bluuebunny/crossref_metadata_2025 huggingface dataset:
VX-765 ameliorates inflammation and extracellular matrix accumulation by inhibiting the NOX1/ROS/NF-κB pathway in diabetic nephropathy
Authors: Wang Xiaokang , Wu Tiesong , Ma Hongyan , Huang Xiaoling , Huang Kaiyuan , Ye Chunxiao , Zhu Shiping
Published: July 2021

Objective

This study explores the potential role of a highly selective caspase-1 inhibitor, VX-765, on extracellular matrix (ECM) accumulation and inflammation in diabetic nephropathy (DN) and the underlying mechanisms.

Methods

DN rats, induced via high-fat diet/streptozotocin, were used to assess the effects of VX-765. Parallel experiments were carried out on rat mesangial cell line HBZY-1 exposed to high glucose (HG) to reveal the molecular mechanism of VX-765 in preventing DN. Survival analysis, biochemical parameters and renal oxidative stress of rats were observed, and Western blotting and immunofluorescence were evaluated. In vitro, Nicotinamide adenine dinucleotide phosphate (NADPH) oxidases (NOX)1 silencing by RNA interference and quantitative real-time PCR (qPCR) assays were conducted in HBZY-1 cells exposed to HG levels.

Key findings

In vivo, VX-765 significantly reduced the increase in urine albumin excretion and ECM accumulation. The phosphorylation of nuclear factor kappa-B (NF-κB) and the expression of pro-inflammatory cytokines IL-1β, IL-6 and tumor necrosis factor (TNF)-α were significantly down-regulated. Furthermore, the generation of reactive oxygen species (ROS), phosphorylation of NF-κB and the expression of the NOX1 gene or protein were significantly decreased in HBZY-1 with VX-765 (5 μM) treatment in vitro.

Conclusions

Our results demonstrated that VX-765 exerts favourable effects on DN via the simultaneous alleviation of systemic metabolic syndrome and down-regulating the renal NOX1/ROS/NF-κB pathway, suggesting that it has therapeutic potential for DN.
Impact of pre-treatment C-reactive protein level and skeletal muscle mass on outcomes after stereotactic body radiotherapy for T1N0M0 non-small cell lung cancer: a supplementary analysis of the Japan Clinical Oncology Group study JCOG0403
Authors: Matsuo Yukinori , Nagata Yasushi , Wakabayashi Masashi , Ishikura Satoshi , Onishi Hiroshi , Kokubo Masaki , Karasawa Katsuyuki , Shioyama Yoshiyuki , Onimaru Rikiya , Hiraoka Masahiro
Published: July 2021

This study aimed to evaluate the impact of pretreatment C-reactive protein (CRP) and skeletal muscle mass (SMM) on outcomes after stereotactic body radiotherapy (SBRT) for T1N0M0 non-small cell lung cancer (NSCLC) as a supplementary analysis of JCOG0403. Patients were divided into high and low CRP groups with a threshold value of 0.3 mg/dL. The paraspinous musculature area at the level of the 12th thoracic vertebra was measured on simulation computed tomography (CT). When the area was lower than the sex-specific median, the patient was classified into the low SMM group. Toxicities, overall survival (OS) and cumulative incidence of cause-specific death were compared between the groups. Sixty operable and 92 inoperable patients were included. In the operable cohort, OS significantly differed between the CRP groups (log-rank test p = 0.009; 58.8% and 83.6% at three years for high and low CRP, respectively). This difference in OS was mainly attributed to the difference in lung cancer deaths (Gray’s test p = 0.070; 29.4% and 7.1% at three years, respectively). No impact of SMM on OS was observed. The incidence of Grade 3–4 toxicities tended to be higher in the low SMM group (16.7% vs 0%, Fisher’s exact test p = 0.052). In the inoperable cohort, no significant impact on OS was observed for either CRP or SMM. The toxicity incidence was also not different between the CRP and SMM groups. The present study suggests that pretreatment CRP level may provide prognostic information in operable patients receiving SBRT for early-stage NSCLC.
Cold response and tolerance in cereal roots
Authors: Zhou Yaping , Sommer Mauritz Leonard , Hochholdinger Frank
Published: July 2021

Cold stress adversely affects plant growth and is a limiting factor in crop productivity. Temperature volatility as a consequence of climate change will increase the effects of cold stress on crop cultivation. Low temperatures frequently occur early after planting in temperate climates, and severely affect root development in cereals. In this review, we address the question of how cereal root systems respond to cold at different scales. First, we summarize the morphological, physiological, and cellular responses of cereal roots to cold stress and how these processes are regulated by phytohormones. Subsequently, we highlight current understanding of the genetic and molecular analyses of cold tolerance with emphasis on the role of cold-responsive genes in improving cold tolerance in cereal roots. Finally, we discuss the role of beneficial microorganisms and mineral nutrients in ameliorating the effects of cold stress in cereal roots. A comprehensive knowledge of the molecular mechanisms underlying cold tolerance will ensure yield stability by enabling the generation of cold-tolerant crop genotypes.
Unveiling the atomic hydrogen–halo mass relation via spectral stacking
Authors: Chauhan Garima , Lagos Claudia del P , Stevens Adam R H , Bravo Matías , Rhee Jonghwan , Power Chris , Obreschkow Danail , Meyer Martin
Published: July 2021

