bluuebunny/crossref_metadata_2025 huggingface dataset:
Breaking the Connection Between Depressive Symptoms and Alcohol Use Among Adolescents With a Text-Message Delivered Intervention: A Randomized Controlled Pilot Trial in Primary Care
Authors: Mason Michael J. , Coatsworth J. Douglas , Russell Michael , Mennis Jeremy
Published: August 2022

Adolescent depression is a significant public health problem reflected in increasing rates of major depressive episodes. Depression is also a critical risk for adolescent substance use. Adolescents who have experienced a major depressive episode are approximately twice as likely to engage in heavy drinking compared to those without. Developing strategies to intervene early and reduce adolescent depressive disorders and alcohol use is warranted. We examined the relationship between adolescent depressive symptoms and alcohol use with 69 adolescents enrolled in a preventive randomized controlled pilot trial for substance use risk within a federally qualified health care setting. We also tested a mediation model to determine if a text-delivered intervention reduced alcohol use by reducing depressive symptoms. Participants were randomized to a 4-week, text-delivered stress-and-coping intervention or a waitlist control condition. Participants completed baseline assessments and monthly follow-up surveys for 3 months. Logistic regression showed that adolescents with probable depressive disorder had six times higher odds of alcohol use compared to those with sub-clinical depressive symptoms. Mediation analysis revealed that the intervention reduced alcohol use by reducing depressive symptoms for adolescents with sub-clinical depressive scores. Results support targeting proximal risk factors such as depressive symptoms among adolescents presenting for primary care with text-delivered preventive interventions in order to reduce alcohol use. Incorporating more intensive interventions for adolescents with a broad range of presenting depressive symptoms is recommended.
‘It’s not something that I should be ashamed of’ understanding the challenges and lived experiences of disadvantaged students during the Covid-19 pandemic
Authors: Thiele Tamara , Homer Damien
Published: August 2022

The pervasive socioeconomic inequalities that exist in relation to higher education participation within the UK are notably prominent amongst the most selective, ‘elite’ universities, and could become wider still following the Covid-19 pandemic. This case study privileges the accounts of 11 young people from low socio-economic status (SES) backgrounds who were directly affected by the pandemic during their final year at school (Year 13) and who had all taken in part in outreach programmes that specifically aimed to improve access to such top universities in England. Through in-depth phenomenological interviews, this provides insight into the educational and life journeys of these individuals, including their experiences of the pandemic and their interactions with outreach programmes, helping to understand the influence they perceived these to have on their choices, aspirations and trajectories. Findings highlight barriers and challenges that could influence the demand for higher education, some which were amplified by the pandemic. These included issues related to individuals’ personal/home circumstances, finance, the schools they attended, but also issues associated with fit and belonging that have been shown to deter many low SES students from applying to top universities.
Modelling artificial intelligence in economics
Authors: Gries Thomas , Naudé Wim
Published: August 2022

We provide a partial equilibrium model wherein AI provides abilities combined with human skills to provide an aggregate intermediate service good. We use the model to find that the extent of automation through AI will be greater if (a) the economy is relatively abundant in sophisticated programs and machine abilities compared to human skills; (b) the economy hosts a relatively large number of AI-providing firms and experts; and (c) the task-specific productivity of AI services is relatively high compared to the task-specific productivity of general labor and labor skills. We also illustrate that the contribution of AI to aggregate productive labor service depends not only on the amount of AI services available but on the endogenous number of automated tasks, the relative productivity of standard and IT-related labor, and the substitutability of tasks. These determinants also affect the income distribution between the two kinds of labor. We derive several empirical implications and identify possible future extensions.
Identification of hub genes in the subacute spinal cord injury in rats
Authors: Yan Lei , Fu Jiawei , Dong Xiong , Chen Baishen , Hong Hongxiang , Cui Zhiming
Published: August 2022

Background

Spinal cord injury (SCI) is a common trauma in clinical practices. Subacute SCI is mainly characterized by neuronal apoptosis, axonal demyelination, Wallerian degeneration, axonal remodeling, and glial scar formation. It has been discovered in recent years that inflammatory responses are particularly important in subacute SCI. However, the mechanisms mediating inflammation are not completely clear.

Methods

The gene expression profiles of GSE20907, GSE45006, and GSE45550 were downloaded from the GEO database. The models of the three gene expression profiles were all for SCI to the thoracic segment of the rat. The differentially expressed genes (DEGs) and weighted correlation network analysis (WGCNA) were performed using R software, and functional enrichment analysis and protein–protein interaction (PPI) network were performed using Metascape. Module analysis was performed using Cytoscape. Finally, the relative mRNA expression level of central genes was verified by RT-PCR.

Results

A total of 206 candidate genes were identified, including 164 up-regulated genes and 42 down-regulated genes. The PPI network was evaluated, and the candidate genes enrichment results were mainly related to the production of tumor necrosis factors and innate immune regulatory response. Twelve core genes were identified, including 10 up-regulated genes and 2 down-regulated genes. Finally, seven hub genes with statistical significance in both the RT-PCR results and expression matrix were identified, namely Itgb1, Ptprc, Cd63, Lgals3, Vav1, Shc1, and Casp4. They are all related to the activation process of microglia.

