bluuebunny/crossref_metadata_2025 huggingface dataset:
Oral herbal medicine for treatment of postherpetic neuralgia: A protocol for systematic review and meta-analysis
Authors: Jeon Hyoseung , Lee Suji , Kim Sung-A , Lee Unhyung , Lee Seunghoon
Published: December 2022

Background:

Postherpetic neuralgia (PHN) is the most common complication of shingling. Herbal medicine for PHN is clinically used to improve chronic pain and other symptoms that reduce the quality of life (QoL), such as sleep disturbances and emotional problems. This study aims to describe methods for synthesizing evidence for the effectiveness and safety of herbal medicine for treating PHN.

Methods:

Randomized controlled trials using herbal medicine in patients with PHN will be included in this review. Electronic databases such as MEDLINE via PubMed, EMBASE, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, China National Knowledge Infrastructure, WanFang, KoreaMed, Research Information Service System, Korean Studies Information Service System, Database Periodical Information Academic, Oriental Medicine Advanced Searching Integrated System, and Korea Citation Index will be searched without language limitations from their inception to September 2022. Two authors will perform quality assessments independently using the Cochrane risk-of-bias tool. The primary outcome will be pain intensity, and the secondary outcomes will be global impression, anxiety, depression, sleep disturbance, QoL, and safety. All data from eligible studies will be synthesized for meta-analysis.

Results:

This study will be a systematic review and meta-analysis to evaluate the effectiveness and safety of oral herbal medicine for treatment of PHN.

Conclusion:

This study will provide evidence for herbal medicine as a potential treatment for PHN which is advantageous not only for patients but also for researchers and policymakers.
Clinical features and outcomes of male patients with lymphangioleiomyomatosis: A review
Authors: Zhang Haoyu , Hu Zhigang , Wang Sufei , Wu Kanhao , Yang Qiaoyu , Song Xinyu
Published: December 2022

Background:

Lymphangioleiomyomatosis (LAM) is a rare disease involving multiple systems, which is divided into sporadic LAM (S-LAM) and tuberous sclerosis complex-LAM, mostly affecting women who are in childbearing age stage. Data on male patients are limited and scattered. Therefore, it is necessary to conduct a systematic review to investigate the clinical features, diagnosis, treatment, and outcomes of LAM in male.

Methods:

We performed a literature review by searching for all the published reported cases of LAM in male during the past 35 years (April 1986–October 2021).

Results:

36 male patients described in 26 references were included in this article. The median age of onset was 34 years (interquartile range: 1–79). The most common initial manifestations were cough, dyspnea, respite, and hemoptysis, with pulmonary complications such as pneumothorax and chylothorax. Five patients (13.9%) were asymptomatic at admission. Nearly half of the 36 male patients had thin-walled air-filled cysts that were visible throughout both lungs. Considering the abovementioned atypical clinical features, misdiagnosis was committed in 8 patients (22.2%). In addition, patients with tuberous sclerosis complex lymphangioleiomyomatosis often have no pulmonary manifestations at onset but present multiple extrapulmonary manifestations and have higher rates of renal angiomyolipomas than patients with S-LAM (P < 0.01). Eventually, 4 patients with S-LAM eventually died.

Conclusion:

Physicians should increase the awareness of LAM in male. Early monitoring of various systems should be recommended to ensure early management and active follow-up. Tuberous sclerosis complex patients should immediately be tracked for the onset of LAM disease to improve prognosis.
Impact on inadequate lymph node harvest on survival in T4N0 colorectal cancer: A would-be medical center experience in Taiwan
Authors: Kao Yi-Kai , Chen Hsin-Pao , Liu Kuang-Wen , Song Ling-Chiao , Chen Yi-Chieh , Lin Yu-Chun , Chen Chih-I
Published: December 2022

Insufficient lymph node harvest (< 12) may lead to incorrect classification of stage I and II disease. Many studies have indicated a poor prognosis with inadequate lymph node harvest in stages I to III, but few studies have demonstrated the relationship between low lymph node harvest and T4 disease. This study aimed to identify the influence of insufficient number of lymph nodes harvested on survival in T4N0 colorectal cancer. We enrolled patients with T4N0 colorectal cancer who underwent radical resection between 2010 and 2016. A total of 155 patients were divided into 2 groups; 142 patients had ≥ 12 harvested lymph nodes, and the other 13 had < 12 lymph nodes. All patients were followed up for at least 5 years. The primary outcome was the impact of the number of lymph nodes harvested on disease-free survival and overall survival, which were investigated using Kaplan-Meier survival techniques. There were no significant differences in recurrence rate, emergent or elective surgery, laparoscopic or open surgery, or chemotherapy between the 2 groups. Kaplan-Meier analyses showed no statistical differences in 5-year disease-free survival (P = .886) and 5-year overall survival (P = .832) between the groups. There were no significant differences in disease-free survival and overall survival between patients with adequate (≥ 12) and inadequate (< 12) lymph node harvest in T4N0 colorectal cancers.
Exploring the regulatory mechanism of osteoporosis based on intestinal flora: A review
Authors: Awuti Kasimu , Wang Xukai , Sha Liquan , Leng Xiangyang
Published: December 2022

