bluuebunny/crossref_metadata_2025 huggingface dataset:
Introduction
Authors: Geraci Robert M.
Published: May 2022

The introduction describes the rising significance of artificial intelligence (AI) technologies and the importance of understanding the role of religion in our visions of those technologies. Governments, policy advisors, and corporate boards all work on regulatory and ethical structures, and these are deeply impacted by transhumanist perspectives that favour the development of greater-than-human machine intelligence and post-biological evolution. Such inclinations often obfuscate the profound impact of AI on society—including challenges from algorithmic bias to surveillance—and homogenize human approaches to AI despite the existing cultural differences in the design and deployment of technology. The introduction frames these concerns in the rising discussion of religion, science, and technology in the U.S. and India, and then provides summaries of the chapters to come.
Recoding Religion
Authors: Geraci Robert M.
Published: May 2022

Chapter 4 turns to the relevance of the previously explored history and transmission of transhumanist thinking in the U.S. and India. This chapter raises questions of social control that are fundamental to the implementation of artificial intelligence (AI). The ideologies used to justify public and private use of AI matter because they incline users towards specific goals. It is important to see how the religious and cultural environments of the U.S. and India offer separate and worthwhile tools to build a global AI agenda. Recognizing that both U.S. and Indian traditions can have negative or positive consequences, the chapter explores how the best of each can be brought to bear and suggests that a wider discussion of AI values could be leveraged in global policymaking.
The Use of Movement Scripts for Clinical Reasoning in Physical Therapist Education and Practice
Authors: Kirk-Sanchez Neva J , Moore James G , Hartley Gregory W , Wong Marlon
Published: May 2022

The purpose of this Perspective is to present an application of script-based reasoning to physical therapist education and practice. Illness script–based reasoning has been described as a cognitive strategy for medical practitioners to diagnose and manage health conditions. Analogous to this medical model of patient management, “movement scripts” can be used by physical therapists in clinical reasoning. Movement scripts use features of the human movement system to recognize, categorize, and substantiate clinical problems and can be used to facilitate the development of master adaptive learners across the spectrum of physical therapist education and practice. Movement scripts are also consistent with the concept of the “human body as teacher” as the signature pedagogy proposed by the National Study of Excellence and Innovation in Physical Therapy Education. Movement of the human body, as captured by the concept of the human movement system, is a vehicle for lifelong adaptive learning for the physical therapist. Script-based learning and practice are consistent with other elements of this model, including practice-based learning and the creation of adaptive expertise. As the role of the movement system as a guide to physical therapist practice continues to evolve, movement scripts can provide a structure to facilitate development of clinical reasoning skills for physical therapist practice and education.
Do Temporary Demand Shocks Have Long-Term Effects for Startups?
Authors: Hvide Hans K , Meling Tom G
Published: May 2022

Using procurement auctions and register data, we find that temporary demand shocks have long-term effects for startups. Startups that win a procurement auction have 20$\%$ higher sales and employment and are more profitable than startups that narrowly lose an auction, even several years after the contract work has ended. There are no such effects for mature firms. The effects for startups are large: about 50$\%$ of the contract value is transmitted into long-term sales. Our analysis suggests learning-by-doing as a plausible mechanism. Overall, our results point to the importance of path dependence in shaping the long-term outcomes of startups.

Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online
Racial Disparities in the Auto Loan Market
Authors: Butler Alexander W , Mayer Erik J , Weston James P
Published: May 2022

We document racial disparities in auto lending. Combining credit bureau records with borrower characteristics, we find that Black and Hispanic applicants’ approval rates are 1.5 percentage points lower, even after controlling for creditworthiness. In aggregate, this effect crowds out 80,000 minority loans each year. Results are stronger where racial biases are more prevalent and lending competition is lower. Minority borrowers pay 70-basis-point higher interest rates, but default less ceteris paribus, consistent with racial bias rather than statistical discrimination. A major antidiscrimination enforcement policy initiated in 2013, but halted in 2018, reduced unexplained racial differences in interest rates by 60$\%$.

Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Secondary Metabolites Produced by Xylaria necrophora Are Responsible for Foliar Symptoms Associated with Taproot Decline of Soybean
Authors: Garcia-Aroca Teddy , Price Paul “Trey” , Solórzano José E. , Galo David , Sheffield Sophie B. , Doyle Vinson P.
Published: May 2022

Taproot decline (TRD) of soybean ( Glycine max [L] Merr.) is an emerging disease caused by Xylaria necrophora and currently observed in the southern United States. X. necrophora infects soybean roots, causing necrosis and foliar interveinal chlorosis followed by necrosis. The most recent estimates of yield losses associated with this disease (0.57 to 1.18 million bushels) highlight its potential to become a major problem for producers in the region. The mechanism by which X. necrophora affects soybean foliage remains unknown, but a plausible explanation is that phytotoxic secondary metabolites (SMs) are produced by X. necrophora in the roots. To test this hypothesis, cell-free culture filtrates (CFCFs) from three X. necrophora strains and one putative Colletotrichum siamense isolate were used to challenge soybean stem cuttings to determine if foliar symptoms of TRD are caused by SMs, tolerance to SMs among potentially resistant soybean cultivars identified in greenhouse and field experiments, and specificity of SMs across plant species (cotton, peanut, tomato, and soybean). Measurements of chlorophyll content and root length were obtained at 7 and 14 days of exposure. Lower chlorophyll content and shorter roots were observed on all soybean cultivars treated with CFCFs of pathogenic isolates, and no effects on other plant species were observed, suggesting that X. necrophora produces SMs that are detrimental to soybean exclusively and resistance upon direct exposure to SMs does not exist. These results suggest that soybean-specific SMs are produced by X. necrophora in the roots, causing the interveinal chlorosis and subsequent necrosis observed on plants affected by TRD.
Hyperspectral Evaluation of the Human Liver During Major Resection
Authors: Sucher Elisabeth , Sucher Robert , Guice Hanna , Schneeberger Stefan , Brandacher Gerald , Gockel Ines , Berg Thomas , Seehofer Daniel
Published: May 2022

Objective:

This study investigates the effects of PVE and vascular inflow control (VIC) on liver microperfusion and tissue oxygenation using hyperspectral imaging (HSI) technology.

