bluuebunny/crossref_metadata_2025 huggingface dataset:
Revisiting a flux recovery systematic error arising from common deconvolution methods used in aperture-synthesis imaging
Authors: Radcliffe Jack F , Beswick R J , Thomson A P , Njeri A , Muxlow T W B
Published: September 2023

The point-spread function (PSF) is a fundamental property of any astronomical instrument. In interferometers, differing array configurations combined with their uv coverage, and various weighting schemes can produce an irregular but deterministic PSF. As a result, the PSF is often deconvolved using CLEAN-style algorithms to improve image fidelity. In this paper, we revisit a significant effect that causes the flux densities measured with any interferometer to be systematically offset from the true values. Using a suite of carefully controlled simulations, we show that the systematic offset originates from a mismatch in the units of the image produced by these CLEAN-style algorithms. We illustrate that this systematic error can be significant, ranging from a few to tens of per cent. Accounting for this effect is important for current and future interferometric arrays, such as MeerKAT, LOFAR, and the SKA, whose core-dominated configuration naturally causes an irregular PSF. We show that this offset is independent of other systematics, and can worsen due to some factors such as the goodness of the fit to the PSF, the deconvolution depth, and the signal-to-noise ratio of the source. Finally, we present several methods that can reduce this effect to just a few per cent.
Types of Termination in Clinical Music Therapy Practice: A Qualitative Inquiry
Authors: Abbott Elaine A
Published: September 2023

To support student learning about clinical music therapy termination processes, a qualitative research method was used to address three research questions: (a) What are the current termination practices of music therapists from multiple clinical settings? (b) What types of termination practices might they describe? and (c) What processes do they move through in their termination practices? Forty-six music therapists were interviewed about their experiences of clinical termination in music therapy. They described 134 termination scenarios that took place in 18 different types of clinical settings. Inductive thematic analysis of the scenarios identified several themes, one of which is addressed in this paper: termination types. Nine types of termination processes are described in the results. The types were described using the salient features of the termination scenarios. Identifying termination types in this way has the potential to provide students and clinicians with ways to think critically and creatively about what it means to effectively terminate a therapeutic relationship and about what effective termination can look like in different clinical settings.
Quantifying the arms race between LINE-1 and KRAB-zinc finger genes through TECookbook
Authors: Zuo Zheng
Published: September 2023

To defend against the invasion of transposons, hundreds of KRAB-zinc finger genes (ZNFs) evolved to recognize and silence various repeat families specifically. However, most repeat elements reside in the human genome with high copy numbers, making the ChIP-seq reads of ZNFs targeting these repeats predominantly multi-mapping reads. This complicates downstream data analysis and signal quantification. To better visualize and quantify the arms race between transposons and ZNFs, the R package TECookbook has been developed to lift ChIP-seq data into reference repeat coordinates with proper normalization and extract all putative ZNF binding sites from defined loci of reference repeats for downstream analysis. In conjunction with specificity profiles derived from in vitro Spec-seq data, human ZNF10 has been found to bind to a conserved ORF2 locus of selected LINE-1 subfamilies. This provides insight into how LINE-1 evaded capture at least twice and was subsequently recaptured by ZNF10 during evolutionary history. Through similar analyses, ZNF382 and ZNF248 were shown to be broad-spectrum LINE-1 binders. Overall, this work establishes a general analysis workflow to decipher the arms race between ZNFs and transposons through nucleotide substitutions rather than structural variations, particularly in the protein-coding region of transposons.
Effects of lifestyle-based interventions to improve Mediterranean diet adherence among the young population: a meta-analysis of randomized controlled trials
Authors: López-Gil José Francisco , Victoria-Montesinos Desirée , García-Hermoso Antonio
Published: September 2023

Context

Despite the large number of studies published to date, the effect of lifestyle-based interventions on improving adherence to the Mediterranean diet (MedDiet) in young people has not been meta-analyzed.

Objective

The aim of the present systematic review and meta-analysis was two-fold: (1) to determine the pooled intervention effects of lifestyle-based interventions on improving adherence to the MedDiet in a young population aged 3 years–18 years and (2) to examine the potential factors related to those intervention effects.

Data Sources

A systematic search of the MEDLINE (via PubMed), Scopus, Cochrane Library, and Web of Science databases was performed from their inception until June 15, 2023.

Data Extraction

Different meta-analyses were independently performed to observe the effect of lifestyle-based interventions on adherence to the MedDiet (according to the Mediterranean Diet Quality Index in children and adolescents [KIDMED]).

Data Analysis

Compared with the control group, the intervention group showed a small increase in KIDMED score (d = .27; 95% confidence interval [CI], .11 to .43; P < .001; I2 = 89.7%). Similarly, participants in the lifestyle-based intervention groups had a 14% higher probability of achieving optimal adherence to the MedDiet (risk difference = .14; 95% CI, .02 to .26; P = .023; I2 = 96.8%). Greater improvements in achieving optimal adherence to the MedDiet were found in interventions delivered out of school (risk difference = .24, 95% CI, .04 to .44; I2 = 88.4%), those aimed at parents or at both children and parents (risk difference = .20, 95% CI, .07 to .34; I2 = 98.2%), and those including only participants with overweight/obesity (risk difference = .34, 95% CI, .15 to .52; I2 = .0%).

