bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient-reported Outcomes for Children With Unilateral Congenital Below Elbow Deficiency
Authors: Shoghi Azarin , Bagley Anita , Wagner Lisa V. , Abarca Nancy , James Michelle A.
Published: August 2022

Background:

The Patient Reported Outcomes Measurement Information System (PROMIS®) is a validated tool used to evaluate different domains of function in patients with chronic health conditions. This tool has not been validated in children with unilateral congenital below elbow deficiency (UCBED). The purpose of this study was to determine whether PROMIS discerns functional impairment for children with UCBED and whether children with UCBED differ from the general population with respect to PROMIS outcomes. We hypothesized that children with UCBED report mild impairment in upper extremity function but normal mobility, pain interference and peer relations.

Methods:

A retrospective chart review of children aged 5 to 17 years with a diagnosis of UCBED who completed a PROMIS questionnaire at their clinic visit at the [blinded locations] was conducted between April 1, 2017 and March 31, 2020. The mean PROMIS scores of UCBED patients were compared with that of the general reference population. Mann Whitney and ANOVA tests were used to explore the differences across the PROMIS upper extremity function domain by arm length and prosthesis use.

Results:

Fifty-five children (28 boys) with a mean age of 11±3.6 years met the inclusion criteria. Children with UCBED had similar PROMIS scores as the reference population in mobility (51.9±6.2), peer relations (53.5±9.4), and pain interference (40.1±7.2), with mild impairment in the upper extremity function (44.3±10.7). Compared with the 8 to 17-year-old cohort, the parent-proxy (5 to 7-year-old group) reported significantly more upper extremity function impairment (31.3±5.9) vs (48.0±8.8) (P=0.000). The two age groups did not differ with respect to mobility, pain interference and peer relations.

Conclusions:

Our study confirms previous findings that children with UCBED report upper extremity function, peer relationships, pain interference, and mobility, similar to the reference population. In addition, parents of younger children with UCBED report more upper extremity functional impairment than is self-reported by older children with UCBED.

Level of Evidence:

Prognostic Level III (comparison with reference population).
Impact of Spinal/Epidural Anesthesia Versus General Anesthesia on Perioperative Outcomes in Patients Undergoing Lumbar Spine Surgery
Authors: Shui Min , Zhao Deng , Xue Ziyi , Wu Anshi
Published: August 2022

Study Design:

A systematic review and meta-analysis.

Objective:

To compare impact of different anesthesia techniques on perioperative outcomes in patients undergoing lumbar spine surgery.

Summary of Background Data:

Both general anesthesia and spinal anesthesia/epidural anesthesia can be used for lumbar spine surgery. There is still much controversy that which anesthesia technique is much more suitable for lumbar spine surgery with less complications, general anesthesia or regional anesthesia.

Methods:

A comprehensive search of the literature was conducted using Excerpta Medica database (EMBASE), PubMed, and Cochrane library for randomized controlled trials and independent reviewers assessed eligibility for included studies. Primary outcomes included incidences of intraoperative hypertension, hypotension, tachycardia, and bradycardia. Secondary outcomes included postoperative analgesic requirement, postoperative nausea and vomiting (PONV), headache, urinary retention, blood loss, and length of hospital stay.

Results:

Ten randomized controlled trials consisting of 733 adult patients undergoing lumbar spine surgery were included. Spinal anesthesia/epidural anesthesia group had significant lower incidences of intraoperative hypertension [odds ratio (OR), 0.18; 95% confidence interval (CI), 0.08–0.38; P<0.00001; I
2=0.0%] and tachycardia (OR, 0.45; 95% CI, 0.26–0.79; P=0.006; I
2=0.0%), analgesic requirement in postanesthesia care unit (OR, 0.13; 95% CI, 0.08–0.22; P<0.00001; I
2=0.0%), PONV within 24 hours after surgery (OR, 0.27; 95% CI, 0.16–0.46; P<0.00001; I
2=6.0%), and shorter length of postoperative hospital stay (mean difference, −0.28; 95% CI, −0.37 to −0.18; P<0.00001; I
2=32.0%). There were no significant differences in incidences of intraoperative hypotension and bradycardia, PONV in postanesthesia care unit, analgesic requirement, urinary retention, and headache within 24 hours after surgery.

Conclusions:

Low to moderate quality of evidence revealed that patient undergoing lumbar spine surgery might benefit from spinal or epidural anesthesia.
Treatment of the Deltoid and Syndesmotic Ligaments in Chronic Ankle Instability
Authors: Chrea Bopha , Johnson Holly A.
Published: August 2022

Historically, ankle instability research has focused primarily on the lateral ligament complex. However, more recently there has been an increased attention on the role of the deltoid ligament and syndesmosis in chronic ankle instability. We describe historical perspectives as well as the current state of evidence and techniques for a more comprehensive approach to ankle instability.

Level of Evidence:

Diagnostic Level V. See Instructions for Authors for a complete description of levels of evidence.
Biomarkers and immunotherapy: where are we?
Authors: Langouo Fontsa Mireille , Padonou Francine , Willard-Gallo Karen
Published: August 2022

Purpose of review

Here, we reviewed the recent breakthroughs in the understanding of predictive biomarkers for immune checkpoint inhibitors (ICI) treatment.

