bluuebunny/crossref_metadata_2025 huggingface dataset:
May Measurement Month 2022: an analysis of blood pressure screening results from Albania
Authors: Qirjako Gentiana , Tomini Eugena , Draçini Xheladin , Ylli Alban , Hala Romina , Çumashi Rudina , Bele Sonila , Beaney Thomas , Kerr Gabriele , Poulter Neil R , Burazeri Genc
Published: February 2025

The May Measurement Month (MMM) campaign was conducted in Albania in 2022 with the aim of raising awareness of raised blood pressure (BP). Here, we report on the findings of the campaign. Adults aged ≥ 18 years were recruited opportunistically at 27 sites across several districts of Albania. Three seated BP readings were taken for each participant, along with completion of a questionnaire on demographics, lifestyle factors, and comorbidities. Hypertension was defined as a systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg or being on antihypertensive medication. Controlled BP was defined as being on antihypertensive medication with a BP <140/90 mmHg. Multiple imputation was used to estimate any missing BP readings. In total, 12 348 participants were screened, with a mean age of 49.9 (SD ±15.0) years and 59.5% of whom were female. Of all participants, 4908 (39.7%) had hypertension, of whom 3170 (64.6%) were aware, and 3053 (62.2%) were on antihypertensive medication. Of those on antihypertensive medication, 1807 (59.2%) had controlled BP, and of all participants with hypertension, 36.8% had controlled BP. Mean systolic and/or diastolic BP was significantly higher among participants with no formal education and those with a sedentary lifestyle. Whils,t current smoking was positively related to high systolic BP only.

The MMM campaign in Albania identified significant numbers of participants with either untreated or inadequately treated hypertension. Findings from MMM22 underscore the critical need for enhanced hypertension screening management and follow-up care within the Albanian healthcare system.
Sex Differences in Cardiovascular-Kidney-Metabolic Risk Factors Associated with Degenerative Valvular Heart Disease
Authors: Yang Cheng , Li Ziang , Sui Yonggang , Long Tianxin , Cheng Sijing , Guo Xinli , Jiang Chengqing , Ma Haowen , Xu Haiyan , Qian Jie , Wu Yongjian
Published: February 2025

Aims

The cardiovascular-kidney-metabolic (CKM) health approach emphasizes the importance of multidisciplinary early-stage disease prevention. This study aimed to explore sex differences in CKM risk factors associated with common degenerative valvular heart disease (VHD).

Methods

A total of 436,184 participants (54.4% women; mean age, 58 years) free of VHD or heart failure at baseline and with complete information about CKM risk factors were included from the UK Biobank cohort. We assessed sex differences in hazard ratios (HRs) and population-attributable risk (PAR) for incident VHD and VHD-related interventions or mortality, focusing on five CKM risk factors: hypertension, diabetes, obesity, hypertriglyceridemia, and chronic kidney disease (CKD).

Results

At baseline, 81.06% of participants had one or more CKM risk factors: 75.61% had hypertension, 4.80% had diabetes, 24.14% had obesity, 22.26% had hypertriglyceridemia, and 2.32% had CKD. Over a median follow-up period of 13.80 years, incidences of aortic valve stenosis (AS), aortic valve regurgitation (AR), and mitral valve regurgitation (MR) were 11.18 and 5.42, 3.64 and 2.19, and 10.39 and 6.94 events per 10,000 person-years for men and women, respectively. Hypertension was consistently the largest attributable risk factor for incident VHD in both sexes, with PARs of 29.07% and 25.17% for AS, 24.21% and 16.51% for AR, and 19.55% and 13.01% for MR in women and men, respectively. Compared to men, women had higher risks of AS with obesity (HR: 1.17 [1.04–1.32]), AR with CKD (1.59 [1.01–2.49]), and MR with either hypertension (1.25 [1.07–1.47]) or hypertriglyceridemia (1.22 [1.07–1.39]).

Conclusions

Tailoring the prioritization of CKM risk factors based on gender has the potential to enhance the effectiveness of VHD prevention strategies.
Factors explaining age-related prospective memory performance differences: a meta-analysis
Authors: Menéndez-Granda Marta , Schmidt Nadine , Laera Gianvito , Clenin Annick , Kliegel Matthias , Orth Michael , Peter Jessica
Published: February 2025

Objectives

The age-prospective memory paradox states that younger adults perform better than older adults in laboratory tasks, while the opposite has been observed for naturalistic tasks. These terms insufficiently characterise tasks and task settings. We therefore revisited the age-prospective memory paradox using a newly developed taxonomy to better understand how tasks characteristics or task settings contribute to age-related differences in performance.

Methods

We conducted a meta-analysis of 138 studies, classifying prospective memory tasks according to our newly developed taxonomy. The taxonomy included 9 categories that considered how close any task or task setting was to daily life.

Results

When categorizing relevant studies with this taxonomy, we found that older adults did better than younger adults in ‘close to real-life’ tasks done at home and, particularly, in to-do lists and diary tasks. However, they did worse in ‘far from real-life’ tasks done in naturalistic environments or in simulations of real-life tasks in a laboratory.

