bluuebunny/crossref_metadata_2025 huggingface dataset:
MiR-4284 inhibits sensitivity to paclitaxel in human ovarian carcinoma SKOV3ip1 and HeyA8 cells by targeting DMC1
Authors: Sun Dongyan , Shang Di , Miao Pan , Jiang Zhihe , Chen Yanling , Gao Jian
Published: August 2022

An increasing number of studies have confirmed that microRNAs (miRNAs) are involved in various biological processes, including tumor growth and drug resistance. MiR-4284 has been proved to be abnormally regulated in several cancers, but the function of miR-4284 in ovarian carcinoma (OC) is unclear. Paclitaxel resistance is a key obstacle in OC treatment. Here, the role of miR-4284 in cell sensitivity to paclitaxel in OC was investigated. Two OC cell lines (SKOV3ip1 and HeyA8) were utilized for the establishment of paclitaxel-resistant cell lines. Reverse transcription-quantitative PCR (RT-qPCR) was applied to analyze the levels of miR-4284 and potential mRNAs in OC cell lines. Western blotting was performed to evaluate the levels of DNA meiotic recombinase 1 (DMC1) protein and cell cycle-associated proteins. Identification of the relationship between miR-4284 and DMC1 was achieved by luciferase reporter assay. CCK-8 and flow cytometry assays were utilized for evaluating the impact of miR-4284 on the malignant characteristics of paclitaxel-resistant OC cells. MiR-4284 was upregulated in paclitaxel-resistant OC cell lines and correlated with an adverse prognosis in OC patients. Depletion of miR-4284 suppressed cell proliferation and cell cycle progression of paclitaxel-resistant OC. MiR-4284 targeted DMC1 which was downregulated in paclitaxel-resistant cells and reversed the inhibitory influence of miR-4284 silencing on the malignant characters of paclitaxel-resistant OC cells. MiR-4284 targets DMC1 to suppress sensitivity to paclitaxel in human OC cells.
Salvage chemotherapy in patients with nonsmall cell lung cancer after prior immunotherapy: a retrospective, real-life experience study
Authors: Diker Omer , Olgun Polat
Published: August 2022

Patients with advanced nonsmall cell lung cancer (NSCLC) who progress with immune checkpoint inhibitors (ICIs), salvage chemotherapy remains the only viable option for tumors that do not harbor genomic alterations. Data on the efficacy of salvage chemotherapy after immunotherapy (SCAI) are scarce. Our main objective in the current study was to evaluate the efficacy of SCAI. All consecutive patients who were diagnosed as having metastatic NSCLC and received at least one dose of ICIs were retrospectively reviewed. We computed progression-free survival (PFS), overall survival (OS) and objective response rate (ORR) with SCAI. We also analyzed associations between survival and various clinicopathologic factors. We identified 35 patients with advanced NSCLC who received at least one dose of SCAI. The median age was 66 years. Most of patients were male (n = 26, 74.3%) and former or current smokers (n = 33, 94.3%). The majority of the patients were Eastern Cooperative Oncology Group Performance Status (ECOG PS) 2 (n = 22; 62.9%), and there were no patients with driver mutations. SCAI was administered as second-line therapy in 21 (60.0%) patients and third-line in 14 (40.0%) patients. The ORR to SCAI was 20.0% with median PFS and OS were 2.43 (95% CI, 1.69–3.16) months and 4.40 (95% CI, 2.17–6.62) months, respectively. In multivariate analysis, ECOG PS 2 was confirmed as being independently associated with inferior OS. We demonstrated that patients with NSCLC who progressed to ICIs had limited clinical benefit with salvage chemotherapy, particularly for patients who were ECOG PS 2.
Successful treatment with lenvatinib in a patient with thymic carcinoma presenting with cardiac tamponade: a case report and review of literature
Authors: Nakashima Koki , Azuma Takayuki , Ohta Rina , Fujii Yuya , Sato Masayuki , Igarashi Kazunari , Kadowaki Maiko , Umeda Yukihiro , Waseda Yuko , Anzai Masaki , Kobayashi Motohiro , Ishizuka Tamotsu
Published: August 2022

Thymic carcinoma (TC) presenting with cardiac tamponade has a poor prognosis because of the difficulty in controlling malignant pericardial effusion using conventional chemotherapy. Lenvatinib, a multitargeted kinase inhibitor of vascular endothelial growth factor receptor and other kinases, has recently been proven effective against TC. As the inhibition of vascular endothelial growth factor signaling is effective in malignant pericardial effusion, lenvatinib may also be effective in TC presenting with cardiac tamponade. However, no reports have shown that lenvatinib is effective in such cases. Herein, we present a case of successful treatment with lenvatinib in a patient with TC presenting with cardiac tamponade. The present case suggests that lenvatinib should be considered an effective treatment option for such cases.
Leukocytoclastic vasculitis presenting clinically as bullous pyoderma gangrenosum following leucovorin, fluorouracil and oxaliplatin chemotherapy: a rare case report and literature review
Authors: Diab Reem , Rakhshan Azadeh , Kaddah Ali , Abdollahimajd Fahimeh , Mirzaei Hamid Reza
Published: August 2022

