bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Theater Medical Data Store and Reportable Medical Event Records to Theater Animal Bite Reports Submissions, 2018–2019
Authors: Knobbe Marc G , Aden Brandon J , Ashbaugh Hayley R
Published: November 2023

Introduction

This analysis evaluates potential reporting discrepancies of the DD2341 Form (Report of Animal Bite—Potential Rabies Exposure) submitted to a forward-deployed Rabies Advisory Board to the Theater Medical Data Store (TMDS) and Reportable Medical Event (RME) systems to identify reporting gaps that can lead to improved best practices that ensure documentation of Post Exposure Prophylaxis (PEP) of potential rabies exposures into service members (SMs) electronic medical records.

Materials and Methods

The project compares the number of Service Member animal exposure DD2341 reports submitted to the Camp Arifjan, Kuwait Rabies Advisory Board to in-theater treatment electronic records at the same forward deployed locations from January 1, 2018 to December 31, 2019 recorded in the TMDS and RME databases. Records included active duty and reserve SM deployed to six countries in the United States Central Command (USCENTCOM) area of responsibility. The analysis compared some demographic information, type of potential rabies exposure (e.g., whether a bite or scratch), and PEP to rabies with Human Rabies Immune Globulin (HRIG), Human Rabies Vaccine (HRV), or both between the reporting systems.

Results

There were 44 fewer records of PEP from the TMDS data records than reported from in theater written reports. Electronic record data showed 85 coded rabies exposure diagnoses. Twenty-two received HRV and no HRIG, while four received HRIG and HRV for PEP. Only seven of the 26 SM receiving rabies PEP had a confirmed RME associated with the electronic record. There were 116 SM animal exposure written reports, with 70 reporting PEP. There were 41 records indicating the SM received HRIG and HRV as part of PEP, while 29 reports indicated that the patient received only HRV PEP. Of the 41 SM receiving HRIG, 32 of the exposures were from cat scratches or bites. Seven records specified HRIG was indicated for treatment but not available at the location; therefore, HRV was the only treatment available. The most common reason indicated on the written report for not receiving rabies PEP was that treatment was not indicated based on the risk category of animal exposure.

Conclusions

This study is the first to compare the electronic medical record data to in theater reports for potential rabies exposure in a theater of operations. The analysis suggests that some written forms generated in the USCENTCOM theater are not entered into SM Military Health System electronic medical records, indicating that electronic medical records may be a less sensitive method than in-theatre reports for rabies program surveillance in a deployed setting. There is under-reporting in electronic medical records of rabies PEP in both TMDS and RME databases. Rabies PEP is an RME according to the Armed Forces Health Surveillance Division guidelines and case definitions. There needs to be better integration of the DD2341 into the electronic medical records system.
Raising the U.S. Army Height–Weight (Body Mass Index) Standards: Quantifying Metabolic Risk
Authors: Smith Maria , Cooper Alma , Hill James O , Yankovich Michael , Crofford Ira , Thomas Diana M
Published: November 2023

Background & objectives

The U.S. Army fell 25% short of its recruitment goal in 2022 and therefore, increasing the eligibility pool for potential recruits is of interest. Raising the body mass index (BMI) standards for eligibility presents a path to increase the recruitable population; however, there may be additional costs incurred due to attendant health risks that may be present in individuals with higher BMI.

Methods

We filtered the 2017-2020 National Health and Nutrition Examination Survey by age (17-25 years) and BMI (up to 30 kg/m2). A k-means cluster analysis was performed on the filtered dataset for the variables used to determine metabolic syndrome. Metabolic syndrome Clusters were characterized through summary statistics and compared over clinical measurements and questionnaire responses.

Results

Five distinct clusters were identified and mean BMI in two clusters (Clusters1 and 3) exceeded the current U.S. Army BMI thresholds. Of these two clusters, Cluster 1 members had metabolic syndrome. Cluster 3 members were at higher risk for metabolic syndrome compared to members of Clusters 2, 4, and 5. Mean waist circumference was slightly lower in Cluster 3 compared to Cluster 1. None of the clusters had significant differences in depression scores, poverty index, or frequency of dental visits.

Conclusions

Potential recruits from Cluster 1 have excessive health risk and may incur substantial cost to the U.S. Army if enlisted. However, potential recruits from Cluster 3 appear to add little risk and offer an opportunity to increase the pool for recruiting.
Genomic landscape and actionable mutations of brain metastases derived from non–small cell lung cancer: A systematic review
Authors: Andrews Lily J , Thornton Zak A , Saleh Ruqiya , Dawson Sarah , Short Susan C , Daly Richard , Higgins Julian P T , Davies Philippa , Kurian Kathreena M
Published: November 2023

Background

Brain metastases derived from non–small cell lung cancer (NSCLC) represent a significant clinical problem. We aim to characterize the genomic landscape of brain metastases derived from NSCLC and assess clinical actionability.

Methods

We searched Embase, MEDLINE, Web of Science, and BIOSIS from inception to 18/19 May 2022. We extracted information on patient demographics, smoking status, genomic data, matched primary NSCLC, and programmed cell death ligand 1 expression.

