bluuebunny/crossref_metadata_2025 huggingface dataset:
Measuring Clinical, Biological, and Behavioral Variables to Elucidate Trajectories of Patient-Reported Outcomes: The PROFILES Registry
Authors: van de Poll-Franse Lonneke V , Horevoorts Nicole , Schoormans Dounya , Beijer Sandra , Ezendam Nicole P M , Husson Olga , Oerlemans Simone , Schagen Sanne B , Hageman Geja J , Van Deun Katrijn , van den Hurk Corina , van Eenbergen Mies , Mols Floortje ,   the PROFILES Registry Group, Rooij Belle de , Raijmakers Natasja , Vlooswijk Carla , Bonhof Cynthia , Ekels Afke , Hoedjes Meeke , van Cappellen – van Maldegem S J M , Ham Laurien , van de Graaf Danielle , van Roij Janneke
Published: February 2022

To take cancer survivorship research to the next level, it’s important to gain insight in trajectories of changing patient-reported outcomes and impaired recovery after cancer. This is needed as the number of survivors is increasing and a large proportion is confronted with changing health after treatment. Mechanistic research can facilitate the development of personalized risk-stratified follow-up care and tailored interventions to promote healthy cancer survivorship. We describe how these trajectories can be studied by taking the recently extended Dutch population-based Patient Reported Outcomes Following Initial treatment and Long term Evaluation of Survivorship (PROFILES) registry as an example. PROFILES combines longitudinal assessment of patient-reported outcomes with novel, ambulatory and objective measures (eg, activity trackers, blood draws, hair samples, online food diaries, online cognitive tests, weighing scales, online symptoms assessment), and cancer registry and pharmacy databases. Furthermore, we discuss methods to optimize the use of a multidomain data collection–like return of individual results to participants, which may improve not only patient empowerment but also long-term cohort retention. Also, advanced statistical methods are needed to handle high-dimensional longitudinal data (with missing values) and provide insight into trajectories of changing patient-reported outcomes after cancer. Our coded data can be used by academic researchers around the world. Registries like PROFILES, which go beyond boundaries of disciplines and institutions, will contribute to better predictions of who will experience changes and why. This is needed to prevent and mitigate long-term and late effects of cancer treatment and to identify new interventions to promote health.
Assessment of internal exposure to 131I and short-lived radioiodine isotopes and associated uncertainties in the Ukrainian cohort of persons exposed in utero
Authors: Masiuk Sergii , Chepurny Mykola , Buderatska Valentyna , Ivanova Olga , Boiko Zulfira , Zhadan Natalia , Hatch Maureen , Cahoon Elizabeth K , Zamotayeva Galyna , Shpak Victor , Tronko Mykola , Drozdovitch Vladimir
Published: February 2022

This study revised the thyroid doses for 2582 Ukrainian in utero cohort members exposed to Chornobyl fallout (the Ukrainian in utero cohort) based on revision of: (i) 131I thyroid activity measured in the Ukrainian population, (ii) thyroid dosimetry system for entire Ukraine, and (iii) 131I ground deposition densities in Ukraine. Other major improvements included: (i) assessment of uncertainties in the thyroid doses considering shared and unshared error, and (ii) accounting for intake of short-lived radioisotopes of tellurium and iodine (132Te+132I and 133I). Intake of 131I was the major pathway for thyroid exposure, its median contribution to the thyroid dose was 97.4%. The mean prenatal and postnatal thyroid dose from 131I was 87 mGy (median = 17 mGy), higher than previous deterministic dose of 72 mGy (median = 12 mGy). For 39 individuals (1.5%) the dose exceeded 1.0 Gy, while the highest dose among the cohort members was 2.7 Gy. The geometric standard deviation (GSD) of 1000 individual stochastic doses varied from 1.9 to 5.2 with a mean of 3.1 and a median of 3.2. The lowest uncertainty (mean GSD = 2.3, median GSD = 2.2) was found for the subjects whose mothers were measured for 131I thyroid activity, while for individuals, whose mothers were not measured, the mean and median GSDs were 3.4. Uncertainties in thyroid doses were driven by shared errors associated with the parameters of the ecological model.
Participation as Confrontation: Resistance Within and Outside the Mesas de Participación Established for IDPs in Colombia
Authors: Schouw Iversen Karen
Published: February 2022

This article discusses resistance related to the mesas de participación—invited participatory spaces established for internally displaced persons (IDPs) in Colombia. While the existing literature on participation has shown that such spaces can enhance stability and delegitimize dissent, this article foregrounds these spaces’ political ambivalence, pointing to the resistance they facilitate. Drawing on fieldwork conducted in Bogotá between October 2017 and August 2018, the article argues that the mesas have paved the way for two kinds of resistance. First, they have engendered resistance around the meaning of participation itself. Second, IDPs have utilized opportunities conferred by the mesas to strengthen ‘confrontational collective action’ in the form of occupations and protests outside of these government-sponsored spaces. By highlighting the connections that exist between resistance happening within and outside institutional spaces, the article contributes both to a growing body of literature that has emphasized the agency of IDPs in Colombia and, more broadly, to the literature on forced migrants’ participation.
A Cautionary Note on the Hanurav–Vijayan Sampling Algorithm
Authors: Chauvet Guillaume
Published: February 2022

We consider the Hanurav–Vijayan (HV) sampling design, which is the default method programmed in the SURVEYSELECT procedure of the SAS software. We prove that it is equivalent to the Sunter procedure but is capable of handling any set of inclusion probabilities. We prove that the Horvitz–Thompson (HT) estimator is not generally consistent under this sampling design. We propose a conditional HT estimator and prove its consistency under a nonstandard assumption on the first-order inclusion probabilities. Since this assumption seems difficult to control in practice, we recommend not to use the HV sampling design.
Spatially resolved X-ray study of the mixed morphology SNR G359.1-0.5
Authors: Eppens L K , Albacete Colombo J F , Combi J A , Reynoso E M
Published: February 2022

