bluuebunny/crossref_metadata_2025 huggingface dataset:
Galaxy Cruise: Deep Insights into Interacting Galaxies in the Local Universe
Authors: Tanaka Masayuki , Koike Michitaro , Naito Sei’ichiro , Shibata Junko , Usuda-Sato Kumiko , Yamaoka Hitoshi , Ando Makoto , Ito Kei , Kobayashi Umi , Kofuji Yutaro , Kuwata Atsuki , Nakano Suzuka , Shimakawa Rhythm , Tadaki Ken-ichi , Takebayashi Suguru , Tsuchiya Chie , Umemoto Tomofumi , Bottrell Connor
Published: September 2023

We present the first results from GALAXY CRUISE, a community (or citizen) science project based on data from the Hyper Suprime-Cam Subaru Strategic Program (HSC-SSP). The current paradigm of galaxy evolution suggests that galaxies grow hierarchically via mergers, but our observational understanding of the role of mergers is still limited. The data from HSC-SSP are ideally suited to improve our understanding with improved identifications of interacting galaxies thanks to the superb depth and image quality of HSC-SSP. We launched a community science project, GALAXY CRUISE, in 2019 and have collected over two million independent classifications of 20686 galaxies at z < 0.2. We first characterize the accuracy of the participants’ classifications and demonstrate that it surpasses previous studies based on shallower imaging data. We then investigate various aspects of interacting galaxies in detail. We show that there is a clear sign of enhanced activities of super-massive black holes and star formation in interacting galaxies compared to those in isolated galaxies. The enhancement seems particularly strong for galaxies undergoing violent mergers. We also show that the mass growth rate inferred from our results is roughly consistent with the observed evolution of the stellar mass function. The second season of GALAXY CRUISE is currently underway and we conclude with future prospects. We make the morphological classification catalog used in this paper publicly available at the GALAXY CRUISE website, which will be particularly useful for machine-learning applications.
Kaon theory: 50 years later
Authors: Buras Andrzej J
Published: September 2023

We summarize the status of the kaon theory 50 years after the seminal paper of Kobayashi and Maskawa [Prog. Theor. Phys. 49, 652 (1973)], who pointed out that six quarks are necessary to have CP violation in the Standard Model (SM) and presented a parametrization of a 3 × 3 unitary matrix that, after the discovery of the charm quark in 1974 and the b quark in 1977, dominated the field of flavor-changing processes. One of the main goals of flavor physics since then has been the determination of the four parameters of this matrix, which we will choose here to be |Vus|, |Vcb|, and the two angles of the unitarity triangle, β and γ, with |Vus| introduced by Cabibbo in 1963. I will summarize the recent strategy for determination of these parameters without new physics (NP) infection. It is based on the conjecture of the absence of relevant NP contributions to ΔF = 2 processes that indeed can be demonstrated by a negative rapid test: the |Vcb|–γ plot. This in turn allows one to obtain SM predictions for rare K and B decays that are the most precise to date. We present strategies for the explanation of the anticipated anomaly in the ratio ε′/ε and the observed anomalies in b → sμ+μ− transitions that are consistent with our ΔF = 2 conjecture. In particular, the absence of NP in the parameter εK still allows for significant NP effects in ε′/ε and in rare kaon decays, moreover, in a correlated manner. Similarly, the absence of NP in ΔMs combined with anomalies in b → sμ+μ− transitions hints at the presence of right-handed quark currents. We also discuss how the nature of neutrinos, Dirac vs. Majorana ones, can be probed in $K\rightarrow \pi \nu \bar{\nu }$ and $B\rightarrow K(K^{*})\nu \bar{\nu }$ decays. The present status of the ΔI = 1/2 rule and ε′/ε is summarized.
Stem cell therapy for erectile dysfunction: a systematic review
Authors: Furtado Thiago P , Saffati Gal , Furtado Marcelo H , Khera Mohit
Published: September 2023

Introduction

Erectile dysfunction (ED) is a common condition that negatively affects men’s quality of life. It can have various causes, including psychological, vascular, and neurologic factors. Existing treatments for ED mainly focus on symptom relief rather than addressing the underlying cause. Stem cells (SCs) have shown potential as a therapeutic approach for ED due to their anti-inflammatory properties.

Objectives

This systematic review aims to assess the current status of trials and determine the potential impact of SCs on male sexual health.

Methods

A comprehensive search strategy was employed to gather relevant articles from 6 electronic databases. The search included articles published until March 2023. The reference lists of articles were manually reviewed to identify additional studies of relevance. The eligibility criteria for inclusion in the analysis focused on clinical trials involving humans that evaluated the safety and efficacy of SC therapy for ED. Exclusion criteria encompassed case reports, case series, abstracts, reviews, and editorials, as well as studies involving animals or SC derivatives. Data extraction was performed via a standardized form with a focus on erectile outcomes.

Results

A total of 2847 articles were initially identified; 18 were included in the final analysis. These studies involved 373 patients with ED and various underlying medical conditions. Multiple types of SC were utilized in the treatment of ED: mesenchymal SCs, placental matrix–derived mesenchymal SCs, mesenchymal SC–derived exosomes, adipose-derived SCs, bone marrow–derived mononuclear SCs, and umbilical cord blood SCs.

Conclusion

SC therapy shows promise as an innovative and safe treatment for organic ED. However, the lack of standardized techniques and controlled groups in many studies hampers the ability to evaluate and compare trials.
No Visitors
Authors: Knight Stacey L. , Robinson Ruthie , Stinson Cynthia
Published: September 2023

Background/Introduction

Restrictions on visitors during the coronavirus disease 2019 (COVID-19) pandemic had major implications for both patients and families, impacting health care outcomes. Policies included mandatory closures, masking, and visiting restrictions both in acute and long-term care. Despite visiting restrictions in health care systems, little is known about its effects.

