bluuebunny/crossref_metadata_2025 huggingface dataset:
International Law and Technology as a Critical Project: A Collective Reading
Authors: Van Den Meerssche Dimitri
Published: December 2024

This introductory essay traces key themes that run through the five contributions collected in this book review symposium. Distilling common threads and intersecting interventions, the essay aims to draw the contours of an emerging and distinct critical project in the interdisciplinary sphere of international law and technology. It insists on grounding these reflections in the here and now – in relation to the deployment of advanced algorithmic technologies in the ongoing campaign of ethnic cleansing, starvation and civilian targeting in Gaza. A prevailing legal response to harms inflicted or amplified by new technological tools – including military targeting tools such as those deployed in Gaza – has been to extend the reach of existing rights or propose new legal entitlements adapted to the digital domain. In contrast to such attempts at throwing out the ‘normative net’ of international law over a digital domain presumed to be devoid or deficient of norms, critical readings – as illustrated by the essays in this symposium – foreground the co-constitutive relations between the legal and the socio-technical. International legal labour today, as these contributions show, is always already dependent on, constitutive of and routed through digital infrastructures. In tracing these relations and emergent compositions, the critical approaches canvassed here provide both a politically energized exploration of emergent governance formations – extending from the spheres of security and surveillance to the logistical networks that sustain the circulation of capital – and an opening towards new practices of regulation, resistance or refusal orientated towards the material, socio-technical and infrastructural.
Effectiveness of electronic medical record-based strategies for death and hospital admission endpoint capture in pragmatic clinical trials
Authors: Rahafrooz Maryam , Elbers Danne C , Gopal Jay R , Ren Junling , Chan Nathan H , Yildirim Cenk , Desai Akshay S , Santos Abigail A , Murray Karen , Havighurst Thomas , Udell Jacob A , Farkouh Michael E , Cooper Lawton , Gaziano J Michael , Vardeny Orly , Mao Lu , Kim KyungMann , Gagnon David R , Solomon Scott D , Joseph Jacob
Published: December 2024

Objective

Event capture in clinical trials is resource-intensive, and electronic medical records (EMRs) offer a potential solution. This study develops algorithms for EMR-based death and hospitalization capture and compares them with traditional event capture methods.

Materials and Methods

We compared the effectiveness of EMR-based event capture and site-captured events adjudicated by a clinical endpoint committee in the multi-center INfluenza Vaccine to Effectively Stop cardio Thoracic Events and Decompensated heart failure (INVESTED) trial for participants from the Veterans Affairs healthcare system. Varying time windows around event dates were used to optimize events matching. The algorithms were externally validated for heart failure hospitalizations in the Medical Information Mart for Intensive Care (MIMIC)-IV database.

Results

We observed 100% sensitivity for death events with a 1-day window. Sensitivity for cardiovascular, heart failure, pulmonary, and nonspecific cardiopulmonary hospitalizations using discharge diagnosis codes varied between 75% and 95%. Including Centers for Medicare & Medicaid Services data improved sensitivity with no meaningful decrease in specificity. The MIMIC-IV analysis showed 82% sensitivity and 99% specificity for heart failure hospitalizations.

Discussion

EMR-based method accurately identifies all-cause mortality and demonstrates high accuracy for cardiopulmonary hospitalizations. This study underscores the importance of optimal time windows, data completeness, and domain variability in EMR systems.

Conclusion

EMR-based methods are effective strategies for capturing death and hospitalizations in clinical trials; however, their effectiveness may be influenced by the complexity of events and domain variability across different EMR systems. Nonetheless, EMR-based methods can serve as a valuable complement to traditional methods.
Strategic Incentives for Adopting the Global Minimum Tax
Authors: Cui Wei
Published: December 2024

The USA, alongside many other nations, presently faces a vital policy choice: should it adopt the global minimum tax proposed by the Organization for Economic Cooperation and Development, purportedly to ensure basic levels of corporate taxation of large multinationals? I set out a framework for analyzing and predicting global minimum tax adoption by self-interested, national-income-maximizing governments. Contrary to both popular and prior scholarly claims, the global minimum tax is incentive incompatible: countries from which multinationals originate will likely suffer deep losses; the tax’s purported enforcement tool, even read in an aggressive, controversial fashion, is ineffective. The global minimum tax may unravel despite initial adoption. (JEL codes: F23, F55, H25, H73, H87, K34).
A determination of the cosmic microwave background temperature using Galactic molecules
Authors: Cooke Ryan , Welsh Louise
Published: December 2024

We report a new, reliable determination of the cyano radical (CN) excitation temperature of diffuse molecular clouds in the Milky Way, based on ultrahigh spectral resolution observations. Our determination is based on CN $B^{2}\Sigma ^{+}-X^{2}\Sigma ^{+}$ (0, 0) vibronic band absorption spectra seen along the lines of sight to eight bright Galactic stars. Our analysis is conducted blind, and we account for multiple sources of systematic uncertainty. Like previous studies, our excitation temperature measures exhibit an intrinsic scatter that exceeds the quoted uncertainties. Accounting for this scatter, we derive a 3 per cent determination of the typical CN excitation temperature, $T_{01}=2.769^{+0.084}_{-0.072}~{\rm K}$, which is consistent with the direct determination of the cosmic microwave background (CMB) temperature. We also perform a single joint fit to all sightlines simultaneously, and find that our data can be fit with an excitation temperature $T_{01}=2.725\pm 0.015~{\rm K}$ – a 0.55 per cent measure that is consistent with the CMB temperature. We propose a future observational strategy to reduce systematic uncertainties and firmly test the limitations of using CN as a CMB thermometer.
edge: dark matter core creation depends on the timing of star formation
Authors: Muni Claudia , Pontzen Andrew , Read Justin I , Agertz Oscar , Rey Martin P , Taylor Ethan , Kim Stacy Y , Gray Emily I
Published: December 2024

