bluuebunny/crossref_metadata_2025 huggingface dataset:
Hemophagocytic Lymphohistiocytosis Associated With Cytomegalovirus Infection: 5 Cases and a Systematic Review of the Literature
Authors: Chevalier Kevin , Schmidt Julien , Coppo Paul , Galicier Lionel , Noël Nicolas , Lambotte Olivier
Published: August 2022

Hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening disorder characterized by an uncontrolled, persistent, hyperimmune response. It can be triggered by an infectious, neoplastic, or autoimmune event. The involvement of cytomegalovirus (CMV) in the onset of HLH is subject to debate, and the epidemiology of CMV-associated HLH (HLH-CMV) remains poorly characterized. We identified 5 cases of HLH-CMV in our hospital, systematically searched the PubMed database for publications on HLH-CMV, and reviewed 57 publications with a total of 67 cases of HLH-CMV. Only 48 patients (71.6%) were immunodeficient, suggesting that HLH-CMV can occur in immunocompetent patients. The major cause of underlying immunodepression (51%) was inflammatory bowel disease (mainly treated with azathioprine). CMV infection was nearly always symptomatic, and lung involvement was frequent (31 cases). Fifty-five patients recovered. Nineteen patients were treated for CMV infection only and had a good outcome, suggesting that antiviral drugs might be the cornerstone of HLH-CMV treatment.
Long-term outcomes of peroral endoscopic myotomy for Chicago classification type I vs type III achalasia in treatment-naive patients
Authors: Xiang Jingyuan , Chai Ningli , Wang Shasha , Li Longsong , Wang Xiangyao , Linghu Enqiang
Published: August 2022

The efficacy of peroral endoscopic myotomy (POEM) for achalasia has potential associations with Chicago classification by high-resolution manometry (HRM). Type II achalasia demonstrates the best response to POEM of all subtypes, while there remain controversies between type I and type III. Moreover, previous treatment history might cause discrepancy in direct comparison. We aimed to compare the clinical outcome of POEM for type I vs type III in treatment-naive patients. In total, 82 patients with type I or type III achalasia (45 type I, 37 type III) from February 2015 to December 2018 were enrolled and POEM was carried out as the initial treatment. Clinical success, change of Eckardt scores and HRM parameters were analyzed and compared between type I and type III group. About, 43 (95.6%) patients and 34 (91.9%) patients in type I and type III group acquired the clinical success (P = 0.821). Eckardt score and HRM results after POEM treatment decreased significantly in either group (P<0.01). Compared to type III group, higher reduction rates of Eckardt score (type I vs type III, 78.6 vs 66.9%, P = 0.034) and basal LES pressure (type I vs type III, 58.9 vs 40.4%, P = 0.040) were observed in type I group. Type I achalasia patients showed better response to POEM with more favorable clinical remission in Eckardt score and HRM outcomes than type III.
Risk Prediction for Complications in Inflammatory Bowel Disease Surgery: External Validation of the American College of Surgeons’ National Surgical Quality Improvement Program Surgical Risk Calculator
Authors: Lin Viviane , Gögenur Seyma , Pachler Frederik , Fransgaard Tina , Gögenur Ismail
Published: August 2022

Background and Aims

Many patients with inflammatory bowel disease [IBD] require surgery during their disease course. Having individual risk predictions available prior to surgery could aid in better informed decision making for personalised treatment trajectories in IBD surgery. The American College of Surgeons National Surgical Quality Improvement Program [ACS NSQIP] has developed a surgical risk calculator that calculates risks for postoperative outcomes using 20 patient and surgical predictors. We aimed to validate the calculator for IBD surgery to determine its accuracy in this patient cohort.

Methods

Predicted risks were calculated for patients operated for IBD between December 2017 and January 2022 at two tertiary centres and compared with actual outcomes within 30 postoperative days. Predictive performance was assessed for several postoperative complications, using metrics for discrimination and calibration.

Results

Risks were calculated for 508 patient trajectories undergoing surgery for IBD. Incidence of any complication, serious complications, reoperation, and readmission were 32.1%, 21.1%, 15.2%, and 18.3%, respectively. Of 212 patients with an anastomosis, 19 experienced leakage [9.0%]. Discriminative performance and calibration were modest. Risk prediction for any complication, serious complication, reoperation, readmission, and anastomotic leakage had a c statistic of 0.605 (95% confidence interval [CI] 0.534-0.640), 0.623 [95% CI 0.558-0.688], 0.590 [95% CI 0.513-0.668], 0.621 [95% CI 0.557-0.685], and 0.574 [95% CI 0.396-0.751], respectively, and a Brier score of 0.240, 0.166, 0.138, 0.152, and 0.113, respectively.

