bluuebunny/crossref_metadata_2025 huggingface dataset:
Carbon disulfide induces accumulation of TDP-43 in the cytoplasm and mitochondrial dysfunction in rat spinal cords
Authors: Liu Zhidan , Qiang Yalong , Shan Shulin , Wang Shuai , Song Fuyong
Published: January 2024

The relationship between environmental neurotoxicant exposure and neurodegenerative diseases is being extensively investigated. Carbon disulfide, a classic neurotoxicant and prototype of dithiocarbamates fungicides and anti-inflammatory agents, has been detected in urban adults, raising questions about whether exposure to carbon disulfide is associated with a high incidence of neurodegenerative diseases. Here, using rat models and SH-SY5Y cells, we investigated the possible mechanistic linkages between carbon disulfide neurotoxicity and the expression of TDP-43 protein, a marker of amyotrophic lateral sclerosis/frontotemporal lobar degeneration. Our results showed that rats exhibited severe dyskinesia and increased TDP-43 expression in the spinal cord following carbon disulfide exposure. Moreover, carbon disulfide exposure induced abnormal cytoplasmic localization and phosphorylation of TDP-43 in motor neurons. Importantly, carbon disulfide treatment led to the accumulation of TDP-43 in the mitochondria of motor neurons and resulted in subsequent mitochondrial damage, including mitochondrial structural disruption, mitochondrial respiratory chain complex I inhibition, and impaired VCP/p97-dependent mitophagy. In summary, our study provides support for carbon disulfide exposure-mediated TDP-43 mislocalization and mitochondrial dysfunction, contributes to understanding the pathogenesis of environmental neurotoxin-induced neurodegeneration, and provides inspiration for potential therapeutic strategies.
Effect of Ca addition on near-infrared reflection of SrCuSi4O10
Authors: Obata Kenji , Konishi Rin , Okagami Aoshi , Matsushima Shigenori
Published: January 2024

In this study, SrCuSi4O10 powders were synthesized by a complex polymerization method and the effect of Ca addition on the crystal structure and optical properties in the visible and near-infrared regions was examined. Crystalline SrCuSi4O10 was formed at 1,000 °C in air. From the X-ray diffraction measurements, the (002) and (004) reflections of SrCuSi4O10 shifted to higher angles, and the lattice parameter (a and c) decreased with the addition of Ca, suggesting that Ca was successfully introduced into SrCuSi4O10. However, the lattice constant of SrCuSi4O10 increased with further addition of Ca to 10 mol%. Optical measurements of SrCuSi4O10 identified three optical absorption bands in the visible light region, attributed to the d–d transition of Cu2+: namely 2B1g → 2B2g (540 nm), 2B1g → 2Eg (628 nm), and 2B1g → 2A1g (800 nm). The addition of Ca decreased the intensity of these absorptions. The –b* value, which indicates blueness, was estimated using the L*a*b* color system, and SrCuSi4O10 with 5 mol% Ca showed the highest value among the measured samples. On the other hand, the reflectance of SrCuSi4O10 in the near-infrared region increased significantly with the addition of Ca. These results indicate that Ca addition is effective in improving the blue coloration and near-infrared reflectivity of SrCuSi4O10.
Severe aortic stenosis: secular trends of incidence and outcomes
Authors: Benfari Giovanni , Essayagh Benjamin , Michelena Hector I , Ye Zi , Inojosa Jose Medina , Ribichini Flavio L , Crestanello Juan , Messika-Zeitoun David , Prendergast Bernard , Wong Benjamin F , Thapa Prabin , Enriquez-Sarano Maurice
Published: January 2024

Background and Aims

Severe aortic stenosis (AS) is the guideline-based indication for aortic valve replacement (AVR), which has markedly increased with transcatheter approaches, suggesting possible increasing AS incidence. However, reported secular trends of AS incidence remain contradictory and lack quantitative Doppler echocardiographic ascertainment.

Methods

All adults residents in Olmsted County (MN, USA) diagnosed over 20 years (1997–2016) with incident severe AS (first diagnosis) based on quantitatively defined measures (aortic valve area ≤ 1 cm2, aortic valve area index ≤ 0.6 cm2/m2, mean gradient ≥ 40 mmHg, peak velocity ≥ 4 m/s, Doppler velocity index ≤ 0.25) were counted to define trends in incidence, presentation, treatment, and outcome.

Results

Incident severe AS was diagnosed in 1069 community residents. The incidence rate was 52.5 [49.4–55.8] per 100 000 patient-year, slightly higher in males vs. females and was almost unchanged after age and sex adjustment for the US population 53.8 [50.6–57.0] per 100 000 residents/year. Over 20 years, severe AS incidence remained stable (P = .2) but absolute burden of incident cases markedly increased (P = .0004) due to population growth. Incidence trend differed by sex, stable in men (incidence rate ratio 0.99, P = .7) but declining in women (incidence rate ratio 0.93, P = .02). Over the study, AS clinical characteristics remained remarkably stable and AVR performance grew and was more prompt (from 1.3 [0.1–3.3] years in 1997–2000 to 0.5 [0.2–2.1] years in 2013–16, P = .001) but undertreatment remained prominent (>40%). Early AVR was associated with survival benefit (adjusted hazard ratio 0.55 [0.42–0.71], P < .0001). Despite these improvements, overall mortality (3-month 8% and 3-year 36%), was swift, considerable and unabated (all P ≥ .4) throughout the study.

