bluuebunny/crossref_metadata_2025 huggingface dataset:
Prolonged troponin elevation after high-intensity exercise may indicate coronary artery disease
Authors: Hove I , Kleiven O , Bjorkavoll-Bergseth M F , Svane J , Erevik C B , Hansen M W , Bugge C , Skadberg O , Melberg T , Orn S
Published: June 2024

Background

Physical activity is beneficial for individuals with chronic coronary artery disease (CAD). Cardiac troponin (cTn) levels increase following exercise, but the mechanisms are not fully understood. There is limited data on the serum cardiac troponin response to different exercise intensities and durations in individuals with established CAD. This study aimed to explore the serum cardiac troponin I (cTnI) release pattern after high-intensity exercise of increasing duration in individuals with- and without revascularized CAD.

Methods

We included 36 middle-aged (60.4 ±8.7 years) recreational athletes. 14 individuals with successfully revascularized CAD, stable for at least six months before and 30 days after inclusion. 22 were healthy controls without obstructive CAD proven by CT coronary angiography. Both groups had a mean left ventricular ejection fraction >55%, assessed by echocardiography. The maximum exercise capacity of all participants was assessed by a cardiopulmonary exercise test (CPET). The CPET determined the maximal power output (watt) at max VO2. Following the CPET, all individuals exercised once weekly with sessions of alternating 15 seconds at maximal power and 15 seconds of passive recovery. In the first week, participants were exposed to a total exercise duration of 20 minutes. The duration was then increased by 20 minutes each week, ending with a 60-minute session. CTnI was measured before, 3 hours after and 24 hours after each exercise session.

Results

The duration of the CPET was similar in the two groups and there were no significant differences in VO2 max, maximal power output, heart rate or blood pressure during the test (Table 1). CTnI values were significantly higher 3 hours after the 60-minute session than after the CPET and the 20-minute session. There were no significant differences in absolute cTnI values between the two groups before or after any of the exercise sessions. In subjects with CAD, there was no reduction in cTnI from 3 hours to 24 hours following the CPET (Figure 1). In comparison, healthy individuals showed significant reductions in cTnI at 24 hours following all the exercise sessions.

Conclusion

No differences were seen in absolute values comparing the exercise-induced cTnI response in individuals with- and without chronic CAD. However, following the highest intensity exercise session (CPET), individuals with CAD had a sustained cTnI elevation 24 hours after exercise compared to healthy individuals where the cTnI levels significantly decreased. These findings may suggest an association between prolonged post-exercise cTnI elevation and CAD following high-intensity exercise.

Table 1: Data from the cardiopulmonary exercise test (CPET) in both groups. Figure 1  Table 1
Sex-differences in self-reported cardiorespiratory fitness, symptom severity, and quality of life in patients with atrial fibrillation
Authors: Marcal I R , Way K L , Reed J L
Published: June 2024

Background

Patients with atrial fibrillation (AF) often report low cardiorespiratory fitness (CRF), a strong predictor of all-cause mortality, troubling symptoms, and poor quality (QoL). Scarce literature suggests there are sex-differences in cardiovascular outcomes between females and males with AF. Despite sex-based analysis being encouraged in research practices, it is often overlooked, and this research gap in those with AF merits examination.

Purpose

We aimed to assess the sex-differences in CRF, symptom severity, and disease-specific QoL in patients with AF.

Methods

This is an observational study in patients with AF within Canada. Estimated CRF (i.e., peak oxygen uptake [V̇O2peak], and metabolic equivalents [METs]) was measured using the Duke Activity Status Index (DASI). Symptom severity including AF frequency, AF duration, symptom severity, and total AF burden was assessed using the Atrial Fibrillation Severity Scale (AFSS). Disease-specific QoL was examined using the Atrial Fibrillation Effect on Quality of Life (AFEQT) which includes domains of symptoms, physical functioning, treatment concerns, and treatment satisfaction. Mann-Whitney U tests were performed to determine sex-differences on the above-mentioned variables. A P value of < 0.05 was considered significant. Data are presented as medians and 95% confidence intervals.

Results

This study included 210 (33%) females (66.0 [63.5-68.0] years) and 409 (66%) males (66.0 [64.0-67.0] years). Females reported lower levels of CRF as assessed by V̇O2peak (25.5 [23.3-27.2] vs. 30.0 [27.6-30.2] mL/kg/min, P < 0.001) and METs (7.2 [6.6-7.7] vs. 8.5 [7.9- 8.6], P < 0.001) compared to males. Females showed worse symptom severity (5.5 [5.2-6.0] vs. 5.0 [4.5-5.0] points, P < 0.001) and were more bothered by AF symptoms (7.0 [5.0-8.0] vs. 5.0 [4.0-5.0] points, P < 0.001) than males. Females also demonstrated poorer QoL than males (AFEQT total score: 80.6 [77.8-83.3] vs. 83.3 [80.6-86.1] points, P = 0.04).

