bluuebunny/crossref_metadata_2025 huggingface dataset:
Modes of exhibition: Uses of the past in Tehran art galleries
Authors: Sadeghi Yasaman , Islam Gazi
Published: September 2021

While emerging literature explores how organizations engage with the past, investigations of how complex relationships to the past influence mobilizing multiple forms of historical representation in practice remain scarce. The current study examines different relationships to the past to shed light on how their complex and at times contradictory connotations relates to the use of multimodal historical cues in organizational practices, based on a qualitative study of art galleries in downtown Tehran, Iran. We describe how fondness for, aversion to and conflicted relationships with the past coexist, and how and why actors use diverse historical cues to express these diverse relationships in practice. We add to current understandings of organizational uses of the past by offering insights into how and why organizations actively evoke and manage positive, negative, and conflicted relationships to the past, and how these relationships draw upon diverse discursive and non-discursive supports to organizational practices aiming at different yet complementary goals.
Decision making regarding management of compromised first permanent molars in patients with molar incisor hypomineralisation: A comparison of orthodontists and paediatric dentists
Authors: Alkadhimi Aslam , Cunningham Susan J , Parekh Susan , Noar Joe H , Travess Helen C
Published: September 2021

Objectives:

To obtain the views and opinions of specialist members of the British Orthodontic Society (BOS) and British Society of Paediatric Dentistry (BSPD) in relation to (1) the multidisciplinary management of patients affected by molar incisor hypomineralisation (MIH) and (2) the diagnosis and management of MIH-affected first permanent molars (FPMs) in four clinical scenarios, and compare the responses to those of an expert panel consensus.

Design:

A prospective cross-sectional study.

Setting:

Part 1: Eastman Dental Institute and part 2: online questionnaire.

Methods:

Four clinical scenarios showing patients with differing severities of MIH affected FPMs were considered by a panel of orthodontists and paediatric dentists to agree on the severity of MIH and management. A 21-item online questionnaire sent to both specialist groups, after pilot study. The questionnaire covered demographics, access to multidisciplinary clinics, clinicians’ opinions on various management aspects, and questions relating to the management of the same 4 clinical scenarios.

Results:

The overall response was 21.9% (20% of the orthodontists and 45% of the paediatric dentists). Approximately half of the respondents from both groups felt that these patients should be managed through a multidisciplinary treatment type clinic (49.0% of the orthodontists and 47.2% of the paediatric dentists). Only 40.3% of the orthodontists and 35.0% of the paediatric dentists agreed completely with the panel consensus on all management options. When assessing overall agreement on all four FPMs for all scenarios, agreement was predicted by severity of MIH (P<0.001) and complexity of malocclusion (P<0.001) where more complex malocclusions and more severe MIH resulted in poorer agreement, but specialty was not a significant predictor (P=0.21).

Conclusion:

The majority of the respondents from both groups, felt that managing patients with MIH affected FPMs is challenging. Approximately half of the orthodontists and the paediatric dentists, felt that MIH affected patients should be managed through a multidisciplinary type clinic. Managing more severe cases on multidisciplinary clinics is indicated, to incorporate specialist input into decision making.
Modelling agreement for binary intensive longitudinal data
Authors: Vanbelle Sophie , Lesaffre Emmanuel
Published: September 2021

Devices that measure our physical, medical and mental condition have entered our daily life recently. Such devices measure our status in a continuous manner and can be useful in predicting future medical events or can guide us towards a healthier life. It is therefore important to establish that such devices record our behaviour in a reliable manner and measure what we believe they measure. In this article, we propose to measure the reliability and validity of a newly developed measuring device in time using a longitudinal model for sequential kappa statistics. We propose a Bayesian estimation procedure. The method is illustrated by a validation study of a new accelerometer in cardiopulmonary rehabilitation patients.
Syphilitic Popliteal Pseudoaneurysm Complicated by Acute Lower-Limb Ischemia
Authors: Arasu Rohan , Baimatova Irina , Cohen Toby
Published: September 2021

Case presentation: We present a case of a patient with a syphilitic popliteal pseudoaneurysm who developed acute lower-limb ischemia secondary to thromboembolism related to the pseudoaneurysm. The diagnosis of a syphilitic popliteal aneurysm was made due to positive syphilitic serological testing and with exclusion of all other potential causes. The pseudoaneurysm was surgically repaired using a great saphenous vein patch angioplasty, which was done without delay to prevent further thromboembolic complications. This was then followed by a course of intravenous benzyl penicillin. Discussion: Peripheral arterial involvement of tertiary syphilis remains exceedingly rare, with the vast majority of reported cases of vascular syphilis relating to aortic involvement. Given the paucity of literature on this condition, there is no good evidence to guide current management. Conclusion: With the globally increasing rates of syphilis, more cases of peripheral arterial involvement may become apparent, as was the case in the early 20th century.
Awareness of, attitudes towards, and practices of health information management professionals in South Korea relating to privacy of personal health information
Authors: Kim Yeaeun
Published: September 2021