Objectives/Aims

The objective of this study was to elicit perceptions of individuals who were separated from their loved ones during acute care hospitalization during the COVID pandemic.

Methods

Individuals who experienced separation from hospitalized family members because of the “no-visitor policies” during the COVID-19 pandemic were asked to participate in a study to elicit their perceptions. After institutional review board approval, interviews were completed for those who had loved ones admitted to acute care facilities only. Audiotaped and transcribed interviews were conducted in person, via telephone, or virtually using a primary investigator–developed interview guide. Using the Colaizzi method of analysis, themes were derived.

Results

Of the 11 completed interviews, 100% of participants were female, and all were residents of Texas. Themes derived from this pilot project were advocacy, communication, emotional upheaval, human factors, isolation, and abandonment.

Conclusions

Findings from patient interviews support previous published studies. Ideas for improved patient and family experience discussed by the authors include personal protective equipment for significant others, consideration of visitation policies for those patients without decision-making capabilities, and increased accessibility to communication aids for both patients and families.
Prehospital Critical Care Blood Product Administration
Authors: Hough Randall , Cox Sylvan Charles , Chimelski Erica , Mihm Fred G. , Tobin Joshua M.
Published: September 2023

Background

Prehospital blood transfusion has been widely practiced in the military and is drawing renewed scrutiny after many years of civilian use.

Objective

The objective of this article is to quantify the benefit derived from prehospital transfusion of blood products.

Methods

Deidentified data were extracted retrospectively from the flight records of a critical care transportation program between April 2018 and January 2020. Patients who were transported before a prehospital blood transfusion protocol were compared with patients after initiation of the blood transfusion protocol. Demographic data, vital signs, laboratory analytics, and other outcome measures were analyzed.

Results

Nine scene transport patients who met the transfusion criteria before a blood transfusion protocol were compared with 11 patients transported after initiation of the protocol. Identical outcome measures were analyzed. Patients who received prehospital blood transfusions had a statistically significantly longer hospital length of stay (16.5 vs 3.7 days, P = .03) and were more often taken directly to the operating room (80% vs 28%, P = .04). No statistically significant difference was identified when comparing mean arterial pressure, heart rate, respiratory rate, hemoglobin, hematocrit, or survival to hospital discharge.

Conclusions

Trauma patients who received prehospital blood transfusion had a longer hospital length of stay and were more often taken directly to the operating room, but without improvement in survival.
A Quantitative Intersectionality Analysis of HIV/STI Prevention and Healthcare Access Among Transgender and Nonbinary People
Authors: Tordoff Diana M. , Fernandez Atlas , Perry Nicole Lynn , Heberling William B. , Minalga Brian , Khosropour Christine M. , Glick Sara N. , Barbee Lindley A. , Duerr Ann ,   the Seattle Trans and Non-binary Sexual Health (STARS) Advisory Board
Published: September 2023

Background:

Transgender and nonbinary people experience substantial barriers to accessing healthcare, including prevention of HIV and other sexually transmitted infections (HIV/STI), due to structural inequities. We examined differences in insurance, HIV/STI prevalence, testing, and preexposure prophylaxis use among transgender and nonbinary people living in Washington State by race and ethnicity and gender.

Methods:

We pooled data from five 2019–2021 Washington State HIV/STI surveillance data sources to obtain a large and diverse sample of 1648 transgender and nonbinary participants. We calculated the risk difference (RD) for each outcome and used Poisson regression to estimate a surrogate measure of additive interaction—attributable proportion (AP)—that measures the proportion of the excess prevalence of the outcome observed at the intersection of gendered and racialized experience, beyond that expected from gender or race and ethnicity alone.

Results:

Participants reported overall high levels of poverty (29% incomes <$15,000 and 7% unstable housing). Certain groups, especially racial/ethnic minority transgender women, were disproportionately impacted by HIV/STIs (RDs from 20% to 43% and APs from 50% to 85%) and less likely to currently have insurance (RDs from 25% to 39% and APs from 74% to 93%) than that expected based on gendered or racialized experience alone.

Conclusions:

Our findings highlight the heterogeneity in insurance access, HIV/STI positivity, and prevention utilization within transgender communities. We observed that a large proportion of increased HIV/STI prevalence among racial/ethnic minority transgender women was attributable to the intersection of gender and race and ethnicity. Our findings highlight the importance of trans-inclusive models of HIV/STI prevention that address multilevel barriers rooted in cissexism and structural racism.
A Decade of Tweets: Visualizing Racial Sentiments Towards Minoritized Groups in the United States Between 2011 and 2021
Authors: Nguyen Thu T. , Merchant Junaid S. , Yue Xiaohe , Mane Heran , Wei Hanxue , Huang Dina , Gowda Krishik N. , Makres Katrina , Najib Crystal , Nghiem Huy T. , Li Dapeng , Drew Laura B. , Hswen Yulin , Criss Shaniece , Allen Amani M. , Nguyen Quynh C.
Published: September 2023

Background:

Research has demonstrated the negative impact of racism on health, yet the measurement of racial sentiment remains challenging. This article provides practical guidance on using social media data for measuring public sentiment.

Methods:

We describe the main steps of such research, including data collection, data cleaning, binary sentiment analysis, and visualization of findings. We randomly sampled 55,844,310 publicly available tweets from 1 January 2011 to 31 December 2021 using Twitter’s Application Programming Interface. We restricted analyses to US tweets in English using one or more 90 race-related keywords. We used a Support Vector Machine, a supervised machine learning model, for sentiment analysis.