Conclusion

Our findings show that females with AF reported clinically and statistically poorer CRF, and worse symptom severity and QoL when compared to males with AF. Our findings emphasize the need for sex-specific strategies to improve AF management, particularly in females.
The benefit of early phase 2 cardiac rehabilitation on exercise capacity in worsening anxiety and depression patients after open-heart surgery
Authors: Astuti A W , Rampay D E T R I , Radi B A S U N I , Desandri D R , Putra B D , Ambari A M
Published: June 2024

Background

Cardiac rehabilitation (CR) has benefit effect in improving exercise capacity, quality of life, and reducing the risk of cardiovascular events. Anxiety and depression show detrimental effect for self-management behaviour patients after heart surgery and frequently under-recognized. It might represent risk factors for CR outcomes. Screening by Hospital Anxiety and Depression Scale (HADS) is recommended to check at the start and end of CR. However, exercise capacity (EC) improvement in worsening anxiety (WA) and depression (WD) patients after CR still need to be investigated.

Purpose

This study aims to investigate exercise capacity improvement of post open-heart surgery patients with worsening anxiety and depression after completing CR.

Methods

A cross-sectional study with a pre-post design enrolled 300 post open-heart surgery patients completing 12-session of early phase 2 cardiac rehabilitation in July-November 2023. Anxiety and depression (HADS) category and exercise capacity by 6-minutes walking distance (6MWD) was measured at the beginning (T1) and end of cardiac rehabilitation (T2). The change of 6MWD calculated by subtracting 6MWD at T2 from T1.

Results

There were 63% post coronary artery bypass (CABG), 12% post congenital heart disease correction, and 22.7% post valvular surgery patients divided into category: 7% mild anxiety and 1% mild depression at T1, then 10.3% mild anxiety, 3.3% moderate anxiety and 6% mild depression at T2. The change in T1 to T2 HADS category showed 11% worsening anxiety, 6% worsening depression, 83% constant normal/anxiety (CA) and 93% constant normal/depression (CD). Worsening anxiety and depression patients achieved significant improvement in exercise capacity (change of 6MWD 70.1 meters in WA and 74.6 meters in WD, p<0.001) also fulfill 25 meters minimal clinically important difference in 6MWD for coronary artery patient. No significant difference in 6MWD changes between WA and CA (-13.7 meters, p= 0.077) also WD and CD (-7.74 meters, p= 0,569).

Conclusion

Early phase 2 cardiac rehabilitation gave beneficial effect in improvement of exercise capacity in worsening anxiety and depresion patients after open-heart surgery.
Cardiovascular rehabilitation - determinants of long-term outcomes
Authors: Santos Fonseca J , Simoes Oliveira C , Martins A M , Garcia A B , Abrantes A , Gregorio C , Raposo M , Roxo D , Ramalhinho M , Poupino J , Alves M , Cunha N , Aguiar-Ricardo I , Pinto F , Abreu A
Published: June 2024

Introduction

Recent clinical evidence reinforces cardiac rehabilitation as a cornerstone for patient recovery and improvement after a serious cardiovascular event. Therefore it’s important to study what are the measures with the highest impact on outcomes.

Purpose

To study determinants of long-term success in cardiovascular rehabilitation.

Methods

A retrospective study in patients involved in a cardiovascular rehabilitation program at a tertiary hospital from 2013 to 2023. The main endpoint of major events was a composite of: hospital admission, hospital admission due to cardiac disease, re-infarction, death and death from cardiac causes. Statistical analysis was conducted using dedicated statistical software.

Results

This study involved 446 patients, the majority were male (80.5%) and the average age was 60.5 ± 11.5 years [28; 90]. Patients were followed, on average, for 30.5 ± 21.2 months [1.2; 109.3].

In terms of comorbidities: 72.2% had dyslipidemia, 72.1% hypertension, 26.4% diabetes, 15.3% atrial fibrillation, 13.0% pulmonary disease, 5.9% chronic kidney disease (CKD); and 31.2% were smokers.

The average initial values for: body mass index was 27.6 ± 4.3 Kg/m2, low density lipoprotein (LDL) was 88.8 ± 41.8 mg/dL, glycated hemoglobin was 6.1 ± 1.1%.

Overall, patients attended 13.3 ± 4.3 sessions (92.1 ± 12.2% of the target).

Fifty four (12.1%) patients reached the composite endpoint; 44 (9.9%) were admitted to the hospital, 26 (5.8%) of which due to cardiovascular disease; 4 (0.9%) had a re-infarction; 17 (3.8%) died, 9 (2.0%) of which due to a cardiac cause. Mean time to reach the composite endpoint was 6.3 ± 3.3 months.

The major determinants of the composite endpoint were: being a smoker at baseline (p = 0.009), number of coronary arteries affected (p = 0.027), CKD (p = 0.023), peripheral artery disease (PAD) (p = 0.005), LDL at follow-up (FU) (p = 0.050), final arm strength (p = 0.021), final metabolic equivalent of task (MET) (p = 0.010), and initial end-tidal carbon dioxide pressure (EtCO2) (p = 0.045).

Conclusion

In this study, it was possible to identify initial smoker status, number of coronary arteries affected, CKD, PAD, LDL level at FU, final arm strength, final MET and initial EtCO2 as determinants of cardiovascular rehabilitation success.

Smoking plays a pivotal role in cardiac diseases, making it mandatory to address it in a preemptive way; lipid lowering measures must be taken aggressively and programs ought to include activities to improve a patient's physical conditioning.
Beneficial effects of music listening during treadmill exercise in coronary artery disease patients with a history of percutaneous coronary intervention
Authors: Dritsas A , Laoutaris I D , Iakovou I
Published: June 2024

Background

Music has been shown to potently reduce the perception of fatigue and exertion through dissociation and distraction during exercise. Listening to music prior to and during exercise has been shown to increase motivation and effort, leading to improved performance outcomes.

