bluuebunny/crossref_metadata_2025 huggingface dataset:
Screening Out False Participants in Research Recruitment from Social Media Groups
Authors: Peach Brian C. , Sole Mary Lou , Diaz Sanyerys , Nunez Maireni
Published: July 2023

Social media–based groups offer a rich opportunity for nurse researchers to connect with potential study participants. However, as the authors discovered from recruitment of acute respiratory distress syndrome survivors in social media–based survivorship groups, there is a risk of enrollment of both false and duplicate participants. Nurse researchers should adopt best practices to screen out false participants and prevent duplicate participation. Lessons learned from recruitment in social media groups include avoiding the use of survey links, requiring video interviews or home visits for confirmation of identity, adoption of strategic screening questions, and avoidance of international groups (unless the aim is to recruit foreign nationals). Adoption of these practices can help to ensure that the data collected from group patrons are trustworthy. Nurses who read research and adopt findings into practice should critically examine if researchers implemented strategies to screen out false and duplicate participants to protect data integrity.
Tailored Interventions Improve Cancer Screening Rates in Rural Women
Authors: Rosenberg Karen
Published: July 2023

According to this study:
Gaps Found in Patient Education at Time of Discharge
Authors: Rosenberg Karen
Published: July 2023

According to this study:
Study Demonstrates Difficulties in Preventing Hospital Readmissions
Authors: Rosenberg Karen
Published: July 2023

According to this study:
First line treatments in primary central nervous system lymphomas in young patients
Authors: Schenone Laurence , Alcantara Marion , Houillier Caroline , Soussain Carole
Published: July 2023

Purpose of review

The aim of this review is to provide an update on current first-line treatments as well as on-going studies in immunocompetent patients with primary central nervous system lymphomas.

Recent findings

High-dose methotrexate (HD-MTX)-based polychemotherapy is widely used in induction treatment (IT). Among HD-MTX-based regimens, the best association is not yet defined. IT should be followed by a consolidation or a maintenance according to patient's age and performance status. Thiotepa-based intensive chemotherapy (IC) followed by autologous stem cell transplantation (ASCT) has improved survival in eligible patients compared to a nonmyeloablative consolidation. Because of the high risk of neurotoxicity, conventional whole brain radiotherapy (WBRT; 36–40 Gy) has been abandoned. Reduced-WBRT (23.4 Gy) is an alternative option in patients under 60 years-old in complete response after IT. Its safety remains to be demonstrated in elderly patients. The benefit of maintenance strategies to reduce the risk of relapse is being assessed in several studies in patients beyond 70 years-old.

HD-MTX-based polychemotherapy remains the corner stone of the IT, but the best regimen is not yet defined. Clinical trials assessing new IT regimens are ongoing. Intensive consolidation with IC + ASCT benefits patients up to 70 years-old. Predictive factors are under investigation to better define therapeutic response and guide treatment adjustment.
Neither Antiplatelet nor Anticoagulant Therapy Increases Graft Failure after Split-thickness Skin Grafting
Authors: Walters Elliot T. , Kim Kevin G. , Dekker Paige K. , Stimac Gregory P. , Mehra Shyamin , Elmarsafi Tammer , Steinberg John S. , Attinger Christopher E. , Kim Paul J. , Evans Karen K.
Published: July 2023

Background:

Split-thickness skin grafts (STSG) are an effective modality for lower extremity wound coverage. Many patients in the highly comorbid chronic wound population present with cardiovascular disease requiring chronic antiplatelet or anticoagulant therapy, theoretically increasing risk for bleeding complications, donor site morbidity, and poor graft take. Some surgeons advocate temporary cessation of antithrombotic therapy, which may increase cardiovascular risk. The objective of this study was to examine the effects of anticoagulation use on STSG outcomes.

Methods:

All patients receiving STSGs for lower extremity wounds from 2014 to 2016 at a single institution were retrospectively reviewed. Successful grafts were defined as greater than 99.5% wound coverage. Patients were divided into two groups: anticoagulation/antiplatelet or no anticoagulation/antiplatelet. Continuous variables were described by means and SDs and analyzed using student’s t-test. Categorical variables were described by frequencies and percentages and analyzed using Chi-square or Fisher exact tests as appropriate.

Results:

In total, 231 wounds were identified among 189 patients; 124 patients were receiving at least one antiplatelet/anticoagulant at time of grafting. Three hematomas were reported during 30 days of follow-up; there was no significant difference between groups (P > 0.05). Anticoagulation/antiplatelet therapy in the perioperative period had no significant impact on STSG take and overall healing.

Conclusions:

The findings from this study demonstrate that administration of anticoagulant/antiplatelet agents in the perioperative period does not increase the risk of skin graft failure. Based on these findings, STSG can be performed without cessation of anticoagulation or antiplatelet therapy.
K-wire Fixation of Closed Hand Fractures Outside the Main Operating Room Does Not Increase Infections
Authors: Gillis Joshua A. , Lalonde Jan , Alagar David ,   Canadian K-wire Consortium, Azzi Alain , Lalonde Donald H.
Published: July 2023

Background:

Closed reduction and internal fixation (CRIF) of closed hand fractures in the main operating room (OR) is much more expensive than outside of the OR. However, there is a reluctance to fix fractures out of the OR due to the perceived increase in infections. Our goal was to prospectively analyze the infection rates of performing CRIF of closed metacarpal and phalangeal fractures in these two settings.

