bluuebunny/crossref_metadata_2025 huggingface dataset:
CAN THE SIZE-SPECIFIC DOSE ESTIMATE BE DERIVED FROM THE BODY MASS INDEX? A FEASIBILITY STUDY
Authors: Steiniger Beatrice , Klippel Chris , Teichgräber Ulf , Reichenbach Jürgen R , Fiebich Martin
Published: April 2022

Size-specific dose estimate ($\mathbf{SSDE}$) index appears to be more suitable than the commonly used volume computed tomography dose index ($\mathbf{C}{\mathbf{TDI}}_{\mathbf{vol}}$) to estimate the dose delivered to the patient during a computed tomography (CT) scan. We evaluated whether an ${\mathbf{SSDE}}_{\mathbf{BMI}}$ can be determined from the patient’s body mass index ($\mathbf{BMI}$) with sufficient reliability in the case that a $\mathbf{SSDE}$ is not given by the CT scanner. For each of the three most used examination types, CT examinations of 50 female and 50 male patients were analyzed. The $\mathbf{SSDE}$ values automatically provided by the scanner were compared with ${\mathbf{SSDE}}_{\mathbf{BMI}}$ determined from $\mathbf{C}{\mathbf{TDI}}_{\mathbf{vol}}$ and $\mathbf{BMI}$. A good accordance of ${\mathbf{SSDE}}_{\mathbf{BMI}}$ and $\mathbf{SSDE}$ was found for the chest and abdominal regions. A low correlation was observed for the head region. The presented method is a simple and practically useful surrogate approach for the chest and abdominal regions but not for the head.
SPECIATION OF CESIUM ISOTOPES IN RIVER WATER: A CASE STUDY IN THE UKEDO RIVER
Authors: Tazoe Hirofumi , Tachizaki Ryo , Tomisaka Yuto , Kuwata Haruka , Akata Naofumi
Published: April 2022

137Cs in river systems can be taken up by aquatic animals. In this paper, total 137Cs concentration in the Ukedo River system and 137Cs presence in dissolved, acid-soluble and -insoluble fractions in river water samples were determined. Total 137Cs concentration had the maximum value of 2.08 Bq kg−1 below the Ogaki Dam in May 2012. In the base flow condition, > 87% of 137Cs existed in the dissolved state, and the acid-soluble state and the insoluble state were <13% and the undetectable level, respectively. After the heavy rain event, the particulate fraction (acid-soluble state + insoluble state) was elevated to 65%, which corresponds to twice as much as that in the base flow condition. Particulate 137Cs, especially the acid-soluble Cs, can play a role when taken into the food chain in aquatic ecosystems.
IN-SITU 5G NR BASE STATION EXPOSURE OF THE GENERAL PUBLIC: COMPARISON OF ASSESSMENT METHODS
Authors: Deprez Kenneth , Verloock Leen , Colussi Loek , Aerts Sam , Van den Bossche Matthias , Kamer Jos , Bolte John , Martens Luc , Plets David , Joseph Wout
Published: April 2022

New measurement methods and equipment for correct 5G New Radio (NR) electromagnetic field (EMF) in-situ exposure assessment of instantaneous time-averaged exposure (Eavg) and maximum extrapolated field exposure (Emax) are proposed. The different options are investigated with in-situ measurements around 5G NR base stations (FR1) in different countries. The maximum electric field values satisfy the ICNIRP 2020 limit (maximum 7.7%). The difference between Emax and Eavg is <3 dB for the different measurement equipment at multiple sites in case there is only self-generated traffic. However, in a more realistic scenario, Eavg cannot be used to assess the exposure correctly due to influence of other users as the spatial distribution of user equipment (UE) influences Eavg, while Emax is not affected. However, when multiple UEs are collocated, there is no influence of the number of UEs. A broadband measurement can give a first impression of the RF-EMF exposure up to 700 m, but is not enough to assess the 5G-NR exposure.
Bringing Family Demography Back In: A Life Course Approach to the Gender Gap in Caregiving in the United States
Authors: Ice Erin
Published: April 2022

Despite decades of progress toward gender equality, women remain as the United States’ primary caregivers. Past research has shown how couples and families organize care at distinct life course moments but has not studied how these moments combine to create differences in men and women’s full life courses of caregiving. In this article, I look beyond negotiations within households to introduce a complementary demographic explanation for the gender gap in caregiving—women’s greater likelihood to reside with dependents. A focus on patterns of coresidence is warranted, given the growing diversity of family forms, which may expose women to additional and varied care demands at differing ages. Drawing on data from the 2011 to 2019 American Time Use Surveys, I study how coresidential care demands shape the population gender gap in childcare and eldercare across ages 20–79 and how demands differ for Black, White, and Latina/o women and men. My results show that coresidence with dependents is uneven across the life course, and women’s exposures occur early and late in adulthood, while men are exposed to more care demands in midlife. Patterns of childbearing, partnership, and extended family embeddedness contribute to Black and Latina women’s greater exposure to care demands early in adulthood and White women’s greater exposure to care demands later in the life course. Thus, despite growing egalitarianism within households, the rise of complex families contributes to bolstering population-level gender inequality in caregiving across adulthood.
Mediating role of psychological distress in the associations between neighborhood social environments and sleep health
Authors: Kim Byoungjun , Troxel Wendy M , Dubowitz Tamara , Hunter Gerald P , Ghosh-Dastidar Bonnie , Chaix Basile , Rudolph Kara E , Morrison Christopher N , Branas Charles C , Duncan Dustin T
Published: April 2022

Study Objectives

The characteristics of neighborhood social environments, such as safety and social cohesion, have been examined as determinants of poor sleep. The current study investigates associations between neighborhood social characteristics and sleep health, as well as the mediating role of psychological distress on these possible associations.

