bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Pranayama Applied to Hemodialysis Patients on Fatigue
Authors: İlter Sümeyra Mihrap , Ovayolu Özlem
Published: October 2023

The present study was conducted to examine the effects of Pranayama applied to hemodialysis patients on fatigue. The study was completed with 91 patients, including Pranayama (n = 30), Relaxation (n = 30), and Control groups (n = 31). The patients in the Pranayama group applied the interventions 15 to 20 minutes every day, once a day, for a total of 3 months, and the patients in the relaxation practice group applied the interventions 15 to 20 minutes every day, once a day, for a total of 3 months. Before the study commenced, permission was obtained from health care institutions, the ethics committee, and the patients. The data were collected with a Questionnaire, Piper Fatigue Scale (PFS), visual analog scale, and Vital Findings Form. Piper Fatigue Scale consists of 4 subdimensions, the total score obtained from the scale varies between 0 and 10, and as the score increases, the level of fatigue also increases. It was found that the patients in the Pranayama Group had decreased PFS total and subdimension mean scores after the procedure (P < .05); however, no significant changes were detected in the PFS total and subdimension mean scores of the patients in the Relaxation and Control groups (P > .05). Although the decrease in the daily fatigue severity of the patients in the Pranayama group was at a statistically significant level (P < .05), no statistically significant changes were detected in the fatigue severity of the patients in the Relaxation and Control groups (P > .05). It was also found that the blood pressure values of the patients in the Pranayama and Relaxation groups decreased (P < .05). It was found in the present study that Pranayama reduced the fatigue levels of hemodialysis patients. In this respect, it is recommended to teach and apply Pranayama techniques to patients with the support of nurses.
Machine Learning-Based Scoring System for Early Prognosis Evaluation of Patients with Coronavirus Disease 2019
Authors: Zhang Hao-Min , Shi Lei , Chen Hao-Ran , Zhang Jun-Dong , Liu Ge-Liang , Wang Zi-Ning , Zhi Peng , Wang Run-Sheng , Li Zhuo-Yang , Chen Xi-Meng , Wang Fu-Sheng , Lu Xue-Chun
Published: October 2023

Background

The global spread of coronavirus disease 2019 (COVID-19) continues to threaten human health security, exerting considerable pressure on healthcare systems worldwide. While prognostic models for COVID-19 hospitalized or intensive care patients are currently available, prognostic models developed for large cohorts of thousands of individuals are still lacking.

Methods

Between February 4 and April 16, 2020, we enrolled 3,974 patients admitted with COVID-19 disease in the Wuhan Huo-Shen-Shan Hospital and the Maternal and Child Hospital, Hubei Province, China. (1) Screening of key prognostic factors: A univariate Cox regression analysis was performed on 2,649 patients in the training set, and factors affecting prognosis were initially screened. Subsequently, a random survival forest model was established through machine analysis to further screen for factors that are important for prognosis. Finally, multivariate Cox regression analysis was used to determine the synergy among various factors related to prognosis. (2) Establishment of a scoring system: The nomogram algorithm established a COVID-19 patient death risk assessment scoring system for the nine selected key prognostic factors, calculated the C index, drew calibration curves and drew training set patient survival curves. (3) Verification of the scoring system: The scoring system assessed 1,325 patients in the test set, splitting them into high- and low-risk groups, calculated the C-index, and drew calibration and survival curves.

Results

The cross-sectional study found that age, clinical classification, sex, pulmonary insufficiency, hypoproteinemia, and four other factors (underlying diseases: blood diseases, malignant tumor; complications: digestive tract bleeding, heart dysfunction) have important significance for the prognosis of the enrolled patients with COVID-19. Herein, we report the discovery of the effects of hypoproteinemia and hematological diseases on the prognosis of COVID-19. Meanwhile, the scoring system established here can effectively evaluate objective scores for the early prognoses of patients with COVID-19 and can divide them into high- and low-risk groups (using a scoring threshold of 117.77, a score below which is considered low risk). The efficacy of the system was better than that of clinical classification using the current COVID-19 guidelines (C indexes, 0.95 vs. 0.89).

Conclusions

Age, clinical typing, sex, pulmonary insufficiency, hypoproteinemia, and four other factors were important for COVID-19 survival. Compared with general statistical methods, this method can quickly and accurately screen out the relevant factors affecting prognosis, provide an order of importance, and establish a scoring system based on the nomogram model, which is of great clinical significance.
Twenty-Four-Hour Intraocular Pressure Pattern In Glaucoma Suspects in an African Population
Authors: Aderounmu Azeezat B. , Ademola-Popoola Dupe S. , Olatunji Fatai O. , Yusuf Ibrahim A.
Published: October 2023

Précis:

Twenty-four-hour intraocular pressure measurement (Phasing) among glaucoma suspects showed higher intraocular pressure (IOP), greater fluctuation, and more varying peak times occurring mostly outside clinic hours, between 12 midnight and 8 am in 68.9% of them.

Purpose:

To characterise 24-hour variation in IOP, in glaucoma suspects and normal individuals in an African population.

Materials and Methods:

A cross-sectional analytical study was carried out between March and October 2019 at the University of Ilorin Teaching Hospital. A total of 204 study participants, comprising 102 primary open angle glaucoma (POAG) suspects and 102 age and sex-matched controls with healthy eyes were recruited. Participants had a comprehensive ophthalmic examination. Measurements of IOP were taken every 2 hours during a 24-hour period using an iCare tonometer.

