bluuebunny/crossref_metadata_2025 huggingface dataset:
Big data analysis of endovascular treatment for acute ischemic stroke: a study based on bibliometric analysis
Authors: Lu Xin , Che Huiying , Guan Hongjian
Published: August 2024

Background While bibliometric analyses are prevalent in the medical field, few have focused on ther endovascular treatment for acute ischemic stroke (AIS).

Objective To employ big data analysis to examine the research status, trends, and hotspots in endovascular treatment for AIS.

Methods We conducted a comprehensive search using the Web of Science (WOS) database to identify relevant articles on the endovascular treatment for AIS from 1980 to the present. We used various tools for data analysis, including an online platform (https://bibliometric.com/app), the Citespace software, the Vosviewer software, and the ArcMap software, version 10.8. A number of bibliometric indicators were collected and analyzed, such as publication date, country where the studies were conducted, institutions to which the authors were affiliated, authors, high-frequency keywords, cooperative relationship etc.

Results A total of 5,576 articles were retrieved. A substantial increase in the number of articles occurred after 2010. High-frequency keywords included terms such as large vessel occlusion, reperfusion, outcome, and basilar artery occlusion. Among the top 10 most productive authors, Raul G. Nogueira ranked first, with 136 published articles. Among the journals, The New England Journal of Medicine ranked first, with 5,631 citations. The United States has the closest collaborative ties with other nations.

Conclusion In the present study, we found that the reports of endovascular treatment for AIS gradually increased after 2010. Among them, Raul G. Nogueira was the most productive author in this field. The New England Journal of Medicine was the most cited, and it had the greatest impact. The Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands (MR CLEAN) trial study was the most cited, and it was a landmark study. There are many interesting studies on endovascular treatment for AIS, such as ischemic penumbra, collateral circulation, bridging therapy etc.
An essay on the Charcot and Richer hysteria: from charcoal drawings to cell phones
Authors: Caeira Marlon Wycliff , Coutinho Leo , Nascimento Igor Abrahim , Paola Luciano de , Teive Hélio Afonso Ghizoni
Published: August 2024

Hysteria, previously also known as the disease of the womb, has moved from being a woman's illness through the medieval times' stigma of demonic possession, to the modern concept of a functional neurological disorder. Interestingly to the present assay, Charcot (1825–1893) and Richer (1849–1933) described, in their 1887 work Les Démoniaques dans l'art, by means of iconography, semiological aspects of the so-called Grande Attaque Hystérique, which resembles features of psychogenic nonepileptic seizures emulating grand mal epileptic seizures. The aim of the present assay is to describe how those charcoal iconographic representations evolved through history and are nowadays portrayed in videos recorded at epilepsy monitoring units and patients' cell phones.
‘Our biology is listening’: biomarkers as molecular vestiges of early life and the production of positive childhood experiences in behavioral epigenetics
Authors: Jeffries Hein Robbin , Lappé Martine , Fahey Fionna Francis
Published: August 2024

The sciences of environmental epigenetics and the Developmental Origins of Health and Disease have become central in efforts to understand how early life experiences impact health across the life course. This paper draws on interviews with epigenetic scientists and laboratory observations in the United States and Canada to show how scientists conceptualize epigenetic biomarkers as molecular vestiges of early life and the consequences this has for postgenomic approaches to health, risk, and intervention. We argue that this process demarcates early life as the optimal time to study and intervene in health and positions biomarkers as conceptual and methodological tools that scientists mobilize to reimagine early life environments. These environments include Positive Childhood Experiences (PCEs), which reflect an emergent and increasingly prominent epistemic object in behavioral epigenetics. Though distinct from widespread research on Early Life Adversity, we show how PCEs continue to essentialize experience in gendered and individualized ways. Further, this paper suggests that focusing on biomarkers as molecular vestiges of early life allows scientists to create stability despite ongoing epistemological and biological unknowns in epigenetics and DOHaD. Our findings contribute new perspectives to social studies of epigenetics, biomarkers, and the production of novel epistemic objects in postgenomic knowledge practices.
Countering Fraud Organizations and Frameworks
Authors: Betts Michael J , Eshelby Laura , Whitehouse-Hayes David
Published: August 2024

This chapter explores the fraud landscape focusing on the ecosystem of organizations involved in responding to fraud in the UK and beyond. These include the key organizations from public administration and law enforcement providing a detailed view on the wider organizations involved in detecting, preventing, and responding to fraud, corruption, and wider economic crime. It includes an introduction to the Public Sector Fraud Authority which launched in 2022, housed in the Cabinet Office and HM Treasury, with a mandate to provide strategic leadership, and counter fraud services to bolster capacity and capability for departments and public bodies. References are given to the Government Counter Fraud Profession and associated standards for counter fraud practitioners, including leadership, management, and strategy, with a focus on their practical application. Due to the design of the competency frameworks these have utility in a range of sectors describing the knowledge, skills, and behaviours that lead to excellence in leadership in this particular counter fraud context. The Fraud Management Model is described which was developed from domestic and international best practice, and considers how to deter and manage the risk of fraud. Other models are included to provide a range of options for leaders in this field to draw from in their roles now and in the future.
Fraud Investigation Fundamentals
Authors: Betts Michael J , Eshelby Laura , Whitehouse-Hayes David
Published: August 2024

