic diversity could be explained by the lower density of beech and stronger interspecific competition in forest stands at high elevation. Here, the less dense forest structure may facilitate gene flow in this wind pollinated species. Future studies on other beech populations and other species with similar life history traits along elevational gradients are needed to test how common such patterns are.
Incidental prostate cancer status in the era post-PSA screening in two tertiary hospitals in Rwanda
Authors: Ndayishimye Theophile , Mutuyimana Diane Joyeuse , Ikugabire Sonia , Ngendahayo Edouard , Gasana Afrika Guido , Muhawenimana Emmanuel , Mwizerwa Jean Luc
Published: July 2024

Introduction
: Prostate cancer is the second most common noncutaneous cancer in men, with a lifetime risk of 16%. The incidental discovery of prostate cancer during surgical treatment for benign prostatic hyperplasia (BPH) indicates the significant worldwide occurrence of this disease. This study evaluated the incidence of prostate cancer in specimens of prostate obtained during prostatectomy or trans-urethral resection of the prostate (TURP) for benign diagnoses.
Methods
Review of all TURP and open prostatectomy specimens obtained for benign pathologies at two tertiary hospitals between January 2015 and October 2022. The preoperative clinical characteristics, pathology reports, and Gleason scores were retrieved for all patients. The primary outcome was the incidence of incidental prostate cancer. Univariable logistic regressions were performed to assess associations between prostate-specific antigen (PSA) levels, preoperative clinical characteristics of patients, and primary .
Results
The study included 153 patients ranging in age from 47 to 97 years whose procedures were performed for benign diagnoses. Prostate cancer was diagnosed in six individuals (6/153) (4%). The Gleason score varied, ranging from 3 + 3 = 6 to 4 + 5 = 9. The patients' disease stages included pT1a, pT1b, pT1c, and T3N1M0. Active surveillance was chosen for three of the patients, while the remaining three underwent androgen deprivation therapy (ADT). Preoperative hematuria and low back pain were found to be independent predictors of incidental prostate cancer. All incidental prostate cancers were found in patients with PSA levels higher than 4 ng/mL.
Conclusion
There is a low rate of incidental prostate cancer among surgical specimens from patients treated for BPH, and core needle biopsies can be omitted for patients with a PSA lower than 4 ng/ml and without clinical signs suggestive of metastasis or invasion like, such as low back pain and hematuria. In addition to a low rate, only one-third of diagnosed patients required actual treatment. Prospective and more extensive studies are recommended to guide systematic histopathological review of surgical specimens from patients with BPH.
Analyses of the Characteristics and Prognosis of Elderly Patients Visiting a High-Capacity Turkish Emergency Department Due to an Occupational Accident: Cross-Sectional Study
Authors: OZENSOY Habibe Selmin , GURU Selahattin , ERTURK Nihal , ORUN Serhat , CEYHAN Mehmet Ali
Published: July 2024

Background

Most elderly people will live in low-middle-income countries and need to work. With the increase in the number of elderly people in the workforce, it can be predicted that occupational accidents (OAs) in elderly people will continue to constitute an important patient group for emergency departments (EDs). In this study, the descriptive characteristics of elderly individuals who were admitted to a high-capacity ED due to OAs and some features that could predict their prognosis were examined.

Materials & Methods

Patients aged 65 years and older who visited the ED due to OA between June 1, 2019, and June 30, 2023, were retrospectively investigated. The results such as demographic characteristics, trauma-related characteristics, injury severity scores (ISSs), outcome measures such as ED and hospital stay lengths, and mortality ​​were revealed and compared.

Results

Within the scope of the study, 92 elderly people with OA were examined. The most common trauma mechanism involved incisions (n=34, 37%), and the upper extremities were most frequently injured (n=39, 42.4%). Those with thorax trauma, those injured by falls from a height, and those with a high ISS had longer ED and hospital stays (p=0.045, p=0.003, and p <0.001, respectively).

Conclusions

In elderlyindividuals, OAs most commonly injure the upper extremities. Injuries often occur through incisions. Among elderly people injured with OA, those with thoracic trauma fall heights, and those with a high ISS have a poor prognosis.
Predictive accuracy of the ASIG and DETECT screening algorithms to identify pulmonary arterial hypertension in systemic sclerosis; a retrospective cohort study
Authors: Brown Zoe , Hansen Dylan , McWilliams Leah , Moghaddami Mahin , Stevens Wendy , Walker Jennifer , Morrisroe Kathleen , Nikpour Mandana , Proudman Susanna
Published: July 2024

