bluuebunny/crossref_metadata_2025 huggingface dataset:
Veno-arterial extracorporeal membrane oxygenation versus standard medical management for massive pulmonary embolism
Authors: Kelty Catherine E , Berjaoui Wael , Shrestha Nabin K , Fitch Stephen , Jovinge Stefan M , Rendon Renzo Loyaga
Published: June 2023

Purpose

There is limited research on the use and outcomes of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) treatment for massive pulmonary embolism (PE). This study compared VA-ECMO treatment for massive PE versus patients treated medically.

Materials and methods

Patients diagnosed with massive PE at one hospital system were reviewed. VA-ECMO and non-ECMO groups were compared by t test and Chi-square. Mortality risk factors were identified by logistic regression. Survival was assessed by Kaplan Meier and propensity matching of groups.

Results

Ninety-two patients were included (22 VA-ECMO and 70 non-ECMO). Age (OR 1.08, 95% CI 1.03–1.13), arterial SBP (OR 0.97, 95% CI 0.94–0.99), albumin (OR 0.3, 95% CI 0.1–0.8), and phosphorus (OR 2.0, 95% CI 1.4–3.17) were independently associated with 30-day mortality. Alkaline phosphate (OR 1.03, 95% CI 1.01–1.05) and SOFA score (OR 1.3, 95% CI 1.06–1.51) were associated with 1-year mortality. Propensity matching showed no difference in 30-day (59% VA-ECMO versus 72% non-ECMO, p = 0.363) or 1-year survival (50% VA-ECMO versus 64% non-ECMO, p = 0.355).

Conclusions

Patients treated with VA-ECMO for massive PE and medically treated patients have similar short- and long-term survival. Further research is needed to define clinical recommendations and benefits of intensive therapy such as VA-ECMO in this critically ill population.
Treatment of a case of primary alveolar soft part sarcoma of the lung: Case report and literature review
Authors: Li Feiyang , Lu Haowei , Zhao Dong , Shen Zhiyuan
Published: June 2023

Alveolar soft part sarcoma (ASPS) is an extremely rare type of soft tissue sarcoma. The primary sites of ASPS are mostly located in the extremities and trunk. Primary pulmonary ASPS is extremely rare. A search of the PubMed® database identified only five cases of primary pulmonary ASPS. This current case report describes the sixth case of ASPS in a 15-year-old male that presented with recurrent headaches. Head computed tomography showed space-occupying lesions in the left parietal lobe. Positron emission tomography–computed tomography confirmed the space-occupying lesions in the left parietal lobe and showed multiple nodules and masses in the two lungs and pleura, which were considered to be low-grade malignant mesenchymal tumours. The case report presents the clinical characteristics, diagnosis and treatment process. Programmed cell death protein 1 monoclonal antibody (sintilimab) combined with a tyrosine kinase inhibitor (anlotinib hydrochloride) achieved a good therapeutic effect, indicating that this combination therapy is worth exploring further. Large-scale prospective studies are needed to explore and develop standardized treatments for ASPS.
From Crisis to Advocacy: Tracing the Emergence and Evolution of the LGBTQIA+ Consumer Market
Authors: Montecchi Matteo , Micheli Maria Rita , Campana Mario , Schau Hope Jensen
Published: June 2023

Although governments and organizations are increasingly addressing the importance of diversity and inclusion policies, LGBTQIA+ consumers still experience instances of discrimination and stigmatization in the market. Research identifying the barriers and struggles that these consumers face is therefore imperative in order to inspire more inclusive marketplace practices. By combining bibliometric and automated text mining methods, this article systematically reviews the existing scholarship on LGBTQIA+ issues at the intersection of marketing and public policy and identifies five thematic clusters: consumer experiences, marginalized consumer identities, imagery creation in advertising, marketplace policies, and minority targeting strategies. Further, this article plots the temporal evolution of this literature domain and identifies three substantive phases: crisis, marketization, and advocacy. The outcome is a phasic framework that unpacks how the LGBTQIA+ consumer market emerged and evolved. This conceptual framework can be used to understand and strategically invigorate research that leads to more inclusive marketing and public policy efforts.
Innovative solutions of public libraries offered to business
Authors: Stanikūnienė Brigita , Kvedaraitė Nida , Žvirelienė Renata
Published: June 2023

Today, in order to remain viable and meet the needs and expectations of a global, entrepreneurial and learning society, public libraries must change and reinvent their roles in society, find new solutions for business, and actively engage in partnerships between education, business and local government. This paper presents the findings of qualitative research using an interview method and uncovers the possibilities of innovative services offered by public libraries to the business community. The qualitative analysis of the experiences of business representatives revealed that in order to become competitive organizations, public libraries need to focus not only on satisfying the needs of different communities, but also on providing innovative services to the business community by playing the roles of an information facilitator, an organizer of cultural and lifelong learning activities, a project partner and a developer of virtual social network.
Post-COVID-19 depression and anxiety in patients with systemic lupus erythematosus
Authors: Abd EL-Khalik Dina M. , Eltohamy Mohamed
Published: June 2023

Objectives

This study aimed to evaluate depression and anxiety in patients with systemic lupus erythematosus (SLE) in the post-coronavirus disease-2019 (COVID-19) period and their potential association with the disease activity and related organ damage.

