bluuebunny/crossref_metadata_2025 huggingface dataset:
Filtering heart rates using data densities: The boxfilter R package
Authors: Ruf Thomas , Signer Claudio , Arnold Walter , Vetter Sebastian G. , Bieber Claudia
Published: April 2024

Over the past decades, there has been a growing interest in long‐term heart rate records, especially from free‐living animals. Largely, this increase is because most of the metabolic activity of tissues is based on oxygen delivery by the heart. Therefore, heart rate has served as a proxy for energy expenditure in animals.

However, heart rates or other physiological variables recorded in humans and animals using loggers often contain noise. False measurements are sometimes eliminated by hand or by filters that reject variables based on the shape or frequency of the signal. Occasionally, outliers are rejected because they occur a long distance from genuine data.

We introduce an R package, boxfilter, which enables users to eliminate noise based on counting the number of close neighbours inside a gliding window. Depending on the cut‐off value chosen, a focal point with a low proportion of neighbours will be rejected as noise.

All three parameters, namely window width and height, as well as the cut‐off value, can be computed automatically. The choice of the clip‐off value beyond which data points are discarded is crucial. The package boxfilter cannot, of course, solve problems caused by completely erroneous measurements.

Like the human eye, this filter prefers points that are part of a pattern, such as a dense band, and rejects isolated values. The boxfilter may also be applied to other measures than heart rate that do not change instantaneously, such as body temperature, blood pressure or sleep parameters.
Long‐term trends in beverage‐specific drinking in the National Alcohol Surveys: Differences by sex, age, and race and ethnicity
Authors: Kerr William C. , Lui Camillia K. , Ye Yu , Li Libo , Greenfield Thomas , Karriker‐Jaffe Katherine J. , Martinez Priscilla
Published: April 2024

Background

Despite substantial declines in underage drinking and binge drinking, alcohol consumption has increased in the past 30 years. This study examined how beverage‐specific drinking patterns varied by sex, age, and race and ethnicity from 1979 to 2020.

Methods

Secondary data analysis was conducted on pooled data from the National Alcohol Survey series from 1979 to 2020 of a sample of U.S. adults ages 18 years or older. Total and beverage‐specific volume were calculated from graduated frequency questions on reported beverage type, which included beer, wine, and spirits. Sex‐stratified analyses focused on descriptive trends of each alcohol measure over time and by age and race and ethnicity. Time‐varying effect models were also conducted to identify subgroups at higher risk for increased consumption over time.

Results

Women's drinking increased, with alcohol volume rising substantially from 2000 to 2020; the largest increase was among women 30 and older. Men's alcohol volume also rose over this period but remained below the levels of 1979 and 1984, with older adults increasing their consumption those 18–29 decreased their drinking. Beverage‐specific trends showed some similarities by gender: in 2020, wine volume was at its highest level for both women and men, while spirits volume also was at its highest level for men and in women was tied with the 1979 peak in spirits consumption. Increases were also found among Black men and women and Latina women from 2000 to 2020.

Conclusions

Given the increases in alcohol volume, particularly among women and older age groups, alcohol policy, interventions, and education should consider ways to reduce harms associated with alcohol use among these groups. Continued monitoring of beverage‐specific drinking patterns is needed to track policy‐relevant changes.
Antenatal health and perinatal outcomes of Pacific Islander women in Australia with and without gestational diabetes: A ten‐year retrospective cohort study
Authors: Jones Annabel S. , Deitch Jessica , Yates Christopher , Hamblin Peter Shane , Teale Glyn , Kevat Dev , Lee I‐Lynn
Published: April 2024

Background

Pacific Islander (PI) women in Australia have an increased risk of gestational diabetes (GDM); however, their perinatal outcomes are poorly understood.

Aim

The aim was to determine the maternal characteristics and perinatal outcomes of PI women with and without GDM compared to Australian/European (AE)–born women.

Methods

A retrospective analysis of perinatal outcomes of singleton deliveries >20 weeks’ gestation between 1 January 2011 and 31 December 2020 was conducted at a tertiary provider (Melbourne, Australia). Antenatal details and birth outcomes were extracted from the Birth Outcome Systems database. t‐Tests and χ2, univariate and multivariable logistic regression analyses assessed the relationship between ethnicity and outcomes.

Results

Of 52,795 consecutive births, 24,860 AE women (13.3% with GDM) and 1207 PI‐born women (20.1% with GDM) were compared. PI women had significantly greater pre‐pregnancy body mass index (BMI) and significantly lower rates of smoking and nulliparity. PI women with GDM had higher rates of pre‐eclampsia (P < 0.001), large‐for‐gestational age (LGA) neonates (P = 0.037) and neonatal hypoglycaemia (P = 0.017) but lower rates of small‐for‐gestational age neonates (P = 0.034). Neonatal intensive care unit (NICU)/special care nursery requirements did not increase. After having adjusted for covariates, PI women's risk of LGA neonates (adjusted odds ratio (aOR): 1.06, 95% confidence interval (CI): 0.86–1.31) was attenuated; however, risk of pre‐eclampsia (aOR: 1.49, 95% CI: 1.01–2.21) and neonatal hypoglycaemia (aOR: 1.40, 95% CI: 1.01–1.96) still increased. They were less likely to require a primary caesarean section (aOR: 0.86, 95% CI: 0.73–0.99).

