bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance of Bandage Contact Lens in Patients Post-ocular Surgeries: A Systematic Literature Review
Authors: Zheng Yan , Zhai Chang-Bin
Published: October 2023

This study systematically reviewed the performance of bandage contact lenses (BCL) such as lotrafilcon A, lotrafilcon B, senofilcon A, balafilcon A, and comfilcon A as postoperative treatment in different ocular surgeries. A systematic search of English and Chinese databases (from inception to December 2021) was conducted for studies reporting the efficacy of BCLs after ocular surgeries. Postoperative symptoms, corneal healing, and visual outcomes were studied. Overall, 38 studies were identified. Bandage contact lens was applied as a postoperative aid in corneal refractive, cataract, and vitrectomy surgeries. Most studies were on photorefractive keratectomy. Reduced postoperative symptoms were observed within 4 hr to 3 days, whereas re-epithelization of the cornea and healing was complete within 3 to 7 days after ocular surgeries except for vitrectomy. In a vitrectomy, greater comfort and improved corneal epithelium were observed on the seventh day after surgery. An improvement in dry eye symptoms was observed at 7 days with considerable benefits observed after 1 month of cataract surgery. These findings indicate that BCLs are effective for improving postoperative symptoms and facilitation of early visual rehabilitation with a wear time of 8 hr to 7 days depending on the type of ocular surgery.
Real-World Outcomes of Neutralizing Monoclonal Antibody Treatment in Patients Affected by Nosocomial Coronavirus Disease 2019
Authors: Boglione Lucio , Poletti Federica , Rostagno Roberto , Moglia Roberta , Cantone Marco , Esposito Maria , Borrè Silvio
Published: October 2023

Introduction

Neutralizing monoclonal antibodies (NmAbs) are a treatment option in patients with early SARS-CoV-2 infection. In this study, we examined the role of NmAbs therapies in a cohort of patients affected by nosocomial COVID-19 infection and high risk of illness progression.

Methods

A retrospective, single-center analysis was performed including all patients affected by nosocomial SARS-CoV-2 infection receiving NmAbs treatment between April 2021 and March 2022.

Results

The overall included patients were 75. Mortality rate was 13.3%; disease progression was observed in 22 patients (29.3%); clinical improvement was reported in 49 subjects (65.3%). In multivariate logistic regression, the presence of immunosuppression risk factor and late administration of therapies were recognized as independent predictors of treatment failure.

Conclusions

In this real-world analysis, the treatment with NmAbs was safety and effectiveness in high-risk patients with nosocomial COVID-19 infection, but the timing of administration and the role of viral variants are the main limiting factors of this approach.
Systematic and objective wet-lab testing of instruments for phacoemulsification: new Formalin Quadrant Model
Authors: Giger-Lange Christina , Rattenbacher-Kiser Karin , Di Lanzo Jessica , Di Nardo Silvio , Menapace Rupert , Ille Fabian
Published: October 2023

Purpose:

To validate an improved wet-lab model for systematic and objective efficiency testing of instruments for phacoemulsification.

Setting:

Institute of Medical Engineering, Lucerne University of Applied Sciences and Arts, Lucerne, Switzerland.

Design:

Experimental study.

Methods:

Porcine lenses were incubated for different time spans in formalin to simulate different cataract densities. Lenses were cut in quadrants and emulsified in a silicone test chamber. The use of ultrasound was restricted to full occlusion and the minimal power needed to promote emulsification. Equivalence to the surgical situation and cataract consistency were judged by an experienced surgeon. Efficiency was rated by effective phacoemulsification time, liquid consumption, and total surgery time.

Results:

Formalin incubation times of 2 hours, 1.25 hours, and 0.5 hours were validated for hard, middle-hard, and soft cataracts, respectively. Systematic testing of different fluidics settings revealed the unique opportunities of the improved model: Experiments could be performed by laboratory staff without any surgical experience after a short training, and the model provided results in a fast and reproducible manner. Reduced effective phacoemulsification time, shorter total surgery time, and less liquid consumption were observed with higher fluidics settings, confirming and complementing earlier clinical findings.

Conclusions:

The Formalin Quadrant Model can be used to test new designs of instrumentation on different cataract densities or various instrument settings for efficiency. Using a validated cataract substitute, it closely represents the clinical situation and thus renders valid results in a short time. Instruments can be tested and improved profoundly before costly and elaborate clinical trials have to be applied.
Influence of posterior capsule abnormalities in pediatric cataract surgery
Authors: Ding Yichao , Zhang Jing , Huang Yusen
Published: October 2023

Purpose:

To report how to manage posterior capsule abnormalities (PCAs) in pediatric cataracts and evaluate the influence of PCAs during intraocular lens (IOL) optic implantation in Berger space surgeries.

Setting:

Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China.

Design:

Retrospective case series study.

Methods:

Pediatric patients with PCAs who underwent cataract surgery were evaluated. A video-based analysis of the surgical interventions included the type of crystalline lens opacification, types and management of PCAs, complications during primary posterior continuous curvilinear capsulorhexis (PCCC), need for anterior vitrectomy (AV), and feasibility of IOL optic capture.

