bluuebunny/crossref_metadata_2025 huggingface dataset:
INCREASING THE VISIBILITY DURING INTERNAL LIMITING MEMBRANE PEELING IN VITRECTOMY SURGERY
Authors: Matsumoto Keiji , Sakanishi Yoshihito , Fujii Tatsuya , Usui-Ouchi Ayumi , Sakuma Toshiro , Ebihara Nobuyuki
Published: November 2024

Purpose:

The aim of the study is to explore the effectiveness of using monochrome mode with Brilliant Blue G during vitrectomy surgery with the NGENUITY 3D Visualization System.

Methods:

Vitrectomy cases involving BBG-stained internal limiting membrane peeling with the NGENUITY 3D Visualization System (Alcon Laboratories, Inc.) at Juntendo University Urayasu Hospital from October 2022 to February 2023 were selected. The contrast ratios between peeled and stained internal limiting membrane areas under three settings were assessed: normal, yellow, and monochrome. In the monochrome setting, a yellow hue was used with zero saturation, while the Friedman test compared these ratios.

Results:

Nineteen patients (19 eyes; 7 males, 12 females; average age 68.5 ± 10.3 years) with retinal conditions such as epiretinal membrane (n = 11), macular hole (n = 4), macular traction syndrome (n = 3), and retinoschisis (n = 1) were included. We obtained contrast ratios of 1.57 ± 0.21 (normal), 1.60 ± 0.21 (yellow), and 1.92 ± 0.29 (monochrome). The monochrome setting showed significantly higher contrast than that shown by the normal and yellow settings (P = 0.0001, P = 0.0005), with no difference between the normal and yellow settings (P = 0.903).

Conclusion:

Monochrome mode in NGENUITY with Brilliant Blue G potentially enhances contrast and increases visibility during internal limiting membrane peeling.
SPLIT OUTER PLEXIFORM LAYER APPEARANCE REPRESENTS AN ACQUIRED CONE DYSFUNCTION PHENOTYPE OF AUTOIMMUNE RETINOPATHY
Authors: Boyce Timothy M. , Fortenbach Christopher , Thurtell Matthew , Stone Edwin M. , Han Ian C.
Published: November 2024

Purpose:

Autoimmune retinopathy (AIR) is a poorly understood condition with a wide phenotypic spectrum and heterogeneous findings on clinical examination and imaging. In this study, the authors characterize the clinical features of a recently described phenotypic subtype of AIR with a distinct split outer plexiform layer appearance on OCT.

Methods:

This was a retrospective, observational study of patients with a diagnosis of AIR seen at the University of Iowa between January 2007 and September 2023 who were found to have decreased visual acuity, central scotoma on visual field testing, split outer plexiform layer appearance on OCT, and abnormal light-adapted electroretinogram, consistent with an acquired cone dysfunction. Clinical course and multimodal imaging and physiologic testing were reviewed.

Results:

Ten patients were identified in the retrospective cohort. All patients presented with bilateral, asymmetric, subacute, and progressive central vision loss. A diagnosis of cancer was present or subsequently diagnosed in 5 out of 10 patients (50%). Overall, 40% of patients underwent treatment with immunosuppressives, and one patient underwent tumor resection, with partial visual recovery seen.

Conclusion:

Patients with split outer plexiform layer appearance on OCT have an acquired cone dysfunction that is important to recognize as treatment in some cases may result in improved or stabilized visual function.
Scleral Contact Lens Benefits for Myopic Patients With Regular Corneas: A Prospective Randomized Study
Authors: Liang Ruixue , Li Na , Liu Lin , Du Bei , Pazo Eric , Wei Ruihua
Published: November 2024

Objectives:

To evaluate the impact of scleral contact lens (SL) wear on the visual quality and the ocular surface wettability in myopic patients with regular corneas.

Methods:

This prospective, randomized, controlled study enrolled a total of 80 myopes with regular corneas. Subjects were randomly allocated to wear SL or rigid corneal lens (RCL) for 3 months. The objective optical quality parameters were detected using the Optical Quality Analysis System-II, and the ocular surface wettability was assessed using the Keratograph 5M noninvasive ocular surface analyzer. The National Eye Institute 25-Item Visual Function Questionnaire and Ocular Surface Disease Index questionnaire were performed.

Results:

Both SL and RCL wear could obtain good best-corrected visual acuity. Strehl ratio, modulation transfer function cutoff frequency, objective scattering index, and Optical Quality Analysis System values (Optical Quality Analysis System values at 100%, 20%, and 9% contrasts) in the SL group significantly improved from baseline to the third month (both P<0.05), but not in the RCL group. At the third month, tear meniscus height and noninvasive tear break-up time showed a significant increase in the SL wearers from baseline (both P<0.05), but exhibited no significant changes in the RCL group. At the third month, SL wearers had significantly higher noninvasive tear break-up time compared with RCL wearers (P<0.05). Besides, after 3-month SL wear, the National Eye Institute 25-Item Visual Function Questionnaire score and the Ocular Surface Disease Index score both remarkably improved from baseline (both P<0.05).