Purpose

To study the effects of music listening on clinical, ECG and hemodynamic indices measured during exercise in patients (pts) with documented coronary artery disease (CAD) and a history of percutaneous coronary intervention (PCI).

Methods

Thirty two asymptomatic pts (29M/3F) with CAD and a history of previous PCI (12-36 months) were studied during follow-up treadmill exercise test (Bruce Protocol). All pts maintained good LV function assessed by standard echocardiography. Sixteen pts consisting music group (MG) (mean age 60±9) were openly exposed to instrumental classical music delivered during exercise via high quality audio system connected to speakers. Another group of 16 pts (NMG) (mean age 59±8) was not exposed to music during exercise and acted as a control group. All pts were assessed according to standard hemodynamic and ECG measurements obtained during exercise testing in CAD pts. All pts were asked post-exercise to indicate levels of anxiety-stress felt during the procedure on a Visual Analogue Scale (VAS) (range 0-10 cm).

Results

All pts achieved >85% of their max predicted heart rate and no pt developed angina symptoms during the test. ST-T segment exercise ECG abnormalities were detected in 4(25%) pts in MG compared to 5(31%) pts in NMG group (p=ns). Twelve (81%) pts in MG and 13 (87%) in NMG group were on a b-blocker during the test. Exercise duration was longer in MG (9.4±1.6 min) compared to NMG (8.0±1.2 min) (p=0.009). In addition, VAS score was lower in M (4.8±1.8 cm) vs NM group (6.2±1.3 cm) (p=0.017) indicating a reduced level of perceived anxiety-stress in MG .

Conclusion

Music listening improves exercise tolerance during treadmill exercise in pts with CAD and history of PCI. This improvement may be related to a reduction in the perception of anxiety induced by music listening on exercise. Music may be a useful tool to achieve maximal performance and optimize exercise testing diagnosis in cardiovascular pts.
Genetic background determines the severity of age-dependent cardiac structural abnormalities and arrhythmia susceptibility in Scn5a-1798insD mice
Authors: Marchal Gerard A , Rivaud Mathilde R , Wolswinkel Rianne , Basso Cristina , van Veen Toon A B , Bezzina Connie R , Remme Carol Ann
Published: June 2024

Aims

Patients with mutations in SCN5A encoding NaV1.5 often display variable severity of electrical and structural alterations, but the underlying mechanisms are not fully elucidated. We here investigate the combined modulatory effect of genetic background and age on disease severity in the Scn5a1798insD/+ mouse model.

Methods and results

In vivo electrocardiogram and echocardiograms, ex vivo electrical and optical mapping, and histological analyses were performed in adult (2–7 months) and aged (8–28 months) wild-type (WT) and Scn5a1798insD/+ (mutant, MUT) mice from the FVB/N and 129P2 inbred strains. Atrio-ventricular (AV) conduction, ventricular conduction, and ventricular repolarization are modulated by strain, genotype, and age. An aging effect was present in MUT mice, with aged MUT mice of both strains showing prolonged QRS interval and right ventricular (RV) conduction slowing. 129P2-MUT mice were severely affected, with adult and aged 129P2-MUT mice displaying AV and ventricular conduction slowing, prolonged repolarization, and spontaneous arrhythmias. In addition, the 129P2 strain appeared particularly susceptible to age-dependent electrical, functional, and structural alterations including RV conduction slowing, reduced left ventricular (LV) ejection fraction, RV dilatation, and myocardial fibrosis as compared to FVB/N mice. Overall, aged 129P2-MUT mice displayed the most severe conduction defects, RV dilatation, and myocardial fibrosis, in addition to the highest frequency of spontaneous arrhythmia and inducible arrhythmias.

Conclusion

Genetic background and age both modulate disease severity in Scn5a1798insD/+ mice and hence may explain, at least in part, the variable disease expressivity observed in patients with SCN5A mutations. Age- and genetic background–dependent development of cardiac structural alterations furthermore impacts arrhythmia risk. Our findings therefore emphasize the importance of continued assessment of cardiac structure and function in patients carrying SCN5A mutations.
Implementation of cardiac enhanced recovery after surgery at Lausanne University Hospital, our roadbook to certification
Authors: Ltaief Zied , Verdugo-Marchese Mario , Carel Dan , Gunga Ziyad , Nowacka Anna , Melly Valentine , Addor Valerie , Botteau Caroline , Hennemann Marius , Lavanchy Luc , Kirsch Matthias , Rancati Valentina
Published: June 2024

OBJECTIVES

Enhanced recovery after surgery (ERAS) is a multidisciplinary, patient-centred approach aimed at expediting recovery, improving clinical outcomes, and reducing healthcare costs. Initially developed for colorectal surgery, ERAS principles have been successfully applied across various surgical specialties, including cardiac surgery. This study outlines the implementation and certification process of the ERAS program in a tertiary cardiac surgical centre within the Heart-Vessel Department at Lausanne University Hospital.

METHODS

The implementation involved forming a multidisciplinary team, including cardiac surgeons, anaesthesiologists, intensivists, a cardiologist, clinical nurse specialists and physiotherapists. The ERAS nurse coordinator played a central role in organizing meetings, promoting the program, developing protocols, and collecting data. The certification process required adherence to ERAS guidelines, structured training and external evaluation. Key phases included pre-ERAS data collection, protocol dissemination, inclusion of the 1st patients, followed by analysis and full implementation.

