bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance of Anti-Carbamylated Protein Antibody Testing in the Routine Evaluation of Rheumatoid Arthritis from a Single Center
Authors: Nelson Heather A , Novis Camille L , Lebiedz-Odrobina Dorota , Nandakumar Vijayalakshmi
Published: November 2023

Background

Detection of anticyclic citrullinated peptide antibodies (anti-CCP) and rheumatoid factors (RF) in sera support the diagnosis of rheumatoid arthritis (RA); however, these markers are not detected in about 20% of RA patients. More recently, antibodies against carbamylated proteins (anti-CarP) have emerged with implications for preclinical RA diagnosis. The objective of this study was to assess the clinical performance of anti-CarP and correlate with disease severity in routine clinical practice.

Methods

Retrospective chart review of 331 subjects submitted for RA panel serology: 136 clinically defined RA-positive and 195 RA-negative patients. Fifty additional individuals were recruited for healthy controls. Patients’ sera were tested for anti-CCP, anti-CarP, and RF antibodies. Clinical performance characteristics were evaluated for anti-CarP individually and in combination with anti-CCP and RF. Documented erosions and synovitis were correlated with anti-CarP positivity.

Results

Anti-CarP had a clinical sensitivity and specificity of 27% and 94%, respectively, for established RA. This sensitivity was lower than anti-CCP (79%) and RF (85%). The specificity of anti-CarP was similar to anti-CCP (93%) and higher than RF (69%). Anti-CarP in combination with anti-CCP and RF increased specificity (100%) but decreased sensitivity (21%). There was no correlation of anti-CarP positivity with presence of bone erosions; however, there was an increase in anti-CarP positivity among patients with synovitis.

Conclusions

Anti-CarP demonstrates high specificity in diagnosis of established RA but lacks clinical sensitivity. In combination, anti-CarP does not improve clinical performance of anti-CCP and RF but may be useful in anti-CCP negative patients and in identifying patients with more active disease.
The capsid revolution
Authors: Taylor Ian A , Fassati Ariberto
Published: November 2023

Lenacapavir, targeting the human immunodeficiency virus type-1 (HIV-1) capsid, is the first-in-class antiretroviral drug recently approved for clinical use. The development of Lenacapavir is attributed to the remarkable progress in our understanding of the capsid protein made during the last few years. Considered little more than a component of the virus shell to be shed early during infection, the capsid has been found to be a key player in the HIV-1 life cycle by interacting with multiple host factors, entering the nucleus, and directing integration. Here, we describe the key advances that led to this ‘capsid revolution’.
Principal components analysis in stylometry
Authors: Craig Hugh
Published: November 2023

Principal components analysis (PCA) has been one of the staple methods used in stylometry. In a 2021 article, Pervez Rizvi casts doubt on this method and argues that some widely cited results based on it should be set aside. In the current article, I show that none of Rizvi’s theoretical claims or experimental results stand up to examination. Rizvi argues that discarding the principal components beyond the first two makes the method unreliable, but permutation testing of PCAs shows that the top components in these trials are significant and robust, and the results across many experiments show the combination of the first and second component to be effective in classification. Rizvi argues that PCA components must be treated separately, and much of his critique of the PCA method is based on this standpoint, but this is not the practice in the work presented in the publications he cites or in the wider literature. Rizvi is unable to replicate a chart in an article by Craig, but his replication, unlike the original, does not account for the widely varying sizes of samples in his data. The current article shows that Rizvi’s claims are misguided and that using PCA in the Burrows tradition to find and formalize authorial discriminations in text samples from plays of the Shakespearean era is efficacious and robust.
Lunar occultations events from the Earth–Moon equilateral Lagrangian point: simulations and scientific potential
Authors: Richichi A , Fors O , Canales D , Patel K , Mendoza Zambrano L E , Criscola F , Bevilacqua R , Eikenberry S S , Gómez J M
Published: November 2023

Recently, a novel idea has been proposed to use a spacecraft orbiting closely around the L4 or L5 Lagrangian points of the Earth–Moon system as a vantage location for astronomical observations under unique and advantageous conditions, e.g. to investigate the Solar corona or Kordylewski clouds. In this paper, we explore the scientific advantages of this configuration to observe lunar occultations. By using simulations based on actual orbital parameters and detector performance, we find that even a telescope as small as 10 cm in a L4 orbit would enable better light-curve sampling and higher angular resolution than from ground, and open up at the same time new spectral windows such as e.g. in the UV. We focus in particular on angular diameter measurements, which we find would be possible at the 100 $\mu$as level even at magnitudes normally considered faint in the context of ground-based LOs. Considerable benefits would also be afforded in the area of small separation binary objects, not just in terms of angular resolution but also by the capability of L4-based observations to repeat an LO scan of a source at multiple different position angles. Additional science cases would be made possible by the high time resolution intrinsic to the LO technique and the access to UV wavelengths. On-board data pipeline codes already exist, greatly simplifying the automatic pre-processing and the data transfer requirements.
Tidal dissipation in rotating and evolving giant planets with application to exoplanet systems
Authors: Lazovik Yaroslav A , Barker Adrian J , de Vries Nils B , Astoul Aurélie
Published: November 2023

