bluuebunny/crossref_metadata_2025 huggingface dataset:
Rewarding Effects of Nicotine Self-administration Increase Over Time in Male and Female Rats
Authors: Chellian Ranjithkumar , Behnood-Rod Azin , Wilson Ryann , Bruijnzeel Adriaan W
Published: May 2021

Introduction

Smoking and the use of other nicotine-containing products is rewarding in humans. The self-administration of nicotine is also rewarding in male rats. However, it is unknown if there are sex differences in the reward-enhancing effects of nicotine self-administration and if the rewarding effects of nicotine change over time.

Methods

Rats were prepared with catheters and intracranial self-stimulation (ICSS) electrodes to investigate the effects of nicotine and saline self-administration on reward function. A decrease in thresholds in the ICSS procedure reflects an enhancement of reward function. The ICSS parameters were determined before and after the self-administration sessions from days 1 to 10, and after the self-administration sessions from days 11 to 15.

Results

During the first 10 days, there was no sex difference in nicotine intake, but during the last 5 days, the females took more nicotine than the males. During the first 10 days, nicotine self-administration did not lower the brain reward thresholds but decreased the response latencies. During the last 5 days, nicotine lowered the reward thresholds and decreased the response latencies. An analysis with the 5-day averages (days 1–5, 6–10, and 11–15) showed that the reward enhancing and stimulatory effects of nicotine increased over time. There were no sex differences in the reward-enhancing and stimulatory effects of nicotine. The nicotinic receptor antagonist mecamylamine diminished the reward-enhancing and stimulatory effects of nicotine.

Conclusion

These findings indicate that the rewarding effects of nicotine self-administration increase over time, and there are no sex differences in the reward-enhancing effects of nicotine self-administration in rats.

Implications

This study investigated the rewarding effect of nicotine and saline self-administration in male and female rats. The self-administration of nicotine, but not saline, enhanced brain reward function and had stimulatory effects. The rewarding effects of nicotine increased over time in the males and the females. Despite that the females had a higher level of nicotine intake than the males, the reward-enhancing effects of nicotine self-administration were the same. These findings suggest that in new tobacco and e-cigarette users, nicotine’s rewarding effects might increase quickly, and a higher level of nicotine use in females might not translate into greater rewarding effects.
Negative Perceptions of Young People Using E-Cigarettes on Instagram: An Experiment With Adolescents
Authors: Lazard Allison J , Nicolla Sydney , Darida Avery , Hall Marissa G
Published: May 2021

Introduction

Although e-cigarette marketing on social media increases positive attitudes and experimentation, little is known about non-influencer e-cigarette portrayals of young people.

Aims and Methods

High school adolescents (n = 928, 15–18) were recruited by Lightspeed Health for an online experiment and randomized to view an Instagram post with or without e-cigarette use. Outcomes were positive and negative perceptions (prototypes), social distance, and willingness to use.

Results

Half (50%) of participants were susceptible to e-cigarette use. E-cigarettes shown (vs. not) led to less positive prototypes, p = .017, more negative prototypes, p = .004, and more social distance, p < .001. Negative prototypes and social distance were moderated by susceptibility (both p < .05); effects among non-susceptible adolescents only. Showing e-cigarettes did not impact willingness to use if offered.

Conclusions

Negative perceptions of e-cigarettes use challenge assumptions that vaping online is universally admirable. Highlighting unfavorable opinions of vaping or negative impacts for adolescents’ social image are potential strategies for tobacco counter-marketing.

Implications

Despite daily use of visual-based social media by most adolescents, little is known about the influence of e-cigarette use among young people online. Adolescent negative perceptions and desired distance from non-influencers using e-cigarettes on Instagram indicate digital e-cigarette portrayals are not universally accepted. Negative impacts for adolescents’ social image present a counter-marketing strategy.
Implementation of the Uniformed Services University Pain Registry Biobank: A Military and Veteran Population–Focused Biobank and Registry
Authors: Kroma Raymond B , Giordano Nicholas A , Highland Krista B , Bedocs Peter , McDuffie Mary , Buckenmaier Chester C
Published: May 2021

Objective

The objective of this overview is to discuss the development, implementation, data content, and structure of the Uniformed Services University Pain Registry Biobank. Additionally, procedures and policies for accessing samples for pain-related research purposes are detailed.

Design

Cross-sectional overview.

Setting

Multiple military treatment facilities.

Subjects

Adult beneficiaries seeking care within the Military Health System.

Methods

Participants complete a baseline battery of biopsychosocial survey measures, including Patient-Reported Outcomes Measurement Information System (PROMIS®) measures, and provide biological samples (e.g., blood and saliva). Relevant health history, including medications and surgical history, is extracted from medical records. During the course of the subsequent year, enrolled participants complete surveys and provide biological samples at 3 months, 6 months, and 12 months. Thereafter, participants are contacted once annually to complete self-reported assessments and provide biological samples.

Results

In the first year alone, 86 subjects have participated in the Uniformed Services University Pain Registry Biobank and provided 390 observations (e.g., biological samples and biopsychosocial patient-reported outcomes). The Uniformed Services University Pain Registry Biobank’s integration of biological samples, patient-reported outcomes, and health record data over a longitudinal period across a diverse sample recruited from multiple military facilities addresses many of the limitations faced by other pain-related registries or biorepositories.

