bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding the relationship between care team perceptions about CHWs and CHW integration within a US health system, a qualitative descriptive multiple embedded case study
Authors: McCarville Erin E. , Martin Molly A. , Pratap Preethi Lakshmi , Pinsker Eve , Seweryn Steven M. , Peters Karen E.
Published: December 2022

Background

Community health workers (CHW) have grown in prominence within the healthcare sector, yet there is no clear consensus regarding a CHW’s role, purpose, and value within health systems. This lack of consensus has the potential to affect how CHWs are perceived, utilized, and ultimately integrated within the healthcare sector. This research examines clinical care teams that currently employ CHWs to (1) understand how members of the care team perceive CHWs’ purpose and value, and (2) consider how perceptions of CHWs are related to CHW integration within health care teams.

Methods

Researchers conducted a qualitative descriptive multiple embedded case study at the University of Illinois at Chicago’s Hospital and Health Science System (UI Health). The embedded subunits of analysis were teams within UI Health that are currently employing CHWs to assist with the provision of clinical care or services to patients. Data were collected via semi-structured interviews and document review.

Results

In total, 6 sub-units were enrolled to participate, and 17 interviews were conducted with CHWs (n = 9), and administrators or health care providers (n = 8). Reported perceptions of CHWs were inconsistent across respondents. CHWs roles were not always understood, and the CHW’s purpose and value was perceived differently by different members of the care team. Moreover, evaluation metrics did not always capture CHWs’ value to the health care system. In some cases, care teams were more aligned around a shared understanding of the CHW’s roles and purpose within the care team. When perceptions regarding CHWs were both positive and aligned, respondents reported higher levels of integration within the healthcare system.

Conclusions

Alignment in a care team’s perception of a CHW’s role, purpose, and value within the health system could play an important role in the integration of CHWs within healthcare teams.
Transdisciplinary allied health assessment for patients with stroke: a pre-/post- mixed methods study protocol
Authors: Martin Aleysha K. , Green Theresa L. , McCarthy Alexandra L. , Sowa P. Marcin , Laakso E-Liisa
Published: December 2022

Background

Transdisciplinary approaches can streamline processes and build workforce capacity by blurring traditional responsibilities and integrating aspects of care. Emerging evidence shows transdisciplinary approaches can improve time-efficiency, quality of care and cost-effectiveness across various healthcare settings, however no empirical study is based on an acute stroke unit.

Methods

The SPIRIT checklist was used to guide the content of the research protocol. The study is a pragmatic pre−/post- mixed methods four-phase study with a 3-month follow up, based at the Mater Hospital Brisbane. Participants experiencing stroke symptoms will be recruited as they are admitted to the acute stroke unit. Patients presenting with mild stroke symptoms or Transient Ischaemic Attack will be allocated to Phase 1 (baseline) or Phase 2 (implementation), while patients presenting with moderate to severe stroke symptoms will be allocated to Phase 3 (baseline) or Phase 4 (implementation). Participants in baseline Phases 1 and 3 will receive standard allied health assessment, while participants in implementation Phases 2 and 4 will receive the novel transdisciplinary assessment. For the primary aim, allied health professionals will time their assessments to evaluate time taken to administer a novel transdisciplinary assessment, compared to usual discipline-specific assessments. Non-inferiority of the novel transdisciplinary assessment will also be explored in terms of patient safety, compliance to national standards, use of the assessment, and stakeholder perceptions. A retrospective medical record audit, staff focus group, patient/staff surveys, and patient phone interviews at 3-months will be completed. Quantitative results will be estimated using general linear and logistic regression models in Stata 15.1. Qualitative results will be analysed using frequency counts and NVivo software. An economic evaluation will be performed using three scopes including the allied health assessment, hospital admission, and patient outcomes at 3-months.

Discussion

When designing the study, pragmatic factors related to staff willingness to be involved, patient safety, and existing clinical pathways/processes were considered. To address those factors, a co-design approach was taken, resulting in staff buy-in, clinically relevant outcome measures, and the pre−/post- four-phase study design.

Trial registration

Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12621000380897. Registered 06 April 2021 - retrospectively registered, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=381339&isReview=true
Neoadjuvant pyrotinib, trastuzumab, and docetaxel for HER2-positive breast cancer (PHEDRA): a double-blind, randomized phase 3 trial
Authors: Wu Jiong , Jiang Zefei , Liu Zhenzhen , Yang Benlong , Yang Hongjian , Tang Jinhai , Wang Kun , Liu Yunjiang , Wang Haibo , Fu Peifen , Zhang Shuqun , Liu Qiang , Wang Shusen , Huang Jian , Wang Chuan , Wang Shu , Wang Yongsheng , Zhen Linlin , Zhu Xiaoyu , Wu Fei , Lin Xiang , Zou Jianjun
Published: December 2022

Background

Pyrotinib (an irreversible pan-ErbB inhibitor) plus capecitabine has survival benefits and acceptable tolerability in patients with HER2-positive metastatic breast cancer. We further assessed addition of pyrotinib to trastuzumab and docetaxel in the neoadjuvant setting.