Results:

There were 227 pediatric cataract surgeries performed during the study period, and 76 eyes of 66 children with PCAs were evaluated (33.5%, 76/227). Unilateral cataract with PCAs were found in 50 eyes (22.0%, 50/227) and bilateral were found in 26 eyes (11.5%, 26/227). The PCAs were posterior capsule plaque (19.8%, 45/227), posterior capsule defect (6.2%, 14/227), posterior lenticonus (3.1%, 7/227), and persistent fetal vasculature (4.4%, 10/227). In the PCA cases, primary PCCC was successful in 44.7% of the cases (34/76). An unplanned AV during the surgeries was performed in 47.4% (36) of the 76 eyes. IOL optic implantation in Berger space was achieved in 63.2% of the eyes (48/76).

Conclusions:

PCAs are often encountered during pediatric cataract surgeries, especially in unilateral cases. The presence of PCAs may complicate a primary PCCC procedure, resulting in an unplanned AV in some cases. IOL optic implantation in Berger space can also be performed fortunately with well-designed and skilled operation.
The Association Between Intrapersonal Resilience Resources and Quality of Life Among Older Persons Living With HIV: A Systematic Review
Authors: Haase Shakaye R. , Billings Rebecca , Vance David E. , Fazeli Pariya L.
Published: October 2023

Despite positive improvements in health care, older persons living with HIV (PWH) still face psychosocial challenges and medical issues that affect their overall quality of life (QoL). Intrapersonal resilience resources may serve as a protective factor allowing PWH to better cope with adversity, thereby improving their well-being. In our systematic review, we examined intrapersonal resilience resources and their association with QoL outcomes among middle-aged and older PWH (≥40 years). Four databases (CINAHL, PubMed, PsycINFO, and Embase) were searched, and 1,400 articles were yielded. Following screening and full-text review, 19 studies met full criteria and were included. Based on our findings from these studies, trait resilience, spirituality, and self-efficacy were the most common resilience resources investigated. Resilience resources were positively associated with QoL outcomes and mediated the association between various psychosocial factors (e.g., stigma) and QoL. Future studies should explore resilience resources and QoL over time among diverse populations of PWH.
Perioperative Morbidity and Outcomes in Pediatric Patients Transitioned From Extracorporeal Membrane Oxygenation to Ventricular Assist Device Support: A Study of the Society of Thoracic Surgeons Congenital Heart Surgery Database
Authors: Desai Manan H. , Trivedi Jaimin R. , Gerhard Eleanor F. , Sinha Pranava , Alsoufi Bahaaldin , Deshpande Shriprasad R.
Published: October 2023

As a bridge to transplant strategy, children transitioned from extracorporeal membrane oxygenation (ECMO) to ventricular assist device (VAD) have higher waitlist mortality compared with those who receive de novo VAD. However, the contribution of the immediate perioperative period and differences in the two groups are not well studied. We performed a nested case–control study between children receiving de novo VAD (group 1) and those transitioned from ECMO to VAD (group 2) between 2014 and 2019 using The Society of Thoracic Surgeons (STS) database. A total of 735 children underwent VAD placement with 498 in group 1 and 237 in group 2. Patients in group 2 were significantly younger, smaller, and significantly sicker, were twice as likely to transition to biventricular VAD and need unplanned reoperations. Overall mortality was 16% for group 1 and 34% for group 2 (p < 0.01). Regression analysis showed that ECMO use (odds ratio [OR], 2.17 [1.3–3.4]), ventilator need (OR, 2.2 [1.3–3.9]), and cardiogenic shock (OR, 1.8 [1.2–2.8]) were all independent preoperative predictors of VAD mortality while dialysis need (OR, 25.5 [8.6–75.3]), stroke (OR, 6.2 [3.1–12.6]), and bleeding (OR, 1.9 [1.1–3.4]) were independent postoperative predictors of VAD mortality within 30 days (all p < 0.05). The study demonstrated significant baseline differences between the two cohorts, warranting avoidance of comparison. Early elective VAD placement in this cohort of patients should be sought to avoid interim ECMO and high post-VAD mortality.
Hemofiltration Improves Blood Perfusate Conditions Leading to Improved Ex Situ Heart Perfusion
Authors: Kaffka genaamd Dengler Selma E. , Mishra Mudit , Vervoorn Mats T. , Kernkamp Jord , van Tuijl Sjoerd , de Jager Saskia C. A. , Sluijter Joost P. G. , Doevendans Pieter A. , van der Kaaij Niels P.
Published: October 2023

The aim was to optimize the perfusate composition by including a hemofiltrator to the PhysioHeartplatform for ex situ heart perfusion of porcine slaughterhouse hearts. Fourteen hearts were harvested from Dutch Landrace pigs and slaughtered for human consumption. All hearts were preserved for 4 hours using static cold storage before reperfusion for 4 hours on the PhysioHeart platform. Seven hearts were assigned to the hemofiltration group, where a hemofiltrator was added to the perfusion circuit, while the control group did not receive hemofiltration. In the hemofiltration group, the perfusion fluid was filtrated for 1 hour with a flow of 1 L/hour before reperfusion. After mounting the heart, hemofiltration was maintained at 1 L/hour, and cardiac function and blood samples were analyzed at multiple time points. Preserved cardiac function was defined as a cardiac output >3.0 L/min with a mean aortic pressure >60 mm Hg and a left atrial pressure <15 mm Hg. Hemofiltration resulted in a significantly reduced potassium concentration at all time points (p < 0.001), while sodium levels remained at baseline values (p < 0.004). Furthermore, creatinine and ammonia levels decreased over time. Functional assessment demonstrated a reduced left atrial pressure (p < 0.04) and a reduction of the required dobutamine dose to support myocardial function (p < 0.003) in the hemofiltration group. Preserved cardiac function did not differ between groups. Hemofiltration results in an improved biochemical composition of the whole blood perfusate and preserves cardiac function better during normothermic perfusion based on a reduced left atrial pressure (LAP) and dobutamine requirement to support function.
Long Term Veno-Pulmonary Arterial Extracorporeal Membrane Oxygenation as Bridge to Lung Transplantation and Its Challenges: A Case Report
Authors: Montoya-Beltran Juan Sebastian , Ramirez-Herrrera Laura , Santana Yimy Alberto , Mantilla Hugo Andrés , Forero Julian Francisco , Franco-Gruntorad German Andres , Santacruz-Escudero Carlos Miguel
Published: October 2023

