bluuebunny/crossref_metadata_2025 huggingface dataset:
Frequency of screening for cardiac allograft vasculopathy: warranty period of initial low risk positron emission tomography
Authors: Abadie Bryan , Albert Chonyang , Bhat Pavan , Harb Serge , Jacob Miriam , Starling Randall C , Tang W H Wilson , Jaber Wael A
Published: January 2024

Aims

The short-term risk of moderate–severe cardiac allograft vasculopathy (CAV) after a low-risk positron emission tomography/computed tomography (PET/CT) is unknown, and therefore, there is no guidance on how frequently to perform screening. The aim of this study was to assess the rate of progression to moderate–severe CAV as part of an annual screening programme.

Methods and results

Patients with no history of CAV 2/3 and a low-risk result on initial screening PET/CT (CAV 0/1) were enrolled in the study. The primary outcome was the progression to CAV 2/3 as part of an annual screening programme (within 6–18 months of initial scan). PET CAV results were graded according to a published and externally validated diagnostic criterion for CAV. Over the study period, 231 patients underwent an initial PET/CT and had a subsequent evaluation for CAV. In this cohort, 4.3% of patients progressed to CAV 2/3 at a median of 374 days (interquartile range 363–433). Initial PET CAV grade was the most significant patient characteristic associated with the progression of CAV, with 17% of patients with PET CAV 1 progressing to CAV 2/3 compared with 1.6% with PET CAV 0 (odds ratio 12.4, 95% confidence interval 3.06–50.3).

Conclusion

The rate of progression to moderate–severe CAV at 1 year after the lowest-risk PET/CT is low, but approximately 1/6 patients with PET CAV 1 progress to CAV 2/3. Annual screening with PET/CT for select patients with PET CAV 0 may not be warranted. The optimal screening interval awaits confirmation of our findings in multi-centre registries.
In vitro effects of selective serotonin reuptake inhibitors on Cryptococcus gattii capsule and biofilm
Authors: Viveiro Letícia Rampazzo da Gama , Rehem Amanda Rodrigues , Santos Evelyn Luzia De Souza , Carmo Paulo Henrique Fonseca do , Junqueira Juliana Campos , Scorzoni Liliana
Published: January 2024

Infections caused by Cryptococcus gattii mainly affect immunocompetent individuals and the treatment presents important limitations. This study aimed to validate the efficacy of selective serotonin reuptake inhibitors (SSRI), fluoxetine hydrochloride (FLH), and paroxetine hydrochloride (PAH) in vitro against C. gattii. The antifungal activity of SSRI using the microdilution method revealed a minimal inhibitory concentration (MIC) of 31.25 µg/ml. The combination of FLH or PAH with amphotericin B (AmB) was analyzed using the checkerboard assay and the synergistic effect of SSRI in combination with AmB was able to reduce the SSRI or AmB MIC values 4–8-fold. When examining the effect of SSRI on the induced capsules, we observed that FLH and PAH significantly decreased the size of C. gattii capsules. In addition, the effects of FLH and PAH were evaluated in biofilm biomass and viability. The SSRI were able to reduce biofilm biomass and biofilm viability. In conclusion, our results indicate the use of FLH and PAH exhibited in vitro anticryptococcal activity, representing a possible future alternative for the cryptococcosis treatment.
Machine Learning Made Easy (MLme): a comprehensive toolkit for machine learning–driven data analysis
Authors: Akshay Akshay , Katoch Mitali , Shekarchizadeh Navid , Abedi Masoud , Sharma Ankush , Burkhard Fiona C , Adam Rosalyn M , Monastyrskaya Katia , Gheinani Ali Hashemi
Published: January 2024

Background

Machine learning (ML) has emerged as a vital asset for researchers to analyze and extract valuable information from complex datasets. However, developing an effective and robust ML pipeline can present a real challenge, demanding considerable time and effort, thereby impeding research progress. Existing tools in this landscape require a profound understanding of ML principles and programming skills. Furthermore, users are required to engage in the comprehensive configuration of their ML pipeline to obtain optimal performance.

Results

To address these challenges, we have developed a novel tool called Machine Learning Made Easy (MLme) that streamlines the use of ML in research, specifically focusing on classification problems at present. By integrating 4 essential functionalities—namely, Data Exploration, AutoML, CustomML, and Visualization—MLme fulfills the diverse requirements of researchers while eliminating the need for extensive coding efforts. To demonstrate the applicability of MLme, we conducted rigorous testing on 6 distinct datasets, each presenting unique characteristics and challenges. Our results consistently showed promising performance across different datasets, reaffirming the versatility and effectiveness of the tool. Additionally, by utilizing MLme’s feature selection functionality, we successfully identified significant markers for CD8+ naive (BACH2), CD16+ (CD16), and CD14+ (VCAN) cell populations.

