bluuebunny/crossref_metadata_2025 huggingface dataset:
High-Grade Appendiceal Mucinous Neoplasm Mimicking Appendiceal Tubulovillous Adenoma: A Case Report and Literature Review
Authors: Shao Huilin , Zhang Shuhong , Liu Weihua , Chen Guangyong
Published: July 2024

High-grade appendiceal mucinous neoplasm (HAMN) has been separated from appendiceal adenocarcinoma recently as an independent entity and categorized into appendiceal mucinous neoplasms. These neoplasms demonstrate distinct histological characteristics, including architectures and appendiceal mural changes similar to low-grade appendiceal mucinous neoplasm but with high-grade cytology, and no infiltrative invasion. Overt mucinous feature are not evident in some cases as the high-grade neoplastic epithelium may show intracytoplasmic mucin reduction. Occasionally, the neoplastic epithelial cells show florid proliferation and tubulovillous configuration and may be misdiagnosed as appendiceal tubulovillous adenoma. We report the case of a 67-year-old woman with appendicular dilatation and luminal mucin. She underwent an ileocecoectomy. The appendiceal lesion was found histologically to be a HAMN, which closely resembled appendiceal tubulovillous adenoma. The tumor cells demonstrated wild-type p53 expression and mismatch repair proficiency by immunochemistry. Molecular testing showed 1 KRAS mutation, 2 PIK3CA mutations, and 1 BRCA2, EP300, TGFBR2, CHD4, CREBBP, FANCC, PKHD1 mutation each in the tumor. The patient was followed up for 1 year with no evidence of disease.
Prevention of Neighborhood Effects on the Susceptibility to Radicalization: Results of a Comparative Study in Germany
Authors: Kurtenbach Sebastian , Küchler Armin , Zick Andreas
Published: July 2024

This study examines whether the neighborhood effect on vulnerability to radicalization can be mitigated by the density and diversity of social service organizations. In this study, vulnerability to radicalization is composed of perceived discrimination, distrust of democracy, and authoritarianism. To this end, data from surveys conducted in the three German cities of Dortmund ( n = 1,900), Bonn ( n = 1,986), and Berlin ( n = 2,060) is combined with data on social structure and the size, density, and heterogeneity of local social service organizations at the neighborhood level in hierarchical models. Although the findings show no clear preventive effects of organizational ecology on vulnerability to radicalization, they suggest that local social service organizations are more likely to be effective depending on the extent of local challenges.
The digital divide between primary and secondary care: An analysis using SARS-CoV-2 hospital admissions
Authors: Sagi Amit , Asopa Vipin , Mitchell Benjamin , Shiyamasundaran Mahalingam , Koch Caleb , Getachew Fanuelle , Afzal Irrum , Sochart David , Field Richard
Published: July 2024

Using data from two ED. departments of 773 patients admitted with SARS-CoV-2, ICD-10 codes derived from the General Practitioner - Summary Care Record (GP-SCR) and Emergency Department (ED.) records were analysed for code discrepancies and whether this related to increased mortality. The average number of ICD-10 codes in both GP-SCR and ED. records was higher for patients who died than patients who survived (all p < .0001). Pre-existing GP digital data provides a better prediction of mortality than data collected manually during admission clerking in the ED. Up to 78.47% of GP-SCR codes were missed in the ED. records and up to 45.49% of the ED. record codes were not in the GP-SCR. A subset of missed ICD-10 codes were identified as being able to predict outcome; a trend towards increasing death rate as the proportion of missed codes increases. Initiatives to make the GP-SCR available to the wider healthcare community should improve patient care and reduce bias during development of machine learning based algorithms.
Study on partial oxidation phenomena of post-injection fuel in diesel engines
Authors: Shibata Gen , Karumai Kensei , Sakai Suzune , Ogawa Hideyuki
Published: July 2024

In diesel engines, post fuel is injected in the expansion stroke, oxidized by the diesel oxidation catalysts and the high temperature gas re-generates the diesel particulate filters. However, it is empirically known that the post fuel at advanced injection timing is partially oxidized in the cylinder due to the high temperature-pressure conditions and it is a cause of the reduction of fuel consumption. The purpose of this research is to analyze post-injection fuel behaviors in cylinder and investigate the optimum fuel injections that maximize the unburnt hydrocarbons to the diesel oxidation catalysts. The engine employed in this research is a turbo charged 2.0 L four-cylinder DI diesel engine with two fuel injection systems to change the heterogeneity of air-fuel mixture and temperature distributions in cylinder; n-hexane is injected in the intake manifold to produce the homogeneous air-fuel mixture and diesel fuel is directly injected into the cylinder. The partial oxidation ratio of post fuel and the fuel loss mainly by fuel adhesion was calculated by injected fuel quantity, air quantity, and emission data. The 3D-CFD software was introduced to analyze the partial oxidation of post fuel and flow in the cylinder. The heterogeneity of burned gas mixture of post injection atmosphere and the post-injection timings were the parameters of engine tests and 3D-CFD simulations. The results suggest that the heterogeneity of equivalence ratio and the non-uniformity of gas temperature inside the cylinder at the start of post injection affect the partial oxidation of post-injection fuel. The more homogeneous these conditions are, the better the suppression of partial oxidation of post-injection fuel and the avoidance of fuel adhesion to the cylinder wall can be achieved.
Comparison of pipeline embolization device and flow redirection endoluminal device in the treatment of intracranial aneurysms: A systematic review and meta-analysis
Authors: Musmar Basel , Orscelik Atakan , Salim Hamza , Musmar Fares , Adeeb Nimer , Naamani Kareem El , Essibayi Muhammed Amir , Spellicy Samantha , Abdelgadir Jihad , Dmytriw Adam A. , Patel Aman B. , Pereira Vitor Mendes , Cuellar-Saenz Hugo H. , Guthikonda Bharat , Zomorodi Ali , Jabbour Pascal , Hasan David
Published: July 2024

