bluuebunny/crossref_metadata_2025 huggingface dataset:
Intraoperative ultrasonography (IOUS)‐guided vs conventional laparoscopic nephrectomy: a randomised control trial
Authors: Das Manoj K. , Rohith Gorrepati , Mandal Swarnendu , Gaur Abhay Singh , Nayak Prasant , Kumaraswamy Santosh , Tarigopula Vivek , Dheroo Dheeraj Kumar , Tripathy Sambit
Published: July 2023

Objectives

To assess the efficacy of routine use of intraoperative ultrasonography (IOUS) in improving perioperative outcomes in patients undergoing IOUS‐guided laparoscopic nephrectomy (IOUS‐LN) and conventional laparoscopic nephrectomy (C‐LN).

Patients and Methods

This was a parallel‐arm, single‐blinded, randomised controlled trial (CTRI/2021/12/038906). All patients undergoing LN, either for benign or malignant causes, were included. Patients undergoing partial/cytoreductive nephrectomy, with venous thrombus were excluded. In the study arm, IOUS‐guided renal vascular assessment was performed after colon mobilisation and a standard LN was performed in the control arm. The primary outcome was intraoperative duration. The secondary outcomes were blood loss, need for open conversion, blood transfusion, perioperative complications, duration of Intensive Care Unit (ICU) stay and length of hospitalisation (LOH). The patients were followed for 3 months after surgery.

Results

A total of 104 patients were included, with 52 in each arm. Demographic characteristics were comparable in both arms. A significant reduction in the operative duration (mean [sd] 181.69 [40.8] vs 199.7 [41.8] min, P = 0.02) was seen in the IOUS‐LN group. The difference in blood loss showed no significant difference when compared between both groups (median [interquartile range] 84.55 [74–105.5] vs 99.95 [78.5–111] mL, P = 0.08). On subgroup analysis, the reduction in the operative duration was significant in patients who underwent laparoscopic simple nephrectomy (LSN; mean [sd] 194.4 [42.5] vs 221.2 [36.4] min, P = 0.01), whereas comparable operative durations were seen in patients undergoing laparoscopic radical nephrectomy (LRN; mean [sd] 168.96 [35.3] vs 178.3 [35.9] min, P = 0.34). Similar conversion rates were seen in both groups (P = 0.98) along with blood transfusions (P = 0.78). The LOH, ICU stay, and complications were similar in both groups. Significantly less blood loss (P = 0.03) was noted with IOUS in patients undergoing LSN. IOUS did not influence any outcomes in patients undergoing LRN.

Conclusion

Intraoperative ultrasonography significantly reduced the operative duration in LN, but with no significant reduction in the volume of blood loss. Significant reduction in intraoperative duration and blood loss was seen in patients who underwent LSN on subgroup analysis.
Biomarkers of immune checkpoint inhibitor response and toxicity: Challenges and opportunities
Authors: Goodman Rachel S. , Jung Seungyeon , Balko Justin M. , Johnson Douglas B.
Published: July 2023

Immune checkpoint inhibitors have transformed cancer therapy, but their optimal use is still constrained by lack of response and toxicity. Biomarkers of response may facilitate drug development by allowing appropriate therapy selection and focusing clinical trial enrollment. However, aside from PD‐L1 staining in a subset of tumors and rarely mismatch repair deficiency, no biomarkers are routinely used in the clinic. In addition, severe toxicities may cause severe morbidity, therapy discontinuation, and even death. Here, we review the state of the field with a focus on our research in therapeutic biomarkers and toxicities from immune checkpoint inhibitors.
Whole‐of‐government and joined‐up government: A systematic literature review
Authors: Aoki Naomi , Tay Melvin , Rawat Stuti
Published: July 2023

We conducted a systematic literature review of 340 journal articles (1992–2021) pertaining to whole‐of‐government (WG) and joined‐up government (JUG)—two terms that denote public sector efforts to promote cross‐boundary work and restructuring. This review clarifies and renews our understanding of developments with respect to WG/JUG research. While JUG articles do not appear to be increasing, the number of WG articles is on a general upward trend. As of 2021, more WG articles were published on countries other than the Western nations typically recognized as centers for these reforms, signaling increasing global relevance of the topic. These articles were published in over 200 journals and span various policy spheres, suggesting the wide impact research can have. While the qualitative studies we reviewed update the list of recommendations for effective WG/JUG, large‐N hypothesis testing remains limited—a gap that can be addressed to generate robust knowledge on this topic.
MdHB7‐like positively modulates apple salt tolerance by promoting autophagic activity and Na+ efflux
Authors: Yang Jie , Qiu Lina , Mei Quanlin , Sun Yunxia , Li Na , Gong Xiaoqing , Ma Fengwang , Mao Ke
Published: July 2023