Conclusion

MLme serves as a valuable resource for leveraging ML to facilitate insightful data analysis and enhance research outcomes, while alleviating concerns related to complex coding scripts. The source code and a detailed tutorial for MLme are available at https://github.com/FunctionalUrology/MLme.
A multiscale magma system beneath the Tengchong volcano in western Yunnan revealed by ambient noise tomography
Authors: Lin Ye , Liu Shaolin , Yang Dinghui , Xu Xiwei , Yang Shuxin , Wang Wenshuai
Published: January 2024

The western Yunnan is located in the SE Tibetan Plateau, and is characterized by the active Tengchong volcano (TCV), complex crust–mantle coupling and intense earthquakes. To elucidate tectonism in the western Yunnan, we construct a 3-D S-wave velocity model to 80 km depth via ambient noise tomography using dense seismic stations. Our model shows significant low-velocity anomalies at different depths in the crust and uppermost mantle. Compared with the results of previous regional tomography, we image low-velocity anomalies consistent with a large-scale source of partial melts in the uppermost mantle beneath the Tengchong and Baoshan blocks, rather than just below the Tengchong block. Our results also reveal a magma chamber extending from the shallow subsurface to the lower crust beneath the TCV, which is fed by the mantle source. Based on these findings, we propose that the mantle source and crustal magma chamber form a multiscale magma system. Moreover, the mantle source is potentially resulted from asthenospheric upwelling, which is related to the subduction of the Indian slab. In addition, our model shows that the 1976 M7.4 and M7.3 Longling earthquakes occurred near a magma chamber. Thus, fluids from the magma chamber likely reduced the frictional coefficient on the seismogenic fault and caused the Longling earthquakes.
Preterm Birth and in Utero Exposure to Corticosteroids Are Associated With Increased Infection Risk in Children of Mothers With IBD
Authors: Vestergaard Thea , Holm Meiltoft Ida , Julsgaard Mette , Bek Helmig Rikke , Friedman Sonia , Kelsen Jens
Published: January 2024

Background

Corticosteroids, thiopurines, and biologics may come into play during pregnancy in women with inflammatory bowel disease and potentially impact the developing fetal immune system. We aimed to assess the risk of serious infections in children stratified by in utero exposure to biologics and immunomodulators or concomitant treatment with corticosteroids.

Methods

All singleton IBD pregnancies between 2008 and 2022 at a tertiary IBD center in Denmark were included. Maternal and offspring demographics, maternal disease activity, antenatal medical treatment, and infant infections resulting in hospital admission were recorded after review of medical records.

Results

In 602 live births (99.0%), we registered exposure to antenatal treatment as follows: biological monotherapy (n = 61, 10.2%), thiopurines (n = 110, 17.9%), biologics and concomitant thiopurines (n = 63, 10.3%), and controls (ie, no treatment with biological and/or thiopurines; n = 369, 60.6%). Preterm delivery (<37 gestational weeks) and systemic steroid administration during the third trimester were associated with an increased risk of serious infection in the offspring immediately after birth (relative risk = 17.5; 95% confidence interval, 7.8-39.8; P < .001, and relative risk = 4.8; 95% confidence interval, 1.5-12.7; P = 0.003, respectively).

Intra-uterine exposure to biologics or combination treatment were not associated with a statistically significant higher risk of serious infections compared with controls; however, combination treatment showed an inclination towards an increased risk across analyses.

Conclusion

Preterm birth and systemic corticosteroid administration late in pregnancy are significant risk factors for serious infections in the offspring of IBD mothers.
SARS-CoV-2 inactivation on hard non-porous airplane cabin material surfaces was limited after exposure to far UV-C (222 nm) radiation
Authors: Wilson Mark E , Quigley Wes W C , Davis Angela C , Critchlow Nyle K , Madonna Angelo J , Hogan Jeffery N , Rogers Adam Z , Olson Nels A
Published: January 2024

Aims

To test the efficacy of 222 nm far UV-C for surface disinfection of SARS-CoV-2 on inanimate surfaces from airplane cabins.

Methods and results

Two far ultraviolet (UV-C) irradiation light systems were evaluated for disinfection of SARS-CoV-2. Materials used for carriers (test surfaces) included polished stainless steel and used airplane materials, including seat belt latches, window dust covers, sidewall laminates, and tray tables.

Conclusions

While demonstrating reasonable efficacy under some experimental conditions, the data indicated that 222 nm far UV-C disinfection alone does not reliably provide a 3 log10 or 99.9% reduction of SARS-CoV-2 on inanimate surfaces from an airplane cabin. An Ushio (Cypress, CA) 1.7″ × 2.3″ Care222® 12 W 222 nm BI lamp module tested in triplicate at a low (⁓1.5 mJ cm−2), medium (⁓3.0 mJ cm−2), and high (⁓6–9 mJ cm−2) fluence did not provide a ≥3 log10 or 99.9% reduction of SARS-CoV-2. The reduction of SARS-CoV-2 was greatest on stainless steel. The result was a log10 reduction of 2.83, 1.33, 2.58, and 2.21 logs for virus samples containing saline, saline with 2.5 mg BSA, saline with 0.25 mg BSA, and artificial saliva, respectively, at a dosage of 5–9 mJ cm−2. The log10 reduction of SARS-CoV-2 in saline with 2.5 mg bovine serum albumin was lowest with 1.33 for stainless steel, 0.93 for belt latch, and 0.61 for tray table at a dosage of 5–6 mJ cm−2. The second UV lighting system tested was a prototype mobile wand with a built-in short-pass filtered krypton-chloride cylindrical lamp. One pass of the wand over a tray holding carriers inoculated with SARS-CoV-2 in artificial saliva at a rate of ∼1 foot (1′) per second exposed the carriers to 7.3 mJ cm−2. The log10 reductions determined for the single pass were 2.97, 3.75, 1.78, 1.91, and 1.28 logs for stainless steel, belt latch, dust cover, sidewall, and tray table, respectively. Two passes of the wand generated 17.2 mJ cm−2 and resulted in log10 reductions of 4.04, 3.74, 4.24, 3.68, and 1.66 logs for stainless steel, belt latch, dust cover, sidewall, and tray table, respectively. The combination of higher fluence from multiple passes of the wand, the close proximity (10 cm wand to the carrier), the exposure to elevated temperatures up to 35°C, and ozone from the bulb being blown directly onto the carriers contributed to effective viral inactivation on all surfaces except the airplane tray table. The impact of temperature and ozone on viral inactivation should be determined for future testing of the 222 nm UV-C wand.
Hypoxia rewires glucose and glutamine metabolism in different sources of skeletal stem and progenitor cells similarly, except for pyruvate
Authors: Loopmans Shauni , Tournaire Guillaume , Stockmans Ingrid , Stegen Steve , Carmeliet Geert
Published: January 2024

