bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of antenatal corticosteroids among infants during gestational age at 24 to 31 weeks in 57 neonatal intensive care units of China: a cross-sectional study
Authors: Zhao Jing , Feng Zongtai , Dai Yun , Zhang Wanxian , Jiang Siyuan , Wang Yanchen , Gu Xinyue , Sun Jianhua , Cao Yun , Lee Shoo K. , Tian Xiuying , Yang Zuming
Published: February 2023

Background:

Antenatal corticosteroids (ACS) can significantly improve the outcomes of preterm infants. This study aimed to describe the ACS use rates among preterm infants admitted to Chinese neonatal intensive care units (NICU) and to explore perinatal factors associated with ACS use, using the largest contemporary cohort of very preterm infants in China.

Methods:

This cross-sectional study enrolled all infants born at 24+0 to 31+6 weeks and admitted to 57 NICUs of the Chinese Neonatal Network from January 1st, 2019 to December 30th, 2019. The ACS administration was defined as at least one dose of dexamethasone and betamethasone given before delivery. Multiple logistic regressions were applied to determine the association between perinatal factors and ACS usage.

Results:

A total of 7828 infants were enrolled, among which 6103 (78.0%) infants received ACS. ACS use rates increased with increasing gestational age (GA), from 177/259 (68.3%) at 24 to 25 weeks’ gestation to 3120/3960 (78.8%) at 30 to 31 weeks’ gestation. Among infants exposed to ACS, 2999 of 6103 (49.1%) infants received a single complete course, and 33.4% (2039/6103) infants received a partial course. ACS use rates varied from 30.2% to 100.0% among different hospitals. Multivariate regression showed that increasing GA, born in hospital (inborn), increasing maternal age, maternal hypertension and premature rupture of membranes were associated with higher likelihood to receive ACS.

Conclusions:

The use rate of ACS remained low for infants at 24 to 31 weeks’ gestation admitted to Chinese NICUs, with fewer infants receiving a complete course. The use rates varied significantly among different hospitals. Efforts are urgently needed to propose improvement measures and thus improve the usage of ACS.
Integrins in human hepatocellular carcinoma tumorigenesis and therapy
Authors: Gao Qiong , Sun Zhaolin , Fang Deyu
Published: February 2023

Integrins are a family of transmembrane receptors that connect the extracellular matrix and actin skeleton, which mediate cell adhesion, migration, signal transduction, and gene transcription. As a bi-directional signaling molecule, integrins can modulate many aspects of tumorigenesis, including tumor growth, invasion, angiogenesis, metastasis, and therapeutic resistance. Therefore, integrins have a great potential as antitumor therapeutic targets. In this review, we summarize the recent reports of integrins in human hepatocellular carcinoma (HCC), focusing on their abnormal expression, activation, and signaling of integrins in cancer cells as well as their roles in other cells in the tumor microenvironment. We also discuss the regulation and functions of integrins in hepatitis B virus-related HCC. Finally, we update the clinical and preclinical studies of integrin-related drugs in the treatment of HCC.
Challenges and optimal strategies of CAR T therapy for hematological malignancies
Authors: Zhang Yajing , Xu Yang , Dang Xiuyong , Zhu Zeyu , Qian Wenbin , Liang Aibin , Han Weidong
Published: February 2023

Remarkable improvement relative to traditional approaches in the treatment of hematological malignancies by chimeric antigen receptor (CAR) T-cell therapy has promoted sequential approvals of eight commercial CAR T products within last 5 years. Although CAR T cells’ productization is now rapidly boosting their extensive clinical application in real-world patients, the limitation of their clinical efficacy and related toxicities inspire further optimization of CAR structure and substantial development of innovative trials in various scenarios. Herein, we first summarized the current status and major progress in CAR T therapy for hematological malignancies, then described crucial factors which possibly compromise the clinical efficacies of CAR T cells, such as CAR T cell exhaustion and loss of antigen, and finally, we discussed the potential optimization strategies to tackle the challenges in the field of CAR T therapy.
Continuation, reduction, or withdrawal of tofacitinib in patients with rheumatoid arthritis achieving sustained disease control: a multicenter, open-label, randomized controlled trial
Authors: Wang Mengyan , Xue Yu , Du Fang , Ma Lili , Lu Liang-jing , Jiang Lindi , Tao Yi-Li , Yang Chengde , Shi Hui , Liu Honglei , Cheng Xiaobing , Ye Junna , Su Yutong , Zhao Dongbao , Dai Sheng-Ming , Teng Jialin , Hu Qiongyi
Published: February 2023

Background:

Rheumatoid arthritis (RA), a chronic systemic autoimmune disease, is characterized by synovitis and progressive damage to the bone and cartilage of the joints, leading to disability and reduced quality of life. This study was a randomized clinical trial comparing the outcomes between withdrawal and dose reduction of tofacitinib in patients with RA who achieved sustained disease control.

Methods:

The study was designed as a multicenter, open-label, randomized controlled trial. Eligible patients who were taking tofacitinib (5 mg twice daily) and had achieved sustained RA remission or low disease activity (disease activity score in 28 joints [DAS28] ≤3.2) for at least 3 months were enrolled at six centers in Shanghai, China. Patients were randomly assigned (1:1:1) to one of three treatment groups: continuation of tofacitinib (5 mg twice daily); reduction in tofacitinib dose (5 mg daily); and withdrawal of tofacitinib. Efficacy and safety were assessed up to 6 months.