Conclusion

In this study, we identified the hub genes and signaling pathways involved in subacute SCI using bioinformatics methods, which may provide a molecular basis for the future treatment of SCI.
Association between serum albumin levels and paroxysmal atrial fibrillation by gender in a Chinese population: a case–control study
Authors: Zhong Xia , Jiao Huachen , Zhao Dongsheng , Teng Jing
Published: August 2022

Background

Hypoalbuminemia is linked to the emergence of cardiovascular events. However, there is an unclear association between serum albumin (ALB) and gender in paroxysmal AF patients. This retrospective study aimed to explore the association between ALB levels and paroxysmal AF by gender in a Chinese population.

Methods

This study included patients with paroxysmal AF who were hospitalized consecutively in China from January 2019 to September 2021. Controls with sinus rhythm and without paroxysmal AF were matched (2:1) to cases by gender and age. Pearson correlation analysis was used to study the correlation between ALB and blood lipid profiles, multivariate regression models were performed to investigate the association between ALB and paroxysmal AF.

Results

There were 305 patients with paroxysmal AF and 610 patients with controls included in this study. Low ALB in male with AF patients were significantly associated with paroxysmal AF (OR = 0.889, 95% CI 0.832–0.950). ALB was positively correlated with triglyceride (TG) (r = 0.212, p < 0.001), total cholesterol (TC) (r = 0.381, p = 0.002), low-density lipoprotein cholesterol (LDL-C) (r = 0.263, p < 0.001), and high-density lipoprotein cholesterol (HDL-C) (r = 0.329, p < 0.001).

Conclusion

Low ALB in male patients is significantly associated with paroxysmal AF in a Chinese population. Monitoring for hypoalbuminemia in men might help reduce the incidence of paroxysmal AF.
Epidemiological and viral characteristics of undiagnosed HIV infections in Botswana
Authors: Bhebhe Lynnette , Moyo Sikhulile , Gaseitsiwe Simani , Pretorius-Holme Molly , Yankinda Etienne K. , Manyake Kutlo , Kgathi Coulson , Mmalane Mompati , Lebelonyane Refeletswe , Gaolathe Tendani , Bachanas Pamela , Ussery Faith , Letebele Mpho , Makhema Joseph , Wirth Kathleen E. , Lockman Shahin , Essex Max , Novitsky Vlad , Ragonnet-Cronin Manon
Published: August 2022

Background

HIV-1 is endemic in Botswana. The country’s primary challenge is identifying people living with HIV who are unaware of their status. We evaluated factors associated with undiagnosed HIV infection using HIV-1 phylogenetic, behavioural, and demographic data.

Methods

As part of the Botswana Combination Prevention Project, 20% of households in 30 villages were tested for HIV and followed from 2013 to 2018. A total of 12,610 participants were enrolled, 3596 tested HIV-positive at enrolment, and 147 participants acquired HIV during the trial. Extensive socio-demographic and behavioural data were collected from participants and next-generation sequences were generated for HIV-positive cases. We compared three groups of participants: (1) those previously known to be HIV-positive at enrolment (n = 2995); (2) those newly diagnosed at enrolment (n = 601) and (3) those who tested HIV-negative at enrolment but tested HIV-positive during follow-up (n = 147). We searched for differences in demographic and behavioural factors between known and newly diagnosed group using logistic regression. We also compared the topology of each group in HIV-1 phylogenies and used a genetic diversity-based algorithm to classify infections as recent (< 1 year) or chronic (≥ 1 year).

Results

Being male (aOR = 2.23) and younger than 35 years old (aOR = 8.08) was associated with undiagnosed HIV infection (p < 0.001), as was inconsistent condom use (aOR = 1.76). Women were more likely to have undiagnosed infections if they were married, educated, and tested frequently. For men, being divorced increased their risk. The genetic diversity-based algorithm classified most incident infections as recent (75.0%), but almost none of known infections (2.0%). The estimated proportion of recent infections among new diagnoses was 37.0% (p < 0.001).

Conclusion

Our results indicate that those with undiagnosed infections are likely to be young men and women who do not use condoms consistently. Among women, several factors were predictive: being married, educated, and testing frequently increased risk. Men at risk were more difficult to delineate. A sizeable proportion of undiagnosed infections were recent based on a genetic diversity-based classifier. In the era of “test and treat all”, pre-exposure prophylaxis may be prioritized towards individuals who self-identify or who can be identified using these predictors in order to halt onward transmission in time.
Construction and validation of a gene signature related to bladder urothelial carcinoma based on immune gene analysis
Authors: Xing Peng , Jiang Zhengming , Liu Yang
Published: August 2022

Background

This study developed a gene signature associated with a malignant and common tumor of the urinary system, the Bladder Urothelial Carcinoma (BLCA).

Methods

The Cancer Genome Atlas (TCGA) database was searched to obtain 414 BLCA samples and the expression spectra of 19 normal samples. Single-sample Gene Set Enrichment Analysis (ssGSEA) was conducted to determine the enrichment levels in the BLCA samples of the 29 immune genes. Unsupervised hierarchical clustering, gene set enrichment analysis (GSEA), single-factor Cox analysis, least absolute shrinkage and selection operator (LASSO) regression models, and GEO queues were used to determine the BLCA immune gene subtype, analyze the biological pathway differences between immune gene subtypes, determine the characteristic genes of BLCA associated with prognosis, identify the BLCA-related genes, and verify the gene signature, respectively.

