bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical presentation and treatment outcomes of Renal Medullary Angiitis in ANCA associated vasculitis: A single-center case series.s
Authors: Kirby Grant , Salas Antonio , Alabdulsalam Abdulrahman K. , Dasgupta Alana , Geetha Duvuru
Published: July 2024

Introduction:
Antineutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) with renal involvement primarily affects the renal cortex and presents with key histopathologic findings of a pauci-immune necrotizing and crescentic glomerulonephritis. Infrequently reported and poorly characterized is renal medullary angiitis (RMA), a pathologic variant of AAV primarily involving the renal medulla. This study seeks to describe the presentation and treatment outcomes of RMA.
Methods:
In this single center cohort, renal pathology samples classified as AAV with renal involvement underwent secondary review to determine if they met histopathologic criteria for renal medullary angiitis (RMA). Demographic, clinical, and laboratory data were obtained via electronic medical record review. Descriptive statistical analysis was performed on key variables.
Results:
Of the 136 kidney biopsy samples classified as ANCA associated vasculitis with renal involvement, histopathologic features of RMA were present in 13 cases. The mean (SD) age at the time of RMA diagnosis was 65 (19) years and 54% were female. Most cases presented with extra-renal manifestations of disease. Initial median (IQR)eGFR and proteinuria on presentation was 16 (10-19) mL/min/1.73m2 and 1100 (687-2437)mg respectively. The primary histologic features were high degrees of interstitial inflammation comprised of leukocytes, neutrophils, plasma cells, and eosinophils along with either interstitial hemorrhage or necrosis. All patients were treated with glucocorticoids in combination with either cyclophosphamide, rituximab or mycophenolate. All patients achieved disease remission. During a median (IQR) follow up of 42 (14-68) months, one patient reached ESKD and one patient died.
Conclusions:
In this single center case series, we identified the presence of RMA in 9.5% of AAV samples that underwent secondary review. RMA presented with severe impairment in renal function and multi-system disease. Standard of care immunosuppression for AAV was effective for remission induction in RMA. It remains unclear whether standard prognostication tools are useful in this population.
Endobronchial Valves in Treatment of Persistent Air Leak: European Case-Series Study and Best Practice Recommendations – From an Expert Panel
Authors: Smesseim Illaa , Morin-Thibault Louis-Vincent , Herth Felix J.F. , Tonkin James , Shah Pallav L. , Slebos Dirk-Jan , Koster David T. , Dickhoff Chris , Daniels Johannes Marlene Andreas , Annema Jouke , Bonta Peter
Published: July 2024

Introduction: Persistent air leak (PAL) is associated with prolonged hospitalization, high morbidity and increased treatment costs. Conservative treatment consists of observation, chest tube drainage, and pleurodesis. Guidelines recommend surgical evaluation if air leak does not respond after 3–5 days. One-way endobronchial valves (EBV) have been proposed as a treatment option for patients with PAL in which surgical treatment is not feasible, high risk or has failed. We aimed to provide a comprehensive overview of reported EBV use for PAL and issue best practice recommendations based on multicenter experience. Methods: We conducted a retrospective observational case-series study at four different European academic hospitals and provided best practice recommendations based on our experience. A systematic literature review was performed to summarize the current knowledge on EBV in PAL. Results: We enrolled 66 patients, male (66.7%), median age 59.5 years. The most common underlying lung disease was chronic obstructive pulmonary disease (39.4%) and lung cancer (33.3%). The median time between pneumothorax and valve placement was 24.5 days (interquartile range: 14.0–54.3). Air leak resolved in 40/66 patients (60.6%) within 30 days after EBV treatment. Concerning safety outcome, no procedure-related mortality was reported and complication rate was low (6.1%). Five patients (7.6%) died in the first 30 days after intervention. Conclusion: EBV placement is a treatment option in patients with PAL. In this multicenter case-series of high-risk patients not eligible for lung surgery, we show that EBV placement resulted in air leak resolution in 6 out of 10 patients with a low complication rate. Considering the minimally invasive nature of EBV to treat PAL as opposed to surgery, further research should investigate if EBV treatment should be expanded in low to intermediate risk PAL patients.
Effectors of the Future: Universal Chimeric Antigen Receptor
Authors: Schlegel Lara Sophie , Schlegel Patrick
Published: July 2024

Background: Cellular therapies leveraging genetically engineered immune effector cells have witnessed a remarkable surge in success, particularly evident in the notable high rates of remission induction and durable remissions observed in a substantial proportion of heavily pretreated patients with refractory B-lineage malignancies. A diverse array of effector cells and therapeutic strategies are now at our disposal, representing the culmination of advancements made over the past 3 decades. The swift pace of development in modern genetic diagnostics, the emergence of spatial proteomics, and the expanding capabilities and precision of computational sciences have profoundly enriched our comprehension of tumor biology and the intricate workings of our immune system. Empowered by advancements in synthetic biology and genome editing, we can expedite the development of next-generation immune effector cells tailored for clinical applications, balancing safety with efficacy. Summary: Universal adapter chimeric antigen receptor (CAR) technologies present the most straightforward solution to tackle antigen heterogeneity and antigen evasion mechanisms employed by tumors. Moreover, due to the decoupling of antigen recognition and signaling in adapter CAR technologies, additional effector functions can safely enhance anticancer activity and most importantly, synergistic combination of patient-specific cellular products with off-the-shelf manufactured antibodies promise increased cost-efficiency. The pivotal collaboration between clinical trial units and regulatory institutions holds the key to surmounting contemporary challenges in trial design, potentially paving the way for the exploration of patient-individualized therapies. Key Messages: In this review, we elaborate on the concept of antibody-dependent cellular cytotoxicity mediated by universal adapter CARs and delineate how recent strides in CAR engineering have the potential to furnish a versatile cellular platform, ushering in an era of cancer-adapted, multitargeted immunotherapies employing universal CAR effector cells.
Development and Validation of a Simple and Multifaceted Instrument, Chronic Constipation-Therapeutic Efficacy and Satisfaction Test, for the Clinical Evaluation of Patients with Chronic Constipation
Authors: Nakada Koji , Nagahara Akihito , Isshi Kimio , Oshima Tadayuki , Futagami Seiji , Tanaka Yoshimasa , Yamaguchi Yoshiharu , Kuribayashi Shiko , Arihiro Seiji , Oshio Atsushi , Manabe Noriaki ,   the CC-TEST Study Group
Published: July 2024