Results

We found 72 included papers and data on 2346 patients. The most frequently mutated genes from our data were EGFR (n = 559), TP53 (n = 331), KRAS (n = 328), CDKN2A (n = 97), and STK11 (n = 72). Common missense mutations included EGFR L858R (n = 80) and KRAS G12C (n = 17). Brain metastases of ever versus never smokers had differing missense mutations in TP53 and EGFR, except for L858R and T790M in EGFR, which were seen in both subgroups. Of the top 10 frequently mutated genes that had primary NSCLC data, we found 37% of the specific mutations assessed to be discordant between the primary NSCLC and brain metastases.

Conclusions

To our knowledge, this is the first systematic review to describe the genomic landscape of brain metastases derived from NSCLC. These results provide a comprehensive outline of frequently mutated genes and missense mutations that could be clinically actionable. These data also provide evidence of differing genomic landscapes between ever versus never smokers and primary NSCLC compared to the BM. This information could have important consequences for the selection and development of targeted drugs for these patients.
Dipesh Chakrabarty
Authors: Dube Saurabh , Eguiarte Ruelas Eduardo
Published: November 2023

Dipesh Chakrabarty (b. 1948) is widely recognized as a cultural historian and postcolonial theorist of immense acuity and formidable imagination. Known especially for his critical coinage of “provincializing Europe” and cross-disciplinary considerations of the Anthropocene, Chakrabarty has variously contributed to the rethinking of subaltern historiography and working-class culture, modernity and history, and climate change and planetary subjects. Dipesh was born and raised in the city of Calcutta. He received a BSc (honors) in physics from Presidency College, University of Calcutta, a master’s in business management from the Indian Institute of Management (Calcutta), and his PhD in history from the Australian National University, Canberra. Chakrabarty is currently the Lawrence A. Kimpton Distinguished Service Professor in History, South Asian Languages and Civilizations, and the College at the University of Chicago.
The Black Aesthetic
Authors: Raengo Alessandra
Published: November 2023

Aesthetics is commonly associated with ideas of beauty and the philosophy of the arts, yet, as a specific branch of philosophy aesthetics establishes itself in the eighteenth century to reflect primarily on sensorial knowledge. However, with Kant specifically, “form” rather than the senses becomes primary in order to ground the possibility for the universality of judgment of taste. In this latter capacity, aesthetics becomes also a regulative discourse on the human and provides the foundation for the concept of the “disinterested” liberal subject who alone is allowed full participation in the sphere of politics. Thus, as conceived within the Kantian philosophical tradition, aesthetic has a necessarily antagonistic relationship to blackness, which it excludes from its concept of the human, the subject, the public sphere, as well as any idea of the beautiful and the universal. Theories and practices of black aesthetic, therefore, intervene in this antagonism at a number of levels: by critiquing the universalist premise of Western aesthetics or rejecting it altogether; by contesting its implied ideals of beauty; by returning it to its earlier formulations, more attuned to sensorial knowledge, rather than formal thinking as philosophy of the arts, in order to claim everyday practices as sources of meaning and value; by exposing how aesthetic philosophy has been instrumental to processes of racialization; by embracing the political valences of judgment of taste; by critiquing the processes of evaluation that are intrinsic to aesthetic judgments; by offering alternative aesthetic traditions rooted in the specificity of black cultural practices; and by offering blackness itself as an aesthetic practice and black studies as aesthetic theory.
Defense Counsel
Authors: Bellone Eric
Published: November 2023

The role of defense counsel is complex. Defense counsel has the duty to help the defendant navigate the complexities of their criminal defense while formulating and implementing defensive strategies. Although defense counsel is guaranteed under the US Constitution, at what point that right attaches and what duties defense counsel owes the defendant have evolved over time.
Augustinianism in Renaissance Thought
Authors: Urlings Sam
Published: November 2023

It is hard to overestimate the enduring impact that St. Augustine of Hippo (b. 354–d. 430) has exerted on the development of Western thought, from its most personal expressions to its broadly cultural reflections. Theology, philosophy, literature, visual arts, even politics—all were pervasively influenced by the Church Father’s thought and its reverberations through the ages. Situated at the crossroads of two hard-to-define descriptors, Renaissance Augustinianism (not to be confused with Heiko A. Oberman’s anti-Pelagian “Augustinian Renaissance”) in essence, but not unambiguously, refers to the reception and development of that thought in Europe from around the mid-14th to the mid-17th century. Such a broad definition naturally invites scrutiny—“Augustinianism” in se is an imprecise term that brings to mind a range of (sometimes conflicting) meanings—but, fundamentally, this entry concerns the ways in which Augustine was reappropriated and reconstructed in the transition to early modernity. The result is multifaceted by its nature: the bishop’s prolific output on a plethora of topics led to an equally diverse readership, from the early Italian humanists to the followers of John Calvin. A “late-classical” author in the eyes of many, Augustine, too, was the object of the ad fontes attitude thought of as characteristic of the Renaissance; and as many of his more neglected works were rediscovered, he proved a singular authority that was thought to embody the harmonization of antiquity with Christianity. The variety of interpretations—and opposition from certain circles—notwithstanding, the Church Father’s doctrines of trinitarianism, original sin, illumination, and the nature of the soul and of knowledge were widely prevalent; as was his conception of the City of God opposite to the city of man. In many ways, the friars that belonged to the mendicant Ordo Eremitarum Sancti Augustini (OESA) laid the foundation for this widespread awareness of his writings. No wonder that many scholars consider the Renaissance to constitute a “rebirth” of Augustine—and of Augustinianism—as well. For a general overview of patristics in the Renaissance, see the separate Oxford Bibliographies in Renaissance and Reformation article “The Church Fathers in Renaissance and Reformation Thought.”
Christine de Pizan
Authors: Smith Geri
Published: November 2023