Results

We identified two immune gene subtypes (immunity_L and immunity_H). The latter was significantly related to receptors, JAK STAT signaling pathways, leukocyte interleukin 6 generation, and cell membrane signal receptor complexes. Four characteristic genes (RBP1, OAS1, LRP1, and AGER) were identified and constituted the gene signature. Significant survival advantages, higher mutation frequency, and superior immunotherapy were observed in the low-risk group patients. The gene signature had good predictive ability. The results of the validation group were consistent with TCGA queue results.

Conclusions

We constructed a 4-gene signature that helps monitor BLCA occurrence and prognosis, providing an important basis for developing personalized BLCA immunotherapy.
Impaired insight in schizophrenia: impact on patient-reported and physician-reported outcome measures in a randomized controlled trial
Authors: Lysaker Paul H. , Weiden Peter J. , Sun Xiaowu , O’Sullivan Amy K. , McEvoy Joseph P.
Published: August 2022

Background

Impaired insight poses a challenge in the treatment of patients with schizophrenia because of its potential to jeopardize therapeutic engagement and medication adherence. This study explored how insight impairment, graded from none to extreme, is related to patient-reported mental health status, depression, and neurocognition in schizophrenia.

Methods

In a post hoc analysis of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study (NCT00014001), insight was measured using the Positive and Negative Syndrome Scale (PANSS) Item G12 (lack of insight). Additional assessments for this analysis included the 12-Item Short-Form Health Survey (SF-12) Mental Component Summary (MCS), physician- and patient-reported Clinical Global Impression–Severity (CGI-S), MATRICS Consensus Cognitive Battery, and Calgary Depression Scale for Schizophrenia. Relationships between patient-reported outcomes and PANSS total and Item G12 ratings were evaluated.

Results

Among 1431 CATIE study participants in this analysis, increasingly impaired insight at baseline was significantly associated with better patient-reported quality of life (QoL), lower baseline depression, and greater divergence between physician- and patient-reported illness severity. Patients with more severely impaired insight reported milder illness compared with physician reports, particularly those with moderate-severe to extreme impairment (PANSS Item G12 rating ≥ 5), approximately 10% (138/1431) of CATIE participants. For the 90% of patients with PANSS Item G12 ratings < 5, patient-reported QoL decreased with increasing symptoms. SF-12 MCS scores were linearly related to baseline PANSS total score only in patients with PANSS total score < 90 (moderately ill or better), and better symptom scores were associated with higher QoL. No significant relationship between insight and neurocognition was observed.

Conclusions

In the small subgroup (10%) of CATIE study patients with schizophrenia and PANSS Item G12 ratings ≥5, moderate-severe–severe/extreme insight impairment was associated with significantly more positive perception of QoL and illness severity by the patient versus the treating physician. This was not observed in the remaining 90% of patients with normal to moderately impaired insight, suggesting that poor insight as a threat to the validity of self-report is uncommon.
Microsurgical treatment of lumbar paravertebral tumors via lateral retroperitoneal approach: operative technique and a series of 6 patients
Authors: Zhang Lei , Chen Shichao , Wang Kai , Wu Hao
Published: August 2022

Objective

To investigate the surgical techniques and postoperative therapeutic effectiveness of microsurgical treatment of lumbar paravertebral tumors via lateral retroperitoneal approach.

Methods

The clinical data of 6 cases with lumbar paravertebral tumors treated by lateral retroperitoneal approach in the Neurosurgery department of Xuanwu Hospital, Capital Medical University were analyzed retrospectively. The mean operation time, blood loss, incision length, length of hospital stay, and the resection rate of paravertebral tumors were collected, and the score of The Ability to Perform Activities of Daily Living (ADL) and incidence of postoperative complications was recorded.

Results

The operation time ranged from 56 to 181 min, with an average of (94.8 ± 48.3) minutes. The blood loss was between 5 and 100 ml, with an average of (31.7 ± 37.5) ml. The incision length was 6–7 cm, with an average of (6.7 ± 0.5) cm. The hospitalization length was between 5 and 11 days, with an average of (8.7 ± 2.6) days. The resection rate of paravertebral tumors was 100%. Postoperative pathological diagnosis results revealed 4 cases of schwannoma, 1 case of ganglioneuroma, and 1 case of malignant small round cell tumor. During the 3-month follow-up, there were no tumor recurrence, abdominal infection, incision infection, incisional hernia, or death, and there was no significant decrease in the ADL score compared with that before the operation.

Conclusion

The surgical treatment of lumbar paravertebral tumors via the lateral retroperitoneal approach has the advantages of the short operation time, minimally invasive procedures, quick postoperative recovery, and fewer complications.
A survey of the awareness and knowledge of oral cancer among residents in Beijing
Authors: Zhou Xing-Hong , Huang Ying , Yuan Chao , Zheng Shu-Guo , Zhang Jian-Guo , Lv Xiao-Ming , Zhang Jie
Published: August 2022

Background

The present study aimed to investigate oral cancer awareness and its related knowledge among residents in Beijing.

