bluuebunny/crossref_metadata_2025 huggingface dataset:
Maintenance of acetabular correction following PAO: a multicenter study comparing stainless-steel and titanium screws
Authors: Zhao Lei , Uchtman Molly , Aretakis Alexander , Selberg Courtney , McCarthy James J , Whitlock Patrick W
Published: February 2024

Stainless-steel screws are commonly used for fragment fixation during periacetabular osteotomy (PAO) at our institutions. Titanium is reserved for patients with documented nickel allergies. Titanium screws possess a significantly lower Young’s modulus than stainless steel and, therefore, potentially less resistance to physiologic loading. Thus, we hypothesized that the use of titanium screws might be associated with changes in acetabular correction prior to healing. The aim of this study was to compare the maintenance of acetabular correction following PAO using stainless-steel or titanium screws. A documented nickel allergy was confirmed with an allergy specialist. Patients’ age at surgery, gender and BMI were collected. The lateral center–edge angle of Wiberg (LCEA), medial center–edge angle (MCEA), anterior wall index (AWI), posterior wall index (PWI) and Tönnis angle were measured. The delta value for radiographic parameters was calculated as the difference between values immediately post-operation and at 6 months post-operation. Only age at surgery (P < 0.001) and the pre-operative LCEA (P = 0.013) were significantly different between groups (Tables I and II). The remaining pre- and post-operative radiological measurements were similar (Table II). Comparison of delta values at 6 months follow-up indicated no significant differences between screw types (Table III). No patients in the titanium group had a trans-iliac retrograde screw included in their construct (P = 0.003). All patients healed from their osteotomies. The use of titanium screws in patients with an allergy to nickel was not associated with differences in acetabular correction or the rate of osseous union rates despite its lower inherent mechanical properties.
Depoliticizing money: how the International Monetary Fund transformed central banking
Authors: Bagchi Kanad
Published: February 2024

After the 2008 Global Financial Crisis, the politics of money and central banking came to the forefront. Calls for repoliticizing central banking towards social goals such as inequality, poverty, and climate change have gathered much traction. Economists and political scientists have called for revisiting the long-lost developmental mandates of central banks and for understanding them as social institutions and as terrains of overlapping contestations. Yet, the role of law in framing the discourse on money and monetary policy has been less explored. In this paper, I argue that international law, especially the International Monetary Fund (IMF/Fund), played a crucial role in the depoliticization of money in the 1970s and 1980s. Legal instruments of the Fund, including conditionality and surveillance, were operationalized to transpose ‘price stability’ and ‘central bank independence’ into the legal mandate of central banks worldwide. From a distinctly political enterprise, central banking became ‘technocratic’ endeavour operating strictly under the paradigm of rationality and neutrality. If, as this paper shows, the law has played a crucial role in depoliticizing money, the law can also be a tool in reorienting central banking towards progressive ends such as tackling poverty or inequality. This would require a careful re-evaluation of the legal institutions of global money, beginning with the Fund itself.
A simple coordinate transformation method for quickly locating the features of interest in TEM samples
Authors: Zeng Mingzhi , Wang Wenzhao , Yin Yang , Zheng Changlin
Published: February 2024

We developed a simple coordinate transformation method for quickly locating features of interest (FOIs) of samples in transmission electron microscope (TEM). The method is well suited for conducting sample searches in aberration-corrected scanning/transmission electron microscopes (S/TEM), where the survey can be very time-consuming because of the limited field of view imposed by the highly excited objective lens after fine-tuning the aberration correctors. For implementation, a digital image of the sample and the TEM holder was captured using a simple stereo-optical microscope. Naturally presented geometric patterns on the holder were referenced to construct a projective transformation between the electron and optical coordinate systems. The test results demonstrated that the method was accurate and required no electron microscope or specimen holder modifications. Additionally, it eliminated the need to mount the sample onto specific patterned TEM grids or deposit markers, resulting in universal applications for most TEM samples, holders and electron microscopes for fast FOI identification. Furthermore, we implemented the method into a Gatan script for graphical-user-interface-based step-by-step instructions. Through online communication, the script enabled real-time navigation and tracking of the motion of samples in TEM on enlarged optical images with a panoramic view.
The Politics of Risking Peace Revisited: The Fate of Rebel Leaders Who Signed Peace Agreements
Authors: Ortiz Juliana Tappe
Published: February 2024

Are rebel leaders punished for signing peace agreements? Many studies have found that leaders face domestic punishment for signing peace agreements. However, while this may be true for state leaders, it remains unclear whether this is also the case for rebel leaders. Between 1975 and 2018, I describe what happened to the rebel leaders who signed a peace agreement. One-third of rebel leaders in these countries experienced exile, imprisonment, or unnatural death, while the rest shifted to politics or pursued rebellion. I describe two prototypical life paths after peace agreements of former rebel leaders in Colombia and Niger: the unpunished and the punished. This study shows how the database of rebel leader attributes (ROLE) can be advanced with novel data, enabling the kinds of studies on rebel leaders that scholars have conducted on state leaders in international politics. Future studies should extend research on rebel leader characteristics and peace negotiations.
Perforated appendicitis with endosalpingiosis
Authors: Sealey Andrew J , Balasooriya Janaka
Published: February 2024

