bluuebunny/crossref_metadata_2025 huggingface dataset:
Vedolizumab subcutaneous formulation maintenance therapy for patients with IBD: a systematic review and meta-analysis
Authors: Hu Qiong , Tang Xing-zhou , Liu Fang , Liu De-wu , Cao Bo
Published: April 2023

Background:

The application of vedolizumab (VDZ) subcutaneous (SC) formulation has brought more convenience and hope to patients with moderate-to-severe inflammatory bowel diseases (IBDs) in the coronavirus disease 2019 context.

Objective:

This study aimed to systematically evaluate all previous studies that used VDZ SC formulation for maintenance therapy in patients with IBD.

Design:

Systematic review and meta-analysis.

Data Sources and Methods:

The search was conducted using the subject and free terms related to ‘Vedolizumab’, ‘Subcutaneous’, and ‘IBD’, in Embase, PubMed, Web of Science, Cochrane, and at ClinicalTrials.gov databases between 2008 and 2022. The methodological quality of randomized controlled trials (RCTs) and cohort studies was assessed using the Cochrane Handbook of Systematic Reviews and the Newcastle–Ottawa Scale, respectively. The endpoints included efficacy, safety, and immunogenicity.

Results:

A total of 60 studies and 2 completed clinical registry trials were retrieved, of which 3 RCTs with high methodological quality, and 3 cohort studies with large heterogeneity were included in the meta-analysis. In the RCT study design, patients with ulcerative colitis (UC) under different conditions after treated with VDZ SC were significantly distinct than those for placebo (PBO) in clinical remission, endoscopic remission, and biochemical remission. In Crohn’s disease (CD), the aforementioned parameters were slightly higher than those for PBO, but there was not statistically significant in endoscopic remission and the efficacy of anti-tumor necrosis factor-naive patients. The clinical remission, endoscopic remission, and biochemical remission in patients with UC after VDZ SC treatment were similar to those after intravenous (IV) treatment. The risk ratios in patients experiencing adverse events (AEs) and serious AEs after VDZ SC and PBO treatments were 86% and 89% in UC, and 96% and 80% in CD, respectively. Compared with IV, safety was not statistically different. The risk of developing anti-VDZ antibody after VDZ SC treatment was only 20% of that after PBO in patients with UC, but it was 9.38 times in CD.

Conclusion:

VDZ SC treatment maintained the clinical efficacy of IV induction in patients with IBD without increasing the safety risk, and the efficacy was more pronounced in patients with UC. Immunogenicity might be a potential factor for the decrease in efficacy rate in patients with IBD.

Registration:

INPLASY 2022120115
The natural history of histological changes in microscopic colitis
Authors: Sehgal Kanika , Tome June , Kamboj Amrit K. , Dierkhising Ross A. , Pardi Darrell S. , Khanna Sahil
Published: April 2023

Background:

Microscopic colitis (MC) causes chronic diarrhea. It has two histologic subtypes: lymphocytic colitis (LC) and collagenous colitis (CC). Little is known about the natural progression of disease with time and with treatment.

Objectives:

We aimed to assess histological changes over time.

Design:

We designed a retrospective study including adults diagnosed with MC from January 1992 to January 2020 at Mayo Clinic.

Methods:

Pathology reports were reviewed until 31 October 2020. Histological assessments at least 8 weeks apart were considered as adequate follow-up. Histological change from one subtype to the other and resolution were tracked with univariate and multivariable Cox proportional hazards models.

Results:

Overall, 416 patients with a median age at diagnosis of 63.9 years with >1 histopathological assessment were identified. Histology at initial diagnosis was CC in 218 (52.4%) patients and LC in 198 (47.6%). No medications were associated with a histological change. However, histological resolution was more likely with the use of aspirin [hazard ratio (HR): 2.10, 95% confidence interval (CI): 1.34–3.31, p = 0.001) and proton-pump inhibitors (PPIs; HR: 2.01, 95% CI: 1.34–3.02, p = 0.001). Histological resolution was more likely with budesonide treatment (HR: 1.86, 95% CI: 1.16–3.00, p = 0.010) and less likely with mesalamine (HR: 0.40, 95% CI: 0.19–0.83, p = 0.014), compared to medications such as prednisone, loperamide, and bismuth. Patients with CC were less likely to change their histology compared to patients with LC (HR: 0.24, 95% CI: 0.14–0.42, p < 0.001). There was no difference in histological resolution between the two subtypes (HR: 0.70, 95% CI: 0.47–1.05, p = 0.084).

Conclusion:

Patients with LC have a higher chance of changing their histology as compared to CC. However, histological resolution was associated with the use of PPIs and aspirin, and treatment with budesonide.
Effect of peripartum Clostridioides difficile infection on pregnancy and neonatal outcomes: an observational study
Authors: Saha Srishti , Pardi Ryan , Theiler Regan N. , Pardi Darrell S. , Khanna Sahil
Published: April 2023

Background:

The incidence of Clostridioides difficile infection (CDI) in peripartum women is rising, but limited data on its effect on maternal and neonatal outcomes are available.

Objective:

To study the effect of peripartum CDI on pregnancy and neonatal outcomes.

