bluuebunny/crossref_metadata_2025 huggingface dataset:
Nutritional Interventions in Adult Patients With Irritable Bowel Syndrome: An Umbrella Review of Systematic Reviews and Meta-analyses of Randomized Clinical Trials
Authors: Zeraattalab-Motlagh Sheida , Ranjbar Mahsa , Mohammadi Hamed , Adibi Peyman
Published: August 2024

Context

There is still debate regarding the effect of nutritional interventions in improving irritable bowel syndrome (IBS) symptoms.

Objectives

The aim was to examine the evidence certainty and validity of all existing meta-analyses of intervention trials on nutritional interventions in patients with IBS.

Data Sources

Scopus, PubMed, and Web of Science were reviewed until June 2023.

Data Extraction

Meta-analyses assessing the impacts of nutritional interventions in adults with IBS were entered. Effect sizes of nutritional interventions were recalculated by applying a random-effects model. GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) was implemented to determine evidence certainty.

Results

A total of 175 trials in 58 meta-analyses were entered describing the effects of 11 nutritional interventions on IBS-related outcomes. Nutritional interventions had beneficial effects on some IBS-related outcomes. For instance, soluble fiber, peppermint oil, and aloe vera improved IBS symptoms, and vitamin D3 and curcumin improved IBS symptom severity. Tongxieyaofang improved abdominal pain severity and stool frequency. Nevertheless, these outcomes have mainly shown small effects and low to very low evidence certainty. With regard to abdominal pain after probiotic supplementation (relative risk [RR]: 4.04; 95% confidence interval [CI]: 2.36, 6.92; GRADE = moderate) and IBS symptoms after a low–fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet (RR: 1.48; 95% CI: 1.14, 1.93; GRADE = moderate), there was evidence that probiotics and a low-FODMAP diet can confer clinical and favorable effects.

Conclusion

The current review does not support nutritional interventions for improving IBS symptoms. With regard to probiotics and a low-FODMAP diet, considering limitations like short-term study duration, there was an influential clinical impact.

Systematic Review Registration

PROSPERO registration no. CRD42023429991.
Clinical Characteristics and Mortality Risks Among Patients With Culture-Proven Coccidioidomycosis Who Are Critically Ill: A Multicenter Study in an Endemic Region
Authors: Lim James , Scott Ashley M , Wig Rebecca , Tan Rachel V , Harnois Emily R , Zangeneh Tirdad T , Al-Obaidi Mohanad M
Published: August 2024

Background

Coccidioidomycosis is an endemic mycosis in the southwestern United States. While most infections are mild, severe cases can be devastating. We aimed to describe the clinical characteristics and mortality risks of patients in the intensive care unit (ICU) with culture-proven coccidioidomycosis.

Methods

We performed a retrospective chart review of patients in the ICU with positive Coccidioides spp culture in a large health care system in Arizona between 1 October 2017 and 1 July 2022. All data were entered into REDCap.

Results

An overall 145 patients were identified and included. The median age was 51 years, with the majority male (69%) and non-Hispanic White (39%). Most patients (n = 104, 72%) had pulmonary coccidioidomycosis, and 41 had extrapulmonary disease (17 meningitis, 13 fungemia, 10 musculoskeletal disease, and 4 pericardial or aortic involvement). Seventy patients (48%) died during hospitalization, and most (91%) received antifungal therapy during hospitalization. In the multivariate logistic regression model, age ≥60 years (odds ratio [OR], 7.0; 95% CI, 2.6–18.8), cirrhosis (OR, 13.1; 95% CI, 1.6–108.8), and mechanical ventilation or vasopressor support (OR, 15.4; 95% CI, 3.9–59.6) were independently associated with increased all-cause mortality, but pre-ICU antifungal use had a statistically insignificant mortality risk association (OR, 0.5; 95% CI, .2–1.2).

Conclusions

In our study of patients in the ICU with coccidioidomycosis and multiple comorbidities, the mortality rate was high. Older age, cirrhosis, and mechanical ventilation or vasopressor support were significantly associated with high mortality. Future studies are recommended to evaluate those risk factors and the efficacy of rapid diagnosis and early therapy in patients at high risk.
The state of British policymaking: How can UK government become more effective?
Authors: Cairney Paul , Boswell John , Ayres Sarah , Durose Catherine , Elliott Ian C , Flinders Matt , Martin Steve , Richardson Liz
Published: August 2024

How can UK and devolved governments be more effective when addressing chronic problems like inequalities or crises like climate change? The dominant story is of pessimism: policymaking is bound to a Westminster tradition of short-termism, elitism, and centralization, and reform efforts are doomed to failure. We present a more cautiously optimistic account about the prospects for a more effective government, grounded in theory-informed lessons from two decades of UK and devolved government reform efforts. We describe a potentially more innovative and less blundering state and present a coherent Positive Public Policy agenda that can help to realize this potential.
Liberty, the Maria Luz Incident and the Liminal Legal Status of Chinese Indentured Labourers and Japanese Licensed Prostitutes
Authors: Mihalopoulos Bill
Published: August 2024

While covering the same ground as recent scholarship on the emancipatory potential of the Maria Luz incident, this article takes a radical departure, arguing that the background to the incident was British desire to disrupt the Macao trade in Chinese labour to Peru; that the legal focus of the ad hoc tribunals was not on any nascent human right to free the Chinese men and minors from being trafficked to Peru but on who owned and controlled their labour; and that the release of Japanese licensed prostitutes from their contracts was an unintended consequence of the legal fiction that the Japanese legal system was comparable with the principles of British common law.
The Jasmonic Acid Biosynthetic Genes SmLOX4 and SmLOX5 Are Involved in Heat Tolerance in Eggplant
Authors: Liu Renjian , Shu Bingbing , Wang Yuyuan , Feng Jiazhu , Yu Bingwei , Gan Yuwei , Liang Yonggui , Qiu Zhengkun , Yan Shuangshuang , Cao Bihao
Published: August 2024