Background: While information and communication technology has continued to advance, privacy of personal health information (PHI) has remained a challenge for health information management (HIM) professionals. Objective: This study aims to examine the awareness, attitude and practice relating to PHI privacy among HIM professionals in South Korea. Method: A survey questionnaire was developed for the study based on critical appraisal of relevant literature and expert consensus. It was completed by a sample of 312 respondents who were members of the Korean Health Information Management Association, over the age of 21, and worked in a healthcare organisation. Demographic data and questionnaire items (assessed on a 5-point Likert-type scale) were analysed using descriptive statistics, t-tests and ANOVA. Results: Mean scores and SDs for awareness, attitude and practice related to PHI privacy were calculated: 4.21 (0.60) for awareness, 4.17 (0.60) for attitude and 4.31 (0.63) for practice. Significant positive correlations were found between awareness and attitude scores (r = 0.765, p < 0.01); awareness and practice scores (r = 0.585; p < 0.01); and attitude and action scores (r = 0.672; p < 0.01). HIM professionals’ awareness, attitude, and practice towards PHI privacy differed significantly according to age, level of education, years of HIM experience, type of employment, main task, number of completed privacy education activities within the previous 3 years and whether or not they had signed a pledge of confidentiality on PHI. More highly-educated, full-time employed respondents, those who had completed a greater number of privacy education activities and had more experience as HIM professionals, achieved higher scores on awareness, attitude and practice than did other respondents. These differences were all statistically significant ( p < 0.01). Conclusion: Although causality cannot be inferred from results of this study, findings suggest that there is a relationship between PHI being a core responsibility of HIM professionals and their subsequent awareness, attitude and practice to ensure its privacy and confidentiality. To improve privacy practice, educational efforts should be prioritised and supported at all levels, including national, organisational, individual, and by professional HIM associations.
Pediatric Smart Insulin Pen Use: The Next Best Thing
Authors: Ilkowitz Jeniece , Wissing Vanessa , Gallagher Mary Pat
Published: September 2021

In the pediatric population, insulin pump therapy, or CSII, is often considered the gold standard for intensive diabetes management. Insulin pump technology offers families and caregivers many beneficial features including a calculator for insulin dosing and the ability to review diabetes management data to provide data-driven diabetes management. However, for those who find CSII challenging or choose to use multiple daily injections (MDI) there is an option that offers similar features called the Smart Insulin Pen (SIP). Even though SIP technology provides a safe and data-driven diabetes self-management tool for the pediatric population using MDI, there is limited pediatric specific literature. This article will describe current options, data-driven diabetes management, benefits, challenges and clinical use of SIP technology in the pediatric population.
Outcomes after endovascular embolization for the treatment of nasal and oropharyngeal hemorrhage: safety, efficacy, and rebleeding
Authors: Hoffman Haydn , Jalal Muhammad S , Masoud Hesham E , Gould Grahame C
Published: September 2021

Background

Intractable nasal and oropharyngeal hemorrhage may be treated with endovascular embolization, but limited data are available. We sought to evaluate the efficacy, safety, and factors associated with rebleeding.

Methods

A retrospective analysis of consecutive embolizations for nasal and oropharyngeal hemorrhage over a 10-year period at a single institution was performed. Outcomes included procedural success (defined as cessation of hemorrhage in the immediate postoperative period), rebleeding requiring an additional intervention, and procedural complications.

Results

A total of 47 embolizations on 39 patients were included. The mean age was 60 years (standard deviation 16.1), 23.1% of patients were women, and 21 (53.8%) patients had a previously diagnosed head/neck malignancy. Bleeding sites were the nose in 20 patients and oropharynx in 21 (two patients presented with both nasal and oral bleeding). Immediate procedural success was achieved in 45 (95.7%) embolizations. Rebleeding requiring an additional intervention occurred after 11 (23.4%) embolizations at a median of one day after the procedure. In the multivariate analysis, preoperative hypotension (odds ratio 4.78, 95% confidence interval 1.04–24.61) and the use of coils (odds ratio 6.09, 95% confidence interval 1.24–46.69) were associated with rebleeding requiring repeat intervention. Complications included two watershed strokes that were anticipated due to occlusion of the internal carotid artery.

Conclusions

In our experience endovascular embolization was a safe and effective treatment option for stopping oral and nasal hemorrhage. However, rebleeding was present after 23.4% of treatments and was associated with preoperative hypotension and the use of coils. Further study in a large multi-institutional cohort is warranted.
Impact of pulmonary hypertension in patients with acute exacerbation of chronic obstructive pulmonary disease and its effect on healthcare utilization
Authors: Munshi Rezwan F. , Pellegrini James R. , Patel Pranavi , Kashin Maxim , Kang James , Sexton Robert , Russe Jose R. , Makaryus Amgad N. , Patel Palakkumar , Thakkar Samarthkumar , Pelletier Brandon , Abraham Tinu , Tiwana Muhammad , Anjum Fatima
Published: September 2021

