bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiovascular and renal outcomes of GLP-1 receptor agonists vs. DPP-4 inhibitors and basal insulin in type 2 diabetes mellitus: A systematic review and meta-analysis
Authors: Evans Marc , Kuodi Paul , Akunna Chisom Joyqueenet , McCreedy Nicole , Donsmark Morten , Ren Hongye , Nnaji Chukwudi A
Published: December 2023

Objective

To compare the cardiovascular and renal outcomes of GLP-1 RA versus DPP4i and basal insulin in the management of T2DM.

Methods

Data from 22 studies involving over 200,000 participants were pooled using the inverse variance method and random-effects meta-analysis. The review was reported in accordance with PRISMA.

Results

Compared with DPP4i, treatment with GLP-1 RA was associated with a greater benefit on composite cardiovascular outcomes (HR:0.77, 95% CI:0.69–0.87), myocardial infarction (HR:0.82, 95% CI:0.69–0.97), stroke (HR:0.83, 95% CI: 0.74–0.93), cardiovascular mortality (HR:0.76, 95% CI:0.68–0.85) and all-cause mortality (HR:0.65, 95% CI:0.48–0.90). There was no difference in effect on heart failure (HR:0.97, 95% CI:0.82–1.15). Compared with basal insulin, GLP-1 RA was associated with better effects on composite cardiovascular outcomes (HR:0.62, 95% CI:0.48–0.79), heart failure (HR:0.57, 95% CI:0.35–0.92), myocardial infarction (HR:0.70, 95% CI:0.58–0.85), stroke (HR:0.50, 95% CI:0.40–0.63) and all-cause mortality (HR:0.31, 95% CI:0.20–0.48). Evidence from a small number of studies suggests that GLP-1 RA had better effects on composite and individual renal outcomes, such as eGFR, compared with either DPP4i and basal insulin.

Conclusion

Available evidence suggests that treating T2DM with GLP-1 RA can yield better benefits on composite and specific cardiorenal outcomes than with DPP4i and basal insulin.

PROSPERO Registration Number

CRD42022335504.
Alterations in circulating mitochondrial signals at hospital admission for COPD exacerbation
Authors: Amado Carlos A , Martín-Audera Paula , Agüero Juan , Ferrer-Pargada Diego , Josa Laorden Begoña , Boucle Daymara , Berja Ana , Lavín Bernardo A , Guerra Armando R , Ghadban Cristina , Muñoz Pedro , García-Unzueta Mayte
Published: December 2023

Background

Chronic obstructive pulmonary disease (COPD) exacerbation (ECOPD) alters the natural course of the disease. To date, only C-reactive protein has been used as a biomarker in ECOPD, but it has important limitations. The mitochondria release peptides (Humanin (HN), FGF-21, GDF-15, MOTS-c and Romo1) under certain metabolic conditions. Here, we aimed to evaluate the pathophysiologic, diagnostic and prognostic value of measuring serum mitochondrial peptides at hospital admission in patients with ECOPD.

Methods

A total of 51 consecutive patients admitted to our hospital for ECOPD were included and followed for 1 year; in addition, 160 participants with stable COPD from our out-patient clinic were recruited as controls.

Results

Serum FGF-21 ( p < .001), MOTS-c ( p < .001) and Romo1 ( p = .002) levels were lower, and GDF-15 ( p < .001) levels were higher, in patients with ECOPD than stable COPD, but no differences were found in HN. In receiver operating characteristic analysis, MOTS-c (AUC 0.744, 95% CI 0.679–0.802, p < .001) and GDF-15 (AUC 0.735, 95% CI 0.670–0.793, p < .001) had the best diagnostic power for ECOPD, with a diagnostic accuracy similar to that of C-RP (AUC 0.796 95% IC 0.735–0.848, p < .001). FGF-21 (AUC 0.700, 95% CI 0.633–0.761, p < .001) and Romo1 (AUC 0.645 95% CI 0.573–0.712, p = .001) had lower diagnostic accuracy. HN levels did not differentiate patients with ECOPD versus stable COPD ( p = .557). In Cox regression analysis, HN (HR 2.661, CI95% 1.009–7.016, p = .048) and MOTS-c (HR 3.441, CI95% 1.252–9.297, p = .016) levels exceeding mean levels were independent risk factors for re-admission.

Conclusions

Most mitochondrial peptides are altered in ECOPD, as compared with stable COPD. MOTS-c and GDF15 levels have a diagnostic accuracy similar to C-RP for ECOPD. HN and MOTS-c independently predict future re-hospitalization.
More Than Just a Scratch: A Scoping Review on Physical and Psychological Consequences of Violence Against Police
Authors: Goormans Isabo , Verbouw Agnes , Vandeviver Christophe
Published: December 2023

