bluuebunny/crossref_metadata_2025 huggingface dataset:
Inadequate care and excessive overprotection during childhood are associated with the presence of diabetes mellitus in adulthood in a general Japanese population: a cross-sectional analysis from the Hisayama Study
Authors: Shibata Mao , Hosoi Masako , Anno Kozo , Hirabayashi Naoki , Hirakawa Yoichiro , Kawata Hiroshi , Iwaki Rie , Sawamoto Ryoko , Sudo Nobuyuki , Ninomiya Toshiharu
Published: October 2023

Objective

To investigate associations between parenting styles during childhood and diabetes in adulthood in a Japanese community.

Methods

In 2011, 710 community-dwelling Japanese residents aged ≥ 40 years were assessed for the presence of diabetes and for their perceptions of the parenting style of their parents, as measured using the “care” and “overprotection” scales of the Parental Bonding Instrument. Care and overprotection scores for each parent were dichotomized by age-specific median values. Diabetes mellitus was defined as a fasting plasma glucose level of ≥ 7.0 mmol/L, a 2-h post-loaded glucose level of ≥ 11.1 mmol/L, HbA1c ≥ 6.5%, and/or the current use of insulin or oral glucose-lowering agents. The odds ratios (ORs) for prevalent diabetes were calculated using a logistic regression model.

Results

The prevalence of diabetes was 14.9%. Subjects with a high paternal overprotection score had a significantly greater likelihood of prevalent diabetes than those with a low paternal overprotection score after adjusting for confounders (OR 1.71, 95% confidence interval [CI] 1.06–2.77), while there was no significant association between paternal care and diabetes. Additionally, the multivariable-adjusted ORs for the presence of diabetes were significantly higher in subjects with a low maternal care score (OR 1.61, 95%CI 1.00–2.60) or in subjects with a high maternal overprotection score (OR 1.73, 95%CI 1.08–2.80). Moreover, the subjects with a low care score and high overprotection score for both their father and mother had a significantly higher multivariable-adjusted OR of diabetes than those with a high care score and low overprotection score for both parents (OR 2,12, 95%CI 1.14–3.95).

Conclusions

This study suggests that inadequate care and excessive overprotection during childhood may contribute to the development of diabetes in adulthood.
Drug treatment for oral submucous fibrosis: an update
Authors: Chen Xueru , Xie Hui , Guo Jincai
Published: October 2023

Objective

The aim of this review is to evaluate the different medicinal interventions available for the management of oral submucous fibrosis (OSF).

Materials and methods

We conducted a comprehensive electronic search on PubMed, Web of Science, and Cochrane Library databases for articles related to OSF patients treated with medications from December 2011 to September 2022. GRADE system was used to evaluate the evidence quality. The reporting of the systematic review is in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The main outcomes were the improvement of maximum mouth opening, burning sensation, cheek flexibility, and tongue protrusion.

Results

Twenty-nine randomized controlled trials (RCTs), five clinical trials (CCTs) were included, and the use of drugs for OSF treatment were evaluated. Drugs like steroids, hyaluronidase, pentoxifylline, lycopene, curcumin, dpirulina, aloe vera, omega3, oxitard, allicin, colchicine have been used. It was found that drugs with evidence high quality were salvia miltiorrhiza combined with triamcinolone acetonide, lycopene, pentoxifylline, curcumin, and aloe vera, and those with evidence moderate quality were allicin, colchicine, omega 3, and oxitard.

Conclusion

Based on the results of our comprehensive analysis, for long-term treatment, we found lycopene with low side effects, whereas for relieving the symptoms of severe burning sensation, aloe vera is the most effective. Although the recent review has made some progress, drug therapy for OSF remains unclear, and more high-quality RCTs are needed to identify better treatments for OSF.
Novel compound heterozygous variants of the SEC23A gene in a Chinese family with cranio-lenticulo-sutural dysplasia based on data from a large cohort of congenital cataract patients
Authors: Wang Qiwei , Lin Xiaoshan , Lai Kunbei , Liu Yinghui , Qin Tingfeng , Tan Haowen , Li Jing , Lin Zhuoling , Zhang Xulin , Li Xiaoyan , Lin Haotian , Chen Weirong
Published: October 2023

Background

Cranio-lenticulo-sutural dysplasia (CLSD) is a rare dysmorphic syndrome characterized by skeletal dysmorphism, late-closing fontanels, and cataracts. CLSD is caused by mutations in the SEC23A gene (OMIM# 607812) and can be inherited in either an autosomal dominant or autosomal recessive pattern. To date, only four mutations have been reported to cause CLSD. This study aims to identify the disease-causing variants in a large cohort of congenital cataract patients, to expand the genotypic and phenotypic spectrum of CLSD, and to confirm the association between SEC23A and autosomal recessive CLSD (ARCLSD).

Methods

We collected detailed medical records and performed comprehensive ocular examinations and whole-exome sequencing (WES) on 115 patients with congenital cataracts. After suspecting that a patient may have CLSD based on the sequencing results, we proceeded to conduct transmission electron microscopy (TEM) on the cultured skin fibroblasts. The clinical validity of the reported gene-disease relationships for the gene and the disease was evaluated using the ClinGen gene curation framework.

Results

Two novel compound heterozygous variants (c.710A > C p.Asp237Ala, c.1946T > C p.Leu649Pro) of the SEC23A gene, classified as variant of uncertain significance, were identified in the proband with skeletal, cardiac, ocular, and hearing defects. The observation of typical distended endoplasmic reticulum cisternae further supported the diagnosis of CLSD. Application of the ClinGen gene curation framework confirmed the association between SEC23A and ARCLSD.

