bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical characteristics of rheumatoid arthritis patients complicated with pulmonary nontuberculous mycobacterial disease: A cross-sectional case series study
Authors: Nakayama Yoichi , Tanaka Eisaku , Ueyama Masakuni , Terada Satoru , Inao Takashi , Kaji Yusuke , Yasuda Takehiro , Hashimoto Seishu , Hajiro Takashi , Hatta Kazuhiro , Noma Satoshi , Taguchi Yoshio
Published: October 2022

Objectives

Pulmonary nontuberculous mycobacterial disease (pNTM) is a common pulmonary complication of rheumatoid arthritis (RA), but their association has rarely been researched. We aimed to reveal the clinical characteristics of RA with pNTM.

Methods

Among all the RA patients who visited Tenri hospital from April 2017 to March 2018, we enrolled those fulfilling the 2007 ATS/IDSA diagnostic criteria of pNTM, and sex- and age- matched control group at a ratio of 1:5. Demographic characteristics were compared between the two groups.

Results

Among 865 RA patients, 35 (4.0%) patients were complicated with pNTM. RA patients with pNTM had significantly lower BMI and higher rheumatoid factor (RF) and anti-citrullinated protein antibody (ACPA) positivity. Bronchiectasis was the most frequent lesion, followed by clusters of small nodules, patchy consolidation and cavity. Multivariable logistic regression analysis revealed bronchiectasis as a strong independent associated factor of pNTM. Treatment for pNTM was needed in 14 of the 35 (40%) RA patients with pNTM and sputum negative conversion was accomplished in 11 of the 14 cases (78.6%).

Conclusions

RA patients with lower BMI, RF/ACPA positivity, and bronchiectasis were associated with pNTM. Treatment for pNTM may attain sputum negative conversion and radiological improvement in patients with RA.
microbioTA: an atlas of the microbiome in multiple disease tissues of Homo sapiens and Mus musculus
Authors: Wang Ping , Zhang Sainan , He Guoyou , Du Meiyu , Qi Changlu , Liu Ruyue , Zhang Siyuan , Cheng Liang , Shi Lei , Zhang Xue
Published: October 2022

microbioTA (http://bio-annotation.cn/microbiota) was constructed to provide a comprehensive, user-friendly resource for the application of microbiome data from diseased tissues, helping users improve their general knowledge and deep understanding of tissue-derived microbes. Various microbes have been found to colonize cancer tissues and play important roles in cancer diagnoses and outcomes, with many studies focusing on developing better cancer-related microbiome data. However, there are currently no independent, comprehensive open resources cataloguing cancer-related microbiome data, which limits the exploration of the relationship between these microbes and cancer progression. Given this, we propose a new strategy to re-align the existing next-generation sequencing data to facilitate the mining of hidden sequence data describing the microbiome to maximize available resources. To this end, we collected 417 publicly available datasets from 25 human and 14 mouse tissues from the Gene Expression Omnibus database and use these to develop a novel pipeline to re-align microbiome sequences facilitating in-depth analyses designed to reveal the microbial profile of various cancer tissues and their healthy controls. microbioTA is a user-friendly online platform which allows users to browse, search, visualize, and download microbial abundance data from various tissues along with corresponding analysis results, aimimg at providing a reference for cancer-related microbiome research.
EURISCO update 2023: the European Search Catalogue for Plant Genetic Resources, a pillar for documentation of genebank material
Authors: Kotni Pragna , van Hintum Theo , Maggioni Lorenzo , Oppermann Markus , Weise Stephan
Published: October 2022

The European Search Catalogue for Plant Genetic Resources (EURISCO) is a central entry point for information on crop plant germplasm accessions from institutions in Europe and beyond. In total, it provides data on more than two million accessions, making an important contribution to unlocking the vast genetic diversity that lies deposited in >400 germplasm collections in 43 countries. EURISCO serves as the reference system for the Plant Genetic Resources Strategy for Europe and represents a significant approach for documenting and making available the world’s agrobiological diversity. EURISCO is well established as a resource in this field and forms the basis for a wide range of research projects. In this paper, we present current developments of EURISCO, which is accessible at http://eurisco.ecpgr.org.
High-throughput screen to identify compounds that prevent or target telomere loss in human cancer cells
Authors: Wilson Chris , Murnane John P
Published: October 2022

Chromosome instability (CIN) is an early step in carcinogenesis that promotes tumor cell progression and resistance to therapy. Using plasmids integrated adjacent to telomeres, we have previously demonstrated that the sensitivity of subtelomeric regions to DNA double-strand breaks (DSBs) contributes to telomere loss and CIN in cancer. A high-throughput screen was created to identify compounds that affect telomere loss due to subtelomeric DSBs introduced by I-SceI endonuclease, as detected by cells expressing green fluorescent protein (GFP). A screen of a library of 1832 biologically-active compounds identified a variety of compounds that increase or decrease the number of GFP-positive cells following activation of I-SceI. A curated screen done in triplicate at various concentrations found that inhibition of classical nonhomologous end joining (C-NHEJ) increased DSB-induced telomere loss, demonstrating that C-NHEJ is functional in subtelomeric regions. Compounds that decreased DSB-induced telomere loss included inhibitors of mTOR, p38 and tankyrase, consistent with our earlier hypothesis that the sensitivity of subtelomeric regions to DSBs is a result of inappropriate resection during repair. Although this assay was also designed to identify compounds that selectively target cells experiencing telomere loss and/or chromosome instability, no compounds of this type were identified in the current screen.
The Social Context
Authors: Berry Stephen R.
Published: October 2022

