bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Analysis of 76 Cases of Second Branchial Cleft Fistula
Authors: Li Yanzhen , Wang Shengcai , Zhang Jie , Zhang Xuexi , Liu Qiaoyin , Sun Nian , Liu Zhiyong , Ni Xin
Published: April 2024

Objective: To provide the experience of diagnosis and treatment of second branchial cleft fistula in children. Methods: The clinical data of 76 children with second branchial cleft fistulas admitted to Beijing Children’s Hospital affiliated with Capital Medical University from January 2016 to December 2020 were retrospectively analyzed. All patients underwent cervical ultrasonography and resection of the second branchial cleft fistula, and their clinical manifestations, surgical methods, complications, recurrence condition, and lesion appearance of the patients were analyzed. Results: Among the 76 cases, the lesions of 43 cases were on the right side, 20 were on the left side, and 13 were bilateral, for a total of 89 lesions. There were 49 type I lesions, 28 type II lesions, 8 type III lesions, and 4 type IV lesions. Type I and type II cases underwent complete excision of the fistula through a small incision in the neck; 2 cases of type III branchial cleft fistulas were treated with trapezoidal incision; 2 cases of type III branchial cleft fistulas underwent single transverse incisions; single small incision-assisted endoscopic resection was adopted in 4 cases of type III and 4 cases of type IV branchial cleft fistulas. During the follow-up period of 6 to 60 months, only 3 cases developed postoperative infection, the others had no postoperative complications, and no cases had recurrence during postoperative follow-up. Conclusion: The incision of the second branchial fistula should be selected according to imaging examination to achieve removal of the fistula while maintaining esthetics.
Parkinson’s disease cerebrovascular reactivity pattern: A feasibility study
Authors: van der Horn Harm Jan , Vakhtin Andrei A , Julio Kayla , Nitschke Stephanie , Shaff Nicholas , Dodd Andrew B , Erhardt Erik , Phillips John P , Pirio Richardson Sarah , Deligtisch Amanda , Stewart Melanie , Suarez Cedeno Gerson , Meles Sanne K , Mayer Andrew R , Ryman Sephira G
Published: April 2024

A mounting body of research points to cerebrovascular dysfunction as a fundamental element in the pathophysiology of Parkinson’s disease (PD). In the current feasibility study, blood-oxygen-level-dependent (BOLD) MRI was used to measure cerebrovascular reactivity (CVR) in response to hypercapnia in 26 PD patients and 16 healthy controls (HC), and aimed to find a multivariate pattern specific to PD. Whole-brain maps of CVR amplitude (i.e., magnitude of response to CO2) and latency (i.e., time to reach maximum amplitude) were computed, which were further analyzed using scaled sub-profile model principal component analysis (SSM-PCA) with leave-one-out cross-validation. A meaningful pattern based on CVR latency was identified, which was named the PD CVR pattern (PD-CVRP). This pattern was characterized by relatively increased latency in basal ganglia, sensorimotor cortex, supplementary motor area, thalamus and visual cortex, as well as decreased latency in the cerebral white matter, relative to HC. There were no significant associations with clinical measures, though sample size may have limited our ability to detect significant associations. In summary, the PD-CVRP highlights the importance of cerebrovascular dysfunction in PD, and may be a potential biomarker for future clinical research and practice.
Examining Trajectories of Change on the Dynamic Risk Assessment for Offender Re-Entry (DRAOR)
Authors: Rieger Danielle J. , Perley-Robertson Bronwen , Serin Ralph C.
Published: April 2024

Dynamic risk scales have largely been evaluated using singular assessment scores, including those obtained at the start of supervision. While this approach includes assessment of dynamic factors, it ignores changes with reassessment, failing to examine whether an instrument is truly dynamic in nature. This is problematic, as proximal risk assessments have consistently outperformed baseline assessments in the prediction of recidivism. In the current study, we examined the dynamic properties of the Dynamic Risk Assessment for Offender Reentry (DRAOR) in 4,736 adults on community supervision in Iowa, United States ( N = 33,965 assessments). As expected, while clients demonstrated statistically significant changes on the DRAOR domains over time, changes were small in magnitude. We also examined the predictive validity of baseline and proximal DRAOR total and domain scores on criminal recidivism and revocation in a larger sample of 11,421 adults in the same jurisdiction. While DRAOR baseline scores did predict both outcomes, prediction did not improve with proximal scores. This conflicted with expected findings from previous research on the DRAOR in New Zealand. The results of both of these research questions indicate there was an overall lack of change reflected in this sample. Potential issues regarding implementation fidelity are discussed. Additional research is needed to examine the dynamic properties of the DRAOR in Iowa given the importance of reassessment data in community corrections.
Transubstantiation as a normative process: James Joyce and Carl Schmitt in 1922
Authors: Engelking Wojciech
Published: April 2024

The thesis that legal norms are rooted in theology is not new. It is worth considering, however, to what extent not only singular norms, but also models of normativity are the structural representation of theological concepts. In this article, I consider transubstantiation as one of such ideas. I analyse its place in two political theologies published at the same time (in 1922): Carl Schmitt’s Political Theology and James Joyce’s Ulysses. I argue that both thinkers used the idea of transubstantiation as a normative mechanism to deal with anomie that encompassed European societies after the First World War.
Uncovering the recycling potential of industrial waste in Sri Lanka
Authors: Edirisinghe Loku Gamage Lakmini Malika , de Alwis Ajith , Wijayasundara Mayuri
Published: April 2024