Design:

Retrospective cohort study.

Methods:

Patients with peripartum CDI 12 weeks before pregnancy through 6 weeks postpartum (January 1996–February 2018) were matched with controls (peripartum women without CDI) 1:1 by age, year of delivery, and prior pregnancies. McNemar’s test and conditional logistic regression were used to analyze the effect of CDI on pregnancy and neonatal outcomes (complications, mode of delivery). p < 0.05 was considered statistically significant.

Results:

Overall, 101 cases and 100 controls (1997–2018) were included; median age 27 (range, 20–41) years. Timing of CDI was as follows: pre-pregnancy: 15.8% ( n = 16), during pregnancy: 51.5% ( n = 52), and postpartum: 32.7% ( n = 33). The commonest risk factor was outpatient/emergency room visits. Pregnancy and neonatal outcomes were analyzed for 67 matched pairs with CDI before or during pregnancy. Cases had higher odds of cesarean delivery ( p = 0.02) and lower odds of Group B Streptococcus (GBS) infection/colonization ( p = 0.03). Odds of cesarean delivery remained high after controlling for labor arrest disorders [odds ratio (OR): 17.23 (95% confidence interval (CI), 2.19–543.19; p = 0.004)]; odds of GBS remained low after controlling for antibiotic use (OR: 0.25, 95% CI, 0.04–0.99; p = 0.049). Neonatal outcomes were similar in cases and controls. CDI treatment did not affect treatment-related or delivery outcomes.

Conclusion:

Peripartum CDI was associated with higher odds of cesarean delivery and lower odds of GBS infections. Larger studies exploring the effect of CDI on pregnancy and neonatal outcomes are needed.
COVID-19 and celiac disease: a review
Authors: Cohen Brandon S. , Lebwohl Benjamin
Published: April 2023

The aim of this review is to broadly cover how the COVID-19 pandemic has affected individuals with celiac disease, including perceived risk, risk of contraction or severe infection, considerations regarding vaccination, access to gluten-free food during the pandemic, and possible long-term changes to the practice of celiac disease management spurred by the pandemic. While initially there was increased perceived risk about COVID-19 in the celiac disease population, studies have found that individuals with celiac disease are not at an increased risk of contracting or having a severe course compared to the general population. There is not yet evidence that COVID-19 infection will lead to an increase in celiac disease incidence, though more research on this topic with longer-term follow-up is necessary to make this determination. Limited access to in-person visits led to an increase in telemedicine, which was adopted swiftly by this patient population and may offer improved access in the long term. In summary, individuals with celiac disease do not appear to be at an increased risk of contracting COVID-19 or having a more severe disease course.
Impact of clinical note format on diagnostic accuracy and efficiency
Authors: Payton Evita M , Graber Mark L , Bachiashvili Vasil , Mehta Tapan , Dissanayake P Irushi , Berner Eta S
Published: April 2023

Background

Clinician notes are structured in a variety of ways. This research pilot tested an innovative study design and explored the impact of note formats on diagnostic accuracy and documentation review time.

Objective

To compare two formats for clinical documentation (narrative format vs. list of findings) on clinician diagnostic accuracy and documentation review time.

Method

Participants diagnosed written clinical cases, half in narrative format, and half in list format. Diagnostic accuracy (defined as including correct case diagnosis among top three diagnoses) and time spent processing the case scenario were measured for each format. Generalised linear mixed regression models and bias-corrected bootstrap percentile confidence intervals for mean paired differences were used to analyse the primary research questions.

Results

Odds of correctly diagnosing list format notes were 26% greater than with narrative notes. However, there is insufficient evidence that this difference is significant (75% CI 0.8–1.99). On average the list format notes required 85.6 more seconds to process and arrive at a diagnosis compared to narrative notes (95% CI -162.3, −2.77). Of cases where participants included the correct diagnosis, on average the list format notes required 94.17 more seconds compared to narrative notes (75% CI -195.9, −8.83).

Conclusion

This study offers note format considerations for those interested in improving clinical documentation and suggests directions for future research. Balancing the priority of clinician preference with value of structured data may be necessary.

Implications

This study provides a method and suggestive results for further investigation in usability of electronic documentation formats.
Remote Digital Technologies for the Early Detection and Monitoring of Cognitive Decline in Patients With Type 2 Diabetes: Insights From Studies of Neurodegenerative Diseases
Authors: DuBord Ashley Y. , Paolillo Emily W. , Staffaroni Adam M.
Published: April 2023

Type 2 diabetes (T2D) is a risk factor for cognitive decline. In neurodegenerative disease research, remote digital cognitive assessments and unobtrusive sensors are gaining traction for their potential to improve early detection and monitoring of cognitive impairment. Given the high prevalence of cognitive impairments in T2D, these digital tools are highly relevant. Further research incorporating remote digital biomarkers of cognition, behavior, and motor functioning may enable comprehensive characterizations of patients with T2D and may ultimately improve clinical care and equitable access to research participation. The aim of this commentary article is to review the feasibility, validity, and limitations of using remote digital cognitive tests and unobtrusive detection methods to identify and monitor cognitive decline in neurodegenerative conditions and apply these insights to patients with T2D.
Stroke and Disseminated Intravascular Coagulation in a Patient With Metastatic Prostate Cancer
Authors: Zuflacht Jonah P. , Levine Joshua M.
Published: April 2023