Conclusion

Healthy lifestyle-based interventions seem to be effective in increasing adherence to the MedDiet and in achieving optimal adherence to this dietary pattern among children and adolescents.

Systematic Review Registration

PROSPERO registration no. CRD2022369409.
Shifts in survival and reproduction after chronic warming enhance the potential of a marine copepod to persist under extreme heat events
Authors: de Juan Carlos , Calbet Albert , Saiz Enric
Published: September 2023

The study of a species’ thermal tolerance and vital rates responses provides useful metrics to characterize its vulnerability to ocean warming. Under prolonged thermal stress, plastic and adaptive processes can adjust the physiology of organisms. Yet it is uncertain whether the species can expand their upper thermal limits to cope with rapid and extreme changes in environmental temperature. In this study, we reared the marine copepod Paracartia grani at control (19°C) and warmer conditions (25°C) for >18 generations and assessed their survival and fecundity under short-term exposure to a range of temperatures (11–34°C). After multigenerational warming, the upper tolerance to acute exposure (24 h) increased by 1–1.3°C, although this enhancement decreased to 0.3–0.8°C after longer thermal stress (7 days). Warm-reared copepods were smaller and produced significantly fewer offspring at the optimum temperature. No shift in the thermal breadth of the reproductive response was observed. Yet the fecundity rates of the warm-reared copepods in the upper thermal range were up to 21-fold higher than the control. Our results show that chronic warming improved tolerance to stress temperatures and fecundity of P. grani, therefore, enhancing its chances to persist under extreme heat events.
Representation and Extrapolation: Evidence from Clinical Trials
Authors: Alsan Marcella , Durvasula Maya , Gupta Harsh , Schwartzstein Joshua , Williams Heidi
Published: September 2023

This article examines the consequences and causes of low enrollment of Black patients in clinical trials. We develop a simple model of similarity-based extrapolation that predicts that evidence is more relevant for decision-making by physicians and patients when it is more representative of the group being treated. This generates the key result that the perceived benefit of a medicine for a group depends not only on the average benefit from a trial but also on the share of patients from that group who were enrolled in the trial. In survey experiments, we find that physicians who care for Black patients are more willing to prescribe drugs tested in representative samples, an effect substantial enough to close observed gaps in the prescribing rates of new medicines. Black patients update more on drug efficacy when the sample that the drug is tested on is more representative, reducing Black-white patient gaps in beliefs about whether the drug will work as described. Despite these benefits of representative data, our framework and evidence suggest that those who have benefited more from past medical breakthroughs are less costly to enroll in the present, leading to persistence in who is represented in the evidence base.
New Pricing Models, Same Old Phillips Curves?
Authors: Auclert Adrien , Rigato Rodolfo , Rognlie Matthew , Straub Ludwig
Published: September 2023

We show that in a broad class of menu cost models, the first-order dynamics of aggregate inflation in response to arbitrary shocks to aggregate costs are nearly the same as in Calvo models with suitably chosen Calvo adjustment frequencies. We first prove that the canonical menu cost model is first-order equivalent to a mixture of two time-dependent models, which reflect the extensive and intensive margins of price adjustment. We then show numerically that in any plausible parameterization, this mixture is well approximated by a single Calvo model. This close numerical fit carries over to other standard specifications of menu cost models. Thus, for shocks that are not too large, the Phillips curve for a menu cost model looks like the New Keynesian Phillips curve, but with a higher slope.
Adenosine 5’monophosphate-activated protein kinase activation reduces the risks of psoriasis and its comorbidities: a Mendelian randomization study in the UK Biobank
Authors: Xiao Yi , Jing Danrong , Zhou Guowei , Tang Zhenwei , Peng Cong , Kuang Yehong , Zhu Wu , Chen Xiang , Liu Hong , Shen Minxue
Published: September 2023

Objective

Whether metformin and its adenosine 5‘monophosphate-activated protein kinase (AMPK) activation protect from psoriasis risk is unconcluded. We investigated the effect of AMPK, a pharmacological target of metformin, on the risk of psoriasis and its comorbidities and mortality among participants in the UK Biobank (UKB).

Methods

To avoid immortal time biases in pharmacoepidemiologic studies, Mendelian randomization was used to infer the AMPK pathway-dependent effects. The cut-off age for distinguishing early-onset/late-onset psoriasis (EOP/LOP) was set at 60 years, based on the incident psoriasis peak in UKB. A genetic instrument comprising 44 single-nucleotide polymorphisms associated with glycated haemoglobin (HbA1c), serving as a proxy for AMPK genetic risk score (negatively associated with AMPK activation), was employed as previously reported in the literature. Log-binomial models were used to estimate the effect size of AMPK regarding relative risk (RR) and 95% CI.

Results

A total of 407 159 participants were analysed, including 9126 EOP and 3324 LOP. The AMPK genetic risk score was associated with a 12.4% increase in the risk of LOP in men (RR = 1.124, 95% CI: 1.022–1.236). This association was not significant for EOP or women. AMPK genetic risk score exhibited an elevated risk of ischemic heart disease (RR = 1.217, 95% CI 1.062–1.395) in male psoriasis patients.

