bluuebunny/crossref_metadata_2025 huggingface dataset:
Ecology of aerobic anoxygenic phototrophs on a fine-scale taxonomic resolution in Adriatic Sea unravelled by unsupervised neural network
Authors: Stojan Iva , Šantić Danijela , Villena-Alemany Cristian , Trumbić Željka , Matić Frano , Vrdoljak Tomaš Ana , Lepen Pleić Ivana , Piwosz Kasia , Kušpilić Grozdan , Ninčević Gladan Živana , Šestanović Stefanija , Šolić Mladen
Published: April 2024

Background

Aerobic anoxygenic phototrophs are metabolically highly active, diverse and widespread polyphyletic members of bacterioplankton whose photoheterotrophic capabilities shifted the paradigm about simplicity of the microbial food chain. Despite their considerable contribution to the transformation of organic matter in marine environments, relatively little is still known about their community structure and ecology at fine-scale taxonomic resolution. Up to date, there is no comprehensive (i.e. qualitative and quantitative) analysis of their community composition in the Adriatic Sea.

Results

Analysis was based on pufM gene metabarcoding and quantitative FISH-IR approach with the use of artificial neural network. Significant seasonality was observed with regards to absolute abundances (maximum average abundances in spring 2.136 ± 0.081 × 104 cells mL−1, minimum in summer 0.86 × 104 cells mL−1), FISH-IR groups (Roseobacter clade prevalent in autumn, other Alpha- and Gammaproteobacteria in summer) and pufM sequencing data agglomerated at genus-level. FISH-IR results revealed heterogeneity with the highest average relative contribution of AAPs assigned to Roseobacter clade (37.66%), followed by Gammaproteobacteria (35.25%) and general Alphaproteobacteria (31.15%). Community composition obtained via pufM sequencing was dominated by Gammaproteobacteria clade NOR5/OM60, specifically genus Luminiphilus, with numerous rare genera present in relative abundances below 1%. The use of artificial neural network connected this community to biotic (heterotrophic bacteria, HNA and LNA bacteria, Synechococcus, Prochlorococcus, picoeukaryotes, heterotrophic nanoflagellates, bacterial production) and abiotic environmental factors (temperature, salinity, chlorophyll a and nitrate, nitrite, ammonia, total nitrogen, silicate, and orthophosphate concentration). A type of neural network, neural gas analysis at order-, genus- and ASV-level, resulted in five distinct best matching units (representing particular environments) and revealed that high diversity was generally independent of temperature, salinity, and trophic status of the environment, indicating a potentially dissimilar behaviour of aerobic anoxygenic phototrophs compared to the general bacterioplankton.

Conclusion

This research represents the first comprehensive analysis of aerobic anoxygenic phototrophs in the Adriatic Sea on a trophic gradient during a year-round period. This study is also one of the first reports of their genus-level ecology linked to biotic and abiotic environmental factors revealed by unsupervised neural network algorithm, paving the way for further research of substantial contribution of this important bacterial functional group to marine ecosystems.
Swedish massage as an adjunct approach to Help suppOrt individuals Pregnant after Experiencing a prior Stillbirth (HOPES): a convergent parallel mixed-methods single-arm feasibility trial protocol
Authors: Fogarty Sarah , Heazell Alexander E. P. , Munk Niki , Hay Phillipa
Published: April 2024

Background

Women experiencing pregnancy after stillbirth experience high levels of anxiety, fear and depression. Standard antenatal care may be emotionally unsuitable for many women at this time, and there is a lack of evidence on what interventions or approaches to care might benefit these women. Therapeutic massage may assist women after stillbirth by decreasing anxiety, worry and stress.

Objective

This paper outlines the objectives, methodology, outcome and assessment measures for the Helping suppOrt individuals Pregnant after Experiencing a Stillbirth (HOPES) feasibility trial which evaluates massage as an adjunct approach to care for pregnant women who have experienced a prior stillbirth. It also outlines data collection timing and considerations for analysing the data.

Methods

HOPES will use a convergent parallel mixed-methods, single-arm repeated measures trial design in trained massage therapists’ private clinics across Australia. HOPES aims to recruit 75 individuals pregnant after a previous stillbirth. The intervention is massage therapy treatments, and participants will receive up to five massages within a 4-month period at intervals of their choosing. Primary quantitative outcomes are the feasibility and acceptability of the massage intervention. Secondary outcomes include determining the optimal timing of massage therapy delivery and the collection of measures for anxiety, worry, stress and self-management. A thematic analysis of women’s experiences undertaking the intervention will also be conducted. A narrative and joint display approach to integrate mixed-methods data is planned.

Discussion

The HOPES study will determine the feasibility and preliminary evidence for massage therapy as an intervention to support women who are pregnant after a stillbirth.

Trial registration.

ClinicalTrials.gov NCT05636553. Registered on December 3, 2022, and the trial is ongoing.
Variants in structural cardiac genes in patients with cancer therapy-related cardiac dysfunction after anthracycline chemotherapy: a case control study
Authors: Boen Hanne M. , Alaerts Maaike , Goovaerts Inge , Saenen Johan B. , Franssen Constantijn , Vorlat Anne , Vermeulen Tom , Heidbuchel Hein , Van Laer Lut , Loeys Bart , Van Craenenbroeck Emeline M.
Published: April 2024

Background

Variants in cardiomyopathy genes have been identified in patients with cancer therapy-related cardiac dysfunction (CTRCD), suggesting a genetic predisposition for the development of CTRCD. The diagnostic yield of genetic testing in a CTRCD population compared to a cardiomyopathy patient cohort is not yet known and information on which genes should be assessed in this population is lacking.