We study tidal dissipation in models of rotating giant planets with masses in the range 0.1–10MJ throughout their evolution. Our models incorporate a frequency-dependent turbulent effective viscosity acting on equilibrium tides (including its modification by rapid rotation consistent with hydrodynamical simulations) and inertial waves in convection zones, and internal gravity waves in the thin radiative atmospheres. We consider a range of planetary evolutionary models for various masses and strengths of stellar instellation. Dissipation of inertial waves is computed using a frequency-averaged formalism fully accounting for planetary structures. Dissipation of gravity waves in the radiation zone is computed assuming these waves are launched adiabatically and are subsequently fully damped (by wave breaking/radiative damping). We compute modified tidal quality factors Q′ and evolutionary time-scales for these planets as a function of their ages. We find inertial waves to be the dominant mechanism of tidal dissipation in giant planets whenever they are excited. Their excitation requires the tidal period (Ptide) to be longer than half the planetary rotation (Prot/2), and we predict inertial waves to provide a typical Q′ ∼ 103(Prot/1d)2, with values between 105 and 106 for a 10-d period. We show correlations of observed exoplanet eccentricities with tidal circularization time-scale predictions, highlighting the key role of planetary tides. A major uncertainty in planetary models is the role of stably-stratified layers resulting from compositional gradients, which we do not account for here, but which could modify predictions for tidal dissipation rates.
On the extremely low polarization in Comet C/2023 P1 (Nishimura)
Authors: Zheltobryukhov Maxim , Zubko Evgenij , Chornaya Ekaterina , Kochergin Anton , Hines Dean C , Videen Gorden
Published: November 2023

On September 6 and 7 of 2023, we measured the degree of linear polarization of Comet C/2023 P1 (Nishimura) with the R filter. Our observations reveal an extremely low amplitude of positive polarization. Our modelling suggests Mg-rich silicate dust particles are the dominant species in the coma; whereas, an alternative explanation is that such low positive polarization in comets is attributed to the depolarizing effect of their gaseous emission. These two alternative explanations predict dramatically different polarimetric responses at small phase angle that can be discriminated in future polarimetric observations of Comet C/2023 P1 (Nishimura).
Association of Chronic Medical Conditions With Severe Outcomes Among Nonpregnant Adults 18–49 Years Old Hospitalized With Influenza, FluSurv-NET, 2011–2019
Authors: Famati Efemona A , Ujamaa Dawud , O’Halloran Alissa , Kirley Pam Daily , Chai Shua J , Armistead Isaac , Alden Nisha B , Yousey-Hindes Kimberly , Openo Kyle P , Ryan Patricia A , Monroe Maya L , Falkowski Anna , Kim Sue , Lynfield Ruth , McMahon Melissa , Angeles Kathy M , Khanlian Sarah A , Spina Nancy L , Bennett Nancy M , Gaitán Maria A , Shiltz Eli , Lung Krista , Thomas Ann , Talbot H Keipp , Schaffner William , George Andrea , Staten Holly , Bozio Catherine H , Garg Shikha
Published: November 2023

Background

Older age and chronic conditions are associated with severe influenza outcomes; however, data are only comprehensively available for adults ≥65 years old. Using data from the Influenza Hospitalization Surveillance Network (FluSurv-NET), we identified characteristics associated with severe outcomes in adults 18–49 years old hospitalized with influenza.

Methods

We included FluSurv-NET data from nonpregnant adults 18–49 years old hospitalized with laboratory-confirmed influenza during the 2011–2012 through 2018–2019 seasons. We used bivariate and multivariable logistic regression to determine associations between select characteristics and severe outcomes including intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), and in-hospital death.

Results

A total of 16 140 patients aged 18–49 years and hospitalized with influenza were included in the analysis; the median age was 39 years, and 26% received current-season influenza vaccine before hospitalization. Obesity, asthma, and diabetes mellitus were the most common chronic conditions. Conditions associated with a significantly increased risk of severe outcomes included age group 30–39 or 40–49 years (IMV, age group 30–39 years: adjusted odds ratio [aOR], 1.25; IMV, age group 40–49 years: aOR, 1.36; death, age group 30–39 years: aOR, 1.28; death, age group 40–49 years: aOR, 1.69), being unvaccinated (ICU: aOR, 1.18; IMV: aOR, 1.25; death: aOR, 1.48), and having chronic conditions including extreme obesity and chronic lung, cardiovascular, metabolic, neurologic, or liver diseases (ICU: range aOR, 1.22–1.56; IMV: range aOR, 1.17–1.54; death: range aOR, 1.43–2.36).

Conclusions

To reduce the morbidity and mortality associated with influenza among adults aged 18–49 years, health care providers should strongly encourage receipt of annual influenza vaccine and lifestyle/behavioral modifications, particularly among those with chronic medical conditions.
Clinical valve thrombosis and arterial embolism in a cancer patient after transcatheter aortic valve replacement
Authors: Sawano Shinnosuke , Miura Mizuki , Higashikuni Yasutomi , Saigusa Hiroyuki , Kodera Satoshi , Takeda Norifumi , Hatano Masaru , Ando Jiro , Ono Minoru , Komuro Issei
Published: November 2023

