bluuebunny/crossref_metadata_2025 huggingface dataset:
Greed personality trait links to negative psychopathology and underlying neural substrates
Authors: Wei Shiyu , Jin Weipeng , Zhu Wenwei , Chen Shuning , Feng Jie , Wang Pinchun , Im Hohjin , Deng Kun , Zhang Bin , Zhang Manman , Yang Shaofeng , Peng Maomiao , Wang Qiang
Published: July 2022

Greed personality trait (GPT), characterized by the desire to acquire more and the dissatisfaction of never having enough, has been hypothesized to link with negative emotion/affect characteristics and aggressive behaviors. To describe its emotion-related features, we utilized a series of scales to measure corresponding emotion/affect and aggression (n = 411) and collected their neuroimaging data (n = 330) to explore underlying morphological substrates. Correlational analyses revealed that greedy individuals show more negative symptoms (e.g. depression, loss of interest, negative affect), lower psychological well-being and more aggression. Mediation analyses further demonstrated that negative symptoms and psychological well-being mediated greedy individuals’ aggression. Moreover, exploratory factor analysis extracted factor scores across three factors (negative psychopathology, happiness, and motivation) from the measures scales. Negative psychopathology and happiness remained robust mediators. Importantly, these findings were replicated in an independent sample (n = 68). Voxel-based morphometry analysis also revealed that gray matter volumes (GMVs) in the prefrontal-parietal-occipital system were associated with negative psychopathology and happiness, and GMVs in the frontal pole and middle frontal cortex mediated the relationships between GPT and aggressions. These findings provide novel insights into the negative characteristics of dispositional greed, and suggest their mediating roles on greedy individuals’ aggression and underlying neuroanatomical substrates.
Changing the Antipsychotic in Early Nonimprovers to Amisulpride or Olanzapine: Randomized, Double-Blind Trial in Patients With Schizophrenia
Authors: Heres Stephan , Cordes Joachim , Feyerabend Sandra , Schmidt-Kraepelin Christian , Musil Richard , Riedel Michael , Spellmann Ilja , Langguth Berthold , Landgrebe Michael , Fran Elmar , Petcu C Camelia , Hahn Eric , Ta Tam M T , Matei Valentin , Dehelean Liana , Papava Ion , Leweke F Markus , van der List Till , Tamasan Simona C , Lang Fabian U , Naber Dieter , Ruhrmann Stephan , Wolff-Menzler Claus , Juckel Georg , Ladea Maria , Stefanescu Cristinel , Lautenschlager Marion , Bauer Michael , Zamora Daisy , Horowitz Mark , Davis John M , Leucht Stefan
Published: July 2022

Background and Hypothesis

Meta-analyses have shown that the majority of patients with schizophrenia who have not improved after 2 weeks of treatment with an antipsychotic drug are unlikely to fully respond later. We hypothesized that switching to another antipsychotic with a different receptor binding profile is an effective strategy in such a situation.

Study Design

In total, 327 inpatients with an acute exacerbation of schizophrenia were randomized to double-blind treatment with either olanzapine (5–20 mg/day) or amisulpride (200–800 mg/day). Those patients who had not reached at least 25% Positive-and-Negative-Syndrome-Scale (PANSS) total score reduction from baseline after 2 weeks (the “non-improvers”) were rerandomized double-blind to either staying on the same compound (“stayers”) or to switching to the other antipsychotic (“switchers”) for another 6 weeks. The primary outcome was the difference in the number of patients in symptomatic remission between the combined “switchers” and the “stayers” after 8 weeks of treatment, analyzed by logistic regression.

Study Results

A total of 142 nonimprovers were rerandomized at week two. 25 (45.5 %) of the ‘stayers' compared to 41 (68.3 %) of the “switchers” reached remission at endpoint (p = .006). Differences in secondary efficacy outcomes were not significant, except for the PANSS negative subscore and the Clinical-Global-Impression-Scale. “Switchers” and “stayers” did not differ in safety outcomes.

Conclusions

Switching “non-improvers” from amisulpride to olanzapine or vice-versa increased remission rates and was safe. The superiority in the primary outcome was, however, not paralleled by significant differences in most secondary efficacy outcomes and the effect was only apparent at the last visit making replications of longer duration necessary.
Factors Associated with Nurses’ Perceived Competence in Pressure Injury Care in a Tertiary Hospital in Yunnan, China
Authors: Huang Sijia , Saensom Donwiwat
Published: July 2022

Objective

To assess nurses’ perceived competence in pressure injury (PI) care and explore the association between perceived competence and nurses’ backgrounds, knowledge, attitudes, and self-efficacy in PI care.

Methods

This study used a descriptive correlational design. During January and February 2021, the authors sent an online questionnaire to 117 nurses caring for patients with or at risk of PI at a tertiary level hospital in Kunming, Yunnan Province, China, to collect information regarding demographics, knowledge, attitude, self-efficacy, and perceived competence in PI care. Univariate and multiple regressions were performed to assess the associations.

Results

A total of 111 completed questionnaires were obtained, a response rate of 94.9%. Nurses reported inadequate knowledge and relatively low self-efficacy in PI care. However, they had positive attitudes and acceptable levels of perceived competence in PI care. According to a univariate analysis, being a wound specialist, having read PI-related articles or practice guideline within the past year, and having knowledge and self-efficacy in PI care were associated with nurses’ perceived competence.