Results:

Overall, 122 eligible patients were enrolled, with 41 in the continuation group, 42 in the dose-reduction group, and 39 in the withdrawal group. After 6 months, the percentage of patients with a DAS28-erythrocyte sedimentation rate (ESR) of <3.2 was significantly lower in the withdrawal group than that in the reduction and continuation groups (20.5%, 64.3%, and 95.1%, respectively; P < 0.0001 for both comparisons). The average flare-free time was 5.8 months for the continuation group, 4.7 months for the dose reduction group, and 2.4 months for the withdrawal group.

Conclusion:

Withdrawal of tofacitinib in patients with RA with stable disease control resulted in a rapid and significant loss of efficacy, while standard or reduced doses of tofacitinib maintained a favorable state.

Trial Registration:

Chictr.org, ChiCTR2000039799.
Remote ischemic conditioning-induced hyperacute and acute responses of plasma proteome in healthy young male adults: a quantitative proteomic analysis
Authors: Song Siying , Wu Hao , Liu Yunhuan , Lan Duo , Jiao Baolian , Wan Shuling , Guo Yibing , Zhou Da , Ding Yuchuan , Ji Xunming , Meng Ran
Published: February 2023

Background:

Long-term remote ischemic conditioning (RIC) has been proven to be beneficial in multiple diseases, such as cerebral and cardiovascular diseases. However, the hyperacute and acute effects of a single RIC stimulus are still not clear. Quantitative proteomic analyses of plasma proteins following RIC application have been conducted in preclinical and clinical studies but exhibit high heterogeneity in results due to wide variations in experimental setups and sampling procedures. Hence, this study aimed to explore the immediate effects of RIC on plasma proteome in healthy young adults to exclude confounding factors of disease entity, such as medications and gender.

Methods:

Young healthy male participants were enrolled after a systematic physical examination and 6-month lifestyle observation. Individual RIC sessions included five cycles of alternative ischemia and reperfusion, each lasting for 5 min in bilateral forearms. Blood samples were collected at baseline, 5 min after RIC, and 2 h after RIC, and then samples were processed for proteomic analysis using liquid chromatography-tandem mass spectrometry method.

Results:

Proteins related to lipid metabolism (e.g., Apolipoprotein F), coagulation factors (hepatocyte growth factor activator preproprotein), members of complement cascades (mannan-binding lectin serine protease 1 isoform 2 precursor), and inflammatory responses (carboxypeptidase N catalytic chain precursor) were differentially altered at their serum levels following the RIC intervention. The most enriched pathways were protein glycosylation and complement/coagulation cascades.

Conclusions:

One-time RIC stimulus may induce instant cellular responses like anti-inflammation, coagulation, and fibrinolysis balancing, and lipid metabolism regulation which are protective in different perspectives. Protective effects of single RIC in hyperacute and acute phases may be exploited in clinical emergency settings due to apparently beneficial alterations in plasma proteome profile. Furthermore, the beneficial effects of long-term (repeated) RIC interventions in preventing chronic cardiovascular diseases among general populations can also be expected based on our study findings.

Registration:

ClinicalTrials.gov, NCT03105141.
Hepatocyte apoptosis fragment product cytokeratin-18 M30 level and non-alcoholic steatohepatitis risk diagnosis: an international registry study
Authors: Zhang Huai , Rios Rafael S. , Boursier Jerome , Anty Rodolphe , Chan Wah-Kheong , George Jacob , Yilmaz Yusuf , Wong Vincent Wai-Sun , Fan Jiangao , Dufour Jean-François , Papatheodoridis George , Chen Li , Schattenberg Jörn M. , Shi Jun-ping , Xu Liang , Wong Grace Lai-Hung , Lange Naomi F. , Papatheodoridi Margarita , Mi Yuqiang , Zhou Yujie , Byrne Christopher D. , Targher Giovanni , Feng Gong , Zheng Minghua
Published: February 2023

Background:

Liver biopsy for the diagnosis of non-alcoholic steatohepatitis (NASH) is limited by its inherent invasiveness and possible sampling errors. Some studies have shown that cytokeratin-18 (CK-18) concentrations may be useful in diagnosing NASH, but results across studies have been inconsistent. We aimed to identify the utility of CK-18 M30 concentrations as an alternative to liver biopsy for non-invasive identification of NASH.

Methods:

Individual data were collected from 14 registry centers on patients with biopsy-proven non-alcoholic fatty liver disease (NAFLD), and in all patients, circulating CK-18 M30 levels were measured. Individuals with a NAFLD activity score (NAS) ≥5 including a score of ≥1 for each of steatosis, ballooning, and lobular inflammation were diagnosed as having definite NASH; individuals with a NAS ≤2 and no fibrosis were diagnosed as having non-alcoholic fatty liver (NAFL).