Conclusions

Over 20 years, the population incidence of severe AS remained stable with increased absolute case burden related to population growth. Despite stable severe AS presentation, AVR performance grew notably, but while declining, undertreatment remained substantial and disease lethality did not yet decline. These population-based findings have important implications for improving AS management pathways.
A cross-sectional nationwide survey of guideline based syncope units in the Netherlands: the SU-19 score—a novel validation for best practices
Authors: van Zanten Steven , de Jong Jelle S Y , Scheffer Mike G , Kaal Evert C A , de Groot Joris R , de Lange Frederik J
Published: January 2024

Aims

We aimed to identify all syncope units (SUs) in the Netherlands and assess the extent to which these SUs fulfil the essential requirements outlined by the consensus statements of the European Heart Rhythm Association and the European Society of Cardiology syncope guidelines. For this, we developed the SU-19 score, a novel guideline based validation tool for best practice.

Methods and results

All outpatient clinics of cardiology, neurology, and internal medicine in the Netherlands were screened for presence of any form of structured specialized syncope care. If present, these were included as SUs and requested to complete a questionnaire regarding syncope care. We assessed all SUs using the SU-19 score regarding structure (3 points), available tests (12 points), and initial evaluation (4 points). Twenty SUs were identified in the Netherlands, both academic (5/20) and non-academic hospitals (15/20), 17/20 reported multidisciplinary involvement during initial evaluation. In 19/20, neurology, cardiology, or both were responsible for the syncope management. Non-physicians were involved performing the head-up tilt test (44%) and initial evaluation (40%). The mean SU-19 score was 18.0 ± 1.1, 45% achieved the maximum score of 19 points. Variations were observed in protocols for active standing test, carotid sinus massage, and head-up tilt test.

Conclusion

There is a network of 20 SUs in the Netherlands. Forty-five per cent fully met the SU-19 score (mean 18.0 ± 1.1). Slight variety existed in protocols for autonomic function tests. Neurology and cardiology were mostly involved in syncope management. Non-physicians play an important role in syncope care.
Small states and the dilemma of geopolitics: role change in Finland and Sweden
Authors: Michalski Anna , Brommesson Douglas , Ekengren Ann-Marie
Published: January 2024

This article focuses on foreign policy role change in small liberal states caused by a weakening rules-based order illustrated by the decisions of Finland and Sweden to apply for membership of NATO, thereby abandoning longstanding policies of military non-alignment. Although both countries sought alignment with NATO in the context of intense security threats in northern Europe, the domestic processes of foreign policy role change proceeded along different trajectories. In Finland, the domestic process of role change was characterized by strong elite and public consensus on membership of NATO, whereas in Sweden there was more hesitation regarding giving up military non-alignment and losing freedom of action. In this article, we address a gap in the literature on role theory and domestic role change by conceptualizing the dilemma of small liberal states being compelled to reassess national role conceptions in their domestic settings in the face of external challenges outside their control, without jeopardizing national autonomy and deep-seated social identities. To this end, we construct a model for national action strategies based on scope conditions of domestic role change, varying according to the level of congruence in national identity and the degree of domestic elite consensus concerning national foreign policy.
The scholarship–practitioner nexus: lessons from Latin American foreign policy
Authors: Deciancio Melisa
Published: January 2024

Various studies have explored the role of International Relations research in policy-making, predominantly focusing on countries in the global North. However, there needs to be a better understanding of this dynamic in peripheral countries of the global South. This article addresses this gap by examining the relationship between theory and practice in Latin American foreign policy; the synergy between scholarly research and practical implementation offers valuable insights. This interplay sheds light on the impact research can have by developing unique theoretical frameworks and guiding current foreign policy strategies. Using Argentine foreign policy as a case-study, I explore specialized knowledge networks that have driven foreign policy studies, their inception in Latin America and pivotal theoretical developments that have influenced both academia and policy. Employing qualitative analysis, I triangulate data from diverse sources such as archives, official documents, journals, institutional histories, reports and expert interviews. This investigation underscores the collaborative efforts of Latin American scholars and policy-makers, driven by a shared goal to address regional challenges through both theoretical insights and practical solutions.
Circulating miR-199a and long noncoding-RNA ANRIL as Promising Diagnostic Biomarkers for Inflammatory Bowel Disease
Authors: Erfan Randa , Shaker Olfat G , Khalil Mahmoud A F , Mahmoud Fatma A M , Gomaa Mohamed S , Abu-El-Azayem Abeer K , Zaki Othman M , Ahmed Azza M , Samy Amira , Mohammed Asmaa
Published: January 2024

Background & Aims

Inflammatory bowel disease (IBD), involving both Crohn’s disease (CD) and ulcerative colitis (UC), represents a chronic, immune-mediated inflammatory disease due to an uncontrolled, ongoing inflammatory response to intestinal bacteria in those with genetic susceptibility. MicroRNA (miRNA) extrusion from relevant remote organs or tissues is reflected in the expression of miRNAs in serum and plasma. Both UC and CD patients had higher blood levels of expressed miR-199a. Long noncoding RNA (lncRNA) ANRIL is a proinflammatory gene that mediates nuclear factor κB to play a role in inflammatory diseases, such as IBD. The aim of the current study is to investigate the potential role of both miR-199a and ANRIL in diagnosing IBD in adult patients.