High-temperature stress (HTS) affects the growth and production of vegetable crops, including eggplant (Solanum melongena L.). Jasmonic acid (JA) plays key roles in regulating resistance to biotic and abiotic stresses in plants. Nonetheless, reports on the role of JA in heat tolerance in eggplant are rare. Herein, the effects of JA on heat tolerance in eggplant and the functions of the JA biosynthetic genes SmLOX4 and SmLOX5 were analyzed. The results showed that the JA content increased under high-temperature treatment (HTT) and exogenous methyl jasmonate (MeJA) treatment reduced the damage caused by HTT to eggplant. The expression of SmLOX4 and SmLOX5 was induced by HTT and significantly positively correlated with JA biosynthesis. SmLOX4 and SmLOX5 were localized in chloroplasts. The silencing of SmLOX4 and SmLOX5 by virus-induced gene silencing suppressed the heat tolerance of eggplant, whereas the overexpression of SmLOX4 and SmLOX5 enhanced the heat tolerance of Arabidopsis thaliana. JA content and the expression of JA signaling–related genes decreased in the SmLOX4- and SmLOX5-silenced plants but increased in the OE-SmLOX4 and OE-SmLOX5 transgenic plants. These results revealed that SmLOX4 and SmLOX5 improved eggplant heat tolerance by mediating JA biosynthesis and JA signaling pathways.
Unlocking the mystery of heterosis opens the era of intelligent rice breeding
Authors: Gu Zhoulin , Han Bin
Published: August 2024

Heterosis refers to the phenomenon where the first filial offspring (F1) from genetically diverse parents displays advantages in growth rate, yield, and adaptability compared with its parents. The exploitation of heterosis in rice breeding has greatly increased the productivity, making a significant contribution to food security in the last half of the century. Conventional hybrid rice breeding highly relies on the breeder's experience on random crossing and comprehensive field selection. This process is time-consuming and labor-intensive. In recent years, rice hybrid breeding has encountered challenges stemming from limited germplasm resource, low breeding efficiency, and high uncertainty, which constrain the progress in yield increase, coupled with difficulties in balancing grain yield, quality, and resistance. Understanding the genetic basis of rice heterosis could lead to significant advancements in breeding concepts and methods. This will fully unleash the advantages of heterosis. In this review, we focus on the research progress of the genetic dissection of crop heterosis and briefly introduce some key advancements in modern intelligent breeding of rice hybrid.
Analytic and Numerical Approaches for Depictive 3-Loop Integrals Using Sector Decomposition
Authors: de Doncker Elise , Ishikawa Tadashi , Kato Kiyoshi , Yuasa Fukuko
Published: August 2024

Four 3-loop two-point functions are studied analytically and numerically using a simplified sector decomposition method. The coefficients of the ultraviolet divergent part are determined analytically, and those of the finite part are computed numerically. The energy dependence of the integrals is shown explicitly, and a discussion of its behavior is presented.
Validation of HAND OA US inflammatory and structural damage score (HOUSE) for thumb-base joints: systematic review on truth and discrimination
Authors: Kortekaas Marion C , Vanhaverbeke Tine , Keen Helen I , Terslev Lene , Hammer Hilde B , D’Agostino Maria Antonietta , Wittoek Ruth ,   OMERACT Hand OA US Working Group, Möller Ingrid , Mathiessen Alexander , Berghea Florian , Madsen Norman , Vreju Florentin , Porta Francesco , Filippou Georgios , De Lucia Orazio , Sirotti Silvia
Published: August 2024

Objectives

Recently, the HAND OA US Examination (HOUSE) inflammatory and structural damage scores were developed by the OMERACT US Working Group. However, the thumb base was not, or was only partly, included. This systematic review examines US scoring methods and scanning techniques assessing thumb-base OA, alongside existing evidence on validity, reliability and responsiveness.

Methods

A comprehensive search strategy in three different databases identified 30 eligible studies.

Results

In general, studies predominantly focused on US assessment of the CMC1 joint, with fewer investigating the scaphotrapeziotrapezoid (STT) joint. Most studies utilized a semiquantitative scale for scoring structural and inflammatory features, aligning with the HOUSE scoring system. Validity was supported by a limited number of studies, with one demonstrating a positive association between US structural damage and radiographic damage, and another showing a similar association with function. Associations between US inflammatory features and pain were observed, albeit with some variability. Reliability was from moderate to good for the CMC1 joint but limited for the STT joint. Responsiveness varied across studies. The methodological quality of included studies varied, indicating areas for future research improvement.

Conclusion

While promising, additional research is necessary to validate the HOUSE scoring system and improve its clinical utility for thumb-base OA assessment. Future research should concentrate on optimal scanning positions and on the reliability and responsiveness of the HOUSE scoring system.
The Association Between Trajectories of Self-reported Psychotic Experiences and Continuity of Mental Health Care in a Longitudinal Cohort of Adolescents and Young Adults
Authors: Gerritsen Suzanne E , Bolhuis Koen , van Bodegom Larissa S , Maras Athanasios , Overbeek Mathilde M , van Amelsvoort Therese A M J , Wolke Dieter , de Girolamo Giovanni , Franić Tomislav , Madan Jason , McNicholas Fiona , Paul Moli , Purper-Ouakil Diane , Santosh Paramala , Schulze Ulrike M E , Singh Swaran P , Street Cathy , Tremmery Sabine , Tuomainen Helena , Dieleman Gwen C , Mesman Esther
Published: August 2024

Background and Hypothesis

Young people (YP) with psychotic experiences (PE) have an increased risk of developing a psychiatric disorder. Therefore, knowledge on continuity of care from child and adolescent (CAMHS) to adult mental health services (AMHS) in relation to PE is important. Here, we investigated whether the self-reported trajectories of persistent PE were associated with likelihood of transition to AMHS and mental health outcomes.

