bluuebunny/crossref_metadata_2025 huggingface dataset:
Bidirectional Violence in Intimate Relationships: A Systematic Review
Authors: Machado Andreia , Sousa Catarina , Cunha Olga
Published: August 2023

Intimate partner violence is a public health problem with significant consequences at different levels. Over the years, the literature has shown that most violence is not unidirectional and perpetrated by men against women but rather bidirectional, in which both couple elements may be victims, perpetrators, or both. In this systematic literature review, we aimed to systematize the empirical knowledge to assess the prevalence of bidirectional violence, the most reported types of violence, and the influence of sex and sexual orientation on this phenomenon. The search for this systematic review was conducted in four databases, and we included studies that showed the prevalence of bidirectional violence in samples aged over 18 years, in articles written in English or Portuguese, and published between 2012 and 2022. In the qualitative synthesis, 42 empirical studies were included. The results showed that bidirectional violence is the most common pattern of violence, with psychological violence being the most reported type of bidirectional violence; men and women reported bidirectional violence at similar rates, and homosexual couples reported higher percentages of bidirectional violence than heterosexual couples. These results contradict the patriarchalist view of violence that assigns the exclusivity role of the victim to women and of the perpetrator to men, demonstrating that violence occurs regardless of sex or sexual orientation. The practical implications and future directions at the level of public policies to give visibility to the phenomenon will be duly discussed.
Quality and Readability of Spanish-Language Online Information for Aortic Aneurysm and Its Endovascular Treatment
Authors: San Norberto Enrique M. , Revilla Álvaro , Brizuela José A. , Taylor James H.
Published: August 2023

Background

Aortic aneurysms represent a chronic degenerative disease with life-threatening implications. In order for patients to comprehend health related information, it must be written at a level that can be readily understood.

Study Design

In January 2023, we searched “aneurisma aorta” and “endoprótesis aorta” terms on Google, Yahoo and Microsoft/Bing. The 31th websites provided by each search engine were analyzed. Four readability measures were used to evaluate websites regarding aortic aneurysm and their endovascular treatment in Spanish language: Flesch Index, Flesch-Szigriszt Index, Fernández-Huerta Index and grading Inflesz scale. The quality on information was evaluated by the HONcode seal, the DISCERN instrument and the JAMA benchmark criteria.

Results

180 websites containing the terms “aneurisma aorta” and “endoprótesis aorta” were analyzed. Among the websites retrieved, the mean Flesh index score (53.12 ± 6.09 and 47.48 ± 7.12, respectively; P = .019), the Flesch-Szigriszt index (56.39 ± 5.72 and 48.10 ± 8.33; P = .000), and the Fernández Huerta index (61.30 ± 5.59 and 53.19 ± 8.21; P = .000), corresponding to a “somewhat difficult” readability level. In addition, the Inflesz scale (2.62 ± .59 and 2.07 ± .61; P = .000) reported a “somewhat difficult” readability, higher for the websites regarding aortic aneurysm. The HONcode seal was only presented in websites regarding aortic aneurysm (16.7%), whereas none of the websites relating to aortic endoprostheses presented it (0%) ( P = .000). Websites that presented the HONcode seal obtained higher DISCERN score ( P = .000, 95% CI = 6.42-16.84) and JAMA score (P = .000, 95% CI = 3.44-11.32).

Conclusion

Internet information on aortic aneurysms and aortic endoprostheses is too difficult to read for the general Spanish-speaking population and is lacking in quality.
Blind receiver design-based multi-dimensional stable distribution model using the EM algorithm
Authors: Ying Wenwei , Xiao Jun , Li Chengjun , Hong Shaohua
Published: August 2023

Multi-antenna receivers are a key technology for modern communication systems. Signal attenuation in the very low frequency (VLF) channel is a serious problem. In addition to high signal attenuation, the resulting noise on the VLF channel is non-Gaussian. Hence, to analyze and address the issue of the normal operation of the multi-antenna receiver in the VLF channel, we must study the signal detection problem in a multi-dimensional non-Gaussian fading channel. Motivated by the existing blind receiver in an underwater submarine single-antenna receiver, we study the signal detection and estimation algorithm under the fading channel for a multi-dimensional non-Gaussian noise model. In this study, we propose a blind receiver based on the expectation-maximization (EM) algorithm. The proposed blind receiver can reduce non-Gaussian noise. In addition, we propose a nonlinear receiver that can accurately receive the transmitted signal over the high-attenuation VLF communication systems. Numerical and simulation results over uncorrelated and correlated non-Gaussian channels confirm that the design of the proposed blind receiver is close to optimal, with low computation complexity.
Crowds Can Effectively Identify Misinformation at Scale
Authors: Martel Cameron , Allen Jennifer , Pennycook Gordon , Rand David G.
Published: August 2023

