bluuebunny/crossref_metadata_2025_split huggingface dataset:
GSK3β and mTORC1 Represent 2 Distinct Signaling Markers in Peripheral Blood Mononuclear Cells of Drug-Naive, First Episode of Psychosis Patients
Authors: Petrikis Petros , Polyzou Alexandra , Premeti Kyriaki , Roumelioti Argyro , Karampas Andreas , Georgiou Georgios , Grigoriadis Dionysios , Leondaritis George 
Published: June 2022

Abstract

Background and Hypothesis
Schizophrenia is characterized by a complex interplay between genetic and environmental risk factors converging on prominent signaling pathways that orchestrate brain development. The Akt/GSK3β/mTORC1 pathway has long been recognized as a point of convergence and etiological mechanism, but despite evidence suggesting its hypofunction, it is still not clear if this is already established during the first episode of psychosis (FEP).

Study Design
Here, we performed a systematic phosphorylation analysis of Akt, GSK3β, and S6, a mTORC1 downstream target, in fresh peripheral blood mononuclear cells from drug-naive FEP patients and control subjects.

Study Results
Our results suggest 2 distinct signaling endophenotypes in FEP patients. GSK3β hypofunction exhibits a promiscuous association with psychopathology, and it is normalized after treatment, whereas mTORC1 hypofunction represents a stable state.

Conclusions
Our study provides novel insight on the peripheral hypofunction of the Akt/GSK3β/mTORC1 pathway and highlights mTORC1 activity as a prominent integrator of altered peripheral immune and metabolic states in FEP patients.
Psychological Pathways to Paranoia and Psychotic-Like Experiences in Daily-Life: The Mediating Role of Distinct Affective Disturbances
Authors: Monsonet Manel , Rockwood Nicholas J , Kwapil Thomas R , Barrantes-Vidal Neus 
Published: June 2022

Abstract

Background and Hypothesis
Influential models of psychosis indicate that the impact of putative causal factors on positive symptoms might be explained partly through affective disturbances. We aimed to investigate whether pathways from stress and self-esteem to positive symptoms, as well as reversal pathways from symptoms to stress and self-esteem, were mediated through specific affective disturbances across the extended psychosis phenotype.

Study Design
Using experience sampling methodology, 178 participants (65 high-schizotypy, 74 at-risk mental state, and 39 first-episode psychosis) were assessed on levels of momentary stress, self-esteem, anxiety, sadness, psychotic-like experiences (PLE), and paranoia. Multilevel mediation models were fit to examine indirect effects of each of these pathways. Considering evidence of mediation, each indirect pathway will be combined in a single model to explore their relative contributions.

Study Results
Anxiety, sadness, and self-esteem mediated the pathways from stress to PLE and paranoia in daily-life. In the pathway to paranoia, sadness, and self-esteem showed larger contributions than anxiety. Pathways from self-esteem to PLE and paranoia were mediated by anxiety and sadness, the later showing a larger contribution. Pathways from symptoms to stress, but not from symptoms to self-esteem, were differently explained by emotional states; sadness lost its mediating effect and anxiety was the most important mediator. Few differences across groups were found.

Conclusions
This study lends support to psychological models of psychosis that highlight the relevance of affective disturbances in the risk and expression of psychosis. Furthermore, specific influences of different negative emotional states were identified, which could enhance psychological treatments.
Factors Influencing Faculty Decisions to Teach LGBTQ Content in Undergraduate Nursing Programs
Authors: Marsh Paige , Polster Remy , Ricco George , Kemery S. Alexander 
Published: June 2022

Abstract

AIM
The purpose of this study was to identify factors influencing the decision to teach lesbian, gay, bisexual, transgender, and queer (LGBTQ) content in baccalaureate nursing programs and determine priority areas for future intervention.

BACKGROUND
LGBTQ people face a variety of health disparities. Lack of LGBTQ-focused education in nursing schools contributes to these disparities.

METHOD
Using the theory of planned behavior as a framework, nurse educators from across the United States (n = 111) were surveyed on concepts that influenced their intention to teach LGBTQ content.

RESULTS
Average scores on items related to barriers, outcomes, control, norms, and attitudes were found to significantly correlate with the intention to teach LGBTQ content.