Evangelicalism emerged in the social context of the first British Empire that connected Great Britain with its American and Caribbean colonies. Neither solely the product of a North American context or the extension of a European one, evangelicalism developed amid transatlantic social and cultural commerce. While Restoration policies diminished older forms of religious dissent, the subsequent Glorious Revolution firmly cemented Protestantism in England and created space for new Protestant alternatives. In terms of the broader political context, evangelicalism arose during the Second Hundred Years War (1689–1815) that repeatedly pitted Protestant Britain against Catholic France and fomented the pan-Protestant solidarity that energized evangelical thought and action. These cycles of warfare greatly expanded Britain’s naval and commercial shipping, which created the mechanism for people, goods, and ideas to traverse the Atlantic more regularly. This free circulation of people and ideas through migration and communication networks brought together the German Pietist, Scottish Presbyterian, New England Puritan, and Anglican Methodist strains, which contributed to the birth of a distinct new Protestant movement. Britain’s shipping power also forcibly transported millions of Africans to its colonies in the eighteenth century, making slavery an inextricable part of the social order and adding a population that would make further contributions to evangelicalism. Britain’s expanded shipping and commercial networks in the context of religiously charged warfare created a social context in which the people and ideas of early evangelicalism could emerge simultaneously on both sides of the North Atlantic.
Sport, Leadership, and Social Responsibility
Authors: Sparvero Emily S. , Chalip Laurence
Published: October 2022

Sport organizations are increasingly using corporate social responsibility (CSR) programs to pursue financial and public relations objectives by addressing social issues. As organizations face pressure to demonstrate CSR bona fides, it has been claimed that sport may be well-positioned to serve as a CSR vehicle. Sport-based CSR research assumes that to be the case, thereby relying on descriptions and advocacy that do not critically examine the intersections between leadership and CSR but that do presuppose or assert positive benefits from CSR. Social and managerial theories have been applied haphazardly, while fundamental theoretical imperatives regarding social agency, market functioning, and human behavior have been overlooked. Those imperatives could help to explain choices for CSR program design and implementation, as well as CSR program effects. Future research can better serve the development of informative and applicable theory by modeling the structure of contingencies, including economic concerns, facing CSR leadership in varied contexts.
Global long-term observations reveal wide geographic divergence in coastal phytoplankton species niches
Authors: Longobardi Lorenzo , Dubroca Laurent , Sarno Diana , Zingone Adriana
Published: October 2022

As a fundamental component for marine ecosystem functioning, phytoplankton require an appraisal of the extent of their adaptive potential to interpret the effects of natural or human-induced changes in marine habitats. To this aim, the study of the present ecological characteristics of phytoplankton species represents the first effort to assess their adaptive potential in a wide spectrum of environmental variables. Using a set of nine time series, this study aimed at describing the ecological niche of 10 worldwide-distributed species and testing whether individual species occupy the same niche across different environments. The species showed wide variations in frequency, average abundance and seasonal pattern among sites, while their annual maxima occurred over ample ranges of physical–chemical variables, with marked differences from site to site depicting a considerably wide global niche for each species. Although in some of the species this result can be attributed to the existence of multiple, morphologically similar taxa hardly identifiable in light microscopy, other cases could be explained by intraspecific diversity and/or enhanced adaptation potential in phytoplankton populations. Although probably not applicable to species with more restricted distribution ranges, these results should be considered when projecting present species distributions into a future scenario of climate change.
Deacylation of galactolipids decomposes photosystem II dimers to enhance degradation of damaged D1 protein
Authors: Jimbo Haruhiko , Wada Hajime
Published: October 2022

Photosystem II (PSII) contains many lipid molecules that are essential for the function and maintenance of PSII. Under strong light conditions, PSII complexes are dynamically modified during the repair process; however, the molecular mechanism of the dynamic changes in the PSII structure is still unclear. In the present study, we investigated the role of a lipase in the repair of PSII in Synechocystis sp. PCC 6803. We identified a protein encoded by the sll1969 gene, previously named lipase A (lipA), in the Synechocystis sp. PCC 6803 genome as a candidate for the lipase involved in PSII repair. Recombinant protein expressed in Escherichia coli cells hydrolyzed fatty acids at the sn-1 position of monogalactosyldiacylglycerol (MGDG) and digalactosyldiacylglycerol as well as triacylglycerol esterified with stearic acids. PSII repair in a disrupted mutant of the lipA gene was suppressed by the slow degradation of damaged D1 protein under strong light. The level of the PSII dimer remained higher in lipA mutant cells than wild-type (WT) cells under strong light. LipA protein was associated with the PSII dimer in vivo, and recombinant LipA protein decomposed PSII dimers purified from WT cells to monomers by reducing MGDG content in the PSII complex. These results indicate that LipA reacts with PSII dimers, dissociates them into monomers by digesting MGDG, and enhances D1 degradation during PSII repair.
Early characterization of difficult-to-treat rheumatoid arthritis by suboptimal initial management: a multicentre cohort study
Authors: Giollo Alessandro , Zen Margherita , Larosa Maddalena , Astorri Davide , Salvato Mariangela , Calligaro Antonia , Botsios Konstantinos , Bernardi Cristina , Bianchi Gerolamo , Doria Andrea
Published: October 2022

Objectives

To demonstrate that unsuccessful treatment optimization in early disease is associated with difficult-to-treat RA (D2T-RA).

