bluuebunny/crossref_metadata_2025 huggingface dataset:
P-597 SUPPORT NEEDS FOR RETURN TO WORK AMONG SELF-EMPLOYED WORKERS: A FOCUS GROUP STUDY
Authors: De Wit Mariska , Montanus Alexandra , Bosma Astrid , Juurlink Trees
Published: July 2024

Introduction

In the Netherlands, support during sick leave and return to work (RTW) differs between self-employed workers and workers in paid employment. Studies on how to support self-employed workers during their RTW are lacking. Therefore, in this study we aim to explore facilitators, barriers and support needs of self-employed workers when returning to work.

Methods

Three focus groups with in total 15 Dutch self-employed workers who were on sick-leave due to physical or mental health problems, were conducted. The transcripts of the focus groups were analyzed through qualitative content analysis.

Results

Self-employed workers indicated that having autonomy and control over their working hours can be a facilitator for RTW. Most workers did not have disability insurance, mostly because it is too expensive. Therefore, they experienced pressure to keep working despite health complaints. They mentioned a lack of information about self-employment, sick leave and financial consequences. Overall, the workers indicated a need for more financial support, more guidance from occupational health professionals and tailored information regarding their RTW process.

Discussion

Although being self-employed can have advantages when it comes to RTW after sick-leave, overall self-employed workers experience a lack of support in their RTW. The results of this study emphasize the need for optimizing national policy and support for self-employed workers with health problems.

Conclusion

More financial support, guidance from occupational health professionals and tailored information could help self-employed workers during their sick leave and RTW.
P-605 SUPPORTING EMPLOYERS IN IMPLEMENTING GRADUAL RETURNS TO WORK: A TRANSDIAGNOSTIC AND INCLUSIVE TOOL
Authors: Durand Marie-José , Coutu Marie-France , Sylvain Chantal , Côté Daniel
Published: July 2024

Introduction

The Tool for Supporting a Gradual Return to Work (TS-GRTW) allows implementation of gradual RTW by facilitating collaboration between employers and workers with MSD-related work disabilities. This tool was adapted for use with workers who have common mental disorders, taking some vulnerability factors into account. The aim is to test the usability of this adapted tool with individuals responsible for disability management in workplaces.

Methods

A simple descriptive design was retained. Purposive sampling was used to recruit 23 individuals working for at least the previous year in disability management in their workplace. Various types of workplaces were sought. Semi-structured interviews were conducted and transcribed. The verbatim were analyzed based on a qualitative approach.“

Results

The participants (6 M, 17 F, mean age 42.6 years, SD 8.1) came from 10 activity sectors, mostly in large companies. Many of them (17/23) saw benefits in using the tool in their organization, as it allows to:

1. standardize the RTW process,

2. delegate tasks to managers and supervisors,

3. structure communication among stakeholders,

4. monitor actions

5. motivate worker engagement, and

6. foster common understanding and legitimization of the process within the organization.

A large proportion of participants (17/23) envisaged using the tool. Certain organizational constraints could limit implementation (e.g. lack of time).

Discussion

Our results support the usability of the adapted TS-GRTW by potential users. However, our results mainly reflect large companies, which often have structures in place.

Conclusion

The next step would be to test usability with the workers and its implementation.
P-619 ASSESSMENT OF MUSCULOSKELETAL DISORDERS AND ASSOCIATED RISK FACTORS IN AN AGRI-FOOD FACTORY: A CROSS-SECTIONAL STUDY
Authors: Daoud Hanene , Sellami Imen , Ben Chabene Cyrine , Feki Afef , Rmadi Nehla , Meska Ahmed , Ghrab Mohamed Anis , Haddar Aicha , Hajjaji Mounira , Masmoudi Mohamed Larbi , Hammami Kaouthar Jmal
Published: July 2024

Introduction

Musculoskeletal disorders (MSDs) in the agri-food sector result from various work-related factors, posing challenges for companies. This study aims to assess MSDs and associated sociodemographic, occupational, and psychosocial risk factors.

Methods

A cross-sectional study in a Sfax confectionery factory involved 132 workers. Questionnaires and workplace assessments gathered data. The Nordic Musculoskeletal Questionnaire screened for MSDs, while the Depression Anxiety Stress Scale-21 evaluated mental health.

Results

The majority were women (61.2%). The mean age was 33.2 ± 8.7 years, with 8.5 ± 8 years of work experience. Participants worked 48 hours/week, with 56% perceiving workload as difficult. Prevalence of MSDs was 62.1%, primarily in the lower back (33.3%), neck (28.9%), and shoulders (28.5%). Severe depression, anxiety, and stress symptoms were observed in 8.3%, 17.4%, and 12.1% respectively. MSDs were significantly associated with age, work experience, work ability, biomechanical constraints, and mental health issues.

Discussion

Industrious sector work exposes employees to physical and psychosocial factors, contributing to MSDs. Associations between MSDs, age, work experience, work ability, biomechanical constraints, and mental health issues emphasize the complex interplay of factors influencing MSD occurrence.

Conclusion

Working conditions in the agri-food sector led to MSDs. Detecting MSDs and their risk factors can guide preventive strategies to enhance workplace health and safety.
Workplace ethical climate and its relationship with depression, anxiety and stress
Authors: Borrelli I , Melcore G , Perrotta A , Santoro P E , Rossi M F , Moscato U
Published: July 2024

Background

Ethical climate in the workplace has been highlighted to have an important impact on workers’ mental health; the evaluation of workplace ethics and its impact on workers’ health should be considered an occupational health issue.

