bluuebunny/crossref_metadata_2025 huggingface dataset:
Baseline Pydiflumetofen Sensitivity of Fusarium pseudograminearum Isolates Collected from Henan, China, and Potential Resistance Mechanisms
Authors: Zhou Feng , Cui Ye-Xian , Zhou Yu-Dong , Duan Si-Tong , Wang Zi-Yi , Xia Zhi-Hao , Hu Hai-Yan , Liu Run-Qiang , Li Cheng-Wei
Published: January 2023

Fusarium crown rot (FCR), caused by Fusarium pseudograminearum, is one of the most important diseases impacting wheat production in the Huanghuai region, the most important wheat-growing region of China. The current study found that the SDHI fungicide pydiflumetofen, which was recently developed by Syngenta Crop Protection, provided effective control of 67 wild-type F. pseudograminearum isolates in potato dextrose agar, with an average EC50 value of 0.060 ± 0.0098 μg/ml (SE). Further investigation revealed that the risk of fungicide resistance in pydiflumetofen was medium to high. Four F. pseudograminearum mutants generated by repeated exposure to pydiflumetofen under laboratory conditions indicated that pydiflumetofen resistance was associated with fitness penalties. Mutants exhibited significantly (P < 0.05) reduced sporulation in mung bean broth and significantly (P < 0.05) reduced pathogenicity in wheat seedlings. Sequence analysis indicated that the observed pydiflumetofen resistance of the mutants was likely associated with amino acid changes in the different subunits of the succinate dehydrogenase target protein, including R18L and V160M substitutions in the FpSdhA sequence; D69V, D147G, and C257R in FpSdhB; and W78R in FpSdhC. This study found no evidence of cross-resistance between pydiflumetofen and the alternative fungicides tebuconazole, fludioxonil, carbendazim, or fluazinam, which all have distinct modes of action and could therefore be used in combination or rotation with pydiflumetofen to reduce the risk of resistance emerging in the field. Taken together, these results indicate that pydiflumetofen has potential as a novel fungicide for the control of FCR caused by F. pseudograminearum and could therefore be of great significance in ensuring high and stable wheat yields in China.
Isolates of Colletotrichum truncatum with Resistance to Multiple Fungicides from Soybean in Northern Thailand
Authors: Poti Teeranai , Thitla Tanapol , Imaiam Naphatsawan , Arunothayanan Hatthaya , Doungsa-ard Chanintorn , Kongtragoul Pornprapa , Nalumpang Sarunya , Akimitsu Kazuya
Published: January 2023

In Thailand, four systemic fungicides—carbendazim (Car), azoxystrobin (Azo), difenoconazole (Dif), and penthiopyrad (Pen)—are commonly used to control soybean anthracnose caused by Colletotrichum truncatum; however, the pathogen has developed resistance. From 2019 to 2020, fungicide resistance in C. truncatum from fields in Chiang Rai and Chiang Mai was monitored. In tests of 85 C. truncatum isolates for resistance to multiple fungicides, 15.3% were CarRAzoR, 34.1% were triple resistant (CarRAzoRDifR or CarRAzoRPenR), and 50.6% were CarRAzoRDifRPenR. Surprisingly, all isolates tested had lost their sensitivity to one or more of the fungicides tested. The carbendazim-resistant isolates carried a point mutation in the β-tubulin gene at codon 198 (E198A) or 200 (F200Y), and all azoxystrobin-resistant isolates had a mutation in the cytochrome b gene at codon 143 (G143A) or 129 (F129L). Moreover, a novel mutation at codon 208 (S208Y) in the gene encoding succinate dehydrogenase subunit B was detected in all of the isolates highly resistant to penthiopyrad. No mutation linked with difenoconazole resistance was detected in the genes encoding cytochrome P450 sterol 14α-demethylase. To the best of our knowledge, this is the first report of C. truncatum isolates resistant to multiple fungicides and serves as a warning to take measures to prevent the occurrence and distribution of these multiple-fungicide-resistant populations in soybean fields.
QTL Pyramiding Provides Marginal Improvement in 2NvS-Based Wheat Blast Resistance
Authors: Cruppe Giovana , Lemes da Silva Cristiano , Lollato Romulo P. , Fritz Allan K. , Kuhnem Paulo , D. Cruz Christian , Calderon Lidia , Valent Barbara
Published: January 2023

Wheat blast, caused by the fungus Magnaporthe oryzae Triticum pathotype (MoT), is a devastating disease affecting South America, Bangladesh, and Zambia. Resistance to wheat blast has strongly relied on the 2NvS translocation; however, newer MoT isolates have increased aggressiveness, threatening the 2NvS translocation’s effectiveness and durability. To identify genomic regions associated with wheat blast resistance, we performed a quantitative trait loci (QTL) mapping study using 187 double-haploid (DH) lines from a cross between the Brazilian wheat cultivars ‘TBIO Alvorada’ and ‘TBIO Sossego’, which are moderately resistant and susceptible to blast, respectively. The DH population was evaluated in a greenhouse in Brazil and Bolivia, and field conditions in Bolivia. Contrasting models best explained the relationship between traits evaluated according to differences in disease levels and the presence of the 2NvS. A large effect-locus, derived from ‘TBIO Sossego’, was identified on chromosome 2AS, which was confirmed to be 2NvS translocation and explained 33.5 to 82.4% of the phenotypic variance. Additional significant loci were identified on 5AL, 1DS, 4DS, 5DL, and 6DL chromosome arms with phenotypic variance <6%, but they were not consistent across trait–environment combinations. QTL pyramiding analyses showed that some specific loci had an additive effect when combined with the 2NvS, suggesting that stacking multiple loci may be an effective strategy to help manage wheat blast. The markers associated with the 2NvS can be used as dominant diagnostic markers for this alien translocation. Additional characterization of these loci using a broader set of MoT isolates is critical to validate their effectiveness against current MoT populations.
Crinivirus Tomato Chlorosis Virus Compromises the Control of Tomato Yellow Leaf Curl Virus in Tomato Plants by the Ty-1 Gene
Authors: Fortes Isabel M. , Fernández-Muñoz Rafael , Moriones Enrique
Published: January 2023