We aim to study the impact of pulmonary hypertension on acutely exacerbated chronic obstructive pulmonary disease (AECOPD). We used the 2016 and 2017 National Readmission Database with an inclusion criterion of AECOPD as a primary and pulmonary hypertension as a secondary diagnosis using ICD 10‐CM codes. Exclusion criteria were age under 18 years, non‐elective admission, and discharge in December. The primary outcome was in‐hospital mortality during the index admission. Secondary outcomes were 30‐day readmission rate, resource utilization, and instrument utilization including intubation, prolonged invasive mechanical ventilation >96 h (PIMV), tracheostomy, chest tube placement, and bronchoscopy during the index admission. A total of 627,848 patients with AECOPD were included in the study, and 68,429 (10.90%) patients had a diagnosis of pulmonary hypertension. Pulmonary hypertension was more common among females (61.14%) with a mean age of 71 ± 11.66, Medicare recipients (79.5%), higher Charlson comorbidity index, and treatment in an urban teaching hospital. Pulmonary hypertension was associated with greater mortality (adjusted odds ratio (aOR) 1.89, p < 0.001), higher 30‐day readmission (aOR 1.24, p < 0.001), higher cost (adjusted mean difference (aMD) $2785, p < 0.01), length of stay (aMD 1.09, p < 0.001), and higher instrument utilization including intubation (aOR 199, p < 0.001), PIMV (aOR 2.12, p < 0.001), tracheostomy (aOR 2.1, p < 0.001), bronchoscopy (aOR 1.46, p = 0.007), and chest tube placement (aOR 1.39 p < 0.004). We found that pulmonary hypertension is related to higher in‐hospital mortality, length of stay, increased instrument utilization, readmission, and costs. Our study aims to shed light on the impact of pulmonary hypertension on AECOPD in hopes to improve future management.
High-flow nasal cannula therapy for hypoxemic respiratory failure in patients with COVID-19
Authors: Chavarria Adrian Palacios , Lezama Erika Salinas , Navarro Mauricio Gonzalez , Vazquez Rafael Ricardo Valdez , Bello Héctor Herrera , Gascon Julieta Lomelín , Juárez Linda Morales , Avendaño Mónica Arboleya , Gonzalez Luis Esteban Ramirez , Ville Benavides Rodrigo , Wyssmann Renate Victoria Álvarez , Ortiz Brenda Sandoval , de la Cerda Mariana Lizbeth Rodríguez , Castañeda Lidia Moreno , Martinez-Juarez Luis Alberto , Gallardo-Rincón Héctor , Tapia-Conyer Roberto
Published: September 2021

Introduction:

High-flow nasal cannula (HFNC) therapy in patients with hypoxemic respiratory failure due to COVID-19 is poorly understood and remains controversial.

Methods:

We evaluated a large cohort of patients with COVID-19-related hypoxemic respiratory failure at the temporary COVID-19 hospital in Mexico City. The primary outcome was the success rate of HFNC to prevent the progression to invasive mechanical ventilation (IMV). We also evaluated the risk factors associated with HFNC success or failure.

Results:

HFNC use effectively prevented IMV in 71.4% of patients [270 of 378 patients; 95% confidence interval (CI) 66.6–75.8%]. Factors that were significantly different at admission included age, the presence of hypertension, and the Charlson comorbidity index. Predictors of therapy failure (adjusted hazard ratio, 95% CI) included the comorbidity-age-lymphocyte count-lactate dehydrogenase (CALL) score at admission (1.27, 1.09–1.47; p < 0.01), Rox index at 1 hour (0.82, 0.7–0.96; p = 0.02), and no prior steroid treatment (0.34, 95% CI 0.19–0.62; p < 0.0001). Patients with HFNC success rarely required admission to the intensive care unit and had shorter lengths of hospital stay [19/270 (7.0%) and 15.0 (interquartile range, 11–20) days, respectively] than those who required IMV [104/108 (96.3%) and 26.5 (20–36) days, respectively].

Conclusion:

Treating patients with HFNC at admission led to improvement in respiratory parameters in many patients with COVID-19.
A case report of recalcitrant aphthous ulcers in two patients treated with interleukin-17 inhibitors
Authors: Ward Madison , Maliyar Khalad , Gooderham Melinda
Published: September 2021

The interleukin-17 signaling pathway plays a critical role in the pathogenesis of psoriasis. By inhibiting this pathway, there is a reduction in the severity of psoriasis and many patients achieve clear skin. We present two individuals, a 34-year-old male and a 40-year-old female, who developed aphthous ulcers on the oral mucosa and oral and vulvar mucosa, respectively, while undergoing treatment with interleukin-17 inhibitors. The ulcers did not respond to conventional therapy, including topical corticosteroids and nystatin 100,000 unit/mL oral suspension. Both patients underwent biopsies which confirmed the diagnosis of ulcer. Once confirmed, the interleukin-17 inhibitor was discontinued and the ulcers resolved in both cases. As we see biologic treatment, specifically interleukin-17 inhibitor, becoming more popular for the treatment of psoriasis, it is important for physicians to be aware of this potential adverse event. Early detection and intervention are important to avoid complications that can develop from rare but often painful ulcers.
How obesity affects the benefits of holmium laser enucleation of the prostate for the treatment of male lower urinary tract symptoms
Authors: Tamalunas Alexander , Westhofen Thilo , Schott Melanie , Keller Patrick , Atzler Michael , Stief Christian G , Magistro Giuseppe
Published: September 2021

Objectives:

Holmium laser enucleation of the prostate (HoLEP) can be used regardless of prostate size and offers durable long-term results for patients suffering from lower urinary tract symptoms (LUTS)/benign prostatic obstruction (BPO), with reduced perioperative morbidity. In most western societies almost half of the population are overweight, and obesity itself is often a risk factor for surgical treatment of patients. We therefore analysed the impact of body mass index (BMI) on outcomes and perioperative morbidity in patients undergoing HoLEP for LUTS at our tertiary referral centre.