There are no published cases about bullous pyoderma gangrenosum induced by leucovorin, fluorouracil and oxaliplatin (FOLFOX) chemotherapy. With the increasing incidence of gastric and colorectal cancers and the increased usage of targeted therapies, some cutaneous adverse effects may become common. An 84-year-old male presented to our clinic with multiple ulcerative plaques covered with hemorrhagic crusts on both extremities after several FOLFOX chemotherapy sessions for gastric cancer and liver metastasis. Two weeks later, multiple bullae also appeared, especially on the acral areas. The histopathology examination was compatible with acute leukocytoclastic vasculitis. The FOLFOX chemotherapy regimen is increasingly administered considering the rising incidence of gastrointestinal cancers. Hence, our understanding of its possible side effects and complications must be heightened.
Response to trametinib in a nonsmall cell lung cancer patient with osimertinib resistance harboring GNAS R201C and R201H mutations: a case report
Authors: Lv You , Zhou Chao , Chen Zhonghai , Zhao Xiaokai , Sun Yonghua , Li Jieyi , Gong Ziying , Zhang Daoyuan , Huang Hai
Published: August 2022

Osimertinib, an orally administered third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, is widely approved for the first-line and second-line treatment of advanced non-small-cell lung cancer (NSCLC) with EGFR mutations. However, the rapid development of osimertinib resistance renders the unsustainable treatment benefit. Patients with EGFR-mutated NSCLC who develop osimertinib resistance, especially those acquiring relatively rare and ‘off-target’ resistance mutations, still lack effective therapeutic options for postosimertinib therapy. Herein, we reported a 73-year-old woman diagnosed with T1N3M1 lung adenocarcinoma harboring EGFR L858R mutation, who acquired two GNAS mutations (R201C and R201H) and lost the EGFR L858R mutation after progression on icotinib and osimertinib. The patient was subsequently treated with trametinib and there was no obvious tumor increase. Our study revealed that GNAS R201 can confer the osimertinib resistance in EGFR-positive NSCLC, and present the first report of the prevalence of GNAS R201C and R201H mutants in NSCLC which response to trametinib treatment. Our case suggests that trametinib could be a treatment option in NSCLC patients harboring GNAS-activating mutations.
Association of genetic polymorphisms of CYP3A4 and CYP2D6 with gefitinib-induced toxicities
Authors: Kwok Wang Chun , Lam David Chi Leung , Ip Mary Sau Man , Tam Terence Chi Chun , Ho James Chung Man
Published: August 2022

Dermatological, gastrointestinal and hepatic toxicities are the most common adverse events associated with gefitinib use. Gefitinib is metabolized by cytochrome P450. Inconsistent associations of single nucleotide genetic polymorphisms of CYP450 and gefitinib-induced adverse effects were reported. We aim to investigate the association between CYP450 genetic polymorphism and the development of gefitinib-associated adverse events. A retrospective cohort study of Chinese patients with metastatic nonsmall cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations who received first-line gefitinib treatment was conducted. Single nucleotide polymorphisms (SNPs) of CYP2D6, CYP3A4 and CYP3A5 were assayed using a multiplex SNP microarray. Risks of development of gefitinib-induced toxicities associated with different SNPs were determined. Among the 152 patients treated with gefitinib, 52 (34.2%) had gefitinib-induced hepatotoxicity, 113 (74.3%) had cutaneous reactions and 53 (34.9%) had gastrointestinal adverse effects. CYP2D6*41 CT, CYP2D6*10 AA and CYP3A4*1/*1G TT genotypes were significantly associated with hepatic, cutaneous and gastrointestinal adverse effects [odds ratio (OR) 3.773; (95% confidence interval {CI},1.046–13.610; P = 0.043), 3.368 (95% CI, 1.000–11.345; P = 0.050) and 20.000 (95% CI, 2.381–167.965; P = 0.006), respectively]. CYP2D6*41 CT, CYP2D6*10 AA and CYP3A4*1/*1G TT genotypes may be associated with increased risks of gefitinib-induced toxicities in the liver, skin and gastrointestinal tract.
Brief Communication on the Impact of β-blockers on Outcomes in Patients Receiving Cancer Immunotherapy
Authors: Kennedy Oliver John , Neary Marianne Therese
Published: August 2022

Preclinical studies show that β-adrenergic activation suppresses the immune system and reduces the effectiveness of cancer immunotherapy. As a result, there is considerable interest in using β-blockers (BBs), a cheap and safe class of medication, in combination with immunotherapy to improve outcomes in cancer. This study is a systematic review and meta-analysis of clinical studies. A comprehensive literature search was performed up to May 2022. Studies were included if they reported hazard ratios (HRs) of overall survival (OS), all-cause mortality or progression-free survival (PFS) associated with BBs in patients with solid organ cancer treated with immunotherapy. Study-specific HRs and 95% confidence intervals were pooled in random effects meta-analyses. Nine studies involving over 6350 patients with melanoma, lung, renal, urothelial, or other solid cancers treated with a range of immunotherapies met the inclusion criteria. Across all studies combined, there was no association between concomitant BB use and OS (HR 0.99, 0.83–1.18) or PFS (HR 0.97, 0.89–1.05). In subgroup analyses, BB use made no difference to OS or PFS in melanoma (OS HR 0.66, 0.33–1.34; PFS HR 0.81, 0.62–1.05) or to OS in lung cancer (OS HR 1.00, 0.49–2.07). In summary, this study found no evidence that BBs enhance immunotherapy effectiveness.
Preweaning environmental enrichment alters neonatal ultrasonic vocalisations in a rat model for prenatal infections
Authors: Wilkin-Krug Linda C. M. , Macaskill Anne C. , Ellenbroek Bart A.
Published: August 2022

Objective

Maternal infections are a well-known risk factor for neurodevelopmental defects. Such defects are associated with a range of symptoms, and environmental enrichment (EE) could be a promising approach to rehabilitate these. We used the well-established prenatal poly I:C (polyinosinic-polycytidylic acid) model in rats to examine the effects of preweaning EE on rat pups’ ultrasonic vocalisations (USVs) when separated from their mothers. USVs are one of the earliest indicators of a pup’s functional level and, thus, well-suited as a marker of neurodevelopmental abnormalities.

