bluuebunny/crossref_metadata_2025 huggingface dataset:
Health‐related quality of life trajectories in melanoma patients after electrochemotherapy: real‐world insights from the InspECT register
Authors: Campana L.G. , Quaglino P. , de Terlizzi F. , Mascherini M. , Brizio M. , Spina R. , Bertino G. , Kunte C. , Odili J. , Matteucci P. , MacKenzie Ross A. , Schepler H. , Clover J.A.P. , Kis E. ,   InspECT Melanoma and QoL Working Groups
Published: July 2022

Background

Electrochemotherapy (ECT) effectively controls skin metastases from cutaneous melanoma.

Objectives

This study aimed to evaluate health‐related quality of life (HRQoL) in melanoma patients pre−/post‐ECT and its effect on treatment outcome.

Methods

The analysis included prospective data from the International Network for Sharing Practices of ECT register. Following the Standard Operating Procedures, patients received intravenous or intratumoural bleomycin (15 000 IU/m2; 1000 IU mL/cm3) followed by 100‐microsecond, 1000‐V/cm electric pulses. Endpoints included response (RECIST v3.0), local progression‐free survival (LPFS), toxicity (CTCAE v5.0), and patient‐reported HRQoL at baseline, one, two, four, and 10 months (EuroQol [EQ‐5D‐3L], including 5‐item utility score [EQ‐5D] and visual analogue scale for self‐reported health state [EQ‐VAS]). Comparisons within/between subgroups were made for statistical and minimal important differences (MID). HRQoL scores and clinical covariates were analysed to identify predictors of response in multivariate analysis.

Results

Median tumour size was 2 cm. Complete response rate, G3 toxicity, and one‐year LPFS in 378 patients (76% of the melanoma cohort) were 47%, 5%, and 78%, respectively. At baseline, age‐paired HRQoL did not differ from the general European population. Following ECT, both EQ‐5D and EQ‐VAS scores remained within MID boundaries, particularly among complete responders. A subanalysis of the EQ‐5D items revealed a statistically significant deterioration in pain/discomfort and mobility (restored within 4 months), and self‐care and usual activities (throughout the follow‐up) domains. Concomitant checkpoint inhibition correlated with better EQ‐5D and EQ‐VAS trajectories. Baseline EQ‐5D was the exclusive independent predictor for complete response (RR 14.76, P = 0.001).

Conclusions

HRQoL of ECT melanoma patients parallels the general population and is preserved in complete responders. Transient deterioration in pain/discomfort and mobility and persistent decline in self‐care and usual activities may warrant targeted support interventions. Combination with checkpoint inhibitors is associated with better QoL outcomes. Baseline HRQoL provides predictive information, which can help identify patients most likely to respond.
Outcome and long‐term treatment protocol for topical tacrolimus in oral lichen planus
Authors: Utz S. , Suter V.G.A. , Cazzaniga S. , Borradori L. , Feldmeyer L.
Published: July 2022

Background and objective

Topical tacrolimus has been shown to be beneficial in the treatment of oral lichen planus (OLP). However, long‐term effects and its optimal application protocol with gradual reduction have not been studied. Accordingly, we analysed the clinical response of OLP to tacrolimus in our daily clinical practice with a focus on the optimal long‐term therapeutic scheme.

Methods

Retrospective analysis of all consecutive patients diagnosed with OLP and treated with topical tacrolimus (0.03% oral rinse) in a clinical setting between 2015 and 2020. The objective clinical response was measured by a 4‐point scale (complete remission, major remission, partial remission and no response), and subjective impairment by a 3‐point scale (severe, moderate and none).

Results

Fifty‐seven patients (74% women; median age: 66 years) were included. Fifty‐six (98%) patients had prior treatment with topical steroids. After introduction of tacrolimus, objective remission (major or complete) was reached by 28%, 62%, 87% and 97% of patients after 3, 6, 12 and 24 months respectively. Subjective remission was reported by 16%, 48%, 69% and 83% after 3, 6, 12 and 24 months of treatment respectively. The treatment frequency could be gradually reduced from initially twice daily to once daily or less in 28%, 61%, 78% and 87% after 3, 6, 12 and 24 months respectively; 41% of patients completely suspended the treatment at one point, but 67% of them experienced a relapse after a median time of 3.3 months. Four patients (7%) developed a squamous cell carcinoma (SCC) during the observation period. Otherwise, there were only few and minor side‐effects.

Conclusion

Topical tacrolimus can be an effective second‐line therapy for OLP refractory to potent topical corticosteroids. The therapy frequency can often be reduced during the maintenance period. Both signs of clinical activity and subjective impairment should guide therapy. Regular follow‐up is necessary to recognize possible SCC.
Psoriasis and progression of Parkinson's disease: a Mendelian randomization study
Authors: Li C. , Li X. , Lin J. , Cui Y. , Shang H.
Published: July 2022

Background

Epidemiological studies have suggested psoriasis was associated with an increased risk of Parkinson's disease (PD). However, whether psoriasis has an effect on PD progression is not explored yet.

Objectives

To evaluate the causal role of psoriasis in PD progression.

Methods

We conducted a two‐sample Mendelian randomization analysis using summary statistics from genome‐wide association study of psoriasis (N = 33 394), age at onset (N = 28 568) and progression (N = 4093) of PD.

Results

One standard deviation increase in genetically determined psoriasis risk was significantly associated with faster progression to dementia (OR = 1.07, 95% CI: 0.1.03–1.1, P = 4.71E‐04). Meanwhile, higher psoriasis risk was nominally associated with faster progression of PD measured by time to Hoehn and Yahr stage 3 (OR = 1.05, 95% CI: 1.02–1.08, P = 1.53E‐03) and depression (OR = 1.06, 95% CI: 1.02–1.11, P = 1.77E‐03) of PD. The results were robust under all sensitivity analyses.

