bluuebunny/crossref_metadata_2025 huggingface dataset:
Cranial Remolding Orthosis Study on the Use of a Temperature Sensor to Measure Wear Time
Authors: Thach Scott , Corso Jessica , Cimorelli Anthony , Owens Jaccalyn , Davis Catherine Leigh
Published: July 2024

Introduction

The effectiveness of cranial remolding orthoses (CROs) in treating nonsynostotic deformational plagiocephaly (DP) is anecdotally related to adherence. Efficacy of CROs has been evaluated but lacks evidence regarding necessary wear time to achieve a positive outcome. A 23 hr/d wear schedule is generally prescribed regardless of presentation. The study compares daily wear time to treatment outcomes.

Materials and Methods

Subjects

Infants aged 3–18 months diagnosed with DP were included with initial cranial vault asymmetry (CVA) > 6 mm or cephalic ratio (CR) > 0.90. Subjects were treated with an Orthomerica STARband CRO. A total of 106 subjects enrolled, with 69 completed.

Apparatus

A questionnaire assessed caregiver’s reported adherence with the CRO. Maximum Integrated’s iButton temperature loggers (iButtons) recorded objective wear time.

Procedures

3D head shape measurements via Orthomerica STARScanner, caregivers’ questionnaires, and iButton data were collected every 5–8 weeks.

Data Analysis

Descriptive statistics were obtained, and data reported as mean ± SD or median [25th, 75th percentiles]. Nonparametric sign tests were used to assess differences from CRO fabrication scan to subsequent follow-ups. Spearman rank correlations and corresponding 95% confidence intervals and P values between average wear time and change of measurements were obtained.

Results

Self-reported wear time was 22 (22, 23) hrs/d. Measured wear time was 17–18 (12, 20) hrs/d. Longer average wear time was significantly associated with larger reductions in CVA (P = 0.0054), CR (P = 0.0080), and CVAI (P = 0.0059).

Conclusions

Results showed longer average daily wear increased effectiveness in CRO treatment of plagiocephaly. Increased sample sizing is required to determine if generalizable to brachycephalic and asymmetrical brachycephalic head shapes.

Clinical Relevance

A CRO wear schedule of 23 hrs a day is currently recommended, but difficult for families to adhere. The impact of the study may indicate a more realistic wear schedule that would improve adherence while achieving optimal outcomes.
Prognostic model for resected borderline and locally advanced pancreatic cancer after neoadjuvant chemotherapy
Authors: Son Jimin , Lee Woohyung , Lee Jung Bok , Hong Kwangpyo , Sung Min Kyu , Park Yejong , Jun Eunsung , Song Ki Byung , Hwang Dae Wook , Lee Jae Hoon , Kim Song Cheol
Published: July 2024

Background:

The current AJCC 8th has been reported to have a poor ability to predict the prognosis in patients with resected borderline resectable pancreatic cancer and locally advanced pancreatic cancer following neoadjuvant chemotherapy. This study aimed to develop an improved prognostic model by incorporating pathology and parameters of biologic response (BR).

Materials and methods:

A retrospective cohort study was conducted including patients who underwent curative-intent surgery following chemotherapy. The authors developed a modified ypT staging system and incorporated the BR, involving normalization of carbohydrate antigen 19-9 and reduction in the maximum standardized uptake value simultaneously after chemotherapy. The prognostic performance of the current pathologic system, modified pathologic system, and newly developed system incorporating pathology and BR were compared.

Results:

In this study, 171 patients underwent surgery following chemotherapy. The modified T stage, which unified ypT2 and ypT3, demonstrated improved prognostic performance than the current staging system [area under the curve (AUC): 0.706 vs. 0.661]. Biologic unresponsiveness was an independent prognostic factor for worse survival (hazard ratio 2.31, 95% CI: 1.50–3.55, P<0.001). The modified pathology with BR system demonstrated the highest discriminative ability in predicting 5-year overall survival than the current pathologic system (AUC: 0.785 vs. 0.661, P=0.010) and modified pathologic staging system (AUC: 0.785 vs. 0.706, P=0.002).

Conclusions:

The prognostic model, incorporating modified ypT staging and elevated carbohydrate antigen 19-9 levels and maximum standardized uptake value simultaneously, demonstrated improved results in predicting oncologic outcomes for patients who underwent surgery following neoadjuvant chemotherapy.
Restratification of intermediate risk factors on the recurrence of papillary thyroid carcinoma: a retrospective cohort study
Authors: Chen Qiang , Zou Xiuhe , Liu Feng , Su Anping , Jiang Yong , Wei Tao , Gong Rixiang , Zhu Jingqiang , Li Zhihui
Published: July 2024

Background:

Data regarding the long-term recurrence in patients with intermediate-risk papillary thyroid carcinoma (PTC) are limited. The aim of this study was to assess the impact of primary tumor-related risk factors and lymph node (LN)-only risk factors on recurrence-free survival (RFS) in patients with intermediate-risk PTC.

Materials and methods:

Patients with PTC who received initial treatment at our institution between 2010 and 2016 were retrospectively reviewed. A total of 799 intermediate-risk PTC patients were included and further categorized into subgroups according to the different categories of intermediate-risk factors. The RFS rates of these subgroups were investigated and compared.