Introduction: This study evaluated the psychometric properties of the newly developed chronic constipation-therapeutic efficacy and satisfaction test (CC-TEST) among patients with chronic constipation. Methods: Japanese patients with moderate or severe chronic constipation underwent a 4-week remedy. The baseline, 2-week, and 4-week assessments included the CC-TEST, Constipation Scoring System (CSS), Medical Outcome Study Short Form-8 Health Survey (SF-8), and Hospital Anxiety and Depression Scale (HADS). The CC-TEST comprises three domains: (1) symptoms; chronic constipation symptom severity (seven items), defecation status (five items), (2) impact for daily life; dissatisfaction with daily life level (DS; four items), and (3) therapeutic response; therapeutic efficacy measured by patients and medication compliance (four items). Results: Of 201 eligible patients at baseline, 110 completed the 4-week treatment and the survey responses. Cronbach’s α values for the stool, defecation, and abdominal symptom subscales, as well as the total symptom score and DS subscale, showed good internal consistency reliability (0.72–0.80). Pearson’s r for comparisons between corresponding items (CC-TEST symptoms with CSS, and CC-TEST DS with SF-8 physical and mental component summary scores) was significant. After 4 weeks, scores for symptoms, defecation status, and DS items/subscales notably decreased, with a significant effect size (p < 0.005, Cohen’s d; 0.30–1.16). Statistically significant differences emerged between treatment responders and nonresponders using the three responder definitions, in changes in scores for most CC-TEST symptoms, defecation status, and DS items/subscales (p < 0.05). Conclusion: CC-TEST demonstrates commendable reliability, convergent and known-group validity, and responsiveness to treatment effects. As a simple, comprehensive, and versatile patient-reported outcome measure, CC-TEST may be well suited for clinical trials and primary care of Japanese patients with chronic constipation.
Long-Term Follow-Up of Eltrombopag Treatment for Patients with Cyclosporin A Refractory/Relapsed Transfusion-Dependent Non-Severe Aplastic Anemia: A Report from a Single Center in China
Authors: Hu Qinglin , Yang Yuan , Yang Chen , Chen Miao , Han Bing
Published: July 2024

Introduction: Aplastic anemia (AA) is characterized by bone marrow failure and cytopenia. Eltrombopag (ELT) is effective and safe for treating refractory/relapsed AA; however, reports on the long-term outcomes of transfusion-dependent non-severe AA (TD-NSAA) are limited. Methods: Patients with TD-NSAA refractory to immunosuppressive therapy (IST) or relapsed after IST, treated with ELT alone, and followed up for at least 12 months were retrospectively enrolled. The baseline characteristics of patients, efficacy and adverse effects of ELT, and relapse and clone evolution rates after ELT were documented. Results: Of the 55 patients with TD-NSAA included, 24 (43.6%) were men. Median age at diagnosis was 46 (19–80) years. Twenty-four patients had relapsed TD-NSAA, and 31 patients had refractory TD-NSAA. During the median follow-up period of 28 (12–48) months, the overall and complete response rates at 3, 6, and 12 months of ELT treatment were 38.2, 60.0, and 52.7 and 9.1, 14.6, and 9.1%, respectively. After a median follow-up of 28 (12–48) months, 21.2% (7/33) of patients experienced relapse, with a median duration from ELT treatment to relapse of 14 (6–45) months. Conclusion: ELT was effective in patients with relapsed/refractory TD-NSAA, with tolerable adverse effects.
Aortoesophageal Fistula Mimicking Dieulafoy Disease: A Case Report
Authors: Pacheco Tatiana , Costa-Moreira Pedro , Monteiro Sara , Pinto Joana , Barros Luísa , Silva Jorge
Published: July 2024