Methods

A questionnaire survey was conducted among Beijing residents concerning their knowledge of oral cancer, and its prevention and treatment.

Results

A total of 3055 questionnaires were completed, 45.8% by males and 54.2% by females. The ages of the respondents ranged from 15 to 93 years; 12.4% were smokers, 1.1% chewed betel nuts, and 82.5% brushed their teeth at least twice a day. Lung cancer was heard of by the most respondents, followed by gastric cancer and liver cancer; oral cancer was the least heard of. More than 60% of respondents were unaware of the risk factors and early signs of oral cancer.

Conclusions

This survey demonstrated a general lack of public awareness and knowledge about oral cancer. Specific measures should be taken to improve public awareness of oral cancer and its prevention and treatment.
Subjective achievement from psychiatry rotation in the Japanese postgraduate residency system: a longitudinal questionnaire study
Authors: Matsuzaka Yusuke , Taniho Koichi , Maeda Kengo , Sakai Shintaro , Michitsuji Toru , Ozono Eriko , Morimoto Yoshiro , Kinoshita Hirohisa , Matsushima Kayoko , Hamada Hisayuki , Imamura Akira , Kumazaki Hirokazu , Ozawa Hiroki
Published: August 2022

Background

Psychiatry rotation has been mandatory in the Japanese postgraduate residency system since 2020. Some psychiatry-related competency items are stipulated as mandatory for residents. The current study aimed to clarify whether psychiatry rotation affected residents’ subjective achievement of these competency items.

Methods

This longitudinal study was conducted among postgraduate residents who completed a rotation in the psychiatry department at Nagasaki University Hospital across two academic years (2020–2021). The survey was administered at the start and at the end of the psychiatry rotation. Residents evaluated their subjective understanding and confidence regarding initiating treatment for these competency items using a six-point Likert scale. The average scores for each item were compared between pre-rotation and post-rotation.

Results

In total, 99 residents (91.7%) responded to this survey. Residents had significantly higher scores at post-rotation compared with pre-rotation in all psychiatry-related competency items in both subjective understanding and confidence in initiating treatment. Additionally, strong effect sizes were found for many items.

Conclusion

Residents improved learning about psychiatry-related competency items through psychiatry rotation. This finding suggests that it is reasonable for psychiatry rotation to be mandatory in the current Japanese postgraduate residency system. The importance of psychiatry is likely to increase in both undergraduate and postgraduate medical education in the future. It is necessary to continuously update educational strategies to meet changing social needs over time. As this study was conducted at a single institution, a multi-center study is needed to expand the current findings.
From a voluntary vaccination policy to mandatory vaccination against COVID-19 in cancer patients: an empirical and interdisciplinary study in bioethics
Authors: Stoeklé Henri-Corto , Sekkate Sakina , Angellier Elisabeth , Kennel Titouan , Benmaziane Asmahane , Mabro May , Geay Jean-François , Beuzeboc Philippe , Hervé Christian
Published: August 2022

Background

At the start of 2021, oncologists lacked the necessary scientific knowledge to adapt their clinical practices optimally when faced with cancer patients refusing or reluctant to be vaccinated against COVID-19, despite the marked vulnerability of these patients to severe, and even fatal forms of this new viral infectious disease. Oncologists at Foch Hospital were confronted with this phenomenon, which was observed worldwide, in both the general population and the population of cancer patients.

Methods

Between April and November 2021, the Ethics and Oncology Departments of Foch Hospital decided to investigate this subject, through an empirical and interdisciplinary study in bioethics. Our scientific objective was to try to identify and resolve the principal bio-ethical issues, with a view to improving clinical practices in oncology during future major pandemics of this kind, from a highly specific bio-ethical standpoint (= quality of life/survival). We used a mainly qualitative methodological approach based on questionnaires and interviews.

Results

In April 2021, 29 cancer patients refused or were reluctant to be vaccinated (5.6%; 29/522). Seventeen of these patients said that making vaccination mandatory would have helped them to accept vaccination. In October 2021, only 10 cancer patients continued to maintain their refusal (1.9%; 10/522). One of the main reasons for the decrease in refusals was probably the introduction of the “pass sanitaire” (health pass) in July 2021, which rendered vaccination indispensable for many activities. However, even this was not sufficient to convince these 10 cancer patients.

Conclusion

We identified a key bio-ethical issue, which we then tried to resolve: vaccination policy. We characterized a major tension between “the recommendation of anti-COVID-19 vaccination” (a new clinical practice) and “free will” (a moral value), and the duty to “protect each other” (a moral standard). Mandatory vaccination, at least in France, could resolve this tension, with positive effects on quality of life (i.e. happiness), or survival, in cancer patients initially refusing or reluctant to be vaccinated, but only if collective and individual scales are clearly distinguished.
Effectiveness of interventions to support the transition home after acute stroke: a systematic review and meta-analysis
Authors: O’Callaghan Geraldine , Fahy Martin , Murphy Paul , Langhorne Peter , Galvin Rose , Horgan Frances
Published: August 2022

Background

Effective support interventions to manage the transition to home after stroke are still mostly unknown.

Aim

The purpose of this systematic review was to investigate the effectiveness of support interventions at transition from organised stroke services to independent living at home.