Methods

We retrospectively included 46 cancer patients with a history of anthracycline induced CTRCD (defined as a decrease in left ventricular ejection fraction (LVEF) to < 50% and a ≥ 10% reduction from baseline by echocardiography). Genetic testing was performed for 59 established cardiomyopathy genes. Only variants of uncertain significance and (likely) pathogenic variants were included. Diagnostic yield of genetic testing was compared with a matched cohort of patients with dilated cardiomyopathy (DCM, n = 46) and a matched cohort of patients without cardiac disease (n = 111).

Results

Average LVEF at time of CTRCD diagnosis was 30.1 ± 11.0%. Patients were 52.9 ± 14.6 years old at time of diagnosis and 30 (65.2%) were female. Most patients were treated for breast cancer or lymphoma, with a median doxorubicin equivalent dose of 300 mg/m2 [112.5-540.0]. A genetic variant, either pathogenic, likely pathogenic or of uncertain significance, was identified in 29/46 (63.0%) of patients with CTRCD, which is similar to the DCM cohort (34/46, 73.9%, p = 0.262), but significantly higher than in the negative control cohort (47/111, 39.6%, p = 0.018). Variants in TTN were the most prevalent in the CTRCD cohort (43% of all variants). All (likely) pathogenic variants identified in the CTRCD cohort were truncating variants in TTN.

There were no significant differences in severity of CTRCD and in recovery rate in variant-harbouring individuals versus non-variant harbouring individuals.

Conclusions

In this case-control study, cancer patients with anthracycline-induced CTRCD have an increased burden of genetic variants in cardiomyopathy genes, similar to a DCM cohort. If validated in larger prospective studies, integration of genetic data in risk prediction models for CTRCD may guide cancer treatment. Moreover, genetic results have important clinical impact, both for the patient in the setting of precision medicine, as for the family members that will receive genetic counselling.
Association between perioperative non-steroidal anti-inflammatory drug use and cardiovascular complications after non-cardiac surgery in older adult patients
Authors: Komatsu Ryu , Singleton Michael D. , Dinges Emily M. , Wu Jiang , Bollag Laurent A.
Published: April 2024

Background

We investigated in older adult non-cardiac surgical patients whether receipt of perioperative non-steroidal anti-inflammatory drugs (NSAIDs) is associated with increased incidence of postoperative cardiovascular complications.

Methods

We retrospectively extracted the information for patients with age ≥  65 years who had inpatient non-cardiac surgery with a duration of ≥  1 h from the American College of Surgeons-National Surgical Quality Improvement Program registry data acquired at the University of Washington Medical Center. We compared patients who received NSAIDs perioperatively to those who did not receive NSAIDs, on the two composite outcomes: (1) the incidence of postoperative cardiovascular complications within 30 days of the surgery, and (2) the incidence of combined postoperative gastrointestinal and renal complications, and length of postoperative hospital stay. We used separate multivariable logistic regression models to analyze the two composite outcomes and a Poisson regression model for the length of hospital stay.

Results

The receipt of perioperative NSAIDs was not associated with postoperative cardiovascular complications (estimated odds ratio (OR), 1.78; 95% confidence interval (CI), 0.97 to 3.25; P =  0.06), combined renal and gastrointestinal complications (estimated OR, 1.30; 95% CI, 0.53 to 3.20; P =  0.57), and length of postoperative hospital stay in days (incidence rate ratio, 1.06; 95% CI, 0.93 to 1.21; P =  0.39).

Conclusions

In older adult non-cardiac surgical patients, receipt of perioperative NSAIDs was not associated with increased incidences of postoperative cardiovascular complications, and renal and gastrointestinal complications within 30 days after surgery, or length of postoperative hospital stay.
Projections of functional dependence among the late middle-aged and older population from 2018-2048 in China: a dynamic microsimulation
Authors: Jiang Yawen , Li Limin
Published: April 2024

Background

The population of China is aging rapidly. However, the long-term trajectories of functionally dependent late middle-aged and older Chinese people are currently absent. The present study aimed to estimate the population size and proportion of late middle-aged and older adults with difficulties and dependence on activities of daily living (ADL) and instrumental activities of daily living (IADL) in China from 2018 to 2048.

Methods

We constructed a dynamic microsimulation model to project the population size and proportions of late middle-aged and older Chinese people who have difficulty and dependence in ADL and IADL from 2018-2048. The model was populated with a representative sample of the target population and allowed individual-level interaction between risk factors, diseases, and health outcomes. Analyses by socioeconomic subgroups were also conducted.

Results

Almost 25% and 38% of late middle-aged and older people in China will become ADL- and IADL-dependent by 2048, respectively. Also, 17% of the target population will be severely ADL-disabled by 2048. The inequity in functional status across subgroups by sex, educational level, and urban/rural residency will become substantial.

