bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nomogram for predicting risk factors for moderate to severe pain in critical postoperative patients during the transition from the surgical intensive care unit to the surgical ward
Authors: Tang Zhihong , Li Na , tian yongming 
Published: June 2024

Abstract

Background: Patients may face the risk of pain during transition from the surgical intensive care unit (SICU) to the surgical ward. The incidence and risk factors of pain during this period are currently unclear.
Objective: To investigate the prevalence and risk factors of moderate to severe pain in critical postoperative patients during the transition period (24 h before and 24 h after transfer) from the SICU to the surgical ward and to construct a nomogram for predicting the moderate to severe pain in critical postoperative patients during the transition from the SICU to the surgical ward.
Design: A prospective survey study
Methods: 552 patients，data were collected between June 2021 and April 2022 at West China Hospital, Sichuan University by convenience sampling. Descriptive, bivariate, and logistic regression analyses were performed, after which a prediction nomogram was constructed. The Hosmer-Lemeshow goodness-of-fit test and calibration curve were used to evaluate the calibration of the nomogram, and the area under the receiver operating characteristic curve (AUC) was used to evaluate its discriminatory ability.
Results: In total, 552 patients were included in the study, 28.44% of whom experienced moderate to severe pain during the 24-h transition period. The independent risk factors for moderate to severe pain identified by logistic regression analysis were acute pain 24 h before transfer out (odds ratio [OR] = 4.644; P < 0.001), APACHE II score (OR = 6.721; P < 0.001), length of stay in the SICU (OR = 3.344; P = 0.012), and number of drainage tubes (OR = 1.382; P = 0.023). A nomographic prediction model was established based on the weighting of these four risk factors. The AUC of the model was 0.975 (95% confidence interval: 0.964–0.987). The Hosmer-Lemeshow test (P=0.551) and calibration curve showed good calibration for the prediction of the moderate to severe pain in critical postoperative patients during the transition from the SICU to the surgical ward.
Conclusions: A high incidence of pain was observed among critically ill postoperative patients during the 24-h transition period from the SICU to the surgical ward. Acute pain 24 h before transfer out, APACHE II score, length of stay in the SICU, and number of drainage tubes were found to be significantly associated with moderate to severe pain in critical postoperative patients during the transition from the SICU to the surgical ward. The predictive nomogram was useful in identifying the risk factors of moderate to severe pain in critical postoperative patients.
Decoding the Impact of Lipid Metabolism on Osteoporosis: A Study on Phosphatidylcholine, Inflammatory Factors, and Immune Cells
Authors: Ye Huihuang , Wu Shaohao , Meng Hongming , Chen Chun , Bai Zhibiao 
Published: June 2024

Abstract

Objective: This study utilized Mendelian randomization to elucidate the causal relationship between Phosphatidylcholine (O-17:0_15:0) levels and osteoporosis, exploring the mediating roles of inflammatory factors and immune cells.
Methods: The genetic information of osteoporosis patients was obtained from the Finnish FinnGen project, with supplementary data including sequencing results for 179 liposome, 91 inflammatory factors, and 713 immune cells sourced from GWAS summary datasets. In this study, we analyzed liposome profiles as the exposure and osteoporosis as the outcome, with inflammatory factors and immune cells being examined as mediating factors. Two-sample Mendelian randomization, employing the inverse variance weighted method, and mediation analyses were conducted to assess the impact of Phosphatidylcholine on osteoporosis through inflammatory and immune pathways. Analyses of heterogeneity and pleiotropy was also conducted to assess the complexity and potential biases in the causal relationship between identified liposome and osteoporosis.
Results: Our analysis has unveiled a significant positive causal relationship between the levels of Phosphatidylcholine (O-17:0_15:0) in serum and the risk of osteoporosis. Notably, it was observed that the levels of Phosphatidylcholine (O-17:0_15:0) in serum contribute to the downregulation of tumor necrosis factor (TNF) and the activation of CD16-CD56 positive natural killer (NK) cells, both of which are protective factors against osteoporosis. This dual mechanism underscores the complex interplay between liposome and bone health, providing new insights into the pathophysiology of osteoporosis and highlighting potential targets for therapeutic intervention. Sensitivity analyses confirmed the robustness of these findings, showing no evidence of pleiotropy or reverse causation.
Conclusion: This study provides compelling evidence that Phosphatidylcholine (O-17:0_15:0) levels causally affect osteoporosis risk, with significant mediation effects observed through both inflammatory and immune mechanisms. These findings offer new insights into the complex interplay between lipid metabolism, inflammation, and immune regulation in osteoporosis, suggesting potential targets for therapeutic intervention in bone-related diseases.
Financing Immunisation in Kenya: Examining bottlenecks in health sector planning and budgeting at decentralised level
Authors: Adjagba Alex O. , Akoth Catherine , Oguta James Odhiambo , Wambiya Elvis O , Nonvignon Justice , Jackson Debra 
Published: June 2024