Patients and Methods

This is a case–control study including 120 adult Egyptian patients with SLE: sixty patients with SLE who were proven previously to be positive for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by polymerase chain reaction (PCR) and recovered during the 3 months prior to the study were included in the case group and an equal number of age- and sex-matched patients with SLE and no evidence of SARS-CoV-2 infection were included in the control group. Patients’ clinical history was collected, and they underwent clinical evaluation, including SLE disease activity, damage assessment, and psychological assessment.

Results

The mean depression and anxiety scores were significantly higher in cases than in the control group. Both scores showed a significant positive correlation with age, disease duration, the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index for SLE (SDI), and SLE disease activity index (SLEDAI) and a significant negative correlation with education years. Hierarchical multivariate regression analyses revealed that COVID-19 infection was a predictor for severe depression and moderate-to-severe anxiety.

Conclusions

Patients with SLE, who are already vulnerable to physiological stressors, are especially predisposed to more risk of anxiety and depression when they are contracted with COVID-19 disease. Furthermore, anxiety and depression are associated with SLE activity and damage scores, and COVID-19 infection is a significant predictor for their severity. These results suggest that healthcare providers should give special attention to the mental health of SLE patients, especially during the COVID-19 pandemic.
Apalutamide-induced lichenoid reaction in a patient with non-metastatic castrate-resistant prostate cancer
Authors: Cremante Malvina , Puglisi Silvia , Gandini Annalice , Guadagno Antonio , Catalano Fabio , Damassi Alessandra , Murianni Veronica , Llaja Obispo Miguel Angel , Banna Giuseppe Luigi , Buti Sebastiano , Rebuzzi Sara Elena , Rescigno Pasquale , Fornarini Giuseppe
Published: June 2023

Introduction

Apalutamide is an oral selective androgen receptor inhibitor, approved by the FDA for the treatment of patients with non-metastatic, castration-resistant prostate cancer (M0 CRPC) at high risk of developing metastases and for patients with metastatic castration-sensitive prostate (mHSPC) in association with androgen deprivation therapy (ADT). In the registration studies, skin reactions were reported among the most common side effects and as an adverse event of special interest.

Case Report

Apalutamide-induced rash includes a wide spectrum of different types of skin reactions, but few cases reports and case series have described this adverse event. Here, we report an M0 CRPC patient who experienced a rare skin adverse event, a lichenoid reaction.

Management & Outcome

After 4 months of therapy with apalutamide, the patient reported dorsal pricking and dry skin. Lichenoid reaction was confirmed histologically and its correlation to the drug was demonstrated after pursuing a multidisciplinary approach.

Discussion

To our knowledge, this is one of the first cases of Apalutamide-related lichenoid reaction and this clinical case showed the relevance of a multidisciplinary management when assessing drug-related adverse events. A broader knowledge of the spectrum of drug-related reactions would allow for a better diagnosis and therapy management by both physicians and patients.
New territories for fan studies: The insurrection, QAnon, Donald Trump and fandom
Authors: Petersen Line Nybro , Reinhard CarrieLynn D , Dannar Anthony , Le Clue Natalie
Published: June 2023

The following roundtable is a recorded and edited discussion between four fan studies researchers that took place in March 2022. Having all worked with QAnon and the insurrection in the context of fan studies, our discussion took its departure from the US insurrection on January 6, 2021, as QAnon fans, Trump fans, and other right-wing groups stormed the US Capitol building while live-streaming their endeavor to social media. The discussion draws out some main perspectives that may guide our future thinking in the context of fandom, complicity, and politics and points toward new cultural and social territories for research into fandom and fan practices. Centrally, as fandom enters into the domain of politics and conspiracy theories, it seems increasingly unfruitful to distinguish between fan practices and participatory culture. Instead, participatory culture’s primary mode seems to be deeply driven by fan practices, that is, textual poaching and enunciative and textual productivity (Jenkins, 2013; Fiske, 1992). Instead, understanding this amalgamation of fan practices into other social domains can help us make sense of current phenomena in the seeming growth of conspiracy theory communities and right-wing movements alike. Participatory culture is a source of great creativity, playfulness, and mobilization of social and political movements, but, as Jenkins pointed out as early as 2006 “has benefited third parties, revolutionaries, reactionaries, and racists alike” (Jenkins, 2006, p. 221). In some instances, it seems that these online communities are driven by fan practices, in other instances fan communities are weaponized in order to serve a political agenda. While research into fandom and politics (see Hinck, 2019; Jenkins et al., 2020, Sandvoss, 2012, etc.) and toxic cultures (Proctor et. al., 2018) is certainly not new, it seems that the current transmedial landscapes drive participation and complicity in very specific ways that fan studies would do well to focus on in the coming years.
Dynamic analysis of a porous wall fencing offshore fish cage subjected to regular waves
Authors: Abdul Shareef Shaik , Thuvanismail Nasar , E Sai Kiran Naik , Vijaykumar Manisha
Published: June 2023