Recent findings

ICI have revolutionized cancer therapy enabling novel therapeutic indications in multiple tumor types and increasing the probability of survival in patients with metastatic disease. However, in every considered tumor types only a minority of patients exhibits clear and lasting benefice from ICI treatment, and due to their unique mechanism of action treatment with ICI is also associated with acute clinical toxicities called immune related adverse events (irAEs) that can be life threatening. The approval of the first ICI drug has prompted many exploratory strategies for a variety of biomarkers and have shown that several factors might affect the response to ICI treatment, including tumors intrinsic factors, tumor microenvironment and tumor extrinsic or systemic factor. Currently, only three biomarkers programmed death-ligand 1 (PD-L1), tumor microenvironment and microsatellite instability had the US Food and Drug Administration-approbation with some limitations

The establishment of valid predictive biomarkers of ICI sensitivity has become a priority to guide patient treatment to maximize the chance of benefit and prevent unnecessary toxicity.
Digital Transformation of Faculty Development: Responding and Supporting Academia During Disruptions Caused by the Coronavirus Disease 2019 Pandemic
Authors: Yilmaz Yusuf , McDonald Peter J. , Locke Shawn , Lal Sarrah , Bayer Ilana , Tong Xiao Catherine , Kundi Anjali , Chan Teresa M.
Published: August 2022

Introduction:

The coronavirus disease 2019 pandemic disrupted the current practices for teaching and learning in medical and health professions education, creating challenges and opportunities for rapid transition. The authors describe how McMaster University's Program for Faculty Development (MacPFD) responded to this disruption by engaging in a digital transformation.

Methods:

The digital transformation process of MacPFD was mapped to the conceptual framework of digital transformation: Vial's building blocks of the framework. A new website was launched to host and disseminate the content. Subsequently, both the website and the content were promoted using social media tools. Content generation, Google Analytics, event registrations, and Zoom webinar attendance records were data sources for the results. Analysis of the data was based on the reach component of the RE-AIM framework.

Results:

Six-month data range results were reported as producer-centered and user-centered outcomes. The former consisted of 54 resources from diverse content authors, whereas the latter received 33,045 page views from 26,031 unique users from 89 countries. Live webinar events had 1484 registrants, with 312 (21%) being guests from external institutions. Before the coronavirus disease 2019 disruption, MacPFD was a local program to support its faculty.

Discussion:

The MacPFD's digital transformation shows a clear transition to a new “glocal” approach: an expanded global reach while still tending to our local development needs of the home institution's faculty members.
Anaesthesia for elite athletes
Authors: Bourgonjon Bram , Vermeylen Kris , Tytgat Niek , Forget Patrice
Published: August 2022

BACKGROUND

Sports participation has been growing rapidly since the 1960s. Anaesthesiologists are increasingly confronted with athletes in a peri-operative setting. The right choice of type of anaesthesia technique, pain management of injuries, specific physiologic adaptations of the athlete and knowledge of prohibited substances are eminent for a correct approach of this subpopulation.

PURPOSE

This review aims to give an overview of athletes’ specific anaesthetic management in peri-operative and postoperative settings and to guide the nonspecialised anaesthetist.

METHODS

We comprehensively reviewed the literature, gathered all the information available on, and synthesised it in a narrative way, regarding preoperative evaluation, intraoperative implications and postoperative pain management of the elite athlete undergoing a surgical procedure.

RESULTS

An anaesthesiologist should recognise the most common benign ECG findings in athletes like bradycardia, isolated left ventricle hypertrophy on voltage criteria and early repolarisation as normal features in the athlete's heart. Isotonic physiology typically produces four-chamber dilation. In contrast, isometric stress creates high intravascular pressure leading to left ventricular hypertrophy. Pre-operative evaluation should also identify possible consumers of performance-enhancing drugs. Intraoperative points of interest for the anaesthesiologist is mainly avoiding drugs on the prohibited list of the World Anti-Doping Agency (WADA). Postoperative and chronic pain management are still developing fields in this population. The International Olympic Committee (IOC) proposed treating acute pain with a combination of paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), topical analgesics, injectable NSAIDs and local anaesthetics. It may be suggested that chronic pain management in elite athletes could benefit from treatment in specialised multidisciplinary pain clinics.

CONCLUSION

This literature review aims to serve as a guide for the anaesthesiologist taking care of the elite athlete.
Punishment of ethanol choice in rhesus monkeys
Authors: Stinson Benjamin T. , Galbo Lindsey K. , Flynn Shawn M. , Gouin Angelique , Epperly Phillip M. , Davenport April T. , Czoty Paul W.
Published: August 2022

A defining characteristic of individuals diagnosed with alcohol use disorder (AUD) is that negative outcomes related to drinking do not lead them to reduce their alcohol use. In rodent models of AUD, this characteristic has been studied by adding the bitter tastant quinine to an ethanol solution. In this study, we extended this approach to a nonhuman primate model in which the ability of quinine to decrease the choice of a 4% ethanol solution vs. water was measured. Five adult female rhesus monkeys with 7.3 years of experience drinking ethanol were given access to a 4% ethanol solution and water for 3 h per day. When ethanol choice was stable, a single quinine concentration (0.03–5.6g/L) was added to the ethanol solution for 1 day until a quinine concentration-effect curve was generated. After determining the quinine concentration that reduced ethanol choice by half (the quinine EC50), the relative reinforcing strength of ethanol was manipulated by adding quinine or sucrose to the water alternative depending on the monkey’s baseline choice. Adding quinine to ethanol produced a concentration-dependent decrease in ethanol choice and intake. Importantly, water intake increased, indicating an effect on response allocation rather than simply a decrease in fluid consumption. Consistent with this conclusion, the addition of quinine or sucrose to the water alternative resulted in predictable increases and decreases, respectively, in ethanol choice. These studies establish a model of punishment of ethanol choice in nonhuman primates that can be used to understand the contextual, biologic and pharmacologic factors that influence sensitivity to the punishment of alcohol drinking.
Cardiac Rehabilitation Improves Fitness in Patients With Subclinical Markers of Cardiotoxicity While Receiving Chemotherapy
Authors: Kerrigan Dennis J. , Reddy Madhulata , Walker Eleanor M. , Cook Bernard , McCord James , Loutfi Randa , Saval Matthew A. , Baxter Jodi , Brawner Clinton A. , Keteyian Steven J.
Published: August 2022