Methods

In this retrospective multicentre cohort study conducted from 09/2021–03/2022, we enrolled individuals fulfilling the 2010 ACR/EULAR RA criteria diagnosed 2000–2019. The outcome was D2T-RA by the EULAR definition. We used robust regression to examine the associations with delay, dose, duration of methotrexate and discontinuation of glucocorticoids. We tested through multinomial regression which factors were associated with persistent inflammatory refractory RA (PIRRA) or non-inflammatory refractory RA (NIRRA). Sensitivity analysis included a case-control study matching the year of diagnosis.

Results

We enrolled 48 D2T-RA patients and 145 non-D2T-RA controls. Methotrexate was started within 3 months in 16.7% of D2T-RA vs 33.1% of non-D2T-RA (P = 0.011). Adequate duration of methotrexate was obtained in significantly fewer D2T-RA patients (70.8% vs 85.5%). Glucocorticoids were continued beyond 6 months in a higher proportion of D2T-RA patients (70.8% vs 33.8%, P < 0.001). In multiple regression, treatment delay beyond 3 months (OR 0.3; 95% CI 0.1, 0.9) and non-discontinuation of glucocorticoids after 6 months (OR 4.6; 95% CI 2.2, 9.5) were significantly associated with D2T-RA. Treatment delay was significantly associated with PIRRA only, while non-discontinuation of glucocorticoids was significantly associated with PIRRA and NIRRA. Results were replicated in sensitivity analyses.

Conclusion

Failure to start methotrexate within 3 months and not being off glucocorticoids within 6 months are early predictive features of D2T-RA.
Cutaneous vasculitis occurring in the setting of systemic lupus erythematosus: a multicentre cohort study
Authors: Breillat Paul , Jachiet Marie , Ditchi Yoan , Lenormand Cédric , Costedoat-Chalumeau Nathalie , Mathian Alexis , Moguelet Philippe , Duriez Paul , Trendelenburg Marten , Huynh-Do Uyen , Chizzolini Carlo , Beuvon Clément , Roy-Peaud Frederique , Bouaziz Jean-David , Barbaud Annick , Francès Camille , Mékinian Arsène , Fain Olivier , Amoura Zahir , Chasset François ,   for EMSED study group (Etude des maladies systémiques en dermatologie) and the Swiss SLE Cohort Study (SSCS), Bessis Didier , Cordel Nadège , Lipsker Dan , Cassius Charles , Ribi Camillo
Published: October 2022

Objectives

To describe the clinical and pathological features of biopsy-proven cutaneous vasculitis (CV) associated with SLE, focusing on diagnosis classification and impact on overall SLE activity.

Methods

Retrospective multicentric cohort study including SLE patients with biopsy-proven CV identified by (i) data from pathology departments of three university hospitals and (ii) a national call for cases. SLE was defined according to 1997 revised ACR and/or 2019 ACR/EULAR criteria. CV diagnosis was confirmed histologically and classified by using the dermatological addendum of the Chapel Hill classification. SLE activity and flare severity at the time of CV diagnosis were assessed independently of vasculitis items with the SELENA-SLEDAI and SELENA-SLEDAI Flare Index.

Results

Overall, 39 patients were included; 35 (90%) were female. Cutaneous manifestations included mostly palpable purpura (n = 21; 54%) and urticarial lesions (n = 18; 46%); lower limbs were the most common location (n = 33; 85%). Eleven (28%) patients exhibited extracutaneous vasculitis. A higher prevalence of Sjögren’s syndrome (51%) was found compared with SLE patients without CV from the French referral centre group (12%, P < 0.0001) and the Swiss SLE Cohort (11%, P < 0.0001). CV was mostly classified as urticarial vasculitis (n = 14, 36%) and cryoglobulinaemia (n = 13, 33%). Only 2 (5%) patients had no other cause than SLE to explain the CV. Sixty-one percent of patients had inactive SLE.

Conclusion

SLE-related vasculitis seems very rare and other causes of vasculitis should be ruled out before considering this diagnosis. Moreover, in more than half of patients, CV was not associated with another sign of active SLE.
Assessing program fidelity to critically reflect on the suitability of Critical Time Intervention to facilitate exiting sex work
Authors: Perri Melissa , Shareck Martine , Buhariwala Pearl , Hassan Maha , Balla Ermelina , O’Campo Patricia
Published: October 2022

An emerging approach to facilitating exiting sex work is through applying the Critical Time Intervention [CTI] model. CTI represents a time-limited approach that supports marginalized individuals during periods of transition. We performed a fidelity assessment as part of a process evaluation of Exit Doors Here [EDH], a program supporting women who wish to exit sex work. We reflect on the appropriateness of the CTI model for supporting these women, and highlight contextual and population specificities which might need to be considered for effective scaling up of similar programs. First, we applied an existing fidelity assessment tool to the EDH program. Program staff highlighted areas for adaptation. We then adapted the tool based on this feedback and assessed program fidelity by analyzing data from eight participants’ CTI charts. Fidelity ratings were computed and interpreted according to established guidelines. Consultations with program staff resulted in adaptations to seven of the 12 fidelity assessment tool items. The majority of adaptations surrounded the time-limited nature of CTI and unique needs of the program participants such as their experiences with violence and substance use. The fidelity assessment of the adapted tool demonstrated that even after adaptations were made, certain items were still not appropriate for this study population. Difficulties in implementing selected program components with high fidelity can be attributed to contextual and population specificities of the study population. This study reiterates the importance of considering such factors when developing and implementing programs aimed at improving the health and livelihoods of marginalized women such as those who engage in sex work.
Parent Survey Identifies Low-Cost Emotional and Educational Supports in NICU and Beyond
Authors: Franklin-Luther Prarthana , Bacchini Fabiana , Gillett James B. , McDonald Sarah D.
Published: October 2022

Background:

Families face significant mental health challenges after preterm birth. However, there are few low-cost and sustainable services to help with mental health challenges.