Results:

Structural recurrence developed in 11 patients (1.4%) of the whole cohort during a median follow-up duration of 96 months. There were no significant differences in RFS between the primary tumor-only risk group and the LN-only risk group, while the combined group of primary tumor risk factors and LN risk factor (metastatic LNs >5) was associated with a worse RFS rate. In the matched-pair analysis, no significant difference in RFS was found between patients who underwent thyroid lobectomy and those who underwent total thyroidectomy (6-year RFS: 99.6 vs. 98.8%, P=0.316) during a median follow-up duration of 100 months.

Conclusions:

Intermediate-risk PTC patients who underwent thyroid lobectomy had a comparable RFS to those who underwent total thyroidectomy. The combination of primary tumor risk factors and LN risk factor (metastatic LNs >5) may be a useful tool for predicting the risk of long-term structural recurrence in patients with intermediate-risk PTC.
What are the Protocols and Resources for Sport-Related Concussion Among Top National Collegiate Athletic Association Football Programs? A Cross-Sectional Survey of A5 Schools
Authors: Clugston James R. , Diemer Kelsey , Chrabaszcz Sarah L. , Long Connor C. , Jo Jacob , Terry Douglas P. , Zuckerman Scott L. , Fitch Robert Warne
Published: July 2024

Objective:

This study summarizes findings from a cross-sectional survey conducted among National Collegiate Athletic Association (NCAA) Division 1 football programs, focusing on sport-related concussion (SRC) protocols for the 2018 season.

Design:

Cross-sectional survey study.

Setting:

65 football programs within the Autonomy Five (A5) NCAA conferences.

Participants:

Athletic trainers and team physicians who attended a football safety meeting at the NCAA offices June 17 to 18, 2019, representing their respective institutions.

Intervention:

Electronic surveys were distributed on June 14, 2019, before the football safety meeting.

Main Outcome Measures:

Results for 16 unique questions involving SRC protocols and resources were summarized and evaluated.

Results:

The survey garnered responses from 46 of 65 programs (response rate = 71%). For baseline testing, 98% measured baseline postural stability and balance, 87% used baseline neurocognitive testing, while only 61% assessed baseline vestibular and/or ocular function. Regarding concussion prevention, 51% did not recommend additional measures, while 4% and 24% recommended cervical compression collars and omega-3 supplementation, respectively. In postconcussion treatment, 26% initiated aerobic exercise 1 day postconcussion if symptoms were stable, 24% waited at least 48 hours, 4% waited for the athlete to return to baseline, 11% waited until the athlete became asymptomatic, and 35% determined procedures on a case-by-case basis.

Conclusions:

Most institutions assessed postural stability/balance and neurocognitive functioning at baseline and introduced light aerobic exercise within 48 h postconcussion. There was variation in baseline assessment methods and concussion prevention recommendations. These survey findings deepen our understanding of diverse SRC protocols in NCAA football programs.
Characteristics analysis of hepatitis B core–related antigen in children with hepatitis B e antigen–positive chronic viral hepatitis B infection
Authors: Wang Fu-Chuan , Dong Yi , Xu Zhi-Qiang , Gao Yin-Jie , Yan Jian-Guo , Cao Li-Li , Feng Dan-Ni , Liu Chao , Zhong Yan-Wei , Zhang Min , Xin Shao-Jie
Published: July 2024

Background

The objective of antiviral therapy for chronic viral hepatitis B infection (CHB) is to achieve a functional cure. An important viral marker in the serum of patients with CHB is the serum hepatitis B core–related antigen (HBcrAg). However, there is limited research on HBcrAg in juvenile patients with CHB. In this study, we aimed to investigate the correlation between serum HBcrAg and other hepatitis B virus (HBV) markers in children with CHB and its predictive significance for prognosis during antiviral therapy.

Methods

A single-center retrospective study was conducted involving 79 children with CHB, aged between 0 and 16 years. All the children were treated with interferon [or combined nucleos(t)ide analogs] for 48 weeks. HBcrAg, hepatitis B surface antigen (HBsAg), and HBV DNA were measured before treatment, and at 12 and 48 weeks after treatment. The enrolled children were classified into the seroclearance group and the nonseroclearance group based on the therapeutic outcome.

Results

HBsAg seroclearance was observed in 28 out of 79 patients and hepatitis B e antigen seroconversion without HBsAg seroclearance was observed in 14 out of 79 patients following the conclusion of the treatment, with baseline HBcrAg titer levels showing no statistical significance in both the seroclearance and nonseroclearance groups (P = 0.277). HBsAg and HBV DNA were positively correlated with HBcrAg in children with CHB (R
2 = 0.3289, 0.4388). The area under the receiver operating characteristic curve of the decrease in HBcrAg at 12 weeks of treatment as a predictor of seroclearance at 48 weeks of treatment, exhibited a value of 0.77.

Conclusion

A decrease in serum HBcrAg levels in children with hepatitis B serves as a prognostic indicator.
Association of dietary intake and serum concentration of omega-3 fatty acids on celiac disease: evidence from observational study and Mendelian randomization
Authors: Bai Tongtong , Peng Juanjuan , Wu Chengyu
Published: July 2024

Objective

The association between omega-3 fatty acids (O3FA) and celiac disease lacks sufficient investigation.