Background:

Mechanisms triggering future liver remnant (FLR) augmentation introduced by PVE have not been sufficiently studied in humans. Particularly, the arterial buffer response (ABR) of the liver might play a vital role.

Methods:

Hyperspectral datacubes (TIVITA) acquired during 58 major liver resections were qualitatively and quantitatively analyzed for tissue oxygenation (StO2%), near-infrared (NIR) perfusion, organ-hemoglobin indices (OHI), and tissue-water indices (TWI). The primary study endpoint was measurement of hyperspectral differences in liver parenchyma subject to PVE and VIC before resection.

Results:

HSI revealed parenchyma specific differences in StO2% with regard to the underlying disease (P < 0.001). Preoperative PVE (n = 23, 40%) lead to arterial hyperoxygenation and hyperperfusion of corresponding liver segments (StO2: 77.23% ± 11.93%, NIR: 0.46 ± 0.20[I]) when compared with the FLR (StO2: 66.13% ± 9.96%, NIR: 0.23 ± 0.12[I]; P < 0.001). In a case of insufficient PVE and the absence of FLR augmentation hyperspectral StO2 and NIR differences were absent. The hyperspectral assessment demonstrated increased liver tissue-oxygenation and perfusion in PVE-segments (n = 23 cases) and decreased total VIC in nonembolized FLR hemilivers (n = 35 cases; P < 0.001). Intraoperative HSI analysis of tumor tissue revealed marked tumor specific differences in StO2, NIR, OHI, and TWI (P < 0.001).

Conclusions:

HSI allows intraoperative quantitative and qualitative assessment of microperfusion and StO2% of liver tissue. PVE lead to ABR-triggered tissue hyperoxygenation and cross-talk FLR augmentation. HSI furthermore facilitates intraoperative tumor tissue identification and enables image-guided liver surgery following VIC.
Reformatting of Computed Tomography Scans Parallel to the S1 End Plate Increases Visualization of Trans Sacral Pathway in the First Sacral Segment, Especially With Dysmorphism
Authors: Kellam Patrick J. , O'Neill Dillon C. , Daryoush Joshua R. , Dekeyser Graham J. , Steffenson Lillia N. , Gary Joshua L. , Higgins Thomas F. , Kellam James F. , Rothberg David L. , Sciadini Marcus , Warner Stephen , Working Zachary , Marchand Lucas S. , Haller Justin M.
Published: May 2022

Objective:

To determine whether reformatted computed tomography (CT) scans would increase surgeons' confidence in placing a trans sacral (TS) screw in the first sacral segment.

Setting:

Level 1 trauma center.

Design:

A retrospective cohort study.

Patients/Participants:

There were 50 patients with uninjured pelvises who were reviewed by 9 orthopaedic trauma fellowship-trained surgeons and 5 orthopaedic residents.

Main Outcome Measurements:

The overall percentage of surgeons who believe it was safe to place a TS screw in the first sacral segment with standard (axial cuts perpendicular to the scanner gantry) versus reformatted (parallel to the S1 end plate) CT scans.

Results:

Overall, 58% of patients were believed to have a safe corridor in traditional cut axial CT scans, whereas 68% were believed to have a safe corridor on reformatted CT scans (P < 0.001). When grouped by dysplasia, those without sacral dysplasia (n = 28) had a safe corridor 93% of the time on traditional scans and 93% of the time with reformatted CT scans (P = 0.87). However, of those who had dysplasia (n = 22), only 12% were believed to have a safe corridor on original scans compared with 35% on reformatted scans (P < 0.001).

Conclusions:

CT scan reformatting parallel to the S1 superior end plate increases the likelihood of identifying a safe corridor for a TS screw, especially in patients with evidence of sacral dysplasia. The authors would recommend the routine use of reformatting CT scans in this manner to provide a better understanding of the upper sacral segment osseous fixation pathways.
Hematologic Toxicity Comparison of Intensity Modulated Proton Therapy and Intensity Modulated Radiation Therapy in Anal Cancer Patients
Authors: Nelson Bailey , Tadesse Dawit G. , Sudhoff Mickaela , Wang Kyle , Meier Teresa , Mascia Anthony , Kharofa Jordan
Published: May 2022

Purpose:

We hypothesize that hematologic toxicity will be lower in anal cancer patients treated definitively with intensity modulated proton therapy (IMPT) compared with patients treated with intensity modulated radiation therapy (IMRT).

Methods:

Patients enrolled on a prospective feasibility trial assessing the use of IMPT for anal cancer were compared with contemporaneous patients treated with IMRT. Blood counts were collected during chemoradiation. Hematologic events were graded according to CTCAE version 5.0. Pelvic bone marrow (PBM) and positron emission tomography-defined active bone marrow (ABM) were defined and contoured for each patient. Toxicity rates, PBM and ABM dose metrics were compared between groups.

