bluuebunny/crossref_metadata_2025 huggingface dataset:
Do we need dosimetry for the optimization of theranostics in CNS tumors?
Authors: Cicone Francesco , Gnesin Silvano , Santo Giulia , Stokke Caroline , Bartolomei Mirco , Cascini Giuseppe Lucio , Minniti Giuseppe , Paganelli Giovanni , Verger Antoine , Cremonesi Marta
Published: October 2024

Radiopharmaceutical theranostic treatments have grown exponentially worldwide, and internal dosimetry has attracted attention and resources. Despite some similarities with chemotherapy, radiopharmaceutical treatments are essentially radiotherapy treatments, as the release of radiation into tissues is the determinant of the observed clinical effects. Therefore, absorbed dose calculations are key to explaining dose-effect correlations and individualizing radiopharmaceutical treatments. The present article introduces the basic principles of internal dosimetry and provides an overview of available loco-regional and systemic radiopharmaceutical treatments for central nervous system (CNS) tumors. The specific characteristics of dosimetry as applied to these treatments are highlighted, along with their limitations and most relevant results. Dosimetry is performed with higher precision and better reproducibility than in the past, and dosimetric data should be systematically collected, as treatment planning and verification may help exploit the full potential of theranostic of CNS tumors.
Chronic myelomonocytic leukemia with NPM1 mutation or acute myeloid leukemia?
Authors: Castaño-Díez Sandra , Álamo José Ramón , López-Guerra Mònica , Gómez-Hernando Marta , Zugasti Inés , Jiménez-Vicente Carlos , Guijarro Francesca , López-Oreja Irene , Esteban Daniel , Charry Paola , Torrecillas Víctor , Mont-de Torres Lucia , Cortés-Bullich Albert , Bataller Álex , Guardia Ares , Munárriz Daniel , Carcelero Esther , Riu Gisela , Triguero Ana , Tovar Natalia , Vela Dolors , Beà Silvia , Costa Dolors , Colomer Dolors , Rozman Maria , Esteve Jordi , Díaz-Beyá Marina
Published: October 2024

The 2022 WHO revision and the ICC classification have recently modified the diagnostic criteria for chronic myelomonocytic leukemia (CMML) and acute myeloid leukemia. However, there is no consensus on whether CMML with NPM1 mutation (NPM1mut) should be diagnosed as AML. Nowadays, it is a subject of discussion because of its diagnostic and therapeutic implications. Therefore, we describe a case of a patient diagnosed with CMML NPM1mut and briefly review the literature to highlight the uncertainty about how to classify a CMML with NPM1 mutation. We emphasize the importance of a comprehensive molecular study, which is crucial to optimize the individualized treatment of patients, enabling them to access targeted therapies.
Discriminant Divisors for Conic Bundles
Authors: Tanaka Hiromu
Published: October 2024

We study some foundational properties on discriminant divisors for generically smooth conic bundles. In particular, we extend the formula $\Delta_f \equiv -f_*K_{X/T}^2$ to arbitrary characteristics.
Dynamic Market Making with Asymmetric Information and Market Power
Authors: Chen Wen , Wang Yajun
Published: October 2024

We study the dynamics of trading volume and bid-ask spread using a multiperiod trading model with oligopolistic market makers. Traders smooth out their trading even though they are not strategic, and thus trading persists after the arrival of information or liquidity shocks. Traders act quickly on their private information while postponing hedging trades until later periods. The market power of market makers enables them to widen bid-ask spreads when trading incentives are heightened. Consequently, both trading volume and bid-ask spread may exhibit U-shaped patterns. Our model calibration aligns with the empirical intraday patterns observed in bid-ask spreads and trading volumes. (JEL D53, D61, D82, G12, G14, G18)
Rhodopseudomonas palustris Atp2 Protein Exerts Antifungal Effects by Targeting the Ribosomal Protein MoRpl12 in Magnaporthe oryzae
Authors: Chen Chunyan , Wu Xiyang , Huang Qiang , Qin Yingfei , Li Chenggang , Zhang Xin , Wang Pei , Tan Xinqiu , Liu Yong , Chen Yue , Zhang Deyong
Published: October 2024

Rice blast is one of the most hazardous diseases affecting rice production. Previously, we discovered that the Atp2 protein of Rhodopseudomonas palustris could significantly inhibit the appressorium formation and pathogenicity of Magnaporthe oryzae. However, the molecular mechanism of this fungus has remained unknown. This study revealed that Atp2 can enter the cell and interact with the ribosomal protein MoRpl12 of M. oryzae, directly affecting the expression of the MoRpl12 protein. Silencing the MoRPL12 gene can affect cell wall integrity, growth, conidiogenesis, and fungal pathogenicity. The quantitative reverse transcription PCR results showed significant changes in the expression of conidiation-related genes in the MoRPL12 gene-silenced mutants or in the Atp2 protein-treated plants. We further found that Atp2 treatment can influence the expression of ribosomal-related genes, such as RPL, in M. oryzae. Our study revealed a novel antifungal mechanism by which the Atp2 protein binds to the ribosomal protein MoRpl12 and inhibits the pathogenicity of rice blast fungus, providing a new potential target for rice blast prevention and control.
The Curious Case of “Men in Nursing” as a Diversity Issue
Authors: Padgett Stephen M.
Published: October 2024

