bluuebunny/crossref_metadata_2025 huggingface dataset:
ALK-Rearranged Epithelioid and Spindle Cell Neoplasm of the Sinonasal Tract
Authors: Zhu Peipei , Wang Jian
Published: February 2024

Anaplastic lymphoma kinase (ALK)-rearranged mesenchymal neoplasms (non-inflammatory myofibroblastic tumor and non-epithelioid fibrous histiocytoma) have been recently described which tend to occur in the superficial and deep soft tissues. Occurrence as a primary sinonasal neoplasm has not been reported thus far. Herein, we describe the first case of sinonasal ALK-rearranged mesenchymal tumor that harbored remarkable epithelioid and spindle cell morphology. The tumor affected a 40-year-old man who presented with flu-like symptoms and was thought to have influenza A. However, computed tomography demonstrated a nasal polypoid lesion causing curvature of the nasal septum. Histological examination revealed a heterogeneous tumor composed of round to epithelioid cells with foci of spindle cells. The tumor cells exhibited moderate pleomorphism and mitotic activity. By immunohistochemistry, they showed diffuse staining of CD34, S100, ALK (D5F3) and CD30. Fluorescence in situ hybridization analysis demonstrated ALK rearrangement. Subsequent next-generation sequencing (RNA-seq) identified a rare PLEKHH2exon6::ALKexon20 fusion. This study further demonstrates the importance of molecular profiling in identifying kinase fusion-positive soft tissue tumors, particularly for those that arise at unusual sites and display atypical cytomorphology.
GRM1-Rearranged Chondromyxoid Fibroma With FGF23 Expression: A Potential Pitfall in Small Biopsies
Authors: Machado Isidro , Zhang Yanming , Hameed Meera , Hwang Sinchun , Sharma Aarti E. , Bilsky Mark H. , Linos Konstantinos
Published: February 2024

The clinical, radiological, and histopathological features of chondromyxoid fibroma can sometimes resemble those of other benign or malignant tumors. Recently, recurrent GRM1 rearrangements have been identified in chondromyxoid fibroma, and GRM1 positivity by immunohistochemistry has emerged as a dependable surrogate marker for this molecular alteration. Phosphaturic mesenchymal tumor is a rare tumor that often exhibits overexpression of fibroblastic growth factor 23 (FGF23) through various mechanisms. In this report, we present a case of GRM1-rearranged chondromyxoid fibroma that also exhibited FGF23 expression via in situ hybridization, posing significant diagnostic challenges during workup of the initial core biopsy. We hope that this case can serve as an educational resource, shedding light on a rare diagnostic pitfall.
Multiple Gastrointestinal Stromal Tumors, Malignant Peripheral Nerve Sheath Tumor and Atypical Neurofibromatous Neoplasm With Uncertain Biologic Potential Developing in A Single Patient With Neurofibromatosis Type 1 Syndrome
Authors: Cerrah Elif , Çomunoğlu Cem
Published: February 2024

Neurofibromatosis type 1 (NF1) is the most common human genetic disease. In these patients, the incidence of malignant peripheral nerve sheath tumors (MPNST) and gastrointestinal stromal tumors (GIST) is increased. A male patient in his forties with neurofibromatosis 1, presented with the coexistence of multiple GISTs located at intestinal and colonic mesentery, MPNST located at his leg and atypical neurofibromatous neoplasm with uncertain biologic potential located at colonic mesentery. By FISH, the MPNST harbored CDKN2A loss and recurred 1 year later. After reresection and radiotherapy, the patient is now disease-free without evidence of disease. Atypical neurofibromatous neoplasm with uncertain biologic potential is a newly defined entity, and it is important to discriminate it from low-grade MPNST, which requires more aggressive treatment methods. To the best of our knowledge, this is the first report describing synchronous GISTs, MPNST, and atypical neurofibromatous neoplasm with uncertain biologic potential developing in a single NF1 patient.
Ocular Lichen Planus: A clinicopathologic review
Authors: Reekie Ian R. , Simpson Alasdair , Erikitola Ore , Lyall Douglas , Roberts Fiona
Published: February 2024

Lichen planus is a chronic inflammatory dermatosis that can affect the skin, mucous membranes and nails. Cutaneous lichen planus lesions are best described by the “six Ps” – purple pruritic polygonal planar papules and plaques. Mucous membrane lesions are commonly associated with cutaneous lichen planus. Ocular involvement with lichen planus is rare and conjunctival involvement usually predominates, it can however be visually devastating. Ocular lichen planus often progresses to extensive conjunctival scarring which can be impossible to distinguish clinically from other cicatrising conjunctivitis, requiring histopathological confirmation. Here we review the ocular pathology of this condition.
Incidence and predisposing factors of intraocular Lens tilt following secondary ciliary sulcus implantation in children: An ultrasound biomicroscopic study
Authors: Farag Christina S. , Gouda Jylan , Maher Sara , El-Fayoumi Dina , Elhilali Hala
Published: February 2024

Purpose

To evaluate the incidence and causes of intraocular lens (IOL) tilt and changes in anterior chamber angle after secondary IOL sulcus implantation following congenital cataract removal.

Methods

A retrospective observational study was conducted on children who underwent secondary sulcus IOL implantation following pediatric cataract removal in the period from 2017-2020 in Cairo university Hospitals. Children were examined for IOL position, centration, and tilt. Intraocular pressure (IOP) measurement, fundus and gonioscopic examination was performed. Ultrasound biomicroscopy (UBM) was performed on both eyes in children with clinically detected tilt.