Methods:

A multicenter prospective analysis of patients undergoing CRIF of metacarpal or phalangeal fractures inside or outside the OR was performed. Demographic data, injury characteristics, surgery information and postoperative infectious complications were recorded, including cellulitis, frank pus, and osteomyelitis.

Results:

The study involved 1042 patients with a total of 2265 Kirschner-wires (K-wires). Infection rates were not statistically higher in the 719 patients who had CRIF outside of the OR (cellulitis 2.5%, frank pus 1.4%) compared with the 323 patients with CRIF in the OR group (cellulitis 3.4%, frank pus 2.5%). The OR group had a longer time to operation and a longer procedure time, but a shorter time with the K-wires in place.

Conclusion:

K-wire fixation of closed hand fractures outside of the OR under field sterility is safe because it does not increase infectious complications compared to CRIF in the main OR under full sterility.
Effectiveness of the Superiorly Based Pharyngeal Flap in Treating Velopharyngeal Insufficiency
Authors: Rabah Sari M. , Alkahtani Fahad Saeed , Jarman Abdulaziz , Aljohar Latifa , Alhargan Alanood , Almalaq Ali Abdulaziz
Published: July 2023

Background:

Velopharyngeal insufficiency (VPI) is a condition characterized by failure of the posterior part of the soft palate to reach the pharyngeal wall and separate the nasopharynx from the oropharynx during speech and swallowing. VPI may persist following cleft palate repair. This study aimed to determine the outcomes of the superiorly based pharyngeal flap to treat VPI post cleft palate repair.

Methods:

A retrospective cohort study included patients with VPI post cleft palate repair who underwent secondary speech surgery. The criteria were based on clinical symptoms, physical examination, nasometry, and videofluoroscopy/nasoendoscopy findings. Data were analyzed by using SPSS program, version 22.0. A P value less than 0.05 was considered significant.

Results:

Thirty-five patients were identified. VPI was reduced to 14.3% postoperatively. Before the surgery 25.7% of the patients had severe hypernasality, 68.6% had moderate hypernasality, and 5.7% had mild hypernasality. After the surgery, only 8.6% of the patients still had severe hypernasality, 22.9% had moderate hypernasality, 57.1% had mild hypernasality, and hypernasality became absent in 11.4%. Articulation disorders were present in 91.4% of patients before surgery, and decreased to 71.4% postoperatively. Speech intelligibility improved postoperatively in comparison with preoperative findings.

Conclusion:

The present study concluded that the superiorly based pharyngeal flap was successful in treating VPI that persisted post cleft palate repair.
Outcomes of Biosynthetic and Synthetic Mesh in Ventral Hernia Repair
Authors: Sivaraj Dharshan , Fischer Katharina S. , Kim Trudy S. , Chen Kellen , Tigchelaar Seth S. , Trotsyuk Artem A. , Gurtner Geoffrey C. , Lee Gordon K. , Henn Dominic , Nazerali Rahim S.
Published: July 2023

Background:

The introduction of mesh for reinforcement of ventral hernia repair (VHR) led to a significant reduction in hernia recurrence rates. However, it remains controversial whether synthetic or biologic mesh leads to superior outcomes. Recently, hybrid mesh consisting of reinforced biosynthetic ovine rumen (RBOR) has been developed and aims to combine the advantages of biologic and synthetic mesh; however, outcomes after VHR with RBOR have not yet been compared with the standard of care.

Methods:

We performed a retrospective analysis on 109 patients, who underwent VHR with RBOR (n = 50) or synthetic polypropylene mesh (n = 59). Demographic characteristics, comorbidities, postoperative complications, and recurrence rates were analyzed and compared between the groups. Multivariate logistic regression models were fit to assess associations of mesh type with overall complications and surgical site occurrence (SSO).

Results:

Patients who underwent VHR with RBOR were older (mean age 63.7 versus 58.8 years, P = 0.02) and had a higher rate of renal disease (28.0 versus 10.2%, P = 0.01) compared with patients with synthetic mesh. Despite an unfavorable risk profile, patients with RBOR had lower rates of SSO (16.0 versus 30.5%, P = 0.12) and similar hernia recurrence rates (4.0 versus 6.78%, P = 0.68) compared with patients with synthetic mesh. The use of synthetic mesh was significantly associated with higher odds for overall complications (3.78, P < 0.05) and SSO (3.87, P < 0.05).

Conclusion:

Compared with synthetic polypropylene mesh, the use of RBOR for VHR mitigates SSO while maintaining low hernia recurrence rates at 30-month follow-up.
Assessment of laparoscopic intracorporeal intestinal anastomosis training using simulation-based 3D printed models: exploring surgical performance and learning curves
Authors: Xia Jianfu , Wu Junjie , Chen Hao , Mao Jinlei , Xu Xiaodong , Zhang Jing , Yang Jin , Wang Zhifei
Published: July 2023

Background & Aims:

Intestinal anastomosis is a clinical procedure widely used to reconstruct the digestive tract, but authentic laparoscopic intracorporeal intestinal anastomosis（LIIA） models are lacking. However, three-dimensional (3D) printing can enable authentic and reusable models. In this paper, a novel cost-effective 3D-printing training model of LIIA is designed and the authenticity and validity of the model are tested.

Methods:

An FDM 3D printing and assembled lab model were built to test LIIA. Fifteen surgeons were required to perform LIIA, and their operation score and time were recorded and analyzed. Five experts were invited to assess the face and content validity of the models. A study was also performed to further evaluate and validate the learning curve of surgeons.