Purpose:

To understand suggestions for low-cost and sustainable mental health supports to help families.

Methods:

This was an internet-based survey made available to preterm families through the Canadian Premature Babies Foundation social media (Facebook private parents' group).

Results:

Families reported that peer support, such as connecting with other parents and families who experience preterm birth, was most beneficial. Parents also reported ways to allow families to access the existing mental health services, such as providing child care options and improving advertisement of available resources.

Implications:

Our results can help implement beneficial low-cost and sustainable mental health supports across many contexts (eg, hospitals and community organization) both in-person and online.
Improvements in Outcomes and Cost after Adult Spinal Deformity Corrective Surgery between 2008 and 2019
Authors: Passias Peter G. , Kummer Nicholas , Imbo Bailey , Lafage Virginie , Lafage Renaud , Smith Justin S. , Line Breton , Vira Shaleen , Schoenfeld Andrew J. , Gum Jeffrey L. , Daniels Alan H. , Klineberg Eric O. , Gupta Munish C. , Kebaish Khaled M. , Jain Amit , Neuman Brian J. , Chou Dean , Carreon Leah Y. , Hart Robert A. , Burton Douglas C. , Shaffrey Christopher I. , Ames Christopher P. , Schwab Frank J. , Hostin Richard A. , Bess Shay ,   on behalf of the International Spine Study Group
Published: October 2022

Study Design.

Retrospective cohort

Objective.

To assess whether patient outcomes and cost effectiveness of adult spinal deformity (ASD) surgery have improved over the past decade.

Background.

Surgery for ASD is an effective intervention, but one that is also associated with large initial healthcare expenditures. Changes in the cost profile for ASD surgery over the last decade has not been evaluated previously.

Methods.

ASD patients who received surgery between 2008-19 were included. ANCOVA was used to marginal means for outcome measures (complication rates, reoperations, HRQLs, total cost, utility gained, QALYs, cost efficiency [cost per QALY]) by year of initial surgery. Cost was calculated using the PearlDiver database and represented national averages of Medicare reimbursement for services within a 30-day window including length of stay and death differentiated by complication/comorbidity, revision, and surgical approach. Internal cost data was based on individual patient DRG codes, limiting revisions to those within 2Y of the initial surgery. Cost per QALY over the course of 2008-2019 were then calculated.

Results.

There were 1236 patients included. There was an overall decrease in rates of any complication (0.78 vs. 0.61), any reoperation (0.25 vs. 0.10), and minor complication (0.54 vs. 0.37) between 2009 and 2018 (all P<0.05). National average 2Y cost decreased at an annual rate of $3,194 (R2=0.6602), 2Y Utility Gained increased at an annual rate of 0.0041 (R2=0.57), 2Y QALYs Gained increased annually by 0.008 (R2=0.57), and 2Y Cost per QALY decreased per year by $39,953 (R2=0.6778).

Conclusion.

Between 2008 and 2019, rates of complications have decreased concurrently with improvements in patient reported outcomes, resulting in improved cost effectiveness according to national Medicare average and individual patient cost data. The value of ASD surgery has improved substantially over the course of the last decade.
Should Global Realignment Be Tailored to Frailty Status for Patients Undergoing Surgical Intervention for Adult Spinal Deformity?
Authors: Passias Peter G. , Williamson Tyler K. , Krol Oscar , Tretiakov Peter , Joujon-Roche Rachel , Imbo Bailey , Ahmad Salman , Bennett-Caso Claudia , Owusu-Sarpong Stephane , Lebovic Jordan , Robertson Djani , Vira Shaleen , Dhillon Ekamjeet , Schoenfeld Andrew J. , Janjua M. Burhan , Raman Tina , Protopsaltis Themistocles , Maglaras Constance , O’Connell Brooke , Daniels Alan H. , Paulino Carl , Diebo Bassel G. , Smith Justin S. , Schwab Frank J. , Lafage Renaud , Lafage Virginie
Published: October 2022

Study Design.

Retrospective Cohort Study

Objective.

Assess whether modifying spinal alignment goals to accommodate frailty considerations will decrease mechanical complications and maximize clinical outcomes.

Summary of Background Data.

The Global Alignment and Proportion(GAP) score was developed to assist in reducing mechanical complications, but has had less success predicting such events in external validation. Higher frailty and many of its components have been linked to development of implant failure. Therefore, modifying the GAP score with frailty may strengthen its ability to predict mechanical complications.

Methods.

We included 412 surgical ASD patients with two-year(2Y) follow-up. Frailty was quantified using the ASD modified Frailty Index(mASD-FI). Outcomes: proximal junctional kyphosis(PJK) and failure(PJF), major mechanical complications, and ‘Best Clinical Outcome’(BCO), defined as ODI<15 and SRS-22 Total>4.5. Logistic regression analysis established a six-week score based on GAP score,frailty and ODI US-Norms. Logistic regression followed by conditional inference tree(CIT) analysis generated categorical thresholds. Multivariable logistic regression analysis controlling for confounders was used to assess the performance of the frailty modified GAP score.

Results.