Results

Ciliary sulcus secondary IOL implantation was performed in 102 eyes (57 children). IOL tilt was detected clinically in 16 eyes of 14 children (15.7%). UBM showed clinically undetected tilt in the fellow eye in additional 4 eyes. The mean angle of tilt was 12.8 ± 3.9° in clinically detected tilt compared to 7.5 ± 1.2° in UBM detected tilt. Mean anterior chamber depth (ACD) was 2.4 ± 0.5 mm IOP was >21 mmHg in 1.9% of eyes. Narrowing of the anterior chamber angle (ACA) after sulcus implantation occurred in 40% of eyes with open angle. Sulcus proliferations and obliterated sulcus were detected in all 20 eyes. Sommering's ring was found in 7 eyes (35%). Axial length, corneal diameter, and presence of persistent fetal vasculature did not affect IOL position.

Conclusion

The presence of residual lens matter or an obliterated ciliary sulcus is associated with a higher incidence of IOL malposition following ciliary sulcus implantation.
Surgical management of oculomotor nerve palsy – a review of the literature
Authors: Hankinson Jake , Shuaib Asmaa
Published: February 2024

We aim to review the surgical management techniques available for patients with oculomotor nerve (OMN) palsy, compare and contrast the approaches and subsequent outcomes. A search of the literature was carried out to yield all papers relevant to the topic, and a wide spectrum of surgical techniques were identified. These included: muscle shortening and lengthening procedures, muscle transposition, globe fixation and ptosis surgery. Patients often require a synergistic combination of these techniques. Strabismus surgery for OMN palsy can be approached through a variety of different techniques to improve the quality of life, independence and aesthetics for the patient.
Intraocular pressure in patients suffering from Wilson's disease
Authors: Bozic Marija , Svetel Marina , Svetel Marko
Published: February 2024

Purpose

The purpose of this study was to evaluate intraocular pressure (IOP) levels in patients suffering from Wilsons disease.

Methods

In observational, cross-sectional, non-interventional study, IOP was measured by applanation tonometry in 52 patients with Wilson's disease (WD), and compared to 52 healthy controls (HC).

Results

Patients with Wilsons disease had significantly lower IOPs, compared to control group (CG) (13.20 ± 2.5 versus 14.98 ± 2.0, p < .000, t test).

Conclusions

We found that IOP is significantly lower in patients with WD.
Long term follow up of patients with MNV3 treated with intra-vitreal Aflibercept
Authors: Browning Andrew C , Grinton Michael E , Quinn Stephanie , Jain Tania , Manikavasagar Venughanan , Aftab Akhunzada M
Published: February 2024

Purpose

MNV3 or Retinal angiomatous proliferation is a subtype of neovascular age-related macular degeneration (nAMD). We present the 5 year long term visual and anatomical outcomes of patients with MNV3 lesions treated with intravitreal Aflibercept.

Methods

This is a prospective study of treatment naïve patients with reading centre graded MNV3 lesions. After the loading phase, the patients received intravitreal Aflibercept as per the View study up to year 3, thereafter it was given on a prn basis. At each visit, best corrected visual acuity (BCVA) and optical coherence tomography (OCT) central macular thickness (CMT) was measured.

Results

Thirty one patients reached study completion. Mean BCVA of treated eyes had decreased by 0.6 ETDRS letters at the end of year 5 compared with baseline. At study completion, 81% of eyes had stable vision while 19% of eyes had gained 15 letters or more. At study end, 26% of eyes had BCVA of 6/12 or better, while 19% had lost 15 letters or more (all had central foveal photoreceptor loss). There was a maximal mean reduction in CMT of 164 microns (p = <0.0001) while 68% of maculae were fluid free at study completion. Eighty seven percent of treated eyes developed nascent GA, of which in 74% of eyes was involving the fovea.

Discussion

Despite initial improvement in mean BCVA, the improvement in BCVA was not maintained despite good overall control of the MNV3 lesions. The loss of BCVA was most likely due to the majority of eyes developing centre involving macular atrophy.
No contraindication to internal jugular central venous catheter insertion in patients at increased risk of bleeding: Results from a prospective observational study in a internal medicine department
Authors: Mumoli Nicola , Mereghetti Marco , Capra Riccardo , Pistoia Matteo , Dalla Torre Laura , Dentali Francesco , Giarretta Igor
Published: February 2024

Implantation of centrally inserted central venous catheter (CICC) may be complicated by bleedings particularly in patients with severe coagulopathy or taking antithrombotic drugs. It has been shown that the application of the Italian Group for Venous Access Devices (GAVeCeLT) bundle reduces the incidence of bleeding in patients admitted to intensive care units (ICU), but its effectiveness has never been demonstrated in different contexts. In this study we evaluated the incidence of bleeding after urgent internal jugular CICC (J-CICC) implantation in patients with increased or no risk of bleeding complications when recommended preventive strategies are applied systematically. We included 185 patients admitted to Internal Medicine Units who underwent urgent J-CICC implantation from April 2016 to December 2018. The incidence of major and minor bleeding immediately after the procedure and in the following 30 days was recorded. None of the enrolled patients showed major bleeding. The incidence of minor bleedings was 2.1% (95% IC: 0.03–4.2) with two patients requiring line removal and repositioning (1.1%; 95% IC: −0.45 to 2.6). Bleeds were not correlated with age or sex, although they all occurred in female subjects. The incidence of bleeds was not increased in patients with increased risk of bleeding compared with those without (5.0% vs 1.3%; p = 0.16). The use of anti-thrombotic medications was significantly associated with increased risk of minor bleedings ( p = 0.03). In this study we demonstrated that the application of the GAVeCeLT suggested bundle can minimize the number of bleeding complications even in patients hospitalized in Internal Medicine Units. Further data are needed in patients taking antithrombotic drugs who appear to be more prone to minor bleeding, however the benefit of completing the procedure appears to significantly outweigh the risk of mechanical complications.
Understanding how classroom drama workshops can facilitate social capital for newly arrived migrant and refugee adolescents: Insights from Denmark
Authors: Dähne Finja , Jervelund Signe Smith , Primdahl Nina Langer , Siemsen Nicoline , Derluyn Ilse , Verelst An , Spaas Caroline , de Haene Lucia , Skovdal Morten
Published: February 2024

