Showing papers by "Loma Linda University published in 2022"
TL;DR: In this paper , the authors explain when and how staggered difference-in-differences regression estimators, commonly applied to assess the impact of policy changes, are biased, and present three alternative estimators developed in the econometrics and applied literature for addressing these biases, including their differences and tradeoffs.
238 citations
TL;DR: The Post-hospitalisation COVID-19 study (PHOSP-COVID) as mentioned in this paper is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID19 across the UK.
118 citations
TL;DR: In this article , the role of caspase-1 mediated inflammasome activation on extrinsic blood coagulation in CSF after subarachnoid haemorrhage (SAH) was explored.
11 citations
TL;DR: In a case-only study of 2998 women with breast cancer, overall and stratified by race and estrogen receptor (ER) status, the associations of hair dye and relaxer use with increased breast cancer risk were found as discussed by the authors.
9 citations
TL;DR: The laparoscopic hysterectomy readmission score (LHRS) was created to identify patients for whom same day discharge (SDD) after minimally-invasive hystoralctomy (MIH) may not be advisable and includes diabetes, chronic obstructive pulmonary disease, disseminated cancer, chronic steroid use, bleeding disorder, length of surgery, and any postoperative complication prior to discharge as mentioned in this paper .
4 citations
TL;DR: The tumor microenvironment plays an essential role in the development, proliferation, and survival of leukemic blasts in acute myeloid leukemia (AML) as discussed by the authors , and the role of natural products in modulating the TME to enhance response to immunotherapy.
Abstract: The tumor microenvironment (TME) plays an essential role in the development, proliferation, and survival of leukemic blasts in acute myeloid leukemia (AML). Within the bone marrow and peripheral blood, various phenotypically and functionally altered cells in the TME provide critical signals to suppress the anti-tumor immune response, allowing tumor cells to evade elimination. Thus, unraveling the complex interplay between AML and its microenvironment may have important clinical implications and are essential to directing the development of novel targeted therapies. This review summarizes recent advancements in our understanding of the AML TME and its ramifications on current immunotherapeutic strategies. We further review the role of natural products in modulating the TME to enhance response to immunotherapy.
4 citations
TL;DR: In this article , the effects of recipient body mass index (BMI) on waitlist strategies, waitlist outcomes, and post-transplant outcomes among adult patients listed for heart transplantation under the updated 2018 allocation system have not been well characterized.
Abstract: The effects of recipient body mass index (BMI) on waitlist strategies, waitlist outcomes, and post-transplant outcomes among adult patients listed for heart transplantation under the updated 2018 allocation system have not been well characterized.The United Network of Organ Sharing data set between October 2015 and March 2021 was analyzed, and patients were grouped based on recipient BMI and whether listing occurred in the old (pre-October 2018) or new allocation system.Listing strategies differed by BMI group, but trends of increased use of temporary mechanical support and decreased use of durable support remained among all BMI groups, except those with BMI > 35 kg/m2 . Waitlist outcomes improved among all BMI cohorts in the new allocation system, including among patients with BMI 30-34.9 and >35 kg/m2 , although patients with higher BMIs continued to have longer waitlist times. Post-transplant outcomes in the new allocation system are worse for patients with BMI > 30 kg/m2 (hazard ratio: 1.47; confidence interval: 1.19-1.82; p < .001).The 2018 change to the heart transplant allocation system was associated with similar changes in the use of mechanical support for listing strategy across BMI ranges, except in the most obese, and improved waitlist outcomes across all BMI ranges. Post-transplant outcomes in the new allocation system are worse for patients with BMI > 30 kg/m2 compared to patients with BMI < 30 kg/m2 . These findings have important clinical implications for our understanding of the ongoing influence of BMI on waitlist courses and post-transplant outcomes among patients listed for heart transplantation.
3 citations
TL;DR: In this paper , the authors compared DRTT reconstruction with probabilistic fiber tracking and showed that the probabilistically reconstructed DRTT was superior in spatial proximity to the physiology-guided DBS lead and to the empirically chosen active contact.