Identifying successful approaches for reducing the belief and spread of online misinformation is of great importance. Social media companies currently rely largely on professional fact-checking as their primary mechanism for identifying falsehoods. However, professional fact-checking has notable limitations regarding coverage and speed. In this article, we summarize research suggesting that the “wisdom of crowds” can be harnessed successfully to help identify misinformation at scale. Despite potential concerns about the abilities of laypeople to assess information quality, recent evidence demonstrates that aggregating judgments of groups of laypeople, or crowds, can effectively identify low-quality news sources and inaccurate news posts: Crowd ratings are strongly correlated with fact-checker ratings across a variety of studies using different designs, stimulus sets, and subject pools. We connect these experimental findings with recent attempts to deploy crowdsourced fact-checking in the field, and we close with recommendations and future directions for translating crowdsourced ratings into effective interventions.
A Consensus Statement for Continuous Glucose Monitoring Metrics for Inpatient Clinical Trials
Authors: Spanakis Elias K. , Cook Curtiss B. , Kulasa Kristen , Aloi Joseph A. , Bally Lia , Davis Georgia , Dungan Kathleen M. , Galindo Rodolfo J. , Mendez Carlos E. , Pasquel Francisco J. , Shah Viral N. , Umpierrez Guillermo E. , Aaron Rachel E. , Tian Tiffany , Yeung Andrea M. , Huang Jingtong , Klonoff David C.
Published: August 2023

Diabetes Technology Society organized an expert consensus panel to develop metrics for research in the use of continuous glucose monitors (CGMs) in a hospital setting. The experts met virtually in small groups both before and after an April 13, 2023 virtual meeting of the entire panel. The goal of the panel was to develop consensus definitions in anticipation of greater use of CGMs in hospital settings in the future. Establishment of consensus definitions of inpatient analytical metrics will be easier to compare outcomes between studies. Panelists defined terms related to 10 dimensions of measurements related to the use of CGMs including (1) hospital hypoglycemia, (2) hospital hyperglycemia, (3) hospital time in range, (4) hospital glycemic variability, (5) hospital glycemia risk index, (6) accuracy of CGM devices and reference methods for CGMs in the hospital, (7) meaningful time blocks for hospital glycemic goals, (8) hospital CGM data sufficiency, (9) using CGM data for insulin dosing, and (10) miscellaneous factors. The panelists voted on 51 proposed recommendations. Based on the panel vote, 51 recommendations were classified as either strong (43) or mild (8). Additional research is needed on CGM performance in the hospital. This consensus report is intended to support that type of research intended to improve outcomes for hospitalized people with diabetes.
Association between serum trace elements and sleep disturbance in patients with decompensated cirrhosis
Authors: Zhang Ziyue , Hui Yangyang , Yang Wanting , Guo Gaoyue , Cui Binxin , Li Chaoqun , Wang Xiaoyu , Fan Xiaofei , Sun Chao
Published: August 2023

Background:

Sleep disturbance and trace elements imbalance are common features in patients with decompensated cirrhosis, partially sharing similar mechanistic contributors and linking to adverse outcomes. However, there is a paucity of data concerning their relationship.

Objectives:

To investigate the association between serum trace elements levels and sleep quality in the context of cirrhosis.

Design:

Cross-sectional study.

Methods:

We consecutively enrolled 160 patients with decompensated cirrhosis. The sleep disturbance was determined by the Pittsburgh Sleep Quality Index (PSQI > 5). Serum trace elements [magnesium, calcium, iron, copper (Cu), zinc (Zn), lead, and manganese] was measured by inductively coupled plasma mass spectrometry. Association of examined trace elements levels and sleep disturbance was analyzed by multiple linear (global PSQI scores) and multivariate logistic (dichotomized PSQI categories) regression models, respectively.

Results:

In total, 91 patients (56.88%) represented PSQI-defined sleep disturbance, characterized by female preponderance, lower body mass index levels, and higher serum Cu levels (all p < 0.05). Looking into its clinical relevance with debilitating conditions, we showed that Cu/Zn ratio (CZr) is significantly higher in cirrhosis with poor sleep quality (1.77 versus 1.48, p = 0.003). Diagnostic performance analysis indicated CZr > 1.62 to exhibit better discrimination relative to respective Cu. Both multiple linear (β = 0.355, p < 0.001) and multivariate logistic regression (odds ratio = 2.364, p = 0.019) identified higher CZr as an independent risk factor associated with sleep disturbance.

Conclusion:

Our findings implied an association between higher CZr and the presence of sleep disturbance in patients with decompensated cirrhosis.
Rational or Impulsive? Early Backers’ Investment Behavior in Agri-Food Crowdfunding from 4P–4C Perspectives
Authors: Du Junjuan
Published: August 2023

Lack of funds and poor agricultural-product sales are the main problems that limit agricultural development, which can be well solved by agri-food crowdfunding. How to attract more backers to invest in the early stage of a project is extremely crucial for agri-food crowdfunding. Using a unique sample comprising 1,136 agri-food crowdfunding campaigns on Crowdfunding Net, among the most influential crowdfunding platforms in China, a model is constructed that includes the five dimensions of people, product, promotion, cost, and convenience. Drawing on the classic 4P and 4C marketing theories, multiple regression analysis is used to examine the mechanism through which a project’s presentation information influences the number of early backers. The results reveal that the factors in the three dimensions of people, product, and convenience positively impact the number of early backers in agri-food crowdfunding. In contrast, the cost-dimension factor is negatively related to the number of early backers. The promotion-dimension factors fail to pass the significance test. Additionally, the number of first-day backers partially moderates the effect of the initiator category, investment threshold, and lottery on the number of early backers. The effects of the trademark registration and number of reward categories on the number of early backers are completely moderated by the number of first-day backers. The evidence also shows that early backers’ rational investment decisions are based on reliable information and lucrative rewards. The research conclusions offer practical enlightenment for initiators, crowd-funding platforms, and regulators in the agri-food crowdfunding industry.
Cervical Disc Arthroplasties Fail to Maintain Physiological Kinematics Under Lateral Eccentric Loads
Authors: Roch Paul Jonathan , Hemprich Constantin , Klockner Friederike , Meier Marc-Pascal , Jäckle Katharina , Lehmann Wolfgang , Wachowski Martin Michael , Weiser Lukas
Published: August 2023

Study design

In vitro human cadaveric biomechanical analysis.