Conclusion:

Short-term SL wear could provide satisfactory visual quality, ocular comfort, and stable tear film for myopic patients.
Establishing Knowledge and Skills for Service Coordinators in Early Intervention
Authors: Nichols Sarah L. , Schnurr Melissa P. , Hill Corinne F. , Hardison Melissa P. , Kastanis Maria P.
Published: November 2024

A survey was developed and distributed to service coordination constituents across the nation to determine whether the DRAFT Knowledge and Skills for Service Coordinators (KSSC) were comprehensive and complete. Participants (N = 933) included service coordinators (SCs), supervisors/administrators, and other early intervention (EI)-related professionals. Overall, respondents agreed that the DRAFT KSSC were comprehensive and complete, reflective of what SCs should know and be able to do, and the statements were clear. Furthermore, no significant differences were found among SCs, supervisors/administrators, and other EI constituents regarding any of these outcomes. Qualitative data were used to inform edits to the KSSC. Findings were used to validate the DRAFT KSSC, which, in turn, will be used to guide systems planning and decision-making to ensure SCs are well-prepared with the knowledge and skills necessary to partner with families and professionals from diverse backgrounds in EI.
Developmental Delay With Increasing Trend During 2019–2022 in Mexican Children Under 5 Years
Authors: Rodríguez-Vidales Edgar P. , Santos-Flores Izamara , Santos-Flores Jesús M. , Garza-Rodríguez Mara I. , Alvarado-Medina Ofelia M. , Garza-Carrillo Denise , Montes de Oca-Luna Roberto , Marroquín-Escamilla Alma R.
Published: November 2024

Despite its importance, studies involving developmental delay remain low in the last 10 years in Latin. The objective of the present study was to estimate and compare the prevalence of developmental delay during 2019–2022 in Mexican children under 5 years of age. This was a cross-sectional study carried out in Nuevo Leon, Mexico (n = 2,951). Developmental delay was measured with the Prueba de Desarrollo Infantil screening test. Point prevalence and 95% confidence interval (CI) were estimated globally, per area, and per year. The association of sex and children’s age to developmental delay was evaluated with binary logistic regression analysis. The prevalence of developmental delay was 42.1% (95% CI: 40.3–43.9). An upward trend was identified; prevalence reached 76% at the end of the study period. Alarm signs and language registered the highest prevalence. Being male doubled the chances of developmental delay (odds ratio 2.2, 95% CI: 1.9–2.6), and having 2.0–2.9 years increased seven times the possibilities of developmental delay (odds ratio 6.7, 95% CI: 5.3–8.7). Findings highlight the challenge that the health sector faces to stop and reverse the developmental delay statistics.
Technical means of preventing and treating anastomotic leakage after colorectal surgery: A review
Authors: Zhao Lu , Wang Fei , Chen Jian-Hua , Wei Chen , Ma Yi-Chao , Ji Hao , Zhao Jia-Hao , Tang Dong
Published: November 2024

With its significant morbidity and mortality, anastomotic leaking is a serious concern in the field of colorectal surgical treatments. A number of strategies and actions have been introduced in the last few years with the goal of reducing the incidence of this surgical complication and the clinical consequences that follow. Based on the most recent academic research, this article aims to provide a comprehensive assessment of the current approaches for the prevention and management of anastomotic leakage in the context of colorectal cancer surgeries. In addition to encouraging more study and innovation in this crucial field, the aim is to provide useful insights and references for clinical practices in the prevention and treatment of anastomotic leakage.
Exploring the Relationship Between eHealth Literacy and Diabetes Knowledge, Self-Efficacy, and Self-Care Behaviors in Chinese Diabetic Patients: A Cross-Sectional Study
Authors: JI Xing , CHI Juntao
Published: November 2024

Background

The importance of online educational resources enhancing self-management among patients is underscored by the growing prevalence of diabetes. It is crucial to comprehend how patients with diabetes in China seek diabetes-related information and use mobile applications (apps) designed for diabetes management. Although the Knowledge-Attitude-Practice theory plays an integral role in diabetes management, in-depth studies on eHealth literacy (eHL) and Knowledge-Attitude-Practice in populations with diabetes remain scarce.

Purpose

This study was developed to provide insights into the online information-seeking behaviors of and diabetes apps used by individuals living with diabetes by exploring the relationships among eHL, diabetes knowledge, self-efficacy, and self-care behaviors.

Methods

A cross-sectional survey was conducted from November 2022 to June 2023 on 380 inpatients with diabetes at the Yantai Yuhuangding Hospital in Shandong Province. The participants voluntarily completed surveys covering sociodemographic characteristics, diabetes status, diabetes app usage, online diabetes information searching, eHL, diabetes knowledge, self-efficacy, and self-care behaviors. Structural equation modeling analyses were employed to assess model fitness and the interrelationships between latent constructs and observable variables.

Results

Of the 380 participants, 57.1% (217/380) reported actively seeking diabetes information online, whereas only 3.7% (14/380) had used diabetes apps. eHL was shown to have a direct effect on diabetes knowledge (β = 0.377, p < .001) but no direct impact on self-care behaviors (β = 0.017, p = .860). However, an indirect effect on self-care behaviors was observed via diabetes knowledge and self-efficacy.

Conclusions/Implications for Practice

The results of this study indicate that, despite widespread online information-seeking behavior, diabetes app utilization remains limited in China. Also, the findings indicate enhancing patients' eHL contributes to more comprehensive diabetes knowledge. Furthermore, eHL was shown to influence self-care behaviors via diabetes knowledge and self-efficacy. A self-managed intervention strategy should be developed to improve eHL that utilizes internet resources to improve patients' knowledge and self-efficacy and promote better self-care behaviors.
Work Functioning Impairment and Telework
Authors: Yoshida Ai , Okawara Makoto , Matsugaki Ryutaro , Nagata Tomohisa , Tateishi Seiichiro , Eguchi Hisashi , Tsuji Mayumi , Matsuda Shinya , Fujino Yoshihisa ,   for the CORoNaWork Project
Published: November 2024

Objectives

To clarify the association between telework with family members at home and work functioning impairment.

