bluuebunny/crossref_metadata_2025 huggingface dataset:
Body and Mind, Husband and Household, Collaborators and Communities: Centrifugal Spheres of Protection in an Aramaic Incantation Bowl (MC 77.233)
Authors: Marcus Alexander
Published: February 2023

MC 77.233, an incantation bowl in Jewish Babylonian Aramaic script held in the Magnes Collection, is here published for the first time. Written primarily for Ḥammādā daughter of Xwārōy, it deepens and nuances our understanding of apotropaic activities in late antique Babylonia and surrounding regions, with terminology and phrases that are, at turns, typical and unique. Notable, too, are its combinations of, and allusions to, motifs that are elaborated with greater detail on other specimens. My discussion focuses on the role of both client and scribe in the bowl’s production, highlighting connections to bowls of other clients, to several well-attested formula repertoires, and to other Sasanian literary sources like the Babylonian Talmud. Throughout, I emphasize the opportunities for comparative analysis that are now available due to the increasing volume of bowl publications and recent scholarship on religious life, material culture, and interactions between Jews and others in late antique Mesopotamia.
Heat Shock Proteins Are Differentially Expressed in the Domestic Cat (Felis catus) Testis, Epididymis, and Vas Deferens
Authors: Liman Narin
Published: February 2023

Heat shock proteins (HSPs) play key roles in controlling the morphological transformation of germ cells during spermatogenesis and posttesticular maturation of sperm. This study aims to reveal the presence and localization patterns of large adenosine triphosphate (ATP)-dependent HSPs family members in adult domestic cat testis and excurrent ducts utilizing Western blot, immunohistochemistry, and immunofluorescence techniques. The results indicated that the relative amounts of heat shock protein D1 (HSPD1)/HSP60, heat shock protein C (HSPC)/HSP90, and heat shock protein H (HSPH)/HSP105/110 were highest in the testis, while heat shock protein A (HSPA)/HSP70 was highest in the corpus epididymis. HSPs exhibited spermatogenic stage-dependent localization patterns in germ cells. Sertoli and Leydig cells were positive for other HSPs except for HSPC/HSP90. The tubules rectus and rete testis epithelia showed only HSPD1/HSP60 and HSPA/HSP70 immunoreactivity, while the ciliated cells of efferent ductules were positive for all HSPs. In the epididymis and vas deferens, HSPs localizations were cell and region specific. HSPD1/HSP60 was localized in the midpiece of the immature spermatozoa tail, while HSPA/HSP70 and HSP90 were found only in the proximal cytoplasmic droplet (CD). HSPH/HSP105 was observed in CD and the principal piece but not the midpiece. Overall, the different expression of HSPs throughout the domestic cat testis and excurrent ducts indicates their critical roles in maintaining reproductive functions under physiological conditions.
A case of Hermansky-Pudlak with dyspnea
Authors: Takaldani Ali Hossein Samadi , Javanshir Nima , Salimi Maryam , Negaresh Mohammad
Published: February 2023

Hermansky-Pudlak syndrome (HPS) is a rare multisystem disorder inherited in an autosomal recessive manner. Its prevalence is 1 in 500 000 to 1 000 000 people worldwide. The cause of this disorder is genetic mutations that lead to defective organelles of lysosomes. In this report, a 49-year-old man is introduced who was referred to the medical center with ocular albinism and recently exacerbated shortness of breath. Imaging showed peripheral reticular opacities, ground-glass opacities of the lungs with subpleural sparing in some regions, and thickening of bronchovascular bundles, which were all in favor of non-specific interstitial pneumonia. This imaging pattern is an unusual finding in a patient with HPS.
Takotsubo cardiomyopathy induced by pheochromocytoma: a case report
Authors: Awadji Fabrice Boris , Sasmita Bryan Richard , Huang Bi , Han Yuying , Yang Yuan , Luo Suxin , Liu Gang
Published: February 2023

Pheochromocytoma presents various clinical manifestations and imprecise signs and symptoms. Along with other diseases, it is considered to be ‘the great mimic’. This is the case of a 61-year-old man who on arrival presented with extreme chest pain accompanied by palpitations, and with a blood pressure of 91/65 mmHg. An echocardiogram showed an ST-segment elevation in the anterior leads. The cardiac troponin was 1.62 ng/ml, 50 times the upper limit of normal. Bedside, echocardiography revealed global hypokinesia of the left ventricle, with an ejection fraction of 37%. Because ST-segment elevation myocardial infarction-complicated cardiogenic shock was suspected, an emergency coronary angiography was performed. It showed no significant coronary artery stenosis, while left ventriculography demonstrated left ventricular hypokinesia. Sixteen days after admission, the patient suddenly presented with palpitations, headache and hypertension. A contrast-enhanced abdominal CT showed a mass in the left adrenal area. Pheochromocytoma-induced takotsubo cardiomyopathy was suspected.
Nanocarrier of Pin1 inhibitor based on supercritical fluid technology inhibits cancer metastasis by blocking multiple signaling pathways
Authors: Zhang Fengzhu , Zhang Aiwen , Xie Youning , Wen Haiying , Kankala Ranjith Kumar , Huang Jing , Zhang Anjun , Wang Qi , Chen Biaoqi , Dong Haiyan , Guo Zhao , Chen Aizheng , Yang Dayun
Published: February 2023