Osteoporosis is 1 of the common diseases of bone metabolism in clinic. With the aging of the population in China, osteoporosis is becoming more and more serious, and it has become 1 of the major public health problems. However, traditional therapies, such as calcium therapy and estrogen therapy, can cause serious adverse effects and damage to the body when ingested over a long period of time. Therefore, there is an urgent need to explore alternative therapies with less side effects in clinical practice. Intestinal flora is a hot topic of research in recent years. It has been studied in inflammatory bowel disease, diabetes, depression and so on. Recently, intestinal flora has received increasing attention in the pathways regulating bone metabolism. This paper contains a review of recent studies related to osteoporosis and gut flora in terms of its metabolites, immune, endocrine, and brain-gut axis pathways. The strong association between intestinal flora and bone metabolism suggests, to some extent, that intestinal flora can be a potential target for osteoporosis prevention and treatment, providing new ideas and therapies for the prevention and treatment of osteoporosis.
Recurrent pancreatitis and sepsis in glycogen storage disease type Ia caused by complex heterozygous mutations in 2 sisters: Case report
Authors: Liu Qin , Yu Fang , Lu Huilin , Luo Jian , Sun Ting , Yu Lu , Gan Shenglian
Published: December 2022

Rationale:

Glycogen storage disease (GSD) is a glycogen metabolism disorder caused by congenital enzyme defects, with type I being the most common. Owing to the rarity of glycogen storage disease type Ia (GSD Ia) and the involvement of diverse systems, patients are prone to delayed diagnosis and inappropriate treatment. Additional studies are required to standardize the diagnosis and treatment of GSD Ia.

Patient concerns:

We report 2 cases of GSD Ia that occurred in 2 sisters. The elder sister also had recurrent pancreatitis, and the pancreatic pseudocyst rupture resulted in sepsis, portal hypertension, and splenic infarction. The younger sister had the same mutation site, but the clinical phenotypes were not identical.

Diagnosis:

Abdominal computed tomography and laboratory examinations revealed regional portal hypertension, splenic infarction, and sepsis in the elder sister; diagnosis was confirmed by whole exome sequencing. Sanger sequencing was used to confirm that the younger sister and their parents also had the mutation site.

Interventions:

The elder sister was treated with corn starch therapy, and medication for antiinfection and reducing hypertriglyceridemia, inhibiting trypsin activity, relieving hyperuricemia. The younger sister was treated with raw cornstarch-based nutritional therapy and sodium bicarbonate.

Outcomes:

The elder sister’s infection was controlled and she gradually returned to a normal diet. After discharge, hyperlipidemia was not controlled satisfactorily, but hypoglycemia, hyperuricemia, hyperlactatemia, and anemia improved.

Lessons:

GSD should be considered in childhood patients with hypoglycemia, hypertriglyceridemia, hyperuricemia, and hyperlactatemia. Gene sequencing can enable quick identification of GSD subtypes. This case report highlights the common clinical manifestations can be linked to rare diseases. Clinical work requires careful observation of the correlations between patient history, physical examinations, and laboratory examinations.
An uncommon perineal embryonal rhabdomyosarcoma in adult: A case report
Authors: Qu Sifeng , Li Weiwei , Yao Yuan , Huang Huangwei
Published: December 2022

Rationale:

Embryonal rhabdomyosarcoma (ERMS) is a major subtype of rhabdomyosarcoma, mainly affect children. There is seldom report for perineal ERMS in adults, since its rare location and the age.

Patient concerns:

A 20-year old male adult was admitted due to the perineal mass.

Diagnoses:

Diagnosis by histopathological examination of the biopsy sample was ERMS. Magnetic resonance imaging showed the tumor was found in the perineal region, with metastasis to pelvic cavity, right testis, lymph nodes and bone.

Interventions:

The patient received Isophosphamide and Epirubicin for 4 cycles, followed by Irinotecan and Vindesine Sulfate for 2 cycles, then cisplatin, Dacarbazine and Apatinib for 3 cycles.

Outcome:

The patient showed no response to chemotherapy.

Lessons:

Perineal ERMS in adults is very rare. There is still no standard therapy for adult ERMS. Personalized therapy might be promising treatment for each individual.
Triple mapping for axillary staging after neoadjuvant therapy: Axillary reverse mapping with indocyanine green and dual agent sentinel lymph node biopsy
Authors: Tasdoven Ilhan , Balbaloglu Hakan , Erdemir Rabiye Uslu , Bahadir Burak , Guldeniz Karadeniz Cakmak
Published: December 2022

Axillary staging is 1 of the major issues of current breast cancer management after neoadjuvant systemic therapy (NST). Sentinel lymph node biopsy (SLNB) is an option for clinically node negative patients. Axillary reverse mapping (ARM) was introduced to identify and preserve the lymphatic drainage from the arm. The aim of the presented study is to employ triple mapping (radiocolloid, blue dye and indocyanine green [ICG]) to assess the crossover rate and metastatic involvement of ARM nodes after NST. Clinically node positive patients before NST who were converted to N0 and scheduled for targeted axillary dissection were included. sentinel lymph node (SLN) mapping was performed via dual agent mapping. ICG was used for ARM procedure. Blue, hot and fluorescent nodes and lymphatics were visualized in the axilla using infrared camera system and dual opto-nuclear probe (Euoroprobe3). Fifty-two patients underwent targeted axillary dissection and ARM procedures 12 out of whom had axillary node dissection. 45 of the 52 patients had at least 1 hot or blue SLN identified intraoperatively. Of these, 61.5% cases had hot SLNs, 42.3% had hot and blue, 15.4% had hot/blue/fluorescent, 7.7% had blue/fluorescent, 6 11.5% had hot/fluorescent and 7 13.5% had only clipped nodes. The overall identification rate of ARM-nodes by means of ICG technique was 86.5%. Overall crossover of ARM nodes with SLNs was determined in 36.5%. The ICG intensity was found to be higher in both hot and blue SLNS (8 out of 18 ICG positive cases, 44.4%). In 3 of 52 patients (5.7%) metastatic SLNs were hot or blue but fluorescent which predicts metastatic involvement of the ARM-nodes. More than 1-third of the patients revealed a crossover between arm and breast draining nodes. The higher observed rate of overlap might partially explain why more patients develop clinically significant lymphedema after NST even after sentinel lymph node biopsy alone. The triple mapping provides valuable data regarding the competency of lymphatic drainage and would have the potential to serve selecting patients for lymphovenous by-pass procedures at the index procedure. NST reduces the metastatic involvement of the ARM nodes. However, conservative axillary staging with sparing ARM nodes after NST necessitates further studies with larger sample size and longer follow-up.
Effect of preoperative tropisetron treatment on postoperative cognitive function: A retrospective cohort study
Authors: Zhang Dongbin , Si ShangKun , Shang WeiXun , Zhou Xi
Published: December 2022

