bluuebunny/crossref_metadata_2025 huggingface dataset:
Botrytis cinereainfection accelerates ripening and cell wall disassembly to promote disease in tomato fruit
Authors: Silva Christian J , Adaskaveg Jaclyn A , Mesquida-Pesci Saskia D , Ortega-Salazar Isabel B , Pattathil Sivakumar , Zhang Lisha , Hahn Michael G , van Kan Jan A L , Cantu Dario , Powell Ann L T , Blanco-Ulate Barbara
Published: September 2022

Postharvest fungal pathogens benefit from the increased host susceptibility that occurs during fruit ripening. In unripe fruit, pathogens often remain quiescent and unable to cause disease until ripening begins, emerging at this point into destructive necrotrophic lifestyles that quickly result in fruit decay. Here, we demonstrate that one such pathogen, Botrytis cinerea, actively induces ripening processes to facilitate infections and promote disease in tomato (Solanum lycopersicum). Assessments of ripening progression revealed that B. cinerea accelerated external coloration, ethylene production, and softening in unripe fruit, while mRNA sequencing of inoculated unripe fruit confirmed the corresponding upregulation of host genes involved in ripening processes, such as ethylene biosynthesis and cell wall degradation. Furthermore, an enzyme-linked immunosorbent assay (ELISA)-based glycomics technique used to assess fruit cell wall polysaccharides revealed remarkable similarities in the cell wall polysaccharide changes caused by both infections of unripe fruit and ripening of healthy fruit, particularly in the increased accessibility of pectic polysaccharides. Virulence and additional ripening assessment experiments with B. cinerea knockout mutants showed that induction of ripening depends on the ability to infect the host and break down pectin. The B. cinerea double knockout Δbc polygalacturonase1 Δbc polygalacturonase2 lacking two critical pectin degrading enzymes was incapable of emerging from quiescence even long after the fruit had ripened at its own pace, suggesting that the failure to accelerate ripening severely inhibits fungal survival on unripe fruit. These findings demonstrate that active induction of ripening in unripe tomato fruit is an important infection strategy for B. cinerea.
A common whole-genome paleotetraploidization in Cucurbitales
Authors: Wang Jiaqi , Yuan Min , Feng Yishan , Zhang Yan , Bao Shoutong , Hao Yanan , Ding Yue , Gao Xintong , Yu Zijian , Xu Qiang , Zhao Junxin , Zhu Qianwen , Wang Ping , Wu Chunyang , Wang Jianyu , Li Yuxian , Xu Chuanyuan , Wang Jinpeng
Published: September 2022

Cucurbitales are an important order of flowering plants known for encompassing edible plants of economic and medicinal value and numerous ornamental plants of horticultural value. By reanalyzing the genomes of two representative families (Cucurbitaceae and Begoniaceae) in Cucurbitales, we found that the previously identified Cucurbitaceae common paleotetraploidization that occurred shortly after the core-eudicot-common hexaploidization event is shared by Cucurbitales, including Begoniaceae. We built a multigenome alignment framework for Cucurbitales by identifying orthologs and paralogs and systematically redating key evolutionary events in Cucurbitales. Notably, characterizing the gene retention levels and genomic fractionation patterns between subgenomes generated from different polyploidizations in Cucurbitales suggested the autopolyploid nature of the Begoniaceae common tetraploidization and the allopolyploid nature of the Cucurbitales common tetraploidization and the Cucurbita-specific tetraploidization. Moreover, we constructed the ancestral Cucurbitales karyotype comprising 17 proto-chromosomes, confirming that the most recent common ancestor of Cucurbitaceae contained 15 proto-chromosomes and rejecting the previous hypothesis for an ancestral Cucurbitaceae karyotype with 12 proto-chromosomes. In addition, we found that the polyploidization and tandem duplication events promoted the expansion of gene families involved in the cucurbitacin biosynthesis pathway; however, gene loss and chromosomal rearrangements likely limited the expansion of these gene families.
Uncoupling differential water usage from drought resistance in a dwarf Arabidopsis mutant
Authors: Ginzburg Daniel N , Bossi Flavia , Rhee Seung Y
Published: September 2022

Understanding the molecular and physiological mechanisms of how plants respond to drought is paramount to breeding more drought-resistant crops. Certain mutations or allelic variations result in plants with altered water-use requirements. To correctly identify genetic differences which confer a drought phenotype, plants with different genotypes must be subjected to equal levels of drought stress. Many reports of advantageous mutations conferring drought resistance do not control for soil water content (SWC) variations across genotypes and may therefore need to be re-examined. Here, we reassessed the drought phenotype of the Arabidopsis (Arabidopsis thaliana) dwarf mutant, chiquita1-1 (chiq1-1, also called constitutively stressed 1 (cost1)), by growing mutant seedlings together with the wild-type to ensure uniform soil water availability across genotypes. Our results demonstrate that the dwarf phenotype conferred by loss of CHIQ1 function results in constitutively lower water usage per plant, but not increased drought resistance. Our study provides an easily reproducible, low-cost method to measure and control for SWC and to compare drought-resistant genotypes more accurately.
Ignorance-led port policing? The limits of information sharing–based policing in the North Sea Canal Area and Port of Amsterdam and in the Port of Moerdijk
Authors: Eski Yarin , Fiddelers Valérie
Published: September 2022