Measuring the H i–halo mass scaling relation (HIHM) is fundamental to understanding the role of H i in galaxy formation and its connection to structure formation. While direct measurements of the H i mass in haloes are possible using H i-spectral stacking, the reported shape of the relation depends on the techniques used to measure it (e.g. monotonically increasing with mass versus flat, mass-independent). Using a simulated H i and optical survey produced with the shark semi-analytic galaxy formation model, we investigate how well different observational techniques can recover the intrinsic, theoretically predicted, HIHM relation. We run a galaxy group finder and mimic the H i stacking procedure adopted by different surveys and find we can reproduce their observationally derived HIHM relation. However, none of the adopted techniques recover the underlying HIHM relation predicted by the simulation. We find that systematic effects in halo mass estimates of galaxy groups modify the inferred shape of the HIHM relation from the intrinsic one in the simulation, while contamination by interloping galaxies, not associated with the groups, contribute to the inferred H i mass of a halo mass bin, when using large velocity windows for stacking. The effect of contamination is maximal at $M^{\rm }_{\rm vir}$$\sim 10^{12-12.5}\rm M_{\odot }$. Stacking methods based on summing the H i emission spectra to infer the mean H i mass of galaxies of different properties belonging to a group suffer minimal contamination but are strongly limited by the use of optical counterparts, which miss the contribution of dwarf galaxies. Deep spectroscopic surveys will provide significant improvements by going deeper while maintaining high spectroscopic completeness; for example, the WAVES survey will recover ∼52 per cent of the total H i mass of the groups with $M^{\rm }_{\rm vir}$ ∼ 1014M⊙ compared to ∼21 per cent in GAMA.
Stellar winds and metal enrichment from fast-rotating Population III stars
Authors: Liu Boyuan , Sibony Yves , Meynet Georges , Bromm Volker
Published: July 2021

Stellar winds from fast-rotating Population III (Pop III) stars have long been suspected to make important contributions to early metal enrichment, as features in the nucleosynthesis of such ‘spinstars’ are consistent with the chemical abundance patterns of some metal-poor stars in the local Universe. Particularly, stellar winds rich in light elements can provide another pathway towards explaining the carbon enhancement in carbon-enhanced metal-poor (CEMP) stars. In this work, we focus on the feedback of Pop III stellar winds combined with supernovae (SNe), and derive the resulting chemical signatures in the enriched medium. We explore a large parameter space of Pop III star formation, feedback, yields from winds, and SNe with a semi-analytical model. The predicted pattern of carbon and iron abundances of second-generation stars agrees well with observations of CEMP-no stars ($[\rm Ba/Fe]\lt 0$) at $[\rm Fe/H]\lesssim -3$ and A(C) ≲ 7, under the optimistic assumption of significant mass-loss by winds from massive ($\gtrsim 25\ \rm M_{\odot }$) stars that collapse into BHs without SNe. In this scenario, carbon-rich but iron-free second-generation stars can form in systems dominated by enrichment from winds, gaining trace amounts of iron by accretion from the interstellar medium, to become the most iron-poor and carbon-enhanced stars seen in observations ($[\rm Fe/H]\lesssim -4$, $[\rm C/Fe]\gtrsim 2$). We conclude that the observed CEMP-no stars can be explained by both our winds + ISM accretion channel as well as the well-studied faint SN scenario. Wind feedback from Pop III spinstars deserves more detailed modelling in early cosmic structure formation.
Non-Verbal Interactions Between Music Therapists and Persons with Dementia. A Qualitative Phenomenological and Arts-Based Inquiry
Authors: Krøier Julie K , Stige Brynjulf , Ridder Hanne Mette
Published: July 2021

When music therapists are supervising caregivers in how to apply music in their interactions with persons with dementia, we may term this as indirect music therapy practice. Musical interactions are mostly happening through nonverbal, implicit, and embodied knowledge, and, therefore, there is a need for exploring and verbalizing such interactions for music therapists to be able to disseminate to caregivers and other professionals. In this qualitative study, we examine how 6 music therapists with clinical experience in dementia care experience nonverbal interaction with persons with severe dementia living in nursing homes. Explorative focus groups were conducted to study the music therapists’ lived-experience descriptions about their nonverbal interactions with persons with dementia. Focus group transcripts were analyzed by a phenomenological approach, and the findings elaborated and peer validated by the use of musical improvisation as an arts-based analytic approach. The findings included five themes: vitality, disciplined subjectivity, attunement, therapeutic presence, and validation. The music therapists were guided by the vitality of the person with dementia, were aware of their own reactions, and sensed the needs of the person through disciplined subjectivity. They attuned to the person’s nonverbal musical parameters (e.g., tempo pitch and volume) and cocreated an open and mutual field through therapeutic presence and validation. The findings are relevant for future development of direct and indirect music therapy practice but contain limitations due to a homogenous and small group of participants. This study highlights the challenges of exploring nonverbal and musical interactions with the use of language-based methods of inquiry.
Further Consideration of the Impact of Tobacco Control Policies on Young Adult Smoking in Light of the Liberalization of Cannabis Policies
Authors: Vuolo Mike , Lindsay Sadé L , Kelly Brian C
Published: July 2021

Introduction

Changing patterns of cannabis consumption related to the liberalization of cannabis policies may have a countervailing effect on tobacco use. We analyzed whether cannabis policies have tempered the effects of tobacco control policies as well as the extent to which they were associated with young adult cigarette smoking.

