bluuebunny/crossref_metadata_2025 huggingface dataset:
Basic and laboratory immunology
Authors: Blann Andrew
Published: August 2024

This chapter explores basic and laboratory immunology. It discusses the key concepts of organs, cells, and humoral components of the immune system. Some degree of immunological and inflammatory process is present in almost all forms of disease. The immune system aims to protect people from microbiological attacks by recognizing anything that is not part of the body and then destroying it. The chapter examines the interplay between immunology and inflammation, and the differences between the innate immune system and the adaptive immune system. It also explains that laboratories are an indispensable part of the diagnosis and management of immunological and inflammatory diseases.
Disease of the respiratory system
Authors: Blann Andrew
Published: August 2024

This chapter focuses on diseases of the respiratory system. The respiratory system aims to provide blood arriving in the various branches of the pulmonary artery with oxygen and to remove waste products in the form of exhaled breath. In most respiratory diseases, the major clinical consequence is pneumonia, which may be fatal and may progress to acute respiratory distress syndrome. The chapter discusses the inflammatory disease of the upper airways, trachea, and bronchi, the pathology of lung disease, and the diagnosis and treatment of chronic obstructive pulmonary disease (COPD), asthma, and pulmonary embolism. It also considers the full implications of the global COVID-19 pandemic wherein SARS-CoV-2 killed millions of people.
Embryo origami
Authors: Paxson Julia
Published: August 2024

Associate Professor
The Cancer Challenge
Authors: Divan Aysha , Royds Janice
Published: August 2024

The Cancer Challenge provides an overview of key milestones in the history of cancer research, our current understanding of the disease, and future directions in its diagnosis and treatment. The book introduces key concepts in the study of cancer, explaining how cancers develop, covering a variety of approaches to their diagnosis and treatment. It also includes discussions of new approaches to preventing cancers, screening programmes, and innovations in diagnosis that draw on AI. These provide insights into current developments in cancer research and show how they benefit patients.
Food and Agriculture: Using Our Planet to Sustain Ourselves
Authors: Niesenbaum Richard
Published: August 2024

This chapter discusses food systems from the perspective of the present-day food system. It shows how the Green Revolution of the mid-1950s transformed the food system. The current food system can be made more sustainable through changes in policy and new and innovative approaches to food production. Possible sustainable solutions range between organic agriculture, hydroponics, local agriculture, fair trade, permaculture, and sustainable approaches to meat production. The chapter clarifies that the food system will have to adapt to changing conditions as the climate changes since a suite of solutions must be applied to meet current and future nutritional needs.
The biochemistry of cells
Authors: Burrell Helen
Published: August 2024

This chapter examines the biochemistry of cells. It discusses the function of proteins with respect to their structure and levels of organization before elaborating on enzymes and their regulation. In addition to its function of regulating metabolism, enzymes hold particular importance to the pharmaceutical industry as many drugs are enzyme inhibitors. The chapter then provides an overview of the kinetics and pathways of enzyme activity. It looks into the importance of maintaining the glucose level and alternative fuels used by people's bodies. Depending on the blood glucose level, the body either metabolizes what has been taken in or demands fuels from the stores.
The future of UN peace operations: pragmatism, pluralism or statism?
Authors: Paris Roland
Published: August 2024

Although United Nations peace missions have played an important conflict management role for decades, a backlash against the post-Cold War model of ‘liberal peacebuilding’ and other recent developments have called their future into doubt. Some observers contend that a ‘pragmatic turn’ is now underway—a shift away from ambitious plans to transform war-torn societies into liberal democracies and towards more modest and realistic goals. Whether ‘pragmatism’ offers a viable alternative framework for peacebuilding, however, is less clear. This article challenges key assumptions of the pragmatic approach to peacebuilding, including the notion that UN missions can be ‘agnostic’ about the governance arrangements of societies that host these operations, as some proponents of pragmatism recommend. Historical case-studies show that such assumptions are integral features of collective conflict management systems, including UN peace missions. Moreover, a close examination of the pragmatist approach reveals that it, too, is based on such assumptions—namely, that building peace requires the promotion of pluralist societies and states. Pluralist peacebuilding, the article concludes, could offer a compelling foundation for future UN missions in an era of rising statist–authoritarianism, but developing this approach will first require discarding pragmatism's pretence of ideological agnosticism.
Residual and past varinaccuracy measures
Authors: Sharma Akash , Kundu Chanchal
Published: August 2024

Analysing the information measures’ dispersion index has garnered increasing attention. In this regard, variability of entropy has been explored for residual and past lifetimes. In a recent paper, Balakrishnan et al. (2023, Commun. Stat. Theory Methods, 53, 5574–5592) have studied the variability of the Kerridge inaccuracy measure. The dynamic measures of varinaccuracy, namely residual varinaccuracy and past varinaccuracy, have been introduced in this article. A detailed course of theoretical results has been investigated with examples. Further, some applications of the residual varinaccuracy have been added to show the functionality of the defined measure.
Effects of yeast-enriched functionalized canola meal supplementation on apparent total tract macronutrient digestibility and fecal characteristics, fecal microbiota, and immune function of healthy adult dogs
Authors: De La Guardia-Hidrogo Vanessa M , Soto-Diaz Katiria , Rummell Lindsey M , Valizadegan Negin , Fields Christopher J , Steelman Andrew J , Swanson Kelly S
Published: August 2024