Conclusions

The accuracy of risks calculated by the ACS NSQIP Surgical Risk Calculator was deemed insufficient for patients undergoing surgery for IBD, generally underestimating postoperative risks. Recalibration or additional variables could be necessary to predict risks in this cohort.
Full-waveform inversion of ground-penetrating radar data in frequency-dependent media involving permittivity attenuation
Authors: Qin Tan , Bohlen Thomas , Allroggen Niklas
Published: August 2022

Full-waveform inversion (FWI) of ground-penetrating radar (GPR) data has received particular attention in the past decade because it can provide high-resolution subsurface models of dielectric permittivity and electrical conductivity. In most GPR FWIs, these two parameters are regarded as frequency independent, which may lead to false estimates if they strongly depend on frequency, such as in shallow weathered zones. In this study, we develop frequency-dependent GPR FWI to solve this problem. Using the τ-method introduced in the research of viscoelastic waves, we define the permittivity attenuation parameter to quantify the attenuation resulting from the complex permittivity and to modify time-domain Maxwell’s equations. The new equations are self-adjoint so that we can use the same forward engine to back-propagate the adjoint sources and easily derive model gradients in GPR FWI. Frequency dependence analysis shows that permittivity attenuation acts as a low-pass filter, distorting the waveform and decaying the amplitude of the electromagnetic waves. The 2-D synthetic examples illustrate that permittivity attenuation has low sensitivity to the surface multioffset GPR data but is necessary for a good reconstruction of permittivity and conductivity models in frequency-dependent GPR FWI. As a comparison, frequency-independent GPR FWI produces more model artefacts and hardly reconstructs conductivity models dominated by permittivity attenuation. The 2-D field example shows that both FWIs reveal a triangle permittivity anomaly which proves to be a refilled trench. However, frequency-dependent GPR FWI provides a better fit to the observed data and a more robust conductivity reconstruction in a high permittivity attenuation environment. Our GPR FWI results are consistent with previous GPR and shallow-seismic measurements. This research greatly expands the application of GPR FWI in more complicated media.
Constraints on hydraulic properties from free pressure oscillations recorded during pumping operations in boreholes
Authors: Jiménez Martínez Victoria Alegría , Renner Jörg
Published: August 2022

Free pressure oscillations during pumping operations in boreholes may potentially constrain hydraulic characteristics of the surrounding material. These damped oscillations occur when flow rate is suddenly changed, and their period and decay rate depend on the hydraulic properties of the entire hydraulic system: the porous medium, a section of the borehole, and/or the injection line, depending on test set-up. There have been previous attempts to estimate transmissivity values from free pressure oscillations that occurred during slug tests in open boreholes. The analysis used did not account for viscous losses due to the fluid interacting with the borehole wall. In contrast, dispersion relations of flow waves in a tight borehole (i.e. a cylindrical hole in an impermeable medium) account for wall friction. We extend a previous analytical treatment of flow waves by changing the boundary condition of the fluid velocity at the borehole wall to include fluid exchange between borehole and porous medium. In addition, we performed numerical modelling of waves propagating in boreholes with impermeable and permeable walls to assess the effect of the assumptions behind the analytical solution. We established how to distinguish cases in which the flow into the porous medium affects the oscillation characteristics (suitable for a hydraulic analysis) from those in which the equipment properties dominate the observations. Applying our methods to a range of field observations yielded plausible hydraulic property values of the rock volume surrounding the borehole.
Frequency-difference backprojection of earthquakes
Authors: Neo Jing Ci , Fan Wenyuan , Huang Yihe , Dowling David
Published: August 2022

Backprojection has proven useful in imaging large earthquake rupture processes. The method is generally robust and requires relatively simple assumptions about the fault geometry or the Earth velocity model. It can be applied in both the time and frequency domain. Backprojection images are often obtained from records filtered in a narrow frequency band, limiting its ability to uncover the whole rupture process. Here, we develop and apply a novel frequency-difference backprojection (FDBP) technique to image large earthquakes, which imitates frequencies below the bandwidth of the signal. The new approach originates from frequency-difference beamforming, which was initially designed to locate acoustic sources. Our method stacks the phase-difference of frequency pairs, given by the autoproduct, and is less affected by scattering and -time errors from 3-D Earth structures. It can potentially locate sources more accurately, albeit with lower resolution. In this study, we first develop the FDBP algorithm and then validate it by performing synthetic tests. We further compare two stacking techniques of the FDBP method, Band Width Averaged Autoproduct and its counterpart (BWAP and non-BWAP), and their effects in the backprojection images. We then apply both the FDBP and conventional backprojection methods to the 2015 M7.8 Gorkha earthquake as a case study. The backprojection results from the two methods agree well with each other, and we find that the peak radiation loci of the FDBP non-BWAP snapshots have standard error of less than 0.33° during the rupture process. The FDBP method shows promise in resolving complex earthquake rupture processes in tectonically complex regions.
Comparative analysis of the optimum cluster number determination algorithms in clustering GPS velocities
Authors: Özarpacı Seda , Kılıç Batuhan , Bayrak Onur Can , Özdemir Alpay , Yılmaz Yalçın , Floyd Michael
Published: August 2022

The Global Positioning System (GPS), although it has existed for only 30 years, is an important source for active tectonics, resulting in estimates of plate motions very close to geologic estimates over millions of years. GPS is also used for elastic block models to calculate slip rates for a better understanding of Earth’s active crustal deformation. GPS-derived velocity fields may be used as the basis for clustering analysis to create a preliminary definition of block geometry. In this study, we used published horizontal velocity fields to evaluate the effects of data dependences on determining the optimum number of clusters with algorithms. For this purpose, we used different variations of velocity fields in Turkey and tested four different algorithms that are Davies–Bouldin index, the elbow method, GAP statistics algorithm and the silhouette method. We also clustered velocity components with the k-means technique and compared the results with previous studies.
Region-Specific Enhancement of c-fos Expression by Combined Treatment With NMDA Receptor Agonists and Antagonists With Antidepressant Potential
Authors: Vasilescu Andrei-Nicolae , Pfeiffer Natascha , Terraneo Federica , Riva Marco Andrea , Lang Undine E , Inta Dragos , Gass Peter
Published: August 2022