We present a case of a patient with acute respiratory distress syndrome due to severe acute respiratory syndrome coronavirus 2 infection who underwent an extracorporeal membrane oxygenation (ECMO) run of 8 months with various configuration changes, including off-label use of cannulas. The patient eventually underwent successful double lung transplantation after a follow-up of 17 months, demonstrating the successful application of a hybrid approach and careful monitoring in the face of supply shortages during the pandemic. This case highlights the challenges faced by ECMO and transplantation centers during the pandemic and the importance of careful communication and planning to optimize patient outcomes.
Retrospective Evaluation of the Efficacy of Gemcitabine-Based Therapies After FOLFIRINOX Failure in Advanced Pancreatic Cancer, Multi-Center Real-Life Data
Authors: Sütcüoğlu Osman , Doğan Akif , Yilmaz Funda , Şahin Ahmet Bilgehan , Şahin Taha Koray , Esen Selin Aktürk , Erol Cihan , Üner Aytuğ , Özet Ahmet , Turan Nedim , Eraslan Emrah , Deligönül Adem , Odabaş Hatice , Günel Nazan , Uçar Gökhan , Dede Didem Şener , Dizdar Ömer , Çubukçu Erdem , Öksüzoğlu Ömür Berna , Emre Yildirim Mahmut , Yazici Ozan , Özdemir Nuriye
Published: October 2023

Objective

Combination therapies such as FOLFIRINOX or gemcitabine-nanoparticle albumin-bound paclitaxel (GnP) are recommended for the first-line treatment of patients with advanced pancreatic cancer. The purpose of this study was to evaluate the efficacy of gemcitabine-based second-line therapies in patients whose disease progressed on FOLFIRINOX.

Method

Patients diagnosed with advanced pancreatic cancer in 7 tertiary hospitals in Turkey were included. Patients were divided into 3 different groups according to their treatment regimens: GnP, gemcitabine doublet (gemcitabine-cisplatin or gemcitabine-capecitabine), and gemcitabine monotherapy.

Results

A total of 144 patients were included in the study. In the second-line treatment, 65% of patients were given GnP, 20% were given gemcitabine doublet, and 15% were given gemcitabine monotherapy. The median exposure of the patients to gemcitabine-based therapy was 3 cycles, whereas the median progression-free survival was calculated as 3.4 months. The median overall survival for patients who received GnP was 4.6 months, 6.4 months for patients who received gemcitabine doublet therapy, and 3.7 months for patients who received gemcitabine monotherapy (P = 0.248).

Conclusion

In conclusion, it has been shown that gemcitabine-based second-line treatments contribute to survival in patients with advanced pancreatic cancer. In addition, there was no difference in efficacy between gemcitabine monotherapy or combination treatments.
Pancreatic Cancer Cells May Adhere to the External Surface of the Puncture Needle After Endoscopic Ultrasound–Guided Fine-Needle Aspiration
Authors: Kurosu Takahiro , Kida Mitsuhiro , Okuwaki Kosuke , Iwai Tomohisa , Watanabe Masafumi , Hasegawa Rikiya , Imaizumi Hiroshi , Tamaki Akihiro , Yoshida Tsutomu , Kusano Chika
Published: October 2023

Objective

We prospectively investigated whether cells derived from pancreatic cancers adhered to the puncture needle's external surface after endoscopic ultrasound–guided fine-needle aspiration (EUS-FNA) and whether wiping the needle with alcohol swabs removed residual cancer cells.

Methods

The participants were 100 consecutive patients who underwent EUS-FNA for suspected pancreatic ductal adenocarcinoma. In the first pass of EUS-FNA, we prepared aspiration and lavage cytological diagnosis materials from the lumen and external surface of the puncture needle, respectively. This was repeated in the second pass, although the needle's external surface was wiped with an alcohol swab.

Results

The positivity rates of aspiration cytological diagnosis for the first and second passes were 67% and 72%, respectively. The positivity rates of lavage cytological diagnosis of the needle's external surface on the first and second passes were 20% and 3%, respectively. Wiping the needle's external surface with alcohol swabs significantly reduced the proportion of cancer cells detected (P < 0.001). The accuracy rate based on all the collected specimens was 90%. There were no EUS-FNA–related adverse events.

