bluuebunny/crossref_metadata_2025 huggingface dataset:
A meta-analysis of urinary transferrin for early diagnosis of diabetic nephropathy
Authors: Li Bangjian , Wang Jieying , Ye Wen
Published: February 2024

Objective

To assess the diagnostic value of urinary transferrin (Tf) in early diabetic nephropathy (DN) to propose a more sensitive and noninvasive biomarker for screening and monitoring DN in clinical practice.

Methods

We searched 3 databases from their inception to May 2023, to identify studies investigating the diagnostic value of Tf in patients with DN. Meta-DiSc software, version 1.4, and Stata software, version 15.1 (StataCorp) were used to conduct a meta-analysis and evaluate the diagnostic accuracy of urine Tf levels for DN.

Results

The meta-analysis included 6 relevant studies investigating the diagnostic value of Tf level for DN. Urinary Tf as a diagnostic marker demonstrated a combined sensitivity of 0.82 (95% CI, 0.71-0.89) and specificity of 0.88 (0.84-0.92). the positive diagnostic likelihood ratio was 7.07 (4.57-10.93), the negative diagnostic likelihood ratio was 0.20 (0.12-0.35), and the diagnostic odds ratio was 34.49 (13.61-87.44). Also, the area under the receiver operating characteristic curve was 0.92 (0.89-0.94), indicating that urinary Tf has a decent discriminative ability in diagnosing DN.

Conclusion

Tf level is a valuable biological marker for early diagnosis and monitoring of DN in clinical practice. It has statistically significant predictive value for patients in the early phases of DN.
Clinical management of a patient following a granulocyte transfusion from a donor positive for COVID-19
Authors: Woo Jennifer S , Zhuang Lefan , Jackson Ryan , Wang Shirong , Agrawal Vaibhav , Blackmon Amanda , Pourhassan Hoda , Yuan Shan
Published: February 2024

Granulocyte transfusions are indicated for patients with severe neutropenia and evidence of bacterial or fungal infection who are unresponsive to standard antimicrobial therapy. With a limited expiration time of 24 hours after collection, granulocytes are often transfused before results of infectious-disease screening tests are available, and before a transfusion service can perform a risk assessment if postdonation information is provided after the collection. The case we describe herein demonstrates a clinical scenario meeting indications for granulocyte transfusion, coupled with the clinical management undertaken after the granulocyte donor disclosed a positive result for a COVID-19 self-test taken 1 day after donation. In this case, the patient did not develop new COVID-19 symptoms and tested negative for COVID-19 after transfusion of the implicated unit. These findings add to the body of evidence in the literature that COVID-19 is not transmitted via blood transfusion.
The role of gastrin 17 and pepsinogen I:pepsinogen II ratio in pathological diagnosis and endoscopic selection in gastritis patients
Authors: Ye Qian , Xu Kai , Tong Yu , Zhao, Misheng
Published: February 2024

Background

The noninvasive serum markers pepsinogen I (PGI), pepsinogen II (PGII), gastrin-17 (G17), and PGI:PGII ratio (PGR) have recently been proposed as a new tool for predicting various gastric pathologies.

Methods

A total of 83 gastritis patients confirmed by gastroscopy were enrolled, with 78 undergoing concurrent colonoscopies. The control group included 99 healthy subjects. Enzyme-linked immunosorbent assay was used to detect PGI, PGII, G17, and PGR. The performance of serological analysis for detecting gastritis pathology was evaluated using receiver operating characteristic (ROC) curves.

Results

The G17 and PGII levels increased significantly (P < .001), whereas PGR levels decreased (P = .001) in the gastritis group. The ROC analysis revealed that PGR had a sensitivity and specificity of 70.83% and 86.67%, respectively, in predicting Helicobacter pylori-infected gastritis and a sensitivity and specificity of 88% and 65.52%, respectively, in predicting active gastritis. The G17 levels were significantly elevated in gastritis patients undergoing concurrent colonoscopies (P < .05).

Conclusion

Pepsinogen I:pepsinogen II ratio was found to be a useful predictor of active gastritis and H pylori-infected gastritis. Furthermore, G17 was found to be closely related to pathological conditions found by colonoscopy and may provide recommendations for whether gastritis patients should undergo a concurrent colonoscopy.
Differential role of bovine serum albumin and HCO3− in the regulation of GSK3 alpha during mouse sperm capacitation
Authors: Mohanty Gayatri , Sanchez-Cardenas Claudia , Paudel Bidur , Tourzani Darya A , Salicioni Ana M , Santi Celia M , Gervasi María G , Pilsner J Richard , Darszon Alberto , Visconti Pablo E
Published: February 2024