Abstract

Background
Decentralisation has increasingly been adopted by countries as an important health sector reform with the aim of increasing community participation in decision making while enhancing swift response at decentralised levels, thereby accelerating the attainment of health system goals. Kenya adopted a devolved system of government where health services delivery became a function of the 47 semi-autonomous county governments with planning and budgeting functions practised at both levels of government. This study sought to explore challenges facing health sector planning and budgeting and how they affect immunisation service delivery at the county level.
Methods
Data were collected through 77 in-depth interviews of senior county department of health officials across 15 counties in Kenya. We applied an inductive thematic approach in analysing the qualitative data using NVIVO software.
Findings:
The study found a lack of alignment between planning and budgeting processes, with planning being more inclusive compared to budgeting. Inadequate capacity in conducting planning and budgeting and political interference were reported to hinder the processes. Delayed and untimely disbursement of funds was reported to affect execution of health and immunisation budgets. Low prioritisation of preventive health interventions like immunisation influenced resource allocation to the programs.
Conclusion
The findings highlight the need for effective strategies to address bottlenecks facing planning and budgeting to ensure adequate immunisation and health sector funding at the county level.
Comparing Health Insurance-ReimbursedFirst Line Lenvatinib and Self-paid Atezolizumab plus Bevacizumab in Patients with Unresectable Hepatocellular Carcinoma
Authors: Kuo Yuan-Hung , Chen Yen-Hao , Tsai Ming-Chao , Lu Sheng-Nan , Hu Tsung-Hui , Hung Chao-Hung , Chen Chien-Hung , Wang Jing-Houng 
Published: June 2024

Abstract

Background/Purpose: Atezolizumab plus bevacizumab (Ate/Bev) and lenvatinib (Len) are first-line therapies for unresectable hepatocellular carcinoma (uHCC). However, Ate/Bev's high cost limits its common use in real-life practice, while Len is usually covered by national health insurance (NHI). We conducted this study to compare their effectiveness and safety in real-world settings.
Methods: We retrospectively evaluated 346 uHCC patients treated with first-line Ate/Bev (n=80) or Len (n=266) from December 2019 to December 2022, using 1:2 ratio propensity score matching (PSM) analyses.
Results: Compared to the Len group, the Ate/Bev group exhibited higher incidences of Child-Pugh class B (14.1% vs. 5.7%, p=0.014), larger main tumors (58.8% vs. 40.2%, p=0.003), and more main portal vein invasion (25% vs. 12.8%, p=0.008). Treatment-related adverse events were notably lower in the Ate/Bev group (56.3% vs. 72.3%, p=0.007). After PSM, no significant differences were observed in the objective response rate (21.9% vs. 21.6%, p=0.983), progression-free survival (5.1 vs. 6 months, p=0.783), and overall survival (13.3 vs. 14.1 months, p=0.945) between the Ate/Bev (n=73) and Len (n=142) groups. Patients in the Ate/Bev group received more sequential post-treatments compared to the Len group (45.2% vs. 24.6%, p=0.009). Len-based therapies (n=28, 84.8%) and mono- or combined-immunotherapy (n=19, 54.3%) were the most frequently administered sequential therapies following Ate/Bev and Len, respectively.
Conclusion: Patients with uHCC who received first-line self-paid Ate/Bev appeared to have lower liver function reserve and more advanced tumor characteristics compared to those who underwent NHI-reimbursed Len. However, the treatment outcomes and safety profiles were similar between these two groups.
Screening for intrinsic capacity and frailty in the primary care population with multimorbidity using the Integrated Care for Older People Screening Tool and two different frailty measures – the Frailty Phenotype and Clinical Frailty Scale: a cross-sectional study
Authors: Sim Sai Zhen , Ng Xinyao , Lee Poay Sian Sabrina , Koh Hui Li , Tan Shu Yun , Ding Teck Yong Gabriel , Lee Eng Sing 
Published: June 2024

