bluuebunny/crossref_metadata_2025 huggingface dataset:
Distinct uptake and elimination profiles for trastuzumab, human IgG, and biocytin-TMR in experimental HER2+ brain metastases of breast cancer
Authors: Silvestri Vanesa L , Tran Andy D , Chung Monika , Chung Natalie , Gril Brunilde , Robinson Christina , Difilippantonio Simone , Wei Debbie , Kruhlak Michael J , Peer Cody J , Figg W Douglas , Khan Imran , Steeg Patricia S
Published: February 2024

Background

The aim of this study is an improved understanding of drug distribution in brain metastases. Rather than single point snapshots, we analyzed the time course and route of drug/probe elimination (clearance), focusing on the intramural periarterial drainage (IPAD) pathway.

Methods

Mice with JIMT1-BR HER2+ experimental brain metastases were injected with biocytin-TMR and either trastuzumab or human IgG. Drugs/probes circulated for 5 min to 48 h, followed by perfusion. Brain sections were stained for human IgG, vascular basement membrane proteins laminin or collagen IV, and periarterial α-SMA. A machine learning algorithm was developed to identify metastases, metastatic microenvironment, and uninvolved brain in confocally scanned brain sections. Drug/probe intensity over time and total imaged drug exposure (iAUC) were calculated for 27,249 lesions and co-immunofluorescence with IPAD-vascular matrix analyzed in 11,668 metastases.

Results

In metastases, peak trastuzumab levels were 5-fold higher than human IgG but 4-fold less than biocytin-TMR. The elimination phase constituted 85–93% of total iAUC for all drugs/probes tested. For trastuzumab, total iAUC during uptake was similar to the small molecule drug probe biocytin-TMR, but slower trastuzumab elimination resulted in a 1.7-fold higher total iAUC. During elimination trastuzumab and IgG were preferentially enriched in the α-SMA+ periarterial vascular matrix, consistent with the IPAD clearance route; biocytin-TMR showed heterogeneous elimination pathways.

Conclusions

Drug/probe elimination is an important component of drug development for brain metastases. We identified a prolonged elimination pathway for systemically administered antibodies through the periarterial vascular matrix that may contribute to the sustained presence and efficacy of large antibody therapeutics.
National liberation by other means: US visitor diplomacy in the Vietnam War
Authors: Asselin Pierre
Published: February 2024

This article considers Americans who travelled to North Vietnam at the height of the Vietnam War (1965–75). It demonstrates, on the basis of revelations in files from the Vietnamese national archives, that authorities in Hanoi exercised far more control over visits by US citizens and the impressions they created than the visitors themselves and those who have written about them had heretofore surmised. In visiting North Vietnam on Hanoi’s very specific terms, guests unwittingly — for the most part — became accomplices in its ‘diplomatic struggle’, a distinctive aspect of the Vietnamese communist anti-American strategy that was intended to diminish the importance of the military contest inside Vietnam by winning hearts and minds and demonizing Washington policy makers outside the country. By elucidating Hanoi’s rationale for and contributions in arranging the visits, the article decentres the history of the Vietnam War and validates the emergent consensus among international relations historians that traditionally marginalized ‘Third World’ state and non-state actors assumed meaningful roles in shaping the post-1945 international order. The Vietnam War, it turned out, changed the global discourse on the laws of war, human rights and humanitarianism in no small part because of the way Hanoi framed the conflict and reported its dreadful effects to foreign publics.
What is a high-quality research environment? Evidence from the UK’s research excellence framework
Authors: Inglis Matthew , Gadd Elizabeth , Stokoe Elizabeth
Published: February 2024

As part of the UK university sector’s performance-related research funding model, the ‘REF’ (Research Excellence Framework), each discipline-derived ‘Unit of Assessment’ must submit a statement to provide information about their environment, culture, and strategy for enabling research and impact. Our aim in this paper is to identify the topics on which these statements focus, and how topic variation predicts funding-relevant research environment quality profiles. Using latent Dirichlet allocation topic modelling, we analysed all 1888 disciplinary ‘unit-level’ environment statements from REF2021. Our model identified eight topics which collectively predicted a surprisingly large proportion—58.9%—of the variance in units’ environment scores, indicating that the way in which statements were written contributed substantially to the perceived quality of a unit’s research environment. Assessing research environments will increase in importance in the next REF exercise and the insights found through our analysis may support reflection and discussion about what it means to have a high-quality research environment.
Ambient dose equivalent rates of gamma radiation from natural radionuclides and 137Cs at grasslands and forests in the area of the Belarusian NPP in the pre-commissioning period (2019)
Authors: Ramzaev Valery , Bernhardsson Christian , Vodovatov Aleksandr , Chipiga Larisa , Nekrasov Vladislav , Dvornik Alexander
Published: February 2024