Baseline frailty categories: 57% Not Frail,30% frail,14% severely frail. Overall, 39% of patients developed PJK, 8% PJF, 21% mechanical complications, 22% underwent reoperation, and 15% met BCO. The modified ASD-FI demonstrated correlation with developing PJF, mechanical complications, undergoing reoperation, and meeting BCO at 2Y(all P<0.05). Regression analysis generated the following equation: Frailty-Adjusted Realignment Score(FAR Score) =0.49*mASD-FI + 0.38*GAP Score. Thresholds for the FAR score(0-13): Proportioned:<3.5,Moderately Disproportioned:3.5-7.5,Severely Disproportioned:>7.5. Multivariable logistic regression assessing FAR Score demonstrated associations with mechanical complications, reoperation, and meeting Best Clinical Outcome by two years(all P<0.05), whereas the original GAP score was only significant for reoperation.

Conclusion.

This study demonstrated adjusting alignment goals in adult spinal deformity surgery for a patient’s baseline frailty status and disability may be useful in minimizing the risk of complications and adverse events, outperforming the original GAP score in terms of prognostic capacity.

Level of Evidence.

III
Cross Cultural Adaptation and Validation of Hindi Version of EuroQol (EQ-5D-3L) Health Questionnaire in Patients with Chronic Low Back Pain
Authors: Goyal Ankita , Makkar Jeetinder Kaur , Ghai Babita , Sharma Rajni , Kumar Vishal
Published: October 2022

Objective.

The present study is an attempt at validation of Hindi version of EQ-5D-3L questionnaire for patients with chronic low back pain (CLBP).

Design.

Prospective clinical study.

Setting.

The study was conducted in Pain clinic on an out-patient basis with the subjects being followed via online platform on day 3.

Subject.

Native Indian patients >18 years age having CLBP who could speak and read Hindi were enrolled in the study.

Method.

This study is a cross-sectional study, on 132 patients suffering from CLBP after pilot test on 10 patients. Hi-SF-36 was used as a reference scale. Pain was evaluated through NRS. Psychometric properties like internal consistency, test-retest reliability on day 3 and convergent validity were evaluated. Confirmation factor analysis was carried out in order to establish the relationship between five dimensions of Hi-EQ-5D-3L and eight domains of Hi-SF-36.

Result.

The Cronbach’s alpha of 0.984 for index value and 0.944 for VAS confirmed the desired internal consistency of EQ-5D. Intra-class correlation coefficient was found to be excellent for EQ index value (0.969, 95% CI 0.954-0.979) and very good for VAS (0.894, 95% CI 0.844-0.928). Spearman’s rho correlation coefficients of index value correlated strongly with all domains except role emotion with r =0.181 on day 0 and r=0.239 on day 3. Good relationship between Hi-SF-36 and Hi-EQ-5D-3L was confirmed through factor analysis.

Conclusion.

The study results reported that Hindi version of EQ-5D-3L demonstrated comprehensibility, reliability and proved to be valid instrument for evaluation of HRQoL in CLBP patients.
Low-Flow Duration and Outcomes of Extracorporeal Cardiopulmonary Resuscitation in Adults With In-Hospital Cardiac Arrest: A Nationwide Inpatient Database Study*
Authors: Ohbe Hiroyuki , Tagami Takashi , Ogura Takayuki , Matsui Hiroki , Yasunaga Hideo
Published: October 2022

OBJECTIVES:

Although existing guidelines recommend commencing cannulation for extracorporeal cardiopulmonary resuscitation (ECPR) within 10–20 minutes of failed conventional resuscitation efforts for cardiac arrest, there is little supportive evidence. The present study aimed to determine the association of low-flow duration with survival-to-discharge rate in in-hospital cardiac arrest patients who received ECPR.

DESIGN:

A nationwide retrospective cohort study analyzed a nationwide inpatient database in Japan. Low-flow duration was defined as the time interval from initiation of chest compression to termination of chest compression. We assessed the association between low-flow duration and survival-to-discharge rate by predicting estimates with covariate adjustment stratified by categories of low-flow duration.

SETTING:

More than 1,600 acute-care hospitals in Japan.

PATIENTS:

All in-hospital cardiac arrest patients greater than or equal to 18 years old who received ECPR during hospitalization from July 2010 to March 2018.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Among 303,319 in-hospital cardiac arrest patients, 9,844 (3.2%) received ECPR in 697 hospitals during the study period and 9,433 were eligible in the study. The overall survival-to-discharge rate was 20.5% (1,932/9,433). The median low-flow duration was 26.0 minutes (interquartile range, 12.0–46.0 min) in the overall cohort. The highest and lowest estimated survival-to-discharge rates were 35.1% in the group with low-flow duration 0–5 minutes and 7.9% in the group with low-flow duration greater than 90 minutes. The estimated survival-to-discharge rate dropped sharply by about 20% during the first 35 minutes of low-flow duration (decreasing by about 3% every 5 min), followed by small decreases after the first 35 minutes.

CONCLUSIONS:

The estimated survival-to-discharge rate was markedly decreased by approximately 20% during the first 35 minutes of low-flow duration. Whether we should wait for the first 10–20 minutes of cardiac arrest without preparing for ECPR is questionable.
Contribution of cyclooxygenase-2 overexpression to enhancement in tonically active glutamatergic inputs to the rostral ventrolateral medulla in hypertension
Authors: Fan Jie-Fu , Wang Wen , Tan Xing , Ye Peng , Li Ji-Kui , Niu Lu-Yu , Li Wan-Yang , Wang Wei-Zhong , Wang Yang-Kai
Published: October 2022

Objective:

Cyclooxygenase (COX) is critical in regulating cardiovascular function, but its role involved in the central control of blood pressure (BP) is uncovered. The tonic glutamatergic inputs to the rostral ventrolateral medulla (RVLM) are enhanced in hypertension. Here, the present study was designed to investigate the effect and mechanism of central COX on tonic glutamatergic inputs to the RVLM and BP regulation.

