bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality Measurement and Patient Outcomes in Inpatient Behavioral Health: Assessing the Current Framework
Authors: Nowlin Rachel B. , Brown Sarah K. , Ingram Jessica R. , Smith Johan R.
Published: July 2021

Quality measurement across healthcare is undertaken with a goal of improving care and outcomes for patients; however, the relationship between quality measurement and patient outcomes remains largely untested, particularly in inpatient behavioral health. Using a retrospective quantitative design, we assessed 142 behavioral health organizations' quality data submitted to the Hospital-Based Inpatient Psychiatric Services and Inpatient Psychiatric Facility Quality Reporting programs from 2017 to 2018 and tested relationships between compliance on 16 quality measures and symptom improvement on patient self-report outcomes (SROs) at the facility level. Performance on many quality measures was negatively skewed (at least four have almost no room for improvement on average), and there was high interrelatedness between most quality measures. Nine of the assessed measures correlated with patient SROs but not in clear groupings. Findings indicate that an underlying organizational construct may be driving compliance rates on quality measures, but the measures are not linked to treatment outcomes as expected. We encourage an expansion of the current framework of behavioral health quality measurement beyond process and organization and suggest the addition of patient outcomes such as SROs as quality measures to directly assess patient improvement.
Quality of Life and Associated Factors in Older Adults With Heart Failure
Authors: YEH Hsiang-Fen , SHAO Jung-Hua
Published: July 2021

Background

Although heart failure (HF) is negatively known to affect older adults physically, psychologically, and socially, only a few studies have explored the predictors of quality of life (QoL) in older adults with HF in Taiwan.

Purpose

This study was designed to determine the relationships among depression, demographic characteristics, clinical characteristics, and QoL in older patients with HF.

Methods

This was a cross-sectional study. From January 2013 to June 2014, convenience sampling was used to collect data from 175 older adults with HF at two hospitals in Northern Taiwan. Participant data were collected from medical records and researcher-administered structured questionnaires in face-to-face interviews.

Results

The QoL of the participants was found to be associated with clinical characteristics, including hospital readmission for > 10 days with an increased level of HF-related symptom distress (HFSD) and more-severe depression. Depression was found to have a mediating effect, with the New York Heart Association (NYHA) functional class and HFSD both affecting the QoL of the participants through this intermediary.

Conclusions/Implications for Practice

HF is a chronic and debilitating disease that often reduces QoL in older adults significantly. Interventions designed to increase QoL by improving the NYHA functional class and alleviating HFSD are valid treatment options only in cases with depressive symptoms. Nurses treating older adults with HF should consider factors such as NYHA functional class and HFSD to reduce HFSD and readmission rates and to enhance the QoL of these patients. In addition, after both hospital admission and discharge, older adult patients should be assessed regularly to monitor for and quickly address the development of comorbid depression.
A Cross-Sectional Study of the Mismatch Between Telecommuting Preference and Frequency Associated With Psychological Distress Among Japanese Workers in the COVID-19 Pandemic
Authors: Otsuka Souhei , Ishimaru Tomohiro , Nagata Masako , Tateishi Seiichiro , Eguchi Hisashi , Tsuji Mayumi , Ogami Akira , Matsuda Shinya , Fujino Yoshihisa
Published: July 2021

Objective:

To examine how the mismatch between telecommuting preference and telecommuting frequency was associated with psychological distress during the COVID-19 pandemic.

Methods:

Data from 33,302 workers throughout Japan were obtained using an Internet survey. Among 33,302 participants, 20,395 who telecommuted were included in the analysis. Participants’ telecommuting preference and frequency during the COVID-19 pandemic were determined using a questionnaire. Psychological distress was assessed using Kessler 6 (K6).

Results:

Among participants who did and did not prefer to telecommute, those who telecommuted four or more days per week had an OR of psychological distress of 0.67 (P < 0.001) and 1.87 (P = 0.001), respectively, compared with those who rarely telecommuted.

Conclusions:

The association between telecommuting and psychological distress differs depending on telecommuting preference.
The Effect of Noise on the Neurobehavioral Function of the Occupational Population and the Content of Catecholamines
Authors: Zhou Yu , Wang Wen , Liu Ya , Xie Libo , Tang Yan
Published: July 2021

According to the decibel level of noise detection in the working environment, the research objects were divided into high noise group (more than 85 dB), low noise group (55 to 85 dB), and control group (less than 55 dB), the neurobehavioral core test battery (NCTB) was used to systematic tests all workers, radioimmunoassay was used to detect plasma catecholamine levels, and the relationship between noise intensities and the levels of plasma catecholamine was analyzed by canonical correlation. The result shows noise exposure will affect workers’ neurological function and the influence of noise on neurobehavioral function may be related to the increase of the levels of norepinephrine and dopamine in the plasma and the inhibition of the synthesis of epinephrine of noise-exposed workers.
CC16 as a Marker of COE-Induced the Early Change of Blood Composition of Coke Oven Workers
Authors: Zhang Huadong , Chen Fengqiong , Deng Huaxin , Ran Ruihong , He Zhijun
Published: July 2021

Objective:

This project aims to enhance the occupational health insurance for coke oven workers.

Methods:

A total of 136 coke oven emissions workers and 61 oxygen plant workers were recruited to receive physical examinations. The coke oven emissions concentration at the workplace was measured by weighing method. The CC16 concentration was detected by enzyme-linked immunosorbent assay.