RESULTS

Achieving certification required maintaining a compliance rate of over 70% with established protocols. The process involved overcoming various barriers, such as inconsistent practices and the need for multidisciplinary collaboration. In this paper, we provide some solutions to these challenges, including team education, regular meetings and continuous feedback loops. Preliminary data from the initial cohort showed improvements in early mobilization, opioid use, respiratory complications and shorter hospital stays.

CONCLUSIONS

The successful implementation of the ERAS program at our institution demonstrates the feasibility and benefits of a structured, multidisciplinary approach in cardiac surgery. Continuous self-assessment and adherence to guidelines are essential for sustained improvement in patient outcomes and healthcare efficiency.
Halyomorpha halys (Hemiptera: Pentatomidae) as the major contributor to early olive drop in northern Italy
Authors: Sanna Francesco , Mori Nicola , Santoiemma Giacomo , Pozzebon Alberto , Scaccini Davide , Marangoni Federico , Sella Luca
Published: June 2024

In recent years, a new phenomenon of early olive drop is causing production losses in olive groves throughout northern Italy. To analyze the possible causes, field and laboratory trials were performed to assess the involvement of fungal pathogens and insect pests in this disease. External and internal symptoms of fungal infections or insect-feeding activities were researched. Fungi present in healthy and dislodged olives were investigated. The relationship between olives that fell and Halyomorpha halys (Stål) (Hemiptera: Pentatomidae) infestation was assessed in a controlled infestation trial, and the effectiveness of an insecticidal strategy in reducing early olive drop was tested in open field conditions. A comparable number of fungi, mostly endophytes, were isolated and identified from both healthy and dislodged olives. The damage observed on dislodged olives was primarily ascribed to pentatomids feeding activity. Six stink bugs species were found in olive canopies, that is, the invasive H. halys, which was by far the most abundant, and Acrosternum heegeri Fieber, Nezara viridula (Linnaeus), Palomena prasina (Linnaeus), Piezodorus lituratus (Fabricious), and Rhaphigaster nebulosa (Poda). Halyomorpha halys caused intense fruit drop in the controlled infestation trial, and its infestation level significantly correlated with the number of olives that fell. Native stink bugs, present in much lower population compared to H. halys, could also partially contribute to early drop of olives. Insect proof net significantly reduced the early olive drop disease, while insecticide applications only partially reduced the stink bugs population density and, proportionally, early olive drop.
A deep-learning model for the density profiles of subhaloes in IllustrisTNG
Authors: Lucie-Smith Luisa , Despali Giulia , Springel Volker
Published: June 2024

We present a machine-learning-based model for the total density profiles of subhaloes with masses $M \gtrsim 7\times 10^8\, h^{-1}{\rm M}_\odot$ in the IllustrisTNG100 simulation. The model is based on an interpretable variational encoder (IVE) which returns the independent factors of variation in the density profiles within a low-dimensional representation, as well as the predictions for the density profiles themselves. The IVE returns accurate and unbiased predictions on all radial ranges, including the outer region profile where the subhaloes experience tidal stripping; here its fit accuracy exceeds that of the commonly used Einasto profile. The IVE discovers three independent degrees of freedom in the profiles, which can be interpreted in terms of the formation history of the subhaloes. In addition to the two parameters controlling the normalization and inner shape of the profile, the IVE discovers a third parameter that accounts for the impact of tidal stripping on to the subhalo outer profile; this parameter is sensitive to the mass loss experienced by the subhalo after its infall on to its parent halo. Baryonic physics in the IllustrisTNG galaxy formation model does not impact the number of degrees of freedom identified in the profile compared to the pure dark matter expectations, nor their physical interpretation. Our newly proposed profile fit can be used in strong lensing analyses or other observational studies which aim to constrain cosmology from small-scale structures.
The CsDof1.8–CsLIPOXYGENASE09 module regulates C9 aroma production in cucumber
Authors: Sun Yinhui , Li Xuzhen , Wang Hua , Zhang Qiongzhi , Wang Xin , Jiao Yanan , Zhang Jie , Yang Yuying , Xue Wanyu , Qian Yulei , Zhang Xiaojiang , Wang Ruochen , Chen Shuxia
Published: June 2024

Nine-carbon aldehydes and their relative alcohols (C9 aromas) are the main aroma compounds of cucumber (Cucumis sativus L.) fruits and provide a unique cucumber-like note. However, the key regulators of C9 aroma accumulation in cucumber fruit are poorly characterized. Based on C9 aroma dynamic analysis and transcriptome analysis during fruit development of two different cucumber inbred lines, Q16 and Q24, Lipoxygenase09 (CsLOX09) was identified as a candidate gene for C9 aroma accumulation. Additionally, Q24 with higher CsLOX09 expression accumulated more C9 aromas than Q16. To verify the function of CsLOX09, Cslox09 homozygote knockout lines were created. C9 aroma content decreased by 80.79% to 99.16% in these mutants compared to the wild type. To further explore the reasons for the difference in CsLOX09 expression between Q16 and Q24 fruits, a co-expression network was constructed by integrating the C9 aroma-associated metabolism and transcriptomic data. Eighteen candidate transcription factors were highly correlated with the expression of CsLOX09. DNA binding with One Finger 1.8 (CsDof1.8) was confirmed to bind directly to the A/TAAAG motif of the CsLOX09 promoter through dual-luciferase, yeast one-hybrid, chromatin immunoprecipitation−qPCR and electrophoretic mobility shift assays. Furthermore, C9 aroma content and CsLOX09 expression were significantly increased in the CsDof1.8 overexpression lines. Overall, these data elucidate the metabolic regulation of C9 aromas in cucumber and provide a foundation for facilitating the regulation of flavor in cucumber breeding.
‘Initially this work was done by doctors, often ineffectively …’: the History of Sexual Health Advising in twentieth-century England
Authors: Evans David
Published: June 2024