Christine de Pizan (b. c. 1364–d. c. 1431) was one of the most prolific and impactful writers of the late Middle Ages, an early humanist and a rare female voice among the French literati of her day. Both of those distinctions give her a special standing in the evolution of French literature and thought. While the French Renaissance is generally aligned with the 16th century, consideration of intellectual history requires a broader scope. For Christine, that means reaching back to the Italian Renaissance of the 14th century and the body of humanist literature that would form the foundation of Christine’s own work. Having been born in Venice, Christine’s connection with Italy stems from her earliest days. She relocated to Paris at about the age of four to join her father Thomas, a doctor and astrologer in the employ of King Charles V. Raised in the milieu of the court, with access to a library of one of Europe’s largest collections of classical works translated into French, she was able to cultivate her bookish tendencies and a store of knowledge that would sustain her throughout her life. When she was widowed at twenty-five and faced with forging a life for herself and her family, she turned to writing to assuage her grief and earn a living. While her early works largely comprise poetry about love, she would go on to write increasingly in prose and on wider-ranging topics including politics, philosophy, and the art of warfare. Her involvement in the 1401–1402 public literary debate surrounding the Romance of the Rose marked a turning point in her reputation as a writer and intellectual and made her a central figure in the broader querelle des femmes (“debate about women”) that would carry on for centuries. She was also a publisher, overseeing and participating in the production of her manuscripts. She was known early on to an international audience, and her works continued to be printed and disseminated for approximately two centuries following her death. The influence of her writing would ripple through to the early 17th century, informing the English Renaissance as well, until Christine’s work would fall into relative obscurity along with most of medieval literature. Her “rediscovery” dates to the late 19th century and surged in the 1980s, igniting momentum that continues today. See also the separate Oxford Bibliographies in Renaissance and Reformation articles “Women and Learning”; “Women Writing in French”; and the subsections “Renaissance and Humanism” and “Renaissance and Women” under The Renaissance.
Apologies and Accounts
Authors: Kotani Mariko
Published: November 2023

Apology is an action in which one admits the wrongfulness of an act and one’s responsibility for it in dealing with some type of problematic situation, such as interactional offenses in conversation, rule-breaking behaviors, embarrassment, violations of expectations, and social predicaments that can damage relationships. Account is another action in which one tries to explain such a situation so that one can transform the problematic quality of it. Apologies and accounts are both communication practices used to deal with problematic situations, and they can therefore be dealt with together. These two actions are ubiquitous in everyday lives, and studies on them, therefore, especially on apologies, abound across many disciplines. The concepts of apologies and accounts are important for three reasons. First, they help us understand the way in which society is maintained through individual conduct. By apologizing, one claims that one’s act was an exception to the rule, and, as a result, the original rule is sustained. Second, the concepts of apologies and accounts help us understand the way in which one restores one’s preferred image of self, or “face,” and the other’s face, as well as the relationship with the other. Third, these concepts help us explore culturally appropriate communication conduct. By engaging in apologies and accounts, one’s taken-for-granted views of what is wrong and what is acceptable can be revealed. Apologies have been studied in a variety of contexts (e.g., interpersonal, organizational, political, mediated, cultural) and in various fields, including philosophy, sociology, social psychology, sociolinguistics, cross-cultural pragmatics, applied linguistics, rhetoric, discourse analysis, conversation analysis, interpersonal communication, and intercultural communication. Because there has been far more research on the topic than could be covered in one article, this piece focuses on apologies and accounts mainly in interpersonal face-to-face settings, with an emphasis on literature in communication. It also touches on apologies made by political figures. For apologies in other public arenas (e.g., media and online apologies; corporate apologies in crisis communication; apologies in judicial, medical, religious, and international conflicts), see other sources, such as the separate Oxford Bibliographies article “Image Repair Theory.”
Feminist New Materialist Approaches to Childhood Studies
Authors: Mohandas Sid , Osgood Jayne
Published: November 2023