Cancer and stroke comprise two of the most common causes of death worldwide. Despite a significantly increased risk of stroke among patients with cancer, most stroke trials have excluded patients with malignancy. There is thus limited evidence to help guide management decisions in this complex population. We present the case of a 78-year-old man with recurrent strokes – both ischemic and hemorrhagic – in the setting of newly-identified metastatic prostate cancer. An atypical cause of cancer-associated stroke is reviewed and the management is discussed.
The role of arachnoid granulations in idiopathic intracranial hypertension
Authors: Huda Fahimul , Abdelmonem Ahmed , Dehghani Firouzabadi Fatemeh , Srinivas Dola Venkata Naga , Sheikhy Ali , Taheri M Reza
Published: April 2023

Objectives

Idiopathic intracranial hypertension (IIH) is a disease defined by elevated intracranial pressure (ICP) without an established etiology. Arachnoid granulations (AG) are conduits for CSF resorption from the subarachnoid space to the venous system. AG have been implicated to play a central role in maintaining CSF homeostasis. We tested the hypothesis that patients with fewer visible AG on MRI are more likely to present with IIH.

Methods

In this institutional review board (Institutional Review Board)-approved retrospective chart review study, 65 patients with a clinical diagnosis of idiopathic intracranial hypertension were compared to 144 control patients who met inclusion/exclusion criteria. Patients’ signs and symptoms pertaining to IIH were obtained through the electronic medical record Brain MR images were reviewed for the number and distribution of AGs indenting the dural venous sinuses. The presence of imaging and clinical findings associated with long standing increased ICP was noted. Propensity score method (with inverse probability weighting technique) was used to compare case and control groups.

Results

In the control group, the number of AG indenting the dural venous sinuses on MRI (NAG) was lower in women compared to men when matched for age (20–45 yo) and BMI (>30 kg/m2). The NAG was lower in 20–45 yo females in the IIH group as compared to the 20–45 yo females in the control group. This statistically significant difference persists when controlled for BMI. In contrast, the NAG in >45 yo females in the IIH group trended higher compared to the >45 yo females in the control group.

Conclusion

Our results suggest that alterations in arachnoid granulations could play a role in the development of IIH.
Between risk mitigation and labour rights enforcement: Assessing the transatlantic race to govern AI-driven decision-making through a comparative lens
Authors: Aloisi Antonio , De Stefano Valerio
Published: April 2023

In this article, we provide an overview of efforts to regulate the various phases of the artificial intelligence (AI) life cycle. In doing so, we examine whether—and, if so, to what extent—highly fragmented legal frameworks are able to provide safeguards capable of preventing the dangers that stem from AI- and algorithm-driven organisational practices. We critically analyse related developments at the European Union (EU) level, namely the General Data Protection Regulation, the draft AI Regulation, and the proposal for a Directive on improving working conditions in platform work. We also consider bills and regulations proposed or adopted in the United States and Canada via a transatlantic comparative approach, underlining analogies and variations between EU and North American attitudes towards the risk assessment and management of AI systems. We aim to answer the following questions: Is the widely adopted risk-based approach fit for purpose? Is it consistent with the actual enforcement of fundamental rights at work, such as privacy, human dignity, equality and collective rights? To answer these questions, in section 2 we unpack the various, often ambiguous, facets of the notion(s) of ‘risk’—that is, the common denominator with the EU and North American legal instruments. Here, we determine that a scalable, decentralised framework is not appropriate for ensuring the enforcement of constitutional labour-related rights. In addition to presenting the key provisions of existing schemes in the EU and North America, in section 3 we disentangle the consistencies and tensions between the frameworks that regulate AI and constrain how it must be handled in specific contexts, such as work environments and platform-orchestrated arrangements. Paradoxically, the frenzied race to regulate AI-driven decision-making could exacerbate the current legal uncertainty and pave the way for regulatory arbitrage. Such a scenario would slow technological innovation and egregiously undermine labour rights. Thus, in section 4 we advocate for the adoption of a dedicated legal instrument at the supranational level to govern technologies that manage people in workplaces. Given the high stakes involved, we conclude by stressing the salience of a multi-stakeholder AI governance framework.
How hairfall saved the patient from cancer twice – A postmenopausal patient with synchronous endometrial and endocervical carcinomas presenting with endocrine symptoms
Authors: Karangadan Shabnam , Nair Indu R , Menon Usha , Bhati Priya , Remadevi Chithra
Published: April 2023