This chapter introduces the basics of effective investigation including how to plan, lead, and evaluate following the completion of an investigation (post-investigation review). The reader is provided with key approaches for all stages of investigation, and insight into how to manage a range of varying complexities in doing so, including multidisciplinary and multi-agency investigations. It provides a guide to key products and tools to adopt in the pursuit of investigation. It explains the use of techniques and models that will help support consistent-quality investigation outcomes, and also assist with the consolidation of learning and knowledge for the reader. The chapter includes an overview of key challenges and risks to look for and manage in the pursuit of investigation, drawing on personal insight from those with substantial experience in law enforcement and public sector investigations and fraud response. Content is linked to the Government Counter Fraud Profession Standard on investigation and incorporates a review of the basics that underpin the investigative mindset, including decision-making, material attrition, and how to follow the money in a fraud investigation. It has wide applicability in terms of operating environments, and explores the frameworks for regulatory, civil, and criminal investigations.
“Schism Was in the Air”
Authors: Alcántara Jared E
Published: August 2024

This chapter offers an in-depth account of the annual meeting of the National Baptist Convention in 1960, a meeting that was plagued by controversy over the presidential election between Joseph H. Jackson and Gardner C. Taylor, that concluded several days earlier than planned, that produced a lawsuit against Jackson, and that resulted in two leaders claiming to be the duly elected president of the NBC. This chapter also charts the rise and fall of the alliance between the Jackson family and the family of Martin Luther King Jr. as well as the early discussions surrounding the launching of a new denomination: the Progressive National Baptist Convention.
A Resourceful and Pedagogical Approach to Teaching Students with Differences and Disabilities
Authors: Hammel Alice M , Hourigan Ryan M
Published: August 2024

The most effective approach when working within a school and school system is to become a part of the existing team of professionals. Teachers often become compartmentalized when teaching music in another part of the building or when traveling from building to building. Successful child-centered schools function as teams, and active participation is important for each individual teacher and for the overall success of the school. This chapter examines team-building skills and how being proactive and positive can assist teachers as they become involved as integral “team members” within a school. This includes participating in the IEP/504 process as well as maintaining relationships with special education staff, therapists and other team members. Lastly, understanding how to approach caregivers regarding their children is an important consideration when teaching students with differences and disabilities.
Developing a Student-Centered and Inclusive Music Classroom
Authors: Hammel Alice M , Hourigan Ryan M
Published: August 2024

This chapter is designed to provide effective tools and strategies at the micro level (e.g., behavior and management techniques) and the macro level by informing the reader of philosophical underpinnings that encompass a successful inclusive classroom. The socialization and lasting relationships that all students develop in school are also of considerable importance. Therefore, it is imperative for music educators to strive for a caring, inclusive environment that is conducive for all students to learn. The practical strategies suggested at the end of this chapter are presented to encourage music educators to create a tolerant, caring classroom that is conducive for music teaching and learning. Many of the techniques discussed in this chapter are just examples of good teaching, regardless of what population of students you are teaching.
Teaching Music to Students Who Are Intellectually Gifted
Authors: Hammel Alice M , Hourigan Ryan M
Published: August 2024

Most often, music educators adapt teaching to accommodate students who learn at a slower rate; however, it is important to also consider adapting one’s teaching for those students who learn at a faster rate than their peers. These students are often identified as being intellectually gifted. This chapter is specifically aimed at examining students who are intellectually gifted. A common conflation often occurs when music educators consider musical talent and intellectual giftedness as similar or the same. Musical talent is entirely separate from intellectual giftedness. We have chosen to focus on intellectual giftedness in this chapter to continue our discussion of the Cognition Domain in a way that is different from most Cognition Domain conversation.
Resources for Music Teachers and Music Teacher Educators Regarding Teaching Students with Differences and Disabilities
Authors: Knapp Erika J
Published: August 2024

This chapter is a comprehensive collection of resources for music educators. It is meant as a “handbook” style chapter for music educators to access print, electronic, and other tools to enhance their ability to teach students with learning differences. Featured are resources for practicing music educators, higher education music educators, and anyone interested in learning more about disabilities. Digital resources are included as are hubs or communities of families of students with disabilities. Specific medical labels are used in part because the information within the website is named via a label. There are state, region, and national support resources included. This chapter was prepared by Erika J. Knapp, Ph.D.
Effect of intranasal insulin on perioperative cognitive function in older adults: a randomized, placebo-controlled, double-blind clinical trial
Authors: Sun Miao , Ruan Xianghan , Zhou Zhikang , Huo Yuting , Liu Min , Liu Siyuan , Cao Jiangbei , Liu Yan-hong , Zhang Xiaoying , Ma Yu-long , Mi Weidong
Published: August 2024

Background

Postoperative cognitive impairment are common neural complications in older surgical patients and exacerbate the burden of medical care on families and society.

Methods

A total of 140 older patients who were scheduled for elective orthopaedic surgery or pancreatic surgery with general anaesthesia were randomly assigned to Group S or Group I with a 1:1 allocation. Patients in Group S and Group I received intranasal administration of 400 μL of normal saline or 40 IU/400 μL of insulin, respectively, once daily from 5 minutes before anaesthesia induction until 3 days postoperatively. Perioperative cognitive function was assessed using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment-Basic (MoCA-B) at 1 day before and 3 days after surgery and postoperative delirium (POD) incidence was assessed using the 3-minute Diagnostic Interview for CAM (3D-CAM) on postoperative days 1–3. Serum levels of interleukin-6 (IL-6), tumour necrosis factor α (TNF-α), S100-β and C-reactive protein (CRP) were measured on the first day after surgery.