Results:

The difference in Modified anastomosis objective structured assessment of technical skills (MAOSATS) scores between the expert, intermediate and novice groups were significant (64.1±1.8: 48.5±1.7: 29.5±3.1, P < 0.001). In addition, the operation time of the procedure was statistically different for all three groups (21.5±1.9: 30.6±2.8:70.7±4.0, P < 0.001). The five experts rated the face and content validity of the model very highly, with the median being four out of five. Surgeons who underwent repeated training program showed improved surgical performance. After eight training, the novices’ performance was similar to that of the average level of untrained intermediates, while the operation scores of the intermediates were close to that of the average level of experts.

Conclusions:

In this study, it is found that the LIIA model exhibits excellent face, content and construct validity, repeated simulation training of the LIIA training program improved the surgeon’s operative performance, so the model is considered one of the effective methods for LIIA training and assessment of surgical quality in the future and for reducing healthcare costs.
The multiple roles of lysophosphatidic acid in vascular disease and atherosclerosis
Authors: Chattopadhyay Arnab , Reddy Srinivasa T. , Fogelman Alan M.
Published: July 2023

Purpose of review

To explore the multiple roles that lysophosphatidic acid (LPA) plays in vascular disease and atherosclerosis.

Recent findings

A high-fat high-cholesterol diet decreases antimicrobial activity in the small intestine, which leads to increased levels of bacterial lipopolysaccharide in the mucus of the small intestine and in plasma that increase systemic inflammation, and enhance dyslipidemia and aortic atherosclerosis. Decreasing LPA production in enterocytes reduces the impact of the diet. LPA signaling inhibits glucagon-like peptide 1 secretion, promotes atherosclerosis, increases vessel permeability and infarct volume in stroke, but protects against abdominal aortic aneurysm formation and rupture. Acting through the calpain system in lymphatic endothelial cells, LPA reduces the trafficking of anti-inflammatory Treg lymphocytes, which enhances atherosclerosis. Acting through LPA receptor 1 in cardiac lymphatic endothelial cells and fibroblasts, LPA enhances hypertrophic cardiomyopathy.

LPA plays multiple roles in vascular disease and atherosclerosis that is cell and context dependent. In some settings LPA promotes these disease processes and in others it inhibits the disease process. Because LPA is so ubiquitous, therapeutic approaches targeting LPA must be as specific as possible for the cells and the context in which the disease process occurs.
Mechanical ventilation during pediatric extracorporeal life support
Authors: Kneyber Martin C.J. , Cheifetz Ira M.
Published: July 2023

Purpose of review

To discuss the role of ventilator induced lung injury (VILI) and patient self-inflicted lung injury in ventilated children supported on extracorporeal membrane oxygenation (ECMO).

Recent findings

While extracorporeal life support is used routinely used every day around the globe to support neonatal, pediatric, and adult patients with refractory cardiac and/or respiratory failure, the optimal approach to mechanical ventilation, especially for those with acute respiratory distress syndrome (ARDS), remains unknown and controversial. Given the lack of definitive data in this population, one must rely on available evidence in those with ARDS not supported with ECMO and extrapolate adult observations. Ventilatory management should include, as a minimum standard, limiting inspiratory and driving pressures, providing a sufficient level of positive end-expiratory pressure, and setting a low rate to reduce mechanical power. Allowing for spontaneous breathing and use of pulmonary specific ancillary treatment modalities must be individualized, while balancing the risk and benefits. Future studies delineating the best strategies for optimizing MV during pediatric extracorporeal life support are much needed.

Future investigations will hopefully provide the needed evidence and better understanding of the overall goal of reducing mechanical ventilation intensity to decrease risk for VILI and promote lung recovery for those supported with ECMO.
Poly-ADP ribose polymerase inhibitor and androgen receptor signaling inhibitor for all comers for first-line treatment of metastatic castration-resistant prostate cancer: is gene sequencing out?
Authors: Higano Celestia S. , Cheng Heather H.
Published: July 2023

Purpose of review

The landscape for first-line therapy (1L) of metastatic castration-resistant prostate cancer (mCRPC) is rapidly shifting. In the past 2 years, three phase 3 trials have examined the addition of a poly-ADP ribose polymerase inhibitor (PARPi) to an androgen receptor-signaling inhibitor (ARSI) in 1L. The FDA and the EMA recently considered whether one of these combinations should be approved for “all comers.” Here, we review the trial designs, assays for homologous recombination repair mutations (HRRm) and BRCA mutations (BRCAm), and predictive capacity of mutational status on treatment efficacy to understand the basis for the FDA decision.

Recent findings

The phase 3 trials, PROpel, MAGNITUDE, and TALAPRO-2, each compared PARPi and ARSI to placebo (PBO) plus ARSI. PROpel and TALAPRO-2 (cohort 1) included all comers (i.e., no prospective biomarker selection), while MAGNITUDE prospectively assigned patients to HRRm and HRR nonmutated cohorts and TALAPRO-2 (cohort 2) included only those with HRRm. Radiographic progression-free survival (rPFS) was the primary endpoint, and overall survival (OS) was a key secondary endpoint in all trials. Although rPFS with a PARPi and ARSI was improved versus PBO with ARSI, major conclusions differed.