Methods:

Wistar-Kyoto (WKY) rats and spontaneous hypertensive rats (SHRs) received RVLM microinjection of adeno-associated viral vectors to promote or inhibit the COX2 expression were subjected to subsequent experiments. Glutamate level and glutaminase expression were detected by ELISA and western blot, respectively. The function of tonic glutamatergic inputs was assessed by BP response to microinjection of the glutamate receptor antagonist into the RVLM. PC12 cells were used to detect the underlying signal pathway.

Results:

The RVLM COX2 expression and prostaglandin E2 level were significant higher in SHRs than in WKY rats. Overexpression of COX2 in the RVLM produced an increase in basal BP, RVLM glutamate level, and glutaminase expression in WKY rats, while they were significantly reduced by interfering with COX2 expression in SHRs. Microinjections of the glutamate receptor antagonist into the RVLM produced a significant BP decrease in WKY rats with COX2 overexpression pretreatment. Furthermore, the increased levels of BP, glutamate content, and glutaminase activity in the RVLM evoked by central infusion of angiotensin II were attenuated in COX2 knockout mice. It was also found that prostaglandin E2 increased supernatant glutamate level and phosphorylation of signal transducer and activator of transcription 3 in PC12 cells.

Conclusion:

Our findings suggest that upregulated COX2 expression enhances the tonically active glutamatergic inputs to the RVLM, which is associated with cardiovascular regulation in hypertension.
Fatal Injuries in the Health Care and Social Assistance Industry, Census of Fatal Occupational Injuries, 2011 to 2019
Authors: Hawkins Devan , Chavarria Alma Luana
Published: October 2022

Objective

This study aimed to describe the characteristics of workers in the health care and social assistance industry who experience fatal occupation injuries and the nature of these injuries.

Methods

Fatal occupational injury rates were calculated for workers in the health and social assistance industry according to age, sex, race ethnicity, industry, and year.

Results

There were 1224 fatalities among workers in the health care and social assistance industry, resulting in a rate of 6.7 fatalities per 1,000,000 worker-years. The rate of fatal injuries was highest among older workers, men, and Black and White workers. The highest number of fatal injuries was transportation and violent incidents. The highest mortality rates were in the vocational rehabilitation services industry.

Conclusions

These findings can be useful for identifying methods for intervening and preventing fatal injuries among workers in the health care and social assistance industry.
Pleural Disease in Acute COVID-19 Pneumonia
Authors: Swenson Kai , Uribe Juan P. , Ayala Alvaro , Parikh Mihir , Zhang Chenchen , Paton Alichia , Trachtenberg Molly , Majid Adnan
Published: October 2022

Background:

Pleural diseases encompass pleural effusion and pneumothorax (PTX), both of which were uncommon in coronavirus disease of 2019 (COVID-19). We aimed to describe the frequency, characteristics, and main outcomes of these conditions in patients with COVID-19 pneumonia.

Methods:

We performed a retrospective cohort analysis of inpatients with COVID-19 pneumonia between January 1, 2020 and January 1, 2022, at Beth Israel Deaconess Medical Center in Boston, Massachusetts.

Results:

Among 4419 inpatients with COVID-19 pneumonia, 109 (2.5%) had concurrent pleural disease. Ninety-four (2.1%) had pleural effusion (50% seen on admission) and 15 (0.3%) had PTX, both with higher rates of underlying conditions such as heart failure, liver disease, kidney disease, and malignancy. A total of 28 (30%) pleural effusions were drained resulting in 32% being exudative, 43% pseudoexudative, and 25% transudative. Regarding PTX, 5 (33%) were spontaneous and 10 (67%) were due to barotrauma while on mechanical ventilation. We found that the presence of underlying lung disease was not associated with an increased risk of developing PTX. In addition, patients with pleural disease had a higher incidence of severe or critical illness as represented by intensive care unit admission and intubation, longer hospital and intensive care unit stay, and a higher mortality rate as compared with patients without the pleural disease.

Conclusion:

Pleural effusions and pneumothoraces are infrequent findings in patients admitted due to COVID-19 pneumonia, worsened outcomes in these patients likely reflect an interplay between the severity of inflammation and parenchymal injury due to COVID-19 disease and underlying comorbidities.
Evaluation of Insight, Self-Esteem, and Body Satisfaction in Eating Disorders
Authors: Şenay Olcay , Yücel Başak
Published: October 2022

We investigated insight and its relationship with the clinical characteristics in eating disorders (EDs). Thirty anorexia nervosa (AN) and 30 bulimia nervosa (BN) patients, diagnosed based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria, were evaluated with Eating Disorder Examination Questionnaire (EDE-Q), the Body Image Satisfaction Questionnaire (BISQ), Rosenberg Self-Esteem Scale (RSES), and the Brown Assessment of Beliefs Scale (BABS). There was no statistically significant difference between the AN and the BN group in clinical scale scores. Thirty percent of AN and 23.3% of BN patients showed “poor insight” according to BABS. In the whole sample, BABS scores were significantly positively correlated with the EDE-Q eating, shape, weight concern subscales, and global scores, and the RSES scores; and negatively correlated with the BISQ general appearance and trunk subscale scores. Manifestation of “poor insight” is frequent in EDs. Poor insight in EDs is associated with eating, shape and weight concerns, body dissatisfaction, and low self-esteem.
PSMA Immunohistochemistry in Hepatic Neoplasms
Authors: Kmeid Michel , Park Young Nyun , Chung Taek , Lukose Georgi , Sullivan Luz , Brar Rupinder , Lee Hwajeong
Published: October 2022