Conclusions

AMPK activation may protect against LOPs and associated ischemic heart disease in men. A sex-specific, comorbidity-targeted intervention for psoriasis is needed.
Understanding the Causal Pathway of Social Determinants of Psychosis: The Role of Social Functioning, Relevance of Animal Models, and Implications for Treatment
Authors: Jimenez Amy M , Green Michael F
Published: September 2023

There is mounting evidence that the social determinants of psychosis operate via a long and circuitous route. Here, we comment on the striking findings from a recent study by Ku et al., that area-level social environmental factors yield social disability and increased risk for schizophrenia through intervening variables and over a long time course. We discuss the relevance of animal models of social isolation to understand how environmental factors interrelate with individual-level mechanisms. We also discuss treatment implications, including the search for novel psychopharmacological treatments for reduced social motivation, and the need for a comprehensive prediction and prevention model.
2022 tax developments in Argentina
Authors: Canosa Javier
Published: September 2023

In this article, Javier Canosa discusses the effects of high inflation in Argentina and the tax developments of 2022 in Argentina.
Divergent role of nutrient availability in determining drought responses of sessile oak and Scots pine seedlings: evidence from 13C and 15N dual labeling
Authors: Ouyang Shengnan , Tie Liehua , Saurer Matthias , Bose Arun K , Duan Honglang , Li Maihe , Xu Xingliang , Shen Weijun , Gessler Arthur
Published: September 2023

Increased soil nutrient availability can promote tree growth while drought impairs metabolic functioning and induces tree mortality. However, limited information is available about the role of nutrients in the drought responses of trees. A greenhouse experiment was conducted with sessile oak (Quercus petraea (Matt.) Liebl) and Scots pine (Pinus sylvestris L.) seedlings, which were subjected to three fertilization treatments in the first year and two water regimes in the second year. Old and newly fixed carbon (C) and nitrogen (N) allocation were traced by dual labeling with 13C and 15N tracers, respectively, at two time points. Leaf gas exchange, biomass, as well as N and nonstructural carbohydrate (NSC) concentrations of all organs were measured. Fertilization predisposed sessile oak to drought-induced mortality, mainly by prioritizing aboveground growth, C and N allocation, reducing root NSC concentrations and decreasing old C contribution to new growth of leaves. In contrast, fertilization did not additionally predispose Scots pine to drought, with minor effects of fertilization and drought on newly fixed and old C allocation, tissues N and NSC concentrations. The role of nutrients for drought responses of trees seems to be species-specific. Therefore, we suggest nutrient availability and species identity to be considered in the framework of physiological mechanisms affecting drought-induced mortality.
The European Union’s Preferential Trade Agreements: between convergence and differentiation
Authors: Delgado Casteleiro Andrés
Published: September 2023

Gone are the days when tariff liberalization was the centre of the European Union’s Preferential Trade Agreements (EU PTAs). Instead, the current generation of EU PTAs manages trade from a regulatory perspective: they establish rules that apply to domestic measures. Significantly, EU PTAs deploy international standards rather than EU law to regulate trade, directly influencing the speed of regulatory convergence with its treaty partners. Though EU PTAs aim to boost trade through regulatory convergence, they also consider the specific conditions of the EU’s treaty partner. This article analyses this regulatory turn in the EU’s PTAs, its practice and its consequences regarding trade and sustainable development.
Ureteral Stents Do Not Increase the Risk for Acute Kidney Injury after Colorectal Surgery
Authors: Schmied Isaac D. , Rajkumar Dixy , Chang Melissa I. , Colom Sara M. , Cleary Robert K.
Published: September 2023

BACKGROUND:

Ureteral stents are thought to prevent or help identify ureteral injuries. Studies suggesting that ureteral stents increase the risk of postoperative acute kidney injury show inconsistent conclusions. The large ureteral stenting volume at our institution provided a unique opportunity for granular analysis not previously reported.

OBJECTIVE:

Determine if prophylactic ureteral stenting at colorectal surgery increases acute kidney injury.

DESIGN:

Retrospective analysis of colorectal operations with prophylactic ureteral stents were compared to operations without stents. Adjusted analysis was performed with inverse probability treatment weighting.

SETTINGS:

Single institution enhanced recovery colorectal surgery.

PATIENTS:

Prospective institutional database between 07/01/2018 and 12/31/2021.

MAIN OUTCOME MEASURE:

The primary outcome was acute kidney injury defined as increase in creatinine ≥ 0. 3mg/dL (Definition#1) and 1.5-fold increase in creatinine (Definition#2) within 48 hours postoperatively.

RESULTS:

There were 410 patients in the study population – 310 patients in the stent group and 100 in the no-stent group. There were 8 operative ureteral injuries, 4 (1.29%) in the stent group and 4 (4.0%) in the no-stent group (p = 0.103). Unadjusted analysis revealed no significant difference in acute kidney injury between groups. After adjustment, there was still no significant difference in acute kidney injury between groups when defined as Definition#1 (no-stent 23.76% vs stent 26.19%, p = 0.745) and by Definition#2 (no-stent 15.86% vs stent 14.8%, p = 0.867). Subgroup analysis showed that lighted stents were associated with significantly more acute kidney injury than no-stent patients when defined as Definition#1 (p = 0.017) but not when defined as Definition#2 (p = 0.311).