Art-based interventions, such as classroom drama workshops (CDWs), increasingly form part of a collection of mental health-promoting activities introduced in school settings. While research points to the potential benefits of CDWs for the mental well-being of refugee and migrant adolescents, the mechanisms to such improvement are less understood. In this article we respond to the need for qualitative evidence of how CDW interventions affect refugee and migrant adolescents’ experience. The study draws on eight focus group discussions (FGDs) with 41 adolescents, four semi-structured interviews with teachers and a school coordinator, and written documents from two drama therapists. Our thematic analysis revealed that the CDWs were found to foster trust and improve social relations in the classroom—key facets of bonding social capital. Several processes were described as being linked to these changes. Participants spoke about how the CDWs were facilitated in an emancipatory and safe manner, creating social spaces where the adolescents could have fun together, share, and bear witness to each other’s stories, as well as experiencing a sense of agency. In some cases, however, activities in the CDWs crossed the learners’ psychological boundaries, which led to withdrawal and a loss of trust. We conclude that whilst CDWs have the potential to facilitate bonding social capital amongst refugee and migrant adolescents and their teachers, this potential hinges on how the CDWs are facilitated.
Towards a sociology of the future: An exploration in cognitive social theory
Authors: Strydom Piet
Published: February 2024

The aim of this article is a sociology of the future. Since the standard sociological practice of extrapolating from everyday semantics of the future and the time-consciousness of modernity is inadequate, an integrated cognitive sociological perspective allied to critical theory is introduced. It makes visible an essential dimension of social life that is either largely taken for granted, misunderstood or ignored by identifying different levels of cognitive structures organising minds, institutions and culture and following their role in societal dynamics. This perspective mediates the sociocultural and naturalistic approaches and introduces the concept of space-time. Centrally, a modal analysis of the key present-past-future sequence is presented, with the focus on the distinct status of the future. It is modally conceptualised, not simply in terms of possibility as is usual, but rather in terms of its modality as a necessary formal generic cultural model that makes the future in the first place conceivable and enables an orientation towards it to be established and maintained. The resulting cognitive sociological account offers a novel theoretical understanding of the future which could facilitate thorough sociological and critical theoretical analyses in the societal space-time field.
Empathy in clinical performance examinations: Medical students’ use of empathic statements in interaction with standardized patients
Authors: Park Song Hee , Kim Chan Woong , Kim Mi Kyung , Lee Seung-Hee
Published: February 2024

This paper examines interactional functions of empathic statements in clinical performance examinations by using the method of conversation analysis. In video-recordings of 170 consultations between medical students and standardized patients (individuals trained to play the role of the patient), medical students produce empathic utterances in three sequential positions and accomplish different interactional jobs. First, medial students produce empathic statements before the initiation of history taking. They check whether patients have concerns in addition to those in problem presentation. Second, medical students construct empathic statements during history taking. They treat a particular symptom as problematic, in alignment with patients’ display of a problem. Finally, medical students produce empathic statements before the delivery of diagnosis. They portray the upcoming diagnosis as made in recognition of the troublesome nature of patients’ problems. This suggests that functions of empathic statements can vary according to the specific demands of interaction in different sequential contexts.
Investigation of carbon nanotube sheet for lunar dust shielding
Authors: Giri Prakash , Abdallah Shaaban , Kim Woo Kyun , Alverez Noe T. , Schulz Mark
Published: February 2024

Carbon nanotubes (CNT) sheet is a new type of nonwoven fabric that is being evaluated for different applications. This article presents the first friction-based investigation of the use of CNT sheet as a dust shield. The focus application is for shielding future machinery on the moon from lunar dust. Lunar dust is strongly abrasive; it adheres to all surfaces and causes wear. The absence of an atmosphere and water on the moon, along with its low gravity, and electrostatic adhesion exacerbates the issue of lunar dust, which affects all surfaces, including machinery and human apparel. Friction testing was performed to represent the effect of abrasion occurring on a garment surface while astronauts are working on the moon. The coefficients of static and sliding friction between two CNT sheets, held against each other by a weight, were 0.6 and 0.45, respectively. The presence of lunar regolith simulant reduced the friction coefficients between the two CNT sheets by 33% and 22% for static and sliding friction, respectively. The dust in the sheets was easily cleaned with dry wiping and compressed air, showing no requirement to use water for cleaning in space applications. However, the CNT sheets experienced wear after repeated friction tests. The CNT sheets passed the flammability test standards ASTM D6413/D6413M-15 and NPFA 1971 for applications under extreme heat conditions. Thus, CNT sheet can be considered as a multi-functional material for lunar applications, with shielding protection against dust and electromagnetic waves, and resistance to high temperatures.
The impact of platelet-to-lymphocyte ratio on clinical outcomes in heart failure: a systematic review and meta-analysis
Authors: Vakhshoori Mehrbod , Bondariyan Niloofar , Sabouhi Sadeq , Kiani Keivan , Alaei Faradonbeh Nazanin , Emami Sayed Ali , Shakarami Mehrnaz , Khanizadeh Farbod , Sanaei Shahin , Motamedi Niloofaralsadat , Shafie Davood
Published: February 2024