The nuances and interpretation of these trials provide an understanding of the rationale for the FDA's decision to restrict the approval of olaparib and abiraterone and prednisone (AAP) as 1L therapy to those with biomarker evidence of BRCAm.
Pediatric Drug-Associated Pancreatitis Reveals Concomitant Risk Factors and Poor Reliability of Causality Scoring: Report From INSPPIRE
Authors: Morinville Veronique D. , Husain Sohail Z. , Wang Fuchenchu , Cress Gretchen A. , Abu-El-Haija Maisam , Chugh Ankur , Downs Elissa , Ellery Kate , Fishman Douglas S. , Freeman Alvin Jay , Gariepy Cheryl E. , Giefer Matthew , Gonska Tanja , Liu Quin , Maqbool Asim , Mark Jacob , Mcferron Brian Arthur , Mehta Megha , Nathan Jaimie D. , Ng Ken , Ooi Chee Y. , Perito Emily , Ruan Wenly , Schwarzenberg Sarah Jane , Sellers Zachary M. , Serrano Jose , Troendle David M. , Wilschanski Michael , Zheng Yuhua , Yuan Ying , Lowe Mark , Uc Aliye ,   on behalf of the Consortium for the Study of Chronic Pancreatitis, Diabetes and Pancreatic Cancer (CPDPC)
Published: July 2023

Objectives:

Drug-associated acute pancreatitis (DAP) studies typically focus on single acute pancreatitis (AP) cases. We aimed to analyze the (1) characteristics, (2) co-risk factors, and (3) reliability of the Naranjo scoring system for DAP using INSPPIRE-2 (the INternational Study group of Pediatric Pancreatitis: In search for a cuRE-2) cohort study of acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) in children.

Methods:

Data were obtained from ARP group with ≥1 episode of DAP and CP group with medication exposure ± DAP. Physicians could report multiple risk factors. Pancreatitis associated with Medication (Med) (ARP+CP) was compared to Non-Medication cases, and ARP-Med vs CP-Med groups. Naranjo score was calculated for each DAP episode.

Results:

Of 726 children, 392 had ARP and 334 had CP; 51 children (39 ARP and 12 CP) had ≥1 AP associated with a medication; 61% had ≥1 AP without concurrent medication exposure. The Med group had other risk factors present (where tested): 10 of 35 (28.6%) genetic, 1 of 48 (2.1%) autoimmune pancreatitis, 13 of 51 (25.5%) immune-mediated conditions, 11 of 50 (22.0%) obstructive/anatomic, and 28 of 51 (54.9%) systemic risk factors. In Med group, 24 of 51 (47%) had involvement of >1 medication, simultaneously or over different AP episodes. There were 20 ARP and 4 CP cases in “probable” category and 19 ARP and 7 CP in “possible” category by Naranjo scores.

Conclusions:

Medications were involved in 51 of 726 (7%) of ARP or CP patients in INSPPIRE-2 cohort; other pancreatitis risk factors were present in most, suggesting a potential additive role of different risks. The Naranjo scoring system failed to identify any cases as “definitive,” raising questions about its reliability for DAP.
Myopia Progression in Adults: A Retrospective Analysis
Authors: Khan Hashim Ali , Naduvilath Thomas , Tahhan Nina , Sankaridurg Padmaja R.
Published: July 2023

SIGNIFICANCE

Studies on adult myopia progression are limited. This retrospective analysis of a large data set of young adult myopes characterizes myopia progression during adulthood.

PURPOSE

This study aimed to determine the mean annual progression of myopia and to estimate the proportion of progressors in adult myopes.

METHODS

Longitudinal, noncycloplegic subjective refraction data for young adult myopes (spherical equivalent refractive error, −0.5 D or more), age ranging from 18 to 30 years, were retrospectively analyzed. The mean annual progression, as well as the proportion of progressors (at least −0.50 D shift between visits and annualized progression of −0.25 D or more), was estimated.

RESULTS

A total of 354 myopes (230 females [64.7%]), with a mean (standard deviation) age of 22.2 (3.8) years, were considered. The mean (standard deviation) annualized progression was −0.10 (0.21), −0.08 (0.2), and −0.04 (0.21) D in the 18- to 21-year, 22- to 26-year, and 27- to 30-year age groups, respectively (P = .003). The difference between 18- to 21- and 27- to 30-year age groups was significant (P = .05), whereas all other pairwise comparisons were not significant. The proportion (95% confidence interval) of progressors in the 18- to 21-, >21- to 26-, and >26- to 30-year age groups was 18.3% (14.9 to 21.7%), 10.9% (7.1 to 14.7%), and 8.8% (4.4 to 13.1%), respectively. The proportion of progressors working or studying in a higher learning/academic environment was 16.2% with an odds ratio (95% confidence interval) for progression of 2.07 (1.15 to 3.74) compared with those in nonacademic environments (P = .02), with no significant effect of sex or ethnicity.

CONCLUSIONS

This study is consistent with other studies on myopia in young adults, which show that myopia does not progress by substantial amounts throughout the adult years, particularly after the age of 21 years. Although future studies may be challenged by the small rates of change and the small proportion of progressors, further research is needed to understand the implications of adult myopia progression on clinical management.
Implementation of a State-Level Consortium in New Jersey: Improving Infectious Disease Prevention and Mitigation in Childcare and Educational Settings
Authors: Salam Tasnim , Leifer Sarah , Simpson Victoria , DeFrank Stacey , Carothers Barbara , Lifshitz Edward , Ibrahim Sherif
Published: July 2023

The COVID-19 pandemic underscored the need for effective infectious disease prevention and mitigation efforts within childcare and educational settings, supported by local health departments and state agencies. During the pandemic, rapidly evolving guidance, increased surveillance burden, and the vastly increased volume of inquiries from communities and local health departments led to the development of a state-level childcare and educational consortium in New Jersey. The consortium works with state-level partners to support infectious disease prevention and mitigation efforts of educational entities and local health departments.
Socket-residuum coupling integrity affects perception of external stimuli: Effects of altering the transtibial interface using vacuum-assisted suspension
Authors: Kent Jenny A. , Carnahan Kristin J. , Major Matthew J.
Published: July 2023

Background:

Relative movement between the socket and residual limb can impair function in prosthesis users. It is plausible that, in addition to its mechanical effect, the integrity of the socket-residuum interface influences the ability of an individual to sense tactile cues through the prosthesis. Vacuum-assisted suspension (VAS) has been shown to reduce relative movement at this interface, providing a means to test this premise. The purpose of this pilot study was to assess the effects of altering socket-residuum interface integrity through the VAS pressure level on the thresholds of perception of an externally applied vibration stimulus.