Objectives

Optimization of prostheses for cervical disc arthroplasties (CDA) reduces the risk of complications. The instantaneous helical axis (IHA) is a superior parameter for examining the kinematics of functional spinal units. There is no comprehensive study about the IHA after CDA considering all 3 motion dimensions.

Methods

Ten human functional spinal units C4-5 (83.2 ± 7.9 yrs.) were examined with an established measuring apparatus in intact conditions (IC), and after CDA, with 2 different types of prostheses during axial rotation, lateral bending, and flexion/extension. Eccentric preloads simulated strains. The IHA orientation and its position at the point of rest (IHA0-position) were analyzed.

Results

The results confirmed the existing data for IHA in IC. Lateral preloads showed structural alterations of kinematics after CDA: During axial rotation and lateral bending, the shift of the IHA0-position was corresponding with the lateral preloads’ applied site in IC, while after CDAs, it was vice versa. During lateral bending, the lateral IHA orientation was inclined, corresponding with the lateral preloads’ applied site in the IC and oppositely after the CDAs. During flexion/extension, the lateral IHA orientation was nearly vertical in the IC, while after CDA, it inclined, corresponding with the lateral preloads’ applied site. The axial IHA orientation rotated to the lateral preloads’ corresponding site in the IC; after CDA, it was vice versa.

Conclusion

Both CDAs failed to maintain physiological IHA characteristics under lateral preloads, revealing a new aspect for improving prostheses’ design and optimizing their kinematics.
Thalassemia carrier status and groundwater iron: Implication for iron supplementation program for children in Bangladesh
Authors: Rahman Sabuktagin , Lee Patricia , Khan Moududur Rahman , Ahmed Faruk
Published: August 2023

Background:

Thalassemia, a congenital disorder of hemoglobin synthesis is characterized by low hemoglobin and high iron status, is prevalent in Bangladesh. Iron, consumed through drinking groundwater also increases the population iron status in Bangladesh. The study examined the effect of iron containing micronutrient powder (MNP) on the hemoglobin and ferritin status in Bangladeshi children with thalassemia and their non-thalassemia peers exposed to a high concentration of iron from drinking groundwater.

Design and methods:

Three hundred twenty-seven children aged 2–5 years were recruited for an MNP efficacy trial. A sub sample ( n = 222) were screened for thalassemia. Hemoglobin and ferritin levels were measured in children with and without thalassemia. Intake of iron from the key sources—diet, groundwater and MNP was measured. Mann Whitney and t-test were employed to compare the groups.

Results:

Hemoglobin concentration of the children with thalassemia at the endpoint remained unchanged relative to the baseline; 11.56 ± 0.59 g/dL (Endpoint) versus 11.6 ± 0.54 g/dL (Baseline), p = 0.83. In children without thalassemia hemoglobin tended to increase; 12.54 ± 0.72 g/dL (Endpoint) versus 12.41 ± 0.72 g/dL (baseline), p = 0.06. Baseline reserve of body iron was significantly ( p = 0.03) higher in thalassemia carriers (594 gm) compared to their non-carrier peers (558 gm). The increase of the infection-adjusted ferritin from baseline to the endpoint was 7.37% ( p = 0.7) and 10.17% ( p = 0.009) in the carrier and non-carrier groups respectively.

Conclusions:

In Bangladesh, the coexistence of thalassemia and the exposure to a high concentration of iron from drinking groundwater renders anemia prevention program with a low iron MNP potentially lesser hazardous to the thalassemia carriers.
Shared Nationality in Social Exchange: A Trust Vignette Experiment in the United States, South Africa, and Switzerland
Authors: Gereke Johanna , Ruedin Didier
Published: August 2023

Empirical research suggests that societies that are diverse as a result of international migration have lower levels of social trust, but little is known about the mechanisms underlying this relationship. The authors test one possible mechanism: that conationality increases interpersonal trust and the willingness to reciprocate trust. As part of large-scale surveys in the United States, South Africa, and Switzerland, respondents were presented with trust vignettes in which information about the nationality of the interaction partner was systematically varied. Despite overall country-level differences in levels of trust and trustworthiness, no in-group bias associated with conationality was found in these types of interactions. This suggests that the negative association between ethnic diversity and social trust cannot be explained by differences in relational trust conditional on sharing the same nationality.
Assessment of macular pigment optical density in Arab population and its relationship to people’s anthropometric data: a cross-sectional study
Authors: Alsaqr Ali , Alharbi Manal , Aldossary Noura , Alruwished Abdulaziz , Alharbi Mohammed , Alghaib Khalid , Alabdulkarim Abeer , Alhamdan Shatha , Almutleb Esam , Abusharha Ali
Published: August 2023

Background:

Anthropometry facilitates the evaluation of risks associated with reduced macular pigment optical density (MPOD).

Objectives:

To investigate the predictors and anthropometric indices associated with MPOD in healthy adult in Arab population.

Design:

This is a cross-sectional study.