Salt stress adversely affects the yield and quality of crops and limits their geographical distribution. Studying the functions and regulatory mechanisms of key genes in the salt stress response is important for breeding crops with enhanced stress resistance. Autophagy plays an important role in modulating the tolerance of plants to various types of abiotic stressors. However, the mechanisms underlying salt‐induced autophagy are largely unknown. Cation/Ca2+ exchanger proteins enhance apple salt tolerance by inhibiting Na+ accumulation but the mechanism underlying the response to salt stress remains unclear. Here, we show that the autophagy‐related gene MdATG18a modulated apple salt tolerance. Under salt stress, the autophagic activity, proline content, and antioxidant enzyme activities were higher and Na+ accumulation was lower in MdATG18a‐overexpressing transgenic plants than in control plants. The use of an autophagy inhibitor during the salt treatment demonstrated that the regulatory function of MdATG18a depended on autophagy. The yeast‐one‐hybrid assay revealed that the homeodomain‐leucine zipper (HD‐Zip) transcription factor MdHB7‐like directly bound to the MdATG18a promoter. Transcriptional regulation and genetic analyses showed that MdHB7‐like enhanced salt‐induced autophagic activity by promoting MdATG18a expression. The analysis of Na+ efflux rate in transgenic yeast indicated that MdCCX1 expression significantly promoted Na+ efflux. Promoter binding, transcriptional regulation, and genetic analyses showed that MdHB7‐like promoted Na+ efflux and apple salt tolerance by directly promoting MdCCX1 expression, which was independent of the autophagy pathway. Overall, our findings provide insight into the mechanism underlying MdHB7‐like‐mediated salt tolerance in apple through the MdHB7‐like‐MdATG18a and MdHB7‐like‐MdCCX1 modules. These results will aid future studies on the mechanisms underlying stress‐induced autophagy and the regulation of stress tolerance in plants.
What influences decisions to donate plasma? A rapid review of the literature
Authors: Berger Mary , Easterbrook Adam , Holloway Kelly , Devine Dana , Bansback Nick
Published: July 2023

Background and Objectives

Plasma has become an essential ingredient for various medical treatments. Many blood collection agencies rely on voluntary non‐remunerated donation when collecting plasma, but at present many do not collect sufficient plasma to meet domestic demands. This rapid review sought to explore the factors that have been found to influence people's decisions to donate plasma to inform future research.

Methods

Searches were conducted in PubMed, PsycINFO, Social Sciences Citation Index and CINAHL for peer‐reviewed journal articles that discussed plasma donation and the factors associated with donor behaviour. Pertinent information from included articles was extracted and arranged in themes.

Results

In total, 33 articles were included in this review. Three main themes were identified by the authors. The first focused on site‐level factors related to blood collection agencies' engagement with plasma donors and their influence on plasma donation experiences. The second theme considered how individual characteristics and experiences influence willingness to donate plasma. The third theme examined social and cultural‐level factors, such as how social networks and community shape perceptions and experiences with donation.

Conclusion

Our findings suggest that the current understanding of plasma donation is focused mainly on converting whole blood donors and also centres on individual‐level factors to donation. Further research must examine what factors attract non‐whole blood donors to become plasma donors, focusing on broader social‐level influences. This review will inform policies and interventions for blood collection agencies to increase plasma donors.
Social Work England: A regulator worthy of our collective dissent
Authors: Hanley Joe
Published: July 2023

INTRODUCTION: In December 2019, Social Work England (SWE) officially took over as the regulator of the approximately 100,000 social workers in England. This article explores the foundations and first two years of SWE, suggesting that, as a regulator, it has earned the collective dissent of social workers.
APPROACH: Initially, a brief history of social work regulation in England is provided, before moving on to explore the founding of SWE and the makeup of the organisation. The regulator’s standards and rules, approach to consultation and representative role are also discussed.
DISCUSSION: This culminates in a discussion about the dissent that many social workers in England have already started to demonstrate towards SWE, with a particular focus on the new continuing professional development (CPD) requirements. The potential to translate this largely individual dissent into collective action and mutual support is explored.
Draft genome sequence of
Pseudomonas
sp. GOM6, a lipolytic strain isolated from seawater of the Gulf of Mexico
Authors: Rojas-Vargas Jorge , Muriel-Millán Luis Felipe , Pardo-López Liliana
Published: July 2023

We report here the draft genome sequence of a marine
Pseudomonas
sp. novel species with lipase activity isolated from a deep-sea water sample of the Gulf of Mexico. The genome consists of 4.3 Mbp in 48 contigs.
Ibex Hollow Tuff from ca. 12 Ma supereruption, southern Idaho, identified across North America, eastern Pacific Ocean, and Gulf of Mexico
Authors: Sarna-Wojcicki Andrei M. , Knott Jefferey R. , Westgate John A. , Budahn James R. , Barron John , Bray Colin J. , Ludvigson Greg A. , Meyer Charles E. , Miller David M. , Otto Rick E. , Pearce Nicholas J.G. , Smith Charles C. , Walkup Laura C. , Wan Elmira , Yount James
Published: July 2023

The Ibex Hollow Tuff, 12.08 ± 0.03 Ma (40Ar/39Ar), is a widespread tephra layer erupted from the Bruneau-Jarbidge volcanic field of southern Idaho. Tephra from this eruption was deposited across much of western and central North America and adjacent ocean areas. We identified the Ibex Hollow Tuff at Trapper Creek, Idaho, near its eruption site, and at 15 distal sites, from the Pacific Ocean to the Gulf of Mexico, by the chemical composition of its glass shards, using electron-microprobe analysis, instrumental neutron activation analysis, and laser-ablation–inductively coupled plasma–mass spectrometry. By these methods, we distinguished the Ibex Hollow Tuff from overlying and underlying tephra layers near its source and at distal sites. Fluvially reworked Ibex Hollow Tuff ash was transported by the ancestral Mississippi River drainage from the interior of the North American continent to the Gulf of Mexico, where it is present within an ~50-m-thick deposit in marine sediments in the subsurface. The minimum fallout area covered by the ash is ~2.7 million km2, with a minimum volume of ~800 km3, and potential dispersal farther to the north and northeast. The areal distribution for the Ibex Hollow Tuff is similar to that of the Lava Creek B (0.63 Ma) supereruption. The Ibex Hollow Tuff represents a unique chronostratigraphic marker allowing a synoptic view of paleoenvironments at a virtual moment in time across a large terrestrial and marine region. The Ibex Hollow Tuff is also an important marker bed for North American Land Mammal Ages, and it coincides with climatic cooling in the middle to late Miocene documented in marine cores.
Effectiveness of individual nutrition counselling for the prevention of undernutrition among elderly people living in depopulated areas: secondary analysis of a model project in Tsu city
Authors: Okumura Keiko , Ichikawa Shuhei , Wakabayashi Hideki , Hong Young Jae , Tokudome Yuko , Takemura Yousuke
Published: July 2023

Objectives

To examine the effectiveness of nutrition counselling (NC) in preventing undernutrition in elderly people living in depopulated areas.