Introduction: Aortoesophageal fistula (AEF) is a rare and potentially fatal cause of upper gastrointestinal bleeding. The classic Chiari’s triad of symptoms and typical endoscopic findings are not present in all patients, making diagnosis challenging. Case Presentation: An 86-year-old man was admitted to the emergency room for melena and hematemesis with hemodynamic instability. He had a previous hospitalization for cardioembolic stroke complicated by hematemesis of unknown etiology after initiation of anticoagulation (which was suspended), being discharged on aspirin. His medical history also included hypertension, diabetes, ischemic heart disease, and prostate cancer. On upper endoscopy, no lesions were found, despite the presence of a large non-mobilizable clot in the gastric fundus. He was admitted to the intensive care unit, and, on the next day, reassessment esophagogastroduodenoscopy was normal. On the eighth day of hospitalization, the patient presented with hemorrhagic shock due to new-onset hematemesis. Upper endoscopy revealed an esophageal 10-mm non-ulcerated mucosal depression with a visible vessel at 20 cm from the incisors, closed with 3 hemoclips. Thoracic CT angiography showed a brachiocephalic trunk aneurysm with aortoesophageal fistulization. He was deemed unsuitable for endovascular or surgical treatment. About 2 months later, the patient was admitted to the emergency room in cardiorespiratory arrest following an episode of hematemesis at home. Discussion: This report highlights the diagnostic and therapeutic complexity of AEF. Endoscopic treatment can be the main therapy in patients without indication for vascular intervention. The purpose was to palliate new bleeding episodes, maintaining a very poor prognosis.
Impact of Chronic Kidney Disease on the Outcomes of Patients Undergoing Percutaneous Left Atrial Appendage Occlusion: Insights from a Large National Database
Authors: Rivera Frederick Berro , Cha Sung Whoy , Antia Akanimo , Pine Polyn Luz S. , Tangco Gabriel A. , Lapid Princess C. , Jariyatamkitti Sathika , Bantayan Nathan Ross B. , Salva Wailea Faye C. , Idian Anne Mira Nicca , Lumbang Grace Nooriza Opay , Layese Charcel Lex , Lerma Edgar V. , Collado Fareed Moses S. , Volgman Annabelle Santos , Kazory Amir
Published: July 2024

Background: Studies exploring the effectiveness and safety of percutaneous left atrial appendage occlusion (pLAAO) in patients with chronic kidney disease (CKD) are limited.
Objectives: We aimed to analyze trends and outcomes following pLAAO in patients with CKD.
Methods: We utilized the National Inpatient Sample (NIS) to identify hospitalizations for pLAAO from 2016-2020 and further identified cases with concomitant CKD. The primary outcome was mortality, and secondary outcomes were cerebrovascular accidents, major bleeding, vasopressor requirements, percutaneous coronary intervention, cardiac arrest, acute respiratory failure, transfusion, length of stay (LOS), and total hospital charges. Multivariable logistic regression was performed to further adjust for covariates.
Results: A total of 89,309 pLAAO procedures from 2016 to 2020 were identified, of which 21,559 (24.1%) reported concomitant CKD, with males comprising the majority (62.2%). An increasing trend in pLAAO procedures was seen from 2.24 to 13.9 per 10,000 patients from 2016 to 2020. Despite patients with CKD having a higher rate of most comorbidities, there was no difference in mortality (non-CKD vs. CKD, 0.07% vs. 0.42%; aOR: 1.3, 95% CI: 0.4 – 4.4, p=0.686) and complications for CKD and non-CKD patients, while CKD patients had longer LOS and higher total hospital charge. No significant sex differences in outcomes among CKD patients were observed except for a longer LOS in females.
Conclusion: Despite generally having more comorbidities, outcomes of patients with CKD following pLAAO are similar to those without CKD, suggesting that pLAAO can be offered as a safe option for the treatment of AF in eligible patients with CKD.
Intestinal mucosal perfusion and integrity are maintained in hypotensive brain dead mice
Authors: Oltean Mihai , Bagge Jasmine , Casselbrant Anna , Lundgren Andreas , da Anunciação Lucas Ferreira , de Miguel Gomez Lucia , Lorant Tomas , Hellström Mats , Olausson Michael
Published: July 2024

Brain death (BD) leads to complex hemodynamic and inflammatory alterations which may compromise organ perfusion and induce morphologic and functional damage in various organs. The intestine is particularly sensitive to hypoperfusion and donor hypotension usually precludes intestinal donation. Previous studies reported inflammatory intestinal changes following BD but information on mucosal integrity and perfusion are lacking. BD was induced in mice by inflating an epidural balloon catheter. Controls underwent only anesthesia and tracheostomy. Intestinal perfusion was assessed using laser Doppler flowmetry (LDF). Intestinal injury was assessed after 2h of BD by the Chiu-Park score and morphometry. Intestinal tight junction (TJ) proteins (claudin-1, claudin-3, occludin, tricellulin) as well as inflammatory activation (intercellular adhesion molecule-1, vascular cell adhesion molecule-1, and interleukin-6) were also analysed and compared with a sham group. Although blood pressure decreased in BD mice, intestinal perfusion remained similar between BD and sham mice. Histologically, mucosal injury was absent/minimal and TJs appeared well maintained in both groups. BD may trigger intrinsic, autoregulatory mechanisms to preserve microvascular tissue perfusion and mucosal integrity in spite of mild hypotension.
Patient Satisfaction, Esthetic Outcome, and Quality of Life in Oncoplastic and Reconstructive Breast Surgery: A Single Center Experience
Authors: Bolliger Michael , Gambone Luca , Haeusler Theresa , Mikula Fanny , Kampf Stephanie , Fitzal Florian
Published: July 2024