Methods

We used a two-by-two factorial design in which pregnant Sprague–Dawley rats received either saline or the viral mimic poly I:C, and one group of pups was exposed to preweaning enrichment. We measured maternal separation-induced USVs both before postnatal day (PND) 7 and after preweaning enrichment on PND 14.

Results

Poly I:C significantly reduced the number of USVs on PND 7. EE interacted with the poly I:C treatment in that poly I:C pups in the enrichment group called more, whereas saline pups in the enriched environment called less on PND 14 than the respective controls.

Conclusion

We showed that the effects of maternal poly I:C on the offspring’s USVs could be reduced by early EE. If replicated, it could open novel and safe avenues for treating children of mothers who were exposed to infections during pregnancy.
Developing a Spiritual Care Model for Clinical Nurses
Authors: Ghorbani Mojtaba , Mohammadi Eesa , Ramezani Monir
Published: August 2022

This study was carried out to develop a spiritual care model for clinical nurses. This study has used a 3-step strategy proposed by L. O. Walker and K. C. Avant (2019) for theory synthesis. In the second phase of this study, an integrative review was conducted to retrieve and select relevant articles. A total of 227 documents were included for theory construction. After identifying and defining the basic assumptions of the model, the concept of spiritual care was defined as a paradigmatic concept with a holistic approach. Then the metaparadigmatic concepts (ie, human being, environment, nursing, and health) were defined according to the holistic approach. After defining the model care goals, clinical strategies and interventions were defined according to the goals and the concept of health as an outcome of spiritual care. Nurses’ clinical roles were conceptualized within the conceptual framework that includes 3 main steps of nursing process: (1) assessment and identification of the client to explore the spiritual perspective; (2) planning and implementing spiritual care; (3) documenting and evaluating spiritual care. This model can tell clinicians what to do in caring for patients, especially chronic and end-stage patients. Therefore, this model could help provide better care for all clients.
Changes in intraocular pressure after pharmacological pupil dilatation in an elderly Chinese population in Taiwan: The Shipai eye study
Authors: Kuang Tung-Mei , Tsai Su-Ying , Liu Catherine Jiu-Ling , Lee Shui-Mei , Chou Pesus
Published: August 2022

Background:

Mydriatic drugs are often used in ophthalmic clinics for pupil dilatation to assess the optic nerve and retina. Clinical studies have indicated that an increase in intraocular pressure (IOP) after pupil dilation is noted in open-angle glaucoma patients, those with narrow angles and in normal subjects. Asians are more likely to have narrow angles. Moreover, age-related cataract may increase the crowdedness of the angle. This study aimed to assess the effects of mydriatic pupil dilatation on IOP in an elderly Chinese population.

Methods:

The Shihpai Eye Study was a community-based, cross-sectional survey of vision and eye diseases among noninstitutionalized subjects aged 65 years and older in Shihpai, Taipei, Taiwan. IOP was taken using noncontact tonometry. The pupil was dilated with 1% tropicamide. IOP was measured again after maximal pupil dilatation 1 hour after mydriasis.

Results:

Of the 2045 participants, 1361 (66.6%) participated in both the questionnaire and eye examinations. The mean IOP before pupil dilatation was 12.9 ± 3.1 mmHg. and was 12.8 ± 3.4mmHg (range: 5- 36 mmHg) after pupil dilatation. IOP higher than 21 mmHg after pupil dilation was noted in 17 (1.34%) participants, of whom IOP exceeded 30 mmHg in two (0.16%). Overall, the changes in IOP before and after pupil dilatation were insignificant (p=0.04). In the final regression analyses, refractive status towards hyperopia (p<0.01) was the only significant factor associated with an increase in IOP of at least 4 mmHg after pupil dilatation.

Conclusion:

Our results revealed that the increase in IOP after pharmacological pupil dilatation was minimal, and the incidence of acute angle-closure attack was insignificant. Hyperopic status was the only factor related to an increase in intraocular pressure of > 4 mmHg. Caution should be exercised if one is hyperopic or having a history of glaucoma and rechecking IOP in these subjects is suggested after pharmacological mydriasis.
CREST: clinical bleeding and risk evaluation in hematology–oncology patients: a systematic review and meta-analysis of thromboelastography's role
Authors: Khoo Charis E.H. , Long Melody H. , Shi Luming , Guo Liang , Hee Hwan Ing
Published: August 2022

Thrombocytopenia and bleeding are common complications of hematologic malignancies. Often, prophylactic platelets are administered to minimize bleeding risk, based on total platelet count (TPC). However, TPC is a poor predictor, and does not provide rapid information. This review presents a novel prospective in the use of point-of-care viscoelastic studies to assess bleeding risk and guide transfusion therapy in a haematological oncological population, where its use can be extended to a ward level as a bedside test. Monitoring TEG maximum amplitude trends may be useful to guide transfusion protocols, especially for patients with total platelet counts ranging 30–100 × 109/l. Fibrinogen assessment in this group of patients may identify other blood components that require replacing to reduce bleeding risk. Normal maximum amplitude parameters for patients with low platelet counts can be a reassuring sign. This meta-analysis serves to remind the reader that absolute platelet quantity does not equate to the quality of clot formation.
Compliance with the clinical laboratory quality protocol in public primary healthcare centres
Authors: Romero-Arana Adolfo , Gómez-Salgado Juan , Fagundo-Rivera Javier , Cruz-Salgado Óscar , Ortega-Moreno Mónica , Romero-Martín Macarena , Romero Adolfo
Published: August 2022

The clinical and economic relevance of the clinical laboratories procedures in Andalusia (Spain) have led the Regional Department of Health to focus attention on their improvement. A unified laboratory protocol was implemented that consisted of the unification of criteria in the handling and processing of samples, and report of results.