Methods

Three waves of PHRESH Zzz (n = 2699), a longitudinal study conducted in two low-income, predominately Black neighborhoods, were utilized for this analysis. The characteristics of neighborhood social environments were measured using crime rates, a neighborhood social disorder index, and self-reported social cohesion. Sleep health was measured via 7 days of wrist-worn actigraphy as insufficient sleep, sleep duration, wake after sleep onset (WASO), and sleep efficiency. G-estimations based on structural nested mean models and mediation analyses were performed to estimate the effects of neighborhood social environments on sleep as well as direct/indirect effects through psychological distress.

Results

Crime rate around residential addresses was associated with increased risk of insufficient sleep (risk ratio: 1.05 [1.02, 1.12]), increased WASO (β: 3.73 [0.26, 6.04]), and decreased sleep efficiency (β: −0.54 [−0.91, −0.09]). Perceived social cohesion was associated with decreased risk of insufficient sleep (OR: 0.93 [0.88, 0.97]). Psychological distress mediated part of the associations of crime and social cohesion with insufficient sleep.

Conclusions

Neighborhood social environments may contribute to poor sleep health in low-income, predominantly Black neighborhoods, and psychological distress can be a salient pathway linking these neighborhood characteristics and sleep health.
I Know Why the White Lady Cries: Growing Pains of an Antiracist Cleft Habitus
Authors: Ball Amanda C
Published: April 2022

Based on interviews and participant observation of a white antiracist organization, this study asks: Can white people become antiracist? What role do white antiracist organizations play in this process? Bridging literature on whiteness and racialization with theories on habitus, I argue that white antiracist organizations act as incubators for white people to learn the “high culture” of the racial justice field, which is dominated by Black actors. White antiracist organizations provide a space for white people to emotionally process the white habitus and their own racist behaviors, colorblind or otherwise. White antiracists show a shift in behavior and ability to participate in the racial justice field with new-to-them forms of cultural capital but experience a rupture with the white habitus that isolates them as people who are white and antiracist in the larger racial field of the United States. White antiracists experience a cleft habitus that generates discomfort. I expand on the concept of the cleft habitus by including race as central to the process and highlighting the experience of the cleft habitus as it unfolds. These findings expand our understandings of whiteness, habitus, and antiracism as race and racism become more central to conversations about equity in society.
Family Care Work Coverage in Pensions: Mapping and Contextualizing International Variations and Developments
Authors: Frericks Patricia
Published: April 2022

Old-age pensions are the major redistributive system of present-day societies. Central to current discourses on pensions and their reforms is the relevance of work as gainful employment for building up pension rights. Family care work is largely disregarded. Applying the innovative SCQual method, this article systematically quantifies and maps family care work entitlements in ten European countries at different times. The findings suggest that empirical realities and conceptual principles of European pension systems contradict the currently dominant discourses on pensions that result from empirical and theoretical limitations. Family care work entitlements are to be found in all countries, and care work currently provides rather robust entitlements to pensions in most. Since pensions in all welfare states are increasingly built up on the basis of labor-market participation, the different approaches to covering family care work in contribution-based pension systems are separately analyzed.
Maturation Delay of Human GABAergic Neurogenesis in Fragile X Syndrome Pluripotent Stem Cells
Authors: Zhang Ai , Sokolova Irina , Domissy Alain , Davis Joshua , Rao Lee , Hana Utami Kagistia , Wang Yanling , Hagerman Randi J , Pouladi Mahmoud A , Sanna Pietro , Boland Michael J , Loring Jeanne F
Published: April 2022

Fragile X Syndrome (FXS), the leading monogenic cause of intellectual disability and autism spectrum disorder, is caused by expansion of a CGG trinucleotide repeat in the 5ʹ-UTR of the Fragile X Mental Retardation-1 (FMR1) gene. Epigenetic silencing of FMR1 results in loss of the Fragile X Mental Retardation Protein (FMRP). Although most studies to date have focused on excitatory neurons, recent evidence suggests that GABAergic inhibitory networks are also affected. To investigate human GABAergic neurogenesis, we established a method to reproducibly derive inhibitory neurons from multiple FXS and control human pluripotent stem cell (hPSC) lines. Electrophysiological analyses suggested that the developing FXS neurons had a delay in the GABA functional switch, a transition in fetal development that converts the GABAA channel’s function from depolarization to hyperpolarization, with profound effects on the developing brain. To investigate the cause of this delay, we analyzed 14 400 single-cell transcriptomes from FXS and control cells at 2 stages of GABAergic neurogenesis. While control and FXS cells were similar at the earlier time point, the later-stage FXS cells retained expression of neuroblast proliferation-associated genes and had lower levels of genes associated with action potential regulation, synapses, and mitochondria compared with controls. Our analysis suggests that loss of FMRP prolongs the proliferative stage of progenitors, which may result in more neurons remaining immature during the later stages of neurogenesis. This could have profound implications for homeostatic excitatory-inhibitory circuit development in FXS, and suggests a novel direction for understanding disease mechanisms that may help to guide therapeutic interventions.
Intra-articular Injection of Mesenchymal Stem Cells After High Tibial Osteotomy in Osteoarthritic Knee: Two-Year Follow-up of Randomized Control Trial
Authors: Kim Jun-Ho , Kim Kang-Il , Yoon Wan Keun , Song Sang-Jun , Jin Wook
Published: April 2022

