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PUBMED | International journal of audiology | 38690678 | Tone-burst elicited auditory brainstem responses in full-term and pre-term infants. | To investigate the reliability of tone-burst auditory brainstem response (TB-ABR) latencies and thresholds in pre-term and full-term infants. TB-ABRs to 500 Hz and 4000 Hz tone-burst stimuli were recorded at two-week intervals over the first six weeks of life in a group of full-term infants (40-46 weeks gestational age [GA]) and over ten weeks (36-46 weeks gestation) in a group of preterm infants. Linear mixed model analyses evaluated within-subject changes and the effects of the subject group, age at assessment, and stimulus frequency on ABR latency and threshold. Twenty-four infants participated. Nine were full-term (GA: 39-41 weeks) and fifteen were healthy pre-term (GA: 28-34 weeks) at birth. TB-ABR wave V latencies at 70 dBnHL decreased throughout the study (<i>p</i> < 0.001) in pre-term babies for both test frequencies by approximately 0.5 ms. There were, however, no group or GA (at birth) effects indicating that response latency normalized in these children by the due date. Similarly, TB-ABR threshold levels in the premature group were elevated (<i>p</i> = 0.001) by approximately 5 dB in pre-term evaluation but were equivalent to those of full-term participants in the post-term assessment period. In healthy, pre-term infants, tone-burst ABR testing is reliable from 36 weeks gestation. | Rance Gary; Tomlin Dani; Graydon Kelley | 2024-01-05 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy | 38690674 | Changes in right ventricular dimensions, function, and pulmonary circulation loading according to the degree of interdialytic weight gain in maintenance hemodialysis patients. | The aim of this study was to investigate changes in echocardiographic right ventricular (RV) indices in relation to the degree of fluid accumulation between hemodialysis sessions, evaluated according to the recommended threshold of interdialytic-weight-gain corrected for dry weight (IDWG%). A post-hoc analysis was performed using data from 41 maintenance hemodialysis patients. Patients were divided into a higher (>4.5%) and a lower (<4.5%) IDWG% group and underwent an echocardiographic assessment at the start and the end of the 3-day and the 2-day interdialytic interval. RV systolic pressure (RVSP) increments were more pronounced in the higher compared to the lower IDWG% group (16.43 ± 5.37 vs. 14.11 ± 13.38 mm Hg respectively, p = 0.015) over the 3-day interval, while changes in RV filling pressures, did not differ significantly between the groups (p = 0.84). During the 3-day interdialytic interval, pulmonary circulation is particularly overloaded in patients with fluid accumulation higher than the recommended thresholds, as evidenced by higher RVSP elevations. | Anastasiou Vasileios; Theodorakopoulou Marieta P; Kamperidis Vasileios; Daios Stylianos; Tsilonis Konstantinos; Alexandrou Maria-Eleni; Moysidis Dimitrios V; Boutou Afroditi; Giannakoulas George; Ziakas Antonios; Sarafidis Pantelis | 2024-01-05 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Circulation. Arrhythmia and electrophysiology | 38690671 | Impact of Contact Force on Pulsed Field Ablation Outcomes Using Focal Point Catheter. | Conventional focal radiofrequency catheters may be modified to enable multiple energy modalities (radiofrequency or pulsed field [PF]) with the benefit of contact force (CF) feedback, providing greater flexibility in the treatment of arrhythmias. Information on the impact of CF on lesion formation in PF ablations remains limited. An in vivo study was performed with 8 swine using an investigational dual-energy CF focal catheter with local impedance. Experiment I: To evaluate atrial lesion formation, contiguity, and width, a point-by-point approach was used to create an intercaval line. The distance between the points was prespecified at 4±1 mm. Half of the line was created with radiofrequency energy, whereas the other half utilized PF (single 2.0 kV application with a proprietary waveform). Experiment II: To evaluate single application lesion dimensions with a proprietary waveform, discrete ventricular lesions were performed with PFA (single 2.0 kV application) with targeted levels of CF: low, 5 to 15 g; medium, 20 to 30 g; and high, 35 to 45 g. Following 1 week of survival, animals underwent endocardial/epicardial remapping, and euthanasia to enable histopathologic examination. Experiment I: Both energy modalities resulted in a complete intercaval line of transmural ablation. PF resulted in significantly wider lines than radiofrequency: minimum width, 14.9±2.3 versus 5.0±1.6 mm; maximum width, 21.8±3.4 versus 7.3±2.1 mm, respectively; <i>P</i><0.01 for each. Histology confirmed transmural lesions with both modalities. Experiment II: With PF, lesion depth, width, and volume were larger with higher degrees of CF (depth: r=0.82, <i>P</i><0.001; width: r=0.26, <i>P</i>=0.052; and volume: r=0.55, <i>P</i><0.001), with depth increasing at a faster rate than width. The mean depths were as follows: low (n=17), 4.3±1.0 mm; medium (n=26), 6.4±1.2 mm; and high (n=14), 9.1±1.4 mm. Using the same focal point CF-sensing catheter, a novel PF ablation waveform with a single application resulted in transmural atrial lesions that were significantly wider than radiofrequency. Lesion depth showed a significant positive correlation with CF with depths of 6.4 mm at moderate CF. | Younis Arwa; Santangeli Pasquale; Garrott Kara; Buck Eric; Tabaja Chadi; Wass Sojin Y; Lehn Lauren; Kleve Ryan; Hussein Ayman A; Nakhla Shady; Nakagawa Hiroshi; Taigen Tyler; Kanj Mohamed; Sroubek Jakub; Saliba Walid I; Wazni Oussama M | 2024-01-05 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Thoracic cancer | 38690654 | Pulmonary pleomorphic carcinoma arising in mixed squamous and glandular papilloma: A case report. | Solitary pulmonary papillomas (SPPs) are rare lung neoplasms. Histologically, SPP is classified into three subtypes, and mixed squamous and glandular papilloma (MP) is the rarest subtype. Although SPPs are considered benign tumors, there have been several reports on the synchronous malignant transformation in SPPs. An 82-year-old asymptomatic man was referred to our hospital for further examination of a 2.2 cm-sized left lung tumor. Pathology of bronchoscopic specimens showed the possibility of pulmonary papilloma but did not reveal any malignancy. The patient complained of bloody sputum during the eighth month after the initial visit. The size of the lesion had increased to 4.3 cm. These data suggested the existence of malignancy, and the patient underwent an operation. Histologically, the tumor was composed of fibrovascular cores and papillomatous fronds lined by pseudostratified columnar cells and mucin-filled goblet cells. Keratinizing squamous epithelium was also observed. Overall, the diagnosis of MP was obtained by fundamental histology. In addition, a solid part beneath mild atypical squamous epithelia, which was composed of malignant-appearing squamous cells and spindle-shaped atypical cells, was observed. The spindle portion was positive for cytokeratin AE1/AE3 and vimentin, and focally positive for alpha-smooth muscle actin (αSMA). The final diagnosis was pulmonary pleomorphic carcinoma (PPC) arising in the MP. Only two cases have been reported for atypical spindle tumor cells that are found in MP or bronchiolar adenoma/ciliated muconodular papillary tumor (BA/CMPT), which has histologically similar features to MP. This is the second case report of PPC arising in MP. | Nitanda Hiroyuki; Homma Taku; Taguchi Ryo; Umesaki Tetsuya; Ichiki Yoshinobu; Sakaguchi Hirozo; Ishida Hironori | 2024-01-05 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | The Journal of experimental biology | 38690647 | c-fos induction in the choroid plexus, tanycytes and pars tuberalis is an early indicator of spontaneous arousal from torpor in a deep hibernator. | Hibernation is an extreme state of seasonal energy conservation, reducing metabolic rate to as little as 1% of the active state. During the hibernation season, many species of hibernating mammals cycle repeatedly between the active (aroused) and hibernating (torpid) states (T-A cycling), using brown adipose tissue (BAT) to drive cyclical rewarming. The regulatory mechanisms controlling this process remain undefined but are presumed to involve thermoregulatory centres in the hypothalamus. Here, we used the golden hamster (Mesocricetus auratus), and high-resolution monitoring of BAT, core body temperature and ventilation rate, to sample at precisely defined phases of the T-A cycle. Using c-fos as a marker of cellular activity, we show that although the dorsomedial hypothalamus is active during torpor entry, neither it nor the pre-optic area shows any significant changes during the earliest stages of spontaneous arousal. Contrastingly, in three non-neuronal sites previously linked to control of metabolic physiology over seasonal and daily time scales - the choroid plexus, pars tuberalis and third ventricle tanycytes - peak c-fos expression is seen at arousal initiation. We suggest that through their sensitivity to factors in the blood or cerebrospinal fluid, these sites may mediate metabolic feedback-based initiation of the spontaneous arousal process. | Markussen Fredrik A F; Cázarez-Márquez Fernando; Melum Vebjørn J; Hazlerigg David; Wood Shona | 2024-01-05 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Expert review of respiratory medicine | 38690646 | Preoperative frailty screening in elderly patients with non-small cell lung cancer surgery: an essential step for a good surgical outcome. | Non-small cell lung cancer (NSCLC) is a disease commonly diagnosed in the elderly, often in advanced stages. However, elderly patients with lung cancer can benefit from surgery, provided that postoperative risks are assessed appropriately before surgery. Frailty is a measure of age-related impaired functional status and a predictor of mortality and morbidity. However, its importance as a preoperative marker is not well defined. This systematic review discusses the importance of preoperative frailty screening in elderly patients with NSCLC. A literature search was performed on the MEDLINE database in June 2023, and relevant studies on frailty or preoperative assessment of NSCLC which were published between 2000 and 2023 were retained and discussed in this review. Among the types of existing methods used to assess frailty those on the geriatric assessment seem to be the most appropriate; however, they are unable to fully capture the 'surgical' frailty; thus, other instruments should be developed and validated in NSCLC. | Antoniu Sabina Antonela; Iacobescu Radu; Popa Alina Delia; Pavel-Tanase Mariana; Stratulat Teodora Alexa | 2024-01-05 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Clinical transplantation | 38690617 | Risk factors for Pneumocystis jirovecii pneumonia after kidney transplantation: A systematic review and meta-analysis. | Pneumocystis jirovecii pneumonia (PJP), an opportunistic infection, often leads to an increase in hospitalization time and mortality rates in kidney transplant (KT) recipients. However, the risk factors associated with PJP in KT recipients remain debatable. Therefore, we conducted this meta-analysis to identify risk factors for PJP, which could potentially help to reduce PJP incidence and improve outcome of KT recipients. We systematically retrieved relevant studies in PubMed, EMBASE, and the Cochrane Library up to November 2023. Pooled odds ratios (ORs) or mean differences (MDs) and the corresponding 95% confidence intervals (CIs) were calculated to assess the impact of potential risk factors on the occurrence of PJP. 27 studies including 42383 KT recipients were included. In this meta-analysis, age at transplantation (MD = 3.48; 95% CI = .56-6.41; p = .02), cytomegalovirus (CMV) infection (OR = 4.00; 95% CI = 2.53-6.32; p = .001), BK viremia (OR = 3.38; 95% CI = 1.70-6.71; p = .001), acute rejection (OR = 3.66; 95% CI = 2.44-5.49; p = .001), ABO-incompatibility (OR = 2.51; 95% CI = 1.57-4.01; p = .001), estimated glomerular filtration rate (eGFR) (MD = -14.52; 95% CI = -25.37- (-3.67); p = .009), lymphocyte count (MD = -.54; 95% CI = -.92- (-.16); p = .006) and anti-PJP prophylaxis (OR = .53; 95% CI = .28-.98; p = .04) were significantly associated with PJP occurrence. Our findings suggest that transplantation age greater than 50 years old, CMV infection, BK viremia, acute rejection, ABO-incompatibility, decreased eGFR and lymphopenia were risk factors for PJP. | Cheng Bingjie; Qi Chang; Zhang Senlin; Wang Xiaowen | 2024-01-05 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Global mental health (Cambridge, England) | 38690575 | "Early in the morning, there's tolerance and later in the day it disappears" - The intersection of resource scarcity, stress and stigma in mental health and substance use care in South Africa. | Stress is a challenge among non-specialist health workers worldwide, particularly in low-resource settings. Understanding and targeting stress is critical for supporting non-specialists and their patients, as stress negatively affects patient care. Further, stigma toward mental health and substance use conditions also impacts patient care. However, there is little information on the intersection of these factors. This sub-analysis aims to explore how substance use and mental health stigma intersect with provider stress and resource constraints to influence the care of people with HIV/TB. We conducted semi-structured interviews (<i>N</i>=30) with patients (<i>n</i>=15) and providers (<i>n</i>=15, non-specialist health workers) within a low-resource community in Cape Town, South Africa. Data were analyzed using thematic analysis. Three key themes were identified: (1) resource constraints negatively affect patient care and contribute to non-specialist stress; (2) in the context of stress, non-specialists are hesitant to work with patients with mental health or substance use concerns, who they view as more demanding and (3) stress contributes to provider stigma, which negatively impacts patient care. Findings highlight the need for multilevel interventions targeting both provider stress and stigma toward people with mental health and substance use concerns, especially within the context of non-specialist-delivered mental health services in low-resource settings. | Hines Abigail C; Rose Alexandra L; Regenauer Kristen S; Brown Imani; Johnson Kim; Bonumwezi Jessica; Ndamase Sibabalwe; Ciya Nonceba; Magidson Jessica F; Myers Bronwyn | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Global mental health (Cambridge, England) | 38690572 | Demographics and risk factors for suicide in Syria: A retrospective media content analysis of online news sources. | Since the beginning of the Syrian conflict in 2011, Syrians have faced violence and displacement causing an increase in mental health issues. The COVID-19 pandemic, the 2023 earthquake, and deteriorating living conditions have exacerbated these issues. Suicide in Syria remains an under-researched topic since accurate data are difficult to obtain. In this study, we aimed to explore the demographics and risk factors of suicide in Syria by performing a retrospective content analysis of selected online news (media) outlets from across Syria. Twelve news outlets from the three regions of Syria were selected and news of suicide cases were searched retrospectively. The age range was between 9 and 79 years old with the average age being 27.1 ± SD 5.9 years. The most reported causes of suicide were harsh living conditions (18.5%) and relationship problems (18.3%). The most common method of suicide was hanging followed by using firearms. More suicides occurred at night and in the summer and spring seasons. Based on our study's results, young adult, male, unmarried, individuals in rural settings and northern governorates were at the highest risk of suicide in Syria. This study highlights the urgent need for mental health interventions that address the unique challenges faced by Syrians. | Almidani Salma; Abo Hilal Mohammad; Alghadban Marwa; Abou Helal Omama; Alkourdi Manal; Kannan Juman; Ekzayez Abdulkarim; Patel Preeti; El Achi Nassim | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Computational and structural biotechnology journal | 38690549 | Integrating predictive coding and a user-centric interface for enhanced auditing and quality in cancer registry data. | Data curation for a hospital-based cancer registry heavily relies on the labor-intensive manual abstraction process by cancer registrars to identify cancer-related information from free-text electronic health records. To streamline this process, a natural language processing system incorporating a hybrid of deep learning-based and rule-based approaches for identifying lung cancer registry-related concepts, along with a symbolic expert system that generates registry coding based on weighted rules, was developed. The system is integrated with the hospital information system at a medical center to provide cancer registrars with a patient journey visualization platform. The embedded system offers a comprehensive view of patient reports annotated with significant registry concepts to facilitate the manual coding process and elevate overall quality. Extensive evaluations, including comparisons with state-of-the-art methods, were conducted using a lung cancer dataset comprising 1428 patients from the medical center. The experimental results illustrate the effectiveness of the developed system, consistently achieving F1-scores of 0.85 and 1.00 across 30 coding items. Registrar feedback highlights the system's reliability as a tool for assisting and auditing the abstraction. By presenting key registry items along the timeline of a patient's reports with accurate code predictions, the system improves the quality of registrar outcomes and reduces the labor resources and time required for data abstraction. Our study highlights advancements in cancer registry coding practices, demonstrating that the proposed hybrid weighted neural-symbolic cancer registry system is reliable and efficient for assisting cancer registrars in the coding workflow and contributing to clinical outcomes. | Dai Hong-Jie; Chen Chien-Chang; Mir Tatheer Hussain; Wang Ting-Yu; Wang Chen-Kai; Chang Ya-Chen; Yu Shu-Jung; Shen Yi-Wen; Huang Cheng-Jiun; Tsai Chia-Hsuan; Wang Ching-Yun; Chen Hsiao-Jou; Weng Pei-Shan; Lin You-Xiang; Chen Sheng-Wei; Tsai Ming-Ju; Juang Shian-Fei; Wu Su-Ying; Tsai Wen-Tsung; Huang Ming-Yii; Huang Chih-Jen; Yang Chih-Jen; Liu Ping-Zun; Huang Chiao-Wen; Huang Chi-Yen; Wang William Yu Chung; Chong Inn-Wen; Yang Yi-Hsin | 2024-01-12 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Risk management and healthcare policy | 38690537 | Pharmacy-Based Influenza Vaccination: A Study of Patient Acceptance in Romania. | This study explores patient acceptance of influenza vaccination administered by pharmacists in Romania during the 2023 season, considering it a novel strategy to address gaps in knowledge. Pharmacy-based vaccination deviates from traditional methods, providing high-risk patients with full reimbursement and others with 50% reimbursement, allowing a choice between family doctors and pharmacies for vaccine administration. The survey includes 15 questions covering socio-demographic data, health information, vaccination preferences, and perceptions of pharmacy-based vaccinations. Respondents showed a positive inclination toward pharmacy-based vaccination, with 68% expressing favorable sentiments, but an awareness gap exists, as only 36% were aware of pharmacy-based vaccination availability. Challenges include a lack of patient awareness and understanding of benefits, emphasizing the need for structured pharmacist-patient dialogues. Legal changes, a defined funding mechanism, and collaboration are crucial for successful implementation. The study provides valuable insights into patient perceptions, contributing to discussions on optimizing influenza vaccination coverage in Romania and beyond and recognizing pharmacies' potential in achieving broader vaccination goals. | Chirila Sergiu; Hangan Tony; Gurgas Leonard; Costache Monica Georgiana; Vlad Marinela Anisoara; Nitu Bogdan-Florentin; Bittar Sara Melek; Craciun Aurora; Condur Laura; Bjørklund Geir | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Physical therapy research | 38690530 | Early Ambulation Following Lung Resection Surgery: Impact on Short-term Outcomes in Patients with Lung Cancer. | Previous studies indicated that early ambulation following lung resection can prevent postoperative pulmonary complications (PPCs). However, some patients fail to achieve early ambulation owing to factors such as postoperative nausea, vomiting, or pain, particularly on postoperative day 1. This study aimed to address the critical clinical question: Is ambulation for ≥10 m during initial pulmonary rehabilitation necessary after lung resection surgery? This retrospective observational cohort study included 407 patients who underwent lung resection surgery for lung cancer between January 2021 and December 2022. Twelve patients with a performance status of ≥2 and 21 patients lacking pulmonary rehabilitation prescriptions were excluded. Patients were categorized into the "early ambulation" group, which included individuals ambulating ≥10 m during rehabilitation on the first postoperative day, and the "delayed ambulation" group. The primary outcome was PPC incidence, with secondary outcomes encompassing pleural drain duration, hospital length of stay, and Δ6-minute walk distance (Δ6MWD: postoperative 6MWD minus preoperative 6MWD). The early and delayed ambulation groups comprised 315 and 59 patients, respectively. Significant disparities were noted in the length of hospital stay (7 [6-9] days vs. 8 [6-11] days, P = 0.01), pleural drainage duration (4 [3-5] days vs. 4 [3-6] days, P = 0.02), and Δ6MWD (-70 m vs. -100 m, P = 0.04). However, no significant difference was observed in PPC incidence (20.6% vs. 32.2%, P = 0.06). Ambulation for ≥10 m during initial pulmonary