Methods

Utilizing data gleaned from the 2009 to 2014 National Health and Nutrition Examination Survey (NHANES), this research comprises a sample of 13 403 adults, each aged 20 years and above. We conducted a multivariable logistic regression analysis to assess the association between dietary intake of O3FA and celiac disease. Subsequently, a two-sample Mendelian randomization was performed to estimate the unconfounded causal relationship between serum O3FA and celiac disease. The principal analytical strategy utilized the inverse-variance weighted methodology.

Results

In this cross-sectional study, 48 occurrences (0.36%) of celiac disease were encompassed. In the multivariable model, there was no association between dietary intake of O3FA and cases of celiac disease (odds ratio: 1.12, 95% confidence interval: 0.47–2.66, P = 0.792). However, serum levels of O3FA determined by genetic assay were correlated with celiac disease (inverse-variance weighted, β = 0.2439, P = 0.0287), with no evidence of horizontal pleiotropy (P = 0.3689).

Conclusion

The dietary consumption of O3FA did not exhibit an association with the risk of celiac disease in this cross-sectional investigation. However, a correlation between celiac disease and serum levels of O3FA was observed in the Mendelian randomization. Further investigations, including human clinical trials, are warranted.
The role of the fecal microbiota in inflammatory bowel disease
Authors: Khalaf Rami , Sciberras Martina , Ellul Pierre
Published: July 2024

The understanding of the potential role of the microbiota in the pathogenesis of inflammatory bowel disease (IBD) is ever-evolving. Traditionally, the management of IBD has involved medical therapy and/or surgical intervention. IBD can be characterized by gut microbiome alterations through various pathological processes. Various studies delve into nontraditional methods such as probiotics and fecal microbiota transplant and their potential therapeutic effects. Fecal microbiota transplant involves the delivery of a balanced composition of gut microorganisms into an affected patient via multiple possible routes and methods, while probiotics consist of live microorganisms given via the oral route. At present, neither method is considered first-line treatment, however, fecal microbiota transplant has shown potential success in inducing and maintaining remission in ulcerative colitis. In a study by Kruis and colleagues, Escherichia coli Nissle 1917 was considered to be equivalent to mesalamine in mild ulcerative colitis. Alteration of the microbiome in the management of Crohn’s disease is less well defined. Furthermore, variation in the clinical usefulness of 5-aminosalicylic acid medication has been attributed, in part, to its acetylation and inactivation by gut microbes. In summary, our understanding of the microbiome’s role is continually advancing, with the possibility of paving the way for personalized medicine based on the microbiome.
Compared with other methods, cyanoacrylate and lauromacrogol in treating esophagogastric varices did not increase the risk of postoperative infection
Authors: Zeng Qingyu , Lan Chao , He Binbo , Tao Zhang , Liu Jie , Kong Tao , Xu Shan
Published: July 2024

Background

Patients with cirrhosis commonly undergo endoscopic cyanoacrylate injection for gastric and esophageal variceal bleeding. However, postoperative infections can increase the risk of rebleeding and mortality.

Aim

This study aimed to determine the risk of postoperative infections and its associated factors following cyanoacrylate injection treatment in these patients.

Methods

A retrospective analysis was conducted on 57 patients treated with ligation (ligation group), 66 patients treated with cyanoacrylate injection (injection group), and 91 patients treated with conservative treatment (control group) at the Nanchong Central Hospital.

Results

The rate of postoperative infection was similar among the cyanoacrylate, ligation, and conservative treatment groups, with no significant statistical difference observed (P = 0.97). Multivariate analysis identified postoperative Child–Pugh score and renal insufficiency as two independent risk factors for postoperative infection. The rebleeding rate in the injection group was significantly lower than in the other groups (P = 0.01). Mortality was significantly higher in the control group compared with the ligation and injection groups (P = 0.01).

Conclusion

Cyanoacrylate combined with lauromacrogol injection did not significantly increase the risk of infection compared with ligation and conservative treatments, and it was more effective in reducing the risk of rebleeding. This method is safe, effective, and holds clinical value for broader application.
Developing an Evidence-Based Patient Education Guide on Pain Management for Asian Patients on Hospice
Authors: Huang Sally , Spicer Joan Gygax
Published: July 2024

Asian Americans are the fastest-growing racial group in the United States. This article describes the development of a pain management assessment guide for Asian patients on hospice, their families, and their nurses. Thematic analysis was used to evaluate the applicability of research on pain, pain management, and barriers to pain management from primarily Asian countries to Asian patients on hospice in the United States. Thematic analysis of interviews with such patients concurs with research findings. Four themes emerged: enduring pain, preference for Chinese medicine remedies, fear of addiction, and concern about the side effects of pain medications. Interviews with experienced hospice nurses also aligned with these themes. Hospice nurses were asked to share their strategies for assessing and managing pain among their Asian hospice patients. Thematic analysis of their interviews revealed six strategies: focusing on treatment goals, involving family and caregivers, explaining the physiology of pain, explaining the progression of pain medications, addressing concerns about addiction, and managing the side effects of medications. The themes that emerged from patient and hospice nurse interviews were used to develop an evidence-based pain management assessment guide to support Asian patients on hospice, their family, and the nurses who care for them.
Pilot Study to Determine the Effectiveness of a Home Health Nursing Simulation
Authors: Sutherland Jodi L. , Palmer Deborah , Sprague Lori , Si Bing , Rababa Salahaldeen
Published: July 2024