The generation of industrial waste is mainly dependent on several factors, including the type of industry, production capacity, technology use and raw materials involved in the manufacturing processes. The present study is a cross-sectional study that was conducted with 580 industries under six industrial sectors in Sri Lanka in 2022. The main objective of this research was to investigate solid waste generation and estimate the recyclable fraction in the waste. Furthermore, this study calculated the prevailing recycling rate of each industrial sector and the waste generation per person employed in the sector. Industrial processes, the types and quantities of waste, waste disposal methods and management activities in terms of recycling and disposal were evaluated through a structured questionnaire and random field observations. The study identified that the composition of selected recyclable items was 16.7% of the total waste generated in the industrial sector. The prevailing rate of recycling in different sectors was as follows: manufacturing of food products (36.6%), manufacturing of beverages (82.3%), manufacturing of textiles (68.6%), manufacturing of chemical and chemical products (28.5%), manufacturing of rubber and plastic (46.5%) and manufacturing of metallic mineral products (17.8%) from the total generated recyclable material. The study further estimated the waste intensity (waste generation per unit of product output) of the industrial sectors as follows: 0.38 (manufacturing of food products), 0.36 (manufacturing of beverages), 0.27 (manufacturing of textiles), 0.26 (manufacturing of chemical and chemical products), 0.17 (manufacturing of rubber and plastic) and 0.16 (manufacturing of non-metallic mineral products).
The Challenges of Advance Care Planning for Acute Care Registered Nurses
Authors: Rietze Lori L. , Stajduhar Kelli I. , Purkis Mary Ellen , Cloutier Denise
Published: April 2024

Study Background

The practice of acute care nurses is shaped by organizational factors such as lack of privacy, heavy workloads, unclear roles, lack of time, and lack of specific policies and procedures. We know little about the social and organizational structures and processes that influence nurses’ uptake of valuable patient-centered discussions like advance care planning (ACP). ACP is beneficial for patients, their substitute decision makers, and healthcare providers.

Purpose

To describe the operational, organizational, and societal influences shaping nurses’ ACP work in acute care settings.

Methods

This ethnographic study purposively sampled 14 registered nurses and 9 administrators who worked in two acute care hospitals in Northeastern Ontario. Methods consisted of 23 open-ended, semi-structured interviews, 20 hours of observational fieldwork, and a collection of publicly available organizational documents. Data were inductively analyzed using an iterative constant comparative approach.

Results

Nurses were challenged to meet multiple competing demands, leaving them to scramble to manage complex and critically ill acute care patients while also fulfilling organizational tasks aligned with funding metrics, accreditation, and strategic planning priorities. Such factors limited nurses’ capacity to engage their patients in ACP.

Conclusions

Acute care settings that align patient values and medical treatment need to foster ACP practices by revising organizational policies and processes to support this outcome, analyzing the tasks of healthcare providers to determine who might best address it, and budgeting how to support it with additional resources.
Freak out! At the acousmonium: François Bayle and the dynamics of the subject
Authors: Ridout Sam
Published: April 2024

French electroacoustic music in the post-war decades has typically been associated with a high modernism that spurned popular or mass culture. This article situates electroacoustic music in the late 1960s and 1970s in relation to the transformation of the cultural field in this period, which unsettled clear divisions between high and low cultures. Attending in particular to the question of subjectivity as it appears in the theoretical writings of the composers Pierre Schaeffer and François Bayle, the article aligns Bayle's thinking with that of contemporary writers including Julia Kristeva and Roland Barthes, who launched a critique of the Enlightenment subject. This theoretical nexus suggests that Bayle's L’Expérience acoustique (1969–1972) posits a form of subjectivity closer to the psychedelic counterculture than to the sober listening of Schaeffer's writings. In unsettling the Schaefferian listening subject, the piece opens itself to a heterogeneous listening, the social consequences of which remain significant today.
Towards a Re-insurance union? SURE as an EU response to preserve jobs in the COVID-19 pandemic
Authors: Corti Francesco , Huguenot-Noël Robin
Published: April 2024

Is the EU evolving towards a Re-Insurance Union? The creation of SURE, an EU financial tool to support national short-time work (STW) schemes in the midst of the pandemic, has revitalized debates on fiscal stabilizers as a means to counter economic downturns and protect jobs within the European Union. Drawing from document analyses and 17 interviews with EU and national stakeholders, this study explores the politics underpinning SURE’s adoption following a decade of heated and unsuccessful debates on the European Unemployment Reinsurance Scheme (EURS). Through the lens of ‘purposeful opportunism’, the article illustrates how the European Commission leveraged prior EURS insights and the emerging consensus on STW schemes to craft SURE in a way which addressed national concerns about EU-wide welfare harmonization, while positioning the EU as a holding environment for national welfare states. Looking ahead, making SURE a permanent ‘second line of defence’ against macroeconomic shocks could contribute to further substantiating new, EU-wide, social rights codified in the European Pillar of Social Rights.
Teacher Responsiveness and Instruction for Verbal Aggression Victimization: Survey Results of Secondary Students With Emotional and Behavioral Disorders
Authors: Poling Daniel V. , Smith Stephen W. , Ma Jia , Qiu Yuxi
Published: April 2024