Much has been written about the history of policy and practice on venereal diseases/sexually transmitted infections in twentieth-century England, but one key group of actors has been overlooked: sexual health advisers and their predecessors. From the introduction of venereal disease clinics c. 1918, workers variously titled hospital almoners, health visitors, contact tracers, social workers, and, latterly, sexual health advisers have been involved in a range of interconnected activities including counselling, health education, contact tracing, and seeking defaulters from treatment in the community. Leading medical venereologists have generally expressed strong support for the value of such workers, but throughout the century there has been continuing diversity in the background, employment, training, roles, and responsibilities of those workers. In the last decades of the twentieth century, sexual health advisers sought to professionalize by establishing a professional organization and seeking other professional attributes including certified training and professional registration. Although there appeared to be policy support for such steps, by the early twenty-first century a change of government disappointed such professionalization hopes. The history of sexual health advising provides a unique lens on the challenges facing occupational groups seeking to professionalize within the National Health Service.
Predictors of Physician Assistant Student Mistreatment Reporting
Authors: Hudak Nicholas M. , Akroyd Duane
Published: June 2024

Introduction

Many physician assistant (PA) students experience mistreatment by preceptors in clinical settings though most do not report it to their institution. Nonreporting limits an institution's ability to address mistreatment and provide student support. Several reasons for nonreporting have been described in national surveys. The purpose of this study was to identify factors predictive of student reporting behavior.

Methods

This study used a nonexperimental, cross-sectional, predictive research design with quantitative analytic methods. Data were from 2 national surveys administered to PA students and programs in 2019. The sample was PA students who experienced mistreatment performed by preceptors. Logistic regression was used to identify which independent variables were predictors of student mistreatment reporting to their institution.

Results

Students were twice as likely to report mistreatment involving physical or sexual behavior compared with other types. Older students were more likely to report mistreatment than younger students. Policy factors were not significant predictors of student reporting behavior.

Discussion

Student likelihood to reporting severe forms of mistreatment indicate they recognize those behaviors as mistreatment and believe they are important enough to report. Greater likelihood of reporting by older students indicates the influence of student demographics and life experience. Policy factors and institution characteristics were not significant predictors of student reporting behavior, which suggest the limits of policy as a facilitator of mistreatment reporting. These findings have implications for educational program policy design, implementation, and evaluation, as well as underscore the need for further research to understand factors influencing students' decision to report mistreatment.
The Value of International Exchange Programs for Physician Assistants: Surveying a US-Netherlands Advanced Practice Provider Exchange Program
Authors: Wright Sara Lynne , Low Chen Der , Scribner Caroline , Chong Angela , Seligman Adam
Published: June 2024

Introduction

International exchange programs between physician assistants (PAs) and other advanced practice providers (APPs) from different countries can facilitate opportunities for global health training and experiences. This article examines a survey of 5 PAs, 4 nurse practitioners, and 1 certified nursing specialist working in the United States (US) about their experience collaborating in an international exchange program with APPs in the Netherlands.

Methods

Ten APPs in the United States anonymously answered an 8-item survey on their experience in an international exchange program with APPs in the Netherlands with a 100% response rate. The survey contained questions regarding the impact of the program on cultural competence, professional development, and perception of health care systems.

Results

All respondents agree or strongly agree that the program contributed to APP growth in cultural competence and professional development. Eighty percent of respondents found APP practices in the United States compared with the Netherlands to be somewhat or extremely similar, with differences noted in training and education, patterns of utilization, and roles in procedures. Free responses indicate APPs are used similarly in the Netherlands and the United States, while APP training models and health care infrastructure in the 2 countries have notable differences.

Discussion

Survey results examined in this article underscore how an international exchange program can not only enrich individual professional paths but also positively contribute to the broader global health care landscape. The lessons learned, shared experiences, and insights gained have the potential to shape health care practices on an international scale, fostering a collaborative and interconnected future for health care providers worldwide.
Stereotactically intracerebral transplantation of neural stem cells for ischemic stroke attenuated inflammatory responses and promoted neurogenesis: an experimental study with monkeys
Authors: Liu Yi-Fan , Liu Hao-Tian , Chang Chuheng , Yang Cheng-Xian , Liu Xin-Nan , Wang Xia , Ge Wei , Wang Ren-Zhi , Bao Xin-Jie
Published: June 2024

Background:

Ischemic stroke is a common neurovascular disorder with high morbidity and mortality. However, the underlying mechanism of stereotactically intracerebral transplantation of human neural stem cells (hNSCs) is not well elucidated.

Materials and methods:

Four days after ischemic stroke induced by Rose Bengal photothrombosis, seven cynomolgus monkeys were transplanted with hNSCs or vehicles stereotactically and followed up for 84 days. Behavioral assessments, magnetic resonance imaging, blood tests, and pathological analysis were performed before and after treatment. The proteome profiles of the left and right precentral gyrus and hippocampus were evaluated. Extracellular vesicle micro-RNA (miRNA) from the peripheral blood was extracted and analyzed.