Methods:

The MPOD was measured at 0.5° from fovea using a heterochromatic flicker photometer. Healthy participants aged between 20 and 40 years were recruited. The study evaluated the following data of the participants: height, weight, body mass index, body fat percentage, basal metabolic rate, visceral fat level, muscle mass, bone mineral content, and percentage of protein and body water. The correlation between MPOD with anthropometrics and demographic data was evaluated using Spearman’s correlation test. The differences among genders were investigated using the Mann–Whitney U test. The smoking effect on MPOD was analyzed using the Friedman test.

Results:

In all, 143 participants were recruited. The median ± interquartile range was calculated for age (23 ± 4 years), visual acuity (0.00 ± 0.00 logMAR), and MPOD (0.41 ± 0.18). The average MPOD was higher in males than in females but it was not statistically significant ( p > 0.05); on the other hand, they were statistically significantly different in most of the anthropometric data. A significant relationship was found between MPOD and percentage of body fat, protein, and body water ( r = 0.30, p < 0.05). The observed median MPOD value was higher in this study than that found in previous studies in white populations, but lower than that found in studies investigating Asian populations.

Conclusion:

One of the most important risk factors of age-related macular degeneration is associated with a relative absence of macular pigment. This study brought into focus percentage of protein and body water for further studies as well as the well-established links with body fat and obesity. Unknown predictors of MPOD remain uncovered. The study also provided first report on normative values of MPOD for Arab population and confirmed the differences from other ethnicities.
Promotore-Led Versus Registered Nurse-Led Diabetes Self-Management Education in Mexican Americans: A Randomized Clinical Trial
Authors: Kopelowicz Alex , Wali Soma , Polzin Rhonda , Ruiz Maria Elena , Nandy Karabi
Published: August 2023

Purpose:

The purpose of this study is to compare the benefits of a diabetes self-management program led by registered nurses (RNs) versus community health workers ( promotores) for Spanish-speaking Mexican Americans with type 2 diabetes (T2DM).

Methods:

Three hundred thirty Spanish-speaking Mexican American adults with T2DM were randomly assigned to “Tomando Control de Su Diabetes” delivered for six 2.5-hour sessions either by promotores or RNs. The primary outcome measure was the Summary of Diabetes Self-Care Activities (SDSCA). Evaluations were made at baseline, 6 weeks, and at 3, 6, and 12 months. Mixed-effects regression models were fit to test if participants had differential changes in the SDSCA total score by group over time, controlling for demographic and clinical factors.

Results:

SDSCA scores were significantly higher at all time points compared to baseline and not statistically different between the 2 groups. Only years of education correlated with improvement in diabetes self-management behaviors. No moderating variables predicted improvement between groups.

Conclusions:

Spanish-speaking Mexican American adults with T2DM who participated in a diabetes educational program with promotores or RNs demonstrated similar improvements. Promotores may increase the accessibility of effective diabetes self-management training for this difficult-to-reach population.
Prospecting and characterization of plastic clays from the state of São Paulo, Brazil, as raw materials for porcelain stoneware tile production
Authors: Christofoletti Sérgio Ricardo , Motta José Francisco Marciano , Meneghel Eduardo Camargo , Melchiades Fábio Gomes
Published: August 2023

The present work aims to prospect and study the plastic and superplastic clay deposits in the state of São Paulo, Brazil, as a source of raw materials for the ceramic tile industry and especially for the production of porcelain stoneware tiles. To achieve the proposed objectives, a geological study was carried out through the mapping and identification of the present lithologies, lithogeochemical characterization using X-ray diffraction, inductively coupled plasma optical emission spectrometry, cation-exchange capacity and organic carbon and characterization of the ceramic technological properties, including granulometric analysis by sedigraph and Brunauer–Emmett–Teller specific surface area. According to their geological characteristics, the studied deposits were classified into two types: a detrital sedimentary deposit, restricted to Quaternary alluvial sediments and Neogenic Tertiary formations and composed of silt-sandy clay and plastic, kaolinitic, refractory and silico-aluminous facies; and an alterite type, found in Permo-Carboniferous rocks of the Paraná Basin, composed of laminated/massive weathering siltstones, with the highly plastic, fluxing clay minerals illite, kaolinite and smectites. Among the targets studied in these deposits, argillaceous facies with plastic and superplastic characteristics were identified, which affect their applicability in compositions for producing porcelain stoneware tiles and stoneware.
Advanced brain MRI may help understand the link between migraine and multiple sclerosis
Authors: Huang Susie Y. , Salomon Marc , Eikermann-Haerter Katharina
Published: August 2023

Background

There is a clinical association between migraine and multiple sclerosis.

Main body

Migraine and MS patients share similar demographics, with the highest incidence among young, female and otherwise healthy patients. The same hormonal constellations/changes trigger disease exacerbation in both entities. Migraine prevalence is increased in MS patients, which is further enhanced by disease-modifying treatment. Clinical data show that onset of migraine typically starts years before the clinical diagnosis of MS, suggesting that there is either a unidirectional relationship with migraine predisposing to MS, and/or a “shared factor” underlying both conditions. Brain imaging studies show white matter lesions in both MS and migraine patients. Neuroinflammatory mechanisms likely play a key role, at least as a shared downstream pathway. In this review article, we provide an overview of the literature about 1) the clinical association between migraine and MS as well as 2) brain MRI studies that help us better understand the mechanistic relationship between both diseases with implications on their underlying pathophysiology.