Methods

In this multicenter, double-blind, phase 3 study (PHEDRA), treatment-naive women with HER2-positive early or locally advanced breast cancer were randomly assigned (1:1) to receive four neoadjuvant cycles of oral pyrotinib or placebo (400 mg) once daily, plus intravenous trastuzumab (8 mg/kg loading dose, followed by 6 mg/kg) and docetaxel (100 mg/m2) every 3 weeks. The primary endpoint was the total pathological complete response (tpCR; ypT0/is and ypN0) rate per independent central review.

Results

Between Jul 23, 2018, and Jan 8, 2021, 355 patients were randomly assigned, 178 to the pyrotinib group and 177 to the placebo group. The majority of patients completed four cycles of neoadjuvant treatment as planned (92.7% and 97.7% in the pyrotinib and placebo groups, respectively). The tpCR rate was 41.0% (95% CI 34.0 to 48.4) in the pyrotinib group compared with 22.0% (95% CI 16.6 to 28.7) in the placebo group (difference, 19.0% [95% CI 9.5 to 28.4]; one-sided P < 0.0001). The objective response rate per investigator was 91.6% (95% CI 86.6 to 94.8) in the pyrotinib group and 81.9% (95% CI 75.6 to 86.9) in the placebo group after the neoadjuvant treatment, resulting in an increase of 9.7% (95% CI 2.7 to 16.6). The most common grade 3 or worse adverse events were diarrhea (79 [44.4%] in the pyrotinib group and nine [5.1%] in the placebo group), neutropenia (33 [18.5%] and 36 [20.3%]), and decreased white blood cell count (29 [16.3%] and 24 [13.6%]). No deaths were reported during neoadjuvant treatment.

Conclusions

The primary endpoint of the study was met. Neoadjuvant pyrotinib, trastuzumab, and docetaxel significantly improved the tpCR rate compared with placebo, trastuzumab, and docetaxel, with manageable toxicity, providing a new option for HER2-positive early or locally advanced breast cancer.

Trial registration

ClinicalTrials.gov, NCT03588091
Is canine calprotectin in serum stabile after storage at low temperature?
Authors: Kostanjšak Tara , Bojanić Krunoslav , Čičak Helena , Gotić Jelena , Vrbanac Zoran , Šimundić Ana-Maria , Vnuk Dražen , Bottegaro Nika Brkljača
Published: December 2022

Background

In human and veterinary medicine calprotectin is most widely used in diagnosing different gastro-intestinal diseases. The aim of this study was to assess the stability of canine calprotectin (cCP) in serum after storage at low temperatures and imprecision of the method.

Methods

Blood samples were collected from dogs with different clinical diagnoses. Twenty-two dogs were included in this study. Calprotectin concentration was measured 4 hours after serum separation (T0), and after being frozen at − 80 °C for 8 (T1) and 16 weeks (T2). The maximum permissible difference (MPD) was derived from the equation for calculating total error (TE) TE = %Bias + (1.96 x %CV), where bias and coefficient of variation (CV) were defined by the manufacturer. The dogs enrolled in this study were patients admitted during the morning (9–12 a.m.), on the day the first measurement was performed. All sample analysis for determination of stability were done in duplicates. For determination of within-run precision, the two patients’ serum samples were analyzed in 20 replicates. Imprecision was assessed by analyzing 20 replicates on one plate on two samples where high and low concentrations were anticipated.

Results

The calculated value of MPD was 32.52%. Median calprotectin concentrations were higher at T1 114.08 μg/L (IQR = 55.05–254.56) and T2 133.6 μg/L (IQR = 100.57–332.98) than at T0 83.60 μg/L (IQR = 50.38–176.07). Relative and absolute bias at T1 (49.3%; 45.98 μg/L) and T2 (109.93%; 94.09 μg /L) have shown that calprotectin concentrations increase after long term storage at − 80 °C.

Conclusion

The results of the present study indicate that c-CP was not stable for 16 weeks at low storage temperature (− 80 °C). Considering the observed change in the concentration of c-CP at T1, a storage time of 8 weeks should be safely applied. The method imprecision was not satisfactory, especially in the lower concentration range.
Detection and sequence analysis of Canine morbillivirus in multiple species of the Mustelidae family
Authors: Lanszki Zsófia , Lanszki József , Tóth Gábor Endre , Cserkész Tamás , Csorba Gábor , Görföl Tamás , Csathó András István , Jakab Ferenc , Kemenesi Gábor
Published: December 2022

Background

Canine morbillivirus (canine distemper virus, CDV) is a member of the Paramyxoviridae family. Canine distemper is a serious viral disease that affects many mammalian species, including members of the Mustelidae family. These animals have an elusive nature, which makes related virological studies extremely challenging. There is a significant knowledge gap about the evolution of their viruses and about the possible effects of these viruses to the population dynamics of the host animals. Spleen and lung tissue samples of 170 road-killed mustelids belonging to six species were collected between 1997 and 2022 throughout Hungary and tested for CDV with real-time RT-PCR.

Results

Three species were positive for viral RNA, 2 out of 64 Steppe polecats (Mustela eversmanii), 1 out of 36 European polecats (Mustela putorius) and 2 out of 36 stone martens (Martes foina); all 18 pine martens (Martes martes), 10 least weasels (Mustela nivalis) and 6 stoats (Mustela erminea) tested negative. The complete CDV genome was sequenced in five samples using pan-genotype CDV-specific, amplicon-based Nanopore sequencing. Based on the phylogenetic analysis, all five viral sequences were grouped to the Europe/South America 1 lineage and the distribution of one sequence among trees indicated recombination of the Hemagglutinin gene. We verified the recombination with SimPlot analysis.