Global aquaculture is in exponential trend to fulfil the demand for seafood due to the rise in world population. Most countries have implemented nearshore farming and reached their limits, which impacts water quality parameters. Offshore farming is the alternative option to counteract this nearshore farming issue and balance the aquaculture demand and supply. The present study construes on the numerical study of the porous wall fencing offshore fish cage subjected to regular waves. The numerical analysis is carried out for four cages by varying porous hole diameters from 0.5 to 0.7 m and without porosity. All the cages are placed at the same water depth of 200 m, interacting with a constant wave height of 6m with wave periods ranging from 6.92 to 19.05 s. Both frequency and time domain analysis are conducted to study the variation of hydrodynamic parameters, namely added mass, wave excitation forces, radiational potential damping, motion responses, and mooring line tension. Among all cage configurations, the cage with 0.5 m diameter porous hole fencing performs better for all wave conditions considered. Also, a scaled model of 1:75 was considered in both experimental and numerical studies for the purpose of validation. It is learnt that experimental parameters such as motion responses and mooring line tension are in good agreement.
From “Confusion” and “Fear” to “Broadened Horizons.” Students’ Transformative Experiences in Two Higher Education Contexts: Argentina and Sweden
Authors: Bergman Lotta , Hessel Frida
Published: June 2023

This article explores students’ experiences of intellectual, social, and emotional growth during the first year at university and the extent to which these experiences can be considered transformative (Mezirow, 1981). The study is a qualitative interpretive multiple-case study built on semi-structured interviews with students in two higher education contexts, Argentina and Sweden. The results show that most students experience similarly interrelated changes concerning self-confidence, knowledge- and language-abilities, critical thinking, and values and beliefs. For some students, these changes lead to profound shifts in how they perceive themselves and their possibilities. Such transformative experiences are emancipatory and empowering, giving students more control over their lives. Other students are gradually changing, experiencing growth in knowledge, literacy, and self-confidence. However, they do not yet experience profound changes in their worldview and how they perceive themselves. Contextual factors related to family life and future profession affect the significance students attach to experienced changes.
The development and application of glyco-probes for bovine serum albumin
Authors: Gu Xiaomin , Ji Fei , Jiang Dawei , Liang Wenhui , Feng Yan , Niu Shanshan , Zhao Qiang
Published: June 2023

Two glyco-probes, GFP and GFN, which are derived from the condensation of 3-acetyl-5-C-(2,3-dihydroxy-1,4-anhydro-β-D-erythro-tetrofuranosyl)-2-methylfuran with benzaldehyde and 1-naphthaldehyde, respectively, are designed and synthesized. Of these two probes, GFP displays a selective and sensitive switch-on fluorescence response towards bovine serum albumin in phosphate-buffered saline over a wide pH range. Moreover, the fluorescence of this probe displays a good linear relationship with the bovine serum albumin concentration ranging from 0 to 0.8 mg/mL, and has a limit of detection as low as 3.7 nM. The stoichiometric ratio of bovine serum albumin /GFP is 1:1. This research paves the way for the development of glyco-probes for bovine serum albumin sensing.
The New York Times distorts the Palestinian struggle: A case study of anti-Palestinian bias in US news coverage of the First and Second Palestinian Intifadas
Authors: Jackson Holly M
Published: June 2023

This article provides a methodologically novel, large-scale proof of historical bias against Palestine in a newspaper of international importance – The New York Times (NYT) – during the First and Second Palestinian Intifadas. Using state-of-the-art natural language processing toolkits as well as a regression model with over 90 percent accuracy based on a carefully validated word bank, the author analyzes over 33,000 NYT articles for (1) their use of active/passive voice, and (2) the objectivity, tone, and violent sentiment of the language used. She follows up her quantitative analysis with a qualitative validation step, analyzing biased articles in each period. In conjunction with historical context, the article shows that anti-Palestinian bias persisted disproportionately in the NYT during both periods and, in fact, worsened from the First Intifada to the Second. This work builds on a history of qualitative research on anti-Palestinian bias in the US media and attempts to provide a methodological contribution that encourages conversation between quantitative and qualitative metrics of bias.
Three-dimensional virtual reality in surgical planning for breast cancer with reconstruction
Authors: De la Cruz-Ku Gabriel , Mallouh Michael P , Torres Roman Jr Smith , Linshaw David
Published: June 2023

Breast surgery is performed to achieve local control in patients with breast cancer. Visualization of the anatomy with a virtual reality software platform reconstructed from magnetic resonance imaging data improves surgical planning with regards to volume and localization of the tumor, lymph nodes, blood vessels, and surrounding tissue to perform oncoplastic tissue rearrangement. We report the use and advantages of virtual reality added to the magnetic resonance imaging assessment in a 36-year-old woman with breast cancer who underwent nipple sparing mastectomy with tissue expander reconstruction.
The Global South and Climate Coverage: From News Taker to News Maker
Authors: Ejaz Waqas , Najam Adil
Published: June 2023

Global media coverage of climate change has grown consistently—although unevenly—over recent years. While major differences exist in how much attention is paid to climate coverage in different parts of the world, how climate is discussed has been noticeably uniform and the major thrust of the “climate communication agenda” remains recognizably “global” in that it is driven by the more mature media markets in the North and especially by the narratives coming out of international climate institutions (e.g., the Intergovernmental Panel on Climate Change [IPCC], climate Conference of the parties [COPs] international nongovernmental organizations [NGOs], and think tanks). Building on the recent experience of the 2022 floods in Pakistan, this essay argues that with the advent of what we are calling the age of adaptation, climate reporting is likely to shift rapidly from mostly explaining why climate change is important (and generally convergent broad ideas about what might be done about it) to reporting on localized climate impacts (and often divergent preferences on how to allocate responsibility and evaluate the cost of those consequences). This will, we argue, make global media narratives on climate change not only more complex and more contentious, but also more honest.
Correlation Study Between Spinal Cord Function, Spinal Cord Morphology and Cervical Spine Alignments in Patients With Hirayama Disease
Authors: Gao Yuan , Sun Chi , Zhou Shuyi , Zhang Fan , Jiang Jianyuan , Zhang Jun , Wang Hongli
Published: June 2023

Objective

This study aimed to explore the relationship between diffusion tensor imaging (DTI) parameters, cervical spine alignments, and spinal cord morphological parameters in patients with Hirayama disease (HD).

