bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and Validation of a Model to Predict Malignancy Within the First Year After Adult Heart Transplantation
Authors: Baker William L. , Moore Timothy E. , Baron Eric , Jennings Douglas L. , Jaiswal Abhishek
Published: December 2022

Purpose: Malignancy after heart transplantation is associated with poor outcomes. At present, no prediction model exists for any malignancy within the first year after transplant. Methods: We studied adults who underwent heart transplantation included in the multicenter, national Scientific Registry of Transplant Recipients from January 2000 through April 2021. Possible predictors of malignancy were identified based on their known association with malignancy. Multiple imputations were conducted for missing values using predictive mean matching. A multivariable logistic regression model for predicting malignancy development within the first year after transplant was developed and internally validated via 500 bootstrapped samples to estimate the optimism-corrected measures of model accuracy and performance. Results: Among the 47 212 recipients comprising 16% females, 76% whites, 7% with prior malignancy, and a median age of 56 years; 865 (2.3% of those with non-missing data) developed malignancy within the first year after transplant. Prior malignancy, older age at heart transplantation, white race, and nonischemic heart failure etiology were the strongest predictors of new malignancy. The optimism-corrected model had modest discrimination (C-statistic: 0.70, 95% CI: 0.69-0.72) and good calibration and performance (calibration slope: 0.96; Cox-Snell R2: 0.063), particularly at lower predicted risk. A nomogram for the practicing clinician was developed. Conclusions: Using selection variables previously linked to cutaneous malignancy, our model was modestly predictive of the development of any malignancy in the first year after heart transplantation. Future research could identify factors that may improve malignancy prediction, including incorporation of time-to-event data.
The Correlations Between Serum Hcy Level and Seizures and Cognitive Function in Patients After Stroke
Authors: Lan Chen , Huang Zhiqiang , Luo Xinxin , Zhang Yongcheng
Published: December 2022

Backgrounds

Post-stroke cognitive dysfunction (PSCI), a set of illnesses ranging from moderate cognitive impairment to dementia, which is one of the most prevalent consequences following a stroke. Homocysteine (Hcy) has been related to a number of neurological and systemic diseases. It’s also a known risk factor for cardiovascular disease and systemic atherosclerosis (CVD). The link between Hcy and PSCI, on the other hand, is unknown.

Methods

Our hospital evaluated 325 patients with acute cerebral infarction between January 1, 2018 and December 1, 2021. There are biological markers and baseline data available. Patients were divided into two groups based on the results of the Montreal Cognitive Assessment (MoCA). The researchers performed logistic regression analysis to find variables that may be linked to PSCI.

Results

HCY levels were significantly higher in PSCI patients than in non-PSCI patients. Age, education, seizure manifestation, and income level were all shown to be independent risk variables for PSCI in a multivariate logistic analysis. Hcy levels in PSCI patients differed considerably between the high and low groups. The high and low Hcy levels groups had significantly varied hypertension histories and urine levels. Hcy levels in PSCI patients differed considerably between the high and low groups. The high and low Hcy levels groups had significantly varied hypertension histories and urine levels.

Conclusion

Serum Hcy levels have been linked to PSCI in post-stroke patients, and researchers believe that serum Hcy levels will diminish PSCI.
Exploring the Impact of Occupational Adaptation-Focused Interventions on Music Student Health
Authors: Ericsson Katherine , Naber Allison , Laursen Amy
Published: December 2022

Music students are at an elevated risk of playing-related musculoskeletal disorders. This study aimed to explore the impact of occupational adaptation-focused interventions on music student health. A quasi-experimental one-group pretest/posttest design was used. Music students received occupational therapy services grounded in the Occupational Adaptation model of practice. Assessment tools included the Performing Arts Module of the Disabilities of the Arm, Shoulder, and Hand (DASH) and an occupational adaptive process evaluation. Twelve music students, ages 19 to 32 years old, participated in this study. Results indicated a significant decrease in current pain intensity ( Z = −2.038, p < .042), 24-hr pain intensity ( Z = −2.94, p < .003), and DASH scores ( Z = −2.81, p < .005). Strong correlations were found between participants’ adaptive capacity and improved DASH scores and 24-hr pain. Occupational adaptation-focused interventions can improve university-level music student health by addressing body functions affecting music performance and increasing their adaptive capacity.
Wrist Arthrodesis Using the Medartis Carpometacarpal Joint Sparing Plate
Authors: Briotti Joshua , Wilson Stuart , Goh Geraldine , Lawson-Smith Matthew
Published: December 2022

Background:

Total wrist arthrodesis is a well-established surgical technique that provides reliable pain relief in patients with advanced wrist disease. Key limitations of existing plating systems include hardware pull-out, hardware failure, and nonunion. There is limited literature on the newer style carpometacarpal joint (CMCJ) sparing plating system, produced by Medartis. The objective of this study was to determine the long-term clinical and radiological outcomes of wrist arthrodesis with a CMCJ sparing wrist plate.

Methods:

This study retrospectively identified 23 wrist arthrodeses using the Medartis CMCJ sparing plate for review. This study assessed the outcomes of 18 unilateral wrist fusions and 1 bilateral wrist fusion. The study group consisted of 12 men and 5 women with an average age of 56 years (range: 29-82 years) with a mean follow-up period of 17 months.

Results:

At the time of follow-up, all patients’ wrists had fused without postsurgical complication. The final grip strength in the operative hand was 28.2 kg/cm2, which was 87% of the contralateral side. The mean Quick Disabilities of the Arm, Shoulder, and Hand score at follow-up was 23.9, with all patients returning to daily living activities and work. Patients reported minimal pain (1.3/10), with almost all (17/18) satisfied with the outcome of the surgery and describing that they would recommend this procedure.