In recent years the situation of “men in nursing” has been framed as a diversity issue, analogous to efforts to increase the proportion of women in male-dominated occupations, and to racial diversity in health professions. Advocates claim that nursing education is dominated by a “feminine” perspective, resulting in unhappy male students and marginalized male faculty. This is puzzling, as a close reading of the literature finds little support for these claims; and a persistent discounting of male advantages. Portraying men in nursing as victims distorts the nature of systemic oppression, and distracts us from more serious diversity struggles.
Mitigating Risk of Acute Kidney Injury Among Children With Methicillin-resistant Staphylococcus aureus Osteomyelitis
Authors: Challa Lasya , Villani Mary C. , Hachem Ahmad A. , Ma Yuhan , Jo Chanhee , Patel Karisma , Firmani Sarah , Copley Lawson A.
Published: October 2024

Objective:

Children with acute hematogenous osteomyelitis (AHO) from methicillin-resistant Staphylococcus aureus (MRSA) are treated with vancomycin despite the risk of acute kidney injury (AKI). This study evaluates the rate of AKI and resource utilization for children with or without AKI when vancomycin is used in this setting.

Methods:

Children with MRSA AHO treated with vancomycin were retrospectively studied. AKI was assessed by clinical diagnosis and Kidney Disease Improving Global Outcomes (KDIGO) criteria. Cohorts of children with or without AKI were compared for differences in treatment, resource utilization, and outcomes. Multivariate logistic regression analysis assessed factors associated with risk for AKI. Cost analysis was performed using the Pediatric Health Information System and Healthcare Cost and Utilization Project databases.

Results:

Among 85 children studied, 14 (16.5%) had chart-diagnosed AKI and 24 (28.2%) met KDIGO criteria. Children with AKI had more febrile days and higher thrombosis rates. They had longer vancomycin treatment (8 vs 5 d), higher troughs (27.8 vs 17.5 mg/L), and prolonged hospitalization (19.9 vs 11.1 d). Multivariate analysis found a maximum vancomycin trough level (odds ratio: 1.05, P = 0.003) with a cutoff of 21.7 mg/L predicted AKI.

Only 2 of 20 (10%) children who had MRSA isolates with a minimum inhibitory concentration of 2 achieved therapeutic vancomycin levels. Pediatric Health Information System data of 3133 children with AHO treated with vancomycin identified 75 (2.4%) with AKI who had significantly longer lengths of stay (13 vs 7 d) and higher billed charges ($117K vs $51K) than children without AKI.

Conclusions:

Chart documentation of AKI (16.5%) grossly underestimated KDIGO-defined occurrence (28.2%). This study showed that vancomycin-associated AKI required substantially greater resource utilization and higher health care costs. Lowering the targeted trough range, shortening the duration of vancomycin therapy, and considering alternative antibiotics when minimum inhibitory concentration ≥2 will reduce the risk and cost of AKI among children with MRSA AHO.

Level of Evidence:

Level III—retrospective comparative therapeutic study.
Bibliometric Analysis of Studies on Delirium in Critical Care
Authors: Hancı Volkan , Turhan Damar Hale , Damar Muhammet
Published: October 2024

Background

Delirium leads to prolongation in intensive care unit (ICU) and hospital length of stay and an increase in ICU costs and mortality. As a result of this, the number of studies on delirium in ICUs has recently increased significantly, and many articles have been published.

Objectives

The aim of this study was to evaluate the articles related to “delirium” in “critical care” field in the Web of Science database and the first hundred most cited articles on this subject.

Methods

The Web of Science database was searched for articles relevant to “delirium” in the critical care medicine field published between 1980 and 2024. Text analytics and network models used in bibliometric mapping were used for prolific authors, annual trend, citation, and countries.

Results

In our study, it was determined that a total of 1834 articles in the field of delirium in critical care medicine were included. It was determined that the annual citation average was 42.79 and the H-index value was 134. There is a general upward trend over the years, and it was observed that it has intensified in the last 5 to 6 years. With the Reference Spectroscopy analysis, it was determined that the most intensively cited studies on delirium were the studies of 2013 and 2010. The distribution of keywords in recent years has focused on analgosedation, acute brain injury, older patient, COVID-19, and fragility. When examined for the top 100 cited articles, it was seen that mobilization, guidelines, pain, activities of daily living, anesthesia, sedation, and haloperidol have become prominent in recent years.

Conclusion

In recent years, there has been a noticeable increase in the volume of research focusing on delirium studies within the field of critical care medicine. Staying current with trends, incorporating findings from frequently cited studies, and customizing interventions to suit modern difficulties can all improve the quality of care offered to critically ill patients and lead to better outcomes.
Association of insurance type with unmet need for menopause care in Oregon
Authors: Rodriguez Maria I. , Burns Haley , Schrote Kaitlin , Cichowski Sara , Adams Karen
Published: October 2024

Objective

To determine unmet need for menopause care in Oregon and evaluate if insurance type is associated with receipt of care.

Methods

We conducted a cross-sectional survey of patients using an Oregon Listserv. Our primary outcome was use of medication for the treatment of moderate or severe symptoms of menopause. We used the Menopause Rating Scale to evaluate respondents' symptoms: 0‐4 none or little symptoms; 5‐8 mild symptoms; 9‐16 moderate symptoms; and 17+ severe symptoms. We abstracted demographic and clinical information including age, rurality, race, ethnicity, primary language, and insurance type. We used a regression model to determine the association between public insurance and treatment for moderate to severe menopause symptoms. We examined reasons for nonuse of therapy.

