bluuebunny/crossref_metadata_2025 huggingface dataset:
An update on the developments in the treatment of adult T-cell leukemia–lymphoma: current knowledge and future perspective
Authors: Makiyama Junya , Ishitsuka Kenji , Munakata Wataru , Maruyama Dai , Nagai Hirokazu
Published: August 2023

Adult T-cell leukemia–lymphoma is defined as peripheral T-cell lymphoma caused by the human T-cell leukemia virus type I. Adult T-cell leukemia–lymphoma is classified into indolent (favorable chronic or smoldering) or aggressive (acute, lymphoma or unfavorable chronic) types. This review discusses the therapeutic developments for patients with adult T-cell leukemia–lymphoma and unmet issues in treating adult T-cell leukemia–lymphoma. For indolent adult T-cell leukemia–lymphoma, a watchful waiting strategy is recommended until the disease progresses to aggressive adult T-cell leukemia–lymphoma. For aggressive adult T-cell leukemia–lymphoma, multi-agent chemotherapy with or without allogeneic hematopoietic stem cell transplantation has been recommended. However, many patients with adult T-cell leukemia–lymphoma relapse, and their prognosis is poor. Recently, novel agents, including mogamulizumab, lenalidomide, brentuximab vedotin, tucidinostat and valemetostat, have been approved for patients with relapsed or refractory aggressive adult T-cell leukemia–lymphoma, and the combination of mogamulizumab with multi-agent chemotherapy or brentuximab vedotin with cyclophosphamide, doxorubicin and prednisone has been approved for patients with untreated aggressive adult T-cell leukemia–lymphoma in Japan. Importantly, the aging of patients with adult T-cell leukemia–lymphoma has recently been reported, and no standard of care for elderly patients with adult T-cell leukemia–lymphoma has been established. New evidence must be obtained from prospective clinical trials to improve the prognosis of patients with adult T-cell leukemia–lymphoma.
Hippocampal synaptic alterations associated with tau pathology in primary age-related tauopathy
Authors: Morris Meaghan , Coste Gabrielle I , Redding-Ochoa Javier , Guo Haidan , Graves Austin R , Troncoso Juan C , Huganir Richard L
Published: August 2023

Primary age-related tauopathy (PART) is characterized by aggregation of tau in the mesial temporal lobe in older individuals. High pathologic tau stage (Braak stage) or a high burden of hippocampal tau pathology has been associated with cognitive impairment in PART. However, the potential underlying mechanisms are not well understood. Cognitive impairment in many neurodegenerative diseases correlates with synaptic loss, raising the question of whether synaptic loss also occurs in PART. To address this, we investigated synaptic changes associated with tau Braak stage and high tau pathology burden in PART using synaptophysin and phospho-tau immunofluorescence. We compared 12 cases of definite PART with 6 controls and 6 Alzheimer disease cases. In this study, the hippocampal CA2 region showed loss of synaptophysin puncta and intensity in cases of PART with either a high stage (Braak IV) or a high burden of neuritic tau pathology. There was also loss of synaptophysin intensity in CA3 associated with a high stage or high burden of tau pathology. Loss of synaptophysin was present in Alzheimer disease, but the pattern appeared distinct. These novel findings suggest the presence of synaptic loss associated with either a high hippocampal tau burden or a Braak stage IV in PART.
Perinatal hypoxic-ischemic brain injury: What’s behind the “ribbon effect”?
Authors: Viaene Angela N , Nelson Ernest J , Santi Mariarita
Published: August 2023

Ribbon effect describes a perceived macroscopic color reversal of the gray and white matter, characterized by a pale cortex and diffusely dusky underlying white matter. This finding is thought to be unique to the perinatal period and indicative of hypoxic-ischemic injury. However, the clinical and microscopic correlates of this macroscopic finding have not been clearly defined. A 21-year retrospective study of autopsies was performed. Ribbon effect was seen in 190 subjects, ages 20 weeks gestation to 9.5 months adjusted age. Clinical associations and radiographic findings were similar in ribbon effect cases and controls. A variety of histologic findings were observed including acute neuronal injury, diffuse white matter gliosis, and white matter necrosis. Only white matter vascular congestion was significantly correlated to the macroscopic severity of ribbon effect; the severity of white matter injury and acute neuronal injury were not significantly correlated to ribbon effect. While hypoxic-ischemic changes were present in nearly all cases of ribbon effect, the location, severity, and chronicity of these changes varied considerably, and similar findings were observed in controls. The presence of ribbon effect therefore does not predict microscopic findings apart from vascular congestion, highlighting the importance of microscopic examination in perinatal brain autopsies.
Astrometry via close approach events: applications to main-belt asteroid (702) Alauda
Authors: Guo B F , Peng Q Y , Vienne A , Fang X Q
Published: August 2023