Methods

Sixty-seven IBD patients diagnosed clinically, radiologically, endoscopically, and histologically were included in this prospective cohort study. Participants were classified into 3 groups: the UC group (n = 35), the CD group (n = 32), and the control group (n = 30). Demographics, history taking, laboratory characteristics, and treatments were recorded. Tumor necrosis factor α, miR-199a, and ANRIL were measured.

Results

The findings suggested that miR-199a and ANRIL might be associated with the occurrence or progression of IBD because both genes were substantially expressed in the peripheral blood of patients with this condition. Receiver-operating characteristic curve analysis indicated that the detection of miR-199a and ANRIL had a predictive sensitivity of 62.9% and 88.6% and a specificity of 70.7% and 96.7% for the occurrence of UC cases, respectively, and a predictive sensitivity of 72.4% and 46.9% and a specificity of 96.7% and 34.7% for the occurrence of CD cases, respectively.

Conclusions

Both miR-199a and ANRIL are abundant in the sera of IBD adult Egyptian patients (UC and CD). Both can represent a noninvasive marker for early disease diagnosis.
Durability of Adalimumab and Infliximab in Children With Crohn’s Disease: A Nationwide Comparison From the epi-IIRN Cohort
Authors: Atia Ohad , Friss Chagit , Focht Gili , Magen Rimon Ramit , Ledderman Natan , Ben-Tov Amir , Loewenberg Weisband Yiska , Matz Eran , Gorelik Yuri , Chowers Yehuda , Dotan Iris , Turner Dan
Published: January 2024

Background

In a nationwide cohort, we aimed to compare the durability of infliximab and adalimumab as first biologic treatment in children with Crohn’s disease (CD), stratified as combotherapy or monotherapy.

Methods

We used data from the epi-IIRN cohort that includes all patients with inflammatory bowel diseases in Israel. Durability was defined as consistent treatment without surgery or treatment escalation. All comparisons followed stringent propensity-score matching in Cox proportional hazard models.

Results

Of the 3487 children diagnosed with CD since 2005, 2157 (62%) received biologics (1127 [52%] infliximab, 964 [45%] adalimumab and 52 [2%] vedolizumab as first biologic), representing a higher proportion than that among adults diagnosed during the same time period (5295 of 15 776 [34%]; P < .001). Time from diagnosis to initiation of biologic was shorter in pediatric-onset compared with adult-onset disease (median time during the last 3 years was 2.7 months [interquartile range 1.2-5.4] vs 5.2 months [2.6-8.9]; P < .001). The durability of adalimumab monotherapy after 1 and 5 years from initiation of treatment was better than infliximab monotherapy (79%/54% vs 67%/37%, respectively; n = 452 matched children; hazard ratio [HR], 1.7; 95% confidence interval [CI], 1.3-2.3; P < .001), while in those treated with combotherapy, durability was similar (94%/66% with infliximab vs 90%/54% with adalimumab; n = 100; HR, 1.7; 95% CI, 0.9-3.3; P = .1). Durability was higher in children treated with infliximab combotherapy vs infliximab monotherapy (87%/45% vs 75%/39%; n = 440; HR, 1.4; 95% CI, 1.1-1.8; P = .01). The durability of adalimumab monotherapy was similar to infliximab combotherapy (83%/53% vs 89%/56%, respectively; n = 238; HR, 0.9; 95% CI, 0.7-1.2; P = .4).

Conclusion

Our results support using adalimumab monotherapy as a first-line biologic in children with CD. When infliximab is used, combotherapy may be advantageous over monotherapy.
Using fisheries-dependent data to investigate landings of European lobster (Homarus gammarus) within an offshore wind farm
Authors: Thatcher Harry , Stamp Thomas , Moore Pippa J , Wilcockson David
Published: January 2024

The need for alternative strategies to assist in the monitoring and sustainable management of fisheries’ resources is becoming increasingly important. In recent years, greater utilization of fishers’ knowledge has been advocated as a potentially valuable source of data that could be applied to fisheries management issues. In the current study, we addressed this by investigating the landing per unit effort (LPUE) of European lobster (Homarus gammarus) from within an offshore wind farm using a fisheries-dependent commercial fishing logbook. The logbook was provided by a single fisherman who targeted lobsters within the wind farm between 2015 and 2022 using single pots deployed in association with individual wind turbines. Generalized linear mixed modeling was used to investigate changes in LPUE over temporal scales and as the result of the presence of scour protection at turbine locations. LPUE was found to be significantly higher at turbine locations where scour protection was present compared to those turbines where it was not. Predictions from modeling suggested LPUE was nearly 1.5× greater at turbines where scour protection was present. Significant differences in mean monthly and yearly LPUE were detected with this variation likely to reflect seasonal changes in lobster activity and the effect of introducing fishing into a previously unfished area. This work highlights the potential for fishing logbooks to be applied in fisheries management. Our results also demonstrate potential fishing opportunities arising from the development of offshore wind farms and the potential for these opportunities to be enhanced.
LGBT+ rights claims for marriage equality and the possibilities of transforming Indian family law
Authors: Agarwal Akshat
Published: January 2024

