bluuebunny/crossref_metadata_2025 huggingface dataset:
A brown dwarf donor and an optically thin accretion disc with a complex stream impact region in the period-bouncer candidate BW Sculptoris
Authors: Neustroev Vitaly V , Mäntynen Iikka
Published: June 2023

We present an analysis of multi-epoch spectroscopic and photometric observations of the WZ Sge-type dwarf nova BW Scl, a period-bouncer candidate. We detected multiple irradiation-induced emission lines from the donor star allowing the radial velocity variations to be measured with high accuracy. Also, using the absorption lines Mg ii 4481 Å and Ca ii K originated in the photosphere of the accreting white dwarf (WD), we measured the radial velocity semi-amplitude of the WD and its gravitational redshift. We find that the WD has a mass of 0.85 ± 0.04 M⊙, while the donor is a low-mass object with a mass of 0.051 ± 0.006 M⊙, well below the hydrogen-burning limit. Using NIR data, we put an upper limit on the effective temperature of the donor to be ≲1600 K, corresponding to a brown dwarf of T spectral type. The optically thin accretion disc in BW Scl has a very low luminosity ≲4 × 1030 erg s−1 which corresponds to a very low-mass accretion rate of ≲7 × 10−13 M⊙ yr−1. The outer parts of the disc have a low density allowing the stream to flow down to the inner disc regions. The brightest part of the hotspot is located close to the circularization radius of the disc. The hotspot is optically thick and has a complex elongated structure. Based on the measured system parameters, we discuss the evolutionary status of the system.
#3139 PREVALENCE OF INFECTIONS ASSOCIATED WITH THE HEMODIALYSIS CATHETER IN MEXICO CITY
Authors: Rodríguez Rosa María Zaragoza , Flores Jose Andres Santos , Zaragoza Aldo Antonio Moreno
Published: June 2023

Background and Aims

In hemodialysis, intravenous catheter is the most frequent vascular access to begin treatment in patients with chronic kidney disease. Infectious complications are a frequent adverse effect of the vascular access, they may cause vascular access retreat and serious diseases like septic shock, bacterial endocarditis, septic arthritis, venous thromboembolism and death (between 5 and 10%). Leading microorganisms of hemodialysis infection are Gram positive bacteria, while Gram negative are less common.

Method

Study type and design: Used a descriptive, retrospective, open, observational and analytical cross-sectional study. Sampling type: Non-probabilistic of consecutive cases. Population: Patients diagnosed with CKD 5 KDIGO on renal function replacement therapy with hemodialysis through a temporary or permanent catheter in a private kidney care unit in Mexico City from October 2014 to September 2022.

Results

We identified 168 cases of CRBSI throughout the 8 years of the study. We found a prevalence of 0.86% for every 100 hemodialysis and a cumulative incidence of 4.97% for every 100 hemodialysis. Leading etiology pathogens of CRBSI in the kidney care unit were Gram negative bacteria (76.8%), mainly Enterobacter cloacae (20.8%), Escherichia coli (13.7%), Stenotrophomonas maltophilia (11.9%) and Burkholderia cepacia (4.2%). We found that 51,8% of the Gram negative CRBSI were due to multiresistant bacteria, which led to 5 directly related deaths. On the other hand, Gram positive bacteria caused 23.2% of CRBSI. Staphylococcus aureus and Staphylococcus epidermidis were the most frequent with 8.9% and 8.3%, respectively, with no related deaths.

Conclusion

Unlike international literature, in our study, gram negative bacteria were the main agents of CRBSI. The prevalence of CRBSI in our study was high, however, infection directly related mortality remained low. These results led us to investigate the origin of the vascular access infection. In an attempt to reduce the number of CRBSI, we emphasized preventive measures, especially hand hygiene of healthcare professionals within the kidney care unit and with the patient's personal environment at home. We would like to recall that empirical therapy should be based on the results of the kidney care unit microbiology and antibiotic sensitivity, to reduce CRBSI episodes and bacterial resistance.
#3165 ASSOCIATION BETWEEN CKD-MBD AND MORTALITY IN OLDER PATIENTS WITH ADVANCED CKD – RESULTS FROM THE EQUAL STUDY
Authors: Magagnoli Lorenza , Cozzolino Mario Gennaro , Caskey Fergus , Evans Marie , Torino Claudia , Szymczak Maciej , Dekker Friedo W , Wanner Christoph , Chesnaye Nicholas , Jager Kitty J
Published: June 2023

Background and Aims

Chronic Kidney Disease - Mineral and Bone Disorder (CKD-MBD) is a common complication of CKD, associated with higher mortality in dialysis patients. Its impact in non-dialysis patients remains mostly unknown. We investigate the associations between parathyroid hormone (PTH), phosphate, and calcium (and their interactions) and all-cause, cardiovascular (CV), and non-CV mortality in older non-dialysis patients with advanced CKD.

Method

We used data from the EQUAL study, which included patients aged ≥65 with eGFR ≤20 ml/min/1.73m2 from six European countries. Cox models were used to assess the association between baseline and time-dependent CKD-MBD biomarkers and all-cause, CV, and non-CV mortality. Models were sequentially adjusted for other mineral biomarkers, age, sex, country, eGFR, albumin, BMI, comorbidities and medications. Effect modification between biomarkers was also assessed.

Results

In 1294 patients, the prevalence of CKD-MBD at baseline was 94%. Both PTH (aHR 1.12, 95%CI 1.03-1.23, p 0.01) and phosphate (aHR 1.35, 95%CI 1.00-1.84, p 0.05), but not calcium (aHR 1.11, 95%CI 0.57-2.17, p 0.76), were associated with all-cause mortality. Calcium was not independently associated with mortality, but modified the effect of phosphate, with the highest mortality risk found in patients with both hypercalcemia and hyperphosphatemia. PTH level was associated with CV mortality, but not with non-CV mortality, whereas phosphate was associated with both CV and non-CV mortality.