Results:

The mean age was 43.64±14.02 SD and 43.02±13.55 SD (P=1.000) for POAG suspects and controls, respectively. The mean peak IOP was significantly higher in POAG suspects (21.87± 4.65 mm Hg) compared with controls (17.17± 2.32 mm Hg) (P<0.001). Whereas, the mean trough IOP reading was not significantly different between the 2 groups. In both groups of participants, the peak and trough IOP in the majority were recorded outside of clinic hours. The majority (68.9%) of POAG suspects had a peak IOP between midnight and 8 am, whereas the control group peaked mostly at 4 pm (16.7%) and 4 am (41.7%). Twenty-four-hour IOP variation was 6 mm Hg or less in 73.6% of control eyes, while in the POAG suspects, 83.3% of eyes had variation greater than 6 mm Hg.

Conclusions:

Compared with age and sex-matched healthy controls, glaucoma suspects of African descent showed significantly higher mean IOP and IOP variation, with most peak IOP detected outside of clinic hours.
Intraocular Pressure Changes While Reading Smartphone Digital Text Versus Printed Text in Healthy Individuals and those with Glaucoma
Authors: Srivastava Rajat Mohan , Agrawal Siddharth , Amrin Nayani , Bharti Devanand
Published: October 2023

Précis:

Reading results in a rise in intraocular pressure (IOP) which is greater while using smartphones compared with printed text among healthy and individuals with medically controlled primary open angle glaucoma (POAG).

Purpose:

To compare the effect of reading for 30 minutes using smartphone and printed text on IOP.

Patients and Methods:

Sixty healthy volunteers and 22 patients with medically controlled POAG were asked to perform reading tasks using printed text followed by digital (smartphone) text under standardized conditions. IOP assessment was done using a rebound tonometer at baseline and subsequently at 10, 20, and 30 minutes of reading and 10 and 20 minutes post completion of reading tasks. IOP variations from baseline were measured and compared. Paired and independent ‘T’ test analysis was performed to study IOP variations, and a P-value <0.05 was considered statistically significant.

Results:

The mean baseline IOP among volunteers and patients withPOAG was 14.58 (±2.91) and 15.02 (±2.18) mmHg, respectively. There was a rise in IOP in all participants with reading using either of the modalities, which normalized after 20 minutes of cessation. There was a statistically significant difference in rise in IOP from baseline between the 2 modalities (printed text reading and smartphone reading) at 20 minutes {+0.78 & +2.01 (P=0.002)} and 30 minutes {+0.64 & +1.72 (P=0.004)} among healthy volunteers and at 20 minutes {+0.78 & +2.01 (P=0.002)} among POAG patients.

Conclusion:

Reading is associated with the rise in IOP in both healthy volunteers and POAG individuals. The IOP rise is more marked with smartphone compared with printed text reading.
Flow-Diverter stents in intracranial aneurysm treatment: impact on covered cerebral artery branches
Authors: Liu Junyu , Cao Fang , Zhenmei Nibu , Guo Yuxin , Li Yifeng , Yuan Dun , Jiang Weixi , Yan Junxia
Published: October 2023

Objective:

Flow diverter stents (FDSs) have attracted interest for intracranial aneurysm (IA) treatment; however, occlusion of side branches and related complications have been reported. This study aimed to investigate the effects of FDSs in IA management when different branches of intracranial arteries are covered.

Materials and methods

A cross-sectional study was conducted using PUBMED, Embase, Web of Science, and Cochrane databases to include randomized or non-randomized comparative designed studies from January 2000 to August 2022 which reported outcomes of occlusion/narrowing of branches after IA treatment using FDSs. The PRISMA guidelines were used for data abstraction and assessing data quality and validity. Random-effects meta-analysis was conducted to pool the outcomes included incidence rates of occlusion/narrowing of FDS-covered branches, branch occlusion-related symptoms, obliteration of IAs, and ideal clinical outcomes (modified Rankin Scale score ≤ 2).

Results:

We identified 57 studies involving 3789 patients with IA managed by FDSs covering different branches. During the median imaging follow-up at 12 months, the IA obliteration rate was satisfactory (>70%) when covering the ophthalmic artery (OA), posterior communicating artery (PComA), anterior choroidal artery (AChoA) or anterior cerebral artery (ACA), but not the middle cerebral artery-M2 segment (MCA-M2; 69.5%; 95% CI, 50.8%–77.5%) and posterior inferior cerebellar artery (PICA; 59.1%, 13/22). The overall ideal clinical outcome was observed in 97.4% of patients (95% CI, 95.5%–98.9%). Higher rates of occlusion/narrowing of branches were identified when FDSs covered the ACA (66.6%; 95% CI, 45.1%–85.3%), PComA (44.3%; 95% CI, 34.2%–54.6%), or MCA-M2 (39.2%; 95% CI, 24.5%–40.8%); the risks were lower when covering the OA (13.0%; 95% CI, 9.7%–16.7%), PICA (6.8%; 95% CI, 1.5%–14.5%), and AchoA (0.5%; 95% CI, 0.0%–2.9%). The risk of branch-occlusion-related complications was low (incidence rate <5%) for each of the six evaluated branches.