The release of Gaia catalogue is revolutionary to the astronomy of Solar system objects. After some effects such as atmospheric refraction and CCD geometric distortion have been taken into account, the astrometric precision for ground-based telescopes can reach the level of tens of milli-arcseconds (mas). If an object approaches a reference star in a small relative angular distance (less than 100 arcsec), which is called close approach event in this work, the relative positional precision between the object and reference star will be further improved since the systematic effects of atmospheric turbulence and local telescope optics can be reduced. To obtain the precise position of a main-belt asteroid in an close approach event, a second-order angular velocity model with time is supposed in the sky plane. By fitting the relationship between the relative angular distance and observed time, we can derive the time of maximum approximation and calculate the corresponding position of the asteroid. In practice, five nights’ CCD observations including 15 close approach events of main-belt asteroid (702) Alauda are taken for testing by the 1 m telescope at Yunnan Observatory, China. Compared with conventional solutions, our results show that the positional precision significantly improves, which reaches better than 4 mas, and 1 mas in the best case when referenced for the Jet Propulsion Laboratory (JPL) ephemeris in both right ascension and declination.
Control of mitochondrial integrity influences oocyte quality during reproductive aging
Authors: Khan Shaihla A , Reed Laura , Schoolcraft William B , Yuan Ye , Krisher Rebecca L
Published: August 2023

Reduced quality in oocytes from women of advanced maternal age (AMA) is associated with dysfunctional mitochondria. The objective of this study was to investigate the mechanisms controlling mitochondrial quality during maternal aging in mouse and human oocytes. We first evaluated the expression of proteins involved in the mitochondrial unfolded protein response (UPRmt) and mitophagy in in vivo matured metaphase II (MII) oocytes collected from young and aged mice. Expression of UPRmt proteins, HSPD1 and LONP1, and mitophagy proteins, total-PRKN and phosphorylated-PRKN, was significantly decreased in aged compared to young oocytes. Treatment of aged oocytes during in vitro maturation with the mitochondrially targeted antioxidant mitoquinone (MQ) specifically restored total-PRKN and phosphorylated-PRKN expression to levels seen in young oocytes. We next investigated whether maturing young oocytes under a high-oxygen environment would mimic the effects observed in oocytes from aged females. Phosphorylated-PRKN expression in oxidatively stressed young oocytes was reduced compared to that in oocytes matured under normal oxygen levels, and the mitochondrial DNA (mtDNA) copy number was increased. Treating oxidatively challenged young oocytes with MQ restored the phosphorylated-PRKN expression and mtDNA copy numbers. Treatment of oxidatively challenged oocytes with MQ also increased the co-localization of mitochondria and lysosomes, suggesting increased mitophagy. These data correlated with the developmental potential of the oocytes, as blastocyst development and hatching of oxidatively stressed oocytes were reduced, while treatment with MQ resulted in a significant increase in blastocyst development and hatching, and in the percentage of inner cell mass. Consistent with our results in mice, MII oocytes from women of AMA exhibited a significant decrease in phosphorylated-PKRN and total-PRKN compared to those of young women. Our findings suggest that the protein machinery to control the health of the mitochondria via UPRmt and mitophagy may be compromised in oocytes from aged females, which may result in inefficient clearance of dysfunctional mitochondria and reduced oocyte quality.
Exploring the Influence of E-cigarette Ad Features on Perceived Product Appeal and Use Interest Among Young Adults of Varying Tobacco-Use Behaviors
Authors: La Capria Kathryn , Uriarte Caitlin , Elhabashy Maryam , Menkevich Madison , Maxton Olivia , Awadalla Josephine , Tan Andy S L , Moran Meghan B , Chen-Sankey Julia
Published: August 2023

Introduction

Exposure to certain features in commercial e-cigarette ads may influence e-cigarette use perceptions. This study explored the reactions toward common features in e-cigarette ads among young adults of various tobacco-use behaviors.

Aims and Methods

We used data from in-depth interviews with U.S. young adults (ages 18–29) who do not use tobacco (n = 26) and who currently smoke cigarettes (n = 26). Participants viewed 30 print e-cigarette ads that included multiple features (eg, fruit flavors, price promotions, smoker-targeted messages) before discussing their perceived influence of memorable ad features. We used reflective thematic analysis to analyze interview data.

Results

Participants from both groups generally noticed fruit and multiple flavors displayed in the ads, which were seen as appealing and were reported to generate product-use interest because of bright colors, sensory appeal, and a variety of flavor options. Participants who smoke perceived price promotions and positive experience testimonials to be appealing, and some reported this generated use interest. Participants from both groups perceived smoker-targeted messages to be unconvincing, and reported this dampened ad and product appeal and use interest. Participants who do not use tobacco perceived nicotine warnings to be unappealing, resulting in reduced perceived appeal of other attractive features (eg, fruit flavors) appearing in the same ads.

Conclusions

Marketing features appearing in e-cigarette ads may be perceived by young adults of various tobacco-use behaviors in both similar and different ways. Communication and policy strategies that account for these differential perceptions towards various marketing features are needed to reduce the negative impact of e-cigarette marketing.