Rapastinel, formerly Glyx-13, is a novel positive allosteric modulator of the N-methyl-D-aspartate-receptor (NMDAR) that counteracts psychotomimetic actions of NMDAR antagonists. We set out to evaluate the effect of rapastinel alone or in combination with the global and GluN2B subunit–specific NMDAR antagonists MK-801 and Ro25-6981, respectively, on neuronal activation in relevant regions using c-fos brain mapping. Whereas rapastinel alone did not trigger significant c-fos expression beyond the prelimbic cortex, it strongly increased the c-fos expression induced by MK-801 in hippocampal, cingulate, and retrosplenial areas. Similar results were obtained when rapastinel was replaced by D-cycloserine. Our results reveal new interactions at network level between NMDAR modulators with possible implications regarding their therapeutic effects.
Aggressive histological component in subsolid lung adenocarcinoma: priority for resection without delay
Authors: Yotsukura Masaya , Nakagawa Kazuo , Takemura Chihiro , Yoshida Yukihiro , Ito Kimiteru , Watanabe Hirokazu , Kusumoto Masahiko , Yatabe Yasushi , Watanabe Shun-ichi
Published: August 2022

Introduction

This study explored the predictors of a histological aggressive component in ground glass opacity-containing lung adenocarcinoma.

Methods

Of the 2388 patients who underwent resection for lung cancer at our institute between 2017 and 2020, we collected data on the 501 patients with ground glass opacity-containing adenocarcinoma with a total diameter of ≤2 cm. Using a historical cohort, we identified histological aggressive components that were related to a poor prognosis in early-stage adenocarcinoma. A multivariable analysis was conducted to identify predictors for the presence of a histological aggressive component.

Results

Lymphovascular invasion and predominant micropapillary or solid patterns were identified as histological aggressive components by a prognostic analysis using a historical cohort. Of the 501 patients included, 36 (7.2%) had at least one histological aggressive component. A multivariate analysis showed that a consolidation/tumour ratio > 0.5 (P < 0.01), maximum standardized uptake value on positron emission tomography ≥1.5 (P = 0.01) and smoking index >20 pack-years (P = 0.01) were predictors of the presence of a histological aggressive component. A total of 98% of cases without any of the above factors did not have a histological aggressive component.

Conclusions

Approximately 7% of ground glass opacity-containing small adenocarcinomas contained histological aggressive component. A consolidation/tumour ratio > 0.5, maximum standardized uptake value ≥ 1.5 and smoking index >20 pack-years were predictors for such cases. These predictors may be useful for screening patients with a potentially high risk of a poor prognosis and for prioritizing resection without delay.
Medical management of older patients with lung cancer
Authors: Zenke Yoshitaka , Hakozaki Taiki , Nakahara Yoshiro , Horinouchi Hidehito , Ohe Yuichiro ,   the Lung Cancer Study Group of the Japan Clinical Oncology Group (JCOG), Barber Joe
Published: August 2022

Lung cancer is the most common cause of cancer-related death globally. In addition, its incidence increases with age, with approximately half of all cases diagnosed in patients aged ≥70. Molecular targeted therapies and immunotherapies for advanced non-small-cell lung cancer have markedly improved outcomes over the past two decades. Despite the high incidence of lung cancer in older people, most trials excluded such patients from enrollment. Therefore, the optimal treatment strategies for older patients remain unclear. The present review summarizes the published literature and provides guidance on the treatment of older patients with lung cancer within three broad stages: (i) early-stage lung cancer, (ii) locally advanced lung cancer and (iii) metastatic lung cancer. We also discuss the use of the latest evidence for older patients.
γ-Terpinene complexed with β-cyclodextrin attenuates spinal neuroactivity in animals with cancer pain by Ca2+ channel block
Authors: Pina Lícia T S , Rabelo Thallita K , Trindade Gabriela G G , Almeida Iggo K S , Oliveira Marlange A , dos Santos Priscila L , Souza Diego Santos , de Menezes-Filho José E R , de Vasconcelos Carla Maria Lins , Santos Sandra L , Scotti Luciana , Scotti Marcus T , Araújo Adriano A S , Quintans Jullyana S S , Quintans Lucindo J , Guimarães Adriana G
Published: August 2022

Objectives

Considering that γ-terpinene (γ-TPN) is a monoterpene found in Cannabis oil, with high lipophilicity and limited pharmacokinetics, our objective was to evaluate whether its complexation in β-cyclodextrin (γ-TPN/β-CD) could improve its physicochemical properties and action on cancer pain, as well as verify the mechanisms of action involved.

Methods

The γ-TPN/β-CD was prepared and submitted to physicochemical characterization. Animals with sarcoma 180 were treated (vehicle, γ-TPN 50 mg/kg, γ-TPN/β-CD 5 mg/kg or morphine) and assessed for hyperalgesia, TNF-α and IL-1β levels, iNOS and c-Fos activity. The effects of γ-TPN on calcium channels were studied by patch-clamp and molecular docking.

Results

β-CD improved the physicochemical properties and prolonged the anti-hyperalgesic effect of γ-TPN. This compound also reduced the levels of IL-1β, TNF-α and iNOS in the tumour, and c-Fos protein in the spinal cord. In addition, it reduced Ca2+ current, presenting favourable chemical interactions with different voltage-dependent calcium channels.