Methods

In this retrospective cohort study, 41 HD patients were recruited from the Huashan hospital from July 2017 to November 2021. Patients received X-rays, conventional magnetic resonance (MR), and DTI scans in flexion and neutral positions. The DTI parameters assessed were calculated using the region of interest (ROI) method. Paired t-tests were performed on the DTI parameters of neck flexion and neutral position. Cervical spine alignments, including flexion and neutral Cobb angles, were measured, and range of motion (ROM) was calculated. Spinal cord morphological parameters were measured, including spinal cord atrophy (SCA) and loss of attachment (LOA). Spearman’s correlation analysis between DTI parameters, cervical spine alignments, and spinal cord morphological parameters was performed.

Results

In comparing DTI parameters, segments of the C3/4, C4/5, C6/7, and lower cervical spine were significantly different, while segments of C5/6 were not significantly different. In Spearman’s correlation analysis, the flexion Cobb angle was significantly correlated with the fractional anisotropy (FA) value ( R2 = .111, P = .033) and apparent diffusion coefficient (ADC) value ( R2 = .119, P = .027). Flexion FA values were correlated with SCA in C4/5 ( R2 = .211, P = .003), C5/6 ( R2 = .454, P < .001), and C6/7 ( R2 = .383, P < .001) while flexion ADC values were correlated with SCA in the C4/5 ( R2 = .178, P = .006), C5/6 ( R2 = .388, P < .001) and C6/7 segments ( R2 = .187, P = .005).

Conclusion

The DTI parameters were correlated with the flexion Cobb angle and the SCA. These data support the dynamic cervical flexion compression hypothesis and indicate that the degree of SCA may be used to assess the condition of HD patients quantitatively.
High-frequency Trading and Stock Markets: Past, Present and the Road Ahead
Authors: Krishna Jaya Sankar , Lenka Renuka
Published: June 2023

High-frequency trading (HFT) is one of the most significant recent developments in the financial markets. This study aims to assess the present status of HFT in stock markets in India and across the world to identify subjective areas that can be used for carrying out research in HFT in relation to stock markets operating in India. The study will help to bring out significant areas of research gap which can help to regulate the HFT without much impact on the retail investors by reducing the leveraging effect of the prices. With the use of major studies that have highest citations during the previous ten years in the area of HFT, the regulatory measures and their impact on HFT were found to be an interesting area of research that is left unexplored. This study on whole has provided clear synthesis of HFT and its impact on stock markets over the decade which has helped to identify significant areas of research related to Indian as well as world stock markets.
Preliminary Evaluation of Cardiac Telemetry Technician Work in a Large Health System: Mutual Dependence and Considerations for Patient Load
Authors: Nystrom Daniel T. , Thomas Joel , Jones Chris
Published: June 2023

The introduction of continuous cardiac monitoring via telemetry provides a method to ensure patient care is safe and effective. At the same time, the implementation of this technology has raised concerns about telemetry technician (teletech) work. This project provides a two-fold look at teletech’ work in real-time settings to describe teletech interactions with unit staff and to explore the relationship between measures of teletech’ workload and patient load. Results suggest the implementation of telemetry systems necessitate a mutual dependence between teletechs and unit staff: unit staff rely on teletechs to inform them of concerning patient states; teletechs rely on unit staff to maintain the integrity and accuracy of the telemetry system and the patient data they observe. Results from measures of teletech’ workload and patient load align with previous work that explored teletech’ patient load in simulated settings. Agreement between the current project and previous studies also suggest a potential patient load capacity of 33 patients for continuous telemonitoring work. Future research and implications for academics, healthcare operations, and the design of telemetry systems are discussed.
Identifying Barriers and Motivators in Diabetic Eye Examination to Design Medical Screening Systems
Authors: Salas Andrea Macedo , McLaughlin Anne Collins , Grace Landon , Mayorga Maria , Sepulveda Juan Marcos Gonzalez , Fransen Stephen , Wang Tianyu
Published: June 2023

Diabetic Retinopathy (DR) is the main contributor to adult blindness in America. When detected on time, treatment can avoid severe sight loss 95% of the time (Fong et al., 2004). However, only 50% of people with diabetes get screened yearly, making early intervention difficult (Lee, et al., 2003). There is a need to understand how the systems for DR screenings can be designed to comply with the patient's needs, for which it is necessary to understand the user and the factors that affect their behavior. We created a questionnaire from barriers and motivators found in interviews with persons with diabetes regarding their yearly screenings (Salas, et.al., 2022) based on Ajzen’s (2006a) Constructing a Theory of Planned Behavior Questionnaire. The questionnaire measured the influence of attitudes, social norms, and perceived control on screening for DR. This study will add to the current body of literature by helping to identify where to focus efforts when creating systems for DR screening.
Ethical challenges and opportunities in the development and approval of novel therapeutics for rare diseases
Authors: Djordjevic Djurdja , McFadyen Andrew , Anderson James A
Published: June 2023

