bluuebunny/crossref_metadata_2025 huggingface dataset:
Slowly activating voltage-gated potassium current potentiation by ML277 is a novel cardioprotective intervention
Authors: Brennan Sean , Alnaimi Abrar I M , McGuinness Lauren R , Abdelaziz Muhammad I M , McKenzie Robert A , Draycott Sophie , Whitmore Jacob , Sharma Parveen , Rainbow Richard D
Published: May 2023

Cardiovascular disease is thought to account for nearly a third of deaths worldwide, with ischemic heart disease, including acute coronary syndromes such as myocardial infarction, accounting for 1.7 million deaths per year. There is a clear need for interventions to impart cardioprotection against ischemia. Here, we show that the slowly activating voltage-gated potassium current (IKs) potentiator ML277 imparts cardioprotection against ischemia in cellular and whole-heart models by modulating the action potential duration. In three different metabolic inhibition and reperfusion models, an increased contractile recovery and cell survival was observed with ML277, indicative of protection. Finally, ML277 reduced infarct size in an ex vivo Langendorff coronary ligation model, including if only applied on reperfusion. In conclusion, potentiation of the IKs with ML277 imparted a cardioprotection that was equivalent to the protection reported previously by ischemic preconditioning. These data suggest that IKs potentiation may be therapeutically useful in acute coronary syndromes.
The microbiota–gut–brain axis and neurodevelopmental disorders
Authors: Wang Qinwen , Yang Qianyue , Liu Xingyin
Published: May 2023

The gut microbiota has been found to interact with the brain through the microbiota–gut–brain axis, regulating various physiological processes. In recent years, the impacts of the gut microbiota on neurodevelopment through this axis have been increasingly appreciated. The gut microbiota is commonly considered to regulate neurodevelopment through three pathways, the immune pathway, the neuronal pathway, and the endocrine/systemic pathway, with overlaps and crosstalks in between. Accumulating studies have identified the role of the microbiota–gut–brain axis in neurodevelopmental disorders including autism spectrum disorder, attention deficit hyperactivity disorder, and Rett Syndrome. Numerous researchers have examined the physiological and pathophysiological mechanisms influenced by the gut microbiota in neurodevelopmental disorders (NDDs). This review aims to provide a comprehensive overview of advancements in research pertaining to the microbiota-gut-brain axis in NDDs. Furthermore, we analyzed both the current state of research progress and discuss future perspectives in this field.
Assessing the construct validity of musculoskeletal ultrasound and the rheumatoid arthritis foot disease activity index (RADAI-F5) for managing rheumatoid foot disease
Authors: Hoque Anika , Steultjens Martijn , Dickson Diane M , Hendry Gordon J
Published: May 2023

Objective

The RA foot disease activity index (RADAI-F5) is a valid, reliable and clinically feasible patient-reported outcome measure (PROM) for the measurement of RA foot disease activity. Further validation of the RADAI-F5 against musculoskeletal ultrasonography (MSUS) for foot disease activity is necessary before clinical implementation. The aim of this study was to examine the construct validity of the RADAI-F5 in relationship to MSUS and clinical examination.

Methods

Participants with RA completed the RADAI-F5. MSUS was used to evaluate disease activity (synovial hypertrophy/synovitis/tenosynovitis/bursitis) and joint damage (erosion) using greyscale (GS) and power Doppler (PD) at 16 regions in each foot, including joints and soft tissues. These same regions were examined clinically for swelling and tenderness. The construct validity of the RADAI-F5 was assessed using correlation coefficients and a priori-specified hypotheses for the strength of associations.

Results

Of 60 participants, 48 were female, with a mean (s.d.) age of 62.6 (9.96) years and median disease duration of 15.49 (interquartile range 6–20.5) years. Theoretically consistent associations confirming construct validity [95% CI] were observed between the RADAI-F5 and MSUS GS (0.76 [0.57, 0.82]; strong), MSUS PD (0.55 [0.35, 0.71]; moderate), MSUS-detected erosions (0.41 [0.18, 0.61]; moderate), clinical tenderness (0.52 [0.31, 0.68]; moderate) and clinical swelling (0.36 [0.13, 0.55]; weak).

Conclusion

Moderate to strong correlations between RADAI-F5 and MSUS demonstrate the good measurement properties of this instrument. With greater confidence in the utility of the RADAI-F5, clinical use of this new instrument as an adjunct to the disease activity score for 28 joints (DAS-28) could help to identify RA patients at risk for poor functional and radiological outcomes.
CaP-coated Zn-Mn-Li alloys regulate osseointegration via influencing macrophage polarization in the osteogenic environment
Authors: Qiang Huifen , Hou Caiyao , Zhang Yujue , Luo Xin , Li Jun , Meng Chunxiu , Liu Kun , Lv Zhaoyong , Chen Ximeng , Liu Fengzhen
Published: May 2023

Immune response is an important factor in determining the fate of bone replacement materials, in which macrophages play an important role. It is a new idea to design biomaterials with immunomodulatory function to reduce inflammation and promote bone integration by regulating macrophages polarization. In this work, the immunomodulatory properties of CaP Zn-Mn-Li alloys and the specific mechanism of action were investigated. We found that the CaP Zn0.8Mn0.1Li alloy promoted the polarization of macrophages toward M2 and reduced inflammation, which could effectively upregulate osteogenesis-related factors and promote new bone formation, indicating the important role of macrophages polarization in biomaterial induction of osteogenesis. In vivo studies further demonstrated that CaP Zn0.8Mn0.1Li alloy could stimulate osteogenesis better than other Zn-Mn-Li alloys implantations by regulating macrophages polarization and reducing inflammation. In addition, transcriptome results showed that CaP Zn0.8Mn0.1Li played an important regulatory role in the life process of macrophages, activating Toll-like receptor signaling pathway, which participated in the activation and attenuation of inflammation, and accelerated bone integration. Thus, by preparing CaP coatings on the surface of Zn-Mn-Li alloys and combining the bioactive ingredient with controlled release, the biomaterial will be imbibed with beneficial immunomodulatory properties that promote bone integration.
Quantifying the impact of PFOA exposure on B-cell development and antibody production
Authors: Taylor Krystal D , Woodlief Tracey L , Ahmed Aya , Hu Qing , Duncker Patrick C , DeWitt Jamie C
Published: May 2023