Conclusion

These results indicate that the complexation of γ-TPN into β-CD increases its stability and time effect, reducing spinal neuroactivity and inflammation by blocking calcium channels.
Increased Levels of ANGPTL3 and CTRP9 in Patients With Obstructive Sleep Apnea and Their Relation to Insulin Resistance and Lipid Metabolism and Markers of Endothelial Dysfunction
Authors: Fadaei Reza , Azadi Samaneh Mohassel , Laher Ismail , Khazaie Habibolah
Published: August 2022

Objective

Obstructive sleep apnea (OSA) has a close relation with obesity and perturbation in adipokines and hepatokines, which are linked to OSA consequences such as insulin resistance, dyslipidemia, and endothelial dysfunction. This study aimed to assess the relation of C1q/TNF-related protein 9 (CTRP9) and angiopoietin-like protein 3 (ANGPTL3) with OSA and biochemical measurements.

Methods

Serum levels of ANGPTL3, CTRP9, adiponectin, leptin, intercellular adhesion molecule 1 (ICAM-1), and vascular cell adhesion protein 1 (VCAM-1) were determined in 74 OSA patients and 27 controls using enzyme-linked immunosorbent assay kits.

Results

Levels of ANGPTL3, CTRP9, leptin, ICAM-1, and VCAM-1 were increased in the patients compared to the controls, whereas adiponectin levels decreased. ANGPTL3 had a positive correlation with total cholesterol, triglyceride, low-density lipoprotein cholesterol, ICAM-1, and VCAM-1 and was inversely correlated with leptin. CTRP9 showed a positive correlation with body mass index, insulin resistance, ICAM-1, and VCAM-1.

Conclusion

The results indicated the relation of ANGLTP3 and CTRP9 with OSA and its complications, which suggested a possible role for these factors in the consequences of OSA.
Comparison between the Sofia SARS Antigen FIA Test and the PCR Test in Detection of SARS-CoV-2 Infection
Authors: Černila Manca , Logar Mateja , Možina Hugon , Osredkar Joško
Published: August 2022

Objective

The purpose of this study was to compare Quidel’s rapid antigen test Sofia SARS antigen Fluorescent Immunoassay (FIA) (Sofia) with the real-time reverse transcription–polymerase chain reaction (rRT-PCR) test.

Methods

Two samples were taken from each test subject—1 for testing with the Sofia test and 1 for testing with the rRT-PCR test. In total, swabs were taken from 146 subjects who presented symptoms of infection (group 1) and 672 subjects who were tested regardless of symptoms (group 2).

Results

In group 1, the sensitivity of the antigen test was 90.0% and its specificity 97.5%. In group 2, however, the sensitivity of the antigen test was 81.4% and the specificity 98.9%. In addition to asymptomatic patients, false-negative results of rapid antigen tests also occurred in subjects with high threshold values (cycle threshold > 30).

Conclusion

Our results show that the Sofia test meets the standards for diagnostic tests according to the criteria of the World Health Organization, as they show high sensitivity and specificity, and perhaps most importantly, a high negative predictive value (> 95%).
Numerical simulations of a two-fluid jet at a magnetic null point in a solar arcade
Authors: González-Avilés J J , Murawski K , Zaqarashvili T V
Published: August 2022

We study the formation and evolution of jets in the solar atmosphere using numerical simulations of partially ionized plasma. The two-fluid magnetohydrodynamic equations with ion+electron and neutral hydrogen components are used in two-dimensional Cartesian geometry. Numerical simulations show that a localized non-linear Gaussian pulse of ion and neutral pressures initially launched from the magnetic null point of a potential arcade located below the transition region quickly develops into a shock due to the decrease of density with height. The shock propagates upwards into the solar corona and lifts the cold and dense chromospheric plasma behind in the form of a collimated jet with an inverted-Y shape. The inverted-Y shape of jets is connected with the topology of a magnetic null point. The pulse also excites a non-linear wake in the chromosphere, which leads to quasi-periodic secondary shocks. The secondary shocks lift the chromospheric plasma upwards and create quasi-periodic jets in the lower corona. Ion and neutral fluids show generally similar behaviour, but their relative velocity is higher near the upper part of the jets, which leads to enhanced temperature or heating due to ion–neutral collisions. Simulations of jets with an inverted-Y shape and their heating may explain the properties of some jets observed in the solar atmosphere.
Prospects of strongly lensed fast radio bursts: simultaneous measurement of post-Newtonian parameter and Hubble constant
Authors: Gao Ran , Li Zhengxiang , Gao He
Published: August 2022

Strong gravitational lensing effect is a powerful tool to probe cosmological models and gravity theories. Recently, the time-delay cosmography from strong lensing and the stellar kinematics of the deflector, which encode the Hubble constant and the post-Newtonian parameter via two distance ratios reflecting the lensing mass and dynamical mass, respectively, have been proposed to investigate these two parameters simultaneously. Among strong-lensing systems with different sources, strongly lensed fast radio bursts (FRBs) have been proposed as precision probes of the universe since the time-delay ∼ 10 d between images could be measured extremely precisely because of their short duration of a few milliseconds. In this work, we investigate the ability of strongly lensed FRBs on simultaneously estimating these two parameters via simulations. Take the expected FRB detection rate of upcoming facilities and lensing probability into consideration, it is likely to accumulate 10 lensed FRBs in several years and we find that H0 could be determined to an $\sim 1.5{{\,\rm per\,cent}}$ precision and γPPN could be constrained to an $\sim 8.7{{\,\rm per\,cent}}$ precision simultaneously from them. These simultaneous estimations will be helpful for properly reflecting the possible correlation between these two fundamental parameters.
NGC 3147: a prototypical low-luminosity active galactic nucleus with double-peaked optical and ultraviolet lines
Authors: Bianchi Stefano , Chiaberge Marco , Laor Ari , Antonucci Robert , Bagul Atharva , Capetti Alessandro
Published: August 2022