Methods

The Cochrane Central Register of Controlled Trials, six databases including MEDLINE and Embase, trial registries, grey literature, and Google Scholar were all searched, up to June 2021.

We included randomised controlled trials enrolling people with stroke to receive either standard care or any type of support intervention from organised stroke services to home. The primary outcome was functional status.

Two authors determined eligibility, extracted data, evaluated risk of bias (ROB2), and verified the evidence (GRADE). Where possible we performed meta-analyses using Risk Ratios (RR) or Mean Differences (MD).

Results

We included 17 studies. Support interventions led to important improvements in functional status, as determined by the Barthel Index up, to 3-months (MD 7.87 points, 95%CI:6.84 to 19.16; 620 participants; five studies; I2 = 77%). Results showed modest but significant functional gains in the medium to long-term (6–12 month follow up, MD 2.91 points, 95%CI:0.03 to 5.81; 1207 participants; six studies; I2 = 84%). Certainty of evidence was low.

Support interventions may enhance quality of life for up to 3-months (MD 1.3,95% CI:0.84 to 1.76), and reduce depression (SMD -0.1,95% CI:-0.29 to − 0.05) and anxiety (MD -1.18,95% CI:-1.84 to − 0.52) at 6–12 months. Effects on further secondary outcomes are still unclear.

Conclusions

Incorporating support interventions as people who have experienced a stroke transition from hospital to home can improve functional status and other outcomes. Due to study heterogeneity, the essential components of effective transition of care interventions are still unknown. Adoption of core outcome sets in stroke research would allow for greater comparison across studies. Application of a development and evaluation framework engaging stakeholders would increase understanding of priorities for stroke survivors, and inform the key components of an intervention at transition from hospital-to-home.

Trial registration

CRD42021237397 - https://www.crd.york.ac.uk/prospero
Bayesian estimation of the effect of health inequality in disease detection
Authors: Lope Dinah Jane , Demirhan Haydar , Dolgun Anil
Published: August 2022

Background

Measuring health inequality is essential to ensure that everyone has equal accessibility to health care. Studies in the past have continuously presented and showed areas or groups of people affected by various inequality in accessing the health resources and services to help improve this matter. Alongside, disease prevention is as important to minimise the disease burden and improve health and quality of life. These aspects are interlinked and greatly contributes to one’s health.

Method

In this study, the Gini coefficient and Lorenz curve are used to give an indication of the overall health inequality. The impact of this inequality in granular level is demonstrated using Bayesian estimation for disease detection. The Bayesian estimation used a two-component modelling approach that separates the case detection process and incidence rate using a mixed Poisson distribution while capturing underlying spatio-temporal characteristics. Bayesian model averaging is used in conjunction with the two-component modelling approach to improve the accuracy of estimates by incorporating many candidate models into the analysis instead of using fixed component models. This method is applied to an infectious disease, influenza, in Victoria, Australia between 2013 and 2016 and the corresponding primary health care of the state.

Result

There is a relatively equal distribution of health resources and services pertaining to general practitioners (GP) and GP clinics in Victoria, Australia. Roughly 80 percent of the population shares 70 percent of the number of GPs and GP clinics. The Bayesian estimation with model averaging revealed that access difficulty to health services impacts both case detection probability and incidence rate. Minimal differences are recorded in the observed and estimated incidence of influenza cases considering social deprivation factors. In most years, areas in Victoria’s southwest and eastern parts have potential under-reported cases consistent with their relatively lower number of GP or GP clinics.

Conclusion

The Bayesian model estimated a slight discrepancy between the estimated incidence and the observed cases of influenza in Victoria, Australia in 2013-2016 period. This is consistent with the relatively equal health resources and services in the state. This finding is beneficial in determining areas with potential under-reported cases and under-served health care. The proposed approach in this study provides insight into the impact of health inequality in disease detection without requiring costly and time-extensive surveys and relying mainly on the data at hand. Furthermore, the application of Bayesian model averaging provided a flexible modelling framework that allows covariates to move between case detection and incidence models.
Preserving independence among under-resourced older adults in the Southeastern United States: existing barriers and potential strategies for research
Authors: Enogela Ene M. , Buchanan Taylor , Carter Christy S. , Elk Ronit , Gazaway Shena B. , Goodin Burel R. , Jackson Elizabeth A. , Jones Raymond , Kennedy Richard E. , Perez-Costas Emma , Zubkoff Lisa , Zumbro Emily L. , Markland Alayne D. , Buford Thomas W.
Published: August 2022

Disability prevention and preservation of independence is crucial for successful aging of older adults. To date, relatively little is known regarding disparities in independent aging in a disadvantaged older adult population despite widely recognized health disparities reported in other populations and disciplines. In the U.S., the Southeastern region also known as “the Deep South”, is an economically and culturally unique region ravaged by pervasive health disparities – thus it is critical to evaluate barriers to independent aging in this region along with strategies to overcome these barriers. The objective of this narrative review is to highlight unique barriers to independent aging in the Deep South and to acknowledge gaps and potential strategies and opportunities to fill these gaps. We have synthesized findings of literature retrieved from searches of computerized databases and authoritative texts. Ultimately, this review aims to facilitate discussion and future research that will help to address the unique challenges to the preservation of independence among older adults in the Deep South region.
Comparison of short-term and medium-term outcomes between intracorporeal anastomosis and extracorporeal anastomosis for laparoscopic left hemicolectomy
Authors: Wang Li-Ming , Jong Bor-Kang , Liao Chun-Kai , Kou Ya-Ting , Chern Yih-Jong , Hsu Yu-Jen , Hsieh Pao-Shiu , Tsai Wen-Sy , You Jeng-Fu
Published: August 2022

Background

Few studies have evaluated the feasibility and safety of intracorporeal anastomosis (IA) for left hemicolectomy. Here, we aimed to investigate the potential advantages and disadvantages of laparoscopic left hemicolectomy with IA and compare the short- and medium-term outcomes between IA and extracorporeal anastomosis (EA).