Results:

hNSC transplantation reduced the remaining infarcted lesion volume of cynomolgus monkeys with ischemic stroke without remarkable side effects. Proteomic analyses indicated that hNSC transplantation promoted GABAergic and glutamatergic neurogenesis and restored the mitochondrial electron transport chain function in the ischemic infarcted left precentral gyrus or hippocampus. Immunohistochemical staining and quantitative real-time reverse transcription PCR confirmed the promoting effects on neurogenesis and revealed that hNSCs attenuated post-infarct inflammatory responses by suppressing resident glia activation and mediating peripheral immune cell infiltration. Consistently, miRNA-sequencing revealed the miRNAs that were related to these pathways were downregulated after hNSC transplantation.

Conclusions:

This study indicates that hNSCs can be effectively and safely used to treat ischemic stroke by promoting neurogenesis, regulating post-infarct inflammatory responses, and restoring mitochondrial function in both the infarct region and hippocampus.
Efficacy and safety of robotic vs. laparoscopic gastrectomy for patients with gastric cancer: systematic review and meta-analysis
Authors: Li Zhenshun , Zhou Wei , Yang Wanli , Miao Yan , Zhang Yujie , Duan Lili , niu Liaoran , Chen Junfeng , Fan Aqiang , Xie Qibin , Wei Siyu , Bai Han , Wang Chenyang , Chen Xi , Han Yu , Hong Liu
Published: June 2024

Background:

The emergence of robotic surgical systems compensated for the technological shortcomings of laparoscopic approaches. However, whether robotic gastrectomy (RG) has better perioperative outcomes and survival than laparoscopic gastrectomy (LG) for gastric cancer (GC) is still unclear but increasingly drawing attention.

Materials and methods:

In this systematic review and meta-analysis, we searched PubMed, EMBASE, Web of Science, and Cochrane Library as of 20 January 2024, and referenced a list of eligible articles for all published studies comparing RG and LG for patients with GC. Data on study characteristics, individual characteristics, and outcome parameters were extracted. The quality of studies was assessed using the Revised Cochrane risk-of-bias 2 tool and the risk of bias in nonrandomized studies of interventions tool. The main outcome measures were overall survival (OS) and disease-free survival (DFS).

Results:

The authors identified 3641 articles, of which 72 studies (30 081 patients) were included in the meta-analysis. Compared with LG, RG was associated with higher OS [hazard ratio (HR)=0.89, 95% CI=0.83–0.96], lower rate of overall postoperative complications [odds ratio (OR)=0.77, 95% CI=0.71–0.84], longer operating time [mean difference (MD)=35.53, 95% CI=29.23–41.83], less estimated blood loss (MD=−37.45, 95% CI=−46.24 to −28.67), a higher number of retrieved lymph nodes (MD=1.88, 95% CI=0.77–3.00), faster postoperative recovery, and lower rate of conversion (OR=0.44, 95% CI=0.36–0.55). Mortality and DFS were not significantly different between the two groups. The subgroup of meta-analysis results also showed the advantages of robotic surgery over laparoscopic surgery in intracorporeal reconstruction, total gastrectomy, Ⅰ/Ⅱ stage, and BMI≥25, especially for patients with stage Ⅰ/Ⅱ, there are better OS and DFS.

Conclusion:

Our findings point to robotic surgery having great benefits compared with laparoscopic surgery in GC. Our study may help inform decision-making in applying robotic surgical systems to clinical treatment.
Evaluation of the Nautilus Smart Extracorporeal Membrane Oxygenation in Patients With Hemostatic Alteration: A Case Series
Authors: Renghini Mauro , Maddinelli Debora , Papeo Anna , Puglia Carmine , Montisci Andrea , Cattaneo Sergio , Benussi Stefano
Published: June 2024

The intricate management of hemostatic disorders in extracorporeal membrane oxygenation (ECMO) assisted patients poses challenges, particularly when procoagulant administration is necessary. We hereby report the performance of the Nautilus* Smart ECMO Module in three patients with hemostatic disorders. We collected data from ECMO procedures with Nautilus* Smart ECMO Module and analyzed the performance: the operating pressures and resistance of the device in addition to the coagulation status of the patients. During the three procedures, partial pressure oxygen post-oxygenator (paO2) stayed above 100 mm Hg and partial pressure carbon dioxide post-oxygenator (paCO2) did not exceed 45 mm Hg. Membrane FiO2 (fractional inspired O2) did not exceed 75% and air flow remained within a 1:1 ratio with blood flow in veno-arterial ECMO (V-A) and within 1:2 in veno-venous ECMO (V-V). There was no evidence of excessive operating pressure for the device, with a pressure drop consistently below 28 mm Hg and a maximum peak resistance of 7 Δmm Hg/L/min. The Nautilus* Smart ECMO Module showed good performance in patients with hemostatic disorders despite the implications associated with procoagulant administration.
ICU management of cardiogenic shock before mechanical support
Authors: Schaubroeck Hannah , Rossberg Michelle , Thiele Holger , Pöss Janine
Published: June 2024

Purpose of review

Treatment of cardiogenic shock remains largely driven by expert consensus due to limited evidence from randomized controlled trials. In this review, we aim to summarize the approach to the management of patients with cardiogenic shock in the ICU prior to mechanical circulatory support (MCS).