Objective
To evaluate the predictive accuracy of the Australian Scleroderma Interest Group (ASIG) algorithm and the DETECT algorithm to identify pulmonary arterial hypertension (PAH) in an Australian systemic sclerosis (SSc) cohort.
Methods
Algorithm performance evaluated using prospectively collected data from a cohort with annual serum NT-proBNP, TTE and RFT.
Results
From 2009 - 2022, 243 patients had sufficient data to apply both algorithms; 52 underwent right heart catheterisation (RHC), 33 were diagnosed with PAH (13.6%).
The ASIG algorithm was positive in 105 patients (43.21%), 29 were diagnosed with PAH (27.62%). The DETECT algorithm was positive in 172 patients (70.78%), 30 were diagnosed with PAH (17.44%).
The sensitivity of the ASIG algorithm for PAH was 87.88% (95% CI 71.80 – 96.60) and specificity was 31.58% (95% CI 12.58 – 56.55); the DETECT algorithm sensitivity was 90.91% (95% CI 75.67 – 98.08). Specificity and negative predictive value (NPV) of the DETECT algorithm were not able to be calculated as there were no true negative DETECT screen cases. The positive predictive value (PPV) of the ASIG algorithm was 69.05% (95% CI 52.91 – 82.38) and NPV was 60.00% (95% CI 26.24 – 87.84); DETECT algorithm PPV was 61.22% (95% CI 46.24 – 74.80).
Three cases of PAH were not identified by either algorithm; all had co-existent interstitial lung disease (ILD).
Conclusions
ASIG and DETECT screening algorithms for PAH perform well in SSc. A small number of false negative screens in patients with ILD highlight the need to interpret PAH screens in SSc-ILD patients with caution.
A nomogram based on shear wave elastography for predicting hemorrhage complications after ultrasound-guided percutaneous renal biopsy
Authors: Chen Jiaxin , wu qunyan , wang shuqing , pi songying , zhang shushang , xian jianzhong , lu wuzhu , lin yuhong , Su Zhongzhen
Published: July 2024

Background: To derive a simple risk score based on shear wave elastography (SWE) ultrasound to predict the individual risk of post-procedural hematoma complications in patients who underwent a percutaneous renal biopsy.
Methods: A total of 221 patients who underwent ultrasound (US)-guided percutaneous renal biopsy at our institution between April 2019 and November 2023 were enrolled in our study and randomly divided into training (n=155) or validation (n=66) cohorts. After biopsy, ultrasound was employed to evaluate the hematoma, and the maximum diameter of the hematoma was recorded for analysis. A diagnostic nomogram incorporating the selected features was established using multivariable logistic regression analysis.
Results: A total of 148 (67%) patients had postprocedure hematoma (106 and 42 patients in the training and validation cohorts, respectively), and the mean hematoma diameter was 31.12±15.01 mm (10–100 mm). The mean cortical SWE value was 42.87 kPa (21.40-69.30 kPa) for patients without hematoma and 40.18 kPa (14.90-64.50 kPa) for patients with hematoma (p=0.032). The established nomogram integrated the mean cortical swe value, triglyceride level and urinary protein level. The area under the receiver operator characteristic curve (AUC) was 0.82 in the training cohort and 0.61 in the validation cohort.
Conclusions: The risk of postprocedural hematoma complication could be assessed by a simple risk score that integrated mean cortical SWE value, triglyceride and urinary protein levels.
Performance Prediction of Ground Source Heat Pump System With Data-Driven Modelling: Application of Machine Learning Techniques
Authors: DUMAN Netice , YÜKSEK Ahmet Gürkan , BUYRUK Ertan , CANER Mustafa
Published: July 2024

Ground source heat pumps (GSHP) offer a clean and sustainable energy solution by using ground heat as a heat source. Various machine learning techniques are used to estimate coefficient of performance (COP), one of the key metrics for evaluating ground source heat pump systems. In this study, three different machine learning methods, Artificial Neural Network (ANN), Support Vector Machines (SVM) and Gaussian Process Regression (GPR), were used to estimate the performance of the system, using measurements made on an experimental GSHP system established in Sivas province of Turkey. Five different combinations are recommended for each method. Training and testing data were used to evaluate the effectiveness of each method in estimating the COP in the GSHP system. In the first stage, ANN, SVM and GPR models were trained on training data, and in the second stage, validation was carried out with test data. The statistical results obtained show that all three machine learning methods are successful in estimating COP in the GSHP system. R2 values of the model MIP1 in which all variables are used are determined as 0.9726 for ANN, 0.9543 for SVM, and 0.9650 for GPR. This study has demonstrated that different machine learning models can be used as an effective method for predicting the performance of GSHP systems. Additionally, by comparing the applicability and performance of these models, it provides information on determining the most appropriate model that can be used to increase the energy efficiency of GSHP systems and optimize costs.
A Case of Severe Psittacosis Pneumonia Complicated by Splenic Infarction
Authors: Yu Zhao , Qian Yuanyuan , Lv Lan , Hu Wenqing
Published: July 2024