Methods

We retrospectively analyzed 133 consecutive patients who underwent laparoscopic left hemicolectomies from July 2016 to September 2019 and categorized them into the IA and EA groups. Patients with stage 4 disease and conversion to laparotomy or those lost to follow-up were excluded. Postoperative outcomes between IA and EA groups were compared. Short-term outcomes included postoperative pain score, bowel function recovery, complications, duration of hospital stay, and pathological outcome. Medium outcomes included overall survival and disease-free survival for at least 2 years.

Results

After excluding ineligible patients, the remaining 117 underwent IA (n= 40) and EA (n= 77). The IA group had a shorter hospital stay, a shorter time to tolerate liquid or soft diets, and higher serum C-reactive protein level on postoperative day 3. There was no difference between two groups in operative time, postoperative pain, specimen length, or nearest margin. A 2-year overall survival (IA vs. EA: 95.0% vs. 93.5%,p= 0.747) and disease-free survival (IA vs. EA: 97.5% vs. 90.9%,p= 0.182) rates were comparable between two groups.

Conclusions

Laparoscopic left hemicolectomy with IA was technically feasible, with better short-term outcomes, including shorter hospital stays and shorter time to tolerate liquid or soft diets. The IA group had higher postoperative serum C-reactive protein level; however, no complications were observed. Regarding medium-term outcomes, the overall survival and disease-free survival rates were comparable between IA and EA procedures.
Clinical and economic outcomes after sternotomy for cardiac surgery with skin closure through 2-octyl cyanoacrylate plus polymer mesh tape versus absorbable sutures plus waterproof wound dressings: a retrospective cohort study
Authors: Kiaii Bob , Johnston Stephen S. , Jang Se Ryeong , Elangovanraaj Nivesh , Tewari Pranjal , Chen Brian Po-Han
Published: August 2022

Background

To compare clinical and economic outcomes after sternotomy for cardiac surgery with skin closure through 2-octyl cyanoacrylate plus polymer mesh tape (2OPMT) versus conventional absorbable sutures plus waterproof wound dressings (CSWWD).

Methods

Retrospective study using the Premier Healthcare Database. Patients undergoing a cardiac surgery requiring sternotomy with 2OPMT or CSWWD were included. Primary outcome was 60-day cumulative incidence of diagnosis for wound complications (infection, dehiscence). Secondary outcomes were index admission hospital length of stay (LOS), total hospital-borne costs, discharge status, and 60-day cumulative incidences of inpatient readmission and reoperation. After propensity score matching, outcomes were compared between the 2OPMT and CSWWD groups using bivariate multilevel mixed-effects generalized linear models.

Results

Overall, 7,901 2OPMT patients and 10,775 CSWWD patients were eligible for study. After propensity score matching on 68 variables, each group comprised 5,338 patients (total study N = 10,676). The 2OPMT and CSWWD groups did not differ significantly in terms of the 60-day cumulative incidences of wound complication (3.47% vs 3.47%, p = 0.996), inpatient readmission (12.6% vs. 13.6%, p = 0.354), and reoperation (10.3% vs 10.1%, p = 0.808), as well as discharge to home versus non-home setting (77.2% vs. 75.1%), p = 0.254. However, the 2OPMT group had significantly lower LOS (9.2 days vs 10.6 days, p < 0.001) and total hospital-borne costs ($50,174 vs $60,526, p < 0.001).

Conclusions

This large observational study provides evidence that sternotomy skin closure with 2OPMT is associated with nearly identical 60-day cumulative incidence of wound complication as compared with CSWWD, while exhibiting a significant association with lower LOS and total hospital-borne costs.

Trial registration Not applicable.
Impact of remote monitoring in heart failure patients with cardiac implantable electronic devices during COVID-19 pandemic: a single center experience
Authors: Ezer Péter , Gergics Marin , Szokodi István , Kónyi Attila
Published: August 2022

Background

Coronavirus disease 2019 (COVID-19) had spread into a pandemic affecting healthcare providers worldwide. Heart failure patients with implanted cardiac devices require close follow-up in-spite of pandemic related healthcare restrictions.

Methods

Patients were retrospectively registered and clinical outcomes were compared of 61 remote monitored (RMG) versus 71 conventionally (in-office only) followed (CFG) cardiac device implanted, heart failure patients. Follow-up length was 12 months, during the COVID-19 pandemic related intermittent insitutional restrictions. We used a specified heart failure detection algorithm in RMG. This investigation compared worsening heart failure-, arrhythmia- and device related adverse events as primary outcome and heart failure hospitalization rates as secondary outcome in the two patient groups.