Background:

Inflammation has been suggested to play a role in heart failure (HF) pathogenesis. However, the role of platelet-to-lymphocyte ratio (PLR), as a novel biomarker, to assess HF prognosis needs to be investigated. We sought to evaluate the impact of PLR on HF clinical outcomes.

Methods:

English-published records in PubMed/Medline, Scopus, and Web-of-science databases were screened until December 2023. Relevant articles evaluated PLR with clinical outcomes (including mortality, rehospitalization, HF worsening, and HF detection) were recruited, with PLR difference analysis based on death/survival status in total and HF with reduced ejection fraction (HFrEF) patients.

Results:

In total, 21 articles ( n = 13,924) were selected. The total mean age was 70.36 ± 12.88 years (males: 61.72%). Mean PLR was 165.54 [95% confidence interval (CI): 154.69–176.38]. In total, 18 articles ( n = 10,084) reported mortality [either follow-up (PLR: 162.55, 95% CI: 149.35–175.75) or in-hospital (PLR: 192.83, 95% CI: 150.06–235.61) death rate] and the mean PLR was 166.68 (95% CI: 154.87–178.50). Further analysis revealed PLR was significantly lower in survived HF patients rather than deceased group (152.34, 95% CI: 134.01–170.68 versus 194.73, 95% CI: 175.60–213.85, standard mean difference: −0.592, 95% CI: −0.857 to −0.326, p < 0.001). A similar trend was observed for HFrEF patients. PLR failed to show any association with mortality risk (hazard ratio: 1.02, 95% CI: 0.99–1.05, p = 0.289). Analysis of other aforementioned outcomes was not possible due to the presence of few studies of interest.

Conclusion:

PLR should be used with caution for prognosis assessment in HF sufferers and other studies are necessary to explore the exact association.
Moderating Effects of Individual Traits on the Association Between Nature and Patient Wait Experiences
Authors: Lee Jisun , Yoon So-Yeon
Published: February 2024

Objectives:

We empirically investigated to what extent plants in the emergency department (ED) waiting areas influence patient wait experiences (i.e., anxiety, perceived service quality, and perception of wait time) depending on individual differences in cognitive thinking styles and one’s bonds with the natural world.

Background:

Positive effects of nature on patient experiences in healthcare environments are well established by empirical research findings. However, evidence is scarce on the impact of nature on patient wait experiences and the roles of patient traits often related to their backgrounds.

Methods:

A within-subjects study was conducted ( N = 116) with two virtually built ED waiting rooms: with versus without indoor and outdoor plants.

Results:

Findings confirmed that plants lower anxiety and improve perceptions of service quality and wait time. Cognitive thinking style significantly moderated how plants affected patient wait experiences. Although participants with higher connectedness to nature showed more positive responses to the nature condition, connectedness to nature did not significantly affect the association between nature and wait experiences.

Conclusions:

This study contributes to the existing body of knowledge on nature’s effects in healthcare environments by examining the roles of individual differences in patients’ and visitors’ cognitive styles and connectedness to nature. Results highlighted the impact of these differences in patient experiences for effective implications of nature in waiting areas of healthcare facilities.
Caudal epidural, pericapsular nerve group block and lateral femoral cutaneous nerve block in hip fracture surgery: A case report
Authors: Angullia Natesha Eusoof , Tan Elizabeth Sein Jieh
Published: February 2024

Background: Hip fractures are associated with significant morbidity and mortality in the elderly and optimal pain control is essential in improving postoperative outcomes. The sensory innervation of the hip is complex, and blocking the hip branches of the femoral, obturator and sciatic nerves is necessary to provide full sensory coverage of the hip joint.

Objectives: This case report describes the use of a combination of three regional anesthesia techniques – caudal epidural, pericapsular nerve group block and lateral femoral cutaneous nerve block – in hip fracture surgery, and demonstrates its efficacy in minimizing pain and opioid requirements in a high cardiac risk geriatric patient.

Results: Caudal epidural, pericapsular nerve group block and lateral femoral cutaneous nerve blocks were performed in a patient presenting for hip fracture surgery prior to general anaesthesia successfully without the need for further doses of opioids post operatively
The relationship of smartphone addiction with depression, anxiety, and stress among medical students
Authors: Sarhan Adnan Lutfi
Published: February 2024

Introduction:

An increasing amount of research has shown a link between psychopathological behaviors such as smartphone addiction, depression, anxiety, and stress. The aim of this study was to assess the association of smartphone addiction with depression, anxiety, and stress.

Methods:

A cross-sectional study was conducted between 26th January and 3rd March 2021. The sample was chosen using a convenient sampling technique and Raosoft tool. The survey assessed smartphone addiction using abbreviated versions of the Addiction Scale Short Version, a self-administered questionnaire that has been validated in the English and Arabic languages. Also, Depression and Anxiety Stress Scale was used to measure the level of depression, anxiety, and stress among the university students.