Conclusions

The numbers and percentages of China's functionally difficult and dependent late middle-aged and older population will increase by magnitudes as of the mid-21st century, the pressure of which is compounded by its disproportionate distribution across subgroups. To alleviate the overwhelming challenge, efforts to improve the functional status of the underserved subpopulation should also be iterated.
The evaluation of goal-directed activities to promote well-being and health in heart failure: EUROIA scale
Authors: Nolan Robert P. , Syed Fatima , Stogios Nicolette , Maunder Robert , Sockalingam Sanjeev , Tai E. Shyong , Cobain Mark , Peiris Rachel G. , Huszti Ella
Published: April 2024

Background

The EvalUation of goal-diRected activities to prOmote well-beIng and heAlth (EUROIA) scale is a novel patient-reported measure that was administered to individuals with chronic heart failure (CHF). It assesses goal-directed activities that are self-reported as being personally meaningful and commonly utilized to optimize health-related quality of life (HRQL). Our aim was to evaluate psychometric properties of the EUROIA, and to determine if it accounted for novel variance in its association with clinical outcomes.

Methods

This study was a secondary analysis of the CHF-CePPORT trial, which enrolled 231 CHF patients: median age = 59.5 years, 23% women. Baseline assessments included: EUROIA, Kansas City Cardiomyopathy Questionnaire–Overall Summary (KCCQ-OS), Patient Health Questionnaire–9 for depression (PHQ-9), and the Generalized Anxiety Disorder–7 (GAD-7). 12-month outcomes included health status (composite index of incident hospitalization or emergency department, ED, visit) and mental health (PHQ-9 and GAD-7).

Results

Exploratory Principal Axis Factoring identified four EUROIA factors with satisfactory internal reliability: i.e., activities promoting eudaimonic well-being (McDondald’s ω = 0.79), social affiliation (⍺=0.69), self-affirmation (⍺=0.73), and fulfillment of social roles/responsibilities (Spearman-Brown coefficient = 0.66). Multivariable logistic regression indicated that not only was the EUROIA inversely associated with incidence of 12-month hospitalization/ED visits independent of the KCCQ-OS (Odds Ratio, OR = 0.95, 95% Confidence Interval, CI, 0.91, 0.98), but it was also associated with 12-month PHQ-9 (OR = 0.91, 95% CI, 0.86, 0.97), and GAD-7 (OR = 0.94, 95% CI, 0.90, 0.99) whereas the KCCQ-OS was not.

Conclusion

The EUROIA provides a preliminary taxonomy of goal-directed activities that promote HRQL among CHF patients independently from a current gold standard state-based measure.

Clinical trial registration

NCT01864369; https://classic.clinicaltrials.gov/ct2/show/NCT01864369.
Retail CBDC purposes and risk transfers to the central bank
Authors: Baeriswyl Romain , Reynard Samuel , Swoboda Alexandre
Published: April 2024

The issuance of retail central bank digital currency (CBDC) involves a transfer of risk from commercial banks to the central bank. Mechanisms that limit the transfer of risk, such as an unattractive interest rate, a quantity ceiling or the non-convertibility of cash and reserves into CBDC, are likely to discourage the use of CBDC as a medium of exchange and thus defeat the purpose of issuing CBDC.
Surgical repair of incarcerated umbilical hernia in a white German Spitz
Authors: Munif Mohammad Raguib , Masud Rony Ibne , Tasnim Shadia
Published: April 2024

Background

An umbilical hernia is common, but its incarcerated form is quite rare in dogs. An incarcerated hernia is characterized by the entrapment of herniated contents within the hernial sac, often accompanied by a constricted or narrower ring. It is usually refractory to the conservative approach, i.e., manual reduction, and surgical treatment is crucial to avert the risk of ischemia that can potentially lead to necrosis and gangrene in the involved tissues.

Case presentation

A 7-month-old female white German Spitz of 13.22 kg was presented with an ovoid swelling in the umbilicus, including a history of intermittent vomiting, progressive hyporexia, and weakness. Physical examinations led to a presumptive diagnosis of irreducible umbilical hernia after ultrasonography had shown a defect in abdominal wall continuity. Surgical intervention further confirmed an umbilical hernia with the incarceration of an omental flap. Herniorrhaphy was performed after resolving the incarceration and returning the content (i.e., omental flap) to the abdominal cavity. Postoperatively, supportive medications and routine care were provided. The external sutures were removed after two weeks, and periodic follow-ups revealed no complications. Ultrasonography was performed again on the 78th postoperative day, which indicated no breach in the abdominal wall integrity around the umbilicus. To the authors’ knowledge, this is the first documented case of a successfully treated incarcerated umbilical hernia in a white German Spitz.

Conclusions

Umbilical hernias in young Spitz dogs can undergo incarceration over time if left untreated during the early stages. Meticulous diagnosis and specific treatment including surgical correction are essential for optimal outcome, avoiding further complications.
Demand and key technology for a LEO constellation as augmentation of satellite navigation systems
Authors: Yang Yuanxi , Mao Yue , Ren Xia , Jia Xiaolin , Sun Bijiao
Published: April 2024

A Low Earth Orbit (LEO) constellation augmenting satellite navigation is important in the future development of Global Navigation Satellite System (GNSS). GNSS augmented by LEO constellations can improve not only the accuracy of Positioning, Navigation, and Timing (PNT), but also the consistency and reliability of secure PNT system. This paper mainly analyzes the diverse demands of different PNT users for LEO augmented GNSS, including the precision demand in real-time, the availability demand in special areas, the navigation signal enhancement demand in complex electromagnetic environments, and the integrity demand with high security. Correspondingly, the possible contributions of LEO constellations to PNT performance are analyzed from multiple aspects. A particular attention is paid to the special PNT user requirements that cannot be fulfilled with existing GNSS, such as the PNT service demand in the polar regions and the onboard GNSS orbit determination demand of some LEO satellites. The key technologies to be considered in the constellation design, function realization, and payload development of the LEO-augmented navigation system are summarized.
Prognostic factors in patients with heart failure and sarcopenia: an observational retrospective study
Authors: Imamura Yasutaka , Suzuki Atsushi , Kamishima Kazuho , Suzuki Kazuhito , Yamaguchi Junichi
Published: April 2024

Background

Heart failure (HF) prevalence increases with age, and sarcopenia is a poor prognostic factor in patients with HF. We aimed to evaluate the characteristics and prognostic factors in patients with HF and sarcopenia.

