bluuebunny/crossref_metadata_2025 huggingface dataset:
Stricturing ileocaecal endometriosis: a rare concurrent aetiology in a patient with Crohn’s disease
Authors: Fink Teagan , Yong Wei Wei , Jayasuriya Neil
Published: January 2023

A 34-year-old female presented with colicky abdominal pain and symptoms suggestive of subacute small bowel obstruction in the setting of Crohn’s disease (CD). She was on maximal medical therapy and had undergone endoscopic balloon dilatation of a terminal ileal stricture on two occasions. Magnetic resonance enterography demonstrated acute inflammation in two segments of the terminal ileum. The patient proceeded to laparoscopic ileocolic resection. The histopathology revealed a segment of stricturing CD with chronic inflammatory change. There was also an unexpected finding of a segment of stricturing ileal disease secondary to endometriosis. Endometriosis affecting the ileum is uncommon, and concurrent CR and endometriosis is very rare. Further research is required to understand whether these two conditions are associated. Here, we present a discussion on the histopathology differences between endometriosis and CD. Clinicians are reminded of these rare concurrent conditions, as the symptomatology may mimic one another, thus impacting the treatment and management.
Oesophageal squamous papilloma: a rare finding on oesophago-gastro-duodenoscopy with malignant potential
Authors: Li Jia Xi Julian , Pham Toan , Newstead Graham
Published: January 2023

Oesophageal squamous papillomas (OSPs) are rare epithelial lesions, recognized to be benign but with reported malignant potential. We report a case of a 40-year-old female with chronic vomiting, subsequently found on oesophago-gastro-duodenoscopy to have two mid-oesophageal sessile polyps, the largest of which measured 10 mm. These were endoscopically resected with histopathology confirming an OSP without evidence of dysplasia or malignancy. The case under consideration reports the current literature on OSPs regarding their aetiology, malignant potential and optimal management.
Operative challenges of intramedullary nailing for subtrochanteric blastic pathological femur fracture: a case report
Authors: Klahs Kyle J , Heh Ethan , Yousaf Mohammad , Tadlock Joshua , Thabet Ahmed M
Published: January 2023

Prostate adenocarcinoma metastasizes to bone and forms fragile blastic lesions, which can present as dense obstacles intraoperatively. There are limited reports on the challenges surgeons face when operating through these lesions. A 60-year-old male with a pathologic subtrochanteric femur fracture in the presence of blastic lesions was successfully treated with intramedullary (IM) fixation. Pathologic fractures from blastic bone lesions are expected to increase in prevalence as survivability improves for metastatic prostate cancer. Orthopedic surgeons, when performing IM fixation for these fractures, should be prepared to utilize accessory equipment and should adopt creative techniques for reduction and fixation.
Clinical outcome following surgical resection and radiotherapy in adult patients with pleomorphic xanthoastrocytoma as defined by DNA methylation profiling
Authors: Deng Maximilian , Hinz Felix , Harrabi Semi , Sturm Dominik , Sill Martin , Korshunov Andrey , Eichkorn Tanja , Hörner-Rieber Juliane , Herfarth Klaus , Jungk Christine , Unterberg Andreas , Pfister Stefan , Wick Wolfgang , von Deimling Andreas , Jones David , Debus Jürgen , Sahm Felix , König Laila
Published: January 2023

Background

Molecular brain tumor classification using DNA methylation profiling has revealed that the methylation-class of pleomorphic xanthoastrocytoma (mcPXA) comprised a substantial portion of divergent initial diagnoses, which had been established based on histology alone. This study aimed to characterize the survival outcome in patients with mcPXAs—in light of the diverse selected treatment regimes.

Methods

A retrospective cohort of adult mcPXAs were analyzed in regard to their progression-free survival following surgical resection and postoperative radiotherapy. Radiotherapy treatment plans were correlated with follow-up images to characterize the pattern of relapse. Treatment toxicities and molecular tumor characteristics were further analyzed.

Results

Divergent initial histological diagnoses were encountered in 40.7%. There was no significant difference in local progression-free (PFS) and overall survival (OS) following gross total or subtotal resection. Postoperative radiotherapy was completed in 81% (22/27) following surgical intervention. Local PFS was 54.4% (95% CI: 35.3–84.0%) and OS was 81.3% (95% CI: 63.8–100%) after 3 years following postoperative radiotherapy. Initial relapses post-radiotherapy were primarily located in the previous tumor location and/or the planning target volume (PTV) (12/13). All patients in our cohort demonstrated the prognostically favorable pTERT-wildtype mcPXA.

Conclusion

Our study demonstrated that adult patients with mcPXAs display a worse progression-free survival compared to the reported WHO grade 2 PXAs. Future matched-pair analyses are required with a non-irradiated cohort to elucidate the benefit of postoperative radiotherapy in adult patients with mcPXAs.
A Critical Theory of Global Justice
Authors: Ibsen Malte Frøslee
Published: January 2023