Purpose:

Heart failure (HF) due to cardiotoxicity is a leading non–cancer-related cause of morbidity and mortality in cancer survivors. Cardiac rehabilitation (CR) improves cardiorespiratory fitness (CRF) and reduces morbidity and mortality in patients with HF, but little is known about its effects on cardiotoxicity in the cancer population. The objective of this study was to determine whether participation in CR improves CRF in patients undergoing treatment with either doxorubicin or trastuzumab who exhibit markers of subclinical cardiotoxicity.

Methods:

Female patients with cancer (n = 28: breast, n = 1: leiomyosarcoma) and evidence of subclinical cardiotoxicity (ie, >10% relative decrease in global longitudinal strain or a cardiac troponin of >40 ng·L−1) were randomized to 10 wk of CR or usual care. Exercise consisted of 3 d/wk of interval training at 60-90% of heart rate reserve.

Results:

Cardiorespiratory fitness, as measured by peak oxygen uptake (V˙o
2peak), improved in the CR group (16.9 + 5.0 to 18.5 + 6.0 mL∙kg−1 ∙min−1) while it decreased in the usual care group (17.9 + 3.9 to 16.9 + 4.0 mL∙kg−1 ∙min−1) (P = .009). No changes were observed between groups with respect to high-sensitivity troponin or global longitudinal strain.

Conclusion:

This study suggests that the use of CR may be a viable option to attenuate the reduction in CRF that occurs in patients undergoing cardiotoxic chemotherapy. The long-term effects of exercise on chemotherapy-induced HF warrant further investigation.
Preeclampsia and severe acute respiratory syndrome coronavirus 2 infection: a systematic review
Authors: Tossetta Giovanni , Fantone Sonia , delli Muti Nicola , Balercia Giancarlo , Ciavattini Andrea , Giannubilo Stefano Raffaele , Marzioni Daniela
Published: August 2022

Objective:

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of the coronavirus disease 2019 (COVID-19) disease that has rapidly spread worldwide, causing hundreds of thousand deaths. Normal placentation is characterized by many processes strictly regulated during pregnancy. If placentation is impaired, it can lead to gestational disorders, such as preeclampsia that is a multisystem disorder that occurs in 2–8% of pregnancies worldwide.

Methods:

We performed a systematic search to understand the potential involvement of SARS-CoV-2 in preeclampsia onset using the databases, PubMed and Web of Science until 31 January 2022.

Results:

SARS-CoV-2 infection not only causes damage to the respiratory system but also can infect human placenta cells impairing pivotal processes necessary for normal placenta development. The inflammatory response trigged by COVID-19 disease is very similar to that one found in preeclampsia pregnancies suggesting a possible link between SARS-CoV-2 infection and preeclampsia onset during pregnancy.

Conclusion:

Some studies showed that pregnancies affected by COVID-19 had higher incidence of preeclampsia compared with SARS-CoV-2-negative ones. However, increased blood pressure found in COVID-19 pregnancies does not allow to associate COVID-19 to preeclampsia as hypertension is a common factor to both conditions. At present, no diagnostic tools are available to discriminate real preeclampsia from preeclampsia-like syndrome in patients with SARS-CoV-2 infection. Thus, new specific diagnostic tools are necessary to assure an appropriate diagnosis of preeclampsia in these patients, especially in case of severe COVID-19 disease.
Excess pressure but not pulse wave velocity is associated with cognitive function impairment: a community-based study
Authors: Lin Chen-Hua , Cheng Hao-Min , Wang Jiun-Jr , Peng Li-Ning , Chen Liang-Kung , Wang Pei-Ning , Chen Chen-Huan
Published: August 2022

Background:

Carotid-femoral pulse wave velocity (cf-PWV), an index of mainly distal aortic stiffness, has been inconsistently associated with cognitive function. Excess pressure, derived from the arterial reservoir-excess pressure analysis, may integrate the pulsatile load of the proximal aorta. The present study examined whether increased excess pressure is associated with cognitive function impairment in community adults.

Methods:

A total of 992 community participants (69.5% females; mean age: 67.3 years; education 13.6 years) without cerebrovascular disease or dementia received the Montreal Cognitive Assessment (MoCA) to evaluate global cognition. Arterial reservoir and excess pressure, arterial stiffness, and wave reflections were assessed, using carotid tonometry and aortic Doppler flowmetry.

