bluuebunny/crossref_metadata_2025 huggingface dataset:
Pathologically confirmed pancreatic hamartoma after surgical resection with an aldosterone-producing adrenal tumor: a case report
Authors: Kim Jae Han , Yoon Seung Hyun , Choi Ji Ahn , Kwak Ji Hyeon , Kim Milim , Kim Sung Hyun
Published: August 2023

Pancreatic hamartoma is a benign tumor of the pancreas with an extremely low incidence and is commonly diagnosed by pathologic examination after surgery. This report describes the case of a 57-year-old female who was referred for the evaluation of a pancreatic mass and an adrenal incidentaloma. Further imaging studies suggested pancreatic neuroendocrine tumor and aldosterone-producing adrenal tumor. Pylorus-preserving pancreaticoduodenectomy was performed with the initial impression of a pancreatic neuroendocrine tumor. However, pathology results revealed a pancreatic hamartoma. Multiple endocrine neoplasia type 1 syndrome was discussed as a probable explanation for tumor masses in both the pancreas and adrenal gland.
Hospitalists as Facilitators of Surge and Contingency Medical Operations and Planning
Authors: Olson Christina A , Eng-Kulawy Jennifer , Buckland-Coffey Debra D
Published: August 2023

Hospital medicine, a specialty encompassing physicians and advanced practice providers in internal medicine, pediatrics, and family medicine, has been a core and rapidly growing component of civilian health care for the past two decades. More recently, hospitalists have been taking on key roles during surge and contingency planning and operations, most notably during the COVID-19 pandemic which necessitated marked changes in inpatient care across the United States. The military health system has been slower to incorporate hospitalists into clinical care and planning than civilian organizations due to its unique features. However, an increasing focus on future distributed operations in contested environments, pandemic care, and humanitarian assistance/disaster response requires new consideration of their role in military medicine. This stems from hospitalists’ value as clinicians who include triage, resource utilization stewardship, medical inpatient care, pre-/post-operative management of surgical patients, and high acuity patient stabilization and management within their scope, often working collaboratively with other specialists such as emergency medicine physicians, surgeons, and intensivists. Just as importantly, hospitalists are system-level facilitators and leaders of patient capacity expansion and/or clinical process changes when needed for response to incidents in a variety of acute care scenarios. With uniformed billets being increasingly targeted to military platform requirements, there is now an opportunity to revisit the value of hospitalists in military medicine. In this Commentary, we review the roles that hospitalists can fill in hospital and operational medical settings, with a focus on surge and contingency operations. To demonstrate this capability, we present here the experience of two operational units employing hospitalists for high acuity patient management and two civilian hospitals implementing surge operations during the 2022–2023 “tripledemic” of viral respiratory infections in the United States. Their innovations facilitated the care of higher acuity and higher volume during times when medical care requirements were limited by traditional staffing models. We end by reviewing opportunities and challenges related to expanding hospitalist use within the military health system and describing efforts that are underway to address the challenges.
On the nature of the continuum reverberation of X-ray/UV and optical emission of IRAS 09149−6206
Authors: González-Buitrago D H , García-Díaz Ma T , Pozo Nuñez F , Guo Hengxiao
Published: August 2023

We present the results of a continuum reverberation mapping study of the radio-quiet type 1 Seyfert galaxy IRAS 09149−6206. The analysis was performed using X-ray, ultraviolet (UV), and optical observations made with the Swift telescope between 2017 January and December. The time delays between different light curves were measured using three different algorithms: PyI2CCF, PyROA, and JAVELIN. Our results show that the time delays increase with wavelength after τ ∝ λ4/3, as predicted for a geometrically thin and optically thick accretion disc, but only after accounting for significant diffuse continuum emission from the broad-line region. However, the measured size of the accretion disc can be up to five times larger than that predicted by standard theory. To our surprise, the strong increase in soft X-ray fluxes is delayed by about 15 d compared to the optical UV fluctuations, which challenges the prediction of the lamp-post model. Our analysis of the X-ray variability reveals the presence of a non-variable spectral component at 0.3–6.0 keV along with variable excess emission at 2.0–3.0 keV, which could be partly related to relativistic reflection in the inner region of the accretion disc. IRAS 09149−6206 joins the list of objects for which the traditional lamp-post model cannot explain the observed time delays. A scenario that incorporates other geometric considerations into the lamp-post model, e.g. an extended corona along a scattering source, might be better suited to explain the observed long time delays.
One to many: comparing single gravitational-wave events to astrophysical populations
Authors: Mould Matthew , Gerosa Davide , Dall’Amico Marco , Mapelli Michela
Published: August 2023

Gravitational-wave observations have revealed sources whose unusual properties challenge our understanding of compact-binary formation. Inferring the formation processes that are best able to reproduce such events may therefore yield key astrophysical insights. A common approach is to count the fraction of synthetic events from a simulated population that are consistent with some real event. Though appealing owing to its simplicity, this approach is flawed because it neglects the full posterior information, depends on an ad hoc region that defines consistency, and fails for high signal-to-noise detections. We point out that a statistically consistent solution is to compute the posterior odds between two simulated populations, which crucially is a relative measure, and show how to include the effect of observational biases by conditioning on source detectability. Applying the approach to several gravitational-wave events and simulated populations, we assess the degree to which we can conclude model preference not just between distinct formation pathways but also between subpopulations within a given pathway.
Photometric metallicities of fundamental-mode RR Lyr stars from Gaia G band photometry of globular-cluster variables
Authors: Jurcsik Johanna , Hajdu Gergely
Published: August 2023