Results:

The proportion of tweets referencing racially minoritized groups that were negative increased at the county, state, and national levels, with a 16.5% increase at the national level from 2011 to 2021. Tweets referencing Black and Middle Eastern people consistently had the highest proportion of negative sentiment compared with all other groups. Stratifying temporal trends by racial and ethnic groups revealed unique patterns reflecting historical events specific to each group, such as the killing of George Floyd regarding sentiment of posts referencing Black people, discussions of the border crisis near the 2018 midterm elections and anti-Latinx sentiment, and the emergence of COVID-19 and anti-Asian sentiment.

Conclusions:

This study demonstrates the utility of social media data as a quantitative means to measure racial sentiment over time and place. This approach can be extended to a range of public health topics to investigate how changes in social and cultural norms impact behaviors and policy.

A supplemental digital video is available at http://links.lww.com/EDE/C91
A Novel LC-MS/MS Method for Therapeutic Drug Monitoring of Baricitinib in Plasma of Pediatric Patients
Authors: Cafaro Alessia , Baiardi Giammarco , Pigliasco Federica , Barco Sebastiano , Mattioli Francesca , Volpi Stefano , Caorsi Roberta , Gattorno Marco , Cangemi Giuliana
Published: September 2023

Background:

Janus kinase inhibitors are antirheumatic immunosuppressive drugs that target intracellular Janus kinases (JAKs). Baricitinib is a selective and reversible orally administered JAK1/JAK2 inhibitor approved for treating rheumatoid arthritis, atopic dermatitis, and alopecia areata in adult patients. Expanded access to baricitinib has been approved for treating pediatric patients affected by rare Mendelian autoinflammatory diseases with type I interferon-mediated damage. Knowledge of the pharmacokinetic properties and target plasma levels of baricitinib in pediatric patients is limited. In this study, a novel LC-MS/MS method for measuring baricitinib in plasma, validated according to the ICH M10 guidelines, is presented.

Methods:

Sample preparation was performed by adding 10 µL of IS working solution (150 ng/mL) and 200 µL of MeOH to each plasma sample. Chromatographic separation was conducted using a Thermo Scientific Accucore Polar Premium column (50 mm × 2.1 mm, i.d. 2.6 m). This method was applied to 7 real anonymous plasma samples obtained from pediatric patients treated with baricitinib at IRCCS Istituto Giannina Gaslini (Genoa, Italy). Patients of both sexes had a median age of 14 years (range, 10–17 years).

Results:

The LC-MS/MS method resulted linear over wide concentration ranges (1.024–100 ng/mL) and was accurate and reproducible in the absence of matrix effects, allowing for robust, specific, and rapid quantification of baricitinib from a low amount of plasma (50 µL). The plasma concentration of baricitinib in the samples of the patients, expressed as mean ± SD, was 11.25 ± 10.86 ng/mL.

Conclusions:

This novel LC-MS/MS method is suitable for the therapeutic drug monitoring of baricitinib and can help guide therapy optimization in pediatric patients.
Overview and prospect of NAFLD: Significant roles of nutrients and dietary patterns in its progression or prevention
Authors: Mao Tianyu , Sun Yiwen , Xu Xinyi , He Kang
Published: September 2023

NAFLD is the most common chronic liver disease worldwide, characterized by lipid accumulation in the liver, and usually evolves from steatohepatitis to fibrosis, cirrhosis, or even HCC. Its incidence is rapidly rising in parallel with the increasing prevalence of obesity and metabolic syndrome. Current therapies are limited to lifestyle changes including dietary intervention and exercise, in which dietary modification exerts an important part in losing weight and preventing NAFLD. In this review, we briefly discuss the roles and mechanisms of dietary components including fructose, non-nutritive sweeteners, fat, proteins, and vitamins in the progression or prevention of NAFLD. We also summarize several popular dietary patterns such as calorie-restricted diets, intermittent fasting, ketogenic diets, Mediterranean diets, and dietary approach to stop hypertension diets and compare the effects of low-fat and low-carbohydrate diets in preventing the development of NAFLD. Moreover, we summarize the potential drugs targeting metabolic-related targets in NAFLD.
AHRR Hypomethylation mediates the association between maternal smoking and metabolic profiles in children
Authors: Vidal Adriana C. , Chandramouli Shivram A. , Marchesoni Joddy , Brown Nia , Liu Yukun , Murphy Susan K. , Maguire Rachel , Wang Yaxu , Abdelmalek Manal F. , Mavis Alisha M. , Bashir Mustafa R. , Jima Dereje , Skaar David A. , Hoyo Cathrine , Moylan Cynthia A.
Published: September 2023

Background:

Tobacco smoking during pregnancy is associated with metabolic dysfunction in children, but mechanistic insights remain limited. Hypomethylation of cg05575921 in the aryl hydrocarbon receptor repressor (AHRR) gene is associated with in utero tobacco smoke exposure. In this study, we evaluated whether AHRR hypomethylation mediates the association between maternal smoking and metabolic dysfunction in children.

Methods:

We assessed metabolic dysfunction using liver fat content (LFC), serum, and clinical data in children aged 7–12 years (n=78) followed since birth. Maternal smoking was self-reported at 12 weeks gestation. Methylation was measured by means of pyrosequencing at 3 sequential CpG sites, including cg05575921, at birth and at ages 7–12. Regression models were used to evaluate whether AHRR methylation mediated the association between maternal smoking and child metabolic dysfunction.