Aims and Methods

Combining data on tobacco and cannabis policies at the state, county, and city levels with the nationally-representative geocoded National Longitudinal Survey of Youth 1997 and Census data, we use multilevel regression and fixed effect analyses to examine the impact of cannabis policies on any past 30-day cigarette smoking, frequency of smoking, and past 30-day near-daily smoking among young adults while accounting for community and individual covariates.

Results

Tobacco control policies, including significant effects of comprehensive smoking bans, total vending machine restrictions, single cigarette sale restrictions, and advertising restrictions, remain robust in reducing young adult smoking, net of cannabis policy liberalization, including the legal status of possession, penalties for sale, and medical cannabis. Cannabis policies do not directly affect young adult smoking patterns in an adverse way.

Conclusions

This paper provides evidence that the liberalization of cannabis laws has not adversely affected the efficacy of tobacco control efforts.

Implications

While the effects of tobacco control policies on smoking are well-established, little research has considered how the liberalization of cannabis policies may affect these relationships, which is important given the co-use of these substances. This paper provides evidence that the liberalization of cannabis laws has not adversely affected tobacco control efforts.
Health Care Workers’ Attitudes Toward Patients With COVID-19
Authors: Ottolenghi Joseph , McLaren Rodney A , Bahamon Cecilia , Dalloul Mudar , McCalla Sandra , Minkoff Howard
Published: July 2021

Background

Early in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, before the routine availability and/or use of personal protective equipment, health care workers were understandably concerned. Our aim was to explore health care workers’ attitudes toward patients infected with SARS-CoV-2 at the time of the nation’s first surge in 2 highly affected hospitals in New York.

Methods

We performed a cross-sectional, self-administered survey study of health care workers. The survey consisted of 17 multiple-choice questions including demographic information, ethics, and willingness to care for patients with SARS-CoV-2 infection. Subgroup analyses were performed using the Fisher exact test.

Results

Of 340 health care workers approached, 338 (99.4%) consented to the survey; 163 (48.7%) were registered nurses and 160 (48.3%) lived with children. While 326 (97.3%) workers were concerned about putting their family/coworkers at risk of infection after caring for a patient with SARS-CoV-2, only 30 (8.9%) were unwilling to treat a patient with SARS-CoV-2 infection. Registered nurses were more likely than other health care workers to think it was ethical to refuse care for SARS-CoV-2-infected patients, worried more often about contracting infection, and felt that SARS-CoV-2 added to their stress level (P = .009, P = .018, P < .001, respectively). A similar contrast was seen when comparing workers who live with children with those who did not.

Conclusions

Levels of stress and concern were extremely high. In spite of that, the overwhelming majority of workers were willing to treat patients with SARS-CoV-2 infection. Registered nurses and health care workers who live with children were more likely to think it is ethical to refuse care for SARS-CoV-2-infected patients.
A Wandering Missionary’s Burden: Persistent Fever and Progressive Somnolence in a Returning Traveler
Authors: Yagnik Kruti J , Pezo-Salazar Alonso , Rosenbaum David , Jaso Jesse Manuel , Cavuoti Dominick , Nelson Benjamin , Chancey Rebecca J , McKenna Megan L , Castellino Laila M
Published: July 2021

Human African trypanosomiasis incidence has declined, but diagnosis remains difficult, especially in nonendemic areas. Our patient presented with fever, progressive lethargy, and weight loss for 5 months and had previously traveled to Ghana and Cameroon but had not been to areas with recently reported African trypanosomiasis. Extensive workup was negative, except for lymphocytic pleocytosis in cerebrospinal fluid; ultimately, a bone marrow aspiration revealed necrotizing granulomatous inflammation with 2 trypanosomes discovered on the aspirate smear, consistent with Trypanosoma brucei. The patient was treated with combination nifurtimox and eflornithine with full recovery.
Neuroscience Education as Therapy for Migraine and Overlapping Pain Conditions: A Scoping Review
Authors: Minen Mia T , Kaplan Kayla , Akter Sangida , Espinosa-Polanco Mariana , Guiracocha Jenny , Khanns Dennique , Corner Sarah , Roberts Timothy
Published: July 2021

Background

Neuroscience education therapy (NET) has been successfully used for numerous overlapping pain conditions, but few studies have investigated NET for migraine.

Objective

We sought to 1) review the literature on NET used for the treatment of various pain conditions to assess how NET has been studied thus far and 2) recommend considerations for future research of NET for the treatment of migraine.

Design/Methods

Following the PRISMA guideline for scoping reviews, co-author (TR), a medical librarian, searched the MEDLINE, PsychInfo, Embase, and Cochrane Central Clinical Trials Registry databases for peer-reviewed articles describing NET to treat migraine and other chronic pain conditions. Each citation was reviewed by two trained independent reviewers. Conflicts were resolved through consensus.

Results

Overall, a NET curriculum consists of the following topics: pain does not equate to injury, pain is generated in the brain, perception, genetics, reward systems, fear, brain plasticity, and placebo/nocebo effects. Delivered through individual, group, or a combination of individual and group sessions, NET treatments often incorporate exercise programs and/or components of other evidence-based behavioral treatments. NET has significantly reduced catastrophizing, kinesiophobia, pain intensity, and disability in overlapping pain conditions. In migraine-specific studies, when implemented together with traditional pharmacological treatments, NET has emerged as a promising therapy by reducing migraine days, pain intensity and duration, and acute medication intake.