rehabilitation after lung resection surgery may yield short-term benefits as evidenced by improvements in various outcomes. However, it may not significantly affect the PPC incidence. | Kurata Kazunori; Nagata Yukio; Oki Keisuke; Ono Keishi; Miyake Tomohiro; Inui Kaori; Kobayashi Masashi | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Frontiers in pediatrics | 38690521 | Adverse respiratory patterns in near-term spontaneously breathing newborn lambs with elevated airway liquid volumes at birth. | Recent evidence indicates that respiratory distress (RD) in near-term infants is caused by elevated airway liquid (EL) volume at the beginning of air-breathing after birth. While the adverse effects EL volumes on newborn lung function are known, the effects on respiratory control and breathing patterns shortly after birth (<4 h) are unknown. We investigated the effects of EL volumes on cardiorespiratory function and breathing patterns in spontaneously breathing near-term newborn lambs in the first hours after birth. At 137-8 days gestation (2-3 days prior to delivery; term ∼147 days), sterile surgery was performed on fetal sheep (<i>n</i> = 17) to implant catheters and blood flow probes. At 140 days, lambs were delivered via caesarean section under spinal anaesthesia. Airway liquid volumes were adjusted to mimic the level expected following vaginal delivery (∼10 ml/kg; Controls; <i>n</i> = 7), or elective caesarean section (∼30 ml/kg; elevated airway liquid group; EL; <i>n</i> = 10). Spontaneous breathing and cardiorespiratory parameters were recorded over four hours after birth. Non-invasive respiratory support with supplemental oxygen was provided if required. EL lambs required higher inspired oxygen levels (<i>p </i>= 0.0002), were less active (<i>p </i>= 0.026), fed less (<i>p </i>= 0.008) and had higher respiratory morbidity scores than Controls (<i>p </i>< 0.0001). EL lambs also displayed higher rates of breathing patterns associated with RD, such as expiratory braking and tachypnoea. These patterns were particularly evident in male EL lambs who displayed higher levels of severe respiratory morbidity (e.g., expiratory braking) than female EL lambs. The study demonstrates that EL volumes at birth trigger respiratory behaviour and breathing patterns that resemble clinically recognised features of RD in term infants. | Davies I M; Crossley K J; McGillick E V; Nitsos I; Rodgers K; Thiel A; Zahra V A; Badurdeen S; Te Pas A B; Hooper S B | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Frontiers in pediatrics | 38690520 | Risk factors predicting need for the pediatric intensive care unit (PICU) post-hematopoietic cell transplant, PICU utilization, and outcomes following HCT: a single center retrospective analysis. | Hematopoietic cell transplant (HCT) is a curative treatment for multiple malignant and non-malignant disorders. While morbidity and mortality have decreased significantly over the years, some patients still require management in the pediatric intensive care unit (PICU) during their HCT course for additional respiratory, cardiovascular, and/or renal support. We retrospectively reviewed pediatric patients (0-18 years) who underwent HCT from January 2015-December 2020 at our institution to determine risk factors for PICU care and evaluate PICU utilization and outcomes. We also assessed pulmonary function testing (PFT) data to determine if differences were noted between PICU and non-PICU patients as well as potential evolution of pulmonary dysfunction over time. Risk factors of needing PICU care were lower age, lower weight, having an underlying inborn error of metabolism, and receiving busulfan-based conditioning. Nearly half of PICU encounters involved use of each of respiratory support types including high-flow nasal cannula, non-invasive positive pressure ventilation, and mechanical ventilation. Approximately one-fifth of PICU encounters involved renal replacement therapy. Pulmonary function test results largely did not differ between PICU and non-PICU patients at any timepoint aside from individuals who required PICU care having lower DLCO scores at one-year post-HCT. Future directions include consideration of combining our data with other centers for a multi-center retrospective analysis with the goal of gathering and reporting additional multi-center data to work toward continuing to decrease morbidity and mortality for patients undergoing HCT. | Johnson Amanda K; Cornea Sinziana; Goldfarb Samuel; Cao Qing; Heneghan Julia A; Gupta Ashish O | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | World journal of stem cells | 38690515 | Mesenchymal stem cells and their derived exosomes for the treatment of COVID-19. | Coronavirus disease 2019 (COVID-19) is an acute respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 infection typically presents with fever and respiratory symptoms, which can progress to severe respiratory distress syndrome and multiple organ failure. In severe cases, these complications may even lead to death. One of the causes of COVID-19 deaths is the cytokine storm caused by an overactive immune response. Therefore, suppressing the overactive immune response may be an effective strategy for treating COVID-19. Mesenchymal stem cells (MSCs) and their derived exosomes (MSCs-Exo) have potent homing abilities, immunomodulatory functions, regenerative repair, and antifibrotic effects, promising an effective tool in treating COVID-19. In this paper, we review the main mechanisms and potential roles of MSCs and MSCs-Exo in treating COVID-19. We also summarize relevant recent clinical trials, including the source of cells, the dosage and the efficacy, and the clinical value and problems in this field, providing more theoretical references for the clinical use of MSCs and MSCs-Exo in the treatment of COVID-19. | Hou Xiang-Yi; Danzeng La-Mu; Wu Yi-Lin; Ma Qian-Hui; Yu Zheng; Li Mei-Ying; Li Li-Sha | 2024-26-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Cureus | 38690504 | Sinus Tachycardia Following COVID-19 and Its Implications. | Background Within the cardiovascular system, sinus tachycardia has been a noted finding in patients with post-COVID-19 syndrome (symptoms persisting beyond 12 weeks post-infection). To better understand post-COVID-19 tachycardia, we examined the prevalence of sinus tachycardia 12-16 weeks after diagnosis of SARS-COV-2 infection and its correlation with intensive care utilization, ventilator use, and mortality in vaccinated and unvaccinated patients. Methods We identified adult patients in the TriNetX COVID-19 Research Network with confirmed SARS-COV-2 diagnosis from January 20th, 2020, to February 14th, 2022, and sinus tachycardia 12-16 weeks after diagnosis. Two cohorts were created: patients who developed tachycardia 12 weeks after initial diagnosis and patients without tachycardia. The tachycardia cohort was divided further based on vaccination status. Results Of 1,363,907 patients included, 30,705 (2.2%) developed tachycardia. The patients with tachycardia had more comorbidities. Using propensity score matching (PSM), two cohorts of 30,702 were created. The SARS-COV-2 tachycardic cohort had higher mortality (5.1% vs 2.1%, p<0.001), critical care utilization (5.8% vs 2.2%, p<0.001), and ventilator use (1.8% vs 0.5%, p<0.001). Out of 22,878 patients with persistent tachycardia and recorded vaccination status, 14,840 (65%) were not vaccinated. Mortality (5.9% vs 2.3%, p<0.001), critical care utilization (8.3% vs 3.6%, p<0.001), and ventilator use (3.8% vs 0.6%, p<0.001) were higher in the non-vaccinated patients compared with the vaccinated patients after PSM. Conclusion The prevalence of persistent tachycardia after SARS-COV-2 infection is notable at 2.2%. Patients with persistent tachycardia have higher mortality rates and demonstrate greater healthcare utilization at one year compared to patients without persistent tachycardia, particularly if unvaccinated. | Amir-Kabirian Borna; Annie Frank H; Koontz Morgan; Ihle Rayan | 2024-01-03 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Cureus | 38690500 | Advancements in Tuberculosis Diagnostics: A Comprehensive Review of the Critical Role and Future Prospects of Xpert MTB/RIF Ultra Technology. | Tuberculosis remains a persistent global health challenge, demanding swift and accurate diagnostic methods for effective treatment. The emergence of the Xpert MTB/RIF Ultra system marks a significant milestone in combating tuberculosis, streamlining the identification of <i>Mycobacterium tuberculosis</i>, and advancing our pursuit of eradicating the disease. Delving into the therapeutic landscape of tuberculosis and rifampicin resistance, this scientific narrative review offers a comprehensive exploration. It begins by delving into the historical backdrop and the hurdles encountered with traditional tuberculosis diagnostics. From there, it traces the journey of the Xpert MTB/RIF technology, underscoring its molecular underpinnings. In this narrative review, the performance of the Xpert MTB/RIF Ultra system undergoes thorough scrutiny, encompassing investigations into sensitivity, specificity, and comparisons with alternative diagnostic methods. The spotlight shines on its clinical applications across diverse scenarios, from diagnosing pulmonary and extrapulmonary tuberculosis to its pivotal role in identifying rifampicin resistance. The study also evaluates its clinical efficacy in enhancing patient outcomes and supporting global tuberculosis control initiatives. However, the review does not shy away from discussing the challenges and limitations associated with the Xpert MTB/RIF Ultra system. It meticulously addresses concerns regarding cost, infrastructure requirements, and potential diagnostic inaccuracies. Offering a panoramic view, the review assesses the system's impact in resource-constrained settings and its potential to bolster tuberculosis elimination endeavors worldwide. Peering into the future, it explores ongoing research avenues and potential enhancements in Xpert MTB/RIF Ultra technology, envisioning a landscape of improved performance, broader applications, and emerging diagnostic innovations in the realm of tuberculosis diagnostics. | Yadav Sankalp; Rawal Gautam; Jeyaraman Madhan; Jeyaraman Naveen | 2024-01-03 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Cureus | 38690499 | Successful Atrial Septal Defect Closure Subsequent to Medical Pulmonary Preconditioning in an Infant With Severe Pulmonary Hypertension Associated With Bronchopulmonary Dysplasia. | While atrial septal defect (ASD) may contribute to right ventricular decompression in patients with severe pulmonary hypertension (PH), the pulmonary vasculature might be compromised by increased pulmonary blood flow, even though pulmonary vasodilators successfully reduce resistance. ASD closure is a treatment option that may ameliorate PH symptoms associated with bronchopulmonary dysplasia (BPD) in infants. However, the feasibility of ASD closure is obscure in patients with BPD-PH causing right-to-left shunting. Here, we present an eight-month-old girl with ASD complicated by BPD-PH, in which the pulmonary pressure exceeded the systemic pressure; the ASD was successfully closed after pulmonary preconditioning with dexamethasone and high-dose diuretics. Our patient was delivered as the third baby in triplets at a gestational age of 25 weeks, with a birth weight of 344 g. She was diagnosed with BPD at three months of age (37 weeks of postmenstrual age) with a body weight of 1.4 kg. Mild pulmonary hypertension was identified at the age of five months, and oral sildenafil was initiated. While her atrial septal defect was small at the time of PH diagnosis, it became hemodynamically significant when she grew up to 3.4 kg of body weight, at seven months after birth. Her estimated right ventricular pressure was apparently more than the systemic pressure, and oxygen saturation fluctuated between 82% and 97% under oxygen supplementation due to bidirectional interatrial shunt with predominant right-to-left shunting. Pulmonary preconditioning lowered the estimated right ventricular pressure to almost equal the systemic pressure and elevated arterial oxygen saturation while also suppressing right-to-left shunting. Cardiac catheterization after preconditioning revealed a ratio of pulmonary blood pressure to systemic blood pressure ratio (Pp/Ps) of 0.9, pulmonary resistance of 7.3 WU-m<sup>2</sup>, and a pulmonary to systemic blood flow ratio (Qp/Qs) of 1.3 (approximately 1.0 in the normal circulation without significant shunt), with the cardiac index of 2.8 L/min/m<sup>2</sup>. The acute pulmonary vasoreactivity test against the combination of 20 ppm nitric oxide and 100% oxygen was negative, although the patient had consistently high pulmonary flow with makeshift improvements after preconditioning. Despite the high pulmonary resistance even after preconditioning, aggressive ASD closure was performed so that pulmonary flow could be consistently suppressed regardless of the pulmonary condition. Her Pp/Ps under 100% oxygen with 20 ppm nitric oxide was 0.7 immediately after closure. After two years of follow-up, her estimated right ventricular pressure was less than half of the systemic pressure with the use of three pulmonary vasodilators, including sildenafil, macitentan, and beraprost. A strategy to temporarily improve PH and respiratory status aimed at ASD closure could be a treatment option for the effective use of multiple pulmonary vasodilators, by which intensive treatment of BPD can be achieved. | Sato Maki; Saiki Hirofumi; Saito Kanchi; Sato Akira; Kuwata Seiko; Nakano Satoshi; Koizumi Junichi; Oyama Kotaro; Akasaka Manami | 2024-01-03 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Cureus | 38690498 | Ultrasound-Facilitated, Catheter-Directed Thrombolysis for Acute Pulmonary Embolism. | Acute pulmonary embolism (APE) poses a significant risk to patient health, with treatment options varying in efficacy and safety. Ultrasound-facilitated catheter-directed thrombolysis (USCDT) has emerged as a potential alternative to conventional catheter-directed thrombolysis (CDT) for patients with intermediate to high-risk APE. This study aimed to compare the efficacy and safety of USCDT versus conventional CDT in patients with intermediate to high-risk APE. This observational retrospective study was conducted at the Armed Forces Hospital, Al-Hada, Taif, the Kingdom of Saudi Arabia (KSA), on 135 patients diagnosed with APE and treated with either USCDT or CDT (58 underwent CDT, while 77 underwent USCDT). The primary efficacy outcome was the change in the right ventricle to the left ventricle (RV/LV) diameter ratio. Secondary outcomes included changes in pulmonary artery systolic pressure and the Miller angiographic obstruction index score. Safety outcomes focused on major bleeding events. Both USCDT and CDT significantly reduced RV/LV diameter ratio (from 1.35 ± 0.14 to 1.05 ± 0.17, P < 0.001) and systolic pulmonary artery pressure (SPAP) (from 55 ± 7 mmHg to 38 ± 7 mmHg, P < 0.001) at 48- and 12-hours post-procedure, respectively, with no significant differences between treatments. However, USCDT was associated with a significantly lower rate of major bleeding events compared to CDT (0% vs. 3.4%, P = 0.008). Multivariate logistic regression analysis revealed that USCDT was associated with a 71.9% risk reduction of bleeding (OR = 0.281, 95% CI = 0.126 - 0.627, P = 0.002). USCDT is a safe and effective alternative to CDT for the treatment of intermediate to high-risk APE, as it significantly reduces the risk of major bleeding. | Elheet Ahmed A; Elhadidy Amr F; Farrag Mohamad H; Mahmoud Mohamed A; Ibrahim Ayman A; AlAbdali Ali M; Kazim Hameedullah; Elganainy Mohammed N | 2024-01-03 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Cureus | 38690490 | Malignant Pericardial Effusion Presenting as a Sequela of Lung Adenocarcinoma. | Pericardial effusion is a collection of fluid in the pericardial sac that can result in symptoms such as shortness of breath, pleuritic chest pain, and/or hemodynamic instability. Malignant pleural effusions are seen in a few cancer patients and are associated with poor prognosis. Here, we present the case of a 65-year-old female with a large malignant pericardial effusion in the setting of advanced-stage lung adenocarcinoma. | Balaji Nivedha; Velez Oquendo Gabriel; Sun Moyan; Sykalo Christine; Khan Imran | 2024-01-03 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Cureus | 38690487 | An Observational Study of Fungal Infections in COVID-19: Highlighting the Role of Mucormycosis in Tertiary Healthcare Settings. | Background Fungal infections, especially mucormycosis, have remarkably surged during the coronavirus disease 2019 (COVID-19) era, especially during the second wave peak of the pandemic raising the concern of the clinicians for the admitted patients. Steroid therapy, diabetes, and other immunocompromised states are more commonly associated with COVID-19-associated mucormycosis (CAM). Aim and objective The aim of this study is to ascertain the prevalence of fungal infections amidst the second wave of the COVID-19 pandemic and discern the associated risk factors. Materials and methods During the second peak of COVID-19, samples were received in the microbiology laboratory from all clinically suspected mucormycosis patients. These samples underwent processing for potassium hydroxide (KOH) wet mount, fungal culture on Sabouraud's dextrose agar (SDA) medium, and COVID-19 reverse transcription-polymerase chain reaction (RT-PCR) testing. All relevant clinical and associated risk factors were tabulated and analyzed. Results Among the 107 suspected cases of mucormycosis, 39 (36.4%) were confirmed positive for COVID-19 via RT-PCR, while 68 (63.6%) tested negative. Males exhibited a predominant infection rate, with the rhinocerebral system being the most commonly affected site. Significantly higher mortality rates were observed in COVID-19-associated mucormycosis (CAM) patients (33.4%) compared to those without COVID-19 (5.9%), with a notable p-value of 0.0005. CAM patients also demonstrated a higher frequency of ICU admissions (77%) compared to non-COVID-19-associated mucormycosis patients (21.4%), a statistically significant finding (p-value of 0.007). Additionally, immunocompromised states, diabetes, and the administration of oxygen therapy were identified as significant risk factors in CAM (p < 0.05). Notably, mucormycosis accounted for the majority of fungal isolates (48.27%) among COVID-19 patients. Conclusion Mucormycosis infection is more commonly seen in COVID-19-infected patients as compared to non-COVID-19 patients, especially with comorbidities such as diabetes mellitus, steroid usage, and other immunocompromised states. | Singh Rajender; Mittal Garima; Kakati Barnali; Koul Nupur | 2024-01-03 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Cureus | 38690483 | Impact of COVID-19 Pandemic on Radiology Department Employees and Trainees in Al-Qassim, 2021. | Objectives This study aimed to assess the impact of the COVID-19 pandemic on radiology department employees and trainees. It also compared the impact of COVID-19 to the pre-COVID-19 era in the Al-Qassim region. Methods This was a quantitative observational analytical cross-sectional study conducted in the largest government hospitals under the Ministry of Health (MOH) in Al-Qassim. A pre-determined questionnaire was distributed among radiology staff that included demographic characteristics, the impact of the COVID-19 pandemic among radiology staff, the behavior of staff related to COVID-19 infection, and the assessment of mental health using the patient health questionnaire (PHQ-9). Results Eighty-four radiology staff were recruited (64.3% males vs 35.7% females). Of these, 66.7% were trainees and the rest were employees (33.3%). Of the trainees, 32.1% and 42.9% thought that elective imaging, procedures, and outpatient/clinic exposures were reduced during the pandemic, and 37.5% indicated that their training had been affected negatively. The prevalence of depression among radiology staff was 36.9%. The prevalence of depression was substantially higher among radiology trainees (p=0.038), those who were not infected with COVID-16 (p=0.041), and those who indicated that their studying time increased at the time of the pandemic (p=0.047). However, after conducting multivariate regression analysis, these variables did not seem to have significantly affected depression (p>0.05). Conclusion Training and medical education have been affected negatively because of the outbreak. Studying time and research activities of employees and trainees slowed down, which could be critical to their careers. Trainees complained about the significant reduction in their exposure to clinics and imaging procedures. Therefore, a method to safeguard the well-being of employees and trainees in the radiology department is necessary to limit the impact of such pandemics. | Albweady Ali; AlHajji Maryiah; AlBassam Rawaf; Almalki Hala; Almansour Beshair; Alghofaili Renad; Alsubaie Manal | 2024-01-03 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Cureus | 38690482 | Novelty of Physiotherapy Management in a Classic Case of Chronic Obstructive Pulmonary Disease in an 84-Year-Old Male Patient with Hypertension and Well-Controlled Hypothyroidism: A Case Report. | Chronic obstructive pulmonary disease (COPD) often coexists with hypertension and hypothyroidism, posing challenges in management. Physiotherapy is crucial for improving respiratory function and quality of life in COPD patients. This case report details the physiotherapy management of an 84-year-old male with COPD, hypertension, and well-controlled hypothyroidism. The patient presented with worsening cough, breathlessness, and barrel chest. Diagnostic investigations confirmed COPD with respiratory alkalosis, hypoxemia, and well-controlled hypothyroidism. Pharmaceutical management was initiated alongside intensive physiotherapy interventions. A two-week rehabilitation program was tailored to the patient's COPD condition. It included deep breathing exercises, relaxation techniques, and aerobic activities to improve respiratory function and exercise