Abstract

Background
Intrinsic capacity (IC) co-exists with frailty and multimorbidity in primary care. To improve health outcomes, guidelines recommend IC and frailty screening and it is thought that IC screening can support the concurrent and subsequent evaluation of frailty. For feasible implementation of such screening, it is important to understand the association between IC and frailty, including the discriminative ability of IC against frailty in a primary care population with multimorbidity.
Method
A cross-sectional study was conducted across three primary care clinics. Participants were elderly and had the multimorbidity triad of diabetes mellitus, hypertension, and hyperlipidemia. Data collected included sociodemographic variables, IC (Integrated Care Older People Screening Tool), social vulnerability, chronic conditions, functional disability, modified Frailty Phenotype (mFP), and Clinical Frailty Scale (CFS). Logistic regression was used to assess the association between IC and the two measurements of frailty while area under the curve of the receiver operating characteristic (AUC-ROC) was used to assess the discriminative ability of IC against frailty.
Results
411 participants were included. Mean age was 69.9 (± 6.2) years and almost all (98.0%) the participants had reduced IC on screening, of which the most affected domains were the sensory (90.0%), locomotion (44.0%), and cognition (30.9%) domains. 12.4% were mFP frail while 7.4% were CFS frail. While higher IC was associated with reduced odds of frailty regardless of the frailty measure (p ≤ 0.001), the IC domains associated with frailty depended on the frailty measure used. Vitality and locomotion were associated with being mFP frail while the sensory and locomotion domains were associated with being CFS frail. An IC cut-off score of 3 was able to discriminate moderately against the mFP and CFS (AUC 0.72 and 0.74, respectively), but with a high false-positive rate 85.4% and 81.9%, respectively.
Conclusions
In a primary care population with multimorbidity, IC screening discriminates moderately against frailty. In view of the very high prevalence of IC losses, the high false-positive rate of frailty in this population and limited healthcare resources, IC screening followed by frailty screening of selected patients with IC losses may not be feasible and other approaches should be considered.
Surface Properties of Stainless Steel Coated by the HVOF Process
Authors: özbek yıldız , ipek ahmet 
Published: June 2024

Abstract

This study aims to investigate the microstructural and wear properties of WC-Co coating deposited by High-Velocity Oxy-Fuel Spraying (HVOF) by optimising powders with different content ratios. Stainless steel, which is widely used in the industry, was selected as the substrate for testing. The study looked into the parameters of the HVOF process, such as powder type, nozzle distance, and the number of passes. Two different powders were used as coating powder, one containing 50wt.% Sulzer Metco 5810 (WC, wt.%12 Cobalt powder) and 50wt.% Amdry 960 (Ni, Cr, Al), and the other containing 50 wt.% Woka 3653 and 50 wt.% Amdry 960. The coating layer was examined using SEM-EDS, and XRD analyses were applied to the coated surface. The hard phases occurred after the HVOF process, and the hardness values were measured on the cross-section of the coating layer. The coated surface's hardness was found to be increased by five times. The CSM wear tests machine examined the changes in the wear properties of stainless steel according to ASTM G133 standard. Both coatings positively affected wear, and the wear resistance of the coated surface was increased after the HVOF process. The friction coefficients of samples decreased after the coating process. SEM-EDS analyses of worn surfaces were conducted, and a 3D surface topography test was applied to worn surfaces.
Neuropsychological profile in a child with Buschke-Ollendorff syndrome: A case report
Authors: Covuccia Marilina , Spinelli Eleonora , Caravale Barbara 
Published: June 2024