Abstract: BACKGROUND: The ventral intermediate (VIM) thalamic nucleus is the main target for the surgical treatment of refractory tremor. Initial targeting traditionally relies on atlas-based stereotactic targeting formulas, which only minimally account for individual anatomy. Alternative approaches have been proposed, including direct targeting of the dentato-rubro-thalamic tract (DRTT), which, in clinical settings, is generally reconstructed with deterministic tracking. Whether more advanced probabilistic techniques are feasible on clinical-grade magnetic resonance acquisitions and lead to enhanced reconstructions is poorly understood. OBJECTIVE: To compare DRTT reconstructed with deterministic vs probabilistic tracking. METHODS: This is a retrospective study of 19 patients with essential tremor who underwent deep brain stimulation (DBS) with intraoperative neurophysiology and stimulation testing. We assessed the proximity of the DRTT to the DBS lead and to the active contact chosen based on clinical response. RESULTS: In the commissural plane, the deterministic DRTT was anterior (P < 10−4) and lateral (P < 10−4) to the DBS lead. By contrast, although the probabilistic DRTT was also anterior to the lead (P < 10−4), there was no difference in the mediolateral dimension (P = .5). Moreover, the 3-dimensional Euclidean distance from the active contact to the probabilistic DRTT was smaller vs the distance to the deterministic DRTT (3.32 ± 1.70 mm vs 5.01 ± 2.12 mm; P < 10−4). CONCLUSION: DRTT reconstructed with probabilistic fiber tracking was superior in spatial proximity to the physiology-guided DBS lead and to the empirically chosen active contact. These data inform strategies for surgical targeting of the VIM.
3 citations
TL;DR: In this paper , the authors describe optical principles and utility of inexpensive, portable, non-contact digital smartphone-based camera for the acquisition of fundus photographs for the evaluation of retinal disorders.
Abstract: To describe optical principles and utility of inexpensive, portable, non-contact digital smartphone-based camera for the acquisition of fundus photographs for the evaluation of retinal disorders.The digital camera has a high-quality glass 25 D condensing lens attached to a 21.4-megapixel smartphone camera. The white-emitting LED light of the smartphone at low illumination levels is used to visualize the fundus and limit source reflection. The camera captures a high-definition fundus (5344 × 4016) image on a complementary metal oxide semiconductor (CMO) with an area of 6.3 mm × 4.5 mm. The auto-acquisition mode of the device facilitates the quick capture of the image from continuous video streaming in a fraction of a second.This new smartphone-based camera provides high-resolution digital images of the retina (50° telescopic view) in patients at a fraction of the cost (USD 1000) of established, non-transportable, office-based fundus photography systems.The portable user-friendly smartphone-based digital camera is a useful alternative for the acquisition of fundus photographs and provides a tool for screening retinal diseases in various clinical settings such as primary care clinics or emergency rooms. The ease of acquisition of photographs from a continuously streaming video of fundus obviates the need for a skilled photographer.
2 citations
TL;DR: The basic photographic principles, equipment, and techniques that are essential to produce high-quality and standardized patient photographs are reviewed.
2 citations
TL;DR: In this paper , the authors investigated whether PsyF works as a mediator in successful CBT treatment of OCD and found that higher average values in PsyF were associated with lower Y-BOCS sum values.
Abstract: To gain a better understanding about which aspects of the treatment work for obsessive-compulsive disorders (OCD), the investigation of possible change factors is essential. Psychological flexibility (PsyF) has been of interest in research on successful OCD therapy for some time. Exposure interventions and cognitive strategies in cognitive behavioural therapy (CBT) for OCD may enhance PsyF. To date, however, no process studies have been published that clarify the role of PsyF as a possible change factor for the reduction of OCD symptoms.This study investigates whether PsyF works as a mediator in successful CBT treatment of OCD.The study recruited 112 adults diagnosed with OCD in a multi-modal in-patient treatment with specific CBT including exposure and response prevention (ERP). The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used to measure OCD symptoms and three self-constructed items to assess PsyF. PsyF was conceptualised as the capability of patients to accept stressful feelings and thoughts. Data were collected weekly. For statistical analysis at the process level, longitudinal multi-level models (MLMs) with random intercepts and linear growth curves were estimated to test for mediation of PsyF on Y-BOCS.OCD symptoms decreased significantly and PsyF increased in patients throughout the course of therapy. MLM revealed that higher average values in PsyF were associated with lower Y-BOCS sum values, but only values between subjects significantly predicted the degree of obsessions and compulsions.Although research shows that PsyF is enhanced by CBT and also shows a connection with Y-BOCS values, its role as a mediator could not be confirmed.