Photometric metallicity formulae of fundamental-mode RR Lyr (RRab) stars are presented using globular-cluster data exclusively. The aim is to check whether this selection may help increasing the overall accuracy of the fits and eliminating the systematic bias of the photometric results, namely that they tend to overestimate [Fe/H] of the most metal-poor variables. The G band time-series data available in the Gaia DR3 archive and a new compilation of the published spectroscopic globular cluster [Fe/H] values on a uniform solar reference metallicity scale are utilized. We have derived a new [Fe/H]phot − P, φ31 formula, and have diagnosed that no significant increase in the accuracy of the fit can be achieved using non-linear or multiparameter formulae. The best result is obtained when different formulae are applied for variables with Oosterhoff (Oo)-type I and II properties. However, even this solution cannot eliminate the systematic bias of the results completely. This separation of the variables has also led to the conclusion that the photometric estimates of the [Fe/H] are less reliable for the Oo-type II variables than for the Oo-type I sample. Published [Fe/H]phot values and the results of the available photometric formulae in the Gaia G band are compared with the present results. It is found that each of the solutions yields very similar results, with similar accuracy and systematic biases. Major differences are detected only in the zero-points of the [Fe/H] scales, and these offsets are larger than differences in the accepted solar reference values would explain.
A neural network emulator for the Lyman-α forest 1D flux power spectrum
Authors: Cabayol-Garcia L , Chaves-Montero J , Font-Ribera A , Pedersen C
Published: August 2023

The Lyman-α forest offers a unique avenue for studying the distribution of matter in the high redshift universe and extracting precise constraints on the nature of dark matter, neutrino masses, and other ΛCDM extensions. However, interpreting this observable requires accurate modelling of the thermal and ionization state of the intergalactic medium, and therefore resorting to computationally expensive hydrodynamical simulations. In this work, we build a neural network that serves as a surrogate model for rapid predictions of the one-dimensional Lyman-α flux power spectrum (P1D), thereby making Bayesian inference feasible for this observable. Our emulation technique is based on modelling P1D as a function of the slope and amplitude of the linear matter power spectrum rather than as a function of cosmological parameters. We show that our emulator achieves sub-percent precision across the full range of scales (k∥ = 0.1 – $4\, \mathrm{Mpc}^{-1}$) and redshifts (z = 2 – 4.5) considered, and also for three ΛCDM extensions not included in the training set: massive neutrinos, running of the spectral index, and curvature. Furthermore, we show that it performs at the 1 per cent level for ionization and thermal histories not present in the training set and performs at the percent level when emulating down to $k_{\parallel }=8\, \mathrm{Mpc}^{-1}$. These results affirm the efficacy of our emulation strategy in providing accurate predictions even for cosmologies and reionization histories that were not explicitly incorporated during the training phase, and we expect it to play a critical role in the cosmological analysis of the DESI survey.
The timeless timing argument and the total mass of the Local Group
Authors: Sawala Till , Peñarrubia Jorge , Liao Shihong , Johansson Peter H
Published: August 2023

The timing argument connects the motion of a two-body system to its mass in an expanding Universe with a finite age, under the assumption that it has evolved on a self-gravitating orbit. It is commonly applied to the present-day Milky Way (MW)–M31 system in order to infer its unknown mass from the measured kinematics. We use a set of Local Group analogues from the uchuu simulation to investigate the timing argument over cosmic time. We find that the median inferred mass remains almost constant over the past 12 Gyr, even while the haloes themselves grew in mass by more than an order of magnitude. By contrast, we find a closer, and nearly time-invariant agreement between the timing argument value and the mass within a sphere of radius equal to the MW–M31 separation, and we identify this as the total mass of the system. We conclude that the comparatively close present-day agreement between the timing argument and the sum of the halo masses reflects no underlying relation, but merely echoes the fact that the MW and M31 now contain most (but not all) of the mass of the Local Group system.
Cryo-electron microscopy structure and translocation mechanism of the crenarchaeal ribosome
Authors: Wang Ying-Hui , Dai Hong , Zhang Ling , Wu Yun , Wang Jingfen , Wang Chen , Xu Cai-Huang , Hou Hai , Yang Bing , Zhu Yongqun , Zhang Xing , Zhou Jie
Published: August 2023