Conclusions

These results suggested psoriasis accelerated overall progression of PD, and increased risk of dementia and depression of PD. A deeper understanding of neuroinflammation and immune response is likely to elucidate the potential pathogenesis of PD progression and identify novel therapeutic targets.
Onychopapilloma: its clinical, dermoscopic and pathologic features
Authors: Kim T.‐R. , Bae K.‐N. , Son J.‐H. , Shin K. , Kim H.‐S. , Ko H.‐C. , Kim B.‐S. , Kim M.‐B.
Published: July 2022

Background

Onychopapilloma is a benign tumour of the nail bed and distal matrix and commonly presents as longitudinal erythronychia, longitudinal leukonychia or longitudinal melanonychia. Because onychopapilloma is rare, its clinical characteristics and dermoscopic findings have not been well investigated in Asia.

Objectives

This study aimed to investigate the clinical characteristics and dermoscopic and pathologic findings of onychopapilloma in Korea.

Methods

We retrospectively reviewed the medical records and clinical/dermoscopic photographs of 39 patients diagnosed with onychopapilloma in the Pusan National University Hospitals (Busan and Yangsan) for 11 years (2010–2021).

Results

Among 39 patients, 23 (59.0%) were men, and 16 (41.0%) were women. The mean age was 46.1 (16–77) years. All lesions were single, and most of them were located on the fingers (92.3%), especially the thumb (66.7%). The most common clinical feature was longitudinal erythronychia (56.4%), and the most common dermoscopic finding was distal subungual hyperkeratosis (100%). We found two new dermoscopic features: macrolunula and trailing lunula along the longitudinal band. Among 18 patients who underwent surgical excision, only 6 (33.3%) showed typical acanthosis and papillomatosis on the nail bed.

Conclusions

We found that Asian onychopapilloma has similar clinicodermoscopic findings to the Caucasian one, that is to say, longitudinal erythronychia and distal subungual hyperkeratosis were the most common nail change and dermoscopic finding, respectively. We propose two new dermoscopic features of onychopapilloma: macrolunula and trailing lunula along the longitudinal band.
Reproductive biology of the bullseye puffer Sphoeroides annulatus: Gonadosomatic index and its suitability for estimating length at maturity
Authors: Salas‐Singh Carolina , Morales‐Bojórquez Enrique , Aguirre‐Villaseñor Hugo
Published: July 2022

This study aimed to describe updated information on the basic reproductive biology of Sphoeroides annulatus females and potential use of the gonadosomatic index as input data to assess length at 50% maturity () and identify the breeding season. From April 2014 to December 2015, 767 females were analysed along the north‐west coast of the Mexican Pacific Ocean. Both immature and mature females were represented in the total length (), which ranged from 81 to 440 mm, and the smallest mature female was 92 mm (new record for the species). Gonadal maturity phases were assigned through histological analysis. A threshold value was established using the lower whisker value for maturity phase spawning capable (2.06%). The monthly variation of supported the annual spawning seasonality, and the presence of reproductively active mature females coincided with the observed periods with histological data and the peaks for both seasons 2014 and 2015. Also the presence of reproductively inactive mature females confirmed the nonreproductive season observed from January to April 2015. Estimates of were based on the cumulative proportion of reproductively active mature females: both datasets showed a ‘bumpy trajectory’. Considering the functional form of data and models, a second objective was to verify if each dataset presented a simple or double sigmoid trajectory and select the most suitable model through the Akaike information criterion. For both datasets, the best fitted model was the double sigmoidal , while the single sigmoidal had low performance and did not have statistical support. The provided a value ca. 254 mm for both data sets. A trade‐off between the model's correct fit and a reliable value was found, but this fact is not always considered when calculating the maturity, resulting in biased parameters. Correct data fitting may seem trivial, but the consequences for the conservation of immature individuals could be dramatic, affecting the population recruitment. In conclusion, the histologically calibrated was suitable for classifying females of S. annulatus into reproductively inactive or active types, with an agreement percentage of 99%. The  = 2.06% can be useful for subsequent studies for this species.
The first observation of copulation inAndeancatfishAstroblepus ubidiai(Siluriformes, Astroblepidae), inLago San Pablo, Imbabura, Ecuador
Authors: Mena‐Valenzuela Patricio , Valdiviezo‐Rivera Jonathan , Mena‐Olmedo Javier , Aguirre Windsor E.
Published: July 2022

The reproductive behaviour of the Andean catfishAstroblepus ubidiaiwas observed directly and with an underwater camera in a spring located next to Lago San Pablo in the province of Imbabura, Ecuador, in late 2015 and early 2016. Five mating attempts were observed, four of which were video‐taped, and two of which resulted in complete copulation. During copulation, the male grabs the female from the top of the head with its buccal disc and pelvic fins and, from this position, bends its body forming a “C” to reach the genital pore of the female and introduce its copulatory organ. Once copulation is complete, the female swims away rapidly. Details of the copulation are described here through illustrations.
Influence of automatic bagasse feeding on the performance of a modified jaggery plant
Authors: Kumar Rakesh , Kumar Mahesh
Published: July 2022

The lack of automation in jaggery making plants causes high‐fuel (bagasse) requirement and low‐thermal efficiency, which results in high‐running cost and limited profit to the stakeholders. Though, number of researches have been conducted for improving heat utilization in the plant, but still fuel consumption and running cost are very high. In present research work, the bagasse consumption and unit cost of jaggery production of an existing modified plant having manual bagasse feeding (MP‐MBF) are attempted to reduce by fabricating a similar modified plant having automatic bagasse feeding (ABF). A working model of modified two‐pan jaggery plant with automatic bagasse feeding (MP‐ABF) has been fabricated, tested, and analyzed. The implementation of ABF has reduced the bagasse consumption to 0.60 kg/min, which is 7.7% less than that of MP‐MBF without affecting jaggery production rate of 0.42 kg/min. The unit cost of jaggery production of MP‐ABF is $0.35 per kg, which is 2.8% lower than that of MP‐MBF. The thermal efficiency evaluated for MP‐ABF is 50.28%, which is 18.8% higher than that of MP‐MBF. This would also increase the profitability to the investors by $ 438.41 per annum and make the modified plant more fuel self‐sustainable.

