bluuebunny/crossref_metadata_2025 huggingface dataset:
Two‐year impact of COVID‐19 pandemic on hospitalized patients with skin diseases in China
Authors: Pan Jie , Yang Songchun , Chen Xiaozhen , Che Xuanlin , Lin Wenrui , Chen Mingliang , Chen Xiang , Deng Guangtong , Su Juan
Published: January 2023

To investigate the clinical characteristics of skin disorders among hospitalized patients before and during the coronavirus disease 2019 (COVID‐19) pandemic, a retrospective study was conducted based on hospitalized patients with skin diseases from Xiangya Hospital of Central South University, the largest hospital in the south‐central region of China, between January 1, 2018, and December 31, 2021. A total of 3039 hospitalized patients were enrolled in the study, including 1681 patients in the prepandemic group and 1358 patients in the pandemic group. The total number of hospitalized patients in the pandemic group decreased by 19.2%, with an increased proportion of patients over 60 years of age (39.8% vs. 35.8%). Moreover, compared with the prepandemic group, there were decreases in the occurrence of most skin diseases in the pandemic group, but the proportions of keratinolytic carcinoma (6.6% vs. 5.2%), dermatitis (24.0% vs. 18.9%), and psoriasis (18.0% vs. 14.8%) were higher in the pandemic group. In addition, longer hospital stays (β = 0.07, SE = 0.02, P = 1.35 × 10−3) and higher hospital costs (β = 0.06, SE = 0.03, p = 0.031) were found in the pandemic group through general linear models, even after the corresponding adjustment. In summary, the COVID‐19 pandemic has had a lasting impact on patients with skin diseases, with fewer hospitalized patients, increased proportions of older patients, longer hospital stays, and increased hospital costs. These findings will facilitate better preparation for the most effective response to future pandemics.
Space–time variation of large hail‐producing mesoscale convective systems over a complex terrain of the Indian subcontinent as revealed by the integrated Tropical Rainfall Measuring Mission and Global Precipitation Measurement observations
Authors: Roy Partha , Rao Thota Narayana , Biswasharma Rupraj , Sharma Sanjay , Das Sunit
Published: January 2023

Space–time variation of large hail‐producing mesoscale convective systems (MCSs) is investigated over the eastern and northeastern parts of the Indian subcontinent during the premonsoon (March–April–May) season by using long‐term (1998–2020) integrated observations of Precipitation Radar and Microwave Imager onboard the Tropical Rainfall Measuring Mission (TRMM) and Global Precipitation Measurement (GPM) satellites. A threshold of 37.0‐GHz polarization‐corrected temperature (≤176 K) is utilized as a hail proxy. Qualitatively, the space–time variation of satellite‐detected hailstorms is reasonably in good agreement with the available hail reports at the ground. The large hail‐producing MCSs are most frequently observed over the plains, whereas such MCSs are not found over mountains. The MCSs in April have the highest probability to contain hail though the hail‐producing MCSs are more common in May. The average morphological and microphysical properties are distinctly different for the MCSs with and without hail. Compared to the active convective cores of MCSs without hail, the hail‐producing convective cores of MCSs (a) are extended higher vertically and wider horizontally, (b) are associated with much larger area (~1,000 vs. 100 km2) occupied by radar reflectivity larger than 40 dBZ in the mixed‐phase region, and (c) are associated with larger values of cloud ice water content (CIWC; 395 vs. 153 mg·m−3) in the mixed‐phase region. The results from the high‐resolution ERA5 reanalysis data show that the hail‐producing MCSs are more sensitive to synoptic forcing than the MCSs without hail. Very strong mean sea‐level pressure anomalies over the whole northern part of India along the Himalayan foothills to the Bay of Bengal occur for the MCSs with hail days. The findings of this study will help the forecasting of these hailstorms and mitigation of their damage within this less explored region.
Prasugrel — gone, but not forgotten
Authors: Ford Samuel R.
Published: January 2023

Human immunodeficiency virus (HIV) infection and certain retroviral therapies are associated with an increased risk of atherosclerosis with plaque rupture resulting in acute coronary syndromes. Therefore, there is often a need to co‐prescribe antiretroviral and cardiovascular therapies, including antiplatelet agents. Antiplatelet agents, such as the P2Y12 receptor antagonists clopidogrel and prasugrel, require activation by cytochrome P450 3A4 (CYP3A4). The P2Y12 receptor antagonist ticagrelor is also metabolised by CYP3A4. Pharmacokinetic enhancers, such as ritonavir and cobicistat, are utilised to increase the systemic exposure of certain agents within multidrug HIV regimens and are potent CYP3A4 inhibitors. Using these drugs together can result in unintended and undesirable drug–drug interactions. A 55‐year‐old male with a history of HIV presented to the emergency department with central chest pain. He was found to have had a non‐ST‐elevation myocardial infarction and was commenced on dual antiplatelet therapy including ticagrelor, anticoagulation and statin therapy, in addition to his usual HIV therapy, Genvoya (elvitegravir, cobicistat, emtricitabine, tenofovir alafenamide). A drug–drug interaction between Genvoya and ticagrelor was identified by the pharmacist, and the patient was switched to prasugrel on the pharmacist's recommendation. Although prasugrel was delisted from the Pharmaceutical Benefits Scheme (PBS) in July 2020, it remains accessible as a non‐PBS medicine. Prasugrel should be considered the P2Y12 antagonist of choice for patients who are on HIV regimens containing a pharmacokinetic enhancer such as ritonavir or cobicistat.
Reassessing the phylogeny of Quaternary Eurasian Rhinocerotidae
Authors: Pandolfi Luca
Published: January 2023