We study feedback-driven cold dark matter core creation in the edge suite of radiation-hydrodynamical dwarf galaxy simulations. Understanding this process is crucial when using observed dwarf galaxies to constrain the particle nature of dark matter. While previous studies have shown that the stellar mass to halo mass ratio $(M_{\star } / M_\mathrm{200})$ determines the extent of core creation, we find that in low-mass dwarfs there is a crucial additional effect, namely the timing of star formation relative to reionization. Sustained post-reionization star formation decreases central dark matter density through potential fluctuations; conversely, pre-reionization star formation is too short-lived to have such an effect. In fact, large stellar masses accrued prior to reionization are a strong indicator of early collapse, and therefore indicative of an increased central dark matter density. We parametrize this differentiated effect by considering $M_{\star ,\mathrm{post}}/M_{\star ,\mathrm{pre}}$, where the numerator and denominator represent the stellar mass formed after and before $z\sim 6.5$, respectively. Our study covers the halo mass range $10^9 \ \mathrm{M}_\odot < M_{200} < 10^{10} \ \mathrm{M}_\odot$ (stellar masses in the range $10^4 \ \mathrm{M}_\odot < M_{\star } < 10^8 \ \mathrm{M}_\odot$), spanning both ultra-faint and classical dwarfs. In this regime, $M_{\star ,\mathrm{post}}/M_{\star ,\mathrm{pre}}$ correlates almost perfectly with the central dark matter density at $z=0$, even when including simulations with a substantially different variant of feedback and cooling. We provide fitting formulae to describe the new-found dependence.
Understanding the Acid-Base Response to Respiratory Derangements: Finding, and Clinically Applying, the In Vivo Base Excess
Authors: Heldeweg Micah L. A. , Berend Kenrick , Schober Patrick , Duška František
Published: December 2024

OBJECTIVES:

To evaluate the base excess response during acute in vivo carbon dioxide changes.

DESIGN:

Secondary analysis of individual participant data from experimental studies.

SETTING:

Three experimental studies investigating the effect of acute in vivo respiratory derangements on acid-base variables.

SUBJECTS:

Eighty-nine (canine and human) carbon dioxide exposures.

INTERVENTIONS:

Arterial carbon dioxide titration through environmental chambers or mechanical ventilation.

MEASUREMENTS AND MAIN RESULTS:

For each subject, base excess was calculated using bicarbonate and pH using a fixed buffer power of 16.2. Analyses were performed using linear regression with arterial dioxide (predictor), base excess (outcome), and studies (interaction term). All studies show different baselines and slopes for base excess across carbon dioxide titrations methods. Individual subjects show substantial, and potentially clinically relevant, variations in base excess response across the hypercapnic range. Using a mathematical simulation of 10,000 buffer power coefficients we determined that a coefficient of 12.1 (95% CI, 9.1–15.1) instead of 16.2 facilitates a more conceptually appropriate in vivo base excess equation for general clinical application.

CONCLUSIONS:

In vivo changes in carbon dioxide leads to changes in base excess that may be clinically relevant for individual patients. A buffer power coefficient of 16.2 may not be appropriate in vivo and needs external validation in a range of clinical settings.
Examination of the Corneal Endothelium in Patients With Congenital Aniridia With a PAX6 Mutation Using In Vivo Confocal Laser Scanning Microscopy
Authors: Csidey Mária , Csorba Anita , Kormányos Kitti , Náray Annamária , Kéki-Kovács Klaudia , Németh Orsolya , Knézy Krisztina , Bausz Mária , Szigeti Andrea , Szabó Dorottya , Corton Marta , Tory Kálmán , Jávorszky Eszter , Nagy Zoltán Zsolt , Maka Erika , Langenbucher Achim , Sperlich Karsten , Stachs Oliver , Winter Karsten , Szentmáry Nóra
Published: December 2024

Purpose:

In PAX6 syndrome, it is still not clear, whether prenatally, parallel to the iris tissue developmental anomaly, there is neural ectodermal, neural crest, or mesodermal cell deposition at the corneal endothelium, affecting endothelial structure and function. In addition, because of the postnatal corneal inflammation and commonly appearing secondary glaucoma, progressive endothelial changes are expected. Our purpose was to study the corneal endothelium in subjects with PAX6 aniridia, using in vivo confocal laser scanning microscopy.

Methods:

Twenty-seven eyes of 16 subjects with congenital aniridia (age 28.25 ± 16.32 [11–59] years, 8 [50%] female) and 40 eyes of 26 healthy subjects (age 33.8 ± 15.2 [14–67] years, 17 [58.6%] females) were examined. Aniridia-associated keratopathy and iris malformation were graded, and means of endothelial cell density, cell area, cell diameter, spatial pattern of cell centroids (Clark–Evans index), polygonality, neighbor count, percentage of hexagonal cells, and endothelial deposit number were determined by in vivo confocal laser scanning microscopy.