Tomato yellow leaf curl disease (TYLCD) causes severe damage to tomato crops in warm regions of the world, and is associated with infections of several whitefly ( Bemisia tabaci)-transmitted single-stranded (ss)DNA begomoviruses (genus Begomovirus, family Geminiviridae). The most widespread begomovirus isolates associated with TYLCD are those of the type strain of the Tomato yellow leaf curl virus species, known as Israel (TYLCV-IL). The Ty-1 gene is widely used in commercial tomato cultivars to control TYLCV-IL damage, providing resistance to the virus by restricting viral accumulation and tolerance to TYLCD by inhibiting disease symptoms. However, several reports suggest that TYLCV-IL-like isolates are adapting to the Ty-1 gene and are causes of concern for possibly overcoming the provided control. This is the case with TYLCV-IL IS76-like recombinants that have a small genome fragment acquired by genetic exchange from an isolate of Tomato yellow leaf curl Sardinia virus, another begomovirus species associated with TYLCD. Here we show that TYLCV-IL IS76-like isolates partially break down the TYLCD-tolerance provided by the Ty-1 gene and that virulence differences might exist between isolates. Interestingly, we demonstrate that mixed infections with an isolate of the crinivirus (genus Crinivirus, family Closteroviridae) species Tomato chlorosis virus (ToCV), an ssRNA virus also transmitted by B. tabaci and emerging worldwide in tomato crops, boosts the breakdown of the TYLCD-tolerance provided by the Ty-1 gene either with TYLCV-IL IS76-like or canonical TYLCV-IL isolates. Moreover, we demonstrate the incorporation of the Ty-2 gene in Ty-1-commercial tomatoes to restrict (no virus or virus traces, no symptoms) systemic infections of recombinant TYLCV-IL IS76-like and canonical TYLCV-IL isolates, even in the presence of ToCV infections, which provides more robust and durable control of TYLCD.
Early treatment with terlipressin in patients with hepatorenal syndrome yields improved clinical outcomes in North American studies
Authors: Curry Michael P. , Vargas Hugo E. , Befeler Alex S. , Pyrsopoulos Nikolaos T. , Patwardhan Vilas R. , Jamil Khurram
Published: January 2023

Hepatorenal syndrome type 1 (HRS-1) is a serious complication of advanced cirrhosis and a potentially reversible form of acute kidney injury that is associated with rapidly deteriorating kidney function. Liver transplantation remains the only curative treatment for decompensated cirrhosis. However, terlipressin, a vasopressin analog, successfully reverses HRS-1, and may improve patient survival while awaiting liver transplantation. Patients with higher baseline serum creatinine have a reduced response to treatment with terlipressin. These post hoc analyses examined pooled data from 352 patients with HRS-1 treated with terlipressin in 3 North American-centric, Phase III, placebo-controlled clinical studies (i.e. OT-0401, REVERSE, and CONFIRM)—across 3 serum creatinine subgroups (i.e. <3, ≥3–<5, and ≥5 mg/dL)—to further delineate their correlation with HRS reversal, renal replacement therapy-free survival, and overall survival. Serum creatinine was significantly associated with HRS reversal in univariate and multivariate logistic regression analyses (P<0.001). The incidence of HRS reversal inversely correlated with serum creatinine subgroup (<3 mg/dL, 49.2%; ≥3–<5 mg/dL, 28.0%; ≥5 mg/dL, 9.1%). At Day 30 follow-up, renal replacement therapy-free survival was significantly higher for patients with HRS-1 in the lower serum creatinine subgroups than in the higher subgroup (<5 vs. >5 mg/dL; p=0.01). Terlipressin-treated patients with HRS-1, with a lower baseline serum creatinine level, had a higher overall survival (p<0.001) and higher transplant-free survival at Day 90 (p=0.04). Patients with HRS-1 and lower serum creatinine levels who were treated with terlipressin had higher HRS reversal and survival outcomes, highlighting the significant need to identify and treat patients with HRS-1 early when they often have lower serum creatinine levels, and likely a greater response to terlipressin.
Training Tomorrow’s Physicians in Value Conscious Medicine
Authors: Makhoul Alexandra E. , Kertai Miklos D. , Powers James , Dahlman Kimberly B. , Suojanen Krista
Published: January 2023

Problem

Future physicians will practice medicine in an increasingly complex health care system. To become effective leaders of value-based teams and to practice cost-conscious care, medical students need training in and exposure to value conscious medicine (VCM).

Approach

A student-led initiative to enhance education in VCM led to the development of the 4-week elective course (High Value Care: In Policy and in Practice) for postclerkship third- and fourth-year students, introduced in 2021 at Vanderbilt University School of Medicine. The course included structured didactics, self-directed online modules, a book club, and flipped-classroom discussions in addition to clinical rotations focused on VCM in practice.