Conclusions:

Acceptable outcomes were identified following treatment of IAs when FDSs were placed across each of the six studied cerebral arteries. Treatment decisions regarding FDS placement across branch arteries should be made with the risk of complications from branch occlusion in mind.
The Effect of Premenstrual Dysphoric Disorder Diagnosis and Severity on Depression Sensitivity
Authors: Akyuz Cim Emine Fusun , Cim Numan
Published: October 2023

Premenstrual dysphoric disorder (PMDD) is thought to be associated with depressive disorder. In our study, the depression susceptibility of female patients with PMDD was assessed using the depression sensitivity scale, which is different from previous studies. The study was conducted on 32 PMDD patients aged 18–40 years who applied to the psychiatry outpatient clinic and 30 healthy controls. The mean age of women diagnosed with PMDD was similar (p = 0.467). The probability of having a family history of PMDD was significantly higher in the PMDD group than in the control group (χ2 = 11.182, p = 0.001). Previous psychotropic drug use (χ2 = 8.862, p = 0.003) and family history of mental illness (χ2 = 5.995, p = 0.014) were significantly higher in PMDD patients compared with the control group. The sociodemographic questionnaire, the Leiden Index of Depression Sensitivity (LEIDS), and the Premenstrual Assessment Form were administered to the participants. No significant difference was found between the patient and healthy groups regarding LEIDS scores (r = 0.75, p > 0.05). In patients with PMDD, the clinical severity of PMDD was found to increase susceptibility to depression (r = 0.460, p < 0.01). It was revealed that PMDD severity was associated with susceptibility to depression rather than PMDD diagnosis.
Health literacy and pain neuroscience education in an interdisciplinary pain management programme: a qualitative study of patient perspectives
Authors: Oosterhaven Janke , Pell Christopher D. , Schröder Carin D. , Popma Hans , Spierenburg Loes , Devillé Walter L.J.M. , Wittink Harriet
Published: October 2023

Introduction:

Pain neuroscience education is part of interdisciplinary pain management programs (IPMPs). To date, the role of health literacy on patients' understanding of pain neuroscience education has not sufficiently been examined.

Objectives:

Drawing on interviews with patients with diverse levels of health literacy, this article explores patient perspectives on pain neuroscience education.

Methods:

Purposively sampled patients from an IPMP were interviewed twice (waiting list and after 4 weeks). A directed qualitative content analysis was performed with the Integrated Conceptual Model of Health Literacy as an analytic framework.

Results:

Thirteen patients with chronic musculoskeletal pain were interviewed: 4 men and 9 women aged from 21 to 77 years with diverse educational and mostly low health literacy. One participant dropped out after baseline. Some participants gained access to health information actively; others relied on the expertise of their healthcare providers. Most participants did not seem to receive the information in the pain neuroscience education as intended, experienced difficulties with understanding the message, negatively appraised the information, and were not able to apply this in their daily lives. Health literacy levels likely played a role in this.

Conclusions:

Pain neuroscience education tailored to patients' health literacy levels, information needs, and learning strategies is needed.
Potentially Inappropriate Prescribing in Older People Living With HIV: A Scoping Review
Authors: Vélez-Díaz-Pallarés Manuel , Delgado-Silveira Eva , Fernández-Fradejas Jorge , Montero-Llorente Beatriz , Palomar-Fernández Carmen , Montero-Errasquín Beatriz , Cruz-Jentoft Alfonso José , Álvarez-Díaz Ana
Published: October 2023

Background:

Antiretroviral therapy has transformed HIV from a progressive and often fatal infection to a chronic disease. Currently, people living with HIV (PLHIV) have near-normal life expectancy; however, they face accelerated ageing and a rise in non–AIDS-defining HIV-associated conditions. Comorbidities increase the number of prescribed drugs and, therefore, the risk of polypharmacy and prescribing potentially inappropriate medications (PIMs). Still, there are no specific tools to identify PIMs in older PLHIV, which opens a pathway to investigate the particularities in the prescription of medication in this population.

Methods:

We conducted a scoping review in 5 electronic databases for studies reporting the use of tools to identify PIMs in older PLHIV. No language or date restrictions were applied. To complete the search, abstracts published in the most relevant HIV Conferences and Events in their editions from 2010 to 2022 were screened.

Results:

Of 50,193 records returned (13,701 of the databases and 36,492 of the Congresses), 39 studies met the inclusion criteria. Most studies were single-centre and conducted in Europe. Twenty-eight studies were cross-sectional, and most researchers used explicit criteria, mainly Beers and STOPP-START criteria, to identify PIMs.

Conclusions:

Potentially inappropriate prescribing is frequent among older PLHIV. Explicit conventional tools to identify PIMs in older populations may need to be adapted to tackle the needs of PLHIV. Implicit tools may be more valid, although their use is more time-consuming, and standardization is complex.
Accuracy of Estimated Fetal Weight by Ultrasound Versus Leopold Maneuver
Authors: Lunardhi Alicia , Huynh Kimberly , Lee Derek , Pickering Trevor A. , Galyon Kristina D. , Stohl Hindi E.
Published: October 2023