We present a detailed spatially resolved X-ray study of Chandra observations towards the central region of the supernova remnant (SNR) G359.1-0.5. We removed 168 point-like sources and performed an adaptive smoothing on the entire field-of-view of the Chandra ACIS-I observation. The images obtained show an extended X-ray emission below $4.0\, {\rm keV}$ that partially fills the interior of G359.1-0.5. In order to characterize the X-ray emission, we divide the emitting area into 10 different regions inside the remnant. We identify the presence of at least four emission lines that confirm the thin thermal plasma origin. All spectral regions are well fitted by a recombining plasma model (VRNEI) with an absorbing column density range from 1.5 to $2.1\times 10^{22}\, {\rm cm}^{-2}$, and electron temperatures from 0.14 to $0.19\, {\rm keV}$. We also calculated an average electron density of $0.7\, {\rm cm}^{-3}$, estimated an age of 2.8 × 104 yr for the remnant, which can be lower if the filling factor is considered, and an X-ray luminosity of $1.6 \times 10^{35} \, {\rm erg}\, {\rm s}^{-1}$. Finally, we show that the X-ray emission is morphologically anti-correlated with adjacent CO clouds interacting with the SNR. Our results favour that the recombining plasma inside G359.1-0.5 could be explained via adiabatic cooling.
Strong CO absorption features in massive ETGs
Authors: Eftekhari Elham , La Barbera Francesco , Vazdekis Alexandre , Allende Prieto Carlos , Knowles Adam Thomas
Published: February 2022

Massive Early-Type Galaxies (ETGs) in the local Universe are believed to be the most mature stage of galaxy evolution. Their stellar population content reveals the evolutionary history of these galaxies. However, while state-of-the-art Stellar Population Synthesis (SPS) models provide an accurate description of observed galaxy spectra in the optical range, the modelling in the Near-Infrared (NIR) is still in its infancy. Here, we focus on NIR CO absorption features to show, in a systematic and comprehensive manner, that for massive ETGs, all CO indices, from H through to K band, are significantly stronger than currently predicted by SPS models. We explore and discuss several possible explanations of this ‘CO mismatch’, including the effect of intermediate-age, asymptotic-giant-branch-dominated, stellar populations, high-metallicity populations, non-solar abundance ratios, and the initial mass function. While none of these effects is able to reconcile models and observations, we show that ad hoc ‘empirical’ corrections, taking into account the effect of CO-strong giant stars in the low-temperature regime, provide model predictions that are closer to the observations. Our analysis points to the effect of carbon abundance as the most likely explanation of NIR CO line-strengths, indicating possible routes for improving the SPS models in the NIR.
Estimating the feasibility of 21cm-Lyα synergies using the hydrogen Epoch of Reionization array
Authors: Cox Tyler A , Jacobs Daniel C , Murray Steven G
Published: February 2022

Cross-correlating 21cm and Lyα intensity maps of the Epoch of Reionization promises to be a powerful tool for exploring the properties of the first galaxies. Next-generation intensity mapping experiments such as the Hydrogen Epoch of Reionization Array (HERA) and SPHEREx will individually probe reionization through the power spectra of the 21cm and Lyα lines respectively, but will be limited by bright foregrounds and instrumental systematics. Cross-correlating these measurements could reduce systematics, potentially tightening constraints on the inferred astrophysical parameters. In this study, we present forecasts of cross-correlation taking into account the effects of exact uv-sampling and foreground filtering to estimate the feasibility of HERAxSPHEREx making a detection of the 21cm-Lyα cross-power spectrum. We also project the sensitivity of a cross-power spectrum between HERA and the proposed next-generation Cosmic Dawn Intensity Mapper. By isolating the sources of uncertainty, we explore the impacts of experimental limitations such as foreground filtering and Lyα thermal noise uncertainty have on making a detection of the cross-power spectrum. We then implement this strategy in a simulation of the cross-power spectrum and observational error to identify redshifts where fiducial 21cmFAST models predict the highest signal-to-noise detection (z ∼ 8). We conclude that detection of the SPHEREx-HERA cross-correlation will require an optimistic level of 21cm foreground filtering, as well as deeper thermal noise integrations due to a lack of overlapping sensitive modes but for CDIM with its larger range of scales and lower noise forecast detection levels, may be possible even with stricter 21cm foreground filtering.
Conditions for detecting lensed Population III galaxies in blind surveys with the James Webb Space Telescope, the Roman Space Telescope, and Euclid
Authors: Vikaeus Anton , Zackrisson Erik , Schaerer Daniel , Visbal Eli , Fransson Emma , Malhotra Sangeeta , Rhoads James , Sahlén Martin
Published: February 2022