Violence against police is a reality for many officers. Despite growing concerns over the rise in violence against police and the serious individual and societal repercussions associated with it, a comprehensive overview of the psychological and physical consequences of verbal and physical violence against police remains elusive. By performing a scoping review ( n = 21) of studies and reports identified via database searches (Web of Science and Google Scholar), reference mining, and purposive sampling, and published between 2010 and 2023, this article is the first of its kind to map psychological and physical consequences of violence against police, as well as the risk and protective factors that respectively increase and decrease adverse consequences. Results indicate that officers experience primary victimization by a range of different adverse consequences, but also deal with secondary victimization. The literature has come to a standstill due to lack of (recent) studies and a lack of diversity on how consequences of violence against police are studied. We argue that this lack of academic attention might be influenced by predominant societal perspectives and officers’ perceived victim status, and discuss the implications for police, policymakers, and research.
COLEC12 Promotes Tumor Progression and Is Correlated With Poor Prognosis in Gastric Cancer
Authors: Sun Xiangfei , Zhang Qiang , Shu Ping , Lin Xiaohan , Gao Xiaodong , Shen Kuntang
Published: December 2023

Purpose

Collectin subfamily member 12, a transmembrane scavenger receptor C-type lectin, is aberrantly expressed in various cancers. However, its physiological role in gastric cancer remains somewhat unclear. This study aimed to investigate the Collectin subfamily member 12 expression pattern in human gastric cancer and its role in gastric cancer progression.

Methods

The Kaplan-Meier method was used for survival analysis. The univariate and multivariate Cox proportional hazards regression models were used to identify independent predictors for progression-free survival and overall survival. The effects of Collectin subfamily member 12 on gastric cancer cell proliferation, migration, invasion, and apoptosis were detected through the cell counting kit-8 assay, colony formation assay, wound healing assay, transwell assay, and flow cytometry analysis, respectively. Additionally, the correlation between Collectin subfamily member 12 expression and immune cell infiltration was analyzed through bioinformatics.

Results

Collectin subfamily member 12 was highly expressed in advanced gastric cancer (T3-T4, pathologic stage III-IV). High Collectin subfamily member 12 expression was correlated with a worse progression-free survival and overall survival in the gastric cancer patients. In vitro, cell line studies revealed that Collectin subfamily member 12 promoted gastric cancer cell proliferation, migration, and invasion and inhibited gastric cancer cell apoptosis. The bioinformatics analysis further demonstrated that the Collectin subfamily member 12 expression level positively correlated with infiltration of several immune cells, such as M2 macrophages, dendritic cells, neutrophils, and regulatory T cells, suggesting that Collectin subfamily member 12 may also play a role in suppressing tumor immune response in gastric cancer.

Conclusions

Collectin subfamily member 12 was identified as a novel predictive marker and target for the clinical treatment of gastric cancer.
Plantar Thermography in High-Risk Patients With Diabetes Mellitus Compared to Nondiabetic Individuals
Authors: Carro Gabriela Verónica , Noli María Laura , Rodriguez María Gabriela , Ticona Miguel , Fuentes Mariana , Llanos María de los Ángeles , Caporaso Federico , Marciales Guillermo , Turco Sebastián Leandro Emanuel
Published: December 2023

Diabetic foot (DF) is one of the most devastating complications of diabetes mellitus (DM). Infrared thermography has been studied for its potential in early diagnosis and preventive measures against DF ulcers, although its role in the management and prevention of DF complications remains uncertain. The objective of this study was to determine the average temperatures of different points of the plantar foot using infrared thermography in patients with DM and history of DF (DFa group, at the highest risk of developing foot ulcers) and compare them to people without DM (NoDM group). One hundred and twenty-three feet were included, 63 of them belonged to DFa Group and the other 60 to NoDM Group. The average temperature in the NoDM Group was 27.4 (26.3-28.5) versus 28.6 (26.8-30.3) in the DFa Group ( p = .002). There were differences between both groups in temperatures at the metatarsal heads and heels, but not in the arch. Average foot temperatures did not relate to sex, ankle-brachial index, and age, and had a mild correlation with daily temperature (Spearman 0.51, p < .001). Data provided in our study could be useful in establishing a parameter of normal temperatures for high-risk patients. This could serve as a foundational framework for future research and provide reference values, not only for preventative purposes, as commonly addressed in most studies, but also to assess the applicability of thermography in clinical scenarios particularly when one foot cannot serve as a reference, suspected osteomyelitis of the remaining bone, or instances of increased temperature in specific areas which may necessitate adjustments to the insoles in secondary prevention.
Consumption of Fruits and Vegetables and Gastric Cancer Risk: Answers From Case-Control Study
Authors: Aljumaily Maryam , Al-Naimi Noora , Al-Amer Rawdhah , Hamdan Aya , Allehdan Sabika , Al-Jaberi Tareq , Hushki Ahmad , Rayyan Yaser , Tayyem Reema
Published: December 2023

Several dietary and non-dietary factors and genetic predispositions may play an important role in gastric carcinogenesis. The association between fruit and vegetable with gastric cancer (GC) is still unclear. This study aimed to investigate the association between fruit and vegetable intake and GC risk. This case-control study enrolled 173 patients with GC and 313 GC-free controls between March 2015 and August 2018. Dietary data was collected separately from each patient using an interview-based food frequency questionnaire. The results showed a significant ( P ≤ .05) inverse association between grape and melon consumption and GC development. In contrast, the consumption of 100% orange juice, orange, pear, and strawberry increased significantly ( P ≤ .05) the risk of GC. However, mixed vegetables, vegetables fried with olive oil, and onion consumption showed a significant ( P ≤ .05) protective effect against GC. No association was detected for the other examined fruits and vegetables (dates, watermelon, peach, green beans, peas, carrot, and stuffed vegetables). Although many fruits and vegetables may reduce the risk of GC, others may increase it. The method of vegetable and fruit preparation may affect the nutritive value. More studies are warranted to confirm our findings.
Risk–benefit trade-offs and precision utilities in phase I-II clinical trials
Authors: Msaouel Pavlos , Lee Juhee , Thall Peter F
Published: December 2023

