bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing Hearing Outcomes in Irradiated and Conservatively Managed Vestibular Schwannoma
Authors: Ismail Omneya , Sobhy Ossama , Assal Samir , Sanghera Paul , Begg Philip , Irving Richard
Published: January 2022

Objective:

Compare hearing outcome for vestibular schwannoma patients following stereotactic radiosurgery (SRS) or conservative management.

Study Design:

Retrospective review.

Setting:

University Hospital.

Patients:

Patients with small- or medium-sized sporadic vestibular schwannoma (intracanalicular or with CPA component <2 cm) who were managed conservatively or underwent SRS with available clinical, radiological, and audiometric data from the time of presentation (or just before radiotherapy for the SRS group) and most recent follow-up; with the two sets of data to be compared being at least 3 years apart (minimum follow-up period).

Interventions:

SRS or observation.

Main Outcome Measure:

Pure-tone averages, speech discrimination scores, and corresponding hearing classifications.

Results:

Two hundred forty-seven patients met our inclusion criteria; 140 were managed conservatively with a mean follow-up period of 5.9 ± 1.6 years and 107 underwent SRS with a mean follow-up period of 7.1 ± 1.9 years. There was significant deterioration of hearing measures for both groups; with the SRS group displaying consistently worse measures. SRS patients showed worse mean pure-tone averages and speech discrimination scores decline rates by 2.72 dB/yr and 2.98 %/yr, respectively, when compared with conservatively managed patients. Stratifying patients according to Tokyo's hearing classification revealed that 68.75% of conservatively managed patients who had baseline serviceable hearing preserved their hearing throughout the studied period compared with only 15.38% of the SRS patients.

Conclusion:

Based on our data we conclude that patients with small- and medium-sized tumors will have a better hearing outcome if managed via an initial conservative approach with radiotherapy reserved for those demonstrating disease progression.
Mesenchymal Stem Cells for Treatment of Delayed-Healing Tympanic Membrane Perforations Using Hyaluronate-based Laminas as a Delivery System: An Animal Model With Histopathologic Study
Authors: Shahal David , Goncalves Stefania , Angeli Simon I.
Published: January 2022

Hypothesis:

Bone marrow derived-mesenchymal stem cells (BM-MSCs) improve the healing of chronic tympanic membrane perforations (cTMPs) in an animal model.

Background:

cTMPs generate significant morbidity and reduced quality of life, usually requiring surgical assistance. With growing interest in alternative therapies, we sought to evaluate the effect of BM-MSC-therapy on the healing of cTMPs.

Methods:

Sixty cTMPs were established in C57Bl/6 mice and randomized into four groups: hyaluronate scaffold as graft plus BM-MSCs (n = 19 ears), scaffold plus cell culture media (n = 16), scaffold plus phosphate-buffered saline (PBS, n = 12), and no intervention (n = 13). Hyaluronate scaffolds with or without BM-MSCs were applied on 8-week perforated eardrums. After a blinded assessment of perforation sizes at baseline and 2 weeks after treatment, mean perforation reduction rates (%) were compared. Histology characterization was then performed.

Results:

Mean perforation size reduction rates were significantly higher for cTMPs that received scaffolds plus BM-MSCs (Student's t test, p = 0.0207, 12.3% [95% CI: 7.8–16.7]) and scaffolds plus cell culture media (p = 0.0477, 11.3% [95% CI: 4.4–18.2]) when compared with no intervention (4.2% [95% CI: 1.2–7.2]). This was not observed when treating eardrums with scaffolds plus PBS (7.3% [95% CI: 2.7–11.9]). On histology, BM-MSC-treated eardrums demonstrated restoration of the trilaminar configuration and reduced inflammatory changes, while other groups developed tissue architecture disorganization and hypercellular infiltrates surrounding the perforation site.

Conclusions:

BM-MSCs and cell culture media equivalently increased cTMP healing rates. Cell-based therapy conferred a restoration of the trilaminar configuration of the eardrum with relatively compact and organized fibrous layers.
Clinical efficacy of arthroscopic treatment in ischial tuberosity cyst
Authors: Zhu Ying-chun , Mi Yun-feng , Jiang Bo , Dong Qirong
Published: January 2022

Ischial tuberosity cyst is a common disease, and the conventional incision procedure is associated with several disadvantages, leading to unsatisfactory therapeutic outcomes. The aim of the study was to evaluate the clinical outcomes of arthroscopic treatment for ischial tuberosity cyst and compared it with conventional incision surgery.

The clinical data of 57 patients with ischial tuberosity cyst from May 2016 to September 2018 were retrospectively analyzed. According to the inclusion and exclusion criteria, a total of 49 patients were included. Of these patients, 24 patients received arthroscopic procedure (N = 24) and 25 patients received conventional incision procedure (N = 25). The operation time, intraoperative blood loss, postoperative drainage, postoperative hospital stay, and postoperative complications were compared between the 2 groups. Visual analogue scale scores was used to evaluate pain at 1 day, 1 week, and 1 month after the surgery.

