bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of eplerenone and spironolactone treatment in patients with ischemic heart disease hospitalized due to ventricular tachycardia
Authors: Toth P , Komlosi F , Szakal I , Vamosi P , Arnoth B , Bohus G Y , Szegedi N , Sallo Z , Perge P , Osztheimer I , Ferencz A B , Orban G , Merkely B , Geller L , Nagy K V
Published: May 2024

Background

The beneficial effects of mineralocorticoid receptor antagonists (MRAs) regarding sudden cardiac death (SCD) risk and cardiac remodeling are well known, moreover, they also reduce episodes of ventricular tachycardia (VT). However, superiority in effectiveness between receptor selective eplerenone and conventional spironolactone is unknown.

Purpose

Our aim was to assess the effect of eplerenone and spironolactone on ventricular tachycardia (VT) recurrence in patients with ischemic heart disease (IHD).

Methods

We collected data of 563 patients with IHD following hospitalization due to a sustained VT episode in a structured registry. Propensity score matching was performed based on age, hypertension, diabetes, history of acute myocardial infarction, left ventricular ejection fraction (LVEF) and presentation with incessant VT. The matched population consisted of 188 patients and was further analyzed. Predictors were assessed using univariate and multivariate Cox regression models. Kaplan-Meier curves were used for time-to-event analyses.

Results

The median age was 70 years with 81% being male. One third of the patients had an ICD implanted, while 43 (23%) had CRT. The median LVEF was 30%. Twenty-five (13%) patients presented with an electrical storm and 19 (10%) had incessant VT. In 86 cases (46%), the VT caused hemodynamic instability. Ablation was performed in 66 patients (35%), while 4 required mechanical circulatory support. During the median follow-up of 856 [399-1624] days, 69 patients had VT recurrence and 118 patients died. Eplerenone use significantly reduced the risk of VT recurrence compared to spironolactone (HR: 0.48 [0.29-0.78], log-rank p=0.003). This effect was consistent in the multivariate model as well (p=0.006).

Conclusions

Eplerenone use may be more beneficial in terms of VT recurrence in patients with IHD who present with a sustained VT. Further analysis is required to confirm these findings.
3DFin: a software for automated 3D forest inventories from terrestrial point clouds
Authors: Laino Diego , Cabo Carlos , Prendes Covadonga , Janvier Romain , Ordonez Celestino , Nikonovas Tadas , Doerr Stefan , Santin Cristina
Published: May 2024

Accurate and efficient forest inventories are essential for effective forest management and conservation. The advent of ground-based remote sensing has revolutionized the data acquisition process, enabling detailed and precise 3D measurements of forested areas. Several algorithms and methods have been developed in the last years to automatically derive tree metrics from such terrestrial/ground-based point clouds. However, few attempts have been made to make these automatic tree metrics algorithms accessible to wider audiences by producing software solutions that implement these methods. To fill this major gap, we have developed 3DFin, a novel free software program designed for user-friendly, automatic forest inventories using ground-based point clouds. 3DFin empowers users to automatically compute key forest inventory parameters, including tree Total Height, Diameter at Breast Height (DBH), and tree location. To enhance its user-friendliness, the program is open-access, cross-platform, and available as a plugin in CloudCompare and QGIS as well as a standalone in Windows. 3DFin capabilities have been tested with Terrestrial Laser Scanning, Mobile Laser Scanning, and terrestrial photogrammetric point clouds from public repositories across different forest conditions, achieving nearly full completeness and correctness in tree mapping and highly accurate DBH estimations (root mean squared error <2 cm, bias <1 cm) in most scenarios. In these tests, 3DFin demonstrated remarkable efficiency, with processing times ranging from 2 to 7 min per plot. The software is freely available at: https://github.com/3DFin/3DFin.
Dendrite morphogenesis in Caenorhabditis elegans
Authors: Heiman Maxwell G , Bülow Hannes E
Published: May 2024

Since the days of Ramón y Cajal, the vast diversity of neuronal and particularly dendrite morphology has been used to catalog neurons into different classes. Dendrite morphology varies greatly and reflects the different functions performed by different types of neurons. Significant progress has been made in our understanding of how dendrites form and the molecular factors and forces that shape these often elaborately sculpted structures. Here, we review work in the nematode Caenorhabditis elegans that has shed light on the developmental mechanisms that mediate dendrite morphogenesis with a focus on studies investigating ciliated sensory neurons and the highly elaborated dendritic trees of somatosensory neurons. These studies, which combine time-lapse imaging, genetics, and biochemistry, reveal an intricate network of factors that function both intrinsically in dendrites and extrinsically from surrounding tissues. Therefore, dendrite morphogenesis is the result of multiple tissue interactions, which ultimately determine the shape of dendritic arbors.
Inequalities in Disability-Free and Disabling Multimorbid Life Expectancy in Costa Rica, Mexico, and the United States
Authors: Lam Anastasia , Keenan Katherine , Cézard Geneviève , Kulu Hill , Myrskylä Mikko
Published: May 2024

Objectives

To better understand variations in multimorbidity severity over time, we estimate disability-free and disabling multimorbid life expectancy (MMLE), comparing Costa Rica, Mexico, and the United States (US). We also assess MMLE inequalities by sex and education.

Methods

Data come from the Costa Rican Study on Longevity and Healthy Aging (2005–2009), the Mexican Health and Aging Study (2012–2018), and the Health and Retirement Study (2004–2018). We apply an incidence-based multistate Markov approach to estimate disability-free and disabling MMLE and stratify models by sex and education to study within-country heterogeneity. Multimorbidity is defined as a count of 2 or more chronic diseases. Disability is defined using limitations in activities of daily living.