Brewer’s dried yeast has a high nutritional value and has long been utilized by the animal feed industry as a source of protein, B-complex vitamins, and minerals. Brewer’s dried yeast is also rich in bioactive compounds and may thereby be used as a functional ingredient, providing benefits beyond that of its nutrient content. Canola meal is a high-fiber ingredient that also has unique properties, especially when it is wetted and dried using a proprietary drying system that creates a “functionalized” canola meal. The objective of this experiment was to evaluate the effects of a yeast-enriched functionalized canola meal (FCM) on apparent total tract digestibility (ATTD) and the fecal quality, metabolite concentrations, and microbiota populations, and immune function of healthy adult dogs. Twelve adult female beagles (body weight [BW] = 7.6 ± 0.7 kg; age = 5.8 ± 1.3) were used in a replicated 4 × 4 Latin square design with 28-d periods. Each experimental period consisted of a 22-d adaptation phase, 5 d of total and fresh fecal collection, and blood collection on the last day. To start, all dogs were fed a basal diet to maintain BW for 14 d. Following fecal and blood collections at baseline (−1 d) to confirm health status, experimental periods began testing the following dietary treatments using a Latin square design experiment: 1) FCM only (no yeast inclusion), 2) FCM + low yeast dose, 3) FCM + medium yeast dose, and 4) FCM + high yeast dose. All treatments were top-dressed onto the basal diet at a rate estimated to be 1% of daily intake (as-is basis). Statistical analysis was performed using the PROC MIXED procedure of SAS with the main effect of treatment and the random effect of dog. Significance was declared at P ≤ 0.05, and trends reported if 0.05 < P ≤ 0.10. Supplementation with yeast-enriched FCM had no significant effect on the ATTD of macronutrients or energy or the fecal characteristics, metabolite concentrations, and microbiota populations of dogs. Additionally, no significant differences were observed in circulating immune cell counts or response to Toll-like receptor agonists among treatments. Our results suggest that the yeast-enriched FCM could be included in canine diets without negatively affecting stool quality, fecal metabolite concentrations, or ATTD. Further research is necessary to determine the effective dose of yeast-enriched FCM, potential mechanisms of action, and other potential implications it has on canine health.
Landscape analysis of environmental data sources for linkage with SEER cancer patients database
Authors: Tatalovich Zaria , Chtourou Amina , Zhu Li , Dellavalle Curt , Hanson Heidi A , Henry Kevin A , Penberthy Lynne
Published: August 2024

One of the challenges associated with understanding environmental impacts on cancer risk and outcomes is estimating potential exposures of individuals diagnosed with cancer to adverse environmental conditions over the life course. Historically, this has been partly due to the lack of reliable measures of cancer patients’ potential environmental exposures before a cancer diagnosis. The emerging sources of cancer-related spatiotemporal environmental data and residential history information, coupled with novel technologies for data extraction and linkage, present an opportunity to integrate these data into the existing cancer surveillance data infrastructure, thereby facilitating more comprehensive assessment of cancer risk and outcomes. In this paper, we performed a landscape analysis of the available environmental data sources that could be linked to historical residential address information of cancer patients’ records collected by the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program. The objective is to enable researchers to use these data to assess potential exposures at the time of cancer initiation through the time of diagnosis and even after diagnosis. The paper addresses the challenges associated with data collection and completeness at various spatial and temporal scales, as well as opportunities and directions for future research.
Anti-asparaginyl-tRNA synthetase antibody-positive pneumonitis in a patient with immune checkpoint inhibitor treatment: A case report and literature review
Authors: Oda Nobuhiro , Koguchi Okuto , Kontani Hiroki , Hayashi Jun , Hazue Ryo , Oyama Yu , Rokutanda Ryo
Published: August 2024

In recent years, the use of immune checkpoint inhibitors (ICIS) has increased and there have been case reports of anti-aminoacyl-tRNA synthetase (anti-ARS) antibody syndrome during ICI treatment. However, these cases are limited, and their clinical characteristics are not fully understood. We report the first case of anti-ARS antibody syndrome with asparaginyl-tRNA synthetase antibody during ICI therapy. This report presents our case, along with a literature review of other anti-ARS antibody syndrome cases that developed after ICI use, discussing their clinical characteristics and possible mechanisms of onset. Considering the widespread use of ICIs in cancer therapy, we should be aware of anti-ARS antibody syndrome that develops during the use of ICIs.
Defining neuroblastoma: From origin to precision medicine
Authors: Sainero-Alcolado Lourdes , Sjöberg Bexelius Tomas , Santopolo Giuseppe , Yuan Ye , Liaño-Pons Judit , Arsenian-Henriksson Marie
Published: August 2024

Neuroblastoma (NB), a heterogenous pediatric tumor of the sympathetic nervous system, is the most common and deadly extracranial solid malignancy diagnosed in infants. Numerous efforts have been invested in understanding its origin and in development of novel curative targeted therapies. Here, we summarize the recent advances in the identification of the cell of origin and the genetic alterations occurring during development that contribute to NB. We discuss current treatment regimens, present and future directions for the identification of novel therapeutic metabolic targets, differentiation agents, as well as personalized combinatory therapies as potential approaches for improving the survival and quality of life of children with NB.
Dosimetric comparison of hippocampal-sparing technologies in patients with low-grade glioma
Authors: Williamson Aoife , Houston Peter , Paterson Jennifer , Chalmers Anthony J , McLoone Philip , Fullerton Natasha , Foo Sin Yee , James Allan , Nowicki Stefan
Published: August 2024

Background

Radiotherapy (RT) plays an integral role in the management of low-grade gliomas (LGG). Late toxicity from RT can cause progressive neurocognitive dysfunction. Radiation-induced damage to the hippocampus (HCP) plays a considerable role in memory decline. Advancements in photon planning software have resulted in the development of multi-criteria optimization (MCO) and HyperArc technologies which may improve HCP sparing while maintaining planning target volume (PTV) target coverage.