Whereas the Dutch government considers the Port of Rotterdam and Amsterdam Airport as crucial drug transport hubs for organized crime groups, there is scarce governance focus on the increasing shift of these groups to small, medium-sized, and (still) relatively anonymous Dutch ports, like the North Sea Canal Area (NSCA) and the Port of Moerdijk (PoM). They can be considered criminal diversion ports where port policing parties relies strongly on information sharing to establish intelligence-led port policing. What has remained un(der)studied are not only these criminal diversion ports, but also, and more specifically how and why (frontline) port policing staff (do not) share information and intelligence (position) with one another other. What are their motivations to withhold or share information? That is the key research question answered in this contribution by comparing two recent studies, one on the NSCA (Eski, Y., Boelens, M., Mesic, A., and Boutellier, H. (2021). Van Verhalen naar Verbalen: Een verkennende studie naar de aanpak van ondermijnende drugscriminaliteit in het Noordzeekanaalgebied en de haven van Amsterdam (NZKG). The Hague: Sdu.) and the other on the PoM (Fiddelers, V. [2021]. Intel aan het roer. Een studie naar informatiedeling binnen de politie ten behoeve van de aanpak ondermijnende criminaliteit in de haven van Moerdijk. Amsterdam: VU University.). By exploring comparatively the reasons the studies’ participants have, or think others have, for (withholding) information, this article considers to which extent Dutch small, medium-sized criminal diversion ports accommodate ignorance-led port policing (Reiner in Shepherd, J., Pease, K., Reiner, R., Squires, P., and Westmarland, L. (2010). ‘Debating Policing Research: A Research Council for Crime and Justice? Jonathan Shepherd and Ken Pease Call for Medical Research Standards to be Replicated in Policing Studies. Robert Reiner, Peter Squires, and Louise Westmarland respond.’ Criminal Justice Matters 80(1): 2–5.).
Analysing and communicating vulnerability to crime at micro-places: An empirical application of how to improve the visual representation of a spatial crime risk assessment in Iztapalapa, Mexico City
Authors: Dugato Marco
Published: September 2022

This paper proposes an alternative way to analyse and visualize vulnerability to crime at micro-places according to the different combinations of contextual elements that characterize them. The study focuses on violent crimes in the urban area of Iztapalapa, Mexico City. The identification of the risky places follows the Risk Terrain Modelling approach including both information on environmental elements and on the socio-demographic characteristics of the neighbourhoods. Cluster analysis is applied to classify and map these places according to the different environmental settings. The paper discusses how the suggested visual representations is a powerful communicative means to complement traditional risk maps that simply classify the areas according to their future crime likelihood. The paper argues that displaying the combination of crime correlates ensures more effective risk governance. The paper also indicates how effective communication and the selection of proper graphical visualization of analytical findings are pivotal for fostering collaboration between crime analysts, law enforcement agencies, and other stakeholders.
Anti-PM-Scl antibodies–positive patients encompass three different groups with distinct prognoses
Authors: Breillat Paul , Mariampillai Kuberaka , Legendre Paul , Martins Pauline , Dunogue Bertrand , Charuel Jean Luc , Miyara Makoto , Goulvestre Claire , Paule Romain , Vanquaethem Helene , Ackermann Felix , Benveniste Olivier , Nunes Hilario , Mouthon Luc , Allenbach Yves , Uzunhan Yurdagul
Published: September 2022

Objective

To help identify homogeneous subgroups among patients with anti-PM-scleroderma-antibodies (PM-Scl-Abs) positive auto-immune diseases regardless of diagnostic classifications.

Material and methods

This multicentric (four hospitals) retrospective study collected all consecutive patients (from 2011 to 2021) with positive testing for anti-PM-Scl-Abs in a context of CTD. Subgroups of patients with similar clinico-biological phenotypes were defined using unsupervised multiple correspondence analysis and hierarchical clustering analysis of the features recorded in the first year of follow-up.

Results

One hundred and forty-two patients with anti-PM-Scl-Abs were evaluated and 129 patients were included in the clustering analysis and divided into three clusters. Cluster 1 (n = 47) included patients with frequent skin thickening, digestive involvement and interstitial lung disease (ILD) with non-specific interstitial pneumonia (NSIP). They were more likely to develop progressive fibrosing ILD. Cluster 2 (n = 36) included patients who all featured NSIP with frequent organizing pneumonia–associated pattern and mechanic’s hands. This subgroup had increased risk of relapse and ILD was characterized by a good functional outcome. Cluster 3 (n = 46) was characterized by predominant or isolated musculoskeletal involvement and frequently matched UCTD criteria. Although very frequent among anti-PM-Scl-Abs positive patients, muscle involvement was less discriminating compared with skin thickening and ILD pattern to classify patients into subgroups.

Conclusion

Anti-PM-Scl-Abs associated auto-immune diseases are segregated into three subgroups with distinct clinical phenotype and outcomes. Skin thickening and NSIP are determinant predictors in segregation of theses populations.
An assessment of the US Small Business Innovation Research (SBIR) program: A study of project failure
Authors: Link Albert N , Swann Christopher A , van Hasselt Martijn
Published: September 2022

In 2000 and 2012, the US Congress charged the National Research Council (NRC) to study how the Small Business Innovation Research (SBIR) program had stimulated technological innovation and used small businesses to meet Federal research and development needs and to recommend program improvements. Using project data collected by the NRC, we suggest that an important assessment metric not previously considered by the NRC in its reports to Congress relates to the failure rate of funded Phase II research projects. We identify a number of covariates associated with project failure, and we recommend that program managers might decrease the likelihood of project failure if funded firms can be given relevant information about how to contact angel investors, venture capitalists, private investors, and the like, and how to present a proposal for additional research investment dollars. Our findings should have a direct benefit to other countries that have implemented SBIR-like programs.
‘A World Apart’: Change in Student Attitudes during the Interwar Period, 1918–1933
Authors: Harrington Neil
Published: September 2022