Intra-articular injection of adipose-derived mesenchymal stem cell (ADMSC) after medial open-wedge high tibial osteotomy (MOWHTO) would be a promising disease-modifying treatment by correcting biomechanical and biochemical environment for arthritic knee with varus malalignment. However, there is a paucity of clinical evidence of the treatment. This randomized controlled trial (RCT) was aimed to assess regeneration of cartilage defect, functional improvement, and safety of intra-articular injection of ADMSCs after MOWHTO compared with MOWHTO alone for osteoarthritic knee with varus malalignment. This RCT allocated 26 patients into the MOWHTO with ADMSC-injection group (n = 13) and control (MOWHTO-alone) group (n = 13). The primary outcome was the serial changes of cartilage defect on periodic magnetic resonance imaging (MRI) evaluation using valid measurements until postoperative 24 months. Secondary outcomes were the 2-stage arthroscopic evaluation for macroscopic cartilage status and the postoperative functional improvements of patient-reported outcome measures until the latest follow-up. Furthermore, safety profiles after the treatment were evaluated. Cartilage regeneration on serial MRIs showed significantly better in the ADMSC group than in the control group. The arthroscopic assessment revealed that total cartilage regeneration was significantly better in the ADMSC group. Although it was not significant, functional improvements after the treatment showed a tendency to be greater in the ADMSC group than in the control group from 18 months after the treatment. No treatment-related adverse events, serious adverse events, and postoperative complications occurred in all cases. Concomitant intra-articular injection of ADMSCs with MOWHTO had advantages over MOWHTO alone in terms of cartilage regeneration with safety at 2-year follow-up, suggesting potential disease-modifying treatment for knee OA with varus malalignment.
Foreign nongrantor trusts for US beneficiaries: dos and don’ts
Authors: McCaffrey Carlyn S , Zhou Shudan , Cavanagh William G
Published: April 2022

The throwback tax is the US tax law’s main tool for discouraging tax-free accumulation of income by foreign non-grantor trusts for US beneficiaries. Its complex rules are a dangerous minefield that should be avoided. This article reviews the operation of the throwback tax rules, and assesses the effectiveness of this trust anti-deferral regime in various fact patterns. It also discusses how the trust anti-deferral regime interacts with the US law’s foreign corporation anti-deferral regime, another minefield.
Alleviation of chemotherapy-induced acute lung injury via NLRP3/ ASC/ Caspase-1 signaling pathway
Authors: Sherif Iman O , Al-Shaalan Nora H
Published: April 2022

Acute lung injury has been reported following various chemotherapeutic agents administration. Several pathways for lung injury have been speculated however, the exact mechanism of the lung injury induced by methotrexate (MTX) is yet to be defined. The potential protective effect of Ginkgo biloba extract (GB), a Chinese herbal medicine, against MTX-induced lung injury is still not reported. Therefore, this study was performed to examine the possible implication of NLRP3 inflammasome and miRNA-21 in the pathogenesis of the MTX-induced lung injury as well as the protective role of GB in ameliorating the induced lung injury. Rats received GB (100 mg/kg/day, orally) for 10 days and MTX (20 mg/kg single dose, intraperitoneally) on the fifth day. MTX-induced lung injury was manifested by lung histopathology. MTX exhibited a marked increase in lung malondialdehyde beside a notable decrease in lung reduced glutathione. Moreover, MTX injection activated the lung NLRP3 inflammasome by significant upregulation of the NLRP3, ASC, caspase-1 lung mRNA expressions and protein levels in addition to lung NF-kBp65 protein expression, and miRNA-21 expression when compared with the normal control group. However, GB administration mitigated lung injury and inhibited the NLRP3 activation. This study is the first report to reveal the involvement of NLRP3 inflammasome in the pathogenesis of MTX-induced lung injury and also to show that the administration of GB alleviates the lung injury induced by MTX via suppressing the oxidative stress, restoring the antioxidant activity, blocking the NLRP3/ASC/Caspase-1 signaling and downregulating the NF-kBp65 protein expression ae well as miRNA-21 expression in lung tissue.
Immobilization stress exacerbates arsenic-induced reprotoxic effects in adult rats
Authors: Venkaiah Kaduru , Daveedu Thathapudi , Prathima Papisetty , Pavani Ramanadhapuram , Sukeerthi Sadepalli , Reddy Malapati Hanuma , Pradeepkiran Jangampalli Adi , Sainath Sri Bhashyam
Published: April 2022

Objective

The central objective of this study was to investigate the cumulative effects restraint stress and sodium arsenite on reproductive health in male rats.

Methods

Healthy male Wistar rats were allocated into 4 groups (n = 8). Animals in group 1 served as controls and did not subjected to any stress. Rats in groups 2, 3, and 4 were subjected to either restraint stress (5 h/day) or maintained on arsenic (25 ppm) via drinking water or both for 65 days. After completion of the experimental period, all the rats were analyzed for selected reproductive endpoints.