Archaeal ribosomes have many domain-specific features; however, our understanding of these structures is limited. We present 10 cryo-electron microscopy (cryo-EM) structures of the archaeal ribosome from crenarchaeota Sulfolobus acidocaldarius (Sac) at 2.7–5.7 Å resolution. We observed unstable conformations of H68 and h44 of ribosomal RNA (rRNA) in the subunit structures, which may interfere with subunit association. These subunit structures provided models for 12 rRNA expansion segments and 3 novel r-proteins. Furthermore, the 50S–aRF1 complex structure showed the unique domain orientation of aRF1, possibly explaining P-site transfer RNA (tRNA) release after translation termination. Sac 70S complexes were captured in seven distinct steps of the tRNA translocation reaction, confirming conserved structural features during archaeal ribosome translocation. In aEF2-engaged 70S ribosome complexes, 3D classification of cryo-EM data based on 30S head domain identified two new translocation intermediates with 30S head domain tilted 5–6° enabling its disengagement from the translocated tRNA and its release post-translocation. Additionally, we observed conformational changes to aEF2 during ribosome binding and switching from three different states. Our structural and biochemical data provide new insights into archaeal translation and ribosome translocation.
Exposure to Tobacco-Specific Nitrosamines Among People Who Vape, Smoke, or do Neither: A Systematic Review and Meta-Analysis
Authors: Taylor Eve , Simonavičius Erikas , McNeill Ann , Brose Leonie S , East Katherine , Marczylo Tim , Robson Debbie
Published: August 2023

Introduction

Smoking exposes people to high levels of Tobacco-Specific Nitrosamines (TSNAs), which include potent carcinogens. We systematically reviewed TSNA exposure between people smoking, vaping, and doing neither.

Aims and Methods

Databases were searched between August 2017–March 2022, using vaping-related terms. Peer-reviewed articles reporting TSNA metabolites (NNAL, NNN, NAB, and NAT) levels in bio-samples among adults exclusively vaping, exclusively smoking, or doing neither were included. Where possible, meta-analyses were conducted.

Results

Of 12 781 identified studies, 22 were included. TSNA levels fell substantially when people who smoke switched to vaping in longitudinal studies and were lower among people who vaped compared to smoked in cross-sectional studies. Levels of TSNAs were similar when comparing people who switched from smoking to vaping, to those who switched to no use of nicotine products, in longitudinal studies. Levels were higher among people who vaped compared to people who neither vaped nor smoked in cross-sectional studies.

When comparing people who vaped to smoked: pooled urinary NNAL was 79% lower across three randomized controlled trials and 96% lower across three cross-sectional studies; pooled NAB was 87% lower and NAT 94% lower in two cross-sectional studies. When comparing people who neither vaped nor smoked to people who vaped, pooled urinary NNAL was 80%, NAB 26%, and NAT 27% lower in two cross-sectional studies. Other longitudinal data, and NNN levels could not be pooled.

Conclusions

Exposure to all TSNAs was lower among people who vaped compared to people who smoked. Levels were higher among people who vaped compared to people who neither vaped nor smoked.

Implications

As well as TSNAs, there are many other toxicant exposures from smoking and vaping that can increase the risk of disease. However, it is likely that the reduced exposure to TSNAs from vaping relative to smoking reduces the risk to health of those who use vaping products to quit smoking. Future high-quality research, with robust definitions of exclusive vaping and smoking, and accounting for TSNAs half-lives, is needed to fully assess exposure to TSNAs among people who vape.
Telemedicine during the COVID-19 pandemic: Egyptian healthcare professionals’ views
Authors: Hegazy AA , Abdelhai R , Aboushady AT , Elessawy R , Seddik S
Published: August 2023

Introduction: Despite its suggested positive outcomes, telemedicine will only be a helpful health service when people begin to utilize it. Healthcare professionals (HCPs) represent the principal users of telemedicine services, and their willingness to adopt them has a remarkable impact on their successful implementation. Aim: Identify the acceptability of telemedicine services and the relations between the key facilitators and inhibitors of telemedicine services from the perspective of HCPs in Egypt. Methodology: An observational, analytical cross-sectional study employing the internet platforms of social media among HCPs all over Egypt, via a web-based survey over six months, from August 2020 to January 2021. Results: 262 HCPs participated in the study; 32.8% of the studied HCPs stated they had a high knowledge of telemedicine technology, 41.6% stated that telemedicine was easy to implement and 41.3% believed telemedicine was necessary for patient care. Conclusion: While the use of telemedicine is every day in many countries, the results of the current study showed that the knowledge of telemedicine technology was quite limited, which influenced their attitude toward that technology. Therefore, increasing users' knowledge and demonstrating its capabilities and benefits is essential before deployment.
Are Exercise Interventions in Clinical Trials for Chronic Low Back Pain Dosed Appropriately to Meet the World Health Organization’s Physical Activity Guidelines?
Authors: Gibbs Mitchell T , Hayden Jill A , Cashin Aidan G , Shah Brishna , Gilanyi Yannick L , Natoli Andrew , Holmes Grant , Ogilvie Rachel , Hagstrom Amanda D , McAuley James H , Marshall Paul W , Jones Matthew D
Published: August 2023

Objective

This study aimed to estimate the proportion of exercise interventions tested in clinical trials of people with chronic low back pain (CLBP) that meet the World Health Organization’s (WHO) physical activity guidelines.

Methods

A secondary analysis of the 2021 Cochrane review of exercise therapy for CLBP was performed. Data from each study were extracted by 1 reviewer and were checked by a second reviewer. Data extracted related to the frequency, duration and intensity of each exercise intervention, and the proportion of exercise interventions that met the WHO’s physical activity guidelines (aerobic, muscle strengthening, or both) were determined.

Results

The 249 included trials comprised 426 exercise interventions. Few interventions reported an exercise type and dose consistent with the WHO guidelines (aerobic: 1.6%, muscle strengthening: 5.6%, both: 1.6%). Poor reporting of exercise intensity limited our ability to determine whether interventions met the guidelines.