The Indian Supreme Court decriminalized homosexuality in 2018 and recognized the equal constitutional citizenship of LGBT+ Indians. Since then, several petitions seeking marriage equality have been filed before Indian courts. In parallel, critics have argued that traditional approaches to LGBT+ equality ignore problematic family law institutions, and have stressed the need to think beyond legal inclusion to recognize diverse families. These arguments are not unique to India. Claiming LGBT+ rights within existing family law institutions has divided LGBT+ activists the world over. The commonly advanced argument is that assimilation into existing patriarchal social institutions disregards radical transformational possibilities. However, experiences in jurisdictions like the United States challenge this premise and show how family law can potentially be transformed through LGBT+ rights claims. While we still await an authoritative judicial pronouncement on marriage equality in India, this article argues that legally recognizing marriage equality may positively impact existing family laws by generating arguments for expanding recognition of diverse families. It shows that achieving marriage equality through the recognition of LGBT+ relational rights, comprising LGBT+ family equality and the right to legal recognition of LGBT+ relationships, has the potential for progressively expanding Indian parenthood laws. The article specifically demonstrates how this is possible in guardianship, assisted reproduction, and adoption laws and may benefit diverse different-sex families, single parents, and persons in non-marital relationships.
Trends in cell medicine: from autologous cells to allogeneic universal-use cells for adoptive T-cell therapies
Authors: Kawamoto Hiroshi , Masuda Kyoko
Published: January 2024

In currently ongoing adoptive T-cell therapies, T cells collected from patients are given back to them after ex vivo activation and expansion. In some cases, T cells are transduced with chimeric antigen receptor (CAR) or T-cell receptor (TCR) genes during the ex vivo culture period in order to endow T cells with the desired antigen specificity. Although such strategies are effective in some types of cancer, there remain issues to be solved: (i) the limited number of cells, (ii) it is time-consuming, (iii) it is costly, and (iv) the quality can be unstable. Points (ii) and (iv) can be solved by preparing allogeneic T cells and cryopreserving them in advance and methods are being developed using healthy donor-derived T cells or pluripotent stem cells as materials. Whereas it is difficult to solve (i) and (iii) in the former case, all the issues can be cleared in the latter case. However, in either case, a new problem arises: rejection by the patient’s immune system. Deletion of human leukocyte antigen (HLA) avoids rejection by recipient T cells, but causes rejection by NK cells, which can recognize loss of HLA class I. Various countermeasures have been developed, but no definitive solution is yet available. Therefore, further research and development are necessary.
Real-time forecasting within soccer matches through a Bayesian lens
Authors: Divekar Chinmay , Deb Soudeep , Roy Rishideep
Published: January 2024

This article employs a Bayesian methodology to predict the results of soccer matches in real-time. Using sequential data of various events throughout the match, we utilise a multinomial probit regression in a novel framework to estimate the time-varying impact of covariates and to forecast the outcome. English Premier League data from eight seasons are used to evaluate the efficacy of our method. Different evaluation metrics establish that the proposed model outperforms potential competitors inspired by existing statistical or machine learning algorithms. Additionally, we apply robustness checks to demonstrate the model’s accuracy across various scenarios.
Comparison of paired ordinal data with mis-classification and covariates adjustment
Authors: Han Yuanyuan , Lu Zhao-Hua , Li Yimei , Poon Wai-Yin
Published: January 2024

In this paper, we develop an estimation and testing procedure for comparing matched-pair ordinal outcomes in studies with confounding factors. The classification method for the categories of ordinal outcomes that is accessible for all units may be prone to mis-classification, and thus another error-free classification method that can only be affordable for a fraction of the units are used, resulting in a dataset with partial validation. The distribution of categorical variables is modelled using correlated bivariate Gaussian latent variables, and the confounding factors are adjusted as covariates. The mis-classification of ordinal outcomes is addressed by estimating the mis-classification probabilities through the partial validation structure of the dataset. The mis-classification probabilities and the other parameters are estimated by a two-stage maximum likelihood estimator, and the difference between the matched-pair ordinal outcomes are assessed by a Wald test statistic. Simulation studies were conducted to investigate the accuracy of the estimates of the model parameters, and the type I error rates and power of the proposed testing procedure. The motivating dataset from the Garki Project was analysed to demonstrate the applicability of the proposed approach.
Dynamite plots in surgical research over 10 years: a meta-study using machine-learning analysis
Authors: Doggett Thomas J , Way Connor
Published: January 2024

Purpose

Bar charts of numerical data, often known as dynamite plots, are unnecessary and misleading. Their tendency to alter the perception of mean’s position through the within-the-bar bias and their lack of information on the distribution of the data are two of numerous reasons. The machine learning tool, Barzooka, can be used to rapidly screen for different graph types in journal articles.

We aim to determine the proportion of original research articles using dynamite plots to visualize data, and whether there has been a change in their use over time.