Implications

This study revealed evidence related to young adults’ reactions to and perceived influence of commonly used marketing features (eg, fruit flavors, nicotine warnings, price promotions, smoker-targeted messages) in commercial e-cigarette ads. The results highlight the similar and differential perceived appeal and use interest of e-cigarette products promoted with various marketing features among young adults of different tobacco-use behaviors. The results have implications for informing the design of communication strategies and policies related to e-cigarette marketing aimed at promoting complete product switching among young adults who smoke while simultaneously deterring e-cigarette use interest among those who do not use tobacco.
International Relations Theory and the Practice of International History
Authors: Jackson Peter , Imlay Talbot
Published: August 2023

In recent years the field of International Relations (IR) has been enriched by an ‘historical turn’ as scholars have directed their attention to the origins of the discipline. During the same period a number of scholars of International History (IH) have borrowed concepts from IR theory in order to provide new perspectives on subjects such as great power relations in the era of the French Revolution or the origins of the Second World War. These trends have led to the suggestion that we are witnessing a new and exciting convergence of research in these two fields. The chapter shows that the early relationship between the emerging fields of IH and IR was characterized by remarkable convergence. After 1945, however, the two fields diverged as IR evolved into a distinct and self-confident discipline and IH focused increasingly on the origins of world wars. Many of the reasons for this divergence can be understood in terms of this Handbook’s two framing themes: modernity and granularity. Enduring challenges remain to systematic inter-disciplinary collaboration.
The Haitian Revolution
Authors: Younis Musab
Published: August 2023

This chapter sketches out two divergent options for rectifying the neglect of the Haitian Revolution in the field of international relations. First, we can make a claim for Haiti’s centrality to international politics by tracing the effects and repercussions of its revolution on the Caribbean, the Americas and the world at large. Alternatively, we can see Haiti’s revolution as exposing the limitations of the categories we use to measure significance and meaning when we study the international. This latter option means abandoning the idea of centrality altogether, drawing on Haiti’s own intellectual history to sketch an alternative view of the international: its forms of power, hierarchies, constraints, and possibilities.
The Bandung Conference
Authors: Lee Christopher J.
Published: August 2023

This chapter examines the 1955 Asian-African Conference held in Bandung, Indonesia. Attended by delegations from 29 countries in Asia and Africa, the Bandung Conference played a pivotal role in the rise of diplomacy and international relations among postcolonial nation-states during the era of decolonization after the Second World War. Among the leaders who participated were Jawaharlal Nehru of India, Gamal Abdel Nasser of Egypt, and Zhou Enlai of the People’s Republic of China. Though these leaders and others brought competing sets of interests to the meeting, the Bandung Conference was broadly concerned with issues like postcolonial sovereignty and economic modernization in the face of growing Cold War pressures. The ‘Bandung Spirit’ fostered an enduring mythology about the event, though the meeting ultimately contributed to a growth in postcolonial diplomatic networking through the institutionalization of the conference format.
Human Rights
Authors: Paras Andrea
Published: August 2023

This chapter argues for the necessity of a historiographical perspective that reveals how the different historical assumptions we make about human rights have consequences for the way that we understand them in the present. Historiographical analysis illuminates how the intersection between historical narrative and analytical choice produces diverging accounts of the role of human rights practices in contemporary global politics. The chapter applies the modernity problematique to identify three divergent narratives about the trajectory of human rights practices, and then utilizes the concept of granularity to identify a spectrum of analytical choices related to definition, actors, geography, and timescales. It concludes that disagreements amongst scholars about the role of human rights in global politics arise out of historiographical differences that reflect conflicting worldviews and normative perspectives.
Case Study in Music Education
Authors: Barrett Janet R.
Published: August 2023

This chapter discusses the widespread prevalence of case studies and the role they play in music education research. It has five goals: to address divergent definitions of case study; to represent key dimensions of case studies drawn from these definitions in a diagram; to address common criticisms and misconceptions related to tensions between theoretical and context-dependent knowledge, generalizability, and rigor; to apply resulting analytical insights to select case studies drawn from music education journals; and to propose avenues for improving the overall impact and utility of case studies within music education based on their particularity and complexity.
Practitioner Inquiry
Authors: Robbins Janet
Published: August 2023

Practitioner inquiry is a form of systematic and intentional inquiry conducted by teachers using their classrooms as settings to study their own practice and students’ learning. This chapter takes an expanded view of practitioner inquiry to include multiple traditions of action research, teacher research, self-study, and communities of practice. A general overview of the defining qualities of each tradition lays the foundation for an examination of illustrative studies in music education conducted by P-12 teachers, graduate students, and teacher educators. This chapter concludes with a discussion of several common critiques of practitioner inquiry, along with suggestions for ways to move the work of researching teachers from the margins to the mainstream of music education research and practice.
Has FATCA succeeded in reducing tax evasion through foreign accounts?
Authors: De Simone Lisa , Stomberg Bridget
Published: August 2023

The Foreign Account Tax Compliance Act (FATCA) spurred an unprecedented increase in the IRS’s ability to obtain information about assets held and income earned by US persons in foreign financial accounts, which were especially prone to illegal tax evasion. We review the evidence on FATCA’s efficacy at reducing tax evasion through foreign accounts and provide additional, longer-term evidence. We then discuss potential avenues for avoiding FATCA reporting. We also highlight other consequences of FATCA and provide exploratory analyses pointing to the use of the United States as a tax haven for foreign investors. We conclude with policy recommendations and suggestions for future research in areas where more analysis is needed.
Trickle-down revisited
Authors: Risch Max
Published: August 2023