Students identified with emotional and behavioral disorders (EBDs) often have difficulty with social adjustment and academic achievement, engaging in problem behaviors such as defiance, rule-breaking, and truancy, yet one particularly challenging behavior is aggression. Researchers assert that verbal aggression (VA) is the most frequent form of aggression in schools; however, little is known about student perceptions of VA among students with EBD. We surveyed 144 U.S. secondary students with EBD finding infrequent reporting to teachers about VA victimization. According to students, the most effective teacher responses to a report of VA victimization were moving the victim away from the perpetrator, providing advice, and punishing the aggressor. Students reported that the content of teacher instruction about VA most often included reporting victimization to a teacher, avoiding the aggressor, and ignoring the verbally aggressive behavior. We discuss implications for teacher education and practice including what strategies deter VA and effective teacher responses to victimization. We conclude with recommendations for future research such as examining risk and protective factors for VA involvement, assessing whether students’ attitudes and beliefs contribute to VA, and conducting longitudinal studies.
Prognostic and predictive biomarkers with therapeutic targets in nonsmall-cell lung cancer: A 2023 update on current development, evidence, and recommendation
Authors: Chung Clement , Umoru Godsfavour
Published: April 2024

Background

Since the publication of the original work in 2014, significant progress has been made in the characterization of genomic alterations that drive oncogenic addiction of nonsmall cell lung cancer (NSCLC) and how the immune system can leverage non-oncogenic pathways to modulate therapeutic outcomes. This update evaluates and validates the recent and emerging data for prognostic and predictive biomarkers with therapeutic targets in NSCLC.

Data sources

We performed a literature search from January 2015 to October 2023 using the keywords non-small cell lung cancer, clinical practice guidelines, gene mutations, genomic assay, immune cancer therapy, circulating tumor DNA, predictive and prognostic biomarkers, and targeted therapies.

Study selection and data extraction

We identified, reviewed, and evaluated relevant clinical trials, meta-analyses, seminal articles, and published clinical practice guidelines in the English language.

Data synthesis

Regulatory-approved targeted therapies include those somatic gene alterations of EGFR (“classic” mutations, exon 20 insertion, and rare EGFR mutations), ALK, ROS1, BRAF V600, RET, MET, NTRK, HER2, and KRAS G12C. Data for immunotherapy and circulating tumor DNA in next-generation sequencing are considered emerging, whereas the predictive role for PIK3CA gene mutation is insufficient.

Conclusions

Advances in sequencing and other genomic technologies have led to identifying novel oncogenic drivers, novel resistance mechanisms, and co-occurring mutations that characterize NSCLC, creating further therapeutic opportunities. The benefits associated with immunotherapy in the perioperative setting hold initial promise, with their long-term results awaiting.
Factors Contributing to Health Deterioration in the Japanese Long-Term Care Insurance System in Terms of Instrumental Activities of Daily Living
Authors: Nishida Takahiro , Ide Yoshihiko , Fukuda Kenichiro , Honda Ayumi , Honda Sumihisa
Published: April 2024

This study aimed to determine which instrumental activities of daily living (IADL) are associated with health deterioration from the “support level” to the “care level” among users of the long-term care insurance system in Japan. From April 2017 to March 2020, we conducted a retrospective follow-up survey on 178 Japanese community-dwelling older adults (64 men, 114 women) newly certified as support level. Independent variable was 8 IADL items and the outcome defined as the “support level maintenance time.” Cox models were used to assess the risk of health deterioration, with adjustments for age group, family composition, dementia status, and frailty status by gender. Dependence on 5 items, “laundry” (hazard ratio [HR] =2.5; 95% confidence interval [CI]: 1.1-5.8), “cooking” (HR = 3.7; 95% CI: 1.1-12.2), “telephone use” (HR = 2.4; 95% CI: 1.2-4.7), “financial management” (HR = 2.5; 95% CI: 1.2-5.0), and “medication management” (HR = 2.4; 95% CI: 1.2-4.8), was independently associated with a worse outcome among men, whereas dependence on “financial management” (HR = 2.6; 95% CI: 1.5-4.7) and “medication management” (HR = 2.0; 95% CI: 1.1-3.5) was independently associated with a worse outcome among women. These findings suggest that difficulties in “financial management” and “medication management” are common factors associated with health deterioration from the support to the care level among both genders. An association with household tasks was also seen among men, indicating that a paradigm shift is needed to increase the participation of men in household tasks.
From Hegemonic to Hybrid and Back? The Context-Adaptive Masculinity of Polish Male Migrants
Authors: Leszczyńska Katarzyna , Zielińska Katarzyna , Urbańska Sylwia
Published: April 2024