Results:

A total of 367 university students from the Medical and Health Sciences College participated. Our findings showed that smartphone addiction exhibited positive correlations with depression ( r = 0.375, p < 0.01), anxiety ( r = 0.253, p < 0.01), and stress ( r = 0.328, p < 0.05). In addition, there was a strong positive correlation between depression and both anxiety and stress ( r = 0.731, p < 0.01) ( r = 0.778, p < 0.01), respectively. Finally, stress and anxiety showed a positive correlation ( r = 0.708, p < 0.01).

Conclusion:

When combined, our data offer strong support for a bidirectional hybrid theory that takes into account the link between smartphone addiction and depression, anxiety, and stress. The current study’s findings might assist national health authorities in strengthening their efforts to prevent depression, anxiety, and stress associated with the use of modern technology.
Multi-task localization of the hemidiaphragms and lung segmentation in portable chest X-ray images of COVID-19 patients
Authors: Morís Daniel I , de Moura Joaquim , Aslani Shahab , Jacob Joseph , Novo Jorge , Ortega Marcos
Published: February 2024

Background

The COVID-19 can cause long-term symptoms in the patients after they overcome the disease. Given that this disease mainly damages the respiratory system, these symptoms are often related with breathing problems that can be caused by an affected diaphragm. The diaphragmatic function can be assessed with imaging modalities like computerized tomography or chest X-ray. However, this process must be performed by expert clinicians with manual visual inspection. Moreover, during the pandemic, the clinicians were asked to prioritize the use of portable devices, preventing the risk of cross-contamination. Nevertheless, the captures of these devices are of a lower quality.

Objectives

The automatic quantification of the diaphragmatic function can determine the damage of COVID-19 on each patient and assess their evolution during the recovery period, a task that could also be complemented with the lung segmentation.

Methods

We propose a novel multi-task fully automatic methodology to simultaneously localize the position of the hemidiaphragms and to segment the lung boundaries with a convolutional architecture using portable chest X-ray images of COVID-19 patients. For that aim, the hemidiaphragms’ landmarks are located adapting the paradigm of heatmap regression.

Results

The methodology is exhaustively validated with four analyses, achieving an 82.31% [Formula: see text] 2.78% of accuracy when localizing the hemidiaphragms’ landmarks and a Dice score of 0.9688 [Formula: see text] 0.0012 in lung segmentation.

Conclusions

The results demonstrate that the model is able to perform both tasks simultaneously, being a helpful tool for clinicians despite the lower quality of the portable chest X-ray images.
Shared Decision Making in Hallux Valgus Surgery: A Prospective Observational Study
Authors: Bond Michael , Bicknell Mattheus , Crump Trafford , Penner Murray , Veljkovic Andrea , Wing Kevin , Younger Alastair , Liu Guiping , Sutherland Jason M.
Published: February 2024

Patient-physician communication has the potential to improve outcomes and satisfaction through the shared decision-making process (SDM). This study aims to assess the relationship between perception of SDM and demographic, clinical, and patient-reported outcomes in patients undergoing Hallux Valgus (HV) correction. A prospective analysis of 306 patients scheduled for HV surgery was completed. The CollaboRATE score was used to measure SDM. Multivariable linear regression model was used to assess whether SDM scores were associated with preoperative characteristics or postoperative outcome scores. The mean CollaboRATE score was 2.9 (SD 0.9) and did not differ by age, socioeconomic status, or sex. Lower CollaboRATE scores were associated with more symptoms of depression, lower socioeconomic status, and lower general health scores (p-value < 0.05). There was no association between SDM scores and postoperative outcome scores. In this study, patients with depressive symptoms and lower socioeconomic status had worse perceptions of SDM. There was no difference in postoperative outcomes among participants based on SDM scores.

Level of Evidence: Level III, prospective observational study
Management of ALL in adults: 2024 ELN recommendations from a European expert panel
Authors: Gökbuget Nicola , Boissel Nicolas , Chiaretti Sabina , Dombret Hervé , Doubek Michael , Fielding Adele , Foà Robin , Giebel Sebastian , Hoelzer Dieter , Hunault Mathilde , Marks David I. , Martinelli Giovanni , Ottmann Oliver , Rijneveld Anita , Rousselot Philippe , Ribera Josep , Bassan Renato
Published: February 2024

Experts from the European Leukemia Net (ELN) working group for adult acute lymphoblastic leukemia have identified an unmet need for guidance regarding management of adult acute lymphoblastic leukemia (ALL) from diagnosis to aftercare. The group has previously summarized their recommendations regarding diagnostic approaches, prognostic factors, and assessment of ALL. The current recommendation summarizes clinical management. It covers treatment approaches, including the use of new immunotherapies, application of minimal residual disease for treatment decisions, management of specific subgroups, and challenging treatment situations as well as late effects and supportive care. The recommendation provides guidance for physicians caring for adult patients with ALL which has to be complemented by regional expertise preferably provided by national academic study groups.
IP3R1-mediated MAMs formation contributes to mechanical trauma-induced hepatic injury and the protective effect of melatonin
Authors: Shi Rui , Liu Zhenhua , Yue Huan , Li Man , Liu Simin , De Dema , Li Runjing , Chen Yunan , Cheng Shuli , Gu Xiaoming , Jia Min , Li Jun , Li Juan , Zhang Shumiao , Feng Na , Fan Rong , Fu Feng , Liu Yali , Ding Mingge , Pei Jianming
Published: February 2024

Introduction

There is a high morbidity and mortality rate in mechanical trauma (MT)-induced hepatic injury. Currently, the molecular mechanisms underlying liver MT are largely unclear. Exploring the underlying mechanisms and developing safe and effective medicines to alleviate MT-induced hepatic injury is an urgent requirement. The aim of this study was to reveal the role of mitochondria-associated ER membranes (MAMs) in post-traumatic liver injury, and ascertain whether melatonin protects against MT-induced hepatic injury by regulating MAMs.