LIMITATIONS:

Single institution results may not be generalizable.

CONCLUSION:

Prophylactic ureteral stenting does not increase the risk of acute kidney injury for patients undergoing enhanced recovery colorectal surgery, though caution and further study may be warranted for lighted stents. Studies further examining contrasting roles of ureter stenting and imaging in open and minimally invasive colorectal surgery are warranted.
Cervical preparation for second-trimester procedural abortion
Authors: Fraz Farsam , Liu Serena M. , Shaw Kate A.
Published: September 2023

Purpose of review

To review the evidence-informed options for cervical preparation prior to second-trimester dilation and evacuation (D&E).

Recent findings

As abortion restrictions increase and the number of abortion clinics and providers decreases, pregnant people are facing more barriers to abortion access. Those in need are now often required to travel for second-trimester abortion care, only to be faced with additional restrictions, such as mandatory waiting periods. Cervical preparation is recommended prior to D&E and takes time for effect. Given the increasing time required to obtain an abortion, patients and providers may prefer same-day cervical preparation to decrease the total time required. Options for same-day cervical preparation include misoprostol alone with single or serial doses, and misoprostol combined with osmotic dilators or transcervical balloon (Foley catheter). Same-day preparation may require additional clinical space to accommodate people after initiation of cervical preparation to manage side-effects and timing of the abortion. Overnight options are also used and more frequently later in the second trimester. Overnight options include mifepristone, osmotic dilators, and transcervical balloon and are often combined with same-day misoprostol. Medication alone preparation is well tolerated and effective in the second trimester, with the addition of mechanical methods with advancing gestation. With many options and combinations being safe and effective, providers can be dynamic and alter approach with supply shortages, adjust to different clinical settings, consider patient medical and surgical factors, and accommodate provider and patient preferences.

Multiple pharmacologic and mechanical options have been shown to be safe and effective for cervical preparation prior to D&E. Consideration for multiple factors should influence the method of cervical preparation and methods may vary by patient, provider and setting.
Evaluation of Intraoperative Anastomotic Patency with Angiography in Microsurgical Breast Reconstruction
Authors: Bombardelli Joao , Farhat Souha , De La Fuente Hagopian Alexa , Hua Jack , Schusterman Mark Asher , Echo Anthony
Published: September 2023

Background:

Microsurgical breast reconstruction is one of the most challenging, yet rewarding procedures performed by plastic surgeons. Several measures are taken to ensure safe elevation of the flap, preparation of recipient vessels, microvascular anastomosis, and flap inset. Reestablishing proper blood flow to the flap tissue after microvascular anastomosis is one of many critical steps for surgical success. Several measures to assess blood flow to the flap have been used; however, the use of indocyanine green angiography (ICGA) of the anastomosis in breast reconstruction has not been well documented. We present a series using ICGA for the evaluation of microvascular anastomosis success in breast reconstruction.

Methods:

Cases from patients who underwent microsurgical breast reconstruction between March 2022 and January 2023 and who had intraoperative ICGA were retrospectively reviewed. We compared the intraoperative findings on ICGA to flap success.

Results:

Sixteen patients underwent bilateral deep inferior epigastric perforator flap reconstruction with intraoperative ICGA of the microvascular anastomosis, constituting 32 deep inferior epigastric perforator flaps. The ICGA demonstrated return of blood flow in all the flaps after microvascular anastomosis and no flap loss in our sample population. Nine flaps required additional drainage using the superficial inferior epigastric vein, and the superficial circumflex vein was used for additional drainage in one of the flaps.

Conclusions:

The use of intraoperative ICGA provides reliable visual feedback regarding the patency and direction of the blood flow through the microvascular anastomosed vessels. ICGA can be used as an additional tool in the plastic surgeon’s armamentarium for successful breast reconstruction.
Efficacy of Interventions Based on WHO Multimodal Hand Hygiene Improvement Strategy in a Tertiary Care Hospital in Eastern India: A Quasi-Experimental Study
Authors: Biswas Ratnadeep , Kirti Ravi , Ojha Vishnu Shankar , Jaiswal Yash , Kaur Gurleen
Published: September 2023

The study aimed to evaluate the efficacy of the World Health Organization (WHO) multimodal hand hygiene improvement (WHO-5) strategy in enhancing hand hygiene compliance among health care workers at a tertiary care hospital. The interrupted time series study included preintervention, intervention, and postintervention phases, with 2 points of observation each during the pre- and postintervention phases. The baseline hand hygiene compliance was 16%, which improved to 43.9% after the intervention. Health care workers were 4 times more likely to adhere to proper hand hygiene postintervention (odds ratio [OR], 4.117). Independent predictors of hand hygiene compliance included the week of observation (week 3: adjusted odds ratio [AOR], 0.872; week 5: AOR, 3.427; and week 7: AOR, 4.713), health care worker type (consultants: AOR, 0.964; residents: AOR, 2.187; and interns: AOR, 6.684), daytime (AOR, 1.232), and “after” type of hand hygiene opportunity (AOR, 1.577). No significant differences were found in knowledge, attitude, and practices pre- and postintervention, and the interventions’ effect was sustained and increased over time, supporting implementation in hospitals across India.
The role of the dually certified primary care/psychiatric mental health nurse practitioner in treating high-needs/high-cost patients
Authors: Judge-Ellis Teresa (Tess) , Gentil-Archer Anne , Achenbach Andrea , Dehner Hannah , Kelleher Kassiani , Buckwalter Kathleen
Published: September 2023