Results

We retrospectively reviewed 256 consecutive patients admitted to our hospital for HF between May 2018 and May 2021, underwent dual-energy X-ray absorptiometry, and were diagnosed with sarcopenia. The primary endpoint was all-cause mortality. The prognoses and characteristics were evaluated and compared between patients with left ventricular ejection fraction (LVEF) < 50% (reduced LVEF, HF with reduced ejection fraction [HFrEF]) and those with LVEF ≥ 50% (preserved LVEF, HF with preserved ejection fraction [HFpEF]). 83 (32%) and 173 (68%) patients had HFrEF and HFpEF, respectively. The HFrEF group had fewer women, lower hypertension rates, higher ischemic heart disease rates, and brain natriuretic peptide (BNP) levels than did the HFpEF group. Kaplan–Meier analysis for all-cause death showed that the HFrEF group had a significantly worse prognosis than the HFpEF group [log-rank p = 0.002].

Conclusions

In patients with HF and sarcopenia, older age, higher New York Heart Association (NYHA) class, BNP levels, and reduced LVEF were independent predictors of death after evaluation. During the treatment of patients with HF and sarcopenia, it is necessary to manage treatment with close attention to BNP and LVEF.
Right iliopsoas kaposiform hemangioendothelioma: a case report
Authors: Ren Neng , Gu Ye , Song Na , Qian Wen , Gao Wenhui , Zhang Yunfeng
Published: April 2024

Background

Kaposiform hemangioendothelioma (KHE) is a rare neoplasm of vascular origin. It may involve skin, bone, connective tissue, and parenchymal organs, and it is difficult to make a definite diagnosis in the early stage because Kasabach-Merritt phenomenon may occur in some cases.

Case presentation

On June 12, 2022, a 19-month boy was admitted to our department with the chief complaint of flexion of the right hip joint for over 1 year. An exploratory laparotomy and pelvic lesion resection were conducted and the resection of the iliopsoas muscle mass was performed. The intraoperative resection of the neoplasm confirmed the pathological diagnosis of kaposiform hemangioendothelioma. The vital signs of the child were stable and recovered well after surgery, and the platelet and coagulation indices were normal.

Conclusion

KHE is a rare disease in clinics, the number of confirmed cases in the world is still relatively few, and the etiology and mechanism of the disease are still unknown, which could result in misdiagnose and delayed treatment in the disease early stages. It is necessary to continue to collect relevant cases, to unify the standard treatment guidelines as soon as possible, to reduce the mortality rate, and to improve the quality of life of the cases.
Low-dose versus standard-dose normal temporal bone CT in children: a comparison study
Authors: Rashma R. , Kumar Jyoti , Garg Anju , Batra Radhika , Meher Ravi , Phulia Ankita
Published: April 2024

Objective

To compare the image quality of normal anatomical structures and radiation dose on low-dose (LDCT) and standard-dose (SDCT) temporal bone CT in children.

Methods

The study included 45 LDCT (80 kV and 130 mAs) and 45 SDCT (120 kV and 170 mAs) scans in children, 1–15 years of age. LDCT and SDCT scans were analyzed on H60s and H70h reconstruction kernels, respectively. Two readers assessed the image quality for 25 anatomical structures, using a 5-point scale. A score of 3 and above was considered “sufficient” and 2 and below was considered “insufficient” image quality. Image noise, contrast, age and size-specific effective doses were calculated.

Results

Despite an increase in image noise on LDCT, image quality remained sufficient for most structures owing to increased image contrast. The median effective dose on LDCT, calculated with age-specific conversion factor, decreased by 72.9% and that calculated with size-specific conversion factor decreased by 81.8% compared to the dose on SDCT.

Conclusion

LDCT provides comparable image quality for evaluation of temporal bone with significant reduction in radiation dose in children.
Central auditory functions in post-COVID-19 adults; a case control study
Authors: Hewala Sara Hamdy , Kolkaila Enaas Ahmad , Emara Afaf Ahmed , Nada Nashwa
Published: April 2024

Background

This study aimed to evaluate the central auditory abilities in post-coronavirus disease 2019 (COVID-19) adults by using Central Auditory Tests (CATs). This study included a complaining group (GI), a non-complaining group (GII), and a control healthy group (GIII). All subjects were evaluated using CATs

Results

Results demonstrated statistically significant differences across groups as regards Speech Perception in Noise Test (SPIN), Duration Pattern Sequence Test (DPT), Gap in Noise Test (GIN), and Memory Test (ANOVA, p-value ≤ 0.05). The post-hoc test revealed that, except for recognition memory, both study groups showed statistically significant differences from the control group. Also, significant differences were detected between both GI and GII groups regarding SPIN−10 signal-to-noise ratio (S/N), DPT, GIN threshold, memory for content, and memory for sequence

Conclusions

COVID-19 led to central auditory processing disorders (c)APD.
Epidemiological features of depression and anxiety among homeless adults with healthcare access problems in London, UK: descriptive cross-sectional analysis
Authors: Rathod Sujit D. , Annand P. J. , Hosseini Paniz , Guise Andrew , Platt Lucy
Published: April 2024

Background

In England in 2021, an estimated 274 000 people were homeless on a given night. It has long been recognised that physical and mental health of people who are homeless is poorer than for people who are housed. There are few peer-reviewed studies to inform health and social care for depression or anxiety among homeless adults in this setting.