Skeletal stem and progenitor cells (SSPCs) are crucial for bone development, homeostasis, and repair. SSPCs are considered to reside in a rather hypoxic niche in the bone, but distinct SSPC niches have been described in different skeletal regions, and they likely differ in oxygen and nutrient availability. Currently it remains unknown whether the different SSPC sources have a comparable metabolic profile and respond in a similar manner to hypoxia. In this study, we show that cell proliferation of all SSPCs was increased in hypoxia, suggesting that SSPCs can indeed function in a hypoxic niche in vivo. In addition, low oxygen tension increased glucose consumption and lactate production, but affected pyruvate metabolism cell-specifically. Hypoxia decreased tricarboxylic acid (TCA) cycle anaplerosis and altered glucose entry into the TCA cycle from pyruvate dehydrogenase to pyruvate carboxylase and/or malic enzyme. Finally, a switch from glutamine oxidation to reductive carboxylation was observed in hypoxia, as well as cell-specific adaptations in the metabolism of other amino acids. Collectively, our findings show that SSPCs from different skeletal locations proliferate adequately in hypoxia by rewiring glucose and amino acid metabolism in a cell-specific manner.
Treatment of waxborne honey bee (Hymenoptera: Apidae) viruses using time, temperature, and electron-beam irradiation
Authors: Colwell Megan J , Pernal Stephen F , Currie Robert W
Published: January 2024

Viruses are one of many serious threats to honey bee (Apis mellifera L.) health. There are many transmission routes for honey bee viruses, and there is potential for wax comb to act as a reservoir for transmission of viruses. Some work has been done on treating viruses on wax, focusing on irradiation as a potential treatment. However, irradiation is not universally available or economically viable for beekeepers in many regions. With increased colony deaths over winter beekeepers potentially risk further loss from reusing contaminated equipment from dead colonies. Here we explored the use of storage time and temperature on the reduction of waxborne virus levels from winter loss colony wax over 30 days and at −20, 5, and 20 °C. Furthermore, because irradiation has previously worked against waxborne viruses, we performed a dosage experiment with electron-beam irradiation. Winter loss wax was again used, and exposed to 10, 25, 35, and 45 kGy irradiation, including a nonirradiated transport control. Storage time decreased abundance of black queen cell virus and deformed wing virus at times equal or greater than 30 days but temperatures had no significant effect on virus levels. All irradiation doses decreased virus abundance and prevalence, yet only 35 and 45 kGy did so at a greater rate than the effect of transport alone.
The use of Nafs ‘soul’ for self-referencing in al-Maqqarī’s Nafḥ al-ṭīb and the evolution of the ‘divided self’
Authors: Jreis-Navarro Laila M
Published: January 2024

This article will analyze the use of the noun nafs ‘soul’ with the first-person possessive pronominal suffix, through the corpus of Andalusi texts gathered in Nafḥ al-ṭīb by the North-African author Shihāb al-Dīn al-Maqqarī (d. 1632). The aim is threefold: one, to identify patterns of the use of nafsī in the Nafḥ, their semantic performance, and diachronic evolution; two, to compare the use of the term in this corpus with its use in lists of collocates in the macro corpora KSUCCA and arTenTen of Classical and Modern Standard Arabic; and three, to show that linguistically systematizing self-expression is adequate for the identification of highly subjective texts in a corpus. Analysis will show that the notions of the ‘divided self’, sacrificing oneself, and yearning change towards a closer relationship between the subject and the self over time.
The interplay between feedback, accretion, transport, and winds in setting gas-phase metal distribution in galaxies
Authors: Sharda Piyush , Ginzburg Omri , Krumholz Mark R , Forbes John C , Wisnioski Emily , Mingozzi Matilde , Zovaro Henry R M , Dekel Avishai
Published: January 2024

The recent decade has seen an exponential growth in spatially resolved metallicity measurements in the interstellar medium (ISM) of galaxies. To first order, these measurements are characterized by the slope of the radial metallicity profile, known as the metallicity gradient. In this work, we model the relative role of star formation feedback, gas transport, cosmic gas accretion, and galactic winds in driving radial metallicity profiles and setting the mass–metallicity gradient relation (MZGR). We include a comprehensive treatment of these processes by including them as sources that supply mass, metals, and energy to marginally unstable galactic discs in pressure and energy balance. We show that both feedback and accretion that can drive turbulence and enhance metal-mixing via diffusion are crucial to reproduce the observed MZGR in local galaxies. Metal transport also contributes to setting metallicity profiles, but it is sensitive to the strength of radial gas flows in galaxies. While the mass loading of galactic winds is important to reproduce the mass–metallicity relation (MZR), we find that metal mass loading is more important to reproducing the MZGR. Specifically, our model predicts preferential metal enrichment of galactic winds in low-mass galaxies. This conclusion is robust against our adopted scaling of the wind mass-loading factor, uncertainties in measured wind metallicities, and systematics due to metallicity calibrations. Overall, we find that at z ∼ 0, galactic winds and metal transport are more important in setting metallicity gradients in low-mass galaxies whereas star formation feedback and gas accretion dominate setting metallicity gradients in massive galaxies.
eUDS: the SRG/eROSITA X-ray survey of the UKIDSS Ultra Deep Survey field. Catalogue of sources
Authors: Krivonos R , Gilfanov M , Medvedev P , Sazonov S , Sunyaev R
Published: January 2024