Conclusion

Pancreatic cancer cells may adhere to the puncture needle's external surface after EUS-FNA. Wiping the needle with alcohol swabs after each puncture effectively removes residual cancer cells.
AI and Case Management: From Artificial Intelligence to Generative Intelligence
Authors: Powell Suzanne K.
Published: October 2023

Conversations about artificial intelligence (AI) are impossible to escape since the inception of ChatGPT in November 2022—whether it is about the end of our jobs or the end of the world! This Editorial talks about AI and its subsets and how this may relate to health care.
Advancing the Role of the Doctor of Nursing Practice in Palliative Care
Authors: Cormack Carrie L. , Smith Whitney , Durham Catherine , Lindell Kathleen , Reinbeck Donna
Published: October 2023

Doctor of nursing practice–prepared nurses are well suited to provide high-quality palliative care to patients with serious illness and their caregivers. Their rigorous education and expertise prepare them for the complexity often associated with chronic disease and end of life. There are clear and strong recommendations from multiple national organizations supporting palliative care education for nurses and tools available for nurses to implement palliative care into practice. This article is from the perspective of the doctor of nursing practice nurse. It reviews the limited evidence on palliative care integration into the doctor of nursing practice role, the barriers to palliative care education and implementing palliative care into practice, and the potential roles that a doctor of nursing practice palliative care nurse may fill in health care.
Biopsychosocial Correlates and Individual Differences for Eliciting Moral Elevation in Veterans With PTSD
Authors: McGuire Adam P. , Howard Binh An N. , Burns Christina , Zambrano-Vazquez Laura , Szabo Yvette Z.
Published: October 2023

A promising approach to enhancing trauma-focused treatment is moral elevation—feeling inspired by witnessing a virtuous act. This study explored potential links between eliciting elevation and relevant outcomes in a series of case examples. Veterans with probable posttraumatic stress disorder completed experimental tasks including a written trauma narrative exercise and watching elevation-eliciting videos. Participants also completed baseline assessments, repeated measures of trauma-related cognitions, emotions, elevation, and saliva sample collection. Four cases were identified and reviewed: two positive responders (high elevation after videos) and two nonresponders (restricted elevation response). Positive responder cases reported decreased cognitions, emotions, and moral injury distress from after the trauma narrative to after elevation exercises, whereas nonresponders reported minimal to no changes. Positive responders also demonstrated decreases in cortisol, whereas nonresponders demonstrated increases in cortisol. Future work should examine whether elevation contributes to changes in biopsychosocial outcomes and identify individual factors that indicate who might benefit from elevation-based interventions.
Effect of Unfolding Case-Based Learning on Clinical Judgment Among Undergraduate Nursing Students
Authors: Liu Wei
Published: October 2023

Background:

To prepare students for Next Generation National Council Licensure Examination-Registered Nurse (NCLEX-RN), nurse educators need to develop teaching strategies to foster students’ clinical judgment.

Purpose:

This study examined the effects of unfolding case-based learning (CBL) on baccalaureate nursing students’ clinical judgment upon graduation.

Methods:

A prospective cohort design was adopted. Students’ self-reported responses to the Lasater Clinical Judgment Rubric were compared between the unfolding CBL (n = 140) and non-CBL (n = 126) cohorts at a school of nursing in the United States.

Results:

While students’ responses were similar between the study cohorts, a trend was noted for improved clinical judgment among students in the unfolding CBL cohort. Furthermore, unfolding CBL significantly enhanced students’ perceived proficiency in conducting focused observation.

Conclusions:

The findings support early introduction and consistent use of the unfolding CBL throughout the undergraduate nursing program so that students have ample opportunities and contexts to cultivate clinical judgment skills in the classroom.
Teaching Social Determinants of Health in Nursing Programs
Authors: Liu Cheng-Ching , McIntire Emily , Ling Jiying , Sullivan Katie , Ng Teresa , Kaur Loveleen , Sender Jessica
Published: October 2023

Background:

Incorporating social determinants of health (SDoH) into clinical decision-making can clarify disease causes, enhance care planning, and improve health outcomes. Nurse educators should know which strategies are most effective for teaching SDoH in bachelor of science in nursing (BSN) programs.

Objective:

This integrative review synthesizes the literature on familiarizing BSN students with SDoH and identifies effective teaching interventions for SDoH in these programs.

Methods:

The researchers searched CINAHL, PubMed, Web of Science, and ERIC databases, and 21 articles met the inclusion criteria. The PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analysis) guidelines were followed for reporting.

Results:

The curriculum method, service learning, and international outreach experiences were frequently used teaching strategies. Qualitative evaluation was used to evaluate student outcomes.

Conclusions:

Nurse educators should be mindful of these strategies. Interdisciplinary teamwork can bolster students' understanding of disadvantaged populations while integrating SDoH in nursing curricula. Quantitative evaluations of learning outcomes are needed to determine teaching effectiveness.
Deep Learning–Based Diagnostic System for Velopharyngeal Insufficiency Based on Videofluoroscopy in Patients With Repaired Cleft Palates
Authors: Ha Jeong Hyun , Lee Haeyun , Kwon Seok Min , Joo Hyunjin , Lin Guang , Kim Deok-Yeol , Kim Sukwha , Hwang Jae Youn , Chung Jee-Hyeok , Kong Hyoun-Joong
Published: October 2023

