bluuebunny/crossref_metadata_2025 huggingface dataset:
Neutrophil-derived lipocalin-2 in adult-onset Still’s disease: a novel biomarker of disease activity and liver damage
Authors: Jia Jinchao , Yang Luyu , Cao Zhujun , Wang Mengyan , Ma Yuning , Ma Xiong , Liu Qiaoyan , Teng Jialin , Shi Hui , Liu Honglei , Cheng Xiaobing , Ye Junna , Su Yutong , Sun Yue , Chi Huihui , Liu Tingting , Wang Zhihong , Wan Liyan , Yang Chengde , Hu Qiongyi
Published: June 2020

Objective

Liver damage is a common manifestation and can be life-threatening in adult-onset Still’s disease (AOSD), an autoinflammatory disease. The hallmark of AOSD is activation of neutrophils, whose infiltration in liver is suspected to promote tissue injury. Here we aimed to identify a candidate biomarker and to validate its association with liver damage in AOSD.

Methods

Transcriptome analysis of neutrophils from treatment-naïve active AOSD patients and healthy donors was performed. Lipocalin-2 (LCN2) expression was assessed in neutrophils, plasma and liver biopsies of AOSD. The correlations of LCN2 with different variables and its ability to identify liver damage from AOSD patients were analysed.

Results

LCN2, a novel biomarker in hepatic inflammation, was found to be upregulated in AOSD neutrophils by RNA sequencing and confirmed at the mRNA and protein levels. Plasma levels of LCN2 were significantly higher in AOSD patients than healthy controls, RA and SLE patients. Plasma LCN2 levels were closely correlated with inflammatory markers, systemic score, HScore and cytokines. Moreover, LCN2 levels were increased in active AOSD with liver involvement and independently associated with liver dysfunction. Enhanced expression of LCN2 was detected in liver biopsies from three patients with ongoing liver injury. Furthermore, the area under the curve value of LCN2 for identifying AOSD with liver injury from other liver diseases was 0.9694.

Conclusion

Our results reveal that neutrophils-derived LCN2 is higher in plasma and liver tissue in AOSD patients than in healthy controls, and it could serve as a potent biomarker for identifying AOSD with systemic inflammation, especially liver damage caused by hyperinflammation.
Dose-dependent beneficial and harmful effects of berberine on mouse oocyte maturation and fertilization and fetal development
Authors: Huang Chien-Hsun , Wang Fu-Ting , Chan Wen-Hsiung
Published: June 2020

Previous studies have shown that berberine, an isoquinoline alkaloid isolated from several traditional Chinese herbal medicines, suppresses growth and induces apoptosis in some tumor cell lines. It has also been shown that berberine possesses anti-atherosclerosis and antioxidant activities in hyperlipidemic model rats. Our previous study in mice found that berberine causes harmful effects on preimplantation and postimplantation embryonic development, both in vitro and in vivo, by triggering reactive oxygen species (ROS)-mediated apoptotic cascades in mouse blastocysts. In the current investigation, we further showed that berberine treatment has distinct dose-dependent effects on oocyte maturation and subsequent development. Preincubation of oocytes with 2.5 μM berberine significantly enhanced maturation and in vitro fertilization (IVF) rates, with subsequent beneficial effects on embryonic development. In contrast, preincubation with 10 μM berberine negatively impacted mouse oocyte maturation, decreased IVF rates and impaired subsequent embryonic development. Similar dose-dependent effects were also demonstrated in vivo. Specifically, intravenous injection of berberine significantly enhanced mouse oocyte maturation, IVF rate and early-stage embryo development after fertilization at a dose of 1 mg/kg body weight but significantly impaired oocyte maturation and IVF rates and caused harmful effects on early embryonic development at a dose of 5 mg/kg. Mechanistically, we found that berberine enhanced intracellular ROS production and apoptosis of oocytes at a concentration of 10 μM but actually significantly decreased total intracellular ROS content and had no apoptotic effect at a concentration of 2.5 μM. Moreover, pretreatment of oocytes with Ac-DEVD-cho, a caspase-3–specific inhibitor, effectively blocked berberine-induced negative impacts on oocyte maturation, fertilization and subsequent development. Collectively, these findings establish the dose-dependent beneficial versus deleterious effects of berberine and suggest that the mechanism underlying the deleterious effects of berberine involves a caspase-3–dependent apoptotic process acting downstream of an increase in intracellular ROS levels.
Metabolomics, an Essential Tool in Exploring and Harnessing Microbial Chemical Ecology
Authors: Kellogg Joshua , Kang Seogchan
Published: June 2020

Efforts to meet the steadily increasing global need for plant products without continuously expanding the environmental footprint of crop production face several convoluted challenges. One challenge is minimizing crop loss due to diseases and pests without heavily relying on synthetic pesticides. Microorganisms secrete diverse molecules to influence surrounding organisms and environments. Research on these molecules has uncovered diverse mechanisms underpinning both beneficial and harmful microbial interactions and has also resulted in new crop protection strategies. However, compared with rapid advances in research on secreted proteins, research on metabolites, particularly volatile compounds, considerably lags. Diverse roles of secreted metabolites are highlighted here to underscore the need for systematically exploring microbial chemical ecology. This review focuses on how genomics, especially metabolomics, can enlighten the nature and mechanism of diverse microbial chemical ecology processes crucial for plant health and how to translate resulting insights into environment-friendly and sustainable crop protection strategies. Metabolomics entails comprehensive and rapid profiling of an entire measurable set of compounds in complex mixtures derived from organisms or environments using a growing array of analytical instruments. Metabolomics has expediated discoveries of novel bioactive compounds and subsequent studies on their mode of action. We review a variety of metabolomics tools and how they can be integrated with other tools to study and harness microbial chemical ecology.
Can Prescription Drug Use Disorder Predict Suicidality in US Adults With Chronic Pain? A Pilot Study Based on Collaborative Psychiatric Epidemiological Surveys
Authors: Abdelghani Mohamed , Ibrahim Shimaa , Said Amira , Foad Eman
Published: June 2020