Background: Oncoplastic surgery has become an important part of the surgical repertoire to offer both oncologically safe and aesthetically pleasing results in patients with breast cancer. Data comparing oncoplastic and reconstructive breast surgeries are limited. This study aimed to assess patient-reported outcomes (PRO) in our cohort of oncoplastic and reconstructively operated patients. Methods: Patients who underwent oncoplastic surgery, including immediate reconstruction by a single surgeon, between 2010 and 2018 were contacted to participate in this study. In total, 157 patients fulfilled the inclusion criteria. 54 patient data sets were used for statistical evaluation. Body Image Scale (BIS) and BreastQ questionnaires were used to measure subjective PRO scores, and pictures were taken to objectively measure symmetry using the Breast Analyzing Tool (BAT). Patients were divided into three groups according to the Tübingen classification (group 1: Tübingen 3–4 (n = 16), group 2: Tübingen 5 (n = 26), group 3: Breast Reconstruction/Tübingen 6 (n = 12]). Results: The mean age was 53.5 for group 1, 51.4 for group 2 and 46.8 for group 3. The mean follow-up was 62.9 ± 35.82 months. BIS was significantly better in group 3 (3.92 ± 1.73) than in group 1 and 2 (7.69 ± 4.48 and 4.81 ± 3.41, p = 0.016). Symmetry measured using BAT showed only a trend favoring reconstruction (p = 0.12). The BreastQ item “Sexual well-being” was significantly better in oncoplastic breast reduction surgery (p = 0.036). Conclusion: BIS was better after reconstructive breast surgery than after oncoplastic surgery. Reconstructive breast surgery in experienced breast care units offers high patient satisfaction and a high quality of life.
Managing Children and Adolescents with Type 1 Diabetes and Coexisting Celiac Disease: Real-World Data from a Global Survey
Authors: Raicevic Maja , Rosanio Francesco Maria , Dos Santos Tiago Jeronimo , Chobot Agata , Piona Claudia , Cudizio Laura , Alsaffar Hussain , Dumic Katja , Aftab Sommayya , Shaunak Meera , Mozzillo Enza , Vukovic Rade ,   ISPAD JENIOUS and ESPE YES group
Published: July 2024

Introduction: Celiac disease (CD) is among the diseases most commonly associated with type 1 diabetes (T1D). This study aimed to evaluate the worldwide practices and attitudes of physicians involved in pediatric diabetes care regarding diagnosing and managing CD in children with T1D. Methods: The 30-item survey was conducted between July and December 2023 aimed at targeting pediatricians with special interest in T1D and CD. It was shared by the JENIOUS – young investigators group of the International Society of Pediatric and Adolescent Diabetes (ISPAD) – and the YES – early career group of the European Society for Pediatric Endocrinology (ESPE). Results: Overall, 180 physicians (67.8% female) from 25 countries responded. Among respondents, 62.2% expected sustaining optimal glycemic control in children with T1D and CD (T1D + CD) to be more difficult than in children with T1D alone. Majority (81.1%) agreed that more specific guidelines are needed. The follow-up routine for patients with T1D + CD differed, and one-quarter of physicians scheduled more frequent follow-up checkups for these patients. Seventy percent agreed multidisciplinary outpatient clinics for their follow-up is needed. In the multivariate ordinal logistic regression model, a statistically significant predictor of a higher degree of practice according to ISPAD 2022 guidelines was a higher level of country income (OR = 3.34; p < 0.001). Conclusions: These results showed variations in physicians’ practices regarding managing CD in children with T1D, emphasizing the need for more specific guidelines and intensive education of physicians in managing this population, especially in lower-income countries. Our data also suggest the implementation of multidisciplinary outpatient clinics for their follow-up.
The Impact of Drug Interactions on the Results of DAT-SPECT Imaging in a Specialty Movement Disorders Practice: A Retrospective Analysis of Outcomes
Authors: Kang Isabelle Heewon , Bega Danny
Published: July 2024

Introduction: DAT-SPECT imaging is approved as a diagnostic tool for the evaluation of suspected Parkinsonian syndromes, but the FDA-approved package insert lists 16 potential drugs that may interfere with the image obtained. The clinical impact of these drugs on imaging results has not been established. This study aimed to determine the accuracy of DAT-SPECT imaging in assessing presynaptic dopaminergic denervation in the setting of these drugs. Methods: This is a retrospective chart review of patients at a single center who underwent DAT-SPECT imaging while taking “contraindicated” drugs between December 2012 and December 2022. Results: A total of 1,224 charts were screened, and 153 (12.5%) charts met the inclusion criteria. Bupropion (32%, n = 49) and sertraline (26%, n = 40) were the most common contraindicated drugs. The false-positive rate was 9.2%. Conclusion: This retrospective analysis supports the concern that certain drugs may interfere with DAT-SPECT imaging results, leading to potential false positives. This has implications for how clinicians interpret DAT-SPECT imaging in patients taking these medications and whether they should advise patients to stop these medications before a scan is performed.
Performance of Extended Depth of Focus Intraocular Lens in Eyes with Preexisting Retinal Disease
Authors: Reitblat Olga , Velleman David A. , Levy Adi , Assia Ehud I. , Kleinmann Guy
Published: July 2024

Introduction: Extended depth of focus (EDOF) intraocular lens (IOL) offers improved near and intermediate vision, aiming to reduce spectacle dependence in cataract patients. This research aimed to evaluate the performance of EDOF IOL in patients with retinal pathologies following cataract surgery. Methods: The medical charts of thirty-three eyes with retinal pathologies and 100 healthy eyes that underwent cataract extraction with implantation of an EDOF IOL and had at least 3 weeks of postoperative follow-up were retrospectively included. Patients’ overall satisfaction, spectacle dependence, visual perception, and side effects were evaluated with a self-reported questionnaire. Results: Mean uncorrected visual acuities (LogMAR) were significantly better in the healthy eyes compared with the eyes with retinal pathologies: 0.05 and 0.10, p = 0.011 (distance), 0.06 and 0.16, p = 0.001 (intermediate), and 0.20 and 0.28, p = 0.026 (near), respectively. No or rare use of spectacles for any distance was reported by 71% and 38% of patients, respectively (p = 0.004). Haloes/glare were reported by 17% and 23%, respectively (p = 0.556); only in 7% and 4% it was clinically disturbing (p > 0.999). The same IOL would be chosen again in 77% and 73% of patients, respectively, (p = 0.550). Conclusion: Patients with retinal pathologies who were implanted with an EDOF IOL demonstrated excellent distant uncorrected visual results with reasonable intermediate and near uncorrected visual results alongside high satisfaction; however, results were inferior to those of the control healthy eyes.
Cushing’s Disease May Have Higher Incidence than Previously Thought: A Nationwide Study in Iceland 2010–2019
Authors: Matthiasdottir Anna Mjoll , Hardarson Thorgeir Orri , Arnardottir Steinunn , Sigurjonsdottir Helga Agusta
Published: July 2024