The objective of this study is to describe the degree of compliance with the clinical laboratory protocol in the preanalytical phase, which includes the analytical request and up to the delivery in the laboratory, as well as the influencing factors.

Cross-sectional descriptive study with a sample of 214 healthcare professionals involved in the preanalytical phase of laboratory procedures in primary care. A self-reported questionnaire with 11 items was used for data collection. Each item was assessed separately with a scale from 0 to 10. A 5 points score was considered as the cutoff point. Descriptive analysis was conducted and Mann–Whitney U test was used to determine differences between subgroups. Internal consistency of the questionnaire was considered.

The best rated item was verifying the correspondence between the request form and identity of the patient. Each item scored from 3 to 10, and the mean for each item ranged from 6.40 (standard deviation = 3.06) to 8.57 (standard deviation = 2.00). Values above or equal to 8 were obtained, for 63.6% of them. Statistically significant differences between accredited and nonaccredited centres were found. Differences were not noteworthy regarding centres with a teaching activity or those without it. All the items were measured separately. The compliance with the protocol was adequate among primary healthcare professionals, who have a strategic position in the sample collection and its transport during the preanalytical phase. Being so, standardisation should be a priority to reduce errors and improve clinical safety and results.
Meta of classical chemotherapy compared with high-dose chemotherapy and autologous stem cell rescue in newly diagnosed medulloblastoma after radiotherapy
Authors: Zhang Mengting , Liu Chunmei , Zhou Huandi , Wang Wenyan , Wang Lixin , Shi Baojun , Xue Xiaoying
Published: August 2022

Background:

High-dose chemotherapy combined with autologous stem cell rescue (HDCT + ASCR) has been used to treat newly diagnosed medulloblastoma, but there was no high-level evidence to support its efficacy.

Methods:

Databases were retrieved, and patients were divided into 2 groups: group A was radiotherapy combined with HCDT + ASCR, and group B was classical radiotherapy and chemotherapy. The clinical benefit rate, progression-free survival (PFS), overall survival (OS) and toxicities data were extracted.

Results:

22 clinical trials met the inclusion criteria, 416 in group A and 2331 in group B. There was no difference in CBR between 2 groups (80.0% vs 71.5%, P.262). The 3-year PFS (3-y PFS) of group A was significantly better than group B (79.0% vs 69.5%, P = .004). The analysis found that there was no difference between the 2 groups of the standard risk group or the high-risk group. In the standard risk group, the 5-y PFS of group A was significantly better than group B (83.6% vs75.6%, P = .004). Comparison of 3-y OS and 5-y OS between 2 groups of all MB patients showed no difference (P = .086; P = .507), stratified analysis was the same result. The gastrointestinal toxicity in group A was significantly higher than that in group B (P = .016), and the level 3/4 ototoxicity in high-risk group A was higher than that in group B (P = .001).

Conclusions:

HDCT + ASCR can prolong 3-year PFS significantly, and prolong 5-y PFS significantly in the standard risk group, but increase gastrointestinal toxicity significantly for newly diagnosed medulloblastoma.
Predicting article citations using data from 100 top-cited publications in the field of Psoriasis Vulgaris and biological agents (PVBA) since 1991: A bibliometric analysis
Authors: Chen Chieh-Hsun , Chien Tsair-Wei , Yu-Chieh Ho Sam , Lai Feng-Jie
Published: August 2022

Background:

Psoriasis Vulgaris is a chronic inflammatory disease characterized by keratinocyte hyperproliferation. Bibliometric analysis helps determine the most influential article on the topic of “Psoriasis Vulgaris and biological agents (PVBAs)”, and what factors affect article citation remain unclear. This study aims (1) to identify the top 100 most cited articles in PVBA (PVBA100 for short) from 1991 to 2020, (2) to visualize dominant entities on one diagram using data in PVBA100, and (3) to investigate whether medical subject headings (MeSH terms) can be used to predict article citations.

Methods:

The top 100 most cited articles relevant to PVBA (1991–2020) were downloaded by searching the PubMed database. Citation analysis was applied to compare the dominant roles in article types and topic categories using pyramid plots. Social network analysis (SNA) and Sankey diagrams were applied to highlight prominent entities. We examined the MeSH prediction effect on article citations using its correlation coefficients.

Results:

The most frequent article types and topic categories were research support by institutes (46%) and drug therapy (88%), respectively. The most productive countries were the United States (38%), followed by Germany (13%) and Japan (12%). Most articles were published in Br J Dermatol (13%) and J Invest Dermatol (11%). MeSH terms were evident in the prediction power of the number of article citations (correlation coefficient=0.45, t=4.99).