Results

No significant difference was observed in the primary composite end-point during the first 12 months of COVID-19 pandemic (p = 0.672).

In RMG, patients who had worsening heart failure event had relative modest deterioration in heart failure functional class (p = 0.026), relative lower elevation of N terminal-pro BNP levels (p < 0.01) at in-office evaluation and were less hospitalized for worsening heart failure in the first 6 months of pandemic (p = 0.012) compared to CFG patients.

Conclusions

Specified remote monitoring alert-based detection algorithm and workflow in device implanted heart failure patients may potentially indicate early worsening in heart failure status. Preemptive adequate intervention may prevent further progression of deteriorating heart failure and thus prevent heart failure hospitalizations.
The effect of posterior pericardiotomy after thoracic aortic surgery
Authors: Maze Yasumi , Tokui Toshiya , Murakami Masahiko , Yamaguchi Daisuke , Inoue Ryosai , Hirano Koji , Nakamura Bun , Ito Hisato
Published: August 2022

Background

Postoperative pericardial effusion is common after cardiovascular surgery. We aimed to examine the effectiveness of posterior pericardiotomy in reducing the incidence of postoperative pericardial effusion and postoperative atrial fibrillation after thoracic aortic surgery.

Methods

This study included 201 patients who underwent thoracic aortic open surgery between January 2014 and November 2021. We compared surgical outcomes between patients who underwent posterior pericardiotomy and those who did not.

Results

The group that did not undergo posterior pericardiotomy had significantly longer mechanical ventilation duration than the group who did, both in the overall (p = 0.005) and in the propensity-matched cohorts (p = 0.001). The lengths of intensive care unit and hospital stays were significantly longer in the group that did not undergo posterior pericardiotomy compared to the group that did, both in the overall and in the propensity-matched cohorts. The occurrence of postoperative atrial fibrillation and stroke did not differ significantly between the two groups. The amount of pericardial drainage was not significantly lower in the group that underwent posterior pericardiotomy in the overall cohorts (p = 0.09), but the difference was significant in the propensity-matched cohorts (p = 0.04). The amount of mediastinal drainage was significantly lower in the group that underwent posterior pericardiotomy, both in the overall cohorts (< 0.001) and in the propensity-matched cohort (< 0.001). Late pericardial tamponade occurred significantly more frequently in the group that did not undergo posterior pericardiotomy than in the group that did, both in the overall (p = 0.03) and in the propensity-matched cohorts (p = 0.03).

Conclusions

Posterior pericardiotomy has no effect on reducing postoperative atrial fibrillation after thoracic aortic surgery. However, posterior pericardiotomy reduced the occurrence of late pericardial tamponade, length of ICU stay, length of hospital stay, and mechanical ventilation duration after surgery.
Emerging strategies in targeting tumor-resident myeloid cells for cancer immunotherapy
Authors: Wang Yi , Johnson Kai Conrad Cecil , Gatti-Mays Margaret E. , Li Zihai
Published: August 2022

Immune checkpoint inhibitors targeting programmed cell death protein 1, programmed death-ligand 1, and cytotoxic T-lymphocyte-associated protein 4 provide deep and durable treatment responses which have revolutionized oncology. However, despite over 40% of cancer patients being eligible to receive immunotherapy, only 12% of patients gain benefit. A key to understanding what differentiates treatment response from non-response is better defining the role of the innate immune system in anti-tumor immunity and immune tolerance. Teleologically, myeloid cells, including macrophages, dendritic cells, monocytes, and neutrophils, initiate a response to invading pathogens and tissue repair after pathogen clearance is successfully accomplished. However, in the tumor microenvironment (TME), these innate cells are hijacked by the tumor cells and are imprinted to furthering tumor propagation and dissemination. Major advancements have been made in the field, especially related to the heterogeneity of myeloid cells and their function in the TME at the single cell level, a topic that has been highlighted by several recent international meetings including the 2021 China Cancer Immunotherapy workshop in Beijing. Here, we provide an up-to-date summary of the mechanisms by which major myeloid cells in the TME facilitate immunosuppression, enable tumor growth, foster tumor plasticity, and confer therapeutic resistance. We discuss ongoing strategies targeting the myeloid compartment in the preclinical and clinical settings which include: (1) altering myeloid cell composition within the TME; (2) functional blockade of immune-suppressive myeloid cells; (3) reprogramming myeloid cells to acquire pro-inflammatory properties; (4) modulating myeloid cells via cytokines; (5) myeloid cell therapies; and (6) emerging targets such as Siglec-15, TREM2, MARCO, LILRB2, and CLEVER-1. There is a significant promise that myeloid cell-based immunotherapy will help advance immuno-oncology in years to come.
Osteosarcoma with cell-cycle and fibroblast growth factor genomic alterations: case report of Molecular Tumor Board combination strategy resulting in long-term exceptional response
Authors: Persha Hanna E. , Kato Shumei , De Pradip , Adashek Jacob J. , Sicklick Jason K. , Subbiah Vivek , Kurzrock Razelle
Published: August 2022