Discussion

Results of this meta-analysis suggest that the level of abstraction of a task and familiarity of the environment in which the task is taken can explain some of the differences between performances of younger and older people. This is relevant for the choice of task settings and task properties to experimentally address any prospective memory research questions that are being asked.
Significance of measuring the severity of emphysema, in combination with spirometry, on the risk evaluation of patients undergoing major lung resection for cancer
Authors: Suzuki Souichi , Harada-Takeda Aya , Morizono Shoichiro , Takumi Koji , Umehara Tadashi , Kamimura Go , Aoki Masaya , Nagata Toshiyuki , Ueda Kazuhiro
Published: February 2025

OBJECTIVES

Predicted postoperative forced expiratory volume in 1 s (ppoFEV1) and predicted postoperative diffusing capacity of the lungs for carbon monoxide (ppoDLco) are the two most significant parameters for predicting the risk of cardiopulmonary complications after major lung resection for lung cancer. Although the severity of pulmonary emphysema on computed tomography may be an important risk factor for postoperative complications, the clinical significance of measuring the severity of pulmonary emphysema, in combination with ppoFEV1 and ppoDLco, has never been evaluated.

METHODS

We measured the severity of pulmonary emphysema, representing the percentage of low-attenuation area (<-950 Hounsfield units), in the whole lung field, in addition to ppoFEV1 and ppoDLco, in 451 patients who underwent major lung resection for primary lung cancer. We also measured the volume of the upper and lower lobes of emphysematous and non-emphysematous lungs.

RESULTS

Postoperative cardiopulmonary complications developed in 60 patients (13.3%). According to a receiver operating characteristic curve analysis for the diagnostic potential of postoperative complications, the area under the curve was highest for the severity of emphysema, followed by ppoDLco and ppoFEV1. According to a stepwise multivariable logistic regression analysis, the severity of emphysema and ppoDLco were identified as independent risk factors for postoperative complications. Neither the heterogeneous distribution of emphysema nor that of non-emphysema was associated with the occurrence of complications in patients with upper lobe disease or in patients with lower lobe disease.

CONCLUSIONS

The severity of emphysema on computed tomography is a relevant risk factor for cardiopulmonary complications after major lung resection.
Pharmacokinetics and safety of clofazimine in children with rifampicin-resistant tuberculosis
Authors: Hughes Jennifer A , Solans Belén P , Garcia-Prats Anthony J , Draper Heather R , Schaaf H Simon , Nielsen James C , Nortier Elri , Courtney Ingrid , Palmer Megan , van der Laan Louvina , Savic Radojka M , Hesseling Anneke C
Published: February 2025

Background

Paediatric pharmacokinetic and safety data for clofazimine are limited. We described the pharmacokinetics and safety of clofazimine in South African children treated for multidrug/rifampicin-resistant tuberculosis (MDR/RR-TB).

Methods

Children <18 years being routinely treated for MDR/RR-TB were eligible for study participation. Soft gel capsules (Novartis Pharma AG) were administered using WHO-recommended weight-based dosing. Sparse and semi-intensive pharmacokinetic sampling was completed at baseline, Week 2 and 16. Clofazimine weekly area-under-the-concentration-time-curve (wAUC) was compared to target wAUC (60.87 mg*h/L and 111.79 mg*h/L) in adults receiving clofazimine 100mg daily for MDR/RR-TB and leprosy, respectively. Safety monitoring included measurement of QT-interval prolongation and laboratory assessment.

Results

Twenty children, six (30%) male, median age 6.0 years (range, 1.6-14.4), were included. Median clofazimine wAUC was 162.94 (IQR 130.06–263.95), >25% higher than the target adult wAUC in adults with MDR/RR-TB (111.79; IQR 81.9–151.9). No serious or grade ≥3 cardiac events occurred. There was a linear relationship between clofazimine concentration and QT-interval prolongation with an increase of 0.02 ms for every µg/L. There were 59 adverse events at least possibly related to clofazimine; one severe adverse event (elevated ALT) led to temporary withdrawal of clofazimine.

Conclusions

Clofazimine doses used achieved substantially higher exposures in children than adults receiving standard clofazimine doses. The association of higher clofazimine exposures and QT-interval prolongation may pose unnecessary risk to children, particularly in combination with other QT-prolonging drugs. Lower clofazimine doses to achieve appropriate clofazimine exposures should be investigated in children using different drug formulations and harmonised weight bands.
Evaluating Agar-Plating and Dilution-to-Extinction Isolation Methods for Generating Oak-Associated Microbial Culture Collections
Authors: Ordonez Alejandra , Hussain Usman , Cambon Marine C , Golyshin Peter N , Downie Jim , McDonald James E
Published: February 2025

Microbial isolation methods are crucial for producing comprehensive microbial culture collections that reflect the richness and diversity of natural microbiotas. Few studies have focussed on isolation of plant-associated microbiota, with even less focus on forest trees. Here, we tested two isolation methods, (1) agar plating and (2) dilution-to-extinction, for isolation of microbiota from leaf, stem and root/rhizosphere tissues of oak trees. Microbial isolates obtained (culture-dependent) and the endogenous oak microbiota of the source tissue samples (culture-independent) were characterized by 16S rRNA gene and ITS community profiling. We found that the type of growth medium, incubation conditions, and sample type inoculated onto agar, influenced the number of isolates and taxonomic richness of the isolates obtained. Most bacterial and fungal ASVs obtained from isolation-based approaches were only obtained using one of the two isolation methods, with only 12% of the ASVs detected in both. Moreover, the isolation methods captured microorganisms not detected by culture-independent analysis of the microbiota, suggesting these approaches can complement culture-independent analysis by enriching low-abundant taxa. Our results suggest that dilution-to-extinction and agar-plating approaches captured distinct fractions of the oak microbiota, and that a combination of both isolation methods was required to produce taxonomically richer microbial culture collections.
Systematic review and meta-analysis of behavioral interventions for sleep disruption in pediatric neurodevelopmental and medical conditions
Authors: Kamara Dana , Bernard Angel , Clark Emma L M , Duraccio Kara M , Ingram David G , Li Tianjing , Piper Christi R , Cooper Emily , Simon Stacey L
Published: February 2025

Objective

To perform a systematic review and meta-analysis of randomized controlled trials (RCTs) of behavioral interventions for sleep disruption in children with neurodevelopmental and medical conditions.