Introduction: In 2011, we reported the overall incidence of Cushing’s disease (CD) in Iceland from 1955 through 2009 to be 1.5 cases per million per year with highest incidence in the last decade of the study, a higher incidence then earlier reported. We now present a follow-up study reporting the epidemiology of the disease in Iceland during the 10-year period from 2010 to 2019. Methods: In this nationwide retrospective study, clinical information on patients diagnosed with CD was obtained from electronic medical records, reviewed by consulting endocrinologists. Results: Seventeen patients were diagnosed with CD, 12 women (71%) and 5 men (29%) giving an overall incidence of 5.2 cases per million per year. The mean age at diagnosis was 46 years (range 13–85 years). Biochemical analysis was recorded for all patients and 12 patients (71%) had visible pituitary adenoma on imaging studies. Sixteen patients (94%) were treated with transsphenoidal surgery of which 4 patients (24%) had gamma knife radiosurgery and three (18%) bilateral adrenalectomy after pituitary surgery. Two patients died during the study period. Conclusion: The overall incidence of CD of 5.2 cases per million per year is higher than previously reported, indicating the importance of awareness of CD. As all patients with CD are diagnosed and/or treated at the only University Hospital in Iceland, housing the only department of endocrinology as well as neurosurgery, we are confident that all cases diagnosed during the study period were included in the study.
The Association between Blood Pressure and Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Implantation
Authors: Goldberg Idan , Landes Uri , Drozdinsky Genady , Codner Pablo , Bental Tamir , Orvin Katia , Schamroth Pravda Nili , Goldberg Lotem , Soudry Omri , Lerman Tsahi T. , Kornowski Ran , Eisen Alon , Vaknin-Assa Hana
Published: July 2024

Introduction: Transcatheter aortic valve implantation (TAVI) has emerged as a common and effective treatment for patients with severe aortic stenosis. Changes in systemic blood pressure after TAVI have been described, yet their prognostic value is not established. Thus, we aimed to examine the association of the periprocedural changes in systolic blood pressure (SBP) and in pulse pressure on clinical outcomes after the procedure. Methods: A retrospective study of consecutive patients who underwent TAVI procedure in our medical center. We assessed the effect of the periprocedural changes in blood pressure measurements on mortality, acute myocardial infarction, stroke and hospitalizations at 1 year and on the combined outcome of death, myocardial infarction, and stroke 1 year following the procedure. Results: Our cohort included 455 patients (44% males). Of them, 343 patients (75.4%) had raised SBP immediately after the procedure. Patients with raised SBP had a significantly higher rate of the 1-year composite outcome, compared to patients who did not have a raise in SBP following the procedure (43 [13%] vs. 6 [5.4%], respectively, p = 0.033). After adjustment for age and sex, the postprocedural increase in SBP was significantly associated with the composite outcome, with a hazard ratio of 2.42, 95% CI: 1.03–5.7. Conclusion: An immediate increase in SBP after TAVI is associated with worse 1-year clinical cardiovascular outcomes.
High Obesity Indices Are Associated with Gastroesophageal Reflux Disease, but Low Obesity Indices Are Associated with Peptic Ulcer Disease in a Large Taiwanese Population Study
Authors: Chen Chien-Cheng , Geng Jiun-Hung , Wu Pei-Yu , Huang Jiun-Chi , Hu Huang-Ming , Chen Szu-Chia , Kuo Chao-Hung
Published: July 2024

Introduction: Gastroesophageal reflux disease (GERD) and peptic ulcer disease (PUD) are prevalent in Taiwan. Few studies have investigated the associations between obesity indices with GERD and PUD simultaneously. This study aimed to investigate the correlations among obesity indices with GERD and PUD in a large cohort of participants, around 120,000, in the Taiwan Biobank (TWB). Methods: A total of 121,583 participants (male: 43,698; female: 77,885; mean age 49.9 ± 11.0 years) were included to analyze the associations among obesity indices, including body mass index (BMI), waist-hip ratio (WHR), waist-to-height ratio (WHtR), body roundness index (BRI), abdominal volume index (AVI), lipid accumulation product (LAP), visceral adiposity index (VAI), and triglyceride-glucose index (TyG index), with GERD and PUD. Self-reported GERD and PUD were obtained by questionnaires. Multivariate logistic regression analysis was employed to analyze the relationship between obesity indices with GERD and PUD. Results: The prevalence of GERD and PUD was 13.7% and 14.6%, respectively. After multivariable analysis, high WHR (odds ratio [OR] = 1.009, p < 0.001), WHtR (OR = 1.005, p = 0.003), BRI (OR = 1.022, p = 0.005), AVI (OR = 1.013, p < 0.001), LAP (OR = 1.001, p < 0.001), TyG index (OR = 1.068, p < 0.001), and VAI (OR = 1.013, p = 0.002) were significantly associated with GERD, except BMI (p = 0.384). On the other hand, low BMI (OR = 0.984; p < 0.001) and AVI (OR = 0.994; p = 0.036) were significantly associated with PUD. However, the values of WHR (p = 0.151), WHtR (p = 0.304), BRI (p = 0.452), LAP (p = 0.799), VAI (p = 0.347), and TyG index (p = 0.642) were not. Conclusion: This study found that high obesity indices are associated with GERD, but low obesity indices are associated with PUD in a large Taiwanese population study. Our findings may alert physicians to notice that different obesity index may be associated with different gastrointestinal disorder.
Bronchodilator Response in Post-COVID-19 Patients Undergoing Pulmonary Rehabilitation
Authors: Krooss Simon Alexander , Klefenz Isabel , Ott Michael , Klawonn Frank , Leitl Daniela , Schneeberger Tessa , Jarosch Inga , Vogelmeier Claus Franz , Lommatzsch Marek , Gloeckl Rainer , Koczulla Andreas Rembert
Published: July 2024