Estimated fetal weight (EFW) is frequently used for clinical decision-making in obstetrics. The goals of this study were to determine the accuracy of EFW assessments by Leopold and ultrasound and to investigate any associations with maternal characteristics. Postgraduate years 1 and 2 obstetrics and gynecology resident physicians from Harbor-UCLA Medical Center from 2014 to 2020 performed EFW assessments on 10 preterm (<37 weeks' gestational age) fetuses by ultrasound biometry and 10 full-term (≥37 weeks' gestational age) fetuses by ultrasound biometry and Leopold maneuver. Assessments were included if the patients delivered within 2 weeks of the assessments. One thousand six hundred ninety-seven EFW assessments on 1183 patients performed by 33 residents were analyzed; 72.6% of sonographic full-term EFWs, 69% of Leopold full-term EFWs, and 61.5% of sonographic preterm EFWs were within 10% of the neonatal birth weight (BW). The lowest estimation error in our study occurred when actual BW was 3600 to 3700 g. After adjusting for BW, residents were found to have lower accuracy when the mother had a higher body mass index (BMI) for full-term estimation methods (Leopold and ultrasound, β = 0.13 and 0.12, P = 0.001 and 0.002, respectively). Maternal BMI was not related to estimation error for preterm fetuses (β = 0.01, P = 0.75). Clinical and sonographic EFW assessments performed by obstetrics and gynecology junior residents are within 10% of neonatal BW much of the time. In our cohort, they tended to overestimate EFWs of lower-BW infants and underestimate EFWs of higher-BW infants. Accuracy of full-term EFW assessments seems to decrease with increasing maternal BMI.
Clinical Impact of Transanal Drainage Tube on Anastomosis Leakage Following Minimally Invasive Resection Without Diverting Stoma in Patients With Rectal Cancer: A Propensity Score-matched Analysis
Authors: Sueda Toshinori , Tei Mitsuyoshi , Mori Soichiro , Nishida Kentaro , Yasuyama Akinobu , Nomura Masatoshi , Yoshikawa Yukihiro , Tsujie Masanori
Published: October 2023

Objectives:

As one of the most serious complications of rectal cancer (RC) surgery, preventing anastomotic leakage (AL) is crucial. Several studies have suggested a positive role of the transanal drainage tube (TaDT) in AL prevention. However, whether TaDT is beneficial for AL in patients with RC remains controversial. The present study aimed to evaluate the clinical impact of TaDT on AL following minimally invasive resection without diverting stoma (DS) in patients with RC.

Materials and Methods:

We retrospectively analyzed 392 consecutive patients with RC who had undergone minimally invasive resection without DS between 2010 and 2021. Propensity score matching (PSM) was performed to reduce selection bias. AL was classified as grade A, B, or C.

Results:

A TaDT was used in 214 patients overall. After PSM, we enrolled 316 patients (n=158 in each group). Before PSM, significant group-dependent differences were observed in terms of age, American Society of Anesthesiologists physical status, and the use of antiplatelet/anticoagulant agents. The frequency of AL was 7.3% in the overall cohort and was significantly lower in the TaDT group (3.7%) than in the non-TaDT group (11.8%). The rate of grade B AL was significantly lower in the TaDT group than in the non-TaDT group (before PSM, P<0.01; after PSM, P=0.02). However, no significant differences between groups were found for grade C AL. Moreover, multivariate analysis identified the lack of a TaDT as an independent risk factor for AL in the overall and matched cohorts [before PSM, odds ratio, 3.64, P<0.01; after PSM, odds ratio, 2.91, P=0.02].

Conclusion:

These results indicated that TaDT may play a beneficial role in preventing AL, particularly of grade B, for patients with RC undergoing minimally invasive resection without DS. However, further randomized controlled trials, including patient-reported outcomes, are still needed to understand better the role of TaDT in preventing ALs in patients with RC undergoing minimally invasive resection without DS.
Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA): Influences on the Voice Changes and Swallowing Function Disorders
Authors: Chen Zongyi , Guo Youming , Huo Jinlong , Hu Xiaochi , Chen Chen , Gao Dan , Yang Li , Wang Cunchuan , Qu Rui
Published: October 2023

Objective:

The aim of this study was to evaluate the influence of transoral endoscopic thyroidectomy vestibular approach (TOETVA) on voice changes and swallowing function disorders.

Materials and Methods:

We retrospectively reviewed 215 patients who underwent thyroid surgery with TOETVA (105 cases, endoscopic group) and open approach (110 cases, open group). Major outcomes, the changes in voice and swallowing function in the 2 groups of patients before and after surgery were analyzed by using both subjective and objective evaluation indexes. Subjective evaluation indexes included the Voice Handicap Index, voice GRBAS (Grade, Roughness, Breathiness, Asthenia, Strain) classification, and swallowing impairment score; the objective indicators included the fundamental frequency (F0), fundamental frequency perturbation (jitter), amplitude perturbation (shimmer), and maximum phonation time.

Results:

In terms of subjective evaluation indexes, there were no significant differences (all P>0.05) between the groups regarding Voice Handicap Index (1 and 3 mo after surgery) and GRBAS (1 and 3 mo after surgery). The incidence rates of swallowing disorder in the endoscopic group were higher than that in the open group according to the outcomes of swallowing impairment score at 1 and 3 months after surgery (both P<0.05). In addition, no significant changes in terms of jitter, shimmer, and maximum phonation time in both groups of patients at 1 and 3 months after surgery compared with their preoperative values (all P>0.05).

Conclusions:

Voice and swallowing disorders may occur in some patients, either TOETVA or open thyroid surgery, which in most cases will recover within 3 months after surgery. The time to swallowing function recovery is relatively prolonged in patients following TOETVA, which may be probably associated with neck adhesion and fixation after the operation.
Fantastic Needles and Where to Find Them During a Laparoscopic Nissen Fundoplication: Review of Safety Measures to Avoid Needle Loss During Minimally Invasive Surgery
Authors: Di Mento Claudia , Chiodi Annalisa , Cerulo Mariapina , Del Conte Fulvia , Coppola Vincenzo , Carulli Roberto , Lepore Benedetta , Escolino Maria , Esposito Ciro
Published: October 2023

Background:

Losing a needle during laparoscopic surgery may be a dramatic moment for the surgeon and potentially have clinical and medico-legal consequences. This case report aims to describe an unusual case of needle loss that occurred during laparoscopic Nissen fundoplication and how to prevent its further occurrence.

