bluuebunny/crossref_metadata_2025 huggingface dataset:
Pediatric Laryngeal Coccidioidomycosis: A Case Series in an Endemic Region
Authors: Naeem Fouzia , McCarty James , Rowe Mark R , Davis Amy W. , Tablizo Mary Anne , Hady Kelly Kathleen , Vijayan Vini
Published: May 2023

Background:

Laryngeal coccidioidomycosis is a rare but life-threatening manifestation of coccidioidomycosis. Data in children are sparse and limited to case reports. We conducted this study to review the characteristics of laryngeal coccidioidomycosis in children.

Methods:

We performed a retrospective review of patients ≤21 years of age with laryngeal coccidioidomycosis who were treated from January 2010 to December 2017. We collected demographic data, clinical and laboratory studies and patient outcomes.

Results:

Five cases of pediatric laryngeal coccidioidomycosis were reviewed. All children were Hispanic and 3 were female. The median age was 1.8 years and the median duration of symptoms before diagnosis was 24 days. The most common symptoms included fever (100%), stridor (60%), cough (100%) and vocal changes (40%). Airway obstruction requiring tracheostomy and/or intubation for airway management was present in 80%. The most frequent location of lesions was the subglottic area. Coccidioidomycosis complement fixation titers were frequently low and culture/histopathology of laryngeal tissue was necessary to make a definitive diagnosis. All patients required surgical debridement and were treated with antifungal agents. None of the patients had recurrence during the follow-up period.

Conclusions:

This study suggests that laryngeal coccidioidomycosis in children presents with refractory stridor or dysphonia and severe airway obstruction. Favorable outcomes can be achieved with a comprehensive diagnostic work-up and aggressive surgical and medical management. With the rise in cases of coccidioidomycosis, physicians should have a heightened awareness regarding the possibility of laryngeal coccidioidomycosis when encountering children who have visited or reside in endemic areas with stridor or dysphonia.
Clinical and Epidemiologic Profile of Invasive Pneumococcal Disease in Australian Children Following the Relaxation of Nonpharmaceutical Interventions Against SARS-COV-2
Authors: Williams Phoebe C.M. , Howard-Jones Annaleise , Butters Coen , Koirala Archana , Britton Philip N. , Duguid Robert , Wijeratne Priyali , Johnson Niall , Jayasinghe Sanjay
Published: May 2023

A global resurgence of invasive pneumococcal disease (IPD) has been noted in children. We provide a detailed clinical and epidemiological analysis of IPD in Australian children following relaxation of nonpharmaceutical interventions against coronavirus disease 2019, revealing significant morbidity and mortality—even in vaccinated children without known predisposing risk factors. Almost half of the IPD cases were caused by serotypes not covered by the 13-valent pneumococcal conjugate vaccine.
Return to Sport After Operative Fixation of Midshaft Clavicle Fractures in Professional Jockeys
Authors: Fahy Stephen , Ó Doinn Tiarnán , Peters Nina , Pugh Jennifer , Fox Ciara , Kenny Patrick
Published: May 2023

Objective:

Clavicle fractures are the most commonly observed fracture sustained in professional horse racing. This study is the first to report on time lost from injury and functional recovery after surgical fixation of midshaft clavicle fractures in professional jockeys.

Design:

Retrospective cohort study.

Setting:

Professional Horse Racing Ireland; Patients (or Participants): Professional Jockeys in Ireland with midshaft clavicular fractures managed with Open Reduction Internal Fixation. Interventions (or Assessment of Risk Factors or Independent Variables): Operative fixation with Open Reduction Internal Fixation.

Main Outcome Measures:

Assessment of postoperative Quick Disabilities of Arm Shoulder and Hand (QuickDASH) score and Patient Reported Outcome Measures assessing for associated complications and time to return to competition among professional athletes.

Results:

Between 07/06/2013 and 29/09/2022, 22 patients met the predetermined inclusion criteria. Ninety-five percent of patients returned to competition at their preinjury level, one patient failed to return to competition for reasons unrelated to his injury. The mean time for return to competition was 68.14 days postinjury. Few complications were reported, whereas functional recovery was excellent across the cohort, with an average QuickDASH score of 0.85 (0.0-2.3).

Conclusions:

Plate fixation of midshaft clavicle fractures is effective and safe in the setting of professional horse racing. Ninety-five percent of patients can be expected to return within 14 weeks of injury. Patients returning at less than 7 weeks after injury had no adverse outcomes, suggesting a potential role for more aggressive rehabilitation postoperatively and ultimately, a quicker return to competition.
Myasthenia-like paraneoplastic syndrome with multiple cranial nerve tumor infiltration: A case report and literature review
Authors: Wen Chunbei , Yang Jie , Xu Changyou , Wei Dongsheng , Luo Lijun
Published: May 2023

Rationale:

Approximately 0.001% of patients with cancer have paraneoplastic nerve system syndrome, which can affect the central nervous system, neuromuscular junction, or peripheral nervous system. Although myasthenia gravis (MG) may exist as a thymic paraneoplastic syndrome (PNPS), its association with primary lung cancer remains unknown.

Patient concerns:

A 55-year-old female presented with slurred speech, weakness in chewing, sporadic difficulty in swallowing, and weakness in both lower limbs for half a year.

Diagnoses:

Based on cerebrospinal fluid and electromyography findings, we present the case of a female patient diagnosed with overlapping multicranial nerve tumor infiltration and MG-like neurological PNPS secondary to lung adenocarcinoma.