Demand for home care has increased due to the expansion of preventive care, people living longer with chronic conditions, and the need for healthcare services as the baby boom population ages. Nurses must be prepared to meet the needs of patients and families in the home setting. Home care nursing simulations have been utilized as a teaching-learning strategy in baccalaureate nursing education, yet less is known about their use with practicing home care nurses and associate degree nursing students. The purpose of this pilot study using simulation was to prepare practicing nurses and student nurses to respond using nursing skills and clinical judgment. The convenience sample consisted of associate degree nursing students (n = 9), practicing home healthcare nurses (n = 8), and nursing faculty (n = 2). The Simulation Effectiveness Tool - Modified (SET-M) Survey (Leighton et al., 2015) was utilized for data collection. Participants perceived the home healthcare simulation to be an effective practice experience with high overall agreement for Pre-briefing, Scenario-Confidence, Scenario-Learning, and Debriefing. The findings of this study provide data to support partnerships to provide home care simulation experiences for associate degree nursing students and practicing home care nurses.
Reflections on the contribution of IPOS to psycho-oncology
Authors: Watson Maggie
Published: July 2024

This invited commentary briefly describes some of the milestones and events from the period of 2010–2012 while I was President of the International Psycho-Oncology Society (IPOS). Important events covered include the introduction and implementation of an International Standard of Quality Psychosocial Care, the setting up of IPOS Press, the initiation of a partnership with the WHO and further development of the curriculum, and the IPOS Federation of Societies implemented by Dr Luigi Grassi. It also briefly covers important changes to the governance, byelaws, and committee structures of IPOS.
Unusual PEComa With PRCC::TFE3 Fusion Mimicking Sinonasal Tract Melanoma
Authors: Lasota Jerzy , Thompson Lester D.R. , Chłopek Małgorzata , Kowalik Artur , Miettinen Markku
Published: July 2024

Background:

We report a nasal cavity unusual perivascular epithelioid cell tumor (PEComa) mimicking mucosal melanoma.

Methods:

Immunohistochemistry was performed using BenchMark Ultra and panel of antibodies. The Ion Torrent platform and Ion AmpliSeq cancer hotspot panel were utilized for DNA genotyping. Target-specific RNA libraries for the detection of fusion transcripts were constructed using Archer Universal RNA Reagent Kit v2 and Archer FusionPlex Solid Tumor panel and sequenced on the MiSeqDx instrument.

Results:

The tumor, diagnosed in 46-year-old female, was composed of spindle cells, and lacked pigmentation. Immunohistochemically, it showed a patchy HMB-45 positivity. Other melanocytic markers (S100 protein, Melan-A, SOX10) were negative. The tumor cells were weakly positive for KIT (CD117) while negative for smooth muscle actin, pancytokeratin cocktail (AE1/AE3), and synaptophysin. Diagnosis of primary sinonasal tract mucosal melanoma was favored. Additional molecular studies detected PRCC::TFE3 fusion as the sole genetic change, and suggested the diagnosis of unusual PEComa. Previously, TFE3 fusions were reported in a subset of PEComas but not in melanomas, while PRCC involvement has only been documented once in an ocular PEComa. Immunohistochemistry revealed strong nuclear TFE3 expression concordant with the molecular findings.

Conclusions:

This report emphasis the importance of molecular testing in the differential diagnosis between PEComa and melanoma, especially when the tumor arises in a site typical of melanoma but showing an unusual morphology and immunophenotype. The detection of TFE3 fusion transcripts suggested the diagnosis of SNT PEComa, although it cannot be excluded that this and similar tumors represent a distinct diagnostic category.
Associations Between Early-Pregnancy Vitamin D Status and Postpartum Depressive and Anxiety Symptoms
Authors: Domacassé Desirée , de Rooij Susanne R. , Vrijkotte Tanja , de Jonge Ank , Henrichs Jens
Published: July 2024

Objective

Maternal postpartum depressive and anxiety symptoms are risk factors for subsequent maternal and child mental health problems. Little is known about the potential role of antepartum vitamin D and C-reactive protein (CRP) in the etiology of maternal postpartum affective symptoms. We investigated associations between antepartum vitamin D status and postpartum depressive and anxiety symptoms and whether antepartum CRP mediated these associations.

Methods

In 2483 participants of the Amsterdam Born Children and their Development prospective cohort, maternal serum vitamin D and CRP were measured at a median of 13 weeks’ gestation. Vitamin D status was defined as deficient (≤29.9 nM), insufficient (30–49.9 nM), sufficient (50–79.9 nM), or normal (≥80 nM). Maternal depressive symptoms (Center for Epidemiologic Studies-Depression) and anxiety (State-Trait Anxiety Inventory) were assessed 3 months postpartum.

Results

After adjustments for confounders, vitamin D deficiency was only associated with increased postpartum anxiety symptoms (B = 0.17, 95% confidence interval [CI] = 0.03–0.30, p = .017) compared to normal vitamin D levels (≥80 nM). In women not taking vitamin D supplementation (n = 2303), vitamin D deficiency was associated with increased postpartum depressive and anxiety symptoms (B = 0.14, 95% CI = 0.03–0.28, p = .045; and B = 0.17, 95% CI = 0.03–0.32, p = .015). Antepartum CRP did not mediate these links.

