bluuebunny/crossref_metadata_2025 huggingface dataset:
The effectiveness of convalescent plasma administered on the first day of admission for COVID-19 patients: an open-label randomized controlled trial
Authors: Mohammadi Saeed , Pouladzadeh Mandana , Kouhpayeh Hamidreza , Okati Shamsi , Safdarian Mehdi , Eshghi Peyman , Choghakabodi Parastoo Moradi , Mashaei Shahabeddin , Sistani Sharareh Sanei , Khani Yalda , Nasizadeh Soheila , Shamshiri Ahmad Reza , Teimourpour Amir
Published: November 2024

Background:

Given the controversial reports on the effect of convalescent plasma (CP) on coronavirus disease 2019 (COVID-19) patients, this study aimed to clarify the efficacy of early CP administration, improve the understanding of its impact on clinical outcomes, guide future research, address safety concerns, and inform public health policies.

Methods:

In this prospective, multicenter, randomized controlled trial conducted at Razi Hospital (Ahvaz) and Bouali Hospital (Zahedan) in Iran, 232 confirmed COVID-19 patients were randomly assigned into two groups using a computer-generated randomization method. The treatment group (n = 116) received CP with anti-severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) IgG titer ≥1/160 on the first day of admission, along with routine antiviral medications, while the control group received only routine medications (n = 116). Recruitment occurred from 1 March to 30 July 2020, with two months of post-intervention follow-up. The primary outcome was two-month mortality, and secondary outcomes included CP-related side effects and various clinical and laboratory parameters.

Results:

No significant differences were observed between the groups in terms of age (P = 0.119), sex (P = 0.418), comorbidities (P > 0.05), or pre- and post-treatment changes in temperature, lymphocyte count, erythrocyte sedimentation rate, or platelet count (all P > 0.05). Despite a higher CT severity score at admission in the treatment group (P < 0.001), improvements in respiratory rate, C-reactive protein, and lactate dehydrogenase occurred earlier and were more pronounced compared to the control group (P < 0.05). No side effects related to CP therapy were observed during infusion or follow-up. However, no significant differences were observed between the groups in the mortality rate or length of hospitalization. The mortality rate in the treatment group was 11.2% (13/116), compared to 17.2% (20/116) in the control group (P = 0.130). The median hospital stay was 7 days (95% CI: 6–8 days) for the treatment group and 6 days (95% CI: 5–7 days) for the control group (P = 0.560).

Conclusion:

While administering CP with a high titer of anti-SARS-CoV-2 IgG early in infection may improve vital signs and laboratory parameters in COVID-19 patients, it does not significantly reduce mortality risk or length of hospitalization compared to routine medications. Overall, the treatment appears to have few side effects, suggesting it may be a safe option for further evaluation in managing early COVID-19 symptoms.

Trial registration:

This prospective, multicenter, two-parallel randomized controlled trial was prospectively registered in the Iranian Clinical Trials Registry (IRCT20200310046736N1).
Quality of Life in Patients With Acquired Anophthalmia Using an Ocular Prosthesis
Authors: Meer Elana , Miller Amanda C. , Ahmad Meleha , Arnold Benjamin F. , Kersten Robert C. , Grob Seanna R. , Winn Bryan J. , Afshar Armin R. , Vagefi M. Reza
Published: November 2024

Purpose:

To employ a validated survey for evaluation of quality of life (QoL) outcomes and associated factors in a US cohort of adult patients with acquired anophthalmia wearing a prosthesis.

Methods:

A retrospective cohort study was performed at a single, US academic institution of patients cared for between 2012 and 2021. The electronic medical record database was queried for adult patients with a history of evisceration or enucleation surgery and placement of an orbital implant. Identified patients were asked to anonymously complete a validated QoL questionnaire from which the Global Ocular Prosthesis Score was assessed. Summary statistics were reported, and analysis of variance was used to determine surgical and demographic factors associated with QoL survey scores.

Results:

A total of 81 patients completed the questionnaire. Mean age was 45.8 years (range: 18–96 years), and 54.3% of patients identified as women. Enucleation was performed in 81.4% of eyes (n = 66), while the remaining 17.3% underwent evisceration (n = 14). The mean and median Global Ocular Prosthesis Score (out of 100) were 67.51 and 68.00, respectively. Multivariate analysis demonstrated the etiologies of glaucoma (95% confidence interval: 0.84–25.40, p = 0.04) and endophthalmitis (95% confidence interval: 0.41–23.72, p = 0.04) to be significantly associated with higher total Global Ocular Prosthesis Score. Several other factors including employment status, etiology of anophthalmia, gender, and level of education were also significantly associated with subdomain scores (p < 0.05).

Conclusions:

Among patients with anophthalmia wearing an ocular prosthesis, the etiology of anophthalmia was significantly associated with the Global Ocular Prosthesis Score. Employment status, etiology of anophthalmia, gender, and level of education were also observed to have statistically significant associations with subdomain scores. Knowledge of these factors moving forward may help the surgeon manage expectations, mitigate challenges, and promote higher QoL outcomes for patients with acquired anophthalmia.
Pain catastrophizing and pain anxiety mediate changes in physical function in a mind–body intervention for adults with traumatic orthopedic injuries
Authors: Gnall Katherine E. , Jochimsen Kate N. , Brewer Julie R. , Bakhshaie Jafar , Vranceanu Ana-Maria
Published: November 2024

