bluuebunny/crossref_metadata_2025 huggingface dataset:
Familial adversity: association with discontinuation of adjuvant hormone therapy and breast cancer prognosis
Authors: Zeng Erwei , He Wei , Sjölander Arvid , Bergqvist Jenny , Fang Fang , Czene Kamila
Published: March 2024

Background

Many studies have examined patient-related factors affecting adjuvant hormone therapy adherence in patients with breast cancer. Our study aimed to examine associations of family-related factors with adjuvant hormone therapy discontinuation and breast cancer–specific mortality.

Methods

By cross-linking 7 Swedish health registers, we performed a cohort study that included all patients with breast cancer who initiated adjuvant hormone therapy during 2006-2019 in Sweden (N = 10 701). A group-based multitrajectory model was used to identify familial adversity groups based on 3 dimensions: material deprivation, negative family dynamics, and loss or threat of loss. Cox proportional hazard models were used to investigate associations of familial adversity with hormone therapy discontinuation and breast cancer–specific mortality.

Results

We identified 5 distinctive familial adversity groups among the cohort participants. Compared with women who had low familial adversity, higher risks to discontinue adjuvant hormone therapy were observed among women with material deprivation (hazard ratio [HR] = 1.31, 95% confidence interval [CI] = 1.20 to 1.43), negative family dynamics (HR = 1.16, 95% CI = 1.06 to 1.28), loss or threat of loss (HR = 1.15, 95% CI = 1.00 to 1.32), or high familial adversity (HR = 1.53, 95% CI = 1.40 to 1.68). Furthermore, women with material deprivation (HR = 1.37, 95% CI = 1.05 to 1.79), negative family dynamics (HR = 1.41, 95% CI = 1.01 to 1.97), or high adversity (HR = 1.67, 95% CI = 1.26 to 2.23) were at higher risk of dying from breast cancer.

Conclusion

Familial adversity is associated with a higher risk of adjuvant hormone therapy discontinuation and breast cancer–specific mortality. Family-related factors identified in our study may help identify high-risk patients for interventions to prevent treatment discontinuation and subsequently improve breast cancer outcomes.
Δ(9)-tetrahydrocannabinol protects cardiac tissue against endoplasmic reticulum and oxidative stresses, apoptosis, and inflammation in rats with hyperinsulinemia
Authors: Coskun Yazici Zeynep Mine , Yanar Karolin , Bolkent Sema
Published: March 2024

Objectives

In our study, we aimed to examine how δ(9)-tetrahydrocannabinol (THC) administration to hyperinsulinemia (HI) model rats would change endoplasmic reticulum stress (ERS), apoptosis, inflammation, and oxidative stress in cardiac tissue.

Methods

Rats were divided into four groups (n = 32): Control (C), THC, HI, and Treatment (Tre). Fructose (10%) in the drinking water was given to HI and Tre rats for 12 weeks. 1.5 mg/kg/d THC was given intraperitoneally to THC and Tre rats in the last 4 weeks of the experiment. The mRNA expressions of ERS and apoptosis markers in the cardiac tissue were detected. TNF-α concentration and oxidative stress were also analyzed.

Key findings

THC treatment in rats with HI ameliorated the overexpression of GRP-78, IRE1α, ATF6, ATF4, CHOP, Cas-12, Cas-8, Cas-9, and Cas-3 mRNAs, markers of ERS and apoptosis (P < .0001 for all). In addition, THC has been shown to reduce inflammation in the Tre group by causing a decrease in increased cardiac TNF-α levels (P < .01). Moreover, THC prevented cardiac tissue damage by regulating the degraded oxidative stress marker levels and antioxidant enzyme activities in HI.

Conclusions

Our findings suggest that THC treatment in rats with HI exhibited a significant effect in ameliorating cardiac tissue damage by improving the antioxidant defense system, inflammation, apoptosis, ERS, and oxidative stress.
EDGE – Dark matter or astrophysics? Breaking dark matter heating degeneracies with H i rotation in faint dwarf galaxies
Authors: Rey Martin P , Orkney Matthew D A , Read Justin I , Das Payel , Agertz Oscar , Pontzen Andrew , Ponomareva Anastasia A , Kim Stacy Y , McClymont William
Published: March 2024

Low-mass dwarf galaxies are expected to reside within dark matter haloes that have a pristine, ‘cuspy’ density profile within their stellar half-light radii. This is because they form too few stars to significantly drive dark matter heating through supernova-driven outflows. Here, we study such simulated faint systems ($10^4 \le M_{\star }\le 2 \times 10^6 \, \mbox{M}_\mathrm{\odot }$) drawn from high-resolution (3 pc) cosmological simulations from the ‘Engineering Dwarf Galaxies at the Edge of galaxy formation’ (EDGE) project. We confirm that these objects have steep and rising inner dark matter density profiles at z = 0, little affected by galaxy formation effects. But five dwarf galaxies from the suite also showcase a detectable H i reservoir ($M_{\mathrm{H\, {\small I} }}\approx 10^{5}-10^{6} \, \mbox{M}_\mathrm{\odot }$), analogous to the observed population of faint, H i-bearing dwarf galaxies. These reservoirs exhibit episodes of ordered rotation, opening windows for rotation curve analysis. Within actively star-forming dwarfs, stellar feedback easily disrupts the tenuous H i discs ($v_{\phi , g}\approx 10\, \mathrm{km} \, \mathrm{s}^{-1}$), making rotation short-lived ($\ll 150 \, \mathrm{Myr}$) and more challenging to interpret for dark matter inferences. In contrast, we highlight a long-lived ($\ge 500 \, \mathrm{Myr}$) and easy-to-interpret H i rotation curve extending to $\approx 2\, r_{1/2, \text{3D}}$ in a quiescent dwarf, that has not formed new stars since z = 4. This stable gas disc is supported by an oblate dark matter halo shape that drives high-angular momentum gas flows. Our results strongly motivate further searches for H i in rotation curves in the observed population of H i-bearing low-mass dwarfs, that provide a key regime to disentangle the respective roles of dark matter microphysics and galaxy formation effects in driving dark matter heating.
Singleton mutations in large-scale cancer genome studies: uncovering the tail of cancer genome
Authors: Desai Sanket , Ahmad Suhail , Bawaskar Bhargavi , Rashmi Sonal , Mishra Rohit , Lakhwani Deepika , Dutt Amit
Published: March 2024