The eROSITA X-ray telescope on board the Spectrum-Roentgen-Gamma (SRG) spacecraft observed the field of the UKIDSS Ultra-Deep Survey (UDS) in August–September 2019, during its flight to Sun–Earth L2 point. The resulting eROSITA UDS (or eUDS) survey was thus the first eROSITA X-ray imaging survey, which demonstrated the capability of the telescope to perform uniform observations of large sky areas. With a moderate single-camera exposure of 150 ks, eUDS covered ∼5 deg2 with the limiting flux ranging between 4 × 10−15 and 5 × 10−14 erg s−1 cm−2 in the 0.3–2.3 keV band. We present a catalogue of 647 sources detected at likelihood >10 (∼4σ) during the eUDS. The catalogue provides information on the source fluxes in the main energy band 0.3–2.3 keV and forced photometry in a number of bands between 0.3 and 8 keV. Using the deeper 4XMM-DR12 catalogue, we have identified 22 strongly variable objects that have brightened or faded by at least a factor of ten during the eROSITA observations compared to previous observations by XMM–Newton. We also provide a catalogue of 22 sources detected by eROSITA in the hard energy band of 2.3–5 keV.
A Feasibility Study Investigating an Exercise Program in Metastatic Cancer Based on the Patient-Preferred Delivery Mode
Authors: Avancini Alice , Borsati Anita , Baldo Elisabetta , Ciurnelli Christian , Trestini Ilaria , Tregnago Daniela , Belluomini Lorenzo , Sposito Marco , Insolda Jessica , Auriemma Alessandra , Fiorio Elena , Piacentini Michela , Schena Federico , Milella Michele , Pilotto Sara
Published: January 2024

Background

Feasibility of exercise in patients with metastatic cancer is still a challenge. This study aimed to determine the feasibility and preliminary efficacy of an exercise intervention based on a patient-preferred delivery mode in patients affected by metastatic cancer.

Materials and Methods

Forty-four patients with a confirmed diagnosis of metastatic cancer were recruited in a 3-month exercise program. Whereas the exercise program consisted of aerobic and resistance activities performed twice a week, the participants may choose the mode of delivery: home based, personal training, or group based. The primary endpoint was the feasibility, defined by recruitment rate, attendance, adherence, dropout rate, tolerability (comparing the session RPE with the target RPE), and safety (using the Common Terminology Criteria for Adverse Events, version 5.0). Secondary endpoints included cardiorespiratory fitness (six minutes walking test), muscle strength (handgrip strength test and isometric leg press test), flexibility (the back scratch and chair sit and reach tests), anthropometric parameters (body mass index and waist-hip ratio), quality of life (EORTC QLQ C-30 questionnaire), and amount of physical exercise (Godin’s Shepard Leisure Time Exercise Questionnaire). Descriptive statistics, Student t test, and Wilcoxon signed rank test were used to analyze data.

Results

The study recruitment rate was 81%. Out of 44 recruited patients, 28 chose the personal training program, 16 chose the home-based program, and none chose the group-based program. Nine dropouts occurred (20%), 6 in the personal training program, and 3 in the home-based intervention. The median attendance rate was 92%, adherence was 88%, tolerability was 100%, and 9 nonsevere adverse events were registered during the exercise sessions. An increase in cardiorespiratory fitness (P < .001) and flexibility (P = .011 for chair sit and reach; P = .040 for back scratch) was observed at the end of the intervention, while no changes in anthropometric values and muscle strength were detected. Different quality-of-life domains were improved following the intervention, including physical (P = .002), emotional (P < .001), and role functioning (P = .018), fatigue (P = .030), and appetite loss (P = .005).

Conclusion

A 3-month exercise program based on a patient-preferred delivery mode is feasible in patients with metastatic cancer and may improve physical function and quality of life.

Trial Registration

NCT04226508
Association Between Length of Maternity Leave and Breastfeeding Duration in the United States
Authors: Wicklund Lorena , Epstein Allison , Szugye Heidi , Schleicher Mary , Lam Suet Kam
Published: January 2024

OBJECTIVE:

To perform a systematic review to assess the association between the length of maternity leave and breastfeeding duration in the United States.

DATA SOURCES AND METHODS OF STUDY SELECTION:

This review was conducted with a five-stage model for reviews. We included publications from 2000 to 2023, U.S.-based studies written in English, and primary research and peer-reviewed articles. In February 2023, a medical librarian conducted a search across seven databases, yielding 1,540 results. ClinicalTrials.gov was later searched, yielding no results. After duplicates were removed, 835 abstracts were screened. A full-text article review was then conducted of the remaining 34 articles.

