bluuebunny/crossref_metadata_2025 huggingface dataset:
Adaptations in Gastrointestinal Nutrient Absorption and its Determinants During Pregnancy in Monogastric Mammals: A Scoping Review
Authors: Overduin Teunis Sebastian , Page Amanda J , Young Richard L , Gatford Kathryn L
Published: June 2024

Context

Pregnancy increases nutrient demand, but how nutrient uptake and its determinants adapt to facilitate this is unclear.

Objective

This review aimed to identify and characterize evidence and evidence gaps regarding changes in gastrointestinal nutrient absorption and its determinants during pregnancy in monogastric mammals.

Data Sources

A scoping review of peer-reviewed sources was conducted across PubMed, Scopus, Web of Science, Embase, and ProQuest (theses and dissertations) databases.

Data Extraction

Data extracted included species, pregnancy stages and outcomes. Where sufficient data for a given outcome was available, relative values were summarized graphically or in tables, to allow comparison across pregnancy stages and/or small intestine regions. Searches identified 26 855 sources, of which only 159 were eligible. Mechanistic studies were largely restricted to rodents, and most compared non- and late-pregnant groups, with fewer studies including early- or mid-pregnant groups.

Data Analysis

During pregnancy, there is some evidence for greater capacity for glucose uptake but unchanged amino acid uptake, and good evidence for increased uptake of calcium, iron, and zinc, and slower gastrointestinal passage of nutrients. The available evidence indicates that acute glucose uptake, gastric emptying, and the activities of sucrase, maltase, and lactase do not change during pregnancy. Gaps in the knowledge include the effects of pregnancy on uptake of specific amino acids, lipids, and most minerals and vitamins.

Conclusion

The results indicate that the gastrointestinal tract adapts during pregnancy to facilitate increased nutrient absorption. Additional data is required in order to assess the underlying mechanisms for and impacts on the absorption of many nutrients, as well as to determine the timing of these adaptations.
Why is a small sample size not enough?
Authors: Cao Ying , Chen Ronald C , Katz Aaron J
Published: June 2024

Background

Clinical studies are often limited by resources available, which results in constraints on sample size. We use simulated data to illustrate study implications when the sample size is too small.

Methods and Results

Using 2 theoretical populations each with N = 1000, we randomly sample 10 from each population and conduct a statistical comparison, to help make a conclusion about whether the 2 populations are different. This exercise is repeated for a total of 4 studies: 2 concluded that the 2 populations are statistically significantly different, while 2 showed no statistically significant difference.

Conclusions

Our simulated examples demonstrate that sample sizes play important roles in clinical research. The results and conclusions, in terms of estimates of means, medians, Pearson correlations, chi-square test, and P values, are unreliable with small samples.
Multigenerational spaces: the usage and activities of different age groups within six community parks in Victoria, Australia
Authors: Levinger Pazit , Dreher Bronwyn L , Soh Sze-Ee , Dow Briony , Batchelor Frances , Hill Keith D
Published: June 2024

Background

This study investigated how different spaces within multigenerational local parks are being used by older people and other age groups.

Methods

Observation of park visitors occurred in six Victorian parks one month after park refurbishment. Parks were classified into six spaces based on equipment/amenities and associated expected activity. Observations were summarized descriptively, and negative binomial regression models were used to examine the association between visitor counts and classified targeted areas.

Results

A total of 12 501 people visited the parks with 4.1% older visitors. The number of older visitors in each park area was consistently less than other age groups, with counts of older visitors being 50% less in mixed spaces (95% confidence interval [CI] 0.38, 0.65), 40% less in adult exercise equipment areas (95% CI 0.46, 0.77) and 59% less in walking paths (95% CI 0.31, 0.55). The number of older visitors engaging in physical activity were significantly greater in walking paths (incidence rate ratios 1.75; 95% CI 1.16, 2.64) compared with children’s play spaces.

Conclusion

The number of visitors across different age groups varied significantly between the park targeted areas. Most spaces were mainly used by the intended target age group/user, with no particular area used by all age groups in similar proportions.
Using Divide-and-Conquer to Improve Tax Collection
Authors: Kapon Samuel , Del Carpio Lucia , Chassang Sylvain
Published: June 2024

Tax collection with limited enforcement capacity may be consistent with both high- and low-delinquency regimes: high delinquency reduces the effectiveness of threats, thereby reinforcing high delinquency. We explore the practical challenges of unraveling the high-delinquency equilibrium using a mechanism design insight known as divide-and-conquer. Our preferred mechanism takes the form of prioritized iterative enforcement (PIE). Taxpayers are ranked using the ratio of expected collection to capacity use. Collection threats are issued in small batches to ensure high credibility and induce high compliance. Following repayments, liberated capacity is used to issue the next round of threats. In collaboration with a district of Lima, we experimentally assess PIE in a sample of 13,432 property taxpayers. The data validate and refine our theoretical framework. A semi-structural model suggests that keeping collection actions fixed, PIE would increase tax revenue by roughly 10%.
Effects of N-Methyl-d-Aspartate Receptor Antagonists on Gamma-Band Activity During Auditory Stimulation Compared With Electro/Magneto-encephalographic Data in Schizophrenia and Early-Stage Psychosis: A Systematic Review and Perspective
Authors: Bianciardi Bianca , Mastek Helena , Franka Michelle , Uhlhaas Peter J
Published: June 2024

Background and Hypothesis

N-Methyl-d-aspartate receptor (NMDA-R) hypofunctioning has been hypothesized to be involved in circuit dysfunctions in schizophrenia (ScZ). Yet, it remains to be determined whether the physiological changes observed following NMDA-R antagonist administration are consistent with auditory gamma-band activity in ScZ which is dependent on NMDA-R activity.