In this paper I discuss what can be learned about ‘trickle-down’ ideas from recent empirical evidence on tax incidence, or the effect of tax policies on the distribution of welfare. I underscore three lessons. First, recent research suggests that business income taxes affect the earnings of workers, but these effects largely derive from taxing rents and rent-sharing, highlighting the importance of these channels for determining the ultimate incidence. Second, when workers are affected by these taxes, the burden is not borne equally by all workers, but predominantly by those at the top of the earnings distribution. Third, across different tax policies that statutorily affect the rich, the burden is largely borne by the rich, but heterogeneity in responses across tax incentives and taxpayers provides context for incidence analyses. Throughout, I discuss the value of analysing heterogeneous responses, particularly how tax incidence depends on labour markets, product markets, and tax systems.
Rethinking capital and wealth taxation
Authors: Piketty Thomas , Saez Emmanuel , Zucman Gabriel
Published: August 2023

This paper reviews recent developments in the theory and practice of optimal capital taxation. We emphasize three main rationales for capital taxation. First, the frontier between capital and labour income flows is often fuzzy, thereby lending support to a broad-based, comprehensive income tax. Next, the very notions of income and consumption flows are difficult to define and measure for top wealth holders where capital gains due to asset price effects dwarf ordinary income and consumption flows. Therefore the proper way to tax billionaires is a progressive wealth tax. Finally, as individuals cannot choose their parents, there are strong meritocratic reasons why we should tax inherited wealth more than earned income or self-made wealth for which individuals can be held responsible, at least in part. This implies that the ideal fiscal system should also include a progressive inheritance tax, in addition to progressive income and wealth taxes. We then confront our prescriptions with historical experience. Although there are significant differences, we argue that observed fiscal systems in modern democracies bear important similarities with this ideal triptych.
Transcription factor module NLP–NIGT1 fine-tunes NITRATE TRANSPORTER2.1 expression
Authors: Ueda Yoshiaki , Yanagisawa Shuichi
Published: August 2023

Arabidopsis (Arabidopsis thaliana) high-affinity NITRATE TRANSPORTER2.1 (NRT2.1) plays a dominant role in the uptake of nitrate, the most important nitrogen (N) source for most terrestrial plants. The nitrate-inducible expression of NRT2.1 is regulated by NIN-LIKE PROTEIN (NLP) family transcriptional activators and NITRATE-INDUCIBLE GARP-TYPE TRANSCRIPTIONAL REPRESSOR1 (NIGT1) family transcriptional repressors. Phosphorus (P) availability also affects the expression of NRT2.1 because the PHOSPHATE STARVATION RESPONSE1 transcriptional activator activates NIGT1 genes in P-deficient environments. Here, we show a biology-based mathematical understanding of the complex regulation of NRT2.1 expression by multiple transcription factors using 2 different approaches: a microplate-based assay for the real-time measurement of temporal changes in NRT2.1 promoter activity under different nutritional conditions, and an ordinary differential equation (ODE)-based mathematical modeling of the NLP- and NIGT1-regulated expression patterns of NRT2.1. Both approaches consistently reveal that NIGT1 stabilizes the amplitude of NRT2.1 expression under a wide range of nitrate concentrations. Furthermore, the ODE model suggests that parameters such as the synthesis rate of NIGT1 mRNA and NIGT1 proteins and the affinity of NIGT1 proteins for the NRT2.1 promoter substantially influence the temporal expression patterns of NRT2.1 in response to nitrate. These results suggest that the NLP–NIGT1 feedforward loop allows a precise control of nitrate uptake. Hence, this study paves the way for understanding the complex regulation of nutrient acquisition in plants, thus facilitating engineered nutrient uptake and plant response patterns using synthetic biology approaches.
Can active sun exposure decrease the risk of giant cell arteritis and polymyalgia rheumatica in women?
Authors: Gisslander Karl , de Boer Raïssa , Ingvar Christian , Turesson Carl , Isaksson Karolin , Jayne David , Mohammad Aladdin J
Published: August 2023

Objectives

To study if active sun exposure among women affects the risk of developing GCA or PMR in a prospective cohort study with restricted latitudinal variability.

Methods

We linked the response to questions relating to sun exposure from the Melanoma Inquiry in Southern Sweden (MISS) prospective cohort study in women to the risk of developing GCA or PMR. Healthcare data were gathered from the Skåne Healthcare Register (SHR), covering all public healthcare consultations. The direct effect of active sun exposure on the risk of developing GCA or PMR was assessed using Cox proportional hazards models adjusted for covariates based on a directed acyclic graph.

Results

A total of 14 574 women were included in the study; 601 women were diagnosed with GCA or PMR (144 and 457, respectively) during the follow-up time. Women with moderate or high sun exposure were not less likely to develop GCA or PMR compared with women that indicated they avoided sun exposure [hazard ratio (HR) 1.2 (CI 0.9, 1.6) and 1.3 (0.9, 1.9), respectively] when adjusted for diabetes, hyperlipidaemia, hypertension, smoking, obesity and stratified by age. Similar patterns were observed when studying only GCA [HR 1.2 (CI 0.7, 2.3) and 1.3 (0.7, 2.6)] and only PMR [HR 1.3 (CI 0.9, 1.8) and 1.4 (0.9, 2.0)].