Results

Insulin treatment significantly increased postoperative MMSE and MoCA-B scores in group I than in group S (P < 0.001, P = 0.001, respectively), decreased the incidence of POD within the 3-day postoperative period in Group I than in Group S (10.9% vs 26.6%, P = 0.024), and inhibited postoperative IL-6 and S100-β levels in Group I compared to Group S (P = 0.034, P = 0.044, respectively).

Conclusions

Intranasal insulin administration is thus suggested as a potential therapy to improve postoperative cognition in older patients undergoing surgery. However, a more standardized multi-centre, large-sample study is needed to further validate these results.
Profiling of circulating extracellular vesicle microRNAs reveals diagnostic potential and pathways in non-obstructive and obstructive azoospermia
Authors: Qi Yujuan , Wu Yalun , Pang Kun , Cao Yijuan , Li Honglin , Qiao Yu , Yuan Dejian , Liu Xiangen , Li Zhenbei , Hu Fangfang , Yang Wen , Han Conghui , Zhu Zuobin
Published: August 2024

The accurate diagnosis of non-obstructive azoospermia and obstructive azoospermia is crucial for selecting appropriate clinical treatments. This study aimed to investigate the pivotal role of microRNAs in circulating plasma extracellular vesicles in distinguishing between non-obstructive azoospermia and obstructive azoospermia, as well as uncovering the signaling pathways involved in azoospermia pathogenesis. In this study, differential expression of extracellular vesicle miR-513c-5p and miR-202-5p was observed between non-obstructive azoospermia and obstructive azoospermia patients, while the selenocompound metabolism pathway could be affected in azoospermia through Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis. The predictive power of these microRNAs was evaluated using receiver characteristic operator–area under the curve analysis, demonstrating promising sensitivity, specificity, and area under the curve values. A binomial regression equation incorporating circulating plasma levels of extracellular vesicles miR-202-5p and miR-513c-5p along with follicle-stimulating hormone was calculated to provide a clinically applicable method for diagnosing non-obstructive azoospermia and obstructive azoospermia. This study presents a potentially non-invasive testing approach for distinguishing between non-obstructive azoospermia and obstructive azoospermia, offering a possibly valuable tool for clinical practice.
Hormonal profiles and biomarkers leading to parturition in cattle
Authors: Monteiro Pedo L J , Wiltbank Milo C , Frizzarini Waneska S , Andrade João Paulo N , Cabrera Elisa M , Schoenfeld Sophia G , Domingues Rafael R , Hernandez Laura L
Published: August 2024

This study aimed to understand the physiological mechanisms regulating parturition and to identify potential biomarkers to predict onset of birth. Additionally, we compared hormone profiles between cows with shorter and longer gestation lengths. Twenty-eight days before due date until 3d postpartum, cows (n = 18) were blood-sampled daily. Circulating concentrations were measured for progesterone and estradiol by RIA, testosterone, prostaglandin F2α metabolite, cortisol, pregnancy-specific protein B by enzyme-linked immunosorbent assay, and lactate concentrations by colorimetric assay. At end of gestation, progesterone decreased from d-14 to d-4 (from 3.6 to 1.4 ng/mL), most likely from rapid loss of placental progesterone production (64% of decline in 24 h). A second rapid decrease in progesterone to undetectable concentrations was observed from d-2 to parturition (from 1.4 to 0.1 ng/ml; most likely luteal origin) corresponding to increase in prostaglandin F2α metabolite from d-2 to parturition (249.7 to 2868.4 pg/mL). E2 and pregnancy-specific protein B increased ~8-fold from ~13d before parturition with acute rise in E2 but not pregnancy-specific protein B (45% vs. 13% in first 24 h). Testosterone decreased slightly during the same period. Cortisol and lactate increased only at calving. Comparison of cows with shorter vs. longer gestation, when data were normalized to parturition day, a difference was detected in circulating E2 and prostaglandin F2α metabolite patterns, but not progesterone and pregnancy-specific protein B. Thus, the first significant hormonal changes associated with parturition begin at d-14 with E2 and pregnancy-specific protein B as two clear biomarkers of impending parturition. Cows with shorter and longer gestation had hormonal differences indicative of identifiable earlier placental maturation.
Diagnosing scabies in a patient with skin of colour using the burrow ink test
Authors: Balak Deepak M W , Rauwerdink Daan
Published: August 2024

A patient with skin of colour presented with a 3-month history of progressive itch and skin-coloured papules without visible burrows or dermoscopic features of scabies. However, a burrow ink test revealed skin burrows, confirming a clinical diagnosis for scabies. This case underscores the diagnostic utility of the burrow ink test for scabies in patients with darker skin.
Eruptive telangiectasia: a closer look at trastuzumab emtansine cutaneous complications in patients with breast cancer
Authors: Cánovas Seva Carmen , Sáez Padilla José , López-Pardo Rico María , Buján Bonino Cecilia , Aliste Santos Carlos , Moreiras Arias Noelia
Published: August 2024

Breast cancer, the most common malignancy in women, often involves overexpression of human epidermal growth factor receptor 2 (HER2), indicating poor prognosis. Trastuzumab emtansine (T-DM1) is an effective therapeutic option. Although it does have side-effects, these rarely include skin-related issues. However, we present here a case report of a patient with HER2-positive breast carcinoma who, while undergoing T-DM1 treatment, manifested eruptive telangiectatic macules, a rarely reported adverse effect. We conducted a literature review and identified some reports of cases where cutaneous side-effects of T-DM1 were associated with hepatic abnormalities, indicating potential systemic implications. Monitoring for liver damage, possibly through hepatic elastography, could aid in managing T-DM1-associated complications.
A systematic review of nonpharmacological treatment options for skin picking disorder
Authors: Loftus Harrison , Cassidy Caroline , Mun Lisa , Jafferany Mohammad
Published: August 2024