Conclusion

PI women have higher BMI and GDM rates, contributing to an increased likelihood of adverse perinatal outcomes. BMI is a modifiable risk factor that could be addressed prenatally.
Low concentrations of TNF‐α in vitro transform the phenotype of vascular smooth muscle cells and enhance their survival in a three‐dimensional culture system
Authors: Sun Xu‐heng , Jiang Hong‐jing , Liu Qing , Xiao Cong , Xu Jian‐yi , Wu Yindi , Mei Jing‐yi , Wu Shu‐ting , Lin Zhan‐yi
Published: April 2024

Background

Vascular smooth muscle cells (VSMCs) are commonly used as seed cells in tissue‐engineered vascular constructions. However, their variable phenotypes and difficult to control functions pose challenges. This study aimed to overcome these obstacles using a three‐dimensional culture system.

Methods

Calf VSMCs were administered tumor necrosis factor‐alpha (TNF‐α) before culturing in two‐ and three‐dimensional well plates and polyglycolic acid (PGA) scaffolds, respectively. The phenotypic markers of VSMCs were detected by immunofluorescence staining and western blotting, and the proliferation and migration abilities of VSMCs were detected by CCK‐8, EDU, cell counting, scratch, and Transwell assays.

Results

TNF‐α rapidly decreased the contractile phenotypic markers and elevated the synthetic phenotypic markers of VSMCs, as well as markedly increasing the proliferation and migration ability of VSMCs under two‐ and three‐dimensional culture conditions.

Conclusions

TNF‐α can rapidly induce a phenotypic shift in VSMCs and change their viability on PGA scaffolds.
Temporal changes in incidence, prevalence and causes of childhood visual impairment – Learnings from 45 years with the National Danish Registry of Children with Visual Impairment
Authors: Kessel Line , Jensen Hanne , Larsen Ann‐Cathrine , Rosenberg Thomas , Nissen Kamilla Rothe
Published: April 2024

Purpose

The aim of the study was to describe the temporal changes in causes and prevalence of childhood visual impairment in Denmark based on the National Danish Registry of Children with Visual Impairment (NDRCVI).

Methods

Annual reports on the NDRCVI since its establishment in 1979 were reviewed and data on the number of registered children and the causes for registration with a visual impairment were evaluated.

Results

The average annual incidence of childhood visual impairment in Denmark is 2.8 per 1000 live‐born children and the prevalence of childhood visual impairment is 1.6 per 1000 children <18 years. Today, fewer children are severely visually impaired (visual acuity ≤6/60) at the time of registration (31.6% since 2010 vs. 51.1% in the 1980s). Cerebral visual impairment and optic nerve atrophy have remained common causes of childhood visual impairment whereas sequelae to retinopathy of prematurity have been almost eliminated as a cause. Systemic comorbidities are more common now in children with visual impairment (seen in 63.9% in the last decades vs. 44.6%in the 1980‐ties).

Conclusion

Whereas the prevalence of visual impairment has remained relatively stable over the years, the severity of visual impairment has improved, suggesting that more children will be able to live an active life supported by aids compensating vision loss. However, more children have systemic comorbidities in combination with their visual impairment suggesting that children with visual impairment face a life not only limited by the obstacles of poor vision. This calls for multidisciplinary management and support of affected children and families.
Cefepime distribution by microdialysis in peritoneal fluid of rats with or without experimental peritonitis
Authors: dos Anjos Michele Vaz , Possa Eduarda , Fonseca Gisele da Silva , Bergoza Larissa , Tasso Leandro
Published: April 2024

The aim of this study was to investigate the penetration of cefepime into rat peritoneal fluid by microdialysis and to determine the relationship between unbound drug plasma and tissue concentration in healthy animals and in a sepsis model established through cecal ligation and puncture‐induced peritonitis. Probe recovery was performed by dialysis and retrodialysis. Cefepime was administered at a dose of 110 mg/kg intravenously. Samples were collected for about 4 h, and concentrations were determined by liquid chromatography‐electrospray ionization‐QTOF MS. Tissue penetration was also determined. Probe recovery in vivo was 38.78% ± 3.31% and 38.83% ± 2.74% in the control and peritonitis groups, respectively. Cefepime was rapidly distributed in the peritoneal fluid in both groups. The peritoneal fluid/plasma cefepime ratio was 0.38 and 0.32 for the control and peritonitis groups, respectively. Cefepime concentrations were above the MIC of 4 mg/L for the main enterobacteria. The infection model that was used had no apparent effect on the pharmacokinetics of cefepime in rats. This was the first study to determine free cefepime concentrations in the peritoneal fluid of healthy rats and rats with experimental peritonitis.
In vitro determination of the susceptibility of Malassezia furfur biofilm to different commercially used antimicrobials
Authors: Cassola Fábio , Ramírez Nedy , Delarmelina Camila , Duarte Marta Cristina Teixeira
Published: April 2024