Results

Costa Ricans have the lowest MMLE, followed by Mexicans, then individuals from the US. Individuals from the US spend about twice as long with disability-free multimorbidity compared with individuals from Costa Rica or Mexico. Females generally have longer MMLE than males, with particularly stark differences in disabling MMLE. In the US, higher education was associated with longer disability-free MMLE and shorter disabling MMLE. We identified evidence for cumulative disadvantage in Mexico and the US, where sex differences in MMLE were larger among the lower educated.

Discussion

Substantial sex and educational inequalities in MMLE exist within and between these countries. Estimating disability-free and disabling MMLE reveals another layer of health inequality not captured when examining disability and multimorbidity separately. MMLE is a flexible population health measure that can be used to better understand the aging process across contexts.
SuperFeat: Quantitative Feature Learning from Single-cell RNA-seq Data Facilitates Drug Repurposing
Authors: Zhong Jianmei , Yang Junyao , Song Yinghui , Zhang Zhihua , Wang Chunming , Tong Renyang , Li Chenglong , Yu Nanhui , Zou Lianhong , Liu Sulai , Pu Jun , Lin Wei
Published: May 2024

In this study, we devised a computational framework called Supervised Feature Learning and Scoring (SuperFeat) which enables the training of a machine learning model and evaluates the canonical cellular statuses/features in pathological tissues that underlie the progression of disease. This framework also enables the identification of potential drugs that target the presumed detrimental cellular features. This framework was constructed on the basis of an artificial neural network with the gene expression profiles serving as input nodes. The training data comprised single-cell RNA sequencing datasets that encompassed the specific cell lineage during the developmental progression of cell features. A few models of the canonical cancer-involved cellular statuses/features were tested by such framework. Finally, we illustrated the drug repurposing pipeline, utilizing the training parameters derived from the adverse cellular statuses/features, which yielded successful validation results both in vitro and in vivo. SuperFeat is accessible at https://github.com/weilin-genomics/rSuperFeat.
Robustness to Leg Loss in Opiliones: A Review and Framework Considerations for Future Research
Authors: Escalante Ignacio , O'Brien Shannon L
Published: May 2024

Synopsis

Animals have evolved behavioral and morphological traits that allow them to respond to environmental challenges. However, these traits may have long-term consequences that could impact an animal’s performance, fitness, and welfare. Several species in a group of the arachnid order of Opiliones release their legs voluntarily to escape predators. These animals use their legs for locomotion, sensation, and reproduction. Here, we first compile data across species in the suborder Eupnoi, showing that more than half of individuals are found missing legs. Then, we review recent work on the ultimate and proximate implications of leg loss in Opiliones. Field and laboratory experiments showed that leg loss (a) did not affect their survival or mating success and (b) compromised the kinematics and energetics of locomotion, but individuals recovered velocity and acceleration quickly. These findings demonstrate that these animals display robustness, that is, the ability to withstand and overcome the potential consequences of bodily damage. This may explain why leg loss is so prevalent in Opiliones. Additionally, we encourage researchers to consider expanding their hypotheses beyond traditional adaptationist and ableist lenses and incorporate a comprehensive examination of animal welfare when studying animals’ responses to bodily damage. Finally, we highlight avenues for future research in Opiliones, namely assessing how individuals move in three-dimensional environments, the neural plasticity aiding recovery post-leg loss, applications for bio-inspired design, and evidence-based animal welfare measures.
Stochastic modified equations for symplectic methods applied to rough Hamiltonian systems
Authors: Chen Chuchu , Hong Jialin , Huang Chuying
Published: May 2024

We investigate stochastic modified equations to explain the mathematical mechanism of symplectic methods applied to rough Hamiltonian systems. The contribution of this paper is threefold. First, we construct a new type of stochastic modified equation. For symplectic methods applied to rough Hamiltonian systems, the associated stochastic modified equations are proved to have Hamiltonian formulations. Secondly, the pathwise convergence order of the truncated modified equation to the numerical method is obtained by techniques in rough path theory. Thirdly, if increments of noises are simulated by truncated random variables, we show that the error can be made exponentially small with respect to the time step size.
Effects of dietary fiber and biotic supplementation on apparent total tract macronutrient digestibility and the fecal characteristics, metabolites, and microbiota of healthy adult dogs
Authors: Wilson Sofia M , Kang Yifei , Marshall Kemba , Swanson Kelly S
Published: May 2024