Conclusions

We found some evidence that antepartum vitamin D deficiency was associated with increased postpartum affective symptoms, especially in women not taking vitamin D supplementation. Clinical trials should determine whether vitamin D supplementation can reduce the risk for postpartum affective disorders.
Lifetime Trauma Exposure and Arthritis in Older Adults
Authors: Nishimi Kristen , Chen Ruijia , Schmajuk Gabriela , Neylan Thomas C. , O’Donovan Aoife
Published: July 2024

Objective

Experiencing potentially traumatic events across one’s lifecourse increases risk for poor physical health outcomes. Existing models emphasize the effects of any lifetime trauma exposure, risk accumulation (multiple traumas over time), and sensitive periods of exposure (specific exposure timepoints leading to lasting consequences). We examined how different indices of trauma exposure across the lifecourse were associated with later life arthritis, a common and debilitating health condition.

Methods

Data include 5717 Health and Retirement Study participants (age mean [standard deviation] = 65.4 [12.9] years) who reported on lifetime adversity and trauma in 2006–2008. Lifetime trauma exposure was modeled as any trauma, accumulation of traumas, and lifecourse profiles (no exposure, childhood only, adulthood only, childhood and adulthood exposure). Outcomes included prevalent arthritis at baseline and incident arthritis across 12 years of follow-up. Covariate-adjusted generalized linear models for prevalence ratios and Cox proportional hazards models for hazard ratios were conducted.

Results

Any lifetime trauma was associated with both prevalent arthritis at baseline (prevalence ratio = 1.13, 95% confidence interval = 1.05–1.22) and incident arthritis over 12 years (hazard ratio = 1.25, 95% confidence interval = 1.17–1.47). Greater trauma accumulation was significantly associated with both prevalent and incident arthritis. Childhood exposure was particularly strongly associated with prevalent and incident cases, with adulthood exposure being unassociated with incident arthritis. Across models, trauma exposure was associated with prevalent cases of both immune-related and osteoarthritis types.

Conclusions

Higher lifetime trauma burden, especially during childhood, may predispose individuals to arthritis later in life. Early intervention or prevention efforts should identify trauma as an important risk factor for musculoskeletal health across the lifecourse.
Conclusions Regarding the Role of Expectations in Placebo Analgesia Studies May Depend on How We Investigate It: A Meta-Analysis, Systematic Review, and Proposal for Methodological Discussions
Authors: Lunde Sigrid Juhl , Rosenkjær Sophie , Matthiesen Susan Tomczak , Kirsch Irving , Vase Lene
Published: July 2024

Objective

Expectations are highlighted as a key component in placebo effects. However, there are different approaches to whether and how placebo studies should account for expectations, and the direct contribution has yet to be estimated in meta-analyses. Using different methodological approaches, this meta-analysis and systematic review examines the extent to which expectations contribute to pain in placebo studies.

Methods

The databases PubMed, PsycINFO, Embase, and Web of Science were searched for placebo analgesia mechanism studies with numerical measures of both expectations and pain. Thirty-one studies, comprising 34 independent study populations (1566 subjects: patients and healthy participants) were included. Two meta-analyses were conducted: meta-analysis 1, using study-level data, estimated the effect of expectation interventions without taking measures of expectations into account (expectations assumed); and meta-analysis 2, using individual-level data, estimated the direct impact of participants’ expectations on pain (expectations assessed). Risk of bias was assessed using the Cochrane risk-of-bias tool.

Results

Meta-analysis 1 showed a moderate effect of expectation interventions over no expectation intervention on pain intensity (Hedges g = 0.45, I
2 = 54.19). Based on 10 studies providing individual-level data, meta-analysis 2 showed that expectations predicted pain intensity in placebo and control groups (b = 0.36, SE = 0.05), although inconsistently across study methodologies.

Conclusions

Participants’ expectations contributed moderately to pain in placebo analgesia studies. However, this may largely be influenced by how we measure expectations and how their contribution is conceptualized and analyzed—both within and across studies.
Contemporary Patterns of Financial Toxicity Among Patients With Rheumatologic Disease in the United States
Authors: Amen Troy B. , Dee Edward Christopher , Jain Bhav , Batter Stephen , Jain Urvish , Bajaj Simar S. , Varady Nathan H. , Amen Lauren J. , Goodman Susan M.
Published: July 2024

Background/Objective

Rheumatologic diseases encompass a group of disabling conditions that often require expensive clinical treatments and limit an individual's ability to work and maintain a steady income. The purpose of this study was to evaluate contemporary patterns of financial toxicity among patients with rheumatologic disease and assess for any associated demographic factors.

Methods

The cross-sectional National Health Interview Survey was queried from 2013 to 2018 for patients with rheumatologic disease. Patient demographics and self-reported financial metrics were collected or calculated including financial hardship from medical bills, financial distress, food insecurity, and cost-related medication (CRM) nonadherence. Multivariable logistic regressions were used to assess for factors associated with increased financial hardship.

Results

During the study period, 20.2% of 41,502 patients with rheumatologic disease faced some degree of financial hardship due to medical bills, 55.0% of whom could not pay those bills. Rheumatologic disease was associated with higher odds of financial hardship from medical bills (adjusted odds ratio, 1.29; 95% confidence interval, 1.22–1.36; p < 0.001) with similar trends for patients suffering from financial distress, food insecurity, and CRM nonadherence (p < 0.001 for all). Financial hardship among patients with rheumatologic disease was associated with being younger, male, Black, and uninsured (p < 0.001 for all).