Results:

Forty-one patients treated with definitive chemoradiation for anal cancer between 2015 and 2021 were included in this analysis. Of the evaluable patients, 14 patients were treated with IMPT and 27 were treated with IMRT. All PBM dose metrics were lower in patients receiving IMPT. Patients treated with IMPT versus IMRT also had a significantly lower ABM mean dose (1996 vs. 3073 Gy, P<0.01). However, there was no statistically significant difference in hematologic toxicity between the groups. Seventy percent of patients treated with IMRT had at least 1 grade ≥3 hematologic event compared with 86% in the IMPT group (P=0.48).

Conclusion:

Proton treatment reduced bone marrow doses but was not associated with lower hematologic toxicity when compared with IMRT.
Hospital Price Transparency Rule Exposes Muddied Costs for Head and Neck Radiotherapy in One State
Authors: Thompson Samuel , Lewis Luke , Takiar Vinita
Published: May 2022

Objectives:

Financial toxicity due to cancer treatment is a significant concern for patients. To increase transparency related to treatment costs, the Hospital Price Transparency Final Rule (HPTFR) was passed on January 1, 2021. We used hospital pricing documentation to explore the costs of head and neck cancer (HNC) radiotherapy in Ohio, hypothesizing a large variance in cost based on geography.

Materials and Methods:

Radiation oncology facilities were identified using the Ohio Hospital Association (OHA) website. The reported technical charges for Current Procedural Terminology (CPT) codes commonly billed in the definitive management of HNC with radiotherapy were recorded, and total treatment costs (TTCs) were calculated.

Results:

Of 254 OHA-listed hospitals, 102 had radiation oncology facilities. Seven facilities were excluded due to a lack of pricing data, leaving 95 facilities in 40 of 88 counties. Median TTC was $176,496. Average TTC was $184,831 (SD: $83,982). The 22 rural hospitals charged less compared with nonrural hospitals, with a difference in medians of $72,084.38 (P<0.001). No difference was found between the TTCs of nonprofit and public hospitals (P=0.348) nor between academically affiliated and nonacademically affiliated hospitals (P=0.247). There is no correlation between county median household income and TTC (R
2=0.0007). Rather, TTCs varied drastically across counties, regardless of income levels.

Conclusions:

There is a wide range of treatment costs for HNC patients receiving definitive radiotherapy in Ohio, and no variables fully explain this variance. Further policies are needed to improve the quality, quantity, and accessibility of health care data to address financial toxicity.
The Role of Staff in Transmission of SARS-CoV-2 in Long-term Care Facilities
Authors: Adams Carly , Chamberlain Allison , Wang Yuke , Hazell Mallory , Shah Sarita , Holland David P. , Khan Fazle , Gandhi Neel R. , Fridkin Scott , Zelner Jon , Lopman Benjamin A.
Published: May 2022

Background:

US long-term care facilities (LTCFs) have experienced a disproportionate burden of COVID-19 morbidity and mortality.

Methods:

We examined SARS-CoV-2 transmission among residents and staff in 60 LTCFs in Fulton County, Georgia, from March 2020 to September 2021. Using the Wallinga-Teunis method to estimate the time-varying reproduction number, R(t), and linear-mixed regression models, we examined associations between case characteristics and R(t).

Results:

Case counts, outbreak size and duration, and R(t) declined rapidly and remained low after vaccines were first distributed to LTCFs in December 2020, despite increases in community incidence in summer 2021. Staff cases were more infectious than resident cases (average individual reproduction number, Ri = 0.6 [95% confidence intervals [CI] = 0.4, 0.7] and 0.1 [95% CI = 0.1, 0.2], respectively). Unvaccinated resident cases were more infectious than vaccinated resident cases (Ri = 0.5 [95% CI = 0.4, 0.6] and 0.2 [95% CI = 0.0, 0.8], respectively), but estimates were imprecise.

Conclusions:

COVID-19 vaccines slowed transmission and contributed to reduced caseload in LTCFs. However, due to data limitations, we were unable to determine whether breakthrough vaccinated cases were less infectious than unvaccinated cases. Staff cases were six times more infectious than resident cases, consistent with the hypothesis that staff were the primary drivers of SARS-CoV-2 transmission in LTCFs.
Unbiased proteomic analysis detects painful systemic inflammatory profile in the serum of nerve-injured mice
Authors: Zhou Wen Bo Sam , Shi Xiang Qun , Liu Younan , Tran Simon D. , Beaudry Francis , Zhang Ji
Published: May 2022