Interventions:

The patient received intrathecal injections of pemetrexed and neurotrophic (vitamin B) therapy before ceasing chemoradiotherapy and chose cabozantinib on her own.

Outcomes:

Weakness of the proximal limbs, choking cough, and chewing problems did not improve significantly.

Lessons:

Although it is unclear why MG coexists with lung cancer, it is probable that MG is a paraneoplastic condition. Cerebrospinal fluid testing should be carried out along with electrophysiological, serological, and pharmacological procedures pertinent to the diagnosis of MG to thoroughly examine if people simultaneously experience MG-like PNPS and tumor growth. Starting immunotherapy and anticancer medication at the same time that tumor development and MG-like syndrome are discovered is crucial.
Laparoscopic fundoplication in treating refractory gastroesophageal reflux-related chronic cough: A meta-analysis
Authors: Liu Jiannan , Deng Changrong , Zhang Meiguang , Zhang Yu , Hu Zhiwei , Sun Minjie , Wu Jimin
Published: May 2023

Background:

Gastroesophageal reflux-related chronic cough (GERC), is one common type of chronic cough. Drug treatment is effective for some GERC patients. But, there is refractory GERC (rGERC). For rGERC, fundoplication may be the only effective method. However, there were very few studies about laparoscopic fundoplication in treating rGERC, and the cure rate of fundoplication in treating rGERC was unknown. So there is a question, what is the cure rate of fundoplication in treating rGERC? To solve this question, we performed this meta-analysis.

Methods:

The PRISMA strategy and Cochrane collaboration method were used for this study. Our study was registered with PROSPERO (ID: CRD42021251072). We searched PubMed, Medline, Web of Science, and the Cochrane databases from 1990 to December 2022. The meta-analysis was performed with Review Manager 5.4 and Stata 14.

Results:

After selection and exclusion, 8 articles out of 672 were included. The meta-analysis showed the cure rate of laparoscopic fundoplication in treating rGERC was 62% (95% confidence interval: 53–71%), with no deaths in 503 patients. There was no significant heterogeneity or bias in the meta-analysis.

Conclusions:

In terms of safety, laparoscopic fundoplication is quite reliable offered by skilled surgeons. In terms of cure rate, laparoscopic fundoplication could completely heal two-thirds of rGERC patients; however, there are still some patients who can not be completely cured by fundoplication.
Clinical efficacy of selenium supplementation in patients with Hashimoto thyroiditis: A systematic review and meta-analysis
Authors: Kong Xiang-Qi , Qiu Gui-Ying , Yang Zhong-Bin , Tan Zhi-Xiong , Quan Xiao-Qing
Published: May 2023

Background:

Evidence suggests that selenium supplementation could be useful in the treatment of Hashimoto thyroiditis (HT), but the available trials are heterogeneous. This study investigates clinically relevant effects of selenium supplementation in patients with HT.

Methods:

A systematic search was performed in PubMed, Web of Science, EMBASE, Scopus, and the Cochrane Library. The latest update was performed on December 3, 2022. We investigated the changes in thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb) after selenium supplementation. The effect sizes were expressed as weighted mean difference (WMD) with 95% confidence intervals (CIs).

Results:

After screening and full-text assessment, 7 controlled trials comprising 342 patients were included in the systematic review. The results showed that there was no significant change in TPOAb levels (WMD = −124.28 [95% CI: −631.08 to 382.52], P = .631, I
2 = 94.5%) after 3 months of treatment. But there was a significant decrease in TPOAb levels (WMD = −284.00 [95% CI: −553.41 to −14.60], P < .05, I
2 = 93.9%) and TgAb levels (WMD = −159.86 [95% CI: −293.48 to −26.24], P < .05, I
2 = 85.3%) after 6 months of treatment.

Conclusions:

Selenium supplementation reduces serum TPOAb and TgAb levels after 6 months of treatment in patients with HT, but future studies are warranted to evaluate health-related quality or disease progression.
A case report: Hemophagocytic lymphohistiocytosis and thrombotic thrombocytopenic purpura in an otherwise healthy woman
Authors: Li Yuanyuan , Li Wenqiang , Li Zhen , Ma Fubing , Xu Baocai
Published: May 2023

Rationale:

Thrombotic thrombocytopenic purpura (TTP) with hemophagocytic lymphohistiocytosis (HLH) is very rare, and both of these rare blood diseases have high mortality. There have been few reports of 2 diseases being combined at the same time. We provide a rare case with a clear diagnosis, prolonging the patient's survival through aggressive treatment, providing clinicians with our experience in early diagnosis and early treatment of this disease.

Patient concerns:

A 56-year-old woman presented with a 1-month history of fever.

Diagnoses:

She was diagnosed with HLH due to elevated levels of ferritin and lactase dehydrogenase, which were confirmed by the presence of hemophagocytosis in the bone marrow. TTP was diagnosed based on the presence of symptoms characteristic of TTP and significantly low levels of ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type 1 repeats, member 13).

Interventions:

Systemic corticosteroids and plasma exchange using 2 L of virus-inactivated frozen plasma per day were initiated as specific treatment.

Outcomes:

The patient’s consciousness improved posttreatment and platelets also increase gradually. In a follow-up after 1 month, the patient was generally well and without specific discomfort.