Conclusion

Few interventions tested in clinical trials for people with CLBP prescribe an exercise type and dose consistent with the WHO guidelines. Therefore, they do not appear sufficiently dosed to achieve broader health outcomes. Future trials should investigate the effect of WHO guideline-recommended exercise interventions on patient-reported outcomes (pain and disability) as well as health-related outcomes in people with CLBP.

Impact

This exploratory analysis showed the lack of exercise interventions in the CLBP literature that meet the WHO’s physical activity guidelines. With people in chronic pain groups, such as people with CLBP, being at higher risk for noncommunicable disease, it appears this is a key consideration for exercise practitioners when designing interventions for people with CLBP.
Characterizing the lavage and serum cytokine profiles of interstitial pneumonia with autoimmune features and their implications for progressive fibrosis
Authors: Zhang Ziyi , Ma Xiaoqian , Bai Junye , Xia Shu , Han Qian , Luo Qun
Published: August 2023

Objective

To explore whether cytokines could be potential biomarkers to predict the occurrence of the progressive fibrosis (PF) phenotype among patients with interstitial pneumonia with autoimmune features (IPAF).

Methods

This study prospectively collected 51 IPAF and 15 idiopathic pulmonary fibrosis (IPF) patients who were diagnosed at the First Affiliated Hospital of Guangzhou Medical University from July 2020 to June 2021. All IPAF patients were followed up for 1 year to assess the development of PF phenotype. Paired bronchoalveolar lavage fluid (BALF) and serum samples were collected at enrolment and analysed for differences in 39 cytokines expression. Principal component analysis (PCA) and cluster analysis were conducted to identify a subgroup of IPAF patients at high risk for developing the PF phenotype. Finally, cytokine differences were compared between subgroups to identify potential biomarkers for PF-IPAF occurrence.

Results

According to the PCA analysis, 81.25% of PF-IPAF patients share overlapped BALF cytokine profiles with IPF. Cluster analysis indicated that IPAF patients in subtype 2 had a higher risk of developing the PF phenotype within 1 year (P = 0.048), characterized by higher levels of CCL2 and CXCL12, and lower lymphocyte proportion (LYM%) in BALF. Elevated levels of BALF CCL2 (>299.16 pg/ml) or CXCL12 (>660.115 pg/ml) were associated with a significantly higher risk of developing PF phenotype within the 1-year follow-up period (P = 0.009, 0.001, respectively).

Conclusion

PF-IPAF phenotype exhibits similar inflammatory cytokine profiles to IPF. Cytokine CCL2 and CXCL12, and LYM% in BALF serve as potential biomarkers for predicting the PF phenotype in IPAF patients.

Clinical Trial Registration

Register: Qian Han, Website: http://www.chictr.org.cn/showproj.aspx?proj=61619, Registration number: ChiCTR2000040998.
Altered Temporal Dynamics of Resting-State Functional Magnetic Resonance Imaging in Adolescent-Onset First-Episode Psychosis
Authors: Masias Bruns Mireia , Ramirez-Mahaluf Juan Pablo , Valli Isabel , Ortuño María , Ilzarbe Daniel , de la Serna Elena , Navarro Olga Puig , Crossley Nicolas A , González Ballester Miguel Ángel , Baeza Inmaculada , Piella Gemma , Castro-Fornieles Josefina , Sugranyes Gisela
Published: August 2023

Background

Dynamic functional connectivity (dFC) alterations have been reported in patients with adult-onset and chronic psychosis. We sought to examine whether such abnormalities were also observed in patients with first episode, adolescent-onset psychosis (AOP), in order to rule out potential effects of chronicity and protracted antipsychotic treatment exposure. AOP has been suggested to have less diagnostic specificity compared to psychosis with onset in adulthood and occurs during a period of neurodevelopmental changes in brain functional connections.

Study Design

Seventy-nine patients with first episode, AOP (36 patients with schizophrenia-spectrum disorder, SSD; and 43 with affective psychotic disorder, AF) and 54 healthy controls (HC), aged 10 to 17 years were included. Participants underwent clinical and cognitive assessments and resting-state functional magnetic resonance imaging. Graph-based measures were used to analyze temporal trajectories of dFC, which were compared between patients with SSD, AF, and HC. Within patients, we also tested associations between dFC parameters and clinical variables.

Study Results

Patients with SSD temporally visited the different connectivity states in a less efficient way (reduced global efficiency), visiting fewer nodes (larger temporal modularity, and increased immobility), with a reduction in the metabolic expenditure (cost and leap size), relative to AF and HC (effect sizes: Cohen’s D, ranging 0.54 to.91). In youth with AF, these parameters did not differ compared to HC. Connectivity measures were not associated with clinical severity, intelligence, cannabis use, or dose of antipsychotic medication.