Singleton or low-frequency driver mutations are challenging to identify. We present a domain driver mutation estimator (DOME) to identify rare candidate driver mutations. DOME analyzes positions analogous to known statistical hotspots and resistant mutations in combination with their functional and biochemical residue context as determined by protein structures and somatic mutation propensity within conserved PFAM domains, integrating the CADD scoring scheme. Benchmarked against seven other tools, DOME exhibited superior or comparable accuracy compared to all evaluated tools in the prediction of functional cancer drivers, with the exception of one tool. DOME identified a unique set of 32 917 high-confidence predicted driver mutations from the analysis of whole proteome missense variants within domain boundaries across 1331 genes, including 1192 noncancer gene census genes, emphasizing its unique place in cancer genome analysis. Additionally, analysis of 8799 TCGA (The Cancer Genome Atlas) and in-house tumor samples revealed 847 potential driver mutations, with mutations in tyrosine kinase members forming the dominant burden, underscoring its higher significance in cancer. Overall, DOME complements current approaches for identifying novel, low-frequency drivers and resistant mutations in personalized therapy.
The AsiDNA™ decoy mimicking DSBs protects the normal tissue from radiation toxicity through a DNA-PK/p53/p21-dependent G1/S arrest
Authors: Sesink Anouk , Becerra Margaux , Ruan Jia-Ling , Leboucher Sophie , Dubail Maxime , Heinrich Sophie , Jdey Wael , Petersson Kristoffer , Fouillade Charles , Berthault Nathalie , Dutreix Marie , Girard Pierre-Marie
Published: March 2024

AsiDNA™, a cholesterol-coupled oligonucleotide mimicking double-stranded DNA breaks, was developed to sensitize tumour cells to radio- and chemotherapy. This drug acts as a decoy hijacking the DNA damage response. Previous studies have demonstrated that standalone AsiDNA™ administration is well tolerated with no additional adverse effects when combined with chemo- and/or radiotherapy. The lack of normal tissue complication encouraged further examination into the role of AsiDNA™ in normal cells. This research demonstrates the radioprotective properties of AsiDNA™. In vitro, AsiDNA™ induces a DNA-PK/p53/p21-dependent G1/S arrest in normal epithelial cells and fibroblasts that is absent in p53 deficient and proficient tumour cells. This cell cycle arrest improved survival after irradiation only in p53 proficient normal cells. Combined administration of AsiDNA™ with conventional radiotherapy in mouse models of late and early radiation toxicity resulted in decreased onset of lung fibrosis and increased intestinal crypt survival. Similar results were observed following FLASH radiotherapy in standalone or combined with AsiDNA™. Mechanisms comparable to those identified in vitro were detected both in vivo, in the intestine and ex vivo, in precision cut lung slices. Collectively, the results suggest that AsiDNA™ can partially protect healthy tissues from radiation toxicity by triggering a G1/S arrest in normal cells.
The impact of tRNA modifications on translation in cancer: identifying novel therapeutic avenues
Authors: Añazco-Guenkova Ana M , Miguel-López Borja , Monteagudo-García Óscar , García-Vílchez Raquel , Blanco Sandra
Published: March 2024

Recent advancements have illuminated the critical role of RNA modifications in post-transcriptional regulation, shaping the landscape of gene expression. This review explores how tRNA modifications emerge as critical players, fine-tuning functionalities that not only maintain the fidelity of protein synthesis but also dictate gene expression and translation profiles. Highlighting their dysregulation as a common denominator in various cancers, we systematically investigate the intersection of both cytosolic and mitochondrial tRNA modifications with cancer biology. These modifications impact key processes such as cell proliferation, tumorigenesis, migration, metastasis, bioenergetics and the modulation of the tumor immune microenvironment. The recurrence of altered tRNA modification patterns across different cancer types underscores their significance in cancer development, proposing them as potential biomarkers and as actionable targets to disrupt tumorigenic processes, offering new avenues for precision medicine in the battle against cancer.
mRNAid, an open-source platform for therapeutic mRNA design and optimization strategies
Authors: Vostrosablin Nikita , Lim Shuhui , Gopal Pooja , Brazdilova Kveta , Parajuli Sushmita , Wei Xiaona , Gromek Anna , Prihoda David , Spale Martin , Muzdalo Anja , Greig Jamie , Yeo Constance , Wardyn Joanna , Mejzlik Petr , Henry Brian , Partridge Anthony W , Bitton Danny A
Published: March 2024

