bluuebunny/crossref_metadata_2025 huggingface dataset:
Transiently increased circulating CD39+FoxP3+ Treg cells predicts the clinical response to methotrexate in early rheumatoid arthritis
Authors: Villalba Alejandro , Nuño Laura , Benito-Miguel Marta , Nieto-Carvalhal Beatriz , Monjo Irene , Novella-Navarro Marta , Peiteado Diana , García-Carazo Sara , Balsa Alejandro , Miranda-Carús María-Eugenia
Published: August 2024

Objectives

A subset of human circulating FoxP3+ regulatory T cells expresses CD39 (cTreg39+) and hydrolyses pro-inflammatory adenine nucleotides released at inflammatory foci, releasing the anti-inflammatory agent adenosine. Methotrexate (MTX), inhibiting 5-aminoimidazole-4-carboxamide ribonucleotide transformylase, enhances the extrusion of adenine nucleotides and may help Treg39+ cells control inflammation. Therefore, we examined the relation of cTreg39+ cells with the effect of MTX in early rheumatoid arthritis (eRA).

Methods

Freshly isolated peripheral blood lymphocytes from 98 untreated eRA patients and 98 healthy controls (HC) were examined by cytometry. Twelve months (12 m) after initiating MTX, 82 patients were clinically re-evaluated and cytometry was repeated in 40 of them. The effect of MTX on Treg cell potency was assessed in Treg/Tresp cocultures.

Results

The baseline (0 m) cTreg39+ cell frequency was elevated in eRA above HC levels. Patients who reached low disease activity at 12 months (12 m-LDA, DAS28-ESR ≤ 3.2, n = 51) had presented with a significantly higher 0 m cTreg39+ frequency vs those who did not (n = 31). The 0 m cTreg39+ cutoff for attaining 12 m-LDA was 42.0% (sensitivity = 90.4%, specificity = 96.8%). At 12 m, the cTreg39+ frequency was no longer elevated but its association with disease activity remained: it was still significantly higher in patients who had reached LDA vs those who had not. In vitro, MTX augmented the Treg39+ cell potency but had no effect on Treg39− cells.

Conclusion

MTX cooperates with Treg39+ cells and the baseline cTreg39+ frequency predicts the response to MTX in eRA. In addition, the transiently elevated baseline cTreg39+ frequency in eRA may provide a slot for prompt MTX initiation.
Cross-sectional expected returns: new Fama–MacBeth regressions in the era of machine learning
Authors: Han Yufeng , He Ai , Rapach David E , Zhou Guofu
Published: August 2024

We extend the Fama–MacBeth regression framework for cross-sectional return prediction to incorporate big data and machine learning. Our extension involves a three-step procedure for generating return forecasts based on Fama–MacBeth regressions with regularization and predictor selection as well as forecast combination and encompassing. As a by-product, it provides estimates of characteristic payoffs. We also develop three performance measures for assessing cross-sectional return forecasts, including a generalization of the popular time-series out-of-sample R2 statistic to the cross section. Applying our extension to over 200 firm characteristics, our cross-sectional return forecasts significantly improve out-of-sample predictive accuracy and provide substantial economic value to investors. Overall, our results suggest that a relatively large number of characteristics matter for determining cross-sectional expected returns. Our new method is straightforward to implement and interpret, and it performs well in our application.
Meta-analysis of Face Perception in Schizophrenia Spectrum Disorders: Evidence for Differential Impairment in Emotion Face Perception
Authors: Mewton Paige , Dawel Amy , Miller Elizabeth J , Shou Yiyun , Christensen Bruce K
Published: August 2024

Background and Hypothesis

Schizophrenia spectrum disorders (SSD) are associated with face perception impairments. It is unclear whether impairments are equal across aspects of face perception or larger—indicating a differential impairment—for perceiving emotions relative to other characteristics (eg, identity, age). While many studies have attempted to compare emotion and non-emotion face perception in SSD, they have varied in design and produced conflicting findings. Additionally, prior meta-analyses on this topic were not designed to disentangle differential emotion impairments from broader impairments in face perception or cognition. We hypothesize that SSD-related impairments are larger for emotion than non-emotion face perception, but study characteristics moderate this differential impairment.

Study Design

We meta-analyzed 313 effect sizes from 104 articles to investigate if SSD-related impairments are significantly greater for emotion than non-emotion face perception. We tested whether key study characteristics moderated these impairments, including SSD severity, sample intelligence matching, task difficulty, and task memory dependency.

Study Results

We found significantly greater impairments for emotion (Cohen’s d = 0.74) than non-emotion face perception (d = 0.55) in SSD relative to control samples, regardless of SSD severity, intelligence matching, or task difficulty. Importantly, this effect was obscured when non-emotion tasks used a memory-dependent design.