There is a growing body of feminist scholarship that has taken up “new” materialisms to research childhoods. Feminist “new” materialisms, as the name suggests, are marked by a renewed attention to matter. In previous feminist research, such as those informed by feminist post-structuralist and sociocultural approaches, matter was assigned an inert, passive, and determinate role; a substrate on which language and discourse acted upon. In contrast, new materialist ontology views matter as lively, active, and indeterminate, and inseparable from the discursive as expressed in the concatenated term “materialdiscursive.” This is to by no means put feminist post-structuralisms in opposition to new materialist thought, or to assume a radical break from past feminist interventions; instead, feminist new materialisms hold onto the advances made by feminist post-structuralisms while simultaneously expanding its focus beyond just language and discourse. While the “new” in new materialisms is an attempt to distinguish itself from older forms of materialisms such as Marxist-inflected materialism and “scientific” materialism, the claims to “newness” have been a matter of contention. As pointed out by Indigenous and Black scholars like Eve Tuck, Zoe Todd, Zakiyyah Iman Jackson, Uri McMillan, and Tiffany Lethabo King, Black/Indigenous philosophies and cosmologies in diverse locations have held similar views for centuries and millennia, where nonhuman agencies, transient materialities and human-nonhuman relations marked by reciprocity have shaped Black/Indigenous lifeworlds. The feminist inflection of “new” materialisms invite such productive frictions, to ensure West’s hegemony is disrupted while simultaneously enacting care in how Indigenous/Black thought is brought in conversation with new materialisms. In line with other critical approaches in childhood studies, feminist new materialisms disrupt Western humanist and developmentalist approaches, troubling linear, individualized, and deterministic notions of childhood. Childhood is viewed as a leaky, messy and indeterminate terrain, always already more-than the bounded “child.” This is not to undermine the advances made in childhood studies to enhance children’s agencies via multimodal listening, rather such agencies are viewed as inseparable from the nonhuman world. Donna Haraway’s concept of “naturecultures” and “diffraction,” Karen Barad’s agential realist concepts such as “intra-action” and “phenomena,” Stacy Alaimo’s notion of “transcorporeality” and “material memoirs,” and Jane Bennet’s “thing power” all enable disrupting human exceptionalism produced through forced cuts and boundaries imposed by Western epistemological traditions. Foregrounding the entanglements of matter, discourse, affect, temporalities, place, and space offers critical and affirmative possibilities in the field of childhood studies.
Women's Education
Authors: Cordner Sheila
Published: November 2023

Against the backdrop of momentous education reform in 19th-century Britain, women made important inroads to institutional learning. They gained access to elementary and secondary schools as well as the first women’s colleges. Even by the end of the century, however, women often still felt excluded from elite higher education. Like the socially stratified learning models for male students, women’s education was commonly dictated by class. As a result, many scholars have approached the subject of Victorian women’s education through this lens, and many of the sources here are categorized by social class as well as by level of schooling. Education reform sought to provide broader opportunities for children of the lower classes to attend schools, with the Education Act of 1870 making elementary education compulsory. More secondary schools opened for middle-class girls, as reported by the 1868 Schools Inquiry Commission, but they were criticized for being unsystematic and barely more rigorous than the tutored education of accomplishments many bourgeois girls received at home. Some middle-class and upper-middle-class women pursued professional paths as educators, becoming governesses or teachers at the newly proliferated schools. In the second half of the century, as a debate flared regarding women’s physical and intellectual capabilities for higher learning, a small group of women attended universities for the first time. Opponents of the women’s higher education movement highlighted the tensions between women’s rigorous study and their responsibilities as wives and mothers. Despite gaining more access, women were not granted degrees at the two most prestigious universities in England until the twentieth century (1920 at Oxford and 1948 at Cambridge), although Scottish universities allowed women graduates in the late nineteenth century, such as the University of Edinburgh (1893) and the University of Glasgow (1894). Ultimately much direct insight into the education women obtained at home, in schools, and at universities comes from novels, poetry, memoirs, essays, and letters, along with historical studies and scholarship on literature and education.
Sarah Wentworth Morton
Authors: Harvey Tamara
Published: November 2023

Sarah Wentworth Morton (b. 1759–d. 1846) was born in Boston, Massachusetts to James Apthorp and Sarah Wentworth. She was well known as a poet of the early US republic, publishing in periodicals like The Massachusetts Magazine and self-publishing three long history poems during the 1790s. Both the Apthorps and Wentworths were prominent merchants with ties to the slave trade. Morton’s family had Tory leanings during the American Revolution, while Morton had Patriot sympathies, as did her husband, Perez Morton, a Revolutionary leader who pursued a successful career in law and politics. Her marriage to Perez was marked by a notorious scandal—his affair with Sarah’s sister, Frances, who committed suicide after giving birth to their child. This scandal has shaped critical approaches to Morton’s work, most significantly when she was misidentified during the latter half of the nineteenth century and into the twentieth as the author of The Power of Sympathy, a seduction novel by William Hill Brown that treated both her family scandal and the death of Elizabeth Whitman, which later inspired Hannah Webster Foster’s The Coquette. Especially during the 1790s, Morton’s poetry was self-consciously that of the new republic, focusing on American topics framed by classical and world-historical exempla. Her three long poems are particularly ambitious in this regard, with Beacon Hill and The Virtues of Society focusing on battles of the American Revolution in epic terms that highlight US geography and political organization, while Ouâbi represents American vigor and virtue through the heroic sacrifice of a Native American chief. Morton’s shorter abolitionist poem, “The African Chief,” also focuses on the tragic death of a heroic leader. Morton’s contributions to an emerging American imaginary are inseparable from changing opportunities for women writers and the rise of periodical publication during this period, much of it sustained by the works of women writers, including Judith Sargent Murray and Mercy Otis Warren, whom Morton mentions in her works. In 1823, Morton published My Mind and Its Thoughts in Sketches, Fragments, and Essays, a collection of poems, aphoristic reflections, and short essays that demonstrates her ongoing literary ambitions as well as her mature reflections on a life marked by loss and personal challenges. Morton’s life and work shed light on efforts to develop a literary culture to match the political and social aspirations of a new nation as well as opportunities and limitations shaping women’s writing during the early US republic. The author wishes to thank Audrey Morales for her assistance on this project.
Current and future advances in practice: mechanical foot pain
Authors: Halstead Jill , Munteanu Shannon E
Published: November 2023