Study Design

This systematic review investigated the effects of NMDA-R antagonists on auditory gamma-band activity in preclinical (n = 15) and human (n = 3) studies and compared these data to electro/magneto-encephalographic measurements in ScZ patients (n = 37) and 9 studies in early-stage psychosis. The following gamma-band parameters were examined: (1) evoked spectral power, (2) intertrial phase coherence (ITPC), (3) induced spectral power, and (4) baseline power.

Study Results

Animal and human pharmacological data reported a reduction, especially for evoked gamma-band power and ITPC, as well as an increase and biphasic effects of gamma-band activity following NMDA-R antagonist administration. In addition, NMDA-R antagonists increased baseline gamma-band activity in preclinical studies. Reductions in ITPC and evoked gamma-band power were broadly compatible with findings observed in ScZ and early-stage psychosis patients where the majority of studies observed decreased gamma-band spectral power and ITPC. In regard to baseline gamma-band power, there were inconsistent findings. Finally, a publication bias was observed in studies investigating auditory gamma-band activity in ScZ patients.

Conclusions

Our systematic review indicates that NMDA-R antagonists may partially recreate reductions in gamma-band spectral power and ITPC during auditory stimulation in ScZ. These findings are discussed in the context of current theories involving alteration in E/I balance and the role of NMDA hypofunction in the pathophysiology of ScZ.
Intact Serial Dependence in Schizophrenia: Evidence from an Orientation Adjustment Task
Authors: Pascucci David , Roinishvili Maya , Chkonia Eka , Brand Andreas , Whitney David , Herzog Michael H , Manassi Mauro
Published: June 2024

Background and Hypothesis

For a long time, it was proposed that schizophrenia (SCZ) patients rely more on sensory input and less on prior information, potentially leading to reduced serial dependence—ie, a reduced influence of prior stimuli in perceptual tasks. However, existing evidence is constrained to a few paradigms, and whether reduced serial dependence reflects a general characteristic of the disease remains unclear.

Study Design

We investigated serial dependence in 26 SCZ patients and 27 healthy controls (CNT) to evaluate the influence of prior stimuli in a classic visual orientation adjustment task, a paradigm not previously tested in this context.

Study Results

As expected, the CNT group exhibited clear serial dependence, with systematic biases toward the orientation of stimuli shown in the preceding trials. Serial dependence in SCZ patients was largely comparable to that in the CNT group.

Conclusions

These findings challenge the prevailing notion of reduced serial dependence in SCZ, suggesting that observed differences between healthy CNT and patients may depend on aspects of perceptual or cognitive processing that are currently not understood.
Personalized Cognitive Health in Psychiatry: Current State and the Promise of Computational Methods
Authors: Chen Cathy S , Vinogradov Sophia
Published: June 2024

Background

Decades of research have firmly established that cognitive health and cognitive treatment services are a key need for people living with psychosis. However, many current clinical programs do not address this need, despite the essential role that an individual’s cognitive and social cognitive capacities play in determining their real-world functioning. Preliminary practice-based research in the Early Psychosis Intervention Network early psychosis intervention network shows that it is possible to develop and implement tools that delineate an individuals’ cognitive health profile and that help engage the client and the clinician in shared decision-making and treatment planning that includes cognitive treatments. These findings signify a promising shift toward personalized cognitive health.

Study Design

Extending upon this early progress, we review the concept of interindividual variability in cognitive domains/processes in psychosis as the basis for offering personalized treatment plans. We present evidence from studies that have used traditional neuropsychological measures as well as findings from emerging computational studies that leverage trial-by-trial behavior data to illuminate the different latent strategies that individuals employ.

Study Result

We posit that these computational techniques, when combined with traditional cognitive assessments, can enrich our understanding of individual differences in treatment needs, which in turn can guide evermore personalized interventions.

Conclusion

As we find clinically relevant ways to decompose maladaptive behaviors into separate latent cognitive elements captured by model parameters, the ultimate goal is to develop and implement approaches that empower clients and their clinical providers to leverage individual’s existing learning capacities to improve their cognitive health and well-being.
Artificial intelligence and nonoperating room anesthesia
Authors: Pardo Emmanuel , Le Cam Elena , Verdonk Franck
Published: June 2024

Purpose of review

The integration of artificial intelligence (AI) in nonoperating room anesthesia (NORA) represents a timely and significant advancement. As the demand for NORA services expands, the application of AI is poised to improve patient selection, perioperative care, and anesthesia delivery. This review examines AI's growing impact on NORA and how it can optimize our clinical practice in the near future.

Recent findings

AI has already improved various aspects of anesthesia, including preoperative assessment, intraoperative management, and postoperative care. Studies highlight AI's role in patient risk stratification, real-time decision support, and predictive modeling for patient outcomes. Notably, AI applications can be used to target patients at risk of complications, alert clinicians to the upcoming occurrence of an intraoperative adverse event such as hypotension or hypoxemia, or predict their tolerance of anesthesia after the procedure. Despite these advances, challenges persist, including ethical considerations, algorithmic bias, data security, and the need for transparent decision-making processes within AI systems.