Per- and polyfluoroalkyl substances (PFAS) are synthetic chemicals; the vast majority are environmentally and biologically persistent, and some have demonstrated toxicity, including cancer, effects on metabolism, endocrine disruption, and immune dysfunction. Suppression of T-cell-dependent antibody responses (TDAR) has been observed in numerous studies of PFAS but mechanisms remain elusive. Evidence from our work suggests that B cells and how they use energy are impacted by PFAS exposure. We hypothesize that a well-studied and immunotoxic PFAS, perfluorooctanoic acid (PFOA), alters B-cell subclasses and markers of their metabolism. Adult male and female C57BL/6 mice were given PFOA (0 or 7.5 mg/kg) via gavage for 15 days, a duration and dose sufficient to suppress the TDAR. After dosing and immunization of subgroups, spleens were prepared to quantify B-cell subsets. Flow cytometric analysis revealed decreased numbers of plasmablasts, follicular, naïve, and overall B-cell subclasses in female PFOA-exposed groups. Male PFOA-exposed groups had a significant increase in follicular B cells and other subsets had decreases, including in the overall number of B cells. Twenty-four hours after naïve B-cell isolation and ex vivo activation, metabolic measurements revealed a 5-fold increase in metabolic markers in response to stimulation in PFOA-exposed groups compared with controls. These findings suggest that B-cell development and survival may be hindered by PFOA exposure, but that activation of the remaining B cells was not. Based on these findings, PFOA-mediated suppression of the primary IgM antibody response results changes to specific subsets of B cells.
An overview of myelodysplastic syndromes
Authors: Pontrelli Gina , Loscalzo Carina , L'Eplattenier Mark
Published: May 2023

Myelodysplastic syndromes (MDS) can present as a cytopenia—often as unexplained anemia. Because MDS can progress to acute myelogenous leukemia, primary care providers should be aware of the signs and symptoms, which are associated with the corresponding cytopenia that patients experience and may include fatigue, infection, easy bruising, and bleeding. Treatment options center on managing related cytopenias. The only cure, stem cell transplant, is not readily available.
An Outpatient Pain Plan and Emergency Department Pain Pathway for Adults With Sickle Cell Disease
Authors: Mercado Stephanie Harris
Published: May 2023

Sickle cell disease (SCD), one of the most common inherited diseases, is associated with lifetime morbidity and reduced life expectancy. In the United States, SCD primarily affects Black patients and, to a lesser degree, those of Hispanic descent

These populations are known to have health care disparities related to lower socioeconomic status, limited access to health care, and racial bias. The quality-adjusted life expectancy of patients with SCD is less than 35 years, because of progressive complications of the disease. The most common complication is severe episodic pain related to vaso-occlusive ischemic events. Despite guidelines, pain management often is delayed as patients struggle with resistance from clinicians based on concerns over opioid use or abuse, overdose, or drug-seeking behavior. Effective pain management can be accomplished with collaboration between clinicians and patients, a documented outpatient pain management plan, and when necessary, an emergency department clinical pain pathway for acute SCD pain management
Medically Attended Acute Adverse Events in Pregnant People After Coronavirus Disease 2019 (COVID-19) Booster Vaccination
Authors: DeSilva Malini B. , Haapala Jacob , Vazquez-Benitez Gabriela , Boyce Thomas G. , Fuller Candace C. , Daley Matthew F. , Getahun Darios , Hambidge Simon J. , Lipkind Heather S. , Naleway Allison L. , Nelson Jennifer C. , Vesco Kimberly K. , Weintraub Eric S. , Williams Joshua T.B. , Zerbo Ousseny , Kharbanda Elyse O.
Published: May 2023

In this multisite, observational, matched cohort study of more than 80,000 pregnant people, receipt of an mRNA monovalent coronavirus disease 2019 (COVID-19) booster vaccination in pregnancy was not associated with increased risk for thrombocytopenia, myocarditis, venous thromboembolism, ischemic stroke, or other serious adverse events within 21 or 42 days after booster vaccination. The mRNA monovalent COVID-19 booster in pregnancy was associated with an increased risk for medically attended malaise or fatigue within 7 days of vaccination (adjusted rate ratio [aRR] 3.64, 95% CI 2.42–5.48) and lymphadenopathy or lymphadenitis within 21 days (aRR 3.25, 95% CI 1.67–6.30) or 42 days (aRR 2.18, 95% CI 1.33–3.58) of vaccination. Our findings are consistent with prior evaluations of the primary COVID-19 vaccine series and are reassuring with respect to COVID-19 booster vaccination in pregnancy.
Potential risk factors, clinicopathological features and determinants of survival for multiple primary melanoma patients compared to single primary melanoma: a large single-center Italian study
Authors: Mattavelli Ilaria , Patuzzo Roberto , Galeone Carlotta , Pelucchi Claudio , Gallino Gianfranco , Leva Andrea , Valeri Barbara , Santinami Mario , Maurichi Andrea
Published: May 2023