Conclusion

CKD-MBD is very common in older non-dialysis patients with advanced CKD. PTH and phosphate are independently associated with all-cause mortality in this population. While PTH level is only associated with CV mortality, phosphate seems to be associated with both CV and non-CV mortality.
#3472 PRELIMINARY DATA FROM MOTHER HDX STUDY: A MULTICENTRE OPEN-LABEL RCT STUDY TO EXPLORE THE MORBIMORTALITY WITH THE THERANOVA HDX VS OL-HDF
Authors: Ortiz Patricia De Sequera , García Rafael Pérez , Vega Almudena , Maduell Francisco
Published: June 2023

Background and Aims

Dialysis patients have a high rate of cardiovascular morbidity and mortality. For this reason, new technical advances are necessary to be introduced in clinical practice. Medium cut-off (MCO) membranes are a new generation of membranes that allow the removal of a greater number of medium-sized molecules compared to high-flux hemodialysis (HF-HD) but retaining albumin. Theranova, a MCO membrane has an increased permeability and also produces high convective volume in the form of internal filtration. For these special properties, MCO generated a new concept of therapy called expanded HD (HDx). Until now, online hemodiafiltration (OL-HDF) has demonstrated its superiority, in terms of survival, compared to HF-HD. But the comparison between OL-HDF and HDx is a question not solved.

Method

The MOTheR HDx study trial (NCT03714386) is an open-label, multicentric, prospective, 1:1 randomized, parallel-group trial designed to evaluate the efficacy and safety of HDx compared to OL-HDF in incident HD patients in Spain for up to 36 months. The main endpoint is to determinate if HDx is non inferior to OL-HDF at reducing the combined outcome of all-cause dead and stroke (ischemic or hemorrhagic), acute coronary syndrome (angina and myocardial infarction), peripheral arterial disease (amputation or revascularization) and ischemic colitis (mesenteric thrombosis).

Results

Now we have enrolled 513 patients, 44 excluded and 469 were randomized. 229 were allocated to HDx and 240 to OL-HDF. No differences were found in neither baseline characteristics, hemodialysis or pharmacological treatment, nor laboratory parameters. Follow up time was similar in both groups: 15.06 (12.8) vs 13.73 (11.51) months [HR 0.84 (0.50-1.40)] without differences in mortality: 29 (12.7%) vs 31 (12.9%) [HR 0.89 (0.54-1.48)] in HDx and HDF respectively (Figure 1).

Conclusion

These preliminary results from Mother study support that HDx is not inferior to OL-HDF in reducing the all-cause mortality outcome.
#4368 THE PERSISTENT UNDERREPRESENTATION OF PEOPLE WITH CHRONIC KIDNEY DISEASE IN CARDIOVASCULAR TRIALS: A SYSTEMATIC REVIEW AND EVIDENCE MAP
Authors: Colombijn Julia Mt , Idema Demy , van Beem Sanne , Blokland Anna Marthe , van der Braak Kim , Handoko M Louis , Veld Linde Huis In't , Kaul Tabea , Kolagasigil-Akdemir Nurda , Kusters Mike Pt , Meijvis Sabine , Oosting Ilse J , Spijker Rene , Bots Michiel , Hooft Lotty , Verhaar Marianne , Vernooij Robin
Published: June 2023

Background and Aims

People with chronic kidney disease (CKD) have a markedly higher risk for cardiovascular disease. Systematic underrepresentation of people with CKD in cardiovascular randomised controlled trials (RCTs) limits evidence to guide cardiovascular risk management (CVRM). In this systematic review we aimed to identify evidence gaps regarding CVRM medication for people with CKD and evaluated the prevalence of exclusion of people with CKD from cardiovascular RCTs.

Method

We searched Clinicaltrials.gov through the Cochrane Central Register of Controlled Trials from inception until October 2021. Eligible studies were randomised controlled trials (RCTs) that investigate the efficacy of guideline-recommended CVRM medications on (cardiovascular) mortality, cardiovascular morbidity, and end-stage kidney disease in adults with a history of cardiovascular disease or one or more major risk factors for cardiovascular disease. Two reviewers independently determined the eligibility of references and extracted data. Outcomes were an overview of studies that report results for people with CKD, evidence gaps in results, and the rate of exclusion of people with CKD.

Results

We included 1180 of the 2794 eligible RCTs involving 2,158,869 participants (mean age 63±6 years, 36% female). Overall, 841 (71%) RCTs excluded (subgroups of) people with CKD based on heterogenous exclusion criteria. Since 2000, this prevalence has increased from 70% to 75%. Of included RCTs, only 157 (13%) reported results for people with CKD (again in heterogenous subgroups). The prevalence of RCTs with results for people with CKD has increased since 2000 from 10% to 23%. Nevertheless, significant evidence gaps remain for most CVRM interventions, particularly for those with an eGFR <30 ml/min/1.73m2 (22 RCTs), and people who are treated with dialysis (14 RCTs) or received a kidney transplant (1 RCTs).

Conclusion

The majority of cardiovascular RCTs continues to exclude (subgroups of) people with CKD and this has only increased over the years. Although more RCTs report results for people with CKD, evidence gaps for the efficacy most CVRM medications persist, particularly for those with severe CKD.
#4784 IDENTIFICATION OF FACTORS ASSOCIATED WITH DEATH IN DIALYSIS PATIENTS USING A MACHINE LEARNING-BASED PREDICTIVE MODEL
Authors: Vicentini Carolina Aparecida de Almeida , de Andrade Luis Gustavo Modelli , Ponce Daniela
Published: June 2023

Background and Aims

Few studies including unplanned dialysis starts have used machine learning for the prediction of death in dialysis patients. The objective of the study was to use R software algorithms to develop machine learning predictive models for the identification of death-related factors in patients undergoing hemodialysis (HD) and peritoneal dialysis (PD).