The findings underscore the substantial benefits of AI in NORA, which include improved safety, efficiency, and personalized care. AI's predictive capabilities in assessing hypoxemia risk and other perioperative events, have demonstrated potential to exceed human prognostic accuracy. The implications of these findings advocate for a careful yet progressive adoption of AI in clinical practice, encouraging the development of robust ethical guidelines, continual professional training, and comprehensive data management strategies. Furthermore, AI's role in anesthesia underscores the need for multidisciplinary research to address the limitations and fully leverage AI's capabilities for patient-centered anesthesia care.
Population pharmacokinetics of Ainuovirine and exposure–response analysis in human immunodeficiency virus-infected individuals
Authors: Han Xiaoxu , Sun Jin , Zhang Yihang , Jiang Taiyi , Zheng Qingshan , Peng Haiyan , Wang Yao , Xia Wei , Zhang Tong , Sun Lijun , Yun Xinming , Qin Hong , Wu Hao , Su Bin
Published: June 2024

Background:

Ainuovirine (ANV) is a new generation of non-nucleoside reverse transcriptase inhibitor for the treatment of human immunodeficiency virus (HIV) type 1 infection. This study aimed to evaluate the population pharmacokinetic (PopPK) profile and exposure–response relationship of ANV among people living with HIV.

Methods:

Plasma concentration-time data from phase 1 and phase 3 clinical trials of ANV were pooled for developing the PopPK model. Exposure estimates obtained from the final model were used in exposure–response analysis for virologic responses and safety responses.

Results:

ANV exhibited a nonlinear pharmacokinetic profile, which was best described by a two-compartment model with first-order elimination. There were no significant covariates correlated to the pharmacokinetic parameters of ANV. The PopPK parameter estimate (relative standard error [%]) for clearance adjusted for bioavailability (CL/F) was 6.46 (15.00) L/h, and the clearance of ANV increased after multiple doses. The exposure–response model revealed no significant correlation between the virologic response (HIV-RNA <50 copies/mL) at 48 weeks and the exposure, but the incidence of adverse events increased with the increasing exposure (P value of steady-state trough concentration and area under the steady-state curve were 0.0177 and 0.0141, respectively).

Conclusions:

Our PopPK model supported ANV 150 mg once daily as the recommended dose for people living with HIV, requiring no dose adjustment for the studied factors. Optimization of ANV dose may be warranted in clinical practice due to an increasing trend in adverse reactions with increasing exposure.

Trial registration:

Chinese Clinical Trial Registry https://www.chictr.org.cn (Nos. ChiCTR1800018022 and ChiCTR1800019041).
Prenatal efavirenz exposure is independently associated with maternal, but not fetal CYP2B6 genotype
Authors: Eniayewu Oluwasegun , Akinloye Abdulafeez , Shenkoya Babajide , Azuka Uche , Bolaji Oluseye , Adejuyigbe Ebunoluwa , Owen Andrew , Olagunju Adeniyi
Published: June 2024

Objectives

Understanding the influence of fetal and maternal genetics on prenatal drug exposure could potentially improve benefit-risk evaluation. In this study, we investigated the impact of two functional polymorphisms in CYP2B6 on prenatal exposure to efavirenz.

Methods

Dried blood spot (DBS) samples were collected from HIV-positive pregnant women (n = 112) and their newborns (n = 107) at delivery. They were genotyped for single nucleotide polymorphisms in CYP2B6. Efavirenz was quantified by liquid chromatography-tandem mass spectrometry (LC-MS/MS).

Results

Significant correlations were observed in efavirenz concentration between maternal and newborn (r = 0.46, R
2 = 0.21, P < 0.001), and maternal and cord (r = 0.83, R
2 = 0.68, P < 0.001) samples. Median (interquartile range) newborn plasma-to-maternal plasma and cord-to-maternal plasma ratios were 0.85 (0.03–3.49) and 0.78 (0.23–1.96), respectively. Newborn efavirenz concentration in DBS varied significantly based on composite maternal CYP2B6 genotype: fast (CYP2B6 516GG and 983TT, n = 26), 747 ng/ml (602–1060); intermediate (CYP2B6 516GT or 983TC n = 50), 1177 ng/ml (898–1765); and slow (CYP2B6 516GT and 983TC or 516TT or 983CC, n = 14), 3094 ng/ml (2126–3812). Composite newborn CYP2B6 genotype was, however, not significantly associated with prenatal exposure. Efavirenz concentration in newborn stratified as fast (n = 25), intermediate (n = 36), and slow metabolizers (n = 19) from prenatal exposure was 999.7 (774–1285), 1240 (709–1984), and 1792 ng/ml (1201–3188), respectively.

Conclusion

The clinical relevance of the observed influence of maternal genetics on prenatal efavirenz exposure requires further investigation.
Taking the Express Lane: Student Attitudes Towards Tracking in Ob/Gyn Residency
Authors: Cai Fei , Santiago Sarah , Southworth Elizabeth , Stephenson-Famy Alyssa , Fay Emily , Wang Eileen Y. , Burns RALPH​​​​​​ NICHOLAS
Published: June 2024

We sought to determine the subspecialty interests of fourth-year medical students (MS4s) matched to Ob/Gyn and evaluate their attitudes towards residency tracking. Matched MS4s completed a survey regarding subspecialization, confidence in that choice, and desire for tracking. A total of 922 MS4s completed the survey. Of these, 474 (51.4%) desired subspecialty training, but were less confident in their choice compared with those desiring generalist careers (60.0/100 vs. 64.9/100, P=0.003). Those seeking subspecialty training were more likely to desire tracking (15.2% vs. 39.5%, P<0.001). In conclusion, 51% of MS4s desired subspecialty training over generalist careers. Almost 40% of these students are interested in tracking.
Improving diversity in cardiac surgery clinical trials with ROMA:Women as an exemplar
Authors: Masterson Creber Ruth , Eslami Sarah , Gaudino Mario
Published: June 2024

Purpose of review

To describe methods to improve representation of women in cardiac surgery clinical trials.