Practical Applications

The bagasse feeding in traditional and modified plants is manual, because of which its supply is non‐uniform and higher than its requirement. These drawbacks can be overcome by maintaining uniform and optimum feeding of bagasse with the help of automatic bagasse feeder. The implementation of ABF would reduce the bagasse consumption to its optimum level and also eliminate the requirement of labor for this purpose. The investment involved in the implementation of ABF system could be recovered, since it has the potential to reduce the running cost of the plant. The implementation of ABF may also improve the overall performance parameters of existing traditional and modified jaggery plants.
Formulation, characterization, and stability of food grade oil‐in‐water nanoemulsions of essential oils of Tasmannia lanceolata, Backhousia citriodora and Syzygium anisatum
Authors: Alderees Fahad , Akter Saleha , Mereddy Ram , Sultanbawa Yasmina
Published: July 2022

Oil‐in‐water nanoemulsions were formulated using sunflower oil mixed with each of the essential oils of Tasmannia lanceolata (Tasmanian pepper leaf [TPL]), Backhousia citriodora (lemon myrtle [LM]) and Syzygium anisatum (anise myrtle [AM]) and stabilized with Tween 80 using ultrasonication. An oil‐surfactant ratio of 3:1 was found to produce the lowest emulsion droplet sizes of 96.6 nm for LM, 122.2 nm for AM and 131.8 nm for TPL. Increase in surfactant concentration above 10r resulted in larger droplet sizes, 165.8–2,647.2 nm for LM (radius, r = .82), 153.7–2,573.5 nm for AM (r = .93) and 157.4–2,621.6 nm for TPL (r = .83). Sonication for 3 min produced smaller droplet size; however, sonication for 9 min resulted in increase of droplet size by 1.48, 1.43 and 1.47 times for oils of LM (r = .82), AM (r = .93) and TPL (r = .83), respectively. A positive correlation was found between sonication amplitude (20–50%) and droplet size for nanoemulsions of LM (r = .93), AM (r = .98) and TPL (r = .95). TPL and LM nanoemulsions showed broad‐ spectrum antimicrobial activities against yeasts and bacteria. The minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) against weak‐acid resistant yeasts were between 0.001–0.003 and 0.002–0.007 mg/ml for nanoemulsion of TPL and between 0.003–0.014 mg/ml and 0.005–0.027 for nanoemulsion of LM, respectively. The stability and antimicrobial activity of TPL and LM essential oil nanoemulsions confirm their potential for application as food preservatives especially in beverage products that are commonly spoiled by weak‐acid resistant yeasts.
Early readmissions of spontaneous bacterial peritonitis in the USA: Insights into an emerging challenge
Authors: Dahiya Dushyant Singh , Sanaka Madhusudhan R , Kichloo Asim , Singh Amandeep , Wachala Jennifer , Perisetti Abhilash , Goyal Hemant , Garg Rajat , Shaka Hafeez , Pisipati Sailaja , Inamdar Sumant , Al‐Haddad Mohammad
Published: July 2022

Background and Aim

Early readmissions of spontaneous bacterial peritonitis (SBP) are often associated with poor outcomes. We compared characteristics and outcomes for index and 30‐day readmissions of SBP in the USA.

Methods

We analyzed the Nationwide Readmissions Database for 2018 to identify all adult (≥ 18 years) 30‐day readmissions of SBP in the USA. Hospitalization characteristics and outcomes for index and 30‐day readmissions of SBP were compared. Independent predictors of 30‐day readmissions were also identified.

Results

In 2018, of the 5,797 index admissions for SBP, 30% (1726) were readmitted within 30 day. At the time of readmission, the most common admitting diagnosis was alcoholic cirrhosis of the liver with ascites (11.8%) followed by sepsis due to an unspecified organism (9.2%). SBP as an admitting diagnosis was identified for only 8.3% of these 30‐day readmissions. Compared with index admissions, 30‐day readmissions of SBP had a lower mean age (56.1 vs 58.6 years, P < 0.001) without a statistically significant difference for gender. Furthermore, 30‐day readmissions of SBP were associated with significantly higher odds of inpatient mortality (10% vs 4.9%, OR: 2.15, 95% CI: 1.66–2.79, P < 0.001), and mean total hospital charge ($85,031 vs $56,000, mean difference: 29,032, 95% CI: 12,867–45,197, P < 0.001) compared with index admissions. The presence of chronic pulmonary disease, liver failure, inpatient dialysis, and discharge against medical advice were identified as independent predictors for increased 30‐day readmissions of SBP.