Results:

Excess pressure integral (XSPI), percentage XSPI, cf-PWV, characteristic impedance (Zc), and forward and backward pressure amplitude (Pf, Pb, respectively) were significantly higher in 197 participants (19.9%) with a low MoCA score (<26 or <25, depending on level of education). In multivariable analyses, XSPI (standardized odds ratio, 95% confidence interval, 1.30, 1.06–1.59), and percentage XSPI (1.27, 1.06–1.52) but not cf-PWV (1.04, 0.85–1.26) were significantly associated with a low MoCA. Further analysis revealed that Pf and Zc were the major determinants of XSPI (partial R
2: Pf = 0.656, Zc = 0.467) and percentage XSPI (Pf = 0.459, Zc = 0.371). In contrast, age, instead of Pf and Zc, was the major determinant of cf-PWV (partial R
2: age = 0.187).

Conclusions:

Excess pressure (XSPI/percentage XSPI), mainly determined by the pulsatile hemodynamics of the proximal aorta, was significantly associated with cognitive function impairment in middle-aged and elderly community adults.
SEVERE MACULAR EDEMA AFTER TRAUMATIC HEAD INJURY: A CASE OF WHIPLASH MACULOPATHY
Authors: Ballios Brian G.
Published: August 2022

Purpose:

Whiplash or “traumatic” maculopathy is associated with retinal concussion, typically after the rapid acceleration/deceleration experienced in motor vehicle collisions. It has rarely been discussed in the literature, likely given the spontaneous and relatively rapid nature with which the acute macular edema resolves. A focused clinical history around the trauma and characteristic signs and structural features on retinal imaging help to distinguish this condition from other sequelae of concussive retinal injury. We report a case of whiplash maculopathy after a blunt injury to the head, which presented with unilateral and substantial macular edema in the left eye.

Methods:

Case report.

Results:

A 38-year-old man presented with complaint of a central scotoma in his left eye after a blunt trauma to his head. Comprehensive ophthalmological evaluation and retinal imaging with optical coherence tomography confirmed whiplash maculopathy, with acute macular edema in his left eye. Management with observation and close follow-up showed rapid improvement in his visual symptoms over the course of days and improvement in the severity of macular edema. One month after his injury, macular edema had resolved with only mild structural irregularities, the patient's vision had improved, and he was asymptomatic.

Conclusion:

When observing patients with significant macular edema after concussive head injury, whiplash maculopathy should be considered, regardless of a history of motor vehicle collision. The condition can present with significant asymmetry of disease. The diagnosis generally carries a good prognosis for vision; however, there are cases of persistent central visual disturbances.
Lacripep for the Treatment of Primary Sjögren–Associated Ocular Surface Disease: Results of the First-In-Human Study
Authors: Tauber Joseph , Laurie Gordon W. , Parsons Edward C. , Odrich Marc G.
Published: August 2022

Purpose:

The purpose of this study was to assess the safety, tolerability, dosing, and efficacy of the active 19 amino acid fragment of lacritin (Lacripep), a broad regulator of ocular surface homeostasis, in the treatment of ocular surface disease associated with primary Sjögren syndrome.

Methods:

Two hundred four subjects were randomized to receive vehicle, 22 μM Lacripep, or 44 μM Lacripep 3 times daily for 28 days, preceded by a 14-day run-in and followed by 14-day washout. Outcome measures were corneal fluorescein staining (CFS), lissamine conjunctival staining, Schirmer with anesthesia, tear break-up time, SANDE scoring, and visual analog scale assessment of symptoms.

Results:

This study established the safety and tolerability of topical treatment with Lacripep in patients with primary Sjögren syndrome. There were few adverse events: Only mild irritation was found in less than 3 percent of patients dosed with Lacripep. Total CFS and Eye Dryness Score were not significantly changed at day 28. Post hoc analysis of patients with Eye Dryness Severity scores of 60 or greater at baseline revealed significant improvements in inferior CFS at 14 and 28 days and complaints of burning and stinging at 14 days. Significant improvement in regional lissamine conjunctival staining was seen at 14 and 28 days.

Conclusions:

This first-in-human study of Lacripep in patients with primary Sjögren syndrome demonstrated clinically significant improvements in specific signs and symptoms on which to base future studies. This study established safety and tolerability and potential metrics of efficacy in patients with moderate to severe disease. Further work on appropriate dosing and concentration is ongoing.
Acceleration of Regeneration of the Corneal Endothelial Layer After Descemet Stripping Induced by the Engineered FGF TTHX1114 in Human Corneas in Organ Culture
Authors: Pizzuto Sarah , Duffey Grace , Weant Jessica , Eveleth David
Published: August 2022

Purpose:

Descemet stripping only (DSO, descemetorhexis without endothelial keratoplasty) is increasing in clinical use but can impose long recovery times. The objective of this research was to determine whether TTHX1114, an engineered analog of FGF1, could accelerate healing in corneas after DSO.

Methods:

Corneas obtained from eye banks were placed into suspension culture and subjected to DSO with a procedure comparable with that used clinically. The healing of the stripped area and the regeneration of the corneal endothelial cell (CEC) layer were evaluated intermittently for 14 days using trypan blue staining, alizarin red staining, and immunohistochemistry.

Results:

Corneas subjected to DSO showed about 30% of the stripped area healed after 14 days in culture while those treated with TTHX1114 healed 81%. The healed area was similar in both normal corneas and corneas judged by the eye banks to be dystrophic. The regeneration of the endothelial layer in the stripped area was substantially more complete in TTHX1114-treated corneas, most of which demonstrated a contiguous monolayer of CECs expressing ZO-1 at the cell–cell junctions. In corneas not subject to DSO, incorporation of EdU, a marker of proliferation, was stimulated by TTHX1114 treatment.

