bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of metformin on low birth weight girls with precocious puberty: A protocol for systematic review and meta-analysis
Authors: Lin Zhiheng , Sui Xiaohui , Li Lijuan , Wang Ying , Zhao Junde
Published: June 2022

Background:

In recent years, the role of metformin in girls with precocious puberty (PP) has been increasingly frequently studied. The objective of this present study is to assess the effect of metformin on low birth weight girls with precocious puberty (LBW-PP girls).

Methods:

We search the confirmed studies about circulating metformin and PP from the databases of EMBASE, PubMed, and Web of Science. Data were reported as weighted mean difference (WMD) and associated 95% confidence intervals (CIs). Analysis was performed by Review Manager 5.3 and Stata version 12.0.

Results:

A total of 205 cases (metformin group n = 102, untreated group n = 103) were included in this study. The meta-analysis of randomized controlled trials (RCTs) suggested that metformin had statistically significant effects on testosterone (P = .001), androstenedione (P = .022), bone mineral density (BMD; P = .151), triglycerides (P ≤ .001), body mass index Z score (BMI Z score; P ≤ .001), dehydroepiandrosterone-sulfate (DHEAS; P = .053), sex hormone-binding globulin (SHBG; P = .049), high-density lipoprotein (HDL) cholesterol (P ≤ .001), low-density lipoprotein (LDL) cholesterol (P = .021), fat mass (P ≤ .001), lean mass (P = .025), and fasting insulin (P = .002).

Conclusion:

This meta-analysis provided evidence of the efficacy of metformin in girls with LBW-PP girls, which proved that metformin could improve metabolism and reduce weight. Metformin had a positive effect on preventing LBW-PP girls from developing into obesity and polycystic ovarian syndrome. In addition, this meta-analysis provided important reference opinions and directions for the treatment of LBW-PP girls.
Apathy and impulsiveness in Parkinson disease: Two faces of the same coin?
Authors: Palmeri Rosanna , Corallo Francesco , Bonanno Lilla , Currò Simona , Merlino Paola , Di Lorenzo Giuseppe , Bramanti Placido , Marino Silvia , Lo Buono Viviana
Published: June 2022

Apathy and impulsiveness are 2 common non-motor symptoms in Parkinson disease that could occur in different periods or simultaneously. Apathy and impulsiveness could be interpreted as opposite extremes of a spectrum of motivated behavior dependent on dopaminergic dysfunction, in which, impulsivity, is a result of a hyperdopaminergic state, whereas apathy is viewed as a hypodopaminergic. The study aimed to investigate the presence of impulsiveness and other neuropsychiatric symptoms in Parkinson disease patients with apathy symptoms.

Eighty-one patients with Parkinson disease were enrolled in this retrospective study. All subjects were evaluated by the Italian version of the Dimensional Apathy Scale and the Barratt Impulsiveness Scale-version 11, to assess, respectively, apathy and impulsiveness; they were divided into 2 groups (apathy and no apathy). All patients were administered also with questionnaires assessing depressive and anxious symptoms.

Statistical analyses showed relevant results. In no-apathy group, education was a significant predictor on impulsiveness (attentional and motor) and apathy (executive and emotional); depression was a significant predictor on planning impulsivity and apathy.

This study aimed to consider the importance of apathy and impulsivity in Parkinson disease. Although these are considered as opposite extremes of a spectrum of motivated behavior dependent on dopaminergic dysfunction, these can also occur separately. Moreover, several variables could represent important predictors of apathy and impulsiveness, such as depression. Future investigations should deepen the role of other demographics and psychological variables.
Histological and histomorphometric evaluation of alveolar ridge preservation using an allograft and nonresorbable membrane with and without primary closure: A pilot randomized controlled clinical trial
Authors: Aladmawy Majdi A. , Natto Zuhair S. , Kreitzer Michael , Ogata Yumi , Hur Yong
Published: June 2022

The aim of this article is to assess the formation of new vital bone (VB) using histomorphometric analysis in alveolar ridge preservation (ARP), with and without primary closure. Eight patients needed bilateral tooth extraction and planned for ARP. All patients had a nonresorbable membrane with freeze-dried bone allograft after the extractions. Biopsies were obtained 6 months after ARP and were evaluated using histomorphometric analysis. The study included 6 males and 2 females, with an average age of 54.2 years (standard deviation, 9.7). The teeth requiring extraction included a bilateral canine (1 case), premolars (5 cases), and molars (2 cases). Histomorphometric values of new VB, residual bone (RB) substitute particles, and marrow tissue formation were 71.1 %, 16.2%, and 9.69% for closed flap and 50.9%, 15.3%, and 8.19 for open flap. P values were 0.066, 0.878, and 0.326, respectively. The present findings indicate that leaving the flap without primary closure did not have any effect on new VB, RB particles, and immature bone marrow compared with closed flap. However, the results favored the closed-flap technique.
The role of polyglycolic acid sheets in the management of post-endoscopic submucosal dissection gastrointestinal bleeding and esophageal stricture: A PRISMA compliant systematic review and meta-analysis
Authors: Peng Shicheng , Huang Shu , Xia Huifang , Tan Shali , Zhong Chunyu , Peng Yan , Lü Muhan , Tang Xiaowei
Published: June 2022

Background:

As a relatively minimally invasive technique, endoscopic submucosal dissection (ESD) is widely used for the treatment of gastrointestinal lesions. However, it is associated with complications, such as postoperative bleeding, stricture, and perforation. A covering method using polyglycolic acid (PGA) sheets for ESD-induced ulcers has been reported to be effective in reducing the risk of post-ESD bleeding and esophageal stricture. Herein, we conducted a systematic review and meta-analysis to evaluate the role of PGA sheets in the prevention of gastrointestinal bleeding and esophageal stricture after ESD.