Dark matter haloes that reach the H i-cooling mass without prior star formation or external metal pollution represent potential sites for the formation of small – extremely faint – Population III galaxies at high redshifts. Gravitational lensing may in rare cases boost their fluxes to detectable levels, but to find even a small number of such objects in randomly selected regions of the sky requires very large areas to be surveyed. Because of this, a small, wide-field telescope can in principle offer better detection prospects than a large telescope with a smaller field of view. Here, we derive the minimum comoving number density required to allow gravitational lensing to lift such objects at redshift z = 5−16 above the detection thresholds of blind surveys carried out with the James Webb space telescope (JWST), the Roman space telescope (RST) and Euclid. We find that the prospects for photometric detections of Pop III galaxies are promising, and that they are better for RST than for JWST and Euclid. However, the Pop III galaxies favoured by current simulations have number densities too low to allow spectroscopic detections based on the strength of the He ii1640 emission line in any of the considered surveys unless very high star formation efficiencies (ϵ ≳ 0.1) are evoked. We argue that targeting individual cluster lenses instead of the wide-field surveys considered in this paper results in better spectroscopic detection prospects, while for photometric detection, the wide-field surveys perform considerably better.
Hunting extreme BL Lacertae blazars with Fermi-Large Area Telescope
Authors: Nievas Rosillo M , Domínguez A , Chiaro G , La Mura G , Brill A , Paliya V S
Published: February 2022

The emission of very-high-energy (VHE) photons ($E\ \gt\ 100\ \mathrm{GeV}$) in blazars is closely connected to the production of ultra-relativistic particles and the role of these γ-ray sources as cosmic particle accelerators. This work focuses on a selection of 22 γ-ray objects from the 2BIGB catalogue of high-synchrotron-peaked sources, which are classified as blazar candidates of uncertain type in the 4FGL-DR2 catalogue. We study these sources by means of a re-analysis of the first 10 yr of γ-ray data taken with the Fermi-Large Area Telescope, including the attenuation by the extragalactic background light. Their broad-band spectral energy distributions are also evaluated, using multiwavelength archival data in the radio, optical, and X-ray bands, in terms of one-zone synchrotron-self-Compton models, adding an external Compton component when needed. Out of this analysis, we identify 17 new extreme high-synchrotron-peaked (EHSP) candidates and compare their physical parameters with those of prototypical EHSP blazars. Finally, the resulting models are used to assess their detectability by the present and future generation of ground-based Imaging Atmospheric Cherenkov Telescopes. We find two VHE candidates within the reach of the current and next generation of Cherenkov telescopes: J0847.0−2336 and J1714.0−2029.
Revealing dual radio sources in a sub-kpc-scale binary active galactic nucleus candidate
Authors: Brooks J E , Argo M K , Cho Hojin , Woo Jong-Hak , Jung Taehyun , Wrigley N
Published: February 2022

We present new imaging of a sub-kpc-scale binary active galactic nucleus (AGN) candidate from the Karl G. Jansky Very Large Array (VLA) and the Multi-Element Radio Linked Interferometer Network (e-MERLIN). Two unresolved radio sources of similar luminosity around 1022 WHz−1 are identified in ∼35 h of e-MERLIN 6 cm imaging. These radio sources have an angular separation of 0.19 ± 0.06 arcsec and position angle (PA) of 22° ± 10°, corresponding to a projected separation of 0.95 ± 0.29 kpc at the epoch of the source. Our results suggest the presence of a kpc-scale active black hole pair hosted by two galaxies in the late stage of a merger at z  = 0.35. This work follows Woo et al., which presented two optical sources with a similar separation and PA, and a velocity separation of 200 km s−1. Our target adds to the currently limited sample of close-separation binary AGNs, which will aid in understanding the frequency of mergers and the stochastic gravitational wave background.
Prevalence and Predictors of Waterpipe Smoking Initiation and Progression Among Adolescents and Young Adults in Waves 1–4 (2013–2018) of the Population Assessment of Tobacco and Health (PATH) Study
Authors: Gautam Prem , Sharma Eva , Kalan Mohammad Ebrahimi , Li Wei , Ward Kenneth D , Sutherland Matthew T , Cano Miguel Angel , Li Tan , Maziak Wasim
Published: February 2022

Introduction

Waterpipe tobacco (WPT) smoking has increased among the young population in the United States. This study assessed the extent and predictors of WPT smoking initiation and progression among US adolescents (12–17 years) and young adults (18–24 years) longitudinally.

Aims and Methods

We analyzed data from 4 waves (2013–2018) of the Population Assessment of Tobacco and Health (PATH) study comprising 10 692 respondents (adolescents = 5428 and young adults = 5264). Kaplan–Meier survival method estimated probabilities of WPT initiation and progression. Cox proportional hazards regression models delineated predictors of the outcomes.

Results

Between 2013 and 2018, 4.8% of adolescents initiated and 10.6% progressed WPT smoking. Among young adults, 18.5% initiated and 14.1% progressed WPT smoking during the same time interval. Predictors among adolescents included, WPT initiation: Hispanic ethnicity (adjusted odds ratio (aHR) = 1.75, 95% confidence interval (CI) = 1.23–2.49), lower harm perception (aHR = 2.89, 95% CI = 2.10–3.98), and other tobacco products use (aHR = 3.97, 95% CI = 2.73–5.78); WPT progression: illicit drug use (aHR = 4.60, 95% CI = 1.99–10.67). Predictors among young adults included, WPT initiation: non-Hispanic Black (aHR = 2.31, 95% CI = 1.78–3.00), Hispanic (aHR = 1.77, 95% CI = 1.34–2.33), lower harm perception (aHR = 2.77, 95% CI = 2.19–3.50), and other tobacco products use (aHR = 3.14, 95% CI = 2.25–4.38); WPT progression: non-Hispanic Black (aHR = 1.51 95% CI = 1.09–2.10), lower harm perception (aHR = 1.80, 95% CI = 1.41–2.30), and alcohol use (aHR = 1.61, 95% CI = 1.13–2.30).