Conclusion

Active sun exposure did not affect the risk of developing GCA or PMR in women in a cohort with restricted latitudinal variability.
First Report of Alternaria alternata Causing Decay in Exported Sweet Basil During Freight from Israel to Europe
Authors: Krasnow Charles , Ziv Carmit , Nitzan Nadav
Published: August 2023

Sweet basil (Ocimum basilicum) is an important spice herb grown in Israel for local markets and export. The crop is used as a fresh culinary herb or spice, and the essential oils are used in cosmetics and food flavorings. Due to increased demand, the production area of basil has increased in Israel. Postharvest losses due to fungal disease are a major economic concern for growers. In the summer of 2019, a leaf spot was observed in postharvest shipments of sweet basil destined for Europe; in late winter of 2022, leaf spots were observed on greenhouse-grown sweet basil. Fungal isolates from infected leaves were characterized by morphology in culture as Alternaria spp. PCR amplification of the Alternaria major allergen Alt a1, ITS, and gdp gene regions of the recovered isolates confirmed the presence of A. alternata, a common pathogen of numerous herbs and spice plants. In vitro growth tests demonstrated that 25°C was the optimum temperature for growth of the isolates. The isolates were tested for pathogenicity and found to infect a commonly grown cultivar of basil, cultivar Eli (previously cultivar Perrie). Foliar symptoms in pathogenicity tests were identical to those observed in commercial shipments and in the field, which completed Koch’s postulates. Control of the nascent disease by applying fungicides to the plants may be necessary to reduce postharvest losses.
Adopting Open Educational Resources as an Equity Strategy
Authors: Ernstmeyer Kimberly E. , Christman Elizabeth I.
Published: August 2023

Social determinants of learning (SDOL) impact students’ abilities to successfully complete their courses. An economic barrier for vulnerable students is the skyrocketing cost of textbooks. An innovative strategy to promote equity in educational delivery is the adoption of open educational resources (OER). The Open Resources for Nursing (Open RN) project published five OER textbooks with input from over 65 contributors and 300 reviewers. Open RN textbooks have received widespread national and international usage. Analysis of student outcomes indicates similar successful course completion rates by all students in OER course sections and increased rates of successful course completion by non-White students.
Low-dose Initiation of Buprenorphine in Hospitalized Patients on Full Agonist Opioid Therapy: A Retrospective Observational Study
Authors: Schult Rachel F. , Maynard Kaylee M. , Corvelli Jenna M. , Rappaport Stephen , McKinney Benjamin , Clarkson Trevor , Wiegand Timothy J. , Malcho Jade , Acquisto Nicole M.
Published: August 2023

Objective

Buprenorphine can be challenging to initiate in hospitalized patients with opioid dependence because of difficulty tolerating an opioid-free period for buprenorphine induction. The objective of this study was to evaluate efficacy and safety of low-dose initiation of buprenorphine in hospitalized patients receiving full agonist opioids.

Methods

This is a retrospective observational study between January 1, 2019, and December 31, 2020, at an academic tertiary care center and affiliated community hospital. Participants included adult patients at least 18 years old receiving scheduled full agonist opioids who were given sublingual buprenorphine 0.5 mg or less with the intent of increasing to at least 4 mg daily. The primary endpoint was the proportion of patients reaching a target dose of at least 4 mg total per day. The secondary endpoints included the incidence of precipitated opioid withdrawal based on documentation of symptoms and change in morphine milligram equivalents before and after low-dose buprenorphine initiation.

Results

A total of 76 low-dose initiation attempts were performed in 71 predominantly male (68%) patients (some patients had multiple attempts). Most patients received low-dose initiation because of history of opioid use disorder (83%). Low-dose initiation was completed in 54 of 71 patients (76%) after 76 attempts. Precipitated withdrawal was identified in 2 patients (2.8%). Median morphine milligram equivalents excluding buprenorphine 24 hours before low-dose initiation was 1000 mg (interquartile range, 303.5–1720.5 mg) compared with 37.5 mg (interquartile range, 0–254 mg) after reaching target dose (P < 0.001).

Conclusions

Buprenorphine was safely initiated using low-dose initiation in hospitalized patients. This was associated with significant reduction in full agonist opioids.
Asthma and Cardiovascular Diseases: Uncovering Common Ground in Risk Factors and Pathogenesis
Authors: Aggarwal Kanishk , Bansal Vasu , Mahmood Ramsha , Kanagala Sai Gautham , Jain Rohit
Published: August 2023