Study Design

In this prospective cohort study, interviews and questionnaires were used to assess PE, mental health, and service use in 763 child and adolescent mental health service users reaching their service’s upper age limit in 8 European countries. Trajectories of self-reported PE (3 items) from baseline to 24-month follow-up were determined using growth mixture modeling (GMM). Associations were assessed with auxiliary variables and using mixed models. Study results. At baseline, 56.7% of YP reported PE. GMM identified 5 trajectories over 24 months: medium increasing (5.2%), medium stable (11.7%), medium decreasing (6.5%), high decreasing (4.2%), and low stable (72.4%). PE trajectories were not associated with continuity of specialist care or transition to AMHS. Overall, YP with PE reported more mental health problems at baseline. Persistence of PE or an increase was associated with poorer outcomes at follow-up.

Conclusions

PE are common among CAMHS users when reaching the upper age limit of CAMHS. Persistence or an increase of PE was associated with poorer mental health outcomes, poorer prognosis, and impaired functioning, but were less discriminative for continuity of care.
Sleep disturbances across 2 weeks predict future mental healthcare utilization
Authors: Slavish Danica C , Ruggero Camilo J , Luft Benjamin , Kotov Roman
Published: August 2024

Study Objectives

Insufficient sleep costs the US economy over $411 billion per year. However, most studies investigating the economic costs of sleep rely on one-time measures of sleep, which may be prone to recall bias and cannot capture variability in sleep. To address these gaps, we examined how sleep metrics captured from daily sleep diaries predicted medical expenditures.

Methods

Participants were 391 World Trade Center (WTC) responders enrolled in the WTC Health Program (mean age = 54.97 years, 89% men). At baseline, participants completed 14 days of self-reported sleep and stress measures. Mean sleep, variability in sleep, and a novel measure of sleep reactivity (i.e. how much people’s sleep changes in response to daily stress) were used to predict the subsequent year’s medical expenditures, covarying for age, race/ethnicity, sex, medical diagnoses, and body mass index.

Results

Mean sleep efficiency did not predict mental healthcare utilization. However, greater sleep efficiency reactivity to stress (b = $191.75, p = .027), sleep duration reactivity to stress (b = $206.33, p = .040), variability in sleep efficiency (b = $339.33, p = .002), variability in sleep duration (b = $260.87, p = .004), and quadratic mean sleep duration (b = $182.37, p = .001) all predicted greater mental healthcare expenditures. Together, these sleep variables explained 12% of the unique variance in mental healthcare expenditures. No sleep variables were significantly associated with physical healthcare expenditures.

Conclusions

People with more irregular sleep, more sleep reactivity, and either short or long sleep engage in more mental healthcare utilization. It may be important to address these individuals’ sleep problems to improve mental health and reduce healthcare costs.
A novel long noncoding RNA AK029592 contributes to thermogenic adipocyte differentiation
Authors: Hong Pengyu , Wang Dianri , Wu Yue , Zhang Qi , Liu Pan , Pan Jian , Yu Mei , Tian Weidong
Published: August 2024

Exploration of factors originating from brown adipose tissue that govern the thermogenic adipocyte differentiation is imperative for comprehending the regulatory framework underlying brown fat biogenesis and for devising therapeutic approaches for metabolic disorders associated with obesity. Prior evidence has illuminated the pivotal role of long noncoding RNAs (lncRNAs) in orchestrating thermogenesis within adipose tissue. Here, we aimed to explore and identify the critical lncRNA that could promote thermogenic adipocyte differentiation and to provide a novel strategy to treat obesity-related metabolic diseases in the future. In this study, through amalgamation with our previous lncRNA microarray data from small extracellular vesicles derived from BAT (sEV-BAT), we have identified sEV-BAT-enriched lncRNA AK029592 as a critical constituent of the thermogenic program, which actively fostered beige adipocyte differentiation and enhanced the thermogenic capacities of adipose tissue. Moreover, lncRNA AK029592 could sponge miR-199a-5p in adipocytes to stimulate thermogenic gene expression. Consequently, we concluded lncRNA AK029592 as a crucial lncRNA component of the thermogenic program that regulated beige adipocyte differentiation and white adipose tissue browning, thereby providing a novel therapeutic target and strategy in combating obesity and related metabolic diseases.
An Engineered Citrus Tristeza Virus (T36CA)-Based Vector Induces Gene-Specific RNA Silencing and Is Graft Transmissible to Commercial Citrus Varieties
Authors: Krueger Robert R. , Chen Angel Y. S. , Zhou Jaclyn S. , Liu Si , Xu Huaying Karen , Ng James C. K.
Published: August 2024