Recent findings

Main topics covered in this article include diagnosis, monitoring, initial management and key aspects of pharmacological therapy in the ICU for patients with cardiogenic shock.

Despite efforts to improve therapy, short-term mortality in patients with cardiogenic shock is still reaching 40–50%. Early recognition and treatment of cardiogenic shock are crucial, including early revascularization of the culprit lesion with possible staged revascularization in acute myocardial infarction (AMI)-CS. Optimal volume management and vasoactive drugs titrated to restore arterial pressure and perfusion are the cornerstone of cardiogenic shock therapy. The choice of vasoactive drugs depends on the underlying cause and phenotype of cardiogenic shock. Their use should be limited to the shortest duration and lowest possible dose. According to recent observational evidence, assessment of the complete hemodynamic profile with a pulmonary artery catheter (PAC) was associated with improved outcomes and should be considered early in patients not responding to initial therapy or with unclear shock. A multidisciplinary shock team should be involved early in order to identify potential candidates for temporary and/or durable MCS.
Primary Sjogren syndrome – A bibliometric analysis via CiteSpace
Authors: Yang Mingrui , Wang Shangzhi , Zhang Jin , Yan Bin
Published: June 2024

This study employs CiteSpace software to analyze the research status, hotspots, and trends of primary Sjogren syndrome (pSS). Relevant publications from 1999 to 2023 were searched in the Web of Science Core Collection (WoSCC) set, followed by generating a network map using CiteSpace software to identify top authors, institutions, countries, keywords, journals, references, and research trends. A total of 3564 valid articles were included in this study. The People Republic of China had the highest number of articles (n = 524), while the University of Bergen emerged as the institution with the highest publication count (n = 94). Mariette X was identified as the author with the most publications (n = 67), whereas Vitali C received recognition as the most cited author (n = 1706). Annals of Rheumatic Diseases stood out as the journal with the highest citation count (n = 2530). Notably, an article published in the Annals of Rheumatic Diseases in 2017 garnered significant attention by being cited a remarkable 304 times. The bibliometric analysis reveals that key areas of research in pSS encompass investigating pathogenesis; advancing and applying targeted biological agents; and establishing treatment and diagnostic standards.
Comfort nursing theory on the postoperative rehabilitation quality and nursing satisfaction of patients with intracranial aneurysm
Authors: Sun Lili , Liu Peipei , Ye Lei
Published: June 2024

To explore the influence of comfort nursing theory on the postoperative rehabilitation quality of patients with intracranial aneurysms. From October 2017 to December 2022, 315 patients with intracranial aneurysms underwent interventional surgery in our hospital were included in this retrospective study and divided into the routine group (n = 105) and comfort nursing group (n = 210) based on different nursing methods. The Glasgow Outcome Scale (GOS) was used to assess patient rehabilitation outcomes. Patients’ anxiety, pain, quality of life, and their satisfaction with treatment were compared. Compared with the patients receiving routine nursing, the time for comfortable nursing patients to resume normal diet, get out of bed and exercise, and the total hospital stay were significantly shortened. And the GOS score of patients receiving comfort nursing was significantly higher than that of patients receiving routine nursing. After nursing, self-rating anxiety scale and visual analog scale scores of comfortable nursing patients were significantly lower than those of routine nursing, and Karnofsky performance status scores were significantly higher than those of routine nursing. This showed that receiving comfortable nursing was beneficial to improve perioperative anxiety and depression in patients with intracranial aneurysm, and significantly improve the quality of life of patients. The total satisfaction of comfortable nursing patients was 95.24%, while that of routine nursing patients was 76.19%. Complications occurred in 30 patients receiving routine nursing, while only 15 patients received comfort nursing. The immune indexes such as CD3
+, CD4
+, and CD23
+ of comfortable nursing patients were significantly higher than the routine nursing patients within 1 and 5 days after operation, while the immune indexes of CD8
+ were lower than the routine nursing patients 5 days after operation. Comfortable nursing from the perspective of quality nursing can significantly improve the physiological indicators of patients with intracranial aneurysms, accelerate the progress of postoperative rehabilitation, improve the anxiety, pain and quality of life of patients, and improve the satisfaction of patients with nursing. Comfort nursing from the perspective of quality nursing can reduce the occurrence of postoperative complications, which may be achieved by improving the patient’s immune function.
Association of osteoporosis with sarcopenia and its components among community-dwelling older Chinese adults with different obesity levels: A cross-sectional study
Authors: Yu Xing , Zheng Yaqing , Liu Yuewen , Han Peipei , Chen Xiaoyu , Zhang Naiwen , Ni Yejia , Zhou Ziyi , Guo Qi
Published: June 2024