The development of novel therapeutics for rare “orphan” diseases has brought a growing tension between the desire to accelerate access to these breakthrough therapies and the need to generate quality evidence regarding their safety and efficacy. Accelerating the pace of drug development and approval may facilitate the rapid delivery of benefits to patients and cost savings for research and development, which theoretically improves affordability of drugs for the health system. However, several ethical challenges arise with expedited approval, compassionate release of drugs, and subsequent study of drugs in “real-world” settings. In this article, we explore the changing landscape of drug approval and the ethical challenges expedited approval creates for patients, caregivers, clinicians, and institutions, and propose tangible strategies to maximize the benefits of “real-world” data acquisition while mitigating risks to patients, clinicians, and institutions.
Basic, translational and clinical aspects of bronchiectasis in adults
Authors: Chalmers James D. , Elborn Stuart , Greene Catherine M.
Published: June 2023

Bronchiectasis is a common progressive respiratory disease with recognisable radiological abnormalities and a clinical syndrome of cough, sputum production and recurrent respiratory infections. Inflammatory cell infiltration into the lung, in particular neutrophils, is central to the pathophysiology of bronchiectasis. Herein we explore the roles and relationships between infection, inflammation and mucociliary clearance dysfunction in the establishment and progression of bronchiectasis. Microbial and host-mediated damage are important processes underpinning bronchiectasis and the relative contribution of proteases, cytokines and inflammatory mediators to the propagation of inflammation is presented. We also discuss the emerging concept of inflammatory endotypes, defined by the presence of neutrophilic and eosinophilic inflammation, and explore the role of inflammation as a treatable trait. Current treatment for bronchiectasis focuses on treatment of underlying causes, enhancing mucociliary clearance, controlling infection and preventing and treating complications. Data on airway clearance approachesviaexercise and mucoactive drugs, pharmacotherapy with macrolides to decrease exacerbations and the usefulness of inhaled antibiotics and bronchodilators are discussed, finishing with a look to the future where new therapies targeting host-mediated immune dysfunction hold promise.
Extreme weather and asthma: a systematic review and meta-analysis
Authors: Makrufardi Firdian , Manullang Amja , Rusmawatiningtyas Desy , Chung Kian Fan , Lin Sheng-Chieh , Chuang Hsiao-Chi
Published: June 2023

Background:

Climate change's influence on extreme weather events poses a significant threat to the morbidity and mortality of asthma patients. The aim of this study was to examine associations between extreme weather events and asthma-related outcomes.

Methods:

A systematic literature search for relevant studies was performed using the PubMed, EMBASE, Web of Science and ProQuest databases. Fixed-effects and random-effects models were applied to estimate the effects of extreme weather events on asthma-related outcomes.

Results:

We observed that extreme weather events were associated with increasing risks of general asthma outcomes with relative risks of 1.18-fold for asthma events (95% CI 1.13–1.24), 1.10-fold for asthma symptoms (95% CI 1.03–1.18) and 1.09-fold for asthma diagnoses (95% CI 1.00–1.19). Extreme weather events were associated with increased risks of acute asthma exacerbation with risk ratios of asthma emergency department visits of 1.25-fold (95% CI 1.14–1.37), of asthma hospital admissions of 1.10-fold (95% CI 1.04–1.17), of asthma outpatient visits of 1.19-fold (95% CI 1.06–1.34) and of asthma mortality of 2.10-fold (95% CI 1.35–3.27). Additionally, an increase in extreme weather events increased risk ratios of asthma events by 1.19-fold in children and 1.29-fold in females (95% CI 1.08–1.32 and 95% CI 0.98–1.69, respectively). Thunderstorms increased the risk ratio of asthma events by 1.24-fold (95% CI 1.13–1.36).

Conclusions:

Our study showed that extreme weather events more prominently increased the risk of asthma morbidity and mortality in children and females. Climate change is a critical concern for asthma control.
Clinical utility of WHO-recommended screening tools and development and validation of novel clinical prediction models for pulmonary tuberculosis screening among outpatients living with HIV: an individual participant data meta-analysis
Authors: Dhana Ashar , Gupta Rishi K. , Hamada Yohhei , Kengne Andre P. , Kerkhoff Andrew D. , Yoon Christina , Cattamanchi Adithya , Reeve Byron W.P. , Theron Grant , Ndlangalavu Gcobisa , Wood Robin , Drain Paul K. , Calderwood Claire J. , Noursadeghi Mahdad , Boyles Tom , Meintjes Graeme , Maartens Gary , Barr David A.
Published: June 2023

Background:

The World Health Organization (WHO) recommends that outpatient people living with HIV (PLHIV) undergo tuberculosis screening with the WHO four-symptom screen (W4SS) or C-reactive protein (CRP) (5 mg·L−1cut-off) followed by confirmatory testing if screen positive. We conducted an individual participant data meta-analysis to determine the performance of WHO-recommended screening tools and two newly developed clinical prediction models (CPMs).

Methods:

Following a systematic review, we identified studies that recruited adult outpatient PLHIV irrespective of tuberculosis signs and symptoms or with a positive W4SS, evaluated CRP and collected sputum for culture. We used logistic regression to develop an extended CPM (which included CRP and other predictors) and a CRP-only CPM. We used internal–external cross-validation to evaluate performance.