Results:

A total of 2571 participants were screened, and 1008 (153 with NAFL and 855 with NASH) were finally enrolled. Median CK-18 M30 levels were higher in patients with NASH than in those with NAFL (mean difference 177 U/L; standardized mean difference [SMD]: 0.87 [0.69–1.04]). There was an interaction between CK-18 M30 levels and serum alanine aminotransferase, body mass index (BMI), and hypertension (P < 0.001, P = 0.026 and P = 0.049, respectively). CK-18 M30 levels were positively associated with histological NAS in most centers. The area under the receiver operating characteristics (AUROC) for NASH was 0.750 (95% confidence intervals: 0.714–0.787), and CK-18 M30 at Youden's index maximum was 275.7 U/L. Both sensitivity (55% [52%–59%]) and positive predictive value (59%) were not ideal.

Conclusions:

This large multicenter registry study shows that CK-18 M30 measurement in isolation is of limited value for non-invasively diagnosing NASH.
Mental Health of Caregivers of Children with Medical Complexity During COVID-19
Authors: Aryee Emmanuel , Perrin James M. , Clancy Sandra , Merrill Caitlin , Curran Marjorie , Oreskovic Nicolas M.
Published: February 2023

Objective:

The purpose of this study is to investigate the relationship between mental health and financial burden among caregivers of children with medical complexity (CMC) during the COVID-19 pandemic.

Methods:

We conducted a cross-sectional survey on the mental health and financial burden of caregivers of CMC from April 2020 to April 2021. The study sample included 70 caregivers. We analyzed the association between caregiver mental health and caregiver demographics and child characteristics through bivariate linear regressions. We then used multivariate linear regression to assess the association between caregiver mental health and caregiver financial burden adjusting for significant covariates from our bivariate analysis.

Results:

Caregivers reported lower mental health scores (56.2) and higher financial burden scores (15.5) than reference population means: (72.6; SD 20.2) and (10.4; SD 2.2), respectively. Financial burden [−3.4; p = 0.0003; CI: −5.1 to −1.6] and child age [−0.1; p = 0.02; CI: 0.2–1.8] were significantly associated with caregiver mental health in our bivariate analysis. In our multivariate analysis, caregivers with an increased financial burden had lower mental health scores [−3.0; p = 0.002; CI: −4.8 to −1.2].

Conclusion:

Caregivers of children with medically complex conditions experienced more mental health symptoms and greater financial burdens than normative samples during the COVID-19 pandemic. Parents with a greater financial burden also tend to have more mental health issues. Eligibility for financial assistance should include financial burden and income when providing help to families in this population. Local and national stakeholders should consider the provision of financial help in their quest to improve the mental health of caregivers.
Association Between Maternal Postnatal Depression and Offspring Anxiety and Depression in Adolescence and Young Adulthood: A Meta-Analysis
Authors: Chithiramohan Tamara , Eslick Guy D.
Published: February 2023

Objective:

Postnatal depression (PND) is common, with an incidence of 10% to 20% in new mothers. Studies have identified an association between maternal PND and adverse childhood effects. Fewer studies have explored the risk of psychiatric disorders in adolescence and adulthood.

Methods:

MEDLINE, PubMed, PsycINFO, Embase, and EmCare were searched. Studies evaluating the association between maternal PND and offspring anxiety or depression in adolescence or adulthood were included. Five prospective cohort studies met the inclusion criteria. The odds ratios were pooled using a random effects model, and heterogeneity and publication bias were assessed.

Results:

Anxiety: The 4 relevant studies were composed of 273 mothers with PND and 916 controls, followed up for 12 to 23 years. The pooled odds ratio (OR) was 2.19 (1.33–3.61), p = 0.002, with no heterogeneity (I2 = 0.00, p = 0.49). Depression: The 5 studies were composed of 937 mothers with PND and 3099 controls, followed up from 12 to 23 years. The pooled OR was 1.92 (1.08–3.42), p = 0.026, with heterogeneity (I2 = 62.89, p = 0.03).

Conclusion:

Offspring of mothers with PND are twice as likely to suffer from anxiety and almost twice as likely to suffer from depression than those without exposure. This evidence heightens the importance of detection and treatment of postnatal depression. Furthermore, early assessment and support could be provided to the high-risk group of offspring.
Parent-Reported Caregiving Roles of Siblings of Children with Inborn Errors of Metabolism
Authors: Granovetter Madeleine A. , Sumrall Sydney , Lea Dawn , Gelles Shani , Koehly Laura M.
Published: February 2023

Objectives:

Research examining sibling caregiving contributions to medically complex pediatric patients, including those with inborn errors of metabolism (IEMs), is limited. We assess caregiving roles and attributes of siblings and hypothesize that there will be differences in parent-reported contributions among siblings of children with IEMs and siblings of typically developing (TD) children.

Study design:

A convergent parallel mixed-methods study design guided analysis of data from parental surveys and semistructured interviews. Interviews were conducted with parents (n = 49) of children with IEMs and parents (n = 28) of exclusively TD children. We used inductive thematic analysis to identify themes related to sibling caregiving. The caregiving and support roles for siblings (n = 55) of children with IEMs and siblings (n = 42) of TD children were coded to assess each sibling's caregiving contributions and personal attributes.