Cancer metastasis is the primary cause of all cancer-related deaths due to the lack of effective targeted drugs that simultaneously block multiple signaling pathways that drive the dissemination and growth of cancer cells. The unique proline isomerase Pin1 activates numerous cancer pathways, but its role in cancer metastasis and the inhibitory efficacy of Pin1 inhibitors on cancer metastasis are unknown. Moreover, the applicability of Pin1 inhibitor―all-trans retinoic acid (ATRA) is limited due to its several drawbacks. Herein, uniform ATRA-loaded polylactic acid-polyethylene glycol block copolymer nanoparticles (ATRA-NPs) with high encapsulation efficiency, good cellular uptake, excellent controlled release performance and pharmacokinetics are developed using supercritical carbon dioxide processing combined with an optimized design. ATRA-NPs exhibited excellent biosafety and significant inhibition on the growth and metastasis of hepatocellular carcinoma. Pin1 played a key role in cancer metastasis and was the main target of ATRA-NPs. ATRA-NPs exerted their potent anti-metastatic effect by inhibiting Pin1 and then simultaneously blocking multiple signaling pathways and cancer epithelial–mesenchymal progression. Since ATRA-NPs could effectively couple the inhibition of cancer cell dissemination with cancer growth, it provided a novel therapeutic strategy for efficiently inhibiting cancer metastasis.
Lifetime prevalence and knowledge of snakebite among graduates in Nigeria
Authors: Michael Godpower C , Grema Bukar A , Bala Auwal A , Olawumi Abdulgafar L , Gana Aisa A , Madaki Jeremiah K A , Habib Abdulrazaq G
Published: February 2023

Background

Given the lack of studies on snakebite envenoming knowledge in the general population, we examined the lifetime prevalence of snakebite and knowledge of snakebite and its prevention and first aid among recent Nigerian graduates in national service.

Methods

This questionnaire-based cross-sectional study involved 351 consenting national youth corps members at a rural orientation camp in Kano, Nigeria.

Results

Participants’ mean age was 25.3±2.4 y. There were slightly more males (50.7%). Most attended universities (77.8%) and were mainly from the southwest (24.5%) and northeast (24.5%) geopolitical regions and the Yoruba tribe (24.7%). Their lifetime prevalence of snakebite was 4%. Their mean overall knowledge score was 6.8±3.1 out of 20. Only 0.9% had adequate knowledge. Gender (male; 7.2±3.1, t=2.83, p=0.0049), tribe (Yoruba; 7.5±2.9, F=2.968, p=0.0320), region (Southwest; 7.6±3.0, F=2.5289, p=0.0289) and nearly bitten by snake (7.8 ± 2.7, t=3.60, p=0.0004) were significantly associated with a higher mean knowledge score.

Conclusions

Their lifetime prevalence of snakebites is significant, while knowledge of snakebite is very inadequate. However, the national service camp activities period provides an opportunity for educational intervention needed to raise their knowledge to optimal levels that will enable them serve as better snakebite prevention agents, as they will be working in rural communities where snakebite might be prevalent.
Characterizing a century of genetic diversity and contemporary antigenic diversity of N1 neuraminidase in influenza A virus from North American swine
Authors: Hufnagel David E , Young Katharine M , Arendsee Zebulun W , Gay L Claire , Caceres C Joaquin , Rajão Daniela S , Perez Daniel R , Vincent Baker Amy L , Anderson Tavis K
Published: February 2023

Influenza A viruses (IAVs) of the H1N1 classical swine lineage became endemic in North American swine following the 1918 pandemic. Additional human-to-swine transmission events after 1918, and a spillover of H1 viruses from wild birds in Europe, potentiated a rapid increase in genomic diversity via reassortment between introductions and the endemic classical swine lineage. To determine mechanisms affecting reassortment and evolution, we conducted a phylogenetic analysis of N1 and paired HA swine IAV genes in North America between 1930 and 2020. We described fourteen N1 clades within the N1 Eurasian avian lineage (including the N1 pandemic clade), the N1 classical swine lineage, and the N1 human seasonal lineage. Seven N1 genetic clades had evidence for contemporary circulation. To assess antigenic drift associated with N1 genetic diversity, we generated a panel of representative swine N1 antisera and quantified the antigenic distance between wild-type viruses using enzyme-linked lectin assays and antigenic cartography. Within the N1 genes, the antigenic similarity was variable and reflected shared evolutionary history. Sustained circulation and evolution of N1 genes in swine had resulted in a significant antigenic distance between the N1 pandemic clade and the classical swine lineage. Between 2010 and 2020, N1 clades and N1–HA pairings fluctuated in detection frequency across North America, with hotspots of diversity generally appearing and disappearing within 2 years. We also identified frequent N1–HA reassortment events (n = 36), which were rarely sustained (n = 6) and sometimes also concomitant with the emergence of new N1 genetic clades (n = 3). These data form a baseline from which we can identify N1 clades that expand in range or genetic diversity that may impact viral phenotypes or vaccine immunity and subsequently the health of North American swine.
Trade Shocks, Population Growth, and Migration
Authors: Fernández Guerrico Sofía
Published: February 2023

This paper examines the effect of trade-induced changes in Mexican labor demand on population growth and migration responses at the local level. It exploits cross-municipality variation in exposure to a change in trade policy between the United States and China that eliminated potential tariff increases on Chinese imports, negatively affecting Mexican manufacturing exports to the United States. Municipalities more exposed to the policy change, via their industry structure, experienced greater employment loss. In the five years following the change in trade policy, more exposed municipalities experience increased population growth, driven by declines in out-migration. Conversely, 6 to 10 years after the change in trade policy, exposure to increased trade competition is associated with decreased population growth, driven by declines in in-migration and return migration rates, and increased out-migration. The sluggish regional adjustment is consistent with high moving costs and transitions across sectors in the short term.
A Close Look into the Composition and Functions of Fungal Extracellular Vesicles Produced by Phytopathogens
Authors: Maximo Marina F. , Fill Taícia P. , Rodrigues Marcio L.
Published: February 2023

Fungal extracellular vesicles (EVs) were first described in human pathogens. In a few years, the field of fungal EVs evolved to include several studies with plant pathogens, in which extracellularly released vesicles play fundamental biological roles. In recent years, solid progress has been made in the determination of the composition of EVs produced by phytopathogens. In addition, EV biomarkers are now known in fungal plant pathogens, and the production of EVs during plant infection has been demonstrated. In this manuscript, we review the recent progress in the field of fungal EVs, with a focus on plant pathogens.