To investigate the effect of preoperative tropisetron treatment on postoperative cognitive function on the basis of patients’ Mini-Cog scale scores. In this retrospective cohort study, data were retrieved from the medical record database. This research did not involve concerns with patient safety and violation of their interests, and therefore, no ethical review was required. Depending on tropisetron exposure status, patients were assigned to the exposure group (86 patients) and the non-exposure group (74 patients). Patients in the exposure and non-exposure groups were administered tropisetron (10 mg; intravenously 15 minutes before operation) and other antiemetics, respectively. Data on the patients’ demographic characteristics, American society of Anesthesiologists (ASA) classification, comorbid underlying diseases, sleep quality, education level, anesthesia method, duration of fasting, intraoperative blood loss and fluid replacement, intraoperative minimum and maximum systolic blood pressures (SBPs), intraoperative minimum and maximum diastolic blood pressures (DBPs), postoperative Mini-Cog scale (a simple intelligence status assessment scale) score, and postoperative visual analogue scale (VAS) pain score were collected in both the groups. The postoperative Mini-Cog score (as an indicator of cognitive function) and the rate of postoperative cognitive impairment were compared between the exposure and non-exposure groups. A multifactorial logistic regression equation was constructed to analyze the factors associated with impaired cognitive function in the postoperative period. The postoperative cognitive impairment rate in the exposure group was significantly lower than that in the non-exposure group (3.5% vs 16.2%; P < .05). Multifactorial logistic regression analysis suggested that tropisetron was a protective factor for postoperative cognitive function, with a statistically significant effect (odds ratio [OR] = 5.04, 95% confidence interval [CI] = 1.31–19.4). Preoperative tropisetron exposure significantly reduces the incidence of postoperative cognitive impairment in patients, and it is a protective factor for postoperative cognitive function.
Primary meningeal central nervous system lymphoma: A case report and literature review
Authors: Chen Xue , Huang Min , Zhang Zhenyuan , Jing Huilan , Zou Yueli , Bu Hui
Published: December 2022

Rationale:

Primary central nervous system lymphoma (PCNSL) is a rare extranodal non-Hodgkin lymphoma, and isolated meningeal PCNSL, without evidence of parenchymal involvement, is even less common, occurring in only 10% to 15% of cases.

Patient concerns:

A 65-years-old female presented to our hospital with progressive lower extremity motor dysfunction and blurred vision. The initial neurological examination revealed decreased muscle strength in both lower extremities and sensory dysfunction of lower extremities, saddle area, and buttocks. Brain magnetic resonance imaging showed no abnormalities. Lumbar enhanced magnetic resonance imaging showed T11 to L3 horizontal meningeal enhancement. Cerebrospinal fluid (CSF) cytology revealed lymphoma cells. Immunohistochemistry and flow cytometry of the CSF were performed as auxiliary methods to establish the diagnosis of lymphoma.

Diagnoses:

The patient was diagnosed primary meningeal central nervous system lymphoma.

Interventions:

During hospitalization, the patient was treated with 2 courses of high-dose intrathecal methotrexate and rituximab combined with intrathecal chemotherapy and supportive treatment.

Outcomes:

After 2 years of follow-up, the patient was able to walk and take care of herself.

Lessons:

Cases of PCNSL involving only the meninges are rare. Multimodal analysis of the CSF comprises an important component of the diagnostic work-up for patients with primary meningeal central nervous system lymphoma.
Granular cell tumor of the vulva: Case report and systematic review of the literature
Authors: Lin Guang-Yao , Liu Yan , Ye Tao , Lu Xin-Yu , Gao Jie , Wang Yong-Zhou
Published: December 2022

Rationale:

Granular cell tumor (GCT) of the vulva is an exceptionally rare female genital tract tumor. The majority of these are benign and there are no standardized surgical techniques for the special site to reduce tension of the wound.

Patient concerns:

A 47-years-old Chinese woman experienced a nodule on her right vulva with itch sometimes in late 2018.

Diagnoses:

Magnetic resonance imaging showed a high possibility of vulvar cancer. While Chest X-ray, abdominal sonography, and cystoscopy examination were unremarkable.

Interventions:

The patient underwent local complete resection of vulvar tumor under general anesthesia on March 24, 2022. The resection scope was approximately 4 cm × 3 cm × 3 cm. Due to the large surgical incision, Z-plasty was performed to achieve the primary closure for decreasing wound tension and improving aesthetic reduction.