Conclusions

This paper provides the first CDV genome sequences from Steppe polecats and additional complete genomes from European polecats and stone martens. The infected specimens of various species originated from distinct parts of the country over a long time, indicating a wide circulation of CDV among mustelids throughout Hungary. Considering the high virulence of CDV and the presence of the virus in these animals, we highlight the importance of conservation efforts for wild mustelids. In addition, we emphasize the importance of full genomic data acquisition and analysis to better understand the evolution of the virus. Since CDV is prone to recombination, specific genomic segment analyses may provide less representative evolutionary traits than using complete genome sequences.
Construction and validation of a metabolic-related genes prognostic model for oral squamous cell carcinoma based on bioinformatics
Authors: Zhang Jingfei , Ma Chenxi , Qin Han , Wang Zhi , Zhu Chao , Liu Xiujuan , Hao Xiuyan , Liu Jinghua , Li Ling , Cai Zhen
Published: December 2022

Background

Oral squamous cell carcinoma (OSCC) accounts for a frequently-occurring head and neck cancer, which is characterized by high rates of morbidity and mortality. Metabolism-related genes (MRGs) show close association with OSCC development, metastasis and progression, so we constructed an MRGs-based OSCC prognosis model for evaluating OSCC prognostic outcome.

Methods

This work obtained gene expression profile as well as the relevant clinical information from the The Cancer Genome Atlas (TCGA) database, determined the MRGs related to OSCC by difference analysis, screened the prognosis-related MRGs by performing univariate Cox analysis, and used such identified MRGs for constructing the OSCC prognosis prediction model through Lasso-Cox regression. Besides, we validated the model with the GSE41613 dataset based on Gene Expression Omnibus (GEO) database.

Results

The present work screened 317 differentially expressed MRGs from the database, identified 12 OSCC prognostic MRGs through univariate Cox regression, and then established a clinical prognostic model composed of 11 MRGs by Lasso-Cox analysis. Based on the optimal risk score threshold, cases were classified as low- or high-risk group. As suggested by Kaplan–Meier (KM) analysis, survival rate was obviously different between the two groups in the TCGA training set (P < 0.001). According to subsequent univariate and multivariate Cox regression, risk score served as the factor to predict prognosis relative to additional clinical features (P < 0.001). Besides, area under ROC curve (AUC) values for patient survival at 1, 3 and 5 years were determined as 0.63, 0.70, and 0.76, separately, indicating that the prognostic model has good predictive accuracy. Then, we validated this clinical prognostic model using GSE41613. To enhance our model prediction accuracy, age, gender, risk score together with TNM stage were incorporated in a nomogram. As indicated by results of ROC curve and calibration curve analyses, the as-constructed nomogram had enhanced prediction accuracy compared with clinicopathological features alone, besides, combining clinicopathological characteristics with risk score contributed to predicting patient prognosis and guiding clinical decision-making.

Conclusion

In this study, 11 MRGs prognostic models based on TCGA database showed superior predictive performance and had a certain clinical application prospect in guiding individualized.
Therapeutic effect of a MUC1-specific monoclonal antibody-drug conjugates against pancreatic cancer model
Authors: Wu Guang , Li Lan , Liu Mengnan , Chen Chunyan , Wang Guangze , Jiang Zewei , Qin Yaqian , He Licai , Li Hongzhi , Cao Jiawei , Gu Haihua
Published: December 2022

Background

Pancreatic cancer is one of the most aggressive malignancies without effective targeted therapies. MUC1 has emerged as a potential common target for cancer therapy because it is overexpressed in a variety of different cancers including the majority of pancreatic cancer. However, there are still no approved monoclonal antibody drugs targeting MUC1 have been reported. Recently, we generated a humanized MUC1 antibody (HzMUC1) specific to the interaction region between MUC1-N and MUC1-C. In this study, we generated the antibody drug conjugate (ADC) by conjugating HzMUC1 with monomethyl auristatin (MMAE), and examined the efficacy of HzMUC1-MMAE against the MUC1-positive pancreatic cancer in vitro and in vivo.

Methods

Western blot and immunoprecipitation were used to detect MUC1 in pancreatic cancer cells. MUC1 localization in pancreatic cancer cells was determined by confocal microscopy. HzMUC1 was conjugated with the monomethyl auristatin (MMAE), generating the HzMUC1-MMAE ADC. Colony formation assay and flow cytometry were used to assess the effects of the HzMUC1-MMAE cell viability, cell cycle progression and apoptosis. Capan-2 and CFPAC-1 xenograft model were used to test the efficacy of HzMUC1-MMAE against pancreatic cancer.

Results

HzMUC1 antibody binds to MUC1 on the cell surface of pancreatic cancer cells. HzMUC1-MMAE significantly inhibited cell growth by inducing G2/M cell cycle arrest and apoptosis in pancreatic cancer cells. Importantly, HzMUC1-MMAE significantly reduced the growth of pancreatic xenograft tumors by inhibiting cell proliferation and enhancing cell death.