Design

Participants were elderly people aged at least 65 years living in a depopulated area. Participants completed self-administered questionnaires evaluating nutritional status, frailty and body composition at the start of the study, after a non-NC period (3-month control) and after an NC period (3-month intervention). During the NC period, participants attended monthly 1-hour NC sessions over 3 months. Sessions were conducted in three areas (A, B and C), and the schedule was staggered so that the NC period in one area was conducted simultaneously with the non-NC period of the next. All sessions within an area were attended by the same registered dietitian. Outcomes were assessed three times: before the non-NC period, after the non-NC period and after the NC period. The effects of NC were assessed by comparing the results between the non-NC and NC periods of all participants, using the Cochran-Mantel-Haenszel stratified test.

Outcome measures

The primary outcome was undernutrition, as determined by the Mini Nutritional Assessment—Short Form. Secondary outcomes were Dietary Diversity Score (DVS), body weight and frailty. Body composition was also assessed.

Results

Of 106 individuals who joined the project, 61 completed the project and were analysed. The NC in this study had no effect on the primary outcome. DVS in area A was significantly higher after the NC period than after the non-NC period (p=0.012). Frailty in area C was significantly lower after the NC period than after the non-NC period (p=0.025). NC had no significant effects on the other outcomes.

Conclusions

NC improved food variety but did not improve nutritional status, frailty or body composition.
Civil servants’ physical activity status and its associated factors in Northeast Ethiopia: applying Health Belief Model
Authors: Getachew Eyob , Wasihun Yosef , Gutema Hordofa , Bogale Eyob Ketema , Shewaye Melaku , Dessie Anteneh Mengist , Yenew Chalachew
Published: July 2023

Background

Identifying the associated factors of the physical activity of civil servants is necessary to increase the practice of physical activity. However, limited studies addressed associated factors of civil servants’ physical activity status in Ethiopia. Hence, this study assessed civil servants’ physical activity status and associated factors in Northeast Ethiopia.

Methods

An institution-based cross-sectional study design was conducted from 28 February to 13 March 2020 and measured physical activity using WHO physical activity definition. Four hundred and eight civil servants were interviewed using a systematic random sampling technique. A descriptive statistics and multivariable logistic regression model were used.

Result

The percentage of physical activity for the civil servants of the study was only 2.38, with the prevalence of physical activity status of 64.0% (95% CI 60.4% to 67.61%). Perceived self-efficacy (adjusted OR (AOR)=1.98, 95% CI 1.15 to 4.12), cues to action (AOR=2.12, 95% CI 1.04 to 3.22) and being a health professional (AOR=2.19, 95% CI 1.13, 4.23) were main associated factors of physical activity. However, physical activity was not affected by respondents’ sex (AOR=1.01, 95% CI 0.67 to 1.83), educational status (AOR=0.23, 95% CI 0.03 to 1.91), perceived barrier (AOR=0.97, 95% CI 0.91 to 1.04) or perceived benefit (AOR=1.02, 95% CI 0.95 to 1.09).

Conclusion

The health profession, self-efficacy and cues to action were the main associated factors of physical activity. Hence, the Sports Bureau and Health Bureau should pay attention to providing information by focusing on improving self-confidence and creating a positive attitude toward physical activity.
Prognostic utility of N-terminal pro B-type natriuretic peptide ratio in mixed aortic valve disease
Authors: Bernard Jérémy , Jean Guillaume , Bienjonetti-Boudreau David , Jacques Frédéric , Tastet Lionel , Salaun Erwan , Clavel Marie-Annick
Published: July 2023

Objective

We aimed to assess the incremental prognostic value of N-terminal-pro-B-type natriuretic peptide (Nt-proBNP) for risk stratification in mixed aortic valve disease (MAVD) patients.

Methods

We included 556 (73±12 years, 37% women) consecutive patients with at least a moderate aortic stenosis (AS) or aortic regurgitation (AR) lesion with a concomitant AS or AR of any severity in whom Nt-proBNP was measured and expressed as its ratio (measured Nt-proBNP divided by the upper limit of normal Nt-proBNP for age and sex). The primary endpoint was all-cause mortality.

Results

Baseline median Nt-proBNP ratio was 3.8 (IQR: 1.5–11.3), and the median follow-up was 5.6 years (4.8–6.1). Early aortic valve replacement (AVR) was performed within 3 months in 423 (76%) patients, while 133 (24%) remained initially under medical treatment. In comprehensive multivariable analyses, Nt-proBNP ratio was significantly associated with excess mortality (continuous variable: HR (95% CI): 1.24 (1.04 to 1.47), p=0.02; Nt-proBNP ratio ≥3: 2.41 (1.33 to 4.39), p=0.004). The independent prognostic value was also observed in patients with severe or non-severe AS/AR, and those treated by early-AVR (all p<0.04). Nt-proBNP ratio as continuous and dichotomic (≥3) variables showed incremental prognostic value (all net reclassification index >0.42, all p≤0.008). After early-AVR, Nt-proBNP ratio ≥3 was associated with higher 30-day mortality (9 (4%) vs 1 (0.5%), p=0.02).