Methods

A comprehensive literature search was designed and run for studies published between 1970 and July 1, 2023. Original, peer-reviewed RCTs of children ages birth to 18 years with/at risk for sleep disruption and a neurodevelopmental and/or medical condition were included. Interventions without behavioral components, lifestyle interventions, or pharmaceutical interventions were excluded. Primary outcomes included sleep health domains, and secondary outcomes were condition symptomatology and quality of life.

Results

Data from 15 RCTs were examined (1,374 participants, 78% male, 71% White). Sleep disruptions were predominantly insomnia symptoms. Intervention content included parent training, sleep hygiene education, and relaxation strategies. Adaptations to the interventions for use in children with neurodevelopmental and/or medical conditions included behavioral strategies commonly used in those conditions, sleep education specific to the condition, and/or use of case examples specific to the condition. No studies reported on adverse effects. Behavioral sleep interventions had a significant effect on sleep satisfaction, bedtime resistance, and ADHD symptoms at postintervention. At follow-up, effects were maintained only for sleep satisfaction. Parent rating of child sleep duration improved at follow-up but not postintervention.

Conclusions

Despite being at high risk for comorbid sleep disruption, children with neurodevelopmental and/or medical conditions are underrepresented in the sleep intervention literature. Future research is needed with larger, more diverse samples and increased methodological rigor to address sleep disruption in these pediatric populations.

Protocol registration

Open Science Framework Preregistration doi.org/10.17605/OSF.IO/KE58C, date of registration December 9, 2023.
Evaluating the Potential of Large Language Models for Vestibular Rehabilitation Education: A Comparison of ChatGPT, Google Gemini, and Clinicians
Authors: Arbel Yael , Gimmon Yoav , Shmueli Liora
Published: February 2025

Objective

This study aimed to compare the performance of 2 large language models, ChatGPT and Google Gemini, against experienced physical therapists and students in responding to multiple-choice questions related to vestibular rehabilitation. The study further aimed to assess the accuracy of ChatGPT’s responses by board-certified otoneurologists.

Methods

This study was conducted among 30 physical therapist professionals experienced with vestibular rehabilitation and 30 physical therapist students. They were asked to complete a vestibular knowledge test (VKT) consisting of 20 multiple-choice questions that were divided into 3 categories: (1) Clinical Knowledge, (2) Basic Clinical Practice, and (3) Clinical Reasoning. ChatGPT and Google Gemini were tasked with answering the same 20 VKT questions. Three board-certified otoneurologists independently evaluated the accuracy of each response using a 4-level scale, ranging from comprehensive to completely incorrect.

Results

ChatGPT outperformed Google Gemini with a 70% score on the VKT test, while Gemini scored 60%. Both excelled in Clinical Knowledge scoring 100% but struggled in Clinical Reasoning with ChatGPT scoring 50% and Gemini scoring 25%. According to 3 otoneurologic experts, ChatGPT’s accuracy was considered “comprehensive” in 45% of the 20 questions, while 25% were found to be completely incorrect. ChatGPT provided “comprehensive” responses in 50% of Clinical Knowledge and Basic Clinical Practice questions, but only 25% in Clinical Reasoning.

Conclusion

Caution is advised when using ChatGPT and Google Gemini due to their limited accuracy in clinical reasoning. While they provide accurate responses concerning Clinical Knowledge, their reliance on web information may lead to inconsistencies. ChatGPT performed better than Gemini. Health care professionals should carefully formulate questions and be aware of the potential influence of the online prevalence of information on ChatGPT’s and Google Gemini’s responses. Combining clinical expertise and clinical guidelines with ChatGPT and Google Gemini can maximize benefits while mitigating limitations. The results are based on current models of ChatGPT3.5 and Google Gemini. Future iterations of these models are expected to offer improved accuracy as the underlying modeling and algorithms are further refined.

Impact

This study highlights the potential utility of large language models like ChatGPT in supplementing clinical knowledge for physical therapists, while underscoring the need for caution in domains requiring complex clinical reasoning. The findings emphasize the importance of integrating technological tools carefully with human expertise to enhance patient care and rehabilitation outcomes.
Welfare Costs of Idiosyncratic and Aggregate Consumption Shocks
Authors: Constantinides George M
Published: February 2025

I estimate the welfare benefits of eliminating idiosyncratic consumption shocks in the United States related (unrelated) to the business cycle as 36%–39% (lower than 1%) of household utility. Estimates of the former exceed earlier ones because I distinguish between idiosyncratic shocks related/unrelated to the business cycle, estimate the negative skewness of shocks, target moments of idiosyncratic shocks from household-level CEX data, and target market moments. Benefits of eliminating aggregate shocks are lower than 1% of utility. Policy should facilitate the insurance of idiosyncratic shocks related to the business cycle, such as job layoffs, with proof that individuals diligently seek suitable employment during periods of unemployment. (JEL D31, D52, E32, E44, G01, G12)
IGFBP5 regulates fibrocartilage differentiation and cartilage injury induced by T-2 toxin via blocking IGF-1/IGF-1R signaling
Authors: Wang Xiaoqing , Wang Yinxia , Lei Pengzhen , Qu Xiaodong , Qi Rui , Chen Duanmingyu , Chang Yanhai
Published: February 2025

Objectives

Kashin-Beck disease (KBD) is a form of osteoarthropathy that affects the skeletal and joint systems of children and adolescents. Insulin-like Growth Factor Binding Protein 5 (IGFBP5) plays an important role in bone growth and development. This study aimed to investigate the role of IGBFP5 in regulating the function and differentiation of chondrocytes in KBD.