Conclusion

Studies suggest a migraine history predisposes patients to develop MS. Advanced brain MR imaging may shed light on shared and distinct features, while helping us better understand mechanisms underlying both disease entities.
rBahadur: efficient simulation of structured high-dimensional genotype data with applications to assortative mating
Authors: Border Richard , Malik Osman Asif
Published: August 2023

Existing methods for generating synthetic genotype data are ill-suited for replicating the effects of assortative mating (AM). We propose _, a novel and computationally efficient algorithm for generating high-dimensional binary random variates that effectively recapitulates AM-induced genetic architectures using the Bahadur order-2 approximation of the multivariate Bernoulli distribution. The R library is available through the Comprehensive R Archive Network at https://CRAN.R-project.org/package=rBahadur.
Comparing antimicrobial resistant genes and phenotypes across multiple sequencing platforms and assays for Enterobacterales clinical isolates
Authors: Rose Rebecca , Nolan David J. , Ashcraft Deborah , Feehan Amy K. , Velez-Climent Leonor , Huston Christopher , Lain Benjamin , Rosenthal Simon , Miele Lucio , Fogel Gary B. , Pankey George , Garcia-Diaz Julia , Lamers Susanna L.
Published: August 2023

Introduction

Whole genome sequencing (WGS) of bacterial isolates can be used to identify antimicrobial resistance (AMR) genes. Previous studies have shown that genotype-based AMR has variable accuracy for predicting carbapenem resistance in carbapenem-resistant Enterobacterales (CRE); however, the majority of these studies used short-read platforms (e.g. Illumina) to generate sequence data. In this study, our objective was to determine whether Oxford Nanopore Technologies (ONT) long-read WGS would improve detection of carbapenem AMR genes with respect to short-read only WGS for nine clinical CRE samples. We measured the minimum inhibitory breakpoint (MIC) using two phenotype assays (MicroScan and ETEST) for six antibiotics, including two carbapenems (meropenem and ertapenem) and four non-carbapenems (gentamicin, ciprofloxacin, cefepime, and trimethoprim/sulfamethoxazole). We generated short-read data using the Illumina NextSeq and long-read data using the ONT MinION. Four assembly methods were compared: ONT-only assembly; ONT-only assembly plus short-read polish; ONT + short-read hybrid assembly plus short-read polish; short-read only assembly.

Results

Consistent with previous studies, our results suggest that the hybrid assembly produced the highest quality results as measured by gene completeness and contig circularization. However, ONT-only methods had minimal impact on the detection of AMR genes and plasmids compared to short-read methods, although, notably, differences in gene copy number differed between methods. All four assembly methods showed identical presence/absence of the blaKPC-2 carbapenemase gene for all samples. The two phenotype assays showed 100% concordant results for the non-carbapenems, but only 65% concordance for the two carbapenems. The presence/absence of AMR genes was 100% concordant with AMR phenotypes for all four non-carbapenem drugs, although only 22%—50% sensitivity for the carbapenems.

Conclusions

Overall, these findings suggest that the lack of complete correspondence between CRE AMR genotype and phenotype for carbapenems, while concerning, is independent of sequencing platform/assembly method.
Impact of preoperative docetaxel, cisplatin, and 5-fluorouracil (DCF) therapy on degree of malignant esophageal stenosis
Authors: Yamaguchi Takahisa , Okamoto Koichi , Saito Hiroto , Shimada Mari , Tsuji Toshikatsu , Moriyama Hideki , Kinoshita Jun , Nakamura Keishi , Inaki Noriyuki
Published: August 2023

Background

Malignant esophageal stenosis is a common and severe complication of advanced esophageal cancer that can be a serious problem in the continuation of chemotherapy and other anticancer treatments. The impact of chemotherapy regimens on the degree of improvement in esophageal stenosis is unknown. In this study, we focused on the impacts of chemotherapy on the direct anticancer effects, and in the improvement of malignant stenosis.

Methods

Patients who underwent radical esophagectomy after chemotherapy, either adjuvant 5-fluorouracil and cisplatin (FP) or docetaxel, cisplatin, and 5-fluorouracil (DCF) regimen, were included. We assessed the length of the cancerous stenosis, the width of the narrowest segment, and the size of the intraluminal area in the stenotic segment by fluoroscopy, and compared the differences before and after chemotherapy. In addition, we evaluated the dysphagia score (Mellow-Pinkas scoring system) as the evaluation of patients’ symptoms. The antitumor effects of chemotherapy were also investigated.

Results

A total of 81 patients were enrolled: 50 were treated with FP, and 31 were treated with DCF. The expansion rate in the length of the narrowest part was significantly increased in the DCF group compared with the FP group. Furthermore, the stenosis index (intraluminal stenotic area/stenotic length) was significantly increased in the DCF group compared with the FP group (112% vs 96%, P = 0.038). Dysphagia score after chemotherapy significantly improved in the DCF group compared to the FP group (P = 0.007). The response rates were 60% in the FP group and 67.7% in the DCF group. Effective histopathological response (improvement to grade 2 or 3) was 24% in the FP group and 38.8% in the DCF group.

Conclusion

DCF therapy is more effective than FP treatment in the improvement of malignant esophageal stenosis.
Factors associated with diagnostic delay of pulmonary tuberculosis among children and adolescents in Quzhou, China: results from the surveillance data 2011–2021
Authors: Zhang Yating , Zhan Bingdong , Hao Xiaogang , Wang Wei , Zhang Xing , Fang Chunfu , Wang Min
Published: August 2023

Purpose

Tuberculosis is a high-burden disease and a major health concern in China, especially among children and adolescents. The purpose of this study was to assess risk factors for diagnostic delay in students with pulmonary tuberculosis in Quzhou City in eastern China.

