bluuebunny/crossref_metadata_2025 huggingface dataset:
Determining thein vitrosusceptibility of tebipenem, an oral carbapenem, against third-generation cephalosporin-resistantEscherichia coliandKlebsiella pneumoniaeisolated from bloodstream infections
Authors: Ranasinghe Ama , Henderson Andrew , Cottrell Kyra , Tan Cindy S E , Burnard Delaney , Kato Hideo , Paterson David L , Harris Patrick N A
Published: September 2022

Background

Antimicrobials for bloodstream infections due to ESBL- and AmpC-producing Escherichia coli and Klebsiella pneumoniae are significantly limited due to widespread antimicrobial resistance. Tebipenem, an oral carbapenem, exhibits stability against these resistance mechanisms and may prove an attractive alternative.

Methods

The in vitro susceptibility of tebipenem was assessed against previously whole-genome sequenced ESBL- and AmpC-producing E. coli (274 isolates) and K. pneumoniae (42 isolates) derived from bloodstream infections using broth microdilution testing. Resulting tebipenem MICs were compared with those of other carbapenems previously tested against the isolate collection. Tebipenem activity was also compared against those isolates expressing co-resistance to the common oral antibiotics ciprofloxacin and trimethoprim/sulfamethoxazole.

Results

The tebipenem MIC90 value was found to be 0.03 mg/L for E. coli and 0.125 mg/L for K. pneumoniae. For E. coli, the tebipenem MIC90 value was equivalent to that of meropenem, 2-fold lower than that of doripenem, and 8-fold and 4-fold lower than that of imipenem and ertapenem, respectively. For K. pneumoniae, the tebipenem MIC90 value was 2-fold higher than that of meropenem, equivalent to that of doripenem, and 4-fold and 2-fold lower than that of imipenem and ertapenem, respectively. Tebipenem MICs were also unaffected by the expression of co-resistance to ciprofloxacin and trimethoprim/sulfamethoxazole.

Conclusions

The in vitro activity of tebipenem was unaffected by the production of ESBL and AmpC enzymes. Tebipenem also retained its activity against those isolates expressing co-resistance to ciprofloxacin and trimethoprim/sulfamethoxazole. These findings therefore highlight tebipenem as a potential option for the treatment of invasive MDR infections.
Sensitive Serology Measurements in the Saliva of Individuals with COVID-19 Symptoms Using a Multiplexed Immunoassay
Authors: Sohaei Dorsa , Ulndreaj Antigona , Mathew Anu , Campbell Christopher , Stengelin Martin , Sigal George , Joe Jessica , Romero Daniel , Padmanabhan Nikhil , Ren Annie , Ghorbani Atefeh , Soosaipillai Antoninus , Kulasingam Vathany , Prassas Ioannis , Diamandis Eleftherios P
Published: September 2022

Background

There are numerous benefits to performing salivary serology measurements for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative pathogen for coronavirus disease 2019 (COVID-19). Here, we used a sensitive multiplex serology assay to quantitate salivary IgG against 4 SARS-CoV-2 antigens: nucleocapsid, receptor-binding domain, spike, and N-terminal domain.

Methods

We used single samples from 90 individuals with COVID-19 diagnosis collected at 0 to 42 days postsymptom onset (PSO) and from 15 uninfected control subjects. The infected individuals were segmented in 4 groups (0–7 days, 8–14 days, 15–21 days, and >21 days) based on days PSO, and values were compared to controls.

Results

Compared to controls, infected individuals showed higher levels of antibodies against all antigens starting from 8 days PSO. When applying cut-offs with at least 93.3% specificity at every time interval segment, nucleocapsid protein serology had the best sensitivity at 0 to 7 days PSO (60% sensitivity [35.75% to 80.18%], ROC area under the curve [AUC] = 0.73, P = 0.034). Receptor-binding domain serology had the best sensitivity at 8 to 14 days PSO (83.33% sensitivity [66.44%–92.66%], ROC AUC = 0.90, P < 0.0001), and all assays except for N-terminal domain had 92% sensitivity (75.03%–98.58%) at >14 days PSO.

Conclusions

This study shows that our multiplexed immunoassay can distinguish infected from uninfected individuals and reliably (93.3% specificity) detect seroconversion (in 60% of infected individuals) as early as the first week PSO, using easy-to-collect saliva samples.
Rare diseases and orphan medicines: knowledge and perceptions of healthcare professionals and the public
Authors: Vassallo Sharon , Attard Pizzuto Maresca , Azzopardi Lilian M , Serracino-Inglott Anthony
Published: September 2022

Objectives

The aim of this study was to assess the public’s and healthcare professionals’ awareness and perception on rare diseases and orphan drugs, and to identify challenges faced by both populations.

Methods

Two questionnaires, one for healthcare professionals and one for the public including rare disease patients, were developed, validated and disseminated. The experience and awareness of the public and healthcare professionals with regard to rare diseases and orphan medicines were analysed.

Key findings

The questionnaires were completed by 228 members of the public and 73 healthcare professionals. Thirty-seven percent of the public knew or were related to someone with a rare disease. Public participants consisted of those who knew or were related to someone with a rare disease (37%) and rare disease patients (12%). Nineteen percent of rare disease patients had encountered problems while trying to obtain an orphan drug. Seventy-three healthcare professionals completed the questionnaire. Fifty-five percent had diagnosed, encountered or examined a rare disease patient at a point in their career, while 32% had dispensed or tried to dispense an orphan drug. Twenty-seven percent of healthcare professionals had encountered various problems while trying to obtain an orphan drug for patients.