Conclusion:

Our case series highlights that the Medartis wrist arthrodesis plate is a newer design that is a well-tolerated option for wrist arthrodesis based on clinical assessment, functional hand assessment, and patient satisfaction, when compared with the existing literature on traditional plating systems.
Demystifying Participatory Analysis With Children: A South Korean Case of Migrant Children’s Engagement in Analytic Works in Participatory Research
Authors: Ryu Yeonghwi
Published: December 2022

Despite its importance, participatory analysis has traditionally been an unexplored field. In particular, children have been marginalized in the analysis process due to their perceived inexperience and lack of capabilities. Even though there have been efforts to provide children with training, known as capacity-building, in this approach, the pre-existing dominant narrative about who has valuable knowledges and who the experts has been repeated over time. Drawing on the understanding of participatory analysis as an ongoing process and children’s ways of knowing, this study illuminates how a group of migrant children in South Korea engage in analytic work in participatory research. In this study, the migrant children showed their engagement in analytic work while crossing the boundaries of the stages of formal analysis. Particularly, the children’s engagement in analytic work occurred based on various methods of reflection which generated a fruitful explanation about the complexities surrounding their belonging. This study should make us rethink what is regarded as children’s analysis in participatory research. Based on the results, this study suggests children’s participatory analysis needs to be radically reimagined beyond simplifying the practices of adult researchers.
“This Person is Safe”: An Exemplar of Conducting Individual Interviews in Qualitative Research with Black Women
Authors: Walton Quenette L. , Kennedy Priscilla P. , Oyewuwo Olubunmi B. , Allen Phylicia
Published: December 2022

Significant conceptual and empirical evidence has been found through qualitative research about the benefits, limitations, and uses of individual interviews. However, there is scant research illustrating how researchers use specific techniques that center participants’ intersecting identities to build rapport, trust, and authentic connections during individual interviews, and especially during interviews with Black women. We illustrate how we used eight empirically grounded techniques in our qualitative individual interviews with Black women. Through our analysis of the interviews, the concept of safety emerged. “This person is safe” reflects the combined stories the women reported regarding their experiences engaging in individual interviews. In this article, we provide a brief background on individual interviewing in qualitative research, followed by the framing of our work. Thereafter, we provide context about the exemplar study, outline techniques shown to be effective in the literature, and provide examples from the exemplar study to show how each technique was used. Further research is needed to examine how researchers use various techniques in qualitative individual interviews in general, but with Black women more specifically.
Effectiveness of vagus nerve stimulation therapy in refractory hypoxic-ischemic encephalopathy-induced epilepsy
Authors: Guo Mengyi , Wang Jing , Tang Chongyang , Deng Jiahui , Zhang Jing , Xiong Zhonghua , Liu Siqi , Guan Yuguang , Zhou Jian , Zhai Feng , Luan Guoming , Li Tianfu
Published: December 2022

Background:

Epilepsy is one of the important long-term sequelae of neonatal hypoxic-ischemic encephalopathy (HIE) and is typically characterized by drug resistance and poor surgical outcomes. Vagus nerve stimulation (VNS) is a promising neuromodulation therapy for refractory epilepsy.

Objectives:

The present study aimed to first evaluate the effectiveness of VNS in patients with refractory HIE-induced epilepsy and scrutinize potential clinical predictors.

Methods:

We retrospectively collected the outcomes of VNS in all patients with refractory HIE-induced epilepsy and at least 2 years of follow-up. Subgroups were classified as responders and nonresponders according to the effectiveness of VNS (⩾50% or <50% reduction in seizure frequency). Preoperative data were analyzed to screen for potential predictors of VNS effectiveness.

Results:

A total of 55 patients with refractory HIE-induced epilepsy who underwent VNS therapy were enrolled. Responders represented 56.4% of patients, and 12.7% of patients achieved seizure freedom at the last follow-up. In addition, the responder rate increased over time with rates of 23.6%, 38.2%, 50.9%, and 56.4% at the 3-, 6-, 12- and 24-month follow-ups, respectively. After multivariate analysis, neonatal seizure was identified as a negative predictor (OR: 4.640, 95% CI: 1.129–19.066), and a predominant seizure type of generalized onset was identified as a positive predictor (OR: 0.261, 95% CI: 0.078–0.873) of VNS effectiveness.

Conclusion:

VNS therapy was effective in patients with refractory HIE-induced epilepsy and was well tolerated over a 2-year follow-up period. VNS therapy demonstrated better effectiveness in patients without neonatal seizures or with a predominant seizure type of generalized onset.
A Long-Term Perspective on the Chinese Communist Party
Authors: Doyon Jérôme , Froissart Chloé
Published: December 2022