To become fertile, mammalian sperm are required to undergo capacitation in the female tract or in vitro in defined media containing ions (e.g. HCO3 −, Ca2+, Na+, and Cl−), energy sources (e.g. glucose, pyruvate) and serum albumin (e.g. bovine serum albumin (BSA)). These different molecules initiate sequential and concomitant signaling pathways, leading to capacitation. Physiologically, capacitation induces changes in the sperm motility pattern (e.g. hyperactivation) and prepares sperm for the acrosomal reaction (AR), two events required for fertilization. Molecularly, HCO3 − activates the atypical adenylyl cyclase Adcy10 (aka sAC), increasing cAMP and downstream cAMP-dependent pathways. BSA, on the other hand, induces sperm cholesterol release as well as other signaling pathways. How these signaling events, occurring in different sperm compartments and with different kinetics, coordinate among themselves is not well established. Regarding the AR, recent work has proposed a role for glycogen synthase kinases (GSK3α and GSK3β). GSK3α and GSK3β are inactivated by phosphorylation of residues Ser21 and Ser9, respectively, in their N-terminal domain. Here, we present evidence that GSK3α (but not GSK3β) is present in the anterior head and that it is regulated during capacitation. Interestingly, BSA and HCO3 − regulate GSK3α in opposite directions. While BSA induces a fast GSK3α Ser21 phosphorylation, HCO3 − and cAMP-dependent pathways dephosphorylate this residue. We also show that the HCO3−-induced Ser21 dephosphorylation is mediated by hyperpolarization of the sperm plasma membrane potential (Em) and by intracellular pH alkalinization. Previous reports indicate that GSK3 kinases mediate the progesterone-induced AR. Here, we show that GSK3 inhibition also blocks the Ca2+ ionophore ionomycin-induced AR, suggesting a role for GSK3 kinases downstream of the increase in intracellular Ca2+ needed for this exocytotic event. Altogether, our data indicate a temporal and biphasic GSK3α regulation with opposite actions of BSA and HCO3 −. Our results also suggest that this regulation is needed to orchestrate the AR during sperm capacitation.
Hitomi HXT deconvolution imaging of the Crab Nebula dazzled by the Crab pulsar
Authors: Morii Mikio , Maeda Yoshitomo , Awaki Hisamitsu , Hagino Kouichi , Ishida Manabu , Mori Koji
Published: February 2024

We develop a new deconvolution method to recover the precise Crab Nebula image taken by the Hitomi HXT, suppressing the artifact due to the bright Crab pulsar. We extend the Richardson–Lucy method, introducing two components corresponding to the nebula and pulsar with regularization for smoothness and flux, respectively, and performing simultaneous deconvolution of multi-pulse-phase images. The structures, including the torus and jets, seen in the deconvolved nebula image at the lowest energy band of 3.6–15 keV appear consistent with those identified in the high-resolution Chandra X-ray image. Above 15 keV, we confirm NuSTAR’s findings that the nebula size decreases in higher energy bands. We find that the north-east side of the nebula is fainter in higher energy bands. Our deconvolution method is applicable for any telescope images of faint diffuse objects containing a bright point source.
Bridging the Gap in Garnet Diffusion Models at Low Temperatures: Recalibration Using Western Tianshan Eclogitic Breccia
Authors: Chen Junxing , Chu Xu
Published: February 2024

Models concerning the diffusion of divalent cations (Ca2+, Mg2+, Fe2+, and Mn2+) in garnet have been subject to extensive research and application over several decades, yet discrepancies among available models persist. Particularly the diffusion rate of Mn2+, which is the fastest in garnet, varies by more than two orders of magnitude for garnets in eclogite. In this study, we use an eclogitic breccia sample from the Western Tianshan (ultra-) high-pressure metamorphic belt for calibration. The thermobarometry indicates that the sample experienced exhumation from ~2.45 GPa, ~480°C to 1.85 GPa, ~515°C. Previous geochronological constraints estimate the exhumation duration to be a couple of million years to up to 15–20 Myr, with an average slab exhumation rate of ~3.5 mm/year. Although the estimates entail significant uncertainties, this range is still smaller than the discrepancy of Mn diffusion rate predicted among diffusion models. Thus, this natural sample provides valuable insights for calibrating the available diffusion models. Our analysis of garnet compositional profiles demonstrates that the diffusion rates (Di) at the pressure and temperature of interest are DCa:DFe:DMg:DMn = 0.2:0.4:1:2.4. By integrating garnet profiles, pressure–temperature–time information, and existing experimental data, we refine each diffusion model for Mn2+, thereby reducing the uncertainties associated with down-temperature extrapolation. Application of the newly calibrated models indicates that the oscillatory zoning of Mn2+ at the garnet rim is best described by a brief thermal excursion (~0.4 Myr, >20°C) at ~1.9 GPa. This minor thermal pulse punctuating the general exhumation path could be indicative of shear heating between nappes or momentary involvement in the mantle wedge, suggesting stacking or partial reactivation of the thrusts during exhumation.
Photoacclimation in the kleptoplastidic ciliate Mesodinium rubrum and its cryptophyte prey Teleaulax amphioxeia: phenotypic variability and implications for red tide remote sensing
Authors: Pochic Victor , Gernez Pierre , Zoffoli Maria Laura , Séchet Véronique , Carpentier Liliane , Lacour Thomas
Published: February 2024

Mesodinium rubrum is a kleptoplastidic ciliate that sequesters the chloroplasts and nuclei of cryptophyte algae to perform photosynthesis. Blooms of M. rubrum can cause red tides in coastal oceans worldwide. Such red tides are detectable by remote sensing, and studying M. rubrum pigments and optical properties is a crucial step toward characterizing its blooms using satellite observation. Previous studies have shown that M. rubrum photoacclimates, modifying its pigment content depending on irradiance. Using cultures at different irradiance levels, we observed that photoacclimation in M. rubrum closely resembles that of its cryptophyte prey Teleaulax amphioxeia, leading to substantial phenotypic variability. In both species, phycoerythrin 545 cellular concentrations increased 3-fold between the highest and lowest irradiance, suggesting a major role in photoacclimation. Absorption cross-section decreased, and pigment-specific absorption coefficients increased with irradiance at the peak absorption wavelengths of chlorophyll a and phycoerythrin 545. After assessing the variability of absorption properties in M. rubrum, we combined field measurements and high-resolution Sentinel-2 satellite images to estimate chlorophyll a concentration of a coastal red tide and document small-scale spatio-temporal features. This work provides an overview of pigment photoacclimation in a peculiar phytoplankter and suggests guidelines for future studies of M. rubrum blooms.
Training an automated circulating tumor cell classifier when the true classification is uncertain
Authors: Nanou Afroditi , Stoecklein Nikolas H , Doerr Daniel , Driemel Christiane , Terstappen Leon W M M , Coumans Frank A W
Published: February 2024