National nursing organizations have called for nurses to provide leadership in care solutions for high-cost/high-needs vulnerable populations. In response to this call, important modifications are emerging in Doctor of Nursing Practice programs, including an increasing number of nurses pursuing dual certification in primary care and psychiatric mental health or primary care nurse practitioners returning for a postgraduate certificate in psychiatric mental health. This innovative role warrants examination, particularly because it relates to high-needs/high-cost patients such as those with serious mental illness (SMI). This article highlights two aspects of the role of the primary care/psychiatric mental health nurse practitioner (PC/PMHNP): one, to provide a vision of the PC/PMHNP as a unique solution for optimal care of vulnerable patients and two, to demonstrate potential contributions of the PC/PMHNP to the larger health care system. A case exemplar is used to illustrate role contributions of the PC/PMHNP in a high-needs/high-cost patient with SMI and complex co-occurring physical illness. Three capacities of the PC/PMHNP are discussed: depth and breath, expert engagement and rapport building, and full patient-centered care and flexibility. The case exemplar emphasizes the PC/PMHNP value through transitions across care settings and where gaps in service frequently occur. The impact of the PC/PMHNP on improved patient outcomes, patient and provider satisfaction, and cost savings are explored.
Pathophysiology and pharmacology course grades and prediction of success in a graduate nurse practitioner program
Authors: Courtney Maureen (Reni) , Gonzalez John , Cipher Daisha , Lewis Deborah , Jarrell Lynda
Published: September 2023

Background:

During a program review, faculty identified that nurse practitioner (NP) students who received a C grade in Advanced Pathophysiology (Patho) and Advanced Pharmacology (Pharm) appeared to perform poorly in the later NP management courses and on other program outcomes.

Purpose:

The research aimed to determine whether grades in graduate Patho and Pharm courses could predict performance in NP management courses, program progression and completion, and certification pass rates.

Methodology:

This research included deidentified student data from 2016 to 2018 across seven NP specialty tracks (n = 4,575). Nonparametric and parametric tests were used in the analysis.

Results:

A significant correlation (p < .001) existed between Patho and Pharm grades. Lower grades in these two courses were significantly related to each other and to lower management course grades. Logistic regression showed that graduate pathophysiology grades significantly predicted certification examination performance, with lower grades associated with lower certification examination performance. Graduate pharmacology grades, pathophysiology grades, composite management course grades, and admission grade point average (GPA) significantly predicted final cumulative GPA, with lower grades associated with lower performance for all variables.

Conclusions:

Results of this research support the hypothesis that grades of C in Patho or Pharm courses significantly predict C performance in the management NP courses and lower certification success rates.

Implications:

The project model can be used in future research. Study findings can be helpful to NP faculty when considering curriculum decisions.
Screening for hypertension in adults – the use of tonometric blood pressure monitoring
Authors: Hornstrup Bodil G. , Rosenbæk Jeppe B. , Hoffmann-Petersen Nikolai , Bech Jesper N.
Published: September 2023

Objectives

Arterial hypertension increases the risk of developing cardiovascular disease. Reliable screening tools for diagnosing hypertension are important to ensure correct risk stratification of subjects. In this study, we aimed to analyse if a wrist-worn device using a tonometric technique for measuring of 24-hour blood pressure could be used to diagnose hypertension and non-dipping. A conventional device using oscillometric measurements was used as golden standard. Secondary aim was to compare the degree of discomfort related to monitoring with the two devices.

Methods

In 89 subjects with a history of normal blood pressure and naive to ambulatory BP monitoring (ABPM), 24-hour ABPM was measured simultaneously with A&D TM2430 (oscillometric technique) and BPro (tonometric technique).

Results

When comparing measurements from the two devices, we found that the tonometric device misclassified 46% of hypertensive subjects and 69% of non-dippers. The tonometric device measured significantly lower systolic 24-hour and daytime blood pressure. The subjects reported less discomfort related to the tonometric than the oscillometric device.

Conclusion

Despite less discomfort related to usage of the tonometric device for 24-hour blood pressure monitoring compared to an oscillometric device, misclassification of hypertension and non-dipping makes the tonometric device inappropriate as a screening instrument.
Population level screening for celiac disease: is now the time?
Authors: Shuler Brianne , Liu Edwin , Stahl Marisa G.
Published: September 2023

Purpose of review

As incidence and prevalence of celiac disease is increasing, subclinical and asymptomatic presentations are more commonly identified through celiac disease screening. However, the United States Preventive Services Task Force released a statement in 2017 maintaining that there is insufficient evidence to recommend general population screening for celiac disease for asymptomatic individuals. This review summarizes the current available evidence on celiac disease screening.