The article aims to address the complexity of the models of masculinity (re)produced in the transnational context and explain the role of religion in this process. It draws on qualitative research conducted among religiously committed Catholic male migrants from Poland who have settled in multicultural and secular societies: England, Belgium, and Sweden. The transnational context often makes it difficult for migrant men to practice hegemonic masculinity. Our analysis shows how the isomorphic mechanisms allow for (re)constructing new forms of masculinity that combine diverse and often contradictory meanings available in the transnational contexts (i.e., associated with subordinated masculinities or with femininity). Such hybridized version of masculinity not only helps to adapt to the new transnational context but also allows for rebuilding the privileges traditionally offered by hegemonic masculinity. We also discuss the role religion plays in this process by giving credibility to this hybrid masculinity by rooting it in the sacral order and thus legitimizing it.
Genomic Characterization of IS6110 Insertions in Mycobacterium orygis
Authors: Refaya Ahmed Kabir , Vetrivel Umashankar , Palaniyandi Kannan
Published: April 2024

Mycobacterium orygis, a subspecies of the Mycobacterium tuberculosis complex (MTBC), has emerged as a significant concern in the context of One Health, with implications for zoonosis or zooanthroponosis or both. MTBC strains are characterized by the unique insertion element IS 6110, which is widely used as a diagnostic marker. IS 6110 transposition drives genetic modifications in MTBC, imparting genome plasticity and profound biological consequences. While IS 6110 insertions are customarily found in the MTBC genomes, the evolutionary trajectory of strains seems to correlate with the number of IS 6110 copies, indicating enhanced adaptability with increasing copy numbers. Here, we present a comprehensive analysis of IS 6110 insertions in the M. orygis genome, utilizing ISMapper, and elucidate their genetic consequences in promoting successful host adaptation. Our study encompasses a panel of 67 paired-end reads, comprising 11 isolates from our laboratory and 56 sequences downloaded from public databases. Among these sequences, 91% exhibited high-copy, 4.5% low-copy, and 4.5% lacked IS 6110 insertions. We identified 255 insertion loci, including 141 intragenic and 114 intergenic insertions. Most of these loci were either unique or shared among a limited number of isolates, potentially influencing strain behavior. Furthermore, we conducted gene ontology and pathway analysis, using eggNOG-mapper 5.0, on the protein sequences disrupted by IS 6110 insertions, revealing 63 genes involved in diverse functions of Gene Ontology and 45 genes participating in various KEGG pathways. Our findings offer novel insights into IS 6110 insertions, their preferential insertion regions, and their impact on metabolic processes and pathways, providing valuable knowledge on the genetic changes underpinning IS 6110 transposition in M. orygis.
A review of the frequency-amplitude formula for nonlinear oscillators and its advancements
Authors: El-Dib Yusry O
Published: April 2024

The frequency-amplitude relationship is pivotal in understanding oscillatory systems, dictating their dynamic behaviors and responses. This paper delves into the intricacies of the frequency amplitude formula, elucidating its foundational role in both linear and nonlinear oscillations. Through comprehensive analysis, we highlight the formula’s significance in predicting system behaviors, especially in environments with varying amplitudes. Our findings underscore the formula’s potential as a robust tool for enhanced system characterization, offering profound implications for diverse applications across scientific and engineering domains. This study delves deep into the formulation of the frequency-amplitude relationship, extending its application beyond the conventional cubic powers of the restoring force. We introduce three novel and equivalent formulations of the generalized frequency amplitude, breaking traditional boundaries by not confining the restoring force to just odd functions. The formula to determine the frequency of the singular oscillator has been set forth. Our approach, characterized by its simplicity, offers a robust tool for analyzing high nonlinearity vibrations, ushering in a richer, multidimensional perspective to vibration analysis.
The Populist Name Game: About Populism and Naming
Authors: Kidron Uri , Ish-Shalom Piki
Published: April 2024

For populist leaders, naming is an important political tool, helping them to consolidate their leadership while harming the legitimacy of their opponents. The article offers a theoretical framework explaining populist tactical uses of naming; how they name and misname their opponents. The explanation locates the naming tactics within the overall populist framework as a thin-centered ideology. The following three naming tactics are described and analyzed: (1) coining ridiculing nicknames, (2) appropriating existing nicknames, and (3) avoiding the opponent’s name.

To substantiate the theoretical arguments, we discursively analyze these three tactics, as were employed by the former US president, Donald Trump, the prime minister of Israel, Binyamin Netanyahu, and the president of the Russian Federation, Vladimir Putin.
Nationwide Study of the Outcome of Treatment of Lower Extremity Atherosclerotic Lesions With Endovascular Surgery With or Without Drug Eluting Methods in Patients With Diabetes
Authors: Fransson Torbjörn , Sturedahl Andrea Dahl , Resch Timothy , Björn Eliasson , Gottsäter Anders
Published: April 2024

Paclitaxel eluting balloons and stents reduce the development of intimal hyperplasia and restenosis rate after endovascular treatment for peripheral arterial disease (PAD) in the lower extremities. As diabetes mellitus (DM) worsens the prognosis in PAD patients after invasive endovascular treatment, we assessed the effects of drug eluting technology for PAD with special focus on effects in patients with and without DM. All Swedish patients registered in the Swedish vascular registry Swedvasc after vascular or endovascular surgery for intermittent claudication, IC; (n=1948) or chronic limb threatening ischemia, CLTI (n=3353) in 2013 to 2015 were followed up regarding a composite of either major amputation and/or mortality during median 607 days and for reinterventions for PAD during median 522 days. Patients with DM registered in the Swedish National Diabetes Registry (NDR) and patients without DM were evaluated separately. The 201 CLTI patients with DM treated with drug eluting methods had a lower adjusted risk for amputation or mortality after adjustment than the 1476 CLTI patients with DM treated without drug eluting methods (hazard ratio [HR] 0.712 [0.562-0.901], P=.005). There were no differences among IC patients. Regarding the need for reinterventions for PAD, there were no differences between patients treated with and without drug eluting methods, irrespectively of the presence or absence of DM. In conclusion, this nationwide follow-up study indicated potential benefits of drug eluting treatment in CLTI patients with diabetes. The results need to be evaluated and confirmed in prospective randomized studies.