Conclusions

The Uniformed Services University Pain Registry Biobank will serve as a platform for conducting research closely aligned with the Federal Pain Research Strategy. The inclusion of active duty service members, beneficiaries, and civilians living with and without acute or chronic pain provides a unique data repository for all investigators interested in advancing pain science.
Comparing Estimates of News Consumption from Survey and Passively Collected Behavioral Data
Authors: Konitzer Tobias , Allen Jennifer , Eckman Stephanie , Howland Baird , Mobius Markus , Rothschild David , Watts Duncan J
Published: May 2021

Surveys are a vital tool for understanding public opinion and knowledge, but they can also yield biased estimates of behavior. Here we explore a popular and important behavior that is frequently measured in public opinion surveys: news consumption. Previous studies have shown that television news consumption is consistently overreported in surveys relative to passively collected behavioral data. We validate these earlier findings, showing that they continue to hold despite large shifts in news consumption habits over time, while also adding some new nuance regarding question wording. We extend these findings to survey reports of online and social media news consumption, with respect to both levels and trends. Third, we demonstrate the usefulness of passively collected data for measuring a quantity such as “consuming news” for which different researchers might reasonably choose different definitions. Finally, recognizing that passively collected data suffers from its own limitations, we outline a framework for using a mix of passively collected behavioral and survey-generated attitudinal data to accurately estimate consumption of news and related effects on public opinion and knowledge, conditional on media consumption.
Dissecting Public Opinion on Regional Authority: Four Types of Regionalists Based on Citizens’ Preferences for Self-Rule and Shared Rule
Authors: Schakel Arjan H , Brown A J
Published: May 2021

Although regional governments play vital roles in most political systems, citizens’ perceptions regarding regional authority are only rarely studied. Relying on the International Constitutional Values Survey held among more than 6,000 respondents from 142 regions in eight countries, we develop measures to tap into citizens’ preferences for self-rule—i.e., for autonomy for their region—and citizens’ preferences for shared rule—i.e., for regional engagement in national decision-making. A majority of citizens prefer their regional governments to have some level of both self-rule and shared rule, but around a quarter of the citizens prefer their region to have more self-rule and less shared rule or vice versa. The analysis reveals these varying preferences are associated with a region’s actual authority and regional identity. These results are important because they indicate that most citizens do not presume increased self-rule to be the main or only path to a strong regional authority.
Diagnostic delay is common for patients with axial spondyloarthritis: results from the National Early Inflammatory Arthritis Audit
Authors: Russell Mark D , Coath Fiona , Yates Mark , Bechman Katie , Norton Sam , Galloway James B , Ledingham Joanna , Sengupta Raj , Gaffney Karl
Published: May 2021

Objectives

Updated guidelines for patients with axial SpA (axSpA) have sought to reduce diagnostic delay by raising awareness among clinicians. We used the National Early Inflammatory Arthritis Audit (NEIAA) to describe baseline characteristics and time to diagnosis for newly referred patients with axSpA in England and Wales.

Methods

Analyses were performed on sociodemographic and clinical metrics, including time to referral and assessment, for axSpA patients (n = 784) recruited to the NEIAA between May 2018 and March 2020. Comparators were patients recruited to the NEIAA with RA (n = 9270) or mechanical back pain (MBP; n = 370) in the same period.

Results

Symptom duration prior to initial rheumatology assessment was longer in axSpA than RA patients (P < 0.001) and non-significantly longer in axSpA than MBP patients (P = 0.062): 79.7% of axSpA patients had symptom durations of >6 months, compared with 33.7% of RA patients and 76.0% of MBP patients. Following referral, the median time to initial rheumatology assessment was longer for axSpA than RA patients (36 vs 24 days; P < 0.001) and similar to MBP patients (39 days; P = 0.30). Of the subset of patients deemed eligible for early inflammatory arthritis pathway follow-up, fewer axSpA than RA patients had disease education provided (77.5% vs 97.8%) and RA patients reported a better understanding of their condition and treatment.

Conclusion

Diagnostic delay in axSpA remains a major challenge despite improved disease understanding and updated referral guidelines. Disease education is provided to fewer axSpA than RA patients, highlighting the need for specialist clinics and support programmes for axSpA patients.
Financing Labor
Authors: Benmelech Efraim , Bergman Nittai , Seru Amit
Published: May 2021

Financial market imperfections can have significant impact on employment decisions of firms. We illustrate the economic importance of this channel by showing that employment decisions are constrained by firms’ financial health and liquidity. Our main analysis uses a collage of three “quasi-experiments” to trace the effects of finance on employment. The results suggest that financial constraints and the availability of credit play an important role in firm-level employment decisions, as well as aggregate unemployment outcomes.
Comparison of Emotional Intelligence, Attachment Style, and Mental Health in Addicted and Nonaddicted People
Authors: Naeim Mahdi , Rezaeisharif Ali
Published: May 2021

Background:

Nowadays, because of the increasing prevalence of addiction in society, there are many costs involved in treating addicts and returning them to normal lives. This will not be possible except in new and effective ways.

Objectives:

This study aimed to compare emotional intelligence, attachment style, and mental health in addicted and healthy individuals.