The phylogenetic relationships within Eurasian Quaternary rhinoceroses is reassessed for the first time by means of Bayesian analysis. The results show Stephanorhinus as a monophyletic clade, with Pliorhinus as a sister taxon and Coelodonta as their closest relative. A new scenario on the origin, evolution and paleobiogeography of Quaternary rhinoceroses is therefore provided. Stephanorhinus originated in the Mediterranean Basin, dispersing towards Eastern Eurasia during the Early Pleistocene and leading to S. kirchbergensis. S. hemitoechus probably originated in Europe.
Two‐dimensional Shear Wave Elastography: Utility in Differentiating Gallbladder Cancer From Chronic Cholecystitis
Authors: Soundararajan Raghuraman , Dutta Usha , Bhatia Anmol , Gupta Pankaj , Nahar Uma , Kaman Lileswar , Bhattacharya Anish , Kumar Ashok , Sandhu Manavjit Singh
Published: January 2023

Objective

To study the utility of 2D shear wave elastography (SWE) and ascertain cut‐off values of shear wave elasticity (SWe) to differentiate benign and malignant thickening of the gallbladder wall.

Methods

This study was a prospective study of patients with symptomatic gallstone disease (GSD, n = 51) and gallbladder cancer (GBC, n = 46) and controls without any biliary disease (n = 46). All the participants underwent 2D USG and SWE of the gallbladder. Grey‐scale ultrasound and SWE were done in the different regions in the gallbladder.

Results

The median age of the patients with GSD was 49 years (interquartile range [IQR]: 33–55), GBC was 55 years (IQR: 46–65), and controls was 37 years (IQR: 27–48.25). In patients with GBC, asymmetrical mural thickening was the predominant imaging pattern (n = 24, 52.2%). The mean SWe of the abnormal area in GBC (34.99 ± 17.77 kPa [n = 46]) was significantly higher than that of the uninvolved region (18.27 ± 8.12 kPa [n = 35]; P < .01). The mean SWe of the uninvolved region in GBC (18.27 ± 8.12 kPa [n = 35]) was also significantly higher (P < .01) than that of GSD (12.27 ± 4.13 kPa [n = 51]) and controls (10.52 ± 3.75 kPa [n = 46]). On ROC analysis, AUC of 0.927, at a cut‐off of 20 kPa, sensitivity was 91.3%, specificity was 83.5%, positive likelihood ratio was 5.54, and negative likelihood ratio was 0.10 to diagnose GBC.

Conclusion

The 2D SWE is a reliable adjunctive tool to grey‐scale USG in differentiating the malignant from benign gallbladder wall and may help to pick up early malignancy in GSD.
Forced drop swinging on vibrated and textured metal substrates
Authors: Xu Jing , Zhou Dongdong , Ni Jing , Li Bin , Lian Jiadi
Published: January 2023

A new type of vibrated drop wettability mechanism on a micro‐texture surface is proposed and investigated experimentally and theoretically. In this experiment, the mechanical testing machine is used as the vibration source, and the compound control cabinet is used to adjust the vibration liquid feeding table. By comparing the apparent dynamic contact angle, it is concluded that the surface energy of the second cycle is larger than the first one. A swing model and spring‐mass system model are presented to study the vibrated drop motion pattern. The spring‐mass system model is built to analyse the adhesion force working process theoretically. The drop surface energy is transmitted by vibration. With the superposition of vibration energy, the displacement of the drop gravity centre becomes larger and larger until the drop migrates. The adhesion force drives the liquid drop to do reciprocating motion, and it changes the liquid drop dynamic wettability.
Practice patterns regarding combination treatments and laser and energy based devices: A survey of American Society for Laser Medicine and Surgery Members
Authors: Dempsey Alison , Watchmaker Jacqueline , Hibler Brian P. , Rossi Anthony
Published: January 2023

Objective

The use of laser and energy‐based devices (LEBD) has grown exponentially in recent years, and variations in common practices exist. Our study sought to evaluate the current practice paradigms of leaders in the field of LEBD with regard to antimicrobial prophylaxis, adjuvant topical treatments, use of laser procedures in pregnancy, and combination of procedures.

Methods

Anonymous surveys were distributed to leading dermatologists in American Society for Laser Medicine & Surgery (ASLMS) via email.

Results

Surveys were distributed to 65 ASLMS members; 37 submitted responses. Routine antiviral prophylaxis is used by 76% for fractional ablative procedures of the face, but only 27% for fractional non‐ablative procedures. Routine antifungal prophylaxis was used by a minority (16%) for ablative procedures, whereas antibacterial prophylaxis was used by 68%, with varying antibiotics. Wide variations exist in skin preparation and topicals used post‐laser treatment. Most respondents feel comfortable combining same‐day LEBD and botulinum toxin injections, specifically vascular or Q‐switched/picosecond lasers. Most respondents avoid performing LEBD during pregnancy.

Conclusions

Expert consensus in a rapidly growing field sheds light on common, reliable practices. However, even at the expert level, variations exist. Further high‐quality research is needed to standardize and update guidelines.
Estimates for the p‐Laplacian‐type operator in the subcritical Sobolev exponent range
Authors: Byun Sun‐Sig , Heo Moonhyun , Kim Wontae
Published: January 2023

We obtain Calderón–Zygmund‐type gradient estimates below the duality exponent of very weak solutions to p‐Laplacian‐type elliptic equations with non‐divergence datum by providing an analytic approach without using the fractional maximal function of order 1 for the non‐divergence datum.
Antiviral effects and tissue exposure of tetrandrine against SARS‐CoV‐2 infection and COVID‐19
Authors: Liu Jia , Wang Furun , Wang Xi , Fan Shiyong , Li Yufeng , Xu Mingyue , Hu Hengrui , Liu Ke , Zheng Bohong , Wang Lingchao , Zhang Huanyu , Li Jiang , Li Wei , Zhang Wenpeng , Hu Zhihong , Cao Ruiyuan , Zhuang Xiaomei , Wang Manli , Zhong Wu
Published: January 2023