Methods

Original research articles in nine surgical fields of research were sampled based on MeSH terms and then harvested using the Python-based biblio-glutton-harvester tool. After harvesting, they were analysed using Barzooka. Over 40 000 original research articles were included in the final analysis. The results were adjusted based on previous validation data with 95% confidence bounds. Kendall τ coefficient with the Mann–Kendall test for significance was used to determine the trend of dynamite plot use over time.

Results

Eight surgical fields of research showed a statistically significant decrease in use of dynamite plots over 10 years. Oral and maxillofacial surgery showed no significant trend in either direction. In 2022, use of dynamite plots, dependent on field and 95% confidence bounds, ranges from ~30% to 70%.

Conclusion

Our results show that the use of dynamite plots in surgical research has decreased over time; however, use remains high. More must be done to understand this phenomenon and educate surgical researchers on data visualization practices.
Gamma irradiation system’s performance tests
Authors: Taubaldiev Azamat , Živanović Miloš
Published: January 2024

This study reviews the performance analysis of a 137Cs irradiation system that has recently been installed in the laboratory of Uzbek National Institute of Metrology. The laboratory is responsible for calibrating calibration facilities and for calibrating most protection level radiation monitoring instruments used in medical, nuclear, industrial and academic settings in Uzbekistan. This system employs the most advanced radiation safety standards, along with 21st century source automation methods. In this work, we review the system’s performance according to ISO 4037 and present measurement uncertainty budget. Our analysis shows excellent results in terms of scattered radiation, beam uniformity and field size, change in source position, test for source impurities, chamber stability and source calibration, and all these parameters fully comply with the requirements of ISO 4037.
Hemiepiphysiodesis using tension band plates: does the insertion technique or screw length influence the rate of correction?
Authors: Agarwal Anil , Jain Ankit , Sharma Lokesh , Patel Yogesh , Garg Varun , Sachdeva Kishmita
Published: January 2024

We retrospectively studied the effect of certain characteristics of the insertion technique and the construct of tension band plates on its angular correction rates. The study included 68 physes in 28 children. The following preoperative radiological parameters were measured: interscrew angle; the length of the epiphyseal screw, its distance and angle (screw trajectory angle) with respect to the physis. Additionally, changes in the mechanical lateral distal femoral angle and medial proximal tibial angle were calculated from the follow-up radiographs. The statistical calculations involved correlating the above-mentioned parameters and correction rates using a correlation coefficient. The mean patient age at the time of surgery was 8.6 years and the follow-up was 12.1 months. The mean screw trajectory angle was 13.4 degrees, the interscrew angle 18.9 degrees and the proportion of screw length was 41.3%. The mean correction rate recorded was 1.1 degrees/ month. The child’s age (R = −0.13), screw trajectory angle (R = −0.13), interscrew angle (R = −0.02), distance of screw from physis (R = 0.04), and length of screw (R = 0.07) did not show statistically significant correlation with the angular correction rates. The correction rate produced by the tension band plate was found nearly independent of the parameters recorded for insertion technique (screw trajectory angle, interscrew angle, distance of screw from the physis) or construct (length of the epiphyseal screw). It functions as long as the physis is tethered by a side plate adequately secured by appropriate length screws.
Risk factors of diabetes and cancer-specific mortalities in patients with infiltrating ductal carcinoma of the breast: a population-based study
Authors: Elshanbary Alaa Ahmed , Zaazouee Mohamed Sayed , Nourelden Anas Zakarya , Al-Kafarna Mohammed , Matar Sajeda Ghassan , Elsaeidy Ahmed Saad , Ragab Khaled Mohamed , Elhady Mahmoud M. , Albadrani Ghadeer M. , Altyar Ahmed E. , Kensara Osama A. , Abdel-Daim Mohamed M.
Published: January 2024

Background and aims

Breast cancer is considered one of the most common neoplasms worldwide. Diabetes (DM) increases mortality among postmenopausal patients with breast cancer. Our study aims to identify the risk factors of DM-specific mortality and infiltrating ductal carcinoma (IDC) mortality in patients with IDC of the breast.

Materials and methods

Data of IDC patients were obtained from the Surveillance, Epidemiology, and End Results database from 1975 to 2016. Independent variables included age, race, marital status, the primary site of IDC, breast subtype, the disease stage, grade, chemotherapy, radiation, and surgery. Kaplan–Meier, Cox and Binary regression tests were used to analyze the data using SPSS software.

Results

A total of 673 533 IDC patients were analyzed. Of them, 4224 died due to DM and 116 822 died due to IDC. Factors that increase the risk of overall, IDC-specific, and DM-specific mortalities include older age, black race, widowed, uninsured, regional and distant stages, grade II and III, and no treatment with chemotherapy or radiotherapy or surgery. Additionally, the IDC mortality increased with separated status, all primary sites, all breast subtypes, and stage IV.

Conclusion

In patients with IDC, controlling DM besides cancer is recommended to reduce the mortality risk. Old, black, widowed, uninsured, regional and distant stages, grade II and III, and no treatment are common risk factors for DM- and IDC-mortality.
The blood lactate/serum albumin ratio might represent a good prognostic indicator of 28-day mortality in patients with acute respiratory distress syndrome: a retrospective observational study
Authors: Chen Jiahao , Gao Chang , Yang Ling , Yang Lijuan , He Ying , Guo Shiqi , Sun Yuanxiao , He Siyu , Guo Qiang
Published: January 2024

Background

Acute respiratory distress syndrome (ARDS) is an acute inflammatory lung injury with a high mortality rate. However, previous ARDS prognostic scoring systems or predictors have been limited by complex formulas that are relatively expensive and inconvenient to obtain. Thus, this study aimed to explore the clinical significance of the blood lactate/serum albumin ratio (LAR) in assessing the prognosis of ARDS patients and compare it with other indicators related to 28-day mortality in ARDS patients.