Aims

The present study aims to investigate ethical climate as perceived by workers, and its correlation with mental health outcomes, in particular, symptoms of depression, anxiety and stress.

Methods

A cross-sectional study was performed by administering an online survey, investigating socio-demographic variables, workplace ethics (through the Italian short version of the Corporate Ethical Virtues questionnaire) and mental health outcomes (using the short version of the Depression, Anxiety and Stress Scale). Descriptive analyses, analyses of variance and regression models were performed; P-values were considered significant for values ≤0.05.

Results

The sample included 176 workers; the mean age of participants was 46.22 years and 44% were males. The most represented job sector was health care (37%), and 42% of participants had college-level education. Ethical climate was significantly correlated with all mental health outcomes investigated in the study: anxiety (P ≤ 0.001), depression (P ≤ 0.05) and stress (P ≤ 0.05).

Conclusions

Results from this study highlighted a significant correlation between workplace ethical climate and depression, anxiety and stress. This study underlines the importance of evaluating and improving ethical climate to prevent the onset of psychological distress in workers. Furthermore, results from this study should be a starting point for future research investigating the role of ethics and mental health in employees’ turnover intention and job satisfaction.
Association of Hyperoxia During Cardiopulmonary Bypass and Postoperative Delirium in the Pediatric Cardiac ICU
Authors: Weatherly Allison J. , Johnson Cassandra A. , Liu Dandan , Kannankeril Prince J. , Smith Heidi A.B. , Betters Kristina A.
Published: July 2024

OBJECTIVE:

ICU delirium commonly complicates critical illness associated with factors such as cardiopulmonary bypass (CPB) time and the requirement of mechanical ventilation (MV). Recent reports associate hyperoxia with poorer outcomes in critically ill children. This study sought to determine whether hyperoxia on CPB in pediatric patients was associated with a higher prevalence of postoperative delirium.

DESIGN:

Secondary analysis of data obtained from a prospective cohort study.

SETTING:

Twenty-two-bed pediatric cardiac ICU in a tertiary children’s hospital.

PATIENTS:

All patients (18 yr old or older) admitted post-CPB, with documented delirium assessment scores using the Preschool/Pediatric Confusion Assessment Method for the ICU and who were enrolled in the Precision Medicine in Pediatric Cardiology Cohort from February 2021 to November 2021.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Of 148 patients, who underwent cardiac surgery, 35 had delirium within the first 72 hours (24%). There was no association between hyperoxia on CPB and postoperative delirium for all definitions of hyperoxia, including hyperoxic area under the curve above 5 predetermined Pao
2 levels: 150 mm Hg (odds ratio [95% CI]: 1.176 [0.605–2.286], p = 0.633); 175 mm Hg (OR 1.177 [95% CI, 0.668–2.075], p = 0.572); 200 mm Hg (OR 1.235 [95% CI, 0.752–2.026], p = 0.405); 250 mm Hg (OR 1.204 [95% CI, 0.859–1.688], p = 0.281), 300 mm Hg (OR 1.178 [95% CI, 0.918–1.511], p = 0.199). In an additional exploratory analysis, comparing patients with delirium within 72 hours versus those without, only the z score for weight differed (mean [sd]: 0.09 [1.41] vs. –0.48 [1.82], p < 0.05). When comparing patients who developed delirium at any point during their ICU stay (n = 45, 30%), MV days, severity of illness (Pediatric Index of Mortality 3 Score) score, CPB time, and z score for weight were associated with delirium (p < 0.05).

CONCLUSIONS:

Postoperative delirium (72 hr from CPB) occurred in 24% of pediatric patients. Hyperoxia, defined in multiple ways, was not associated with delirium. On exploratory analysis, nutritional status (z score for weight) may be a significant factor in delirium risk. Further delineation of risk factors for postoperative delirium versus ICU delirium warrants additional study.
Prospective Clinical Trial Demonstrating the Efficacy of Hyaluronic Acid Filler for the Improvement of Atrophic Facial Scars up to 2 years
Authors: Siperstein Robyn , Nestor Elizabeth , Meran Suzanne
Published: July 2024

BACKGROUND

Hyaluronic acid (HA) filler longevity has been studied for wrinkles. However, its long-term use for treating atrophic facial scars has not yet been analyzed in long-term prospective studies.

OBJECTIVE

Analyze the safety and duration of a HA filler for the use in atrophic scars.

MATERIALS AND METHODS

Fifteen subjects received VYC-17.5L in atrophic scars on 1 randomized cheek and saline on the other, with 1 optional touch-up treatment and crossover after the short-term trial. Grading for this long-term extension was done on Day 720, using the Global Aesthetic Improvement Scale (GAIS) and the Quantitative Global Scarring Grading System.

RESULTS

On Day 720, a live blind evaluator rated the VYC-17.5L assigned side as having significant reduction in scar severity (−7.2 [t(22) = −6.01, p = .00009]) and number of scars (−8.8 [t(22) = −6.25, p = .00006]) as compared with baseline. There was no significant difference in the results from Day 120 to Day 720. Ninety-two percent (11/12) of subjects reported improvement (GAIS), were satisfied with the treatment, thought it looked natural, and had fewer side effects than expected. There were no persistent or late-onset side effects.