Conclusion

NET is an established treatment for pain conditions, and future research should focus on refining NET for migraine, examining delivery modality, dosage, components of other behavioral therapies to integrate, and migraine-specific NET curricula.
Socio-demographic determinants in the evolution of pain in inflammatory rheumatic diseases: results from ESPOIR and DESIR cohorts
Authors: Kumaradev Sushmithadev , Roux Christian , Sellam Jérémie , Perrot Serge , Pham Thao , Dugravot Aline , Molto Anna
Published: July 2021

Objective

To determine whether socio-demographic factors are associated with heterogeneity in pain evolution in inflammatory rheumatic diseases (IRDs) after accounting for disease-specific characteristics in a system with universal health care.

Methods

This analysis included the data from two prospective observational cohorts of early IRDs (ESPOIR for early RA and DESIR for early SpA). Data on pain was measured, respectively, on 13 and 9 occasions spanning 10 and 6 years of follow-up using the Short-Form 36 bodily pain score for 810 participants of ESPOIR, and 679 participants of DESIR. Linear mixed models were used to characterize differences in pain evolution as a function of age (tertiles), sex, ethnicity, education, marital, and professional status, after accounting for disease-related, treatment, lifestyle, and health factors.

Results

While transitioning from early (disease duration ≤6 months for RA and ≤3 years for SpA) to long-standing disease, differences in pain evolution emerged as a function of age (P < 0.001), sex (P = 0.050), and ethnicity (P = 0.001) in RA, and as a function of age (P = 0.048) in SpA; younger age, males, and Caucasians exhibited lower pain in the latter phases of both diseases. Highly educated participants (RA, β = −3.8, P = 0.007; SpA, β = −6.0, P < 0.001) for both diseases, and Caucasians (β = −5.6, P = 0.021) for SpA presented with low pain early in the disease, with no changes throughout disease course.

Conclusion

Being older, female, non-Caucasian and having lower education was found to be associated with worse pain in early and/or long-standing IRDs, despite universally accessible health-care. Early identification of at-risk populations and implementation of multidisciplinary strategies may reduce patient-reported health outcome disparities.

Trial registration registrations

ESPOIR: ClinicalTrials.gov, www.clinicaltrials.gov, NCT03666091. DESIR: ClinicalTrials.gov, www.clinicaltrials.gov, NCT01648907.
Patient Safety Escape Room
Authors: Jaffe Rebecca , Zavodnick Jillian , Papanagnou Dimitrios , Zhang Xiao C. , Diemer Gretchen
Published: July 2021

Medical errors harm patients and increase costs. Engaging early clinicians in patient safety (PS) is critical but challenging. We evaluated the impact of a Patient Safety Escape Room (PSER) simulation on intern engagement in PS. During the PSER, learner teams identified PS hazards in a simulated hospital room, revealing clues that allow “escape” via event report entry. One-hundred twenty interns from 14 training programs completed 2 PSERs each. Before the PSER, 5% reported experience entering an event report. Following the PSER, all interns had participated in entering an event report. Mean learner-reported comfort in identifying PS hazards improved significantly (6.3 ± 1.57 to 8.0 ± 1.2; P < 0.001). Individual safety hazards were identified by between 6% and 100% of teams. Mean observer-rated teamwork was lower than learner-rated teamwork (41.5 ± 5.18 versus 45.92 ± 3.87; P = 0.01). Subsequent resident reporting rates did not increase compared with historic controls. The PSER engaged early learners, however, translating improvements into the clinical environment remains challenging.
Factors Causing the Tendency to Abuse Addictive Substances in Adolescent Girls
Authors: Seifi Zahra , Ghodsi Maryam , Niri Vahid Savabi , Didar Fardad
Published: July 2021

The use of addictive substances as a social issue has raised many concerns at various levels of human societies. In this, the tendency to addictive substances in adolescent girls as mothers of the next generation is worrying. The purpose of this review was to identify the factors of the tendency to use addictive substances among adolescent girls and to explain the contexts, contexts, and the role of the main and effective variables on the tendency to use addictive substances. During the past years, several studies have been conducted in Iran in the field of etiology and prevention of drug use. Planning is necessary to promote future research activities, evaluate and categorize the scientifically produced results of the past decades regarding the adolescent girl population. This study suggests a clear perspective for specialists and therapists to identify the threatening and predisposing factors for the treatment of addictive substance abuse in adolescent girls and, if necessary, appropriate interventions.
Empirical Assessment of U.S. Coronavirus Disease 2019 Crisis Standards of Care Guidelines
Authors: Bharadwaj Maheetha , Jezmir Julia L. , Kishore Sandeep P. , Winkler Marisa , Diephus Bradford , Haider Hibah , Crowley Conor P. , Pinilla-Vera Mayra , Varon Jack , Baron Rebecca M. , Feldman William B. , Kim Edy Y.
Published: July 2021

OBJECTIVES:

To establish the feasibility of empirically testing crisis standards of care guidelines.

DESIGN:

Retrospective single-center study.

SETTING:

ICUs at a large academic medical center in the United States.

SUBJECTS:

Adult, critically ill patients admitted to ICU, with 27 patients admitted for acute respiratory failure due to coronavirus disease 2019 and 37 patients admitted for diagnoses other than coronavirus disease 2019.

INTERVENTIONS:

Review of electronic health record.