Neuropathic pain is a complex, debilitating disease that results from injury to the somatosensory nervous system. The presence of systemic chronic inflammation has been observed in patients with chronic pain but whether it plays a causative role remains unclear. This study aims to determine the perturbation of systemic homeostasis by an injury to peripheral nerve and its involvement in neuropathic pain. We assessed the proteomic profile in the serum of mice at 1 day and 1 month after partial sciatic nerve injury (PSNL) or sham surgery. We also assessed mouse mechanical and cold sensitivity in naïve mice after receiving intravenous administration of serum from PSNL or sham mice. Mass spectrometry–based proteomic analysis revealed that PSNL resulted in a long-lasting alteration of serum proteome, where most of the differentially expressed proteins were in inflammation-related pathways, involving cytokines and chemokines, autoantibodies, and complement factors. Although transferring sham serum to naïve mice did not change their pain sensitivity, PSNL serum significantly lowered mechanical thresholds and induced cold hypersensitivity in naïve mice. With broad anti-inflammatory properties, bone marrow cell extracts not only partially restored serum proteomic homeostasis but also significantly ameliorated PSNL-induced mechanical allodynia, and serum from bone marrow cell extracts–treated PSNL mice no longer induced hypersensitivity in naïve mice. These findings clearly demonstrate that nerve injury has a long-lasting impact on systemic homeostasis, and nerve injury–associated systemic inflammation contributes to the development of neuropathic pain.
Validation of the Portuguese version of community attitudes toward people with mental illness (CAMI)
Authors: Lopes Inês , de Almeida Raquel Simões , Marques António , Curral Rosário , de Sousa Sara
Published: May 2022

Stigma remains a feature that influences the lifestyle of people with mental illness. Negative attitudes, stereotypes, and discrimination are still prevalent in these people's life. Stigma is considered a public health problem that occurs unconsciously in society, categorizing people. Portugal is the seventh-worst country concerning stigma in Mental Health. There have been few improvements in reducing stigma over time, and there is a great need to create investigations and validate instruments that measure stigma in the population.

Aim:

This study aims to address the gaps in the level of studies and normative instruments that measure the stigma of the Portuguese population in the face of mental illness. It, therefore, aims to adapt and validate community attitudes toward people with mental illness (CAMI) culturally and examine its psychometric properties.

Method:

The 27-item version of CAMI was translated and back-translated into English, which was analyzed and evaluated by a panel of experts. A sociodemographic survey and CAMI were applied in an online format, in which participated 427 adults representing the Portuguese population in general. Finally, the reliability and validity of the instrument were analyzed.

Results:

CAMI showed positive values of reliability and validity but not optimal. The confirmatory factor analysis values satisfactory values that indicate good quality of fit: x
2/df=3.296; comparative fit index = 0.601; goodness of fit index = 0.817; and root mean square error of approximation = 0.073, indicates good quality of fit. Cronbach alpha was different for each factor, but it was positive. Spearman coefficient (ρ = –0.343) obtained a negative but consistent value.

Conclusions:

This study contributed to the achievement and validation of new measures to assess the stigma of the general population related to people with mental illness. We must continue to analyze this theme, complete the validation of this instrument, and understand the existing levels of stigma, its predominance in society, and the possible creation and implementation of new measures that support literacy in mental illness and anti-stigma.
Best Practices for the Coordinated Care of Patients With Neuroendocrine Tumors Undergoing Peptide Receptor Radionuclide Therapy
Authors: Hendifar Andrew E. , Mehr Samuel H. , McHaffie Derek R.
Published: May 2022

Neuroendocrine tumors (NETs) are rare, diverse malignancies; approximately two thirds originate in the gastrointestinal tract and pancreas and are known as gastroenteropancreatic NET. Most cases are diagnosed in the advanced or metastatic setting and overexpress somatostatin receptors. Recommended first-line treatment is somatostatin analogs; however, disease progression is common. [177Lu]Lu-DOTA-TATE is a radiolabeled peptide receptor radionuclide therapy (PRRT) indicated for the treatment of adult patients with somatostatin receptor-positive foregut, midgut, and hindgut gastroenteropancreatic NETs and progression on first-line somatostatin analogs. Many primary oncology practices may lack the staff, expertise, and infrastructure to treat patients with PRRT and primary oncologists may therefore refer their patients to a NET specialist at a tertiary center for treatment. Given the amount of organization required, PRRT treatment may seem to be complex; however, this process will be managed by a care coordinator who acts as a consistent point of contact for primary physicians regarding the care of their patients and ensures blood tests and scans are scheduled. In this article, we share our opinions, procedures, workflow, best practice, and roles and responsibilities when caring for patients receiving [177Lu]Lu-DOTA-TATE and focus on the role of the primary oncologist before, during, and after PRRT treatment.
Efficacy and Safety of Peroral Pancreatoscopy Through the Fistula Created by Endoscopic Ultrasound–Guided Pancreaticogastrostomy
Authors: Suzuki Akinori , Ishii Shigeto , Fujisawa Toshio , Saito Hiroaki , Takasaki Yusuke , Takahashi Sho , Yamagata Wataru , Ochiai Kazushige , Tomishima Ko , Isayama Hiroyuki
Published: May 2022

Objectives

Endoscopic ultrasound/endosonography-guided pancreaticogastrostomy (EUS-PGS) is a useful alternative when endoscopic retrograde pancreatography is difficult. Recently, many procedures, including peroral pancreatoscopy (POPS), have been performed through the mature fistula (MF) created by EUS-PGS. We evaluate the efficacy and safety of POPS to diagnose and treat pancreatic ductal stricture/pancreato-jejunal anastomotic stricture (PDS/PJAS) through the MF.

Methods

Twenty patients underwent EUS-PGS; 13 of these underwent POPS through the MF at Juntendo University Hospital. All patients were studied retrospectively in terms of technical and clinical success rates and adverse events (AEs).

Results

The technical and clinical success rates of EUS-PGS were 95% and 100%. The early and late AEs rates were 20% and 15%. The technical success rate of POPS was 100%, with one AE. Biopsy of PDS/PJAS under POPS guidance revealed recurrent/residual intrapapillary mucinous adenoma (3 patients) and benign fibrotic stricture (10 patients). In the latter patients, multiple plastic stents were placed to dilate PDS/PJAS. Four patients with improvement of PDS/PJAS were stent free, but the remaining patients were not yet.