Conclusions

The elucidation of public’s perception on rare diseases can offer better guidelines for healthcare professionals to support rare disease patients better.
Semi-supervised classification and clustering analysis for variable stars
Authors: Pantoja R , Catelan M , Pichara K , Protopapas P
Published: September 2022

The immense amount of time series data produced by astronomical surveys has called for the use of machine learning algorithms to discover and classify several million celestial sources. In the case of variable stars, supervised learning approaches have become commonplace. However, this needs a considerable collection of expert-labelled light curves to achieve adequate performance, which is costly to construct. To solve this problem, we introduce two approaches. First, a semi-supervised hierarchical method, which requires substantially less trained data than supervised methods. Second, a clustering analysis procedure that finds groups that may correspond to classes or subclasses of variable stars. Both methods are primarily supported by dimensionality reduction of the data for visualization and to avoid the curse of dimensionality. We tested our methods with catalogues collected from the Optical Gravitational Lensing Experiment (OGLE), the Catalina Sky Survey (CSS), and the Gaia survey. The semi-supervised method reaches a performance of around 90 per cent for all of our three selected catalogues of variable stars using only $5{{\ \rm per\ cent}}$ of the data in the training. This method is suitable for classifying the main classes of variable stars when there is only a small amount of training data. Our clustering analysis confirms that most of the clusters found have a purity over 90 per cent with respect to classes and 80 per cent with respect to subclasses, suggesting that this type of analysis can be used in large-scale variability surveys as an initial step to identify which classes or subclasses of variable stars are present in the data and/or to build training sets, among many other possible applications.
Red quasars blow out molecular gas from galaxies during the peak of cosmic star formation
Authors: Stacey H R , Costa T , McKean J P , Sharon C E , Calistro Rivera G , Glikman E , van der Werf P P
Published: September 2022

Recent studies have suggested that red quasars are a phase in quasar evolution when feedback from black hole accretion evacuates obscuring gas from the nucleus of the host galaxy. Here, we report a direct link between dust-reddening and molecular outflows in quasars at z ∼ 2.5. By examining the dynamics of warm molecular gas in the inner region of galaxies, we find evidence for outflows with velocities 500–1000 km s−1 and time-scales of ≈0.1 Myr that are due to ongoing quasar energy output. We infer outflows only in systems where quasar radiation pressure on dust in the vicinity of the black hole is sufficiently large to expel their obscuring gas column densities. This result is in agreement with theoretical models that predict radiative feedback regulates gas in the nuclear regions of galaxies and is a major driving mechanism of galactic-scale outflows of cold gas. Our findings suggest that radiative quasar feedback ejects star-forming gas from within nascent stellar bulges at velocities comparable to those seen on larger scales, and that molecules survive in outflows even from the most luminous quasars.
Signs of environmental effects on star-forming galaxies in the Spiderweb protocluster at z = 2.16
Authors: Pérez-Martínez J M , Dannerbauer H , Kodama T , Koyama Y , Shimakawa R , Suzuki T L , Calvi R , Chen Z , Daikuhara K , Hatch N A , Laza-Ramos A , Sobral D , Stott J P , Tanaka I
Published: September 2022

We use multi-object near-infrared spectroscopy with VLT/KMOS to investigate the role of the environment in the evolution of the ionized gas properties of narrow-band-selected H α emitters (HAEs) in the Spiderweb protocluster at z = 2.16. Based on rest-frame optical emission lines, H α and [N ii]λ6584, we confirm the cluster membership of 39 of our targets (i.e. 93 per cent success rate), and measure their star formation rates (SFR), gas-phase oxygen abundances, and effective radius. We parametrize the environment where our targets reside using local and global density indicators based on previous samples of spectroscopic and narrow-band cluster members. We find that star-forming galaxies embedded in the Spiderweb protocluster display SFRs compatible with those of the main sequence and morphologies comparable to those of late-type galaxies at z = 2.2 in the field. We also report a mild gas-phase metallicity enhancement (0.06 ± 0.03 dex) at intermediate stellar masses. Furthermore, we identify two UVJ-selected quiescent galaxies with residual H α-based star formation and find signs of extreme dust obscuration in a small sample of starbursty submillimetre galaxies based on their FIR and H α emission. Interestingly, the spatial distribution of these objects differs from the rest of HAEs, avoiding the protocluster core. Finally, we explore the gas fraction–gas metallicity diagram for seven galaxies with molecular gas masses measured by ATCA using CO(1−0). In the context of the gas-regulator model, our objects are consistent with relatively low mass-loading factors, suggesting lower outflow activity than field samples at the cosmic noon and thus, hinting at the onset of environmental effects in this massive protocluster.
TangoSIDM: tantalizing models of self-interacting dark matter
Authors: Correa Camila A , Schaller Matthieu , Ploeckinger Sylvia , Anau Montel Noemi , Weniger Christoph , Ando Shin’ichiro
Published: September 2022