Velopharyngeal insufficiency (VPI), which is the incomplete closure of the velopharyngeal valve during speech, is a typical poor outcome that should be evaluated after cleft palate repair. The interpretation of VPI considering both imaging analysis and perceptual evaluation is essential for further management. The authors retrospectively reviewed patients with repaired cleft palates who underwent assessment for velopharyngeal function, including both videofluoroscopic imaging and perceptual speech evaluation. The final diagnosis of VPI was made by plastic surgeons based on both assessment modalities. Deep learning techniques were applied for the diagnosis of VPI and compared with the human experts’ diagnostic results of videofluoroscopic imaging. In addition, the results of the deep learning techniques were compared with a speech pathologist’s diagnosis of perceptual evaluation to assess consistency with clinical symptoms. A total of 714 cases from January 2010 to June 2019 were reviewed. Six deep learning algorithms (VGGNet, ResNet, Xception, ResNext, DenseNet, and SENet) were trained using the obtained dataset. The area under the receiver operating characteristic curve of the algorithms ranged between 0.8758 and 0.9468 in the hold-out method and between 0.7992 and 0.8574 in the 5-fold cross-validation. Our findings demonstrated the deep learning algorithms performed comparable to experienced plastic surgeons in the diagnosis of VPI based on videofluoroscopic velopharyngeal imaging.
A Suture-specific Photo Score for Metopic Synostosis
Authors: Gaillard Linda ,   ERN CRANIO–Craniosynostosis Workgroup
Published: October 2023

Head shape assessments in children with metopic synostosis are a relevant outcome measure in addition to functional measures, such as neurocognitive outcomes, behavioral outcomes, and visual functioning outcomes. However, consensus on head shape assessments in children with metopic synostosis is lacking. The aim of this study is to develop a reproducible and reliable suture-specific photo score that can be used for cross-center comparison of phenotypical severity of metopic synostosis and evaluation of esthetic outcome of treatment later in childhood. We conducted a retrospective study among nonsyndromic metopic synostosis patients aged <18 years. Preoperative and postoperative photosets of patients with metopic synostosis from 6 expert centers were included. The photo score was discussed in the group of expert craniofacial plastic surgeons and pediatric neurosurgeons. Interrater reliability was determined with modified weighted Fleiss’ kappa and intraclass correlation coefficients. Correlation between individual photo score items with overall phenotype was assessed using Spearman correlation analyses. The metopic synostosis photo score contained the following items: “wedging of the forehead”, “hypotelorism”, “temporal hollowing”, “biparietal widening,”and an assessment of “overall phenotype”. Items were scored on a 4-point ordinal scale ranging from normal to severe. We found moderate interrater reliability for all items, but substantial agreement for the summed scores. Correlation with overall phenotype was lowest for biparietal widening. To conclude, although agreement on individual photo score items was suboptimal, the agreement on the summed score was substantial, which indicates there is consensus on the overall severity of the metopic synostosis phenotype.
Impact of Extraction Time During Donation After Circulatory Death Organ Procurement on Kidney Function After Transplantation in The Netherlands
Authors: van Straalen Erika , Rijkse Elsaline , van Staa AnneLoes , Rebers Paul M. , Hagenaars Hanneke J.A.M. , van de Wetering Jacqueline , Ijzermans Jan N.M. , Minnee Robert C.
Published: October 2023

Background.

In The Netherlands, 60% of deceased-donor kidney offers are after donation after circulatory death. Cold and warm ischemia times are known risk factors for delayed graft function (DGF) and inferior allograft survival. Extraction time is a relatively new ischemia time. During procurement, cooling of the kidneys is suboptimal with ongoing ischemia. However, evidence is lacking on whether extraction time has an impact on DGF if all ischemic periods are included.

Methods.

Between 2012 and 2018, 1524 donation after circulatory death kidneys were procured and transplanted in The Netherlands. Donation and transplantation-related data were obtained from the database of the Dutch Transplant Foundation. The primary outcome parameter was the incidence of DGF.

Results.

In our cohort, extraction time ranged from 14 to 237 min, with a mean of 62 min (SD 32). In multivariate logistic regression analysis, extraction time was an independent risk factor for incidence of DGF (odds ratio per minute increase 1.008; 95% confidence interval, 1.003-1.013; P = 0.001). The agonal phase, hypoperfusion time, and anastomosis time were not independent risk factors for incidence of DGF.

Conclusions.

Considering all known ischemic periods during the donation after the circulatory death process, prolonged kidney extraction time increased the risk of DGF after kidney transplantation.
Real-world Experiences in the Transplantation of Hepatitis C-NAAT–positive Organs
Authors: Steinbrink Julie M. , Byrns Jennifer , Berg Carl , Kappus Matthew , King Lindsay , Ellis Matthew J. , Sanoff Scott , Agarwal Richa , DeVore Adam D. , Reynolds John M. , Hartwig Matthew G. , Milano Carmelo , Sudan Debra , Maziarz Eileen K. , Saullo Jennifer , Alexander Barbara D. , Wolfe Cameron R.
Published: October 2023

Background.

Hepatitis C virus (HCV) nucleic acid amplification test (NAAT)–positive donors have increased the organ pool. Direct-acting antivirals (DAAs) have led to high rates of treatment success and sustained virologic response (SVR) in recipients with donor-derived HCV infection without significant adverse effects, although variability remains in the timing and duration of antivirals.

Methods.

This retrospective study analyzed all adult HCV-NAAT–negative transplant recipients who received an organ from HCV-NAAT–positive donors from November 24, 2018, to March 31, 2022, at Duke University Medical Center with protocolized delay of DAA initiation until after hospital discharge, with at least 180-d follow-up on all patients. Transplant and HCV-related outcomes were analyzed.

Results.