A previous narrow-slit (0.1 arcsec) Hubble Space Telescope observation unveiled a broad relativistic Hα profile in NGC 3147, a low-luminosity (Lbol ∼ 1042 erg s−1), low-Eddington ratio (Lbol/LEdd ∼ 10−4) active galactic nucleus (AGN), formerly believed to be a candidate true type 2 AGN intrinsically lacking the broad-line region. The new observations presented here confirm the double-peaked profile of the Hα line, which further shows variability both in flux and in the inner radius of the emitting disc with respect to the previous epoch. Similar disc line profiles are also found in prominent ultraviolet (UV) lines, in particular Lyα and C iv. The new data also allow us to build a simultaneous subarcsec optical-to-X-ray spectral energy distribution of NGC 3147, which is characterized by the absence of a thermal UV bump, and an emission peak in the X-rays. The resulting very flat αox = −0.82 is typical of low-luminosity AGNs, and is in good agreement with the extrapolation to low luminosities of the well-known trend with luminosity observed in a standard AGN. Indeed, we are possibly observing the accretion disc emission in NGC 3147 in the optical, close to the expected peak. On the other hand, the steep −2 UV power law may be Comptonization of that cold disc by a warm corona, what is instead generally observed as a ‘soft excess’ in a more luminous AGN.
Detailed evolutionary models for twins in sight of new spectral data: AN Cam, RS Ari, and V455 Aur
Authors: Yücel Gökhan , Bakış Volkan
Published: August 2022

We present the evolutionary scenarios for three eclipsing twin (q(M2/M1) ∼1) binary systems using their combined spectroscopic and photometric data. Using accurate TESS photometric data, RV measurements, and spectroscopic data enabled us to calculate fundamental parameters, such as mass and radius, better than 2 per cent. The temperature of each component and metallicity of the systems have been obtained via high-resolution spectra. According to our spectral analysis, the metallicity values of AN Cam, RS Ari, and V455 Aur are [M/H] =  0.00 ± 0.12, 0.05 ± 0.08, and −0.07 ± 0.07, respectively. Using the derived metallicity for each system, initial orbital parameters, and detailed evolutionary status of these three systems are calculated with high precision by using mesa. According to our analysis, both components of AN Cam have passed the terminal-age main sequence (TAMS), the primary component of RS Ari is in the giant phase while the secondary component has passed the TAMS, finally, both components of V455 Aur are still on the main sequence. The current ages of the three systems AN Cam, RS Ari, and V455 Aur are 3.0, 3.3, and 1.4 Gyr, respectively, and they will approximately start to transfer mass between components in 400, 250, and 2700 Myr, respectively.
Differences in sex- and age-associated mortality in patients with anti-MDA5-positive dermatomyositis
Authors: He Shuangjun , Zhou Yuhong , Fan Chenyu , Ma Jun , Chen Yi , Wu Wanlong , Zhang Xingyu
Published: August 2022

Objectives

The effect of sex and age on the outcomes of patients with anti-melanoma differentiation–associated gene 5 (MDA5)-positive dermatomyositis (MDA5+ DM) remains unclear. This study aimed to investigate the impact of sex and age on the prognosis of patients with MDA5+ DM.

Methods

We included 251 patients (women, 156; men, 95), who were newly diagnosed with MDA5+ DM between 2014 and 2021. The outcome was 6-month all-cause mortality after the diagnosis of interstitial lung disease. Cox regression analysis was used to assess the mortality. Adjusted restricted cubic spline analysis was performed to explore the non-linear relationship between age and outcomes.

Results

The 6-month mortality rates of women and men were 36.5% and 46.3%, respectively. Multivariate Cox regression revealed that ≥60 years of age was significantly associated with the risk of death (hazard ratio, 2.43; 95% confidence interval, 1.02–5.78). The trend of the risk of 6-month mortality in men was relatively flat until 54 years and increased rapidly afterwards (hazard ratio, 1.14; 95% confidence interval, 1.01–1.29). In contrast, the 6-month mortality rate showed a low linear increasing trend with age among females.