Circulating tumor cell (CTC) and tumor-derived extracellular vesicle (tdEV) loads are prognostic factors of survival in patients with carcinoma. The current method of CTC enumeration relies on operator review and, unfortunately, has moderate interoperator agreement (Fleiss’ kappa 0.60) due to difficulties in classifying CTC-like events. We compared operator review, ACCEPT automated image processing, and refined the output of a deep-learning algorithm to identify CTC and tdEV for the prediction of survival in patients with metastatic and nonmetastatic cancers. Operator review is only defined for CTC. Refinement was performed using automatic contrast maximization CM-CTC of events detected in cancer and in benign samples (CM-CTC). We used 418 samples from benign diseases, 6,293 from nonmetastatic breast, 2,408 from metastatic breast, and 698 from metastatic prostate cancer to train, test, optimize, and evaluate CTC and tdEV enumeration. For CTC identification, the CM-CTC performed best on metastatic/nonmetastatic breast cancer, respectively, with a hazard ratio (HR) for overall survival of 2.6/2.1 vs. 2.4/1.4 for operator CTC and 1.2/0.8 for ACCEPT-CTC. For tdEV identification, CM-tdEV performed best with an HR of 1.6/2.9 vs. 1.5/1.0 with ACCEPT-tdEV. In conclusion, contrast maximization is effective even though it does not utilize domain knowledge.
Inferring networks from time series: A neural approach
Authors: Gaskin Thomas , Pavliotis Grigorios A , Girolami Mark
Published: February 2024

Network structures underlie the dynamics of many complex phenomena, from gene regulation and foodwebs to power grids and social media. Yet, as they often cannot be observed directly, their connectivities must be inferred from observations of the dynamics to which they give rise. In this work, we present a powerful computational method to infer large network adjacency matrices from time series data using a neural network, in order to provide uncertainty quantification on the prediction in a manner that reflects both the degree to which the inference problem is underdetermined as well as the noise on the data. This is a feature that other approaches have hitherto been lacking. We demonstrate our method’s capabilities by inferring line failure locations in the British power grid from its response to a power cut, providing probability densities on each edge and allowing the use of hypothesis testing to make meaningful probabilistic statements about the location of the cut. Our method is significantly more accurate than both Markov-chain Monte Carlo sampling and least squares regression on noisy data and when the problem is underdetermined, while naturally extending to the case of nonlinear dynamics, which we demonstrate by learning an entire cost matrix for a nonlinear model of economic activity in Greater London. Not having been specifically engineered for network inference, this method in fact represents a general parameter estimation scheme that is applicable to any high-dimensional parameter space.
Additional experiments required: A scoping review of recent evidence on key aspects of Open Peer Review
Authors: Ross-Hellauer Tony , Horbach Serge P J M
Published: February 2024

Diverse efforts are underway to reform the journal peer review system. Combined with growing interest in Open Science practices, Open Peer Review (OPR) has become of central concern to the scholarly community. However, what OPR is understood to encompass and how effective some of its elements are in meeting the expectations of diverse communities, are uncertain. This scoping review updates previous efforts to summarize research on OPR to May 2022. Following the PRISMA methodological framework, it addresses the question: “What evidence has been reported in the scientific literature from 2017 to May 2022 regarding uptake, attitudes, and efficacy of two key aspects of OPR (Open Identities and Open Reports)?” The review identifies, analyses and synthesizes 52 studies matching inclusion criteria, finding that OPR is growing, but still far from common practice. Our findings indicate positive attitudes towards Open Reports and more sceptical approaches to Open Identities. Changes in reviewer behaviour seem limited and no evidence for lower acceptance rates of review invitations or slower turnaround times is reported in those studies examining those issues. Concerns about power dynamics and potential backfiring on critical reviews are in need of further experimentation. We conclude with an overview of evidence gaps and suggestions for future research. Also, we discuss implications for policy and practice, both in the scholarly communications community and the research evaluation community more broadly.
Immune checkpoint inhibitor-mediated polymyalgia rheumatica versus primary polymyalgia rheumatica: comparison of disease characteristics and treatment requirement
Authors: Vermeulen Olof C B , Brouwer Elisabeth , Slart Riemer H J A , Sandovici Maria , Rutgers Abraham , Hilterman T Jeroen , Hiddinga Birgitta , Oosting Sjoukje F , Jalving Mathilde , de Heij Albert H , Knapen Daan G , Hospers Geke A P , van der Geest Kornelis S M
Published: February 2024

Objectives

To compare clinical characteristics, imaging findings and treatment requirements of patients with immune checkpoint inhibitor-mediated polymyalgia rheumatica (ICI-PMR) and primary PMR.

Methods

This single centre, retrospective cohort study compared ICI-PMR in patients with cancer (n = 15) to patients with primary PMR (n = 37). A comparison was made between clinical symptoms, laboratory markers, ultrasonography, 18F-FDG-PET/CT findings and treatment requirements related to PMR.