[Formula: see text] The author(s) have dedicated the work to the public domain under the Creative Commons CC0 “No Rights Reserved” license by waiving all of his or her rights to the work worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law, 2023.
Knowledge Gaps, Research Needs, and Opportunities in Plant Disease Diagnostic Assay Development and Validation
Authors: Geiser David M. , Martin Frank N. , Espindola Andres S. , Brown Judith K. , Bell Terrence H. , Yang Yinong , Kang Seogchan
Published: February 2023

Sequence-based identification and detection technologies have revolutionized plant disease diagnostics in the last few decades, opening the door to highly selective and specific diagnostic assays. However, diagnostic assay development and validation remain hindered by many factors that would be ameliorated by research prioritization and coordination. Massive amounts of sequence data, in the forms of evolutionarily informative markers and now whole genomes, are available yet not easily accessible or properly organized to guide efficient assay development and deployment. For many key pathogen groups, particularly those that are not easily culturable, data are scant. Identification of pathogen-specific sequences in microbial genomes, the ultimate diagnostic markers, requires massive data processing and is slowed by a lack of quality data curation pipelines that efficiently translate data into problem solving. New technologies have the potential to enable detection at extremely low titers, but many of these have not yet found their way into diagnostic labs, much less the field. Here, we review the current status of diagnostics readiness in select groups of pathogens and pathosystems and define research priorities to fill knowledge and resource gaps to support scientists engaged in diagnostics. These priorities include improved coordination of data generation and curation and validation of new technologies, such as LAMP, MiFi, RPA, and CRISPR-Cas, to accelerate the implementation of more specific and sensitive assays. Finally, novel approaches, such as detection of volatile profiles and microbiome analyses, have the potential to complement pathogen diagnostics focusing on specific pathogens.

[Formula: see text] The author(s) have dedicated the work to the public domain under the Creative Commons CC0 “No Rights Reserved” license by waiving all of his or her rights to the work worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law, 2023.
Immunogenicity of peptide‐based vaccine composed of epitopes from Echinococcus granulosus rEg.P29
Authors: Lv Yongxue , Chang Liangliang , Yang Jihui , Wen Jia , Zhao Yinqi , Zhu Mingxing , Wu Changyou , Zhao Wei
Published: February 2023

Echinococcus granulosus is one of the main causes of economic loss in the livestock industry because of its food‐borne transmission. Cutting off the transmission route is a valid prevention method, and vaccines are the most effective means of controlling and eliminating infectious diseases. However, no human‐related vaccine has been yet marketed. As a genetic engineering vaccine, recombinant protein P29 of E. granulosus (rEg.P29) could provide protection against deadly challenges. In this study, we generated peptide vaccines (rEg.P29T, rEg.P29B, and rEg.P29T+B) based on rEg.P29 and an immunized model was established by subcutaneous immunization. Further evaluation showed that peptide vaccine immunization in mice induced T helper type 1 (Th1)‐mediated cellular immune responses, leading to high levels of rEg.P29 or rEg.P29B‐specific antibodies. In addition, rEg.P29T+B immunization can induce a higher antibody and cytokine production level than single‐epitope vaccines, and immune memory is also longer. Collectively, these results suggest that rEg.P29T+B has the potential to be developed as an efficient subunit vaccine for use in areas where E. granulosus is endemic.
Diagnostic imaging for elbow TRASH lesions in children and usefulness of ultrasonography using standard planes
Authors: Shintani Kosuke , Hosomi Ryo , Suzuki Keisuke , Hidaka Noriaki , Nakagawa Keisuke , Kitano Toshio
Published: February 2023

Fractures around the elbow in children should be carefully evaluated because the main portion is cartilaginous, and radiographs are not completely reliable. This study aimed to assess the diagnostic imaging for pediatric elbow fractures that require special attention and consider the usefulness of ultrasonography with seven standard planes for the diagnosis. Patients diagnosed with elbow fractures wherein TRASH (The Radiographic Appearance Seemed Harmless) lesions were evaluated retrospectively. The diagnoses on initial radiographs, final diagnoses, additional imaging excluding radiographs, and the treatments were investigated. The standard planes for ultrasonography to detect elbow fractures included an anterior transverse scan at the level of the capitellum and proximal radioulnar joint, an anterior longitudinal scan at the level of the humeroradial and humeroulnar joints, a longitudinal scan along the lateral and medial border of the distal humerus, and a posterior longitudinal scan at the level of the distal humerus. A total of 107 patients with an average age of 5.8 years (range, 0–12 years) at the time of diagnosis were included. Of 46 (43.0%) patients misdiagnosed at the initial radiograph, 19 (17.8%) needed additional treatments due to inappropriate initial management. Ultrasonography using the standard planes was useful for prompt diagnosis and appropriate treatment. Prompt and appropriate evaluation with ultrasonography can prevent the mismanagement of pediatric elbow injuries. Level of evidence: Level IV-retrospective case series.
Technique for facilitating closed reduction of difficult flexion type supracondylar humeral fracture in children
Authors: Badawy Mahmoud , Amin Hosam El-Din , Abdel-Ghani Hisham , Abdelaal Ali Hussein , Yasin Ebeed
Published: February 2023