Methods:

We searched PubMed, Web of Science, and the Cochrane Library databases on October 15, 2019. All eligible articles were selected based on the predefined inclusion and exclusion criteria. The main outcomes were the rates of post-ESD gastrointestinal bleeding and esophageal stricture. Cochrane’s Q statistic and I2 test were used to identify heterogeneity between the studies. When there was no obvious heterogeneity (I2 < 50%, P > .1), a fixed-effect model was used. When there was obvious heterogeneity (I2 > 50%, P < .1), a random effect model was used. Funnel plots and the Egger regression test were used to assess publication bias.

Results:

Fifteen articles were included in the meta-analysis, of which 7 were exclusively about the use of PGA sheets to prevent postoperative gastrointestinal bleeding, and the remaining reported the use of PGA sheets to prevent postoperative esophageal stenosis. Our analysis showed that preventive therapy with PGA sheets decreased the rates of post-ESD gastrointestinal bleeding (risk ratio [RR] = 0.35, 95% confidential interval [CI]: 0.19–0.64, P < .001) and esophageal stricture (RR = 0.46, 95% CI: 0.27–0.79, P = .005), and the gastrointestinal bleeding and esophageal stricture rates after preventive treatment with PGA sheets were 5.7% (95% CI: 3.6%–8.8%) and 20.6% (95% CI: 14.5%–28.4%), respectively.

Conclusion:

The utilization of PGA sheets after ESD has an excellent outcome in reducing the risk of postoperative gastrointestinal bleeding and esophageal stricture.
Clinical observation on the benefits of antidepressant intervention in advanced cancer patients
Authors: Pu Bing , Wang Ning , Wang Chuansheng , Sun Bo
Published: June 2022

To observe the interventional effect of antidepressants on advanced cancer patients from the perspective of patient benefit and analyze patient characteristics to explore reasonable drug use.

Pharmaceutical care was administered to patients with advanced cancer. From June 2018 to June 2020, 152 advanced cancer patients underwent sertraline intervention. The Hospital Anxiety/Depression Scale (HADS) was used to screen for the risk of anxiety and depression, and patients were divided into 4 groups: high, medium, low, and no risk. Concomitant clinical symptoms and antidepressant intervention results were recorded. HADS score change and symptom improvement were used to evaluate the antidepressant intervention effect, and effective intervention time for both indicators was recorded. The guidelines for antidepressant medication for these patients were analyzed, and depression/anxiety assessments and treatment models in this population were discussed.

We observed that concomitant refractory clinical symptoms were the main target for the antidepressant intervention. Of those considered high risk on the basis of the HADS score (i.e., ≥15 points), 41.5% had depression, 26.3% had anxiety, and 20.4% had comorbid anxiety and depression. For the 142 patients who completed the study, the improvement rate of mood-related symptoms based on the efficacy index was 78.2%, with a median of 7 days until improvement was observed. The improvement rate based on the HADS score was 57.0%, with a median of 19 days for improvement. Improvement rate and median days until improvement under both indices were statistically significant. Comparisons by risk group showed that improvement in clinical symptoms was significantly greater in the high- and medium-risk groups than in the low-risk group, and HADS score improvement was significantly greater in the high-risk group than in the other 2 groups. Moreover, sertraline improved chemotherapy tolerance, unhealthy emotions, and clinical symptoms such as fear, dyspnea, agrypnia, fatigue, and intractable pain.

We observed a positive effect of antidepressant drug intervention on refractory clinical symptoms in patients with advanced cancer that was particularly pronounced in those with a high-to-medium risk of depression and anxiety. However, the effect was not correlated with improved HADS score. Antidepression treatment improves concomitant clinical symptoms and benefits patients.
Risk factors for and predictive nomogram of overall survival in adult patients with craniopharyngiomas: A SEER population-based study
Authors: Wu Yong , Xu Bo , Hu Sheng , Shao Bi-Bo
Published: June 2022

Studies with relatively large sample size as well as long-term follow-up focusing on adult craniopharyngioma (CP) patients are still lacking. We attempted to identify independent prognostic factors and establish a nomogram model to estimate survival rates for adult CP patients.

The Surveillance, Epidemiology, and End Results database was used to obtain data on patients with CP. Univariable and multivariable Cox analyses were utilized to identify the prognostic factors of adult CP patients. A survival prediction model was constructed and its predictive performance was also assessed.

A total of 991 patients (695 in training group and 296 in validation group) were eligible for final inclusion. Multivariate Cox analysis presented that age at diagnosis, marital status, race, tumor size, and surgery type were statistically significant prognostic factors for overall survival (all P < .05). A graphical predicting nomogram model was developed to calculate the predicted patients’ survival probabilities at 1, 2, 5, and 10 years. The concordance indexes were 0.708 ± 0.019 and 0.750 ± 0.025 for the training and validation samples, respectively, demonstrating favorable discrimination abilities. Similarly, the time-dependent area under curve also showed overall satisfactory discrimination ability. Favorable consistencies between the predicted and actual survival were presented according to the calibration curves.