Conclusions

This is the first meta-analysis to demonstrate a differential emotion impairment in SSD that cannot be explained by broader impairments in face perception or cognition. The findings also underscore the critical role of task matching in studies of face perception impairments; to prevent confounding influences from memory-dependent task designs.
Interpretation and application of the CISG by the Supreme Court of the Republic of Latvia: an analysis of the judgment in the Boom Conveyor case
Authors: Fillers Aleksandrs , Ratniece Laura
Published: August 2024

The judgment of the Supreme Court of the Republic of Latvia in Boom Conveyor provides an interpretation of Articles 38 and 39 of the United Nations Convention on Contracts for the International Sale of Goods (CISG). As there have not been many cases in Latvia in which the Supreme Court applies the CISG, this judgment offers a rather rare chance to analyse how Latvia’s Supreme Court interprets and applies the Convention. This article provides an analysis of the Court’s judgment and concludes that, unfortunately, the Court misinterpreted the CISG and missed a good chance to establish a sound practice in the interpretation of the CISG in Latvia.
Patients, Peers, and Personal Identity: A Longitudinal Qualitative Study Exploring the Transformative Potential of the Arts and Humanities in Intern Training
Authors: Orr Andrew R. , Hussain Farah , Silver Michelle , Tomescu Oana , Balmer Dorene F.
Published: August 2024

Purpose

Medical education initiatives incorporate arts and humanities (AHs) to foster physician competence and professionalism. However, the full potential of these initiatives is unclear. A recent conceptual framework attempts to clarify this potential but was constructed primarily from undergraduate medical education studies. To explore AH instruction in graduate medical education (GME), the authors asked: What is the potential of a longitudinal curriculum incorporating AHs for the personal and professional development of internal medicine interns throughout the intern year?

Method

From September 2021 to June 2022, 14 internal medicine interns at a large internal medical residency program participated in a longitudinal qualitative study, recording longitudinal audio-diaries (LADs) and participating in semistructured interviews. The LAD response rate was 91%, and the interview completion rate was 96%. The authors identified 3 themes that reflected shared meaning on the transformative potential of AHs: reclaiming personal sense of self, building community, and surfacing empathy. They constructed stories from 2 interns whose trajectories resonated most with AH instruction’s potential for personal and professional development.

Results

Interns valued the abstract over the concrete benefits of AHs. Interns detailed valuable abstract benefits, with reclaiming sense of self, building community, and surfacing empathy apparent across time, pointing to long-term effects of AH interventions. The intern stories revealed a steady appreciation for AHs and difficulty with the practical utility of AHs midyear before a return to recognition of its value by year’s end.

Conclusions

Despite varying AHs experience levels, interns consistently appreciated AH instruction. These findings extend a prior conceptual model to a GME population by highlighting AH instruction’s potential for reclaiming interns’ senses of self, building community, and surfacing empathy. Future curricula can leverage this ability to create meaningful connections with one’s purpose, peers, and patients to maximize the potential of AH instruction for GME learners.
“We Need a Seismic Shift”: Disabled Student Perspectives on Disability Inclusion in U.S. Medical Education
Authors: Jain Neera R. , Stergiopoulos Erene , Addams Amy , Moreland Christopher J. , Meeks Lisa M.
Published: August 2024

Purpose

Students with disabilities have inequitable access to medical education, despite widespread attention to their inclusion. Although systemic barriers and their adverse effects on medical student performance are well documented, few studies include disabled students’ first-person accounts. Existing first-person accounts are limited by their focus predominantly on students who used accommodations. This study bridged these gaps by analyzing a national dataset of medical students with disabilities to understand their perceptions of disability inclusion in U.S. medical education.

Method

The authors analyzed 674 open-text responses by students with disabilities from the 2019 and 2020 Association of American Medical Colleges Year Two Questionnaire responding to the prompt, “Use the space below if you would like to share anything about your experiences regarding disability and medical school.” Following reflexive thematic analysis principles, the authors coded the data using an inductive semantic approach to develop and refine themes. The authors used the political-relational model of disability to interpret themes.

Results

Student responses were wide-ranging in experience. The authors identified key dimensions of the medical education system that influenced student experiences: program structure, processes, people, and culture. These dimensions informed the changes students perceived as possible to support their access to education and whether pursuing such change would be acceptable. In turn, students took action to navigate the system, using administrative, social, and internal mechanisms to manage disability.

Conclusions

Key dimensions of medical school affect student experiences of and interactions with disability inclusion, demonstrating the political-relational production of disability. Findings confirm earlier studies on disability inclusion that suggest systemic change is necessary, while adding depth to understand how and why students do not pursue accommodations. On the basis of student accounts, the authors identify existing resources to help medical schools remedy deficits in their systems to improve their disability inclusion practice.
Effect of Electrode Montage on Frequency Tuning Properties of Air-Conducted Ocular Vestibular-Evoked Myogenic Potential
Authors: Raveendran Rajesh Kumar , Singh Niraj Kumar
Published: August 2024

Objectives:

The use of a 500 Hz tone burst over other frequencies was adopted for the clinical recording of ocular vestibular-evoked myogenic potential (oVEMP) on the basis that this stimulus frequency produces larger response amplitudes (frequency tuning) than the other frequencies. However, the possibility of reflex contamination due to a spatially displaced reference electrode from the muscle of the response origin raises questions about using an infraorbital (IO) montage. Nonetheless, the belly-tendon (BT) montage, which places both the recording electrodes over the inferior oblique muscle, increases the chances of obtaining a response with greater contribution from the inferior oblique muscle. However, whether this response continues to show the frequency tuning to 500 Hz is not known. Therefore, the present study aimed to examine the frequency tuning of oVEMP using various electrode montages.

Design:

Thirty-eight young adults underwent simultaneous oVEMP recording from IO, BT, chin-referenced, and sternum-referenced electrode montages in response to 250, 500, 750, 1000, 1500, 2000, 3000, and 4000 Hz tone bursts.