Conclusion

The 30‐day readmission rate of SBP was 30% and these readmissions were associated with higher odds of inpatient mortality compared with index admissions.
A switch from tenofovir to entecavir prior to hepatitis B treatment cessation is associated with a reduced risk of off‐therapy relapse: An observational study
Authors: Peng Chien‐Wei , Jeng Wen‐Juei , Yang Hwai‐I , Liu Yen‐Chun , Chien Rong‐Nan , Liaw Yun‐Fan
Published: July 2022

Background and Aim

In HBeAg negative chronic hepatitis B (CHB) patients, clinical relapse (CR) occurs more frequently, much earlier and often more severely after stopping tenofovir (TDF) and other nucleos(t)ide analogues (Nucs) than after stopping entecavir (ETV). It is unknown whether off‐Nuc hepatitis flare can be alleviated by switching from one Nuc to another.

Methods

HBeAg‐negative CHB patients who had stopped Nuc according to the APASL stopping rule and had been followed‐up for > 48 weeks after Nuc cessation were recruited. Patients were classified as four groups: ETV monotherapy (mono‐ETV), TDF monotherapy (mono‐TDF), switched to ETV (switch‐ETV), and switched to TDF (switch‐TDF). Both switch groups had switched to the replacement Nuc > 12 weeks prior to end of therapy. Propensity score matching (PSM) was performed to minimize confounders among groups. Cox regression analysis was used to identify risks factors for off‐Nuc CR and flares.

Results

A total of 1309 patients (1022 mono‐ETV, 219 mono‐TDF, 40 switch‐ETV and 28 switch‐TDF) were enrolled. The median time to CR was 39, 13, 38 and 14 weeks in mono‐ETV, mono‐TDF, switch‐ETV and switch‐TDF respectively (P < 0.001). After PSM, the mono‐ETV (adjusted HR: 0.39, P < 0.001) and switch‐ETV patients (adjusted HR: 0.41, P = 0.003) had both significantly later occurrence and lower rates of CR and flare.

Conclusion

In summary, the incidence and timing of CR was determined by ETV or TDF in the last 3 months prior to end of treatment. Patients treated with non‐ETV‐Nuc switched to ETV > 12 weeks before end of the original Nuc therapy may reduce/defer CR.
The usefulness of endobiliary radiofrequency ablation before metal stent placement in unresectable malignant hilar obstruction
Authors: Oh Dongwook , Chong Junyong , Song Tae Jun , Park Do Hyun , Lee Sang Soo , Seo Dong‐Wan , Lee Sung Koo , Kim Myung‐Hwan
Published: July 2022

Background and Aim

EB‐RFA with self‐expandable metal stent (SEMS) may improve the stent patency and patient survival in malignant extrahepatic biliary obstruction. However, there are few studies on the role of EB‐RFA for malignant hilar obstruction (MHO). This study aimed to assess the feasibility, efficacy, and safety of EB‐RFA for MHO.

Methods

We retrospectively compared the stent patency and survival among 79 consecutive patients with MHO who underwent bilateral uncovered SEMS placement without and with EB‐RFA between April 2016 and January 2020.

Results

Fifty‐one patients (64.6%) underwent SEMS placement alone (stent alone group), whereas 28 (35.4%) underwent SEMS placement after EB‐RFA (RFA‐stent group). All procedures were successful (100%). During follow‐up, stent occlusion occurred in 59 patients (74.7%), of which 40 (78.4%) and 19 (67.9%) were in the stent alone and RFA‐stent groups, respectively. There was no difference in stent patency (192 ± 39.2 days vs 140 ± 53.7 days, P = 0.41) and survival (311 ± 24.7 days vs 311 ± 46.9 days, P = 0.73) between the stent alone and RFA‐stent groups. Multivariate cox analysis showed a hazard ratio (HR) of 2.892 (1.579–5.294, P = 0.001) for stent occlusion in patients who did not receive chemotherapy. EB‐RFA had no significant effect on stent occlusion (HR, 1.150, 0.644–2.053, P = 0.636).

Conclusions

SEMS placement after EB‐RFA in MHO was not associated with improvement in the stent patency or patient survival. Further prospective randomized studies are necessary to establish the effectiveness of EB‐RFA with stents in MHO.
Predictors of ICU admission associated with gastrointestinal endoscopy in medical inpatients: A retrospective cohort study
Authors: Sankar Ashwin , Ladha Karim S , Grover Samir C , Jogendran Rohit , Tamming Daniel , Razak Fahad , Verma Amol A
Published: July 2022

Background and Aim

Gastrointestinal (GI) endoscopic procedures are commonly performed in medical inpatients. Limited prior research has examined factors associated with intensive care unit (ICU) admission after GI endoscopy in medical inpatients.

Methods

This retrospective cohort study was conducted using routinely‐collected clinical and administrative data from all general medicine hospitalizations at five academic hospitals in Toronto, Canada between 2010 and 2020. We describe ICU admission and death within 48 h of GI endoscopy in medical inpatients. We examined adjusted associations of patient and procedural factors with ICU admission or death using multivariable logistic regression.

Results

Among 18 290 medical inpatients who underwent endoscopy, 900 (4.9%) required ICU admission or died within 48 h of endoscopy. Following risk adjustment, ICU admission or death were associated with the following procedural factors: endoscopy on the day of hospital admission (aOR 3.16 [2.38–4.21]) or 1 day after admission (aOR 1.92 [1.51–2.44]) and esophagogastroduodenoscopy (EGD) procedures; and the following patient factors: Charlson comorbidity index of two (aOR 1.38 [1.05–1.81]) or three or greater (aOR 1.84 [1.47–2.29]), older age, male sex, lower hemoglobin prior to endoscopy, increased creatinine prior to endoscopy, an admitting diagnosis of liver disease and certain medications (antiplatelet agents and corticosteroids).