Methods

Hepatic mechanical injury was established in Sprague–Dawley rats and primary hepatocytes. A variety of experimental methods were employed to assess the effects of melatonin on hepatic injury, apoptosis, MAMs formation, mitochondrial function and signaling pathways.

Results

Significant increase of IP3R1 expression and MAMs formation were observed in MT-induced hepatic injury. Melatonin treatment at the dose of 30 mg/kg inhibited IP3R1-mediated MAMs and attenuated MT-induced liver injury in vivo. In vitro, primary hepatocytes cultured in 20% trauma serum (TS) for 12 h showed upregulated IP3R1 expression, increased MAMs formation and cell injury, which were suppressed by melatonin (100 μmol/L) treatment. Consequently, melatonin suppressed mitochondrial calcium overload, increased mitochondrial membrane potential and improved mitochondrial function under traumatic condition. Melatonin’s inhibitory effects on MAMs formation and mitochondrial calcium overload were blunted when IP3R1 was overexpressed. Mechanistically, melatonin bound to its receptor (MR) and increased the expression of phosphorylated ERK1/2, which interacted with FoxO1 and inhibited the activation of FoxO1 that bound to the IP3R1 promoter to inhibit MAMs formation.

Conclusion

Melatonin prevents the formation of MAMs via the MR-ERK1/2-FoxO1-IP3R1 pathway, thereby alleviating the development of MT-induced liver injury. Melatonin-modulated MAMs may be a promising therapeutic therapy for traumatic hepatic injury.

Graphical Abstract
Evaluation of penalized and machine learning methods for asthma disease prediction in the Korean Genome and Epidemiology Study (KoGES)
Authors: Choi Yongjun , Cha Junho , Choi Sungkyoung
Published: February 2024

Background

Genome-wide association studies have successfully identified genetic variants associated with human disease. Various statistical approaches based on penalized and machine learning methods have recently been proposed for disease prediction. In this study, we evaluated the performance of several such methods for predicting asthma using the Korean Chip (KORV1.1) from the Korean Genome and Epidemiology Study (KoGES).

Results

First, single-nucleotide polymorphisms were selected via single-variant tests using logistic regression with the adjustment of several epidemiological factors. Next, we evaluated the following methods for disease prediction: ridge, least absolute shrinkage and selection operator, elastic net, smoothly clipped absolute deviation, support vector machine, random forest, boosting, bagging, naïve Bayes, andk-nearest neighbor. Finally, we compared their predictive performance based on the area under the curve of the receiver operating characteristic curves, precision, recall, F1-score, Cohen′s Kappa, balanced accuracy, error rate, Matthews correlation coefficient, and area under the precision-recall curve. Additionally, three oversampling algorithms are used to deal with imbalance problems.

Conclusions

Our results show that penalized methods exhibit better predictive performance for asthma than that achieved via machine learning methods. On the other hand, in the oversampling study, randomforest and boosting methods overall showed better prediction performance than penalized methods.
Draft genome sequence of novel Candidatus Ornithobacterium hominis carrying antimicrobial resistance genes in Egypt
Authors: Ahmed Nada , Azab Marwa , Enany Shymaa , Hanora Amro
Published: February 2024

Background

Candidatus Ornithobacterium hominis (O. hominis), which was identified in nasopharyngeal swabs from Egypt, has been associated with respiratory disorders in humans. O. hominis, a recently identified member of the Flavobacteriaceae family, belongs to the largest family within the Bacteroidetes phylum. This family includes hundreds of species and 90 genera, including major human pathogens such as Capnocytophaga canimorsus and Elizabethkingia meningoseptica. Herein, we presented two draft genome assemblies of O. hominis that were extracted from metagenomic data using the Illumina sequencing method. The alignment of reads against the O. hominis genome was accomplished using BLASTN, and the reads with significant hits were extracted using Seqtk and assembled using SPAdes. The primary goal of this study was to obtain a more profound understanding of the genomic landscape of O. hominis, with an emphasis on identifying the associated virulence, antimicrobial genes, and distinct defense mechanisms to shed light on the potential role of O. hominis in human respiratory infections.

Results

The genome size was estimated to be 1.84 Mb, including 1,931,660 base pairs (bp), with 1,837 predicted coding regions and a G+C content of 35.62%. Genes encoding gliding motility, antibiotic resistance (20 genes), and the toxA gene were all included in the genome assembly. Gliding motility lipoproteins (GldD, GldJ, GldN, and GldH) and the gliding motility-associated ABC transporter substrate-binding protein, which acts as a crucial virulence mechanism in Flavobacterium species, were identified. The genome contained unique genes encoding proteins, such as the ParE1 toxin that defend against the actions of quinolone and other antibiotics. The cobalt-zinc-cadmium resistance gene encoding the protein CzcB, which is necessary for metal resistance, urease regulation, and colonization, was also detected. Several multidrug resistance genes encoding proteins were identified, such as MexB, MdtK, YheI, and VanC.