Methods:

We retrospectively collected data for 877 patients who underwent HoLEP for LUTS/BPO between 2014 and 2018 and divided patients into group 1 (BMI<25), 2 (BMI 25<30), and 3 (BMI⩾30). We analysed perioperative parameters, safety, and short-term functional outcomes.

Results:

In preoperative patient characteristics we observed a similar LUTS profile throughout our patient cohorts. The highest proportion of ASA score ⩾III was observed in the obese patient cohort. Enucleation time was significantly prolonged in morbidly obese patients and operative speed was significantly slower, without difference in perioperative complications. Functional outcomes were assessed 30 days post-surgery with significant improvement in IPSS, quality of life (QoL) and Qmax for all groups.

Conclusion:

Although operating on overweight and obese patients takes significantly longer, HoLEP is efficient and offers acceptable perioperative complication rates even in morbidly obese patients (BMI⩾30).

Level of evidence:

Not applicable.
Economic Analysis of Specialist Referral Patterns in Mackay, Queensland Following HealthPathways Implementation
Authors: Blythe Robin , Lee Xing , Simmons Toni , Cox Janine , McLean Kathleen , Barfield Josephine , Kularatna Sanjeewa
Published: September 2021

Introduction:

HealthPathways is a clinical information portal developed in New Zealand that enables general practitioners to manage and refer their patients in a local context. We analyzed specialist outpatient appointment costs in Mackay, Queensland before and after HealthPathways implementation.

Methods:

We retrospectively examined specialist outpatient costs for patients referred by Mackay general practitioners for conditions with varying levels of HealthPathways implementation. Ranked from most clinical pathways available to none, chronic diabetes, cardiology, respiratory, and urology visits from January to March 2015, pre-pathways, and January to March 2017, post-pathways, were assessed. Monte Carlo simulation was used to estimate cost changes. Per-visit costs were multiplied by visit numbers to estimate policy impact.

Results:

The mean cost per visit increased from $220 to $305 for diabetes and $270 to $323 for respiratory, and decreased from $296 to $257 for cardiology and $444 to $293 for urology. The policy impact for each disease group over 3 months after accounting for visit numbers was a likely saving of $30 360 for diabetes and $10 270 for cardiology, and a likely cost increase of $24 449 for respiratory and $20 536 for urology.

Conclusions:

We observed that conditions with more comprehensive clinical pathways cost Mackay HHS substantially less following implementation. Costs for low and no pathway implementation referrals increased slightly over the same period.
Special Issue on Social Entrepreneurship Education
Authors: Kickul Jill , Mitra Paulami , Weaver Rasheda L. , Orr Jacqueline , Winkler Christoph
Published: September 2021

Our key intention through this special issue in social entrepreneurship education is to capture the best practices in pedagogy and research within this growing field of social entrepreneurship and also to push boundaries and question the taken-for-granted assumptions in this discipline. Therefore, two contributions chosen for this issue advocate the importance of a service learning approach to enhance students’ learning experience beyond the classroom. The other two contributions address the need to challenge assumptions of social entrepreneurship, thus improving students’ practical and theoretical knowledge of the field.
Impact of initial stress field heterogeneity in dynamic soil–structure interaction
Authors: Rioux Marc-Denis , Nollet Marie-José , Galy Bertrand
Published: September 2021

This article covers the impact of soil initial stress field heterogeneity (ISFH) in wave-passage analysis and in prescribed structural acceleration in the context of dynamic soil–structure interaction (DSSI) analysis. ISFH is directly related to the natural behavior of soil where a significant increase in net effective confinement, as is the case in the foundation soil under a building, tends to increase the soil’s modulus and strain. This creates a heterogeneous stress field in the vicinity of the foundation elements, which results in a modification of the dynamic behavior of the soil–structure system. A simple method for considering the impact of ISFH on the value of the soil’s modulus and strain was developed using the direct DSSI approach. The method was used to analyze numerical artifacts and its impact on the surface acceleration values of a nonlinear two-dimensional (2D) numerical soil deposit under transient loading. This analysis was followed by a sample application for a three-story, three-bay concrete moment-resisting frame structure erected on a deep soil deposit. Floor acceleration and relative displacement were used for comparison. The soil deposit was modeled using the typical geotechnical properties of fine-grained, post-glacial soil samples obtained in Eastern Canada from in situ geotechnical borehole drilling, geophysical surveys, and laboratory testing. Ground motion was based on eastern calibrated seismic signals. The results of the soil deposit analysis show that ISFH had a significant impact on surface acceleration values. The effect was found to be period-dependent and to have a direct impact on prescribed acceleration values at the base of structure. Thus, failure to take the effects of ISFH into consideration can lead to errors in calculating prescribed structural accelerations (i.e. over- or underestimation).
How I treat neurologic complications in patients with lymphoid cancer
Authors: Nayak Lakshmi , Batchelor Tracy T.
Published: September 2021