We introduce the TangoSIDM project, a suite of cosmological simulations of structure formation in a Λ-self-interacting dark matter (SIDM) universe. TangoSIDM explores the impact of large dark matter (DM) scattering cross-sections over dwarf galaxy scales. Motivated by DM interactions that follow a Yukawa potential, the cross-section per unit mass, σ/mχ, assumes a velocity-dependent form that avoids violations of current constraints on large scales. We demonstrate that our implementation accurately models not only core formation in haloes but also gravothermal core collapse. For central haloes in cosmological volumes, frequent DM particle collisions isotropise the particles orbit, making them largely spherical. We show that the velocity-dependent σ/mχ models produce a large diversity in the circular velocities of satellites haloes, with the spread in velocities increasing as the cross-sections reach 20, 60, and 100 cm2 g−1 in $10^9~\rm {M}_{\odot }$ haloes. The large variation in the haloes internal structure is driven by DM particles interactions, causing in some haloes the formation of extended cores, whereas in others gravothermal core collapse. We conclude that the SIDM models from the Tango project offer a promising explanation for the diversity in the density and velocity profiles of observed dwarf galaxies.
PD-L1 expression in breast cancer brain metastases
Authors: Chehade Rania , Qazi Maleeha A , Ennis Marguerite , Sahgal Arjun , Das Sunit , Nofech-Mozes Sharon , Jerzak Katarzyna J
Published: September 2022

Background

To evaluate the potential intracranial efficacy of immunotherapy among patients with breast cancer brain metastases (BrM), we analyzed the immunohistochemical expression of programmed death-ligand 1 (PD-L1), a predictive biomarker of response to immunotherapy.

Methods

In this single-center retrospective cohort study, consecutive patients with breast cancer BrM (immunotherapy naïve) who underwent surgery for BrM at Sunnybrook Health Sciences Center between July 1999 and June 2013 were identified. PD-L1 expression by immunohistochemistry (IHC) was assessed on BrM samples in triplicate; PD-L1 positive status was defined as PD-L1 expression ≥1% on tumor-infiltrating cells as a percentage of tumor area using the Ventana SP142 antibody. Estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (HER2) status was determined using 2018 ASCO/CAP guidelines.

Results

The median patient age at the time of BrM diagnosis was 52 (range 32–85). PD-L1 expression using the SP42 antibody was identified in 9 out of 59 (15.3%) breast cancer BrM. The frequency of PD-L1 positive BrM by subtype is as follows: TNBC (n = 3/12, 25.0%), HER2+/HR- (n = 3/14, 21.4%), HR+/HER2- (n = 2/18, 11.1%), and HER2+/HR+ (n = 1/14, 7.1%). 24-month brain-specific progression-free survival was 66.7% (95% CI 37.9%–100%) among patients with PD-L1 positive BrM versus 42% (95% CI 26.6%–67.3%) among those with PD-L1 negative BrM (log-rank P-value .142).

Conclusions

One in 7 patients in our cohort had PD-L1 positive BrM; this proportion was highest (25%) among those with TNBC. Intracranial efficacy of immunotherapy warrants further study, particularly among patients with treatment-naïve metastatic TNBC, for whom extracranial efficacy has already been established.
Race and Tourism
Authors: Stanonis Anthony J.
Published: September 2022

Race was central to the development of modern tourism. The rise of empires in the nineteenth century expanded transportation infrastructure across the globe. Imperialism reified the division between the white, Western world and the colonized world of people of color. People of color occupied servile roles within the international tourism industry, a legacy that lingers within the travel market. Sites catering predominantly to white tourists, particularly hotels, emerged as symbols of exploitation, galvanizing local populations of color during the mid-twentieth century to protest for political and economic freedoms as well as social equality. The civil rights struggle and decolonization efforts after World War II, along with the rise of the internet in the late-twentieth century, offered people of color opportunities to celebrate their history and culture via tourism. People of African descent, for instance, have used the internet to facilitate travel to sites of slavery and racial injustices such as lynching and apartheid. The most prolific scholarship on the relationship between race and tourism over the past two centuries relates to the United States.
Tourism and the International Order after 1945
Authors: Pack Sasha D.
Published: September 2022

This chapter explores the question of how tourism contributed to global order and conflict from the end of World War II to the early twenty-first century. It begins by looking at how political regimes of the interwar period attempted to politicize tourism. After World War II, ideas about tourism as a vehicle for both individual emancipation and mutual understanding among peoples inspired considerable technocratic planning under the aegis of postwar reconstruction. This process contributed to the consolidation of a Western bloc of nations, particularly in Western Europe, and to spectacles of modernization across much of the globe. It also contributed to the rise of a global ideology of free movement, which has posed particular challenges to regimes in the democratic, socialist, and postcolonial worlds.
Heritage Tourism
Authors: Gordon Alan
Published: September 2022

Heritage tourism is a form of cultural tourism in which people travel to experience places, artifacts, or activities that are believed to be authentic representations of people and stories from the past. It couples heritage, a way of imagining the past in terms that suit the values of the present, with travel to locations associated with enshrined heritage values. Heritage tourism sites are normally divided into two often overlapping categories: natural sites and sites related to human culture and history. By exploring the construction of heritage tourism destinations in historical context, we can better understand how and through what attributes places become designated as sites of heritage and what it means to have an authentic heritage experience. These questions are explored through heritage landscapes, national parks, battlefield tourism, architectural tourism, and the concept of world heritage.
Why Do Boards Exist? Governance Design in the Absence of Corporate Law
Authors: Burkart Mike , Miglietta Salvatore , Ostergaard Charlotte
Published: September 2022

We study under which circumstances firms choose to install boards and their roles in a historical setting in which neither boards nor their duties are mandated by law. Boards arise in firms with large, heterogeneous shareholder bases. We propose that an important role of boards is to mediate between heterogeneous shareholders with divergent interests. Voting restrictions are common and ensure that boards are representative and not captured by large blockholders. Boards are given significant powers to both mediate and monitor management, and these roles are intrinsically linked.
Baseline knee extension may be associated with volumetric cartilage loss in the anterolateral tibia: data from the Osteoarthritis Initiative
Authors: Campbell T Mark , Reilly Katherine , Laneuville Odette , Uhthoff Hans K , Trudel Guy
Published: September 2022

Objectives

Animal studies suggest regional unloading of the knee due to flexion contracture (FC) results in cartilage loss in the anterior tibia. We looked for an association between the range of knee extension and articular cartilage thickness in the tibia of patients with knee OA, using quantitative MRI data from the OA Initiative.