Clinical Impact

This retrospective observational registry trial combines national registries for vascular surgical procedures and diabetes mellitus to clarify results of drug eluting technology in treating diabetic subjects with intermittent claudication or chronic limb threatening ischemia compared to treatment of non-diabetic subjects. As earlier proposed and showed in this trial, there may be an implication for a beneficial treatment efficacy with drug eluting therapy in the diabetic population with PAD compared to the non-diabetic population. A finding worth further exploration.
Implementation of Endoscopic Minimally Invasive Mitral Valve Replacement Surgery With Automated Suturing Technology
Authors: Zubarevich Alina , Arjomandi Rad Arian , Beltsios Eleftherios , Salman Jawad , Pitsis Antonios , Popov Aron-Frederik , Schmack Bastian , Bakhtiary Farhad , Ruhparwar Arjang , Weymann Alexander
Published: April 2024

In the evolving landscape of cardiac surgery, this article explores the potential of minimally invasive mitral valve replacement procedures as a viable alternative to conventional surgical techniques. Leveraging advancements in automated suturing devices and video endoscopy, our work aims to demonstrate that minimally invasive approaches can be applied across a broad spectrum of surgical scenarios. Herein we highlight preoperative diagnostics and operative techniques, with a focus on infra-axillary anterolateral minithoracotomy as the access point. Our technique utilizes technology from LSI SOLUTIONS® (Victor, NY, USA), including the RAM® Device for automated suturing, which has an ergonomic design and safety features. The device’s capabilities are further enhanced by the SEW-EASY® Device, the RAM® RING, and the COR-KNOT MINI® Device, which streamline suture management and securement. This work outlines how these technological advancements can mitigate concerns about technical complexity and learning curves, thereby encouraging wider adoption of minimally invasive techniques. Clinical benefits may include reduced surgical trauma, quicker recovery, and cost-effectiveness, making it a compelling option in an era of aggressively promoted transcatheter interventions.
Factors associated with decreasing diffusion-weighted imaging-positive area volume after mechanical thrombectomy in patients with large early ischemic changes
Authors: Shintoku Ryosuke , Shimizu Tatsuya , Aihara Masanori , Asano Hirofumi , Yamaguchi Rei , Tsuneoka Haruka , Shimauchi-Ohtaki Hiroya , Tosaka Masahiko , Yoshimoto Yuhei
Published: April 2024

Objectives

This study aimed to evaluate the factors associated with decreasing diffusion-weighted imaging (DWI) positive areas in patients with large early ischemic changes after mechanical thrombectomy (MT).

Materials and Methods

This retrospective single-center clinical study was conducted between January 2013 and December 2022. We included consecutive patients who underwent MT for acute large-vessel occlusion of the anterior circulation with low pretreatment DWI-Alberta Stroke Program Early Computed Tomography Scores (ASPECTS) (0–5), effective recanalization [thrombolysis in cerebral infarction (TICI) 2b or TICI3], and magnetic resonance imaging (MRI) acquired before and after MT. We measured the DWI-positive area volume before and after MT. The primary endpoint was the after/before-MT DWI-positive area–volume ratio.

Results

In total, 28 patients were included in this study. Eight patients (29%) had an after/before-MT DWI-positive area–volume ratio of <1. The median mean apparent diffusion coefficient (ADC) levels of the DWI-positive areas in the groups with a ratio of <1 or >1 were 717 × 10⁶ mm2/s and 637 × 106 mm2/s, respectively ( p = 0.011). Multivariate logistic regression analysis showed that ADC level (OR, 1.020 [95% confidence intervals (CIs), 1.001–1.040]; p = 0.040) was an independent predictor of a decreased DWI-positive area after MT. There was a negative correlation between the mean ADC level and the after/before-MT DWI-positive area–volume ratio ( p < 0.001, | ρ| = 0.650), and the mean pretreatment ADC cutoff level was 649 × 106 mm2/s (area under the curve (AUC) = 0.806) for predicting a volume ratio of <1.

Conclusions

The mean ADC level before-MT correlated with the after/before-MT DWI-positive area–volume ratio. A mean pretreatment ADC cutoff level of 649 × 106 mm2/s predicted a decreased DWI-positive area after MT.
One-staged brachial-basilic vein transposition versus arm straight arteriovenous graft for hemodialysis
Authors: Srikuea Kanoklada , Prajumsukh Kesanan , Orrapin Saritphat , Benyakorn Thoetphum , Ho Pei , Rerkasem Kittipan , Siribumrungwong Boonying
Published: April 2024

Objectives

After forearm and arm cephalic veins are no longer available as options, the choices of arm vascular access between one-staged brachial-basilic vein transposition (BBAVF) and arm straight arteriovenous graft (AS-AVG) for hemodialysis are controversial. This study aims to compare outcomes between groups.