Results:

Logistic regressions, using generalized estimating equations, were fitted. Results showed that siblings of children with IEMs were significantly more likely to provide monitoring (odds ratio [OR]: 3.62, confidence interval [CI]: 1.30–10.07) and emotional/social support (OR: 4.02, CI: 1.67–9.67) than siblings of TD children. Themes arising from interviews with parents of children with IEMs focused on sibling attributes, parental expectations regarding sibling caregiving, and challenges to the sibling-sibling and parent-sibling relationships. Themes revealed nuances in the sibling caregiving experience.

Conclusion:

Siblings of children with IEMs make meaningful caregiving contributions and may provide care differently than siblings of TD children. Understanding childhood caregiving roles may inform how health care providers and parents encourage sibling caregiving contributions into adulthood.
Hepatic venous reconstruction of the left lateral segment with emphasis on anomalous hepatic vein in pediatric liver transplantation
Authors: da Fonseca Eduardo Antunes , Feier Flavia Heinz , Costa Carolina Magalhães , Benavides Marcel Albeiro Ruiz , Vincenzi Rodrigo , de Oliveira Roda Vincenzi Karina Moreira , Pugliese Renata Pereira Sustovich , Porta Gilda , Miura Irene Kazuo , de Oliveira Caio Marcio Vieira , Chapchap Paulo , Neto João Seda
Published: February 2023

Left lateral segment grafts have become a suitable option in pediatric liver transplantation (PLT). The correlation between hepatic vein (HV) reconstruction and outcome is relevant when assessing the safe use of these grafts. We retrospectively reviewed the medical records prospectively collected from a pediatric living donor liver transplantation database and conducted a comparative analysis of the different left lateral segment graft types according to HV reconstruction. Donor, recipient, and intraoperative variables were analyzed. Post-transplant outcomes included vascular complications such as hepatic vein outflow obstruction, early (≤30 d) and late (>30 d) PVT, hepatic artery thrombosis, and graft survival. From February 2017 to August 2021, 303 PLTs were performed. According to venous anatomy, the distribution of the left lateral segment was as follows: single HV (type I) in 174 (57.4%), close HVs, simple venoplasty for reconstruction (type II) in 97 (32.01%), anomalous hepatic vein (AHV) with a distance between the HVs orifices that allowed simple venoplasty (type IIIA) in 25 (8.26%) and AHV with a distance between the HVs orifices requiring homologous venous graft interposition (type IIIB) in 07 (2.31%) grafts. Type IIIB grafts came from male donors (p=0.04) and had a higher mean donor height (p=0.008), a higher mean graft weight, and a higher graft-to-recipient weight ratio, both p=0.002. The median follow-up time was 41.4 months. The overall cumulative graft survival was 96.3%, and comparative graft survival showed no difference (log-rank p=0.61). No hepatic vein outflow obstructions were observed in this cohort study. There was no statistically significant difference in the post-transplant outcomes between the graft types. The venous reconstruction of the AHV with homologous venous graft interposition had similar outcomes in the short and long term.
Veno-venous Extracorporeal Membrane Oxygenation for COVID-19: A Call For System-Wide Checks to Ensure Equitable Delivery For All
Authors: Condella Anna , Lindo Edwin G. , Badulak Jenelle , Johnson Nicholas J. , Maine Rebecca , Mandell Samuel , Town James A. , Luks Andrew M. , Elizaga Shelby , Bulger Eileen M. , Stewart Barclay T.
Published: February 2023

Extracorporeal membrane oxygenation (ECMO) has emerged in the COVID-19 pandemic as a potentially beneficial yet scare resource for treating critically ill patients, with variable allocation across the United States. The existing literature has not addressed barriers patients may face in access to ECMO as a result of healthcare inequity. We present a novel patient-centered framework of ECMO access, providing evidence for potential bias and opportunities to mitigate this bias at every stage between a marginalized patient’s initial presentation to treatment with ECMO. While equitable access to ECMO support is a global challenge, this piece focuses primarily on patients in the United States with severe COVID-19-associated ARDS to draw from current literature on VV-ECMO for ARDS and does not address issues that affect ECMO access on a more international scale.
Rising Mortality in Coronavirus-19 Patients Supported With Extracorporeal Membrane Oxygenation
Authors: Rando Hannah J. , Fassbinder Marius , Velez Ana K. , Etchill Eric W. , Holmes Sari D. , Whitman Glenn , Cho Sung-Min , Keller Steven , Kim Bo Soo ,   on behalf of HERALD Investigators
Published: February 2023