TABULATION, INTEGRATION, AND RESULTS:

Twenty-three articles met inclusion criteria, two of which were reviews. Of the nonreview articles, all found a positive relationship between increased maternity leave and duration of breastfeeding. Data showed that earlier return to work for the birth parent decreased the odds of breastfeeding dyads meeting breastfeeding recommendations. Many studies adjusted for confounders (eg, race, socioeconomic status); however, Black or Latinx mothers still experience shorter breastfeeding durations or lower breastfeeding exclusivity when given equal leave compared with White mothers.

CONCLUSION:

Results show a positive relationship between length of maternity leave and breastfeeding duration. Advocacy for longer, paid parental leave and more robust research rooted in rigorous methods are needed.
Preliminary experience with 18 months result of endoscopic sleeve gastroplasty from an Asian population: Learning curve of one bariatric surgeon
Authors: Chen Sheng-Shih , Lee Wei-Jei , Kang Lung-Yun , Chou Chu-Kung
Published: January 2024

Background

Endoscopic sleeve gastroplasty (ESG) is emerging as an innovative approach to treating obesity. It provides a bridge between surgical and medical treatments for obesity. Nevertheless, the majority of reports on ESG originate from Western countries, and there is a lack of data from Asian nations. This study aims to share our pioneering experience with this novel technique in Asia.

Materials and Methods

We enrolled obese patients with a body mass index greater than 27 kg/m2 who were at least 20 years old. ESG was conducted following a comprehensive preoperative assessment. Following the procedure, patients were scheduled for regular outpatient department follow-up appointments at 7 days, 1 month, 2 months, 3 months, and then every 3 months up to 18 months postoperation. Body weight and any adverse events were documented during each follow-up visit.

Results

A total of 49 obese patients were enrolled in this study. Our findings demonstrate that ESG can be safely integrated into a conventional bariatric surgery center, with a learning curve observed after 10 cases in this study. In our series, the results showed that total body weight loss (TBWL) reached 7% at 1 month, 9% at 3 months, 14% at 6 months, 16% at 12 months, and 18.6% at 18 months. No adverse events or complications were reported in the study; however, five patients experienced procedure failures. Four of these patients underwent a repeat ESG, whereas one patient opted for surgical intervention.

Conclusions

ESG can be used in Asian countries, and the effectiveness of weight loss has proven to be satisfactory.
Extended Partington procedure for chronic pancreatitis: One-year follow-up results
Authors: Mai Dai Nga , Nguyen Quoc Vinh , Phan Minh Tri , Doan Tien My
Published: January 2024

Background

Over half of the patients who underwent the Partington procedure for painful chronic pancreatitis developed recurrent pain attacks. This occurs because the proximal ducts at the head of the pancreas, often containing stones, are left undrained. To overcome this pitfall, an extended Partington procedure is recommended. The aim of this study was to assess our 1-year follow-up results of the extended Partington procedure in patients with painful chronic pancreatitis.

Materials and Methods

This prospective study comprises patients undergoing extended Partington procedures who were followed for at least 1 year. Data were collected preoperatively and postoperatively in a fixed-interval fashion at 3 months, 6 months, and 1 year.

Results

Thirty-one patients underwent assessment. At 1-year follow-up, effective and complete pain relief was achieved in 81% and 55% of patients, respectively. The Izbicki pain score decreased significantly; the median dropped from 47.5 to 4.4. The quality of life using SF-12 physical and mental component summary improved significantly; the medians increased from 41.7 to 93.8, and 47.5 to 86.7, respectively. Endocrine function remained stable. Exocrine insufficiency developed in most patients as a natural progression of chronic pancreatitis. Two patients had complications directly related to surgical procedures (6%). No early postoperative deaths occurred.

Conclusions

Extended Partington procedure for chronic pancreatitis results in excellent pain relief and quality of life improvement, with a low morbidity rate, and does not worsen pancreatic function. It should replace the original Partington procedure in treating painful chronic pancreatitis.
No effect of real-world universal face masking on post-intravitreal injection endophthalmitis rate at a single tertiary academic center
Authors: Haliyur Rachana , Sinha Alina K. , Andrews Chris A. , Musch David C. , Conrady Christopher D. , Zacks David N. , Huvard Michael J.
Published: January 2024

Purpose:

To determine if universal masking during COVID-19 altered rate and outcomes of post-injection endophthalmitis (PIE).

Methods:

Retrospective, single-site, comparative cohort study. Eyes diagnosed with endophthalmitis within 4 weeks of intravitreal injection at the University of Michigan from 8/1/2012 to 11/15/2022 were identified. Cases were considered “masking” between 3/15/2020 and 11/15/2022. Endophthalmitis rate, visual acuity (VA), and microbial spectrum were investigated.

Results:

There were 20 PIE cases out of 72,194 injections (0.028%; 1 in 3571 injections) pre-masking and 10 of 38,962 with universal masking (0.026%; 1 in 3846 injections) (OR 0.9; 95% [CI]: 0.4-2.0). Referral from the community was unchanged with 32 cases referred pre-masking (0.35 cases/month) and 10 cases with masking (0.31 cases/month). Presenting mean logMAR VA with masking of all PIE cases trended worse (2.35±0.40) compared to pre-masking (2.09±0.48) (P=0.05) with light perception VA more common with masking (31.6% vs 10.9%, P=0.06). There was no delay in time from procedure to initial treatment (P=0.36), no difference in rate of initial treatment with tap and inject (T/I), and similar positive-culture rates (P=0.77) between cohorts. VA after 30 days follow-up was clinically unchanged (∼20/500 vs 20/400) (P=0.59).