Conclusions:

The breakthrough was made by developing one dashboard to display PVBA100. MeSH terms can be used for predicting article citations in PVBA100. These visualizations of PVBA100 could be applied to future academic pursuits and applications in other academic disciplines.
Can the patient pinpoint where the ingested fish bone is impacted?: A single-center, retrospective study
Authors: Oh Gyu Man , Jung Kyoungwon , Kim Jae Hyun , Kim Sung Eun , Moon Won , Park Moo In , Park Seun Ja
Published: August 2022

Among the plethora of foreign body impactions, fish bones are common examples that patients may struggle to properly disclose in clinical situations. This study investigated whether patients could pinpoint where the ingested fish bone was lodged. In addition, we investigated the differences between fish bone and other foreign bodies, the usefulness of computed tomography (CT), and the related risk factors for hospitalization. The cases of patients who underwent an endoscopic removal of fish bone between April 2008 and April 2020 were retrospectively reviewed. The clinical outcomes, X-ray scan, CT, and complications of each patient were investigated. A total of 96 patients were included in this study. The mean size of the impacted fish bone was 23.78 mm, and most were found in the upper esophagus (n = 38). There was a weak correlation between pain location and the actual lesion location (r = 0.419, P < .001). Compared to those of other foreign bodies, the location of impacted fish bones was different (P < .001), the X-ray detection rate of fish bones was lower (P < .001), and the complication incidence was higher (P = .030). CT (95.89%) showed higher sensitivity than X-ray scanning (11.24%) (P < .001). Foreign body size (P = .004) and door-to-endoscopy time (P = .029) were related to admission. Patients only managed to point out the approximate location of the ingested fish bone. CT detected fish bones well, but scans should include at least the entire esophagus instead of solely the area where pain is felt. Fish bone impaction has different clinical characteristics from other foreign bodies. Endoscopic removal without delay can reduce the admission rates.
Incidence of acute kidney injury during pregnancy and its prognostic value for adverse clinical outcomes: A systematic review and meta-analysis
Authors: Trakarnvanich Thananda , Ngamvichchukorn Tanun , Susantitaphong Paweena
Published: August 2022

Background:

Acute kidney injury (AKI) that develops during pregnancy results from pregnancy-induced hypertension, hemorrhage, and sepsis, associated with morbidity and mortality in the fetus and mother. This meta-analysis was conducted to evaluate the incidence of pregnancy-related AKI (PR-AKI) and adverse clinical outcomes.

Methods:

PubMed and Scopus were systematically searched for studies published between 1980 and 2021. We included cross-sectional, retrospective, and prospective cohort studies that reported the incidence of PR-AKI as well as adverse fetal and maternal clinical outcomes. A random-effects model meta-analysis was performed to generate summary estimates.

Results:

The meta-analysis included 31 studies (57,529,841 participants). The pooled incidence of PR-AKI was 2.0% (95% confidence interval [CI] 1.0–3.7). Only 49.3% of patients received antenatal care. The most common cause of PR-AKI was preeclampsia (36.6%, 95% CI 29.1–44.7). The proportion of patients requiring hemodialysis was 37.2% (95% CI 26.0–49.9). More than 70% of patients had complete recovery of renal function, while 8.5% (95% CI 4.7–14.8) remained dependent on dialysis. The pooled mortality rate of PR-AKI was 12.7% (95% CI 9.0–17.7). In addition, fetal outcomes were favorable, with an alive birth rate of 70.0% (95% CI 61.2–77.4). However, the rate of abortion and/or stillbirth was approximately 25.4% (95% CI 18.1–34.4), and the rate of intrauterine death was 18.6% (95% CI 12.8–26.2).

Conclusions:

Although the incidence of PR-AKI is not high, this condition has a high impact on morbidity and mortality in both fetal and maternal outcomes. Early prevention and treatment from health care professionals are needed in PR-AKI, especially in the form of antenatal care and preeclampsia medication.
Incidence of immediate allergic reactions to mRNA COVID-19 vaccines in adults with drug allergies and other allergic disorders
Authors: Marković Ivan , Božan Marina , Perković Tomislav , Paušek Katarina , Nedeljković Vanja , Perković Marina , Kelava Tomislav , Artuković Marinko , Stipić Marković Asja
Published: August 2022

Concerns have been raised about allergic reactions to messenger ribonucleic acid (mRNA) coronavirus disease 2019 (COVID-19) vaccines. A history of allergic reactions, including anaphylaxis to drugs, has been frequently reported in individuals with anaphylaxis to mRNA vaccines.

To estimate the rate of immediate allergic reactions in patients with a history of drug allergy or other allergic disorders.

We included adult patients who had received at least 1 dose of an mRNA COVID-19 vaccine at the Special Hospital for Pulmonary Diseases between March 1, 2021, and October 1, 2021, and who reported a history of drug allergy or other allergic diseases (asthma, allergic rhinitis, atopic dermatitis, food or insect venom allergy, mastocytosis, idiopathic anaphylaxis, acute or chronic urticaria, and/or angioedema). Immediate allergic reactions, including anaphylaxis, occurring within 4 hours of vaccination were recorded.

Six immediate allergic reactions were noted in the cohort of 1679 patients (0.36%). One patient experienced anaphylaxis (0.06%), which resolved after epinephrine administration, and the other reactions were mild and easily treatable.

Most patients with a history of allergies can safely receive an mRNA COVID-19 vaccine, providing adequate observation periods and preparedness to recognize and treat anaphylaxis.
The effectiveness of ARISCAT Risk Index, other scoring systems, and parameters in predicting pulmonary complications after thoracic surgery
Authors: Ülger Gülay , Sazak Hilal , Baldemir Ramazan , Zengin Musa , Kaybal Oya , İncekara Funda , Alagöz Ali
Published: August 2022

The Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) risk index, which is frequently used in nonthoracic surgery, may not be sufficient to predict postoperative pulmonary complications (PPCs). We aimed to evaluate the effectiveness of the ARISCAT risk index, ASA, preoperative albumin level, neutrophil/lymphocyte ratio (NLR), and other parameters in predicting PPCs after thoracic surgery.

Patients undergoing elective thoracic surgery with 1-lung ventilation (OLV) were prospectively analyzed. Demographic data, ARISCAT score, ASA, Nutritional Risk Score-2002, NLR, white blood cell counts, albumin, hemoglobin levels, intraoperative complications, postoperative average visual analogue scale (VAS) score for pain at the 24th-hour, the length of stay in the postoperative intensive care unit, chest tube removal time, postoperative complications, and discharge time were recorded. Patients were assessed for morbidity and mortality on the 90th-day.