This article investigates student culture in interwar universities using the relatively neglected material of student magazines. Recent scholarship suggests that students became increasingly politically aware during the interwar period, accompanied by a significant shift in attitudes in the early 1930s. The present research argues that this change in attitudes was largely superficial, and that underlying ‘corporate’ values remained intact. This is evidenced by the involvement of ex-service students in strengthening corporate culture, and the close identification between these students and immediate ‘post-war’ students. Certainly, aspects of corporate culture were challenged later in the decade, when alongside the influence of pacifism there was a move from a ‘parochial’ style of magazine towards more ‘serious’ and ‘political’ articles. However, it is argued that this represented a temporary shift in focus, rather than a fundamental change in underlying values. Student attitudes continued to be embedded within an existing framework based on public school values, and reflecting a commitment to patriotism, duty, and social obligation.
Occurrence of Phytophthora ramorum and Other Phytophthora Species on Woody Ornamentals in Public Gardens and Parks in Northwestern Spain
Authors: Pintos Cristina , Rial Cristina , Piñón Pilar , Salinero Carmen , Aguín Olga
Published: September 2022

Phytophthora ramorum is a harmful pathogen of ornamental and forest trees in Europe and North America. This pathogen has been recovered from nursery plants in Galicia (northwestern Spain) since 2003 and, despite carrying out the measures implemented by Commission Decision 2002/757/CE, including the eradication of infected plants and periodic inspections in nurseries, it is likely that P. ramorum has spread in landscaped green areas through planting of infected nursery stock. The aim of this work was to survey woody ornamental plants in public parks and gardens in Galicia for the presence of P. ramorum from 2011 to 2018 and to identify and characterize any other species of the genus found. Samples of leaves, twigs, and rhizosphere soil of symptomatic ornamental trees and shrubs were analyzed. Morphological, physiological, and molecular characteristics of 93 collect isolates enabled the identification of 13 species of Phytophthora. The greatest diversity of Phytophthora species was detected on Rhododendron and Camellia. P. ramorum was isolated from leaf samples of Camellia sp., Rhododendron sp ., and Viburnum tinus grown in three sites. To our knowledge, this is the first time that P. ramorum has been detected in landscaped green areas in Spain. These results suggest that regular inspections of symptomatic ornamental woody plants are necessary to control the spread of P. ramorum and other Phytophthora species.
Randomized Trial of Transversus Abdominis Plane Block With Liposomal Bupivacaine After Cesarean Delivery With or Without Intrathecal Morphine
Authors: Habib A.S. , Nedeljkovic S.S. , Horn J.L. , Smiley R.M. , Kett A.G. , Vallejo M.C. , Song J. , Scranton R. , Bao X.
Published: September 2022

(J Clin Anesth. 2021;75:110527. doi: 10.1016/j.jclinane.2021.110527)

Intrathecal morphine (ITM) is regularly used for analgesia following cesarean delivery (CD), although there is no standardized dose. Employed as part of a multimodal analgesia system, recommended ITM dosing ranges from 50 to 150 µg. Dose-dependent opioid-related adverse events including vomiting, nausea, pruritus, and respiratory depression call for investigation into alternate methods that provide effective analgesia with fewer opioid-related adverse events. Previous studies of transverse abdominis plane (TAP) block with long-acting liposomal bupivacaine (LB) combined with ITM suggest enhanced analgesia compared to LB TAP or ITM alone. The comparison of efficacy and safety of LB TAP block with or without ITM (LB and LB + ITM) versus ITM alone has not been previously undertaken. The adequacy of analgesia including pain scores and postsurgical opioid consumption was studied for the 3 intervention groups (LB and LB + ITM, vs. ITM) with noninferiority tested before superiority.
Tranexamic Acid and Obstetric Hemorrhage: Give Empirically or Selectively?
Authors: Shander A. , Javidroozi M. , Sentilhes L.
Published: September 2022

(Int J Obstet Anesth. 2021;48:103206)

Tranexamic acid (TXA) is an antifibrinolytic agent that promotes hemostasis by preventing blood clot deterioration. Common off-label uses of TXA include preventing and treating bleeding and blood loss in trauma, cardiac surgery, intracranial and subarachnoid hemorrhage, orthopedic and spinal surgery, and obstetric settings. Despite its common use, much is unclear about the effects, risks, mechanisms, and dosing of TXA. Since serious side effects like seizures and venous thrombo-embolic events have been observed, a closer look at the dosing and use of TXA is needed.
Early and Systematic Administration of Fibrinogen Concentrate in Postpartum Hemorrhage Following Vaginal Delivery: The FIDEL Randomized Controlled Trial
Authors: Ducloy-Bouthors A.S. , Mercier F.J. , Grouin J.M. , Bayoumeu F. , Corouge J. , Le Gouez A. , Rackelboom T. , Broisin F. , Vial F. , Luzi A. , Capronnier O. , Huissoud C. , Mignon A. ,   the FIDEL Working Group
Published: September 2022

(BJOG. 2021;128:1814–1823)

Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide. Plasma fibrinogen is the first coagulation factor to drop steeply during PPH. As fibrinogen concentration decreases, risk of severe PPH increases. When fibrinogen concentrations drop below 2 g/L, there is a 100% positive predictive value for severe PPH and fibrinogen replacement is recommended. However, systematic fibrinogen administration at an earlier time, specifically, before plasma level determination, may be more effective in avoiding the progression to severe PPH. This study aimed to determine whether early and systematic administration of 3 g fibrinogen concentrate could limit postpartum hemoglobin decrease by 4 g/dL and/or limit transfusion of packed red blood cells to fewer than 2 units.
Time Matters: A Swedish Cohort Study of Labor Duration and Risk of Uterine Rupture
Authors: Hesselman S. , Lampa E. , Wikman A. , Törn A.E. , Högberg U.L.f. , Wikström A.-K. , Jonsson M.
Published: September 2022

(Acta Obstet Gynecol Scand. 2021;100:1902–1909)

In medium- to high-resource settings, a previous cesarean delivery (CD) is the main risk factor for uterine rupture, which is associated with maternal and neonatal morbidity and mortality. Induction of labor and augmentation of labor with oxytocin are both modifiable risk factors but are also common in patients who do not experience uterine rupture. One risk factor that could potentially help identify patients at risk of uterine rupture is slower progression in labor. This study aimed to examine the relationship between duration of labor and uterine rupture in the first trial of labor after one CD. The study also aimed to evaluate risk factors such as induction and use of prostaglandins, oxytocin, and epidural analgesia.
Effect of Educational Training on Nurses’ Ability to Care for Patients with Pressure Injuries: A Meta-analysis
Authors: Yuan Liqiong , Ye Maoting , Yang Ting
Published: September 2022

Objective

To provide up-to-date, systematic pooled evidence on the effect of educational training on nurses’ knowledge and classification skills related to pressure injuries.

Data Sources

The authors searched the following databases: MEDLINE, EMBASE, ScienceDirect, Google Scholar, and Cochrane library.

Study Selection

Two investigators independently performed the primary screening (title, abstract, and keywords). Of the 903 articles identified, 99 studies met the eligibility criteria, and their full texts were reviewed. Of these, nine studies totaling 25,723 participants satisfied the inclusion criteria and were included in the review.

Data Extraction

Manual data extraction was performed by the primary investigator using a predefined, semistructured form and was checked for accuracy by secondary investigators.

Data Synthesis

The majority of the included studies (five out of nine) were low quality. For knowledge score, the pooled standardized mean difference was 1.60 (95% CI, 0.79–2.41), P < .001. For classification skills, the pooled risk ratio was 1.20 (95% CI, 1.12–1.28).

Conclusions

Educational training was relatively effective in improving nurses’ pressure injury knowledge and classification skills, although the studies in this review exhibited significant heterogeneity.
Sclerotherapy in Aesthetic Medicine: Myths and Realities
Authors: Liu Annie , Boen Monica , Fabi Sabrina , Goldman Mitchel P.
Published: September 2022

BACKGROUND

Sclerotherapy is commonly performed for elimination of reticular and telangiectatic leg veins. There are several variations in practice, from the preparation to post-therapy directives.

OBJECTIVE

To critically examine the misconceptions of sclerotherapy for aesthetic indications.

MATERIALS AND METHODS

This review assesses evidence for and against each of the most common myths regarding sclerotherapy for aesthetic indications.

RESULTS

Sclerotherapy can be safely used to treat veins in areas other than the lower extremities, with the exception of the face. Laser therapy is not superior to sclerotherapy for the treatment of small telangiectatic veins on the lower extremities. The type of syringe used to produce foam sclerotherapy is an important procedural consideration. After sclerotherapy, graduated compression stocking usage is a vital part of the procedure. Detergent sclerotherapy agents are similar, but not equivalent. Touch-up treatments after sclerotherapy should not be performed for 2 months post-treatment. Foam sclerotherapy does not have a high risk for air emboli. It is not advisable to treat the leg veins in “sections.” Finally, one cannot reliably treat the telangiectatic veins without treating the feeding reticular veins for a satisfactory result.

CONCLUSION

Many aspects of sclerotherapy have existing evidence to dictate best clinical practice.
An Open-Label, Prospective, Pilot Study of Hypertonic Saline for Hidradenitis Suppurativa
Authors: Porter Martina L. , Salian Prerna , Rosales Santillan Monica , Greif Charlotte , Kimball Alexa B.
Published: September 2022

BACKGROUND

Hidradenitis suppurativa (HS) fistulas are likely to persist without surgical intervention. Hypertonic saline (HTS), a venous sclerosant, disrupts the endothelial lining leading to occlusion and fibrosis when used for venous insufficiency.

OBJECTIVE

To evaluate the efficacy and tolerability of HTS sclerotherapy for HS fistulas.

METHODS AND MATERIALS

This Institutional review board–approved, nonrandomized, clinical trial included adult patients with a diagnosis of HS and at least one confirmed HS fistula who underwent HTS injections into their fistulas every two weeks followed by a 4-week follow-up period. The study was performed from 2016 to 2019 at two academic outpatient dermatology clinics in Boston, MA. Primary outcomes were physician-assessed improvement of HS fistula characteristics between final and baseline visits and physician-assessed HS improvement during course of study.

RESULTS

Overall, 21 patients participated. Physician-assessed overall HS improvement was significant between Visits 2 and 3 (p = .036). Drainage (p = .035), erythema (p = .008), and swelling (p = .025) demonstrated statistically significant improvement from baseline to final visit. Dermatology life quality index scores significantly improved from baseline to Visit 2 (p = .0005), Visit 3 (p = .0008), and final visit (p = .011). Numeric rating scale stinging scores increased with sclerosant volume.