Results:

Logistic regression analysis revealed that exposure to coke oven emissions was correlated with CC16. Correlation analysis revealed that CC16 was related to some physical examination indicators. Multivariate general linear models showed that CC16 was indeed positively correlated with albumin after adjusting for confounding factors.

Conclusions:

Coke oven emissions affected multiple tissues and multiple systems. The blood system might be the earliest system affected and could be detected by the CC16 protein concentration.
Effects of High and Moderate-Intensity Interval Training on Pulmonary and Performance Parameters in Miners Suffering From Chronic Obstructive Pulmonary Diseases
Authors: Batajrobeh Abdolhakim , Ahmadi Mohsen Mohammadnia , Mogharnasi Mehdi
Published: July 2021

Objective:

To characterize the effect of 12 weeks of high and moderate-intensity interval training on pulmonary and functional parameters in miners with chronic obstructive pulmonary disease working in the polluted environment.

Methods:

Forty-five miners with COPD (average degree: 60 > FEV1 < 70), were randomly divided into HIIT (with 100%–125% ISWT); MIIT (with 60%–85% ISWT), and control. The study period was 12 weeks (3 sessions per week). At the beginning and end of the study, pulmonary and functional indices was evaluated.

Results:

Based on results, HIIT and MIIT significantly increased FVC, FEV1, and mean traveled distance in ISWT compared with control. Comparison of training intensities showed that HIIT led to a significant change in FVC, FEV1, and ISWT record compared to MIIT.

Conclusion:

It is suggested that miners suffering from COPD, consider HIIT as part of their treatment plan.
Similar Benefits Seen After Radial Extracorporeal Shockwave Therapy or Autologous Blood Injection in Patients With Chronic Plantar Fasciitis—A Retrospective Cohort Study
Authors: Wheeler Patrick C. , Dudson Chloe
Published: July 2021

Objective:

To compare the outcomes for patients with chronic plantar fasciitis after extracorporeal shockwave therapy (ESWT) or autologous blood injection (ABI).

Design:

Cohort study—retrospective analysis of prospectively collected data.

Setting:

Hospital-based Sports Medicine Outpatient Clinic.

Patients:

One hundred two consecutive patients with chronic plantar fasciitis, treated with either radial-ESWT (rESWT) (n = 54) or ABI (n = 48), with minimum 3-month follow-up and 96% (98/102) having 6-month follow-up. Mean age 49.5 years and mean duration of symptoms 37.5 months before treatment.

Interventions:

Patients received either 3 sessions of radial ESWT (one session per week for 3 weeks), or a single ultrasound-guided dry needling and ABI (3 mL whole autologous blood). All patients received standardized after-care, including progressive structured home exercise program of flexibility, strengthening, and proprioception exercises.

Main Outcome Measures:

0 to 10 numerical rating scale (NRS) for self-reported “average pain” and “average stiffness” values. Secondary outcome measures included assessments of local foot function [including Manchester-Oxford Foot Questionnaire (MOXFQ), revised-Foot Function Index] as well as markers of mental health functioning (HAD), global health (EQ-5D-5L), and physical activity (International Physical Activity Questionnaire).

Results:

This study demonstrated statistically significant improvements in self-reported measures of pain and local foot function after either procedure at 6 weeks, 3 months, and 6 months, but no statistically significant differences were seen between groups at any time-period studied. At 6 months, the average pain using a 0 to 10 NRS was improved from 6.8 ± 1.8 to 4.0 ± 2.7 (P < 0.001) after ESWT and from 7.1 ± 1.6 to 3.8 ± 2.7 (P < 0.001) after ABI. At 6 months, significant improvements were seen following either group using a number of different validated patient-rated outcome measures assessing local foot pain and function, eg, the total score for MOXFQ improved from 56.1 ± 12.8 to 42.5 ± 16.6 (P < 0.001) after ESWT and from 58.8 ± 13.2 to 44.2 ± 19.2 (P < 0.001) after ABI. However, measures of physical activity or wider aspects of patient functioning did not consistently improve from baseline values to follow-up periods.

Conclusions:

Patients with chronic plantar fasciitis improved to statistically significant extent after either rESWT or ABI procedures, with no significant differences seen between groups. The lack of randomization in this pragmatic study is noted, which may have influenced the outcome seen. Potentially larger and more robust studies are required to investigate this treatment comparison further.
The association of dynamic thiol–disulphide balance with white-coat hypertension
Authors: Genç Ömer , Quisi Alaa , Harbalioğlu Hazar , Alici Gokhan , Allahverdiyev Samir , Yildirim Abdullah , Er Fahri , Topuz Mustafa , Gür Mustafa , Kurt İbrahim Halil , Erel Özcan
Published: July 2021

Objective

Dynamic thiol–disulphide homeostasis is an indicator of the antioxidant system that interacts early with the oxidative environment. This study aimed to assess the dynamic thiol/disulphide balance in individuals with white-coat hypertension (WCH).

Methods

This cross-sectional study included a total of 117 individuals who presented to our outpatient cardiology clinic. Seventy patients were diagnosed with WCH. All blood samples were obtained from the patients after a minimum of 8 h of fasting, centrifuged immediately, stored in Eppendorf tubes, and protected at −80°C.