Background

Advancements in flow diversion technology have revolutionized the treatment of intracranial aneurysms. The pipeline embolization device (PED) and the flow redirection endoluminal device (FRED) have emerged as prominent tools in this field. This study aims to compare the safety and efficacy profiles of PED and FRED in the treatment of intracranial aneurysms.

Methods

Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive literature search was conducted across PubMed, Web of Science, and Scopus databases. Studies comparing PED and FRED were included and data extraction focused on study characteristics, patient demographics, and clinical and radiological outcomes. Primary outcomes were favorable outcomes, described as modified Rankin scale (mRS) 0–2 score, and complete/near-complete occlusion, while secondary outcomes included retreatment rate and thromboembolic and hemorrhagic complications.

Results

Five studies, comprising 1238 patients, were included. No significant differences were found between PED and FRED in terms of complete occlusion at 6 months and 1 year, complete/near-complete occlusion at the last follow up, retreatment rates, and thromboembolic, in-stent thrombosis and hemorrhagic complications. However, FRED was significantly associated with higher favorable outcomes compared to PED (odds ratio: 0.37; confidence interval: 0.17 to 0.81; p = 0.01).

Conclusion

This study showed that both PED and FRED had comparable rates of complete occlusion, retreatment and complications, and FRED also demonstrated a higher likelihood of achieving favorable outcomes. The study underscores the need for further research with larger cohorts and longer follow up to consolidate these findings.
#GANGSTER_ARE_COWARDS, #MERCHANTS_ARE_KILLERS and #SAVE_OUR_KIDS: Online geographies of gang content on TikTok originating from Cape Town, South Africa
Authors: Lambrechts Derica
Published: July 2024

Research on gang-related content on social media in an African context is limited, if any exists at all, and this article provides an exploratory and descriptive narrative on this topic. The study establishes online geographies: mapping unique characteristics of the digital world, how it corresponds to the actual reality and what differences can be observed. Data were collected by conducting digital observation on TikTok, and only data originating from searches related to gangs in Cape Town, South Africa, were recorded. In this physical geographical location, TikTok facilitated new virtual territories in mainly two diverse online geographies. First is that of gang culture in the symbolic parading of the criminal life, exploring the creative abilities of TikTok. Gangs occupy the virtual space through communications, associations and threats. The second online geography is found in responses to gangs in the form of community activism and vigilantism, with a significant digital trajectory and aggressive material, aiming to facilitate social change.
Glenoid notching after reverse shoulder arthroplasty: The influence of different neck-shaft angles
Authors: Pereira Catarina , Carrapatoso Manuel , Barros Luís H , Claro Rui
Published: July 2024

Background

The implications of notching in reverse shoulder arthroplasty (RSA), and its relation with the rate of complications are still unclear. Our main aim was to retrospectively study the notching incidence in the three most used implants in our practice, considering their different neck-shaft angle (NSA) and determine its relation with implant failure, or other complications.

Methods

We retrospectively reviewed medical and imaging records of 259 patients who underwent RSA in our hospital, including surgery reports, prosthesis designs and techniques. We assessed all radiographs taken during the follow up to evaluate notching incidence, progression and signs of failure.

Results

Notching occurred in 35% cases. The average time to notch development was 19 months. Implants with a lower NSA showed significantly lower incidence of notching when compared to other implants ( P < 0.001). In a multivariate analysis, the NSA proved to be an independent predictor for the occurrence of notching in this series.

Discussion

According to our results, higher NSA is an independent predictor of the occurrence of notching. There was significant increase in the notching rate with follow up. In the future, larger case series with longer follow-up are necessary to evaluate the relation between notching and radiological and clinical complications.
Successful surgical separation of asymmetrical caudal duplication or parasitic twinning in a kitten
Authors: Botsoglou Rachel , Albert Rebecca , Krauß Maximiljan
Published: July 2024

Case summary

A female kitten with two ectopic supernumerary pelvic limbs arising from the umbilicus was born in our clinic. Five weeks after the kitten’s birth, she showed an acute deterioration in condition, with clinical signs of an ileus in the intestines entering the supernumerary body part. We then performed a surgical separation of the supernumerary limbs and intestines. Based on clinical findings and radiography, the kitten was classified as a case of parasitic twinning-omphalopagus or a subtype of asymmetrical caudal duplication, rather than a case of polymelia. Parasitic twinning and caudal duplication are rare congenital malformations in many animal species and in humans, which can often have a poor outcome. Almost 1 year after the separation, the cat appeared to be living a normal life without complications.