Conclusion

This study expands the genotypic and phenotypic spectrum of CLSD, proposes TEM as a supplemental diagnostic method, and indicates that congenital cataracts are a typical sign of ARCLSD.
A prediction nomogram for deep venous thrombosis risk in patients undergoing primary total hip and knee arthroplasty: a retrospective study
Authors: Lin Zhencan , Sun Hao , Li Deng , Cai Zhiqing , Huang Zhencheng , Liu Fangzhou , Chen Meiyi , Wang Yimin , Xu Jie , Ma Ruofan
Published: October 2023

Introduction

Deep venous thrombosis (DVT) prediction after total hip and knee arthroplasty remains challenging. Early diagnosis and treatment of DVT are crucial. This research aimed to develop a nomogram for early DVT prediction.

Methods

A total of 317 patients undergoing primary total hip and knee arthroplasty in Sun Yat-sen Memorial Hospital were enrolled between May 2020 and September 2022. Data from May 2020 to February 2022 were used as the development datasets to build the nomogram model (n = 238). Using multivariate logistic regression, independent variables and a nomogram for predicting the occurrence of DVT were identified. Datasets used to validate the model for internal validation ranged from March 2022 to September 2022 (n = 79). The nomogram’s capacity for prediction was also compared with the Caprini score.

Results

For both the development and validation datasets, DVT was found in a total of 38 (15.97%) and 9 patients (11.39%) on post-operative day 7 (pod7), respectively. 59.6% patients were symptomatic DVT (leg swelling). The multivariate analysis revealed that surgical site (Knee vs. Hip), leg swelling and thrombin-antithrombin complex (TAT) were associated with DVT. The previously indicated variables were used to build the nomogram, and for the development and validation datasets, respectively. In development and validation datasets, the area under the receiver operating characteristic curve was 0.836 and 0.957, respectively. In both datasets, the predictive value of the Nomogram is greater than the Caprini score.

Conclusions

A proposed nomogram incorporating surgical site (Knee vs. Hip), leg swelling, and thrombin antithrombin complex (TAT) may facilitate the identification of patients who are more prone to develop DVT on pod7.
Dissecting transcription of the 8q24-MYC locus in prostate cancer recognizes the equilibration between androgen receptor direct and indirect dual-functions
Authors: Guo Ju , Wei Zhao , Jia Tianwei , Wang Liyang , Nama Nuosu , Liang Jiaqian , Liao Xinghua , Liu Xiaming , Gao Yanfei , Liu Xiaoqiang , Wang Keshan , Fu Bin , Chen Shaoyong Shawn
Published: October 2023

Background

Androgen receptor (AR) activation and repression dual-functionality only became known recently and still remains intriguing in prostate cancer (PCa). MYC is a prominent oncogene that functionally entangles with AR signaling in PCa. Further exploration of AR regulatory mechanisms on MYC gene transcription bears clinical and translation significance.

Methods

Bioinformatics analysis of PCa cell line and clinical RNA-Seq and ChIP-Seq (chromatin immunoprecipitation-sequencing) datasets to anchor interactions of AR and MYC transcriptional networks. ChIP-qPCR and 3C (chromosome conformation capture) analyses to probe MYC distal regulation by AR binding sites (ABSs). CRISPR/Cas9-mediated genome-editing to specify functions of ABS within the 8q24-MYC locus on androgen-mediated MYC transcription. Global FoxA1 and HoxB13 distribution profiling to advance AR transcriptional mechanisms.

Results

Here we recognize AR bi-directional transcription mechanisms by exploiting the prominent 8q24-MYC locus conferring androgen hyper-sensitivity. At ~ 25 Kb downstream of the MYC gene, we identified an undefined ABS, P10. By chromatin analyses, we validated androgen-dependent spatial interaction between P10 and MYC-Promoter (MYC-Pro) and temporal epigenetic repression of these MYC-proximal elements. We next designed a CRISPR/Cas9-mediated double genomic knock-out (KO) strategy to show that P10-KO slightly lessened androgen-elicited MYC transrepression in LNCaP-AR cells. In similar genomic editing assays, androgen-mediated MYC repression became slightly deepened upon KO of P11, an ABS in the PVT1 gene locus highly enriched in AR-binding motifs and peaks. We also investigated multiple ABSs in the established PCAT1 super-enhancer that distally interacts with MYC-Pro for transactivation, with each KO pool consistently shown to relieve androgen-elicited MYC repression. In the end, we systemically assessed androgen effects in the 8q24-MYC locus and along PCa genome to generalize H3K27ac and BRD4 re-distribution from pioneer factors (FoxA1 and HoxB13) to AR sites.

Conclusion

Together, we reconciled these observations by unifying AR dual-functions that are mechanistically coupled to and equilibrated by co-factor redistribution.

Graphical Abstract
Vertebral bone quality different in magnetic resonance imaging parameters
Authors: Liu Xiang-Ge , Chen Xin , Chen Biao , Liang Pei-Jie , Liu Han-Hui , Fu Meiqi
Published: October 2023

Objective

This was a single-center retrospective study that aimed to measure the vertebral bone quality (VBQ) in people of all ages and compare changes in VBQ across ages. Differences in VBQ under various MRI parameters were compared.

