bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neutering is not associated with early-onset urethral obstruction in cats
Authors: Sampaio Keytyanne de Oliveira , Silva-Junior Valdemiro Amaro da , de Sousa-Filho Reginaldo Pereira , Aleixo Grazielle Anahy de Sousa , Mori da Cunha Marina Gabriela Monteiro Carvalho , da Silva Ellen Cordeiro Bento 
Published: December 2022

Objectives The purpose of this study was to evaluate the correlation between clinical aspects and urethral lesions with reproductive status and age at neutering in obstructed male cats. Methods All cats with compatible signs of urethral obstruction (UO) treated at the Veterinary Hospital of the Federal Rural University of Pernambuco from 2019 to 2021 were divided into three groups according to their reproductive status: intact; prepubertal neutered; and post-pubertal neutered. Cats with compatible signs of UO were selected for further analysis. Age, clinical signs, age at neutering and age of the first obstructive event were documented. Cats with recurrent obstructive urinary signs or urethral trauma that made catheterization impossible were referred for perineal urethrostomy. The morphology of the excised penises was assessed by histopathological analysis. Results Of 84 cats with signs of UO included in this study, 28.6% were classified as intact, 28.6% as prepubertal neutered and 42.8% as post-pubertal neutered. Intact cats had a significantly earlier onset of UO compared with prepubertal and post-pubertal neutered cats, as seen by the age at obstruction (3.6 vs 5.7 and 5.5 years, respectively). Similar clinical signs and histopathological lesions were observed in all groups. The main clinical signs observed were stranguria, hematuria and pollakiuria. All cats had some degree of injury in the penile urethra. The most common lesions were hemorrhage, fibrosis and congestion. Conclusions and relevance It appears that intact cats had an earlier onset of UO than neutered cats, regardless of age at neutering. Urethral histopathological lesions and clinical signs were similar in both groups. Pediatric neutering represents a useful tool in the control of abandoned and stray animals and the consequent dissemination of zoonoses, thus having a positive impact on public health.
Purtscher-like retinopathy in a patient with systemic tacrolimus vasculopathy
Authors: Di Maggio Alessandro , Volpi Nila , Marigliani Davide , Garosi Guido , Rollo Fabio , Ginanneschi Federica , Tosi Gian Marco , Fabiani Claudia 
Published: December 2022

Introduction Purtscher-like retinopathy is a rare occlusive retinal microangiopathy, whose pathogenesis has not been totally defined yet. Most frequent cause of Purtscher-like retinopathy is acute pancreatitis, but it may be triggered by other systemic or toxic conditions. We report herein a case of Purtscher-like retinopathy in the context of systemic tacrolimus vasculopathy. Case report A 56-years old male with history of kidney transplant was referred to local emergency room because of a global worsening of health conditions, with fatigue, muscular pain and diuresis contraction. During hospitalization the patient came to our attention for sudden and severe visual acuity impairment in both eyes. Extensive ophthalmological assessment, optical coherence tomography (OCT) and fluorescein angiography (FA) were performed disclosing a marked drop in best corrected visual acuity (BCVA) (20/200 in the right eye and 10/400 in the left eye) caused by a bilateral severe occlusive retinal microangiopathy complicated by diffuse retinal ischaemia and neovascular glaucoma. Muscular biopsy showed a necrotizing myopathy with autoimmune features, as indicated by conspicuous upregulation of MHC-I complex and microangiopathic changes, consistent with tacrolimus toxicity. Tacrolimus administration was interrupted, and intravenous glucocorticoids were administered. The large areas of retinal ischemia and neovascular glaucoma were treated with pan-retinal photocoagulation and intravitreal injections of bevacizumab with complete regression of iris neovascolarization. BCVA measured 20/200 in both eyes at last follow-up visit, 20 months after symptoms onset. Conclusions Purtscher-like retinopathy should be suspected in patients under treatment with calcineurin inhibitors especially in case of sudden and severe bilateral visual impairment.
Cerebrospinal fluid kappa free light chains for the diagnosis of multiple sclerosis: A systematic review and meta-analysis
Authors: Hegen Harald , Walde Janette , Berek Klaus , Arrambide Georgina , Gnanapavan Sharmilee , Kaplan Batia , Khalil Michael , Saadeh Ruba , Teunissen Charlotte , Tumani Hayrettin , Villar Luisa M , Willrich Maria Alice V , Zetterberg Henrik , Deisenhammer Florian 
Published: December 2022