Recent findings

Literature demonstrates that by limiting screening to individuals with recognized symptoms, celiac disease diagnosis is frequently delayed or missed entirely. Most individuals with screening-identified celiac disease have previously unrecognized symptoms that improve through treatment with a gluten-free diet. Screening-identified individuals also demonstrate signs of impaired nutrition, growth, bone health, and quality of life which improve with treatment. Overall, celiac disease screening is viewed favorably by those identified through celiac disease screening programs.

Individuals with screening-identified celiac disease may still incur complications from untreated disease and receive benefit from treatment with a gluten-free diet. More data is needed to determine the cost effectiveness of different mass screening approaches that incorporate the societal perspective towards screening.
Controversies regarding management of Helicobacter pylori infections
Authors: Price Alyssa , Graham David Y. , Tan Mimi C.
Published: September 2023

Purpose of review

The recognition that Helicobacter pylori should be considered and treated as an infectious disease has yet to fundamentally change diagnostic and treatment practices and has resulted in many controversies.

Recent findings

We discuss the following controversies: whether the current ‘per-patient’ approach to H. pylori testing based on symptoms should be expanded to include achieving population-level H. pylori eradication, whether H. pylori should be approached as an infectious gastrointestinal disease similar to that of other infectious diseases of similar severity and outcome, whether treatment of H. pylori should be primarily empiric or based on antibiotic susceptibility and locally proven successful therapies as are other infectious diseases, whether it is necessary to obtain confirmation of treatment success in every patient treated for H. pylori, and whether potassium-competitive acid blockers should replace proton pump inhibitors in H. pylori therapy.

Available guidelines and meta-analyses do not yet address H. pylori as an infectious disease. The diagnosis and management and treatment success of H. pylori infections trails behind that of other important infectious diseases. We provide new insights and propose changes in the traditional understanding required to modernize the management of H. pylori infections.
How to measure human leukocyte antigen-specific B cells
Authors: Kervella Delphine , Torija Alba , Zúñiga Jose M. , Bestard Oriol
Published: September 2023

Purpose of review

The implementation of highly sensitive immune assays measuring anti-human leukocyte antigen (HLA) antibodies has modified alloimmune risk stratification and diagnosis of rejection. Nonetheless, anti-HLA antibodies represent the downstream effector mechanism of the B-cell response. Better characterizing the cellular components of the humoral immune response (including memory B cells (mBCs) and long-lived plasma cells) could help to further stratify the alloimmune risk stratification and enable discovery of new therapeutic targets. Several tests that characterize HLA-specific mBCs, either functionally or phenotypically, have been developed in the last years, showing promising applications as well as some limitations.

Recent findings

Functional assays involving ex vivo polyclonal activation of mBC have been refined to allow the detection of HLA-specific mBC capable of producing anti-HLA Abs, using different and complementary detection platforms such as multiplex Fluorospot and single antigen bead assay on culture supernatants. Detection of circulating HLA-specific B cells by flow cytometry remains hindered by the very low frequency of HLA-specific mBC.

Technological refinements have allowed the development of tests detecting HLA-specific mBC. Further evaluation of these assays in clinical trials, both for immune risk stratification and to assess treatment efficacy (desensitization strategies, rescue therapies for ABMR) are now urgently needed.
Detection of urological cancers by the signature of organic volatile compounds in urine, from dogs to electronic noses
Authors: Gaye Oumar , Fall Cheikh Bintou , Jalloh Mohamed , Faye Babacar , Jobin Marc , Cussenot Olivier
Published: September 2023

Purpose of review

Urine volatile organic compound (VOC) testing for early detection of urological cancers is a minimally invasive and promising method. The objective of this review was to present the results of recently published work on this subject.

Recent findings

Organic volatile compounds are produced through oxidative stress and peroxidation of cell membranes, and they are eliminated through feces, urine, and sweat. Studies looking for VOCs in urine for the diagnosis of urological cancers have mostly focused on bladder and prostate cancers. However, the number of patients included in the studies was small. The electronic nose was the most widely used means of detecting VOCs in urine for the detection of urological cancers. MOS sensors and pattern recognition machine learning were more used for the composition of electronic noses. Early detection of urological cancers by detection of VOCs in urine is a method with encouraging results with sensitivities ranging from 27 to 100% and specificities ranging from 72 to 94%.

The olfactory signature of urine from patients with urological cancers is a promising biomarker for the early diagnosis of urological cancers. The electronic nose with its ability to recognize complex odors is an excellent alterative to canine diagnosis and analytical techniques. Nevertheless, additional research improving the technology of Enoses and the methodology of the studies is necessary for its implementation in daily clinical practice.
Efficacy of opioid-free anesthesia in modified radical mastectomy: a cross-sectional observational study
Authors: Assaf Georges R. , Yared Fares , Dib Mary-Joe , Mouawad Tony , Tarabay Oriana , Noujeim Jean-Paul , El-Helou Etienne , Kaady Jean , Abboud Bassam
Published: September 2023

Introduction:

Perioperative management of female patients undergoing breast surgeries differs from other patients due to chronic pain and postoperative nausea and vomiting. The anesthesia could consist of opioid-free general anesthesia (OFA) or non-opioid-free general anesthesia (NOFA). OFA relies on multimodal analgesia preoperatively and postoperatively. However, it is not yet established whether OFA could replace NOFA as a standard regimen for the management of breast surgeries. The aim of this study is to evaluate the efficacy of OFA for breast surgeries in female patients.