The idea of a critical theory is famous across the world, yet it is today rarely practiced as originally conceived by the Frankfurt School. The waning influence of critical theory in the contemporary academy may be due to its lack of engagement with global problems and the postcolonial condition. This book offers the first systematic treatment of the idea of a critical theory of world society, advancing the conversation between critical theory and postcolonial and ecological thought. It develops a reconstruction of the Frankfurt School tradition as four paradigms of critical theory, in original interpretations of the work of Max Horkheimer, Theodor W. Adorno, Jürgen Habermas, and Axel Honneth, and considers how the global context has figured in their work and what might be salvaged for a critical theory of contemporary world society. It advances new interpretations of the relationship between critical theory and justice, the idea of communicative freedom, and three conceptions of power in the Frankfurt School tradition. The book further offers extended discussions of two emerging paradigms in the work of Amy Allen and Rainer Forst. The book argues that a critical theory of world society must combine and integrate a Kantian constructivist approach in a critique of global injustice, as defended by Forst, with the reflexive check of a self-problematizing critique of its blind spots and taken-for-granted assumptions regarding the postcolonial condition, as defended by Allen. Finally, the book rethinks the relationship between society and nature in critical theory, with far-reaching normative and methodological implications.
Revenge, Politics and Blasphemy in Pakistan
Authors: Hussain Adeel
Published: January 2023

This book uncovers the hidden stories behind Pakistan's legal fixation with blasphemy--tales of revenge, political scheming, and sovereign betrayal. It opens in nineteenth-century colonial Punjab and traces blasphemy killings and their legal afterlives to the present, linking their emergence to polemic encounters between Hindu and Muslim revivalist sects, namely the Arya Samaj and the Ahmadiyya. It offers the arresting backstories to the assassinations of Pandit Lekh Ram, a leading Hindu nationalist; Swami Shraddhanand, an early progenitor of Hindu nationalism and the principal advocate for converting Muslims to Hinduism; and Rajpal, the Hindu publisher of a sensationalist book on the Prophet Muhammad. Revenge, Politics and Blasphemy in Pakistan then maps the curious legal and political impact of these killings, illuminating the most critical moments in Pakistan's constitutional history: 1953, when outraged protestors smashed stores owned by religious minorities, triggering the country's first state of emergency; 1974, when Islamist parties pressured Zulfiqar Ali Bhutto to put blasphemy on the constitutional agenda; 1984, when Zia-ul-Haq transformed Pakistan according to his Islamist legal vision, which included more severe punishments for blasphemy; and the twenty-first century, when digital media amplified the visibility of blasphemy killings, prompting political parties to demonstrate their commitment to blasphemy laws.
Dissipation-induced dynamical phase transition in postselected quantum trajectories
Authors: Hayata Tomoya , Hidaka Yoshimasa , Yamamoto Arata
Published: January 2023

It is known that effects of dissipation or measurement backreaction in postselected quantum trajectories are described by a non-Hermitian Hamiltonian, but their consequences in real-time dynamics of many-body systems are yet to be elucidated. Through a study of a non-Hermitian Hubbard model, we reveal a novel dissipation-induced dynamical phase transition in postselected quantum trajectories, where time controls the strength of postselection and becomes the intrinsic parameter inducing the phase transition. Our findings are testable in ultracold atom experiments and may open a new avenue in the dissipative engineering of quantum systems.
Coronavirus Disease 2019 (COVID-19) Vaccination in Pregnancy
Authors: Prabhu Malavika , Riley Laura E.
Published: January 2023

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnancy is associated with significant maternal morbidity and mortality, and its risks can be mitigated with coronavirus disease 2019 (COVID-19) vaccination. Vaccination against COVID-19 in pregnancy results in protection against both maternal and neonatal SARS-CoV-2 infection, as well as maternal critical illness. Vaccination during pregnancy is safe, with no documented risks of pregnancy loss, preterm delivery, congenital anomalies, or other adverse perinatal outcomes. For these reasons, COVID-19 vaccination is recommended in pregnancy by the Centers for Disease Control and Prevention, the American College of Obstetricians and Gynecologists, and the Society for Maternal-Fetal Medicine, as well as other national and international professional organizations. In this review, we will summarize the published literature demonstrating the benefit and safety of these vaccines.
Transurethral guidewire loop for manipulation and extraction of stent: A novel, innovative, video-endoscopic technique in ureteral stent removal
Authors: Adam Ahmed , Perera Marlon
Published: January 2023

Background

Ureteral stent removal is one of the most common procedures performed in urology. Herein, we describe a novel technique for stent removal using transurethral guidewire loop for manipulation and extraction of stents method. We aimed to evaluate the role, feasibility, cost, operative time, and complications of the method. A review of the literature outlining the innovations in ureteral stent removal was also performed.

Materials and methods

Cystoscopic stent removal was performed using transurethral guidewire loop for manipulation and extraction of stents in all sequential cases. Variables including sex, age, stent type, duration, reason for stent insertion, type of anesthesia (general/local), cystoscopic stent removal time, and documentation of postprocedural complications were tabulated. In addition, using the search term “novel innovation in ureteral stent removal,” various databases (PubMed, EMBASE, Cochrane Library, SCOPUS, and Web of Science) were searched.

Results

Transurethral guidewire loop for manipulation and extraction of stents was successfully performed in all patients assessed on the first attempt. The patients comprised both sexes. The procedure was well tolerated under local anesthesia (4 of 5 cases), whereas general anesthesia was used in 1 case as the patient was booked for subsequent ureteroscopy under the same anesthetic. The procedure time was <27 seconds in all the cases assessed. No significant complications were noted. Fifteen studies involving novel innovations were included in the critical appraisal.