Tetrandrine (TET) has been used to treat silicosis in China for decades. The aim of this study was to facilitate rational repurposing of TET against SARS‐CoV‐2 infection. In this study, we confirmed that TET exhibited antiviral potency against SARS‐CoV‐2 in the African green monkey kidney (Vero E6), human hepatocarcinoma (Huh7), and human lung adenocarcinoma epithelial (Calu‐3) cell lines. TET functioned during the early‐entry stage of SARS‐CoV‐2 and impeded intracellular trafficking of the virus from early endosomes to endolysosomes. An in vivo study that used adenovirus (AdV) 5‐human angiotensin‐converting enzyme 2 (hACE2)‐transduced mice showed that although TET did not reduce pulmonary viral load, it significantly alleviated pathological damage in SARS‐CoV‐2‐infected murine lungs. The systemic preclinical pharmacokinetics were investigated based on in vivo and in vitro models, and the route‐dependent biodistribution of TET was explored. TET had a large volume of distribution, which contributed to its high tissue accumulation. Inhaled administration helped TET target the lung and reduced its exposure to other tissues, which mitigated its off‐target toxicity. Based on the available human pharmacokinetic data, it appeared feasible to achieve an unbound TET 90% maximal effective concentration (EC90) in human lungs. This study provides insights into the route‐dependent pulmonary biodistribution of TET associated with its efficacy.
Assessing population substructure in the Lebanese population: A population study using data on 23 autosomal short tandem repeats
Authors: El Andari Ansar , Khazouh Mira , Mansour Issam
Published: January 2023

Background

Understanding the genetic substructure of a population is essential for proper forensic genetic analysis. The Lebanese population has a high rate of endogamous and consanguineous marriages and is segregated based on religious belongings. However, no genetic population studies have been performed up to date to estimate the degree of genetic substructure and inbreeding coefficients.

Methods

The present study analyzed a compendium of 23 autosomal STRs typed in 1400 individuals belonging to the seven major Lebanese religious subcommunities. Inbreeding coefficients such as F statistics were estimated.

Results

Results showed a Fst (theta) value of 0.002, indicating a low genetic subdivision within the Lebanese population.

Conclusion

This study aimed at assessing the genetic substructure of the Lebanese population by analyzing 1400 Lebanese citizens' samples using 23 STR markers. F statistics were computed to evaluate the degree of genetic substructure. Results showed a Fst value of 0.002, indicating a low genetic subdivision within the Lebanese population.
Analytical study of a model of fluid flow through a channel with flexible walls
Authors: Shubov Marianna A. , Edwards Madeline M.
Published: January 2023

The present paper is devoted to mathematical analysis of the model that describes fluid flow moving in a channel with flexible walls, which are subject to traveling waves. Experimental data show that the energy of the flowing fluid can be consumed by the structure (the walls) inducing “traveling wave flutter.” In the problems involving two‐media interactions (fluid/structure), flutter‐like perturbations can occur either in the fluid flowing in the channel with harmonically moving walls, or in the solid structure interacting with the flow. In the present research, it is shown that there are no abrupt (or flutter‐like) changes in the flow velocity profiles. Using the mass conservation law and incompressibility condition, we obtain the initial boundary value problem for the stream function. The boundary conditions reflect that (i) there is no movement in the vertical direction along the axis of symmetry and (ii) there is no relative movement between the near‐boundary flow and the structure (“no‐slip” condition). The closed form solution is derived for the stream function, which is represented in the form of an infinite functional series.
Modulatory Effect of Fermented Black Soybean and Adlay on Gut Microbiota Contributes to Healthy Aging
Authors: Koh Yen‐Chun , Kuo Lee‐Han , Chang Ya‐Yun , Tung Yen‐Chen , Lo Yi‐Chen , Pan Min‐Hsiung
Published: January 2023

Scope

Aging is a natural process characterized by a multifactorial, physical decline, and functional disability. Nevertheless, healthy aging can be achieved by following a multidirectional strategy. The current study aims to investigate the anti‐aging potential of fermented black soybean and adlay (FBA).

Methods and results

FBA supplements are incorporated into a natural aging mouse model that is designed to evaluate anti‐aging effects. Results show that FBA supplementation prevents muscle loss and visceral adipose tissue accumulation. FBA can also reduce aging biomarkers (including the expression of hepatic p16INK4A and galactosidase beta‐1 (GLB1). Hepatic 8‐hydoxy‐2'‐deoxyguanosine (8‐oxodG) and pro‐inflammatory cytokines have been significantly reduced. Lastly, FBA supplementation improves aging‐related gut microbial dysbiosis by reshaping gut microbial composition and promoting the growth of beneficial microbes such as Alistipes, Anaeroplasma, Coriobacteriaceae UCG002, and Parvibacter members in both genders of aged mice. In the functional prediction of gut microbiota, correlations to metabolic, neurodegenerative, infectious, and immune system diseases have been reduced in supplemented mice compared to aged mice. Moreover, FBA supplementation can reverse the reduced ability of microbiota in aged mice for lipid metabolism and xenobiotics biodegradation.

Conclusions

The results suggest that FBA exhibits noteworthy anti‐aging effects and that it can potentially be developed into a functional food for healthy aging.
A conditional registration network for continuous 4D respiratory motion synthesis
Authors: Sang Yudi , Ruan Dan
Published: January 2023

Background

Four‐dimensional computed tomography (4DCT) provides an important physiological information for diagnosis and treatment. On the other hand, its acquisition could be challenged by artifacts due to motion sorting/binning, time and effort bandwidth in image quality QA, and dose considerations. A 4D synthesis development would significantly augment the available data, addressing quality and consistency issues. Furthermore, the high‐quality synthesis can serve as an essential backbone to establish a feasible physiological manifold to support online reconstruction, registration, and downstream analysis from real‐time x‐ray imaging.

