bluuebunny/crossref_metadata_2025 huggingface dataset:
The relationship between social determinants of health and neurocognitive and mood-related symptoms in the primary brain tumor population: A systematic review
Authors: Stockdill Macy L , King Amanda , Johnson Morgan , Karim Zuena , Cooper Diane , Armstrong Terri S
Published: March 2024

Social determinants of health (SDOH) impact cancer-related health outcomes, including survival, but their impact on symptoms is less understood among the primary brain tumor (PBT) population. We conducted a systematic review to examine the relationships between SDOH and neurocognitive and mood-related symptoms among the PBT population. PubMed, EMBASE, and CINAHL were searched using PROGRESS criteria (place of residence, race/ethnicity, occupation, gender/sex, religion, education, socioeconomic status, and social capital) on March 8th, 2022. Two individuals screened and assessed study quality using the NHLBI Assessment Tool for Observational Cohort and Cross-sectional Studies. Of 3006 abstracts identified, 150 full-text articles were assessed, and 48 were included for a total sample of 28 454 study participants. Twenty-two studies examined 1 SDOH; none examined all 8. Four studies measured place of residence, 2 race/ethnicity, 13 occupation, 42 gender, 1 religion, 18 education, 4 socioeconomic status, and 15 social capital. Fifteen studies assessed neurocognitive and 37 mood-related symptoms. While higher education was associated with less neurocognitive symptoms, and among individuals with meningioma sustained unemployment after surgery was associated with depressive symptoms, results were otherwise disparate among SDOH and symptoms. Most studies were descriptive or exploratory, lacking comprehensive inclusion of SDOH. Standardizing SDOH collection, reducing bias, and recruiting diverse samples are recommended in future interventions.
Accurate prediction of myopic progression and high myopia by machine learning
Authors: Li Jiahui , Zeng Simiao , Li Zhihuan , Xu Jie , Sun Zhuo , Zhao Jing , Li Meiyan , Zou Zixing , Guan Taihua , Zeng Jin , Liu Zhuang , Xiao Wenchao , Wei Ran , Miao Hanpei , Ziyar Ian , Huang Junxiong , Gao Yuanxu , Zeng Yangfa , Zhou Xing-Tao , Zhang Kang
Published: March 2024

Background

Myopia is a leading cause of visual impairment in Asia and worldwide. However, accurately predicting the progression of myopia and the high risk of myopia remains a challenge. This study aims to develop a predictive model for the development of myopia.

Methods

We first retrospectively gathered 612 530 medical records from five independent cohorts, encompassing 227 543 patients ranging from infants to young adults. Subsequently, we developed a multivariate linear regression algorithm model to predict the progression of myopia and the risk of high myopia.

Result

The model to predict the progression of myopia achieved an R2 value of 0.964 vs a mean absolute error (MAE) of 0.119D [95% confidence interval (CI): 0.119, 1.146] in the internal validation set. It demonstrated strong generalizability, maintaining consistent performance across external validation sets: R2 = 0.950 vs MAE = 0.119D (95% CI: 0.119, 1.136) in validation study 1, R2 = 0.950 vs MAE = 0.121D (95% CI: 0.121, 1.144) in validation study 2, and R2 = 0.806 vs MAE = −0.066D (95% CI: −0.066, 0.569) in the Shanghai Children Myopia Study. In the Beijing Children Eye Study, the model achieved an R2 of 0.749 vs a MAE of 0.178D (95% CI: 0.178, 1.557). The model to predict the risk of high myopia achieved an area under the curve (AUC) of 0.99 in the internal validation set and consistently high area under the curve values of 0.99, 0.99, 0.96 and 0.99 in the respective external validation sets.

Conclusion

Our study demonstrates accurate prediction of myopia progression and risk of high myopia providing valuable insights for tailoring strategies to personalize and optimize the clinical management of myopia in children.
OPEN STOMATA 1 phosphorylates CYCLIC NUCLEOTIDE-GATED CHANNELs to trigger Ca2+ signaling for abscisic acid-induced stomatal closure in Arabidopsis
Authors: Yang Yang , Tan Yan-Qiu , Wang Xinyong , Li Jia-Jun , Du Bo-Ya , Zhu Meijun , Wang Pengcheng , Wang Yong-Fei
Published: March 2024

Multiple cyclic nucleotide-gated channels (CNGCs) are abscisic acid (ABA)-activated Ca2+ channels in Arabidopsis (Arabidopsis thaliana) guard cells. In particular, CNGC5, CNGC6, CNGC9, and CNGC12 are essential for ABA-specific cytosolic Ca2+ signaling and stomatal movements. However, the mechanisms underlying ABA-mediated regulation of CNGCs and Ca2+ signaling are still unknown. In this study, we identified the Ca2+-independent protein kinase OPEN STOMATA 1 (OST1) as a CNGC activator in Arabidopsis. OST1-targeted phosphorylation sites were identified in CNGC5, CNGC6, CNGC9, and CNGC12. These CNGCs were strongly inhibited by Ser-to-Ala mutations and fully activated by Ser-to-Asp mutations at the OST1-targeted sites. The overexpression of individual inactive CNGCs (iCNGCs) under the UBIQUITIN10 promoter in wild-type Arabidopsis conferred a strong dominant-negative-like ABA-insensitive stomatal closure phenotype. In contrast, expressing active CNGCs (aCNGCs) under their respective native promoters in the cngc5-1 cngc6-2 cngc9-1 cngc12-1 quadruple mutant fully restored ABA-activated cytosolic Ca2+ oscillations and Ca2+ currents in guard cells, and rescued the ABA-insensitive stomatal movement mutant phenotypes. Thus, we uncovered that ABA elicits cytosolic Ca2+ signaling via an OST1-CNGC module, in which OST1 functions as a convergence point of the Ca2+-dependent and -independent pathways in Arabidopsis guard cells.
GBF family member PfGBF3 and NAC family member PfNAC2 regulate rosmarinic acid biosynthesis under high light
Authors: Xie Guanwen , Zou Xiuzai , Liang Zishan , Zhang Ke , Wu Duan , Jin Honglei , Wang Hongbin , Shen Qi
Published: March 2024