The number of cancer patients with severe aortic stenosis and atrial fibrillation (AF) is increasing in the aging population. Transcatheter aortic valve replacement (TAVR) is an established treatment option for severe aortic stenosis with high surgical risk, including individuals with cancer. Antithrombotic therapy should be considered for post-TAVR or AF patients. However, antithrombotic management in cancer patients remains challenging due to the increased risk of both thromboembolism and bleeding. We present a case of clinical valve thrombosis and arterial embolism after transcatheter aortic valve replacement in an elderly patient with a history of metastatic pancreatic cancer and permanent atrial fibrillation under treatment of single antiplatelet therapy. Warfarin treatment after successful surgical thrombectomy to the occluded arteries improved clinical valve thrombosis, although the long-term outcome remains unclear. This case demonstrates that novel management algorithms for thromboembolism and bleeding in elderly cancer patients with AF and valvular heart disease are urgently needed.
Intestinal perforation as a first presentation of granulomatosis with polyangiitis: unusual case report
Authors: Khalayli Naram , Aldeeb Maria , Abouharb Dani , Abouharb Lana , Kudsi Maysoun
Published: November 2023

Introduction: Granulomatosis with polyangiitis (GPA) vasculitis typically involves upper and lower airways and kidneys. Gastrointestinal involvement is rare, clinically reported as esophageal involvement, gastrointestinal hemorrhage, intestinal perforation, colitis, and pancreatitis. Case presentation: We present a 36 old man, with intestinal perforation, laterally diagnosed as granulomatosis with polyangiitis. Discussion: Only a few cases of intestinal perforation have been reported in the medical literature. GI symptoms may be present after the disease diagnosis in years. Intestinal perforation usually required surgery. The frequent kidney involvement of GPA is rapidly progressive glomerulonephritis, presented as acute kidney injury, usually accompanied by GI symptoms. Cyclophosphamide plus corticosteroids remain the effective therapy. The patient with GPA had a normal life expectancy due to the advances in treatment. Renal involvement and GI manifestations are considered bad prognosis predictors. Conclusion: This case report illustrates the need to consider intestinal perforation in patients with granulomatosis with polyangiitis, early surgical intervention and appropriate immunosuppressive therapy can be lifesaving.
Spatially explicit Bayesian hierarchical models improve estimates of avian population status and trends
Authors: Smith Adam C , D. Binley Allison , Daly Lindsay , Edwards Brandon P M , Ethier Danielle , Frei Barbara , Iles David , Meehan Timothy D , Michel Nicole L , Smith Paul A
Published: November 2023

Population trend estimates form the core of avian conservation assessments in North America and indicate important changes in the state of the natural world. The models used to estimate these trends would be more efficient and informative for conservation if they explicitly considered the spatial locations of the monitoring data. We created spatially explicit versions of some standard status and trend models applied to long-term monitoring data for birds across North America. We compared the spatial models to simpler non-spatial versions of the same models, fitting them to simulated data and real data from 3 broad-scale monitoring programs: the North American Breeding Bird Survey (BBS), the Christmas Bird Count, and a collection of programs we refer to as Migrating Shorebird Surveys. All the models generally reproduced the simulated trends and population trajectories when there were many data, and the spatial models performed better when there were fewer data and in locations where the local trends differed from the range-wide means. When fit to real data, the spatial models revealed interesting spatial patterns in trend, such as recent population increases along the Appalachian Mountains for the Eastern Whip-poor-will (Antrostomus vociferus), that were much less apparent in results from the non-spatial versions. The spatial models also had higher out-of-sample predictive accuracy than the non-spatial models for a selection of species using BBS data. The spatially explicit sharing of information allows fitting the models with much smaller strata, allowing for finer-grained patterns in trends. Spatially informed trends will facilitate more locally relevant conservation, highlight areas of conservation successes and challenges, and help generate and test hypotheses about the spatially dependent drivers of population change.
Trauma-Informed Cultural Humility Mental Health Practice: Centering History among African American Women
Authors: Hong Sunghyun
Published: November 2023

Social work has made significant strides in providing mental health services. However, advancement in mental health practices grounded in social work values, such as trauma-informed care and cultural humility mental health practice (CHMHP), is still lacking. One possible reason is that many strategies overlook clients’ historical contexts, particularly the collective history held by the community to which the client belongs. By centering “history” in social work practices, clinical social workers can be more equipped to provide high-quality, client-centered services. This article advocates for adopting trauma-informed CHMHP as a critical strategy to elevate history in clinical social work practice and proposes that trauma-informed CHMHP can improve mental health service quality among clients of color who are profoundly disrupted by historical trauma. Specifically, this article proposes that using trauma-informed CHMHP to address historical trauma can enhance mental health treatment outcomes and experiences for African American women. Clinical social workers trained to address these interconnected issues can help reduce disparities in quality treatment access.
Reconstructing relative transmission rates in Bayesian phylodynamics: Two-fold transmission advantage of Omicron in Berlin, Germany during December 2021
Authors: Weber Ariane , Översti Sanni , Kühnert Denise
Published: November 2023