Accurate classification of well-differentiated hepatocellular neoplasms can be challenging especially in core biopsies. Prostate-specific membrane antigen (PSMA) has been shown to highlight tumor-associated neovasculature in many nonprostatic solid tumors including hepatocellular carcinoma (HCC). Archived 164 hepatectomies and explants with 68 HCCs, 31 hepatocellular adenoma (HA), 24 dysplastic nodules (DN), and 42 metastases were retrieved, and pathologic parameters were evaluated. Sensitivity, specificity, accuracy, positive, and negative predictive values for correct diagnosis of HCC were calculated for PSMA and CD34 immunostains in tissue sections and HCC tissue microarrays. PSMA positivity was defined as capillarized sinusoidal/tumor-associated vessel staining involving ≥5% of the tumor area. In all, 55/68 (80.9%) HCC and 37/42 (88.1%) of liver metastasis were PSMA positive. PSMA was negative in HA, DN, and background liver (100% specificity). CD34 had a 98.5% sensitivity but a 65.5% specificity in identifying HCC. PSMA sensitivity remained high in the HCC tissue microarray (89.7%). PSMA was more accurate than CD34 (95.5% vs. 69.7%) in distinguishing grade 1 HCC from HA and high-grade DN while retaining high sensitivity (80%). The degree of PSMA positivity in HCC was greater in older, male, and human immunodeficiency virus patients (P<0.05). No associations were found between PSMA staining and other tumor parameters (P>0.05). PSMA is a marker of neoangiogenesis with increased expression in both primary and metastatic hepatic malignancies. Neovascular PSMA expression is more specific and accurate than CD34 for differentiating HCC from benign and precursor hepatic lesions. Diagnostic and therapeutic utility of PSMA radioligands in malignant liver neoplasms warrant further clinical investigations.
Brief Report: Physician Reimbursement and Retention in HIV Care: Racial Disparities in the US South
Authors: Pan Zhongzhe , Dahman Bassam , Bono Rose S. , Sabik Lindsay M. , Belgrave Faye Z. , Yerkes Lauren , Nixon Daniel E. , Kimmel April D.
Published: October 2022

Background:

Retention in HIV care remains a national challenge. Addressing structural barriers to care may improve retention. We examined the association between physician reimbursement and retention in HIV care, including racial differences.

Methods:

We integrated person-level administrative claims (Medicaid Analytic eXtract, 2008–2012), state Medicaid-to-Medicare physician fee ratios (Urban Institute, 2008, 2012), and county characteristics for 15 Southern states plus District of Columbia. The fee ratio is a standardized measure of physician reimbursement capturing Medicaid relative to Medicare physician reimbursement across states. Generalized estimating equations assessed the association between the fee ratio and retention (≥2 care markers ≥90 days apart in a calendar year). Stratified analyses assessed racial differences. We varied definitions of retention, subsamples, and definitions of the fee ratio, including the fee ratio at parity.

Results:

The sample included 55,237 adult Medicaid enrollees with HIV (179,002 enrollee years). Enrollees were retained in HIV care for 76.6% of their enrollment years, with retention lower among non-Hispanic Black (76.1%) versus non-Hispanic White enrollees (81.3%, P < 0.001). A 10-percentage point increase in physician reimbursement was associated with 4% increased odds of retention (adjusted odds ratio 1.04, 95% confidence interval: 1.01 to 1.07). In stratified analyses, the positive, significant association occurred among non-Hispanic Black (1.08, 1.05–1.12) but not non-Hispanic White enrollees (0.87, 0.74–1.02). Findings were robust across sensitivity analyses. When the fee ratio reached parity, predicted retention increased significantly overall and for non-Hispanic Black enrollees.

Conclusion:

Higher physician reimbursement may improve retention in HIV care, particularly among non-Hispanic Black individuals, and could be a mechanism to promote health equity.
A Novel Forceps for Preventing Mucosal Damage of the Hard Palate in Maxilla Mobilization During Le Fort I Osteotomy
Authors: Chen Kai , Sun Xiumei , Wu Guomin
Published: October 2022

At present, the most effective and common strategy to mobilize the maxilla is to use Rowe disimpaction forceps. But because of the directed forces on the hard palate, the mucosa of the hard palate will have to receive an ineluctable mechanical injury. Therefore, we introduce a novel forceps (Patent No. 202110966069.X China), which can accurately and steadily clamp the maxilla on the premise of protecting the hard palate mucosa from loss of palatal vascularity and pressure necrosis, and then thoroughly mobilize the maxilla. Complaints and mucosal damage were not observed in the initial 3 patients.
Application of Composite Tissue Flap Pedicled With Superficial Temporal Artery and its Branches in the Repair of Various Maxillofacial Defects
Authors: Lei Bowen , Zhong Yehong , Chen Zhewei , Yang Bin
Published: October 2022

Objective:

To discuss and study the application of composite tissue flaps pedicled with the superficial temporal artery (STA) and its branches in the repair of various defects, analyze the advantages and disadvantages of such composite tissue flaps, and provide a reference for the personalized design of various maxillofacial defect repairs.

Materials and Methods:

In recent years, 12 cases of various maxillofacial defects were repaired with composite tissue flaps pedicled with the STA and its branches. The application strategies of this type of tissue flaps were summarized by summarizing experience and reviewing literature.

Results:

According to the different defect characteristics of patients and the requirements of patients for surgery, different tissue flaps have been designed, and good results have been obtained. Except for 2 patients who developed dark purple skin flap within 48 hours after operation, the remaining patients were followed up for 6 to 24 months without serious complications.