Methods

Baseline knee extension was measured using a goniometer. Cartilage thickness was measured using 3-Tesla coronal MRI images of the knee. The tibia articular cartilage was segmented into medial and lateral regions, then further divided into anterior, central and posterior subregions. We evaluated differences between participants with and without a knee FC and associations between knee extension and cartilage thickness, including percentage denudation of bones (0 mm thickness), using linear models.

Results

A total of 596 participants were included. Participants with a knee FC had a larger percentage of denuded bone in the anterolateral tibia vs participants without FC (2.2 ± 0.7% vs 0.4 ± 0.1%; P = 0.006), and knee extension was associated with anterolateral tibia denuded bone (r = 0.16, P < 0.001). After correcting for demographics, knee alignment, and OA severity, presence of FC and lost knee extension were associated with the percentage of denuded bone in the anterolateral tibia [β = 1.702 (0.634–2.770) and β = 0.261 (95% CI 0.134, 0.388), respectively].

Conclusion

While causation cannot be determined in this study, limitation in knee extension was statistically associated with the percentage of denuded bone in the anterolateral tibia. These novel data support that maintaining range of motion over the entire joint surface may help preserve articular cartilage health.
Trust in the attending rheumatologist, health-related hope and medication adherence among Japanese systemic lupus erythematosus patients
Authors: Kurita Noriaki , Oguro Nao , Miyawaki Yoshia , Hidekawa Chiharu , Sakurai Natsuki , Ichikawa Takanori , Ishikawa Yuichi , Hayashi Keigo , Shidahara Kenta , Kishida Dai , Yoshimi Ryusuke , Sada Ken-ei , Shimojima Yasuhiro , Yajima Nobuyuki
Published: September 2022

Objective

Poor medication adherence among patients with SLE is a critical problem associated with adverse outcomes. This study examined the relationship between trust in one’s physician and goal-oriented thinking, hope and medication adherence among Japanese patients with SLE who were ethnically matched to their physicians.

Methods

This cross-sectional study was conducted in the rheumatology outpatient clinics at five academic centres. Patients with SLE who were prescribed oral medications were included. The main exposures were trust in one’s physician measured via the 5-item Japanese version of the Wake Forest Physician Trust Scale and the 18-item Health-related Hope Scale, with each score ranging from 0 to 100 points. Medication adherence was measured using the 12-item Medication Adherence Scale with scores ranging from 5 to 60 points. A general linear model was created after adjusting for demographics, socioeconomic status, disease activity, disease duration, basic health literacy, depression, medication variables, experiencing adverse effects and concerns regarding lupus medications.

Results

Altogether, 373 patients with SLE were included. The mean age of the patients was 46.4 years; among them, 329 (88.2%) were women. Both trust in one’s physician (per 10-point increase: 0.86, 95% CI 0.49, 1.22) and the Health-related Hope score (per 10-point increase: 0.66, 95% CI 0.35, 0.97) were associated with better medication adherence.

Conclusions

This study demonstrated that patients’ health-related hope and trust in their rheumatologist were both associated with better medication adherence in SLE.
Challenges of HIV therapeutic vaccines clinical trials design
Authors: Bailon Lucia , Alarcón-Soto Yovaninna , Benet Susana
Published: September 2022

Purpose of the review

To discuss main challenges of therapeutic vaccine clinical trials design, implementation and analyses in the HIV cure field.

Recent findings

Therapeutic vaccines are progressively being postulated as T-cell stimulating agents to use in combination HIV cure strategies, with the addition of immunomodulators, latency reversing agents and/or broadly neutralizing antibodies. Although promising strategies are rapidly evolving in preclinical studies using nonhuman primate models, translation into human testing in randomized controlled clinical trials is more challenging and expensive to conduct. Adaptive designs, access to cohorts of early-treated individuals, consensus on how to safely conduct analytical treatment interruptions, use of alternative statistical methods, development of point-of-care/home-based testing technologies and ensuring early engagement of communities where research is being developed are some of the critical aspects to consider to facilitate clinical trial development in the HIV cure field.