Recent COVID-19 vaccines unleashed the potential of mRNA-based therapeutics. A common bottleneck across mRNA-based therapeutic approaches is the rapid design of mRNA sequences that are translationally efficient, long-lived and non-immunogenic. Currently, an accessible software tool to aid in the design of such high-quality mRNA is lacking. Here, we present mRNAid, an open-source platform for therapeutic mRNA optimization, design and visualization that offers a variety of optimization strategies for sequence and structural features, allowing one to customize desired properties into their mRNA sequence. We experimentally demonstrate that transcripts optimized by mRNAid have characteristics comparable with commercially available sequences. To encompass additional aspects of mRNA design, we experimentally show that incorporation of certain uridine analogs and untranslated regions can further enhance stability, boost protein output and mitigate undesired immunogenicity effects. Finally, this study provides a roadmap for rational design of therapeutic mRNA transcripts.
Ordered mesoporous nanofibers mimicking vascular bundles for lithium metal batteries
Authors: Zhu Xiaohang , Liu Mengmeng , Bu Fanxing , Yue Xin-Yang , Fei Xiang , Zhou Yong-Ning , Ju Anqi , Yang Jianping , Qiu Pengpeng , Xiao Qi , Lin Chao , Jiang Wan , Wang Lianjun , Li Xiaopeng , Luo Wei
Published: March 2024

Hierarchical self-assembly with long-range order above centimeters widely exists in nature. Mimicking similar structures to promote reaction kinetics of electrochemical energy devices is of immense interest, yet remains challenging. Here, we report a bottom-up self-assembly approach to constructing ordered mesoporous nanofibers with a structure resembling vascular bundles via electrospinning. The synthesis involves self-assembling polystyrene (PS) homopolymer, amphiphilic diblock copolymer, and precursors into supramolecular micelles. Elongational dynamics of viscoelastic micelle solution together with fast solvent evaporation during electrospinning cause simultaneous close packing and uniaxial stretching of micelles, consequently producing polymer nanofibers consisting of oriented micelles. The method is versatile for the fabrication of large-scale ordered mesoporous nanofibers with adjustable pore diameter and various compositions such as carbon, SiO2, TiO2 and WO3. The aligned longitudinal mesopores connected side-by-side by tiny pores offer highly exposed active sites and expedite electron/ion transport. The assembled electrodes deliver outstanding performance for lithium metal batteries.
Mysteriously rapid rise in Legionnaires’ disease incidence correlates with declining atmospheric sulfur dioxide
Authors: Yu Fangqun , Nair Arshad A , Lauper Ursula , Luo Gan , Herb Jason , Morse Matthew , Savage Braden , Zartarian Martin , Wang Meng , Lin Shao
Published: March 2024

Legionnaires’ disease (LD) is a severe form of pneumonia (∼10–25% fatality rate) caused by inhalation of aerosols containing Legionella, a pathogenic gram-negative bacteria. These bacteria can grow, spread, and aerosolize through building water systems. A recent dramatic increase in LD incidence has been observed globally, with a 9-fold increase in the United States from 2000 to 2018, and with disproportionately higher burden for socioeconomically vulnerable subgroups. Despite the focus of decades of research since the infamous 1976 outbreak, substantial knowledge gaps remain with regard to source of exposure and the reason(s) for the dramatic increase in LD incidence. Here, we rule out factors indicated in literature to contribute to its long-term increases and identify a hitherto unexplored explanatory factor. We also provide an epidemiological demonstration that the occurrence of LD is linked with exposure to cooling towers (CTs). Our results suggest that declining sulfur dioxide air pollution, which has many well-established health benefits, results in reduced acidity of aerosols emitted from CTs, which may prolong the survival duration of Legionella in contaminated CT droplets and contribute to the increase in LD incidence. Mechanistically associating decreasing aerosol acidity with this respiratory disease has implications for better understanding its transmission, predicting future risks, and informed design of preventive and interventional strategies that consider the complex impacts of continued sulfur dioxide changes.
Misinformation and harmful language are interconnected, rather than distinct, challenges
Authors: Mosleh Mohsen , Cole Rocky , Rand David G
Published: March 2024

There is considerable concern about users posting misinformation and harmful language on social media. Substantial—yet largely distinct—bodies of research have studied these two kinds of problematic content. Here, we shed light on both research streams by examining the relationship between the sharing of misinformation and the use of harmful language. We do so by creating and analyzing a dataset of 8,687,758 posts from N = 6,832 Twitter (now called X) users, and a dataset of N = 14,617 true and false headlines from professional fact-checking websites. Our analyses reveal substantial positive associations between misinformation and harmful language. On average, Twitter posts containing links to lower-quality news outlets also contain more harmful language (β = 0.10); and false headlines contain more harmful language than true headlines (β = 0.19). Additionally, Twitter users who share links to lower-quality news sources also use more harmful language—even in non-news posts that are unrelated to (mis)information (β = 0.13). These consistent findings across different datasets and levels of analysis suggest that misinformation and harmful language are related in important ways, rather than being distinct phenomena. At the same, however, the strength of associations is not sufficiently high to make the presence of harmful language a useful diagnostic for information quality: most low-quality information does not contain harmful language, and a considerable fraction of high-quality information does contain harmful language. Overall, our results underscore important opportunities to integrate these largely disconnected strands of research and understand their psychological connections.
Current and future advances in practice: aromatase inhibitor–induced arthralgia
Authors: Kim Sara , Chen Nan , Reid Pankti
Published: March 2024