Background: Intrathecal immunoglobulin-G synthesis is a hallmark of multiple sclerosis (MS), which can be detected by oligoclonal IgG bands (OCB) or by κ-free light chains (κ-FLC) in cerebrospinal fluid. Objective: To perform a systematic review and meta-analysis to evaluate whether κ-FLC index has similar diagnostic value to identify patients with clinically isolated syndrome (CIS) or MS compared to OCB, and to determine κ-FLC index cut-off. Methods: PubMed was searched for studies that assessed diagnostic sensitivity and specificity of κ-FLC index and OCB to discriminate CIS/MS patients from control subjects. Two reviewers following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines performed study eligibility assessment and data extraction. Findings from studies were analyzed with bivariate mixed models. Results: A total of 32 studies were included in the meta-analysis to evaluate diagnostic value of κ-FLC index. Sensitivity and specificity ranged from 52% to 100% (weighted average: 88%) and 69% to 100% (89%) for κ-FLC index and from 37% to 100% (85%) and 74% to 100% (92%) for OCB. Mean difference of sensitivity and specificity between κ-FLC index and OCB was 2 and −4 percentage points. Diagnostic accuracy determined by mixed models revealed no significant difference between κ-FLC index and OCB. A discriminatory cut-off for κ-FLC index was determined at 6.1. Conclusion: The findings indicate that κ-FLC index has similar diagnostic accuracy in MS as OCB.
Clinician-administered performance-based tests via telehealth in people with chronic lower limb musculoskeletal disorders: Test–retest reliability and agreement with in-person assessment
Authors: Lawford Belinda J , Dobson Fiona , Bennell Kim L , Merolli Mark , Graham Bridget , Haber Travis , Teo Pek Ling , Mackenzie Dave , McManus Fiona , Lamb Karen E , Hinman Rana S 
Published: December 2022

Introduction Uptake of telehealth has surged, yet no previous studies have evaluated the clinimetric properties of clinician-administered performance-based tests of function, strength, and balance via telehealth in people with chronic lower limb musculoskeletal pain. This study investigated the: (i) test–retest reliability of performance-based tests via telehealth, and (ii) agreement between scores obtained via telehealth and in-person. Methods Fifty-seven adults aged ≥45 years with chronic lower limb musculoskeletal pain underwent three testing sessions: one in-person and two via videoconferencing. Tests included 30-s chair stand, 5-m fast-paced walk, stair climb, timed up and go, step test, timed single-leg stance, and calf raises. Test–retest reliability and agreement were assessed via intraclass correlation coefficients (ICC; lower limit of 95% confidence interval (CI) ≥0.70 considered acceptable). ICCs were interpreted as poor (<0.5), moderate (0.5–0.75), good (0.75–0.9), or excellent (>0.9). Results Test–retest reliability was good-excellent with acceptable lower CI for stair climb test, timed up and go, right leg timed single-leg stance, and calf raises (ICC = 0.84–0.91, 95% CI lower limit = 0.71–0.79). Agreement between telehealth and in-person was good-excellent with acceptable lower CI for 30-s chair stand, left leg single-leg stance, and calf raises (ICC = 0.82–0.91, 95% CI lower limit = 0.71–0.85). Discussion Stair climb, timed up and go, right leg timed single-leg stance, and calf raise tests have acceptable reliability for use via telehealth in research and clinical practice. If re-testing via a different mode (telehealth/in-person), clinicians and researchers should consider using the 30-s chair stand test, left leg timed single-leg stance, and calf raise tests.
Motorcycle-related trauma in Ireland
Authors: Hession Enda , Sheehan Micheal , Brent Louise , Cronin John 
Published: December 2022