Outcomes

Students’ self-ratings of their understanding of VCM, preparation to practice value-based care, and comfort incorporating patient and system costs into clinical decisions improved after completing the course. Most indicated they would recommend the course to their peers. Suggestions for improvement included more teach-back sessions with faculty as well as more direction for preceptors to demonstrate specific aspects of VCM.

Next Steps

The authors share this example of a dedicated medical school VCM course as a step toward achieving the vision of integrating value into clinical decision making and empowering students to become informed and capable future physicians. Other institutions may consider adapting this course example to prepare their students to practice VCM in an increasingly cost-focused system.
Impact of Alcohol Misuse on Requirements for Critical Care Services and Development of Hospital Delirium in Patients With COVID-19 pneumonia
Authors: Jolley Sarah E. , Mowry Christopher J. , Erlandson Kristine M. , Wilson Melissa P. , Burnham Ellen L.
Published: January 2023

OBJECTIVES:

Alcohol misuse has been associated with increased morbidity in the setting of pulmonary infections, including the need for critical care resource utilization and development of delirium. How alcohol misuse impacts morbidity and outcomes among patients admitted with COVID-19 pneumonia is not well described. We sought to determine if alcohol misuse was associated with an increased need for critical care resources and development of delirium among patients hospitalized with COVID-19 pneumonia.

DESIGN:

Retrospective cohort study.

SETTING:

Twelve University of Colorado hospitals between March 2020 and April 2021.

PATIENTS:

Adults with a COVID-19 diagnosis.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

The primary outcome was admission to the ICU. Secondary outcomes included need for mechanical ventilation, development of delirium, and in-hospital mortality. Alcohol misuse was defined by International Classification of Diseases, 10th Revision codes. Of 5,979 patients hospitalized with COVID-19, 26% required ICU admission and 15.4% required mechanical ventilation. Delirium developed in 4.5% and 10.5% died during hospitalization. Alcohol misuse was identified in 4%. In analyses adjusted for age, sex, body mass index, diabetes, and liver disease, alcohol misuse was associated with increased odds of ICU admission (adjusted odds ratio [aOR], 1.46; p < 0.01), mechanical ventilation (aOR, 1.43; p = 0.03), and delirium (aOR, 5.55; p < 0.01) compared with patients without misuse. Mortality rates were not associated with alcohol misuse alone, although the presence of both alcohol misuse and in-hospital delirium significantly increased odds of in-hospital death (aOR, 2.60; p = 0.04).

CONCLUSIONS:

Among patients hospitalized with COVID-19, alcohol misuse was associated with increased utilization of critical care resources including ICU admission and mechanical ventilation. Delirium was an important modifiable risk factor associated with worse outcomes in hospitalized patients with alcohol misuse, including increased odds of death.
Amyloidosis and Carpal Tunnel Syndrome: Surgical Technique for Extended Carpal Tunnel Release with Tenosynovium and Transverse Carpal Ligament Biopsies
Authors: Elzinga Kate , Khayambashi Shahin , Hahn Christopher , Mahe Etienne , Fine Nowell M.
Published: January 2023

Background:

Carpal tunnel syndrome (CTS) is common in patients with transthyretin amyloidosis (ATTR), and many experience residual symptoms and/or develop recurrent disease following routine carpal tunnel release (CTR). An extended CTR with median nerve neurolysis is recommended for thorough nerve decompression. Tissue confirmation of amyloidosis can be performed at the time of CTR with biopsies of the transverse carpal ligament and/or tenosynovium.

Methods:

We describe a retrospective, single-center experience performing an extended CTR technique including unilateral and bilateral cases for 13 consecutive patients (18 wrists) with ATTR and symptomatic median neuropathy at the wrist.

Results:

The mean patient age was 83 (range 67–90) years and 11 (85%) were men. Notable intraoperative findings in all cases included thickened tenosynovium and median nerve epineurium, and adherence of the median nerve to the deep surface of transverse carpal ligament. Pathology findings were positive for amyloidosis from both the transverse carpal ligament and the tenosynovium biopsies in all patients.

Conclusions:

Extended CTR with simultaneous wrist tissue biopsy can be safely performed for ATTR patients with CTS. Characteristic intraoperative findings should increase clinical suspicion for undiagnosed ATTR and prompt performance of biopsy for diagnostic confirmation. Volar wrist tenosynovial biopsy is our preferred tissue for confirmation of ATTR, for patients with and without CTS, given its safety profile and 100% pathological yield in our series.
Content and Readability of Online Recommendations for Breast Implant Size Selection
Authors: Fanning James E. , Okamoto Lauren A. , Levine Emma C. , McGee Shayan A. , Janis Jeffrey E.
Published: January 2023

Background:

Breast augmentation is one of the most frequently performed aesthetic procedures in the United States. Online information is often used by patients to make decisions when undergoing cosmetic procedures. It is vital that online medical information includes relevant decision-making factors and uses language that is understandable to broad patient audiences. Ideally, online resources should aid patient decisions in aesthetic surgical planning, especially implant size selection for breast augmentation. We describe patient decision-making factors and readability of breast implant size selection recommended by private practice plastic surgery webpages.