CONCLUSION
Participants reported positive attitudes and some measure of control over curricula but did not indicate an intent to incorporate LGBTQ content. Lack of time, knowledge/competence, resources, and training were barriers. A toolkit to facilitate teaching LGBTQ content may increase inclusion in nursing curricula.
Acceptance of Remote Education During COVID-19 Outbreak in Undergraduate Nursing Students
Authors: Abuhammad Sawsan , Gharaibeh Besher , Kasem Abedallah , Hamadneh Shereen 
Published: June 2022

Abstract
This study aimed to examine the acceptance and predictors of remote education through Internet-based learning among undergraduate nursing students in Jordan. An online survey was used with a sample of 344 students to assess satisfaction with remote education. Responses indicated that undergraduate nursing students were unsatisfied with remote education for several reasons. Many students (n = 188, 55 percent) strongly agreed that problems and obstacles were encountered when they studied subjects electronically. The acceptance of remote education was predicted by educational level (p = .01), device used (p = .001), and Internet reliability p = .001).
Decompression sickness in SCUBA divers
Authors: Junes Brittania , Smart Christie , Parsh Bridget 
Published: June 2022

Abstract:
There are approximately 2.8 million active self-contained underwater breathing apparatus (SCUBA) divers in the US who are at risk for decompression sickness. This article discusses the pathophysiology, common signs and symptoms, and treatments of this multisystem complication of SCUBA diving.
The complexity of providing humanitarian surgical care in armed conflict: a framework to help categorize needs
Authors: Gianaris Kevin , Stewart Barclay T. , Wren Sherry M. , Kushner Adam L. 
Published: June 2022

Abstract
Armed conflicts are increasing globally due to political unrest and the broader effects of climate change. Without resources to provide quality surgical care, it becomes nearly impossible to provide quality emergency surgery and trauma care similar to that in high-income countries. To understand and help aid organizations provide resources and address the surgical needs of populations facing armed conflict, a matrix to identify variables and help with interventions was envisioned. A previously published global surgery matrix based on the PIPES (Personnel, Infrastructure, Procedures, Equipment and Supplies) surgical capacity tool was adapted to this context. The novel matrix incorporates 108 variables. These variables are grossly divided into local and international agency components to address the issue of who is providing care. Using a time continuum of pre-conflict, conflict, and post-conflict allows organizations to concentrate on when during the conflict to target their intervention. In addition to the previously used personnel, infrastructure, procedures, equipment, and supplies categories, a sixth category called standards was included that addresses the issues such as information technology, data systems, quality improvement programs, and patient safety. Pilot testing of this matrix to obtain feedback from end users is the next step in development. Ultimately, peri-conflict preparedness should increase and improve surgical outcomes and reduce in death and disabilities around the world.
Does reduced chewing ability efficiency influence cognitive function? Results of a 10-year national cohort study
Authors: Kim Mi-Sun , Han Dong-Hun 
Published: June 2022

Abstract
A growing body of literature suggests that oral health can influence cognitive function during aging. However, it is currently unclear whether reduced masticatory efficiency influences cognitive impairment in longitudinal studies.
This study sought to investigate the effects of reduced chewing ability on the incidence of cognitive impairment using national representative data from 10 years of follow-up in Korea. Among the 10,254 people recruited in 2006 (1st wave), 7568 with normal cognitive function were selected. The participants were followed up every 2 years. The number of participants followed up until the 6th wave was 5020 in 2016. Chewing ability and scores on the Mini-Mental State Examination were recorded using self-reported questionnaires. Risk factors for dementia taken from systematic literature reviews were used as covariates. We performed logistic regression and created general estimating equation models after controlling for all covariates to assess the relationship between chewing ability and cognitive decline. Decreased chewing function was associated with mild cognitive impairment after controlling for confounding variables.
The odds ratio for cognitive impairment was about 1.28 times higher than in people with poor chewing function as in those with good chewing function. We identified changes in chewing function from the 1st wave to the 6th wave; the odds ratios were 2.21 (95% confidence interval = 1.90–2.58) in the good-poor group and 2.11 (95% confidence interval = 1.74–2.55) in the poor-poor group.
We identified an impairment in cognitive function in the poor (poor-poor and good-poor) chewing ability group. Therefore, we have confirmed that reduced mastication efficiency may contribute to a deterioration in cognitive function. People with deteriorated chewing ability must be given additional attention to aid in the prevention of cognitive decline.
Comparison of adductor canal block and femoral nerve block for pain management in anterior cruciate ligament reconstruction
Authors: Yin Xiao , Li Xingyue , Zhao Peng 
Published: June 2022

Abstract

Objective:
To compare the efficacy of adductor canal block and femoral nerve block for pain management in patients with anterior cruciate ligament reconstruction.