Dietary fibers and biotics have been shown to support gastrointestinal health in dogs, but are usually tested individually. There is value in testing fiber-biotic combinations that are commonly used commercially. Therefore, this study was conducted to determine the apparent total tract macronutrient digestibility (ATTD) of diets supplemented with fibers or biotics and to evaluate their effects on the fecal characteristics, metabolites, microbiota, and immunoglobulin A (IgA) concentrations of dogs. Twelve healthy adult female beagle dogs (age = 6.2 ± 1.6 yr; body weight = 9.5 ± 1.1 kg) were used in a replicated 3 × 3 Latin square design to test three treatments: 1) control diet based on rice, chicken meal, tapioca starch, and cellulose + a placebo treat (CT); 2) diet based on rice, chicken meal, garbanzo beans, and cellulose + a placebo treat (GB); 3) diet based on rice, chicken meal, garbanzo beans, and a functional fiber/prebiotic blend + a probiotic-containing treat (GBPP). In each 28-d period, a 22-d diet adaptation was followed by a 5-d fecal collection phase. Fasted blood samples were collected on day 28. Data were analyzed using the Mixed Models procedure of SAS 9.4, with P < 0.05 being significant and P < 0.10 being trends. ATTD of dry matter (DM), organic matter, and energy were lower (P < 0.001) and DM fecal output was higher (P < 0.01) in dogs fed GBPP than CT or GB, whereas ATTD of crude protein was higher (P < 0.001) in dogs fed CT and GBPP than GB. ATTD of fat was higher (P < 0.001) and wet fecal output was lower (P < 0.01) in dogs fed CT than GB or GBPP. Fecal DM% was higher (P < 0.001) in dogs fed CT than GBPP or GB, and higher in dogs fed GBPP than GB. Fecal short-chain fatty acid concentrations were higher (P < 0.001) in dogs fed GB than CT or GBPP, and higher in dogs fed GB than GBPP. Fecal IgA concentrations were higher (P < 0.01) in dogs fed GB than CT. Fecal microbiota populations were affected by diet, with alpha diversity being higher (P < 0.01) in dogs fed GB than CT, and beta diversity shifting following dietary fiber and biotic supplementation. The relative abundance of 24 bacterial genera was altered in dogs fed GB or GBPP than CT. Serum triglyceride concentrations were lower in dogs fed GB than GBPP or CT. Our results demonstrate that legume-based dietary fibers, with or without prebiotics and probiotics, reduce ATTD, increase stool output, beneficially shift fecal metabolites and microbiota, and reduce blood lipids in adult dogs.
Effects of late gestational nutrient restriction on uterine artery blood flow, placental size, and cotyledonary mRNA expression in primiparous beef females
Authors: Redifer Colby A , Wichman Lindsey G , Rathert-Williams Abigail R , Meyer Allison M
Published: May 2024

Fall-calving primiparous beef females [body weight (BW): 451 ± 28 (SD) kg; body condition score (BCS): 5.4 ± 0.7] were individually-fed either 100% (control; CON; n = 13) or 70% (nutrient restricted; NR; n = 13) of metabolizable energy and metabolizable protein requirements for maintenance, pregnancy, and growth from day 160 of gestation to parturition. Doppler ultrasonography of both uterine arteries was conducted pre-treatment and every 21 d from days 181 to 265 of gestation. Expelled placentas were collected, and ipsilateral cotyledonary tissue was sampled to assess relative messenger ribonucleic acid (mRNA) expression. Placentas were separated into ipsilateral and contralateral sides, dissected (cotyledonary vs. intercotyledonary), and dried. Data were analyzed with nutritional plane, treatment initiation date, and calf sex (when P < 0.25) as fixed effects. Uterine blood flow included day and nutritional plane × day as repeated measures. We previously reported that post-calving, NR dams weighed 64 kg less and were 2.0 BCS lower than CON, but calf birth weight was not affected. Maternal heart rate was less (P < 0.001) for NR dams than CON after nutritional planes began. Nutritional plane did not affect (P ≥ 0.20) uterine artery hemodynamics, but all variables were affected (P ≤ 0.04) by day. Contralateral cotyledonary and placental weight were less (P ≤ 0.04) and contralateral intercotyledonary weight and number of cotyledons tended to be less (P ≤ 0.10) for NR dams than CON, but ipsilateral and whole placental weights were not affected (P ≥ 0.13). Ipsilateral placental weight as a percentage of total placental weight was greater (P = 0.03) for NR dams than CON. Whole placental cotyledonary: intercotyledonary weight was less (P = 0.01) for NR dams than CON. Placental efficiency was not affected (P = 0.89) by nutritional plane. Cotyledonary relative mRNA expression of GLUT3 and SNAT2 was greater (P ≤ 0.05) and relative expression of GLUT1, GLUT4, and NOS3 tended to be greater (P ≤ 0.07) for NR dams than CON. Nutritional plane did not affect (P ≥ 0.13) relative mRNA expression of GLUT5, 4F2hc, CAT1, LAT1, LAT2, VEGFA, FLT1, KDR, GUCY1B3, and PAG2. Despite less contralateral placental growth, beef heifers experiencing late gestational nutrient restriction maintained uterine artery blood flow and total placental mass and had 4 nutrient transporters and 1 angiogenic factor upregulated in cotyledons, all of which likely contributed to conserving fetal growth.
CYP4G subfamily genes mediate larval integument development in Spodoptera frugiperda
Authors: Zhou Xue , Yuan Hao , Ye Nuojun , Rong Changfeng , Li Yiyu , Jiang Xingchuan , Cao Haiqun , Huang Yong
Published: May 2024

Cytochrome P450 (CYP) 4G subfamily is closely related to the synthesis of cuticular hydrocarbons, leading to the enhanced desiccation and insecticide resistance of pests. However, functions of CYP4Gs in larval integument development remain unknown in Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae), which is a major transboundary migratory pest and become a common pest in China. On the basis of the genome and transcriptome datasets of S. frugiperda, CYP4G74, CYP4G75, CYP4G108, and CYP4G109 were identified, which contained the conserved domains of P450s and CYP4Gs. The spatial and temporal expression analysis showed that CYP4G74 and CYP4G75 were significantly highly expressed in adults and larval integuments, while CYP4G108 and CYP4G109 had low expressions in larval integuments. After silencing CYP4G74 and CYP4G75 by RNA interference, abnormal integument development occurred in larvae, some of which became smaller and dead, indicating important roles of CYP4G74 and CYP4G75 in the synthesis and development of integuments. The results clarify the functions of CYP4Gs in S. frugiperda and provide potential targets for the control of this pest.
Detection of bean damage caused by Epilachna varivestis (Coleoptera: Coccinellidae) using drones, sensors, and image analysis
Authors: Karimzadeh Roghaiyeh , Naharki Kushal , Park Yong-Lak
Published: May 2024