Methods:

Using a depersonalized, anonymous query to Google search engine, the terms “breast implant size factors” and “breast implant size decision” were searched, and 52 plastic surgery private practice webpages were identified. Webpages were analyzed for reported decision-making factors of implant size selection. Readability analyses of webpages were performed with Readability Studio and Hemingway Editor.

Results:

The two major decision-making factors for implant size selection reported by webpages were body/tissue-based measurements and surgeon input. Ten factors related to patient lifestyle, surgical goals, and procedural options were also identified. Average webpage scores for five readability measures exceeded recommended levels for medical information.

Conclusions:

Reported decision-making factors for implant size selection emphasize a plastic surgeon’s expertise but may enhance the patient’s role in preoperative planning. Webpages describing breast implant size selection exceed the sixth and eighth grade reading levels recommended by the AMA and NIH, respectively. Improving the readability of webpages will refine the role of online medical information in preoperative planning of breast augmentation.
High prevalence of liver fibrosis among general population: a Romanian population-based study
Authors: Trifan Anca , Muzica Cristina-Maria , Nastasa Robert , Zenovia Sebastian , Stratina Ermina , Stafie Remus , Rotaru Adrian , Singeap Ana-Maria , Cojocariu Camelia , Sfarti Catalin , Girleanu Irina , Chiriac Stefan , Cuciureanu Tudor , Huiban Laura , Stanciu Carol
Published: January 2023

Although high mortality is associated with liver cirrhosis, patients usually have a good quality of life in the compensated phase, and the disease may progress undiagnosed for many years. Vibration-controlled transient elastography with controlled attenuation parameter is a useful noninvasive tool used to estimate both the severity of fibrosis and steatosis. Hence, we aimed to establish the prevalence of significant liver fibrosis diagnosed by vibration-controlled transient elastography in an apparently healthy population. Between December 2021 and March 2022, we conducted a prospective screening of liver fibrosis in apparently healthy participants from different counties of Northeastern Romania. All subjects’ medical history was recorded through a comprehensive questionnaire and underwent a liver stiffness measurement. Participants with abnormal liver stiffness measurement values were further evaluated by laboratory tests to identify the etiology of chronic liver disease. A total of 127 apparently healthy subjects were enrolled, mainly females (59.8%), with a mean age of 56±11 years. Overall, 12.6% of participants were found to have significant to advanced fibrosis, and 5.4% had liver cirrhosis. Among 184 participants with clinically significant fibrosis (≥8.0 kPa), 26.1% had a history of heavy alcohol intake, 22.3% tested positive for hepatitis B and C infection, and 2.1% with other etiologies. The remaining 49.5% participants with clinically significant fibrosis were diagnosed with NAFLD, with a mean controlled attenuation parameter value of 282±34 dB/m. The high prevalence of significant liver fibrosis in the general population of Romania is alarming and should raise awareness among clinicians and public health systems. Vibration-controlled transient elastography has demonstrated its usefulness as a screening tool to identify advanced liver fibrosis in general population and should be used in liver disease prevention strategies.
NK/T-cell Lymphoma With Orbital Involvement: A Case Report and Systematic Review of the Literature
Authors: Dhodapkar Rahul M. , Spadaro Jane Z. , Heng Jacob S. , Sinard John H. , Lee Yan Ho , Habib Larissa A. , Pointdujour-Lim Renelle
Published: January 2023

Purpose:

To present the clinical course of a patient with recurrent NK/T-cell lymphoma (NKTL) involving the orbit and to review the literature on patients with NKTL involving the orbit.

Methods:

The PubMed database was searched for all cases of NKTL involving orbital, intraocular, or adnexal ocular structures.

Results:

Ninety-six patients were included in the final analysis. The mean age of diagnosis was 48.1 ± 16.8 years. The patients were 53/96 (55.2%) male and 43/96 (44.8%) female. Tumor location varied and included the orbit in 80/96 (83.3%), nasosinus in 56/96 (58.3%), uvea in 11/96 (11.5%), lacrimal gland in 9/96 (9.4%), lacrimal drainage system in 11/96 (11.5%), and conjunctiva in 7/96 (7.3%) cases. Management included surgical debulking in 29/96 (30.2%) cases, radiotherapy in 52/96 (54.2%) cases, and chemotherapy in 82/96 (85.4%) cases. Median survival was 6 months (95% CI: 5–9). Chemotherapy (hazard ratio = 0.80, 95% CI: 0.67–0.95, p = 0.013), radiotherapy (hazard ratio = 0.75, 95% CI: 0.64–0.87, p < 0.001), and orbital involvement being a recurrence of disease (hazard ratio = 0.79, 95% CI: 0.67–0.95, p = 0.009) were associated with improved survival. Advanced Ann Arbor stage (III–IV) at diagnosis (hazard ratio = 1.22, 95% CI: 1.08–1.38, p = 0.001), vision loss (hazard ratio = 1.18, 95% CI: 1.04–1.34, p = 0.009), proptosis (hazard ratio = 1.15, 95% CI: 1.01–1.30, p = 0.035) and periorbital swelling (hazard ratio = 1.15, 95% CI: 1.00–1.33, p = 0.048) were associated with poor survival.