By tracing the Chinese Communist Party's (CCP) 100 years, this special issue brings to light the organisation's contradictions, setbacks, and changes in direction, together with its long-term evolution. Taking a step back from the current focus on the historical juncture of the twentieth CCP Congress, and on Xi Jinping himself, our long-term approach contextualises recent developments. Looking at the CCP's evolution over time shows how the founding structures and objectives of the CCP have had a long-lasting impact on its future developments as well as how they have been tweaked and rearranged to adapt to the new economic and social environment the party contributed to creating. Our long-term historical approach stresses impermanence beyond the apparent permanence of the party's concepts (e.g. “loyalty” and “democratic centralism”), discursive tactics (e.g. the mobilisation of emotions) and on-the-ground practices (e.g. grassroots party building), while also bringing to light the mere recycling of past practices and strategies.
Evaluating the Impact of Applying Personal Glucose Targets in a Closed-Loop System for People With Type 1 Diabetes
Authors: Fattah Mustafa , Boughton Charlotte K. , Ware Julia , Allen Janet M. , Hartnell Sara , Willinska Malgorzata E. , Thankamony Ajay , de Beaufort Carine , Campbell Fiona M. , Fröhlich-Reiterer Elke , Hofer Sabine E. , Kapellen Thomas M. , Rami-Merhar Birgit , Ghatak Atrayee , Randell Tabitha L. , Besser Rachel E. J. , Elleri Daniela , Trevelyan Nicola , Denvir MD Louise , Davis Nikki , Bally Lia , Thabit Hood , Leelarathna Lalantha , Evans Mark L. , Mader Julia K. , Hovorka Roman
Published: December 2022

Background

CamAPS FX is a hybrid closed-loop smartphone app used to manage type one diabetes. The closed-loop algorithm has a default target glucose of 5.8 mmol/L (104.5 mg/dL), but users can select personal glucose targets (adjustable between 4.4 mmol/L and 11.0 mmol/L [79 mg/dL and 198 mg/dL, respectively]).

Method

In this post-hoc analysis, we evaluated the impact of personal glucose targets on glycemic control using data from participants in five randomized controlled trials.

Results

Personal glucose targets were widely used, with 20.3% of all days in the data set having a target outside the default target bin (5.5-6.0 mmol/L [99-108 mg/dL]). Personal glucose targets >6.5 mmol/L (117 mg/dL) were associated with significantly less time in target range (3.9-10.0 mmol/L [70-180 mg/dL]; 6.5-7.0 mmol/L [117-126 mg/dL]: mean difference = −3.2 percentage points [95% CI: −5.3 to −1.2; P < .001]; 7.0-7.5 mmol/L [126-135 mg/dL]: −10.8 percentage points [95% CI: −14.1 to −7.6; P < .001]). Personal targets >6.5 mmol/L (117 mg/dL) were associated with significantly lower time (<3.9 mmol/L [<70 mg/dL]; 6.5-7.0 mmol/L [117-126 mg/dL]: −1.85 percentage points [95% CI: −2.37 to −1.34; P < .001]; 7.0-7.5 mmol/L [126-135 mg/dL]: −2.68 percentage points [95% CI: −3.49 to −1.86; P < .001]).

Conclusions

Discrete study populations showed differences in glucose control when applying similar personal targets.
The Impact of the Healthcare Environment on Patient Experience in the Emergency Department: A Systematic Review to Understand the Implications for Patient-Centered Design
Authors: Rowe Aidan , Knox Michelle
Published: December 2022

Background:

The emergency department (ED) is a complex, volatile, and limited-resource healthcare setting. Many environmental factors, including high patient volumes, overburdened staff, long waits, and a tense atmosphere, converge in the ED. The objective of this study was to perform a systematic review of extant literature to understand how the ED environment drives patient experience and identify methodological or empirical insights for patient-centered ED design.

Methods:

We searched eight academic databases (Web of Science, PubMed, Scopus, Medline [Ovid], CINAHL, PyscInfo, Compendex, and IEEE Explore) to identify studies that employed observational (descriptive) or interventional (evaluative) methodology. We performed a co-citation analysis of potentially eligible articles and a qualitative synthesis of findings from studies included in our final sample.

Results:

Our search yielded 117 records. Of the 35 potentially relevant articles, 18 were published in the last 5 years, and 50% were authored by investigators in the United States. We used 33 articles for a co-citation analysis, revealing three interdisciplinary clusters and promising potential for collaboration across fields. Thirty articles were subjected to a full-text analysis, resulting in the identification of three overarching dimensions linking the ED environment to patient experience.

Conclusion:

The most commonly identified factors influencing patient experience in the ED included overcrowding and wait times, privacy, and communication; however, existing literature is limited. More research is needed to understand how ED environments configure patient experience and can be improved through design. Particularly, there is little research on participatory interventional strategies in the ED, despite strong evidence suggesting a need for stakeholder participation.
Toward New Assessment of Knee Cartilage Degeneration
Authors: Aubonnet Romain , Ramos Jorgelina , Recenti Marco , Jacob Deborah , Ciliberti Federica , Guerrini Lorena , Gislason Magnus K. , Sigurjonsson Olafur , Tsirilaki Mariella , Jónsson Halldór , Gargiulo Paolo
Published: December 2022

Objective

Assessment of human joint cartilage is a crucial tool to detect and diagnose pathological conditions. This exploratory study developed a workflow for 3D modeling of cartilage and bone based on multimodal imaging. New evaluation metrics were created and, a unique set of data was gathered from healthy controls and patients with clinically evaluated degeneration or trauma.

Design

We present a novel methodology to evaluate knee bone and cartilage based on features extracted from magnetic resonance imaging (MRI) and computed tomography (CT) data. We developed patient specific 3D models of the tibial, femoral, and patellar bones and cartilages. Forty-seven subjects with a history of degenerative disease, traumatic events, or no symptoms or trauma (control group) were recruited in this study. Ninety-six different measurements were extracted from each knee, 78 2D and 18 3D measurements. We compare the sensitivity of different metrics to classify the cartilage condition and evaluate degeneration.

Results

Selected features extracted show significant difference between the 3 groups. We created a cumulative index of bone properties that demonstrated the importance of bone condition to assess cartilage quality, obtaining the greatest sensitivity on femur within medial and femoropatellar compartments. We were able to classify degeneration with a maximum recall value of 95.9 where feature importance analysis showed a significant contribution of the 3D parameters.