We aimed to describe practice patterns and outcomes in patients with extracorporeal membrane oxygenation (ECMO) support throughout the coronavirus 2019 (COVID-19) pandemic, with the hypothesis that mortality would improve as we accumulated knowledge and experience. We included 48 patients supported on veno-venous ECMO (VV-ECMO) at a single institution between April 2020 and December 2021. Patients were categorized into three waves based on cannulation date, corresponding to the wild-type (wave 1), alpha (wave 2), and delta (wave 3) variants. One hundred percent of patients in waves 2 and 3 received glucocorticoids, compared with 29% in wave 1 (p < 0.01), and the majority received remdesivir (84% and 92% in waves 2 and 3, vs. 35% in wave 1; p < 0.01). Duration of pre-ECMO noninvasive ventilation was longer in waves 2 and 3 (mean 8.8 days and 3.9 days, vs. 0.7 days in wave 1; p < 0.01), as was time to cannulation (mean 17.2 and 14.6 days vs. 8.8 days in wave 1; p < 0.01) and ECMO duration (mean 55.7 days and 43.0 days vs. 28.4 days in wave 1; p = 0.02). Mortality in wave 1 was 35%, compared with 63% and 75% in waves 2 and 3 (p = 0.05). These results suggest an increased prevalence of medically refractory disease and rising mortality in later variants of COVID-19.
Comparison of Internal and External Distraction in Frontofacial Monobloc Advancement: A Three-Dimensional Quantification
Authors: Rickart Alexander J , van de Lande Lara S , O’ Sullivan Eimear , Bloch Kevin , Arnaud Eric , Schievano Silvia , Jeelani Noor ul Owase , Paternoster Giovanna , Khonsari Roman , Dunaway David J
Published: February 2023

Introduction

Crouzon syndrome is characterised by complex craniosynostosis and midfacial hypoplasia. Where frontofacial monobloc advancement (FFMBA) is indicated, the method of distraction used to achieve advancement holds an element of equipoise. This two-centre retrospective cohort study quantifies the movements produced by internal or external distraction methods used for FFMBA. Using shape analysis, this study evaluates if the different distraction forces cause plastic deformity of the frontofacial segment, producing distinct morphological outcomes.

Methods

Patients with Crouzon syndrome who underwent FFMBA with internal distraction (Necker, Hôpital Necker - Enfants Malades, Paris) or external distraction (GOSH, Great Ormond Street Hospital for Children, London) were compared. DICOM files of pre- and post-operative CT-scans were converted to three-dimensional bone meshes and skeletal movements were assessed using non-rigid iterative closest point registration. Displacements were visualised using colour maps and statistical analysis of the vectors undertaken.

Results

51 patients met the strict inclusion criteria. 25 underwent FFMBA with external distraction and 26 with internal distraction. External distraction provides a preferential midfacial advancement whereas internal distractors produce a more positive movement at the lateral orbital rim. This confers good orbital protection but does not advance the central midface to the same extent. Vector analysis confirmed this to be statistically significant (p<0.01).

Conclusion

Morphological changes resulting from monobloc surgery differ depending on the distraction technique used. Although the relative merits of internal and external distraction still stand, it may be that external distraction is more suited to addressing the midfacial biconcavity seen in syndromic craniosynostosis.
Factors Influencing the Lagophthalmos and Lid Lag After Simple Congenital Blepharoptosis Correction
Authors: Miao Xiaoteng , Wang Tailing , Wang Jiaqi
Published: February 2023

Background:

Lagophthalmos and lid lag is the most common complication after ptosis correction. Great efforts had been made to control it, but little was known about the factors influencing it. So we ran this research to explore the possible mechanisms underlying it. This would be beneficial to solving this problem.

Materials and Methods:

In this cohort study, patients treated with the forked frontalis muscle aponeurosis suspension and levator aponeurosis-Muller’s muscle complex resection were identified. Lagophthalmos height and lid lag was measured at the postoperative week 1 visits. The Spearman correlation test was run to test whether lagophthalmos was related to patients’ age, levator function, and severity of ptosis. Then we measured the contents of collagen and elastin fibers of frontalis muscle fascia and levator aponeurosis from the patients and levator aponeurosis from cadaver heads histologically and compared the contents in these 3 groups.

Results:

No correlation was found between patients’ age, levator function, the severity of ptosis, and with lagophthalmos height. However, the contents of collagen and elastic fibers were both higher in the frontalis fascia than in the normal aponeurosis tissues. The difference in collagen fibers content between frontalis muscle fascia and patients’ aponeurosis was statistically insignificant.

Conclusions:

The severe lagophthalmos and lid lag may be caused by the poor mechanical features of the frontalis muscle. A better source of motive force to elevate the eyelids and a novel sling material with proper elasticity and stiffness would be the solution to improve the lagophthalmos and lid lag after ptosis correction.
Gender-Specific Differences in Chronic Subdural Hematoma
Authors: Ge Ruixiang , Shen Jun
Published: February 2023

Objective:

Few studies concerning aspects of gender-specific differences in chronic subdural hematoma (CSDH). This study aimed to determine whether gender-specific differences exist in CSDH regarding clinical, radiological characteristics, and prognosis.

Methods:

A total of 585 patients with CSDH were retrospectively identified. Patients were divided into 2 groups based on gender. Clinical, radiological characteristics, and prognosis were compared using Fisher’s exact test or Student t test when applicable. The logistic regression model was used to identify independent risk factors associated with death in CSDH patients. The receiver operating characteristic curve was used to detect the sensitivity and specificity of independent risk factors.