Outcomes:

The final pathological diagnosis was benign GCT of the vulva and surgical margins were uninvolved. At 8 months follow-up, no new lesions were detected.

Lessons:

Surgery with negative resection margins is the mainstay for benign GCT of the vulva, while Z-plasty is appropriate for decreasing the tension of the wound and improving aesthetic reduction.
Predicting hepatocellular carcinoma early recurrence after ablation based on magnetic resonance imaging radiomics nomogram
Authors: Yang Xiaozhen , Yuan Chunwang , Zhang Yinghua , Li Kang , Wang Zhenchang
Published: December 2022

Background:

The aim of this study is to investigate a model for predicting the early recurrence of hepatocellular carcinoma (HCC) after ablation.

Methods:

A total of 181 patients with HCC after ablation (train group was 119 cases; validation group was 62 cases) were enrolled. The cases of early recurrence in the set of train and validation were 63 and 31, respectively. Radiomics features were extracted from the enhanced magnetic resonance imaging scanning, including pre-contrast injection, arterial phase, late arterial phase, portal venous phase, and delayed phase. The least absolute shrinkage and selection operator cox proportional hazards regression after univariate and multivariate analysis was used to screen radiomics features and build integrated models. The nomograms predicting recurrence and survival of patients of HCC after ablation were established based on the clinical, imaging, and radiomics features. The area under the curve (AUC) of the receiver operating characteristic curve and C-index for the train and validation group was used to evaluate model efficacy.

Results:

Four radiomics features were selected out of 34 texture features to formulate the rad-score. Multivariate analyses suggested that the rad-score, number of lesions, integrity of the capsule, pathological type, and alpha-fetoprotein were independent influencing factors. The AUC of predicting early recurrence at 1, 2, and 3 years in the train group was 0.79 (95% CI: 0.72–0.88), 0.72 (95% CI: 0.63–0.82), and 0.71 (95% CI: 0.61–0.83), respectively. The AUC of predicting early recurrence at 1, 2, and 3 years in the validation group was 0.72 (95% CI: 0.58–0.84), 0.61 (95% CI: 0.45–0.78) and 0.64 (95% CI: 0.40–0.87).

Conclusion:

The model for early recurrence of HCC after ablation based on the clinical, imaging, and radiomics features presented good predictive performance. This may facilitate the early treatment of patients.
A retrospective study of emergent traumatic dental injuries in permanent teeth in Xi’an, China
Authors: Huang Chao , Yang Yang , Wang Ziheng , Wang Wei , Liu Yanli , Zhang Min
Published: December 2022

Traumatic dental injury is one of the common injuries seen in the emergency department. To determine the distribution features of emergency traumatic dental injuries in Xi’an, China, data from the medical records of 623 patients (aged 6–78 years) were evaluated and analyzed according to age, gender, etiology, factors predisposing teeth to injury, and types of teeth traumatized. The patient records of 397 males (63.7%) and 226 females (36.3%), with a 1.8:1 male-to-female ratio, were included. The total number of traumatized teeth was 1475. The highest frequency of dental trauma was found in the 19- to 30-year age group (30.7%). The greatest frequency of dental trauma injuries was in May (13%). Over one-third of patients with traumatic injuries to permanent teeth (n = 218, 35%) injured 2 permanent teeth. The most commonly affected teeth were the maxillary central incisors (59.3%). The most common type of trauma was concussion (20.4%). There was statistically significant difference among the type composition ratio of age groups (P < .05). The most common causes of dental trauma were falls (50.2%). There was statistically significant difference among the etiological composition ratio of age groups (P < .05). Combined injuries were present in 120 teeth in 103 patients (16.5%). The epidemiological characteristics of dental trauma in Xi’an shows that the occurrence of dental trauma is closely related to the age, sex, time, type of injury, and cause of injury. There exists cross-correlation among the epidemiological factors. The most common type of trauma is concussion and the most common cause of dental trauma is fall. High incidence of combined injuries needs extra attention.
Impact of regional anesthesia on outcomes of geriatric patients undergoing lower extremity revascularization: A propensity score-matched cohort study
Authors: Lim Jung A , Seo Yohan , Choi Eun-Joo , Kwak Sang Gyu , Ryu Taeha , Lee Jae Hoon , Park Ki Hyuk , Roh Woon Seok
Published: December 2022

Lower extremity revascularization (LER) for peripheral artery disease in elderly patients is associated with a high risk of perioperative morbidity and mortality. This study aimed to a conduct retrospective review and propensity score matching analysis to determine whether the use of regional anesthesia (RA) instead of general anesthesia (GA) in geriatric patients undergoing LER for peripheral artery disease results in improved short-term mortality and health outcomes. We reviewed medical records of 1271 patients aged >65 years who underwent LER at our center between May 1998 and February 2016. According to the anesthesia method, patients were grouped in the GA and RA groups. The primary outcome was short-term mortality (7-day and 30-day). The secondary outcomes were 5-year survival rate, intraoperative events, postoperative morbidity, and postoperative length of stay. A propensity score-matched cohort design was used to control for potentially confounding factors including patient demographics, comorbidities, American Society of Anesthesiologists physical status, and preoperative medications. After propensity score matching, 722 patients that received LER under GA (n = 269) or RA (n = 453) were identified. Patients from the GA group showed significantly higher 7-day mortality than those from the RA group (5.6% vs 2.7% P = .048); however, there was no significant difference in 30-day mortality between the groups (GA vs RA: 6.3% vs 3.6%, P = .083). The 5-year survival rate and incidence of arterial and central venous catheter placement or intraoperative dopamine and epinephrine use were significantly higher in the GA group than in the RA group (P < .05). In addition, the frequency of immediate postoperative oxygen therapy or mechanical ventilation support was higher in the GA group (P < .05). However, there was no difference in the postoperative cardiopulmonary and cerebral complications between the 2 groups. These results suggest that RA can reduce intraoperative hemodynamic support and provide immediate postoperative respiratory intensive care. In addition, the use of RA may be associated with better short-term and 5-year survival rates in geriatric patients undergoing LER.
Are the conventional scoring systems efficient in predicting mortality of acute mesenteric ischemia?: Mortality estimation in patients with AMI
Authors: Yilmaz Arda Sakir , Yasar Necdet Fatih , Badak Bartu , Sendil Ahmet Murat , Salis Mustafa , Oner Setenay
Published: December 2022