Methods

We first screened patients without underlying disease and no history of fractures who underwent lumbar MRI in our center in the past four years. Over the span of 10 years, 200 patients (100 males and 100 females) were randomly recruited into each cohort to undergo 1.5 T and 3.0 T MRI scans. Subsequently, we tabulated the number of patients admitted to our hospital with OVCF over the past four years. There were 30 healthy adults under 4 times of MRI scans in different parameters to determine the differentiation of VBQ. The 30 healthy adults were recruited to validate the differentiation of VBQ under various parameters.

Results

A total of 2400 patients without OVCF and 405 patients with OVCF were enrolled. The VBQ value of 1.5 T was significantly higher compared with that of 3.0 T (2.769 ± 0.494 > 2.199 ± 0.432, P < 0.0001). VBQ of 43.31 kHz in 1.5 T was significantly lower than that of 35.36 kHz (2.447 ± 0.350 < 2.632 ± 0.280, P < 0.05). The differentiation of VBQ in 1.5 T and 3.0 T was validated using results of healthy adults.

Conclusions

VBQ is an effective tool for differentiating patients with OVCF and can be used as a primary screening tool for osteoporosis. However, VBQ is significantly affected by magnetic field intensity and bandwidth and cannot achieve its universality as it originally proposed.
Mega-dose sodium ascorbate: a pilot, single-dose, physiological effect, double-blind, randomized, controlled trial
Authors: Yanase Fumitaka , Spano Sofia , Maeda Akinori , Chaba Anis , Naorungroj Thummaporn , Ow Connie Pei Chen , Lankadeva Yugeesh R. , May Clive N. , Betrie Ashenafi H. , Lane Darius J. R. , Eastwood Glenn M. , Plummer Mark P. , Bellomo Rinaldo
Published: October 2023

Background

Mega-dose sodium ascorbate (NaAscorbate) appears beneficial in experimental sepsis. However, its physiological effects in patients with septic shock are unknown.

Methods

We conducted a pilot, single-dose, double-blind, randomized controlled trial. We enrolled patients with septic shock within 24 h of diagnosis. We randomly assigned them to receive a single mega-dose of NaAscorbate (30 g over 1 h followed by 30 g over 5 h) or placebo (vehicle). The primary outcome was the total 24 h urine output (UO) from the beginning of the study treatment. Secondary outcomes included the time course of the progressive cumulative UO, vasopressor dose, and sequential organ failure assessment (SOFA) score.

Results

We enrolled 30 patients (15 patients in each arm). The mean (95% confidence interval) total 24-h UO was 2056 (1520–2593) ml with placebo and 2948 (2181–3715) ml with NaAscorbate (mean difference 891.5, 95% confidence interval [− 2.1 to 1785.2], P = 0.051). Moreover, the progressive cumulative UO was greater over time on linear mixed modelling with NaAscorbate (P < 0.001). Vasopressor dose and SOFA score changes over time showed faster reductions with NaAscorbate (P < 0.001 and P = 0.042). The sodium level, however, increased more over time with NaAscorbate (P < 0.001). There was no statistical difference in other clinical outcomes.

Conclusion

In patients with septic shock, mega-dose NaAscorbate did not significantly increase cumulative 24-h UO. However, it induced a significantly greater increase in UO and a greater reduction in vasopressor dose and SOFA score over time. One episode of hypernatremia and one of hemolysis were observed in the NaAscorbate group. These findings support further cautious investigation of this novel intervention.

Trial registration Australian New Zealand Clinical Trial Registry (ACTRN12620000651987), Date registered June/5/2020.
Metagenome-wide analysis uncovers gut microbial signatures and implicates taxon-specific functions in end-stage renal disease
Authors: Zhang Pan , Wang Xifan , Li Shenghui , Cao Xuesen , Zou Jianzhou , Fang Yi , Shi Yiqin , Xiang Fangfang , Shen Bo , Li Yixuan , Fang Bing , Zhang Yue , Guo Ruochun , Lv Qingbo , Zhang Liwen , Lu Yufei , Wang Yaqiong , Yu Jinbo , Xie Yeqing , Wang Ran , Chen Xiaohong , Yu Jiawei , Zhang Zhen , He Jingjing , Zhan Jing , Lv Wenlv , Nie Yuxin , Cai Jieru , Xu Xialian , Hu Jiachang , Zhang Qi , Gao Ting , Jiang Xiaotian , Tan Xiao , Xue Ning , Wang Yimei , Ren Yimei , Wang Li , Zhang Han , Ning Yichun , Chen Jing , Zhang Lin , Jin Shi , Ren Fazheng , Ehrlich Stanislav Dusko , Zhao Liang , Ding Xiaoqiang
Published: October 2023

Background

The gut microbiota plays a crucial role in regulating host metabolism and producing uremic toxins in patients with end-stage renal disease (ESRD). Our objective is to advance toward a holistic understanding of the gut ecosystem and its functional capacity in such patients, which is still lacking.

Results

Herein, we explore the gut microbiome of 378 hemodialytic ESRD patients and 290 healthy volunteers from two independent cohorts via deep metagenomic sequencing and metagenome-assembled-genome-based characterization of their feces. Our findings reveal fundamental alterations in the ESRD microbiome, characterized by a panel of 348 differentially abundant species, including ESRD-elevated representatives of Blautia spp., Dorea spp., and Eggerthellaceae, and ESRD-depleted Prevotella and Roseburia species. Through functional annotation of the ESRD-associated species, we uncover various taxon-specific functions linked to the disease, such as antimicrobial resistance, aromatic compound degradation, and biosynthesis of small bioactive molecules. Additionally, we show that the gut microbial composition can be utilized to predict serum uremic toxin concentrations, and based on this, we identify the key toxin-contributing species. Furthermore, our investigation extended to 47 additional non-dialyzed chronic kidney disease (CKD) patients, revealing a significant correlation between the abundance of ESRD-associated microbial signatures and CKD progression.