Results

Restraint stress or sodium arsenite treatment increased serum corticosterone levels, reduced testicular daily sperm count, epididymal sperm viability, motility, membrane integrity, and decreased testicular steroidogenic enzymes such as 3β- and 17β-hydroxysteroid dehydrogenases associated with reduced serum testosterone levels, deteriorated testicular architecture, and reduced activity levels of testicular superoxide dismutase and catalase accompanied by elevated lipid peroxidation levels. In rats subjected to restraint stress and sodium arsenite, a significant decrease in selected sperm qualitative and quantitative parameters, serum testosterone levels were observed as compared with rats subjected to sodium arsenite alone. A significant increase in the levels of lipid peroxidation with a concomitant decrease in the activities of antioxidant enzymes was observed in the testis of rats subjected to both restraint stress and sodium arsenite treatment as compared with sodium arsenite alone intoxicated rats. Surprisingly, serum corticosterone levels were significantly elevated in rats following both stressors as compared with arsenic alone treated rats. Analysis of atomic absorption spectroscopy revealed that the accumulation of arsenic in the testis of arsenic-treated and arsenic plus immobilization stress groups was significant as compared with controls.

Conclusions

Based on the findings, it can be concluded that deterioration of male reproductive health could be accelerated in arsenic intoxicated rats following restraint stress.
Defining virus-carrier networks that shape the composition of the mosquito core virome of a local ecosystem
Authors: Konstantinidis Konstantinos , Dovrolis Nikolas , Kouvela Adamantia , Kassela Katerina , Rosa Freitas Maria Goreti , Nearchou Andreas , de Courcy Williams Michael , Veletza Stavroula , Karakasiliotis Ioannis
Published: April 2022

Mosquitoes are the most important vectors of emerging infectious diseases. During the past decade, our understanding of the diversity of viruses they carry has greatly expanded. Most of these viruses are considered mosquito-specific, but there is increasing evidence that these viruses may affect the vector competence of mosquitoes. Metagenomics approaches have focused on specific mosquito species for the identification of what is called the core virome. Despite the fact that, in most ecosystems, multiple species may participate in virus emergence and circulation, there is a lack of understanding of the virus-carrier/host network for both vector-borne and mosquito-specific viruses. Here, we studied the core virome of mosquitoes in a diverse local ecosystem that had 24 different mosquito species. The analysis of the viromes of these 24 mosquito species resulted in the identification of 34 viruses, which included 15 novel viruses, as determined according to the species demarcation criteria of the respective virus families. Most of the mosquito species had never been analysed previously, and a comparison of the individual viromes of the 24 mosquito species revealed novel relationships among mosquito species and virus families. Groups of related viruses and mosquito species from multiple genera formed a complex web in the local ecosystem. Furthermore, analyses of the virome of mixed-species pools of mosquitoes from representative traps of the local ecosystem showed almost complete overlap with the individual-species viromes identified in the study. Quantitative analysis of viruses’ relative abundance revealed a linear relationship to the abundance of the respective carrier/host mosquito species, supporting the theory of a stable core virome in the most abundant species of the local ecosystem. Finally, our study highlights the importance of using a holistic approach to investigating mosquito viromes relationships in rich and diverse ecosystems.
Final 24-hour Drain Output and Postoperative Day Are Poor Indicators for Appropriate Drain Removal
Authors: Chua Charleston , Bascone Corey M. , Pereira Clifford , Hai Josephine , Park Jeannie , Hideshima Kelsey , Bhatti Satninderdeep , Nemanpour Shadi , Leon Bella , Han Gloria
Published: April 2022

Background:

Drains are used in plastic surgery to remove excess fluid while ameliorating complications. However, there is a paucity of evidence supporting guiding parameters on when to discontinue a drain. The aim of our study was to determine whether two of the most common parameters, drain volume 24 hours before removal or postoperative day, are valid indicators for drain removal.

Methods:

A retrospective chart review was conducted for surgical operations performed by our division between July 2014 and May 2019. Of the 1308 patients, 616 had a drain and a complete record. Demographics, medical history, operative time, antibiotic use, anatomic site, donor/recipient, and complication type were recorded. Complications were defined as events that deviated from expected postoperative course or required pharmacological/procedural intervention. T-test and Chi square were used to analyze data.

Results:

In total, 544 patients were in the no complication group, and 72 were in the complication group. The complication group patients had drains removed later than patients in the no complication group (15.7 days versus 12.5 days, P = 0.0003) and had similar final 24-hour drain volumes versus patients in the no complication group (16.7 mL versus 18.8 mL, P = 0.2548). The complication group had more operations on the pelvis (11% versus 2.1%; P = 0.000017) or thigh (8.5% versus 3.4%; P = 0.029).