Malassezia furfur is a yeast known as the etiological agent of seborrheic dermatitis. We evaluated the action of five different antimicrobials (amphotericin B, chloramphenicol, ketoconazole, fluconazole, and nystatin) on inhibiting biofilm formation and removing biofilm already formed by M. furfur. The assays were carried out using the microdilution method, and scanning electron microscopy images were used to analyze the biofilm structure. According to the results obtained, the percentage of inhibition was higher for chloramphenicol, followed by ketoconazole, nystatin, and amphotericin B. Regarding the eradication of the biofilm formed, the highest percentage was chloramphenicol, followed by ketoconazole and nystatin. Amphotericin B did not affect biofilm eradication, whereas fluconazole did not cause significant changes inhibiting or removing M. furfur biofilm. Therefore, except for fluconazole, all evaluated antimicrobials had inhibiting effects on the biofilm of M. furfur, either in its formation and/or eradication. Although the results achieved with chloramphenicol have been highlighted, further in vitro and in vivo studies are still needed in order to include this antimicrobial in the therapy of seborrheic dermatitis due to its toxicity, especially to the bone marrow.
Influences of oxidative stress and energy balance on pregnancy rates after the transfer of embryos to repeat‐breeder Japanese Black cattle
Authors: Isobe Tomohiro , Kajihara Yuusuke , Ikebata Yoshihisa
Published: April 2024

The purpose of this study is to reassess our previously reported findings on the diminished pregnancy rate of embryo transfer (ET) in summer for repeat‐breeder (RB) cows compared with other seasons, with a focus on oxidative stress and energy balance. The study involved Japanese Black cattle, including 224 heifers (aged <3 years) and 278 (aged <9 years) cows with one or more deliveries, defined as RB animals. Evaluation of the effects of season on pregnancy rates revealed significantly lower rates in RB cows during summer compared with spring and autumn. Moreover, serum malondialdehyde (MDA) concentration in RB cows during summer was significantly higher than in winter, with no difference in RB heifers. Seasonal effects on serum nonesterified fatty acid (NEFA) concentration in both RB heifers and RB cows showed no significant differences. However, median MDA and NEFA concentrations in RB cows were significantly elevated compared with RB heifers, suggesting that factors contributing to low fertility should consider parity. Furthermore, our study indicated that RB cows were under oxidative stress, as demonstrated by significantly elevated MDA concentrations compared with normally reproducing cows in summer. Further investigation is necessary to gain a better understanding of these observations in the future.
The information, control, and value models of mobile health‐driven empowerment
Authors: Gray Jesse , Segers Seppe , Mertes Heidi
Published: April 2024

Mobile health tools are often said to empower users by providing them with the information they need to exercise control over their health. We aim to bring clarity to this claim, and in doing so explore the relationship between empowerment and autonomy. We have identified three distinct models embedded in the empowerment rhetoric: empowerment as information, empowerment as control, and empowerment as values. Each distinct model of empowerment gives rise to an associated problem. These problems, the Problem of Interpretation, the Value Alignment Problem, and the Priority Problem, show that mobile health tools in their current form are either insufficient for empowerment or are self‐defeating. These digital health technologies encourage users to adopt an individualized conception of autonomy, one that may weaken the doctor–patient relationship and undermine practices in shared decision making, and ultimately may not deliver on improving the health outcomes for those that need it the most.
Surveillance of non‐muscle‐invasive bladder cancer with blue‐light cystoscopy: a meta‐analysis
Authors: Sari Motlagh Reza , Ghoreifi Alireza , Yanagisawa Takafumi , Kawada Tatsushi , Ahyai Sascha , Merseburger Axel S. , Abufaraj Mohammad , Abern Michael , Djaladat Hooman , Daneshmand Siamak , Shariat Shahrokh F.
Published: April 2024

Objective

To compare the value of flexible blue‐light cystoscopy (BLC) vs flexible white‐light cystoscopy (WLC) in the surveillance setting of non‐muscle‐invasive bladder cancer (NMIBC).

Methods

All major databases were searched for articles published before May 2023 according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement. The primary outcome was the accuracy of flexible BLC vs WLC in detecting bladder cancer recurrence among suspicious bladder lesions.

Results

A total of 10 articles, comprising 1634 patients, were deemed eligible for the quantitative synthesis. In the meta‐analysis focusing on the detection of disease recurrence, there was no difference between flexible BLC and WLC (odds ratio [OR] 1.08, 95% confidence interval [CI] 0.82–1.41)]; the risk difference (RD) showed 1% of flexible BLC, corresponding to a number needed to treat (NNT) of 100. In the subgroup meta‐analysis of detection of carcinoma in situ (CIS) only, there was again no significant difference between flexible BLC and WLC (OR 1.19, 95% CI 0.82–1.69), BLC was associated with a RD of 2% (NNT = 50). The positive predictive values for flexible BLC and WLC in detecting all types of recurrence were 72% and 66%, respectively, and for CIS they were 39% and 29%, respectively.

Conclusion

Surveillance of NMIBC with flexible BLC could detect more suspicious lesions and consequently more tumour recurrences compared to flexible WLC, with a increase in the rate of false positives leading to overtreatment. A total of 100 and 50 flexible BLC procedures would need to be performed to find on additional tumor and CIS recurences, respectively. A risk‐stratified strategy for patient selection could be considered when using flexible BLC for the surveillance of NMIBC patients.
Immunotherapy for advanced or metastatic urothelial carcinoma: an abridged Cochrane review
Authors: Maisch Philipp , Hwang Eu Chang , Kim Kwangmin , Narayan Vikram M. , Bakker Caitlin , Kunath Frank , Dahm Philipp
Published: April 2024

Objectives

To assess the effects of immunotherapy compared to chemotherapy as first‐ and second‐line treatment of advanced or metastatic urothelial carcinoma.