TL;DR: The mRNA vaccines BNT162b2 and mRNA-1273 have played a key role in our global response to the COVID-19 pandemic as they have demonstrated significant advantages over conventional vaccines and have proven to be highly effective against COVID19 associated hospitalization and severe illness in large clinical trials and studies using real-world data as discussed by the authors .
TL;DR: In this article , the authors compared the frequency of nurse-provided spiritual care across diverse cultures and found that "remaining present…" was the most frequent therapeutic, whereas documenting spiritual care and making arrangements for the patient's clergy or a chaplain to visit were among the most infrequent therapeutics.
Abstract: Aims and objectives To compare the frequency of nurse-provided spiritual care across diverse cultures. Background Given an ethical imperative to respect patient spirituality and religiosity, nurses are increasingly taught and expected to provide spiritual care. Although nurses report positive attitudes toward spiritual care, they typically self-report providing it infrequently. Evidence about the reported frequency of spiritual care is constrained by substantial variation in its measurement. Design This cross-sectional, descriptive study involved secondary analysis of data collected in multiple sites globally using one quantitative instrument. Methods Data were collected from practicing nurses using the Nurse Spiritual Care Therapeutics Scale and analysed using descriptive statistics and a meta-analysis procedure with random-effect modelling. Datasets from 16 studies completed in Indonesia, Iran, Malaysia, Philippines, Portugal, Taiwan, Turkey and the United States contributed to a pooled sample (n = 4062). STROBE guidelines for cross-sectional observational studies were observed. Results Spiritual care varied between countries and within countries. It was slightly more frequent within Islamic cultures compared with predominantly Christian cultures. Likewise, frequency of spiritual care differed between nurses in palliative care, predominantly hospital/inpatient settings, and skilled nursing homes. Overall, “Remaining present…” was the most frequent therapeutic, whereas documenting spiritual care and making arrangements for the patient's clergy or a chaplain to visit were among the most infrequent therapeutics. Conclusions In widely varying degrees of frequency, nurses around the world provide care that is cognisant of the spiritual and religious responses to living with health challenges. Future research should be designed to adjust for the multiple factors that may contribute to nurses providing spiritual care. Relevance to clinical practice Findings offer a benchmark and begin to inform nurse leaders about what may be normative in practice. They also encourage nurses providing direct patient care that they are not alone and inform educators about what instruction future nurses require.
TL;DR: The authors proposed a dual speech coordination model in which laryngeal control of pitch-related aspects of prosody and song are coordinated by a hierarchically organized dorsolateral system while supralaryn-geal articulation at the phonetic/syllabic level is coordinated by more ventral system posterior to Broca's area.
Abstract: Classical neural architecture models of speech production propose a single system centred on Broca's area coordinating all the vocal articulators from lips to larynx. Modern evidence has challenged both the idea that Broca's area is involved in motor speech coordination and that there is only one coordination network. Drawing on a wide range of evidence, here we propose a dual speech coordination model in which laryngeal control of pitch-related aspects of prosody and song are coordinated by a hierarchically organized dorsolateral system while supralaryngeal articulation at the phonetic/syllabic level is coordinated by a more ventral system posterior to Broca's area. We argue further that these two speech production subsystems have distinguishable evolutionary histories and discuss the implications for models of language evolution.