There is a paucity of information about molecularly driven therapy in osteosarcomas. We report a 31-year-old woman with chemotherapy–refractory metastatic osteosarcoma who was successfully treated with the combination of palbociclib (CDK4/6 inhibitor) and lenvatinib (multikinase FGFR inhibitor), selected based on next generation sequencing that showed CDK4 and CCND2 amplifications (upregulates CDK4/6), and FGF6 (ligand for FGFR1,2 and 4), FGF23 (ligand for FGFR1,2,3, and 4) and FRS2 (adaptor protein for FGFR signaling) amplifications. The patient’s tumor showed 68% reduction in positron emission tomography (PET) avidity, lasting 31 months after therapy initiation, when a solitary recurrence occurred, was resected, and treatment continued. The patient remains on matched targeted therapy at 51 + months from the start of the combination. Treatment was given at reduced dosing (lenvatinib 10 mg oral daily (approved dose = 24 mg daily)) and palbociclib 75 mg oral daily, one week on and one week off (approved dose = 125 mg oral daily, three weeks on/one week off) and is tolerated well. Therefore, co-targeting the aberrant cyclin and FGFR pathways resulted in long-term exceptional response in a patient with refractory advanced osteosarcoma.
Clustering of Cryptosporidium species infections among sheep and cattle but not children in remote highland communities of Madagascar
Authors: Krumkamp Ralf , Conraths Franz J. , Caccio Simone , Schares Gereon , Hogan Benedikt , Winter Doris , Jaeger Anna , Melhem Sophia , Rakotozandrindrainy Njari , May Jürgen , Rakotozandrindrainy Raphael , Eibach Daniel
Published: August 2022

Background

The aim of this study was to identify local transmission patterns ofCryptosporidiumspp. infections among livestock and humans in four extremely rural and remote highland communities in Madagascar.

Methods

In this cross-sectional study, households were randomly sampled throughout a 1-year study period, with one feces sample collected from each child (≤ 5 years old), sheep and cattle.Cryptosporidiumspp. were identified using a nested PCR assay targeting the18Sribosomal RNA gene. All samples positive forCryptosporidium hominiswere further subtyped by sequencing the 60-kDa glycoprotein gene (gp60). Spatial clustering methods were applied to analyze potential transmission patterns.

Results

In total, 252 households participated in the study, and samples from 197 children, 862 cattle and 334 sheep were collected and included in the study. Of the samples collected, 11 (5.6%) from children, 30 (3.5%) from cattle and 42 (12.6%) from sheep tested positive forCryptosporidiumspp. Very little overlap in the species distribution between human and animal infections was found. Global (overall) and local (spatially defined) clustering was observed forCryptosporidiumspp. infections in sheep and forCryptosporidium xiaoi/bovisinfections among sheep and cattle.

Discussion

The results of this analysis do not support the occurrence of defined disease outbreaks, rather they point to a continuous series of transmission events that are spatially aggregated. Despite the close coexistence between humans, sheep and cattle in the study area, mutual transmission was not observed. Hence, the study underlines the importance of sustained sanitation and hygiene measures to prevent cryptosporidiosis transmission among infants, since asymptomatic children serve as an infection reservoir. Similarly, the study highlights the importance of improving hygiene to reduce the transmission ofCryptosporidiumspp. in livestock, an infection with serious consequences, especially in newborn calves.

Graphical Abstract
Acute effects of ballistic versus heavy-resistance exercises on countermovement jump and rear-hand straight punch performance in amateur boxers
Authors: Yi Wenjuan , Chen Chao , Zhou Zixiang , Cui Weijia , Wang Dexin
Published: August 2022

Background

Ballistic and heavy-resistance exercises may potentially enhance lower body power, which is paramount for the punching performance of amateur boxers. This study aimed to determine the acute effects of ballistic exercise (BE) and heavy-resistance exercise (HRE) on countermovement jump (CMJ) and rear-hand straight punch performance in amateur boxers.

Methods

Ten amateur boxers performed two conditioning exercises in a randomized and counterbalanced order as follows: squat jump with 4 sets × 8 repetitions at 30% one-repetition maximum (1RM) for BE and squat with 3 sets × 5 repetitions at 80% 1RM for HRE. The jump height (JH), relative maximal force (RMF), relative maximal power (RMP) of the CMJ, punch force (PF), and punch speed (PS) of a rear-hand straight punch were measured before and 3, 6, 9, and 12 min after either BE or HRE.

Results

No significant condition × time interaction was found for JH (p = 0.303), RMF (p = 0.875), RMP (p = 0.480), PF (p = 0.939), and PS (p = 0.939). In addition, no main effect of the condition for JH (p = 0.924), RMF (p = 0.750), RMP (p = 0.631), PF (p = 0.678), and PS (p = 0.712). A significant main effect of time was observed for PF (p = 0.001) and PS (p = 0.001), whereas JH (p = 0.081), RMF (p = 0.141), and RMP (p = 0.430) were not. Pairwise comparison identified that PF (p = 0.031) and PS (p = 0.005) significantly increased at 9 min compared with those at baseline.

Conclusions

The findings of this study demonstrated that BE and HRE protocols can potentiate the rear-hand straight punch performance at 9 min but bring less favorable improvements for JH, RMF, or RMP of CMJ.