Results:

The average age of women was 71.50±0.92 years, significantly older than 67.30±0.60 years in men. Hypertension, diabetes mellitus, and uremia were significantly more common in women than in men. Alcohol intake was more in males than in females. CSDH patients in males manifested homogeneous iso-dense and homogeneous hyper-dense was obviously more than that in the females. Although homogeneous hypo-dense and mixed density were significantly more common in the females. The average preoperative hematoma volume of the unilateral CSDH in males was 160.85±3.06 cm3, significantly more than 139.60±5.70 cm3 in females. The mortality of females was 7.4%, higher than 1.7% in males (P=0.004). Female, age, uremia, and recurrence were independent risk factors for death in CSDH patients.

Conclusions:

Gender-specific differences do exist in CSDH. Female, age, uremia, and recurrence were independent risk factors for death in CSDH patients.
Vascular Compromise and Alopecia After Hyaluronic Acid Filler Injection in Temple Region
Authors: Li Congying , Zhang Wei
Published: February 2023

Hyaluronic acid filler injection is widely applied in facial shaping and facial filling. Although hyaluronic acid injection is thought to be relatively safe and effective, there are still incidents being reported occasionally. The authors report here a case of alopecia at vascular compromise area after receiving hyaluronic acid filler injection in the left temple region, skin necrosis, and alopecia were well recovered with the treatment of hyaluronidase and external application of minoxidil.
A Patient With Cryptotia Corrected With Intraoperative Tissue Expansion and Superior Auricular Muscle Transfer Through a Small Hairline Incision
Authors: Kasai Shogo , Kishi Kazuo
Published: February 2023

Cryptotia is a relatively common auricular congenital anomaly in Asia. Nonsurgical molding is easy in infancy. However, surgical correction is often necessary after infancy. The authors report a case of cryptotia in which intraoperative tissue expansion and superior auricular muscle transfer were performed through a small incision at the hairline with good results. The patient is a 7-year-old girl. Three years after the operation, successful results were obtained. This method is advantageous as the procedure is simple, risk of relapse can be reduced by also treating the auricular muscle, and scarring is relatively inconspicuous. In addition, it is possible to switch to another technique when the improvement is poor.
Generation of higher harmonics in dipolar Bose–Einstein condensates trapped in periodically modulated potentials
Authors: Bera Jayanta , Batin Abdul Q. , Ghosh Suranjana , Malomed Boris , Roy Utpal
Published: February 2023

We consider a quasi-one-dimensional Bose–Einstein condensate with contact and long-range dipolar interactions, under the action of the time-periodic modulation applied to the harmonic-oscillator and optical-lattice trapping potentials. The modulation results in generation of a variety of harmonics in oscillations of the condensate’s width and centre-of-mass coordinate. These include multiple and combinational harmonics, represented by sharp peaks in the system’s spectra. Approximate analytical results are produced by the variational method, which are verified by systematic simulations of the underlying Gross–Pitaevskii equation.

This article is part of the theme issue ‘New trends in pattern formation and nonlinear dynamics of extended systems’.
Travelling chimeras in oscillator lattices with advective–diffusive coupling
Authors: Smirnov L. , Pikovsky A.
Published: February 2023

We consider a one-dimensional array of phase oscillators coupled via an auxiliary complex field. While in the seminal chimera studies by Kumamoto and Battogtokh only diffusion of the field was considered, we include advection which makes the coupling left–right asymmetric. Chimera starts to move and we demonstrate that a weakly turbulent moving pattern appears. It possesses a relatively large synchronous domain where the phases are nearly equal, and a more disordered domain where the local driving field is small. For a dense system with a large number of oscillators, there are strong local correlations in the disordered domain, which at most places looks like a smooth phase profile. We find also exact regular travelling wave chimera-like solutions of different complexity, but only some of them are stable.

This article is part of the theme issue ‘New trends in pattern formation and nonlinear dynamics of extended systems’.
Comparative study of convection characteristics for a system with deformable interface based on the Navier–Stokes and Oberbeck–Boussinesq equations
Authors: Bekezhanova Victoria B. , Goncharova Olga N.
Published: February 2023

The right choice of the appropriate mathematical model is crucial for evaluating the physical plausibility of modelling results. The issue of the correct application of the classical Boussinesq approximation for studying the heat and mass transfer in fluidic systems with a deformable boundary is a subject of scientific discussions despite the good agreement of numerous theoretical and numerical results obtained within the convection models based on the Oberbeck–Boussinesq equations with the data of physical experiments and observations. A comparative analysis of the results of numerical simulations in the framework of two-sided models based on the Navier–Stokes equations, and their Boussinesq approximation, is performed in the context of a convection problem in a locally heated two-phase system with a deformable interface. It is demonstrated that the application of the standard Boussinesq approximation allows one to give a consistent description of the effect of interface deformations on combined buoyant–thermocapillary driven fluid motions.