Asthma and cardiovascular diseases (CVDs) are the 2 common and complex health problems with a substantial global impact. Epidemiological studies indicate that asthma and CVDs are common, with evidence supporting their cooccurrence. Inflammation, oxidative stress, obesity, metabolic syndrome, smoking, secondhand smoke exposure, physical inactivity, and environmental exposures are all risk factors for asthma and CVDs. In addition, inflammatory and immunological pathways, autonomic dysfunction, endothelial dysfunction, thrombosis, coagulation, and common genetic risk factors contribute to the asthma–CVD relationship. Asthmatic individuals have higher morbidity and mortality rates related to CVDs and high-risk factors. Techniques such as screening for CVDs in asthma patients, pharmaceutical therapy, and lifestyle changes are critical for effectively managing these comorbid illnesses. Understanding the link between asthma and CVD is necessary for integrated and clinical management approaches to enhance patient outcomes and lessen the burden of these related diseases.
Tumor Marker Trajectories and Survival Analysis in Patients with Normal Carcinoembryonic Antigen Ranges After Colorectal Cancer Resection
Authors: Chern Yih-Jong , Hsu Hsin-Yin , Hsu Yu-Jen , Hsu Le-Yin , Tsai Wen-Sy , Liao Chun-Kai , Jong Bor-Kang , You Jeng-Fu
Published: August 2023

BACKGROUND:

Evidence regarding postoperative CEA for predicting long-term outcomes of colorectal cancer remains controversial, especially in patients with normal postoperative CEA.

OBJECTIVE:

To investigate the risk difference among different postoperative CEA trajectories in patients with normal postoperative CEA after curative colorectal cancer resection.

DESIGN:

This cohort study was conducted at a comprehensive cancer center and included data retrieved from a prospectively collected database between January 2006 and December 2018.

SETTINGS:

Retrospective cohort study.

PATIENTS:

Patients with colorectal cancer who underwent surgery for primary stage I–III colorectal adenocarcinoma were included. Patients with postoperative CEA >5 ng/mL were excluded.

INTERVENTIONS:

Standard curative radical resection was performed.

MAIN OUTCOME MEASURES:

Ten-year overall survival and disease-free survival were analyzed.

RESULTS:

The study population (n = 8156) was categorized into 6 trajectories, including persistently-ultralow (n = 2351), persistent-low (n = 2474), gradually-decrease (n = 401), persistent-medium (n = 1727), slightly-increase (n = 909), and around-upper-limit (n = 394). The median follow-up time was 7.8 years, and the median timeframe in which CEA was measured to determine trajectory was 2.6 years. The persistent-ultralow group had the highest 10-year overall survival (85.1%) and disease-free survival (82.7%). The around-upper-limit group had the lowest 10-year overall survival (55.5%) and disease-free survival (53.4%). The adjusted hazard ratio trend was comparable to crude hazard ratio of the persistent-ultralow group. Consequently, the higher initial serum CEA groups had higher hazard ratios of overall survival and disease-free survival. The adjusted hazard ratios of overall survival/disease-free survival were 2.96/2.66 (95% confidence interval: 2.39–3.66/2.18–3.69) for the around-upper-limit groups.

LIMITATIONS:

The study was limited by its retrospective design.

CONCLUSIONS:

The postoperative serum CEA trajectory is an independent factor associated with long-term outcomes. Although CEA levels were all within normal range, higher levels of postoperative serum CEA trajectory correlated with worse long-term oncological outcomes..
Determining the Relationship Between Intolerance of Uncertainty and Attitudes Toward Complementary and Alternative Medicine in Patients With Cancer
Authors: Akkuş Yeliz , Menekli Tuğba
Published: August 2023

Disease-related uncertainty and the factors associated with uncertainty in patients with cancer have not been adequately investigated. This study aimed to determine the relationship between intolerance of uncertainty and attitudes toward complementary and alternative medicine (CAM) in patients with cancer. This cross-sectional descriptive study included 351 patients treated in the oncology clinic of a university hospital. All participants completed the Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) and the 12-item Intolerance of Uncertainty Scale (IUS-12). Most patients (84.3%) said that they had information about CAM, 39.7% reported obtaining this information from their social environment, 83.2% said that they believed that CAM methods are effective, and 76.0% reported not telling health care professionals about their CAM use. Mean IUS-12 and HCAMQ total scores were 46.53 ± 2.05 and 32.11 ± 2.32, respectively, and showed a weak negative correlation. The patients in our study showed high intolerance of uncertainty and a moderately positive attitude toward CAM, and most patients did not notify health care professionals of their CAM use. Therefore, we recommend assessing intolerance of uncertainty and CAM use in this patient group. By identifying patients experiencing uncertainty and seeking different treatment, nurses can support patients physiologically, psychologically, and socially, and can explain the effects of CAM use.
Small-aperture intraocular lens implantation after multiple penetrating keratoplasties secondary to penetrating ocular trauma
Authors: Vander Zee Brandon L. , Ferguson Tanner J. , Berdahl John P. , Kramer Brent A.
Published: August 2023

Introduction:

The small-aperture intraocular lens (IOL) is a recently introduced IOL that can provide favorable central visual acuity in patients with irregular corneas. This case describes a patient with multiple prior penetrating keratoplasties secondary to ocular trauma that achieved a favorable outcome with the aforementioned IOL.

Patient and Clinical Findings:

A 66-year-old man presented with a penetrating corneal injury that was successfully repaired but was eventually complicated by fungal keratitis requiring a therapeutic penetrating keratoplasty (PKP). The patient had a prolonged postoperative course complicated by multiple graft failures and finally stabilized after a third PKP. Through the protracted course, the patient developed a brunescent cataract, and the multiple PKPs resulted in significant irregular astigmatism.