Conclusion

This study delineates the taxonomic and functional landscapes and biomarkers of the ESRD microbiome. Understanding the role of gut microbiota in ESRD could open new avenues for therapeutic interventions and personalized treatment approaches in patients with this condition.
Effect of short-term compression therapy after thermal ablation for varicose veins: study protocol for a prospective, multicenter, non-inferiority, randomized controlled trial
Authors: Tang Mingjun , Jiang Weihua , Hong Jin , Li Lubing , Shang Dan , Zhao Yue , Liu Zhenjie , Qi Ming , Jin Mingjuan , Zhu Yuefeng
Published: October 2023

Background

For patients with varicose veins, the goal is to relieve pain and swelling, reduce the severity of edema, improve skin changes, and heal ulcers associated with venous disease. Compression therapy is the cornerstone of their management. Several studies have shown that wearing an elastic bandage for the first 24 h and then a compression stocking for a week can effectively reduce the pain after thermal ablation. However, in clinical practice, patient compliance with this treatment could be better, considering difficulties in pulling up and removing the compression stocking, tightness, and skin irritation because these must be worn for a prolonged period. A potential solution to battling these barriers is short-term compression therapy. Besides, the effect and necessity of wearing compression stockings after thermal ablation have been questioned. Based on current clinical experience and limited evidence, although some scholars have suggested that compression therapy may be an unnecessary adjunctive therapy after thermal ablation, there is still a great deal of uncertainty in the absence of compression therapy after thermal ablation compared to compression therapy. Therefore, we advocate further research to evaluate the clinical effect of short-term postoperative compression therapy. Furthermore, well-designed randomized controlled trials are needed.

Methods

A prospective, multicenter, non-inferiority randomized controlled trial is designed to evaluate the non-inferiority of target vein occlusion rate at 3 months. Three hundred and sixty patients will be randomly assigned in a 1:1 ratio to one of the following treatments: (A) 3 M™ Coban™ elastic bandage for 48 h or (B) 3 M™ Coban™ elastic bandage for the first 24 h and then a class II compression full-length stocking (23–32 mm Hg) for 1 week. The two groups will be compared on several variables, including target vein occlusion rate at 3 months (primary outcome indicator), pain, quality of life, clinical severity of varicose veins, postoperative complications, time to return to regular work, and compliance.

Discussion

Suppose the effect of the 3 M™ Coban™ elastic bandage for 48 h proves to be non-inferior to long-term compression therapy. In that case, this short-term treatment may contribute to a future update of clinical guidelines for compression therapy after thermal ablation of varicose veins, resulting in higher patient compliance and better postoperative quality of life.

Trial registration

Clinical Trials NCT05840991. Registered on May 2023.
Blood biomarkers and neurodegeneration in individuals exposed to repetitive head impacts
Authors: Bernick Charles , Shan Guogen , Ritter Aaron , Ashton Nicholas J. , Blennow Kaj , Lantero-Rodriguez Juan , Snellman Anniina , Zetterberg Henrik
Published: October 2023

Background

It is unknown if fluid biomarkers reflective of brain pathologies are useful in detecting and following a neurodegenerative process in individuals exposed to repetitive head impacts. This study explores the relationship between blood biomarkers and longitudinal change in cognitive function and regional brain volumes in a cohort of professional fighters.

Methods

Participants are drawn from a convenience sample of active and retired professional boxers and Mixed Martial Arts fighters and a control group with no prior exposure to head impacts. 3 T MRI brain imaging, plasma samples, and computerized cognitive testing were obtained at baseline and, for a subset, annually. MRI regional volumes were extracted, along with plasma levels of neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), p-tau231, and N-terminal tau (NTA). Statistical analyses were performed to assess the relationship between plasma levels and regional brain volumes and cognitive performance at baseline and longitudinally.

Results

One hundred forty active boxers (mean age: 31 with standard deviation (SD) of 8), 211 active MMA (mean age of 30 with SD of 5), 69 retired boxers (mean age 49 with SD of 9), and 52 control participants (mean age 36 with SD of 12) were included in the analyses. Baseline GFAP levels were highest in the retired boxers (retired boxers v. active MMA: p = 0.0191), whereas active boxers had higher levels of NfL (active boxers v. MMA: p = 0.047). GFAP showed an increase longitudinally in retired boxers that was associated with decreasing volumes of multiple cortical and subcortical structures (e.g., hippocampus: B =  − 1.25, 95% CI, − 1.65 to − 0.85) and increase in lateral ventricle size (B = 1.75, 95% CI, 1.46 to 2.04). Furthermore, performance on cognitive domains including memory, processing speed, psychomotor speed, and reaction time declined over time with increasing GFAP (e.g., processing speed: B =  − 0.04, 95% CI, − 0.07 to − 0.02; reaction time: B = 0.52, 95% CI, 0.28 to 0.76). Among active fighters, increasing levels of GFAP were correlated with lower thalamic (B =  − 1.42, 95% CI, − 2.34 to -0.49) and corpus callosum volumes, along with worsening scores on psychomotor speed (B = 0.14, 95% CI, 0.01 to 0.27).