Ovarian stromal hyperthecosis is an uncommon nonneoplastic cause of ovarian hyperandrogenism mainly in postmenopausal women. Here, we present a case of a postmenopausal woman who presented with features of virilization like alopecia and hirsutism. During its workup, two malignancies were diagnosed at a very early stage. Microscopic focus of endometrial adenocarcinoma in a polyp and similar focus of endocervical adenocarcinoma in the subsequent hysterectomy specimen were noted. Presence of synchronous malignancies in the uterus is very rare and it being detected in a patient who presented with a non-related symptom of hairfall makes it an interesting case scenario.
Multifocal cutaneous phaeohyphomycosis caused by Exophiala spinifera with clinical resolution in an immunocompromised cat
Authors: Kondratjeva Jevgenija , Pressanti Charline , Reynolds Brice S , Trumel Catherine , Delverdier Maxence , Normand Anne-Cécile , Soetart Nicolas , Guillot Jacques , Cadiergues Marie Christine
Published: April 2023

Case summary

A 3-year-old neutered domestic shorthair cat with a long history of idiopathic immune-mediated haemolytic anaemia and thrombocytopenia treated with ciclosporin and prednisolone was referred 2 months after the appearance of nodular dermatitis. A single pigmented nodule was present in the lateral carpal region of the right foreleg. The lesion was 7 mm in diameter, non-exudative and cutaneous to subcutaneous. Fine-needle aspiration of the mass revealed the presence of pigmented fungal elements. Excisional surgery was planned; in the meantime, a plaque-like lesion developed in the interorbital region. Histopathological examination confirmed the presumptive diagnosis of phaeohyphomycosis, and Exophiala spinifera was identified as the aetiological agent. Itraconazole, given orally at a dose of 10 mg/kg for 8 weeks following surgery, enabled clinical resolution despite continued use of immunosuppressants. The follow-up was carried out over 14 weeks.

Relevance and novel information

This case report provides the first evidence of multifocal cutaneous phaeohyphomycosis caused by E spinifera with clinical resolution after combined surgical and itraconazole treatment in an immunocompromised cat.
Screen time, phone usage, and social media usage: Before and during the COVID-19 pandemic
Authors: Voss Claire , Shorter Phoebe , Mueller-Coyne Jessica , Turner Katherine
Published: April 2023

Objective

Technology use has increased in the past several years, especially among younger generations. The COVID-19 pandemic drastically changed how people work, learn, and interact, with many utilizing technology for daily tasks and socializing.

Methods

The current study investigated a sample of college students using a cross-sectional design to determine whether there was a change in how much time students spent on screens, phones, and social media.

Results

Findings indicated that time on screens and phones was significantly higher during the pandemic; however, time spent on social media did not differ significantly.

Conclusion

These findings suggest that students are spending more time working and socializing on their screens and phones, yet social media may not be the platform in which students are doing this. Future studies should further explore technology usage and whether these trends during the COVID-19 pandemic will be lasting.
Policies, Strategies, and the Evolutionary Logic of Large-Scale Teacher Training in China
Authors: Li (李宝敏) Baomin , Yang (杨风雷) Fenglei , Wang (王倩) Qian
Published: April 2023

Purpose

Based on a systematic review of policy documents in China related to teacher training over the past four decades, this paper identifies and analyzes the main policy shifts and strategies in terms of teacher training in China.

Design/Approach/Methods

Using quantitative trend analysis, high-frequency word analysis, and content analysis, this study presents the policy changes in and reform of China's national teacher training system and elucidates the reasons for such changes.

Findings

Chinese teacher training and practice reforms resonate with the paradigm shifts of international teacher training and development, particularly those based on real-world scenarios. However, innovations have also been made in response to the problems of Chinese in-service teacher training and development, such as the lack of time for teachers and the separation between learning and practice. Such innovations reflect the government's efforts to narrow the gaps between theory, policy, and practice by improving China's macro policy design.

Originality/Value

This study contributes to the longitudinal study of policy shifts in teacher training in China.
Relationship Between Patient-Centered Primary Care Provider Communication and Emergency Room Visits in the Medicaid Population in North Carolina, United States
Authors: Platonova Elena A. , Carnes Keith J.
Published: April 2023

Introduction:

Medicaid, a joint federal-state program, finances health care for eligible low-income individuals and families in the United States. Medicaid patients use disproportionately more emergency room (ER) services than other patients in the United States. Inadequate provider communication during primary care visits might be one reason for this well-documented phenomenon. The goal of the study was to examine how patient-centered provider communication related to ER use by Medicaid patients in North Carolina.

Methods:

A 2015 state-wide cross-sectional telephone survey of NC adult Medicaid patients (n = 2652) was based on the CAHPS methodology. Predictors were 4 patient-centered provider communication characteristics assessed by patients. The outcome was the number of ER visits during 6 months prior to the survey. We used negative binomial regression to examine the relationship.

Results:

Effective patient-centered provider communication index was associated with 19% fewer ER visits ( P < .05). Provider’s respect for patients had the biggest impact on the number of visits (37% fewer ER visits, P < .001). Easy to understand provider explanations were associated with 18% fewer ER visits ( P < .05). Longer (>1 year) patient continuity with the current primary care provider was associated with 36% to 38% fewer ER visits ( P < .001).