Results

Patients with ICI-PMR less frequently fulfilled the EULAR/ACR classification criteria for PMR (66.7%) than patients with primary PMR (97.3%). Morning stiffness, weight loss and elevation of the ESR were less frequently seen in patients with ICI-PMR. No differences were observed regarding the presence of inflammatory lesions on ultrasound of the shoulders and hips between the two groups. The Leuven and the Leuven/Groningen 18F-FDG-PET/CT scores were significantly lower in the ICI-PMR group. Finally, the ICI-PMR group could be managed with lower glucocorticoid doses than the primary PMR group, while this treatment could be discontinued more quickly.

Conclusion

Our findings indicate that ICI-PMR may have a milder course with less intense inflammation than primary PMR. ICI-PMR can be managed with a relatively low glucocorticoid dose. Our study underscores that ICI-PMR should be regarded as a PMR-like syndrome.
Differential role of fusiform gyrus coupling in depressive and anxiety symptoms during emotion perception
Authors: Edmiston Elliot Kale , Chase Henry W , Jones Neil , Nhan Tiffany J , Phillips Mary L , Fournier Jay C
Published: February 2024

Anxiety and depression co-occur; the neural substrates of shared and unique components of these symptoms are not understood. Given emotional alterations in internalizing disorders, we hypothesized that function of regions associated with emotion processing/regulation, including the anterior cingulate cortex (ACC), amygdala and fusiform gyrus (FG), would differentiate these symptoms. Forty-three adults with depression completed an emotional functional magnetic resonance imaging task and the Hamilton Depression and Anxiety Scales. We transformed these scales to examine two orthogonal components, one representing internalizing symptom severity and the other the type of internalizing symptoms (anxiety vs depression). We extracted blood oxygen level dependent signal from FG subregions, ACC, and amygdala and performed generalized psychophysiological interaction analyses to assess relationships between symptoms and brain function. Type of internalizing symptoms was associated with FG3-FG1 coupling (F = 8.14, P = 0.007). More coupling was associated with a higher concentration of depression, demonstrating that intra-fusiform coupling is differentially associated with internalizing symptom type (anxiety vs depression). We found an interaction between task condition and internalizing symptoms and dorsal (F = 4.51, P = 0.014) and rostral ACC activity (F = 4.27, P = 0.012). Post hoc comparisons revealed that less activity was associated with greater symptom severity during emotional regulation. Functional coupling differences during emotional processing are associated with depressive relative to anxiety symptoms and internalizing symptom severity. These findings could inform future treatments for depression.
Strategies to enhance treatment fidelity and music-based intervention reporting in dementia research
Authors: Reschke-Hernández Alaine E , Tranel Daniel
Published: February 2024

Creative solutions are needed to address the well-being of the growing number of individuals living with dementia. Music-based interventions (MBIs) are promising and can be cost-effective; however, empirical evidence for MBIs is limited and published findings have not been widely translated into practice. Here, we describe how we implemented strategies to enhance rigor in a randomized clinical trial of an MBI for persons with dementia. We examined the impact of a singing-based MBI on feelings, emotions, and social engagement, relative to a non-music treatment (verbal discussion), delivered in small group format (25 minutes, 3 times/week for 2 weeks). We implemented National Institutes of Health Behavior Change Consortium strategies regarding: (i) design, (ii) interventionist training, (iii) treatment delivery, (iv) treatment receipt, and (v) treatment skills enactment. We applied the MBI Reporting Criteria including: (i) theoretical framework, (ii) musical content, (iii) dosage, (iv) interventionist, (v) treatment fidelity, (vi) setting, and (vii) delivery unit. We analyzed data with a separate linear mixed model for each dependent variable. 32 older adults with dementia (65–97 years) participated. The MBI yielded significant positive effects on all measured outcomes (all p’s < .05). Application of established guidelines enhanced methodological rigor and MBI reproducibility. To support translation of research into practice, clinicians should understand how to implement an MBI reported in research. Our study illustrates practical steps to address the need for improved MBI research in persons with dementia and can provide a model for others to enhance evidence-based practice with this population.
ASB3 promotes hepatocellular carcinoma progression by mediating DR5 ubiquitination in TRAIL resistance
Authors: Huang Linlin , Che Zhihui , Liu Fuchen , Ge Mengxiao , Wu Zhaohui , Wu Lijun , Chen Wenwen , Wang Zuoyun , Zhu Zhiling , Xu Wei , Dong Qiongzhu , Yang Dongqin
Published: February 2024

Ankyrin‐repeat proteins with a suppressor of cytokine signaling box (ASB) proteins belong to the E3 ubiquitin ligase family. 18 ASB members have been identified whose biological functions are mostly unexplored. Here, we discovered that ASB3 was essential for hepatocellular carcinoma (HCC) development and high ASB3 expression predicted poor clinical outcomes. ASB3 silencing induced HCC cell growth arrest and apoptosis in vitro and in vivo. Liver‐specific deletion of Asb3 gene suppressed diethylnitrosamine (DEN)‐induced liver cancer development. Mechanistically, ASB3 interacted with death receptor 5 (DR5), which promoted ubiquitination and degradation of DR5. We further showed that ASB3 knockdown stabilized DR5 and increased the sensitivity of liver cancer cells to the treatment of tumor necrosis factor‐related apoptosis‐inducing ligand (TRAIL) in a DR5‐dependent manner in cellular and in animal models. In summary, we demonstrated that ASB3 promoted ubiquitination and degradation of DR5 in HCC, suggesting the potential of targeting ASB3 to HCC treatment and overcome TRAIL resistance.
Defining the Learning Health Care System: An International Health System Leadership Perspective
Authors: Maggio Lauren A. , Villalba Karina , German Deborah , Kanter Steven L. , Collard Harold R.
Published: February 2024

Purpose

Over the past 2 decades, many academic health centers (AHCs) have implemented learning health systems (LHSs). However, the LHS has been defined with limited input from AHC leaders. This has implications because these individuals play a critical role in LHS implementation and sustainability. This study aims to demonstrate how an international group of AHC leaders defines the LHS, and to identify key considerations they would pose to their leadership teams to implement and sustain the LHS.