Conclusion

Our study focused on identifying virulence factors, and antimicrobial resistance genes present in the core genome of O. hominis. These findings provide valuable insights into the potential pathogenicity and antibiotic susceptibility of O. hominis.
Food security and its association with socioeconomic status and dietary diversity in free living older people in Tehran, Iran
Authors: Pourebrahim Fatemeh , Omidvar Nasrin , Rezazadeh Arezoo , Eini-Zinab Hassan , Shirani Pedram , Ghodsi Delaram
Published: February 2024

Background

Food security is a function of food access and dietary diversity. Older age is a period when adequate and diverse dietary intake is a challenge. This study aimed to investigate the association between food security on the one hand and dietary diversity and socioeconomic factors on the other hand among the free-living older people in the city of Tehran.

Methods

In this cross-sectional study, 583 older people, aged 60–80 years living in Tehran city, were selected through the systematic cluster sampling method. Food security was determined by the United States Household Food Security Survey Module (US-HFSSM (.Socioeconomic status (SES) and two 24-h recalls were obtained. Dietary Diversity Score (DDS) was calculated using the FAO 2010 guideline. Multinomial logistic regression was applied.

Results

The average age of participants was 67.87 ± 5.86 years. Based on US-HFSSM, 56.9% of older people were food secure; while 25.7%, 14.2% and 3.2% suffered from food insecurity (FI) without hunger, with moderate hunger, and with severe hunger, respectively. There was no association between FI and DDS, even after controlling for confounders. FI with mild hunger was associated with household income (OR = 2.744, 95% CI = 1.100–6.846), while FI with severe hunger was associated with Fars ethnicity (OR = 0.146, 95% CI = 0.051–0.424).

Conclusions

Overall, socio-economic status and demographic characteristics were the predictors of FI among older people. The findings can have implication in design and targeting of interventions directed at older people.
Enhancing detection of SARS-CoV-2 re-infections using longitudinal sero-monitoring: demonstration of a methodology in a cohort of people experiencing homelessness in Toronto, Canada
Authors: Richard Lucie , Nisenbaum Rosane , Colwill Karen , Mishra Sharmistha , Dayam Roya M. , Liu Michael , Pedersen Cheryl , Gingras Anne-Claude , Hwang Stephen W.
Published: February 2024

Background

Accurate estimation of SARS-CoV-2 re-infection is crucial to understanding the connection between infection burden and adverse outcomes. However, relying solely on PCR testing results in underreporting. We present a novel approach that includes longitudinal serologic data, and compared it against testing alone among people experiencing homelessness.

Methods

We recruited 736 individuals experiencing homelessness in Toronto, Canada, between June and September 2021. Participants completed surveys and provided saliva and blood serology samples every three months over 12 months of follow-up. Re-infections were defined as: positive PCR or rapid antigen test (RAT) results > 90 days after initial infection; new serologic evidence of infection among individuals with previous infection who sero-reverted; or increases in anti-nucleocapsid in seropositive individuals whose levels had begun to decrease.

Results

Among 381 participants at risk, we detected 37 re-infections through PCR/RAT and 98 re-infections through longitudinal serology. The comprehensive method identified 37.4 re-infection events per 100 person-years, more than four-fold more than the rate detected through PCR/RAT alone (9.0 events/100 person-years). Almost all test-confirmed re-infections (85%) were also detectable by longitudinal serology.

Conclusions

Longitudinal serology significantly enhances the detection of SARS-CoV-2 re-infections. Our findings underscore the importance and value of combining data sources for effective research and public health surveillance.
The effects of oxaliplatin-based adjuvant chemotherapy in high-risk stage II colon cancer with mismatch repair-deficient: a retrospective study
Authors: Liao Leen , Tang Jinghua , Hong Zhigang , Jiang Wu , Li Yuan , Kong Lingheng , Han Kai , Hou Zhenlin , Zhang Chenzhi , Zhou Chi , Zhang Linjie , Sui Qiaoqi , Xiao Binyi , Mei Weijian , Yu Jiehai , Yang Wanjun , Pan Zhizhong , Ding Pei-Rong
Published: February 2024

Background

For high-risk stageIImismatch repair deficient (dMMR) colon cancers, the benefit of adjuvant chemotherapy remains debatable. The principal aim of this study was to evaluate the prognostic value of high-risk factors and the effect of oxaliplatin-based adjuvant chemotherapy among dMMR stageIIcolon cancers.

Methods

Patients with stage II dMMR colon cancers diagnosed between June 2011 and May 2018 were enrolled in the study. Clinicopathological characteristics, treatment, and follow-up data were retrospectively collected. The high-risk group was defined as having one of the following factors: pT4 disease, fewer than twelve lymph nodes harvested (< 12 LNs), poorly differentiated histology, perineural invasion (PNI), lymphatic vascular invasion (LVI), or elevated preoperative carcinoembryonic antigen (CEA). The low-risk group did not have any risk factors above. Factors associated with disease-free survival (DFS) were included in univariate and multivariate Cox analyses.