The Mexican bean beetle, Epilachna varivestis Mulsant (Coleoptera: Coccinellidae), is a key pest of beans, and early detection of bean damage is crucial for the timely management of E. varivestis. This study was conducted to assess the feasibility of using drones and optical sensors to quantify the damage to field beans caused by E. varivestis. A total of 14 bean plots with various levels of defoliation were surveyed aerially with drones equipped with red-blue-green (RGB), multispectral, and thermal sensors at 2 to 20 m above the canopy of bean plots. Ground-validation sampling included harvesting entire bean plots and photographing individual leaves. Image analyses were used to quantify the amount of defoliation by E. varivestis feeding on both aerial images and ground-validation photos. Linear regression analysis was used to determine the relationship of bean defoliation by E. varivestis measured on aerial images with that found by the ground validation. The results of this study showed a significant positive relationship between bean damages assessed by ground validation and those by using RGB images and a significant negative relationship between the actual amount of bean defoliation and Normalized Difference Vegetation Index values. Thermal signatures associated with bean defoliation were not detected. Spatial analyses using geostatistics revealed the spatial dependency of bean defoliation by E. varivestis. These results suggest the potential use of RGB and multispectral sensors at flight altitudes of 2 to 6 m above the canopy for early detection and site-specific management of E. varivestis, thereby enhancing management efficiency.
Macrophage-specific lipoxygenase deletion amplify cardiac repair activating Treg cells in chronic heart failure
Authors: Kain Vasundhara , Grilo Gabriel Araujo , Upadhyay Gunjan , Nadler Jerry L , Serhan Charles N , Halade Ganesh V
Published: May 2024

Splenic leukocytes, particularly macrophage-expressed lipoxygenases, facilitate the biosynthesis of resolution mediators essential for cardiac repair. Next, we asked whether deletion of 12/15 lipoxygenase (12/15LOX) in macrophages impedes the resolution of inflammation following myocardial infarction (MI). Using 12/15flox/flox and LysMcre scheme, we generated macrophage-specific 12/15LOX (Mɸ-12/15LOX−/−) mice. Young C57BL/6J wild-type and Mɸ-12/15LOX−/− male mice were subjected to permanent coronary ligation microsurgery. Mice were monitored at day 1 (d1) to d5 (as acute heart failure [AHF]) and to d56 (chronic HF) post-MI, maintaining no MI as d0 naïve control animals. Post ligation, Mɸ-12/15LOX−/− mice showed increased survival (88% vs 56%) and limited heart dysfunction compared with wild-type. In AHF, Mɸ-12/15LOX−/− mice have increased biosynthesis of epoxyeicosatrienoic acid by 30%, with the decrease in D-series resolvins, protectin, and maresin by 70% in the infarcted heart. Overall, myeloid cell profiling from the heart and spleen indicated that Mɸ-12/15LOX−/− mice showed higher immune cells with reparative Ly6Clow macrophages during AHF. In addition, the detailed immune profiling revealed reparative macrophage phenotype (Ly6Clow) in Mɸ-12/15LOX−/− mice in a splenocardiac manner post-MI. Mɸ-12/15LOX−/− mice showed an increase in myeloid population that coordinated increase of T regulatory cells (CD4+/Foxp3+) in the spleen and injured heart at chronic HF compared with wild-type. Thus, macrophage-specific deletion of 12/15LOX directs reparative macrophage phenotype to facilitate cardiac repair. The presented study outlines the complex role of 12/15LOX in macrophage plasticity and T regulatory cell signaling that indicates that resolution mediators are viable targets to facilitate cardiac repair in HF post-MI.
TIGIT stimulation suppresses autoimmune uveitis by inhibiting Th17 cell infiltration
Authors: Peters Kayleigh , McDonald Trisha , Muhammad Fauziyya , Brady Adrien , Dostal John , Lee Darren J
Published: May 2024

T cell immunoglobulin and ITIM domain (TIGIT) is an immune checkpoint molecule that suppresses T cell activation and promotes an immunosuppressive environment to suppress autoimmune diseases. However, the impact of a TIGIT agonist as a treatment for ocular autoimmune disease has not been investigated. We examined TIGIT expression on T helper 17 (Th17) and regulatory T cells (Tregs), the role of TIGIT on experimental autoimmune uveitis and Th17 cells, and the impact of Treg generation following TIGIT stimulation. TIGIT stimulation at the onset of clinical symptoms reduced the severity of uveitis and suppressed infiltration of Th17 cells into the eye. Further, Tregs from mice treated with the TIGIT agonist were capable of suppressing experimental autoimmune uveitis in recipient mice. This report demonstrates that stimulation of TIGIT at onset of disease suppresses symptoms and allows for induction of regulatory immunity that provides resistance to uveitis.
Motives and Consequences of Libor Strategic Reporting: How Much Can We Learn from Banks’ Self-Reported Borrowing Rates?
Authors: Bonaldi Pietro
Published: May 2024