Conclusions

Pressure injury-related knowledge, attitude, and self-efficacy are independently associated with nurses’ perception of their competency in PI care.
Gun Violence: The Carnage at Home
Authors: Roush Karen
Published: July 2022

We must address this growing public health crisis.
An Introduction to Qualitative Methods for the Nurse Researcher
Authors: Curtis Alexa Colgrove , Keeler Courtney
Published: July 2022

Editor's note: This is the 11th article in a series on clinical research by nurses. The series is designed to give nurses the knowledge and skills they need to participate in research, step by step. Each column will present the concepts that underpin evidence-based practice—from research design to data interpretation. The articles will be accompanied by a podcast offering more insight and context from the authors. To see all the articles in the series, go to https://links.lww.com/AJN/A204.
Functional Outcomes for Children, Adolescents, and Young Adults With Osteonecrosis Following Hip Core Decompression
Authors: DeFeo Brian M. , Neel Michael D. , Pui Ching-Hon , Jeha Sima , Hankins Jane S. , Kaste Sue C. , Srivastava Deo Kumar , Ness Kirsten K.
Published: July 2022

Background:

Patients with pediatric leukemia and sickle cell disease are at risk for developing osteonecrosis (ON), a disease that can result in pain, loss of function, and disability. Hip core decompression surgery is an option aimed to prevent femoral head collapse and avoid future arthroplasty.

Objective:

Describe functional outcomes and gait quality among a young population with hip ON before and after hip core decompression.

Methods:

Study included participants with hip ON secondary to treatment for hematologic malignancy or sickle cell disease, between 8 and 29 years of age, requiring hip core decompression surgery. At 1-year follow-up, 13 participants (9 male, median age of 17 years) completed the Functional Mobility Assessment (FMA), range of motion, and GAITRite testing.

Results:

The participants demonstrated improved mobility and endurance on the FMA at 1 year postoperatively compared with preoperatively, with higher scores for time on the Timed Up and Go (mean FMA score = 2.92 [SD = 1.32] vs 2.07 [SD = 1.70]), time on the Timed Up and Down Stairs (3.69 [0.85] vs 2.92 [1.66]), and 9-Minute Walk Test scores for distance walked (2.69 [0.63] vs 2.23 [0.93]) and heart rate (4.54 [0.66] vs 3.31 [1.38]). GAITRite analysis also showed improvements in many gait parameters at 1-year follow-up.

Limitations:

Cancer treatment complications other than ON could have contributed to results, not all eligible participants agreed to participate, and follow-up was only 1 year.

Conclusions:

Young patients with hip ON demonstrated improvements in functional mobility, endurance, and gait quality 1 year following hip core decompression.
Effect of Experiential Communication Skills Education on Graduate Medical Education Trainees’ Communication Behaviors: A Systematic Review
Authors: Bylund Carma L. , Vasquez Taylor S. , Peterson Emily B. , Ansell Margaret , Bylund Kevin C. , Ditton-Phare Philippa , Hines April , Manna Ruth , Singh Ospina Naykky , Wells Robert , Rosenbaum Marcy E.
Published: July 2022

Purpose

A better understanding of how communication skills education impacts trainees’ communication skills is important for continual improvement in graduate medical education (GME). Guided by the Kirkpatrick Model, this review focused on studies that measured communication skills in either simulated or clinical settings. The aim of this systematic review was to examine the effect of experiential communication skills education on GME trainees’ communication behaviors.

Method

Five databases were searched for studies published between 2001 and 2021 using terms representing the concepts of medical trainees, communication, training, and skills and/or behaviors. Included studies had an intervention design, focused only on GME trainees as learners, used experiential methods, and had an outcome measure of communication skills behavior that was assessed by a simulated or standardized patient (SP), patient, family member, or outside observer. Studies were examined for differences in outcomes based on study design; simulated versus clinical evaluation setting; outside observer versus SP, patient, or family member evaluator; and length of training.

Results

Seventy-seven studies were ultimately included. Overall, 54 (70%) studies reported some positive findings (i.e., change in behavior). There were 44 (57%) single-group pre–post studies, 13 (17%) nonrandomized control studies, and 20 (26%) randomized control studies. Positive findings were frequent in single-group designs (80%) and were likely in nonrandomized (62%) and randomized (55%) control trials. Positive findings were likely in studies evaluating communication behavior in simulated (67%) and clinical (78%) settings as well as in studies with outside observer (63%) and SP, patient, and family member (64%) evaluators.

Conclusions

This review demonstrates strong support that experiential communication skills education can impact GME trainees’ communication behaviors. Marked heterogeneity in communication trainings and evaluation measures, even among subgroups, did not allow for meta-analysis or comparative efficacy evaluation of different studies. Future studies would benefit from homogeneity in curricular and evaluation measures.
Anesthesia care in the interventional neuroradiology suite: an update
Authors: Bello Corina , Paisansathan Chanannait , Riva Thomas , Luedi Markus M. , Andereggen Lukas
Published: July 2022

Purpose of review

The scope of procedures conducted by neurointerventionalists is expanding quickly, with lacking consensus over the best anesthesia modality. Although the procedures involve all age groups, the interventions may be complex and lengthy and may be provided in hospitals currently not yet familiar with the field. Here we review current literature addressing elective outpatient neurointerventional procedures and aim to provide an update on the management of intervention-specific crises, address special patient populations, and provide key learning points for everyday use in the neurointerventional radiology suite.