Methods:

On the basis of inclusion criteria, available sampling method, and semistructured interview based on Diagnostic and Statistical Manual of Mental Disorders-5, 100 addicted men were selected and after matching with 100 nonaddicted men by, Extracurricular Vein Scale (TMMS), light questionnaire Adult Attachment Style (AAS), and the Goldenberg General Health Questionnaire (GHQ) were assessed.

Results:

The results showed that in all 3 components of attention, differentiation, and mood reconstruction of emotional intelligence, addicted people scored lower than the nonaddicted group. The results showed that in the secure attachment style, the mean scores of the nonaddicted group are higher than the addicted group, while in the avoidant insecure style and ambivalent anxiety style, addicted men are significantly higher than nonaddicted men. Also, in all components of mental health, the nonaddicted group obtained higher scores compared with addicted people.

Conclusions:

Psychological correlations of emotional intelligence, adult attachment style, and mental health are important risk factors for the phenomenon of drug addiction and have many practical implications for preventive interventions and treatment of abusive behaviors.
Recovery Housing Program for Drug Addicts: Work Patterns, Substance Abuse, and Housing Situation After a 6-Month Follow-up
Authors: Bosso Rogério A. , Ribeiro Ariadne , Basqueira Ana P. , de Lima Marcelo T. , dos Santos Juliano P. , Perrenoud Luciane O. , Ribeiro Marcelo
Published: May 2021

The use of psychoactive substances is associated with physical and psychological damage, especially among people in situations of high social vulnerability. Housing programs can provide integrated care to people exposed to social determinants of health. This longitudinal study with residents of a recovery house (N=164, maximum stay of 6 mo) investigated substance use, employment, and housing status. The mean length of stay was 144 days (SD=76.8 d), and most residents had been working for at least 4 consecutive months (n=96; 58.5%); 74.4% of the residents received therapeutic discharge and more than half returned to a stable form of residence. Multivariate analysis showed that previous alcohol use was independently associated with working status [odds ratio (OR)=2.29, 95%; confidence interval (CI), 1.00-5.20, P=0.048]. In a multinomial logistic regression model using treatment length as reference, being currently employed (95% CI, 8.74-62.37, P=0.010), and previous history of nonalcohol use (95% CI, 71.59-5.83, P=0.021) were both associated with longer stay in the recovery house. Housing services can provide effective support for substance use recovery, and our findings highlight the need for integrating health and social care strategies.
Use of Electronic Nicotine Delivery Systems (ENDS) in Colombia
Authors: Scoppetta Orlando , Rodríguez-Fandiño Camilo , Villamil Alejandra , Pérez Augusto
Published: May 2021

Background and Aims:

The use of Electronic Nicotine Delivery Systems (ENDS) in Colombia is a new phenomenon. However, there has been an increase in recent years and without any apparent explanation, is necessary to understand the characteristics of the use of ENDS in Colombia.

Methods:

This research is a secondary analysis study based on data from the 2020 National Study of Psychoactive Substance Use in the Colombian territory, which uses a household survey methodology. The study sample includes 49,756 people (48.3% male, 51.8% female), between 12 and 65 years old, distributed in the 32 departments of the country.

Results:

Five percent of Colombians between 12 and 65 years of age have used ENDS at some time in their life (67.8% male). The 12- to 17-year-old group started at 14.6 years average and exists a higher proportion of tobacco smokers among ENDS users in all prevalence.

Conclusions:

The use of ENDS is growing probably because of new marketing strategies that involve novel details and that generate curiosity, especially in the youngest. Some of these are technological designs, pleasant smells and flavors or absence of them and how easy it can be to hide them and consume them in places where it is forbidden to do. So, many young people and adolescents who had not used nicotine before, now do.

There is a knowledge gap about ENDS, therefore they can affect the work has been done for decades in reducing nicotine consumption among young people and be the gateway to the consumption of cigarettes or other substances (marijuana).
Management of proximal humeral fractures: a review
Authors: Domingue Grayson , Garrison Ian , Williams Richard , Riehl John T.
Published: May 2021

Proximal humeral fractures are a common orthopaedic injury. Although many proximal humeral fractures are managed nonoperatively, operative management can result in improved functional outcome when appropriately indicated. Commonly utilized surgical treatment options include open reduction internal fixation (ORIF), arthroplasty, percutaneous fixation, and intramedullary fixation. The most commonly used classification remains the Neer fracture classification. The authors present a comprehensive review of the epidemiology, relevant anatomy, biomechanics, clinical presentation, diagnosis, and management of proximal humeral fractures.
A Case–control Study of Major Genetic Predisposition Risk Alleles in Developing DDD in the Northeast US Population: Effects of Gene–gene Interactions
Authors: Valtchinov Vladimir I. , Zhai Bingxue K. , Hida Tomoyuki , Lacson Ronilda , Raja Ali , Hatabu Hiroro , Khorasani Ramin
Published: May 2021

Study Design.

A case–control study of risk alleles for degenerative disc disease (DDD) using magnetic resonance (MR) imaging for phenotyping.

Objective.

We aim to provide the first statistically adequately powered study of the relationship between the presence of common risk alleles and occurrence of DDD in Eastern US population.

Summary of Background Data.

Many genetic predisposing factors have been identified in elevating the risk of DDD, including common variants in VDR, COL1A1, AGC1, COL9A2/3 genes.

Methods.