Conclusions

Results indicate a high prevalence of WPT initiation and progression among adolescents and young adults over time, with minority racial/ethnic groups being at greater risk for both. WPT-specific risk communication interventions (eg, educational campaigns and health warning labels) are warranted to limit WPT smoking among young people.
Functional Differentiation among the Arabidopsis Phosphatidylinositol 4-Phosphate 5-Kinase Genes PIP5K1, PIP5K2 and PIP5K3
Authors: Watari Machiko , Kato Mariko , Blanc-Mathieu Romain , Tsuge Tomohiko , Ogata Hiroyuki , Aoyama Takashi
Published: February 2022

Phosphatidylinositol 4-phosphate 5-kinase (PIP5K) is involved in regulating various cellular processes through the signaling function of its product, phosphatidylinositol (4,5)-bisphosphate. Higher plants encode a large number of PIP5Ks forming distinct clades in their molecular phylogenetic tree. Although biological functions of PIP5K genes have been analyzed intensively in Arabidopsis thaliana, it remains unclear how those functions differ across clades of paralogs. We performed comparative functional analysis of the Arabidopsis genes encoding PIP5K1, PIP5K2 and PIP5K3, of which the first two and the last belong to closely related but distinct clades, to clarify their conserved and/or differentiated functions. Genetic analysis with their single and multiple mutants revealed that PIP5K1 and PIP5K3 have non-overlapping functions, with the former in total plant growth and the latter in root hair elongation, whereas PIP5K2 redundantly functions in both phenomena. This pattern of functional redundancy is explainable in terms of the overlapping pattern of their promoter activities. In transformation rescue experiments, PIP5K3 promoter-directed PIP5K1-YFP completely rescued the short-root-hair phenotype of pip5k3. However, PIP5K3-YFP could substitute for PIP5K1-YFP only partially in rescuing the severe dwarfism of pip5k1pip5k2 when directed by the PIP5K1 promoter. Phylogenetic analysis of angiosperm PIP5Ks revealed that PIP5K3 orthologs have a faster rate of diversification in their amino-acid sequences compared with PIP5K1/2 orthologs after they arose through a eudicot-specific duplication event. These findings suggest that PIP5K3 specialized to promote root hair elongation and lost some of the protein-encoded functions retained by PIP5K1 and PIP5K2, whereas PIP5K1 differentiated from PIP5K2 only in its promoter-directed expression pattern.
The G Protein-Coupled Receptor Latrophilin-2, A Marker for Heart Development, Induces Myocardial Repair After Infarction
Authors: Lee Choon-Soo , Cho Hyun-Jai , Lee Jin-Woo , Son Hyun Ju , Lee Jaewon , Kang Minjun , Kim Hyo-Soo
Published: February 2022

Discovering cell–surface markers based on a comprehensive understanding of development is utilized to isolate a particular cell type with high purity for therapeutic purposes. Given that latrophilin-2 (Lphn2) substantially contributes to cardiac differentiation, we examined whether Lphn2 regulates functional significance in heart development and repair. We performed whole-mount immunostaining followed by clearing technique of embryo, RNA sequencing related to Lphn2-knockout (KO) embryo, and in vivo functional analyses of Lphn2+ cells using echocardiography. After immunostaining the cleared embryo sample, Lphn2 was exclusively observed in cardiac cells expressing α-sarcomeric actinin at embryonic days E9.5 and E10.5. Homozygous Lphn2-KO mice were embryonically lethal and showed underdevelopment of the ventricular myocardium. However, Lphn2 was not required to develop vessels, including endothelial cells and smooth muscle cells. For the purpose of cardiac regeneration, we transplanted pluripotent stem cell (PSC)–derived Lphn2+ cells into the infarcted heart. PSC–derived Lphn2+ cells differentiated into cardiomyocytes and regenerated the myocardium when transplanted into the infarcted heart, unlike Lphn2− cells. Transplanted Lphn2+ cells improved left-ventricle systolic function and reduced infarct size. We demonstrated that Lphn2 exhibits potential as a cardiomyogenic marker to facilitate targeted stem cell therapy for heart repair in clinical practice.
Intraoperative Hypotension and Acute Kidney Injury, Stroke, and Mortality during and outside Cardiopulmonary Bypass: A Retrospective Observational Cohort Study
Authors: de la Hoz Miguel Armengol , Rangasamy Valluvan , Bastos Andres Brenes , Xu Xinling , Novack Victor , Saugel Bernd , Subramaniam Balachundhar
Published: February 2022

Background

In cardiac surgery, the association between hypotension during specific intraoperative phases or vasopressor-inotropes with adverse outcomes remains unclear. This study’s hypothesis was that intraoperative hypotension duration throughout the surgery or when separated into hypotension during and outside cardiopulmonary bypass may be associated with postoperative major adverse events.

Methods

This retrospective observational cohort study included data for adults who had cardiac surgery between 2008 and 2016 in a tertiary hospital. Intraoperative hypotension was defined as mean arterial pressure of less than 65 mmHg. The total duration of hypotension was divided into three categories based on the fraction of overall hypotension duration that occurred during cardiopulmonary bypass (more than 80%, 80 to 60%, and less than 60%). The primary outcome was a composite of stroke, acute kidney injury, or mortality during the index hospitalization. The association with the composite outcome was evaluated for duration of hypotension during the entire surgery, outside cardiopulmonary bypass, and during cardiopulmonary bypass and the fraction of hypotension during cardiopulmonary bypass adjusting for vasopressor-inotrope dose, milrinone dose, patient, and surgical factors.