Methods:

Seven unilateral transtibial prosthesis users participated. Socket-residual limb integrity was altered using the VAS subatmospheric (vacuum) pressure level. Vibration perception tests were conducted at low, mid, and high vacuum levels, targeting 0, 8, and 19 in Hg respectively, and performed in partially loaded and fully loaded conditions. Vibration intensity was increased using a dial until participants delivered a verbal signal indicating it was perceptible, and the nominal intensity was recorded.

Results:

Intensity thresholds decreased (ie, sensitivity increased) from low to high vacuum settings when fully loaded (P = 0.008). Differences when partially loaded were nonsignificant and variable across participants.

Conclusion:

This study provides preliminary evidence that altering the integrity between the socket and residual limb by modifying the vacuum level affects sensation related to the external environment experienced through the prosthesis, although translation of these findings to real-world stimuli remains to be tested.
Effect of pregnancy on anthropometrics, comfort, and functional performance for women living with transfemoral limb loss: Case report
Authors: Kahle Jason T. , Miro Rebecca M. , Ho Loi T. , Gagliardotto Alexis , Swanson Ann E.
Published: July 2023

Women living with limb loss (amputees) have unique needs that increase during pregnancy. Comfort, pain, and activity are exponentially compromised. Changes in mass and altered center of gravity increase the likelihood of falls and compromise safety for the mother and unborn baby. Subjective and physical functional performance measures data was collected through 2 separate pregnancies on a 36-year-old woman with a right transfemoral amputation. Physiological changes during pregnancy effected comfort, pain, and functional performance. Clinical practice guidelines for prosthetic management should be established to include protocols such as adjustment schedules, specialized socket design, and necessary component changes throughout the course of pregnancy.
The Use of Combined Microplate And Miniplate in the Fixation of the Mandibular Fractures (A Randomized Clinical Trial)
Authors: El Sayed Abdulmotakaber Galal Abdullatif , Ghanem Amr Amin , Al Mansi Youssef Ahmed , Elhadidi Yasser Nabil , El wahab El Kassaby Marwa Abd
Published: July 2023

The study group patients have been treated with 1.6 microplates at the superior border and 2.0 miniplate at the inferior border to evaluate its efficacy in the fixation of symphyseal and parasymphyseal fractures using this technique. The control patients were treated with two 2.0 plates. The stability was assessed using computed tomography immediately performed postoperatively and after 6 months. Assessment of the change in the intercanine distance using the Student T test was statistically Non Significant (P value 0.34). The change of intercanine distance in the study was 0.04 ± 0.05 mm, compared with that of the control, which was 0.01 ± 0.03 mm. Assessment of change in intermental foramina distance was statistically NS (P value = 0.06). The average difference in intermental foramina distance in the study was 0.04 ± 0.05 mm, compared with the control, which was 0.002 ± 0.004 mm. Based on the findings of the current study, the authors recommend the use of microplates combined with miniplates in the correction of both symphyseal and parasymphyseal fractures successfully.
Routine End-ischemic Hypothermic Oxygenated Machine Perfusion in Liver Transplantation from Donors After Brain Death
Authors: Grąt Michał , Morawski Marcin , Zhylko Andriy , Rykowski Paweł , Krasnodębski Maciej , Wyporski Anya , Borkowski Jan , Lewandowski Zbigniew , Kobryń Konrad , Stankiewicz Rafał , Stypułkowski Jan , Hołówko Wacław , Patkowski Waldemar , Mielczarek-Puta Magdalena , Struga Marta , Szczepankiewicz Benedykt , Górnicka Barbara , Krawczyk Marek
Published: July 2023

Objective:

To assess whether end-ischemic hypothermic oxygenated machine perfusion (HOPE) is superior to static cold storage (SCS) in preserving livers procured from donors after brain death (DBD).

Summary Background Data:

There is increasing evidence of the benefits of HOPE in liver transplantation, but predominantly in the setting of high-risk donors.

Methods:

In this randomized clinical trial, livers procured from DBDs were randomly assigned to either end-ischemic dual HOPE for at least 2 h or SCS ( 1:3 allocation ratio). The Model for Early Allograft Function (MEAF) was the primary outcome measure. The secondary outcome measure was 90-day morbidity. (ClinicalTrials. gov, NCT04812054).

Results:

Of the 104 liver transplantations included in the study, 26 were assigned to HOPE and 78 to SCS. Mean MEAF was 4.94 and 5.49 in the HOPE and SCS group (P=0.24), respectively, with the corresponding rates of MEAF >8 of 3.8% (1/26) and 15.4% (12/78; P=0.18). Median comprehensive complication index was 20.9 after transplantations with HOPE and 21.8 after transplantations with SCS (P=0.19). Transaminases activity, bilirubin concentration, and international normalized ratio were similar in both the groups. In the case of donor risk index >1.70, HOPE was associated with significantly lower mean MEAF (4.92 vs. 6.31; P=0.037) and lower median comprehensive complication index (4.35 vs. 22.6; P=0.050). No significant differences between HOPE and SCS were observed for lower donor risk index values.