Recent findings

Cardiovascular disease risk among women is high. Historically, women have been excluded from cardiac surgery trials, in part due to restrictive inclusion criteria. Surgical outcomes, specifically after coronary artery bypass grafting, are consistently worse among female patients, and these outcomes have not improved over the last decade. Addressing treatment effects and clinical benefit among women requires accurate representation in cardiovascular surgery trials. ROMA:Women, is the first cardiac surgery trial to focus solely on women, with the goal of addressing underrepresentation. Through utilizing specific strategies, ROMA:Women is a promising first step in advancing health equity.

Strategies to ensure effective recruitment and representation among women in cardiac surgery clinical trials, such as tailored eligibility criteria and comprehensive strategies to improve communication and increase trust, are two of many potential approaches to address the structural barriers to female representation in cardiac surgery clinical trials. To date, ROMA:Women is an example of a trial that has shown extraordinary preliminary success enrolling women. Designing trials exclusively for women is one strategy to improve the diversity of clinical trial participation.
Docetaxel-induced pigmentary maculopathy
Authors: Skrehot Henry C. , Alsoudi Amer , Chang Emmanuel Y. , Holz Eric R.
Published: June 2024

Purpose:

To report a case of bilateral docetaxel-induced pigmentary maculopathy in an adult.

Methods:

A 79-year-old male with prostate cancer was treated with docetaxel and subsequently developed progressively worsening blurred vision. Prior to initiation of docetaxel therapy, his best corrected visual acuity (BCVA) was 20/20 in the right and left eye. He presented to clinic 5 months after the initiation of docetaxel therapy with BCVA of 20/70 and 20/40 -2 in the right and left eye, respectively. Fundoscopic exam was notable for bilateral focal central areas of macular hyperpigmentation. Toxic maculopathy secondary to docetaxel was suspected and the recommendation to discontinue docetaxel was made to the oncologist.

Results:

Five months after discontinuation of docetaxel, the patient’s BCVA improved to 20/40 -2 in the right and left eye. Fundoscopic exam was stable in both eyes.

Conclusion:

Bilateral pigmentary maculopathy presenting as focal areas of macular hyperpigmentation developed after initiation of docetaxel in an adult with no previous ocular history. Prompt diagnosis and cessation of docetaxel resulted in stable disease.
Leber hereditary optic neuropathy: A case report of concurrent rare mitochondrial mutations and ABCA4 nuclear gene mutation
Authors: Ashrafkhorasani Maryam , Chou Brian , Sadun Alfredo A.
Published: June 2024

Purpose:

This case report aims to describe the clinical presentation of a 21-year-old male patient with subacute bilateral painless vision loss, clinically consistent with Leber hereditary optic neuropathy (LHON), a mitochondrially inherited disorder and to investigate the genetic mutations associated with this condition.

Methods:

Genetic testing was performed on the patient to identify potential LHON-related mutations. Additionally, the patient's medical history and clinical examination findings were recorded.

Results:

The patient tested negative for the three most common LHON-related mutations but exhibited two homoplasmic mitochondrial mutations with unclear significance, m3461 C>T (MT-ND1) and m9358 C>T (MT_CO3). Furthermore, two pathogenic variants of ABCA4 (c.3322>T and c.4539+2028 C>T) were identified in the patient's genetic profile.

Discussion/conclusion: This case underscores the complex interplay between mitochondrial and nuclear mutations in the pathophysiology of LHON. Despite the absence of common LHON mutations, the presence of these mitochondrial and nuclear mutations likely contributed to the patient's LHON phenotype. This case also highlights the importance of considering environmental factors and genetic interactions in LHON development.
Determining Asymmetry Thresholds in Anophthalmia/Microphthalmia Using a Three-dimensional Animated Model
Authors: Romein Emiel J. , Groot Annabel L. W. , Remmers Jelmer S. , Lissenberg Birgit , Moll Annette C. , Saeed Peerooz , Hartong Dyonne T.
Published: June 2024

Purpose:

Congenital microphthalmia and anophthalmia are rare development disorders with underdevelopment of the orbital region, resulting in asymmetry of the face. No clear guidelines exist to determine when these deviations are acceptable.

Methods:

The face of a healthy 6-year-old child was three-dimensionally scanned. On this scan, we modeled various incremental degrees of facial asymmetries using three-dimensional modeling software. We modeled for smaller palpebral fissures, sunken eyes, and downward displacement of the eye. We also tested whether adjusting the vertical palpebral fissure height in relation to the horizontal palpebral fissure width affected perception. A total of 22 videos were created in which the model turned the head horizontally and vertically. We created a questionnaire asking raters how acceptable the face is, on a linear scale from 0 to 10.

Results:

Results showed a correlation between the degree of asymmetry and the acceptability score of the raters. Enophthalmos of ≥6 mm, palpebral fissure width ≤79% compared with the other eye, and 2 mm or more downward displacement of the eye resulted in a significant different acceptability score. The desire for correction was strongly increased when these thresholds were exceeded. Adjusting the vertical palpebral fissure height to the horizontal palpebral fissure width resulted in a worse acceptability score.