Conclusions

Transurethral guidewire loop for manipulation and extraction of stents is a simple, cost-effective, and innovative alternative for removing ureteral stents. It may be easily applied instead of a conventional ureteral stent grasper. Published innovative trends in ureteral stent removal have evolved over time, including advancements in stent design, retrieval devices, and the use of fluoroscope-free and cystoscope-free techniques.
Clinical Outcomes of Individualized Antiplatelet Therapy Based on Platelet Function Test in Patients After Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis
Authors: Peng Wenxing , Zhang Yunnan , Lin Baidi , Lin Yang
Published: January 2023

Platelet function test (PFT) is universally used to assess platelet reactivity to antiplatelet drugs in patients after percutaneous coronary intervention (PCI). However, it remains controversial whether individualized antiplatelet therapy guided by PFT can improve the prognosis in patients after PCI. This meta-analysis was conducted to explore the efficacy and safety of individualized antiplatelet therapy guided by PFT in patients after PCI. Studies that compared PFT-guided antiplatelet therapy with standard antiplatelet therapy were researched. The risks of major adverse cardiovascular and cerebrovascular events (MACCE) and major bleeding events were assessed. Pooled odds ratios (ORs) with 95% CIs were obtained. Finally, a total of 16,835 patients from 22 studies met the criteria and were included in the meta-analysis. Compared with standard antiplatelet therapy, individualized antiplatelet therapy guided by PFT significantly decreased the risk of MACCE (OR: 0.58, 95% CI: 0.43–0.77) in patients after PCI. There was no significant difference in major bleeding events (OR: 0.85, 95% CI: 0.70–1.05, P = 0.13). This study identified that PFT-guided individualized antiplatelet therapy could reduce the incidence of MACCE without increasing the risk of hemorrhage in patients after PCI.
Protocatechuic Aldehyde Alleviates d-Galactose–Induced Cardiomyocyte Senescence by Regulating the TCF3/ATG5 Axis
Authors: Wang Pengjun , Zhang Qingxiang
Published: January 2023

Cardiomyocyte senescence is an independent risk factor for cardiovascular diseases. Protocatechuic aldehyde (PCA) is a natural chemical in the Chinese medicinal herb Salvia miltiorrhiza. PCA could protect against oxidative stress and inflammation in the cardiovascular system. In present study, we treated H9C2 cells with d-galactose to establish an in vitro model of cardiomyocyte senescence and investigated the role and underlying mechanisms of PCA in myocardial cell senescence. It was found that d-galactose induced transcription factor 3 (TCF3) expression and decreased autophagy-related genes 5 (ATG5) expression. Meanwhile, inflammation and senescence were exacerbated by d-galactose. TCF3 transcriptionally inhibited ATG5 expression. TCF3 knockdown abolished the effects of d-galactose on H9C2 by activating ATG5-mediated autophagy. PCA hindered TCF3 and inflammation to alleviate the d-galactose–induced senescence of H9C2 cells in a dose-dependent manner. Whereas, the anti-inflammation and anti-senescence effects of PCA were reversed by TCF3 knockdown. Furthermore, absence of ATG5 partially eliminated the impacts of PCA on H9C2 cells treated with d-galactose. Conclusively, PCA alleviated d-galactose–induced senescence by downregulating TCF3, promoting ATG5-mediated autophagy, and inhibiting inflammation in H9C2 cells. These results elucidated the potential mechanism by which PCA alleviated cardiomyocyte senescence and enabled its application in treating cardiomyocyte senescence.
circNFXL1 Modulates the Kv2.1 Channel Function in Hypoxic Human Pulmonary Artery Smooth Muscle Cells via Sponging miR-29b-2-5p as a Competitive Endogenous RNA
Authors: Li Shan-Shan , Liang Shuang , Li Lu , Yang Houzhi , Long Yao , Zhuo Donghai , Chen Xu , Jin Xin
Published: January 2023

Pulmonary arterial hypertension is characterized by abnormal pulmonary vasoconstriction and vascular remodeling caused by the dysregulation of K+ channels in PA smooth muscle cells (PASMCs). However, how the K+ channels are dysregulated is still unclear. Circular RNAs (circRNAs) are noncoding RNAs with a closed-loop structure capable of sponging microRNAs (miRs), thus regulating gene expression at the post-transcriptional level. Our previous studies have demonstrated the importance of one novel circRNA (hsa_circNFXL1_009, circNFXL1) in pulmonary arterial hypertension patients, playing as a critical regulator for K+ channel activation in hypoxic human PASMCs (hPASMCs). Here, we explore the mechanisms underlying circNFXL1-regulated K+ channel expression and functions in hypoxic hPASMCs. In cultured hPASMCs, the reduction of Kv current induced by hypoxia was significantly recovered by delivering exogenous circNFXL1. Moreover, luciferase, quantitative reverse transcription-quantitative polymerase chain reaction, western blot, and mutagenesis studies confirmed that circNFXL1 reversed hypoxia-induced inhibitory effects on the Kv2.1 channel via sponging hsa-miR-29b-2-5p (miR-29b-2). Furthermore, we found that circNFXL1 reversed the miR-29b-induced Kv2.1 channel dysfunction at the whole-cell and single-channel level in HEK cells using a patch-clamp. Finally, calcium imaging revealed that hypoxia also triggered a substantial rise in the cytosolic calcium concentration ([Ca2
+
]cyt) in hPASMCs, and this hypoxia-induced elevation of [Ca2
+
]cyt was reduced by circNFXL1 through miR-29b-2. These data suggested that circNFXL1-mediated regulation of the Kv2.1 channel activation and the related intracellular calcium concentration may contribute to the effects of hypoxic pulmonary vasoconstriction.
Quantification of the Conjugated Forms of Dichlorobisphenol A (3,3′-Cl2BPA) in Rat and Human Plasma Using HPLC-MS/MS
Authors: Plattard Noemie , Gnanasegaran Riciga , Krekesheva Aida , Carato Pascal , Dupuis Antoine , Migeot Virginie , Albouy Marion , Haddad Sami , Venisse Nicolas
Published: January 2023