Aims

To measure the symptoms of depression and anxiety among adults who are homeless and who have difficulty accessing healthcare, and to describe distribution of symptoms across sociodemographic, social vulnerability and health-related characteristics.

Method

We completed structured questionnaires with 311 adults who were homeless and who had difficulty accessing healthcare in London, UK, between August and December 2021. We measured anxiety and depression symptoms using the 4-item Patient Health Questionnaire (PHQ-4) score. We compared median PHQ-4 scores across strata of the sociodemographic, social vulnerability and health-related characteristics, and tested for associations using the Kruskal–Wallis test.

Results

The median PHQ-4 score was 8 out of 12, and 40.2% had scores suggesting high clinical need. Although PHQ-4 scores were consistently high across a range of socioeconomic, social vulnerability and health-related characteristics, they were positively associated with: young age; food insecurity; recent and historic abuse; joint, bone or muscle problems; and frequency of marijuana use. The most common (60%) barrier to accessing healthcare related to transportation.

Conclusions

Adults who are homeless and have difficulty accessing healthcare have high levels of depression and anxiety symptoms. Our findings support consideration of population-level, multisectoral intervention.
Pediatric Congenital Anterior Skull Base Encephaloceles and Surgical Management: A Comparative Review of 22 Patients Treated Transnasally, Transcranially, or Combined Approach With a Review of the Literature
Authors: Kameda-Smith Michelle M. , Jung Youngkyung , D'Arco Felice , Hewitt Richard , Aquilina Kristian , Jeelani Noor ul Owase
Published: April 2024

BACKGROUND AND OBJECTIVES:

Anterior basal encephaloceles are considered a rare entity and are often associated with midline cerebral abnormalities. Those with a large skull base defect and herniation of brain parenchyma in the neonate or young infant present unique challenges for surgical management.

METHODS:

We analyzed the neurosurgical administrative and operative databases between 1986 and 2022 to determine clinical presentation, operative approach, and outcome of basal encephaloceles.

RESULTS:

Over the 36-year period, 27 pediatric anterior basal encephaloceles were managed, of which 22 had full documentation and images allowing comprehensive review. Mean age at presentation was 5 years (SD 4.94). The majority were transethmoidal encephaloceles (59%), followed by the transsphenoidal-sphenoethmoidal type (32%). Overall, 91% were managed surgically by a transcranial, endoscopic, or combined approach. Four children required subsequent procedures, predominantly for persistent cerebrospinal fluid leak. No significant differences in proportion of patients requiring interval/revision surgery after initial conservative, endoscopic endonasal, or transcranial surgery was identified. Neither age at surgery nor size of the defect on computed tomography scan was associated with the need for revision surgery. Size of cranial defect was significantly smaller in the endoscopic group (P = .01). There was a historic tendency for younger children with larger defects to have a transcranial approach. With the addition of endoscopic skull base expertise, smaller defects in older children were more recently treated endoscopically.

CONCLUSION:

Basal encephaloceles are rare and complex lesions and are optimally managed within a skull base multidisciplinary team able to provide multiple approaches. Large skull base defects with brain parenchymal involvement often require a transcranial or combined transcranial–endoscopic approach.
Angiographic Evolution of Brain Arteriovenous Malformation Angioarchitecture After Partial Endovascular Treatment
Authors: Quarta Colosso Giulio , Aubertin Mathilde , Rius Emily , Guerra Xavier , Burel Julien , Mathon Bertrand , Nouet Aurélien , Premat Kevin , Drir Mehdi , Allard Julien , Lenck Stéphanie , Sourour Nader-Antoine , Clarençon Frédéric , Shotar Eimad
Published: April 2024

BACKGROUND AND OBJECTIVES:

Endovascular embolization of brain arteriovenous malformations (AVMs) is sometimes intentionally partial, in the case of staged treatment for instance. Residual AVMs may be prone to angioarchitectural modification during follow-up. The objective of this work is to evaluate the nature and extent of these modifications.

METHODS:

We performed a retrospective monocentric study on a cohort of adult patients treated by incomplete endovascular embolization for ruptured and unruptured AVMs with an available angiographic follow-up, without any intervening confounding event between the 2 angiographic examinations. AVM angioarchitectural modifications (arterial, nidal, and venous) were analyzed. Clinical and radiological data were tested in univariate analyses for association with the occurrence of AVM regression or progression.

RESULTS:

Eighty-two partial embolization sessions in 57 patients were included in the study. A 40% (33/82) rate of modification was found on follow-up, with 23/82 (28%) controls showing at least one angioarchitectural regression feature and 15/82 (18.3%) showing at least one angioarchitectural progression item. Nidal growth was the most frequent modification occurring after 12/82 (14.6%) embolizations. The only factor associated with nidal volume growth was a longer time interval between embolization and follow-up (median [IQR]: 190 [250] days vs 89.5[133] days in the subgroup without nidal growth; P = .02). Specific modifications of arterial supply, nidal anatomy, and venous drainage were identified and documented.