Conclusion

Our results indicate that HzMUC1-ADC is a promising novel targeted therapy for pancreatic cancer. HzMUC1-ADC should also be an effective drug for the treatment of different MUC1-positive cancers.
C/D box small nucleolar RNA SNORD104 promotes endometrial cancer by regulating the 2ʹ-O-methylation of PARP1
Authors: Lu Bingfeng , Chen Xi , Liu Xin , Chen Jingwen , Qin Honglei , Chen Shuo , Zhao Yang
Published: December 2022

Background

Small nucleolar RNAs (snoRNAs) are dysregulated in many cancers, although their exact role in tumor genesis and progression remains unclear.

Methods

The expression profiles of snoRNAs in endometrial cancer (EC) tissues were analyzed using data from The Cancer Genome Atlas, and SNORD104 was identified as an upregulated snoRNA in EC. The tumorigenic role of SNORD104 in EC was established in CCK8, colony formation, EdU, apoptosis, Transwell, and in vivo xenograft experiments. The molecular mechanisms of SNORD104 were analyzed by RNA immunoprecipitation (RIP), Nm-seq, RTL-P assay, RNA stability assay, qRT-PCR, and western blotting.

Results

Antisense oligonucleotide (ASO)-mediated knockdown of SNORD104 in Ishikawa cells significantly inhibited their proliferation, colony formation ability, migration, and invasion in vitro and increased apoptosis. On the other hand, overexpression of SNORD104 promoted EC growth in vivo and in vitro. RIP assay showed that SNORD104 binds to the 2ʹ-O-methyltransferase fibrillarin (FBL), and according to the results of Nm-seq and RTL-P assay, SNORD104 upregulated PARP1 (encoding poly (ADP-ribose) polymerase 1) 2ʹ-O-methylation. The binding of FBL to PARP1 mRNA was also verified by RIP assay. Furthermore, SNORD104 expression was positively correlated with PARP1 expression in EC tissues. In the presence of actinomycin D, SNORD104 increased the stability of PARP1 mRNA and promoted its nuclear localization. Finally, silencing FBL or PARP1 in the HEC1B cells overexpressing SNORD104 inhibited their proliferative and clonal capacities and increased apoptosis rates.

Conclusions

SNORD104 enhances PARP1 mRNA stability and translation in the EC cells by upregulating 2ʹ-O-methylation and promotes tumor growth.
HIV-related bilateral inflammatory myofibroblastic tumors of the adrenal gland: a case report and literature review
Authors: Zhang Mengmeng , Liu Hui , Zhu Zhiqiang , Zhang Yu , Zhang Yanyan , Hu Xiaopeng
Published: December 2022

Background

Inflammatory myofibroblastic tumor (IMT) is a rare disease that mostly occurs in younger people and is located in the lungs in the general population. We report a rare case of adrenal IMT in a patient with HIV infection, which is believed to be the first of its kind worldwide.

Case presentation

We present a rare case of a 44-year-old man with HIV infection who was diagnosed with adrenal IMT. The patient refused regular highly active antiretroviral therapy 13 years ago until he was admitted to hospital after an adrenal mass was found. The patient underwent successful computed-tomography-guided needle biopsy, and pathological analysis showed fibroblastic–myofibroblastic proliferation with inflammatory infiltration, which confirmed a diagnosis of IMT. We failed to perform complete resection of the tumor because of its diffuse invasion. The patient was complicated with severe multiple pulmonary infections postoperatively because of immunodeficiency, which eventually caused his death 2 months later.

Conclusion

Differential diagnosis of IMT is difficult, and tumor biopsy is an essential means of diagnosis. Surgical resection is preferred for both adrenal and HIV-related IMTs. Conservative treatment should be considered when there are technical difficulties with complete resection, and most patients have achieved good outcomes. However, more cases and longer follow-up are warranted to confirm long-term outcomes of HIV-related IMT.
The perceptions of older people living with hiv/aids towards physical activity and exercise
Authors: Chetty Levin , Cobbing Saul , Chetty Verusia
Published: December 2022

Background

Older people living with HIV (OPLWH) require significant levels of support, including healthcare and rehabilitation interventions. People living with HIV are living longer, but still experience health-related impairments that affect functional activity, participation in day-to-day interactions, livelihoods and overall quality of life. Physical activity and exercise should be included as part of the comprehensive medical management for OPLWH but the investigation of prior studies reveal a gap in understanding and prescription. Our study aimed to explore the perceptions of OPLWH about physical activity and exercise.

Methods

The study adopted a phenomenological, qualitative design, using in-depth interviews, to understand OPLWH perceptions of physical activity and exercise, and their need for, and access to, physical activity and exercise programmes in a community in South Africa. Nine [9] males and seven [7] females participated in the study.

Results

Sixteen individuals voluntarily participated in face-to-face, semi-structured interviews which took place at the healthcare facility where they received regular treatment. All participants were 50 years and older. Personal gratification and the ability to perform activities of daily living as well as participate in community activities were believed to be strong motivators for exercise participation, while barriers to exercise were attributed to physical health issues; lack of proper instruction as well as stigma associated with HIV status within their communities. Participants also favored a combination of aerobic, flexibility and strength activities, as well as proper supervision and instruction within a group exercise setting.