Conclusions

Endoscopic ultrasound/endosonography-guided pancreaticogastrostomy and various procedures (including POPS) performed through the MF are feasible and effective and can diagnose and treat PDS/PJAS with acceptable AEs rates.
Efficacy and Safety of Neoadjuvant Chemoradiation Therapy Administered for 5 Versus 2 Weeks for Resectable and Borderline Resectable Pancreatic Cancer
Authors: Suto Hironobu , Okano Keiichi , Oshima Minoru , Ando Yasuhisa , Matsukawa Hiroyuki , Takahashi Shigeo , Shibata Toru , Kamada Hideki , Kobara Hideki , Tsuji Akihito , Masaki Tsutomu , Suzuki Yasuyuki
Published: May 2022

Objectives

Indications of preoperative treatment for resectable (R-) or borderline resectable (BR-) pancreatic ductal adenocarcinoma (PDAC) are unclear, and the protocol remains to be standardized.

Methods

Included 65 patients with R- and BR-PDAC with venous involvement (V-) received neoadjuvant chemoradiotherapy with S-1 and 50 Gy of radiation as the 5-week regimen. The outcomes of this group were compared with those of 52 patients who underwent S-1 and 30 Gy of radiation as the 2-week regimen, previously collected as our prospective phase II study.

Results

Compared with the 2-week regimen, there were no significant differences in the rate of protocol completion, adverse events, mortality and morbidity, or R0 resection in the 5-week regimen. In subgroup analyses of R-PDAC, there were no significant differences in overall survival and recurrence-free survival between the groups. In contrast, the 5-week regimen had significantly better overall survival and recurrence-free survival than the 2-week regimen for BRV-PDAC. Similar results were observed after propensity score matching analysis.

Conclusions

The 5-week regimen of neoadjuvant chemoradiotherapy has good clinical efficacy and safety for R- and BRV-PDAC. The 5-week regimen could achieve better outcomes than the 2-week regimen for BRV-PDAC. In contrast, both regimens achieved similar outcomes for R-PDAC.
Determination of the Force Required to Produce Stab “Wounds” in Fruit Compared With Cadaveric Chest Tissue
Authors: Gitto Lorenzo , Serinelli Serenella , Werner Frederick W. , Ordway Nathaniel R. , Stoppacher Robert
Published: May 2022

In laymen's terms, it can be difficult to communicate how much force is needed to create a stab wound into a person's chest. Previous work has determined the force to puncture the skin, rib cartilage, or bone but without putting the results in terms that are easy to understand.

The purpose of this study was to determine the force needed to puncture 3 types of fruit using 3 different types of knives, namely, a steak knife, a butcher's knife, and a lock-blade knife, to help put these previous results in perspective.

There was wide variation in the force required to insert a knife into different fruits, but no force for any knife at any location for all fruits exceeded 93.1 N. Results show that force needed to penetrate the skin and allow for an 8-cm blade penetration into the chest is similar to the force required to insert a steak knife for a 6-cm distance into a cantaloupe. In addition, the force needed to penetrate the cartilage is most similar to stabbing a watermelon to 6 cm with a butcher knife. However, the forces required to penetrate the bone are greater than those required to penetrate any fruit with any type of blade.
Hormone -Refractory Prostatic Adenocarcinoma Mimicking Basal Cell Carcinoma: A Case Report
Authors: Caron Justin E. , Hart Steven D. , Chamie Karim , Ye Huihui
Published: May 2022

Prostate cancer is an androgen-driven malignancy. Patients with late-stage prostate cancer often receive androgen-deprivation therapy to suppress the disease progression. Under the selection pressure, some prostate cancers transform to androgen-independent cancers. Treatment-induced small cell neuroendocrine carcinoma is one of the examples. In the last decade, patients with disseminated prostate cancer frequently received second-generation androgen-deprivation agents, such as abiraterone, enzalutamide, and apalutamide. Those more potent drugs have led to an emergence of a novel type of androgen-independent carcinoma named “double-negative” prostate cancer, which is immunohistochemically negative for both neuroendocrine markers and androgen targets. In this report, we present a typical case of “double-negative” end-stage prostate cancer that morphologically resembled basal cell carcinoma of prostate, basaloid large nest type.
Prostatic Malakoplakia: Case Report and Review of the Literature
Authors: Chen Dong , Zou Qiong , Dehner Carina , Cao Dengfeng
Published: May 2022

A 69-year-old Asian man with a history of overactive bladder presented with postvoid dribbling and urinary incontinence in the past three years. He had cervical spinal stenosis surgery one month ago and two episodes of urinary tract infections with multidrug-resistant Escherichia coli species in urine culture in the last three months. Digital rectal examination revealed a 1-cm hard nontender nodule within the right side of his prostate, concerning for possible prostatic malignancy. Ultrasound study identified a hypoechoic area in the right lateral prostate. Serum prostate-specific antigen level was 2.03 ng/mL (reference range, ≤5.40 ng/mL). Biopsies of the prostate showed only focal chronic inflammation in the left lobe, but there were collections of abundant histiocytes with associated plasma cells and lymphocytes, as well as fibrosis in 5 of 7 cores in the right lobe. Within the histiocytic infiltrate, abundant Michaelis-Gutmann bodies, both intracytoplasmic and extracellular, were identified and confirmed with periodic–acid Schiff and von Kossa stains. The morphologic features and histochemical stains support the diagnosis of malakoplakia. So far, 68 cases of prostatic malakoplakia including ours have been reported (mean age, 63.5 years). Most patients presented with urinary tract symptoms and positive urine culture for E. coli. Eight patients also had associated prostatic adenocarcinoma. Serum prostate-specific antigen may be significantly elevated in patients with prostatic malakoplakia without associated adenocarcinoma. Prostatic malakoplakia can clinically and radiographically mimic prostatic adenocarcinoma. Pathologically malakoplakia should be distinguished from granulomatous prostatitis and other benign and malignant prostatic diseases.
Histopathologic Changes in a Hypogonadal Male on Exogenous Testosterone Diagnosed With Prostatic Adenocarcinoma: A Case Report
Authors: Yang David , Sun Yue
Published: May 2022