Patients and methods

Cases of PTB in students and relevant information in Quzhou from 2011 to 2021 were collected using the TB Management Information System. The outcome of interest was diagnostic delay (i.e. ≥ 28 days between symptom onset and treatment initiation). Risk factors for diagnostic delay were identified using multivariable logistic regression.

Results

A total of 629 students in Quzhou were diagnosed with PTB during the study period, of whom 55.5% were male. The median diagnostic delay was 18 days (Inter Quartile Range, [IQR]: 8–38) and 38.0% of the students had a diagnostic delay. Living in a rural area (adjusted odds ratio, [AOR]: 1.56, 95% confidence interval [CI:] 1.11–2.19), developing PTB symptoms in the first quarter of the year (AOR: 2.18, 95% CI: 1.40–3.40), and no sputum smear result (AOR: 8.73, 95% CI: 1.68–45.30) were significantly associated with a diagnostic delay. Discovery through health examinations (AOR: 0.33, 95% CI: 0.17–0.63) was associated with reduced risk of diagnostic delay.

Conclusion

Schools in rural areas should pay special attention to increasing student awareness of the symptoms of tuberculosis and provide health education on tuberculosis prevention and control to students and staff.
Tubular basement membrane deposits after allogeneic hematopoietic stem cell transplantation
Authors: Zhou Wenyan , Qi Chaojun , Zhang Minfang , Hou Xiaotao , Ni Zhaohui
Published: August 2023

Background

Extraglomerular immune complex deposition is rare and only a few membranous nephropathy cases with tubular basement membrane deposits have been reported following allogeneic hematopoietic stem cell transplantation.

Case presentation

We reported a 56-year-old man with increased serum creatinine after allogeneic hematopoietic stem cell transplantation who underwent a renal biopsy. Tubular interstitial nephritis was identified on light microscope. The unique histologic features were diffuse tubular basement membrane immune complex deposition detected by both immunofluorescence and electron microscopy, while the glomerular involvement was inconspicuous. The differential diagnosis from other forms of tubular basement membrane deposition is discussed.

Conclusion

Diffuse granular tubular basement membrane immune complex deposition with minimal glomerular involvement is also a manifestation of renal complication in hematopoietic stem cell transplantation recipient. However, the exact mechanism and target antigen remains unknown.
COVCOG: Immediate and long-term cognitive improvement after cognitive versus emotion management psychoeducation programs - a randomized trial in covid patients with neuropsychological difficulties
Authors: Willems Sylvie , Didone Vincent , Cabello Fernandez Carmen , Delrue Gael , Slama Hichem , Fery Patrick , Goin Julien , Della Libera Clara ,   COVCOG Group, Moutschen Michel , Rousseau Anne-Françoise , Dupuis Gilles , Billet Maud , Charonitis Maëlle , Demoulin Valentine , Dethier Marie , Guillemin Camille , Kreusch Fanny , Leens Fréderique , Léonard Christina , Lesoinne Alexia , Requier Florence , Reyt Mathilde , Rotsaert Marianne , Collette Fabienne
Published: August 2023

Background

Cognitive difficulties are a frequent complaint in long COVID and persist for more than a year post- infection. There is a lack of evidence-based data on effective intervention strategies. Non-pharmacological intervention programs that are used with other neurological populations have not yet been the subject of controlled trials. COVCOG is a multicentric, randomized trial comparing cognitive intervention and a cognitive-behavioural counselling.

Methods/design

Patients with long covid are selected and recruited at least three months post-infection. Patients are randomised in a 1:1 ratio into the cognitive (neuropsychological psychoeducation) and affective (emotion management with cognitive-behavioural counselling) intervention arms. The inclusion of 130 patients is planned. The cognitive intervention includes psycho-educational modules on fatigue and sleep, attention and working memory, executive functions and long-term memory. The affective intervention includes modules on emotion recognition and communication, uncertainty management and behavioral activation. The main objective is to reduce cognitive complaints 2 months after the intervention. A Follow-up is also planned at 8 months.

Discussion

Given the long-term effects of Covid on cognition and the negative effects of cognitive impairment on quality of life and social participation, it is important to determine whether low-dose, non-pharmacological interventions can be effective. The trial will determine which of the usual types of intervention is the most effective.

Trial registration

Clinicaltrials.gov Number: NCT05167266 (21/12/ 2021).
A novel super-enhancer-related gene signature predicts prognosis and immune microenvironment for breast cancer
Authors: Wu Qing , Tao Xuan , Luo Yang , Zheng Shiyao , Lin Nan , Xie Xianhe
Published: August 2023

Background

This study targeted at developing a robust, prognostic signature based on super-enhancer-related genes (SERGs) to reveal survival prognosis and immune microenvironment of breast cancer.

Methods

RNA-sequencing data of breast cancer were retrieved from The Cancer Genome Atlas (TCGA), 1069 patients of which were randomly assigned into training or testing set in 1:1 ratio. SERGs were downloaded from Super-Enhancer Database (SEdb). After which, a SERGs signature was established based on the training set, with its prognostic value further validated in the testing set. Subsequently, we identified the potential function enrichment and tumor immune infiltration of the model. Moreover, in vitro experiments were completed to further explore the biological functions of ZIC2 gene (one of the risk genes in the prognostic model) in breast cancer.