Neurologic complications of lymphoid cancer can be challenging to recognize and treat. The nervous system can be affected directly by hematogenous or local spread of lymphoma. Indirect neurologic effects of lymphoma include paraneoplastic syndromes and vascular complications. Lymphoma treatments can also cause neurologic complications. Early identification and treatment are crucial to stabilize or reverse neurologic deficits, prevent further nervous system injury, and optimize overall oncologic therapy. This article provides an overview of the different neurologic complications of lymphoma and its treatments, in addition to presenting case studies that emphasize commonly encountered clinical scenarios.
Current evidence on the efficacy and safety of generic imatinib in CML and the impact of generics on health care costs
Authors: Erçalışkan Abdülkadir , Seyhan Erdoğan Duygu , Eşkazan Ahmet Emre
Published: September 2021

Since the introduction of imatinib, the management of chronic myeloid leukemia (CML) has changed considerably. Tyrosine kinase inhibitors (TKIs) are the mainstay of CML treatment; however, the high financial burden of TKIs can be problematic for both the patients and health care systems. After the emergence of generics, reimbursement policies of many countries have changed, and generics offered an alternative treatment option for CML patients. There are many papers published on the use of generics in CML patients with conflicting results regarding both efficacy and safety. In this paper, we systematically reviewed the current literature on generic imatinib use in CML, and 36 papers were evaluated. Both in vitro and in vivo studies of generic imatinib showed comparable results with branded imatinib in terms of bioequivalence and bioavailability. In most studies, generics were comparable with the original molecule in terms of efficacy and safety, both in newly diagnosed patients and after switching from Gleevec. Some generic studies showed contradictory findings regarding efficacy and toxicity, and these differences can be attributed to some factors including the use of different generics in different countries. Both in hypothetical models and in real life, introduction of generic imatinib caused significant reduction in health care costs. In conclusion, generics are not inferior to original imatinib in terms of efficacy with an acceptable toxicity profile. Notwithstanding the generally favorable efficacy and safety of generics worldwide to date, we most probably still need more time to draw firmer conclusions on the longer-term outcomes of generics.
Long-term efficacy and safety of CT-P10 or rituximab in untreated advanced follicular lymphoma: a randomized phase 3 study
Authors: Buske Christian , Jurczak Wojciech , Sancho Juan-Manuel , Zhavrid Edvard , Kim Jin Seok , Hernández-Rivas José-Ángel , Prokharau Aliaksandr , Vasilica Mariana , Nagarkar Rajnish , Kwak Larry , Kim Won-Seog , Lee SangJoon , Kim SungHyun , Ahn KeumYoung , Ogura Michinori
Published: September 2021

Rituximab biosimilars are a cornerstone of treatment of advanced-stage follicular lymphoma (FL). This double-blind, parallel-group, phase 3 trial randomized (1:1) adults (≥18 years) with stage III to IV indolent B-cell lymphoma, including grades 1 to 3a FL, to receive CT-P10 or rituximab (375 mg/m2 IV), with cyclophosphamide, vincristine, and prednisone, every 3 weeks for 8 cycles (induction period). Patients achieving complete response (CR), unconfirmed CR, or partial response (PR) received CT-P10 or rituximab maintenance for 2 years (375 mg/m2, every 8 weeks). Primary end points were previously reported, proving noninferiority of efficacy and pharmacokinetic equivalence of CT-P10 to rituximab. Secondary end points included overall response rate (PR+CR) during the induction period per 2007 International Working Group (IWG) criteria, survival analyses, and overall safety. Between 28 July 2014 and 29 December 2015, 140 patients were randomized (70 per group). Median follow-up was 39.9 months (interquartile range, 36.7-43.5). Per 1999 IWG criteria, 4-year Kaplan-Meier estimates (95% confidence interval [CI]) for CT-P10 and rituximab were 61% (47% to 73%) and 55% (36% to 70%) for progression-free survival (hazard ratio, 1.33 [95% CI, 0.67-2.63]; P=.409), respectively, and 88% (77% to 94%) and 93% (83% to 97%) for overall survival (5.29 [0.84-33.53]; P=.077). Overall, 90% (CT-P10) and 86% (rituximab) of patients experienced treatment-emergent adverse events. Long-term safety profiles were similar between groups. Findings confirm favorable outcomes for CT-P10–treated patients with advanced-stage FL and demonstrate comparable long-term efficacy and overall safety between CT-P10 and rituximab. This trial was registered at www.clinicaltrials.gov as #NCT02162771.
Storage temperature determines platelet GPVI levels and function in mice and humans
Authors: Miles Jeffrey , Bailey S. Lawrence , Obenaus Ava M. , Mollica Molly Y. , Usaneerungrueng Chomkan , Byrne Daire , Fang Lydia , Flynn Jake R. , Corson Jill , Osborne Barbara , Houck Katie , Wang Yi , Shen Yu , Fu Xiaoyun , Dong Jing-Fei , Sniadecki Nathan J. , Stolla Moritz
Published: September 2021