Results:

The frequency tuning most often coincided with a 750-Hz tone burst irrespective of the montage, with the BT montage exhibiting significantly higher response rates and larger peak to peak amplitudes than other montages (p < 0.008). Further, there was a “substantial” agreement on frequency tuning between BT and IO montages.

Conclusions:

With better response rates and response amplitudes yet similar frequency tuning to the IO montage, the BT montage can be a better option for the clinical recording of oVEMP across frequencies.
Ossification of Posterior Longitudinal Ligament Growth in the C1/2 Segment and its Clinical Significance
Authors: Kim Dongkyu , Jang Hyun Jun , Moon Bong Ju , Kim Kyung Hyun , Park Jeong Yoon , Kuh Sung Uk , Kim Keun Su , Chin Dong Kyu
Published: August 2024

Study Design.

A retrospective analysis at a single institution.

Objective.

This study aimed to determine whether ossification of posterior longitudinal ligament (OPLL) growth in the C1/2 area remains clinically uneventful despite visible radiologic enlargement.

Background.

In cervical decompressive surgery for OPLL, preserving the C2 lamina is preferred for stability, and the larger spinal canal space above C2 tends to mitigate clinical issues caused by OPLL growth. However, the effects of OPLL progression in the C1/2 segment, which often remains untreated, on patients’ clinical outcomes are unclear.

Patients and Methods.

We enrolled 144 patients with cervical OPLL who underwent decompression surgery between January 2011 and December 2018. The patients were categorized based on whether they underwent a C2 sparing procedure or C2 laminectomy. The primary outcome was radiologic progression of OPLL, defined as a 2 mm increase in sagittal thickness or longitudinal elongation, and its correlation with clinical symptoms.

Results.

Of the 144 patients, 35 were in the C2 sparing group, and 109 were in the C2 laminectomy group, with an average follow-up period of 5.2 to 5.6 years. The rate of radiologic progression of OPLL in the C1/2 segment was comparable between the two groups (54.3% vs. 51.4%, P = 0.916). However, diagnosis of C1/2 stenosis at the final follow-up was still lower in the C2 sparing group than in the C2 laminectomy group (2.9% vs. 10.1%, P = 0.294), and there were no new cases of symptoms caused by cord compression in the C1/2 segment in either group.

Conclusion.

OPLL in the C1/2 segment was clinically silent despite radiologic growth. For patients who do not present with significant canal stenosis or cord compression due to OPLL above the C2 upper lamina, C2 lamina-sparing decompressive surgery is preferred.

Level of Evidence.

Level III.
Impact of Tricuspid Regurgitation Severity on Accuracy of Echocardiographic Estimation of Systolic Pulmonary Artery Pressure in Patients With Pulmonary Arterial Hypertension
Authors: Xiao Jiawang , Wang Jianming , Huang Shuai , Geng Jingsong , Meng Lili , Wang Zhongchao , Wang Qiguang
Published: August 2024

Objective:

This study aims to investigate the impact of tricuspid regurgitation (TR) severity on the accuracy of echocardiographic estimation of systolic pulmonary arterial pressure (sPAP) in patients with pulmonary arterial hypertension (PAH).

Methods:

Patients who were diagnosed with PAH and had a right heart catheterization (RHC) and echocardiography examination were selected retrospectively from May 2018 to December 2021. sPAP measured by RHC is used as the gold standard. A difference in sPAP of less than 10 mmHg between echocardiographic estimation by peak TR velocity and RHC measurement was defined as accurate, with a difference ≥10 mmHg considered inaccurate. The factors affecting the accuracy of echocardiographic sPAP estimation were analyzed by univariate and multivariate analysis.

Results:

A total of 138 patients aged (45.57 ± 15.97) years with PAH were enrolled. sPAP measured by echocardiography and RHC were (80.83 ± 23.46) and (81.62 ± 30.05) mmHg, respectively. The values of the 2 methods were highly correlated (r = 0.809, P < 0.01) and Bland-Altman plots showed good consistency. The accuracy rate of sPAP estimation by echocardiography was 42.03% (58/138). In the 57.97% (80/138) of patients where echocardiography was inaccurate, sPAP was overestimated in 28.26% (39/138) and underestimated in 29.71% (41/138). Univariate analysis showed that there was a statistically significant difference between the accurate and inaccurate groups in World Health Organization-Function Class, N-terminal pro-B-type natriuretic peptide, severity of TR, tricuspid annular plane systolic excursion (TAPSE), sPAP-RHC, mean pulmonary artery pressure, pulmonary vascular resistance (P < 0.05). Multivariate logistic regression analyses identified the TR severity (odds ratio = 2.292, 95% confidence interval: 1.126–4.667, P = 0.022) and TAPSE (odds ratio = 0.733, 95% confidence interval: 0.621–0.865, P < 0.001) as independent predictors for the accuracy of echocardiographic sPAP estimation.