Recent findings

Various studies have compared the use of different anesthesia modalities and preinterventional and postinterventional care. Monitored anesthesia care is generally recommended for elderly patients, whereas children are preferably treated with general anesthesia. Additional local anesthesia is beneficial for procedures, such as percutaneous kyphoplasty and vascular access.

Combining different anesthetic modalities is a valuable approach in the neurointerventional radiology suite. More interventional and patient population-specific studies are needed to improve evidence-based perioperative management.
Frameworks for value-based care in the nonoperating room setting
Authors: Keswani Aakash , Licht Brian , Urman Richard D.
Published: July 2022

Purpose of review

Nonoperating room anesthesia (NORA) presents a unique opportunity for the application of value-based care (VBC) principles to procedures performed in the office-based and nonoperating room inpatient settings. The purpose of this article is to review how value is defined in NORA and enabling principles by which anesthesiologists can maximize value in NORA.

Recent findings

In order to drive value, NORA providers can target improvements in clinical outcomes where NORA lags behind operating room-based anesthesia (death, over-sedation, nerve injury), implement protocols focusing on intermediate outcomes/quality (postoperative nausea and vomiting, pain control, hypothermia, delirium), incorporate patient-reported outcomes (PROs) to assess the trajectory of a patient's perioperative care, and reduce costs (direct and indirect) through operational and supply-based efficiencies. Establishing a culture of patient and provider safety first, appropriate patient selection with targeted, perioperative optimization of comorbidities, and efficient deployment of staff, space, and resources are critical enablers for success.

Value in NORA can be defined as clinical outcomes, quality, patient-reported outcomes, and efficiency divided by the direct and indirect costs for achieving those outcomes. We present a novel framework adapting current VBC practices in operating room anesthesia to the NORA environment.
The Association Between Perceived Injustice and Opioid Craving in Patients With Chronic Pain: The Mediating Role of Daily Pain Intensity, Negative Affect, and Catastrophizing
Authors: Verner Maria , Sirois Amanda , Coutu-Nadeau Emmanuelle , Fournier Catherine , Carriere Junie , Martel Marc O.
Published: July 2022

Abstract: The rise in the use of opioids has been accompanied by increases in prescription opioid misuse among patients with chronic pain. Opioid craving has emerged as a robust determinant of opioid misuse, but the factors that contribute to opioid craving have yet to be fully elucidated. Perceived injustice has been linked to numerous negative pain outcomes, but little is known about its association with opioid craving.

Objectives

The first objective of this study was to examine the association between perceived injustice and opioid craving in patients with chronic pain who are prescribed opioids. We also examined whether pain intensity, negative affect, or catastrophizing mediated this association.

Methods

In this longitudinal diary study, patients (n = 103) completed a questionnaire assessing perceived injustice and then completed daily measures of pain intensity, negative affect, catastrophizing, and opioid craving for 14 consecutive days.

Results

A significant association was found between perceived injustice and opioid craving (P < 0.01), with higher levels of perceived injustice being associated with heightened levels of opioid craving. A 2-1-1 multilevel mediation analysis indicated that the association between perceived injustice and craving was significantly mediated by catastrophizing (P < 0.05).

Conclusions

The present study provides new insights into the factors that might contribute to opioid craving in patients with chronic pain. Our findings suggest that perceived injustice might lead to increased catastrophizing and, in turn, heightened daily levels of opioid craving. These findings could have implications for chronic pain management clinicians who prescribe opioids.
Preoperative Patient Education and Smaller Prescription Quantity Reduce Opioid Use After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis: Results of a Prospective Study
Authors: Yang Daniel , Jha Sahil , Swallow Jennylee , Caird Michelle S. , Lopyan Alexander , Stepanovich Matthew , Whyte Noelle , Li Ying
Published: July 2022

Background:

Most opioids prescribed postoperatively are unused. Leftover opioids are a major source of nonmedical opioid use among adolescents. Postoperative opioid use has also been associated with prescription quantity. Our purpose was to evaluate the effect of preoperative patient education and implementation of evidence-based prescribing guidelines on opioid use and pain level after posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS).

Methods:

AIS patients aged 10 to 17 years undergoing PSF were prospectively enrolled [postintervention cohort (POST-INT)]. Previous data on 77 patients showed median consumption of 29 doses of oxycodone after PSF [preintervention cohort (PRE-INT)]. All eligible patients during the study period were discharged with 30 doses of oxycodone and standard nonopioid analgesics. Only study participants received education on postoperative pain control. Demographics, radiographic/surgical data, pain level, and patient-reported outcomes were collected. Requests for opioid refills were documented.

Results:

Forty-nine patients were enrolled. POST-INT was divided into low (L, ≤8 doses), average (AVE, 9-25), and high (H, >25) opioid use groups. Demographics, radiographic/surgical data, pain level, and patient-reported outcomes were similar between the groups. However, there was a difference in days of oxycodone use, doses consumed in the first week, and leftover doses (P<0.001). Comparison to the PRE-INT L (≤16 doses), AVE (17 to 42), and high (H, >42) use groups showed that POST-INT L and AVE consumed less oxycodone (L: P=0.002; AVE: P<0.001). Also, the overall POST-INT cohort had fewer mean days of oxycodone use (5.6 vs. 8.9, P<0.001) and doses used in the first week (14 vs. 23, P<0.001) compared with the PRE-INT cohort. Subanalysis showed fewer study participants requested and received an opioid refill [3/49 patients (6%)] compared with eligible patients who declined to participate, withdrew, or missed enrollment [8/35 patients (23%)] (P=0.045).