Libor is an estimate of interbank borrowing costs computed daily from rates reported by a fixed panel of banks. Evidence suggests that banks have manipulated Libor in recent years by misreporting their borrowing costs. I estimate a strategic reporting model that identifies banks’ borrowing costs as well as their motives for misreporting. The estimation places a lower bound on the value that Libor would have had if banks had truthfully reported their borrowing costs. The model is identified even when unobserved heterogeneity exists in the form of a common cost component that is known by all banks but unobservable to the econometrician and is allowed to follow a non-stationary process. The only data used for identification are banks’ Libor quotes. Overall, I find that the estimated lower bound for the unmanipulated Libor is always above the published Libor, with an average deviation of 25 basis points at the worst of the financial crisis of 2007–2008. The estimated bound displays a pattern similar to two other measures of interbank borrowing costs that have been used previously to assess the extent of manipulation. The model is also used to determine the extent to which misreporting was motivated by signalling or banks’ net exposure to Libor. The estimation results indicate that sending creditworthiness signals was the main driver of systematic misreporting from 2007 to 2010.
Aberrant Cardiac Interoception in Psychosis
Authors: Jeganathan Jayson , Campbell Megan E J , Legrand Nicolas , Allen Micah , Breakspear Michael
Published: May 2024

Background and Hypothesis

There is mounting evidence that cardiac interoception, the perception of one’s heartbeat, is central to affective experiences. It has been proposed that symptoms of psychosis could arise from interoceptive dysfunction. Here we hypothesized that people with psychotic disorders would have a specific impairment in cardiac interoception, over and above broader perceptual deficits.

Study Design

43 adults with a history of psychosis (31 schizophrenia, 12 schizoaffective disorder) and 41 matched control participants completed a heart rate discrimination task. Participants responded to whether they perceived a sequence of auditory tones to be faster or slower than their heart rate. By trialing a range of auditory tone rates, we estimated a threshold for each participant, the difference between perceived heart rate and actual heart rate. To test whether differences were specific to interoception, participants completed an exteroceptive control condition, testing their discrimination of the rate of 2 sets of audible sounds instead of heart rate.

Study Results

Participants with a history of psychosis had greater absolute differences between perceived and actual heart rate, indicating over- or under-estimation of heart rate compared to healthy controls. This difference was specific to the interoceptive condition, and not explained by group differences in exteroceptive perception.

Conclusions

Psychotic disorders are associated with misestimation of heart rate. Further research may elucidate whether interoceptive abnormalities contribute to specific symptoms such as somatic delusions or affective features, and whether interoception could be a treatment target in psychotic disorders.
State of the art: the treatment of systemic lupus erythematosus
Authors: Costanzo Giulia , Ledda Andrea Giovanni , Sambugaro Giada
Published: May 2024

Purpose of review

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with dysregulated cells in the immune system. The disease affects organs like kidneys, nervous system, joints, and skin. To manage SLE effectively, novel treatments targeting immune system components have been developed. This review investigates the therapeutic potential of existing targeted therapies and explores future innovative approaches for well tolerated, personalized treatment.

Recent findings

SLE treatment involves cytokine targets and specific immunologic pathways, with even small molecules involved.

The advanced therapeutic options in SLE management give clinicians more tools to control disease activity according to personalized medicine.
Enhancing Our Workforce: Recruitment and Retention in Anesthesiology
Authors: Malinzak Elizabeth B. , Vail Emily A. , Wixson Matthew , Lee Allison
Published: May 2024

Increasingly, both healthcare leaders and studies of healthcare outcomes recommend a medical workforce that is representative of the patient population as a method to reduce health disparities and medical costs. Anesthesiology remains a specialty with lower proportions of women and underrepresented in medicine (URiM) physicians as compared to the overall physician workforce, with 26.1% of anesthesiologists identifying as women and 31.3% of anesthesiologists as URiM. Two areas of focus are commonly identified when discussing inadequate representation in the workforce: recruitment into the specialty and retention in the profession. Asmedical educators, we provide a critical role in the recruitment and retention of women and URiM anesthesiologists, through implementation of processes, programs, and cultural change. Here, we will discuss the current problems of recruitment and retention of women and URiM anesthesiologists and suggest action plans for now and the future to enhance our specialty’s diversity.
Single Versus 3-incision Triple Pelvic Osteotomy: Comparison of Clinical and Radiologic Results
Authors: Kolac Ulas Can , Gazeloglu Ali Okan , Oral Melih , Yilmaz Engin Turkay , Bakircioglu Sancar , Aksoy Mehmet Cemalettin , Yilmaz Guney
Published: May 2024

Background:

Triple pelvic osteotomy (TPO) is indicated when the anatomic and functional realignment of the hip joint is needed. Although the traditional approach for TPO involves a separate incision for ischial cut, there has been a trend for single-incision TPO in recent years. This study aims to compare the clinical and radiologic results of 2 different approaches.

Methods:

Forty-two hips of 39 patients treated using TPO with a minimum of 24 months of follow-up were included in our cohort. Demographics, perioperative, and radiologic parameters were evaluated. Harris Hip Score and International Hip Outcome Tool were used for clinical evaluation.

Results:

A single anterolateral incision approach was used in 18 hips (17 patients), whereas a 3-incision approach was used in 24 hips (22 patients). The mean follow-up was 4.7 years in the 3-incision group and 3.8 years in the single-incision group (P=0.43), with mean surgery age at 8.7 years (range, 5.4 to 12) for single-incision and 9.7 years (range, 7.7 to 11.7) for 3e-incision (P=0.22). There were no significant differences observed between the 2 groups concerning radiographic measurements, complications, and functional scores. The mean surgical time was 118.6 minutes in the single-incision group and 97.9 minutes in 3-incision group (P=0.036). Mean intraoperative blood loss was 181.7 ml in the single-incision group and 243.4 ml in 3-incision group (P=0.028). Three-incision group demonstrated significantly higher intraoperative blood loss, leading to lower hemoglobin values (P=0.042).