In situ gamma-spectrometric measurements were performed at grasslands (45 plots) and forests (6 plots) in the vicinity of the Belarusian nuclear power plant in September–October 2019. The aim of the study was to evaluate the baseline level of ambient dose equivalent rates of gamma radiation from natural radionuclides and 137Cs in the period preceding the commissioning of the NPP. The study revealed more than a 2-fold variability in values of the total ambient dose equivalent rate: from 29 to 72 nSv/h. This spread can be explained by variability in the content of natural radionuclides in the environment and, accordingly, ambient dose equivalent rate. At forest sites, compared to grassland sites, the values of ambient dose equivalent rates of gamma radiation from natural radionuclides were statistically significantly lower. The contribution of gamma radiation from 137Cs to the total ambient dose equivalent rate was insignificant and averaged 3% for grasslands and 6% for forests.
Anti-Asian Hate’s Impact on Asian American Social Workers: Implications for Professional Training and Education
Authors: Bersamira Clifford S , Lau Sophia B , Lee Yeonjung Jane , Yamauchi Jaron
Published: February 2024

This article explores the impact of recent incidents of anti-Asian hate and violence against Asian American social workers, clients, and communities. Asian Americans represent a small but growing proportion of the U.S. population. Yet, Asians are underrepresented in the social work profession—approximately 3.6 percent of the social work workforce and 2.1 percent of licensed social workers are Asian, and data on underrepresented racial and ethnic groups in the workforce continue to omit details on Asian people. Recent social and political framing of the COVID-19 pandemic as attributable to Asian people has fueled racist rhetoric and incidents of hate and bias crimes against Asian people. Through exploratory research to understand the experiences of Asian American social workers in the proliferation of anti-Asian hate, authors identified that more should be done to support and meet the needs of Asian American social workers, clients, and communities by improving social work education and training, by addressing the social work workforce and agency practices, and by expanding upon advocacy and community building.
Hexaconazole exposure may lead to Parkinson via disrupting glucocerebrosidase and parkin: molecular interaction, dynamics, MMPBSA and DFT based in-silico predictive toxicology
Authors: Alkholifi Faisal K , Abdi Sayed Aliul Hasan , Qadri Marwa , Sayed Shabihul Fatma , Khardali Amani , Nagarajan Sumathi , Abdulrahman Alhamyani , Aldabaan Nayef , Alghazwani Yahia
Published: February 2024

Hexaconazole is a known fungicide for agricultural purposes. It has bioaccumulation ability which makes it important for its toxicological characterization. There are various neurological impacts of pollutants on human health. Therefore, in this study, we have done predictive analyses of the interaction mechanism of hexaconazole by molecular interaction analysis, molecular dynamics simulation, and Poisson-Boltzmann surface area (MM-PBSA) to assess hexaconazole’s potency to disrupt the homeostasis of glucocerebrosidase (−7.9 kcal/mol) and parkin (−5.67 kcal/mol) proteins which have significant roles in the manifestation of Parkinson disease. The findings reveal that hexaconazole has the potency to form stable interactions with glucocerebrosidase and parkin. This research provides a molecular and atomic-level understanding of how hexaconazole exposure may disrupt the homeostasis of glucocerebrosidase and parkin. The root mean square deviation (RMSD), root mean square fluctuation (RMSF), radius of gyration, and hydrogen bonding exhibited the potent molecular interactions of hexaconazole, which may lead to neurological manifestations such as Parkinson disease.
Rate of Unexpected Malignancy in Patients Undergoing Percutaneous Vertebroplasty after Implementing a New Scanning Protocol
Authors: Wickstrøm Line A. , Rafaelsen Søren R. , Andersen Mikkel Ø. , Andresen Andreas D. K. , Elmose Signe F. , Carreon Leah
Published: February 2024

Study Design.

Retrospective quality improvement study.

Objective.

To investigate if the rate of unsuspected malignancy in biopsies in patients with VCF who underwent percutaneous vertebroplasty (PVP) at the same orthopedic department has changed after the implementation of a new MRI scanning protocol.

Summary of Background Data.

Discrimination between benign and malign vertebral compression fracture (VCF) can be difficult. However, early diagnosis of malignant VCF is crucial to further treatment and prognosis. An earlier study at an orthopedic department reported a rate of unsuspected malignancy of 4.9% in patients with VCF who underwent PVP when biopsies were obtained during the procedure. The MRI scanning protocol was changed in this period.

Methods.

Retrospective on 427 patients with vertebral compression fracture undergoing PVP from April 28, 2017 to April 28, 2022, identifying operated patients from the Danish national DaneSpine registry. Subsequently, individual clinical information was collected in journal records.

Results.

The rate of unsuspected malignancy was 0.9% (4/427), and the overestimation of malignant VCF was 50% (16/32).

Conclusion.

During the last 5 years, the rate of unsuspected malignancy in patients with VCF undergoing PVP has improved considerably from 4.9% to 0.9%. Furthermore, MRI is over-diagnosing malignancies. Thus, the new scanning procedure is effective in differentiating between benign and malign VCFs.

Level of Evidence.

3.
Stereotactic ablative radiation therapy in metastatic prostate cancer
Authors: Bazyar Soha , Mannuel Heather , Tran Phuoc T.
Published: February 2024

Purpose of review

The evolving role of stereotactic ablative radiation therapy (SABR) as metastasis-directed therapy (MDT) for oligometastatic prostate cancer (omPCa) will be discussed.