Aromatase inhibitors (AIs) have shown great success as adjuvant therapy for post-menopausal women with hormone receptor–positive breast cancers. AI-induced arthralgia (AIA) is a frequent AI toxicity contributing to non-adherence and discontinuation. This review aims to understand current knowledge of AIA. The mean incidence of AIA was 39.1% and the mean discontinuation of AI therapy due to AIA was 9.3%. Most of the AIAs were non-inflammatory. A shorter time since the last menstrual period and pre-existing joint pain were risk factors. Vitamin D3 supplementation may be a preventative measure and treatment with duloxetine, acupuncture and/or exercise is supported by large randomized controlled trials. There was consistent improvement in AIAs with switching to an alternate AI, and this could additionally allow continuation of cancer treatment with AI. Further research is needed to identify predictive biomarkers, better characterize AIA subcategories and study more reliable therapeutic options.
A double-network porous hydrogel based on high internal phase emulsions as a vehicle for potassium sucrose octasulfate delivery accelerates diabetic wound healing
Authors: Wang Zhiwei , Sun Lingshun , Wang Weixing , Wang Zheng , Shi Ge , Dai Honglian , Yu Aixi
Published: March 2024

Diabetic wounds are a difficult medical challenge. Excessive secretion of matrix metalloproteinase-9 (MMP-9) in diabetic wounds further degrades the extracellular matrix and growth factors and causes severe vascular damage, which seriously hinders diabetic wound healing. To solve these issues, a double-network porous hydrogel composed of poly (methyl methacrylate-co-acrylamide) (p(MMA-co-AM)) and polyvinyl alcohol (PVA) was constructed by the high internal phase emulsion (HIPE) technique for the delivery of potassium sucrose octasulfate (PSO), a drug that can inhibit MMPs, increase angiogenesis and improve microcirculation. The hydrogel possessed a typical polyHIPE hierarchical microstructure with interconnected porous morphologies, high porosity, high specific surface area, excellent mechanical properties and suitable swelling properties. Meanwhile, the p(MMA-co-AM)/PVA@PSO hydrogel showed high drug-loading performance and effective PSO release. In addition, both in vitro and in vivo studies showed that the p(MMA-co-AM)/PVA@PSO hydrogel had good biocompatibility and significantly accelerated diabetic wound healing by inhibiting excessive MMP-9 in diabetic wounds, increasing growth factor secretion, improving vascularization, increasing collagen deposition and promoting re-epithelialization. Therefore, this study provided a reliable therapeutic strategy for diabetic wound healing, some theoretical basis and new insights for the rational design and preparation of wound hydrogel dressings with high porosity, high drug-loading performance and excellent mechanical properties.
National Beef Quality Audit-2022 Phase 1: face-to-face and digital interviews
Authors: Smith Colton L , Thompson Tyler W , Harr Keayla , Goretska Macey , Mayer Thachary R , Schwartz Trent E , Borders Sydni E , Gehring Kerri B , Bass Phil D , Pfeiffer Morgan M , Mafi Gretchen G , Pendell Dustin L , Morgan J Brad , Griffin Davey B , Savell Jeffrey W , Scanga John A , Nair Mahesh N , Belk Keith E
Published: March 2024

The National Beef Quality Audit (NBQA) has been conducted regularly since 1991 to assess and benchmark quality in the U.S. beef industry, with the most recent iteration conducted in 2022. The goal of NBQA Phase I is to evaluate what needs to be managed to improve beef quality and demand. Interviews (n = 130) of industry personnel were conducted with the aid of routing software. In total, packers (n = 24), retailers (n = 20), further processors (n = 26), foodservice (n = 18), and allied government agencies and trade organizations (n = 42) were interviewed. Interviews were routed in software based on interviewee involvement in either the fed steer and heifer market cow and bull sectors, or both. Interviews were structured to elicit random responses in the order of determining “must-have” criteria (quality factors that are required to make a purchase), best/worst ranking (of quality factors based on importance), how interviewees defined quality terms, a strength, weakness, opportunities, threats (SWOT) analysis, general beef industry questions, and sustainability goals (the latter four being open-ended). Quality factors were 1) visual characteristics, 2) cattle genetics, 3) food safety, 4) eating satisfaction, 5) animal well-being, 6) weight and size, and 7) lean, fat, and bone. Best/worst analysis revealed that “food safety” was the most (P < 0.05) important factor in beef purchasing decisions for all market sectors and frequently was described as “everything” and “a way of business.” Culture surrounding food safety changed compared to previous NBQAs with interviewees no longer considering food safety as a purchasing criterion, but rather as a market expectation. The SWOT analysis indicated that “eating quality of U.S. beef” was the greatest strength, and cited that educating both consumers and producers on beef production would benefit the industry. Irrespective of whether companies’ products were fed or market cow/bull beef, respondents said that they believed “environmental concerns” were among the major threats to the industry. Perceived image of the beef industry in the market sectors has improved since NBQA-2016 for both fed cattle and market cow/bull beef.
Implementation support for the data-driven components of care in a multisite network of coordinated specialty care programs
Authors: Oluwoye Oladunni , Siddiqi Khairul A , Stokes Bryony , Stokes Sheldon
Published: March 2024