Methods

All one-staged BBAVF and AS-AVG from August 2014 to December 2019 were reviewed. In cases of suitable basilic vein of 3 mm or more present from cubital crease to axilla, one-staged BBAVF was preferred. AS-AVG was performed for patients who need timely functioning access or have no suitable basilic vein.

Results

Twenty-eight one-staged BBAVF and 74 AS-AVG were included. Baseline characteristics were not significantly different, except AS-AVG had less previous ipsilateral access (9% vs 39%; p < .001). Postoperative complications were not different. With six loss follow-ups (3 in BBAVF and 3 in AS-AVG), 24 (96%) and 64 (90%) matured after one-staged BBAVF and AS-AVG, respectively ( p = .676). BBAVF took about 30 days (95% CI: 10, 51) longer time to first successful cannulation. Primary patency was significantly better for one-staged BBAVF (hazard ratio (HR) of 3.0 (95%CI: 1.2, 7.7)), whereas secondary patency was not different. The total access failure (i.e. failure to mature combined with any thrombosis or intervention to maintain patency) significantly favored BBAVF (HR 2.7 (95%CI: 1.1, 6.6)).

Conclusions

Provided a suitable arm basilic vein is available, one-staged BBAVF is preferred over AS-AVG when forearm AVF, forearm AVG, and arm cephalic veins are out. However, it requires a longer time to start cannulating than AS-AVG.
Treatment modalities for paediatric functional daytime lower urinary tract disorders: an updated review
Authors: Wijekoon Naveen , Deshpande Aniruddh
Published: April 2024

Paediatric functional bladder disorders especially those causing daytime symptoms are a common cause of significant psychosocial and/or physical morbidity and impaired quality of life. Despite the availability of many therapeutic modalities, a significant number of children appear to be refractory to treatment and continue to have symptoms. In this review, we aim to evaluate the current evidence in the use of existing and novel therapeutic options for the management of daytime lower urinary tract disorders in children. We also aim to highlight the controversies around the terminology and diagnosis of paediatric lower urinary tract dysfunction (LUTD) and specific conditions. The article will then provide a reasonable critique of the existing and emerging treatment modalities in functional daytime LUTD in children including their mode of action, efficacy, indications, and recent advances. These include standard urotherapy, specific urotherapy comprised of biofeedback, alarm therapy and electrical neural stimulation and pharmacotherapy involving selective and non-selective anticholinergics, ß3 adrenergic agonists, alpha blockers and botulinum toxin. A better understanding of this common clinical problem may help clinicians achieve better profiling of these children’s diagnoses to further enable specific, targeted treatment.
A retrospective study on the management of ureteric stones following presentation to the emergency department in the University Hospitals Sussex Trust East from November 2020 to November 2021
Authors: Rietdyk Ava , Zakikhani Paimaun , Symes Andrew
Published: April 2024

Objective:

To ascertain which patient demographic, clinical and stone-specific factors were significant when predicting intervention for ureteric stones and determine the proportion of patients with smaller, more distally located stones requiring intervention to establish whether follow-up imaging was indicated to confirm stone passage.

Subjects/patients and methods:

This is a retrospective review of 227 patients presenting with ureteric stones on non-contrast computerised tomography (NCCT) between November 2020 and November 2021. Eleven different clinical, demographic and imaging-related factors were recorded, and multivariate logistical regression was used to determine which factors were significant when predicting intervention.

Results:

A total of 53 patients (23.3%) underwent some form of intervention with only stone size ( p < 0.001) and stone location ( p < 0.001) significant in predicting treatment. Only 4.17% of patients with a ⩽ 4 mm distally located stone required intervention. These patients either had raised inflammatory markers or significant pain.

Conclusion:

Given that 95.83% of patients with ⩽ 4 mm distal ureteric calculi passed their stone spontaneously, a patient-initiated follow-up (PIFU) could be implemented to replace a follow-up NCCT. Based on this dataset, the application of PIFU could have prevented additional radiation exposure of 1.5–3 mSv/patient and excess financial cost of approximately £7000 to services.

Level of Evidence:

Level 3
Case Study of Anna Pratha in Rural Areas of Bundelkhand Region
Authors: Singh Priya
Published: April 2024

In this research article, there is an attempt to understand the concept of Anna Pratha in rural areas of Bundelkhand region. There is an attempt to uncover that this Pratha is directly or indirectly related to adverse geographical conditions of this area. Agrarian crisis, water scarcity and Anna Pratha are interrelated phenomena. To understand these aspects, one village, Nahari, from Banda district of Uttar Pradesh, part of Bundelkhand region, was selected by the researcher randomly. The primary method of data collection has been used by the researcher. Through interview schedule, the researcher collected in-depth information regarding Anna Practice prevailed in this region. Since 2018–2020, data have been collected by the researcher through field visits in this area.
A Case of Infective Endocarditis Caused by Citrobacter koseri: Unraveling a Rare Pathogen and Dire Outcome
Authors: Sharma Divisha , Sulaiman Zoheb I. , Tu Patrick J. , Harrell Sean , Cavalieri Stuart , Skidmore Peter J. , Baer Stephanie L.
Published: April 2024