Melanoma patients have a high risk of developing subsequent primary melanomas, a condition known as multiple primary melanoma (MPM). We aimed to compare risk factors of patients with MPM and single primary melanoma (SPM). Primary MPM and SPM consecutively treated at the National Cancer Institute in Milan, Italy, from 1978 to 2021 were retrospectively investigated. Demographic and clinicopathological characteristics were analyzed. Multivariate hazard ratios and mortality were estimated using Cox proportional hazards regression models. Overall, 9122 patients with SPM and 944 with MPM were included. A total of 1437 and 85 deaths occurred in SPM and MPM group, respectively. Of these, 1315 (14.4%) within SPM patients and 60 (6.4%) in MPM group were melanoma-specific deaths (MSDs). Males had a higher risk for MPM (hazard ratio = 1.29), while age was not associated with MPM (hazard ratio = 0.98). The risk of MPM decreased by about 50% for Breslow thickness >1 mm, and by about 45 and 75% in presence of mitoses and ulceration, respectively. The multivariate hazard ratio of death for MPM compared to SPM patients was 0.85 (95% confidence interval, CI: 0.67–1.06), while considering MSD the corresponding hazard ratio was 0.93 (95% CI: 0.71–1.22). Melanoma patients should receive regular follow-up with complete skin examination to detect early subsequent primary melanoma. Patients with more advanced primary have decreased risk of MPM, while males have higher risk. Our study reported no significant difference in mortality between SPM and MPM, but the issue is still open for discussion and further studies.
Orbital and Eyelid Characteristics, Strabismus, and Intracranial Pressure Control in Apert Children Treated by Endoscopic Strip Craniectomy versus Fronto-Orbital Advancement
Authors: Dohlman Jenny C. , Prabhu Sanjay P. , Staffa Steven J. , Kanack Melissa D. , Mackinnon Sarah , Warkad Vivekanand U. , Meara John G. , Proctor Mark R. , Dagi Linda R.
Published: May 2023

Background:

Apert syndrome is characterized by eyelid dysmorphology, V-pattern strabismus, extraocular muscle excyclorotation, and elevated intracranial pressure (ICP). We compare eyelid characteristics, severity of V-pattern strabismus, rectus muscle excyclorotation, and ICP control in Apert syndrome patients initially treated by endoscopic strip craniectomy (ESC) at about 4 months of age versus fronto-orbital advancement (FOA) performed about 1 year of age.

Methods:

Twenty-five patients treated at Boston Children’s Hospital met inclusion criteria for this retrospective cohort study. Primary outcomes were magnitude of palpebral fissure downslanting at 1, 3, and 5 years of age, severity of V-pattern strabismus, rectus muscle excyclorotation, and interventions to control ICP.

Results:

Before craniofacial repair and through 1 year of age, none of the studied parameters differed for FOA versus ESC treated patients. Palpebral fissure downslanting became statistically greater for those treated by FOA by 3 (P < 0.001) and 5 years of age (P = 0.001). Likewise, severity of palpebral fissure downslanting correlated with severity of V-pattern strabismus at 3 (P = 0.004) and 5 (P = 0.002) years of age. Palpebral fissure downslanting and rectus muscle excyclorotation were typically coexistent (P = 0.053). Secondary interventions to control ICP were required in four of 14 patients treated by ESC (primarily FOA) and in two of 11 patients initially treated by FOA (primarily third ventriculostomy) (P = 0.661).

Conclusions:

Apert patients initially treated by ESC had less severe palpebral fissure downslanting and V-pattern strabismus, normalizing their appearance. Thirty percent initially treated by ESC required secondary FOA to control ICP.
Donor and Recipient Nerve Axon Counts in Gender-affirming Radial Forearm Phalloplasty: Informing Choice of Nerve Coaptations
Authors: Krasnoff Chloe , Ferrin Peter , Peters Blair R.
Published: May 2023

Background:

A key component of success of a nerve transfer is the innervation density, which is directly affected by the donor nerve axonal density and donor-to-recipient (D:R) axon ratio. Optimal D:R axon ratio for a nerve transfer is quoted at 0.7:1 or greater. In phalloplasty surgery, there are currently minimal data available to help inform selection of donor and recipient nerves, including unavailability of axon counts.

Methods:

Five transmasculine people who underwent gender-affirming radial forearm phalloplasty had nerve specimens processed with histomorphometric evaluation to determine axon counts and approximate donor-to-recipient axon ratios.

Results:

Mean axon counts for recipient nerves were 6957 ± 1098 [the lateral antebrachial (LABC)], 1866 ± 590 [medial antebrachial (MABC)], and 1712 ± 121 [posterior antebrachial cutaneous (PABC)]. Mean axon counts for donor nerves were 2301 ± 551 [ilioinguinal (IL)] and 5140 ± 218 [dorsal nerve of the clitoris (DNC)]. D:R axon ratios using mean axon counts were DNC:LABC 0.739 (0.61–1.03), DNC:MABC 2.754 (1.83–5.91), DNC:PABC 3.002 (2.71–3.53), IL:LABC 0.331 (0.24–0.46), IL:MABC 1.233 (0.86–1.17), and IL:PABC 1.344 (0.85–1.82).

Conclusions:

The DNC is the more powerful donor nerve with greater than two times the axon count of the IL. The IL nerve may be under-powered to re-innervate the LABC based on an axon ratio consistently less than 0.7:1. All other mean D:R are more than 0.7:1. DNC axon counts may be excessive for re-innervation of the MABC or PABC alone with D:R of more than 2.5:1, potentially increasing risk of neuroma formation at the coaptation site.
Patient Utilization of Premium Intraocular Lenses Before and During the COVID-19 Pandemic
Authors: Cha Eumee , Arsiwala-Scheppach Lubaina T. , Srikumaran Divya , Prescott Christina R.
Published: May 2023

Purpose:

To compare the choice of intraocular lens (IOL) and sociodemographic characteristics between patients who underwent elective cataract surgery before the COVID-19 pandemic and during the pandemic at the Wilmer Eye Institute.