Method

A semistructured survey was developed and administered in 2022 to members of the Association of Academic Health Centers President’s Council on the Learning Health System to explore how AHC leaders define the LHS in relation to their leadership roles. The authors then conducted a focus group, informed by the survey, with these leaders. The focus group was structured using the nominal group technique to facilitate consensus on an LHS definition and key considerations. The authors mapped the findings to an existing LHS framework, which includes 7 components: organizational, performance, ethics and security, scientific, information technology, data, and patient outcomes.

Results

Thirteen AHC leaders (100%) completed the survey and 10 participated in the focus group. The AHC leaders developed the following LHS definition: “A learning health system is a health care system in which clinical and care-related data are systematically integrated to catalyze discovery and implementation of new knowledge that benefits patients, the community, and the organization through improved outcomes.” The key considerations mapped to all LHS framework components, but participants also described as important the ability to communicate the LHS concept and be able to rapidly adjust to unforeseen circumstances.

Conclusions

The LHS definition and considerations developed in this study provide a shared foundation and road map for future discussions among leaders of AHCs interested in implementing and sustaining an LHS.
Altered Corneal Biomechanics According to the Biomechanical E-Staging in Pellucid Marginal Degeneration
Authors: Mergen Burak , Sideroudi Haris , Seitz Berthold , Flockerzi Elias
Published: February 2024

Purpose:

The purpose of this study was to investigate corneal biomechanics in pellucid marginal degeneration (PMD) compared with healthy controls using Corvis ST (Oculus, Germany) by using the new biomechanical E-staging (based on the Corvis Biomechanical Factor, the linearized Corvis Biomechanical Index) together with tomographic parameters.

Methods:

Corneal biomechanical and topographic data of 75 eyes of 75 patients with PMD and 75 eyes of 75 age-matched and sex-matched healthy controls were investigated. Topographic parameters (K1, K2, Kmax, central corneal thickness (CCT), and Belin/Ambrósio Deviation Index (BAD-D) were evaluated in dependence of and correlated with the biomechanically defined E-stages. Biomechanical parameters were also recorded for the 2 groups.

Results:

Patients with PMD showed higher K2, Kmax, BAD-D, and Corvis Biomechanical Factor values and a lower CCT compared with healthy controls (P < 0.001). The E-stage was positively correlated with K1, K2, Kmax, BAD-D, and intraocular pressure difference and negatively correlated with CCT. Stage-dependent analysis revealed a significant increase in K1, K2, Kmax (P < 0.001), and BAD-D (P = 0.041) in stage E3 compared with E0 and a significant decrease in stage E2 in CCT (P = 0.009) compared with E0.

Conclusions:

This study showed that patients with PMD may have a reduced corneal stiffness compared with healthy controls which worsens with increasing E-stage. Significant changes in topographic parameters were observed at stage E2 for CCT and at stage E3 for K1, K2, Kmax, and BAD-D when compared with stage E0.
Efficacy of a new water-free topical cyclosporine 0.1% solution for optimizing the ocular surface in patients with dry eye and cataract
Authors: Akpek Esen K. , Sheppard John D. , Hamm Adam , Angstmann-Mehr Simone , Krösser Sonja
Published: February 2024

This is a pooled analysis from 2 phase III clinical trials investigating a water-free topical cyclosporine 0.1% for the treatment of moderate to severe dry eye. The analyses included 1162 patients: 35% with cataract, 20% with pseudophakia, and 45% without cataract. Demographics or baseline characteristics were comparable across groups except for age and vision. The cyclosporine-treated patients achieved large mean improvements from baseline by day 15: −3.7 in patients without cataract, −3.2 in patients with cataract, and −3.1 in pseudophakic patients. These improvements were statistically significantly higher compared with the respective vehicle groups. In the cataract subgroup, 59% of patients treated with cyclosporine achieved ≥3 grade improvements in corneal staining score, as early as day 15. The magnitude of the effect and early onset of action make this new cyclosporine solution a promising candidate for preoperative management of ocular surface in patients undergoing cataract surgery.
Machine-learning models are superior to severity scoring systems for the prediction of the mortality of critically ill patients in a tertiary medical center
Authors: Chou Ruey-Hsing , Hsu Benny Wei-Yun , Yu Chun-Lin , Chen Tai-Yuan , Ou Shuo-Ming , Lee Kuo-Hua , Tseng Vincent S. , Huang Po-Hsun , Tarng Der-Cherng
Published: February 2024

Background:

Intensive care unit (ICU) mortality prediction helps to guide therapeutic decision making for critically ill patients. Several scoring systems based on statistical techniques have been developed for this purpose. In this study, we developed a machine-learning model to predict patient mortality in the very early stage of ICU admission.

Methods:

This study was performed with data from all patients admitted to the intensive care units of a tertiary medical center in Taiwan from 2009 to 2018. The patients’ comorbidities, co-medications, vital signs, and laboratory data on the day of ICU admission were obtained from electronic medical records. We constructed random forest and extreme gradient boosting (XGBoost) models to predict ICU mortality, and compared their performance with that of traditional scoring systems.