Methods

Three planning methods for hippocampal sparing (HS) were compared, volumetric modulated arc therapy (VMAT) without HS (VMAT_noHS), VMAT with HS (VMAT_HS), MCO with HS (MCO_HS), and HyperArc with HS (HyperArc_HS).

Results

Twenty-five patients were identified. The contralateral HCP was spared in 16 patients and bilateral HCP in 9 patients with superiorly located tumors. All 3 HS planning techniques showed significant reductions in dose to the spared HCP in contralateral cases but only VMAT_HS and MCO_HS achieved this in bilateral cases (P < .008). Only MCO_HS was superior to VMAT_HS in lowering the dose to both contralateral HCP and bilateral HCP in all measured metrics (P < .008). PTV and OAR (organ at risk) dose constraints were achieved for all plans.

Conclusions

This retrospective dosimetric study demonstrated the feasibility of HS for low-grade glioma. All 3 HS planning techniques achieved significant dose reductions to the spared contralateral hippocampus, but only MCO_HS and VMAT_HS achieved this in bilateral cases. MCO was superior to other planning techniques for sparing both bilateral and contralateral hippocampi.
The Effects of Combustible Cigarettes and Electronic Nicotine Delivery Systems on Immune Cell-Driven Inflammation and Mucosal Healing in Ulcerative Colitis
Authors: Kastratovic Nikolina , Markovic Vladimir , Arsenijevic Aleksandar , Volarevic Ana , Zdravkovic Natasa , Zdravkovic Marija , Brankovic Marija , Gmizic Tijana , Harrell Carl Randall , Jakovljevic Vladimir , Djonov Valentin , Volarevic Vladislav
Published: August 2024

Introduction

The effects of combustible cigarettes (CCs) and electronic nicotine delivery systems (ENDS) on immune cell-driven colon inflammation and intestinal healing of patients with ulcerative colitis (UC) are still unknown and, therefore, were examined in this study.

Aims and Methods

Intracellular staining and flow cytometry analysis of immune cells isolated from UC patients who used ENDS (UCENDS), CCs (UCCC) and who were nonsmokers (UCAIR) were performed to elucidate cellular mechanisms which were responsible for CCs and ENDS-dependent modulation of immune response during UC progression. Additionally, dextran sulfate sodium (DSS)-colitis was induced in ENDS/CC/air-exposed mice (DSSENDS/ DSSCC/DSSAIR groups) to support clinical findings.

Results

Significantly increased number of immunosuppressive, IL-10, TGF-β, and IL-35-producing, FoxP3-expressing CD3 + CD4 + T regulatory cells (Tregs) was observed in the blood of UCENDS patients while the reduced presence of inflammatory, TNF-α and IFN-γ-producing, Tbx21-expressing CD3 + CD4 + Th1, IL-4-producing Gata3-expresing Th2 and IL-17, IL-22-producing, RORγT, IL-23R-expressing Th17 cells were noticed in the blood of UCCC patients. Exposure to either CCs or ENDS was associated with enhanced mucosal healing, ameliorated spontaneous recovery, and improved survival of DSS-treated mice. An expansion of immunosuppressive cells (IL-10-producing tolerogenic CD11c + dendritic cells, alternatively activated CD206, Arginase 1-expressing, IL-10-producing F4/80 + macrophages, IL-10-producing FoxP3-expressing Tregs) was noticed in the colons of DSSENDS–treated mice, while reduced number of inflammatory, IL-17- and IL-4-producing T lymphocytes was observed in the colons of DSSCC-compared to DSSAIR-treated mice.

Conclusions

Despite different mechanisms of action, both ENDS and CCs attenuated ongoing colon inflammation, enhanced healing, and ameliorated recovery of injured intestines of DSS-treated mice and UC patients.

Implications

This is the first study that compared the effects of CCs and ENDS on immune cells of patients suffering from UC, providing new information about molecular and cellular mechanisms which were responsible for ENDS and CCs-dependent modulation of immune cell-driven colon injury and inflammation. Obtained results showed that both ENDS and CCs had the capacity to attenuate detrimental immune response, enhance healing, and ameliorate recovery of injured intestines.
The Protective Effect of Octanoic Acid on Sepsis: A Review
Authors: Tang Jiabao , Li Xiaohua , Li Wei , Cao Chun
Published: August 2024

Sepsis, a systemic inflammation that occurs in response to a bacterial infection, is a significant medical challenge. Research conducted over the past decade has indicated strong associations among a patient's nutritional status, the composition of their gut microbiome, and the risk, severity, and prognosis of sepsis. Octanoic acid (OA) plays a vital role in combating sepsis and has a protective effect on both animal models and human patients. In this discussion, the potential protective mechanisms of OA in sepsis, focusing on its regulation of the inflammatory response, immune system, oxidative stress, gastrointestinal microbiome and barrier function, metabolic disorders and malnutrition, as well as organ dysfunction are explored. A comprehensive understanding of the mechanisms by which OA act may pave the way for new preventive and therapeutic approaches to sepsis.
Efficacy and safety of camrelizumab, apatinib, and capecitabine combination therapy in advanced biliary tract cancer: a phase 2, nonrandomized, prospective study
Authors: Jing Chao , Bai Zhigang , Tong Kuinan , Yang Xiaobao , Liu Kun , Wu Hongwei , Zhu Jiegao , Guo Wei , Zhang Zhongtao , Deng Wei
Published: August 2024

Background

Biliary tract cancer (BTC) is a highly malignant tumor, with limited therapy regimens and short response duration. In this study, we aim to assess the efficacy and safety of the combination of camrelizumab, apatinib, and capecitabine as the first- or second-line treatment in patients with advanced BTC.