The displaced flexion type supracondylar humeral fractures (SCHF) are inherently unstable and there is great intraoperative difficulty in obtaining and maintaining the fracture reduction by closed means. We introduced a technique for closed reduction and K-wires pinning of displaced flexion type SCHF. Fourteen patients with flexion-type SCHF (9 boys and 5 girls) underwent a reduction technique using a construct of three K-wires. The proximal wire was used for rotational control of the proximal fragment and the two distal wires were used for correction of the flexion and rotational deformity of the distal fragment. The patient’s mean age was 7 (6–11) years. Results were evaluated by the anterior humeral line, Baumann’s angle, carrying angle radiographically and Flynn’s criteria clinically. The mean time for the union was 4.8 (4–6)  weeks. The anterior humeral line passed through the middle one-third of the capitulum in 12 patients and the anterior third in two patients. The mean Baumann’s angle was 19.60 ± 3.8 and the mean carrying angle was 14.21 ± 3.04. We reported no cases of failed closed reduction. The median operation time in this study was 30 (25–40)  min. The mean number of C-arm images was 33.5 ± 5.23. According to Flynn’s criteria; 10 cases (71.4%) were excellent and 4 (28.6%) were good. This technique can achieve the accurate reduction of flexion type SCHF and avoid the complications of both repeated closed reduction trials and open reduction. Level of Evidence: Level IV, case series.
Surgery for foot deformities in MECP2 disorders: prevalence and risk factors
Authors: Kanashvili Bidzina , Shrader M Wade , Rogers Kenneth J. , Miller Freeman , Howard Jason James
Published: February 2023

Foot deformities in methyl-CpG binding protein 2 (MECP2) disorders are thought to be common, but reports are scant. The purpose of this study was to report the prevalence and type of foot deformities and surgical management for MECP2 disorders. In this retrospective, comparative study, all children presenting between June 2005 and July 2020, with a genetically confirmed MECP2-related disorder, were included. The primary outcome measure was the prevalence of surgery for foot deformities. Secondary outcomes included type and frequency of foot surgeries, age at surgery, ambulatory status, genetic severity, presence of scoliosis/hip displacement, seizures, and associated comorbidities. Chi-square testing was utilized for the analysis of risk factors. Fifty-six patients (Rett syndrome: N = 52, MECP2 duplication syndrome: N = 4; 93% female) met the inclusion criteria. The mean age at first presentation to orthopedics was 7.3 (SD, 3.9) years, with a final follow-up of 4.5 (SD, 4.9) years. Seven (13%) patients developed foot deformities, most commonly equinus or equinovarus (five patients, 71%), requiring surgical management. The remaining two patients had calcaneovalgus. The most common surgical procedure was Achilles tendon lengthening, followed by triple arthrodesis, at a mean age of 15.9 (range: 11.4–20.1)  years. Hip displacement (P = 0.04), need for hip surgery (P = 0.001) and clinically relevant scoliosis (P = 0.04) were significant risk factors for the development of symptomatic foot deformities. Although not as prevalent as scoliosis or hip displacement, foot deformities are still relatively common in MECP2 disorders, often necessitating surgical intervention to improve brace tolerance. Level of evidence: Level III – a retrospective comparative study.
Iliotibial band tightness and internal rotation of the tibia in the stance phase of running associated with patella instability
Authors: Šarčević Zoran , Tepavčević Andreja
Published: February 2023

Management of patellar instability is still a clinical challenge, especially in pediatric and adolescent athletes. The purpose of the study was to check the association between the positive apprehension test (which is a sign of patellar instability) and positive Ober’s test [which is a sign of a tight iliotibial band (ITB)] and the lower degree of internal rotation of the tibia in young athletes determined by inertial sensors. The participants of this observational case–control study were 56 young athletes aged 10–15. The moving patellar apprehension test for lateral patellar instability and Ober’s test for assessing the flexibility of the ITB were performed on all participants. There were 32 sides with positive apprehension tests (cases) and 80 with negative apprehension tests (controls). The degree of internal rotation of the tibia was determined with an inertial sensor. Internal rotation of the tibia in the stance phase of running was lower in the case group than in the control group. Logistic regression analysis showed that the degree of internal rotation of the tibia in the stance phase of running was a good predictor of patellar instability. Our study illustrates that wearable devices can be valuable in determining possible initial patellar instability. Using inertial sensors, a strong association between patellar instability, ITB tightness, and lower internal rotation of the tibia in the stance phase of running was determined. The significance of this study might be the possibility of preventing damage or dislocations of the patella by improving the elasticity of the ITB, which is particularly relevant since patellar instability is common among adolescents.
High cut-off membranes in patients requiring renal replacement therapy: a systematic review and meta-analysis
Authors: Zhou Zhifeng , Kuang Huang , Wang Fang , Liu Lu , Zhang Ling , Fu Ping
Published: February 2023

Background:

Whether high cut-off (HCO) membranes are more effective than high-flux (HF) membranes in patients requiring renal replacement therapy (RRT) remains controversial. The aim of this systematic review was to investigate the efficacy of HCO membranes regarding the clearance of inflammation-related mediators, β2-microglobulin and urea; albumin loss; and all-cause mortality in patients requiring RRT.