Acute mesenteric ischemia is a surgical emergency with high morbidity and mortality rates. Therefore, it is important to determine the prognosis for this disease. In the present study, we aimed to compare the prediction accuracy of 3 scoring systems: Acute physiology and chronic health evaluation II, sequential organ failure assessment score and simplified acute physiology score II (SAPS II). The retrospective cohort study was conducted in a university hospital. Eighty-two acute mesenteric ischemia patients were evaluated retrospectively. The mortality prediction abilities of the scoring systems were evaluated by comparing the prediction rates of > 10%, 30% and 50% and the actual mortality among survivors and non-survivors in pairs. Predicted mortality rates among survivors and non-survivors differed among the 3 classification systems. The mortality estimates of the SAPS II were closer to the actual mortality rates. Analysis of the estimated mortality rates as mortality risk limits showed that acute physiology and chronic health evaluation II was superior to sequential organ failure assessment score and SAPS II in estimating mortality rates, whereas SAPS II was more successful in detecting survivors. The estimated mortality rates of the 3 rating systems, the estimated mortality rates were higher in the non-survivor group than in the survivor group. The accuracy of the SAPS II in determining prognosis was relatively better.
Exploration of the Relationships Between Stress and Distinct Pain and Sleep Disturbance Profiles in Patients Undergoing Chemotherapy
Authors: Romanovska Vita , Block Astrid , Paul Steven M. , Cooper Bruce A. , Hammer Marilyn J. , Conley Yvette P. , Levine Jon D. , Kober Kord M. , Miaskowski Christine
Published: December 2022

Background

Unrelieved pain and sleep disturbance are common symptoms in oncology patients. Increased stress may be an underlying cause for both symptoms.

Objectives

The purposes of this study were to identify subgroups of outpatients with distinct pain and sleep disturbance profiles and to evaluate differences among these subgroups in demographic and clinical characteristics. Differences in global stress, cancer-specific stress, and cumulative life stress, as well as resilience and coping, were evaluated.

Methods

Patients (N = 1343) completed self-report questionnaires for demographic and clinical characteristics and stress, resilience, and coping. Latent profile analysis was used to identify subgroups of patients with distinct pain and sleep disturbance profiles. Differences among the subgroups were determined using parametric and nonparametric tests.

Results

Three distinct profiles were identified (ie, No Pain + Moderate Sleep Disturbance (SD) (27.6%), Moderate Pain + Moderate SD (38.6%), Severe Pain + High SD (33.8%)). Compared with the other 2 classes, Severe Pain + High SD class was younger, had fewer years of education, was more likely to be female, more likely to live alone, less likely to be employed, and had a higher level of comorbidity. This class had the highest stress scores and was more likely to report higher rates of adverse childhood experiences.

Conclusion

Over 70% of our sample reported clinically meaningful levels of both symptoms, and 33.8% reported relatively high rates of adverse childhood experiences.

Implication for Practice

Clinicians need to perform routine assessments, particularly of adverse childhood experiences, and initiate appropriate referrals.
Findings From a Scoping Review: Presumptive Treatment for Chlamydia trachomatis and Neisseria gonorrhoeae in the United States, 2006–2021
Authors: Allen Katie S. , Hinrichs Rachel , Heumann Christine L. , Titus Melissa K. , Duszynski Thomas J. , Valvi Nimish R. , Wiensch Ashley , Tao Guoyu , Dixon Brian E.
Published: December 2022

Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) are the 2 most common reported sexually transmitted infections in the United States. Current recommendations are to presumptively treat CT and/or GC in persons with symptoms or known contact. This review characterizes the literature around studies with presumptive treatment, including identifying rates of presumptive treatment and overtreatment and undertreatment rates. Of the 18 articles that met our inclusion criteria, 6 pertained to outpatient settings. In the outpatient setting, presumptive treatment rates, for both asymptomatic and symptomic patients, varied from 12% to 100%, and the percent positive of those presumptively treated ranged from 25% to 46%. Three studies also reported data on positive results in patients not presumptively treated, which ranged from 2% to 9%. Two studies reported median follow-up time for untreated, which was roughly 9 days. The remaining 12 articles pertained to the emergency setting where presumptive treatment rates, for both asymptomatic and symptomic patients, varied from 16% to 91%, the percent positive following presumptive treatment ranged from 14% to 59%. Positive results without presumptive treatment ranged from 4% to 52%. Two studies reported the percent positive without any treatment (6% and 32%, respectively) and one reported follow-up time for untreated infections (median, 4.8 days). Rates of presumptive treatment, as well as rates of overtreatment or undertreatment vary widely across studies and within care settings. Given the large variability in presumptive treatment, the focus on urban settings, and minimal focus on social determinants of health, additional studies are needed to guide treatment practices for CT and GC in outpatient and emergency settings.
Three-Dimensional Quantitative Assessment of Condylar Displacement and Adaptive Remodeling in Asymmetrical Mandibular Prognathism Patients After Sagittal Split Ramus Osteotomy
Authors: Jha Nayansi , Kim MyungSu , Cevidanes Lucia , Kim Yoon-Ji
Published: December 2022