Skin picking disorder (SPD) is a well-described neuropsychiatric disorder that causes severe stress and impairment. However, there is no clear protocol for treating patients, and only a relatively small body of literature evaluating treatment approaches. This review aims to summarize and compare recent publications and provide an up-to-date guide of current nonpharmacological treatments for SPD. A literature review was conducted on all nonpharmacological SPD treatment studies published between 2017 and 2023 using PubMed, CINAHL Plus with Full Text (EBSCO) and Scopus. Search terms included ‘skin picking’, ‘excoriation’, ‘psychiatry’, ‘treatment’ and ‘psychodermatology’. Studies including SPD within other body-focused repetitive behaviours, studies using pharmacological agents, and studies not available in English were excluded. A minimum of two authors screened each abstract to assess for inclusion while being blinded to minimize bias. Eleven studies (2068 participants) were included, with a variety of study designs including feasibility, randomized controlled trial, longitudinal cohort, multiple-baseline experimental, naturalistic trial, and controlled single-case design with multiple-baseline studies. The treatments include cognitive behavioural therapy (CBT), acceptance and commitment therapy (ACT), ACT-enhanced group behavioural therapy (AE-GBT), ACT-informed exposure therapy, group therapy, psychotherapy, repetitive transcranial magnetic stimulation, online self-help modules, and expressive writing. Studies implementing CBT, habit reversal therapy, AE-GBT, online self-help modules, and expressive writing demonstrated the best results in treating SPD. Several studies achieved significant outcomes for participants with SPD, confirming the usefulness of nonpharmacological treatment in SPD. Based on our results, CBT, AE-GBT, online self-help modules and expressive writing appear to be the most effective in treating SPD. Additionally, most of these treatment modalities can be tailored to meet patient-specific needs. Some limitations of the studies include small sample sizes, lack of control groups and randomization, limited long-term follow-up data and lack of gender variability.
Temporal dynamics of white and gray matter plasticity during motor skill acquisition: a comparative diffusion tensor imaging and multiparametric mapping analysis
Authors: Emmenegger Tim , David Gergely , Mohammadi Siawoosh , Ziegler Gabriel , Callaghan Martina F , Thompson Alan , Friston Karl J , Weiskopf Nikolaus , Killeen Tim , Freund Patrick
Published: August 2024

Learning new motor skills relies on neural plasticity within motor and limbic systems. This study uniquely combined diffusion tensor imaging and multiparametric mapping MRI to detail these neuroplasticity processes. We recruited 18 healthy male participants who underwent 960 min of training on a computer-based motion game, while 14 were scanned without training. Diffusion tensor imaging, which quantifies tissue microstructure by measuring the capacity for, and directionality of, water diffusion, revealed mostly linear changes in white matter across the corticospinal-cerebellar-thalamo-hippocampal circuit. These changes related to performance and reflected different responses to upper- and lower-limb training in brain areas with known somatotopic representations. Conversely, quantitative MRI metrics, sensitive to myelination and iron content, demonstrated mostly quadratic changes in gray matter related to performance and reflecting somatotopic representations within the same brain areas. Furthermore, while myelin and iron-sensitive multiparametric mapping MRI was able to describe time lags between different cortical brain systems, diffusion tensor imaging detected time lags within the white matter of the motor systems. These findings suggest that motor skill learning involves distinct phases of white and gray matter plasticity across the sensorimotor network, with the unique combination of diffusion tensor imaging and multiparametric mapping MRI providing complementary insights into the underlying neuroplastic responses.
The Dynamic Adaptation of the Journey of Hope: A School-Based Intervention to Support Pandemic and Disaster–Affected Children and Youth
Authors: Powell Tara , Wetzel Greta , Berger Cardoso Jodi
Published: August 2024

The Journey of Hope (JoH) is an evidence-based behavioral health prevention intervention model designed for disaster-affected children and youth. While the in-person JoH model has been extensively delivered and studied, the virtual implementation of this intervention, specifically tailored for the unique needs of children and youth during the COVID-19 pandemic, has not been previously explored. In this context, authors of this article adapted the JoH to a virtual delivery model, aiming to provide access to behavioral health preventive services for children and youth during the COVID-19 pandemic when in-person services were not feasible. This adaptation, utilizing the dynamic adaptation process (DAP) and community-based participatory research (CBPR) principles, was carefully designed to meet pandemic-related challenges while maintaining the core components of the original intervention. The primary objectives of this article are twofold: (1) to provide an overview of the theoretical and conceptual underpinnings of the JoH-C19, including the framework that guided the adaptation, and (2) to describe the virtually adapted curriculum and initial pilot of the JoH-C19. This adaptation represents a crucial step in ensuring the accessibility of virtual behavioral health interventions for young populations facing various collective traumas and challenges in a rapidly evolving world.
In-hospital initiation of angiotensin receptor–neprilysin inhibition in acute heart failure: the PREMIER trial
Authors: Tanaka Atsushi , Kida Keisuke , Matsue Yuya , Imai Takumi , Suwa Satoru , Taguchi Isao , Hisauchi Itaru , Teragawa Hiroki , Yazaki Yoshiyuki , Moroi Masao , Ohashi Koichi , Nagatomo Daisuke , Kubota Toru , Ijichi Takeshi , Ikari Yuji , Yonezu Keisuke , Takahashi Naohiko , Toyoda Shigeru , Toshida Tsutomu , Suzuki Hiroshi , Minamino Tohru , Nogi Kazutaka , Shiina Kazuki , Horiuchi Yu , Tanabe Kengo , Hachinohe Daisuke , Kiuchi Shunsuke , Kusunose Kenya , Shimabukuro Michio , Node Koichi
Published: August 2024