CONCLUSION

This study demonstrated physician-reported and patient-reported improvement in fistulas following serial HTS injections. HTS injections were well tolerated.
Impact of 60 days of head-down bed rest on large arteries
Authors: Boutouyrie Pierre , Fayol Antoine , Fortier Catherine , Khettab Hakim , Cristian Catalin , Gencer Umit , Fouassier David , Mousseaux Elie , Derobertmasure Audrey , Leguy Carole , Bruno Rosa-Maria
Published: September 2022

Background:

The long-term cardiovascular consequences of microgravity on large arteries are a threat for long-term space missions. We hypothesized that changes in arterial properties differ according to the arterial territory (upper or lower body), and arterial structure (elastic vs. muscular arteries), in response to 60-day head-down bed rest (HDBR).

Method:

Twenty healthy male volunteers were included and received a daily multivitamin supplementation in a double-blind fashion. At baseline, 29 and 52 days during strict HDBR, then 12 and 30 days after HDBR, aortic stiffness was measured using carotid-to-femoral pulse wave velocity (cf-PWV) and aortic MRI. Carotid, femoral, brachial and popliteal arteries were studied by ultrasound echo tracking, central blood pressure (BP) by tonometry and endothelial function by flow-mediated dilatation.

Results:

Cf-PWV increased during HDBR (+0.8 and +1.1m/s, at D29 and D52, respectively, P = 0.004), corresponding to an increase in vascular age up to +11 years (P = 0.003). Changes were similar to those observed on MRI (+0.8 m/s at D52, P < 0.01) and were independent of BP and heart rate changes. After HDBR, cf-PWV showed a substantial recovery at R12 but still remained higher than baseline at R30 (+0.8 m/s, P = 0.018), corresponding to +6.5 years of vascular aging (P = 0.018). Thoracic aorta diameter increased significantly (+6%, P = 0.0008). During HDBR, femoral and popliteal arteries showed dimensional changes, leading to femoral inward hypotrophic remodeling (femoral diameter: −12%, P < 0.05; wall cross-sectional area: −25%, P = 0.014) and popliteal inward eutrophic remodeling (popliteal diameter: −25%, P < 0.05; wall cross-sectional area: −3%, P = 0.51). After HDBR, both arterial territories of the leg recovered. We did not observe any significant changes for carotid arteries nor for endothelial function during and after HDBR. Multivitamin supplementation did not affect vascular changes. HDBR was associated with an important increase in aortic stiffness, which did not completely recover 1 month after the end of HDBR. The thoracic aorta and the lower body muscular arteries underwent significant changes in dimensions whereas the common carotid arteries were preserved.

Conclusion:

These results should raise caution for those exposed to microgravity, real or simulated.
EVALUATION OF THE RETINAL HAZARD WITH 3D DIGITALLY ASSISTED VISUALIZATION SYSTEM AND CONVENTIONAL MICROSCOPE IN MACULAR SURGERIES
Authors: Horigome Yuka , Iwashita Yume , Hirono Kazushi , Inoue Tatsuya , Konno Ami , Kadonosono Kazuaki , Yanagi Yasuo
Published: September 2022

Purpose:

To investigate the retinal light hazard during macular surgery using a digital three-dimensional visualization system (3D) and a conventional microscope (CM).

Design:

Experimental study and retrospective evaluation of a case–control study.

Subjects:

A total of 20 and 10 patients who underwent pars plana vitrectomy for epiretinal membrane using 3D and CM, respectively.

Methods:

Spectral irradiances of endoilluminators were measured for representative settings used during core vitrectomy and macular manipulations with 3D and CM. From the medical record of the patients, time needed for core vitrectomy and macular manipulations was extracted. The total retinal light hazard index and the macular hazard index were calculated based on the spectral irradiances weighted by the standard functions. Total retinal light hazard index, macular hazard index, and the number of cases that exceeded the maximum permissible radiant power exposure were compared between the two groups.

Results:

The spectral irradiance were 1.6 and 3.9 mW/cm2 for core vitrectomy and 3.4 and 8.1 mW/cm2 for macular manipulations using typical settings for 3D and CM groups, respectively. The total retinal light hazard index ranged from 4.31 kJ/m2 to 17.37 kJ/m2 for 3D and 11.09 kJ/m2 to 27.70 kJ/m2 for CM groups, respectively, whereas the macular hazard index ranged from 2.93 kJ/m2 to 14.58 kJ/m2 for 3D and from 6.84 kJ/m2 to 23.55 kJ/m2 for CM, respectively (P < 0.001). One (5%) and 6 (60%) pars plana vitrectomy cases exceeded the threshold limits with 3D and CM groups, respectively (P < 0.05, chi-square test).

Conclusion:

The 3D digitally assisted visualization system offers significantly safer macular surgery compared with the CM, considering the potential retinal hazard.
Impact of social determinants of health on anticoagulant use among patients with atrial fibrillation: Systemic review and meta-analysis
Authors: Khatib Rasha , Glowacki Nicole , Byrne John , Brady Peter
Published: September 2022

Background:

A growing body of literature now exists examining associations between social determinants of health (SDOH) and adverse outcomes in patients with atrial fibrillation; however, little is available on anticoagulant prescriptions and the impact of SDOH.

Purpose:

Evaluate the impact of SDOH on anticoagulant prescriptions in patients with atrial fibrillation.

Data Sources:

Medline and Embase databases up to January 2021.

Study Selection:

Noninterventional studies were included if they reported associations between at least 1 of 14 SDOH domains and anticoagulant prescription in patients with atrial fibrillation. Two investigators independently screened and collected data.

Data Extraction:

Two investigators independently screened and collected data.