Conclusion

The present work demonstrates the potential for improving sensitivity in cartilage assessment. Indeed, current trends in cartilage research point toward improving treatments and therefore our contribution is a first step toward sensitive and personalized evaluation of cartilage condition.
Capturing the successes and failures during pandemic teaching: An investigation of university students’ perceptions of their faculty’s emergency remote teaching approaches
Authors: Nussli Natalie , Oh Kevin , Davis Jason P
Published: December 2022

This research investigates teacher candidates’ experiences during two semesters of imposed remote instruction during a pandemic. Through qualitative research interviewing, the perceptions of a purposeful sample of five preservice teachers were captured to investigate the faculty’s emergency remote teaching approaches. The theory-based interview guide was developed based on six concepts, namely, feedback, care, student engagement, choices, collaboration, and autonomous learning. The results present factors affecting the quality of feedback. Several challenges were identified in the way and the timing in which content was structured, presented, and released. The interviewed participants’ engagement levels were determined by regular synchronous interaction, highly structured learning platforms, and precise communication. The challenges of collaboration, a lack of social cohesion, and a lack of adaptations made to the digital curriculum affected students’ motivation, engagement, and efficiency levels. Distinct structures, clearly communicated purposes, and a well-defined organization were considered to be key to ensuring learning autonomy. The study contributes to refocusing efforts with a view towards post-pandemic teaching.
City Bias: Affordable Housing Accessibility Assessment—Evidence From 153 Prefectural Cities in China
Authors: He Chunyan , Li Ding , Ma Qiong , Yi Daichun
Published: December 2022

This study explores the invisible bias quantification of urban governments in their affordable housing service delivery, which can accurately identify the deficiencies of affordable housing policy and alleviate homelessness, poverty, and inequality. We identified complicated eligibility criteria for public rental housing programs in 153 prefectural cities and constructed a public rental housing accessibility index for urban residents and migrants. We used the principal component analysis method; this study offers a new perspective to explore these disparities. We found distinct regional differences in local governments’ behaviors and preferences regarding affordable housing. Cities’ affordable housing provision for migrants is selective and mainly targets young and highly educated migrants. We suggest that local governments pay more attention to elderly migrant workers in affordable housing provision and build a comprehensive evaluation system to set reasonable access conditions to prioritize those with urgent housing needs.
The Chemo-Gut Study: A Cross-Sectional Survey Exploring Physical, Mental, and Gastrointestinal Health Outcomes in Cancer Survivors
Authors: Deleemans Julie M. , Toivonen Kirsti , Reimer Raylene A. , Carlson Linda E.
Published: December 2022

Background

Cancer treatments, such as chemotherapy, may adversely affect gastrointestinal (GI), physical and mental health in survivors of cancer.

Objective

This study investigated associations between GI, mental and physical health outcomes, and cancer treatment-related variables, such as chemotherapy, in adult cancer survivors.

Methods

A one-time cross-sectional survey with patient-reported outcomes was used. Cancer survivors (N = 317) aged ≥18 years, living in Canada, who completed cancer treatments were included. Descriptive statistics, correlation, and linear regression analyses are reported.

Results

Mean age at diagnosis was 40.90 ± 15.40 years. Most survivors received chemotherapy (86.1%). Persistent GI symptoms include constipation (53.6%), diarrhea (50.5%), and bloating/pain (54.9%). Mean GI symptom duration was 30.53 ± 33.42 months. Severity of GI symptom interference was moderate to extreme for 51.9% of survivors. Compared to normative values of 50 in healthy people, survivors scored poorer for mental health (M = 42.72 ± 8.16) and physical health (M = 45.55 ± 7.93), and reported more belly pain (M = 56.10 ± 8.58), constipation (M = 54.38 ± 6.81), diarrhea (M = 55.69 ± 6.77), and gas/bloating (M = 56.08 ± 8.12). Greater GI symptom severity was associated with poorer mental and physical health ( P < .01). Chemotherapy was associated with increased belly pain ( B = 4.83, SE = 1.65, P < .01) and gas/bloating ( B = 3.06, SE = 1.45, P = .04).

Conclusion

We provide novel evidence that many cancer survivors experience chronic, moderate to severe GI symptoms lasting for years after cancer treatment, which are associated with worse mental and physical health. Chemotherapy is associated with specific GI symptoms. Integrative therapies are needed to address GI symptoms in cancer survivors.
An Unsuspected Case of Rocky Mountain Spotted Fever: A Lesson to Keep a Broad Differential
Authors: Barbina Sarah , Quiroga Myra , Petz Chelsey
Published: December 2022

Rocky Mountain spotted fever (RMSF), a tick-borne illness, can cause serious illness or death even in a healthy individual. Unfortunately, this illness can be difficult to diagnose as symptoms are nonspecific and oftentimes mimic benign viral illnesses. Delayed diagnosis can be detrimental as the timing of antibiotic administration is critical to prevent associated morbidity and mortality. A careful travel and social history can sometimes provide clues to make the diagnosis. Being aware of lesser-known objective findings such as hyponatremia, neurologic derangements, transaminitis, and thrombocytopenia may help raise suspicion for the disease. This is a case of a 72-year-old woman who presented with nonspecific symptoms and hyponatremia without known tick exposure. She was eventually diagnosed with RMSF. The timing of her presentation corresponded with a surge in COVID-19 infections throughout her area of residence, which further complicated her presentation and contributed to a delayed diagnosis.
Inequality among the Disadvantaged? Racial/Ethnic Disparities in Earnings among Young Men and Women without a College Education
Authors: Oh Byeongdon , Mackin Freeman Daniel , Shifrer Dara
Published: December 2022