MEASUREMENTS AND MAIN RESULTS:

Many U.S. states released crisis standards of care guidelines with algorithms to allocate scarce healthcare resources during the coronavirus disease 2019 pandemic. We compared state guidelines that represent different approaches to incorporating disease severity and comorbidities: New York, Maryland, Pennsylvania, and Colorado. Following each algorithm, we calculated priority scores at the time of ICU admission for a cohort of patients with primary diagnoses of coronavirus disease 2019 and diseases other than coronavirus disease 2019 (n = 64). We assessed discrimination of 28-day mortality by area under the receiver operating characteristic curve. We simulated real-time decision-making by applying the triage algorithms to groups of two, five, or 10 patients. For prediction of 28-day mortality by priority scores, area under the receiver operating characteristic curve was 0.56, 0.49, 0.53, 0.66, and 0.69 for New York, Maryland, Pennsylvania, Colorado, and raw Sequential Organ Failure Assessment score algorithms, respectively. For groups of five patients, the percentage of decisions made without deferring to a lottery were 1%, 57%, 80%, 88%, and 95% for New York, Maryland, Pennsylvania, Colorado, and raw Sequential Organ Failure Assessment score algorithms, respectively. The percentage of decisions made without lottery was higher in the subcohort without coronavirus disease 2019, compared with the subcohort with coronavirus disease 2019.

CONCLUSIONS:

Inclusion of comorbidities does not consistently improve an algorithm’s performance in predicting 28-day mortality. Crisis standards of care algorithms result in a substantial percentage of tied priority scores. Crisis standards of care algorithms operate differently in cohorts with and without coronavirus disease 2019. This proof-of-principle study demonstrates the feasibility and importance of empirical testing of crisis standards of care guidelines to understand whether they meet their goals.
Hairy cell leukemia: a brief update on current knowledge and treatment prospects
Authors: Puła Anna , Robak Tadeusz
Published: July 2021

Purpose of review

This article provides a brief update on the recommended diagnosis and treatment strategies for patients with the classic form of hairy cell leukemia (HCL) and HCL variant (HCLv).

Recent findings

HCL is a chronic B-cell malignancy with multiple treatment options. In recent years, many novel drugs have been assessed for HCL treatment with promising results. The investigated nonchemotherapy options include moxetumomab pasudotox, which targets CD22; vemurafenib or dabrafenib, which target the BRAFV600E protein; trametinib, which targets mitogen-activated protein kinase enzyme; and ibrutinib, which targets Bruton tyrosine kinase.

Purine analogs significantly improve survival in patients with HCL. However, patients often relapse, require multiple treatments, and may become refractory. The introduction of novel agents has expanded the spectrum of therapy possibilities in those patients. In the coming years, they will assist standard therapy for patients with HCL who may currently have suboptimal results.
Review of the Metabolic Risk Factors for Increased Severity of Coronavirus Disease-2019
Authors: Fishkin Tzvi , Goldberg Michael D. , Frishman William H.
Published: July 2021

The coronavirus 2019 (COVID-19) pandemic has presented many new challenges to the healthcare community with the sheer number of individuals affected and the range of symptoms at presentation. Early findings have shown that increased age is an independent risk factor for COVID-19 severity. Diabetes and hypertension were also found to be strong independent risk factors for severe COVID-19. It was later discovered that obesity is a strong risk factor for severe disease as well. Possible mechanisms for the increased risk associated with metabolic disease include the increased prevalence of acute respiratory syndrome, immune cell dysfunction, and chronic inflammatory states associated with obesity and diabetes. Acknowledging these risk factors has consequences for addressing vaccination strategies as well as healthcare disparities.
Assessment of the tricuspid valve using cardiovascular magnetic resonance
Authors: Zhan Yang , Shah Dipan
Published: July 2021

Purpose of review

The rapid search for suitable tricuspid transcatheter devices has ignited renewed enthusiasm in accurate characterization of tricuspid valve disease. Cardiovascular magnetic resonance (CMR), traditionally used as the gold standard in assessment for right ventricular size and function, has recently seen its use expanded to assess both the structure and function of the tricuspid apparatus. This review will highlight the role of CMR in tricuspid valve disease and compare it with other commonly used imaging modalities.

Recent findings

Dynamic anatomical assessment of the tricuspid apparatus, in combination with accurate leaflet identification, is possible with CMR. Tricuspid regurgitation volume and fraction are derived through an indirect volumetric method, and therefore, able to overcome many traditional hurdles involved with valve regurgitation quantitation. Adverse right heart prognostic factors in tricuspid valve disease, such as right heart volumes, function, and tissue characterization, are optimally assessed using CMR.

Cardiovascular magnetic resonance is a powerful modality that should be harnessed in order to obtain a multifaceted assessment of tricuspid valve structure, function, and the effects of valve disease on right heart remodeling.
Effects of blood pressure and heart rate circadian rhythms on left atrial function
Authors: Zhao Yixiao , Liu Yan , Sun Qiaobing , Han Jiayu , Wei Yushan , Lu Yan , Zhang Ying , Song Wei , Cheng Yunpeng , Cong Tao , Jiang Yinong
Published: July 2021

Objective:

We examined the associations among the circadian rhythms of blood pressure (BP), heart rate (HR) and left atrial function in essential hypertensive patients.