Introduction Motorcyclists are over-represented in collision statistics in Ireland. There is a lack of descriptive studies assessing the impact and injury pattern of this trauma cohort. This study examines this trauma subset using data collected by the Major Trauma Audit (MTA) by the National Office of Clinical Audit (NOCA) to identify patient demographics, injury mechanism and type, treatments received, and outcomes. Methods All motorcycle-related trauma cases recorded on the MTA, NOCA in Ireland for the period 2014 to 2019 were gathered and analysed. Results There were 704 cases identified; 94% of cases were male. The median (interquartile range (IQR)) age was 38.2 (26.7–49.7). There were 6.4% ( n = 45) aged 0–18 years, 88.2% ( n = 621) aged 18–64 and 5.4% ( n = 38) greater than 65 years. The median injury severity score (ISS) overall of this trauma cohort was 13 (IQR 9–24) but 306 patients (43.5%) had an ISS > 15. The most severe injury body region with 35.4% ( n = 249) was the limbs. Most patients arrived during the summer months with Sunday the highest day of attendance ( n = 181, 25.7%). May to August were the months with the most attendance ( n = 366, 52%). Most patients were discharged home ( n = 372, 52.8%) and 43.8% ( n = 308) required transfer to at least one other hospital for definitive care. There were 19 patients (2.7%) who died after arrival to hospital. Conclusion Motorcycle trauma predominantly affects a young male population with moderate severity injury characteristics. A significant proportion of patients present at weekends during the summer months, likely the result of recreational riding. A large cohort of patients requires transfer for definitive care, which has significant implications for trauma care pathways. National policies to enforce safety measures and public awareness for recreational motorcycle use may improve traffic safety and ultimately population health.
Longitudinal analysis of neutrophil-to-lymphocyte ratio over time after major trauma
Authors: Qiu Yunfei , Fitzgerald Mark , Mitra Biswadev 
Published: December 2022

Background The neutrophil-to-lymphocyte ratio has been proposed as a marker of systemic inflammation in major trauma patients that is associated with in-hospital mortality. However, the initial neutrophil-to-lymphocyte ratio does not appear to be predictive of in-hospital mortality. The aim of this study is to determine the discriminative ability of the neutrophil-to-lymphocyte ratio profile over 48 h as a predictor of in-hospital mortality following major trauma. Methods This was a case-control study involving all major trauma patients meeting the criteria for inclusion into the Alfred Health Trauma Registry who presented directly from the scene of injury over a 24-month period. Patients were then divided into two groups, cases being major trauma patients who died at hospital discharge and controls being patients who survived. We extracted data for Day 0, Day 1 and Day 2 neutrophil-to-lymphocyte ratio values for each patient. The primary outcome was mortality at hospital discharge. Results Data were extracted for 1689 major trauma patients, of which 72% were male, the median age was 49 years (IQR 31–68) and most (90%) patients presented after a blunt mechanism of injury. There were 165 cases that were compared to 1524 controls. Patients who died were older ( p < 0.001), and had higher injury severity scores ( p < 0.001) and lower revised trauma scores ( p < 0.001). Analysis of response profiles demonstrated a significant difference between the trajectories of the neutrophil-to-lymphocyte ratio over time ( p < 0.001). Conclusions The profile of neutrophil-to-lymphocyte ratio over 48 h after injury shows promise as a prognostic tool in trauma and warrants further investigation.
Is the Risk Perception Attitude Framework Associated with the Accuracy of Self-Reported vs Actual Cardiometabolic Risk and Physical Activity in Young Adults with Overweight/Obesity?
Authors: DiPietro Loretta , Rimal Rajiv , Tjaden Ashley H. , Bailey Caitlin P. , Napolitano Melissa A. 
Published: December 2022