Methods

Based on a published protocol, we performed a systematic search of multiple databases. Two review authors independently performed the literature selection, identified relevant studies, assessed the eligibility of studies for inclusion, and extracted data. We performed statistical analyses using a random‐effects model and assessed the quality of the evidence on a per‐outcome basis according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Results

We included five randomised controlled trials and also identified seven single‐arm studies. When used as first‐line therapy, immunotherapy probably has little to no effect on the risk of death from any cause compared to chemotherapy (hazard ratio [HR] 0.97, 95% confidence interval [CI] 0.87–1.07; moderate‐certainty evidence). immunotherapy probably has little to no effect on health‐related quality of life (mean difference [MD] 4.10, 95% CI 3.83–4.37; moderate). Immunotherapy probably reduces grade 3–5 adverse events (risk ratio [RR] 0.47, 95% CI 0.29–0.75; moderate). In the second‐line setting immunotherapy may reduce the risk of death from any cause (HR 0.72, 95% CI 0.63–0.81; low). Immunotherapy may have little to no effect on health‐related quality of life when compared to chemotherapy (MD 4.82, 95% CI −3.11 to 12.75; low). Immunotherapy may reduce grade 3–5 adverse events (RR 0.89, 95% CI 0.81–0.97; low).

Conclusions

Compared to chemotherapy, immunotherapy has little to no effect on the risk of death from any cause in a first‐line setting. Nevertheless, it may reduce the risk of death from any cause when used as second‐line therapy. The health‐related quality of life of participants receiving first‐ and second‐line therapy does not appear to be affected by immunotherapy. Immunotherapy probably reduces or may reduce grade 3–5 adverse events when used as first‐ and second‐line therapy, respectively.
Last interglacial in western Europe: 20 years of multidisciplinary research on the Eemian (MIS 5e) calcareous tufa sequence at Caours (Somme basin, France) – a review
Authors: Antoine Pierre , Limondin‐Lozouet Nicole , Dabkowski Julie , Bahain Jean‐Jacques , Ghaleb Bassam , Reyss Jean‐Louis , Auguste Patrick , Sévêque Noemie , Jamet Guillaume , Jolly‐Saad Marie‐Claude , Gauthier Agnès , Lebreton Loïc , Locht Jean‐Luc
Published: April 2024

The calcareous tufa sequence and associated Palaeolithic site of Caours were discovered in 2002 during a test‐pit campaign aimed at identifying last interglacial (MIS 5e) archives in the fluvial terrace system of the Somme basin, northern France. The presence of an outstanding stratigraphical succession with four in situ Palaeolithic layers within the tufa sequence has motivated archaeological excavations of the site since 2005. The first malacological studies and U‐series ages quickly showed that the sequence was mainly deposited during the Eemian interglacial (MIS 5e). After 20 years of investigations, we propose here a summary of this multidisciplinary research project including stratigraphy, sedimentology, geochronology, geochemistry, malacology, mammals, palaeovegetation and archaeology. By combining 25 dates obtained by U‐series, ESR/U‐series, TL and OSL methods, the Caours calcareous tufa sequence is securely dated to the Eemian (123.1±2.8 ka). Based on the summary of the whole information, we propose a robust and detailed reconstruction of the modification of the valley environments between the Late Saalian and the Early Weichselian. At the scale of northwestern Europe, Caours provides a reference terrestrial molluscs record for the Eemian interglacial, including the climatic optimum, that is also described in the same layers by δ18O and δ13C analyses on calcite and by mammal remains. Moreover, the 300‐m‐long transect crossing the fluvial terrace covered by the tufa sequence and the bottom valley formation, combined with the chronology established from U‐series and OSL ages, shows that the incision of the present‐day valley, leading to the setting of the Very Low Terrace, was achieved during the first stages of the Early Weichselian (MIS 5d–5c). From an archaeological point of view, the configuration of the Caours site is unique at the scale of western Europe and demonstrates the adaptation of Neandertals to a forested environment and to fully temperate conditions during the Eemian.
Exploring Australian Dietitians' knowledge, experience and perspectives of time‐restricted eating in private practice: A qualitative study
Authors: Pye Caitlin , Parr Evelyn B. , Flint Steve A. , Devlin Brooke L.
Published: April 2024

Time‐restricted eating is a novel nutrition intervention with evidence of beneficial effects on weight loss, blood glucose management, and other metabolic health outcomes. Adherence to time‐restricted eating is higher than some traditional nutrition interventions to support individuals living with overweight/obesity and type 2 diabetes mellitus. However, there may be an evidence‐practice gap of time‐restricted eating in Australian dietetic practice. The present study aimed to explore dietitians' knowledge, experiences, and perspectives of time‐restricted eating and timing of eating advice in practice. Semi‐structured interviews with 10 private practice dietitians across Australia were conducted. Audio recordings were transcribed and analysed thematically. Six themes were identified: (i) distinction of time‐restricted eating to other fasting protocols; (ii) knowledge of health benefits of time‐restricted eating; (iii) patient‐led advice frequently given: timing of breakfast and dinner; (iv) dietitian‐led advice frequently given: eating cut‐off time to avoid late night snacking; (v) barriers and facilitators to offering time‐restricted eating or timing of eating advice; (vi) timing of eating advice within professional guidelines and resources. These findings suggest the need for development of professional resources and educational development tools for dietitians on time‐restricted eating.
Association of postsystolic shortening on stress echocardiography and significant coronary artery stenosis: A single‐centre retrospective cohort study
Authors: Toftgård Joel , Hedskog Henrik , Rune Lars , Svedenhag Jan , Riva Gabriel
Published: April 2024

Background

Postsystolic shortening (PSS) is one of the proposed quantitative measures to predict myocardial ischaemia in the stress echocardiographic (SE) evaluation. It is previously known that hypo‐/akinesia (HA) correlates well with coronary stenosis. However, some patients undergoing SE only present with PSS, and their risk of significant coronary stenosis is less clear. This study aimed to evaluate the association between PSS and significant coronary stenosis compared with HA.