Conclusions

dFC measures hold potential towards the development of brain-based biomarkers characterizing adolescent-onset SSD.
Basal-Forebrain Cholinergic Nuclei Alterations are Associated With Medication and Cognitive Deficits Across the Schizophrenia Spectrum
Authors: Schulz Julia , Brandl Felix , Grothe Michel J , Kirschner Matthias , Kaiser Stefan , Schmidt André , Borgwardt Stefan , Priller Josef , Sorg Christian , Avram Mihai
Published: August 2023

Background and Hypothesis

The cholinergic system is altered in schizophrenia. Particularly, patients’ volumes of basal-forebrain cholinergic nuclei (BFCN) are lower and correlated with attentional deficits. It is unclear, however, if and how BFCN changes and their link to cognitive symptoms extend across the schizophrenia spectrum, including individuals with at-risk mental state for psychosis (ARMS) or during first psychotic episode (FEP).

Study Design

To address this question, we assessed voxel-based morphometry (VBM) of structural magnetic resonance imaging data of anterior and posterior BFCN subclusters as well as symptom ratings, including cognitive, positive, and negative symptoms, in a large multi-site dataset (n = 4) comprising 68 ARMS subjects, 98 FEP patients (27 unmedicated and 71 medicated), 140 patients with established schizophrenia (SCZ; medicated), and 169 healthy controls.

Results

In SCZ, we found lower VBM measures for the anterior BFCN, which were associated with the anticholinergic burden of medication and correlated with patients’ cognitive deficits. In contrast, we found larger VBM measures for the posterior BFCN in FEP, which were driven by unmedicated patients and correlated at-trend with cognitive deficits. We found no BFCN changes in ARMS. Altered VBM measures were not correlated with positive or negative symptoms.

Conclusions

Results demonstrate complex (posterior vs. anterior BFCN) and non-linear (larger vs. lower VBM) differences in BFCN across the schizophrenia spectrum, which are specifically associated both with medication, including its anticholinergic burden, and cognitive symptoms. Data suggest an altered trajectory of BFCN integrity in schizophrenia, influenced by medication and relevant for cognitive symptoms.
Skyline Fossilized Birth–Death Model is Robust to Violations of Sampling Assumptions in Total-Evidence Dating
Authors: Zhang Chi , Ronquist Fredrik , Stadler Tanja
Published: August 2023

Several total-evidence dating studies under the fossilized birth–death (FBD) model have produced very old age estimates, which are not supported by the fossil record. This phenomenon has been termed “deep root attraction (DRA).” For two specific data sets, involving divergence time estimation for the early radiations of ants, bees, and wasps (Hymenoptera) and of placental mammals (Eutheria), it has been shown that the DRA effect can be greatly reduced by accommodating the fact that extant species in these trees have been sampled to maximize diversity, so-called diversified sampling. Unfortunately, current methods to accommodate diversified sampling only consider the extreme case where it is possible to identify a cut-off time such that all splits occurring before this time are represented in the sampled tree but none of the younger splits. In reality, the sampling bias is rarely this extreme and may be difficult to model properly. Similar modeling challenges apply to the sampling of the fossil record. This raises the question of whether it is possible to find dating methods that are more robust to sampling biases. Here, we show that the skyline FBD (SFBD) process, where the diversification and fossil-sampling rates can vary over time in a piecewise fashion, provides age estimates that are more robust to inadequacies in the modeling of the sampling process and less sensitive to DRA effects. In the SFBD model we consider, rates in different time intervals are either considered to be independent and identically distributed or assumed to be autocorrelated following an Ornstein–Uhlenbeck (OU) process. Through simulations and reanalyses of Hymenoptera and Eutheria data, we show that both variants of the SFBD model unify age estimates under random and diversified sampling assumptions. The SFBD model can resolve DRA by absorbing the deviations from the sampling assumptions into the inferred dynamics of the diversification process over time. Although this means that the inferred diversification dynamics must be interpreted with caution, taking sampling biases into account, we conclude that the SFBD model represents the most robust approach currently available for addressing DRA in total-evidence dating.
International Survey of Cardiopulmonary Physical Therapy Management of Adult Intensive Care Unit Patients and the Impact of COVID-19
Authors: Ntoumenopoulos George , Patman Shane
Published: August 2023

Objectives:

The aim of this study was to report on the cardiorespiratory assessments, interventions, and outcome measures used by physical therapists with critically ill patients and the impact of COVID-19.

Design:

An anonymous international online survey of practice (through Google Forms) of physical therapists was conducted.

Setting:

The study was conducted in adult intensive care units.

Participants:

A total of 309 physical therapists participated in the study.

Interventions:

A survey was used to determine current cardiopulmonary physical therapy practices in ICU.

Results:

Predominantly participants were female (74%), aged 31 to 40 years (40%), having worked in intensive care unit (ICU) for either 0 to 5 years (38%) or 11 to 20 years (28%), and worked full time (72%). Most participants worked in the United Kingdom (36%), Europe (21%), or Australia/Oceania (18%). The 3 most frequently reported assessment indicators for cardiopulmonary physical therapy interventions were lobar collapse/atelectasis, audible secretions, and decreased/added lung auscultation sounds. The 3 most commonly used outcome measures included lung auscultation, arterial blood gas analysis, and transcutaneous arterial saturation. The 3 most commonly used physical therapy interventions (“very often” in a descending order) included patient mobilization, repositioning to optimize gas exchange, and endotracheal suctioning. For the COVID-19 cohort, participants reported similar use of patient repositioning to optimize gas exchange and postural drainage, and lower use of patient mobilization and endotracheal suctioning, deep breathing exercises, active cycle of breathing technique, and oropharyngeal suctioning.