Despite the rapid expansion of higher education, many young adults still enter the labor market without a college education. However, little research has focused on racial/ethnic earnings disadvantages faced by non-college-educated youth. We analyze the restricted-use data from the High School Longitudinal Study of 2009 to examine racial/ethnic earnings disparities among non-college-educated young men and women in their early 20s as of 2016, accounting for differences in premarket factors and occupation with an extensive set of controls. Results suggest striking earnings disadvantages for Black men relative to white, Latinx, and Asian men. Compared to white men, Latinx and Asian men do not earn significantly less, yet their earnings likely differ substantially by ethnic origin. While racial/ethnic earnings gaps are less prominent among women than men, women of all racial/ethnic groups have earnings disadvantages compared to white men. The results call for future studies into the heterogeneity within racial/ethnic groups and the intersectionality of race/ethnicity and gender among non-college-educated young adults.
Depression as a Consequence of Elder Mistreatment: A Case Report
Authors: Marsigit Jessica , Khasanah Fira Tania , Nainggolan Leonard , Wahyudi Edy Rizal
Published: December 2022

A 61-year-old elderly woman came to the emergency room in tertiary hospital in Jakarta, Indonesia due to epigastric pain for the past 7 months which was worsened in the past 4 days. Due to her illness, her daughters prevent her to do daily chores and her hobbies, such as singing and gardening. On admission, she had hypertension with moderate dependency, frail, cognitive impairment, malnutrition, risk of sarcopenia, and risk of depression. She was later diagnosed with poorly differentiated colon adenocarcinoma and adjustment disorders with anxiety and depressive reaction due to emotional elder mistreatment. There are a variety of forms of elder abuse, not only physical, but also emotional, sexual, financial, and neglect. The prevalence of elder mistreatment is projected between 5% and 10% all over the world and it is thought to be underdiagnosed. Among the consequences of mistreatment or abuse include social alongside, economic, physical, and mental (e.g., isolation, constrained relationships, and broken social networks). This is a case report of depression because of elder mistreatment.
A Comparative Study of Levetiracetam and Phenobarbital for Neonatal Seizures as a First Line Treatment
Authors: Akeel Nagwa Elsayed , Suliman Hany Abdelaziz , Al-Shokary Ashraf Hamed , Ibrahim Asmaa Obada , Kamal Naglaa M. , Abdelgalil Abobakr Abosree , Elmala Moustafa Kotb , Elshorbagy Hatem Hamed , Nasef Khaled Amin , Attia Ahmed Mahmoud , Fathallah Mohamed Gamal El Din
Published: December 2022

Objectives

We aimed to evaluate the use of intravenous levetiracetam as the first-line treatment of neonatal seizures compared with phenobarbital.

Methods

The study was conducted on 104 neonates (0-28 days) with clinical seizures after inclusion criteria. They were assigned in equal ratio into 2 groups; 1 included neonates who received phenobarbitone, and the other included neonates who received levetiracetam. Neonates were loaded with 20 mg/kg of intravenous drug-A (phenobarbitone) or drug-B (levetiracetam). In persistent seizures, a second loading dose of the same drug was given. Crossover to other drugs occurred if seizures persisted after the second dose of the same drug. The proportion of neonates who achieved cessation of seizures following the first or second loading dose of either drug-A or drug-B (PB or LEV) was the main outcome measure provided that they remained free of seizure for the following 24 hours.

Results

After 1 or 2 doses of Levetiracatam or Phenobarbitone, clinical seizures stopped (and remained seizure-free for 24 hours) in 41 (78.84%) and 34 (65.38%) patients, respectively ( P = .01). Neonates in the LEV group showed better seizure control than neonates in the PB group (RR = 0.57; 95% CI (0.17, 0.80). We did not report any adverse drug reactions in the LEV group. However, 12 (23.07%) neonates developed adverse drug reactions in the PB Group.

Conclusion

Levetiracetam is considered an effective and safe drug as a first-line AED in neonatal seizures.
Serum S-100B adds incremental value for the prediction of symptomatic intracranial hemorrhage and brain edema after acute ischemic stroke
Authors: Honegger Tim , Schweizer Juliane , Bicvic Antonela , Westphal Laura P , Schütz Valerie , Inauen Corinne , Pokorny Thomas , Bracher Katja , Arnold Marcel , Fischer Urs , Bonati Leo H , De Marchis Gian Marco , Nedeltchev Krassen , Kahles Timo , Cereda Carlo , Kägi Georg , Montaner Joan , Bustamante Alejandro , Palà Elena , Ntaios George , Foerch Christian , Luft Andreas , Spanaus Katharina , Saleh Lanja , von Eckardstein Arnold , Arnold Markus , Katan Mira
Published: December 2022

Background:

Early identification of patients developing symptomatic intracranial hemorrhage and symptomatic brain edema after acute ischemic stroke is essential for clinical decision-making. Astroglial protein S-100B is a marker of blood-brain barrier disruption, which plays an important role in the formation of intracranial hemorrhage and brain edema. In this study, we assessed the prognostic value of serum S-100B for the development of these complications.

Methods:

Serum S-100B levels were measured within 24 h from symptom onset in 1749 consecutive acute ischemic stroke patients from the prospective, observational, multicenter BIOSIGNAL cohort study (mean age 72.0 years, 58.3% male). To determine symptomatic intracranial hemorrhage or symptomatic brain edema, follow-up neuroimaging was performed in all patients receiving reperfusion therapy or experiencing clinical worsening with an NIHSS increase of ⩾4.