Background:

Identifying optimal doses in early-phase clinical trials is critically important. Therapies administered at doses that are either unsafe or biologically ineffective are unlikely to be successful in subsequent clinical trials or to obtain regulatory approval. Identifying appropriate doses for new agents is a complex process that involves balancing the risks and benefits of outcomes such as biological efficacy, toxicity, and patient quality of life.

Purpose:

While conventional phase I trials rely solely on toxicity to determine doses, phase I-II trials explicitly account for both efficacy and toxicity, which enables them to identify doses that provide the most favorable risk–benefit trade-offs. It is also important to account for patient covariates, since one-size-fits-all treatment decisions are likely to be suboptimal within subgroups determined by prognostic variables or biomarkers. Notably, the selection of estimands can influence our conclusions based on the prognostic subgroup studied. For example, assuming monotonicity of the probability of response, higher treatment doses may yield more pronounced efficacy in favorable prognosis compared to poor prognosis subgroups when the estimand is mean or median survival. Conversely, when the estimand is the 3-month survival probability, higher treatment doses produce more pronounced efficacy in poor prognosis compared to favorable prognosis subgroups.

Methods and Conclusions:

Herein, we first describe why it is essential to consider clinical practice when designing a clinical trial and outline a stepwise process for doing this. We then review a precision phase I-II design based on utilities tailored to prognostic subgroups that characterize efficacy–toxicity risk–benefit trade-offs. The design chooses each patient’s dose to optimize their expected utility and allows patients in different prognostic subgroups to have different optimal doses. We illustrate the design with a dose-finding trial of a new therapeutic agent for metastatic clear cell renal cell carcinoma.
Analysis of the competition programmes of elite and sub-elite swimmers: The influence of sex, stroke and race distance
Authors: Johns Karen L. , Philipson Peter M. , Powell Cormac
Published: December 2023

The purpose of this study was to analyse contemporary performance data in elite and sub-elite Irish swimmers, to explore the number of days and races required for swimmers to achieve their fastest competitive performances and how this may be influenced by sex, stroke and race distance. The initial dataset consisted of n = 3930 observations on n = 56 swimmers, with n1 = 2709 (68.9%) long course (LC) observations and n2 = 1221 (31.1%) short course (SC) observations. The main findings indicated that, firstly, the swimmers (LC & SC) produced their fastest swim in their first race of the season, approximately 39% of the time. Secondly, there were no significant differences between male and female swimmers regarding the number of days and races required to achieve their fastest performances. The final key finding identified the number of days and races between first and fastest performance was influenced by (a) stroke, for example, LC and SC freestyle and individual medley swimmers required less races and shorter timeframes to fastest swim, with breaststroke requiring the greatest number of mean days in LC and SC formats and (b) race distance, for example, across LC and SC, 400 m swimmers required fewer races (n = 1.83 & 1.64) and shorter time frame (n = 24.83 & 21.26 days) to fastest swim than other distances. These findings are valuable to coaches and practitioners, as (a) they can provide guidelines when designing competition programmes, and (b) support exploration of what a swimmer's competition may look like in terms of volume and duration to support the fastest performance.
Isolated renal and urinary tract aspergillosis: a systematic review
Authors: Bongomin Felix , Morgan Bethan , Ekeng Bassey E. , Mushi Martha F. , Kibone Winnie , Olum Ronald , Meya David B. , Hamer Davidson H. , Denning David W.
Published: December 2023

Background:

Aspergillosis localized to the kidneys and the urinary tract is uncommon. We conducted a comprehensive systematic review to evaluate risk factors and clinical outcomes of patients with isolated renal and genito-urinary tract aspergillosis.

Methods:

We systematically searched Medline, CINAHL, Embase, African Journal Online, Google Scholar, and the Cochrane Library, covering the period from inception to August 2023 using the key terms ‘renal’ OR ‘kidney*’ OR ‘prostate’ OR ‘urinary bladder’ OR ‘urinary tract*AND ‘aspergillosis’ OR ‘aspergillus’ OR ‘aspergilloma’ OR ‘mycetoma’. We included single case reports or case series. Review articles, guidelines, meta-analyses, animal studies, protocols, and cases of genitourinary and /or renal aspergillosis occurring as a part of disseminated disease were excluded.