Conclusion:

This survey reports on the characteristics of physical therapists who work in ICU, and their cardiopulmonary physical therapy assessments, interventions, and outcome measures most commonly used, inclusive of patients with COVID-19. There were some differences in interventions provided to the COVID-19 cohort compared with the non–COVID-19 cohort.
Prospective study of 100 infertile couples: does infertility lead to sexual dysfunction
Authors: Sharma Anuj , Sharma Aarti , Bakshi Rita , Bakshi Sarthak
Published: August 2023

Background:

There is a correlation between infertility and serious mental, emotional, and social difficulties reported in the literature. Sexual dysfunction (SD) is quite common in both males and females and often are linked with infertility among couples.

Aim and objective:

The purpose of this study is to investigate whether or not there is a correlation between infertility and SD in couples who are having treatment for infertility at an infertility clinic.

Materials and methods:

Total of 100 couples were included in this study and were given the Changes in Sexual Functioning Questionnaire (CSFQ) questionnaire. The data thus obtained were recorded and analyzed using SPSS software.

Result:

The present study finding indicated that the mean CSFQ score was significantly lower in infertile females compared with the males, indicating that females suffered from SD more. The mean of CSFQ among males was 48.37, and for CSFQ among females; the average was 40.32, which was below the cut-off rate indicating SD is more common in females compared with males. However, our study showed no positive correlation between the lower CSFQ score between both genders with the place of living. As maximum of the study participants were Hindu we have not performed any correlation analysis with religion. Further, this study showed no such differences in duration of the infertility with the CSFQ score.

Conclusion:

This study thus concluded that SD is more common in infertile couples. The prevalence of SD is more in females compared with males.
Predictors for persistent endometrial cavity fluid from fresh to subsequent frozen embryo transfer
Authors: Wang Meng , Wang Zhe , Tian Yi-zheng , Qi Dan , Xu Xinxin , Lv Jia-nan , Yan Lei , Liu Wen , Lv Hong
Published: August 2023

Introduction:

During the process of assisted reproductive technology, clinicians are always faced with the problem of endometrial cavity fluid (ECF) interfering with pregnancy outcomes, especially those patients with ECF. The aim of this study was to identify which characteristics of those patients with ECF during the preparation of fresh embryo transfer would predict their recurrent ECF when they were to undergo this cycle of frozen embryo transfer due to cancellation of fresh embryo transfer or failure to obtain a live birth after fresh embryo transfer.

Methods:

We collected relevant clinical information of those patients receiving assisted reproduction therapy at Reproductive Hospital affiliated with Shandong University between January 2014 and December 2020, including those patients who developed ECF before fresh embryo transfer and canceled fresh embryo transfer for different reasons or did not obtain pregnancy after transfer. Patients were divided into persistent and transient ECF groups according to whether they still had ECF before the current cycle of frozen embryo transfer. We compared relevant data that may influence the persistence of ECF and performed logistic regression analysis to examine whether these variables were associated with the persistence of ECF.

Results:

The proportion of continued existence of ECF was 14.13% (276/1953). The variables related to the persistence of ECF were as follows: polycystic ovarian syndrome status, previous hysteroscopic adhesiolysis history, history of cesarean section, controlled ovarian hyperstimulation protocol, and endometrial thickness on human chorionic gonadotropin trigger day.

Conclusions:

It is recommended to inform those patients who present with a thin endometrium on human chorionic gonadotropin trigger day, the diagnosis of polycystic ovarian syndrome, a history of hysteroscopic adhesiolysis, cesarean section history, or were treated with gonadotropin-releasing hormone antagonist protocol that the ECF is less likely to resolve spontaneously, and early intervention based on the corresponding high-risk factors should be recommended.
Role of Cardiac Biomarkers in Monitoring Cardiotoxicity in Chemotherapy Patients
Authors: Battisha Ayman , Sawalha Khalid , Obeidat Yasin , Patel Brijesh
Published: August 2023

Purpose:

This review aims to highlight the different types of chemotherapy-induced cardiotoxicity and will discuss the evidence base behind the use of different cardiac biomarkers to predict cardiovascular complications. Additionally, we will review the use of cardiac biomarkers to monitor cardiac outcomes and the role of cardioprotective medications in reducing cardiovascular side effects.

Recent findings:

Chemotherapy has been linked to an increased risk of cardiotoxicity and heart failure. Currently, patients receiving chemotherapy undergo echocardiogram before starting chemotherapy and every 6 months to monitor for any decline in cardiac function. We reviewed the current evidence and practice guidelines of monitoring chemotherapy cardiotoxicity.