An easy-to-use nomogram, being proven to be with reliable discrimination ability and accuracy, was established to help predict overall survival for adult patients with CP using the identified significant prognostic factors.
Recent trends in the antibiotic resistance of Helicobacter pylori in patient with dyspepsia
Authors: Buran Tahir , Sürücüoğlu Süheyla , Kurutepe Semra , Gazi Hörü
Published: June 2022

The aim of this study was to determine the resistance status and to identify the point mutations conferring resistance to clarithromycin and fluoroquinolones among dyspeptic patients in Manisa, Turkey.

The study included a sample of 140 patients with an indication for upper gastrointestinal endoscopy randomly selected from 2100 dyspeptic patients attending to the Gastroenterology and Endoscopy Unit at Manisa Celal Bayar University Hafsa Sultan Hospital between April 2016 and May 2018. A commercially available GenoType Helico DR test was used to detect the presence of Helicobacter pylori and mutations associated with resistance to clarithromycin and fluoroquinolones in biopsy specimens.

In total, 116 (82.9%) of 140 biopsies obtained from the same number of dyspeptic patients were positive for H pylori and 82 (approximately 71%) of them harbored resistance mutations in 23SrRNA and/or gyrA. Resistance to clarithromycin, levofloxacin, or both were detected in 43.1% (50/116), 27.6% (32/116), and 16/116 (13.8%) of tested biopsies, respectively. The most common mutation conferring resistance to clarithromycin was A2147G (96%, 48/50). Resistance to fluoroquinolones was frequently due to mutation in codon 91 and the most common mutation detected was D91G (34.4%). Heteroresistance patterns were observed in 48.0% (24/50) of clarithromycin-resistant samples and 28.1% (9/32) of levofloxacin-resistant samples.

The resistance rates and detected mutations in this study are in line with the country data. However, to achieve better H pylori eradication and to prevent the spread of multidrug-resistant strains in Turkey, the molecular-based susceptibility tests should be considered routinely. Further studies are needed to determine the various mutations among resistant strains.
Effectiveness and safety of moxibustion for vascular dementia: A systematic review and meta-analysis
Authors: Jiang Xinqi , Lu Tao , Dong Yihang , Shi Jiaru , Duan Mengyao , Zhang Xiaoqing
Published: June 2022

Background:

Vascular dementia (VD) is the only type of dementia that can be prevented and treated. Compared to conventional treatment methods, moxibustion therapy is more effective for VD. This study evaluated the effectiveness and safety of moxibustion in the treatment of VD through a meta-analysis, to provide a complete overview to the advantages of traditional Chinese medicine and provide guidance for clinical application.

Methods:

Clinical trials on the therapeutic effects of moxibustion or moxibustion combined with acupuncture on VD were retrieved from the VIP information database, Wanfang, CNKI, PubMed, EMBase, and other resources. The included studies were conducted from January 2000 to October 2020. Among the retrieved studies, the content met the standards upon being collated and extracted, and RevMan5.3 was used for meta-analysis.

Results:

Thirteen randomized controlled trials (RCTs) were included with 997 patients. The RevMan bias risk assessment revealed that the quality of the studies was generally low. The meta-analysis showed that compared to conventional treatments, moxibution therapy in terms of effective rate, posttreatment Hasegawa Dementia Scale, Mini-Mental State Examination (MMSE), Activity of Daily Living Scale (ADL), Somatostatin (SS), Arginine Vasopressin (AVP), and Syndrome Differentiation Scale of VD were more favorable, and the difference in efficacy was statistically significant. Furthermore, no adverse events were observed in either group. Sensitivity analysis showed strong homogeneity and stable results, whereas funnel plot analysis revealed no significant publication bias.

Conclusions:

Moxibustion is effective and safe in the treatment of VD, but more high-quality evidence from further studies is required to support this.
Comparison of outcomes after transcatheter aortic valve replacement between elderly (65–79 years) and super-elderly (≥80 years) patients
Authors: Oh Seok , Kim Ju Han , Hwang Cho-Hee , Hyun Dae Young , Cho Kyung Hoon , Kim Min Chul , Sim Doo Sun , Hong Young Joon , Ahn Youngkeun , Jeong Myung Ho
Published: June 2022

Transcatheter aortic valve replacement (TAVR) is an effective treatment option for patients with severe symptomatic aortic stenosis. Nonetheless, there is a paucity of data regarding the differences in the clinical outcomes of TAVR procedures between elderly and super-elderly patients. This study aimed to compare the clinical characteristics and outcomes of patients aged 65 to 79 years and ≥80 years who underwent TAVR for aortic stenosis.

The clinical characteristics and outcomes of 134 patients with aortic stenosis who underwent TAVR were analyzed. Patients were categorized into 2 groups: an elderly group (EG; 65–79 years) and a super-elderly group (SEG) (≥80 years). The in-hospital and follow-up clinical outcomes were compared between the 2 groups.

The EG tended to be more overweight, obese, and diabetic than the SEG, whereas the SEG had a higher surgical risk but lower creatinine clearance, hematocrit level, and effective orifice area than the EG. However, no difference was found in in-hospital clinical outcomes between the 2 groups, except for atrial fibrillation. In the propensity score matching and inverse probability of treatment weighting-adjusted analyses, these results were similar. All follow-up clinical outcomes were similar, except for rehospitalization, which was statistically attenuated after propensity score matching and inverse probability of treatment weighting-adjusted analyses.