We utilized the Mass General Brigham (MGB) Biobank in which subjects’ Medical Record is linked with genotyped data from single-nucleotide polymorphism (SNP) arrays. Subjects with lumbosacral spine MR imaging studies were used to construct the Cases cohort; the Biobank's Controls cohort was used as the Control cohort. Odds ratios (OR) and False-discovery-rate (FDR) q values from multiple-hypotheses-testing corrections were used to assess the likelihood of DDD given occurrence of the listed DDD risk alleles.

Results.

Four-hundred-fourteen subjects (mean age = 64, range = 27 to 94) were Cases and 925 Controls (mean age = 46, range = 21–61). A systematic search has identified 25 SNPs in 18 genes in the SNP arrays. At univariate level, rs1544410 in VDR was significantly associated with DDD for male subjects (odds ratio [OR] = 0.594, P = 0.011). After adjustment for all significant variants and demographics, three predictor variables had a significant association with the outcome, age (OR = 1.130, q < 0.0001), rs143383 (OR = 1.951, q = 0.056), and rs3737821 (OR = 2.701, q = 0.069). A novel variant-to-variant correlation rs143383:rs763110 had a significant adjusted OR = 7.933, q = 0.070).

Conclusion.

In this large-scale study of common variants’ correlation with the presence of DDD in the Northeast United States, we have found a novel and significant variant-to-variant interaction to be associated with the risk of developing DDD, corroborating and necessitating the inclusion of gene–gene interactions in predictive risk model development for DDD.

Level of Evidence: 4
Volar Plate Capsulodesis With Internal Brace Augmentation for the Claw Hand
Authors: Shin Steven S. , Sun Michael , Park Il-Jung , Maniglio Mauro
Published: May 2021

Claw hand deformity is characterized by hyperextension of the metacarpophalangeal joints and flexion of the proximal interphalangeal joints. Surgical treatment of claw hand deformities often involves soft tissue procedures such as tendon transfers or volar plate capsulodesis. However, tissue attenuation over time can lead to recurrence of the deformity. Augmentation with an internal brace may help to address this problem. This report presents a novel technique for the treatment of claw hand deformity involving augmentation of the traditional volar plate capsulodesis with internal brace. Two illustrative cases utilizing the described technique are presented.
Needle-in-needle Pinning Technique Using Disposable Hypodermic Needles for Fractures of Distal Phalanx With Dorsal Disruption
Authors: Takamoto Koji , Takano Sayaka , Takano Kazuaki
Published: May 2021

Fingertip injuries are frequently encountered by the hand surgeon, and often present with a combination of the following: avulsed or broken nail plate, nail bed disruption, and/or distal phalangeal fracture. Recommended management of these injuries consists of reduction of the fracture followed by repair of soft tissues. To achieve an anatomic reduction and sufficient stability of the fracture, current management consists of temporary Kirschner-wire stabilization. Hypodermic needles can be substituted to secure temporary transosseous fixation. We describe a technique for stabilizing open distal phalangeal fracture using hypodermic needles which are readily available. Eight patients over 12 months have been treated with this technique which has proven to be successful. We would advocate that providers consider this technique when Kirschner-wires or other necessary instruments are unavailable.
Desmoid-type fibromatosis: toward a holistic management
Authors: Penel Nicolas , Kasper Bernd , van Der Graaf Winette T.A.
Published: May 2021

Purpose of review

Desmoid-type fibromatosis, a rare locally aggressive fibroblastic proliferation, is a treatment challenge. This review aimed to explore recent data about the management of desmoid-type fibromatosis.

Recent findings

New data underline the role of kinases and ɣ-secretase in stimulating cell proliferation and invasiveness in desmoid-type fibromatosis. This explains the proven activity of multikinase inhibitors (sorafenib or pazopanib) in the management of desmoid-type fibromatosis or the emerging role of a ɣ-secretase inhibitor. An international guideline for management was recently published, and this guideline take into account patient point of view. Lastly, recent studies highlight the multidimensional burden of desmoid-type fibromatosis, particularly health-related quality of life (HRQoL).

Active surveillance with planned MRI is the first-line management in desmoid-type fibromatosis. A site-specific and stepwise approach should be considered for progressive desmoid-type fibromatosis. Further, a risk–benefit analysis that considers the side effects and long-term sequelae should be conducted before deciding to start any treatment. A less aggressive approach should be considered. Multikinase inhibitors are effective, but their tolerability and side effects should be discussed with the patients. The symptoms and HRQoL should be integrated in decision-making. Desmoid-type fibromatosis patients should be offered support to address their needs supportive care.
Contemporary Issues in Obstetric Fistula
Authors: WALL L. Lewis , OUEDRAOGO ITENGRE , AYENACHEW FEKADE
Published: May 2021

We discuss a variety of contemporary issues relating to obstetric fistula. These include definitions of these injuries, the etiologic mechanisms by which fistulas occur, the role of specialist fistula centers in diagnosis and management, the classification of fistulas, and the assessment of surgical outcomes. We also review the growing need for complex reconstructive surgical procedures, follow-up challenges, and the transition to a fistula-free world in which other pathologies (such as pelvic organ prolapse) will be of increasing importance. Finally, we discuss the need to develop responsive systems of maternal health care that treat women with competence, compassion, respect, and fairness.
Gut microbiome diversity and composition is associated with hypertension in women
Authors: Louca Panayiotis , Nogal Ana , Wells Philippa M. , Asnicar Francesco , Wolf Jonathan , Steves Claire J. , Spector Tim D. , Segata Nicola , Berry Sarah E. , Valdes Ana M. , Menni Cristina
Published: May 2021

Objectives:

Animal studies support a role for the gut microbiota in hypertension development, but large human studies are lacking. Here, we investigated the relationship between hypertension prevalence and gut microbial composition in two cohorts.