Traumatic orthopedic injuries are common and frequently associated with persistent pain, disability, and emotional distress. Risk factors of persistent pain and disability include pain catastrophizing and pain anxiety, though most interventions for orthopedic injuries are primarily biomedical (eg, surgeries, pharmacology, physiotherapy/exercise). The Toolkit for Optimal Recovery (TOR) is a brief, live video mind–body program designed to directly target pain catastrophizing and anxiety in patients with recent traumatic orthopedic injury to prevent persistent disability. This study was a secondary analysis from a recently completed multisite feasibility RCT of TOR compared with Minimally Enhanced Usual Care (MEUC). We examined the extent to which the purported mechanisms of change in TOR (ie, reductions in pain catastrophizing and anxiety) mediate improvement in physical function. Participants with a recent orthopedic trauma (N = 195; M

age
= 44.01) recruited from 4 Level I trauma centers were randomized to TOR or MEUC and completed self-report surveys at baseline, postintervention, and follow-up (3 months after baseline). A multiple mediation analysis using multilevel structural equation modeling (MSEM) demonstrated that pain catastrophizing (b = −5.22, SE = 3.02, Bootstrapped 95% CIs = -0.04, -12.37) and pain anxiety (b = −8.45, SE = 3.59, Bootstrapped 95% CIs = -0.04, -12.37) each significantly mediated improvement in physical function. Overall, findings elucidate the mechanistic role of TOR's primary treatment targets (ie, reductions in pain catastrophizing and anxiety) in improving physical function. Findings highlight the importance of targeting pain catastrophizing and pain anxiety early after orthopedic injury through psychosocial interventions such as TOR.
Individual differences in conditioned pain modulation are associated with functional connectivity within the descending antinociceptive pathway
Authors: Li Janet Z. , Mills Emily P. , Osborne Natalie R. , Cheng Joshua C. , Sanmugananthan Vaidhehi V. , El-Sayed Rima , Besik Ariana , Kim Junseok A. , Bosma Rachael L. , Rogachov Anton , Davis Karen D.
Published: November 2024

The perception of pain and ability to cope with it varies widely amongst people, which in part could be due to the presence of inhibitory (antinociceptive) or facilitatory (pronociceptive) effects in conditioned pain modulation (CPM). This study examined whether individual differences in CPM reflect functional connectivity (FC) strengths within nodes of the descending antinociceptive pathway (DAP). A heat-based CPM paradigm and resting-state functional magnetic resonance imaging (rs-fMRI) were used to test the hypothesis that an individual's capacity to exhibit inhibitory CPM (changes in test stimuli [TS] pain due to a conditioning stimulus [CS]) reflects FC of the subgenual anterior cingulate cortex (sgACC), periaqueductal gray (PAG), and rostral ventromedial medulla (RVM). A total of 151 healthy participants (72 men, 79 women) underwent CPM testing and rs-fMRI. Three types of CPM were identified based on the effect of the CS on TS pain: (1) Antinociception: CS reduced TS pain in 45% of participants, (2) No-CPM: CS did not change TS pain in 15% of participants, and (3) Pronociception: CS increased TS pain in 40% of participants. Only the Antinociceptive subgroup exhibited FC between the left sgACC and PAG, right sgACC and PAG, and RVM and PAG. Furthermore, only the Antinociceptive subgroup exhibited a correlation of both left and right sgACC-RVM FC (medium effect sizes) with CPM effect magnitude. Women, compared with men were more likely to be categorized as pronociceptive. These data support the proposition that FC of the DAP reflects or contributes to inhibitory CPM.
Minimally invasive versus open surgery for nonfunctioning pancreatic neuroendocrine tumors: a systematic review and meta-analysis
Authors: Wei Kongyuan , Zheng Qingyong , Cheng Luying , li Wei , Nießen Anna , Uzunoglu Faik G. , Nickel Felix , Tian Jinhui , Wang Zheng , Hackert Thilo
Published: November 2024

Introduction:

Nonfunctioning pancreatic neuroendocrine tumors (NF-PNETs) have been diagnosed increasingly often but still represent rare pancreatic neoplasms. Surgery is a potentially curative approach for patients with NF-PNETs. In recent years, minimally invasive surgery (MIS) has been applied more frequently for surgical resection of NF-PNETs. The evidence for using MIS for NF-PNETs is still being determined and controversial.

Materials and Methods:

PubMed, Cochrane Library, and the Web of Science database were searched systematically from its inception to July 2023. All studies comparing MIS versus open surgery (OPS) of NF-PNETs were included. The primary outcomes were the incidence of overall postoperative complications and pancreas-specific complications [postoperative pancreatic fistula (POPF) and delayed gastric emptying (DGE)]. The secondary measures were duration of operation, intraoperative blood loss, and length of postoperative hospital stay. Pooled results are presented as odds ratios (OR) or mean difference (MD) with a 95% CI.

Results:

Five observational studies with a total of 1178 patients were included in the final analysis. The meta-analysis indicated that MIS attained less intraoperative blood loss (MD=−58.59, 95% CI [−92.76 to −24.41], P<0.01) and shorter length of hospital stay (MD=−3.07, 95% CI [−5.28 to −0.87], P<0.01) in contrast to open surgery for NF-PNETs. There were no significant differences concerning operative time (MD=52.04, 95% CI [−8.74 to 112.81], P=0.67), overall postoperative complications (OR=0.78, 95% CI [0.59–1.03], P=0.08), POPF (OR=0.99, 95% CI [0.66–1.47], P=0.94), and DGE (OR=0.58, 95% CI [0.58–1.42], P=0.67).