Conclusions:

Preoperative patient education and smaller prescription quantity successfully reduced opioid use while maintaining excellent pain control after PSF for AIS. Setting expectations regarding postoperative pain management is critical, as nonstudy participants were significantly more likely to request an opioid refill.

Level of Evidence:

Level II—therapeutic.
Patients With Coronal Malalignment Undergoing Adult Spinal Deformity Surgery
Authors: Zuckerman Scott L. , Chanbour Hani , Hassan Fthimnir M. , Lai Christopher , Kerolus Mena , Ha Alex , Buchannan Ian , Cerpa Meghan , Lehman Ronald A. , Lenke Lawrence G.
Published: July 2022

Study Design:

Retrospective cohort study.

Objectives:

The objectives were to: (1) characterize the changes in coronal vertical axis (CVA) after adult spinal deformity (ASD) surgery from immediate postoperative to 2-years postoperative, and (2) assess for predictors of CVA change from immediate postoperative to 2-years postoperative.

Summary of Background Data:

It is unknown whether coronal correction obtained immediately postoperative accurately reflects long-term coronal alignment.

Materials and Methods:

A retrospective, single-institution registry was queried for patients undergoing ASD surgery from 2015-2019, including patients undergoing ≥6-level fusions with preoperative coronal malalignment (CM), defined as CVA≥3 cm. A clinically significant change in CVA was defined a priori as ≥1 cm. Radiographic variables were obtained preoperatively, immediately postoperative, and at 2-years postoperative.

Results:

Of 368 patients undergoing ASD surgery, 124 (33.7%) had preoperative CM, and 64 (17.0%) completed 2-years follow-up. Among 64 patients, mean age was 53.6±15.4 years. Preoperatively, absolute mean CVA was 5.4±3.1 cm, which improved to 2.3±2.0 cm (P<0.001) immediately postoperative and 2.2±1.6 cm (P<0.001) at 2-years. The mean change in CVA from preoperative to immediately postoperative was 2.2±1.9 cm (0.3–14.4). During the immediate postoperative to 2-years interval, 29/64 (45.3%) patients experienced a significant change of CVA by ≥1 cm, of which 22/29 (76%) improved by a mean of 1.7 cm and 7/29 (24%) worsened by a mean of 3.5 cm. No preoperative or surgical factors were associated with changed CVA from immediately postoperative to 2-years.

Conclusion:

Among 64 patients undergoing ASD surgery with preoperative CM, 45.3% experienced a significant (≥1 cm) change in their CVA from immediately postoperative to 2-years postoperative. Of these 29 patients, 22/29 (76%) improved, whereas 7/29 (24%) worsened. Although no factors were associated with undergoing a change in CVA, this information is useful in understanding the evolution and spontaneous coronal alignment changes that take place after major ASD coronal plane correction.
Future development of chimeric antigen receptor T cell therapies for patients suffering from malignant glioma
Authors: Watchmaker Payal B. , Colton Maggie , Pineo-Cavanaugh Psalm L. , Okada Hideho
Published: July 2022

Purpose of review

Chimeric antigen receptor (CAR) T cell therapy has been successful in some haematologic malignancies, but the central nervous system (CNS) presents unique obstacles to its use against tumours arising therein. This review discusses recent improvements in the delivery and design of these cells to improve the efficacy and safety of this treatment against malignant gliomas.

Recent findings

The immunosuppressive environment of the CNS affects the functionality of CAR T cells, but recent developments using metabolic manipulation and cytokine delivery have shown that the performance of CAR T cells can be improved in this environment. Emerging techniques can improve the delivery of CAR T cells to the CNS parenchyma, which is normally well protected from peripheral immune cells. The implementation of novel antigens and CAR-expression regulation strategies will improve the specificity and efficacy of these cells. Finally, although autologous T cells have historically been the standard, recent developments have made the use of allogeneic T cells or natural killer (NK) cells more clinically feasible.

The discoveries highlighted in this review will aid the development of CAR cells that are safer, more resilient against immunosuppressive signals in the CNS, and able to specifically target intracranial tumour cells.
Molecular oncology: what is needed to speed access to innovative therapies in clinical research?
Authors: Gourari Karim , Awada Ahmad , Kotecki Nuria
Published: July 2022

Purpose of review

A better understanding of the biology of cancer cells has led in the past 20 years to more and more molecular and immunological driven treatment strategies impacting both clinical trials and day-to-day practice. The aim of this review is to describe new approaches to conduct clinical trials in this area to speed up drug development and increase access to innovation for cancer patients.

Recent findings

The design of an early phase trial has an impact on its clinical benefit. Trials deriving from a specific biomarker or histologic characteristic (also known as enrichment design) are more likely to demonstrate benefit than trials based on a more conventional design. However, the increase of low incidence cancer molecular subtypes poses a major hurdle in the clinical management and drug development research for cancer patients.

With the identification of news targets and the subsequent introduction of precision medicine, new strategies and tools are needed to provide access to biomarker identification and target-oriented clinical trials to all cancer patients. We propose to set up a new patient-centered model to conduct clinical trials allowing simply to ‘bring the trial to the patient’.
Squamous Cell Carcinoma With Bone Invasion: A Systematic Review and Pooled Survival Analysis
Authors: Russell Emma , Udkoff Jeremy , Knackstedt Thomas
Published: July 2022

BACKGROUND

Bone invasion has long been recognized as a poor prognostic indicator for cutaneous squamous cell carcinoma (SCC). Survival analyses of factors associated with SCC with bone invasion have not been published.