All 49 patients were followed up for (11.3 ± 3.3) months. All patients in the arthroscopy group achieved phase I healing while 3 patients in conventional incision group developed complications. The operation time, intraoperative blood loss, postoperative drainage, and hospital stay in the arthroscopy group were (54.7 ± 7.7) minutes, (20.8 ± 3.5) mL, (20.3 ± 5.6) mL, and (2.8 ± 0.6) days, and were significantly better than those of (71.8 ± 8.8) minutes, (67.3 ± 12.0) mL, (103.6 ± 20.3) mL, and (7.8 ± 2.9) days in the conventional incision group, respectively. In the arthroscopy group, the visual analogue scale scores at 1 day, 1 week, and 1 month after the surgery [(2.6 ± 0.7), (0.5 ± 0.6), (0.3 ± 0.5) points] were significantly lower than those in the conventional incision group [(6.0 ± 0.7), (3.0 ± 1.0), and (1.1 ± 1.0) points], and the differences were statistically significant (P < .05). Finally, no significant difference was observed in the incidence of postoperative complications between the 2 groups (P > .05).

In the treatment of ischial tuberosity cysts, arthroscopy has advantages of minimal invasion, less blood loss during perioperative period, milder postoperative pain, and rapid recovery when compared with conventional incision surgery.
Thermotherapy for shoulder pain
Authors: Bin Chen , Cimin Shen , Li Na , Wang Lu , Chen Dandan
Published: January 2022

Background:

Shoulder pain is a common musculoskeletal disorder prompting many patients to seek treatment. Thermotherapy is a common treatment for shoulder which has been widely used in hospitals. But its efficiency has not been scientifically and methodically evaluated. This protocol aims to evaluate the efficacy and safety of thermotherapy for treating shoulder pain.

Methods:

Eight databases will be searched from their inception to October 2021. They are as follows: PubMed, Embase, Cochrane Library, ClinicalTrials.gov, China Knowledge Resource Integrated Database (CNKI), Weipu Database for Chinese Technical Periodicals (VIP), Chinese Biomedical Literature Database (CBM), and Wanfang Database. Two researchers will independently select studies, collect data, and assess the methodology quality by the Cochrane risk of bias tool.

Results:

The systematic review will provide high-quality evidence to assess the efficacy and safety of thermotherapy for shoulder pain as well as adverse events.

Conclusion:

The systematic review will provide evidence to assess the effectiveness and safety of thermotherapy therapy for shoulder pain patients.

INPLASY registration number:

INPLASY2021110086.
The effects on pain and quality of life of traditional Chinese manual therapy for knee osteoarthritis
Authors: Zheng Yu , Ren Jun , Zhang Shuaipan , Zhou Xin , He Tianxiang , Kong Lingjun
Published: January 2022

Background:

Knee osteoarthritis (KOA) is a common disease with the high occurrence in the world. The symptoms of pain and dysfunction decrease quality of life in KOA patients. Several studies reported traditional Chinese manual therapy showed beneficial effects in improving pain and dysfunction of patient with KOA, but most previous reviews did not focus on the effects on quality life of traditional Chinese manual therapy for KOA. However, better quality of life is important for patients suffering KOA. Therefore, the current review and meta-analysis will be conducted to assess the effects on clinical symptoms and quality of life of traditional Chinese manual therapy for KOA.

Methods:

Eight electronic databases including PubMed, Embase, the Cochrane Library, Web of Science, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang Data, and Chinese Scientific Journal Database will be searched from the beginning to December 2021. Two reviewers will independently select included studies and extract data. Heterogeneity will be evaluated by I

2
statistic before the data synthesis. Subgroup analysis will be performed by duration of KOA, different types of traditional Chinese manual therapy, different outcomes, and different intervention time. The primary outcome is quality of life in KOA patients, and the secondary outcomes include pain and dysfunction due to KOA. Rev Man 5.3 software will be used for meta-analysis.

Results:

The results of this review will be reported in a peer-reviewed journal.

Conclusion:

The results of this review will provide reliable evidence for the effects on quality of life and clinical symptoms of traditional Chinese manual therapy for KOA.

INPLASY registration number:

INPLASY2021120043
Femoral varus derotational osteotomy without pelvic osteotomy in nonambulatory children with cerebral palsy
Authors: Iwase Dai , Fukushima Kensuke , Kusumoto Yasuaki , Metoki Yukie , Aikawa Jun , Kenmoku Tomonori , Minato Sayoko , Matsuo Atsushi , Takaso Masashi
Published: January 2022

Whether femoral varus derotational osteotomy (VDRO) alone or a combination of femoral and pelvic osteotomies should be performed for hip dislocation in nonambulatory children with cerebral palsy (CP) remains controversial. Few studies have reported radiographical results after the surgical treatment in nonambulatory children with CP. This study aimed to assess the results and determine predictors indicating progressive hip subluxation and redislocation after VDRO without pelvic osteotomy. We retrospectively analyzed 22 hips in 15 nonambulatory children with CP. All patients underwent VDRO without pelvic osteotomy and were followed up for at least 5 years. The mean follow-up period was 7.3 ± 1.9 years. In radiological assessments, we investigated migration percentage (MP), center-edge angle, neck-shaft angle, teardrop distance, break in Shenton's line (SL), sharp's angle, acetabular ridge angle (ARA), and the change ratio of MP (Change MP). We classified patients with an MP of <40% at final follow-up in the Good group and those with an MP of ≥40% in the Poor group. The Good group included 10 children (14 hips), and the Poor group included 8 children (8 hips). No preoperative differences were found in the means of all the radiographical parameters. However, MP was significantly different between the groups from 1 year postoperatively. ARA showed improvement 5 years after surgery in the Good group. Change MP in the Good group was maintained from immediately after surgery to the final follow-up. Multivariate logistic regression analyses revealed that preoperative break in SL and Change MP immediately after surgery were parameters to predict MP at the final follow-up. In the receiver operating characteristic analysis, the cut-off values were estimated to be 19.2 mm for preoperative SL and 79.0% for Change MP immediately after surgery. Within 7.3 years of follow-up, 63.6% of the patients who underwent VDRO without pelvic osteotomy had good results. Preoperative SL and postoperative Change MP can be considered as predictors of postoperative subluxation and/or dislocation.
The effect of lung-conduction exercise in chronic obstructive pulmonary disease
Authors: Lee Su Won , Park Jae Jun , Lyu Yee Ran , Lee Eun Jung , Kim Si Yeon , Kang Weechang , Son Ji Woong , Jung In Chul , Park Yang Chun
Published: January 2022