Psittacosis pneumonia, a zoonotic infectious disease transmitted from birds to humans, is caused by Chlamydia psittaci and represents a type of chlamydial pneumonia [1]. In severe instances, the disease may progress to critical pneumonia and respiratory failure, necessitating intensive support measures, including mechanical ventilation. The advent of technologies such as Metagenomic Next-Generation Sequencing (mNGS) for the etiological diagnosis of infectious diseases [2] has enhanced the diagnostic and treatment success rates for Psittacosis. Instances of severe chlamydial pneumonia with complications such as splenic infarction are uncommon. A patient with severe Psittacosis pneumonia complicated by splenic infarction was admitted to the Emergency Intensive Care Unit (EICU) of Haining People's Hospital and subsequently improved following effective anti-infective and anticoagulant therapy. This report and share are as follows.
Association of energy source with outcomes in en bloc TURB. Secondary analysis of a randomized trial
Authors: Mancon Stefano , Soria Francesco , Hurle Rodolfo , Enikeev Dmitry , Xylinas Evanguelos , Lusuardi Lukas , Heidenreich Axel , Gontero Paolo , Compérat Eva , Shariat Shahrokh F. , D’Andrea David
Published: July 2024

Purpose
To comprehensively evaluate the efficacy of different energy sources used for en-bloc transurethral resection of bladder tumors (ERBT) on perioperative outcomes.
Methods
This sub-analysis derived from a prospective randomized study that enrolled patients undergoing ERBT vs conventional transurethral resection of the bladder (cTURB) from January 2019 to January 2022 (NCT03718754). Endpoints were to investigate the association of monopolar (m-ERBT), bipolar (b-ERBT), or laser (l-ERBT) ERBT with pathological specimen quality and perioperative outcomes.
Results
237 bladder tumors resected in 188 patients included in the analyses: 29 (12.2%) m-ERBT, 136 (57.4%) b-ERBT and 72 (30.4%) l-ERBT. Detrusor muscle (DM) was detected in 191 (80.6%) specimens. Per-tumor analysis revealed comparable rate of DM in the specimens obtained via different energy modalities (p=0.7). Operative time was longer in the l-ERBT cohort compared to m-ERBT and b-ERBT (p=0.02) and no obturator nerve reflex (ONR) onset was reported. On logistic regression analysis, b-ERBT was associated with negative lateral resection margins (OR 2.81;95%CI 1.02-7.70; p=0.04). There was no significant association of the resection technique with perforation and conversion rates (all p > 0.05). Within a median follow up of 22mo (IQR 11-29), a total of 35 (18.6%) patients had a local recurrence. On Cox regression analysis, patients resected with b-ERBT were less likely to have a recurrence (HR 0.34; 95%CI 0.15-0.78; p=0.01); When adjusting for established confounders, this association was confirmed (HR 0.24; 95%CI 0.10-0.60; p=0.002).
Conclusions
Different energy sources might achieve comparable perioperative outcomes. Further perspectives involve the assessment of long-term differential oncological outcomes associated with various energy modalities.
Characterization of the gut microbiota in different immunological responses among PLWH
Authors: Guo Yanyan , Tang Gan , Wang Ziwei , Chu Qinshu , Zhang Xinhong , Xu Xuewei , Fan Yinguang
Published: July 2024

Objectives
Despite gut microbial dysbiosis has been demonstrated in HIV-infected patients, the association between gut microbial and inflammatory cytokines in HIV-infected with different immunoreaction to antiretroviral therapy (ART) is poorly understood. The purpose of this study is to explore between gut microbial and inflammatory cytokines in HIV-infected with different immunoreaction.
Method
68 HIV-infected patients and 27 healthy controls in Anhui Province were recruited from December 2021 to March 2022, including 35 immunological responders (IRs) (CD4+T-cell count ≥ 350 cells/µL) and 33 immunological non-responders (INRs) (CD4+T-cell count < 350 cells/µL) without comorbidities. Blood and stool samples were collected from all participants. Blood was used to detect microbial translocation biomarkers and inflammatory cytokines. Luminex Multifactor Detection Technology were performed to quantify plasma microbial translocation biomarkers and inflammation cytokines. Bacterial 16S rDNA sequencing was performed on stool samples.
Result
Microbiome sequencing revealed that the relative abundances of Fusobacteria, Actinobacteria, Verrucomicrobiaceae Acidaminococcaceae, Fusobacteriaceae and Megasphaera were greater, whereas Verrucomicrobia, Ruminococcaceae, Megamonas, Faecalibacterium, Roseburia and Dialister were more depleted in the HIV groups than those in the HCs (all P < 0.05). In the INRs group, the relative abundances of Actinomycetales, Micrococcaceae, Actinomyces, Intestinibacter, Rothia were greater (all P < 0.05), whereas Sutterellaceae, Parabacteroides, Veillonella, Butyricimonas resulted less abundant than in the IRs (all P < 0.05). TNF-ɑ are negatively correlated with the abundances of Dialiste (P = 0.022). CD54 are negatively correlated with Dialister and Subdoligranulum (P = 0.011). Recent and baseline CD4+T cells counts are directly proportional to Butyricimonas and Parabacteroides, while are inversely proportional with Veillonella and Rothia (all P < 0.05).
Conclusion
Dysbiosis of the gut microbial might be one of the factors leading to the different immunoreaction and therapeutic effects of ART.
WITHDRAWN: Development of four-point transversus abdominis plane block technique in pigs. A pilot cadaveric study
Authors: Sreden Jerneja , Brankovič Jana , Tratar Urša Lampreht , Čemažar Maja , Đokić Mihajlo , Seliškar Alenka
Published: July 2024