In the United States, prostatic adenocarcinoma is the most common nonskin cancer and second leading cause of cancer death. Pathologic diagnostics are paramount to guiding treatment but require an awareness that hormonal treatments have the capacity to alter the histological appearance of prostate cancer. This case highlights the importance of accurate diagnostics and grading through a discussion of histological findings in an unusual case of a male patient with hypogonadism on long-term exogenous testosterone who was diagnosed with prostatic adenocarcinoma.
Mixed Small Cell Neuroendocrine Carcinoma and Conventional Acinar Adenocarcinoma of the Prostate: A Case Report
Authors: Cordeiro-Rudnisky Fernanda , Wu Yubo , Sun Yue
Published: May 2022

Prostate cancer with neuroendocrine (NE) differentiation can be classified into six categories: conventional adenocarcinoma with NE differentiation, adenocarcinoma with Paneth cell–like NE differentiation, carcinoid tumor, small cell carcinoma, large cell carcinoma, and mixed NE carcinoma-acinar adenocarcinoma. Mixed NE carcinoma-acinar carcinoma is a biphasic carcinoma characterized by the presence of NE (small or large cell) carcinoma and conventional acinar adenocarcinoma. In rare cases, these two components overlap without discrete classic small cell carcinoma or a usual prostate adenocarcinoma component, making it particularly difficult to determine whether these overlapping cases should be diagnosed as small cell carcinoma or adenocarcinoma with a high Gleason score. Here, we present the case of a 74-year-old man who was diagnosed with mixed small cell NE carcinoma and conventional acinar adenocarcinoma of the prostate.
Blue Nevus of the Prostate: A Report of Two Cases and Review of the Literature
Authors: Legesse Teklu , Sesterhenn Isabell , Paulk Adina
Published: May 2022

Pigmented lesions of the prostate are very rare and include melanosis, blue nevus, and malignant melanoma. Of these lesions, blue nevus (also known as pigmented melanocytosis or pigmentary nevohyperplasia) is the most frequently reported one. It is morphologically similar to its much more common cutaneous counterpart and composed mainly of heavily pigmented spindle cells within the prostatic stroma. It is often discovered incidentally in needle biopsies, transurethral resection of the prostate, or prostatectomy specimens performed for prostatic cancer or benign prostatic hyperplasia. It is a benign lesion with no potential for malignant transformation. Recognition of this entity is important because of the differential diagnosis with the much rarer malignant melanoma involving the prostate. The pathologic features and differential diagnosis with relevant literature review are discussed in this report.
Cost-effectiveness Analysis of Peripherally Inserted Central Catheters Versus Central Venous Catheters for in-Hospital Parenteral Nutrition
Authors: Comas Mercè , Domingo Laia , Jansana Anna , Lafuente Elisabeth , Civit Anna , García-Pérez Lídia , Lasso de la Vega Carmen , Cots Francesc , Sala Maria , Castells Xavier
Published: May 2022

Objective

Our objective was to evaluate the cost-effectiveness of the use of peripherally inserted central venous catheters (PICCs) by a vascular access team (VAT) versus central venous catheters (CVCs) for in-hospital total parenteral nutrition (TPN).

Methods

The study used a cost-effectiveness analysis based on observational data retrospectively obtained from electronic medical records from 2018 to 2019 in a teaching hospital. We included all interventional procedures requiring PICCs or CVCs with the indication of TPN. We recorded the costs of insertion, maintenance, removal, and complications. The main outcome measure was the incidence rate of catheter-associated bacteremia per 1000 catheter days. Cost-effectiveness analysis was performed from the hospital perspective within the context of the publicly funded Spanish health system. Confidence intervals for costs and effectiveness differences were calculated using bootstrap methods.

Results

We analyzed 233 CVCs and 292 PICCs from patients receiving TPN. Average duration was longer for PICC (13 versus 9.4 days, P < 0.001). The main reason for complications in both groups was suspected infection (9.77% CVC versus 5.18% PICC). Complication rates due to bacteremia were 2.44% for CVC and 1.15% for PICC. The difference in the incidence of bacteremia per 1000 catheter days was 1.29 (95% confidence interval, −0.89 to 3.90). Overall, costs were lower for PICCs than for CVCs: the difference in mean overall costs was −€559.9 (95% confidence interval, −€919.9 to −€225.4). Uncertainty analysis showed 86.37% of results with lower costs and higher effectiveness for PICC versus CVC.