Methods

This was a retrospective cohort study at the hospital of S:t Görans, Stockholm, Sweden. All patients who underwent SE to investigate inducible ischaemia between 1 January 2018 and 15 October 2021 were eligible for inclusion. Exclusion criteria were normal SE and inconclusive test. Pathological SE were divided into two groups, patients with HA and those with PSS. Outcome was significant coronary artery stenosis visualized by invasive coronary angiography.

Results

The final study population consisted of 108 patients (73 PSS, 35 HA). The presence of HA was associated with a higher risk of significant stenosis compared to those with PSS (63% vs. 23%, p < 0.001). This relationship was observed among males (p < 0.001), but not among females (p = 0.133). Nonsignificant stenosis trended to be more common among patients with PSS (21% vs. 6%, p = 0.053)

Conclusions

The finding of PSS without HA was associated with a lower risk of significant coronary stenosis than HA. However, patients with PSS still often had nonsignificant coronary stenosis and PSS in the evaluation for nonobstructive coronary artery disease (CAD) should be further investigated.
Case of usefulness of drill dilator for pancreatic stone disease in a reverse‐Z type main pancreatic duct
Authors: Yamamoto Kenta , Ota Shogo , Itani Toshinao
Published: April 2024

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Type 2 diabetes mellitus in patients with ischemic stroke – A nationwide study
Authors: Hastrup Sidsel , Hedegaard Jakob Nebeling , Andersen Grethe , Rungby Jorgen , Johnsen Soren Paaske
Published: April 2024

Aims

Type 2 diabetes (T2D) is a risk factor for ischemic stroke (IS) and associated with an adverse prognosis. Both stroke and diabetes care has evolved substantially during the last decade.

This study aimed to determine the prevalence of T2D among IS patients along with time trends in the risk profile, use of glucose‐lowering medications, quality‐of‐care and clinical outcomes, including stroke severity; length‐of‐stay; mortality, readmission and recurrent stroke in a large national cohort.

Methods

Registry‐based cohort study including all IS events in Denmark from 2004 to 2020.

IS with co‐morbid T2D were compared to IS without diabetes while adjusting for age, sex, stroke severity, co‐morbidity and socio‐economic factors.

Results

The study included 169,262 IS events; 24,479 with co‐morbid T2D. The prevalence of T2D in IS increased from 12.0% (2004–2006) to 17.0% (2019–2020). The adjusted absolute 30‐day mortality risk in IS with T2D decreased from 9.9% (2004–2006) to 7.8% (2019–2020). The corresponding adjusted risk ratios (aRR) were 1.22 95% confidence interval (1.09–1.37) and 1.29 (1.11–1.50), respectively. The aRR of 365‐day mortality was in 2004–2006: 1.20 (1.12–1.29) and in 2019–2020: 1.34 (1.22–1.47). The 30‐ and 365‐day readmissions rates were also consistently higher in IS with T2D.

Conclusions

The prevalence of T2D in IS increased over time. The 30‐ and 365‐day mortality rates decreased over the time‐period but were consistently higher in IS with co‐morbid T2D. Readmissions were also higher in IS with T2D. This highlights an urgent need for strategies to further improve the prognosis in IS patients with co‐morbid T2D.
Plasma microbial cell‐free DNA following chimeric antigen receptor T cell therapy in pediatric patients with relapsed/refractory leukemia
Authors: Aftandilian Catherine , Bito Xue Rachel , Berman David , Zhang Amy , Duttagupta Radha , Davis Kara L.
Published: April 2024

Chimeric antigen receptor (CAR) T cell therapy is a promising treatment for pediatric patients with relapsed or refractory B cell acute lymphoblastic leukemia (R/R B ALL). Cytokine release syndrome (CRS) is a common toxicity after CAR T cell therapy and fever is often the first symptom. Differentiating CRS from infection after CAR T cell therapy can be challenging. Plasma microbial cell free DNA (mcfDNA) is a novel diagnostic tool which allows for qualitative and quantitative assessment of over 1000 organisms. This pilot study sought to characterize mcfDNA results in pediatric patients with R/R B ALL in the first 2 months after CAR T cell therapy.
Early and late contingent negative variation (CNV) reflect different aspects of deficits in schizophrenia
Authors: Akgül Özge , Fide Ezgi , Özel Fatih , Alptekin Köksal , Bora Emre , Akdede Berna Binnur , Yener Görsev
Published: April 2024