CONCLUSION

VYC-17.5L improved rolling atrophic facial scars, and the results were sustained throughout the 2-year trial without side effects.
The factors that influence the diagnostic accuracy and sample adequacy of EUS-guided tissue acquisition for the diagnosis of solid pancreatic lesions
Authors: Sun Liqi , Li Yuqiong , Song Qiuyue , Peng Lisi , Xing Ying , Huang Haojie , Jin Zhendong
Published: July 2024

Background and Objectives

EUS-guided tissue acquisition (EUS-TA) is the preferred method to acquire pancreatic cancer (PC) tissues. The factors associated with false-negative outcomes and inadequate samples should be explored to gain an understanding of EUS-TA.

Methods

The patients who underwent EUS-TA for suspected solid PC but whose results were false-negative were analyzed. The PC patients who underwent EUS-TA with true-positive results on the first day of every month during the study period were selected as the control group. The factors influencing diagnostic accuracy and sample adequacy were explored.

Results

From November 2017 to January 2022, 184 patients were included in the false-negative group, and 175 patients were included in the control group. Multivariate logistic regression demonstrated that the recent acute pancreatitis [odds ratio (OR): 0.478, 95% confidence interval (CI): 0.250–0.914, P = 0.026] and high echo component within the tumor (OR: 0.103, 95% CI: 0.027–0.400, P = 0.001) were independently associated with false-negative EUS-TA results. Meanwhile, using fine-needle biopsy (FNB) needles (OR: 2.270, 95% CI: 1.277–4.035, P = 0.005), more needle passes (OR: 1.651,95% CI: 1.239–2.199, P = 0.005), large tumor size (OR: 1.053, 95% CI: 1.029–1.077, P < 0.001), and high CA-19-9 level (OR: 1.001, 95% CI: 1.000–1.001, P = 0.019) were independently associated with true-positive EUS-TA outcomes. Three needle passes are needed to achieve optimal EUS-TA outcomes. Tumor location in the body/tail (OR: 1.38, 95% CI: 1.01–1.72; P = 0.04), needle passes ≥3 (OR: 1.90; 95% CI: 1.22–2.56; P < 0.001), and using the FNB needle (OR: 2.10; 95%: 1.48–2.85; P < 0.001) were independently related to sample adequacy.

Conclusion

Numerous factors were identified to be associated with the diagnostic accuracy and sample adequacy of EUS-TA.
Nonsurgical Correction of Congenital Auricular Anomalies: Design and Effectiveness of the Ear Splint
Authors: Chang Yachun , Chen Lirong
Published: July 2024

Congenital auricular anomaly is a common problem for newborns. In recent years, the correction technology of ear molding has gradually become the mainstream therapy. Therefore, the purpose of this case report is to describe ear molding devices with low-temperature thermoplastic splints, designed by occupational therapists and called the Ear Splint for Taiwan, and to explore its effectiveness in treating newborns with congenital auricular anomalies. The ear splint is made by an occupational therapist based on the theory of corrective mechanics. The molded splint adjusts the ear to normal shape. Patients who received ear treatments at the Mennonite Christian Hospital in 2020 were enrolled as the subjects. A posttest research design was adopted in this case report to conduct a questionnaire survey among parents. The ear splint is a double C-shaped bracket. In this case report, there were two subjects in total, and two different types of malformed ears. According to the questionnaire survey, the average score of auricle shape improvement effectiveness after interventions were 5 and 4 points (5 excellent; 1 bad). The results of this case report indicate that it is feasible for occupational therapists to use the ear splint to mold the congenital auricular anomalies of newborns. Preliminary evidence shows that ear shapes can be corrected. The ear splint provides an early interventional therapy for newborns with congenital auricular anomalies in Taiwan.
Serologic extracellular matrix remodeling markers are related to fibrosis stage and prognosis in a phase 2b trial of simtuzumab in patients with primary sclerosing cholangitis
Authors: Thorburn Douglas , Leeming Diana J. , Barchuk William T. , Wang Ya , Lu Xiaomin , Malkov Vladislav A. , Ito Kaori L. , Bowlus Christopher L. , Levy Cynthia , Goodman Zachary , Karsdal Morten A. , Muir Andrew J. , Xu Jun
Published: July 2024

Background:

Novel noninvasive predictors of disease severity and prognosis in primary sclerosing cholangitis (PSC) are needed. This study evaluated the ability of extracellular matrix remodeling markers to diagnose fibrosis stage and predict PSC-related fibrosis progression and clinical events.

Methods:

Liver histology and serum markers of collagen formation (propeptide of type III collagen [Pro-C3], propeptide of type IV collagen, propeptide of type V collagen), collagen degradation (type III collagen matrix metalloproteinase degradation product and type IV collagen matrix metalloproteinase degradation product), and fibrosis (enhanced liver fibrosis [ELF] score and its components [metalloproteinase-1, type III procollagen, hyaluronic acid]) were assessed in samples from baseline to week 96 in patients with PSC enrolled in a study evaluating simtuzumab (NCT01672853). Diagnostic performance for advanced fibrosis (Ishak stages 3–6) and cirrhosis (Ishak stages 5–6) was evaluated by logistic regression and AUROC. Prognostic performance for PSC-related clinical events and fibrosis progression was assessed by AUROC and Wilcoxon rank-sum test.

Results:

Among 234 patients, 51% had advanced fibrosis and 11% had cirrhosis at baseline. Baseline Pro-C3 and ELF score and its components provided moderate diagnostic ability for discrimination of advanced fibrosis (AUROC 0.73–0.78) and cirrhosis (AUROC 0.73–0.81). Baseline Pro-C3, ELF score, and type III procollagen provided a moderate prognosis for PSC-related clinical events (AUROC 0.70–0.71). Among patients without cirrhosis at baseline, median changes in Pro-C3 and ELF score to week 96 were higher in those with than without progression to cirrhosis (both p < 0.001).