This study was performed to evaluate the condylar displacement and associated condylar remodeling in class III patients following mandibular setback surgery via sagittal split ramus osteotomy (SSRO). The sample comprised of 26 condyles of 13 subjects (mean age of 21.2±2.6 y). We evaluated patients with mandibular prognathism and facial asymmetry who had undergone SSRO for mandibular setback at Korea University Hospital between January 2016 and December 2018. Three-dimensional segmentation of the mandibular condyles was done using the initial cone-beam computed tomography scan and scan taken 12 months postoperatively or later. Quantitative assessments of the 3-dimensional condylar displacement from T0 to T1 and bony remodeling of 8 regions of the condylar head were performed. The correlation between the condylar displacement and condylar head remodeling on the deviated (D) and nondeviated (ND) sides was analyzed. Significant correlations between condylar displacement and surface remodeling were observed in both D and ND condyles. The anteroposterior condylar displacement was significantly different between the D and ND sides (P=0.007). There was no significant difference in condylar remodeling between the 2 sides. Condylar displacement and adaptive remodeling after SSRO varied greatly among individuals. Compared with displacement in the ND condyle, displacement in the D condyle has a greater association with condylar remodeling in both D and ND condyles. There is no significant difference in condylar head remodeling between D and ND condyles.
Delayed Pharyngocutaneous Fistula After Total Laryngectomy Caused by an Anterior Cervical Spine plate
Authors: Jung Eun Kyung , Lee Dong Eun , Lee Joon Kyoo
Published: December 2022

Pharyngocutaneous fistula (PCF) caused by a previous anterior cervical spine fixation plate more than a decade ago has not been reported yet. A 70-year-old man with dysphagia was diagnosed as supraglottic cancer. After partial laryngectomy and concurrent chemoradiation, due to increasing arytenoid lesion, total laryngectomy was followed. Pharyngocutaneous fistula occurred but resolved spontaneously. However, retropharyngeal granulation tissue emerging from the anterior cervical spine fixation plate caused delayed PCF. Dysphagia and PCF resolved after fixation plate removal.
Trends in Craniofacial Fellowship Career Outcomes: A Call for Expanding Professional Opportunities in Craniofacial Surgery
Authors: Rogers Ashley E. , Sayyed Adaah A. , Marable Julian , Harshbarger Raymond , Taub Peter J. , Taylor Jesse , Baker Stephen B.
Published: December 2022

Purpose:

Limited available pediatric plastic surgery positions fail to accommodate the increasing number of craniofacial fellows trained annually. However, many adult indications have increased the demand for craniofacial expertise. Given new opportunities available to craniofacial surgeons, the authors aim to evaluate career prospects for recent craniofacial graduates and explore additional career opportunities.

Methods:

Upon approval from the American Society of Craniofacial Surgeons (ASCFS), an anonymous online survey invitation was sent to craniofacial fellows who graduated from 2016 to 2021. Respondents were queried regarding their craniofacial fellowship and subsequent career prospects.

Results:

A total of 124 eligible participants were identified, of which 30 (24.2%) responded. Craniomaxillofacial case distribution at respondents’ current practices varied, with 42.3% reporting a 50% to 75% craniofacial caseload and 38.5% reporting less than 25%. Craniofacial trauma reconstruction was performed most at current positions (92.3%), followed by general reconstruction (92.3%) and breast surgery (69.2%); the least commonly performed was facial feminization (23.1%). Most respondents desired an increased craniomaxillofacial caseload (65.4%). However, 26.9% were unable to secure their current position before fellowship completion, and 80.0% cited limited craniofacial job availability. Recommendations to improve fellowship comprehensiveness and increase candidate competitiveness included increased facial feminization, facial esthetic, and microsurgical experience.

Conclusion:

To adapt to trends in craniomaxillofacial surgery, ASCFS should encourage developing fellowships that increase exposure to gender-affirming, adult craniofacial reconstruction, orthognathic, and skeletal facial esthetic surgery. Expanding training beyond congenital deformities can provide additional employment opportunities while maintaining excellence and innovation in facial plastic surgery.
Malrotation and Fibroblast Growth Factor Receptor-2–Associated Craniosynostosis: An Underrecognized Association and Management Pathway
Authors: Harwood Rachel , O’Shea Kathryn , Hennedige Anusha , Parks Christopher , Turnock Colette , Wood Sarah
Published: December 2022

Introduction:

Feeding difficulties are common and multifactorial in children with Fibroblast Growth Factor Receptor-2 (FGFR-2) mutations. Intestinal rotation anomalies have been demonstrated to occur more frequently in animals with FGFR-2 mutations. This study aims to describe intestinal rotation anomalies, surgical management, and feeding assistance in children with FGFR-2 mutations who have undergone upper gastrointestinal (UGI) contrast studies.