Conclusions:

NK/T-cell lymphoma involving the orbit, globe, or ocular adnexa heralds a poor prognosis where early diagnosis and therapy are critical. The use of radiotherapy and chemotherapy is associated with improved survival.
Single flow diverter to manage multiple intracranial aneurysms in a parent artery
Authors: Lee Chien-Hui , Luo Chao-Bao , Lai Yen-Chun , Chang Feng-Chi , Lin Chung-Jung
Published: January 2023

Background:

Endovascular coil embolization has become an important method in the management of intracranial aneurysm. However, simultaneously coiling multiple intracranial aneurysms (MIAs) in unilateral parent artery in one-stage may fail or insufficient in geographic difficult aneurysm. Flow diverter (FD) has the potential to manage MIAs with nonamenable to coiling. Herein, we report periprocedural morphologic change and outcomes using single FD to manage unruptured MIAs in a parent artery.

Methods:

Over a 3-year period, a total of 63 patients with 126 MIAs successful managed by single FD with complete angiographic follow-up. There were 49 women and 14 men, with ages ranging from 42 to 77 years (mean: 59 years). We retrospectively assessed the clinical data, aneurysm characteristic, angiographic and clinical outcomes of all patients and compared with 171 patients with single aneurysm managed by FD.

Results:

Sixty-one patients with 118 aneurysms (94%) located in internal carotid artery or middle cerebral artery (n = 4, 3%), two patients with four aneurysms (4%) were found in the basilar artery. The mean aneurysm size was 5.6 mm (range from 1.8 to 38 mm). Mean angiographic follow-up was 14 months. Complete obliteration of aneurysm was achieved in 102 aneurysms (83%), subtotal or partial aneurysm obliteration was demonstrated in 18 aneurysms (15%), unchanged aneurysm morphology in three (2%). Aneurysm morphology synchronized alteration in 55 patients (87%), other eight patients (13%) with 16 aneurysms showed different morphologic alteration in angiographic follow-up. Four patients (6.3%) had intraprocedural ischemic complication. During the follow-up period, 61 patients (97%) were neurologic stable; there was no hemorrhagic or ischemic event.

Conclusion:

Single FD was feasible to treat MIAs in a parent artery with both effective and safe in one-stage management. Most aneurysms synchronized alteration of morphology in a mid-term follow-up. The procedure was almost the same with FD managing single aneurysm, but longer FD is needed in MIAs.
A Seat at the Table: An Examination of Hospital Governing Board Diversity, 2011–2021
Authors: Silvera Geoffrey A. , Erwin Cathleen O. , Garman Andrew N.
Published: January 2023

Goal:

Board diversity is increasingly important for hospitals and healthcare systems, with national attention focused on eliminating health disparities and improving health equity. Yet, it remains a challenge despite concerted efforts by leading professional associations (e.g., American College of Healthcare Executives) to galvanize their constituents around the importance of the issue.

Methods:

This study used survey data from The Governance Institute to explore the ethnoracial and gender diversity of hospital boards spanning 2011 through 2021.

Principal Findings:

The results showed modest gains in the mean number of female board members, although a small proportion of hospital boards still have no female representation. There was little change in the number of boards with ethnic minority representation until an uptick in 2021, likely in direct response to high-profile racial incidents and protests.

Practical Applications:

Intentional and sustained efforts are necessary to increase diversity and create a culture of inclusion that fosters meaningful engagement of diverse board members.
Factors Associated With Peripheral Nerve Injury After Pelvic Laparoscopy: The Importance of Surgical Positioning
Authors: ZARANDONA DEL CAMPO Ainhoa , HERREROS MARIAS Nerea , TORVISCO MACIAS Alazne , BARANDICA BILBAO Ana María , RODRIGUEZ OTAZUA Lorea , AGUIRRE LARRACOECHEA Urko , VILLANUEVA ETXEBARRIA Ane , PORTUGAL PORRAS Vicente
Published: January 2023

Background

Nerve damage after abdominal and pelvic surgery is rare but potentially serious. The incidence of peripheral nerve injury is difficult to assess, and rates of between 0.02% and 21% have been cited in the literature. Signs and symptoms of this type of injury may appear immediately after surgery or a few days later.

Purpose

This study was developed to assess the rate of peripheral nerve injury after pelvic laparoscopy and to identify associated risk factors.

Methods

A pilot prospective cohort study was conducted between March 2018 and April 2019 on 101 patients with a 1-month follow-up using two semistructured clinical interviews. We carried out a descriptive analysis followed by univariable and multivariable logistic regression analyses.

Results

Thirteen patients were found to have peripheral nerve injuries, representing a rate of 12.9%. Overall, 14 injuries (five severe and nine mild) were detected. One patient had two mild injuries. In this study, the risk of injury was found to increase 1.77-fold (OR = 1.77, 95% CI [1.13, 2.76], p = .007) for each hour the patient was in the Trendelenburg position.

Conclusions/Implications for Practice

The longer the patient is in the Trendelenburg position, the greater the risk of peripheral nerve damage. Patients aged 60 years or less also face a higher risk of nerve injury.
Arachnoid cysts in paediatrics
Authors: Sarwar Shaheera , Rocker Joshua
Published: January 2023

Purpose of review

Arachnoid cysts are incidentally found on neuroimaging at an increasing rate in the paediatric population. Hence, learning their clinical implications to better inform families is important. The purpose of this review is to outline the current understanding of epidemiology, disease and clinical features based on location, imaging and management of arachnoid cysts in paediatrics.

Recent findings

The prevalence of arachnoid cysts is 2.6% in paediatrics, with greater than 90% being asymptomatic. When they do cause symptoms, it is based primarily on their location and size. The most accurate diagnostic modality is MRI. Recent literature focuses primarily on the origin of arachnoid cysts, new approaches to treating symptomatic arachnoid cysts and long-term implications for patients.