Abnormal reward processing and psychomotor slowing are well‐known in schizophrenia (SZ). As a slow frontocentral potential, contingent negative variation (CNV) is associated with anticipatory attention, motivation and motor planning. The present study aims to evaluate the early and late amplitude and latencies of CNV in patients with SZ compared to healthy controls during a reward processing task and to show its association with clinical symptoms. We recruited 21 patients with SZ and 22 healthy controls to compare early and late CNV amplitude and latency values during a Monetary Incentive Delay (MID) Task between groups. Patients' symptom severity, levels of negative symptoms and depressive symptoms were assessed. Clinical features of the patients were further examined for their relation with CNV components. In conclusion, we found decreased early CNV amplitudes in SZ during the reward condition. They also displayed diminished and shortened late CNV responses for incentive cues, specifically at the central location. Furthermore, early CNV amplitudes exhibited a significant correlation with positive symptoms. Both CNV latencies were linked with medication dosage and the behavioural outcomes of the MID task. We revealed that early and late CNV exhibit different functions in neurophysiology and correspond to various facets of the deficits observed in patients. Our findings also emphasized that slow cortical potentials are indicative of deficient motivational processes as well as impaired reaction preparation in SZ. To gain a deeper understanding of the cognitive and motor impairments associated with psychosis, future studies must compare the effects of CNV in the early and late phases.
Leveraging the AAPPL to promote positive washback in K‐12 language teaching
Authors: Vyn Reuben
Published: April 2024

In recent years, the use of external proficiency‐based tests to measure learners' language ability has increased significantly, in part thanks to the Seal of Biliteracy movement. However, there exists very limited research investigating the influence of such tests and their subsequent outcomes data on teachers' practices. As such, this study examines the washback effects of the ACTFL Assessment of Performance toward Proficiency in Languages (AAPPL) on teachers' instruction and planning in an urban Midwest K‐12 district. Survey and interview data revealed that teachers increased their use of ACTFL key documents, placed more emphasis on target language usage, and sought to balance their use of the three modes of communication to better meet learners' needs and facilitate their proficiency development. This evidence of positive washback was observed among teachers across languages and levels and was enhanced by the opt‐in approach to test implementation and the close link between testing and teaching. For some, the AAPPL served as a catalyst to further align their curricula and instruction. Recommendations are offered for those who may wish to implement a standards‐based external language assessment such as the AAPPL as a means by which to foster professional growth and promote teachers' adoption of proficiency‐oriented practices.
Validation study of age‐independent fibrosis score (Fibrosis‐3 index) in patients with metabolic dysfunction‐associated steatotic liver disease
Authors: Nouso Kazuhiro , Kawanaka Miwa , Fujii Hideki , Kariyama Kazuya , Toyoda Hidenori , Iwaki Michihiro , Hayashi Hideki , Oeda Satoshi , Hyogo Hideyuki , Morishita Asahiro , Munekage Kensuke , Kawata Kazuhito , Tsutsumi Tsubasa , Sawada Koji , Maeshiro Tatsuji , Tobita Hiroshi , Yoshida Yuichi , Naito Masafumi , Araki Asuka , Arakaki Shingo , Kawaguchi Takumi , Noritake Hidenao , Ono Masafumi , Masaki Tsutomu , Yasuda Satoshi , Tomita Eiichi , Yoneda Masato , Tokushige Akihiro , Kamada Yoshihiro , Takahashi Hirokazu , Ueda Shinichiro , Aishima Shinichi , Sumida Yoshio , Nakajima Atsushi , Kumada Takashi , Okanoue Takeshi ,   Japan Study Group of Nonalcoholic Fatty Liver Disease (JSG‐NAFLD)
Published: April 2024

Background and Aims

Because the accuracy of the Fibrosis‐4 (FIB‐4) index for predicting liver fibrosis changes with age, the need for different cut‐offs in various age groups has frequently been discussed. We developed the age‐independent score, the Fibrosis‐3 (FIB‐3) index, and have shown its usefulness in patients with metabolic dysfunction‐associated steatotic liver disease (MASLD). This study aimed to validate the diagnostic ability of the FIB‐3 index to predict fibrosis progression using a large new patient cohort.

Methods

The ability of the FIB‐3 index to predict liver fibrosis was analyzed by comparing it with that of the FIB‐4 index using data from 1398 patients with MASLD enrolled in the Asia‐based clinical outcome NAFLD study.

Results

The areas under the receiver operating characteristic curves for predicting fibrosis stage F3 or higher were not different between the FIB‐3 and FIB‐4 indices in the entire cohort. Using the single ideal cut‐offs of the indices (3.41 for FIB‐3 index and 2.01 for FIB‐4 index), the predictive accuracy of the FIB‐3 index was not significantly different from that of the FIB‐4 index among patients aged <60 years; however, the accuracy of the FIB‐3 index was significantly higher than that of the FIB‐4 index in those aged ≥60 years (0.645 and 0.529, respectively; p < 0.0001).

Conclusion

The high ability of the FIB‐3 index with a single cut‐off to predict liver fibrosis in patients with MASLD was confirmed. The FIB‐3 index could serve as a useful tool for assessing liver fibrosis regardless of age.
Evaluation of fine‐needle core biopsy specimens for pancreatic ductal adenocarcinoma: Diagnostic utility and helpful histological features
Authors: Gonzalez Raul S , Yin Tiffany , Rosenbaum Matthew W , Quintana Liza
Published: April 2024

Aims

With the advent of new biopsy devices, fine‐needle core biopsy specimens can be obtained from pancreas masses. This study aimed to report the histological spectrum of intrapancreatic adenocarcinoma on fine‐needle core biopsy and the accuracy of sampling.