Beyond training providers prior to the roll-out of coordinated specialty care (CSC) for first-episode psychosis in clinical settings, implementation support for data-informed care remains an area that has received very little attention. The current paper describes the development and refinement of implementation support for the data-driven components of care in the New Journeys network, Washington State’s CSC model for psychosis, comprised of 14 CSC programs. Using the Evidence-Based System for Innovation Support Logic Model, this paper outlines the individual components for implementation support, tools, training, technical assistance, and quality improvement/evaluation that have been developed for the New Journeys network. We present examples of modifications that have occurred over nine years to address the needs of clients, providers, and state-level network administrators to facilitate the data-driven components of care. We conclude with recommendations based on lessons learned in Washington State aimed at improving implementation of data-driven care in CSC models throughout the USA.
Swine influenza A virus infection dynamics and evolution in intensive pig production systems
Authors: Lagan Paula , Hamil Michael , Cull Susan , Hanrahan Anthony , Wregor Rosanna M , Lemon Ken
Published: March 2024

Swine influenza A virus (swIAV) is one of the main viral pathogens responsible for respiratory disease in farmed pigs. While outbreaks are often epidemic in nature, increasing reports suggest that continuous, endemic infection of herds is now common. The move towards larger herd sizes and increased intensification in the commercial pig industry may promote endemic infection; however, the impact that intensification has on swIAV infection dynamics and evolution is unclear. We carried out a longitudinal surveillance study for over 18 months on two enzootically infected, intensive, indoor, and multi-site pig production flows. Frequent sampling of all production stages using individual and group sampling methods was performed, followed by virological and immunological testing and whole-genome sequencing. We identified weaned pigs between 4 and 12-weeks old as the main reservoir of swIAV in the production flows, with continuous, year-round infection. Despite the continuous nature of viral circulation, infection levels were not uniform, with increasing exposure at the herd level associated with reduced viral prevalence followed by subsequent rebound infection. A single virus subtype was maintained on each farm for the entire duration of the study. Viral evolution was characterised by long periods of stasis punctuated by periods of rapid change coinciding with increasing exposure within the herd. An accumulation of mutations in the surface glycoproteins consistent with antigenic drift was observed, in addition to amino acid substitutions in the internal gene products as well as reassortment exchange of internal gene segments from newly introduced strains. These data demonstrate that long-term, continuous infection of herds with a single subtype is possible and document the evolutionary mechanisms utilised to achieve this.
Spontaneous Hypothermia As an Indicator of Early Diffuse Anoxic Brain Injury in Post-Cardiac Arrest Patients
Authors: Palka Sydney V. , Gonillo-Davis Jenna A. , George Benjamin P. , McHugh Daryl C.
Published: March 2024

OBJECTIVES:

To determine the association between spontaneous hypothermia (SH), defined as initial post-resuscitation core body temperature less than 34°C, and diffuse anoxic brain injury (DABI) on initial CT scan of the head (CTH) in post-cardiac arrest patients.

DESIGN, SETTING, AND PARTICIPANTS:

This was a retrospective, observational cohort study. This study was performed at the University of Rochester Medical Center Strong Memorial Hospital. All in-hospital and out-of-hospital cardiac arrest patients with return of spontaneous circulation admitted between January 1, 2022, and October 31, 2022, were included.

MAIN OUTCOMES AND MEASURES:

The primary outcomes were the odds of DABI on initial CTH for patients with SH compared with patients without SH post-cardiac arrest using a multivariable logistic regression controlling for patient covariates including basic demographics and arrest features. DABI on initial CTH was measured qualitatively and quantitatively using neuroradiologist interpretation and calculated gray-white matter ratio of the basal ganglia, respectively. Secondary outcome measures included length of stay (LOS), inpatient mortality, and those who underwent withdrawal of life-sustaining therapy (WOLST) or progression to brain death.

RESULTS:

Out of the observed 150 cases of cardiac arrest, 31 patients (21%) had SH. Of the 128 patients who had an initial CTH performed, 27 (21%) had DABI. The adjusted odds ratio of DABI on initial CTH associated with SH was 3.55 (95% CI, 1.08–11.64; p = 0.036) and 2.18 (95% CI, 0.69–6.91; p = 0.182) when DABI was measured qualitatively and quantitatively, respectively, after controlling for multiple covariates. There was a difference observed in LOS between the groups (3 vs. 10 d; p = 0.0005) and this was driven by early WOLST.

CONCLUSIONS AND REVELANCE:

Patients presenting with SH after cardiac arrest may be at greater risk of early DABI on initial CTH compared with those with higher body temperatures in the post-arrest period. Recognition of early SH may help to risk stratify post-cardiac arrest patients at highest risk of DABI.
Modified percutaneous nephropexy for nephroptosis: Technical description and short-term results
Authors: Liu Honglei , Gao Wenzhi , Zhang Zheng , Yang Kunlin , Meng Chang , Wang Bing , Han Yangjun , Diao Mingxin , Zuo Chao , Zhang Minghua , Diao Yingzhi , Li Zhihua , Li Xinfei , Wang Gang , Wang Chunji , Gao Zihui , Gu Yaming , Li Xuesong
Published: March 2024

Objectives

Percutaneous nephropexy (PCN) has been demonstrated as a feasible method for treating nephroptosis. This study describes an improved technique for PCN that better addresses the issue of nephroptosis.