Incidental arachnoid cysts are being found most often due to the more frequent use of neuroimaging. There is a higher prevalence for arachnoid cysts in men and they are more commonly found on the left side. Despite their impressive size or location, greater than 90% of these lesions are asymptomatic and require no intervention. However, follow up with neurosurgery to help determine the clinical significance of these lesions is essential.
Emerging systemic treatment for metastatic castration-resistant prostate cancer: a review of recent randomized controlled trials
Authors: Yanagisawa Takafumi , Kawada Tatsushi , Rajwa Pawel , Kimura Takahiro , Shariat Shahrokh F.
Published: January 2023

Purpose of review

The landscape of therapy for metastatic castration-resistant prostate cancer (mCRPC) has seen an unprecedented transformation with the emergence of combination therapies. This review summarizes the current findings from randomized controlled trials (RCTs) assessing the oncologic outcomes of mCRPC.

Recent findings

In the first-line, treatment-naïve setting, recent RCTs demonstrated the oncologic benefit of adding AKT inhibitors or poly (adenosine diphosphate–ribose) polymerase (PARP) inhibitors to abiraterone in terms of radiographical progression-free survival. Although this is a strong surrogate endpoint, these agents have not yet shown overall survival (OS) improvement. In the second- or later-line settings, olaparib improved OS in patients with at least one alteration in BRCA1, BRCA2, or ATM gene and lutetium-177-prostate-specific membrane antigen-617 [177-Lu-prostate-specific membrane antigen (PSMA)-617] were superior to repeat androgen receptor signaling inhibitor (ARSI) therapy. In addition, 177-Lu-PSMA-617 had better progression-free survival compared with cabazitaxel but failed to result in an OS benefit. To date, there is no evidence for effective immune checkpoint inhibitor regimens/combinations for mCRPC.

According to recent RCTs, several novel agents and/or combinations exhibit promising oncologic outcomes. In the first-line setting, OS benefits compared with currently available regimens are still missing. Results from ongoing/well-designed phase 3 RCTs and real-world data regarding the sequential impact of currently available agents on outcomes of mCRPC patients after ARSI-based combination therapy for metastatic hormone-sensitive prostate cancer are awaited. Such data will improve clinical decision-making in the ever-intensifying treatment era.
Celebrating Magnet® Nursing Excellence – Meet the Recipients of the 2022 National Magnet Nurse of the Year Awards and ANCC Magnet Prize
Authors: Curto Christine
Published: January 2023

This month's Magnet® Perspectives column spotlights the recipients of the 2022 ANCC Magnet Program National Magnet Nurse of the Year (MNOY) Awards and the ANCC Magnet Prize, sponsored by Oracle Cerner, announced during the colocated ANCC National Magnet Conference® and the ANCC Pathway to Excellence® Conference in Philadelphia, Pennsylvania, on October 13 to 15, 2022.
Nurse Performance Metrics
Authors: DePesa Christopher D. , Jurgens Corrine Y. , Lee Christopher S. , O'Reilly-Jacob Monica
Published: January 2023

OBJECTIVE

The purposes of this scoping review are: 1) to identify instances in the literature that describe measuring individual nurse performance and 2) characterize those metrics.

BACKGROUND

The impact of nurses on patient outcomes has been demonstrated at the unit or hospital level, with nurses measured in aggregate. There is an opportunity to evaluate individual nurse performance by creating metrics that capture it.

METHODS

A scoping review based on the framework published by the Joanna Briggs Institute was performed.

RESULTS

Researchers identified 12 articles. Three themes were trended: the emerging nature of these metrics in the literature, variability in their applications, and performance implications.

CONCLUSIONS

Individual nurse performance metrics is an emerging body of research with variability in the types of metrics developed. There is an opportunity for future researchers to work with nurse leaders and staff nurses to optimize these metrics and to use them to support nursing practice and patient care.
Chimeric Antigen Receptor T-Cell Therapy
Authors: Brookens Shawna K. , Posey Avery D.
Published: January 2023

Genetically engineered chimeric antigen receptor (CAR) T-cell therapy leverages the ability of the immune system to eliminate tumors and redirects cytotoxic functions toward cells expressing specified tumor-restricted antigens. Although 6 CAR T-cell therapies have received Food and Drug Administration (FDA) approval for the treatment of many hematological malignancies, limitations involving T cell–intrinsic, T cell–extrinsic, and therapeutic factors remain in the treatment of both liquid and solid tumors. Chimeric antigen receptor design, signals from the tumor microenvironment, tumor antigen escape mechanisms, and systemic inflammatory consequences of CAR T-cell infusion all influence the efficacy and feasibility of CAR T-cell therapy in different malignancies. Here, we review the core structure of the CAR, the evolution of different CAR generations, CAR T-cell therapy limitations, and current strategies being investigated to overcome the T cell–intrinsic, T cell–independent, and therapeutic barriers to successful CAR T-cell therapy.
Interesting Findings in 68Ga-FAPI-46 PET/CT Imaging in a Patient With Glioblastoma Multiforme
Authors: Mohammadzadeh Kosari Hadis , Kiamanesh Zahra , Sadeghi Ramin , Kamali Hassan , Aryana Kamran
Published: January 2023