Method

This study included adult patients undergoing HD and PD started in a planned or urgent manner in a dialysis center between January 2014 and January 2019. Epidemiological, clinical and laboratory data were collected. Univariate analysis was followed by ML-based analyses. Then, multivariate regressions were obtained using stepwise and Cox regression analyses. Finally, a Random Forest predictive model was generated after variables with missing values >30% were removed.

Results

Of 581 patients included, 170 died (29,2%). On univariate analysis death was associated with age, number of comorbidities, dialysis modality switching, creatinine, PTH and albumin values at dialysis initiation, presence of diabetes (DM), hospitalization, function recovery and central venous catheter (CVC) for dialysis access. Patients who started dialysis with a CVC had a worse survival (p = 0.0034) than those who did not use CVC, started HD with AVF, or received PD (Figure 1). Data were split into 20% for testing the regression model, and 80% for training the model. Data preprocessing for Cox regression included imputing some values using bag impute (decision trees), creating dummy variables, and removing collinear variables. Death was associated with older age (p < 0.001), fewer ESI-free months (p < 0.001) and lower initial creatinine (p = 0.008) (Table 1). The model C-index was 0.8099. Random forest ranked the following variables predictive of death in descending order of importance: ESI-free months; age; initial levels of creatinine, PTH and albumin; number of comorbidities; dialysis-related infection; initial phosphorus and hemoglobin; hospitalizations; male gender; modality switching (Figure 2). The agreement of the model obtained was 0.8110.

Conclusion

ESI-free months, age and initial levels of creatinine were associated with death on both multivariate and ML-based analyses.
#5736 IDENTIFICATION AND CHARACTERIZATION OF URINARY AND SERUM AMINOACIDS IN DIABETIC KIDNEY DISEASE PATIENTS USING MS-HPLC
Authors: Mogos Maria , Socaciu Carmen , Socaciu Andreea , Vlad Adrian , Gadalean Florica , Bob Flaviu , Milas Livia Oana , Cretu Octavian , Suteanu-Simulescu Anca , Glavan Mihaela , Balint Lavinia , Silvia Ienciu , Jianu Catalin , Petrica Ligia
Published: June 2023

Background and Aims

Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease, but few biomarkers of early identification of DKD are available. The aim of the study was to asses new urinary and plasma biomarkers in early stages of DKD, especially in normoalbuminuric type 2 diabetes mellitus (DM) patients.

Method

This cross-sectional pilot study performed an integrated metabolomic profiling of blood and urine in 90 patients with type 2 DM, classified into 3 stages (30 normo-, 30 micro-, and 30 macroalbuminuric, respectively) and 30 age- and gender-matched healthy controls through high-performance liquid chromatography and mass spectrometry (UPLC-QTOF-ESI* MS). Metabolites were discovered and processed by the advanced Metaboanalyst 5.0. online software using multi- and univariate untargeted analysis. Both multivariate and univariate bioinformatics confirmed the relevance of certain amino acids as biomarkers to be responsible for the occurrence of early renal involvement in the course of type 2 DM.

Results

A total of 5 metabolites, namely Taurine, Tiglylglycine, Tryptophan, Kynurenic acid, and L-acetylcarnitine were discovered as potential biomarkers for the early identification of DKD. UPLC-QTOF-ESI* MS revealed that: (1) the urinary amino acids levels were increased in normoalbuminuric type 2 DM patients as compared with healthy control subjects; (2) a number of key biomarkers have been identified in the urine, which reflect kidney injury at specific sites along the nephron, including glomerular injury and tubular damage, oxidative stress, inflammation, and activation of the intrarenal renin-angiotensin system.

Conclusion

High-performance liquid chromatography coupled with mass spectrometry showed that the urinary amino acids levels were increased in normoalbuminuric type 2 DM patients. The results of the study provide a particular metabolomic profile related to blood and urine metabolites which could impact both the glomeruli and the tubules, even in the early stages of DKD.
#6949 MPO ANCA-ASSOCIATED VASCULITIS IN A PATIENT WITH A HISTORY OF METHAMPHETAMINE ABUSE
Authors: Sánchez Jesús Alejandro Rico , Arreguin Yuliana López
Published: June 2023

Background and Aims

Methamphetamines cause kidney damage by different mechanisms. The most common is the tubular lesion associated with myoglobinuria secondary to rhabdomyolysis. Other renal effects include prerenal azotemia, acute tubular necrosis, malignant hypertension, and necrotizing vasculitis have been reported. It is important to consider this drug as a possible cause of glomerulonephritis.

Method

We present the case report of a patient with suspected MPO ANCA-associated vasculitis from methamphetamines.