Methods:

We searched all relevant studies on PubMed, Embase, Web of Science, the Cochrane Library, and China National Knowledge Infrastructure, with no language or publication year restrictions. Two reviewers independently selected studies and extracted data using a prespecified extraction instrument. Only randomized controlled trials (RCTs) were included. Summary estimates of standardized mean differences (SMDs) or weighted mean differences (WMDs) and risk ratios (RRs) were obtained by fixed-effects or random-effects models. Sensitivity analyses and subgroup analyses were performed to determine the source of heterogeneity.

Results:

Nineteen RCTs involving 710 participants were included in this systematic review. Compared with HF membranes, HCO membranes were more effective in reducing the plasma level of interleukin-6 (IL-6) (SMD −0.25, 95% confidence interval (CI) −0.48 to −0.01, P 
= 0.04, I
2 = 63.8%); however, no difference was observed in the clearance of tumor necrosis factor-α (TNF-α) (SMD 0.03, 95% CI −0.27 to 0.33, P = 0.84, I
2 = 4.3%), IL-10 (SMD 0.22, 95% CI −0.12 to 0.55, P = 0.21, I
2 = 0.0%), or urea (WMD −0.27, 95% CI −2.77 to 2.23, P = 0.83, I
2 = 19.6%). In addition, a more significant reduction ratio of β2-microglobulin (WMD 14.8, 95% CI 3.78 to 25.82, P = 0.01, I
2 = 88.3%) and a more obvious loss of albumin (WMD −0.25, 95% CI −0.35 to −0.16, P < 0.01, I
2 = 40.8%) could be observed with the treatment of HCO membranes. For all-cause mortality, there was no difference between the two groups (RR 1.10, 95% CI 0.87 to 1.40, P = 0.43, I
2 = 0.0%).

Conclusions:

Compared with HF membranes, HCO membranes might have additional benefits on the clearance of IL-6 and β2-microglobulin but not on TNF-α, IL-10, and urea. Albumin loss is more serious with the treatment of HCO membranes. There was no difference in all-cause mortality between HCO and HF membranes. Further larger high-quality RCTs are needed to strengthen the effects of HCO membranes.
Current status and future perspectives of bispecific antibodies in the treatment of lung cancer
Authors: Wang Wanying , Qiu Tianyu , Li Fei , Ren Shengxiang
Published: February 2023

Monoclonal antibodies have been successfully incorporated into the current therapeutical landscape of lung cancer in the last decades. Recently, with technological advances, bispecific antibodies (bsAbs) have also shown robust efficacy in the treatment of malignant cancers, including lung cancer. These antibodies target two independent epitopes or antigens and have been extensively explored in translational and clinical studies in lung cancer. Here, we outline the mechanisms of action of bsAbs, related clinical data, ongoing clinical trials, and potent novel compounds of various types of bsAbs in clinical studies, especially in lung cancer. We also propose future directions for the clinical development of bsAbs, which might bring a new era of treatment for patients with lung cancer.
Efficacy and Safety of Gonioscopy-Assisted Transluminal Trabeculotomy for Primary Congenital Glaucoma
Authors: Aktas Zeynep , Ozmen Mehmet C. , Ozdemir Zeydanli Ece , Oral Merve , Eskalen Oğuzcan
Published: February 2023

Précis:

Gonioscopy-assisted transluminal trabeculotomy (GATT) provided effective intraocular pressure (IOP) control in primary congenital glaucoma (PCG). Also, approximately two third of patients did not need antiglaucoma medication at an average follow-up of 1 year after surgery.

Purpose:

The purpose of this study was to assess the safety and efficacy of GATT surgery in eyes with PCG.

Materials and Methods:

This study is a retrospective review of patients who underwent GATT surgery for PCG. Outcome measures were changes in IOP and number of medications at all time points (1, 3, 6, 9, 12, 18, 24, and 36 mo after surgery), and success rates. Success was defined as IOP<21 mm Hg with at least a 30% reduction from the baseline, complete if without medications, or qualified if with or without medications. Cumulative success probabilities were analyzed using the Kaplan-Meier survival analyses.

Results:

Twenty-two eyes of 14 patients diagnosed with PCG were enrolled in this study. The mean IOP reduction was 13.1 mm Hg (57.7%) with a mean decrease of 2 glaucoma medications at the final follow-up. All mean IOP readings during postoperative follow-up were significantly lower than baseline (P<0.05 for all). Cumulative probability of qualified success was 95.5% and the cumulative probability of complete success was 66.7%.

Conclusion:

GATT was safe and successfully lowered IOP in patients with PCG with the advantage of avoiding conjunctival and scleral incisions.
Outcomes of Selective Laser Trabeculoplasty After Prior Incisional Surgery for Open Angle Glaucoma
Authors: Wu Connie M. , Zheng Cindy X. , Kuley Brandon , Wong Jae-Chiang , Lin Michael M. , Moster Stephen J. , Moster Marlene R. , Schmidt Courtland , Pro Michael J. , Lee Daniel
Published: February 2023

Précis:

This retrospective case series of patients with open angle glaucoma and prior trabeculectomy or tube shunt surgery found that selective laser trabeculoplasty (SLT) resulted in significant intraocular pressure (IOP) reductions in the intermediate follow-up period in select cases.

Purpose:

The purpose of this study was to assess the IOP-lowering effect and tolerability of SLT after prior trabeculectomy or tube shunt surgery.