Background:

Pulmonary rehabilitation (PR) is a management modality that improves the quality of life of patients with chronic obstructive pulmonary disease (COPD); however, PR is not readily accessible. Therefore, we developed lung-conduction exercises (LCE) that can be performed easily without any limitations. The purpose of this randomized, assessor-blind, multicenter pilot trial was to compare the effects of LCE with PR and standard care (SC) in COPD patients.

Methods:

Twenty-five participants who met the eligibility criteria were randomly allocated to the SC group (only medication, n = 9), LCE group (medication + LCE, 5 times a week, n = 8), or PR group (medication + PR, 5 times a week, n = 8). The 6-minute walk distance (6WMD), pulmonary function test, modified Medical Research Council dyspnea scale, COPD assessment test (CAT), and St. George Respiratory Questionnaire (SGRQ) survey were carried out before starting the trial and after 4 and 8 weeks to determine motor performance, lung function, and dyspnea.

Results:

After 8 weeks, the pulmonary function test scores were the same. The 6MWD (PR, 28.3 ± 38.5; LCE, 14.5 ± 53.1; SC, 11.5 ± 20.5; P = .984), modified Medical Research Council dyspnea scale (PR, 0.8 ± 1.0; LCE, 0.8 ± 0.8; SC, 0.3 ± 0.5; P = .772), CAT (PR, 7.3 ± 6.2; LCE, 4.2 ± 5.2; SC, 1.0 ± 2.2; P = .232), and SGRQ scores (PR, 11.5 ± 15.4; LCE, 5.5 ± 13.1; SC, 4.8 ± 5.1; P = .358 [PR vs LCE], P = .795 [PR vs SC]) had improved in order of PR, LCE, and SC group. Although there were no statistically significant differences in the outcome measures between the groups, there were clinically significant improvements in the CAT and SGRQ scores.

Conclusions:

In this trial, PR showed more improvement in symptoms and quality of life than SC alone. To seek a more precise use of LCE, further full-sized studies with a long duration and additional outcome measures such as psychological assessment tools and cost-effectiveness ratio should be conducted.

Trial registration:

KCT0004724.
Gender differences in motor and non-motor symptoms in early Parkinson disease
Authors: Kang Kyung Wook , Choi Seong-Min , Kim Byeong C.
Published: January 2022

Gender differences in motor and non-motor symptoms in Parkinson disease (PD) are still controversial. This study aimed to investigate gender differences in clinical characteristics in patients with early PD.

This study included 415 PD patients (201 men and 214 women) with modified Hoehn-Yahr stage 1 to 3 and a disease duration of ≤5 years. Demographic information was obtained by interviews, and motor and non-motor PD symptoms were evaluated with appropriate scales.

Women with PD had a shorter duration of formal education than men with PD. No significant differences were found in other demographic variables. Women with PD had significantly lower scores in Unified Parkinson Disease Rating Scale part III and postural tremor compared to men with PD, which was significant after controlling for formal education. No significant gender-related differences were found in scores related to other motor symptoms. Concerning non-motor symptoms, men with PD had higher scores of sexual function on the Non-Motor Symptoms Scale, which means sexual dysfunction was more severe or occurred more frequently in men with PD. Women with PD had significantly higher scores of sleep disturbance in the Pittsburgh Sleep Quality Index, which was not significant after adjustment for multiple comparison.

The present study suggests that women with PD had milder motor symptoms compared to men with PD, and gender differences in sexual function can be observed as non-motor symptoms.
The impact of biological features for a better prediction of posttransplant hepatocellular cancer recurrence
Authors: Lai Quirino , lesari Samuele , Lerut Jan P.
Published: January 2022

Purpose of review

Morphological criteria (i.e., Milan Criteria) have been considered for a long time to be the best tool for selecting patients with hepatocellular cancer (HCC) waiting for liver transplantation (LT). In the last ten years, a refinement of the selection criteria has been observed, with the introduction of biological tumor characteristics enabling to enlarge the number of potential transplant candidates and to select LT candidates with a lower risk of posttransplant recurrence.

Recent findings

Several biological tumor aspects have been explored and validated in international cohorts to expand the ability to predict patients at high risk for recurrence. Alpha-fetoprotein, radiological response to locoregional treatments, and other more recently proposed markers have been principally explored. Moreover, more complex statistical approaches (i.e., deep learning) have been advocated to explore the nonlinear intercorrelations between the investigated features.