Endosalpingiosis a condition of ectopic glandular epithelium diagnosed histologically, most commonly on pelvic and abdominal peritoneum, that can be associated with abdominal pain mimicking appendicitis. There is evidence emerging that endosalpingiosis may be associated with serous ovarian malignancies. Here we describe a case of perforated appendicitis with concurrent endosalpingiosis. Further research is required to better elucidate the association between endosalpingiosis and malignancy, and the implications of a concurrent presentation with a hollow viscus perforation.
A Comprehensive Summary of the Meta-Analyses and Systematic Reviews on Platelet-Rich Plasma Therapies for Knee Osteoarthritis
Authors: Mende Emily , Love Ryan J , Young Jody-Lynn
Published: February 2024

Introduction

Osteoarthritis (OA), including that of the knee joint, represents a significant proportion of musculoskeletal injuries in the Canadian Armed Forces (CAF) due to the frequent, high-stress physical activity for which member participation is necessary. Platelet-rich plasma (PRP) is a conservative, autologous treatment that has the potential to relieve symptoms and improve functionality of military members to decrease the impact of the disease and ultimately strengthen the CAF.

Materials and Methods

A search of systematic reviews and meta-analyses was conducted to determine the efficacy of PRP injections in treating knee OA. The Scopus database, PubMed database, and Omni academic search tools were scoped for relevant publications. English literature, published up to and including March 2023, that investigated only clinically randomized controlled trials (RCTs) was eligible for inclusion. The results of network meta-analyses were investigated and summarized independent of reviews and non-network meta-analyses.

Results

A total of 225 unique systematic reviews and meta-analyses were initially identified, of which 39 publications, including 7 network meta-analyses, adhered to the defined inclusion and exclusion criteria. PRP was found to significantly alleviate symptoms of pain based on the visual analog scale and Western Ontario and McMaster Universities Arthritis Index pain scores within the 12-month follow-up. Function, activity, sport, quality of life, and stiffness were additionally determined to generally improve to a greater extent from PRP treatment compared to controls, while adverse effects were minor and temporary. PRP placed in the top 3 in 9 reported surface under the cumulative ranking curves, while individually reported rankings of leukocyte-poor and leukocyte-rich PRP both placed in the top 4. The clinical recommendations made were generally positive, with 17 publications acknowledging the benefits of PRP, 3 supporting possible efficacy, and an additional 8 recommending that it be an option for the conservative treatment of knee OA.

Conclusion

The results of this review support the efficacy of PRP for relieving symptoms of pain and improving function, stiffness, and quality of life for patients experiencing knee OA within 12 months. As a result, leukocyte-poor-PRP could be considered for members of the CAF with mild to moderate knee OA (Kellgren–Lawrence grades 1–3) to slow the progression of OA and extend the military careers of CAF members. There continues to be a need for future studies to investigate the longer-term effects of PRP to verify sustained benefits at follow-up points greater than 12 months, including findings of improvement in a delayed fashion at the 3- and 6-month timeframe compared to hyaluronic acid treatment.
Numerical MHD models of stream interaction regions (SIRs) and corotating interaction regions (CIRs) using sunRunner3D: comparison with observations
Authors: Aguilar-Rodriguez E , González-Avilés J J , Riley P , Ben-Nun M , Rodriguez-Martinez M , González R F , Perez-Rivera M A , Raga-Rasmussen A C
Published: February 2024

In this work, we present numerical simulations of Stream Interaction Regions (SIRs) and Corotating Interaction Regions (CIRs) using the sunrunner3d tool that employs as a coronal model the boundary conditions obtained by corhel/mas with the pluto code that describes the global 3D structure of the solar wind using the magnetohydrodynamics (MHD) approach in the inner heliosphere. Specifically, we selected a set of SIRs and CIRs observed by the Parker Solar Probe (PSP) and STEREO-A (STA) missions during the Carrington rotations (CRs) 2207 to 2210 and CRs from 2020 to 2022. In order to describe the dynamics of the plasma that constitutes the solar wind background conditions for the selected CRs, we solve the ideal MHD equations in an inertial frame of reference, managing the solar rotation by rotating the boundary values in ϕ (longitude) at a rate corresponding to the sidereal rotation rate of the solar equator. We show that our results using sunrunner3d can globally reproduce the plasma parameters, such as radial velocity, number proton density, and radial magnetic field strength of these large-scale structures, observed by PSP and STA at distances near the Sun and around 1 au, respectively. These results allow exploring the global evolution of SIRs/CIRs in the inner heliosphere using sunrunner3d.
Cell-specific housekeeping role of lncRNAs in COVID-19-infected and recovered patients
Authors: Chattopadhyay Partha , Mehta Priyanka , Soni Jyoti , Tardalkar Kishore , Joshi Meghnad , Pandey Rajesh
Published: February 2024