Rosmarinic acid (RA) is an important medicinal metabolite and a potent food antioxidant. We discovered that exposure to high light intensifies the accumulation of RA in the leaves of perilla (Perilla frutescens (L.) Britt). However, the molecular mechanism underlying RA synthesis in response to high light stress remains poorly understood. To address this knowledge gap, we conducted a comprehensive analysis employing transcriptomic sequencing, transcriptional activation, and genetic transformation techniques. High light treatment for 1 and 48 h resulted in the upregulation of 592 and 1,060 genes, respectively. Among these genes, three structural genes and 93 transcription factors exhibited co-expression. Notably, NAC family member PfNAC2, GBF family member PfGBF3, and cinnamate-4-hydroxylase gene PfC4H demonstrated significant co-expression and upregulation under high light stress. Transcriptional activation analysis revealed that PfGBF3 binds to and activates the PfNAC2 promoter. Additionally, both PfNAC2 and PfGBF3 bind to the PfC4H promoter, thereby positively regulating PfC4H expression. Transient overexpression of PfNAC2, PfGBF3, and PfC4H, as well as stable transgenic expression of PfNAC2, led to a substantial increase in RA accumulation in perilla. Consequently, PfGBF3 acts as a photosensitive factor that positively regulates PfNAC2 and PfC4H, while PfNAC2 also regulates PfC4H to promote RA accumulation under high light stress. The elucidation of the regulatory mechanism governing RA accumulation in perilla under high light conditions provides a foundation for developing a high-yield RA system and a model to understand light-induced metabolic accumulation.
Tetrad stage transient cold stress skews auxin-mediated energy metabolism balance in Chinese cabbage pollen
Authors: Liu Dandan , He Yuanrong , Wang Yijie , Chen Weiwei , Yang Jianli , Zhang Yuzhi , Feng Yaoyao , Zhao Yuxue , Lin Sue , Huang Li
Published: March 2024

Changing ambient temperature often impairs plant development and sexual reproduction, particularly pollen ontogenesis. However, mechanisms underlying cold stress-induced male sterility are not well understood. Here, we exposed Chinese cabbage (Brassica campestris) to different cold conditions during flowering and demonstrated that the tetrad stage was the most sensitive. After completion of pollen development at optimal conditions, transient cold stress at the tetrad stage still impacted auxin levels, starch and lipid accumulation, and pollen germination, ultimately resulting in partial male sterility. Transcriptome and metabolome analyses and histochemical staining indicated that the reduced pollen germination rate was due to the imbalance of energy metabolism during pollen maturation. The investigation of β-glucuronidase (GUS)-overexpressing transgenic plants driven by the promoter of DR5 (DR5::GUS report system) combined with cell tissue staining and metabolome analysis further validated that cold stress during the tetrad stage reduced auxin levels in mature pollen grains. Low-concentration auxin treatment on floral buds at the tetrad stage before cold exposure improved the cold tolerance of mature pollen grains. Artificially changing the content of endogenous auxin during pollen maturation by spraying chemical reagents and loss-of-function investigation of the auxin biosynthesis gene YUCCA6 by artificial microRNA technology showed that starch overaccumulation severely reduced the pollen germination rate. In summary, we revealed that transient cold stress at the tetrad stage of pollen development in Chinese cabbage causes auxin-mediated starch-related energy metabolism imbalance that contributes to the decline in pollen germination rate and ultimately seed set.
Prison Abolitionism and the Liberal Imagination
Authors: Abolafia Jacob
Published: March 2024

One of the most controversial political demands to emerge from the mass protests of the summer of 2020 was the abolition of police departments and prisons. This review article takes stock of the rationale behind prison abolitionism and of the philosopher Tommie Shelby's The Idea of Prison Abolition, a recent effort to initiate a dialogue between Angela Davis, the intellectual vanguard of contemporary abolitionists, and Shelby's own style of liberal political philosophy in the tradition of John Rawls. Although it shares a name with the successful nineteenth century movement to end slavery, today's abolitionists have much broader and far-reaching aims. The antislavery movement claimed to be bringing liberal society in line with liberalism's own values by abolishing chattel slavery, but Shelby's argument reaffirms that the prison, for its part, actually has a deep conceptual and historical compatibility with liberalism. Prison abolitionists, conscious of the connections between liberalism and incarceration, therefore, level their attacks not only at imprisonment but against liberal society as a whole. The close entwinement of liberalism and incarceration and deep disagreements about the meaning of basic terms like reform and criminality mean that long-term collaboration between liberals and abolitionists is probably unrealistic, both theoretically and politically.
Minimal Clinically Important Difference of the Disabilities of the Arm, Shoulder and Hand (DASH) and the Shortened Version of the DASH (QuickDASH) in People With Musculoskeletal Disorders: A Systematic Review and Meta-Analysis
Authors: Galardini Lorenzo , Coppari Andrea , Pellicciari Leonardo , Ugolini Alessandro , Piscitelli Daniele , La Porta Fabio , Bravini Elisabetta , Vercelli Stefano
Published: March 2024