Recent findings

Oligometastatic disease (OMD) is an intermediate state between localized and wide-spread malignant disease. OMD has recently been spotlighted given the increasing demonstration of clinical benefit from local therapies despite presence of metastatic disease and allure of the curative potential of MDT in select cases. Among the different forms of MDT, SABR has rapidly become a widely adopted treatment modality. Significant efforts in this space have focused on omPCa, owing to its relatively indolent biology, presence of a sensitive and specific serum biomarker and recent advances in molecular imaging. While most studies have evaluated the role of SABR MDT in hormone sensitive omPCa, new emerging clinical data also suggests benefits of SABR MDT for even castration-resistant disease.

Treating omPCa with SABR MDT appears to generate an efficacy signal with minimal morbidity across both hormone-sensitive and castration-resistant disease. However, additional definitive omPCa trial data are needed. Future research efforts should investigate biomarkers for this heterogeneous disease space and the role of SABR MDT in combination with systemic agents to improve upon standard of care treatments.
Reducing Menopausal Symptoms With Mindfulness-Based Meditation
Authors: Winges Conflitti Barbara , Hoffman Sarah J. , Mathiason Michelle
Published: February 2024

Midlife women often experience menopausal symptoms despite being treated according to clinical guidelines. The consequences of not addressing menopausal symptoms holistically are that 55% of women see primary care providers frequently with menopausal symptom complaints. The problem was women's lack of coping strategies to deal with their symptoms effectively. The interventions aimed to (1) develop a protocol to provide point-of-care mindfulness-based meditation intervention as a standard of care, (2) evaluate improvements in coping self-efficacy skills, and (3) demonstrate the intervention's impact on menopausal symptoms. Twenty women participated in a short meditation intervention at a micro practice in Oregon from January to May 2022 and continued an 8-week home practice. Self-reported measures of menopausal symptoms, coping self-efficacy, and demographic data were collected pre- and pos-tprogram. A percentage of women determined improvements, and t tests evaluated differences between pre-and postintervention assessments. Pearson correlation coefficients identified associations between the Menopausal Rating Scale (MRS), its subscales, and the Coping Self-Efficacy Scale (CSES) postintervention. The women showed 78% improved coping self-efficacy and 89% alleviated menopausal symptoms. The t test revealed a statistically significant change between pre- and post-CSES scores (t
17 = 4.19, P < .001) and MRS scores (t
17 = 4.78, P < .001). The post-MRS total score was significantly negatively correlated with the post-CSES score (r = −0.49, P = .039), indicating that symptoms decreased as self-efficacy improved. The outcomes of this project show that menopausal women can cope and alleviate their symptoms with an easy and feasible mindfulness-based meditation intervention.
Comparison of Two Measurement Paradigms to Determine Electrically Evoked Cochlear Nerve Responses and Their Correlation to Cochlear Nerve Cross-section in Infants and Young Children With Cochlear Implant
Authors: Schrank Leonhard , Nachtigäller Pascal , Müller Joachim , Hempel John-Martin , Canis Martin , Spiegel Jennifer L. , Rader Tobias
Published: February 2024

Introduction

Electrically evoked compound action potentials (ECAPs) are used for intra-/postoperative monitoring with intracochlear stimulation of cochlear implants. ECAPs are recorded in MED-EL (Innsbruck, Austria) implants using auditory response telemetry (ART), which has been further developed with automatic threshold determination as AutoART. The success of an ECAP measurement also depends on the number of available spiral ganglion cells and the bipolar neurons of the cochlear nerve (CN). It is assumed that a higher population of spiral ganglion cell implies a larger CN cross-sectional area (CSA), which consequently affects ECAP measurements.

Methods

Intraoperative ECAP measurements from 19 implanted ears of children aged 8 to 18 months were retrospectively evaluated. A comparison and correlation of ART/AutoART ECAP thresholds/slopes at electrodes E2 (apical), E6 (medial), E10 (basal), and averaged E1 to E12 with CN CSA on magnetic resonance imaging was performed.

Results

A Pearson correlation of the ART/AutoART ECAP thresholds/slopes for E2/E6/E10 and the averaged electrodes E1 to E12 showed a significant correlation. The CN CSA did not correlate significantly with the averaged ART/AutoART ECAP thresholds/slopes across all 12 electrodes.

AutoART provides reliable measurements and is therefore a suitable alternative to ART. No significant influence of CN CSA on ECAP thresholds/slopes was observed. A predictive evaluation of the success of ECAP measurements based on CN CSA for a clinical setting cannot be made according to the present data.
Asymmetry in Cortical Thickness of the Heschl’s Gyrus in Unilateral Ear Canal Atresia
Authors: Siegbahn Malin , Jörgens Daniel , Asp Filip , Hultcrantz Malou , Moreno Rodrigo , Engmér Berglin Cecilia
Published: February 2024

Hypothesis

Unilateral congenital conductive hearing impairment in ear canal atresia leads to atrophy of the gray matter of the contralateral primary auditory cortex or changes in asymmetry pattern if left untreated in childhood.

Background

Unilateral ear canal atresia with associated severe conductive hearing loss results in deteriorated sound localization and difficulties in understanding of speech in a noisy environment. Cortical atrophy in the Heschl’s gyrus has been reported in acquired sensorineural hearing loss but has not been studied in unilateral conductive hearing loss.

Methods

We obtained T1w and T2w FLAIR MRI data from 17 subjects with unilateral congenital ear canal atresia and 17 matched controls. Gray matter volume and thickness were measured in the Heschl's gyrus using Freesurfer.