OBJECTIVE

To analyze all published demographic, clinical, and treatment data for SCC with bone invasion and assess the impact of prognostic variables on disease progression, disease-specific death, and overall mortality.

MATERIALS AND METHODS

A systematic review and pooled-survival analysis was performed using individual patient data from case reports. Progression-free survival (PFS), disease-specific survival (DSS), and overall survival (OS) were estimated by Kaplan–Meier analysis.

RESULTS

The study included 76 cases of SCC with bone invasion from 49 publications. Recurrent tumors and nonsurgical treatment modality were predictors of disease progression in univariable analysis and tumors of the trunk, head, and neck were predictors of disease progression in multivariable analysis. At 5 years from bone invasion diagnosis, patients had a PFS, DSS, and OS rate of 66.7%, 71.7%, and 66.2%, respectively.

CONCLUSION

Cases of SCC with bone invasion had poor DFS, DSS, and OS rates, with worse outcomes imparted to tumors of the trunk, head, and neck.
Exposure to natural vegetation in relation to mammographic density in a Massachusetts-based clinical cohort
Authors: Blair Lyndsey K. , Warner Erica T. , James Peter , Hart Jaime E. , VoPham Trang , Barnard Mollie E. , Newton Johnnie D. , Murthy Divya J. , Laden Francine , Tamimi Rulla M. , DuPre Natalie C.
Published: July 2022

Background:

Inverse associations between natural vegetation exposure (i.e., greenness) and breast cancer risk have been reported; however, it remains unknown whether greenness affects breast tissue development or operates through other mechanisms (e.g., body mass index [BMI] or physical activity). We examined the association between greenness and mammographic density—a strong breast cancer risk factor—to determine whether greenness influences breast tissue composition independent of lifestyle factors.

Methods:

Women (n = 2,318) without a history of breast cancer underwent mammographic screening at Brigham and Women’s Hospital in Boston, Massachusetts, from 2006 to 2014. Normalized Difference Vegetation Index (NDVI) satellite data at 1-km2 resolution were used to estimate greenness at participants’ residential address 1, 3, and 5 years before mammogram. We used multivariable linear regression to estimate differences in log-transformed volumetric mammographic density measures and 95% confidence intervals (CIs) for each 0.1 unit increase in NDVI.

Results:

Five-year annual average NDVI was not associated with percent mammographic density in premenopausal (β = –0.01; 95% CI = –0.03, 0.02; P = 0.58) and postmenopausal women (β = –0.02; 95% CI = –0.04, 0.01; P = 0.18). Results were similar for 1-year and 3-year NDVI measures and in models including potential mediators of BMI and physical activity. There were also no associations between greenness and dense volume and nondense volume.

Conclusions:

Greenness exposures were not associated with mammographic density.

Impact:

Prior observations of a protective association between greenness and breast cancer may not be driven by differences in breast tissue composition, as measured by mammographic density, but rather other mechanisms.
Bone Flap Preservation in Subcutaneous Abdominal Pocket for Decompressive Craniectomy
Authors: Ishikawa Yohei , Kamochi Hideaki , Ishizaki Ryuji , Wataya Takafumi
Published: July 2022

We report our experiences of two pediatric cases in which a bone flap was preserved in the subcutaneous abdominal pocket for decompressive craniectomy. In one case, the bone flap was divided and preserved for cranioplasty without complications; in the other case, the bone flap was left intact as one piece. In pediatric patients, the storage space for a bone flap is sometimes difficult to achieve, and the technique described herein is useful in such situations. Notably, because the bone resorption rate with cryopreservation is higher in pediatric patients, in vivo preservation may be more useful in this population.
Impairments in Physiological Reactivity to Emotive Stimuli After Traumatic Brain Injury: A Systematic Review of Skin Conductance and Heart Rate Variability Evidence
Authors: Sarah Alysha , Ownsworth Tamara , Clough Bonnie , Neumann David L.
Published: July 2022

Objective:

To examine evidence of impairments in physiological reactivity to emotive stimuli following traumatic brain injury (TBI).

Methods:

A search of PsychINFO, CINAHL (Cumulative Index to Allied Health Literature), Web of Science, EMBASE (Excerpta Medica dataBASE), and Scopus databases was conducted from 1991 to June 24, 2021, for studies comparing changes in skin conductance or heart rate variability to emotive stimuli between adults with TBI and controls. Two reviewers independently assessed eligibility and rated methodological quality.

Results:

Twelve eligible studies examined physiological reactivity to laboratory-based emotive stimuli, which included nonpersonal pictures/videos, posed emotion, stressful events, and personal event recall. Overall, 9 reported evidence that individuals with TBI experience lower physiological reactivity to emotive stimuli compared with healthy controls, although the findings varied according to the type and valence of emotional stimuli and physiological parameter. Most studies using nonpersonal pictures or videos found evidence of lower physiological reactivity in TBI participants compared with controls.