Results

Our sample included 845 perimenopausal or postmenopausal individuals who were predominantly White (93.0%), aged 45‐49 (32.8%) or 50‐54 years (39.1%), and privately insured (81.3%). Overall, 62.4% of individuals with moderate and severe symptoms of menopause were not receiving any therapy. After adjustment for age and rurality, public insurance was associated with an average of 47% increased odds of nontreatment for moderate or severe menopause symptoms (adjusted odds ratio: 1.47, 95% CI: 0.99‐2.19). The most common reasons for nontreatment in both groups were “therapy was not recommended by a provider” (43%) and worries about safety or side effects (40%).

Conclusions

Even in well-insured persons, the majority of people with moderate and severe symptoms of menopause are not receiving treatment. People who are publicly insured are more likely to go untreated than privately insured individuals.
Addressing menopause symptoms in the primary care setting: opportunity to bridge care delivery gaps
Authors: Bevry Mackenzie L. , Stogdill Emily R. , Lea Catherine M. , Taylor Kathryn R. , Lovaas Anna M. , Bailey Kaitlyn J. , Mara Kristin C. , Dierkhising Ross A. , Chaudhry Rajeev , Faubion Stephanie S. , Kapoor Ekta
Published: October 2024

Objective

Menopause symptoms affect quality of life and financial well-being but are often unaddressed in primary care clinics. Therefore, we evaluated the extent of menopause symptom documentation in electronic health records (EHRs) by primary health care professionals.

Methods

We retrospectively reviewed adult women who reported moderate or higher vasomotor symptoms on a Mayo Clinic survey conducted from March 1, 2021, through June 30, 2021. We then assessed adequacy of menopause symptom documentation in the EHRs of these women who had primary care visits during the survey period. We reviewed the percentage of documented vasomotor symptoms from May 1, 2019, through May 1, 2021.

Results

In the Mayo Clinic Health System—Northwest Wisconsin Region, 229 women self-reported moderate or higher vasomotor symptoms in the Mayo Clinic survey. Although only 23% of these women had vasomotor symptoms listed in the EHR clinical problem lists, 60% of these women had vasomotor symptoms documented in their clinic notes from the primary care visit. Approximately 6% of women reported hormone therapy use for management of menopause symptoms, and nearly 15% reported use of nonhormone prescription therapies for vasomotor symptoms.

Conclusions

A greater proportion of women in our study had EHR documentation of bothersome menopause symptoms than those reported in other studies, but vasomotor symptoms remain generally untreated. We need better methods for identifying midlife women with bothersome menopause symptoms in primary care clinics so that appropriate treatment options, including hormone therapy, can be discussed and offered.
Limb Salvage and Treatment of Posttraumatic Lymphedema in a Mangled Lower Extremity
Authors: Dahl Victoria A. , Tadisina Kashyap Komarraju , Xu Kyle Y.
Published: October 2024

Post traumatic lymphedema (PTL) is a known complication of extremity trauma that is detrimental to limb form and function, healing, and quality of life. In cases of complex lower extremity trauma with vascular and extensive soft tissue injury, the risk of PTL is increased. However, many trauma patients are lost to follow-up, making the risk and potential management of these patients’ lymphedema difficult to characterize. The purpose of this report is to describe the successful surgical management of PTL secondary to significant lower extremity trauma requiring complex limb salvage reconstruction. A 43-year-old woman involved in a motorcycle accident presented with a Gustilo IIIB right tibial fracture and single-vessel leg. She underwent successful limb salvage with serial debridement, bony fixation, creation of an arteriovenous loop with a contralateral saphenous vein graft, and a chimeric latissimus dorsi-serratus anterior muscle flap. At the 5-month follow-up, she presented with significant right lower extremity lymphedema. She underwent lymphovenous bypass surgery guided by preoperative indocyanine green lymphography, which resulted in a 62% improvement in functional outcome measures, eliminated her prior need for compression garments and inability to wear regular shoes, and sustained improvement at two years follow-up. This case illustrates a near circumferential traumatic defect reconstructed with a muscle flap and successful delayed lymphatic reconstruction with lymphovenous bypass in the same patient.
Are previously validated blood pressure self-measurement devices accepted under the Universal Standard? A systematic review
Authors: de Oliveira Estefanie Siqueira Vigato , de Albuquerque Nila Larisse Silva , Dordetto Priscila Rangel , Lamas José Luiz Tatagiba
Published: October 2024

This study aimed to analyze whether oscillometric blood pressure devices validated for the general population may be considered approved under Universal Standard criteria. A systematic review was conducted, with searches in nine databases, up to September 2023, including 32 validation studies of noninvasive arm cuff devices for self-measurement. The British Hypertension Society protocol was most common (68%), followed by the Association for the Advancement of Medical Instrumentation (40%). Most devices met Universal Standard criterion 1, but only 17 (53%) met criterion 2. Few studies contained details about the choice of cuffs, the number of participants by arm circumference, or the differences between methods by cuff subgroup. Due to the considerable differences between validation protocols, 53% of the devices analyzed were approved under the Universal Standard. The study contributes to expanding the validated pool of self-measurement devices under the Universal Standard.
Chronic cannabidiol treatment induces cardiovascular improvement in renovascular hypertensive rats
Authors: Flôr Atalia Ferreira Lima , Duarte-Maia Samuel , Fernandes-Costa Francineide , Pessoa de Souza Rayane Maria , Braga Valdir de Andrade , Amaral Sandra Lia , Mascarenhas Sandra Rodrigues , Brito-Alves José Luiz , Colombari Debora Simões Almeida , Cruz Josiane Campos
Published: October 2024