Cardio-oncology is a rapidly evolving subspecialty in cardiology, especially with the advent of new chemotherapeutic agents, which have cardiovascular side effects. Early detection of these effects is crucial to prevent life-threatening and irreversible cardiovascular outcomes. Monitoring troponin, pro–brain natriuretic peptide, and other cardiac biomarkers during chemotherapy will help to early detect cardiotoxicity.
Caffeine Drug Interactions and its Clinical Implication After Acute Coronary Syndrome: A Literature Review
Authors: Yaghoobian Ramin , Sharifi Mohammad , Rezaee Malihe , Vahidi Hamed , Salehi Negin , Hosseini Kaveh
Published: August 2023

The hemodynamic and cardiovascular impacts of coffee and caffeine have long been controversial. However, due to the worldwide popularity of coffee and caffeinated beverages, it is essential to understand how they affect the cardiovascular system, specifically in patients with a history of acute coronary syndrome. This literature review was conducted to explore the cardiovascular effects of coffee and caffeine and their interactions with common drugs after acute coronary syndrome and percutaneous coronary intervention. The evidence suggests that moderate coffee and caffeine consumption is not associated with cardiovascular disease in healthy individuals and patients with a history of acute coronary syndrome. The interactions of coffee or caffeine with common medications after acute coronary syndrome or percutaneous coronary intervention are less studied. However, based on the current human studies in this field, the only interaction is with the protective effect of statins on cardiac ischemia.
Transcatheter Leadless Pacemaker for the Treatment of Vasovagal Syncope
Authors: Kadado Anis John , Gobeil Kyle , Motta Jishu , Chalhoub Fadi
Published: August 2023

Vasovagal syncope (VVS) is largely a benign condition focused on patient education, lifestyle modification, and avoidance of triggers. However, a subset of patients may benefit from permanent pacemaker placement. Commonly, patients with VVS are younger and those requiring pacing have symptoms associated with severe cardioinhibitory syncope. With the advent of leadless pacemaker systems, a lot of the risks associated with traditional transvenous pacemaker systems are mitigated. In this article, we provide a comprehensive review of the data available for the treatment of cardioinhibitory vasovagal syncope using leadless pacemaker systems.
Therapeutic Effect of Using Autologous Platelet Concentrate in Vitrectomy for Macular Hole: A Systematic Review and Meta-analysis
Authors: Wang Yuelin , Xu Zhengbo , Zhao Xinyu , Meng Lihui , Yang Jingyuan , Chen Youxin
Published: August 2023

Purpose:

To summarize the current evidence regarding the therapeutic effect of using autologous platelet concentrate (APC) in vitrectomy for macular hole (MH).

Methods:

The PubMed, Web of Science, Embase, etc. databases were searched according to the PROSPERO Protocol (CRD42022366202). Controlled trials comparing whether APC was used in the vitrectomy of MH were included. The primary outcome was the closure rate of MH and postoperative best-corrected visual acuity (BCVA), and the secondary outcome was the incidence of different types of complications.

Results:

Seven studies that included 634 eyes were eligible. For the primary outcome, the usage of APC significantly improved the closure rate of MH in vitrectomy (OR = 5.34, 95% CI, 2.83 to 10.07, P <0.001). Postoperative visual acuity did not significantly differ between the APC group and similar baseline controls (SMD=-0.07, 95% CI, -0.35 to 0.22, P=0.644). For the secondary outcome, using APC did not result in additional complications in terms of postoperative retinal detachment or the recurrence of MH.

Conclusion:

The use of APC in vitrectomy was associated with a superior closure rate of the hole and no additional complications; therefore, it is effective and safe in MH surgery.
Influence of Initial Treatment Strategy on Outcomes for Children With Rectal Prolapse
Authors: Rincon-Cruz Lorena , Staffa Steven J. , Dickie Belinda , Nandivada Prathima
Published: August 2023

Objective:

Pediatric rectal prolapse is a common and often self-limited condition with multiple management options. Selecting the optimal approach requires personalization and remains a challenge for pediatricians and pediatric surgeons.

Methods:

A single-center retrospective review of 67 children with rectal prolapse undergoing surgical evaluation between 2010 and 2021. Patients with anorectal malformations, Hirschsprung disease, inflammatory bowel disease, and cystic fibrosis were excluded. We used multivariable logistic regression to compare medical management, sclerotherapy, and surgical correction (rectopexy or transanal resection) as initial treatment strategies, with a primary endpoint of prolapse resolution.

Results:

Younger patients (<5 years) were more likely to be initially treated with medical management alone (P < 0.001). Patients with a psychiatric diagnosis were more likely to be offered either sclerotherapy or surgery upfront (P = 0.009). The resolution rate with surgery as initial management was 79% (n = 11/14). The resolution rate with sclerotherapy as initial management was 54% (n = 13/24), with 33% (n = 8/24) resolving with sclerotherapy alone and 21% (n = 5/24) resolving after a subsequent surgical procedure (P = 0.011). Patients who underwent initial surgical management had an adjusted odds ratio of 8.0 (95% CI: 1.1–59.1; P = 0.042) for resolution of prolapse compared to patients who underwent sclerotherapy initially. Markers of severity (bleeding, need for manual reduction) were not associated with initial therapy offered (P = 0.064).

Conclusions:

Surgical intervention (sclerotherapy, rectopexy, transanal resection) resolved rectal prolapse in most children (63%). Surgery as an initial management approach had a significantly higher success rate than sclerotherapy, even after controlling for severity of disease, psychiatric diagnosis, need for manual reduction, and age.
Novel issues in the epidemiology of asbestos-related diseases
Authors: Pira Enrico , Godono Alessandro , Ciocan Catalina
Published: August 2023

Purpose of review

Exposure to asbestos continues to persist because of the use of this mineral in developing countries and because of the naturally occurring asbestos and of the presence of asbestos in the asbestos-containing materials. After more than 30 years since the ban in some countries, asbestos-related malignancies are still diagnosed yearly. Thus, we conducted a systematic search for articles regarding epidemiologic advances in asbestos-related diseases in the last 18 months in order to summarize the newest findings that could, eventually, improve the prevention strategies for asbestos-related cancers.