Design and development of HIV therapeutic vaccine clinical trials poses many challenges, from Phase 0/pilot studies to Phase I/II trials in which efficacy of the intervention is being tested and antiretroviral therapy cessation is needed, complexity of cure trials progressively increases. Understanding fundamental issues and careful planning of therapeutic vaccine clinical trials is crucial to minimize design flaws, reduce loss of follow-ups and missing data while ensuring participant's safety and guarantee valid and accurate analyses and thus, better contribute towards an HIV cure.
Retrospection and Reflection on the Role of Henry C. Lu as a Traditional Chinese Medicine Writer, Educator, and Translator
Authors: Li Xiao-Li , Ma Li-An , Wu Qing
Published: September 2022

This paper respectfully commemorates the life of Dr. Henry C. Lu (1936–2022), who was the founding president of International College of Traditional Chinese Medicine of Vancouver. Dr. Lu was an active educator, a prolific writer and translator of traditional Chinese medicine (TCM) in the West and an influential figure during the initial stage of the international dissemination of TCM. By comprehensively searching, referencing, and cross-validating the literature, this article reviewed Dr. Lu’s major life events, bibliography, and, most importantly, his contribution to TCM education and translation. Dr. Lu should be given more credit for his achievements, and further studies are needed in future.
In the Spirit of Benevolence: Taking Action to Fight Against the COVID-19 Pandemic
Authors: Wang Xu-Jie , Zhang Wan-Tong , Zhang Xue-Xue , Li Jia-Xi , Li Qiu-Yan , Weng Wei-Liang
Published: September 2022

Confucian doctors are representative of traditional Chinese medicine (TCM) practitioners with excellent moral character and medical knowledge, they are not hidden in the depths of ancient documents but are a guiding inspiration for professional medical personnel today. Confucian doctors are representative group of benevolence in Confucian philosophy and demonstrate the scientific and humanistic spirit of Confucian philosophy and demonstrate the scientific and humanistic spirit of Confucianism in their medical practice. They are also leading medical practitioners who uphold professional ethics in their pursuits of scientific research, clinical diagnosis & treatment, and scholarship. Both TCM and Confucian doctors played important roles during the outbreak of the coronavirus disease 2019 (COVID-19) pandemic in China. By virtue of the superb medical skills of Confucian doctors, integrated Chinese and Western medicine can quickly alleviate patients’ symptoms, increase cure rates, reduce mortality rates, thus saving lives. Following the results of extensive clinical trials, this integrated therapy is now understood to be a beneficial treatment for COVID-19. The combination of TCM and Western medicine is a major feature of COVID-19 prevention and control in China. In particular, TCM plays a significant role in the fight against the COVID-19 pandemic with its unique advantages.
Efficacy of traditional Chinese medicine combined with rivaroxaban in the treatment of lower extremity deep vein thrombosis: A meta-analysis
Authors: Zheng Dandan , Qi Gui , Adu Isaac Kumi , Wu Haichao , Zhu Mingyuan
Published: September 2022

Background:

Despite the usefulness of traditional Chinese medicine (TCM) in the treatment of lower deep vein thrombosis (DVT), there is no consensus on safety and efficacy. We aim to systematically evaluate the safety and efficacy of TCM combined with Rivaroxaban in the treatment of lower limb DVT.

Methods:

An online search of databases such as Cochrane Library, Embase, Pubmed, and Web of science, as well as CBM, China Science and Technology Journal Database, China Knowledge Network (CNKI) and Wanfang Data (from inception to July, 2021) was performed. All published clinical randomized controlled trials (RCTs) were screened manually, evaluated for quality and considered for meta-analysis using RevMan 5.3.

Results:

Nine RCTs with a total of 730 cases were included, 368 cases in the trial group were treated with TCM combined with Rivaroxaban, and 362 cases in the control group were treated with Rivaroxaban alone after surgery. Clinical efficiency was significantly higher in the test group [OR = 3.33, 95% CI (2.01, 5.53), P < .00001], the circumference of the affected limb was significantly lower in the thigh and calf, respectively [MD = −1.48, 95% CI (−1.88, −1.09), P < .00001], [MD = −0.54, 95% CI (−0.62, −0.46), P < .00001], pain scores were significantly lower [MD = −0.97, 95% CI (−1.58, −0.36), P = .002], coagulation index plasma fibrinogen (FIB) was significantly lower [MD = −0.85, 95% CI (−1.18, −0.52), P < .00001], coagulation function index D-2 aggregates were significantly reduced [MD = −0.69, 95% CI (−1.13, −0.24), P = .002], serum hypersensitive C-reactive protein (hs-CRP) measurements were significantly reduced [MD = −5.37, 95% CI (−9.20, −1.55), P = .006], complications measurement was significantly lower [OR = 0.60, 95% CI (0.27, 1.30), P = .20], activated partial thrombin time (ATPP) measurement was significantly lower [MD = 5.70, 95% CI (4.28, 7.12), P < .00001] and prothrombin time (PT) measurement was significantly lower [MD = 1.64, 95% CI (0.70, 2.57), P = .0006].

Conclusion:

Based on the available evidence, TCM combined with Rivaroxaban for treating lower extremity DVT have better clinical efficacy and safety profile, reducing the risk of bleeding complications and adverse effects. Further improved studies are needed to support this inference.
High attenuation value in non-contrast computer tomography can predict pyonephrosis in patients with upper urinary tract stones
Authors: Lu Xiaofei , Hu Dechao , Zhou Benzheng
Published: September 2022