Background:

Bisphenol A (BPA) is a ubiquitous contaminant that has endocrine-disrupting effects. Chlorinated derivatives of BPA are formed during chlorination of drinking water and have higher endocrine-disrupting activity. Dichlorobisphenol A (Cl2BPA) is the most abundant chlorinated BPA derivative found in several human biological matrices. Recent in vitro experiments have shown that Cl2BPA is metabolized in sulpho- and glucuro-conjugated compounds. To date, no assay has been developed to quantify the sulfo- and glucuro-conjugates of 3,3′-Cl2BPA (3,3′-Cl2BPA-S and 3,3′-Cl2BPA-G, respectively).

Methods:

A high-performance liquid chromatography-tandem mass spectrometry assay for the determination of 3,3′-Cl2BPA conjugated forms in plasma samples was developed and validated according to the European Medicines Agency guidelines. Quantification was performed in the multiple reaction monitoring mode for all target analytes using a SCIEX 6500 + tandem mass spectrometer with an electrospray source operating in the negative ionization mode. Chromatographic separation was achieved using a C18 column maintained at 40°C and a binary mobile phase delivered in the gradient mode at a flow rate of 0.35 mL/min. Sample was prepared via simple precipitation using acetonitrile. The assay was validated and applied to rat and human plasma samples.

Results:

Linearity was demonstrated over the range of 0.006–25 ng/mL for 3,3′-Cl2BPA-G and 0.391–100 ng/mL for 3,3′-Cl2BPA-S. Intraday and interday bias values were in the 95%–109% range, and the imprecision <9%. Internal standard corrected matrix effects were also investigated. This method enabled quantification of the conjugated forms of 3,3′-Cl2BPA in plasma samples.

Conclusions:

This is the first report on the development and validation of an analytical method for the quantification of 3,3′-Cl2BPA-G and 3,3′-Cl2BPA-S in the plasma matrix. This study is also the first report on the in vivo occurrence of these metabolites.
The impact of right atrial pressure on outcomes in patients undergoing TIPS, an ALTA group study
Authors: Bommena Shoma , Mahmud Nadim , Boike Justin R. , Thornburg Bartley G. , Kolli Kanti P. , Lai Jennifer C. , German Margarita , Morelli Giuseppe , Spengler Erin , Said Adnan , Desai Archita P. , Junna Shilpa , Paul Sonali , Frenette Catherine , Verna Elizabeth C. , Goel Aparna , Gregory Dyanna , Padilla Cynthia , VanWagner Lisa B. , Fallon Michael B. ,   on behalf of Advancing Liver Therapeutic Approaches (ALTA) Study Group
Published: January 2023

Background and Aims:

Single-center studies in patients undergoing TIPS suggest that elevated right atrial pressure (RAP) may influence survival. We assessed the impact of pre-TIPS RAP on outcomes using the Advancing Liver Therapeutic Approaches (ALTA) database.

Approach and Results:

Total 883 patients in ALTA multicenter TIPS database from 2010 to 2015 from 9 centers with measured pre-TIPS RAP were included. Primary outcome was mortality. Secondary outcomes were 48-hour post-TIPS complications, post-TIPS portal hypertension complications, and post-TIPS inpatient admission for heart failure. Adjusted Cox Proportional hazards and competing risk model with liver transplant as a competing risk were used to assess RAP association with mortality. Restricted cubic splines were used to model nonlinear relationship. Logistic regression was used to assess RAP association with secondary outcomes.

Pre-TIPS RAP was independently associated with overall mortality (subdistribution HR: 1.04 per mm Hg, 95% CI, 1.01, 1.08, p=0.009) and composite 48-hour complications. RAP was a predictor of TIPS dysfunction with increased odds of post-90-day paracentesis in outpatient TIPS, hospital admissions for renal dysfunction, and heart failure. Pre-TIPS RAP was positively associated with model for end-stage liver disease, body mass index, Native American and Black race, and lower platelets.

Conclusions:

Pre-TIPS RAP is an independent risk factor for overall mortality after TIPS insertion. Higher pre-TIPS RAP increased the odds of early complications and overall portal hypertensive complications as potential mechanisms for the mortality impact.
The association between hepatic steatosis and incident cardiovascular disease, cancer, and all-cause mortality in a US multicohort study
Authors: Ahmed Heidi S. , Wang Na , Carr J. Jeffrey , Ding Jingzhong , Terry James G. , VanWagner Lisa B. , Hou Lifang , Huo Yuankai , Palmisano Joseph , Zheng Yinan , Benjamin Emelia J. , Long Michelle T.
Published: January 2023

Background and Aims:

NAFLD strongly associates with cardiovascular disease (CVD) risk factors; however, the association between NAFLD and incident CVD, CVD-related mortality, incident cancer, and all-cause mortality is unclear.