Results:

We identified 91 renal and urinary aspergillosis cases extracted from 76 publications spanning 1925–2023. Among the participants, 79 (86.8%) were male, with a median age of 46 years. Predominantly, presentations consisted of isolated renal infections (74 instances, 81.3%), followed by prostate (5 cases, 5.5%), and bladder (7 cases, 7.7%) involvement. Aspergillus fumigatus (42.9%), Aspergillus flavus (9.9%), and Aspergillus niger/glaucus (1.1% each) were isolated. Underlying risk factors included diabetes mellitus (29.7%), HIV (12.1%), haematological malignancies (11%), and liver cirrhosis (8.8%), while common symptoms encompassed flank pain (36.3%), fever (33%), and lower urinary tract symptoms (20.9%). An autopsy was conducted in 8.8% of cases. Diagnostic work-up involved histopathology (70.5%), renal CT scans and urine microscopy and culture (52.6% each), and abdominal ultrasound (17.9%). Treatments included amphotericin B (34 cases, 37.4%) and azole-based regimens (29 cases, 31.9%). Nephrectomy was performed in 16 of 78 renal cases (20.5%). All-cause mortality was 24.4% (19 cases). No significant mortality rate difference was observed among antifungal regimens ( p = 0.739) or nephrectomy status ( p = 0.8).

Conclusion:

Renal and urinary aspergillosis is an important cause of morbidity and mortality, particularly in immunocompromised and people with diabetes mellitus. While varied treatment strategies were observed, mortality rates showed no significant differences based on treatments or nephrectomy status. Further research is needed to refine diagnostics, optimize treatments, and enhance awareness among clinicians for early detection and management.

PROSPERO registration number:

CRD42023430959.
Infective Endocarditis in an Intravenous Drug User Leading to Myocardial Rupture and Hemopericardium
Authors: Cao Cathy , Herath Jayantha
Published: December 2023

Introduction:

Infective endocarditis (IE) is an infectious disorder of the innermost lining of the heart that can be fatal if left untreated. Infective endocarditis can spread beyond the endocardium into the myocardium and cause arrhythmias and myocardial wall rupture. Individuals with a history of intravenous drug use are at increased risk of developing IE and are at higher risk of dying, given their limited access to health care and adherence to treatment.

Methods:

A medicolegal autopsy was performed on a 30-year-old woman with a history of intravenous drug use and recent assault after a hospital admission during which she did not survive resuscitation.

Results:

The cause of death was found to be myocardial rupture in the setting of transmural IE. Postmortem imaging showed hemopericardium which was identified grossly with valvular vegetations in the heart. A ventricular wall defect along with transmural abscess formation was identified. Perimortem toxicology was positive for fentanyl, methamphetamine, and benzoylecgonine, a metabolite of cocaine. Postmortem blood cultures were positive for coagulase-negative Staphylococci, Staphylococcus aureus, Candida tropicalis, and Viridians group Streptococci. Postmortem tissue cultures taken from the heart was positive for Candida glabrata and Streptococcus mitis.

Discussion:

The decedent had significant risk factors for IE, such as intravenous drug use and a prior admission to hospital for IE. The organisms identified on culture are in-keeping with the gross findings of IE and the terminal event of myocardial rupture was likely the result of tissue damage resulting from IE.
Why the caged bird sings: Rethinking the Anthropocene with Gallus gallus
Authors: Nicolaisen Jeffrey
Published: December 2023

Previous research argues Gallus gallus (chickens) makes a strong candidate for a chrono-stratigraphic signal of the Anthropocene, but the history of how G. gallus came to mark the Anthropocene remains to be told. At the macro-level, G. gallus tells a story of slavery, sexism, scientific progress, settler colonialism, nation building, socialist welfare programs, capitalist expansionism, and plantation agriculture. At the micro-level, G. gallus tells a story of the suffering of crippling growth rates and confinement as well as the agency of metabolic labor; goal-directed behavior of hunger, thirst and survival; and resistance in the form of efforts at escape and violence of feather pecking. This paper tells a history that recognizes the sensorial worlds and intentionality of G. gallus, and demonstrates how G. gallus is one instantiation of an assemblage of species that were co-opted into a system that partially overlaps with and simultaneously sustains and threatens the technosphere.
We asked Chat GPT to describe brain fog in chronic pain: What did we learn?
Authors: Dass Ronessa , Packham Tara
Published: December 2023

Chat GPT is a modern artificial intelligence program: its recent introduction has created controversy in the academic world. This commentary discusses the utility of Chat GPT to explore healthcare issues such as chronic pain and associated conditions. To illustrate the potential application of brain fog, this commentary presents an example of Chat GPT using brain fog. Brain fog is a phenomenon which has been increasingly discussed in both academic and social media discourses. Further, the potential advantages and dangers of Chat GPT are described. Noted advantages include search facilitation, drafting patient information, identifying opportunities for future research, and highlighting areas with a lack of consensus. Dangers of Chat GPT include the possibility for misinformation and the reproduction of social stereotypes and assumptions. Lastly, this commentary concludes with recommendations for healthcare professionals considering use of Chat GPT. Artificial intelligence-driven technologies like Chat GPT become increasingly available and trusted in our society, so does the importance of our awareness for both benefit and potential for harm when artificial intelligence is used for non-critical information seeking and self-education.
Virtual presence, real connections: Exploring the role of parasocial relationships in virtual idol fan community participation
Authors: Liu Jiahui
Published: December 2023