Citrobacter koseri (formerly classified as Citrobacter diversus) is a gram-negative bacillus (GNB) that occurs as an opportunistic pathogen in neonates and immunocompromised patients. Citrobacter species have been implicated in nosocomial settings leading to infections involving the urinary tract, respiratory tract, liver, biliary tract, meninges, and even in rarer conditions—blood stream infection and infective endocarditis (IE). Gram-negative bacilli are responsible for 3% to 4% of all IE cases and have been traditionally associated with intravenous drug users. Patients with non-HACEK (species other than Haemophilus species, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, or Kinglella species) GNB IE have poor clinical outcomes with higher rates of in-hospital mortality and complications. The American Heart Association (AHA) and Infectious Diseases Society of America (IDSA) both recommend the use of combination antibiotic therapy with a beta-lactam (penicillins, cephalosporins, or carbapenems) and either an aminoglycoside or fluoroquinolones for 6 weeks (about 1 and a half months) to treat IE due to non-HACEK GNB. Citrobacter koseri is becoming more recognized due to its inherent resistance to ampicillin and emerging drug resistance to beta lactams and aminoglycosides requiring carbapenem therapy. Our case is of a 75-year-old male with no previously reported history of primary or secondary immunodeficiency disorders who developed C koseri blood stream infection. His infectious work-up revealed mitral valve IE and septic cerebral emboli resulting in ischemic infarcts. This case illustrates the importance of recognizing GNB organisms as rising human pathogens in IE cases even without active injection drug use or nosocomial exposure.
A Case Report of Pulmonary Vein Stenosis Within the Labyrinth of Fibrosing Mediastinitis
Authors: Alagha Zakaria , Adams Catherine , Johnson Kylie , Al-Astal Amro
Published: April 2024

This case centers on a 76-year-old male experiencing exertional dyspnea and hemoptysis, with a medical history marked by recurrent pulmonary embolism and chronic obstructive pulmonary disease (COPD). Notably, he resides in a histoplasmosis-endemic area. A computed tomography (CT) pulmonary embolism scan revealed notable findings, including an enlarged right lower pulmonary artery, vascular congestion, atelectasis, and a mass exerting pressure on the right lower pulmonary vein. Biopsy results identified the mass as fibrosing mediastinitis, likely attributed to histoplasmosis. A transthoracic echocardiogram indicated right ventricular dilatation, impaired function, and a right ventricular systolic pressure of 63 mm Hg. During right heart catheterization, the patient displayed disparate pulmonary artery wedge pressures (PAWPs) between the right and left sides. This discrepancy was linked to a blunted back wave from the left atrium to the catheter, induced by pulmonary vein compression. Although an infrequent phenomenon, the recorded asymmetry in PAWPs played a crucial role in guiding accurate patient management. The absence of subsequent evaluation of PAWP on the left side could have altered the treatment plan, potentially delaying appropriate patient care. This case emphasizes the necessity of thorough exploration with right heart catheterization when clinical symptoms warrant, highlighting the importance of standardized practices in such procedures.
Providing Trauma-Informed Care During a Pandemic: How Health Care Workers at Ryan White-Funded Clinics in the Southeastern United States Responded to COVID-19 and Its Effects on Their Well-Being
Authors: Kokubun Caroline W. , Anderson Katherine M. , Manders Olivia C. , Kalokhe Ameeta S. , Sales Jessica M.
Published: April 2024

As HIV/AIDS health care workers (HCWs) deliver services during COVID-19 under difficult conditions, practicing trauma-informed care (TIC) may mitigate negative effects on mental health and well-being. This secondary qualitative analysis of a larger mixed methods study sought to understand the pandemic's impact on HCWs at Ryan White-funded clinics (RWCs) across the southeastern US and assess changes in prioritization of TIC. RWC administrators, providers, and staff were asked about impacts on clinic operations/culture, HCW well-being, institutional support for well-being, and prioritization of TIC. HCWs described strenuous work environments and decreased well-being (eg, increased stress, burnout, fear, and social isolation) due to COVID-19. RWCs initiated novel responses to disruptions of clinic operations and culture to encourage continuity in care and promote HCW well-being. Despite increased awareness of the need for TIC, prioritization remained variable. Implementing and institutionalizing trauma-informed practices could strengthen continuity in care and safeguard HCW well-being during public health emergencies.
Social Infrastructure Availability and Suicide Rates among Working-Age Adults in the United States
Authors: Zhang Xue , Rhubart Danielle C. , Monnat Shannon M.
Published: April 2024

Social infrastructure (SI) may buffer against suicide risk by improving social cohesion, social support, and information and resource sharing. The authors use an ecological approach to examine the relationship between county-level SI availability and suicide rates among working-age adults (25–64 years) in the United States, a population among which suicide rates are high, rising, and geographically unequal. Mortality data are from the National Vital Statistics System for 2016 to 2019. SI data are from the National Neighborhood Data Archive for 2013 to 2015 and capture the availability of typically free SI (e.g., libraries, community centers) and commercial SI (e.g., coffee shops, diners, entertainment venues). Results from negative binomial models show that suicide rates are significantly lower in counties with more SI availability, net of county demographic, socioeconomic, and health care factors. This relationship held for both typically free and commercial SI. Policy makers should consider strengthening existing and developing new SI as part of a broader strategy to reduce suicide rates in the United States.
Surgical Drainage of Large Macular Cystoid Spaces in Coats Disease
Authors: Yiu Glenn , Hang Abraham , Fong Rodney
Published: April 2024