Background:

Cannabidiol (CBD) is increasingly studied for its therapeutic potential in neurodegenerative diseases. Previous research on acute CBD administration has demonstrated cardiovascular benefits in hypertensive rats, including reduced mean blood pressure and oxidative stress.

Aim:

To investigate the long-term cardiovascular effects of chronic CBD treatment in renovascular hypertension induced by the 2-kidney-1-clip (2K1C) model.

Methods:

Male Wistar rats (180–200 g, 8 weeks old) underwent 2K1C or SHAM surgery. Six weeks later, rats received chronic CBD treatment (20 mg/kg, twice daily for 14 days). A combination of ex vivo, in vitro, and in vivo methods was used to assess CBD's cardiovascular effects in 2K1C hypertensive rats.

Results:

Chronic CBD treatment significantly reduced blood pressure and the depressor response to hexamethonium (a ganglionic blocker). It also normalized variability in low-frequency (LF) power and LF/high-frequency (HF) ratio. CBD enhanced vasodilation and reduced vasoconstriction in the mesenteric artery of 2K1C rats, accompanied by decreased expression of aortic reactive oxygen species (ROS).

Conclusion:

Our findings suggest that chronic CBD treatment exerts antihypertensive effects by improving baroreflex sensitivity and vascular function while decreasing arterial ROS levels and sympathetic nerve activity. These results underscore CBD's potential therapeutic role in managing cardiovascular complications associated with renovascular hypertension.
The effects of metformin on inflammation and apoptosis in rats with preeclampsia
Authors: Chen Yinmin , Gao Zhuanzhuan , Wang Liyuan , Duan Ruiyun , Hao Huiniu , Jia Ran , Ma Huijing , Gao Ruifan , Su Min , Yang Hailan , Tu Zengrong
Published: October 2024

Background:

Defined clinically by elevated blood pressure along with either proteinuria and/or maternal organ dysfunction, representing a major cause of morbidity and mortality pregnant women and newborns. Metformin (MET), an oral antidiabetic medication, has been shown to prevent preeclampsia (PE) through various mechanisms, including reducing inflammation, improving endothelial dysfunction, improving mitochondrial function, and altering cellular homeostasis and energy metabolism. Herein, we explored the role of MET in PE and its underlying molecular mechanisms using in in vivo experiments.

Methods:

RT-qPCR, Western blot (WB), and immunohistochemistry (IHC) were conducted to assess the mRNA or protein expression of genes related to mitochondrial apoptosis. Additionally, ELISA was conducted to quantify the expression of mitochondrial apoptosis and inflammation-related genes, as well as PE biomarkers.

Results:

Treatment with MET in PE rats ameliorated hypertension and proteinuria, altered the expression of PE biomarkers, and significantly inhibited L-NAME-induced inflammation and cell apoptosis. MET modulated the levels of inflammatory cytokines tumor necrosis factor alpha (TNF-α), interleukin (IL)-6, and IL-10, mitigating inflammation in PE rats. Furthermore, MET regulated mitochondrial outer membrane permeability (MOMP), thereby reducing cell apoptosis occurring in the mitochondrial pathway of PE rats.

Conclusions:

This study demonstrates that MET alleviates inflammation and cell apoptosis in PE rats by modulating the expression of inflammatory factors and MOMP. Our results indicate that MET has huge therapeutic potential against PE.
Cytokine Profile in Children Following SARS-CoV-2 Infection: Preliminary Findings
Authors: Buonsenso Danilo , Camporesi Anna , Di Sante Gabriele , Sali Michela , Boza Maria del Carmen Pereyra , Morello Rosa , Valentini Piero , Raffaelli Francesca , Rodriguez Lucie , Gonzalez Laura , Johnsson Anette , Mugabo Constantin Habimana , Lakshmikanth Tadepally , Brodin Petter
Published: October 2024

We provide preliminary evidence that, also in children, Long coronavirus disease (COVID) may be characterized by a proinflammatory signature. Ten Long COVID patients, 7 convalescent subjects after COVID infection and 4 healthy controls were enrolled. When adjusted for sex, children with long COVID had statistically significant differences in the levels of Flt3L, CD5, uPA, CCL23, CD40 and TGFα. When adjusted for age, CCL23 levels remained statistically significant.
The neuropsychological impacts of coronavirus disease 2019 in nonhospitalized patients with long coronavirus disease and brain fog
Authors: Chuang Yu-Chen , Cheng Yu-Hsiang , Tsai Meng-Ju , Lu Yi-Jiun , Fuh Jong-Ling
Published: October 2024

Background:

Coronavirus disease 2019 (COVID-19) causes persistent symptoms, including brain fog. Based on limited research on the long-term consequences of mild COVID-19, which has yielded inconsistent results, we investigated which cognitive functions were most affected by COVID-19 in nonhospitalized Asian patients with long-term COVID and subjective cognitive complaints.