Conclusions:

The corneal organ culture model recapitulated clinical observations of DSO, only with much more rapid recovery. Within the immediate postsurgical time frame of 2 weeks, treatment with TTHX1114 stimulated near-total regeneration of the CEC layer, suggesting that TTHX1114 may be useful as an adjunct to DSO.
Association Between Low Back Pain, Workaholism, and Work Engagement in Japanese Hospital Workers
Authors: Nihei Kenji , Suzukamo Yoshimi , Matsudaira Ko , Tanabe Motoko , Izumi Shin-Ichi
Published: August 2022

Objective

This study aimed to examine the association between two types of heavy work investment, workaholism and work engagement, and low back pain prevalence.

Methods

We conducted a paper-based survey of Japanese hospital workers. The Dutch Workaholism Scale (DUWAS) and the Utrecht Work Engagement Scale (UWES) were used to classify the participants into four groups and perform multiple logistic regression analyses.

Results

Among 699 participants, the group with low DUWAS and high UWES at 37.1% had the lowest low back pain prevalence. In order, the groups with low DUWAS and UWES were at 51.7%; those with high DUWAS and UWES, 58.5%; and those with high DUWAS and low UWES, 62.4%, with multivariate-adjusted odds ratios of 1.77, 2.01, and 2.33, respectively.

Conclusions

Low back pain prevalence among Japanese hospital workers was reduced by high levels of work engagement, even at high levels of workaholism.
Feasibility and Acceptability of Policies and Environmental Strategies for Improving Physical Activity and Healthy Eating in Japanese Small and Medium Corporations
Authors: Ozaki Itsuko , Nishijima Mariko , Konishi Michiko
Published: August 2022

Objective

We assessed the implementation status of policies and environmental strategies for increasing physical activity (PA) and healthy eating (HE) in small and medium corporations to identify feasible and acceptable interventions.

Methods

An anonymous self-administered questionnaire was administered to 655 small and medium corporations to determine whether they implemented PA (18 items) and HE (17 items) policies and environmental strategies and, if not, their intention to do so in the future. We compared differences in the implementation and intention to implement rate by corporation size.

Results

The implementation and intention rates of costly items for PA and HE were low, regardless of corporation size, but were significantly lower in small corporations than in medium corporations.

Conclusions

To overcome cost barriers, employee participation must be encouraged, and employee knowledge of PA and HE must be improved.
IgG4-Related Sclerosing Disease of the Temporal Bone: A Systematic Review
Authors: Oochit Krishna Kushalsingh , Wong Yun Yan , Mihuna Aishath , Oliwa Agata , Kontorinis Georgios
Published: August 2022

Objective

IgG4-related disease (IgG4-RD) involving the temporal bone is an uncommon and underrecognized pathology often mistaken for malignancy. This systematic review is the first that aims to thoroughly analyze IgG4-RD of the temporal bone.

Databases Reviewed

Ovid MEDLINE, EMBASE, Cochrane Library, and Google Scholar.

Methods

We used the following search keywords: “lgG4-RD,” “skull,” “skull base,” “cranial,” “temporal bone,” “inner ear.” We additionally manually searched the bibliographies of relevant articles. The JBI Critical Appraisal Checklist for Case Reports and Case Series was used to assess the risk of bias; because of the scarcity of the reports, data were available through limited case series and reports; thus, data synthesis was not possible.

Results

We identified 17 studies with 22 cases with temporal bone involvement. The most common presenting symptoms were hearing loss, otalgia, and headache. The mastoid and petrous bone were the most affected anatomical areas. Both computed tomography and magnetic resonance imaging were used. Biopsies showed the characteristic lymphoplasmacytic infiltrate in all cases, with histopathology being the diagnostic modality that set the diagnosis. Most patients were treated with corticosteroids ± surgery or a combination of corticosteroids and immunosuppressants with 95.5% symptomatic response and disease control.

Conclusion

IgG4-RD of the temporal bone radiologically manifests as space-occupying, lytic lesions; clinically, it presents with vague otological symptoms. Diagnosis involves a thorough workup, with histopathology being crucial in setting a definite diagnosis. IgG4-RD tends to respond well to systemic corticosteroids, whereas surgery is mostly required for diagnostic purposes.
The Spatial Distribution of Cellular Voids in the Human Otic Capsule: An Unbiased Quantification of Osteocyte-Depleted Areas
Authors: Hansen Lars Juul , Bloch Sune Land , Sørensen Mads Sølvsten
Published: August 2022

Objective

This study aimed to describe the spatial distribution of osteocyte-depleted areas, so-called cellular voids, in the human otic capsule and compare it with that of otosclerosis.

Background

Systematic histological studies of the bony otic capsule have revealed an osteoprotegerin (OPG)-mediated inhibition of normal bone remodeling around the inner ear. The resulting accumulation of bony degeneration and dead osteocytes has been thoroughly documented, and the spatial distribution of dead osteocytes and matrix microcracks resembles that of the human ear disease otosclerosis. Clusters of dead osteocytes that may interfere with osteocyte connectivity and thereby the OPG signaling pathway have been described in human temporal bones. It is possible that these cellular voids create disruptions in the antiresorptive OPG signal that may give rise to local pathological remodeling.