tolerance. Physiotherapy sessions focused on patient education with medical treatment. Significant improvements were noted in dyspnea grading, perceived exertion rate, and thoracic excursion post-rehabilitation. Follow-up assessments showed sustained benefits with improved daily activities and reduced dyspnea. This case underscores the efficacy of multidisciplinary management, highlighting the essential role of physiotherapy in optimizing outcomes for COPD patients with comorbidities. | Nangliya Radha; Yadav Vaishnavi; Nandanwar Sojwal P | 2024-01-03 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Cureus | 38690481 | Efficacy of Computerized Tomography-Guided Core Biopsy in Identifying the Subtypes of Lung Adenocarcinoma: An Observational Perspective From Pakistan. | Background Lung carcinoma is a leading cause of death worldwide. Histological subtype of lung adenocarcinoma is an important indicator of patient's outcome as it is helpful in surgical planning and guidance of prognosis. Objective To determine the diagnostic efficacy of computerized tomography-guided core needle biopsy (CNB) in identifying the histopathological subtype of lung adenocarcinoma. Methods and materials This is a retrospective, descriptive study including clinical data of 73 patients irrespective of their age and gender, who underwent computerized tomography-guided CNB for lung masses at the Department of Pathology, Aznostics - the Diagnostic Centre, Lahore, Pakistan from January 01, 2019 to June 30, 2023. Data collected was analyzed via Google Form (Google Inc., Mountainview, CA) and Statistical Package for Social Sciences (IBM SPSS Statistics for Windows, Version 24, released 2016; IBM Corp., Armonk, New York, United States) and was sent to statistician for descriptive analysis. Categorical data was used for calculating frequency and percentage, while continuous data was computed as mean and standard deviation. Results Seventy-three patients with adenocarcinoma underwent pulmonary biopsy. The mean age of included patients was 64.88 ± 11.39 year with a male predominance of 61.64%. Upper lobe was commonly affected by adenocarcinoma lung in 57.53% patients and 58.90% cases involved the right lung. The most common subtype was acinar with 51.65% followed by solid with 17.58% cases. Computerized tomography-guided CNB showed a diagnostic yield of 75.34% and identified histological subtypes of lung adenocarcinoma in 55 cases. Conclusion Computerized tomography-guided CNB is a useful, yet minimally invasive diagnostic tool to identify the histological subtype of lung adenocarcinoma. It not only helps in planning the surgical and adjuvant management of the patients, but also guides the patient-prognosis. | Yasin Babar; Saeed Hasan; Ahmad Muhammad Awais; Najam Sara; Niazi Mehwish; Tariq Humza; Khan Allah Yar Yahya; Khaliq Shoaib; Zaidi Syeda Gul E Zehra; Mehmood Qadri Haseeb | 2024-01-03 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Cureus | 38690475 | Clinical Features Predicting COVID-19 Severity Risk at the Time of Hospitalization. | The global spread of COVID-19 has led to significant mortality and morbidity worldwide. Early identification of COVID-19 patients who are at high risk of developing severe disease can help in improved patient management, care, and treatment, as well as in the effective allocation of hospital resources. The severity prediction at the time of hospitalization can be extremely helpful in deciding the treatment of COVID-19 patients. To this end, this study presents an interpretable artificial intelligence (AI) model, named COVID-19 severity predictor (CoSP) that predicts COVID-19 severity using the clinical features at the time of hospital admission. We utilized a dataset comprising 64 demographic and laboratory features of 7,416 confirmed COVID-19 patients that were collected at the time of hospital admission. The proposed hierarchical CoSP model performs four-class COVID severity risk prediction into asymptomatic, mild, moderate, and severe categories. CoSP yielded better performance with good interpretability, as observed via Shapley analysis on COVID severity prediction compared to the other popular ML methods, with an area under the received operating characteristic curve (AUC-ROC) of 0.95, an area under the precision-recall curve (AUPRC) of 0.91, and a weighted F1-score of 0.83. Out of 64 initial features, 19 features were inferred as predictive of the severity of COVID-19 disease by the CoSP model. Therefore, an AI model predicting COVID-19 severity may be helpful for early intervention, optimizing resource allocation, and guiding personalized treatments, potentially enabling healthcare professionals to save lives and allocate resources effectively in the fight against the pandemic. | Sagar Dikshant; Dwivedi Tanima; Gupta Anubha; Aggarwal Priya; Bhatnagar Sushma; Mohan Anant; Kaur Punit; Gupta Ritu | 2024-01-03 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Cureus | 38690473 | From Campus to Crisis: Psychological Effect of the COVID-19 Pandemic on Indian Management Students. | The COVID-19 pandemic has adversely affected students pursuing higher education, but limited studies highlight student's psychological experiences, especially from Western India. The present study aimed to understand psychological experiences, coping behaviors, and the perceived role of tele-counseling services among final-year students of Masters of Business Administration from leading business schools (B-schools) in Western India. A qualitative research design was adopted for the study. A semi-structured interview guide was utilized to conduct in-depth interviews with 35 students. Students were reached via personal networks and social media, and data was gathered after the second wave of the COVID-19 pandemic. A thematic analysis technique was employed to analyze the data. The findings showed that management students had upsetting psychological experiences. Key stressors that emerged in the study were job concerns, lifestyle changes, concerns about their own and parents' health and safety, uncertainty about the future, and social isolation. They expressed the need for mental health help; however, they were reluctant to utilize tele-counseling services. The authors present an integrated psychological well-being model for promoting positive mental health among students in higher education institutions. The study explains the psychological toll on management students. Enhancing mental health literacy through awareness sessions and other innovative means would be critical to addressing myths around mental health and mental healthcare-seeking behavior in higher education institutions. An integrated approach to promoting positive mental health and well-being is needed. | Panchamia Jallavi; Sinha Anamika; Pandya Apurvakumar | 2024-01-03 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Cureus | 38690470 | Multifaceted Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on ST-Elevation Myocardial Infarction (STEMI): A Literature Review of Incidence, Treatment Modalities, and Outcomes. | The global repercussions of coronavirus disease 2019 (COVID-19) include substantial worldwide mortality and have brought to light existing gaps in healthcare systems. Particularly, diseases requiring time-sensitive treatment, such as ST-elevation myocardial infarction (STEMI), have faced significant challenges due to the impact and revelations of the COVID-19 pandemic on healthcare infrastructure. This review addresses the impact of the pandemic on STEMI, exploring incidence, treatment modalities, and clinical outcomes. Through a critical examination of existing literature, the intricate relationship between the pandemic and cardiovascular health, specifically STEMI, is elucidated. The COVID-19 pandemic has had a significant impact on the management of STEMI, with changes in hospitalization rates, treatment strategies, and the presentation of the disease posing significant challenges. The contradictory results of COVID-19 and post-vaccine myocardial infarction, as well as gender differences in reported cases, highlight the need for further research to clarify these relationships. | Choi Hoi K; Maity Madhurima; Qureshi Mohammed; Haider Ali; Kapadia Sagar; Fuerte Sofia; Antony Simon; Razzaq Waleed; Akbar Anum | 2024-01-03 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Cureus | 38690469 | A Case of COVID-19 Pneumonia Leading to Acute Respiratory Distress Syndrome (ARDS) and Multi-organ Failure Requiring Extracorporeal Membrane Oxygenation (ECMO) for Six Months and an Associated Critical Limb Ischemia. | This article presents the case of a 57-year-old woman with a history of rheumatoid arthritis who developed severe coronavirus disease 2019 (COVID-19) pneumonia that progressed to acute respiratory distress syndrome (ARDS) and multi-system organ failure. Despite initial slow progression and multiple hospital readmissions, her condition rapidly deteriorated, leading to full respiratory failure requiring intubation and ventilation. She was transferred to a specialized center where she underwent extracorporeal membrane oxygenation (ECMO) and hemodialysis for acute renal failure. Unfortunately, she remained dependent on ECMO for an extended period of six months. Although she made a gradual recovery, the prolonged critical care treatment resulted in critical ischemia of multiple extremities, necessitating a below-knee amputation (BKA) of her left lower extremity and transmetatarsal amputations of her right hand. This case reports one of the longest ECMO treatments for COVID-19 and associated comorbidities in the literature. Clinicians could include a longer duration of treatment and potential associated disabilities in the informed consent. | Durrani Kulsoom; Butt Faiza; Atif Syed; Azhar Erum; Waheed Abdul | 2024-01-03 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Cureus | 38690468 | Prevalence of Pulmonary Hypertension in Liver Cirrhosis Patients: A Cross-Sectional Analytical Study. | Liver cirrhosis (LC) is a common complication of chronic liver disease. Its prevalence has increased markedly over the last few years. With liver cirrhosis comes cardiovascular morbidity and mortality. It is important that the detection of the abnormalities by echocardiography be given priority, as this can change the clinical outcome of these patients with cardiovascular abnormalities in liver cirrhosis. This study aims to determine the prevalence of pulmonary hypertension in LC patients. A cross-sectional analytical study was carried out at JUTH (Jos University Teaching Hospital) over a period of one year. We recruited 210 adult patients with liver cirrhosis from the gastroenterology clinic and wards for this study. Data from these patients were collected with questionnaires administered by the interviewer and analysed using SPSS 23 statistical software (IBM Corp., Armonk, NY). The data obtained are presented in tables and charts. Categorical variables were expressed as proportions and frequencies, while continuous data were expressed as the median, mean, and standard deviation. Pulmonary hypertension was found in 30.5% of the participants, with mild pulmonary hypertension being the most common. No one had severe pulmonary hypertension. There was an increased risk of developing pulmonary hypertension in patients with coughs, easy fatigability, bilateral leg swelling, abdominal swelling, and ascites (P<0.05). The result showed that there is a high prevalence of pulmonary hypertension in patients with liver cirrhosis. | Enenche Augustine A; Kweki Anthony G; Aiwuyo Henry O; Akinti Oluwasegun M; Nevolina Anna; Perry Jamal C; Ayinalem Yonael; Osarenkhoe John O; Ukenenye Emmanuel; Poluyi Charles O; Ibrahim Aishatu O | 2024-01-03 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Cureus | 38690457 | Survival and Lung Function Changes in Hypersensitivity Pneumonitis According to Radiological Phenotypes Compared With Idiopathic Pulmonary Fibrosis. | The main objective of this study was to estimate survival and changes in lung function in patients with chronic hypersensitivity pneumonitis (HP), both fibrotic (f-HP) and nonfibrotic (nf-HP), and to compare them with those in patients with idiopathic pulmonary fibrosis (IPF). HP was diagnosed based on antigen exposure, HRCT (high-resolution CT scan), BAL (bronchoalveolar lavage), and histology. According to HRCT, HP was classified into fibrotic and non-fibrotic phenotypes. In most cases, IPF was diagnosed based on HRCT findings. We identified 84 patients: 46 with IPF, 18 with f-HP, and 20 with nf-HP. Five-year survival was 23.9% in IPF, 72% in f-HP, and 100% in nf-HP (p <0.0001). Honeycombing was associated with decreased survival in IPF (p <0.001) and in f-HP (p <0.0001). The mean loss of FVC (forced vital capacity) % pred. (percent predicted) was -18.3% in IPF (p =0.001), -4.8% in f-HP, and -6.0% in nf-HP. The mean change in DLCO (diffusion capacity for carbon monoxide) % pred. was -10.2% in IPF (p <0.002), -0.5% in f-HP, and +1.9% in nf-HP. The agreement between radiological phenotypes and histology in HP was 89.6%. We found shorter survival in IPF, followed by f-HP, and nf-HP. Over time, we did not find significant changes in FVC% pred. or DLCO% pred. in HP, while a significant decline in IPF was noted. In HP, we found strong agreement between radiological phenotypes and histology. Radiological signs suggestive of lung fibrosis in HP were reliable for the diagnosis of f-HP and seem to have intrinsic prognostic value. | Juliá-Serdá Gabriel; Navarro-Esteva Javier; Doreste-Salgado Laura; Véliz-Flores Ibrahim; Pestana-Santana Rubén; González-Martín Jesús María; Rodríguez-de Castro Felipe | 2024-01-03 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Cureus | 38690453 | Post-COVID-19 Pulmonary Inflammatory Pseudotumors Treated With Steroid Taper. | The aftermath of COVID-19 continues to unveil an array of pulmonary complications, extending beyond the acute phase of the viral infection. Among these emerging sequelae, we present the case of a 58-year-old individual who developed pulmonary inflammatory pseudotumors (PIPs) following recovery from COVID-19. PIPs are exceedingly rare benign lesions that can pose a diagnostic challenge due to their clinical and radiological resemblance to malignant neoplasms. Histologically, PIPs are characterized by a proliferation of myofibroblastic spindle cells accompanied by inflammatory infiltrates, including lymphocytes, plasma cells, and histiocytes. As our understanding of post-COVID-19 complications evolves, this case serves as the first exploration into the complex interplay between COVID-19 infections and the subsequent development of inflammatory pseudotumors. In this report, an investigation is performed into the clinical presentation, diagnostic challenges, and successful management of post-COVID-19 PIPs with a focus on the pivotal role of corticosteroid therapy in mitigating the inflammatory response associated with this unique post-viral entity and resolution of the masses. | Karimi Rayhan; Adlakha Arun | 2024-01-03 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Cureus | 38690449 | A Less Invasive Technique for Surfactant Administration in a Full-Term Newborn With Moderate Meconium Aspiration Syndrome. | Meconium aspiration syndrome (MAS) presents significant challenges in neonatal care, particularly in the context of respiratory distress. This report explores the efficacy of administering surfactant through a less invasive surfactant administration (LISA) technique in a full-term neonate with MAS. Our case highlights the potential of this method in reducing the need for mechanical ventilation, drawing parallels with its established benefits in preterm neonates with respiratory distress syndrome. The successful application of LISA in this case suggests a promising avenue for managing MAS in full-term neonates, warranting further investigation. | Abusallout Nuor; Abdulrahman Sarah; Elhadidi Ahmed; Ben Ayad Aimen | 2024-01-03 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | JTCVS open | 38690443 | The effect of donor-recipient sex matches on lung transplant survival: An analysis of the United Network for Organ Sharing database. | To investigate the impact of donor-recipient (DR) sex matches on survival after lung transplantation while controlling for size difference in the United Network of Organ Sharing (UNOS) database. We performed a retrospective study of 27,423 lung transplant recipients who were reported in the UNOS database (January 2005-March 2020). Patients were divided into groups based on their respective DR sex match: male to male (MM), male to female (MF), female to female, (FF), and female to male (FM). Kaplan-Meier curve and Cox regression with log-rank tests were used to assess 1-, 3-, 5-, and 10-year survival. We also modeled survival for each group after controlling for size-related variables via the Cox regression. Kaplan-Meier curves showed overall significance at 1-, 3-, 5-, and 10-year end points (<i>P</i> < .0001). Estimated median survival time based on Kaplan-Meier analysis were 6.41 ± 0.15, 6.13 ± 0.18, 5.86 ± 0.10, and 5.37 ± 0.17 years for FF, MF, MM, and FM, respectively (<i>P</i> < .0001). After we controlled for size differences, FF had statistically significantly longer 5- and 10-year survival than all other cohorts. MF also had statistically significantly longer 5- and 10-year survival than FM. When variables associated with size were controlled for, FF had improved survival than other DR groups. A female recipient may experience longer survival with a female donor's lungs versus a male donor's lungs of similar size. | Profozich Elizabeth; Kashem Abul; Yanagida Roh; Suryapalam Manish; Cheng Ke; Kehara Hiromu; Shigemura Norihisa; Toyoda Yoshiya | 2024-01-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | JTCVS open | 38690442 | Mortality index is more accurate than volume in predicting outcome and failure to rescue in Medicare beneficiaries undergoing robotic right upper lobectomy. | Surgical volume is known to influence failure to rescue (FTR), defined as death following a complication. Robotic lung surgery continues to expand and there is variability in outcomes among hospitals. We sought to estimate the contribution of hospital-based factors on outcomes and FTR following robotic right upper lobectomy (RRUL). Using the Centers for Medicare and Medicaid Services inpatient claims database, we evaluated all patients age ≥65 years with a diagnosis of lung cancer who underwent RRUL between January 2018 and December 2020. We excluded patients who had undergone segmentectomy, sublobar, wedge, or bronchoplastic resection; had metastatic or nonmalignant disease; or had a history of neoadjuvant chemotherapy. Primary outcomes included FTR rate, length of stay (LOS), readmissions, conversion to open surgery, complications, and costs. We analyzed hospitals by tertiles of volume and Medicare Mortality Index (MMI). Defined as the institutional number of deaths per number of survivors, MMI is a marker of overall hospital performance and quality. Propensity score models were adjusted for confounding using goodness of fit. Data for 4317 patients who underwent robotic right upper lobectomy were analyzed. Hospitals were categorized by volume of cases (low, <9; medium, 9-20; high, >20) and MMI (low, <0.04; medium, 0.04-0.13; high, >0.13). After propensity score balancing, patients from tertiles of lowest volume and highest MMI had higher costs ($34,222 vs $30,316; <i>P</i> = .006), as well as higher mortality (odds ratio, 7.46; 95% confidence interval, 2.67-28.2; <i>P</i> < .001). Compared to high-volume centers, low-volume centers had higher rates of conversion to open surgery, respiratory failure, hemorrhagic anemia, and death; longer LOS; and greater cost (<i>P</i> < .001 for all). The C-statistic for volume as a predictor of overall mortality was 0.6, and the FTR was 0.8. Hospitals in the highest tertile of MMI had the highest rates of conversion to open surgery (<i>P</i> = .01), pneumothorax (<i>P</i> = .02), and respiratory failure (<i>P</i> < .001). They also had the highest mortality and rate of readmission, longest LOS, and greatest costs (<i>P</i> < .001 for all) and the shortest survival (<i>P</i> < .001). The C-statistic for MMI as a predictor of overall mortality was 0.8, and FTR was 0.9. The MMI incorporates hospital-based factors in the adjudication of outcomes and is a more sensitive predictor of FTR rates than volume alone. Combining MMI and volume may provide a metric that can guide quality improvement and cost-effectiveness measures in hospitals seeking to implement robotic lung surgery programs. | Hayanga J W Awori; Tham Elwin; Gomez-Tschrnko Manuel; Mehaffey J Hunter; Lamb Jason; Rothenberg Paul; Badhwar Vinay; Toker Alper | 2024-01-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | JTCVS open | 38690441 | Randomized controlled trials in lung cancer surgery: How are we doing? | Randomized control trials are considered the highest level of evidence, yet the scalability and practicality of implementing randomized control trials in the thoracic surgical oncology space are not well described. The aim of this study is to understand what types of randomized control trials have been conducted in thoracic surgical oncology and ascertain their success rate in completing them as originally planned. The ClinicalTrials.gov database was queried in April 2023 to identify registered randomized control trials performed in patients with lung cancer who underwent surgery (by any technique) as part of their treatment. There were 68 eligible randomized control trials; 33 (48.5%) were intended to examine different perioperative patient management strategies (eg, analgesia, ventilation, drainage) or to examine different intraoperative technical aspects (eg, stapling, number of ports, port placement, ligation). The number of randomized control trials was relatively stable over time until a large increase in randomized control trials starting in 2016. Forty-four of the randomized control trials (64.7%) were open-label studies, 43 (63.2%) were conducted in a single facility, 66 (97.1%) had 2 arms, and the mean number of patients enrolled per randomized control trial was 236 (SD, 