Methods

In this phase 2, nonrandomized, prospective study, eligible patients received camrelizumab (200 mg, d1, Q3W), apatinib (250 mg, qd, d1-d21, Q3W), and capecitabine (1000 mg/m², bid, d1-d14, Q3W) until trial discontinued. The primary endpoint was the objective response rate (ORR). The secondary endpoints were disease control rate, progression-free survival (PFS), overall survival (OS), and safety.

Results

From July 2019 to April 2023, we enrolled a total of 28 patients, of whom 14 patients were in the first-line treatment setting and 14 patients were in the second-line setting. At the data cutoff (April 30, 2023), the median follow-up duration was 18.03 months. Eight of 28 patients reached objective response (ORR: 28.57%), with an ORR of 50% and 7.1% for first-line and second-line treatment patients (P = .033). The median PFS was 6.30 months and the median OS was 12.80 months. Grade 3 or 4 adverse events (AEs) occurred in 9 (32.14%) patients, including elevated transaminase, thrombocytopenia, etc. No serious treatment-related AEs or treatment-related deaths occurred.

Conclusions

In this trial, the combination of camrelizumab, apatinib, and capecitabine showed promising antitumor activity and manageable toxicity in patients with advanced BTC, especially in the first-line setting.

Clinical Trial Registration

NCT04720131.
Growth performance and meat quality of broiler chickens fed diet containing bird eye pepper of varying proportion and sieve size
Authors: Adegoke Adeola V , Oduola Abdul-basit O , Adeyemo Adedayo A
Published: August 2024

This study investigated the potency of bird eye pepper (BEP) of varying proportion and sieve size on growth performance and meat quality of broiler chickens. Two hundred and forty-six 2-wk-old broiler chicks were randomly allotted to six treatment groups (basal diet (B) inclusive × 2) in a 2 × 3 factorial arrangement each replicated four times (10 × 10 × 10 × 11) in a completely randomized design. Diets containing BEP of varying proportion (0, 150, and 300 g) and sieve size (0.05 and 0.1 mm) were offered in two phases, starter (14 d) and finisher (17 d). Postfeeding, 48 birds (two per replicate) were sacrificed to further evaluate performance and assess the quality of meat produced. Result obtained indicates chicks fed 150 g BEP consumed less feed compared to 300 g BEP. Also, 0 and 150 g BEP groups had better (P < 0.05) feed conversion ratio (FCR) than 300 g BEP, while 0.05 mm BEP diet improved (P < 0.05) FCR as against 0.1 mm BEP. Interaction of proportion and sieve size effects of BEP increased (P < 0.05) the final weight of the birds and suppressed (P < 0.05) feed intake for all groups as against 300 g (0.1 mm) BEP (1,576.00 g/bird; 964.20 g/bird). Feeding 150 and 300 g BEP diets lowered (P < 0.05) superoxide dismutase (SOD) production compared to 0 g BEP, while 150 g BEP diet increased (P < 0.05) catalase production over 0 g BEP. Interactive effect of proportion and sieve size of BEP reduced (P < 0.05) SOD production in 150 g (0.05 and 0.1 mm) BEP and 300 g (0.05 mm) BEP groups, followed by 300 g (0.1 mm) BEP group that had lower (P < 0.05) SOD than both basal groups. Birds fed B + 150 g (0.05 mm) BEP diet produced more (P < 0.05) catalase compared to both basal groups. Meat pH for 150 and 300 g BEP groups was significantly (P < 0.05) reduced than 0 g BEP. The Hue angle corresponds with a high value (P < 0.05) to 0 g BEP, while 300 g BEP showed a low value. This study has shown BEP at low concentration (150 g) screened with 0.05 and 0.1 mm sieves enhanced chick welfare, while a higher concentration (300 g) screened at 0.05 mm improved overall growth performance (endogenous antioxidant profile) at finisher phase. Broiler chickens, farmers, and meat processors will benefit from diet containing BEP screened through 0.05 mm sieve.
The Scholarship of Wellness and Mindfulness to Support First-Year Nursing Students’ Response to Stress
Authors: Strout Kelley , Schwartz-Mette Rebecca , Parsons Kayla , Sapp Maile
Published: August 2024

An educational innovation centered on mindfulness was developed to support the well-being of first-year nursing students at a large public university. Students participated in a week-long experiential learning program before their first semester. They then enrolled in a one-credit course that fostered well-being through research and evidence-based mindfulness practices. The course was highly ranked because of the quality of learning, environment, and theories presented, indicating that supportive wellness initiatives are acceptable and feasibility for future implementation.
October 7th Mass Casualty Attack in Israel: Injury Profiles of Hospitalized Casualties
Authors: Goldman Sharon , Lipsky Ari M. , Radimislensky Irina , Givon Adi , Almog Ofer , Benov Avi ,   Israel Trauma Group, Katorza Eldad
Published: August 2024

Background:

On Saturday, October 7th, approximately 3000 Hamas-led terrorists infiltrated Israel’s southern border and attacked civilians and soldiers. Terrorists murdered close to 1200 people, abducted hundreds, and injured thousands. This surprise attack involved an unprecedented number of casualties. This article describes the injuries and outcomes of the hospitalized casualties.