Relevance and novel information

A good outcome is rare in parasitic twinning because many of these animals present with other concurrent health issues, such as congenital heart malformation or cleft palate, or they are stillborn. However, this pathological entity is scarce in small animal medicine, and there is no documented survival rate. To our knowledge, this is the first officially documented case of parasitic twinning-omphalopagus in a cat in the past decade.
Remote sensing mental health: A systematic review of factors essential to clinical translation from validation research
Authors: Bidargaddi Niranjan , Leibbrandt Richard , Paget Tamara L , Verjans Johan , Looi Jeffrey CL , Lipschitz Jessica
Published: July 2024

Background

Mental illness remains a major global health challenge largely due to the absence of definitive biomarkers applicable to diagnostics and care processes. Although remote sensing technologies, embedded in devices such as smartphones and wearables, offer a promising avenue for improved mental health assessments, their clinical integration has been slow.

Objective

This scoping review, following preferred reporting items for systematic reviews and meta-analyses guidelines, explores validation studies of remote sensing in clinical mental health populations, aiming to identify critical factors for clinical translation.

Methods

Comprehensive searches were conducted in six databases. The analysis, using narrative synthesis, examined clinical and socio-demographic characteristics of the populations studied, sensing purposes, temporal considerations and reference mental health assessments used for validation.

Results

The narrative synthesis of 50 included studies indicates that ten different sensor types have been studied for tracking and diagnosing mental illnesses, primarily focusing on physical activity and sleep patterns. There were many variations in the sensor methodologies used that may affect data quality and participant burden. Observation durations, and thus data resolution, varied by patient diagnosis. Currently, reference assessments predominantly rely on deficit focussed self-reports, and socio-demographic information is underreported, therefore representativeness of the general population is uncertain.

Conclusion

To fully harness the potential of remote sensing in mental health, issues such as reliance on self-reported assessments, and lack of socio-demographic context pertaining to generalizability need to be addressed. Striking a balance between resolution, data quality, and participant burden whilst clearly reporting limitations, will ensure effective technology use. The scant reporting on participants’ socio-demographic data suggests a knowledge gap in understanding the effectiveness of passive sensing techniques in disadvantaged populations.
Academic Medical Centers and Federally Qualified Health Centers: Collaboration for the Care of Underserved Communities
Authors: Conway Sarah J. , Murphy Jacob , Efron Jonathan E.
Published: July 2024

Academic Medical Centers (AMCs) and Federally Qualified Health Centers (FQHCs) are similarly tasked with managing the health of their local community, yet they each face unique challenges in their ability to do so. Integrating AMCs and FQHCs into novel care delivery models can leverage both organizations strengths, providing care in a comprehensive and sustainable fashion. Johns Hopkins Medicine (JHM) implemented this model with a large East Baltimore medical center, creating an AMC-FQHC collaboration focused on providing care to the East Baltimore patient population. This system provided various improvements in care delivery, including increased staffing, new wraparound services, improved access to funding dollars, and decreased out of pocket costs for patients qualifying for financial assistance. The academic missions of research and training were preserved, serving as the primary continuity clinic for several residency programs and as a community site for research. These changes resulted in more robust care for patients while improving the financial standing of the clinic. Through AMC and FQHC partnership, progress can be made toward providing holistic and financially sustainable primary care services in underserved areas while preserving the tripartite mission of academic medicine, with significant pedagogical and research opportunities.
How transformative can a democratic project of the urban be?
Authors: Beveridge Ross , Koch Philippe
Published: July 2024

In our initial paper we presented the urban as a question of democracy. The aim was to advance thinking about democracy through thinking about the urban, to use contemporary urban theory to theorise contemporary democracy. Seeing Democracy Like a City involves looking differently at the urban world out there, but also looking a little differently at the world of urban research in journals like this one. Underpinning our work was the epistemological release arising from an urban ontology of politics, as the state shuffles stage right and urbanity moves centre stage. The forum articles suggest that seeing democracy like a city can be inspiring. But the question of how transformative this approach can actually be is posed by all the authors. In this rejoinder we highlight some of the issues we think are crucial to address this question and to unlock the transformative potential of an urban democracy.
TLR7 agonist, DSP-0509, with radiation combination therapy enhances anti-tumor activity and modulates T cell dependent immune activation
Authors: Ota Yosuke , Inagaki Ryosaku , Nagai Yasuhiro , Hirose Yuko , Murata Masashi , Yamamoto Setsuko
Published: July 2024

Background

TLR7 is a key player in the antiviral immunity. TLR7 signaling activates antigen-presenting cells including DCs and macrophages. This activation results in the adaptive immunity including T cells and B cells. Therefore, TLR7 is an important molecule of the immune system. Based on these observations, TLR7 agonists considered to become a therapy weaponize the immune system against cancer. Radiation therapy (RT) is one of the standard cancer therapies and is reported to modulate the tumor immune response. In this study, we aimed to investigate the anti-tumor activity in combination of TLR7 agonist, DSP-0509, with RT and underlying mechanism.

Result

We showed that anti-tumor activity is enhanced by combining RT with the TLR7 agonist DSP-0509 in the CT26, LM8, and 4T1 inoculated mice models. We found that once- weekly (q1w) dosing of DSP-0509 rather than biweekly (q2w) dosing is needed to achieve superior anti-tumor activities in CT26 model. Spleen cells from the mice in RT/DSP-0509 combination treatment group showed increased tumor lytic activity, inversely correlated with tumor volume, as measured by the chromium-release cytotoxicity assay. We also found the level of cytotoxic T lymphocytes (CTLs) increased in the spleens of completely cured mice. When the mice completely cured by combination therapy were re-challenged with CT26 cells, all mice rejected CT26 cells but accepted Renca cells. This rejection was not observed with CD8 depletion. Furthermore, levels of splenic effector memory CD8 T cells were increased in the combination therapy group. To explore the factors responsible for complete cure by combination therapy, we analyzed peripheral blood leukocytes (PBLs) mRNA from completely cured mice. We found that Havcr2low, Cd274low, Cd80high, and Il6low were a predictive signature for the complete response to combination therapy. An analysis of tumor-derived mRNA showed that combination of RT and DSP-0509 strongly increased the expression of anti-tumor effector molecules including Gzmb and Il12.