Mechanical foot pain affects ∽20% of the UK population >50 years of age, with ∼10% reporting disabling pain that impacts daily activities. For most people, foot pain improves over time, but for some this can become chronic and disabling, affecting physical activity, participation, mental health and work capacity. Mechanical foot pain can present as localized pain, but more often the pain presents in multiple structures. Traditional treatments for mechanical foot pain are largely based on self-management that includes pain control, reassurance of healing trajectory, and activity or footwear modifications. Randomized controlled trials support the short-term use of exercise and foot orthoses for some foot conditions; however, accessibility can be limited by regional variations in procurement compounded by a lack of long-term trials. The roles of weight loss and strengthening of the foot and leg muscles offer new avenues to explore.
Cancer worry at higher-risk sample of hereditary cancer in Spain
Authors: Costa-Requena Gema , Richart-Aznar Paula , Segura-Huerta Ángel
Published: November 2023

Background:

Few studies have examined the prevalence of cancer worry in the general and at-risk population. The objective of this study was to describe the prevalence of cancer worry in a sample of individuals at increased risk of developing hereditary cancer, determine differences in cancer worry by socio-demographic characteristics and assess the relationship between cancer worry and psychological distress.

Methods

A cross-sectional study was designed with 895 patients. The Cancer Worry Scale (CWS), Hospital Anxiety and Depression Scale (HADS) for psychological distress and sociodemographic characteristics were examined. The multiple linear regression model was developed to explore what variables were predicted for cancer worry. To identify variables associated with higher cancer worry scores, a logistic model was fitted.

Results

In the at-higher-risk sample of hereditary cancer, the mean of CWS was 10.20 (SD: 3.70). The significant predictors for cancer worry were gender, age, previous psychiatric treatment, patients affected by cancer and having children. In the sample, 38% of patients had higher scores on cancer worry, the variables associated were patients affected by cancer compared, women, widow/divorced participants, less than secondary school, patients with previous psychiatric treatment and patients less than 55 years old. Using the HADS cutoff score 29% of the sample showed significant psychological distress, more anxiety (35%) than depressive (22%) symptomatology. Psychological distress showed a higher variability (36%) on cancer worry.

Conclusion

Findings highlighted distinctive profiles in socio-demographic characteristics according to the degree of cancer worry; therefore, genetic counseling should continue to be provided to address cancer worry and relieve psychological distress.
Updated disease distributions, risk factors, and trends of laryngeal cancer: A global analysis of cancer registries
Authors: Huang Junjie , Chan Sze Chai , Ko Samantha , Lok Veeleah , Zhang Lin , Lin Xu , Lucero-Prisno Don Eliseo , Xu Wanghong , Zheng Zhi-Jie , Elcarte Edmar , Withers Mellissa , Wong Martin CS
Published: November 2023

Background:

Though the laryngeal cancer only has 1% of the total cancer cases and related deaths, it is a type of head and neck cancers with the highest prevalence. This study aims to investigate the epidemiological trend of laryngeal cancer with updated data on the global distribution of the disease burden.

Materials and Methods:

The incidence and mortality rate of laryngeal cancer was extracted from GLOBOCAN (2020), Cancer Incidence in Five Continents series I-X, WHO mortality database, the Nordic Cancer Registries, and the Surveillance, Epidemiology, and End Results Program. The Global Health data exchanges for the prevalence of its associated risk factors. A Joinpoint regression analysis was used to calculate Average Annual Percentage Change (AAPC).

Results:

The age-standardised rate (ASR) of laryngeal cancer incidence and mortality were 2.0 and 1.0 per 100,000 worldwide. The Caribbean (ASR = 4.0) and Central and Eastern Europe (ASR = 3.6) had the highest incidence and mortality rate. Incidence and risk factors associated with laryngeal cancer included tobacco usage, alcohol consumption, poor diet, obesity, diabetes, hypertension, and lipid disorders. There was an overall decreasing trend in incidence, especially for males, but an increasing incidence was observed in female populations and younger subjects.