Results

A 24-year-old male, he was admitted to nephrology due to hematuria and proteinuria accompanied by serum creatinine elevation (2.5 mg/dl). He reported inhaled methamphetamine abuse since the age of 14, smoking and occasional ethylism. His symptoms began in October 2022 with asthenia and adinamia, accompanied by generalized pallor and edema in both malleoli. At admission with normal blood pressure (112/70 mmHg). Laboratory tests revealed: leukocytes 6.35 thousand/UL, hemoglobin 7.7 g/dl, platelets 698,000 thousand/UL, urea 70.81 mg/dl, sodium 137 mmol/L, potassium 4.72 mmol/L, albumin 3.85 g/dl, urine test with proteinuria 25 mg/dl, hemoglobinuria 250 eri/microL, leukocytes 15-20 field and countless erythrocytes, albuminuria 450.87 mg/day, globular sedimentation rate 18 mm/hr, reactive protein C 37 mg/L. Complement levels were normal, negative serologies for hepatitis B, C, human immunodeficiency viruses, antinuclear antibodies, double-stranded anti DNA and anti-proteinase 3, but was positive for IgG anti myeloperoxidase (anti-MPO) 33.6 U/ml. Urinary sediment showed the presence of dysmorphic erythrocytes, as well as abundant erythrocyte and granular casts. Ultrasound-guided renal biopsy was performed; light microscopy reported 21 glomeruli, 6 globally sclerosed, 4 with irregular segmental sclerosis, 4 with destruction and granuloma formation. Immunofluorescence showed traces of mesangial IgM, the rest negative for IgG, IgA, C3, C1q, fibrinogen, kappa and lambda. The patient received 3 pulses of methylprednisolone 500 mg followed by oral prednisone and rituximab. Baseline creatinine decreased to 1.88 mg/dl.

Conclusion

Inhaled methamphetamine is commonly used in young people, it is important to consider this drug as a possible cause of crescentic and necrotizing glomerulonephritis.
#3737 RENAL RESERVE IN LIVING KIDNEY DONORS: THE HIDDEN ROLE OF OVERWEIGHT
Authors: Sorensen Cristian Acosta , Porrini Esteban , Lima Sergio Luis , Perera Coriolano Cruz , Martin Laura Díaz , Mena Natalia Negrãn , Puga Ana Ramírez , Morales Adelaida , Vega-Diaz Nicanor , Gallego Eduardo , Martin Edduin , Moya Elisa Cabello , Gil Marta Gómez , Cabrera Beatriz Escamilla , González-Rinne Ana
Published: June 2023

Background and Aims

Renal reserve (RR) is the capacity to increase glomerular filtration rate (GFR) under certain stimuli such as obesity, hyperglycaemia, metabolic syndrome, etc. The importance of the presence or absence of RR is unknown. We investigated the prevalence and factors associated with RR in a group of living donors for renal transplantation.

Method

We investigated RR before donation in 52 living kidney donors. GFR was measured by iohexol clearance before and after the stimulation of RR by endovenous amino acid infusion. The presence of RR was defined as an increase greater than 10% of basal GFR. According with the presence or absence of RR, subjects were grouped in those without RR; with RR and using RR. The latter was defined as the lack of increase in GFR after stimulation in patients with GFR > 100 mL/min. GFR was unadjusted to body surface area (BSA). The characteristics of these three groups were evaluated.

Results

13 (25%) had no RR, 24 (46%) had RR and 15 (29%) were using RR. Subjects without RR was predominantly female (92%) with lower BSA and BMI than those with RR or using RR (BMI: 22 ± 3 vs 28 ± 3 and 29 ± 4, p < 0.005); also had a lower GFR than the other groups (84 ± 10 vs 95 ± 14 and 131 ± 22, p < 0.005). Subjects with RR or using RR had more frequently metabolic syndrome traits i.e. prediabetes than those without RR. Finally, subject using RR present larger kidney length than the other groups (right kidney: 11.3 ± 0.8 vs 10.3 ± 0.36 and 10.4 ± 0.8, p < 0.005; left kidney: 11.8 ± 0.5 vs 10.4 ± 0.6 and 10.7 ± 0.7, p < 0.005). No differences were observed regarding dyslipidaemia and arterial hypertension.

Conclusion

overweight and prediabetes may be factors that stimulate RR in a healthy population such as living kidney donors. Future implications of these factors, particularly after donation both in donors and recipients, deserve attention.
Molecular Advances in the Treatment of Advanced Gastrointestinal Stromal Tumor
Authors: Venkataraman Vinayak , George Suzanne , Cote Gregory M
Published: June 2023

Most gastrointestinal stromal tumors (GIST) are driven by activating mutations in Proto-oncogene c-KIT (KIT) or PDGFRA receptor tyrosine kinases (RTK). The emergence of effective therapies targeting these mutations has revolutionized the management of advanced GIST. However, following initiation of first-line imatinib, a tyrosine kinase inhibitor (TKI), nearly all patients will develop resistance within 2 years through the emergence of secondary resistance mutations in KIT, typically in the Adenosine Triphosphate (ATP)-binding site or activation loop of the kinase domain. Moreover, some patients have de novo resistance to imatinib, such as those with mutations in PDGFRA exon 18 or those without KIT or PDGFRA mutation. To target resistance, research efforts are primarily focused on developing next-generation inhibitors of KIT and/or PDGFRA, which can inhibit alternate receptor conformations or unique mutations, and compounds that impact complimentary pathogenic processes or epigenetic events. Here, we review the literature on the medical management of high-risk localized and advanced GIST and provide an update on clinical trial approaches to this disease.
KSIM: simulating KIDSpec, a Microwave Kinetic Inductance Detector spectrograph for the optical/NIR
Authors: Hofmann V Benedict , O’Brien Kieran
Published: June 2023