Background:

Individuals with chronic pain are at higher risk for suicide than other populations, and their potential for prescription drug use disorder (PDUD) enormously exists. This study aimed to estimate the prevalence and correlates of suicidality and to determine its relation to PDUD, among US adults with a history of chronic pain.

Methods:

Data were obtained from the Collaborative Psychiatric Epidemiology Surveys (2001–2003). This analysis was limited to respondents who had a history of chronic pain (N = 5301). Logistic regression was used to determine the association between suicidality and prescription drug use disorder among those populations.

Results:

Among study respondents, there was a strong positive association between PDUD and suicidal ideation and attempts (P value < 0.001, = 0.006, respectively). Adjusted logistic regression analysis showed those with PDUD had 1.5 times greater likelihood of suicidal ideation (95% CI 1.2–1.8). Among respondents with a history of chronic pain and PDUD, Non-Hispanic Whites, female gender, lifetime mood and/or anxiety, and substance use disorders were associated with increased suicide risk (P value = 0.020, = 0.011, < 0.001, < 0.001, respectively).

Conclusions:

There is a robust relationship between PDUD and suicidality in US adults with a history of chronic pain. Ethnicity, gender, and comorbid mood, anxiety or substance use disorders can predict suicidality among individuals with both chronic pain and PDUD. Longitudinal studies need to investigate the causal relationship between PDUD and suicidality among those populations.
Overhead Mounted Optical Coherence Tomography in Childhood Glaucoma Evaluation
Authors: Go Michelle S. , Barman Navajyoti R. , Kelly Michael P. , House Robert J. , Rotruck Jill C. , El-Dairi Mays A. , Freedman Sharon F.
Published: June 2020

Précis:

Overhead mounted spectral-domain optical coherence tomography (OCT) enables high-quality imaging of the optic nerve and macula in childhood glaucoma, and is particularly useful when standard tabletop OCT has failed or is not possible.

Purpose:

Tabletop OCT, integral to adult glaucoma management, can be limited in childhood glaucoma patients because of young age, poor cooperation, and/or technical challenges. To address these imaging difficulties, we determined the feasibility and quality of an overhead mounted unit in childhood glaucoma. Secondary aims included evaluation of peripapillary retinal nerve fiber layer (pRNFL), parafoveal total retinal thickness, and parafoveal ganglion cell complex (GCC) thickness.

Materials and Methods:

Children and adults with a diagnosis of childhood glaucoma were imaged with an overhead mounted spectral-domain OCT as part of a prospective cross-sectional study. Participants had poor quality or unobtainable tabletop OCT and were scheduled for an examination under anesthesia and/or surgery as part of standard care.

Results:

A total of 88 affected eyes in 60 of 65 (92.3%) enrolled patients (mean age, 5.9±5.9 y; range, 0.2 to 24.5) were successfully imaged. The mean image quality for analyzed scans was 22.9±6.0 dB (n=236 images). Mean values for pRNFL (80.5±31.0 µm; n=86), parafoveal total retinal thickness (301.10±39.9 µm; n=79), and parafoveal GCC thickness (96.0±21.6 µm; n=74) were calculated.

Conclusions:

Overhead mounted OCT allowed high-quality image acquisition and analysis in childhood glaucoma patients unable to be imaged with the tabletop counterpart, presenting an opportunity for improved clinical management and study of childhood glaucoma-related pathophysiology. pRNFL, parafoveal total retinal thickness, and parafoveal GCC thickness were decreased for affected eyes of children under 6 years of age compared with age-matched controls from a companion normative study.
Evaluation of a Preparticipation Cardiovascular Screening Program Among 1,686 National Collegiate Athletic Association Division I Athletes: Comparison of the Seattle, Refined, and International Electrocardiogram Screening Criteria
Authors: Conway Justin J. , Krystofiak Jason , Quirolgico Kristina , Como Brenda , Altobelli Anthony , Putukian Margot
Published: June 2020

Objectives:

To: (1) analyze the results of 5 years of preparticipation cardiac screening including 12-lead electrocardiogram (ECG) of National Collegiate Athletic Association (NCAA) Division I athletes; and (2) assess the rates of ECG screening abnormalities and false-positive rates among 3 ECG screening criteria.

Design:

Retrospective chart review.

Setting:

National Collegiate Athletic Association Division I University.

Participants:

One thousand six hundred eighty-six first-year athletes presenting for their preparticipation examination including 12-lead resting ECG.

Interventions:

At the completion of the study period, all ECGs were retrospectively reviewed using the Seattle, Refined, and International Criteria.

Main Outcome Measures:

(1) Prevalence of pathologic cardiac conditions identified by screening; and (2) number of ECG screening abnormalities by criteria.