The addition of biological aspects to morphology has improved the ability to discriminate among high- and low-risk patients for recurrence. New prognostic algorithms based on the more sophisticated artificial intelligence approach are further improving the capability to select LT candidates with HCC.
Leveraging Implementation Science to Achieve Empirical Outcomes
Authors: Kaiser Jennifer
Published: January 2022

Organizations are often challenged to demonstrate the evidence of empirical outcomes required for Magnet® application and designation. Theoretically, the application of evidence-based guidelines to the clinical setting leads to empirical outcomes. However, successful integration of guidelines into practice remains problematic. This article explains how organizations can leverage implementation science to promote the effective uptake of best practice standards to achieve the outcomes necessary to improve care and demonstrate Magnet standards.
Impact of Practice Scholarship as Perceived by Nurses Holding a DNP Degree
Authors: Kesten Karen S. , Moran Katherine , Beebe Sarah L. , Conrad Dianne , Burson Rosanne , Manderscheid Amy , Pohl Elizabeth , Corrigan Catherine
Published: January 2022

OBJECTIVE

The aim of this study was to explore the perceived impact of practice scholarship among DNP-prepared nurses and the relationship of impact to primary work role and years since graduation.

BACKGROUND

Healthcare organizations continuously seek ways to improve health outcomes and reduce cost. Doctor of Nursing Practice–prepared nurses are educated with essential competencies to lead healthcare reform initiatives based on their practice scholarship contribution.

METHODS

A cross-sectional design was used to administer a self-report online survey to a convenience sample of 306 DNP graduates currently in practice.

RESULTS

The highest impact of practice scholarship was perceived on patients, populations, quality of care, and the profession. The impact on policy, cost, and cost savings was significantly lower. No significant difference was found on practice scholarship impact based on role or between years of experience since graduation.

CONCLUSION

Doctor of Nursing Practice competencies support practice scholarship outcomes. Organizational resources are needed to support the impact of practice scholarship.
Resilience, Moral Distress, and Job Satisfaction Driving Engagement in Emergency Department Nurses
Authors: Clark Paul , Hulse Brandonn , Polivka Barbara J.
Published: January 2022

AIM

The aim of this study was to explore how resilience, job satisfaction, and moral distress affect emergency department (ED) nurses' workplace engagement.

BACKGROUND

Stressful nursing workplace conditions increase moral distress. Lowering moral distress and improving resilience can increase workplace engagement.

METHOD

Semistructured qualitative interviews were conducted with 15 ED nurses.

RESULTS

Participants indicated that greater nursing experience, increased confidence in skills, ability to overcome emotional stressors, and more satisfaction with patient care all improved resilience and workplace engagement. Morally distressed, disengaged nurses reportedly lacked workplace autonomy and/or ability to make workplace changes or worked in hostile and/or unsafe workplaces. Engaged nurses invested more time in their job and were more willing to remain in their workplace.

CONCLUSION

Retaining older, more experienced nurses, valuing staff work, and creating a meaningful workplace foster workplace engagement.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers can support nurses' workplace engagement through interventions that build resilience, lower moral distress, and increase job satisfaction.
The Relation of End-Tidal CO2 Values With Infarct Volume and Early Prognosis in Patients With Acute Ischemic Stroke
Authors: Eyler Yesim , Kilic Turgay Yilmaz , Duman Atilla Ozge , Arslan Yildiz , Capar Ahmet Ergin , Idil Hasan , Suner Asli
Published: January 2022

Background:

The aim of this study is to reveal the relationship between end-tidal CO2 (EtCO2) values with infarct volume and early prognosis in patients diagnosed with acute ischemic stroke in the emergency department.

Materials and Methods:

This prospective cross-sectional study was conducted in a tertiary hospital. The demographics, characteristics, EtCO2, volume of the stroke area on diffusion-weighted magnetic resonance imaging and the modified Rankin Scale (mRS) of the patients were recorded. The values calculated at admission and at discharge were labeled as “mRS-1” and “mRS-2,” respectively, and the mRS-2 measurement was used as a prognostic indicator. The “good” and the “poor” functional outcomes were defined as mRS ≤2 and mRS >2, respectively. Correlations between levels of EtCO2 and infarct volume, mRS were calculated.

Results:

In total, 44 patients were included in the study. The median age of the patients was 69 years (interquartile range; 16; min-max: 35 to 88 y) and 68.2% of them were male. In the univariate logistic regression models of the mRS-2 [0 to 2 (0) and 3 to 6 (1)], all variables were not statistically significant to predict mRS-2 group. There were statistically significant differences in EtCO2 values between mRS-1 (P=0.03) and mRS-2 (P=0.04). A negative moderate correlation was found between EtCO2 and mRS-2 (r=−0.410; P=0.006). The correlation between EtCO2 and infarct volume was not statistically significant (r=−0.256; P=0.093).

Conclusions:

This study highlights the importance of capnography follow-up of patients with acute ischemic stroke. In patients with acute ischemic stroke, the EtCO2 value measured at the time of admission is lower in the group with high mRS at both admission and discharge.
Comparison of Arterial Ischemic and Hemorrhagic Pediatric Stroke in Etiology, Risk Factors, Clinical Manifestations, and Prognosis
Authors: Pangprasertkul Sipang , Borisoot Wattawan , Buawangpong Nida , Sirikul Wachiranun , Wiwattanadittakul Natrujee , Katanyuwong Kamornwan , Sanguansermsri Chinnuwat
Published: January 2022

Background

Stroke is relatively rare in children but has a significant impact on long-term morbidity and mortality. There are limited data regarding the etiology, clinical manifestation, and prognosis of arterial ischemic stroke (AIS) and hemorrhagic stroke (HS) in children.