Methods:

A retrospective chart review of patients who underwent cataract surgery before the COVID-19 pandemic (June 1 to November 30, 2019) and during the pandemic (June 1 to November 30, 2020) was conducted. Sociodemographic information, including age, sex, race, and insurance, and choice of IOL (premium or standard) were analyzed. The association between timing of surgery and choice of IOL was analyzed using multivariable logistic regression.

Results:

The study included 2,877 patients (3,946 eyes) before COVID-19 and 2,564 patients (3,605 eyes) during COVID-19. However, 9.0% (357/3,946) of surgeries before COVID-19 used premium IOLs compared with 11.1% (399/3,605) during COVID-19 (P=0.004). There was no difference in the racial characteristics of patients between before and during COVID-19. After adjusting for time of surgery and demographics, the odds of choosing premium IOLs for black patients was 0.32 times the odds for white patients (P<0.001). There was an increase in private-insured patients but a decrease in Medicare-insured patients during COVID-19. After adjusting for time of surgery and demographics, private-insured patients had higher odds of choosing premium IOLs (P<0.001), whereas Medicaid-insured patients had lower odds (P=0.007) when compared with Medicare-insured patients.

Conclusion:

More patients chose premium IOLs during COVID-19 than before COVID-19, concurrent with change in insurance status. White patients were more likely to choose premium IOLs than black patients, as were private-insured patients compared with Medicare-insured patients.
Video-Assisted Versus Traditional Problem-Based Learning: A Quasi-Experimental Study Among Pediatric Nursing Students
Authors: YANG Sun-Yi , OH Yun-Hee
Published: May 2023

Background

The text-assisted problem-based, methods traditionally used to teach nursing students cannot adequately simulate holistic clinical situations and patient symptoms. Although video-assisted, problem-based learning methods combined with text have shown positive results in terms of improving comprehension and cognitive abilities, some studies have shown these methods to be inferior to text-assisted methods in terms of promoting deep critical thinking in medical students.

Purpose

This study was designed to assess the benefits in nursing education of video-assisted, problem-based learning using online multimedia technologies compared with text-assisted, problem-based learning using traditional face-to-face classes.

Methods

A quasi-experimental, nonequivalent control group, preintervention-and-postintervention design was used. The experimental group (n = 31) received video-assisted, problem-based learning materials with multimedia technologies (video scenarios, Google Docs worksheets, Google slides, Zoom cloud meetings, and e-learning management system) and weekly online lectures (100 minutes) for 4 weeks. The control group (n = 35) received text-assisted, problem-based learning materials with traditional face-to-face classes and weekly lectures (100 minutes) for 4 weeks. The study data were analyzed using chi-square, Fisher's exact, and independent t tests as well as analysis of variance.

Results

At posttest, learning motivation (t = 3.25, p = .002), academic self-efficacy (t = 2.41, p = .019), and self-directed learning (t = 3.08, p = .003) were significantly higher in the experimental group than in the control group.

Conclusions/Implications for Practice

Video-assisted, problem-based learning using multimedia technologies was shown to be effective in increasing learning motivation, academic self-efficacy, and self-directed learning in nursing students. These findings have implications for the development and planning of contactless classes in response to the coronavirus pandemic. Notably, no intergroup differences were found in terms of problem-solving skills. Future studies should include in-depth reviews and assessments of the difficulties faced in producing problem scenarios as well as the methods of instruction.
Exploring Mental Health and Psychosocial Well-Being in Recovered Jordanian Individuals With COVID-19: A Phenomenological Study
Authors: HAMDAN MANSOUR Ayman M. , KHALIFEH Anas H. , ALSHIBI Ahmad N. , HAMAIDEH Shaher H. , ABU AL-KHAIR Feda' M. , KHRAISAT Omar , ALHALAIQA Fadwa N.
Published: May 2023

Background

COVID-19-related healthcare services focus primarily on medical and physical treatments. Related treatments for psychosocial and mental health needs have not been a priority for healthcare professionals. Understanding the process by which individuals who have recovered from COVID-19 adapt psychologically will allow better planning for mental healthcare and healthcare outcomes.

Purpose

The purpose of this study was to explore how recovered individuals with COVID-19 adapted to related psychological and social stressors during the infection period.

Methods

A descriptive phenomenological approach was used to investigate a purposive sample of 13 individuals in Jordan who had recovered from COVID-19. Data were collected using semistructured interviews.

Results

Perceptions related to being diagnosed with COVID-19 were distinguished into four major themes: conscious awareness (acceptance, victimization, and normalizing), uncertainty (apprehension and poor communication), sources of psychosocial support (caring family, healthcare professionals' support, and self-grieving), and resilience (optimism, positive thinking, and spirituality).

Conclusions

The findings of this study indicate the need to integrate psychosocial and mental healthcare services into healthcare plans provided to individuals with COVID-19 and similar pandemic infections.
The Department of Veterans’ Affairs Depleted Uranium Cohort in the Time of COVID-19
Authors: McDiarmid Melissa A. , Hines Stella , Cloeren Marianne , Gucer Patricia , Condon Marian , Oliver Marc , Roth Tracy , Lewin-Smith Michael R. , Strathmann Frederick , Velez-Quinones Maria A. , Gaitens Joanna M.
Published: May 2023

Objective

In 2021, 37 members of a cohort of depleted uranium-exposed Gulf War I veterans were evaluated using a protocol tailored to accommodate COVID-19 safety practices on a telehealth platform.