120 patients’ data were analyzed. PPCs developed in 26 patients. The development of PPCs was statistically significant in patients with high ARISCAT scores (P = .002), high ARISCAT grades (P = .009), and ASA III (P = .002). The albumin level was statistically significantly lower in patients who had mortality within 3 months (P = .007). When scoring systems and laboratory parameters were evaluated together, patients with high ARISCAT grade, Albumin < 35g/L, and ASA III had significantly higher development of PPCs (P = .004).

ARISCAT risk index and ASA were found to be significant in predicting PPCs after thoracic surgery. They were also valuable when evaluated in combination with preoperative albumin levels. Additionally; age, male gender, duration of surgery, and duration of OLV were also found to be associated with PPCs.
Clinical features and management of trophoblastic epithelioid tumors: A systematic review
Authors: Gorun Florin , Tomescu Larisa , Motoc Andrei , Citu Cosmin , Sas Ioan , Serban Denis Mihai , Forga Marius , Citu Ioana Mihaela , Gorun Oana Maria
Published: August 2022

Background:

This study aimed to systematically review the existing literature on epithelioid trophoblastic tumors (ETTs), the rarest type of gestational trophoblastic neoplasia.

Methods:

A systematic review according to PRISMA guidelines was performed, using ScienceDirect, Web of Science, and Scopus databases. The only filter used was the English language. Eligibility/inclusion criteria: retrospective observational studies (case reports, case series) including full case description of epithelioid trophoblastic tumor lesions.

Results:

Seventy studies were assessed for synthesis, including 147 cases. 66.7% of patients with ETT presented with irregular vaginal bleeding. Pretreatment β-hCG levels ranged up to 1000 mIU/mL in 58.5% patients. Of most patients, 42.2% had stage I disease, 10.9% stage II, 25.2% stage III, and 21.8% of patients had stage IV. The most common sites of metastatic disease were the lungs, followed by the liver and brain. After treatment, complete remission was achieved in 75.5% of patients, partial remission in 10.2% of patients, and 14.3% of patients died. On univariate and multivariate analyses, stage IV disease was an independent prognostic factor for overall and disease-free survival.

Conclusions:

Hysterectomy and metastatic lesion resection are essential for controlling ETT. Investigational studies on molecules like EGFR, VEGF, PD-1, CD105, and LPCAT1 are potential therapeutic targets for metastatic ETT.
Analysis of clinical characteristics, pathogen infection, and drug sensitivity of Marine injury patients: A cross-sectional study
Authors: Ge Lei , Gao Yang , Wang Kai , Liu Qiandong , Cui Panpan , Dong Qinglin
Published: August 2022

The infection rate is high in patients injured at sea, and because of the unique distribution of marine microorganisms, the infection is often not easily controlled effectively with the empirical application of antibiotics. This study aims to consider the clinical characteristics and pathogen infection and drug susceptibility of patients injured at sea. From 2019 to 2021, there were 635 patients injured at sea in Rizhao People’s Hospital. We assess the patient’s basic condition, while performing bacterial culture and drug susceptibility testing on wound exudate or pus from infected patients. Among the 635 patients injured at sea, 195 people were infected, and the infection rate was 30.71%. Infected patients are usually older, have longer prehospital visits, and have lower normal levels of red blood cells, hemoglobin, total protein, and albumin. The causes of injury in infected patients were mainly avulsion and puncture injuries, and the types of injuries were mainly bone fracture, vascular injury, and nerve injury. A total of 305 strains of pathogenic bacteria were cultured in 195 patients. Gram-negative bacteria accounted for 77.05% (235 strains), of which Proteus was the most. Gram-positive bacteria accounted for 22.95% (70 strains), of which Staphylococcus aureus was the most. Gram-negative bacilli were sensitive to aminoglycosides, lactam antibiotics, carbapenems antibiotics, sulfonamides, quinolones, fourth-generation cephalosporins, and antibacterial drugs containing enzyme inhibitors, while most of the bacteria were resistant to penicillins, first-generation cephalosporins, and second-generation cephalosporins. Gram-positive bacteria were sensitive to quinuptin/dafoptin, rifampicin, linezolid, gentamicin, tigacycline, and vancomycin but resistant to penicillin antibiotics. Due to the particularity of marine injuries, patients are prone to infection. Pathogen culture and drug sensitivity analysis play an important role in guiding antiinfective treatment for marine injured patients.
Paediatric cannabinoid hyperemesis
Authors: Lonsdale Hannah , Wilsey Michael J.
Published: August 2022

Purpose of review

The prevalence of adolescent cannabinoid hyperemesis syndrome (CHS) continues to grow, as clinicians increasingly recognize the presenting features of cyclical nausea, emesis, abdominal pain and relief of symptoms with hot showers, in the setting of chronic cannabinoid use.

Recent findings

Our understanding of the contributory mechanisms continues to grow, but high-quality evidence of effective treatment in adolescents remains lacking. Current best evidence in the treatment of acute paediatric CHS suggests intravenous rehydration and electrolyte correction, followed by 0.05 mg/kg haloperidol with or without a benzodiazepine. The only long-term treatment remains complete cessation of cannabinoid use.