Background and Aims

The efficacy and safety of early sacubitril/valsartan (Sac/Val) initiation after acute heart failure (AHF) has not been demonstrated outside North America. The present study aimed to evaluate the effect of in-hospital Sac/Val therapy initiation after an AHF episode on N-terminal pro-B-type natriuretic peptide (NT-proBNP) level in Japanese patients.

Methods

This was an investigator-initiated, multicentre, prospective, randomized, open-label, blinded-endpoint pragmatic trial. After haemodynamic stabilization within 7 days after hospitalization, eligible inpatients were allocated to switch from angiotensin-converting enzyme inhibitor or angiotensin receptor blocker to Sac/Val (Sac/Val group) or to continue angiotensin-converting enzyme inhibitor or angiotensin receptor blocker (control group). The primary efficacy endpoint was the 8-week proportional change in geometric means of NT-proBNP levels.

Results

A total of 400 patients were equally randomized, and 376 (median age 75 years, 31.9% women, de novo heart failure rate 55.6%, and median left ventricular ejection fraction 37%) were analysed. The per cent changes in NT-proBNP level geometric means at Weeks 4/8 were −35%/−45% (Sac/Val group) and −18%/−32% (control group), and their group ratio (Sac/Val vs. control) was 0.80 (95% confidence interval 0.68–0.94; P = .008) at Week 4 and 0.81 (95% confidence interval 0.68–0.95; P = .012) at Week 8, respectively. In the pre-specified subgroup analyses, the effects of Sac/Val were confined to patients with a left ventricular ejection fraction < 40% and were more evident in those in sinus rhythm and taking mineralocorticoid receptor antagonists. No adverse safety signal was evident.

Conclusions

In-hospital Sac/Val therapy initiation in addition to contemporary recommended therapy triggered a greater NT-proBNP level reduction in Japanese patients hospitalized for AHF. These findings may expand the evidence on Sac/Val therapy in this clinical situation outside North America.

Clinical Trial Registration

ClinicalTrial.gov (NCT05164653) and Japan Registry of Clinical Trials (jRCTs021210046).
Proenkephalin improves cardio-renal risk prediction in acute coronary syndromes: the KID-ACS score
Authors: Wenzl Florian A , Wang Peizhi , Arrigo Mattia , Parenica Jiri , Jones Donald J L , Bruno Francesco , Tarnowski Daniel , Hartmann Oliver , Boucek Lubos , Lang Fabian , Obeid Slayman , Schober Andreas , Kraler Simon , Akhmedov Alexander , Kahles Florian , Schober Alexander , Ow Kok Weng , Ministrini Stefano , Camici Giovanni G , Bergmann Andreas , Liberale Luca , Jarkovsky Jiri , Schweiger Victor , Sandhu Jatinderpal K , von Eckardstein Arnold , Templin Christian , Muller Olivier , Ondrus Tomas , Olic Janet-Jacqueline , Roffi Marco , Räber Lorenz , Cao Thong H , Jungbauer Carsten G , Ng Leong L , Mebazaa Alexandre , Lüscher Thomas F
Published: August 2024

Background and Aims

Circulating proenkephalin (PENK) is a stable endogenous polypeptide with fast response to glomerular dysfunction and tubular damage. This study examined the predictive value of PENK for renal outcomes and mortality in patients with acute coronary syndrome (ACS).

Methods

Proenkephalin was measured in plasma in a prospective multicentre ACS cohort from Switzerland (n = 4787) and in validation cohorts from the UK (n = 1141), Czechia (n = 927), and Germany (n = 220). A biomarker-enhanced risk score (KID-ACS score) for simultaneous prediction of in-hospital acute kidney injury (AKI) and 30-day mortality was derived and externally validated.

Results

On multivariable adjustment for established risk factors, circulating PENK remained associated with in-hospital AKI [per log2 increase: adjusted odds ratio 1.53, 95% confidence interval (CI) 1.13–2.09, P = .007] and 30-day mortality (adjusted hazard ratio 2.73, 95% CI 1.85–4.02, P < .001). The KID-ACS score integrates PENK and showed an area under the receiver operating characteristic curve (AUC) of .72 (95% CI .68–.76) for in-hospital AKI and .91 (95% CI .87–.95) for 30-day mortality in the derivation cohort. Upon external validation, KID-ACS achieved similarly high performance for in-hospital AKI (Zurich: AUC .73, 95% CI .70–.77; Czechia: AUC .75, 95% CI .68–.81; Germany: AUC .71, 95% CI .55–.87) and 30-day mortality (UK: AUC .87, 95% CI .83–.91; Czechia: AUC .91, 95% CI .87–.94; Germany: AUC .96, 95% CI .92–1.00), outperforming the contrast-associated AKI score and the Global Registry of Acute Coronary Events 2.0 score, respectively.