Methods:

Hospitalized trauma casualties with an injury date of October 7 to 8, 2023, and with ICD9 E-codes E979 and E990 through E999, were extracted from the Israel National Trauma Registry. Demographic, injury, and hospital resource-use data were analyzed.

Results:

A total of 630 hospitalized casualties (277 civilians and 353 soldiers) suffered from gunshot wounds (90%), explosion-related wounds (19%), and multiple injury mechanisms (16%). The median age for civilians was 33 years (ages <1–88) and 21 years for soldiers. The most frequently injured body regions were lower (49%) and upper (42%) extremities, abdominal (28%), and thoracic (23%) injuries. Four hundred thirty-one (68%) patients underwent surgery, of which 240 within 12 hours. Over half of the severe and critical (Injury Severity Score 16+) casualties were discharged to a rehabilitation center. In-hospital mortality rate was 2.5%.

Conclusion:

Israel’s hospitals faced many challenges following the mega mass casualty incident, including the absorption, diagnosis, treatment, and rehabilitation of a massive number of casualties. Hospitals needed to immediately repurpose to provide additional imaging equipment and operating rooms. Additionally, the huge demand for rehabilitation resources necessitated immediate reorganization and transformation of existing medical facilities to accommodate the many casualties requiring rehabilitation. The injury details and outcomes from this mega mass casualty incident provide important information for planning and preparedness at local, regional, and national levels.
Identifying Risk Factors for Open Reduction in Pediatric Supracondylar Humerus Fractures
Authors: Kolac Ulas Can , Oral Melih , Sili Mazlum Veysel , Ibik Serkan , Aydinoglu Hasan Samil , Bakircioglu Sancar , Yilmaz Guney
Published: August 2024

Background:

Supracondylar humerus fractures (SCHFs) are the most common injuires of the elbow in children, often categorized by the Gartland classification. While type 1 and 2 fractures commonly managed conservatively, type 3 and 4 fractures typically require surgical treatment. Although closed reduction and percutaneous pinning have shown success, open reduction may be required in cases where adequate reduction cannot be achieved. This study aims to identify radiological and clinical risk factors associated with transitioning from closed reduction to open reduction in Gartland type 3 and 4 SCHF in children.

Study Design and Methods:

We retrospectively analysed 159 patients operated on between 2014 and 2022 for Gartland type 3 and 4 SCHF. Parameters including age, gender, injury severity, time to surgery, neurovascular damage, medial spike angle, fracture-skin distance, medial-lateral deviation, rotation, fracture level, and Baumann angle were evaluated.

Results:

A total of 159 SCHF in children aged 3 to 12 years, classified as Gartland type 3 (106 patients, 66.6%) and type 4 (53 patients 33.4%), underwent surgical intervention. Notably, 46 patients (28.9%) initially managed with closed reduction exhibited failure, prompting the necessity for conversion to open reduction. Injury severity, lateral deviation, advanced age, low medial spike angle, and low fracture tip-to-skin distance were found to be factors that could potentially increase the need for open reduction (P<0.05). Logistic regression analysis showed that the low medial spike angle, flexion type injury, and low fracture type increased the likelihood of open surgery (P<0.05). Sex, side, duration to surgery, and Baumann angle showed no significant associations.

Conclusions:

SCHF commonly necessitate surgical intervention in children. Although the risk factors for failed closed reduction and the need for open surgery have been discussed in the literature, there is no consensus. Preoperative planning, particularly for patients with specific factors like lateral deviation, advanced age, low medial spike angle, low fracture-to-skin distance and high injury severity, should consider potential open surgery requirements.

Level of Evidence:

Level III
Infinity: A Prospective Trial for Safety and Accuracy of Navigated Posterior Cervical and Thoracic Instrumentation in long-segment Fusions
Authors: Wang Joshua L. , Eaton Ryan G. , Dhaliwal Joravar , Lam Chi Shing , Xu David S. , Viljoen Stephanus V. , Grossbach Andrew J.
Published: August 2024

Study Design.

Unblinded single-arm prospective clinical trial

Objective.

Evaluate safety and accuracy of navigation for placement of posterior cervicothoracic instrumentation.

Summary of Background Data.

Computer assisted stereotactic navigation for placement of spinal instrumentation has been widely studied and implemented in the thoracic and lumbar spine. However less literature exists regarding the use of computer assisted navigation for posterior cervical instrumentation, particularly with lateral mass fixation. Here we present the first prospective study of navigated cervical lateral mass screw placement for cervicothoracic fusion.

Methods.

Patients who met indications for posterior cervical fusion were screened, consented, and enrolled preoperatively for instrumentation with Medtronic Infinity Occipital-Cervical-Thoracic implants, with use of intraoperative O-arm and stereotactic Stealth navigation. Postoperative CTs of the instrumented levels were obtained during the same hospital admission. Primary outcome of the trial was safety. Secondary outcomes were screw accuracy assessed by Gertzbein-Robbins grade, neurologic exams, and patient reported outcomes on the PROMIS 29 questionnaire.

Results.

A total of 50 patients underwent surgery, and 557 screws were placed. There were no adverse events related to the use of navigation or screw malposition. Gertzbein-Robbins grade A or B placement comprised 95% of navigated screws. There was a decrease in positive Hoffmann sign rate postoperatively, and sensory and motor exams remained stable. There was improvement in patient reported pain and sleep domains.

Conclusions.