The reconstruction of idol worship culture is evident with the rise of virtual personas, especially within the realm of AI-powered entities. It is important to consider cultural specificities, particularly in regions like China, where unique fan culture practices intersect with the proliferation of AI technology. Virtual idols, born from digital media technologies, authentically emulate real idols in performances and human interactions. While existing research primarily focuses on real-life idols in the interaction between celebrities and fans, limited attention has been given to understanding why fans gravitate toward virtual idols. Adopting the perspective of parasocial relationships (PSRs) and employing the survey method, this study explores the factors that drive fan community participation in virtual idol fandom within the context of Chinese society. The findings reveal that both interpersonal attractiveness and feelings of loneliness significantly influence the development of parasocial relationships between virtual idols and fans, and these PSRs positively impact fan community participation. Furthermore, this study elucidates that both the perceived interpersonal attractiveness of virtual idols and the loneliness experienced by fans directly contribute to increased fan community participation through the mediating effect of PSRs. This investigation scrutinizes the pivotal factors sustaining the relationship between virtual idols and fans, particularly in an era where AI-powered entities increasingly mirror human-like qualities and adeptly engage with audiences. This study highlights the characteristics of Chinese subculture and provides evidence for the “de-stigmatization” of subcultures in the era of AI, which contributes to a broader discourse on the impact of AI on diverse cultural practices. It underscores the necessity for global and contextual approaches in comprehending the evolving dynamics between virtual idols and their fan communities, enriching our understanding of AI’s influence on cultural phenomena.
Tracing urban transformations: Ni Weihua’s playful intervention in China’s evolving sociospatial landscape
Authors: Wang Meiqin
Published: December 2023

This article delves into the multifaceted public art project entitled Tracing, orchestrated by Shanghai artist Ni Weihua, within the context of China’s sweeping socioeconomic transformation, as reflected in the geographical, spatial, and visual transformations of urban peripheries. Beginning in 2018 when Ni initiated it by meticulously tracing around the pictorial vestiges adorning dilapidated walls in Shanghai’s urban outskirts using black acrylic paint, Tracing has evolved into a collaborative endeavor spanning the globe. This article explores the origins and development of Tracing, situating it within Ni’s body of work, which responds to the ever-changing spatial and visual landscapes of China’s urbanization. Blurring the boundaries of graffiti, drawing, performance art, conceptual art, documentary photography, and media art, Tracing serves as both documentation and embodiment of the ongoing struggle between state-led spatial production and grassroots initiatives in the face of urban regeneration and urban-rural integration efforts. This article contends that Tracing, through its artistic, playful, and liberating approach to spatial intervention and image creation, empowers Ni and other participants to engage with marginalized spaces, amplify the voices of disadvantaged communities, and complicate prevailing narratives of urban development in China and beyond. In doing so, it contributes to a bottom-up mode of visual knowledge production about urbanism and expands the role of art as a medium for public participation, collective expression, and community building.
Effect of Corporate Social Responsibility on Portfolio Performance: Evidence From Turkey
Authors: Borak Metin , Dogukanli Hatice
Published: December 2023

This study investigates the performance of corporate social responsibility (CSR) portfolios based on ESG scores of stocks traded in Borsa Istanbul (BIST). It also evaluates the performance of a trading strategy that represents buying portfolios that include companies with high CSR performance and selling portfolios comprising companies with low CSR performance. Therefore, two portfolios with high and low CSR performance were formed from stocks traded in Borsa Istanbul. These portfolios’ performances were compared from July 2010 to June 2020. The findings show that the alpha coefficient of the portfolio containing stocks of companies with high CSR performance is generally positive and significant. Thus, companies’ past CSR performances provide valuable information for investors. Additionally, based on this, investors can achieve a superior performance against the market. However, the alpha of the difference portfolio, which shows the difference between the two portfolios’ performance, is, in most cases, insignificant. This suggests that there is no proof that the portfolio comprising companies with high CSR performance is superior to the portfolio including companies with low CSR performance. These findings are supported by additional testing. Consequently, our result provides supporting evidence for the “no effect” hypothesis.
Designing for Sensory Adaptation: What You See Depends on What You’ve Been Looking at - Recommendations, Guidelines and Standards Should Reflect This
Authors: Webster Michael A. , Parthasarathy Mohana Kuppuswamy , Zuley Margarita L. , Bandos Andriy I. , Whitehead Lorne , Abbey Craig K.
Published: December 2023

Sensory systems continuously recalibrate their responses according to the current stimulus environment. As a result, perception is strongly affected by the current and recent context. These adaptative changes affect both sensitivity (e.g., habituating to noise, seeing better in the dark) and appearance (e.g., how things look, what catches attention) and adjust to many perceptual properties (e.g., from light level to the characteristics of someone's face). They therefore have a profound effect on most perceptual experiences, and on how well the senses work in different settings. Characterizing the properties of adaptation, how it manifests, and when it influences perception in modern environments can provide insights into the diversity of human experience. Adaptation could also be leveraged both to optimize perceptual abilities (e.g., in visual inspection tasks like radiology) and to mitigate unwanted consequences (e.g., exposure to potentially unhealthy stimulus environments).
Reaching Students with Reading Disabilities During the Summer
Authors: Christodoulou Joanna A. , Azor Adriana M. , Marks Rebecca A.
Published: December 2023