Results

The two groups were well-balanced in terms of age, gender, and BMI. Native thiol and total thiol levels were lower in the WCH group than in normotensive individuals. However, disulphide levels were higher in the former. Serum disulphide concentration positively correlated with 24-h SBP, and 24-h DBP. In backward stepwise logistic regression analysis, serum disulphide [odds ratio (OR) = 1.165 (1.089–1.245), 95% confidence interval (CI), P < 0.001] and serum total thiol levels [OR = 0.992 (0.984–1.000), 95% CI, P = 0.050] were independently associated with WCH.

Conclusion

We demonstrated that dynamic thiol/disulphide balance shifted strongly towards disulphide formation due to thiol oxidation in patients with WCH.
Effects of acupuncture at acupoints along lung meridian on cervical spondylosis of cervical type
Authors: Fan Lin , Lu Gang , Yuan Haiguang , Wang Xiangyang , Qiao Haifa
Published: July 2021

Background:

Cervical spondylosis is a disorder of the neck, shoulder, and back due to degenerative changes of the cervical intervertebral disc, muscles, ligament, and bones. Previous trails have shown that acupuncture contributes to relieving patients with cervical spondylosis. We aim to determine the efficacy of acupuncture at acupoints on the lung meridian for cervical spondylosis.

Methods:

A total of 64 patients diagnosed with cervical spondylosis of cervical type using visual analog scale scores and range of motion of the cervical spine as measures of injury, will be recruited. Patients are to be randomly assigned to two groups, those treated with acupoints either on the Lung Meridian or Heart Meridian at a 1:1 allocation ratio. Patients in the group treated with acupoints on Lung Meridian will receive acupuncture at LU 7 (Lieque) and LU 5 (Chize) while the group treated with acupoints on Heart Meridian will receive acupuncture at HT 4 (Lingdao) and HT 3 (Shaohai). Both groups will receive 2-weeks of treatment over 6 sessions. Treatment outcomes, including visual analog scale score, range of motion of the cervical spine, muscle assessment, musculoskeletal ultrasound, MRI, the MOS 36-item short-form health survey scale, neck disability index, self-rating anxiety scale, self-rating depression scale, complete blood count, C-reactive protein, erythrocyte sedimentation rate, functional magnetic resonance imaging, and diffusion tensor imaging are recorded at baseline, after 4 weeks (at the end of 2-weeks of intervention), 8 weeks (after the 4-week follow-up examination) and 16 weeks (after the 12-week follow-up examination).

Discussion:

We aim to demonstrate the efficacy and safety of acupuncture at acupoints along the Lung Meridian and verify that it counters cervical spondylosis of cervical type. The results will not only justify selecting acupoints on this meridian for this form of neck pain but provide optimized guidance for the treatment of other disorders by acupuncture.
Myopericytoma in the knee joint
Authors: Takeda Koji , Nakamura Mitsuhiro , Soda Yoshinori , Adachi Nobuo
Published: July 2021

Introduction:

Myopericytoma is a relatively new disease entity described by Granter and colleagues in 1998. It is a benign tumor classified as a pericytic/perivascular tumor. Myopericytomas are most commonly seen in the dermis and subcutaneous soft tissue of the peripheral extremities of adults, but some rare reports indicate that myopericytoma can occur in the deep soft tissue around the knee joint. We report a case of a woman in her 30s with myopericytoma around the knee joint.

Patient concerns:

A 30-year-old woman presented with popliteal pain that increased during deep knee flexion in the left knee.

Diagnosis:

Magnetic resonance imaging showed a cystic lesion behind the posterior cruciate ligament. An intra-articular lesion was suspected, we performed arthroscopy; however, no lesions were observed. An additional contrast-enhanced magnetic resonance imaging showed a strong contrast effect in the lesion and surrounding soft tissue. We suspected chronic lymphadenitis, hemangiomas, and neoplastic lesions, and an excisional biopsy was performed.

Interventions:

Through the Burks approach, we performed an excisional biopsy. Based on the characteristic spindle-shaped cell array and immunohistochemistry, the diagnosis was myopericytoma.

Outcomes:

Six months after surgery, the patient was doing well with no pain.

Conclusion:

Although myopericytoma is difficult to diagnose preoperatively, it is a disease that should be differentiated from the tumor around the knee joint. The key for diagnosing this disease is histopathological and immunohistochemistry examination.
An unusual case of acute cholecystitis following anterior lumbar interbody fusion
Authors: Kim Ju-Hwi , Kim Sang-Heon , Kim Sang-Kyou , Lee Min-Cheol , Kim In-Hwan , Kim Soo-Han , Lee Jung-Kil
Published: July 2021

Introduction:

Acute acalculous cholecystitis is also likely to occur in critical systemic conditions, such as trauma, burns, and postoperative situations. Here, we report a rare case of acute cholecystitis after anterior lumbar interbody fusion (ALIF).

Patient concerns:

A 75-year-old female experienced low-grade fever (< 38.3°C), following ALIF of L4–5. On postoperative day 3, the patient exhibited acute jaundice without abdominal discomfort.

Diagnosis:

Laboratory investigations revealed elevated values for liver function tests and bilirubin levels (aspartate aminotransferase, 79 IU/L; alanine aminotransferase, 56 IU/L; total bilirubin, 7.6 mg/dL; and direct bilirubin 4.1 mg/dL), with no prominent abnormalities, such as stones or dilatation of the hepatobiliary tract, on abdominal computed tomography. However, endoscopic ultrasound revealed diffuse thickening of the gallbladder (GB) wall and large amounts of echogenic material in the GB lumen, suggesting acute cholecystitis with GB sludge.