Purpose

Our study aims to synthesize continuous 4D respiratory motion from two extreme respiration phases.

Methods

A conditional image registration network is trained to take the end‐inhalation (EI) and end‐exhalation (EE) as input, and output arbitrary breathing phases by varying the conditional variable. A volume compensation and calibration post‐processing is further introduced to improve intensity synthesis accuracy. The method was tested on 20 4DCT scans with a four‐fold cross‐testing scheme and compared against two linear scaling methods and an image translation network.

Results

Our method generated realistic 4D respiratory motion fields that were spatiotemporally smooth, achieving a root‐mean‐square error of (70.1 ± 33.0) HU and structural similarity index of (0.926 ± 0.044), compared to the ground‐truth 4DCT. A 10‐phase synthesis takes about 2.85 s.

Conclusions

We have presented a novel paradigm to synthesize continuous 4D respiratory motion from end‐inhale and end‐exhale image pair. By varying the conditional variable, the network can generate the motion field for an arbitrary intermediate breathing phase with precise control.
Design and field procedures for the clinical reappraisal of the Composite International Diagnostic Interview version 3.3 in Qatar's national mental health study
Authors: Amro Iman , Ali Amal , Hassan Mohamed H. M. O. , Al Shawwaf Mahmoud , Alhassan Ahmed , Al Bahari Dalia , El Fakki Hana , Hijawi Zainab , Aly Sheeren , Amin Asmaa , Mohammed Rumaisa , Nofal Marwa , Abdelkader Menatalla , Salman Salma , Currie James , Alabdulla Majid , Sampson Nancy A. , First Michael , Kessler Ronald C. , Woodruff Peter W. , Khaled Salma M.
Published: January 2023

Background

The Composite International Diagnostic Interview (CIDI) has been clinically reappraised in several studies conducted mainly in the US and Europe. This report describes the methodology used to conduct one of the Middle East's largest clinical reappraisal studies. The study was carried out in conjunction with the World Mental Health Qatar—the first national psychiatric epidemiological study of common mental disorders in the country. This study aimed to evaluate the diagnostic consistency of core modules of the newly translated and adapted Arabic version of the CIDI 5.0 against the independent clinical diagnoses based on the Structured Clinical Interview for DSM‐5 (SCID‐5).

Methods

Telephone follow‐up interviews were administered by trained clinicians using the latest research edition of the SCID for DSM‐5. Telephone administered interviews were key in the data collection, as the study took place during the COVID‐19 pandemic.

Results

Overall, within 12 months, 485 interviews were completed. The response rate was 52%. Quality control monitoring documented excellent adherence of clinical interviews to the rating protocol.

Conclusions

The overall methods used in this study proved to be efficient and effective. For future research, instrument cultural adaptation within the cultural context is highly recommended.
Simultaneous proton resonance frequency T1 ‐ MR shear wave elastography for MR‐guided focused ultrasound multiparametric treatment monitoring
Authors: Odéen Henrik , Hofstetter Lorne W. , Payne Allison H. , Guiraud Ludovic , Dumont Erik , Parker Dennis L.
Published: January 2023

Purpose

To develop an efficient MRI pulse sequence to simultaneously measure multiple parameters that have been shown to correlate with tissue nonviability following thermal therapies.

Methods

A 3D segmented EPI pulse sequence was used to simultaneously measure proton resonance frequency shift (PRFS) MR thermometry (MRT), T1 relaxation time, and shear wave velocity induced by focused ultrasound (FUS) push pulses. Experiments were performed in tissue mimicking gelatin phantoms and ex vivo bovine liver. Using a carefully designed FUS triggering scheme, a heating duty cycle of approximately 65% was achieved by interleaving FUS ablation pulses with FUS push pulses to induce shear waves in the tissue.

Results

In phantom studies, temperature increases measured with PRFS MRT and increases in T1 correlated with decreased shear wave velocity, consistent with material softening with increasing temperature. During ablation in ex vivo liver, temperature increase measured with PRFS MRT initially correlated with increasing T1 and decreasing shear wave velocity, and after tissue coagulation with decreasing T1 and increasing shear wave velocity. This is consistent with a previously described hysteresis in T1 versus PRFS curves and increased tissue stiffness with tissue coagulation.

Conclusion

An efficient approach for simultaneous and dynamic measurements of PRSF, T1, and shear wave velocity during treatment is presented. This approach holds promise for providing co‐registered dynamic measures of multiple parameters, which correlates to tissue nonviability during and following thermal therapies, such as FUS.
Confounder‐correctedT1mapping in the liver through simultaneous estimation ofT1,PDFF, R2*, and B1+ in a single breath‐hold acquisition
Authors: Roberts Nathan T. , Tamada Daiki , Muslu Yavuz , Hernando Diego , Reeder Scott B.
Published: January 2023

Purpose

Quantitative volumetricT1mapping in the liver has the potential to aid in the detection, diagnosis, and quantification of liver fibrosis, inflammation, and spatially resolved liver function. However, accurate measurement of hepaticT1is confounded by the presence of fat and inhomogeneous excitation. Furthermore, scan time constraints related to respiratory motion require tradeoffs of reduced volumetric coverage and/or increased acquisition time. This work presents a novel 3D acquisition and estimation method for confounder‐correctedT1measurement over the entire liver within a single breath‐hold through simultaneous estimation ofT1, fat and .

Theory and Methods

The proposed method combines chemical shift encoded MRI and variable flip angle MRI with a mapping technique to enable confounder‐correctedT1mapping. The method was evaluated theoretically and demonstrated in both phantom and in vivo acquisitions at 1.5 and 3.0T. At 1.5T, the method was evaluated both pre‐ and post‐ contrast enhancement in healthy volunteers.