Conclusions

Patients with MDA5+ DM, who received contemporary treatment, had unfavourable outcomes. The 6-month mortality risk increased with age, particularly in male patients aged >54 years.
Treatment of secondary hyperparathyroidism in non-dialysis CKD: an appraisal 2022s
Authors: Ketteler Markus , Bover Jordi , Mazzaferro Sandro
Published: August 2022

The situation of secondary hyperparathyroidism (SHPT) in chronic kidney disease patients not on dialysis (ND-CKD) is probably best characterised by the Kidney Disease: Improving Global Outcomes Chronic Kidney Disease–Mineral and Bone Disorder Update 2017 guideline 4.2.1 stating that the optimal parathyroid hormone levels are not known in these stages. Furthermore, new caution became recommended with regard to the routine use of active vitamin D analogues in early CKD stages and moderate SHPT phenotypes, due to their potential risks for hypercalcaemia and hyperphosphataemia aggravation. Nevertheless, there is still a substantial clinical need to prevent the development of parathyroid gland autonomy, with its associated consequences of bone and vascular damage, including fracture risks and cardiovascular events. Therefore we now attempt to review the current guideline-based and clinical practice management of SHPT in ND-CKD, including their strengths and weaknesses, favouring individualised approaches respecting calcium and phosphate homeostasis. We further comment on extended-release calcifediol (ERC) as a new differential therapeutic option now also available in Europe and on a potentially novel understanding of a required vitamin D saturation in more advanced CKD stages. There is no doubt, however, that knowledge gaps will remain unless powerful randomised controlled trials with hard and meaningful endpoints are performed.
Novel combination coccospheres fromHelicosphaeraspp indicate complex relationships between species
Authors: Sturm Daniela , Langer Gerald , Wheeler Glen
Published: August 2022

Coccolithophores play an important role in global biogeochemical cycling, but many aspects of their ecology remain poorly understood, including their heteromorphic haplo-diplontic life cycle. The presence of combination coccospheres in environmental samples, which represent a transition between the lightly calcified haploid (HOL) and heavily calcified diploid (HET) life phases, provides crucial evidence linking the two life cycle phases of a particular species. Here, we describe combination coccospheres from the Southern Ocean that show a novel association between Helicosphaera hyalina (HET) and Helicosphaera HOL catilliferus type. The ability of Helicosphaera HET and HOL morphospecies to form multiple different combinations indicates a substantial complexity in the relationships between life cycle phases in this group. The findings suggest recent divergence within the Helicosphaera lineage may have resulted in significant inter- and intra-specific variability, with cryptic speciation in one or both life cycle phases contributing to their ability to form multiple HET/HOL associations.
Optimal Capital Structure with Stock Market Feedback
Authors: Machado Caio , Pereira Ana Elisa
Published: August 2022

This article studies optimal capital structure when firms learn from financial markets. We present a tractable model of stock market feedback with imperfect information aggregation. Debt issuance affects speculators’ incentives to trade both directly, by changing the payoff structure of equity holders, and indirectly, through an asset substitution effect. We show that issuing debt can increase market informativeness and firm value, and may eliminate a coordination failure equilibrium with no provision of market information. We derive the optimal capital structure in this setting and present novel empirical predictions regarding the relationship between market frictions, market informativeness, and capital structure. Once the effect of debt on market informativeness is considered, risky debt does not necessarily lead to risk shifting.
Hospital Surgical Volume Is Poorly Correlated With Delivery of Multimodal Treatment for Localized Pancreatic Cancer
Authors: Powers Benjamin D. , McDonald James , Mhaskar Rahul , Lee Simon J. Craddock , Permuth Jennifer B. , Vadaparampil Susan , Gilbert Scott M. , Denbo Jason W. , Kim Dae Won , Pimiento Jose M. , Hodul Pamela J. , Malafa Mokenge P. , Anaya Daniel A. , Fleming Jason B.
Published: August 2022

Objectives:

Using Donabedian’s quality of care model, this study assessed process (hospital multimodal treatment) and structure (hospital surgical case volume) measures to evaluate localized pancreatic cancer outcomes.

Background:

Treatment at high surgical volume hospitals has been shown to improve short-term outcomes. However, multimodal treatment—surgery and chemotherapy—is the standard of care yet only received by 35% of US patients and has not been examined at the hospital level.

Methods:

The National Cancer Database was used to identify a cohort of clinical stage I pancreatic cancer patients eligible for multimodal treatment from 2004 to 2016. Hospital multimodal treatment was defined as the number of patients receiving surgery and chemotherapy by the number of eligible patients per hospital. Descriptive statistics and survival analyses were conducted.

Results:

A total of 16,771 patients met inclusion criteria, of whom 68.0% received curative-intent surgery and 35.8% received multimodal treatment. There was poor correlation between hospital surgical volume and delivery of multimodal treatment (Spearman correlation 0.214; P < 0.001). Of patients cared for at the highest surgical volume hospitals, 18.8% and 52.1% were treated at hospitals with low (0%–25%) and moderate (>25%–50%) multimodal treatment delivery, respectively. Higher hospital multimodal treatment delivery was associated with improved overall survival.

Discussion:

Although the volume–outcome relationship for pancreatic cancer has demonstrated improved outcomes, this work identified poor correlation between hospital surgical volume and delivery of multimodal treatment. The role of care coordination in the delivery of multimodal treatment warrants further investigation as it is associated with improved survival for patients with localized pancreatic cancer.
Chopart Joint Injuries: Assessment, Treatment, and 10-Year Results
Authors: Rammelt Stefan , Missbach Tobias
Published: August 2022

Objectives:

To investigate injury patterns and long-term outcomes of midtarsal (Chopart) injuries in a sizeable number of patients.

Design:

Prospective study.

Setting:

Level 1 trauma center.

Patients:

One hundred twenty-two patients (average age 37.6 years) with 128 Chopart injuries over a 15-year period, 27% of who were polytraumatized. In 47%, more than 1 of the 4 bones of the midtarsal joint was fractured. The navicular and cuboid were fractured most often. Purely ligamentous dislocations occurred in 4%.