Conclusions:

This study demonstrates that minimally invasive surgery for NF-PNETs is safe and associated with a considerably shorter postoperative hospital stay. Further studies are needed to verify the evidence.
Long-term mortality of coronavirus disease 2019 critically ill patients that required percutaneous tracheostomy in Chile: A multicenter cohort study
Authors: Ulloa-Morrison Rodrigo , Escalona José , Navarrete Pablo , Espinoza Javiera , Bravo Sebastián , Pastore Antonia , Reyes Sebastián , Bozinovic Milan , Abbott Francisco , Pairumani Ronald , Noguera Roselyn , Vera Magdalena , González Felipe , Valle Felipe , Bakker Jan , Bugedo Guillermo , Kattan Eduardo
Published: November 2024

Background:

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection leads to mechanical ventilation (MV) in approximately 20% of hospitalized patients. Tracheostomy expedites weaning of respiratory support. Moreover, there is a paucity of data regarding long-term outcomes of tracheostomized coronavirus disease 2019 (COVID-19) patients. The objective of this study was to describe 1-year mortality in a cohort of COVID-19 critically ill patients who required percutaneous tracheostomy in Chile and to assess the impact of age on outcomes.

Methods:

A multicenter prospective observational study was conducted in 4 hospitals in Chile between March 2020 and July 2021. Patients with confirmed SARS-CoV-2 infection connected to MV and required percutaneous tracheostomy were included. Baseline data, relevant perioperative and long-term outcomes, such as 1-year mortality, MV duration, intensive care unit (ICU), and hospital length of stay were registered. Patients were dichotomized according to age group (< and ≥ 70 years). Univariate and multivariate logistic regressions were performed to identify predictors of 1-year mortality.

Results:

Of 1319 COVID-19 ventilated critically ill patients, 23% (304) required a percutaneous tracheostomy. One-year mortality of the study group was 25% (20.2%-30.3%). ICU and hospital length of stay (LOS) were of 37 (27-49) and 52 (40-72) days. One-year mortality was higher in patients ≥ 70 years (36.9% vs. 21.2%, P = 0.012). Multivariate analysis confirmed age and baseline sequential organ failure assessment (SOFA) score as independent predictors, while time from intubation to tracheostomy was not.

Conclusion:

In COVID-19 critically ill patients who required percutaneous tracheostomy in Chile, the 1-year mortality rate was 25%, with a relevant impact of age on outcomes. An appropriate patient selection likely accounted for the low mortality rate. Future studies should confirm these results.
Harvi Cardiovascular Modeling Accurately Predicts Hemodynamic Improvements Produced by a New Direct Cardiac Compression Device
Authors: Perez Erica C. , Bolch Christina M. , Tompkins Reagan M. , Burkhoff Daniel , Letsou George V. , Criscione John C.
Published: November 2024

Despite advancements in mechanical circulatory support (MCS) technology, persistent critical complications related to blood contact remain unresolved. To provide a safer alternative therapy, CorInnova is developing a non-blood contacting direct cardiac compression (DCC) device for MCS. To support product development toward clinical trials, a simulation platform has been developed to predict clinical outcomes under patient-specific conditions, guiding patient selection for clinical trials. The Harvi simulation was validated using preclinical in vivo data from experimental studies with the CorInnova device, with n = 28 hemodynamic samples simulated from animal data (n = 4 ovine). After confirming validation, further simulation was performed to predict additional hemodynamic outcomes not captured in animal studies. The simulated effects of CorInnova device therapy were not significantly different from animal data for cardiac output, systemic arterial blood pressure, mean pulmonary artery pressure, central venous pressure, or left ventricular pressure (p > 0.050). Harvi accurately predicts the effects of the CorInnova device in heart failure conditions and can be used in preparation for future clinical trials.
The persistent problem of persistent air-leaks: approach to management
Authors: Mundanchira George , Frye Laura , Reisenauer Janani , Agrawal Abhinav
Published: November 2024

Purpose of review

Persistent air leaks, defined as an air leak extending beyond 5 days, pose a significant challenge for cardiothoracic surgeons and pulmonologists. Although current guidelines advocate for surgical intervention as the primary treatment, many patients may not suitable candidates for immediate return to the operating room. Alternatively, conservative management, which involves watchful waiting for pleural healing, often results in prolonged hospital stays and increased morbidity.

Recent findings

Although current guidelines advocate for surgical intervention as the primary treatment, many patients may not suitable candidates for immediate return to the operating room. Alternatively, conservative management, which involves watchful waiting for pleural healing, often results in prolonged hospital stays and increased morbidity. For patients who are not surgical candidates, use of autologous blood patch, pleurodesis or endobronchial valves may offer a viable alternative to conservatively manage air leak.

This review evaluates the various noninvasive therapies that have been explored, including sealants, Heimlich valves, chemical and autologous blood patch pleurodesis, and endo and intrabronchial valves. Although these alternatives show promise, further research is needed to compare these treatments before they can be recommended in new guidelines.
Psychological Distress as a Mediator Between Work-Family Conflict and Nurse Managers' Professional and Organizational Turnover Intentions
Authors: Labrague Leodoro J.
Published: November 2024

OBJECTIVE

This study aimed to investigate the mediating role of psychological distress in the relationship between work-family conflict and nurse managers' (NMs') professional and organizational turnover intentions.

BACKGROUND

Work-family conflict is prevalent among NMs. It can have a significant impact on their intent to leave their organization and the profession. However, the role of psychological distress as a potential mediator in the relationship between work-family conflict and turnover intentions has not been studied in the context of NMs.

METHODS

A cross-sectional design was used, and data were collected from a sample of 260 NMs using self-report questionnaires.