Navigation for cervicothoracic instrumentation is safe overall and leads to high rates of accurately placed screws. Longer term follow up could provide more insight to whether the use of this technology results in durable improvement in spinal alignment parameters and patient reported outcomes.

Level of Evidence.

3
Conservation of resources perspective on authentic leadership and employee well-being: The influence of job stress and emotional intelligence
Authors: Shih Fang-Chi , Yeh Shu-Chuan Jennifer
Published: August 2024

Background

Health care industries must consider their sustainable development, and employee well-being is a crucial environmental, social, and governance indicator that should be prioritized. During events such as the COVID-19 pandemic, information transparency is a concern for health care workers. Authentic leaders can build trust by openly sharing their thoughts and feelings. Understanding how authentic leadership affects employee well-being through job stress and how emotional intelligence reduces job stress is essential for health care workers.

Purposes

This study investigated the effect of authentic leadership on employee well-being and considered the mediating role of job stress and moderating role of emotional intelligence in this effect.

Methodology/Approach

A time-lagged survey of 452 full-time health care workers (comprising nurses, allied health professionals, and administrative workers) from a general hospital in Taiwan was conducted.

Findings

Authentic leadership was positively associated with employee well-being, and job stress mediated the effects of authentic leadership on employee well-being. Among the employees who perceived leadership to be authentic, those with higher emotional intelligence felt less job stress.

Conclusion

From the perspective of conservation of resources theory, authentic leadership was identified as a crucial factor influencing how health care workers reduce job stress and improve their well-being. Emotional intelligence was identified as essential in enhancing the effects of authentic leadership on reducing the job stress of health care workers.

Practice Implications

Organizations should promote authentic interactions between leaders and followers and provide training for developing authentic leadership. They should also provide training to improve their employees' emotional intelligence.
PERFLUOROCARBON LIQUID USE DURING VITRECTOMY FOR MACULA-OFF RETINAL DETACHMENT HAS NO IMPACT ON MACULAR FOLDS AND METAMORPHOPSIA
Authors: Wurtz Mathieu , Dormegny Lea , Muller Candice , Bourcier Tristan , Ballonzoli Laurent , Gaucher David , Saleh Maher
Published: August 2024

Purpose:

To compare two drainage techniques in macula-off retinal detachment surgery: perfluorocarbon liquid (PFCL)-assisted drainage and partial subretinal fluid drainage without PFCL. This study investigated morphological and functional outcomes, focusing on metamorphopsia quantification.

Methods:

Eighty eyes with macula-off retinal detachment were retrospectively included. All underwent a 25-gauge pars plana vitrectomy. In the PFCL group, subretinal fluid drainage was performed using PFCL. In the partial subretinal fluid drainage (SRFD) group, subretinal fluid was partially drained through a preexisting retinal break without PFCL. A follow-up at 3 months and 6 months evaluated anatomical outcomes using optical coherence tomography, best-corrected visual acuity, and metamorphopsia quantified with M-charts.

Results:

Reattachment rates were comparable in the PFCL group (97.5%) and the SRFD group (95%) (P > 0.05). Mean best-corrected visual acuity (logMAR) was 0.23 ± 0.32 (PFCL group) and 0.15 ± 0.13 (SRFD group) (P = 0.206). Metamorphopsia was reported by 19 patients (47.5%) in the PFCL group and by 12 patients (30%) in the SRFD group (P = 0.332). The mean metamorphopsia score was similar in both groups (0.27 ± 0.12 in the PFCL group and 0.28 ± 0.11 in the SRFD group, P = 0.866). Morphological optical coherence tomography findings were comparable in both groups.

Conclusion:

Morphological and functional outcomes were similar in PFCL and SRFD groups. Metamorphopsia quantification scores did not improve with PFCL. While both of these techniques might be effective and could be recommended for primary macula-off retinal detachment management, potential PFCL toxicity should be kept in mind and its use dedicated to selected cases.
Engineered autologous nasal cartilage for repair of nasal septal perforations: a case series
Authors: Kaiser Benedict , Miot Sylvie , Wixmerten Anke , Pullig Oliver , Eyrich Matthias , Fulco Ilario , Vavrina Josef , Schaefer Dirk J. , Martin Ivan , Barbero Andrea , Haug Martin D.
Published: August 2024

Objective:

This phase I clinical trial assessed the use of autologous nasal chondrocyte tissue-engineered cartilage (N-TEC) for functional repair of nasal septal perforations (NSP).

Background:

The most widely used technique to treat NSP, namely interposition grafting with a polydioxanone (PDS) plate combined with a deep temporal fascia (DTF) graft, is still suboptimal towards patient satisfaction and revision rates.

Methods:

Patients (n=5, all female, age range: 23–54 years) had a 0.5–2.0 cm diameter NSP. N-TEC was manufactured by expansion and 3D culture of autologous nasal septum chondrocytes into Chondro-Gide collagen membranes. N-TEC was then shaped intraoperatively and enveloped in the harvested DTF before suturing it into the NSP. Safety (primary outcome) was assessed by the number of serious adverse reactions (SAR) until 12 months. Secondary outcomes included feasibility, assessed by surgical graft manipulation, and efficacy, assessed using subjective scoring (nasal obstruction symptom evaluation, NOSE, and visual analog scale, VAS, scores) and objective breathing function tests. Structural closure of NSP after 12 months was defined using endoscopy and computed tomography (CT) scans.