Results:

We pooled data from eight cohorts (n=4315 participants). The extended CPM had excellent discrimination (C-statistic 0.81); the CRP-only CPM had similar discrimination. The C-statistics for WHO-recommended tools were lower. Both CPMs had equivalent or higher net benefit compared with the WHO-recommended tools. Compared with both CPMs, CRP (5 mg·L−1cut-off) had equivalent net benefit across a clinically useful range of threshold probabilities, while the W4SS had a lower net benefit. The W4SS would capture 91% of tuberculosis cases and require confirmatory testing for 78% of participants. CRP (5 mg·L−1cut-off), the extended CPM (4.2% threshold) and the CRP-only CPM (3.6% threshold) would capture similar percentages of cases but reduce confirmatory tests required by 24, 27 and 36%, respectively.

Conclusions:

CRP sets the standard for tuberculosis screening among outpatient PLHIV. The choice between using CRP at 5 mg·L−1cut-off or in a CPM depends on available resources.
Pulmonary rehabilitation and physical interventions
Authors: Troosters Thierry , Janssens Wim , Demeyer Heleen , Rabinovich Roberto A.
Published: June 2023

Pulmonary rehabilitation has established a status of evidence-based therapy for patients with symptomatic COPD in the stable phase and after acute exacerbations. Rehabilitation should have the possibility of including different disciplines and be offered in several formats and lines of healthcare. This review focusses on the cornerstone intervention, exercise training, and how training interventions can be adapted to the limitations of patients. These adaptations may lead to altered cardiovascular or muscular training effects and/or may improve movement efficiency. Optimising pharmacotherapy (not the focus of this review) and oxygen supplements, whole-body low- and high-intensity training or interval training, and resistance (or neuromuscular electrical stimulation) training are important training modalities for these patients in order to accommodate cardiovascular and ventilatory impairments. Inspiratory muscle training and whole-body vibration may also be worthwhile interventions in selected patients. Patients with stable but symptomatic COPD, those who have suffered exacerbations and patients waiting for or who have received lung volume reduction or lung transplantation are good candidates. The future surely holds promise to further personalise exercise training interventions and to tailor the format of rehabilitation to the individual patient's needs and preferences.
Hepatitis C virus screening in community pharmacies: results on feasibility from a Swiss pilot
Authors: Stämpfli Dominik , Imfeld-Isenegger Tamara Leila , Hersberger Kurt E. , Messerli Markus
Published: June 2023

Background

Hepatitis C virus (HCV) infections are a public health burden worldwide and often go undetected until sequelae develop. Offering HCV screening for the different vulnerable populations in community pharmacies could help prevent further undetected HCV infections. This pilot aimed to assess the feasibility and pharmacist acceptance of HCV rapid antibody saliva testing in community pharmacies.

Methods

A structured pharmaceutical care intervention was developed that included addressing, informing, and screening clients, as well as referral and reporting to subsequent health care providers. Participating pharmacies from French-, German- and Italian-speaking parts of Switzerland were trained to provide this service to local vulnerable populations. Information on client recruitment, feasibility, and acceptability of HCV screening was collected.

Results

Of 36 pharmacies initially recruited, 25 started the pilot and approached 435 clients, 145 of whom (33%) were interested in screening. Eight of these rapid antibody tests returned positive (prevalence rate: 5.5%). Facilitators were being able to offer a free rapid test (73%), followed by having training prior to the project (67%) and having a new service to offer (67%). The possibility of clients reacting dismissively (53%) and of unsettling clients (47%) were reported to be the main barriers.

Conclusions

This pilot demonstrated the general feasibility of an HCV screening service with rapid antibody saliva testing in Swiss community pharmacies, which achieved a higher prevalence rate than national estimates. With appropriate communication training and remuneration, Swiss community pharmacies could be an important partner in implementing HCV elimination strategies.
Wound size and location affect the prognosis of penetrating ocular injury
Authors: Gao Xue , Zhang Qiuqiu , Wang Fang , Li Xuewei , Ma Chunli , Li Yixiao , Zhao Xiaofei , Zhang Han
Published: June 2023

Background

Ocular trauma is a leading cause of vision loss. Penetrating ocular injury is a major type of open globe injury(OGI), while its epidemiology and clinical characteristics are still uncertain. The aim of this study is to reveal the prevalence and prognostic factors of penetrating ocular injury in the Shandong province.

Methods

A retrospective study of penetrating ocular injury was performed at the Second Hospital of Shandong University, from January 2010 to December 2019. Demographic information, injury causes, ocular trauma types, and initial and final visual acuity(VA) were analyzed. To obtain more precise characteristics of penetrating injury, the eye global was divided into three zones and analyzed.

Results

Among 210 OGI, there are 83 penetrating injuries which account for 39.5% of all. In addition, the final VA of 59 penetrating injuries recovered to 0.1 or better, which possesses the highest frequency among OGI. In order to research the relationship between the wound location and the final VA, we took 74 cases of penetrating injuries without retina or optic nerve damage for analysis. Results show that 62 were male and 12 were female. The average age was 36.01 ± 14.15. The most frequent occupation is the worker followed by the peasant. Statistics show that there is an obvious deviation in the Ocular trauma score (OTS) predicting the final VA and the actual final VA in the 45–65 score group (p < 0.05). Results suggest that the commonest penetrating injury zone is zone III (32 cases, 43.8%). Zone III, which is farthest from the center of the visual axis, has the largest improvement of the final VA (p = 0.0001). On the contrary, there is no statistical difference in the visual improvement in zone I and zone I + II that involves the injury of the central visual axis.