Conclusion:

The composite tissue flap pedicled with the STA and its branches is a kind of functional tissue flap for facial defect repair. Individualized repair schemes can be designed according to different defect types of patients.
Association Between Malignant Diseases and Medication-Related Osteonecrosis of the Jaw (MRONJ): A Systematic Review and Meta-Analysis
Authors: Yao Sheng , Ding Xiaoyong , Rong Gang , Zhou Jie , Zhang Bo
Published: October 2022

Purpose:

The aim was to identify whether malignant diseases increase the risk of medication-related osteonecrosis of the jaw (MRONJ) occurrence when patients are exposed to bisphosphonate, antiresorptive or antiangiogenic drugs. To analyze related factors.

Methods:

A systematic literature searching was performed in PubMed, Embase, and Google Scholar for studies with information about whether patients have malignant diseases. Patients involved must be treated with MRONJ-related drugs and at high risk of developing MRONJ.

Results:

A total of 6 cohort studies and 3 case-control studies were included. Analysis according 9 studies shows that malignant diseases have significant influence on MRONJ occurrence (risk ratio (RR): 2.62; 95% confidence interval (95% CI): 1.58–4.33; P=0.0002). Subgroup analysis according 6 cohort studies also shows that malignant diseases significantly affect MRONJ occurrence (RR: 3.50; 95% CI: 1.63–7.52; P=0.001). Chemotherapy have no obvious influence on MRONJ occurrence (RR: 1.64; 95% CI: 0.79–3.39; P=0.18). Intravenous drug administration significantly influences MRONJ occurrence (RR: 2.67; 95% CI: 1.27–5.58; P=0.009).

Conclusions:

Patients with malignant diseases have higher risk of MRONJ occurrence when exposed to bisphosphonate, antiresorptive, or antiangiogenic drugs. Cumulative dosages from intravenous drugs administration contribute to MRONJ developing. Prevention of MRONJ in patients with malignancy should be emphasized.
The simultaneous appearance of Kasabach-Merritt syndrome and focal nodular hyperplasia: a rare case with literature review
Authors: Seerwan Karzan , Kaka Ali Hemn H. , Ghalib Omar H. , Ismaeil Deari A. , Hassan Hemin A. , Salih Abdulwahid M. , Kakamad Fahmi H. , Mohammed Shvan H. , Ali Rawa M. , Ahmed Dlshad Hamasaeed
Published: October 2022

Introduction and importance:

The simultaneous development of Kasabach-Merritt syndrome (KMS) and focal nodular hyperplasia (FNH) in the same individual is rare. This study aims to report the coexistence of KMS and FNH in a 32-year-old female.

Case presentation:

A 32-year-old woman presented to the gastroenterology clinic complaining of heavy menses, fatigue, and hematuria. Physical examination revealed multiple ecchymoses on the skin. Abdominal computed tomography scan revealed a large hepatic lesion with features of atypical hemangioma. Complete blood count showed normochromic, normocytic red blood cells, and thrombocytopenia. Surgery was decided based on a clinical diagnosis of KMS resulting from a giant liver hemangioma. Histopathologic diagnosis of the resected lesion was FNH.

Clinical discussion:

KMS, which refers to a giant hemangioma associated with thrombocytopenia, was initially described by Kasabach and Merritt. It occurs in nearly 1% of hemangiomas and primarily affects infants. KMS is a life-threatening condition that could be fatal if adequate, timely treatment is not administered. FNH is a benign hepatocellular neoplasm with a predilection for females.

Conclusion:

KMS and FNH are 2 distinct conditions that can rarely co-exist in the same patient. Corticosteroids, radiotherapy, and surgical resection are the primary modalities of treatment.
Intraoperative Hypotension and 30-D Mortality After Liver Transplantation
Authors: Wang Libing , Bui Christine Myo , Hofer Ira , Gabel Eilon , Wray Christopher , Xia Victor W.
Published: October 2022

Background.

Intraoperative hypotension (IOH) is common and associated with mortality in major surgery. Although patients undergoing liver transplantation (LT) have low baseline blood pressure, the relation between blood pressure and mortality in LT is not well studied. We aimed to determine mean arterial pressure (MAP) that was associated with 30-d mortality in LT.

Methods.

We performed a retrospective cohort study. The data included patient demographics, pertinent preoperative and intraoperative variables, and MAP using various metrics and thresholds. The endpoint was 30-d mortality after LT.

Results.

One thousand one hundred seventy-eight patients from 2013 to 2020 were included. A majority of patients were exposed to IOH and many for a long period. Eighty-nine patients (7.6%) died within 30 d after LT. The unadjusted analysis showed that predicted mortality was associated with MAP <45 to 60 mm Hg but not MAP <65 mm Hg. The association between MAP and mortality was further tested using adjustment and various duration cutoffs. After adjustment, the shortest durations for MAPs <45, 50, and 55 mm Hg associated with 30-d mortality were 6, 10, and 25 min (odds ratio, 1.911, 1.812, and 1.772; 95% confidence interval, 1.100-3.320, 1.039-3.158, and 1.008-3.114; P = 0.002, 0.036, and 0.047), respectively. Exposure to MAP <60 mm Hg up to 120 min was not associated with increased mortality.

Conclusion.

In this large retrospective study, we found IOH was common during LT. Intraoperative MAP <55 mm Hg was associated with increased 30-d mortality after LT, and the duration associated with postoperative mortality was shorter with lower MAP than with higher MAP.