Results:

NSP treatment by N-TEC implantation was safe and feasible, as no SAR and no challenge in graft manipulation was recorded for any of the patients. One year postoperative, subjective scoring improved in all patients, unless already optimal (average improvement of 23 and 28.6 points out of 100, respectively, for NOSE and VAS scores). Objective respiratory function overall confirmed – with the exception of one case – the observations above (average improvement of 172 ml/s). NSP were closed and the mucosae completely healed in three patients.

Conclusion:

Autologous N-TEC is a valid treatment for NSP and warrants further clinical tests.
The reduction of LEDD leads to visual dysfunction in patients with PD after STN-DBS: a randomized clinical trial
Authors: Sun Jinxing , Ma Shengmei , Li Zhenke , Jia Junheng , Wu Qianqian , Hou Ying , Wang Hong , Wang Qi , Zhang Guangjian , Zhao Zhimin , Huang Bin , Ma Xiangyu , Li Xingang , Li Weiguo , Zhang Chao
Published: August 2024

Background:

Medication adjustment after deep brain stimulation (DBS) of the subthalamic nucleus (STN) in patients with Parkinson’s disease (PD) may influence visual function. However, no clinical trials have been designed specifically to investigate this effect.

Objectives:

To compare the effects of levodopa-equivalent daily dose (LEDD) reduction and non-reduction on visual function in patients with Parkinson’s disease (PD) following STN-DBS.

Methods:

This was a multi-center, prospective, randomized, double-blinded clinical trial. A total of 208 patients with Parkinson’s disease were referred for DBS between June 2019 and July 2021 and analyzed between June 2023 and July 2023. STN-DBS was performed, and the LEDD was reduced in one study arm but not in the other. The primary outcome measure was visual impairment in Parkinson’s disease questionnaire (VIPD-Q) with or without LEDD reduction 12 months postoperatively, and the secondary outcomes included retinal nerve fiber layer (RNFL) thickness, vessel density, eye-tracking system results, contrast sensitivity and visual field.

Results:

During the short-term follow-up, DBS implantation and stimulation did not significantly affect visual function (VIPD-Q, baseline vs. 1 month, 9.269±8.385 vs. 8.938±7.666, Mann–Whitney U tests; P=0.6746). In the long-term follow-up, the reduction group demonstrated a significant decline in visual function, RNFL thickness, and vessel density after STN-DBS compared with the control group without STN-DBS (P<0.001).

Conclusions:

Visual dysfunction, particularly a thinner RNFL and lower vessel density, is related to LEDD reduction after STN-DBS. Prolonged administration of dopamine-mimetic drugs prevents visual symptoms. Thus, physicians should consider LEDD adjustment when patients report visual dysfunction before surgery or severe visual symptoms after STN-DBS.
Papillary thyroid carcinoma with invasion of the trachea
Authors: Mohtasib Mohammad Eid Al , Sharabate Khulood “Mohammad Marwan” , Dweik Raghad Faisal Yahia , Shawar Fatimah Iyad Azmi , Shehadeh Daleen Ashraf Azmi
Published: August 2024

Introduction:

Papillary thyroid carcinoma typically has a favourable survival rate and a low recurrence rate. However, extrathyroidal extension has a significant negative impact on survival. Among the extrathyroidal extensions, invasion of the trachea by papillary thyroid carcinoma is rare and serves as a marker of more aggressive tumour behaviour. This case report aims to highlight the unusual clinical course of papillary thyroid carcinoma.

Case presentation:

A 75-year-old female patient from Gaza has been diagnosed with papillary thyroid carcinoma in 2020. With mediastinal lymph node invasion. she underwent total thyroidectomy and neck dissection and mediastinal lymph node dissection. After the surgery, the patient did not follow up regularly or receive radioiodine treatment. On 2023 presented with hemoptysis, shortness of breath computed tomography (CT) and bronchoscopy reveal thyroid cancer with tracheal invasion, which has invaded the trachea to the left side. The authors treat the patient by bronchoscopy debulking and sent for oncological management.

Discussion:

Papillary thyroid carcinoma is the most common type of thyroid cancer and generally has a good prognosis. Tumour staging through various imaging techniques is crucial for determining the next steps. Cases involving tracheal invasion should undergo bronchoscopy for tumour debulking. Surgical management followed by iodine therapy has shown positive outcomes.

Conclusion:

When patients with Papillary thyroid carcinoma have haemoptysis, and the imaging examinations reveal a space-occupying lesion in airway, clinicians should focus on Papillary thyroid carcinoma with tracheal invasion, a bronchoscopic examination must be immediately performed because the subsequent surgical management depends on the degree of tracheal invasion.
Elacestrant in the treatment landscape of ER-positive, HER2-negative, ESR1-mutated advanced breast cancer: a contemporary narrative review
Authors: Qureshi Zaheer , Jamil Abdur , Altaf Faryal , Siddique Rimsha , Adilovic Edin , Fatima Eeshal , Shah Shivendra
Published: August 2024

Introduction:

Estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2−) breast cancer with ESR1 mutations presents a significant therapeutic challenge due to its adaptive resistance mechanisms to chemotherapy, especially endocrine treatment. Elacestrant, a novel oral selective estrogen receptor degrader (SERD), has emerged as a promising agent in this treatment-resistant era.

Method:

A comprehensive search was conducted on pivotal clinical trials, including the RAD1901-005 Trial, EMERALD TRIAL, ELIPSE, and ELEVATE, focusing on their methodologies, patient populations, treatment regimens, and outcomes.