Methods

Recently, a method of detecting cellular voids was developed. This study uses unbiased stereology to document the spatial distribution of cellular voids in bulk-stained undecalcified human temporal bone.

Results

Cellular voids accumulate around the inner ear and increase in number and size with age. Furthermore, cellular voids are more frequently found in the anterior and lateral regions of the otic capsule, which are known predilection sites of otosclerosis.

Conclusion

This colocalization of cellular voids and otosclerosis suggests a causal relationship between focal degeneration and otosclerotic remodeling.
The impact of alfentanil supplementation on the sedation of bronchoscopy: A meta-analysis of randomized controlled trials
Authors: Ou Yan , Feng Malong , Hu Bingqing , Dong Yishan
Published: August 2022

Background:

The efficacy of alfentanil supplementation for the sedation of bronchoscopy remains controversial. We conduct a systematic review and meta-analysis to explore the influence of alfentanil supplementation on the sedation during bronchoscopy.

Methods:

We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through December 2019 for randomized controlled trials (RCTs) assessing the effect of alfentanil supplementation versus placebo for the sedation during bronchoscopy. This meta-analysis is performed using the random-effect model.

Results:

Five RCTs are included in the meta-analysis. Overall, compared with control group for bronchoscopy, alfentanyl supplementation is associated with significantly reduced coughing scores (Std. MD = –0.55; 95% CI = –0.96 to –0.14; P = 0.009) and dose of propofol (Std. MD = –0.34; 95% CI = –0.64 to –0.04; P = 0.03), but reveals the increase in hypoxemia (RR = 1.56; 95% CI = 1.17 to 2.08; P = 0.002).

Conclusions:

Alfentanyl supplementation benefits to reduce coughing scores and dose of propofol for bronchoscopy, but increases the incidence of hypoxemia. The use of alfentanyl supplementation for bronchoscopy should be with caution.
The frequency and characteristics of ultrasonographic ankle joint involvement in systemic lupus erythematosus: A prospective cross-sectional single-center study
Authors: Smiljanic Tomicevic Ljiljana , Hocevar Alojzija , Sukara Goran , Cubelic Darija , Mayer Miroslav
Published: August 2022

The involvement of ankles in systemic lupus erythematosus (SLE) has not been widely studied. The aim of our prospective study was to determine the characteristics of the ankle joint and tendon involvement in SLE using ultrasound (US) as an imaging modality. Sixty consecutive patients with SLE underwent a detailed clinical evaluation and US examination. Gray-scale and power Doppler US of the bilateral tibiotalar (TT) joints, subtalar (ST) joints, and ankle tendons were performed using a multiplanar scanning technique. Joint effusion, synovitis, tenosynovitis, enthesitis, and vascularization were assessed according to the OMERACT recommendations. The Total Ankle Ultrasound Score (TAUSS) was calculated as the sum of the grades of joint effusion and synovial hypertrophy for both TT and ST joints bilaterally (ranging from 0–24) and power Doppler activity was assessed separately. Finally, US findings were correlated with physical evaluation, laboratory parameters, and SLE activity scores. US ankle joint involvement was present in 32/60 (53.3%) patients. TT joints were affected in 26 (43.3%) and ST joints in 16 (26.7%) patients. Thirteen (21.7%) patients had US tendons and/or enthesal involvement. TT joint effusion was the most frequent finding, present in 55/240 (22.9%) examined joints, followed by synovial hypertrophy detected in 18/240 (7.5%) joints. The median (interquartile range; range) TAUSS of the US-affected joints was 1 (0–2; range 1–10). There were no significant correlations between US findings and inflammatory parameters or serological parameters of disease activity, but we found a weak positive correlation between TAUSS and the European Consensus Lupus Activity Measurement (r = 0.281, P = .029). This study revealed a high prevalence of pathological US ankle changes in patients with SLE and a positive correlation between ankle US involvement and disease activity score (European Consensus Lupus Activity Measurement).
Efficacy and safety of thread embedding acupuncture for knee osteoarthritis: A randomized controlled pilot trial
Authors: Woo Sang Ha , Lee Hyun-Jong , Park Yu-kyeong , Han Jihoon , Kim Jae Soo , Lee Jung Hee , Park Chung A. , Choi Seong-Hun , Lee Woo Dong , Yang Chang Sop , Kim Min Ji , Han Chang-Hyun
Published: August 2022

Background:

Thread embedding acupuncture (TEA) is a widely used clinical procedure for the treatment of musculoskeletal pain. However, few clinical studies have been conducted on the efficacy and safety of TEA for knee osteoarthritis (KOA), and data from randomized controlled trials are lacking. This randomized controlled pilot study aimed to assess the feasibility of conducting large-scale studies on the efficacy and safety of TEA for KOA.

Methods:

Forty participants were included in the study and randomly divided into 2 groups (TEA and acupuncture) of 20 each. The intervention period was 6 weeks. The experimental group received TEA once a week (total of 6 sessions) on 14 defined knee areas, and the control group received acupuncture twice a week (total of 12 sessions) on 9 defined acupuncture points. The primary outcome measure was the visual analogue scale score, and the secondary outcome measures were the short-form McGill pain questionnaire, and Western Ontario and McMaster Universities Osteoarthritis Index scores. Participants were assessed prior to the intervention (baseline) and at 3, 6, and 10 weeks (4 weeks after the end of intervention). The adverse effects of TEA and acupuncture were documented. Hematological examination and biochemical tests were performed at the screening and at 6 weeks.