Interventions:

Emergency endoscopic retrograde cholangiopancreatography and biliary drainage were performed by inserting a single-tail catheter through the biliary tract.

Outcomes:

Clinical symptoms, including skin jaundice and icteric sclera, gradually improved, and the patient was discharged 13 days after the surgery. Liver function tests and bilirubin levels were normalized in the final laboratory investigations during the hospitalization period (aspartate aminotransferase. 26 IU/L; alanine aminotransferase. 16 IU/L; total bilirubin, 2.1 mg/dL; direct bilirubin, 0.9 mg/dL; and C-reactive protein, 0.21 mg/dL).

Conclusion:

Spinal surgeons should be aware of the possibility of biliary complications after ALIF. In particular, postoperative cholecystitis in elderly patients has a poor prognosis; therefore, early diagnosis and intervention are the only ways to improve the prognosis.
The therapeutic properties of ketogenic diets, slow-wave sleep, and circadian synchrony
Authors: O’Hearn L. Amber
Published: July 2021

Purpose of review

To summarize emerging connections between sleep, ketogenic diets, and health.

Recent findings

Mechanisms involved in the therapeutic benefits of ketogenic diets continue to be elucidated. Concurrently, the importance of sleep quality and circadian rhythms in their effects on metabolic and cognitive health is increasingly appreciated. Advances in the understanding of the actions of adenosine, nicotinamide adenine dinucleotide, and slow-wave sleep underscore connections between these areas of research.

Many molecular pathways activated during ketogenic diets are known to modulate sleep–wake cycles, circadian rhythms, and sleep stages. Ketogenic diets often have beneficial effects on sleep at the same time as having beneficial effects on particular medical conditions. Enhancement of slow-wave sleep and rejuvenation of circadian programming may be synergistic with or causally involved in the benefits of ketogenic diets.
Ketogenic diet as an advanced option for the management of pediatric obesity
Authors: Favret Jenny , Wood Charles T. , Maradiaga Panayotti Gabriela M.
Published: July 2021

Purpose of review

The Duke Healthy Lifestyles Program (HL), established in 2006, has treated over 15,000 pediatric patients with obesity. A subset of patients with obesity do not respond to dietary and lifestyle changes. Development of the Staged Transitional Eating Plan (STEP) in 2012 provided a ketogenic advanced dietary option for these specific patients.

Recent findings

The goal of STEP is to facilitate weight loss, while assuring adequacy and the promotion of health through the abundant inclusion of vegetables, fatty fish, nuts, olive oil, and other foods consistent with the Mediterranean Diet. STEP is a three-phase eating plan, each with a defined carbohydrate limit. STEP is ideal for patients eager to try a low carbohydrate diet, those with good vegetable acceptance, and those with families who are able to participate in the same eating plan as them.

STEP, the HL version of low carbohydrate high fat eating, is a safe dietary intervention for a carefully selected subset of pediatric patients with obesity who are trying to lose weight.
International patient group harnesses social media to help inform rare disease research: use of a low carbohydrate ketogenic diet in McArdle disease
Authors: Reason Stacey L. , Løkken Nicoline , Voermans Nicol
Published: July 2021

Purpose of review

To highlight the benefits of a partnership between patient advocacy organizations (PAO) and clinical researchers in order to clinically study the prior anecdotal patient experience of utilizing a low-carbohydrate ketogenic diet (LCKD) to manage McArdle disease.

Recent findings

The bedside-to-bench and back again method of translational research is well suited to explore anecdotal patient experiences, particularly for rare diseases. In McArdle disease, patients have explored the use of a LCKD to address the ubiquitous occurrence of physical activity intolerance and minimize associated adverse events. The International Association for Muscle Glycogen Storage Disease harnessed the power of social media to better understand this patient-centric finding and has subsequently partnered with clinical researchers to convey patient-centered priorities for research. From this partnership, a series of clinical and survey studies have been initiated.

Collaboration between PAOs and clinical researchers has the potential to foster patient empowerment, advance anecdotal experiences into scientific hypotheses, and ultimately guide the development of management guidelines that reflect the patient perspective.
Review: The Quiet Eye in Sports Performance—Is the Quiet Eye the Ultimate Explanation or Only the Beginning?
Authors: Dalton Kristine
Published: July 2021

SIGNIFICANCE

The quiet eye is a gaze behavior that seems to differentiate both expert-novice performance and successful and unsuccessful performance in experts; however, the quiet eye may only represent one aspect of the perceptual-cognitive expertise differences that exist between athletes and nonathletes.

Research suggests that expert-novice differences in vision and visual-motor coordination skills exist between athletes and nonathletes, although the underlying mechanisms driving these differences are not well understood. The quiet eye is the final fixation or tracking gaze made before the initiation of the action of importance in a motor coordination task and is quite possibly the most well-studied vision strategy variable in sport. The quiet eye has been shown to be a key component of both expert ability and successful performance. However, the quiet eye is not without its criticisms, and the perceptual mechanisms underlying this unique gaze behavior are not yet well understood. The question that remains to be answered is whether the differences in vision and visual-motor coordination skills that exist between athletes and nonathletes can be explained by the quiet eye alone or if the explanation is more complicated.
Review: Visual Performance Assessments for Sport
Authors: Erickson Graham B.
Published: July 2021

SIGNIFICANCE

Eye care professionals seek to provide effective vision care for a variety of patient needs, including performance in sports and recreational pursuits. This review provides an analysis of common visual performance assessments, including summaries of recent clinical research from a diverse array of professional literature.