Results

The composite outcome occurred in 256 (5.1%) of 4,984 included patient records; 66 (1.3%) patients suffered stroke, 125 (2.5%) had acute kidney injury, and 109 (2.2%) died. The primary outcome was associated with total duration of hypotension (adjusted odds ratio, 1.05; 95% CI, 1.02 to 1.08; P = 0.032), hypotension outside cardiopulmonary bypass (adjusted odds ratio, 1.06; 95% CI, 1.03 to 1.10; P = 0.001) per 10-min exposure to mean arterial pressure of less than 65 mmHg, and fraction of hypotension duration during cardiopulmonary bypass of less than 60% (reference greater than 80%; adjusted odds ratio, 1.67; 95% CI, 1.10 to 2.60; P = 0.019) but not with each 10-min period hypotension during cardiopulmonary bypass (adjusted odds ratio, 1.04; 95% CI, 0.99 to 1.09; P = 0.118), fraction of hypotension during cardiopulmonary bypass of 60 to 80% (adjusted odds ratio, 1.45; 95% CI, 0.97 to 2.23; P = 0.082), or total vasopressor-inotrope dose (adjusted odds ratio, 1.00; 95% CI, 1.00 to 1.00; P = 0.247).

Conclusions

This study confirms previous single-center findings that intraoperative hypotension throughout cardiac surgery is associated with an increased risk of acute kidney injury, mortality, or stroke.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
Ketamine Psychedelic and Antinociceptive Effects Are Connected
Authors: Olofsen Erik , Kamp Jasper , Henthorn Thomas K. , van Velzen Monique , Niesters Marieke , Sarton Elise , Dahan Albert
Published: February 2022

Background

Ketamine produces potent analgesia combined with psychedelic effects. It has been suggested that these two effects are associated and possibly that analgesia is generated by ketamine-induced dissociation. The authors performed a post hoc analysis of previously published data to quantify the pharmacodynamic properties of ketamine-induced antinociception and psychedelic symptoms. The hypothesis was that ketamine pharmacodynamics (i.e., concentration–effect relationship as well as effect onset and offset times) are not different for these two endpoints.

Methods

Seventeen healthy male volunteers received escalating doses of S- and racemic ketamine on separate occasions. Before, during, and after ketamine infusion, changes in external perception were measured together with pain pressure threshold. A population pharmacokinetic–pharmacodynamic analysis was performed that took S- and R-ketamine and S- and R-norketamine plasma concentrations into account.

Results

The pharmacodynamics of S-ketamine did not differ for antinociception and external perception with potency parameter (median [95% CI]) C50, 0.51 (0.38 to 0.66) nmol/ml; blood-effect site equilibration half-life, 8.3 [5.1 to 13.0] min), irrespective of administration form (racemic ketamine or S-ketamine). R-ketamine did not contribute to either endpoint. For both endpoints, S-norketamine had a small antagonistic effect.

Conclusions

The authors conclude that their data support an association or connectivity between ketamine analgesia and dissociation. Given the intricacies of the study related to the pain model, measurement of dissociation, and complex modeling of the combination of ketamine and norketamine, it is the opinion of the authors that further studies are needed to detect functional connectivity between brain areas that produce the different ketamine effects.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
Hospital Variation in Management and Outcomes of Acute Respiratory Distress Syndrome Due to COVID-19
Authors: Johnson Shelsey W. , Garcia Michael A. , Sisson Emily K. Q. , Sheldrick Christopher R. , Kumar Vishakha K. , Boman Karen , Bolesta Scott , Bansal Vikas , Lal Amos , Domecq J. P. , Melamed Roman R. , Christie Amy B. , Husain Abdurrahman , Yus Santiago , Gajic Ognjen , Kashyap Rahul , Walkey Allan J. ,   from the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group
Published: February 2022

OBJECTIVES:

To describe hospital variation in use of “guideline-based care” for acute respiratory distress syndrome (ARDS) due to COVID-19.

DESIGN:

Retrospective, observational study.

SETTING:

The Society of Critical Care Medicine’s Discovery Viral Infection and RESPIRATORY ILLNESS UNIVERSAL STUDY COVID-19 REGISTRY.

PATIENTS:

Adult patients with ARDS due to COVID-19 between February 15, 2020, and April 12, 2021.

INTERVENTIONS:

Hospital-level use of “guideline-based care” for ARDS including low-tidal-volume ventilation, plateau pressure less than 30 cm H2O, and prone ventilation for a Pao
2/Fio
2 ratio less than 100.

MEASUREMENTS AND MAIN RESULTS:

Among 1,495 adults with COVID-19 ARDS receiving care across 42 hospitals, 50.4% ever received care consistent with ARDS clinical practice guidelines. After adjusting for patient demographics and severity of illness, hospital characteristics, and pandemic timing, hospital of admission contributed to 14% of the risk-adjusted variation in “guideline-based care.” A patient treated at a randomly selected hospital with higher use of guideline-based care had a median odds ratio of 2.0 (95% CI, 1.1–3.4) for receipt of “guideline-based care” compared with a patient receiving treatment at a randomly selected hospital with low use of recommended therapies. Median-adjusted inhospital mortality was 53% (interquartile range, 47–62%), with a nonsignificantly decreased risk of mortality for patients admitted to hospitals in the highest use “guideline-based care” quartile (49%) compared with the lowest use quartile (60%) (odds ratio, 0.7; 95% CI, 0.3–1.9; p = 0.49).