Results:

Three athletes (0.2%) were found to have conditions that are associated with sudden cardiac death. Retrospective review of ECGs using Seattle, Refined, and International criteria revealed an abnormal ECG rate of 3.0%, 2.1%, and 1.8%, respectively. International criteria [odds ratios (OR), 0.58; P = 0.02] demonstrated a lower false-positive rate compared with the Seattle criteria. There was no significant difference in false-positive rates between the Seattle and Refined (OR, 0.68; P = 0.09) or the International and Refined criteria (OR, 0.85; P = 0.5).

Conclusions:

There was a low rate of significant cardiac pathology in this population, and no athletes were permanently restricted from play as a result of screening. Our results suggest that the International criteria have the lowest false-positive rate of athlete-specific ECG criteria, and thus, it is the preferred method for preparticipation ECG screening in NCAA athletes.
Metabolic support in sepsis: corticosteroids and vitamins: the why, the when, the how
Authors: Fujii Tomoko , Deane Adam M. , Nair Priya
Published: June 2020

Purpose of review

Sepsis is a global health issue, and there is a need for effective, low-cost adjunct metabolic treatments. Corticosteroids have been investigated in many trials for decades, and recently the administration of vitamin C, thiamine (vitamin B1), and vitamin D have been proposed as novel therapies in patients with sepsis.

Recent findings

APROCCHSS (N = 1241) and ADRENAL (N = 3800) trial reported inconsistent results in mortality outcome; however, both demonstrated a decreased duration of shock with low-dose corticosteroids. The CITRIS-ALI trial (N = 170) examined the effects of intravenous vitamin C 200 mg/kg/day and reported no effect on organ dysfunction or biomarkers. The VITAMINS trial (N = 216) compared combination therapy of vitamin C 6 g/day, thiamine 200 mg/day, and hydrocortisone 200 mg/day with hydrocortisone alone to find that the combination did not increase vasopressor free time. A single trial (N = 88) evaluating the effect of thiamine in patients with sepsis reported a neutral result. Two randomized trials (N = 475 and N = 1360) on the supplementation of vitamin D in the critically ill patients did not identify statistically significant reduction in mortality.

Evidence from high-quality research is still insufficient to support the use of vitamin C, thiamine, and vitamin D as metabolic support in sepsis treatment.
Nutrition in times of Covid-19, how to trust the deluge of scientific information
Authors: Correia Maria Isabel T.D.
Published: June 2020

Purpose of review

The Covid-19 pandemic has daunted the world with its enormous impact on healthcare, economic recession, and psychological distress. Nutrition is an integral part of every person life care, and should also be mandatorily integrated to patient care under the Covid-19 pandemic. It is crucial to understand how the Covid-19 does develop and which risk factors are associated with negative outcomes and death. Therefore, it is of utmost importance to have studies that respect the basic tenets of the scientific method in order to be trusted. The goal of this review is to discuss the deluge of scientific data and how it might influence clinical reasoning and practice.

Recent findings

A large number of scientific manuscripts are daily published worldwide, and the Covid-19 makes no exception. Up to now, data on Covid-19 have come from countries initially affected by the disease and mostly pertain either epidemiological observations or opinion papers. Many of them do not fulfil the essential principles characterizing the adequate scientific method.

It is crucial to be able to critical appraise the scientific literature, in order to provide adequate nutrition therapy to patients, and in particular, to Covid-19 infected individuals.
Pancreatobiliary manifestations of nonalcoholic fatty liver disease: a retrospective case-control multicenter study
Authors: Sbeit Wisam , Greener Tomer , Kadah Anas , Mari Amir , Goldin Eran , Khoury Tawfik , Mahamid Mahmud
Published: June 2020

Background:

Nonalcoholic fatty liver disease (NAFLD) has become a major cause of chronic liver disease. Several extrahepatic manifestations have been reported in relation to NAFLD. However, data regarding pancreatobiliary manifestation are scarce.

Aim:

We aimed to explore the association of pancreatobiliary manifestation with NAFLD.

Methods:

A retrospective multicenter study that included all patients who underwent an endoscopic ultrasound performed for hepatobiliary indications and for whom the endosonographer reported on the presence or absence of fatty liver. The endoscopic ultrasound reports were reviewed and all pathological findings were reported.

Results:

Overall, 545 patients were included in the study, among them, 278 patients had fatty liver (group A) as compared to 267 who did not have (group B). The average age in group A was 64.5 ± 13.5 years vs. 61.2 ± 14.7 years in group B. Male sex constituted 49.6 and 58% in groups A and B, respectively. On multivariate analysis, fatty pancreas [odds ratio (OR) 4.02; P = 0.001], serous cystadenoma (SCA) (OR 5.1; P = 0.0009), mucinous cystadenoma (MCA) (OR 9.7; P = 0.005), side-branch intraductal papillary mucinous neoplasm (IPMN) (OR 2.76; P < 0.0001), mixed-type IPMN (OR 16.4; P = 0.0004), pancreatic neuroendocrine tumor (NET) (OR 8.76; P < 0.0001), gallbladder stones (OR 1.9; P = 0.02) and hilar lymphadenopathy (OR 6.8; P < 0.0001) were significantly higher among patients with NAFLD. After adjustment for fatty pancreas, the association remained significant for SCA (OR 3; P = 0.01), MCA (OR 4.6; P = 0.03), side-branch IPMN (OR 1.7; P = 0.02), mixed-type IPMN (OR 5.5; P = 0.01) and pancreatic NET (OR 4.5; P = 0.001).