Lessons:

HLH patients themselves can have a significant reduction in platelet, as with TTP, it is very easy to misdiagnose or delay the diagnosis. How to diagnose early, actively find the primary disease, and treat it is crucial to improve the prognosis of HLH.
Galectin-3 changes from admission to discharge and its prognostic value for in-hospital mortality in heart failure: A prospective observational study
Authors: Bui Thanh-Hien Thi , Dinh Nhan Hieu
Published: May 2023

The aim of this study was to compare the levels of Galectin-3 (Gal-3) in heart failure patients at admission and discharge, and to evaluate the ability of Gal-3 at admission in predicting in-hospital mortality. A total of 111 patients were enrolled. Gal-3 and B-type natriuretic peptide (BNP) levels were measured at admission and discharge. Receiver operating characteristic analysis was used to determine the optimal cutoff values for Gal-3 and BNP, and logistic regression was used to assess the predictive ability of these biomarkers for in-hospital mortality. Gal-3 levels at discharge (24.08 ± 9.55) were significantly lower than those at admission (30.71 ± 11.22). The majority of patients (72.07%) experienced a decrease in Gal-3 levels, with a median reduction of 19.9% (interquartile range [IQR] 8.7–29.8). Gal-3 levels showed a weak correlation with BNP levels both at admission and discharge. Combining Gal-3 and BNP significantly improved the ability to predict in-hospital mortality, and including heart failure stage as a third predictor further improved the predictive accuracy. The optimal cutoff values for Gal-3 and BNP to predict in-hospital mortality were identified as 28.1 ng/mL and 1782.6 pg/mL, respectively, with moderate to good sensitivity and specificity. A median reduction of 19.9% of Gal-3 may indicate possibility to discharge. Our findings suggest that Gal-3 and BNP, when combined with heart failure stage, may be useful for predicting in-hospital mortality.
Surgical treatment of gastric stump carcinoma after Whipple procedure: A case report
Authors: Xie Wenjie , Liu Kuan , Lai Jianxiong , Li Jian
Published: May 2023

Rationale:

Gastric stump carcinoma (GSC) is very exceptional and little known after Whipple procedure, and its diagnosis and treatment are extremely difficult to handle.

Patient concerns:

The patient, a 68-year-old man, visited our hospital’s General surgery outpatient clinic complaining of upper abdominal pain that had been bothering him for half a month. The endoscopy revealed lesions in the stomach residual, and the pathological results suggested adenocarcinoma. The patient underwent Whipple procedure for periampullary adenocarcinoma in the 4th year ago.

Diagnoses:

The final diagnosis was gastric adenocarcinoma and its pathological stage was Ⅱ A (T3N0M0).

Interventions:

The patient underwent stump gastrectomy and end-to-side esophagojejunostomy (Roux-en-Y reconstruction).

Outcomes:

The operation went smoothly and the patient recovered well with only mild bloating and nausea, and the symptoms completely disappeared during the hospital stay.

Lessons:

The development of GSC several years after Whipple procedure is uncommon. This is the first case from China that has received international attention. Early diagnosis is crucial. Surgery is considered to be the most effective treatment for GSC after Whipple procedure if long-term survival is possible and surgical risks are controllable.
Stomach ulcer caused by mistakenly oral medication of 14,400 mg ibuprofen: A case report
Authors: Meijuan Zhang , Yu Penglong , Yuan Jie , Yu Tao , SUN Dan
Published: May 2023

Rationale:

Gastric mucosal ulcer caused by drug overdose is very rare in clinical practice, and here is a case of gastric antral ulcer caused by drug overdose.

Patient concerns:

A 35-year-old housewife from a mountainous region in China took 48 Ibuprofen Sustained-Release capsules (300 mg/capsule) orally at 1 time. Because of severe tingling in the upper abdomen accompanied by a sharp increase in blood pressure, she came to the doctor 48 hours later.

Diagnoses:

Gastric antral ulcer (multiple stage A1), duodenococcitis, chronic nonatrophic gastritis, Helicobacter pylori infection, moderate depression, and cognitive impairment.

Interventions:

Acid suppression, antihypertensive and a series of symptomatic treatments.

Outcomes:

All somatic symptoms disappeared after a follow-up visit 2 months later.

Lessons:

This case provides valuable information to the clinic, through the compilation of literature and case analysis, the author found that paying attention to mental health, to women in poor areas and to women from families of low education level are indispensable in medical diagnosis and treatment.
A bibliometric analysis of publications on trauma-related hemorrhagic shock from 2012 to 2022: Research landscape and future trends
Authors: Du Zhe , Wang Tianbing
Published: May 2023

Trauma-related hemorrhagic shock is a global problem. This study aimed to analyze the knowledge domain and frontiers of trauma-related hemorrhagic shock research through a bibliometric analysis. Articles on trauma-related hemorrhagic shock published between 2012 and 2022 were retrieved from the Web of Science Core Collection, and a bibliometric analysis was conducted using CiteSpace and VOSviewer. A total of 3116 articles and reviews were analyzed. These publications primarily came from 441 institutions in 80 countries, with the USA having the highest number of publications, followed by China. Among the publications, Ernest E. Moore published the most papers, whereas John B. Holcomb had the most co-citations. The most productive institution was the University of Pittsburgh in the USA. The keyword burst and reference clustering analysis indicated that “reboa,” “whole blood,” “exsome,” “glycocalyx,” “endotheliopathy,” and “predictor” are new trends and developing areas of interest. With the help of CiteSpace and VOSviewer, this study provides a deeper understanding of the research landscape, frontier hotspots, and future trends in trauma-related hemorrhagic shock over the last decade. “Whole blood” instead of “component therapy” shows potential advantage while “REBOA” is increasingly discussed in rapid hemostasis. This study provides important clues for researchers to understand the knowledge domain and frontiers of this study field.
Aberrant expression of UBE2C in endometrial cancer and its correlation to epithelial mesenchymal transition
Authors: Zhang Yan , Li Xueting , Gong Yingying , Du Danli , Chen Huilei , Liu Lei , Cheng Zenong
Published: May 2023