Conclusions

Placement of PICC by VAT compared with CVC for TPN reduces costs and may decrease the rate of bacteremia.
Body Mass Index Is Not an Independent Factor Associated With Recovery Room Length of Stay for Patients Undergoing Outpatient Surgery
Authors: Alonso Stephany , Du Austin L , Waterman Ruth S. , Gabriel Rodney A.
Published: May 2022

Objectives

Prolonged recovery time in the postanesthesia care unit (PACU) increases cost and administrative burden of outpatient surgical staff. The primary aim of this study was to determine whether body mass index (BMI) is associated with prolonged recovery in the PACU after outpatient surgery in a freestanding ambulatory surgery center.

Methods

We retrospectively studied 3 years of surgeries performed at a freestanding ambulatory surgery center. Mixed-effects logistic (for binary outcomes) and linear (for continuous outcomes) regressions were performed, in which the random effect was the surgical procedure. Prolonged PACU length of stay was modeled as a binary variable, that is, stay greater than the third quartile, and as a continuous variable, that is, actual duration of stay in minutes. We reported odds ratio and 95% confidence interval from the logistic regression and estimates with standard errors from the linear regression.

Results

Patients with obesity (BMI ≥ 30 kg/m2) did not demonstrate increased odds for prolonged PACU length of stay (all P > 0.05). Furthermore, BMI—represented as a continuous variable—was not associated with actual PACU length of stay (estimate = 0.05, standard error = 0.06, P = 0.41). No association was found between obesity and PACU length of stay on a subgroup analysis where only patients with obstructive sleep apnea were analyzed.

Conclusions

There was no association between BMI and PACU length of stay among patients who received outpatient surgery at a freestanding ambulatory surgery center.
Prescribe to Save Lives: Improving Buprenorphine Prescribing Among HIV Clinicians
Authors: Jawa Raagini , Walley Alexander Y. , Wilson Donna J. , Green Traci C. , McKenzie Michelle , Hoskinson Randall , Bratberg Jeffrey , Ramsey Susan , Rich Josiah D. , Friedmann Peter D.
Published: May 2022

Background:

HIV clinicians are uniquely positioned to treat their patients with opioid use disorder using buprenorphine to prevent overdose death. The Prescribe to Save Lives (PtSL) study aimed to increase HIV clinicians' buprenorphine prescribing via an overdose prevention intervention.

Methods:

The quasi-experimental stepped-wedge study enrolled 22 Ryan White–funded HIV clinics and delivered a peer-to-peer training to clinicians with follow-up academic detailing that included overdose prevention education and introduced buprenorphine prescribing. Site-aggregated electronic medical record (EMR) data measured with the change in X-waivered clinicians and patients prescribed buprenorphine. Clinicians completed surveys preintervention and at 6- and 12-month postintervention that assessed buprenorphine training, prescribing, and attitudes. Analyses applied generalized estimating equation models, adjusting for time and clustering of repeated measures among individuals and sites.

Results:

Nineteen sites provided EMR prescribing data, and 122 clinicians returned surveys. Of the total patients with HIV across all sites, EMR data showed 0.38% were prescribed buprenorphine pre-intervention and 0.52% were prescribed buprenorphine postintervention. The intervention increased completion of a buprenorphine training course (adjusted odds ratio 2.54, 95% confidence interval: 1.38 to 4.68, P = 0.003) and obtaining an X-waiver (adjusted odds ratio 2.11, 95% confidence interval: 1.12 to 3.95, P = 0.02). There were nonsignificant increases at the clinic level, as well.

Conclusions:

Although the PtSL intervention resulted in increases in buprenorphine training and prescriber certification, there was no meaningful increase in buprenorphine prescribing. Engaging and teaching HIV clinicians about overdose and naloxone rescue may facilitate training in buprenorphine prescribing but will not result in more treatment with buprenorphine without additional interventions.
JMM profile: Loop-mediated isothermal amplification (LAMP): for the rapid detection of nucleic acid targets in resource-limited settings
Authors: Hassan Marwa M. , Grist Lucy F. , Poirier Aurore C. , La Ragione Roberto M.
Published: May 2022

Loop-mediated isothermal amplification (LAMP) is a rapid alternative to PCR, in which the reaction occurs at one temperature and uses a polymerase with high displacement activity, e.g.

Bacillus stearothermophilus

DNA polymerase I (Bst) or homologues. Since the discovery of LAMP in 2000, several applications have been developed to employ this technique in the rapid detection of nucleic acid targets and enhance its performance. Improvements to the LAMP technique and a variety of innovative detection methods have led to its application for a wide range of targets in medical and veterinary microbiology, particularly in resource-poor settings. The key advantages of LAMP-based diagnostics include the ability to rapidly detect target nucleic acid sequences within 30 min and its ease of use, facilitating its application in field, bedside, pen-side, point-of-care and point-of-need diagnostic settings. LAMP can be a valuable tool to aid in the detection and management of disease outbreaks.
Novel 16S rRNA methyltransferase RmtE3 in Acinetobacter baumannii ST79
Authors: Taylor Emma , Jauneikaite Elita , Sriskandan Shiranee , Woodford Neil , Hopkins Katie L.
Published: May 2022

Introduction. The 16S rRNA methyltransferase (16S RMTase) gene armA is the most common mechanism conferring high-level aminoglycoside resistance in

Acinetobacter baumannii

, although rmtA, rmtB, rmtC, rmtD and rmtE have also been reported.

Hypothesis/Gap statement. The occurrence of 16S RMTase genes in

A. baumannii

in the UK and Republic of Ireland is currently unknown.