Conclusions:

Health care quality improvement should focus on training providers how to show respect, give easily understood explanations, and maintain good interpersonal relationships with patients. Relevant agencies should emphasize training and accreditation with a specific emphasis on communication of providers delivering care to Medicaid patients.
Effects of Slide Sheet Use and Bed Position on Muscle Activities in the Low Back and Extremities: A Pilot Experimental Simulation Study
Authors: Higuchi Daisuke , Takahashi Yuko , Tomita Yosuke
Published: April 2023

Background:

Low-friction slide sheets (SS) are designed to reduce compression loads on the body during manual handling tasks, such as boosting patients. Using SS has been shown to decrease muscle activity in the lower back and upper extremities. However, it is unclear if this effect varies with different bed positions. To investigate this, we studied the effects of SS use, bed height, and their combination on muscle activity during a simulated patient boost.

Methods:

Thirty-three Japanese undergraduate students (age 21.0 ± 1.1 years; 14 men, 19 women) participated. Participants were asked to boost a dummy figure on the bed three times each using four conditions. During the repositioning task, electromyography of eight muscles of the lower back and upper and lower extremities, hip and knee joint flexion angles, pelvic forward tilt angle, and position of the center of mass based on the posterior superior iliac spine were evaluated.

Findings:

Electrophysiological activities of muscles of lower back and upper extremities were significantly lower with SS than without it in both bed positions (30% and 40% of body height); the reduction in muscle activities with SS use was 20% to 40%. Lowering the bed did not affect the SS effect magnitude on reducing muscle activities, although postural changes, including hip and knee joint flexion, were observed.

Conclusions/Application to Practice:

SS reduced muscle activities in the back, upper, and lower extremities when the bed was in the low position, and this effect persisted at a bed height of ≥30% of the participant’s height.
Parental Financial Assistance and Psychological Well-Being Among Korean Emerging Adults: Pressure from and Fulfillment of Parental Career Expectations as Mediators
Authors: Oh Sangmin , Lee Jaerim
Published: April 2023

Many emerging adults receive parental financial assistance (PFA) to prepare for their future and career, but it can also be a psychological burden through parental career expectations. The purpose of this study was to examine whether actual PFA (APFA) and the evaluation of PFA (EPFA) were associated with Korean emerging adults’ psychological well-being both directly and indirectly through pressure from and the fulfillment of parental career expectations. Our data came from 1,107 never-married Korean emerging adults (593 women; 19-34-year-olds) who had at least one living parent. Structural equation modeling indicated that APFA was directly associated with higher life satisfaction while EPFA was directly related to both depressive symptoms and life satisfaction. Pressure from parental career expectations alone mediated the relationship between APFA/EPFA and depressive symptoms. The indirect relationship between APFA/EPFA and life satisfaction was also significant when pressure from career expectations and fulfillment of career expectations were sequential mediators.
Supportive Policy Intervention in Incubating Innovative Enterprises for the Creation of a Self-Reliant Economy
Authors: Sultana Nazia , Gupta Nidhi
Published: April 2023

Incubating innovative enterprises has become a key success factor for the progress of emerging economies. A systematic outlook of how incubators are established, funded and what determines their tenant firm’s success has become the need of the hour. This study examines the service portfolio of incubators and assesses the role of government policies in supporting the incubation of innovative enterprises. Employing a purposive sampling technique, 50 incubators and 50 start-up firms in South India are chosen, and smart PLS 3.2.9 is used to validate the proposed GIIE model (Government Incubating Innovative Enterprises). Parameters such as incubator’s criteria for selecting tenants, factors affecting a firm’s affiliation decision, government schemes for incubators and SERVQUAL of incubators are studies that corroborate the developments across emerging economies such as the National Innovation System in Taiwan, customized incubation arrangements in Brazil and so on. The study concludes that business incubators are enablers of enterprise building, trustees of policy grants and facilitators of incubation services. An Incubator Benchmark Assessment Toolkit is recommended through this study to grant funds only to those incubators that meet the benchmark criteria and provide not only capital and infrastructural support but also mentoring assistance, which was found to be lacking as reported by the study’s tenant firms. The study implies strategic coupling of policy support in incubating innovative enterprises for achieving self-reliance.
Augmenting ACL Repair With Suture Tape Improves Knee Laxity: A Biomechanical Study
Authors: He Jinshen , Kanto Ryo , Fayed Aly M. , Price Taylor M. , DiNenna Michael A. , Linde Monica A. , Smolinski Patrick , van Eck Carola F.
Published: April 2023

Background:

Anterior cruciate ligament (ACL) repair is an alternative to reconstruction; however, suture tape support may be necessary to achieve adequate outcomes.

Purposes:

To investigate the influence of suture tape augmentation (STA) of proximal ACL repair on knee kinematics and to evaluate the effect of the 2 flexion angles of suture tape fixation.

Study Design:

Controlled laboratory study.

Methods:

Fourteen cadaveric knees were tested using a 6 degrees of freedom robotic testing system under anterior tibial (AT) load, simulated pivot-shift (PS) load, and internal rotation (IR) and external rotation loads. Kinematics and in situ tissue forces were evaluated. Knee states tested were (1) ACL intact, (2) ACL cut, (3) ACL repair with suture only, (4) ACL repair with STA fixed at 0° of knee flexion, and (5) ACL repair with STA fixed at 20° of knee flexion.