Methods and results

We identified 423 SharkCore™ fine‐needle core biopsies taken from patients with a high clinical concern for pancreatic adenocarcinoma. For each, we recorded patient age and sex, percentage of diagnostic tissue in each sample and tumour site, size and histological findings. The cases came from 392 patients (193 men, 199 women; mean age 69 years). Median diagnostic tissue amount in the samples was 30%. Common histological findings included desmoplasia (36%), single atypical cells (44%), haphazard glandular growth pattern (68%), nuclear pleomorphism > 4:1 (39%), incomplete gland lumens (18%) and detached atypical epithelial strips (37%). Additional levels were ordered on 143 cases. Final clinical diagnoses associated with the 423 cases were adenocarcinoma (n = 343), pancreatitis (n = 22), intraductal neoplasm or other benign/low‐grade process (n = 16) and unknown (n = 42, patients lost to follow‐up). Of the adenocarcinoma cases, the diagnosis was established by the evaluated fine‐needle core biopsy sample alone in 178, by fine‐needle aspiration biopsy alone in 30, by both concurrently in 89 and by subsequent biopsy or resection in 37 cases. Among 68 cases called suspicious on fine‐needle core biopsy, 78% ultimately represented adenocarcinoma.

Conclusions

Fine‐needle core biopsy allows for histological diagnosis of pancreatic adenocarcinoma, using known histological parameters. Common findings include single atypical cells, desmoplasia, haphazard gland growth and nuclear pleomorphism. Cases interpreted as suspicious often represent malignancy.
The proportion of tumour stroma predicts response to treatment of immune checkpoint inhibitor in combination with chemotherapy in patients with stage IIIB−IV non‐small cell lung cancer
Authors: Yi Lina , Wen Yingmei , Xiao Mengxia , Yuan Jingping , Ke Xiaokang , Zhang Xiuyun , Khan Liaqat , Song Qibin , Yao Yi
Published: April 2024

Aims

Immunotherapy has brought a new era to cancer treatment, yet we lack dependable predictors for its effectiveness. This study explores the predictive significance of intratumour stroma proportion (iTSP) for treatment success and prognosis in non‐small cell lung cancer (NSCLC) patients undergoing treatment with immune check‐point inhibitors (ICIs) together with chemotherapy.

Methods and results

We retrospectively collected data from patients with unresectable stage IIIB−IV NSCLC who were treated with first‐line ICIs and chemotherapy. Each patient received a confirmed pathological diagnosis, and the pathologist evaluated the iTSP on haematoxylin and eosin (H&E)‐stained sections of diagnostic tissue slides. Among the 102 H&E‐stained biopsy samples, 61 (59.8%) were categorised as stroma‐L (less than 50% iTSP), while 41 (40.2%) were classified as stroma‐H (more than 50% iTSP). We observed that the stroma‐L group exhibited a significantly better objective response rate (ORR) (72.1 versus 51.2%, P = 0.031) and deeper response depth (DpR) (−50.49 ± 28.79% versus −35.83 ± 29.91%, P = 0.015) compared to the stroma‐H group. Furthermore, the stroma‐L group showed longer median progression‐free survival (PFS) (9.6 versus 6.0 months, P = 0.011) and overall survival (OS) (24.0 versus 12.2 months, P = 0.001) compared to the stroma‐H group. Multivariate Cox proportional hazards regression analysis indicated that iTSP was a highly significant prognostic factor for both PFS [hazard ratio (HR) = 1.713; P = 0.030] and OS (HR = 2.225; P = 0.003).

Conclusion

Our findings indicate that a lower iTSP corresponds to improved clinical outcomes and greater DpR in individuals with stage IIIB−IV NSCLC treated with first‐line ICIs and chemotherapy. The iTSP could potentially serve as a predictive biomarker for ICIs therapy response.
Exploring approaches to pulp vitality assessment: A scoping review of nontraditional methods
Authors: Afkhami Farzaneh , Wright Patricia Paule , Chien Philip Yuan‐Ho , Xu Chun , Walsh Laurence James , Peters Ove Andreas
Published: April 2024

Introduction

Diagnostic procedures for pulp vitality assessment are a crucial aspect of routine dental practice. This review aims to provide a comprehensive overview of nontraditional techniques and methodologies for assessing pulp vitality, specifically exploring promising approaches that are currently not used in dental practice.

Methods

The study protocol was registered a priori (https://osf.io/3m97z/). An extensive electronic search was conducted across multiple databases, including MEDLINE via PubMed, Scopus, Web of Science, and Embase. Inclusion criteria were guided by the research question based on the PCC model as follows: “What are the potential nontraditional techniques (Concept) for assessing pulp vitality (Population) in the field of endodontics or clinical practice (Context)?” Studies were included that explored possible approaches to pulp vitality assessment, utilizing a range of techniques, whilst any studies using traditional pulp tests (cold, heat, and electric stimulation) or well‐known methods (pulse oximetry and laser Doppler flowmetry) were excluded. Reviewers independently screened articles and extracted data. A patent search was also performed.

Results

Of 3062 studies, 65 were included that described nontraditional approaches for assessing pulp vitality. These included a range of optical diagnostic methods, ultrasound Doppler flowmetry (UDF), magnetic resonance imaging (MRI), terahertz imaging, tooth temperature measurements, as well as invasive methodologies, including 133xenon washout, radioisotope‐labelled tracers, hydrogen gas desaturation, intravital microscopy and fluorescent microspheres isotope clearance. The patent search included artificial intelligence and biomarkers methods.