Objective

The aim of this study is to identify and compare etiology, risk factors, clinical manifestations, and prognostic outcomes between arterial ischemic and hemorrhagic pediatric stroke.

Methods

We retrospectively reviewed all hospital medical records and pediatric neurology database of 83 children who were first diagnosed with AIS and HS at the Pediatric Department, Chiang Mai University Hospital, Chiang Mai, Thailand between January 1, 2009, and December 31, 2018. All children were from 1 month to 18 years old.

Results

Fifty-one AIS (56%) and 32 (35.2%) HS were identified. The median age of onset was 6.9 years for AIS and 5.3 years for HS. Moyamoya disease/syndrome was the most common cause in AIS (21.6%). Rupture of cerebral arteriovenous malformation was the most common cause in HS (21.9%). More than one-third (39%) of children had multiple risk factors associated with stroke. Iron deficiency anemia was commonly found in children with AIS (39.2%). The majority of clinical presentations were hemiparesis (80.4%) for AIS and alteration of consciousness (68.8%) for HS. The median time to diagnosis exceeded 6 hours in both AIS and HS. The overall mortality rate of acute stroke was 5.1 per 100 person-years (95% confidence interval [CI], 2.9–9). The mortality rate was higher in HS compared with that in AIS with statistical significance (16.6; 95% CI, 8.9–30.8 vs 1.1%; 95% CI, 0.3–4.6 per 100 person-years). Thirty children (36.1%) developed epilepsy during the follow-up (median duration, 26 months). Recurrent stroke occurred in 1 child with AIS and 1 child with HS.

Conclusions

Moyamoya disease/syndrome and arteriovenous malformation rapture are the most common cause of AIS and HS, respectively. Iron deficiency anemia was commonly found in childhood AIS. The time to diagnosis in both AIS and HS was delayed. The mortality rate in HS was higher than in AIS. Neurological deficits are seen in 70% of childhood AIS during the follow-up. One-third of the children in our study developed epilepsy, which generally responds to a single antiseizure medication. The recurrence rate of childhood stroke was low compared with adult stroke.
Describing the Patient Population of a Pediatric Emergency Department Based on Visit Frequency
Authors: Hall Jeanine E. , Pham Phung K. , Liberman Danica B.
Published: January 2022

Objective

A small number of children in the United States use a disproportionate share of emergency healthcare services. Our study objective was to examine characteristics associated with frequent pediatric emergency department (PED) utilization.

Methods

A retrospective cohort-sequential study of patients seen in the PED of an urban children's hospital was conducted. Patients were categorized into 2 groups: infrequent users (<4 visits during index year 2017) and frequent users (≥4 visits in 2017). Frequent PED users were further divided into persistent frequent (≥4 visits in the year before and after 2017) and incidental frequent (≥4 visits in 2017). Patient- and visit-level characteristics were analyzed for associations with PED utilization.

Results

In 2017, there were 82,361 visits by 56,767 patients to our PED. Frequent users comprised 4% of the total patient volume but accounted for 13% of visits. Compared with infrequent users, frequent users were younger, more likely publicly insured, and English speaking. Frequent user visits were more likely to occur outside clinic hours, be triaged as emergent, and involve subspecialists. Compared with visits by incidental frequent users, visits by persistent frequent users were more likely to be emergent or urgent, and involve subspecialists, diagnostic imaging, laboratory testing, and medication administration.

Conclusions

Although the percentage of frequent users to a PED in 2017 was low, they made up a disproportionate share of total visits. Differences between persistent and incidental frequent PED users suggest that these subgroups may benefit from tailored interventions to reduce frequent PED utilization.
Monoclonal Antibodies in Acute Myeloid Leukemia—Are We There Yet?
Authors: Abaza Yasmin , Fathi Amir T.
Published: January 2022

Despite recent advances in the treatment of acute myeloid leukemia (AML), relapses remain high, and long-term survival is poor, emphasizing the need for better treatment options. Development of targeted antibody-based immunotherapeutic agents has been an area of growing research in AML. Target antigens of interest include CD33, CD123, CD47, CD70, FLT3, and CLL-1 because of their high expression on AML blasts and leukemic stem cells. Gemtuzumab ozogamicin, a CD33-directed antibody-drug conjugate, is the only Food and Drug Administration–approved monoclonal antibody (mAb) in AML providing evidence for the potential future role of mAb-based therapies in AML. This article provides an overview of the progress made in targeted immunotherapy in AML, particularly focusing on unconjugated and conjugated mAbs.
Preoperative Depression Status and 5 Year Metabolic and Bariatric Surgery Outcomes in the PCORnet Bariatric Study Cohort
Authors: Coughlin Janelle W. , Nauman Elizabeth , Wellman Robert , Coley R. Yates , McTigue Kathleen M. , Coleman Karen J. , Jones Daniel B. , Lewis Kristina H. , Tobin Jonathan N. , Wee Christina C. , Fitzpatrick Stephanie L. , Desai Jay R. , Murali Sameer , Morrow Ellen H. , Rogers Ann M. , Wood G. Craig , Schlundt David G. , Apovian Caroline M. , Duke Meredith C. , McClay James C. , Soans Rohit , Nemr Rabih , Williams Neely , Courcoulas Anita , Holmes John H. , Anau Jane , Toh Sengwee , Sturtevant Jessica L. , Horgan Casie E. , Cook Andrea J. , Arterburn David E. ,   for the PCORnet Bariatric Study Collaborative
Published: January 2022

Objective:

To examine whether depression status before metabolic and bariatric surgery (MBS) influenced 5–year weight loss, diabetes, and safety/utilization outcomes in the PCORnet Bariatric Study.