Methods:

We included 871 unrelated TwinsUK women with faecal microbiome data (16s rRNA gene sequencing). Multivariable linear models adjusted for age, age2 and BMI as well as MiRKAT models, were used to estimate the association of hypertension with alpha- and beta-diversity metrics. To identify taxa associated with hypertension, a generalized additive model for location scale and shape was computed adjusting for covariates and multiple testing. Results were replicated in 448 women from PREDICT-1.

Results:

We found that measures of alpha diversity are significantly lower in hypertensive cases [Beta(95% confidence interval, 95% CI) = −0.05 (−0.095 to −0.004), P = 0.03] and a significant association between beta diversity and hypertension (FDR < 0.05). We identified and replicated two genera associated with hypertension. The genus, Ruminiclostridium 6 was less abundant in hypertension cases [meta-analysis (95% CI) = −0.31 (−0.5 to −0.13), P = 1 × 10−3]. The uncultured microbe Erysipelotrichacea-UCG003 was more abundant in hypertensive cases [meta-analysis (95% CI) = 0.46 (0.3–0.62), P = 1 × 10−4]. We genomically analysed the 16 s rRNA sequence and established a 100% identity match with the 16 s rRNA sequence of the genus Faecalibacillus. We functionally annotated Ruminiclostridium, identifying 83 metabolic pathways, including pathways previously linked to blood pressure regulation.

Conclusion:

In this large human observation, we show that gut microbiome diversity and composition are associated with hypertension. Our results suggest that targeting the microbiome may be a novel means to prevent or treat hypertension.
Pharmacological strategies for treating presbyopia
Authors: Orman Betina , Benozzi Giovanna
Published: May 2021

Purpose of review

Presbyopia is the normal progressive loss of accommodation, which leads to the inability to focus clearly on objects located at different distances. Some of the accepted methods for treating this condition are glasses, contact lenses, and surgery. Pharmacological treatments are a new and promising noninvasive option for dealing with presbyopia. The aim of this review is to provide an update on some recent advances in this field.

Recent findings

Currently, there are three different strategies for the pharmacological treatment of presbyopia. The first one aims to produce miosis and increase depth of focus through a pinhole effect, therefore improving uncorrected near visual acuity. The second one tries to restore the elasticity the lens has lost due to aging. Finally, the third strategy is based on rehabilitating accommodation; which is to say, in a binocular way, allowing for good vision at all distances.

Pharmacological treatments are a new alternative that expands the diversity of existing strategies for treating presbyopia. These treatments are based on the instillation of eyedrops with different compositions, which vary according to the different strategies. Many of these developments will most likely be on the market in the next few years. If the process of patient selection is done properly, any one of these three strategies can be used successfully.
Postrefractive infectious keratitis: prevention, diagnosis, management, and prognosis
Authors: Viriya Elizabeth , Mah Francis
Published: May 2021

Purpose of review

Improve outcomes from an elective procedure by preventing a rare but sight-threatening complication.

Recent findings

Advancement in anti-infective prophylaxis, and therefore shift in the causative organism permits better diagnostic and empiric management.

Infectious keratitis presents in different patterns depending on the refractive procedure. Atypical causative organisms may respond poorly to empiric therapy and impair vision. Therefore, microbial identification is of utmost importance and therapy is adjusted accordingly.
Pediatric Antibiotic Stewardship
Authors: Kreitmeyr Katharina , Pecar Alenka , Mikolajczyk Rafael , von Both Ulrich , Huebner Johannes
Published: May 2021

Background:

Vancomycin has been a first-line treatment for Gram-positive infections for decades. However, strategies for therapeutic drug monitoring (TDM) and dose-optimization in pediatrics remain controversial. In this study, we analyzed the impact of specific antibiotic stewardship interventions on efficacy and safety of vancomycin therapy.

Methods:

From September 2014 to May 2017, we conducted a prospective study to compare a control and a TDM intervention group in our tertiary care center. As part of an antibiotic stewardship program, we implemented internal guidelines on correct vancomycin dosing, TDM timing, as well as targeted trough level range and installed a pharmacokinetic (PK) consultation service to adapt vancomycin dosing to individually calculated PK parameters. As primary clinical outcomes, the percentage of patients with sustained therapeutic vancomycin trough levels and treatment days with therapeutic vancomycin trough levels, that is, 10–15 mg/L were analyzed. Secondary outcomes included nephrotoxicity, readmission rate and mortality. Median daily dose required to achieve therapeutic trough levels was examined.

Results:

Clinical outcomes for 90 control patients were compared with outcomes for 19 patients guided by a PK consultation service. Percentage of patients with sustained therapeutic vancomycin trough levels increased from 17.8% to 94.7% (P < 0.001) and percentage of treatment days with therapeutic vancomycin trough levels increased from 18.4% (117/637) to 665% (155/233, P < 0.001). Readmission rate decreased from 24.4% to 5.3% (P = 0.07). No differences in nephrotoxicity or mortality rate were observed between groups. A median daily dose of 72 mg/kg/d was required to achieve therapeutic trough levels.