Conclusion:

The single-incision TPO demonstrated similar outcomes compared with the traditional 3-incision approach in terms of radiologic correction and functional improvement. The single-incision technique exhibited advantages such as reduced intraoperative blood loss and potential benefit of decreased pain due to fewer scars. However, it required a longer surgical time compared with the 3-incision approach. Surgeons should consider patient-specific factors and their expertise when selecting the most appropriate approach for each case.

Level of Evidence:

Level III—retrospective comparative series.
An Efficient Approach to Nowcasting the Time-varying Reproduction Number
Authors: Sumalinab Bryan , Gressani Oswaldo , Hens Niel , Faes Christel
Published: May 2024

Estimating the instantaneous reproduction number (

) in near real time is crucial for monitoring and responding to epidemic outbreaks on a daily basis. However, such estimates often suffer from bias due to reporting delays inherent in surveillance systems. We propose a fast and flexible Bayesian methodology to overcome this challenge by estimating

while taking into account reporting delays. Furthermore, the method naturally takes into account the uncertainty associated with the nowcasting of cases to get a valid uncertainty estimation of the nowcasted reproduction number. We evaluate the proposed methodology through a simulation study and apply it to COVID-19 incidence data in Belgium.
Nipple Adenoma: Systematic Review of Literature
Authors: Berger Ori , Gersh Guy , Talisman Ran
Published: May 2024

Background:

Nipple adenomas (NAs) are rare benign proliferative tumors presenting as palpable nodules, erosive lesions, or nipple discharge, mimicking other conditions. This systematic review categorizes cases into sole NA (ONA) or co-diagnoses with other conditions (CONA) to enhance clinical recognition, diagnosis, and treatment efficacy.

Methods:

Following PRISMA guidelines, a PubMed search was conducted for NA. Inclusion criteria covered original research, excluding reviews or other breast diseases. Bias risk was assessed through a thorough search, authors independently evaluated studies, and data were synthesized using varied measures. Subgroups ONA and CONA were formed. Analyses were conducted in Excel and R, complemented by a qualitative review due to case report predominance. Biases in case reports were transparently addressed.

Results:

Of the 86 studies, 387 cases were analyzed, showing 10.34% with co-diagnoses of malignant or premalignant conditions. Mean age was 44, with a female predominance (97%). ONA (347 cases) and CONA (40 cases) subgroups exhibited variations in symptoms, physical findings, and imaging. Treatment modalities included excision (51.39%), biopsy alone (11.1%), and mastectomy (8.6%). Mean follow-up of 56.73 months revealed recurrence (2.87%) and malignancy development (1.79%), notably in CONA cases (33.33%).

Conclusions:

This study provides insights into the broader age range of NA and its associations. Higher co-diagnosis rates were correlated with older age, highlighting the necessity for thorough investigation, with excision as the primary treatment. Follow-up emphasizes the significance of identifying and monitoring CONA cases, which pose a higher malignancy risk. Recurrence is presumed to be linked to proper lesion excision and co-diagnosis.
Guidelines for safe use of Polygoni Multiflori Radix
Authors: Xiao Xiaohe , Wang Jiabo , Song Haibo , Ouyang Dongsheng , Zou Zhengsheng , Wang Ruilin , He Tingting , Jing Jing , Guo Yuming , Bai Zhaofang , Zhan Xiaoyan , Niu Ming , Ma Zhijie , Li Chunyu ,   on Behalf of the Branch of Chinese Patent Medicine, China Association of Chinese Medicine; Branch of Hepatobiliary Diseases, China Association of Chinese Medicine; Committee of Clinical Chinese Pharmacy, Chinese Pharmaceutical Association; Subcommittee of Liver Diseases, Committee of Drug-Induced Diseases, Chinese Pharmacological Society; Committee of Clinical Toxicology, Chinese Society of Toxicology
Published: May 2024

Polygoni Multiflori Radix (He Shou Wu) is a Chinese medicine widely used in clinical treatment and preventive healthcare. However, recently there have been frequent reports of liver injury caused by Polygoni Multiflori Radix and its related preparations, and some patients have serious adverse outcomes, attracting wide attention worldwide. The risk of liver damage caused by preparations containing Polygoni Multiflori Radix or Polygoni Multiflori Caulis has been repeatedly reported by the Chinese Food and Drug Administration. Fortunately, substantial progress has recently been made in revealing the basic properties, main causes, material basis, and molecular mechanism of Polygoni Multiflori Radix-related liver injury. The basic characteristics and biomarkers of susceptible people have been identified, indicating that Polygoni Multiflori Radix has the risk of inducing liver injury only in a few specific populations and is safe for most populations. This study provides a scientific basis for a correct and objective understanding of liver injury caused by Polygoni Multiflori Radix, and a reasonable formulation of safe medication measures for Polygoni Multiflori Radix and related preparations. The China Association of Chinese Medicine organized experts in relevant fields across the country to draft and formulate the “Guidelines for Safe Use of Polygoni Multiflori Radix” with the aim of helping the public and relevant institutions at home and abroad to scientifically understand, evaluate, and avoid the risk of liver injury; guide the rational use; protect the health rights and interests of consumers; and promote the healthy and sustainable development of Polygoni Multiflori Radix and related preparations. These guidelines were issued by the China Association of Chinese Medicine (No. T/CACM 1328-2019).
Response to treatment of epiretinal neovascularization secondary to ischemic retinal vein occlusion in proliferative MacTel 2
Authors: Stöckl Victoria , Stattin Martin , Zehetner Claus , Bui Patricia , Krepler Katharina , Ansari-Shahrezaei Siamak
Published: May 2024

Purpose:

To describe a case of unilateral epiretinal neovascularization (ERN) secondary to an old ischemic retinal vein occlusion (RVO) in a patient with bilateral proliferative macular teleangiectasia type 2 (MacTel 2; Toto stage 4) and its response to treatment as documented by multimodal imaging.