Results:

Forty six patients (2.6%) developed symptomatic intracranial hemorrhage and 90 patients (5.2%) developed symptomatic brain edema. After adjustment for established risk factors, log10S-100B levels remained independently associated with both symptomatic intracranial hemorrhage (OR 3.41, 95% CI 1.7–6.9, p = 0.001) and symptomatic brain edema (OR 4.08, 95% CI 2.3–7.1, p < 0.001) in multivariable logistic regression models. Adding S-100B to the clinical prediction model increased the AUC from 0.72 to 0.75 ( p = 0.001) for symptomatic intracranial hemorrhage and from 0.78 to 0.81 ( p < 0.0001) for symptomatic brain edema.

Conclusions:

Serum S-100B levels measured within 24 h after symptom onset are independently associated with the development of symptomatic intracranial hemorrhage and symptomatic brain edema in acute ischemic stroke patients. Thus, S-100B may be useful for early risk-stratification regarding stroke complications.
Polycyclic Aromatic Hydrocarbons: Evaluation of concentrations in environmental media in Bayelsa State
Authors: Ephraim-Emmanuel Benson C , Okokon Enembe , Ordinioha Best
Published: December 2022

Background and aim

Artisanal refining of crude oil is an illegal refining process that contributes to environmental pollution through the release of Polycyclic Aromatic Hydrocarbons (PAHs). PAHs compounds are known for their destructive effects on the environment as well as their harmful effects on human health. This study thus assessed the concentrations of PAHs in water, soil, and fish in communities where artisanal refining of crude oil is practiced in Bayelsa State.

Materials and methods

This descriptive, comparative study was conducted in Sampou (mildly exposed community), Gbarain, and Nembe (severely exposed communities) in Bayelsa State. Water, fish, and soil samples were collected using pre-existing environmental media collection guidelines and sent to the laboratory for GC-FID determination of the PAH concentrations. The data obtained were analyzed using the Statistical Package for Social Sciences (SPSS) software.

Results

Mean and (total) PAHs concentration in water samples obtained from Sampou was 3.50 ± 4.51 (59.59) μg/L; Gbarain 1.76 ± 4.35 (29.87) μg/L and Nembe 1.90 ± 4.20 (32.25) μg/L. A significant difference in the concentrations was also identified p-value: of 0.021. The mean concentration of PAHs in soil samples obtained from Sampou was 10.73 ± 15.53 (183.38) μg/kg; Gbarain 12.00 ± 19.57 (204.32) μg/kg and Nembe was 8.49 ± 10.07 (144.48) μg/kg. Finally, the mean concentration in fish samples obtained from Sampou was 5.62 ± 5.92 (95.43) μg/kg; Gbarain 3.81 ± 5.57 (64.75) μg/kg and Nembe 4.61 ± 5.33 (78.35) μg/kg. The difference in these concentrations was however not significant. Source diagnostic ratios of the PAHs in the water included Flt/(Flt + Pyr) ratio of 0.23, 0.16, and 0.21; Ant/(Ant + Phe) ratio of 0.87, 0.76, and 0.87 as well as BaA/(BaA + Chr) ratio of 0.43, 0.51 and 0.66 in Sampou, Gbarain and Nembe respectively.

Conclusion

Concentrations of total PAHs in water and fish samples obtained from the three communities exceeded the acceptable limits for ƩPAHs of 2.0 μg/L and 2 μg/kg in water and fish respectively stipulated by the United States Environmental Protection Agency and the Nigerian Petroleum Regulatory Authority. ƩPAHs concentrations from the samples obtained from Sampou were also higher than the other two communities. There is a need for regular environmental monitoring of PAH concentrations, especially in oil-producing communities, and a shift of focus toward the elimination of pyrolytic sources of PAH pollution.
Experiences of Patients Adopting and Adapting to Closed-Loop Insulin Delivery Systems (CLIDS)
Authors: Manero Chrystina
Published: December 2022

Purpose:

The purpose of the study was to explore the perspectives and experiences of adults with type 1 diabetes (T1DM) who are currently using the closed-loop insulin delivery system (CLIDS).

Methods:

Eleven adults with T1DM who used closed-loop insulin pumps for at least 6 months participated in this qualitative descriptive study.

Results:

Four themes emerged from the rich descriptions: (1) striving for improvement, (2) missing a magic wand effect, (3) seeking support, and (4) barriers to adaptation. These themes represent both process-based and psychosocial implications for nursing practice and patient education.

Conclusions:

To optimize CLIDS use and outcome, the antecedent conditions that contribute to patients’ decision to adopt it must be understood. Then, interventions that focus on setting realistic expectations must be created. Patients need support as they incorporate CLIDS into their T1DM self-management. Training health care providers on the idiosyncrasies of adapting to CLIDS is critical. Patients must learn to relinquish control and trust the machine and manage the anxiety the system’s intrusive alarms cause them so they can be better supported cognitively and psychosocially.
Comparison of Two-Dimensional Transvaginal Ultrasound, Three-Dimensional Transvaginal Ultrasound and Hysteroscopy to Diagnose in Patients With Abnormal Uterine Bleeding: A Retrospective Observational Study
Authors: Kutlucan Hazal , Işık Gizem , Cevher Akdulum Münire Funda , Demirdağ Erhan , Erdem Özlem , Bozkurt Nuray
Published: December 2022

Objective:

The principal objective was to compare the diagnostic accuracy of two-dimensional transvaginal ultrasonography (2D TVUS), three-dimensional transvaginal ultrasonography (3D TVUS), and hysteroscopy with histopathology in patients with abnormal uterine bleeding.