Conclusions:

Our data demonstrate that implementation of internal guidelines and a PK consultation service was associated with a profound improvement of vancomycin therapy and, therefore, patient safety.
Postoperative Rehabilitation of Posterior Cruciate Ligament Surgery: A Systematic Review
Authors: Simhal Rishabh K. , Bovich Miriam , Bahrun Ehab A. , Dreese James C.
Published: May 2021

Posterior cruciate ligament (PCL) injuries can be debilitating knee injuries, having involvement in up to 44% of traumatic knee injuries. However, isolated PCL injuries are relatively infrequent. Therefore, effective evidence-based rehabilitation protocols have proven to be elusive. This systematic review aims to summarize the latest evidence on postoperative rehabilitation protocols for patients undergoing PCL reconstruction. Studies included in this paper included those published from 1991 to 2019 with a grade 1 to 5 level of evidence discussing the postoperative PCL rehabilitation. A multidatabase search using largely PubMed and Ovid was conducted using relevant keywords such as “PCL,” “postoperative,” and “rehabilitation,” initially leading to 955 papers, which were narrowed by relevance to 12 final published studies used in the analysis. Through careful review of the evidence, crucial principles of rehabilitation, such as an initial focus on protecting the graft during strengthening, as well as an optimized PCL reconstruction protocol are presented here. Rehabilitation following PCL reconstruction continues to be limited by a lack of high-quality evidence-based publications.
Effectiveness of electroacupuncture for the treatment of sudden sensorineural hearing loss
Authors: Zhou Xu-feng , Jin Xiu-lin
Published: May 2021

This retrospective study investigated the use of electroacupuncture (EA) for the treatment of patients with sudden sensorineural hearing loss (SSNHL).

Between May 2016 and April 2020, 140 patients with SSNHL were retrospectively analyzed. They were allocated to a treatment group (n = 70, received EA) and a control group (n = 70, received acupuncture). They received EA or acupuncture for a total of 3 months. The outcomes included average hearing threshold (AHT), tinnitus (as assessed by tinnitus handicap inventory [THI]), dizziness (as measured by dizziness handicap inventory [DHI]), and adverse events (AEs).

After treatment, patients in both groups exerted more reduction in HT (P < .01), THI (P < .01), and DHI (P < .01), than those before the treatment. Furthermore, patients in the treatment group showed more relief in HT (P < .01), THI (P < .01), and DHI (P < .01), than those of patients in the control group. When it comes to AEs, both modalities had similar safety profile.

The findings of this retrospective study indicated that the effectiveness of EA is superior to acupuncture in treating SSNHL. Future high quality studies are needed to warrant the present findings.
Indonesian registry on atrial fibrillation (OneAF)
Authors: Raharjo Sunu Budhi , Chandranegara Agung Fabian , Hanafy Dicky Armein , Yamin Muhammad , Rasyid Hauda El , Haryadi  , Rizal Ardian , Ardhianto Pipin , Hermanto Dony Yugo , Yuniadi Yoga
Published: May 2021

Background:

Data on the optimal therapeutic international normalized ratio (INR) for non-valvular and valvular atrial fibrillation (AF) in Indonesia is currently unavailable. Therefore, we designed the Indonesian Registry on Atrial Fibrillation (OneAF) registry in order to seek a safe and beneficial range of INR in Indonesian patients with non-valvular and valvular AF.

Methods/design:

The OneAF registry is a nationwide collaboration of the Indonesian Heart Rhythm Society (InaHRS) enrolling all hospitals with cardiac electrophysiologists in Indonesia. It is a prospective, multicentre, nationwide, observational study aiming to recruit non-valvular and valvular AF patients in Indonesia. The registry was started in January 2020 with a planned 2 years of recruitment. There are 2 respondents for this registry: non-cohort and cohort respondents. Non-cohort registry respondents are AF patients at hospitals who fulfill inclusion and exclusion criteria but did not consent for a 24 month follow up. Whereas patients who consented for a 24 month follow up were included as cohort registry respondents. Key data collected includes basic sociodemographic information, symptoms and signs, medical history, results of physical examination and laboratory test, details of diagnostics and treatment measures and events.

Results:

Currently, a total of 1568 respondents have been enrolled in the non-cohort registry, including 1065 respondents with non-valvular AF (67.8%) and 503 respondents with valvular AF (32.2%). We believe that the OneAF registry will provide insight into the regional variability of anticoagulant treatment for AF, the implementation of rhythm/rate control approaches, and the clinical outcomes concerning cardiocerebrovascular events.

Trial registration:

Registered at clinicaltrials.gov (NCT04222868).
Low vision rehabilitation in improving the quality of life for patients with impaired vision: Retraction
Authors: Liu Jianhua , Dong Jige , Chen Yaping , Zhang Weidong , Tong Shuai , Guo Jiangzhou
Published: May 2021

Background & aim:

Low vision rehabilitation optimizes the use of residual vision after severe vision loss, but also teaches skills to improve visual functioning in daily life. These skills promote independence and active participation in society. This meta-analysis was designed to evaluate the efficacy of low vision rehabilitation in improving the quality of life (QoL) in visually impaired adults.