CONCLUSIONS:

During the first year of the COVID-19 pandemic, only half of patients received “guideline-based care” for ARDS management, with wide practice variation across hospitals. Strategies that improve adherence to recommended ARDS management strategies are needed.
The Value of Nutrition Support Pharmacist Interventions
Authors: Salman Genene , Boullata Joseph I.
Published: February 2022

The PHarmacist Avoidance or Reductions in Medical Costs in CRITically Ill Adults: PHARM-CRIT Study by Rech et al demonstrated the value of critical care pharmacists’ interventions. The services provided by nutrition support pharmacists were briefly mentioned. This article aims to highlight the value of interventions provided by nutrition support pharmacists.
Simultaneous Immune Attack to Multiple Roots and the Spinal Cord
Authors: Chroni Elisabeth , Veltsista Dimitra , Zampakis Petros
Published: February 2022

A patient with concurrent occurrence of polyradiculopathy and myelopathy is presented. Diagnostic investigation and clinical outcome supported the diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy variant.
What Is in the Literature
Authors: Bromberg Mark B.
Published: February 2022

This issue of What Is in the Literature focuses on articles on amyotrophic lateral sclerosis over the past year. Amyotrophic lateral sclerosis remains a challenging disorder with progression to death. Within the past year, a phase 2 trial of a drug combination showed slowing in the rate of progression. While awaiting a phase 3 trial or approval by the Food and Drug Administration, selected articles that aid the diagnosis, contribute to care, or add to general knowledge about the disease are reviewed.
Iridodialysis Repair With Intrascleral Fixation of Flattened Flanged Polypropylene Suture
Authors: Ucar Fikret
Published: February 2022

Purpose:

To present the flattened flanged polypropylene suture technique developed to obtain round and stable pupils in patients with iridodialysis.

Methods:

After performing a fornix-based conjunctival peritomy, a flange was created at the tip of a 6.0 polypropylene suture by cautery. In the quadrant of iridodialysis, an ultrathin 30-gauge needle was inserted into the sclera at a distance of 2 mm from the limbus and advanced 1.5 mm intrasclerally, parallel to the limbus. The needle was directed radially into the eye and easily passed through the edge of the peripheral iris. The polypropylene suture was pushed into the lumen of the needle with the help of forceps. After the needle was externalized, the tip of the suture was flanged by cautery, and the flange was immediately flattened using a needle holder.

Results:

Six eyes of six patients with iridodialysis were enrolled in this study. Postoperatively, the irises remained well positioned and the pupils became round in all eyes. None of the patients developed suture erosion, suture loosening or rupture, hyphema, hypotony, chronic iridocyclitis, and angle closure.

Conclusion:

The present technique provides a minimally invasive surgery and robust iris fixation without the need to create a scleral flap, groove, or pocket.
PARACENTRAL ACUTE MIDDLE MACULOPATHY AND OCULAR ISCHEMIC SYNDROME AFTER INTRANASAL STEROID INJECTION: A CASE REPORT AND REVIEW OF THE LITERATURE
Authors: Weinstein Jessica E. , Greven Margaret A.
Published: February 2022

Purpose:

To describe a case of paracentral acute middle maculopathy and ocular ischemic syndrome after intranasal steroid injection.

Methods:

Case report.

Results:

Following an intranasal steroid injection, the patient experienced an episode of amaurosis fugax in her right eye lasting several minutes. Afterward, her visual acuity returned to baseline, but she noted a persistent central scotoma. Optical coherence tomography demonstrated paracentral acute middle maculopathy and fluorescein angiography showed staining and leakage to peripheral vessels concerning for diffuse ischemia.

Conclusion:

Steroid injections to the face and nasopharynx may result in ischemic and vaso-occlusive events in the retina. Ophthalmologists and other physicians performing these procedures need to be aware of this potential adverse outcome.
Glasses-Assisted 3D Display System–Guided Descemet Membrane Endothelial Keratoplasty Tissue Preparation
Authors: Borroni Davide , Rocha-de-Lossada Carlos , Bonci Paola , Rechichi Miguel , Rodríguez-Calvo-de-Mora Marina , Rachwani-Anil Rahul , Sánchez González Jose’ Maria , Urbinati Facundo , Lorente María García , Vigo Luca , Carones Francesco
Published: February 2022

Purpose:

The aim of this study was to evaluate the feasibility of Descemet membrane endothelial keratoplasty (DMEK) tissue preparation using a glasses-assisted 3-dimensional (3D) display system and to compare it with a conventional surgical microscope.

Methods:

Healthy pairs of human corneas suitable for penetrating keratoplasty surgery were selected for this study. The tissues were randomly divided into 2 groups. Each pair of corneas had 1 cornea (group 1) prepared with NGENUITY (Alcon) with a 5-second staining time with vision blue, and the fellow cornea (group 2) was prepared using a OPMI Lumera 700 surgical microscope (Carl Zeiss Meditec, Jena, Germany) with a 30-second staining time. DMEK graft preparation time, speed of stripping, graft width, and endothelial cell loss were evaluated.

Results:

Twenty-eight pairs of corneas were included in this study. The graft preparation time was significantly higher in the 3D group than in the conventional group (498 ± 147 vs. 418 ± 85 seconds, P value = 0.031). The mean speed of stripping was 0.59 ± 0.081 mm/s in group 1 and 0.089 ± 0.005 mm/s in group 2 (P value = 0.024). The mean endothelial cell density in group 1 and group 2 before tissue preparation was 2162 ± 115.21 and 2153 ± 122.45, respectively (P value > 0.1). After tissue preparation, the endothelial cell density reduced to 1911 ± 150.72 in group 1 and 1998 ± 90.72 in group 2 (P value = P value > 0.05). The graft width was 5.05 ± 0.71 mm in group 1 and 4.92 ± 0.23 mm in group 2 (P value > 0.05).