187). Of 21 completed randomized control trials (31%), the average time to complete accrual was 1605 days (4.4 years) and average time to complete primary/secondary outcomes and adverse events collection was 2125 days (5.82 years). Given the immense investment of resources that randomized control trials require, these findings suggest the need to scrutinize future randomized control trial proposals to assess the likelihood of successful completion. Future study is needed to understand the various contributing factors to randomized control trial success or failure. | Wong Lye-Yeng; Li Yanli; Elliott Irmina A; Backhus Leah M; Berry Mark F; Shrager Joseph B; Oh Daniel S | 2024-01-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | JTCVS open | 38690438 | Debunking the July Effect in lung transplantation recipients. | The "July Effect" is a theory that the influx of trainees from July to September negatively impacts patient outcomes. We aimed to study this theoretical phenomenon in lung transplant recipients given the highly technical nature of thoracic procedures. Adult lung transplant hospitalizations were identified within the National Inpatient Sample (2005-2020). Recipients were categorized as academic Q1 (July to September) or Q2-Q4 (October to June). In-hospital mortality, operator-driven complications (pneumothorax, dehiscence including wound dehiscence, bronchial anastomosis, and others, and vocal cord/diaphragm paralysis, all 3 treated as a composite outcome), length of stay, and inflation-adjusted hospitalization charges were compared between both groups. Multivariable logistic regression was performed to assess the association between academic quarter and in-hospital mortality and operator-driven complications. The models were adjusted for recipient demographics and transplant characteristics. Subgroup analysis was performed between academic and nonacademic hospitals. Of 30,788 lung transplants, 7838 occurred in Q1 and 22,950 occurred in Q2-Q4. Recipient demographic and clinical characteristics were similar between groups. Dehiscence (n = 922, 4% vs n = 236, 3%), post-transplant cardiac arrest (n = 532, 2% vs n = 113, 1%), and pulmonary embolism (n = 712, 3% vs n = 164, 2%) were more common in Q2-Q4 versus Q1 recipients (all <i>P</i> < .05). Other operator-driven complications, in-hospital mortality, and resource use were similar between groups (<i>P</i> > .05). These inferences remained unchanged in adjusted analyses and on subgroup analyses of academic versus nonacademic hospitals. The "July Effect" is not evident in US lung transplantation recipient outcomes during the transplant hospitalization. This suggests that current institutional monitoring systems for trainees across multiple specialties, including surgery, anesthesia, critical care, nursing, and others, are robust. | Kalra Andrew; Ruck Jessica M; Akbar Armaan F; Zhou Alice L; Leng Albert; Casillan Alfred J; Ha Jinny S; Merlo Christian A; Bush Errol L | 2024-01-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | JTCVS open | 38690435 | Surgical pulmonary arterioplasty at bidirectional cavopulmonary anastomosis leads to favorable pulmonary hemodynamics at final stage palliation. | Pulmonary arterioplasty (PA plasty) at bidirectional cavopulmonary anastomosis (BDCA) is associated with increased morbidity, but outcomes to final stage palliation are unknown. We sought to determine the influence of PA plasty on pulmonary artery growth and hemodyamics at Fontan. We retrospectively reviewed clinical data and outcomes for BDCA patients from 2006 to 2018. PA plasty was categorized by extent (type 1-4), as previously described. Outcomes included pulmonary artery reintervention and mortality before final palliation. Five hundred eighty-eight patients underwent BDCA. One hundred seventy-nine patients (30.0%) underwent concomitant PA plasty. Five hundred seventy (97%) patients (169 [94%] PA plasty) survived to BDCA discharge. One hundred forty out of 570 survivors (25%) required PA/Glenn reintervention before final stage palliation (59 out of 169 [35%]) PA plasty; 81 out of 401 (20%) non-PA plasty; <i>P</i> < .001). Twelve-, 24-, and 36-month freedom from reintervention after BDCA was 80% (95% CI, 74-86%), 75% (95% CI, 69-82%), and 64% (95% CI, 57-73%) for PA plasty, and 95% (95% CI, 93-97%), 91% (95% CI, 88-94%), and 81% (95% CI, 76-85%) for non-PA plasty (<i>P</i> < .001). Prefinal stage mortality was 37 (6.3%) (14 out of 169 PA plasty; 23 out of 401 non-PA plasty; <i>P</i> = .4). Five hundred four (144 PA plasty and 360 non-PA plasty) patients reached final stage palliation (471 Fontan, 26 1.5-ventricle, and 7 2-ventricular repair). Pre-Fontan PA pressure and pulmonary vascular resistance were 10 mm Hg (range, 9-12 mm Hg) and 1.6 mm Hg (range, 1.3-1.9 mm Hg) in PA plasty and 10 mm Hg (range, 8-12 mm Hg) and 1.5 mm Hg (range, 1.3-1.9 mm Hg) in non-PA plasty patients, respectively (<i>P</i> = .29, .6). Fontan hospital mortality, length of stay, and morbidity were similar. PA plasty at BDCA does not confer additional mortality risk leading to final palliation. Despite increased pulmonary artery reintervention, there was reliable pulmonary artery growth and favorable pulmonary hemodynamics at final stage palliation. | Olds Anna; Gray W Hampton; Bojko Markian; Weaver Carly; Cleveland John D; Bowdish Michael E; Wells Winfield J; Starnes Vaughn A; Kumar S Ram | 2024-01-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | JTCVS open | 38690426 | The cost of lung transplantation in the United States: How high is too high? | To identify patient and process factors that contribute to the high cost of lung transplantation (LTx) in the perioperative period, which may allow transplant centers to evaluate situations in which transplantation is most cost-effective to inform judicious resource allocation, avoid futile care, and reduce costs. The MarketScan Research databases were used to identify 582 privately insured patients undergoing single or bilateral LTx between 2013 and 2019. The patients were subdivided into groups by disease etiology using the United Network of Organ Sharing classification system. Multivariable generalized linear models using a gamma distribution with a log link were fit to examine the associations between the etiology of lung disease and costs during the index admission, 3 months before admission, and 3 months after discharge. Our results indicate that the index admission contributed the most to the total transplantation costs compared to the 3 months before admission and after discharge. The regression-adjusted mean index hospitalization cost was 35% higher for patients with pulmonary vascular disease compared to those with obstructive lung disease ($527,156 vs $389,055). The use of extracorporeal membrane oxygenation, mechanical ventilation, and surgical complications in the post-transplantation period were associated with higher costs during the index admission. Surprisingly, age ≥55 was associated with lower costs during the index admission. This analysis identifies pivotal factors influencing the high cost of LTx, emphasizing the significant impact of the index admission, particularly for patients with pulmonary vascular disease. These insights offer transplant centers an opportunity to enhance cost-effectiveness through judicious resource allocation and service bundling, ultimately reducing overall transplantation costs. | Harris Chelsea S; Lee Hui-Jie; Alderete Isaac S; Halpern Samantha E; Gordee Alexander; Jamieson Ian; Scales Charles; Hartwig Matthew G | 2024-01-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | JTCVS open | 38690424 | Use of a novel microbiome modulator improves anticancer immunity in a murine model of malignant pleural mesothelioma. | Malignant pleural mesothelioma is a fatal disease and a clinical challenge, as few effective treatment modalities are available. Previous evidence links the gut microbiome to the host immunoreactivity to tumors. We thus evaluated the impact of a novel microbiome modulator compound (MMC) on the gut microbiota composition, tumor immune microenvironment, and cancer control in a model of malignant pleural mesothelioma. Age- and weight-matched immunocompetent (n = 23) or athymic BALB/c mice (n = 15) were randomly assigned to MMC or no treatment (control) groups. MMC (31 ppm) was administered through the drinking water 14 days before AB12 malignant mesothelioma cell inoculation into the pleural cavity. The impact of MMC on tumor growth, animal survival, tumor-infiltrating leucocytes, gut microbiome, and fecal metabolome was evaluated and compared with those of control animals. The MMC delayed tumor growth and significantly prolonged the survival of immunocompetent animals (<i>P</i> = .0015) but not that of athymic mice. The improved tumor control in immunocompetent mice correlated with increased infiltration of CD3<sup>+</sup>CD8<sup>+</sup>GRZB<sup>+</sup> cytotoxic T lymphocytes in tumors. Gut microbiota analyses indicated an enrichment in producers of short chain fatty acids in MMC-treated animals. Finally, we observed a positive correlation between the level of fecal short chain fatty acids and abundance of tumor-infiltrating cytotoxic T cells in malignant pleural mesothelioma. MMC administration boosts antitumor immunity, which correlates with a change in gut microbiome and metabolome. MMC may represent a valuable treatment option to combine with immunotherapy in patients with cancer. | Gattlen Christophe; Frank Kirby R; Marie Damien N; Trompette Aurélien; Chriqui Louis-Emmanuel; Hao Yameng; Abdelnour Etienne; Gonzalez Michel; Krueger Thorsten; Dyson Paul J; Siankevich Sviatlana; von Garnier Christophe; Ubags Niki D J; Cavin Sabrina; Perentes Jean Y | 2024-01-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | JTCVS open | 38690420 | Oncological feasibility of segmentectomy for inner-located lung cancer. | Oncological feasibility of segmentectomy for internal non-small cell lung cancer (NSCLC) has not been assessed adequately. We assessed the oncological feasibility of segmentectomy for inner-located NSCLC by investigating surgical margins and patient prognosis after undergoing the procedure. Of the 3555 patients who underwent resection for lung cancer between 2013 and 2019 at our institution, 659 patients who underwent segmentectomy for clinical stage 0 to stage1A NSCLC were included in this study. Patients were separated into 2 groups according to whether the tumor was in the inner or outer third of the lung area. Clinical characteristics and prognoses were retrospectively compared between the groups. Of the included 659 cases, 183 (27.8%) were inner-located, and 476 (72.2%) had outer-located NSCLC. The surgical margin was significantly shorter in the inner-located group than in the outer group (median, 16 vs 25 mm; <i>P</i> < .001). The 5-year recurrence-free survival and overall survival probabilities were 91.1%/91.8% (<i>P</i> = .530) and 94.1%/95.6% (<i>P</i> = .345) for inner/outer-located groups, respectively. Multivariate analysis showed that clinical stage IA2 or 3 (<i>P</i> = .043), lymphovascular invasion (<i>P</i> < .001), and surgical margins <20 mm (<i>P</i> = .017) were independent prognostic factors for recurrence-free survival. The location of the inner or outer tumors was not related to the prognosis. For clinical stage 0 to stage1A NSCLC, tumor location in the inner two-thirds of the lung was not associated with prognosis after segmentectomy. Because one of the independent prognostic factors is margin distance, segmentectomy for inner-located NSCLC would be oncologically acceptable when an adequate surgical margin is secured. | Yano Kaito; Yotsukura Masaya; Watanabe Hirokazu; Akamine Takaki; Yoshida Yukihiro; Nakagawa Kazuo; Yatabe Yasushi; Kusumoto Masahiko; Watanabe Shun-Ichi | 2024-01-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | JTCVS open | 38690419 | En bloc chest wall resection in locally advanced cT3N2 (stage IIIB) lung cancer involving the chest wall: Revisiting guidelines. | Current National Comprehensive Cancer Network guidelines recommend definitive chemoradiation rather than surgery for patients with locally advanced clinical stage T3 and N2 (stage IIIB) lung cancer involving the chest wall. The data supporting this recommendation are controversial. We studied whether surgery confers a survival advantage over definitive chemoradiation in the National Cancer Database. We identified all patients with clinical stage T3 and N2 lung cancer in the National Cancer Database from 2004 to 2017 who underwent a lobectomy with en bloc chest wall resection and compared them with patients with clinical stage T3 and N2 lung cancer who had definitive chemoradiation. We used propensity score matching to minimize confounding by indication while excluding patients with tumors in the upper lobes to exclude Pancoast tumors. We used 1:1 propensity score matching and Kaplan-Meir survival analyses to estimate associations. Of 4467 patients meeting all inclusion/exclusion criteria, 210 (4.49%) had an en bloc chest wall resection. Patients undergoing surgical resection were younger (mean age = 60.3 ± 10.3 years vs 67.5 ± 10.4 years; <i>P</i> < .001) and had more adenocarcinoma (59.0% vs 44.5%; <i>P</i> < .001) but were otherwise similar in terms of sex (37.1% female vs 42.0%; <i>P</i> = .167) and race (Whites 84.3% vs 84.0%; <i>P</i> = .276) compared with the definitive chemoradiation group. After resection, there was an unadjusted 30- and 90-day mortality rate of 3.3% and 9.5%, respectively. A substantial survival benefit with surgical resection persisted after propensity score matching (log-rank <i>P</i> < .001). In this large observational study, we found that in select patients, en bloc chest wall resection for locally advanced clinical stage T3 and N2 lung cancer was associated with improved survival compared with definitive chemoradiation. National Comprehensive Cancer Network guidelines should be revisited. | Zywiciel Joseph F; Verm Raymond A; Raad Wissam; Baker Marshall; Freeman Richard; Abdelsattar Zaid M | 2024-01-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | JTCVS open | 38690416 | Determining optimal air leak resolution criteria when using digital pleural drainage device after lung resection. | There is limited clinical evidence to support any specific parenchymal air leak resolution criteria when using digital pleural drainage devices following lung resection. The aim of this study is to determine an optimal air leak resolution criteria, where duration of chest tube drainage is minimized while avoiding complications from premature chest tube removal. Airflow data averaged at 10-minute intervals was collected prospectively using a digital pleural drainage device (Thopaz; Medela) in 400 patients from 2015 to 2019. All permutations of air leak resolution criteria from <10 to 100 mL/minute for 4 to 12 hours were applied retrospectively to the pleural drainage data to determine air leak duration, and air leak recurrence frequency and volume. Air leak recurrence indicates potential for rather than occurrence of adverse events. Descriptive statistics were used to identify the optimal criteria based on patient safety (low frequency and volume of air leak recurrences), and efficiency (shortest initial air leak duration). The majority of the 400 patients underwent lobectomy (57% [227 out of 400]), wedge resections (29% [115 out of 400]), or segmentectomies (8% [32 out of 400]) for lung cancer (90% [360 out of 400]). An airflow threshold <50 mL/minute resulted in longer air leak duration before meeting the criteria for air leak resolution (<i>P</i> < .0001). Air leak recurrence frequency and volume were greater in patients with a monitoring period <8 consecutive hours (<i>P</i> < .0001). When using a digital pleural drainage device, a postoperative air leak resolution criteria <50 mL/minute for 8 consecutive hours was associated with the best safety and efficiency profile. | Alayche Mohsen; Choueiry Justen; Mekdachi Adnan; Maziak Donna E; Seely Andrew J E; Sundaresan Sudhir R; Villeneuve Patrick J; Jones Daniel; Klement William; Gilbert Sebastien | 2024-01-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | JTCVS open | 38690414 | Lung volume reduction surgery is safe and leads to functional improvement in patients who fail or cannot undergo bronchoscopic lung volume reduction. | Bronchoscopic lung volume reduction (BLVR) has supplanted surgery in the treatment of patients with advanced emphysema, but not all patients qualify for it. Our study aimed to investigate the outcomes of lung volume reduction surgery (LVRS) among patients who either failed BLVR or were not candidates for it. We conducted a retrospective analysis of patients who underwent LVRS for upper lobe-predominant emphysema at a single tertiary center between March 2018 and December 2022. The main outcomes measures were preoperative and postoperative respiratory parameters, perioperative morbidity, and mortality. A total of 67 LVRS recipients were evaluated, including 10 who had failed prior valve placement. The median patient age was 69 years, and 35 (52%) were male. All procedures were performed thoracoscopically, with 36 patients (53.7%) undergoing bilateral LVRS. The median hospital length of stay was 7 days (interquartile range, 6-11 days). Prolonged air leak (>7 days) occurred in 20 patients. There was one 90-day mortality from a nosocomial pneumonia (non-COVID-related) and no further deaths at 12 months. There were mean improvements of 10.07% in forced expiratory volume in 1 second and 4.74% in diffusing capacity of the lung for carbon monoxide, along with a mean decrease 49.2% in residual volume (<i>P</i> < .001 for all). The modified Medical Research Council dyspnea scale was improved by 1.84 points (<i>P</i> < .001). LVRS can be performed safely in patients who are not candidates for BLVR and those who fail BLVR and leads to significant functional improvement. Long-term follow-up is necessary to ensure the sustainability of LVRS benefits in this patient population. | Magarinos Jessica; Egelko Aron; Criner Gerard J; Abbas Abbas; Enofe Nosayaba; Thomas JiJi; Carney Kevin; Friedberg Joseph; Bakhos Charles | 2024-01-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | JTCVS open | 38690413 | Human immunodeficiency virus infection is associated with greater risk of pneumonia and readmission after cardiac surgery. | Human immunodeficiency virus infection (HIV+) is associated with a 2-fold increased risk of cardiovascular disease. Increasingly, patients who are HIV + are being evaluated to undergo cardiac surgery. Current risk-adjusted scoring systems, including the Society of Thoracic Surgeons Predicted Risk of Mortality score, fail to stratify HIV + risk. Unfortunately, there exists a paucity of cardiac surgery outcomes data in modern patients who are HIV+. We conducted a retrospective review of PearlDiver, an all-payer claims administrative database. In total, 14,714,743 patients were captured between 2010 and 2020. Of these, 59,695 (0.4%) of patients had a history of HIV+, and 1759 (2.95%) of these patients underwent cardiac surgery. Patients who were HIV+ were younger, more often male, and had greater comorbidity, history of hypertension, chronic obstructive pulmonary disease, chronic liver disease, chronic kidney disease, chronic lung disease, and heart failure. Postoperatively, patients who were HIV + had significantly greater rates of pneumonia (relative risk, 1.70; <i>P</i> = .0003) and 30-day all-cause readmission (relative risk, 1.28, <i>P</i> < .0001). After linear regression analysis, these results remained significant. Data also show that a lesser proportion of patients with HIV + underwent coronary artery bypass grafting, aortic valve replacement, and any cardiac surgery compared with controls. Patients who are HIV + undergoing cardiac surgery are at greater risk of pneumonia and readmission. Moreover, we discovered lower rates of cardiac surgery in patients who are HIV+, which may reflect limited access to surgery when indicated. Today's risk-adjusted scoring systems in cardiac surgery need to better account for the modern patient who is HIV+. | Zadeh Ali Vaeli; Justicz Alexander; Plate Juan; Cortelli Michael; Wang I-Wen; Melvan John Nicholas | 2024-01-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | JTCVS open | 38690409 | Tracheostomy is associated with decreased vasoactive-inotropic score in postoperative cardiac surgery patients on prolonged mechanical ventilation. | We sought to quantify the influence that tracheostomy placement has on the hemodynamic stability of postoperative cardiac surgery patients with persistent ventilatory requirements. A retrospective, single-center, and observational analysis of postoperative cardiac surgery patients with prolonged mechanical ventilation who underwent tracheostomy placement from 2018 to 2022 was conducted. Patients were excluded if receiving mechanical circulatory support or if they had an unrelated significant complication 3 days surrounding tracheostomy placement. Vasoactive and inotropic requirements were quantified using the Vasoactive-Inotrope Score. Sixty-one patients were identified, of whom 58 met inclusion criteria. The median vasoactive-inotrope score over the 3 days before tracheostomy compared with 3 days after decreased from 3.35 days (interquartile range, 0-8.79) to 0 days (interquartile range, 0-7.79 days) (<i>P</i> = .027). Graphic representation of this trend demonstrates a clear inflection point at the time of tracheostomy. Also, after tracheostomy placement, fewer patients were on vasoactive/inotropic infusions (67.2% [n = 39] pre vs 24.1% [n = 14] post; <i>P</i> < .001) and sedative infusions (62.1% [n = 36] pre vs 27.6% [n = 16] post; <i>P</i> < .001). The percent of patients on active mechanical ventilation did not differ. The median vasoactive-inotrope score in cardiac surgery patients with prolonged mechanical ventilation was significantly reduced after tracheostomy placement. There was also a significant reduction in the number of patients on vasoactive/inotropic and sedative infusions 3 days after tracheostomy. These data suggest that tracheostomy has a positive effect on the hemodynamic stability of