Background
This prospective pilot cadaveric study aimed to develop an ultrasound-guided transversus abdominis plane (TAP) block technique that desensitizes cranial and mid-abdominal wall in pigs.
Methods
In phase I, the ultrasound anatomy of the abdominal wall musculature was examined on three pig cadavers and the ultrasound localization of the needle in the corresponding interfascial plane was practised. In phase II, a three-point TAP injection was performed in three freshly euthanized cadavers. A 1% methylene blue solution (0.3 mL/kg per injection point) was injected between the transversus abdominis and internal oblique muscle. In phase III, methylene blue solution was injected at four points (0.2 mL/kg per injection point) in four anaesthetized pigs prior to euthanasia. Positive nerve staining was defined as continuous staining of at least 1 cm of the nerve length. Binary variables (positive/negative) were used for nerve staining assessment.
Results
The four-point technique with a lower injected volume stained more nerves than the three-point technique with a higher injected volume. In phase III, 69% of the observed nerves from the eighth-last thoracic to the third lumbar nerve were stained. The nerves in the centre were stained with a higher success rate, while the eighth-last thoracic and the second lumbar nerve were stained with less success (1/8 and 3/8, respectively). The third lumbar nerve was not reached by any injection.
Conclusions
The four-point TAP technique could be used as part of a multimodal analgesia approach for cranial and middle abdominal surgery in pigs, but live animal studies are needed to evaluate the clinical applicability and efficacy of desensitisation.
Barriers and Facilitators for Participation in Brain Magnetic Resonance Imaging (MRI) Scans in Cancer Research: A Feasibility and Acceptability Analysis
Authors: Manuweera Thushini , Karunakaran Keerthana , Baechler Camille , Rosales Javier , Kleckner Amber S. , Rosenblatt Paula , Ciner Aaron , Kleckner Ian R.
Published: July 2024

Purpose
A growing body of research suggests that the brain is implicated in cognitive impairment, fatigue, neuropathy, pain, nausea, sleep disturbances, distress, and other prevalent and burdensome symptoms of cancer and its treatments. Despite anecdotal evidence of difficulties using gold-standard magnetic resonance imaging (MRI) to study the brain, no studies have systematically reported reasons that patients with cancer do or do not complete research MRI scans, making it difficult to understand the role of the brain related to these symptoms. The goal of this study was to investigate these reasons and to suggest possible solutions.
Methods
We analyzed data from 72 patients with cancer (mostly breast and gastrointestinal) from 3 studies: MRI was mandatory in Study 1; MRI was optional in Studies 2–3. Patients provided reasons for completing or not completing optional research MRI scans.
Results
The percentage of scans completed when MRI was mandatory was 76%, and when optional, it was 36%. The most common reasons for not completing optional scans were claustrophobia (40%), safety contraindications (11%), discomfort (5%), a busy MRI schedule (5%), and the scanner being too far away (4%). Older patients were more likely to complete at least one scan (log(odds) = 0.09/year, p = 0.02).
Conclusion
Although brain MRI is feasible for many patients with cancer, it can be difficult or not feasible for patients with claustrophobia, safety issues, busy schedules, or transportation issues. Improving communication, comfort, and access to a scanner may help. Reducing inequities related to study participation can improve research supportive care research.
DNA methylation stability in cardiac tissues kept at different temperatures and time intervals
Authors: Poggiali Brando , Dupont Mikkel Eriksen , Jacobsen Stine Bøttcher , Smerup Morten Holdgaard , Christiansen Steffan Noe Niikanoff , Tfelt-Hansen Jacob , Vidaki Athina , Morling Niels , Andersen Jeppe Dyrberg
Published: July 2024