Introduction: SARS-CoV-2 infections can result in a broad spectrum of symptoms from mild to life-threatening. Long-term consequences on lung function are not well understood yet. Methods: In our study, we have examined 134 post-COVID patients (aged 54.83 ± 14.4 years) with dyspnea on exertion as a leading symptom 6 weeks to 24 months after a SARS-CoV-2 infection for bronchodilator responsiveness during their stay in our pulmonary rehabilitation clinic. Results: Prior to bronchial dilation, 6 out of 134 patients (4.47%) presented an FEV1/FVC ratio below lower limit of normal (Z-score = −1.645) indicative of an obstructive airway disease. Following inhalation of a β2-adrenergic agonist we measured a mean FEV1 increase of 181.5 mL in our cohort, which was significantly elevated compared to a historical control group (ΔFEV1 = 118 mL). 28.7% of the patients showed an increase greater than 200 mL and 12% displayed a significant bronchodilation response (>200 mL ΔFEV1 and >12% FEV1 increase). Interestingly, no significant difference in bronchial dilation effect was observed when comparing patients hospitalized and those non-hospitalized during the course of their SARS-CoV-2 infection. Conclusion: Our data provide evidence for increased prevalence of obstructive ventilatory defects and increased bronchodilator responsiveness in patients with persisting symptoms after COVID-19. Depending on the extent of this complication, post-COVID patients may benefit from an adapted β2-inhalation therapy including subsequent reevaluation.
Piaget’s Different Intelligence Test: From IQ Tests to Operatory Intelligence
Authors: Kitchener Richard F.
Published: July 2024

A signature event in the history of psychology occurred in 1919 when Jean Piaget was asked to standardize Cyril Burt’s tests of intelligence on Parisian children. Impressed by the errors students made, Piaget studied the underlying reasoning process of these children. This led to Piaget ‘s new méthode clinique for studying the intelligence of children and its development. But why was there a need for such standardization? How did Burt’s intelligence test differ from Binet’s version? How did Burt’s version pave the way for Piaget’s very different kind of intelligence test – from IQ tests to tests of operatory intelligence? I examine the history of this series of events pointing out the difference between Binet’s version and Burt’s version, how they differed from Piaget’s similar questions and how the standardization of Burt’s intelligence tests paved the way for Piaget’s different type of intelligence test, a test of operatory intelligence.
Internet-Based Trauma Recovery Intervention for Nurses: A Randomized Controlled Trial
Authors: Kim Sunah , Park Jinyoung , Lee Wongyeong , Kim Goun
Published: July 2024

Introduction: Nurses, who care for patients with various traumas, may also experience post-traumatic stress disorder due to indirect or direct exposure to traumatic situations. This study examined the effectiveness of an Internet-based trauma recovery intervention for Korean nurses.
Methods: This randomized controlled trial was conducted with 112 nurses aged 23–40 years who were randomly assigned to the intervention (n = 56) or control group (n = 56) from May 7 to December 20, 2020. Nurses in the intervention group attended eight sessions, and the same intervention was administered to the control group. Repeated measures were collected at pre-test, post-test 1 (immediately after the intervention), and post-test 2 (four weeks after the intervention). A total of 102 nurses (intervention group: n = 49; control group: n = 53) were completed because 10 nurses dropped out before the first session. Data were analyzed using the chi-square test, Fisher’s exact test, t-test, Mann-Whitney U-test, and repeated measures ANOVA (intention-to-treat and per protocol).
Results: There were significant changes in functional health, resilience, post-traumatic stress, depressive symptoms, state anxiety, and trait anxiety over time and in the group-by-time interactions (intention-to-treat and per protocol). There was a significant difference in social support in the group-by-time interactions, but there were no significant changes between the two groups or over time (intention-to-treat and per protocol).
Conclusion: The Internet-based trauma recovery nursing intervention is effective in clinical and community settings for nurses who cannot participate in fixed-schedule programs due to shift work. This study’s findings are relevant for implementing Internet-based trauma recovery programs for nurses and the general population, including survivors and relatives of patients who suffered from COVID-19. This program will also be very useful for people in other high-stress situations. Nurse leaders should consider different populations and situations when offering effective coping strategies suitable for changing environments.
Clinical trial registration number: NCT04989582
Comparison of the Efficacy, Safety, and Quality of Life of Pegylated Liposomal Doxorubicin-Cyclophosphamide versus Epirubicin-Cyclophosphamide in Patients with Early-Stage HER2-Negative Breast Cancer: A Prospective, Randomized, Multicenter, Phase II Study
Authors: Tseng Ling-Ming , Chen Fang Ming , Chen Shou-Tung , Cheng Fiona Tsui-Fen , Chao Tsu-Yi , Dai Ming-Shen , Kao Woei-Yau , Yeh Ming-Hsin , Chen Dar-Ren , Liu Liang-Chih , Wang Hewi Chung , Chang Hong-Tai , Wang Being Whey , Yu Jyh-Cherng , Chen Shin Cheh , Liao Guo-Shiou , Hou Ming-Feng
Published: July 2024