Results

A risk score system of prognostic value was constructed with 6 SERGs (ZIC2, NFE2, FOXJ1, KLF15, POU3F2 and SPIB) to find patients in high-risk group with significantly worse prognosis in both training and testing sets. In addition, a multivariate regression was established via integrating the 6 genes with age and N stage, indicating well performance by calibration, time-dependent receiver operating characteristic (ROC) analysis and decision curve analysis (DCA). Further analysis demonstrated that tumor-associated pathological processes and pathways were significantly enriched in the high-risk group. In general, the novel SERGs signature could be applied to screen breast cancer with immunosuppressive microenvironment for the risk score was negatively correlated with ESTIMATE score, tumor-infiltration lymphocytes (such as CD4 + and CD8 + T cell), immune checkpoints and chemotactic factors. Furthermore, down-regulation of ZIC2 gene expression inhibited the cell viability, cellular migration and cell cycle of breast cancer cells.

Conclusions

The novel SERGs signature could predict the prognosis of breast cancer; and SERGs might serve as potential therapeutic targets for breast cancer.
Accuracy and reproducibility analysis of different reference axes for femoral prosthesis rotation alignment in TKA based on 3D CT femoral model
Authors: Liu Kun , Liu Xuande , Guan Yujun , Ma Haotong , Fu Donglin , Fan Zongqing
Published: August 2023

Background

There are many reference axes to determine the rotational positioning of the femoral prosthesis in total knee arthroplasty (TKA), mainly including the surgical transepicondylar axis (sTEA), anatomical transepicondylar axis (aTEA), Whiteside line, and the posterior condylar line (PCL), etc., but there is still no definite conclusion on which is the most accurate reference axis.

Objective

To explore the reproducibility of each reference axis of femoral external osteotomy based on the 3D CT femoral model, compare the deviation of the simulated femoral prosthesis rotation alignment, positioned based on each reference axis, with the gold standard sTEA, and analyze the accuracy of each reference axis.

Methods

The imaging data of 120 patients with knee osteoarthritis who underwent a 3D CT examination of the knee in our hospital from June 2018 to December 2021 were retrospectively collected. The 3D model of the femur was established by Mimics software. The line relative to PCL externally rotated 3° (PCL + 3°), aTEA, and the vertical line of the Whiteside line were constructed and compared with the gold standard sTEA. Intra-observer, as well as inter-observer reproducibility analysis, was performed by the intra-group correlation coefficient (ICC) and Bland-Altman method.

Results

The angle ∠WS, between the vertical line of Whiteside and sTEA, was 2.54 ± 2.30°, with an outlier of 54.2%; the angle ∠aTEA, between aTEA and sTEA, was 4.21 ± 1.01°, with an outlier of 99.1%; the angle ∠PCL, between PCL + 3° external rotation and sTEA, was 0.50 ± 1.06°, with the highest accuracy and an outlier of 5.8%, and the differences among all three were statistically significant, P < 0.05. The intra-observer ICC values of ∠WS, ∠aTEA, and ∠PCL were 0.975 (0.964–0.982), 0.926 (0.896–0.948), and 0.924(0.892,0.946), respectively, and the reproducibility levels were excellent; the inter-observer ICC values of ∠WS, ∠aTEA, and ∠PCL were 0.968(0.955–0.978), 0.906 (0.868–0.934) and 0.970 (0.957,0.979), respectively, with excellent reproducibility levels; Bland-Altman plots suggested that the scatter points of intra-observer and inter-observer measurement differences more than 95% were within the limits of agreement.

Conclusion

The reference axis for locating the distal femoral external rotation osteotomy based on the 3D CT femoral model has good reproducibility. The PCL is easy to operate, has the highest precision, and the lowest outliers among the reference axes is therefore recommended.
Determination of serum CA724 levels using fluorescence immunochromatography
Authors: Liu Chang , Chen Cuicui , Peng Fenglan , Liang Huankun , Zhong Shuhai , Liu Tiancai , Li Laiqing , Boronin Alexander , Dong Wenqi
Published: August 2023

Background

Carbohydrate antigen 724 (CA724) is a sensitive and specific indicator for multiple malignant tumors. The aim of this study was to establish a Eu-time resolved fluorescence immunochromatography (Eu-TRFICO) method for quantitative detection of CA724 in serum.

Methods

Eu-TRFICO strips were optimized and assembled. The sensitivity, specificity and precision were evaluated using CA724 standard dilutions and matrix serum. Meanwhile, the reference interval, comparison, and sensitivity/specificity were performed using clinical negative/positive gastric cancer serum samples.

Results

The standard curve equation was y = 9.869 x − 154.12 (R2 = 0.993), and the sensitivity was 0.42 U/mL. The common interferents in serum could not affect the quantitative results with low cross-reactivities (all no more than 1.09%). All average recoveries of the intra- and interbatch ranged from 102.38 to 106.40%, and all CVs were below 10%. The reference interval of the healthy subjects was < 4.68 U/mL and the reference interval of the subjects with grade I/II gastric cancer was > 9.54 U/mL. Additionally, a high Pearson r (0.9503) and sensitivity/specificity (92.86%/94.20%) were obtained.