Summary of Background Data:

Research on the impact of depression on MBS outcomes is inconsistent with few large, long–term studies.

Methods:

Data were extracted from 23 health systems on 36,871 patients who underwent sleeve gastrectomy (SG; n=16,158) or gastric bypass (RYGB; n=20,713) from 2005–2015. Patients with and without a depression diagnosis in the year before MBS were evaluated for % total weight loss (%TWL), diabetes outcomes, and postsurgical safety/utilization (reoperations, revisions, endoscopy, hospitalizations, mortality) at 1, 3, and 5 years after MBS.

Results:

27.1% of SG and 33.0% of RYGB patients had preoperative depression, and they had more medical and psychiatric comorbidities than those without depression. At 5 years of follow-up, those with depression, versus those without depression, had slightly less %TWL after RYGB, but not after SG (between group difference = 0.42%TWL, P = 0.04). However, patients with depression had slightly larger HbA1c improvements after RYGB but not after SG (between group difference = – 0.19, P = 0.04). Baseline depression did not moderate diabetes remission or relapse, reoperations, revision, or mortality across operations; however, baseline depression did moderate the risk of endoscopy and repeat hospitalization across RYGB versus SG.

Conclusions:

Patients with depression undergoing RYGB and SG had similar weight loss, diabetes, and safety/utilization outcomes to those without depression. The effects of depression were clinically small compared to the choice of operation.
Factors Influencing Quality of Life Among Older Persons Living With Osteoarthritis Using 3 Different Definitions
Authors: Mat Sumaiyah , Ng Chin Teck , Fadzli Farhana , Rozalli Faizatul Izza , Morgan Karen , Tan Maw Pin
Published: January 2022

Aim:

While the impact of osteoarthritis (OA) on the older person's quality of life (QoL) has been established, the associations are complicated by numerous potential mediators and variations in diagnostic criteria. This study was conducted to explore the relationship between OA and QoL and the influence of physical performance, symptoms severity, and psychological factors on this potential relationship using 3 different methods of identification of OA.

Methods:

This cross-sectional study used data from the Malaysian Falls Assessment and Intervention Trial study. Radiological OA (ROA), clinical OA (COA), or self-reported physician-diagnosed OA (SOA) was determined using established criteria. Quality of life was measured with the 19-item Control, Autonomy, Self-Realization and Pleasure (CASP-19) questionnaire.

Results:

Of 370 participants (219 fallers, 151 nonfallers), mean (SD) age = 73.71 (6.57) years, COA (odds ratio [OR] 95% confidence interval [CI]; 1.38 [0.64-2.94]) and SOA (1.84 [1.19-2.84]) were associated with CASP-19 of 47 and less but not ROA. The association between SOA and CASP-19 of 47 and less was attenuated by physical performance while COA was no longer associated with CASP-19 of 47 and less after adjustment for psychological status.

Conclusion:

Our findings hold important clues to unraveling factors that influence QoL in older adults with OA and will inform future intervention studies aimed at reducing the burden of OA among older adults.
The 2-Minute Step Test
Authors: Mollinedo-Cardalda Irimia , Cancela-Carral José María
Published: January 2022

Background:

The 2-minute step test (2MST) evaluates aerobic endurance in patients with Parkinson's disease and can act as a dual test that also evaluates balance. The aim of this study was to observe how the 2MST behaves in the different Hoehn & Yahr stages of patients with Parkinson's disease and ascertain whether this test can be used to assess the degree of balance presented by patients with Parkinson's disease.

Methods:

A total of 91 people with Parkinson's disease were studied using the 2MST, 8-Foot Up-and-Go, and 6-minute walk test.

Results:

The Pearson correlation was performed between the 2-MST and the other 2 tests (8-Foot Up-and-Go and 6-minute walk test). A significant correlation was observed for the 2MST and the 8-Foot-Up-and-Go, which increased as the disease stage advanced, but the 6-minute walk test showed a significant correlation for Hoehn & Yahr stages I and II.

Conclusion:

We suggest that the 2MST assess both aerobic endurance and dynamic balance in patients with Parkinson's disease with Hoehn & Yahr stages I and II but that it be used to assess balance in stages III and IV.
“Until Body Do Us Part”
Authors: Cannella Valentina , Serrat Rodrigo , Villar Feliciano
Published: January 2022

Using a socioecological model as a theoretical framework, we aimed to explore the barriers to retain in competitive sport 463 senior athletes (aged 61.4 ± 5.5 years) actively engaged in sports disciplines from 4 European countries. Participants answered an open-ended question regarding perceived barriers to continued engagement in sports, and their answers were subject to content analysis. The results highlighted physical determinants as the main reasons for potential disengagement from competitive sports. Our data suggest the need to minimize these potential barriers by implementing programs that are designed to keep senior athletes competing in sports for as long as possible.
Effectiveness of Cognitive Stimulation Personalized by the Preexisting Cognitive Level in Older Adults
Authors: Calatayud Estela , Jiménez-Sánchez Carolina , Calvo Sandra , Brandín-de la Cruz Natalia , Herrero Pablo , Gómez-Soria Isabel
Published: January 2022