KIDSpec, the Kinetic Inductance Detector Spectrometer, is a proposed optical to near-IR Microwave Kinetic Inductance Detector (MKID) spectrograph. MKIDs are superconducting photon counting detectors which are able to resolve the energy of incoming photons and their time of arrival. KIDSpec will use these detectors to separate incoming spectral orders from a grating, thereby not requiring a cross-disperser. In this paper, we present a simulation tool for KIDSpec’s potential performance upon construction to optimize a given design. This simulation tool is the KIDSpec Simulator (KSIM), a Python package designed to simulate a variety of KIDSpec and observation parameters. A range of astrophysical objects are simulated: stellar objects, an SDSS observed galaxy, a Seyfert galaxy, and a mock galaxy spectrum from the JAGUAR catalogue. Multiple medium spectral resolution designs for KIDSpec are simulated. The possible impact of MKID energy resolution variance and dead pixels was simulated, with impacts on KIDSpec performance observed using the Reduced Chi-Squared (RCS) value. Using dead pixel percentages from current instruments, the RCS result was found to only increase to 1.21 at worst for one of the designs simulated. SNR comparisons of object simulations between KSIM and X-Shooter’s ETC were also simulated. KIDSpec offers a particular improvement over X-Shooter for short and faint observations. For a Seyfert galaxy (mR = 21) simulation with a 180 s exposure, KIDSpec had an average SNR of 4.8, in contrast to 1.5 for X-Shooter. Using KSIM the design of KIDSpec can be optimized to improve the instrument further.
Investigating Protein–Protein Interactions Between Grapevine Leafroll-Associated Virus 3 and Vitis vinifera
Authors: Mostert Ilani , Bester Rachelle , Burger Johan T. , Maree Hans J.
Published: June 2023

Grapevine leafroll disease (GLD) is a globally important disease that affects the metabolic composition and biomass of grapes, leading to a reduction in grape yield and quality of wine produced. Grapevine leafroll-associated virus 3 (GLRaV-3) is the main causal agent for GLD. This study aimed to identify protein–protein interactions between GLRaV-3 and its host. A yeast two-hybrid (Y2H) library was constructed from Vitis vinifera mRNA and screened against GLRaV-3 open reading frames encoding structural proteins and those potentially involved in systemic spread and silencing of host defense mechanisms. Five interacting protein pairs were identified, three of which were demonstrated in planta. The minor coat protein of GLRaV-3 was shown to interact with 3-deoxy-D-arabino-heptulosonate 7-phosphate synthase 02, a protein involved in primary carbohydrate metabolism and the biosynthesis of aromatic amino acids. Interactions were also identified between GLRaV-3 p20A and an 18.1-kDa class I small heat shock protein, as well as MAP3K epsilon protein kinase 1. Both proteins are involved in the response of plants to various stressors, including pathogen infections. Two additional proteins, chlorophyll a-b binding protein CP26 and a SMAX1-LIKE 6 protein, were identified as interacting with p20A in yeast but these interactions could not be demonstrated in planta. The findings of this study advance our understanding of the functions of GLRaV-3-encoded proteins and how the interaction between these proteins and those of V. vinifera could lead to GLD.
Strategies for Developing Journal Peer Reviewers: A Scoping Review
Authors: Gazza Elizabeth A. , Matthias April D. , Griffin Jeff , Chick Katie
Published: June 2023

AIM

This scoping review examined development strategies for preparing reviewers to critically appraise the content of manuscripts submitted to peer-reviewed journals.

BACKGROUND

The journal peer review process is the crux of building the science of nursing education to inform teaching and learning.

METHOD

Using the Joanna Briggs Institute procedure for scoping reviews, five databases were searched for articles published in English in peer-reviewed health sciences journals between 2012 and 2022 that included strategies for developing journal peer reviewers.

RESULTS

Of the 44 articles included in the review, a majority were commentaries (52%) published by medicine (61%), followed by nursing (9%) and multidisciplinary journals (9%). Reviewer development strategies aligned with three themes: pedagogical approaches, resources, and personal practices.

CONCLUSION

Although multiple disciplines addressed peer reviewer development, a comprehensive and effective approach was not reported in the reviewed literature. The findings can inform a multilevel reviewer development program led by academic nurse educators.
Comparative review of airway anesthesia and sedation methods for awake intubation
Authors: Rao Prashant N. , Soffin Ellen M. , Beckman James D.
Published: June 2023

Purpose of review

Successful awake intubation hinges upon adequate airway anesthesia and sedation for patient comfort. This review will summarize relevant anatomy and regional anesthesia techniques to achieve airway anesthesia, and compare various airway anesthesia and sedation regimens.

Recent findings

Overall, nerve blocks consistently provided superior airway anesthesia, shorter time to intubation, higher patient comfort, and higher postintubation patient satisfaction. Additionally, ultrasound guidance can further provide benefit by reducing the amount of local anesthetic administered, leading to denser blockade, and proving invaluable in challenging clinical situations. Regarding sedation methods, numerous studies supported the use of dexmedetomidine, with or without the addition of supplemental sedation, such as midazolam, ketamine, or opioids.

Emerging evidence has indicated that nerve blocks for airway anesthesia may be superior to other methods of topicalization. Additionally, dexmedetomidine can be useful, both as monotherapy and with supplemental sedatives, to safely provide anxiolysis for the patient and increase success. However, it is crucial to note that the method of airway anesthesia and sedation regimen should be adapted to each patient and clinical situation, and knowledge of multiple techniques and sedation regimens can best equip anesthesiologists to do so.
(How) Do We Theorize?
Authors: Eppel-Meichlinger Jasmin , Cartaxo Ana , Clement Theresa , Hirt Julian , Wallner Martin , Mayer Hanna
Published: June 2023

There are increasing discussions on theory dynamics in nursing research. We aimed at mapping the theoretical publication output by nursing researchers from the European German-speaking area. We conducted a focused mapping review and synthesis, focusing on nursing journals articles with a theory-related aim. We identified 32 eligible publications, reflecting 2% of the nursing journal articles affiliated with researchers from our target region. Twenty-one articles involved an inductive approach. Eleven articles intended to test or revise a theory. The theoretical publication output with a theory-related aim was low. Theory-building efforts were fragmented and mostly without reference to a meta-theoretical level.
The Relationship Between Nitrate-Induced Headache and -Blood Viscosity: An Observational Prospective Study
Authors: Toprak Kenan , Kaplangöray Mustafa , Memioglu Tolga , İnanır Mehmet , Biçer Asuman , Demirbağ Recep , Erdoğdu Hamza
Published: June 2023