Conclusion:

Routine use of HOPE in DBD liver transplantations does not seem justified as the clinical benefits are limited to high-risk donors.
Loss of appetite in patients with cancer: an update on characterization, mechanisms, and palliative therapeutics
Authors: Haemmerle Robert J. , Jatoi Aminah
Published: July 2023

Purpose of review

Over the past year, loss of appetite in patients with cancer has continued to be an area of active investigation. This review provides an update of recently published findings.

Recent findings

Despite the emergence of new cancer therapeutic agents, this symptom of loss of appetite continues to trouble patients, and it continues to be associated with poor survival. Recent preclinical research promises to lead to newer approaches and newer, more effective palliative agents. Recent clinical research shows that agents such as olanzapine, anamorelin, and cannabis either do or might palliate this symptom.

Loss of appetite in patients with cancer remains an important area of clinical and research focus. Recent published data provide greater clarity with respect to how to palliate this symptom. Today, although clinicians have more options to palliate cancer-associated loss of appetite than ever before, questions remain unanswered about how to palliate this symptom optimally and how to improve the quality of life of patients who suffer from it.
Strategies to Improve the Utilization and Function of DCD Livers
Authors: Kim Steven C. , Foley David P.
Published: July 2023

Despite the increased usage of livers from donation after circulatory death (DCD) donors in the last decade, many patients remaining on the waitlist who need a liver transplant. Recent efforts have focused on maximizing the utilization and outcomes of these allografts using advances in machine perfusion technology and other perioperative strategies such as normothermic regional perfusion (NRP). In addition to the standard donor and recipient matching that is required with DCD donation, new data regarding the impact of graft steatosis, extensive European experience with NRP, and the increasing use of normothermic and hypothermic machine perfusion have shown immense potential in increasing DCD organ overall utilization and improved outcomes. These techniques, along with viability testing of extended criteria donors, have generated early promising data to consider the use of higher-risk donor organs and more widespread adoption of these techniques in the United States. This review explores the most recent international literature regarding strategies to optimize the utilization and outcomes of DCD liver allografts, including donor–recipient matching, perioperative strategies including NRP versus rapid controlled DCD recovery, viability assessment of discarded livers, and postoperative strategies including machine perfusion versus pharmacologic interventions.
Proteomic studies of human placentas reveal partnerships associated with preeclampsia, diabetes, gravidity, and labor
Authors: Ho Shannon J. , Chaput Dale , Sinkey Rachel G. , Garces Amanda H. , New Erika P. , Okuka Maja , Sang Peng , Arlier Sefa , Semerci Nihan , Steffensen Thora S. , Rutherford Thomas J. , Alsina Angel E. , Cai Jianfeng , Anderson Matthew L. , Magness Ronald R. , Uversky Vladimir N. , Cummings Derek A. T. , Tsibris John C. M.
Published: July 2023

VEGFR2 is a central regulator of placental angiogenesis. The study of the VEGFR2 proteome of chorionic villi at term revealed its partners MDMX and PICALM. The oxytocin receptor (OT-R) and vasopressin V1aR receptor were detected in MDMX and PICALM immunoprecipitations. Immunogold electron microscopy showed VEGFR2 on endothelial cell (EC) nuclei, mitochondria, and Hofbauer cells (HC), the tissue-resident macrophages. MDMX, PICALM, and V1aR were on EC plasma membranes, nuclei, and HC nuclei. Unexpectedly, PICALM and OT-R were detected on EC projections into the fetal lumen and OT-R on 20-150 nm clusters therein, prompting the hypothesis that placental exosomes transport OT-R to the fetus and across the blood-brain barrier. Insights on gestational complications were gained by univariable and multivariable regression analyses associating preeclampsia with lower MDMX protein levels in membrane extracts of chorionic villi, and lower MDMX, PICALM, OT-R, and V1aR with spontaneous vaginal deliveries compared to cesarean deliveries before labor. We found select associations between higher MDMX, PICALM, OT-R and either gravidity, diabetes, BMI, maternal age, or neonatal weight, and correlations between PICALM-OT-R (p<2.7x10-8), PICALM-V1aR (p<0.006), and OT-R-V1aR (p<0.001). These results offer for exploration new partnerships in metabolic networks, tissue-resident immunity, and labor, notably for HC that predominantly express MDMX.
Machine learning fairness analysis on clinical data of The EMory BrEast imaging Dataset (EMBED)
Authors: Ramachandra Vikas , Sethi Mohit
Published: July 2023

This paper explores the use of machine learning (ML) for predictive modeling on clinical data from the EMory BrEast imaging Dataset (EMBED) [1] with a focus on ML model fairness analysis. The aim of this study is to develop and evaluate fair machine learning models that can accurately predict breast cancer risk. We trained and tested various machine-learning models. Our findings show that machine learning can be effective for predicting breast cancer risk or diagnosing breast cancer, and that fairness considerations are crucial in the development of such models. Overall, our study highlights the potential of machine learning for clinical applications while emphasizing the need for ethical and fair practices in this field.
Parental intention, attitudes, beliefs, trust and deliberation towards childhood vaccination in the Netherlands in 2022: Indications of change compared to 2013
Authors: Knijff Marthe , van Lier Alies , Boer Maartje , de Vries Marion , Hament Jeanne-Marie , de Melker Hester E.
Published: July 2023

Background and aim

Vaccine uptake within the Dutch National Immunisation Programme (NIP) has slightly declined since the COVID-19 pandemic. We studied psychosocial factors of vaccine uptake, namely parental intention, attitudes, beliefs, trust and deliberation (i.e., self-evidence), before (2013) and two years into the pandemic (2022).