Conclusions:

Universal masking had no effect on PIE rate nor rate of culture-positive cases. While presenting VA appeared worse with masking, this was not statistically significant and current treatment paradigms resulted in similar visual outcomes.
Development and evaluation of a neonatal nurse practitioner mentoring workshop
Authors: Moss Colleen Reilly
Published: January 2024

New graduate neonatal nurse practitioners (NNPs) need more than an orientation; they need mentoring to facilitate successful role transition and enhance job satisfaction. A gap exists in the literature about mentoring participant training and launching of successful programs for NNPs. This article provides an overview of the development and evaluation of a nurse practitioner (NP) mentoring workshop before the start of a formalized mentoring program. Workshop participants attended a half-day education event with an emphasis on mentoring program expectations, mentor and mentee roles, and effective communication. After the workshop, participants completed an electronic survey to evaluate satisfaction with the teaching and areas for improvement. From January 2022 through January 2023, newly hired NPs paired with experienced NP mentors participated in this structured workshop. Twenty-eight participants in two cohorts evaluated the workshop to identify meaningful aspects of the presentations and areas for improvement. Participants reported high levels of satisfaction with the interactive components of the 4-hr workshop. An interactive mentoring workshop helps participants establish realistic expectations and mutual goals. Further study is needed to identify time- and cost-efficient strategies in the preparation of effective mentoring participants to enhance the quality of mentoring programs.
Transmastoid Surgery for Superior Canal Dehiscence: Prospective Longitudinal Objective and Patient-Reported Audiovestibular Outcomes
Authors: Eberhard Kristine Elisabeth , West Niels Cramer , Cayé-Thomasen Per
Published: January 2024

Objective

We assess symptom control, reversal and stability of objective third-window indicators, and hearing and balance function after transmastoid superior canal dehiscence plugging. To do this, we combine patient self-assessment questionnaires with auditory and vestibular test data collected at a preoperative and multiple postoperative visits.

Study Design

Prospective cohort study.

Setting

Tertiary referral center.

Patients

Patients who underwent transmastoid plugging for superior canal dehiscence from 2012 to 2020.

Intervention(s)

Plugging of the superior semicircular canal using the transmastoid approach.

Main Outcome Measure(s)

Patients were evaluated preoperatively, 3-month postoperative, and at yearly follow-ups (up to 8 yr postoperative). Self-assessment questionnaires included Autophony Index, Dizziness Handicap Inventory, Tinnitus Handicap Inventory, and Hearing Handicap Inventory. Objective tests included audiometry, cervical vestibular evoked myogenic potential, ocular vestibular evoked myogenic potential, and video head impulse test.

Results

There was a statistically significant improvement in Autophony Index and Hearing Handicap Inventory total scores from the preoperative evaluation to 1 year postoperative. Dizziness Handicap Inventory and Tinnitus Handicap Inventory total scores also improved but statistically insignificant. Cervical and ocular vestibular evoked myogenic potential amplitudes and low-frequency air-bone gap showed statically significant reversal of the third-window effect preoperative versus 1 year postoperative. Video head impulse test of the superior semicircular canal revealed cases of pathological function preoperative with postoperative recovery. Results were stable over time.

Conclusions

Superior canal dehiscence repair resolves symptoms of autophony and improves hearing disability. Objective third-window indicators reverse and show long-term stability. Auditory and vestibular function is preserved postoperative, even superior semicircular canal function may be normal. Data suggest that surgical outcomes should not be evaluated until 1 year postoperative.
Cochlear Implantation in Sporadic Intralabyrinthine Schwannomas with Single-Sided Deafness: Implications for Binaural Hearing
Authors: West Niels , Sørensen Rikke Skovhøj , Kressner Abigail Anne , Bille Michael , Marozeau Jeremy , Cayé-Thomasen Per
Published: January 2024

Background and Objective

Intralabyrinthine schwannomas (ILSs) may have detrimental effects on ipsilateral hearing, commonly leading to single-sided deafness (SSD). Cochlear implantation in patients with ILSs is an option to partly restore ipsilateral hearing; however, the available literature fails to account for the binaural hearing benefits of a cochlear implant (CI) for ILSs.

Methods

We prospectively evaluated SSD patients with sporadic ILS undergoing cochlear implantation with simultaneous tumor resection (n = 10) or with tumor observation (n = 1). Patients completed the Speech, Spatial and Qualities Questionnaire (SSQ12) and the Nijmegen Cochlear Implant Questionnaire (NCIQ) pre- and postoperatively, as well as the Bern Benefit in Single-Sided Deafness (BBSSD) questionnaire postoperatively. Patients were also tested postoperatively with and without their CI to measure the effect on localization ability and binaural summation, squelch, and head shadow.

Results

Evaluation was completed for nine and six patients (subjective and objective data, respectively). The CI significantly improved the speech reception threshold (SRT) in the head shadow condition where the target signal was presented to the CI side and the noise to the front (SCIN0). On the other hand, the SRTs in the colocated condition (S0N0) and the condition where the target signal was presented to the front and the noise to the CI side (S0NCI) were unaffected by the CI. The mean localization error decreased significantly from 102° to 61° (p = 0.0031) with the addition of a CI. The scores from SSQ12 demonstrated nonsignificant changes. For NCIQ, the self-esteem and the social interaction domains increased significantly but insignificantly for the remaining domains. The BBSSD responses ranged from +0.5 to +3.5 points.