Conclusion:

Pancreatobiliary manifestations are common among patients with NAFLD. Assessment of these coexistent manifestations should be considered in the setting of patients with NAFLD.
Long-term outcomes of interventional treatment for Budd–Chiari syndrome with chronic accessory hepatic vein obstruction
Authors: Li Huawei , Zhang Xi , Xu Hao , Zu Maoheng , Wei Ning , Liu Hongtao , Xiao Jinchang , Shen Bin , Huang Qianxin , Zhang Qingqiao
Published: June 2020

Objective

Interventional treatment is the main therapy for Budd–Chiari syndrome (BCS) with hepatic vein obstruction. The aim of this study was to investigate the long-term outcomes of endovascular management for BCS with chronic accessory hepatic vein (AHV) obstruction.

Methods

In total, 68 patients with primary BCS who underwent AHV dilation with or without stenting from January 2008 to December 2018 were included in this retrospective study. The technical success rate and complications were recorded. Cumulative patency rates were estimated by the Kaplan–Meier curves and compared using the log-rank test.

Results

Technical success was achieved in all 68 patients, and AHV patency was confirmed by postoperative angiography. Fifty-two patients underwent balloon dilation alone and 16 underwent adjunctive stent implantation. During a mean follow-up period of 60.2 ± 30.5 months, AHV reocclusion occurred in 14 patients in the balloon group and four patients in the stent group (χ
2 = 0.034, P = 0.855). The overall cumulative 1-, 3-, 5-, and 7-year primary and secondary AHV patency rates were 90.6, 76.6, 72.0, and 68.2% and 98.4, 91.4, 89.2, and 89.2%, respectively. The cumulative 1-, 3-, 5-, and 7-year primary patency rates of the AHV were 89.8, 73.8, 71.2, and 71.2% in the balloon group and 93.3, 86.2, 75.4, and 60.3% in the stent group, respectively. There was no statistically significant difference between the two groups (P = 0.934).

Conclusion

Interventional treatment of BCS with chronic AHV obstruction has good long-term outcomes. Both balloon dilation alone and adjunctive stent implantation can be used for AHV recanalization.
Adolescent body image: influencing factors and the clinician's role
Authors: Hartman-Munick Sydney M. , Gordon Allegra R. , Guss Carly
Published: June 2020

Purpose of review

Body image is a crucial part of adolescent development for teens all over the world. Studies show that negative body image impacts many aspects of adolescent health and that anticipatory guidance about body image is important at the annual health maintenance exam visit. Weight bias is closely tied to body image and is associated with negative health effects as well; research shows weight bias is a problem throughout healthcare. The purpose of this review is to discuss influencing factors on adolescent body image and to explore interventions to promote positive body image.

Recent findings

Research shows that adolescent body image is shaped by media influence, athletics and personal relationships. Studies have also begun to show that negative and positive body image are separate entities, and that overall health outcomes seem to be better in adolescents with positive body image. In thinking about intervention, there are ways to promote positive body image in the provider--patient interaction, within the school and community, in healthcare education, and at the societal level.

Body image is an incredibly important aspect of adolescent health, and clinicians should be aware of ways to help promote positive body image in adolescents.
Artificial intelligence and organ transplantation: challenges and expectations
Authors: Briceño Javier
Published: June 2020

Purpose of review

Classifiers based on artificial intelligence have emerged in all areas of medicine. Although very subtle, many decisions in organ transplantation can now be addressed in a more concisely manner with the support of these classifiers.

Recent findings

Any aspect of organ transplantation (image processing, prediction of results, diagnostic proposals, therapeutic algorithms or precision treatments) consists of a set of input variables and a set of output variables. Artificial intelligence classifiers differ in the way they establish relationships between the input variables, how they select the data groups to train patterns and how they are able to predict the possible options of the output variables. There are hundreds of classifiers to achieve this goal. The most appropriate classifiers to address the different aspects of organ transplantation are Artificial Neural Networks, Decision Tree classifiers, Random Forest, and Naïve Bayes classification models. There are hundreds of examples of the usefulness of artificial intelligence in organ transplantation, especially in image processing, organ allocation, D-R matching, precision pathology, real-time immunosuppression, transplant oncology, and predictive analysis.

In the coming years, clinical transplant experts will increasingly use Deep Learning-based models to support their decisions, specially in those cases where subjectivity is common.
The need for a living donor wellness program
Authors: Kim Jim , Kim Susan , Genyk Yuri , Maw Thin Thin
Published: June 2020

Purpose of review

Living donation has a tremendous impact in bridging the gap between the shortage of organs and the growing list of transplant candidates but remains underutilized as a percentage of total transplants performed. This review focuses on obesity and social determinants of health as potential barriers to the expansion of living kidney donation.

Recent findings

The growing rate of obesity and associated metabolic syndrome make many potential donors unacceptable as donor candidates because of the future risk for developing chronic health conditions, such as hypertension and diabetes. There is also increasing evidence demonstrating socioeconomic differences and racial disparities potentially limit access to living donation in certain populations. These potentially modifiable factors are not exclusive of each other and together serve as significant contributing factors to lower rates of living donation.