Nitrates are one of the most prescribed medications in the treatment of angina pectoris today. Headache is the most common side effect of nitrates, and there is limited prospective data on the determinants of this effect. Our aim in this study is to open a foresight window for clinicians in clinical practice by explaining the possible relationship between nitrate-induced headache and whole-blood viscosity (WBV). After coronary revascularization treatment, 869 patients with angina who were prescribed nitrate preparations were divided into groups according to the development of headache or not and categorized according to the 4-grade scale level. Those who had no headache during nitrate use were graded as grade 0, those who felt mild headache were grade 1, those who felt moderate headache were grade 2, and those who described severe headache were graded as grade 3. The groups were compared according to WBV values. A total of 869 participants were included in the study. Most patients (82.1%) experienced some level of headache. Headache severity correlated with both WBV at high shear rate (r = 0.657; P < 0.001) and WBV at low shear rate (r = 0.687; P < 0.001). In multivariate analysis, WBV was determined as an independent predictor of headache experience. WBV predicted nitrate-induced headache with 75% sensitivity and 75% specificity at high shear rate and 77% sensitivity and 77% specificity at low shear rate. WBV seems to be one of the major determinants for nitrate-induced headache. WBV may be a guide for initiating alternative antianginal drugs without prescribing nitrates to the patient to increase patient compliance.
No Cancer Occurrences in 10-year Follow-up after Prophylactic Nipple-sparing Mastectomy
Authors: Boyd Carter J. , Bekisz Jonathan M. , Ramesh Sruthi , Hemal Kshipra , Guth Amber A. , Axelrod Deborah M. , Shapiro Richard L. , Hiotis Karen , Schnabel Freya R. , Choi Mihye , Karp Nolan S.
Published: June 2023

Background:

Prophylactic nipple-sparing mastectomies (NSM) have become increasingly common, although there is little long-term data on its efficacy in prevention of breast cancer. The objective of this study was to assess the incidence of breast cancer in a cohort of patients undergoing prophylactic NSM with a median follow-up of 10 years.

Methods:

Patients receiving prophylactic NSM at a single institution from 2006 to 2019 were included in a retrospective nature. Patient demographics, genetic mutations, operative details, and specimen pathology were recorded, and all postoperative patient visits and documentation were screened for cancer occurrence. Descriptive statics were performed where appropriate.

Results:

Two hundred eighty-four prophylactic NSMs were performed on 228 patients with a median follow-up of 120.5 ± 15.7 months. Roughly, a third of patients had a known genetic mutation, with 21% BRCA1 and 12% BRCA2. The majority (73%) of prophylactic specimens had no abnormal pathology. The most commonly observed pathologies were atypical lobular hyperplasia (10%) and ductal carcinoma in situ (7%). Cancer was identified in 10% of specimens, with only one case of lymphovascular invasion. Thus far, there have been no incidences of locoregional breast cancer occurrence in this cohort.

Conclusions:

The long-term breast cancer occurrence rate in this cohort of prophylactic NSM patients at the time of this study is negligible. Despite this, continued surveillance of these patients is necessary until lifetime risk of occurrence following NSM has been established.
Management of alcohol use disorder in patients with chronic liver disease
Authors: Mellinger Jessica L. , Fernandez Anne C. , Winder G. Scott
Published: June 2023

Alcohol use disorder (AUD) rates have risen dramatically in the United States, resulting in increasing rates of alcohol-associated liver disease (ALD), but many patients struggle to access alcohol use treatment. AUD treatment improves outcomes, including mortality, and represents the most urgent means by which care can be improved for those with liver disease (including ALD and others) and AUD. AUD care for those with liver disease involves 3 steps: detecting alcohol use, diagnosing AUD, and directing patients to alcohol treatment. Detecting alcohol use can involve questioning during the clinical interview, the use of standardized alcohol use surveys, and alcohol biomarkers. Identifying and diagnosing AUD are interview-based processes that should ideally be performed by a trained addiction professional, but nonaddiction clinicians can use surveys to determine the severity of hazardous drinking. Referral to formal AUD treatment should be made, especially where more severe AUD is suspected or identified. Therapeutic modalities are numerous and include different forms of one-on-one psychotherapy, such as motivational enhancement therapy or cognitive behavior therapy, group therapy, community mutual aid societies (such as Alcoholics Anonymous), inpatient addiction treatment, and relapse prevention medications. Finally, integrated care approaches that build strong relationships between addiction professionals and hepatologists or medical providers caring for those with liver disease are crucial to improving care for this population.
Thermal ablation compared to stereotactic body radiation therapy for hepatocellular carcinoma: A multicenter retrospective comparative study
Authors: Moon Andrew M. , Kim Hannah P. , Singal Amit G. , Owen Dawn , Mendiratta-Lala Mishal , Parikh Neehar D. , Rose Steven C. , McGinty Katrina A. , Agala Chris B. , Burke Lauren M. , Abate Anjelica , Altun Ersan , Beyer Christian , Do John , Folkert Michael R. , Forbes Chalon , Hattangadi-Gluth Jona A. , Hayashi Paul H. , Jones Keri , Khatri Gaurav , Kono Yuko , Lawrence Theodore S. , Maurino Christopher , Mauro David M. , Mayo Charles S. , Pak Taemee , Patil Preethi , Sanders Emily C. , Simpson Daniel R. , Tepper Joel E. , Thapa Diwash , Yanagihara Ted K. , Wang Kyle , Gerber David A.
Published: June 2023

Background & Aims:

Early-stage HCC can be treated with thermal ablation or stereotactic body radiation therapy (SBRT). We retrospectively compared local progression, mortality, and toxicity among patients with HCC treated with ablation or SBRT in a multicenter, US cohort.