Methods

A cross-sectional survey was conducted in 27,036 participants. Having children or cohabitants in need of care at home during telework was considered an exposure factor. Multilevel logistic regression analysis was used to calculate odds ratios (ORs) for work functioning impairment, assessed by The Work Functioning Impairment Scale (WFun).

Results

Participants living with cohabitants in need of care at home had higher odds of work functioning impairment, whereas those living with preschool children or a spouse had lower odds. Participants living with children or cohabitants in need of care at home during telework had higher odds.

Conclusions

We found an association between having children or cohabitants in need of care at home during telework and work functioning impairment.
Assessing the Impact of the COVID-19 Pandemic on Small and Medium Businesses in North Carolina
Authors: McAden Emily P. , Leff Maija S. , Jardel Hanna V. , Greenberg Rosa W. , Staley John A. , Linnan Laura A. , Nylander-French Leena A.
Published: November 2024

Objective

As the COVID-19 pandemic presented new challenges for businesses and worker safety and health, an interdisciplinary team launched the COVID-19 Worksite Impact Survey to assess COVID-19–related impacts and responses at small and medium businesses in 10 North Carolina counties.

Methods

We collected data from October 2 to December 1, 2020, and analyzed survey results to evaluate businesses' operational changes, concerns, needs, pandemic preparedness, workplace health promotion programming, and infection control practices.

Results

Most businesses, including essential ones, were inadequately prepared for the pandemic and did not implement the most effective COVID-19 infection control practices. Larger businesses and those with existing preparedness practices or health promotion programs were more likely to implement effective measures.

Conclusions

We should be acting now to improve small and medium businesses' preparedness for future public health crises.
Multicontextual Factors That Influence Work-Life Balance of Family Caregivers of Adults With Parkinson’s Disease
Authors: Hellmers Natalie , Stimpfel Amy Witkoski , Fletcher Jason , Dickson Victoria Vaughan
Published: November 2024

Objective

The purpose of study was to explore family caregiver perspectives on work-life balance while caring for adults with Parkinson’s disease.

Methods

The study was performed using a convergent mixed methods design and a revised adaptation of the Work-Life Conflict model. Caregivers completed surveys followed by semistructured interviews (n = 40).

Results

Work-life balance is bidirectionally influenced by time, stress, and behavior across the working and caregiving role. Caregiver burden was offset by higher decision latitude at work. Supervisor support and coworker support were positively associated with work-life balance. Barriers included physical, emotional, and financial stress, and speech and cognitive changes of the care recipient.

Conclusions

The results of this study identify the influence of work-life imbalance on caregiver burden and stress, and generate discussion of potential solutions that optimize well-being and health of this working population.
Analgesia After Vestibular Schwannoma Surgery in Europe—Potential for Reduction of Postoperative Opioid Usage
Authors: Gerlitz Matthias , Yildiz Erdem , Dahm Valerie , Herta Johannes , Matula Christian , Roessler Karl , Arnoldner Christoph , Landegger Lukas D.
Published: November 2024

Objective

Excessively prescribed opioids promote chronic drug abuse and worsen a highly prevalent public health problem in the era of the opioid epidemic. This study aimed to (a) determine general analgesic prescription patterns after surgery for vestibular schwannoma (VS) with a focus on opioid prescription rates, (b) identify risk factors for receiving narcotics for postoperative pain management, and (c) highlight the feasibility of opioid-free analgesic treatment strategies.

Study Design

Retrospective chart review.

Setting

Tertiary referral center.

Patients

A total of 105 adult inpatients who underwent VS surgery.

Interventions

Analgesic prescription patterns were evaluated, and factors associated with opioid prescriptions were identified.

Main outcome measure

Number of prescribed analgesics.

Results

Metamizole (=dipyrone) and acetaminophen (=paracetamol) were the most frequently prescribed non-opioid drugs. Sixty-three (60%) patients received an opioid with a median intake of 23.2 ± 24 mg of oral morphine equivalents. Only 10 (9.5%) individuals received opioids for longer than postoperative day 1. Subjects with small tumors undergoing middle cranial fossa tumor removal (p = 0.007) were more likely to receive opioid drugs. In contrast, patients undergoing retrosigmoid craniotomy required fewer opioids for pain control (p = 0.004). Furthermore, individuals receiving opioids were prone to obtain higher dosages of acetaminophen (odds ratio 1.054, 95% confidence interval 1.01–1.10, p = 0.022).

Conclusions

Opioids for acute postoperative analgesia after VS surgery may be necessary in many patients. However, middle- and long-term pain control can be accomplished using non-opioid treatment regimens, resulting in a reduction in opioid prescriptions and the accompanying negative effects on individual and public health.
Efficient use of the TM-2441 ambulatory blood pressure measurement device in patients with diabetes
Authors: Cicco Sebastiano , Marozzi Marialuisa Sveva , Schirosi Gabriella , Corvasce Francesco , Romano Daniele Egidio , Vacca Angelo , Nazzaro Pietro
Published: November 2024

Background and objective

Ambulatory blood pressure monitoring (ABPM) requires automatic measurement and the use of a validated device, according to current guidelines and international standardization. The TM-2441 (A&D Co. Ltd, Tokyo, Japan) ABPM device is small, lightweight, and suitable for use in ambulatory settings. It was validated against the ISO 81060-2:2013 standard in the general population. This study investigated the reliability of the ABPM device for patients with type 2 diabetes.