Living donors make sacrifices to provide the gift of life to transplant recipients, despite the potential risks to their own health. Studies describing risk factors to living donation call attention to the overall need for more action to prioritize and promote the health and well being of living donors.
Hereditary Thrombotic Thrombocytopenic Purpura in a 9-Month-old: Diagnosing and Managing an Ultra-rare Disorder
Authors: Wyatt Kirk D. , Kohorst Mira A. , Coon Lea M. , Hurley Rachel M. , van Dorland Hendrika Anette , Arndt Carola A.S.
Published: June 2020

Hereditary thrombotic thrombocytopenic purpura is an ultra-rare disorder caused by biallelic mutations in the ADAMTS13 gene. Because it can be difficult to diagnose, plasma ADAMTS13 activity assessment should be considered in patients with thrombocytopenia, anemia, and schistocytes on peripheral blood smear. We present the diagnostic evaluation of a patient with hereditary thrombotic thrombocytopenic purpura. Genetic testing revealed one known pathogenic mutation and one novel mutation of ADAMTS13 classified as likely pathogenic on the basis of parental genetic testing and in silico analyses. We further discuss off-label use of prophylactic plasma-derived Factor VIII (Koate-DVI) and the benefit of rare disease registries.
Pediatric Paroxysmal Nocturnal Hemoglobinuria Presenting as Acute Kidney Injury
Authors: Henderson Christopher , Lo Megan , Massey Gita
Published: June 2020

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare disease characterized by variable and diverse symptoms including the classic triad of hemolytic anemia, thrombosis, and bone marrow failure. It is a disorder primarily seen in the adult population. The authors report a unique case of an 8-year-old girl diagnosed with PNH after initially presenting with a febrile illness and acute kidney injury. Though rare in children, PNH should remain in the differential diagnosis of a child presenting with acute kidney injury. The disease has serious long-term complications, mandating timely diagnosis and appropriate therapy.
New Graduate Orientation Evaluation: Are There Any Best Practices Out There?
Authors: Laflamme Jennifer , Hyrkas Kristiina
Published: June 2020

Efficient, cost-effective, and safe orientations with clear expectations are necessary for new graduates in their transition from student to practicing nurse. In the current nursing shortage, healthcare needs to invest more in retaining new graduates. Orientation can be a factor in decisions to leave. This scoping review revealed that strong evidence is lacking regarding best practices during orientation for evaluating new graduate nurses’ readiness to practice on their own. More resources, research, and tools are needed.
Prognostic Factors for the Failure of Endometrial Ablation: A Systematic Review and Meta-analysis
Authors: Beelen Pleun , Reinders Imke M. A. , Scheepers Wessel F. W. , Herman Malou C. , Geomini Peggy M. A. J. , van Kuijk Sander M. J. , Bongers Marlies Y.
Published: June 2020

(Abstracted from Obstet Gynecol 2019;134:1269–1281)

An important health problem affecting approximately 30% of women is heavy menstrual bleeding, which has a major effect on their quality of life. A frequently used minimally invasive procedure that can destroy or remove the endometrial tissue is endometrial ablation (EA).
Association Between First-Trimester Subchorionic Hematomas and Adverse Pregnancy Outcomes After 20 Weeks of Gestation in Singleton Pregnancies
Authors: Naert Mackenzie N. , Rodriguez Alberto Muniz , Khadraoui Hanaa , Naqvi Mariam , Fox Nathan S.
Published: June 2020

(Abstracted from Obstet Gynecol 2019;134:863–868)

Subchorionic hematoma (SCH) (or bleed) is commonly observed in the first trimester of pregnancy, with a reported incidence ranging widely from 0.46% to 39.5%. So far, studies looking at the relationship between subchorionic bleed and adverse outcomes in later pregnancy have been unclear.
Current Role of Urethrolysis and Partial Excision in Patients Seeking Revision of Anti-incontinence Sling
Authors: Drain Alice , Enemchukwu Ekene , Shah Nihar , Syan Raveen , Rosenblum Nirit , Nitti Victor W. , Brucker Benjamin M.
Published: June 2020

(Abstracted from Female Pelvic Med Reconstr Surg 2019;25:409–414)

Stress urinary incontinence (SUI) affects 5% to 30% of women. After the introduction of the first synthetic midurethral sling (transvaginal tape) in1996, there was a rapid rise in the number of midurethral slings available, and these products were widely adopted and used.
Endometrial CD138 Count Appears to be a Negative Prognostic Indicator for Patients Who Have Experienced Previous Embryo Transfer Failure
Authors: Fan Xiangxiu , Li Xiaofeng , Li Yuan , Liao Jingnan , Chen Huijun , Li Yi , Lu Guang-Xiu , Lin Ge , Gong Fei
Published: June 2020

(Abstracted from Fertil Steril 2019;112:1103–1111)

Chronic endometriosis (CE) is a chronic infectious disease that is often misdiagnosed due to its vague symptomatic severity, lack of typical clinical or ultrasounds symptoms, and requirement for histopathologic diagnosis. Evidence has shown that CE may be associated with various subgroups of reproductive failure.
Effects of Trunk Stabilization Exercise While Wearing a Pelvic Compression Belt on Walking and Balancing Abilities in Patients With Stroke
Authors: Choi Yoon-Hee , Kim Nan-Hyang , Son Sung-Min , Cha Yong-Jun
Published: June 2020

Objective

The aim of this study was to investigate the effects of wearing a pelvic compression belt during trunk stability exercise on balance and gait ability in patients with stroke.