Conclusions:

DMEK tissue preparation with 3D display system NGENUITY is feasible with a slightly increased preparation time. The improved visualization allows a reduced staining time that could be beneficial for eye banks because it may reduce the toxic effect of staining colorants.
Severe Recurrent Bacterial Pneumonia Among Children Living With HIV
Authors: Boettiger David C. , An Vu Thien , Lumbiganon Pagakrong , Wittawatmongkol Orasri , Huu Truong Khanh , Chau Do Viet , Van Nguyen Lam , Sun Ly Penh , Kinikar Aarti , Ounchanum Pradthana , Puthanakit Thanyawee , Kurniati Nia , Kumarasamy Nagalingeswaran , Kumara Wati Dewi , Chokephaibulkit Kulkanya , Jamal Mohamed Thahira A. , Sudjaritruk Tavitiya , Nik Yusoff Nik Khairulddin , Siew Fong Moy , Nallusamy Revathy A. , Kariminia Azar ,   on behalf of the TREAT Asia Pediatric HIV Observational Database
Published: February 2022

Background:

Bacterial pneumonia imparts a major morbidity and mortality burden on children living with HIV, yet effective prevention and treatment options are underutilized. We explored clinical factors associated with severe recurrent bacterial pneumonia among children living with HIV.

Methods:

Children enrolled in the TREAT Asia Pediatric HIV Observational Database were included if they started antiretroviral therapy (ART) on or after January 1st, 2008. Factors associated with severe recurrent bacterial pneumonia were assessed using competing-risk regression.

Results:

A total of 3,944 children were included in the analysis; 136 cases of severe recurrent bacterial pneumonia were reported at a rate of 6.5 [95% confidence interval (CI): 5.5–7.7] events per 1,000 patient-years. Clinical factors associated with severe recurrent bacterial pneumonia were younger age [adjusted subdistribution hazard ratio (aHR): 4.4 for <5 years versus ≥10 years, 95% CI: 2.2–8.4, P < 0.001], lower weight-for-age z-score (aHR: 1.5 for <−3.0 versus >−2.0, 95% CI: 1.1–2.3, P = 0.024), pre-ART diagnosis of severe recurrent bacterial pneumonia (aHR: 4.0 versus no pre-ART diagnosis, 95% CI: 2.7−5.8, P < 0.001), past diagnosis of symptomatic lymphoid interstitial pneumonitis or chronic HIV-associated lung disease, including bronchiectasis (aHR: 4.8 versus no past diagnosis, 95% CI: 2.8−8.4, P < 0.001), low CD4% (aHR: 3.5 for <10% versus ≥25%, 95% CI: 1.9−6.4, P < 0.001) and detectable HIV viral load (aHR: 2.6 versus undetectable, 95% CI: 1.2−5.9, P = 0.018).

Conclusions:

Children <10-years-old and those with low weight-for-age, a history of respiratory illness, low CD4% or poorly controlled HIV are likely to gain the greatest benefit from targeted prevention and treatment programs to reduce the burden of bacterial pneumonia in children living with HIV.
Pediatric Emergency Department Testing for Gonorrhea and Chlamydia in Children
Authors: Kazmir Sundes , Pierce Mary Clyde , Simonton Kirsten , Rodean Jonathan , Neuman Mark I. , Simon Norma-Jean E. , Alpern Elizabeth R.
Published: February 2022

Objective

This study aimed to describe trends in the utilization of nucleic acid amplification (NAAT) testing for gonorrhea and chlamydia in US pediatric emergency departments. Nucleic acid amplification has been recommended over genital culture by the American Academy of Pediatrics and Centers for Disease Control and Prevention for children evaluated for sexual abuse.

Methods

We conducted a multicenter study of children aged 12 months to 11 years tested for gonorrhea and chlamydia between 2004 and 2018 at 22 hospitals in the Pediatric Health Information System. We included patients diagnosed with maltreatment concerns and/or genitourinary (GU) symptoms. The primary outcome was prevalence of testing with NAAT, culture, or both. We analyzed groups based on patient sex, as well as diagnoses of maltreatment versus GU symptoms.

Results

A total of 36,312 visits were analyzed. Visits were 73.4% girls and 26.6% boys. During the study period, there was an increase in use of NAAT-only testing for girls (49.3% to 94.3%; P < 0.001) and boys (54.5% to 96.1%; P < 0.001). There was a decrease in use of culture alone for girls (40% to 1.6%; P < 0.001) and boys (38.7% to 0.8%; P < 0.001). Use of both tests in the same encounter was higher among children diagnosed with maltreatment than GU symptoms, regardless of sex (P < 0.001).

Conclusions

Over a 14-year period, downtrend of culture use with increase in NAAT was observed, suggesting general adherence to evidence-based guidelines. Almost 10% of children diagnosed with maltreatment continued to be tested with culture. This could indicate provider concerns regarding test accuracy, legal admissibility, or lack of test availability.
Multiple Continuous Y-to-V–Plasties for Excision and Reconstruction of Constriction Band Syndrome: Case Series and Description of Surgical Technique
Authors: Chan Andrea H. W. , Zeitlinger Lauren , Little Kevin J.
Published: February 2022

Background:

Many patients with constriction band syndrome will seek treatment to improve limb function and cosmesis. Although several techniques for excision are reported, cosmetic and functional deficits can persist, including hourglass deformity, lymphedema, and inadequate band excision with resultant neurovascular compromise, which may lead to revision surgery, including amputation. The authors present a novel technique that uses multiple continuous opposing Y-to-V–plasties in a single or staged manner to correct extremity constriction bands.

Methods:

Seven patients with 10 involved extremities were included in this retrospective case series. Patient demographics, associated abnormalities, and operative indications were collected from medical records. The primary outcome measures were primary wound healing and release of the constriction band. Secondary outcomes measures were perioperative complications and the need for revision surgery.