Conclusion:

Higher TR severity and lower TAPSE values reduce the accuracy of sPAP estimated by echocardiography. Therefore, TR severity and right heart function should be considered when echocardiography is used to estimate sPAP by the TR velocity.
Insights Into Evaluating the Total Coronary Atherosclerosis Burden
Authors: Liu Jinxing , Lv Naqiang , Gu Yingzhen , Han Xiaorong , Li Yifan , Lin Xuze , Zhang Wei , Dang Aimin
Published: August 2024

The coronary plaque burden represents an essential tool for evaluating coronary blood flow and cardiovascular outcomes. However, the concept of “coronary plaque burden” does not accurately reflect the complex pathological progression of coronary artery disease. In this review, various aspects of the total coronary atherosclerosis burden are present, including its mechanics, geometrical characteristics, plaque morphology, coronary artery calcium deposition, and coronary inflammation, to provide a complete view. Different tools used to evaluate the coronary atherosclerosis burden are also assessed according to the most recent studies. Compelling evidence is provided by our findings to advocate for a comprehensive use of the term “coronary atherosclerosis burden”.
Breast cancer burden among young women from 1990 to 2021: a global, regional, and national perspective
Authors: Tang Zhuojun , Wei Yiying , Liang Yanqing , Zhu Xuexian , Tang Junjie , Sun Yulin , Zhuang Qingyuan
Published: August 2024

Background

Breast cancer, the most prevalent tumor in women globally, significantly impacts young women, compromising their daily lives and overall well-being. Breast cancer represents a significant public health concern due to its extensive physical and psychological consequences.

Material and methods

Data from the Global Burden of Disease (GBD) were used to assess the global, regional, and national burden of breast cancer in young women aged 20–39 from 1990 to 2021. This analysis focused on trends measured by the estimated annual percentage change (EAPC) and explored the socioeconomic impacts via the sociodemographic index (SDI).

Results

During 1990–2021, the incidence and prevalence of breast cancer among young women increased globally, with annual rates of 0.82 and 0.87%, respectively. The mortality rate and disability-adjusted life years (DALYs) also rose annually by −0.12% and −0.05, respectively. A significant burden shift was observed towards regions with lower SDI, with diet high in red meat, alcohol use, and high fasting plasma glucose identified as prominent risk factors, particularly in lower SDI regions.

Conclusion

Our findings underscore breast cancer in young women as an escalating global health challenge, with the burden increasingly shifting towards lower socioeconomic areas. This underscores the necessity for targeted prevention and control strategies for breast cancer, focusing on reducing the identified risk factors and ensuring equitable health resource distribution.
Review and Therapeutic Approach to Malalignment of the Great Toenails: A Common Condition That Is Uncommonly Diagnosed
Authors: Baltz Julia O. , Porter Hannah J. , Richert Bertrand , Jellinek Nathaniel J.
Published: August 2024

BACKGROUND

Malalignment of the great toenails is a common nail disorder that is uncommonly recognized in general practice.

OBJECTIVE

Review available literature on lateral malalignment of the great toenails to increase awareness of this underdiagnosed condition and provide management recommendations.

METHODS

A PubMed search was conducted using the terms “congenital malalignment toenail” and “malalignment great toenail”. All articles were reviewed, and all relevant articles were included in this analysis.

RESULTS

Thirty-four distinct articles encompassing 117 patients with similar clinical findings: lateral deviation of the great toenails with yellow brown dyschromia, thickening, and scalloping.

Limitations

Description of malalignment and terminology can vary, which may have led to exclusion of some relevant articles.

CONCLUSION

Lateral malalignment is a common nail condition that is underappreciated and often misdiagnosed in general dermatologic and medical practice. This review aims to increase awareness to facilitate better care of these patients.
Severe menopausal symptoms linked to cognitive impairment: an exploratory study
Authors: Calle Andrés , Blümel Juan E. , Chedraui Peter , Vallejo María S. , Belardo Alejandra , Dextre Maribel , Elizalde-Cremonte Alejandra , Escalante Carlos , Espinoza María T. , Gómez-Tabares Gustavo , Monterrosa-Castro Álvaro , Ñañez Mónica , Ojeda Eliana , Rey Claudia , Rodríguez Doris , Rodrigues Marcio A. , Salinas Carlos , Tserotas Konstantinos , Aedo Sócrates
Published: August 2024

Objective

To evaluate the association between menopausal symptoms and cognitive decline in postmenopausal women.

Methods

This was a subanalysis of a cross-sectional, observational study conducted among women attending gynecological consultations across nine Latin American countries. The survey involved late postmenopausal women who were asked to complete a general questionnaire and the Menopause Rating Scale (MRS) to assess menopausal symptoms, with the Montreal Cognitive Assessment used to evaluate cognitive function as an outcome. A Montreal Cognitive Assessment score of less than 21 was used to define women with mild cognitive impairment (MCI).

Results

The study included 1,287 postmenopausal women with a mean age of 55.5 years and a mean body mass index of 26.3 kg/m2. On average, participants had 13.8 years of education and 2.3 ± 1.8 children, with 72.8% reporting having a partner. Additionally, 36.7% ever used menopausal hormone therapy. Regarding lifestyle factors, 50.3% engaged in a sedentary lifestyle, whereas 70.5% had never smoked. 15.3% of women had MCI exhibited significantly more intense menopausal symptoms compared with those without MCI (MRS total score 15.24 ± 12.58 vs 10.53 ± 8.84, respectively, P < 0.001). Logistic regression analysis revealed a significant association between severe menopausal symptoms (MRS total score ≥14 points) and MCI (odds ratio [OR], 1.74; 95% CI, 1.25-2.42). Conversely, a lower body mass index (OR, 0.96; 95% CI, 0.95-0.98), sexual activity (OR, 0.70; 95% CI, 0.51-0.96), physical exercise (OR, 0.55; 95% CI, 0.39-0.76), menopausal hormone therapy use (OR, 0.36; 95% CI, 0.24-0.55), and higher educational level (OR, 0.31; 95% CI, 0.21-0.46) were associated with lower odds for MCI.