Conclusions:

Based on laboratory-based studies, individuals with TBI may experience lower physiological reactivity to emotive stimuli. Further research is needed to investigate physiological responses to personally relevant emotional stimuli in real-world settings and to understand the interplay between physiological reactivity, subjective experiences, and behavior.
Association of Sleep Disturbance With Neurocognition, Symptom Severity, and Recovery in Pediatric Concussion: A 10-Year Retrospective Analysis of a Tertiary Referral Concussion Clinic
Authors: Cassimatis Maree , Orr Rhonda , Fyffe Andrew , Browne Gary
Published: July 2022

Objectives:

To investigate the relationship between sleep disturbance, neurocognition, symptom severity, and recovery in children and adolescents with concussion. Sex-related comparisons were also examined.

Setting:

Pediatric tertiary referral concussion clinic.

Participants:

Children and adolescents (aged 6-18 years; n = 554) diagnosed with concussion.

Design:

Cross-sectional retrospective study.

Main Measures:

Assessment data were obtained from Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) Applications. Sleep disturbance was quantified using the sleep-related domains of the Post-Concussion Symptom Scale (PCSS) and self-report sleep duration. Sleep duration was categorized as short (<7 hours), intermediate (7-9 hours), and long (≥9 hours). Outcome measures included neurocognition, measured via composite scores of ImPACT cognitive domains (verbal memory, visual memory, visual motor speed, reaction time); symptom severity, using the PCSS; and concussion recovery time (days).

Results:

Short sleep resulted in significantly poorer verbal memory (P = .03), visual memory (P = .02), and reaction time (P = .01). Sleep disturbance was strongly associated with total symptom burden (ρ = 0.90, P < .001). Recovery time, median (interquartile range), was significantly prolonged with short sleep, 61 (30-136) days, compared with intermediate, 38 (21-72) days, and long, 34 (19-71) days, sleep (P < .001). Overall, female participants demonstrated significantly longer recovery times than male participants (mean 91 ± 95 vs 58 ± 85 days, P < .001). Females exhibited similar concussion recovery times irrespective of reported sleep duration (P = .95), whereas mean recovery time in males was significantly longer with short sleep (84 ± 82 days) than with intermediate (61 ± 106 days) and long (49 ± 62 days) sleep (P < .001).

Conclusion:

Sleep disturbance following concussion poses as a promising modifiable risk factor to alleviate postinjury impairments, including cognitive deficits and symptom burden. Female children were found to experience more severe concussion symptoms and protracted recovery times than their male counterparts. Investigations into the factors that may contribute to sex-related differences following concussion are warranted.
Highly Prevalent SARS-CoV-2 Antigenemia in COVID-19 Patients
Authors: Zhang Wenyan , Liu Wei , Lin Jiawang , Jin Jing , Zhao Kefu , Zhu Liwei , Wang Xiuzhen , Wang Lijie , Tang Renshu , Zhu Yindi , Zhou Wei , You Enqing , Zhang Lei , Liu Xuxiang , Wu Jinju , Chen Lili , Wang Wenjing , Zhang Qiang , Gao Rongbao
Published: July 2022

Background:

Many issues, such as severity assessment and antibody responses, remain to be answered eagerly for evaluation and understanding of COVID-19. Immune lesion is one of key pathogenesis of the disease. It would be helpful to understand the disease if an investigation on antigenemia and association was conducted in the patients with SARS-CoV-2 infection.

Methods:

A total of 156 patients admitted to the First People's Hospital of Hefei or Anhui Provincial Hospital on January to February 2020 were involved in this study. SARS-CoV-2 nucleocapsid (NP) antigen, specific IgM/IgG antibodies, and RNA were detected in sequential sera from three COVID-19 patients, and additional 153 COVID-19 patients by means of NP-antigen capture enzyme-linked immunosorbent assay, colloidal gold quick diagnosis, and real-time RT-PCR, respectively. The clinical types of COVID-19 patients were classified into asymptomatic, mild, moderate, severe, and critical, following on the Chinese guideline of COVID-19 diagnosis and treatment. The demographic and clinical data of patients were obtained for comparable analysis.

Results:

NP antigen was detected in 5 of 20 sequential sera collected from three COVID-19 patients with typically clinical symptoms, and 60.13% (92/153) expanded samples collected within 17 days after illness onset. No SARS-CoV-2 RNA segment was detected in these sera. The NP positive proportion reached a peak (84.85%, 28/33) on 6 to 8 days after illness onset. Both NP concentration and positive proportion were increased with the increase of clinical severity of COVID-19. Compared to NP negative patients, NP positive patients had older age [years, medians (interquartile ranges (IQR)), 49 (6) vs. 31 (11)], lower positive proportion of NP specific IgM [27.17% (25/92) vs. 59.02% (36/61)], and IgG [21.74% (20/92) vs. 59.02% (36/61)] antibodies, and longer duration [days, medians (IQR), 24 (10) vs. 21 (13)] from illness to recovery.

Conclusions:

SARS-CoV-2 NP antigenemia occurred in COVID-19, and presented highly prevalent at early stage of the disease. The antigenemia was related to clinical severity of the disease, and may be responsible for the delay of detectable SARS-Cov-2 IgM.
MHC Class I Assembly Function and Intracellular Transport Routes for Hepatitis B Virus Antigen Cross-presentation by Heat Shock Protein gp96
Authors: Qin Lijuan , Liu Yongai , Xu Yuxiu , Li Yang , Hu Jun , Ju Ying , Zhang Yu , Wang Shuo , Li Zihai , Li Changfei , Li Xin , Meng Songdong
Published: July 2022

Background:

During hepatitis B virus (HBV) infection, virus-infected hepatocytes directly cross-present viral antigens and regulate T cell response within the liver microenvironment. However, little is known regarding the regulatory pathways involved in viral antigen presentation in HBV-infected hepatocytes. This study investigated the underlying mechanism of antigen assembly and the HBV antigen-presenting function of major histocompatibility complex (MHC) class I molecules using heat shock protein gp96.