Materials and methods:

Patients undergoing modified radical mastectomy were retrospectively recruited. Two groups were defined: group 1, consisting of treated patients using OFA and group 2, consisting of treated patients using NOFA. Mean time to extubate and mean dose of morphine after recovery were computed. Postoperative morphine and antiemetic use were assessed for up to 24 h. A comparison of the computed data was conducted between both groups.

Results:

A total of 116 patients were included with a mean age of 53±13 years. Group 1 consisted of 56 (mean age was 54±14 years). Group 2 consisted of 60 patients (mean age was 51±12 years). Demographic parameters and time to extubate did not yield significant differences. We noticed morphine sparing at T0 and T12 with statistically significant differences P=0.043 and P=0.006, respectively.

Conclusion:

OFA could be considered in modified radical mastectomy management in female patients; nerve block seemed to act as morphine sparing in operative and postoperative settings by providing significantly less time to extubate with less postoperative morphine requirement.
EBV-IgA antibody responses in endemic and nonendemic populations with nasopharyngeal carcinoma: tumour marker prognostication study and a cross-sectional study
Authors: Budiningsih Insani , Verkuijlen Sandra A.W.M. , Dachlan Yoes P. , Arfijanto Muhammad V. , Hadi Usman , Middeldorp Jaap M.
Published: September 2023

Nasopharyngeal carcinoma (NPC) is the most prevalent head and neck cancer in Indonesia, with 100% Epstein–Barr virus (EBV) infection in tumor cells. NPC is rare in the Netherlands. The involvement of EBV in NPC pathogenesis is reflected by early onset aberrant IgA antibody responses to various EBV proteins. Screening for elevated EBV-IgA levels is proposed for NPC risk assessment in endemic countries but is poorly studied in nonendemic regions. This study analyzed the overall diversity (immunoblot) as well as the prevalence and normalized levels of IgA responses to immunodominant peptide epitopes of EBV proteins VCA P18, EBNA 1, and Zebra (Zta) (N-terminus, P 125, P 130, full-length recombinant Zebra) in Indonesian (n=50) and Dutch (n=50) patients with NPC. The results confirmed that elevated levels of IgA-VCA P18 and IgA-EBNA 1 were found in both NPC populations, but that IgA-Zta was more variable. IgA-Zta responses were more pronounced in Indonesian NPC cases, reflecting more frequent EBV reactivation overall. IgA-VCA P18 and IgA-EBNA are independent tumor markers and are both necessary for NPC risk assessment. Overall, these results confirmed the diagnostic benefit of combined IgA-VCA P18/-EBNA 1 testing for NPC risk assessment in endemic and nonendemic populations.
Thermal necrosis in orthopedic bone tumors: experimental research
Authors: Wang Xue Qi , Brown Jeffrey M. , Lorimer Shannon , Jones Kevin B. , Groundland John S.
Published: September 2023

Introduction:

The extent of surgical resection in orthopedic oncology differs according to tumor biology. While malignant bone tumors are operatively managed with wide resection, benign bone tumors and metastatic carcinomas are often treated through intralesional excision and adjuvant modalities, including the elimination of residual neoplastic cells through thermal necrosis. This study investigates in vitro temperature thresholds for thermal necrosis in common orthopedic bone tumors.

Methodology:

Eleven cell lines, including metastatic carcinomas to bone (A549, A498, FU-UR-1, PC3, MDA-MB-231, TT, MCF7, and K1), giant cell tumor of bone, osteosarcoma (HG-63), and control non-neoplastic cells (HEK293) were cultured. Cells were exposed to thermal stress at varying times and temperatures and evaluated for survival and viability with crystal violet and MTT assays.

Results:

Both the MTT and crystal violet assay demonstrated statistically superior rates of viability and survival for A549 (lung carcinoma), FU-UR-1 (renal carcinoma), K1 (thyroid carcinoma), and MG-63 (osteosarcoma) cell lines compared to control (HEK293 cells) at 60°C. Additionally, the MTT assay demonstrated superior viability for PC3 (prostate carcinoma), MCF7 (breast carcinoma), and A498 (renal carcinoma) compared to control. All cell lines demonstrated significantly decreased survival and viability in temperatures more than 90°C.

Conclusion:

This study demonstrated in vitro thresholds for thermal necrosis for cell lines of common orthopedic tumors of bone. The A549 (lung carcinoma), K1 (thyroid carcinoma), and FU-UR-1 (renal carcinoma) cell lines demonstrated greater resistance to heat stress compared to non-neoplastic control cells. Temperatures in excess of 90°C are necessary to reliably reduce cell survival and viability to less than 10%.
Pulmonary alveolar microlithiasis: a rare case report from Syria
Authors: Batesh Duaa , Habash Roaa , Alhaffar Mhd Nabih , Almani Imad
Published: September 2023

Introduction and importance:

This report presents a case of pulmonary alveolar microlithiasis (PAM), a rare disease characterized by dry cough, dyspnea, and chest pain. Most reported cases are from Turkey, with a frequency of 1.85 in 1 million, and there are no documented cases from Syria in the medical literature. Here, we present the first case report from Syria.