A plethora of studies have demonstrated the roles of lncRNAs in modulating disease severity and outcomes during infection. However, the spatio-temporal expression of these lncRNAs is poorly understood. In this study, we used single-cell RNA-seq to understand the spatio-temporal expression dynamics of lncRNAs across healthy, SARS-CoV-2-infected, and recovered individuals and their functional role in modulating the disease and recovery. We identified 203 differentially expressed lncRNAs, including cell type-specific ones like MALAT1, NEAT1, ZFAS1, SNHG7, SNHG8, and SNHG25 modulating immune function in classical monocyte, NK T, proliferating NK, plasmablast, naive, and activated B/T cells. Interestingly, we found invariant lncRNAs (no significant change in expression across conditions) regulating essential housekeeping functions (for example, HOTAIR, NRAV, SNHG27, SNHG28, and UCA1) in infected and recovered individuals. Despite similar repeat element abundance, variant lncRNAs displayed higher Alu content, suggesting increased interactions with proximal and distal genes, crucial for immune response modulation. The comparable repeat abundance but distinct expression levels of variant and invariant lncRNAs highlight the significance of investigating the regulatory mechanisms of invariant lncRNAs. Overall, this study offers new insights into the spatio-temporal expression patterns and functional roles of lncRNAs in SARS-CoV-2-infected and recovered individuals while highlighting the importance of invariant lncRNAs in the disease context.
Typhoon- and pollution-driven enhancement of reactive bromine in the mid-latitude marine boundary layer
Authors: Wang Shanshan , Li Qinyi , Zhang Ruifeng , Mahajan Anoop Sharad , Inamdar Swaleha , Benavent Nuria , Zhang Sanbao , Xue Ruibin , Zhu Jian , Jin Chenji , Zhang Yan , Fu Xiao , Badia Alba , Fernandez Rafael P , Cuevas Carlos A , Wang Tao , Zhou Bin , Saiz-Lopez Alfonso
Published: February 2024

Tropospheric reactive bromine is important for atmospheric chemistry, regional air pollution, and global climate. Previous studies have reported measurements of atmospheric reactive bromine species in different environments, and proposed their main sources, e.g. sea-salt aerosol (SSA), oceanic biogenic activity, polar snow/ice, and volcanoes. Typhoons and other strong cyclonic activities (e.g. hurricanes) induce abrupt changes in different earth system processes, causing widespread destructive effects. However, the role of typhoons in regulating reactive bromine abundance and sources remains unexplored. Here, we report field observations of bromine oxide (BrO), a critical indicator of reactive bromine, on the Huaniao Island (HNI) in the East China Sea in July 2018. We observed high levels of BrO below 500 m with a daytime average of 9.7 ± 4.2 pptv and a peak value of ∼26 pptv under the influence of a typhoon. Our field measurements, supported by model simulations, suggest that the typhoon-induced drastic increase in wind speed amplifies the emission of SSA, significantly enhancing the activation of reactive bromine from SSA debromination. We also detected enhanced BrO mixing ratios under high NOx conditions (ppbv level) suggesting a potential pollution-induced mechanism of bromine release from SSA. Such elevated levels of atmospheric bromine noticeably increase ozone destruction by as much as ∼40% across the East China Sea. Considering the high frequency of cyclonic activity in the northern hemisphere, reactive bromine chemistry is expected to play a more important role than previously thought in affecting coastal air quality and atmospheric oxidation capacity. We suggest that models need to consider the hitherto overlooked typhoon- and pollution-mediated increase in reactive bromine levels when assessing the synergic effects of cyclonic activities on the earth system.
Patterns and Drivers of Antifungal Prescribing in Acute Leukemia: A Retrospective Cohort Study
Authors: Houston Hamish , Dutey-Magni Peter , Steel Matthew , Patel Selina , Wong Wai Keong , Shallcross Laura , Wilson Andrew James , Stone Neil
Published: February 2024

Background

Patients with hematological malignancy are at high risk of invasive fungal infections (IFIs). Diagnosis is challenging, which can lead to overtreatment. Reducing exposure to inappropriate antifungal prescribing is likely to improve patient safety, but modifying prescribing behavior is difficult. We aimed to describe patterns and drivers of therapeutic antifungal prescribing in a large tertiary hemato-oncology center in the United Kingdom.

Methods

We studied adults receiving treatment for acute leukemia at our center between 1 April 2019 and 14 October 2022. We developed a reproducible method to analyze routinely collected data on antifungal therapy episodes in a widely used electronic health record system. We report antifungal use in days of therapy stratified by level of diagnostic confidence, as defined by consensus diagnostic guidelines (European Organisation for Research and Treatment of Cancer/Mycoses Study Group).

Results

Two hundred ninety-eight patients were included in the analysis; 21.7% of inpatient antifungal use occurred in cases of proven/probable IFI. Substantial antifungal use occurred in the absence of strong evidence of infection in patients receiving high-intensity first-line chemotherapy or approaching death (81.0% and 77.9%, respectively). Approximately 33% of high-resolution computed tomography (HRCT) reports were indeterminate for IFI. Indeterminate reports were around 8 times more likely to be followed by a new antifungal therapy episode than a negative report.