Conclusion

The qualitative nature of our study provided an in-depth understanding of the perceptions of OPLWH towards physical activity and exercise. Our study highlighted the factors that hinder adherence to physical activity and exercise in this population. Many indicated that they would love to engage in structured physical activity programmes, but did not know where, when or how to begin. Creating a suitable environment with proper supervision and instruction by suitably qualified health professionals are essential when developing a community-based exercise programme for OPLWH.
Transmission dynamics of human herpesvirus 6A, 6B and 7 from whole genome sequences of families
Authors: Chrisman Brianna S. , He Chloe , Jung Jae-Yoon , Stockham Nate , Paskov Kelley , Wall Dennis P.
Published: December 2022

While hundreds of thousands of human whole genome sequences (WGS) have been collected in the effort to better understand genetic determinants of disease, these whole genome sequences have less frequently been used to study another major determinant of human health: the human virome. Using the unmapped reads from WGS of over 1000 families, we present insights into the human blood DNA virome, focusing particularly on human herpesvirus (HHV) 6A, 6B, and 7. In addition to extensively cataloguing the viruses detected in WGS of human whole blood and lymphoblastoid cell lines, we use the family structure of our dataset to show that household drives transmission of several viruses, and identify the Mendelian inheritance patterns characteristic of inherited chromsomally integrated human herpesvirus 6 (iciHHV-6). Consistent with prior studies, we find that 0.6% of our dataset’s population has iciHHV, and we locate candidate integration sequences for these cases. We document genetic diversity within exogenous and integrated HHV species and within integration sites of HHV-6. Finally, in the first observation of its kind, we present evidence that suggests widespread de novo HHV-6B integration and HHV-7 integration and reactivation in lymphoblastoid cell lines. These findings show that the unmapped read space of WGS is a promising source of data for virology research.
What influences psychological functioning in patients with mood disorders? The role of clinical, sociodemographic, and temperamental characteristics in a naturalistic study
Authors: Di Vincenzo Matteo , Sampogna Gaia , Della Rocca Bianca , Brandi Carlotta , Mancuso Emiliana , Landolfi Lorenzo , Volpicelli Antonio , Di Cerbo Arcangelo , Fiorillo Andrea , Luciano Mario
Published: December 2022

Background

The present study aims to assess clinical and psychological correlates of psychological functioning in patients with mood disorders, in a naturalistic setting. In particular, we aimed to describe which sociodemographic, clinical, and temperamental dispositions are more frequently associated with poor psychological functioning, and to describe the association between cognitive and psychological functioning in euthymic patients with major depression and bipolar disorder.

Methods

Inclusion criteria were as follows: (1) diagnosis of major depression, or bipolar disorder type I or II; (2) age between 18 and 65 years; and (3) being in a stable phase of the disorder. Patients’ psychiatric symptoms, quality of life, affective temperaments, and impulsivity were investigated with validated assessment instruments.

Results

166 patients have been recruited, mainly female (55.4%), whose mean age was 47.1 ± 14.2 years. 42.6% of individuals reported a diagnosis of major depression. According to regression analyses, poor cognitive performance (p < 0.05), reduced perceived quality of life (p < .0001), lifetime suicide attempts (p < 0.01), and increased trait-related impulsivity (p <0 .001) strongly correlated with poor psychological functioning. Moreover, cyclothymic and irritable dispositions were also associated with poor social functioning (p < 0.01), whereas hyperthymic affective disposition was associated to a better psychological performance (p < 0.01).

Conclusions

Our results support the evidence that patients with mood disorders should be assessed for psychological functioning and affective dispositions, to identify patients at higher risk to develop worse long-term outcomes and to develop targeted interventions.
Sports-related concussion: assessing the comprehension, collaboration, and contribution of chiropractors
Authors: Shannon Nicholas , Patricios Jon
Published: December 2022

Over the last 2 decades, sports-related concussion (SRC) awareness and management have evolved from an emphasis on complete cognitive and physical rest to evidence-based protocols and interventions. Chiropractors are primary care providers with exposure to athletes and teams in collision sports and, in addition, manage patients with concussion-like symptoms including neck pain, dizziness, and headache. With SRC frequently occurring in the absence of a medical practitioner, the role of allied health practitioners like chiropractors should be emphasised when it comes to the recognition, assessment, and management of SRC. This commentary discusses the potential contribution of chiropractors in SRC and the specific role their expertise in the cervical spine may play in symptom evaluation and management. A PubMed and Google scholar review of the chiropractic SRC literature suggests that the chiropractic profession appears under-represented in concussion research in athletic populations compared to other medical and allied health fields. This includes an absence of chiropractic clinicians with a focus on SRC participating in the Concussion in Sport Group (CISG) and the International Consensus Conferences on Concussion. Furthermore, with evolving evidence suggesting the importance of cervicogenic manifestations in SRC, there is an opportunity for chiropractors to participate in SRC diagnosis and management more fully and contribute scientifically to an area of specialised knowledge and training. With a dearth of chiropractic orientated SRC science, clinical SRC expertise, and clinical chiropractic representation in the CISG; it is incumbent on chiropractic clinicians and scientists to take up this opportunity through meaningful contribution and involvement in the SRC field.
Intraoperative arthrography favorably impacts the early outcome of operatively managed fractures of the lateral humeral condyle displaced 1–5 mm in children
Authors: Lari Ali , Alenezi Ahmad , Abughaith Jarrah , AlShehawy Haitham , Hammady Wael , AlSaifi Saleh
Published: December 2022

Background

Controversy exists surrounding the optimal approach to managing pediatric lateral humeral condyle fractures (LHCF). The difficulty in assessing the articular surface using radiography and the intra-articular element potentially involved make LHCF susceptible to complications and delayed diagnoses. Arthrography has been used to delineate the articular surface to aid in deciding whether closed or open reduction is necessary. However, there has been scarce evidence to determine the accuracy of using radiography versus arthrography to predict articular disruption in LHCF displaced 1–5 mm. This study assesses; (1) the utility of intraoperative arthrography in modifying the method of operative reduction, (2) the accuracy of plain radiography in identifying articular integrity, and (3) the clinical outcomes of early operative treatment.