Objective

The objective of this study was to perform a meta-analysis of the minimal clinically important difference (MCID) of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and its shortened version (ie, the QuickDASH).

Methods

MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, Cochrane Library, and Scopus were searched up to July 2022. Studies on people with upper limb musculoskeletal disorders that calculated the MCID by anchor-based methods were included. Descriptive and quantitative synthesis was used for the MCID and the minimal detectable change with 90% confidence (MDC90). Fixed-effects models and random-effect models were used for the meta-analysis. I2 statistics was computed to assess heterogeneity. The methodological quality of studies was assessed with the Consensus-Based Standards for the Selection of Health Measurement Instruments checklist for measurement error and an adaptation of the checklist for the studies on MCID proposed by Bohannon and Glenney.

Results

Twelve studies (1677 patients) were included, producing 17 MCID estimates ranging from 8.3 to 18.0 DASH points and 8.0 to 18.1 QuickDASH points. The pooled MCIDs were 11.00 DASH points (95% CI = 8.59–13.41; I2 = 0%) and 11.97 QuickDASH points (95% CI = 9.60–14.33; I2 = 0%). The pooled MDC90s were 9.04 DASH points (95% CI = 6.46–11.62; I2 = 0%) and 9.03 QuickDASH points (95% CI = 6.36–11.71; I2 = 18%). Great methodological heterogeneity in the calculation of the MCID was identified among the primary studies.

Conclusion

Reasonable MCID ranges of 12 to 14 DASH points and 12 to 15 QuickDASH points were established. The lower boundaries represent the first available measure above the pooled MDC90, and the upper limits represent the upper 95% CI of the pooled MCID.

Impact

Reasonable ranges for the MCID of 12 to 14 DASH points and 12 to 15 QuickDASH points were proposed. The lower boundaries represent the first available measure above the pooled MDC90, and the upper limits represent the upper 95% CI of the pooled MCID. Information regarding the interpretability of the 2 questionnaires was derived from very different methodologies, making it difficult to identify reliable thresholds. Now clinicians and researchers can rely on more credible data. The proposed MCIDs should be used to assess people with musculoskeletal disorders. Heterogeneity was found related particularly to the anchor levels used in the primary studies. To promote comparability of MCID values, shared rules defining the most appropriate types of anchoring will be needed in the near future.
Dosimetric comparison of O-ring versus conventional C-arm linear accelerator for volumetric modulated arc therapy (VMAT) of head and neck cancer and carcinoma cervix patients
Authors: Patodi Vibhor , Soni Tej P , Singh Dinesh K , Patni Nidhi , Jakhotia Naresh , Chittappurath Vineeth , Kuyyanangadan Rajkamal , Jenny Ashna , Kanniyappan Elumalai , Gupta Anil K , Gupta Tara C , Singhal Harish , Natrajan Thirumoorthy , Kather Farzana S
Published: March 2024

The objective of this study is dosimetric comparison between the O-ring Halcyon and C-arm Clinac iX linac for volumetric modulated arc therapy (VMAT) plans for head & neck (H&N) cancer and carcinoma cervix patients. Total 60 patients of H&N cancer and carcinoma cervix were enrolled prospectively from March 2021 to March 2023. VMAT plans with 6 MV photons for Halcyon and Clinac iX were generated and compared for each patient by dose volume histogram for planning target volume coverage and organ at risk (OAR) sparing. There were no differences in between both the linacs for PTV D2% and D98%, homogeneity index, conformity index, Dmax (maximum dose) and Dmean (mean dose) of OAR. Halcyon had significantly shorter treatment time compared to Clinac iX. Halcyon delivered higher integral dose and monitor units. O-ring Halcyon produces VMAT plans comparable to other C-arm linacs for H&N and carcinoma cervix patients.
Flexibility loss and worker well-being: what happens to job satisfaction when workers lose their telework usage?
Authors: Araki Satoshi , Rappleye Jeremy
Published: March 2024

The association between flexible work arrangements (FWA) and worker well-being has been extensively investigated. However, the Covid-19 pandemic has generated a new phenomenon where workers return to inflexible workstyles after experiencing FWA. This article examines the consequence of this ‘flexibility loss’ with attention to telework and job satisfaction (JS). Using panel data collected by the Japanese government in 2020–2021, regressions and generalized structural equation modeling reveal (a) workers who frequently telework exhibit higher JS in both years; (b) on average, losing telework does not affect JS; and (c) workers who experienced telework-related challenges in 2020 and continue to work remotely next year report lower JS, whereas those who lost telework opportunities possess higher JS. These results suggest that a new type of labor stratification emerges based on the compound of workers’ FWA experience (upsides or downsides) and their FWA usage (continuation or withdrawal), which affects well-being either functionally or adversely.
Skodsborg Badesanatorium: An Adventist Health Resort on the Fringe of Danish Public Healthcare 1898–1992
Authors: Lodahl Anders Bank
Published: March 2024