TAVR was associated with similar safety outcomes in the EG (65–79 years) and the SEG (≥80 years). Advanced age is not negatively associated with clinical outcomes after the TAVR procedure.
The significance of m6A RNA methylation modification in prognosis and tumor microenvironment immune infiltration of cervical cancer
Authors: Guo Yilin , Bai Yangyang , Wang Lu , Xu Zhen , Wang Xiliang , Wang Wuliang
Published: June 2022

Recent studies have highlighted that N6-methyladenosine (m6A) plays a significant role in tumorigenicity and progression. However, the mechanism of m6A modifications in the tumor microenvironment (TME) immune cell infiltration in cervical cancer (CC) remains unclear.

Clinical and RNA sequencing data of 25 m6A RNA methylation regulators were acquired from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) database. LASSO Cox regression analysis was used to generate a prognostic risk signature. m6A modification patterns were identified based on the expression of 25 m6A regulators, and their correlation with TME immune cell-infiltrating characterization was analyzed. Principal component analysis was used to construct an m6A-scoring signature (m6A score) to evaluate the m6A modification patterns of individual CC samples and guide the selection of more effective immunotherapeutic strategies.

Genetic and expression alterations of 25 m6A regulators were highly heterogeneous between CC and normal tissues. METTL14 and IGF2BP1 were selected to conduct the prognostic risk signature. Three m6A modification patterns were identified in 659 CC samples, which were associated with distinct clinical outcomes and biological pathways. The TME immune cell-infiltrating characterization of the three m6A modification patterns was highly consistent with 3 tumor immune phenotypes, including immune-excluded, immune-inflamed, and immune-desert phenotypes. Due to the heterogeneity of m6A modification patterns, an m6A scoring signature was established to evaluate the m6A modification patterns of individual CC samples. Univariate and multivariate Cox regression analyses revealed that the m6A score is a robust and independent prognostic biomarker for assessing the prognosis of CC patients. A low m6A score, characterized by higher somatic mutation and higher expression of proliferation-related and DNA repair-related genes, indicated poor overall survival. Activation of immune infiltration was exhibited by the high m6A score, which was likely to have a good response and clinical benefits to antiPD-1/L1 immunotherapy.

This study highlights the prognostic value of 25 m6A regulators in CC. The m6A modification is related to immune regulation and the formation of TME heterogeneity and complexity. An m6A scoring signature to clarify the individual m6A modification pattern could enhance our understanding of TME immune cell-infiltrating characterization and guide immunotherapy strategies.
Effect of binaural beat in the inaudible band on EEG (STROBE)
Authors: Choi Mi-Hyun , Jung Jin-Ju , Kim Kyu-Beom , Kim Ye-Jin , Lee Je-Hyeop , Kim Hyung-Sik , Yi Jeong-Han , Kang Ok-Ri , Kang Young-Tae , Chung Soon-Cheol
Published: June 2022

This study aimed to determine the effects of the binaural beat (BB) on brainwave induction using an inaudible baseline frequency outside the audible frequency range. Experiments were conducted on 18 subjects (11 males [mean age: 25.7 ± 1.6 years] and 7 females [mean age: 24.0 ± 0.6 years]). A BB stimulation of 10 Hz was exerted by presenting frequencies of 18,000 Hz and 18,010 Hz to the left and right ears, respectively. A power spectrum analysis was performed to estimate the mean of the absolute power of the alpha frequency range (8–13 Hz). The variation in the mean alpha power during the rest and stimulation phases in each brain area was compared using the Wilcoxon signed-rank test. Compared to the rest phase, the stimulation phase with BB showed an increasing trend in the mean alpha power across all 5 brain areas. Notably, a significant increase was found in the frontal, central, and temporal areas. This is a significant study in that it determines the effects of only BB without the influence of auditory perception, which has been overlooked in previous studies.
The clinical characteristics and outcomes of patients with pulmonary hypertension in association with hyperthyroid state: A systematic review
Authors: Ata Fateen , Khan Adeel Ahmad , Yousaf Zohaib , Choudry Hassan , Mohammed Areej Marwan , Ahmed Bilal , Umer Ahmed Muaaz , Khan Fareeha , Al Mohanadi Dabia Hamad SH , Naem Emad , Zahid Muhammad
Published: June 2022

Background:

Pulmonary hypertension (PHTN) may occur in thyroid disorders, especially in hypothyroidism. However, there is increasing evidence of PHTN in hyperthyroidism (HTH). The etiology, clinical course, management, and factors associated with outcomes of PHTN in the setting of HTH are unascertained. This systematic review consolidates available evidence on patients with HTH who developed PHTN.

Methods:

We conducted a systematic review on English articles from PubMed, Scopus, and Google Scholar reporting PHTN in patients with hyperthyroidism. Data were analyzed and reported in Microsoft Excel 2020, SPSS version 26, and Jamovi version 1.2.