Purpose: To describe an option of surgically draining large macular cystoid spaces in a patient with Coats disease. Methods: A case and its findings were analyzed. Results: A standard pars plana vitrectomy was performed to aspirate large macular cystoid spaces using a subretinal cannula with intraoperative optical coherence tomography guidance. Because of the viscous nature of the chronic fluid and lipid exudates, the contents of the large cystoid spaces were drained through a retinotomy using a soft-tipped aspiration cannula. Postoperative follow-up after surgical drainage showed immediate resolution of the macular cystoid spaces and gradual resolution of the dense subfoveal exudates over 1 year. Although surgical intervention led to the eventual resolution of the macular edema and exudates, visual recovery was limited by the chronicity of the condition. Conclusions: Surgical drainage of large macular cystoid spaces in Coats disease can be achieved in eyes that are refractory to medical management. Earlier surgical intervention in select cases may allow for visual rehabilitation.
The relationship between serum astroglial and neuronal markers and AQP4 and MOG autoantibodies
Authors: Chatanaka Miyo K. , Avery Lisa M. , Pasic Maria D. , Sithravadivel Shanthan , Rotstein Dalia , Demos Catherine , Cohen Rachel , Gorham Taron , Wang Mingyue , Stengelin Martin , Mathew Anu , Sigal George , Wohlstadter Jacob , Prassas Ioannis , Diamandis Eleftherios P.
Published: April 2024

Background

Certain demyelinating disorders, such as neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) exhibit serum autoantibodies against aquaporin-4 (αAQP4) and myelin oligodendrocyte glycoprotein (αMOG). The variability of the autoantibody presentation warrants further research into subtyping each case.

Methods

To elucidate the relationship between astroglial and neuronal protein concentrations in the peripheral circulation with occurrence of these autoantibodies, 86 serum samples were analyzed using immunoassays. The protein concentration of glial fibrillary acidic protein (GFAP), neurofilament light chain (NFL) and tau protein was measured in 3 groups of subcategories of suspected NMOSD: αAQP4 positive (n = 20), αMOG positive (n = 32) and αMOG/αAQP4 seronegative (n = 34). Kruskal-Wallis analysis, univariate predictor analysis, and multivariate logistic regression with ROC curves were performed.

Results

GFAP and NFL concentrations were significantly elevated in the αAQP4 positive group (p = 0.003; p = 0.042, respectively), and tau was elevated in the αMOG/αAQP4 seronegative group (p < 0.001). A logistic regression model to classify serostatus was able to separate αAQP4 seropositivity using GFAP + tau, and αMOG seropositivity using tau. The areas under the ROC curves (AUCs) were 0.77 and 0.72, respectively. Finally, a combined seropositivity versus negative status logistic regression model was generated, with AUC = 0.80.

Conclusion

The 3 markers can univariately and multivariately classify with moderate accuracy the samples with seropositivity and seronegativity for αAQP4 and αMOG.
HMGB1 prefers to interact with structural RNAs and regulates rRNA methylation modification and translation in HeLa cells
Authors: Liao Meimei , Cao Jiarui , Chen Wen , Wang Mengwei , Jin Zhihui , Ye Jia , Ren Yijun , Wei Yaxun , Xue Yaqiang , Chen Dong , Zhang Yi , Chen Sen
Published: April 2024

Background

High-mobility group B1 (HMGB1) is both a DNA binding nuclear factor modulating transcription and a crucial cytokine that mediates the response to both infectious and noninfectious inflammation such as autoimmunity, cancer, trauma, and ischemia reperfusion injury. HMGB1 has been proposed to control ribosome biogenesis, similar as the other members of a class of HMGB proteins.

Results

Here, we report that HMGB1 selectively promotes transcription of genes involved in the regulation of transcription, osteoclast differentiation and apoptotic process. Improved RNA immunoprecipitation by UV cross-linking and deep sequencing (iRIP-seq) experiment revealed that HMGB1 selectively bound to mRNAs functioning not only in signal transduction and gene expression, but also in axon guidance, focal adhesion, and extracellular matrix organization. Importantly, HMGB1-bound reads were strongly enriched in specific structured RNAs, including the domain II of 28S rRNA, H/ACA box snoRNAs including snoRNA63 and scaRNAs. RTL-P experiment showed that overexpression of HMGB1 led to a decreased methylation modification of 28S rRNA at position Am2388, Cm2409, and Gm2411. We further showed that HMGB1 overexpression increased ribosome RNA expression levels and enhanced protein synthesis.

Conclusion

Taken together, our results support a model in which HMGB1 binds to multiple RNA species in human cancer cells, which could at least partially contribute to HMGB1-modulated rRNA modification, protein synthesis function of ribosomes, and differential gene expression including rRNA genes. These findings provide additional mechanistic clues to HMGB1 functions in cancers and cell differentiation.