Approach and Results:

We included 10,040 participants from the Framingham Heart Study, the Coronary Artery Risk Development in Young Adults Study, and the Multi-ethnic Study of Atherosclerosis to assess the longitudinal association between liver fat (defined on CT) and incident CVD, CVD-related mortality, incident cancer, and all-cause mortality. We performed multivariable-adjusted Cox regression models including age, sex, diabetes, systolic blood pressure, alcohol use, smoking, HDL, triglycerides, and body mass index at baseline or time-varying covariates. The average age was 51.3±3.3 years and 50.6% were women. Hepatic steatosis was associated with all-cause mortality after 12.7 years of mean follow-up when adjusting for baseline CVD risk factors, including body mass index (HR: 1.21, 1.04–1.40); however, the results were attenuated when utilizing time-varying covariates. The association between hepatic steatosis and incident CVD was not statistically significant after we accounted for body mass index in models considering baseline covariates or time-varying covariates. We observed no association between hepatic steatosis and CVD-related mortality or incident cancer.

Conclusions:

In this large, multicohort study of participants with CT-defined hepatic steatosis, accounting for change in CVD risk factors over time attenuated associations between liver fat and overall mortality or incident CVD. Our work highlights the need to consider concurrent cardiometabolic disease when determining associations between NAFLD and CVD and mortality outcomes.
Improvement of clinical outcomes in patients undergoing peritoneal dialysis using hydroxymethylglutaryl-CoA reductase inhibitors: A systematic review and meta-analysis
Authors: Lee Dan-Ying , Huang Chi-Jung , Yeh Wan-Yu , Sung Shih-Hsien , Chen Chen-Huan , Cheng Hao-Min
Published: January 2023

Background:

It is unclear whether hydroxymethylglutaryl-CoA reductase inhibitor (statin) therapy decreases the risk of mortality and cardiovascular disease (CVD) in patients undergoing peritoneal dialysis (PD).

Methods:

We performed a literature search of PubMed, Cochrane Library, Embase, and other databases for research publications up to June 2022. The outcomes of interest were fatal and nonfatal CVDs, all-cause mortality, and changes in the biochemical profiles. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled and synthesized using a random-effects model. The certainty of the evidence was determined using Grading of Recommendations, Assessment, Development, and Evaluation.

Results:

Nine studies, including 2,933 patients undergoing PD, were included. Among them, three studies, including 2,099 patients, reported all-cause mortality, and three, including 1,571 patients, reported CVDs. In these patients, pooling results of two observational studies (very low-certainty evidence) showed that statin therapy significantly reduced CVDs (HR = 0.67; 95% CI = 0.54–0.84; p = 0.0004). Moreover, statin therapy was associated with significantly reduced low-density lipoprotein cholesterol, total cholesterol, and C-reactive protein levels (very low certainty of evidence). However, the effects of statin therapy on triglyceride, high-density lipoprotein, and albumin levels were not statistically significant.

Conclusion:

Although statin therapy was associated with significantly reduced low-density lipoprotein cholesterol, total cholesterol, and C-reactive protein levels, the probable beneficial effect of statins on CVD risk in patients undergoing PD could not be concluded firmly. Additional high-quality studies are required to assess the potential beneficial effects of statin therapy in PD patients.
Freezing nitrogen ethanol composite reduces periprosthetic infection caused by Staphylococcus aureus contaminated metal implants: An animal study
Authors: Chen Kuan-Lin , Chen Chao-Ming , Chen Yi-Chung , Wang Jir- You , Chen Cheng-Fong , Wu Po-Kuei , Chen Wei-Ming
Published: January 2023

Background:

Implant-associated infection remains a major complication of orthopedic surgery. The treatment of such infection is complicated by bacterial biofilm formation on the metal surfaces of implants. Biofilm surrounds and protects the bacteria against the organism’s endogenous defense system and from external agents such as antibiotics and mechanical debridement. This study aims to evaluate whether freezing nitrogen ethanol composite (FNEC), the combination of liquid nitrogen and 95% ethanol in a 3 to 1 ratio, used frequently in bone tumor surgery, is capable of disinfecting Staphylococcus aureus contaminated implants.

Methods:

The femurs of six New Zealand white rabbits were implanted with S. aureus-contaminated screws, half of which were treated with FNEC before implantation. The femurs were harvested 14 days after implantation. Histological analysis and TUNEL assay were conducted. The autoclaved screw, contaminated screw, and FNEC-treated contaminated screw were investigated using scanning electron microscopy to evaluate the biofilm structure.

Results:

The FNEC-treated group had significantly lower relative C-reactive protein levels. An obvious periosteal reaction at the implant site was observed in all rabbits in the non-FNEC group but none was observed in the FNEC-treated group. The FNEC-treated group exhibited fewer empty lacunae, less inflammatory infiltration, and less bone necrosis. Immunohistochemical analysis showed no S. aureus in bone tissue from the FNEC-treated group. Scanning electron microscopy showed disruption of the biofilm on the contaminated screw treated with FNEC.

Conclusion:

FNEC showed potential in disinfecting S.aureus-contaminated implants. Further investigation is warranted, such as the effect on the implant-cement-bone interface, for FNEC to be used clinically in treating implant-associated infection.
Bone age assessment: Large-scale comparison of Greulich-Pyle method and Tanner-Whitehouse 3 method for Taiwanese children
Authors: Yuh Yeong-Seng , Chou Ting Ywan , Tung Tao-Hsin
Published: January 2023

Background:

The Greulich-Pyle (GP) and Tanner-Whitehouse 3 (TW3) methods are two common methods for assessing bone age (BA). The applicability of these methods for populations other than those in the United States and Europe has been questioned. Thus, this study tested the applicability of these methods for Taiwanese children.