Results

The proposed method demonstrated excellent linear agreement with reference inversion‐recovery spin‐echo basedT1in phantom acquisitions at both 1.5 and 3.0T, with minimal bias (5.2 and 45 ms, respectively) overT1ranging from 200–1200 ms. In vivo results were in general agreement with reference saturation‐recovery based 2DT1maps (SMART1Map, GE Healthcare).

Conclusion

The proposed 3DT1mapping method accounts for fat and confounders through simultaneous estimation ofT1, , PDFF and . It demonstrates strong linear agreement with referenceT1measurements, with low bias and high precision, and can achieve full liver coverage in a single breath‐hold.
The patient burden of nocturnal polyuria in the United States: Results from the epidemiology of nocturnal polyuria (EpiNP) study
Authors: Chapple Christopher R. , Rosenberg Matt T. , Mueller Elizabeth R. , Chughtai Bilal , Weiss Jeffrey P. , Juul Kristian , Brooks Anne B. , Bacci Elizabeth D. , Andersson Fredrik L. , Coyne Karin S. , Bosch JLH Ruud
Published: January 2023

Objectives

To explore the impact of nocturnal polyuria (NP) on health‐related quality of life (HRQoL), work productivity, mental health, fatigue, bother, and daytime sleepiness.

Materials and Methods

This large‐scale, US population‐representative epidemiologic study was conducted in two parts: a web‐based survey and 3‐day bladder diary. Consenting participants completed the baseline Epidemiology of NP (EpiNP) survey online (Lower Urinary Tract Symptoms [LUTS] Tool, comorbidities, burden, and multiple HRQoL measures). Participants who reported ≥2 voids/night, and a random sample of 100 respondents each reporting 0 or 1 void/night, were sent urine measurement containers and asked to complete the 3‐day bladder diary. NP was defined as Nocturnal Polyuria Index >0.33 (NPI33) or nocturnal urine production >90 ml/h (NUP90). Five subgroups were created: Idiopathic NP (NP with no underlying cause), NP associated with symptoms of overactive bladder (NPOAB) or bladder outlet obstruction (NPBOO; men only), NP associated with other comorbidities (NPCOM; e.g., diabetes, hypertension, heart disease, sleep apnea), and no NP (did not meet NP criteria).

Results

A total of 4893 men and 5297 women completed the EpiNP survey; mean age was 54.4 (SD = 14.7). Significantly greater patient burden (p < 0.0001) was evidenced in the nocturia group (≥2 voids/night) versus no nocturia group (0–1 void/night) on daily impact of nocturia, LUTS Bother, prostate symptoms (men only), work productivity, physical and mental health component scores, depression, fatigue, and daytime sleepiness. NP subgroup analyses showed men in the NPBOO group and women in the NPOAB group reported the greatest impact on LUTS bother, fatigue, physical health, work productivity impairment, daytime sleepiness, and depression (women only).

Conclusion

This was the first large‐scale, epidemiologic study to explore the impact of different forms of NP on patients' HRQoL. Findings demonstrate that NP associated with other urologic or comorbid conditions appears to have greater patient burden than idiopathic NP, in particular for women.
Sleep Disorders, Comorbidities, Actions, Lower Urinary Tract Dysfunction, and Medications (“Sleep C.A.L.M.”) in the evaluation and management of nocturia: A simple approach to a complex diagnosis
Authors: Monaghan Thomas F. , Weiss Jeffrey P. , Wein Alan J. , Rahman Syed N. , Lazar Jason M. , Bliwise Donald L. , Everaert Karel , Lemack Gary E. , Cornu Jean‐Nicolas , Drake Marcus J. , Chapple Christopher R. , Hashim Hashim , Blaivas Jerry G. , Dmochowski Roger R.
Published: January 2023

Introduction

Nocturia arises from a fundamental mismatch between nocturnal urine production, storage capacity, and sleep architecture, which may be driven by abnormalities of the genitourinary tract, but also by sleep disorders, medical diseases, patient actions/lifestyle factors, or medications. This article introduces a novel system for organizing the complex differential diagnosis for nocturia, as proposed by an international collective of practicing urologists, physician specialists, and sleep experts: “Sleep CALM”—Sleep Disorders, Comorbidities, Actions, Lower Urinary Tract Dysfunction, and Medications.

Methods

Narrative review of current evidence regarding the relevance of each “Sleep CALM” factor to nocturia pathogenesis, evaluation, and management.

Results

Nocturia and sleep disorders are highly intertwined and often bidirectional, such that nocturnal awakenings for reasons other than a sensation of bladder fullness should not be used as grounds for exclusion from nocturia treatment, but rather leveraged to broaden therapeutic options for nocturia. Nocturia is an important potential harbinger of several serious medical conditions beyond the genitourinary tract. Urologists should have a low threshold for primary care and medical specialty referral for medical optimization, which carries the potential to significantly improve nocturnal voiding frequency in addition to overall health status. Adverse patient actions/lifestyle factors, lower urinary tract dysfunction, and medication use commonly coexist with disordered sleep and comorbid medical conditions, and may be the primary mediators of nocturia severity and treatment response, or further exacerbate nocturia severity and complicate treatment.

Conclusion

“Sleep CALM” provides a memorable and clinically relevant means by which to structure the initial patient history, physical exam, and clinical testing in accordance with current best‐practice guidelines for nocturia. Although not intended as an all‐encompassing diagnostic tool, the “Sleep CALM” schema may also be useful in guiding individualized ancillary testing, identifying the need for specialty referral and multidisciplinary care, and uncovering first‐line treatment targets.
Patterns of Lymph Node Metastasis in Parotid Cancer and Implications for Extent of Neck Dissection
Authors: Voora Rohith S. , Panuganti Bharat , Califano Joseph , Coffey Charles , Guo Theresa
Published: January 2023

Objective

The role and extent of neck dissection in primary parotid cancer are controversial. Herein, we characterize patterns of lymph node metastasis in parotid cancer.