Methods

This was a single-center prospective study that involved operatively treated pediatric LHCF with a displacement of 1–5 mm. Patient demographics, radiographic displacement, predicted radiographic articular integrity, articular integrity on arthrograms, modification of management and follow-up clinical outcomes were obtained.

Results

A total of 72 patients were included with a mean displacement of 2.6 mm and a mean follow-up of 16 months. The articular surface was disrupted in 21% of patients. The reduction method (open versus closed) was modified in 15 patients (21%) after an intraoperative arthrogram. Out of 25 patients with displacement < 2 mm, four of which (15%) had disrupted articular surface and were subsequently treated with open reduction internal fixation (ORIF). While eleven patients with > 4 mm displacement had an intact articular hinge that were managed with closed reduction and percutaneous pinning (CRPP). All patients achieved union with no documented major complications. The ability of radiography to discriminate between disrupted/ intact articular integrity decreases as displacement decreases.

Conclusions

Data from this study suggest using the degree of displacement measured on plain radiography is insufficient in predicting articular integrity for fractures displaced 1–5 mm. The use of arthrography guides reduction method and adequacy, avoiding scenarios of unnecessary open reduction and insufficient closed reduction. Further, a significant amount of outliers exist that have intact articular hinges above 4 mm and disrupted hinges below 2 mm of displacement. Finally we report favorable outcomes using a lower threshold for early operative treatment.
Inflammatory pseudotumor-like follicular/fibroblastic dendritic cell sarcoma: focus on immunohistochemical profile and association with Epstein-Barr virus
Authors: Pagliuca Francesca , Ronchi Andrea , Auricchio Annamaria , Lieto Eva , Franco Renato
Published: December 2022

Inflammatory pseudotumour-like follicular/fibroblastic dendritic cell sarcoma (IPT-like FDCS) is a rare EBV-associated variant of follicular dendritic cell sarcoma, usually arising in the liver or spleen and characterized by a favourable prognosis. The neoplastic cells show variable follicular dendritic cell or fibroblastic reticular cell differentiation and their immunoprofile is still poorly characterized. We describe a case of splenic IPT-like FDCS with unexpected CD31 expression and provide a concise review of English literature on the topic.
Letrozole increases preantral follicle growth and decreases estradiol production without impairing follicle survival
Authors: Kasuga-Yamashita Fukiko , Baba Tsuyoshi , Nagao Sachiko , Fujibe Yuya , Morishita Miyuki , Kuno Yoshika , Mariya Tasuku , Honnma Hiroyuki , Endo Toshiaki , Kiya Tamotsu , Saito Tsuyoshi
Published: December 2022

Background

Letrozole has been reported to be effective in treating anovulation, preventing ovarian hyperstimulation syndrome (OHSS), and retrieving oocytes in breast cancer patients. However, the role and mechanism of letrozole in follicular development remain unclear.

Results

We treated mouse preantral follicles with various treatments; we found no significant difference in follicle survival rates in the letrozole (LET) group compared with the control group, but the average diameter of follicles in the LET group tended to be larger (CTRL vs. LET 30, p = 0.064; CTRL vs. LET 100, p = 0.025). The estradiol concentrations in culture media of the LET group were significantly lower than those observed in the control group (CTRL vs. LET 30, p = 0.038; CTRL vs. LET 100, p = 0.025). We further found a marked increase in follicle-stimulating hormone receptor (FSHR) gene expression in response to letrozole treatment (CTRL vs. LET 30, p = 0.075; CTRL vs. LET 100, p = 0.034). This result suggested that increased FSHR expression promotes follicle development. Letrozole inhibited aromatase activity, but the effect was limited. Letrozole did not significantly reduce vascular endothelial growth factor (VEGF) gene expression.

Conclusions

Letrozole may promote follicle development by increasing the expression of FSHR. Letrozole may be useful for fertility preservation of patients with estrogen-dependent cancers such as breast cancer and various other cancers. Whether letrozole has a direct effect in reducing OHSS requires further investigation.
Chronic Toxoplasma gondii infection contributes to perineuronal nets impairment in the primary somatosensory cortex
Authors: de Medeiros Brito Ramayana Morais , Meurer Ywlliane da Silva Rodrigues , Batista Jully Anne Lemos , de Sá Andréa Lima , de Medeiros Souza Cássio Ricardo , de Souto Janeusa Trindade , de Andrade-Neto Valter Ferreira
Published: December 2022