Abstract

Introduction:
Buschke-Ollendorff syndrome (BOS) is a rare autosomal dominant genodermatosis caused by a mutation in the LEMD3 gene. While it primarily affects the skin with the development of connective tissue nevi, it can be associated with other conditions such as intellectual disability or developmental delay. These co-occurring conditions add complexity to the clinical picture and necessitate comprehensive evaluation and management strategies.
Case report:
We describe the clinical history of a 7-year-old male child diagnosed with BOS, exploring his neuropsychological profile and finding the presence of mild intellectual disability, impaired attentional abilities, and difficulties in language, motor coordination, and learning.
Discussion
Our findings support the hypothesis of the presence of neurodevelopmental disorders in children with BOS. However, further studies are needed to determine the existence and understand the nature of the possible link between these conditions.
Effect of metabolic bariatric surgery in patients with obesity aged 55 years or older
Authors: Lee Yoontaek , kim Sang Hyun , Park Young Suk , Lee Han Hong , Seo Ho Seok , Son Sang-Yong , Lee Chang Min 
Published: June 2024

Abstract

Many studies have reported the safety and efficacy of metabolic bariatric surgery (MBS) in older patients. However, there are no such studies targeting East Asians. This study evaluates the safety and efficacy of MBS in older and younger populations with obesity by comparing and analyzing their postoperative outcomes. We reviewed the electronic medical records of 410 patients who underwent MBS in 2019, categorizing them into two age groups: ≥ 55 years and < 55 years. Older patients had lower mean body weight and higher rates of comorbidities such as hypertension, dyslipidemia, and diabetes mellitus compared to younger patients. Despite these differences, there was no significant disparity in operative time, postoperative hospital stay, or post-operative complications between the groups. The one-year follow-up showed a significant difference in percent total weight loss, favoring younger patients, but no significant difference in percent excess BMI loss. Our findings indicate that MBS is safe for older patients in East Asia, offering acceptable weight loss outcomes and suggesting that age alone should not be a barrier to surgery.
How cytology and cytology-based HPV testing could assist clinicians in the diagnosis of head and neck squamous cell carcinoma
Authors: Yang Xin , Cui Ying , Zhao Huan , Zhang Zhihui , Zhao Linlin , Yu Jing , Ni Xiaoguang , Guo Huiqin 
Published: June 2024

Abstract

Introduction:
Given the limitations of biopsy in the diagnosis of head and neck squamous cell carcinoma (HNSCC), we explored the diagnostic efficiency of cytology at the primary tumor site of HNSCC. In addition, p16 immunohistochemistry (IHC) can yield a false positive result in the detection of HPV status in HNSCC, so we sought to perform APTIMA HPV testing to improve the diagnostic accuracy for HPV status in HNSCC patients.
Methods
We categorized 151 enrolled HNSCC patients into two groups. The first cohort comprised 78 patients who underwent cytology examination at the primary tumor sites of HNSCC. The other cohort consisted of 132 patients whose HPV status was evaluated and whose cytology specimens underwent HPV APTIMA testing while their histologic biopsy specimens underwent p16 IHC. Patients with discordant Aptima HPV and p16 IHC results were reexamined with RNAscope assays.
Results
Among the 78 patients whose samples from the primary site of HNSCC underwent cytological examination, 71 underwent simultaneous pathological biopsy; due to sampling difficulties, the biopsy failed for the remaining 7 patients. There were 13 cases of HNSCC that could not be definitively diagnosed as SCC with preoperative biopsy. Of these 13 histologically underdiagnosed cases, SCC was ultimately diagnosed cytologically in six cases. Of the 7 patients whose preoperative biopsy failed, five were cytologically diagnosed with SCC. For all 132 HNSCC patients whose cytology specimens underwent HPV APTIMA testing, compared to p16 IHC, the APTIMA HPV test had greater specificity and positive predictive values (98.8% and 98.0% vs. 89.2% and 84.5%, p2 = 0.018, p3 = 0.020) and similar sensitivity and negative predictive values (98.0% and 98.8% vs. 100% and 100%, p1 = 1.000, p4 = 1.000).
Conclusion
Cytological examination can complement preoperative pathological biopsy in the diagnosis of HNSCC at the primary tumor site. Furthermore, cytology specimens could be utilized for HPV testing using the APTIMA HPV test to uncover potential errors in p16 IHC results on biopsy samples, allowing a more precise diagnosis and treatment of HNSCC.
Mechanism of Transplanted Novel Umbilical Cord Mesenchymal Stem Cells with High Cytokine Secretion for the Treatment of Vaginitis
Authors: Cheng Yanwen , He Zi , Zhou Hui , Han Xinye , An Yihua 
Published: June 2024