Conclusion:

A unilateral sunken eye (enophthalmos) of 6 mm or more, asymmetric horizontal palpebral fissure length of ≤79%, and a lower position of one eye of more than 2 mm resulted in unacceptable judgment. These data can be used to evaluate treatment outcome in children treated for congenital microphthalmia and anophthalmia.
Fluorescein-conjugated hyaluronic acid enables visualization of retained ophthalmic viscosurgical device in anterior chamber
Authors: Rocher Erick E. , Eghrari Allen O.
Published: June 2024

Purpose:

To develop and assess the utility of an ophthalmic viscosurgical device (OVD) manufactured with fluorescein-conjugated hyaluronic acid (conjHA).

Setting:

Department of Biomedical Engineering and the Wilmer Eye Institute, Johns Hopkins University and School of Medicine, Baltimore, Maryland.

Design:

Laboratory study.

Methods:

ConjHA and unconjugated HA (unconjHA) at varied ratios were used to produce OVD (conjOVD) with varied fluorescence intensity. The conjHA:unconjHA ratio was optimized to maximize clarity under white light and fluorescence intensity under cobalt blue light (CBL), allowing for conditional visualization. The effect of conjugation on conjOVD viscosity was assessed by rotational rheometry. Intraocular lenses (IOLs) were immersed in conjOVD for 4 hours to assess staining of IOLs. A proof-of-concept study was performed in ex vivo porcine eyes. After injection and visualization, the OVDs were removed from the eyes by irrigation/aspiration (I/A).

Results:

0.5 mg/mL of conjHA (degree of substitution = 0.005) enabled robust fluorescence of conjOVD under CBL. Fluorescein conjugation did not significantly affect conjOVD viscosity (P > .05 for mean difference in viscosity at all shear rates tested). No staining of IOLs was appreciated. ConjOVD was visualized under CBL when injected ex vivo and maintained clarity of the anterior chamber under white light. Importantly, conjHA enabled delineation of retained OVD after I/A.

Conclusions:

Use of OVD composed of fluorescein-conjugated HA is a feasible method to enable conditional visualization of OVD intraoperatively without nonspecific staining of ocular structures. Further development of this technology may enable accelerated OVD removal in ocular surgery or decreased OVD retention postoperatively.
Updating the no-history method in intraocular lens power calculation after myopic laser vision correction
Authors: Shammas H. John , Cooke David L. , Riaz Kamran M. , Tonk Rahul , Shammas Maya C. , Bleeker Adam , Anter Abdelrahman M. , Suraneni Sanjana , Leal Sebastian
Published: June 2024

Purpose:

To describe the Shammas-Cooke formula, an updated no-history (NH) formula for IOL calculation in eyes with prior myopic laser vision correction (M-LVC), and to compare the results with the Shammas PL, Haigis-L, and Barrett True-K NH formulas.

Setting:

Bascom Palmer Eye Institute (BPEI), The Lennar Foundation Medical Center, University of Miami, Miami, Florida; Dean A. McGee Eye Institute (DMEI), University of Oklahoma, Oklahoma City, Oklahoma; and private practice, Lynwood, California, and St Joseph, Michigan.

Design:

Retrospective observational study.

Methods:

We analyzed 2 large series of cataractous eyes with prior M-LVC. The training set (BPEI series of 330 eyes) was used to derive the new corneal power conversion equation to be used in the new Shammas-Cooke formula and the testing set (165 eyes of 165 patients in the DMEI series) to compare the updated formula with 3 other M-LVC NH formulas on the ASCRS calculator: Shammas PL, Haigis-L, and Barrett True-K NH.

Results:

Mean prediction error was 0.09 ± 0.56 diopters (D), −0.44 ± 0.61 D, −0.47 ± 0.59 D, and −0.18 ± 0.56 D and the mean absolute error was 0.43 D, 0.60 D, 0.61 D, and 0.45 D for the Shammas-Cooke, Shammas PL, Haigis-L, and Barrett True-K NH, respectively. The percentage of eyes within ±0.50 D was 66.7% vs 47.9%, 48.5%, and 65.5%, respectively.

Conclusions:

The Shammas-Cooke formula performed better than the Shammas PL and Haigis-L (P < .001 for both) and as well as the Barrett True-K NH formula (P = .923).
Antibiotic prophylaxis for surgical wound infections in clean and clean-contaminated surgery: an updated systematic review and meta-analysis
Authors: Tang Xiao-Fei , Bin Xiang , Qu Ke-Yi , Liu Hong-Jun , Lei Haike , Li Wei-Fan , Min Zhou , Xia Yu , Dai Li-Hua , Yu Su-Ying , Bao Yun-Ping , Zhu Jia-Quan , Bing Tan
Published: June 2024

Background:

The efficacy and necessity of prophylactic antibiotics in clean and clean-contaminated surgery remains controversial.

Methods:

The studies were screened and extracted using databases including PubMed, Embase, Cochrane Library, Web of Science, and Clinical Trials.gov according to predefined eligibility criteria. Randomized controlled trials (RCTs) comparing the effect of preoperative and postoperative prophylactic antibiotic use on the incidence of surgical site infections (SSIs) in patients undergoing any clean or clean-contaminated surgery.