Methods:

The patient is an 11-year-old boy with a body mass index of 32.4 kg/m2. He suffered from severe gastroesophageal reflux disease not responding to medical therapy and hiatal hernia. A laparoscopic Nissen fundoplication was performed.

Results:

At the closure of the Nissen wrap, CO2 leakage through the umbilical trocar caused the needle lost during the introduction of the thread. We attempted to find the needle by exploring the entire abdominal cavity without success. Therefore, we decided to complete the surgical procedure. Another 2/0 nonresorbable thread was inserted in the same way as before. But this suture also disappeared. Hence, we manually straightened the needle and introduced it under vision. The operation was accomplished successfully. An intraoperative x-ray was obtained, showing the 2 needles at the level of the 12th rib, near the working port used for the liver retractor. A peritoneal window was created using a monopolar hook, allowing to finally extract the 2 hidden needles.

Conclusion:

The loss of needles, although a rare event, can occur during laparoscopic surgery. Based on our experience, we suggest that needle insertion during laparoscopic operations should be performed under direct vision, especially in obese patients, to reduce the likelihood of such complications.
Short-term Outcome of Peroral Endoscopic Myotomy Performed by the Same Endoscopist on Achalasia and Nonachalasia Esophageal Motility Disorders
Authors: Mubashir Maryam , Andrus Victoria , Okuampa David , Neice Michelle , Armstrong Elizabeth , Canezaro Hailey , Dies Ross , Deville Ashely , Kawji Lena , Rashid Shazia , Raza Syed Musa , Hafiz Nazar , Faisal Abu Saleh Mosa , Bhuiyan Mohammad Alfrad Nobel , Cai Qiang
Published: October 2023

Background:

Peroral endoscopic myotomy (POEM) is a relatively new but increasingly therapeutic option for achalasia. In recent years, POEM has been used for nonachalasia esophageal motility disorders (NAEMDs), such as diffuse esophageal spasm, esophagogastric junction outlet obstruction, and hypercontractile disorder, with some clinical success. No studies thus far compare the outcomes of these two groups. We perform the first head-to-head comparison of outcomes after POEM in patients with achalasia and NAEMD.

Patients and Methods:

A retrospective analysis of all patients undergoing POEM at one university hospital by a single expert endoscopist from July 2021 to December 2022 was performed. All patients were symptomatic, and the presence of esophageal motility disorders was confirmed using multiple diagnostic modalities. These patients were then divided into 2 groups, achalasia and NAEMD, based on the underlying diagnosis. Statistical analysis of different clinical outcomes, including effectiveness and safety, was performed.

Results:

Thirty-seven patients (mean age: 59.55, females: 22) underwent POEM in the study period. Twenty patients had achalasia and 17 patients had NAEMD. The median myotomy length was 5.5 cm for the achalasia group and 10 cm for the NAEMD group. This excluded patients with esophagogastric junction outlet obstruction in which the median myotomy length was 3 cm. The procedure time, the duration of hospital stays, the rates of same-day discharge, and complications were similar between the two. Short-term outcomes of POEM for the two groups were similar with improvement in 94% of patients in the achalasia group and 93.75% in the NAEMD group.

Conclusion:

Contrary to prior observations, our study highlights that POEM is equally effective in achieving clinical improvement in patients with NAEMD as achalasia over 6 months of follow-up. In addition, POEM has a comparable safety profile in both patient groups making it a feasible therapeutic option for these debilitating and challenging disorders.
Research protocol to identify progression and death amongst patients with metastatic hormone-sensitive prostate cancer treated with available treatments: PIONEER IMI’s “big data for better outcomes” program
Authors: Gomez Rivas Juan , Nicoletti Rossella , Ibáñez Laura , Steinbeisser Carl , de Meulder Bertrand , Golozar Asieh , Axelsson Susan Evans , Snijder Robert , Bjartell Anders , Cornford Philip , Van Hemelrijck Mieke , Beyer Katharina , Willemse Peter-Paul , Murtola Teemu , Roobol Monique J. , Moreno-Sierra Jesús , Campi Riccardo , Gacci Mauro , Mottet Nicolas , Merseburger Axel , Ndow James ,   PIONEER consortium
Published: October 2023

Androgen deprivation therapy-based with or without first-generation anti-androgens, was the standard of care for patients with metastatic hormone-sensitive prostate cancer (mHSPC) for decades. However, the development of docetaxel chemotherapy and new androgen receptor-targeted agents, abiraterone acetate and prednisolone, apalutamide , enzalutamide and darolutamide (in combination with docetaxel chemotherapy) has proven that combination of treatments is more effective. Recently, intensification therapy, so-called “triplets”, have emerged in the armamentarium of mHSPC treatment. Metastatic disease is a clinical state that remains poorly understood. The optimal diagnostic and management of patients with mHSPC are changing thanks to the development of new imaging techniques and therapies. The primary objective of this study is to develop and validate a predictive model for the occurrence of symptomatic progression, initiation of new treatments and death amongst patients with mHSPC treated with one of the approved treatment plans, on characteristics present at admission.
Consciousness Recovery in Traumatic Brain Injury: A Systematic Review Comparing Modafinil and Amantadine
Authors: Seifi Ali , Hassannezhad Sina , Mosaddeghi-Heris Reza , Haji Kamanaj Olia Arash , Adib Ali , Hafeez Shaheryar , Barthol Colleen
Published: October 2023

Objectives

Acute traumatic brain injury is one of the most common causes of death and disability. Reduction in the level of consciousness is a significant complication that can impact morbidity. Glasgow Coma Scale (GCS) is the most widely used method of assessing the level of consciousness. Neurostimulants such as amantadine and modafinil are common pharmacologic agents that increase GCS in patients with brain trauma. This study aimed to compare the effectiveness of these 2 drugs.