Methods:

Retrospective case report

Results:

A 75-year-old woman with a six-year-history of MacTel 2 and the consecutive development of proliferative outer retinal neovascularization in both eyes over time presented with an ERN in addition to neovascularization of the optic disc, delayed filling of the retinal veins, peripheral capillary ischemia and intravitreal hemorrhage only in her left eye in September 2023. She was therefore treated with anti-vascular endothelial growth factor (anti-VEGF; aflibercept 2mg) intravitreally. The ERN responded well to a single intravitreal injection of anti-VEGF, while flow in the outer retinal proliferation persisted. Diagnosis and treatment with anti-VEGF were observed via optical coherence tomography angiography.

Conclusion:

We believe that the ERN formation was a reaction to ischemia of the inner retinal capillary plexus due to a preceding RVO. The herein presented case provides a new perspective on the development and treatment of ERN in MacTel 2.
Implantable phakic contact lens: vault evaluation 5 years postoperatively
Authors: Bianchi Germán R. , Paredes Andrés , Puccio Belén , Parra-Hernández Andrea
Published: May 2024

Purpose:

To evaluate the stability of the postoperative vault of the implantable phakic contact lens (IPCL) 5 years after implantation.

Setting:

Clínica de Ojos Dr. Nano, Olivos, Buenos Aires, Argentina.

Design:

Retrospective case-series study.

Methods:

Myopic patients operated with the IPCL for spherical correction in which preoperative data were compared with different scenarios of postoperative vault at 1, 3, and 5 years postoperatively. The main parameter to be evaluated was the vault obtained 5 years postoperatively.

Results:

140 eyes of 72 patients, aged 31.9 ± 2.8 years (21 to 50), were included. Most of the eyes (78.6%) obtained a vault between 250 μm and 750 μm, while in 15% of the eyes, it was less than 250 μm, and 6.4% were greater than 750 μm. The vault evaluated 1, 3, and 5 years postoperatively remained stable. Subcapsular cataracts were detected in 2 eyes, with vault <250 μm. A total of 50 eyes (35.7%) had cysts in the sulcus (5 cases in the group of eyes with vault >750 μm). No changes were detected in relation to intraocular pressure or endothelial cell count.

Conclusions:

In eyes implanted with the IPCL over 5 years, it was observed that the vault remained stable over time. The proportion of eyes with cysts was higher in eyes with vaults larger than 750 μm.
Subacute combined degeneration of the spinal cord with cerebellar lesions: A case report
Authors: Zhu Manmin , Yu Changyin , Xu Zucai , Zhang Haiqing , Huang Hao
Published: May 2024

Rationale:

Subacute combined degeneration of the spinal cord is a degenerative disease of the central and peripheral nervous systems caused by vitamin B12 deficiency, mainly involving the spinal cord posterior, lateral, and peripheral nerves, but rarely involving the cerebellum.

Patient concerns:

A 41-year-old woman presented with a 2-year history of walking unsteadily. Her hematologic examination revealed megaloblastic anemia and vitamin B12 deficiency. Electromyography showed multiple peripheral nerve damage (sensory fibers and motor fibers were involved). Imaging examination showed long T2 signal in the cervical, thoracic and lumbar spinal cord and cerebellum. Gastroscopy revealed autoimmune gastritis.

Diagnoses:

Subacute combined degeneration of the spinal cord.

Interventions:

By supplementing with vitamin B12.

Outcomes:

The patient’s symptoms of limb weakness, diet, and consciousness were improved, and the muscle strength of both lower limbs recovered to grade IV.

Lessons:

The symptomatic people should seek medical treatment in time to avoid further deterioration of the disease. When esophagogastroduodenoscopy is performed as part of routine physical examination in asymptomatic people, it should be checked for the presence of autoimmune gastritis. Early diagnosis can prevent irreversible neuropathy.
A multicenter, retrospective archive study of radiological and clinical features of ALK-positive non-small cell lung cancer patients and crizotinib efficacy
Authors: Kilickap Saadettin , Ozturk Akin , Karadurmus Nuri , Korkmaz Taner , Yumuk Perran Fulden , Cicin Irfan , Paydas Semra , Cilbir Ebru , Sakalar Teoman , Uysal Mukremin , Yesil Cinkir Havva , Uskent Necdet , Demir Necla , Sakin Abdullah , Dursun Oldac Uras , Aver Birkan , Turhal Nazim Serdar , Keskin Serkan , Tural Deniz , Eralp Yesim , Bugdayci Basal Fatma , Yasar Hatime Arzu , Sendur Mehmet Ali Nahit , Demirci Umut , Cubukcu Erdem , Karaagac Mustafa , Cakar Burcu , Tatli Ali Murat , Yetisyigit Tarkan , Urvay Semiha , Gursoy Pinar , Oyan Basak , Turna Zeynep Hande , Isikdogan Abdurrahman , Olmez Omer Fatih , Yazici Ozan , Cabuk Devrim , Seker Mehmet Metin , Unal Olcun Umit , Meydan Nezih , Okutur Sadi Kerem , Tunali Didem , Erman Mustafa ,   Lung Sub-Group Study of the Turkish Oncology Group
Published: May 2024