Abstract

Objective: Vaginitis, characterised by inflammation of the vagina, is commonly caused by bacterial, fungal or parasitic infections and has a significant physical and psychological impact on patients. Stem cell therapy, particularly using cells with robust cytokine secretion, is a promising treatment approach. This study aims to investigate the mechanism by which umbilical cord mesenchymal stem cells (UCMSC) can be induced to secrete elevated levels of cytokines for the treatment of vaginitis.
Methods: We developed a method to stimulate significant cytokine secretion in UCMSC. The optimal cell induction programme was identified through a comprehensive assessment of cytokine secretion capacity, secretion characteristics, cell phenotype, lipid formation capacity and safety profile of the cells before and after induction. We then applied the UCMSC induced to secrete increased levels of neurotrophic and immunomodulatory factors (UCMSC-NTF) in the treatment of a vaginitis disease model.
Results: Flow cytometric analysis revealed no significant differences in the expression of UCMSC phenotypic markers before and after induction. AAH-BLG-1 antibody microarray results showed a significantly higher level of cytokines secreted by the UCMSC-NTF group compared to the UCMSC group. In addition, the lipid-forming ability and cell proliferation activity of UCMSC-NTF showed improvement compared to the UCMSC group. The induced UCMSC-NTF was then used to treat the vaginitis model. Western blot analysis after cell transplantation showed a significant reduction in the expression levels of inflammatory factors in the UCMSC-NTF group. Immunofluorescence results showed significantly increased expression levels of COL I, CD31 and cytokeratin CK in the UCMSC-NTF group compared to both the UCMSC and sham groups. Regeneration and repair observed in the UCMSC-NTF group were significantly superior to the other control groups.
Conclusion: Induced UCMSC-NTF exhibit enhanced cytokine secretion and proliferative capacity. Transplantation of UCMSC-NTF not only reduced inflammation levels at the lesion site, but also facilitated vascular regeneration, epithelial tissue keratosis and type I collagen restoration. These combined effects contributed significantly to the improved regeneration and repair of the lesion site.
Efficacy of Bacillus subtilis BMT4i/Activated carbon composite for removal of diclofenac and carbamazepine from aqueous solution
Authors: Tiwari Chhaya , RAYCHOUDHURY TRISHIKHI , Bag Ramakrishna 
Published: June 2024

Abstract

Pharmaceutical contaminants (PhACs) have become a worldwide concern in the present scenario. It is considered a group of emerging contaminants and is ubiquitously found in different water bodies in higher concentrations, leading to the deterioration of the water quality and causing ecotoxicity to several non-target organisms. This study extensively evaluates the efficacy of the bacterial strain Bacillus subtilis BMT4i for removing two emerging PhACs, diclofenac (DCF) and carbamazepine (CBZ), from an aqueous solution. A series of batch experiments were conducted by keeping parameters similar to wastewater effluent to investigate the biodegradation of B. subtilis BMT4i in removing PhACs in real scenarios. The study showed that around 67% and 50% of DCF and CBZ were removed within 72 hours when PhACs were supplied as the sole carbon source. Moreover, in co-metabolism with other carbon and nitrogen sources, the percentage removal was enhanced by 20-30%. Further, B. subtilis BMT4i were immobilized on two activated carbons (ACs) i.e., ACEco, and ACDarco prepared from coconut shells and coal so that the composite could directly be used as a bioreactor. The biofilm formation over ACs was confirmed by scanning electron microscopy and Fourier-transform infrared spectroscopy. The results obtained with batch experiment showed over 85-100% removal of both PhACs in a short duration of 2 hours. Moreover, the column studies revealed that around 60-77% of 1 mg/l PhACs were removed by passing over 2 liters of PhACs contaminated water. Overall, the current study confirms that the B. subtilis BMT4i/ACs composite shows promising performance for removing selected PhACs from water.