Toxoplasma gondii is able to manipulate the host immune system to establish a persistent and efficient infection, contributing to the development of brain abnormalities with behavioral repercussions. In this context, this work aimed to evaluate the effects of T. gondii infection on the systemic inflammatory response and structure of the primary somatosensory cortex (PSC). C57BL/6 and BALB/c mice were infected with T. gondii ME49 strain tissue cysts and accompanied for 30 days. After this period, levels of cytokines IFN-γ, IL-12, TNF-α and TGF-β were measured. After blood collection, mice were perfused and the brains were submitted to immunohistochemistry for perineuronal net (PNN) evaluation and cyst quantification. The results showed that C57BL/6 mice presented higher levels of TNF-α and IL-12, while the levels of TGF-β were similar between the two mouse lineages, associated with the elevated number of tissue cysts, with a higher occurrence of cysts in the posterior area of the PSC when compared to BALB/c mice, which presented a more homogeneous cyst distribution. Immunohistochemistry analysis revealed a greater loss of PNN labeling in C57BL/6 animals compared to BALB/c. These data raised a discussion about the ability of T. gondii to stimulate a systemic inflammatory response capable of indirectly interfering in the brain structure and function.

Graphical Abstract
The gut microbiome of obese postpartum women with and without previous gestational diabetes mellitus and the gut microbiota of their babies
Authors: Dualib Patricia Medici , Fernandes Gabriel , Taddei Carla R. , Carvalho Camila R. S. , Sparvoli Luiz Gustavo , Bittencourt Célia , Silva Isis T. , Mattar Rosiane , Ferreira Sandra R. G. , Dib Sergio A. , de Almeida-Pititto Bianca
Published: December 2022

Background

The incidence of gestational diabetes mellitus (GDM) is increasing worldwide, and has been associated with some changes in the gut microbiota. Studies have shown that the maternal gut microbiota pattern with hyperglycemia can be transmitted to the offspring. The study aimed to evaluate the gut microbiota of obese postpartum women with and without previous GDM and their offspring.

Methods

We evaluated a total of 84 puerperal women who had (n = 40) or not GDM (n = 44), and their infants were also included. Stool samples were obtained 2–6 months after delivery. The molecular profile of the fecal microbiota was obtained by sequencing V4 region of 16S rRNA gene (Illumina® MiSeq).

Results

We found that the gut microbiota structures of the puerperal women and their infants were similar. Stratifying according to the type of delivery, the relative abundance of Victivallis genus was higher in women who had natural delivery. Exposure to exclusive breastfeeding was associated with a greater abundance of Bacteroides and Staphylococcus. The differential abundance test showed correlations to clinical and laboratory parameters. This work showed no difference in the microbiota of obese puerperal women with and without GDM and their offspring. However, breastfeeding contributed to the ecological succession of the intestinal microbiota of the offspring.

Conclusion

This work can contribute to understanding the potential effects of GDM and early life events on the gut microbiome of mothers and their offspring and its possible role in metabolism later in life.
Immunoglobulin replacement therapy in patients with immunodeficiencies: impact of infusion method on patient-reported outcomes
Authors: Mallick Rajiv , Solomon Geneviève , Bassett Paul , Zhang Xiang , Patel Palak , Lepeshkina Oleksandra
Published: December 2022

Background

Understanding the impact of different immunoglobulin (Ig) infusion methods (intravenous [IVIg] and subcutaneous [SCIg]) upon treatment experience can potentially facilitate optimization of patient outcomes. Here, the perspective of patients with primary and secondary immunodeficiency diseases (PID and SID, respectively) receiving IVIg and SCIg was evaluated, in terms of treatment satisfaction, accounting for treatment history, using Association des Patients Immunodéficients du Québec (APIQ) survey data.

Methods

The online APIQ survey (shared October 2020–March 2021) of patients with immunodeficiencies in Canada contained 101 questions on: Ig use, history, and detailed infusion characteristics; as well as structured patient-reported outcomes such as treatment satisfaction (via TSQM-9), symptom state (via PASS), general health perception (via GHP), and physical and mental function (via PROMIS). Adult respondents (≥ 18 years old) currently using Ig were compared by their current Ig infusion method (IVIg or SCIg cohort) overall, and in a sub-analysis, the IVIg cohort was compared with the SCIg cohort after stratification by respondents who started SCIg when naïve to Ig (‘SCIg naïve’) or with previous IVIg experience (‘SCIg switch’).

Results

In total, 54 respondents currently used IVIg and 242 used SCIg. The average duration per infusion of a weekly SCIg infusion was significantly shorter compared with the average duration of a 3–4 weekly IVIg infusion (p < 0.001). The SCIg cohort was associated with significantly higher scores for the TSQM-9effectivenessdomain compared with the IVIg cohort. The scores for TSQM-9convenienceandglobal satisfactiondomains were similar in the two cohorts. The SCIg cohort was also associated with a significantly higher proportion of respondents who were in an acceptable symptom state and a lower proportion who reported very poor or poor perception of health compared with the IVIg cohort. Further, the SCIg naïve subgroup was associated with significantly higher TSQM-9effectivenessandconveniencedomain scores compared with the IVIg cohort, while there was no significant difference between the SCIg switch subgroup and the IVIg cohort in terms ofconvenience.