patients after cardiac surgery and should be considered to facilitate postoperative recovery. | O'Shea Thomas F; Franko Lynze R; Paneitz Dane C; Shelton Kenneth T; Osho Asishana A; Auchincloss Hugh G | 2024-01-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | JTCVS open | 38690408 | An angiotensin system inhibitor (losartan) potentiates antitumor efficacy of cisplatin in a murine model of non-small cell lung cancer. | Previous studies have demonstrated synergistic antitumor effects of angiotensin system inhibition (ASI) combined with cisplatin therapy in pancreatic cancer. This study examines whether or not synergistic antitumor effects occur with combination ASI and cisplatin treatment in lung cancer, and whether or not ASI-induced changes in epithelial-mesenchymal transition play a role in the mechanism of this antitumor phenomenon. A set of lung cancer cell lines representing a spectrum of epithelial to mesenchymal phenotypes were identified and characterized. Response of epithelial-mesenchymal transition markers to losartan was characterized. Cell culture models of lung cancer were next treated with losartan, cisplatin, or combination of both. Markers of epithelial-mesenchymal transition or surrogates of other signaling pathways (AKT, Stat3, and programmed death-ligand), and cell viability were quantified. Findings were confirmed in both allogenic and syngeneic in vivo murine flank tumor models. Losartan treatment significantly increased E-cadherin and reduced vimentin in human lung cancer cell lines. Combination treatment with losartan and cisplatin enhanced epithelial markers, reduced mesenchymal markers, inhibited promesenchymal signaling mediators, and reduced cell viability. Findings were confirmed in vivo in a murine flank tumor model with transition from mesenchymal to epithelial phenotype and reduced tumor size following combination losartan and cisplatin treatment. Combination losartan and cisplatin treatment attenuates the epithelial-mesenchymal transition pathway and enhances the cytotoxic effect of chemotherapy with in vitro and in vivo models of non-small cell lung cancer. This study suggests an important role for ASI therapy in the treatment of lung cancer. | Tang Hexiao; Abston Eric; Sojoodi Mozhdeh; Wang Yongtao; Erstad Derek J; Lin Zenan; Fuchs Bryan C; Tanabe Kenneth K; Lanuti Michael | 2024-01-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Frontiers in microbiology | 38690371 | The airway microbiome of persons with cystic fibrosis correlates with acquisition and microbiological outcomes of incident Stenotrophomonas maltophilia infection. | Chronic infection with <i>Stenotrophomonas maltophilia</i> in persons with cystic fibrosis (pwCF) has been linked to an increased risk of pulmonary exacerbations and lung function decline. We sought to establish whether baseline sputum microbiome associates with risk of <i>S. maltophilia</i> incident infection and persistence in pwCF. pwCF experiencing incident <i>S. maltophilia</i> infections attending the Calgary Adult CF Clinic from 2010-2018 were compared with <i>S. maltophilia</i>-negative sex, age (+/-2 years), and birth-cohort-matched controls. Infection outcomes were classified as persistent (when the pathogen was recovered in ≥50% of cultures in the subsequent year) or transient. We assessed microbial communities from prospectively biobanked sputum using V3-V4 16S ribosomal RNA (rRNA) gene sequencing, in the year preceding (Pre) (<i>n</i> = 57), at (At) (<i>n</i> = 22), and after (Post) (<i>n</i> = 31) incident infection. We verified relative abundance data using <i>S. maltophilia</i>-specific qPCR and 16S rRNA-targeted qPCR to assess bioburden. Strains were typed using pulse-field gel electrophoresis. Twenty-five pwCF with incident <i>S. maltophilia</i> (56% female, median 29 years, median FEV<sub>1</sub> 61%) with 33 total episodes were compared with 56 uninfected pwCF controls. Demographics and clinical characteristics were similar between cohorts. Among those with incident <i>S. maltophilia</i> infection, sputum communities did not cluster based on infection timeline (Pre, At, Post). Communities differed between the infection cohort and controls (<i>n</i> = 56) based on Shannon Diversity Index (SDI, <i>p</i> = 0.04) and clustered based on Aitchison distance (PERMANOVA, <i>p</i> = 0.01) prior to infection. At the time of incident <i>S. maltophilia</i> isolation, communities did not differ in SDI but clustered based on Aitchison distance (PERMANOVA, <i>p</i> = 0.03) in those that ultimately developed persistent infection versus those that were transient. <i>S. maltophilia</i> abundance within sputum was increased in samples from patients (Pre) relative to controls, measuring both relative (<i>p</i> = 0.004) and absolute (<i>p</i> = 0.001). Furthermore, <i>S. maltophilia</i> abundance was increased in sputum at incident infection in those who ultimately developed persistent infection relative to those with transient infection, measured relatively (<i>p</i> = 0.04) or absolute (<i>p</i> = 0.04), respectively. Microbial community composition of CF sputum associates with <i>S. maltophilia</i> infection acquisition as well as infection outcome. Our study suggests sputum microbiome may serve as a surrogate for identifying infection risk and persistence risk. | Bowron Lauren A; Acosta Nicole; Thornton Christina S; Carpentero Jennifer; Waddell Barbara-Jean M; Bharadwaj Lalit; Ebbert Kirsten; Castañeda-Mogollón Daniel; Conly John M; Rabin Harvey R; Surette Michael G; Parkins Michael D | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Frontiers in cellular and infection microbiology | 38690325 | Infection with the multidrug-resistant Klebsiella pneumoniae New Delhi metallo-B-lactamase strain in patients with COVID-19: Nec Hercules contra plures? | During the coronavirus disease 2019 (COVID-19) pandemic, in patients treated for SARS-CoV-2 infection, infections with the <i>Klebsiella pneumoniae</i> bacteria producing New Delhi metallo-B-lactamase (NDM) carbapenemase in the USA, Brazil, Mexico, and Italy were observed, especially in intensive care units (ICUs). This study aimed to assess the impact of <i>Klebsiella pneumoniae</i> NDM infection and other bacterial infections on mortality in patients treated in ICUs due to COVID-19. The 160 patients who qualified for the study were hospitalized in ICUs due to COVID-19. Three groups were distinguished: patients with COVID-19 infection only (N = 72), patients with COVID-19 infection and infection caused by <i>Klebsiella pneumoniae</i> NDM (N = 30), and patients with COVID-19 infection and infection of bacterial etiology other than <i>Klebsiella pneumoniae</i> NDM (N = 58). Mortality in the groups and chosen demographic data; biochemical parameters analyzed on days 1, 3, 5, and 7; comorbidities; and ICU scores were analyzed. Bacterial infection, including with <i>Klebsiella pneumoniae</i> NDM type, did not elevate mortality rates. In the group of patients who survived the acute phase of COVID-19 the prolonged survival time was demonstrated: the median overall survival time was 13 days in the NDM bacterial infection group, 14 days in the other bacterial infection group, and 7 days in the COVID-19 only group. Comparing the COVID-19 with NDM infection and COVID-19 only groups, the adjusted model estimated a statistically significant hazard ratio of 0.28 (p = 0.002). Multivariate analysis revealed that age, APACHE II score, and CRP were predictors of mortality in all the patient groups. In patients treated for SARS-CoV-2 infection acquiring a bacterial infection due to prolonged hospitalization associated with the treatment of COVID-19 did not elevate mortality rates. The data suggests that in severe COVID-19 patients who survived beyond the first week of hospitalization, bacterial infections, particularly Klebsiella pneumoniae NDM, do not significantly impact mortality. Multivariate analysis revealed that age, APACHE II score, and CRP were predictors of mortality in all the patient groups. | Janc Jarosław; Słabisz Natalia; Woźniak Anna; Łysenko Lidia; Chabowski Mariusz; Leśnik Patrycja | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Data in brief | 38690314 | Digital skills among youth: A dataset from a three-wave longitudinal survey in six European countries. | This dataset provides longitudinal survey data from a European project, ySKILLS, which was focused on the role of digital skills in youths' development. It contains data from 10,821 participants from Grades 6-10 (in Wave 1) in Estonia, Finland, Germany, Italy, Poland, and Portugal. The data was collected between Spring 2021 and Spring 2023, the participants were recruited through schools, where the data collection also took place, except for online data collections due to restrictions caused by COVID-19. The dataset is novel in its multidimensional approach to the construct of digital literacy. It provides insight into the development of digital skills in youth and the role of digital skills and internet usage in youths' positive and negative online experiences and wellbeing. It also contains data that allows for the analysis of the role of digital skills in class networks. The data are beneficial for researchers interested in the examination of youths' online skills, internet usage, online experiences, and wellbeing from a longitudinal perspective. | Machackova Hana; Jaron Bedrosova Marie; Muzik Michal; Zlamal Rostislav; Fikrlova Jana; Literova Anna; Dufkova Eliska; Smahel David; Boomgaarden Hajo; Song Hyunjin; Tolochko Petro; d'Haenens Leen; Joris Willem; Kalmus Veronika; Tikerperi Mari-Liis; Opermann Signe; Napp Marit; Soidla Indrek; Uibos Andre; Soo Kadri; Salmela-Aro Katariina; Järvinen Jussi; Mannerström Rasmus; Suvila Erkki; Waechter Natalia; Brando Christin; Kadera Stepanka; Mascheroni Giovanna; Cino Davide; Lombi Linda; van Deursen Alexander; van Laar Ester; Pyżalski Jacek; Walter Natalia; Iwanicka Agnieszka; Ponte Cristina; Batista Susana; Baptista Rita; Schneider Luc; Helsper Ellen Johanna | 2024-01-06 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Frontiers in immunology | 38690286 | The effects of IL-27 and IL-35 gene variation and expression levels on the susceptibility and clinical manifestations of pulmonary tuberculosis. | Inflammatory cytokines have crucial roles in the pathogenesis of tuberculosis (TB), and interleukin (IL)-27 and IL-35 have a pro-inflammatory and anti-inflammatory effect on many diseases, including infectious diseases. Therefore, we evaluated the relationship between <i>IL-27</i> and <i>IL-35</i> gene polymorphism, expression levels, and pulmonary TB (PTB) susceptibility. Nine single-nucleotide polymorphisms (SNPs) in the <i>IL-27</i> gene (rs181206, rs153109, and rs17855750) and the <i>IL-35</i> gene (rs4740, rs428253, rs9807813, rs2243123, rs2243135, and rs568408) were genotyped by the SNPscan technique in 497 patients with PTB and 501 controls. There was no significant difference regarding the genotype and allele frequencies of the above SNPs in the <i>IL-27</i> and <i>IL-35</i> genes between patients with PTB and controls. Haplotype analysis showed that the frequency of the GAC haplotype in the <i>IL-35</i> gene was significantly decreased in patients with PTB when compared to controls (<i>p =</i> 0.036). Stratified analysis suggested that the frequency of the <i>IL-27</i> rs17855750 GG genotype was significantly increased in patients with PTB with fever. Moreover, the lower frequency of the <i>IL-35</i> rs568408 GA genotype was associated with drug-induced liver injury in patients with PTB. The <i>IL-35</i> rs428253 GC genotype, as well as the rs4740 AA genotype and A allele, showed significant relationships with hypoproteinemia in patients with PTB. When compared with controls, the IL-27 level was significantly increased in patients with PTB. Taken together, <i>IL-35</i> gene variation might contribute to a protective role on the susceptibility to PTB, and <i>IL-27</i> and <i>IL-35</i> gene polymorphisms were associated with several clinical manifestations of patients with PTB. | Gao Lei; Xiong Yan-Jun; Liang Ya-Xue; Huang Peng-Fei; Liu Shuang; Xiao Yu; Huang Qian; Wang Hua; Wu Hui-Mei | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Frontiers in immunology | 38690277 | Single cell transcriptomic analyses reveal diverse and dynamic changes of distinct populations of lung interstitial macrophages in hypoxia-induced pulmonary hypertension. | Hypoxia is a common pathological driver contributing to various forms of pulmonary vascular diseases leading to pulmonary hypertension (PH). Pulmonary interstitial macrophages (IMs) play pivotal roles in immune and vascular dysfunction, leading to inflammation, abnormal remodeling, and fibrosis in PH. However, IMs' response to hypoxia and their role in PH progression remain largely unknown. We utilized a murine model of hypoxia-induced PH to investigate the repertoire and functional profiles of IMs in response to acute and prolonged hypoxia, aiming to elucidate their contributions to PH development. We conducted single-cell transcriptomic analyses to characterize the repertoire and functional profiles of murine pulmonary IMs following exposure to hypobaric hypoxia for varying durations (0, 1, 3, 7, and 21 days). Hallmark pathways from the mouse Molecular Signatures Database were utilized to characterize the molecular function of the IM subpopulation in response to hypoxia. Our analysis revealed an early acute inflammatory phase during acute hypoxia exposure (Days 1-3), which was resolved by Day 7, followed by a pro-remodeling phase during prolonged hypoxia (Days 7-21). These phases were marked by distinct subpopulations of IMs: MHCII<sup>hi</sup>CCR2<sup>+</sup>EAR2<sup>+</sup> cells characterized the acute inflammatory phase, while TLF<sup>+</sup>VCAM1<sup>hi</sup> cells dominated the pro-remodeling phase. The acute inflammatory phase exhibited enrichment in interferon-gamma, IL-2, and IL-6 pathways, while the pro-remodeling phase showed dysregulated chemokine production, hemoglobin clearance, and tissue repair profiles, along with activation of distinct complement pathways. Our findings demonstrate the existence of distinct populations of pulmonary interstitial macrophages corresponding to acute and prolonged hypoxia exposure, pivotal in regulating the inflammatory and remodeling phases of PH pathogenesis. This understanding offers potential avenues for targeted interventions, tailored to specific populations and distinct phases of the disease. Moreover, further identification of triggers for pro-remodeling IMs holds promise in unveiling novel therapeutic strategies for pulmonary hypertension. | Kumar Sushil; Mickael Claudia; Kumar Rahul; Prasad Ram Raj; Campbell Nzali V; Zhang Hui; Li Min; McKeon B Alexandre; Allen Thaddeus E; Graham Brian B; Yu Yen-Rei A; Stenmark Kurt R | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Frontiers in immunology | 38690274 | Clinical and immunological comparison of COVID-19 disease between critical and non-critical courses: a systematic review and meta-analysis. | Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which appeared in 2019, has been classified as critical and non-critical according to clinical signs and symptoms. Critical patients require mechanical ventilation and intensive care unit (ICU) admission, whereas non-critical patients require neither mechanical ventilation nor ICU admission. Several factors have been recently identified as effective factors, including blood cell count, enzymes, blood markers, and underlying diseases. By comparing blood markers, comorbidities, co-infections, and their relationship with mortality, we sought to determine differences between critical and non-critical groups. We used Scopus, PubMed, and Web of Science databases for our systematic search. Inclusion criteria include any report describing the clinical course of COVID-19 patients and showing the association of the COVID-19 clinical courses with blood cells, blood markers, and bacterial co-infection changes. Twenty-one publications were eligible for full-text examination between 2019 to 2021. The standard difference in WBC, lymphocyte, and platelet between the two clinical groups was 0.538, -0.670, and -0.421, respectively. Also, the standard difference between the two clinical groups of CRP, ALT, and AST was 0.482, 0.402, and 0.463, respectively. The odds ratios for hypertension and diabetes were significantly different between the two groups. The prevalence of co-infection also in the critical group is higher. In conclusion, our data suggest that critical patients suffer from a suppressed immune system, and the inflammation level, the risk of organ damage, and co-infections are significantly high in the critical group and suggests the use of bacteriostatic instead of bactericides to treat co-infections. | Hedayati-Ch Mojtaba; Ebrahim-Saraie Hadi Sedigh; Bakhshi Arash | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Frontiers in immunology | 38690272 | Trivalent mRNA vaccine-candidate against seasonal flu with cross-specific humoral immune response. | Seasonal influenza remains a serious global health problem, leading to high mortality rates among the elderly and individuals with comorbidities. Vaccination is generally accepted as the most effective strategy for influenza prevention. While current influenza vaccines are effective, they still have limitations, including narrow specificity for certain serological variants, which may result in a mismatch between vaccine antigens and circulating strains. Additionally, the rapid variability of the virus poses challenges in providing extended protection beyond a single season. Therefore, mRNA technology is particularly promising for influenza prevention, as it enables the rapid development of multivalent vaccines and allows for quick updates of their antigenic composition. mRNA vaccines have already proven successful in preventing COVID-19 by eliciting rapid cellular and humoral immune responses. In this study, we present the development of a trivalent mRNA vaccine candidate, evaluate its immunogenicity using the hemagglutination inhibition assay, ELISA, and assess its efficacy in animals. We demonstrate the higher immunogenicity of the mRNA vaccine candidate compared to the inactivated split influenza vaccine and its enhanced ability to generate a cross-specific humoral immune response. These findings highlight the potential mRNA technology in overcoming current limitations of influenza vaccines and hold promise for ensuring greater efficacy in preventing seasonal influenza outbreaks. | Mazunina Elena P; Gushchin Vladimir A; Kleymenov Denis A; Siniavin Andrei E; Burtseva Elena I; Shmarov Maksim M; Mukasheva Evgenya A; Bykonia Evgeniia N; Kozlova Sofia R; Evgrafova Elina A; Zolotar Anastasia N; Shidlovskaya Elena V; Kirillova Elena S; Krepkaia Anastasiya S; Usachev Evgeny V; Kuznetsova Nadezhda A; Ivanov Igor A; Dmitriev Sergey E; Ivanov Roman A; Logunov Denis Y; Gintsburg Alexander L | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Frontiers in immunology | 38690262 | Critical role of G3BP1 in bovine parainfluenza virus type 3 (BPIV3)-inhibition of stress granules formation and viral replication. | It remains unclear whether BPIV3 infection leads to stress granules formation and whether G3BP1 plays a role in this process and in viral replication. This study aims to clarify the association between BPIV3 and stress granules, explore the effect of G3BP1 on BPIV3 replication, and provide significant insights into the mechanisms by which BPIV3 evades the host's antiviral immunity to support its own survival. Here, we use Immunofluorescence staining to observe the effect of BPIV3 infection on the assembly of stress granules. Meanwhile, the expression changes of eIF2α and G3BP1 were determined. Overexpression or siRNA silencing of intracellular G3BP1 levels was examined for its regulatory control of BPIV3 replication. We identify that the BPIV3 infection elicited phosphorylation of the eIF2α protein. However, it did not induce the assembly of stress granules; rather, it inhibited the formation of stress granules and downregulated the expression of G3BP1. G3BP1 overexpression facilitated the formation of stress granules within cells and hindered viral replication, while G3BP1 knockdown enhanced BPIV3 expression. This study suggest that G3BP1 plays a crucial role in BPIV3 suppressing stress granule formation and viral replication. | Liu Nian; Yang Wei; Luo Lingzhi; Ma Mingshuang; Cui Jin; Dong Xiumei; Li Yijing | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Frontiers in immunology | 38690261 | Tumor-derived extracellular vesicles regulate macrophage polarization: role and therapeutic perspectives. | Extracellular vesicles (EVs) are important cell-to-cell communication mediators. This paper focuses on the regulatory role of tumor-derived EVs on macrophages. It aims to investigate the causes of tumor progression and therapeutic directions. Tumor-derived EVs can cause macrophages to shift to M1 or M2 phenotypes. This indicates they can alter the M1/M2 cell ratio and have pro-tumor and anti-inflammatory effects. This paper discusses several key points: first, the factors that stimulate macrophage polarization and the cytokines released as a result; second, an overview of EVs and the methods used to isolate them; third, how EVs from various cancer cell sources, such as hepatocellular carcinoma, colorectal carcinoma, lung carcinoma, breast carcinoma, and glioblastoma cell sources carcinoma, promote tumor development by inducing M2 polarization in macrophages; and fourth, how EVs from breast carcinoma, pancreatic carcinoma, lungs carcinoma, and glioblastoma cell sources carcinoma also contribute to tumor development by promoting M2 polarization in macrophages. Modified or sourced EVs from breast, pancreatic, and colorectal cancer can repolarize M2 to M1 macrophages. This exhibits anti-tumor activities and offers novel approaches for tumor treatment. Therefore, we discovered that macrophage polarization to either M1 or M2 phenotypes can regulate tumor development. This is based on the description of altering macrophage phenotypes by vesicle contents. | Wang Lijuan; Wang Weihua; Hu