Results:

Data from 12,377 patients was allocated to training (n = 9901) and testing (n = 2476) datasets. The median patient age was 70.0 years; 9210 (74.41%) patients were under mechanical ventilation in the ICU. The areas under receiver operating characteristic curves for the random forest and XGBoost models (0.876 and 0.880, respectively) were larger than those for the Acute Physiology and Chronic Health Evaluation II score (0.738), Sequential Organ Failure Assessment score (0.747), and Simplified Acute Physiology Score II (0.743). The fraction of inspired oxygen on ICU admission was the most important predictive feature across all models.

Conclusion:

The XGBoost model most accurately predicted ICU mortality and was superior to traditional scoring systems. Our results highlight the utility of machine learning for ICU mortality prediction in the Asian population.
Early double-balloon enteroscopy was not related to better clinical outcomes in patients with suspected overt small bowel bleeding
Authors: Ye Yong-Cheng , Sung Kuan-Yi , Chang Tien-En , Wu Pei-Shan , Wang Yen-Po , Luo Jiing-Chyuan , Hou Ming-Chih , Lu Ching-Liang
Published: February 2024

Background:

Device-assisted enteroscopy has been used for over 20 years for the management of patients with suspected small bowel bleeding. Unlike esophagogastroduodenoscopy and colonoscopy, the appropriate timing of enteroscopy is still unknown. In recent guidelines, early enteroscopy is suggested to maximize diagnostic yield and therapeutic yield in patients with suspected small bowel bleeding. However, few studies have identified its influence on clinical outcomes, including mortality or rebleeding rate. We conducted this study to evaluate the influence of the timing of double-balloon enteroscopy on clinical outcomes in patients with suspected small bowel bleeding.

Methods:

Patients with overt small bowel bleeding who underwent double-balloon enteroscopy from January 2013 to February 2021 were retrospectively reviewed. Patients were categorized into an early enteroscopy group (≤14 days) and a nonearly enteroscopy group (>14 days). Clinical outcomes, including short-term mortality and rebleeding rate, long-term mortality and rebleeding rate, diagnostic yield, and therapeutic yield, were analyzed.

Results:

A total of 100 patients (mean age, 66.2 years; 53% male) were included, and 44 patients were stratified into the early enteroscopy group. The diagnostic yield, therapeutic yield, mortality, and rebleeding rate were similar between two groups. In multivariate conditional logistic regression analysis, there were no significant differences between two groups regarding the 30-day rebleeding rate (adjusted odds ratio [aOR], 1.43; 95% CI, 0.47-4.33), 90-day rebleeding rate (aOR, 1.18; 95% CI, 0.47-2.94), 30-day mortality rate (aOR, 1.29; 95% CI, 0.21-8.13), 90-day mortality rate (aOR, 1.94; 95% CI, 0.48-7.87), and 90-day bleeding-related mortality (aOR, 2.18; 95% CI, 0.24-19.52). The Kaplan-Meier survival curve analysis showed that the timing of DBE was not associated with the long-term rebleeding rate or mortality rate (p = 0.57 and 0.83, respectively).

Conclusion:

The timing of enteroscopy did not influence the clinical outcomes, including the short-term mortality rate, short-term rebleeding rate, long-term mortality rate, and rebleeding rate, in patients with suspected overt small bowel bleeding.
Successful utilization of nirmatrelvir/ritonavir and dexamethasone in a patient with total artificial heart and COVID-19: A case report
Authors: Alowais Shuroug A. , Bosaeed Mohammed , Saleh Khalid Bin , AlQahtani Hajar , Selimovic Nedim , Ahmed Husnat , Alghamdi Abdullah A. , Hussain Arif , Badreldin Hisham A.
Published: February 2024

Rationale:

Management of coronavirus disease 2019 (COVID-19) has been the subject of extensive research and study, leading to the development of strategies and treatments. Nonetheless, there remains a dearth of information concerning patients who require mechanical circulatory system support. This case report presents one of the first documented cases of successful utilization of nirmatrelvir/ritonavir (Paxlovid) and dexamethasone in the treatment of a patient with a total artificial heart.

Patient concerns:

The patient in this case study was a 28-year-old male who had been experiencing severe heart failure. In need of a heart transplant, he underwent a procedure for implantation of a total artificial heart as a bridge to transplantation.

Diagnoses:

Unfortunately, after the surgical intervention, the patient contracted COVID-19, as confirmed by polymerase chain reaction.

Interventions:

The therapeutic approach involved a 5-day regimen of nirmatrelvir/ritonavir at a dosage of 300/100 mg administered twice daily, along with a daily dosage of 6 mg of dexamethasone.

Outcomes:

Remarkably, the patient oxygenation level improved on the second day of therapy. Consequently, he was transferred from the intensive care unit to the general floor. After 71 days with the total artificial heart, the patient successfully underwent heart transplantation.

Lessons:

This case report provides a compelling example of the successful application of nirmatrelvir/ritonavir and dexamethasone in the treatment of a COVID-19 patient with a total artificial heart. The positive outcome observed in this case underscores the potential use of these therapeutic agents in this specific patient population. However, it is imperative to conduct further research to corroborate and validate these initial findings. This study lays the foundation for further exploration of the efficacy of these drugs in patients with mechanical circulatory support systems.
HIV-related neurocognitive disorders: Diagnosis, Treatment, and Mental Health Implications: A Review
Authors: Elendu Chukwuka , Aguocha Chinyere Mirian , Okeke Chinelo V. , Okoro Chinonso B. , Peterson Jesse C.
Published: February 2024

HIV-related neurocognitive disorders (HAND) have emerged as a significant concern in the context of HIV infection. This article provides a comprehensive overview of the diagnosis, treatment, and mental health implications associated with HAND.