Conclusions

Circulating PENK offers incremental value for predicting in-hospital AKI and mortality in ACS. The simple six-item KID-ACS risk score integrates PENK and provides a novel tool for simultaneous assessment of renal and mortality risk in patients with ACS.
Biomarker-based prediction of sinus rhythm in atrial fibrillation patients: the EAST-AFNET 4 biomolecule study
Authors: Fabritz Larissa , Al-Taie Christoph , Borof Katrin , Breithardt Günter , Camm A John , Crijns Harry J G M , Roth Cardoso Victor , Chua Winnie , van Elferen Silke , Eckardt Lars , Gkoutos Georgios , Goette Andreas , Guasch Eduard , Hatem Stéphane , Metzner Andreas , Mont Lluís , Murukutla Vaishnavi Ameya , Obergassel Julius , Rillig Andreas , Sinner Moritz F , Schnabel Renate B , Schotten Ulrich , Sommerfeld Laura C , Wienhues-Thelen Ursula-Henrike , Zapf Antonia , Zeller Tanja , Kirchhof Paulus
Published: August 2024

Background and Aims

In patients with atrial fibrillation (AF), recurrent AF and sinus rhythm during follow-up are determined by interactions between cardiovascular disease processes and rhythm control therapy. Predictors of attaining sinus rhythm at follow-up are not well known.

Methods

To quantify the interaction between cardiovascular disease processes and rhythm outcomes, 14 biomarkers reflecting AF-related cardiovascular disease processes in 1586 patients in the EAST-AFNET 4 biomolecule study (71 years old, 45% women) were quantified at baseline. Mixed logistic regression models including clinical features were constructed for each biomarker. Biomarkers were interrogated for interaction with early rhythm control. Outcome was sinus rhythm at 12 months. Results were validated at 24 months and in external datasets.

Results

Higher baseline concentrations of three biomarkers were independently associated with a lower chance of sinus rhythm at 12 months: angiopoietin 2 (ANGPT2) (odds ratio [OR] .76 [95% confidence interval .65–.89], P < .001), bone morphogenetic protein 10 (BMP10) (OR .83 [.71–.97], P = .017), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) (OR .73 [.60–.88], P < .001). Analysis of rhythm at 24 months confirmed the results. Early rhythm control interacted with the predictive potential of NT-proBNP (Pinteraction = .033). The predictive effect of NT-proBNP was reduced in patients randomized to early rhythm control (usual care: OR .64 [.51–.80], P < .001; early rhythm control: OR .90 [.69–1.18], P = .453). External validation confirmed that low concentrations of ANGPT2, BMP10, and NT-proBNP predict sinus rhythm during follow-up.

Conclusions

Low concentrations of ANGPT2, BMP10, and NT-proBNP identify patients with AF who are likely to attain sinus rhythm during follow-up. The predictive ability of NT-proBNP is attenuated in patients receiving rhythm control.
Constructing a One Health governance architecture: a systematic review and analysis of governance mechanisms for One Health
Authors: Faijue Darlington David , Segui Allison Osorio , Shringarpure Kalpita , Razavi Ahmed , Hasan Nadeem , Dar Osman , Manikam Logan
Published: August 2024

The integration of human, animal, and environmental health in the One Health framework is crucial for tackling complex health and environmental issues. Governance structures in One Health initiatives are essential for coordinating efforts, fostering partnerships, and establishing effective policy frameworks. This systematic review, registered with PROSPERO, aims to evaluate governance architectures in One Health initiatives. Searches in PubMed, Scopus, WoS, and Cochrane from 2000 to 2023 were conducted. Key terms focused on peer-reviewed articles, systematic reviews, and relevant grey literature. Nine eligible studies were selected based on inclusion criteria. Data synthesis aimed to assess governance mechanisms’ functionality and effectiveness. Among 1277 sources screened, nine studies across diverse regions were eligible. An adapted framework assessed implementation mechanisms of international agreements, categorizing them into Engagement, Coordination, Policies, and Financial domains. The findings highlight the importance of effective governance, stakeholder engagement, and collaborative approaches in addressing One Health’s challenges. Identified challenges include deficient intersectoral collaboration, funding constraints, and stakeholder conflicts. Robust governance frameworks are pivotal in One Health paradigms, emphasizing stakeholder engagement and collaboration. These insights guide policymakers, practitioners, and researchers in refining governance structures to enhance human-animal health and environmental sustainability. Acknowledging study limitations, such as methodological variations and limited geographical scope, underscores the importance of further research in this area.
Cholinesterase Inhibitor Initiation Does Not Increase the Risk of Fall-Related Injury in Older Adults Treated With Beta-Blockers: A Self-Controlled Case Series Design
Authors: Cupp Meghan A , Berry Sarah D , Hayes Kaleen N , Daiello Lori A , Ko Darae , Riester Melissa R , Zullo Andrew R
Published: August 2024

Background

Prescribing cholinesterase inhibitors (ChEIs) concurrently with beta-blockers might cause syncope that increases the risk of fall-related injuries (FRIs). This self-controlled case series study assesses the risk of FRIs associated with initiating ChEIs while receiving beta-blockers among Medicare fee-for-service-insured nursing home (NH) residents in the United States.