Methods:

Retrospective data were collected of children born between 1988 and 2020 in a UK quaternary craniofacial unit with FGFR-2–associated craniosynostosis. A consultant survey of approach to malrotation was undertaken.

Results:

Thirty-four children were included, 17 (50%) female. Six (18%) had UGI symptoms, which included bilious vomiting (n=2), nonbilious vomiting (n=5), retching (n=1), feed intolerance (n=3), and failure to thrive (n=3). Nine had a gastrostomy in situ. Intestinal rotation anomalies occurred in 4 (12%) children, 3 of whom underwent a Ladd procedure and two third required gastrojejunal feeding postoperatively. Consultants agreed that all children with FGFR-2 mutation and UGI symptoms should undergo UGI contrast study, as should children requiring a gastrostomy.

Discussion:

Intestinal rotation anomalies in children with FGFR-2 mutations occur more frequently than the general population. Prompt consideration of UGI contrast in symptomatic children with FGFR-2 mutation is recommended to enable early surgical management of children with malrotation.
Spontaneous Closure of Congenital Cranial Defect: Is Early Surgical Intervention Warranted?
Authors: Seu Michelle Y. , Aminzada Amir , Harmon Kelly A. , Guidetti Martina , Espinoza Orías Alejandro A. , Figueroa Alvaro A. , Tragos Christina
Published: December 2022

Infantile cranial development typically occurs in a predictable sequence of events; however, less is known about how the development occurs in isolated, nonsyndromic congenital craniofacial anomalies. Furthermore, the timing of pediatric cranioplasty has been extrapolated from adult studies. Thus, the management of nonsyndromic congenital craniofacial anomalies presents with unique challenges to the craniofacial surgeon. The authors describe the case of a baby girl who was born with right Tessier 3 cleft, cleft palate, anophthalmos, and severe left craniofacial microsomia with Pruzansky grade III left mandibular anomaly. By analyzing 3-dimensional chronological models of the patient, the authors found that her abnormal fontanelle initially increased in size until 22 weeks of age, with subsequent spontaneous closure at a rate of 60.53 mm2/y. Although similar cranial anomalies are typically surgically corrected early in life, delaying treatment until after 2 years of age may be appropriate in some patients, obviating surgical morbidity in the newborn period.
Amplified Natural Killer Cell Activity and Attenuated Regulatory T-cell Function Are Determinants for Corneal Alloimmunity in Very Young Mice
Authors: Nakao Takeshi , Inomata Takenori , Blanco Tomas , Musayeva Aytan , Tahvildari Maryam , Amouzegar Afsaneh , Yin Jia , Chauhan Sunil K. , Chen Yihe , Dana Reza
Published: December 2022

Background.

Corneal transplantation outcomes are generally less favorable in young children compared with adults. The purpose of this study was to determine the immunological mechanisms underlying this difference.

Methods.

A murine model of allogeneic corneal transplantation was used in the study, and graft survival was determined by evaluating opacity scores for 8 wk. Syngeneic transplantation in the very young host served as a surgical control. The frequencies of total and activated natural killer (NK) cells in cornea posttransplantation were kinetically evaluated using flow cytometry. The regulatory T cell (Treg) frequency and function in naive animals were assessed by flow cytometry and in vitro suppression assays, respectively. Finally, graft survival and immune responses were determined in NK cell–depleted, or adult naive Treg-transferred, young hosts.

Results.

Corneal allograft survival in the very young recipients was significantly lower than in adult hosts. The frequencies of total NK cells and their interferon gamma–expressing subset in the cornea were significantly higher in the very young mice posttransplantation. In ungrafted mice, frequencies of Treg in draining lymph nodes as well as their capabilities to suppress NK-cell secretion of interferon gamma were lower in the very young compared with adults. In NK cell–depleted or adult Treg–-transferred very young recipients, the allograft survival was significantly improved along with the suppressed NK-cell response.

Conclusions.

Our data demonstrate that amplified activity of NK cells, together with lower suppressive function of Treg, contributes to early rejection of corneal allografts in very young graft recipients.
Process Optimization of Plasma Bubbling Set Up for Cow Milk Decontamination and Quality Evaluation
Authors: Dash Samarpita , Jaganmohan Rangarajan
Published: December 2022

Cold plasma aims to decontaminate and maintain the naturality of the food. The present study discussed the application of novel plasma bubbling for raw milk pasteurization with different combinations of processing parameters such as voltage, flow rate of air, time interval and volume. The observation showed a decline in microbial load, with an increase in pH value up to 6.9 at optimised conditions (200 volts, the flow rate of air 10 Litres/hour, time 15 minutes and volume 100 mL). The optimized condition was observed was found to be appropriate and could be beneficial to the food industry.
One-shot design elevates functional expression levels of a voltage-gated potassium channel
Authors: Weinstein Jonathan Jacob , Saikia Chandamita , Karbat Izhar , Goldenzweig Adi , Reuveny Eitan , Fleishman Sarel Jacob
Published: December 2022

Membrane proteins play critical physiological roles as receptors, channels, pumps, and transporters. Despite their importance, however, low expression levels often hamper the experimental characterization of membrane proteins. We present an automated and web-accessible design algorithm called mPROSS (https://mPROSS.weizmann.ac.il), which uses phylogenetic analysis and an atomistic potential, including an empirical lipophilicity scale, to improve native-state energy. As a stringent test, we apply mPROSS to the Kv1.2-Kv2.1 paddle chimera voltage-gated potassium channel. Four designs, encoding 9-26 mutations relative to the parental channel, were functional and maintained potassium-selective permeation and voltage dependence inXenopusoocytes with up to 14-fold increase in whole-cell current densities. Additionally, single-channel recordings reveal no significant change in the channel-opening probability nor in unitary conductance, indicating that functional expression levels increase without impacting the activity profile of individual channels. Our results suggest that the expression levels of other dynamical channels and receptors may be enhanced through one-shot design calculations.