Results:

Of the 40 participants, 37 completed the study and 3 participants dropped out. Both the TEA and acupuncture groups showed a significant improvement in the visual analogue scale, short-form McGill Pain Questionnaire, and Western Ontario and McMaster Universities Osteoarthritis Index scores in a time-dependent manner. However, there was no significant interaction between group and time. No serious adverse events were reported in the groups, and no clinically significant changes were observed in the hematological and biochemical parameters.

Conclusion:

This pilot study suggests that TEA is a safe and effective procedure for relieving pain in patients with KOA. The results of this study provide basic data and indicate the feasibility of large-scale clinical studies to evaluate the efficacy and safety of TEA for KOA.
An original method of analysis of the breast contour curve with 3-dimensional imaging: Case series
Authors: Otsuki Yuki , Ueda Koichi , Ichida Tatsuya , Nuri Takashi , Okada Masashi
Published: August 2022

Introduction:

Postoperative assessment of breast reconstruction results has become increasingly important. In this paper, a unique analysis method with 3-dimensional surface images of patients who were treated with immediate breast reconstruction is presented.

Patient concerns:

Five Japanese women were suspected of having breast cancer and visited our hospital for treatment.

Diagnosis:

Breast cancer was diagnosed by biopsy, mammography, ultrasonography, computed tomography, and magnetic resonance imaging.

Interventions:

Five patients underwent nipple/skin-sparing mastectomy, concomitant sentinel lymph node biopsy, and immediate breast reconstruction in our hospital. Three cases were reconstructed by extended latissimus dorsi flaps, one was reconstructed by a pedicled transverse rectus abdominis myocutaneous flap, and one was reconstructed by a deep inferior epigastric artery perforator flap. Three-dimensional photographs were taken 1 year postoperatively. The similarity of the breast contours between the reconstructed breast and the nonaffected opposite breast obtained from 3-dimensional images was analyzed. The calculated value is called the breast contour score.

Outcomes:

No recurrence was observed during the follow-up period in any cases. All cases could be analyzed by breast contour score to evaluate the breast shapes.

Conclusion:

The scores become a relative value that ranges from 0 (completely different) to 100 (completely the same). By expressing the score as a relative value, the breast contour score could help us understand the degree of breast symmetry more intuitively.
Detrimental correlation between air pollution with skin aging in Taiwan population
Authors: Huang Chao-Hsin , Chen Szu-Chia , Wang Yi-Chian , Wang Chen-Feng , Hung Chih-Hsing , Lee Su-Shin
Published: August 2022

Dissecting the complex relationships between skin aging and air pollution has been an ongoing effort. The increased exposure to air pollution over time imposed a negative effect on skin. This study explores the correlation between skin aging in the Asian population and levels of air pollutants to show different relationship between the two. This study was retrospective and included 389 patients, age between 30 and 74, who planned to receive a session of laser treatment for skin disorders in Kaohsiung Medical University Hospital (KMUH) from 2006 to 2019. Preoperative skin condition quantified by VISIA Complexion Analysis System (Canfield Imaging Systems, Fierfield, NJ, US). Eight air pollutants such as carbon monoxide (CO), non-methane hydrocarbon (NMHC), nitrogen oxides (NO, NO2, and NOx), particulate matters (PM2.5 and PM10), ozone (O3), sulfur dioxide (SO2) and 8 skin condition such as spots, wrinkles, textures, pores, ultraviolet spots (UV spots), brown spots, red area, and porphyrin were analyzed to explore correlation between air pollution and skin aging. Strong correlation was found between NMHC exposure and texture, pores and brown spots formation. A positive correlation between O3 and better VISIA texture and pores scores was found. Brown spots was found to negatively associate with CO, NMHC, NO2, NOx, PM10, PM2.5, and SO2. The skin condition of population over age 45 affected by CO, NMHC, NO2, NOx, PM2.5, PM10, and SO2. Skin condition of the bottom 10% strongly correlates with exposure to PM10 and SO2, whereas skin condition of the top 10% was affected by PM10. Air pollutants such as CO, NO2, NOx, PM2.5, PM10, SO2, and NMHC were found to correlate with negative skin quality strongly. In contrast, O3 exposure is associated with less texture and pores. Future studies are warranted to further appreciate the relationships between air pollutants and skin condition.
Neuromuscular electrical stimulation in the intensive care unit prevents muscle atrophy in critically ill older patients: A retrospective cohort study
Authors: Nonoyama Tadayoshi , Shigemi Hiroko , Kubota Masafumi , Matsumine Akihiko , Shigemi Kenji , Ishizuka Tamotsu
Published: August 2022

Critically ill patients in the intensive care unit (ICU) develop muscle atrophy and decreased physical function. Though neuromuscular electrical stimulation (NMES) therapy has been shown to be effective in preventing this, but its effect on older patients is unknown.

To examine the course of critically ill older patients treated with NMES in the ICU and to define the impact of its use.

A retrospective cohort study was conducted using older ICU patients (≥65 years) categorized into a control group (n = 20) and an NMES group (n = 22). For subgroup analysis, each group was further classified into pre-old age (65–74 years) and old age (≥75 years).

The control group showed significant decrease in muscle thickness during ICU and hospital stay. The NMES group showed lower reduction in muscle thickness and showed decrease in muscle echo intensity during hospital stay, compared to the control group. NMES inhibited decrease in muscle thickness in the pre-old age group versus the old age group. The decreasing effect of NMES on echo intensity during hospital stay manifested only in the pre-old age group. We did not find much difference in physical functioning between the NMES and control groups.