Results:

Mean cell diameter and mean Clark–Evans index were significantly lower (P = 0.049; P = 0.008) in congenital aniridia eyes than in controls. There were hyperreflective endothelial deposits in congenital aniridia eyes but not in controls (P < 0.001). Only aniridia-associated keratopathy grade correlated positively with mean endothelial deposit number (P = 0.017).

Conclusions:

In congenital aniridia, the corneal endothelium might possess a slightly better quality and greater reserves than in healthy subjects. Corneal endothelial deposition seems to be independent from developmental abnormalities but may be related to up to date undescribed endothelial inflammatory or metabolic changes.
“We Are the Bridge.” A Qualitative Approach to Compare Value Perceptions of Rehabilitation Therapists in the Academic Medical Center
Authors: Felter Cara , Garguilo Emily , Keys Rylenn , Kim Diana , Saathoff Emmy , Johnson Diana , Wells Chris
Published: December 2024

Introduction and Review of Literature:

Rehabilitation therapists contribute to academic medical center (AMC) teams. However, their self-perceptions of the value they add in the AMC have not been fully explored, which may contribute to misunderstandings about their role in the AMC. The purpose of this study was to explore and compare rehabilitation therapists’ perceived value in the AMC from the viewpoints of rehabilitation therapists and non-rehabilitation therapists (NRTs).

Subjects:

A convenience sample of 25 rehabilitation therapists and 16 NRTs participated in this study.

Methods:

Participants were recruited via email to answer a survey including demographic data and an invitation to participate in a focus group. Therapist participants were also surveyed about their perceived value. Survey data were analyzed in Microsoft Excel. Focus groups were conducted virtually, and data were analyzed using a grounded theory approach. Coding was performed iteratively until the researchers derived the themes and subthemes.

Results:

Quantitative data indicated that rehabilitation therapists believed they were more valued by fellow therapists than NRTs. Qualitative themes from the therapists were: (1) value in our unique professional role, (2) misunderstandings of the professional role, (3) lack of respect about what we contribute, and (4) bridging the gaps between the patient and caregivers with the rest of the interprofessional team. NRTs’ themes were: (1) role of the therapist, (2) therapy as a resource, and (3) value to patients and NRTs.

Discussion and Conclusions:

Data demonstrated differences in therapists’ and NRTs’ perceptions of value and guided opportunities for AMC leaders to improve interprofessional communication and collaboration to influence a positive culture shift. A deeper understanding of rehabilitation therapists’ value could enhance therapists’ professional identity and their interprofessional interactions in the AMC.
Potential preventive effects of time-restricted eating on cancer
Authors: Fang Ruo-Xin , Yan Ling , Liao Zheng-Kai
Published: December 2024

Intermittent fasting is a novel dietary intervention that has been demonstrated to improve the efficacy of cancer therapy and reduce complications. Time-restricted eating is a specific form of intermittent fasting. It usually restricts only the daily eating window and not the amount of calories consumed. In addition to providing a means for weight management and improving metabolism like other intermittent fasting methods, time-restricted eating also synchronizes circadian rhythms and affects autophagy levels, which has potential antiaging effects. Some studies have shown that time-restricted eating can prevent tumorigenesis and slow tumor progression. Moreover, because of its simplicity and mild adverse effects, time-restricted eating is safe and has a high rate of compliance. It may be used an adjuvant therapy and may be part of a healthy lifestyle suitable for long term by cancer patients or those at high risk of developing specific cancers. This article expounds on the potential impact of time-restricted eating on the prevention and treatment of cancer, as well as the potential mechanism(s) of action. There are 3 main aspects considered to be impacted by time-restricted eating: improving obesity and metabolic disorders, synchronizing the circadian rhythm, and upregulating autophagy. We herein present the current research progress related to the effects of time-restricted eating on malignant tumors. The purpose of this review is to provide a theoretical basis and direction for future research to explore the potential of time-restricted eating as a nutritional intervention to prevent the occurrence of cancer and as a treatment or adjuvant therapy for cancer. We believe that this approach may be conducive to improving the nutritional status of cancer patients and improving their prognosis and quality of life.
Mechanistic associations between dietary patterns and colorectal cancer
Authors: Han Jing-Xiang , Liu Cheng-Fei , Xu Shao-Qiang , Cao Ying-Lei , Wang Yan-Li , Yao Tian , Qiu Fu-Bin , Huang He
Published: December 2024

Colorectal cancer (CRC) is a common cancer with high morbidity and mortality rates. Its occurrence and development are determined by many factors, including genetics, the environment, lifestyle, and so on. The occurrence of CRC is often accompanied by changes in the intestinal microenvironment. Numerous studies have focused on the association between dietary patterns, dietary components, and CRC now. This article reviews five different dietary patterns: the Western diet, the Mediterranean diet, the ketogenic diet, the Dietary Approaches to Stop Hypertension diet, and fasting, and the mechanistic associations between their food components and CRC. The finding can provide a reference for further studies on the association between different dietary patterns and CRC and will help clinicians formulate reasonable and feasible dietary interventions.
Association of T lymphocyte subset counts with the clinical features of colorectal cancer
Authors: Zhang Lei , Shi Yong-Can , Yang Ying-Xin , Wang Zhi-Guo , Wang Song-Song , Zhang Hua
Published: December 2024

Background

Colorectal cancer (CRC) is a common gastrointestinal malignancy. The T lymphocyte subsets are important in the development, invasion and metastasis of tumors, including CRC. Nevertheless, limited research has explored the relationship between T cell subpopulations and the clinical characteristics of CRC. This study compared the T lymphocyte subsets in patients with CRC and healthy individuals and assessed the relationship between these values and clinical characteristics.