The extended summer break from school brings a renewed opportunity to offer high-quality literacy experiences to vulnerable readers, including children with reading disabilities (RD). Students with RD trail their peers in reading progress during the school year; the summer months present an opportunity to address the gap in reading achievement. Policy makers can support reading achievement during summer vacation empowered by interdisciplinary knowledge spanning cognitive neuroscience and education. The science of brain plasticity emphasizes the requirement of impactful reading experiences, especially for word-level skills, toward building reading brain networks. A review of research on summer programming and current policies culminates in recommendations to capitalize on summer opportunities to advance reading achievement.
Implementation of a Teleophthalmology Screening Program for Diabetic Retinopathy in New York City
Authors: Capellan Pamela , Dillon Alexander B. , Rodriguez Geoff , Chua Jason , Abdallah Mahrous M. , Kovacs Kyle , Van Tassel Sarah , D’Amico Donald J. , Kiss Szilard , Orlin Anton
Published: December 2023

Purpose: To examine the implementation of a teleophthalmology program for diabetic retinopathy (DR) screening at a metropolitan hospital system and identify the challenges that the clinical teams encountered using the program. Methods: The study was conducted in 2 parts. The first was a pilot retrospective chart review of 300 consecutive patients screened for DR by the teleophthalmology screening program. The baseline variables, DR capture rate and staging, and continuity of care for those diagnosed with DR were analyzed. The second was a web-based survey identifying the barriers encountered by 36 physicians and clinical staff as they participated in the teleophthalmology screening program. Results: Part 1: Of the patients evaluated, 57 (19.0%) were diagnosed with DR; 42 (73.7%) had mild nonproliferative DR (NPDR), 7 (12.3%) had moderate NPDR, none had severe NPDR, and 8 (14.0%) had PDR. Thirty-one patients (54.4%) with retinopathy diagnoses were referred for an in-person follow-up at the clinic while the rest continued monitoring via the program. Of this subset, 22 (71.0%) completed the follow-up visit. Part 2: The survey respondents comprised 28 physicians (77.8%), 6 licensed nurse practitioners (16.7%), and 2 medical assistants (5.6%). Twenty-two providers (71.0%) preferred initiating referrals for in-person annual examinations over teleophthalmology screening referrals. The most common barriers described were related to workflow interruption, time constraints, and staff shortages. Conclusions: The teleophthalmology DR screening program allowed identification of early or absent DR at clinics in an urban setting (New York City). The findings suggest areas for targeted improvement in the screening program to better complement internal referral practices’ workflows.
The association of technology acceptance and physical activity on frailty in older adults during the COVID-19 pandemic period
Authors: Kwan Rick Yiu Cho , Yeung Joanna Wing Yan , Lee Janet Lok Chun , Lou Vivian W. Q.
Published: December 2023

Background

Physical activity was known to be the protective factor against frailty. Technology acceptance is associated with behavioural intention to technology usage. Technology has been effective in promoting healthy behaviour of physical activity. The purposes of this study were to examine the association between physical activity and technology acceptance with frailty and examine the moderation effect of technology acceptance on physical activity and frailty. We hypothesize that 1) physical activity and technology acceptance are associated with frailty, and 2) technology acceptance moderates the association of physical activity with frailty.

Methods

This study employed a cross-sectional design and was conducted in the community settings of Hong Kong in 2021. Eligible participants were old people aged ≥60 and were community-dwelling. Key variables included physical activity measured by Rapid Assessment of Physical Activity (RAPA), social network measured by Lubben Social Network Scale-Six items (LSNS-6); depressive symptoms measured by Patient Health Questionnaire-Nine items (PHQ-9), technology acceptance measured by Senior Technology Acceptance Model-14 items (STAM-14) and frailty measured by Fatigue, Resistance, Ambulation, Illnesses, & Loss of Weight scale (FRAIL). Ordinal logistic regression was employed to test the hypotheses. The moderation effect was examined by introducing an interaction term formed by the multiplication of an independent variable (i.e., physical activity) and a moderating variable (i.e., technology acceptance).

Results

This study recruited 380 eligible participants with a mean age of 66.5 years. Technology acceptance (Beta = − 0.031, p < 0.001, Pseudo-R2 = 0.087) and physical activity (Beta = − 0.182, p = 0.003, Pseudo-R2 = 0.027) were associated with frailty in the unadjusted models. Technology acceptance (Beta = − 0.066, p < 0.001) and physical activity (Beta = − 1.192, p < 0.001) were also associated with frailty in the fully adjusted model (Pseudo-R2 = 0.352). Interaction term formed by the multiplication of technology acceptance and physical activity (Beta = 0.012, p = 0.001) was associated with frailty. Physical activity was significantly associated with frailty in the lower technology acceptance subgroup (Beta = − 0.313, p = 0.002) in the subgroup analysis. However, in the subgroup of higher technology acceptance, the association of physical activity (Beta = 0.104, p = 408) on frailty became positive but not significant.

Conclusions

This study showed that physical activity and technology acceptance were associated with frailty, and technology acceptance moderated the association of physical activity with frailty. This study recommends engaging older adults in physical activity to combat frailty preferentially in those with a lower level of technology acceptance.
Corneal ring infiltrate- far more than Acanthamoeba keratitis: review of pathophysiology, morphology, differential diagnosis and management
Authors: Przybek-Skrzypecka J. , Skrzypecki J. , Suh L. , Szaflik J. P.
Published: December 2023

Objective

Ring infiltrates usually accompany numerous infectious and sterile ocular disorders. Nevertheless, systemic conditions, drugs toxicity and contact lens wear may present with corneal ring infiltrate in substantial part. Considering its detrimental effect on vision, detailed knowledge on etiology, pathophysiology, differential diagnosis, and management should be considered essential for every ophthalmologist.