Conclusion

In this nationally representative study, we found that a substantial proportion of adults with rheumatologic disease in the United States struggled with paying their medical bills and suffered from food insecurity and CRM nonadherence. National health care efforts and guided public policy should be pursued to help ease the burden of financial hardship for these patients.
Comparing the Diagnostic Value of FDG PET or PET/CT With FDG PET/MR in Inflammatory Bowel Disease—A Systematic Review and Meta-analysis
Authors: Lin Chun-Yi , Chang Ming-Che , Kao Chia-Hung
Published: July 2024

Background

The aim of this study was to compare the diagnostic value of 18F-FDG PET or PET/CT with FDG PET/MR in patients with inflammatory bowel disease (IBD).

Methods

A comprehensive search was performed in PubMed for studies reporting the diagnostic performance of FDG PET (PET/CT) and FDG PET/MR in IBD from the inception of the database to March 14, 2024, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Fourteen studies were included in this systematic review and meta-analysis. Pooled estimates of segment-based sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio for FDG PET (PET/CT) and FDG PET/MR were calculated alongside 95% confidence intervals. Summary receiver operating characteristic (SROC) curves were plotted, and the area under the SROC curve was determined alongside the Q* index.

Results

The segment-based pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the SROC curve of FDG PET (PET/CT) for diagnosing IBD (9 studies) were 0.81, 0.86, 5.76, 0.22, 31.92, and 0.92, respectively. Those of FDG PET/MR (5 studies) were 0.78, 0.92, 10.97, 0.25, 51.79, and 0.95. There was no significant difference in the abilities of detecting or excluding IBD between FDG PET (PET/CT) and FDG PET/MR.

Conclusions

For diagnostic value in patients with IBD, there was no significant difference between FDG PET (PET/CT) and FDG PET/MR. Both FDG PET (PET/CT) and FDG PET/MR have demonstrated high diagnostic performance for accurate diagnosing in patients with IBD.
Septoplasty During Primary Cleft Lip Reconstruction: A Historical Perspective and Scoping Review
Authors: Lam Theodore , Munns Callum , Fell Matthew , Chong David
Published: July 2024

Background:

Traditional surgical approaches excluded septoplasty at primary cleft lip reconstruction due to concerns about restricted nasal and midfacial growth. Modern opinion in the treatment of cleft lip has increasingly employed primary septoplasty; this scoping review and historical perspective aims to chronicle the evolution of septoplasty in patients born with cleft lip and palate and discuss current evidence.

Methods:

The historical perspective explicitly contrasts American and European perceptions of septoplasty in cleft lip deformity and the competing anatomical theories of the role of the septum on midfacial and nasal growth. For the scoping review, articles were extracted from Embase, PubMed, and Medline, as well as manual searches of reference lists. Results were compiled, grouped, and appraised by date, outcomes, and historical significance. Inclusion criteria consisted of children who underwent primary septoplasty for any indication and were followed up on outcomes of facial growth and nasal function. Literature reviews, opinion articles, case reports, guidelines, or studies not available in English or online were excluded.

Results:

Evolving anatomical theories relating to midfacial growth in the mid-late 20th century underpinned a progressive ideological shift on the safety and efficacy of septoplasty in children. This is supported by our scoping review, which included 23 articles mutually selected for inclusion by 2 blinded assessors. Several competing methods have been employed to measure endpoints on facial growth and nasal function, but generally indicate primary septoplasty is successful in improving nasal function and preserving midfacial growth.

Conclusion:

Perceptions towards septoplasty on facial growth in the pediatric population have transformed significantly and suggest a growing acceptance of primary septoplasty techniques in patients born with a cleft lip.
Minor/Major Congenital Malformations and Neurodevelopmental Outcomes in Children Prenatally Exposed to Levetiracetam, Lamotrigine, and Carbamazepine Monotherapy
Authors: Ertürk Çetin Özdem , Algedik Pınar , Akyüz Gülcan , Sürmeli Reyhan , Zanapalıoğlu Ümit , Alev Saltak Gülce , Güven Şirin
Published: July 2024

Objectives

The relationship of older antiseizure drugs with congenital malformations has been known for many years. Studies are mostly limited to major malformations and few studies have investigated minor malformations. In recent years, the long-term cognitive and behavioral effects of these drugs have also come to the fore. The aim of our study was to evaluate the incidence of major and minor congenital malformations and neurodevelopmental outcomes in children prenatally exposed to levetiracetam (LEV), lamotrigine (LTG), and carbamazepine (CBZ) monotherapy.

Methods

This was a prospective observational study conducted in two university hospital epilepsy centers. It included 32 pregnant women who were continuously treated with LEV, LTG, or CBZ from conception throughout pregnancy. Children were followed up from birth until 18 months. Neurodevelopmental outcomes were evaluated with the Ages and Stages Questionnaire and Denver Developmental Screening Test.

Results

Eighteen of the patients were on LEV, 10 were on LTG, and 4 were on CBZ. Diaphragmatic hernia was detected in a child. At least one minor anomaly was observed in 58.1% of the patients. More than 80% of children were normal in the Ages and Stages Questionnaire.