Conclusions

Antifungal stewardship remains challenging in the absence of reliable diagnostics, particularly in more unwell patients. The proportion of antifungal therapy given for proven/probable infection is a new metric that will likely be useful to target antifungal stewardship programs. The thoracic HRCT report is an important contributor to diagnostic uncertainty.
Identification and functional characterization of conserved cis-regulatory elements responsible for early fruit development in cucurbit crops
Authors: Xin Hongjia , Liu Xin , Chai Sen , Yang Xueyong , Li Hongbo , Wang Bowen , Xu Yuanchao , Lin Shengnan , Zhong Xiaoyun , Liu Bin , Lu Zefu , Zhang Zhonghua
Published: February 2024

A number of cis-regulatory elements (CREs) conserved during evolution have been found to be responsible for phenotypic novelty and variation. Cucurbit crops such as cucumber (Cucumis sativus), watermelon (Citrullus lanatus), melon (Cucumis melo), and squash (Cucurbita maxima) develop fruits from an inferior ovary and share some similar biological processes during fruit development. Whether conserved regulatory sequences play critical roles in fruit development of cucurbit crops remains to be explored. In six well-studied cucurbit species, we identified 392,438 conserved noncoding sequences (CNSs), including 82,756 that are specific to cucurbits, by comparative genomics. Genome-wide profiling of accessible chromatin regions (ACRs) and gene expression patterns mapped 20,865 to 43,204 ACRs and their potential target genes for two fruit tissues at two key developmental stages in six cucurbits. Integrated analysis of CNSs and ACRs revealed 4,431 syntenic orthologous CNSs, including 1,687 cucurbit-specific CNSs that overlap with ACRs that are present in all six cucurbit crops and that may regulate the expression of 757 adjacent orthologous genes. CRISPR mutations targeting two CNSs present in the 1,687 cucurbit-specific sequences resulted in substantially altered fruit shape and gene expression patterns of adjacent NAC1 (NAM, ATAF1/2, and CUC2) and EXT-like (EXTENSIN-like) genes, validating the regulatory roles of these CNSs in fruit development. These results not only provide a number of target CREs for cucurbit crop improvement, but also provide insight into the roles of CREs in plant biology and during evolution.
A Rademacher-type exact formula for partitions without sequences
Authors: Bridges Walter , Bringmann Kathrin
Published: February 2024

In this paper, we prove an exact formula for the number of partitions without sequences. By work of Andrews, the corresponding generating function is a mixed mock modular form weight of 0. The proof requires evaluating and bounding Kloosterman sums and the Circle Method.
Universality theorems of Selberg zeta functions for arithmetic groups
Authors: Hashimoto Yasufumi
Published: February 2024

We prove a universality theorem for the Selberg zeta function of subgroups of $\mathrm{SL}_2(\mathbb{Z})$ or co-compact arithmetic groups derived from quaternion algebras, in the strip $\{5/6 \lt \mathrm{Re}{s} \lt 1\}$, improving the range compared with a previous work by Drungilas–Garunkštis–Kačenas. We also obtain the same range for a joint universality theorem for congruence subgroups, which improves a result by Mishou.
N-Acetylcysteine and a Specialized Preventive Intervention for Individuals at High Risk for Psychosis: A Randomized Double-Blind Multicenter Trial
Authors: Wasserthal Sven , Muthesius Ana , Hurlemann René , Ruhrmann Stephan , Schmidt Stefanie J , Hellmich Martin , Schultze-Lutter Frauke , Klosterkötter Joachim , Müller Hendrik , Meyer-Lindenberg Andreas , Poeppl Timm B , Walter Henrik , Hirjak Dusan , Koutsouleris Nikolaos , Fallgatter Andreas J , Bechdolf Andreas , Brockhaus-Dumke Anke , Mulert Christoph , Philipsen Alexandra , Kambeitz Joseph
Published: February 2024

Background and Hypothesis

Clinical high risk for psychosis (CHR-P) offers a window of opportunity for early intervention and recent trials have shown promising results for the use of N-acetylcysteine (NAC) in schizophrenia. Moreover, integrated preventive psychological intervention (IPPI), applies social-cognitive remediation to aid in preventing the transition to the psychosis of CHR-P patients.

Study Design

In this double-blind, randomized, controlled multicenter trial, a 2 × 2 factorial design was applied to investigate the effects of NAC compared to placebo (PLC) and IPPI compared to psychological stress management (PSM). The primary endpoint was the transition to psychosis or deterioration of CHR-P symptoms after 18 months.

Study Results

While insufficient recruitment led to early trial termination, a total of 48 participants were included in the study. Patients receiving NAC showed numerically higher estimates of event-free survival probability (IPPI + NAC: 72.7 ± 13.4%, PSM + NAC: 72.7 ± 13.4%) as compared to patients receiving PLC (IPPI + PLC: 56.1 ± 15.3%, PSM + PLC: 39.0 ± 17.4%). However, a log-rank chi-square test in Kaplan–Meier analysis revealed no significant difference of survival probability for NAC vs control (point hazard ratio: 0.879, 95% CI 0.281–2.756) or IPPI vs control (point hazard ratio: 0.827, 95% CI 0.295–2.314). The number of adverse events (AE) did not differ significantly between the four groups.