Methods:

In total, 1476 radiographs (654 boys, 822 girls) were analyzed. A subset of 200 radiographs was evaluated to determine intrarater and interrater reliability and the time required to yield a BA assessment. BA was determined by two reviewers using the GP method and two of the TW3 methods (the Radial-Ulnar-Short bones [RUS] method and the carpals method [Carpal]). The GP and TW3 methods were directly compared using statistical techniques. A subgroup analysis by age was performed to compare BA and chronological age using a paired t test for each age group.

Results:

The average times required to yield an assessment using the GP and TW3-RUS methods were 0.79 ± 0.14 and 3.01 ± 0.84 min (p < 0.001), respectively. Both the intrarater and interrater correlation coefficients were higher for the GP method (0.993, 0.992) than the TW3-RUS (0.985, 0.984) and TW3-Carpal (0.981, 0.973) methods. The correlation coefficient for the GP and TW3-RUS methods was highest in the pubertal stage (0.898 for boys and 0.909 for girls). The mean absolute deviations for the GP and TW3-RUS methods in the pubertal stage were 0.468 years (boys) and 0.496 years (girls). Both the GP and TW3-Carpal methods underestimated BA for boys in the prepubertal stage. Both the GP and TW3-RUS methods overestimated BA for girls in the pubertal and postpubertal stages.

Conclusion:

The GP and TW3-RUS methods exhibit strong agreement in the pubertal and postpubertal stages for both sexes. With appropriate adjustments based on Taiwanese data, both methods are applicable to our children.
Validity Properties of a Self-reported Modified Frailty Phenotype Among People With HIV in Clinical Care in the United States
Authors: Ruderman Stephanie A. , Webel Allison R. , Willig Amanda L. , Drumright Lydia N. , Fitzpatrick Annette L. , Odden Michelle C. , Cleveland John D. , Burkholder Greer , Davey Christine H. , Fleming Julia , Buford Thomas W. , Jones Raymond , Nance Robin M. , Whitney Bridget M. , Mixson L. Sarah , Hahn Andrew W. , Mayer Kenneth H. , Greene Meredith , Saag Michael S. , Kamen Charles , Pandya Chintan , Lober William B. , Kitahata Mari M. , Crane Paul K. , Crane Heidi M. , Delaney Joseph A. C.
Published: January 2023

Modifications to Fried's frailty phenotype (FFP) are common. We evaluated a self-reported modified frailty phenotype (Mod-FP) used among people with HIV (PWH). Among 522 PWH engaged in two longitudinal studies, we assessed validity of the four-item Mod-FP compared with the five-item FFP. We compared the phenotypes via receiver operator characteristic curves, agreement in classifying frailty, and criterion validity via association with having experienced falls. Mod-FP classified 8% of PWH as frail, whereas FFP classified 9%. The area under the receiver operator characteristic curve for Mod-FP classifying frailty was 0.93 (95% CI = 0.91–0.96). We observed kappa ranging from 0.64 (unweighted) to 0.75 (weighted) for categorizing frailty status. Both definitions found frailty associated with a greater odds of experiencing a fall; FFP estimated a slightly greater magnitude (i.e., OR) for the association than Mod-FP. The Mod-FP has good performance in measuring frailty among PWH and is reasonable to use when the gold standards of observed assessments (i.e., weakness and slowness) are not feasible.
Experiences of Underrepresented Racial Minorities in the Entry-Level Physical Therapy Education Application Process: A Conceptual Framework
Authors: Yeung Melissa
Published: January 2023

Introduction.

The purpose of this study was to explore the experiences of Black and Latinx students as they navigate the entry-level physical therapy education program (PTEP) admissions process and how they made meaning of their experiences.

Review of Literature.

Existing literature is focused on quantitative aspects of the admissions process and on the applicant's potential for success within an entry-level PTEP. There is currently not enough evidence to provide the applicant perspective when navigating the entry-level physical therapy education admissions process.

Subjects.

A total of 11 participants were recruited from all entry-level PTEPs through social media sites and national student organizations for Black and Latinx students enrolled in entry-level PTEPs.

Methods.

Three interviews were conducted for each participant. Their responses were combined with a demographic survey received before the first. Interviews were then transcribed and coded with deductive and inductive processes.

Results.

The study yields a conceptual model for recruitment of Black and Latinx students. Factors for programs to consider include introduction to the profession, challenges and factors of support within the application process, and factors influencing enrollment decisions.

Discussion and Conclusion.

This exploratory study provides a roadmap to better understand the experiences and journey of Black and Latinx students to the field of physical therapy. Findings could be used by entry-level PTEPs to provide better access to information for prospective students.
Digital imaging software versus the “eyeball” method in quantifying steatosis in a liver biopsy
Authors: Long Jane J. , Nijhar Kieranjeet , Jenkins Reed T. , Yassine Adham , Motter Jennifer D. , Jackson Kyle R. , Jerman Stephanie , Besharati Sepideh , Anders Robert A. , Dunn Ty B. , Marsh Christopher L. , Rayapati Divya , Lee David D. , Barth Rolf N. , Woodside Kenneth J. , Philosophe Benjamin
Published: January 2023