Results:

We identified 589 patients with PHTN in the setting of HTH. Etiologies included Grave disease 66.7%), toxic multinodular goiter (TMNG) (16.8%), drug-induced HTH (0.3%), thyroiditis(0.8%), and toxic adenoma(0.1%). Most patients did not receive any specific management for PHTN and were managed by antithyroid treatment (97.4%). Outcomes of PHTN were reported in 181 patients, with a 94% recovery rate. Pulmonary artery pressures (PAP) before and after HTH management ranged from 22.5 to 75 mm Hg and from 24 to 50 mm Hg, respectively. Outcome analysis performed on data from case reports and series with individually identifiable data revealed a 67.6% female preponderance. An estimated 73.5% of the patients had PHTN at the initial presentation of HTH, which was associated with a better resolution rate of PHTN(OR: 12, P-value: 0.048). TRAB was positive in 47% patients with no clinical difference in outcomes. antiTG AB was reported positive in 29.4%, all of whom had an improvement, compared to an 83.3% improvement rate in those with negative antiTG AB. Various etiologies and treatments did not have any significant differences in the outcome of PHTN.

Conclusions:

PHTN can be present at the initial diagnosis of HTH, which is associated with better outcomes of PHTN. There is a clear female preponderance in the development of PHTN. However, resolution rates seem to be better in males. Although TRAB is associated with the development of PHTN, it does not seem to affect the outcomes. PHTN in patients with HTH does not need any specific management, with >90% resolution with antithyroid therapy. Whether any specific antithyroid therapy has a better outcome in PHTN needs to be explored prospectively.
Acute rheumatic fever in adult patients
Authors: Wang Chrong-Reen , Lee Nan-Yao , Tsai Hung-Wen , Yang Chao-Chun , Lee Cheng-Han
Published: June 2022

Acute rheumatic fever (ARF) is considered as a disorder of children, and attacks in adults are usually a recurrence of disease acquired in the child’s life. Although the incidence of ARF in children has a decreasing trend in developed countries, resurgent and sporadic epidemics still occur in adults. The first attacks of ARF in adult patients without a childhood history can lead to a diagnostic dilemma.

A medical record review in adults at least 18 years of age with an arthralgia complaint fulfilling 2015 revised Jones criteria was performed from January 1, 2000 to December 31, 2019.

Eleven ARF patients were identified, including 8 with initial attacks (6 females aged 26–42 years, 33.9 ± 5.3) and 3 pre-existing valvular heart disease with recurrent attacks (2 females aged 38–52 years, 45.0 ± 7.0). In addition to febrile pharyngitis and migratory polyarthritis in initial attacks, pericarditis was encountered in 1, valvulitis in 2, prolong PR interval in 3 and skin involvement in 2 patients with erythema marginatum and IgA vasculitis. All responded to antibiotics and nonsteroidal anti-inflammatory drugs therapy with normalized clinical and laboratory abnormalities, no new-onset carditis, and no recurrent disease during a long-term follow-up (3.8–19.8 years, 12.7 ± 5.4).

A sporadic occurrence of adult ARF is observed in southern Taiwan. This disease should be considered by physicians for the differential diagnosis of febrile pharyngitis with arthritis and/or carditis in adults, even in areas with a low incidence of ARF.
In-hospital outcomes of patients with spontaneous supratentorial intracerebral hemorrhage
Authors: Yang Chao-Chun , Lee Ming-Hsue , Chen Kuo-Tai , Lin Martin Hsiu-Chu , Tsai Ping-Jui , Yang Jen-Tsung
Published: June 2022

Spontaneous intracerebral hemorrhage (ICH) in the brain parenchyma accounts for 16.1% of all stroke types in Taiwan. It is responsible for high morbidity and mortality in some underlying causes. The objective of this study is to discover the predicting factors focusing on in-hospital outcomes of patients with spontaneous supratentorial ICH.

Between June 2014 and October 2018, there were a total of 159 patients with spontaneous supratentorial ICH ranging from 27 to 91 years old in our institution. Twenty-three patients died during hospitalization, whereas 59 patients had an extended length of stay of >30 days. The outcomes were measured by inpatient death, length of stay, and activity of daily living (ADL). Both univariate and multivariate binary logistic regression, as well as multivariate linear regression, were used for statistical analysis.

Multivariate binary linear regression analysis showed the larger hematoma in initial computed tomography scan of >30 cm3 (odds ratio [OR] = 2.505, P = .013) and concurrent in-hospital infection (OR = 4.173, P = .037) were both statistically related to higher mortality. On the other hand, in-hospital infection (≥17.41 days, P = .000) and surgery (≥11.23 days, P = .001) were correlated with a longer length of stay. Lastly, drastically poor change of ADL (ΔADL <–30) was associated with larger initial ICH (>30 cc, OR = 2.915, P = .049), in-hospital concurrent infection (OR = 4.695, P = .01), and not receiving a rehabilitation training program (OR = 3.473, P = .04).

The results of this study suggest that age, prothrombin, initial Glasgow Coma Scale, computed tomography image, location of the lesion, and surgery could predict the mortality and morbidity of the spontaneous ICH, which cannot be reversed at the time of occurrence. However, effective control of international normalized ratio level, careful prevention against infection, and the aid of rehabilitation programs might be important factors toward a decrease of inpatient mortality rate, the length of stay, and ADL recovery.
Evaluating the value of tumor length times width in colorectal adenocarcinoma with different tumor locations
Authors: Zhou Encheng , Chen Jianhui , Peng Shuwang , Chen Jingfeng , Fei Ting , Wang Xiaojun , Qi Changlei , Huang Qing
Published: June 2022

The T classification, which reflects the vertical growth pattern of the tumor, is one of the most important prognostic factors in colorectal cancer. We aimed to investigate the prognostic value of tumor length and width in patients with colorectal cancer (CRC).