Approach & Results:

We included adult patients with treatment-naïve HCC lesions without vascular invasion treated with thermal ablation or SBRT per individual physician or institutional preference from January 2012 to December 2018. Outcomes included local progression after a 3-month landmark period assessed at the lesion level and overall survival at the patient level. Inverse probability of treatment weighting was used to account for imbalances in treatment groups. The Cox proportional hazard modeling was used to compare progression and overall survival, and logistic regression was used for toxicity. There were 642 patients with 786 lesions (median size: 2.1 cm) treated with ablation or SBRT. In adjusted analyses, SBRT was associated with a reduced risk of local progression compared to ablation (aHR 0.30, 95% CI: 0.15–0.60). However, SBRT-treated patients had an increased risk of liver dysfunction at 3 months (absolute difference 5.5%, aOR 2.31, 95% CI: 1.13–4.73) and death (aHR 2.04, 95% CI: 1.44–2.88, p < 0.0001).

Conclusions:

In this multicenter study of patients with HCC, SBRT was associated with a lower risk of local progression compared to thermal ablation but higher all-cause mortality. Survival differences may be attributable to residual confounding, patient selection, or downstream treatments. These retrospective real-world data help guide treatment decisions while demonstrating the need for a prospective clinical trial.
Clinical Features and Prognostic Value of Bacillary Layer Detachment in Acute Vogt–Koyanagi–Harada Disease
Authors: Kwak Jay Jiyong , Lee Junwon , Byeon Suk Ho
Published: June 2023

Purpose:

To evaluate the characteristics of bacillary layer detachment (BALAD) in acute Vogt–Koyanagi–Harada (VKH) disease and determine its prognostic value.

Methods:

Seventy patients with acute VKH disease with a minimum follow-up of 6 months were studied. The primary outcomes were clinical characteristics associated with BALAD, including features on multimodal imaging at baseline and follow-up. The secondary outcomes included best-corrected visual acuity (BCVA) and VKH with recurrence features.

Results:

Of 70 eyes (36 patients), 41 (58.6%) showed BALAD. The mean baseline BCVA and mean BCVA after resolution of serous retinal detachment (SRD) were significantly lower in the BALAD group than in the no-BALAD group (0.90±0.49 vs. 0.35±0.35 log minimum angle of resolution [logMAR], P<0.001 and 0.39±0.27 vs. 0.20±0.20 logMAR, P=0.020). The loss of ellipsoid zone (EZ) integrity at baseline, proportion of SRD, duration of SRD, loss of EZ integrity at 1 month, and subfoveal choroidal thickness (SFCT) at baseline were significantly higher in the BALAD group (P =0.017, P =0.006, P =0.023, P=0.002, and P=0.046, respectively). The mean BCVA and SFCT did not differ between the two groups at 6 months (P=0.380 and P=0.180, respectively). BALAD at baseline was found to be a significant prognostic factor for VKH with recurrence features (P=0.007).

Conclusions:

VKH with BALAD featured more severe clinical characteristics than VKH without BALAD during the acute phase. Patients with baseline BALAD require more vigilant monitoring as they are more likely to show recurrence features within the first 6 months.
Pores of the internal limiting membrane: A common finding in vitreo-maculopathies
Authors: Schumann Ricarda G , Banyai Daniel , Hagenau Felix , Mautone Luca , Hammer Thomas , Wolf Armin , Priglinger Siegfried G , Vogt Denise
Published: June 2023

Purpose:

To describe presence and distribution of pores of the inner limiting membrane (ILM) in eyes with vitreo-maculopathies,

Methods:

ILM specimens were harvested from 117 eyes of 117 patients during vitrectomy with membrane peeling from eyes with vitreomacular traction syndrome, idiopathic and secondary epiretinal gliosis, and idiopathic full-thickness macular hole (FTMH). All specimens were processed as flat-mounts for immunocytochemistry and examined by phase-contrast, interference and fluorescence microscopy. Demographic and clinical data were correlated.

Results:

ILM pores were found in all vitreo-maculopathies. They were identified in 47 (40.2%) of 117 eyes being most evident with anti-laminin. In eyes with FTMH >400μm, pores were seen in more than half of all eyes. They occur as numerous and uniformly distributed defects of the flat mounted ILM with a mean diameter of 9.5 ± 2.4 µm. Edges of ILM pores are round with an irregular contour and no specific cellular pattern. Pores were distinguished from retinal vessel thinning and iatrogenic artefacts.

Conclusion:

Contrary to previous reports, ILM pores are a common finding in vitreo-maculopathies easily visible with anti-laminin staining. Further studies are needed to clarify whether their presence correlates with differences in disease progression or imaging before and after vitrectomy with ILM peeling.
Artificial intelligence for ocular oncology
Authors: Koseoglu Neslihan Dilruba , Corrêa Zélia Maria , Liu T.Y. Alvin
Published: June 2023

Purpose of review

The aim of this article is to provide an update on the latest applications of deep learning (DL) and classical machine learning (ML) techniques to the detection and prognostication of intraocular and ocular surface malignancies.

Recent findings

Most recent studies focused on using DL and classical ML techniques for prognostication purposes in patients with uveal melanoma (UM).