Steatotic livers represent a potentially underutilized resource to increase the donor graft pool; however, 1 barrier to the increased utilization of such grafts is the heterogeneity in the definition and the measurement of macrovesicular steatosis (MaS). Digital imaging software (DIS) may better standardize definitions to study posttransplant outcomes. Using HALO, a DIS, we analyzed 63 liver biopsies, from 3 transplant centers, transplanted between 2016 and 2018, and compared macrovesicular steatosis percentage (%MaS) as estimated by transplant center, donor hospital, and DIS. We also quantified the relationship between DIS characteristics and posttransplant outcomes using log-linear regression for peak aspartate aminotransferase, peak alanine aminotransferase, and total bilirubin on postoperative day 7, as well as logistic regression for early allograft dysfunction. Transplant centers and donor hospitals overestimated %MaS compared with DIS, with better agreement at lower %MaS and less agreement for higher %MaS. No DIS analyzed liver biopsies were calculated to be >20% %MaS; however, 40% of liver biopsies read by transplant center pathologists were read to be >30%. Percent MaS read by HALO was positively associated with peak aspartate aminotransferase (regression coefficient= 1.041.081.12, p<0.001), peak alanine aminotransferase (regression coefficient =1.041.081.12, p<0.001), and early allograft dysfunction (OR=1.101.401.78, p=0.006). There was no association between HALO %MaS and total bilirubin on postoperative day 7 (regression coefficient =0.991.011.04, p=0.3). DIS provides reproducible quantification of steatosis that could standardize MaS definitions and identify phenotypes associated with good clinical outcomes to increase the utilization of steatite livers.
Lithium Use for Suicide Prevention, Revisited
Authors: Wortzel Hal S. , Simonetti Joseph A. , Oslin David W. , Hermes Eric , Matarazzo Bridget B.
Published: January 2023

The literature on lithium’s role in suicide prevention is rife with competing interpretations and diverging opinions, in part stemming from the complexity of the underlying literature base. Conclusions that lithium unequivocally offers suicide prevention benefits do not appear warranted based on the strength of existing studies. Given the evidence along with the indisputable risks associated with lithium (especially in overdose), and the need for sustained therapeutic dosing to achieve any theoretical antisuicide benefit, it seems evident that any potential role for lithium in suicide prevention is far narrower than originally hypothesized. As such, the goal of this article is to provide an evidence-informed, therapeutic risk management approach to clinical decision-making concerning the use of lithium for suicide prevention to ensure that such prescribing is done in a patient-centered fashion that mitigates, to the extent possible, the potential risks of lithium use. This includes a review of potential justifications for not employing lithium for suicide prevention, given the recommendations in the existing guidelines. Clinicians should approach this clinical decision in an individualized fashion with full consideration of the potential risks associated with lithium use and availability, as well as potential alternative treatment options. An individualized risk/benefit analysis must also take into consideration the presence of comorbid conditions; the acuity of suicide risk, and any history of self-directed violence, with special attention to suicide attempts via overdose; treatment adherence, past and present; the presence and/or strength of a therapeutic relationship; and other viable treatment options.
Mirtazapine-induced Acute Pancreatitis in Patients With Depression: A Systematic Review
Authors: Milosavljević Miloš N. , Janković Slobodan M. , Kostić Marina J. , Pejčić Ana V.
Published: January 2023

Objective:

Antidepressant-induced pancreatitis is a rare, albeit serious, adverse effect, with a frequency of occurrence that is not equally distributed among antidepressant drugs. The goal of this study was to investigate the association and causal relationship between mirtazapine treatment of patients with depression and pancreatitis.

Methods:

The study was designed as a systematic review of the literature, accompanied by the description of a new case of mirtazapine-associated acute pancreatitis.

Results:

Nine cases of mirtazapine-associated pancreatitis have been reported, involving 7 female patients and 2 male patients with a mean age of 46.4 years (range: 26 to 83 y of age). All of the patients were hospitalized, with an average length of stay of 16.2 days (range: 3 to 34 d). In 6 cases, “de-challenge” followed by improvement was reported. The patients for whom the outcome was reported (7 of 9) recovered completely.

Conclusion:

Although a rare adverse effect, mirtazapine-induced pancreatitis should be considered when patients taking mirtazapine report abdominal discomfort.
Using the Generic Analysis Method to Analyze Sentinel Event Reports Across Hospitals: A Retrospective Cross-Sectional Study
Authors: Baartmans Mees C. , Van Schoten Steffie M. , Smit Bert J. , Wagner Cordula
Published: January 2023

Objectives

Improving patient safety by investigating sentinel events (SEs) is hampered by the focus on isolated events within hospitals and a narrow scope of traditional root cause analysis methods. We aimed to examine if performing cross-hospital aggregate analysis of SEs applying a novel generic analysis method (GAM) bearing a human factor perspective can enhance learning from SEs.

Methods

A retrospective cross-sectional review of SE reports from 28 Dutch general hospitals using the GAM to reanalyze events was performed. A qualitative approach was used to identify contributing factors and system issues. Findings were discussed with a patient safety expert panel. Descriptive statistics and measures of associations between domains were calculated.

Results

Sixty-nine SE reports were reviewed. Applying the GAM provided a more holistic SE analysis than a traditional method. Of the 405 identified contributing factors in all SEs, the majority was related to the persons involved (patients and professionals, n = 146 [36.2%]) and the organization (n = 121 [30%]). The most frequently recurring pattern was the combination of factors related to the persons involved, the technology used, the tasks of professionals, and organizational factors influencing the event. Cross-hospital aggregate GAM analysis of SEs helped to identify system issues and propose more system-oriented overarching recommendations.