This article reviews our growing knowledge of adolescent CHS and provides practical guidance for diagnosis, treatment and understanding the underlying mechanisms of the condition.
Pediatric Emergency Medicine Fellowship Program Directors' Viewpoint
Authors: Hsu Deborah C. , Baghdassarian Aline , Caglar Derya , Rose Jerri A. , Herman Bruce E. , Schwartz Alan , Mink Richard , Langhan Melissa L.
Published: August 2022

Objectives

Entrustable Professional Activities (EPAs) are essential tasks physicians perform within their professions. Entrustment levels that pediatric emergency medicine (PEM) fellowship program directors (FPDs) expect graduating fellows to achieve for PEM-specific and common pediatric subspecialty EPAs remain unreported. This study aims to determine minimum entrustment levels FPDs require fellows to achieve to graduate from fellowship and to compare FPD expectations for fellows versus practicing PEM physicians.

Methods

Secondary analysis of PEM-specific data from a national multispecialty cross-sectional survey of pediatric subspecialty FPDs. For 6 PEM-specific and 7 common pediatric subspecialty EPAs, PEM FPDs indicated (1) minimum entrustment levels fellows should achieve by training completion, (2) whether they would allow a fellow to graduate below these minimum levels, and (3) minimum levels for safe and effective practice by PEM physicians. Minimum levels were defined as the level that more than 80% of FPDs would not drop below.

Results

Sixty of 77 PEM FPDs (78%) completed the survey. Most respondents did not require fellows to achieve the highest level (level 5—no supervision) by graduation for any PEM-specific EPAs. The median level FPDs expected for practicing PEM physicians was 5 (trusted to perform without supervision) for EPAs 1 and 4 and level 4 (indirect supervision for complex cases) for the remaining PEM-specific EPAs. Minimum levels expected by FPDs for common subspecialty pediatric EPAs were lower for both groups.

Conclusions

Most PEM FPDs indicated that they would graduate fellows before their achievement of the highest entrustment level for all EPAs. Most also indicated that they do not expect practicing PEM physicians to perform all EPAs without supervision. These findings indicate need for stakeholders to evaluate current structure and outcomes of PEM fellowship programs and for institutions and organizations to ensure adequate support in time and resources for ongoing learning for practicing PEM physicians.
Change in Body Mass Index and Attributable Risk of New-Onset Hypertension Among Obese Living Kidney Donors
Authors: Reed Rhiannon D. , McLeod M. Chandler , MacLennan Paul A. , Kumar Vineeta , Pittman Sydney E. , Maynor Andrew G. , Stanford Luke A. , Baker Gavin A. , Schinstock Carrie A. , Silkensen John R. , Roll Garrett R. , Segev Dorry L. , Orandi Babak J. , Lewis Cora E. , Locke Jayme E.
Published: August 2022

Objective:

To examine whether body mass index (BMI) changes modify the association between kidney donation and incident hypertension.

Background:

Obesity increases hypertension risk in both general and living kidney donor (LKD) populations. Donation-attributable risk in the context of obesity, and whether weight change modifies that risk, is unknown.

Methods:

Nested case-control study among 1558 adult LKDs (1976–2020) with obesity (median follow-up: 3.6 years; interquartile range: 2.0–9.4) and 3783 adults with obesity in the Coronary Artery Risk Development in Young Adults (CARDIA) and Atherosclerosis Risk in Communities (ARIC) studies (9.2 y; interquartile range: 5.3–15.8). Hypertension incidence was compared by donor status using conditional logistic regression, with BMI change investigated for effect modification.

Results:

Overall, LKDs and nondonors had similar hypertension incidence [incidence rate ratio (IRR): 1.16, 95% confidence interval (95% CI): 0.94–1.43, P=0.16], even after adjusting for BMI change (IRR: 1.25, 95% CI: 0.99–1.58, P=0.05). Although LKDs and nondonors who lost >5% BMI had comparable hypertension incidence (IRR: 0.78, 95% CI: 0.46–1.34, P=0.36), there was a significant interaction between donor and >5% BMI gain (multiplicative interaction IRR: 1.62, 95% CI: 1.15–2.29, P=0.006; relative excess risk due to interaction: 0.90, 95% CI: 0.24–1.56, P=0.007), such that LKDs who gained weight had higher hypertension incidence than similar nondonors (IRR: 1.83, 95% CI: 1.32–2.53, P<0.001).

Conclusions:

Overall, LKDs and nondonors with obesity had similar hypertension incidence. Weight stability and loss were associated with similar hypertension incidence by donor status. However, LKDs who gained >5% saw increased hypertension incidence versus similar nondonors, providing support for counseling potential LKDs with obesity on weight management postdonation.
Temporal Slant Recession of the Inferior Rectus Muscle: A Simple Surgical Treatment for Diplopia Caused by Small Vertical Deviations
Authors: Brodsky Michael C.
Published: August 2022

Background:

To evaluate the therapeutic effect of temporal slant recession of the inferior rectus muscle (TSRIRM) for the treatment of small vertical deviations in patients with vertical diplopia, with consideration of the theoretical additive effects of this procedure on ocular torsion and horizontal incomitance.

Methods:

Retrospective review of 11 patients who were treated with TSRIRM. Eight patients with vertical diplopia and small hyperdeviations (up to 6 prism diopters (PDs)) were treated with isolated TSRIRMs. Three patients with vertical diplopia from unilateral superior oblique palsies with large hyperdeviations (>15 PDs) were treated with TSRIRMs in conjunction with contralateral inferior oblique recessions.

Results:

Six of the 8 patients with small vertical deviations had successful vertical realignment with elimination of symptomatic diplopia after an isolated TSRIRM. Two of the eight patients had residual hypertropia with symptomatic diplopia. Three additional patients with unilateral superior oblique palsy had successful vertical realignment with elimination of symptomatic diplopia after ipsilateral inferior oblique recession and contralateral TSRIRM. In total, 9 of 11 patients had successful surgical results after TSRIRM.