Results:

A total of 16 189 participants in 48 RCTs were included in the primary meta-analysis following the eligibility criteria. The pooled odds ratio (OR) for SSI with antibiotic prophylaxis versus placebo was 0.60 (95% CI: 0.53–0.68). The pooled OR among gastrointestinal, oncology, orthopedics, neurosurgery, oral, and urology surgery was 3.06 (95% CI: 1.05–8.91), 1.16 (95% CI: 0.89–1.50), 2.04 (95% CI: 1.09–3.81), 3.05 (95% CI: 1.25–7.47), 3.55 (95% CI: 1.78–7.06), and 2.26 (95% CI: 1.12–4.55), respectively. Furthermore, the summary mean difference (MD) for patients’ length of hospitalization was −0.91 (95% CI: −1.61, −0.16). The results of sensitivity analyses for all combined effect sizes showed good stability.

Conclusion:

Antibiotics are both effective, safe, and necessary in preventing surgical wound infections in clean and clean-contaminated procedures, attributed to their reduction in the incidence of surgical site infections as well as the length of patient hospitalization.
Neoadjuvant chemoimmunotherapy in resectable locally advanced oral squamous cell carcinoma: a single-center retrospective cohort study
Authors: Li Bowen , Xie Shule , Han Jingjing , Cao Haotian , Lin Zhaoyu , Hu Huijun , Pan Chaobin , Li Qunxing , Li Jintao , Wang Liansheng , Chen Suling , Rao Guangxin , Huang Guoxin , Tan Yongmei , Chen Rongxi , Fan Song , Duan Xiaohui , Li Haigang , Li Jinsong
Published: June 2024

Background:

Surgery and postoperative adjuvant therapy is the standard treatment for locally advanced resectable oral squamous cell carcinoma (OSCC), while neoadjuvant chemoimmunotherapy (NACI) is believed to lead to better outcomes. This study aims to investigate the effectiveness of NACI regimens in treating locally advanced resectable OSCC.

Materials and methods:

Patients diagnosed with locally advanced resectable OSCC who received NACI and non-NACI were reviewed between December 2020 and June 2022 in our single center. The pathologic response was evaluated to the efficacy of NACI treatment. Adverse events apparently related to NACI treatment were graded by Common Terminology Criteria for Adverse Events, version 5.0. The disease-free survival (DFS) and overall survival (OS) rate were assessed.

Results:

Our analysis involved 104 patients who received NACI. Notably, the pathological complete response rate was 47.1%, and the major pathological response (MPR) rate was 65.4%. The top three grade 1–2 treatment-related adverse events (TRAEs) were alopecia (104; 100%), anemia (81; 77.9%), and pruritus (62; 59.6%). Importantly, patients achieving MPR exhibited higher programmed cell death-ligand 1 (PD-L1) combined positive scores (CPS). The diagnostic value of CPS as a biomarker for NACI efficacy was enhanced when combined with total cholesterol level. The 3-year estimated DFS rates were 89.0% in the NACI cohort compared to 60.8% in the non-NACI cohort, while the 3-year estimated OS rates were 91.3 versus 64.0%, respectively.

Conclusions:

The NACI treatment showed safe and encouragingly efficacious for locally advanced resectable OSCC patients. The high response rates and favorable prognosis suggest this approach as a potential treatment option. Prospective randomized controlled trials are needed to further validate these findings.
Utility of PSMA-PET derived volumetric parameters in initial risk stratification and prediction of prostate cancer metastasis – a head-to-head comparison of the radiotracers 18F-PSMA-1007 and 68Ga-PSMA-11
Authors: Chandekar Kunal Ramesh , Satapathy Swayamjeet , Singh Harmandeep , Kumar Rajender , Kumar Santosh , Kakkar Nandita , Mittal Bhagwant Rai , Singh Shrawan Kumar
Published: June 2024

Objective

This study aimed to explore and compare the utility of baseline 18F-PSMA-1007 and 68Ga-PSMA-11 PET/computed tomography (CT) derived volumetric parameters in initial risk stratification and prediction of prostate cancer (PCa) metastasis.

Methods

Forty treatment-naïve, biopsy-proven intermediate-/high-risk PCa patients were prospectively recruited. Each patient underwent PET/CT with 68Ga-PSMA-11 and 18F-PSMA-1007 (within 2 weeks). The maximum and mean standardized uptake values (SUVmax and SUVmean) of primary tumor, prostate PSMA-tumor volume (PSMA-TVp), and prostate total lesion PSMA (TL-PSMAp) were measured.

Results

PSMA-TVp and TL-PSMAp (with both radiotracers) mostly exhibited moderate-to-strong correlation with Gleason score, serum prostate-specific antigen level and clinical tumor stage (Spearman ρ = 0.361–0.783, P-values ≤0.022). Primary tumor SUVmax values were similar across initial risk categories. PSMA-TVp and TL-PSMAp, however, were significantly higher in high-risk PCa compared to intermediate-risk PCa (P-values ≤0.001). Receiver operating characteristic (ROC) curve analysis revealed that F-PSMA-TVp, Ga-PSMA-TVp, F-TL-PSMAp, and Ga-TL-PSMAp (optimal cutoff values of 20.9, 23.4, 142.5, and 144.8, respectively) could effectively differentiate high-risk from intermediate-risk PCa [area under the ROC curve (AUCs) 0.859–0.898, P-values <0.001] with high sensitivity (~68.8–75%) and excellent specificity (100%). PSMA-TVp and TL-PSMAp (with both radiotracers) could predict presence of regional and extraregional nodal metastasis (AUCs 0.703–0.801, P-values ≤0.03) with moderate sensitivity (~47.8–70.6%) and excellent specificity (~82.6–94.1%).