CONCLUSION:

Angioarchitectural modifications (both progression and regression) of brain AVMs are frequent findings after partial embolization. Nidal volume growth is associated with longer time intervals between embolization and follow-up.
External Validation of the Modified Southwestern Aneurysm Severity Index in the Barrow Ruptured Aneurysm Trial Surgical Cohort
Authors: Labib Mohamed A. , Catapano Joshua S. , Inoue Mizuho , Kupanoff Kristina M. , Singh Rohin , Abramov Irakliy , Scherschinski Lea , Srinivasan Visish M. , Youn Teddy S. , Spetzler Robert F. , Lawton Michael T.
Published: April 2024

BACKGROUND AND OBJECTIVES:

Predicting functional outcomes after surgical management of ruptured aneurysms is essential. This study sought to validate the modified Southwestern Aneurysm Severity Index (mSASI), which predicts functional outcomes 1 year after treatment.

METHODS:

The surgical arm of a randomized controlled trial, the Barrow Ruptured Aneurysm Trial, was used to validate the mSASI model. mSASI scores incorporating the Hunt and Hess scale, Non-Neurological American Society of Anesthesiologists Physical Classification Status, imaging findings, and other modifiers were assigned and evaluated against the Glasgow Outcome Scale (GOS) score at 1 year. The model's performance was assessed for discrimination and calibration. Similar evaluations were constructed using the modified Rankin Scale (mRS) as the 1-year functional outcome measurement. Long-term outcomes (3, 6, 10 years) were also evaluated.

RESULTS:

Of 280 clinical trial patients treated surgically, 242 met the inclusion criteria. The mean age was 54.1 ± 12.9 years; 31% were men. Favorable GOS score (4-5) and mRS score (0-2) at 1 year were observed in 73.6% and 66.1% of patients, respectively. The mSASI model predicted unfavorable GOS score at 1 year with fair to good discrimination (area under the curve = 0.75, 95% CI = 0.68-0.82) and accurate calibration (R2 = 0.98). Similar results were obtained when mRS was used as the outcome measure (area under the curve = 0.75, 95% CI = 0.68-0.82; R2 = 0.95).

CONCLUSION:

The mSASI model was externally validated in our cohort to predict functional outcomes using the GOS or mRS scores 1 year after surgery. This index may be used for prognosticating outcomes of patients undergoing surgery for ruptured aneurysms at short-term and long-term intervals.
Extent of Resection Thresholds in Molecular Subgroups of Newly Diagnosed Isocitrate Dehydrogenase–Wildtype Glioblastoma
Authors: Dono Antonio , Zhu Ping , Takayasu Takeshi , Arevalo Octavio , Riascos Roy , Tandon Nitin , Ballester Leomar Y. , Esquenazi Yoshua
Published: April 2024

BACKGROUND AND OBJECTIVES:

Maximizing the extent of resection (EOR) improves outcomes in glioblastoma (GBM). However, previous GBM studies have not addressed the EOR impact in molecular subgroups beyond IDH1/IDH2 status. In the current article, we evaluate whether EOR confers a benefit in all GBM subtypes or only in particular molecular subgroups.

METHODS:

A retrospective cohort of newly diagnosed GBM isocitrate dehydrogenase (IDH)–wildtype undergoing resection were prospectively included in a database (n = 138). EOR and residual tumor volume (RTV) were quantified with semiautomated software. Formalin-fixed paraffin-embedded tumor tissues were analyzed by targeted next-generation sequencing. The association between recurrent genomic alterations and EOR/RTV was evaluated using a recursive partitioning analysis to identify thresholds of EOR or RTV that may predict survival. The Kaplan–Meier methods and multivariable Cox proportional hazards regression methods were applied for survival analysis.

RESULTS:

Patients with EOR ≥88% experienced 44% prolonged overall survival (OS) in multivariable analysis (hazard ratio: 0.56, P = .030). Patients with alterations in the TP53 pathway and EOR <89% showed reduced OS compared to TP53 pathway altered patients with EOR>89% (10.5 vs 18.8 months; HR: 2.78, P = .013); however, EOR/RTV was not associated with OS in patients without alterations in the TP53 pathway. Meanwhile, in all patients with EOR <88%, PTEN-altered had significantly worse OS than PTEN-wildtype (9.5 vs 15.4 months; HR: 4.53, P < .001).

CONCLUSION:

Our results suggest that a subset of molecularly defined GBM IDH-wildtype may benefit more from aggressive resections. Re-resections to optimize EOR might be beneficial in a subset of molecularly defined GBMs. Molecular alterations should be taken into consideration for surgical treatment decisions in GBM IDH-wildtype.
Direct V3 Vertebral Artery Access for Embolization of Partially Thrombosed Fusiform Basilar Trunk Aneurysm: Technical Case Instruction
Authors: Nguyen Vincent N. , Demetriou Alexandra N. , Dallas Jonathan , Lin Michelle , Fujii Tatsuhiro , Gogia Angad S. , Rennert Robert C. , Atai Nadia A. , Abedi Aidin , Russin Jonathan J. , Mack William J.
Published: April 2024

BACKGROUND AND IMPORTANCE:

Fusiform vertebrobasilar aneurysms carry significant morbidity. Endovascular strategies are preferred; however, unsafe or unfeasible access can call for innovative strategies.