Methods:

Fifty-five nonhospitalized patients with subjective cognitive complaints after COVID infection (24 males and 31 females, mean age: 45.6 ± 14.6 years, mean duration of education: 14.4 ± 3.0 years) finished the study. Neuropsychological assessments included screening tests for overall cognition, and comprehensive tests for memory, executive function, processing speed, and subjective emotional and disease symptoms. Cognitive test scores were converted into Z-scores. Moreover, principal component analysis (PCA) was used to define cognitive domains across subtest scores.

Results:

Comprehensive assessments revealed cognitive impairment in 69.1% of patients (<1.5 SD in at least one test). The processing speed (27.3%), memory recall (21.8%), memory learning (20.0%), and inhibitory control (18.2%) were the most affected areas. Self-reported anxiety and depression were observed in 35% and 33% of patients, respectively. Furthermore, the degree of anxiety was predictive of learning performance.

Conclusion:

Nearly 70% of patients with subjective cognitive complaints and long COVID had objective cognitive impairments. A comprehensive evaluation is essential for these patients, even when they present with mild symptoms.
Clinical outcomes in ventilator-associated pneumonia patients with and without chronic obstructive pulmonary disease
Authors: Lu Caiden Taowei , Fang Tien-Pei , Hung Ming-Szu , Lin Yi-Tsung
Published: October 2024

Background:

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Critically ill patients with COPD exacerbations may require invasive mechanical ventilation (IMV). Ventilator-associated pneumonia (VAP) commonly occurs in the intensive care unit (ICU) and is usually associated with high mortality. Current studies on the association between COPD and VAP are limited. This work compared the causes and clinical outcomes of VAP in patients with and without COPD in Taiwan.

Methods:

This retrospective observational study was conducted at the Chiayi Chang Gung Memorial Hospital. Patients diagnosed with VAP were enrolled between January 2015 and December 2019. The COPD diagnosis was based on postbronchodilator pulmonary function tests. We compared the bacterial cause, ICU and hospital stay length, IMV duration and mortality rates in patients with and without COPD.

Results:

A total of 175 patients with VAP were enrolled, 44% of whom presented had preexisting COPD. The disease severity on the day of admission was similar in both groups. Microorganisms were identified in 83 (47%) patients, with Pseudomonas aeruginosa, Acinetobacter spp., and Klebsiella pneumoniae being the most common pathogens. The proportion of multidrug resistant isolates showed no significant differences between groups. Most patients underwent antibiotic treatment before VAP onset. The length of ICU and hospital stays and IMV duration after VAP onset were similar between the two groups, as well as ICU mortality, in-hospital mortality, and 14-day mortality.

Conclusion:

Our study revealed that COPD was not associated with worse clinical outcomes in patients with VAP. No significant differences in bacterial cause were observed between the two groups.
Mapping the evolution of 3D printing in cardio-thoracic diseases: a global bibliometric analysis
Authors: Tian Jie , Dong Ying-Xian , Wang Li , Wu Yong-Ming , Zhao Zi-Yi , Che Guo-Wei
Published: October 2024

Background:

Despite the growing research on 3D printing (3DP) in cardio-thoracic diseases, comprehensive bibliometric analyses remain scarce. This study aims to bridge this gap by identifying key research trends and hotspots within the field.

Methods:

A bibliometric analysis was conducted on publications from 1991 to 2024 using data from the Web of Science Core Collection, with analysis performed using VOSviewer, CiteSpace, and the R package ‘bibliometrix’.

Results:

The analysis included 2836 documents authored by 14 206 researchers across 85 countries. A significant rise in annual publications was observed, with the United States, China, and the United Kingdom leading in contributions. Prominent institutions, including Stanford University, were highlighted, while Scientific Reports and Biomaterials were identified as influential journals. Key research areas encompass cardiovascular, lung, and breast diseases, along with chest wall reconstructions, with emerging trends focusing on advanced materials for drug delivery and tissue engineering.

Conclusion:

This comprehensive bibliometric analysis of 3DP in cardio-thoracic diseases reveals global research trends, emerging themes, and the crucial role of 3DP in advancing medical education and personalized treatment, highlighting areas for future research and development.
Elastography-based AI model can predict axillary status after neoadjuvant chemotherapy in breast cancer with nodal involvement: a prospective, multicenter, diagnostic study
Authors: Huang Jia-Xin , Lu Yao , Tan Yu-Ting , Liu Feng-Tao , Li Yi-Liang , Wang Xue-Yan , Huang Jia-Hui , Lin Shi-Yang , Huang Gui-Ling , Zhang Yu-Ting , Pei Xiao-Qing
Published: October 2024

Objective:

To develop a model for accurate prediction of axillary lymph node (LN) status after neoadjuvant chemotherapy (NAC) in breast cancer patients with nodal involvement.