Methods

In 2022 and 2013, parents with a young child (aged <3.5 years) participated in online surveys on vaccination (n=1,000 and 800, (estimated) response=12.2% and 37.2%, respectively). Psychosocial factors were measured on 7-point Likert scales. Multivariate logistic regression analysis was used to study differences between parents in 2022 and 2013 in ‘negative’ scores (≤2) of psychosocial factors.

Results

In both 2022 and 2013, most parents with a young child expressed positive intention (2022=83.1%, 2013=87.0%), attitudes (3 items: 2022=66.7%-70.9%, 2013=62.1%-69.8%) and trust (2022=51.8%, 2013=52.0%) towards the NIP and felt that vaccinating their child was self-evident (2022=57.2%, 2013=67.3%). Compared to parents with a young child in 2013, parents with a young child in 2022 had significantly higher odds of reporting negative attitudes towards vaccination (3 items combined: OR=2.84), believing that vaccinations offer insufficient protection (OR=4.89), that the NIP is not beneficial for the protection of their child’s health (OR=2.23), that vaccinating their child does not necessarily protect the health of other children (OR=2.24) or adults (OR=2.22) and that vaccinations could cause severe side effects (OR=2.20), preferring natural infection over vaccination (OR=3.18) and reporting low trust towards the NIP (OR=1.73).

Conclusions

Although most parents had positive intention, attitudes and trust towards vaccination and perceived vaccinating their child as self-evident, proportions of parents with negative scores were slightly larger in 2022 compared to 2013. Monitoring these determinants of vaccine uptake and developing appropriate interventions could contribute to sustaining high vaccine uptake.
New frontiers in health literacy: Using ChatGPT to simplify health information for people in the community
Authors: Ayre Julie , Mac Olivia , McCaffery Kirsten , McKay Brad R , Liu Mingyi , Shi Yi , Rezwan Atria , Dunn Adam G
Published: July 2023

Background

Most health information does not meet the health literacy needs of our communities. Writing health information in plain language is time-consuming but the release of tools like ChatGPT may make it easier to produce reliable plain language health information.

Objective

To investigate the capacity for ChatGPT to produce plain language versions of health texts.

Design

Observational study.

Subjects

Twenty-six health texts from reputable websites.

Interventions

ChatGPT was prompted to ‘rewrite the text for people with low literacy.’ Researchers captured three revised versions of each original text.

Main Measures

Objective health literacy assessment, including Simple Measure of Gobbledygook (SMOG), proportion of the text that contains complex language (%), number of instances of passive voice, and subjective ratings of key messages retained (%).

Key Results

On average, original texts were written at Grade 12.8 (SD=2.2) and revised to Grade 11.0 (SD=1.2), p<0.001. Original texts were on average 22.8% complex (SD=7.5%) compared to 14.4% (SD=5.6%) in revised texts. Original texts had on average 4.7 instances (SD=3.2) of passive text compared to 1.7 (SD=1.2) in revised texts. On average 80% of key messages were retained. The more complex original texts showed more improvements than less complex original texts. For example, when original texts were ≥ Grade 13, revised versions improved by an average 3.3 Grades (SD=2.2), p<0.001. Simpler original texts (< Grade 11) improved by an average 0.5 grades (SD=1.4), p<0.001.

Conclusions

This study used multiple objective assessments of health literacy to demonstrate that ChatGPT can simplify health information while retaining most key messages. However, the revised texts typically did not meet health literacy targets for grade reading level, and improvements were marginal for texts that were already relatively simple.
Predicting Huntington’s disease state with ensemble learning & sMRI: more than just the striatum
Authors: Kohli Maitrei , Pustina Dorian , Warner John H. , Alexander Daniel C. , Scahill Rachael I. , Sampaio Cristina , Tabrizi Sarah J. , Wijeratne Peter A.
Published: July 2023

Developing effective treatments for Huntington’s disease (HD) requires reliable markers of disease progression. Striatal atrophy has been the hallmark of HD progression, but volumetric anomalies are also found in other brain regions. Little is known about the potential increase in predictive biomarking accuracy when volumetric scores from multiple brain regions are combined to predict the HD status of individual participants. We used cross-sectional structural MRI data from 184 HD gene-positive participants to a) test a novel ensemble machine learning model in classifying participants in one of four HD progression states (PreHD A; PreHD B; HD1; HD2), and (b) identify the brain regions that carry HD biomarking signal from 15 regions. We used 5-fold cross validation and backward feature elimination to find the optimal predictors and investigated the stability of the findings through repeated analyses. The ensemble predictive model systematically matched or outperformed the accuracy of nine standard machine learning models, reaching 55.3%±6.1 balanced accuracy in 4-group classification. The accuracy was higher for binary classifications (PreHD vs HD: 83.3%±6.3; PreHD A vs PreHD B: 76.7%±8.0; PreHD B vs HD1: 75.9%±8.5; HD1 vs HD2: 70.9%±9.4). Striatal structures (caudate and putamen) were systematically found to be top predictors. However, the accuracy increased substantially when we included other regions in the model (e.g., occipital cortex, lateral ventricles, cingulate, temporal lobe). Optimal models frequently included 2-7 brain regions from different areas. Overall, the accuracy of classifications remained stable across repetitions but the list of selected brain regions could vary, likely due to collinearities in volumetric scores. This is the first study to demonstrate the improvement of classification accuracy when predicting HD progression with a stacked ensemble model. Our findings indicate that HD progression is marked not only by striatal atrophy but also by volumetric changes outside the striatum, without which biomarking models cannot achieve optimal results. The robust methods applied here exposed instability in the selection of brain regions despite the sizeable sample size (n=184); such instabilities could lead to different conclusions in different studies when single analyses are applied on smaller sample sizes. From a translational perspective, our study informs on the selection of candidate endpoints or target regions for therapeutic intervention in future clinical trials.
WEIRD or not: A Cross-Cultural Behavioral Economic Assessment of Demand for HIV and COVID-19 Vaccines
Authors: Tewogbola Promise , Jacobs Eric A. , McDaniel Justin T.
Published: July 2023