Results

In unilateral congenital ear canal atresia, Heschl's gyrus exhibited cortical thickness asymmetry (right thicker than left, corrected p = 0.0012, mean difference 0.25 mm), while controls had symmetric findings. Gray matter volume and total thickness did not differ from controls with normal hearing.

Conclusion

We observed cortical thickness asymmetry in congenital unilateral ear canal atresia but no evidence of contralateral cortex atrophy. Further research is needed to understand the implications of this asymmetry on central auditory processing deficits.
Asymptomatic uterine perforation and IUD migration to the broad ligament: A case report
Authors: Jia Guifeng , Liu Xiaojing , He Yanling , Du Peng , Sun Zhiwei , Chai Wei
Published: February 2024

Rationale:

Uterine perforation is a serious complication of intrauterine contraceptive device (IUD) placement. However, as complete uterine perforation and extrauterine migration may remain asymptomatic, thorough localization of the IUD is important prior to reinsertion.

Patient concerns:

A 33-year-old patient who has had 4 IUD insertions, wherein the location of the first IUD (inserted 14 years ago) was not identified prior to reinsertion and replacement of the subsequent three. She presented to hospital with a 6-month history of abdominal pain. Pelvic ultrasonography (US), radiography, hysteroscopy and laparoscopy examinations confirmed that a retained migrated IUD in the right broad ligament.

Diagnosis:

Uterine perforation, IUD migration to the broad ligament.

Interventions:

The patient underwent hysteroscopy and laparoscopy.

Outcomes:

Both IUDs were successfully removed without any complications.
Efficacy of adjuvant-associated COVID-19 vaccines against SARS-CoV-2 variants of concern in randomized controlled trials: A systematic review and meta-analysis
Authors: Cheng Meng-qun , Weng Zhi-Ying , Li Rong , Song Gao
Published: February 2024

Background:

Adjuvants may enhance the efficacy of vaccines. however, the efficacy of adjuvant-associated COVID-19 vaccines (ACVs) remains unclear since the emergence of the COVID-19 pandemic. This study aimed to address this gap by conducting a systematic review and meta-analysis of the efficacy of ACVs against Severe Acute Respiratory Syndrome Coronavirus 2 CoV (SARS-CoV-2) variants of concern (VOC).

Methods:

A systematic search was conducted of randomized controlled trials (RCTs) evaluating the vaccine efficacy (VE) of ACVs against VOC (alpha, beta, gamma, delta, or Omicron), up to May 27, 2023. The DerSimonian-Laird random-effects model was used to assess VE with 95% confidence intervals (CI) through meta-analysis. Cochrane Risk of Bias tools were used to assess the risk of bias in RCTs.

Results:

Eight RCTs with 113,202 participants were included in the analysis, which incorporated 4 ACVs [Matrix-M (NVX-CoV2373), Alum (BBV152), CpG-1018/Alum (SCB-2019), and AS03 (CoVLP]). The pooled efficacy of full vaccination with ACVs against VOC was 88.0% (95% CI: 83.0–91.5). Full vaccination was effective against Alpha, Beta, Delta, and Gamma variants, with VE values of 93.66% (95% CI: 86.5–100.74), 64.70% (95% CI: 41.87–87.54), 75.95% (95% CI: 67.9–83.99), and 91.26% (95% CI: 84.35–98.17), respectively. Currently, there is a lack of RCT evidence regarding the efficacy of ACVs against the Omicron variant.

Conclusion:

In this meta-analysis, it should be that full vaccination with ACVs has high efficacy against Alpha or Gamma variants and moderate efficacy against Beta and Delta variants. Notably, with the exception of the aluminum-adjuvanted vaccine, the other ACVs had moderate to high efficacy against the SARS-CoV-2 variant. This raises concerns about the effectiveness of ACVs booster vaccinations against Omicron.
Preferences in anterior cruciate ligament reconstruction: A survey among orthopedic surgeons in China
Authors: Tang Hang , Xiao Yi-fan , Liu Wei-jie , Meng Jia-hao , Wu Yu-mei , Xiong Yi-lin , Gao Shu-guang
Published: February 2024

The purpose of this study was to reveal the current trends and preferences of Chinese orthopedic surgeons regarding anterior cruciate ligament (ACL) reconstruction through a nationwide web-based survey conducted in China. The survey questionnaire was distributed via WeChat to the chairmen of provincial orthopedic and sports medicine organizing committees in China, who then shared it in their respective WeChat workgroups. The questionnaire consisted of 52 multiple-choice questions covering 8 sections. Data collection was implemented by Questionnaire Star. A total of 812 valid questionnaires were returned: 94.21% of the respondents preferred single-bundle reconstruction of ACL, while 61.70% preferred autogenous semitendinosus plus gracilis reconstruction; 76.35% of the respondents preferred establishing the femoral tunnel first, while 47.29% preferred establishing the femoral tunnel through a medial auxiliary approach; and 85.10% of the respondents recommended patients to undergo surgery within 3 months after ligament injury. Besides, the vast majority of respondents chose to retain the ligamentous remnant bundle (92.98%) and recommended routine use of knee braces postoperatively (94.09%). It is recommended to perform arthroscopic single-bundle ACL reconstruction with the remnant preserving technique using a hamstring autograft within 3 months of ACL rupture, with support of postoperative functional braces.
Characteristics of patients with chronic hepatitis B infection in China: A retrospective claims database study
Authors: Meng Xing , Gillespie Iain A. , Dong Jane , Ning Yi , Kendrick Stuart
Published: February 2024