DL has emerged as the leading ML technique for prognostication in ocular oncological conditions, particularly in UM. However, the application of DL may be limited by the relatively rarity of these conditions.
Gastroenteritis is Less Severe But is More Often Associated With Systemic Inflammation in SARS-CoV-2-positive Than in SARS-CoV-2-Negative Children
Authors: Milani Gregorio P. , Buonsenso Danilo , Marchisio Paola , Agostoni Carlo , Corso Chiara Maria , Guarino Alfredo , Poeta Marco , Proli Francesco , Drosi Alessandra , Morello Rosa , Lo Vecchio Andrea
Published: June 2023

This study aims to characterize the clinical and metabolic features of acute gastroenteritis in children with and without severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A multicenter case–control study was conducted in 2022 including 200 children. Clinical data and laboratory tests were analyzed. Children with SARS-CoV-2 presented less frequently hyponatremia and metabolic acidosis, but more often systemic inflammation as compared with children without SARS-CoV-2.
Iron deficiency in Taiwanese patients with heart failure and reduced ejection fraction
Authors: Sung Hsiao-Ping , Hsu Chien-Yi , Lee Ying-Hsiang , Lin Po-Lin , Liao Chia-Te , Chung Fa-Po , Ko Shao-Lun , Huang Chun-Yao , Lin Kuan-Chia , Chang Hung-Yu
Published: June 2023

Background:

Iron deficiency (ID) is a common comorbidity among patients with heart failure and reduced ejection fraction (HFrEF), and is associated with poorer outcomes independent of anemia. This study aimed to evaluate the prevalence and prognostic significance of ID in Taiwanese patients with HFrEF.

Methods:

We included HFrEF patients from two multicenter cohorts at different periods. The multivariate Cox regression analysis was applied to assess the risk of outcomes associated with ID, accounting for the varying risk of death.

Results:

Of the 3612 patients with HFrEF registered from 2013 to 2018, 665 patients (18.4%) had available baseline iron profile measurements. Of these, 290 patients (43.6%) were iron deficient; 20.2% had ID+/anemia+, 23.4% ID+/anemia−, 21.5% ID−/anemia+, and 34.9% ID−/anemia−. Regardless of anemia status, patients with coexisting ID had a higher risk than those without ID (all-cause mortality: 14.3 vs 9.5 per 100 patient-years, adjusted hazard ratio [HR] 1.33; 95% confidence interval [CI], 0.96-1.85; p = 0.091; cardiovascular mortality: 10.5 per 100 patient-years vs 6.1, adjusted HR 1.54 [95% CI, 1.03-2.30; p = 0.037]; cardiovascular mortality or first unplanned hospitalization for HF: 36.7 vs 19.7 per 100 patient-years, adjusted HR 1.57 [95% CI, 1.22-2.01; p < 0.001]). Among patients eligible for treatment in the IRONMAN trial design (43.9%), parenteral iron therapy was estimated to reduce heart failure hospitalizations and cardiovascular deaths by 13.7 per 100 patient-years.

Conclusion:

Iron profiles were tested in less than one-fifth of the Taiwanese HFrEF cohort. ID was present in 43.6% of tested patients and was independently associated with poor prognosis in these patients.
Personalized Postacute Hospitalization Recovery: A Novel Intervention to Improve Patient Experience and Reduce Cost
Authors: Minga Iva , Balasubramanian Senthil , Adum Juan Pablo Salazar , Kwak Esther , Macrinici Victor , Schwartz Alan , Spiro Alan , Shtein Yoni , Tafur Alfonso , Lampert Mark
Published: June 2023

Goal:

Readmissions are a significant financial burden for payers. Cardiovascular-related discharges are particularly prone to readmission. Posthospital discharge support can impact patient recovery and probably reduce patient readmissions. This study aimed to address the underlying behavioral and psychosocial factors that can negatively affect patients after discharge.

Methods:

The study population was adult patients admitted to the hospital with a cardiovascular diagnosis who had a plan to discharge home. Those who consented to participate were randomized to intervention or control groups on a 1:1 basis. The intervention group received behavioral and emotional support, whereas the control group received usual care. Interventions included motivational interviewing, patient activation, empathetic communication, addressing mental health and substance use, and mindfulness.

Principal Findings:

Observed total readmission costs were significantly lower in the intervention group than in the control group ($1.1 million vs. $2.0 million) as was the observed mean cost per readmitted patient ($44,052 vs. $91,278). The mean expected cost of readmission after adjustment for confounding variables was lower in the intervention group than in the control group ($8,094 vs. $9,882, p = .011).

Practical Applications:

Readmissions are a costly spend category. In this study, posthospital discharge support addressing the psychosocial factors contributing to patients' readmissions resulted in a lower total cost of care for those with a cardiovascular diagnosis. We describe an intervention that is reproducible and can be scaled broadly through technology to reduce readmission costs.
Comparison of physical function, proprioception, muscle strength, postural balance, and walking in older women with and without total knee arthroplasty
Authors: Choi Wonjae
Published: June 2023

The benefit of total knee arthroplasty (TKA) is that it alleviates pain caused by osteoarthritis; however, other postoperative effects on physical function are unclear. This study aimed to investigate the differences in physical function, proprioception, muscle strength, postural balance, and walking in older women with and without TKA. A total of 36 participants were included in this study; the TKA group comprised older women who underwent TKA (n = 18) and the non TKA group comprised older women who did not undergo TKA (n = 18). All the participants were evaluated for physical function, proprioception, muscle strength, postural balance, and walking. The outcome measures were compared between the 2 groups using an independent t test. Correlations were assessed using Pearson correlation coefficients. Participants in the TKA group had significantly reduced physical function, postural balance, and walking ability compared with those in the non TKA group (P < .05). In the TKA group, physical function was statistically correlated with proprioception, postural balance, and walking (P < .05); in particular, it had a strong correlation with proprioception (R > .60). In the non TKA group, postural balance was significantly associated with muscle strength and walking (P < .05). In particular, it was strongly correlated with walking (R > .90). This study demonstrated that older women undergoing TKA need to actively perform interventions to improve physical function, postural balance, and walking compared with older women with osteoarthritis.