Materials and Methods:

Open angle glaucoma patients at Wills Eye Hospital who previously underwent incisional glaucoma surgery and subsequently received SLT between 2013 and 2018 were included, along with an age-matched control group. Baseline characteristics, procedural data, and post-SLT data were recorded at 1, 3, 6, 12 months, and most recent visit. The primary success of SLT treatment was defined as IOP reduction of 20% or greater without the use of additional glaucoma medications compared to pre-SLT IOP. Secondary success was defined as IOP reduction ≥20% with the use of additional glaucoma medications compared to pre-SLT IOP.

Results:

There were 45 eyes in the study group and 45 eyes in the control group. In the study group, IOP decreased from a baseline of 19.5±4.7 mm Hg on 2.2±1.2 medications to 16.7±5.2 mm Hg (P=0.002) on 2.2±1.1 glaucoma medications (P=0.57). In the control group, IOP decreased from 19.5±4.2 mm Hg on 2.4±1.0 medications to 16.4±5.2 mm Hg (P=0.003) on 2.1±1.3 medications (P=0.36). There was no difference in IOP reduction or change in number of glaucoma medications after SLT at any postoperative visit between the 2 groups (P≥0.12 for all). Primary success rates at 12 months were 24.4% for the control group and 26.7% for the prior incisional glaucoma surgery group with no significant difference between the groups (P=0.92). There were no persistent complications after SLT treatment in either group.

Conclusion:

SLT may effectively lower IOP in patients with open angle glaucoma who have had previous incisional glaucoma surgery and should be considered in select cases.
A Novel Visual Field Screening Program for Glaucoma With a Head-Mounted Perimeter
Authors: Arai Kota , Nishijima Euido , Ogawa Shumpei , Hosaka Daisuke , Itoh Yoshinori , Noro Takahiko , Okude Sachiyo , Okada Satomi , Yoshikawa Keiji , Nakano Tadashi
Published: February 2023

Précis:

A novel visual field screening program with a head-mounted perimeter ‘imo’ could detect glaucoma at all stages in a short time with high accuracy.

Purpose:

The present study aimed to examine the accuracy and availability of a novel glaucoma visual field screening program using a head-mounted visual perimeter ‘imo.’

Participants and Methods:

Eyes of 76 non-glaucoma participants and 92 glaucoma patients were examined. All patients underwent visual field tests using the Humphrey Visual Field Analyzer (30-2 or 24-2 Swedish Interactive Thresholding Algorithm standard program) and imo (the visual field screening program). We evaluated five visual field screening program indicators: sensitivity, specificity, positive predictive value, negative predictive value, and testing time. We also evaluated the ability of this visual field screening program to differentiate between glaucoma patients and normal controls using the receiver operating characteristic curves and areas under the receiver operating characteristic curves.

Results:

The sensitivity, specificity, positive predictive value, and negative predictive value of the visual field screening program were 76%–100%, 91%–100%, 86%–89%, and 79%–100%, respectively. The visual field screening program test time was 46±13 seconds for normal controls and 61±18, 82±21, and 105±16 econds, respectively for mild, moderate, and advanced-stage patients. The areas under the receiver operating characteristic curves were 0.77, 0.97, and 1.0 in the mild, moderate, and advanced stages, respectively.

Conclusions:

Visual field screening using a head-mounted perimeter ‘imo’ detected glaucoma at all stages in a short time with high accuracy.
Glaucoma and Telemedicine
Authors: Brandão-de-Resende Camilo , Alcântara Liliane de Abreu Rosa de , Vasconcelos-Santos Daniel Vítor , Diniz-Filho Alberto
Published: February 2023

Précis:

Teleglaucoma is the future, but there is a need for clearer regulation by government agencies and medical entities, as well as for studies to further demonstrate the cost-effectiveness and safety of teleglaucoma strategies at a global scale.

The coronavirus disease 2019 pandemic drastically impacted global health, forcing institutions to provide alternative models of safe and reliable health care. In this context, telemedicine has been successfully used to overcome distance barriers and improve access to medical services. Teleglaucoma is the application of telemedicine to screen and monitor glaucoma, a chronic and progressive optic neuropathy. Teleglaucoma screening aims to detect the disease at an earlier stage, especially in high-risk populations and underserved areas, also identifying patients who require more urgent treatment. Teleglaucoma monitoring seeks to provide remote management through virtual clinics, where classic in-person visits are replaced by synchronous data collection (clinical measurements) performed by non-ophthalmologists and asynchronous review (decision-making) by ophthalmologists. This may be employed for low-risk patients with early disease, improving health care logistics, reducing the number of face-to-face consultations, and saving time and costs. New technologies may also allow home monitoring of patients in teleglaucoma programs, with the addition of artificial intelligence methods, which are expected to increase the accuracy of remote glaucoma screening/monitoring and support clinical decision-making. However, for the incorporation of teleglaucoma into clinical practice, a complex system for collection, transfer, flow, and interpretation of data is still necessary, in addition to clearer regulatory markers by government agencies and medical entities.
V-shaped Folded Nasolabial Flap in the Repair of the Anterior Buccal Mucosal Defect
Authors: Lu Ruohuang , Huang Jiang , Guo Xincheng
Published: February 2023

Objective:

To investigate the efficacy of V-shaped folded nasolabial flap in the repair of small-sized and medium-sized defects of the anterior buccal mucosa.