Conclusions

In this series of MAVD patients, Nt-proBNP ratio was a powerful predictor of early and long-term mortality, even in patients with both non-severe AS/AR. Moreover, early-AVR may be an option for patients with Nt-proBNP ratio ≥3. Further randomised studies are needed to validate this last point.
Least Trimmed Squares for Regression Models with Stable Errors
Authors: Shiekh Albasatneh Mohammad Bassam , Mohammadpour Adel
Published: July 2023

Least Trimmed Squares (LTS) is a robust regression method with respect to outliers. It is based on performing Ordinary Least Squares (OLS) estimates on sub-datasets and determining the optimal solution corresponding to the minimum sum of squared residuals. Since the method of LTS is based on OLS, errors in regression models have finite variance. This work aims to generalize LTS for heavy tail data with infinite variance. When errors have infinite variance, it is impossible to benefit from OLS estimates. We use the property of variance existence of most ordered errors to find an initial robust OLS estimate. We polish the LTS method with a maximum likelihood estimator based on the density function of order statistics and determine the optimal solution for stable regression models. The proposed algorithm is implemented for linear regression models.
THE EFFECT OF TECAR THERAPY USING WINBACK ON DIAPHRAGM MOVEMENT AND CHEST MOBILITY IN ADULTS WITH LIMITED CHEST MOBILITY
Authors: CHA YOUNGJOO , PARK CHANHEE , PARK ILBONG , YOON SAMWON
Published: July 2023

The diaphragm is an essential respiratory muscle that accounts for 70% of the inspiratory function during stable breathing. Diaphragm weakness leads to decreased thoracic mobility due to inspiratory assist muscles overuse. It is closely related to respiratory dysfunction. This study aims to define the effect of TECAR therapy using Winback on diaphragm movement and chest mobility in adults with limited chest mobility. Thirty-six young adults with limited chest mobility were selected as participants in this study. TECAR therapy was applied to the participant’s diaphragm for 15[Formula: see text]min. Ultrasound measured each group’s diaphragm movement, and a tape measure was used to measure chest mobility. A paired t-test analyzed each group’s diaphragm movement and chest mobility change, and an independent t-test analyzed the difference in the amount of change between groups. The value was set to 0.05. As a result, after the intervention, diaphragm movement (unit: cm) significantly increased from [Formula: see text] to [Formula: see text] ([Formula: see text]). Upper chest movement (unit: cm) significantly increased from [Formula: see text]-[Formula: see text], middle chest movement (unit: cm) increased from [Formula: see text]-[Formula: see text], and lower chest movement (unit: cm) increased from [Formula: see text]-[Formula: see text] ([Formula: see text]). The results provide innovative clinical evidence that TECAR therapy significantly affected diaphragm movement and chest mobility improvement in young adults with limited chest mobility.
COMPARISON BETWEEN DIRECT ANTERIOR APPROACH AND MINIMALLY INVASIVE POSTEROLATERAL APPROACH FOR BIPOLAR HEMIARTHROPLASTY IN ELDERLY PATIENTS WITH FEMORAL NECK FRACTURE
Authors: LIU WEI , HAO CONGQIANG , ZONG YAQI , LIN WEI
Published: July 2023

Background: This study was performed to compare the clinical effect of bipolar hemiarthroplasty via the direct anterior approach (DAA) or minimally invasive posterolateral approach (MIPA) in elderly patients with femoral neck fracture. Methods: In total, 196 elderly patients with femoral neck fractures were divided into the DAA group ([Formula: see text]) and MIPA group ([Formula: see text]). The clinical data, postoperative pain and complications, time until able to remain seated for 1 hour and walk independently, postoperative Harris score of functional activity at 6 weeks and 2 years postoperatively, and mortality at 2 years postoperatively were compared between the groups. Results: The DAA group had a longer operation time but a lower incidence of pneumonia 72 hours postoperatively, lower visual analogue scale score 24 hours postoperatively, and earlier time until able to remain seated for 1 hour and walk independently ([Formula: see text]). Six weeks postoperatively, the Harris scores for putting on socks, tying shoelaces, sitting comfortably on a chair, and climbing stairs were better in the DAA than the MIPA group ([Formula: see text]). After 2 years, there was no significant difference in the Harris scores between the two groups ([Formula: see text]). Conclusion: In elderly patients undergoing bipolar hemiarthroplasty, the DAA can be more effective than the MIPA in reducing the incidence of complications associated with long-term bed rest, relieving early postoperative pain, and improving early postoperative hip function.
RESEARCH ON WIDE SPECTRUM FULL-COLOR NIGHT VISION ELDERLY FACIAL VIDEO HEART RATE AUTOMATIC MEASUREMENT AND WARNING SYSTEM
Authors: XU ZIYUAN , CAI YANNA , WANG XIAOZHON , ZHOU SHAOJIN , LIU XIHUA , HUA KEWEI , WANG KEQIONG , JIANG YU
Published: July 2023

In recent years, the prevalence of cardiovascular diseases has been growing geometrically, especially among the elderly. Real-time heart rate monitoring becomes an effective measure for preventing cardiovascular diseases. Traditional contact-based real-time heart rate measurement methods require long-term wearing of contact electrodes, which can cause inconvenience to the elderly population. In this study, a wide spectrum full color night vision elderly face video heart rate automatic measurement and early warning system was designed and developed by combining imaging photoplethysmography (IPPG), video acquisition equipment based on starlight wide spectrum camera and high-speed face recognition signal processing algorithm based on deep learning. By constructing a software and hardware platform, a comprehensive evaluation of the system’s application in elderly facial video heart rate measurement experiments was conducted.
THE ASSOCIATION BETWEEN EPILEPSY AND SYNAPTIC PLASTICITY: BIBLIOMETRICS RESEARCH AND VISUAL ANALYSIS USING CITESPACE
Authors: CUI YUNMEI , WANG QIANQI , ZHAI HUIGE , YAN GEN , LI JINZI
Published: July 2023