Today healthcare in Denmark is overwhelmingly public, but around 1900 much was left to religious institutions. One of the largest and most long-lived was Skodsborg Badesanatorium, which survived from 1898 to 1992. Founded on the Seventh-day Adventists’ health principles, the sanatorium introduced therapies and medical ideas, which were frowned upon in Denmark around 1900. The sanatorium had to navigate between alternative and orthodox medicine, constantly defining itself as alternative enough to provide what patients could not get at the public hospitals, but orthodox enough to be scientifically reliable. The article analyses how the therapy at the sanatorium was presented, comparing alternative and orthodox medicine. Likewise, the sanatorium’s relation to public healthcare is analysed from its extensive administrative material. This article sheds light on private healthcare institutions, which are largely neglected in Danish historical health research, and thereby explores the space between public and private healthcare and orthodox and non-orthodox medicine.
The new normal chemical landscape: the future of risk assessment toward optimum consumer safety
Authors: Osborne Olivia J , Boobis Alan , Botham Phil , Price Shirley Christine , Kuhnle Gunter C , Mulholland Cath , Potter Claire , Gott David
Published: March 2024

The further optimization of consumer safety through risk assessment of chemicals present in food will require adaptability and flexibility to utilize the accelerating developments in safety science and technology. New Approach Methodologies (NAMs) are gaining traction as a systematic approach to support informed decision making in chemical risk assessment. The vision is to be able to predict risk more accurately, rapidly and efficiently. The opportunity exists now to use these approaches which requires a strategy to translate the science into future regulatory implementation. Here we discuss new insights obtained from three recent workshops on how to translate the science into future regulatory implementation. To assist the UK in this endeavor, the Food Standards Agency (FSA) and the scientific advisory committee on chemical toxicity (COT) have been developing a roadmap. In addition, we discuss how these new insights fit into the bigger picture of the new chemical landscape for better consumer safety and the importance of international harmonization.
Efficacy of a low dose of antivenom for severe neuroparalysis in Bungarus caeruleus (common krait) envenomation: a pilot study
Authors: Pannu Ashok Kumar , Chand Duni , Bhalla Ashish , Dhibar Deba Prasad
Published: March 2024

Introduction

Despite the widespread use of antivenom for the treatment of snakebite envenoming in the Indian subcontinent, the ideal dose of antivenom has been a point of contention. Low-dose regimens can economize on a scarce resource in low- and middle-income countries. This study assessed the effectiveness of a low-dose (10 vials) antivenom regimen compared to the usual 20 vials in patients with krait bite neuroparalysis requiring mechanical ventilation.

Methods

This study was a prospective controlled pilot study conducted in a tertiary-care hospital in north India. Participants were eligible if they were ≥12 years old, had krait bite neurotoxicity, showed severe paralysis requiring mechanical ventilation, and had access to antivenom therapy within 24 h of the bite. The primary outcome was the duration of mechanical ventilation, and the secondary outcomes were the length of hospital stay and in-hospital survival.

Results

Fifteen patients received 10 vials of antivenom, and 25 received 20 vials. The two treatment groups had similar baseline demographics, clinical and laboratory features, snakebite severity scores, and median time from snakebite to initiation of antivenom therapy. The low-dose regimen was as effective as the standard dose concerning the median duration of mechanical ventilation (41 h vs. 55 h, P = 0.094), the median length of stay (78 h vs. 85.5 h, P = 0.360), and in-hospital deaths (1 vs. 3, P = 1.000). The incidence of ventilator-associated pneumonia was similar between the two groups (1 vs 3, P = 1.000).

Conclusion

A low dose of antivenom effectively treats patients with severe krait bite neuroparalysis.
A holistic perspective on species delimitation outperforms all methods based on single data types in freshwater gastropods (Caenogastropoda: Hydrobiidae: Pseudamnicola)
Authors: Delicado Diana , Boulaassafer Khadija , Khalloufi Noureddine , Hauffe Torsten
Published: March 2024

Freshwater gastropods are one of the most species-rich and severely threatened animal groups in continental aquatic ecosystems. Unfortunately, understanding their species diversity, which is key to conservation, is often hampered by their small size, simple morphology, and restricted distribution. This is particularly the case for spring snails of the genus Pseudamnicola (family Hydrobiidae), a species-rich taxon across the Mediterranean region. Contrasting species diversities derived from molecular phylogenies and traditional taxonomy call for a holistic approach, in which molecular markers are used to identify putative taxonomic units that can then be validated morphologically. We integrated DNA sequence and morphometric data from 92 populations into a species delimitation framework to assess the taxonomic status of 25 nominal and 14 informally recognized species of Pseudamnicola across its geographical range. Although seven discovery methods delimited a varying number of putative species, taking an integrative approach generally improved species support over single datasets. The statistically favoured integrative scheme corroborated 30 of the 39 initial species as separate entities, whereas nine require taxonomic re-evaluation. Six species are described here formally. Pseudamnicola exemplifies the importance of considering multiple lines of evidence to evaluate species diversity in taxonomically complex groups, with newly developed approaches providing the needed toolbox.
Patient preferences for operative versus nonoperative treatment of LC1 pelvis fracture: a discrete choice experiment
Authors: Patterson Joseph T. , Parry Joshua A. , Working Zachary M. , McKibben Natasha A. , Baca Joseph , Duong Andrew , Senior Joshua , Kim Annabel , Marchand Lucas S. , O’Hara Nathan
Published: March 2024

OBJECTIVE:

To quantify how patients with LC1 pelvis fracture value attributes of operative versus nonoperative treatment.