Results:

ACL repair alone did not restore the intact ACL AT translation at 0°, 15°, 30°, or 60° of flexion. Adding suture tape to the repair significantly decreased AT translation at 0°, 15°, and 30° of knee flexion but not to the level of the intact ACL. With PS and IR loadings, only ACL repair with STA fixed at 20° of flexion was not significantly different from the intact state at all knee flexion angles. ACL suture repair had significantly lower in situ forces than the intact ACL with AT, PS, and IR loadings. With AT, PS, and IR loadings, adding suture tape significantly increased the in situ force in the repaired ACL at all knee flexion angles to become closer to that of the intact ACL state.

Conclusion:

For complete proximal ACL tears, suture repair alone did not restore normal knee laxity or normal ACL in situ force. However, adding suture tape to augment the repair resulted in knee laxity closer to that of the intact ACL. STA with fixation at 20° of knee flexion was superior to fixation with the knee in full extension.

Clinical Relevance:

The study findings suggest that ACL repair with STA fixed at 20° could be considered in the treatment of femoral sided ACL tears in the appropriate patient population.
A Review of Recent Innovations in Cartilage Regeneration Strategies for the Treatment of Primary Osteoarthritis of the Knee: Intra-articular Injections
Authors: Householder Nicholas A. , Raghuram Akshay , Agyare Kofi , Thipaphay Skyler , Zumwalt Mimi
Published: April 2023

Background:

The pathology of primary osteoarthritis (OA) begins with structural cartilage damage, which initiates a self-propagating inflammatory pathway that further exacerbates cartilage deterioration. Current standard of care for knee primary OA involves treating the inflammatory symptoms to manage pain, which includes intra-articular (IA) injections of cortisone, an anti-inflammatory steroid, followed by a series of joint-cushioning hyaluronic acid gel injections. However, these injections do not delay the progression of primary OA. More focus on the underlying cellular pathology of OA has prompted researchers to develop treatments targeting the biochemical mechanisms of cartilage degradation.

Purpose:

Researchers have yet to develop a United States Food and Drug Administration (FDA)–approved injection that has been demonstrated to significantly regenerate damaged articular cartilage. This paper reviews the current research on experimental injections aimed at achieving cellular restoration of the hyaline cartilage tissue of the knee joint.

Study Design:

Narrative review.

Methods:

The authors conducted a narrative literature review examining studies on primary OA pathogenesis and a systematic review of non–FDA-approved IA injections for the treatment of primary OA of the knee, described as “disease-modifying osteoarthritis drugs” in phase 1, 2, and 3 clinical trials.

Conclusion:

New treatment approaches for primary OA investigate the potential of genetic therapies to restore native cartilage. It is clear that the most promising IA injections that could improve treatment of primary OA are bioengineered advanced-delivery steroid-hydrogel preparations, ex vivo expanded allogeneic stem cell injections, genetically engineered chondrocyte injections, recombinant fibroblast growth factor therapy, injections of selective proteinase inhibitors, senolytic therapy via injections, injectable antioxidant therapies, injections of Wnt pathway inhibitors, injections of nuclear factor–kappa β inhibitors, injections of modified human angiopoietin-like–3, various potential viral vector–based genetic therapy approaches, and RNA genetic technology administered via injections.
Progressive Flaccid Paraplegia in a Toddler due to Chiari Type I Malformation Complicated with Hydrocephalus and Syringomyelia. A Case Report
Authors: Lo Angelina , LaRocca Megan C. , Whalen Danielle , Gonzalez-Castillo Zurisadai
Published: April 2023

Chiari malformation is a clinico-radiological entity defined by herniation of rhombencephalic structures through the foramen magnum. The most common type, Chiari I, involves herniation of the cerebellar tonsils specifically. We present the case of a 2-year-old with three weeks of progressive bilateral leg weakness, absent reflexes, and the inability to walk. The patient was found to have Chiari I with hydrocephalus and syringomyelia. This is the youngest patient reported in the literature presenting with a clinical picture of spinal shock. Early recognition of this entity allows for proper treatment and improved outcomes.
Scarring Alopecia in Tumor Necrosis Factor-α Antagonists-Induced Scalp Psoriasis
Authors: Baniel Avital , Peled Alon , Samuelov Liat , Zemser Valentina , Gat Andrea , Dodiuk-Gad Roni P. , Ziv Michael , Azzam Wassim , Zittan Eran , Matz Hagit , Sprecher Eli , Pavlovsky Mor
Published: April 2023

Background

A broad spectrum of adverse reactions associated with the use of tumor necrosis factor alpha (TNFα) antagonists has been recognized over the past years. Induction of scalp psoriasis is a less known undesirable consequence of the use of these drugs and is not well characterized.

Objective

To characterize TNFα inhibitors-induced psoriatic alopecia.

Methods

We studied 6 patients with TNF-inhibitor induced psoriatic alopecia and reviewed 28 patients with this condition reported in the literature to date.

Results

In addition to severe scalp psoriasis, we report hair follicle pathologies ranging from alopecia areata to scarring alopecia. Prognosis was good, but discontinuation of TNFα inhibitors was required in more than half of the cases in order to achieve a favourable outcome.