A protein-expressing citrus tristeza virus-based vector construct, pT36CA-V1.3, obtained from a California isolate of the T36 strain (T36CA), was retooled into a virus-induced gene silencing system intended for use with studies of California citrus. Virus-induced gene silencing constructs engineered with a truncated Citrus macrophylla PHYTOENE DESATURASE ( CmPDS) gene sequence in the sense or antisense orientation worked equally well to silence the endogenous CmPDS gene. In a parallel effort to optimize vector performance, two nonsynonymous nucleotides in open reading frame 1a of pT36CA-V1.3 were replaced with those conserved in the reference sequences from the T36CA cDNA library. The resulting viruses, T36CA-V1.4 (with one amino acid modification: D760N) and T36CA-V1.5 (with two amino acid modifications: D760N and P1174L), along with T36CA-V1.3, were individually propagated in Nicotiana benthamiana and C. macrophylla plants. Enzyme-linked immunosorbent assay (ELISA) measurements of extracts of the newly emerged leaves suggested that all three viruses accumulated to similar levels in N. benthamiana plants at 5 weeks postinoculation. ELISA values of T36CA-V1.4- and -V1.5-infected C. macrophylla samples were significantly higher than that of T36CA-V1.3-infected samples within an 8- to 12-month postinoculation window, suggesting a higher accumulation of T36CA-V1.4 and -V1.5 than T36CA-V1.3. However, at 36 months postinoculation, the ELISA values suggested that all three viruses accumulated to similar levels. When C. macrophylla plants infected with each of the three viruses were grafted to commercial citrus varieties, a limited number of receptor plants became infected, demonstrating a weak but nonetheless (the first) successful delivery of T36CA to California-grown commercial citrus.
CORRECTION OF TRAUMA-INDUCED COAGULOPATHY BY GOAL DIRECTED THERAPY
Authors: Lindsay Charlotte , Davenport Ross , Baksaas-Aasen Kjersti , Kolstadbråten Knut Magne , Naess Pål Aksel , Curry Nicola , Maegele Marc , Juffermans Nicole , Stanworth Simon , Stensballe Jakob , Johansson Per Ingemar , Gaarder Christine , Brohi Karim
Published: August 2024

BACKGROUND:

Trauma hemorrhage induces a coagulopathy with a high associated mortality rate. The Implementing Treatment Algorithms for the Correction of Trauma Induced Coagulopathy (ITACTIC) randomized trial tested two goal-directed treatment algorithms for coagulation management, one guided by conventional coagulation tests and one by viscoelastic hemostatic assays (viscoelastic). The lack of a difference in 28-day mortality led us to hypothesize that coagulopathic patients received insufficient treatment to correct coagulopathy.

METHODS:

During ITACTIC, two sites were co-enrolling patients into an ongoing prospective observational study, which included serial blood sampling at the same intervals as in ITACTIC. The subgroup in both studies had conventional and viscoelastic test results for each patient available for analysis. A goal-directed treatment was defined as one triggered by an ITACTIC algorithm. Coagulopathy was defined as ROTEM EXTEM A5 <40mm. The primary outcome was correction of coagulopathy by the 12th unit of red blood cell transfusion during resuscitation.

RESULTS:

Full viscoelastic and conventional coagulation test results were available for 133 patients. 71% were coagulopathic on admission, and 16% developed a coagulopathy during resuscitation. ITACTIC VHA group patients were more likely to receive goal-directed treatment than the standard group (76% vs 47%, OR 3.73, 95%CI:1.64–8.49, p=0.002). However, only 54% of patients received goal-directed treatment, and only 20% corrected their coagulopathy (vs 0% with empiric treatment alone, not significant). Median time to first goal-directed treatment was 68(53-88) minutes for viscoelastic and 110(77-123) minutes for standard, p=0.005.

CONCLUSION:

In ITACTIC, many bleeding trauma patients did not receive an indicated goal-direct treatment. Interventions arrived late during resuscitation and were only partially effective at correcting coagulopathy.
Advances in the diagnosis of multiorgan involvement in systemic sclerosis: a focus on MRI
Authors: Feher Attila , Del Galdo Francesco , Plein Sven
Published: August 2024

Purpose of review

Systemic sclerosis (SSc) is a rare chronic multisystem autoimmune disease characterized by endothelial dysfunction, tissue hypoxia, and diffuse organ fibrosis. MRI provides a radiation free approach to noninvasively assess the key manifestations of SSc in multiple organs. The purpose of this review is to summarize recent advances in MRI techniques to provide diagnostic and prognostic information in patients with SSc.

Recent findings

MRI can probe processes that play a key role in the development of SSc-related complications, including neointima proliferation, fibrosis, and hypoxia. Feature tracking and parametric mapping MRI can detect cardiac involvement at the subclinical level. Contrast-free MRI angiography with Digital Artery Volume Index (DAVIX) assessment allow comprehensive assessment of hand involvement. T1 mapping and BOLD imaging can assess SSc effects on skeletal muscle, and lung MRI is becoming a key method for imaging of interstitial lung disease. As a new exciting application, the sodium content of the skin can be quantified by 23Na MRI reflective of glycosaminoglycan content.