RESULTS

NMs experienced a moderate level of work-family conflict and psychological distress. Organizational turnover intention was moderate, whereas professional turnover intention was low. Higher levels of work-family conflict among NMs contributed to increased psychological distress, which, in effect, influenced their desire to leave the organization.

CONCLUSION

To support NMs and mitigate turnover intentions, healthcare organizations need to prioritize the creation of a work environment that promotes work-life balance and reduces psychological distress.
A Preliminary Qualitative Exploration of the Lived Experiences of Presenteeism Among Taiwanese Nursing Staff
Authors: Hung Shiao-Pei , Ming Jin-Lain , Tsao Lee-Ing , Jeng Chii
Published: November 2024

OBJECTIVE

The aim of this study was to explore the lived experiences of presenteeism among Taiwanese nursing staffs.

BACKGROUND

Presenteeism is a subjective and multifaceted experience, but nurses have rarely been invited to provide their own views of presenteeism.

METHODS

A qualitative study based on content analysis was conducted. Fifteen participants were recruited. Data were collected through face-to-face interviews and analyzed using the constant comparative method.

RESULTS

Four key categories and their subcategories were identified: 1) burden of being forced to attend work; 2) physical or mental discomfort; 3) predisposing factors; and 4) binding duty.

CONCLUSION

This preliminary study provides guidance for administrators to establish a healthy workplace and maintain quality patient care. Managers should understand the predisposing factors that lead to absenteeism, such as insufficient staffing, and propose effective measures. This study contributes to the development of research and measurement tools, adds preliminary data, and explores nursing staff presenteeism.
The Importance of Frailty in Older Adults With Benign Paroxysmal Positioning Vertigo
Authors: Pauwels Sara , Lemkens Nele , Lemmens Winde , Meijer Kenneth , Meyns Pieter , Berg Raymond V. D. , Spildooren Joke
Published: November 2024

Background and Purpose:

Even though Benign Paroxysmal Positioning Vertigo (BPPV) is one of the most reported vestibular disorders, its interaction with frailty and postural control in older adults is hardly or not investigated.

Methods:

Thirty-seven older adults (≥65 years) with a diagnosis of BPPV (oaBPPV) (mean age 73.13 (4.8)) were compared to 22 age-, weight-, and height-matched controls (mean age 73.5 (4.5)). Modified Fried criteria were used to assess frailty. Postural control was assessed with the timed chair stand test, mini Balance Systems Evaluation test (mini-BESTest), a Clinical Test of Sensory Interaction on Balance (CTSIB), and 10-m walk test. Falls were inquired. The Dizziness Handicap Inventory, Falls Efficacy Scale, and 15-item Geriatric Depression Scale assessed dizziness-related handicap, fear of falling, and feelings of depression, respectively. To assess the importance of frailty, all variables were also compared between frail oaBPPV, robust oaBPPV, and robust controls in a sub-analysis. The significance level was set at α = 0.05.

Results:

oaBPPV reported significantly more multiple falls (P = 0.05) and difficulties to remain standing with increasing task difficulty of the CTSIB (P = 0.004). They were significantly more (pre-)frail compared to controls (P < 0.001). Moreover, frail oaBPPV had a significantly decreased reactive postural control (P < 0.001) and dynamic gait (P < 0.001). Their fear of falling (P < 0.001) and dizziness-related handicap (P < 0.001) were significantly higher compared to robust oaBPPV.

Discussion and Conclusions:

oaBPPV were less healthy and more (pre-)frail compared to controls, impacting their daily functioning. Future research should investigate whether frailty and postural control were already decreased before the BPPV onset and if this recovers after treatment with repositioning maneuvers or if additional rehabilitation is necessary.

Impact Statement:

Older adults with Benign Paroxysmal Positional Vertigo (BPPV) can present with an impaired sensory orientation, declined cognition, significantly more multiple falls, and (pre-)frailty compared to controls. Moreover, frail older adults with BPPV also had a significantly decreased reactive postural control and dynamic gait, and an increased odds of falling compared to robust controls. BPPV and frailty appear to be linked with each other, which cannot be ignored in future research and clinicians treating older adults with BPPV.
Serum Phosphorus and Hypophosphatemia During Therapy of Diabetic Ketoacidosis in Children: Single-Center, Retrospective Cohort 2016–2022
Authors: Hasan Rashed A. , Hesen Jacob Z. , Millican Nicklaus , Pederson John M. , Agus Michael S. D.
Published: November 2024

OBJECTIVES:

To assess factors associated with serum phosphorus (P) and hypophosphatemia in children with type 1 diabetes mellitus (T1DM) treated for diabetic ketoacidosis (DKA).

DESIGN:

Retrospective cohort.

SETTING:

Community-based PICU in a university-affiliated hospital.