Design

Thirty-six patients with stroke participated and were randomly allocated to three groups: the paretic group (trunk stability exercise wearing a pelvic belt on the paretic side), the nonparetic group (trunk stability exercise wearing a pelvic belt on the nonparetic side), or the control group (trunk stability exercise without a pelvic belt). Walking and balancing abilities were assessed before and after trunk stabilization exercise.

Results

Significantly larger gains were identified in the paretic group than in the control group for all variables (P < 0.017). In addition, significantly larger gains were observed in the paretic group than in the nonparetic group (P < 0.017) (limit of stability, 15.6%; stance phase of paretic side, 4.1%; 10-m walking test, −10.1%; 6-min walking test, 4.6%).

Conclusion

Wearing a pelvic belt on the paretic side during trunk stabilization exercise seems to be more effective at improving the balancing and walking abilities of patients with stroke than wearing a pelvic compression belt on the nonparetic side or not wearing a pelvic belt.
Bringing Psychiatry into the Mosque: Analysis of a Community Psychoeducation Intervention
Authors: MUSHTAQ SAMAIYA B. , AYVACI EMINE R. , HASHIMI MARIAM , NORTH CAROL S.
Published: June 2020

Objective:

Mental health care in the growing US Muslim population is a relevant topic given ongoing discrimination and self-stigma similar to that seen in other racial and religious communities. Data concerning efforts to integrate religious practice or spiritual concepts into mental health education are limited. Therefore, the objective of this study was to analyze views about psychiatric illness and treatment before and after a mental health symposium at a community mosque led by faith leaders and mental health professionals.

Methods:

A total of 31 matched presurveys and postsurveys were collected from participants at the symposium to assess attitudes about psychiatric illness and treatment before and after the intervention. The surveys were analyzed using SAS.

Results:

At baseline, the highly religious and educated population that participated in the survey had high levels of agreement with the conceptualization of psychiatric illness as a biological problem and less so as a spiritual problem. Even so, at baseline, only approximately half of the participants indicated that they would talk to a medical doctor about mental health problems, and participants were significantly less positive about taking psychotropic medication for illness, compared with after the intervention. Educational attainment was positively associated with the conceptualization of psychosis as a biological problem, with willingness to speak to a medical doctor, and with willingness to take antidepressant medications.

Conclusions:

The findings of this study suggest the potential effectiveness of coordinated interventions by religious leaders and mental health professionals to address the reluctance of Muslims to use psychotropic medication treatment when indicated. Limitations of this study include the self-selection of a highly-educated subset of the greater Muslim population that may already have been interested in a mental health symposium. For the future, research should consider the use of psychoeducation in general religious services to reach a more representative sample of practicing Muslims.
Therapeutic Risk Management: Suicide Postvention
Authors: NAZEM SARRA , PAO CHRISTINE , WORTZEL HAL
Published: June 2020

When considering critical elements involved in suicide prevention, dialogs are often dominated by suicide assessment, management, and intervention themes. Proactive consideration on what to do if a patient dies by suicide is often overlooked, which can be especially detrimental to our practice and those we serve. In this article, we extend the philosophy of the therapeutic risk management model to consider ways in which we can take good care of the extended community of suicide loss survivors, including providers. We begin by briefly describing the widespread impact of suicide loss and the lack of suicide postvention education and awareness. Given the increased likelihood that providers will be touched by suicide loss, we then provide recommendations and resources to assist the provider in developing and/or enhancing suicide postvention practices.
Saethre-Chotzen Syndrome
Authors: Abulezz Tarek Abdelhameed , Allam Karam A. , Wan Derrick C. , Lee Justine C. , Kawamoto Henry K.
Published: June 2020

Introduction

Saethre-Chotzen syndrome is a genetic condition characterized by craniofacial and limb anomalies, with craniosynostosis (mainly coronal) being the most frequent craniofacial finding. Cranial and facial deformities can be extremely variable requiring individualization of treatment strategies. We present our case series to highlight clinical findings, treatment philosophy, and challenges facing Saethre-Chotzen patients.

Methods

A retrospective review was performed on records of patients given a diagnosis of Saethre-Chotzen syndrome at the University of California Los Angeles (UCLA) Craniofacial Clinic (n = 7) between 1980 and 2010. Patients with complete records were included in this study, and review of demographic data, clinical findings, surgical interventions and postoperative follow-up, and stability were performed.

Results

Seven patients (1 male and 6 female) were included in this study. The average age at which the patients were first seen was 6.5 years. Suture involvement was bicoronal (n = 6) and unicoronal (n = 1). There was 1 patient having superimposed metopic synostosis, and there was another patient having Kleeblattschädel deformity. Previous procedures performed for patients before establishing care at UCLA were strip craniectomy (n = 2) and fronto-orbital advancement (n = 2). All patients (n = 7) had fronto-orbital advancements at UCLA. Other skeletal operations included the following: redo forehead advancement and contouring (n = 3), monobloc advancement (n = 1), and LeFort III distraction (n = 1). Five patients reached skeletal maturity, and 2 patients received LeFort I advancement for class III malocclusion, one of which also required a bilateral sagittal split osteotomy of the mandible.