Conclusions

ICU admission or death after endoscopy was associated with procedural factors such as EGD and timing of endoscopy, and patient factors indicative of acute illness and greater comorbidity. These findings can contribute to improved triage and monitoring for patients requiring inpatient endoscopy.
Dispositional optimism and positive health outcomes: Moving from epidemiology to behavioral interventions
Authors: Cobert Julien , O'Donovan Aoife
Published: July 2022

This Editorial comments on the articles by Koga et al. and Jeffrey M. Levine in this issue.
Trace‐element heterogeneity in rutile linked to dislocation structures: Implications for Zr‐in‐rutile geothermometry
Authors: Verberne Rick , van Schrojenstein Lantman Hugo W. , Reddy Steven M. , Alvaro Matteo , Wallis David , Fougerouse Denis , Langone Antonio , Saxey David W. , Rickard William D. A.
Published: July 2022

The trace‐element composition of rutile is commonly used to constrain P–T–t conditions for a wide range of metamorphic systems. However, recent studies have demonstrated the redistribution of trace elements in rutile via high‐diffusivity pathways and dislocation‐impurity associations related to the formation and evolution of microstructures. Here, we investigate trace‐element migration in low‐angle boundaries formed by dislocation creep in rutile within an omphacite vein of the Lago di Cignana unit (Western Alps, Italy). Zr‐in‐rutile thermometry and inclusions of quartz in rutile and of coesite in omphacite constrain the conditions of rutile deformation to around the prograde boundary from high pressure to ultra‐high pressure (~2.7 GPa) at temperatures of 500–565°C. Crystal‐plastic deformation of a large rutile grain results in low‐angle boundaries that generate a total misorientation of ~25°. Dislocations constituting one of these low‐angle boundaries are enriched in common and uncommon trace elements, including Fe and Ca, providing evidence for the diffusion and trapping of trace elements along the dislocation cores. The role of dislocation microstructures as fast‐diffusion pathways must be evaluated when applying high‐resolution analytical procedures as compositional disturbances might lead to erroneous interpretations for Ca and Fe. In contrast, our results indicate a trapping mechanism for Zr.
Subthalamic nucleus exclusively evokes dopamine release in the tail of the striatum
Authors: Todd Kathryn L. , Lipski Janusz , Freestone Peter S.
Published: July 2022

A distinct population of dopamine neurons in the substantia nigra pars lateralis (SNL) has a unique projection to the most caudolateral (tail) region of the striatum. Here, using two electrochemical techniques to measure basal dopamine and electrically evoked dopamine release in anesthetized rats, we characterized this pathway, and compared it with the ‘classic’ nigrostriatal pathway from neighboring substantia nigra pars compacta (SNc) dopamine neurons to the dorsolateral striatum. We found that the tail striatum constitutes a distinct dopamine domain compared with the dorsolateral striatum, with consistently lower basal and evoked dopamine, and diverse dopamine release kinetics. Importantly, electrical stimulation of the SNL and SNc evoked dopamine release in entirely separate striatal regions; the tail and dorsolateral striatum, respectively. Furthermore, we showed that stimulation of the subthalamic nucleus (STN) evoked dopamine release exclusively in the tail striatum, likely via the SNL, consistent with previous anatomical evidence of STN afferents to SNL dopamine neurons. Our work identifies the STN as an important modulator of dopamine release in a novel dopamine pathway to the tail striatum, largely independent of the classic nigrostriatal pathway, which necessitates a revision of the basal ganglia circuitry with the STN positioned as a central integrator of striatal information.

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Metronomic chemotherapy in patients with advanced neuroendocrine tumors: A single‐center retrospective analysis
Authors: Arrivi Giulia , Spada Francesca , Frassoni Samuele , Bagnardi Vincenzo , Laffi Alice , Rubino Manila , Gervaso Lorenzo , Fazio Nicola
Published: July 2022

Neuroendocrine tumors (NETs) are more commonly slow‐growing, therefore patients often receive chronic systemic therapies for tumor growth control and preservation of quality of life. Metronomic chemotherapy (mCT) is in line with this goal as it leads to stabilization of tumor growth over time without severe systemic toxicity. This is a retrospective analysis of patients with metastatic NETs receiving metronomic capecitabine (mCAP) or temozolomide (mTEM), at a NET‐referral center. The aims of the study were to explore activity and safety of mCT and relationships between some characteristics of the patient population and clinical outcomes. Among a total of 67 patients with metastatic well or moderately differentiated (W/M‐D) NETs, mostly gastroenteropancreatic (GEP) and nonfunctioning, 1.2 years (95% CI: 0.8–1.8) median progression‐free survival (mPFS), and 3.0 years (95% CI: 2.3–4.9) median overall survival (mOS) were observed. Disease control rate was 85%. Grade 3 adverse events occurred in 15% of patients in mCAP and 13% in mTEM, and were mostly hematological and gastrointestinal. At univariate and multivariate analysis none of the variables analyzed (treatment regimen, sex, age at diagnosis, site of primary tumor and metastases, number of previous mCT lines, baseline tumor status before mCT, Ki67 value) were significantly correlated to OS and PFS. Our retrospective study suggested that mCAP and mTEM can be active and well tolerated in patients with metastatic W/M‐D NETs, irrespective of the primary site, site of metastases, line of treatment and baseline tumor status.
Protection of hair color with pomegranate peel extract‐loaded liposomal formulation: Preparation, characterization, and ex‐vivo activity studies
Authors: Tuncay Tanriverdi Sakine , Gokce Evren Homan , Filiz Simtac Bengi , Kose Fadime Aydin , Ozer Ozgen
Published: July 2022

Background

Pomegranate peel extract is known as a powerful antioxidant and due to preventing oxidation, it can reduce color change of dyed hair after washing. Liposomes are vesicular systems that include lipids and can form a film on hair fibers. Delivery system and active agent have a synergistic effect on protecting hair color and reducing dyeing frequency.