METHODS:

Design: Discrete choice experiment.

Setting:

3 US Level 1 trauma centers.

Patient Selection Criteria:

Adult survivors of an LC1 pelvis treated between June 2016 through March 2023 were identified from institutional registries. The choice experiment was administered as a survey from March through August 2023.

Outcome Measures and Comparisons:

Participants chose between 12 hypothetical comparisons of treatment attributes including operative or nonoperative care, risk of death, severity of pain, risk of secondary surgery, shorter hospital stay, discharge destination, and independence in ambulation within one month of injury. The marginal utility of each treatment attribute, e.g. the strength of participants’ aggregate preference for an attribute as indicated by their survey choices, was estimated by multinomial logit modeling with and without stratification by treatment received.

RESULTS:

449 eligible patients were identified. The survey was distributed to 182 patients and collected from 72 (39%) patients at a median 2.3 years after injury. Respondents were 66% female with a median age of 59 years (IQR 34-69). Before injury, 94% ambulated independently and 75% were working. 41% received operative treatment. Independence with ambulation provided the highest relative marginal utility (21%, p<0.001), followed by discharge to home versus skilled nursing (20%, p<0.001), moderate versus severe post-discharge pain (17%, p<0.001), shorter hospital stay (16%, p<0.001), secondary surgery (15%, p<0.001), mortality (10%, p=0.02). Overall, no relative utility for operative versus nonoperative treatment was observed (2%, p=0.54). However, respondents strongly preferred the treatment they received: operative patients valued operative treatment (utility, 0.37 vs. -0.37, p<0.001); nonoperative patients valued nonoperative treatment (utility, 0.19 vs. -0.19, p<0.001).

CONCLUSIONS:

LC1 pelvis fracture patients valued independence with ambulation, shorter hospital stay, and avoiding secondary surgery and mortality in the month after their injury. Patients preferred the treatment they received rather than operative versus nonoperative care.

LEVEL OF EVIDENCE:

Therapeutic level III. See Instructions for Authors for a complete description of levels of evidence.
Association between neighborhood poverty and ovarian reserve: the ovarian aging study
Authors: Pan Anwesha , Crowder Kyle D. , Cedars Marcelle I. , Bleil Maria E.
Published: March 2024

Objective

This study aimed to examine the association between neighborhood poverty and ovarian reserve.

Methods

Among 1,019 healthy premenopausal women in the Ovarian Aging Study, aggregate exposure to neighborhood poverty was examined in relation to biomarkers of ovarian reserve, antimüllerian hormone (AMH) and antral follicle count (AFC). Specifically, the interaction of age-x-neighborhood poverty was assessed cross-sectionally to determine whether AMH and AFC declines across women may be greater in women exposed to more neighborhood poverty. Neighborhood poverty was assessed by geocoding and linking women's residential addresses in adulthood to US Census data.

Results

Independent of covariates, a significant interaction term showed the association between age and AMH varied by degree of exposure to neighborhood poverty in adulthood (b = −0.001, P < 0.05). AMH declines increased progressively across women exposed to low, medium, and high levels of neighborhood poverty. In addition, main effects showed that higher neighborhood poverty was related to higher AMH in the younger women only (b = 0.022, P < 0.01). Results related to AFC were all nonsignificant (P > 0.05).

Conclusions

Across women, greater aggregate exposure to neighborhood poverty in adulthood was related to lower ovarian reserve, indexed by AMH. In addition, there was a positive association between neighborhood poverty and AMH in younger women that attenuated in the older women. Together, results suggest that neighborhood disadvantage may have detrimental impacts that manifest as initially higher AMH, resulting in greater ovarian follicle loss over time. However, it remains unclear whether these results examining differences across women may replicate when AMH declines by neighborhood poverty are examined longitudinally.
Body composition, physical activity, and menopause symptoms: how do they relate?
Authors: Moore Sam R. , Cabre Hannah E. , Smith-Ryan Abbie E.
Published: March 2024

Objective

This study characterized the impact of physical activity (light, moderate, and vigorous [VIG] active minutes per day) and body composition (percent body fat [%BF] and fat-free mass index) on total menopausal symptoms (TMSs) in 72 premenopausal, perimenopausal (PERI), or postmenopausal women.

Methods

Activity minutes were collected from wearable fitness trackers. Body composition was evaluated using a whole-body dual-energy x-ray absorptiometry scan. TMSs were quantified using The North American Menopause Society Questionnaire.