Investigating DNA methylation (DNAm) in cardiac tissues is vital for epigenetic research in cardiovascular diseases (CVDs). During cardiac surgery, biopsies may not be immediately stored due to a lack of human or technical resources at the collection site. Assessing DNAm stability in cardiac samples left in suboptimal conditions is crucial for applying DNAm analysis. We investigated the stability of DNAm in human cardiac tissues kept at 4°C and 22°C for periods of 1, 7, 14, and 28 days (exposed samples) using the Illumina Infinium MethylationEPIC v1.0 BeadChip Array. We observed high correlations between samples analysed immediately after tissue collection and exposed ones (R2 > 0.992). Methylation levels were measured as β-values and median absolute β-value differences (|∆β|) ranged from 0.0093–0.0119 in all exposed samples. Pairwise differentially methylated position (DMP) analysis revealed no DMPs under 4°C (fridge temperature) exposure for up to 28 days and 22°C (room temperature) exposure for one day, while 508, 1,588, and 488 DMPs were observed for 22°C samples at 7, 14, and 28 days, respectively. This study provides insights into the stability of genome-wide DNAm, showing that cardiac tissue can be used for reliable DNAm analysis even when stored suboptimally after surgery.
Development and validation of a clinical model of second fractures for hip fracture patients after surgery
Authors: Zhang Linlin , Zhou Yanling , Xue Wenping , Wang Wei , Lin Shuqiu
Published: July 2024

Background Second fracture following initial hip fracture surgery poses a life-threatening risk in the elderly population. This study aims to investigate the associated risk factors and establish a prediction model.
Methods Retrospectively data were obtained from two affiliated hospitals at Soochow University for older patients diagnosed with hip fractures who underwent surgical treatment between January 2019 and December 2021. The endpoint was a second fracture. Independent risk factors for second fractures in patients were identified through the least absolute shrinkage and selection operator (LASSO) regression and multivariate Cox regression. A nomogram was established and assessed for predictability, discriminatory ability, and clinical applicability using areas under the receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) in both cohorts.
Results: Among 1735 patients, 8.7% (115/1735) had second fractures within two years after surgery. Variables screened by LASSO, including age, hip joint function, neurovascular disease, eye disease, living alone, and regular exercise, were incorporated into the Cox regression model. The nomogram demonstrated favorable discriminatory ability, with areas under the ROC curves (AUC) of 0.832 (95% CI, 0.765-0.895) and 0.773 (95% CI, 0.727-0.818) after development and validation, respectively. The calibration curves showed good consistency between the actual second fracture incidence and the predicted probability. DCA of the nomogram demonstrated the model’s excellent clinical efficacy.
Conclusions The nomogram model enabled accurate individualized prediction of second fractures in elderly patients within two years after surgical treatment, which might assist clinicians in precise perioperative management and rehabilitation education following initial hip surgery.
Development of Lateral Flow Immunochromatographic Assay with Anti-Pythium insidiosum Antibodies for Point-of-Care Testing of Vascular Pythiosis
Authors: Tongchai Panwad , Burassakarn Ati , Langsiri Nattapong , Worasilchai Navaporn , Chindamporn Ariya
Published: July 2024

The pathogenic oomycete Pythium insidiosum causes a fatal infectious illness known as pythiosis, impacting humans and certain animals in numerous countries in the tropics and subtropics. Delayed diagnosis is a primary factor contributing to the heightened morbidity and mortality associated with the disease. Several new serodiagnostic methods have been developed to improve the identification of pythiosis. However, these assays provide only indirect evidence of pythiosis and are not readily available in the commercial market. Here, we have developed an affordable point-of-care test (POCT) kit based on an immunochromatographic assay for the direct detection of P. insidiosum antigens. Our recent findings reveal that the lateral flow sandwich immunological testing cassette can accurately identify vascular pythiosis antigens using a small volume of patient’s plasma, accomplishing 100% accuracy and a limit of detection (LOD) of 8 ng/mL. This prototype cartridge represents a significant stride toward the advancement of enriched POCT for pythiosis serodiagnosis.
Canine glioma stem-like cells demonstrate DNA methylation-dependent enhancement of cellular respiration following low oxygen tension
Authors: Toedebusch Ryan , Hwang Chang-il , Syed-Quadri Shafee , Aboud Orwa , Woolard Kevin , York Daniel , Parys Maciej , Dickinson Peter , Meyers Frederick , McPherson John , Toedebusch Christine
Published: July 2024

Glioma stem cells (GSCs) have been implicated in radio- and chemotherapeutic resistance of glioblastoma (GBM). Therapeutic targeting of GSCs has shown promise in immunocompromised rodent models but have not been translated into effective therapies for human patients. The limited success of translating therapies from rodent models to GBM patients may be attributed, in part, to the lack of co-evolution between tumors and the tumor microenvironment in immunocompromised rodent models. Thus, spontaneous canine high-grade gliomas (HGGs) may provide a complementary translational model for human therapeutic development. While described in canine HGGs, little is known about canine glioma stem cell biology. In this study, we evaluatedcellular metabolism, DNA methylation, gene expression, and functional tests of malignancy to interrogate differences between canine glioma stem-cell like (GSLC) lines and a traditional serum grown glioma cell line following exposure to hypoxia. Hypoxia increased oxygen consumption rates in GSLCs, which correlated with hypoxia-induced hypomethylation and increased mRNA levels of genes important in cellular metabolism and stemness (e.g., KCNN3, KDM4B, TCF7L2), as well as augmented features of malignancy in GSLCs. Importantly, we were able to demonstrate a positive correlation between up-regulated genes in human GBM GSCs and hypomethylation of orthologous canine genes following hypoxia. Together, these data highlight similarities between canine and human GBM GSC cellular metabolism and their epigenetic regulation.
Serial mediation of the association between adverse childhood experiences, suicidality and self-harm by sexual orientation discrimination and anhedonia in adolescents
Authors: Ma Qianshu , Xie Min , Cai Jia , Liu Yunjia , Zhao Zhengyang , Lv Qiuyue , Tao Shiwan , Zhang Jiashuo , Zou Min , Wang Qiang
Published: July 2024