Chronic hepatitis B (CHB) infection affects approximately 90 million people in China, where there are profoundly unmet clinical and public health needs. This study evaluated patient demographics, disease progression, and treatment management using national administrative claims data. This retrospective, observational study used anonymized data from the China Health Insurance Research Association claims database (January 1–December 31, 2016); data that could not be validated, or from duplicate entries, were excluded. Patients were identified using the International Classification of Diseases, 10th Revision diagnostic code for CHB (B18.0 and B18.1), using keyword searches for “CHB or HBV” and free-text descriptions of CHB treatments including nucleos(t)ide analogues. Primary objectives included evaluation of: demographics and clinical characteristics of patients with CHB, overall and by presence or absence of cirrhosis and hospital tier; proportion of patients prescribed CHB treatment; and healthcare costs and utilization overall and by presence or absence of cirrhosis and hospital tier. Most identified patients with CHB were male, aged 25 to 65 years, resided in East China, and had employee health insurance. Cirrhosis was common (16.20%) and associated with male preponderance, older age, hepatitis C virus coinfection, and higher hospital care demands and costs. The most frequently visited hospitals were Tier III; patients visiting Tier III generally required more hospital care compared with those visiting Tier I/II hospitals. Only two-thirds of patients were prescribed antiviral therapy for CHB (most commonly nucleos(t)ide analogues). Results from this study highlight a substantial need to improve access to appropriate CHB treatment in China.
The mechanism of Zhenzhu Pills treating intracerebral hemorrhage secondary injury based on network pharmacology and molecular docking
Authors: Wu Gang , Ren Zeng , Hao Qingpei , Wong Yu , Zha Duo , Cao Xudong , Liu Ruen
Published: February 2024

Background:

Intracerebral hemorrhage (ICH) secondary injury is serious and affects patient’s prognosis. The Zhenzhu Pills used to treat subacute ICH in Tibet has shown to have a certain curative effect. Network pharmacology and molecular docking technology are employed to explore the potential mechanism of Zhenzhu Pills. The components and potential targets of Zhenzhu Pills were screened from the Traditional Chinese Medicine Systems Pharmacology database. The Gene Expression Omnibus Series 24265 was used to screen differentially expressed genes between perihematomal tissue and normal brain.

Methods:

The herbs–components–targets network was established, with weighted eigenvalue to identify the core components and targets of Zhenzhu Pills treatment of ICH secondary injury. Targets’ bioinformatics enrichment was proceeded by gene ontology and Kyoto Encyclopedia of Genes and Genome (KEGG) pathway analysis. Finally, molecular docking was used to identify the hydrogen bonding activity between the key components and action targets.

Results:

Five herbal drugs were screened from Traditional Chinese Medicine Systems Pharmacology database, with a total of 48 components and 234 targets. The Gene Expression Omnibus Series 24265 dataset was evaluated and 920 differentially expressed genes were identified. A total of 29 intersection targets of Zhenzhu Pills were explored in the treatment of ICH secondary injury. Drugs–components–targets network analysis showed that the pivotal targets were prostaglandin G/H synthase 2, interleukin 6, heme oxygenase-1, vascular endothelial growth factor, and vascular cell adhesion molecule 1, and the core components were quercetin, luteolin, and kaempferol. Gene ontology and KEGG pathway enrichment analysis showed that biological processes such as cell chemotaxis, wound healing, leukocyte migration, and regulation of body fluid levels played an important role in the secondary injury of ICH. The results of KEGG pathway analysis were mainly related to advanced glycation end products-receptor for advanced glycation end products signal pathway and tumor necrosis factor signal pathway. Molecular docking of 3 flavonoids with 5 core targets with the results also showed active hydrogen bonding.

Conclusions:

This study provides insights into the potential mechanisms of Zhenzhu Pills in the treatment of secondary injuries resulting from ICH and highlights specific components, targets, and molecular pathways involved in this therapeutic effect. These possible therapeutic mechanisms include inhibiting inflammation, edema, oxidative stress, and so on.
Point of care thoracic ultrasound versus chest computed tomography in the approach of febrile neutropenia patients: A diagnostic accuracy cohort study
Authors: Rendon-Ramirez Erick J. , Treviño-Garcia Karla Belen , Peña-Lozano Samantha P. , Treviño Mario Alonso , Mercado-Longoria Roberto , Nañez-Terreros Homero , Salinas-Chapa Matias , Gómez-Almaguer David , Cantú-Rodriguez Olga G. , Cedillo-Huerta Hector Enrique , Vaquera-Alfaro Héctor A. , Colunga-Pedraza Perla R.
Published: February 2024