Methods:

The study included 237 essential hypertensive patients who completed 24-h ambulatory BP, HR monitoring and two-dimensional speckle tracking echocardiography (2DSTE). The strain and strain rate images were studied, and the following parameters were measured: left atrial reservoir strain and strain rate (LAS-S and LASR-S), left atrial conduit strain and strain rate (LAS-E and LASR-E), and left atrial booster strain and strain rate (LAS-A and LASR-A). The left atrial stiffness index (LASI) was identified as the ratio of E/e’ to LAS-S. All participants were divided into three groups according to the percentage of nocturnal BP dipping (dippers, nondippers and reverse dippers).

Results:

The LASI was significantly higher in BP reverse dippers than in dippers and nondippers. LAS-S, LAS-E and LASR-E were significantly lower in BP reverse dippers than dippers and nondippers. Multivariate logistic regression analysis demonstrated that age, night-time mean SBP and the percentage of nocturnal HR decline were independently related to an increased LASI.

Conclusion:

Impairment of the left atrial reservoir and conduit functions was correlated with abnormal BP and HR circadian rhythms in hypertension. Increased left atrial stiffness was associated with night-time SBP and the percentage of nocturnal HR decline.
Does an increase in estimated pulse wave velocity increase the incidence of hypertension?
Authors: Chen Haojia , Wu Weiqiang , Fang Wei , Chen Zhichao , Yan Xiuzhu , Chen Youren , Wu Shouling
Published: July 2021

Objective:

As a risk indicator of hypertension, arterial stiffness is difficult to measure. Thus, we aimed to evaluate the association between estimated pulse wave velocity (ePWV) as a convenient indicator and the incidence of hypertension.

Methods:

The Kailuan cohort was selected for statistical analysis and 54 849 individuals were included in the final cohort. Multiple linear regression was used to analyse the correlation between ePWV and mean SBP (SBP_m) measured at five time points over a 10-year period and between ePWV and mean DBP (DBP_m) measured at five time points over a 10-year period. Logistic regression was used to analyse the effect of estimated arterial stiffness on hypertension.

Results:

The mean age of individuals was 48.44 ± 9.32 years, and 41 419 individuals (75.51%) were male. A multiple linear regression analysis showed that ePWV was positively correlated with both SBP_m and DBP_m. For every 1 cm/s increase in ePWV, SBP_m and DBP_m increased by 5.60 and 2.12 mmHg, respectively. A logistic regression analysis showed that in the total cohort, the incidence of hypertension in populations with moderate, moderate–high and high ePWV values was 3.03, 5.44 and 7.87-times higher, respectively, compared with individuals with low ePWV values. ePWV had a higher predictive value in female and middle age population compared with male and the eldly population grouped by sex and age respectively.

Conclusion:

ePWV positively correlates with both SBP_m and DBP_m, and an increase in ePWV is associated with an increase in the incidence of hypertension.
Transepithelial accelerated corneal crosslinking for keratoconus eyes with maximum keratometry values larger than 58 diopters
Authors: Sun Ling , Zhao Jing , Zhang Xiaoyu , Shen Yang , Tian Mi , Zhou Xingtao
Published: July 2021

Purpose:

To evaluate the safety and efficacy of transepithelial accelerated corneal crosslinking (CXL) for advanced keratoconus eyes with maximum keratometry (Kmax) values >58 diopters (D).

Setting:

Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China.

Design:

Prospective parallel control study.

Methods:

41 keratoconus eyes from 41 patients (mean age, 21.93 ± 5.48 years) who underwent transepithelial accelerated CXL were included prospectively. The enrolled eyes were divided into 2 groups according to their Kmax values (Group A, Kmax ≥58.0 D; Group B, Kmax <58.0 D). The examinations including assessment of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), corneal topography, and corneal endothelial cell density count were conducted preoperatively, at 1 day, 1 month, 3 months, 6 months, and 1 year postoperatively.

Results:

All 41 eyes finished 1 year follow-up. No statistical difference was noted between the mean UDVA and CDVA in both groups throughout the follow-up duration. At 1-year postoperative follow-up, the CDVA increased by ≥2 lines in 45% (9/20) and 28.6% (6/21) eyes in Groups A and B, respectively. The mean preoperative Kmax in Groups A and B were 62.51 ± 3.34 D and 49.98 ± 4.32 D, respectively, and that at postoperative 1-year follow-up were 61.94 ± 4.11 D and 50.24 ± 4.72 D, respectively. The Kmax values of 30% (6/20) eyes in Group A and 4.8% (1/21) eyes in Group B decreased by more than 1 D. Deduction of flat K, steep K, mean K, and Kmax showed no significant difference between the 2 groups at 1-year postoperative follow-up. Moreover, 20% (4/20) and 23.8% (5/21) of eyes in Groups A and B, respectively, showed progress at postoperative 1-year follow-up.

Conclusions:

Transepithelial accelerated CXL can safely treat advanced keratoconus eyes with Kmax values ≥58.0 D with some extent of efficacy and has similar progressive rate as Kmax values <58.0 D.
Effect of surgical abstinence on the risk for posterior capsule rupture during cataract surgery
Authors: Matarazzo Francesco , Phylactou Maria , Day Alexander C. , Maurino Vincenzo
Published: July 2021

Purpose:

To evaluate the impact of surgery restrictions on cataract surgery performance.

Setting:

Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom.

Design:

Retrospective, observational cross-sectional study.

Methods:

A single-center, retrospective review of all patients who underwent phacoemulsification surgery at Moorfields Eye Hospital between September 2019 and January 2021 was conducted. The main outcome measure was posterior capsule rupture (PCR) rate before and after COVID-19–imposed restrictions to elective cataract surgery.