Study Design

Retrospective analysis.

Setting

National Cancer Database.

Methods

Patients with the 6 most common histologic subtypes of parotid cancer were selected. Primary outcomes were the distribution of positive lymph nodes by level and overall survival assessed by Cox analysis. Secondary outcomes included predictors of extended lymph node involvement (≥3 lymph nodes or Level IV/V involvement), via logistic regression.

Results

Six thousand nine hundred seventy‐seven patients with acinic cell carcinoma, adenocarcinoma, adenoid cystic carcinoma, carcinoma ex pleomorphic adenoma (CExPA), mucoepidermoid carcinoma, and salivary duct carcinoma (SDC) were included. Among cN0 patients, 8.2% of low‐grade tumor patients had occult nodal metastasis versus 30.9% in high‐grade tumor patients. Elective neck dissection was not associated with an overall survival benefit (adjusted hazard ratio: 1.10; 0.94‐1.30, p = .238). Among cN+ tumors, CExPA (odds ratio [OR]: 1.88, 1.05‐3.39, p = .034) and high‐grade pathology (OR: 3.03, 1.87‐4.93, p < .001) were predictive of having ≥3 pathologic nodes. CExPA (OR: 2.13, 1.22‐3.72, p = .008), adenocarcinoma (OR: 1.60, 1.11‐2.31, p = .013), SDC (OR: 1.92, 1.17‐3.14, p < .01), and high‐grade pathology (OR: 3.61, 2.19‐5.97, p < .001) were predictive of Level IV/V neck involvement.

Conclusions

In parotid malignancy, nodal metastasis distribution is dependent on histology and grade. High‐grade tumors and certain histologies (SDC and adenocarcinoma) had a higher incidence of occult nodes. Comprehensive neck dissection should also be considered for node‐positive high‐grade tumors, SDC, and adenocarcinoma.
Office‐Based Photodynamic Therapy Using Locally Applied 5‐aminolevulinic Acid and 635 nm Laser for Laryngeal Leukoplakia
Authors: Zhang Chi , Zhong Jingting , Jiang Jack J. , Hou Qian , Ren Hui , Silverman Matthew , Li Gelin
Published: January 2023

Objective

Photodynamic therapy (PDT) is a minimally invasive method with strong tissue selectivity and nonthermal effects. We aim to investigate the efficacy of an in‐office method utilizing PDT with local application of 5‐aminolevulinic acid (ALA) and 635 nm diode laser for treating laryngeal leukoplakia.

Study Design

Retrospective cohort study.

Setting

Outpatient clinic‐tertiary medical center.

Methods

This study reviewed 32 patients with laryngeal leukoplakia, including 11 recurrent cases after surgery. All the procedures were performed in an office setting under topical anesthesia. Fifteen percent ALA solution was locally applied to the lesion through a flexible laryngoscope. Light illumination was performed using a 635 nm diode laser through a 400 μm optic fiber. The power density was 165 mW/cm2 to reach 100 J/cm2. Results of laryngostroboscopy and voice evaluation during follow‐up were collected.

Results

The mean follow‐up was 7.91 ± 4.83 (3‐18) months. Thirty‐nine procedures were performed, including 1 session for 27 patients, 2 sessions for 3 patients, and 3 sessions for 2 patients. The total response rate was 96.875% (31/32), including complete responses in 26 (81.25%) patients, partial responses in 5 patients (15.625%), and no response in 1 patient (3.125%). It appeared that PDT selectively eliminated the leukoplakia without affecting lamina propria and the surrounding normal mucosa remained unharmed. Scores of Voice Handicap Index‐10, jitter, shimmer, and harmonic‐to‐noise ratio were significantly improved after PDT.

Conclusion

Office‐based PDT is an effective, repeatable, and practical method for treating laryngeal leukoplakia. Local application of ALA is sufficient to achieve photodynamic reactions. PDT could eliminate laryngeal leukoplakia selectively while protecting the normal laryngeal structure.
Impact of Sociodemographic Disparities on Language Outcomes After Cochlear Implantation in a Diverse Pediatric Cohort
Authors: Liao Elizabeth N. , Yaramala Naveen , Coulthurst Sarah , Merrill Kris , Ho Melissa , Kramer Kurt , Chan Dylan K.
Published: January 2023

Objective

We examined how sociodemographic and audiologic factors affect receptive and expressive language outcomes in children with cochlear implantation.

Study Design

Retrospective cohort study.

Setting

A hearing loss (HL) clinic at a tertiary center.

Methods

Sociodemographic variables, HL characteristics, age at implantation, and receptive language scores (Preschool Language Scale and the Clinical Evaluation of Language Fundamentals) were collected from patients with congenital HL who received their first implant by 4 years old after January 1, 2007. t Tests, linear regression, Mann‐Whitney, Cohen's d, and mediation analysis were used for descriptive statistics and hypothesis testing.

Results

Among 79 patients, 42 (53%) were females, 44 (56%) under‐represented minorities, and 56 (71%) had public insurance. At least 1 year after implantation, the median receptive language score was 69 (range 50‐117). Females (p = .005), having private insurance (p = .00001), having a Cochlear Implant Profile score below 4 (p = .0001), and receiving their implant at or before 12 months of age (p = .0009) were significantly associated with improved receptive language outcomes. Insurance type had a significant effect on receptive language outcomes, independent from age at first implantation (total effect: coef = −13.00, p = .02; direct effect: coef = −12.26, p = .03; indirect effect: coef = −0.75, p = .47). Sociodemographic variables had large effect sizes, with the Cochlear Implant Profile score having the largest effect size (d = 1.3).