Conclusions

This review provides details for potential innovative tests that may directly describe pulp vitality. Importantly, these methods range from clinically impractical through to promising methods that may transform clinical practice. Several nontraditional techniques have the potential to enhance diagnostic accuracy and could provide valuable insights into the assessment of pulp vitality in challenging clinical scenarios.
Functional and biological implications of clonotypic diversity among human donor‐unrestricted T cells
Authors: Maerz Megan D , Cross Deborah L , Seshadri Chetan
Published: April 2024

T cells express a T‐cell receptor (TCR) heterodimer that is the product of germline rearrangement and junctional editing resulting in immense clonotypic diversity. The generation of diverse TCR repertoires enables the recognition of pathogen‐derived peptide antigens presented by polymorphic major histocompatibility complex (MHC) molecules. However, T cells also recognize nonpeptide antigens through nearly monomorphic antigen‐presenting systems, such as cluster of differentiation 1 (CD1), MHC‐related protein 1 (MR1) and butyrophilins (BTNs). This potential for shared immune responses across genetically diverse populations led to their designation as donor‐unrestricted T cells (DURTs). As might be expected, some CD1‐, MR1‐ and BTN‐restricted T cells express a TCR that is conserved across unrelated individuals. However, several recent studies have reported unexpected diversity among DURT TCRs, and increasing evidence suggests that this diversity has functional consequences. Recent reports also challenge the dogma that immune cells are either innate or adaptive and suggest that DURT TCRs may act in both capacities. Here, we review this evidence and propose an expanded view of the role for clonotypic diversity among DURTs in humans, including new perspectives on how DURT TCRs may integrate their adaptive and innate immune functions.
Factors associated with the quality of life of persons with young‐onset dementia: A systematic literature review
Authors: Yang Yoosun , Song Jun‐Ah
Published: April 2024

This review examines factors associated with quality of life (QoL) in persons with young‐onset dementia (YOD). Studies investigating and analysing factors related to QoL in persons with YOD were included. Databases searched included PubMed, CINAHL, Web of Science, EMBASE, and SCOPUS. Due to inconsistent outcome variables across studies, synthesis without meta‐analysis was used for data integration. Methodological quality was assessed, and results were synthesised. Eleven studies were included in this review, identifying different factors influencing QoL in persons with YOD, which could be categorised into six groups. Behavioural and psychiatric factors showed the highest significant findings ratio (SFR), as determined by the ratio of ‘studies finding significance’ to the ‘total number of studies addressing the factor’. Following in terms of SFR were care‐related and physical factors. Demographic and dementia‐characteristic factors had the lowest SFR. Among single factors, depressive symptoms, and neuropsychiatric symptoms, both included in behavioural and psychiatric factors, had the highest SFR. This systematic review highlights the importance of behavioural and psychiatric elements in QoL in persons with young onset and points to depressive symptoms and neuropsychiatric symptoms as potential therapeutic targets. However, as research on QoL in persons with YOD continues to expand, the inclusion of methods such as meta‐analysis may be beneficial.
Effects of workplace incivility and workload on nurses’ work attitude: The mediating effect of burnout
Authors: Lee Seung Eun , Seo Ja‐Kyung , Macphee Maura
Published: April 2024

Aim

The study's aim was to examine how workplace incivility and workload influence nurses' work attitudes (turnover intention, job satisfaction, and organizational commitment) using the stress–strain–outcome framework.

Background

There is a lack of comprehensive research on the combined effects of workplace incivility and workload on nurses' work attitudes.

Introduction

Two workplace stressors, incivility and workload, were hypothesized to lead to burnout, which in turn influences nurses’ work attitudes.

Methods

A cross‐sectional, descriptive correlational study was conducted. Survey data were collected from 1,255 direct care nurses with a minimum of 6 months’ nursing experiences in 34 general hospitals across Korea. Structural equation modeling was used to test the hypothesized model. This study is reported using the STROBE checklist.

Results

As hypothesized, both workplace incivility and workload increased burnout. Heightened burnout correlated with increased turnover intention, lowered job satisfaction, and reduced organizational commitment. While workplace incivility impacted these outcomes both directly and indirectly via its effect on burnout, workload influenced the outcomes solely through burnout.

Conclusion

The study's findings are based on one, nonrandomized sample of nurses working at South Korean hospitals. Despite such study limitations, the study findings support the adverse impact of two workplace stressors on burnout and nurses’ work attitudes.

Implications for nursing

Evidence‐informed interventions for both workplace stressors include training programs, clear policy guidelines, open communication channels, and supportive work environments.

Implications for nursing and health policy

Zero tolerance and equity, diversity and inclusivity policies to promote workplace civility must be enforced. Workload needs to be patient‐centered, ensuring a “fit” between patient needs and nurse staffing.
A variable neighborhood search for the median location problem with interconnected facilities
Authors: Lozano‐Osorio I. , Sánchez‐Oro J. , López‐Sánchez A.D. , Duarte A.
Published: April 2024

The ‐median problem has been widely studied in the literature. However, there are several variants that include new constraints to the classical problem that make it more realistic. In this work, we study the variant that considers interconnected facilities, that is, the distances between each pair of facilities are less than or equal to a certain threshold . This optimization problem, usually known as the median location problem with interconnected facilities, consists of locating a set of interconnected facilities to minimize the distance between those interconnected facilities and the demand points. The large variety of real‐world applications that fit into this model makes it attractive to design an algorithm able to solve the problem efficiently. To this end, a procedure based on the variable neighborhood search methodology is designed and implemented by using problem‐dependent neighborhoods. Experimental results show that our proposal is able to reach most of the optimal solutions when they are known. Additionally, it outperforms previous state‐of‐the‐art methods in those instances where the optima are unknown. These results are further confirmed by conducting nonparametrical statistical tests.