Results

We collected a total of 262 consecutive patients with stage II dMMR colon cancer. 179 patients (68.3%) have at least one high-risk factor. With a median follow-up of 50.1 months, the low-risk group was associated with a tended to have a better 3-year DFS than the high-risk group (96.4% vs 89.4%; P = 0.056). Both elevated preoperative CEA (HR 2.93; 95% CI 1.26–6.82; P = 0.013) and pT4 disease (HR 2.58; 95% CI 1.06–6.25; P = 0.037) were independent risk factors of recurrence. Then, the 3-year DFS was 92.6% for the surgery alone group and 88.1% for the adjuvant chemotherapy group (HR 1.64; 95% CI 0.67–4.02; P = 0.280). Furthermore, no survival benefit from oxaliplatin-based adjuvant chemotherapy was observed in the high-risk group and in the subgroups with pT4 disease or < 12 LNs.

Conclusions

These data suggests that not all high-risk factors have a similar impact on stage II dMMR colon cancers. Elevated preoperative CEA and pT4 tumor stage are associated with increased recurrence risk. However, oxaliplatin-based adjuvant chemotherapy shows no survival benefits in stage II dMMR colon cancers, either with or without high-risk factors.
A potential role for inflammatory cytokines in a rare late-onset capsular block syndrome: a case report
Authors: Du Ying-Hua , Liang Xiao-Fang , Hirooka Kazuyuki , Xia Hui-Ka , Jia Zhi-Yang
Published: February 2024

Background

Late-onset capsule block syndrome (CBS) is a rare complication of cataract phacoemulsification and the implantation of a posterior chamber intraocular lens (PCIOL), which manifests six months to years after surgery. The hallmark of CBS is the formation of an opaque liquid substance between the implanted intraocular lens (IOL) and the posterior capsule. However, its pathogenesis remains unclear.

Case presentation

A 64-year-old female patient with chronic angle-closure glaucoma (axis length < 21 mm) underwent trabeculectomy surgery combined with phacoemulsification and PCIOL. After a 4-year follow-up, a decline in visual acuity occurred in her right eye due to the location of opaque fluid in the visual axis and distension of the capsular bag. The initial course of action was to release the trapped fluid. Neodymium: yttrium-aluminum-garnet (Nd: YAG) laser capsulotomy could not be employed due to her non-dilating pupil and high extension of the posterior capsule. Subsequently, anterior capsule peeling and anterior segment vitrectomy surgery were performed. The depth of the anterior chamber (ACD), the distance between the face of the retro-IOL and the posterior capsule, the best-corrected visual acuity (BCVA), and the visual quality (VQ) were measured both before and after surgery. Inflammatory cytokine levels in the opaque substances (OS) trapped between the PCIOL and the posterior capsule were assessed using a flow cytometer and compared to normal statistical data in aqueous humor. After surgery, the patient experienced a significant improvement in BCVA and VQ. The distance between the face of the retro-IOL and the posterior capsule was on the verge of disappearing. However, ACD did not differ between pre- and post-operatively. Interleukin-8 (IL-8) and basic fibroblast growth factor (BFGF) concentrations were higher in the OS than in aqueous humor, especially in the former. However, the concentration of vascular cell adhesion molecule (VCAM) in the OS was lower than in aqueous humor.

Conclusions

Anterior segment vitrectomy surgery proved to be a successful treatment for late-onset CBS, presenting a challenging case. In the human lens, inflammatory cytokines originating from the opaque substances may contribute to abnormal metabolism in the sealed area, a consequence of late-onset CBS.
Multilayer factors associated with excess all-cause mortality during the omicron and non-omicron waves of the COVID-19 pandemic: time series analysis in 29 countries
Authors: Zou Fengjuan , Xiao Jianpeng , Jin Yingying , Jian Ronghua , Hu Yijun , Liang Xiaofeng , Ma Wenjun , Zhu Sui
Published: February 2024

Background

The COVID-19 pandemic has resulted in significant excess mortality globally. However, the differences in excess mortality between the Omicron and non-Omicron waves, as well as the contribution of local epidemiological characteristics, population immunity, and social factors to excess mortality, remain poorly understood. This study aims to solve the above problems.

Methods

Weekly all-cause death data and covariates from 29 countries for the period 2015–2022 were collected and used. The Bayesian Structured Time Series Model predicted expected weekly deaths, stratified by gender and age groups for the period 2020–2022. The quantile-based g-computation approach accounted for the effects of factors on the excess all-cause mortality rate. Sensitivity analyses were conducted using alternative Omicron proportion thresholds.

Results

From the first week of 2021 to the 30th week of 2022, the estimated cumulative number of excess deaths due to COVID-19 globally was nearly 1.39 million. The estimated weekly excess all-cause mortality rate in the 29 countries was approximately 2.17 per 100,000 (95% CI: 1.47 to 2.86). Weekly all-cause excess mortality rates were significantly higher in both male and female groups and all age groups during the non-Omicron wave, except for those younger than 15 years (P < 0.001). Sensitivity analysis confirmed the stability of the results. Positive associations with all-cause excess mortality were found for the constituent ratio of non-Omicron in all variants, new cases per million, positive rate, cardiovascular death rate, people fully vaccinated per hundred, extreme poverty, hospital patients per million humans, people vaccinated per hundred, and stringency index. Conversely, other factors demonstrated negative associations with all-cause excess mortality from the first week of 2021 to the 30th week of 2022.

Conclusion

Our findings indicate that the COVID-19 Omicron wave was associated with lower excess mortality compared to the non-Omicron wave. This study’s analysis of the factors influencing excess deaths suggests that effective strategies to mitigate all-cause mortality include improving economic conditions, promoting widespread vaccination, and enhancing overall population health. Implementing these measures could significantly reduce the burden of COVID-19, facilitate coexistence with the virus, and potentially contribute to its elimination.