Methods:

We searched the Cochrane Library, PubMed, EMBASE, and Web of Science up to January 1, 2020. Randomized controlled trials (RCTs) that compared rehabilitation interventions with active or inactive controls were included. The standardized mean difference (SMD) with a 95% confidence interval (CI) was estimated to compare outcomes. Two reviewers extracted data and assessed trial quality independently. All statistical analyses were performed using the standard statistical procedures of RevMan 5.2.

Results:

A total of 52 RCTs with 6,239 participants were included in this meta-analysis. Compared to inactive comparators including waiting list or no care, low vision rehabilitation improved vision-related QoL, visual functioning (QoL: psychological aspect), and self-efficacy or self-esteem (QoL: psychological aspect), with pooled SMDs of −0.61 (95% CI −0.95 to −0.26; P = .0006), -1.14 (95% CI −1.69 to −0.59; P < .0001), and −0.84 (95% CI −1.47 to −0.22; P < .0001), respectively. Compared to active comparators, low vision rehabilitation improved vision-related QoL (SMD −0.26; 95% CI −0.46 to −0.06; P = .01) and activities of daily living (QoL: physical aspect) (SMD −0.39; 95% CI −0.67 to −0.12 P < .0001). However, no significant difference in health-related QoL and adaptation to vision loss (QoL: psychological aspect) was found between low vision rehabilitation and inactive comparators.

Conclusions:

This meta-analysis indicated that low vision rehabilitation interventions, particularly psychological therapies and methods of enhancing vision, may improve vision-related QoL and visual functioning in people with sight loss compared to usual care. Further studies should explore longer maintenance effects and the costs of several types of low vision rehabilitation. Studies characterizing the mechanisms of rehabilitation interventions in different settings, including low-income countries, are also required.
The potential for reduced radiation dose from deep learning-based CT image reconstruction
Authors: Lee Ji Eun , Choi Seo-Youn , Hwang Jeong Ah , Lim Sanghyeok , Lee Min Hee , Yi Boem Ha , Cha Jang Gyu
Published: May 2021

The purpose of this phantom study is to compare radiation dose and image quality of abdominal computed tomography (CT) scanned with different tube voltages and tube currents, reconstructed with filtered back projection (FBP), hybrid iterative reconstruction (IR) and deep learning image reconstruction (DLIR) algorithms.

A total of 15 CT scans of whole body phantoms were taken with 3 different tube voltages and 5 different tube currents. The images were reconstructed with FBP, 30% and 50% hybrid IR adaptive statistical iterative reconstruction (ASIR-V), and low, medium and high strength DLIR algorithms. The image scanned with tube voltage/tube current of 120 kV/ 200 mA and reconstructed with FBP algorithm was chosen as the reference image. Five radiologists independently analyzed the images individually and also compared it with the reference image in overall, using the visual grading analysis. The mean score of each image was calculated and compared.

Using DLIR algorithms, the radiation dose was reduced by 65.5% to 68.1% compared with the dose used in the reference image, while maintaining comparable image quality. Using the DLIR algorithm of medium strength, the image quality was even better than the reference image with a reduced radiation dose up to 36.2% to 50.0%. The DLIR algorithms generated better quality images than ASIR-V algorithms in all the data sets. In addition, among the data sets reconstructed with DLIR algorithms, image quality was the best at the medium strength level, followed by low and high.

This phantom study suggests that DLIR algorithms may be considered as a new reconstruction technique by reducing radiation dose while maintaining the image quality of abdominal CTs.
Efficacy of Xiang-Sha-Liu-Jun-Zi on chemotherapy-induced nausea and vomiting
Authors: Xiao Hang , Liu Liangji , Ke Shiwen , Zhang Yuqin , Zhang Wenqiang , Xiong Shaobin , Zhang Wei , Ouyang Jiaqing
Published: May 2021

Background:

Cancer is the main cause of death worldwide, and chemotherapy is the basic method of treating cancer. However, chemotherapy-induced nausea and vomiting (CINV) is the most common side effect of chemotherapy, and conventional antiemetics for the treatment of CINV also have side effects. At present, a large number of randomized controlled trials have shown that Xiang-Sha-Liu-Jun-Zi (XSLJZ) can effectively treat CINV, but there is no systematic review. Therefore, this systematic review aims to discuss the effectiveness of XSLJZ in the treatment of CINV.

Methods:

Search for relevant documents in the Chinese and English databases, and the search time is limited to March 2021. Databases include Embase, Cochrane Library, Web of Science, PubMed, China National Knowledge Infrastructure, Chongqing VIP Information Resource Integration Service Platform, Wanfang Data, Chinese Biomedical Literature, etc. We will search the international clinical trial registration platform and the Chinese clinical trial registration platform to find ongoing and unpublished clinical trials. Randomized controlled trial of the efficacy of XSLJZ in the treatment of CINV were collected. After screening the literature according to the inclusion and exclusion criteria, two researchers independently extracted the data. The effective rate of treatment is the main outcome indicator of this study. The secondary indicators of this study include the incidence of adverse reactions and the improvement rate of quality of life. RevMan 5.3.5 software was used for statistical analysis. Grades of Recommendation, Assessment, Development, and Evaluation system will be used to evaluate the quality evidence for each outcome.

Results:

This study will provide the latest evidence for the treatment of CINV by XSLJZ.

Conclusion

: To evaluate the efficacy of XSLJZ in the treatment of CINV.