Results:

Average AHRR methylation at birth was significantly higher among children of nonsmoking mothers compared with children of mothers who smoked (69.8% ± 4.4% vs. 63.5% ± 5.5, p=0.0006). AHRR hypomethylation at birth was associated with higher liver fat content (p=0.01), triglycerides (p=0.01), and alanine aminotransferase levels (p=0.03), and lower HDL cholesterol (p=0.01) in childhood. AHRR hypomethylation significantly mediated associations between maternal smoking and liver fat content (indirect effect=0.213, p=0.018), triglycerides (indirect effect=0.297, p=0.044), and HDL cholesterol (indirect effect = -0.413, p=0.007). AHRR methylation in childhood (n=78) was no longer significantly associated with prenatal smoke exposure or child metabolic parameters (p>0.05).

Conclusions:

AHRR hypomethylation significantly mediates the association between prenatal tobacco smoke exposure and features of childhood metabolic dysfunction, despite the lack of persistent hypomethylation of AHRR into childhood. Further studies are needed to replicate these findings and to explore their causal and long-term significance.
Incidence and risk factors of graft-versus-host disease after liver transplantation: A national study 2010–2020
Authors: Huang Yuting , Wang Yichen , Chase R. Christopher , Yang Liu
Published: September 2023

Background:

Graft-versus-host disease (GVHD) is a common complication of hematopoietic cell transplantation, and its incidence is low in liver transplantation (LT). Estimating the incidence of GVHD after LT is challenging due to the paucity of available data from the United Network for Organ Sharing. This is the first national analysis of the incidence and risk factors of GVHD after LT.

Methods:

This retrospective cohort study used the National Readmission Database to calculate the incidence rate of GVHD within 1 year of LT using survival analysis. The predictors of GVHD were identified using univariate and multivariate Cox regression analyses.

Results:

From 2010 to 2020, of 88,433 LTs, 383 cases of GVHD occurred within 1 year after LT, resulting in an incidence rate of 1.0% (95% CI: 0.8%–1.3%). We observed no statistically significant change in the incidence of GVHD after LT from 2010 to 2020 (beta-coefficient, −0.07%; 95% CI: −0.17% to 0.04%, p = 0.188). Interestingly, alcohol-associated liver disease was associated with a lower risk of GVHD (adjusted HR, 0.57; 95% CI: 0.36–0.91, p = 0.018), whereas a higher risk was found to be related to a secondary diagnosis of COVID-19 on index admission.

Conclusion:

Our study found that the incidence rate of GVHD within 1 year of LT in the United States was 1.0% and remained stable from 2010 to 2020. The predictors associated with GVHD include alcohol-associated liver disease and COVID-19. Our study provides valuable insights into the incidence, risk factors, and outcomes of GVHD after LT.
Severe acute hepatitis of unknown etiology in a large cohort of children
Authors: Mehta Sagar , John Tomisin , Feld Jordan J. , Shah Hemant , Mullaithilaga Nisa , Campigotto Aaron , Leung Karen , Kamath Binita M. , Ling Simon C. , Science Michelle , Ng Vicky L.
Published: September 2023

Background:

We evaluated the proportion, clinical features, and outcomes of previously healthy children presenting to a large Canadian quaternary pediatric center with severe acute hepatitis of unknown etiology.

Methods:

All patients with serum alanine aminotransferase (ALT) > 500 U/L or aspartate aminotransferase (AST) > 500 U/L between June 1, 2018, and May 31, 2022, at The Hospital for Sick Children, were identified. Subjects with only AST > 500 U/L were excluded. Clinical characteristics, investigations, and outcomes for patients without clear etiology for ALT > 500 U/L (severe acute hepatitis of unknown etiology) for our study period and from October 1 to May 31 of each year 2018–2021 were reviewed.

Results:

Of 977 patients with ALT/AST> 500 U/L, 720 had only ALT > 500 U/L. We excluded age below 6 months (n = 99) or above 16 years (n = 66), known pre-existing liver conditions (n = 66), and ALT > 500 U/L in already admitted patients (n = 151). Among the remaining 338 children with ALT > 500 U/L at presentation, an etiology was identified in 303 subjects. 33 (9.8%) children [median age 6.1 y (range 0.5–15.5); 61% male] were confirmed as severe acute hepatitis of unknown etiology. Twenty patients (60.6%) were tested for blood adenovirus by PCR, and 1 (5%) was positive (serotype B7). Liver tissue specimens from 18 patients revealed no evidence of viral inclusions or adenovirus. Twelve (36.3%) presented with pediatric acute liver failure, with 8 (24.2%) requiring liver transplantation. There were no deaths. Hepatitis-associated aplastic anemia occurred in 5 (15%) patients.

Conclusions:

Of children presenting with severe acute hepatitis to a quaternary children’s hospital over a 48-month period, 9.8% had unknown etiology with no change over time. Liver transplantation remains an important treatment strategy for those presenting with pediatric acute liver failure phenotype. The frequency of cases associated with human adenovirus infection was noncontributory.
AMD Injection Frequency: Effects of Distance Traveled and Travel Support
Authors: Meer Elana A. , Targ Sonia , Zhang Ning , Hoggatt Katherine J. , Mehta Kala M. , Brodie Frank
Published: September 2023

Purpose:

While efficacious, intravitreal anti-VEGF therapy regimens for neovascular age-related macular degeneration (NVAMD) can prove difficult for patients to adhere to due to high cost and burden of transportation.