Conclusion

These data suggest that TLR7 agonist, DSP-0509, can be a promising concomitant when used in combination with RT by upregulating CTLs activity and gene expression of effector molecules. This combination can be an expecting new radio-immunotherapeutic strategy in clinical trials.
Effect of seed priming with auxin on ROS detoxification and carbohydrate metabolism and their relationship with germination and early seedling establishment in salt stressed maize
Authors: Ellouzi Hasna , Ben Slimene Debez Imen , Amraoui Souhir , Rabhi Mokded , Hanana Mohsen , Alyami Nouf M. , Debez Ahmed , Abdelly Chedly , Zorrig Walid
Published: July 2024

As crucial stages in the plant ontogeny, germination and seedling establishment under adverse conditions greatly determine staple crop growth and productivity. In the context of green technologies aiming to improve crop yield, seed priming is emerging as an effective approach to enhance seed vigor and germination performance under salt stress. In this study, we assess the efficiency of seed priming with indole-3-acetic acid (IAA) in mitigating the adverse effects of salt stress on maize (Zea mays L.) seedlings during germination and early seedling stages. In unprimed seeds, salt stress reduced germination indices, and seedling (both radicle and coleoptile) growth, together with decreased tissue hydration. However, seed priming using IAA significantly improved maize salt response, as reflected by the increased seed germination dynamics, early seedling establishment, and water status. Besides, seedlings from IAA-primed seeds showed a higher activity of α-amylase, resulting in increased sugar contents in roots and coleoptiles of salt-stressed plants. Further, IAA-seed priming stimulated the accumulation of endogenous IAA in salt-stressed seedlings, in concomitance with a significant effect on reactive oxygen species detoxification and lipid peroxidation prevention. Indeed, our data revealed increased antioxidant enzyme activities, differentially regulated in roots and coleoptiles, leading to increased activities of the antioxidant enzymes (SOD, CAT and GPX). In summary, data gained from this study further highlight the potential of IAA in modulating early interactions between multiple signaling pathways in the seed, endowing maize seedlings with enhanced potential and sustained tolerance to subsequent salt stress.
Remimazolam protects the liver from ischemia-reperfusion injury by inhibiting the MAPK/ERK pathway
Authors: Shi Yanhua , Deng Housheng , Zhang Zhiming , Zhu Xiaoling , Zeng Zhiqin
Published: July 2024

Background

Ischemia-reperfusion (I/R) injury is a major factor in liver damage following hepatic resection and liver transplantation, with anesthetics demonstrating the ability to shield organs from this type of injury.

Methods

Hypoxia-reoxygenation (H/R) was used to create in vitro I/R hepatocyte cell injury models. The CCK-8 assay, flow cytometer, LDH assay, and ELSIA were utilized to assess hepatocyte injury. The in vivo I/R injury rat model was then built. HE and TUNEL staining were used to assess liver tissue damage. Western-blot was applied to assess the activation of the MAPK/ERK pathway.

Results

Remimazolam (RMZL) remarkably improved cell viability and decreased apoptosis in H/R-induced hepatocyte injury. RMZL reduced the release of H/R-induced inflammatory mediators (TNF-α and IL-6) as well as LDH levels. We also discovered that RMZL inhibited p38 and ERK1/2 phosphorylation in vivo and in vitro. The stimulation of MAPK/ERK, on the other hand, abolished RMZL’s anti-inflammation effects in H/R-induced hepatocyte injury. Furthermore, RMZL reduced liver tissue injury in I/R rats.

Conclusion

RMZL prevented hepatic I/R damage by inhibiting MAPK/ERK signaling.
Psychometric properties of the Fraboni scale of ageism (FSA) applied to long-term caregivers in nursing homes
Authors: Li Jie , Dong Ziyan , Xie Wen , Yang Liuqing , Qi Xiaojing
Published: July 2024

Background

The aging society has resulted in enormous demand for long-term care services. However, ageism is a common phenomenon in long-term care facilities, which not only hinders the quality of care for the recipients but also negatively influences caregivers’ well-being. In this paper, we first applied the Fraboni Scale of Ageism (FSA) to evaluate its reliability and construct validity among Chinese long-term caregivers in nursing homes. This study could contribute to assessing the prevalence of ageism in Chinese long-term caregivers, prompting facilities and the government to recognize the issue of ageism and explore necessary interventions to reduce ageism in long-term caregivers.

Methods

This is a cross-sectional study. We recruited 392 long-term caregivers using a convenience sampling strategy in nursing homes from two cities in Chinese central and northern regions. Parameters included the demographic characteristics, Cronbach’s alpha coefficients, and intraclass correlation coefficient. The construct validity was conducted by exploratory factor analysis and confirmatory factor analysis.

Results

The Cronbach’s alpha of FSA (Chinese version) was 0.856 and ICC was 0.871. The factor analysis identified 3 principal factors, explaining 43.95% of the total variance. The 3-factor model was confirmed to fit by confirmatory factor analysis.