Data Synthesis:

Meta-analyses using random-effect models evaluated associations between SDOH and receiving an anticoagulant prescription. We included 13 studies, 11 of which were included in meta-analyses that reported on the impact of 9 of the 14 SDOH included in the search. Pooled estimates indicate a 0.85 (95% confidence interval [CI]: 0.75, 0.97) lower odds of receiving anticoagulant prescriptions among Black compared to non-Black patients (reported in 6 studies); 0.42 (95% CI: 0.32, 0.55) lower odds of receiving anticoagulant prescriptions among patients with mental illness compared to those without mental illness (2 studies); and a 0.64 (95% CI: 0.42, 0.96) lower likelihood of receiving oral anticoagulant prescription among employed patients compared to unemployed patients (2 studies).

Limitations:

SDOH lack consistent definitions and measures within the electronic health record.

Conclusion:

The literature reports on only half of the SDOH domains we searched for, indicating that many SDOH are not routinely assessed. Second, social needs impact the decision to prescribe anticoagulants, confirming the need to screen for and address social needs in the clinical setting to support clinicians in providing guideline concordant care to their patients.

Registration:

This systematic review and meta-analysis was registered with PROSPERO.
Complementary and alternative medicine for functional dyspepsia: An Asian perspective
Authors: Yoon Jin Young , Ko Seok-Jae , Park Jae-Woo , Cha Jae Myung
Published: September 2022

A considerable number of Asian patients with functional dyspepsia (FD) are searching for complementary and alternative medicine (CAM) because they are unsatisfied with conventional medical treatment. However, no article has focused on CAM for FD from Asian perspective. In Asian countries, many traditional herbal formulas, including Banha-sasim-tang, Soyo-san, Sihosogan-san, Yukgunja-tang, and Pyeongwi-san, are used in patients with FD. In the few blinded and placebo-controlled studies conducted, the weak evidence regarding the effectiveness of herbal prescriptions in patients with FD did not allow any conclusions to be made. The clinical efficacy and safety of STW-5 were proven in several prospective randomized controlled trials and systematic reviews. Hence, it was recently approved as a therapeutic option for the treatment of FD. Peppermint and caraway, FDgard, black seed oil, and Jollab have been used in patients with FD, but there is limited evidence supporting their use. Reviews of acupuncture in patients with FD showed inconsistent results: a Cochrane review reported a negative result, while other meta-analyses reported positive results. Psychotherapy, including hypnotherapy, psychoanalytic psychotherapy, and cognitive behavioral therapy, may be used in patients with FD, although it is only supported by weak evidence. Therefore, well-planned, large-scale studies are necessary to evaluate the efficacy of CAM in treating FD, especially in Asian countries.
Investigation of the effects of anti-TNF agents on hemoglobin levels in patients with inflammatory bowel disease
Authors: Okuyucu Muhammed , Avcioğlu Ufuk , Şenel Tuğba , Ustaoğlu Müge
Published: September 2022

Inflammatory bowel disease (IBD) is characterized by many clinical features. Anemia is 1 of the most frequent complications and/or extraintestinal manifestations of IBD. There are conflicting data regarding the relationship between changes in hemoglobin levels and disease prevalence in IBD patients with and without antitumor necrosis factor (antiTNF) therapy. In our study, we aimed to investigate the long-term effect of antiTNF agents on anemia in IBD.

The records of IBD patients followed-up in our hospital between January 2011 and January 2021 were reviewed retrospectively. Demographic, clinical, endoscopic, radiological and medical treatment data of the patients were recorded. Complete blood count and laboratory markers of inflammation and disease activation, were recorded at the beginning and at the first year of treatment in all patients. The data of patients with and without antiTNF therapy were analyzed statistically. A total of 240 IBD patients who met the inclusion criteria were enrolled in the study. The number of patients with and without antiTNF therapy was 102 (42.5%) and 138 (57.5%), respectively. The change in all laboratory parameters between the beginning and the first year of treatment was statistically significant (P < .001) in all IBD patients with and without antiTNF therapy. The change in Hb level after 1 year of treatment was significantly different in patients with antiTNF therapy compared to those without therapy (3.00 ± 1.78 g/dL vs 1.19 ± 1.38 g/dL, P < .001). In the multiple regression analysis, male gender, antiTNF therapy, baseline Hb level and iron therapy were independent significant variables of hematopoietic response. This study showed that with appropriate treatment, hemoglobin levels of IBD patients with and without antiTNF therapy increased within 1 year, and the use of antiTNF agents in the treatment of IBD was an independent variable in correcting anemia.
Residual intraperitoneal carbon dioxide gas following laparoscopy for adnexal masses: Residual gas volume assessment and postoperative outcome analysis
Authors: Yi Sang Wook
Published: September 2022