Methods

This systematic review obtained articles from Google Scholar, PubMed, Scopus, Embase, and MEDLINE databases. Extensive searches were conducted separately by 4 individuals in 3 stages. Ultimately, 16 clinical trials, cohort studies, case reports, and case series articles were obtained after reading the title, abstract, and full text and considering the exclusion criteria. The data of the final article were entered into the analysis table. This study was registered with PROSPERO (registration number CRD42022334409) and conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Results

Amantadine seems to be associated with a higher overall response rate. In contrast, modafinil is associated with the most remarkable change in GCS score during treatment. However, the number of clinical trials with high quality and sample size has not been satisfactory to compare the effectiveness of these 2 drugs and their potential side effects.

Conclusions

The authors recommend additional double-blind clinical trials are needed to be conducted with a larger sample size, comparing amantadine with modafinil to delineate the efficacy and adverse effects, both short and long term.
A cross-sectional study in critically ill patients affected by COVID-19 in an intensive care unit: would Acinetobacter baumannii resistant to carbapenems be the biggest villain?
Authors: Rocha Yamashita Sayuri , Milani Martins Vera Lucia , Pires Maciel Elves Anderson , Azeredo Francine Johansson
Published: October 2023

Aim: to describe cases of infection of Acinetobacter baumannii (A. baumannii) in critically ill patients affected by COVID-19, admitted to an intensive care unit (ICU), using dexamethasone. Methodology: cross-sectional study conducted on patients admitted to the intensive care unit COVID-19 survey among hospitalized patients from November 2020 to March 2021. Setting: large hospital, reference for caring for patients with COVID-19 in Bahia (Brazil). Patients: a convenience sample of 22 patients admitted to the COVID ICU signed the consent form agreeing to participate in the study. Three patients were excluded for having decided to participate without signing the form. Results: of the 22 patients listed, 45 % (10) had blood infection or mechanical ventilation-associated pneumonia by

A. baumannii

in blood cultures and/or tracheal aspirate secretion. We observed that there is a moderate correlation between the length of stay and infection by

A. baumannii

(Spearman’s ρ; 0.592; p-value<0.005) and a strong correlation between the number of days on mechanical ventilation and infection by these bacteria (Spearman’s ρ; 0.740; p-value<0.001). This percentage is higher than the value of 0.62 % of infection by

A. baumannii

in this ICU in the same period of the year before COVID-19 (p-value<0.0001). Conclusions: hospitals that receive patients with COVID-19 may be vulnerable to outbreaks of multi-drug resistant organisms, such as

A. baumannii

. It is worth reflecting on the care and operational practices in handling these patients, especially in isolation and restriction measures for those from other nosocomial areas.
Case Report: A missed case of chronic Q fever Infective Endocarditis demonstrating the ongoing diagnostic challenges
Authors: Grey Victoria , Simos Peter , Runnegar Naomi , Eisemann Jared
Published: October 2023

The diagnosis of chronic Q fever is often difficult to for clinicians to make, particularly in the presence of a second pathology. In addition to the chronic constitutional symptoms the most common manifestations of chronic Q fever include infective endocarditis and endovascular infection. We describe a case of prosthetic valve infective endocarditis caused by both Streptococcus sanguinis and Coxiella burnetti on a background of a previous aortic graft and bioprosthetic aortic valve replacement two years earlier. The diagnosis of chronic Q fever infective endocarditis was delayed because the significance of the abnormal valve histology from the patient’s previous surgery was initially overlooked. It was only after the patient had relapsed on appropriate therapy for the S. sanguinis prosthetic valve endocarditis that a subsequent review of the operative valve histology, along with the patient’s epidemiological risk factors led to consideration of other causes of culture negative infective endocarditis. Histological examination of the valve tissue had shown exophytic fibrin vegetations and acute inflammation. Further clinical assessment revealed previous exposure to Q fever and Coxiella burnetti DNA was detected via Polymerase Chain Reaction on the valve tissue. Q fever infective endocarditis must be considered if valves are inflamed or have vegetations with a subsequent negative culture. It should also still be considered in the presence of an alternative bacteraemia if the patient has risk factors for exposure.
Molecular basis of the phenotypic variants arising from a Pseudoalteromonas lipolytica mutator
Authors: Zeng Zhenshun , Gu Jiayu , Lin Shituan , Li Qian , Wang Weiquan , Guo Yuexue
Published: October 2023

Bacterial deficiencies in the DNA repair system can produce mutator strains that promote adaptive microevolution. However, the role of mutator strains in marine

Pseudoalteromonas

, capable of generating various gain-of-function genetic variants within biofilms, remains largely unknown. In this study, inactivation of mutS in

Pseudoalteromonas lipolytica

conferred an approximately 100-fold increased resistance to various antibiotics, including ciprofloxacin, rifampicin and aminoglycoside. Furthermore, the mutator of