Conclusions:

Pro-C3 correlated with fibrosis stage, and Pro-C3 and ELF score provided discrimination of advanced fibrosis and cirrhosis and predicted PSC-related events and fibrosis progression. The results support the clinical utility of Pro-C3 and ELF score for staging and as prognostic markers in PSC.
Collagen in hepatocellular carcinoma: A novel biomarker and therapeutic target
Authors: Ding Dong-yang , Jiang Shu-ya , Zu Yun-xi , Yang Yuan , Gan Xiao-jie , Yuan Sheng-xian , Zhou Wei-ping
Published: July 2024

HCC is globally recognized as a major health threat. Despite significant progress in the development of treatment strategies for liver cancer, recurrence, metastasis, and drug resistance remain key factors leading to a poor prognosis for the majority of liver cancer patients. Thus, there is an urgent need to develop effective biomarkers and therapeutic targets for HCC. Collagen, the most abundant and diverse protein in the tumor microenvironment, is highly expressed in various solid tumors and plays a crucial role in the initiation and progression of tumors. Recent studies have shown that abnormal expression of collagen in the tumor microenvironment is closely related to the occurrence, development, invasion, metastasis, drug resistance, and treatment of liver cancer, making it a potential therapeutic target and a possible diagnostic and prognostic biomarker for HCC. This article provides a comprehensive review of the structure, classification, and origin of collagen, as well as its role in the progression and treatment of HCC and its potential clinical value, offering new insights into the diagnosis, treatment, and prognosis assessment of liver cancer.
Nuclear imaging techniques for cardiac amyloidosis
Authors: Saad Jean Michel , Al-Mallah Mouaz H.
Published: July 2024

Purpose of review

Cardiac amyloidosis is a condition marked by the misfolding of precursor proteins into insoluble amyloid fibrils, leading to restrictive cardiomyopathy and heart failure symptoms. This review discusses advancements in nuclear imaging techniques that enhance the diagnosis and guide the management of cardiac amyloidosis, addressing the critical need for early and accurate detection in clinical practice.

Recent findings

Recent studies and guidelines emphasizes the pivotal role of nuclear imaging techniques in diagnosing cardiac amyloidosis. Cardiac scintigraphy, using bone-avid tracers like 99mTc-PYP, 99mTc-DPD, and 99mTc-HMDP, is instrumental in distinguishing between transthyretin amyloidosis and light chain amyloidosis. PET, with tracers such as 11C-Pittsburgh Compound B (11C-PiB) and 18F-Florbetapir, offers significant potential in measuring amyloid burden and monitoring disease progression, providing detailed insights into the myocardial involvement.

The advancements in nuclear imaging techniques significantly impact the management of cardiac amyloidosis. These methods allow for a more accurate diagnosis, detailed assessment of disease extent, and better differentiation between amyloidosis types, which are crucial for tailoring treatment approaches. The integration of these techniques into clinical practice is essential for improving patient outcomes and advancing research in cardiac amyloidosis.
Systemic anti-VEGF biosimilar therapy associated with improved macular anatomy and duration of effect in a patient with nearly recalcitrant neovascular age-related macular degeneration
Authors: Morgan Kipp R , Richards Paige J , Chang Jonathan S
Published: July 2024

Purpose:

To present a patient with neovascular AMD treated systemically with the biosimilar bevacizumab-awwb (Mvasi) with superior SRF resolution when compared to continuous and repeated intravitreal treatments.

Methods:

Retrospective single case report.

Results:

After 3 years of monthly aflibercept treatment for nAMD, the patient had persistent subretinal fluid (SRF). Systemic bevacizumab-awwb (Mvasi) infusions were initiated by her oncologist for ovarian cancer and SRF resolved for the first time. After one additional aflibercept injection, and continued bevacizubam-awwb infusions for her cancer, SRF did not recur. Thirteen weeks later, at final follow-up before the patient passed away, the macula remained dry and no additonal intravitreal treatment was given.

Conclusion:

When systemic anti-VEGF biosimilar therapy was administered, there was improved anatomy and prolonged duration of effect compared to the intravitreal therapy alone. Adverse systemic effects limit the routine use of systemic anti-VEGF therapy for retinal disease. However if a patient requires systemic anti-VEGF or anti-VEGF biosimilar therapy for malignancy, it may also benefit retinal disease leading to benefits in quality of life and fewer office visits.
Recalcitrant Peripapillary Pachychoroid Syndrome Responds to High-Dose Aflibercept Therapy
Authors: Feo Alessandro , Abraham Neda , Mafi Mostafa , Sarraf David
Published: July 2024

Purpose:

To describe a case of recalcitrant bilateral peripapillary pachychoroid syndrome (PPS) treated with high-dose (HD) intravitreal aflibercept injections.

Methods:

Medical and imaging records were retrospectively evaluated. Multimodal imaging included ultra-widefield indocyanine green and fluorescein angiography and fundus autofluorescence. Tracked optical coherence tomography (OCT) B scans were reviewed to assess intra- (IRF) and subretinal fluid (SRF), and to measure choroidal thickness (CT). Macular neovascularization was excluded with OCT angiography.

Results:

A 75-year-old man with bilateral PPS and severe peripapillary and macular edema underwent multiple sessions of photodynamic therapy, intravitreal aflibercept injections, and corticosteroid eye drop application with minimal improvement of the fluid. After two monthly intravitreal HD aflibercept injections, the peripapillary and macular fluid was almost completely resolved with commensurate choroidal thickness reduction and significant visual gain in each eye.