Two hundred eleven transplants (111 kidneys, 41 livers, 34 hearts, and 25 lungs) were performed from HCV-NAAT–positive donors to HCV-NAAT–negative recipients. Ninety percent of recipients became viremic within 7 d posttransplant. Ninety-nine percent of recipients were initiated on pangenotypic DAAs in the outpatient setting a median of 52 d posttransplant, most commonly with 12-wk courses of sofosbuvir–velpatasvir (lungs) and glecaprevir–pibrentasvir (heart, kidney, and liver). Ninety-seven percent of recipients had SVR after a first-line DAA; all ultimately achieved SVR at 12 wk after subsequent treatment courses. The median peak HCV RNA for all organ systems was 2 436 512 IU/mL; the median time from antiviral to undetectable RNA was 48 d, although differences were noted between organ groups. No patient deaths or graft losses were directly attributable to HCV infection.

Conclusions.

One hundred percent of transplant recipients of HCV-NAAT–positive organs ultimately developed SVR without significant adverse effects when HCV antivirals were initiated in the outpatient setting after transplant hospitalization, suggesting that this real-world treatment pathway is a viable option.
Characterizing the role of autaptic feedback in enhancing precision of neuronal firing times
Authors: Vahdat Zahra , Gambrell Oliver , Singh Abhyudai
Published: October 2023

In a chemical synapse, information flow occurs via the release of neurotransmitters from a presynaptic neuron that triggers an Action potential (AP) in the postsynaptic neuron. At its core, this occurs via the postsynaptic membrane potential integrating neurotransmitter-induced synaptic currents, and AP generation occurs when potential reaches a critical threshold. This manuscript investigates feedback implementation via an autapse, where the axon from the postsynaptic neuron forms an inhibitory synapse onto itself. Using a stochastic model of neuronal synaptic transmission, we formulate AP generation as a first-passage time problem and derive expressions for both the mean and noise of AP-firing times. Our analytical results supported by stochastic simulations identify parameter regimes where autaptic feedback transmission enhances the precision of AP firing times consistent with experimental data. These noise attenuating regimes are intuitively based on two orthogonal mechanisms - either expanding the time window to integrate noisy upstream signals; or by linearizing the mean voltage increase over time. Interestingly, we find regimes for noise amplification that specifically occur when the inhibitory synapse has a low probability of release for synaptic vesicles. In summary, this work explores feedback modulation of the stochastic dynamics of autaptic neurotransmission and reveals its function of creating more regular AP firing patterns.
Review of Teleradiology Applications in Some Selected African Countries
Authors: Nortey Jacob Nii Noye , Agbotsigah Linda Akorfa , Osei Eric Opoku , Adabo Andrew , Gborgblah Miriam , Suleiman Rashida
Published: October 2023

The role of radiology is central to disease management however, its application is hindered by the low distribution of radiology worldwide with the situation direr in Africa. Information and communication technology (ICT) methods have been used to s healthcare systems and lessen the negative after-effects of widespread unavailability of high-quality radiological services. Telemedicine, specifically teleradiology was identified as a prime mitigator resulting in increased access to quality radiological services and effective diagnostic reporting thus contributing to achieving universal health coverage. Around the world, teleradiology adoption and implementation has seen significant boost and healthcare benefits but in Africa, the situation is reversed. Africa’s low adoption can be linked to policymakers not having adequate evidence-based data to inform decisions and policies on teleradiology implementation. In this study, we review the implementation of teleradiology in five (5) African countries: South Africa, Egypt, Morocco, Kenya, and Ghana. Articles were searched on Databases such as PubMed, Google Scholar, and ScienceDirect using defined search strings. Sixty papers were initially downloaded, but only those meeting the inclusion criteria were retained after the titles and abstracts were reviewed. Nineteen articles were found suitable for the study after careful assessment. All of these were summed up, and the study’s most important takeaways were plotted. Few studies met our inclusion criteria, indicating that teleradiology is not widely used in the nations we looked at. As a result, it is necessary to conduct extensive investigations to direct the widespread implementation of teleradiology in Africa. The findings show that teleradiology is been implemented in these countries however, there exists the challenge of lack of technology, policies, human sources, and training that are hindering teleradiology practices. Therefore, it recommended that various governments and scholars should address the challenges facing teleradiology and examine the limitations identified in this study.
Modeling magnesium and calcium transport along male rat kidney and the effects of diuretics
Authors: Dutta Pritha , Layton Anita T.
Published: October 2023