Unique INPLASY number:

INPLASY202140079.
Effects of acupoint massage combined with relaxation therapy on patients with postoperative fatigue syndrome after lumbar surgery
Authors: Zheng Qiuhui , Wang Rongyun , Shi Yanan , Sun Qiuhua
Published: May 2021

Background

: Lumbar disc herniation (LDH) is a common disease in orthopedics. Surgery is shown to provide significant faster relief of pain compared to conservative therapy. However, due to the influence of surgical trauma, anesthesia and other perioperative stress factors, patients may have complications. Among them, postoperative fatigue syndrome (POFS) is a common complication. Traditional Chinese medicine or integrated traditional Chinese and Western medicine have been proved to be effective in improving postoperative fatigue.

Methods

: This study is a randomized controlled trial. One hundred eighty Chinese patients with POFS of LDH will be randomly divided into control group, experimental group 1, experimental group 2 and experimental group 3 according to the ratio of 1:1:1:1. The patients in the control group will be treated with conventional treatment after operation, the patients in the experimental group 1 will be treated with acupoint massage, the patients in the experimental group 2 will be treated with relaxation therapy, and the patients in the experimental group 3 will be treated with acupoint massage combined with relaxation therapy. The whole treatment will last for 5 days. The main outcome measures will be fatigue visual analogue scale and identity-consequence fatigue scale, and the secondary outcome measures will be hospital anxiety and depression scale.

Discussion

: This study is to observe the effects of acupoint massage comblined with relaxation therapy on reducing postoperative fatigue of lumbar disc herniation surgical patients.

Trial registration

: Chinese Clinical Trial Registry (http://www.chictr.org.cn/edit.aspx?pid=123978&htm=4), No. ChiCTR2100044788. Registered on March 27, 2021.
Nivolumab as adjuvant treatment for a spinal melanocytoma
Authors: Hean Virginie , Bouleftour Wafa , Ramirez Carole , Forest Fabien , Boutet Claire , Rivoirard Romain
Published: May 2021

Rationale:

Meningeal melanocytoma is a rare benign melanocytic tumor of the central nervous system. We report for the first time a case of meningeal melanocytoma treated with immunotherapy.

Patient concerns:

A 70-year-old man with no medical history was admitted to the Emergency Room. He suffered from a motor and sensory deficit in his left lower limb and a bilateral upper arm neuralgia.

Diagnoses:

A contrast-enhanced magnetic resonance imaging (MRI) was performed. It showed a C7-T1 bleeding intramedullary tumor. Laminectomy was decided and performed. The results of the pathologic examination showed a melanocytic tumor harboring GNAQ mutation. Meningeal melanocytoma was the final diagnosis.

Interventions:

The patient was treated with 10 radiotherapy sessions and 6 cycles of nivolumab. A year later, the patient experienced neuralgia again with severe pain and an increasing sensory motor deficit. He underwent a second surgery that was incomplete. As the tumor kept growing, he received temozolomide. But the 6th cycle had to be interrupted due to bedsore infection in the hip area.

Outcomes:

Disease progression finally led to the patient's death 3 years after diagnosis.

Lessons:

This case report is the first about a patient with meningeal melanocytoma treated with immunotherapy. Treatment based on biomolecular mutations will probably change spinal melanocytoma therapeutic approach in the next few years.
New mutation in WT1 gene in a boy with an incomplete form of Denys-Drash syndrome
Authors: Akramov Nail R. , Shavaliev Rafael F. , Osipova Ilsiya V.
Published: May 2021

Rationale:

Pediatric patients with WTl-associated syndromes (including Wilms’ tumor-aniridia syndrome and Denys-Drash syndrome), Perlman syndrome, mosaic aneuploidy, and Fanconi anemia with a biallelic breast cancer type 2 susceptibility protein mutation have the highest risk of developing Wilms’ tumor.

Patient concerns and diagnosis:

We describe a patient with bilateral metachronous Wilms’ tumor, ambiguous genitalia characterized by 46, XY disorder of sexual development (DSD) with scrotal hypospadias and bilateral abdominal cryptorchidism, but without nephropathy. At the age of 7 months, the child underwent left nephrectomy with left orchiopexy. At follow-up after 8 months, a second tumor with a diameter of 10 mm was detected in abdominal CT scans at the lower pole of the right kidney.

Intervention:

Intra-operative macroscopic inspection of the right kidney revealed a tight attachment of the right proximal ureter to the tumor. Thus, retroperitoneoscopic resection of the lower pole of the right kidney had to be changed to an open surgical procedure with partial resection of the proximal ureter and high uretero-ureterostomy. We subsequently performed orchiopexy and two-stage correction of hypospadias using a free skin graft.

Outcomes:

At the last follow-up at the age of 8 years, no pathology requiring treatment was noted. A pair-end-reading (2 × 125) DNA analysis with an average coverage of at least 70 to 100 × revealed a previously unknown heterozygous mutation in exon 7 of the Wilms’ tumor suppressor gene 1 (WT1) gene (chr11:32417947G>A), leading to the appearance of a site of premature translation termination in codon 369 (p.Arg369Ter, NM_024426.4). This mutation had not been registered previously in the control samples “1000 genomes,” Exome Sequencing Project 6500, and the Exome Aggregation Consortium. Thus, to the best of our knowledge this represents a newly identified mutation causing incomplete Denys-Drash syndrome.