To evaluate whether the higher attenuation value [Hounsfield unit (HU)] in non-contrast CT can predict pyonephrosis in patients with upper urinary tract stones (UTS). Between October 2019 and October 2021, patients with hydronephrosis or pyonephrosis secondary to upper UTS were retrospectively searched in our study. All patients with UTS were treated with percutaneous nephrostomy, percutaneous nephrolithotomy, retrograde ureteral stent or transurethral ureteroscope lithotripsy. We excluded patients treated with extracorporeal shock-wave lithotripsy. Patients whose CT was not performed in our hospital or treated in another hospital were also excluded. Clinical data regarding basic information, clinical feature, Calculi-related indicators, HU values of the renal pelvis, the thick wall of the renal pelvis on CT were collected. Univariate and multivariate logistic analyses were performed. Receiver operative characteristic curves were drawn to predict pyonephrosis. A total of 240 patients with UTS were retrospected in this research, 191 patients had hydronephrosis (Group 1), and 49 patients had hydronephrosis with pyonephrosis (Group 2). The HU value of the renal collecting system in Group 2 (mean, 15.46; range, +1/+30) was significantly higher than that in Group 1 (mean, 5.5; 5 range −6/+24) (P = .02); the receiver operative characteristic curve analysis revealed that the best cut-off value of 9.5 could predict the presence of pyonephrosis, with 71.4% sensitivity and 70.2% specificity (area under the curve = 0.613; 95% CI: 0.514–0.713). In this study, we found the HU attenuation value of the renal collecting system can be used to distinguish pyonephrosis from hydronephrosis in patients with UTS.
Clinical significance of early venous enhancement on CT angiography of the ischemic lower limbs
Authors: Byeon Je Yeon , Kwak Si Hyun , Choi Hwan Jun , Kim Jun Hyuk , Lee Da Woon
Published: September 2022

The authors observed good clinical courses in patients with lower limb ulcers and extensive skin inflammation who showed early venous enhancement at contrast-enhanced lower extremity computed tomographic angiography. The author hypothesized that these early venous enhancements tend to occur in conditions of healthier vascular status. A total of 145 patients who met the inclusion criteria were classified based on the degree of arterial occlusion and early venous enhancement according to lower extremity angiography. Early venous enhancement correlated with age over 65 (t-score = 0.001), absence of ulcer history (t-score = 0.003), absence of amputation history (t-score = 0.004), and low ankle-brachial index (P value = .001). We confirmed that the factors related with early venous enhancement differ from the factor inducing arterial occlusion. Prior to this study, early enhancement of veins in the lower limb was thought to be an artifact. However, in this study, veins that show early enhancement are suspected of being healthier and more responsive to inflammation than those that do not show early enhancement. These findings may help to predict the clinical course and to determine therapeutic planning without additional studies. Also, it can be easily reproduced in other facilities.
The effectiveness of nab-paclitaxel plus gemcitabine and gemcitabine monotherapy in first-line metastatic pancreatic cancer treatment: A real-world evidence
Authors: Prejac Juraj , Tomek Hamzić Dora , Librenjak Nikša , Goršić Irma , Kekez Domina , Pleština Stjepko
Published: September 2022

Pancreatic cancer is one of the most lethal malignancies with a rise in mortality rates. FOLFIRINOX and nab-paclitaxel plus gemcitabine demonstrated a survival benefit compared to gemcitabine alone. Both protocols are now considered the standard of first-line treatment with no significant difference between them, primarily based on observational studies. Although new therapeutic options have emerged recently, the prognosis remains poor. We conducted a retrospective single-center study on 139 patients treated for metastatic pancreatic adenocarcinoma (mPDAC) with gemcitabine monotherapy (Gem) or nab-paclitaxel + gemcitabine (Nab-P/Gem) in the first line. The aim of our study was to evaluate the effectiveness in terms of overall survival (OS) and progression-free survival (PFS) as well as the influence of patient and disease characteristics on outcomes. Nab-P/Gem resulted in OS of 13.87 months compared to 8.5 months in patients receiving Gem. The same trend was achieved in PFS, 5.37 versus 2.80 months, respectively, but without reaching statistical significance. Furthermore, the 6-month survival in the Nab-P/Gem group was also higher, 78.1% versus 47.8%. In terms of survival, the group of elderly patients, patients of poorer performance, with higher metastatic burden and liver involvement, benefited the most from combination therapy. In our analysis ECOG performance status (p.s.), previous primary tumor surgery, and liver involvement were found to be independent prognostic factors. The addition of nab-paclitaxel to gemcitabine resulted in a significant improvement in the OS of patients with mPDAC. Subgroup analysis demonstrated that patients with some unfavorable prognostic factors benefited the most.
Identification of a clinical web-based nomogram to predict overall survival in elderly retroperitoneal sarcoma patients: A population-based study
Authors: Zheng Honghong , Wei Junqiang
Published: September 2022

The purpose of this study was to develop a web-based nomogram and risk stratification system to predict overall survival (OS) in elderly patients with retroperitoneal sarcoma (RPS). Elderly patients diagnosed with RPS between 2004 and 2015 were identified in the Surveillance, Epidemiology, and End Results (SEER) database. We used univariate and multivariate Cox analysis to identify independent prognostic factors. We plotted the nomogram for predicting the OS of elderly RPS patients at 1, 3, and 5 years by integrating independent prognostic factors. The nomograms were subsequently validated by receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). By calculating the Nomogram score for each patient, we build a risk stratification model to evaluate the survival benefit of elderly RPS patients. A total of 722 elderly RPS patients were included in our study. The nomogram includes 5 clinicopathological variables as independent prognostic factors: age, histological subtype, grade, metastasis status, and surgery. Through the validation, we found that the nomogram has excellent prediction performance. Then web-based nomograms were established. We performed a web-based nomogram and a risk stratification model to assess the prognosis of elderly RPS patients, which are essential for prognostic clustering and decision-making about treatment.
CIMP-positive glioma is associated with better prognosis: A systematic analysis
Authors: Xu Yingying , Xiao Huashi , Hu Wenqing , Shen He-Chun , Liu Wanjun , Tan Siyuan , Ren Chuanli , Zhang Xiaomin , Yang Xishuai , Yu Guo , Yang Ting , Yu Duonan , Zong Liang
Published: September 2022

Background:

CpG island methylator phenotype (CIMP) was closely related to the degree of pathological differentiation of tumors, and it’s an important determinant of glioma pathogenicity. However, the molecular and pathological features of CIMP-positive glioma have not been fully elucidated. In addition, CIMP have been reported to be a useful prognostic marker in several human cancers, yet its prognostic value in gliomas is still controversial. Therefore, we aimed to evaluate gene mutations and pathological features of CIMP-positive glioma and explore the prognostic value of CIMP in gliomas.