Methods

Individuals aged more than 12 years affected with type 2 diabetes were recruited by our outpatient clinic. The blood pressure assessment was performed using the opposite limb simultaneous measurement according to the updated ISO 81060-2:2018.

Results

Forty-five subjects were included in the clinical investigation. The mean difference between blood pressure values measured by the TM-2441 ABPM device and the reference sphygmomanometer was within limits allowed by the ISO standard. Bland–Altman plots of the measurements and differences between the values obtained from the study device and those from the reference device showed no systematic variations in error. It was not possible to perform a stress test in most patients due to refusal or poor physical condition.

Conclusion

The TM-2441 ABPM device fulfilled all the requirements of the ISO standard for ambulatory testing not only in a general population but also in the subgroup of subjects with type 2 diabetes.
Factors Associated With Psychotherapist and Psychiatrist Participation in Public Insurance
Authors: Tadmon Daniel , Gao Yihe Nina
Published: November 2024

Objectives:

This study aims to evaluate rates of public insurance participation among the different psychotherapist professions as well as among psychiatrists. In addition, it seeks to assess individual and contextual factors that are associated with public insurance participation.

Background:

Historically, Medicaid- and Medicare-insured individuals have faced unique barriers to access to mental health professionals. Because prior literature has focused on psychiatrists, little is currently known of public insurance participation rates among psychotherapists—even though they constitute the bulk of the mental health workforce.

Methods:

A retrospective analysis of Medicaid and Medicare participation among a census of all Georgia psychologists, licensed clinical social workers, licensed professional counselors, marriage and family therapists, as well as psychiatrists, using their complete licensing rosters as of November 2023 (N = 21,260).

Results:

Findings show that 82.7% of psychotherapists did not accept any public insurance. This rate was 58.8% among psychiatrists. Among Georgia-licensed clinicians located outside of the state, likely to practice through telehealth, insurance acceptance was substantially lower than their in-state peers', suggesting that telehealth may have limited reach among publicly-insured patients. Psychotherapists’ different professions, as well as factors such as urbanicity, hospital setting, practice size, and individual tenure length, were strongly associated with the likelihood of insurance participation.

Conclusion:

Psychotherapists’ low rates of participation in public insurance programs and meaningful variation between professions underscore that policies to better Medicaid and Medicare beneficiaries’ access to mental health treatment must consider psychotherapists’ unique practice patterns and implement interventions informed by them.
Quebec Health-Related Quality-of-Life Population Norms Using the Health Utilities Index Mark 3
Authors: Poder Thomas G. , Dohouin Irène ,   on Behalf of the TORSADE Cohort Working Group
Published: November 2024

Objectives:

To provide population utility norms from the Health Utilities Index Mark 3 (HUI3) for the province of Quebec, Canada.

Methods:

This study used data from the Care Trajectories Enriched Data (TorSaDE) cohort, which combines data from the Canadian Community Health Survey (CCHS) and the Quebec Provincial Insurance Board [Régie de l’assurance maladie du Quebec (RAMQ)]. The CCHS is a multiround health-related survey conducted by Statistics Canada since 2007. For each round spanning over 2 years, respondents were randomly selected and completed an online questionnaire. Quebec data for the HUI3 were available in the CCHS for rounds 2007, 2009, and 2013. The RAMQ database is an administrative database that contains information on health care services use and medical diagnostics. HUI3 scores were stratified by sociodemographic variables, as well as by self-reported health problems in the CCHS and by medical diagnostics from the RAMQ. Medical diagnostics were retrieved for the CCHS completion year and the year before and identifiable with the ICD-9 code in the RAMQ database.

Results:

A total of 55,656 individuals were considered in this analysis. The mean (95% CI) and the median interquartile range of HUI3 were respectively 0.919 (0.918–0.919) and 0.973 (0.905–1) for the entire population. Individuals with lower scores were females, those aged 75 and over, divorced or widowed, unemployed during the last 12 months, less educated, or with a lower annual household income. Individuals born abroad and with normal weight of body mass index had higher utility scores. HUI3 score decreased with the number of diagnosed diseases from 0.946 (0.946–0946) for individuals without diagnosed disease to 0.682 (0.678–0.686) for individuals diagnosed with up to 18 diseases. Regardless of the number of diagnosed diseases in the RAMQ database, individuals who self-reported suffering from a single health problem presented a significantly lower HUI3 ranging from 0.944 (0.943–0.944) for Asthma to 0.789 (0.782–0.796) for Alzheimer compared with 0.956 (0.956–0.957) for individuals with no reported health problems. The same pattern was observed when considering individuals regardless of the diagnosed and self-reported diseases.

Conclusion:

Utility score norms for HUI3 were produced in the general population of Quebec. Significant differences among various health problems were identified and norms can be used to compare populations in studies that do not have a control group.
Population health strategies for health equity in chronic kidney disease management: Retracted
Authors: Brown Christopher O. , Pham Phuong-Chi , Shah Anuja , Dukkipati Ramanath , Shen Jenny , Dai Tiane , Raff Evan A. , Kalantar-Zadeh Kamyar
Published: November 2024

Purpose of review

Chronic kidney disease (CKD) is a widespread health issue, affecting one out of every 10 adults. This prevalence is even higher among vulnerable and underserved populations, including low-income individuals, racial and ethnic minorities, and immigrants. Urban areas such as New York City and Los Angeles County offer municipal safety-net healthcare systems for these groups.