Recent advances in MRI provide a unique opportunity to study the key pathophysiologic processes and clinical manifestations of SSc in multiple organs noninvasively, which can pave the way for the development of effective therapies.
Oxidative stress in diabetes mellitus and its complications: From pathophysiology to therapeutic strategies
Authors: Chen Xingyu , Xie Na , Feng Lixiang , Huang Yujing , Wu Yuyao , Zhu Huili , Tang Jing , Zhang Yuanyuan
Published: August 2024

Oxidative stress due to aberrant metabolism is considered as a crucial contributor to diabetes and its complications. Hyperglycemia and hyperlipemia boost excessive reactive oxygen species generation by elevated mitochondrial respiration, increased nicotinamide adenine dinucleotide phosphate oxidase activity, and enhanced pro-oxidative processes, including protein kinase C pathways, hexosamine, polyol, and advanced glycation endproducts, which exacerbate oxidative stress. Oxidative stress plays a significant role in the onset of diabetes and its associated complications by impairing insulin production, increasing insulin resistance, maintaining hyperglycemic memory, and inducing systemic inflammation. A more profound comprehension of the molecular processes that link oxidative stress to diabetes is crucial to new preventive and therapeutic strategies. Therefore, this review discusses the mechanisms underlying how oxidative stress contributes to diabetes mellitus and its complications. We also summarize the current approaches for prevention and treatment by targeting the oxidative stress pathways in diabetes.
Transperineal anastomotic urethroplasty with distal transection versus proximal transection: How to predict?
Authors: Wang Lin , Song Wenxiong , Chen Gong , Li Zuowei , Lyu Rong , Jin Chongrui , Ye Xuxiao , Liu Yidong , Sa Yinglong , Lyu Xiangguo
Published: August 2024

Objectives

To evaluate the pubourethral stump angle (PUA) to determine the site of urethral transection during transperineal anastomotic urethroplasty (TAU).

Patients and methods

Patients diagnosed with pelvic fracture urethral distraction defect who underwent preoperative magnetic resonance (MR) urethrography and were treated with TAU between June 2019 and December 2021 were retrospectively reviewed. According to the site of urethral transection during TAU, patients were classified into proximal and distal groups receiving TAU with proximal and distal transection, respectively. The demographic and clinical data were recorded. The PUA was measured on sagittal T2-weighted MR urethrography. The relationship between the site of urethral transection and PUA was analyzed.

Results

Sixty-seven patients were included. Forty-one and 26 patients were included in the proximal and distal groups, respectively. Finally, the success rates in the proximal and distal groups were 95.1% and 92.3%, respectively. The PUAs were 123.7° ± 14.6° and 86.5° ± 9.8° (p = 0.005), respectively. The curves for the 2 groups intersected between 90° and 110°. The scribing effects at 90°, 100°, and 110° in the 2 groups were compared in detail. Compared with 90° and 110°, 100° had the highest sensitivity as the demarcation line.

Conclusions

In the treatment of pelvic fracture urethral distraction defect, the PUA on MR urethrography is an objective and valid parameter for evaluating the site of urethral transection during TAU. A PUA >100° indicates that proximal transection should be preferentially attempted.
The Efficacy of INa Block to Cardiovert Atrial Fibrillation Is Enhanced by Inhibition of IK1
Authors: Burashnikov Alexander , Antzelevitch Charles
Published: August 2024

There is a need for more efficient pharmacological cardioversion of atrial fibrillation (AF). We tested the hypothesis that inhibition of IK1 significantly enhances the efficacy of INa block to depress atrial excitability and to cardiovert AF. The study was conducted in canine isolated arterially perfused right atrial preparations with rim of ventricular tissue. AF was induced in the presence of acetylcholine (ACh; 0.5 µM). BaCl2 (10 µM) was used to inhibit IK1 and flecainide (1.5 µM) to block INa. Sustained AF (>45 minutes) was recorded in 100% atria (5/5) in the presence of ACh alone. Flecainide cardioverted AF in 50% of atria (4/8), BaCl2 in 0% (0/5), and their combination in 100% (5/5). AF cardioversion occurred in 15 ± 9 minutes with flecainide alone (n = 4) and in 8 ± 9 minutes with the combination (n = 5). Following drug-induced AF cardioversion, AF was inducible in 4/4 atria with flecainide alone (≤5 minutes duration) and in 2/5 atria with the combination (≤30 seconds duration). Atrial excitability was significantly more depressed by combined versus monotherapies. There was little to no effect on ventricular excitability under any condition tested. Thus, inhibition of IK1 significantly enhances the efficacy of flecainide to depress atrial excitability and to cardiovert AF in our experimental setting. A combination of INa and IK1 inhibition may be an effective approach for cardioversion of AF.
SUB RETINAL PIGMENT EPITHELIUM HYPOREFLECTIVE SPACES PRECEDING LARGE DRUSEN COLLAPSE
Authors: Bousquet Elodie , Abraham Neda , Estawro Rania , Khadka Simanta , Voichanski Shilo , Mafi Mostafa , Au Adrian , Santina Ahmad , Sadda SriniVas , Sarraf David
Published: August 2024

Purpose:

To describe and study hyporeflective subretinal pigment epithelium (RPE) spaces in large drusen and drusenoid pigment epithelial detachment before collapse.

Method:

Retrospective longitudinal study enrolled patients with large and very large drusen caused by intermediate age-related macular degeneration. The following optical coherence tomography parameters were assessed: drusen size (maximum width and height), optical coherence tomography biomarkers of RPE atrophy, presence of intraretinal and subretinal fluid, acquired vitelliform lesion, and sub-RPE regions of hyporeflectivity within the pigment epithelial detachment compartment.

Results:

Of the 50 eyes from 41 patients (mean age 77.1 ± 9 years, 78% women) with large and very large drusen, 16 eyes progressed to collapse. Eyes with sub-RPE hyporeflective spaces (n = 8 eyes, 50%) were associated with greater drusen width and height than those without sub-RPE hyporeflective spaces. At the collapse visit, eyes with sub-RPE hyporeflective spaces displayed poorer visual acuity and greater incomplete RPE and outer retinal atrophy and complete RPE and outer retinal atrophy length than eyes without sub-RPE hyporeflective spaces (P = 0.004 and P = 0.04, respectively).