Conclusion

Severe menopausal symptoms in postmenopausal women were associated with cognitive impairment. This study highlights the intricate interplay between hormonal, lifestyle, and sociodemographic factors and cognitive health.
Clearing the Smoke: The Evidence behind Risk of Electrocautery Smoke and Mitigation Strategies
Authors: Tyle Madison Rose , Olafson Amra , Hiro Matthew E. , Payne Wyatt G.
Published: August 2024

Background:

Electrocautery has been a useful, fundamental instrument utilized for surgical procedures since its implementation in the 1920s. However, concerns exist regarding the health hazards of the by-product smoke associated with the use of electrocautery.

Methods:

A comprehensive review of articles on the composition, mitigation, and effects of smoke was conducted using the PubMed search engine and excluding articles that did not meet the predetermined inclusion criteria. From January 1963 to December 2021, a total of 264 articles resulted, and a total of 69 articles were included in this narrative review.

Results:

Surgical smoke contains volatile organic compounds, polycyclic aromatic compounds, viral particles, and ultrafine particles. There has been some evidence of mutagenicity to bacterial cells during animal in vivo studies, and one human survey study has shown similar mutagenic effects. We also discuss additional hemostatic techniques that can be used, including the use of hemostatic and antithrombolytic agents, epinephrine infiltration, and the use of tourniquet when appropriate.

Conclusions:

Further studies should be conducted regarding human effects, but until the data are available, we recommend precautionary measures and actions to protect operating room staff from cautery smoke exposure.
Ocular Adverse Effects of Over-the-Counter Cosmetics and Personal Care Products Reported to the Food and Drug Administration
Authors: Zhu Aretha , Aftab Owais M. , Mahajan Jasmine , Burkat Cat N.
Published: August 2024

Purpose:

Personal care and cosmetic products can cause periocular and ocular adverse effects (AEs), for example, ocular surface disease, trauma, and hypersensitivity. The publicly available Food and Drug Administration (FDA) Center for Food Safety and Applied Nutrition Adverse Event Reporting System (CAERS) database includes AE reports by consumers, healthcare practitioners, and manufacturers. The purpose of this study was to characterize ophthalmic AE associated with cosmetics and personal care products reported by the FDA CAERS database.

Methods:

AE related to the eye or ocular adnexa from cosmetics submitted by consumers, healthcare practitioners, and manufacturers from January 2004 to June 2022 were identified after filtering using the Medical Dictionary for Regulatory Activities coding system. Demographic information, case outcome, and categories of product and AE were included. Chi-square analysis, with statistical significance at a = 0.05, was performed to ascertain variation in ocular, periocular, and general outcomes by product category.

Results:

Reports of ophthalmic AEs related to cosmetics per year increased from 2006 to 2018, reaching a maximum of 161 reports in 2018, then decreased from 2018 to 2021. In total, 959 and 1382 unique periocular and ocular AEs were reported. There were 1711 total incidences of reported periocular AEs and 2485 ocular AEs. The most reported periocular AEs were inflammation (770/1711) and hypersensitivity (331/1711). The most reported ocular effects were discomfort (946/2485) and inflammation (709/2485). Ocular, periocular, and general outcomes significantly varied by product category.

Conclusions:

Consumers, healthcare practitioners, and manufacturers should be made aware of potential ophthalmic AE and outcomes associated with cosmetics and personal care products.
Standalone interventional glaucoma: evolution from the combination-cataract paradigm
Authors: Micheletti J. Morgan , Brink Matthew , Brubaker Jacob W. , Ristvedt Deborah , Sarkisian Steven R.
Published: August 2024

One of the most impactful recent developments in the glaucoma community has been the concept of interventional glaucoma. In brief, this paradigm shift involves proactive rather than reactive intervention to address glaucoma earlier in the disease process, including in both standalone and combination-cataract settings. By intervening earlier with minimally invasive surgical, laser, or drug-delivery treatments instead of prolonged topical medications, interventional glaucoma aims to take the burden of medication compliance off the patient. It also allows for standalone surgical interventions rather than letting cataract surgery dictate the glaucoma treatment plan. This interventional mindset has been made possible by the increasing diversity and availability of effective minimally invasive treatment options. With these options as a springboard, it is time to reevaluate and advance the traditional glaucoma treatment paradigm.
Select Dietary Components Are Associated With Better Global Cognition in U.S. Adults With HIV: A Pilot Study
Authors: Fazeli Pariya L. , Davey Christine Horvat , Webel Allison R. , Oliveira Vitor , Buford Thomas W. , Vance David E. , Burkholder Greer , Crane Heidi M. , Fleming Julia , Willig Amanda L.
Published: August 2024