Conclusion

TNFα inhibitors-associated psoriatic alopecia is rarely reported but requires a high index of suspicion and prompt diagnosis, as timely intervention may prevent irreversible damage.
Access to Inclusive Urban Public Transport System in Bangladesh: The Case of Dhaka City
Authors: Rahman Dalia , Bhuiyan Md. Imran Hossain , Khan Niaz Ahmed
Published: April 2023

This article examines the state of people’s access to the inclusive urban transport system in Dhaka and suggests strategies for improving access to the transport system. By adopting an exploratory approach, both quantitative and qualitative tools of data collection were employed to gather primary data through questionnaires and key informant interviews (KIIs). The findings reveal the lack of passengers’ trust and satisfaction in terms of the availability, accessibility, accommodation, acceptability and affordability of public buses for the vulnerable groups in Dhaka city. To make the transport system accessible and inclusive, suitable vehicles need to be introduced with additional resource commitments along with sensitive training and public awareness to respect and support vulnerable groups to access transport systems with ease in Dhaka and similar cities.
Medical Therapy for Ineffective Esophageal Motility: A Systematic Review
Authors: Reddy Alexander T. , Song Erin J. , Shimpi Rahul A. , Cantrell Sarah , Leiman David A.
Published: April 2023

Background:

Ineffective esophageal motility (IEM) is a commonly identified disorder of peristalsis. Although often asymptomatic, IEM can be associated with dysphagia. Aside from treating co-existing gastroesophageal reflux disease and sources of mechanical obstruction, few options are available for management in this context. We therefore systematically reviewed the literature to identify randomized controlled trials (RCTs) for medical treatments of IEM.

Methods:

MEDLINE, Embase, Cochrane Library, and Web of Science were searched using controlled vocabulary and keywords to identify RCTs from inception through 9/22/2021. Prospective studies evaluating medical therapy to improve dysphagia in adults with IEM were included. The risk of bias was assessed using the revised Cochrane risk-of-bias tool.

Results:

Among 1046 studies identified, 6 (0.58%) met inclusion criteria with a total of 65 patients. Most studies evaluated serotonin receptor agonists (buspirone, mosapride, prucalopride, and sumatriptan), primarily assessing changes on esophageal high-resolution manometry parameters, and only 1 study evaluated patient reported outcomes. Overall, medical therapy improved these pooled outcomes in 5 (83%) studies. Although treatment endpoints varied, the risk of bias in study reporting was low for 4 studies and uncertain for 2 studies.

Conclusions:

There are currently few therapeutic options available for IEM patients with symptomatic non-obstructive dysphagia. Our systematic review identified 6 studies utilizing medical therapy in patients with IEM, and a majority demonstrated an improvement in HRM parameters. Medical therapy may therefore be considered in this context, but additional studies are warranted to assess for similar improvement in patient symptoms.
How people think about possibilities
Authors: Byrne Ruth M.J.
Published: April 2023

Hypothetical thinking is an extraordinary human ability that allows people to think beyond the facts of a situation to imagine alternative possibilities. I first consider how people understand factual conditionals, such as, ‘if there was an apple in the fruit bowl there was a banana’, then how they understand counterfactual conditionals, such as, ‘if Pearl had studied harder she would have passed the exam’, and then how they understand counterpossible conditionals, that is, conditionals about impossibilities, such as, ‘ if people were made of steel they would not bruise easily’. I discuss the theory that people understand conditionals by envisaging models of possibilities, and consider experimental evidence that corroborates its predictions for factual, counterfactual, and impossible conditionals.
Urban public space quality evaluation methods and practices in China
Authors: Ma Yue , Su Nanxi , Tu Tangqi
Published: April 2023

As the focus of human settlements in China shifts from incremental to quality improvement, scientific assessment and quantitative research on urban public space quality are urgently needed. However, there is no research to review and summarize the progress of urban public space quality evaluation of Chinese publications. Through a systematic review, this study screens the relevant literature of China National Knowledge Infrastructure and conducts statistical analysis on the 43 included studies, including the publication time, authors’ field, study area, study dimension, index system, method and purpose. It is found that Chinese studies on urban public space quality evaluation have developed rapidly in the last five years, and the study objects mainly focus on street space. A few studies (17, 32.6%) can focus on both physical space characteristics and human perception. Compared with traditional methods such as questionnaire survey and field survey, street view images combined with machine learning technology is now the most commonly used method to measure public space quality. The purposes of the existing studies mainly focus on the space quality evaluation itself (22, 51.2%), and the optimization of measurement methods and the externalities, influencing factors and mechanisms of public space quality need to be further studied.
Social cognition in chronic migraine with medication overuse: a cross-sectional study on different aspects of mentalization and social relationships
Authors: Bottiroli Sara , Rosi Alessia , Sances Grazia , Allena Marta , De Icco Roberto , Lecce Serena , Vecchi Tomaso , Tassorelli Cristina , Cavallini Elena
Published: April 2023

Background

Social cognition refers to all mental operations to decipher information needed in social interactions. Here we aimed to outline the socio-cognitive profile of Chronic Migraine with Medication Overuse (CM + MO), given they are recognized to be at risk of socio-cognitive difficulties. Given the multidimensionality of this construct, we considered: (1) socio-cognitive abilities, (2) socio-cognitive beliefs, (3) alexithymia and autism traits, and (4) social relationships.