Recent findings

There are advances regarding the diagnosis and treatment of mesothelioma. Recent publications confirm a trend for mesothelioma for time since last exposure, while for asbestos-related lung cancer, findings show a linear association between asbestos exposure level and lung cancer risk. Other asbestos-related malignancies have been hypothesized. The importance of an accurate diagnosis of mesothelioma has been further emphasized for the prognosis and therapeutic success of this cancer.

Latest findings allow public health to project prevention, and clinicians to project better treatment strategies for asbestos-related diseases. More studies on the treatment options are needed and ‘Tailored’ therapy should be among the focal points.
Cumulative Effects of Comorbid Burden and Overactive Bladder Symptoms on Fall Risk Among Older Women Seeking Treatment for Urogynecologic Conditions
Authors: Fisher Steve R. , Halder Gabriela E. , Lee Mi Jung , Allen Lindsay , Kilic Gokhan S.
Published: August 2023

Importance

Overactive bladder (OAB) syndrome and urinary incontinence, age, and comorbid burden are strong risk factors for falls in women. Less is known about their cumulative effects on fall risk in a urogynecologic population.

Objective

The purpose of this study was to investigate the effects of coexisting OAB, older age, and comorbidities on risk of falling among treatment seeking women with pelvic floor disorders.

Study Design

We conducted a retrospective medical records review of 348 consecutive women presenting to a urogynecology clinic over 6 months. Fall risk was determined by the Centers for Disease Control and Prevention’s, Stopping Elderly Accidents, Deaths, and Injuries screening tool. Clinical and sociodemographic measures were abstracted from the electronic medical record. Odds of screening positive for high fall risk based on different patient profiles were calculated. We then used a classification and regression tree analysis to determine the relative importance of the different variables on fall risk within the homogeneous subgroups.

Results

Of the 348 women (mean age, 58.7 ± 15.8 years) who completed the fall risk screen, 124 (36%) screened positive for increased fall risk. Overactive bladder symptoms increased the likelihood of a positive fall risk screen across all combinations of age and comorbid burden. The patient profile of ≥3 OAB symptoms, ≥4 comorbid conditions, and age 65 years or older increased the odds of screening positive for high fall risk more than 6-fold (odds ratio, 6.4; 95% confidence interval, 3.1–12.9). In the following order of importance, the combination of high comorbid burden, OAB, and older age identified approximately 3 in 4 patients (73.3%) at high risk of falling.

Conclusion

The presence of 3 easily identifiable patient characteristics is strongly associated with a risk of falls in women seeking care for pelvic floor disorders.
ORCHID: A Comprehensive Oral Cancer Histology Image Database for Histopathological Analytics and Diagnostics
Authors: Chaudhary Nisha , Rai Arpita , Rao Aakash Madhav , Faizan Md Imam , Augustine Jeyaseelan , Chaurasia Akhilanand , Mishra Deepika , Chandra Akhilesh , Chauhan Varnit , Kutum Rintu , Ahmad Tanveer
Published: August 2023

Oral cancer is a global health challenge with a difficult histopathological diagnosis. The accurate histopathological interpretation of oral cancer tissue samples remains difficult. However, early diagnosis is very challenging due to a lack of experienced pathologists and inter-observer variability in diagnosis. The application of artificial intelligence (deep learning algorithms) for oral cancer histology images is very promising for rapid diagnosis. However, it requires a quality annotated dataset to build AI models. We present ORCHID (ORalCancerHistologyImageDatabase), a specialized database generated to advance research in AI-based histology image analytics of oral cancer and precancer. The ORCHID database is an extensive multicenter collection of 300,000 image patches, encapsulating various oral cancer and precancer categories, such as oral submucous fibrosis (OSMF) and oral squamous cell carcinoma (OSCC). Additionally, it also contains grade-level sub-classifications for OSCC, such as well-differentiated (WD), moderately-differentiated (MD), and poorly-differentiated (PD). Furthermore, the database seeks to bolster the creation and validation of innovative artificial intelligence-based rapid diagnostics for OSMF and OSCC, along with subtypes.
Endotoxin, unidentified material, and low amounts of defined toxicants are confounding factors when using the air pollution Standard Reference Material (SRM) 2786 in biological experiments
Authors: Miller Charles
Published: August 2023

The National Institute of Standards and Technology (NIST) provides the reference sample SRM 2786 for use in analytical studies of particulate air pollution. The sample originated from an atypical source and possibly contains materials that are unrelated to air pollution. Investigators conducting studies with SRM 2786 should note the relatively low amounts of toxic components listed in the certificate of analysis as well as a large amount of uncharacterized material. Additionally, there is no unsized reference material that can be used as a control for the particulate nature of SRM 2786. The presence of a low amount of endotoxin in SRM 2786 is reported here. Endotoxin and other uncharacterized material in SRM 2786 may influence results and conclusions for biological studies using this reference material.