Conclusion

Sociodemographic factors have a large impact on receptive language outcomes. Public insurance is associated with worse receptive language, not mediated by later age at implantation, suggesting that other factors primarily impact language outcomes in publicly insured children with cochlear implants.
Portable Sleep Study Device Versus Polysomnography: A Meta‐analysis
Authors: Cagle Joshua L. , Young Benjamin D. , Shih Michael C. , Nguyen Shaun A. , Meyer Ted A. , White David R. , Clemmens Clarice S.
Published: January 2023

Objective

To provide an updated comparison of apnea‐hypopnea index (AHI), oxygen desaturation index (ODI), respiratory disturbance index (RDI), oxygen saturation (O2 sat), and lowest oxyhemoglobin saturation (LSAT) measured by portable sleep study devices (PSSDs) compared to polysomnography (PSG).

Data Sources

Primary studies were identified through PubMed, Scopus, CINAHL, and Cochrane.

Review Methods

A systematic review was performed by searching databases from inception through August 2021. Only studies examining simultaneous monitoring of a PSSD and PSG were included.  Respiratory indices AHI, ODI, RDI, O2 sat, and LSAT was collected Meta‐correlations and meta‐regressions were conducted to compare sleep variable measurements between PSSD and PSG.

Results

A total of 24 studies (N = 1644 patients) were included. The mean age was 49.5 ± 12.0 (range = 13‐92), mean body mass index (BMI) was 30.4 ± 5.7 (range = 17‐87), and 69.4% were male. Meta‐correlation showed significant associations between PSSD and PSG for AHI (n = 655, r = .888; p < .001), ODI (n = 241, r = .942; p < .001), RDI (n = 313, r = .832; p < .001), O2 sat (n = 171, r = .858; p < .001), and LSAT (n = 197, r = .930; p < .001). Meta‐regressions indicated significant predictive correlations for AHI (n = 655; r = .96; p < .001), ODI (n = 740; r = .75; p = .031), RDI (n = 197; r = .99; p = .005), and LSAT (n = 197; r = .85; p = .030), but not for O2 sat (n = 171; r = .31; p = .692).

Conclusions

Respiratory indices correlate strongly between PSSD and PSG, which is further supported by meta‐regressions results. PSSD might be a valuable cost and time‐saving OSA screening tool.
High Tracheal Resection With Intralaryngeal Extension as an Alternative to Cricotracheal Resection for Treatment of Subglottic Stenosis
Authors: Liang Kevin Y. , Nelson Rebecca C. , Bryson Paul C. , Lorenz Robert R.
Published: January 2023

Objective

Some patients with subglottic stenosis (SGS) require open airway reconstruction, which traditionally involves resection of the anterior cricoid cartilage. As an alternative, we present a novel technique: cricoid‐sparing high tracheal resection with excision of subglottic stenotic tissue from below. A novel set of posterior circumferential cricoid sutures is used to reline the exposed cricoid plate.

Study Design

Retrospective chart review.

Setting

Single tertiary care center.

Methods

The surgical technique is described and illustrated. A chart review was performed for all patients who underwent surgery between January 1, 2016, and June 30, 2021.

Results

Fourteen patients (100% female) underwent this airway resection and reconstruction surgery during the study time period. After a mean follow‐up of 12 months, no patients required tracheostomy. Twelve of 14 patients (86%) had durable airways. Two patients (14%) have required repeated endoscopic procedures for recurrent stenosis and are considered treatment failures. None exhibited postoperative dysfunction to suggest posterior cricoarytenoid muscle injury. Thirteen patients (93%) had a postoperative normal voice or only transient dysphonia. One patient had permanent unilateral vocal fold paralysis.

Conclusion

Cricoid‐sparing high tracheal resection is a safe and effective alternative to cricotracheal resection, especially for predominantly posterior SGS. The cricoid cartilage and cricothyroid muscles are left undisturbed, potentially decreasing the risk of postoperative dysphonia, namely lowered fundamental frequency. This is especially meaningful in the setting of a predominantly female patient population.
Current Status of Circulating Tumor Cells in Head and Neck Squamous Cell Carcinoma: A Review
Authors: Aktar Sharmin , Baghaie Hooman , Islam Farhadul , Gopalan Vinod , Lam Alfred King‐Yin
Published: January 2023

Objective

Circulating tumor cells (CTCs) are found in the blood of patients with cancer, including head and neck squamous cell carcinomas (HNSCCs). The aim is to review the most up‐to‐date status of CTCs for applications in patients with HNSCC.

Data Sources

English articles in PubMed.

Review Methods

All the studies on CTCs in HNSCCs in the literature were reviewed.

Conclusions

There is emerging information on the diagnostic and prognostic value of CTCs in HNSCCs. Evidence also highlights the advantages of various downstream analysis approaches over circulating tumor DNA (ctDNA), such as single‐CTC analysis, ex vivo, and in vivo expansion of CTCs. Multiple phenotypic surface markers (cytokeratins, EpCAM, vimentin, etc.), used for CTCs characterization using different immunoassays, could predict disease progression as well as patients' response to treatment efficacy. Immune checkpoint inhibitors' status in CTCs could also provide better insight into treatment. Clonal expansion of CTCs and single‐cell analysis of CTCs are the most emerging fields nowadays which may offer an understanding of the mechanism of tumor evolution as well as therapeutic efficacy. Although several clinical trials are ongoing, limitations still exist in the detection and characterization of CTCs. Due to the lack of a gold standard protocol, the sensitivity and specificity of CTC enumeration methods vary.