Die; Liang Yan; Liu Zhanyu; Zhong Tianyu; Wang Xiaoling | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | National journal of maxillofacial surgery | 38690255 | Guidelines for dental implants in the times of COVID-19. | Since the first reported case in December 2019, COVID-19 has become a worldwide pandemic. Although primarily a zoonotic infection, human-to-human transmission is well reported now and the mode of spread is mainly via respiratory droplets during direct contact or via surfaces contaminated with the virus as it remains viable on the surfaces for a long time. Direct communication and consistent exposure to body fluids such as blood and saliva and the fact that routinely done dental procedures generate aerosols predisposing dental professionals to serious risk for COVID-19 infection. Hence, to ensure the smooth working and safety of dental professionals as well as the patients, a set of directives are of paramount importance. Various guidelines have been released for the efficient operation of dental professionals; however, no such recommendations/directives have been laid out pertaining to dental implants in particular. Here, we are presenting a set of recommendations for managing urgent implant-related treatment procedures. | Solanki Neeti; Yadav Lakshya Kumar; Singh Mayank; Chand Pooran | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | National journal of maxillofacial surgery | 38690254 | Evaluation of the non-endoscopic and endoscopic-assisted platysma flap - A randomized control trial. | As oral submucous fibrosis (OSMF) is a chronic progressive disorder, the treatment is based on the severity of the disease. Surgical treatment is the only choice for grade III and grade IV OSMF cases because the patient can neither clean his/her mouth nor properly chew. The resulting soft tissue defect requires resurfacing with various well-vascularized tissues such as extraoral flaps, intraoral flaps, microvascular flaps, and allografts that have been used. Reconstruction of the resultant defects proved to be challenging. Till date, none of the flaps has been proven to be effective and is universally accepted for the treatment of OSMF because of various drawbacks of the available techniques. This study was conducted to know whether an endoscopic-assisted platysma flap is associated with better outcomes in terms of ease of operation and postoperative function than the conventional approach. This study included 40 patients of grade III and grade IV OSMF reporting to the outpatient department of oral and maxillofacial surgery in a tertiary center of North India. These patients were divided randomly into two groups. Group I and Group II had 20 patients each, undergoing endoscopic-assisted platysma flap and non-endoscopic-assisted platysma flap for reconstruction after resection of OSMF bands, respectively. Data were analyzed for the mouth opening, operating time, flap viability, congestion of neck and oral cavity, signs of inflammation, neurologic assessment, and measurement of the drain. The results showed significant increase in mouth opening from the preoperative value to the values immediately after surgery and at 24 h, 1 week, 15 days, 1 month, 3 months, and 6 months after surgery in both the study groups. Reduced bleeding incidence was found in group I compared to group II, with better postoperative outcomes noted during follow-up. But the mean intraoperative time of the subjects in group I was 130.80 ± 5.5.908 min and in group II was 105.74 ± 2. 491 min. Increased time taken in group I may be due to the long learning curve. The present study concluded that the Endoscope-assisted technique has a key role during supra and subplatysmal dissection to allow for better accessibility, handling, and visibility of the flap and its orientation in relation to the underlying structures to avoid postoperative complications and to overcome the drawback of platysma myocutaneous flap in reconstruction of OSMF defects. | Kumar Sandeep; Pal Uma Shanker; Mohammad Shadab; Singh Vibha; Kumar Vijay; Agrawal Amiya; Singh Aastha | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | National journal of maxillofacial surgery | 38690250 | Comparative efficacy of pre-operative and post-operative administration of amoxicillin in third molar extraction surgery - A systematic review and meta-analysis. | To compare the effectiveness of pre-operative and post-operative administration of amoxicillin in patients undergoing third molar extraction surgery. A systematic search was executed according to PRISMA guidelines for studies published till December 2021. Studies were included based on the pre-eligibility criteria. The risk of bias was assessed using the Cochrane risk of bias tool. The heterogeneity was evaluated, and a random effect model was used for meta-analysis. A total of five studies were included from an initial search of 96 studies. The included studies were randomized controlled trials and comparative studies assessing pre-operative and post-operative administration of antibiotics among patients undergoing third molar extraction surgery. For comparison between pre-operative and post-operative groups, interincisal distance, complications, pain, and swelling were systematically reviewed and meta-analysis was done for interincisal distance and complications. The mean change in interincisal distance ranged from 5.5 to 47.9 and from 4.56 to 46.1 in the pre-operative and post-operative amoxicillin groups, respectively. Complications reported were infections, alveolar osteitis, nausea, diarrhea, gastric pain, rash, and headache with a pooled incidence of 4.3-33% in the pre-operative amoxicillin group and 0-22.7% in the post-operative amoxicillin group. Quantitative synthesis of data carried out from meta-analysis shows a significant difference in the pre-operative and post-operative amoxicillin groups in improving the interincisal distance and incidence of complications post surgery. The qualitative synthesis of data derived from systematic review for pain provides favoring results for post-operative amoxicillin administration. In case of swelling, a non-conclusive result was obtained. | Karemore Tapasya V; Ashtankar Kanchan A; Motwani Mukta | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | National journal of maxillofacial surgery | 38690248 | Interim management of Pierre Robin sequence using a custom-made face mask. | Pierre Robin sequence poses a great challenge for anesthesiologists during laryngoscopy and intubation, making oxygenation and ventilation difficult. The role of early surgical intervention is recommended for the improvement of the airway and overall survival of the neonate. The situation becomes even more challenging, when the neonate may not be fit for such surgical interventions. The present case posed such a challenge to the team. To the authors' knowledge, the decision to use a face mask as an interim life-saving measure was considered for the first time. This provided a greater window of opportunity for further course of action, only to be later managed by distraction osteogenesis of the mandible. The unconventional use of orthopedic appliances for the management of threatened airways may provide the clinician with time, where further management may be carried out. The present article will explain such a procedure that was carried out as a life-saving measure. | Kulkarni Vishal; Senthil Kumar C; Rath Mukti K; Singh Madhu | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | National journal of maxillofacial surgery | 38690244 | A clinic-pathological research explored the significance of ascorbic acid and iron levels in serum and saliva in premalignant disorder patients at Kanpur, Uttar Pradesh. | Oral submucous fibrosis (OSMF), or OSMF, is a well-known, potentially premalignant condition of the oral cavity. Monitoring OSMF widespread effects necessitate interventions in at-risk individuals, ideally before the disease becomes aggressive. Ascorbic acid and iron, for instance, are significant micronutrients in the pathogenesis of OSMF. This study aimed to investigate the significance of ascorbic acid and iron levels in serum and saliva in patients with premalignant disorder (OSMF) and to correlate variations in ascorbic acid and iron levels with histopathological grading. The present study was conducted on 195 patients over a period of 10 months. These patients were divided into two groups, Group I (<i>n</i> = 88, Control), Group II (<i>n</i> = 107, clinically diagnosed and histopathologically confirmed cases of OSMF). Serum and salivary ascorbic acid were analyzed by the dintrophenyl hydrazine method, whereas serum and salivary iron were analyzed by the dipyridyl method. Paired <i>t</i>-test and Fisher test were used to compare between the mean and to find the level of significance <i>P</i> value. The serum and salivary ascorbic acid levels consistently decreased with the progression of histopathological grading of OSMF. Serum and salivary iron levels were also decreased in OSMF patients, and it came as significant. Excess collagen synthesis during OSMF may have been promoted with ascorbic acid and iron. As a reason, serum and salivary monitoring may be significant in detecting and diagnosing OSMF early on. | Sachdev Rohan; Garg Kriti; Mehrotra Vishal; Shwetam Samiksha; Singh Praveen; Srivastava Akash | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | National journal of maxillofacial surgery | 38690241 | Fabrication of orbital prosthesis by two different methods in patients with post-COVID-19 rhino-orbital maxillary mucormycosis: A case series. | Neoplasms, congenital disorders, fungal infections, and traumatic injuries are the predominant causes of orbital defects. Various retentive mechanisms such as application of adhesive, utilization of mechanical undercuts, and implant-supported attachments are generally used in the maxillofacial prosthesis. In the orbital region, the result of magnet-retained attachments is favorable compared with other mechanisms. Different advantages of the magnet-retained prosthesis are less manual dexterity needed during insertion or removal and better maintenance of hygiene. The skin-implant interface and thick tissues in the maxillofacial region are the critically important points that should be given importance during the planning and placement of implants. Ideally, implant sites for orbital prosthesis are the lateral, infra-, and supraorbital rims of the orbital region. The following case series describes two different methods to rehabilitate patients with an exenterated eye due to mucormycosis by individually designed implant with magnetic attachment and mechanical undercut-retained orbital prosthesis. | Bhattacharjee Bappaditya; Srivastava Roopal; Bansal Rajesh; Sharma Naresh K | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | National journal of maxillofacial surgery | 38690233 | Assessment of neurovascular channels in lateral maxillary sinus wall using cone-beam computed tomography: An imperative clinicians guide for implant placements. | The aim of this study is to evaluate the location and radio morphometric features of the posterior superior alveolar artery (PSAA) in patients undergoing rehabilitation of posterior maxilla and other sinus augmentation surgical procedures by cone-beam computed tomography (CBCT). A total of 816 CBCT scans were included. Various radio morphometric measurements were done to assess the PSAA location, diameter, and distances to the sinus floor and alveolar crest. The PSAA was mostly intraosseous in the maximum in the age group 31-51 years (56%), in males (53.4%), and in dentate patients (57.4%). The artery tends to be wider in older patients. Distances to the sinus floor or the alveolar crest tend to be shorter in women. This study suggests that CBCT is a valuable pre-surgical tool and the evaluation of the PSAA on CBCT images could reduce the likelihood of excess bleeding during surgery in the maxillary posterior region. | Rai Shalu; Misra Deepankar; Misra Akansha; Jain Ankit; Dabas Priyanka; Ali Qaiser; Kumar Manish | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Frontiers in psychiatry | 38690205 | Stalking, harassment, gendered abuse, and violence towards politicians in the COVID-19 pandemic and recovery era. | High levels of harassment and threats against parliamentarians are being reported internationally, especially in the social media space. This is occurring alongside changes in our social landscape, with increasing political polarisation and the ongoing ramifications from the COVID-19 pandemic. Harassment of politicians has been shown to have implications for psychological wellbeing and physical safety. To investigate harassment and violence towards parliamentarians in the COVID-19 pandemic and recovery era, including whether there had been a change in its nature and quantity, and to explore the contribution of social media. A survey of all New Zealand's parliamentarians was fielded in 2022, focusing on their experiences of harassment analysed quantitatively and with manifest and latent content analysis of free text responses. Data were disaggregated and compared by gender. Secondary analyses were conducted on similar data collected from parliamentarians in 2014 to compare trends over time. We obtained a cleaned achieved survey sample of 54 Members of Parliament (MPs). Harassment was reported by 98% of respondents, ranging from disturbing communication to actual physical violence. The vast majority of MPs endorsed multiple modalities of harassment occurring on multiple occasions. Ninety-six percent of MPs had been harassed over social media, with over half being threatened, including threats of physical violence (40%), sexual violence (14%), threats made towards MP's family members (19%), threats towards staff (12%), and death threats (27%). Almost all forms of harassment had increased significantly since 2014. Most MPs reported experiencing abuse related to the Government response to the COVID-19 pandemic (e.g. lockdowns and vaccine mandates). Many MPs commented that the frequency and intensity of abuse increased markedly during the COVID pandemic and had not subsequently abated. Women were at significantly higher risk of certain types of social media harassment including gendered abuse, sexualised comments, threat of sexual violence, and threats toward their family. Harassment of parliamentarians is an escalating issue. Online threats and misogyny are increasingly apparent. This harassment has significant psychosocial costs for victims, their family and staff, and for democratic processes. | Every-Palmer Susanna; Hansby Oliver; Barry-Walsh Justin | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Frontiers in psychiatry | 38690202 | Machine learning models predict the emergence of depression in Argentinean college students during periods of COVID-19 quarantine. | The COVID-19 pandemic has exacerbated mental health challenges, particularly depression among college students. Detecting at-risk students early is crucial but remains challenging, particularly in developing countries. Utilizing data-driven predictive models presents a viable solution to address this pressing need. 1) To develop and compare machine learning (ML) models for predicting depression in Argentinean students during the pandemic. 2) To assess the performance of classification and regression models using appropriate metrics. 3) To identify key features driving depression prediction. A longitudinal dataset (N = 1492 college students) captured T1 and T2 measurements during the Argentinean COVID-19 quarantine. ML models, including linear logistic regression classifiers/ridge regression (LogReg/RR), random forest classifiers/regressors, and support vector machines/regressors (SVM/SVR), are employed. Assessed features encompass depression and anxiety scores (at T1), mental disorder/suicidal behavior history, quarantine sub-period information, sex, and age. For classification, models' performance on test data is evaluated using Area Under the Precision-Recall Curve (AUPRC), Area Under the Receiver Operating Characteristic curve, Balanced Accuracy, F1 score, and Brier loss. For regression, R-squared (R2), Mean Absolute Error, and Mean Squared Error are assessed. Univariate analyses are conducted to assess the predictive strength of each individual feature with respect to the target variable. The performance of multi- vs univariate models is compared using the mean AUPRC score for classifiers and the R2 score for regressors. The highest performance is achieved by SVM and LogReg (e.g., AUPRC: 0.76, 95% CI: 0.69, 0.81) and SVR and RR models (e.g., R2 for SVR and RR: 0.56, 95% CI: 0.45, 0.64 and 0.45, 0.63, respectively). Univariate models, particularly LogReg and SVM using depression (AUPRC: 0.72, 95% CI: 0.64, 0.79) or anxiety scores (AUPRC: 0.71, 95% CI: 0.64, 0.78) and RR using depression scores (R2: 0.48, 95% CI: 0.39, 0.57) exhibit performance levels close to those of the multivariate models, which include all features. These findings highlight the relevance of pre-existing depression and anxiety conditions in predicting depression during quarantine, underscoring their comorbidity. ML models, particularly SVM/SVR and LogReg/RR, demonstrate potential in the timely detection of at-risk students. However, further studies are needed before clinical implementation. | López Steinmetz Lorena Cecilia; Sison Margarita; Zhumagambetov Rustam; Godoy Juan Carlos; Haufe Stefan | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Frontiers in psychiatry | 38690200 | Becoming a first-time father during the COVID-19 pandemic in France. | The role of fathers in Western societies has undergone significant change over time. However, their psychopathology remains largely misunderstood and difficult to identify. This study aims to explore the lived experiences of first-time fathers during the COVID-19 pandemic. Twenty-seven first-time French fathers were recruited for the study, which involved a narrative interview, the Rorschach projective test, the Edinburgh Postnatal Depression Scale (EPDS), and a semi-structured interview. Narrative interviews revealed several challenges faced by these fathers, including the pressure of paternal responsibility, the need to be actively involved in the prenatal activities and caregiving (haptonomy, skin-to-skin contact), and concerns about the future of their couple and family as a triad. The Rorschach tests showed numerous perinatal responses and difficulties in identifying phallic representations among the fathers. Additionally, the EPDS scores indicated that 15% of fathers showed signs of depression, while 52% exhibited signs of anxiety. This study also examines the impact of the COVID-19 pandemic and its associated health context on creating the initial triad. Lastly, the case of one father is presented to illustrate the need for diagnostic tools to address the psychopathology of fathers, as narrative or semi-structured interviews have often fallen short of addressing this issue. | Jean-Dit-Pannel Romuald; Belot Rose-Angélique; Mellier Denis; Robert Laura; Petersen Célia; Dinet Benoît; Bréhat Cécile; Koliouli Flora | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine | 38690183 | Impact of frailty on long-term survival in patients discharged alive from hospital after an ICU admission with COVID-19. | Though frailty is associated with mortality, its impact on long-term survival after an ICU admission with COVID-19 is unclear. We aimed to investigate the association between frailty and long-term survival in patients after an ICU admission with COVID-19. This registry-based multicentre, retrospective, cohort study included all patients ≥16 years discharged alive from the hospital following an ICU admission with COVID-19 and documented clinical frailty scale (CFS). Data from 118 ICUs between 01/01/2020 through 31/12/2020 in New Zealand and 31/12/2021 in Australia were reported in the Australian and New Zealand Intensive Care Society Adult Patient Database. The patients were categorised as 'not frail' (CFS 1-3), 'mildly frail' (CFS 4-5) and 'moderately-to-severely frail' (CFS 6-8). The primary outcome was survival time up to two years, which we analysed using Cox regression models. We included 4028 patients with COVID-19 in the final analysis. 