CLINICAL PRESENTATION:

An octogenarian patient with an enlarging fusiform proximal basilar artery aneurysm causing a sixth nerve palsy was found to have multiple anatomic features that precluded a transradial or transfemoral endovascular approach. She was thus treated with direct microsurgical access of the V3 segment of the vertebral artery for subsequent coil embolization and flow diversion.

CONCLUSION:

This case introduces a novel combined microsurgical and endovascular strategy for treating a complex partially thrombosed fusiform basilar artery aneurysm. This approach should be reserved only for patients where conventional endovascular access is dangerous or unfeasible.
Arf GTPase-Activating proteins ADAP1 and ARAP1 regulate incorporation of CD63 in multivesicular bodies
Authors: Suzuki Kasumi , Okawa Yoshitaka , Akter Sharmin , Ito Haruki , Shiba Yoko
Published: April 2024

Arf GTPase-activating proteins (ArfGAPs) mediate the hydrolysis of GTP bound to ADP-ribosylation factors. ArfGAPs are critical for cargo sorting in the Golgi-to-ER traffic. However, the role of ArfGAPs in sorting into intralumenal vesicles (ILVs) in multivesicular bodies (MVBs) in post-Golgi traffic remains unclear. Exosomes are extracellular vesicles (EVs) of endosomal origin. CD63 is an EV marker. CD63 is enriched ILVs in MVBs of cells. However, the secretion of CD63 positive EVs has not been consistent with the data on CD63 localization in MVBs, and how CD63-containing EVs are formed is yet to be understood. To elucidate the mechanism of CD63 transport to ILVs, we focused on CD63 localization in MVBs and searched for the ArfGAPs involved in CD63 localization. We observed that ADAP1 and ARAP1 depletion inhibited CD63 localization to enlarged endosomes after Rab5Q79L overexpression. We tested epidermal growth factor (EGF) and CD9 localization in MVBs. We observed that ADAP1 and ARAP1 depletion inhibited CD9 localization in enlarged endosomes but not EGF. Our results indicate ADAP1 and ARAP1, regulate incorporation of CD63 and CD9, but not EGF, in overlapped and different MVBs. Our work will contribute to distinguish heterogenous ILVs and exosomes by ArfGAPs.
Enzyme-linked immunosorbent assay and immunohistochemical analysis of mast cell related biochemicals in oral submucous fibrosis
Authors: Gharote Harshkant , Bhowate Rahul , Dangore-Khasbage Suwarna
Published: April 2024

Oral submucous fibrosis (OSMF), a potentially malignant disorder, is developed by progressive fibrous tissue deposition in connective tissue along with atrophy of oral mucosa. Histological sections also show the mast cell infiltration in submucosa which may indicate their possible role in this entity. Abundant availability of biochemicals in mast cells like histamine and serine proteases like chymase may be released and play specific pathways in the disease pathophysiology. Possibly, if the histamine release has some part to play, diamine oxidase may also be found to have a relationship as it metabolizes histamine. The present study is proposed to identify the presence of chymase, histamine, and diamine oxidase in both, serum as well as tissue by enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry (IHC) respectively. This study may provide probable insight into the mast cell-related chemicals and their association with OSMF.
Screen-H Website Audiometry as a Diagnostic Tool for Hearing Screening in Patients with Hearing Loss
Authors: Sudiro Melati , Hasansulama Wijana , Digdayan Makerto Rano , Ayu Hardianti Saputri Raden
Published: April 2024

Background Hearing loss, affecting 16.8% of Indonesians, impacts quality of life and daily activities. Limited access to hearing loss evaluation and treatment, due to demographic and socioeconomic conditions, particularly in remote areas, hinders early detection and intervention. Website audiometry Screen-H, accessible on mobile phones, tablets, and computers, offers a fast, painless, and non-invasive solution. Purpose This study aimed to assess the agreement between Screen-H and gold standard pure-tone audiometry. Methods In this analytical observational study with a cross-sectional design, participants over 10 years old with hearing loss were consecutively sampled at the Audiology Clinic of Otorhinolaryngology-Head and Neck Surgery, Dr. Hasan Sadikin General Hospital, Bandung. The sensitivity and specificity of Screen-H® were evaluated, and the Kappa score measured agreement with pure-tone audiometry. Results We included 321 patients, comprising 150 women (47%) and 171 men (53%). Screen-H® showed 82.8% sensitivity and 94.1% specificity in the right ear, and 80.8% sensitivity and 93.1% specificity in the left ear. Conclusion The high specificity and sensitivity of Screen-H, combined with its speed, ease of use, non-invasiveness, and cost-effectiveness, make it an effective screening tool for hearing loss in environments with noise levels ≤ 40 dB HL, starting from 35 dB HL stimuli.
Understanding of plagiarism amid North-African post-graduate dental students: A cross sectional pilot study
Authors: Kallala Rim , Khemiss Mehdi , Azzouzi Ines , Gassara Yosra , Touzi Soumaya , Harzallah Belhassen , Ben Saad Helmi
Published: April 2024