Conclusions

The superiority of NAC or IPPI in preventing psychosis in patients with CHR-P compared to controls could not be statistically validated in this trial. However, results indicate a consistent pattern that warrants further testing of NAC as a promising and well-tolerated intervention for CHR patients in future trials with adequate statistical power.
How a timely policy contributes to technological capability building: insights from Iran’s biopharmaceutical sector
Authors: Ghorbani Amir , Fartash Kiarash , Bagheri Abolfazl
Published: February 2024

Building technological capabilities is influenced by different factors, notably policies. This paper explains the co-evolution of policies, i.e. policy tools, on the technological capabilities in Iran’s biopharmaceutical sector from 1995 to 2022. By adopting a qualitative research method, we gathered primary data through thirty-nine semi-structured as well as secondary data from reports and statistics. This paper explains technological capabilities enhancement from operational capabilities to innovative capabilities based on our proposed framework, which includes six levels. While the lack of an efficient policy tools, until the mid-2000s, was decisive in the inertia of biopharmaceutical sector capabilities, a proactive policy tools in recent years led to considerable promising results in terms of manufacturing and exporting advanced biosimilar products. Our findings shed light on the role of government support in the acceleration and directionality of technological capabilities building. Achieving advanced levels of technological capabilities requires learning, international collaboration, and export-oriented policies.
Effect of exogenous melatonin on the cellular response of Holstein heifer calves during vaccination
Authors: Martin Allie E , Machado Vinicius S , Rathmann Ryan J , Crossland Whitney L
Published: February 2024

Despite rigorous vaccination protocols, calf morbidity is the primary contributor to economic loss in the calf sector of the dairy industry. Melatonin has modulated immune response in other mature animal species. We hypothesized that exogenous melatonin may improve the cellular response to vaccination in dairy calves. Our objective was to evaluate the effect of exogenous melatonin on polymorphonuclear leukocyte (PMN) function in Holstein heifer calves during immunization. Sixty neonatal Holstein heifers were enrolled by birth cohort (block) and randomized to one of four treatments: control (CON), vaccination of 0.5 mg ovalbumin on days 0 and 21 (VAC), implantation of 24 mg melatonin on day 0 (MEL), or both melatonin and vaccine treatments (MVAC). Jugular blood was collected on days 0, 21, 42, and 63 to measure circulating melatonin, anti-ovalbumin immunoglobulin-G, and PMN function. Calves implanted with melatonin had greater circulating melatonin than non-implanted on day 21 (P < 0.01). Anti-ovalbumin IgG was greater for vaccinated than non-vaccinated calves (P < 0.01). Anti-ovalbumin IgG was greater for MVAC than VAC calves on day 63. Percent of cells and mean florescence intensity of cells performing oxidative burst decreased from day 0 to day 63 (P < 0.01) but were not affected by treatment (P ≥ 0.26). There was a tendency (P = 0.10) for an interaction of melatonin, vaccination, and day for the mean florescence intensity of cells performing phagocytosis where MVAC was greater than all other treatments on d 42. Exogenous melatonin may alter PMN function of calves during vaccination. Further research is needed to define the effect of melatonin on development of antigen-specific IgG during programmed vaccination protocols.
Monogenic lupus: insights into disease pathogenesis and therapeutic opportunities
Authors: Qin Yuting , Ma Jianyang , Vinuesa Carola G.
Published: February 2024

Purpose of review

This review aims to provide an overview of the genes and molecular pathways involved in monogenic lupus, the implications for genome diagnosis, and the potential therapies targeting these molecular mechanisms.

Recent findings

To date, more than 30 genes have been identified as contributors to monogenic lupus. These genes are primarily related to complement deficiency, activation of the type I interferon (IFN) pathway, disruption of B-cell and T-cell tolerance and metabolic pathways, which reveal the multifaceted nature of systemic lupus erythematosus (SLE) pathogenesis.

In-depth study of the causes of monogenic lupus can provide valuable insights into of pathogenic mechanisms of SLE, facilitate the identification of effective biomarkers, and aid in developing therapeutic strategies.
Preoperative Oswestry Disability Index Should not be Utilized to Determine Surgical Eligibility for Patients Requiring Lumbar Fusion for Degenerative Lumbar Spine Disease
Authors: Issa Tariq Z. , Haider Ameer A. , Lambrechts Mark J. , Sherman Matthew B. , Canseco Jose A. , Vaccaro Alexander R. , Schroeder Gregory D. , Kepler Christopher K. , Hilibrand Alan S.
Published: February 2024

Study Design.

Retrospective cohort study.

Objective.

To evaluate how preoperative Oswestry Disability Index (ODI) thresholds might affect minimal clinically important difference (MCID) achievement following lumbar fusion.

Summary of Background Data.

As payers invest in alternative payment models, some are suggesting threshold cutoffs of patient-reported outcomes (PROMs) in reimbursement approvals for orthopedic procedures. The feasibility of this has not been investigated in spine surgery.

Materials/Methods.

We included all adult patients undergoing one to three-level primary lumbar fusion at a single urban tertiary academic center from 2014 to 2020. ODI was collected preoperatively and one year postoperatively. We implemented theoretical threshold cutoffs at increments of 10. MCID was set at 14.3. The percent of patients meeting MCID were determined among patients “approved” or “denied” at each threshold. At each threshold, the positive predictive value (PPV) for MCID attainment was calculated.

Results.

A total 1368 patients were included and 62.4% (N=364) achieved MCID. As the ODI thresholds increased, a greater percent of patients in each group reached the MCID. At the lowest ODI threshold, 6.58% (N=90) of patients would be denied, rising to 20.2%, 39.5%, 58.4%, 79.9%, and 91.4% at ODI thresholds of 30, 40, 50, 60, and 70, respectively. The PPV increased from 0.072 among patients with ODI>20 to 0.919 at ODI>70. The number of patients denied a clinical improvement in the denied category per patient achieving the MCID increased at each threshold (ODI>20: 1.96; ODI>30: 2.40; ODI>40: 2.75; ODI>50: 3.03; ODI>60: 3.54; ODI>70: 3.75).