Vision is recognized as an important element of sports performance. Elite athletes frequently demonstrate exceptional abilities to see and respond effectively in sports competition. Which visual factors are important and how to most effectively assess visual performance are the sources of much debate. This topical review presents an evidence-based review of the common visual performance factors assessed in athletes, beginning with guidance for conducting a visual task analysis for the variety of sports that athlete patients may compete in. An information processing model is used to provide a framework for understanding the contributions of the many visual performance factors used during sports.
Retinal Microvascular Vessel Density Differences between Adult Athletes and Nonathletes
Authors: Ugurlu Adem , Icel Erel
Published: July 2021

SIGNIFICANCE

Regular physical activity may affect the neurovascular structures. Many studies have shown the positive effects of physical activity on ocular disorders such as glaucoma, retinopathy, and macular degeneration. Athletes were expected to have a better retinal vascular structure compared with the nonathletes.

PURPOSE

This study aimed to evaluate the effects of regular physical activity on the retinal microvascular structure.

METHODS

This observational and cross-sectional study was conducted between January and July 2020 with participants aged 20 to 35 years who had a visual acuity of ≥20/20, axial length of 22 to 24 mm, refractive defect spherical equivalent of ≤±1 D, and IOP of ≤21 mmHg. Updated AngioScan software (Navis version 1.8.0) of Nidek's RS-3000 Advance system was used to analyze the spectral-domain optical coherence tomography and optical coherence tomography angiography images.

RESULTS

A total of 60 right eyes of 60 individuals were included in the study. Thirty subjects were in the athlete group, and 30 patients were in the nonathlete group. Sixteen of the individuals in the athlete group and 15 in the nonathlete group were women (P > .05). Retinal nerve fiber layer and ganglion cell complex thicknesses in all quadrants were thinner in nonathletes (P < .05). All of the Early Treatment Diabetic Retinopathy Study regions except central foveal subfield thickness were significantly higher in the athlete group (P < .05). In the nonathlete group, significantly reduced vessel densities of the superficial and deep capillary plexus and radial peripapillary capillary plexus, and the foveal avascular zone circularity index along with an increased foveal avascular zone perimeter and area were also detected (P < .05).

CONCLUSIONS

Our study revealed that optical coherence tomography angiography measurements may be used in the determination of the effects of physical activity on retinal vascular structure changes.
Small Bowel Obstruction in an Adolescent Boy With No Apparent Risk Factors
Authors: Thiessen Brianna , Hickey Christine , Daniel Reethamma
Published: July 2021

Superior mesenteric artery syndrome (SMAS) is an uncommon condition that can lead to upper gastrointestinal obstruction. Although SMAS is a rare diagnosis, our patient, a 13-year-old adolescent boy with no relevant medical or surgical history, had a classical presentation of the disorder. In this article, we discuss the risk factors, common presentation, and treatment options of SMAS, and why it is important to consider in the differential diagnosis of a pediatric patient presenting with bilious emesis and no other risk factors for intestinal obstruction.
The Association of Posttraumatic Stress Disorder With Longitudinal Change in Glomerular Filtration Rate in World Trade Center Responders
Authors: Koraishy Farrukh M. , Coca Steven G. , Cohen Beth E. , Scherrer Jeffery F. , Mann Frank , Kuan Pei-Fen , Luft Benjamin J. , Clouston Sean A.P.
Published: July 2021

Objective

High levels of psychological distress increase the risk of a wide range of medical diseases. In this study, we investigated the association between posttraumatic stress disorder (PTSD) and kidney disease.

Methods

World Trade Center (WTC) responders were included if they had two or more measures of estimated glomerular filtration rate (eGFR). The PTSD Checklist (PCL) was used to define no PTSD (PCL < 40), “mild” PTSD (40 ≤ PCL <50), and “severe” PTSD (PCL ≥50). Subtypes of PTSD by symptom clusters were analyzed. Multinomial logistic regression was used to estimate the association of PTSD with two GFR change outcomes (decline or increase) compared with the stable GFR outcome.

Results

In 2266 participants, the mean age was 53.1 years, 8.2% were female, and 89.1% were White. Individuals with PTSD (n = 373; 16.5%) did not differ in mean baseline GFR from individuals without PTSD (89.73 versus 90.56 mL min−1 1.73 m−2; p = .29). During a 2.01-year mean follow-up, a mean GFR decline of −1.51 mL min−1 1.73 m−2 per year was noted. In multivariable-adjusted models, PTSD was associated with GFR decline (adjusted relative risk [aRR] = 1.74 [1.32–2.30], p < .001) compared with stable GFR, with “hyperarousal” symptoms showing the strongest association (aRR =2.11 [1.40–3.19]; p < .001). Dose-response effects were evident when comparing mild with severe PTSD and comparing PTSD with versus without depression. PTSD was also associated with GFR rise (aRR = 1.47 [1.10–1.97], p < .009). The association between PTSD and GFR change was stronger in participants older than 50 years.