Methods

We conducted a single-center retrospective study involving patients who fulfilled the Berlin definition of ARDS between 2016 and 2021. Clinical data were collected from medical records within 24 hours after ARDS diagnosis. The LAR, neutrophil-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio (MLR) were calculated. The primary clinical outcome was 28-day mortality. The risk factors for 28-day mortality were determined using logistic regression analysis. The receiver operating characteristic curve was used to evaluate the area under the curve (AUC).

Results

A total of 276 ARDS patients met the inclusion criteria and were divided into surviving and nonsurviving groups according to 28-day mortality. There were significant differences in the Acute Physiologic Assessment and Chronic Health Evaluation II scores, Sequential Organ Failure Assessment scores, MLRs, and LARs between the surviving and nonsurviving groups. The AUC for the LAR was 0.790 (P < 0.001), whereas the AUCs for the Acute Physiologic Assessment and Chronic Health Evaluation II score, Sequential Organ Failure Assessment score, neutrophil-to-lymphocyte ratio, and MLR were 0.584, 0.599, 0.524, and 0.587, respectively. After grouping according to an LAR optimal cutoff value of 0.07, 28-day mortality was significantly higher in the high-LAR group than in the low-LAR group (47.18 vs 12.69, P < 0.001).

Conclusions

The LAR is an independent risk factor for 28-day mortality in ARDS patients and can be used to assess the severity of ARDS to a certain extent, making it superior to other commonly used indicators.
Golden Ratio Flap Designed Using the Golden Ratio Rectangle
Authors: Sakamoto Akio , Fujita Toshiharu , Noguchi Takashi , Matsuda Shuichi
Published: January 2024

Background:

Rotation flaps are arcuate repairs that redistribute tension vectors and recruit adjacent and/or distant tissue laxity. The incision curve could be a logarithmic spiral curve to reduce the length of an incision. We propose a rotation flap—the golden ratio flap—designed using a golden rectangle.

Methods:

The flap incision is an arc though the major square which is beside the minor square of a golden rectangle. The defect is attached to the line of another minor square and diagonal to the major square. The bottom line runs from the incision end to the tangent point of the circle or the oval, and the perpendicular height line runs from the bottom line to the cross point of the flap incision. These parameters were analyzed retrospectively for four superficial sarcomas that were treated using a rotation flap with an incision approximating the logarithmic spiral curve.

Results:

The ratio of height to bottom of the golden ratio flap design was highly similar to the preoperative flap design in the four cases assessed. With the new design, the ratio of bottom to the defect diameter (minor axis in the oval defect) was 1.3, and for the height, it was 1.4.

Conclusions:

The golden ratio flap, designed using the golden rectangle, is reproducible. The parameters of height and bottom approximate the flap shape, or the length and width, respectively. For clinical applications, step-by-step guidance for drawing the new flap are also proposed.
Accuracy of Cancer Registry Primary Payer Information and Implications for Policy Research
Authors: Davidoff Amy J. , Enewold Lindsey , Williams Courtney P. , Bhattacharya Manami , Sanchez Janeth I.
Published: January 2024

Background:

Cancer registry-based “primary payer at diagnosis” (PPDx) data are commonly used to evaluate the effect of insurance on cancer care outcomes, yet little is known about how well they capture Medicaid or Medicare enrollment.

Methods:

We linked the National Cancer Institute’s Surveillance, Epidemiology, and End Results registry data to monthly Centers for Medicare and Medicaid Services (CMS) Medicaid and Medicare enrollment records, state-year Medicaid policy, and managed care enrollment. We selected adults aged 19–64 years diagnosed between 2007 and 2011. We used bivariate analyses to compare PPDx to CMS enrollment at diagnosis month and assessed underreporting rates by patient characteristics and state-year policy.

Results:

PPDx reported 7.8% Medicare and 10.1% Medicaid, whereas CMS enrollment indicated 5.5% Medicare, 10.4% Medicaid, and 3.4% dual Medicare-Medicaid (N = 896,031). Positive predictive values for PPDx assignment to Medicaid and Medicare were 65.3% and 75.4%, with false negative rates of 52.0% and 33.8%, respectively. Medicaid underreporting was higher in low (56.5%) versus high (50.8%) poverty areas, for males (56.1%) versus females (48.9%), for Medicaid poverty expansion or waiver enrolled (63.8%) versus cash assistance-related eligibility (47.3%), and in states with large managed care enrollment (all P < 0.001). If Medicaid and Medicare enrollment data were used to edit PPDx, 12.0% of persons would switch primary payer assignment.