Methods:

From March 2019 to December 2021, 9 cases of male patients with anterior buccal mucosal lesions were enrolled in this study. After the lesions were completely excised, the mucosa and part of the buccal mucosal defect were left. A transverse V-shaped folded nasolabial flap was created with the pedicle located at the corner of the mouth and the long axis along the nasolabial fold. The lower part was lifted from the end to the pedicle. Next, from the level of the superficial musculo-aponeurotic system, the upper and lower parts were lifted from the end to the pedicle, and the V-shaped flap was folded and turned over through the buccal tunnel to repair the mucosal defect. The extraoral donor site was directly pulled and sutured.

Results:

The nasolabial flap survived in 9 patients, and the wounds inside and outside the mouth healed at stage I. The postoperative follow-up time was 4 to 32 months, and the patients had no recurrence, with symmetrical buccal shape, and no traction and deformation in the affected buccal organs. In addition, the linear scar had no obvious hyperplasia and was hidden in the affected nasolabial folds, without symptoms of buccal nerve injury, and the shape of the corner of the mouth was normal. The width and opening degree of oral fissure were not significantly reduced compared with those before operation. Meanwhile, the intraoral flap was thin and flat, and healed well with the surrounding mucosa, without obvious flap contracture, buccal bite, or incomplete closure.

Conclusion:

Overall, V-shaped folded nasolabial flap has the advantages of flexible design, simple preparation, reliable blood supply, and protection of the donor site, which may be one of the effective methods for repairing small-sized and medium-sized defects in the anterior buccal mucosa.
Endoscopic Removal of a Retained Throat Pack: A Profound Lesson
Authors: Yang Chengshuai , Xu Xiaofeng , Shi Jun , Zhang Wenbin
Published: February 2023

Throat packing/pharyngeal packing is typically applied in all oral and maxillofacial surgeries. It prevents the entry of saliva, blood, disinfectant, other liquids, and oral foreign objects (brackets) into the trachea or esophagus. The retention of throat packing results in severe complications such as airway obstruction and digestive tract symptoms. We present a case of postextubation throat pack ingestion. The pack was identified and retrieved successfully from the gastrointestinal tract.
Uncommon Insidious Dumbbell-shaped Double Thyroglossal Duct Cyst
Authors: Guo Yang , Huang Qiang , Chen Hui , Xu Chengzhi
Published: February 2023

As one of the most common congenital neck masses, thyroglossal duct cyst (TGDC) developed from the residual ductal epithelial cells in any remnants of thyroglossal duct. However, the reports of double TGDCs were rare. A 60-year-old male was referred to our department because of the presentation of an anterior neck mass. Only a hypodense oval mass inferior to hyoid bone was shown by computed tomography. During the Sistrunk operation, the dumbbell-shaped double TGDCs with the hyoid bone as the pivot were excised. No recurrence was observed. Before surgery, ultrasonography and computed tomography or magnetic resonance imaging should be conducted to verify the locations and sizes of TGDCs. During Sistrunk procedure, the rims of hyoid bone should be checked to avoid possible duct remnants.
Morphologic Changes of the Temporomandibular Joint in Pruzansky-Kaban Type IIa Hemifacial Microsomia Postmandibular Distraction Osteogenesis
Authors: Shu kai-yi , Liu Wei , Zhao Jiu-li , Zhang Zhi-yong , Li Xi-yuan , Shan Ba-ga , Ma Lun-Kun , Liang Ying-xiang
Published: February 2023

Objective:

Mandibular distraction osteogenesis (MDO) is a powerful tool for the correction of hemifacial microsomia (HFM). The temporomandibular joint (TMJ) is the focus of attention in the diagnosis and treatment of HFM. This observational retrospective cross-sectional study aimed to investigate morphologic changes in TMJ post-MDO in type IIa HFM.

Methods:

We recruited 48 patients with unilateral type IIa HFM who had completed MDO and mandibular distractor extraction (MDE). Data relating to the length, distance, angle, and volume of the TMJ were measured on 3-dimension models created by the analysis of computed tomography data. Normality analysis was performed by using the Shapiro-Wilk test. Data were compared with the paired t test and Wilcoxon signed-ranks test.

Results:

The spaces between the affected condyle and the affected glenoid fossa before MDO were all significantly larger than before MDE (P<0.05). The breadth of the affected glenoid fossa before MDO was significantly longer than before MDE (P<0.001). The height of the affected condyle before MDO was significantly longer than before MDE (P<0.001). The volume of the affected condyle before MDO was significantly larger than before MDE (P<0.001). The ratio between the volume of the affected condyle and unaffected condyle before MDO was 0.20±0.13. The ratio between the volume of the affected condyle before MDE and MDO was 0.65±0.32. The resorption rate of the affected condyle post-MDO was 0.35±0.32.

Conclusion:

Herein, we characterized anatomic changes of the TMJ in type- IIa HFM post-MDO. Condylar resorption and the compression of space between the condyle and the glenoid fossa on the affected side were 2 typical manifestations. Our findings enhanced the understanding of the application of MDO on HFM.
Impact of COVID-19 Pandemic on Management and Outcomes of Acute Cholecystitis at US Academic Centers
Authors: Ruhi-Williams Perisa , Manasa Morgan , Fazl Alizadeh Reza , Sullivan Brittany , Kirby Katharine A , Amin Alpesh , Nguyen Ninh T
Published: February 2023

Background:

The COVID-19 pandemic has had wide-ranging effects on management of medical conditions. Many hospitals encountered staffing shortages, limited operating room availability, and shortage of hospital beds. There was increased psychological stress and fear of contracting COVID-19 infection leading to delay in medical care for various disease processes. The objective of this study was to examine changes in management and outcomes attributed to the COVID-19 pandemic in patients presenting with acute calculus cholecystitis at US academic centers.