This randomized clinical trial analyzed whether a personalized cognitive stimulation based on the individual's preexisting cognitive levels may be more effective in the short and long terms than a standard cognitive stimulation program. In total, 288 older adults were randomized into an intervention group and a control group, stratified according to their cognitive levels. There were significant differences between groups, with a small effect size at postintervention (10 weeks), follow-up I (26 weeks), and follow-up II (52 weeks) (P < .001, 0.2 <r < 0.4) and in the cognitive category (P < .001). The personalization of cognitive stimulation is effective to maintain normal cognitive functioning and to delay cognitive decline.
Validity and Reliability of the Iconographical Falls Efficacy Scale Short Version in Community-Dwelling Older Adults in Turkey
Authors: Yağci Şentürk Aysun , Livanelioğlu Ayşe
Published: January 2022

The Iconographical Falls Efficacy Scale (Icon-FES) is the first scale that consists of visual expressions and evaluates the fear of falling. The study aims to adapt the scale to Turkish. The Icon-FES, the Falls Efficacy Scale International, and the Activities-specific Balance Confidence Scale were applied to 150 older adults. The study indicated that Icon-FES has excellent psychometric properties. Presence of chronic diseases was found to be associated factors affecting the fear of falling (P < .05). The short-version Icon-FES-Turkish is a valid and reliable scale and it should be carried out on illiterate older adults.
Comparison of Grip Strength, Gait Speed, and Quality of Life Among Obese, Overweight, and Nonobese Older Adults
Authors: Park Kyue-nam , Kim Si-hyun
Published: January 2022

Introduction:

Obesity is related to a high risk of chronic diseases and increased rate of morbidity. This study was performed to compare grip strength, gait speed, and quality of life among obese, overweight, and nonobese older adult women.

Methods:

The study population consisted of 62 older adult women older than 65 years. The subjects were classified according to body mass index (BMI) as obese (BMI ≥25 kg/m2; n = 25), overweight (BMI 23-24.9 kg/m2; n = 13), or nonobese (BMI 18.5-22.9 kg/m2; n = 24). Grip strength and gait speed were measured, and quality of life was determined according to the 36-Item Short Form Health Survey (SF-36) questionnaire. One-way analysis of variance with Bonferroni's post hoc analysis was used to analyze the differences in grip strength, gait speed, and SF-36 score among the 3 groups.

Results:

There were significant differences in grip strength (F = 8.053, P = .001) and gait speed (F = 4.850, P  = .011), but not in the physical (F = 2.194, P  = .121) and mental (F = 1.247, P  = .295) composite of the SF-36, among the 3 groups. The obese group showed significantly lower grip strength and slow gait speed compared with the overweight and nonobese groups.

Conclusions:

Obesity in older women has a negative impact on grip strength and gait speed. Grip strength and gait speed reflect health status in older adults, and the findings presented here suggest that grip strength and gait speed should be considered for obesity management in older women.
The Short-Term Effect of Myofascial Relaxation by Roller Massage on Ankle Joint Range of Motion in Older Adults
Authors: Kasli Kutay , Devrim Sahin Ceren , Ilcin Nursen
Published: January 2022

Purpose:

The flexibility of the fascia is reduced with aging, due to degenerative changes in the connective tissue. The aim of this study is to compare the acute effects of roller massager application on the ankle joint range of motion in healthy older adults.

Methods:

Fifty-two community-dwelling older adults who could walk without using ancillary equipment were divided into 2 groups of equal numbers with a table of random numbers. The first group was warmed for 5 minutes, followed by 3 sets of 60-second ankle plantar flexors, while the second group after warmed for 5 minutes was rested for the same period. Active ankle dorsiflexion range of motion was recorded before, after application, 10 minutes and 20 minutes after application, with the mobile goniometer.

Results:

The mean age of the subjects participating in the study was 71.23 ± 4.70 years and the mean body mass index was 30.52 ± 4.43 kg/m2. Before application, there was a statistically significant difference in dorsiflexion angles of the groups (P = .013). In the control group, the first measurement and between measurements had no statistically difference (P = .301) and the angle of dorsiflexion increased statistically significant when the initial and subsequent measurements of the roller massager group were compared (P = .000). Significant differences were noted in the roller massage group when compared with baseline (P = .000), 10 minutes (P = .000), and 20 minutes (P = .006).

Discussion:

In this study, in older adults, the roller massager is effective acutely and this effect is maintained for up to 20 minutes. It has been shown that older adults can be included in physiotherapy programs to increase joint motion. New researches are needed for long-term results.
AI-based graptolite identification improves shale gas exploration
Authors: Niu Zhi-Bin , Xu Hong-He
Published: January 2022

Graptolites are fossils from the mid-Cambrian to lower Carboniferous periods that inform both our understanding of evolution and the exploration of shale gas [1–4]. The identification of graptolite species remains a visual task carried out by experienced taxonomists because their fine-grained morphologies and incomplete preservation in multi-fossil samples have hindered automation. Artificial intelligence (AI) holds great promise for transforming such meticulous tasks, and has already proven useful in applications ranging from animal classification to medical diagnostics [5–15]. Here we demonstrate that graptolites can be identified with taxonomist accuracy using a deep learning model [16–18]. We develop a convolutional neural network to classify macrofossils, and construct a comprehensive dataset of >34,000 images of 113 graptolite species annotated at pixel-level resolution to train the model. We validate the model’s performance by comparing its ability to identify 100 images of graptolite species that are significant for rock dating and shale gas exploration with 21 experienced taxonomists from research institutes and the shale gas industry. Our model achieves 86% and 81% accuracy when identifying the genus and species of graptolites, respectively; outperforming taxonomists in terms of accuracy, time, and generalization. By investigating the decisions made by the neural network, we further show that it can recognise fine-grained morphological details better than taxonomists. Our AI approach, providing taxonomist-level graptolite identification, can be deployed on web and mobile apps to extend graptolite identification beyond research institutes and improve the efficiency of shale gas exploration.
ABLE: Automated Brain Lines Extraction Based on Laplacian Surface Collapse
Authors: Fernández-Pena Alberto , de Blas Daniel Martín , Navas-Sánchez Francisco J. , Marcos-Vidal Luis , Gordaliza Pedro M. , Santonja Javier , Janssen Joost , Carmona Susanna , Desco Manuel , Alemán-Gómez Yasser
Published: January 2022