Background
The rate of suicidality and non-suicidal self-injury (NSSI) among youth has been rising. Previous studies have shown adverse childhood experiences (ACEs) are risk factors for psychological issues and children exposed to ACEs are more sensitive to discrimination. This study investigates the relationship between adverse childhood experiences (ACEs) and suicidality and NSSI in adolescents, with a specific focus on the sequential mediating roles of perceived sexual orientation discrimination and anhedonia.
Methods
We included 11,880 children aged 9 to 10 years in the Adolescent Brain and Cognitive Development (ABCD) cohort. Data collection for one baseline and two follow-up surveys were completed from 2016 to 2018. Logistic regression and longitudinal mediation analyses were conducted to assess the association between exposures and outcomes and to investigate whether perceived discrimination and anhedonia sequentially mediate the impact of ACEs on adolescent suicidality and NSSI.
Results
The findings show ACEs were associated with increased risk of perceived discrimination against gay/lesbian/bisexual (OR = 1.28, 95% CI = 1.16, 1.41), and anhedonia (OR = 1.13, 95% CI = 1.06, 1.21), suicidality (OR = 1.17, 95% CI = 1.08, 1.26) and NSSI (OR = 1.14, 95% CI = 1.03, 1.26). In addition, perceived discrimination against gay/lesbian/bisexual was associated with an elevated risk of anhedonia (OR = 1.53, 95% CI = 1.02, 231), suicidality (OR = 2.22, 95% CI = 1.46, 3.35) and NSSI (OR = 2.99, 95% CI = 1.86, 4.81). Also, anhedonia was associated with an increased risk for suicidality (OR = 3.25, 95% CI = 2.54, 4.15) and NSSI (OR = 3.31, 95% CI = 2.44, 4.50). The associations between ACEs and suicidality and NSSI were sequentially mediated by perceived discrimination against gay/lesbian/bisexual and anhedonia.
Conclusions
Our study underscored the significant predictive roles of ACEs, perceived discrimination, and anhedonia in adolescent suicidality and NSSI. Findings may support the idea that eliminating specific discrimination and addressing anhedonia may help reduce suicidality and NSSI risk in adolescents who have experienced ACEs.
Characteristics and pregnancy outcomes of subtypes of gestational diabetes mellitus based on HOMA-IR and BMI
Authors: jiang li , Li An-qiong
Published: July 2024

Aims To identify the characteristics and pregnancy outcomes across different subtypes of gestational diabetes mellitus (GDM) based on insulin resistance and body mass index.Methods This retrospective study included 1804 women who underwent a 75g-OGTT during 22-28weeks of gestation, categorized into normal glucose tolerance (NGT) and GDM. Metabolic indicators were measured, and equation of homeostatic model assessment (HOMA) were used to calculate indices of insulin resistance (HOMA-IR), β-cell secretory (HOMA-B), and insulin sensitivity (HOMA-%S) in early and mid-pregnancy .The cut-off value of HOMA-IR in early pregnancy was determined by ROC curve(1.75), which was combined with pre-pregnancy BMI to group NGT and GDM groups into six subgroups each ,stratified according HOMA-IR ≥ 1.75 or HOMA-IR < 1.75 and BMI < 18.5kg/m2 or 18.5 ≤ BMI < 25kg/m2 or BMI ≥ 25kg/m2.Results Compared with women with NGT (1487), women with GDM(317[17.57%]of the total cohort), were significantly older, had higher BMI, fasting plasma glucose(FPG) ,insulin and lipids in early pregnancy, more pronounced insulin resistance in early and mid-pregnancy, and worse outcomes. Analysis of subgroups provided further information. In early pregnancy, except for the GDM subgroup with HOMA-IR ≥ 1.75/BMI ≥ 25kg/m2 having higher FPG than the control subgroup, other subgroups had similar FPG, fasting insulin, HOMA-IR, HOMA-B, and HOMA-%S compared with the NGT subgroups. At the time of OGTT, the peak of glucose and insulin were out of sync in GDM subgroups, accompanied by increased HOMA-IR and HOMA-B and decreased HOMA-%S except for the GDM subgroup with HOMA-IR < 1.75/BMI < 18.5kg/m2. Compared with the corresponding NGT subgroups, the GDM subgroup had higher rates of neonatal jaundice (36.5% vs 12.5, p < 0.001), LGA (28.8% vs 14.3%, p = 0.004), macrosomia (3.6% vs 3.2%, p = 0.007), NICU (12.2% vs 5.5%, p = 0.046) in women with HOMA-IR > 1.75/18.5kg/m2 ≤ BMI < 25 kg/m2, the rates of LGA and macrosomia were 28.4% and 16% in women with HOMA-IR > 1.75/BMI ≥ 25 kg/m2. While the GDM subgroup had the highest rates of PROM and postpartum hemorrhage in women with HOMA-IR < 1.75/BMI < 18.5kg/m2 and 1-minute Apgar score in women with HOMA-IR < 1.75/18.5kg/m2 ≤ BMI < 25 kg/m2.Conclusion GDM presents a more adverse metabolic profile and severe insulin resistance from early pregnancy, with a greater risk of adverse pregnancy outcomes. Subgrouping based on early BMI and IR in GDM reveals different β-cell function at the time of OGTT, along with varying outcomes.
Acute appendicitis in children with malignancies
Authors: Chen Wei , Zhang Tingchong , Wang Dayong , Liu Tingting , Chen Yajun
Published: July 2024