Objective: This study used CiteSpace to look at the current state of research on epilepsy and synaptic plasticity and to point out the hotspots and frontiers. Method: We searched Web of Science (WoS) for studies related to epilepsy and synaptic plasticity. CiteSpace was used to construct network maps of cooperation across countries, institutions, and authors to identify frontiers and hotspots in epilepsy and synaptic plasticity research. Results: A total of 1700 studies on epilepsy and synaptic plasticity were retrieved from the WoS. The United States and Baylor College of Medicine were the most prolific nation and institution in this field with 680 and 28 publications, respectively. The most prolific author (11 articles) was Xuefeng Wang. The Journal of Neuroscience published the most articles (71, 6.71%) and had the most co-citations (1557, 4.57%). In this paper, the interaction and mechanism between epilepsy and synaptic plasticity, as well as future research hotspots, are highlighted. Conclusion: CiteSpace can reveal the institutions, leaders, journals, cited papers, and research hotspots involved in epilepsy and synaptic plasticity. To the best of our knowledge, this is the first study that visualizes the relationship between epilepsy and synaptic plasticity and provides references for future research directions.
COMPARISON OF CONVOLUTIONAL NEURAL NETWORK IMAGE CLASSIFICATION PERFORMANCE RELATIVE TO THE AMOUNT OF TRAINING DATA USING CARDIOMEGALY X-RAY IMAGES
Authors: KIM MINJEONG , KIM JUNGHUN , LEE JONGMIN
Published: July 2023

Deep learning simultaneously learns a large amount of data, correct answers (labels), and extracts and learns features from the data. When training a deep learning model, the amount of data in your dataset has a significant impact on model performance. However, in the case of medical images, it is difficult to collect a large amount of data due to problems such as personal information protection. Also, since dedicated expertise is required to build an effective dataset, the amount of data that can be obtained is limited. Data augmentation techniques have been utilized to improve performance in various medical artificial intelligence studies and are considered an essential process to improve the performance of deep learning models. Data augmentation allows you to learn from different types of data. However, the standard process for achieving good performance when using a specific size of training data is still unclear. We compared the classification performance of several convolutional neural network models using datasets with different amounts of data to identify the optimal amount of training data that ensures good performance. We attempted to quantify the optimal amount of data for each convolutional neural network model by comparing overall results using both real and augmented datasets.
Primary Hyperoxaluria Type 1: Clinical, Paraclinical, and Evolutionary Aspects in Adults from One Nephrology Center
Authors: Meriam Hajji , Bettaieb Asma , Kaaroud Hayet , Ben Hamida Fethi , Gargeh Taher , Mrad Ridha , Bouzid Kahena , Abderrahim Ezzeddine
Published: July 2023

Introduction. Primary hyperoxaluria type 1 (PH1) is a rare and inherited condition of urolithiasis. The aim of our study was to analyze clinical, paraclinical, and evolutionary aspects of PH1 in adult patients in our Nephrology department. Methods. We conducted a retrospective single-center study between 1990 and 2021. We collected patients followed for PH1 confirmed by genetic study and/or histopathological features of renal biopsy and morphoconstitutional analysis of the calculi. Results. There were 25 patients with a gender ratio of 1.78. The median age at onset of symptoms was 18 years. A delay in diagnosis more than 10 years was noted in 13 cases. The genetic study found the I244T mutation in 17 cases and 33-34 InsC in 4 cases. A kidney biopsy was performed in 5 cases, on a native kidney in 4 cases and on a graft biopsy in one case. The analysis of calculi was done in 10 cases showing type Ic in 2 cases. After a median follow-up of 13 years (1 year–42 years), 14 patients progressed to end-stage chronic renal failure (ESRD). The univariate study demonstrated a remarkable association with progression to ESRD in our population (44% vs. 56%) RR = 13.32 (adjusted ORs (95% CI): 2.82–62.79) (

p
<
0.01

). Conclusion. Progression to ESRD was frequent in our series. Early diagnosis and adequate management can delay such an evolution.
TABLE 1 from Salvage Ipilimumab plus Nivolumab after Anti-PD-1/PD-L1 Therapy in Advanced Hepatocellular Carcinoma
Authors: Alden Stephanie L. , Lim Mir , Kao Chester , Shu Daniel , Singal Amit G. , Noonan Anne , Griffith Paige , Baretti Marina , Ho Won Jin , Kamel Ihab , Yarchoan Mark , Hsiehchen David
Published: July 2023

Patient demographicsa
Supplementary Table S1-S5 from Kinase inhibitor pulldown assay identifies a chemotherapy response signature in triple negative breast cancer based on purine-binding proteins
Authors: Wang Junkai , Saltzman Alexander B , Jaehnig Eric J , Lei Jonathan T. , Malovannaya Anna , Holt Matthew V. , Young Meggie N. , Rimawi Mothaffar F. , Ademuyiwa Foluso O. , Anurag Meenakshi , Kim Beom-Jun , Ellis Matthew J.
Published: July 2023

Supplementary Table S1-S5
Supplementary Figure 4 from Kinase inhibitor pulldown assay identifies a chemotherapy response signature in triple negative breast cancer based on purine-binding proteins
Authors: Wang Junkai , Saltzman Alexander B , Jaehnig Eric J , Lei Jonathan T. , Malovannaya Anna , Holt Matthew V. , Young Meggie N. , Rimawi Mothaffar F. , Ademuyiwa Foluso O. , Anurag Meenakshi , Kim Beom-Jun , Ellis Matthew J.
Published: July 2023

Supplementary Figure 4
Reliable Cerebrospinal Fluid Cytology and Immunocytochemistry Reporting over an Extended Period by the Addition of Aldehyde and Osmolyte-Based Preservative Solution
Authors: Singh Lavleen , Rastogi Kanika , Jajoo Mamta
Published: July 2023