We examined the accuracy of perceived vs actual cardiometabolic risk and physical activity within the Risk Perception Attitude Framework (RPA). We analyzed baseline data from 343 young adults (23.3 ± 4.4 years) participating in a weight management clinical trial. Cardiometabolic risk factors were measured according to standard clinical procedures. A cardiometabolic risk score was created from five biomarkers according to whether or not a standard clinical risk cut point was exceeded. Physical activity was determined by ActiGraph and self-report. Perceived risk and physical activity self-efficacy were assessed by validated measures. The Proactive cluster (low perceived risk/high self-efficacy) was most accurate regarding actual vs perceived risk awareness (54%), while the Responsive cluster (high perceived risk/high self-efficacy) was the least accurate (16%). All RPA clusters underestimated their actual physical activity, self-reporting less than half the moderate-to-vigorous physical activity that was captured via accelerometry. The RPA Framework can identify young adults unlikely to be aware of their cardiometabolic risk. Given the growing prevalence of metabolic syndrome, efforts early in adulthood to increase knowledge and awareness of cardiometabolic risk, and behaviors necessary to reduce that risk, can have substantial impact on future health.
First Death Involving 4-Fluoroethylphenidate (4F-EPH): Case Report, User Experiences, and Review of the Related Literature
Authors: Corkery John Martin , Schifano Fabrizio 
Published: December 2022

Background: 4-Fluoroethylphenidate (4F-EPH) is a psychoactive substance, sold primarily over the Internet as a `research chemical'. Recreational and `functional' use of this drug has been reported by online user fora. Scientifically-based data on the pharmacological, physiological, psychopharmacological, toxicological, and epidemiological characteristics of this molecule is non-existent. The aim of this paper is to remedy this situation. Methods: Recent literature (including ’grey‘) was searched to update what is known about 4F-EPH, especially its toxicity. This was supplemented by netnographic examinations of internet sites. Results: The resultant information is presented, including details of the first reported death involving 4F-EPH use in 2016. There are no international controls imposed on 4F-EPH. However, it has been made a controlled drug in several European countries, including the United Kingdom since 31 May 2017, as well as Canada. Conclusions: It is vital that any other cases, including non-fatal overdoses, are documented so that a firmer scientific evidence-base can be established for this molecule. This will then help inform clinical practice.
Creating Effective Post-Pandemic Psychiatric Nursing Clinical Experiences Using the Roy Adaptation Model
Authors: Quidley-Rodriguez Narciso , de Tantillo Lila , Wolf Lindsay J. 
Published: December 2022

Introduction The COVID-19 pandemic significantly impacted students in psychiatric clinical rotations. Clinicals were frequently limited or canceled, restricting exposure of student nurses to this experience. Many modifications led to permanent changes in the psychiatric clinical setting. Objectives The purpose of this manuscript is to provide a cohesive approach to serving student nurses in the post-pandemic psychiatric clinical setting. Methods A theoretical exploration of the literature framed by the Roy Adaptation Model (RAM) was conducted. Discussion Results are presented using the four modes of the theory: Physiological, Self-Concept, Role Function, and Interdependence. Conclusions Findings include strategies to enhance student learning while supporting students’ health and wellness. Educators and practitioners should provide high-quality, safe learning environments for student nurses.
The spectrum of GATA2 deficiency syndrome
Authors: Calvo Katherine R. , Hickstein Dennis D. 
Published: December 2022