Results

Significant associations were observed between TMSs and %BF (r = 0.464, P < 0.001) and VIG (r = −0.245, P = 0.038). %BF and VIG were significant predictors for TMSs across groups (R
2 = 0.146 and R
2 = 0.092, respectively), but only %BF maintained for PERI (R
2 = 0.421, P < 0.001)

Conclusions

%BF predicted nearly half of the variance in PERI TMSs, whereas VIG predicted 9% of the sample variance, demonstrating an important influence of body fat accumulation and intense physical activity in the menopause transition. High-intensity exercise interventions to alleviate body composition changes may also reduce menopausal-related symptoms for PERI women.
Differences in the impact of newly diagnosed type 2 diabetes on cardiovascular mortality between normotensive and hypertensive individuals
Authors: Sasaki Nobuo , Maeda Ryo , Ozono Ryoji , Yoshimura Kenichi , Nakano Yukiko , Higashi Yukihito
Published: March 2024

Objective:

We investigated the interrelationship between hyperglycemia and hypertension on cardiovascular mortality in the middle-aged and elderly people.

Methods:

In this retrospective cohort study that used data from the Hiroshima Study on Glucose Metabolism and Cardiovascular Diseases, we included 16,564 participants without cardiovascular disease (mean age: 65.8 years; 6179 normoglycemic people, 3017 people with newly diagnosed type 2 diabetes, and 7368 people with prediabetes per the 75-g oral glucose tolerance test). Hypertension was defined as the use of antihypertensive medications and/or having a systolic/diastolic blood pressure of at least 140/90 mm Hg.

Results:

During a median follow-up period of 12.4 years, a total of 1513 cardiovascular death occurred. Cardiovascular death rates per 1000 participant-years were 4.01, 4.98, 8.33, 8.22, 8.81, and 11.1 among normotensive participants with normal glycemia, prediabetes, and diabetes and hypertensive participants with normal glycemia, prediabetes, and diabetes, respectively. Prediabetes was significantly associated with a high risk of cardiovascular mortality in normotensive individuals [hazard ratio: 1.24, 95% confidence interval (95% CI): 1.02–1.50] but not in hypertensive individuals. Type 2 diabetes was associated with a high risk of cardiovascular mortality in both normotensive (hazard ratio: 1.94, 95% CI: 1.55–2.43) and hypertensive individuals (hazard ratio: 1.35, 95% CI: 1.13–1.62). Stratified analyses revealed no significant impact of type 2 diabetes on cardiovascular mortality in hypertensive individuals aged at least 65 years.

Conclusion:

The effect of hyperglycemia on cardiovascular death differed with age and the presence or absence of hypertension, demonstrating the clinical importance of case-specific risk assessments.
Angiotensin-converting enzyme inhibitors, statins and the polypill in cardiovascular diseases prevention: ignorance is bliss or not?
Authors: Natale Francesco , Golino Paolo , Cimmino Giovanni
Published: March 2024

The polypill strategy, which combines several medicines that simultaneously control different risk factors/diseases in a single pill, is one of the approaches used in cardiovascular therapy. In different guidelines, this one-pill combination therapy is suggested as first-line step in disease management. Because the cardiovascular diseases (CVD) pandemia, prevention is essential. The approaches that could improve adherence are of great importance to achieve health, social and economical benefits. However, direct or indirect experience of adverse drug reaction is often the reason for discontinuation, with serious fatal and non-fatal consequences especially for a polypill. Angiotensin-converting enzyme inhibitors (ACEi) and statins are the most prescribed medications in CVD prevention. It is well known that both drugs may have adverse effects that induce discontinuation. Often, the personal awareness of these effects is a reason for self-discontinuation. In this study an analysis of the ACEi/statin awareness is reported. Is it potentially harmful for polypill?
Coordinated Same- or Next-Day Radiosurgery and Cochlear Implantation for Vestibular Schwannoma
Authors: Macielak Robert J. , Dornhoffer James R. , Plitt Aaron R. , Neff Brian A. , Driscoll Colin L.W. , Carlson Matthew L. , Link Michael J.
Published: March 2024

Objective

To describe the experience and results from coordinated and closely scheduled radiosurgery and cochlear implantation (CI) in a vestibular schwannoma (VS) cohort.

Patients

Patients with VS who underwent radiosurgery followed by CI on the same or next day.

Interventions

Interventions included sequential radiosurgery and CI.

Main Outcome Measures

Tumor control defined by tumor growth on posttreatment surveillance and audiometric outcomes including consonant-nucleus-consonant words and AzBio sentences in quiet.

Results

In total, six patients were identified that met the inclusion criteria, with an age range of 38 to 69 years and tumor sizes ranging from 2.0 to 16.3 mm. All patients successfully underwent radiosurgery and CI on the same or immediately successive day. Postoperatively, all patients obtained open-set speech recognition. Consonant-nucleus-consonant word scores ranged from 40 to 88% correct, and AzBio scores ranged from 44 to 94% correct. During posttreatment magnetic resonance imaging surveillance, which ranged from 12 to 68 months, all tumors were noted to be adequately visualized, and no tumor progression was noted.

Conclusion

Coordinated radiosurgery and CI can be safely performed in patients with VS on the same or next day, serving to decrease burden on patients and increase access to this vital rehabilitative strategy.
Reduced Channel Interaction Improves Timbre Recognition Under Vocoder Simulation of Cochlear Implant Processing
Authors: Yüksel Mustafa , Çiprut Ayça
Published: March 2024

Objective

This study aimed to investigate the influence of the number of channels and channel interaction on timbre perception in cochlear implant (CI) processing. By utilizing vocoder simulations of CI processing, the effects of different numbers of channels and channel interaction were examined to assess their impact on timbre perception, an essential aspect of music and auditory performance.