Methods

The PUBMED database was searched for “corneal ring infiltrate” and “ring infiltrate” phrases, “sterile corneal infiltrate” and “corneal infiltrate”. We analyzed articles written in English on risk factors, pathophysiology, clinical manifestation, morphological features, ancillary tests (anterior-segment optical coherence tomography, corneal scraping, in vivo confocal microscopy), differential diagnosis and management of corneal ring infiltrate.

Results

Available literature depicts multifactorial origin of corneal ring infiltrate. Dual immunological pathophysiology, involving both antibodies-dependent and -independent complement activation, is underlined. Furthermore, we found that the worldwide most prevalent among non-infectious and infectious ring infiltrates are ring infiltrates related to contact-lens wear and bacterial keratitis respectively. Despite low incidence of Acanthamoeba keratitis, it manifests with corneal ring infiltrate with the highest proportion of the affected patients (one third). However, similar ring infiltrate might appear as a first sign of general diseases manifestation and require targeted treatment. Every corneal ring infiltrate with compromised epithelium should be scraped and treat as an infectious infiltrate until not proven otherwise. Of note, microbiological ulcer might also lead to immunological ring and therefore require anti-inflammatory treatment.

Conclusion

Corneal ring infiltrate might be triggered not only by ocular infectious and non-infectious factors, but also by systemic conditions. Clinical assessment is crucial for empirical diagnosis. Furthermore, treatment is targeted towards the underlying condition but should begin with anti-infectious regimen until not proven otherwise.
Inferior vena cava collapsibility index as a predictor of hypotension after induction of general anesthesia in hypertensive patients
Authors: Fathy Mohamed Metwaly , Wahdan Rehab A , Salah Amal Abdul Azeem , Elnakera Abeer M
Published: December 2023

Background

Hypertensive patients are more susceptible to develop hypotension after the induction of general anesthesia (GA), most likely due to hypovolemia. An inferior vena cava collapsibility index (IVCCI) > 40–50% can predict hypotension after the induction of GA in the general population by variable accuracies. The current study aimed to investigate IVCCI% as a predictor of postinduction hypotension in hypertensive patients undergoing noncardiac surgery.

Methods

Ultrasound IVCCI % was assessed for all controlled hypertensive patients immediately before induction of GA. After induction of GA, patients were diagnosed with postinduction hypotension if their systolic arterial pressure (SAP) dropped by ≥ 30% of the baseline value and/or mean arterial pressure (MAP) dropped to < 65 mmHg up to 15 min after intubation. The receiver operating characteristic (ROC) curve of IVCCI% was compared to patients’ classification either developing hypotension after induction of GA or not as a gold standard.

Results

Of the 153 patients who completed the study, 62 (40.5%) developed hypotension after the induction of GA, and 91 (59.5%) did not. An IVCCI > 39% predicted the occurrence of postinduction hypotension with high accuracy (84%) (AUC 0.908, P < 0.001). The area of uncertainty (by gray zone analysis) of IVCCI lies at values from 39 to 45%. This gray zone included 21 patients (13.7% of all patients).

Conclusion

An inferior vena cava collapsibility index > 39% before anesthetic induction can be a simple noninvasive reliable predictor of hypotension after the induction of GA for hypertensive patients not treated with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) and undergoing noncardiac surgery.

Trial registration

This clinical trial was approved by the Institutional Review Board (IRB) at Zagazig University (ZUIRB #9424 dated 03/04/2022), and patients’ informed consent for participation in the study was obtained during the period from May 2022 to May 2023. All study procedures were carried out in accordance with the ethical standards of the Helsinki Declaration of 2013.
Relationship between blood urea nitrogen to serum albumin ratio and short-term mortality among patients from the surgical intensive care unit: a population-based real-world study
Authors: Zhang Jinyu , Zhong Lei , Min Jie , Wei Yunhai , Ding Lan
Published: December 2023

Background

Patients admitted to the surgical intensive care unit (SICU) often suffer from multi-organ dysfunction and have a high mortality rate. Therefore, finding a simple but effective clinical indicator to predict the prognosis of patients is essential to improve their survival. The aim of this study was to investigate the relationship between blood urea nitrogen to serum albumin ratio (B/A) and short-term mortality among patients from the SICU.

Methods

All eligible adult patients admitted to the SICU from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database were recruited for this study. Participants were divided into a death group (n = 638) and a survival group (n = 2,048) based on the 90-day prognosis, and then grouped by B/A quartiles. We used restricted cubic splines (RCS) to visually analyze the correlation of B/A with 30- and 90-day risk of death. Cumulative survival rates were estimated using Kaplan–Meier survival curves according to B/A quartiles and evaluated using the log-rank test. Cox proportional risk models were developed and sensitivity analyses were performed to explore whether B/A was independently associated with short-term outcomes in SICU patients. Receiver operating characteristic (ROC) curves were analyzed to ascertain the value of B/A for prognosticating 90-day outcome.