Methods

Peripheral blood was collected from 100 patients with CRC and 54 healthy individuals. The numbers of CD3+ T, CD4+ T, and CD8+ T lymphocytes, natural killer (NK) cells, and the CD4+/CD8+, ratio in peripheral blood were measured using flow cytometry and were compared between CRC patients and healthy individuals. Spearman’s correlation analysis was performed to investigate the relationship between the T lymphocyte subsets in patients diagnosed with CRC and the levels of carcinoembryonic antigen (CEA) and thymidine kinase 1 (TK1). Receiver operating characteristic (ROC) curves were utilized to evaluate the potential utility of the T lymphocyte counts in predicting lymph node metastasis, vascular infiltration, and high Ki-67 expression.

Results

The CRC patients had lower counts of CD3+ T, CD4+ T, and CD8+ T lymphocytes compared to the healthy population (P < 0.05). However, no significant differences were observed in the CD4+/CD8+ ratio or NK cells (P > 0.05). Notably, the CD3+ T, CD4+ T, and CD8+ T lymphocyte counts were higher in patients with stage I-II disease, no lymph node metastasis, no vascular invasion, and low Ki-67 expression than in those with stage III, lymph node metastasis, vascular invasion, and high Ki-67 expression (P < 0.05). There was a negative association between the CD3+ T, CD4+ T, and CD8+ T lymphocyte counts and CEA and TK1 levels in patients with CRC. The ROC curves demonstrated that CD3+ T, CD4+ T, and CD8+ T lymphocyte counts had significant predictive value for lymph node metastasis, vascular infiltration, and high Ki-67 expression.

Conclusions

The peripheral blood CD3+ T, CD4+ T, and CD8+ T lymphocyte counts are related to the clinical traits of patients with CRC and can predict the prognosis of the disease.
Dietary patterns and cancer prognosis
Authors: Zhang Chu-Ying , Zhang Ge-Ge , Cheng Hao-Qing , Guo Peng-Xia , Fida Saba , Song Chun-Hua
Published: December 2024

Cancer is the leading cause of global mortality, resulting in millions of deaths each year. Even a small attenuation in cancer rates through preventive care can have a significant impact. Dietary habits are closely associated with cancer. Unhealthy eating habits may contribute to traditional risk factors and accelerate the progression of cancer. Recent studies have demonstrated the potential of healthy dietary interventions in the prevention and treatment of various cancers, particularly through dietary patterns such as the Mediterranean diet, Dietary Approaches to Stop Hypertension diet, plant-based diet, and ketogenic diet. This review summarizes several studies on the impact of dietary patterns on cancer prognosis and explores the recent findings regarding the mechanisms through which dietary interventions influence cancer progression and prognosis.
Gender Minority Physician Assistant/Associate Applicants and Likelihood of Matriculation: A Retrospective Analysis
Authors: Rolls Joanne , Showstark Mary , Najmabadi Shahpar , Loder Rayne , Barry Carey , Honda Trenton
Published: December 2024

Introduction

Gender minorities are undermeasured among physician assistant/associate programs and across the profession. This study describes the 2020 to 2021 Centralized Application Service for Physician Assistants self-identified gender minority applicant pool, examining whether gender minority status is associated with matriculation.

Methods

A retrospective cohort of 2020 to 2021 admission cycle participants (n = 30,123) was described and evaluated for associations between self-identified gender minority status and likelihood of program matriculation using logistic regression. Models were controlled for important potential confounders, including total undergraduate grade point average, race/ethnicity, hours of patient experience, and age.

Results

Of the 30,123 total applicants, 0.21% (n = 63) self-identified as a gender minority. Total matriculation was 27.64% (n = 8325) compared with gender minority matriculation of 20.63% (n = 13). Gender minority status was associated with a nonsignificant lower likelihood of matriculation (odds ratio [OR] = 0.68; 95% confidence interval [CI]: 0.37–1.25). Fully adjusted models were unchanged controlling for academic achievement, patient care experience, age, and race/ethnicity (OR = 0.83; 95% CI: 0.51–1.35).

Discussion

These findings suggest that gender minority applicants have a similar likelihood of matriculation in physician assistant/associate programs as compared with non–gender minority applicants. Low prevalence of self-identified gender minority status could indicate reluctance to self-identify and is concerningly lower than population prevalence.
Immune checkpoint inhibitors in the posttransplant landscape of HCC: A systematic literature review
Authors: Kahramangil Doga , Zarrinpar Ali , Sahin Ilyas
Published: December 2024