Methods:

Between October 2018 and February 2024, 671 breast cancer patients with biopsy-proven LN metastasis who received NAC followed by axillary LN dissection were enrolled in this prospective, multicenter study. Preoperative ultrasound (US) images, including B-mode ultrasound (BUS) and shear wave elastography (SWE), were obtained. The included patients were randomly divided at a ratio of 8:2 into a training set and an independent test set, with five-fold cross-validation applied to the training set. The authors first identified clinicopathological characteristics and conventional US features significantly associated with the axillary LN response and developed corresponding prediction models. The authors then constructed deep learning radiomics (DLR) models based on BUS and SWE data. Models performances were compared, and a combination model was developed using significant clinicopathological data and interpreted US features with the SWE-based DLR model. Discrimination, calibration and clinical utility of this model were analyzed using the receiver operating characteristic curve, calibration curve, and decision curve, respectively.

Results:

Axillary pathologic complete response (pCR) was achieved in 52.41% of patients. In the test cohort, the clinicopathologic model had an accuracy of 71.30%, while radiologists’ diagnoses ranged from 64.26 to 71.11%, indicating limited to moderate predictive ability for the axillary response to NAC. The SWE-based DLR model, with an accuracy of 80.81%, significantly outperformed the BUS-based DLR model, which scored 59.57%. The combination DLR model boasted an accuracy of 88.70% and a false-negative rate of 8.82%. It demonstrated strong discriminatory ability (AUC, 0.95), precise calibration (P-value obtained by Hosmer–Lemeshow goodness-of-fit test, 0.68), and practical clinical utility (probability threshold, 2.5–97.5%).

Conclusions:

The combination SWE-based DLR model can predict the axillary status after NAC in patients with node-positive breast cancer, and thus, may inform clinical decision-making to help avoid unnecessary axillary LN dissection.
The role of radical cystectomy and lymphadenectomy in the management of bladder cancer with clinically positive lymph node involvement
Authors: Pfail John , Lichtbroun Benjamin , Golombos David M. , Jang Thomas L. , Packiam Vignesh T. , Ghodoussipour Saum
Published: October 2024

Purpose of review

The role of radical cystectomy and pelvic lymph node dissection in muscle-invasive bladder cancer (MIBC) with clinically positive lymph nodes is debated. This review examines the role of surgery in treating patients with clinical N1 and more advanced nodal involvement (N2–N3) within a multimodal treatment approach.

Recent findings

For clinical N1 disease, guidelines typically recommend neoadjuvant chemotherapy followed by surgery. However, for N2–N3 disease, guidelines vary. Advances in diagnostics, systemic therapies, and surgical recovery have improved the prognosis for these patients. Research is increasingly identifying MIBC patients, including those with positive nodes, who may achieve complete pathologic response and long-term survival, supporting the role of surgery even in advanced nodal stages.

Managing MIBC with clinically positive lymph nodes, especially in N2–N3 disease, requires a tailored approach. While neoadjuvant chemotherapy followed by radical cystectomy is standard for N1 disease, the role of surgery in advanced nodal stages is growing because of better patient selection and treatment strategies. Emerging evidence suggests that consolidative surgery may improve outcomes in these complex cases.
Care Coordination in Primary Care
Authors: Whitebird Robin R. , Beran Mary Sue , Solberg Leif I. , JaKa Meghan M. , Kindt Joan M. , Bergdall Anna R. , Dehmer Steven P.
Published: October 2024

Background:

Care coordination is an important strategy for addressing patient needs and improving outcomes of care.

Purpose:

The Minnesota Care Coordination Effectiveness Study sought to better understand the perspectives and experiences of clinicians/clinic leaders regarding the value, barriers, and facilitators for care coordination in primary care.

Methods:

We conducted semi-structured interviews with 18 clinic managers, physicians, and advanced practice clinicians. Data were analyzed using a directed content analysis approach.

Results:

Five themes arose in the interviews: financial issues were perceived as a primary barrier to care coordination; participants valued care coordination as an important asset; they employed significant variation in how care coordination was structured; they identified both medical and social needs of patients as important; and care coordinators’ background, experience, and integration were viewed as critical to program success.

Conclusions:

Care coordination received strong support from clinicians and clinic leaders who viewed it as a valuable component of successful care delivery.
Prevalence and Risk Factors of PTSD, Depression, and Grief Among Survivors of 2023 Türkiye Earthquake
Authors: Ulusoy Sevinc , Celik Zulal , Guleryuz Aleyna , Esgibag Havva Ceren , Yavuz Kaasim Fatih
Published: October 2024

This study investigated the prevalence and risk factors of probable posttraumatic stress disorder (PTSD), depression, and complicated grief among 529 adults residing in a container city, 4 months after the 2023 earthquakes in Türkiye. Participants were assessed using the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, the Hamilton Depression Scale, and the Inventory of Complicated Grief. The prevalence rates of probable PTSD, depression, and complicated grief were 21.4%, 15.9%, and 64.7%, respectively. Logistic regression analyses indicated that PTSD was significantly associated with the loss of a loved one, fear of future earthquakes, and decreased perceived life control. Similarly, depression was associated with being trapped under debris, experiencing fear during the earthquake, and reduced perceived life control. These findings suggest that individuals presenting these risk factors warrant closer follow-up for potential psychological issues. Additionally, the impact of fear related to the earthquake and the role of perceived life control emerge as crucial considerations for psychological interventions.
Feasibility and Acceptability of a REDCap-Embedded HIPAA-Compliant Text Messaging Application to Track Medication Adherence in Adolescents With Lupus
Authors: Harry Onengiya , Richard Brittany , Taxter Alysha , Skelton Joseph
Published: October 2024