Conclusion:

High-dose intravitreal aflibercept therapy may lead to remarkable anatomical and functional improvement in eyes with recalcitrant PPS.
Concurrent Central Retinal Vein Occlusion and Rhegmatogenous Retinal Detachment in Two Young Healthy Patients
Authors: Rashid Simatul , Meshkin Ryan S. , Cakir Bertan , Hoyek Sandra , Rossin Elizabeth J. , Eliott Dean , Patel Nimesh A.
Published: July 2024

Purpose:

Central retinal vein occlusion (CRVO) and rhegmatogenous retinal detachment (RRD) are two distinct retinal conditions that typically affect older patient populations with comorbidities or predisposing risk factors. This case report presents unusual co-occurrences of CRVO and RRD in two young, healthy adult patients and proposes potential etiological factors contributing to the complex presentations.

Methods:

Retrospective case-series of two young, healthy males with no history of systemic diseases who presented with concurrent CRVO and RRD.

Results:

The first case was a 28-year-old male construction worker, who presented with acute, painless vision loss and extensive intra-retinal hemorrhages in the right eye, tortuous dilated retinal veins, significant macular edema, optic disc edema, and a macula sparing RRD. Treatment included intravitreal injections of bevacizumab followed by RRD repair with scleral buckle, cryotherapy, external drainage, and later a pneumatic retinopexy. His visual acuity had improved from 20/200 to 20/30 in the right eye. The second case was a 19-year-old male patient who also presented with acute painless vision loss in the left eye and was diagnosed with CRVO and concomitant RD. Treatment included intravitreal bevacizumab injections, oral prednisone trial, and surgical repair with scleral buckle, vitrectomy, and silicone oil insertion. Workup for inflammatory, infectious, and hypercoagulable conditions was negative in both cases.

Conclusions:

Concurrent CRVO and RRD can occur in young healthy patients. Prompt surgery is indicated and treatment with anti-VEGF can be initiated in the perioperative period without complications.
Quantum Molecular Resonance Electrotherapy for the Treatment of Pediatric Ocular Rosacea
Authors: Surapaneni Leena , Giachos Ioannis , Palioura Sotiria
Published: July 2024

Purpose:

The purpose of this study was to report the outcomes of quantum molecular resonance (QMR) electrotherapy in the management of refractory pediatric ocular rosacea.

Methods:

This is a retrospective case series on 3 female pediatric patients (ages 12, 15, 14 years) with ocular rosacea. Two patients presented with corneal stromal neovascularization and punctate epithelial erosions while 1 patient presented with corneal scarring and paracentral stromal thinning. After failing conservative management, the patients were treated with 4 consecutive QMR electrotherapy sessions with the intensity set at 5 corresponding on average to a power of 12 W, with 60 V voltage and 200 mA current. Informed consent was obtained for off-label use. Patients were assessed for changes in vision, foreign body sensation, tearing, photophobia, and redness at each visit to determine symptomatic improvement. Outcome measures include best-corrected visual acuity, use of supplemental therapies (eg topical steroids) for symptom relief, extent of corneal neovascularization via serial slitlamp photography, and corneal scar remodeling via high resolution anterior segment optical coherence tomography.

Results:

Two of the 3 patients experienced improvement in visual acuity after QMR electrotherapy. Corneal neovascularization and scarring regressed significantly in all 3 patients. Two months post-QMR electrotherapy, corneal remodeling was evident on optical coherence tomography in 2 patients. All 3 patients were able to discontinue topical immunosuppressants and remain symptom-free at 1.5 years of follow-up.

Conclusions:

QMR electrotherapy is a promising alternative in the treatment of refractory ocular rosacea in childhood and puberty, and it may potentiate corneal remodeling.
“Blue Scrub Lid Retraction”: Changes in Eyelid Position on the Day of Surgery
Authors: Ducker Laurence G. , Halbach Caroline S. , Piazza Amber N. , Rajjoub Raneem D. , Kamboj Alisha , Harrison Andrew R. , Mokhtarzadeh Ali
Published: July 2024

Purpose:

The aim of this study is to test the hypothesis that margin-reflex distance 1 (MRD1) on the day of surgery will be higher than the MRD1 measured at the in-clinic consult visit among patients undergoing blepharoptosis repair due to an increased sympathetic drive.

Methods:

Patients evaluated for involutional blepharoptosis repair were prospectively enrolled over a 12-month period in this single-center, self-controlled study. Three investigators independently determined MRD1 using cropped photos taken of patients at the in-clinic consult visit and on the day of surgery. A difference in height was tested for by using the 2-tailed Wilcoxon signed rank test.

Results:

Evaluated in this study were 76 eyelids from 38 patients. Over 3-quarters of study participants had a higher MRD1 in the right and OSs on the day of surgery than at their in-clinic consultation visit (p < 0.001). The mean increase in MRD1 for the right eyelid and left eyelid was 1.0 mm (range: 0–3.15 mm) and 1.1 mm (range: 0–2.7 mm), respectively.