Conclusions:

TSRIRM provides an effective and reliable treatment for small angle vertical strabismus. Its ease of surgical access renders it useful for implementation in an outpatient neuro-ophthalmology setting.
Preventing nipple pain/trauma in breastfeeding women: a best practice implementation project at the Marqués de Valdecilla University Hospital (Spain)
Authors: Cornejo-del Río Elsa , Cobo-Sánchez José Luis , Mateo-Sota Sonia , Lasarte-Oria Lorena , Sáez de Adana-Herrero María , Gortázar-Arias Pilar , Gómez-Pérez Tamara , Sainz-Gómez Gema , Lechosa-Muñiz Carolina
Published: August 2022

Objectives:

To assess compliance with recommendations to alleviate nipple pain and/or trauma (NPT) and to reduce the rate of breastfeeding abandonment for this reason.

Introduction:

As a fundamental priority, health programmes encourage mothers to breastfeed exclusively for the first 6 months of the baby's life and to supplement breast milk with other foods up to the age of 2 years. However, the presence of NPT can reduce or prevent compliance with this recommendation.

Methods:

The project was designed and carried out using a framework based on the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI-PACES). Six audit criteria were used in preaudits and postaudits to observe any changes in compliance with the recommendations. Between audits, the Getting Research into Practice (GRiP) tool was used to identify stakeholders, barriers and facilitators of the project.

Results:

Two hundred and sixty-seven breastfeeding women were studied in the baseline phase and 275 during follow-up. Compliance in four criteria improved, and the rates of NPT decreased (pain: from 63.3 to 53.5%; P = 0.02; trauma: from 37.8 to 24.7%; P = 0.01). The proportion of women advised by qualified personnel increased from 63 to 88% whereas those who cited pain as the reason for abandoning exclusive breastfeeding decreased from 1.5 to 1.1%.

Conclusion:

The evidence-based implementation project we describe significantly improved compliance rates in most of the evidence-based criteria considered. In consequence, the prevalence of NPT fell significantly. Nevertheless, there was no significant impact on the proportion of mothers abandoning breastfeeding for this reason.
TRIM family proteins: roles in proteostasis and neurodegenerative diseases
Authors: Zhu Yan , Afolabi Lukman O. , Wan Xiaochun , Shim Joong Sup , Chen Liang
Published: August 2022

Neurodegenerative diseases (NDs) are a diverse group of disorders characterized by the progressive degeneration of the structure and function of the central or peripheral nervous systems. One of the major features of NDs, such as Alzheimer's disease (AD), Parkinson's disease (PD) and Huntington's disease (HD), is the aggregation of specific misfolded proteins, which induces cellular dysfunction, neuronal death, loss of synaptic connections and eventually brain damage. By far, a great amount of evidence has suggested that TRIM family proteins play crucial roles in the turnover of normal regulatory and misfolded proteins. To maintain cellular protein quality control, cells rely on two major classes of proteostasis: molecular chaperones and the degradative systems, the latter includes the ubiquitin-proteasome system (UPS) and autophagy; and their dysfunction has been established to result in various physiological disorders including NDs. Emerging evidence has shown that TRIM proteins are key players in facilitating the clearance of misfolded protein aggregates associated with neurodegenerative disorders. Understanding the different pathways these TRIM proteins employ during episodes of neurodegenerative disorder represents a promising therapeutic target. In this review, we elucidated and summarized the diverse roles with underlying mechanisms of members of the TRIM family proteins in NDs.
Efficacy of attention bias modification via smartphones in a large population sample
Authors: Chelliah Alysha , Robinson Oliver
Published: August 2022

Negative affective biases are a key feature of anxiety and depression that uphold and promote negative mood. Bias modification aims to reduce these biases using computerized training, but shows mixed success and has not been tested at scale. The aim was to determine whether bias modification delivered via smartphones can improve mood in a large sample. In total, 153 385 self-referring participants were randomly assigned to modification or sham bias training on a dot-probe or visual-search task. The primary outcome of interest was balance of mood, assessed on the Positive and Negative Affect Schedule. In total, 22 933 participants who provided at least two mood ratings were included in analyses. There was a large amount of participant attrition. In the remaining smaller sample, results supported the prediction that visual-search modification would result in improved mood (95%CI [0.10, 0.82];
p
= 0.01,
d
= 0.05,
N
= 2588 after two ratings; 95%CI [1.75,6.54];
p
= 0.001,
d
= 0.32,
N
= 118 after six ratings), which was not seen for the sham version (
N
= 4818 after two ratings;
N
= 138 after six ratings). Dot-probe modification was not associated with mood improvements (
p
= 0.52). Visual-search, but not dot-probe, bias modification slightly but significantly improved mood. Although this effect size is very small and subject to large participant drop-off, it might be worth considering an adjunct to current treatments.
Diversity strengthens competing teams
Authors: Rowlett J. , Karlsson C. J. , Nursultanov M.
Published: August 2022

How does the composition of a collection of individuals affect its outcome in competition with other collections of individuals? Assuming that individuals can be different, we develop a model to interpolate between individual-level interactions and collective-level consequences. Rooted in theoretical mathematics, the model is not constrained to any specific context. Potential applications include research, education, sports, politics, ecology, agriculture, algorithms and finance. Our first main contribution is a game theoretic model that interpolates between the internal composition of an ensemble of individuals and the repercussions for the ensemble as a whole in competition with others. The second main contribution is the rigorous identification of all equilibrium points and strategies. These equilibria suggest a mechanistic underpinning for biological and physical systems to tend towards increasing diversity due to the strength it imparts to the system in competition with others.