Methods

The mRNA and protein expressions of IGFBP5, IGF-1 and IGF-1R were detected by RT-qPCR and western blot assays. Commercial kits were performed to measure the mitochondrial ROS content, calcium loading and ATP synthesis in chondrocytes. MTT assay was used to detect the cell viability of chondrocytes. Co-IP and pull-down assays were conducted to verify the binding activity of IGFBP5 to IGF-1R. The rat KBD model was constructed by a low selenium diet and T-2 toxin.

Results

The expression of IGFBP5 was upregulated in KBD patient and rat tissues. Further studies showed that interfering with IGFBP5 effectively inhibited T-2-induced chondrocyte damage and mitochondrial stress. IGFBP5 depressed the interaction between IGF-1 and IGF-1R, thereby affecting the regulation of IGF-1/IGF-1R signalling in the repair of chondrocytes. In addition, the fibrous differentiation of cartilage progenitor cells (CPCs) and the activity and migration of CPCs induced by T-2 stimulation were suppressed under IGFBP5 silence treatment.

Conclusion

IGFBP5 was upregulated during the pathological progression of KBD, and IGFBP5 competitively bound with IGF-1R to impede the interactions between IGF-1 and IGF-1R. Knockdown of IGFBP5 inhibited fibrotic differentiation and ameliorated reduction of CPC function in KBD model.
Administering the maternal appeasing substance to Bos taurus and B. indicus cattle placed as yearlings in feedlots with different environmental conditions
Authors: Cooke Reinaldo F , Mackey Shea J , de Souza Izadora S , Mello Ingo A S , Barreto Yasmin M , Gouvea Vinicius N
Published: February 2025

Two experiments evaluated growth performance of finishing cattle placed on feed as yearlings, and receiving the maternal bovine appeasing substance (mBAS) during stressful management events. In Exp. 1, 240 Angus-influenced yearling steers arrived at the research feedyard on d -1 after a 4-h road transport, and body weight (BW) was recorded upon arrival (411.8 ± 2.5 kg). Steers were ranked by arrival BW and received 1 of 2 treatments during initial processing (d 0): 1) 10 mL of a mBAS (Ferappease®; FERA Diagnostics and Biologicals; College Station, TX) or 2) 10 ml of mineral oil (CON; placebo). Treatments were applied topically to the nuchal skin area (5 mL) and above the muzzle (5 mL). During initial processing, steers were weighed, vaccinated against Clostridium spp. and respiratory pathogens, dewormed, implanted, and then distributed into 30 drylot pens according to arrival BW and treatment (n = 15 pens/treatment, 8 steers/pen). Steers were reapplied treatments concurrently with reimplanting on d 75. Initial BW was the average BW on d -1 and 0, final BW was the average of BW recorded on d 138 and 139, and steers were slaughtered on d 139. Steers assigned to mBAS had greater (P ≤ 0.04) ADG, final BW, and hot carcass weight (HCW). Feed intake was greater (P ≤ 0.05) in mBAS steers, but mostly after reimplanting (treatment × day; P < 0.01). Carcass yield grade, backfat thickness, marbling score, and % Choice or better were greater (P ≤ 0.05) in mBAS steers. In Exp. 2, Nelore (Bos indicus) yearling bulls (n = 2,626) arrived at a feedyard (d 0) after a 96-h road transport, and BW was recorded upon arrival (shrunk BW = 352.9 ± 0.6 kg). Bulls were assigned to receive mBAS or CON as in Exp. 1 during initial processing on d 0 (10 pens/treatment; ~130 bulls/pen) which included deworming and vaccination against Clostridium spp. and respiratory pathogens. Bulls were on feed for 96.0 ± 1.0 d until slaughter. Bull ADG was calculated using arrival BW considering a 14% shrink and final BW recorded when loading bulls to slaughter. Bulls assigned to mBAS had greater (P ≤ 0.04) ADG, feed intake, final BW, and HCW. Morbidity and mortality rates due to respiratory disease were less (P = 0.02) in mBAS bulls. Collectively, mBAS administration during stressful management events improved growth performance, mainly by increasing feed intake, in finishing cattle placed on feed as yearlings in feedlot systems typical of US (Exp. 1) and tropical regions (Exp. 2).
Inhibition of the Hippo pathway by verteporfin reduces the proliferation and stemness of rat hair follicle neural crest stem cells under hypoxia
Authors: Liu Weihai , Chen Suhua , Chen Xin , Xue Lixiang , Wang Yan , Yang Jun
Published: February 2025