Conclusion

Longitudinal plasma GFAP levels may have a role in identifying individuals exposed to repetitive head impacts who are at risk of showing progressive regional atrophy and cognitive decline.
RETRACTED ARTICLE: Hybrid traffic security shaping scheme combining TAS and CQSF of time-sensitive networks in smart grid
Authors: Zhai Hongting , Zhang Qingrui , Tang Ruilin , Zhang Yantong , Sun Lili , Zhai Qi , Bian Ruochen , He Xinxin
Published: October 2023

The new intelligent factory introduces Time-Sensitive Network into industrial Ethernet to provide real time and deterministic guarantee communication for production system. Since the problem pertaining to data leakage or damage during transmission has increasingly become pronounced, security protection technology has been introduced, but this technology will bring about a delay in user response and a decline in the quality of service. Meanwhile, ensuring the deterministic mixed transmission of time-sensitive and large-bandwidth data traffic supported by the same switching device is a still challenging problem. Therefore, this study proposes a hybrid security scheduling scheme which combines Time-Aware Shaper and cycle specified queuing and forwarding (CSQF). Specifically, the mechanism first adopts various encryption methods for different traffic, and afterward, it reduces its resource occupation by adjusting the sampling period of the time-sensitive traffic. At the same time, it adopts CSQF to schedule the large-bandwidth data traffic, thereby improving the scheduling success rate. According to the experimental results, this scheme enhances network security and network scheduling success rate by up to 51%. The scheduling of mixed traffic in the Time-sensitive Network is realized securely and efficiently.
Digital and innovative entrepreneurship in the Indian handicraft sector after the COVID-19 pandemic: challenges and opportunities
Authors: Yadav Uma Shankar , Tripathi Ravindra , Tripathi Mano Ashish , Ghosal Indrajit , Kumar Ashish , Mandal Mitu , Singh Akanksha
Published: October 2023

This research focuses on the factors that barriers and foster (drivers) digital innovation and entrepreneurship amongst small businesses operating in the Handicraft industry after the economic downturn. From the perspective of new Indian craft entrepreneurs, digital and innovative entrepreneurship is crucial to surviving the crisis. It will eventually encourage the development of the handmade goods market and the artisanal reconfiguration as a business. In this study, the qualitative method was used. For the creation of themes, Inductive content analysis (analytical, inductive technique) was used to interview fifty online handicraft business owners who rely on their craft talents for income. After the pandemic, two types of motivation were generated for handmade entrepreneurs. The first motivation was extrinsic, which conditioned the handicraft market, restricted mobility, and upgraded household status for entrepreneurship. The second was intrinsic motivation among the craft entrepreneurs who generated individual and professional skill growth. These two factors encouraged digital craft innovations and entrepreneurial advancement of transitioning handicraft companies to digital platforms. After the interview, respondents explained several hindrances or restrictions, market interruption, and quality internet. Even after that, it resolved as the effect of the pandemic reduced and digital skill training for innovation and entrepreneurship passion increased for developing a robust programme that supports the handicraft new entrepreneurs after the economic calamities. This finding contributes to the area of investigation and contributes to entrepreneurship literature. This study will open the route for making the policy and development of solid strategic plans for the handicraft sector’s new craft entrepreneurs. With the help of innovative and digital entrepreneurs, small-scale or craft industries will boost the Indian economy and give some of the best suggestions for global economies. For developing economies, this study will also empower entrepreneurs to open new dimensions for marketing, supply chain, and exportation and will finally increase the Globalisation of handmade products.
What should we expect when two myositis-specific antibodies coexist in a patient
Authors: Zheng Yiming , Zhao Yawen , Hao Hongjun , Wang Zhaoxia , Gao Feng , Zhang Wei , Yuan Yun
Published: October 2023

Background

The coexistence of two myositis-specific autoantibodies (MSA) is considered extremely rare. We describe three patients with both anti-signal recognition particle (SRP) antibodies and another MSA in serum.

Methods

We performed a retrospective clinical data collection and follow-up studies of the clinical manifestations and treatment outcome of three patients positive with anti-SRP antibodies and other MSAs. IgG antibodies against MSAs were detected using commercial line immunoblot assay.

Results

The tests of MSA showed positive result of anti-SRP antibodies and another one MSA including anti-TIF1-γ, anti-Jo1, or anti-EJ antibodies, respectively. The proximal muscle weakness appeared in 2 patients; interstitial lung disease presented in 2 patients. The serum CK level was elevated in 1 patient. The muscle biopsy showed necrotizing myopathy in 1 patient and deposition of membrane attack complex on scattered myofibers in the other one patient. One of the two patients with interstitial lung disease died because of respiratory failure. One patient had completely improved and the other one showed partial remission after immunosuppressive therapy.

Conclusions

The patients with anti-SRP antibodies co-occurred with the other MSA may have various clinical characteristics. The clinicopathological phenotypes of these patients seem to be mainly caused by one of the MSAs, namely the responsible antibody.
Reliability of point-of-care ultrasound to evaluate fluid tolerance performed by critical care residents
Authors: Guerrero-Gutiérrez Manuel A. , García-Guillén Francisco Javier , Adame-Encarnación Humberto , Monera-Martínez Fernando , Ñamendys-Silva Silvio A. , Córdova-Sánchez Bertha M.
Published: October 2023

Background

Patients with hypotension usually receive intravenous fluids, but only 50% will respond to fluid administration. We aimed to assess the intra and interobserver agreement to evaluate fluid tolerance through diverse ultrasonographic methods.