Conclusions:

As overall global trends of laryngeal cancer have been decreasing, especially for the male population, this could possibly be attributed to reduced tobacco use and alcohol consumption. Decrease in mortality may be due to improved diagnostic methods and accessibility to treatment, yet disparity in trend remains potentially because of differences in the level of access to surgical care. Disparities in temporal trends across countries may require further research and exploration to determine other underlying factors influencing this.
Comparison of perioperative outcomes of selective arterial clipping guided by near-infrared fluorescence imaging using indocyanine green versus undergoing standard robotic-assisted partial nephrectomy: a systematic review and meta-analysis
Authors: Zhou Lin , Zhou Junjie , Shuai Hui , Xu Qian , Tan Ying , Luo Jia , Xu Pengjun , Duan Xi , Mao Xiaorong , Wang Shanshan , Wu Tao
Published: November 2023

Background:

This study employs a meta-analytic approach to investigate the impact of robotic-assisted partial nephrectomy, with and without near-infrared fluorescence imaging (NIRF-RAPN vs S-RAPN), on patients’ perioperative outcomes and postoperative changes in renal function.

Materials and Methods:

We conducted a comprehensive and rigorous systematic review and cumulative meta-analysis of primary outcomes following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), AMSTAR (Assessing the Methodological Quality of Systematic Reviews) Guidelines, and Risk-of-Bias Tool (RoB2). To ensure a thorough search, we systematically searched five major databases, including Medline, PubMed, Cochrane Library, Scopus, and Web of Science, from databases’ inception to April 2023.

Results:

No significant differences were found between the two groups in terms of age (P=0.19), right side (P=0.54), BMI (P=0.39), complexity score (P=0.89), tumor size (P = 0.88), operating time (P = 0.39), estimated blood loss (P = 0.47), length of stay (P = 0.87), complications (P = 0.20), transfusion (P = 0.36), and positive margins (P = 0.38). However, it is noteworthy that the NIRF-RAPN group exhibited significant reductions in warm ischemia time (P=0.001), the percentage change in estimated glomerular filtration rate at discharge (P=0.01) compared to the S-RAPN group.

Conclusion:

This meta-analysis provides evidence that the group undergoing NIRF-RAPN showed a statistically significant protective effect on the estimated glomerular filtration rate (eGFR).
Automated office blood pressure measurement with the assistance of an instructional video in patients with hypertension
Authors: Toba Ayumi , Ishikawa Joji , Harada Kazumasa
Published: November 2023

Objectives

Automated office blood pressure (AOBP) measurement often requires assistance. Accompanied by an instructional video, AOBP measurement could be performed independently by patients.

Design and methods

Seventy-five patients with hypertension were enrolled. AOBP was measured three times at 1-min intervals after 5 min of rest by an automated BP measurement device with the assistance of an animated instructional video. The video was designed originally to instruct patients on the way to measure BP appropriately. Perceived stress was evaluated using a questionnaire after the AOBP measurement. Office BP was measured three times using the same device. Home BP measurement was performed on 5 consecutive days.

Results

The mean age of the patients was 74.5 ± 10.6 years, and 96% were taking antihypertensive drugs. Mean AOBP, office BP and home BP measurements were 135.2 ± 17.2/81.3 ± 11.1, 139.3 ± 16.3/78.6 ± 10.9 and 129.2 ± 16.7/72.7 ± 8.9 mmHg, respectively. Regarding SBP, the mean AOBP was significantly lower than office BP (P = 0.005) and higher than home BP (P = 0.004). The differences in SBP and DBP between AOBP and home BP measurements were significantly related to patients’ perceived stress when performing AOBP measurements (r = 0.289; P = 0.013 and r = 0.328; P = 0.004). In a multivariate analysis, patients’ perceived stress was a significant predictor of the difference between AOBP and home BP (P = 0.013), even after adjusting for age, sex, BMI and mean of AOBP and home BP.

Conclusion

AOBP values measured with the assistance of an instructional video were between conventional office and home BP measurements. Perceived stress during AOBP measurement was related to the difference in AOBP from home BP.
Where do we stand with immunotherapy for nonmelanoma skin cancers in the curative setting?
Authors: Alberti Andrea , Gurizzan Cristina , Baggi Alice , Bossi Paolo
Published: November 2023

Purpose of review

Nonmelanoma skin cancers (NMSC) represent a heterogeneous group of diseases that encompasses among the principal histologies basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (cSCC), and Merkel cell carcinoma (MCC). Given the fact that high tumor mutational burden due to ultraviolet mutagenesis represents a common hallmark of NMSCs, immunotherapy has proved to be a promising therapeutic approach in recent years. The aim of this review is to shed light on immunotherapy applications in NMSCs in the curative setting.

Recent findings

Immune checkpoint inhibitors represent the first-line treatment of choice for advanced cSCC and MCC, while in second line for BCC. Given this success, more and more trials are evaluating the use of immune checkpoint blockade in neoadjuvant setting for NMSCs. Clinical trials are still ongoing, with the most mature data being found in cSCC. Also, translational studies have identified promising biomarkers of response.