Introduction: The cytological examination of cerebrospinal fluid (CSF) is an important investigation in the workup of various inflammatory, malignant, or traumatic disorders of the central nervous system. The cells in the CSF lyse and degenerate at a very fast rate owing to its low tonicity, buffering capacity, redox potential, and pH, making it crucial to examine it within 2 h of sampling. We have hereby designed an aliphatic aldehyde, osmolyte, metal halide, and a buffer-based solution which will preserve the cellular components of CSF for 48 h. Methods: Thirty-nine CSF specimens were examined within 2 h of collection, and this reading was recorded as time zero reading. The CSF specimens were then divided into two tubes with (i) pre‐servative:CSF ratio of 1:5; and (ii) no preservative. Total and differential leukocyte counts and immunocytochemistry were performed on the paired specimens at 24 h and 48 h and were compared with the readings at zero hours. Results: The preservative-containing CSF showed significantly higher cellularity than the undiluted samples at 24 h and 48 h (p < 0.001). Median cell counts observed in the preservative-containing CSF were 5 times and 12 times higher than in the undiluted CSF. Neutrophils, lymphocytes, and RBCs showed immunopositivity for MPO, CD45, and GLUT-1 at both time intervals. Conclusion: Adding the prepared preservative solution to CSF in the ratio of 1:5 can optimally preserve the CSF cells for absolute and differential quantitation, morphological assessment, and immunological testing at a later date.
Improved Osteoarthritis during Erenumab Treatment for Migraine: A Case Report
Authors: Jantzen Frederik Thal , Christensen Rune Häckert , Chaudhry Basit Ali , Amin Faisal Mohammad
Published: July 2023

Antibodies blocking the calcitonin gene-related peptide have revolutionized episodic and chronic migraine treatment. However, their applicability to non-cephalic pain conditions, such as osteoarthritis, is yet unknown. Osteoarthritis remains a clinical challenge, associated with high disability and limited treatment options. Like migraine, neuropeptides including calcitonin gene-related peptides are involved in its pathophysiology. We present the first case of a patient: a 73-year-old female with osteoarthritis who received monthly treatment for her chronic migraine with 140 mg subcutaneous erenumab, a monoclonal antibody against the receptor of calcitonin gene-related peptide. Though the migraine was unresponsive, the patient’s arthritic symptoms improved drastically during treatment period with erenumab; daily pain decreased from VAS 7 to 2, and walking distance doubled from 1,000 m to 2,000 m. The arthritic symptoms relapsed after discontinuation of erenumab. Erenumab could potentially have beneficial effects on symptoms of osteoarthritis. Future studies investigating these effects are warranted.
Differential Unmet Needs and Experience of Restorative Dental Care in Trajectories of Dental Caries Experience: A Birth Cohort Study
Authors: Ruiz Begoña , Broadbent Jonathan M. , Thomson W. Murray , Ramrakha Sandhya , Hong Chuen Lin , Poulton Richie
Published: July 2023

Dental caries is a chronic and cumulative disease but little has been reported on the continuity of the disease and its treatment through life. Group-based multi-trajectory modeling was used to identify developmental trajectories of untreated carious tooth surfaces (DS), restored tooth surfaces (FS), and teeth extracted due to caries (MT) from ages 9 to 45 years in a New Zealand longitudinal birth cohort, the Dunedin Multidisciplinary Health and Development Study (n = 975). Associations between early-life risk factors and trajectory group membership were examined by specifying the probability of group membership according to a multinomial logit model. Six trajectory groups were identified and labeled: “low caries rate”; “moderate caries rate, maintained”; “moderate caries rate, unmaintained”; “high caries rate, restored”; “high caries rate, tooth loss”; and “high caries rate, untreated caries”. The two moderate-caries-rate groups differed in count of FS. The three high-caries-rate groups differed in the relative proportion of accumulated DS, FS, and MT. Early childhood risk factors associated with less favorable trajectories included higher dmfs scores at age 5, lack of exposure to community water fluoridation during the first 5 years of life, lower childhood IQ, and low childhood socioeconomic status. Parent self-ratings of their own or their child’s oral health as “poor” were associated with less favorable caries experience trajectories. Children who had clinical signs of dental caries together with a parent rating of child’s oral health as poor were more likely to follow a less favorable caries trajectory. Higher deciduous dentition caries experience at age 5 years was associated with less favorable caries trajectories, as were children whose parents gave “poor” ratings of their own or their child’s oral health. These findings highlight the considerable intergenerational continuity in dental caries experience from early childhood to midlife. Subjective measures of child oral health are informative and might aid as predictors of adult caries experience in cases where childhood dental clinical data were not available.
Ectopic Cushing’s Syndrome Secondary to Acinic Cell Carcinoma of the Parotid Gland: A Case Report
Authors: Antunes Meireles Pedro Miguel , Pessoa Diana , Pinheiro Sara , Filipe Juliana Faria , Rito Miguel , Sargento Isabel
Published: July 2023

We present a case report of a patient with a rare high-grade transformation of an acinic cell carcinoma (ACC) of the parotid gland, who developed Cushing’s syndrome (CS) as a result of ectopic secretion of adrenocorticotropic hormone by the tumour. The hypercortisolism was successfully treated with metyrapone, and the ACC was treated with local radiotherapy and a combined six cycles of gemcitabine and cisplatin, having achieved a partial response to the tumour. A multidisciplinary approach and combined medical treatment with radiotherapy and were essential for disease control and CS management. ACC should be considered in the differential diagnosis of ectopic CS.
Predictors of Outcomes in Gastric Neuroendocrine Tumors: A Retrospective Cohort
Authors: Ortigão Raquel , Afonso Luís Pedro , Pimentel-Nunes Pedro , Dinis-Ribeiro Mário , Libânio Diogo
Published: July 2023