Conclusion:

Sub-RPE hyporeflective spaces are a novel optical coherence tomography finding of large and very large drusen that collapse to atrophy. Progressive RPE dysfunction and failure may lead to reduced drusenoid material formation and progressive degenerative hydration of the large drusen before collapse, but this awaits confirmation with histopathological analysis.
Review and analysis of history and utilization of panretinal photocoagulation and ranibizumab after publication of protocol S
Authors: Shah Serena , Chou Brandon , Patel Marissa , Watane Arjun , Shah Lea , Yannuzzi Nicolas , Sridhar Jayanth
Published: August 2024

Purpose of review

We describe the history, utilization, and series results of panretinal photocoagulation (PRP) and ranibizumab and provide an analysis of PRP and ranibizumab usage before versus after the publication of the 2-year and 5-year results of the Diabetic Retinopathy Clinical Research Network (DRCR.net) Protocol S trial.

Recent findings

Number of ranibizumabs performed began to increase and number of PRPs performed began to decrease in 2016. After publication of the 2-year results, there was significant negative trend in PRP services and significant positive trend in ranibizumab services (both P < 0.001). After publication of the 5-year results, there was significant negative trend in PRP services (P = 0.003). There were significant negative trends (all P < 0.001) in reimbursement factors for PRP from 2013 to 2020: average work RVU (wRVU), nonfacility physical expense RVU, facility PE RVU, malpractice RVU (MP RVU).

Both PRP and ranibizumab have undergone numerous trials comparing their efficacy to other treatment options or no treatment at all. The publication of the 2-year results of Protocol S was associated with an increase in utilization of ranibizumab and decrease in utilization of PRP, with continued decrease after the publication of the 5-year results.
Dermatologic implications of COVID-19 infection and immunization: hair loss
Authors: Bielecki Nicole
Published: August 2024

The purpose of this article is to review the treatment of COVID-19 virus infection and immunization-induced alopecia. Hair loss has long been considered cosmetic, oftentimes self-limiting or as a result of the natural aging process. Identifying different contributing factors, being aware of COVID-19–induced hair loss, and treating these patients early will improve outcomes and further educate clinicians on the nature of the disease. The PubMed database was used with search terms including “COVID-19,” “hair loss,” “COVID-19 and dermatologic implications,” “alopecia,” “alopecia areata,” “COVID-19 infection,” “immunization,” “vaccine,” and “telogen effluvium.” Filters with parameters were set for <5 years after publication and systematic reviews, which resulted in 40 results. Medical subject headings (MeSH) terms that were used included “alopecia/complications,” “SARS-CoV-2,” “COVID-19 prevention/control.” Studies have shown that there are psychological implications of hair loss, which has led to the study of trichopsychodermatology. Additional research is needed to determine whether COVID-19–induced alopecia is caused by the associated physical and emotional stress, the viral illness itself, medications used for treatment of COVID-19 virus infection, or associated nutritional deficiencies.
Shape-sensing Robotic-assisted Bronchoscopy (SS-RAB) in Sampling Peripheral Pulmonary Nodules
Authors: Xie Fangfang , Zhang Quncheng , Mu Chuanyong , Zhang Qin , Yang Huizhen , Mao Jingyu , Simoff Michael J. , Huang Jian’an , Zhang Xiaoju , Sun Jiayuan
Published: August 2024

Background:

The ION system is a shape-sensing robotic-assisted bronchoscopy (SS-RAB) platform developed to biopsy peripheral pulmonary nodules (PPNs). There is a lack of data describing the use of this system in the Chinese population. The study aimed to assess the feasibility and safety of using SS-RAB to diagnose PPNs across multiple centers within China.

Methods:

This prospective, multicenter study used SS-RAB in consecutive patients with solid or sub-solid PPNs 8 to 30 mm in largest diameter. Primary endpoints were diagnostic yield and the rates of procedure- or device-related complications. Radial endobronchial ultrasound (rEBUS) was to confirm lesion localization, followed by sampling, using the Flexision biopsy needle, biopsy forceps, and cytology brush. Subjects with nonmalignant index biopsy results were followed up to 6 months.

Results:

A total of 90 PPNs were biopsied from 90 subjects across 3 centers using SS-RAB. The median nodule size was 19.4 mm (IQR: 19.3, 24.6) in the largest dimension. In all (100%) cases, the catheter successfully reached the target nodule with tissue samples obtained. The diagnostic yield was 87.8% with a sensitivity for malignancy of 87.7% (71/81). In a univariate analysis, nodule lobar location, presence of bronchus sign, and rEBUS view were associated with a diagnostic sample, but only rEBUS view showed an association in a multivariate analysis. The overall pneumothorax rate was 1.1% without pneumothorax requiring intervention, and there was no periprocedural bleeding.