Methods:

First, western blotting, flow cytometry, co-immunoprecipitation, GST pull-down, and confocal microscopic assays were performed to determine whether endogenous gp96 affects MHC-I levels via an antigen presentation pathway. Second, the B3Z assay and an AAV/HBV-infected hepatocyte-specific gp96-deficient mouse model were used to determine whether gp96 knockout functionally impaired peptide cross-presentation and produced a weakened antiviral cytotoxic T cell (CTL) response both in vivo and in vitro. Finally, confocal microscopic analysis and the B3Z assay were employed to show that exogenous gp96-associated peptide was present in MHC-I molecules via the endoplasmic reticulum (ER)-Golgi secretory pathway.

Results:

Compared with the control, gp96 knockdown significantly reduced the cell surface levels of MHC-I by approximately 75% (P < 0.01). Endogenous gp96 interacts with MHC-I and is involved in antigen presentation. Moreover, a weakened antiviral CTL response (34% compared to control mice) has been observed in hepatocyte-specific gp96-deficient mice following HBV infection. gp96 directed exogenous antigen to the ER, and the exogenous gp96-chaperoned peptide was endosome- and proteasome-dependent but not transporter associated with antigen processing dependent.

Conclusions:

Cellular gp96 promotes the assembly and antigen presentation of MHC class I molecules. In addition, extracellular gp96 served as a natural adjuvant to induce a CTL response in a concerted and regulated manner within different cellular compartments. Our results elucidate the mechanism of assembly of MHC class I molecules by gp96, which may be beneficial for the design of immunotherapy and vaccines.
Descriptive Analysis of Cornea and Anterior Segment Fellowship Program Directors in 2020
Authors: Lam Sophia S. , Garg Kartik , Shalaby Wesam S. , Rapuano Christopher J. , Syed Zeba A.
Published: July 2022

Purpose:

To investigate demographic characteristics, educational backgrounds, and academic achievements among program directors (PDs) of Cornea and External Disease and Anterior Segment fellowships in the United States in 2020.

Setting:

N/A.

Design:

Cross-sectional study.

Methods:

PDs of Cornea and External Disease and Anterior Segment fellowships were identified using the San Francisco Match website. Fellowship program features reviewed included academic or private practice type, number of cornea faculty, and sex of chairperson. PD demographic characteristics, educational and training background, and academic productivity were analyzed using publicly available profiles and databases.

Results:

76 Cornea and External Disease and 10 Anterior Segment fellowships were reviewed. Of 86 reviewed programs, 55 (64.0%) were considered academic, 30 (34.9%) were private practice, and 1 (1.2%) was hybrid. 76 Cornea and External Disease PDs and 12 Anterior Segment PDs were identified. Overall, 21 (23.9%) of PDs were women and the mean age for all PDs was 52.6±11.5 years. Of the 88 PDs, the average number of publications was 45.1±55.9. Mean h-index was 16.7±15.4 and was higher among Cornea and External Disease than Anterior Segment PDs (18.2±15.5 vs. 7.1±11.4, p=0.008) and also higher among academic than private practice PDs (19.9±15.1 vs. 11.2±14.7, p=0.011). More female PDs were in departments with a female chairperson compared to male PDs [6 (28.6%) vs. 4 (6.0%), p=0.011].

Conclusions:

Cornea and External Disease and Anterior Segment fellowship PDs represent a wide array of backgrounds and scholarly achievements. Female PDs remain in the minority and are more common in departments with female chairpersons.
Factors predisposing to Intraoperative Floppy Iris Syndrome (IFIS): an updated systematic review and meta-analysis
Authors: Christou Chrysanthos D. , Esagian Stepan M. , Ziakas Nikolaos , Prousali Efthymia , Tzamalis Argyrios
Published: July 2022

Intraoperative Floppy Iris Syndrome (IFIS) is an increasingly recognized condition that is proven to lead to higher rates of intraoperative complications. This study provides an updated systematic review and meta-analysis regarding all the identified factors predisposing to IFIS. The study was performed in accordance with the PRISMA guidelines. 38 studies were finally included in the meta-analysis. The factors that were found to predispose to IFIS significantly were male gender(OR=4.25/CI=2.58-7.01), hypertension(OR=1.55/CI=1.01-2.37), tamsulosin(OR=31.06/CI=13.74-70.22), finasteride(OR=4.60/CI=1.97-10.73), benzodiazepines(OR=2.88/CI=1.17-7.12) and antipsychotics intake(OR=6.91/CI=2.22-21.50). A decreased dilated pupil preoperatively was found predisposing to IFIS (weighted mean difference=-0.93/CI=-1.19--0.67]). Intracameral epinephrine which was investigated as a potential prophylactic measure for preventing IFIS, did not reach statistical significance (OR=0.29/CI=0.08-1.06). A comprehensive preoperative assessment of all risk factors is vital to stratify the surgical risk, which is crucial in addressing IFIS since unanticipated IFIS could turn a routine surgery into one of significant visual morbidity.
Transcatheter edge-to-edge repair in patients with mitral regurgitation and cardiogenic shock: a new therapeutic target
Authors: Jung Richard G. , Simard Trevor , Di Santo Pietro , Hibbert Benjamin
Published: July 2022

Purpose of review

Cardiogenic shock with significant mitral regurgitation portends a poor prognosis with limited therapeutic options. Herein, we review the available evidence regarding the patient characteristics, management, impact of transcatheter edge-to-edge repair (TEER) on hemodynamics, and clinical outcomes of patients with cardiogenic shock and mitral regurgitation.