Calcium (Ca2+) and magnesium (Mg2+) are essential for cellular function. The kidneys play an important role in maintaining the homeostasis of these cations. Their reabsorption along the nephron is dependent on distinct trans- and paracellular pathways, and is coupled to the transport of other electrolytes. Notably, sodium (Na+) transport establishes an electrochemical gradient to drive Ca2+reabsorption. Consequently, alterations in renal Na+handling, under pathophysiological conditions or pharmacological manipulations, can have major effects on Ca2+transport. One such condition is the administration of diuretics, which are used to treat a large range of clinical conditions, but most commonly for the management of blood pressure and fluid balance. While the pharmacological targets of diuretics typically directly mediate Na+transport, they also indirectly affect renal Ca2+and Mg2+handling, i.e., by establishing a prerequisite electrochemical gradient. Thus, substantial alterations in divalent cation handling can be expected following diuretic treatment. To investigate renal Ca2+and Mg2handling, and how those processes are affected by diuretics treatment, we have developed sex-specific computational models of electrolyte transport along the nephrons. Model simulations indicate that along the proximal tubule and thick ascending limb, the transport of Ca2+and Mg2+occusr in parallel with Na+, but those processes are dissociated along the distal convoluted tubule. We also simulated the effects of acute administration of loop, thiazide, and K-sparing diuretics. The model predicted significantly increased Mg2+excretion, no significant alteration in Mg2+excretion, and significantly decreased Mg2+excretion on treatment with loop, thiazide, and K-sparing diuretics, respectively, in agreement with experimental studies. The present models can be used to conductin silicostudies on how the kidney adapts to alterations in Ca2+and Mg2+homeostasis during various physiological and pathophysiological conditions, such as pregnancy, diabetes, and chronic kidney disease.
BatchEval Pipeline: Batch Effect Evaluation Workflow for Multiple Datasets Joint Analysis
Authors: Zhang Chao , Kang Qiang , Li Mei , Xie Hongqing , Fang Shuangsang , Xu Xun
Published: October 2023

As genomic sequencing technology continues to advance, it becomes increasingly important to perform joint analyses of multiple datasets of transcriptomics. However, batch effect presents challenges for dataset integration, such as sequencing data measured on different platforms, and datasets collected at different times. Here, we report the development of BatchEval Pipeline, a batch effect workflow used to evaluate batch effect on dataset integration. The BatchEval Pipeline generates a comprehensive report, which consists of a series of HTML pages for assessment findings, including a main page, a raw dataset evaluation page, and several built-in methods evaluation pages. The main page exhibits basic information of the integrated datasets, a comprehensive score of batch effect, and the most recommended method for removing batch effect from the current datasets. The remaining pages exhibit evaluation details for the raw dataset, and evaluation results from the built-in batch effect removal methods after removing batch effect. This comprehensive report enables researchers to accurately identify and remove batch effects, resulting in more reliable and meaningful biological insights from integrated datasets. In summary, the BatchEval Pipeline represents a significant advancement in batch effect evaluation, and is a valuable tool to improve the accuracy and reliability of the experimental results.

Availability & Implementation

The source code of the BatchEval Pipeline is available athttps://github.com/STOmics/BatchEval.
Genomic landscape of endometrial, ovarian and cervical cancers in Japan from database in the Center for Cancer Genomics and Advanced Therapeutics
Authors: Xi Qian , Kage Hidenori , Ogawa Miho , Matsunaga Asami , Nishijima Akira , Sone Kenbun , Kawana Kei , Oda Katsutoshi
Published: October 2023

Objective

This study aimed to comprehensively clarify genomic landscape, and its association with tumor mutation burden-high (TMB-H, ≧10 mut/Mb) and microsatellite instability-high (MSI-H) in endometrial, cervical, and ovarian cancers.

Methods

We obtained genomic datasets of a comprehensive genomic profiling test, FoundationOne® CDx, with clinical information by using the “Center for Cancer Genomics and Advanced Therapeutics” (C-CAT) database in Japan. The patients could take the tests only after the standardized treatments under universal health insurance coverage.

Results

Endometrial cancers (n=561) were characterized by high frequency of tumor mutational burden-high (TMB-H) (13.9%) and MSI-high (MSI-H) (10.8%), especially in endometrioid carcinomas. The lower ratio ofPOLEexonuclease mutations (1.4%) and higher ratio ofTP53mutations (54.4%) than previous reports suggested the prognostic impact of the molecular subtypes. Among 839 cervical cancers, frequent mutations ofKRAS(32.2%),TP53(29.4%),PIK3CA(22.2%),STK11(22.2%),CDKN2A(18.3%), andERBB2(16.7%) were observed in adenocarcinomas, while the ratio of TMB-H was significantly higher in squamous cells carcinomas (20.6%). Among 1,606 ovarian cancers, genomic profiling of serous (n=784), clear cell (n=333), endometrioid (n=92), and mucinous carcinomas (n=91) was characterized. Pathogenic mutations in thePOLEexonuclease domain were linked to high TMB (TMB >100 mut/Mb), and the mutation ratio was low in both cervical (0.0%) and ovarian cancer (0.19%).

Conclusion

The C-CAT database is useful to provide mutational landscape of each cancer type and each histological subtype. As the dataset is collected exclusively from patients after the standardized treatments, the information of “druggable” alterations highlights the unmet needs for drug development in major gynecological cancers.
Neural consequences of 5-Hz transcranial alternating current stimulation over right hemisphere: an eLORETA EEG study
Authors: Lee Tien-Wen , Li Chiang-Shan R. , Tramontano Gerald
Published: October 2023

Introduction

Transcranial alternating current stimulation (tACS) at 5-Hz to the right hemisphere can effectively alleviate symptoms of anxiety. The objective of this study was to explore the neural mechanisms that drive the therapeutic benefits.

Methods

We collected electroencephalography (EEG) data from 24 participants with anxiety disorders both before and after the tACS treatment during a single session. We applied the stimulation over the right hemisphere, with 1.0 mA at F4, 1.0 mA at P4, and 2.0 mA at T8, following the 10-10 EEG convention. With eLORETA, we transformed the scalp signals into the current source density in the cortex. We then assessed the differences between post- and pre-treatment brain maps across multiple spectra (delta to low gamma) with non-parametric statistics.