Conclusion:

As an emerging technology in the Chinese population, SS-RAB can safely biopsy PPNs with strong diagnostic performance.
Successful Extracorporeal Cardiopulmonary Resuscitation Despite Aortic Occlusion
Authors: Becker Torben K. , Bruno John , Jeng Eric I. , Phillips Jordan , Smith Taylor N. , Roberts David L. , Carr Casey T. , Cooper Michol A. , Back Martin R. , Anderson R. David , Maybauer Marc O.
Published: August 2024

We present the case of a 62-year-old man with severe coronary artery disease who presented to the hospital in refractory ventricular fibrillation cardiac arrest. He showed signs of life despite prolonged resuscitation. We thus decided to initiate extracorporeal cardiopulmonary resuscitation (ECPR). The patient had a known total occlusion of his infrarenal aorta that had been surgically bypassed with a bifemoral-axillary graft. We successfully initiated ECPR via the surgical graft, establishing blood flow to the central circulation through the axillary artery in a peripheral configuration while ensuring blood flow to the left leg via the femoral-femoral graft. The patient was extubated neurologically intact the following day and subsequently underwent coronary artery bypass graft surgery while on extracorporeal membrane oxygenation (ECMO) support. He was subsequently weaned off inotropic support and decannulated from ECMO. He was discharged home neurologically intact and independent in his activities of daily living. This case demonstrates that cannulation for ECPR via a surgical vascular graft is possible and that a total occlusion of the infrarenal aorta in the presence of a surgical bypass is not an absolute contraindication to ECMO.
Heparin pretreatment in ST segment elevation myocardial infarction: a systematic review and meta-analysis
Authors: Costa Gonçalo , Resende Bernardo , Oliveiros Bárbara , Gonçalves Lino , Teixeira Rogério
Published: August 2024

Background:

Unfractionated heparin (UFH) is frequently administered before percutaneous coronary intervention in patients with ST segment elevation myocardial infarction (STEMI). Current guidelines, however, do not provide clear recommendations for UFH pretreatment before arrival at the coronary catheterization laboratory.

Methods

Between June and July 2023, we systematically searched PubMed, Embase, and Cochrane databases for studies comparing UFH pretreatments in patients with STEMI. A random-effects meta-analysis and meta-regression analyses were performed.

Results

Fourteen studies were included, of which four were randomized clinical trials. A total of 76 446 patients were included: 31 238 in the pretreatment group and 39 208 in the control group. Our meta-analysis revealed lower all-cause mortality for the pretreatment strategy when compared with the control group, albeit with high heterogeneity [pooled odds ratio (OR) = 0.61, 95% confidence interval (CI): 0.49–0.76, P < 0.01; I
2 = 77%]; lower in-hospital cardiogenic shock (pooled OR = 0.68, 95% CI: 0.58–0.78, P < 0.21; I
2 = 27%) and a higher rate of spontaneous reperfusion events (pooled OR = 1.68, 95% CI: 1.47–1.91, P < 0.01; I
2 = 79%). In terms of major bleeding, the UFH pretreatment strategy further revealed a decreased rate of events (pooled OR = 0.85, 95% CI: 0.73–0.99, P = 0.40; I
2 = 4%).

Conclusion

Our study suggests that UFH pretreatment in patients with STEMI undergoing primary percutaneous coronary intervention was associated with reduced all-cause mortality, cardiogenic shock, enhancing reperfusion rates while diminishing major bleeding events.
Exploring the role of dreams: insights from recent studies
Authors: Scarpelli Serena , Alfonsi Valentina , De Gennaro Luigi
Published: August 2024

Purpose of review

Dreaming has only recently become a topic of scientific research. This review updates current findings on dream studies, emphasizing recent research on the neural mechanisms of dreaming. Additionally, it summarizes new evidence on the functional role of dreams, including insights from studies on dreams and nightmares during the coronavirus disease 2019 (COVID-19) pandemic.

Recent findings

Recent advances on the neural basis of mental activity during sleep have shifted towards dream-related phenomena, such as dream experiences in relation to parasomnias and hypnagogic hallucinations. Although some findings are consistent with the main models explaining dream recall (i.e., continuity hypothesis; activation hypothesis), some results contrast with the role of parieto-occipital region in dream experience. Moreover, recent findings – related to COVID-19 pandemic – underlined that dream experiences could express emotion regulation processes as well as provide a simulation of reality to prepare for future dangerous or social interactions.

Overall, we highlighted the intricate interplay between brain regions in dreaming and suggest that dreams serve multiple functions, from reflecting waking-life experiences to simulating adaptive responses to threats. Understanding the neural bases and functions of dreaming can provide valuable insights into human mental health, nevertheless, further research is needed.
Prognostic value of 18F-FDG PET/CT in postoperative recurrence of retroperitoneal liposarcoma: a single-center retrospective study
Authors: Lang Juntao , Liu Wenshuai , Liu Guobing , Liu Siwei , Zhang Yiqiu
Published: August 2024

Objective

Recurrence is the leading cause of tumor-related death in retroperitoneal liposarcoma (RPLPS). Variant subtypes of RPLPS determine different recurrence 18F]-fluoro-2-deoxy-D-glucose (18F-FDG) PET/computed tomography (PET/CT). This study analyzed the characteristics of different histologic subtypes of 18F-FDG PET/CT and their associations with recurrence and prognosis.

Methods

Clinical-pathological information, 18F-FDG PET/CT data, recurrence, and progression-free survivals (PFS) of 83 patients with RPLPS were collected. Maximum and peak standardized uptake values (SUVmax and SUVpeak, respectively) and mean CT value (CTmean) of tumors were measured and correlated with histologic subtype. Receiver operating characteristics (ROC) curves were used to analyze the predictability for subtype and recurrence. Kaplan-Meier analysis examined SUVmax and SUVpeak as recurrence risk factors.

Results

Studied patients with different types of liposarcomas. Dedifferentiated liposarcomas (DDLPS) had higher SUVmax and SUVpeak than well-differentiated (WDLPS) and myxoid/round cell (MLPS) types. WDLPS had lower CTmean values compared to MLPS and DDLPS. Using ROC curves, determined cut-off values for SUVmax (5.1) to differentiate DDLPS, SUVpeak (3.0) for WDLPS, and CTmean (12.3 Hu) for WDLPS. These cut-offs were found to be best for predicting recurrence. Kaplan–Meier analysis showed that histologic subtype, SUVmax, and SUVpeak were all linked to recurrence-free survival.