PATIENTS:

Patients 1–20 years old with T1DM hospitalized for DKA from July 1, 2016, to July 31, 2022.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

We collected age, sex, duration of T1DM, conscious state at presentation, and most recent glycohemoglobin level. P was tested initially and then every 4 hours. Probability of hypophosphatemia and time to hypophosphatemia and hospital length of stay (LOS) were analyzed via binomial and linear mixed-effects regression analyses, respectively. A total of 852 DKA episodes occurred in 365 patients (46.3% female, median age 14.7 yr), of which 158 (18.5%) episodes were new-onset T1DM. Hypophosphatemia developed during 656 of 852 (77%) episodes, including 49 of 852 (5.8%) episodes of severe hypophosphatemia with median (interquartile range) onset 8.0 hours (4.7–11.9 hr) and 12.0 hours (8.1–17.6 hr), respectively, following initiation of therapy. Higher glycohemoglobin was associated with greater odds of hypophosphatemia (odds ratio [OR], 1.22; p < 0.001). However, lower odds of hypophosphatemia were associated with older age (OR, 0.89; p < 0.01), male (OR, 0.11; p = 0.01), longer T1DM duration (OR, 0.87; p < 0.001), and having initial normal conscious state (OR, 0.18; p < 0.01). Older age (3.0%/yr; p = 0.02), T1DM duration (4.1%/yr; p = 0.01), and initial serum P (23.4%/mg/dL; p < 0.001) were associated with later hypophosphatemia. LOS was shorter with increased T1DM duration (3.6%/yr; p < 0.001) and normal conscious state (33.1% shorter; p < 0.001), but longer with increasing glycohemoglobin (4.0%; p < 0.001). All patients survived with normal neurologic function.

CONCLUSIONS:

Higher glycohemoglobin was associated with greater odds of hypophosphatemia and longer LOS. Older male, longer duration of T1DM, and conscious at admission were factors associated with lower odds of developing hypophosphatemia and with later onset when it occurred. Hypophosphatemia was associated with longer LOS.
Dementia and Emergency Department Use in Older Adults With Systemic Lupus Erythematosus
Authors: Lieber Sarah B. , Nahid Musarrat , Navarro-Millán Iris , Rajan Mangala , Sattui Sebastian E. , Reid M. Carrington , Mandl Lisa A.
Published: November 2024

Background/Objective

Systemic lupus erythematosus (SLE) is associated with increased dementia risk. Whether this association is present among older adults with SLE is unclear. Further, whether individuals with concomitant SLE and dementia are at increased risk of emergency department (ED) use has not been explored. Using US Centers for Medicare & Medicaid Services (2006–2015) administrative claims data, we (1) quantified long-term all-cause dementia prevalence in adults with SLE ≥65 years of age and (2) determined whether dementia duration is associated with risk of ED visits in a cohort of older adults with SLE relative to comparators.

Methods

Medicare beneficiaries ≥65 years of age with SLE and age- and sex-matched comparators (1:4) with osteoarthritis were identified at baseline (2006). Dementia was considered a time-varying exposure, updated annually. Mixed-effect Poisson regression was used to estimate the effect of dementia duration on risk of multiple ED visits for the study period (January 2006 to September 2015), adjusting for relevant covariates.

Results

Baseline dementia prevalence was similar among beneficiaries with SLE (n = 1338 [4.6%]) and non–systemic rheumatic disease (non-SRD) comparators (n = 5352 [5.7%]). Stronger association between dementia duration and ED use was observed in older adults with SLE, including after adjustment for covariates (SLE: incidence rate ratio, 1.10; 95% confidence interval, 1.07–1.13; non-SRD: incidence rate ratio, 1.05; 95% confidence interval, 1.03–1.06).

Conclusions

Although dementia prevalence was similar between older adults with SLE and non-SRD comparators, dementia duration had a greater impact on ED use in aging adults with SLE versus non-SRD comparators. Geriatric assessment may be especially important in older adults with SLE.
An Unexpected Mediastinal Fibrosis Case Detected and Evaluated of Treatment Response With 18F-FDG PET/CT
Authors: Akgun Elife , Kaya Meryem
Published: November 2024

IgG4-releated disease is systemic fibroinflammatory disease characterized by infiltration of IgG4-positive plasma cells in the affected tissue. Mediastinal fibrosis, which is also known as fibrosing mediastinitis, is a rare form of IgG4-releated disease. We present a case of mediastinal and retroperitoneal fibrosis in 52-year-old man who was detected with increased radiopharmaceutical uptake in 18F-FDG PET/CT imaging.
FDG PET/CT in a Case of Metastasizing Pleomorphic Adenoma in the Ilium
Authors: Xiao Zhengguang , Dong Aisheng , Wang Yang , Yao Weiwu , Bai Yushu
Published: November 2024

Although pleomorphic adenomas of the salivary glands are benign tumors, they can metastasize to distant organs without evidence of malignant transformation. We describe FDG PET/CT finding in a case of metastasizing pleomorphic adenoma in the right ilium occurring 22 years after initial surgical resection of a lip pleomorphic adenoma. On FDG PET/CT, the iliac metastasis appeared as an expansile osteolytic lesion with heterogeneous activity. This case indicates that metastasizing pleomorphic adenoma, although rare, should be included in the differential diagnosis of FDG-avid osteolytic bone lesions in patients with a history of salivary gland pleomorphic adenoma.
Re-Rechallenge 177Lu-PSMA-617 Radioligand Therapy in Metastatic Castration-Resistant Prostate Cancer
Authors: Aggarwal Piyush , Gunasekaran Vinisha , Sood Ashwani , Kumar Narendra , Rathore Yogesh , Kumar Rajender , Mittal Bhagwant Rai
Published: November 2024

177Lu-PSMA-617 radioligand therapy has been US Food and Drug Administration–approved safe and effective treatment modality for metastatic castration-resistant prostate cancer, usually administered in 4 to 6 cycles at 6 to 8 weeks apart. Many patients achieve partial response or stable disease with biochemical response after treatment. However, these effects are usually short-lived, and patients ultimately show disease progression after a median period of 6 to 9 months. Rechallenge therapy appears to be safe and effective treatment modality in such patients. We show the clinical efficacy and safety of re-rechallenge 177Lu-PSMA radioligand therapy in a 64-year-old man with metastatic castration-resistant prostate cancer with disease progression on multiple lines of hormonal and chemotherapy treatment.
11C-Methionine PET/CT in Cryptococcus Meningoencephalitis
Authors: Otomi Yoichi , Teshima Natsumi , Shinya Takayoshi , Otsuka Hideki , Harada Masafumi
Published: November 2024

