Background Unilateral biportal endoscopy (UBE) is a newly developed technique for spine surgery. Owing to the convenience of nerve decompression and compatibility with open surgical instruments under endoscopic guidance, this technique has seen widespread global use. In this study, we first used modified UBE with suture anchor fixation for cervical laminoplasty in a 65-year-old female patient with good clinical outcomes. Methods We used bilateral biportal endoscopy (BBE) for cervical laminoplasty with suture anchor fixation in a patient with cervical stenosis. Under endoscopic guidance, a bilateral approach was used to make the gutter and lift the lamina door. After the lamina doors were opened, sutures were tied tightly using facia cannula and knot pusher. After confirming the solidarity of the open-door status, the drainage tube was inserted and the incisions were closed. The patient’s pre- and postoperative radiological and clinical results were evaluated. Results Postoperative Japanese Orthopaedic Association (JOA) and Neck Disability Index (NDI) scores were improved clinically, and cervical canal was decompressed radiologically. Conclusions BBE laminoplasty combined with suture anchor fixation showed a favorable clinical and radiological result and appears to be a safe and effective technique for cervical stenosis.

Background There is evidence that occupational stress is a risk factor for turnover intentions. However, the structural relationship between occupational stress and turnover intention among emergency physicians has rarely been studied. This study aimed to examine the pathways of occupational stress on turnover intention through job satisfaction and depressive symptoms among emergency physicians in China. Methods A cross-sectional study was conducted in China from July 2018 to August 2018. Data were collected using a structured questionnaire that included demographic characteristics, occupational stress, job satisfaction, depressive symptoms, and turnover intention. Hierarchical linear regression was performed to explore the related factors of turnover intention. Structural equation modeling was used to examine the pathways from occupational stress to turnover intention. Results A total of 10,457 emergency physicians completed the questionnaire. The score of turnover intention was 11.34 (SD = 3.25), and the average item score of turnover intention was 2.84 (SD = 0.81). In structural equation modeling, the occupational stress not only had a direct effect on turnover intention (standardized direct effect = 0.311, bias-corrected 95% confidence interval [0.261, 0.361], P < 0.001), but also had an indirect effect through job satisfaction and depressive symptoms (standardized indirect effect = 0.448, bias-corrected 95% confidence interval [0.412, 0.484], P < 0.001). However, the effect of depressive symptoms on turnover intention was weak (standardized coefficient [β] = 0.08, P < 0.001). Conclusions Job satisfaction partially mediated the relationship between occupational stress and turnover intention. However, due to the weak effect of depressive symptoms on turnover intention, the mediating role of depressive symptoms between occupational and turnover intention had little practical value. It is recommended that hospital administrators prioritize increasing job satisfaction of emergency physicians to reduce the impact of occupational stress on their turnover intention.

Objective To explore the correlated clinical and psychological factors of stigmatization and investigate the relationship between stigma and white matter abnormalities in epilepsy patients. Methods Stigmatization was obtained by a three-item stigma scale in 256 epilepsy patients with genetic or unknown etiology. Personality and quality of life (QOL) were assessed by Eysenck Personality Questionnaire (EPQ) and QOL-31 questionnaire respectively. One hundred and fourteen of them were performed Hamilton Depression Scale-17 (HAMD) and scanned with diffusion tensor imaging in 3T MRI. Fractional anisotropy (FA) values of frontotemporal contact fibers were calculated. Results There were about 39.8% patients felt stigma, with the highest score (Score 3) in 8.2% (21/256). Stigma scores were significantly negatively correlated with education ( P < 0.01), age of onset ( P < 0.05), extraversion score of EPQ ( P < 0.01), total and all the subscale QOL scores ( P < 0.001), and positively correlated with duration ( P < 0.01), HAMD score ( P < 0.001), neuroticism score of EPQ ( P < 0.001). We found negative correlation between stigma scores and FA values of right superior longitudinal fasciculus and left cingulum ( P < 0.05). Logistic regression results showed that FA value of left cingulum ( P = 0.011; OR = 0.000), social function ( P = 0.000; OR = 0.935) of QOL, and neuroticism score of EPQ ( P = 0.033; OR = 1.123) independently correlated to felt stigma. Conclusion Felt stigma in epilepsy patients was found to be correlated with neuroticism, depression, and deficient social function of QOL, which might be predisposed by the impairment of the left cingulum. Our results provide preliminary evidence for the underlying neural circuits in stigmatization.