Ubiquitin-conjugating enzyme E2C (UBE2C), its overexpression promotes tumor progression, is a key component of the ubiquitin conjugating proteasome complex. Epithelial-mesenchymal transition, which is lost epithelial features and gained mesenchymal features in some epithelial cancers, is involved in epithelial cancers’ invasiveness and metastasis. The aim of this study is to detect the expression of UBE2C, WNT5α, and E-cad in endometrial cancer (EC) and their clinical significance. The expression of UBE2C, WNT5α, and ZEB1 in 125 cases EC tissues were detected by immunohistochemistry. Patients clinicopathological, demography, and follow-up data were also collected. Positive rates of expression of UBE2C and ZEB1 were significantly higher in EC tissues when compared with the control tissues. The positive expression of UBE2C and ZEB1 were positively associated with tumor stages, local lymph node metastasis, and International Federation of Gynecology and Obstetrics (FIGO) stages. The positive rate of expression of WNT5a was significantly lower in EC tissues when compared with the control tissues. And positive expression of E-cad was inversely related to tumor stages, lymph node metastasis stages, and FIGO stages. Kaplan–Meier analyses demonstrated that positive expression of UBE2C or ZEB1 for EC patients had unfavorably overall survival time when compared with patients with negative expression of UBE2C or ZEB1. And EC patients with positive expression of WNT5a had favorably overall survival time when compared with EC patients with negative expression of WNT5a. Multivariate analysis demonstrated that positive expression UBE2C, WNT5α, and ZEB1, as well as FIGO stages were independent prognostic factors for EC patients. UBE2C, ZEB1, and WNT5a should be considered promising biomarkers for EC patients’ prognosis.
Using Rasch KIDMAP to identify whether China dominates the research area of computer science (CS) based on the specialization index of article citations: Bibliometric analysis
Authors: Yen Po-Tsung , Chien Tsair-Wei , Chou Willy , Kan Wei-Chih
Published: May 2023

Background:

Scientific comparative advantage is measured by using a specialization index (SI) of article citations. The profile data have been published in the literature. However, no such research has been conducted to determine which countries dominate the field of computer science (CS) (subject category [SC]) using the SI. A KIDMAP in the Rasch model has been applied to the display of individual student performance in school. Based on the SI of article citations, we used KIDMAP to determine whether China dominates the field of CS.

Methods:

The data were derived from published research in the Web of Science, which included 199 countries and 254 subject categories (SC, between 2010 and 2019). A total of 96 SC related to biomedicine were extracted. We examined 7 factors associated with CS using exploratory factor analysis. Based on the SI in CS under the Rasch model, 1-dimensional SCs on CS were displayed on Wright Maps and KIDMAPs. An analysis of the dominance of CS in China was presented on the basis of a scatter plot.

Results:

Our findings indicate that (1) CS domains are divided into 2 groups (traditional and advanced domains); (2) no evidence has been found that China dominates CS; based on SI indicators, China was ranked third with -−2.62 and 0.79 logits after Taiwan and Slovenia (-(−2.62 and 9.24 logits in Factors 1 and 2) in the period from 2010 to 2019.

Conclusions:

There is insufficient evidence to demonstrate that China has a dominant role over other countries/regions despite ranking third in CS. In future studies, it is recommended to include a KIDMAP visual to assess dominant roles in other areas of research, rather than to confine ourselves to CS as we did in this study.
First experience of lymphaticovenular anastomosis using BHC RobotiScope: A case report
Authors: Chung Jae-Ho , Kim Dong-Jin , Yoon Eul-Sik , Park Seung-Ha
Published: May 2023

Rationale:

The RoboticScope (BHS Technologies GmbH, Innsbruck, Austria) is a robotic exoscope, which consists of a robotic arm that holds a 3-dimensional camera. It has an advantage that a surgeon can perform an operation comfortably with a favorable ergonomic position. Also, it allows the delivery of clear and high-quality visualization for surgeons. In this study, we would like to share our initial experience with this newly developed microscope technology in lymphaticovenular anastomosis (LVA). To the best of our knowledge, it is the first experience of LVA using this microscope in Asia.

Patient concerns:

A 65-year-old woman presented with bilateral lower extremity lymphedema after a hysterectomy that was performed 25 years back. Despite complex decongestive physiotherapy, an edematous symptom in both legs worsened.

Diagnoses:

In lymphoscintigraphy, a decreased visualization of main lymphatic flow in both the lower extremities was evident which was further suggestive of lymphatic obstruction.

Intervention:

Although both sides showed edematous symptoms, we decided to proceed with the surgery on the left side first, because of the worsened condition. Four LVAs were performed at the dorsum of the foot (×2), ankle, and the superior edge of the knee using RoboticScope

Outcomes:

At 6-months follow-up after operation, the postoperative circumference diameters were improved than preoperative in 10 cm above the knee (45 cm vs 49 cm), 10cm below the knee (37 cm vs 41 cm) and lateral malleolus (25 cm vs 28 cm). The lower extremity lymphedema index was also improved from 346.7 to 287.4 postoperatively. The RoboticScope provided a high-resolution image and a favorable ergonomic position during an operation.