Materials and Methods:

Fifty patients were included and underwent the three imaging methods. The negative predictive value, positive predictive value, sensitivity, and specificity of the methods were calculated. Determination of endometrial pathology and endometrial polyps by measuring the endometrial thickness, volume, and uterine area was examined.

Results:

The complaint of menorrhagia was reported by 72.0% of participants. Histopathologically, 70.0% of the patients had endometrial polyps and leiomyoma being monitored. An endometrial polyp was detected in 58.0% of the patients by 2D TVUS, 80.0% by 3D TVUS, and 68.0% by hysteroscopy. While 2D TVUS demonstrated 65.71% accuracy in the detection of an endometrial polyp, 3D TVUS had an 80.0% accuracy, and hysteroscopy had a 77.77% accuracy. An endometrial polyp was detected when the uterine area was ≥237 mm2. If the endometrial thickness was over 10.5 mm, it was found to be related to an endometrial polyp. According to the volume measurements by 3D TVUS, the detection of an endometrial polyp was made with 96.4% sensitivity, provided that the pathology volume was ≥0.082 cm3.

Conclusion:

In this cohort of patients, 3D TVUS achieved a high sensitivity to detect abnormalities and could be considered as an initial diagnostic modality, prior to the surgery, and may rival invasive procedures, such as hysteroscopy.
Lisocabtagene maraleucel as second-line therapy for large B-cell lymphoma: primary analysis of the phase 3 TRANSFORM study
Authors: Abramson Jeremy S. , Solomon Scott R. , Arnason Jon , Johnston Patrick B. , Glass Bertram , Bachanova Veronika , Ibrahimi Sami , Mielke Stephan , Mutsaers Pim , Hernandez-Ilizaliturri Francisco , Izutsu Koji , Morschhauser Franck , Lunning Matthew , Crotta Alessandro , Montheard Sandrine , Previtali Alessandro , Ogasawara Ken , Kamdar Manali
Published: December 2022

This global phase 3 study compared lisocabtagene maraleucel (liso-cel) with a standard of care (SOC) as second-line therapy for primary refractory or early relapsed (≤12 months) large B-cell lymphoma (LBCL). Adults eligible for autologous stem cell transplantation (ASCT; N = 184) were randomly assigned in a 1:1 ratio to liso-cel (100 × 106 chimeric antigen receptor–positive T cells) or SOC (3 cycles of platinum-based immunochemotherapy followed by high-dose chemotherapy and ASCT in responders). The primary end point was event-free survival (EFS). In this primary analysis with a 17.5-month median follow-up, median EFS was not reached (NR) for liso-cel vs 2.4 months for SOC. Complete response (CR) rate was 74% for liso-cel vs 43% for SOC (P < .0001) and median progression-free survival (PFS) was NR for liso-cel vs 6.2 months for SOC (hazard ratio [HR] = 0.400; P < .0001). Median overall survival (OS) was NR for liso-cel vs 29.9 months for SOC (HR = 0.724; P = .0987). When adjusted for crossover from SOC to liso-cel, 18-month OS rates were 73% for liso-cel and 54% for SOC (HR = 0.415). Grade 3 cytokine release syndrome and neurological events occurred in 1% and 4% of patients in the liso-cel arm, respectively (no grade 4 or 5 events). These data show significant improvements in EFS, CR rate, and PFS for liso-cel compared with SOC and support liso-cel as a preferred second-line treatment compared with SOC in patients with primary refractory or early relapsed LBCL. This trial was registered at www.clinicaltrials.gov as #NCT03575351.
Sensitivity and complications of thoracentesis and thoracoscopy: a meta-analysis
Authors: Martinez-Zayas Gabriela , Molina Sofia , Ost David E.
Published: December 2022

Background

Thoracentesis and thoracoscopy are used to diagnose malignant pleural effusions (MPE). Data on how sensitivity varies with tumour type is limited.

Methods

Systematic review using PubMed was performed through August 2020 to determine the sensitivity of thoracentesis and thoracoscopy for MPE secondary to malignancy, by cancer type, and complication rates. Tests to identify sources of heterogeneity were performed. Study quality was assessed using Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 and National Institutes of Health quality assessment tools. Publication bias was tested using funnel plots.

Results

Meta-analyses for sensitivity of thoracentesis for MPE secondary to malignancy, mesothelioma and lung and breast cancer included 29, eight, 12 and nine studies, respectively. Pooled sensitivities were 0.643 (95% CI 0.592–0.692), 0.451 (95% CI 0.249–0.661), 0.738 (95% CI 0.659–0.836) and 0.820 (95% CI 0.700–0.917), respectively. For sensitivity of thoracoscopy for MPE secondary to malignancy and mesothelioma, 41 and 15 studies were included, respectively. Pooled sensitivities were 0.929 (95% CI 0.905–0.95) and 0.915 (95% CI 0.871–0.952), respectively. Pooled complication rates of thoracentesis and thoracoscopy were 0.041 (95% CI 0.025–0.051) and 0.040 (95% CI 0.029–0.052), respectively. Heterogeneity was significant for all meta-analyses. Funnel plots were asymmetric.