Aims

This study aimed to prepare liposomes suspension as an innovative formulation of pomegranate peel extract to reduce hair color changing.

Methods

Pomegranate peel extract‐loaded liposomes were prepared with lipidic film hydration method. The characterizations of formulations (F1 and F2) were defined by several parameters. The pH, particle size, polydispersity index, zeta potential, microscopical image, loading capacity (LC), and encapsulation efficiency (EE) of formulations were determined. The antioxidant capacity of formulations and actives were tested. The effect of formulations on hair color change was shown with ex‐vivo studies.

Results

The results showed that cholesterol influenced particle size, zeta potential, and antioxidant capacity. The particle sizes of formulations were 217.71 ± 6.74 nm and 577.5 ± 1.41 nm for F1 and F2, respectively. F2 formulation had better results for zeta potential (33.8 mV) while F1 was neutral. Morphologic images confirmed vesicular structure or liposomes. The EE was found higher for F2 than F1 (F1: 57.14 and F2: 78.69). Antioxidant studies confirmed that active substance and the vesicular system had a synergistic effect on protection from oxidation. Selected formulation reduced hair color change as shown in ex‐vivo tests.

Conclusion

Pomegranate peel extract‐loaded liposomes were designed for hair color protection. It was shown with this study that prepared formulations have a good color protection on hair fibers due to antioxidant properties of pomegranate peel extract and film forming effect of liposomal formulations. According to results, prepared liposomal formulations may serve as a good alternative for reducing dyeing frequency and protecting hair fibers.
Pro‐inflammatory versus anti‐inflammatory cytokines in psoriatic patients (case–control study)
Authors: Elbana Amaal Mohamed , Elgamal Emadeldin , Hashim Osama , Emran Tarek Mostafa , Alkhrsawy Amr Abdelhady
Published: July 2022

Background

Psoriasis (PsO) is a systemic autoimmune disease. Many pro‐inflammatory and anti‐inflammatory biomarkers have been associated with the pathogenetic process of psoriasis. IL‐35 act as an anti‐inflammatory cytokine through downregulation of TH‐17 cell development and cytokine production. So, IL‐35 might be utilized as potential future therapeutic agent for psoriasis.

Aims

To investigate the association between inflammatory (IL‐17, TNF‐α, IFN‐γ) and anti‐inflammatory cytokines (IL‐35, TGF‐β) in psoriasis patients.

Patients and Methods

A case–control study enrolled two groups: (Group I: 40 patients with psoriasis) and (Group II: 40 healthy age and sex‐matched subjects). Full history was taken from all cases along with full dermatologic examination. The assessment of psoriasis severity was conducted by using PASI score. Assessment of inflammatory (IL‐17, TNF‐α, IFN‐γ) and anti‐inflammatory cytokines (IL‐35, TGF‐β) was performed by using ELISA technique.

Results

There was a statistically significant increase of mean level of TNF‐α, IL‐17, and IFN‐γ among psoriasis cases in comparison with controls. The mean level of TGF‐β and IL‐35 was statistically significantly reduced among the psoriasis cases in comparison with controls. TNF‐α, IL‐17, and IFN‐γ showed a significant strong positive association in between and statistically significant strong negative relationship with IL‐35 and TGF‐β.

Conclusion

IL‐35 has a significant role in the pathogenetic process of PsO, and it serves as a potential future therapeutic agent for psoriasis. The current results could be used as a clue for the utilization of inflammatory (IL‐17, TNF‐α, IFN‐γ) versus anti‐inflammatory cytokines (IL‐35, TGF‐β) in psoriasis patients as a diagnostic biomarker for severity of cases with psoriasis.
NOT SO “HAPPY BUMP”: A complication due to hyaluronic acid
Authors: de Almeida Balassiano Laila Klotz , Cavallieri Fernanda A. , Munhoz Gabriela , Tembra Maria Fernanda , Ramos‐e‐Silva Marcia
Published: July 2022

Introduction

The use of hyaluronic acid (HA) as a dermal filler is considered safe. However, as new brands come to the market, reports of adverse events are becoming more and more common.

Objective

To describe a particular type of adverse effect that, unlike the erythematous, indurated, and painful nodules described in the literature as “angry red bumps,” is characterized by noninflammatory, stony‐like nodules that appear in sites previously treated with HA.

Methods

The report of four patients who presented this complication, and the occurrence of two HA syringes from the same batch that had hardened the product inside at the time of filling.

Conclusion

The authors propose the nomenclature “happy bump” to group adverse reactions to HA that translate into noninflammatory nodules, with a stony consistency, appearing up to 4 weeks (recent) or after one month (late) in sites previously treated with AH.
The insomnia, fatigue, and psychological well‐being of hospital nurses 18 months after the COVID‐19 pandemic began: A cross‐sectional study
Authors: Sagherian Knar , Cho Hyeonmi , Steege Linsey M.
Published: July 2022

Background

Research has shown sleep problems, elevated fatigue, and high cases of burnout, as well as signs of post‐traumatic stress and psychological distress among nurses during the COVID‐19 pandemic. Many US hospitals attempted to minimise its impact on staff by providing basic resources, mental health services, and wellness programs. Therefore, it is critical to re‐evaluate these well‐being indices and guide future administrative efforts.

Purpose

To determine the long‐term impact of the COVID‐19 pandemic after 18 months on hospital nurses' insomnia, fatigue, burnout, post‐traumatic stress, and psychological distress.