Single-center prospective cohort diagnostic accuracy study. Our study aimed to evaluate the accuracy and reproducibility of Thoracic Ultrasound (TUS) in detecting pulmonary pathology in immunosuppressed patients. We conducted a single-center prospective study. Consecutive patients with febrile neutropenia who underwent CT (Computerized Tomography) underwent TUS evaluation within 24h of CT. Both studies were performed by an expert who was blinded to the clinical information and results of the alternative imaging modalities. 34 patients met the inclusion criteria. The median age was 39.9 years (±17 standard deviation). TUS as a diagnostic test had a sensitivity of 92.9% and specificity of 83.3%, negative predictive value of 71.4%, and positive predictive value of 96.3%. Substantial between-method agreement was demonstrated with a kappa of 0.71 (P = .001) between the TUS and chest CT findings. We obtained a kappa of 1 (P = .001) for the final diagnosis of Pleural Effusion (PE). We concluded that TUS is a promising screening test for immunocompromised individuals. The results showed good diagnostic performance of TUS compared to CT for the detection of pulmonary findings highly suggestive of pathology with high accuracy and reproducibility.
Prevalence and relevant factors of depression among adolescents in Xinjiang, China: A cross-sectional survey
Authors: Muyiduli Xiamusiye , Zhang Rong , Zhang Jun , Zhe Wei , Dong Yan , Wang Wenlei , Fang Ping , Zhang Yi , Zhang Song , Sulidan Adila , Rejiafu Shawulaxi , Sun Jingxuan
Published: February 2024

The aim of this study is to elucidate the prevalence of depression and examine the contributing factors to depression among adolescents in Xinjiang, China. A stratified cluster sampling methodology was employed in this study, with the sample size determined through consideration of prior studies on adolescent depression. Employing this approach, 6 schools were chosen from each prefecture-level city, designated as urban areas, and 3 schools were selected from each county. Subsequently, individual classes were treated as units, and a minimum of 80 students from each grade were surveyed within the entire class. The investigation of adolescents involved the administration of a questionnaire assessing the factors influencing depression, along with the Center for Epidemiologic Studies Depression Scale (CES-D). Multivariate linear regression was used to analyze the influencing factors of depression. The occurrence rates of depression were 12.17%, 13.05%, 12.32%, and 9.29% in junior middle school, senior middle school, vocational high school, and college, respectively. The corresponding CES-D scores were 10.54 ± 8.26, 11.20 ± 8.37, 12.17 ± 6.94, and 11.33 ± 6.28. Significant associations with the CES-D score were observed for gender, smoking, alcohol consumption, and spending more than 4 hours online daily across the educational levels mentioned. The risk of experiencing depressive symptoms was elevated among female junior and senior high school students who spent more than 4 hours daily on the internet, engaged in cigarette smoking, and consumed alcohol. The findings underscore the significance of targeting high-risk groups, particularly through home-school collaborations, to mitigate excessive internet use and consequently reduce the likelihood of depressive symptoms in students.
Physical activity and depressive symptoms during the fifth wave of COVID-19 pandemic: Implication for public policy and administrators
Authors: Ofili Perpetua Chinyere , Ede Moses Onyemaechi , Anyaegbunam Ngozi Joannes , Oforka Kingsley Okechukwu , Okereke Innocent Ebere , Umeifekwem Joshua Emeka , Bosa Chukwuebuka Nnagozie , Ngwoke Saint Oliver Rotachukwu , Okoroafor Uzochukwu , Oyibo Melitus Amadi , Ogueri Emmanuel Obinna , Ibhafido Akhere , Abbah Oliver Igwebuike , Nwakamma Jude Chikezie , Ezeufodiama Stella C. , Okechukwu Emmanuel Chijioke , Omeye Rita Okechukwu , Nwaiwu Nnochiri , Anozie Keyna Chinyere , Ikediashi Olisa Emmanuel , Ogbochie Andrew Nnabuchi , Obeagu Emmanuel Ifeanyi , Okoroafor Judith Chikamma , Odo Edward Odogbu
Published: February 2024

Depression is a public mental health problem that can progress to suicidal ideation, literature suggests regular physical activity may ameliorate it. The study assessed the link between physical activity and depression symptoms during the fifth wave of the COVID-19 pandemic and the Academic Staff Union (ASU) strike among undergraduates. Four hundred and eighteen undergraduates were recruited and participated in the study. Participants completed the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and Patient Health Questionnaire-9 (PHQ-9) to measure depression severity. The result on PA showed that about one-third of the participants were inactive, above half were moderately active, while a few achieved high PA levels. Above one-fifth of the participants experienced minimal or no depression while a good percent had mild, moderate, moderately severe, and severe depression. Non-parametric tests between PA total score and depression total score with demographic variables were not significant. Spearman’s correlation showed a strong negative relationship between PHQ-9 scores and IPAQ-SF scores. This suggests that a high PA level is associated with lower depression symptoms. The COVID-19 pandemic and the ASU strike experiences resulted in increased depression among undergraduates. The university administration needs to formulate an urgent policy to promote PA among undergraduates and provide treatment for the affected students.
A case report of vaginal delivery in the second trimester of severe uterine prolapse complicated with cervical incarceration
Authors: Yang Xiaoyue , Feng Tongfu
Published: February 2024

Background:

Uterine prolapse is a rare complication of pregnancy, and there is still no consensus on the choice of delivery method.