Methods

Individual elements of the legacy protocol were reviewed for urgency and feasibility of inclusion in a modified, telehealth platform.

Results

The redesigned protocol included a participant readiness for telehealth assessment, nurse and physician telehealth visits, collection of usual health questionnaires, and urine collections for exposure monitoring for uranium and other fragment-related metal measures.

Conclusions

Despite some limitations in scope, the telehealth platform permitted a visual “visit” with surveillance participants who expressed a high comfort level with the format. The telehealth platform has apparent utility for occupational surveillance and should be explored as a standard approach for surveillance outside of public health emergencies.
Absenteeism Due to Mental Disorders in Agents Fighting Endemic Diseases in Ceará/Northeast Brazil
Authors: Bastos Maria Luiza Almeida , Silva de Carvalho Thalyta Gleyane , Mattos Lacerda Eliana , Monteiro Ferreira Marcelo José
Published: May 2023

Objective

The purpose of this study is to quantify the days away from work by mental disorders (MDs) in endemic fighting agents (EFAs) in the state in Northeast Brazil.

Methods

This is a historical cohort carried out from the survey of 584 expert medical records of EFA. The association measures were performed using Poisson regression models.

Results

The days away from work increased over time. Endemic fighting agents who have been on sick leaves by mood disorders ([cumulative incidence like relative risk (IRR)], 21.37; 95% CI, 12.36–36.93), alcoholism (IRR, 17.12; 95% CI, 10.04–29.34), and stress-related disorders (IRR, 10.32; 95% CI, 6.05–17.63) have a higher risk of absenteeism longer than 15 days.

Conclusion

This study reinforces the importance of actions for coping with MD in EFA.
The Effectiveness of the DeskCycle in Reducing Sedentary Behavior Among Female Office Workers
Authors: Odhiambo Lorriane A. , Marion Alexander J. , Callihan Thomas R. , Harmatz Alison E. , Yala Joy A. , Bundy Kristina , Zullo Melissa D.
Published: May 2023

Objective

To evaluate the effectiveness of the DeskCycle in reducing sedentary behavior among female office workers at an educational institution.

Methods

This was a randomized control trial with a crossover design (N = 80). The intervention was conducted in two 8-week phases and included the DeskCycle and an informational handout with benefits and suggestions about the frequency of use. The primary outcome was weekly average nonsedentary time. Secondary outcomes included weight and mood.

Results

DeskCycle users reported significantly higher weekly average nonsedentary time compared with nonusers (phase I: 402.3 ± 72.4 vs 169.3 ± 17.5,P< 0.00; phase II: 282 ± 45 vs 216 ± 23,P= 0.00). There were no significant differences in weight or mood.

Conclusions

The DeskCycle is effective in reducing sedentary behavior, suggesting workers in sedentary office occupations could integrate it into their workday, where possible, to prevent negative health outcomes.
Residual or recurrent obstruction after septal myectomy in young children and infants with hypertrophic cardiomyopathy: cohort study
Authors: Dong Shuo , Du Chuhao , Song Jiangping , Dong Jie , Meng Hong , Xu Haitao , Sun Yangxue , Zou Mengxuan , Li Shoujun , Yan Jun
Published: May 2023

Background:

The outcomes after septal myectomy in young children and infants with hypertrophic obstructive cardiomyopathy (HOCM) are not clear. The study sought to report the outcomes after septal myectomy in young children and infants and identify the mechanisms of residual or recurrent obstruction after surgery.

Methods:

The authors performed an observational cohort study of children and infants under the age of 14 who underwent septal myectomy for HCOM from January 2013 to December 2020. Mean follow-up among 94.3% (n=50) of hospital survivors was 42.09±24.38 months.

Results:

In total, 56 children and infants [mean (SD) age, 5.38 (3.78) years; 29 (58.1%) were male] underwent septal myectomy for HOCM. Cumulative survival was 100, 96.6, 93.0, and 81.4% at 1, 3, 5, and 7 years, respectively, among hospital survivors. The incidence of residual and recurrent obstruction was 14.3% (8/56) and 13.0% (6/46), respectively. The mechanisms of residual obstruction were identified as subaortic obstruction caused by inadequacy of previous septal excision in two patients, midventricular obstruction caused by inadequacy of septal excision in five patients, and untreated abnormal papillary muscles in one patient. Recurrent obstruction was caused by isolated midventricular obstruction (n=4) and newly emerged systolic anterior motion (SAM)-related subaortic obstruction combining abnormal mitral valve apparatus (n=2). Residual or recurrent obstruction was associated with age less than 2 years at surgery (OR=6.157, 95% CI: 1.487–25.487, P=0.012) and biventricular outflow obstruction (OR=6.139, 95% CI: 1.292–29.172, P=0.022). Recurrent obstruction was associated with age less than 2 years at surgery (OR=6.976, 95% CI: 1.233–39.466, P=0.028).

Conclusions:

Septal myectomy is still effective and safe in young children and infants. The rate of residual or recurrent obstruction with diverse causes is relatively high, which is more likely to occur in children aged less than 2 years at surgery and those with biventricular obstruction.
Professional Development for Associated Faculty: A National Assessment of Available Resources
Authors: Bilyeu Catherine , Niski Jessica , Reilly Michelle
Published: May 2023

Introduction.

Faculty development has been identified as an important initiative in Doctor of Physical Therapy (DPT) education. However, little is known about opportunities available for associated faculty (AF). These unique educators who make notable contributions to physical therapist education often lack formal preparation for teaching. The purpose of this study was to explore AF development opportunities across physical therapist education programs nationally.