Diagnosis of HAND involves a multifaceted approach, combining clinical assessments, neurocognitive testing, and neuroimaging techniques. Various screening tools and standardized assessments have been developed to aid in the early detection and monitoring of HAND. Timely diagnosis allows for appropriate interventions and personalized treatment strategies. Treatment for HAND encompasses a multidisciplinary approach targeting different aspects of cognitive impairment. Antiretroviral therapy (ART) remains the cornerstone of treatment, effectively reducing viral load and preventing further neurocognitive decline. Adjunctive therapies, including cognitive rehabilitation, pharmacological interventions, and psychosocial support, play crucial roles in managing cognitive symptoms and enhancing overall quality of life. Mental health implications associated with HAND are profound and require special attention. Individuals with HAND are at higher risk of experiencing psychological distress, depression, anxiety, and reduced social functioning. Integrated care models that address physical and mental health aspects are vital in optimizing treatment outcomes and promoting mental well-being in this population. Furthermore, this paper highlights the need for ongoing research to unravel the underlying mechanisms of HAND and develop targeted interventions. Identifying risk factors, understanding the impact of HIV on the brain, and exploring novel treatment modalities are essential areas of focus. Additionally, living with HAND social and cultural aspects must be considered to ensure equitable access to care and support for all affected individuals.
Diagnosis and therapy of giant epidermoid double cysts with infection on the buttock: A case report and literature review
Authors: Wu Peiliang , Wang Cong , Jiang Yiran , Zhang Zhi , Gao Junlan , Fan Zhe
Published: February 2024

Rationale:

Epidermoid cyst (EC) is a common clinical condition and it can be filled with keratinized material. EC often represents painless, slow progressive growth, and single cyst. The cyst is usually 1 to 5 cm in size. Giant epidermoid cysts on the buttock area are extremely rare, and reports of giant epidermoid double cysts on the buttock are even rarer.

Patient concerns:

This paper reports a patient with a painless mass was on the left buttock.

Diagnosis:

A giant epidermoid double cysts with infection in a left buttock paranal location.

Interventions:

The mass was surgically removed.

Outcomes:

The patient recovered well after surgical treatment and currently has no recurrence.

Conclusion:

For patients with EC, MRI is recommended as a routine examination before surgery in order to detect the variation and extent of the cyst early. This lays a foundation for the complete resection of the lesion during the operation. The review of relevant literature will hopefully be helpful to clinicians.
Is seborrheic dermatitis associated with early-stage osteoarthritis?
Authors: Kulakli Sevgi , Kulakli Fazil , Yilmaz Betül , Sari İlker Fatih , Oğuz Işil Deniz
Published: February 2024

Seborrheic dermatitis (SD) and osteoarthritis involve similar factors in their pathogenesis. Both of these diseases are associated with an increased frequency of metabolic syndrome and underlying systemic inflammation. This study evaluated the thickness of the distal femoral cartilage using ultrasonography in patients with SD. The study enrolled 60 patients with SD (19 females and 41 males, mean age: 34.07 ± 12.56 years) and 60 controls matched for age and sex (20 females and 40 males, mean age: 35.08 ± 12.78 years). Ultrasonography was used to measure the distal femoral cartilage thickness (FCT) of the right medial condyle, right lateral condyle, right intercondylar area, left medial condyle, left lateral condyle, and left intercondylar area. FCT values at all points were significantly higher in patients with SD than in the controls (P < .05). Further, all FCT values were significantly higher in patients with moderate SD than in those with mild SD (P < .001). A strong positive correlation was observed between disease severity and FCT measured at right medial condyle (r = .7,P < .001), right lateral condyle (r = .749,P < .001), right intercondylar area (r = .79,P < .001), left medial condyle (r = .624,P < .001), and left intercondylar area (r = .703,P < .001). Further, a moderately positive correlation was observed between disease severity and FCT measured at left lateral condyle (r = .581,P < .001). Increased FCT in patients with SD might be an early indicator of osteoarthritis. However, further studies, especially those evaluating older patients with SD, are required to support our findings.
A Bibliometric Analysis of the 36-Year History of Cancer Nursing (1987-2023)
Authors: Kaya Ayla , Tuzcu Ayla
Published: February 2024

Background

Bibliometric analysis is an effective method for evaluating the publication characteristics and development of a journal. To our knowledge, this study is the first such analysis of the publications in Cancer Nursing.

Objective

This study aimed to analyze the publication characteristics and evolution of Cancer Nursing over a period of 36 years since its inception.

Methods

Bibliometric analysis was carried out on 3095 publications. Data were collected from the Web of Science Core Collection database on September 15, 2023. Data analysis was conducted with Web of Science Core Collection, VOSviewer, and Bibliometrix package in R software.

Results

The results showed a steady increase in the citation and publication structure of Cancer Nursing. “Quality of life” was at the center of the studies, and “quality of life,” “women,” and “breast cancer” were identified as trend topics. The United States was both at the center of the cooperation network and was the country that contributed the most publications to the journal.

Conclusion

Cancer Nursing has had an increasing contribution to and impact on cancer nursing in terms of the quality and citations of published articles. It was noted that the journal’s network of collaboration has expanded globally and that its thematic diversity is high. Although quality of life, women, and breast cancer have been reported extensively, more studies addressing the concepts of “children,” “support,” and “needs” are needed in the journal.