Conclusions:

In patients with involutional blepharoptosis, we conclude that MRD1 is higher on the day of surgery as compared with the in-clinic consult visit. This may be secondary to the stress of surgery and an associated increase in sympathetic drive. In some cases, this change in eyelid position led to resolution of apparent involutional ptosis altogether. Caution should be used when considering deferral of ptosis repair on the basis of exam findings present on the day of surgery.
What is associated with painful polyneuropathy? A cross-sectional analysis of symptoms and signs in patients with painful and painless polyneuropathy
Authors: Gierthmühlen Janne , Attal Nadine , Baskozos Georgios , Bennedsgaard Kristine , Bennett David L. , Bouhassira Didier , Crombez Geert , Finnerup Nanna B. , Granovsky Yelena , Jensen Troels Staehelin , John Jishi , Kennes Lieven Nils , Laycock Helen , Pascal Mathilde M.V. , Rice Andrew S.C. , Shafran-Topaz Leah , Themistocleous Andreas C. , Yarnitsky David , Baron Ralf
Published: July 2024

It is still unclear how and why some patients develop painful and others painless polyneuropathy. The aim of this study was to identify multiple factors associated with painful polyneuropathies (NeuP). A total of 1181 patients of the multicenter DOLORISK database with painful (probable or definite NeuP) or painless (unlikely NeuP) probable or confirmed neuropathy were investigated clinically, with questionnaires and quantitative sensory testing. Multivariate logistic regression including all variables (demographics, medical history, psychological symptoms, personality items, pain-related worrying, life-style factors, as well as results from clinical examination and quantitative sensory testing) and machine learning was used for the identification of predictors and final risk prediction of painful neuropathy. Multivariate logistic regression demonstrated that severity and idiopathic etiology of neuropathy, presence of chronic pain in family, Patient-Reported Outcomes Measurement Information System Fatigue and Depression T-Score, as well as Pain Catastrophizing Scale total score are the most important features associated with the presence of pain in neuropathy. Machine learning (random forest) identified the same variables. Multivariate logistic regression archived an accuracy above 78%, random forest of 76%; thus, almost 4 out of 5 subjects can be classified correctly. This multicenter analysis shows that pain-related worrying, emotional well-being, and clinical phenotype are factors associated with painful (vs painless) neuropathy. Results may help in the future to identify patients at risk of developing painful neuropathy and identify consequences of pain in longitudinal studies.
An integrated approach to improving clinical outcomes in inflammatory disease
Authors: Wilchowski Sara M.
Published: July 2024

To determine whether lifestyles changes, such as dietary modifications and exercise, can improve clinical outcomes in patients with psoriasis, a PubMed search was conducted using the following key terms: “psoriasis,” “lifestyle,” “obesity,” “inflammation,” “diet,” and “exercise.” There is a growing body of literature supporting the implementation of lifestyle changes as well as nutritional modifications to dampen system inflammatory cytokines. Several lifestyle changes, including intermittent fasting, diet, and physical activity, can improve symptoms for patients with psoriasis. Multiple larger studies with more patients would provide more clues to the bidirectional relationship between obesity and inflammatory disease.
Interleukin-1β-stimulated macrophage-derived exosomes improve myocardial injury in sepsis via regulation of mitochondrial homeostasis: experimental research
Authors: Ma Chunhua , Yang Zhaocong , Wang Jing , She Han , Tan Lei , Mo Xuming , Li Tao , Liu Liangming
Published: July 2024

Background:

The purpose of this study was to investigate the effects of interleukin-1β (IL-1β) stimulation on the protection of macrophage-derived exosomes miR-146a (M-IL-exo-146a) on sepsis-induced myocardial injury (SMI) in vitro and in vivo.

Materials and methods:

Macrophage-derived exosomes (M-exo) and IL-1β-stimulated macrophage exosomes (M-IL-exo) were isolated from macrophages of sepsis with or without IL-1β. The expressions of miR-146a in M-exo and M-IL-exo were detected by fluorescence quantitative PCR. Related molecular biology technologies were used to evaluate the role and mechanism of M-exo-146a and M-IL-exo-146a on SMI and the enhancing effect of IL-1β.

Results:

Compared with M-exo, the expression of miR-146a in M-IL-exo was significantly increased. M-IL-exo-146a significantly alleviated SMI by decreasing the level of serum myocardial enzymes, serum and myocardial oxidative stress and cytokines, and improved myocardial mitochondrial imbalance. The mechanism responsible for IL-1β enhancing the production of IL-M-exo miR-146a was via JNK-1/2 signal pathway. The mechanism responsible for M-exo-IL-miR-146a protecting SMI was related to miR-146a inhibiting inflammatory response and mitochondrial function via MAPK4/Drp-1 signal pathway.

Conclusions:

This study provides a new strategy for the treatment of SMI by delivering M-IL-exo.
A pilot study of Keto Prescribed+: A healthy thinking and eating educational program for African American women
Authors: Hanners Audra , Melnyk Bernadette , Bedell Teryn , Conroy Sara , Volek Jeff , Brock Guy , Kelley Marjorie
Published: July 2024

African American (AA) women have the highest prevalence of obesity in addition to health disparities in preventable diet-related diseases (i.e., diabetes, hypertension), which places them at increased risk for cardiovascular disease. The purpose of this pilot study was to assess the feasibility, acceptability, and preliminary effectiveness of the Keto Prescribed+ (KetoRx+) program on associated physical and psychosocial outcomes among this population. The KetoRx+ program is a healthy eating and thinking educational intervention. The program combined online and in-person community group sessions over 8 weeks. The Keto Prescribed+ was found to be feasible and acceptable with comments on ways to increase acceptability from participants completing program (n = 10). Physical outcomes changed showed an average decrease in weight of 10lbs (SD = 5), baseline average 226lbs. Waist-to-hip ratio and systolic blood pressure also trended down. Psychosocial outcomes showed improvement trends. The KetoRx+ program is feasible and acceptable for overweight or obese AA women. Preliminary efficacy was established for most physical and psychosocial outcomes. However, more research is needed to identify specific program components contributing to healthy lifestyle behavior change and to establish program efficacy and effectiveness. Culturally adapted community-based biopsychosocial interventions using ketogenic nutrition therapy may help improve cardiovascular health of adult AA women.
Deregulation of MMP-2 and MMP-9 in laryngeal cancer: A retrospective observational study
Authors: Lin Mingxia , Ashraf Nida Sarosh , Mahjabeen Ishrat
Published: July 2024