Conclusions

PTSD may be a novel risk factor for exaggerated longitudinal GFR change in young, healthy adults. These findings need to be validated in other cohorts.
Skin Tone, Discrimination, and Allostatic Load in Middle-Aged and Older Puerto Ricans
Authors: Cuevas Adolfo G. , Abuelezam Nadia N. , Chan Sze Wan (Celine) , Carvalho Keri , Flores Cecilia , Wang Kaipeng , Mattei Josiemer , Tucker Katherine L. , Falcon Luis M.
Published: July 2021

Objective

A growing body of research suggests that skin tone may be a health risk indicator for Hispanics. Black and darker-skinned Hispanics have worse mental and physical outcomes than White and lighter-skinned Hispanics. Discrimination exposure has been implicated as a risk factor that may explain the association between skin tone and health. However, there is scant research examining the interrelationship between skin tone, discrimination, and health, particularly among Puerto Ricans. We examine the interrelationships between two measures of skin tone, two measures of discrimination, and allostatic load (AL) among Puerto Rican adults.

Methods

Using cross-sectional data from wave 3 of the Boston Puerto Rican Health Study (n = 882), we examined the indirect association (IA) of skin tone on physiological dysregulated systems, also known as AL, through major discrimination and everyday discrimination. We tested these associations using two distinct measures of skin tone: interviewer-ascribed skin tone and spectrophotometer-measured skin tone.

Results

Interviewer-ascribed skin tone was indirectly associated with AL through major discrimination (IA = 0.03, 95% confidence interval = 0.004 to 0.06). However, there was no evidence of an IA of interviewer-ascribed skin tone on AL through everyday discrimination (IA = −0.01, 95% confidence interval = −0.03 to 0.01). In addition, there was no evidence that spectrophotometer-measured skin tone was indirectly associated with AL through major discrimination or everyday discrimination.

Conclusions

The sociocultural significance of skin tone may affect how Puerto Ricans are perceived and treated by others, which can, in turn, have physiological health consequences. Future research is needed to replicate these findings and examine the interrelationship between skin tone, discrimination, and other health outcomes.
A Longitudinal Exploration of Self-Reported Hearing Loss, Tinnitus, and Posttraumatic Stress Disorder Treatment Outcomes in Australian Veterans
Authors: Terhaag Sonia , Phelps Andrea , Howard Alexandra , O’Donnell Meaghan , Cowlishaw Sean
Published: July 2021

Objective

Tinnitus, hearing loss, and posttraumatic stress disorder (PTSD) are common conditions among veterans. Shared underlying symptoms, such as hypervigilance and heightened sense of threat, may interfere with talk-based psychological treatments. The aim was to investigate the prevalence and risk factors for self-reported tinnitus and hearing loss among Australian treatment-seeking veterans, as well as links with PTSD symptoms and quality of life (QOL) after treatment.

Methods

Australian veterans participating in hospital-based PTSD treatment (n = 523) completed self-report measures of subjective hearing impairment, service-related factors, PTSD symptoms, and QOL at treatment intake and discharge, as well as 3- and 9-month follow-ups. Univariate analyses of covariance modeled symptom change over time.

Results

More than half of veterans on PTSD treatment self-reported doctor-diagnosed hearing loss or tinnitus, whereas 43% reported both. However, 75% reported subjective mild to moderate hearing impairment, and only 1% reported severe impairment. Service-related factors, such as longer length of service and exposure to explosions, were risk factors for having any hearing condition. After controlling for intake scores, there were no significant differences on PTSD or QOL outcomes over time between those with and without hearing conditions.

Conclusions

Although self-reported tinnitus and hearing loss are prevalent among veterans, those with severe hearing impairments are unlikely to be represented in this context. There is a need for psychological treatments that are accessible to patients with severe hearing impairments, which should be examined routinely among military members accessing psychological treatments.
History of Depression, Elevated Body Mass Index, and Waist-to-Height Ratio in Preadolescent Children
Authors: Lewis-de los Angeles William W. , Liu Richard T.
Published: July 2021

Objective

This study aimed to evaluate whether a history of depression or self-injurious thoughts and behaviors predict elevated body mass index (BMI) and elevated waist-to-height ratio in preadolescents.

Methods

Baseline data were evaluated from a large, nationally representative cohort study of 9- and 10-year-old children (unweighted n = 11,875), the Adolescent Brain and Cognitive Development study.

Results

In the weighted sample, 10.6% of children had a history of depression, 7.0% had engaged in nonsuicidal self-injury, 13.1% had experienced suicidal ideation in their lifetime, and 1.1% had a history of attempted suicide. Among the children, 34.1% had an elevated BMI in the overweight or obese range and 31.9% had a waist-to-height ratio >0.5. In multivariate analyses, history of depression was associated with elevated BMI and waist-to-height ratio. Furthermore, interactions with sex were found; girls with a history of depression were more likely to have an elevated BMI (odds ratio = 1.47, 95% confidence interval = 1.24–1.74) and elevated waist-to-height ratio (odds ratio = 1.48, 95% confidence interval = 1.18–1.86) than girls without a history of depression, but no differences were observed between boys with and without a history of depression. Self-injurious thoughts and behaviors were not associated with elevated BMI or elevated waist-to-height.