Results:

A total of 15 688 surgeries were performed by 256 different surgeons in the study period. In the prerestriction period (September 2019 to March 2020), the PCR rate was 0.99%, whereas in the 19-week postrestriction period, the PCR rate spiked to 1.62% (odds ratio 1.65; P = .001; CI 1.24 to 2.20; relative risk: 1.64).

Conclusions:

The COVID-19 pandemic provided a unique opportunity to assess a large group of surgeons' performances after prolonged surgical abstinence. A 19-week restriction period in surgical activity showed an increased incidence of PCR complications. This is relevant because it can concern any surgeon on the extended time off from work such as sick, sabbatical, research, and parental leave. Supporting strategies should be implemented by associated regulators to minimize this negative impact.
One-year multicenter evaluation of a new hydrophobic acrylic intraocular lens with hydroxyethyl methacrylate in an automated preloaded delivery system
Authors: Oshika Tetsuro , Sasaki Noriyuki ,   Clinical Study Group on New Intraocular Lens and Delivery System
Published: July 2021

Purpose:

To assess a single-piece monofocal hydrophobic acrylic intraocular lens (IOL) with hydroxyethyl methacrylate (HEMA) (Clareon) contained in automated preloaded delivery system (AutonoMe).

Setting:

18 surgical sites in Japan.

Design:

Observational study.

Methods:

In patients undergoing phacoemulsification and IOL implantation of a new hydrophobic acrylic IOL using an automated injector, clinical data were collected preoperatively and at 1 day, 1 week, and 1 month, 6 months, and 12 months postoperatively. The degree of glistenings was graded on a 4-point scale. The surgeons rated usability and performance of the IOL delivery system on a 5-point scale.

Results:

The study enrolled 384 eyes of 384 patients, ranging in age from 41 to 93 (73.8 ± 8.2, mean ± SD) years. The percentage of eyes with corrected distance visual acuity of 20/25 or better at 1 day, 1 week, and 1 month, 6 months, and 12 months postoperatively was 82.6%, 91.9%, 92.8%, 96.6%, and 95.2%, respectively. Refractive error was within 1.0 diopter in approximately 90% of cases. No glistenings were found in all cases throughout the study period. The rate of Nd:YAG laser posterior capsulotomy was 0.9% at 1 year. The IOL delivery system received high ratings on its usability and performance by the surgeons.

Conclusions:

The new hydrophobic acrylic IOL with HEMA showed excellent visual and refractive outcomes without developing glistenings throughout the 1-year study period. The surgeons gave high marks for usability and performance of the automated preloaded delivery system.
Impact of Screening Modality on the Detection of Cervical Adenocarcinoma In Situ and Adenocarcinoma
Authors: Zhang Ran C. , Vue Nujsaubnusi C. , Obasi Lisa U. , Vogel Rachel I. , Subramanian Amar T. , Khalifa Mahmoud A. , Reddy Buvana R. , Erickson Britt K.
Published: July 2021

Objective

The aim of the study was to determine the impact of screening modality on the detection of cervical adenocarcinoma in situ (AIS) and adenocarcinoma.

Materials and Methods

This was a cross-sectional study of patients with AIS or adenocarcinoma who had undergone routine screening with cytology and high-risk human papillomavirus (HPV) cotesting between January 2007 and December 2017. Patients were stratified into 3 groups by screening test results: (1) HPV positive with abnormal cytology (HPV+/Pap+), (2) HPV negative with abnormal cytology (HPV−/Pap+), and (3) HPV positive with normal cytology (HPV+/Pap−). Demographic and clinical characteristics were collected. Data were analyzed with χ2, Fisher exact tests, and t tests as appropriate.

Results

Of the 118 patients diagnosed with AIS (n = 97) or adenocarcinoma (n = 21) after abnormal screening tests, 92 (78%) were detected by HPV+/Pap+, 15 (12.7%) were HPV+/Pap−, and 11 (9.3%) were HPV−/Pap+. Demographics were similar between groups, although the HPV+/Pap− patients had higher body mass indices. Rates of definitive hysterectomy were similar between groups (53.3%–80.0%, p = .11).

Conclusions

In our cohort, a significant proportion of AIS and adenocarcinoma was detected by both HPV alone (with normal cytology) and cytology alone (with negative HPV), suggesting that cotesting with both HPV and cytology may be a more sensitive method of detection of AIS and adenocarcinoma.
Severe Pulmonary Hemorrhage in a Neonate With Hypoxic Ischemic Encephalopathy and Sepsis Managed on Extracorporeal Membrane Oxygenation
Authors: Cardona Vilmaris Quinones , Joshi Swosti , Conway Daniel , Menkiti Ogechukwu R.
Published: July 2021

Pulmonary hemorrhage (PH) is an infrequent and potentially fatal event in term neonates. Reports of successful management of PH on extracorporeal membrane oxygenation (ECMO) are limited, given the accentuated risk of mortality imposed by the use of heparin to prevent thrombosis on ECMO. We present a case of a term neonate with hypoxic ischemic encephalopathy undergoing controlled hypothermia who developed hypoxic respiratory failure, hemodynamic instability, Enterobacter cloacae pneumonia and sepsis complicated by severe PH who required support with veno-arterial ECMO. We describe the therapeutic strategies used on veno-arterial ECMO to successfully manage this infant, including clamping the endotracheal tube, aggressive correction of coagulopathy, and use of dornase alfa, as well as elaborate on the subtle changes in ECMO parameters during the run that preceded worsening pneumonia with sepsis.
Regulation and importance of factor VIII levels in hemophilia A carriers
Authors: Cygan Peter H. , Kouides Peter A.
Published: July 2021

Purpose of review

To summarize the recent literature related to female hemophilia A carriers with respect to prevalence in the population, the impact of baseline factor VIII levels and other influences on bleeding phenotype, and clinical management needs.