Conclusion

Clinical presentation and severity of deformity in Saethre-Chotzen syndrome are variable. Our current report reviews our treatment strategies and illustrates the predominance of cranial and upper face deformities and frequent need for redo surgeries to address forehead asymmetry in this group of syndromic craniosynostosis patients.
A Novel Method for Complex Diagnostics of Globes’ Position
Authors: Gushchina Marina B. , Afanasyeva Daria S. , Gushchin Alexander V.
Published: June 2020

Spiral computed tomography is a gold standard in diagnostics of intraorbital pathological changes. Modern software provides great opportunities at viewing and analyzing DICOM files. Earlier, the authors introduced a method of computed exophthalmometry for precise measurement of globes’ position even in the cases of lateral orbital rim fracture. However, eye proptosis is known to be depending on the eye length (ocular component), retrobulbar volume (orbital component), as well as anatomy of neurocranium and brain (cerebral component). Nevertheless, conventional Hertel exophthalmometry and other proposed methods do not specify the component, involved in the pathogenesis of enophthalmos or exophthalmos, that is why additional examinations are required. In this article, the authors propose a novel approach, which can complement and/or substitute instrumental methods used for differential diagnostics of enophthalmos or exophthalmos.
Periodontal Regeneration Using Recombinant Human Bone Morphogenetic Protein-2 and a Bilayer Collagen Matrix
Authors: Lee Jungwon , Yun Junseob , Kim Kyoung-Hwa , Koo Ki-Tae , Seol Yang-Jo , Lee Yong-Moo
Published: June 2020

Previous studies demonstrated that recombinant human bone morphogenetic protein-2 (rhBMP-2) delivered using a collagen sponge could be a candidate for periodontal regeneration therapy. However, there is little evidence related to rhBMP-2 delivered with a bilayer collagen matrix. The aim of this study was to investigate the proper dose of rhBMP-2 using a bilayer collagen matrix for periodontal regeneration in a 1-wall defect. The mandibular first premolars and first molars of 6 beagle dogs were extracted, and an 8-week healing period was allowed. One-wall intrabony defects (4 mm in width and 5 mm in height) were made on the mesial side of the 2nd premolar and/or the distal side of the 4th premolar bilaterally. Subsequently, a bilayer collagen matrix containing 0 μg (C), 200 μg (T1), or 500 μg (T2) of lyophilized rhBMP-2 was randomly applied to the defect area. Calcein and xylenol orange were injected at 4 and 8 weeks following the surgery, respectively, to label periodic bone formation. After a 12-week healing period, the animals were sacrificed for micro-computed tomography and histomorphometric analysis. Bone mineral density and bone volume density showed statistically significant differences between the control group and group T1, while no significant differences were observed between the control group and group T2 or between groups T1 and T2. The bone height in groups T1 and T2 was smaller than that in the control group. Low doses of rhBMP-2 delivered using a bilayer collagen matrix in 1-wall intrabony defects can promote periodontal regeneration compared to no or high doses of rhBMP-2.
Variations in the Morphology of Foramen Lacerum
Authors: Singh Rajani , Kumar Raj
Published: June 2020

Greater petrosal and deep petrosal nerves unite in foramen lacerum to form vidian nerve which innervate lacrimal, buccal, nasopharynx, and nasal glands. Moreover, the superior part of this foramen transmits lacerum part of internal carotid artery which irrigates major part of brain. Change in the morphology of foramen lacerum may result in compression of neurovascular structures creating neurovascular complications which at times may be fatal/morbid. In addition to this, there is paucity of literature elucidating the morphology of foramen lacerum. So, the aim of the study is to describe the morphology of foramen lacerum and associated clinical significance.

The study was carried out in the Department of Anatomy, Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India using 26 half skulls. The skulls were observed for morphological variations of foramen lacerum besides carrying out morphometry of these foramina.

Complete obliteration of foramen lacerum culminating into circular opening at its superior part bilaterally was observed in 5 skulls (19.2%). Incomplete ossification of foramen was detected in 7 skulls (26.9%). The mean diameters of carotid foramina in cases of complete obliteration were 6 mm and 7 mm on right and left sides respectively. The mean antero-posterior diameters of anterior and posterior apertures on right side were 7 and 6 mm respectively while these dimensions on left sides were 7 mm.

Due to morphological variations in foramen lacerum through partial/complete obliteration, the neurovascular structures passing through it may be squeezed leading to neurovascular complications. Thus, the study is of paramount importance to neurovascular surgeons, neuro-interventionists, and anatomists.
Perceptions and Preferences of Laypersons in the Management of Positional Plagiocephaly
Authors: Vu Giap H. , Magoon Katherine , Zimmerman Carrie E. , Kalmar Christopher L. , Humphries Laura S. , Swanson Jordan W. , Bartlett Scott P. , Taylor Jesse A.
Published: June 2020

Background:

Uncertain clinical evidence for treating positional plagiocephaly, especially with helmet therapy, creates difficulties in counseling parents of patients. This study investigates layperson perceptions and treatment preferences for positional plagiocephaly to provide patient-oriented evidence for management.

Methods:

Adult laypersons were recruited through crowdsourcing to view digitally-modified images of normal, mildly, moderately, or severely plagiocephalic infant heads. Participants provided demographic information and rated the infant's head shape and potential related social difficulties, likelihood of consulting a physician for treatment options, and likelihood of seeking helmeting treatment for the infant.