Implications for Practice

Prospective clinical trials are still needed before CTCs can be employed as diagnostic and prognostic markers in the clinical management of patients with HNSCC.
Going Off Guidelines: An NCDB Analysis of Missed Adjuvant Therapy Among Surgically Treated Oral Cavity Cancer
Authors: Tassone Patrick , Topf Michael C. , Dooley Laura , Galloway Tabitha , Biedermann Gregory , Trendle Michael
Published: January 2023

Objective

Patient factors associated with failure to receive adjuvant therapy after oral cavity cancer resection remain understudied. Here, we identified rates of missed adjuvant therapy, determined factors associated with missed therapy, and assessed associations with survival.

Study Design

Retrospective cohort.

Setting

National Cancer Database.

Methods

Patients with resected oral cavity squamous cell carcinoma and known adjuvant therapy status were included. T3‐4 stage, N2‐3 stage, and lymphovascular invasion were considered indications for adjuvant radiation. Extranodal extension or positive margins were considered indications for chemoradiation. Patient factors were examined for associations with missed adjuvant therapy. Overall survival was evaluated by Cox proportional hazard analysis.

Results

A total of 53,503 patients were included. 27.5% missed adjuvant therapy altogether, and 26.7% with a documented indication for chemoradiation missed chemotherapy. Factors associated with missed adjuvant therapy were age, white race, low income, metropolitan population, increasing comorbidities, travel distance, lip primary, and treatment at the academic facility. Factors associated with missed chemotherapy were age, female sex, nontongue subsite, and treatment at a nonacademic center. Among patients with indications for adjuvant radiation, missed radiation was associated with worse overall survival (hazard ratio [HR]: 1.42, 95% confidence interval [CI]: 1.31‐1.53). Among patients with indications for adjuvant chemoradiation, missed chemotherapy was associated with worse overall survival (HR: 1.19, 95% CI: 1.09‐1.29).

Conclusion

Missed adjuvant therapy occurs frequently after oral cavity resection. Patients treated at academic centers may be at risk of missed therapy related to travel distance, though these patients are more likely to receive adjuvant chemotherapy when indicated. Missed adjuvant therapy is associated with worse survival.
Polylactide/poly[(R)‐3‐hydroxybutyrate] (PHB) blend fibers with superior heat‐resistance: Effect ofPHBon crystallization
Authors: Huang Wei , Shi Yamin , Wang Wenling , Sheng Yongji , Guo Yuying , Li Yi , Yang Qiu , Chen Peng
Published: January 2023

Blending low content of poly[(R)‐3‐hydroxybutyrate‐co‐4‐hydroxybutyrate] (P34HB ≤8 wt %) with poly(L‐lactide) (PLLA) has proven effective in enhancing heat resistance of PLLA fibers. Unfortunately, the enhancement is relatively limited with boiling water shrinkage of PLLA/P34HB blend fibers reduced to 9.9% at most. In this study, a series of PLLA/poly[(R)‐3‐hydroxybutyrate] (PHB) blend fibers with low PHB content (≤8 wt %) was prepared with sound spinnability. Surprisingly, the PLLA/PHB blend fibers showed much lower boiling water shrinkage than the PLLA/P34HB blend fibers with the same blend ratio. In particular, the boiling water shrinkage was dropped from ca. 80% for neat PLLA fibers to 9.9% for the PLA/P34HB blend fibers and further to 3.8% for the PLA/PHB blend fibers with 8 wt % P34HB or PHB added. Such an exceptionally improved heat resistance of the PLLA/PHB blend fibers could be closely related to an increase in crystallinity (Xc,PLLA) of the PLLA phase. Specifically, the mobility of the PLLA segments was promoted in the presence of PHB, along with notably improved orientation of the PLLA phase in the PLLA/PHB blend fibers. More importantly, investigation on crystallization behaviors revealed that the PHB phase served as an effective nucleating agent to accelerate the overall crystallization of PLLA. By contrast, the P34HB phase only acted as spherulite growth‐accelerating and/or nucleation‐assisting agents. These findings help provide a facile and effective strategy to improve heat resistance of PLLA fibers more significantly.
Loss of the crumbs cell polarity complex disrupts epigenetic transcriptional control and cell cycle progression in the developing retina
Authors: Owen Nicholas , Toms Maria , Tian Yuan , Toualbi Lyes , Richardson Rose , Young Rodrigo , Tracey‐White Dhani , Dhami Pawan , Beck Stephan , Moosajee Mariya
Published: January 2023

The crumbs cell polarity complex plays a crucial role in apical–basal epithelial polarity, cellular adhesion, and morphogenesis. Homozygous variants in human CRB1 result in autosomal recessive Leber congenital amaurosis (LCA) and retinitis pigmentosa (RP), with no established genotype–phenotype correlation. The associated protein complexes have key functions in developmental pathways; however, the underlying disease mechanism remains unclear. Using the oko meduzym289/m289 (crb2a−/−) zebrafish, we performed integrative transcriptomic (RNA‐seq data) and methylomic [reduced representation bisulphite sequencing (RRBS)] analysis of whole retina to identify dysregulated genes and pathways. Delayed retinal cell specification was identified in both the crb2a−/− zebrafish and CRB1 patient‐derived retinal organoids, highlighting the dysfunction of cell cycle modulation and epigenetic transcriptional control. Differential DNA methylation analysis revealed novel hypermethylated pathways involving biological adhesion, Hippo, and transforming growth factor β (TGFβ) signalling. By integrating gene expression with DNA methylation using functional epigenetic modules (FEM), we identified six key modules involving cell cycle control and disturbance of TGFβ, bone morphogenetic protein (BMP), Hippo, and SMAD protein signal transduction pathways, revealing significant interactome hotspots relevant to crb2a function and confirming the epigenetic control of gene regulation in early retinal development, which points to a novel mechanism underlying CRB1‐retinopathies. © 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.