Background Plagiarism remains poorly understood among post-graduate dental students (PGDSs) in North Africa. Data on the level of understanding of plagiarism (UP) in this population is lacking. This study assessed UP of Tunisian PGDSs'. Methods A cross-sectional pilot study was conducted at the Faculty of Dental Medicine of Monastir, involving 147 PGDSs registered in 2022. Students were recruited via email invitations and convenience sampling at a medical congress. A French survey with 11 questions on UP, offering three-choice answers (yes/no/maybe) was administered. Each correct answer received one point, and a total UP score below six indicated a low-level of UP. Results The mean±SD UP score of the 106 students who accepted to participate in the study was 4.7±2.2, indicating a low-level of UP. The majority of PGDSs (81.13%) demonstrated a low-level of UP. A comparison between subjective and objective assessments of UP revealed that a significant percentage of PGDSs underestimated their understanding (81.13% vs. 62.26%, respectively). The two groups of PGDSs with low (n=86) and acceptable/excellent (n=20) UP showed comparable characteristics in terms of age, sex, discipline, post-graduate-level, experience-level, graduation-status, and survey-response modality. Conclusion This study highlights a lack of awareness of UP among North African PGDSs, emphasizing the need for further efforts to enhance awareness and promote better UP in this population.
Monitoring Global Progress in Core Diabetes Control Metrics: Protocol for a Systematic Review of Prevalence (2015–2023)
Authors: McCaffrey John , Jabakhanji Samira Barbara , Mehta Roopa , James Steven , Mairghani Maisoon , Bhatia Dominika , Ní Chonchubhair Hazel , Walsh Killian , Clyne Barbara , Gregg Edward W.
Published: April 2024

Background The Global Diabetes Compact is a WHO-sponsored initiative that aims to improve diabetes care and prevention, and to reduce the global burden of diabetes. This includes the goal of monitoring the progress and achievement of country-level diabetes metrics and targets. The objective of this systematic review is to examine population-based studies from 2015–2023 to determine the status of core diabetes control metrics: glycaemic (HbA1c), blood pressure and lipid control (low-density lipoprotein and non-high-density lipoprotein cholesterol), and statin use. This review will describe regional and country-level variation in attainment gaps concerning these indicators. Methods This review will follow the JBI methodological approach to systematic reviews of prevalence, and will be reported using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. We will include population-based observational studies, conducted in all geographic settings that report data on adult populations (≥18 years) with diagnosed Type 1 or Type 2 diabetes, with no language restrictions. We will search the following databases: Ovid MEDLINE, Embase, Scopus, Cochrane Library, and WHO Global Index Medicus. Using Covidence, two reviewers will independently screen titles and abstracts against eligibility criteria, review potentially relevant full-text articles, and extract data from eligible studies. A third reviewer will resolve any conflicts. Reviewers will use a standardised data extraction form to extract study population, methodological, and outcome data. Primary outcomes are levels of glycaemic, blood pressure, and lipid control, and statin use. Methodological quality of included studies will be assessed using the JBI Critical Appraisal tool for studies reporting prevalence data. Extracted data will be synthesised using descriptive statistics and summarised narratively. Dissemination Findings will be used to inform global diabetes surveillance, prevention, and treatment initiatives. The completed review will be submitted for publication in a peer-reviewed journal, and presented at national and international conferences. PROSPERO registration CRD42024505286 OSF https://doi.org/10.17605/OSF.IO/DZYJK
12 tips for developing Educational Conferences for Physicians
Authors: McCoy Kelly , Fore-Arcand Lisa
Published: April 2024

The education of a physician is a life-long process that starts in medical school and extends throughout their career. Healthcare is a dynamic field characterized by continuous advancements in medicine, evolving treatment options, changing regulations, care models, and technology. Physicians must keep up-to-date with new practices, procedures, medications, and diseases and fulfill the educational requirements to maintain their medical licensure. Continuing education for physicians serves the essential purpose of nurturing lifelong learning, ensuring that medical practices align with the latest standards, and ultimately enhancing the quality of patient care and outcomes. In a broader context, physician education encompasses all activities designed to enhance skills, professional performance, and relationships that physicians employ to provide services to patients and the public and to improve collaborations within the field. This paper outlines a step-by-step plan for designing high-quality educational conferences for practicing physicians in any field. It aims to assist in developing ongoing education, aligning physician practices with the latest medical care standards, and optimizing their clinical performance to improve patient and community health.
Case-based learning in undergraduate orthodontic education: A cross sectional study
Authors: Shafique Asma , Ur Rehman Asad , Ibnerasa Shazia , Glanville Rebecca , Ali Kamran
Published: April 2024

Introduction Student centric learning approaches have been reported to be effective in introducing higher order cognitive skills required by the health professionals. However, learners’ perceptions must be constructively aligned with new learning interventions to achieve a positive impact on their learning. The aim of this study was to explore the learning experiences of undergraduate dental students with case-based learning in orthodontics. Methods A case-based learning model was introduced on orthodontic diagnosis and treatment planning for final year students on a Bachelor of Dentistry programme toward the end of their academic year. A survey was conducted to explore the perceptions and experiences of the participants. The research instrument was based on a previously validated questionnaire and included information on demographics and consisted of 12 items aimed at evaluating the benefits and challenges of cased based learning. Results All 67 students in the final-year cohort participated in study, yielding a response rate of 100 percent. Participants across the board perceived CBL to be an effective strategy to learn the subject content and helpful in improving the students’ skills in orthodontic diagnosis, treatment planning and team-working. CBL did not pose any significant challenges or barriers to student learning. Discussion Participants reported high acceptance of CBL in orthodontic teaching and learning and a positive impact on their educational experiences. CBL was perceived to be an appropriate strategy to enhance the diagnostic, treatment planning and team-working skills of dental students.