A 70-year-old man experienced an epileptic seizure. Subsequent MRI performed on close examination revealed high signal in the left occipital cortex on fluid-attenuated inversion recovery. Gadolinium contrast indicated enhancement along the cortex. 11C-Methionine PET/CT scan, performed to differentiate from a brain tumor, showed high uptake mainly along the left occipital lobe cortex. Spinal fluid examination revealed Cryptococcus neoformans, leading to a diagnosis of Cryptococcus meningoencephalitis.
Bilateral Glomus Caroticum With Rare Metastatic Sites Demonstrated on 68Ga-DOTATATE PET/CT
Authors: Aydinbelge-Dizdar Nur , Cinar Alev , Inanir Ayberk , Ozmen Ozlem
Published: November 2024

A 39-year-old woman with bilateral carotid body tumors was referred to 68Ga-DOTATATE PET/CT for further evaluation. Unknown metastatic sites with increased 68Ga-DOTATATE uptake were detected in the left cervical lymph node, liver, and bone. Carotid body paragangliomas (CBPs) represent less than 0.5% of all head and neck tumors and are rarely seen as metastatic disease. 68Ga-DOTATATE PET/CT is a substantial imaging method for primary staging of CBPs, revealing unknown lesions, changing the treatment approaches and determining prognosis. We aimed to present the contribution of 68Ga-DOTATATE PET/CT to patient management in a rare case of bilateral CBPs with rare metastatic sites.
Lupus Nephritis Revealed by FAPI PET/CT
Authors: Zhang Wenjie , Qi Zhongzhi , Shen Guohua
Published: November 2024

A 38-year-old woman received a 68Ga-FAPI-04 PET/CT scan for the evaluation of systemic lupus erythematosus. Diffuse uptake in both kidney parenchyma indicated the presence of lupus nephritis. In addition, an incidental carotid body tumor with increased FAPI uptake was also observed. Our case described the imaging features of lupus nephritis coexistent with a carotid body tumor on FAPI PET/CT.
Implementation of Electronic Medical Record Interventions to Maximize Opioid Disposal after Surgery in Routine Clinical Practice
Authors: Deshmukh Yash , Amezcua Mateo L , Barth Brendan W , Cotter Robin R , Barth Richard J
Published: November 2024

Background:

Despite guideline directed opioid prescribing after surgery, many patients retain excess opioids. Leftover pills increase the risk for misuse, diversion, and dependency. It is unclear whether interventions applied in routine clinical practice can increase excess opioid disposal rates.

Study Design:

All adult patients at our institution with postoperative opioid prescriptions were identified in general surgery, otolaryngology, plastic surgery, neurosurgery, urology and transplant surgery. Disposal rates for 453 pre-intervention patients (surgery between 3/1/23—6/30/23) were compared with 545 intervention patients (surgery between 10/1/23—1/31/24). Pre- and post-intervention patients were called 1-3 months after surgery and asked about excess opioids.

Interventions:

1. Opioid disposal information sheets provided after surgery.

2. Opioid disposal reminder delivered via patient portal in electronic medical record (EMR).

3. Best practice alert (BPA) triggered in EMR at post operative visit reminded providers to discuss opioid disposal.

Results:

Opioid disposal outcomes were obtained from 70% (699/998) of patients. 54% (375/699) had excess opioids. The percentage of patients disposing of their excess opioids increased from 30% (39/130) pre-intervention to 83% (204/245) post-intervention, p<0.00001. Forty-seven percent (247/545) of post-intervention patients had discussions with their providers after a BPA fired at their post-operative visits. Patients who had a provider discussion were more likely to dispose of excess opioids than those who only received an information sheet and patient portal reminder (92% vs 70%, p < 0.00001).

Conclusions:

Interventions easily incorporated into the EMR as part of routine clinical practice can markedly increase excess opioid disposal rates after surgery. When information on opioid disposal and patient portal reminders are combined with disposal discussions with providers at the postoperative visit, opioid disposal rates of >90% can be achieved.
Speech motor cortex enables BCI cursor control and click
Authors: Singer-Clark Tyler , Hou Xianda , Card Nicholas S. , Wairagkar Maitreyee , Iacobacci Carrina , Peracha Hamza , Hochberg Leigh R. , Stavisky Sergey D. , Brandman David M.
Published: November 2024

Decoding neural activity from ventral (speech) motor cortex is known to enable high-performance speech brain-computer interface (BCI) control. It was previously unknown whether this brain area could also enable computer control via neural cursor and click, as is typically associated with dorsal (arm and hand) motor cortex. We recruited a clinical trial participant with ALS and implanted intracortical microelectrode arrays in ventral precentral gyrus (vPCG), which the participant used to operate a speech BCI in a prior study. We developed a cursor BCI driven by the participant’s vPCG neural activity, and evaluated performance on a series of target selection tasks. The reported vPCG cursor BCI enabled rapidly-calibrating (40 seconds), accurate (2.90 bits per second) cursor control and click. The participant also used the BCI to control his own personal computer independently. These results suggest that placing electrodes in vPCG to optimize for speech decoding may also be a viable strategy for building a multi-modal BCI which enables both speech-based communication and computer control via cursor and click.
Timing of decompressive craniectomy and in-hospital mortality in children following severe traumatic brain injury using the German Hospital Database
Authors: Hojeij Rayan , Brensing Pia , Kowall Bernd , Stang Andreas , Nonnemacher Michael , Felderhoff-Müser Ursula , Dammann Philipp , Dudda Marcel , Dohna-Schwake Christian , Bruns Nora
Published: November 2024

Introduction

Decompressive craniectomy (DC) is a last tier to control refractory intracranial pressure elevation in children with severe traumatic brain injury (sTBI), but the optimal timing is unknown. This study aimed to describe the association between timing of DC and in-hospital mortality in children with sTBI in Germany.