Aim. To identify the occurrence of 16S RMTase genes in

A. baumannii

isolates from the UK and the Republic of Ireland between 2004 and 2015.

Methodology. Five hundred and fifty pan-aminoglycoside-resistant

A. baumannii

isolates isolated from the UK and the Republic of Ireland between 2004 and 2015 were screened by PCR to detect known 16S RMTase genes, and then whole-genome sequencing was conducted to screen for novel 16S RMTase genes.

Results. A total of 96.5 % (531/550) of isolates were positive for 16S RMTase genes, with all but 1 harbouring armA (99.8 %, 530/531). The remaining isolates harboured rmtE3, a new rmtE variant. Most (89.2 %, 473/530) armA-positive isolates belonged to international clone II (ST2), and the rmtE3-positive isolate belonged to ST79. rmtE3 shared a similar genetic environment to rmtE2 but lacked an ISCR20 element found upstream of rmtE2.

Conclusion. This is the first report of rmtE in

A. baumannii

in Europe; the potential for transmission of rmtE3 to other bacterial species requires further research.
Effects of apple polyphenols on color, hardness, digestibility, and syneresis of corn starch gels
Authors: Park Han-Sol , Chung Hun-Sik
Published: May 2022

The present study investigated the effect of addition of apple polyphenols on the color values, pH, hardness, in vitro digestibility, and syneresis of corn starch gels. Corn starch gels supplemented with various amounts of polyphenols (0%, 0.03%, 0.06%, 0.13%, 0.27%, 0.53%, and 1.06%) isolated from young fuji apple fruits were prepared, and their quality properties were determined. The L* and h° values of corn starch gels decreased but the a* and b* values increased with the increasing amount of apple polyphenols. Further, the pH of corn starch gels decreased with the increasing amount of apple polyphenols. The amount of apple polyphenols added did not affect the initial hardness of corn starch gels; however, concentrations of apple polyphenols exceeding 0.27% delayed the hardening of stored starch gels. Finally, the addition of apple polyphenols up to 0.27% decreased in vitro α-amylase digestibility but increased the syneresis of corn starch gels during the freeze–thaw process. Overall, the addition of apple polyphenols affected the quality parameters of corn starch gels. These findings can serve as a reference for apple polyphenol application and starch processing.
Biological activity of Brassica oleracea var. capitata fermented with Lactobacillus plantarum
Authors: Lee Hyo-Jeong , Park Se-Eun , Choi Jun-Hui , Kim Ki-Man
Published: May 2022

White cabbage (Brassica oleracea var. capitata) reportedly exerts antioxidant, anti-inflammatory, and anti-gastric effects. We aimed to evaluate the biological activity of B. oleracea fermented with Lactobacillus plantarum (FBO). The plant material was fermented for 7 d. The antioxidative potentials of FBO (DPPH radical-scavenging activity, and total phenol and total flavonoid contents) and ability of FBO to inhibit digestive enzymes (α-amylase and lipase) were tested. Anti-inflammatory and anti-allergic effects were also determined by measuring the release of NO, inflammatory cytokines (IL-1β, TNF-α and IL-4), β-hexosaminidase and histamine. FBO contained 15.84±0.25 mg GAE/g phenols and 1.19±0.09 mg NA/g flavonoids. FBO showed DPPH radical-scavenging activity, and inhibited α-amylase and lipase. It also inhibited of NO, PGE2 and inflammatory cytokine production by LPS-stimulated RAW 264.7 macrophages. Finally, FBO inhibited degranulation and inflammatory cytokine production in antigen-stimulated RBL-2H3 mast cells, in a dose-dependent manner. Collectively, these observations indicate that white cabbage fermented with L. plantarum can be used as a functional material and edible resource in industrial setting.
Preparation of β-aminoisobutyric acid and
branched chain amino acid-enhanced hydrolysates from chicken breast: Effect
of protease types and hydrolysis conditions
Authors: Kim Eun-Bee , Kim Dae-Woon , Choi Han-Suk , Kim Young-Hoi , Kim Myung-Kon
Published: May 2022

Beta-aminoisobutyric acid (BAIBA) and branched-chain amino acids (BCAA) have
recently received considerable attention because of their various health
benefits. In this study, the hydrolysis characteristics of chicken breast for 11
commercially proteolytic enzymes were studied to evaluate the effect of protease
type, reaction pH (5-8), leaction time (2-24 h) and enzyme concentration
(0.25-8%), and the effect of two combined enzymes for the preparation of BAIBA-
and BCAA-enriched chicken breast hydrolysates. The content of BAIBA was higher
in hydrolysate by prozyme 2000P (38.72±3.01 mg/g, dry weight base),
foodpro alkaline protease (30.24±2.54 mg/g) and alcalase
(26.24±1.01 mg/g) while the BCAA content was higher in prozyme 2000P
(108.96±2.63 mg/g), flavourzyme (81.12±4.78 mg/g) and sumizyme LP
(62.88±3.83 mg/g). As the effects of reaction pH, time, and amount of
added enzymes, the optimum condition for the preparation of BAIBA- and
BCAA-enriched hydrolysates were as follows; reaction pH 6-7, reaction time 8-16
h and the amount of enzyme 4% (w/w) based on the dried chicken breast. However,
no significant increase of BAIBA and BCAA content was observed when hydrolyzed
with two combined enzymes. These results suggest that commercial proteolytic
enzymes can be applied to prepare BAIBA- and BCAA-enriched chicken breast
hydrolysates.