Methods:

Analysis of electronic health record data from the San Francisco Veterans Administration Medical Center (SF VAMC) eye clinic (1/1/2010-12/31/2019) was performed, extracting demographic data, anti-VEGF injection history, and enrollment in the SFVA travel benefit program. Two-tailed p-values were calculated for poisson regression examining average number of injections per year as the outcome and distance traveled as the primary predictor. Travel benefit was evaluated as a modifying effect on the distance – injection relationship.

Results:

318 patients who received intravitreal injection for treatment of NVAMD were included in the analysis. Median (IQR) distance to clinic was 31.5 miles (7.4-69.4 miles). Driving distance in miles was inversely associated with average number of injections per year. Among all 318 patients, for every additional 100 miles a patient lived from our clinic, the patient received on average 2.5 fewer injections per year (

distance= -0.0025, p<0.001), but this was not the case for patients with travel benefits (

distance= -0.0011, p=0.362).

Conclusion:

The greater the distance from a patient’s eye clinic the lower the average number of injections per year. However, travel benefits mitigated this relationship, highlighting opportunities for improving patient’s adherence through assistance programs.
UNILATERAL MACULAR HOLE IN A PATIENT WITH RETINITIS PIGMENTOSA TREATED WITH COVER FLAP TECHNIQUE WITH THE USE OF PLATELET-RICH PLASMA UNDER AIR TAMPONADE
Authors: Lo Giudice Gregorio , Alessandria Amedeo , Imburgia Aurelio , Anastasi Marco , Randazzo Viviana , Masaniello Filippo , Pioppo Antonino
Published: September 2023

Purpose:

The purpose of the study is to show the excellent anatomical result of the inverted flap-assisted technique with platelet-rich plasma under air for retinitis pigmentosa complicated with macular hole.

Methods:

A 32-year-old woman, previously diagnosed with retinitis pigmentosa, was referred to our department complaining of decreased central vision in her left eye for 4 weeks. At the time of presentation, the optical coherence tomography and fundoscopy examination showed the presence of a macular hole of 620 μm in diameter. The closure of the macular hole was observed after the surgical procedure, but endophthalmitis occurred 5 days, postoperatively.

Results:

In our presented case, the cover flap-assisted technique with platelet-rich plasma under air for retinitis pigmentosa complicated with macular hole resulted in excellent anatomical outcomes with unremarkable visual recovery.

Conclusion:

The physiopathology of full-thickness macular holes in retinitis pigmentosa patients remains still not fully elucidated. Pars plana vitrectomy with the adjunct of highly concentrated pure platelet-rich plasma have shown successful results.
Sex differences in visceral sensitivity and brain activity in a rat model of comorbid pain: a longitudinal study
Authors: Da Silva Joyce T. , Hernandez-Rojas Luis G. , Mekonen Hayelom K. , Hanson Shelby , Melemedjian Ohannes , Scott Alison J. , Ernst Robert K. , Seminowicz David A. , Traub Richard J.
Published: September 2023

Temporomandibular disorder (TMD) and irritable bowel syndrome (IBS) are 2 chronic overlapping pain conditions (COPCs) that present with significant comorbidity. Both conditions are more prevalent in women and are exacerbated by stress. While peripheral mechanisms might contribute to pain hypersensitivity for each individual condition, mechanisms underlying the comorbidity are poorly understood, complicating pain management when multiple conditions are involved. In this study, longitudinal behavioral and functional MRI-based brain changes have been identified in an animal model of TMD-like pain (masseter muscle inflammation followed by stress) that induces de novo IBS-like comorbid visceral pain hypersensitivity in rats. In particular, data indicate that increased activity in the insula and regions of the reward and limbic systems are associated with more pronounced and longer-lasting visceral pain behaviors in female rats, while the faster pain resolution in male rats may be due to increased activity in descending pain inhibitory pathways. These findings suggest the critical role of brain mechanisms in chronic pain conditions and that sex may be a risk factor of developing COPCs.
Prospective Cohort Study of Parathyroid Function and Quality of Life After Total Thyroidectomy for Thyroid Cancer: Robotic Surgery vs. Open Surgery
Authors: Qin Xiangquan , Luo Jia , Ma Jing , Cao Xiaozheng , Zhao Jinjin , Jiang Jun , Zhang Yi , Zeng Lingjuan , Fan Linjun
Published: September 2023

Objective:

To compare robot-assisted thyroidectomy (RT) and open thyroidectomy (OT) through a prospective cohort study focusing on the rate of postoperative hypoparathyroidism, efficacy, and quality of life (QoL).

Summary Background Data:

Hypoparathyroidism is a frequent complication after thyroidectomy. Reducing the risk of hypoparathyroidism after total thyroidectomy is a crucial and difficult task for thyroid surgeons.

Methods:

We prospectively enrolled 306 patients with papillary thyroid carcinoma(PTC) into an RT group and OT group. The former used “super-meticulous” capsular dissection (SMCD) and the latter used traditional meticulous capsular dissection. Patients were evaluated by scales [Short Form (SF)-36, Visual Impairment Scale (VIS), Swallowing Impairment Scale (SIS), Neck Impairment Scale (NIS), Scar questionnaire (SCAR-Q)].

Results:

The rates of transient hypoparathyroidism, permanent hypoparathyroidism, and transient hypocalcemia after surgery in the OT group and RT group were significantly different (P<0.001). SIS and VIS scores in the two groups were significantly different (P<0.001). SF-36 showed significant differences (P<0.001) in the subsections of “physiological function”, “body pain”, “general health”, “vitality”, “social function”, “role emotional”, and “mental health” between the two groups. SCAR-Q showed that the length and appearance of scars showed significant differences between the two groups.