Methods

We identified individuals at their first dispensing of a beta-blocker between 2016 and 2019 after at least 45 days of long-stay NH residency. Individuals were followed from the first day of beta-blocker use until beta-blocker discontinuation, Medicare disenrollment, death, or study end. ChEI initiation was classified as the first 60 days of new ChEI dispensing after 45 days of no ChEI exposure. FRIs were assessed during beta-blocker use periods, and age-adjusted incidence rate ratios (IRR) for ChEI-initiation days versus other days were calculated using conditional Poisson regression models. Analyses were weighted for event-dependent observation periods due to the high risk of mortality after an FRI in this population. Subgroup analyses were conducted for several key time-fixed variables, including sex, age, ChEI type, ChEI dose, beta-blocker selectivity, and beta-blocker dose.

Results

The FRI risk after ChEI initiation was not elevated among 837 residents who experienced an FRI while using beta-blockers (IRR=0.90 [95%CLs 0.71, 1.15]). Analyses of ChEI initiation in several subgroups yielded similar results.

Conclusions

There was no substantial difference in FRI risk when initiating ChEIs among older NH residents receiving beta-blocker therapy versus periods without ChEI initiation, suggesting that there is no clinically significant pharmacodynamic drug–drug interaction between beta-blockers and ChEIs.
2-(3,4-Dihydroxyphenyl)ethyl 3-hydroxybutanoate Ameliorates Cognitive Dysfunction and Inflammation Via Modulating Gut Microbiota in Aged Senescence-Accelerated Mouse Prone8 Mice
Authors: Shi Le , Gao Peipei , Zhang Yue , Liu Quanyu , Hu Ranrui , Zhao Zhuang , Hu Yachong , Xu Xiaohong , Shen Yehua , Liu Jiankang , Long Jiangang
Published: August 2024

Numerous studies have indicated a close association between gut microbiota dysbiosis, inflammation, and cognitive impairment, highlighting their crucial role in the aging process. 2-(3,4-Dihydroxyphenyl)ethyl 3-hydroxybutanoate (HTHB), a novel derivative of hydroxytyrosol, known for its metabolic and anti-inflammatory properties, was investigated for its effects on memory, inflammation, and gut microbiota in senescence-accelerated mouse prone 8 mice. The study employed behavioral testing, biochemical detection, and 16S RNA analysis. Results revealed that HTHB mitigated memory decline and lymphocyte aberrance, reduced inflammation in the brain cortex, intestine and peripheral system, and modulated gut microbiota dysbiosis. Interestingly, the cognitive function and serum inflammation of mice significantly correlated with differences in gut microbiota in senescence-accelerated mouse prone 8 mice. Furthermore, HTHB treatment exhibited an enhancement of gut barrier integrity in colon tissue in SAMP8 mice. In vitro experiments using HCT116 and DLD1 cells further evidenced that HTHB rescued the tight junction protein levels impaired by lipopolysaccharide. These findings demonstrate that HTHB effectively ameliorates cognitive dysfunction in aged mice, by modulating gut microbiota, suppressing inflammation, and promoting intestinal barrier integrity. This highlights the potential of HTHB as a therapeutic agent for age-related cognitive loss.
Combination therapy with IV fosfomycin for adult patients with serious Gram-negative infections: a review of the literature
Authors: Butler David A , Patel Nimish , O’Donnell J Nicholas , Lodise Thomas P
Published: August 2024

Treatment of patients with serious infections due to resistant Gram-negative bacteria remains highly problematic and has prompted clinicians to use existing antimicrobial agents in innovative ways. One approach gaining increased therapeutic use is combination therapy with IV fosfomycin. This article reviews the preclinical pharmacokinetic/pharmacodynamic (PK/PD) infection model and clinical data surrounding the use of combination therapy with IV fosfomycin for the treatment of serious infections caused by resistant Gram-negative bacteria. Data from dynamic in vitro and animal infection model studies of highly resistant Enterobacterales and non–lactose fermenters are positive and suggest IV fosfomycin in combination with a β-lactam, polymyxin or aminoglycoside produces a synergistic effect that rivals or surpasses that of other aminoglycoside- or polymyxin-containing regimens. Clinical studies performed to date primarily have involved patients with pneumonia and/or bacteraemia due to Klebsiella pneumoniae, Pseudomonas aeruginosa or Acinetobacter baumannii. Overall, the observed success rates with fosfomycin combination regimens were consistent with those reported for other combination regimens commonly used to treat these patients. In studies in which direct treatment comparisons can be derived, the results suggest that patients who received fosfomycin combination therapy had similar or improved outcomes compared with other therapies and combinations, especially when it was used in combination with a β-lactam that (1) targets PBP-3 and (2) has exceptional stability in the presence of β-lactamases. Collectively, the data indicate that combination therapy with IV fosfomycin should be considered as a potential alternative to aminoglycoside or polymyxin combinations for patients with antibiotic-resistant Gram-negative infections when benefits outweigh risks.
Yu-Ping-Feng formula: a promising traditional Chinese medicine for the treatment of primary Sjögren's syndrome
Authors: Xu Haoling , Song He
Published: August 2024

Administration of the Yu-Ping-Feng formula leads to significant modulation of immune responses in Primary Sjögren's Syndrome.
Urologist communication is a primary factor leading to erectile dysfunction treatment postprostatectomy
Authors: Baunacke Martin , Groeben Christer , Borkowetz Angelika , Hoffmann Falk , Chun Felix K H , Weissbach Lothar , Thomas Christian , Huber Johannes
Published: August 2024

Background

Studies have shown insufficient utilization of care for patients with erectile dysfunction (ED) after radical prostatectomy (RP).

Aim

The aim of this study was to evaluate variables associated with barriers to seeking and receiving ED treatment.