Methods

We prospectively included critically ill patients on mechanical ventilation. One trained intensivist and two intensive care residents obtained the left ventricular outflow tract velocity–time integral (VTI) variability, inferior vena cava (IVC) distensibility index, internal jugular vein (IJV) distensibility index, and each component of the venous excess ultrasound (VExUS) system. We obtained the intraclass correlation coefficient (ICC) and Gwet’s first-order agreement coefficient (AC1), as appropriate.

Results

We included 32 patients. In-training observers were unable to assess the VTI-variability in two patients. The interobserver agreement was moderate to evaluate the IJV-distensibility index (AC1 0.54, CI 95% 0.29–0.80), fair to evaluate VTI-variability (AC1 0.39, CI 95% 0.12–0.66), and absent to evaluate the IVC-distensibility index (AC1 0.19, CI 95% − 0.07 to 0.44). To classify patients according to their VExUS grade, the intraobserver agreement was good, and the interobserver agreement was moderate (AC1 0.52, CI 95% 0.34–0.69).

Conclusions

Point-of-care ultrasound is frequently used to support decision-making in fluid management. However, we observed that the VTI variability and IVC-distensibility index might require further training of the ultrasound operators to be clinically useful. Our findings suggest that the IJV-distensibility index and the VExUS system have acceptable reproducibility among in-training observers.
A dynamic online nomogram for predicting death in hospital after aneurysmal subarachnoid hemorrhage
Authors: Li Tian , Zhuang Dongzhou , Xiao Yong , Chen Xiaoxuan , Zhong Yuan , Ou Xurong , Peng Hui , Wang Shousen , Chen Weiqiang , Sheng Jiangtao
Published: October 2023

Background

This study aimed to validate the efficacy the multiplication of neutrophils and monocytes (MNM) and a novel dynamic nomogram for predicting in-hospital death in patients with aneurysmal subarachnoid hemorrhage (aSAH).

Methods

Retrospective study was done on 986 patients with endovascular coiling for aSAH. Independent risk factors associated with in-hospital death were identified using both univariate and multivariate logistic regression analysis. In the development cohort, a dynamic nomogram of in-hospital deaths was introduced and made available online as a straightforward calculator. To predict the in-hospital death from the external validation cohort by nomogram, calibration analysis, decision curve analysis, and receiver operating characteristic analysis were carried out.

Results

72/687 patients (10.5%) in the development cohort and 31/299 patients (10.4%) in the validation cohort died. MNM was linked to in-hospital death in univariate and multivariate regression studies. In the development cohort, a unique nomogram demonstrated a high prediction ability for in-hospital death. According to the calibration curves, the nomogram has a reliable degree of consistency and calibration. With threshold probabilities between 10% and 90%, the nomogram’s net benefit was superior to the basic model. The MNM and nomogram also exhibited good predictive values for in-hospital death in the validation cohort.

Conclusions

MNM is a novel predictor of in-hospital mortality in patients with aSAH. For aSAH patients, a dynamic nomogram is a useful technique for predicting in-hospital death.
Strategies for supervising people with mental illnesses on probation caseloads: results from a nationwide study
Authors: Van Deinse Tonya B. , Mercier Mariah Cowell , Waters Allison K. , Disbennett Mackensie , Cuddeback Gary S. , Velázquez Tracy , Lichtman Andrea Murray , Taxman Faye
Published: October 2023

Probation officers are tasked with supervising the largest number of people living with mental illnesses in the criminal legal system, with an estimated 16–27% of individuals on probation identified as having a mental health condition. While academic research has recently focused on building the evidence base around the prototypical model of specialty mental health probation, less focus has been directed to the individual components of specialized mental health caseloads and other strategies agencies use to supervise people with mental illnesses. More specific information about these strategies would benefit probation agencies looking to implement or enhance supervision protocols for people with mental illnesses. This article describes the results from a nationwide study examining (1) probation agencies’ mental health screening and identification methods; (2) characteristics of mental health caseloads, including eligibility criteria, officer selection, required training, and interfacing with service providers; and (3) other strategies agencies use to supervise people with mental illnesses beyond mental health caseloads. Strategies for identifying mental illnesses varied, with most agencies using risk needs assessments, self-report items asked during the intake process, or information from pre-sentencing reports. Less than a third of respondents reported using screening and assessment tools specific to mental health or having a system that tracks or “flags” mental illnesses. Results also showed wide variation in mental health training requirements for probation officers, as well as variation in the strategies used for supervising people with mental illnesses (e.g., mental health caseloads, embedded mental health services within probation, modified cognitive behavioral interventions). The wide variation in implementation of supervision strategies presents (1) an opportunity for agencies to select from a variety of strategies and tailor them to fit the needs of their local context and (2) a challenge in building the evidence base for a single strategy or set of strategies.
Contextual topic discovery using unsupervised keyphrase extraction and hierarchical semantic graph model
Authors: Du Hung , Thudumu Srikanth , Giardina Antonio , Vasa Rajesh , Mouzakis Kon , Jiang Li , Chisholm John , Bista Sanat
Published: October 2023