Results:

Nine hundred forty-five individuals participated in the study. Perception of head shape, prediction of future embarrassment and social difficulties, likelihood of seeking physician evaluation, likelihood of choosing helmet therapy, and willingness-to-pay for helmet therapy were pairwise-different between 4 plagiocephaly severities (corrected-P < 0.001 for all), except between normocephaly (n = 194) and mild (n = 334) plagiocephaly or between moderate (n = 203) and severe (n = 214) plagiocephaly. Younger respondents were more likely to consult a physician (uncorrected-P = 0.016) and choose helmet therapy (uncorrected-P = 0.004) for infants with normocephaly or mild plagiocephaly. Parents of children with physical disabilities were 6 times as likely as other participants to choose helmet therapy for mild plagiocephaly (corrected-P = 0.036).

Conclusions:

Laypersons perceived moderate and severe plagiocephaly as equally abnormal and mild plagiocephaly as normal, consistent with their treatment preferences. Parents of physically disabled children were significantly more likely than other participants to choose helmet therapy. Our findings provide medical professionals with lay perspectives on positional plagiocephaly that may facilitate effective counseling of parents.
Epidermal Inclusion Cyst Formation After Barbed Thread Lifting
Authors: Baek Sang Oon , Shin Jeonghwan , Lee Jun Yong
Published: June 2020

Barbed thread lifting is a widely used method because it is easier to learn, faster, and the lower frequency of complications than the invasive lifting technique. The number of reported cases about complication requiring an invasive procedure is very small, and most cases are limited to minor complications. The authors introduce a chronic, recurrent epidermal inclusion cyst that occurs after Barbed thread lifting. A 61-year-old woman visited the hospital with recurrent inflammation and scar accompanied by discharge in the temporal area lasting 2 years. She had barbed thread lifting in the area of inflammation 4 years ago. CT images showed soft tissue infiltration invading superficial fascia. intraoperative view, A multi directional barbed thread was anchored in the scar tissue. The barbed thread was pulled out and cut off inflammatory lesions, including scarring wounds, were totally excised. Histopathological examination confirmed the epidermal inclusion cyst and polydioxanone suture. After surgery, the patient recovered without any complications. In this case, the cause of epidermoid cyst is considered iatrogenic concerning history of barbed thread lifting
A Novel Simulated Training Platform and Study of Performance Among Different Levels of Learners in Flexible Cystoscopy
Authors: Cantillon-Murphy Pádraig , Jaeger Herman Alexander , Donovan Michelle , Standley Laura , O'Shea Conor , Sweeney Paul , Marescaux Jacques , Piechaud Thierry
Published: June 2020

Introduction

The aims of this study were to test a novel simulation platform suitable for flexible cystoscopy using a standard scope, to assess the platform's proposed use as a training tool for flexible cystoscopy, and to assess the user experience through surveyed response.

Methods

Thirty-one urologists (11 novices, 20 experts) were evaluated using a novel light-based bladder model and standard flexible cystoscope. Time to complete full inspection of the simulated bladder was measured, and the scope trajectory was recorded. Participants also completed a survey of the training platform.

Results

Thirty participants completed a simulated inspection of a portable bladder model with a mean ± SD time for 153.1 ± 76.1 seconds. One participant failed to complete. Novice urologists (defined as those having completed less than 50 flexible cystoscopies in clinic) had a mean ± SD time of 176.9 ± 95.8 seconds, whereas with experts, this decreased to 139.3 ± 60.7 seconds. Dynamic trajectory maps identified “blind spots” within each user's cystoscopy performance. In a poststudy follow-up, 27 participants considered the tool valuable or extremely valuable for training, whereas 19 participants considered that the tool either very well or excellently replicated the clinical setting. All participants ranked the tool as very good or excellent for overall quality of training.

Discussion

Advances in electronic technology make portable low-cost models a potential low-cost alternative to endourology training platforms. In providing a quantifiable measure of user performance, the tool may shorten the learning curve in flexible cystoscopy and, potentially, reduce clinical errors and provide quantifiable measures for further clinical training.
Social Media Responses to Elective Surgery Cancellations in the Wake of COVID-19
Authors: Rao Saieesh A. , Ravi Mohan S. , Zhao Jeffrey W. , Sturgeon Cord , Bilimoria Karl Y.
Published: June 2020

Objective:

To assess public response to cancellations of elective surgeries following the American College of Surgeons’ (ACS) recommendation on March 13.

Methods:

We queried text comments from Reddit, a social media platform and the fifth most popular website in the United States. Comments were manually reviewed to assess for relevance to elective surgery in the United States during the global coronavirus outbreak, whether the text was written by a healthcare worker (HCW), whether the user was based in the United States, and whether the text documented cancellations of surgery, expected cancellations of surgery, or surgery ongoing after the ACS announcement. Analysis of overall sentiment and negativity in comment text was performed using the Valence Aware Dictionary for sEntiment Reasoning (VADER), a validated natural language processing tool previously used in studies of health behaviors using social media. Non-parametric tests were used for subgroup comparisons based on posting date and characteristics identified during manual review.

Results:

Following manual review, 1272 comments were included for analysis. Overall sentiment among non-HCWs became significantly more negative following the ACS announcement (P = 0.037). Overall sentiment did not significantly differ between HCWs and non-HCWs prior to the ACS announcement (P = 0.98), but non-HCW sentiment became significantly more negative than HCW sentiment after the announcement (P = 0.027). Negativity scores in posts describing cancellations were significantly higher among posts written by non-HCWs than HCWs (P = 0.028).

Conclusions:

Cancellation of elective surgeries had an adverse emotional impact on non-HCWs. This finding highlights the importance of access to elective surgery to patients’ emotional well-being.