Conclusion

Our results suggest that baseline PSMA-PET primary tumor volumetric parameters provide a noninvasive, objective, and accurate index for initial risk stratification and can predict presence of regional and extraregional nodal metastasis in PCa patients. Larger studies are warranted to evaluate their incremental role over conventional parameters.
Evaluation of Empiric Voriconazole Dosing and Therapeutic Drug Monitoring in Hospitalized Pediatric Patients
Authors: Schweiger Jennifer A. , Heiden Alyssa M. , MacBrayne Christine E.
Published: June 2024

Invasive fungal infections are a significant cause of morbidity and mortality in children with immunodeficiencies. Current dosing recommendations for voriconazole often result in subtherapeutic exposure in pediatric patients. In this single-center retrospective study, we reviewed hospitalized pediatric patients receiving voriconazole with at least one inpatient serum trough concentration measured. Patient characteristics and voriconazole dosing courses with associated trough concentrations were summarized for all patients as well as grouped by age (0 to 1 y, 2 to 11 y, and 12 to 18 y). Of 106 included patients, the median age was 9 years (range, 29 d to 18 y). Five hundred ninety courses of voriconazole were administered with 365 associated troughs. Most troughs were subtherapeutic (49%) and 30% of patients never attained a therapeutic trough. The median oral daily dose associated with a therapeutic trough was higher in younger age groups: 21.6 mg/kg 0 to 1 year, 17.9 mg/kg 2 to 11, and 9.5 mg/kg 12 to 18 years (P<0.001). Patients younger than 2 years had the largest proportion of subtherapeutic troughs and variability in dosing. Attainment of therapeutic voriconazole concentrations was challenging across all pediatric age groups. Higher starting doses for patients younger than 2 years are likely needed.
Hereditary Spherocytosis with Mitochondrial Retention, Increased Oxidative Stress, and Alterations to Bioactive Membrane Lipids
Authors: Principe Daniel R. , Reilly Paige , Dhavamani Sugasini , Rivers Angela , Molokie Robert , Hsu Lewis L. , Ramasamy Jagadeesh
Published: June 2024

The clinical course for Hereditary Spherocytosis (HS) patients is highly varied, even within families with identical driving mutations. Here, we describe four siblings with HS attributed to an unreported SPTB mutation. All patients displayed an increased fraction of mitochondria-positive erythrocytes. This was associated with increased reactive oxygen species (ROS) generation and alteration to alterations to bioactive membrane lipids associated with oxidant stress. Given the early promise for mitophagy-inducing agents in sickle cell disease and ready availability of antioxidants, this concept warrants continued exploration as a disease-modifying factor and a potential target for therapy.
A Randomized, Controlled Trial of Continuous Heparin Infusion to Prevent Asymptomatic Catheter-Related Thrombosis at Discharge in Infants After Cardiac Surgery: The CHIP-CRT Trial
Authors: Tan Yuyu , Sun Xin , Zhong Jing , Zou Youqun , Ren Yuan , Liu Yumei , Zhao Lijie , Zhuang Jian , Wang Sheng , Sun Yunxia , Wang Yifei
Published: June 2024

Objectives:

There are conflicting results in preventing catheter-related thrombosis (CRT). Continuing infusion of unfractionated heparin (UFH) was a potential option for CRT. This study was to determine the effect of continuous UFH infusion on asymptomatic CRT at discharge in infants after cardiac surgery.

Study Design:

This study was a randomized, placebo-controlled, clinical trial at a single center. All infants with central venous catheters after cardiac surgery, below 3 months of age, were eligible. Stratified by CRT, infants were randomly assigned to the UFH group or the normal saline group. UFH was initiated at a speed of 10 to 15 units/kg/h for infants with CRT and 2 to 3 units/kg/h without CRT. The primary outcome was to determine the rate of CRT at discharge. The secondary outcomes included thrombosis 6 months after surgery, adverse events of UFH, and post-thrombotic symptoms.

Results:

Due to slow recruitment during the COVID-19 pandemic, this trial was prematurely stopped. Only 35 infants were randomly assigned to the UFH or control groups. There was no statistically significant difference in CRT rate at discharge (P=0.429) and 6 months after surgery (P=1.000) between groups. All CRTs except one disappeared at discharge. No thrombosis or post-thrombotic symptom was reported at follow-up evaluation. There was no difference between groups in duration of thrombus (P=0.088), D dimer (P=0.412), catheter in situ days (P=0.281), and post-thrombotic syndrome (P=1.000), except for activated partial thromboplastin time (P=0.001).

Conclusions:

With the early stop of this trial and limited data, it is difficult to draw a definitive conclusion about the efficacy of UFH on CRT. Meanwhile, considering the data from 6 months follow-up, in this population, asymptomatic CRT might resolve with no intervention.
Achievement Goal Theory and Mindsets
Authors: Williams Cheryl
Published: June 2024

Background:

Many nursing schools are transitioning to a competency-based model due to the increasing complexity of medical information, skills, task acuities, and cognitive overload.

Problem:

Nursing faculty may not be familiar with the synergy between achievement goal theory and the growth mindset (GM) model to prepare nursing students within a competency-based model effectively.

Approach:

This article presents a persuasive argument for how integrating achievement goal theory and the GM model could effectively foster mastery goals essential for competency development.