Recent technological advancements have led to a significant increase in digital documents. A document’s key information is generally represented by the keyphrases that provide the abstract description contained therein. With traditional keyphrase techniques, however, it is difficult to identify relevant information based on context. Several studies in the literature have explored graph-based unsupervised keyphrase extraction techniques for automatic keyphrase extraction. However, there is only limited existing work that embeds contextual information for keyphrase extraction. To understand keyphrases, it is essential to grasp both the concept and the context of the document. Hence, a hybrid unsupervised keyphrase extraction technique is presented in this paper called ContextualRank, which embeds contextual information such as sentences and paragraphs that are relevant to keyphrases in the keyphrase extraction process. We propose a hierarchical topic modeling approach for topic discovery based on aggregating the extracted keyphrases from ContextualRank. Based on the evaluation on two short-text datasets and one long-text dataset, ContextualRank obtains remarkable improvements in performance over other baselines in the short-text datasets.
Co-creation of the Global Patient Experience Data Navigator: a multi-stakeholder initiative to ensure the patient voice is represented in health decision-making
Authors: Willgoss Tom , Escontrias Omar A. , Scrafton Carole , Oehrlein Elisabeth , Livingstone Victoria , Chaplin Fiona C. , Benivento Maddalena , Chapman Hayley , Brooke Nicholas
Published: October 2023

Background

Putting patients’ needs and priorities at the forefront of healthcare initiatives and medical product development is critical to achieve outcomes that matter most to patients. This relies on the integration of early, meaningful patient engagement (PE) to learn what is important to patients, and collection of representative patient experience data (PXD). The increased number of PE/PXD efforts across global regulatory, health technology assessment, and healthcare systems is an important step forward to deliver improved health outcomes for patients. However, these initiatives are fragmented and lack integration, which is necessary to maximize efforts and reduce burden on patients. To overcome these challenges, the Global Patient Experience Data Navigator has been co-created by Patient Focused Medicines Development to provide practical resources that can facilitate and optimize PXD generation, collection, analysis, and dissemination for patient benefit and aims to be applicable across all therapeutic areas for all stakeholders.

Methods

Co-creation of the Navigator took place through an iterative process of validation and formalization driven by a diverse, multi-stakeholder working group with individuals who have varying knowledge/experience in PE/PXD.

Results

A series of workshops took place to conduct a gap analysis, develop a taxonomy model, and integrate existing frameworks. The collective insights led to the development of the Navigator consisting of four specific tools in the form of downloadable templates, which can be used to: (1) prioritize outcomes that matter most to patients and their caregivers; (2) select appropriate measurement methods for these outcomes; (3) identify when and why PXD is used throughout the product development cycle for each stakeholder; (4) identify when and why PXD is used throughout the healthcare process for each stakeholder. A public consultation was carried out to collect user feedback before the Navigator was made publicly available in December 2022.

Conclusion

To our knowledge, the Global Patient Experience Data Navigator is the only publicly available toolkit developed with a multi-stakeholder and disease-agnostic approach providing taxonomically grouped resources to optimize the collection and collation of PXD for patient benefit. Future work will aim to further engage patients by adding a PE dimension to the Navigator.
Novel radionuclides for use in Nuclear Medicine in Europe: where do we stand and where do we go?
Authors: Radzina Maija , Saule Laura , Mamis Edgars , Koester Ulli , Cocolios Thomas Elias , Pajuste Elina , Kalnina Marika , Palskis Kristaps , Sawitzki Zoe , Talip Zeynep , Jensen Mikael , Duchemin Charlotte , Leufgen Kirsten , Stora Thierry
Published: October 2023

Background

In order to support the ongoing research across Europe to facilitate access to novel radionuclides, the PRISMAP consortium (European medical radionuclides programme) was established to offer the broadest catalog of non-conventional radionuclides for medical and translational research. The aim of this article is to introduce readers with current status of novel radionuclides in Europe.

Main body

A consortium questionnaire was disseminated through the PRISMAP consortium and user community, professional associations and preclinical/clinical end users in Europe and the current status of clinical end-users in nuclear medicine were identified. A total of 40 preclinical/clinical users institutions took part in the survey. Clinical end users currently use the following radionuclides in their studies: 177Lu, 68 Ga, 111In, 90Y, other alpha emitters, 225Ac, 64Cu and Terbium isotopes. Radionuclides that would be of interest for users within the next 2–5 years are 64Cu, Terbium radionuclide “family” and alpha emitters, such as 225Ac.

Conclusions

Thanks to a questionnaire distributed by the PRISMAP consortium, the current status and needs of clinical end-users in nuclear medicine were identified.
Are open educational resources (OER) and practices (OEP) effective in improving learning achievement? A meta-analysis and research synthesis
Authors: Tlili Ahmed , Garzón Juan , Salha Soheil , Huang Ronghuai , Xu Lin , Burgos Daniel , Denden Mouna , Farrell Orna , Farrow Robert , Bozkurt Aras , Amiel Tel , McGreal Rory , López-Serrano Aída , Wiley David
Published: October 2023