Conclusion.

Patients with poorer preoperative ODI are significantly more likely to achieve MCID following lumbar spine fusion at all ODI thresholds. Setting a preoperative ODI threshold for surgical eligibility will restrict access to patients who may benefit from spine fusion despite ODI>20 demonstrating the lowest predictive value for MCID achievement.

Level of Evidence.

3.
The Effect of Full-Dose Versus Half-Dose Ketamine for Induction During Rapid Sequence Intubation on Patient Outcomes
Authors: Asberry Cassandra , Martini Alaina
Published: February 2024

Prehospital rapid sequence intubation (RSI), like inpatient RSI, is not without risk of adverse effects to the patient. The most notable of these adverse effects is postintubation hemodynamic instability. Air medical providers choose induction agents for critically ill patients who require emergent airway management, some of whom may already be hemodynamically unstable prior to RSI. Ketamine is often selected as the induction agent of choice for patients who are either unstable before RSI or have a high index of suspicion of becoming unstable in the postintubation period. Although widely considered to have a good safety profile for induction, ketamine administration has been correlated with episodes of postintubation hypotension. In this retrospective literature review, the effect of using half-dose ketamine for induction in patients who show pre-RSI instability (systolic blood pressure <90 mm Hg or body mass index >30) on postintubation hemodynamics is examined.
Development of a Comprehensive Model for Cancer Symptom Care for Women With Ovarian or Endometrial Cancer
Authors: Christiansen Mille Guldager , Jarden Mary , Colomer-Lahiguera Sara , Eicher Manuela , Bryant-Lukosius Denise , Mirza Mansoor Raza , Pappot Helle , Piil Karin
Published: February 2024

Background:

Women with ovarian or endometrial cancer experience multiple symptoms during chemotherapy. Specialized cancer nurses possess specific knowledge and competencies to effectively monitor and manage treatment-related toxicities and provide self-management support.

Objective:

To describe the conception and development of a comprehensive cancer symptom model of care in an oncological setting for women diagnosed with ovarian or endometrial cancer.

Methods:

The participatory evidence-based, patient-focused process for guiding the development, implementation, and evaluation of advanced practice nursing roles—the participatory, evidence-based, patient-centered process for advanced practice (PEPPA) framework directed the process. The first 6 steps of this 9-step framework were utilized to incorporate research evidence, engage, and obtain the input of key stakeholders.

Results:

Stakeholders (n = 27) contributed with specific knowledge, perspectives, and feedback to the entire development process, and several needs were identified. Following structured discussions, a new model of cancer symptom care with elements such as symptom management, electronic patient-reported outcomes, and an expanded nursing role in the form of nurse-led consultations was developed.

Conclusions:

We effectively utilized the PEPPA framework to design a new cancer symptom model of care, that was agreed upon by key stakeholders.

Implications for Practice:

This stakeholder-engaged, and evidence-driven process could be used as a template for others wanting to develop a population-specific model of care to improve cancer symptom management.

What is Foundational:

With the expansion of the cancer nursing role, the new model has the potential to improve the quality of cancer care and health outcomes related to symptom management.
Considerations Regarding Management of Heart Failure in Older Adults
Authors: Alagiakrishnan Kannayiram , Mah Darren , Aronow Wilbert S. , Lam Phillip H. , Frishman William H. , Ahmed Ali , Deedwania Prakash
Published: February 2024

Understanding noncardiovascular comorbidities and geriatric syndromes in elderly patients with heart failure (HF) is important as the average age of the population increases. Healthcare professionals need to consider these complex dynamics when managing older adults with HF, especially those older than 80. A number of small studies have described associations between HF and major geriatric domains. With information on patients’ cognitive, functional decline, and ability to adhere to therapy, physicians can plan for individualized treatment goals and recommendations for these patients.
Robotic excision of a giant seminal vesicle cyst
Authors: Carbin Danny Darlington , Perry Matthew James Alexander , Abou Chedid Wissam
Published: February 2024

Zinner syndrome is a rare congenital condition characterized by unilateral renal agenesis, ejaculatory duct obstruction, and seminal vesicle cyst. This syndrome is caused by an embryonic malformation of the mesonephric or Wolffian duct. Seminal vesicle cysts are commonly reported, and men with these cysts often present with infertility. This report presents a case of a giant seminal vesicle cyst that was incidentally found while evaluating for bowel symptoms. The seminal vesicle cyst was successfully managed by robot-assisted excision.
Coniochaeta hoffmannii and mutabilis Invasive Fungal Keratitis: A Case Series and Literature Review
Authors: Pegany Roma B. , Wilson Reid L. , Stiefel Hillary , Albert Daniel M. , Chamberlain Winston D. , Redd Travis K.
Published: February 2024

Purpose:

To describe 2 Coniochaeta species (Coniochaeta hoffmannii and Coniochaeta mutabilis) as rare causes of invasive fungal keratitis resulting in enucleations and to provide a review of ocular infections caused by the genus Coniochaeta and underscore changes to its classification over the past 3 decades, which may clarify previous reports with outdated nomenclature.