Study Design:

Using the Vizient database, patients with the diagnosis of acute calculus cholecystitis who underwent intervention during the 15 months prior to the pandemic (pre-pandemic, October 2018 – December 2019) were compared to 15 months during the pandemic (pandemic, March 2020 – May 2021). Outcome measures included demographics, characteristics, type of intervention, length of stay (LOS), in-hospital mortality, and direct cost.

Results:

There were 146,459 patients with acute calculus cholecystitis identified (pre-pandemic: 74,605 vs. pandemic: 71,854). Patients in the pandemic group were more likely to undergo medical management (29.4% vs 31.8%; p<0.001) or percutaneous cholecystostomy tube placement (21.5% vs. 18%, p<0.001), and less likely to undergo laparoscopic cholecystectomy (69.8% vs 73.0%, p<0.001). Patients in the pandemic group who underwent procedural intervention had longer length of stay (6.5 days vs 5.9 days, p<0.001), higher in-hospital death (3.1% vs. 2.3%, p<0.001), and higher cost ($14,609 vs $12,570, p<0.001).

Conclusion:

In this analysis of patients with acute calculus cholecystitis, there were distinct changes in the management and outcomes of patients due to the COVID-19 pandemic. Changes in the type of intervention and outcomes are likely related to delayed presentation with increases in severity and complexity of the disease.
Differences in fungal communities in the fur of two- and three-toed sloths revealed by ITS metabarcoding
Authors: Rojas-Gätjens Diego , Avey-Arroyo Judy , Chaverri Priscila , Rojas-Jimenez Keilor , Chavarría Max
Published: February 2023

Sloths have dense fur on which insects, algae, bacteria and fungi coexist. Previous studies using cultivation-dependent methods and 18S rRNA sequencing revealed that the fungal communities in their furs comprise members of the phyla Ascomycota and Basidiomycota. In this note, we increase the resolution and knowledge of the mycobiome inhabiting the fur of the two- (Choloepus hoffmanni) and three-toed (Bradypus variegatus) sloths. Targeted amplicon metagenomic analysis of ITS2 nrDNA sequences obtained from 10 individuals of each species inhabiting the same site revealed significant differences in the structure of their fungal communities and also in the alpha-diversity estimators. The results suggest a specialization by host species and that the host effect is stronger than that of sex, age and animal weight. Capnodiales were the dominant order in sloths’ fur and Cladosporium and Neodevriesia were the most abundant genera in Bradypus and Choloepus, respectively. The fungal communities suggest that the green algae that inhabit the fur of sloths possibly live lichenized with Ascomycota fungal species. The data shown in this note offer a more detailed view of the fungal content in the fur of these extraordinary animals and could help explain other mutualistic relationships in this complex ecosystem.
Current Stroke Clinical Outcomes of Direct Anticoagulation Therapy in Patients with Valvular Atrial Fibrillation: A Scoping Review
Authors: Dabhi Nisha , Chu Lucy , Roach Necrisha , Chapman Sherita
Published: February 2023

While direct oral anticoagulants (DOACs) have been proven effective in stroke prevention in patients with non-valvular AF (NVAF), there is limited evidence-based guidance on DOAC use in valvular atrial fibrillation. This scoping review aims to examine clinical cerebrovascular outcomes and safety profiles within valvular AF (VAF) patients treated with DOACs. This scoping review was conducted following the Joanna Briggs Institute methodology for scoping reviews and reported consulting the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews checklist. Pubmed, OVID Medline and Web of Science databases were searched for manuscripts published from inception to July 25, 2022 and included based on pre-registered criteria. Data extraction included patient demographics, valvular disease and Afib classification, DOAC type, cerebro-cardiovascular outcomes variables, and bleeding risks. There were 12 studies with 69,741 VAF patients treated with DOACs. At the 12-month follow-up, acute ischemic stroke and major bleeding events occurred in 3.5% and 5.8% of these patients, respectively. DOACs in VAF were associated with similar clinical cerebrovascular outcomes with decreased risk of fatal bleeding rates when compared to warfarin. More controlled studies are needed to further assess the safety and efficacy of DOACs in this population.
Strigolactone-dependent gene regulation requires chromatin remodeling
Authors: Humphreys J.L. , Beveridge C. , Tanurdzic M.
Published: February 2023

Strigolactones (SL) function as plant hormones in control of multiple aspects of plant development. Regulation of gene expression by SL is a critical component of SL function. Immediate early gene regulation by SL remains unexplored due to difficulty in dissecting early from late gene expression responses to SL in whole plants. We used leaf-derived Arabidopsis protoplasts to explore early (5-180 minutes) changes in gene expression induced by SL by employing RNA-seq and ATAC-seq. We discovered over 1500 genes regulated by SL as early as 20 minutes, and up to 3669 genes across the entire time course of the experiment, indicative of rapid, dynamic regulation of gene expression in response to SLs. We identified 1447 regions of changing chromatin accessibility in response to SL that are likely to harbour SL cis-regulatory elements and cognate candidate trans-acting factors regulated early by SL. Importantly, we discovered that this extensive transcriptomic reprogramming requires the SYD-containing SWI/SNF chromatin remodelling complex(es) and regulates other chromatin remodellers. This study therefore provides the first evidence that SL signalling requires regulation of chromatin accessibility, and it identifies previously unknown transcriptional targets of strigolactones.

One sentence summary

Strigolactone regulated gene expression reprogramming requires chromatin remodelling by SPLAYED.