Conclusions

The findings confirm that the FSA is easy to use and has good psychometric properties. This study will contribute to improving the condition of ageism, thereby improving the quality of care for the elderly and retention of professional talents in the LTC system.
Advancing ASD identification with neuroimaging: a novel GARL methodology integrating Deep Q-Learning and generative adversarial networks
Authors: Zhou Yujing , Jia Guangbo , Ren Yingtong , Ren Yingxin , Xiao Zhifeng , Wang Yinmei
Published: July 2024

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that affects an individual's behavior, speech, and social interaction. Early and accurate diagnosis of ASD is pivotal for successful intervention. The limited availability of large datasets for neuroimaging investigations, however, poses a significant challenge to the timely and precise identification of ASD. To address this problem, we propose a breakthrough approach, GARL, for ASD diagnosis using neuroimaging data. GARL innovatively integrates the power of GANs and Deep Q-Learning to augment limited datasets and enhance diagnostic precision. We utilized the Autistic Brain Imaging Data Exchange (ABIDE) I and II datasets and employed a GAN to expand these datasets, creating a more robust and diversified dataset for analysis. This approach not only captures the underlying sample distribution within ABIDE I and II but also employs deep reinforcement learning for continuous self-improvement, significantly enhancing the capability of the model to generalize and adapt. Our experimental results confirmed that GAN-based data augmentation effectively improved the performance of all prediction models on both datasets, with the combination of InfoGAN and DQN's GARL yielding the most notable improvement.
Prevalence and clinical correlates of abnormal lipid metabolism in older Chinese patients with first-episode drug-naïve major depressive disorder
Authors: Huang Xiao , Yuan Sun M. M. , Zhang Xiang-Yang
Published: July 2024

Background

Older major depressive disorder (MDD) patients have more complex clinical symptoms and higher abnormal lipid metabolism (ALM) rates. This study aimed to compare clinical differences between those with and without ALM in a sample of older first-episode drug naïve (FEDN) patients.

Methods

We recruited 266 older MDD patients. Socio-demographic variables, clinical data, and lipid parameters were obtained. The Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), and the positive subscale of the Positive and Negative Syndrome Scale (PANSS-P) were conducted to evaluate patients’ depression, anxiety and psychotic symptoms, respectively.

Results

In this study, we found that the prevalence of comorbid ALM was 86.1% in older MDD patients. Compared with the non-abnormal lipid metabolism (NALM) group, the ALM group had a higher duration of illness, higher clinical global impression of severity scale (CGI-S) and HAMD scores, higher thyroid stimulating hormone (TSH) and glucose levels. Logistic regression analysis indicated that duration of illness (OR = 1.11, P = 0.023, 95%CI = 1.015–1.216) and CGI-S score (OR = 2.28, P = 0.014, 95%CI = 1.18–4.39) were associated with ALM in older MDD patients.

Conclusion

The importance of regular lipid assessment in older MDD patients needs to be taken into account.
Effect of exercise and manual therapy or kinesiotaping on sEMG and pain perception in chronic low back pain: a randomized trial
Authors: Blanco-Giménez P , Vicente-Mampel J. , Gargallo P , Maroto-Izquierdo S , Martín-Ruíz J , Jaenada-Carrilero E , Barrios C
Published: July 2024

The importance of incorporating lumbo-pelvic stability core and controlling motor exercises in patients with chronic low back pain (CLBP) reinforces the use of strategies to improve biopsychosocial beliefs by reducing biomedical postulations. However, clinical practice guidelines recommend multimodal approaches incorporating exercise and manual therapy (MT), and instead reject the application of kinesiotape (KT) in isolation. Therefore, the objectives of this study were to analyze the effects of 12 weeks of exercises combined with MT or KT on perceived low back pain using the visual analog scale (VAS) and muscle electric activity measured with electromyography (EMG) of the rectus abdominis and multifidus in CLBP (mild disability) and to explore the relationship between the rectus abdominis and multifidus ratios and pain perception after intervention. A blinded, 12-week randomized controlled trial (RCT) was carried out, involving three parallel groups of patients with CLBP. The study was registered at Clinicaltrial.gov and assigned the identification number NCT05544890 (19/09/22). The trial underwent an intention-to-treat analysis. The primary outcome revealed a multimodal treatment program supplemented by additional therapies such as MT and KT, resulting in significant reductions in perceived low back pain. The subjective assessment of individuals with CLBP indicated no discernible distinction between exclusive core stability exercises and control-motor training when combined with MT or KT. Notably, our findings demonstrated positive alterations in both the mean and peak EMG values of the right rectus abdominis in the exercise group, suggesting a beneficial impact on muscle activation. This study focused on assessing the activation levels of the trunk musculature, specifically the rectus abdominis (RA) and multifidus (MF), in individuals with CLBP exhibiting mild disability according to the Oswestry Disability Index. Importantly, improvements in the VAS values were observed independently of changes in muscle electrical activity.
Maxillary labial frenectomy: a randomized, controlled comparative study of two blue (445 nm) and infrared (980 nm) diode lasers versus surgical scalpel
Authors: Sobouti Farhad , Moallem Savasari Aryousha , Aryana Mehdi , Hakimiha Neda , Dadgar Sepideh
Published: July 2024

Background

This study aimed to compare the intra and postoperative complications of frenectomy procedure with a surgical scalpel versus 445 nm and 980 nm diode lasers.