This article is part of the theme issue ‘New trends in pattern formation and nonlinear dynamics of extended systems’.
Pattern formation in Faraday instability—experimental validation of theoretical models
Authors: Dinesh B. , Livesay J. , Ignatius I. B. , Narayanan R.
Published: February 2023

Two types of resonance-derived interfacial instability are reviewed with a focus on recent work detailing the effect of side walls on interfacial mode discretization. The first type of resonance is the mechanical Faraday instability, and the second is electrostatic Faraday instability. Both types of resonance are discussed for the case of single-frequency forcing. In the case of mechanical Faraday instability, inviscid theory can forecast the modal forms that one might expect when viscosity is taken into account. Experiments show very favourable validation with theory for both modal forms and onset conditions. Lowering of gravity is predicted to shift smaller wavelengths or choppier modes to lower frequencies. This is also validated by experiments. Electrostatic resonant instability is shown to lead to a pillaring mode that occurs at low wavenumbers, which is akin to Rayleigh Taylor instability. As in the case of mechanical resonance, experiments show favourable validation with theoretical predictions of patterns. A stark difference between the two forms of resonance is the observation of a gradual rise in the negative detuning instability in the case of mechanical Faraday and a very sharp one in the case of electrostatic resonance.

This article is part of the theme issue ‘New trends in pattern formation and nonlinear dynamics of extended systems’.
The emergence of spatial patterns for compartmental reaction kinetics coupled by two bulk diffusing species with comparable diffusivities
Authors: Pelz Merlin , Ward Michael J.
Published: February 2023

Originating from the pioneering study of Alan Turing, the bifurcation analysis predicting spatial pattern formation from a spatially uniform state for diffusing morphogens or chemical species that interact through nonlinear reactions is a central problem in many chemical and biological systems. From a mathematical viewpoint, one key challenge with this theory for two component systems is that stable spatial patterns can typically only occur from a spatially uniform state when a slowly diffusing ‘activator’ species reacts with a much faster diffusing ‘inhibitor’ species. However, from a modelling perspective, this large diffusivity ratio requirement for pattern formation is often unrealistic in biological settings since different molecules tend to diffuse with similar rates in extracellular spaces. As a result, one key long-standing question is how to robustly obtain pattern formation in the biologically realistic case where the time scales for diffusion of the interacting species are comparable. For a coupled one-dimensional bulk-compartment theoretical model, we investigate the emergence of spatial patterns for the scenario where two bulk diffusing species with comparable diffusivities are coupled to nonlinear reactions that occur only in localized ‘compartments’, such as on the boundaries of a one-dimensional domain. The exchange between the bulk medium and the spatially localized compartments is modelled by a Robin boundary condition with certain binding rates. As regulated by these binding rates, we show for various specific nonlinearities that our one-dimensional coupled PDE-ODE model admits symmetry-breaking bifurcations, leading to linearly stable asymmetric steady-state patterns, even when the bulk diffusing species have equal diffusivities. Depending on the form of the nonlinear kinetics, oscillatory instabilities can also be triggered. Moreover, the analysis is extended to treat a periodic chain of compartments.

This article is part of the theme issue ‘New trends in pattern formation and nonlinear dynamics of extended systems’.
The development and usability testing of two arts-based knowledge translation tools for pediatric asthma
Authors: Scott Shannon D. , Hartling Lisa
Published: February 2023

Asthma is the most common chronic condition in children with an estimated 15% of children and youth living with asthma in Canada. Acute asthma exacerbations, or asthma attacks, are the main reason for children to seek emergency care, contributing to financial burdens for families and healthcare systems. This burden highlights opportunities to reduce health system costs and improve patient and family education.

We worked with parents of children with asthma to develop and evaluate two digital knowledge translation (KT) tools on asthma. These tools merge the best available research evidence with narratives of parent experiences, and use art and engaging media (video and interactive infographic) to optimize uptake and appeal. Following prototype completion, usability testing was conducted among 60 parents (30 parents per tool) in an urban Alberta emergency department waiting room. Parents viewed the tools on an iPad and answered questions via an electronic survey. Usability was assessed based on nine items with responses on a five-point Likert scale from 1=strongly disagree to 5=strongly agree. Overall, results were positive and the tools were highly rated across most usability items. Mean scores across usability items were 4.13 to 4.63 for the video and 4.10 to 4.43 for the infographic. The scores from the usability testing suggest arts-based digital tools are useful in sharing complex health information with parents about the care of a child with asthma and provide meaningful guidance on how to improve KT tools to better reflect the needs of parents of children with asthma.
A Systematic review and Network Meta-analysis of pharmaceutical interventions used to manage chronic pain
Authors: Shetty Ash , Delanerolle Gayathri , Cavalini Heitor , Deng Chunli , Yang Xiaojie , Boyd Amy , Fernandez Tacson , Phiri Peter , Bhaskar Arun , Shi Jian Qing
Published: February 2023

Background

It is estimated 1.5 billion of the global population suffer from chronic pain with prevalence increasing with demographics including age. It is suggested long-term exposure to chronic could cause further health challenges reducing people’s quality of life. Therefore, it is imperative to use effective treatment options.

Purpose

We explored the current pharmaceutical treatments available for chronic pain management to better understand drug efficacy and pain reduction.

Methods

A systematic methodology was developed and published in PROSPERO (CRD42021235384). Keywords of opioids,acute pain, pain management, chronic pain, opiods, NSAIDs, and analgesicswere used across PubMed, Science direct, ProQuest, Web of science, Ovid Psych INFO, PROSPERO, EBSCOhost, MEDLINE,ClinicalTrials.govand EMBASE. All randomised controlled clinical trials (RCTs), epidemiology and mixed-methods studies published in English between the 1stof January 1990 and 30thof April 2022 were included.