Conclusion

After implantation, patients achieved significantly better scores across some of the patient-reported and objective parameters. In addition to reporting on a number of ILS cases where implantation was performed, the study is the first of its kind to document patient-reported and objective binaural hearing improvement after cochlear implantation in patients with ILS and, thereby, lends support to the active management of ILS.
Advancements in Preclinical Models of Pancreatic Cancer
Authors: Salu Philip , Reindl Katie M.
Published: January 2024

Pancreatic cancer remains one of the deadliest of all cancer types with a 5-year overall survival rate of just 12%. Preclinical models available for understanding the disease pathophysiology have evolved significantly in recent years. Traditionally, commercially available 2-dimensional cell lines were developed to investigate mechanisms underlying tumorigenesis, metastasis, and drug resistance. However, these cells grow as monolayer cultures that lack heterogeneity and do not effectively represent tumor biology. Developing patient-derived xenografts and genetically engineered mouse models led to increased cellular heterogeneity, molecular diversity, and tissues that histologically represent the original patient tumors. However, these models are relatively expensive and very timing consuming. More recently, the advancement of fast and inexpensive in vitro models that better mimic disease conditions in vivo are on the rise. Three-dimensional cultures like organoids and spheroids have gained popularity and are considered to recapitulate complex disease characteristics. In addition, computational genomics, transcriptomics, and metabolomic models are being developed to simulate pancreatic cancer progression and predict better treatment strategies. Herein, we review the challenges associated with pancreatic cancer research and available analytical models. We suggest that an integrated approach toward using these models may allow for developing new strategies for pancreatic cancer precision medicine.
Factors Impacting Maltreatment Evaluation and Reports to Child Protective Services in Pediatric Substance Exposures
Authors: Breeden Karli , Loiselle Claire , Hossain Jobayer , De Jong Allan R. , Deutsch Stephanie Anne
Published: January 2024

Objectives

The objective of this study was to assess demographic, clinical, and psychosocial factors associated with pediatric substance exposures, describe the medical evaluation, and identify factors associated with social work (SW) and hospital-based child protection team (CPT) safety assessments and reports to child protective services (CPS).

Methods

We retrospectively reviewed charts of electronic medical records for children ages 0 to 72 months presenting for accidental ingestion evaluated May 1, 2015 to May 1, 2021 at a level 1 pediatric trauma center. Cases of environmental exposures, iatrogenic medication errors, dosing errors, and allergies/adverse reactions were excluded. Data were analyzed using descriptive statistics; χ2 and multivariable logistic regression analysis assessed factors associated with two primary outcomes of interest, SW/CPT assessment and CPS report.

Results

Among 773 total cases of substance exposures during the studied time frame, 27% were referred to SW/CPT for further safety assessments and 15.4% were reported to CPS. Being admitted to the hospital, prescription medication or recreational/illegal/illicit substance exposures, and increasing psychosocial risk factors were found to be significantly associated with referrals. Age, race, and insurance status were not found to be associated. Toxicology screening was performed in only 24.7% of cases. Of those eligible for further imaging per hospital protocol, skeletal surveys were obtained in 5.5% of cases and head imaging was obtained in 9% of cases.

Conclusions

There is significant variability in pediatric substance exposure assessment practices. Disparities based on demographic characteristics are uncommon. Perceived severity of condition, exposures involving recreational/illegal/illicit substances, and greater prevalence of family psychosocial adversities are associated with higher rates of SW/CPT assessment and CPS reports.
The predictors for the knee extension strength at 2 years after total knee arthroplasty using regression tree analysis
Authors: Kitamura Gakuto , Nankaku Manabu , Yuri Takuma , Kuriyama Shinichi , Nakamura Shinichiro , Nishitani Kohei , Ikeguchi Ryosuke , Matsuda Shuichi
Published: January 2024

Objective

To clarify the interactive combinations of clinical factors associated with knee extension strength (KES) 2 years after TKA.

Design

A retrospective cohort study was conducted on 264 patients who underwent TKA. KES was assessed preoperatively, 3 weeks, and 2 years after TKA. Physical functions were measured with 10 m walking test (10MWT), Timed-up and Go test (TUG), one-leg standing time, isometric knee flexion strength, knee joint stability, knee pain, femora-tibial angle, and passive knee extension and flexion angle before surgery as a baseline and 3 weeks after TKA as acute phase. Regression tree analysis was conducted to clarify the interactive combinations that accurately predict the KES 2 years after TKA.

Results

Operational side KES (> 1.00 Nm/kg) at acute phase was the primal predictor for the highest KES at 2 years after TKA. Acute phase TUG (≤ 10.13 seconds) and baseline 10MWT (≤ 11.72 seconds) was the second predictor. Acute phase non-operative side KES (> 0.90 Nm/kg) was also selected as the predictor.

Conclusion

This study demonstrated that KES or TUG in the acute phase and 10MWT before TKA are useful for estimating the KES after TKA. The results will help determine specific postoperative rehabilitation goals and training options.
Utility of Structured Oculomotor, Balance, and Exercise Testing in Civilian Adults with Mild Traumatic Brain Injury (mTBI)
Authors: DeGroot Andrew , Simons Mary U. , Huber Daniel L. , Leddy John , McCrea Michael A. , Johnson Blair D. , Nelson Lindsay D.
Published: January 2024

Purpose

Assessments of oculomotor, balance, and exercise function detect different responses to mild traumatic brain injury (mTBI) in sport-related mTBI. These assessments are understudied in the adult community mTBI population. We evaluated level 1 trauma center patients with non-sports related mTBI on oculomotor functioning (near point of convergence [NPC] and accommodation [NPA]), balance (Balance Error Scoring System [BESS]), and exercise tolerance (Buffalo Concussion Treadmill Test [BCTT]).