The archetypical folded shape of the human cortex has been a long-standing topic for neuroscientific research. Nevertheless, the accurate neuroanatomical segmentation of sulci remains a challenge. Part of the problem is the uncertainty of where a sulcus transitions into a gyrus and vice versa. This problem can be avoided by focusing on sulcal fundi and gyral crowns which represent the topological opposites of cortical folding. We present Automated Brain Lines Extraction (ABLE), a method based on Laplacian surface collapse to segment sulcal fundi and gyral crown lines reliably. ABLE is built to work on standard FreeSurfer outputs, and eludes the delineation of anastomotic sulci while maintaining sulcal fundi lines that traverse the regions with the highest depth and curvature. First, it segments the cortex into gyral and sulcal surfaces; then, each surface is spatially filtered. A Laplacian-collapse-based algorithm is then applied to obtain a thinned representation of the surfaces. This surface is then used for careful detection of the endpoints of the lines. Finally, sulcal fundi and gyral crown lines are obtained by eroding the surfaces while preserving the connectivity between the endpoints. The method is validated by comparing ABLE with three other sulcal extraction methods using the Human Connectome Project (HCP) test-retest database to assess the reproducibility of the different tools. The results confirm ABLE as a reliable method to obtain sulcal lines with an accurate representation of the sulcal topology while ignoring anastomotic branches and the overestimation of the sulcal fundi lines. ABLE is publicly available via https://github.com/HGGM-LIM/ABLE.
Expansion and Adaptive Evolution of the mTERF Gene Family in Plants
Authors: Zhao Yanxin , Cai Manjun , Luo Meijie , Zhang Jianhua , Li Yurong , Zhang Xiaobo , Yue Bing , Xiao Hailin , Zhao Jiuran , Zheng Yonglian , Qiu Fazhan
Published: January 2022

Mitochondrial transcription termination factor (mTERF) genes are encoded in the nucleus and bind to nucleic acids to regulate the replication, transcription and translation of mitochondrial genomes. Plants possess a large family of mTERF genes that play important roles in regulating organellar gene expression and stress response. However, their origin and expansion in land plants has not been examined. Here, we conducted a comprehensive molecular evolution analysis of 611 mTERF genes identified in 18 plant species, including algae, moss, fern, gymnosperm and flowering plants. Higher plants have more mTERF genes compared to lower plants, forming a huge higher plant-specific clade (M-class mTERF genes). M-class mTERF genes occur in clusters, suggesting that tandem duplication contributed to their expansion. Compared to other mTERF genes, M-class mTERF genes have undergone rapid evolution, and several significant positively selected sites were located in nucleic acid-binding sites. The strong correlation between the number of M-class mTERF genes and corresponding mitochondrial genome variation suggests that the rapid evolution of M-class mTERF genes might account for the changes in the complex machinery for expression regulation of plant mitochondrial genomes, providing molecular evidence for the host-parasite interaction hypothesis between the nucleus and mitochondria.
Arousal and locomotion differently modulate activity of somatostatin neurons across cortex
Authors: Khoury Christine F. , Fala Noelle G. , Runyan Caroline A.
Published: January 2022

Arousal powerfully influences cortical activity, in part by modulating local inhibitory circuits. Somatostatin-expressing inhibitory interneurons (SOM) are particularly well-situated to shape local population activity in response to shifts in arousal, yet the relationship between arousal state and SOM activity has not been characterized outside of sensory cortex. To determine whether SOM activity is similarly modulated by behavioral state across different levels of the cortical processing hierarchy, we compared the behavioral modulation of SOM neurons in auditory cortex (AC), a primary sensory region, and posterior parietal cortex (PPC), an association-level region of cortex. Behavioral state modulated activity differently in AC and PPC. In PPC, transitions to high arousal were accompanied by large increases in activity across the full PPC neural population, especially in SOM neurons. In AC, arousal transitions led to more subtle changes in overall activity, as individual SOM and Non-SOM neurons could be either positively or negatively modulated during transitions to high arousal states. The coding of sensory information in population activity was enhanced during periods of high arousal in AC, but not PPC. Our findings suggest unique relationships between activity in local circuits and arousal across cortex, which may be tailored to the roles of specific cortical regions in sensory processing or the control of behavior.

Significance statement

The effects of arousal on brain networks are profound, but vary across regions. Somatostatin neurons may carry out some of the effects of arousal on local network activity in sensory cortex, by modulating response gain and decorrelating population activity. However, SOM neurons have not been well studied outside of sensory cortex, and so it is unknown whether SOM neurons are similarly affected by shifts in brain state throughout the cortex. Here, we have revealed specialization in the relationship between arousal and activity in SOM neurons that could contribute to the diversity of arousal-related impacts on local computation across cortical regions.