Conclusions

In this study, 9- and 10-year-old girls with a history of depression were more likely to have an elevated BMI and elevated waist-to-height ratio than girls with no history of depression. These results provide important clinical context in caring for preadolescents with a history of depression.
Brief Report: Increased Inflammation and Liver Disease in HIV/HBV-Coinfected Individuals
Authors: Copeland Nathanial K. , Eller Michael A. , Kim Dohoon , Creegan Matthew , Esber Allahna , Eller Leigh Anne , Semwogerere Michael , Kibuuka Hannah , Kiweewa Francis , Crowell Trevor A. , Polyak Christina S. , Ake Julie A.
Published: July 2021

Objective:

HIV and hepatitis B virus (HBV) coinfection can accelerate morbidity and mortality, especially in sub-Saharan Africa where both infections are common. Although inflammation contributes to disease progression, more information is needed to better understand the pathology. This study compared markers of cirrhosis and inflammation in HIV/HBV-coinfected individuals compared with monoinfected and uninfected patients.

Setting:

The HIV/HBV-coinfected subjects from the Ugandan arm of the prospective African Cohort Study were selected for evaluation and matched by age and gender with HIV-monoinfected, HBV-monoinfected, and uninfected controls.

Methods:

Plasma samples were used to quantify markers of immune activation and inflammation. The FIB-4 (a simple index to predict significant liver fibrosis) score was used to estimate liver fibrosis. Demographic and laboratory characteristics were compared across the groups.

Results:

Together, 31 HIV/HBV-coinfected participants were identified and compared with 62 HIV-monoinfected, 7 HBV-monoinfected, and 62 uninfected controls. The HIV/HBV-coinfected group had generally higher levels of inflammation. Most notably, matrix metalloproteinase-2, matrix metalloproteinase-9, and fibroblast growth factor-19 levels were dysregulated among the HIV/HBV-coinfected individuals. Furthermore, the FIB-4 score was higher in the HIV/HBV-coinfected group compared with the HIV-monoinfected group and revealed that 11% of HIV/HBV-coinfected individuals had evidence of undiagnosed advanced liver disease.

Conclusions:

Differences in levels of inflammation exist between individuals with HIV/HBV coinfection compared with monoinfected and uninfected controls. A distinct signature of inflammation was associated with HIV/HBV coinfection that could reflect the mechanism of liver fibrosis and increased risk for disease progression. Finally, there may be an underappreciated amount of undiagnosed advanced liver disease in sub-Saharan Africa.
How coronavirus disease will change the face of travel medicine
Authors: Wilson Mary E.
Published: July 2021

Purpose of review

The current article will review how the coronavirus disease 2019 pandemic has changed travel and travel medicine.

Recent findings

Travelers spread severe acute respiratory syndrome coronavirus 2 globally and continue to spread variants. The characteristics of the virus, the place, and time created a perfect storm that allowed the virus to quickly spread globally. The virus spread by every mode of travel with risk of transmission influenced by proximity to an infected person, duration of trip, physical characteristics of the space, and ventilation. Superspreading events were common; a small percentage of infected people accounted for most of transmission. The travel and tourist industry was devastated as lockdowns and quarantines severely restricted domestic and international travel. A trip includes multiple segments and shared sequential spaces, mostly indoors. Creating safe travel requires attention to all segments of a trip.

The coronavirus disease 2019 pandemic has affected every part of travel and travel medicine. The rapid development of multiple safe and effective vaccines and their deployment is allowing resumption of travel, yet many populations lack access to vaccines, and high levels of transmission continue in many areas. Providing documentation of vaccination or immunity in a consistent, verifiable, interoperable system is one of many active issues.
Osseous Tumor Reporting and Data System—Multireader Validation Study
Authors: Chhabra Avneesh , Gupta Anurag , Thakur Uma , Pezeshk Parham , Dettori Nathan , Callan Alexandra , Xi Yin , Weatherall Paul
Published: July 2021

Objective

To develop and validate an Osseous Tumor Reporting and Data System (OT-RADS) with the hypothesis that the proposed guideline is reliable and assists in separating benign from malignant osseous tumors with a good area under the curve, and that could assist further patient management.

Methods

In this multireader cross-sectional validation study, an agreement was reached for OT-RADS categories based on previously described magnetic resonance imaging features and consensus of expert musculoskeletal radiologists. World Health Organization classification was used, and a wide spectrum of benign and malignant osseous tumors was evaluated. Magnetic resonance imaging categories were as follows: OT-RADS 0—incomplete imaging; OT-RADS I—negative; OT-RADS II—definitely benign; OT-RADS III—probably benign; OT-RADS IV—suspicious for malignancy or indeterminate; OT-RADS V—highly suggestive of malignancy; and OT-RADS VI—known biopsy-proven malignancy or recurrent malignancy in the tumor bed. Four blinded readers categorized each tumor according to OT-RADS classification. Intraclass correlation (ICC) and Conger κ were used. Diagnostic performance measures including area under the receiver operating curve were reported. Osseous Tumor Reporting and Data System was dichotomized as benign (I–III) and malignant (IV and V) for calculating sensitivity and specificity.

Results

Interreader agreement for OT-RADS (ICC = 0.78) and binary distinction of benign versus malignant (κ = 0.67) were good to excellent, while agreement for individual tumor feature characteristics were poor to fair (ICC = 0.25–0.36; κ = 0.16–0.39). The sensitivities, specificities, and area under the receiver operating curve of the readers ranged from 0.93–1.0, 0.71–0.86, and 0.92–0.97, respectively.