Conclusions:

Robot-assisted thyroidectomy with Super-meticulous capsular dissection can protect parathyroid function and improve postoperative QoL, and could be a new option for robot-assisted surgery against thyroid cancer.
Creation of a decellularized vaginal matrix from healthy human vaginal tissue for potential vagina reconstruction – experimental studies
Authors: Sueters Jayson , Xiao Fangxin , Roovers Jan-Paul , Bouman Mark-Bram , Groenman Freek , Maas Huub , Huirne Judith , Smit Theo
Published: September 2023

Background:

When a disorder causes absence of a healthy, full-size vagina, various neovaginal creation methods are available. Sometimes dilation or stretching of the vaginal cavity is sufficient, but intestinal or dermal flap tissue is generally required. However, different inherent tissue properties cause complications. Therefore, a lost body part should be replaced with a similar material. The use of organ-specific acellular vaginal tissue carries great potential, as its similar architecture and matrix composition make it suitable for vaginal regeneration.

Methods:

We developed an optimized protocol for decellularization of healthy, human vaginal tissue. Resected colpectomy tissue from 12 healthy transgender patients was used. Successful decellularization was confirmed by applying acellular criteria from in vivo remodeling-reports. Suitability as tissue-mimicking scaffold for vaginal reconstruction was determined by visible structural features, biocompatibility during stretching and presence of visible collagen, elastin, laminin and fibronectin.

Results:

Histological examination confirmed the preservation of structural features and minimal cellular residue was seen during fluorescence microscopy, DNA and RNA quantification and fragment-length examination. Biomechanical testing showed decreased peak load (55%, P<0.05), strain at rupture (23%, P<0.01) and ultimate tensile stress (55%, P<0.05) after decellularization, while the elastic modulus (68%) did not decrease significantly. Fluorescence microscopy revealed preserved Fibronectin-I/II/III and Laminin-I/II, while Collagen-I and Ficolin-2B were decreased but mostly retained.

Conclusions:

The absence of cellular residue, moderately altered biomechanical extracellular matrix (ECM) properties and mostly preserved structural proteins, appear to make our decellularized human vaginal matrix a suitable tissue-mimicking scaffold for vagina transplantation when tissue survival through vascularization and innervation are accomplished in the future.
Finding the minimum number of retrieved lymph nodes in Node-negative colorectal cancer using Real-world Data and the SEER database
Authors: Qiao Yihuan , Zhu Jun , Han Tenghui , Jiang Xunliang , Wang Ke , Chen Rujie , Du Yongtao , Li Jipeng , Sun Li
Published: September 2023

Background:

Current clinical guidelines recommend the removal of at least 12 lymph nodes (LNs) in resectable colorectal cancer (CRC). With advancements in lymphadenectomy technologies, the number of retrieved lymph nodes (rLNs) has markedly increased. This study aimed to investigate the lowest number of rLNs in node-negative patients.

Materials and Methods:

A total of 1103 N0 and 208 N1a stage patients were enrolled in our cohort, while 8503 N0 and 1276 N1a patients from the Surveillance, Epidemiology, and End Results CRC database were included. Propensity score matching and multivariate Cox regression analyses were performed to mitigate the influence of selection bias and control for potential confounding variables.

Results:

The median number of rLNs in N0 patients increased from 13.5 (interquartile range [IQR]: 9-18) in 2013 to 17 (IQR: 15-20) in 2019. The restrictive cubic spline illustrated a nonlinear relationship between rLNs and prognosis (nonlinearity, P=0.009), with a threshold (N=16) influencing clinical outcomes. Patients at either N0 or N1a stage with sufficient rLNs (≥ 16) demonstrated superior prognoses to those with a limited rLNs (<16). After adjusting for clinical confounders, similar prognoses were observed in N0 limited and N1a adequate populations. Furthermore, Kaplan-Meier curves revealed N0 limited patients who received chemotherapy exhibited better outcomes than those who did not.

Conclusions:

Among patients with node-negative CRC, it is crucial to remove 16 or more LNs effectively. Fewer than 16 rLNs should be regarded as an independent risk factor, implying the need for adjuvant chemotherapy.
“Because of this rotation, this is what I want to do”: Implementation and evaluation of a telehealth opioid use disorder clinical placement for nurse practitioner students
Authors: French Rachel , Lyons Erica , Schachter Allison , Treston June A. , Marshall Ami , Lattimer Jennie , Bisaga Adam , Behar Emily , Aronowitz Shoshana V.
Published: September 2023

The lack of clinicians comfortable prescribing buprenorphine is a barrier to access for people with opioid use disorder (OUD). Accordingly, a telehealth OUD treatment clinic, Ophelia, launched a clinical training program for nurse practitioner (NP) students. The goal of this study was to assess a telehealth-based model of OUD clinical training. To evaluate the program, we (1) identified students' knowledge related to providing OUD care to patients before and after their clinical rotation with Ophelia and (2) characterized students' attitudes about providing OUD care following their clinical rotation with Ophelia. Online pre- and postsurveys were conducted with 57 and 29 students, respectively, and semistructured interviews were conducted with 19 students who completed clinical rotations with Ophelia. We used quantitative descriptive analysis to compare presurvey and postsurvey results and conducted thematic analysis to analyze qualitative interview data. We identified three themes from the interviews: the continuum of learning opportunities, the comfort providing OUD treatment following participants' clinical rotation, and the relevance of a substance use disorder clinical rotation for all NP students. The survey also supported these findings. Of note, there were descriptive differences between presurvey and postsurvey responses related to an increase in knowledge, preparedness, and acquisition of skills to treat OUD. Using a telehealth clinical rotation for NP students to learn about OUD treatment may represent an important step in increasing the number of clinicians who can prescribe buprenorphine. These findings can inform interventions and policies that target clinician training barriers.
Pediatric Cholelithiasis in the United States: National Hospitalization Trends, 2006 to 2019
Authors: Agawu Atu , Kanagawa Christina , Wong Janeline , Shults Justine , Feudtner Chris , Bewtra Meenakshi
Published: September 2023

Objectives:

Previous studies have shown increasing hospitalizations for pediatric cholelithiasis, but recent trends are unknown. We conducted a national study of pediatric cholelithiasis to characterize recent hospitalization rate trends.