A 55-year-old disabled man with glioblastoma multiforme was referred to us for fibroblast activation protein inhibitor (FAPI) PET/CT imaging. 68Ga-DOTA-FAPI-46 scan revealed uptake in the primary tumor and unexpected uptakes in soft tissue, especially in periarticular regions. These latter foci were compatible with calcifications on the CT. One in the breast was compatible with fibrotic tissue, but 2 other foci, in the rectus abdominis and gallbladder wall, could not be correlated with the CT findings. In Neurogenic heterotopic ossification, hypoxia-associated oxidative stress results in the metaplastic transformation of fibroblasts. Abnormal differentiation of fibroblasts in neurogenic heterotopic ossification before ossification could explain radiolabeled FAPI avidity in the mentioned areas.
Rhizopus homothallicus, an uncommon causative agent of Rhino-orbital mucormycosis: A Case report
Authors: SAHA UMA SHANKAR , Gupta Minakshi , Kumar Alok , Mishra Minakshi
Published: January 2023

Introduction: Rhizopus oryzae is the most common Mucorales to cause angio-invasive infections though other species may also be found to be associated with different type of invasive infections. This case is about an uncommon species of Mucorales found to cause fungal sinusitis.
Case presentation: A male patient in his late 60s with known history of uncontrolled type 2 diabetes for about last 10 years presented with headache, nasal congestion and with history of fever in recent past. As condition did not improve with initial symptomatic treatment given, further workup was advised. Magnetic resonance imaging (MRI) was carried out which was suggestive of sinusitis. Biopsy was taken from affected sinus for further testing and work up. Microscopic examination from material taken out by biopsy showed few broad aseptate hyaline hyphae with right angle branching (Figure 1).  Fungal culture in Sabouraud Dextrose Agar media incubated at 37o C and 25o C showed white cottony growth within 3 days. Lactophenol Cotton Blue mount showed broad, aseptate hyphae with not-well-developed sporangiophores bearing few globose sporangia and many large numbers of golden brown zygospores with stellate walls and with suspensor cells, which was identified as Rhizopus homothallicus. Liposomal amphotericin B was given for treatment along with resection of local infected area. Subsequently patient improved with treatment.
Conclusion: Our purpose of reporting this case was to highlight the fact that though uncommon this species may emerge sporadically. More cases like this may be reported in future from different parts of the world as well.
Solicola gregarius gen. nov., sp. nov., a soil actinobacterium isolated after enhanced cultivation with Micrococcus luteus culture supernatant
Authors: Lopez Marin Marco A. , Suman Jachym , Jani Kunal , Ulbrich Pavel , Cajthaml Tomas , Filipova Alena , Pajer Petr , Neumann-Schaal Meina , Strejcek Michal , Uhlik Ondrej
Published: January 2023

An actinobacterial strain, designated A5X3R13T, was isolated from a compost soil suspension supplemented with extracellular material from a

Micrococcus luteus

-culture supernatant. The strain was cultured on tenfold-diluted reasoner’s 2A agar. The cells were ovoid-to-rod shaped, non-motile, Gram-stain-positive, oxidase-negative, catalase-positive and had a width of 0.5 µm and a length of 0.8–1.2 µm. The results of both 16S rRNA-based phylogenetic and whole-genome analyses indicate that A5X3R13T forms a distinct lineage within the family

Nocardioidaceae

(order

Propionibacteriales

). On the basis of the 16S rRNA gene sequence, A5X3R13T was closely related to

Aeromicrobium terrae

CC-CFT486T (96.2 %),

Nocardioides iriomotensis

IR27-S3T (96.2 %),

Nocardioides guangzhouensis

130T (95.6 %),

Marmoricola caldifontis

YIM 730233T (95.5 %),

Aeromicrobium alkaliterrae

KSL-107T (95.4 %),

Aeromicrobium choanae

9H-4T (95.4 %),

Aeromicrobium panaciterrae

Gsoil 161T (95.3 %), and

Nocardioides jensenii

NBRC 14755T (95.2 %). The genome had a length of 4 915 757 bp, and its DNA G+C content was 68.5 mol %. The main fatty acids were 10-methyl C17 : 0, C16 : 0, C15 : 0, C18 : 0, C17 : 0 and iso-C16 : 0. The main polar lipids were phosphatidylglycerol, diphosphatidylglycerol, phosphatidylinositol and two unidentified phospholipids. MK-9(H4) was the predominant respiratory quinone. The peptidoglycan type was A3γ (A41.1) and contained alanine, glycine, glutamic acid and ll-diaminopimelic acid in a molar ratio of 1.2 : 0.9 : 1.0 : 0.8. On the basis of the results of the phylogenetic and phenotypic analyses and comparisons with other members of the family

Nocardioidaceae

, strain A5X3R13T is proposed to represent a novel species within a novel genus, for which the name Solicola gregarius gen. nov., sp. nov. is proposed. The type strain is A5X3R13T (=DSM 112953T=NCCB 100840T).
Putting ChatGPT’s Medical Advice to the (Turing) Test
Authors: Nov Oded , Singh Nina , Mann Devin M.
Published: January 2023

Importance

Chatbots could play a role in answering patient questions, but patients’ ability to distinguish between provider and chatbot responses, and patients’ trust in chatbots’ functions are not well established.

Objective

To assess the feasibility of using ChatGPT or a similar AI-based chatbot for patient-provider communication.