Conclusion

This study describes the epidemiology and clinical characteristics of patients hospitalized for penetrating ocular injury without retina damage in Shandong province. It can be concluded that larger size and closer location to the visual axis of damage are accompanied by worse prognosis improvement. The study provides a better understanding of the disease and enlightenment for the prediction of visual prognosis.
Akkermansia muciniphila and its membrane protein ameliorates intestinal inflammatory stress and promotes epithelial wound healing via CREBH and miR-143/145
Authors: Wade Henry , Pan Kaichao , Duan Qihua , Kaluzny Szczepan , Pandey Ekta , Fatumoju Linda , Saraswathi Viswanathan , Wu Rongxue , Harris Edward N. , Su Qiaozhu
Published: June 2023

Background

The intestinal epithelial barrier is the interface for interaction between gut microbiota and host metabolic systems. Akkermansia muciniphila (A. muciniphila) is a key player in the colonic microbiota that resides in the mucus layer, whose abundance is selectively decreased in the faecal microbiota of inflammatory bowel disease (IBD) patients. This study aims to investigate the regulatory mechanism among A. muciniphila, a transcription factor cAMP-responsive element-binding protein H (CREBH), and microRNA-143/145 (miR-143/145) in intestinal inflammatory stress, gut barrier integrity and epithelial regeneration.

Methods

A novel mouse model with increased colonization of A muciniphila in the intestine of CREBH knockout mice, an epithelial wound healing assay and several molecular biological techniques were applied in this study. Results were analysed using a homoscedastic 2-tailed t-test.

Results

Increased colonization of A. muciniphila in mouse gut enhanced expression of intestinal CREBH, which was associated with the mitigation of intestinal endoplasmic reticulum (ER) stress, gut barrier leakage and blood endotoxemia induced by dextran sulfate sodium (DSS). Genetic depletion of CREBH (CREBH-KO) significantly inhibited the expression of tight junction proteins that are associated with gut barrier integrity, including Claudin5 and Claudin8, but upregulated Claudin2, a tight junction protein that enhances gut permeability, resulting in intestinal hyperpermeability and inflammation. Upregulation of CREBH by A. muciniphila further coupled with miR-143/145 promoted intestinal epithelial cell (IEC) regeneration and wound repair via insulin-like growth factor (IGF) and IGFBP5 signalling. Moreover, the gene expressing an outer membrane protein of A. muciniphila, Amuc_1100, was cloned into a mammalian cell-expression vector and successfully expressed in porcine and human IECs. Expression of Amuc_1100 in IECs could recapitulate the health beneficial effect of A. muciniphila on the gut by activating CREBH, inhibiting ER stress and enhancing the expression of genes involved in gut barrier integrity and IEC’s regeneration.

Conclusions

This study uncovers a novel mechanism that links A. muciniphila and its membrane protein with host CREBH, IGF signalling and miRNAs in mitigating intestinal inflammatory stress–gut barrier permeability and promoting intestinal wound healing. This novel finding may lend support to the development of therapeutic approaches for IBD by manipulating the interaction between host genes, gut bacteria and its bioactive components.
Quantifying the spatial spillover effects of non-pharmaceutical interventions on pandemic risk
Authors: Wang Keli , Han Xiaoyi , Dong Lei , Chen Xiao-Jian , Xiu Gezhi , Kwan Mei-po , Liu Yu
Published: June 2023

Background

Non-pharmaceutical interventions (NPIs) implemented in one place can affect neighboring regions by influencing people’s behavior. However, existing epidemic models for NPIs evaluation rarely consider such spatial spillover effects, which may lead to a biased assessment of policy effects.

Methods

Using the US state-level mobility and policy data from January 6 to August 2, 2020, we develop a quantitative framework that includes both a panel spatial econometric model and an S-SEIR (Spillover-Susceptible-Exposed-Infected-Recovered) model to quantify the spatial spillover effects of NPIs on human mobility and COVID-19 transmission.

Results

The spatial spillover effects of NPIs explain$$61.2\%$$61.2%[$$95\%$$95%credible interval: 52.8-$$84.4\%$$84.4%] of national cumulative confirmed cases, suggesting that the presence of the spillover effect significantly enhances the NPI influence. Simulations based on the S-SEIR model further show that increasing interventions in only a few states with larger intrastate human mobility intensity significantly reduce the cases nationwide. These region-based interventions also can carry over to interstate lockdowns.

Conclusions

Our study provides a framework for evaluating and comparing the effectiveness of different intervention strategies conditional on NPI spillovers, and calls for collaboration from different regions.
A successive time-to-event model of phyllochron dynamics for hypothesis testing: application to the analysis of genetic and environmental effects in maize
Authors: Plancade Sandra , Marchadier Elodie , Huet Sylvie , Ressayre Adrienne , Noûs Camille , Dillmann Christine
Published: June 2023

Background

The time between the appearance of successive leaves, or phyllochron, characterizes the vegetative development of annual plants. Hypothesis testing models, which allow the comparison of phyllochrons between genetic groups and/or environmental conditions, are usually based on regression of thermal time on the number of leaves; most of the time a constant leaf appearance rate is assumed. However regression models ignore auto-correlation of the leaf number process and may lead to biased testing procedures. Moreover, the hypothesis of constant leaf appearance rate may be too restrictive.