Conclusions:

Our data suggest neither postoperative day nor 24-hour volume before drain removal are valid indicators for removal. Late removal correlates with more complications; however, persisting output leading to later removal may be predictive of an impending complication rather than delays in drain removal causing the complication.
Delayed Hypersensitivity Reaction to Titanium-coated Polypropylene Mesh in Breast Reconstruction
Authors: Jouve Eva , Giordano-Labadie Françoise , Selmes Gabrielle , Soule-Tholy Marc , Navarro Anne-Sophie , Gangloff Dimitri , Meresse Thomas , Duprez-Paumier Raphaelle , Tournier Emilie , Vaysse Charlotte
Published: April 2022

Breast implant reconstructions increasingly incorporate meshes like the synthetic nonresorbable titanium-coated polypropylene mesh commercialized as Tiloop (Pfm medical). We report the case of a 48-year-old woman, with a medical history of nickel allergy, who presented with an extensive erythematous eruption, a periprosthetic reaction, and an axillary node reaction, 18 months after a unilateral prophylactic mastectomy. We excluded infectious, sarcoidosis and carcinomatosis. The patient’s medical history, the clinical evolution, and the particularly fast and complete healing after removal of the mesh were suggestive of an unusual allergic reaction to the titanium in the titanium-coated polypropylene mesh. Titanium allergies are very rare events, predominantly described in the dental and orthopedic fields. We also discussed the hypothesis of a tardive red breast syndrome related to a synthetic mesh, also mediated by immunological response as described recently in another case report.
AN 8-YEAR-OLD CALIFORNIA GIRL WITH ASYMPTOMATIC HEPATIC CYSTS
Authors: Passarelli Patrick , Ramchandar Nanda , Naheedy John , Kling Karen , Choi Lillian , Pong Alice
Published: April 2022

Echinococcus infections are rare in the United States but may present a growing public health threat. We present the case of an 8-year-old female patient from Southern California who was diagnosed with hepatic echinococcosis after the incidental discovery of large hepatic cysts.
Treatment of Severe Refractory Thrombocytopenia in Brucellosis with Eltrombopag: A Case Report
Authors: Zhang Xian-Wen , Ren Peng , Huang Ti-Long
Published: April 2022

Brucellosis is a zoonotic disease. Severe refractory thrombocytopenia caused by brucellosis is very rare and easily misdiagnosed. We reported a 5-year-old girl who developed severe refractory thrombocytopenia secondary to brucellosis. The first-line treatment including corticosteroids and intravenous immunoglobulin did not elevate her platelets, but eltrombopag worked well and her platelet count recovered rapidly.
Two Balance Measures as Poststroke Predictors of Ambulation Status at Discharge From Inpatient Rehabilitation
Authors: Berry Olivia , Voigtmann Christina , Curran Christopher , Dawson Nicole , Dominguez Jose , Beato Morris
Published: April 2022

Purpose:

Early predictors of the degree of walking ability poststroke are vital considering the decreased length of stay in most inpatient rehabilitation facilities (IRFs). Prediction of functional walking capability upon discharge from IRFs requires more investigation. This study aimed to (1) determine whether the Postural Assessment Scale for Stroke (PASS) and the Berg Balance Scale (BBS) can predict an individual's IRF discharge poststroke gait category and (2) establish cut-off scores for these assessments to better forecast gait category upon discharge.

Methods:

A total of 180 individuals with an admitting stroke diagnosis were assessed with both balance measures and the 10-m walking test at admission and discharge from inpatient rehabilitation. Participants were stratified by gait speed into 4 groups (nonambulators: 0 m/s; household ambulators: <0.4 m/s; limited community ambulators: 0.4-0.8 m/s; and community ambulators: >0.8 m/s).

Results:

Both the admission PASS and the BBS scores may predict patients who will be ambulatory and performed similarly in differentiating between gait classifications upon discharge from inpatient rehabilitation (P < .01). Cut-off scores of 6 or less on the BBS (sensitivity 96%; specificity 83%) and 17 on the PASS (sensitivity 92%; specificity 90%) were established to predict nonambulators, and cut-off scores of 29 or more on the BBS (sensitivity 92%; specificity 86%) and 30 on the PASS (sensitivity 80%; specificity 87%) were established to predict community ambulators.

Conclusions:

These results can inform clinicians of poststroke patients' walking prognosis and advise discharge needs early in a patient's IRF stay.
In Vivo Evaluation of a Novel Control Algorithm for Left Ventricular Assist Devices Based Upon Ventricular Stroke Work
Authors: Habigt Moriz A. , Hein Marc , Gesenhues Jonas , Abel Dirk , Rossaint Rolf , Mechelinck Mare
Published: April 2022

The physical fitness of patients with terminal heart failure and an implanted left ventricular assist device (LVAD) might be improved by load-adaptive control of the LVAD. In this study, three control strategies for LVAD were compared in eight pigs: (1) a constant stroke work (CSW) control strategy that ensures a constant ventricular load using ventricular stroke work as the control variable; (2) a work ratio (WR) controller that maintains a constant ratio of ventricular work to hydraulic pump work; and (3) a controller that maintains the pump pace at a constant speed (CS). Biventricular heart insufficiency was induced by increased isoflurane application, and preload, afterload, and contractility alterations were performed. LVAD speed changes were significantly more pronounced in all load interventions with the CSW control strategy (preload: P < 0.001 vs. CS and P = 0.004 vs. WR; afterload: P < 0.001 vs. CS and P < 0.001 vs. WR; contractility: P < 0.001 vs. CS and P < 0.001 vs. WR). However, a significant difference in systemic flow only became evident in the experiments upon afterload increase (P < 0.001 vs. CS and P = 0.004 vs. WR). An implementation of an evolved version of the CSW control strategy that dispenses with invasively measured parameters might be feasible for clinical use.
Kerion Celsi caused by Microsporum gypseum in a Chinese child, a case report
Authors: Wei Shuyue , Wang Haiying , Li Ailan , Yuan Chunying
Published: April 2022

Rationale:

Kerion Celsi, a severe form of tinea capitis, is generally caused by zoophilic and geophilic fungi. This is the first report of an unusual case of kerion Celsi caused by Microsporum gypseum in a 6-year-old boy.