Background Serious games (SGs) as one kind of intervention that can improve the level of knowledge and change behavior to affect health outcomes has been increasingly applied in health care. Objective Analyze hotspots and trends of the application of SGs in health care and provide reference and direction for further research in the future. Methods The Web of Science (WoS) Core Collection database was used for extracting the literature on SGs in health care for the period from the database established to 11 October, 2021. Scoping review and bibliometric analysis were used to deeply analyze and visualize countries, categories of studies, annual study output, cited authors, cited journals, cited articles, and keywords of healthcare field. Results A total of 1,322 articles were retrieved, then every articles' title and abstract were read one by one, and 795 articles were included after screening with an exponential increase in publication volume. The United States of America made the greatest contribution to global publications regarding SGs in health care. From the total, 20.8% of articles fall under the category of health care sciences services. The target groups were mainly concentrated in children (18.0%), youth (13.8%), the elderly (10.9%), adolescents (9.1%), and adults (3.4%). Baranowski T ( n = 103 citations) is the most influential author, followed by Kato PM ( n = 73 citations) and Desmet A ( n = 58 citations). The top three cited journals were “ Plos One ” ( n = 268 citations), “ Games for Health Journal ” ( n = 209 citations), and “ Journal of Medical Internet Research ” ( n = 197 citations), and the top three cited articles were “A meta-analysis of serious digital games for healthy lifestyle promotion,” “A Systematic Review of Serious Games in Training Health Care Professionals,” and “Video game training enhances cognitive control in older adults.” More and more studies focus on specific age groups, such as children, adolescents, and the elderly. The research hotspots and trends included “rehabilitation,” “medical education,” and “design.” Conclusions The application of SGs in health care remains important areas for future research. “Rehabilitation,” “medical education,” and “design” reflected the latest research hotpots and future trends.

Objective To describe the characteristics of body composition by air-displacement plethysmography (ADP) among Chinese preschool children. Methods Preschool children were recruited from three kindergartens. Adiposity indices were evaluated using the ADP method. BMI, fat mass index (FMI), fat-free mass index (FFMI) and waist-to-height ratio (WHtR) were calculated. Overweight and obesity were diagnosed using the WHO reference. Analyses were executed by SPSS and MedCalc software. Smoothed curves were constructed using the lambda-mu-sigma (LMS) method. Results This study evaluated the growth trend for body composition of ADP-based body fat indices based on a relatively large sample of preschool children, the first ever reported in China. A total of 1,011 children aged 3–5 years comprised our study population. BMI and FFMI increased with age, but the slope ( P = 0.710) and y intercept ( P = 0.132) in the BMI trend analysis demonstrated no differences between boys and girls. For the FFMI trend lines, the slope was significantly higher for boys than for girls ( P = 0.013). The percentage of fat mass (FM%), FMI, and WHtR were negatively correlated with age for both sexes, except for FMI in girls ( P = 0.094). The 95% CI regression lines for FM% according to different weight statuses intersected. Conclusions ADP is applicable to estimating body composition among Chinese preschool children. Misclassifications might occur when overweight/obese status is defined based on surrogate indices.

Allogeneic stem cell transplantation from haplo-identical donors (haplo-HSCT) has become a well-established therapeutic option for hematological malignancies. The fever of unknown origin (haplo-fever) early after the infusion of T cell repleted graft, which returned to normal right after post-transplantation cyclophosphamide (PTCy), is a unique clinical feature in patients undergoing haplo-HSCT. In the current study, the characteristics of haplo-fever and cytokine profiles during haplo-fever were retrospectively analyzed in a cohort of 37 patients undergoing T cell repleted haplo-HSCT with PTCy as graft versus host disease (GvHD) prophylaxis. In total, 33 patients (89.2%) developed haplo-fever from day 0 to day +7. Patients with high peak temperatures tended to have a lower incidence of chronic GvHD (cGvHD) ( p = 0.07), moderate to severe cGvHD ( p = 0.08), and superior GvHD and relapse-free survival (GRFS, p = 0.04). During the haplo-fever, there were significant increases in multiple cytokines, such as interferon gamma, interleukin (IL) 6, IL2, IL2 receptor, IL8, IL10, IL17, and tumor necrosis factor (TNF). The increases in IL2 receptor ( p = 0.037) and TNF ( p 1.8055-fold on day +4 was the best predictive threshold for cGvHD, and was correlated with a lower incidence of cGvHD ( p < 0.001), moderate to severe cGvHD ( p = 0.003), and superior GRFS ( p < 0.001). These observations may reflect the early reactivation of donor T cells after haplo graft infusion, which would potentially be eliminated by PTCy. Further studies with larger independent cohorts of patients are warranted, to clarify the clinical significance of haplo-fever, and day +4 TNF as a potential biomarker to predict GvHD and GRFS.