Review of Literature.

Formal faculty development programs have been successful in medical and nursing education programs to enhance educator identity, skill, and retention in both core and clinical faculty. No evidence of faculty development programs for AF in physical therapy education was found in the literature.

Subjects.

Participants were program directors or identified faculty development leads from CAPTE accredited and in-candidacy physical therapist education programs. Seventy participants completed an anonymous survey and 10 participated in semistructured interviews following the completion of the survey.

Methods.

A parallel, convergent, mixed methods approach was used to assess the national state of formal AF development opportunities. A survey was developed to assess development opportunities available to AF. Descriptive statistics and Chi square analyses were performed to analyze quantitative data. An instrumental collective case study further explored development opportunities. Deductive and inductive thematic analysis techniques were used to analyze qualitative data from interview transcripts. Quantitative and qualitative approaches were integrated in the data analysis.

Results.

Survey data, aligned with interview outcomes, suggest that despite ideologic support for faculty development, low percentages of AF have access to formal development activities, and even fewer are receiving adequate breadth of educational content related to proficiency in their role.

Discussion and Conclusion.

A lack of formal development opportunities exists for AF. Excellence in DPT education requires deeper development across all levels of faculty, including opportunities tailored specifically to the unique needs and role of AF.
Massive spontaneous portosystemic shunt is a solid, easily identifiable prognostic factor in patients with cirrhosis
Authors: García-Villarreal Luis , Ortega-Quevedo Vanesa , Pérez-Aguado Guillermo , Saavedra-Santana Pedro , Quiñones Ildefonso , Chang WooRym , Hernández-Socorro Carmen R. , Cabrera-Cabrera Juan
Published: May 2023

Objectives

Spontaneous portosystemic shunts (SPSSs) are associated with complications and death in cirrhosis. We evaluated chronic portosystemic encephalopathy (CPSE) and survival in cirrhotic patients with massive (>10 mm diameter) SPSS (MSPSS).

Methods

We have retrospectively compared 77 cirrhotic patients with MSPSS and 77 paired-matched patients without SPSS.

Results

More patients with MSPSS presented with CPSE (40.3% vs. 20.8%, P = 0.010) or died (33.8% vs. 18.2%, P = 0.039). Model for Endstage Liver Disease (MELD) score [hazard ratio (HR) 1.146, 95% confidence interval (CI) 1.099–1.195], follow-up (FU) ascites (HR 5.128, 95% CI 2.396–10.973) and age (HR 1.048, 95% CI 1.017–1.080) were associated with CPSE; and MELD score (HR 1.082, 95% CI 1.035–1.131), FU renal failure (HR 9.319, 95% CI 3.595–24.158), and FU ascites (HR 4.320, 95% CI 1.615–11.555) were associated with death. Liver function worsened faster in the MSPSS group. Among patients with better liver function (MELD < 11.5), MSPSS patients presented worse survival (P = 0.048, Breslow test). Comparing patients by the Child-Pugh group, we did not find differences in survival; in patients from Child-Pugh group B + C, the MSPSS group presented less time free of CPSE (P < 0.05, log-rank test). Patients with splenorenal MSPSS presented better survival (P = 0.04, log-rank test), and patients with umbilical MSPSS had shorter time free of CPSE (P < 0.016, log-rank test).

Conclusion

MSPSS increased CPSE and death risks during long FU. Even with better liver function (MELD < 11.5), MSPSS was associated with lower survival. Splenorenal MSPSS presented better survival and the umbilical type was associated with shorter time free of CPSE.
Effect of age on the association between the Glasgow Coma Scale and the anatomical brain lesion severity: a retrospective multicentre study
Authors: Benhamed Axel , Isaac Chartelin Jean , Boucher Valérie , Yadav Krishan , Mercier Eric , Moore Lynne , D’Astous Myreille , Bernard Francis , Dubucs Xavier , Gossiome Amaury , Emond Marcel
Published: May 2023

Background and importance Older adults are at higher risk of undertriage and mortality following a traumatic brain injury (TBI). Early identification and accurate triage of severe cases is therefore critical. However, the Glasgow Coma Scale (GCS) might lack sensitivity in older patients. Objective This study investigated the effect of age on the association between the GCS and TBI severity. Design, settings, and participants This multicentre retrospective cohort study (2003–2017) included TBI patients aged ≥16 years with an Abbreviated Injury Scale (AIS of 3, 4 or 5). Older adults were defined as aged 65 and over. Outcomes measure and analysis Median GCS score were compared between older and younger adults, within subgroups of similar AIS. Multivariable logistic regressions were computed to assess the association between age and mortality. The primary analysis comprised patients with isolated TBI, and secondary analysis included patients with multiple trauma. Main results A total of 12 562 patients were included, of which 9485 (76%) were isolated TBIs. Among those, older adults represented 52% (n = 4931). There were 22, 27 and 51% of older patients with an AIS-head of 3, 4 and 5 respectively compared to 32, 25 and 43% among younger adults. Within the different subgroups of patients, median GCS scores were higher in older adults: 15 (14–15) vs. 15 (13–15), 15 (14–15) vs. 14 (13–15), 15 (14–15) vs. 14 (8–15), for AIS-head 3, 4 and 5 respectively (all P < 0.0001). Older adults had increased odds of mortality compared to their younger counterparts at all AIS-head levels: AIS-head = 3 [odds ratio (OR) = 2.9, 95% confidence interval (CI) 1.6–5.5], AIS-head = 4, (OR = 2.7, 95% CI 1.6–4.7) and AIS-head = 5 (OR = 2.6, 95% CI 1.9–3.6) TBI (all P < 0.001). Similar results were found among patients with multiple trauma. Conclusions In this study, among TBI patients with similar AIS-head score, there was a significant higher median GCS in older patients compared to younger patients.
In-home Visits and Subsequent Health Outcomes in Medicare Advantage Beneficiaries With Coronary Artery Disease, Diabetes, Hypertension, and Depression
Authors: Smolderen Kim G. , Heath Kevin , Ameli Omid , Spencer Donna , Natwick Tanya , Musich Shirley , Miedico Tania M. , Mena-Hurtado Carlos
Published: May 2023

Background:

Coronary artery disease, diabetes, hypertension, and depression are common burdensome conditions.