Platelets are currently stored at room temperature before transfusion to maximize circulation time. This approach has numerous downsides, including limited storage duration, bacterial growth risk, and increased costs. Cold storage could alleviate these problems. However, the functional consequences of cold exposure for platelets are poorly understood. In the present study, we compared the function of cold-stored platelets (CSP) with that of room temperature–stored platelets (RSP) in vitro, in vivo, and posttransfusion. CSP formed larger aggregates under in vitro shear while generating similar contractile forces compared with RSP. We found significantly reduced glycoprotein VI (GPVI) levels after cold exposure of 5 to 7 days. After transfusion into humans, CSP were mostly equivalent to RSP; however, their rate of aggregation in response to the GPVI agonist collagen was significantly lower. In a mouse model of platelet transfusion, we found a significantly lower response rate to the GPVI-dependent agonist convulxin and significantly lower GPVI levels on the surface of transfused platelets after cold storage. In summary, our data support an immediate but short-lived benefit of cold storage and highlight the need for thorough investigations of CSP. This trial was registered at www.clinicaltrials.gov as #NCT03787927.
Fungal keratitis after small incision lenticule extraction (SMILE): a case report and review of the literature
Authors: Soleimani Mohammad , Haydar Ali A.
Published: September 2021

Purpose

To report a case of perforated fungal keratitis after small incision lenticule extraction (SMILE) treated with penetrating keratoplasty (PKP).

Methods

Case report and literature review.

Results

A 41-year-old woman presented with culture-proven unilateral fungal keratitis 4 days after uneventful SMILE. Her visual acuity was hand motion. The patient was treated with voriconazole irrigation (50 μm/0.1 ml) of the pocket and intrastromal voriconazole injection, in addition to systemic and topical antifungals. Despite aggressive management and decreased infiltration, the cornea was perforated and subsequently treated with PKP.

Conclusions

Infectious keratitis after SMILE is unusual. To our knowledge, this is the first report of perforated fungal keratitis post-SMILE. PKP eradicated the infection.
miR-153/KCNQ4 axis contributes to noise-induced hearing loss in a mouse model
Authors: Wang Qin , Li Wei , Cai Cuiyun , Hu Peng , Lai Ruosha
Published: September 2021

Damage to the cochlear sensory epithelium is a key contributor to noise-induced sensorineural hearing loss (SNHL). KCNQ4 plays an important role in the cochlear potassium circulation and outer hair cells survival. As miR-153 can target and regulate KCNQ4, we sought to study the role of miR-153 in SNHL. 12-week-old male CBA/J mice were exposed to 2–20 kHz broadband noise at 96 dB SPL to induce temporary threshold shifts and 101 dB SPL to induce permanent threshold shifts. Hearing loss was determined by auditory brainstem responses (ABR). Relative expression of miR-153 and KCNQ4 in mice cochlea were determined by Real-Time quantitative PCR. miR-153 mimics were co-transfected with wild type or mutated KCNQ4 into HEK293 cells. Luciferase reporter assay was used to validate the binding between miR-153 and KCNQ4. AAV-sp-153 was constructed and administrated intra-peritoneally 24- and 2-h prior and immediately after noise exposure to knockdown miR-153. The KCNQ4 is mainly expressed in outer hair cells (OHCs). We showed that the expression of KCNQ4 in mice cochlea was reduced and miR-153 expression was significantly increased after noise exposure compared to control. miR-153 bound to 3′UTR of KNCQ4, and the knockdown of miR-153 with the AAV-sp-153 administration restored KCNQ4 mRNA and protein expression. In addition, the knockdown of miR-153 reduced ABR threshold shifts at 8, 16, and 32 kHz after permanent threshold shifts (PTS) noise exposure. Correspondingly, OHC losses were attenuated with inhibition of miR-153. This study demonstrates that miR-153 inhibition significantly restores KNCQ4 in cochlea after noise exposure, which attenuates SNHL. Our study provides a new potential therapeutic target in the prevention and treatment of SNHL.
Sevoflurane blocks glioma malignant development by upregulating circRELN through circRELN-mediated miR-1290/RORA axis
Authors: Kang Xiaofang , Li Hongxia , Zhang Zaiwang
Published: September 2021

Background

Sevoflurane (Sev) has been reported to inhibit cancer development, and sevoflurane treatment in cancers is implicated with the deregulation of specific non-coding RNAs (ncRNAs). This study aimed to investigate the relationship between sevoflurane and circular RNA reelin (circRELN) in glioma.

Methods

The expression of circRELN, microRNA-1290 (miR-1290) and RAR-related orphan receptor A (RORA) was measured by quantitative real-time PCR (qPCR). Cell proliferative capacity was assessed by cell counting kit-8 (CCK-8) and colony formation assays. Cell apoptosis and cell cycle distribution were monitored by flow cytometry assay. Cell migration was assessed by wound healing assay and transwell assay, and cell invasion was assessed by transwell assay. The protein levels of matrix metalloproteinase-2 (MMP2), MMP9 and RORA were quantified by western blot. Tumor growth in vivo was assessed by Xenograft models. The binding relationship between miR-1290 and circRELN or RORA was verified by dual-luciferase reporter assay and RNA immunoprecipitation (RIP) assay.

Results

We found that circRELN expression was declined in glioma tissues and cells, while Sev treatment enhanced circRELN expression. In function, Sev notably inhibited glioma cell proliferation, migration and invasion and promoted apoptosis and cell cycle arrest, while circRELN knockdown reversed these effects. MiR-1290 served as a target of circRELN, and glioma cell malignant phenotypes recovered by circRELN knockdown were partly repressed by miR-1290 deficiency. In addition, RORA was a target of miR-1290, and glioma cell malignant phenotypes promoted by miR-1290 restoration were partly blocked by RORA overexpression. CircRELN regulated RORA expression by targeting miR-1290. In Xenograft models, Sev inhibited tumor growth by upregulating circRELN.