People with HIV (PWH) are at an increased risk for cognitive impairment. Lifestyle factors can have protective effects on cognition; little work has examined diet and cognitive function in PWH. In this cross-sectional pilot study, 86 PWH (mean age 56 years) completed diet recalls and a neurocognitive assessment. Correlations were conducted between diet and cognitive function, adjusting for total calories, sex, and education (multiple comparison correction p values are reported). Diet quality of the sample was poor. Greater calories per day (r = 0.28, p =.08) and greater percentage of calories from saturated fatty acids (SFAs; r = 0.26, p = 0.08) were associated with better cognition. Higher intake of SFAs (rs 0.30–0.31, ps = 0.07), amino acids (rs = 0.27, ps = 0.08), and phosphorus (r = 0.29, p = .07) and magnesium (r = 0.25, p = .08) were associated with better cognition. A diet reflecting higher protein and fat relative to carbohydrates was associated with better cognition. Targeting individual nutrients, improving diet quality, and adequate caloric intake may preserve cognition in PWH.
Emotional Loneliness Is Related to Objective Cognitive Function in Older People With HIV in the Washington-Baltimore Area: A Cross-sectional Study
Authors: Yoo-Jeong Moka , Dastgheyb Raha M. , Shorer Eran F. , Demsky Cornelia , Fox Olivia , Inaganti Divya , Kanner Sarah , Neijna Ava G. , Buchholz Alison , Wilson Tracey E. , Rubin Leah H.
Published: August 2024

Loneliness confers a significant risk to numerous health outcomes, including cognitive impairment. This study assessed the relationship between loneliness subtypes (social and emotional) and cognition in older people with HIV (OPWH ≥ 50 years). Forty-two participants (STET = 61.5 years; 48% male; 74% Black) completed the six-item De Jong Gierveld Loneliness Scale and measures assessing objective and subjective cognition and depressive symptoms (Patient Health Questionnaire [PHQ-9]). Loneliness–cognition associations were examined using linear regression. Models were first adjusted for age, sex, race, and education, and then PHQ-9 score. Mean emotional and social loneliness scores were 1.24 (SD = 1.22) and 1.21 (SD = 1.14), respectively. After sociodemographic and PHQ-9 adjustment, emotional, but not social, loneliness was associated with poorer objective cognitive performance on processing speed (Digit Symbol) and executive function (CalCAP™). Findings have potential clinical importance for interventions that target specific loneliness subtypes to optimize cognitive performance in OPWH.
Validation and Refinement of the Self-Regulatory HIV/AIDS Symptom Management Model Among People With HIV in China Using Path Analysis: A Secondary Data Analysis
Authors: Xie Meilian , Wang Aiping , Zhang Zhiyun , Wang Kerong , Yu Yanping
Published: August 2024

This study explored the path affecting the quality of life (QOL) of people with HIV in China and clarified the applicability and interpretability of the Self-Regulatory HIV/AIDS Symptom Management Model. We conducted a cross-sectional survey in nine regions of China and collected information about demographics, symptom experience, social support, perceived symptom manageability, self-efficacy, and QOL. A total of 711 patients participated in this survey. After four rounds of path analysis were conducted, the most fit indices met the standards (χ2/df = 2.633, Root Mean Square Error of Approximation = 0.081, Goodness-of-Fit Index/Adjusted Goodness-of-Fit Index/Comparative Fit Index/Incremental Fit Index/Tucker–Lewis Coefficient > 0.9), and the relationships between variables were statistically significant (p < .05). Among all the pathways, social support had the most significant impact on the QOL, with a total path coefficient of 0.665. Symptom experience, as a negative factor, had a total effect value of −0.361. This study showed how all the factors influencing QOL were interconnected, serving as a crucial theoretical foundation for intervention strategies in future clinical practice.
Advancing Nurse Practitioner proficiency and confidence: An evaluation of postgraduate training in rural and medically underserved communities
Authors: Ketel Christian , McClure Natasha , Elkins Tonya , Kapu April , Jones Pam
Published: August 2024

Background:

Nurse practitioners (NPs) are critical in delivering primary health care, especially in underserved and rural areas. Transitioning from academic training to practical application poses challenges, highlighting the need for structured post-licensure training (PLT).

Purpose:

To address the knowledge gap regarding the impact of PLT programs on the clinical development, confidence, and care delivery of NPs using an innovative evaluative approach.

Methodology:

Using a mixed-methods approach, this study engaged 19 NP fellows in quantitative and qualitative evaluations. Assessments of clinical skills and feedback were collected using the REDCap platform, focusing on mentorship and the practical application of skills.

Results:

Quantitative analysis showed improvements in several domains: patient-centered care (median score increase from 8 to 10, p = .005), knowledge of evidence-based practice (median score from 8 to 9, p = .028), and health systems (median score from 8 to 9, p = .014). Qualitative feedback underscored the benefits of the program's structured support and practical learning experiences while revealing the need for improvements in mentor preparedness.

Conclusions:

The PLT program effectively advanced NP proficiency across various domains, particularly in patient-centered care and evidence-based practice. However, it also highlighted a crucial need for focused mentorship in developing leadership skills. The study's limited scope, dependence on self-reported measures, and specific statistical methods constrain the broader applicability of its findings. Future research should aim to validate these results across diverse settings and explore long-term outcomes.