Methods:
A computerized search was performed in the database of PubMed, Embase, Web of Science and Cochrane Library for randomized controlled trials. The outcome measures included visual analog scale, morphine consumption, quadriceps strength, length of hospitalization and postoperative adverse events. The risk of bias of randomized controlled trials was assessed according to the Cochrane Risk of Bias Tool. All quantitative syntheses were completed using STATA version 14.

Results:
Seven randomized controlled trials involving a total of 643 patients were included in our meta-analysis. The present meta-analysis indicated that there were no significant differences between the 2 groups in terms of postoperative pain score, opioid consumption, length of hospitalization or adverse effects after anterior cruciate ligament reconstruction. However, adductor canal block showed superior quadriceps strength and range of motion in the early postoperative period.

Conclusion:
Adductor canal block shows similar and adequate analgesia compared to the femoral nerve block in anterior cruciate ligament reconstruction and adductor canal block can preserve a higher quadriceps strength and better range of motion.
Association between neutrophil-lymphocyte ratio and lymph node metastasis in gastric cancer
Authors: Kotecha Krishna , Singla Animesh , Townend Philip , Merrett Neil 
Published: June 2022

Abstract

Introduction and Aim:
The prognostic role of neutrophil to lymphocyte ratio (NLR) has been explored extensively in the literature. The aim of this meta-analysis was to evaluate the link between NLR and lymph node metastasis in gastric cancer. A method for increasing specificity and sensitivity of pre-treatment staging has implications on treatment algorithms and survival.

Search Strategy:
The relevant databases were searched as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart. After selection, 12 full text articles that met the inclusion criteria were included for quantitative analysis. 2 × 2 squares were generated using lymph node positive/negative, and NLR high/low data. The effect size for each study was calculated using the DerSimonian–Laird random effects model. P values were calculated using the chi-square method. Finally publication bias was evaluated. All statistics were calculated using R Studio.

Results:
Meta-analysis showed a 1.90 times (odds ratio, with 95% CI 1.52–2.38) increase in risk of positive lymph node status with high neutrophil to lymphocyte ratio. This has significant implications for cancer screening and staging, as NLR is a highly reproducible, cost-effective, and widely available prognostic factor for gastric cancer patients. Additionally, high or low NLR values may have implications for management pathways. Patients with lymph node metastasis can be offered neoadjuvant chemotherapy, avoiding salvage therapy in the form of adjuvant chemoradiotherapy, which is poorly tolerated.

Conclusion:
This meta-analysis shows an association between NLR and positive lymph node status in gastric cancer patients with implications for staging, as well as preoperative personalisation of therapy.
An unexplained fetal intracranial hemorrhage with extensive and multifocal hemorrhagic lesions
Authors: Gao Baorong , Zhang Li , Wei Qiang 
Published: June 2022

Abstract

Rationale:
Fetal intracranial hemorrhage (ICH) is an extremely rare complication of pregnancy, with subsequent neurological sequelae or fetal death. The diagnosis of fetal ICH is primarily based on ultrasound or magnetic resonance imaging.

Patient concerns:
An asymptomatic woman at 31 weeks of gestation was referred for a detailed anomaly scan because routine fetal ultrasonography showed suspected fetal ICH.

Diagnoses:
Fetal ICH with extensive and multifocal hemorrhagic lesions was diagnosed by ultrasound and magnetic resonance imaging imaging and finally confirmed by postmortem examination.

Interventions:
The woman opted for pregnancy termination after medical consultation. Labor was induced by mifepristone and rivanol infusion.