TL;DR: Wang et al. as mentioned in this paper proposed a sparse convolutional recurrent network with a sparse gating mechanism that is able to reduce the complexity of the network by an improved gate unit while keeping the performance of the model.
Abstract: With the continuous development of deep learning, more and more huge deep learning models are developed by researchers, which leads to an exponential increase of the parameters of models. Therein, the convolutional recurrent network as a type of widely used deep learning method is often employed to handle spatiotemporal data, e.g., traffic data. However, because of the large number of parameters in the model, the convolutional recurrent network needs to consume a lot of computing resources and time in the training process. To reduce the consumption of resources, we propose a sparse convolutional recurrent network with a sparse gating mechanism that is able to reduce the complexity of the network by an improved gate unit while keeping the performance of the model. We evaluate the performance of our proposed network on traffic flow datasets, and the experimental results show that the parameters of the model are significantly reduced under the condition of similar prediction accuracy compared with the traditional convolutional recurrent network.
27 Jan 2022
01 Jan 2022
TL;DR: A brief overview of the pre-and post-market FDA regulation of combination products can be found in this article , where the FDA's primary goal is to develop an efficient, modern, and transparent regulation of combinations of drugs, devices, and biological products to benefit patients' health and safety.
Abstract: The new advancement in research and technology has enabled immense progress in the field of combination drug therapy. The combination therapy and associated products are getting significant attention in recent times due to their therapeutic advancement. Combination therapy is emerging as a powerful therapeutic tool in treating various serious diseases. Combination therapy has more therapeutic advantages compared to monotherapy. The potential to provide enhanced therapeutic advantages, such as reduced multidrug resistance, reduced toxicity, and target specificity. Food and Drug Administration (FDA) and other jurisdiction agencies work diligently to regulate combination therapy products based on their primary mode of action. The FDA’s primary goal is to develop an efficient, modern, and transparent regulation of combination products consisting of combinations of drugs, devices, and biological products to benefit patients’ health and safety. This article provides a brief overview of the pre- and postmarket FDA regulation of combination products.
TL;DR: In this paper , a combination therapy of insulin-like growth factor 1 (IGF-I) and BTP-2 was evaluated in a mouse liver injury model induced by lipopolysaccharide (LPS).
Abstract: Acute liver injury is a common disease without effective therapy in humans. We sought to evaluate a combination therapy of insulin-like growth factor 1 (IGF-I) and BTP-2 in a mouse liver injury model induced by lipopolysaccharide (LPS). We chose this model because LPS is known to increase the expression of the transcription factors related to systemic inflammation (i.e., NFκB, CREB, AP1, IRF 3, and NFAT), which depends on calcium signaling. Notably, these transcription factors all have pleiotropic effects and account for the other observed changes in tissue damage parameters. Additionally, LPS is also known to increase the genes associated with a tissue injury (e.g., NGAL, SOD, caspase 3, and type 1 collagen) and systemic expression of pro-inflammatory cytokines. Finally, LPS compromises vascular integrity. Accordingly, IGF-I was selected because its serum levels were shown to decrease during systemic inflammation. BTP-2 was chosen because it was known to decrease cytosolic calcium, which is increased by LPS. This current study showed that IGF-I, BTP-2, or a combination therapy significantly altered and normalized all of the aforementioned LPS-induced gene changes. Additionally, our therapies reduced the vascular leakage caused by LPS, as evidenced by the Evans blue dye technique. Furthermore, histopathologic studies showed that IGF-I decreased the proportion of hepatocytes with ballooning degeneration. Finally, IGF-I also increased the expression of the hepatic growth factor (HGF) and the receptor for the epidermal growth factor (EGFR), markers of liver regeneration. Collectively, our data suggest that a combination of IGF-I and BTP-2 is a promising therapy for acute liver injury.
TL;DR: In this paper , the authors evaluated the patterns of outpatient opioid prescription in patients with bone sarcomas after resection of the primary tumor, and to assess for factors that may lead to increased opioid dosing in these patients.