Free residual gas after laparoscopy may cause shoulder pain, decreasing patient satisfaction with the procedure. We analyzed the correlation between postoperative residual carbon dioxide gas and shoulder pain, explored the peri- and postoperative factors associated with residual carbon dioxide and determined the effects of the use of a drainage tube. A cohort of 326 patients who underwent laparoscopic adnexal surgery between March 2005 and June 2018 at a teaching hospital in Korea was retrospectively analyzed through a medical records review. The enrolled patients were divided into 1-, 2-, and 3-port groups. The right volume, left volume, and total volume of residual gas were calculated using a formula based on measurements obtained from chest X-rays. Continuous variables were compared using Student t tests. Categorical variables were compared with the chi-square test or Kruskal–Wallis test. The total volumes of postoperative residual carbon dioxide gas were significantly different between the 1- and 2-port groups and between the 1- and 3-port groups (157.3 ± 179.2 vs 25.1 ± 92.3 mL and 157.3 ± 179.2 vs 12.9 ± 36.4 mL, respectively). The volume of residual gas and the time to the first passage of gas were positively correlated. The total volume of residual gas was more strongly correlated with the operative wound pain score than with the shoulder pain score. Additionally, the pre- and postoperative white blood cell counts, postoperative hospitalization duration, residual carbon dioxide volume, and shoulder pain score were significantly different between patients with and without a drainage tube. Although the volume of residual gas was not correlated with the shoulder pain score, the author found that both were lower in patients with a drainage tube than in those without, indicating that a drainage tube could be safely used to decrease residual gas volume and the shoulder pain score without increasing the risk of postoperative infection.
Clinical features and characteristics of pediatric patients with COVID-19 infection: Experiences in a Tertiary Taiwan Hospital
Authors: Bai Geng-Hao , Shih Ping-Yi , Chen Shih-Yen , Hsieh Kai-Sheng , Chou Cheng-Che , Feng Po-Hao , Kong Shu-Sing , Lin Wen-Chuan , Lu Meng-Che
Published: September 2022

Coronavirus disease 2019 (COVID-19) patients have distinct clinical features in the pediatric groups. However, there is a paucity of research focused on clinical manifestation within pediatric group in Taiwan. This study is to conduct a retrospective study of the clinical features of COVID-19 in Taiwan pediatric patients.

A retrospective study was conducted on pediatric patients (Aged ≤ 18 years) in a Northern Taiwan hospital from May 1st, 2021 to June 30th, 2021. Thirty-eight patients were included from emergency room. They were laboratory confirmed COVID-19 through specimens from nasopharyngeal swab by real-time reverse-transcription polymerase chain reaction (RT-PCR). Data including RT-PCR cycle threshold (Ct) values, clinical and epidemiological features were collected and analyzed.

Thirty-eight patients aged from 7-month to 18-year-old were included. The median age of patients was 15-year-old. The patients had sex ratio of 23 males to 15 females. More than half patients were infected from family members. Asymptomatic patients were 47.37%. In the symptomatic patients, fever (34.21%) was the most predominant symptom. Cough, nasal obstruction and sore throat were also common. Asymptomatic children had significantly higher Ct-values than symptomatic children, and diagnosed patients with Ct-values more than 19 were associated with asymptomatic infection (P = .0084).

Ct-values higher than 19 were associated with asymptomatic infection, which may be a predictor of pediatric disease severity. Our results highlight the distinct clinical manifestations and outcomes in pediatric COVID-19 patients. Compared to the adults, pediatric patients aged ≤ 18 years with COVID-19 in Taiwan mainly had mild disease.
Immunological characteristics of IgG4-related Kuttner tumors
Authors: Kim Su Geun , Lee Chan Mi , Hong Yong Tae
Published: September 2022

Immunoglobulin G4-related disease (IgG4-RD) has recently been well recognized and Kuttner tumor is known to be a chronic sclerosing sialadenitis, representing the focal manifestation of IgG4-RD, in the submandibular gland (SMG). This study is to evaluate the immunologic features of IgG4-related Kuttner tumor in the SMG. We retrospectively chose 13 patients who were confirmed as having Kuttner tumor by surgical biopsy between May 2012 and January 2019. The fine-needle aspiration cytology, serum antibody levels (anti-Ro antibodies, anti-La antibodies), IgG serum levels (total IgG and IgG4), and immunohistochemical findings for IgG and IgG4-positive plasma cells were reviewed. The cytologic results found that 7 of the 9 cases were reported as chronic sialoadenitis, and the other 3 as benign lymphoproliferative lesion. The serum levels of autoantibodies, Sjögren-syndrome-related antigen A/Ro-Ab and Sjögren-syndrome-related antigen A/Ro-La, showed all normal values of serum level. The serum level of IgG was increased in only 4 among the cases. However, the IgG4 levels were significantly increased in 11 among the cases. In all the patients who received resection of SMG, immunohistochemical findings showed all positive for IgG4-RD, with elevated numbers of IgG and IgG4-positive plasma cells. The evaluation of IgG4 serum level should be very informative for the diagnosis of this tumor before surgery. Fine-needle aspiration cytology with ultrasound guidance are not conclusive in this study. The immunological study including IgG4 serum level should be required for proper diagnosis and treatment, with clinical features of the Kuttner tumor. The level of evidence was IV.
Health vulnerabilities in female sex workers in Brazil, 2016
Authors: Braga Letícia Penna , Szwarcwald Célia Landmann , Damacena Giseli Nogueira , de Souza-Júnior Paulo Roberto Borges , Dourado Inês , de Brito Ana Maria , Grangeiro Alexandre , Crosland Guimarães Mark Drew
Published: September 2022