Diagnosis, Intervention, and Outcomes:

The patient underwent cataract surgery in the affected eye with implantation of a small-aperture IOL 18 months after his initial injury. The patient's uncorrected distance visual acuity was 20/20 at six months post-operatively and he reported excellent quality of vision.

Conclusions:

This case represents the first use of the small-aperture IOL in a patient with prior PKP since its U.S. Food and Drug Administration approval. The small-aperture IOL can overcome high levels of corneal irregularities and provide favorable visual acuity in complex eyes.
Updates in Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) in Children
Authors: Rupasinghe Kushila , Hind Jonathan , Hegarty Robert
Published: August 2023

The obesity epidemic is one of the major health concerns of the 21st century. Nonalcoholic fatty liver disease (NAFLD) is linked with the increased adiposity associated with obesity. NAFLD has become the most frequent cause of chronic liver disease in adults and children worldwide. Metabolic dysfunction-associated fatty liver disease (MAFLD) also known in children as pediatric fatty liver disease (PeFLD) type 2 has begun to supersede NAFLD as the preferred nomenclature in the pediatric population. Evidence suggests the etiology of MAFLD is multifactorial, related to the complex interplay of hormonal, nutritional, genetic, and environmental factors. Current limitations in accurate diagnostic biomarkers have rendered it a diagnosis of exclusion and it is important to exclude alternative or coexisting causes of PeFLD. Lifestyle changes and modifications remains the primary treatment modality in MAFLD in children. Weight loss of 7%–10% is described as reversing MAFLD in most patients. The Mediterranean diet also shows promise in reversing MAFLD. Pharmacological intervention is debatable in children, and though pediatric trials have not shown promise, other agents undergoing adult clinical trials show promise. This review outlines the latest evidence in pediatric MAFLD and its management.
Development of an Interactive 3D Visualization Tutorial for Pathophysiology in Graduate Nursing Education
Authors: Rogers Julia L. , Reyes Abel , Yang Xiaoli
Published: August 2023

Background:

A recent revision to the Nurse Practitioner Role Core Competencies will lead to robust changes in graduate education. Incorporating innovative technology into the core courses of advanced practice nursing will prepare practice-ready providers with a high level of competence leading to successful health outcomes, improved patient satisfaction, and decreased health care costs.

Problem:

Graduate education lacks effective, innovative, and interactive visualization tools to study pathophysiology. There is a lack of evidence for the use of 3-dimensional (3D) augmented reality (AR) and virtual reality in advanced practice core courses.

Approach:

A collaborative iterative approach was used to design, develop, analyze, update, and reiterate a 3D AR tutorial for advanced pathophysiology.

Outcomes:

Students had a positive experience and perceive 3D AR as a learning tool that can increase examination scores. The visualization connected the pathophysiologic process of a disease to the pathogenesis, clinical manifestations, and associated treatments.

Conclusions:

3D AR tutorials are an effective solution to facilitate learning difficult concepts in pathophysiology by incorporating following multiple learning techniques: visual, aural, verbal, kinesthetic, and logical.
Using a Clinical Triggers System to Improve Early Recognition of Clinical Changes
Authors: Lee Betty , Leng Jennifer , Kerbel Russell
Published: August 2023

Purpose

A medical-surgical telemetry unit implemented a clinical triggers system for early recognition of clinical deterioration and bedside management between nurses and providers. The goal was to decrease cardiopulmonary arrest events.

Description of the Project

A clinical triggers system was developed to help nurses to identify clinical markers early and advocate for prompt bedside assessment and interventions. When clinical triggers were identified, the nurse notified the provider, who performed a bedside assessment within 15 minutes. If the provider did not respond promptly, the rapid response team was activated.

Outcomes

Before intervention, the unit experienced 14 cardiopulmonary arrest events (rate of 1.37 per 1000 patient days). Incidences decreased annually to 5, 4, and 3 events (rates of 0.49, 0.39, and 0.3 per 1000 patient days) during the 3-year implementation period.

Conclusions

The clinical triggers system was successful in achieving the project objective of decreasing unit cardiopulmonary arrest events through early recognition and response to patient deterioration during the implementation period. The clinical nurse specialist helped nurses to use the clinical triggers system to detect and respond to clinical changes. Nurses were empowered to address concerns and promote patient safety.
Transparency films: intraoperative templating to prevent limb deformity
Authors: Stine Sasha , Joiner Jonathan Daniel , Andersen Daniel , Schweller Eric , Vaidya Rahul
Published: August 2023

Operative management of fractures and malunions can be challenging when restoring native anatomy is not straightforward. Comminuted fractures and managing deformity correction in the setting of osteolysis, callus, and even complete fracture healing must include careful planning. Preoperative planning has been popularized and taught as an integral part of a surgeon's skill set, with critical evaluation and assessment of the implemented plan being the final step in the process. We present a robust, reproducible, and cost-effective technique for intraoperative fracture fixation assessment with case examples, used routinely at our institution.
Nd:YAG Laser Capsulotomy: Efficacy and Outcomes Performed by Optometrists
Authors: Lighthizer Nathan , Johnson Spencer , Holthaus Jared , Holthaus Kathleen , Cherian Bibin , Swindell Ryan , Weber Brianna , Weise Karli , Cockrell David , Lewis Stephen , Wroten Christopher , Anastasio Jeff , Ellen Jason , Miller Jeffrey M.
Published: August 2023

SIGNIFICANCE

An increasing number of optometrists are performing Nd:YAG laser capsulotomy procedures; however, there is limited published information on the outcomes of these procedures.