Methods:

We comprehensively searched PubMed, Embase, and MEDLINE for studies describing gene mutations, pathological features and overall survival of gliomas stratified by CIMP status. Odds ratios (OR), hazard ratios (HR), and their 95% confidence intervals (CI) were used to estimate the correlation between CIMP and the outcome parameters.

Results:

Twelve studies with 2386 gliomas (1051 CIMP-positive and 1335 CIMP-negative) were included. Our results showed that CIMP was more frequent in isocitrate dehydrogenase 1 (IDH1)-mutated gliomas (OR 229.07; 95% CI 138.72–378.26) and 1p19q loss of heterozygosis (LOH) gliomas (OR 5.65; 95% CI 2.66–12.01). Pathological analysis showed that CIMP was common in low-malignant oligodendroglioma (OR 5.51; 95% CI 3.95–7.70) with molecular features including IDH1 mutations and 1p19q LOH, but rare in glioblastoma (OR 0.14; 95% CI 0.10–0.19). However, CIMP showed no obvious correlation with anaplastic oligoastrocytomas (OR 1.57; 95% CI 1.24–2.00) or oligoastrocytomas (OR 0.79; 95% CI 0.35–1.76). Concerning the prognosis, we found that CIMP-positive gliomas had longer overall survival (HR 0.57; 95% CI 0.97–0.16) than CIMP-negative gliomas.

Conclusions:

CIMP could be used as a potential independent prognostic indicator for glioma.
Correlation of uric acid with body mass index based on NHANES 2013–2018 data: A cross-sectional study
Authors: Wang Huashuai , Yao Jia , Ding Ning , He Yongheng
Published: September 2022

Clinical investigation of obesity-related risk factors aids in the early detection, prevention, and management of obesity. We aimed to examine the association between obesity and serum uric acid (sUA). A cross-sectional study was conducted including 18473 subjects from the National Health and Nutrition Examination Survey (NHANES). The exposure and outcome variables were sUA and body mass index (BMI), respectively. The weighted multivariate linear regression models and smooth curve fittings were conducted to assess the association between sUA and BMI. There were significantly positive correlations between sUA and BMI in both males and females (β = 1.414, 95% CI: 1.323−1.505, P < .0001, β = 1.853, 95% CI: 1.740−1.966, P < .0001, respectively). Furthermore, individuals in the higher sUA quartiles had higher BMI than those in the lowest quartile in both males and females. Subgroup analyses were stratified by race/ethnicity, results indicated the positive association of sUA with BMI in males remained in all races including Mexican American (β = 1.203, 95% CI: 0.965−1.442, P < .0001), other Hispanic (β = 1.126, 95% CI: 0.858−1.395, P < .0001), non-Hispanic White (β = 1.493, 95% CI: 1.343−1.642, P < .0001), non-Hispanic Black (β = 1.331, 95% CI: 1.122−1.540, P < .0001), and other races (β = 1.329, 95% CI: 1.115−1.544, P < .0001). And the positive association of sUA with BMI in females also remained in all races including Mexican American (β = 1.806, 95% CI: 1.520−2.092, P < .0001), other Hispanic (β = 2.033, 95% CI: 1.687−2.379, P < .0001), non-Hispanic White (β = 1.847, 95% CI: 1.657−2.037, P < .0001), non-Hispanic Black (β = 2.141, 95% CI: 1.874−2.408, P < .0001), and other races (β = 1.348, 95% CI: 1.081−1.615, P < .0001). The current cross-sectional study with 18473 US participants found that an elevated sUA was positively correlated with a higher BMI in males, females, and all kinds of races.
An observational study of health care provider collaboration networks and heterogenous hospital cost efficiency and quality outcomes
Authors: Linde Sebastian , Shimao Hajime
Published: September 2022

Provider network structure has been linked to hospital cost, utilization, and to a lesser degree quality, outcomes; however, it remains unknown whether these relationships are heterogeneous across different acute care hospital characteristics and US states. The objective of this study is to evaluate whether there are heterogeneous relationships between hospital provider network structure and hospital outcomes (cost efficiency and quality); and to assess the sources of measured heterogeneous effects. We use recent causal random forest techniques to estimate (hospital specific) heterogeneous treatment effects between hospitals’ provider network structures and their performance (across cost efficiency and quality). Using Medicare cost report, hospital quality and provider patient sharing data, we study a population of 3061 acute care hospitals in 2016. Our results show that provider networks are significantly associated with costs efficiency (P < .001 for 7/8 network measures), patient rating of their care (P < .1 in 5/8 network measures), heart failure readmissions (P < .01 for 3/8 network measures), and mortality rates (P < .02 in 5/8 cases). We find that fragmented provider structures are associated with higher costs efficiency and patient satisfaction, but also with higher heart failure readmission and mortality rates. These effects are further found to vary systematically with hospital characteristics such as capacity, case mix, ownership, and teaching status. This study used an observational design. In summary, we find that hospital treatment responses to different network structures vary systematically with hospital characteristics..
Clinical effect of antibiotic combined with fiber bronchoscope perfusion in treatment of pneumonia after severe cerebral hemorrhage
Authors: Wang Weigang , Zhao Lizhen , Li Junxia , Shi Jiankun
Published: September 2022