Methods:

The patient’s reproductive history included an abortion and eutocic delivery of a girl weighing 3200 g; the current pregnancy was the third pregnancy. Her cervical region was outside the vaginal opening and was red in color, with evident enlargement (6 × 4 cm) and a broken surface. The cervical area also showed white discharge. According to her Transvaginal ultrasonography revealed a fetus in the uterine cavity at approximately 19 weeks of gestation. Gynecological examination revealed prolapse of both the anterior and posterior vaginal walls. Evaluation of the pelvic organ prolapse-Q scores showed that the patient had uterine prolapse at stage IV.

Results:

Vaginal delivery was performed smoothly after oral administration mifepristone and misoprostol tablets for a few days, obtaining a dead female fetus in cephalic, 25 cm in length. The cervix of the pregnant woman did not prolapse during the delivery.

Conclusion:

For pregnancy with uterine prolapse and cervical incarceration, transvaginal delivery is a potential treatment option. Maintenance of cervical retraction and oral mifepristone administration with misoprostol tablets is crucial during this delivery. This treatment can minimize the risk of cervical lacerations and uterine rupture, helping surgeons to complete the operation successfully.
Circulating endothelial cells in pathophysiology
Authors: Brett Victor Emmanuel , Dignat George Francoise , James Chloe
Published: February 2024

Purpose of review

The purpose of this review is to synthesize recent insights into the roles and importance of circulating endothelial cells (CECs) as indicators of the severity, progression, and prognosis of vascular-related diseases.

Recent findings

Recent studies have identified elevated counts of CECs in pathological conditions, notably inflammatory or cardiovascular diseases such as acute myocardial infarction and heart failure, underscoring their potential as sensitive indicators of disease. Furthermore, the rise in CEC levels in cancer patients, particularly with disease advancement, points to their role in cancer-associated angiogenesis and response to treatment.

This review underscores the evolving significance of CECs as markers for evaluating the gravity and advancement of diseases with vascular injury, including cardiovascular diseases, cancer, inflammatory conditions, and thromboembolic events. These last years, efforts made to standardize flow cytometry detection of CEC and the development of highly sensitive techniques to isolate, quantify or phenotype rare cells open promising avenues for clinical application. This may yield extensive knowledge regarding the mechanisms by which endothelial cells contribute to a variety of vascular-related disorders and their clinical value as emerging biomarkers
Familial hypercholesterolemia in children and the importance of early treatment
Authors: van den Bosch Sibbeliene E. , Hutten Barbara A. , Corpeleijn Willemijn E. , Kusters D. Meeike
Published: February 2024

Purpose of review

Familial hypercholesterolemia leads to elevated levels of low-density lipoprotein cholesterol (LDL-C) from birth onwards due to a pathogenetic variation in genes in cholesterol metabolism. Early screening to identify and subsequently treat children with familial hypercholesterolemia is crucial to reduce the risk of premature atherosclerotic cardiovascular disease (ASCVD). This review focuses on recent insights in the field of pediatric familial hypercholesterolemia.

Recent findings

Screening in childhood and early initiation of optimal lipid-lowering therapy (LLT) have shown promising outcomes in the prevention of ASCVD. In addition, cost-effectiveness research has demonstrated highly favorable results. With the availability of novel therapies, familial hypercholesterolemia has become a well treatable disease.

Children with familial hypercholesterolemia benefit from early detection and optimal treatment of their elevated LDL-C levels.
Enhancement of Preoperative Mental Health Assessment Through Clinical Nurse Specialist Project Leadership
Authors: Dinsmore Jill S. , Schmidt Carrie L. , Messner Penny K. , Loth Ann R. , Meiers Sonja J.
Published: February 2024

Purpose/Objectives

The aim of the project was to discern whether a collaborative, consultative-rich, clinical nurse specialist–led project could increase completion rates of a patient health questionnaire for depression and a generalized anxiety disorder questionnaire with appropriate referrals in adult patients in the ambulatory and hospital settings of a robust cardiovascular surgery practice before cardiovascular surgery.

Description of Project

The Define, Measure, Analyze, Improve, Control implementation methodology guided this quality improvement project. The workflow was analyzed in collaboration with stakeholders, and barriers to and facilitators of questionnaire completion were identified. Interpreter services partnerships were enhanced and used for patients with a preferred language other than English. Weekly data analysis assessed ongoing questionnaire completion rates.

Outcome

Documented completion rates of questionnaires improved across ambulatory and hospital settings by 15%. Patients with a preferred language other than English had an 80-percentage-point increase in documented questionnaire completion.

Conclusion

Clinical nurse specialists are poised to lead projects because of their use of the collaborative and consultative core competencies. A formal electronic health record report was established for monitoring outcomes. Embedding questionnaire administration within the standard workflow of ambulatory and hospital staff makes administering questionnaires preoperatively a sustainable practice in both settings.
Clinical Nurse Specialist Role Advocacy
Authors: Toth Chantal , Miller Kelsey , Hart Amanda , Kidd Micah
Published: February 2024

Purpose/Objectives

The purpose of this article is to guide the clinical nurse specialist in constructing a scorecard to track clinical outcomes and identify the associated financial impact.