Study Design, Setting, and Patients

Fourteen CI recipients, with at least 1 year of CI device use, and two groups (N = 16 and N = 19) of normal hearing (NH) participants completed a timbre recognition (TR) task. NH participants were divided into two groups, with each group being tested on different aspects of the study. The first group underwent testing with varying numbers of channels (8, 12, 16, and 20) to determine an ideal number that closely reflected the TR performance of CI recipients. Subsequently, the second group of NH participants participated in the assessment of channel interaction, utilizing the identified ideal number of 20 channels, with three conditions: low interaction (54 dB/octave), medium interaction (24 dB/octave), and high interaction (12 dB/octave). Statistical analyses, including repeated-measures analysis of variance and pairwise comparisons, were conducted to examine the effects.

Results

The number of channels did not demonstrate a statistically significant effect on TR in NH participants (p > 0.05). However, it was observed that the condition with 20 channels closely resembled the TR performance of CI recipients. In contrast, channel interaction exhibited a significant effect (p < 0.001) on TR. Both the low interaction (54 dB/octave) and high interaction (12 dB/octave) conditions differed significantly from the actual CI recipients' performance.

Conclusion

Timbre perception, a complex ability reliant on highly detailed spectral resolution, was not significantly influenced by the number of channels. However, channel interaction emerged as a significant factor affecting timbre perception. The differences observed under different channel interaction conditions suggest potential mechanisms, including reduced spectro-temporal resolution and degraded spectral cues. These findings highlight the importance of considering channel interaction and optimizing CI processing strategies to enhance music perception and overall auditory performance for CI recipients.
Measurement and estimation of energy in the critically ill
Authors: Kamel Amir Y.
Published: March 2024

Purpose of review

Recent changes in guidelines recommendation during early phase of critical illness and use of indirect calorimetry. The aim of this review is to discuss methods of determining energy requirements in the critically ill and highlight factors impacting resting energy expenditure.

Recent finding

An appraisal of recent literature discussing indirect calorimetry guided-nutrition potential benefits or pitfalls. Recent attempts to devise strategy and pilot indirect calorimetry use in the critically ill patients requiring continuous renal replacement therapy or extracorporeal membrane oxygenation are also discussed. Additionally, we briefly touched on variability between guidelines recommended energy target and measured energy expenditure for adult critically ill patients with obesity.

While energy requirement in the critically ill continues to be an area of controversy, recent guidelines recommendations shift toward providing less aggressive calories during acute phase of illness in the first week of ICU.

Use of indirect calorimetry may provide more accurate energy target compared to the use of predictive equations. Despite the absence of literature to support long term mortality benefits, there are many potential benefits for the use of indirect calorimetry when available.
Anticipating ICU discharge and long-term follow-up
Authors: Rosa Regis Goulart , Teixeira Cassiano , Piva Simone , Morandi Alessandro
Published: March 2024

Purpose of review

This review aims to summarize recent literature findings on long-term outcomes following critical illness and to highlight potential strategies for preventing and managing health deterioration in survivors of critical care.

Recent findings

A substantial number of critical care survivors experience new or exacerbated impairments in their physical, cognitive or mental health, commonly named as postintensive care syndrome (PICS). Furthermore, those who survive critical illness often face an elevated risk of adverse outcomes in the months following their hospital stay, including infections, cardiovascular events, rehospitalizations and increased mortality. These findings underscore the need for effective prevention and management of long-term health deterioration in the critical care setting. While robust evidence from well designed randomized clinical trials is limited, potential interventions encompass sedation limitation, early mobilization, delirium prevention and family presence during intensive care unit (ICU) stay, as well as multicomponent transition programs (from ICU to ward, and from hospital to home) and specialized posthospital discharge follow-up.

In this review, we offer a concise overview of recent insights into the long-term outcomes of critical care survivors and advancements in the prevention and management of health deterioration after critical illness.
What's new in whole blood resuscitation? In the trauma bay and beyond
Authors: Coulthard Stacy L. , Kaplan Lewis J. , Cannon Jeremy W.
Published: March 2024

Purpose of review

Transfusion therapy commonly supports patient care during life-threatening injury and critical illness. Herein we examine the recent resurgence of whole blood (WB) resuscitation for patients in hemorrhagic shock following trauma and other causes of severe bleeding.

Recent findings

A growing body of literature supports the use of various forms of WB for hemostatic resuscitation in military and civilian trauma practice. Different types of WB include warm fresh whole blood (FWB) principally used in the military and low titer O cold stored whole blood (LTOWB) used in a variety of military and civilian settings. Incorporating WB initial resuscitation alongside subsequent component therapy reduces aggregate blood product utilization and improves early mortality without adversely impacting intensive care unit length of stay or infection rate. Applications outside the trauma bay include prehospital WB and use in patients with nontraumatic hemorrhagic shock.