Conclusions:

Registry-reported PPDx fails to fully capture Medicaid and Medicare enrollment, which may result in biased estimates of insurance-related policy impacts. Enhancement with objective enrollment data could reduce measurement error and bias in estimates necessary to support policy assessment.
Integrins in biliary injury and fibrosis
Authors: Schaub Johanna R. , Chen Jennifer Y. , Turner Scott M.
Published: January 2024

Purpose of review

Current treatment options for cholangiopathies are severely limited and there is thus a critical need to identify and develop therapies. This review discusses the role of integrins in biliary injury and fibrosis and their potential as therapeutic targets.

Recent findings

There are a diverse set of roles that integrins play in biliary injury and fibrosis. Some integrins activate TGF-β signaling or are involved in sensing of the extracellular matrix, making them attractive targets for biliary fibrosis. In recent work, autoantibodies to αvβ6 were identified in patients with PSC, supporting the relevance of this integrin in the disease. In addition, a role for α2β1 in cyst formation was identified in a mouse model of polycystic liver disease. Leukocyte integrins (e.g. αEβ7 and α4β7) contribute to lymphocyte trafficking, making them potential targets for biliary inflammation; however, this has not yet translated to the clinic.

While all members of the same family of proteins, integrins have diverse roles in the pathogenesis of biliary disease. Targeting one or multiple of these integrins may slow or halt the progression of biliary injury and fibrosis by simultaneously impacting different pathologic cells and processes.
Targeting osteopontin to treat primary sclerosing cholangitis
Authors: De Muynck Kevin , Devisscher Lindsey
Published: January 2024

Purpose of review

Primary sclerosing cholangitis is a chronic cholestatic liver disease for which no pharmacological treatment options are available. It is an immune-mediated disease and macrophages have been implicated in disease pathogenesis. However, which specific macrophage populations contribute to disease, and how we can apply this as therapeutic strategy is still unclear.

Recent findings

Recent studies have shown that fibrous tissue is characterized by osteopontin-positive macrophages, including in patients with primary sclerosing cholangitis. Experimental models indicate that intracellular osteopontin in macrophages confers protection, while secreted osteopontin contributes to disease. Serum osteopontin is increased in different liver diseases, including primary sclerosing cholangitis, and might thus serve as therapeutic target.

Although several studies report on the role of osteopontin in liver disease, only a minority of the studies have focused on isoform-specific functions, and the importance of the cellular source of secreted osteopontin. Future studies investigating these aspects, and how this can be translated to therapies for primary sclerosing cholangitis, and other chronic liver diseases, are required.
Partial Response to Naxitamab for Brain Metastasis in Neuroblastoma
Authors: Onyeukwu Chinyere , Williams Autumn , Seyboth Brian , Muñoz Lorenzo , Scaria Gladson , Kent Paul
Published: January 2024

Neuroblastoma (NBL) is a common pediatric tumor arising from sympathetic ganglion cells. High-risk NBL is based on age, stage, histology, and MYCN amplification, and is associated with a high mortality rate. The combination of naxitamab (NAX) and granulocyte-macrophage (cerebrospinal fluid) is a new treatment for high-risk and relapsed NBL approved for bone or bone marrow disease. NAX is a monoclonal antibody directed against anti-disialoganglioside, which is overexpressed in neuroblastoma. Under normal circumstances, monoclonal antibodies, such as NAX, cannot cross the blood-brain barrier due to size. We present the case of a patient with high-risk NBL treated with NAX for multiple bony relapses. Unexpectedly, her brain metastasis responded clinically, histologically, and by imaging to the treatment. We believe this is the first documented case of NBL of the brain responding to NAX.
Structured Telephone Support for Heart Failure Patients
Authors: Eckstadt Kathrine
Published: January 2024

More than 5 million people in the United States suffer from heart failure. The impact of this chronic disease on costs, morbidity, and mortality is staggering. There is a critical need to improve heart failure management to reduce costs and improve quality of life. One strategy is structured telephone support, which consists of a healthcare provider calling the patient after hospital discharge at scheduled intervals to conduct symptom screening and disease management education. The purpose of this literature review is to analyze the quality and strength of studies that examined the effect of structured telephone support on heart failure outcomes. Eleven articles met the inclusion criteria. Beneficial outcomes were noted in hospital readmission rates, mortality, quality of life, and heart failure symptoms. Given the propensity of structured telephone support to improve quality of life while decreasing readmission and mortality rates, home healthcare agencies should consider implementing this low-cost intervention.
Developing 60-Day Readmission Risk Score among Home Healthcare Patients with Heart Failure
Authors: Kang Youjeong , Stoddard Greg , Stehlik Josef , Stephens Caroline , Facelli Julio , Gouripeddi Ram , Horne Benjamin D.
Published: January 2024

Heart failure (HF) readmissions are common, costly, and often preventable. Despite the implementation of HF programs across clinical settings, rehospitalization is still common. Efforts to identify risk factors for 60-day rehospitalization among HF patients exist, but risk scoring has not been utilized in home healthcare. The purpose of this study was to develop a 60-day rehospitalization risk score for home care patients with HF. This study is a secondary data analysis of a retrospective cross-sectional dataset that was composed of data using the Outcome Assessment Information Set (OASIS)-C version for patients with HF. We computed the Charlson Comorbidity Index (CCI) to use as a confounder. The risk score was computed from the final logistic regression model regression coefficients. The median age was 78 years old, 45.4% were male, and 81.0% were White. We identified 10 significant risk factors including CCI score. The risk score achieved a c-statistic of 0.70 in this patient sample. This risk score could prove useful in clinical practice for guiding attention and decision-making for personalized care of patients with unrecognized or under-treated health needs.
Home Care Nurses' Knowledge and Attitudes Regarding Telehealth to Promote Medication Compliance among Older Adults
Authors: Logan Diane Renee , Zipp Genevieve Pinto
Published: January 2024