Methods:

This is a small case series from a single academic institution (Casey Eye Institute) with a summary of the literature.

Results:

The first case describes a 53-year-old man who had an indolent but persistent anterior chamber reaction after repair of a penetrating nail injury. Cultures from a second penetrating keratoplasty identified C. hoffmannii, which was determined through phenotypic characterization and DNA sequencing. Despite surgical management, cultures were persistently positive for C. hoffmannii. Two years post-injury, he developed a funnel retinal detachment with proliferative vitreoretinopathy and elected for enucleation. The second case describes a 54-year-old woman with poor contact lens hygiene with a presumed filamentous fungal keratitis that remained refractory to topical natamycin. Broad-range polymerase chain reaction of an anterior chamber aspirate identified C. mutabilis. Therapeutic keratoplasty was performed for worsening infection; however, because of intractable pain, she elected for enucleation. Pathology from the enucleation specimen demonstrated persistent, but sparse, fungal elements.

Conclusions:

This is the first case series characterizing ocular infections caused by Coniochaeta, a rare cause of invasive fungal keratitis resulting in devastating outcomes for our patients. Identification of Coniochaeta was initially difficult by traditional culturing techniques, and subsequent molecular diagnostic testing proved useful in detection. Our review of ocular Coniochaeta clarifies previous reports with outdated nomenclature.
Geographic atrophy: current and future therapeutic agents and practical considerations for retinal specialists
Authors: Vakharia Priya , Eichenbaum David
Published: February 2024

Purpose of review

Geographic atrophy (GA) from age-related macular degeneration (AMD) remains a leading cause of vision loss. The purpose of this review is to summarize currently available intravitreal therapeutics, and discuss pipeline therapeutics that are currently in clinical trials.

Recent findings

The FDA approval of pegcetacoplan and avacincaptad pegol, both approved in 2023, represent the first therapeutics to treat GA. These are delivered via intravitreal injections, and have been shown to slow progression of GA. Both drugs have a risk of new onset neovascular age-related macular degeneration (nAMD). Initial indications seem to be that pegcetacoplan therapy has higher risks of inflammation, vasculitis, and nonarteritic ischemic optic neuropathy (NAION) as compared to avacincaptad pegol, but more real-world data will help to clarify this further. Pipeline therapeutics that we discuss include intravitreal gene therapy, oral anticomplement therapy, and intravitreal injections of a novel glycoprotein.

Both pegcetacoplan and avacincaptad pegol are FDA approved to treat GA. The decision to treat patients is still complex and nuanced, but the approval of two treatments for GA is a tremendous advance in our field. Future therapeutics may further refine our ability to treat patients more effectively and safely.
Low-frequency (5-Hz) stimulation of ventrolateral periaqueductal gray modulates the descending serotonergic system in the peripheral neuropathic pain
Authors: Park Minkyung , Koh Chin Su , Chang Heesue , Kim Tae Jun , Mun Wonki , Chang Jin Woo , Jung Hyun Ho
Published: February 2024

Neuropathic pain is a type of chronic pain that entails severe prolonged sensory dysfunctions caused by a lesion of the somatosensory system. Many of those suffering from the condition do not experience significant improvement with existing medications, resulting in various side effects. In this study, Sprague–Dawley male rats were used, and long-term deep brain stimulation of the ventrolateral periaqueductal gray was conducted in a rat model of spared nerve injury. We found that 5-Hz deep brain stimulation effectively modulated mechanical allodynia and induced neuronal activation in the rostral ventromedial medulla, restoring impaired descending serotonergic system. At the spinal level, glial cells were still activated but only the 5-HT1a receptor in the spinal cord was activated, implying its inhibitory role in mechanical allodynia. This study found that peripheral neuropathy caused dysfunction in the descending serotonergic system, and prolonged stimulation of ventrolateral periaqueductal gray can modulate the pathway in an efficient manner. This work would provide new opportunities for the development of targeted and effective treatments for this debilitating disease, possibly giving us lower chances of side effects from repeated high-frequency stimulation or long-term use of medication.
Quality Improvement Interventions to Enhance Vaccine Uptake in Cancer Patients: A Systematic Review
Authors: Kazi Basil , Talukdar Zain , Schriefer Jan
Published: February 2024

Introduction:

Cancer patients, because of their compromised immune responses, face a higher risk of preventable infections, leading to increased morbidity and mortality. Despite this, vaccination rates among these patients are suboptimal, and research on effective interventions to improve vaccination rates is limited.

Methods:

We conducted a comprehensive search in PubMed and Cochrane Library for studies investigating quality improvement (QI) interventions targeting vaccine uptake in cancer patients. Two authors independently screened, extracted data, and analyzed studies, resolving any discrepancies through consensus.

Results:

Thirteen studies met the inclusion criteria, published between 2014 and 2022. Seven studies focused on the influenza vaccine, five on the pneumococcal vaccine, and one on both. Twelve studies used multiple interventions, whereas one used a single intervention. Most interventions aimed to enhance patient and family knowledge and identify eligible patients before their appointments. All studies demonstrated improved vaccine uptake after implementing the interventions.