We aimed to investigate whether sarcopenia and its components are associated with osteoporosis in community-dwelling older Chinese adults with different obesity levels. This cross-sectional study included 1938 participants (42.1% male) with a mean age of 72.1 ± 5.9 years. The categorization of individuals into various weight categories was based on the Working Group on Obesity in China’s criteria, utilizing the body mass index (BMI) as follows: underweight, BMI < 18.5 kg/m2; normal weight, 18.5 ≤ BMI < 24 kg/m2; overweight, 24 ≤ BMI < 28 kg/m2; and obesity, BMI ≥ 28 kg/m2. In this research, the osteoporosis definition put forth by the World Health Organization (bone mineral density T-score less than or equal to −2.5 as assessed by Dual-energy X-ray absorptiometry (DXA)). Sarcopenia was defined according to the diagnostic criteria of the Asian Working Group for Sarcopenia. The prevalence of osteoporosis was highest in the underweight group and gradually decreased with increasing BMI (Underweight: 55.81% vs Normal weight: 45.33% vs Overweight: 33.69% vs Obesity: 22.39). Sarcopenia was associated with elevated odds of osteoporosis in normal-weight subjects independent of potential covariates (OR = 1.70, 95% CI = 1.22–2.35, P = .002). In normal-weight participants, a higher appendicular skeletal muscle mass index (ASMI) was associated with a reduced risk of osteoporosis (OR = 0.56, 95% CI = 0.42–0.74, P < .001). In this study, we found that the prevalence of osteoporosis was highest in the underweight group and gradually decreased with increasing BMI. Sarcopenia, body fat percentage, and ASMI were associated with elevated odds of osteoporosis in normal-weight subjects independent of potential covariates, and higher percent body fat (PBF) was associated with an increased risk of osteoporosis in overweight people, and no such association was found in other weight groups. Different amounts of adipose tissue and muscle mass may alter bone biology. Further longitudinal follow-up studies are required to more accurately assess the risk of osteoporosis and sarcopenia in different weight populations. This cross-sectional study found that the prevalence of osteoporosis was highest in the underweight group and gradually decreased with increasing BMI. Sarcopenia was associated with elevated odds of osteoporosis in normal-weight subjects independent of potential covariates.
The efficacy of 3 root canal sealers combined with warm gutta-percha vertical compression technique in the treatment of dental pulp disease
Authors: Li Wenbo , Ju Bo , Cheng Gang , Lv Zhijun
Published: June 2024

To investigate the efficacy of 3 root canal sealants such as AH Plus, GuttaFlow and iRoot SP combined with warm gutta-percha vertical compression technique in the treatment of dental pulp disease. This was a single-center retrospective study. 180 patients with dental pulp disease were divided into AH Plus group (n = 60), GuttaFlow group (n = 60) and iRoot SP group (n = 60) according to the different treatment methods. Patients in different groups were treated with corresponding root canal sealant combined with warm gutta-percha vertical compression technique. The quality of root canal filling, filling time, filling area ratio, the incidence of pain after operation, serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) and efficacy at 6 months after operation were compared among the 3 groups, respectively. The filling time in the GuttaFlow group and the iRoot SP group was significantly shorter than that in the AH Plus group (P < .001). There were significant differences in pain grade (P = .015) and pain rate (P = .016) among the 3 groups, and the pain rate in the GuttaFlow group and the iRoot SP group was significantly lower than that in the AH Plus group (P = .016). The time-point effect, intergroup effect and time-groups effect of serum TNF-α and IL-6 were significantly different (P < .001), and the levels of the 3 groups after treatment were significantly lower than those before treatment (P < .05), and the levels were significantly lower in the GuttaFlow group and the iRoot SP group (P < .05). There were significant differences in efficacy grading and effective rate among the 3 groups (P = .028), and the effective rate of iRoot SP group was significantly higher than that of AH Plus group (P < .05). The iRoot SP or GuttaFlow as root canal sealant combined with warm gutta-percha vertical compression technique in the treatment of dental pulp disease is better than AH Plus, and the former one can shorten the filling time, relieve the postoperative pain and improve the inflammatory response, but the long-term apical sealing effect of iRoot SP is better than GuttaFlow.
The impact of gender differences on the clinical characteristics of critically ill patients with venous thromboembolism: A retrospective, observational study
Authors: He Meng , Ye Jiuhang , Zheng Weiwei , Qiao Peng , Gu Haiyan , Qin Wenwen , He Xuehong
Published: June 2024

The aim of this study is to describe the general information, disease and treatment of venous thromboembolism (VTE) in critically ill patients, to explore the characteristics of severe patients with deep venous VTE and provide clinical reference data for the prevention and treatment of VTE in critically ill patients. This study carried out a retrospective study on the medical records of patients who were treated in the intensive care unit of Affiliated Hospital of Jining Medical College from 2020 to 2022. The general data, general conditions, drug use, past history, VTE prevention measures, post-VTE conditions, and Padua risk score of 297 patients with VTE during the period of hospitalization in intensive care unit (ICU) were classified and statistically analyzed. A total of 297 including 171 male and 126 male patient medical records were included in the analysis, we compared multiple clinical indicators between male and female patients. Compared to women, male patients have a higher acute physiology and chronic health evaluation II score(APACHE-II score) (P = .027), a higher state of consciousness (P = .003), a higher rate of smoking and drinking history (P < .001), a lower rate of heart failure (P = .003) and chronic depression (P = .013), and a higher rate of recommended operations for male patients after VTE (P = .031). The prothrombin time (PT) (P = .041) and activated partial thromboplastin time (APTT) (P = .040) of male patients were significantly higher than those of female patients, while triglyceride (P = .009) and total cholesterol (TC) (P = .001) were significantly lower than those of female patients. The difference in D-dimer (P = .739) was not significant. This study shows that male and female patients with VTE in the ICU have significant differences in general characteristics, general clinical conditions, history of past illness, thrombosis character, and examination items, this may be the reason for the different rates of VTE between male and female patients in the ICU.