Significance statement

Heterologous expression levels of membrane proteins are often low, limiting research and applications. We combine homologous-sequence analysis with Rosetta atomistic calculations to enable one-shot design of dozens of mutations that improve native-state energy. Applied to a voltage-gated potassium channel, designs exhibited up to 14-fold improved functional expression levels in oocytes with almost no change in the single-channel activity profile. This design approach may accelerate research of many challenging membrane proteins, including receptors, channels, and transporters.
High-quality nuclear genome and mitogenome ofBipolaris sorokinianastrain LK93, a devastating pathogen causing wheat root rot
Authors: Zhang Wanying , Yang Qun , Yang Lei , Li Haiyang , Zhou Wenqing , Meng Jiaxing , Hu Yanfeng , Wang Limin , Kang Ruijiao , Li Honglian , Ding Shengli , Li Guotian
Published: December 2022

Bipolaris sorokiniana, one of the most devastating hemibiotrophic fungal pathogens, causes root rot, crown rot, leaf blotching, and black embryos of gramineous crops worldwide, posing a serious threat to global food security. However, the host-pathogen interaction mechanism betweenB. sorokinianaand wheat remains poorly understood. To facilitate related studies, we sequenced and assembled the genome ofB. sorokinianastrain LK93. Nanopore long reads and next generation sequencing short reads were applied in the genome assembly, and the final 36.4 Mb genome assembly contains 16 contigs with the contig N50 of 2.3 Mb. Subsequently, we annotated 11,811 protein-coding genes including 10,620 functional genes, 258 of which were identified as secretory proteins including 211 predicted effectors. Additionally, the 111,581 bp mitogenome of LK93 was assembled and annotated. The LK93 genomes presented in this study will facilitate research in theB. sorokiniana-wheat pathosystem for better control of crop diseases.
Species boundaries to the limit: validating species delimitation methods is critical to avoid taxonomic inflation in the genomic era
Authors: Burriel-Carranza Bernat , Estarellas Maria , Riaño Gabriel , Talavera Adrián , Tejero-Cicuéndez Héctor , Els Johannes , Carranza Salvador
Published: December 2022

With the advent of molecular phylogenetics, the number of taxonomic studies unveiling and describing cryptic diversity has greatly increased. However, speciation between cryptic lineages is often defined without evaluating population structure or gene flow, which can lead to false claims of species status and, subsequently, taxonomic inflation. In the present study we focus on the intriguing case of the Arabian geckoTrachydactylus hajarensis(Squamata: Gekkonidae), a species for which cryptic diversity has been previously reported. We generated mitochondrial data (12S rDNA) and genome-wide SNP data (ddRADseq) for 52 specimens to determine phylogenomic relationships, population structure and gene flow within this species. Then, we applied species delimitation methods (SDMs) to evaluate several competing species hypotheses through the Multispecies Coalescent model. Results show thatT. hajarensisis comprised by three well-defined lineages, two of them in the Hajar Mountains of eastern Arabia, and one in Masirah Island, in the southeastern coast of Oman. Even though high levels of past introgression and strong mitonuclear discordances were found, current gene flow is scarce with clear boundaries between populations and shallow levels of admixture in the contact zone between lineages. Surprisingly, species tree topology differed between methods and when different individuals were used in downsampled datasets. Conventional SDMs supported up to three putative new species within the group. However, after species validation with the genealogical divergence index (gdi), none of the putative species held. Overall, this study highlights the importance of sample choice, integrative analyses, and validation methods to not incur into taxonomic inflation, providing a set of already available tools to assess and validate population structure, gene flow, and SDMs before describing new species.
Nicotiana benthamiana XYLEM CYSTEINE PROTEASEgenes facilitate tracheary element formation in interfamily grafting
Authors: Huang Chaokun , Kurotani Ken-ichi , Tabata Ryo , Mitsuda Nobutaka , Sugita Ryohei , Tanoi Keitaro , Notaguchi Michitaka
Published: December 2022

Grafting is a plant propagation technique widely used in agriculture. A recent discovery of the capability of interfamily grafting inNicotianahas expanded the potential combinations of grafting. In this study, we showed that xylem connection is essential for the achievement of interfamily grafting and investigated the molecular basis of xylem formation at the graft junction. Transcriptome and gene network analyses revealed gene modules for tracheary element (TE) formation during grafting that include genes associated with xylem cell differentiation and immune response. The reliability of the drawn network was validated by examining the role of theNicotiana benthamiana XYLEM CYSTEINE PROTEASE (NbXCP)genes in TE formation during interfamily grafting. Promoter activities ofNbXCP1andNbXCP2genes were found in differentiating TE cells in the stem and callus tissues at the graft junction. Analysis of aNbxcp1;Nbxcp2loss-of-function mutant indicated thatNbXCPscontrol the timing ofde novoTE formation at the graft junction. Moreover, grafts of theNbXCP1overexpressor increased the scion growth rate as well as the fruit size. Thus, we identified gene modules for TE formation at the graft boundary and demonstrated potential ways to enhanceNicotianainterfamily grafting.