Recent findings

Safety-net providers are essential to the healthcare landscape for vulnerable populations with chronic diseases including the Los Angeles County Health Services that exemplifies how effective population health strategies can be utilized to manage CKD and at-risk persons. These approaches focus on risk assessment, integrated practices, patient and care-partner education, cost reduction, and strategic partnerships. Kidney care tailored “Expected Practices” ensure that management strategies are equitable and based on clinical evidence. The eConsult system allows CKD patients’ primary care providers to efficiently consult nephrologists, facilitating timely specialty care appointments through “Precision Scheduling.” Priority goals include slowing CKD progression, equitable access to home dialysis, and preemptive kidney transplantation. As highlighted by Kalantar-Zadeh et al. in 2025 CJASN, advancing equitable kidney care through population health approaches support comprehensive and efficient CKD management, including diabetic kidney disease, in Los Angeles County's safety-net system.

With a large, underserved patient population affected by CKD, urban safety-net healthcare systems like those in Los Angeles County emphasize early detection, multidisciplinary management, shared decision-making, and equitable access to CKD. They prioritize equitable access to home dialysis modality choice and kidney transplantation, aiming to improve outcomes and the quality-of-life for diverse patient groups.
Predicting higher-risk growth patterns in invasive lung adenocarcinoma with multiphase multidetector computed tomography and 18F-fluorodeoxyglucose PET radiomics
Authors: Luo Yi , Li Xiaoguang , Sun Jinju , Liu Suihan , Zhong Peng , Liu Huan , Chen Xiao , Fang Jingqin
Published: November 2024

Purpose

To develop a predictive model for identifying the higher-risk growth pattern of invasive lung adenocarcinoma using multiphase multidetector computed tomography (MDCT) and 18F-fluorodeoxyglucose (FDG) PET radiomics.

Methods

A total of 203 patients with confirmed invasive lung adenocarcinoma between January 2018 and December 2021 were enrolled and randomly divided into training (n = 143) and testing sets (n = 60). Patients were classified into two groups according to the predominant growth pattern (lower-risk group: lepidic/acinar; higher-risk group: papillary/solid/micropapillary). Preoperative multiphase MDCT and 18F-FDG PET images were evaluated. The Artificial Intelligence Kit software was used to extract radiomic features. Five predictive models [arterial phase, venous phase, and plain scan (AVP), PET, AVP-PET, clinical, and radiomic-clinical (Rad-Clin) combined model] were developed. The models’ performance was assessed using receiver-operating characteristic (ROC) curves and compared using the DeLong test.

Results

Among the radiomics models (AVP, PET, and AVP-PET), the AVP-PET model [area under ROC curve (AUC) = 0.888] outperformed the PET model (AUC = 0.814; P = 0.015) in predicting the higher-risk growth patterns. The combined Rad-Clin model (AUC = 0.923), which integrates AVP-PET radiomics and five independent clinical predictors (gender, spiculation, long-axis diameter, maximum standardized uptake value, and average standardized uptake value), exhibited superior performance in predicting the higher-risk growth pattern compared with radiomic models (P = 0.043, vs. AVP-PET; P = 0.016, vs. AVP; P = 0.002, vs. PET) or the clinical model alone (constructing based on five clinical predictors; AUC = 0.793; P < 0.001).

Conclusion

The combined Rad-Clin model can predict the higher-risk growth patterns of invasive adenocarcinoma (IAC). This approach could help determine individual therapeutic strategies for IAC patients by distinguishing predominant growth patterns with high risk.
Recent advances in applying metabolomics to uncover dietary impact on cardiometabolic health
Authors: Zhang Naixin , Lundbergh Bjørn , Guasch-Ferré Marta
Published: November 2024

Purpose of review

Cardiometabolic diseases are a major global health concern, with diet playing a crucial role in their prevention and management. Recent advancements in the identification of metabolic signatures related to dietary patterns offer a more objective assessment of individualized dietary exposure and provide deeper insights into diet-disease associations.

Recent findings

Recent studies have shown that distinct metabolic signatures are associated with the adherence to various dietary patterns. These signatures show even stronger associations with cardiometabolic disease incidence, independent of traditional risk factors and self-reported adherence to such dietary patterns. Emerging dietary approaches, such as sustainable diets, health outcome-focused diets, and population data-driven dietary patterns, also hold promise for improving cardiometabolic health. Additionally, metabolic signatures could offer insights into diet-disease associations in underrepresented populations, addressing genetic and lifestyle differences.

Application of metabolomics provides a more precise understanding of how dietary patterns influence cardiometabolic health. Although the number of studies remains limited, and current evidence is inconsistent, the approach has significant potential for improving clinical and public health strategies. Future research should prioritize prospective studies and address population- and outcome-specific dietary needs to enable targeted interventions that optimize cardiometabolic health.
Advances in cellular therapies for children and young adults with solid tumors
Authors: Choe Michelle , Campbell Matthew , Albert Catherine M.
Published: November 2024

Purpose of review

Adoptive immunotherapy brings hope to children and young adults diagnosed with high-risk solid tumors. Cellular (cell) therapies such as chimeric antigen receptor (CAR) T cell, CAR natural killer (NK) cell, and T cell receptor (TCR) T cell therapy are potential avenues of targeted therapy with limited long-term toxicities. However, development of cell therapies for solid tumors is in its nascent stages. Here, we will review the current clinical experience, barriers to efficacy, and strategies to improve clinical response and patient access.