'Moderately-to-severely frail' patients were older (66.6 [56.3-75.8] vs. 69.9 [60.3-78.1]; p < 0.001) than those without frailty (median [interquartile range] 53.0 [40.1-64.6]), had higher sequential organ failure assessment scores (p < 0.001), and less likely to receive mechanical ventilation (p < 0.001) than patients without frailty or mild frailty. After adjusting for confounders, patients with mild frailty (adjusted hazards ratio: 2.31, 95%-CI: 1.75-3.05) and moderate-to-severe frailty (adjusted hazards ratio: 2.54, 95%-CI: 1.89-3.42) had higher mortality rates than those without frailty. Frailty was independently associated with shorter survival times to two years in patients with severe COVID-19 in ANZ following hospital discharge. Recognising frailty provides individualised patient intervention in those with frailty admitted to ICUs with severe COVID-19. Not applicable. | Subramaniam Ashwin; Ling Ryan Ruiyang; Pilcher David | 2024-01-03 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Frontiers in oncology | 38690167 | Case report: Acquired resistance to crizotinib from a MET Y1230H mutation in a patient with non-small cell lung cancer and KIF5B-MET fusion. | The c-met proto-oncogene (<i>MET</i>) serves as a significant primary oncogenic driver in non-small cell lung cancer (NSCLC) and has the potential to fuse with other genes, such as <i>KIF5B</i>, although it occurs infrequently. Only a limited number of reported cases have examined the clinical efficacy of crizotinib in patients with <i>KIF5B-MET</i> gene fusion, with no known data regarding acquired resistance to crizotinib and its potential mechanisms. In this report, we present the clinical progression of a female patient diagnosed with NSCLC and harboring a <i>KIF5B-MET</i> gene fusion. The patient initially exhibited partial response to first-line crizotinib treatment, albeit for a short duration and with limited efficacy. Subsequent disease progression revealed the emergence of a secondary <i>MET</i> mutation, specifically MET Y1230H, leading to acquired resistance to crizotinib. The reporting of this case is imperative for informing clinical practice, given the uncommon occurrence of NSCLC with <i>MET</i> fusion, displaying responsiveness to MET tyrosine kinase inhibitor therapy, as well as the emergence of the secondary Y1230H alteration as a potential resistance mechanism. | Dong Su-Su; Dong Wen; Tan Ya-Fen; Xiao Qiang; Wang Tian-Li | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Frontiers in oncology | 38690166 | Advancements and trends in exosome research in lung cancer from a bibliometric analysis (2004-2023). | Lung cancer, characterized by its high morbidity and lethality, necessitates thorough research to enhance our understanding of its pathogenesis and discover novel therapeutic approaches. Recent studies increasingly demonstrate that lung cancer cells can modulate the tumor microenvironment, promoting tumor growth, and metastasis through the release of exosomes. Exosomes are small vesicles secreted by cells and contain a variety of bioactive molecules such as proteins, nucleic acids, and metabolites. This paper presents a comprehensive review of exosome research in lung cancer and its progress through bibliometric analysis. Publications related to exosomes in lung cancer patients were systematically searched on the Web of Science Core Collection (WoSCC) database. Bibliometric analysis was performed using VOSviwers, CiteSpace, and the R package "Bibliometrics". Publications were quantitatively analyzed using Microsoft Office Excel 2019. The language of publication was restricted to "English" and the search strategy employed TS=(exosomes or exosomes or exosomes) and TS=(lung cancer). The search period commenced on January 1, 2004, and concluded on November 12, 2023, at noon. The selected literature types included Articles and Reviews. The study encompassed 1699 papers from 521 journals across 71 countries and 2105 institutions. Analysis revealed a consistent upward trend in lung cancer exosome research over the years, with a notable surge in recent times. This surge indicates a growing interest and depth of inquiry into lung cancer exosomes. Major research institutions in China and the United States, including Nanjing Medical University, Shanghai Jiao Tong University, Chinese Academy Of Sciences, and Utmd Anderson Cancer Center, emerged as crucial research hubs. The annual publication count in this field witnessed a continuous rise, particularly in recent years. Key terms such as lung cancer, non-small cell lung cancer (NSCLC), microvesicles, intercellular communication, exosomal miRNAs, and oncology dominated the research landscape. Fields like cell biology, biochemistry, biotechnology, and oncology exhibited close relation with this research. Clotilde Théry emerged as the most cited author in the field, underlining her significant contributions. These results demonstrate the broad impact of exosome research in lung cancer, with key terms covering not only disease-specific aspects such as lung cancer and NSCLC but also basic biological concepts like microvesicles and intercellular communication. Explorations into exosomal microRNAs and oncology have opened new avenues for lung cancer exosome research. In summary, lung cancer exosome research is poised to continue receiving attention, potentially leading to breakthroughs in treatment and prevention. Publications on lung cancer exosomes show a rising trend year by year, with China and the United States ranking first and second in terms of the number of publications. However, there is insufficient academic learning cooperation and exchanges between the two sides, and Chinese universities account for a large proportion of research institutions in this field. Jing Li is the most productive author, Clotilde Théry is the most co-cited author, and Cancers is the journal with the highest number of publications. The current focus in the field of lung cancer exosomes is on biomarkers, liquid biopsies, immunotherapy, and tumor microenvironment. | Zhong Wen; Zhao Xiaofei; Zhang Xiabiao; Xu Yiwen; Liu Mengqian; Yang Xiaoyun; Jiang Yi; Shen Xiaozhu | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Journal of multidisciplinary healthcare | 38690156 | The Impact of the COVID-19 Pandemic on Orthodontic Adult Patients' Characteristics and Decision on Orthodontic Appliance. | There is an overall paucity of data examining the specific details of orthodontic patients' patterns or orthodontic service disruptions possibly influenced by COVID-19 pandemic. Therefore, this study aimed to explore the impact of the COVID-19 pandemic on orthodontic clinic disruption regarding the change in adult patients' characteristics and decisions of orthodontic treatment devices. A retrospective sample of 311 patients receiving orthodontic treatment from 2018 to 2022 were collected and divided into two groups: before (n = 167) and during (n = 144) the COVID-19 pandemic. Demographics, dental indices, the index of complexity outcome and need (ICON), and the degree of treatment difficulty were analyzed. There were fewer students among patients during the COVID-19 pandemic than before (24.5% versus 35.9%, P = 0.036). Compared with patients before the pandemic, more patients selected ceramic brackets or Invisalign during the pandemic (P = 0.022). There were higher percentage of class I dental malocclusions among patients during than before the COVID-19 pandemic (P = 0.044). Moreover, the ICON score and the score of the degree of treatment difficulty were both significantly lower for patients during than before the COVID-19 pandemic (63.9±14.0 versus 58.3±15.3, P=0.001 and 7.4±2.6 versus 6.8±2.6, P=0.049, respectively). The COVID-19 pandemic influenced the characteristics and decisions of orthodontic patients. Those who still came to the orthodontic clinic despite the COVID-19 outbreak may have been those with less malocclusion severity and treatment difficulty. Besides, during the time of covid-19 pandemic, more patients chose ceramic bracket and Invisalign as their orthodontic treatment device rather than conventional or self-ligating metal brackets. | Kuo Yun-Yu; Fang Jason Chen-Chieh; Wang I-Kuan; Huang Chiung-Shing; Chen Hui-Ling; Yen Tzung-Hai | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Global health & medicine | 38690136 | Crisis management for the future: Building a platform to provide information on emerging and re-emerging infectious diseases from normal times in Japan. | At the beginning of the mpox (disease caused by monkey pox) epidemic, there was no platform in Japan to provide appropriate information on emerging and re-emerging infectious diseases (EIDs), and the number of accesses to bioterrorism-related information sites increased rapidly. Even though the interest in mpox was much smaller than in coronavirus infectious disease, emerged in late 2019 (COVID-19), the increase in the number of views were much greater than during the COVID-19 epidemic. This may not be because mpox is bioterrorism-related as an analog of smallpox, but rather because there were no other websites providing information on mpox. For future crisis management, there should be a platform to provide information on possible epidemics of EIDs from normal times in Japan. | Adachi Eisuke; Otani Amato; Yotsuyanagi Hiroshi; Saijo Masayuki; Saito Tomoya | 2024-30-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Global health & medicine | 38690133 | Proposal to apply a "Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment (PERMA)" based approach to manage the COVID-19-related mental health problems in the era of long COVID. | Long COVID (LC)-related health problems are highly concerned. Many patients seem to have "recovered" from an acute SARS-CoV-2 infection, however, they might experience various symptoms, almost involving all organs and systems. Of those, neuropsychiatric symptoms like depression, anxiety, and post-traumatic stress disorder (PTSD) are not rare. These problems significantly impact the quality of life (QOL) of patients, family, and caregivers, even lead a tragic suicide outcome. Other than the conventional psychological and medical approaches, here, we proposal a positive emotion, engagement, relationships, meaning, and accomplishment (PERMA)-based approach to fight against these COVID-19-related mental health problems (CRMHPs). This approach is characterized by positive psychological interventions and self-achievements, which has been proved to be a powerful tool against mood disorders in common people. Nowadays, abolishment of certain prophylactic measures (such as isolation, lockdown, compulsorily wearing a mask and maintaining social distance, measures to avoid crowding) enables us to have more opportunities to contact patients and implement the PERMA-based approach to the patients with CRMHPs. We believe that application of PERMA-based approach is conducive to alleviate the influence of the CRMHPs and improve their QOL. | Sun Kai; Zhou Rongfeng; Xu Fang; Lu Hongzhou; Asakawa Tetsuya | 2024-30-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Global health & medicine | 38690131 | Developments and current challenges in the process of cell culture-based seasonal influenza vaccine manufacture in Japan. | Seasonal influenza is an acute respiratory infection primarily caused by influenza A and B viruses, which circulate annually and cause substantial morbidity and mortality worldwide. Annual influenza vaccination is currently the most effective measure for preventing influenza and greatly reduces the risk of disease severity and the incidence of complications and death. Annual seasonal influenza vaccines are traditionally produced in Japan and many other countries using viruses propagated in embryonated chicken eggs. However, at present, the effectiveness of the seasonal influenza vaccines has some significant limitations, partly because of egg-adaptive mutations in the antigenic sites of the influenza virus haemagglutinin, which are caused by the continued evolution of seasonal influenza viruses. To overcome the limitations of egg-based influenza vaccine production, a mammalian cell culture-based influenza vaccine production system has been developed in Japan in the past decade as an alternative to the current production method. In this review, I have summarised the progress in the development of cell-based seasonal influenza vaccines and discussed the technological challenges encountered in the development of influenza vaccines. | Hamamoto Itsuki | 2024-30-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | JBMR plus | 38690127 | Collagen mutation and age contribute to differential craniofacial phenotypes in mouse models of osteogenesis imperfecta. | Craniofacial and dentoalveolar abnormalities are present in all types of osteogenesis imperfecta (OI). Mouse models of the disorder are critical to understand these abnormalities and underlying OI pathogenesis. Previous studies on severely affected OI mice report a broad spectrum of craniofacial phenotypes, exhibiting some similarities to the human disorder. The Brtl/+ and G610c/+ are moderately severe and mild-type IV OI, respectively. Little is known about the aging effects on the craniofacial bones of these models and their homology to human OI. This study aimed to analyze the Brtl/+ and G610c/+ craniofacial morphometries during aging to establish suitability for further OI craniofacial bone intervention studies. We performed morphological measurements on the micro-CT-scanned heads of 3-wk-old, 3-mo-old, and 6-mo-old female Brtl/+ and G610c/+ mice. We observed that Brtl/+ skulls are shorter in length than WT (<i>P</i> < .05), whereas G610c/+ skulls are similar in length to their WT counterparts. The Brtl/+ mice exhibit alveolar bone with a porotic-like appearance that is not observed in G610c/+. As they age, Brtl/+ mice show severe bone resorption in both the maxilla and mandible (<i>P</i> < .05). By contrast, G610c/+ mice experience mandibular resorption consistently across all ages, but maxillary resorption is only evident at 6 mo (<i>P</i> < .05). Western blot shows high osteoclastic activities in the Brtl/+ maxilla. Both models exhibit delayed pre-functional eruptions of the third molars (<i>P</i> < .05), which are similar to those observed in some bisphosphonate-treated OI subjects. Our study shows that the Brtl/+ and G610c/+ mice display clear features found in type IV OI patients; both show age-related changes in the craniofacial growth phenotype. Therefore, understanding the craniofacial features of these models and how they age will allow us to select the most accurate mouse model, mouse age, and bone structure for the specific craniofacial bone treatment of differing OI groups. | Sung Hsiao H; Spresser Wyatt J; Hoffmann Joseph P; Dai Zongrui; Van der Kraan Peter M; Caird Michelle S; Davidson Esmeralda Blaney; Kozloff Kenneth M | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Oncology letters | 38690101 | Primary lung adenocarcinoma with breast metastasis harboring the EML4‑ALK fusion: A case report. | Pulmonary adenocarcinoma with breast metastasis is rarely encountered in clinical practice. Therefore, precise clinical diagnosis of patients with this disease is crucial when selecting subsequent treatment modalities and for overall prognosis assessment. The present study reported on a case of lung cancer with breast metastasis harboring the <i>EML4-ALK</i> fusion. The patient was initially diagnosed with triple-negative breast cancer with lung metastasis, but comprehensive breast cancer treatment was ineffective. Reevaluation of the patient's condition via lung biopsy revealed primary lung adenocarcinoma. In addition, the results of genetic testing revealed the <i>EML4-ALK</i> fusion protein in both lung and breast tissues. After treatment with <i>ALK</i> inhibitors, the patient's symptoms improved rapidly. This case highlights the prolonged diagnostic journey from presentation with a breast mass to ultimately being diagnosed with lung cancer with breast metastasis, underscoring the critical need for heightened awareness among clinicians regarding the possibility of rare metastatic patterns. Timely identification of lung cancer with breast metastasis, facilitated by comprehensive genetic testing, not only refines treatment decisions but also emphasizes the importance of interdisciplinary collaboration in navigating complex clinical scenarios. Such insight contributes to the ongoing development of personalized cancer care that guides clinicians toward more effective and tailored therapeutic strategies for patients with similar diagnostic challenges. | Zhang Wenwen; Zhang Yu; Zhou Lei; Tan Na; Bai Yuju; Xing Shiyun | 2024-01-06 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Arthroplasty today | 38690096 | The Impact of the Coronavirus Disease 2019 Pandemic on US Total Knee and Hip Arthroplasty Procedures in 2020. | The coronoavirus disease 2019 (COVID-19) pandemic had profound impact on elective procedures in the United States. We characterized the longer-term decline and recovery of hip and knee arthroplasty procedures following the onset of the COVID-19 pandemic in the United States. We conducted a retrospective analysis of patients undergoing primary and revision total knee and hip arthroplasty (TKA and THA) in the United States between 2014 and 2020 using claims from a large national commercial payer data set contaivning deidentified information from patients with commercial health coverage. We calculated the percentage of cases lost by month using a forecast model to predict TKA and THA volumes in the absence of COVID-19. We then calculated the association between COVID-19 positivity rates and THA/TKA procedures by state and month. There was a large initial decline in procedures, with primary TKA and THA volumes declining by 93.2% and 87.1% in April 2020, respectively, with revisions seeing more modest declines. Cases quickly recovered with volumes exceeding expected levels in summer months. However, cumulative 2020 volumes remained below expected with 9.7% and 7.5% of expected primary TKA and THA cases lost, respectively. Higher state COVID-19 positivity rates were associated with lower primary TKA, THA, and revision knee procedure rates. After the initial decline in March and April, knee and hip arthroplasty cases resumed quickly; however, by the end of 2020, the annual procedure volume had still not recovered fully. The loss in case volume within states was worse in months with higher COVID-19 positivity rates. | Barnes Matthew R; Zagaria Alexandra B; Werth Paul M; Jevsevar David S | 2024-01-06 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Case reports in neurology | 38690082 | Survival from Rhino-Orbital-Cerebral Mucormycosis in SARS-CoV-2-Positive Diabetic Patients: Two Case Reports. | Rhino-orbital-cerebral mucormycosis (ROCM) is a rare angioinvasive fungal infection known to be associated with high morbidity and over 50% mortality. ROCM is becoming more common due to an increase in predisposing immunocompromising comorbidities as well as COVID-19. We report 2 cases - a 75-year-old woman with diabetes and a 39-year-old man with recurrent diabetic ketoacidosis. Both presented initially with acute sinonasal symptoms, were positive for SARS-CoV-2, and diagnosed with acute ROCM. Both underwent mutilating surgical therapy as well as high-dose amphotericin B treatment. With continued oral antifungal treatment, patient 1 showed stable symptoms despite radiographically increasing disease and died of urosepsis 5 months after first surgery. With posaconazole treatment, patient 2 recovered from the disease and showed no clinical sign of disease progression after 1 year. Despite the rarity of the disease, ROCM should be considered if the findings of clinical and radiological examination fit, so that a delay in treatment initiation can be avoided. As our both cases show, survival from ROCM is possible - albeit at a high cost. | Lädrach Claudia; Wartenberg Martin; Zimmerli Stefan; Anschuetz Lukas; Bohlen Stefan; Ebner Julian; de Gouyon Matignon de Pontouraude Claire M F; Caversaccio Marco; Wagner Franca | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Respirology case reports | 38690063 | Tracheobronchomalacia following allogeneic haematopoietic stem cell transplantation. | Tracheobronchomalacia (TBM) occurs due to the weakening of cartilaginous part of the trachea, resulting in compromised airway function and leading to symptoms such as dyspnea, cough, and inability to clear secretions. Bronchiolitis obliterans syndrome (BOS) is the most prevalent late noninfectious pulmonary complication in patients who underwent allogeneic haematopoietic stem cell transplantation (HSCT). Therefore, patients experiencing progressive dyspnea and chronic cough after allogenic HSCT, with new obstructive pattern on pulmonary function test, are typically diagnosed with post-transplant BOS. However, it is important to note that TBM can also manifest as an obstructive defect pattern on pulmonary function test. Tracheomalacia has been reported as a rare complication of allogenic stem cell transplantation. We present two patients who developed TBM following allogeneic HSCT and were initially treated for post-transplant BOS but did not experience symptom improvement. However, after treatment with continuous positive airway pressure, their symptom subsided. | Panpruang Pitirat; Eksombatchai Dararat; Boonsarngsuk Viboon | 2024-01-05 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | World journal of gastrointestinal surgery | 38690053 | Blastomas of the digestive system in adults: A review. | Blastomas, characterized by a mixture of mesenchymal, epithelial, and undifferentiated blastematous components, are rare malignant neoplasms originating from precursor blast cells. This review focuses on digestive system blastomas in adult patients, including gastroblastoma, hepatoblastoma, and pancreatoblastoma. Gastroblastoma is a biphasic, epitheliomesenchymal tumor, with only sixteen cases reported to date. In addition to the characteristic histology, metastasis-associated lung adenocarcinoma transcript 1 - glioma-associated oncogene homolog 1 gene fusion is typical, although recently novel ewing sarcoma breakpoint region 1 - c-terminal binding protein 1 and patched 1 - glioma-associated oncogene homolog 2 fusions have been described. Hepatoblastoma is exceptionally rare in adults and can show a variety of histologic patterns which may cause diagnostic difficulty. Pancreatoblastoma, primarily a pediatric tumor, displays acinar differentiation and squamoid nests with other lines of differentiation also present, especially neuroendocrine. Diagnostic approaches for these blastomas include a combination of imaging modalities, histopathological examination, and molecular profiling. The treatment generally involves surgical resection, which may be supplemented by chemotherapy or radiotherapy in some cases. Prognoses vary with gastroblastoma generally showing favorable outcomes post-surgery whereas hepatoblastoma and pancreatoblastoma often have poorer outcomes, particularly in the setting of metastases. This review highlights the complexity of diagnosing and managing these rare adult blastomas as well as the need for ongoing research to better understand their pathogenesis and improve treatment strategies. | Liu Yu; El Jabbour Tony; Somma Jonathan; Nakanishi Yukihiro; Ligato Saverio; Lee Hwajeong; Fu Zhi-Yan | 2024-27-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Heliyon | 38690000 | Distinguishing optimal candidates for primary tumor resection in patients with metastatic lung adenocarcinoma: A predictive model based on propensity score matching. | Primary tumor resection is associated with survival benefits in patients with metastatic lung adenocarcinoma (mLUAD). However, there are no established methods to determine which individuals would benefit from surgery. Therefore, we developed a model to predict the patients who are likely to benefit from surgery in terms of survival. Data on patients with mLUAD were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Depending on