Conclusion

Sev blocked the progression of glioma by increasing circRELN expression, and circRELN played roles in glioma partly by regulating the miR-1290/RORA network.
Clinical characteristics of children with airway malacia complicated by pneumonia
Authors: Wang Ting , Xu Qiuyan , Dai Ge , Hong Yu , Chen Zhengrong , Lu Min , Yan Yongdong , Jiang Wujun
Published: September 2021

Background

Airway malacia is an important cause of noisy breathing, recurrent wheezing and respiratory infections, chronic coughing, and episodes of respiratory distress in young children. As the clinical manifestations of airway malacia are not common, many clinicians have insufficient understanding of this disease. So the purpose of this study is to summarize the pathogenic bacteria and clinical manifestations of airway softening complicated with pneumonia in children.

Methods

Children hospitalized with airway malacia complicated by pneumonia were eligible for enrollment from January 1, 2013 to December 31, 2019. Medical records of patients were reviewed for etiology, clinical characteristics, and laboratory examination results.

Results

A total of 164 pneumonia patients with airway malacia were admitted. The male-to-female ratio was 3:1. The age of patients ranged from 1 month to 4 years old. The median age was 6 (3–10) months. The most commonly detected pathogen wereMycoplasma pneumoniae(25/164, 15.24%),Streptococcus pneumoniae(18/164, 10.98%), and respiratory syncytial virus (16/164, 9.76%). Common signs among the 164 patients with confirmed airway malacia included cough (98.78%), wheezing (67.07%), fever (35.37%), intercostal retractions (23.17%), dyspnea (10.98%), cyanosis (11.11%), and crackles (50%). Compared with those without airway malacia, the incidence of premature delivery and mechanical ventilation was higher, and the duration of symptoms before admission (median, 13.5 d) and hospital stay (median 10.0 d) were longer. Of the children with pneumonia, 11.59% of those with airway malacia required supplemental oxygen compared with 4.88% of those without airway malacia (p < 0.05).

Conclusion

The median age of children with airway malacia was 6 months. The most common pathogen in patients with airway malacia complicated by pneumonia wasMycoplasma pneumoniae. Patients with airway malacia complicated by pneumonia often presented with a longer disease course, more severe symptoms, and had delayed recovery.
Detection of aerobe–anaerobe mixed infection by metagenomic next-generation sequencing in an adult suffering from descending necrotizing mediastinitis
Authors: Duan Jing , Zhang Chuncheng , Che Xiaoshuang , Fu Juanjuan , Pang Feng , Zhao Qigang , You Zhiqing
Published: September 2021

Background

Descending necrotizing mediastinitis (DNM) is one of the most virulent forms of mediastinitis. The main causes of high mortality in DNM are believed to stem from difficulty and delay in the diagnosis. Fast and accurate identification of pathogens is important for the treatment of these patients. Metagenomics next-generation sequencing (mNGS) is a powerful tool to identify all kinds of pathogens, especially for rare and complex infections.

Case presentation

A 64-year-old male patient was admitted to the intensive care unit (ICU) with unconsciousness, dyspnea, and swelling in the mandible and neck. Computed tomography (CT) scan results combined with clinical laboratory examination indicated DNM. Vancomycin and imipenem were used, and vacuum sealing drainage was applied for debridement and drainage of the infected area. The positive mNGS results of drainage fluid confirmed the presence of mixed infection caused by Streptococcus anginosus, Prevotella oris, and several other anaerobes. The antibiotics were adjusted to piperacillin/tazobactam and tinidazole according to the mNGS results and antimicrobial susceptibility testing of cultured pathogens. After 11 days of antibiotic therapy, the infection symptoms of the neck and mediastinum improved, and the patient was transferred out of the ICU on the 26th day after negative result of drainage fluid culture.

Conclusion

This case suggested that mNGS is a promising technology for precise and fast pathogens identification with high sensitivity, which may guide the diagnosis of infectious diseases in the future trend.
Diagnostic utility of metabolic parameters on FDG PET/CT for lymph node metastasis in patients with cN2 non-small cell lung cancer
Authors: Nakanishi Keita , Nakamura Shota , Sugiyama Tomoshi , Kadomatsu Yuka , Ueno Harushi , Goto Masaki , Ozeki Naoki , Fukui Takayuki , Iwano Shingo , Chen-Yoshikawa Toyofumi Fengshi
Published: September 2021

Background

The aim of this study was to assess the diagnostic utility of metabolic parameters on fluorine-18-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET)/computed tomography (CT) for predicting lymph node (LN) metastasis in patients with cN2 non-small cell lung cancer (NSCLC).

Methods

We retrospectively reviewed patients who underwent surgery for cN2 NSCLC between 2007 and 2020. Those who had clinically diagnosed positive hilar and mediastinal LNs by routine CT and PET/CT imaging were investigated. To measure the metabolic parameters of LNs, the data according to maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and LN-to-primary tumor ratio of SUVmax (LPR) were examined. The diagnosis of each retrieved LN was confirmed based on histopathological examination of surgical tissue specimens. Receiver operating characteristics (ROC) curves with area under the curve (AUC) calculations and multivariate analysis by logistic regression were performed.