Objectives:

To examine whether multidimensional preventive in-home visits were associated with fewer emergency and inpatient care episodes and higher quality of care.

Research Design:

An observational, retrospective data analysis.

Subjects:

A nationwide Medicare Advantage population from the Optum Labs Data Warehouse.

Measures:

We compared beneficiaries with 1 or more of the conditions with an in-home visit in 2018 (“Exposure”) with those without a visit in 2018 but with a future visit in 2019 (“Wait List Control”) using a difference-in-differences analysis. Primary outcomes were 1-year all-cause inpatient care and emergency visit counts. Secondary outcomes included primary care visits, major adverse cardiovascular events, and select quality-of-care metrics. An exploratory outcome was the time-to-first primary care visit after the index date.

Results:

Among those eligible to receive an in-home visit, a total of 48,566 patients had an in-home visit in 2018 (the “Exposure” group), and 36,549 beneficiaries constituted the “Wait List” control group. Receiving an in-home visit early was associated with a greater decrease in inpatient stays for all 4 conditions (change score range for any stay: −5.22% to −2.47%) (P<0.001, depression <0.05); decrease in emergency visits (change score range for any stay: −4.39% to −3.67%) (P<0.0.001, depression <0.05); and fewer major adverse cardiovascular events for coronary artery disease and depression (P<0.001 and <0.025, respectively) 1 year later. Minimal differences were noted for change in ambulatory and primary care visits, with no consistent increase in quality-of-care metrics. Time-to-first primary care visit was shorter for the “Exposure” versus the Wait List control group in all conditions (difference between 2.45 and 4.95 d).

Conclusions:

The feasibility and impact of a nationwide multidimensional preventive in-home visit were demonstrated, targeting common and high morbidity conditions. Benefits were observed against a Wait List control group, resulting in less resource-intense care.
Safety and Efficacy of 177Lu-DOTATATE in Neuroendocrine Tumor Patients With Extensive Bone Disease
Authors: Alsadik Shahad , Gnanasegaran Gopinath , Chen Luohai , Quigley Ann-Marie , Mandair Dalvinder , Toumpanakis Christos , Caplin Martyn , Navalkissoor Shaunak
Published: May 2023

Aim

The aim of this study was to assess the efficacy and safety of 177Lu-DOTATATE in patients with neuroendocrine tumors (NETs) and extensive bone metastases, that is, more than 50% of the skeleton involved.

Method

A single-center retrospective analysis was performed in 30 patients (13 women and 17 men, mean age, 60 years; range, 35–77 years) undergoing 177Lu-DOTATATE therapy. Patients had progressive metastatic NETs with extensive skeletal metastases (>50% skeletal involvement seen on baseline 68Ga-DOTATATE PET/CT). The average administered activity was 7.308 (SD, 0.02) GBq per cycle with average treatment interval of 15 weeks. Survival analyses (progression-free survival [PFS], overall survival), radiological response assessment, toxicity assessment, and health-related quality of life (QoL) was performed.

Results

Overall, 26 patients completed 4 cycles, and 4 patients had less than 4 cycles of 177Lu-DOTATATE. One patient (3%) did not complete treatment because of hematological toxicity. The estimated median PFS and median overall survival were calculated at 27 and 35 months, respectively. End-of-treatment radiological assessment showed partial response in 5 patients (17%), stable disease in 20 patients (66%), and radiological progressive disease in 3 patients (10%). Clinical progression was seen in a further 2 patients (7%).

The incidence of grade 3/4 bone marrow toxicity was 10%. No patient had grade 3/4 peptide receptor radionuclide therapy–related nephrotoxicity. There was overall improvement in global QoL score (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire—Gastrointestinal NET-21) (P = 0.019)

Conclusion

177Lu-DOTATATE seems to have satisfactory therapeutic outcome in patients with advanced metastatic NET with extensive bone disease, with reasonable PFS and significant improvement in the global health-related QoL. The bone marrow toxicity was within the accepted range. Increasing the interval between cycles does not seem to reduce efficacy and may reduce toxicity, ensuring the bone marrow has sufficient time to recover between cycles.
Bladder Distention Demonstrating Vesicourachal Diverticulum on 18F-FDG PET/CT Images of a Lung Cancer Patient
Authors: Lu Xuan-Ping , Sung Wen-Wei , Weng Jui-Hung , Weng Jui-Hung , Hsia Jiun-Yi , Kao Pan-Fu
Published: May 2023

A 58-year-old man with lung cancer was referred for an 18F-FDG PET/CT scan for pretreatment staging. The FDG PET/CT scan revealed focal uptakes in the lower abdomen. We differentiated the etiology of the lesions by performing a delayed scan with urine retention and bladder distension. The delayed scan demonstrated a tubular, radioactivity-filled structure arising above the urinary bladder. Combining the FDG PET/CT scan, clinical findings, and ultrasonography, we made the diagnosis of vesicourachal diverticulum.
Incidental Detection of Ilium Langerhans Cell Histiocytosis on 99mTc-DTPA Renal Dynamic Scintigraphy
Authors: Deng Yujiao , He Jian , He Limeng , Gao Haiyan , Zhang Wei
Published: May 2023