Results

A total of 2686 participants were included in the final study, and their 30-day and 90-day all-cause mortality rates were 17.61% and 23.75%, respectively. The differences in 30-day and 90-day mortality rates were statistically significant among the four groups of patients (all p < 0.001). RCS curves showed that B/A was linearly associated with the risk of 30-day and 90-day all-cause mortality in SICU patients (χ2 = 0.960, p = 0.811; χ2 = 1.940, p = 0.584). Kaplan–Meier analysis showed that the 90-day cumulative survival rate gradually decreased as B/A increased, with patients in the highest quartile of B/A having the lowest survival rate (p < 0.001). Cox regression indicated that elevated B/A (> 9.69) was an independent risk factor for 30-day and 90-day all-cause mortality in SICU patients. The analysis of ROC curves demonstrated that B/A exhibited a significant predictive ability for 90-day mortality, with an optimal threshold of 6.587, a sensitivity of 56.9%, and a specificity of 64.8%.

Conclusions

Elevated B/A (> 9.69) on admission was an independent risk factor for short-term mortality in SICU patients, and clinicians should pay more attention to this group of patients and intervene clinically at an early stage to reduce mortality.
Net clinical benefit of oral anticoagulants in Asian patients with atrial fibrillation based on a CHA2DS2-VASc score
Authors: Methavigul Komsing , Chichareon Ply , Yindeengam Ahthit , Krittayaphong Rungroj
Published: December 2023

Background

This study was conducted to assess the net clinical benefit (NCB) for oral anticoagulant (OAC) in atrial fibrillation (AF) patients according to the CHA2DS2-VASc score.

Methods

Patients with AF were prospectively recruited in the COOL AF Thailand registry from 2014 to 2017. The incidence rate of thromboembolic (TE) events and major bleeding (MB) was calculated. Cox proportional hazards model was used to compare the TE and MB rate in patients with and without OACs in CHA2DS2-VASc score of 0–1 and ≥ 2, respectively. The survival analysis was performed based on CHA2DS2-VASc score. The NCB of OACs was defined as the TE rate prevented minus the MB rate increased multiplied by a weighting factor.

Results

A total of 3,402 AF patients were recruited. An average age of patients was 67.38 ± 11.27 years. Compared to non-anticoagulated patients, the Kaplan Meier curve showed anticoagulated patients with CHA2DS2-VASc score of 2 or more had the lower thromboembolic events with statistical significance (p = 0.043) and the higher MB events with statistical significance (p = 0.018). In overall AF patients, there were positive NCB in warfarin patients with CHA2DS2-VASc score of 3 or more while there were positive NCB in DOACs patients regardless of CHA2DS2-VASc score. Females with CHA2DS2-VASc score of 3 or more had a positive NCB regardless of OACs type. Good anticoagulation control (TTR ≥65%) improved an NCB in males with CHA2DS2-VASc score of 3 or more.

Conclusions

AF patients with CHA2DS2-VASc score of 3 or more regardless warfarin or DOACs had a positive NCB. The NCB of OACs was more positive for DOACs compared to warfarin and for females compared to males.
Association between cardiopulmonary bypass time and mortality among patients with acute respiratory distress syndrome after cardiac surgery
Authors: Hu Jiaxin , liu Yan , Huang Lixue , Song Man , Zhu Guangfa
Published: December 2023

Background

Cardiopulmonary bypass (CPB) can lead to lung injury and even acute respiratory distress syndrome (ARDS) through triggering systemic inflammatory response. The objective of this study was to investigate the impact of CPB time on clinical outcomes in patients with ARDS after cardiac surgery.

Methods

Totally, patients with ARDS after cardiac surgery in Beijing Anzhen Hospital from January 2005 to December 2015 were retrospectively included and were further divided into three groups according to the median time of CPB. The primary endpoints were the ICU mortality and in-hospital mortality, and ICU and hospital stay. Restricted cubic spline (RCS), logistic regression, cox regression model, and receiver operating characteristic (ROC) curve were adopted to explore the relationship between CPB time and clinical endpoints.

Results

A total of 54,217 patients underwent cardiac surgery during the above period, of whom 210 patients developed ARDS after surgery and were finally included. The ICU mortality and in-hospital mortality were 21.0% and 41.9% in all ARDS patients after cardiac surgery respectively. Patients with long CPB time (CPB time ≥ 173 min) had longer length of ICU stay (P = 0.011), higher ICU (P < 0.001) mortality and in-hospital(P = 0.002) mortality compared with non-CPB patients (CPB = 0). For each ten minutes increment in CPB time, the hazards of a worse outcome increased by 13.3% for ICU mortality and 9.3% for in-hospital mortality after adjusting for potential factors. ROC curves showed CPB time presented more satisfactory power to predict mortality compared with APCHEII score. The optimal cut-off value of CPB time were 160.5 min for ICU mortality and in-hospital mortality.

Conclusions

Our findings demonstrated the significant prognostic value of CPB time in patients with ARDS after cardiac surgery. Longer time of CPB was associated with poorer clinical outcomes, and could be served as an indicator to predict short-term mortality in patients with ARDS after cardiac surgery.