Lessons:

The results represent the possibility of the application of a robotic microscope in the field of microsurgery, and further studies are necessitated to confirm the efficacy of this system.
Home monitoring vs hospitalization for mild acute pancreatitis. A pilot randomized controlled clinical trials
Authors: Sorribas Maria , Carnaval Thiago , Peláez Núria , Secanella Luis , Salord Silvia , Sarret Sònia , Videla Sebastián , Busquets Juli ,   On Behalf of the RHINO Study Group
Published: May 2023

Introduction:

Acute pancreatitis is a high-incidence benign disease. In 2009, it was the second highest cause of total hospital stays, the largest contributor to aggregate costs (approximately US$ 7000.00 per hospitalization), and the fifth leading cause of in-hospital deaths in the United States. Although almost 80% of acute pancreatitis cases are mild (usually requiring short-term hospitalization and without further complications), severe cases can be quite challenging.

Classifications, scores, and radiological criteria have been developed to predict disease severity and outcome accurately; however, in-hospital care remains of widespread use, regardless of disease severity. A recent Turkish study reported that mild acute pancreatitis can be effectively and safely managed with home monitoring. Although the optimal timing for oral refeeding remains controversial and could cast some doubt on the feasibility of home monitoring, some guidelines already advocate for starting it within 24 hours.

The present clinical trial aims to assess whether home monitoring is effective, safe and non-inferior to hospitalization for managing mild acute pancreatitis.

Methods:

This will be a multicenter open-label randomized (1:1) controlled clinical trial to assess the efficacy and safety of home monitoring compared to in-hospital care for mild acute pancreatitis. All patients coming to the emergency department with suspected acute pancreatitis will be screened for enrollment. The main variable will be treatment failure (Yes/No) within the first 7 days after randomization.

Discussion:

Acute pancreatitis implies a high economic burden in healthcare systems worldwide. Recent evidence suggests that mild disease can be safely and effectively treated with home monitoring. This approach may produce considerable cost savings and positively impact patients’ quality of life. We expect the results to show that home monitoring is effective and not inferior to hospitalization for managing mild acute pancreatitis and that the economic costs are lower, kickstarting similar trials throughout the world, optimizing the use of limited healthcare budgets, and improving patients’ quality of life.
Radiological findings of contrast-induced encephalopathy following cerebral angiography: A case report
Authors: Wu Bin , Zeng Ling , Peng Kaifa , Shao Xi , Liu Li , Man Rongyong , Tang Xianbi , Zhong Yushi
Published: May 2023

Introduction:

Contrast-induced encephalopathy (CIE) is a rare complication associated with the use of contrast media. New contrast agents make contrast complications increasingly rare. The diagnosis of CIE is challenging, particularly in patients with acute ischemic stroke. Neuroimaging results for patients with CIE can also be highly variable.

Patient concerns:

A 63-year-old man with severe internal carotid artery stenosis who experienced several symptoms, including dizziness, nausea, vomiting, fever, and blurred vision after being administered the contrast agent iodixanol.

Diagnoses:

Multiple CT and MRI brain scans were performed. After excluding other differential diagnoses such as electrolytes imbalance, hypo/hyperglycemia and other neurological emergencies such as cerebral hemorrhage, cerebral infarction, the final diagnosis of CIE was made.

Intervention:

Treatment consisted of adequate hydration, intravenous dexamethasone, mannitol, and anticonvulsants.

Outcome:

The patient demonstrated progressive neurological improvement, and recovered from all symptoms on the fifth day. Follow-up at 3 months shows a good prognosis for patients.

Conclusion:

Patients with CIE may have a high signal on diffusion-weighted imaging and a low signal on apparent diffusion coefficient brain MRI. This is similar to the MRI findings in acute stroke. This needs to be distinguished from acute cerebral infarction and suggests that we should closely monitor patients’ neurological symptoms at the time of cerebral angiography and after the investigations.
Students Provisionally Enrolled Due to Vaccination Requirements: Variation in State Laws and Rates
Authors: Yang Y. Tony , Strack Claire N. , Delamater Paul L.
Published: May 2023

This research examined the laws and regulations surrounding provisional enrollment in schools across the United States. Provisional enrollment refers to children who have started, but not completed, their required vaccinations and are allowed to attend school while completing their vaccinations. We found that nearly all states have laws regarding provisional enrollment, with 5 essential components to compare the laws including vaccine- and dose-specific requirements, type of personnel permitted to authorize, length of time that the children have to become up to date on their vaccinations (grace period), follow-up procedures, and consequences for noncompliance. In addition, we found that the percentage of provisionally enrolled kindergarteners varied greatly from state to state, with some states having less than 1% of provisionally enrolled kindergarteners and others having more than 8% between school years 2015-2016 and 2020-2021. We suggest that reducing the number of provisional entrants could be an alternative intervention to increase vaccination coverage.
Wild and Willful Kids: Can We Help Parents? The Effectiveness of a Group Parent Training Program Without a Psychiatric Label
Authors: Sluiter Maruschka N. , Bos Elisabeth H. , Doornenbal Jeannette M. , de Jonge Peter , Batstra Laura
Published: May 2023