Hair follicle neural crest stem cells reside in the bulge region of the outer root sheath of hair follicles, originate from the ectoderm, and have multidirectional differentiation potential, making them ideal candidates for tissue engineering applications. These cells mainly reside in a hypoxic microenvironment that favors the maintenance of stemness. Recently, many studies have elucidated the involvement of the Hippo pathway in the regulation of stem cell fate. However, few studies have investigated whether the Hippo signaling pathway regulates the growth of hair follicle neural crest stem cells in hypoxic environments. In the present study, we investigated the role of the Hippo pathway in the regulation of hair follicle neural crest stem cells under hypoxic conditions. We identified neural crest‐derived stem cells from single‐cell RNA‐seq data of skin organoids in a public database, and reported that the Hippo pathway was activated in the cell population. Hair follicle neural crest stem cells were isolated from rat hair follicles and cultured under hypoxic (3% oxygen) and normoxic (20% oxygen) conditions. Cell viability was assessed via the CCK8 assay. The expression levels of several key genes, including Hif2α, Nestin, Sox10, Oct4, Nanog, Sox2, and Klf4, were evaluated via quantitative real‐time PCR, after which we treated the cells with verteporfin, a small molecule inhibitor of the Hippo pathway. Changes in the subcellular localization of the hair follicle neural crest stem cell‐specific marker SOX10 were assessed via immunofluorescence. Western blotting was used to analyze the expression levels of proteins associated with stemness and hypoxia responses, including HIF2α, SOX10, OCT4, NANOG, SOX2, and KLF4. The results showed that hypoxic conditions facilitated the maintenance of stemness in hair follicle neural crest stem cells, including the promotion of proliferation and the expression of multipotential markers. Inhibition of the Hippo pathway results in a significant decrease in cell proliferation. The protein expression of HIF2α, SOX10, OCT4, NANOG, SOX2, and KLF4 was also reduced under hypoxic conditions.
The Value of Blood T Cell Frequencies for Risk Prediction of Postoperative Complications in Pancreatic Cancer Surgery
Authors: Natusch Loreen , Heiduk Max , Klimova Anna , Beer Carolin , Willms Tido , Digomann David , Reiche Charlotte , Aust Daniela E. , Hempel Sebastian , Oehme Florian , Distler Marius , Weitz Jürgen , Seifert Adrian M. , Seifert Lena
Published: February 2025

Objective:

To quantify and characterize preoperative blood T cells in patients with pancreatic ductal adenocarcinoma (PDAC), who underwent tumor resection, and to determine their relevance as biomarkers for postoperative pancreas-specific complications.

Background:

Pancreas-specific complications after pancreatic surgery are associated with a high morbidity and mortality, which both deprive patients of adjuvant chemotherapy. Noninvasive biomarkers for risk prediction of postoperative complications are missing, and the role of blood T cells for preoperative risk stratification is unknown.

Methods:

The preoperative frequency of blood T cell subsets was analyzed for 73 patients with PDAC, who underwent proximal pancreatectomy. Patients were screened for postoperative complications such as pancreatic fistula, postpancreatectomy hemorrhage, and postpancreatectomy acute pancreatitis. The frequency of CD8+, conventional CD4+, and regulatory T cells, as well as the differentiation state of each T cell subset in the peripheral blood of patients with PDAC, was analyzed.

Results:

Of 73 patients with PDAC, 19.2% developed pancreas-specific complications. The occurrence of postoperative complications was independent of the type of resection performed (Whipple procedure vs pylorus-preserving pancreaticoduodenectomy). Neither the frequency of CD8+, conventional CD4+, and regulatory T cells nor the state of T cell differentiation in the peripheral blood was associated with postoperative pancreas-specific complications. Notably, a significantly lower preoperative bilirubin serum level was observed in patients, who developed postpancreatectomy hemorrhage after proximal pancreatectomy (P =0.001).

Conclusions:

A low preoperative bilirubin serum level was associated with a higher risk for postpancreatectomy hemorrhage after proximal pancreatectomy. However, the preoperative blood T cell frequency does not predict postoperative pancreas-specific complications.
Association of Obesity With Sedative Dosing, Sedative Response, and Clinical Outcomes in Mechanically Ventilated Critically Ill Children
Authors: Ward Shan L. , Dawkins-Henry Onella S. , Asaro Lisa A. , Wypij David , Curley Martha A. Q. ,   for the Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE) Study Investigators
Published: February 2025

OBJECTIVES:

This study aimed to investigate the impact of obesity on the use of analgesics and sedatives, rates of iatrogenic withdrawal syndrome (IWS), and outcomes in mechanically ventilated pediatric patients. Additionally, it sought to assess whether a nurse-implemented sedation protocol would be equally effective for children with and without obesity.

DESIGN:

Secondary analysis of the Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE) pediatric multicenter clinical trial.

SETTING:

Thirty-one U.S. PICUs.

PATIENTS:

Children 1–17 years old, categorized as with or without obesity according to World Health Organization and Centers for Disease Control and Prevention criteria.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

The study assessed various factors including medication exposure, adequacy of pain and sedation management, IWS rates, and clinical outcomes. Obesity occurred in 22% of patients. Obesity did not influence choice of opiate, but it led to extended exposure to these medications. There were no differences in dosing per kilogram of admission weight, resulting in significantly higher daily and cumulative doses in those with obesity. In the protocolized sedation arm, patients with obesity received significantly higher median opiate doses compared with the nonobesity protocolized sedation group. IWS rates did not differ; however, protocolized sedation obesity patients experienced more instances of inadequate sedation, longer time to extubation readiness, longer duration of mechanical ventilation and PICU stay, and higher 28-day in-hospital mortality than the protocolized sedation nonobesity group. These weight-based differences were not noted in the usual care arm.