Implications for Practice

This study not only enriches global readers in the field of cancer nursing but may also be beneficial in providing input to guide future research.
Outcomes of Prophylactic Peritoneal Dialysis Catheter Insertion in Children Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis
Authors: Ulrich Emma H. , Bedi Prabhjot K. , Alobaidi Rashid , Morgan Catherine J. , Paulden Mike , Zappitelli Michael , Bagshaw Sean M.
Published: February 2024

OBJECTIVES:

The objective of this Prospective Register of Systematic Reviews (CRD42022384192) registered systematic review and meta-analysis was to determine whether prophylactic peritoneal dialysis (PD) catheter insertion at the time of pediatric cardiac surgery is associated with improved short-term outcomes.

DATA SOURCES:

Databases search of the MEDLINE, EMBASE, CINAHL, and Cochrane Library completed in April 2021 and updated October 2023.

STUDY SELECTION:

Two reviewers independently completed study selection, data extraction, and bias assessment. Inclusion criteria were randomized controlled trials (RCTs) and observational studies of children (≤ 18 yr) undergoing cardiac surgery with cardiopulmonary bypass. We evaluated use of prophylactic PD catheter versus not.

DATA EXTRACTION:

The primary outcome was in-hospital mortality, as well as secondary short-term outcomes. Pooled random-effect meta-analysis odds ratio with 95% CI are reported.

DATA SYNTHESIS:

Seventeen studies met inclusion criteria, including four RCTs. The non-PD catheter group received supportive care that included diuretics and late placement of PD catheters in the ICU. Most study populations included children younger than 1 year and weight less than 10 kg. Cardiac surgery was most commonly used for arterial switch operation. In-hospital mortality was reported in 13 studies; pooled analysis showed no association between prophylactic PD catheter placement and in-hospital mortality. There were mixed results for ICU length of stay and time to negative fluid balance, with some studies showing shortened duration associated with use of prophylactic PD catheter insertion and others showing no difference. Overall, the studies had high risk for bias, mainly due to small sample size and lack of generalizability.

CONCLUSIONS:

In this meta-analysis, we have failed to demonstrate an association between prophylactic PD catheter insertion in children and infants undergoing cardiac surgery and reduced in-hospital mortality. Other relevant short-term outcomes, including markers of fluid overload, require further study.
A Quality Improvement Initiative to Transform Seasonal Immunization Processes Using Learning from the Coronavirus 2019 Pandemic
Authors: Robinette Eric D. , Nelly Pamela M. , Engler Laurie J. , Bigham Michael T.
Published: February 2024

Background:

Surge demands for annual influenza vaccines challenge healthcare systems. Mass immunizations differ from the traditional care model. The coronavirus 2019 (COVID-19) pandemic challenged current care models with amplified demand and infection risks while challenging the organization to create new and improve existing processes.

Methods:

Using the Model for Improvement, the team set out to (1) safely meet a surge in vaccination demand and (2) adopt pandemic-driven innovations into routine immunization practice.

Results:

This free-standing pediatric system delivered 87,000 COVID-19 vaccines (~1.3% state total). It administered over 50% of COVID-19 vaccines using new mass immunization processes, including 37,000 adult vaccines before pediatric authorization. In the 2021–2022 influenza season, it used the new or improved immunization processes to deliver 22% of influenza vaccines.

Conclusions:

Pandemic-driven adaptation for the COVID-19 vaccine substantially increased the efficiency of influenza vaccination processes but did not result in a clear increase in influenza vaccine administration rates.
Outcomes of Flap Reconstruction for Diabetic Foot Ulcers: A Systematic Review and Meta-Analysis of Clinical Studies
Authors: Reed Alistair J. M. , Lim Nicole T. Y. , Yip Sharon W. L. , Thurley Neal , Wormald Justin C. R. , Rodrigues Jeremy N. , Shirley Rebecca Anna , Chan James K. K.
Published: February 2024

Background:

People with diabetic foot ulcers (DFUs) are at risk of major amputation, which is associated with a high mortality rate (exceeding 50% at 5 years) and reduced quality of life. The authors hypothesized that flap reconstruction of DFUs improves patient outcomes in comparison with standard treatment modalities, including major amputation.

Methods:

MEDLINE, Embase, the Cochrane Library, and gray literature were searched on February 9, 2022. Comparative and single-arm studies reporting outcomes of DFUs treated with local, regional, or free flaps that included function, limb loss, mortality rates, and flap failure rates were included. Risk of bias was assessed, and meta-analysis of proportions was performed.

Results:

A total of 3878 records were retrieved, of which 45 met the inclusion criteria, including the records of 1681 patients who underwent flap reconstruction of DFUs. Free flaps were most commonly performed (n = 1257 [72%]). Only one study used a verified functional outcome measure. At 12 months, the mortality rate was 6.35% (95% CI, 3.89% to 10.20%), the limb loss rate was 11.39% (95% CI, 7.02% to 17.96%), and the free flap failure rate was 9.95% (95% CI, 8.19% to 12.05%). All studies were at high risk of bias. A comparative meta-analysis of interventions was not performed because of study method and outcome heterogeneity.

Conclusions:

There is short-term evidence that flap reconstruction (including microsurgical transfer) has low mortality, limb loss, and flap failure rates. However, there are limited high-quality comparative studies, and uncertainty remains regarding the outcome of DFU flap reconstruction in comparison to other treatments.