Phylodynamic methods have lately played a key role in understanding the spread of infectious diseases. During the coronavirus disease (COVID-19) pandemic, large scale genomic surveillance has further increased the potential of dynamic inference from viral genomes. With the continual emergence of novel severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) variants, explicitly allowing transmission rate differences between simultaneously circulating variants in phylodynamic inference is crucial. In this study, we present and empirically validate an extension to the BEAST2 package birth–death skyline model (BDSKY), BDSKY$\lambda $, which introduces a scaling factor for the transmission rate between independent, jointly inferred trees. In an extensive simulation study, we show that BDSKY$\lambda $ robustly infers the relative transmission rates under different epidemic scenarios. Using publicly available genome data of SARS-CoV-2, we apply BDSKY$\lambda $ to quantify the transmission advantage of the Omicron over the Delta variant in Berlin, Germany. We find the overall transmission rate of Omicron to be scaled by a factor of two with pronounced variation between the individual clusters of each variant. These results quantify the transmission advantage of Omicron over the previously circulating Delta variant, in a crucial period of pre-established non-pharmaceutical interventions. By inferring variant- as well as cluster-specific transmission rate scaling factors, we show the differences in transmission dynamics for each variant. This highlights the importance of incorporating lineage-specific transmission differences in phylodynamic inference.
Ten-Year Outcomes of Cervical Disc Arthroplasty Versus Anterior Cervical Discectomy and Fusion
Authors: Quinto Ernesto S. , Paisner Noah D. , Huish Eric G. , Senegor Moris
Published: November 2023

Study Design.

A systematic review with meta-analysis of randomized controlled trials and comparative retrospective cohort studies.

Objective.

The purpose of this study is to compare the 10-year outcomes of cervical disc arthroplasty (CDA) with those of anterior cervical discectomy and fusion (ACDF) for the treatment of cervical degenerative disc disease (CDDD).

Summary of Background Data.

ACDF is the gold standard for the treatment of CDDD. However, the loss of motion at the operative level may accelerate adjacent segment disease (ASD). The preservation of motion with CDA attempts to prevent this complication of cervical fusion. Short-term and mid-term data reveal comparable results for CDA versus ACDF; however, long-term results are unknown.

Materials and Methods.

A systematic review with meta-analysis was performed to determine if CDA had improved outcomes compared with ACDF at 10-year follow-up. PubMed and Web of Science database searches through 2023 were performed to identify randomized controlled trials and comparative retrospective cohort studies involving treatment of one-level or two-level CDDD.

Results.

Six studies were eligible for analysis. CDA had significantly improved neck disability index and visual analog scale scores but lower Japanese Orthopaedic Association scores compared to ACDF at 10-year follow-up (P < 0.05). None of these results met minimal clinically important differences. CDA had significantly fewer secondary surgeries and adverse events compared to ACDF (P<0.05). There were no significant differences in neurological success.

Conclusions.

The authors found that significantly fewer secondary surgeries and adverse events were seen after CDA than after ACDF at 10-year follow-up. CDA had statistically, but not clinically, improved neck disability index and visual analog scale scores but lower Japanese Orthopaedic Association scores in comparison to ACDF. CDA was not significantly different from ACDF in terms of a successful neurological outcome.
A Bibliometric Analysis of the 100 Most Cited Articles in Cornea
Authors: Thanitcul Chanon , Khan Asher , Justin Grant A. , Srikumaran Divya , Soiberman Uri S. , Riaz Kamran M. , Woreta Fasika A.
Published: November 2023

Purpose:

To identify the 100 most-cited articles in cornea to provide a bibliometric perspective of highly relevant works in recent years.

Methods:

The ISI Web of Knowledge database was selected as a bibliographic database to search for cornea-related articles published between 2013 and 2021. The search was performed in June 2022 and was conducted in all medical and scientific journals available on the database. The search was also refined to include articles in the “Ophthalmology” category.

Results:

Most articles were published in Ophthalmology (22%), followed by the American Journal of Ophthalmology (15%), Investigative Ophthalmology & Visual Science (12%), and Cornea (8%). The corresponding authors were from 22 countries, predominantly from the United States (22%), China (14%), and Japan (11%). The most common study types include case series (31%), randomized clinical trials (15%), and cross-sectional studies (12%). The major topics of these articles included dry eye disease (19%), crosslinking (16%), keratoconus (12%), and keratoplasty (11%). There was a statistically significant correlation between the number of years since publication and the number of citations per year (Pearson's correlation coefficient = −0.80, P < 0.001). COVID-related articles (5%) also demonstrated significantly higher numbers of citations per year compared to the rest of the articles (mean numbers of citations per year: 69.1 vs. 18.5, P = 0.003). There were 16 institutions that produced more than 1 article in the top 100 articles.

Conclusions:

This bibliometric study provided a unique perspective of the most relevant trends and themes of research in cornea in recent years.
A Randomized Clinical Trial of Bayesian-Guided Beta-Lactam Infusion Strategy and Associated Bacterial Resistance and Clinical Outcomes in Patients With Severe Pneumonia
Authors: Maranchick Nicole F. , Trillo-Alvarez Cesar , Kariyawasam Vidhu , Venugopalan Veena , Kwara Awewura , Rand Kenneth , Peloquin Charles A. , Alshaer Mohammad H.
Published: November 2023

Background:

Antimicrobial resistance is a growing health concern worldwide. The objective of this study was to evaluate the effect of beta-lactam infusion on the emergence of bacterial resistance in patients with severe pneumonia in the intensive care unit.

Methods:

Adult intensive care patients receiving cefepime, meropenem, or piperacillin–tazobactam for severe pneumonia caused by Gram-negative bacteria were randomized to receive beta-lactams as an intermittent (30 minutes) or continuous (24 hours) infusion. Respiratory samples for culture and susceptibility testing, with minimum inhibitory concentrations (MIC), were collected once a week for up to 4 weeks. Beta-lactam plasma concentrations were measured and therapeutic drug monitoring was performed using Bayesian software as the standard of care.