Conclusions

The use of SUV and CT features on 18F-FDG PET/CT imaging may increase confidence in subtype diagnosis. Patients with SUVmax > 5.1 or SUVpeak > 3.0 suggest a poor prognosis.
Impact of Preoperative Time Intervals for Neoadjuvant Chemoradiotherapy on Short-term Postoperative Outcomes of Esophageal Cancer Surgery
Authors: Wang Jingpu , de Jongh Cas , Wu Zhouqiao , de Groot Eline M. , Challine Alexandre , Markar Sheraz R. , Brenkman Hylke J.F. , Ruurda Jelle P. , van Hillegersberg Richard ,   on behalf of the Dutch Upper Gastrointestinal Cancer Audit (DUCA) group
Published: August 2024

Objective:

To clarify the impact of the preoperative time intervals on short-term postoperative and pathologic outcomes in patients with esophageal cancer who underwent neoadjuvant chemoradiotherapy (nCRT) followed by esophagectomy.

Background:

The impact of preoperative intervals on patients with esophageal cancer who received multimodality treatment remains unknown.

Methods:

Patients (cT1-4aN0-3M0) treated with nCRT plus esophagectomy were included using the Dutch national DUCA database. Multivariate logistic regression was used to determine the effect of different time intervals upon short-term postoperative and pathologic outcomes: diagnosis-to-nCRT intervals (≤5, 5–8, and 8–12 weeks), nCRT-to-surgery intervals (5–11, 11–17, and >17 weeks) and total preoperative intervals (≤16, 16–25, and >25 weeks).

Results:

Between 2010 and 2021, a total of 5052 patients were included. Compared with diagnosis-to-nCRT interval ≤5 weeks, the interval of 8 to 12 weeks was associated with a higher risk of overall complications (P=0.049). Compared with nCRT-to-surgery interval of 5 to 11 weeks, the longer intervals (11–17 and >17 weeks) were associated with a higher risk of overall complications (P=0.016; P<0.001) and anastomotic leakage (P=0.004; P=0.030), but the interval >17 weeks was associated with lower risk of ypN+ (P=0.021). The longer total preoperative intervals were not associated with the risk of 30-day mortality and complications compared with the interval ≤16 weeks, but the longer total preoperative interval (>25 weeks) was associated with higher ypT stage (P=0.010) and lower pathologic complete response rate (P=0.013).

Conclusions:

In patients with esophageal cancer undergoing nCRT and esophagectomy, prolonged preoperative time intervals may lead to higher morbidity and disease progression, and the causal relationship requires further confirmation.
Quantitative Analysis of Factors of Attrition in a Double-blind rTMS Study for Alzheimer Treatment
Authors: Bretecher Carly A. , Verot Ashley , Teschuk James M. , Uehara Maria A. , Fitzgerald Paul B. , Koski Lisa , Lithgow Brian J. , Moussavi Zahra
Published: August 2024

Attrition is a particular concern in studies examining the efficacy of a treatment for Alzheimer disease. Analyzing reasons for withdrawal in Alzheimer studies is crucial to ruling out attrition bias, which can undermine a study’s validity. In contrast, attrition in studies using repetitive transcranial magnetic stimulation (rTMS) has received much less attention. Our goal was to identify any commonalities between participants who withdrew for the same reasons. Three independent coders rated each response concerning the reasons for withdrawal, and frequency tables were generated to characterize the participants within each category. This study was conducted on the 28 withdrawn cases from a 7-month study investigating the short-term and long-term therapeutic effects of rTMS for Alzheimer disease among 156 participants across 3 sites of the study. Seven reasons for withdrawal were identified, with health and medical changes being the most commonly reported reason (7 participants). Personal issues involving family or caregivers were the next most common (5 participants), and the remaining 5 categories consisted of 3 participants each. Although the limited sample size prevented the use of inferential statistics, our findings highlight the need for more transparent reporting of attrition rates and withdrawal reasons by rTMS researchers.
People, places, things and communities: expanding behaviour settings theory in the twenty-first century
Authors: McGann Marek , Lucas Miranda , McHugh Cillian , Barrett Louise
Published: August 2024

Trends and developments in recent behavioural and cognitive sciences demonstrate the need for a well-developed theoretical and empirical framework for examining the ecology of human behaviour. The increasing recognition of the role of the environment and interaction with the environment in the organization of behaviour within the cognitive sciences has not been met with an equally disciplined and systematic account of that environment (Heft 2018
Ecol. Psychol
.
30
, 99–123 (doi:
10.1080/10407413.2018.1410045
); McGann 2014
Synth. Philos.
29
, 217–233). Several bodies of work in behavioural ecology, anthropology and ecological psychology provide some frameworks for such an account. At present, however, the most systematic and theoretically disciplined account of the human behavioural ecosystem is that of behaviour settings, as developed by the researchers of the Midwest Psychological Field Station (see Barker 1968
Ecological psychology: concepts and methods for studying the environment of human behavior
). The articles in this theme issue provide a critical examination of these theoretical and methodological resources. The collection addresses their theoretical value in connecting with contemporary issues in cognitive science and research practice in psychology, as well as the importance of the methodological specifics of behaviour settings research. Additionally, articles diagnose limitations and identify points of potential extension of both theory and methods, particularly with regard to changes owing to the advance of technology, and the complex relationship between the individual and the collective in behaviour settings work.

This article is part of the theme issue ‘People, places, things, and communities: expanding behaviour settings theory in the twenty-first century’.