Laryngeal carcinoma (LC) is reported to have a higher incidence rate among all types of head and neck cancers around the globe. Mechanisms resulting in the pathogenesis of LC are complicated due to involvement of invasion and metastasis and there is a need to understand this complicated multistep process. Numerous molecules including matrix metalloproteinases (MMPs) are involved in regulating metastatic mechanisms. Furthermore, activation and expression of different classes of MMPs have been observed in multiple pathological and physiological events including inflammation, invasion, and metastasis. Among all members of MMPs, matrix metalloproteinases-2 (MMP-2), and matrix metalloproteinases-9 (MMP-9) have been frequently reported to correlate with tumor pathogenesis. The present study is designed to check the involvement of MMP-2 and MMP-9 in LC pathogenesis. 184 laryngeal tumor samples along with adjacent uninvolved healthy sections were collected to check the expression deregulation of the above-mentioned gene in LC using real-time PCR and immunohistochemistry (IHC). Real-time PCR and IHC analyses showed the significant upregulation of MMP-2 (P < .0001) and MMP-9 (P < .0001) genes in laryngeal tumors compared to controls. Spearman correlation showed the positive correlation of expression deregulation of selected MMPs with advanced TNM stage [MMP-2, (P < .0001); MMP-9, P < .0001] and smoking status [MMP-2 (P < .0001); MMP-9 P < .0001] in laryngeal pathogenesis. Receiver operating curve (ROC) analysis showed the good diagnostic/prognostic value of said markers in laryngeal cancer patients. The present study showed that significant upregulation of selected MMPs was found associated with an increased risk of laryngeal cancer and can act as good diagnostic markers for the detection of said disease.
Effectiveness and safety of dolutegravir plus lamivudine in treating HIV in China, including outcomes of patients coinfected with tuberculosis
Authors: Hou Haohua , Ba Huanhuan , Jin Xinyan , Luo Peipei , Zhang Yuan , Li Jiajia , Jin Juan
Published: July 2024

Antiretroviral regimens for human immunodeficiency virus (HIV) infection have continuously evolved; however, antiretrovirals can cause severe adverse reactions. Two-drug regimen therapy can decrease lifetime cumulative drug exposure and long-term toxicities associated with multiple antiretrovirals. The preferred 2-drug regimen constitutes dolutegravir (DTG) and lamivudine (3TC). This study determined the rate of virological suppression and incidence of adverse events at week 48 in treatment-naïve people living with HIV initiated on DTG + 3TC. This was a single-center, retrospective, observational study. Treatment-naïve people aged ≥18 years who received at least 1 DTG + 3TC dose between May 2020 and May 2022 were included. Eighty-nine people living with HIV were enrolled. Twenty-five (28.1%) patients with a DTG + 3TC regimen at baseline were analyzed because of comorbidities, and 48% because of concomitant tuberculosis (TB). Viral suppression at 48 weeks was achieved in 91.67% of patients, and TB was well controlled. At week 48, 84 (94.38%) patients had viral loads < 50 copies/mL, and 21 (91.31%) of the 23 participants with a baseline HIV-1-RNA level ≥ 1 × 105 copies/mL achieved virological success. Fifteen (88.23%) of the 17 participants with a baseline CD4 + cell count of <200 cells/µL achieved virological suppression. The median CD4 + cell count change from baseline was 539.5 cells/µL. No significant changes in triglycerides, low-density lipoprotein cholesterol, weight, or creatinine were observed from baseline to 48 weeks. One patient had severe insomnia at 4 weeks. Our findings support the real-world effectiveness and low metabolic impact of DTG + 3TC. Using DTG + 3TC in patients coinfected with TB and HIV has favorable therapeutic outcomes.
Analysis of the effectiveness and safety of Jiedu Xiezhuo Yishen Tang in the treatment of gouty arthritis: An observational study
Authors: He Ling , Peng Yan , Ding Mingqiao
Published: July 2024