Methods

A retrospective cohort study of the German national hospital discharge database (2016-2022) was conducted for cases < 18 years. Children undergoing DC following sTBI were extracted. Time from admission to DC were calculated as complete hours and data were compared between early (time to DC ≤ 2 hours) and late DC (> 2 hours). Hierarchical logistic regression models evaluated the association of DC timing with in-hospital mortality, functional outcomes (Pediatric Complex Chronic Conditions (PCCC) ≥2)), poor outcome (composite outcome of death or PCCC≥2), length of hospital stay, days on mechanical ventilation (MV) and coding of seizures.

Results

Among 13,492,821 children hospitalized, 9,495 had sTBI. DC was performed in 598 cases with time to decompression ranging from 0 to 27 days. More than half of DCs (54.8%) were performed within the first two hours after admission. 164 (27.6%) deaths occurred, with a median time from admission to death of 2 days. Early DC had a higher case-fatality (37.4%) compared to late DC (15.8%), with higher odds of death (adjusted odds ratio [OR] 2.89; 95% confidence interval [95%CI] 1.43-5.85) and poor outcome (OR 1.22; 95% CI 0.71-2.21). However, in survivors, early DC was associated with a shorter duration of MV. No differences in functional outcomes were associated with the timing of DC.

Conclusion

Children undergoing early DC exhibited a higher risk of case fatality and poor outcome, alongside with less days on MV in survivors.

Key points

Question

Is there an association between the timing of decompressive craniectomy (DC) and in-hospital mortality in children with severe traumatic brain injury (sTBI)?

Finding

Early DC (≤ 2 hours after admission) was associated with higher case fatality and poor outcomes but fewer days on mechanical ventilation in survivors compared to late DC (> 2 hours).

Meaning

The timing of DC may impact survival and recovery outcomes in pediatric sTBI, suggesting the need to balance early intervention with potential risks.
High δ15N values in Predynastic Egyptian archeological remains: A potential indicator for localised soil fertilisation practices in extreme conditions
Authors: Poulallion Eve , Perraud Annie , Besson David , Berthet Didier , Richardin Pascale , Vinçon-Laugier Arnauld , Fourel François , Flandrois Jean-Pierre , Maureille Bruno , Lécuyer Christophe
Published: November 2024

Predynastic Egypt arose around 5700 BC when nomadic people settled in the Nile Valley. Without voluntary practice related to anthropic mummification, as will be seen with the Egyptian Dynastic empires, human remains from this period were naturally mummified because of the natural environmental conditions, possibly enveloped in plant mats and animal skins. This study focuses on four mummies from the Natural History Museum of Musée des Confluences in Lyon (France). The geographic origin of the mummies and climatic conditions at that time were deduced from ο18O measurements on teeth and bones. These measurements confirm that the primary source of drinking water was the Nile, and that one mummy of unknown origin also originated from Upper Egypt like the other three. The diet and life habits of these individuals were inferred from carbon (ο13C), nitrogen (ο15N) and sulfur (ο34S) isotope compositions of their skins and bone collagens. Our study is of particular interest as we were able to analyse the animal skins and plant material enveloping the mummies using the same isotopic systems. The mean ο15N values obtained in human skins (17.9±2.4‰, AIR) were found to be high, and consistent with the values measured in animal skins (16.0±2.9‰, AIR). The analysed plants have even higher values, with an average of 22.1±2.2‰, AIR. The most probable explanation for the markedly elevated δ15N values observed in all the materials investigated is localised soil amendment practices. This is corroborated by the consistent nitrogen isotopic signatures across all the examined tissues, with a notable prevalence in plant tissues.
Beyond Integration: SuperGLUE Facilitates Explainable Training Framework for Multi-modal Data Analysis
Authors: Liu Tianyu , Zhao Jia , Zhao Hongyu
Published: November 2024

Single-cell Multi-modal Data Integration has been an area of active research in recent years. However, it is difficult to unify the integration process of different omics in a pipeline, and evaluate the contributions of data integration. In this manuscript, we revisit the definition and contributions of multi-modal data integration, and propose a novel and scalable method based on probabilistic deep learning with an explainable framework powered by statistical modeling to extract meaningful information after data integration. Our proposed method is capable of integrating different types of omic and sensing data. It offers an approach to discovering important relationships among biological features or cell states. We demonstrate that our method outperforms other baseline models in preserving both local and global structures and perform a comprehensive analysis for mining structural relationships in complex biological systems, including inference of gene regulatory networks, extraction of significant biological linkages, and analysis of differentially regulatory relationships.
RobustCell: Exploring the Model Attack-Defense Framework for Robust Transcriptomic Data Analysis
Authors: Liu Tianyu , Xiao Yijia , Luo Xiao , Zhao Hongyu
Published: November 2024