Locoregional treatments of NMSCs can have non negligible functional and cosmetic impacts on patients, affecting their quality of life. As immunogenic diseases, neoadjuvant immunotherapy represents a promising treatment that could change the therapeutic path of these patients. Upcoming results from clinical trials will address these crucial issues.
A Comprehensive Study of Heterogeneous Mismatch Repair Expression in Solid Tumors Reveals Different Immunohistochemical Patterns and Distinct Genetic Mechanisms
Authors: Wang Jing , Zhang Zijuan , Cai Yumeng , Lu Junliang , Zhang Hui , Pang Junyi , Wu Huanwen , Liang Zhiyong
Published: November 2023

Objective:

Immunohistochemistry is routinely performed to detect mismatch repair deficiency in solid tumors. Heterogeneous MMR expression (MMR-het) has been reported occasionally but not systemically studied.

Methods:

In this study, we depicted MMR-het patterns of 40 tumors of different anatomical sites and analyzed MMR genetic alterations and tumor mutational burdens (TMB) through comprehensive genomic profiling.

Results:

The MMR-het patterns were classified into 4 subgroups: “single-loss” (3 cases), “MLH1/PMS2 double-loss” (16 cases), “MSH2/MSH6 double-loss” (8 cases), and “triple/tetra-loss” (13 cases). Seventeen MMR-het cases exhibited histological heterogeneity, in which MMR protein loss was generally confined to either poorly differentiated or well-differentiated tumor areas. All “single-loss” tumors had MMR somatic mutations and coexistingPOLEexonuclease domain mutations. “MLH1/PMS2 double-loss” tumors unexceptionally harboredMLH1hypermethylation without MMR germline mutations. In the “MSH2/MSH6 double-loss” subgroup, 4 cases hadMSH2/MSH6germline mutations, while another 4 cases had multipleMSH2/MSH6somatic mutations. AdditionalPOLEexonuclease domain mutations were identified in 2 cases. Tumors in the “triple/tetra-loss” subgroup generally hadMLH1abnormalities (8MLH1hypermethylation, 4MLH1germline mutation, 1MLH1double somatic mutations), and coexistent somatic mutations onMSH2/MSH6. Thirty-one cases (83.8%) were TMB-H, and allPOLE-mutated cases exhibited ultra-high TMB (111.4 to 524.2 mut/Mb).

Conclusion:

Our findings highlighted the importance of accurately interpreting heterogeneous MMR protein staining patterns for developing a more efficient personalized genetic investigation strategy.
Initial experiences withMycobacterium tuberculosisDNA extraction for downstream Deeplex Myc-TB targeted deep sequencing in a high burden setting
Authors: Limberis Jason D , Nalyvayko Alina , Steyn Janré , Williams Jennifer , Grobbelaar Melanie , Warren Robin M , Metcalfe John Z
Published: November 2023

The propensity forM. tuberculosisto develop resistance and the lack of clinical tools for the rapid determination of such resistance has long significantly complicated tuberculosis (TB) therapeutics. Targeted next-generation sequencing (NGS) has improved our understanding of the genetic basis and identification of drug-resistant TB. However, to achieve accurate results reliable enough for clinical implementation, high-qualityM. tuberculosisDNA must be extracted from patient-derived samples within high burden routine laboratory workflows. In advance of a large cluster RCT in the Western Cape of South Africa evaluating the Deeplex Myc-TB targeted NGS assay (GenoScreen; Lille, France), we sought to compare DNA extraction methods for both early MGIT culture-positive samples and processed patient sputum. Given the lack of reference standard method, we assessed a representative set of DNA extraction protocols, including the GenoScreen-recommended method, in parallel in South Africa and at UC San Francisco. Our findings provide preliminary insights into an optimal DNA extraction method for the utilization of Deeplex Myc-TB in routine laboratory settings and can inform future experiments evaluating newer generation assays.
Electrophysiologically-defined excitation-inhibition autism neurosubtypes
Authors: Bertelsen Natasha , Mancini Gabriele , Sastre-Yague Davide , Vitale Andrea , Malerba Simone Blanco , Lorenz Gabriel Matias , Bolis Dimitris , Mandelli Veronica , Martinez-Canada Pablo , Gozzi Alessandro , Panzeri Stefano , Lombardo Michael V
Published: November 2023