Methods

We propose a stochastic process model in which emergence of new leaves is considered to result from successive time-to-events. This model provides a flexible and more accurate modeling as well as unbiased testing procedures. It was applied to an original maize dataset collected in the field over three years on plants originating from two divergent selection experiments for flowering time in two maize inbred lines.

Results and conclusion

We showed that the main differences in phyllochron were not observed between selection populations but rather between ancestral lines, years of experimentation and leaf ranks. Our results highlight a strong departure from the assumption of a constant leaf appearance rate over a season which could be related to climate variations, even if the impact of individual climate variables could not be clearly determined.
Comparison of outcome after stereotactic ablative radiotherapy of patients with metachronous lung versus primary lung cancer
Authors: Benzaquen Jonathan , Bondiau Pierre-Yves , Otto Josiane , Marquette Charles-Hugo , Berthet Jean-Philippe , Naghavi Arash O. , Schiappa Renaud , Hannoun-Levi Jean-Michel , Padovani Bernard , Doyen Jérôme
Published: June 2023

Background

Early-stage lung cancer, primarily treated with surgery, often occur in poor surgical candidates (impaired respiratory function, prior thoracic surgery, severe comorbidities). Stereotactic ablative radiotherapy (SABR) is a non-invasive alternative that provides comparable local control. This technique is particularly relevant for surgically resectable metachronous lung cancer, in patients unable to undergo surgery.. The objective of this study is to evaluate the clinical outcome of patients treated with SABR for stage I metachronous lung cancer (MLC) versus stage I primary lung cancer (PLC).

Patients and methods

137 patients treated with SABR for stage I non-small cell lung cancer were retrospectively reviewed, of which 28 (20.4%) were MLC and 109 (79.6%) were PLC. Cohorts were evaluated for differences in overall survival (OS), progression-free survival (PFS), metastasis-free survival, local control (LC), and toxicity.

Results

After SABR, patients treated for MLC have comparable median age (76.6 vs 78.6, p = 0.2), 3-year LC (83.6% vs. 72.6%, p = 0.2), PFS (68.7% vs. 50.9%, p = 0.9), and OS (78.6% vs. 52.1%, p = 0.9) as PLC, along with similar rates of total (54.1% vs. 42.9%, p = 0.6) and grade 3 + toxicity (3.7% vs. 3.6%, p = 0.9). Previous treatment of MLC patients was either surgery (21/28, 75%) or SABR (7/28, 25%). The median follow-up was 53 months.

Conclusion

SABR is a safe and effective approach for localized metachronous lung cancer.
P2X7 receptor inhibition ameliorates ubiquitin–proteasome system dysfunction associated with Alzheimer’s disease
Authors: Bianchi Carolina , Alvarez-Castelao Beatriz , Sebastián-Serrano Álvaro , Di Lauro Caterina , Soria-Tobar Lucia , Nicke Annette , Engel Tobias , Díaz-Hernández Miguel
Published: June 2023

Background

Over recent years, increasing evidence suggests a causal relationship between neurofibrillary tangles (NFTs) formation, the main histopathological hallmark of tauopathies, including Alzheimer’s disease (AD), and the ubiquitin–proteasome system (UPS) dysfunction detected in these patients. Nevertheless, the mechanisms underlying UPS failure and the factors involved remain poorly understood. Given that AD and tauopathies are associated with chronic neuroinflammation, here, we explore if ATP, one of the danger-associated molecules patterns (DAMPs) associated with neuroinflammation, impacts on AD-associated UPS dysfunction.

Methods

To evaluate if ATP may modulate the UPS via its selective P2X7 receptor, we combined in vitro and in vivo approaches using both pharmacological and genetic tools. We analyze postmortem samples from human AD patients and P301S mice, a mouse model that mimics pathology observed in AD patients, and those from the new transgenic mouse lines generated, such as P301S mice expressing the UPS reporter UbG76V-YFP or P301S deficient of P2X7R.

Results

We describe for the first time that extracellular ATP-induced activation of the purinergic P2X7 receptor (P2X7R) downregulates the transcription of β5 and β1 proteasomal catalytic subunits via the PI3K/Akt/GSK3/Nfr2 pathway, leading to their deficient assembly into the 20S core proteasomal complex, resulting in a reduced proteasomal chymotrypsin-like and postglutamyl-like activities. Using UPS-reported mice (UbGFP mice), we identified neurons and microglial cells as the most sensitive cell linages to a P2X7R-mediated UPS regulation. In vivo pharmacological or genetic P2X7R blockade reverted the proteasomal impairment developed by P301S mice, which mimics that were detected in AD patients. Finally, the generation of P301S;UbGFP mice allowed us to identify those hippocampal cells more sensitive to UPS impairment and demonstrate that the pharmacological or genetic blockade of P2X7R promotes their survival.

Conclusions

Our work demonstrates the sustained and aberrant activation of P2X7R caused by Tau-induced neuroinflammation contributes to the UPS dysfunction and subsequent neuronal death associated with AD, especially in the hippocampus.