To explore the curative effect of antibiotic combined with mucosolvan perfusion under fiber bronchoscope in treatment of pneumonia after severe cerebral hemorrhage. The clinical data of 120 patients with pneumonia after severe cerebral hemorrhage admitted to our hospital from January 2017 to December 2019 were collected. All patients were divided into the lavage group and perfusion group by random number method, with 60 patients in each group. Patients in the lavage group received antibiotics combined with mucosolvan lavage therapy under fiber bronchoscope, while patients in the perfusion group received antibiotics combined with mucosolvan perfusion therapy under fiber bronchoscope. Clinical pulmonary infection score (CPIS), arterial blood gas index, clinical symptom improvement, and hospitalization costs were compared between the two groups before and after treatment. CPIS scores were improved after treatment in both groups (P < .05), and CPIS scores of patients in the perfusion group were lower than those in the lavage group at 3, 5, and 7 days after treatment (P < .05). The blood oxygen saturation and partial arterial oxygen pressure of the perfusion group were all higher than those of the lavage group (P < .05), while the partial carbon dioxide pressure was lower than that of the lavage group (P < .05). In the perfusion group, the duration of cough, adequacy of fever, disappearance of rhonchus in the lungs, and the length of hospital stay were less than those in the lavage group (P < .05). The hospitalization costs of perfusion group were lower than that of lavage group (P < .05). The combination of antibiotics and mucosolvan infusion therapy under fiber bronchoscope can effectively improve the clinical efficacy, reduce the hospitalization cost, and improve the prognosis of patients with pneumonia after severe cerebral hemorrhage.
Prolonged ileus in traumatic pelvic ring injury patients who underwent arterial angio-embolization: A retrospective study
Authors: Park Chan-Hee , Lee Jeong-Woo , Kim Beom-Soo , Cho Myung-Rae , Song Suk-Kyoon
Published: September 2022

Paralytic ileus occurs in up to 18% of the patients with pelvic bone fractures. The aim of this study is to determine if massive bleeding requiring arterial angio-embolization is related with the duration of ileus in patients with traumatic pelvic ring injuries. This retrospective study included 25 patients who underwent arterial angio-embolization for traumatic pelvic ring injuries. Data were collected from prospectively maintained databases of two independent hospitals. Demographic characteristics (such as age, sex, body mass index, and Charlson Comorbidity Index), cause of trauma, and severity of pelvic injuries were similar in the non-prolonged and prolonged ileus groups. As expected, the prolonged ileus group had a significantly longer duration of ileus than the non-prolonged ileus group (8.0 ± 4.2 days vs 1.2 ± 0.4 days, respectively; P < .001). The mortality rate was higher in the prolonged ileus group (20% vs 0%), but it was not significantly different (P = .13). Interestingly, the prolonged ileus group received significantly higher amounts of packed red blood cell transfusions (6.1 ± 2.1 units vs 3.8 ± 2.5 units; P = .02). The amount of packed red blood cell transfusions was associated with a greater risk of prolonged ileus development (P = .03, odds ratio = 2.04, 95% confidence interval = 1.08–3.88). This study supports the idea that the duration of the ileus is related with the amount of bleeding caused by the traumatic pelvic ring injury. In order to prevent further complications, conservative treatments of the ileus should be considered.
Integrative analysis of the characteristic of lipid metabolism-related genes for the prognostic prediction of hepatocellular carcinoma
Authors: Zhu Peng , Zhang Feng , Deng Weijie , Chen Wenbiao
Published: September 2022

Background:

Dysregulation of lipid metabolism is implicated in the progression of hepatocellular carcinoma (HCC). We therefore investigated the molecular characteristics of lipid-metabolism-related genes in HCC.

Methods:

Multi-dimensional bioinformatics analysis was conducted to comprehensively identify the lipid metabolism-related genes (LMRGs) from public databases, as well as the clinical information, immune features, and biological characteristics of HCC. The IMGR were then used to classify HCC into molecular phenotypes. Six lipid metabolism-related genes sets with the potential to predict the prognosis of HCC patients were identified.

Results:

A total of 770 HCC patients with complete clinical information and corresponding 776 LMRGs were downloaded from 3 databases. Univariate cox and non-negative matrix factorization analyses were used to classify HCC patients into 2 clusters. This molecular classification was associated with overall survival, clinical characteristics, and immune cells. The biological function of the differentially expressed LMRGs in the 2 clusters showed the genes associated with tumor-related metabolism pathways. A combination of multivariate/univariate cox regression and least absolute shrinkage and selection operator analyses were conducted to build a 6 LMRGs signature (6-IS) to predict the prognosis of HCC. The 6-IS signature was found to be an independent prognostic factor. Performance of the 6-IS prognostic signature was verified in a validation set and compared with an external data set. Results revealed the 6-IS signature could effectively predict the prognosis of patients with HCC.

Conclusions:

This study provides new insights into the role of LMRG in the pathogenesis of HCC and presents a novel prognostic signature 6-IS monitoring the clinical course of HCC.