Abstract: The majority of children with bone sarcomas experience pain. Opioids remain the mainstay treatment of cancer-related pain in children. The patterns of outpatient opioid prescription after surgery for primary bone sarcomas remains unknown. The purpose of this study is to evaluate the patterns of outpatient opioid prescription in patients with bone sarcomas after resection of the primary tumor, and to assess for factors that may lead to increased opioid dosing in these patients.A retrospective chart review of 28 patients with bone sarcomas undergoing primary tumor resection was performed. Demographic, medical, surgical, and pharmacological data was collected from all patients. The total morphine milligram equivalents (MMEs) prescribed after patient discharge were compared at 30-day intervals. The MMEs were then stratified by tumor location, presence of metastasis at time of surgery, and preoperative opioid use. Independent predictors of increased 30-day and total 120-day opioid utilization were evaluated.Patients with preoperative opioid use were prescribed significantly more opioids in every 30-day postoperative interval and for the 120-day total. When stratified by tumor location, patients with primary tumors in the pelvis had significantly greater postoperative opioid utilization when compared with patients with tumors located in the lower and upper extremities during postoperative days 61 to 90 (5970 vs. 1060.4 and 0 MMEs, respectively, P=0.048) and during postoperative days 91 to 120 (6450 vs. 829.6 and 0 MMEs, respectively, P=0.015). Older age, diagnosis of osteosarcoma, increased length of stay postoperatively and presence of metastases were associated with a higher 30-day postoperative opioid utilization.Multiple factors were associated with increased opioid use including preoperative opioid use, longer postoperative stay in the hospital, metastatic disease, and primary sarcomas in the pelvis. The patient's sex, body mass index, race, type of insurance, type of surgery performed, reoperation during the same admission and use of nonopioid adjuvants had no effect on opioid use. The results of this study can be used to stratify the average opioid requirement of pediatric patients undergoing primary bone sarcoma resection.Level IV.
TL;DR: The Society for Cardiovascular Magnetic Resonance (SCMR) annual meeting was an all-virtual event for the first time in its history in 2019 as mentioned in this paper , where a modified social media strategy aimed to re-create the sociability of an in-person conference whilst also promoting global dissemination of the science being presented.
Abstract: Most cardiac imaging conferences have adopted social media as a means of disseminating conference highlights to a global audience well beyond the confines of the conference location. A deliberate and thoughtful social media campaign has the potential to increase the reach of the conference and allow for augmented engagement. The coronavirus disease 2019 (COVID-19) pandemic triggered a radical transformation in not just the delivery of healthcare but also the dissemination of science within the medical community. In the past, in-person medical conferences were an integral annual tradition for most medical professionals to stay up to date with the latest in the field. Social distancing requirements of the COVID-19 pandemic resulted in either cancelling medical conferences or shifting to a virtual format. Following suit, for the first time in its history, the 2021 Society for Cardiovascular Magnetic Resonance (SCMR) annual meeting was an all-virtual event. This called for a modified social media strategy which aimed to re-create the sociability of an in-person conference whilst also promoting global dissemination of the science being presented. This paper describes the employment of social media as well as the evolution through the SCMR scientific sessions for 2020 and 2021 that serves as a model for future cardiovascular conferences.
TL;DR: The tricuspid valve (TV) is a complex structure between the right atrium and the right ventricle; it generally consists of 3 leaflets (anterior, posterior, and septal) inserted in the fibrous tricusid annulus and connected to the papillary muscle via the chordae tendinae.
Abstract: Transcatheter valve interventions have seen a significant increase in the past decade. The combination of improved techniques and available tools provides less invasive options supplementing surgical therapies. The tricuspid valve (TV) apparatus is a complex structure between the right atrium and the right ventricle; it generally consists of 3 leaflets (anterior, posterior, and septal) inserted in the fibrous tricuspid annulus and connected to the papillary muscle via the chordae tendinae. This article reviews TV anatomy, the pathophysiology of tricuspid regurgitation, and multimodality imaging to study TV, as well as provides an overview of transcatheter TV intervention.