A total of 259 patients with stage I–III CRC who underwent curative resection were reevaluated according to tumor location. One-way ANOVA analysis was conducted to investigate the relationship between the tumor length times width (TLTW) and clinical parameters. Univariate and multivariate analyses were conducted to analyze the potential prognostic factors affecting overall survival (OS) of patients with stage I–III CRC. In the entire cohort, the TLTW was analyzed as a continuous variable.

The results suggested that TLTW (P = .003) and tumor location (P = .04) could be independent prognostic factors for patients with CRC. In addition, TLTW had an intimate relationship with tumor location (P < 0.001) and differentiation (P = .003). The mean TLTW of the right colon was significantly larger than mean TLTW of the left colon and rectal cancers. However, the mean TLTW of the left colon cancer was similar to that of the rectal cancer TLTW (P > 0.05, not shown). Subgroup analysis of TLTW according to tumor location suggested that TLTW was an independent prognostic factor for patients with right colon cancer (RCC) (P = .007) rather than left colon cancer (LCC) (P = .49) or rectal cancer (P = .16). Kaplan-Meier (K-M) analysis based on tumor location suggested that the survival rate of RCC patients had a distinctly higher trend rate than LCC patients and RECC patients in the long-term rather than in the short-term.

TLTW is closely associated with tumor location in CRC. In addition, TLTW may be an independent prognostic factor for patients with RCC.
Emerging trends in rhinoplasty education: accelerated adoption of digital tools and virtual learning platforms
Authors: McIntosh Cameron , Patel Krupa R. , Lekakis Garyfalia , Wong Brian J.F.
Published: June 2022

Purpose of review

The COVID-19 pandemic catalyzed the rapid adoption of digital tools and virtual learning platforms by rhinoplasty educators and trainees alike. This review provides an overview of the variety of digital software and web-based tools rhinoplasty educators have adopted and highlights the advantages and potential drawbacks of virtual learning via e-content.

Recent findings

Medical education including subspecialty surgical training has recently undergone a dramatic digital transformation. Rhinoplasty surgeon-educators have been forced to embrace new digital tools, including videoconferencing, podcasts, virtual simulation and social media to reach and teach trainees. Recognizing the advantages of this new, limitless digital space, rhinoplasty surgeons are also engaging in virtual transcontinental collaboration and distance mentorship.

The dramatic evolution in how clinical educational materials are now digitally created, curated, disseminated and consumed is likely to far outlast the COVID-19 pandemic itself. Rapid, exponential growth of this digital library, however, places increased responsibility on educators to guide trainees towards evidence-based and state-of-the-art content.
Meeting the Challenges of COVID-19
Authors: Squeri Barbara , Gayton Matthew , Huang Jennifer , Chavez Silvia , Souffront Kimberly
Published: June 2022

The early months of the COVID-19 pandemic caused suspension of physician home visits at our NYC home-based primary care practice as well as disruptions in community-based services homebound patients rely on. This produced gaps in care for a vulnerable patient population that is considered underserved and medically and socially complex. Telephone triage nurses at Mount Sinai Visiting Doctors Program responded to these gaps in care with targeted enhancements to telephonic patient assessment: creating an encrypted email address to receive photographs, the use of two Epic dot phrases to screen and educate regarding COVID-19, assessment of patients' ability to complete a video visit, the reassessment of goals of care, and the assessment of changes in home care services. We surveyed 15 attending physicians in our practice to evaluate primary care providers' opinions regarding changes in nurse telephone triage and how helpful they were in managing patients at home during the early pandemic. We found enhancements to nurse telephone triage were viewed by physicians as beneficial, valuable, and improved patient care. Physicians found changes improved timeliness of care, could improve self-management, helped avoid transfer to emergency department, and helped manage patient care at home. As the pandemic continues and telehealth becomes more widely used, nurse telephone triage may be adaptable to help care for a variety of patient populations during future public health emergencies.
Overcoming the Disruption of Clinical Nursing Education
Authors: Warren Joan Insalaco , Zipp Jennifer Stephenson , Goodwin Jana , David-Sherman Eursula
Published: June 2022

Havoc of the COVID-19 pandemic on prelicensure nursing programs caused students to lose precious onsite clinical opportunities to gain competency in basic fundamental skills. A statewide task force of faculty and hospital leaders developed the Transition to Nurse Residency Program to develop new nurses’ skills and behaviors routinely learned during onsite clinical experiences. This article describes the program contents and shares its contents for use by nursing professional development practitioners.
Retinal Thinning in People With Well-Controlled HIV Infection
Authors: Geannopoulos Katrina , McMahan Cynthia , Maldonado Ramiro S. , Abbott Akshar , Knickelbein Jared , Agron Elvira , Wu Tianxia , Snow Joseph , Nair Govind , Horne Elizabeth , Lau Chuen-Yen , Nath Avindra , Chew Emily Y. , Smith Bryan R.
Published: June 2022

Background:

Retinal measurements correlate with disease progression in patients with multiple sclerosis; however, whether they associate with neurologic disease in people with controlled HIV is unknown. Using spectral domain optical coherence tomography, we evaluated retinal differences between people with HIV and HIV-negative controls and investigated clinical correlates of retinal thinning.

Methods:

People with HIV on antiretroviral therapy for at least 1 year and HIV-negative controls recruited from the same communities underwent spectral domain optical coherence tomography, ophthalmic examination, brain MRI, and neuropsychological testing. Retinal nerve fiber layer (RNFL) and ganglion cell inner plexiform layer (GC-IPL) thicknesses were compared between groups using analysis of covariance with relevant clinical variables as covariates. Linear regression was used to explore associations of HIV history variables, cognitive domain scores, and MRI volume measurements within the HIV group.