Methods:

Retrospective repeated cross-sectional analysis of pediatric (age < 18 years) cholelithiasis-associated hospitalizations combining data from the 2006 through 2019 Kids’ Inpatient Database releases. The primary outcome of interest was the national hospitalization rate (per 100,000 children). We examined rates stratified by age group and sex and characterized hospitalization outcomes and characteristics for pediatric cholelithiasis.

Results:

Twenty-nine thousand one hundred two hospital records representing 42,282 gallstone-associated hospitalizations were identified. The hospitalization rate declined from 12.9 [95% confidence interval (CI): 12.6–13.2] in 2006 to 9.1 (95% CI: 8.8–9.3) in 2019. Consistent with the literature, hospitalizations occurred most often among teenagers (71%) and individuals with female sex (72%). The proportion of hospitalizations at freestanding children’s hospitals increased significantly (from 18.2% to 35.1%). Finally, the proportion of hospitalizations involving a potentially medical predisposing condition increased significantly.

Conclusions:

The estimated US hospitalization rate for pediatric cholelithiasis declined by 30% between 2006 and 2019. Female patients and teenagers had the largest decline, and hospitalizations increasingly occurred at freestanding children’s hospitals. Potential explanations include potential changes in delivery of care as well as changes in population disease burden.
Determinants t of patient satisfaction with pharmacy services at Felege Hiwot comprehensive specialized hospital, Bahir Dar, Ethiopia
Authors: Yehualaw Adane , Tafere Chernet , Demsie Desalegn Getnet , Feyisa Kebede , Bahiru Bereket , Kefale Belayneh , Berihun Malede , Yilma Zewdu
Published: September 2023

Background:

Patients have explicit desire for quality services when they visit health institutions. Patient satisfaction is a primary means of measuring the effectiveness of healthcare delivery. However, inadequate discovery of their needs may result in patient dissatisfaction. Patients who are satisfied with pharmaceutical care are likely to adherence, seeking for medical attentions and take medications properly. Providing better access to quality pharmacies is a way to improve patient satisfaction with healthcare services.

Study objective:

The study was aimed to assess patient satisfaction with pharmacy services at Felege Hiwot Comprehensive Specialized Hospital (FHCSH).

Methods and materials:

An institution-based cross-sectional study design was conducted at FHCSH from 1 May 2021 to 30 October 2021. Data were collected by interview with structured questionnaires. Then the data were coded, entered, and then analyzed by SPSS version 23. The association between predictors and outcome was measured using bivariate logistic regression.

Result:

In this study, 384 study participants were included. Majority of the participants were males (55.37%, N=227). The overall satisfaction score of the participants of this study was 65.37%. In our study, clients showed greater satisfaction towards pharmacists’ commitment to correct myths (92%), pharmacist availability (88.78), and cleanliness (87.8%). Multivariate analysis indicated physical restriction [adjusted odds ratio (AOR)=6:95%; 95% CI (2.98, 25.9)] and rural residence [AOR=2.43; 95% CI (1.71, 9.6)] had significant association with pharmacy service dissatisfaction. Among the quality pharmacy service indicators, counselling on how medications work [AOR=9; 95% CI (1.48, 8.85)], keeping to dosage regimen [AOR=7.3; 95% CI (5.49, 11.06)], and advice on the current medical condition had greater odds of client dissatisfaction.

Conclusion:

The findings of the current study showed that patients’ satisfaction towards outpatient pharmacy services provided by FHCSH is very low as it is indicated in their perception towards revealing written information about medication use, medication availability, medication storage, and instructions about medication side effects.
First case report of a perinatally HIV-infected infant with HIV resistance to dolutegravir associated with tenofovir/lamivudine/dolutegravir use in mothers
Authors: Francois Kesner , Van Onacker Joelle Deas , Jordan Michael R. , Journel Ito , Buteaue Josiane , Pierre Emmanuel , Duval Nirva , Dos Santos Georges , Giron Amalia , Geffrard Harry , Sued Omar , Inzaule Seth C.
Published: September 2023

Perinatally HIV-infected infants can be infected with a drug-resistant virus or select for drug resistance by exposure to sub-therapeutic levels of maternal antiretroviral drugs present in breastmilk or from sub-therapeutic infant prophylaxis. We report a case of dolutegravir resistance detected in a treatment-naive perinatally HIV-infected infant whose mother was receiving tenofovir/lamivudine/dolutegravir. This case was detected during a national survey of HIV drug resistance in Haiti amongst infants testing positive for HIV through the national early infant diagnosis program between April 2020 and March 2021. This unique case underscores the need for prompt management of high viral loads in pregnant and breastfeeding women and supports HIV drug resistance surveillance efforts targeted at antiretroviral therapy-naive infants born to mothers in low-and middle-income countries.
Endemic mycoses – are we making progress in management?
Authors: Bahr Nathan C. , Thompson George R.
Published: September 2023

Purpose of review

The endemic fungi are a significant cause of morbidity and mortality in effected patients. The range of endemicity for these are expanding with infections observed outside of traditional locations. Enhanced diagnostic and treatment practices may significantly alter patient outcomes.