Immune checkpoint inhibitors (ICIs) have shown promise in the treatment of HCC. However, their safety and efficacy in recipients of liver transplants with recurrent HCC remain unclear. This systematic review aims to evaluate the use of ICIs for recurrent HCC after liver transplantation (LT) and to identify potential predictive factors associated with graft rejection and treatment response. A comprehensive literature search was conducted using PubMed and Scopus databases to identify case reports and case series describing the use of ICIs for HCC recurrence after LT. Data on patient characteristics, treatment details, and outcomes were extracted and analyzed. Twenty-one case reports and case series involving 39 patients were included. The median time from LT to ICI initiation was 24 months. Nivolumab was the most commonly used ICI (59.0%). Among all cases, 25.6% demonstrated a positive response, including stable disease and partial or complete response, while 46.2% experienced progressive disease. Graft rejection occurred in 20.5% of patients, with 50% of these cases resulting in death. Although reported in only some of the cases (17 out of 39), positive programmed cell death ligand-1 expression was associated with a higher risk of graft rejection (66.7%) compared to negative expression (0%). calcineurin inhibitors-based immunosuppressive regimens appeared to have lower rejection rates (20%) compared to mammalian target of rapamycin inhibitor-based regimens (80%). ICIs show potential for treating recurrent HCC after LT, but the risk of graft rejection is significant. Careful patient selection, close monitoring, and individualized management of immunosuppression are crucial. Positive programmed cell death ligand-1 expression and the choice of immunosuppressive regimen appear to influence the risk of graft rejection; however, these findings are based on limited data. Prospective studies with larger sample sizes are needed to validate these findings and establish evidence-based guidelines for the use of ICIs in the posttransplant setting.
Advantages of using touch-controlled, minimally invasive implantation technique on soft tissue in the aesthetic zone of maxillary anterior teeth
Authors: Li Wenchao , Ruan Ning , Tian Yuan , Li Senhao , Boldbaatar Damdindorj , Badral Batbayar
Published: December 2024

Endosseous implant is an ideal treatment option for the treatment of denture defects and omissions. However, how to maintain the perfect gum contour of patients has been an important research topic for stomatologists and has attracted much attention. The objective of this study was to explore the advantages of minimally invasive touch-controlled implantation in maintaining soft tissue morphology in the aesthetic area of maxillary anterior teeth. Forty patients underwent preoperative cone-beam computed tomography and were randomly divided into 2 groups: experimental group (touch-controlled, minimally invasive implantation approach, n = 20) and control group (traditional flap implantation approach, n = 20). The operative time, postoperative pain, gingival recession, and patient satisfaction were compared between the 2 groups. The independent sample t test was employed to compare the results, with a significance level of α = 0.05. Statistical significance was determined at P < .05. The operative time was 4.50 and 9.21 minutes, respectively, for 2 groups, P < .001. The mean pain scores of 2 groups were 1.09 and 2.14, respectively, at 24 hours after surgery, P < .001. The H values (the distance from the labial edge of the implant healing cap to the lowest gingival margin), 6 weeks after surgery, of 2 groups were 2.69 and 3.05, respectively, P = .023. There was a significant difference in patient satisfaction between 2 groups 24 hours after surgery (P < .001). Touch-controlled minimally invasive implantation has shorter operative time and lesser bleeding, postoperative pain, and gingival recession than traditional flap implantation, which is conducive to the preservation of gingival shape.
No need for hip precautions after total hip arthroplasty with posterior approach: A systematic review and meta-analysis
Authors: Guo Jiale , He Qionghan , Sun Yue , Liu Xianglong , Li Yehai
Published: December 2024

Background:

Nowadays, total hip arthroplasty (THA) is one of the most successful procedures in the field of orthopedics and trauma. The posterior approach has historically been associated with a higher rate of hip dislocation. To reduce the rate of hip dislocation in the posterior approach, most orthopedic surgeons would recommend hip precautions (HP) for their patients postoperatively based on previous theories. However, recent randomized controlled trials have shown no significant difference in hip dislocation rates with or without HP, in contrast to previous theories. Based on these, this study conducted a meta-analysis of these randomized controlled trials to try to get qualitative conclusions.

Methods:

Randomized controlled trials of HP after THA up to July 28, 2023, were searched in 3 databases, PubMed, Embase, and the Cochrane Library. Data extraction and literature quality assessment were performed by 2 independent authors and extracted hip dislocation, hip disability and Osteoarthritis Outcome Score, joint replacement (HOOS JR) scores over 6 weeks, and time to discontinuation of mobility aids. Stata software and Revman software were used to perform this meta-analysis.

Results:

Following screening, 3 papers with a total of 1215 participants were included in the analysis. This meta-analysis showed that there was no statistically significant difference in hip dislocation rates with or without HP after THA undergoing the posterior approach and that the without HP group instead showed better outcomes in terms of HOOS JR scores and time to discontinuation of mobility aids.

Conclusion:

THA with a posterior approach does not require hip precautions.
Wnt5a manipulate the progression of osteoarthritis via MMP-13 dependent signaling pathway
Authors: Minghua Sun , Jiwei Tian , Lei Zhang , Jizhou Qi , Zhiyuan Liu , Jiangang Cao
Published: December 2024

The object of this study was to propose a Wnt5a–matrix metalloproteinase (MMP)-13 dependent signaling axis for osteoarthritis (OA) progression. To this end, the chondrocytes were isolated from both OA patients and normal controls. The chondrocytes were treated with diverse concentrations of Wnt5a (0, 50, 100, and 200 ng/mL), respectively. The expression levels of Wnt5a, MMP-13, and Collagen type II were examined using reverse transcription-polymerase chain reaction and western blotting. At the same time, the cell proliferation and cell apoptosis of chondrocytes were also observed. Compared with control tissues, the activities of Wnt5a and MMP-13 were significantly enhanced in chondrocytes of OA patients. Treated with different concentrations of Wnt5a (0, 50, 100, and 200 ng/mL), chondrocyte cell proliferation was clearly downregulated. At the same time, the chondrocyte cell apoptosis was obviously accelerated. The expression pattern of Collagen type II was same as cell proliferation manner. Co-treatment of MMP-13 siRNA could significantly compensate the functions of Wnt-5a administration, suggesting MMP-13 was a direct target of Wnt-5a. Collectively, the study speculated a novel Wnt5a–MMP-13 molecular mechanism for OA progression and shed an innovative signaling axis for the disorder.
High dietary calcium to phosphorus ratio is associated with high prevalence of kidney stone
Authors: Zhang Weiyu , Lou Benxing , Peng Yu , Wu Feng , Zhang Dan , Wang Qi
Published: December 2024