Conclusions:

Mastery goals, a component of the GM model, can be used as tangible indicators for assessing and evaluating competency development.
Association of retinal image–based, deep learning cardiac BioAge with telomere length and cardiovascular biomarkers
Authors: Vaghefi Ehsan , An Songyang , Corbett Rini , Squirrell David
Published: June 2024

SIGNIFICANCE

Our retinal image–based deep learning (DL) cardiac biological age (BioAge) model could facilitate fast, accurate, noninvasive screening for cardiovascular disease (CVD) in novel community settings and thus improve outcome with those with limited access to health care services.

PURPOSE

This study aimed to determine whether the results issued by our DL cardiac BioAge model are consistent with the known trends of CVD risk and the biomarker leukocyte telomere length (LTL), in a cohort of individuals from the UK Biobank.

METHODS

A cross-sectional cohort study was conducted using those individuals in the UK Biobank who had LTL data. These individuals were divided by sex, ranked by LTL, and then grouped into deciles. The retinal images were then presented to the DL model, and individual's cardiac BioAge was determined. Individuals within each LTL decile were then ranked by cardiac BioAge, and the mean of the CVD risk biomarkers in the top and bottom quartiles was compared. The relationship between an individual's cardiac BioAge, the CVD biomarkers, and LTL was determined using traditional correlation statistics.

RESULTS

The DL cardiac BioAge model was able to accurately stratify individuals by the traditional CVD risk biomarkers, and for both males and females, those issued with a cardiac BioAge in the top quartile of their chronological peer group had a significantly higher mean systolic blood pressure, hemoglobin A1c, and 10-year Pooled Cohort Equation CVD risk scores compared with those individuals in the bottom quartile (p<0.001). Cardiac BioAge was associated with LTL shortening for both males and females (males: −0.22, r
2 = 0.04; females: −0.18, r
2 = 0.03).

CONCLUSIONS

In this cross-sectional cohort study, increasing CVD risk whether assessed by traditional biomarkers, CVD risk scoring, or our DL cardiac BioAge, CVD risk model, was inversely related to LTL. At a population level, our data support the growing body of evidence that suggests LTL shortening is a surrogate marker for increasing CVD risk and that this risk can be captured by our novel DL cardiac BioAge model.
Recent Single-Family Home Buyer Knowledge, Attitudes, and Behaviors Related to Lead and Radon Exposure Prevention
Authors: Dignam Timothy , Flanders W.D. , Neri Antonio , Gallaway Michael Shayne
Published: June 2024

Context: Federal law requires property owners to disclose the presence of known lead-based paint and/or lead hazards to potential home buyers and renters in homes built before 1978. Objective: Using 2015-2016 randomized survey data, we measured lead and radon knowledge, awareness, and exposure avoidance practices. Setting: Home buyers from 4 US states (Illinois, Minnesota, North Carolina, and Ohio). Participants: 477 recent, single-family pre-1978 dwelling home buyers. Main Outcome Measure(s): Predictors of the home buyer decision to purchase the home during the entire home buying experience based on their understanding of health issues related to lead-based paint and radon exposure. Results: Personal networks (22%) and real estate agents (21%) were the most common sources of health-related lead information. Many home buyers (77%) reported that their awareness of lead did not affect their purchasing decision, and 78% could not confirm that their homes were tested for lead. Respondents who understood lead-related health effects were 5.4 times more likely (95% CI, 1.7–17.5) to have their decision to buy a home affected when their real estate agent discussed lead-based paint issues. Many home buyers reported either they did not remember (37%) or did not sign (20%) the federal law requirement that property owners reveal known lead paint hazards to prospective buyers before a property is sold. Home buyers with awareness of health issues caused by radon were 1.7 times (95% CI, 1.4–2.1) more likely than those who understood lead-related health issues to have their decision to buy the home affected. Conclusion: Real estate agents play an important role to increase awareness of potential lead-based paint health issues when people buy older homes. Home buyer knowledge, awareness, and practice of radon exposure prevention was greater compared to lead exposure prevention. More than half of home buyers did not sign or remember signing lead disclosure paperwork.
Efficacy of Repetitive Transcranial Magnetic Stimulation over the Supplementary Motor Area on Motor Function in Parkinson's Disease: A Meta-Analysis
Authors: Lu Qi-qi , Zhu Ping-an , Li Zhi-liang , Holmes Clayton , Zhong Yu , Liu Howe , Bao Xiao , Xie Ju-Ying
Published: June 2024

ABSTACT

Objectives

The objective of this study was to assess the effect of repetitive transcranial magnetic stimulation (rTMS) on the supplementary motor area (SMA) in motor function in Parkinson's disease (PD) patients.

Method

Databases searched included 5 databases from October 7,2022 to January 4, 2023. The Cochrane Bias Risk Assessment Tool was used for quality assessment. Standardized mean differences (SMDs) were calculated using a random-effects model. Outcome measure is the motor function examination of the motor part of Unified Parkinson's Disease Rating Scale (UPDRS-III).

Results

Seven studies totaling 374 patients were included. Meta-analysis showed that stimulation of SMA significantly improved motor function in PD patients compared with sham stimulation (SMD = -1.24; 95% CI, -2.24 to -0.24; P = 0.02; I2
= 93%). Stimulation of the same target (SMA), subgroup analysis showed that high-frequency rTMS (HF-rTMS) is more effective than low-frequency rTMS (LF-rTMS) in improving motor function in PD (SMD = -1.39; 95% CI, -2.21 to -0.57; P = 0.04; I2
= 77.2%).

Conclusions

Overall, rTMS over SMA had a statistically significant improvement in motor function in PD patients, and HF-rTMS is statistically significantly more effective than LF-rTMS.