This study is for exploring the effectiveness and security of Jiedu Xiezhuo Yishen Tang in the treatment of gouty arthritis. This retrospective study collected 100 patients with gouty arthritis between February 2022 and February 2023. According to the different treatment methods, the data of patients were divided into control group and experimental group. The control group received routine treatment with benzbromarone, while the experimental group received additional treatment with Xuedu Xiezhuo Yishen Tang on the basis of the control group. The evaluation indicators for the effectiveness of treatment include serum levels of 8-hydroxydeoxyguanosine, 3-NT, interleukin-6, interleukin-10, interleukin-1β, tumor necrosis factor-α, C-reactive protein, erythrocyte sedimentation rate, urea nitrogen, creatinine, evaluation of knee joint function and pain level, traditional Chinese medicine syndrome score, and safety evaluation. After treatment, the overall treatment effect of the experimental group reached 98%, while the control group was 78%. After treatment, the differences in various indicators possessed statistical significance (SS) (P < .05). In the Lysholm score, the improvement in the experimental group was markedly more excellent than the control group, and the difference possessed SS (P < .05). In the NRS score, the experimental group’s NRS score decreased from 8.39 to 1.08 before and after treatment, while the control group only decreased to 3.61. In addition, both groups of patients showed significant improvement in the joint score in the Traditional Chinese medicine syndrome sub-items. The experimental group was able to effectively improve symptoms such as joint pain, joint redness and swelling, joint fever, and limited joint mobility. After treatment, the incidence of adverse reactions in the experimental group was only 8%, while the incidence of adverse reactions in the control group was 24%. After statistical analysis of the incidence of adverse reactions during treatment among the participants, it was found that the difference possessed SS (P < .001). The combination treatment of Jiedu Xiezhuo Yishen Tang and benbromarone can effectively improve oxidative stress response and significantly reduce blood uric acid levels. Meanwhile, this combination therapy can effectively inhibit inflammatory reactions, significantly alleviate knee joint pain, and promote the recovery of knee joint function. This treatment regimen has lower toxic side effects and higher safety.
Case report of an unusual allergic reaction to a routine skin prick test performed in an outpatient clinic: Diagnosis, management, and knowledge gaps
Authors: Robles-Velasco Karla , Cevallos-Levicek Denisse , Mosnaim Giselle , Fok Jie Shen , Cherrez-Ojeda Ivan
Published: July 2024

Background:

The skin prick test (SPT) is a standard procedure in allergy/immunology clinics, crucial for evaluating conditions like allergic rhinitis and food allergies. As a cornerstone in investigating immunoglobulin E-mediated allergy, it plays a vital role in diagnosing allergies, including those triggered by common dust mites like Dermatophagoides pteronyssinus, Dermatophagoides farinae, Euroglyphus maynei, and Blomia tropicalis. Despite its widespread use, adverse reactions to SPT are uncommon (15 per 100,000 patients), though the procedure is not entirely risk-free. This article presents a clinical case involving a 17-year-old female who experienced a moderately delayed allergic reaction 120 minutes post-SPT, managed effectively with subsequent symptom resolution.

Methods:

The patient, with a history of persistent rhinorrhea, itchy nose, eyes, and postnasal drip, sought consultation due to worsening symptoms. Diagnostic measures, including patient-reported outcomes and SPT with a standard aeroallergen panel, revealed sensitization to various allergens.

Results:

Post-test, the patient reported ocular pruritus, left eyelid swelling, and moderate rhinorrhea, persisting for about 24 hours. On the subsequent medical visit, the patient received rupatadine and deflazacort, leading to symptom resolution within 3 hours.

Conclusion:

This article delves into a systemic allergic reaction post-SPT, emphasizing the 2 main stages of type I hypersensitivity reactions. While the acute phase involves mast cell-driven mediators within 15 minutes, the delayed phase (4–8 hours) includes de novo cytokine release. Vigilance regarding symptom onset and differentiation between mild and severe reactions is crucial. Notably, the absence of specific waiting time guidelines post-SPT underscores the need for reporting to enhance understanding and subsequent management. Performing these procedures in specialized centers with qualified professionals is essential for effectively managing potential anaphylactic reactions. Addressing these knowledge gaps will contribute to enhanced patient safety during diagnostic procedures.
Identification of immune- and oxidative stress-related signature genes as potential targets for mRNA vaccines for pancreatic cancer patients
Authors: Li Jiaxu , Han Yongjiao , Zhao Ning , Lv Liping , Ma Ping , Zhang Yangyang , Li Mingyuan , Sun Hua , Deng Jiang , Zhang Yanyu
Published: July 2024

Adenocarcinoma of the pancreas (PAAD) is one of the deadliest malignant tumors, and messenger ribonucleic acid vaccines, which constitute the latest generation of vaccine technology, are expected to lead to new ideas for the treatment of pancreatic cancer. The Cancer Genome Atlas-PAAD and Genotype-Tissue Expression data were merged and analyzed. Weighted gene coexpression network analysis was used to identify gene modules associated with tumor mutational burden among the genes related to both immunity and oxidative stress. Differentially expressed immune-related oxidative stress genes were screened via univariate Cox regression analysis, and these genes were analyzed via nonnegative matrix factorization. After immune infiltration analysis, least absolute shrinkage and selection operator regression combined with Cox regression was used to construct the model, and the usefulness of the model was predicted based on the receiver operating characteristic curve and decision curve analysis curves after model construction. Finally, metabolic pathway enrichment was analyzed using gene set enrichment analysis combined with Kyoto Encyclopedia of Genes and Genomes and gene ontology biological process analyses. This model consisting of the ERAP2, mesenchymal-epithelial transition factor (MET), CXCL9, and angiotensinogen (AGT) genes can be used to help predict the prognosis of pancreatic cancer patients more accurately than existing models. ERAP2 is involved in immune activation and is important in cancer immune evasion. MET binds to hepatocyte growth factor, leading to the dimerization and phosphorylation of c-MET. This activates various signaling pathways, including MAPK and PI3K, to regulate the proliferation, invasion, and migration of cancer cells. CXCL9 overexpression is associated with a poor patient prognosis and reduces the number of CD8 + cytotoxic T lymphocytes in the PAAD tumor microenvironment. AGT is cleaved by the renin enzyme to produce angiotensin 1, and AGT-converting enzyme cleaves angiotensin 1 to produce angiotensin 2. Exposure to AGT-converting enzyme inhibitors after pancreatic cancer diagnosis is associated with improved survival. The 4 genes identified in the present study – ERAP2, MET, CXCL9, and AGT – are expected to serve as targets for messenger ribonucleic acid vaccine development and need to be further investigated in depth.