Results

Forty-five patients with 84 clinically diagnosed positive hilar or mediastinal LNs were enrolled in the present study. Of the 84 LNs, 63 LNs were pathologically proven as positive (75%). The SUVmax, MTV, TLG, and LPR of LN metastasis were significantly higher than those of benign nodes. In the ROC analysis, the AUC value of LPR [AUC, 0.776; 95% confidence interval (CI), 0.640–0.913] was higher than that of LN SUVmax (AUC, 0.753; 95% CI, 0.626–0.880) or LN TLG3.5 (AUC, 0.746; 95% CI, 0.607–0.885). Using the optimal LPR cutoff value of 0.47, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 84.1, 66.7, 88.3, 58.3, and 79.8%, respectively. Multivariate analysis by logistic regression showed that LPR was an independent predictor for LN metastasis (odds ratio, 6.45; 95% CI, 1.785–23.301; P = 0.004). In the subgroup analysis of adenocarcinoma patients (n = 18; 32 LNs), TLG3.5 was a better predictor (AUC, 0.816; 95% CI, 0.639–0.985) than LPR (AUC, 0.792; 95% CI, 0.599–0.986) or LN SUVmax (AUC, 0.792; 95% CI, 0.625–0.959).

Conclusions

Our findings suggest that LPR on FDG-PET is a useful predictor for LN metastasis in patients with cN2 NSCLC. TLG can be a good predictor for LN metastasis in patients with adenocarcinoma.
Forecasting lung cancer incidence, mortality, and prevalence to year 2030
Authors: Jakobsen Erik , Olsen Karen Ege , Bliddal Mette , Hornbak Malene , Persson Gitte F. , Green Anders
Published: September 2021

Background

Lung cancer incidence and prevalence is increasing worldwide and there is a focus on prevention, early detection, and development of new treatments which will impact the epidemiological patterns of lung cancer. The clinical characteristics and the trends in incidence, mortality, and prevalence of lung cancer in Denmark from 2006 through 2015 are described and a model for predicting the future epidemiological profile of lung cancer through 2030 is introduced.

Methods

The study population comprised all cases of lung cancer, registered in the Danish Cancer Registry, who were alive on January 1, 2006 or had a first-time ever diagnosis of lung cancer during 2006 through 2015. Information on morphology, stage of the disease, comorbidity and survival was obtained from other Danish health registers. Based on NORDCAN data and estimated patient mortality rates as well as prevalence proportions for the period 2006 through 2015, future case numbers of annual incidence, deaths, and resulting prevalence were projected.

Results

A total of 44.291 patients were included in the study. A shift towards more patients diagnosed with lower stages and with adenocarcinoma was observed. The incidence increased and the patient mortality rate decreased significantly, with a doubling of the prevalence during the observation period. We project that the numbers of prevalent cases of lung cancer in Denmark most likely will increase from about 10,000 at the end of 2015 to about 23,000 at the end of 2030.

Conclusions

Our findings support that lung cancer is being diagnosed at an earlier stage, that incidence will stop increasing, that mortality will decrease further, and that the prevalence will continue to increase substantially. Projections of cancer incidence, mortality, and prevalence are important for planning health services and should be updated at regular intervals.
Vaping during the COVID-19 lockdown period in Belgium
Authors: Adriaens Karolien , Van Gucht Dinska , Van Lommel Sven , Baeyens Frank
Published: September 2021

Background

Due to the Corona Virus Disease 2019 (COVID-19), the Belgian government set out a range of measures to prevent the spread of the virus. One measure included closing all non-food shops, including vape shops.

Methods

A retrospective online questionnaire was used to investigate the impact of closing the vape shops on the vaping and/or smoking behavior of current vapers.

Results

The sample (n = 202) reached consisted of 70% exclusive vapers, 29% dual users and 1% no-product users. Over half (55%, 112/202) of participants needed to buy e-liquid during the lockdown, with a small majority being able to buy e-liquids – mostly with their usual nicotine concentrations, flavor or brand –, but as much as 39% (44/112) of them ran out of e-liquid. Those buying e-liquid mainly did so by making purchases via foreign online webshops. A similar pattern was observed with respect to purchasing hardware, with about half (47%, 95/202) of participants reporting hardware availability and with a small majority (53%, 107/202) reporting hardware unavailability. Of those indicating that hardware was not available, 38% (41/107) ran out of a properly functioning e-cigarette. A non-trivial minority had to consume e-liquids with another nicotine concentration, flavor or brand than usual. One seventh of exclusive vapers before lockdown relapsed partly or completely to smoking during the lockdown. The main reasons for changing vaping and/or smoking behavior included the unavailability of e-liquid with nicotine, the unavailability of hardware, and stress/worries about COVID-19.

Conclusions

The majority of vapers succeeded in maintaining their vaping behavior as usual, highly likely due to (illegally) buying consumables online. Nevertheless, for a minority the lockdown period resulted in unintended consequences and these vapers relapsed (completely) to smoking. Even during periods of lockdown, smokers and vapers should be able to purchase low(er)-risk alternatives to smoking, for example e-cigarettes.