Conclusions

This study found that applying the GAM to analyze SEs across hospitals can help to improve learning from SEs and may result in proposing stronger recommendations. The method can support hospitals, working together in a network of hospitals, to jointly learn from SEs.
An invasive ant increases deformed wing virus loads in honey bees
Authors: Dobelmann Jana , Felden Antoine , Lester Philip J.
Published: January 2023

The majority of invasive species are best known for their effects as predators. However, many introduced predators may also be substantial reservoirs for pathogens. Honey bee-associated viruses are found in various arthropod species including invasive ants. We examined how the globally invasive Argentine ant (
Linepithema humile
), which can reach high densities and infest beehives, is associated with pathogen dynamics in honey bees. Viral loads of deformed wing virus (DWV), which has been linked to millions of beehive deaths around the globe, and black queen cell virus significantly increased in bees when invasive ants were present. Microsporidian and trypanosomatid infections, which are more bee-specific, were not affected by ant invasion. The bee virome in autumn revealed that DWV was the predominant virus with the highest infection levels and that no ant-associated viruses were infecting bees. Viral spillback from ants could increase infections in bees. In addition, ant attacks could pose a significant stressor to bee colonies that may affect virus susceptibility. These viral dynamics are a hidden effect of ant pests, which could have a significant impact on disease emergence in this economically important pollinator. Our study highlights a perhaps overlooked effect of species invasions: changes in pathogen dynamics.
Life history in primate teeth is revealed by changes in major and minor element concentrations measured via field-emission SEM-EDS analysis
Authors: Cerrito Paola , Hu Bin , Kalisher Rachel , Bailey Shara E. , Bromage Timothy G.
Published: January 2023

Overcoming the non-specificity of histological accentuated growth lines in hard tissues is an ongoing challenge. Identifying season at death and reproductive events has profound implications for evolutionary, ecological and conservation studies. Dental cementum is a mineralized tissue with yearly periodicity that continues deposition from tooth formation until death, maintaining a record spanning almost the entire life of an individual. Recent work has successfully employed elemental analysis of calcified incremental tissues to detect changes in extrinsic conditions such as diet and climate and to identify two important life-history milestones: weaning and sexual maturity. Here, we employ field-emission scanning electron microscopy and energy-dispersive X-ray analysis to measure the relative concentrations of calcium, phosphorous, oxygen, magnesium and sodium in the cementum of 34 teeth from seven male and female rhesus macaques with known medical and life-history information. We find that changes in relative magnesium concentrations correspond with reproductive events in females and breastfeeding in infants. Additionally, we observe seasonal calcium patterns in 77.3% of the samples.
Social learning in a nocturnal marsupial: is it a possum-ability?
Authors: Godfrey Emma J. , Cameron Elissa Z. , Hickling Graham J.
Published: January 2023

Social learning can reduce the costs associated with trial-and-error learning. There is speculation that social learning could contribute to trap and bait avoidance in invasive species like the common brushtail possum (
Trichosurus vulpecula
)—a marsupial for which social learning has not previously been investigated. In large outdoor pens, we presented wild-caught ‘demonstrator’ possums with puzzle devices containing an attractive food reward; 2 of 8 demonstrators accessed the reward the first night the puzzle was presented and another three succeeded on later nights. Meanwhile, ‘observer’ possums in adjacent pens watched the demonstrators for five nights and then were given the opportunity to solve the puzzle themselves; 15 of 15 succeeded on their first night (a highly significant improvement). This experiment thus provides strong evidence of social learning by common brushtail possums. Future research should investigate whether information about aversive stimuli (such as traps and toxic baits) can similarly be transmitted between possums by social learning; if so, this could have important implications for possum pest control.
Neurodegenerative disease of the brain: a survey of interdisciplinary approaches
Authors: Davenport Franca , Gallacher John , Kourtzi Zoe , Koychev Ivan , Matthews Paul M. , Oxtoby Neil P. , Parkes Laura M. , Priesemann Viola , Rowe James B. , Smye Stephen W. , Zetterberg Henrik
Published: January 2023

Neurodegenerative diseases of the brain pose a major and increasing global health challenge, with only limited progress made in developing effective therapies over the last decade. Interdisciplinary research is improving understanding of these diseases and this article reviews such approaches, with particular emphasis on tools and techniques drawn from physics, chemistry, artificial intelligence and psychology.
Foot shape is related to load-induced shape deformations, but neither are good predictors of plantar soft tissue stiffness
Authors: Schuster Robert W. , Cresswell Andrew G. , Kelly Luke A.
Published: January 2023

Modern human feet are considered unique among primates in their capacity to transmit propulsive forces and re-use elastic energy. Considered central to both these capabilities are their arched configuration and the plantar aponeurosis (PA). However, recent evidence has shown that their interactions are not as simple as proposed by the theoretical and mechanical models that established their significance. Using three-dimensional foot scans and statistical shape and deformation modelling, we show that the shape of the longitudinal and transverse arches varies widely among the healthy adult population, and that the former is subject to load-induced arch flattening, whereas the latter is not. However, longitudinal arch shape and flattening are only one of the various foot shape–deformation relationships. PA stiffness was also found to vary widely. Yet only a small amount of this variability (approx. 10–18%) was explained by variations in foot shape, deformation and their combination. These findings add to the mounting evidence showing that foot mechanics are complex and cannot be accurately represented by simple models. Especially the interactions between longitudinal arch and PA appear to be far less constrained than originally proposed, most likely due to the many degrees of freedom provided by the structural complexity of our feet.