We report the case of a 24-year-old man who underwent 99mTc-DTPA scintigraphy for the evaluation the renal function. This scan incidentally showed an abnormal uptake of 99mTc-DTPA in the left lower abdominal region. SPECT/CT fusion images showed osteolytic bone destruction in the left ilium associated with soft tissue mass and elevated DTPA uptake. Biopsy pathology of the ilium lesion demonstrated Langerhans cell histiocytosis.
18F-FDG PET/CT of Alveolar Rhabdomyosarcoma of Prostate in a 17-Year-Old Boy
Authors: Datta Deepanksha , Kumar Rajesh , Chavan Nitish , Vaswani Shruti , Nalwa Aasma
Published: May 2023

Rhabdomyosarcoma of the prostate is a rare malignancy that usually presents in childhood and adolescence with symptoms of bladder outlet obstruction. Serum prostate-specific antigen is usually normal, and 18F-FDG PET/CT has a crucial role to rule out distant metastases. We present a case of alveolar rhabdomyosarcoma of the prostate in a 17-year-old boy.
Safety outcomes of sodium-glucose cotransporter-2 inhibitors in patients with type 2 diabetes and other risk factors for cardiovascular disease: a systematic review and meta-analysis
Authors: Deshpande Radhika , Patel Raj , Regmi Manjari R. , Salih Mohsin , Kropp Robert , Al-Bast Basma , Sheikh Muhammad A. , Sagalov Andrew , Kulkarni Abhishek , Siddique Momin , Hegde Shruti , Bhattarai Mukul
Published: May 2023

Introduction

Sodium-glucose cotransporter-2 inhibitors (SGLT2-Is) have emerged as standard therapy for heart failure. We aim to assess the safety of SGLT2-Is in patients with a high risk of cardiovascular disease.

Areas covered

An electronic database search was conducted for randomized control trials comparing SGLT2-Is to placebo in patients with a high risk of cardiac disease or heart failure. Data were pooled for outcomes using random-effect models. The odds ratio (OR) and 95% confidence interval (CI) were used to compare eight safety outcomes between the two groups. The analysis included ten studies with 71 553 participants, among whom 39 053 received SGLT2-Is; 28 809 were male and 15 655 were female (mean age, 65.2 years). The mean follow-up period was 2.3 years with the range being 0.8–4.2 years. The SGLT2-Is group had a significant reduction in AKI (OR = 0.8;95% CI 0.74–0.90) and serious adverse effects (OR = 0.9; 95% CI 0.83–0.96) as compared to placebo. No difference was found in fracture (OR = 1.1; 95% CI 0.91–1.24), amputation (OR = 1.1; 95% CI 1.00–1.29), hypoglycemia (OR 0.98;95% CI 0.83–1.15), and UTI (OR = 1.1; 95% CI 1.00–1.22). In contrast, DKA (OR = 2.4; 95% CI 1.65–3.60) and volume depletion (OR = 1.2; 95% CI 1.07–1.41) were higher in SGLT2-Is group.

Expert opinion/commentary

The benefits of SLGT2-Is outweigh the risk of adverse events. They may reduce the risk of AKI but are associated with an increased risk of DKA and volume depletion. Further studies are warranted to monitor a wider range of safety outcomes of SGLT2-Is.
Marinobacter panjinensis sp. nov., a moderately halophilic bacterium isolated from sea tidal flat environment
Authors: Yang Wen-Ling , An Ming-Li , He Wei-Hong , Luo Xin , Zhu Lin , Chen Guan-Bin , Zhang Ying-Tao , Wang Ya-Nan
Published: May 2023

Two moderately halotolerant bacterium strains, designated PJ-16T and PJ-38, were isolated from a tidal flat of the red beach in Panjin City, Liaoning Province, PR China. Cells were found to be Gram-stain-negative, aerobic, motile, rod-shaped with a single polar flagellum. Optimum growth of strain PJ-16T occurred at 30 °C, pH 7.0 and 0.2–8.0  % (w/v) NaCl, and strain PJ-38 at 30 °C, pH 6.0–7.0 and 0.2–8.0  % (w/v) NaCl. Phylogenetic analysis based on 16S rRNA gene sequences showed that strain PJ-16T was most closely related to

Marinobacter denitrificans

KCTC 62941T (99.2 % 16S rRNA gene sequence similarity),

Marinobacter algicola

DSM 16394T (98.6 %),

Marinobacter salarius

JCM 19399T (98.4 %) and

Marinobacter confluentis

KCTC 42705T (98.2 %), and strain PJ-38 was most closely related to

M. denitrificans

KCTC 62941T (99.1 %),

M. algicola

DSM 16394T (98.6 %),

M. salarius

JCM 19399T (98.4 %) and

M. confluentis

KCTC 42705T (98.1 %). The G+C content of the genomic DNA of strain PJ-16T based on its draft genomic sequence was 57.4 mol%. The major cellular fatty acids of strain PJ-16T were C16 : 0, C16 : 1
 ω7c/C16 : 1
 ω6c and C18 : 1
 ω9c. The major respiratory quinone of PJ-16T was ubiquinone-9 and the major polar lipids were diphosphatidylglycerol, phosphatidylethanolamine and phosphatidylglycerol. The results of the phenotypic, phylogenetic and genomic analyses revealed that strains PJ-16T and PJ-38 represent a novel species of the genus

Marinobacter

, and the name Marinobacter panjinensis sp. nov. is proposed. The type strain is PJ-16T (= CGMCC 1.13694T= KCTC 72023T).