Methods

This randomized controlled clinical trial was conducted on 174 patients requiring maxillary labial frenectomy. After completion of fixed orthodontic treatment and primary closure of maxillary diastema, the patients were randomly assigned into three groups (n = 58): group 1 (frenectomy via 445 nm diode laser, continuous-wave, 1.5 W), group 2 (frenectomy via 980 nm laser, continuous-wave, 1.7 W), and control group (V-Y plasty technique via scalpel). Intra-operative bleeding, discomfort in chewing and speaking, pain, and tissue healing were compared among the groups immediately, at 7 and 30 days postoperatively using the Kruskal-Wallis, Mann-Whitney, and Chi-square tests.

Results

Pain scores were significantly lower in group 1 compared to group 2 (immediately and day 7, P < 0.05). Significant faster tissue healing at days 7 and 30 were observed in group 1 compared to group 2 (P < 0.05). Group 1 was superior to the control group regarding lower intraoperative bleeding, discomfort in chewing and speaking (immediately and day 7), lower pain (immediately and day 7), and tissue healing (day 7) (P < 0.05 for all). Group 2 was significantly superior to the control group in lower intraoperative bleeding, discomfort in chewing and speaking (immediately and day 7), and better tissue healing (day 7) (P < 0.05 for all).

Conclusions

In conclusion, diode laser frenectomy resulted in significantly lower intra and postoperative complications compared to the scalpel. Moreover, 445 nm diode laser showed significantly superior effects compared to 980 nm diode laser.

Trial registration

The study protocol was registered on 29.10.2022 at the Iranian Registry of Clinical Trials (www.irct.ir) (registration number: IRCT20220630055326N1).
Dementia patients in palliative care according to data from the German National Hospice and Palliative Care Register (2009–2021)
Authors: Donath Carolin , Ostgathe Christoph , Heckel Maria
Published: July 2024

Background

People with dementia are less in focus of palliative care research than other patient groups even though the awareness of their palliative and end-of-life care needs is rising. Empirical data analyses on people with dementia in palliative care services are lacking.

Aim

To explore the prevalence of dementia diagnoses as per the ICD criteria among users of various palliative care settings and to compare use of palliative services, care pathways, and outcomes in people with and without a dementia diagnosis.

Design

We conducted retrospective analysis of dementia diagnoses as per ICD (F00-F03/G30) in the German National Hospice and Palliative Care Register between 2009 and 2021. The analysis used methods of descriptive and inferential statistics, including the Bonferroni correction for alpha error inflation.

Setting/participants

We limited the analysis to the subsample of people aged over 64.

Results

The prevalence of dementia in the different settings of palliative care was lower than in the age-comparable population: Of the 69,116 data sets included in the analysis, a small minority (3.3%) was coded with dementia as the principal diagnosis. Among patients on inpatient palliative care wards, 0.8% (148 of 19,161) had a dementia diagnosis, as did 2.2% (52 of 2,380) of those under hospital palliative care support teams and 4.3% (2,014 of 46,803) of those receiving specialized palliative care at home.

Conclusions

The records of the German National Hospice and Palliative Care Register suggest that the prevalence of dementia is lower than one might expect from general population data, though numbers are in line with international studies on proportion of dementia patients receiving palliative care. Future research could usefully examine whether this discrepancy stems either from omissions in coding dementia as patients’ principal diagnosis respectively from lapses in documentation of a dementia diagnosis previously made, or from barriers to accessing palliative care services or even displays being excluded from palliative care when trying to access it.

Trial registration

No registration.
Nonlinear association between visceral adipose tissue area and remnant cholesterol in US adults: a cross-sectional study
Authors: Gu Xi , Wang Xun , Wang Sujie , Shen Ying , Lu Leiqun
Published: July 2024

Background

Excessive visceral adipose tissue (VAT) is associated with a spectrum of diseases, including diabetes, cancer, and cardiovascular diseases. Remnant cholesterol (RC), denoting cholesterol within triglyceride-rich lipoproteins and their metabolic byproducts, has been identified as a key contributor to cardiovascular diseases and related mortality. However, the association between the VAT and RC remains unclear. In this study, the objective is to provide new evidence regarding the association between VAT and RC concentrations.

Methods

4727 individuals aged 18–59 were selected from the National Health and Nutrition Examination Survey conducted between 2011 and 2018 as study participants. This study utilized several weighted linear regression models and a restricted cubic spline (RCS) to explore the association and potential nonlinearities between VAT and RC. Subgroup analyses were performed to determine the consistency of findings.

Results

The mean VAT value was 103.82 ± 1.42 cm2, and the median RC value was 18 mg/dl. VAT demonstrated a positive association with RC in a fully adjusted model, with a β and 95% confidence interval (CI) of 0.09 (0.08, 0.11) after adjustment for potential confounders. Analysis using RCS revealed a nonlinear association between the VAT area and RC (P < 0.001 for nonlinearity). Adjusted two-piecewise regression models demonstrated β coefficients of 0.13 (95%CI: 0.11 ~ 0.16, P < 0.001) for RC in individuals with VAT < 143 cm2, and 0.02 (95%CI: -0.01 ~ 0.06, P = 0.15) for those with VAT ≥ 143 cm2. Interactions were observed among the body mass index (BMI) subgroup; the β coefficients for RC were 0.14 (95%CI: 0.12 ~ 0.16) in those with BMI < 30 kg/m2 and 0.05 (95%CI:0.04 ~ 0.07) in those with BMI ≥ 30 kg/m2, with a P-value of < 0.001 for interaction.