Description of the Project/Program

Creation of a scorecard highlighting the financial impact of the clinical nurse specialist team was used to disseminate financial outcomes to hospital executive stakeholders, allowing the clinical nurse specialist team to demonstrate its clinical and financial value.

Outcome

During development and ongoing maintenance of the scorecard, the clinical nurse specialist team cultivated skills to identify the financial impact of projects. The team also utilized financial implications of individual and group projects to prioritize work. At the end of fiscal year 2022, the clinical nurse specialist team demonstrated revenue generation of $29 890 and cost avoidance of $2 854 807.30. The clinical nurse specialist scorecard was presented quarterly to the chief nursing officer, who shared with executive leadership.

Conclusion

Clinical nurse specialists are positioned to make significant and positive financial impact to organizations. A scorecard presented to executive leadership offers a clinical nurse specialist team a tool to capture and disseminate a clinical nurse specialist team's unique financial contribution at the system level.
Oncology Clinical Nurse Specialists Practice in the Outpatient Setting
Authors: Inumerables Faye , Freedman Kara , Leary Megan , Short Kathleen
Published: February 2024

Purpose/Objectives

With rapidly evolving oncology care, the role of the outpatient clinical nurse specialist is most valuable and essential. The purpose of this article is to describe the role of the clinical nurse specialist in the ambulatory oncology settings and highlight the clinical nurse specialists' unique influence across the spheres of impact.

Description of the Project/Program

This article shares several contributions of an outpatient clinical nurse specialist, which include ways this role impacts nursing practice, patient care, and standardizing organizational guidelines. A method of recording the clinical nurse specialists' encounters or indirect consults was also utilized to provide a process to log consultation received in the day-to-day practice. Work exemplars were included to further demonstrate the impact of this role in this setting.

Conclusion

Outpatient clinical nurse specialist need is rising especially in the oncology setting where the majority of cancer care and treatment is delivered. It is important to continue to disseminate and highlight the value it brings to the organization.
Inpatient Rehabilitation of Hematopoietic Stem Cell Transplant Patients
Authors: Fu Jack B. , Morishita Shinichiro
Published: February 2024

Hematopoietic stem cell transplants play an important role in the treatment of cancer, particularly hematologic malignancies. These patients can encounter functional impairments unique to hematopoietic stem cell transplant, including deconditioning, cancer-related fatigue, steroid myopathy, graft versus host disease, and capillary leak syndrome. Medical fragility and increased risk of infection may make rehabilitation challenging on the acute care and postacute care settings. Patients admitted to acute inpatient rehabilitation experience a high rate of transfer to the primary acute service and high rate of mortality after transfer back. Physical medicine and rehabilitation physicians can use a number of strategies to mitigate these patients’ risk of medical complications including evidence-based predictive models to assist with postacute rehabilitation triage, physiatry-led consult-based rehabilitation, and oncology hospitalist comanagement on inpatient rehabilitation.
Telemedicine in Cancer Rehabilitation
Authors: Davidoff Chanel , Cheville Andrea
Published: February 2024

Advancements in telemedicine have revolutionized the landscape of healthcare delivery, with particular implications for cancer rehabilitation. This journal article provides a comprehensive review of the utilization and application of telemedicine in cancer rehabilitation, spanning the entire cancer care continuum. The integration of telemedicine in cancer rehabilitation services is explored from diagnosis through survivorship, addressing the unique challenges and opportunities at each stage.
Association of Academic Physiatrists Residency and Fellowship Program Directors’ Resident Recruitment Subcouncil Position Paper on Residency Recruitment
Authors: Dragojlovic Nikola , Romanoski Natasha L. , Bolger Ashlee , Friedlander Tracy , Helkowski Wendy , Huss Sara A. , Jenkins Jeffrey G. , Knowlton Tiffany , Nguyen Dianna H. , Rand Stephanie E. , Raum George , Sullivan William , Tonkin Brionn K. , Escalon Miguel X.
Published: February 2024

Residency recruitment practices have undergone significant changes in the last several years. Interviews are now conducted fully virtually leading to both positive and negative downstream effects including decreased cost to applicants and programs, decreased time away from clinical activities, flexibility in scheduling, and increased applications for applicants and program directors. In response to these changes, the Association of Academic Physiatrists (AAP) Residency and Fellowship Program Directors Council convened a workgroup consisting of program directors, program coordinators, residents, and medical students who reviewed the available literature to provide an evidence-based set of best practices for program leaders and applicants. Available data from the Association of American Medical Colleges (AAMC) and its relevance to future recruitment cycles is also discussed.
Evidence-based practice education in physical medicine and rehabilitation residency programs: A Canadian national survey
Authors: Kumbhare Dinesh , Rizzo John Ross , Bean Allison , Annaswamy Thiru ,   and the AAP Research Committee:
Published: February 2024

Objective

The current extent and quality of evidence based practice (EBP) training for physiatrists is unclear at this time. Training of EBP is also available to residents in Canada. The extent, quality and impact of the training was explored.

Design

Cohort study Results: about half of the Canadian programs reported a formal EBP curriculum. The most frequently reported method of providing EBP education were resident participation in journal club.

Conclusions

Despite the increasing integration of EBP into residency program education, there remains a critical lack of knowledge and skills for implementation of EBP into clinical practice among Canadian PM&R residency programs.