Kidney stones formation is a multifactorial condition and influenced, in some degree, by dietary habits. Authoritative clinical guidelines published nutritional recommendations for individuals prone to kidney stone formation. The association between dietary intake calcium to phosphorus (Ca/P) ratios and the prevalence of kidney stones is not well-established in extensive epidemiological studies. Data from the National Health and Nutrition Examination Survey 2017 to 2018 database were utilized in this study. A total of 3 149 participants with a history of kidney stones were enrolled in the present analysis. The participants were categorized into 4 groups based on their dietary Ca/P ratio, divided by quartiles, with quartile 1 representing the lowest ratio and quartile 4 indicating the highest ratio. We applied survey-weighting to all the data and conducted logistic regression models to assess the connections between Ca/P ratio and the likelihood of developing kidney stones. We utilized restricted cubic spline analysis to assess the nonlinear relationship between dietary Ca/P ratio intake and the risk of kidney stones. In a fully adjusted model referred by quartile 1, participants in quartile 4 had a significantly higher rate of kidney stones (odds ratio 1.5697, P < .001). Compared with single calcium or phosphorus consumption, the Ca/P ratio was found to be a better predictor of the risk of kidney stones. The quartile analysis suggested an appropriate Ca/P ratio of 0.5513 to 0.6810 to meet a lower risk of kidney stones. There was a significant association between dietary Ca/P ratio intake and the risk of kidney stones. A moderate intake of dietary Ca/P ratio was recommended.
Integrated approach of scalp electroacupuncture and pharmacotherapy in managing Parkinson’s disease: A systematic review, meta-analysis, and trial sequential analysis of randomized clinical trials
Authors: Li Hanzhang , Ju Geyongqin , Chen Jiayi , Wang Yao
Published: December 2024

Background:

Parkinson disease (PD) is a progressive neurological disorder that may be managed with therapies like scalp electroacupuncture (SEA). The combination of SEA and medication could potentially offer a new approach for managing PD symptoms. The systematic review and meta-analysis aimed to assess the combined impact of SEA and medication on PD through a comprehensive analysis of randomized clinical trials, focusing on outcomes like effective rate and various scores (total Unified Parkinson Disease Rating Scale (UPDRS), UPDRS III, and Webster).

Methods:

It was conducted an unrestricted search from the beginning of each database until April 19, 2024, across 7 databases. These included 4 international databases: PubMed, Web of Science, Scopus, and Cochrane Library, and 3 Chinese databases: CNKI, VIP, and Wanfang. Review Manager, version 5.3 was used to calculate the mean difference (MD) or risk ratio along with a 95% confidence interval (CI). The Comprehensive Meta-Analysis version 3.0 was employed for conducting bias analyses, meta-regression, and sensitivity analyses.

Results:

From 1422 records identified in the databases, 17 articles were included in both the systematic review and meta-analysis. The pooled risk ratio and its 95%CI in the intervention (SEA + medication) group compared to the control (medication) group for the effective rate is 1.24 [1.17, 1.32] with a P < .00001. The pooled MD and its 95%CI for the Webster score is −0.51 [−6.36, 5.35] with a P = .86. The pooled MD and its 95%CI for total UPDRS is 8.73 [2.88, 14.58] with a P = .003. The pooled MD and its 95%CI for UPDRS III is 4.42 [3.23, 5.61] with a P < .00001. The results for total UPDRS and UPDRS III showed that intervention reduced the severity and progression of PD in patients more than medication.

Conclusions:

The intervention (SEA + medication) has shown significant effectiveness compared to the control (medication) in terms of the effective rate, total UPDRS, and UPDRS III in PD patients. However, it did not show a significant effect on the Webster score.
Short and long-term mortality of spontaneous bacterial peritonitis in cirrhotic patients
Authors: Hung Tsung-Hsing , Wang Chih-Ying , Tsai Chih-Chun , Lee Hsing-Feng
Published: December 2024

Spontaneous bacterial peritonitis (SBP) remains a significant concern for patients with cirrhosis. This study aims to reevaluate the trends in both short-term and long-term mortality rates associated with SBP. A retrospective cohort study was conducted using population data obtained from Taiwan’s Health and Welfare Data Science Center, Ministry of Health and Welfare. The database, derived from Taiwan’s National Health Insurance program, included information from 925 cirrhotic patients discharged after an episode of SBP between January 01, 2014 and December 31, 2015. Each patient’s outcomes were tracked for up to 3 years following their initial hospitalization for SBP. The overall mortality rates for cirrhotic patients with SBP at 30 days, 90 days, 1 year, and 3 years were 10.8%, 23.0%, 44.0%, and 60.9%, respectively. Following Cox regression analysis with adjustments for patient age, gender, and underlying medical conditions, the short-term prognostic factors of significance were age (hazard ratio [HR] = 1.03, 95% confidence interval [CI] = 1.01–1.05, P = .001), concurrent sepsis (HR = 2.73, 95% CI = 1.82–4.08, P < .001), and renal function impairment (HR = 3.28, 95% CI = 2.07–5.18, P < .001). Although the 30-day mortality rate for SBP in cirrhotic patients is around 10%, the long-term mortality remains significantly high. Renal function impairment and the presence of concurrent sepsis serve as indicators of poor short-term prognosis in cirrhotic patients with SBP.
Causal relationship between sleep apnea and prostatitis: A 2-sample Mendelian randomization study
Authors: Chen Lifeng , Huang Jiaguo , Sun Ji , Fan Yi , Xie Yinfang
Published: December 2024