Introduction: This multicenter, phase II randomized, non-inferiority study reports from the first prospective two-armed randomized control trial that compared the efficacy, safety, and quality of life (QoL) of pegylated liposomal doxorubicin (PLD)-based and epirubicin-based as adjuvant chemotherapy for stage I-II human epidermal growth factor receptor 2 (HER2)-negative breast cancer. Methods: Patients with stage I/II HER2-negative breast cancer received PLD (37.5 mg/m2, Q3W, 5 cycles, LC arm) plus cyclophosphamide (600 mg/m2) or epirubicin (90 mg/m2, Q3W, 4 cycles, EC arm) plus cyclophosphamide (600 mg/m2). Randomization was stratified by lymph node and ER and PR status. The primary endpoint was disease-free survival (DFS), and secondary endpoints were overall survival (OS), safety profiles, and QoL. QoL was assessed using the EORTC-QLQ-C30 and QLQ-BR23 questionnaires. Results: A total of 256 patients were assigned to LC (n = 148) and EC (n = 108). There was no difference in 5-year DFS and OS rate between the two groups. LC-based adjuvant regimens had significantly less alopecia and low-grade 3–4 hematologic adverse events (AEs). Significantly improved QoL was observed in the LC arm during and after treatment for symptoms including fatigue, nausea and vomiting, and systemic therapy side effects. Conclusion: Comparable efficacy and safety between adjuvant PLD and epirubicin for stage I-II HER2-negative breast cancer was observed. There was no difference in the 5-year DFS and OS rates between the two treatment arms. However, low-grade 3–4 AEs and a trend of favorable QoL symptom scales were observed in the LC arm, suggesting that PLD-containing regimen could become a new standard treatment for early-stage HER2-negative breast cancer patients.
Nomenclatural notes on type materials of fourteen names in Lythraceae
Authors: PRASANTH ARUN , SARDESAI MILIND M.
Published: July 2024

In the present study, we designate lectotypes and epitypes for fourteen names (for accepted names/basionyms/synonyms) of three genera Ammannia, Lagerstroemia, and Rotala of family Lythraceae, to facilitate the correct application of these names. Lectotypes are designated for three names in Ammannia, three names in Rotala, and four names in Lagerstroemia. Second-step lectotype are designated for two names in Rotala and one name in each Ammannia and Lagerstroemia. Further, an epitype for the name Rotala floribunda is assigned.
Protocolized Gastrointestinal Fistula Management is Superior to Historic Data and National Averages: A Retrospective Review of an Enterocutaneous Fistula Registry
Authors: Moore Lucie , Entelisano Trina , McKean Jordan , Vanzant Erin , Rosenthal Martin
Published: July 2024

Background: Enterocutaneous fistula (ECF) management remains a complex clinical problem. Prehabilitation (prehab) protocols are becoming more popular. The prehabilitation protocol used in this paper was adopted in 2017 at the University of Florida. The Fistula Registry at University of Florida has captured the efforts of the UFAIR (University of Florida Abdominal Wall Reconstruction and Intestinal Rehab) service. We analyzed if the prehabilitation program is successful in reducing deaths, length of stay, recurrence of fistula, and readmissions to the hospital in our database.

Methods: Charts were queried for patients with ECF/EAF from the UFAIR database from January 1, 2017, until present day. Several factors were recorded including: cause of fistula, recurrence of fistula, wound infection, postoperative sepsis, hospital length of stay, postoperative ICU length of stay, postoperative length of stay, death, discharge disposition, and if taken back to surgery.

Results: 31 patients underwent prehabilitation while 30 patients underwent standard nutritional therapy. No deaths were reported in the prehab group, compared to 7 deaths in the standard group ( P = .006). The prehab population had an average hospital stay of 15.19 days while the standard group had an average stay of 21.16 days ( P = .045). 2/31 in the prehab protocol had a recurrence of ECF while 10/30 in the standard protocol recurred ( P = .01). Conclusions: Our study showed promising data for the effects of prehabilitation protocol for patients with ECF. The outcomes of those in the prehab protocol surpassed historical outcomes. Our patients had no deaths, shorter hospital stays, and lower rates of recurrence.
Sensorimotor Challenges in Minimally Invasive Surgery: A Theoretically-Oriented Review
Authors: Hewitson Christopher L. , Crossley Matthew J. , Cartmill John , Kaplan David M.
Published: July 2024

Objective

This review surveys the literature on sensorimotor challenges impacting performance in laparoscopic minimally invasive surgery (MIS).

Background

Despite its well-known benefits for patients, achieving proficiency in MIS can be challenging for surgeons due to many factors including altered visual perspectives and fulcrum effects in instrument handling. Research on these and other sensorimotor challenges has been hindered by imprecise terminology and the lack of a unified theoretical framework to guide research questions in the field.