Excitation-inhibition (E:I) imbalance has long been considered one of the primary neurobiological theories explaining autism. However, the theory has been bolstered heavily by research on high-penetrance genetic mechanisms which are only found in a small proportion of the autism population and can manifest with potentially different directionality. How well does E:I imbalance explain idiopathic autistic males and does such E:I imbalance manifest in one particular direction? Answering this question in human patients necessitates a need for validated tools that allow for inference about E:I balance from non-invasively measured in-vivo electrophysiological (EEG, LFP) time-series data. Predictions from in-silico modelling alongside in-vivo validations from mouse electrophysiological data show that alterations of synaptic E:I balance cause changes in fractal long memory characteristics of the neural time-series that are captured with a metric known as the Hurst exponent (H). H estimated in resting state EEG data of idiopathic autistic males allows us to discover two distinct E:I 'neurosubtypes' that generalize at high levels (>92% accuracy) in independent data. Each autism neurosubtype captures approximately half of the sample and each can be described by opposing patterns of E:I imbalance relative to a typically-developing (TD) comparison group. Autism E:I neurosubtypes also show differential relationships between H and behavioral and demographic variables consisting of age, intelligence, and autism symptomatology. This work establishes causal evidence for interpreting changes in EEG-derived H as an E:I-relevant biomarker and suggests that idiopathic autistic males can be characterized by opposing types of E:I imbalance with differential phenotypic relevance.
Kidney Function Assessment Using Cystatin C and Serum Creatinine in Heart Transplantation Recipients: Implications for Valganciclovir Dosing
Authors: Pinsino Alberto , Jennings Douglas L , Ladanyi Annamaria , Duong Phuong , Sweat Austin O , Mahoney Ian , Bohn Bruno , Demmer Ryan T , Takeda Koji , Sayer Gabriel T , Uriel Nir , Leb Jay S , Husain Syed A , Mohan Sumit , Colombo Paolo C , Yuzefpolskaya Melana
Published: November 2023

Background

Among heart transplantation (HT) recipients, the accuracy of serum creatinine (sCr)-based estimated glomerular filtration rate (eGFR) may be limited by fluctuations in muscle mass. Cystatin C (cysC) is less influenced by muscle mass; however, its levels may increase with obesity and steroid use. Herein, we: i) longitudinally compared changes in eGFRcysC and eGFRsCr among HT recipients; ii) investigated the association of body mass index (BMI), steroid use and muscle mass with discrepancies between eGFRs; and iii) explored the implications of eGFRcysC use on valganciclovir (VGC) dosing.

Methods

cysC and sCr were measured in 294 blood samples obtained from 80 HT recipients. Intra-individual differences between eGFRs (eGFRdiffcysC-sCr) were calculated. Negative eGFRdiffcysC-sCrvalues correspond to eGFRsCr > eGFRcysC and positive values to eGFRcysC > eGFRsCr. In a patient subset (n=21), pectoralis muscle measures were derived from computed tomography scans.

Results

Marked differences between eGFRcysC and eGFRsCr were observed, particularly early post-HT (1-week post-HT, median eGFRdiffcysC-sCr−28 ml/min/1.73 m2). eGFRcysC demonstrated stability following a transient post-operative decline, while eGFRsCr decreased in the first year post-HT. Lower BMI and higher prednisone dose displayed a modest association with more negative eGFRdiffcysC-sCrvalues. Conversely, pectoralis muscle measures indicative of greater muscle mass and better tissue quality exhibited a stronger association with more positive eGFRdiffcysC-sCrvalues. eGFRcysC use would have resulted in VGC dose adjustment in 46% of samples, predominantly towards lower doses.

Conclusions

Among HT recipients, eGFRcysC and eGFRsCr markedly differ with implications for VGC dosing. The observed discrepancies may reflect changes in body composition and steroid use.
Hurricanes Pose Substantial Risk to New England Forest Carbon Stocks
Authors: Tumber-Dávila Shersingh Joseph , Lucey Taylor , Boose Emery , Laflower Danelle , León-Sáenz Agustín , Wilson Barry T. , MacLean Meghan Graham , Thompson Jonathan R.
Published: November 2023

Nature-based climate solutions are championed as a primary tool to mitigate climate change, especially in forested regions capable of storing and sequestering vast amounts of carbon. New England is one of the most heavily forested regions in the United States (>75% forested by land area), and forest carbon is a significant component of regional climate mitigation strategies. Large infrequent disturbances, such as hurricanes, are a major source of uncertainty and risk for policies that rely on forest carbon for climate mitigation, especially as climate change is projected to alter the intensity and geographic extent of hurricanes. To date, most research into disturbance impacts on forest carbon stocks has focused on fire. Here we show that a single hurricane in the region can down between 121-250 MMTCO2e or 4.6-9.4% of the total aboveground forest carbon, much greater than the carbon sequestered annually by New England’s forests (16 MMTCO2e yr-1). However, the emissions from the storms are not instantaneous; it takes approximately 19 years for the downed carbon to become a net emission, and 100 years for 90% of the downed carbon to be emitted. Using hurricane reconstructions across a range of historical and projected wind speeds, we find that an 8% and 16% increase in hurricane wind speeds leads to a 10.7 and 24.8 fold increase in the extent of high-severity damaged areas (widespread tree mortality). Increased wind speed also leads to unprecedented geographical shifts in damage; both inland and northward into heavily forested regions traditionally unaffected by hurricanes. Given that a single hurricane can emit the equivalent of 10+ years of carbon sequestered by forests in New England, the status of these forests as a durable carbon sink is uncertain. Understanding the risks to forest carbon stocks from large infrequent disturbances is necessary for decision-makers relying on forests as a nature-based climate solution.