Computational methods should be accurate and robust for tasks in biology and medicine, especially when facing different types of attacks, defined as perturbations of benign data that can cause a significant drop in method performance. Therefore, there is a need for robust models that can defend attacks. In this manuscript, we propose a novel framework named RobustCell to analyze attack-defense methods in single-cell and spatial transcriptomic data analysis. In this biological context, we consider three types of attacks as well as two types of defenses in our framework and systemically evaluate the performances of the existing methods on their performance of both clustering and annotating single cells and spatial transcriptomic data. Our evaluations show that successful attacks can impair the performances of various methods, including single-cell foundation models. A good defense policy can protect the models from performance drops. Finally, we analyze the contributions of specific genes toward the cell-type annotation task by running the single-gene and group-genes attack methods. Overall, RobustCell is a user-friendly and extension-flexible framework for analyzing the risks and safety of analyzing transcriptomic data under different attacks.
MCC: Automated Mass and Charge Curation at Genome-Scale Applied toC. tuberculostearicum
Authors: Mostolizadeh Reihaneh , Mier Finn , Dräger Andreas
Published: November 2024

Background

For many years, antibiotics reliably protected mankind against bacterial infections, including the respiratory tract colonizerCorynebacterium tuberculostearicum. However, the spread of antimicrobial resistance necessitates the search for new treatment options, where the microbiota may play a crucial role. One way to investigate the complex nature of bacteria and their interactions with human hosts or microbiota is through genome-scale metabolic models (GEMs). Constructing GEMs is labor-intensive and time-consuming.

Results

We introduce the Python package Mass and Charge Curation (MCC), which implements a new automated algorithm to facilitate mass and charge balancing—one of the most time-consuming reconstruction steps. This package manipulates reconstructions by consolidating data from multiple resources and updating thenotes-field with relevant changes. It also generates a visual comparison between draft and curated models, ensuring high-quality metabolic reconstructions. Using MCC, we developed a metabolic reconstruction ofC. tuberculostearicumstrain DSM 44922. The model was improved based on standardization policies, resulting in a functional, well-annotated, high-quality product. We also simulated the organism’s growth in synthetic nasal medium 3 (SNM3).

Conclusions

The high-quality modeliCTUB2024RM consistently resembles growth behavior under realistic conditions in an artificial human nasal environment, enhancing understanding ofC. tuberculostearicumand its potential impact on health and disease. The curation process of this model led to the development of the MCC package, which facilitates the mass and charge balancing of arbitrary flux balance constraints (fbc) models in SBML format.

Availability

MCC is freely available via PIP, fromhttps://github.com/draeger-lab/MassChargeCuration/. The modeliCTUB2024RM can be obtained as an SBML file wrapped in an OMEX archive from BioModels Database, accessionMODEL2407310001.

Importance

The rise of antibiotic resistance has made it essential to explore alternative treatments for bacterial infections, particularly those caused by respiratory tract colonizers likeCorynebacterium tuberculostearicum. Understanding the metabolic behavior of these bacteria and their interactions with the human host or microbiota is crucial. genome-scale metabolic models (GEMs) are powerful tools for investigating these interactions, but they are time-consuming to build. Our new Python package, Mass and Charge Curation (MCC), automates a crucial step in the GEM reconstruction process-mass and charge balancing-making it more efficient and reliable. By applying this tool, we developed a high-quality, functional metabolic model forC. tuberculostearicum(iCTUB2024RM), which provides deeper insights into the organism’s growth in a simulated human nasal environment. This work offers a foundation for future research into microbial communities and their role in human health.
Mitigating Chemotherapy Side Effects through Targeted Gamma-Ray Delivery and Convolutional Neural Networks: A Step Toward Precision Oncology
Authors: Siddiqui Seher , ElDeen Shahd El-Sayed Shehab
Published: November 2024

The systemic nature of chemotherapy results in widespread side effects that severely impact patients’ quality of life. This study presents a novel framework combining convolutional neural networks (CNNs) with precision gamma-ray delivery systems to selectively target malignant cells, minimizing collateral damage to healthy tissues. A ResNet-50-based CNN was trained on 12,000 annotated imaging datasets and integrated with a robotic radiation system for real-time targeting. Experimental validation on synthetic tissue models demonstrated a 92% reduction in healthy tissue damage and a 78% decrease in reported side effects. Statistical analyses confirmed model sensitivity (97.2%), specificity (94.8%), and improved treatment accuracy. This research provides a foundation for advancing personalized oncology and reducing the physical and emotional toll of chemotherapy.
Drivers of diversity within and between microbial communities during stochastic assembly
Authors: Marrec Loïc , Bank Claudia
Published: November 2024

No two microbial communities share the same species richness and abundance. Experiments have shown that the assembly of new microbial communities from the same environmental pool is sufficient to generate diversity within and between communities. To identify the mechanisms behind these experimental results, we build a stochastic model that considers both the dispersal of microbes from a pool to communities and microbial division. By analyzing timescales, we identify distinct assembly regimes. Specifically, if dispersal is slower than division, microbial communities show low diversity within communities but high diversity between communities. Conversely, if dispersal is faster than division, microbial communities exhibit high diversity within communities but low diversity between them. We validate these predictions both numerically, using Gillespie simulations, and analytically, by deriving equations for species richness and abundance distributions. Our derivations pinpoint two key metrics, the bimodality coefficient and mean relative abundance, which identify the assembly regime and quantify trait differences. We apply these metrics to reanalyze an experimental data set, demonstrating their practical application. Overall, our study provides general predictions on how stochasticity, timescales, and traits impact diversity within and between communities during the assembly of new microbial communities, allowing for a better understanding of variation in microbiome formation.