01 Jul 2022
TL;DR: Cutaneous lupus erythematosus (CLE) is an autoimmune connective tissue disease that may be limited to the skin or be part of the widespread multiorgan involvement seen in systemic Lupus infection as discussed by the authors .
Abstract: Inflammation driven by immune-mediated mechanisms can lead to a wide variety of skin manifestations. Cutaneous lupus erythematosus (CLE), for example, is an autoimmune connective tissue disease that may be limited to the skin or be part of the widespread multiorgan involvement seen in systemic lupus erythematosus. Clinical findings are divided into lupus-specific (acute, subacute, and chronic) and nonspecific skin lesions. The diagnosis of CLE requires a thorough physical examination and, in some cases, skin biopsy and laboratory evaluation for any underlying systemic involvement. CLE treatment is dependent on the cutaneous manifestations and severity of disease. In addition to lifestyle measures, particularly avoidance of sunlight, topical and systemic therapies have proven beneficial. Prognosis is varied by disease severity, although chronic CLE notoriously results in cosmetic damage. Early recognition and management of CLE is important as it may also be the presenting manifestation of systemic lupus erythematosus. Patient care includes education and close collaboration with primary care providers, dermatologists, and rheumatologists.
01 Aug 2022
TL;DR: In this article , an acute (2 hrs) novel MRI signal where reduced T2 relaxation values in the basolateral amygdala (BLA) predicted epilepsy in adulthood was identified; this T2 signal remains incompletely understood and it may be influenced by vascular topology.
Abstract: Febrile status epilepticus (FSE) is an important risk factor for temporal lobe epilepsy and early identification of those at high risk for epilepsy is vital. In a rat model of FSE, we identified an acute (2 hrs) novel MRI signal where reduced T2 relaxation values in the basolateral amygdala (BLA) predicted epilepsy in adulthood; this T2 signal remains incompletely understood and we hypothesized that it may be influenced by vascular topology. Experimental FSE induced in rat pups reduced blood vessel density of the cortical vasculature in a lateralized manner at 2 hrs post FSE. Middle cerebral artery (MCA) exhibited abnormal topology in FSE pups but not in controls. In the BLA, significant vessel junction reductions and decreased vessel diameter were observed, together with a strong trend for reduced vessel length. Perfusion weighted MRI (PWI) was acutely increased cerebral blood flow (CBF) in cortex, amygdala and hippocampus of FSE pups that correlated to decreased T2 relaxation values compared to controls. This is consistent with increased levels of deoxyhemoglobin associated with increased metabolic demand. In summary, FSE acutely modifies vascular topological and CBF in cortex and BLA that may underlie acute MRI signal changes that predict progression to future epilepsy.
17 Jun 2022
TL;DR: In this paper , the authors investigated the effect of royal jelly on gene expression of squalene epoxidase (SE), a major enzyme involved in cholesterol biosynthesis in HepG2 cells.
Abstract: Excessive cholesterol in the liver is harmful for our health and may cause many diseases, such as fatty liver disease. Many studies in human and animal models have reported that royal jelly (RJ) can be used to treat atherosclerosis. However, the real mechanisms behind this action is unclear. In this study, we investigated the effectivity of RJ on gene expression of squalene epoxidase (SE) a major enzyme involved in cholesterol biosynthesis in HepG2 cells. We found that the expression of SE was decreased in response to RJ treatment. We also found that the origin of the RJ affected its strength. To find out the active ingredient of RJ in cholesterol suppression, we separated RJ into two parts based on the molecular weights using ultrafiltration membrane. We found that the fraction < 10kDa from RJ had comparable effect on SE expression, especially its water-soluble part. Taken together, we think RJ suppresses cholesterol by decreasing SE gene expression in liver. The active ingredient of RJ in this action is < 10kDa in water-soluble form.
TL;DR: In this paper , the authors evaluated anxiety level among severe asthmatics while undergoing bronchial thermoplasty (BT) procedure, where subjects self-evaluated their overall anxiety level using the burns anxiety inventory (BAI) questionnaire at baseline and prior to each of three BT treatments.