To evaluate radiological and clinical features in metastatic anaplastic lymphoma kinase+ non-small cell lung cancer patients and crizotinib efficacy in different lines. This national, non-interventional, multicenter, retrospective archive screening study evaluated demographic, clinical, and radiological imaging features, and treatment approaches in patients treated between 2013-2017. Totally 367 patients (54.8% males, median age at diagnosis 54 years) were included. Of them, 45.4% were smokers, and 8.7% had a family history of lung cancer. On radiological findings, 55.9% of the tumors were located peripherally, 7.7% of the patients had cavitary lesions, and 42.9% presented with pleural effusion. Pleural effusion was higher in nonsmokers than in smokers (37.3% vs. 25.3%, P = .018). About 47.4% of cases developed distant metastases during treatment, most frequently to the brain (26.2%). Chemotherapy was the first line treatment in 55.0%. Objective response rate was 61.9% (complete response: 7.6%; partial response: 54.2%). The highest complete and partial response rates were observed in patients who received crizotinib as the 2nd line treatment. The median progression-free survival was 14 months (standard error: 1.4, 95% confidence interval: 11.2–16.8 months). Crizotinib treatment lines yielded similar progression-free survival (P = .078). The most frequent treatment-related adverse event was fatigue (14.7%). Adrenal gland metastasis was significantly higher in males and smokers, and pleural involvement and effusion were significantly higher in nonsmokers—a novel finding that has not been reported previously. The radiological and histological characteristics were consistent with the literature data, but several differences in clinical characteristics might be related to population characteristics.
Tislelizumab combined with GT chemotherapy for intimal sarcoma of inferior vena cava: A case report
Authors: Liao Haihong , Fang Yong , Li Da , Pan Yuefen , Niu Zhongfeng , Fu Tianhong , Wu Zhuoxuan , Sheng Jin , Dong Yong , Han Shuwen , Qi Quan , Liu Yulong
Published: May 2024

Rationale:

Intimal sarcoma of inferior vena cava (IVC) is a rare soft tissue sarcoma with no typical symptoms and specific imaging features in the early stage, and there is a lack of standardized treatment and methods.

Patient concerns:

A 54-year-old female patient presented to Fenghua District People’s Hospital with a post-active cough and hemoptysis and was subsequently referred to our hospital.

Diagnoses:

The patient was pathologically diagnosed as intimal sarcoma of IVC complicating multiple intrapulmonary metastases. Chest CT revealed left lung malignant tumor with multiple intrapulmonary metastases; while enhanced upper abdominal CT showed cancer embolus of IVC with extension to right atrium and bilateral renal veins. Besides, hematoxylin and eosin staining suggested intimal sarcoma of veins. Immunohistochemical staining showed positivity for PD-L1, Ki-67, CD31, Desmin and ERG.

Interventions:

The patient initially received GT chemotherapy (gemcitabine injection + docetaxel). Then, immunotherapy (tislelizumab) was added based on the results of genetic testing (TP53 gene mutation).

Outcomes:

The disease was stabilized after receiving the treatment.

Lessons:

Given the lack of characteristic clinical manifestations in patients with intimal sarcoma of IVC, imaging examination combined with immunohistochemical index were helpful for diagnosis of intimal sarcoma of IVC. Furthermore, the combination of tislelizumab and GT chemotherapy was feasible in such patients with positive PD-L1 expression and TP53 mutation.
Nursing observations of stage-based care in patients diagnosed with hepatitis B virus infection based on TBIL and ALT levels
Authors: Lin Yanyan , Wu Biyu , Lin Pingzhen , Zhang Liling , Li Weichao
Published: May 2024

This study explored techniques and effects of stage-based care on patients with chronic hepatitis B virus (HBV) infection. The clinical data of 156 patients with chronic HBV infection treated in our hospital from September 2018 to December 2019 were retrospectively analyzed and classified as the experimental group (EG). Patients were categorized into early, intermediate, and late hepatitis stages and received targeted clinical care during the various phases of chronic HBV infection. In addition, 144 cases of patients with chronic HBV admitted to the hospital from January 2018 to August 2018 and treated without stage-based care were classified as the control group (COG). General care was implemented for all patients before the initiation of stage-based care. Patient satisfaction, mortality rates of patients at different stages, liver pain scores, depression scores, blood biochemical indices, and alanine transaminase and total bilirubin levels before and after nursing care were compared. The total satisfaction rate of the EG group (90.38%) was significantly higher than that of the COG group (83.33%) (P < .05). We found no significant differences in the mortality rates of early-, middle-, and late-stage patients in the EG group when compared with those of the COG group at corresponding stages (P < .05). The self-care agency scores (for all dimensions) and psychosocial adaptation scores in the EG group were significantly higher than those in the COG group (P < .05) after care. Moreover, the pain scores in the EG group were significantly lower than those in the COG group after care (P < .05). Furthermore, the observed psychological status of patients in the EG group significantly improved when compared with that in the COG group (P < .05). Stage-based care for patients with severe chronic type B hepatitis increased clinical satisfaction, relieved pain, reduced depression, and improved blood biochemical indices. Therefore, stage-based care for chronic HBV infection should be included in the clinical environment.