Lower limb muscle atrophy reduces in critically ill older patients (≥65 years) with NMES and is pronounced in patients aged < 75 years. The impact of NMES on the physical functioning of older patients in ICU needs to be further investigated.
Factors associated with long-term smoking relapse in those who succeeded in smoking cessation using regional smoking cessation programs
Authors: Lee Seung Hun , Yi Yu Hyeon , Lee Young In , Lee Hyo Young , Lim Kyoung-Min
Published: August 2022

It is known that approximately 10% of successful quitters relapse annually. This study aimed to investigate the factors related to long-term smoking relapse in individuals who succeeded in maintaining smoking cessation for 6 months after attending a regional smoking cessation program.

This study enrolled 943 individuals registered for the regional smoking cessation program at the Busan Smoking Cessation Center in 2018–2019 who maintained smoking cessation for 6 months. A survey was conducted using a smartphone link or through phone calls, and the data for 305 participants who finally completed the survey were analyzed. The questionnaire addressed individual, inter-individual, organizational, and community-level factors related to smoking relapse. Multivariate logistic regression analysis was performed to evaluate the factors associated with smoking relapse by period. The Cox proportional hazard regression model was used for the factors associated with smoking relapse for the entire period.

The smoking relapse rate at the time of the survey was 25.4%. In the analysis of smoking relapse by period, relapse was associated with the belief that smoking relieves stress, the number of single-person households, and poor subjective health status. In the analysis of smoking relapse during the entire period, we observed a significant association with the belief that smoking relieves stress (hazard ratio [HR]: 2.65, 95% confidence interval [CI]: 1.52–4.61), single-person households (HR: 1.95, 95% CI: 1.16–3.26), and high levels of emotional stress (HR: 1.72, 95% CI: 1.04–2.85).

Long-term follow-up is necessary to prevent smoking relapse in single-person households, individuals who believe that smoking relieves stress, and those experiencing high levels of subjective emotional stress. Interventional therapies for stress relief and awareness improvement in smokers need to be developed.
Epidemiological survey of self-reported food allergy among university students in China
Authors: Feng Hua , Liu Yong , Xiong Xiujuan , Xu Qunying , Zhang Zhongwei , Wu Yongning , Lu Yuanan
Published: August 2022

The aim of this study was to investigate the prevalence of self-reported food allergy among university students in China.

A cluster-random sampling population-based cross-sectional study using self - administrated questionnaire was conducted with 2538 college students recruited from 6 universities in China. The questionnaire included data on age, sex, weight, height, FA, comorbid allergic diseases, family history, and understanding food allergy. Data were analyzed by SPSS 25.0 statistical software. Multivariate logistic regression analysis was performed to analyze the risk factors related to self-reported food allergy and estimate the odds ratio.

A total of 2538 questionnaires were distributed to the undergraduate students and 2313 completely effective questionnaires were collected, the effective response rate was 91.1%. 834 males and 1479 females were recruited, and their age ranged from 18 to 25 years old. The prevalence of self-reported food allergy was 15.7%, and the rate of doctor-diagnosed food allergy was 8.4%. The leading food allergens included shrimp, shellfish, milk, egg, peach, mango, beef, and peanut, and the prevalence of shrimp allergy was the highest (5.8%). The main clinical manifestation included skin mucous membrane and respiratory symptoms. The prevalence of food allergy were statistically significant difference (P < .05) between different age groups, family history, sun exposure times, smoking, and antibiotic use. Over 45% college students know little about food allergy.

The prevalence of self-reported food allergy among Chinese college students was high (15.7%). Shrimp was the main allergenic food, followed by shellfish, milk, egg, peach, and mango. Family history, sun exposure, obesity, and using antibiotics may be the influencing factors of food allergy. The Chinese undergraduates lacked the knowledge about food allergy. Thus, it is necessary to strengthen the health education program on food allergy for college students in China and other middle high-income nations.
Bentall procedure for retrograde type A dissection after endovascular repair in type A aortic dissection: A case report
Authors: Ma Li , Liu Long , Yan Sheng , Yan Jun
Published: August 2022

Rationale:

The management of retrograde type A dissection (RTAD) after thoracic endovascular aortic repair (TEVAR) for type A aortic dissection (TAAD) has rarely been reported. We report the management of RTAD after TEVAR with in situ fenestration for TAAD.

Patient concerns:

A 59-year-old man with TAAD had undergone TEVAR with in situ fenestration 4 months prior to presenting to our emergency room complaining of acute chest and back pain. Computed tomography angiography showed RTAD starting from the proximal endograft and extending to the aortic root.

Diagnosis:

The patient was diagnosed with RTAD.

Interventions:

We performed only the Bentall procedure, and the patient did not require total arch replacement. We removed the bare spring of the proximal endograft and anastomosed the prosthetic graft with the endograft and the native ascending aortic wall.

Outcomes:

The postoperative course was uneventful, and the patient remained asymptomatic for 3 years after surgery. Computed tomography angiography at the 3-year follow-up showed no perivalvular or anastomotic leakage.

Lessons:

RTAD after TEVAR for TAAD was safely and effectively treated by anastomosing the prosthetic graft with the endograft and the native ascending aortic wall instead of total arch replacement.