Many children with a classification of attention-deficit/hyperactivity disorder exhibit mild-to-moderate problem behavior. For these children, a stepped diagnosis and stepped care approach has been proposed. Although a psychiatric classification may bring support to families, it may also have negative consequences. Therefore, in this preliminary study, the effect of a group parent training program without child-bound classifications (named Wild & Willful, Druk & Dwars in Dutch) was investigated. In 7 sessions, groups of parents (experimental, n=63; waiting list control, n=38) learned strategies to deal with wild and willful behavior in their children. Outcome variables were assessed by questionnaires. Multilevel analyses showed that, compared with the control group, the intervention group had significantly lower scores on parental stress and communication problems (Cohen d=0.47 and 0.52, respectively), but not on attention and hyperactivity problems, oppositional defiant problems, and responsivity. Zooming in on the course of outcome variables over time in the intervention group, improvements on all variables were seen, with small to moderate effect sizes (Cohen d=0.30 to 0.52). Overall, the group parent training program without the need for a classification for children seemed beneficial. The training is low cost, brings together parents who are facing similar problems in rearing their children, and may help to reduce overdiagnosis of mild and moderate problems, without risking undertreatment of severe difficulties.
Seven Mechanistically Different Classes of Medications Can Be Used to Treat Insomnia and Related Sleep Disorders
Authors: Preskorn Sheldon H.
Published: May 2023

This column reviews the neurobiology of the sleep-wake cycle as it is currently known, the 7 classes of currently available sleep-enhancing medications, and how their mechanisms of action relate to the neurobiology of sleep. Clinicians can use this information to select medications for their patients, which is particularly important because some patients respond to some of these medications but not others, or tolerate some but not others. This knowledge can also help the clinician switch among classes when a medication that was initially efficacious begins to fail a patient. It can also prevent the clinician from cycling through all of the members of a single medication class. Such a strategy is unlikely to be helpful for a patient except in the situation in which pharmacokinetic differences among members of the medication class result in some agents in that class being helpful for a patient who has either a delayed onset of action or undesirable carry-over effects with other agents in that class. An understanding of the classes of sleep-enhancing medications highlights the importance of knowing the neurobiology that underlies a psychiatric illness. The activity of a number of neurobiological circuits, such as the one reviewed in this column, has now been well established, while work to understand others is still at a much earlier stage. Psychiatrists who gain an understanding of such circuits will be better able to provide effective care for their patients.
“Financial Literacy in Plastic Surgery Training: Importance and Current Status”
Authors: Krasniak Peter J. , Kraft Casey T. , O’Brien Andrew L. , Huayllani Maria T. , Kaptsan Irina , Pearson Gregory D. , Moore Amy M.
Published: May 2023

Background:

Medical training is known to impose financial burden on trainees, which has been shown to contribute to burnout, even possibly compromising patient care. Financial literacy allows for management of financial situations affecting professional and personal life. We aimed to evaluate the financial status and knowledge amongst Plastic Surgery residents.

Methods:

A survey regarding finances and financial literacy of plastic surgery residents was sent to all the current accredited US residency programs. The same survey was distributed internally. A descriptive analysis was performed, and multiple Fisher’s Exact tests and a Student’s T-test evaluated comparisons.

Results:

Eighty-six residents were included. Most trainees had a student loan (59.3%), with 22.1% having more than $300k. A majority had at least one personal loan debt other than educational (51.1%). Residents with more debt were significantly less likely to pay off their balances monthly. A total of 17.4% of trainees had no plan for how to invest their retirement savings, whereas 55.8% reported not knowing how much they need to save to retire. One in five trainees did not feel prepared to manage personal finances/retirement planning after graduation, a majority had no formal personal finance education in their curriculum, and 89.5% agreed that financial literacy education would be beneficial. Our institutional data largely mirrored national data.

Conclusion:

Many residents are lacking in financial knowledge, despite most having significant debt. Additional financial literacy education is needed in Plastic Surgery training. Curricula development at an institutional or national society level are possible paths towards a coordinated response towards this need.
Psychological Factors Predict Higher Odds and Impairment of Post-COVID Symptoms: A Prospective Study
Authors: Milde Christopher , Glombiewski Julia A. , Wilhelm Marcel , Schemer Lea
Published: May 2023

Objective

The causes of the long-term persistence of symptoms after a severe acute respiratory syndrome coronavirus 2 infection (i.e., post-COVID syndrome) remain elusive. Although previous research identified demographic and medical risk factors for the development of post-COVID, the present prospective study is the first to investigate the role of psychological factors.

Methods

The interview and survey data of polymerase chain reaction–positive participants (n = 137; 70.8% female) were assessed in the acute, subacute (3 months after symptom onset), and chronic phases (6 months after symptom onset) of COVID.

Results

After controlling for medical (body mass index, disease score) and demographic factors (sex, age), psychosomatic symptom burden (measured by the Somatic Symptom Disorder—B Criteria Scale) predicted higher odds and magnitude of COVID-related symptom impairment in the post-COVID phases. Fear of COVID-related health consequences (measured by the Fear of COVID Scale) also predicted higher odds of reporting any COVID symptoms in the subacute and chronic phases, whereas it only predicted a higher magnitude of COVID-related symptom impairment in the subacute phase. In subsequent exploratory analyses, we found that other psychological factors were associated with an overall increase (i.e., chronic stress and depression) or decrease (i.e., trait positive affect) in the odds and magnitude of COVID-related symptom impairment.

Conclusions

We conclude that psychological factors can fuel or temper the experience in post-COVID syndrome, opening new possibilities for psychological interventions.