Methods

Seventy-one patients suffering from CM + MO, 61 from episodic migraine (EM), and 80 healthy controls (HC) were assessed with a comprehensive battery: (1) the Faux Pas test (FP), the Strange Stories task (SS), the Reading Mind in the Eyes test (RMET), (2) the Tromsø Social Intelligence Scale, (3) the Toronto Alexithymia Scale, the Autism Spectrum Quotient, (4) the Lubben Social Network Scale, the Friendship Scale.

Results

CM + MO: (1) performed similar to EM but worse than HC in the FP and SS, while they were worse than EM and HC in the RMET; (2) were similar to EM and HC in social intelligence; (3) had more alexithymic/autistic traits than EM and HC; (4) reported higher levels of contact with their family members but felt little support from the people around them than HC.

Conclusions

CM + MO results characterized by a profile of compromised socio-cognitive abilities that affects different dimensions. These findings may have a relevant role in multiple fields related to chronic headache: from the assessment to the management.
A qualitative study of people who use methamphetamine during the early COVID-19 pandemic to inform future ED harm reduction strategies
Authors: Morse Sophie C. , Fockele Callan , Huynh Ly Ngoc , Zatzick Alina , Whiteside Lauren Kirsten
Published: April 2023

Background

Morbidity and mortality rates related to methamphetamine are on the rise. Simultaneously, social-distancing guidelines were issued in March 2020 to decrease transmission of COVID-19. The aim of this study was to explore concerns regarding methamphetamine use during the COVID-19 pandemic and subsequent harm reduction strategies with patients who use methamphetamine to inform emergency department (ED)-based harm reduction approaches.

Methods

A mixed-methods study of adults residing in Washington with high-risk methamphetamine use and a recent ED visit from April-September 2020 was performed. Participants completed a survey and a semi-structured interview on perceptions and experiences of COVID-19. Descriptive statistics were used for survey responses. Interview transcripts were analyzed and guided by modified grounded theory using an iterative approach to refine the guide and codebook. Interviews were independently coded by 2 investigators and discussed until consensus.

Results

Twenty-five participants completed the survey; 20 participants were interviewed (45% recently used heroin, 40% unstably housed). Thirty-five percent was worried about COVID-19 infection. Three themes emerged from the interviews: (1) increase in meth use, (2) interplay of meth obtention and COVID-19, and (3) interactions with healthcare and social services.

Conclusions

People who use methamphetamine noted an increase in use along with the social distancing guidelines put in place for COVID-19 and employed a variety of harm reduction profiles when obtaining methamphetamine. Also, the pandemic brought difficulties in accessing care and amplified mistrust in healthcare instructions and public health messages. Based on these qualitative interviews, further work should consider aligning methamphetamine and COVID-19 harm reduction messages and working with trusted community resources to improve harm reduction strategies for methamphetamine use and COVID-19. IRB: Informed Consent by the University of Washington Human Subjects Division (approval number, STUDY00009277).
Development of an electrochemical biosensor for the detection of mammary gland carcinoma using molybdenum enhanced poly taurine nano-biofilms confirmed pathological findings
Authors: Nasrollahpour Hassan , Khalilzadeh Balal , Rahbarghazi Reza , Erk Nevin , Rashidi Mohammad-Reza , Naseri Abdolhossein
Published: April 2023

Background

Developing high-performance sensing frameworks for diagnosing anaplastic changes is the subject of debate. The lack of on-time diagnosis in patients with suspicious cancers can affect the prognosis and survival rate. As a correlate, the emergence of de novo strategies for developing transducing frameworks has an inevitable role in advanced biosensing. The combination of green chemistry procedures with eco-friendly and biocompatible materials is of high desirability in this context. The synthesis of new biocompatible and cost-effective nanomaterials to meet the emerging needs of rising demands appeals to new synthetic methodologies.

Methods

Here, we applied the electrochemical synthesis method to the fabrication of biocompatible and subtly governed Molybdenum trioxide/poly taurine nano-bio films to monitor human epidermal growth factor receptor-2 (HER-2) in sera from breast cancer patients. Morphological and elemental assessments were performed using a scanning electron microscope, energy-dispersive X-Ray spectroscopy, and dot mapping analyses. In addition, HER-2 immunohistochemistry (IHC) staining was performed on tissue samples, and data were compared to the values obtained by Molybdenum trioxide/poly taurine nano-bio films.

Results

We also noted our platform is eligible for feasible, rapid, and specific determination of HER-2 factor in human samples. The method had a lower limit of quantification of 0.000001 ng/mL and a linear dynamic range between 0.1 ng/mL and 0.000001 ng/mL. IHC imaging showed that the degree of anaplastic changes in breast samples (intensity of HER-2 factor) was closely associated with the intensity of signals obtained by our developed immunosensor.

Conclusions

According to the obtained desirable coordination with pathological studies, the designed biosensor has excellent capability to use as a reliable diagnostic tool in clinical laboratories.

Graphical Abstract