Recent findings

Cell therapies are shown to be generally safe and well tolerated. Strategies to optimize antitumor activity have now moved into early-phase trials. The immunosuppressive tumor microenvironment remains a major barrier to efficacy, and efforts are underway to gain better understanding. This will inform future treatment strategies to enhance the antitumor activity of cell therapies.

Clinical experiences to date provide important insights on how to leverage cell therapies against solid tumors. Key factors in advancing the field include a better understanding of immune cell biology, tumor cell behavior, and the tumor microenvironment. Lastly, improving access to novel cell therapies remains an important consideration in the conduct of clinical trials and for future implementation into standard practice.
Neuroblastoma Occurring in Nijmegen Breakage Syndrome
Authors: Djurisic Marina , Sarajlija Adrijan , Radivojevic Danijela , Cirkovic Sanja , Djokic Dragoljub , Djuricic Slavisa , Samardzija Gordana , Pasic Srdjan
Published: November 2024

Nijmegen breakage syndrome (NBS) is a rare primary immunodeficiency disease due to a pathogenic variant in the NBN gene causing impaired DNA repair and increased predisposition for lymphoid malignancy. By contrast, solid tumors have been rarely reported. Neuroblastoma (NB) is a rare childhood solid tumor, associated with the worse outcome if MYCN oncogene is amplified. We describe 2 young pediatric patients with NBS who developed high-risk NB. The first patient died shortly after chemotherapy was introduced. The second patient successfully received modified chemotherapy resulting in clinical remission lasting 2 years after an initial diagnosis of NB.
Management of Spontaneous Epidural Hematoma in the Setting of Vaso-Occlusive Crisis Among Pediatric Patients With Sickle Cell Disease: A Case Series and Scoping Literature Review
Authors: Patel Rutvi , Reisert Hailey , Keymakh Margaret , Drakou Eleni , Briggs Jessica , Cohen Joshua , Lee Jimmy S. , Lax Daniel , Strumph Kaitlin , Behbahani Mandana , Baker Amanda , Kobets Andrew
Published: November 2024

Spontaneous epidural hematoma (EDH) is a rare sickle cell disease (SCD) complication. We report 3 pediatric cases with SCD and spontaneous EDH and 1 with subgaleal hematomas in the setting of vaso-occlusive crises and elaborate on their presentation and management. Through a scoping review, we identified 71 additional cases reported from 1970 to 2024 and highlighted notable features. We highlight skull infarction as a prognostic factor associated with 88% lower odds of death relative to patients without skull infarction (P<0.01). We clarify optimal management strategies like early and aggressive treatment of disseminated intravascular coagulation (DIC), as 57% of patients with DIC died such that DIC was associated with 7.56 times higher odds of death (P=0.01).
Increasing Prevalence of Cerebral Palsy Among Two-Year-Old Children Born at <27 Weeks of Gestation: A Cohort Study
Authors: DeMauro Sara B. , McDonald Scott A. , Heyne Roy J. , Vohr Betty R. , Duncan Andrea F. , Newman Jamie E. , Das Abhik , Hintz Susan R. ,   On Behalf of the NICHD Neonatal Research Network
Published: November 2024

(Abstracted from J Pediatr 2024;268:113944)

Cerebral palsy (CP) is a group of neurodevelopmental motor and coordination disorders that disproportionately affect preterm children. While some studies suggest a decline in CP diagnoses among preterm children born from the 1990s to the early 2010s, findings vary by gestational age and birth weight.
IRF8 Demonstrates Positivity in a Significant Subset of Histiocytic and Dendritic Cell Neoplasms
Authors: Patwardhan Pranav P. , Bailey Nathanael G. , Monaghan Sara A. , Singhi Aatur D. , Aggarwal Nidhi , Djokic Miroslav , Moore Erika M. , Rea Bryan
Published: November 2024

Histiocytic and dendritic cell neoplasms, especially histiocytic sarcoma, can show morphologic and phenotypic overlap with immature monocytic neoplasms. IRF8 immunohistochemical staining has been demonstrated to be useful in identifying monoblasts, but it has not been extensively studied in histiocytic and dendritic cell neoplasms. IRF8 immunohistochemistry was performed on cases of histiocytic sarcoma (HS, n=6), Langerhans cell histiocytosis (LCH, n=25), Rosai Dorfman disease (RDD, n=17), follicular dendritic cell sarcoma (FDCS, n=3), and Erdheim Chester disease (ECD, n=5), along with a control group that included a subset of myeloid neoplasms with monocytic differentiation. Of 89 total cases, IRF8 was positive in 3/6 cases of HS, 3/5 cases of ECD, 12/17 cases of RDD, 7/25 cases of LCH, and 0/3 cases of FDCS. Control cases were stained similarly to previous reports, with IRF8 expression roughly correlating to monoblast count and normal staining in other control groups. We demonstrate that IRF8 is expressed in a significant subset of tested neoplasms of histiocytic and dendritic cell lineage. While we confirmed that IRF8 is useful to identify monoblasts, these results highlight that IRF8 cannot be reliably used to distinguish histiocytic sarcomas from myeloid neoplasms of monocytic lineages, and caution is advised interpreting IRF8 staining in that setting.
Perceptions of Criticality and Frequency of Tasks by the Public Health Workforce, 2022
Authors: Kurz Richard S. , Foster Allison , Bowen L. Michael , Bender Kaye
Published: November 2024

Introduction:

Since the occurrence of the COVID-19 pandemic, there has been significant interest in the public health workforce and its development. Substantial emphasis has been placed on the competencies needed for the development of the workforce. As important as this work on competencies is to a competent public health workforce, the certification of public health professionals and the maintenance of their skills and knowledge is of equal importance. The National Board of Public Health Examiners (NBPHE), along with other organizations, plays a key role in this process. Based on the National Board of Public Health Examiner’s 2022 JTA, this study investigates the specific tasks that are performed by the public health workforce in each of 10 domains, their criticality and frequency, and the relationship of their criticality to their frequency.