CONCLUSIONS:

This study underscores the significance of accounting for body habitus when selecting and dosing opiates in children with acute respiratory failure. Obesity had substantial impact on medication exposure and clinical outcomes, particularly within a structured, protocolized sedation regimen. Further research is warranted to explore the intricate relationship between medication dosing and clinical outcomes in children with obesity.
Diverging trends in lung cancer: a 26-year analysis of sex-specific patterns and histological shifts in Northern Italy
Authors: Bertolaccini Luca , Santucci Claudia , La Vecchia Carlo , Toffolutti Federica , Corso Giovanni , Spaggiari Lorenzo , Serraino Diego
Published: February 2025

Lung cancer is the leading cause of cancer-related mortality worldwide, and understanding its pathological patterns and trends is of interest for clinical and public health interventions. This study investigates the trends in lung cancer incidence rates from 1995 to 2021 in the Friuli Venezia Giulia (FVG) region in northeastern Italy, focusing on histological subtypes and sex-specific differences. Data were obtained from the population-based FVG Cancer Registry. Data on histological types of lung cancer were analyzed. Using census-based population estimates, age-standardized incidence rates (ASIRs) were calculated for three calendar periods (1995–2003, 2004–2012, 2013–2021). Joinpoint regression analysis was used to assess significant changes in trends, estimating annual percent change and average annual percent change (AAPC). A total of 24 519 lung cancer cases were recorded between 1995 and 2021, 70% in males. During 2013–2021, ASIRs were 31.9/100 000 males and 16.9/100 000 females. Adenocarcinoma accounted for the highest ASIRs in both sexes (15.2/100 000 males and 9.9/100 000 females). Over the 1995–2021 period, the overall incidence of lung cancer decreased in males (AAPC: −3.2%), whereas it increased in females (AAPC: +1.0%). Trends in adenocarcinoma were inconsistent for males but continued to rise in females. Squamous and small cell lung cancer incidence declined in males, while both increased in females. These trends underscore the importance of targeted prevention strategies, especially addressing smoking cessation in middle-aged females.
Poly(ADP-ribose) polymerase inhibitors in cancer therapy
Authors: Zhu Ziqi , Shi Yujun
Published: February 2025

Poly(ADP-ribose) polymerase (PARP) inhibitors (PARPis) have emerged as critical agents for cancer therapy. By inhibiting the catalytic activity of PARP enzymes and trapping them in the DNA, PARPis disrupt DNA repair, ultimately leading to cell death, particularly in cancer cells with homologous recombination repair deficiencies, such as those harboring BRCA mutations. This review delves into the mechanisms of action of PARPis in anticancer treatments, including the inhibition of DNA repair, synthetic lethality, and replication stress. Furthermore, the clinical applications of PARPis in various cancers and their adverse effects as well as their combinations with other therapies and the mechanisms underlying resistance are summarized. This review provides comprehensive insights into the role and mechanisms of PARP and PARPis in DNA repair, with a particular focus on the potential of PARPi-based therapies in precision medicine for cancer treatment.
Sickle Cell Trait and Vascular Health: Insights into Complications and Management
Authors: Soni Zeal , Maheta Darshilkumar , Agrawal Siddharth , Frishman William H. , Aronow Wilbert S.
Published: February 2025

Sickle cell trait was once considered to benign hereditary condition, besides the association of renal medullary carcinoma, affecting red blood cells. The inherited disorder creates several health issues under various conditions, such as dehydration, hypoxia, or extreme physical exertion. Healthcare professionals and patients with the disorder should understand the importance of vascular complications in sickle cell traits. This article emphasizes the pathophysiology, epidemiology, and molecular basis of the sickle cell trait, which involves virtually every organ system and involves vascular endothelial dysfunction, cerebral vasculopathy, renal complications, cardiopulmonary manifestations, and splenic issues. Techniques of prevention and management strategies for quality-of-life improvement in the case of sickle cell trait are presented.
Enhanced Recovery Independently Lowers Failure to Rescue After Colorectal Surgery
Authors: Catarci Marco , Ruffo Giacomo , Viola Massimo Giuseppe , Garulli Gianluca , Pavanello Maurizio , Scatizzi Marco , Bottino Vincenzo , Guadagni Stefano ,   The Italian ColoRectal Anastomotic Leakage (iCral) study group
Published: February 2025

BACKGROUND:

High adherence to the enhanced recovery after surgery pathway reduces morbidity and mortality rates after elective colorectal surgery.

OBJECTIVE:

To evaluate the effect of adherence to the enhanced recovery after surgery pathway on the failure to rescue rates after elective colorectal surgery.

DESIGN:

Retrospective analysis of a prospective database.

PATIENTS:

Adults (≥ 18 years old) who underwent elective colorectal resection with anastomosis for benign and malignant disease.

SETTINGS:

Prospective enrolment in 78 centers in Italy from 2019 to 2021.

INTERVENTIONS:

All the outcomes were measured at 60 days after surgery. Several patient-, disease-, treatment-, hospital-, and complication-related variables were analyzed for the outcomes. After univariate analyses, independent predictors of the endpoints were identified through logistic regression analyses, presenting odds ratios and 95% confidence intervals.

MAIN OUTCOME MEASURES:

Failure to rescue after any adverse event, defined as the ratio between the number of deaths and the number of patients showing any adverse event; failure to rescue after any major adverse event, with the denominator represented by the number of patients showing any major adverse event.

RESULTS:

An adverse event was recorded in 2,321 out of 8,359 patients (27.8%), a major adverse event in 523 patients (6.3%), and death in 88 patients (1.0%). The failure to rescue rates were 3.8% after any adverse event and 16.8% after any major adverse event. Independent predictors of primary endpoints were identified among patient- (age, American Society of Anesthesiologists class, nutritional status), treatment- (type of resection), and complication-related (anastomotic leakage, reoperation) variables. Enhanced recovery pathway adherence > 70% independently reduced failure to rescue rates.

LIMITATIONS:

Clustering from multicenter data, and unmeasured confounding from observational data.