Method

We conducted a systematic survey of the MIS literature, focusing on studies investigating sensorimotor challenges affecting laparoscopic performance. To provide a common foundation for cross-study comparisons, we propose a standardized taxonomy that distinguishes between different experimental paradigms used in the literature. We then show how the computational motor learning perspective provides a unifying theoretical framework for the field that can facilitate progress and motivate future research along clearer, hypothesis-driven lines.

Results

The survey identified diverse sensorimotor perturbations in MIS, which can be effectively categorized according to our proposed taxonomy. Studies investigating monitor-, camera-, and tool-based perturbations were systematically analyzed, elucidating their impact on surgical performance. We also show how the computational motor learning perspective provides deeper insights and potential strategies to mitigate challenges.

Conclusion

Sensorimotor challenges significantly impact MIS, necessitating a systematic, empirically informed approach. Our proposed taxonomy and theoretical framework shed light on the complexities involved, paving the way for more structured research and targeted training approaches to enhance surgical proficiency.

Application

Understanding the sensorimotor challenges inherent to MIS can guide the design of improved training curricula and inform the configuration of setups in the operating room to enhance surgeon performance and ultimately patient outcomes. This review offers key insights for surgeons, educators, and researchers in surgical performance and technology development.
Interpersonal dynamics of traumatic brain injury within romantic relationships described in online forums
Authors: Knobloch Leanne K. , Pool Kirsten
Published: July 2024

Traumatic brain injury (TBI) can have serious consequences for people’s physical health and the quality of their romantic relationships. Less clear, however, are the interpersonal dynamics of couples navigating the aftermath of TBI. We used data scraping techniques to capture five years of posts submitted to online help-seeking forums, and we analyzed the resulting 349 single-spaced pages of data using codebook thematic analysis. Both TBI survivors and partners reported the focal themes of personality changes and relationship changes. TBI survivors emphasized a lack of understanding that led to grief and loss, relational uncertainty, and isolation. Partners reported poor treatment that culminated in negative emotions and relational uncertainty. The data showed notable similarities and differences between TBI survivors and partners. We interpret the results via four prominent theories of marriage and family relationships: ambiguous loss theory, relational turbulence theory, the theory of resilience and relational load, and family systems theory. Overall, our findings shed light on interpersonal dynamics after TBI and lay a foundation for future theoretical and clinical advances.
Ethnobiology's Contributions to Sustainability Science
Authors: Arrivabene Alexandre , Lasic Lou , Blanco Julien , Carrière Stéphanie M. , Ladio Ana , Caillon Sophie , Porcher Vincent , Teixidor-Toneu Irene
Published: July 2024

Progress toward the achievement of the Sustainable Development Goals (SDGs) is insufficient at a global scale. A thorough and interdisciplinary understanding of barriers and levers to sustainability, including synergies and trade-offs between SDGs, is utterly important but still limited. Ethnobiology is often advocated as a key discipline to address this research gap. We conducted a systematic literature review to explore (i) the visibility of ethnobiology within sustainability science, (ii) how ethnobiology understands the notion of sustainability, (iii) if ethnobiology literature on sustainability issues engages differently with nonacademic knowledge and people compared to other types of ethnobiology research, and (iv) which SDGs are addressed (explicitly or implicitly) by ethnobiology. Our study reveals a minimal overlap between sustainability science and ethnobiology literature. The articles reviewed never mention the SDGs explicitly, but often address them implicitly. Reviewed ethnobiological articles addressed themes of relevance to almost all SDGs, especially the linkages between SDGs 1–3 and 15, but always implicitly. Biodiversity's understanding (SDG 15) provides the basis for culture and Indigenous and local knowledge and ensures communities’ food security (SDG 2), health and well-being (SDG 3), and prosperity (SDG 1). We found that ethnobiology does not examine sustainability through the lens of the global sustainability agenda, and that knowledge coproduction processes are rarely reported. While ethnobiology demonstrates its relevance to address SDGs and contribute to transformative change, this potential is not fully realized because of a persisting decoupling between place-based research and global sustainability frameworks.
Coupled CFD-FEM modeling of fluid–thermal–structural interaction in a single-strand tundish
Authors: Sheng Dong-Yuan
Published: July 2024

A mathematical model has been developed to study the fluid–thermal–structural interaction in a single-strand tundish based on a coupled computational fluid dynamics (CFD) and finite element method (FEM) approach. The flow pattern and temperature distribution of the molten steel were predicted by the CFD calculation. Heat transfer and thermal stress profiles in the solid layers were investigated by the FEM analysis. Case studies were carried out comparatively to investigate the effect of tundish preheating and thermal insulation. The results show that tundish preheating can maintain the desired temperature of the molten steel at the exit. The heating efficiency drops significantly after 3 h of preheating. Reducing the thermal conductivity of the insulation material will reduce the temperature of the tundish shell and increase the thermal stress on the working lining. The modeling results can be used to improve the reliability and lifetime of the tundish and reduce production costs.
Representation of countries in IFLA
Authors: Prado Jorge Moisés Kroll do
Published: July 2024

This study investigates the participation of countries in one of the leading international library organizations, IFLA. IFLA has aimed to strengthen libraries for a more literate, informed and participatory society. Its structure includes Sections, a Governing Board, and Regional and Professional Divisions. From an exploratory investigation on the IFLA web pages, the author surveyed the participation of countries in the entire structure, the nationality of the presidents and the headquarters of the World Library and Information Congress. The need for the organization to expand its regional diversity through internal policies stands out, since Global South countries, such as those in Latin America and Africa, occupy few places. Since IFLA is the main global entity in librarianship, it is essential to expand these representations, from participation in its structure to the possibility of a president-elect from these regions or the largest congress being hosted in these areas more often.