Introduction/Aim: Gastric neuroendocrine tumors (GNETs) frequently have an indolent clinical course, despite their metastatic potential. The aim of the study was to identify prognostic factors associated with overall survival and risk of metastases and to evaluate the impact of serial measurements of chromogranin A (CgA). Methods: The authors performed a retrospective cohort study including consecutive patients with GNET diagnosed between 2010 and 2019, with a minimum follow-up of 1 year. Univariate and multivariate analyses were performed. Results: We included 132 patients with GNET (type I, 113 patients; type II, 1 patient; type III, 14 patients; type IV, 2 patients; not classifiable, 2 patients), with 61% being female and a mean age at diagnosis of 66 years. During the follow-up period (median 66 months), 3 (2.3%) patients died due to metastatic disease (1 patient with type III and 2 patients with type IV). Male gender (p = 0.030), type III/IV (p < 0.001), Ki-67 index >20% (p < 0.001), grade 2/3 (p < 0.001), invasion beyond the submucosa (p < 0.001), and presence of metastases (p < 0.001) were identified as risk factors for mortality in the univariate analysis. Metastasis developed in 7 patients (5.3%). Multivariable analysis revealed that Ki-67 >20% (p = 0.016) was an independent risk factor for metastasis. Overall, CgA showed a sensitivity of 20% for detection of recurrence and a specificity of 79% (sensitivity of 8% and specificity of 71% in type I GNETs). Conclusion: Identification of risk factors for the presence of metastases and for mortality in these groups of patients can help in individualizing the therapeutic strategy. CgA seems to be a weak marker for monitoring patients with GNET.
Prognostic Significance of CD20 Expression in Children with Philadelphia Chromosome-Negative B-Cell Precursor Acute Lymphoblastic Leukemia
Authors: Wang Yu , Xue Yu-Juan , Jia Yue-Ping , Zuo Ying-Xi , Lu Ai-Dong , Zhang Le-Ping
Published: July 2023

Introduction: The prognostic significance of CD20 in pediatric B-cell precursor acute lymphoblastic leukemia (BCP-ALL) remains unclear. Therefore, in this study, we evaluated the prognostic value of CD20 expression in leukemia blasts in pediatric BCP-ALL at our institute. Methods: Between 2005 and 2017, 796 children with newly diagnosed Philadelphia-negative BCP-ALL were enrolled consecutively; clinical characteristics and treatment outcomes were analyzed and compared between CD20-positive and CD20-negative groups. Results: CD20 positivity was observed in 22.7% of enrolled patients. The analysis of overall and event-free survival showed that white blood cell count ≥50 × 109/L, no ETV6-RUNX1, day 33 minimal residual disease (MRD) ≥0.1%, and week 12 MRD ≥0.01% were independent risk factors. Meanwhile, in the CD20-positive group, week 12 MRD ≥0.01% was the only factor associated with long-term survival. Moreover, subgroup analysis revealed that in patients with extramedullary involvement (p = 0.047), MRD ≥0.1% on day 33 (p = 0.032), or MRD ≥0.01% at week 12 (p = 0.004), CD20 expression led to a poorer outcome compared to those without CD20 expression. Conclusions: Pediatric BCP-ALL with CD20 expression had unique clinicopathological characteristics, and MRD remained the major prognostic factor. CD20 expression had no prognostic value in pediatric BCP-ALL.
Anesthesia Management of a Pregnant Patient with Idiopathic Intracranial Hypertension and Sepsis Who Needs Emergency Cesarean Section: A Case Report
Authors: Hashey Ahmed Maher Ibrahim
Published: July 2023

Idiopathic intracranial hypertension (IIH) is a rare neurological disorder, characterized by raising intracranial pressure of unknown reason, increased cerebrospinal fluid pressure without changes in its composition, and usually it is presented by headache, papilledema. In this report, we will discuss the anesthesia management of cesarean section for a 31-year-old, morbidly obese patient (body mass index = 42 kg/m2), pregnant at 37 weeks, with IIH along with sepsis.
Utility of the Proposed Sydney System for Classification of Fine-Needle Aspiration Cytopathology of Lymph Node: A Retrospective Study at a Tertiary Care Center
Authors: Kanhe Rucha , Tummidi Santosh , Kothari Kanchan , Agnihotri Mona
Published: July 2023

Introduction: Fine-needle aspiration cytology (FNAC) is an established first-line technique for the evaluation of lymphadenopathy and, with the help of ancillary testing, can in many instances obviate the need for an open biopsy. The Sydney system was recently proposed to provide consensus guidelines for the performance, classification, and reporting of lymph node FNAC. The present study was undertaken to evaluate its utility and study the impact of rapid on-site evaluation (ROSE). Material and Methods: A retrospective analysis in which 1,500 lymph node FNACs was reviewed and assigned a diagnostic category from the Sydney system. Cyto-histopathological correlation and adequacy parameters were evaluated. Observation and Results: The cervical group of lymph nodes was the commonest group aspirated (89.7%). A total of 1,205/1,500 (80.3%) cases were category II (benign), and necrotizing granulomatous lymphadenitis was the most common pathology. The 750 cases with ROSE were subclassified as follows: 15 category I (inadequate), 629 category II (benign), 2 category III (atypia of undetermined significance), 9 category IV (suspicious for malignancy), and 95 category V (malignant). Among 750 cases without ROSE, 75 cases were in category I, 576 in category II, 3 in category III, 6 in category IV, and 90 in category V. Category I was thus significantly lower in the ROSE group compared to the non-ROSE group. Overall, the risk of malignancy was L1-0%, L2-0.20%, L3-100%, L4-92.3%, and L5-100%. Accuracy parameters revealed a sensitivity of 97.7%, specificity of 100%, PPV of 100%, NPV of 99.10%, and diagnostic accuracy of 99.54%. Discussion and Conclusion: FNAC can be used as the 1st line of treatment for lymph node pathology. ROSE can be used as an add-on to FNAC for reducing unsatisfactory rates and help triage material for ancillary testing whenever possible. The Sydney system should be implemented for achieving uniformity and reproducibility.
Low-Density Lipoprotein Adsorption by Centrifugal Plasma Separation Can Shorten Treatment Time
Authors: Ohkubo Atsushi , Sakurasawa Takatoshi , Naito Shotaro
Published: July 2023