Patient concerns:

A 6-year-old boy presented to the dermatology clinic with the complaint of multiple pustules, edematous plaques over the scalp with hair loss for 1 month.

Diagnosis:

Clinical and laboratory investigations, including reverse transcriptase-quantitative polymerase chain reaction, confirmed M gypseum causing kerion Celsi.

Interventions:

Upon combination therapy using oral itraconazole and oral prednisolone along with the topical terbinafine, kerion Celsi remitted in the patient.

Outcome:

New hair growth was noted during the 4-month follow-up.

Lesson:

We presented the first case of kerion Celsi infection secondary to M gypseum that was probably transmitted from a guinea pig.
Effectiveness and safety of chemotherapy combined with immunomodulatory therapies for multiple myeloma
Authors: Deng Jie , Liu Li , Sun Jianhai , Ma Yanlin , Li Li
Published: April 2022

Background:

Multiple myeloma (MM) is considered one of the prevalent malignant plasma cell diseases affecting people. In essence, maintenance treatment is valuable for prolonging the survival time of patients experiencing MM. The majority of the currently used treatment protocols for MM are founded on a combination of chemotherapy and immunomodulatory drugs, of which immunomodulatory drugs seems to be one of the most active drugs. However, in the literature, chemotherapy combined with immunomodulatory therapies have not been unambiguously proven. To systematically appraise and synthesize these results, the present investigation will evaluate whether combining chemotherapy with immunomodulatory therapies an effective and safe approach to treating patients with MM.

Methods:

Two authors relied in 7 different databases: PubMed, EMBASE, Cochrane Library, Web of Science, WanFang Database, Chinese Biomedical Literature Database, China National Knowledge Infrastructure and for studies on chemotherapy's effectiveness when combined with immunomodulatory therapies. The authors only considered studies published up to December 16, 2021 and only those written in English or Chinese. They will also carry out selection of studies, extraction of data, along with assessing risk of bias. Besides, they will also use RevMan V.5.3 to conduct data synthesis. They will establish heterogeneity using the I
2 test. At the same time, the authors will evaluate publication bias by making a funnel plot and conducting the Begg as well as Egger tests.

Ethics and dissemination:

The present study will not necessitate ethics approval since it will be funded on already published works.

OSF registration number:

10.17605/OSF.IO/X7DE4.
Traction method versus conventional endoscopic submucosal dissection for gastric epithelial neoplasms
Authors: Kinoshita Jun , Iguchi Mikitaka , Maekita Takao , Wan Ke , Shimokawa Toshio , Fukatsu Kazuhiro , Ito Daisaku , Taki Shinya , Nishimoto Masayuki , Takao Masaki , Tabata Yasuto , Mukai Yousuke , Kitano Masayuki
Published: April 2022

Introduction:

Endoscopic submucosal dissection (ESD) is an advanced therapeutic technique for en bloc resection of superficial gastrointestinal neoplasms. Although gastric ESD is minimally invasive and provides favorable outcomes, it is technically difficult and requires a long procedure time for dissection. The traction-assisted approach overcomes some of the difficulties of gastric ESD, but its ability to reduce the procedure time remains unclear. The traction-assisted approach using dental floss and a clip did not reduce procedure time in the total population, but it reduced procedure time for lesions limited to the greater curvature of the upper or middle of the stomach. Although the traction direction of the clip-with-line method may be limited to the oral side via the cardia, EndoTrac ESD may provide flexible traction at any time during the procedure. This prospective randomized control study has been designed to compare the efficacy and safety of EndoTrac and conventional gastric ESD.

Methods/design:

This multicenter, randomized control trial will enroll 150 patients at 2 hospitals in Japan undergoing EndoTrac or conventional ESD for gastric epithelial neoplasia. Patients with a single gastric epithelial neoplasm who meet the inclusion and exclusion criteria will be randomized to EndoTrac or conventional ESD. Patients will be randomized by a computer-generated random sequence with stratification by operator experience, tumor size, tumor location, and institution. The primary endpoint will be ESD procedure time, defined as the time from the start of the submucosal injection to the completion of resection. Other outcomes will include the rates of adverse events and pathological curability

Discussion:

The ability of EndoTrac ESD to reduce the long procedure time and/or adverse events observed with conventional ESD can not only reduce physical stress on the patient, but can also reduce length of hospital stay and medical costs. Reduced technical difficulty will contribute to the widespread adoption of this ESD technique worldwide.

Trial registration:

University Hospital Medial Information Network Clinical Trials Registry (UMIN-CTR), ID: 000044450; Registered on June 6, 2021.

https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000050485.