Materials and methods

We reviewed 4 patients who underwent the improved PCN procedure between January 2021 and January 2023. These patients were diagnosed with nephroptosis, with 1 case having both a narrow ureteropelvic junction and nephroptosis due to a kidney stone, and 3 cases having simple nephroptosis. Patient characteristics, perioperative data, and follow-up results were collected. Surgical success was determined by symptom relief (subjective success) and the absence of kidney descent by intravenous pyelography (objective success).

Results

Preoperative computed tomography urography showed that all patients had hydronephrosis, with severe hydronephrosis in 75% (3/4) and moderate hydronephrosis in 25% (1/4) of cases. The mean operative time was 63.8 minutes (range, 45–95 minutes), and the mean blood loss was 5 mL (range, 5–50 mL). The mean length of hospital stay was 4.5 days (range, 3–6 days). The mean time to removal of the nephrostomy tube was 2 months (range, 1–4 months). No serious complications (Clavien-Dindo grade ≥3) occurred during or after the procedure. The mean postoperative serum creatinine level was 54.75 μmoI/L (range, 43–65 μmoI/L). The mean follow-up time was 6.25 months (range, 4–8 months). The objective and subjective success rates were both 100%.

Conclusions

The improved PCN procedure that was used in this study is feasible and provides a good option for treating nephroptosis.
Prevalence and influencing factors of social alienation among elderly patients undergoing radical prostatectomy for prostate cancer
Authors: Fang Xiao , Ren Kong , Li Yan , Meng Qiao , Li Mingyue , Miao Miao , Zhan Jing , Wang Xia , Wu Fei , Zhang Meixia
Published: March 2024

Objectives

This study aims to not only investigate the prevalence of social alienation among elderly patients undergoing radical prostatectomy for prostate cancer but also identify the contributing factors.

Materials and methods

A total of 245 elderly patients diagnosed with prostate cancer and undergoing radical prostatectomy at a tertiary care general hospital in Jinan were included in this study. To assess the patients, several questionnaires were used. These included the General Situation Questionnaire, General Alienation Scale, Social Impact Scale, Modified Memorial Anxiety Scale for Prostate Cancer, and Perceived Social Support Scale. Pearson correlation analysis was conducted to examine the relationships between variables, whereas multiple linear regression was used to identify the factors influencing social alienation among patients who underwent radical prostatectomy.

Results

Patients who underwent radical prostatectomy had a mean total score of 44.13 ± 7.24 on the Social Alienation Scale. The results of the Pearson correlation analysis indicated that social alienation showed an inverse association with social support (r= −0.627,p< 0.05) and positive associations with age, disease stigma, and anxiety (r= 0.325, 0.575, 0.421, allp’s < 0.01) among patients who underwent radical prostatectomy. The findings from multiple linear regression analysis demonstrated that educational level, age, urinary incontinence, disease stigma, anxiety, and social support significantly influenced social alienation among elderly patients who underwent radical prostatectomy (p< 0.05).

Conclusions

Elderly patients who undergo radical prostatectomy often experience social alienation. This study found that social alienation was associated with factors such as educational level, age, urinary incontinence, social support, anxiety, and disease stigma. Consequently, healthcare providers should actively monitor the degree of social alienation in elderly patients after radical prostatectomy and provide suitable psychological care to facilitate positive social reintegration and alleviate their feelings of social alienation.
ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR TREATMENT IN DIABETIC MACULAR EDEMA
Authors: Zur Dinah , Hod Keren , Trivizki Omer , Rabinovitch David , Schwartz Shulamit , Shulman Shiri
Published: March 2024

Purpose:

To explore visual acuity (VA) outcomes of anti–vascular endothelial growth factor (VEGF) intravitreal injections in treatment-naive eyes with diabetic macular edema (DME), with bevacizumab as first-line treatment.

Methods:

Retrospective single-center cohort study over a three-year follow-up. Overall, 1765 eyes from 1179 patients treated with intravitreal injections were evaluated. The cohort was divided according to the treatment given: (1) bevacizumab monotherapy, (2) eyes switched to a second-line agent, and (3) eyes switched to a third-line agent.

Results:

In total, 644 eyes of 444 patients met inclusion criteria. The mean age at presentation was 64.0 ± 11.1 years. The mean follow-up period was 24.6 ± 12.4 months. Furthermore, 67.1% of eyes were treated with bevacizumab monotherapy, 25.45% switched to a second-line agent, and 7.45% were switched to a third-line agent. The mean number of injections decreased significantly during each treatment year in the total cohort and within each treatment group (P < 0.001). Mean VA for the total cohort and within each treatment group improved significantly throughout follow-up (P < 0.001). No significant difference in VA was found between the groups (P = 0.373).

Conclusion:

This real-world study demonstrates robust and consistent VA gains over long-term follow-up in eyes with DME treated with either bevacizumab monotherapy or switching to alternative anti-VEGF agents in cases of suboptimal response.
CONCENTRIC MACULAR RINGS SIGN IN COMBINED HAMARTOMA OF RETINA AND RETINAL PIGMENT EPITHELIUM
Authors: da Silva Conci Lívia , Maia Renata Martins , Cavalcanti Lira Rodrigo Pessoa , Zacharias Leandro Cabral , Cunha de Souza Eduardo , Gianotti Pimentel Sergio Luis , Shields Carol
Published: March 2024

Purpose:

To describe two cases of concentric macular rings (CMR) sign in patients with combined hamartoma of retina and retinal pigment epithelium (CHRRPE).