whether surgery was performed on the primary tumor, patients were categorized into two groups: cancer-directed surgery (CDS) and no-cancer-directed surgery (No-CDS). Propensity Score Matching (PSM) was utilized to address bias between the CDS and No-CDS groups. The prognostic impact of CDS was assessed using Kaplan-Meier analysis and Cox proportional hazard models. Subsequently, we constructed a nomogram to predict the potential for surgical benefits based on multivariable logistic regression analysis using preoperative factors. A total of 89,039 eligible patients were identified, including 6.4% (5705) who underwent surgery. Following PSM, the CDS group demonstrated a significantly longer median overall survival (mOS) compared with the No-CDS group (23 [21-25] vs. 7 [7-8] months; <i>P</i> < 0.001). The nomogram showed robust performance in both the training and validation sets (area under the curve [AUC]: 0.698 and 0.717, respectively), and the calibration curves exhibited high consistency. The nomogram proved clinically valuable according to decision curve analysis (DCA). According to this nomogram, surgical patients were categorized into two groups: no-benefit candidates and benefit candidates groups. Compared with the no-benefit candidate group, the benefit candidate group was associated with longer survival (mOS: 25 vs. 6 months, <i>P</i> < 0.001). Furthermore, no difference in survival was observed between the no-benefit candidates and the no-surgery groups (mOS: 6 vs. 7 months, <i>P</i> = 0.9). A practical nomogram was developed to identify optimal CDS candidates among patients with mLUAD. | Qi Yuying; Guo Xiaojin; Li Zijie; Ren Bingzhang; Wang Zhiyu | 2024-15-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Heliyon | 38689973 | L-Thyroxine and L-thyroxine-based antimicrobials against Streptococcus pneumoniae and other Gram-positive bacteria. | The rise of antibiotic-resistant <i>Streptococcus pneumoniae</i> (<i>Sp</i>) poses a significant global health threat, urging the quest for novel antimicrobial solutions. We have discovered that the human hormone l-thyroxine has antibacterial properties. In order to explore its drugability we perform here the characterization of a series of l-thyroxine analogues and describe the structural determinants influencing their antibacterial efficacy. We performed a high-throughput screening of a library of compounds approved for use in humans, complemented with ITC assays on purified <i>Sp</i>-flavodoxin, to pinpoint molecules binding to this protein. Antimicrobial <i>in vitro</i> susceptibility assays of the hit compound (l-thyroxine) as well as of 13 l-thyroxine analogues were done against a panel of Gram-positive and Gram-negative bacteria. Toxicity of compounds on HepG2 cells was also assessed. A combined structure-activity and computational docking analysis was carried out to uncover functional groups crucial for the antimicrobial potency of these compounds. Human l-thyroxine binds to <i>Sp</i>-flavodoxin, forming a 1:1 complex of low micromolar <i>K</i><sub>d</sub>. While l-thyroxine specifically inhibited <i>Sp</i> growth, some derivatives displayed activity against other Gram-positive bacteria like <i>Staphylococcus aureus</i> and <i>Enterococcus faecalis</i>, while remaining inactive against Gram-negative pathogens. Neither l-thyroxine nor some selected derivatives exhibited toxicity to HepG2 cells. l-thyroxine derivatives targeting bacterial flavodoxins represent a new and promising class of antimicrobials. | Galano-Frutos Juan José; Maity Ritwik; Iguarbe Verónica; Aínsa José Antonio; Velázquez-Campoy Adrián; Schaible Ulrich E; Mamat Uwe; Sancho Javier | 2024-15-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Heliyon | 38689964 | HIF1A-dependent overexpression of MTFP1 promotes lung squamous cell carcinoma development by activating the glycolysis pathway. | Mitochondrial fission process 1 (<i>MTFP1</i>) is an inner mitochondrial membrane (IMM) protein implicated in the development and progression of various tumors, particularly lung squamous cell carcinoma (LUSC). This study aims to provide a more theoretical basis for the treatment of LUSC. Through bioinformatics analysis, <i>MTFP1</i> was identified as a novel target gene of <i>HIF1A</i>. <i>MTFP1</i> expression in LUSC was examined using The Cancer Genome Atlas (TCGA), Gene Expression Omnibus (GEO), and Proteomics Data Commons (PDC) databases. The Kaplan-Meier plotter (KM plotter) database was utilized to evaluate its correlation with patient survival. Western blot and chromatin immunoprecipitation (ChIP) assays were employed to confirm the regulatory relationship between <i>MTFP1</i> and <i>HIF1A</i>. Additionally, cell proliferation, colony formation, and migration assays were conducted to investigate the mechanism by which <i>MTFP1</i> enhances LUSC cell proliferation and metastasis. Our findings revealed that <i>MTFP1</i> overexpression correlated with poor prognosis in LUSC patients(P < 0.05). Moreover, <i>MTFP1</i> was closely associated with hypoxia and glycolysis in LUSC (R = 0.203; P < 0.001, R = 0.391; P < 0.001). <i>HIF1A</i> was identified as a positive regulator of <i>MTFP1</i>. Functional enrichment analysis demonstrated that <i>MTFP1</i> played a role in controlling LUSC cell proliferation. Cell proliferation, colony formation, and migration assays indicated that <i>MTFP1</i> promoted LUSC cell proliferation and metastasis by activating the glycolytic pathway (P < 0.05). This study establishes <i>MTFP1</i> as a novel <i>HIF1A</i> target gene that promotes LUSC growth by activating the glycolytic pathway. Investigating <i>MTFP1</i> may contribute to the development of effective therapies for LUSC patients, particularly those lacking targeted oncogene therapies. | Ji Jing; Wang Yasong; Jing Aixin; Ma Ling; Yang Jiayan; Ren Dexu; Lv Jinyu; Lv Mingxiao; Xu Menghan; Yuan Qing; Ma Xinhui; Qian Qilan; Wang Weiling; Geng Ting; Ding Yuanyuan; Qin Jingting; Liu Yuanyuan; Zhou Jiaojiao; Zuo Lingyi; Ma Shaojie; Wang Xiujun; Liu Bin | 2024-15-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Heliyon | 38689951 | Spurring SMEs' performance through business intelligence, organizational and network learning, customer value anticipation, and innovation - Empirical evidence of the creative economy sector in East Java, Indonesia. | Several studies have explored firm performance in the post-Covid-19 pandemic era. However, there is not much research to find reports divulging the complex relationship dynamics between business intelligence, organizational and network learning, customer value anticipation, and creative economy-based small-medium enterprises (SMEs) performance in developing countries. This study aims to uncover the complexity of those relationships. The quantitative data were collected from 313 creative economy-based SMEs in East Java, Indonesia. Using PLS-SEM, this study disclosed that business intelligence practices could not directly impact SMEs' performance. Business intelligence will be crucial to SMEs' performance with the support of organizational learning as a mediator. The finding also confirmed the presence of serial mediation of organizational learning and innovation in the relationship between business intelligence and SMEs' performance. However, the role of network learning and innovation is also important, considering their relatively large direct impact on SMEs' performance. The theoretical implications of this research broke the boundaries of strategic management theory in resource-based view and knowledge-based view in the latest era, where creative economy-based SMEs have been able to mobilize resources to carry out business intelligence to realize innovation and high performance. Further research is suggested to explore the role of business intelligence in promoting specific performance areas, such as marketing performance, financial performance, and human resource management. In addition, it is advisable to choose more specific research subjects, including those in the culinary subsector, and pay attention to other areas, e.g., the demographics of respondents in the model as a control variable. | Anjaningrum Widiya Dewi; Azizah Nur; Suryadi Nanang | 2024-15-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | MedEdPublish (2016) | 38689938 | Medical education in Bangladesh from Student and Teacher's Perspective: Impact and challenges of the COVID-19 pandemic. | In low- and middle-income countries like Bangladesh, where medical education faces a range of challenges-such as lack of infrastructure, well-trained educators, and advanced technologies, abrupt changes in methodologies without adequate preparation are more challenging than in higher-income countries. This was worsened during the COVID-19 pandemic and these challenges have resulted in a change in medical education methodology. This study assesses the medical education procedure, impacts and adaptation strategies and challenges of the COVID-19 pandemic in the medical education system of Bangladesh from learners' as well as educators' perspectives. The study collected data from 22 Medical Colleges/Universities across 18 districts of eight divisions using quantitative and qualitative methods. A total of 408 samples were collected consisting of 316 from students and 92 from medical teachers. Descriptive analysis and probit model were performed for obtaining results. The efficacy of online learning was questionable, but results showed that it was more effective for theory classes (92.4%) followed by clinical classes (75.63%) and the efficacy rate was low for practical classes (54.11%). All types of classes (theory, practical and clinical) are currently using mixed methods to some extent in medical education in Bangladesh. Regarding impacts and adaptation strategy, approximately 75.3% of the students surveyed expressed their acceptance of online education. Over 80% of the participants acknowledged the advantages of online learning, highlighting the freedom to learn from home, cost and time savings, and avoiding physical closeness with other students as major benefits. To address future challenges like the COVID-19 pandemic in medical education in Bangladesh, a comprehensive policy approach such as strengthening technological infrastructure, promoting blended learning approaches, enhancing faculty training and support, integrating telemedicine into the curriculum, and continuously evaluating and improving policies and interventions can enhance the resilience of its medical education system, and prepare for future challenges. | Rahman M Wakilur; Hasan Md Mahfuzul; Palash Md Salauddin; Asaduzzaman Md | 2023-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Frontiers in nutrition | 38689936 | Exploring food system resilience to the global polycrisis in six Asian countries. | The world is currently in the midst of a global food crisis brought about and exacerbated by a series of mutually reinforcing shocks to food systems This study investigated the resilience of food systems in six Asian countries (Bangladesh, Kyrgyz Republic, Lao PDR, Pakistan, Philippines, and Sri Lanka) amidst the global 'polycrisis' caused by COVID-19, geopolitical conflicts, and climate change. Trend analyses were performed for 19 indicators sourced from global databases and World Food Programme national data, representing the four domains of food system resilience: exposure to shocks; resilience capacities and agro- and food diversity, resilience responses and strategies; and long-term resilience outcomes. The analysis revealed that all six countries experienced the effects of the 'polycrisis', leading to diverse impacts on exchange rates, with Sri Lanka, Pakistan, and Lao PDR facing significant currency depreciation. While most countries increased crop production and decreased food imports during the crisis, government economic support during the pandemic varied widely. Resilience outcomes, including national food price inflation and the proportion of populations facing food insecurity, witnessed upward variations. Overall, countries with higher resilience capacities at the start of the 'polycrisis' showed less severe long-term resilience outcomes. Our findings highlight the varied challenges and resilience capacities across each country, influenced by a complex interplay of economic, political, agricultural, and food affordability factors crucial for determining long-term resilience in their food systems. Recommendations for future research include focusing on resilience assessment in food systems, integrating climate change adaptation measures, and developing early intervention strategies. | Favas Caroline; Cresta Chiara; Whelan Elizabeth; Smith Kristie; Manger Mari S; Chandrasenage Damith; Singhkumarwong Anusara; Kawasaki Jintana; Moreno Susana; Goudet Sophie | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | 3D printing and additive manufacturing | 38689930 | Synthesis and Investigation of Mechanical Properties of the Acrylonitrile Butadiene Styrene Fiber Composites Using Fused Deposition Modeling. | Additive manufacturing is becoming a global phenomenon due to its versatile properties and numerous benefits, which is not possible by conventional machining processes. Fused deposition modeling (FDM) shows a huge potential of shift from rapid prototyping toward the rapid manufacturing. Nowadays, the strength of the FDM-printed parts is very important to consider along with all the printing parameters, which affect the strength of these parts. This study includes the investigation of printing parameters (infill density, layer thickness, and shell count) on the strength of FDM-printed parts of acrylonitrile butadiene styrene (ABS) and carbon fiber-reinforced ABS (ABS-CF). These printing parameters directly affect the quality as well as the strength of the 3D-printed parts through FDM. Tensile tests were performed on the universal testing machine on both types of printed parts. The optimized parameters for the 3D-printed samples of the pristine ABS are found to be 0.1045 mm of layer thickness, 57.72% of infill density, and 7.63 numbers of shell count, while the optimum parameters obtained for ABS-CF are 0.2780 mm of layer thickness, 28.37% of infill density, and 9.88 numbers of shell count. The results show that the layer thickness and shell count have a significant effect on the ultimate tensile strength of the 3D-printed parts. | Zahid Ali; Anwar Muhammad Tuoqeer; Ahmed Arslan; Raza Yasir; Gohar Ghulam Abbas; Jamshaid Muhammad | 2024-01-04 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Preventive medicine reports | 38689887 | Short Communication: Radon testing via a state tobacco quitline. | Exposure to radon gas at home is the second largest cause of lung cancer after smoking and dramatically increases smokers' risk of lung cancer. State tobacco quitlines are uniquely positioned to inform smokers about radon, yet, to our knowledge, none does so. We explored the feasibility of introducing free radon tests via the tobacco quitline in North Dakota, a state with one of the highest radon levels in the U.S. Five hundred consecutive callers to the ND Quits Tobacco quitline from February 2021 to February 2023 were invited to complete a brief radon questionnaire and receive a free radon test kit. Radon tests were bar-coded so that the return rate of the tests and the radon levels could be determined. Two hundred fifty-one (51 %) callers completed the questionnaire and seventy-five radon tests were successfully returned to the laboratory. More than one third of the test results were ≥ 4.0 pCi/L, the action level recommended by the EPA. Only 1 in 5 participants reported knowing that radon caused lung cancer. Radon knowledge among ND smokers is poor. Radon test distribution via quitlines is feasible and may be a valuable addition to quitline services, particularly in states with high radon levels. | Schmitz David; Klug Marilyn G; Schwartz Gary G | 2024-01-06 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Frontiers in cardiovascular medicine | 38689861 | Atrial fibrillation and COVID-19: an analysis of the ambulatory database. | Atrial fibrillation (AF) is the most common heart rhythm disorder in clinical practice. It worsens the quality of life of patients, leads to an increase in the mortality rate because of its association with a high risk of thromboembolic complications. The current pandemic of a new coronavirus infection, which began in March 2020, was marked by an increase in cardiovascular diseases, including an increase in the number of patients with AF. That is why it is extremely relevant to find answers to questions about the association and mutual influence of AF and coronavirus infection to reduce the risk of vascular complications. However, most research in this area has focused on hospital patients. In this study, an electronic database of outpatients with AF, including patients with a history of COVID-19 infection was analyzed in order to assess the most significant risk factors for complications. | Sizova Zhanna M; Zakharova Valeria L; Shindryaeva Natalya N; Lapidus Natalia I; Melnik Mariya V; Shikh Evgenia V; Grebenshchikova Ludmila Y; Beloborodova Alexandra V; Polovikov Ivan P | 2024-01-01 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
PUBMED | Infectious Disease Modelling | 38689855 | An SEIHR model with age group and social contact for analysis of Fuzhou COVID-19 large wave. | The structure of age groups and social contacts of the total population influenced infection scales and hospital-bed requirements, especially influenced severe infections and deaths during the global prevalence of COVID-19. Before the end of the year 2022, Chinese government implemented the national vaccination and had built the herd immunity cross the country, and announced Twenty Measures (November 11) and Ten New Measures (December 7) for further modifications of dynamic zero-COVID polity on the Chinese mainland. With the nation-wide vaccination and modified measures background, Fuzhou COVID-19 large wave (November 19, 2022-February 9, 2023) led by Omicron BA.5.2 variant was recorded and prevailed for three months in Fujian Province. A multi-age groups susceptible-exposed-infected-hospitalized-recovered (SEIHR) COVID-19 model with social contacts was proposed in this study. The main object was to evaluate the impacts of age groups and social contacts of the total population. The idea of Least Squares method was governed to perform the data fittings of four age groups against the surveillance data from Fujian Provincial Center for Disease Control and Prevention (Fujian CDC). The next generation matrix method was used to compute basic reproduction number for the total population and for the specific age group. The tendencies of effective reproduction number of four age groups were plotted by using the Epiestim R package and the SEIHR model for in-depth discussions. The sensitivity analysis by using sensitivity index and partial rank correlation coefficients values (PRCC values) were operated to reveal the differences of age groups against the main parameters. The main epidemiological features such as basic reproduction number, effective reproduction number and sensitivity analysis were extensively discussed for multi-age groups SEIHR model in this study. Firstly, by using of the next generation matrix method, basic reproduction number <i>R</i><sub>0</sub> of the total population was estimated as 1.57 using parameter values of four age groups of Fuzhou COVID-19 large wave. Given age group <i>k</i>, the values of <i>R</i><sub>0<i>k</i></sub> (age group <i>k</i> to age group <i>k</i>), the values of <math xmlns="http://www.w3.org/1998/Math/MathML"><msubsup><mrow><mi>R</mi></mrow><mrow><mn>0</mn></mrow><mrow><mi>k</mi></mrow></msubsup></math> (an infected of age group <i>k</i> to the total population) and the values of <math xmlns="http://www.w3.org/1998/Math/MathML"><msubsup><mrow><mover><mrow><mi>R</mi></mrow><mo>^</mo></mover></mrow><mrow><mn>0</mn></mrow><mrow><mi>k</mi></mrow></msubsup></math> (an infected of the total population to age group <i>k</i>) were also estimated, in which the explorations of the impacts of age groups revealed that the relationship <math xmlns="http://www.w3.org/1998/Math/MathML"><msubsup><mrow><mi>R</mi></mrow><mrow><mn>0</mn></mrow><mrow><mi>k</mi></mrow></msubsup><mo>></mo><msub><mrow><mi>R</mi></mrow><mrow><mn>0</mn><mi>k</mi></mrow></msub><mo>></mo><msubsup><mrow><mover><mrow><mi>R</mi></mrow><mo>^</mo></mover></mrow><mrow><mn>0</mn></mrow><mrow><mi>k</mi></mrow></msubsup></math> was valid. Then, the fluctuating tendencies of effective reproduction number <i>R</i><sub><i>t</i></sub> were demonstrated by using two approaches (the surveillance data and the SEIHR model) for Fuzhou COVID-19 large wave, during which high-risk group (G4 group) mainly contributed the infection scale due to high susceptibility to infection and high risks to basic diseases. Further, the sensitivity analysis using two approaches (the sensitivity index and the PRCC values) revealed that susceptibility to infection of age groups played the vital roles, while the numerical simulation showed that infection scale varied with the changes of social contacts of age groups. The results of this study claimed that the high-risk group out of the total population was concerned by the local government with the highest susceptibility to infection against COVID-19. This study verified that the partition structure of age groups of the total population, the susceptibility to infection of age groups, the social contacts among age groups were the important contributors of infection scale. The less social contacts and adequate hospital beds for high-risk group were profitable to control the spread of COVID-19. To avoid the emergence of medical runs against new variant in the future, the policymakers from local government were suggested to decline social contacts when hospital beds were limited. | Lan Xiaomin; Chen Guangmin; Zhou Ruiyang; Zheng Kuicheng; Cai Shaojian; Wei Fengying; Jin Zhen; Mao Xuerong | 2024-01-09 | {'Introduction': '', 'Methodology': '', 'Findings': '', 'Discussion': '', 'Conclusion': '', 'Other Texts': ''} |
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