Conclusions

The risk of major congenital malformations is lower with newer antiseizure drugs. We found a high incidence of minor ones. However, because the population prevalence of minor malformations is also variable, more studies are needed to confirm the results. Neurodevelopmental outcomes were favorable with LTG and LEV and slightly unfavorable with CBZ. Longer-term follow-up with large groups of children is required to reach more reliable results.
Use of Citicoline in Attention-Deficit/Hyperactivity Disorder: A Pilot Study
Authors: Hübner Isabel Barros , Scheibe Denise Bisolo , Marchezan Josemar , Bücker Joana
Published: July 2024

Objectives

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurobehavioral disorder in school-aged children. Although there are several drug treatment options, some patients do not have adequate therapeutic responses to conventional medications or experience considerable adverse effects. Citicoline is an endogenous molecule that has beneficial effects on attention, impulsivity, and memory and is a potential treatment for ADHD. This study aimed to evaluate the effect of citicoline in pediatric patients diagnosed with ADHD.

Methods

This randomized, crossover, double-blind, placebo-controlled clinical trial included with patients aged 7–12 years diagnosed with ADHD.

Results

As a result, no statistically significant difference was noted between the use of citicoline and placebo in the evaluated parameters. The treatment had no adverse effects.

Conclusions

Citicoline seems to be a safe molecule to be administered in the pediatric age group. Further studies are required to assess the therapeutic potential of citicoline in ADHD.
Pathogenicity and enzyme screening of some selected non-dermatophytic moulds
Authors: Nwofor C.N. , Onyenwe N.E. , Osuoha C.B.
Published: July 2024

Ten non-dermatophytic moulds isolated from both symptomatic and asymptomatic cattle skin, including Penicillum citrinum, Aspergillus welwitschiae, Aspergillus aculeatus, Curvularia kusanol, Cladosporium teniussmum, Pestalotiopsis microspora, Fusarium oxysporum, Fusarium linchenicola, Absidia sp. and Aspergillus fumigatus, were subjected to a pathogenicity test using albino mice. These isolates were also screened for five enzymes using a standard plate method. Results from pathogenicity tests showed that Absidia sp., Cladosporium tenuissimum and Aspergillus welwitschiae were able to elicit discoloration, lesion production and alopecia on the albino mice skin, respectively, providing evidence of clinical symptoms associated with cutaneous mycoses. The enzyme screening results revealed the highest zone of activity for keratinase (65 mm), amylase (86 mm), protease (60 mm), lipase (60 mm) and cellulase (86 mm) which were observed on Pestalotiopsis microspora, Aspergillus welwitschiae, Cladosporium tenuissimum, Aspergillus welwitschiae and Aspergillus welwitschiae respectively. Pathogenicity tests showed that some of these moulds may be virulent and this can be attributed to their possession of some virulence factors, including secretion of hydrolytic enzymes.
Corynebacterium amycolatum peritonitis in a patient undergoing peritoneal dialysis: case report and literature review
Authors: ADIL Fatima Zahra , ARAGON Imane , BENAISSA Elmostafa , BENLAHLOU Yassine , BSSAIBIS Fatna , MALEB Adil , CHADLI Mariama , ELOUENNASS Mostafa
Published: July 2024

Peritoneal dialysis is a blood purification technique used in cases of end-stage chronic kidney failure, based on the filtering capabilities of the peritoneum. Infections, often caused by poor asepsis during catheter manipulation, are generally attributed to Staphylococcus epidermidis and Staphylococcus aureus. Corynebacterium, usually considered non-pathogenic, is rarely involved in these infections. We present a case of peritonitis due to Corynebacterium amycolatum in a patient undergoing peritoneal dialysis. The diagnosis was made based on cytobacteriological examination of the dialysate fluid, which on two occasions showed high levels of white blood cells with a predominance of neutrophilic polymorphonuclear and a monomorphic appearance of colonies on agar medium, whose identification by biochemical tests and antibiotic sensitivity study confirmed the presence of Corynebacterium amycolatum. The patient was successfully treated with vancomycin, resulting in symptom resolution and sterilization of the dialysate fluid. Although rare, the involvement of Corynebacterium species underscores the importance of confirming its pathogenicity. Further studies are needed to better understand the epidemiology of these infections and guide future treatments. This case also highlights the need for a rigorous approach to confirming the pathogenicity of Corynebacterium, despite its traditional classification as a contaminant.
Rebalancing Viral and Immune Damage versus Tissue Repair Prevents Death from Lethal Influenza Infection
Authors: Ichise Hiroshi , Speranza Emily , La Russa Federica , Veres Tibor Z. , Chu Colin J. , Gola Anita , Germain Ronald N.
Published: July 2024

Maintaining tissue function while eliminating infected cells is fundamental to host defense. Innate inflammatory damage contributes to lethal influenza and COVID-19, yet other than steroids, immunomodulatory drugs have modest effects. Among more than 50 immunomodulatory regimes tested in mouse lethal influenza infection, only the previously reported early depletion of neutrophils showed efficacy, suggesting that the infected host passes an early tipping point in which limiting innate immune damage alone cannot rescue physiological function. To re-balance the system late in infection, we investigated whether partial limitation of viral spread using oseltamivir (Tamiflu) together with enhancement of epithelial repair by blockade of interferon signaling or the limitation of further epithelial cell loss mediated by cytotoxic CD8+T cells would prevent death. These treatments salvaged a large fraction of infected animals, providing new insight into the importance of repair processes and the timing of adaptive immune responses in survival of pulmonary infections.
Transcriptomic Hallmarks of Mortality Reveal Universal and Specific Mechanisms of Aging, Chronic Disease, and Rejuvenation
Authors: Tyshkovskiy Alexander , Kholdina Daria , Ying Kejun , Davitadze Maria , Molière Adrian , Tongu Yoshiyasu , Kasahara Tomoko , Kats Leonid M , Vladimirova Anastasiya , Moldakozhayev Alibek , Liu Hanna , Zhang Bohan , Khasanova Uma , Moqri Mahdi , Van Raamsdonk Jeremy M. , Harrison David E. , Strong Randy , Abe Takaaki , Dmitriev Sergey E. , Gladyshev Vadim N.
Published: July 2024