Results:

The study was terminated early owing to slow enrollment. Thirty-five patients were enrolled in this study. Cefepime (n = 22) was the most commonly prescribed drug at randomization, followed by piperacillin (n = 8) and meropenem (n = 5). Nineteen patients were randomized into the continuous infusion arm and 16 into the intermittent infusion arm. Pseudomonas aeruginosa was the most common respiratory isolate (n = 19). Eighteen patients were included in the final analyses. No differences in bacterial resistance were observed between arms (P = 0.67). No significant differences in superinfection (P = 1), microbiological cure (P = 0.85), clinical cure at day 7 (P = 0.1), clinical cure at end of therapy (P = 0.56), mortality (P = 1), intensive care unit length of stay (P = 0.37), or hospital length of stay (P = 0.83) were observed. Achieving 100% ƒT > MIC (P = 0.04) and ƒT > 4 × MIC (P = 0.02) increased likelihood of clinical cure at day 7 of therapy.

Conclusions:

No differences in the emergence of bacterial resistance or clinical outcomes were observed between intermittent and continuous infusions. Pharmacokinetic/pharmacodynamic target attainment may be associated with a clinical cure on day 7.
Recommendation for a Therapeutic Reference Range of Cariprazine—A Short Communication
Authors: Sattaf Fabian , Scherf-Clavel Maike , Unterecker Stefan , Reif Andreas , Hahn Martina
Published: November 2023

Background:

Therapeutic reference ranges are essential for therapeutic drug monitoring to evaluate results and adjust pharmacotherapy. The measured serum concentrations of cariprazine-treated patients have frequently been found to lie beyond the currently used therapeutic reference range; furthermore, reliable data for establishing evidence-based therapeutic ranges are scarce. The current therapeutic reference ranges have only been estimated; however, real-world data on cariprazine are missing. Individual serum concentrations were analyzed, and the validity of the currently used reference ranges was assessed.

Methods:

Serum concentrations of 19 psychiatric patients treated with cariprazine without pharmacokinetic abnormalities were retrospectively analyzed. Only the last measurement per patient was included in the analysis, and patients who underwent a dose adjustment in the subsequent 2 weeks after sampling were excluded (assuming that the target dose and response had been achieved at that time). Serum concentrations were compared with the therapeutic reference range (10–20 ng/mL) of the Arbeitsgemeinschaft für Neuropsychiatrie und Pharmakotherapie consensus guidelines of 2017 and with a recent recommendation for a lower therapeutic reference range (5–15 ng/mL).

Results:

The mean serum concentration was 9.1 ± 4.1 SD ng/mL. A total of 47.4% of the values were within the therapeutic reference range of 10–20 ng/mL, and 78.9% fell within the range of 5–15 ng/mL.

Conclusions:

These results support previous recommendations for lowering the therapeutic reference range to 5–15 ng/mL. The calculated therapeutic reference range was 5.0–13.2 ng/mL. It may even be potentially lower because clinicians may have tried to titrate the dose to a serum concentration within the current therapeutic reference range of 10–20 ng/mL.
A multiorgan Intra-thoracic herniation in traumatic Diaphragmatic Rupture: our experience
Authors: Marra E. , Di Bernardo V. , Rispoli C. , Gargiulo S. , Cappabianca A. , Pannullo M. , Cacciapuoti M. , Codella U. , Esposito B. , Alberico A. , Armiento N. , Giuliani A.
Published: November 2023

Multiorgan Intra-thoracic herniation is a rare complication of traumatic diaphragmatic rupture that occurs in particular after a vehicle accident. Because of its specific clinical signs it can be misdiagnosed. We present a rare case of a traumatic left diaphragmatic rupture with transthoracic migration of stomach, splenic flexur colon, spleen, and pancreas tail, that was successfully repaired primarily.
Effects of Autologous Serum and Platelet-Rich Plasma on Human Corneal Endothelial Cell Regeneration: A Comparative Study
Authors: Kilic-Toprak Emine , Cort-Donmez Aysegul , Toprak Ibrahim
Published: November 2023

Objectives:

To investigate the effects of autologous serum (AS) and platelet-rich plasma (PRP) on human corneal endothelial cell (HCEC) proliferation and apoptosis in comparison to Y-27632 as the commonly studied Rho-associated kinase (ROCK) inhibitor.

Methods:

The human corneal endothelial primary cell line was used for this study. As the treatment groups, HCECs were incubated with AS, PRP, and Y-27632, whereas the control group received no treatment. Cell proliferation (measured by 5-bromo-2′-deoxyuridine [BrdU] incorporation) and apoptosis (based on the caspase-3 level) were compared between the control, Y-27632, AS, and PRP groups.

Results:

In the Y-27632, AS, and PRP groups, the ratios of BrdU-incorporated cells were significantly higher (115±0.2%, 125±0.2%, 122±0.4% at 24 hr, and 138±2.4%, 160±0.2%, 142±0.2% at 48 hr, respectively) than in the control group (100±18.4% at 24 hr, 100±1.1% at 48 hr) (P<0.05 for all). Furthermore, AS provided a higher HCEC proliferation ratio compared with the Y-27632 group at 24 and 48 hr (P<0.05 for all). Caspase-3 was significantly lower in the AS group (60.3±3.3%) than in the control (100±2.3%), Y-27632 (101.9±5.2%), and PRP (101±6.8%) groups (P<0.05 for all).