Discussion:

This narrative review describes the available preclinical and clinical evidence on elacestrant, focusing on its pharmacodynamics, pharmacokinetics, efficacy, and safety within the existing literature. Elacestrant has demonstrated excellent activity against ESR1 mutations associated with resistance to first-line endocrine therapies. Clinical trials have shown improved progression-free survival in patients with advanced ER+/HER2−, ESR1-mutated breast cancer. Safety profiles indicate a tolerable side effect spectrum consistent with other agents. Its oral bioavailability offers a convenient alternative to injectable SERDs, with potential implications for patient adherence and quality of life. The review also discusses the comparative efficacy of elacestrant relative to existing endocrine therapies and its possible use in combination regimens.

Conclusion:

Ongoing clinical trials assessing elacestrant and other SERDs will yield data that might aid clinicians in determining the optimal selection and order of endocrine treatment drugs for ER+ breast cancer. The integration of targeted and immunotherapeutic agents with traditional chemotherapy represents a pivotal shift in Breast Cancer treatment, moving towards more personalized and effective regimens.
The pulse of sleep: novel interventions in understanding the sleep-cardiovascular connection: a literature review
Authors: Uwishema Olivier , Nazir Abubakar , Munyangaju Isabelle , Shariff Sanobar , Al Komi Omar , Chibueze Nweke , Wojtara Magda
Published: August 2024

Introduction:

Sleep disorders represent common complaints in different medical illnesses. They encompass a risk for diverse inflammatory, metabolic, and cardiovascular diseases. Sleep disorders include disorders of hypersomnolence, insomnia, parasomnias, sleep-related movement disorders, circadian rhythm sleep-wake-disorders, and sleep-related breathing disorders, each one of which was associated with increased cardiovascular disease risk in a different mechanism. In this review, the authors address the most recent research on the correlation between sleep and CVD.

Methods:

The literature on sleep disorders and their potential links to various cardiovascular diseases was reviewed in narrative form. For the published papers up to June 2023, the authors searched the databases of PubMed and Google Scholar. Literature demonstrating the relationship between these illnesses, pathophysiological mechanisms, diagnosis, and various therapeutic approaches was included.

Results:

Sleep disorders were significantly linked to heart rate variability, hypertension, and obesity, which can eventually result in cardiovascular consequences and affect mortality and morbidity. The disruption in sleep cycles, which can be noticed in different sleep disorders, can obviously result in blood pressure, heart rate, and other cardiac functions. The clinical assessment acts as the cornerstone in the diagnosis of different spectrums of sleep disorders. The management of sleep disorders ranges from cognitive-behavioral therapy to continuous positive airway pressure (CPAP).

Conclusion:

Additional research on the topic is needed to pinpoint any potential links and pathological processes. To improve clinical treatment and preventive measures, further observational studies should emphasize the reliability of early diagnostic signs.
The relationship between parenting styles and self-esteem of medical students with age and gender as moderators
Authors: Gul Fahad , Abbas Khawar , Saeed Sajeel , Haider Tehseen , Qayyum Sardar Noman , Noori Samim
Published: August 2024

Introduction:

Among various factors that determine an individual’s self-esteem, parenting styles play a significant role. This study investigates the link between parenting styles and self-esteem among medical students while exploring the role of age and gender in this context.

Methodology:

A cross-sectional study was carried out among medical students from December 2020 to March 2021. An online survey was prepared using the Rosenberg Self-Esteem Scale and Parental Authority Questionnaire-Short Version, and students were asked to fill it out. Data were gathered from 255 students by simple random sampling technique, of which 230 forms were filled. SPSS version 26.0 was used to enter and analyze the data. One sample t-test, Pearson Correlation, and Hierarchal regression analysis were applied. AMOS version 26.00 was used for confirmatory factor analysis.

Results:

Out of 230 participants, 60% of the sample population experienced an authoritative parenting style. Authoritarian and authoritative parenting styles were significantly correlated with self-esteem. Females who experienced authoritative parenting and males who experienced authoritarian and permissive parenting styles had higher self-esteem than their respective counterparts.

Conclusion:

Authoritative parenting was the most common and the only parenting style with a statistically significant positive correlation with self-esteem. This study further highlights the importance of consistent parental supervision and open communication in determining an individual’s self-esteem.
Herpes Simplex Type 1 as the Predominant Cause of Genital Herpes in College Students
Authors: Falk-Hanson Elizabeth , Marconi Agustina , Sarrouf Elena Beatriz , Sullivan Phoebe
Published: August 2024

Background

Genital herpes etiology has been shifting to include a greater proportion of herpes simplex virus type 1 (HSV-1) infection in the last few decades. A prior study published in 2003 found that 48.9% of infections in a college health population were HSV-1.

Methods

We evaluated the number of positive HSV polymerase chain reaction test results obtained from anogenital sites from undergraduate and graduate students from 2013 to 2022 in a college health clinic setting and analyzed the number caused by HSV-1 and HSV type 2 and compared by sex. This was then compared with the prior study from 1993 to 2001.

Results

We received 691 (of 2685 samples) positive polymerase chain reaction results for HSV of both types in the period analyzed. Overall, 600 (86.8%) of these were HSV-1, and 520 (75.2%) were in female patients. The prior study in 1993 to 2001 found that 48.9% (244 of 675) of all positive test results were HSV-1; we observed an increase in the percentage of positive HSV-1 over all positive test results of 1.8 (χ
2 = 16.548; P < 0.001).

Conclusions

Our study shows that 86.8% of the positive genital HSV test results from 2013 to 2022 were HSV-1. This shows that most positive HSV test results in this setting are now HSV-1, a substantial increase from the previous study in our clinic.