Outcomes:
The patient delivered a stillborn male infant weighing 1522 g. We tried our best to screen the possible etiology contributing to fetal ICH; unfortunately, no evidence of obvious causes or predisposing factors was identified.

Lessons:
Medically unexplained massive fetal ICH may cause an unfavorable prognosis, and prompt termination of pregnancy is appropriate, although there is no consensus on the optimal mode of delivery.
Case report: hypoglycemia secondary to methimazole-induced insulin autoimmune syndrome in young Taiwanese woman with Graves’ disease
Authors: Wu Hsuan-Yu , Chen I-Hua , Lee Mei-Yueh 
Published: June 2022

Abstract

Rationale:
Hypoglycemia is an emergent condition with many causes, including underlying diabetes mellitus either with the use of insulin or oral anti-diabetic medications for glucose control, and organ (heart, hepatic, or renal) failure. Insulin autoimmune syndrome (IAS) can also cause hypoglycemia, however it is relatively difficult to diagnose as it is rare clinically. Although uncommon, IAS can be life threatening in patients with persistent hypoglycemia.

Patient concern:
We report the case of a 27-year-old female with underlying Graves’ disease who was treated with methimazole (MTZ). After 6 weeks of treatment, she developed hypoglycemia symptoms accompanied by dizziness and cold sweating. We excluded underlying diabetes mellitus, the use of insulin or oral anti-diabetic medications, and organ failure.

Diagnoses:
Laboratory data showed elevated insulin and C-peptide levels. Therefore, insulinoma and IAS were suspected. Abdominal computed tomography and magnetic resonance imaging ruled out insulinoma, and MTZ-induced IAS was finally diagnosed.

Interventions and outcomes:
The hypoglycemia symptoms resolved after MTZ was switched to propylthiouracil, confirming the diagnosis of IAS.

Lessons:
This case emphasizes the significance of life-threatening MTZ-induced IAS. IAS should be suspected in patients who develop spontaneous hypoglycemia, especially in those with underlying Graves’ disease receiving MTZ who present with hyperinsulinism.
CONSORT-Characteristics and metabolic phenotype of gut microbiota in NAFLD patients
Authors: Ge Haize , Wei Wei , Tang Liang , Tian Yaqiong , Zhu Yu , Luo Yan , Liu Shuye 
Published: June 2022

Abstract
Patients with nonalcoholic fatty liver disease (NAFLD) have symptoms of a gut microbiota disorder with abnormal amino acid and glycolipid metabolism. This study was designed to analyze the characteristics of gut microbiota in patients with NAFLD, predict the gut microbiota phenotype, explore its role in the diagnosis of NAFLD, and establish its significance in disease progression.
The characteristics of the gut microbiota in NAFLD patients (n = 28, 45.8 ± 14.2 years, male/female = 18/10) and healthy subjects (n = 20, 49.6 ± 4.8 years, male/female = 14/6) during March–May 2020 were analyzed using 16S rRNA sequencing technology and the phenotypes with large differences were predicted using the Tax4Fun method. The metabolites in the fecal samples of the patients were analyzed using mass spectrometry, and their correlation with different microorganisms was examined. The accuracy of the gut microbiota in diagnosing NAFLD was investigated by receiver operating characteristic curve analysis.
We found that the microbial diversity and Bacteroides/Firmicutes (BF) ratio changed significantly (P < .05) in the feces of NAFLD patients. Phenotypic prediction showed that there were significant differences in the phenotypes of amino acid, glucose, and lipid metabolism of gut microbiota in the NAFLD group (P < .05). receiver operating characteristic curve analysis revealed that combination of Bacteroides and the BF ratio resulted in 88% and 100% sensitivity and specificity, respectively, when used for NAFLD diagnosis. Metabolomics and bioinformatics analysis revealed changes in the metabolism of nicotinate, nicotinamide, and pyrimidine; signaling pathways of calcium and oxytocin; pancreatic secretion with metabolites such as uracil, xanthine, and biliverdin; and enzymes such as xanthine dehydrogenase and xanthine oxidase (P < .05).
Therefore, the phenotypic changes may be a potential marker for NAFLD and we considered that a combined analysis of Bacteroides and BF ratio had good diagnostic accuracy for NAFLD.
Resveratrol decreases local inflammatory markers and systemic endotoxin in patients with aggressive periodontitis
Authors: Zhang Qiang , Xu Shuhan , Xu Wenxiu , Zhou Yang , Luan Hairong , Wang Deli 
Published: June 2022

Abstract

Background:
Inflammation is hypothesized to contribute to the pathogenesis of periodontitis. Resveratrol (RV) is known for its anti-inflammatory properties. The purpose of this study was to investigate the inhibitory effect of RV on local inflammatory markers and systemic endotoxin in patients with periodontitis.