Methods

In this multicenter prospective cross-sectional study, the functional outcomes of 936 patients were assessed 10 to 15 years after RP. A total of 525 patients with ED or incontinence were asked about their treatment experiences or lack thereof. The data were analyzed using the chi-square test, t test, and multivariate logistic analyses.

Outcomes

Patients answered validated questionnaires regarding information sources, communication with their partner and urologist, and barriers to ED treatment.

Results

Of the 525 patients, 80 were not available to survey. A total of 304 patients answered the survey (response: 68.0%). A total of 246 patients had ED and were included in this study. The mean age at surgery was 64.4 ± 6.1 years, and the mean age at the time of this survey was 77.1 ± 6.2 years. The mean follow-up duration was 12.7 ± 1.5 years. Forty-six percent (n = 114 of 246) of the patients had never received ED treatment. The most important conversation partners regarding the ED were the partner (69% [n = 169 of 246]) and the urologist (48% [n = 118 of 246]). Patients who never received ED treatment were less likely to have conversations with their urologist (34% vs 60%; P < .001), had less support (51% vs 68%; P = .01), and had less interest in sex from their partner (20% vs 40%; P = .001). Communication with other groups (general practitioners, other physicians, family, friends, and the Internet) had no influence on ED treatment utilization. The most relevant barrier to receiving ED treatment was the belief that treatment would not help (65%). No interest in sex from their partner (odds ratio, 3.9) and no conversation with their urologist about ED (odds ratio, 2.9) were found to be independent predictors of not receiving ED treatment.

Clinical Implications

Urologists should have enhanced awareness of how to approach patients directly about their ED and actively offer them treatment options.

Strengths and Limitations

These results should be further validated in a multicenter, prospective study. Response bias may have affected the results. Furthermore, the current cohort was relatively old.

Conclusion

This study revealed that no interest in sex from one’s partner and insufficient communication with a urologist were relevant barriers to insufficient utilization of ED treatment after RP.
Sacred journeys and pilgrimages: health risks associated with travels for religious purposes
Authors: Parker Salim , Steffen Robert , Rashid Harunor , Cabada Miguel M , Memish Ziad A , Gautret Philippe , Sokhna Cheikh , Sharma Avinash , Shlim David R , Leshem Eyal , Dwyer Dominic E , Lami Faris , Chatterjee Santanu , Shafi Shuja , Zumla Alimuddin , Mahomed Ozayr
Published: August 2024

Background

Pilgrimages and travel to religious mass gatherings (MGs) are part of all major religions. This narrative review aims to describe some characteristics, including health risks, of the more well-known and frequently undertaken ones.

Methods

A literature search was conducted using keywords related to the characteristics (frequency of occurrence, duration, calendar period, reasons behind their undertaking and the common health risks) of Christian, Muslim, Hindu, Buddhist and Jewish religious MGs.

Results

About 600 million trips are undertaken to religious sites annually. The characteristics vary between religions and between pilgrimages. However, religious MGs share common health risks, but these are reported in a heterogenous manner. European Christian pilgrimages reported both communicable diseases, such as norovirus outbreaks linked to the Marian Shrine of Lourdes in France, and non-communicable diseases (NCDs). NCDs predominated at the Catholic pilgrimage to the Basilica of Our Lady of Guadalupe in Mexico, which documented 11 million attendees in 1 week. The Zion Christian Church Easter gathering in South Africa, attended by ~10 million pilgrims, reported mostly motor vehicle accidents. Muslim pilgrimages such as the Arbaeen (20 million pilgrims) and Hajj documented a high incidence of respiratory tract infections, up to 80% during Hajj. Heat injuries and stampedes have been associated with Hajj. The Hindu Kumbh Mela pilgrimage, which attracted 100 million pilgrims in 2013, documented respiratory conditions in 70% of consultations. A deadly stampede occurred at the 2021 Jewish Lag BaOmer MG.

Conclusion

Communicable and NCD differ among the different religious MGs. Gaps exists in the surveillance, reporting and data accessibility of health risks associated with religious MGs. A need exists for the uniform implementation of a system of real-time monitoring of diseases and morbidity patterns, utilizing standardized modern information-sharing platforms. The health needs of pilgrims can then be prioritized by developing specific and appropriate guidelines.
The inhibitory effect of copper, zinc, and manganese on Legionella longbeachae in potting mix leachate
Authors: Jun Hyunwoo , Chambers Stephen T , Williman Jonathan , Slow Sandy , Murdoch David R , Scott-Thomas Amy
Published: August 2024

Legionella longbeachae is the leading cause of Legionnaires’ disease (LD) in Australasia and has been linked to exposure to compost and potting soils. Adding antimicrobial metal ions such as copper (Cu2+), zinc (Zn2+), and manganese (Mn2+) to potting soils may reduce the load of L. longbeachae bacteria and infection risk. Baseline concentrations of metal ions in leachate from peat, bark dust, bagging base, and an all-purpose potting soil were: iron 0.40–0.99 µg/ml, Cu of 0.003–0.03 µg/ml, Zn 0.01–0.06 µg/ml and Mn 0.11–0.29 µg/ml. Addition of Cu2+ ions to leachate reduced L. longbeachae viability in a concentration dependent manner. A similar effect was seen in potting soil with Zn2+ and Mn2+ but 10-fold higher concentrations were needed. These metal ions have potential to reduce the load of L. longbeachae in potting soils but toxicity in plants needs to be determined.