Data synthesis

A total of 119 studies were included. The data was synthesised using a tri-partied statistical methodology of a meta-analysis (24), pairwise meta-analysis (24) and network meta-analysis (34).

Limitations

Small sample sizes, lack of uniformity with pain assessments and sub-optimal clinical trial designs were observed within the pooled data.

Conclusion

Chronic pain is a public health problem that requires far more effective pharmaceutical interventions with minimal better side-effect profiles which will aid to develop better clinical guidelines. The importance of understanding ubiquity of pain by clinicians, policy makers, researchers and academic scholars is vital to prevent social determinant which aggrevates issues.
Clinical characteristic and imaging findings of post-infarction left ventricular pseudoaneurysm versus aneurysm: a pooled analysis of 21,472 patients
Authors: Afshar Elmira Jafari , Tayebi Amirhossein , Samimisedeh Parham , Shahnavaz Vahid , Madady Aryan , Rastad Hadith , Hassani Neda Shafiabadi
Published: February 2023

Background

Left ventricular pseudoaneurysm (LVPA) is a rare but life-threatening complication of myocardial infarction (MI). Given the similarities in the clinical presentations and the appearance of the cardiac imaging, differentiation of LVPA from left ventricular aneurysm (LVA) remains a challenge but is imperative for timely management. We summarized and compared clinical and imaging findings of post-MI LVPA and LVA.

Method

We performed a comprehensive search of the literature in PubMed and Scopus databases using combinations of key terms covering LVPA / LVA and MI. In both LVA and LVPA, individual-level patient data (IPD) and aggregated-level data (AD) studies were combined through a two-stage analysis method.

Results

We identified 379 eligible articles on LVPA (N= 504 patients) and 120 on LVA (n= 20,968). Based on our pooled analysis, cases were predominantly male in both groups (70.4%and 75.7 %, respectively), but LVPA patients were roughly older (Mean (95% Confidence interval (CI): (65.4 (62.4, 68.4) vs. 60.8 (58.9, 62.8) years, respectively) and had a shorter mean time interval from MI to diagnosis than LVA (5.1 vs. 27.8, months). At presentation, while 33.8 (95% CI: 22.1, 46.0) of patients with LVA had arrhythmia, only 1.0 % (95% CI: 0.0, 2.9) of LVPA patients presented with this symptom. LVPA compared to the LVA group, more frequently had ST-segment elevation (43.2% Vs. 28.6, respectively) but less frequently ECG signs of the old MI (42.2% Vs. 61.9, respectively). Echocardiography showed a lower diagnostic value in LVPA than LVA (Sensitivity: 81.4% Vs. 97.5%). Contrary to LVA, LVPA is mainly located on posterior and inferior segments based on echocardiography evaluations. On Cardiac MRI, the majority of LVPA patients had pericardial LGE (84.0% (CI 95%: 63.9, 95.5)). A higher percentage of LVPA compared to the LVA group dead during hospitalization (13.8% vs. 4.7%, respectively) or after discharge (17.5%vs. vs. 9.0%, respectively).

Conclusion

Arrhythmia is likely common in LVA patients at presentation but not in LVPA. LVPA is mainly located on the posterior and inferior, and LVA is on the anterior and apical segments. On cardiac MRI, pericardial LGE may suggest the presence of LVPA rather than LVA in suspected patients.
The Role of Neuroimaging in Evolving TBI Research and Clinical Practice
Authors: Dennis Emily L , Keleher Finian , Tate David F , Wilde Elisabeth A
Published: February 2023

Neuroimaging technologies such as computed tomography (CT) and magnetic resonance imaging (MRI) have been widely adopted in the clinical diagnosis and management of traumatic brain injury (TBI), particularly at the more acute and severe levels of injury. Additionally, a number of advanced applications of MRI have been employed in TBI-related clinical research with great promise, and researchers have used these techniques to better understand underlying mechanisms, progression of secondary injury and tissue perturbation over time, and relation of focal and diffuse injury to later outcome. However, the acquisition and analysis time, the cost of these and other imaging modalities, and the need for specialized expertise have represented historical barriers in extending these tools in clinical practice. While group studies are important in detecting patterns, heterogeneity among patient presentation and limited sample sizes from which to compare individual level data to well-developed normative data have also played a role in the limited translatability of imaging to wider clinical application. Fortunately, the field of TBI has benefitted from increased public and scientific awareness of the prevalence and impact of TBI, particularly in head injury related to recent military conflicts and sport-related concussion. This awareness parallels an increase in federal funding in the United States and other countries allocated to investigation in these areas. In this article we summarize funding and publication trends since the mainstream adoption of imaging in TBI to elucidate evolving trends and priorities in the application of different techniques and patient populations. We also review recent and ongoing efforts to advance the field through promoting reproducibility, data sharing, big data analytic methods, and team science. Finally, we discuss international collaborative efforts to combine and harmonize neuroimaging, cognitive, and clinical data, both prospectively and retrospectively. Each of these represent unique, but related, efforts that facilitate closing gaps between the use of advanced imaging solely as a research tool and the use of it in clinical diagnosis, prognosis, and treatment planning and monitoring.