Implications:

This study provides new perspectives on NP workforce development, emphasizing the importance of structured mentorship and training, especially in medically underserved communities.
Thoracoabdominal Normothermic Regional Perfusion Using Mobile Closed Extracorporeal Circuit in Circulatory Death Determination Heart Donors
Authors: Antonini Marta Velia , Martin-Suàrez Sofia , Botta Luca , Circelli Alessandro , Cordella Erika , Zani Gianluca , Terzitta Marina , Agnoletti Vanni , Pacini Davide
Published: August 2024

Thoracoabdominal normothermic regional perfusion (TA-NRP) is increasingly implemented in donation after circulatory determination of death (DCD). Thoracoabdominal normothermic regional perfusion allows thoracic and abdominal organs to be perfused with warm, oxygenated blood after declaration of death, interrupting ischemia. Evidence is accumulating supporting the use of TA-NRP to improve the outcome of grafts from DCD donors. Thoracoabdominal normothermic regional perfusion may restore and maintain a near-physiological environment during procurement. Moreover, during TA-NRP it is feasible to evaluate the heartin situ. Thoracoabdominal normothermic regional perfusion could be performed through different cannulation techniques, central or peripheral, and, with different extracorporeal circuits. The use of conventional cardiopulmonary bypass and extracorporeal life support (ECLS) devices equipped with open circuits has been described. We report the use of a fully mobile, closed ECLS circuit to implement TA-NRP. The procedure was successfully performed in a peripheral center without a cardiac surgery program through a percutaneous cannulation approach. This strategy resulted in combined heart, liver, and kidney recovery despite a significantly prolonged functional warm ischemia time. The feasibility of TA-NRP using modified but still closed fully mobile ECLS circuits could furtherly support the expansion of DCD programs, increasing the availability of heart for transplantation, and the quality of the grafts, improving recipients’ outcome.
Efficacy of vitamin D supplementation in the treatment of patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials
Authors: Adil Mariam , Saleem Muhammad Meeran , Vijay Sneha , Ehsan Muhammad , Atiq Isha , Anwar Eman , Oduoye Malik Olatunde
Published: August 2024

Context:

COVID-19 has substantial effects on respiratory health and overall well-being. Recent studies suggest vitamin D as a potential treatment, but the results are inconclusive.

Objective:

The authors conducted a systematic review of randomized controlled trials (RCTs) to examine the link between vitamin D and patients with COVID-19.

Data sources:

The authors searched electronic databases PubMed, Cochrane, CINAHL, EMBASE and Google Scholar from their inception till August 2023.

Study selection:

Inclusion criteria used in our systematic review include: (1) patients who tested positive for COVID-19, (2) intervention was vitamin D supplementation, (3) the comparator was either a placebo, standard care of treatment, or, no treatment, (4) at least one of the clinical outcomes of interest were investigated, (5) study design being RCTs.

Data extraction:

Two independent reviewers manually extracted information from selected articles, including study characteristics, patient characteristics, and the primary outcomes: all-cause mortality, ICU and hospital stay length and secondary outcomes: mechanical ventilation, supplemental oxygen, ICU admission, and adverse events. Risk ratios or mean differences and 95% CIs were calculated using a random-effects model.

Data synthesis:

The authors’ analysis included 14 RCTs with 2165 patients. Vitamin D significantly reduced ICU admissions and lowered the need for mechanical ventilation compared to placebo. However, it did not significantly affect hospital stay length, ICU stay length, mechanical ventilation duration, mortality, or the need for supplemental oxygen.

Conclusion:

Vitamin D does not significantly improve certain clinical outcomes, such as hospital and ICU stay length, for patients with COVID-19. However, it still may be significantly beneficial in decreasing the burden on intensive care services.
Pityriasis rubra pilaris with eosinophilia in a young patient: a case report
Authors: Shrestha Amrita , Baral Abal , KC Kusha
Published: August 2024

Introduction and importance:

Pityriasis rubra pilaris is a rare inflammatory papulosquamous disorder which manifests in six clinical subtypes affecting both pediatric and adult populations.

Presentation of case:

A 14-year-old female presented with multiple itchy scaly lesions on her hands and legs which began as vesicles 9 days after birth. Histopathological examination confirmed the diagnosis of pityriasis rubra pilaris. Further investigations revealed significant peripheral and tissue eosinophilia. The patient was treated with oral isotretinoin, which resulted in the resolution of the lesions.

Case discussion:

It is a rare inflammatory papulosquamous disorder characterized by palmoplantar keratoderma and follicular papules coalescing into distinct plaques characterized by a reddish-orange hue and nonadherent flaking scales. The patients with tissue and/or peripheral eosinophilia are usually older at presentation and more likely to have multisite disease. Our patient, in contrast, is a young female which makes this case noteworthy.

Conclusion:

This unusual finding of eosinophilia in a young patient underscores the necessity for further research and evaluation to enhance understanding of the pathophysiology of pityriasis rubra pilaris.
Decompressive craniectomy in trauma: What you need to know
Authors: Solomou Georgios , Sunny Jesvin , Mohan Midhun , Hossain Iftakher , Kolias Angelos G. , Hutchinson Peter J.
Published: August 2024