While several studies have investigated the various effects of open educational resources (OER) and open educational practices (OEP), few have focused on its connection to learning achievement. The related scientific literature is divided about the effects of OER and OEP with regards to their contribution to learning achievement. To address this tension, a meta-analysis and research synthesis of 25 studies (N = 119,840 participants) was conducted to quantitatively investigate the effects of OER and OEP on students’ learning achievement. The analysis included course subject, level of education, intervention duration, sample size, geographical distribution, and research design as moderating variables of the obtained effects. The findings revealed that OER and OEP have a significant yet negligible (g = 0.07, p < 0.001) effect. Additionally, the analysis found that the obtained effect can be moderated by several variables, including course subject, level of education and geographical distribution. The study findings can help various stakeholders (e.g., educators, instructional designers or policy makers) in understanding what might hinder OER and OEP effect on learning achievement, hence accommodating better learning outcomes and more effective interventions.
The role of creatine kinase in distinguishing generalized tonic–clonic seizures from psychogenic non-epileptic seizures (PNES) and syncope: a retrospective study and meta-analysis of 1300 patients
Authors: Abdelnaby Ramy , Elgenidy Anas , Heckelmann Jan , Bedewy Mahmoud Mostafa , Shabib Ahmed Samy , Ebrahim Mohamed Ayman , Elmenawi Khaled Abdelmoneim , Maallem Imene , Youssef Merna Wagih , Attia Abdelrahman M. , Moawad Mostafa Hossam , Mohamed Khaled Ashraf , Gaballa Ahmed
Published: October 2023

Background/aim

As the clinical differentiation between epileptic seizures, psychogenic non-epileptic seizures (PNES), and syncope depends mainly on a detailed report of the event, which may not be available, an objective assessment of a potential biochemical analysis is needed. We aimed to investigate whether serum creatine kinase (CK) could be used to differentiate epileptic seizure from PNES and syncope and to assess the strength of evidence present.

Methods

We directed a retrospective cohort study coupled with a systematic review and meta-analysis of studies that measured CK in patients with epilepsy, PNES, syncope, and healthy controls.

Results

The cohort study, which traced 202 patients, showed that the CK level was significantly higher 48 h after the event in the epilepsy group versus patients with syncope (p < 0.01) Along with 1086 patients obtained through a database search for meta-analysis, CK level compared to different types of seizures from PNES was higher in epileptic seizure patients with a mean difference of 568.966 mIU/ml (95% CI 166.864, 971.067). The subgroup analysis of CK showed that it was higher in GTCS compared to syncope with a mean difference of 125.39 mIU/ml (95% CI 45.25, 205.52).

Discussion

Increased serum levels of CK have been associated mainly with epileptic seizures in relation to non-epileptic events. However, further studies would try to explore the variation in measurements and any other potential diagnostic marker.

Conclusion

The cohort study shows that the CK level in epilepsy seizures is higher after 48 h from the event compared to syncope. Moreover, the meta-analysis results show the present diagnostic utility of CK and its importance to be used in accordance with a detailed report of the event.
Multi-functional epoxides cross-linked collagen sponges for tissue engineering scaffolds
Authors: Zhang Yuanzhi , Yang Changkai , Gu Min , Zhang Xiaoxia , Zhang Xueqing , Li Guoying
Published: October 2023

With the efficient cross-linking abilities and the flexible regulation abilities to the performances of cross-linked products, the multi-functional aliphatic epoxides were once widely used to cross-link the collagen-based materials in the last century. In present work, the multi-functional epoxides were used to construct and cross-link collagen sponges for tissue engineering scaffolds, which was hoped to board the theoretical system of epoxides and explore their potentials for modern applications. The bi- to tetra-functional epoxides were used to cross-link collagen solutions and establish the gel-like precursors, then using freeze-drying to form the final sponges. The SEM observed that the sponges had shown regular porous structures with a wide range of pore sizes from 160 to 440 μm. The sponges had presented the resistance to enzymatic degradation, shape-remaining ability, and reversible compressibility in aqueous environments, which all could be regulated through the functionalities of epoxides. The regulation abilities of multi-functional epoxides on the performances of sponges had been mainly achieved through the cross-linking degrees that the higher functionality of epoxides would bring higher cross-linking degree. Such higher cross-linking degrees could enhance the elastic behaviors of gel-like precursors, and improve the compressive strengths and thermal stabilities of sponges. Nevertheless, the multi-functional epoxides had barely affected the safety of collagen sponges at the cellular level according to the results of CCK8 assay and the SEM and CLSM images of L929 fibroblasts cultured on the cross-sections of sponges.

Graphical abstract
Can introduction of sleep hygiene videos improve sleep and concentration in 5th and 6th graders? Interventional study
Authors: Hassanin Eman , Peters Shelbea , Rotimi Folasade
Published: October 2023

Background

Insomnia is a very common condition in childhood with a prevalence of 25–50%. It can present as difficulty with initiating and maintaining sleep with frequent disruptions throughout the night. Sleep insomnia is known to affect children’s development and contribute to poor attention and memory. Establishing a good sleep routine will have a beneficial effect not just on the child’s wellbeing and development but the whole family.

The objective of the study was to assess the effectiveness of sleep hygiene videos in improving sleep quality and subsequent cognitive function in children aged 10–11 years.

Two cartoon videos on sleep hygiene were designed along with a child-friendly questionnaire to be filled by grade 5 and 6 students in two different schools in the city of Leeds, England. Questionnaires were filled prior to viewing the videos and 2 to 3 weeks afterward to assess response to the video contents. The videos were viewed in April and May 2022.

Results

In the East of Leeds School, 49 students participated. In the North of Leeds School, 45 students participated. Significance of outcomes were analysed using the Wilcoxon signed-rank test. In the first school, there was a significant improvement in sleep duration, sleep disturbance, sleep latency, daytime dysfunction due to sleepiness and sleep efficiency (p < 0.05). In the second school, there was a significant improvement in sleep duration, sleep disturbance and sleep latency (p < 0.05).

Conclusion

Poor sleep function is a major issue in children. The results demonstrated that the use of sleep hygiene videos can support children with sleep difficulties and help them to modify their behaviour through self-health promotion.