Conclusions

This study identified a nonlinear association between VAT and RC in American adults. Reducing the VAT area may be beneficial in lowering RC concentration, particularly when VAT is < 143 cm2 and those with a BMI < 30 kg/m2.
Screening high-risk individuals for primary gastric carcinoma: evaluating overall survival probability score in the presence and absence of lymphatic metastasis post-gastrectomy
Authors: Qu Wenqing , Li Ling , Ma Jinfeng , Li Yifan
Published: July 2024

Objective

The aim of this study was to develop and validate prognostic models for predicting overall survival in individuals with gastric carcinoma, specifically focusing on both negative and positive lymphatic metastasis.

Methods

A total of 1650 patients who underwent radical gastric surgery at Shanxi Cancer Hospital between May 2002 and December 2020 were included in the analysis. Multiple Cox Proportional Hazards analysis was performed to identify key variables associated with overall survival in both negative and positive lymphatic metastasis cases. Internal validation was conducted using bootstrapping to assess the prediction accuracy of the models. Calibration curves were used to demonstrate the accuracy and consistency of the predictions. The discriminative abilities of the prognostic models were evaluated and compared with the 8th edition of AJCC-TNM staging using Harrell’s Concordance index, decision curve analysis, and time-dependent receiver operating characteristic curves.

Results

The nomogram for node-negative lymphatic metastasis included variables such as age, pT stage, and maximum tumor diameter. The C-index for this model in internal validation was 0.719, indicating better performance compared to the AJCC 8th edition TNM staging. The nomogram for node-positive lymphatic metastasis included variables such as gender, age, maximum tumor diameter, neural invasion, Lauren classification, and expression of Her-2, CK7, and CD56. The C-index for this model was 0.674, also outperforming the AJCC 8th edition TNM staging. Calibration curves, time-dependent receiver operating characteristic curves, and decision curve analysis for both nomograms demonstrated excellent prediction ability. Furthermore, significant differences in prognosis between low- and high-risk groups supported the models’ strong risk stratification performance.

Conclusion

This study provides valuable risk stratification models for lymphatic metastasis in gastric carcinoma, encompassing both node-positive and negative cases. These models can help identify low-risk individuals who may not require further intervention, while high-risk individuals can benefit from targeted therapies aimed at addressing lymphatic metastasis.
KM04416 suppressed lung adenocarcinoma progression by promoting immune infiltration
Authors: Lin Yalan , Wu Weijing , Lin Huihuang , Chen Shiyuan , Lv Huiying , Chen Shuchao , Li Chuzhao , Wang Xinwen , Chen Yunfeng
Published: July 2024

Objectives

Lung adenocarcinoma (LUAD) is a malignant tumor originating from the bronchial mucosa or glands of the lung, with the fastest increasing morbidity and mortality. Therefore, the prognosis of lung cancer remains poor. Glycerol-3-phosphate dehydrogenase 2 (GPD2) is a widely existing protein pattern sequence in biology and is closely related to tumor progression. The therapy values of GPD2 inhibitor in LUAD were unclear. Therefore, we aimed to analyze the therapy values of GPD2 inhibitor in LUAD.

Materials and methods

The Cancer Genome Atlas (TCGA)-LUAD database was used to analyze the expression levels of GPD2 in LUAD tissues. The relationship between GPD2 expression and LUAD patient survival was analyzed by Kaplan-Meier method. Moreover, KM04416 as a target inhibitor of GPD2 was used to further investigate the therapy value of GPD2 inhibitor in LUAD cells lines (A549 cell and H1299 cell). The TISIDB website was used to investigate the associations between GPD2 expression and immune cell infiltration in LUAD.

Results

The results showed that GPD2 is overexpressed in LUAD tissues and significantly associated with poor survival. KM04416 can suppress the progression of LUAD cells by targeting GPD2. Low expression of GPD2 is related to high infiltration of immune cells.

Conclusions

In summary, our present study found that targeting inhibition of GPD2 by KM04416 can suppress LUAD progression via adjusting immune cell infiltration.
Effects of mind-body interventions on polycystic ovary syndrome: a comprehensive meta-analysis
Authors: Zhao Kun , Nie Liuyan , Ye Xiangming , Hu Xiaoyan
Published: July 2024

Background

Mind-body interventions (MBI) have emerged as a potential therapeutic approach, but their effectiveness in the treatment of Polycystic Ovary Syndrome (PCOS) remains inconclusive. This study systematically evaluates the effectiveness of MBI on quality of life, anthropometry, androgen secretion, glucose, and lipid metabolism in PCOS.

Methods

A computer search was conducted across three databases: PubMed, the Cochrane Library, and EMBASE, to identify randomized controlled trials (RCTs) related to MBI for PCOS from their inception until July 2024. DerSimonian and Laird’s random-effects model and Stata 17.0 software was employed for our meta-analysis.

Results

Twelve RCTs were included. MBI significantly improved PCOSQ subscale scores, including emotional disturbances (MD: 7.75, 95% CI: 6.10 to 9.40), body hair (MD: 2.73, 95% CI: 0.54 to 4.91), menstrual problems (MD: 3.79, 95% CI: 2.89 to 4.69), and weight (MD: 1.48, 95% CI: 0.03 to 2.93). Furthermore, there was a reduction in depression levels (MD: -1.53, 95% CI: -2.93 to -0.13). Sensitivity analysis confirmed the robustness of PCOSQ-Emotional disturbances and PCOSQ-Menstrual problems, with a high GRADE level of evidence for these subscales. Secondary outcome measures, including waist-hip ratio, fasting blood glucose, and HOMA-IR exhibited statistically significant differences. Subgroup analysis revealed that obesity could influence treatment outcomes.