CONCLUSIONS:

Following elective colorectal resection, adherence > 70% to the enhanced recovery pathway independently decreased failure to rescue rates, along with other patient- or treatment-related factors. See Video Abstract.
Winter-time solar radiation, precipitation, and psychotropic medication purchases: A cohort study in Finnish public sector employees
Authors: Raza Auriba , Partonen Timo , Aalto Ville , Ervasti Jenni , Ruuhela Reija , Asp Magnus , Engström Erik , Pentti Jaana , Vahtera Jussi , Halonen Jaana I.
Published: February 2025

Background:

In Northern latitudes, winter is the darkest time of the year, and depressive episodes during winter are prevalent. Although changing weather patterns due to climate change are projected to result in warmer and wetter and, thus, even darker winters, research on the impact of winter-time natural light and precipitation on mental health is scarce. We examined associations of exposure to solar radiation and precipitation with psychotropic medication and antidepressant purchases in winter months.

Methods:

Of the 251,268 eligible participants from the Finnish public sector study, aged ≥18 years, 72% were women. Associations for municipality-level 4-week average solar radiation and precipitation with register-based medication purchases from 1999 to 2016 were analyzed using random effects method with Poisson regression. A 6-month washout period with no purchases was applied to each purchase. Confounding by region and year, and effect modifications by sex, age, and socioeconomic status were examined.

Results:

No association was observed for an increase in 4-week average of solar radiation by standard deviation (585 kJ/m2) with any psychotropic medications (incidence rate ratio: 0.99; 95% confidence interval: 0.98, 1.00) or antidepressants (1.00; 0.99, 1.01). No difference in any psychotropic medication or antidepressant purchases in participants exposed to high solar radiation (≥2000 kJ/m2) compared with those with the lowest exposure (<500 kJ/m2) was observed. No associations were observed for precipitation.

Conclusion:

No evidence linking higher solar radiation exposure to reduced psychotropic medication purchases, nor higher precipitation exposure to increased medication purchases in winter was observed. Further research is needed to validate and expand upon these findings.
Short-term exposure to relative humidity and lung health in early adolescents
Authors: Nassikas Nicholas J. , Ni Wenli , Rifas-Shiman Sheryl L. , Luttmann-Gibson Heike , Synn Andrew , Oken Emily , Gold Diane R. , Rice Mary B.
Published: February 2025

Background:

Extremes in humidity can induce bronchoconstriction and trigger breathing symptoms in people with asthma. Less is known about how humidity influences measurements of lung health in children and adolescents. Our objective was to assess the extent to which short-term exposures to high and low relative humidity (RH) are associated with lung function and fractional exhaled nitric oxide (FeNO) in adolescents.

Methods:

We included adolescents (mean age 13.2 y, SD: 0.9) from a northeast US prospective prebirth cohort (n = 1019). We assigned daily RH levels to geocoded participant addresses. We defined low or high RH as ≤10th or ≥90th internal percentiles, respectively, of the cohort-specific RH distribution and the reference RH as the median. We evaluated the linearity of associations of RH in the 1–7 days before assessment with forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FeNO using generalized additive models with penalized splines (df = 3). We log-transformed FeNO due to non-normality. For nonlinear relationships, we used distributed lag nonlinear models to explore the cumulative effects of lag 1–7 day RH on FEV1, FVC, and FeNO.

Results:

Median RH was 65.6% (interquartile range [IQR] = 19.8%), 10th percentile 47.2%, 90th percentile 86.6%. Mean FeNO (SD) was 25.9ppb (26.9ppb). High (vs. median) RH was associated with 38.0% higher FeNO (95% CI = 10.3, 72.7). Exposure to low (vs. median) RH was associated with 186.2 ml lower FEV1 (95% CI = −299.2, −73.3) and −130.2 ml lower FVC (95% CI = −251.9, −8.5).

Conclusion:

Short-term exposures to extremes of RH were associated with lower lung function and higher FeNO, a measure of airway inflammation, in adolescents.
Patient experience of menopause care after breast cancer in the UK: a cross-sectional study
Authors: Glynne Sarah , Reisel Daniel , Kamal Aini , Newson Louise
Published: February 2025

Objectives

This study aimed to explore women's experience of menopause care after breast cancer in the UK.

Methods

An online survey incorporating the validated Shared Decision Making SDM-Q-9 questionnaire was disseminated via social media to breast cancer survivors in the UK.

Results

A total of 1,195 women completed the survey. The menopause symptom burden was high (99.7%). Fear of recurrence was the dominant concern for 55.6% of women, but 44.4% were more concerned about quality of life and future risk of long-term conditions associated with estrogen deficiency. Women further from diagnosis were less concerned about recurrence (fear of recurrence was the dominant concern for 58.6% of women within 2 y of diagnosis vs. 43.1% of women more than 15 y from diagnosis, P = 0.001). Of all women, 68.3% were offered treatment (nonhormone treatment, 58.5%; vaginal hormones, 35.5%; menopause hormone therapy, 13.1%; testosterone, 10.1%). Menopause specialists were more likely to prescribe MHT versus nonmenopause specialists (68.2% vs. 31.8%, P < 0.0001); GP menopause specialists were more likely to prescribe testosterone versus gynecologist menopause specialists (60.8% vs. 39.2%, P < 0.0001). Of all women, 49.6% who were not offered menopause hormone therapy were willing to consider it, and 83.7% wanted more information about menopause hormone therapy. Information provision and time allocated to menopause-related discussion were poor (<10 min for 73.52% of women). Involvement in menopause-related treatment decisions was low (SDM-Q-9 median score, 11.1/100; IQR, 0.0-28.9). Women who consulted a menopause specialist (30.2%) were significantly more able to discuss their concerns (P < 0.001), were given significantly more time (>10 min for 75.6%, P < 0.001), and felt significantly more involved in menopause-related treatment decisions (P < 0.001). Overall, 96% of women wanted more support for menopausal symptoms.