Interpretation

Sensitivity of thoracentesis varied significantly per cancer type. Pooled complication rates were low. Awareness of how sensitivity of thoracentesis changes across cancers can improve decision-making when MPE is suspected.
New antibiotics for Gram-negative pneumonia
Authors: Bassetti Matteo , Magnè Federica , Giacobbe Daniele Roberto , Bini Lorenzo , Vena Antonio
Published: December 2022

Pneumonia is frequently encountered in clinical practice, and Gram-negative bacilli constitute a significant proportion of its aetiology, especially when it is acquired in a hospital setting. With the alarming global rise in multidrug resistance in Gram-negative bacilli, antibiotic therapy for treating patients with pneumonia is challenging and must be guided byin vitrosusceptibility results. In this review, we provide an overview of antibiotics newly approved for the treatment of pneumonia caused by Gram-negative bacilli. Ceftazidime-avibactam, imipenem-relebactam and meropenem-vaborbactam have potent activity against some of the carbapenem-resistant Enterobacterales, especiallyKlebsiella pneumoniaecarbapenemase producers. Several novel antibiotics have potent activity against multidrug-resistantPseudomonas aeruginosa, such as ceftazidime-avibactam, ceftolozane-tazobactam, imipenem-relabactam and cefiderocol. Cefiderocol may also play an important role in the management of pneumonia caused byAcinetobacter baumannii, along with plazomicin and eravacycline.
The emerging role of pyroptosis-related inflammasome pathway in atherosclerosis
Authors: Xu Xiao-Dan , Chen Jia-Xian , Zhu Lin , Xu Shu-Ting , Jiang Jian , Ren Kun
Published: December 2022

Atherosclerosis (AS), a chronic sterile inflammatory disorder, is one of the leading causes of mortality worldwide. The dysfunction and unnatural death of plaque cells, including vascular endothelial cells (VEC), macrophages, and vascular smooth muscle cells (VSMC), are crucial factors in the progression of AS. Pyroptosis was described as a form of cell death at least two decades ago. It is featured by plasma membrane swelling and rupture, cell lysis, and consequent robust release of cytosolic contents and pro-inflammatory mediators, including interleukin-1β (IL-1β), IL-18, and high mobility group box 1 (HMGB1). Pyroptosis of plaque cells is commonly observed in the initiation and development of AS, and the levels of pyroptosis-related proteins are positively correlated with plaque instability, indicating the crucial contribution of pyroptosis to atherogenesis. Furthermore, studies have also identified some candidate anti-atherogenic agents targeting plaque cell pyroptosis. Herein, we summarize the research progress in understating (1) the discovery and definition of pyroptosis; (2) the characterization and molecular mechanisms of pyroptosis; (3) the regulatory mechanisms of pyroptosis in VEC, macrophage, and VSMC, as well as their potential role in AS progression, aimed at providing therapeutic targets for the prevention and treatment of AS.
Elevated circulating levels of gasdermin D are related to acute myocardial infarction and pyrogptosis
Authors: Weng Yawen , Ye Bozhi , Lin Jiahui , Lin Shuang , Zhong Lingfeng , Huang Weijian , Cai Xueli , Wang Weiqi
Published: December 2022

Background

Acute myocardial infarction (AMI) is one of the leading contributors to morbidity and mortality worldwide, with a prevalence of nearly three million people, and more than one million deaths reported in the United States every year. Gasdermin D (GSDMD) is involved in the development of atherosclerosis as a key protein of proptosis. This study was designed to determine the potential relationship of GSDMD with AMI in Chinese patients.

Methods

One hundred patients with AMI and 50 controls were consecutively enrolled in this prospective observational study. GSDMD expression levels and other clinical variables in peripheral blood mononuclear cells (PBMCs) were measured upon admission to the hospital. All patients were followed up for 360 days, and the endpoint was considered the occurrence of major adverse cardiovascular events (MACE).

Results

GSDMD expression levels in the PBMCs of patients with AMI were significantly higher than those in the controls. Moreover, our analysis showed that GSDMD was an independent biomarker of AMI and had a promising diagnostic ability for it. Finally, the results suggested that high expression of GSDMD and diabetes increased the risk of MACE after AMI.

Conclusions

This study indicated that the GSDMD expression level in PBMCs was elevated in AMI patients and was closely associated with the pyroptosis of AMI.
Double contrast-enhanced ultrasound for the preoperative gross classification of gastric cancer: a comparison with multidetector computed tomography
Authors: He Ping , Zeng Lan , Miao Liying , Wang Tianli , Ye Juxiang , Meng Lingmei , Xue Heng , Zhang Fan , Zhao Bo , Ge Huiyu
Published: December 2022

Purpose

To compare the diagnostic performance of double contrast-enhanced ultrasound (DCEUS) and multi-detector row computed tomography (MDCT) in the gross classification of gastric cancer (GC) preoperatively.

Methods

54 patients with histology proved GC were included in this retrospective study. The sensitivity and specificity of DCEUS and MDCT for the gross classification of GC was calculated and compared. The area under the curve (AUC) from a receiver operating characteristic curve analysis was used to evaluate the difference of the diagnostic performance between these two methods.

Results

There were no significant differences between DCEUS and MDCT in terms of AUC for early gastric cancer (EGC), Borrmann I, II, III and Borrmann (III + IV) (P = 0.248, 0.317, 0.717, 0.464 and 0.594, respectively). The accuracy of DCEUS in diagnosing EGC, Borrmann I, II and Borrmann (III + IV) was higher than that of MDCT (96% vs 92%; 96% vs 94%; 87% vs 80%; 83% vs 73%), while in determining Borrmann III and IV, that of DCEUS was lower than that of MDCT (72% vs 74%; 89% vs 96%).

Conclusion

Considering the revolution in clinical decision, prognosis evaluation, safety and non-invasion aspects, DCEUS can be used as the main alternative method for Borrmann classification of GC preoperatively.