Results:

The HIV group (n = 69), with long-duration HIV infection (median time from diagnosis 19 years) and outstanding viral control have thinner retinal layers than HIV-negative controls (n = 28), after adjusting for covariates (GC-IPL: P = 0.002; RNFL: P = 0.024). The effect of HIV on GC-IPL thickness was stronger in women than in men (Women: P = 0.011; Men: P = 0.126). GC-IPL thickness is associated with information processing speed in the HIV group (P = 0.007, semipartial r = 0.309). No associations were found with retinal thinning and MRI volumes or HIV factors.

Conclusions:

People with HIV on antiretroviral therapy have thinning of the RNFL and GC-IPL of the retina, and women particularly are affected to a greater degree. This retinal thinning was associated with worse performance on tests of information processing speed.
Neurophysiological and Clinical Correlates of Acute Posthypoxic Myoclonus
Authors: Freund Brin E. , Kaplan Peter W.
Published: June 2022

Prognostication following cardiorespiratory arrest relies on the neurological examination, which is supported by neuroimaging and neurophysiological testing. Acute posthypoxic myoclonus (PHM) is a clinical entity that has prognostic significance and historically has been considered an indicator of poor outcome, but this is not invariably the case. “Malignant” and more “benign” forms of acute PHM have been described and differentiating them is key in understanding their meaning in prognosis. Neurophysiological tests, electroencephalogram in particular, and clinical phenotyping are crucial in defining subtypes of acute PHM. This review describes the neurophysiological and phenotypic markers of malignant and benign forms of acute PHM, a clinical approach to evaluating acute PHM following cardiorespiratory arrest in determining prognosis, and gaps in our understanding of acute PHM that require further study.
Whole Genome Sequencing Based Characterization of Streptomyces sp. 6(4): focus on natural products
Authors: Borba Marcela Proença , Witusk João Paulo , Cunha Débora Marchesan , de Lima-Morales Daiana , Martins Andreza Francisco , Van Der Sand Sueli
Published: June 2022

We have sequenced the whole genome of Streptomyces sp. 6(4) isolated from tomato roots that presents antifungal activity against phytopathogenic fungi, mainly against Bipolaris sorokiniana . The genome has almost 7 Mb and 3,368 hypothetical proteins that were analyzed and characterized in Uniprot with emphasize in biological compounds. MLST analysis were performed in effort to characterize and identify this isolate, resulting in a new ST, classified as ST64. Phenetic and phylogenetic trees were constructed to investigate Streptomyces sp. 6(4) evolution and sequence similarity, and the isolate is a strain closer to Streptomyces prasinus and Streptomyces viridosporus . It is known that Streptomyces genera comprises a huge metabolism capacity with the presence of cryptic genes. These genes are usually present in clusters who are responsible for production of a high diversity of natural products, mainly antibiotics. In addition, 6(4) showed 11 biosynthetic gene cluster through antiSMASH, including 3 clusters PKS and NRPS type.
Biological Brain Age Prediction Using Machine Learning on Structural Neuroimaging Data: Multi-Cohort Validation Against Biomarkers of Alzheimer’s Disease and Neurodegeneration stratified by sex
Authors: Cumplido-Mayoral Irene , García-Prat Marina , Operto Grégory , Falcon Carles , Shekari Mahnaz , Cacciaglia Raffaele , Milà-Alomà Marta , Lorenzini Luigi , Ingala Silvia , Wink Alle Meije , Mutsaerts Henk JMM , Minguillón Carolina , Fauria Karine , Luis Molinuevo José , Haller Sven , Chetelat Gael , Waldman Adam , Schwarz Adam , Barkhof Frederik , Suridjan Ivonne , Kollmorgen Gwendlyn , Bayfield Anna , Zetterberg Henrik , Blennow Kaj , Suárez-Calvet Marc , Vilaplana Verónica , Gispert Juan Domingo ,   ALFA study,   EPAD study,   ADNI study,   OASIS study
Published: June 2022

Brain-age can be inferred from structural neuroimaging and compared to chronological age (brain-age delta) as a marker of biological brain aging. Accelerated aging has been found in neurodegenerative disorders like Alzheimer’s disease (AD), but its validation against markers of neurodegeneration and AD is lacking. Here, imaging-derived measures from the UK Biobank dataset (N=22,661) were used to predict brain-age in 2,314 cognitively unimpaired (CU) individuals at higher risk of AD and mild cognitive impaired (MCI) patients from four independent cohorts with available biomarker data: ALFA+, ADNI, EPAD and OASIS. Brain-age delta was associated with abnormal amyloid-β, more advanced stages (AT) of AD pathology andAPOE-ε4 status. Brain-age delta was positively associated with plasma neurofilament light, a marker of neurodegeneration, and sex differences in the brain effects of this marker were found. These results validate brain-age delta as a non-invasive marker of biological brain aging related to markers of AD and neurodegeneration.
Subtyping of Small Cell Lung Cancer using plasma cell-free nucleosomes
Authors: Fialkoff Gavriel , Takahashi Nobuyuki , Sharkia Israa , Gutin Jenia , Hermoni Nadav , Kumar Rajesh , Pongor Lorinc , Nichols Samantha , Sciuto Linda , Graham Chante , Desai Parth , Nirula Micheal , Suresh Priya , Abel Melissa , Elmeskini Rajaa , Maoz Miriam , Rottenberg Yakir , Shoshan Nevo , Nechushtan Hovav , Peretz Tamar , Roame Diana , Carter Paula , Hubert Ayala , Cohen Jonathan E , Salah Azzam , Temper Mark , Grinshpun Albert , Weaver-Ohler Zoe , Rajan Arun , Figg William Douglas , Zick Aviad , Sadeh Ronen , Friedman Nir , Thomas Anish
Published: June 2022