Methods:
A total of 160 patients with periodontitis were enrolled in this study. The selected patients were randomly divided into four groups and received placebo, high-dose (500 mg/d) of RV (HRV, n = 40), middle-dose (250 mg/d) of RV (middle dose RV (MRV), n = 40) and low-dose (125 mg/d) of RV (low dose RV (LRV), n = 40) with orally administration. All patients received an 8-week treatment. The periodontal status of patients with periodontitis was recorded by using clinical attachment level (CAL), bleeding index (BI), oral hygiene index-simplified (OHI-S), and probing pocket depth (PPD). The levels of inflammatory markers in serum and gingival crevicular fluid (GCF), and systemic levels of endotoxin were evaluated using high sensitivity enzyme-linked immuno sorbent assay.

Results:
Outcomes showed that symptoms of periodontitis determined by CAL, BI OHI-S and PPD were improved by RV compared to placebo. RV treatment decreased inflammatory markers in serum and GCF compared to placebo in patient with periodontitis. Systemic endotoxin declined more in the RV group than the placebo-treated group.

Conclusion:
In conclusion, data in the current study indicate that RV is an efficient drug for the treatment of patients with periodontitis. The findings of the present study find that RV inhibits systemic local inflammatory markers and systemic endotoxin and suggest that 500 mg/d RV is the ideal dose for patients with periodontitis.
Clinical and genetic features of congenital bile acid synthesis defect with a novel mutation in AKR1D1 gene sequencing
Authors: Pham Anh-Hoa Nguyen , Thi Kim-Oanh Bui , Thi Mai-Huong Nguyen , Ngo Diem-Ngoc , Naritaka Nakayuki , Nittono Hiroshi , Hayashi Hisamitsu , Dao Trang Thi , Nguyen Kim-Huong Thi , Nguyen Hoai-Nghia , Giang Hoa , Tang Hung-Sang , Nguyen Tat-Thanh , Truong Dinh-Kiet , Tran Minh-Dien 
Published: June 2022

Abstract

Rationale:
Congenital bile acid synthesis defect (BASD) is a rare disease caused by mutations in the aldo-keto reductase 1D1 gene, which encodes the primary Δ4-3-oxosteroid 5β-reductase enzyme. Early disease diagnosis is critical for early treatment with bile acid replacement therapy, with an excellent chance for recovery. In contrast, protracted diagnosis and treatment may lead to poor outcomes, including decompensated hepatic cirrhosis, liver transplant, and even death.

Patient concerns:
Three clinical congenital bile acid synthesis defect cases in the Vietnamese population are herein reported. These pediatric patients presented with symptoms of prolonged postpartum jaundice and abnormal loose stool (mucus, lipids, and white). The clinical examinations showed hepatosplenomegaly. Urinalysis showed a very low fraction of primary bile acids and atypical 3-oxo-Δ4- bile acids in all three patients.

Diagnoses:
The patients were diagnosed with primary Δ4-3-oxosteroid 5β-reductase deficiency. Next-generation gene sequencing revealed two homozygous mutations in the aldo-keto reductase family 1 member D1 gene. The first is a documented variant, c.797G>A (p.Arg266Gln), and the second is a novel mutation at c.155T>C (p.Ile52Thr).

Interventions:
Immediately after diagnosis, patients were treated with oral chenodeoxycholate 5 mg/kg/d.

Outcomes:
The patients’ symptoms, signs, and primary bile acids levels improved significantly.

Lessons:
Clinicians should consider genetic disorders related to cholestasis for effective and life-saving treatment. A prompt genetic analysis by next-generation gene sequencing enables patients to access bile acid replacement therapy earlier, significantly improving short- and long-term outcomes.