Results

We observed a trend of heightened power in alpha and reduced power in mid-to-high beta and low gamma, in accord with the EEG markers of anxiolytic effects reported in previous studies. Additionally, contrary to the widely circulated entrainment theory of the neural effects of tACS, we observed a consistent trend of de-synchronization at the stimulating sites across spectra.

Conclusion

We confirmed that tACS 5-Hz over the right hemisphere demonstrated EEG markers of anxiety reduction. Regarding changes in power spectra, the effects of tACS on the brain are intricate and cannot be explained solely by entrainment theory.
Trends, Outcomes, and Healthcare Disparities of Asian patients with Heart Failure and Advanced Chronic Kidney Disease
Authors: Tan Samuel S. , Tan Wenchy YY. , Zheng Lucy S. , Kumar Shasawat
Published: October 2023

Background

Data on outcomes and risk factors for Asian patients with advanced chronic kidney disease admitted for heart failure are limited. The purpose of this study was to investigate contemporary racial and socioeconomic disparities in Asian patients with advanced kidney disease admitted for heart failure exacerbation.

Methods

This was a retrospective cohort study that utilized data from the National Inpatient Sample between January 2016 and December 2020. Patients who had a primary diagnosis of HF and a concomitant diagnosis of advanced CKD were included. The primary outcome of interest was in-hospital mortality. Secondary outcomes include hospital cost, length of stay, and other clinical outcomes. Weighted multivariable logistic regression was used to adjust for comorbidities.

Results

A total of 186,431 admissions for heart failure exacerbation with advanced kidney disease were identified, of which 10.7% (n =20,006) were of Asian descent. Asian patients had the lowest prevalence of comorbidities compared with all other ethnicities. After adjusting for comorbidities, sex, and age, Whites (OR: 1.11; 95% CI 1.03 to 1.20; p<0.009) had higher odds of mortality, while Black (OR: 0.58; 95% CI 0.53 to 0.63; p< 0.001) and Hispanic patients (OR: 0.69; 95% CI 0.62 to 0.78; p< 0.001) had lower odds of mortality compared to Asian patients.

Conclusion

Despite recent efforts to address healthcare inequality, health disparities among Asian patients with HF and CKD remain. The significant difference in odds of mortality and complications, despite a lower comorbidity burden, indicates the importance of further research regarding the possible causality of such disparities.
How does the macroenvironment influence brain and behaviour – a review of current status and future perspectives
Authors: Polemiti Elli , Hese Soeren , Schepanski Kerstin , Yuan Jiacan , Schumann Gunter ,   environMENTAL consortium
Published: October 2023

The environment influences mental health, both detrimentally and beneficially. Current research has emphasized the individual psychosocial ‘microenvironment’. Less attention has been paid to ‘macro-environmental’ challenges including climate change, pollution, urbanicity and socioeconomic disparity. With the advent of large-scale big-data cohorts and an increasingly dense mapping of macroenvironmental parameters, we are now in a position to characterise the relation between macroenvironment, brain, and behaviour across different geographic and cultural locations globally. This review synthesises findings from recent epidemiological and neuroimaging studies, aiming to provide a comprehensive overview of the existing evidence between the macroenvironment and the structure and functions of the brain, with a particular emphasis on its implications for mental illness. We discuss putative underlying mechanisms and address the most common exposures of the macroenvironment. Finally, we identify critical areas for future research to enhance our understanding of the aetiology of mental illness and to inform effective interventions for healthier environments and mental health promotion.
Dissecting the causal relationships between childhood-onset asthma and major mental disorders: a univariable and multivariable Mendelian randomization study
Authors: Chen Banghong , Xue Mingzhu , Zhang Lan , Ren Peng
Published: October 2023

Background

Asthma with a childhood-onset is found to be associated with increased risk of severe mental illnesses in later life. However, the causal relationships between childhood-onset asthma and major mental disorders remained unclear.

Methods

We conducted a two-sample Mendelian randomization (MR) analysis to investigate the causal effects of childhood-onset asthma (n=327,670) on six major mental illnesses, including major depressive disorders (n=143,265), bipolar disorder (n=353,899), schizophrenia (n=130,644), anxiety (n=10,240), autism (n=46,350), and ADHD (n=225,534) using summary statistics of genome-wide association studies (GWAS). The inverse variance weighted (IVW) method, along with weighted median and MR-Egger were employed for the causal estimates. Multiple sensitivity analyses were conducted to examine the robustness of the estimates. Moreover, the direct effects of childhood-onset asthma on mental disorders after accounting for the effects of adult-onset asthma were evaluated through the multivariable MR (MVMR) analysis.

Results

We found that genetically determined childhood-onset asthma significantly increased the risk of depression (IVW OR=1.059, 95%CI:1.025-1.095, p=5.72e-04) and bipolar disorder (IVW OR=1,065, 95%CI:1.027-1.105, p=6.75e-04), but not associated with other mental disorders. Further MVMR analysis indicated that the causal relationships remained significant with the adjustment of adult-onset asthma. Interestingly, we found that childhood-and adult-onset asthma exerted distinct causal effects on depression and bipolar disorders. No significant heterogeneity and horizontal pleiotropy were found to influence the causal estimates.

Conclusions

MR analysis indicated a significant causal relationship between genetically determined childhood-onset asthma and increased risk of depression and bipolar disorder in later life. The causal effects of childhood-onset asthma were distinct to the adult-onset asthma. Further studies were warranted to investigate the mechanisms underlying the causal relationships.