Recent findings

Several observational studies and systematic reviews have demonstrated the feasibility and safety of TEER in cardiogenic shock complicated by degenerative or functional mitral regurgitation. Surgical interventions for mitral regurgitation remain limited owing to the risk profile of patients in cardiogenic shock. TEER has been studied in both degenerative and functional mitral regurgitation and remains feasible in the critically ill population. Moreover, TEER is associated with reduction in mitral regurgitation and improvement in-hospital and long-term mortality.

TEER remains a promising therapeutic option in cardiogenic shock complicated by significant mitral regurgitation, but additional research is required to identify patient and procedural characteristics, hemodynamic parameters, and the optimal time for intervention. Moreover, future randomized controlled trials are in progress to evaluate the potential benefit of TEER against medical management in cardiogenic shock and mitral regurgitation.
Evaluation of the effect of intravenous nitroglycerine on short-term survival of patients with acute heart failure according to congestion and perfusion status at emergency department arrival
Authors: Miró Òscar , Espinosa Begoña , Gil Víctor , Jacob Javier , Alquézar-Arbé Aitor , Masip Josep , Llauger Lluís , Tost Josep , Andueza Juan Antonio , Garrido José Manuel , Mojarro Enrique Martín , Urbano Carmen Agüera , Núñez Julio , Chioncel Ovidiu , Mullens Wilfred , Cotter Gad , Llorens Pere ,   on behalf of the ICA-SEMES Research Group
Published: July 2022

Objectives:

We investigated if the phenotypic classification of acute heart failure (AHF) based on the number of signs/symptoms of congestion and hypoperfusion at emergency department (ED) arrival identifies subgroups in which intravenous (IV) nitroglycerine (NTG) use improves short-term survival.

Methods:

We included consecutive AHF patients diagnosed in 45 Spanish EDs, who were grouped according to phenotype severity. The main outcome was 30-day all-cause death. Propensity scores (PS) for NTG use were generated using variables associated with death. Analysis of interaction was performed in subgroups of patients based on congestion, hypoperfusion, age, sex, coronary artery disease (CAD), left ventricular ejection fraction (LVEF) and SBP.

Results:

We analyzed 16 437 AHF patients (median = 83 years; women = 56%); 1882 received NTG (11.4%). In the whole cohort, the cumulative 30-day mortality in patients receiving NTG was higher (11.5% vs. 9.6%; unadjusted HR, 1.19; 95% CI, 1.04–1.36), but not in the PS-matched cohorts (1698 pairs of patients; 11.5% vs. 10.5%; HR, 1.10; 95% CI, 0.90–1.35). Mortality was increased in NTG-treated patients with mild congestion (HR, 2.09; 95% CI, 1.19–3.67), especially in those without hypoperfusion (HR, 2.51; 95% CI, 1.24–5.10). Interaction analysis of the PS-matched cohorts confirmed detrimental effects of NTG use in less congested patients, whereas beneficial effects were only observed in patients with decreased LVEF (<50% subgroup: HR, 0.59; 95% CI, 0.37–0.92; ≥50% subgroup: HR, 1.30; 95% CI, 0.66–2.56; P = 0.002).

Conclusion:

Phenotypical classification of AHF based on congestion/hypoperfusion at ED arrival does not identify subgroups of patients in whom IV-NTG would decrease mortality, although it could potentially be beneficial in those with LVEF of less than 50%. This hypothesis will have to be confirmed in the future. Conversely, our results suggest that IV-NTG may be harmful in patients with only mild clinical congestion.
Polygenic risk score in prostate cancer
Authors: Oh Jong Jin , Hong Sung Kyu
Published: July 2022

Purpose of review

This study was conducted in order to review the outcomes regarding polygenic risk score (PRS) in prediction of prostate cancer (PCa). With the increasing proficiency of genetic analysis, assessment of PRS for prediction of PCa has been performed in numerous studies. Genetic risk prediction models for PCa that include hundreds to thousands of independent risk-associated variants are under development. For estimation of additive effect of multiple variants, the number of risk alleles carried by an individual is summed, and each variant is weighted according to its estimated effect size for generation of a PRS.

Recent findings

Currently, regarding the accuracy of PRS alone, PCa detection rate ranged from 0.56 to 0.67. A higher rate of accuracy of 0.866–0.880 was observed for other models combining PRS with established clinical markers. The results of PRS from Asian populations showed a level of accuracy that is somewhat low compared with values from Western populations (0.63–0.67); however, recent results from Asian cohorts were similar to that of Western counterparts. Here, we review current PRS literature and examine the clinical utility of PRS for prediction of PCa.

Emerging data from several studies regarding PRS in PCa could be the solution to adding predictive value to PCa risk estimation. Although commercial markers are available, development of a large-scale, well validated PRS model should be undertaken in the near future, in order to translate hypothetical scenarios to actual clinical practice.