Emerging data on small cell lung cancer (SCLC), an aggressive malignancy with exceptionally poor prognosis, support subtypes driven by distinct transcription regulators, which engender unique therapeutic vulnerabilities. However, the translational potential of these observations is limited by access to tumor biopsies. Here, we leverage chromatin immunoprecipitation of cell-free nucleosomes carrying active chromatin modifications followed by sequencing (cfChIP-seq) on 442 plasma samples from individuals with advanced SCLC, neuroendocrine carcinomas (NEC), non-SCLC cancers, and healthy adults. Beyond providing reliable estimates of SCLC circulating free DNA tumor fraction, cfChIP-seq captures the unique epigenetic states of SCLC tissue- and cell-of-origin. Comparison of cfChIP-seq signals to matched tumor transcriptomes reveals genome-wide concordance, establishing a direct link between gene expression in the tumor and plasma cell-free nucleosomes. Exploiting this link, we develop a classifier that discriminates between SCLC lineage-defining transcription factor subtypes based on cfChIP-seq data. This work sets the stage to non-invasively profile SCLC transcriptomes using plasma cfDNA histone modifications.
Genotyping, sequencing and analysis of 140,000 adults from the Mexico City Prospective Study
Authors: Ziyatdinov Andrey , Torres Jason , Alegre-Díaz Jesús , Backman Joshua , Mbatchou Joelle , Turner Michael , Gaynor Sheila M. , Joseph Tyler , Zou Yuxin , Liu Daren , Wade Rachel , Staples Jeffrey , Panea Razvan , Popov Alex , Bai Xiaodong , Balasubramanian Suganthi , Habegger Lukas , Lanche Rouel , Lopez Alex , Maxwell Evan , Jones Marcus , García-Ortiz Humberto , Ramirez-Reyes Raul , Santacruz-Benítez Rogelio , Nag Abhishek , Smith Katherine R. ,   Regeneron Genetics Center, Reppell Mark , Zöllner Sebastian , Jorgenson Eric , Salerno William , Petrovski Slavé , Overton John , Reid Jeffrey , Thornton Timothy , Abecasis Goncalo , Berumen Jaime , Orozco-Orozco Lorena , Collins Rory , Baras Aris , Hill Michael R , Emberson Jonathan R , Marchini Jonathan , Kuri-Morales Pablo , Tapia-Conyer Roberto
Published: June 2022

The Mexico City Prospective Study (MCPS) is a prospective cohort of over 150,000 adults recruited two decades ago from the urban districts of Coyoacán and Iztapalapa in Mexico City. We generated genotype and exome sequencing data for all individuals, and whole genome sequencing for 10,000 selected individuals. We uncovered high levels of relatedness and substantial heterogeneity in ancestry composition across individuals. Most sequenced individuals had admixed Native American, European and African ancestry, with extensive admixture from indigenous groups in Central, Southern and South Eastern Mexico. Native Mexican segments of the genome had lower levels of coding variation, but an excess of homozygous loss of function variants compared with segments of African and European origin. We estimated population specific allele frequencies at 142 million genomic variants, with an effective sample size of 91,856 for Native Mexico at exome variants, all available via a public browser. Using whole genome sequencing, we developed an imputation reference panel which outperforms existing panels at common variants in individuals with high proportions of Central, South and South Eastern Native Mexican ancestry. Our work illustrates the value of genetic studies in populations with diverse ancestry and provides foundational imputation and allele frequency resources for future genetic studies in Mexico and in the United States where the Hispanic/Latino population is predominantly of Mexican descent.
Probabilistic embedding, clustering, and alignment for integrating spatial transcriptomics data with PRECAST
Authors: Liu Wei , Liao Xu , Luo Ziye , Yang Yi , Lau Mai Chan , Jiao Yuling , Shi Xingjie , Zhai Weiwei , Ji Hongkai , Yeong Joe , Liu Jin
Published: June 2022

Spatially resolved transcriptomics involves a set of emerging technologies that enable the transcriptomic profiling of tissues with the physical location of expressions. Although a variety of methods have been developed for data integration, most of them are for single-cell RNA-seq datasets without consideration of spatial information. Thus, methods that can integrate spatial transcriptomics data from multiple tissue slides, possibly from multiple individuals, are needed. Here, we present PRECAST, a data integration method for multiple spatial transcriptomics datasets with complex batch effects and/or biological effects between slides. PRECAST unifies spatial factor analysis simultaneously with spatial clustering and embedding alignment, while requiring only partially shared cell/domain clusters across datasets. Using both simulated and four real datasets, we show improved cell/domain detection with outstanding visualization, and the estimated aligned embeddings and cell/domain labels facilitate many downstream analyses. We demonstrate that PRECAST is computationally scalable and applicable to spatial transcriptomics datasets from different platforms.