Observational studies indicate that the risk of prostatitis in sleep apnea patients is higher than those without sleep apnea. However, the causal relationships remain to be determined. This study aims to investigate the causal relationships of sleep apnea on prostatitis using Mendelian randomization (MR). Summary-level data for sleep apnea (16,761 cases and 201,194 controls) and prostatitis (1859 cases and 72,799 controls) were available from the GWAS summary data. Two-sample MR analyses were performed to investigate the causal relationship between sleep apnea and prostatitis. The inverse variance weighted (IVW) analysis was employed as the primary statistical method. In 2-sample MR analyses, we found that IVW estimates revealed that sleep apnea inferred an effect on risk of prostatitis at statistical significance (odds ratio [OR] = 1.370, 95% confidence interval [CI] = 0.094–0.535, P = .005). This MR study strengthens the evidence of a causal relationship between sleep apnea and prostatitis in Europeans.
Study on the predictive value of APACHE II score and neurogenic dysphagia in carbapenem-resistant Klebsiella pneumoniae
Authors: Zhou Xuan , Zhang Zhipeng , Wang Xiaoqiong , Wang Yongsheng
Published: December 2024

Carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a growing challenge in clinical treatment globally. Early identification of high-risk patients is essential to control infection spread and improve treatment outcomes. This retrospective study analyzed 152 patients with K pneumoniae infections at the Second People’s Hospital of Hefei City, Anhui Province, dividing them into carbapenem-resistant and non–carbapenem-resistant groups. Clinical data, microbiological test results, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, and neurogenic dysphagia status were evaluated to identify risk factors for CRKP infection. The study revealed that patients in the carbapenem-resistant group had significantly higher APACHE II scores and a higher incidence of neurogenic dysphagia (P < 0.05). Multivariate logistic regression analysis identified APACHE II scores and neurogenic dysphagia as independent risk factors for CRKP infection. Receiver operating characteristic curve analysis showed an area under the curve of 0.824 (95% confidence interval: 0.749–0.898) for the APACHE II score, with an optimal threshold of 14.5 points. A new predictive model combining neurogenic dysphagia with APACHE II scores improved classification performance, as demonstrated by Net Reclassification Improvement (NRI = 0.0967, 95% confidence interval: −0.0477 to 0.2410) and reclassification probability analysis, correctly reclassifying 24.32% of individuals into a higher risk category. The findings highlight the combined predictive value of APACHE II scores and neurogenic dysphagia for early identification and intervention in high-risk CRKP patients.
Relationship between neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio and osteoporosis in postmenopausal type 2 diabetic patients: A retrospective study
Authors: Xue Yuan , Bao Weichao , Huang Wenying , Zou Xin , Guo Ying
Published: December 2024

Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR) are newly discovered inflammatory markers in recent years. To explore the relationship between NLR, MLR, PLR, and bone mineral density (BMD), as well as osteoporosis (OP), in postmenopausal patients with type 2 diabetes mellitus (T2DM). 320 postmenopausal patients with T2DM who were admitted to the Department of Endocrinology and Metabolic Diseases of our hospital from January 2022 to January 2024 for treatment were included in this retrospective study. The patients were divided into 3 groups according to the BMD: normal bone mass group (n = 109), osteopenia group (n = 99), and OP group (n = 112). Clinical data and blood laboratory parameters were collected from the patients. The NLR, MLR, and PLR were calculated. Statistically significant differences were found in the comparison of NLR, MLR, and PLR among the 3 groups of patients (P < .001). The OP group had higher NLR, MLR, and PLR than the normal bone mass group and the osteopenia group. NLR, MLR, and PLR were negatively correlated with BMD at the lumbar spine (L1-L4), left femoral neck, and left hip, respectively. Analysis revealed that elevated levels of NLR and PLR were independent risk factors for OP in postmenopausal patients. The results of the receiver operating characteristic curve analysis indicated that the area under the curve (AUC) for NLR was higher than that of PLR. Combined use of NLR and PLR resulting in an improved AUC of 0.904. Neutrophils produce mediators such as interferon-gamma (IFN-γ), interleukin-6 (IL-6), interleukin-1 (IL-1), and receptor activator of nuclear factor kappa-B ligand (RANKL), which increase the number and activity of osteoclasts. Peripheral blood monocytes play a vital role in osteoclastogenesis as osteoclast precursors. The BMD of postmenopausal T2DM patients is negatively correlated with NLR, MLR, and PLR. NLR and PLR can both serve as predictive indicators for the occurrence of OP in postmenopausal T2DM patients.
Effect of Tui-Na versus positional release techniques on pregnancy-related low back pain in the third-trimester: A randomized comparative trial
Authors: Elabd Aliaa M. , Hasan Shahnaz , Alghadir Ahmad H. , Elabd Omar M. , Shawky Ghada Mohamed , Iqbal Amir , Marwan Yara N.
Published: December 2024

Background:

Researchers are prioritizing the development of an effective treatment approach for third-trimester pregnancy-related low back pain (LBP), a prevalent and costly disorder. Therefore, this study aimed to examine the effects of Tui-Na (TN) versus positional release techniques (PRT) on third trimester pregnancy-related LBP.