Conclusions:

A variety of QI interventions have effectively increased pneumococcal and influenza vaccine uptake among cancer patients. Future research should address roadblocks to implementation and explore the effect of these interventions on other vaccines.
Effect of telemonitoring and as-needed patient support on positive airway pressure therapy adherence
Authors: Owens Saoirse , Doghramji Karl
Published: February 2024

Background:

Obstructive sleep apnea (OSA) affects patient health and public welfare. Positive airway pressure (PAP) therapy is the preferred treatment of OSA, but therapy adherence rates remain suboptimal. Current literature demonstrates telemonitoring interventions to support improved PAP therapy adherence.

Purpose:

To evaluate the effect of interval telemonitoring of PAP therapy data at 2 and 4 weeks after treatment initiation in patients with moderate-to-severe obstructive sleep apnea with as-needed patient support and troubleshooting by telephone consultation.

Methodology:

Ninety-nine participants were enrolled in this study, 50 in the control group and 49 in the intervention group. Data were analyzed using descriptive and inferential statistics using SPSS 28.0 software. The primary outcome of interest was 90-day PAP adherence.

Results:

Mean PAP adherence scores diverged at 90 days after PAP initiation, with the intervention group having a significantly higher mean score (M = 49.24, SD = 38.18) relative to the control group (M = 36.38, SD = 37.69). Likewise, continued PAP usage at 90 days after therapy initiation diverged between participant groups, with the intervention group having a significantly higher mean score (M = 89.80, SD = 30.58) relative to the control group (M = 72.00, SD = 45.36).

Conclusions:

The intervention resulted in significantly higher mean PAP adherence and a greater percentage of participants demonstrating continued PAP usage at 90 days after therapy initiation but did not result in a statistically significant increase in what is considered and defined as “good PAP adherence” (adherence of ≥70%).

Implications:

Data-triggered telemonitoring protocols offer supplementary support to patients in need and improve PAP adherence.
Prevalence of depression among pregnant women and its correlation with the choice of delivery method
Authors: Vaziri-harami Roya , Kazemi Seyyedeh Neda , Vaziri-harami Saharnaz , Najafiarab Hanieh
Published: February 2024

Background:

Caesarean section is usually limited to cases where natural vaginal delivery is not possible or poses a serious risk to the foetus and mother. Psychological health of mothers is likely to play an important role in the method of delivery. This study aims to investigate the prevalence of depression in pregnant women and its relationship with the choice of delivery method and other demographic parameters.

Methods:

In this descriptive cross-sectional study, 250 mothers referring to the hospitals of Shahid Beheshti University of Medical Sciences, Tehran, Iran, were selected, and their demographic information and level of depression was collected using a questionnaire. Statistical analysis was conducted to evaluate the correlation between depression, method of delivery and other associated parameters.

Results:

Among 250 pregnant women, 225 (90%) had no depression, 25 (10%) had mild depression and no moderate or severe depression was reported in any pregnant mother. Also, 146 (58.4%) were willing to have a caesarean section and 104 (41.6%) wanted to have a normal delivery. The choice of delivery method was not significantly associated with depression. Analyzes showed that increasing maternal age is associated with a greater tendency to caesarean delivery. The incidence and higher depression scores of mothers showed a significant association with the history of previous abortions.

Conclusion:

Although in this study no significant association was observed between depression in pregnant mothers and the choice delivery, due to the high prevalence of caesarean section in the country and its progression to higher percentages, it seems that the design and implementation of effective programs and interventions is required.
Sex Cord-Stromal Tumors of the Ovary: An Update and Review. Part II — Pure Sex Cord and Sex Cord-Stromal Tumors
Authors: Devins Kyle M. , Young Robert H. , Oliva Esther
Published: February 2024

We review the time honored but still frequently challenging features of ovarian sex cord-stromal tumors and also emphasize new developments, including unusual morphologic appearances that, despite the relative rarity of many of the tumors, result in a disproportionate number of differential diagnostic problems, variant immunohistochemical profiles, and specific molecular and syndromic associations. These neoplasms are also of historical interest as current knowledge is still based in significant part to the contributions of 2 giants of gynecologic pathology, Dr Robert Meyer and Dr. Robert E. Scully. In part I, we reviewed the pure ovarian stromal tumors. Now, in part II, we present the major clinical, pathologic, and genomic features of pure sex cord and sex cord-stromal tumors.
Skin Expander for Scalp Reconstruction: Reappraisal of a Reconstructive Procedure for Aplasia Cutis Congenita
Authors: Arcuri Francesco , Ardito Emanuela , Bianchi Bernardo
Published: February 2024

Purpose:

Aplasia cutis congenita (ACC) is a heterogeneous group of congenital disorders characterized by the absence of epidermis, dermis, appendages, subcutaneous tissue, and bone. The aim of the study is to describe a clinical report of ACC of the scalp treated with skin expanders.

Clinical Report:

In October 2019, a 16-year-old female patient underwent scalp expansion with 2 rectangular devices (150 and 250 cm3; Radovan Mentor-Johnson&Johnson). The inflation started 30 days after surgery and continued once every 7 to 10 days to gain 10% of overexpansion. After 3 months, the patient underwent the second surgical step with the expanded scalp transposed to close the defect. Clinical examination 6 months after surgery revealed an acceptable cosmetic result with a hidden surgical scar and hair growth in the previous area of frontoparietal alopecia.

Conclusion:

Skin expander for the reconstruction of extensive ACC defects of the scalp is a valid procedure.