Low-density lipoprotein (LDL) apheresis is effective for nephrotic syndrome in drug-resistant focal segmental glomerulosclerosis (FSGS). Dextran sulfate adsorption of LDL (DSAL) is widely used for this purpose. The Liposorber LA-15 system performs DSAL by membrane plasma separation (mDSAL) using an MA-03 plasma purification device. However, sufficient blood flow (Qb) frequently cannot be obtained from a peripheral vein with mDSAL. The recommended plasma filtration flow rate (Qf) when using the OP-05W membrane plasma separator is no more than 1/3 of Qb, giving plasma removal efficiency (PRE) of about 30%. In contrast, the centrifugal blood component separator Spectra Optia has PRE of 87–92.5% because centrifugal separation enables effective separation of plasma components even at low Qb. Here, we present the case of a man in his 40s with FSGS, for whom we began treatment with mDSAL with the intention of completing a 12-session cycle, but extended treatment times were required due to low Qb. Therefore, we switched to DSAL by centrifugation (cDSAL) using the Liposorber LA-40 system from the 6th session onward. Treatment time decreased from 190 min for the fifth session using mDSAL to 140 min for the sixth session using cDSAL. Mean treatment time also decreased from 155 ± 9 min for mDSAL (5 sessions) to 119 ± 20 min for cDSAL (7 sessions). Moreover, the LDL removal rate at a processed plasma volume was similar for both modalities. In conclusion, cDSAL can enable efficient plasma separation even with low Qb, with a comparable LDL removal rate and shorter treatment time relative to mDSAL.
Sex Hormones, Neurosteroids, and Glutamatergic Neurotransmission: A Review of the Literature
Authors: Goyette Meredith J. , Murray Sidney L. , Saldanha Colin J. , Holton Kathleen
Published: July 2023

Glutamatergic dysfunction has been implicated in the pathophysiology of multiple conditions including epilepsy, chronic pain, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD), raising interest in potential ways of modifying glutamate in the nervous system. Emerging research has suggested an interactive effect between sex hormones and glutamatergic neurotransmission. The objective of this paper was to review existing literature on the mechanism of interaction between sex hormones and glutamatergic neurotransmission, as well as to explore what is known about these interactions in various neurological and psychiatric conditions. This paper summarizes knowledge regarding mechanisms for these effects, and glutamatergic response to direct modulation of sex hormones. Research articles were identified via scholarly databases including PubMed, Google Scholar, and ProQuest. Articles were included if they were original research from peer-reviewed academic journals that dealt with glutamate, estrogen, progesterone, testosterone, neurosteroids, glutamate and sex hormone interactions, or the potential impact of glutamate and sex hormone interactions in the following conditions: chronic pain, epilepsy, PTSD, and PMDD. Current evidence suggests that sex hormones can directly modulate glutamatergic neurotransmission, with specific protective effects against excitotoxicity noted for estrogens. An effect of monosodium glutamate consumption on sex hormone levels has also been demonstrated, suggesting a possible bidirectional effect. Overall, there is a good deal of evidence suggesting a role for sex hormones, and specifically for estrogens, in the modulation of glutamatergic neurotransmission.
Associations of Cerebral Small Vessel Disease on the Features of Hematoma and Hematoma Expansion in Intracerebral Hemorrhage
Authors: Chen Chih-Hao , Chen Shuo-Fu , Tsai Hsin-Hsi , Chen Ya-Fang , Tang Sung-Chun , Jeng Jiann-Shing
Published: July 2023

Introduction: Several early noncontrast CT (NCCT) signs of spontaneous intracerebral hemorrhage (ICH) can predict hematoma expansion (HE). However, the associations of underlying cerebral small vessel disease (SVD) on early NCCT signs and HE have been less explored. Methods: We conducted an analysis of all patients with spontaneous supratentorial ICH and received follow-up imaging between 2016 and 2020 at a stroke center. The early NCCT signs were categorized as shape or density signs. HE was defined as an increase in hematoma volume ≥6 mL or 33% from baseline. The severity of SVD was assessed by both a 3-point CT-based and a 4-point magnetic resonance imaging (MRI)-based SVD score. Regression models were used to examine the associations between SVD score and hematoma volume, NCCT signs, and HE. Results: A total of 328 patients (median age: 64 years; 38% female) were included. The median baseline ICH volume was 8.6 mL, with 38% of the patients had shape signs and 52% had density signs on the initial NCCT. Higher MRI-SVD scores were associated with smaller ICH volumes (p = 0.0006), fewer shape (p = 0.001), or density signs (p = 0.0003). Overall, 16% of patients experienced HE. A higher MRI-SVD score was inversely associated with HE (adjusted odds ratio 0.71, 95% CI: 0.53–0.96). Subgroup analysis revealed that this association was primarily observed in patients who were younger (<65 years), male, had deep hemorrhage, or did not meet the criteria for cerebral amyloid angiopathy diagnosis. Conclusions: In patients with spontaneous ICH, a more severe SVD was associated with smaller hematoma volume, fewer NCCT signs, and a lower risk of HE. Further research is required to investigate why a higher burden of severely diseased cerebral small blood vessels is associated with less bleeding.