Recent findings

Recently completed clinical trials have focused on an assessment of improving efficacy while minimizing patient toxicity. Practice changing trials have been completed in histoplasmosis showing the utility of a single up-front liposomal amphotericin B dose followed by standard itraconazole dosing. The recent evaluation of several antifungal options including isauvconazole in the treatment of coccidioidomycosis also show promise for additional therapeutic agents. A recently conducted trial has also shown the superiority of amphotericin B therapy over itraconazole in the treatment of talaromycosis.

The increased range of endemic mycoses coupled with the growing immunocompromised patient population mandates continued investigation of improved diagnostic and therapeutic options. Advances in these areas have led to more rapid diagnosis and more efficacious antifungal therapy.
Diagnostic Utility of 99mTc-MDP Bone Scintigraphy for Nivolumab-Induced Inflammatory Arthritis
Authors: Araki Yoshihiro , Misaki Tomonori , Ueda Yasuhiro , Matsumoto Naoyuki , Takaso Yuji
Published: September 2023

Immune checkpoint inhibitors can revive exhausted helper T-cells, and inflammatory cell reactivation may cause autoimmune disease–like conditions. Drug-induced arthritis is an immune-related adverse event, but the diagnostic approach is undefined. We present the diagnostic utility of 99mTc-MDP bone scintigraphy for nivolumab-induced inflammatory arthritis. A 67-year-old man with hypopharyngeal carcinoma presented bilateral multiple metacarpophalangeal joint pain and swelling at each nivolumab administration. Regular imaging findings were atypical for inflammatory arthritis and did not fulfill the criteria for rheumatoid arthritis. We diagnosed nivolumab-induced inflammatory arthritis based on clinical symptoms and the symmetrical moderate uptake of the affected joints on 99mTc-MDP bone scintigraphy.
Somatostatin Receptor–Directed PET/CT Can Differentiate Between Different Subtypes of Head and Neck Paragangliomas
Authors: Zhi Yingjun , Gerhard-Hartmann Elena , Hartrampf Philipp E. , Weich Alexander , Higuchi Takahiro , Bley Thorsten A. , Hackenberg Stephan , Hagen Rudolf , Rosenwald Andreas , Scherzad Agmal , Remde Hanna , Fassnacht Martin , Werner Rudolf A. , Serfling Sebastian E.
Published: September 2023

Background

Given their neuroendocrine origin, head and neck paragangliomas (HNPGLs) can be imaged with somatostatin receptor (SSTR)–directed PET/CT. We aimed to determine whether the in vivo PET signal can differentiate between varying HNPGL subtypes.

Patients and Methods

Fourteen patients with HNPGL received pretherapeutic SSTR-PET/CTs using 68Ga-DOTATOC. Six (42.9%) patients had a jugular paraganglioma (PGL-J), 5 (35.7%) were diagnosed with carotid paraganglioma (PGL-Cs), and the remaining 3 patients (21.4%) had PGL-C with pathogenic SDHx germline variants (PGL-C-SDH). A visual and quantitative assessment of the primary tumor on SSTR-PET was performed, including SUVmax and target-to-background ratio (TBR). Quantitative values were then compared between subgroups of patients affected with different HNPGL entities.

Results

On visual assessment, all primary HNPGLs could be identified on SSTR-PET/CT. Quantification of HNPGL revealed substantially elevated SUVmax in PGL-J (101.7 ± 58.5) when compared with PGL-C-SDH (13.4 ± 5.6, P < 0.05), but not when compared with PGL-C (66.7 ± 27.3, P = 0.4; PGL-C vs PGL-C-SDH, P = 0.2). TBR of PGL-J (202.9 ± 82.2), however, further differentiated between PGL-C (95.7 ± 45.4, P < 0.05) and PGL-C-SDH (20.4 ± 12.2, P < 0.01; PGL-C vs PGL-C-SDH, P = 0.3). Moreover, whole-body readout revealed metastases in 2/3 (66.7%) of PGL-C-SDH patients, with a single SSTR-expressing skeletal lesion in one subject and bipulmonary lesions in the other patient.

Conclusions

In patients with HNPGL, SSTR-PET/CT identified the primary and metastatic disease and provides substantially elevated TBR, indicating excellent image contrast. PET-based quantification can also differentiate between varying HNPGL subtypes.
Unilateral Chronic Parotitis With 68Ga-DOTA-FAPI-04 PET/CT and 18F-FDG PET/CT Imaging in a Case of a Patient With Papillary Thyroid Carcinoma
Authors: Roshanravan Vahid , Sadeghi Ramin , Zakavi Seyed Rasoul , Norouzbeigi Nasim , Aghaee Atena
Published: September 2023

The68Ga-FAPI (fibroblast activation protein inhibitor) radiotracer is a novel and versatile tool in nuclear medicine, exhibiting potential for use in various conditions due to its significant upregulation in cancerous and inflammatory conditions, particularly those involving fibrotic and infectious processes. In this report, we present the case of a patient with papillary thyroid carcinoma who underwent total thyroidectomy and iodine therapy. He was referred because of high thyroglobulin despite negative diagnostic radioiodine imaging (TENIS syndrome). The patient underwent18F-FDG and68Ga-DOTA-FAPI-46 PET/CT imaging for metastatic workup and treatment planning. FAPI uptake was observed in the right parotid gland (with no FDG uptake), prompting a99mTcO4−salivary scintigraphy. Subsequently, a diagnosis of chronic sialadenitis was made.