Abstract
Inherited or de novo germ line heterozygous mutations in the gene encoding the transcription factor GATA2 lead to its deficiency. This results in a constellation of clinical features including nontuberculous mycobacterial, bacterial, fungal, and human papillomavirus infections, lymphedema, pulmonary alveolar proteinosis, and myelodysplasia. The onset, or even the presence, of disease is highly variable, even in kindreds with the identical mutation in GATA2. The clinical manifestations result from the loss of a multilineage progenitor that gives rise to B lymphocytes, monocytes, natural killer cells, and dendritic cells, leading to cytopenias of these lineages and subsequent infections. The bone marrow failure is typically characterized by hypocellularity. Dysplasia may either be absent or subtle but typically evolves into multilineage dysplasia with prominent dysmegakaryopoiesis, followed in some instances by progression to myeloid malignancies, specifically myelodysplastic syndrome, acute myelogenous leukemia, and chronic myelomonocytic leukemia. The latter 3 malignancies often occur in the setting of monosomy 7, trisomy 8, and acquired mutations in ASXL1 or in STAG2. Importantly, myeloid malignancy may represent the primary presentation of disease without recognition of other syndromic features. Allogeneic hematopoietic stem cell transplantation (HSCT) results in reversal of the phenotype. There remain important unanswered questions in GATA2 deficiency, including the following: (1) Why do some family members remain asymptomatic despite harboring deleterious mutations in GATA2? (2) What are the genetic changes that lead to myeloid progression? (3) What causes the apparent genetic anticipation? (4) What is the role of preemptive HSCT?
Activation priming and cytokine polyfunctionality modulate the enhanced functionality of low-affinity CD19 CAR T cells
Authors: Michelozzi Ilaria M. , Gomez-Castaneda Eduardo , Pohle Ruben V. C. , Cardoso Rodriguez Ferran , Sufi Jahangir , Puigdevall Costa Pau , Subramaniyam Meera , Kirtsios Efstratios , Eddaoudi Ayad , Wu Si Wei , Guvenel Aleks , Fisher Jonathan , Ghorashian Sara , Pule Martin A. , Tape Christopher J. , Castellano Sergi , Amrolia Persis J. , Giustacchini Alice 
Published: December 2022

Abstract
We recently described a low-affinity second-generation CD19 chimeric antigen receptor (CAR) CAT that showed enhanced expansion, cytotoxicity, and antitumor efficacy compared with the high-affinity (FMC63-based) CAR used in tisagenlecleucel, in preclinical models. Furthermore, CAT demonstrated an excellent toxicity profile, enhanced in vivo expansion, and long-term persistence in a phase 1 clinical study. To understand the molecular mechanisms behind these properties of CAT CAR T cells, we performed a systematic in vitro characterization of the transcriptomic (RNA sequencing) and protein (cytometry by time of flight) changes occurring in T cells expressing low-affinity vs high-affinity CD19 CARs following stimulation with CD19-expressing cells. Our results show that CAT CAR T cells exhibit enhanced activation to CD19 stimulation and a distinct transcriptomic and protein profile, with increased activation and cytokine polyfunctionality compared with FMC63 CAR T cells. We demonstrate that the enhanced functionality of low-affinity CAT CAR T cells is a consequence of an antigen-dependent priming induced by residual CD19-expressing B cells present in the manufacture.
Paired bone marrow and peripheral blood samples demonstrate lack of widespread dissemination of some CH clones
Authors: Osman Afaf E. G. , Mencia-Trinchant Nuria , Saygin Caner , Moma Luke , Kim Aelin , Housman Genevieve , Pozsgai Matthew , Sinha Eti , Chandra Pooja , Hassane Duane C. , Sboner Andrea , Sangani Kishan , DiNardi Nick , Johnson Christopher , Wallace Sara S. , Jabri Bana , Luu Hue , Guzman Monica L. , Desai Pinkal , Godley Lucy A. 
Published: December 2022

Abstract
Clonal hematopoiesis (CH) represents clonal expansion of mutated hematopoietic stem cells detectable in the peripheral blood or bone marrow through next generation sequencing. The current prevailing model posits that CH mutations detected in the peripheral blood mirror bone marrow mutations with clones widely disseminated across hematopoietic compartments. We sought to test the hypothesis that all clones are disseminated throughout hematopoietic tissues by comparing CH in hip vs peripheral blood specimens collected at the time of hip replacement surgery. Here, we show that patients with osteoarthritis have a high prevalence of CH, which involve genes encoding epigenetic modifiers and DNA damage repair pathway proteins. Importantly, we illustrate that CH, including clones with variant allele frequencies &gt;10%, can be confined to specific bone marrow spaces and may be eliminated through surgical excision. Future work will define whether clones with somatic mutations in particular genes or clonal fractions of certain sizes are either more likely to be localized or are slower to disseminate into the peripheral blood and other bony sites.