Methods:

Using data from the National Board of Public Health Examiners (NBPHE) job task analysis (JTA), the criticality and frequency of tasks and their relationship were investigated through tabular analysis.

Results:

Ten tasks were identified as the most critical, focused on the domains of communication, leadership, resource and program management, and law and ethics. The 10 most frequent tasks were the same as the most critical tasks in 8 instances. When the criticality of all tasks was related to their frequency, 12 tasks were found to have high criticality and high frequency, 17 tasks had low criticality and low frequency, and 74 tasks had high criticality and low frequency. In our data, no low criticality tasks were performed frequently.

Discussion:

Results are discussed for their relevance to education in public health and practitioner development. A key takeaway is that workforce tasks and competencies appear to provide two different and important ways to analyze workforce activity in future research.
An Incognito Standardized Patient Approach for Measuring and Reducing Intersectional Healthcare Stigma: A Pilot Cluster Randomized Control Trial
Authors: Smith M. Kumi , Luo Danyang , Meng Siyan , Fei Yunqing , Zhang Wei , Tucker Joseph , Wei Chongyi , Tang Weiming , Yang Ligang , Joyner Benny L. , Huang Shujie , Wang Cheng , Yang Bin , Sylvia Sean Y.
Published: November 2024

Background:

Consistent evidence shows stigma impedes healthcare access in people living with HIV (PLWH) and men who have sex with men (MSM). We evaluated the impact of stigma reduction training for providers whose design was informed by direct observation of their clinical behaviors obtained through visits by incognito standardized patients (SPs).

Setting:

We conducted this study in sexually transmitted disease clinics in Guangzhou, China.

Methods:

This pilot cluster randomized control trial assessed the feasibility, acceptability, and preliminary efficacy of an intervention whose design was informed by a baseline round of incognito visits in which SPs presented standardized cases to consenting doctors. By randomly varying the HIV status and sexual orientation of each case, we could quantify stigma as differences in care quality across scenarios. We then conducted a follow-up round of SP visits and assessed the impact using linear fixed effects regression.

Results:

Feasibility and acceptability among the 55 provider participants were high, with no adverse visit events. The provider training improved the offering of testing to HIV-negative MSM (0.05 percentage points, 95% confidence interval, −0.24 to 0.33) and diagnostic effort for HIV-positive MSM (0.23 SD improvement, 95% CI: −0.92 to 1.37). Patient-centered care only improved for HIV-positive straight cases (SD, 0.57; 95% CI: −0.39 to 1.53). All estimates lacked statistical precision, an expected outcome of a pilot randomized control trial.

Conclusions:

Our training reduced stigma in several domains of care, but least of all for PLWH, suggesting that future trainings should include more clinical content to strengthen clinical skills in PLWH management.
IDEAL-IQ Magnetic Resonance Imaging Fat Fraction Quantification in Distinguishing Thymic Hyperplasia From Low-Risk Thymoma and Thymic Lymphoma in Adulthood: A Reliability and Efficacy Analysis
Authors: Zhang Jie , Feng Xiu-Long , Ma Yu-Hui , Lan Jiang-Tao , Wang Shu-Mei , Yang Guang , Hu Yu-Chuan , Cui Guang-Bin
Published: November 2024

Objectives

Detection of fat content in thymic lesions is essential to differentiate thymic hyperplasia from thymic tumors. This study assesses the reliability and efficacy of “iterative decomposition of water and fat with echo asymmetry and least-squares estimation quantization” IDEAL-IQ magnetic resonance sequence in distinguishing thymic hyperplasia from low-risk thymoma and thymic lymphoma in adulthood.

Methods

Thirty patients with thymic hyperplasia, 28 low-risk thymomas, and 13 thymic lymphomas were respectively enrolled. All subjects underwent conventional thorax magnetic resonance imaging and IDEAL-IQ sequence. The fat fraction (FFmean and FFtotal), signal intensity index, and R2* values of the lesions were compared for differences among 3 groups by the Mann-Whitney U and Kruskal-Wallis tests. Receiver operating characteristic curve analysis was performed to determine the differentiating efficacy.

Results

Both FFmean and FFtotal values in patients with thymic hyperplasia are significantly higher than those in patients with low-risk thymoma and thymic lymphoma (FFmean: 26.41% vs 1.78% and 1.93%, FFtotal: 27.67% vs 2.21% and 2.44%; both P < 0.001), whereas there was no significant difference in these values between low-risk thymomas and thymic lymphomas (both P > 0.05). Similarly, signal intensity index and R2* values of thymic hyperplasia were significantly higher than those of patients with low-risk thymoma and thymic lymphoma (P < 0.001). Receiver operating characteristic curve analysis showed that FFmean had an area under the curve of 0.998, with a cutoff of 4.78% yielding 95.12% sensitivity and 100% specificity, and FFtotal had an area under the curve of 0.994, with a cutoff of 8.57% yielding 97.56% sensitivity and 96.67% specificity in distinguishing thymic hyperplasia from tumors.