Trial Registration

The study protocol was preregistered in the Open Science Framework (https://osf.io/k9j7t).
Psychological Resilience to Trauma and Risk of COVID-19 Infection and Somatic Symptoms Across 2 Years
Authors: Nishimi Kristen , Tan Jeri , Scoglio Arielle , Choi Karmel W. , Kelley Dennis Parker , Neylan Thomas C. , O’Donovan Aoife
Published: May 2023

Objective

Exposure to trauma increases the risk of somatic symptoms, as well as acute and chronic physical diseases. However, many individuals display psychological resilience, showing positive psychological adaptation despite trauma exposure. Resilience to prior trauma may be a protective factor for physical health during subsequent stressors, including the COVID-19 pandemic.

Methods

Using data from 528 US adults in a longitudinal cohort study, we examined psychological resilience to lifetime potentially traumatic events early in the pandemic and the risk of COVID-19 infection and somatic symptoms across 2 years of follow-up. Resilience was defined as level of psychological functioning relative to lifetime trauma burden, assessed in August 2020. Outcomes included COVID-19 infection and symptom severity, long COVID, and somatic symptoms assessed every 6 months for 24 months. Using regression models, we examined associations between resilience and each outcome adjusting for covariates.

Results

Higher psychological resilience to trauma was associated with a lower likelihood of COVID-19 infection over time, with one standard deviation higher resilience score associated with a 31% lower likelihood of COVID-19 infection, adjusting for sociodemographics and vaccination status. Furthermore, higher resilience was associated with lower levels of somatic symptoms during the pandemic, adjusting for COVID-19 infection and long COVID status. In contrast, resilience was not associated with COVID-19 disease severity or long COVID.

Conclusions

Psychological resilience to prior trauma is associated with lower risk of COVID-19 infection and lower somatic symptoms during the pandemic. Promoting psychological resilience to trauma may benefit not only mental but also physical health.
Streptococcus parasanguinis: An emerging pathogen causing neonatal endocarditis: A case report
Authors: Shrimali Twishi , Malhotra Shikhir , Relhan Nidhi , Tak Vibhor , Choudhary Sushil Kumar , Gupta Neeraj , Singh Arun Kumarendu
Published: May 2023

Background
The microbial infection of the endocardium, popularly known as Infective Endocarditis (IE), is typically classified on the basis of anatomy, valve nativity and its associated microbiology. As per the associated microbiology, Staphylococcus aureus is the most common microorganism responsible for the cause of IE. Even though, Streptococcus group  accounts for a smaller percentage of IE, however this doesn’t give us the liberty of ignoring the high mortality and morbidity associated with this pathogen.
Case presentation
We report an unusual case of neonatal sepsis, complicated with endocarditis, caused by penicillin resistant Streptococcus parasanguinis. The neonate however died of the same despite all efforts. The said baby was given birth by a mother with gestational diabetes mellitus.  
Conclusion
High index of clinical suspicion and prompt diagnosis are the most important factors of patient management, especially in cases of life threatening neonatal infections. In such conditions a coordinated interdepartmental approach is very much needed.
Exploring the Microbial Communities in Green Honey from Banggi Island, Sabah, Malaysia using Amplicon Sequencing Analysis
Authors: Ullah Saeed , Abdul Wahabb Roswanira , Oyewusi Habeebat Adekilekun , HUYOP FAHRUL
Published: May 2023

The green honey food product from honeybee is produced in the forest's subsurface region on Banggi Island, Because of its uniqueness, the product attracts a great market price. Naturally the honey doesn’t acquire microorganisms due to strong chemical property and dormant nature. Major causes of microbial contamination are probable to include pollen, the digestive tracts of honeybees, sources that are extremely difficult to control include earth, air, dust, and nectar. This study was carried out to determine the microbial diversity of green honey using amplicon sequencing method, we targeted 16S rRNA V3-V4 region for bacterial species and ITS1 region for fungal diversity. Result revolved that; Bacteria include the largest number of identified taxa (256) and read (136856400), total of (118) different bacteria species identified and validated with seven distinct phyla, namely protobacteria, Firmicutes, Actinobacteriota, Bacteriodata, fusobacteriota, chloroflexota, and some unclassified phylum. Among other identified species only 11 bacterial species relative abundance is higher than one percent. Fungi is the second largest with 08 taxa identified and number of read (16217100). Six different species of fungi and only two species of yeast were identified, all the identified species were belong to two different phyla Ascomycota and Basidiomycota. Among other identified genera genus Zygosaccharomyces have relative abundance (99%) as compared to other species identified, it reflects the very high abundance of Zygosaccharomyces in green honey sample.
Proposal of Eoetvoesiella gen. nov., Paludihabitans gen. nov., Rivihabitans gen. nov. and Salella gen. nov. as replacement names for the illegitimate prokaryotic generic names Eoetvoesia, Paludicola, Rivicola and Sala, respectively
Authors: Deshmukh Umakant Bhoopati , Oren Aharon
Published: May 2023

The prokaryotic generic names

Eoetvoesia

Felföldi et al. 2014,

Paludicola

Li et al. 2017,

Rivicola

Sheu et al. 2014 and Sala Song et al. 2023 are illegitimate because they are later homonyms of the genus names