Case presentation:

A 56-year-old male patient complained of a dry cough that began 4 years ago and had worsened over the last 3 months, along with a grade I dyspnea. Chest radiograph showed a ‘sandstorm-like’ appearance, and a computed tomography scan revealed diffuse ground-glass opacities. To confirm the diagnosis, we performed a transbronchial lung biopsy and bronchial washing. Histopathology results revealed interalveolar calcification consistent with PAM. The diagnosis was based on radiological and lung biopsy findings. The patient received oxygen therapy, resulting in significant improvement. We recommended the use of a home oxygen machine for episodes of shortness of breath.

Clinical discussion:

PAM is an autosomal recessive disease caused by a mutation in the SLC34A2 gene (solute carrier family 34, member 2 gene), characterized by intra-alveolar airspace microliths called calcospherites. Miliary tuberculosis should be considered a differential diagnosis.

Conclusions:

The disease progresses slowly and is often diagnosed incidentally. Lung transplantation remains the only effective treatment.
Effect of laparoscopic mini-gastric bypass versus laparoscopic sleeve gastrectomy on hypertension and dyslipidemia in obese type 2 diabetes mellitus patients
Authors: Ahmad Wassim B. , Al Shalabi Abdul Ghani , Kabalan Younes
Published: September 2023

Objective:

The aim of the research was to compare the effect of the laparoscopic mini-gastric bypass (LMGB) technique with the laparoscopic sleeve gastrectomy (LSG) technique in bariatric surgery on type 2 diabetes mellitus (T2DM), hypertension (HTN), and dyslipidemia in obese T2DM patients.

Materials and methods:

A prospective, cross-sectional study, conducted in Surgery Department at Al-Mouwasat and Al-Assad University Hospitals in Damascus, and included T2DM obese patients who would undergo bariatric surgery using the LMGB or LSG technique.

Results:

The research included two groups: the LSG group (92 patients, 60.9% female, age 44.6 year, BMI 41.85 kg/m2) and the LMGB group (137 patients, 59.1% female, age 47.1 year, BMI 43 kg/m2). Before surgery, the prevalence of HTN and dyslipidemia were similar in the two groups. After one year: T2DM improvement and remission rate in the LMGB group (13.9, 80.3%) were greater than in the LSG group (13, 62%), the difference was statistically significant. The HTN improvement and remission rate in the LMGB group (52.9, 41.4%) were greater than in the LSG group (47.5, 39%), the difference was not statistically significant. The dyslipidemia improvement rate was greater in LSG group (47.2 vs. 32.7%), while the dyslipidemia remission rate was greater in LMGB group (67.3 vs. 52.8%), the difference was statistically significant.

Conclusions:

The authors found that the LMGB technique was more effective than the LSG technique in controlling cardiovascular risk factors of obesity, T2DM, HTN, and dyslipidemia.
Efficacy and complications of hyaluronic acid and polylactic acid for penile augmentation: a systematic review and meta-analysis
Authors: Kusumaputra Ahmad , Setiawan Muhammad R. , Soebadi Mohammad A. , Wirjopranoto Soetojo
Published: September 2023

Background:

Penile size is considered a symbol of manhood and is a subjective problem for men, especially those with small penis syndrome. Penile augmentation was introduced to correct penile size problems from a medical, psychological, or esthetic point of view. Hyaluronic acid (HA) and polylactic acid (PLA) are two types of augmentation agents that are popularly used today. However, no systematic studies and meta-analyses have compared these two modalities as penile augmentation agents. This study aimed to analyze the efficacy and safety of penile filler injections with HA compared to PLA.

Methods:

This study was based on the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Articles examining the differences in efficacy and adverse events of the administration of HA and PLA in patients undergoing penile augmentation were systematically reviewed from the PubMed, Proquest, Web of Science, and Scopus databases. An odds ratio with a 95% CI was applied to measure the study outcome. The analysis was performed with RevMan 5.4 software. The risk of bias for each study was evaluated using the Risk of Bias v2 instrument from Cochrane. This research protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO) registry.

Result:

Four articles consisting of 283 research subjects were included in this study. The meta-analysis for penile girth enhancement after penile augmentation found significant results in the HA group compared to the PLA group (P=0.01). There was no difference in the level of satisfaction with penile appearance 4 weeks after penile augmentation in the HA group compared to the PLA group (P=0.79). HA was significantly superior in sexual satisfaction 12 weeks postpenile augmentation (P=0.0004). There was no difference in the incidence of pain after penile augmentation in the HA group compared to the PLA group (P=0.33). In the postaugmentation penile inflammation, there was no difference (P=0.98) in the HA group compared to the PLA group.

Conclusion:

There are differences in the efficacy of penile augmentation with the superiority of HA in increasing penile diameter and postaugmentation sexual satisfaction compared to PLA. There was no difference in the incidence of complications between using HA and PLA.