Results:

All patients achieved primary closure with excellent healing in one or two stages. No infections or scar complications occurred, and no revision surgery of the band was required. One patient had mild indentation of scar tissue after their second stage, which improved with scar massage. One patient who had preoperative sciatic compression neuropathy and an insensate foot secondary to band constriction developed chronic calcaneal osteomyelitis requiring a subsequent Syme amputation. Postoperative lymphedema occurred in two patients, which resolved with the use of compression bandages over several weeks.

Conclusion:

Use of multiple continuous opposing Y-to-V–plasties is a safe and effective technique for adequate constriction band excision without residual hourglass deformity and good functional outcomes for patients with partial or circumferential constriction bands.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Comparison of HIV-Infected and Noninfected Patients Undergoing Bariatric Surgery: The ObeVIH Study
Authors: Pourcher V. , Capeau J. , Dudoit Y. , Boccara F. , Soulié C. , Ndoadoumgue A.L. , Charlotte F. , Fellahi S. , Bastard J. P. , Béréziat V. , Lagathu C. , Marcelin A. G. , Peytavin G. , Boutron-Ruault M. C. , Tubbax C. , D'Avout D'Auerstaedt A. , Valantin M. A. , Schneider L. , Costagliola D. , Katlama C. , Assoumou L. , Pourcher G.
Published: February 2022

Objective:

The aim of this study was to compare clinical characteristics and adipose/liver tissue histology analysis in HIV-infected and HIV-uninfected subjects undergoing bariatric surgery.

Design:

This was a cross-sectional study of HIV-infected subjects undergoing single-port sleeve gastrectomy with prospective enrolment and frequency age (±5 years), sex, and body mass index (BMI, ± 5 kg/m2) matched on HIV-uninfected subjects.

Methods:

This study was conducted at a single clinical site at Pitié-Salpêtrière hospital-Paris-France comprising 19 HIV-uninfected and 21 HIV-infected subjects with plasma VL < 20 copies/mL, all with a BMI > 40 kg/m2 or >35 kg/m2 with comorbidities. Histology of subcutaneous and visceral abdominal adipose tissue (SCAT/VAT) and liver biopsies was collected during single-port sleeve gastrectomy. Outcomes included anthropometric characteristics, comorbidities, cardiovascular parameters, adipose tissue, and liver histology.

Results:

The age of HIV-infected participants was (median, interquartile range IQR) 48 y (42–51), with 76.2% females, a BMI of 41.4 kg/m2 (37.3–44.4), an antiretroviral duration of 16 y (8–21), current integrase strand transfer inhibitor (INSTI)-based regimen in 15 participants and non-INSTI regimen in 6 participants, and a CD4 count of 864/mm3 (560–1066). The age of controls was 43 y (37–51), with 78.9% females and a BMI of 39.2 kg/m2 (36.3–42.6). Anthropometric characteristics, comorbidities, and cardiovascular parameters did not differ according to HIV status and INSTI treatment. The number of macrophage crown-like structures in SCAT was lower in INSTI-treated participants than in HIV-uninfected participants (P = 0.02) and non–INSTI-treated HIV-infected subjects (P = 0.07). Hepatic steatosis and liver disease severity global score were lower in INSTI-treated participants than in non–INSTI-treated HIV-infected participants (P = 0.05 and P = 0.04, respectively).

Conclusions:

HIV-infected and HIV-uninfected subjects undergoing bariatric surgery presented a similar profile regarding anthropometric measures, cardiovascular parameters, and comorbidities. However, INSTI-treated participants presented milder SCAT and liver alterations than non–INSTI-treated participants.
Diabetes mellitus self-management education at Jimma University Medical Center: evidence-based implementation project
Authors: Berhanu Hiwot , Feyissa Garumma Tolu , Geleta Daniel , Sudhakar Morankar
Published: February 2022

Background:

Low and middle-income countries are currently enduring the heaviest global burden of diabetes and diabetes-related mortalities. Diabetes self-management education (DSME) improves patient clinical outcomes, health status, and quality of life. Lack of awareness about best practice guidelines and recommendations may be associated with increased risk of diabetes morbidity and mortality.

Objectives:

The objective of this study was to improve knowledge and skill of healthcare providers and patients with diabetes by enhancing evidence-based practice through self-management education to increase compliance with best practice recommendations.

Methods:

JBI's three-phase Practical Application of Clinical Evidence System and Getting Research into Practice audit criteria of diabetes of audit management criteria were used. To understand barriers, 12 audit criteria, patient's medical record handling and educational plan according to set standards were evaluated. To mitigate the barriers, strategies of training and supportive supervision on evidence-based DSME were implemented from 20 April 2018 to 7 June 2018. Sixteen health professionals and 80 patients with diabetes participated in the study conducted in Jimma University Medical Center. Both a baseline and follow-up audit was conducted using the JBI feedback tool.

Result:

The baseline audit results indicate that 3 of the 12 audit criteria recorded zero percent compliance, whereas other compliances were below 40%, representing poor compliance with the current evidence. The post implementation audit reported 100% compliance for criteria on availability of structured education plan, existence of appropriate training for staff, the presence of education regarding nutrition and medications, while for the remaining criteria on competency of staff members for delivering DSME, assessment of prior diabetes knowledge, status of documentation after each session, and the presence of appropriate referrals or booking the compliance rate was improved to 88%. Similarly, criteria on the presence of individualized education plan improved (0–75%), encountering knowledge regarding physical activity (6–75%), self-monitoring of blood glucose (4–60%), and prevention diabetes complications (10–90%).

Conclusion:

There were remarkable changes in both patients and care providers on comparison of pre-intervention and post-intervention, particularly in availability of materials, involvement of staff in self-management education, nutrition, and medication.