Eoetvoesia

Schulzer et al. 1866 (Ascomycota),

Paludicola

Wagler 1830 (Amphibia) and

Paludicola

Hodgson 1837 (Aves),

Rivicola

Fitzinger 1833 (Mollusca) and Sala Walker 1867 (Hemiptera) and the subgenus name Sala Ross 1937 (Hymenoptera), respectively (Principle 2 and Rule 51b(4) of the International Code of Nomenclature of Prokaryotes). We therefore propose the replacement generic names Eoetvoesiella, Paludihabitans, Rivihabitans and Salella, with type species Eoetvoesiella caeni, Paludihabitans psychrotolerans, Rivihabitans pingtungensis and Sallella cibi, respectively.
Biological activity of Euonymus alatus (Thunb.) Sieb. wing extracts
Authors: Min Hye-Ji , Kim Du-Hyun , Seo Kwon-Il
Published: May 2023

Euonymus alatus (Thunb.) Sieb., also known as the arrow tree in Korea, is a plant in East Asia used in traditional medicine and food. In particular, the wings of E. alatus are rich in phenolic compounds. This study evaluated the antioxidant, α-glucosidase inhibition, and anti-cancer activities of E. alatus wing extracts. The radical and hydrogen peroxide scavenging acitvities and reducing the power of 1,000 μg/mL E. alatus wing extracts, were similar to those of the positive control (0.1% BHT, 0.1% α-tocopherol). In addition, ethanol and methanol extract at 250 μg/mL showed 95.70 and 94.99% of α-glucosidase inhibition activity, respectively. The ethanol extract of E. alatus wings had the highest total polyphenol and flavonoid contents (867.8 mg% and 521.7 mg%, respectively). The E. alatus wing extracts significantly decreased the cell viability of LNCaP human prostate cancer cells (p<0.001), MDA-MB-231 human breast cancer cells (p<0.001), and HT-29 human colon cancer cells (p<0.001) in a dose-dependent manner. However, there was no significant effect on B16 mouse melanoma cells. Notably, the ethanol extracts showed higher cancer cell growth inhibitory activity in LNCaP and HT-29 cells than the other extracts. These results suggest that E. alatus wing extracts could have significant clinical applications, and our results can be used as basic data for future functional food material development.
Concurrent measurement of O2and isoprene production during photosynthesis: pros, cons, and metabolic implications
Authors: Som Suman , Gallo Luiza , Sunder Aatish , Demus Jilian , Dominges Tomas F. , Wistrom Christina M. , Gu Lianhong , Tcherkez Guillaume , Jardine Kolby J.
Published: May 2023

During oxygenic photosynthesis, oxygen (O2) is generated from water photolysis, which provides reducing power to sustain CO2assimilation. To date, traditional leaf gas-exchange experiments have been focused on net CO2exchange (Anet), with limited observations of net oxygen production (NOP). Here, we present the first gas-exchange/fluorescence system, coupling CO2/H2O analysis (photosynthesis and transpiration) with NOP and isoprene emission measurements. This configuration allowed us to calculate the assimilatory quotient (AQ = Anet/NOP) and thus obtain a more complete picture of the photosynthetic redox budget via photosynthetic production of O2, electron transport rate (ETR), and isoprene biosynthesis. We used cottonwood leaves (Populus trichocarpa) and carried out response curves to light, CO2and temperature along with18O-labelling with18O-enriched water. We found that Anetand NOP were linearly correlated across environmental variables with AQ of 1.27 +/- 0.12 regardless of light, CO2, and temperature. Anetand NOP had optimal temperatures (Topt) of 31°C, while ETR (35°C) and isoprene emissions (39°C) had distinctly higher Topt. Leaves labelled with H218O produced labeled (18O16O) oxygen with the same Toptas ETR (35°C). The results confirm a tight connection between water oxidation and ETR and are consistent with a suppression of Anetand NOP at high temperature driven by an acceleration of (photo)respiration. The findings support the view of isoprene biosynthesis primarily driven by excess photosynthetic ATP/NADPH not consumed by the Calvin cycle during photorespiratory conditions as an important thermotolerance mechanism linked with high rates of CO2and O2recycling.

Keywords

Photosynthesis, net oxygen production, gross oxygen production, H218O labeling

One sentence summary

A leaf gas-exchange system is presented enabling a more complete picture of the photosynthetic redox budget and calculation of the assimilatory quotient.
Gap junction and amino acid import in somatic cells promote germ cell growth
Authors: Vachias Caroline , Tourlonias Camille , Grelée Louis , Gueguen Nathalie , Renaud Yoan , Venugopal Parvathy , Richard Graziella , Pouchin Pierre , Brasset Émilie , Mirouse Vincent
Published: May 2023

Gap junctions allow the exchange of small molecules between cells. How this function could be used to promote cell growth is not yet fully understood. DuringDrosophilaovarian follicle development, germ cells, which are surrounded by epithelial somatic cells, undergo massive growth. We found that this growth depends on gap junctions between these cell populations, with a requirement for Innexin4 and Innexin2, in the germ cells and the somatic cells, respectively. Translatomic analyses revealed that somatic cells express enzymes and transporters involved in amino acid metabolism that are absent in germ cells. Among them, we identified an amino acid transporter required for germline growth. Its ectopic expression in the germline can compensate for its absence in somatic cells. Moreover, affecting either gap junctions or amino-acid import in somatic cells induces P-bodies in the germ cells, a feature associated with an arrest of translation. Finally, in somatic cells, innexin2 expression and gap junction assembly are regulated by the insulin receptor/PI3K kinase pathway. Overall, these results support the view that metabolic transfer through gap junction promotes cell growth and illustrate how such a mechanism can be integrated into a developmental programme, coupling growth control by extrinsic systemic signals with the intrinsic coordination between cell populations.