Objective: To elucidate the clinical characteristics and treatment strategies for acute appendicitis in pediatric patients with cancer.
Methods: A retrospective analysis was conducted on the clinical data of 31 pediatric patients with cancer who were diagnosed and treated for acute appendicitis at Beijing Children’s Hospital from March 2007 to October 2023.
Results: The cohort comprised 31 patients with a mean age of 5.2 years (range 13 months to 15.3 years) and a male-to-female ratio of 4.2:1. The most prevalent underlying malignancy was acute lymphoblastic leukemia (22, 71%). The most common clinical manifestations were abdominal pain (23, 74%) and fever (27, 87%). Neutropenia was present in 81% of the patients. Nine patients underwent initial surgical treatment, while 22 received conservative management. The proportion of complicated appendicitis was significantly higher in the surgical group compared to the conservative treatment group (78% vs 23%, p = 0.012). However, the absolute neutrophil count was lower in the conservative treatment group compared to the surgical group (0.06 vs 0.35 × 109/L, p = 0.006). The length of hospital stay was significantly shorter for patients who underwent laparoscopic surgery compared to the conservative treatment group (5 vs 9.0 days; p = 0.037). All patients were successfully treated for acute appendicitis with no mortality.
Conclusion: Both surgical and conservative management are safe and effective treatment options for acute appendicitis in cancer children. Laparoscopic appendectomy may be a more advantageous approach, reducing hospital stay and potentially benefitting the management of the underlying malignancy.
Growth patterns of the Golden Lancehead and their determinants: Conservation strategies for critically endangered species
Authors: Banci Karina Rodrigues Silva , Siqueira Lucas Henrique Carvalho , Marques Otavio Augusto Vuolo
Published: July 2024

The Golden Lancehead, Bothrops insularis, is a critically endangered viperid species, endemic to Queimada Grande Island. The diet of adults relies mainly on migratory birds, which peaks in March and July on the island. Herein, we describe the growth rate of the Golden Lancehead for the very first time, testing the hypothesis that growth and adult body size may decrease as a result of resource scarcity and environmental variability in the island, in comparison to a captive population. Our findings suggest that both food intake, temperature, and reproductive requirements might influence body size, growth rate, and sexual maturity of B. insularis. More specifically, wild animals attain smaller body size and mass, show lower growth rate, and attain sexual maturity later, in comparison to the captive individuals of the same sex, possibly as a result of lower food availability. This situation is more evident among males, and, apparently, morphological constraints make it difficult for them to explore large prey at the island. Females are the largest sex, possibly as a result of fecundity optimization. Fecundity also depends on energy reserve for vitellogenesis, and, due to the metabolic costs involved, females take a longer time to mature, showing, therefore, delayed maturity when compared to males. These aspects are especially important for conservation. Concerning species conservation, the impact of the larger body size in captive animals on other traits, such as habitat use, must be considered, especially if reintroduction of these animals become necessary. As for the Golden Lanceheads in the island, it is mandatory that the conservation strategies encompass the maintenance of the population of the migratory birds, in order to ensure the energetic income to the snakes.
Clinical balance assessment tools for children with hearing loss: A scoping review
Authors: Mbhele Sphilile , Rogers Christine , Saman Yougan
Published: July 2024