Methods:

Fifty pregnant women in their third trimester with low back pain were randomly assigned to 1 of 2 groups for 4 weeks of prescribed treatment (TN or PRT). The primary outcome was LBP intensity. Secondary outcomes included the Oswestry disability index for back disability and the pressure pain threshold of lumbar tender points. Two-way multivariate analysis of variance was used for the data analysis.

Results:

Multivariate tests indicated statistically significant effects of group (F = 10.062, P < .001, partial η
2 = 0.302), time (F = 473.5, P < .001, partial η
2 = 0.953), and group-by-time interactions (F = 4.045, P < .001, partial η
2 = 0.148). However, the TN group, when compared to the PRT group, revealed a significant decrease in back disability (P < .001, partial η
2 = 0.124) and a significant increase in pressure pain threshold at the Rt and Lt points (P = .02 and .001, partial η
2 = 0.055, and 0.108, respectively). Within-group comparisons were significant for all measured variables in both the groups (P < .001).

Conclusion:

Although both TN and PRT are beneficial treatments for third trimester pregnancy-related LBP, TN leads to more beneficial outcomes.
Enhanced recovery after surgery pathway reduces back pain, hospitalization costs, length of stay, and satisfaction rate of lumbar tubular microdiscectomy: A retrospective cohort study
Authors: Wang Xiaochen , Wang Peng , Wang Lulu , Ding Tao
Published: December 2024

Tubular microdiscectomy is one of the most commonly performed surgical procedures for lumbar disc herniation (LDH). This study aimed to investigate the effectiveness of the enhanced recovery after surgery (ERAS) pathway for microdiscectomy in improving perioperative clinical outcomes in patients with LDH. This study retrospectively analyzed the prospectively collected perioperative outcomes of patients in pre-ERAS (January 2020 to December 2021) and post-ERAS (January 2022 to September 2023) groups. Length of stay was the primary outcome measure, while secondary outcome measures included operative time, estimated blood loss (EBL), postoperative first ambulation time, postoperative drainage volume, drainage tube removal time, complication rate, hospitalization cost, perioperative visual analog scale (VAS) scores for leg pain and low back pain (LBP), readmission rate within 30 days, and patient satisfaction rate. No significant differences in baseline parameters, including sex, age, body mass index, preoperative VAS scores for leg pain and LBP, and comorbidities, were observed between the groups. Additionally, operative time, complication rates, and 30-day readmission rates did not differ significantly between the groups. However, the post-ERAS group exhibited significantly lower length of stay compared to the pre-ERAS group (5.1 ± 1.2 vs 6.2 ± 1.6, P < .001). Additionally, the estimated blood loss (P < .001), drainage tube removal time (P < .001), postoperative drainage volume (P = .002), postoperative first ambulation time (P < .001), and hospitalization costs (P = .032) in the post-ERAS group were significantly lower in the pre-ERAS group. Furthermore, the LBP VAS score was significantly lower on the first day (P = .001) and third days (P = .002) postoperatively in the post-ERAS group, whereas the patient satisfaction rate on the first day (P = .036) postoperatively was significantly higher in the pre-ERAS group. Compared with the conventional pathway, the ERAS pathway in tubular microdiscectomy is associated with better perioperative clinical outcomes in patients with LDH.
Delayed Horner’s syndrome and acute stress disorder caused by a large dog bite on the neck: Case report
Authors: Dai Guoping , Yan Xin
Published: December 2024

Rationale:

The occurrence of delayed Horner’s syndrome caused by a dog bite to the neck is rarely reported. Acute stress disorder (ASD) can easily be neglected when diagnosing this disease in trauma patients who cannot be effectively observed. The symptoms of Horner’s syndrome may not be readily detected in patients with ASD.

Patient concerns:

In this report, we present a rare case of a 55-year-old woman with delayed Horner’s syndrome and ASD who initially presented with an internal jugular vein injury caused by a large dog bite on her left neck.

Diagnosis:

Delayed Horner’s syndrome and ASD.

Interventions:

Neck exploration and internal jugular vein repair were performed under general anesthesia. After the occurrence of Horner’s syndrome and ASD, methylprednisolone and mecobalamin were administered to relieve edema and promote nerve repair, compound anisodine was injected once daily near the left superficial temporal artery to improve microcirculation, escitalopram oxalate and lorazepam were administered to treat anxiety and improve sleep, psychotherapy and narrative nursing were administered once a week.

Outcomes:

In the follow-up 4 months at the outpatient clinic after discharge, the patient’s Horner’s syndrome had not healed, but she did not complain of significant discomfort and affected appearance, and ASD did not recur or develop post-traumatic stress disorder.

Lessons:

Surgeons should be aware of the possibility of sympathetic nerve injury in patients with deep neck injury, especially in patients with internal jugular vein injury. Peripheral nerves should be explored during the operation. Attention should be paid to the possibility of delayed neurological symptoms and the prevention and treatment of ASD after operation.