Background/Objective

Despite advances in clinical care and treatment options, adolescents with lupus continue to experience adverse health outcomes. Poor adherence to medication regimens is a major contributor to these negative outcomes. The utility of short message service (SMS) in tracking barriers to adherence prospectively remains untested for adolescents with lupus. Our objectives were (1) feasibility of incorporating a Health Insurance Portability and Accountability Act (HIPAA)–compliant SMS text messaging application into REDCap and (2) acceptability of using SMS text messaging to track barriers to medication adherence in adolescents with lupus

Methods

This study is a 12-week pilot cohort study of adolescents with SLE per the 1997 revised American College of Rheumatology. A REDCap-embedded HIPAA-compliant text messaging application was used to send biweekly messages with survey link to track medication adherence. Measures were completed. Descriptive statistics were used to summarize demographics, medical, and acceptability data. Response to text messages and survey completion rates were reported as a measure of feasibility.

Results

Most eligible adolescents approached agreed to participate (n = 17, 71% enrollment rate). The cellphone ownership rate among adolescents eligible for participation was 92%. Nine subjects responded to all text messages sent (53% response and completion rate). Eleven subjects (65%) responded to two thirds of the text messages. Overall, 77% of enrolled subjects completed at least half of the surveys sent. Reminders to complete surveys were sent to 30% of enrolled adolescents.

Conclusions

This study shows that embedding a HIPAA-compliant SMS text message application in REDCap is feasible and can be used to engage adolescents with chronic conditions in monitoring between clinic visits.
Wong-Type Dermatomyositis
Authors: Wanzenberg Anna , Sami Naveed
Published: October 2024

Wong-type dermatomyositis (WTDM) was first formally discussed in the literature in 1969 by Dr. K.O. Wong. This rare variant of dermatomyositis (DM) is characterized by overlapping features of both classic DM and the cutaneous features of pityriasis rubra pilaris. Since 1969, few cases of WTDM have been published in the literature likely due to the rarity of this condition or lack of recognition by clinicians. This narrative review presents the current published English literature on WTDM, analyzing its clinical presentation, diagnostic testing, and treatments along with a comparison to classic DM. Given the overlap of features of both diseases and patients experiencing a better response to classic DM treatments, our results suggest that WTDM is a rare subtype of DM rather than simply an overlap of pityriasis rubra pilaris and DM presenting in 1 patient. We suggest that clinicians evaluate WTDM patients with very thorough histories, physical examinations, histopathology, and appropriate serological studies and monitor closely for systemic symptoms and development of malignancy. WTDM should be treated using conventional treatments for classical DM. Further studies are needed to understand the pathogenesis of WTDM including more specific and distinguishing autoantibody profiles from classical DM, as well as long-term clinical course of WTDM for best management, including recently available biological treatments.
“Mortise and Tenon Joint” Technique to Improve the Stability of Three-Dimensional Costal Cartilage Framework in Fully Expansion Ear Reconstruction
Authors: Yang Meirong , Pan Bo , Yu Xiaobo
Published: October 2024

Objective:

For full expansion of ear reconstruction, the stability of a cartilage framework is very important. However, most techniques for framework fabrication focus on three-dimensional structure and adequate projection. Few studies are available on improving the stability of the reconstructed framework. This study introduces a new “mortise and tenon joint” technique to create a more stable framework in fully expansion ear reconstruction.

Methods:

A total of 137 patients with microtia underwent full expansion ear reconstruction with the “mortise and tenon joint” technique from January 2018 to July 2022.

Results:

Hematoma was found in 2 patients after the expander was implanted and evacuated timely to save the flap. Ear cartilage framework exposure occurred in 3 patients after the second stage of surgery. The wounds were debridement and covered by a retroauricular fascia flap with a skin graft. No other complications, such as infection, expander exposure, or rupture, were observed. All patients were followed up for 6 to 12 months after ear reconstruction and asked to fill in a form anonymously about their satisfaction with the reconstructed ear. One hundred thirty-four patients (97.8%) were satisfied with the results.

Conclusions:

In fully expansion ear reconstruction, the “mortise and tenon joint” technique improves not only the stability of the cartilage framework but also the stereoperception of the reconstructed ear. Most patients who underwent the new technique were satisfied with clear contour and delicate substructures of the reconstructed ear, matched skin color, and long-term dimensional stability.
Advances in the Treatment of Congenital Infiltrating Lipomatosis of the Face: The Role of PIK3CA Mutations and Microvascular Reconstruction
Authors: Moreno Stephen D. , Liu Robert H. , Robbins Quinn , Burkes Jason
Published: October 2024

Congenital infiltrating lipomatosis of the face is a rare aggressive-benign disorder characterized by progressive hemifacial overgrowth and complex, often asymmetrical, facial differences. Recently linked with the PIK3CA-Related Overgrowth Spectrum, it arises from mosaic mutations in the PIK3CA gene. Treatment, largely supportive and tailored to individual clinical presentations, requires a multidisciplinary approach. This article reviews the longitudinal care of a young adult patient from 8 years of age, detailing his journey through combined orthognathic and microvascular reconstructive surgery and the outcomes thereof. In addition, it explores the treatment’s implications in the context of the PIK3CA mutation, offering insights into potential prognostic and therapeutic considerations.
Inflammatory Gene Expression in Livers Undergoing Ex Situ Normothermic Perfusion Is Attenuated by Leukocyte Removal From the Perfusate
Authors: Bahadori Kasra , Lee Colin Y.C. , Ferdinand John R. , Cabantous Mia , Butler Andrew J. , Rouhani Foad J. , Watson Christopher J.E. , Clatworthy Menna R.
Published: October 2024

Background.