Conclusions

Osseous Tumor Reporting and Data System lexicon is reliable and helps stratify tumors into benign and malignant categories. It can be practically used by radiologists to guide patient management, improve multidisciplinary communications, and potentially impact outcomes.
Meckel Cave: An Anatomical Study Using Magnetic Resonance Imaging
Authors: Tsutsumi Satoshi , Ono Hideo , Ishii Hisato
Published: July 2021

Objective

To our knowledge, few studies have investigated anatomy of the Meckel cave with neuroimaging modalities. The present study aimed to characterize it using magnetic resonance imaging (MRI).

Patients and Methods

Following conventional MRI examination, a total of 101 patients underwent T2-weighted imaging in thin-sliced coronal and sagittal sections, and 11 patients underwent constructive interference steady-state sequences in thin-sliced sagittal sections. Moreover, 3 injected cadaver heads were dissected.

Results

In the cadaver specimens, the size and extent of the cerebrospinal fluid-filled space between the Gasserian ganglion and surrounding arachnoids were difficult to define. On the T2-weighted imaging, the Meckel cave was delineated with variable morphologies and left-right asymmetry. On the sagittal images, the shape of the Meckel cave could be classified into 3 different types, bulbous, oval, and flat, with the oval being the most frequent that comprised 60%. Furthermore, on the sagittal constructive interference steady-state images, parts of the trigeminal nerve distributed in the Meckel cave were delineated in all patients. The ophthalmic, maxillary, and mandibular divisions were clearly distinguished on both sides.

Conclusions

The Meckel cave is a structure characterized by diverse morphologies and left-right asymmetry. Thin-sliced T2-weighted imaging is useful for exploring the anatomy of the Meckel cave.
A Comparative Study of Multidetector Computed Tomography, Cone Beam Computed Tomography, and Computed Microtomography on Trabecular Bone Structures in the Human Mandible: An Ex Vivo Study
Authors: Sarmento Viviane Almeida , de Oliveira Gonzalez Thais Feitosa Leitão , Lopes Ricardo Tadeu , Novaes Marco , Borges Sirlene Mendes , Rubira-Bullen Izabel Regina Fischer
Published: July 2021

Objective

The aim of this study was to evaluate the accuracy of multislice computed tomography (MSCT) and cone beam computed tomography (CBCT) scanners in the assessment of trabecular bone microarchitecture by radiomorphometric analysis.

Methods

Eight dry human hemimandibles were selected and scanned by 4- and 128-MSCT, CBCT with different voxel sizes, and a computed microtomography (micro-CT). The images were spatially aligned, the axial slices were segmented using CTAn software (Skyscan, Konitch, Belgium), and 10 bone morphometric parameters were quantified. The micro-CT images were the criterion standard.

Results

The results show the superiority of CBCT images with 0.2-mm voxel size and 128-MSCT.

Conclusions

We can conclude that the CBCT scanner with 0.2-mm voxel size and 128-MSCT had better performance on reproducibility of the distribution and organization of trabecular bone and marrow spaces evaluated in this study.
Cystic Hepatic Neuroendocrine Tumor
Authors: Haupt Fabian , Afshar-Oromieh Ali , Obmann Verena Carola , Huber Adrian Thomas , Maurer Martin
Published: July 2021

A 70-year-old man presented with unspecific abdominal symptoms and weight loss was referred for a sonographic examination. Sonography revealed 3 cystic hepatic masses in an otherwise unremarkable liver. Contrast-enhanced MRI of the liver was performed to characterize the hepatic lesions and elucidate their etiology. The differential diagnosis was primarily parasitic disease or metastases with cystic transformations. 68Ga-DOTATOC PET/CT revealed the neuroendocrine origin of these lesions, confirmed by biopsy. However, the primary site of the neuroendocrine tumor remained unclear, leaving primary hepatic neuroendocrine tumor and neuroendocrine cancer of unknown primary as possible diagnostic options.
Identification of Acute Mesenteric Ischemia on 18F-FDG PET/CT
Authors: Smith Mathew V. , Yang Ming , Roarke Michael C.
Published: July 2021

Acute mesenteric ischemia resulting in bowel necrosis is a surgical emergency. First identification of acute mesenteric ischemia with FDG PET/CT is uncommon, because patients with bowel ischemia are usually diagnosed by other imaging methods such as CT. Nevertheless, prompt imager recognition of the PET/CT findings of mesenteric ischemia and necrosis is critical for proper triage of the patient to potentially lifesaving interventions. We present a 39-year-old woman with portal vein thrombosis who was sent for 18F-FDG PET/CT evaluation of a suspected pancreatic head neoplasm but was unexpectedly found to have ischemic and necrotic small bowel secondary to mesenteric venous infarction.
Features of Systemic Immune Response From COVID-19 Vaccination on 18F-FDG PET/CT
Authors: Nawwar Ayah Adel , Searle Julie , Lyburn Iain Douglas
Published: July 2021

The rapid rollout of COVID-19 vaccination is accompanied by incidental findings on 18F-FDG PET/CT. Most cases describe reactive axillary lymphadenopathy. A 46-year-old woman with previous history of stage 3A breast cancer underwent follow-up 18F-FDG PET/CT, which demonstrated avid left axillary nodes and intense diffuse splenic uptake and moderate diffuse bone marrow uptake. She had been administered COVID-19 vaccination in the left deltoid 1 week earlier and required hospitalization for 24 hours due to fever. Symptoms settled with supportive treatment. One month after the PET/CT scan, she remained well. Sites of uptake were taken to relate to a systemic immune response.