Conclusions

IDEAL-IQ sequence provides accurate fat quantitative parameters and can differentiate thymic hyperplasia from thymic neoplasms with robust efficacy and reliability.
Safety of Gadopiclenol After Its First Year of Clinical Use
Authors: Spinazzi Alberto , Lancelot Eric , Vitali Letizia , Cot Christophe , Pirovano Gianpaolo , Joseph Alvin , Kirchin Miles A. , Darmon-Kern Elisabeth , Bourrinet Philippe
Published: November 2024

Gadopiclenol is a novel, macrocyclic high-relaxivity gadolinium-based contrast agent recently approved for use in magnetic resonance imaging of the central nervous system and body organs at a dose of 0.05 mmol/kg body weight. Postmarketing surveillance of its first year of clinical use in the United States of America showed no serious adverse events (AEs) following over 882,550 administrations and a very low rate of nonserious AEs (1 case every 27,580 exposures). The types of observed AEs were similar to those reported for other gadolinium-based contrast agents in clinical use. Safety data from postmarketing surveillance of gadopiclenol further confirm its positive benefit-risk profile demonstrated in preapproval clinical studies.
Human placental stem cell–based therapies for prevention of abdominal adhesions: A prospective randomized preclinical trial
Authors: Carmichael Samuel P. , Chandra Prafulla K. , Vaughan John W. , Kline David M. , Holcomb John B. , Atala Anthony
Published: November 2024

BACKGROUND

Abdominal adhesions are networks of fibrotic tissues that form between organs postoperatively. Current prophylactic strategies do not reproducibly prevent adhesive small bowel obstruction across the entire abdomen. Human placental-derived stem cells produce an anti-inflammatory secretome that has been applied to multiple fibrosing diseases. The purpose of this project is to test human placental stem cell (hPSC)–based therapies for prevention of abdominal adhesions in a clinically relevant rat model.

METHODS

Fifty-four (n = 54, n = 6/group) male Sprague-Dawley rats (250–350 g) underwent model creation and treatment randomization under anesthesia. Experimental groups included human placental-derived stem cells (hPSC, 5 × 106 cells/10 mL Plasmalyte A), human placental-derived stem cells in a hyaluronic acid (HA-Mal-hPSC) hydrogel, the human placental-derived stem cell secretome from conditioned media in 10 mL Plasmalyte A, human placental-derived stem cells' conditioned media in a hyaluronic acid (HA-Mal-CM) hydrogel, Plasmalyte A (media alone, 10 mL), hyaluronic acid hydrogel alone (HA-Mal), Seprafilm (Baxter, Deerfield, IL), and the control groups, model with no treatment (MNT) and sham animals. Treatments were administered intraperitoneally, and the study period was 14 days postoperation. Adhesions were scored at necropsy and analyzed as the difference between means of an index statistic (Animal Index Score) versus MNT. Underlying molecular mechanisms were explored by functional genomic analysis and histology of peritoneal tissues.

RESULTS

Hyaluronic acid hydrogel alone, HA-Mal-CM hydrogel, and Seprafilm significantly reduced the overall appearance of abdominal adhesions by mean Animal Index Score at 14 days versus MNT. Human placental stem cell, HA-Mal-hPSC hydrogel, HA-Mal-CM hydrogel, HA-Mal hydrogel alone, and Seprafilm significantly reduced the collagen content of injured peritoneal tissues. Human placental stem cell and HA-Mal-hPSC hydrogel suppressed expression of the most profibrotic genes. Conditioned media, HA-Mal hydrogel alone, and media alone significantly altered the expression of proteins associated with peritoneal fibrotic pathways.

CONCLUSION

Human placental stem cell–based therapies reduce abdominal adhesions in a prospective randomized preclinical trial. This effect is supported by suppression of profibrotic genomic and proteomic pathways.
Mitigating High-risk EBV and CMV Through Kidney Paired Donation: A Survey of Potential Donor and Recipient Candidates
Authors: Kalaria Arjun , Mehta Rajil B. , Sood Puneet , Zhang Xingyu , Morford Harry J. , Potluri Vishnu , Bridges John F. P. , Puttarajappa Chethan M.
Published: November 2024

Background.

High-risk cytomegalovirus (CMV) and Epstein-Barr virus (EBV) mismatches (ie, seropositive donors to seronegative recipients) among kidney transplant recipients lead to increased healthcare utilization, inferior allograft outcomes, and high mortality. We assessed the interest among prospective kidney donor and recipient candidates to participate in kidney paired donation (KPD) for averting CMV/EBV high-risk mismatches.

Methods.

We surveyed 51 potential living donors and 102 kidney recipient candidates presenting for their evaluation visit at the University of Pittsburgh Medical Center between October 2022 and May 2023. We evaluated their general inclination toward KPD and their interest in KPD under various risk-benefit scenarios, particularly emphasizing the mitigation of high-risk mismatches associated with EBV and CMV. This was done using a 5-point Likert scale (1-low interest; 5-high interest) customized survey.

Results.

There was high interest in KPD among both donor and recipient candidates (median score 4 versus 4; P = 0.09). However, donor candidates had a lower interest in KPD if they were compatible with their intended recipient (median score 2 versus 4; P < 0.001). Most donor (80.4%; N = 41) and recipient candidates (89.2%; N = 91) expressed a strong willingness to participate in KPD to prevent high-risk CMV and EBV mismatches, but this interest declined with longer transplant delays. Interest also varied on the basis of participants’ income and employment status.

Conclusions.

Interest in KPD for avoiding CMV and EBV was high among both donor and recipient candidates. Additional research is required to assess the capacity and desirability for KPD expansion, particularly among ABO and HLA-compatible pairs.