Ex situ normothermic perfusion (ESNP) is a method to evaluate and potentially recondition organs before transplantation. However, increased expression of inflammatory molecules, including by tissue-resident immune cells, may occur during the perfusion process, potentially negating the beneficial effects of perfusion.

Methods.

We used RNA sequencing to assess gene expression in 31 livers undergoing ESNP, including 23 donated after circulatory death (DCD) and 8 donated after brain death. In 7 DCD livers, a leucocyte filter was added to the circuit during perfusion. Biopsies were available for transcriptomic assessment in all cases at the start of perfusion and at varying time points postperfusion.

Results.

During ESNP in DCD livers, we observed an increase in proinflammatory, profibrinolytic, and prorepair pathway genes. SERPINE1, encoding plasminogen activator inhibitor-1, was among the genes most significantly upregulated during perfusion in DCD livers, potentially promoting fibrin clot persistence in vasculature. We also found increased expression of monocyte and neutrophil recruiting chemokine and proinflammatory cytokine transcripts during ESNP, but several prorepair molecules, including thymic stromal lymphopoietin, were also upregulated. In both DCD and donation after brain death livers, interferon-gamma response genes were enriched, whereas oxidative phosphorylation genes decreased in organs with high perfusate alanine transaminase, a biomarker associated with adverse clinical outcomes. The inclusion of a leukocyte filter in the perfusion circuit mitigated the induction of inflammation/immune pathway genes during perfusion and was associated with enrichment in oxidative phosphorylation genes.

Conclusions.

Leukocyte removal during ESNP abrogates transcriptional changes that are associated with unfavorable clinical outcomes, potentially benefiting human livers undergoing ESNP.
Social media addiction, personality traits, and disorders: an overview of recent literature
Authors: Ahmed Eiman , Ahmed Saad
Published: October 2024

Purpose of review

The rapid proliferation of social media has raised concerns regarding the maladaptive use of these platforms. Individuals exhibiting specific personality traits and disorders may be particularly vulnerable to the adverse outcomes associated with social media addiction. Despite the increasing research attention this topic has received, the relationship between personality traits, personality disorders, and addiction to social media remains fragmented and unclear.

Recent findings

Research has primarily investigated the association between Big Five and Dark Triad model personality traits and social media addiction. Findings indicate that while most of the traits within the Big Five model vary in terms of significance, personality disorders and traits within the Dark Triad, which are generally associated with maladaptive thoughts and behaviors, are positively related to addictive social media use.

Personality traits and disorders play a vital role in individuals’ behavior. Research shows discrepancies in the relationship between certain traits in the Big Five model and social media addiction, warranting further investigation. At the same time, research also underscores the role of social media in potentially exacerbating conditions for those with personality disorders.
Field evidence for the role of plant volatiles induced by caterpillar oral secretion in prey localization by predatory social wasps
Authors: Grof-Tisza Patrick , Turlings Ted C. J. , Bustos-Segura Carlos , Benrey Betty
Published: October 2024

One assumed function of herbivore-induced plant volatiles (HIPVs) is to attract natural enemies of the inducing herbivores. Field evidence for this is scarce. In addition, the assumption that elicitors in oral secretions that trigger the volatile emissions are essential for the attraction of natural enemies has not yet been demonstrated under field conditions. After observing predatory social wasps removing caterpillars from maize plants, we hypothesized that these wasps use HIPVs to locate their prey. To test this, we conducted an experiment that simultaneously explored the importance of caterpillar oral secretions in the interaction.
Spodoptera
caterpillars pinned onto mechanically damaged plants treated with oral secretion were more likely to be attacked by wasps compared with caterpillars on plants that were only mechanically wounded. Both of the latter treatments were considerably more attractive than plants only treated with oral secretion or left untreated. Subsequent analyses of headspace volatiles confirmed differences in emitted volatiles that likely account for the differential predation across treatments. These findings highlight the importance of HIPVs in prey localization by social wasps, hitherto underappreciated potential biocontrol agents and provide evidence for the role that elicitors play in inducing attractive odour blends.
Searching for potential acetylcholinesterase inhibitors: a combined approach of multi-step similarity search, machine learning and molecular dynamics simulations
Authors: Thai Quynh Mai , Pham Minh Quan , Tran Phuong-Thao , Nguyen Trung Hai , Ngo Son Tung
Published: October 2024

Targeting acetylcholinesterase is one of the most important strategies for developing therapeutics against Alzheimer’s disease. In this work, we have employed a new approach that combines machine learning models, a multi-step similarity search of the PubChem library and molecular dynamics simulations to investigate potential inhibitors for acetylcholinesterase. Our search strategy has been shown to significantly enrich the set of compounds with strong predicted binding affinity to acetylcholinesterase. Both machine learning prediction and binding free energy calculation, based on linear interaction energy, suggest that the compound CID54414454 would bind strongly to acetylcholinesterase and hence is a promising inhibitor.