Conclusions:

The results of this study demonstrated for the first time that AS and PRP promoted HCEC proliferation and AS significantly decreased apoptosis in HCECs. A superior effect on HCEC proliferation was also observed with AS compared with Y-27632. Future “autologous” regenerative therapeutic options for corneal endothelial failure may involve the utilization of AS and PRP owing to their accessibility, simplicity in preparation, immunologic compatibility, and donor-free nature.
Modified Magnetic Resonance Imaging Burden of Cerebral Small Vessel Disease and Related Risk Factors in Patients With Thalassemia
Authors: Liu Xiuying , Yang Kunling , Sun Lanfeng , Huang Qi , Long Lianqing , Ou Sijie , Wei Xing , Wu Yuan
Published: November 2023

Objective:

This study aimed to explore the burden of magnetic resonance imaging (MRI) of cerebral small vessel disease (CSVD) in patients with thalassemia and related risk factors.

Methods:

The clinical data and MRI of patients with thalassemia were retrospectively analyzed, and non-thalassemia controls with matched sex and age were selected. The modified MRI burden of CSVD included recent small subcortical infarct, presumed vasogenic white matter hyperintensity, presumed vasogenic lacunae, perivascular space (PVS), and brain atrophy.

Results:

This study included 110 patients in each of the thalassemia and control groups. There was no significant difference in sex, age, and common cerebrovascular disease risk factors between the 2 groups. The patients with thalassemia had a higher red blood cell count and lower content of hemoglobin. The PVS and modified MRI burden scores in the thalassemia group were higher than in the control group. With the increase in age, patients with thalassemia have a more severe CSVD burden.

Conclusion:

Patients with thalassemia have a heavier modified MRI burden of CSVD than non-thalassemia patients, particularly PVS, and aging is an important risk factor for CSVD changes.
Mechanical Thrombectomy in Anticoagulated Patients With Acute Ischemic Stroke
Authors: Zhang HaoLiang , Chen Shiqin , Zhu QianYuan , Li ZongShan , Lv Tian , Liu Chengjiang
Published: November 2023

Background:

According to a previous studies, mechanical thrombectomy(MT) is safe for anticoagulated patients. However, the safety and prognosis of direct oral anticoagulants (DOACs) and vitamin K antagonists (VKA) have not been compared with those of MT.This meta-analysis aimed at determining the efficacy of DOACs or VKA for patients after MT.

Review Summary:

We searched PubMed, Embase, Web of Science databases, and Cochrane from their inception to Aug 2022. Revman 5.3 served for the meta-analysis. The meta-analysis included 12 studies that covered 3571 patients, finding that after MT treatment, DOACs significantly decreased the symptomatic intracerebral hemorrhage [odd ratio (OR)=0.49, 95% CI 0.30-0.80, P=0.004] and mortality (OR=0.63, 95% CI 0.48-0.83, P=0.001) compared with VKA. Meanwhile, no obvious differences were found between DOACs and VKA after MT treatment in terms of in any hemorrhagic transformation (OR=1.07, 95% CI 0.84-1.37, P=0.59), good functional outcome (OR=1.06, 95% CI 0.88-1.27, P=0.53), and successful arterial recanalization (OR=1.24, 95% CI 1.00-1.53, P=0.05).

Conclusions:

This meta-analysis demonstrates that the application of DOACs in MT treatment for anticoagulated patients with acute ischemic stroke is safer than that in the VKA group. However, further studies are necessary to confirm these results.
Ginger Update
Authors: Singletary Keith W.
Published: November 2023

The spice ginger is prepared from the rhizome ofZingiber officinale(Rosc.) belonging to the family Zingiberaceae. The unique aromas and flavors of the many cultivars make them suited for multiple food-related purposes. Besides being used in the preparation of pickles, candies, gingerbread, biscuits, soups, puddings, alcoholic beverages, and soft drinks, ginger and its extracts are also packaged in dietary supplements. Ginger has been a part of traditional medicine for thousands of years treating such ailments as gastrointestinal disorders, nausea, pain, cold, and asthma. In the past 10 to 15 years, a considerable number of preclinical and clinical studies have explored in more detail the potential of ginger to ameliorate diverse conditions such as nausea and vomiting, glycemic dysfunction, pain, and the metabolic syndrome. This narrative review provides an update on the clinical evidence related to potential benefits of ginger and discusses future research opportunities.
Time and Training Limitations May Increase Reliance on Social Media for Weight Management Dietitians
Authors: Metcalf Kevin B. , Wright Lauri , Arikawa Andrea Y. , Ross Jenifer
Published: November 2023

Dietitians are charged with implementing evidence-based practice, and in fields such as weight management, there are continually new emerging and conflicting approaches that have not been fully researched. Dietitians rely on their professional expertise and clinical judgment in determining how to use the best available evidence to address emerging issues in their daily practice.
Noninvasive Neurally Adjusted Ventilatory Assist in Infants With Bronchiolitis: Respiratory Outcomes in a Single-Center, Retrospective Cohort, 2016–2018*
Authors: Lepage-Farrell Alex , Tabone Laurence , Plante Virginie , Kawaguchi Atsushi , Feder Joshua , Al Omar Sally , Emeriaud Guillaume
Published: November 2023

OBJECTIVES:

To describe our experience of using noninvasive neurally adjusted ventilatory assist (NIV-NAVA) in infants with bronchiolitis, its association with the evolution of respiratory effort, and PICU outcomes.