Conclusion

MBI can serve as an alternative therapy, modulating effect on the quality of life and depression in PCOS patients. Future well-designed, high-quality, and large-scale studies should be conducted to thoroughly assess the impact of different Mind-Body Interventions (MBI) on various PCOS phenotypes.

Trial registration

PROSPERO (CRD42023472035).
Changes in quality of life 1 year after intensive care: a multicenter prospective cohort of ICU survivors
Authors: Porter Lucy L. , Simons Koen S. , Corsten Stijn , Westerhof Brigitte , Rettig Thijs C. D. , Ewalds Esther , Janssen Inge , Jacobs Crétien , van Santen Susanne , Slooter Arjen J. C. , van der Woude Margaretha C. E. , van der Hoeven Johannes G. , Zegers Marieke , van den Boogaard Mark
Published: July 2024

Background

With survival rates of critical illness increasing, quality of life measures are becoming an important outcome of ICU treatment. Therefore, to study the impact of critical illness on quality of life, we explored quality of life before and 1 year after ICU admission in different subgroups of ICU survivors.

Methods

Data from an ongoing prospective multicenter cohort study, the MONITOR-IC, were used. Patients admitted to the ICU in one of eleven participating hospitals between July 2016 and June 2021 were included. Outcome was defined as change in quality of life, measured using the EuroQol five-dimensional (EQ-5D-5L) questionnaire, and calculated by subtracting the EQ-5D-5L score 1 day before hospital admission from the EQ-5D-5L score 1 year post-ICU. Based on the minimal clinically important difference, a change in quality of life was defined as a change in EQ-5D-5L score of ≥ 0.08. Subgroups of patients were based on admission diagnosis.

Results

A total of 3913 (50.6%) included patients completed both baseline and follow-up questionnaires. 1 year post-ICU, patients admitted after a cerebrovascular accident, intracerebral hemorrhage, or (neuro)trauma, on average experienced a significant decrease in quality of life. Conversely, 11 other subgroups of ICU survivors reported improvements in quality of life. The largest average increase in quality of life was seen in patients admitted due to respiratory disease (mean 0.17, SD 0.38), whereas the largest average decrease was observed in trauma patients (mean -0.13, SD 0.28). However, in each of the studied 22 subgroups there were survivors who reported a significant increase in QoL and survivors who reported a significant decrease in QoL.

Conclusions

 This large prospective multicenter cohort study demonstrated the diversity in long-term quality of life between, and even within, subgroups of ICU survivors. These findings emphasize the need for personalized information and post-ICU care.

Trial registration: The MONITOR-IC study was registered at ClinicalTrials.gov: NCT03246334 on August 2nd 2017.
The complexities of decision-making associated with on-demand treatment of hereditary angioedema (HAE) attacks
Authors: Betschel Stephen D. , Caballero Teresa , Jones Douglas H. , Longhurst Hilary J. , Manning Michael , van Kooten Sally , Heckmann Markus , Danese Sherry , Goga Ledia , Burnette Autumn Ford
Published: July 2024

Background

Hereditary angioedema (HAE) is characterized by debilitating attacks of tissue swelling in various locations. While guidelines recommend the importance of early on-demand treatment, recent data indicate that many patients delay or do not treat their attacks.

Objective

This survey aimed to investigate patient behavior and evaluate the key factors that drive on-demand treatment decision-making, as reported by those living with HAE.

Methods

People living with HAE were recruited by the US Hereditary Angioedema Association (HAEA) to complete a 20-minute online survey between September 6, and October 19, 2022.

Results

Respondents included 107 people with HAE, 80% female, 98% adults (≥ 18 years). Attack management included on-demand therapy only (50%, n = 53) or prophylaxis with on-demand therapy (50%, n = 54). Most patients (63.6%) reported that they did not carry on-demand treatment at all times when away from home. The most common reason for not carrying on-demand treatment when away from home was ‘prefer to treat at home’ (72.1%). Overall, 86% of respondents reported delaying on-demand treatment, despite recognizing the initial onset of an HAE attack and despite 97% of patients agreeing that it is important to recover quickly from an HAE attack. Reasons for non-treatment or treatment delay included ‘the attack is not severe enough to treat’ (91.9% and 88.0%, respectively), ‘cost of treatment’ (31.1% and 40.2%, respectively), anxiety about refilling the prescription for on-demand treatment quickly (31.1% and 37.0%, respectively), the pain (injection or burning) associated with their on-demand treatment (18.9% and 28.3%, respectively), the lack of a suitable/private area to administer on-demand treatment (17.6% and 27.2%, respectively), lack of time to prepare on-demand treatment (16.2% and 16.3%, respectively), and a ‘fear of needles’ (13% and 12.2%, respectively). Survey findings from the patient perspective revealed that when on-demand treatment was delayed, 75% experienced HAE attacks that progressed in severity, and 80% reported longer attack recovery.

Conclusions

Survey results highlight that decision-making regarding on-demand treatment in HAE is more complicated than expected. The burden associated with current parenteral on-demand therapies is often the cause of treatment delay, despite acknowledgment that delays may result in progression of HAE attacks and longer time to recovery.