PURPOSE

This study aimed to assess the efficacy and safety of capsulotomy procedures performed by optometrists.

METHODS

Subjects diagnosed with posterior capsule opacification causing reduced vision and subjective visual complaints were recruited for this study. A baseline examination was performed to ensure that the subjects met all the necessary criteria. The procedure was performed by a licensed doctor of optometry at six different clinics, and each subject was monitored for visual outcome and any potential complications.

RESULTS

Subjects' Snellen visual acuity improved from an average of 20/40 to 20/23 (P < .001) with no complications of increased intraocular pressure, inflammation, visually significant lens pitting, macular edema, or retinal detachment. Of 78 subjects who responded to a post-procedure survey, 77 (99%) reported subjective improvement in vision after capsulotomy.

CONCLUSIONS

Based on the outcomes of this study, YAG laser capsulotomies are effective treatments to improve patient vision that can be safely and effectively performed by optometrists.
Reporting Rigor of Cancer Rehabilitation Interventions: Application of the CReDECI-2 Guidelines
Authors: Brick Rachelle , Voss Lauren , Arbid Sasha , Joshi Yash , Tome Genevieve , El Hassanieh Dima , Sleight Alix G. , Klein Caroline , Sabir Aisha , Wechsler Stephen , Campbell Grace , Campbell Kristin L. , Lam Adrienne , Lyons Kathleen D. , Padgett Lynne , Jones Jennifer
Published: August 2023

Clear reporting of cancer rehabilitation interventions is critical for interpreting and translating research into clinical practice. This study sought to examine the completeness of intervention reporting of cancer rehabilitation interventions addressing disability and to identify which elements are most frequently missing. This was a secondary analysis of randomized controlled trials included in two systematic reviews examining effectiveness of cancer rehabilitation interventions that address cancer-related disability, including functional outcomes. Eligible trials were reviewed for intervention reporting rigor using the Criteria for Reporting the Development and Evaluation of Complex Interventions in Healthcare-2 (CReDECI-2) checklist. Intervention descriptions for cancer rehabilitation interventions were generally incomplete. Approximately 85% (n = 157) of trials described ≤50% of CReDECI-2 checklist items. Commonly underreported items included description of the intervention’s underlying theoretical basis, fidelity, description of process evaluation or external conditions influencing intervention delivery, and costs or required resources for intervention delivery. The findings reveal that cancer rehabilitation intervention descriptions lacked necessary detail in this body of literature. Poor descriptions limit the translation of research to clinical practice. To ensure higher quality study design and reporting, future intervention research should incorporate an intervention reporting checklist to ensure more complete descriptions for research and practice.
Parental Preconception Posttraumatic Stress Symptoms and Maternal Prenatal Inflammation Prospectively Predict Shorter Telomere Length in Children
Authors: Rinne Gabrielle R. , Carroll Judith E. , Guardino Christine M. , Shalowitz Madeleine U. , Ramey Sharon Landesman , Dunkel Schetter Christine
Published: August 2023

Objective

Parental trauma exposure and trauma-related distress can increase the risk of adverse health outcomes in offspring, but the pathways implicated in intergenerational transmission are not fully explicated. Accelerated biological aging may be one mechanism underlying less favorable health in trauma-exposed individuals and their offspring. This study examines the associations of preconception maternal and paternal posttraumatic stress disorder (PTSD) symptoms with child telomere length, and maternal prenatal C-reactive protein (CRP) as a biological mechanism.

Methods

Mothers (n = 127) and a subset of the fathers (n = 84) reported on PTSD symptoms before conception. Mothers provided blood spots in the second and third trimesters that were assayed for CRP. At age 4 years, children provided buccal cells for measurement of telomere length. Models adjusted for parental age, socioeconomic status, maternal prepregnancy body mass index, child biological sex, and child age.

Results

Mothers’ PTSD symptoms were significantly associated with shorter child telomere length (β = −0.22, SE = 0.10, p = .023). Fathers’ PTSD symptoms were also inversely associated with child telomere length (β = −0.21, SE = 0.11), although nonsignificant (p = .065). There was no significant indirect effect of mothers’ PTSD symptoms on child telomere length through CRP in pregnancy, but higher second-trimester CRP was significantly associated with shorter child telomere length (β = −0.35, SE = 0.18, p = .048).

Conclusions

Maternal symptoms of PTSD before conception and second-trimester inflammation were associated with shorter telomere length in offspring in early childhood, independent of covariates. Findings indicate that intergenerational transmission of parental trauma may occur in part through accelerated biological aging processes and provide further evidence that prenatal proinflammatory processes program child telomere length.

Open Science Framework Preregistration:
https://osf.io/7c2d5/?view_only=cd0fb81f48db4b8f9c59fc8bb7b0ef97.