Decompressive craniectomy (DC) is a surgical procedure in which a large section of the skull is removed, and the underlying dura mater is opened widely. After evacuating a traumatic acute subdural hematoma, a primary DC is typically performed if the brain is bulging or if brain swelling is expected over the next several days. However, a recent randomized trial found similar 12-month outcomes when primary DC was compared with craniotomy for acute subdural hematoma. Secondary removal of the bone flap was performed in 9% of the craniotomy group, but more wound complications occurred in the craniectomy group. Two further multicenter trials found that, whereas early neuroprotective bifrontal DC for mild to moderate intracranial hypertension is not superior to medical management, DC as a last-tier therapy for refractory intracranial hypertension leads to reduced mortality. Patients undergoing secondary last-tier DC are more likely to improve over time than those in the standard medical management group. The overall conclusion from the most up-to-date evidence is that secondary DC has a role in the management of intracranial hypertension following traumatic brain injury but is not a panacea. Therefore, the decision to offer this operation should be made on a case-by-case basis. Following DC, cranioplasty is warranted but not always feasible, especially in low- and middle-income countries. Consequently, a decompressive craniotomy, where the bone flap is allowed to “hinge” or “float,” is sometimes used. Decompressive craniotomy is also an option in a subgroup of traumatic brain injury patients undergoing primary surgical evacuation when the brain is neither bulging nor relaxed. However, a high-quality randomized controlled trial is needed to delineate the specific indications and the type of decompressive craniotomy in appropriate patients.
Does implicit mentalizing involve the representation of others' mental state content? Examining domain-specificity with an adapted Joint Simon task
Authors: Wong Malcolm K. Y. , Bazhydai Marina , Hartley Calum , Wang J. Jessica
Published: August 2024

Implicit mentalizing involves the automatic awareness of others’ perspectives, but its domain-specificity is debated. The Joint Simon task demonstrates implicit mentalizing as a Joint Simon effect (JSE), proposed to stem from spontaneous action co-representation of a social partner's frame of reference in the Joint (but not Individual) task. However, evidence also shows that any sufficiently salient entity (not necessarily social) can induce the JSE. Here, we investigated the content of co-representation through a novel Joint Simon task where participants viewed a set of distinct images assigned to either themselves or their partner. Critically, a surprise image recognition task allowed us to identify partner-driven effects exclusive to the Joint task-sharing condition, versus the Individual condition. We did not observe a significant JSE, preventing us from drawing confident conclusions about the effect's domain-specificity. However, the recognition task results revealed that participants in the Joint task did not recognize their partner's stimuli more accurately than participants in the Individual task. This implies that participants were no more likely to encode content from their partner's perspective during the Joint task. Overall, this study pushes methodological boundaries regarding the elicitation of co-representation in the Joint Simon task and demonstrates the potential utility of a surprise recognition task.
What does lack of language lateralization signify? Evidence of fluctuating asymmetry rather than hemispheric equipoise on non-lateralized tasks
Authors: Bishop Dorothy V. M.
Published: August 2024

In a study of patterns of language laterality in left- and right-handers, Woodhead
et al
. (Woodhead ZVJ, Thompson PA, Karlsson EM, Bishop DVM. 2021
R. Soc. Open Sci
.
8
, 200696. (doi:
10.1098/rsos.200696
)) noted that several tasks showed no bias to the left hemisphere in left-handed individuals. This might appear to suggest that these functions were mediated by the two hemispheres working together equally—what can be termed ‘hemispheric equipoise’. Here, I consider an alternative possibility that individuals show lateral bias on these tasks, but the bias can occur to either the left or right—a form of fluctuating asymmetry. Further analysis of the distributions of data from individuals in Woodhead
et al.
is compared with simulated data. The pattern of results suggests that the impression of hemispheric equipoise may be an artefact of reliance on group data: even though the group mean does not differ from zero, a high proportion of individuals are biased to the left or right.
Interspecific competition models and resource inequality between individuals
Authors: Anazawa Masahiro
Published: August 2024

Most classical discrete-time population models of interspecific competition have emerged as population-level phenomenological models with no evident basis at the individual level. This study shows that the Hassell–Comins model, a widely used discrete-time model of interspecific competition, can be derived in a bottom-up manner from a simple model of random resource competition between individuals of two species as an expression of expected population sizes in the next generation. The random competition leads to inequalities in resource allocation between individuals, which are related to the key parameters of the Hassell–Comins model that determine the density dependence of each species. The relationship between population-level parameters, such as intra- and interspecific competition coefficients, and individual-level parameters is discussed in detail, as is how the derived competition equations depend on the degree of inequality within each species. By considering limits of maximum or minimum resource inequality within each species, the derived model can describe interspecific competition for various combinations of two species exhibiting ideal scramble or ideal contest intraspecific competition.
A belly full of jelly? DNA metabarcoding shows evidence for gelatinous zooplankton predation by several fish species in Greenland waters
Authors: Dischereit Annkathrin , Throm Julia Katharina , Werner Karl Michael , Neuhaus Stefan , Havermans Charlotte
Published: August 2024

The waters of Greenland harbour a high species richness and biomass of gelatinous zooplankton (GZP); however, their role in the diet of the many fish species, including commercially exploited species, has not yet been verified. Traditionally, GZP was considered to be a trophic dead end, i.e. with a limited contribution as prey for higher trophic levels. We applied DNA metabarcoding of two gene fragments (COI, 18S V1–V2) to the stomach contents of seven pelagic and demersal fish species in Greenland waters, to identify their prey composition as well as the occurrence of GZP predation. We detected GZP DNA reads in the stomachs of all investigated fish species, with frequency of occurrences ranging from 12.5% (for
Melanogrammus aeglefinus
) to 50% (for
Argentina silus
). GZP predation had not yet been reported for several of these species. GZP were found to majorly contribute to the diet of
A. silus
and
Anarhichas denticulatus
, particularly, the siphonophore
Nanomia cara
and the scyphozoan
Atolla
were of a high importance as prey, respectively. The use of multiple genetic markers enabled us to detect a total of 59 GZP taxa in the fish stomachs with several GZP species being detected only by one of the markers.