Conclusions

Many women in the study cohort had unmet menopause-related health needs after breast cancer, and the quality of menopause care received was poor. Most women felt uninvolved in menopause-related treatment decisions. Women experienced higher quality menopause care if they had access to a menopause specialist.
Quantitative Fluorescein Angiography Biomarkers in Diabetic Macular Edema
Authors: Huang Ryan S. , Mihalache Andrew , Popovic Marko M. , Munn Colyn , Melo Isabela Martins , Pecaku Aurora , Friedman Alon , Pimentel Miguel Cruz , Tang Tina , Yan Peng , Wong David T. , Muni Rajeev H.
Published: February 2025

Purpose:

To investigate the association between baseline clinical characteristics of patients with diabetic macular edema (DME) and quantitative intravenous fluorescein angiography (IVFA) parameters.

Methods:

Consecutive patients with DME presenting with a central macular thickness (CMT) >310 μm were recruited from 2017-2023. Ultra-widefield IVFA images were analyzed with the RETICAD algorithm to extract quantitative measures of blood-retinal barrier (BRB) permeability, retinal perfusion, and blood flow. Univariable and multivariable regression models were used to investigate associations between IVFA parameters and baseline best-corrected visual acuity (BCVA), CMT, and macular volume.

Results:

The study population consisted of 56 eyes with DME, and seven eyes from healthy controls. In our multivariable analysis, BRB permeability measured in the central and peripheral retina was significantly associated with BCVA (p=0.003 and 0.002, respectively) and macular volume (p=0.025 and 0.045, respectively). Both central and peripheral BRB permeability were significantly higher in DME eyes relative to healthy controls (p<0.001).

Conclusion:

Increased BRB permeability measured on IVFA in DME eyes was associated with a greater baseline macular volume and worse BCVA, suggesting its potential in providing an objective assessment of disease severity. Future research should explore the clinical utility of quantitative IVFA measurements in diverse patient populations.
Serotonin Reuptake Inhibitors may reduce the risk of Retinal Vein Occlusion
Authors: Thomas Faye , Lochhead Jonathan
Published: February 2025

Purpose:

To investigate any difference in the rate of serotonin reuptake inhibitor (SRI) use in patients with retinal vein occlusions (RVO), compared to an age matched control group.

Methods:

Retrospective data collection of risk factors and prescribed drugs from consecutive electronic patient records of all patients diagnosed with RVO over 5 years. Routine, age matched patients were identified for a control group. The two groups were compared with Chi2 test and multiple Logistic regression. Odds ratios (OR) were calculated.

Results:

In total, 775 patients were included in this study. 283 patients were in the RVO group and 492 in the control group. The rate of SRI and Statin use was significantly different in both groups for all ages (p<0.001). Logistic regression confirmed a significant reduction in RVO associated with SRI use (OR 0.39), Statins (OR 0.51) and combined drugs (OR 0.22) with all groups reaching statistical significance (p<0.001)

Conclusion:

This study has found lower rates of RVO in patients receiving an SRI or a Statin compared to controls. This data suggests that individuals taking an SRI are less likely to suffer a RVO and SRIs may have an additive effect when combined with Statins.
Visual Outcomes following implantation of a non-diffractive extended depth of focus Intraocular Lens in patients with early dry macular degeneration
Authors: Vasavada Shail , Shastri Lajja , Nath Vandana , Dwivedi Shyamal , Patel Asav , Vasavada Vaishali , Srivastava Samaresh , Vasavada Abhay R.
Published: February 2025

Purpose:

Evaluate visual outcomes following implantation of a non-diffractive extended deapth of focus (EDOF) intraocular lens (IOL) in patients with early dry age-related macular degeneration (AMD)

Setting:

Iladevi Cataract & IOL Research Centre, Ahmedabad, India

Design:

Prospective, interventional series

Methods:

Patients undergoing cataract surgery with the EDOF Acrysof Vivity IOL and having early dry AMD were included. Primary outcome measures were monocular unaided and corrected distance visual acuity (UDVA, CDVA) 3 months postoperatively. Secondary outcome measures were: monocular unaided and distance corrected intermediate (UIVA, DCIVA) (66cm) and near (UNVA, DCNVA) (40cm) visual acuity as well as mesopic contrast sensitivity (CS).

Results:

40 eyes (40 patients) with a mean age of 68.5 + 8.38 (standard deviation, SD) years were included. UDVA and CDVA at 3 months follow up were 0.12 + 0.07 and 0.10 + 0.10 (SD) LogMAR. UIVA, DCIVA were 0.25 + 0.09, 0.12 + 0.09 LogMAR. UNVA, DCNVA were 0.23 + 0.10, 0.19 + 0.15 LogMAR. Mesopic CS values without glare were 1.50 + 0.10, 1.69 + 0.26, 1.40 + 0.30 and 0.84 + 0.5 units at 3, 6, 12 and 18 cycles per degree (CPD). Mesopic CS with glare was 1.53 + 0.16, 1.63 + 0.21, 1.21 + 0.45 and 0.75 + 0.42 units.

Conclusion:

The Acrysof Vivity IOL gives very good distance visual acuity with improved intermediate and near visual acuity without significant compromise in contrast sensitivity in eyes with early dry AMD.