Protocol version number:

1.1, March 1, 2022. Patient enrolment began on June 6, 2021 and is expected to be completed by July 19, 2025.
Nonimprovement in Chronic Fatigue Syndrome: Relation to Activity Patterns, Uplifts and Hassles, and Autonomic Dysfunction
Authors: Friedberg Fred , Adamowicz Jenna L. , Bruckenthal Patricia , Milazzo Maria , Ramjan Sameera , Quintana Daniel
Published: April 2022

Objective

To test a model of nonimprovement in chronic fatigue syndrome (CFS) using self-report activity patterns (e.g., “push-crash”), uplifts and hassles, and a biological measure of cardiac autonomic function. Activity pattern impacts on symptoms and objective measures of autonomic and physical activity were also examined.

Methods

This prospective study in CFS collected all data remotely, including 6 months of weekly web diaries that recorded symptom ratings, activity patterns, and hassles and uplifts. In addition, 6 months of weekly heart monitoring and 3 months of daily waking actigraphy data were collected. Improvement or nonimprovement status was assessed using semistructured interviews at the 6-month follow-up.

Results

A total of 148 individuals (87.2% female) were enrolled, and 12.2% were lost to follow-up. Participants reporting nonimprovement (n = 92), as compared with improvement (n = 38), showed greater autonomic dysfunction (lower heart rate variability, group difference = 5.93 [SE = 2.73] milliseconds; p = .032) and lower mean intensity of behavioral uplifts (group difference = 0.14 [SE = 0.16]; p = .043), but no significant differences in any activity pattern, including push-crash, limiting activity, and healthy pacing.

Conclusions

This study provided evidence for linking patient-reported nonimprovement to a biological variable indexing autonomic dysfunction and a behavioral measure indicating a deficit in psychological uplifts. These findings suggest a possible marker of illness trajectory that could potentially advance the biomedical underpinnings of CFS.

Trial Registration:
ClinicalTrials.gov ID: NCT02948556.
Facial Emotion Expression and the Inducibility of Myocardial Ischemia During Cardiac Stress Testing: The Role of Psychological Background Factors
Authors: Bekendam Maria T. , Mommersteeg Paula M.C. , Vermeltfoort Ilse A.C. , Widdershoven Jos W. , Kop Willem J.
Published: April 2022

Objective

Negative emotional states, such as anger and anxiety, are associated with the onset of myocardial infarction and other acute clinical manifestations of ischemic heart disease. The likelihood of experiencing these short-term negative emotions has been associated with long-term psychological background factors such as depression, generalized anxiety, and personality factors. We examined the association of acute emotional states preceding cardiac stress testing (CST) with inducibility of myocardial ischemia and to what extent psychological background factors account for this association.

Methods

Emotional states were assessed in patients undergoing CST (n = 210; mean [standard deviation] age = 66.9 [8.2] years); 91 (43%) women) using self-report measures and video recordings of facial emotion expression. Video recordings were analyzed for expressed anxiety, anger, sadness, and happiness before CST. Psychological background factors were assessed with validated questionnaires. Single-photon emission computed tomography was used to evaluate inducibility of ischemia.

Results

Ischemia occurred in 72 patients (34%). Emotional states were not associated with subsequent inducibility of ischemia during CST (odds ratio between 0.93 and 1.04; p values > .50). Psychological background factors were also not associated with ischemia (odds ratio between 0.96 and 1.06 per scale unit; p values > .20) and did not account for the associations of emotional states with ischemia.

Conclusions

Emotional states immediately before CST and psychological background factors were not associated with the inducibility of ischemia. These findings indicate that the well-documented association between negative emotions with acute clinical manifestations of ischemic heart disease requires a different explanation than a reduced threshold for inducible ischemia.
Health Impact and Cost-Effectiveness of HIV Testing, Linkage, and Early Antiretroviral Treatment in the Botswana Combination Prevention Project
Authors: Resch Stephen C. , Foote Julia H. A. , Wirth Kathleen E. , Lasry Arielle , Scott Justine A. , Moore Janet , Shebl Fatma M. , Gaolathe Tendani , Feser Mary K. , Lebelonyane Refeletswe , Hyle Emily P. , Mmalane Mompati O. , Bachanas Pamela , Yu Liyang , Makhema Joseph M. , Holme Molly Pretorius , Essex Max , Alwano Mary Grace , Lockman Shahin , Freedberg Kenneth A.
Published: April 2022

Background:

The Botswana Combination Prevention Project tested the impact of combination prevention (CP) on HIV incidence in a community-randomized trial. Each trial arm had ∼55,000 people, 26% HIV prevalence, and 72% baseline ART coverage. Results showed intensive testing and linkage campaigns, expanded antiretroviral treatment (ART), and voluntary male medical circumcision referrals increased coverage and decreased incidence over ∼29 months of follow-up. We projected lifetime clinical impact and cost-effectiveness of CP in this population.

Setting:

Rural and periurban communities in Botswana.

Methods:

We used the Cost-Effectiveness of Preventing AIDS Complications model to estimate lifetime health impact and cost of (1) earlier ART initiation and (2) averting an HIV infection, which we applied to incremental ART initiations and averted infections calculated from trial data. We determined the incremental cost-effectiveness ratio [US$/quality-adjusted life-years (QALY)] for CP vs. standard of care.