P. lipolytica

generated variants that displayed enhanced biofilm formation but reduced swimming motility, indicating a high phenotypic diversity within the ΔmutS population. Additionally, we observed a significant production rate of approximately 50 % for the translucent variants, which play important roles in biofilm formation, when the ΔmutS strain was cultured on agar plates or under shaking conditions. Using whole-genome deep-sequencing combined with genetic manipulation, we demonstrated that point mutations in AT00_17115 within the capsular biosynthesis cluster were responsible for the generation of translucent variants in the ΔmutS subpopulation, while mutations in flagellar genes fliI and flgP led to a decrease in swimming motility. Collectively, this study reveals a specific mutator-driven evolution in

P. lipolytica

, characterized by substantial genetic and phenotypic diversification, thereby offering a reservoir of genetic attributes associated with microbial fitness.
Probabilistic Graphical Modeling under Heterogeneity
Authors: Chen Liying , Acharyya Satwik , Luo Chunyu , Ni Yang , Baladandayuthapani Veerabhadran
Published: October 2023

Probabilistic graphical models are powerful and widely used tools to quantify, visualize and interpret dependencies in complex biological systems such as highthroughput genomics and proteomics. However, most existing graphical modeling methods assume homogeneity within and across samples which restricts their broad applicability to cases where sample-specific heterogeneity exists e.g. tumor heterogeneity. We propose a flexible Bayesian approach calledGraphicalRegression (GraphR) which (a) allows direct incorporation of intrinsic factors of sample heterogeneity at different scales through a regression-based formulation, (b) enables sparse network estimation at a sample-specific level, (c) allows identification and uncertainty quantification of potential effects of heterogeneity on network structures, and (d) is computationally efficient through the use of variational Bayes algorithms. We illustrate the comparative efficiency of GraphR against existing methods in terms of graph structure recovery and computational cost across multiple realistic simulation settings. We use GraphR to analyze four diverse multi-omics and spatial transcriptomics datasets to study inter- and intra-sample molecular networks and delineate biological discoveries that otherwise cannot be revealed by existing approaches. We have developed aGraphR R-packagealong with an accompanyingShiny Appthat provides comprehensive analysis and dynamic visualization functions.
Cortical circuits for cross-modal generalization
Authors: Guyoton Maëlle , Matteucci Giulio , Foucher Charlie G. , Getz Matthew P. , Gjorgjieva Julijana , El-Boustani Sami
Published: October 2023

Adapting goal-directed behaviors to changing sensory conditions is a fundamental aspect of intelligence. The brain uses abstract representations of the environment to generalize learned associations across sensory modalities. The circuit organization that mediates such cross-modal generalizations remains, however, unknown. Here, we demonstrate that mice can bidirectionally generalize sensorimotor task rules between touch and vision by using abstract representations of peri-personal space within the cortex. Using large-scale mapping in the dorsal cortex at single-cell resolution, we discovered multimodal neurons with congruent spatial representations within multiple associative areas of the dorsal and ventral streams. Optogenetic sensory substitution and systematic silencing of these associative areas revealed that a single area in the dorsal stream is necessary and sufficient for cross-modal generalization. Our results identify and comprehensively describe a cortical circuit organization that underlies an essential cognitive function, providing a structural and functional basis for abstract reasoning in the mammalian brain.
BioKG: a comprehensive, large-scale biomedical knowledge graph for AI-powered, data-driven biomedical research
Authors: Zhang Yuan , Sui Xin , Pan Feng , Yu Kaixian , Li Keqiao , Tian Shubo , Erdengasileng Arslan , Han Qing , Wang Wanjing , Wang Jianan , Wang Jian , Sun Donghu , Chung Henry , Zhou Jun , Zhou Eric , Lee Ben , Zhang Peili , Qiu Xing , Zhao Tingting , Zhang Jinfeng
Published: October 2023

To cope with the rapid growth of scientific publications and data in biomedical research, knowledge graphs (KGs) have emerged as a powerful data structure for integrating large volumes of heterogeneous data to facilitate accurate and efficient information retrieval and automated knowledge discovery (AKD). However, transforming unstructured content from scientific literature into KGs has remained a significant challenge, with previous methods unable to achieve human-level accuracy. In this study, we utilized an information extraction pipeline that won first place in the LitCoin NLP Challenge to construct a large-scale KG using all PubMed abstracts. The quality of the large-scale information extraction rivals that of human expert annotations, signaling a new era of automatic, high-quality database construction from literature. Our extracted information markedly surpasses the amount of content in manually curated public databases. To enhance the KG’s comprehensiveness, we integrated relation data from 40 public databases and relation information inferred from high-throughput genomics data. The comprehensive KG enabled rigorous performance evaluation of AKD, which was infeasible in previous studies. We designed an interpretable, probabilistic-based inference method to identify indirect causal relations and achieved unprecedented results for drug target identification and drug repurposing. Taking lung cancer as an example, we found that 40% of drug targets reported in literature could have been predicted by our algorithm about 15 years ago in a retrospective study, demonstrating that substantial acceleration in scientific discovery could be achieved through automated hypotheses generation and timely dissemination. A cloud-based platform (https://www.biokde.com) was developed for academic users to freely access this rich structured data and associated tools.
Developmental pyrethroid exposure in mouse leads to disrupted brain metabolism in adulthood
Authors: Curtis Melissa A. , Saferin Nilanjana , Nguyen Jennifer H. , Imami Ali S. , Ryan William G. , Neifer Kari L. , Miller Gary W. , Burkett James P.
Published: October 2023