Recent findings

Many female hemophilia A carriers are at risk for abnormal bleeding, yet they are underrecognized by healthcare providers and their bleeding symptoms are underreported. Low FVIII levels are consistently associated with clinically significant bleeding and correlate well with skewed X chromosome inactivation (XCI). Most interestingly, bleeding tendency is also observed in some hemophilia A carriers with normal factor VIII levels and requires further investigation. Well controlled studies investigating peripartum and periprocedural FVIII levels and adequate hemostatic treatment are necessary to inform management guidelines.

Prevalence and bleeding tendency of hemophilia A carriers remain underreported, despite a significant proportion having low FVIII levels. Skewed XCI may explain low FVIII but does not explain the bleeding risk encountered in a larger proportion of hemophilia A carriers with random XCI and borderline/normal FVIII.
Modeling genetic platelet disorders with human pluripotent stem cells: mega-progress but wanting more on our plate(let)
Authors: Nations Catriana C. , Pavani Giulia , French Deborah L. , Gadue Paul
Published: July 2021

Purpose of review

Megakaryocytes are rare hematopoietic cells that play an instrumental role in hemostasis, and other important biological processes such as immunity and wound healing. With the advent of cell reprogramming technologies and advances in differentiation protocols, it is now possible to obtain megakaryocytes from any pluripotent stem cell (PSC) via hematopoietic induction. Here, we review recent advances in PSC-derived megakaryocyte (iMK) technology, focusing on platform validation, disease modeling and current limitations.

Recent findings

A comprehensive study confirmed that iMK can recapitulate many transcriptional and functional aspects of megakaryocyte and platelet biology, including variables associated with complex genetic traits such as sex and race. These findings were corroborated by several pathological models in which iMKs revealed molecular mechanisms behind inherited platelet disorders and assessed the efficacy of novel pharmacological interventions. However, current differentiation protocols generate primarily embryonic iMK, limiting the clinical and translational potential of this system.

iMK are strong candidates to model pathologic mutations involved in platelet defects and develop innovative therapeutic strategies. Future efforts on generating definitive hematopoietic progenitors would improve current platelet generation protocols and expand our capacity to model neonatal and adult megakaryocyte disorders.
Urinary diversions for benign and oncologic indications: what did we learn about short term complications in the last 24 months?
Authors: Liedberg Fredrik , Bobjer Johannes
Published: July 2021

Purpose of review

Urinary diversion (UD) with or without cystectomy is a procedure with high short term complication rates. In this review, we summarize the most relevant findings of the last 2 years.

Recent findings

The use of a prophylactic mesh decreases the risk of parastomal hernia after ileal conduit (IC) surgery without adding mesh-related complications according to a recent randomized multicentre trial. Robot-assisted surgery is increasingly applied for UD and is evolving from extra- to intra-corporeal reconstruction in both continent and incontinent diversions, but there is still a need for appropriately designed studies assessing both short- and long-term complications. Promising techniques to decrease ureterointestinal stricture rates have been reported from small series, such as retrosigmoid placement of the proximal IC to avoid transpositioning of the left ureter, or in robot-assisted surgery the use of indocyanine green with near-infrared light to improve visualisation of distal ureteral viability.

Most recent reports derive from observational data. Appropriate randomized studies are warranted for the evaluation of new techniques to be implemented in a surgical area that still is associated with high complication rates.
Evaluation of the Online Partner Messaging Service for Sexually Transmitted Infections Let Them Know
Authors: Htaik Kay , Fairley Christopher K. , Bilardi Jade E. , Chow Eric P.F. , Ong Jason J. , Chen Marcus Y.
Published: July 2021

Background

There are limited data on the extent of use of online services that support partner notification for sexually transmitted infections. The online partner notification service Let Them Know was implemented in 2008 to support partner messaging for chlamydia in Australia. In 2010, the service was expanded to include gonorrhea, syphilis, Mycoplasma genitalium, and Trichomonas vaginalis. We aimed to determine usage of Let Them Know between 2011 and 2019.

Methods

The number of text messages sent via Let Them Know for each infection between 2011 and 2019 was extracted by using Microsoft SQL Server Management Studio. Users who sent a text message were asked “Were you more likely to let a partner know because of this website?”

Results

The number of text messages sent for each infection increased over the evaluation period with a total of 148,256 text messages sent from the service. Sixty-nine percent (103,026) of users indicated that they were more likely to let a partner know because of the website. The number of text messages increased between 2011 and 2019 from 4,666 to 17,889 (283%) for chlamydia, from 2101 to 6328 (201%) for gonorrhea, from 1895 to 4908 (159%) for syphilis, from 703 to 1953 (178%) for M. genitalium, and from 173 to 629 (264%) for trichomonas.

Conclusions

This fully automated partner messaging service showed high and increasing use with data suggesting it helped most users contact partners.