Results:

In CP, 1418 additional people with HIV initiated ART and an additional 304 infections were averted. For each additional person started on ART, life expectancy increased 0.90 QALYs and care costs increased by $869. For each infection averted, life expectancy increased 2.43 QALYs with $9200 in care costs saved. With CP, an additional $1.7 million were spent on prevention and $1.2 million on earlier treatment. These costs were mostly offset by decreased care costs from averted infections, resulting in an incremental cost-effectiveness ratio of $79 per QALY.

Conclusions:

Enhanced HIV testing, linkage, and early ART initiation improve life expectancy, reduce transmission, and can be cost-effective or cost-saving in settings like Botswana.
The Siege of Ayder Hospital: A Cri de Coeur From Tigray, Ethiopia
Authors: Wall L. Lewis
Published: April 2022

In November 2020, the federal government of Ethiopia invaded its northern region of Tigray, in collusion with the Government of Eritrea and ethnic Amhara militias. The invading forces pillaged the schools, destroyed the transportation infrastructure, burned crops and killed livestock, and looted the health care system. Thousands of civilians were killed, often in extrajudicial executions. Thousands of Tigrayan women were raped. Tens of thousands of Tigrayans fled to Sudan as refugees. Hundreds of thousands face famine and millions more have been internally displaced. The region is under a total communications blackout. The banking system has collapsed. The federal government has harassed external aid workers and imposed a de facto blockade on all medicines and famine relief. A man-made humanitarian catastrophe unlike any in recent memory is unfolding. The world medical community must speak up. The madness must stop.
Optic Perineuritis Associated With Cryptococcal Meningitis Presenting With a “Hot Orbit” in a Patient With Chronic Lymphocytic Leukemia
Authors: Liebman Daniel L. , Tam Emily K. , Lithgow Marie Y. , Kane Joseph E. , Fischbein Nancy J. , Lefebvre Daniel R. , Chwalisz Bart K. , Gaier Eric D.
Published: April 2022

A 75-year-old man presented with 3 days of progressive left retro-orbital pain, eyelid swelling, tearing, and pain with extraocular movement. His medical history was significant for type II diabetes mellitus and chronic lymphocytic leukemia, stable on no therapy since diagnosis 8 years prior. The initial examination was significant for diffuse restriction of left ocular motility, marked lid edema, and mild dyschromatopsia. Computed tomography demonstrated asymmetric left periorbital soft tissue swelling and intraconal fat stranding with an irregular left optic nerve sheath complex and clear paranasal sinuses. He was hospitalized for orbital cellulitis and treated empirically with broad-spectrum intravenous antibiotics, but his visual acuity declined over the ensuing 2 days. Subsequent MRI demonstrated left-greater-than-right circumferential optic nerve sheath enhancement, and leptomeningeal enhancement. An orbital biopsy demonstrated monoclonal B-cell lymphocyte aggregation, whereas a lumbar puncture was positive for Cryptococcus antigen with subsequent demonstration of abundant Cryptococcus by Papanicolaou stain. The final diagnosis was optic perineuritis secondary to cryptococcal meningitis presenting with orbital inflammation. Although his clinical course was complicated by immune reconstitution inflammatory syndrome, symptoms and signs of optic neuropathy ultimately resolved after 1 month of intensive antifungal therapy.
Impact of Greater Occipital Nerve Block on Photophobia Levels in Migraine Patients
Authors: Membrilla Javier A. , de Lorenzo Íñigo , Sánchez-Casado Lucía , Sastre María , Díaz de Terán Javier
Published: April 2022

Background:

To study the effect of greater occipital nerve (GON) block on migraine-associated photophobia levels. Photophobia is one of the most bothersome symptoms reported by migraine patients. Studies investigating the impact of migraine treatment on this symptom are scarce.

Methods:

This is an observational prospective case–control study. Patients with migraine and photophobia attending a Headache Clinic were recruited. Cases were defined as patients in whom GON block was performed, following usual clinical practice guidelines. All patients were evaluated with the Hospital Anxiety and Depression Scale, the Migraine Specific Quality of Life Questionnaire, the Utah Photophobia Symptom Impact Scale (UPSIS-12), and the Korean Photophobia Questionnaire (KUMC-8); both in the first visit (V1) and one week after (V2).

Results:

Forty-one patients were recruited, 28 (68.3%) cases and 13 (31.7%) controls. At V1, there were no significant differences in the median [p25-p75] score of UPSIS-12 in cases vs controls (32.0 [21.0–34.0] vs 30.5 [22.0–37.0], P = 0.497) or KUMC-8 (6.5 [5.5–7.0] vs 7.0 [6.0–8.0], P = 0.463). At V2, cases experimented a significant improvement in UPSIS-12 of −5.5 [−8.8 to −1.3] and in KUMC-8 of −0.5 [−2.0 to 0], whereas there were no significant changes in the control group. Migraine with aura patients presented higher UPSIS-12 score at V1 (33.5 [24.5–37.0] vs 26.0 [16.0–35.0]) and lesser improvement at V2 after GON block compared with migraine without aura patients (−4.0 [−6.0 to −1.0] vs −8.0 [−17.0 to −2.0]), although statistical significance was not achieved (P = 0.643 and P = 0.122, respectively). There was no significant variation in the remaining scales.

Conclusions:

Greater occipital nerve block improves migraine-associated photophobia, measured with UPSIS-12 and KUMC-8. Patients without aura may exhibit a greater improvement. Physicians could consider GON block for management of photophobia in migraine patients.