Design

Cross‐sectional.

Methods

Data were collected online mainly through state board and nursing association listservs between July–September 2021 (N = 2488). The survey had psychometrically tested instruments (Insomnia Severity Index, Occupational Fatigue Exhaustion Recovery Scale, Maslach Burnout Inventory, Short Post‐Traumatic Stress Disorder, and Patient Health Questionnaire‐4) and sections on demographics, health, and work. The STrengthening the Reporting of Observational studies in Epidemiology checklist was followed for reporting.

Results

Nurses had subthreshold insomnia, moderate‐to‐high chronic fatigue, high acute fatigue, and low‐to‐moderate intershift recovery. Regarding burnout, they experienced increased emotional exhaustion and personal accomplishment, and some depersonalisation. Nurses had mild psychological distress but scored high on post‐traumatic stress. Nurses who frequently cared for patients with COVID‐19 in the past months scored significantly worse in all measures than their co‐workers. Factors such as nursing experience, shift length, and frequency of rest breaks were significantly related to all well‐being indices.

Conclusion

Nurses' experiences were similar to findings from the early pandemic but with minor improvements in psychological distress. Nurses who frequently provided COVID‐19 patient care, worked ≥12 h per shift, and skipped rest breaks scored worse on almost all well‐being indices.

Relevance to clinical practice

Administration can help nurses' recovery by providing psychological support, mental health services, and treatment options for insomnia, as well as re‐structure current work schedules and ensure that rest breaks are taken.
Magnetic resonance imaging characteristics of polypoid endometriosis and review of the literature
Authors: Takeuchi Mayumi , Matsuzaki Kenji , Bando Yoshimi , Harada Masafumi
Published: July 2022

Aim

Polypoid endometriosis is a rare variant of endometriosis and may mimic malignancy. The purpose of this study is to evaluate magnetic resonance (MR) imaging characteristics of polypoid endometriosis for the differential diagnosis with malignancy.

Methods

MR imaging findings of four histologically proven polypoid endometriosis were retrospectively evaluated with the review of the literature.

Results

All polypoid endometriosis exhibited high signal intensity on T2‐weighted images reflecting abundant dilated endometrial glands. Peritoneal lesions were surrounded by low signal intensity rim represented the “black rim sign” reflecting endometriotic fibrous adhesion. Two cases arising from endometriotic cysts showed transmural extension (peritoneal extension and myometrial infiltration). Endometriotic hemorrhagic foci were demonstrated in four lesions as high signal intensity on T1‐weighted images and/or susceptibility‐induced signal voids on susceptibility‐weighted MR sequence. Diffusion‐weighted images showed high signal intensity with relatively high apparent diffusion coefficient (ADC) due to T2 shine‐through effect but no diffusion restriction, and dynamic contrast‐enhanced (DCE) MR imaging showed gradually increasing contrast‐enhancement pattern like benign pathologies.

Conclusions

Polypoid endometriosis may mimic malignancy; however, black rim sign may be a characteristic MR imaging finding for the peritoneal lesions, and no diffusion restriction and gradually increasing contrast‐enhancement pattern may reflect its benign nature.
The outcomes of sequential embryo transfer in patients undergoing in vitro fertilization with frozen–thawed embryos: A retrospective study
Authors: Ji Mengxia , Zhang Ling , Fu Xiaohua , Xie Wenjie , Wu Xiangli , Shu Jing
Published: July 2022

Aim

To explore whether sequential embryo transfer benefits patients with repeated implantation failure (RIF) undergoing frozen–thawed embryo transfer (FET) cycles.

Methods

We included 311 patients with a history of RIF in this retrospective study. We did sequential transfers with a cleavage embryo on day 3 and a blastocyst on day 5 in 77 patients; blastocyst transfers with two blastocysts on day 5 in 80 patients; and cleavage embryo transfers with two cleavage embryos on day 3 in 154 patients. We compared clinical outcomes between the three groups.

Results

The clinical pregnancy rate was comparable between the blastocyst transfer group (48.8%), the sequential transfer group(48.1%) and the cleavage embryo transfer group (48.1%). There was no statistically significant difference found (p > 0.05). The ongoing pregnancy and multipregnancy rates were also comparable between the three groups (p > 0.05). The early miscarriage rate was significantly higher in the sequential transfer group (32.4%) compared with the blastocyst group (12.8%) and the cleavage embryo group (12.2%) (p < 0.05). However, after adjusting for confounders, there was no significant difference in early miscarriage rates in the sequential transfer group compared with the blastocyst group (odds ratio [OR], 2.97; 95% confidence interval [CI], 0.85–9.24; p = 0.07) and the cleavage embryo group (OR, 3.03; 95% CI, 0.94–8.06; p = 0.08).

Conclusions

Sequential embryo transfer failed to improve clinical outcomes for patients with RIF.
Three‐dimensional magnetic resonance imaging assessment of levator ani in women progressing from full‐term pregnancy to 10 months postpartum
Authors: Liu Yunlu , Liu Ping , Peng Cheng , Chen Chunlin , Lu Yijia , Li Yige , Chen Ruiying
Published: July 2022

Aim

To identify the anatomical morphology of levator ani (LA) in primigravidae at term pregnancy and its natural process of changing after delivery.

Methods

Forty‐one primigravidae (vaginal delivery: 29 women, cesarean delivery in the first stage of labor: 12 women) underwent magnetic resonance imaging (MRI) at full‐term pregnancy, 6 weeks and 10 months postpartum. Three‐dimensional (3‐D) model of LA created from MRI data using Mimics v.21.0 software and source images were assessed to determine the morphology. LA volume (LVOL) was calculated and used as indicator of muscle atrophy.