DESIGN:

Retrospective analysis of a prospectively curated, high-frequency electronic database.

SETTING:

A PICU in a university-affiliated maternal-child health center in Canada.

PATIENTS:

Patients younger than 2 years old who were admitted with a diagnosis of acute bronchiolitis and treated with NIV-NAVA from October 2016 to June 2018.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Patient characteristics, as well as respiratory and physiologic parameters, including electrical diaphragmatic activity (Edi), were extracted from the electronic database. Respiratory effort was estimated using the modified Wood Clinical Asthma Score (mWCAS) and the inspiratory Edi. A comparison in the respiratory effort data was made between the 2 hours before and 2 hours after starting NIV-NAVA. In the two seasons, 64 of 205 bronchiolitis patients were supported with NIV-NAVA. These 64 patients had a median (interquartile range [IQR]) age of 52 days (32–92 d), and there were 36 of 64 males. Treatment with NIV-NAVA was used after failure of first-tier noninvasive respiratory support; 25 of 64 patients (39%) had at least one medical comorbidity. NIV-NAVA initiation was associated with a moderate decrease in mWCAS from 3.0 (IQR, 2.5–3.5) to 2.5 (IQR, 2.0–3.0; p < 0.001). NIV-NAVA initiation was also associated with a statistically significant decrease in Edi (p < 0.01). However, this decrease was only clinically relevant in infants with a 2-hour baseline Edi greater than 20 μV; here, the before and after Edi was 44 μV (IQR, 33–54 μV) compared with 27 μV (IQR, 21–36 μV), respectively (p < 0.001). Overall, six of 64 patients (9%) required endotracheal intubation.

CONCLUSIONS:

In this single-center retrospective cohort, in infants with bronchiolitis who were considered to have failed first-tier noninvasive respiratory support, the use of NIV-NAVA was associated with a rapid decrease in respiratory effort and a 9% intubation rate.
Sudden Unexplained Death in Childhood
Authors: Wojcik Monica H. , Krous Henry F. , Goldstein Richard D.
Published: November 2023

Sudden unexplained death in childhood is a term that encompasses apparently natural deaths in children aged older than 1 year with no discernible cause despite a thorough assessment. Definitive underlying causes vary but most cases remain largely unexplained. Research has furthered the view that sudden unexplained death in childhood is not an accident, but rather a sentinel medical event for which a thorough postmortem investigation is indicated. Emerging evidence in genetics, neurology, and neuropathology point to heterogeneous causes that in some cases share features of recognized diseases.
Management of severe congenital femoral deficiency: Does surgical intervention enhance prosthetic function?
Authors: Calder Peter , Elsheikh Ahmed , Cross George , Thornton Matt , Wright Jonathan , Eastwood Deborah , Sedki Imad
Published: November 2023

Background & Objective:

The purpose of this study was to evaluate prosthetic outcome in patients with severe congenital femoral deficiency and the potential benefits of surgical intervention on prosthetic fitting and gait.

Methods:

A retrospective review identified 26 active case records with a proximal femoral focal deficiency using a prosthesis. Validated outcome measures evaluated comfort, function, and prosthetic use and quality-of-life assessment. Outcome compared age groups and surgical intervention. Gait analysis performed in 7 patients further evaluated hip and knee function.

Results:

Eleven male patients and 15 female patients, including 13 children (mean age 10 years, range 5–16) and 13 adults (mean age 36 years, range 23–63) were evaluated. Better prosthetic function and PedsQL scores were recorded in the pediatric group. There was a trend for better scores after surgery. Gait analysis demonstrated reduced hip extension compensated by knee flexion in 3 patients, 2 patients had hip extension with near normal kinematics, 1 untreated patient walked with an unsteady gait, and the remaining walked well using an ischial-bearing prosthesis with pelvic compensatory movements.

Conclusion:

The management strategy in severe proximal femoral focal deficiency remains a major challenge. Hip reconstruction seems to improve functional scores. Overall, the scores seem to decline into adulthood but not significantly. Gait analysis before further surgical intervention is recommended because compensatory knee flexion may improve step length in terminal stance. Limited numbers, with short follow-up, prevents clear guidance on the benefit of surgery.
A systematic review of methods used to assist transtibial prosthetic alignment decision-making
Authors: Malaheem Mohammad S. , Abd Razak Nasrul Anuar , Abu Osman Noor Azuan
Published: November 2023