Environmental and genetic risk factors, and their interactions, contribute significantly to the etiology of neurodevelopmental disorders (NDDs). Recent epidemiology studies have implicated pyrethroid pesticides as an environmental risk factor for autism and developmental delay. Our previous research showed that low-dose developmental exposure to the pyrethroid pesticide deltamethrin in mice caused male-biased changes in the brain and in NDD-relevant behaviors in adulthood. Here, we used a metabolomics approach to determine the broadest possible set of metabolic changes in the adult male mouse brain caused by low-dose pyrethroid exposure during development. Using a litter-based design, we exposed mouse dams during pregnancy and lactation to deltamethrin (3 mg/kg or vehicle every 3 days) at a concentration well below the EPA-determined benchmark dose used for regulatory guidance. We raised male offspring to adulthood and collected whole brain samples for untargeted high-resolution metabolomics analysis. Developmentally exposed mice had disruptions in 116 metabolites which clustered into pathways for folate biosynthesis, retinol metabolism, and tryptophan metabolism. As a cross-validation, we integrated metabolomics and transcriptomics data from the same samples, which confirmed previous findings of altered dopamine signaling. These results suggest that pyrethroid exposure during development leads to disruptions in metabolism in the adult brain, which may inform both prevention and therapeutic strategies.

Highlights

Developmental pyrethroid exposure disrupts brain metabolism in adulthood

Exposure disrupts metabolic pathways for folate, retinol, and tryptophan

Exposure disrupts genetic and metabolic pathways for dopamine signaling
Interspecific Aggression Of Two Wrens Along An Environmental Gradient In Western Ecuador
Authors: Montalvo Luis Daniel , Kimball Rebecca T. , Robinson Scott K.
Published: October 2023

Interspecific territoriality is a prevalent form of interference competition among animals. However, the connections between hybridization, climate, and interspecies territorial aggression in tropical regions remain largely unexplored. Here, we investigated territorial aggression in two hybridizing tropical bird species,C. z. brevirostrisandC. f. pallescens, in western Ecuador using playback experiments. We tested three hypotheses: 1) hybridizing species exhibit comparable intra- and inter-specific territorial aggression; 2) asymmetrical aggression driven byC. z. brevirostrisdominance determines gene flow patterns; and 3) precipitation influences territorial aggression. Supporting hypothesis 1, the admixedC. f. pallescensNorth showed no difference in intra-vs inter-specific aggression. However, the non-admixedC. f. pallescensSouth exhibited greater inter-specific aggression, providing partial support for hypothesis 1. Contrary to hypothesis 2,C. f. pallescensSouth displayed significantly higher aggression thanC. z. brevirostrisandC. f. pallescens North. Furthermore, precipitation models outperformed null models, supporting hypothesis 3 that precipitation influencesCampylorhynchusterritorial aggression. Collectively, these findings suggest hybridization can stabilize coexistence via territoriality, and precipitation strongly affects aggression, potentially through resource availability. Unexpectedly,C. z. brevirostrisdominance did not appear to drive asymmetric introgression between species, warranting further investigation into the underlying mechanisms. Complex factors shape territorial aggression in tropical birds, including genetic admixture, group size, latitude, and climate. This study highlights the need for additional research elucidating the relationships between hybridization, territoriality, and environmental stressors in tropical avian communities. We discuss possible mechanisms explaining the detected effects of precipitation on aggression and the lack ofC. z. brevirostrisdominance in determining introgression patterns.
Zebrafish model oftcn2deletion reveals new molecular insights into the role of vitamin B12 in embryonic development
Authors: Verma Ajay Deepak , Nongmaithem Suraj S , Mounika Challapalli , Ramachandran Swetha , Umesh Anushri , Chandak Giriraj Ratan
Published: October 2023

Vitamin B12 (B12) is one of the key co-factors in One-Carbon Metabolism pathway, and its dysregulation is associated with various clinical conditions including congenital malformations, neural tube defects, and low birthweight, etc. However, the underlying molecular mechanism is scarcely studied. This study investigated the role of B12 in early embryonic development by generating a knockout of transcobalamin 2 (tcn2), a B12 transporter in zebrafish.

We generatedtcn2-/-zebrafish by creating premature stop codons in exon 7 and confirmed by qRT-PCR and immunoblotting. Phenotypic changes were captured, growth and survival assays were conducted at different developmental stages. B12 supplementation assay was conducted by rearingtcn2-/-embryos in embryo-medium containing 10 µM cyanocobalamin. RNA-sequencing data was generated in triplicates in embryos at 1-cell and 24 hpf stages, with and without B12 supplementation. Genes with log2FC ≥ 0.6 and adjusted p-value ≤ 0.01 were considered differentially expressed genes (DEGs) and proceeded for functional annotation and enrichment analysis.

The F1tcn2-/-embryos grew normally. However, the F2tcn2-/-embryos remained unhatched, showed delayed somitogenesis, curved or deformed tails, abnormal yolk extension, pericardial and yolk sac edema, etc. and ∼70% were dead by 4 dpf. The abnormalities were partially ameliorated by B12 supplementation throughout developmental stages. Transcriptome analysis identified DEGs enriched in pathways including spliceosome, ribosome biogenesis, branched-chain amino acid degradation, lysosome, iron homeostasis, metabolic and immune response pathways, etc. We observed dysregulated expression of many genes with epigenetic functions includingsfswap,ctcf,mettl3,alkbh5, andhdac,etc.,in the 1-celltcn2-/-embryos. Notably, B12 supplementation restored expression of many DEGs indicating a potential role of B12 in transcriptional regulation during embryonic development.

Our study delineates the importance of B12 during embryonic development and provides interesting insights into the molecular mechanisms underlying the observed phenotypic changes.