Results

Decrease of levator hiatus length (LH‐L) was shown in both groups since 6 weeks postpartum. In the vaginal delivery group, the differences in LVOL between time points were significant (p < 0.05), showing a persistent decreasing tendency. Puborectalis attachment width (PAW) on the left was the smallest at 6 weeks postpartum (p < 0.05). LA avulsion and significant 2‐D morphological change after delivery were only observed in this group (p < 0.05); In the cesarean section group, smaller LVOL was found at 6 weeks postpartum comparing with full‐term pregnancy (p < 0.05); Larger levator‐symphysis gap (LSG) and levator hiatus width (LH‐W), smaller PAW were observed in vaginal delivery group comparing with cesarean section group at 6 weeks postpartum (p < 0.05), but none of the values exhibited between‐group differences (p > 0.05) at 10 months postpartum. No other comparisons were considered significant (p >0.05).

Conclusions

Vaginal delivery, or even active labor itself may both lead to LA atrophy. And the morphology of LA is basically similar in different delivery modes at 10 months postpartum once the onset of labor has occurred, even though it changes more complicatedly after vaginal delivery.
Perceived Organizational Purpose: Systematic Literature Review, Construct Definition, Measurement and Potential Employee Outcomes
Authors: Jasinenko Anna , Steuber Josephina
Published: July 2022

Organizational purpose has recently gained great popularity in research and practice. However, the development of this nascent research field has struggled with definitional ambiguity, the lack of a measurement instrument and little empirical testing of potential outcomes. In our paper, we first introduce and define the multidimensional construct of perceived organizational purpose, which sheds light on the individual and subjective experiences of organizational purpose. Second, building on our construct definition, we develop and validate a four‐dimensional Perceived Organizational Purpose Scale. Third, we disentangle the related yet differentiated concepts of perceived organizational purpose and meaningful work and theorize how substantial knowledge in the field of meaningful work can be transferred to the relatively new and untested field of perceived organizational purpose. Fourth, we critically elaborate and empirically test the relationship of perceived organizational purpose with employee job satisfaction, subjective wellbeing and work‐life conflict.
“That is Giving a Banquet”: Neighbor‐Love as Spiritualization of Romantic Loves in Works of Love
Authors: Hanson Jeffrey
Published: July 2022

Recent readings of Kierkegaard's Works of Love have admirably shown how his apparent reservations about romantic love can be deflected on his own terms by imbuing them with some of the moral rigor of neighbor‐love. This paper argues however that these readings must be complemented by the reverse argument, which would show how some of the qualities of romantic loves are in fact preserved in neighbor‐love. By drawing on his dialectics of sensate love, psychical love, spiritual love, and self‐love, I show how Kierkegaard believes neighbor‐love should be impartial and yet exhibit some of the character of preferential romantic loves.
Impact of a Montessori‐Based Nutrition Program on Children's Knowledge and Eating Behaviors
Authors: Vitale Nicole , Coccia Catherine
Published: July 2022

BACKGROUND

Poor dietary habits in childhood can lead to obesity and chronic diseases later in life. Increasing children's nutrition knowledge and liking of fruits and vegetables are key factors in improving diet quality. The purpose of this study was to assess the effects of a nutrition program on knowledge, liking and intake of fruits and vegetables in Montessori students.

METHODS

Clustered‐randomized control trial conducted in a Southeastern US Montessori school. Children aged 4‐6 years old (intervention, n = 22; control, n = 29) participated in a 4‐week nutrition education with taste testing of 12 fruits and vegetables. Nutrition knowledge, fruit and vegetable liking, and intake were measured with questionnaires, and analyzed using repeated measures analysis of covariance and descriptive analyses (SPSS v.23); significance defined as p < 0.05.

RESULTS

Controlling for covariates, significant between group effects for nutrition knowledge (F = 24.16, p < 0.001) and liking tomatoes (F = 7.01, p = 0.01) were found. The intervention group increased vegetable intake (Hedges'g = 1.01) compared to the control, although it was not significant between groups (F = 1.95, p = 0.17).

CONCLUSIONS

Initial examination of this program indicates that it was effective in increasing knowledge, vegetable liking and intake for young children in the sample. More research is needed to compare outcomes between educational delivery methods.
Explaining the gender gap in negotiation performance: Social network ties outweigh internal barriers
Authors: Turetsky Kate M. , Curley James P. , Carter Ashli B. , Purdie‐Greenaway Valerie
Published: July 2022

Gender disparities in negotiation outcomes contribute to inequality in the workplace and beyond. Explanations of gender gaps in negotiation often focus on internal barriers women face as a consequence of contending with stigma in the workplace and other historically male‐dominated environments, such as stereotype threat and apprehension about negotiating. However, stigma is also associated with relational consequences that may influence success in negotiations. This research compared internal and relational mechanisms for gender disparities in negotiation performance. Seventy‐seven MBA executives reported their apprehension about negotiating, stereotype threat in negotiations, mindset about negotiation‐related stress, and class social networks. Participants were then randomly paired to complete a series of one‐on‐one negotiations based on real‐world scenarios. Overall, men outperformed women in negotiations. Significant gender differences emerged in stereotype threat, stress mindset, and social network centrality. However, only network centrality—specifically number and strength of ties—significantly mediated the relationship between gender and negotiation performance. Position in informal social networks may play an important role in negotiation outcomes, particularly in a shared social environment like the workplace. Although efforts to explain the gender gap in negotiation performance often center internal psychological mechanisms, this research suggests that relational explanations, such as disparities in social networks, merit further attention. Limitations and recommendations for future research and policy are discussed.