Balance dysfunction exists in children with hearing loss, especially sensorineural loss, impacting on cognitive development, socio-emotional development and literacy. However, there is limited assessment of balance in this population, which has further impedes childhood development. The objective of this review was to identify clinical, low- technology and inexpensive tools used to evaluate balance in children with hearing loss. Methods: A scoping review method with reference to the JBI, was used where a search was conducted on electronic databases including EBSCOHost, MEDLINE, PubMED, Web of Science and Wiley. In addition, gray literature and hand searches were also used. The review included children between 3 – 15 years of age with hearing loss. Results: A total of 53 articles were found where 53% of the tests were norm-referenced tests, 44% were criterion referenced tests and 2% could not be identified. Conclusion: Tests such as the Tandem gait test, Pediatric Balance Scale (PBS), Clinical Test of Sensory Interaction for Balance (mCTSIB)/Pediatric Version of Clinical Test for Sensory Interaction of Balance (P-CTSIB), Dynamic Gait Index and the Timed-up-and-Go were identified to be relatively inexpensive and low-technology based clinical tools and have thus, been summarized in this review.
Efficacy and safety of INTERCEED® in rabbit trabeculectomy model
Authors: Shiotani Nobutaka , Mizobuchi Kei , Honzawa Koki , Ito Ryosuke , Horiguchi Hiroshi , Gunji Hisato , Nakano Tadashi
Published: July 2024

The purpose of this study was to evaluate the efficacy and safety of INTERCEED® (Johnson & Johnson, New Brunswick, NJ, USA) with a rabbit trabeculectomy model. This study included six eyes of six rabbits that were categorized into groups 1 and 2. Group 1 received trabeculectomy with mitomycin C (MMC) (applied by a cellulose sponge). Group 2 received trabeculectomy with INTERCEED®. Clinical examinations, including intraocular pressure (IOP) measurement, slit-lump examination (bleb scores), and anterior-segment optical coherence tomography (AS-OCT), were conducted for all cases on postoperative days 1, 7, 28, 56, and 84. All experiments were performed under general anesthesia. All rabbits were underwent surgery without any significant complications and were observed for general and ophthalmic conditions for 84 days postoperatively. There were no significant differences in the clinical course of IOP, slit-lamp photo findings, and bleb score between the INTERCEED® and MMC groups. Regarding the AS-OCT findings, filtering bleb was confirmed in both groups in the early period after trabeculectomy but hardly confirmed in the MMC group in the late period. Conversely, the scleral flap and traffic into the anterior chamber were visible in the INTERCEED® group even a long time after trabeculectomy. Our results indicated INTERCEED® could act as an effective and safe method for eye surgery and be helpful in preventing adhesion after trabeculectomy.
Prevalence, Predictors and Effect of Vitamin D Probiotics Fortification on Asymptomatic Urinary Tract Infections Among Pregnant Women: A Prospective Cohort Study
Authors: Ayamah Vivian , Apprey Charles , Owusu Eric , Annan Reginald , Senu Ebenezer
Published: July 2024

Background
Maternal urinary tract infections (UTIs) remains the commonest non-intestinal infection globally, and it is a major public health concern. Moreover, Vitamin D is a known immunomodulator, and its deficiency is common in pregnant women. Few evidence shows vitamin D deficiency may expose the urinary tract to infections. For the first time, this study investigated the prevalence, associated factors and effect of Vitamin D probiotics fortification on asymptomatic UTIs among pregnant women in Ghana.
Methods
This prospective cohort study included 126 pregnant women aged 18 years and above without symptoms of UTI attending antenatal care at the Ejisu Government Hospital and Juaben Government Hospital in Ejisu-Juaben Municipality in the Ashanti Region, Ghana. Pregnant women were further divided into Vitamin D probiotics fortified group (63) and non-fortified group (63) and follow-up for 6 months. Sociodemographic and clinical data were collected. Venous blood samples were also collected at baseline and end line for laboratory analyses. Quantification of serum 25(OH)D levels was done using ELISA (Thermo scientific). Statistical analyses were done in SPSS version 26.0 and GraphPad version 8.0 at p < 0.05 and 95% confidence interval.
Results
This study found 23.6% prevalence of UTI among pregnant women with most isolated bacteria being Escherichia coli (69.0%) and staphylococcus spp. (17.2%). In a logistics regression prediction model, inadequate knowledge on UTI (cOR: 2.85, 95% CI: (1.00-8.14); p = 0.049) was significantly associated with 3-odds increased likelihood of UTI, and poor attitude towards UTI (aOR: 3.00, 95% CI: (1.22–7.37); p = 0.017) was independent predictor of increased chances of UTI among pregnant women. At end line of treatment, the prevalence of UTI among Vitamin D fortified group reduced from 21.0–3.2% and among non-fortified group reduced from 26.2% 16.4%, indicating a drastic effects of Vitamin D fortification in reducing UTI among pregnant women.
Conclusion
The prevalence of UTI remains high among pregnant women. Inadequate knowledge on UTI and poor attitude towards UTI contributes significantly to increasing chances of UTI among pregnant women. However, public health strategies incorporating Vitamin D supplementation could reduce UTI incidences and related adverse maternal and neonatal outcomes.