Conclusions

A better understanding of how different IgRT administration methods impact treatment experience and satisfaction may assist with informed treatment decision making and ultimately further improvements in patient outcomes.
Novel PGM3 mutation in two siblings with combined immunodeficiency and childhood bullous pemphigoid: a case report and review of the literature
Authors: Fallahi Mazdak , Jamee Mahnaz , Enayat Javad , Abdollahimajd Fahimeh , Mesdaghi Mehrnaz , Khoddami Maliheh , Segarra-Roca Anna , Frohne Alexandra , Dmytrus Jasmin , Keramatipour Mohammad , Mansouri Mahboubeh , Eslamian Golnaz , Fallah Shahrzad , Boztug Kaan , Chavoshzadeh Zahra
Published: December 2022

Background

Bullous pemphigoid is the most common autoimmune subepidermal blistering disorder with a low incidence in childhood. Combined immunodeficiencies (CIDs) are a group of monogenic inborn errors of immunity (IEIs) characterized by T- and B-cell dysfunction leading to recurrent infections, lymphoproliferation, predisposition to malignancy, and autoimmunity. Here, we report two Afghan siblings with a diagnosis of CID and extremely rare manifestation of diffuse bullous pemphigoid skin lesions.

Case presentation

The older sibling (patient 1) was a 32-month-old male with facial dysmorphism, protracted diarrhea, failure to thrive, recurrent oral candidiasis, recurrent otitis media with tympanic membrane perforation, who had been previously diagnosed with CID. While he was under treatment with intravenous immunoglobulin (IVIg), he developed extensive blistering lesions, which were diagnosed as childhood bullous pemphigoid. Methylprednisolone and azathioprine were added to the regimen, which resulted in a remarkable improvement of the skin lesions and also the feeding condition. However,2 weeks later, he was re-admitted to the intensive care unit (ICU) and eventually died due to fulminant sepsis. Later, his 12-month-old sister (patient 2) with similar facial dysmorphism and a history of developmental delay, food allergy, recurrent oral candidiasis, and respiratory tract infections also developed blistering skin lesions. She was under treatment for occasional eczematous lesions, and had been receiving IVIg for 3 months due to low levels of immunoglobulins. Further immunologic workup showed an underlying CID and thus treatment with IVIg continued, gradually improving her clinical condition. The genetic study of both siblings revealed a novel homozygous mutation in exon 7 of the PGM3 gene, c.845 T > C (p.Val282Ala).

Conclusions

Dermatologic disorders may be the presenting sign in patients with CID and mutated PGM3. This case report further extends the spectrum of skin manifestations that could be observed in PGM3 deficiency and emphasizes the importance of considering CIDs during the assessment of skin disorders, particularly if they are extensive, recurrent, refractory to treatment, and/or associated with other signs of IEIs.
High isolation MIMO antenna for 5G C-band application by using combination of dielectric resonator, electromagnetic bandgap, and defected ground structure
Authors: Sandi Efri , Diamah Aodah , Al Mawaddah Mumtaz
Published: December 2022

High isolation between massive MIMO antenna elements is one of the important parameters that improves antenna performance, especially for 5G communication applications. In this study, we propose a design to improve isolation between elements to enhance the antenna performance. The proposed solution to improve the performance of massive MIMO antennas is to use a combination of dielectric resonator, electromagnetic bandgap (EBG) and defected ground structure (DGS) techniques at the frequency band 3.5 GHz as the 5G frequency band under 6 GHz. The material used is FR-4 which has a dielectric constant ($${\varepsilon }_{r}$$

ε
r

) of 4.3. Simulation results and measurements between antenna elements show an improvement in mutual coupling, widening the bandwidth and increasing the gain of the antenna. The proposed design using the dielectric resonator antenna (DRA) by MIMO 8 × 8 16 port—64 elements and the addition of EBG and DGS structures on the ground plane—has shown to suppress mutual coupling parameter lower than without using DRA-EBG-DGS design by 15 dB, increase bandwidth to 246 MHz, increase gain to 24.7 dB and improve the overall envelope correlation coefficient (ECC) parameter.
Investigating the most essential skills of planners in Ethiopia’s Amhara National Regional State’s Regiopolitan cities
Authors: Workineh Nigatu Amsalu
Published: December 2022

This study intends to answer the specific skills and skills Ethiopian planners, particularly Amhara National Regional State's Regiopolitan cities planners, require the most in their urban planning profession. In today's urban world, understanding city dynamics, forecasting and predicting vibrant cities, making urban planning decisions and putting them into practice, collaborating with stakeholders from various governments and educational backgrounds, persuading people to accept urban plans, and building good personal and skilled relationships have all become highly complex and challenging. As a result, to succeed in their jobs in Ethiopia, planners must possess particular skills. This study looks into the essential skills that planners require in today's dynamic and complex urban environment. The investigation was conducted in Ethiopia as part of a more extensive regional study of Regiopolitan cities. A structured questionnaire survey of 104 experienced planners was undertaken, and semi-structured in-depth interviews with 9 key informants to investigate the essential planners' skills in the Ethiopian planning system to find the essential skills needed in practice. The findings demonstrate that an urban planning method in Regiopolitan cites of Amhara National Regional State, Ethiopia urban planning system is such practical planners who wish to carve out a position for them must equip themselves with analytical and synthesis skills. Finally, the study included recommendations for improving planners’ future skills and more research into the matter.