Methods

A prospective, cohort study of adults with mTBI (N = 36) were assessed at 1 week and (N = 26) 1 month post-mTBI using NPC, NPA, BESS, BCTT, and the Rivermead Post Concussion Symptoms Questionnaire [RPQ]. Prevalence of test impairment and association between performance and mTBI-related symptom burden (RPQ scores) were characterized.

Results

Participants demonstrated varying levels of impairment (e.g., 33.3% oculomotor, 44.1% balance, and 55.6% exercise impairment at 1 week). Participants displayed diverse impairment profiles across assessments. We observed medium-to-large correlations between poorer NPC and BCTT performance and greater mTBI symptom burden.

Conclusions

Clinical examinations of oculomotor function, balance, and exercise adopted from sport-related concussion assessments detect impairment in adult community members with mTBI. While findings warrant larger-scale replication, they imply that incorporating these simple, structured exams into the assessment of mTBI may facilitate more personalized management strategies.
Time Kills: Impact of Socioeconomic Deprivation on Timely Access to Guideline-Concordant Treatment in Foregut Cancer
Authors: Fonseca Annabelle L , Ahmad Rida , Amin Krisha , Tripathi Manish , Vobbilisetty Vijay , Richman Joshua S , Hearld Larry , Bhatia Smita , Heslin Martin J
Published: January 2024

BACKGROUND:

Receipt of guideline-concordant treatment (GCT) is associated with improved prognosis in foregut cancers. Studies show that patients living in areas of high neighborhood deprivation have worse healthcare outcomes; however, its effect on GCT in foregut cancers has not been evaluated. We studied the impact of the area deprivation index (ADI) as a barrier to GCT.

STUDY DESIGN:

A single-institution retrospective review of 498 foregut cancer patients (gastric, pancreatic, and hepatobiliary adenocarcinoma) from 2018 to 2022 was performed. GCT was defined based on National Comprehensive Cancer Network guidelines. ADI, a validated measure of neighborhood disadvantage was divided into terciles (low, medium, and high) with high ADI indicating the most disadvantage.

RESULTS:

Of 498 patients, 328 (66%) received GCT: 66%, 72%, and 59% in pancreatic, gastric, and hepatobiliary cancers, respectively. Median (interquartile range) time from symptoms to workup was 6 (3 to 13) weeks, from diagnosis to oncology appointment was 4 (1 to 10) weeks, and from oncology appointment to treatment was 4 (2 to 10) weeks. Forty-six percent were diagnosed in the emergency department. On multivariable analyses, age 75 years or older (odds ratio [OR] 0.39 [95% CI 0.18 to 0.87]), Black race (OR 0.52 [95% CI 0.31 to 0.86]), high ADI (OR 0.25 (95% CI 0.14 to 0.48]), 6 weeks or more from symptoms to workup (OR 0.44 [95% CI 0.27 to 0.73]), 4 weeks or more from diagnosis to oncology appointment (OR 0.76 [95% CI 0.46 to 0.93]), and 4 weeks or more from oncology appointment to treatment (OR 0.63 [95% CI 0.36 to 0.98]) were independently associated with nonreceipt of GCT.

CONCLUSIONS:

Residence in an area of high deprivation predicts nonreceipt of GCT. This is due to multiple individual- and system-level barriers. Identifying these barriers and developing effective interventions, including community outreach and collaboration, leveraging telehealth, and increasing oncologic expertise in underserved areas, may improve access to GCT.
Mesonia profundi sp. nov., isolated from deep-sea sediment of the Mariana Trench
Authors: Wang Na , Liu Jia-Rong , Zhang Xi-Ying , Fan Shen , Zhang Yu-Zhong , Fu Hui-hui
Published: January 2024

A Gram-stain-negative, aerobic, rod-shaped, non-flagellated, non-gliding bacterial strain, designated MT50T, was isolated from a deep-sea sediment sample collected from the Mariana Trench. Optimal growth of strain MT50T was observed at 25 °C, pH 7.0–7.5 and in the presence of 3–5 % (w/v) NaCl. The strain was positive for oxidase and catalase. Phylogenetic analysis of 16S rRNA gene sequences revealed that strain MT50T is affiliated with the genus

Mesonia

, showing the highest sequence similarity (98.5 %) to the type strain of

Mesonia ostreae

. The digital DNA–DNA hybridization and average nucleotide identity values between strain MT50T and four closely related type strains of known

Mesonia

species (14.1–54.8 % and 72.7–86.8 %, respectively) were all below the threshold values to discriminate bacterial species, indicating that strain MT50T is affiliated with a novel species within the genus. The genomic G+C content deduced from the genome of strain MT50T was 36.2 mol%. The major fatty acids of strain MT50T were iso-C15 : 0, iso-C17 : 0 3-OH and anteiso-C15 : 0. The predominant respiratory quinone of the strain was MK-6. The polar lipids of strain MT50T included phosphatidylethanolamine and two unidentified lipids. Based on the polyphasic data presented in this study, strain MT50T represents a novel species of the genus

Mesonia

, for which the name Mesonia profundi sp. nov. is proposed. The type strain is MT50T (=MCCC 1K07833T=KCTC 92380T).