Whole blood may be transfused as FWB or LTOWB to support a hemostatic approach to hemorrhagic shock management. Although the bulk of WB resuscitation literature has appropriately focused on hemorrhagic shock following injury, extension to other etiologies of severe hemorrhage will benefit from focused inquiry to address cost, efficacy, approach, and patient-centered outcomes.
Challenges with medical tourism
Authors: Maltezou Helena C. , Pavli Androula
Published: March 2024

Purpose of review

With the return of international travels to almost prepandemic levels, the number of patients who travel abroad to seek healthcare services is once again growing rapidly. Nevertheless, the expected benefits of medical tourism may be challenged by serious infectious complications. This review summarizes the evolving published evidence on infectious complications related with medical tourism of the last eighteen months.

Recent findings

There has been an increase of reported infectious complications in patients who had received healthcare abroad. Such complications were frequently associated with serious and prolonged morbidity, repeated treatments and hospitalizations, high healthcare costs, and occasionally fatalities. A devastating outbreak of fungal meningitis occurred among US residents who underwent epidural anesthesia for cosmetic surgery in two clinics in Mexico. Overall, as of July 5, 2023 there were 31 cases with severe cerebrovascular complications and eight deaths. Infections caused by nontuberculum mycobacteria and Candida sp have been also reported the last years.

Considering the expected expansion of medical tourism in the forthcoming years, public health authorities and scientific societies should raise awareness of such infections among physicians and other healthcare professionals and issue recommendations for their management. A system to report complications in patients receiving healthcare abroad is needed.
Significance of Spread Through Air Spaces and Vascular Invasion in Early-stage Adenocarcinoma Survival
Authors: Nicotra Samuele , Melan Luca , Pezzuto Federica , Bonis Alessandro , Silvestrin Stefano , Verzeletti Vincenzo , Cannone Giorgio , Rebusso Alessandro , Comacchio Giovanni Maria , Schiavon Marco , Dell’Amore Andrea , Calabrese Fiorella , Rea Federico
Published: March 2024

Spread through air spaces (STAS) is a novel invasive pattern of lung cancer associated with poor prognosis in non-small cell cancer (NSCLC). We aimed to investigate the incidence of STAS in a surgical series of adenocarcinomas (ADCs) resected in our thoracic surgery unit and to identify the association of STAS with other clinicopathological characteristics. We retrospectively enrolled patients with stage cT1a-cT2b who underwent resection between 2016 and 2022. For each case, a comprehensive pathologic report was accessible which included histotype, mitoses, pleural invasion, fibrosis, tumor infiltrating lymphocytes, necrosis, inflammation, vascular and perineural invasion, as well as STAS. PD-L1 expression was also investigated. A total of 427 patients with ADCs underwent surgery. Regarding overall survival (OS), no significant difference was observed between the STAS positive (STAS+) and STAS negative (STAS−) groups (P=0.44). However, vascular invasion (VI) was associated with a poorer survival probability (P=0.018). STAS+/VI+ patients had tendentially worse survival compared with STAS+/VI− (P=0.089). ADCs with pathologic evidence of immune system (IS) activation (TILs>10% and PD-L1≥1) demonstrated significantly increased OS compared with ADCs with no IS and VI. In terms of recurrence rate, no statistical differences were found between the STAS+ and STAS− samples (P=0.2). VI was also linked to a significantly elevated risk of recurrence (P=0.0048). Our study suggests that in resected early-stage ADCs, STAS+ does not seem to influence recurrence or mortality. VI was instead an adverse pathologic prognostic factor for both survival and recurrence, whereas IS seemed to be protective.
Effect of lateral wedge insole on medial meniscus extrusion and its association with knee osteoarthritis progression
Authors: Ishii Yosuke , Ishikawa Masakazu , Shimada Noboru , Takahashi Makoto , Iwamoto Yoshitaka , Date Shota , Kurumadani Hiroshi , Kamei Goki , Sunagawa Toru , Adachi Nobuo
Published: March 2024

Background:

Medial meniscus extrusion (MME) is associated with knee osteoarthritis (OA) progression because of increased loading stress in the medial compartment of the knee. Using a lateral wedge insole (LWI) decreases loading stress and immediately reduces MME.

Objective:

To investigate whether the wearing duration of LWI affects the midterm response to MME and is associated with knee OA progression.

Study design:

Cohort study.

Methods:

Twenty-three patients with knee OA who were conservatively treated with LWI were classified according to the duration of the LWI wear per day: less than 5 h (short-duration group) or over 5 h (long-duration group). MME was evaluated in the single-leg standing position by ultrasound. Knee OA progression and limb alignment were evaluated radiographically. These evaluations were performed thrice: at the initial office visit as a baseline without LWI (time 0), with LWI (LWI-time 0), and 1 year after intervention with LWI (LWI-1 year).

Results:

In both groups, the MMEs at LWI time 0 were significantly decreased compared with those at time 0. In the long-duration group, this reduction in MME was maintained 1 year after the intervention compared with time 0 (time 0: 3.9 ± 0.9, LWI-1 year: 2.6 ± 1.1), but this improvement was not observed in the short-duration group (time 0: 3.8 ± 1.7, LWI-1 year: 3.6 ± 1.7). In addition, three of four patients demonstrated OA progression, and varus alignment had significantly progressed compared with that at time 0 in the short-duration group. However, the long-duration group showed OA progression only in one patient and maintained limb alignment.

Conclusions:

The duration of wearing LWI affects the midterm reduction of MME and knee OA progression while maintaining limb alignment.