Female sex workers (FSW) suffer stigma and discrimination that negatively impact their physical and mental health and affect access to health care services. This paper aims to describe selected health indicators among FSW in 12 Brazilian cities in 2016. Brazilian cross-sectional Biological Behavioral Surveillance Survey was conducted in 2016 among 4328 FSW recruited by respondent-driven sampling. The sample weighing was inversely proportional to participant’s network sizes and the seeds were excluded from the analysis. Health indicators were estimated with 95% confidence interval and included indicators of health status, symptoms of depression, antenatal care, pap smear coverage, signs and symptoms of sexually transmitted infection, contraception and regular condom use, number of births and children alive per women, human immunodeficiency virus and syphilis testing, usual source of care, and perception of discrimination. Most participants self-rated their health as very good/good (65.8%) and 27.7% were positively screened for major depressive disorder episode on Patient Health Questionnaire-2. Antenatal coverage was 85.8% and 62.3% of FSW had access to pap smear exam in the past 3 years. A total of 67.0% of FSW were using some contraceptive method at the time of the study. Male condom was the most common method (37.1%), followed by oral pill (28.9%). A total of 22.5% FSW had never been tested for HIV and the main reasons were “not feeling at risk” (40.4%) and “being afraid or ashamed” (34.0%). The vast majority of FSW used Brazilian National Health System as their usual source of health care (90.2%). Approximately one-fifth of the participants felt discriminated against or were treated worse for being FSW (21.4%) and only 24.3% disclose their sex work status in health services. The vulnerability of FSW is expressed in all health indicators. Indicators of health status, antenatal care, pap smear coverage, and contraception were worse than in the Brazilian population, and point out to the importance of increase FSW’s access to health care services. Also, stigma and discrimination emerged as an important barrier to FSW’s health care in all dimensions and need to be struggled.
Differences in temperament and character inventory (TCI) profile between suicidal and nonsuicidal psychiatric outpatients
Authors: Hong Sumin , Jeon Hong Jun , Ha Jee Hyun
Published: September 2022

The purpose of this study was to identify personality traits associated with suicide attempt in a clinical sample. Temperament and character inventory (TCI) profiles of 759 patients who met the inclusion criteria among 1000 randomly selected hospital records collected. Of these 759 patients, 103 had a history of at least 1 actual suicide attempt (suicidal group) whereas 656 had no such history (nonsuicidal group). The suicidal group showed higher scores of novelty seeking (mean ± SD: 36.1 ± 1.2 vs 33.3 ± 0.5; P = .026) and harm avoidance (57.1 ± 1.5 vs 53.0 ± 0.6; P = .01) but lower scores of self-directedness (27.5 ± 1.5 vs 34.4 ± 0.6; P < .001) than the nonsuicidal group. Higher novelty seeking (OR [95% CI]: 1.031 [1.008–1.054]; P = .007) and lower self-directedness: 0.955 [0.927–0.983]; P = .002 were also associated with suicide attempts in the analysis of 7 personality scales. These findings suggest that patients who attempt suicide differ from nonattempters in terms of personality traits, especially in novelty seeking (NS), harm avoidance (HA), and self-directedness (SD). It is noteworthy that this study contains data from actual visits to the emergency room to evaluate suicide attempts.

Abbreviations: CO = cooperativeness, Ha = harm avoidance, NS = novelty seeking, PS = persistence, RD = reward dependence, SD = self-directedness, ST = self-transcendence, TCI = temperament and character inventory.
Effects of sleep insufficiency on spatial working memory in low-pressure and hypoxic environments
Authors: Li Bingqi , Dong Haotian , Wang Yanxiang , Li Fangming , Gao Xiaolei , Ma Hailin , Gao Lei
Published: September 2022

Background:

This study aimed to investigate the effects of sleep insufficiency on spatial working memory in low-pressure and hypoxic environments.

Methods:

We selected 58 insufficient sleepers and 27 normal sleepers among the college students living in high-altitude areas for a long time to receive a spatial 2-back working memory task, while collecting behavioral and electroencephalograph data. We adopted an independent sample t-test and repeated measures analysis of variance to compare the differences in response time and accuracy, P2 and late positive potential components, and theta band energy values in the spatial working memory task between insufficient and normal sleepers.

Results:

We found no significant differences in response time and accuracy between the insufficient sleep group and the normal sleep group; however, the P2 peak value and the early theta band energy value were higher in the insufficient sleep group than in the normal sleep group.

Conclusions:

These results suggest that the spatial working memory ability of individuals with sleep insufficiency was weakened under low-pressure and low-oxygen environment.
mRNA expression profiling of the cancellous bone in patients with idiopathic osteonecrosis of the femoral head by whole-transcriptome sequencing
Authors: Song Da , Ha Cheng-Zhi , Xu Qi , Hu Yan-Hui
Published: September 2022

Idiopathic osteonecrosis of the femoral head (INFH) seriously affects patients’ activities and is a heavy burden to society and patients’ families. Therefore, the early diagnosis and treatment of INFH is essential in reducing pain and burden. In the present study, the cancellous bone under the cartilage of the femoral head was isolated from patients with INFH and femoral neck fracture (FNF). Histological examination revealed that the bone trabecular and the medullary cavity in the INFH group compared with those in the FNF group. Whole-transcriptome sequencing (WTS), a recently applied technology, plays a significant role in the screening of risk factors associated with the onset of femoral head necrosis. Herein, WTS was used to obtain the mRNA expression profile in the cancellous bone of the femoral head isolated from 5 patients with INFH and 5 patients with FNF. Compared with the FNF group, a total of 155 differentially expressed genes were identified in the INFH group. Among these genes, 96 and 59 were upregulated and downregulated, respectively. Reverse transcription-quantitative PCR and western blot analyses revealed that leucine-rich repeat-containing 17 (LRRC17) displayed the most significantly decreased mRNA and protein expression levels between the INFH and FNF groups. The expression profile of the differentially expressed genes and LRRC17 protein in the INFH and FNF groups was consistent with that obtained by WTS. LRRC17, a leucine repeat sequence, plays a significant role in regulating bone metabolism, thus indicating that LRRC17 downregulation could affect bone metabolism and could be considered a key factor in the pathogenesis of INFH.