Methods:

History and clinical examination, spectral-domain optical coherence tomography (SD-OCT), and optic coherence tomography angiography (OCTA)

Results:

The first patient was a 26-year-old woman with clinical diagnosis of Neurofibromatosis type 2. The Best-Corrected Visual Acuity (BCVA) was 20/25 in the right eye (OD) and 20/20 in the left eye (OS). She presented a subtle grayish lesion in the macular region of OD. On macular SD-OCT, there was a thickened and disorganized retina, suggestive of CHRRPE. In addition, at the parafoveal region, there was a dentate pattern in the outer plexiform layer (OPL) and Henle fiber layer (HFL) on cross-sectional SD-OCT. OCTA showed no foveal avascular zone (FAZ) in OD and Optos ultra-wide-field revealed CMR sign in this eye. The second patient was a 14-year-old boy, with diabetes mellitus type 1. His BCVA was 20/25 in OD and 20/20 in OS. He had a subtle whitish lesion in the macular region of OD, with SD-OCT findings suggestive of CHRRPE. Similar to the first case, there was a dentate pattern in the OPL and HFL, on SD-OCT. In OD, blue reflectance images exhibited the CMR sign, and OCTA showed absent FAZ.

Conclusion:

CHRRPE may be related to changes in the OPL and HFL interface and may present the CMR sign.
Double-Bubble Technique Assisted by Holding Forceps: A Modified Technique in Descemet Membrane Endothelial Keratoplasty for Vitrectomized Eyes With Scleral Fixated Intraocular Lens
Authors: Igarashi Ami , Yokogawa Hideaki , Shimizu Toshiki , Kobayashi Akira , Yamagami Satoru , Hayashi Takahiko
Published: March 2024

Purpose:

Several techniques have been developed for graft unfolding approaches in Descemet membrane endothelial keratoplasty (DMEK). However, despite these techniques, graft deployment and configuration in eyes with deep anterior chambers remain challenging in some cases. Therefore, in this study, we described a modified technique for DMEK, known as the “double-bubble technique assisted by holding forceps.”

Methods:

This was a retrospective interventional case series. Patients who underwent DMEK between August 2022 and July 2023, including cases with a history of vitrectomy and scleral fixation of intraocular lens, were enrolled in this study. Two experienced surgeons performed DMEK. In brief, after graft insertion into the anterior chamber, the first bubble with a small volume of air was injected above the graft to open the tight roll, and the graft edge was held using a 25-gauge graft manipulator. The second bubble was injected underneath the graft for fixation, while the graft edge was grasped using forceps during gas injection. The graft was released from the forceps. Best spectacle corrected visual acuity, central corneal thickness, endothelial cell density, and incidence of postoperative complications were measured before and after DMEK.

Results:

Eleven eyes of 11 patients were included in this study (mean follow-up period, 4.5 ± 4.4 months). Best spectacle corrected visual acuity and central corneal thickness significantly improved postoperatively (P < 0.001). Rebubbling was required in 2 eyes; no other postoperative complications or primary graft failure were observed.

Conclusions:

The present technique enables safe and feasible DMEK surgery in vitrectomized eyes with scleral fixated IOLs and in those with a deep anterior chamber.
Traumatic flap dehiscence 15 years after LASIK: case report and review of the literature
Authors: Slavinsky Victoria , Mahan Marielle , Donovan Kelsey , Turlapati Namratha , Lustbader Jay
Published: March 2024

Introduction:

Corneal flap trauma rarely occurs years after laser in situ keratomileusis (LASIK), and management is not standardized. The authors report a case of LASIK flap dehiscence 15 years postoperatively with a review of the literature describing clinical characteristics, management, and outcomes of similar cases occurring at least 6 years postoperatively.

Patient and Clinical Findings:

A 55-year-old man with a history of LASIK surgery 15 years prior presented with flap dehiscence after trauma with a tree branch. His right eye uncorrected distance visual acuity (UDVA) at presentation was counting fingers. On slitlamp examination, the medial flap edge was folded underneath the temporal aspect.

Diagnosis, Intervention, and Outcomes:

The flap was unfolded, irrigated, repositioned, and instilled with topical antibiotics. The patient was started on prednisolone acetate 1% and moxifloxacin. On postoperative day 1, his UDVA improved to 20/50 and the flap remained centered and clear. His vision stabilized at 20/30 after 7 months. Peripheral epithelial ingrowth was noted without visual axis obscuration.

Conclusions:

This case, along with 20 reported instances of late traumatic flap dehiscence, highlights that early recognition with prompt intervention can optimize visual outcomes. Comparison of injury mechanisms, treatments, and complications may guide surgeons in patient counseling and care.
Suicide by Gunshot Wound to the Posterior Head and Neck: A Retrospective Case Series and Review of the Literature
Authors: Bovio Nicholas R. , Brooks Jared K. , Prahlow Joseph A.
Published: March 2024