Health is strongly affected by aging and lifespan-modulating interventions, but the molecular mechanisms of mortality regulation remain unclear. Here, we conducted an RNA-seq analysis of mice subjected to 20 compound treatments in the Interventions Testing Program (ITP). By integrating it with the data from over 4,000 rodent tissues representing aging and responses to genetic, pharmacological, and dietary interventions with established survival data, we developed robust multi-tissue transcriptomic biomarkers of mortality, capable of quantifying aging and change in lifespan in both short-lived and long-lived models. These tools were further extended to single-cell and human data, demonstrating common mechanisms of molecular aging across cell types and species. Via a network analysis, we identified and annotated 26 co-regulated modules of aging and longevity across tissues, and developed interpretable module-specific clocks that capture aging- and mortality-associated phenotypes of functional components, including, among others, inflammatory response, mitochondrial function, lipid metabolism, and extracellular matrix organization. These tools captured and characterized acceleration of biological age induced by progeria models and chronic diseases in rodents and humans. They also revealed rejuvenation induced by heterochronic parabiosis, early embryogenesis, and cellular reprogramming, highlighting universal signatures of mortality, shared across models of rejuvenation and age-related disease. They includedCdkn1aandLgals3, whose human plasma levels further demonstrated a strong association with all-cause mortality, disease incidence and risk factors, such as obesity and hypertension. Overall, this study uncovers molecular hallmarks of mammalian mortality shared across organs, cell types, species and models of disease and rejuvenation, exposing fundamental mechanisms of aging and longevity.
Much Ado About Nothing: Accelerating Maximum Likelihood Phylogenetic Inference via Early Stopping to evade (Over-)optimization
Authors: Togkousidis Anastasis , Stamatakis Alexandros , Gascuel Olivier
Published: July 2024

Maximum Likelihood (ML) based phylogenetic inference constitutes a challenging optimization problem. Given a set of aligned input sequences, phylogenetic inference tools strive to determine the tree topology, the branch-lengths, and the evolutionary parameters that maximize the phylogenetic likelihood function. However, there exist compelling reasons to not push optimization to its limits, by means of early, yet adequate stopping criteria. Since input sequences are typically subject to stochastic and systematic noise, one should exhibit caution regarding (over-)optimization and the inherent risk of overfitting the model to noisy input data. To this end, we propose, implement, and evaluate four statistical early stopping criteria in RAxML-NG that evade excessive and compute-intensive (over-)optimization. These generic criteria can seamlessly be integrated into other phylo-genetic inference tools while not decreasing tree accuracy. The first two criteria quantify input data-specific sampling noise to derive a stopping threshold. The third, employs the Kishino-Hasegawa (KH) test to statistically assess the significance of differences between intermediate treesbefore, andaftermajor optimization steps in RAxML-NG. The optimization terminates early when improvements are insignificant. The fourth method utilizes multiple testing correction in the KH test. We show that all early stopping criteria infer trees that are statistically equivalent compared to inferences without early stopping. In conjunction with a necessary simplification of the standard RAxML-NG tree search heuristic, the average inference times on empirical and simulated datasets are ∼3.5 and ∼1.8 times faster, respectively, than for standard RAxML-NG v.1.2. The four stopping criteria have been implemented in RAxML-NG and are available as open source code under GNU GPL athttps://github.com/togkousa/raxml-ng.
Macrovascular contributions to resting-state fMRI signals: A comparison between EPI and bSSFP at 9.4 Tesla
Authors: Ramadan Dana , Mueller Sebastian , Stirnberg Ruediger , Bosch Dario , Ehses Philipp , Scheffler Klaus , Bause Jonas
Published: July 2024

The draining-vein bias of T2*-weighted sequences, like gradient echo echo-planar imaging (GRE-EPI), can limit the spatial specificity of functional MRI (fMRI). The underlying extravascular signal changes increase with field strength (B0) and the perpendicularity of draining veins to the main axis of B0, and are therefore particularly problematic at ultra-high field (UHF). In contrast, simulations showed that T2-weighted sequences are less affected by the draining-vein bias, depending on the amount of rephasing of extravascular signal. As large pial veins on the cortical surface follow the cortical folding tightly, their orientation can be approximated by the cortical orientation to. In our work, we compare the influence of the cortical orientation toon the resting-state fMRI signal of three sequences aiming to understand their macrovascular contribution. While 2D GRE-EPI and 3D GRE-EPI (both T2*-weighted) showed a high dependence on the cortical orientation to, especially on the cortical surface, this was not the case for 3D balanced steady-state free precession (bSSFP) (T2/T1-weighted). Here, a slight increase of orientation dependence was shown in depths closest to WM. And while orientation dependence decreased with increased distance to the veins for both EPI sequences, no change in orientation dependence was observed in bSSFP. This indicates the low macrovascular contribution to the bSSFP signal, making it a promising sequence for layer fMRI at UHF.