Interventions:

Operative treatment tailored to the individual fracture pattern was performed in 91.4%.

Main Outcome Measurements:

Foot Function Index, American Orthopaedic Foot and Ankle Society score, SF-36 physical (PCS) and mental component summary (MCS).

Results:

Seventy-three patients with 75 Chopart injuries were available for follow-up at an average of 10.1 years. The Foot Function Index averaged 26.9, the American Orthopaedic Foot and Ankle Society score averaged 71.5, and the SF-36 PCS and MCS averaged 43.5 and 51.2, respectively. Negative prognostic factors were a high injury severity score, work-related accidents, open and multiple fractures, purely ligamentous dislocations, staged surgery, delay of treatment >4 weeks, postoperative infection, and primary or secondary fusion. Open reduction and internal fixation led to significantly better results than attempted closed reduction and percutaneous fixation. Radiographic signs of posttraumatic arthritis were observed in 93%, but only 4.7% of cases required a late fusion at the Chopart joint.

Conclusions:

Chopart joint injuries lead to functional restrictions in the long term. Purely ligamentous dislocations have the worst prognosis, whereas fractures of a single bone have a favorable outcome after anatomic reduction and internal fixation.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Arthrodesis of the First to Second Metacarpal for Definitive Management of Failed Thumb Carpometacarpal Arthroplasty: A Case Series
Authors: Taleghani Eric R. , Moran Thomas E. , Ignozzi Anthony , Chhabra Abhinav Bobby , Freilich Aaron
Published: August 2022

Thumb carpometacarpal (CMC) arthroplasty with resection of the trapezium and soft tissue interposition, with or without ligament reconstruction, has historically proven to be an efficacious treatment for thumb CMC arthritis. The incidence of failure following primary thumb CMC arthroplasty is low; however, the evaluation and management of a patient experiencing an unsatisfactory outcome following CMC arthroplasty is challenging. If symptoms are refractory to conservative measures, then revision surgical treatment may be indicated. Clinical decision making becomes even more complicated in cases of failure after an initial revision surgery has already been performed. In patients with a failed CMC arthroplasty revision in whom all soft tissue options have been exhausted, the senior author considers arthrodesis of the first metacarpal base to the second metacarpal base as a salvage procedure. The authors describe this surgical technique and present our experience with 4 cases in 3 patients who underwent this surgical intervention. Successful radiographic fusion was achieved in all 4 cases, with satisfactory clinical outcome in 3 out of 4 cases, supporting this surgical technique as a definitive option for patients who have failed multiple CMC arthroplasty revision surgeries.
Ectopic Acsl6 Overexpression Partially Improves Isoproterenol-Induced Cardiac Hypertrophy In Vivo and Cardiomyocyte Hypertrophy In Vitro
Authors: Xu Li , Liu Qiong , Long Tianyi , Peng Liming , Li Fei , Sun Zelin , Xie Qiying
Published: August 2022

The increase in cardiac myocyte size is a critical issue in cardiac hypertrophy development. In this study, 61 differentially expressed genes between hypertrophic rats and normal controls were enriched in the positive modulation of fatty acid uptake, fatty acid metabolism and degradation, cardiac conduction, and the oxidation of carbohydrates and other processes. Acsl6 was significantly downregulated in hypertrophic rat and mouse hearts according to online data. Based on the experimental data, Acsl6 was underexpressed in ISO-induced cardiac hypertrophy mouse model and isoproterenol (ISO)-induced cardiomyocyte hypertrophy cell model. In vivo, Acsl6 overexpression partially attenuated ISO-induced increases in the cross-sectional area and cardiac hypertrophy, elevated hypertrophic markers, and caused impairment of cardiac function. In vitro, Acsl6 overexpression partially attenuated ISO-induced cardiomyocyte hypertrophy and increased hypertrophic markers. Conclusively, Ascl6 is downregulated in ISO-induced cardiac hypertrophy mouse model and ISO-induced cardiomyocyte hypertrophy cell model. Acsl6 overexpression could partially improve cardiac hypertrophy in vivo and cardiomyocyte hypertrophy in vitro, possibly through the regulation of HIF-1α/Hippo pathway.
A Systematic Review of Clinical Trials on Lumateperone and Its Effects on Body Weight
Authors: Satodiya Ritvij M. , Brown Victoria R. , Njuguna Susan W. , Bied Adam M.
Published: August 2022

Background

Antipsychotic-induced weight gain (AIWG) is a clinically relevant and concerning adverse effect of contemporary antipsychotic medications. Lumateperone is a novel antipsychotic, which became commercially available in 2020 and received Food and Drug Administration approval for schizophrenia and bipolar disorder in 2019 and 2021, respectively. To date, no comprehensive review exists on its AIWG profile. This systematic review aims to assess the association between lumateperone and AIWG.

Methods

Data Sources: A comprehensive search of published studies on “lumateperone” OR “ITI-007” OR “Caplyta” was conducted on PubMed, CINAHL Complete, APA PsychInfo, Cochrane Library, and Embase databases until January 2022.

Study Selection: A total of 149 articles in English were collected. After removing duplicates, all human trials on lumateperone were screened for the inclusion criteria.

Data Extraction: Two reviewers conducted an independent screening followed by full-text analysis of extracted studies adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Third reviewer resolved the conflicts as tiebreaker.