Conclusion

This study prepared Eu-TRFICO strips with high sensitivity, specificity, precision and satisfactory clinical testing performance, which provides more options for clinical quantitative and convenient testing of CA724.
Readiness for interprofessional learning among health science students: a cross-sectional Q-methodology and likert-based study
Authors: Oliveira Ana , Brewer-Deluce Danielle , Akhtar-Danesh Noori , Wojkowski Sarah
Published: August 2023

Background

Interprofessional education (IPE) prepares healthcare students for collaboration in clinical practice, but the effectiveness of this teaching method depends on students’ readiness for and perceptions of IPE. Evaluating students’ readiness for and perceptions of IPE is challenging, due to the lack of comprehensive measures. This study characterized the level of IPE readiness and perspectives across first-year undergraduate and graduate health science students using the readiness for interprofessional learning Likert Scale (RIPLS) and Q-methodologies.

Methods

This is a cross-sectional, online study. Students were randomized to answer the Likert-scale version of RIPLS (80%) or a matched Q-methodology survey (20%). An ANCOVA compared RIPLS scores between students from different program levels (graduate/undergraduate) and specialization (health professional and general programs). The Q-data was analysed using a by-person factor analysis.

Results

Three hundred and four (33% response rate) and 71 (30% response rate) students completed the Likert scale and the Q-methodology surveys, respectively. Students from graduate programs demonstrated high readiness for IPE (higher total RIPLS scores p < 0.001) in comparison to undergraduates. Three factors, associated with program specialization (p = 0.04), emerged from the Q-methodology analysis characterizing students learning priorities. Students in undergraduate general programs were focused on IPE relevance and benefits to “the clinical team”, students in graduate programs focused on “the patient”, and those in undergraduate health professional programs focused on themselves (“me”).

Conclusions

This novel mixed-methods approach combining traditional Likert-scales with Q-methodology elucidated not only associations between program and specialization with readiness (Likert) but also which components of IPE were valued the most (Q-methodology) and by whom.
Small area analysis methods in an area of limited mapping: exploratory geospatial analysis of firearm injuries in Port-au-Prince, Haiti
Authors: Burlotos Athanasios , Pierre Tayana Jean , Johnson Walter , Wiafe Seth ,   PROTRA Haiti Group, Pean Corinne , McCalla Monet , Lominy Carl Stephane , Lefevre Jean Antoni Sebastien , Lot Yvelie Saint , Lartigue Jean Wilguens , Therone Alence , Torres Carolina , Cahill Gabrielle , Joseph Michelle
Published: August 2023

Background

The city of Port-au-Prince, Haiti, is experiencing an epidemic of firearm injuries which has resulted in high burdens of morbidity and mortality. Despite this, little scientific literature exists on the topic. Geospatial research could inform stakeholders and aid in the response to the current firearm injury epidemic. However, traditional small-area geospatial methods are difficult to implement in Port-au-Prince, as the area has limited mapping penetration. Objectives of this study were to evaluate the feasibility of geospatial analysis in Port-au-Prince, to seek to understand specific limitations to geospatial research in this context, and to explore the geospatial epidemiology of firearm injuries in patients presenting to the largest public hospital in Port-au-Prince.

Results

To overcome limited mapping penetration, multiple data sources were combined. Boundaries of informally developed neighborhoods were estimated from the crowd-sourced platform OpenStreetMap using Thiessen polygons. Population counts were obtained from previously published satellite-derived estimates and aggregated to the neighborhood level. Cases of firearm injuries presenting to the largest public hospital in Port-au-Prince from November 22nd, 2019, through December 31st, 2020, were geocoded and aggregated to the neighborhood level. Cluster analysis was performed using Global Moran’s I testing, local Moran’s I testing, and the SaTScan software. Results demonstrated significant geospatial autocorrelation in the risk of firearm injury within the city. Cluster analysis identified areas of the city with the highest burden of firearm injuries.

Conclusions

By utilizing novel methodology in neighborhood estimation and combining multiple data sources, geospatial research was able to be conducted in Port-au-Prince. Geospatial clusters of firearm injuries were identified, and neighborhood level relative-risk estimates were obtained. While access to neighborhoods experiencing the largest burden of firearm injuries remains restricted, these geospatial methods could continue to inform stakeholder response to the growing burden of firearm injuries in Port-au-Prince.
Testing the influence of harm reduction messages on health risk attitudes, injunctive norms and perceived behavioral control
Authors: Katz Sherri Jean , Cohen Elisia , Hatsukami Dorothy
Published: August 2023

Background

E-cigarettes can potentially be a harm reduction pathway for adults who smoke and who are seeking to make the complete switch from cigarettes. However, often people who smoke believe that e-cigarettes are just as damaging as cigarettes to their health. From a harm reduction perspective, the key question is whether providing information about the reduced toxicant intake of e-cigarettes, compared to cigarettes, could influence their perceptions and whether there are certain message features that might further support this transition.

Methods

In this experiment (n = 305), we test whether a harm reduction (reduced toxicant intake, complete switch) message will influence the health risk attitudes, injunctive norms and perceived behavioral control of people who smoke, compared to those who do not view a message and whether including a “smoking cue” within the message influences their response.

Results

Results indicate that those who viewed the harm reduction message with a smoking cue had lower health risk attitudes than those who did not view a message (p = 0.025) and higher injunctive norms than those who viewed the message without a smoking cue (p = 0.006).

Conclusions

These findings demonstrate that a harm reduction message with a smoking cue can influence the perceptions of adults who smoke, lowering health risk attitudes and increasing injunctive norms.