Prosthetic alignment is a highly subjective process that is still based on clinical judgments. Thus, researchers have aimed their effort to quantify prosthetic alignment by providing an objective method that can assist and guide prosthetists in achieving transtibial (TT) prosthetic alignment. This systematic review aimed to examine the current literature on TT prosthetic alignment to scope the qualitative and quantitative methods designed to guide prosthetists throughout the TT prosthetic alignment process as well as evaluate the reported instruments and devices that are used to align TT prostheses and their clinical feasibility. A literature search, completed in June 2022, was performed using the following databases: Web of Science (Clarivate), SCOPUS (Elsevier), and Pub Med (Medline) with searching terms focusing on TT, prosthesis, prosthetist, prosthetic alignment, and questionnaires, resulting in 2790 studies being screened. Twenty-four studies have used quantitative methodologies, where sensor technologies were found to be the most frequently proposed technology combined with gait analysis tools and/or subjective assessments. A qualitative method that assists prosthetists throughout the alignment process was not found. In this systematic review, we presented diverse methods for guiding and assisting clinical decision-making regarding TT prosthetic alignment. However, most of these methods considered varied parameters, and there is a need for elaboration toward standardized methods, which would improve the prosthetic alignment clinical outcome.
Discriminative features in White-Sutton syndrome: literature review and first report in Iran
Authors: Esmaeilzadeh Emran , Jafari Harandi Aysan , Astaraki Fatemeh , Khorram Khorshid Hamid Reza
Published: November 2023

White-Sutton Syndrome is one of the rare neurodevelopmental disorder inherited in an autosomal dominant manner, mainly caused by de novo mutations in the POGZ gene and shows many phenotypic signs such as intellectual disability, Autism Spectrum Disorder and other spectra. About 70 patients with this syndrome have been reported worldwide. In this paper, we have described different phenotypic features of the White-Sutton Syndrome with a brief review of recent literatures. Finally, we have reported an Iranian male with intellectual disability and visual impairment. We have explained the clinical symptoms of the patient and have compared the patient’s phenotype with existing data from individuals with White-Sutton Syndrome. The results of Whole Exome Sequencing test, performed for the patient, declared the presence of a de novo mutation in POGZ gene and confirmed the White-Sutton Syndrome diagnosis.
A meta-analytic cognitive framework of nudge and sludge
Authors: Luo Yu , Li Andrew , Soman Dilip , Zhao Jiaying
Published: November 2023

Public and private institutions have gained traction in developing interventions to alter people's behaviours in predictable ways without limiting the freedom of choice or significantly changing the incentive structure. A nudge is designed to facilitate actions by minimizing friction, while a sludge is an intervention that inhibits actions by increasing friction, but the underlying cognitive mechanisms behind these interventions remain largely unknown. Here, we develop a novel cognitive framework by organizing these interventions along six cognitive processes: attention, perception, memory, effort, intrinsic motivation and extrinsic motivation. In addition, we conduct a meta-analysis of field experiments (i.e. randomized controlled trials) that contained real behavioural measures (
n
= 184 papers,
k
= 184 observations,
N
= 2 245 373 participants) from 2008 to 2021 to examine the effect size of these interventions targeting each cognitive process. Our findings demonstrate that interventions changing effort are more effective than interventions changing intrinsic motivation, and nudge and sludge interventions had similar effect sizes. However, these results need to be interpreted with caution due to a potential publication bias. This new meta-analytic framework provides cognitive principles for organizing nudge and sludge with corresponding behavioural impacts. The insights gained from this framework help inform the design and development of future interventions based on cognitive insights.
Kernel-based joint independence tests for multivariate stationary and non-stationary time series
Authors: Liu Zhaolu , Peach Robert L. , Laumann Felix , Vallejo Mengod Sara , Barahona Mauricio
Published: November 2023

Multivariate time-series data that capture the temporal evolution of interconnected systems are ubiquitous in diverse areas. Understanding the complex relationships and potential dependencies among co-observed variables is crucial for the accurate statistical modelling and analysis of such systems. Here, we introduce kernel-based statistical tests of joint independence in multivariate time series by extending thed-variable Hilbert–Schmidt independence criterion to encompass both stationary and non-stationary processes, thus allowing broader real-world applications. By leveraging resampling techniques tailored for both single- and multiple-realization time series, we show how the method robustly uncovers significant higher-order dependencies in synthetic examples, including frequency mixing data and logic gates, as well as real-world climate, neuroscience and socio-economic data. Our method adds to the mathematical toolbox for the analysis of multivariate time series and can aid in uncovering high-order interactions in data.
ThermoCyte: an inexpensive open-source temperature control system for
in vitro
live-cell imaging
Authors: O'Carroll Ross , Reynolds James P. , Al-Roqi Mazen , Aiyegbusi Emmanuelle Damilola , Dooley Dearbhaile
Published: November 2023

Live-cell imaging is a common technique in microscopy to investigate dynamic cellular behaviour and permits the accurate and relevant analysis of a wide range of cellular and tissue parameters, such as motility, cell division, wound healing responses and calcium (Ca
2
+
) signalling in cell lines, primary cell cultures and
ex vivo
preparations. Furthermore, this can occur under many experimental conditions, making live-cell imaging indispensable for biological research. Systems which maintain cells at physiological conditions outside of a CO
2
incubator are often bulky, expensive and use proprietary components. Here we present an inexpensive, open-source temperature control system for
in vitro
live-cell imaging. Our system ‘ThermoCyte’, which is constructed from standard electronic components, enables precise tuning, control and logging of a temperature ‘set point’ for imaging cells at physiological temperature. We achieved stable thermal dynamics, with reliable temperature cycling and a standard deviation of 0.42°C over 1 h. Furthermore, the device is modular in nature and is adaptable to the researcher's specific needs. This represents simple, inexpensive and reliable tool for laboratories to carry out custom live-cell imaging protocols, on a standard laboratory bench, at physiological temperature.