Results

Primary search generated 77 articles, excluding 72 duplicates, of which 51 were deemed appropriate for exclusion. Full-text analysis of the remaining 26 articles concluded with 5 studies for finalized review per inclusion criteria. Excluded studies were manually reviewed for relevant citation of studies per inclusion criteria. Three randomized, double-blinded, placebo-controlled clinical trials and 2 open-label trials were derived from this systematic review. Lumateperone showed a favorable weight profile compared with placebo and alternate antipsychotics.

Conclusions

Lumateperone displays minimal to no weight gain among participants in the studies reviewed.
Establishing midwife-led continuity of care interventions in perinatal mental health in high-risk pregnancies: a best practice implementation project
Authors: Morlans-Lanau Miriam , González-Vives Maria L. , Rodríguez-Quiroga Alberto , Casbas Mayte M. , Klugarová Jitka , Klugar Miloslav
Published: August 2022

Objectives:

The current best practice implementation project aimed to improve the quality of continuity of care and emotional well-being in women with high-risk pregnancies.

Introduction:

Perinatal mental health disorders, such as perinatal depression and anxiety, are considered major health issues and are associated with poor maternal and neonatal outcomes. Women with high-risk pregnancies are considered a group of women with a substantial vulnerability and the value of continuity of care is vital in this group.

Methods:

The current project used the pre–post implementation clinical audit following the JBI Evidence Implementation framework. A baseline audit and a follow-up audit were conducted involving 120 high-risk pregnant women in a hospital's obstetric unit. An intervention was performed establishing a midwife consultation and a referral circuit for the different healthcare professionals. A screening was performed through several validated questionnaires.

Results:

To reflect the continuum of care, three topics were selected, including antenatal psychosocial assessment, intrapartum care and postpartum depression assessment, with a total of 10 criteria. The baseline audit results showed 0% compliance in all the criteria since the proposed standards of care did not exist before the audit. After the implementation of the strategies, the compliance achieved 100% in all audit criteria. A multidisciplinary hospital guideline was established for standardized care and mental well-being care for high-risk pregnant women.

Conclusion:

Follow-up in the mental health of pregnant women is insufficient. Improving emotional well-being in pregnancy should be a target of clinical practice. More national and international guidelines to assess mental well-being during pregnancy and the postpartum period should be developed.
Confidence of probabilistic predictions modulates the cortical response to pain
Authors: Mulders Dounia , Seymour Ben , Mouraux André , Mancini Flavia
Published: August 2022

Pain typically evolves over time and the brain needs to learn this temporal evolution to predict how pain is likely to change in the future and orient behavior. This process is termed temporal statistical learning (TSL). Recently, it has been shown that TSL for pain sequences can be achieved using optimal Bayesian inference, which is encoded in somatosensory processing regions. Here, we investigate whether the confidence of these probabilistic predictions modulates the EEG response to noxious stimuli, using a TSL task. Confidence measures the uncertainty about the probabilistic prediction, irrespective of its actual outcome. Bayesian models dictate that the confidence about probabilistic predictions should be integrated with incoming inputs and weight learning, such that it modulates the early components of the EEG responses to noxious stimuli, and this should be captured by a negative correlation: when confidence is higher, the early neural responses are smaller as the brain relies more on expectations/predictions and less on sensory inputs (and vice versa). We show that participants were able to predict the sequence transition probabilities using Bayesian inference, with some forgetting. Then, we find that the confidence of these probabilistic predictions was negatively associated with the amplitude of the N2 and P2 components of the Vertex Potential: the more confident were participants about their predictions, the smaller was the Vertex Potential. These results confirm key predictions of a Bayesian learning model and clarify the functional significance of the early EEG responses to nociceptive stimuli, as being implicated in confidence-weighted statistical learning.

SIGNIFICANCE

The functional significance of EEG responses to pain has long been debated because of their dramatic variability. This study indicates that such variability can be partly related to the confidence of probabilistic predictions emerging from sequences of pain inputs. The confidence of pain predictions is negatively associated with the cortical EEG responses to pain. This indicates that the brain relies less on sensory inputs when confidence is higher and shows us that confidence-weighted statistical learning modulates the cortical response to pain.
Exploring the role of the potential surface in the behaviour of early warning signals
Authors: Nugent Andrew , Southall Emma , Dyson Louise
Published: August 2022

The theory of critical slowing down states that a system displays increasing relaxation times as it approaches a critical transition. These changes can be seen in statistics generated from timeseries data, which can be used as early warning signals of a transition. Such early warning signals would be of value for emerging infectious diseases or to understand when an endemic disease is close to elimination. However, in applications to a variety of epidemiological models there is frequent disagreement with the general theory of critical slowing down, with some indicators performing well on prevalence data but not when applied to incidence data. Furthermore, the alternative theory of critical speeding up predicts contradictory behaviour of early warning signals prior to some stochastic transitions. To investigate the possibility of observing critical speeding up in epidemiological models we characterise the behaviour of common early warning signals in terms of a system’s potential surface and noise around a quasi-steady state. We then describe a method to obtain these key features from timeseries data, taking as a case study a version of the SIS model, adapted to demonstrate either critical slowing down or critical speeding up. We show this method accurately reproduces the analytic potential surface and diffusion function, and that these results can be used to determine the behaviour of early warning signals and correctly identify signs of both critical slowing down and critical speeding up.