Background

Despite empirical evidence supporting vaccine effectiveness, vaccine hesitancy continues to thrive. Demand as a behavioral economic process provides useful indices for evaluating vaccine acceptance likelihood in individuals and groups. Using this framework, our study investigates the dynamics governing vaccine acceptance in two culturally dissimilar countries.

Methods

Hypothetical purchase tasks (HPTs) assessed how Nigerian and US participants varied vaccine acceptance as a function of hospitalization risks due to vaccination (N= 109). Aggregate and individual demand indices (Q0andPmax) were computed with nonlinear regressions. Secondary analyses were conducted using repeated measures ANOVAs with vaccine type (COVID-19 and HIV) as the within-subject factor; country, age, and socioeconomic status as between-subjects factors; demand indices served as dependent variables.

Results

Demand indices varied significantly as a function of vaccine type (F(1, 57) = 17.609,p <.001,). Demand for HIV vaccines was higher relative to COVID19 vaccines. Interactions between vaccine type and country of origin (F(1, 56) = 4.001,p= .05,) were also significant with demand for HIV vaccines among Nigerian respondents higher than that of COVID-19 vaccines. This was reversed for US participants. Interactions between vaccine type, country of origin and age were also significant (F(2, 51) = 3.506,p <.05,).

Conclusions

These findings provide evidence that vaccine type can influence demand. The relationship between demand and vaccine type also varies as a function of country of origin and age. Significance, limitations, and future directions are also discussed.
Discovery of fibrotic intervertebral disc in mice
Authors: He Jian , Huang Sha , Yan Pulin , Li Yangyang , Jin Huaijian , Hu Ou , Zhu Jun , Lin Peng , Wang Yingbo , Zhang Liang , Guo Yu , Wang Liting , Zhao Jianhua , Xie Yangli , Chen Lin , Lan Yu , Liu Bing , Liu Peng , Gan Yibo
Published: July 2023

Mechanical overload on the spine is a critical factor in the onset of intervertebral disc (IVD) degeneration. However, the lack of a precise and reliable animal model impedes a comprehensive understanding of the pathogenesis associated with IVD degeneration. In this study, we identified the high prevalence of spontaneous fibrotic alterations in IVDs predominantly located in the tail base, spanning from Co3/4 to Co5/6 levels, as early as 28 days in mice. These fibrotic IVDs manifested characteristics including extracellular matrix fibrosis and a decline in cell density. We leveraged a finite element model of computational biomechanics to generate fully predictive, three-dimensional simulations of flexion motion in the mouse tail. Our simulations revealed that the caudal discs in the mouse tail base underwent various mechanical overloads. Hence, we propose that the caudal IVDs in mice can serve as a novel mechanical model for investigating the mechanisms underlying the pathogenesis of IVD degeneration.
Single-cell precision nanotechnologyin vivo
Authors: Molbay Muge , Kick Benjamin , Zhao Shan , Todorov Mihail Ivilinov , Ohn Tzu-Lun , Roth Stefan , Simats Alba , Singh Vikramjeet , Khalin Igor , Pan Chenchen , Bhatia Harsharan Singh , Hellal Farida , Zeidler Reinhard , Liesz Arthur , Plesnila Nikolaus , Dietz Hendrik , Erturk Ali
Published: July 2023

Targeting nanoparticle therapeutics with cellular accuracy in whole organisms could open breakthrough opportunities in precision medicine. However, evaluating and fine-tuning the biodistribution of such systems in the whole organism at the cellular level remains a major obstacle. Here, we constructed targetable DNA origami, and analyzed biodistribution in transparent mice, in addition to studying tolerability, clearance kinetics, and immune response parameters. Untargeted DNA origami primarily accumulated in the spleen and the liver, while an immune cell-targeting variant successfully attached to immune cells throughout the body. A cancer cell-targeting mimetic co-localized on solid-tumor metastasis in the liver and the lung. These findings indicate that DNA origami can be directed in vivo, providing an important proof-of-concept and highlights the potential of high-resolution tissue-clearing imaging technologies in their development.

Graphical Abstract

Highlights

This study demonstrates the potential of DNA origami-based drug delivery systems as versatile tool for for targeted delivery, which could be used to treat a range of diseases with applications.

The immune compatibility, half-life, targeting efficiency, and the biodistribution evaluation of DNA origami indicate its potential for systemic drug delivery.

Our approach enables the assessment of biodistribution of nanoparticles in the intact body with a sensitivity to the single-cell level, highlighting the high-resolution tissue clearing technoloies in revealing DNA origami’s feasibility for drug targeting.