Suicide by firearm is a significant public health concern in specific regions of the world. Depending on firearm availability, any type of firearm may be used, including handguns, shotguns, and long rifles. Common entrance wound sites in suicidal gunshot wounds include the head, with classic gunshot wound locations including the temple, the forehead, the submental aspect of the chin, and inside the mouth. Occasionally, suicidal gunshot wounds occur in atypical body locations such as the back of the head and neck. Given their relative rarity, suicidal gunshot wounds in these regions may be mistaken for homicides. In this report, we present 5 cases of suicidal gunshot wounds to the back of the head and/or neck. In our series, we focus on differentiating each case from homicides involving gunshot wounds in similar areas of the head and neck.
Patient Safety Indicators During the Initial COVID-19 Pandemic Surge in the United States
Authors: Rodriguez Jorge A. , Samal Lipika , Ganesan Sandya , Yuan Nina H. , Wien Matthew , Ng Kenney , Huang Hu , Park Yoonyoung , Rajmane Amol , Jackson Gretchen Purcell , Lipsitz Stuart R. , Bates David W. , Levine David M.
Published: March 2024

Objective

The COVID-19 pandemic presented a challenge to inpatient safety. It is unknown whether there were spillover effects due to COVID-19 into non–COVID-19 care and safety. We sought to evaluate the changes in inpatient Agency for Healthcare Research and Quality patient safety indicators (PSIs) in the United States before and during the first surge of the pandemic among patients admitted without COVID-19.

Methods

We analyzed trends in PSIs from January 2019 to June 2020 in patients without COVID-19 using data from IBM MarketScan Commercial Database. We included members of employer-sponsored or Medicare supplemental health plans with inpatient, non–COVID-19 admissions. The primary outcomes were risk-adjusted composite and individual PSIs.

Results

We analyzed 1,869,430 patients admitted without COVID-19. Among patients without COVID-19, the composite PSI score was not significantly different when comparing the first surge (Q2 2020) to the prepandemic period (e.g., Q2 2020 score of 2.46 [95% confidence interval {CI}, 2.34–2.58] versus Q1 2020 score of 2.37 [95% CI, 2.27–2.46]; P = 0.22). Individual PSIs for these patients during Q2 2020 were also not significantly different, except in-hospital fall with hip fracture (e.g., Q2 2020 was 3.42 [95% CI, 3.34–3.49] versus Q4 2019 was 2.45 [95% CI, 2.40–2.50]; P = 0.01).

Conclusions

The first surge of COVID-19 was not associated with worse inpatient safety for patients without COVID-19, highlighting the ability of the healthcare system to respond to the initial surge of the pandemic.
Detection Rate of Small Pancreas Cysts and Intrareader Reliability of the Cysts Size Measurements on Transabdominal Ultrasonography
Authors: Yoon Do Won , Kim Dong Kyu , Kim Taeho , Lee Kyu-Chong
Published: March 2024

This study aimed to assess the detection rate of small (<10 mm) pancreas cyst and intrareader reliability for cyst size measurements on transabdominal ultrasonography (US). From 2020 to 2022, 194 pancreas cysts in 173 patients, incidentally detected on computed tomography or magnetic resonance imaging, were evaluated on US by 1 of 2 radiologists (readers 1 and 2). Intrareader agreements of cyst size measurements on US were assessed by intraclass correlation coefficient (ICC). Bland-Altman plot was used to visualize the differences between the first and second size measurements in each reader. In this study, readers 1 and 2 evaluated 86 cysts in 76 patients and 108 cysts in 97 patients, respectively. Most of the cysts (191 of 194) were located in the nontail portion of the pancreas. Overall detection rate of pancreas cysts by US was 92.3% (179 of 194). The mean size of measured 179 pancreas cysts was 4.7 ± 1.5 mm. The readers showed excellent intrareader agreements (ICC = 0.925 and 0.960) for cyst size measurements, except for the cysts with size ≤5 mm, where both readers showed good intrareader agreements (ICC = 0.848 and 0.873). The 95% limits of agreement of readers 1 and 2 were 13.8% and 14.9% of the mean, respectively. Therefore, transabdominal US could be a reliable follow-up imaging modality for small (<10 mm) nontail pancreas cysts incidentally detected on computed tomography or magnetic resonance imaging, especially for the cysts with size between 5 and 10 mm. Size changes of the pancreas cysts approximately less than 15% may be within the measurement error.
Application of Mass Cytometry Platforms to Solid Organ Transplantation
Authors: Zhang Wenming , Sen Ayantika , Pena Josselyn K. , Reitsma Andrea , Alexander Oliver C. , Tajima Tetsuya , Martinez Olivia M. , Krams Sheri M.
Published: March 2024

Transplantation serves as the cornerstone of treatment for patients with end-stage organ disease. The prevalence of complications, such as allograft rejection, infection, and malignancies, underscores the need to dissect the complex interactions of the immune system at the single-cell level. In this review, we discuss studies using mass cytometry or cytometry by time-of-flight, a cutting-edge technology enabling the characterization of immune populations and cell-to-cell interactions in granular detail. We review the application of mass cytometry in human and experimental animal studies in the context of transplantation, uncovering invaluable contributions of the tool to understanding rejection and other transplant-related complications. We discuss recent innovations that have the potential to streamline and standardize mass cytometry workflows for application to multisite clinical trials. Additionally, we introduce imaging mass cytometry, a technique that couples the power of mass cytometry with spatial context, thereby mapping cellular interactions within tissue microenvironments. The synergistic integration of mass cytometry and imaging mass cytometry data with other omics data sets and high-dimensional data platforms to further define immune dynamics is discussed. In conclusion, mass cytometry technologies, when integrated with other tools and data, shed light on the intricate landscape of the immune response in transplantation. This approach holds significant potential for enhancing patient outcomes by advancing our understanding and facilitating the development of new diagnostics and therapeutics.