Design

Survey in January 2023

Setting

Survey

Participants

A US representative sample of 430 study participants aged 18 and above was recruited on Prolific, a crowdsourcing platform for academic studies. 426 participants filled out the full survey. After removing participants who spent less than 3 minutes on the survey, 392 respondents remained. 53.2% of respondents analyzed were women; their average age was 47.1.

Exposure(s)

Ten representative non-administrative patient-provider interactions were extracted from the EHR. Patients’ questions were placed in ChatGPT with a request for the chatbot to respond using approximately the same word count as the human provider’s response. In the survey, each patient’s question was followed by a provider- or ChatGPT-generated response. Participants were informed that five responses were provider-generated and five were chatbot-generated. Participants were asked, and incentivized financially, to correctly identify the response source. Participants were also asked about their trust in chatbots’ functions in patient-provider communication, using a Likert scale of 1-5.

Main Outcome(s) and Measure(s)

Main outcome: Proportion of responses correctly classified as provider- vs chatbot-generated. Secondary outcomes: Average and standard deviation of responses to trust questions.

Results

The correct classification of responses ranged between 49.0% to 85.7% for different questions. On average, chatbot responses were correctly identified 65.5% of the time, and provider responses were correctly distinguished 65.1% of the time. On average, responses toward patients’ trust in chatbots’ functions were weakly positive (mean Likert score: 3.4), with lower trust as the health-related complexity of the task in questions increased.

Conclusions and Relevance

ChatGPT responses to patient questions were weakly distinguishable from provider responses. Laypeople appear to trust the use of chatbots to answer lower risk health questions. It is important to continue studying patient-chatbot interaction as chatbots move from administrative to more clinical roles in healthcare.

Conclusions and Relevance

AI in Medicine; ChatGPT; Generative AI; Healthcare AI; Turing Test;
Limits on Inferring Gene Regulatory Networks Subjected to Different Noise Mechanisms
Authors: Saint-Antoine Michael , Singh Abhyudai
Published: January 2023

One of the most difficult and pressing problems in computational cell biology is the inference of gene regulatory network structure from transcriptomic data. Benchmarking network inference methods on model organism datasets has yielded mixed results, in which the methods sometimes perform reasonably well and other times fail to outperform random guessing. In this paper, we analyze the feasibility of network inference under different noise conditions using stochastic simulations. We show that gene regulatory interactions with extrinsic noise appear to be more amenable to inference than those with only intrinsic noise, especially when the extrinsic noise causes the system to switch between distinct expression states. Furthermore, we analyze the problem of false positives between genes that have no direct interaction but share a common upstream regulator, and explore a strategy for distinguishing between these false positives and true interactions based on noise profiles of mRNA expression levels. Lastly, we derive mathematical formulas for the mRNA noise levels and correlation using moment analysis techniques, and show how these levels change as the mean mRNA expression level changes.
Board gender diversity and workplace diversity: a machine learning approach
Authors: Ranta Mikko , Ylinen Mika
Published: January 2023

Purpose

This study aims to examine the association between board gender diversity (BGD) and workplace diversity and the relative importance of various board and firm characteristics in predicting diversity.

Design/methodology/approach

With a novel machine learning (ML) approach, this study models the association between three workplace diversity variables and BGD using a social media data set of approximately 250,000 employee reviews. Using the tools of explainable artificial intelligence, the authors interpret the results of the ML model.

Findings

The results show that BGD has a strong positive association with the gender equality and inclusiveness dimensions of corporate diversity culture. However, BGD is found to have a weak negative association with age diversity in a company. Furthermore, the authors find that workplace diversity is an important predictor of firm value, indicating a possible channel on how BGD affects firm performance.

Originality/value

The effects of BGD on workplace diversity below management levels are mainly omitted in the current corporate governance literature. Furthermore, existing research has not considered different dimensions of this diversity and has mainly focused on its gender aspects. In this study, the authors address this research problem and examine how BGD affects different dimensions of diversity at the overall company level. This study reveals important associations and identifies key variables that should be included as a part of theoretical causal models in future research.
Integrating higher degree education with practice: exploring the value proposition of executive MBA apprenticeships
Authors: Evans Marian , Cloutier L. Martin
Published: January 2023

Purpose

The study aims to explore how the collective representations of stakeholders associated with an Executive MBA (EMBA) apprenticeship are conceptualised, and what value elements are perceived as relevant for personal, professional and organisational development.

Design/methodology/approach

Forty stakeholders participated in a mixed methods-based group concept mapping (GCM) approach, representing the tripartite relationship of an EMBA apprenticeship. This approach allowed the deconstruction and shared understanding of the value proposition of higher degree apprenticeships.

Findings

Analysis identified seven conceptualised value clusters around an eight central cluster “Professional Development”. Two regions of meaning were identified: the personal dimensions of apprentices and their contribution within and to their organisation. Findings showed that a work-based designed curriculum improves confidence and communication skills and that much of the value proposition is personal and self-managed by the apprentices. The tripartite relationship was shown to be incomplete and inconsistent, particularly regarding mentoring and reflective practice.

Practical implications

The pandemic has brought about significant changes in business practice. This study identifies several areas for improving higher degree apprenticeship pedagogy in readiness for the new business landscape, as well as identifying limitations of the tripartite relationship.

Originality/value

The study addresses a gap in the literature by exploring the value proposition an EMBA apprenticeship programme. The interrelatedness of cluster concepts has identified value elements missing from previous apprenticeship delivery. Deconstructing the senior leader apprenticeship enables educators to redesign and refine models of engagement for improving the apprenticeship experience.