Medication noncompliance among older adults is a persistent problem resulting in morbidity, hospital readmissions, and decreased quality of life. Home care nurses are in a key position to assist older adults to employ medication compliance strategies that are tailor-made to fit their individual needs and abilities. The purpose of this study was to understand the knowledge and attitudes of home care nurses regarding telehealth practices to promote medication compliance of older adult patients and their perceived readiness to do so. We employed a qualitative research approach using semi-structured interviews. Individual interviews were conducted via Teams platform for a maximum of 60 minutes. Participants were home care nurses who use telehealth technology to advance medication compliance strategies. Ten interviews were conducted. Several themes emerged from the data which suggested home care nurses accept telehealth technology, are supportive of its continued use, and are willing to be educated on future advances in this technology to assist older adults with medication compliance strategies. Universities and home care agencies must provide opportunities to prepare nurses to utilize telehealth technologies to promote medication compliance among older adult home care patients.
Vascular Neoplasms With NFATC1/C2 Gene Alterations
Authors: Dashti Nooshin K. , Perret Raul , Balzer Bonnie , Naous Rana , Michal Michael , Dermawan Josephine K. , Antonescu Cristina R.
Published: January 2024

Despite significant advances in their molecular pathogenesis, skeletal vascular tumors remain diagnostically challenging due to their aggressive radiologic appearance and significant morphologic overlap. Within the epithelioid category and at the benign end of the spectrum, recurrent FOS/FOSB fusions have defined most epithelioid hemangiomas, distinguishing them from epithelioid hemangioendothelioma and angiosarcoma. More recently, the presence of EWSR1/FUS::NFATC1/2 fusions emerged as the genetic hallmark of a novel group of unusual vascular proliferations, often displaying epithelioid morphology, with alternating vasoformative and solid growth, variable atypia, reminiscent of composite hemangioendothelioma. In this study, we further our understanding and morphologic spectrum of NFATC-fusion positive vascular neoplasms by describing 9 new cases, including soft tissue locations and novel fusion partners. Combining with the initial cohort of 5 cases, a total of 14 patients were analyzed, showing slight female predilection and an age range of 10 to 66 (mean 42 y). Twelve patients had solitary lesions, while 2 had multifocal polyostotic (pelvic bones) disease. Overall, 12 lesions were intra-osseous and 2 in soft tissue. By targeted RNA Fusion panels or FISH, there were 6 cases of EWSR1::NFATC1, 4 EWSR1::NFATC2, 2 FUS::NFATC2, 1 EWSR1 rearrangement, and 1 with a novel FABP4::NFATC2 fusion. Follow-up was available in 4 patients. One patient experienced 2 local recurrences, 11 and 15 years postdiagnosis, and one patient experienced progressive disease despite multimodality treatment (curettings, embolization, radiation) over 3 years. In summary, our extended investigation confirms that NFATC-related fusions define a distinct group of vascular neoplasms with variable architecture, epithelioid phenotype, and cytologic atypia, commonly located in the bone, occasionally multifocal and with potential for local recurrence and aggressive behavior but no metastatic potential. Molecular analysis is recommended in diagnostically challenging cases with atypical histology to exclude malignancy.
Persistent Risk of Developing Autoimmune Diseases Associated With COVID-19
Authors: Inokuchi Shoichiro , Shimamoto Koji
Published: January 2024

Objective

This study aimed to investigate the risk of developing autoimmune diseases associated with coronavirus disease 2019 (COVID-19) in Japan, including long-term risks and risks specific to different variants of concern.

Methods

This observational study used an electronic medical record database in Japan. The COVID-19 group is composed of patients diagnosed with COVID-19, whereas the non–COVID-19 group had data sampled from the database. The outcomes of interest encompassed several autoimmune diseases, including rheumatoid arthritis, systemic sclerosis, and immunoglobulin G4–related disease, as well as a composite of these diseases (any autoimmune disease). We examined the relative risk of autoimmune diseases using standardized mortality ratio weighting and the Cox proportional hazards model. Subgroup analyses based on epidemic variants were performed. In addition, short- and long-term risks were investigated using piecewise constant hazard models.

Results

A total of 90,855 COVID-19 and 459,827 non–COVID-19 patients were included between January 16, 2020, and December 31, 2022. The relative risk of any autoimmune disease was 2.32 (95% confidence interval, 2.08–2.60). All the investigated outcomes showed a significant risk associated with COVID-19. Several autoimmune diseases exhibit a risk associated with COVID-19 in the short to long term, and the long-term risk is substantial for systemic sclerosis and immunoglobulin G4–related disease. The variant-specific risk varied across outcomes.

Conclusions

COVID-19 is associated with an increased risk of developing autoimmune diseases in the Japanese population, and this effect persists for a long time. This study provides insights into the association between viral infections and autoimmunity.