bluuebunny/crossref_metadata_2025 huggingface dataset:
Expression of TMEM59L associated with radiosensitive in glioblastoma
Authors: Gao Dezhi , Wang Peng , Zhi Lin , Sun Shibin , Qiu Xiaoguang , Liu Yanwei
Published: July 2023

Radiotherapy is one of the cornerstone of the glioblastoma treatment paradigm. However, the resistance of tumor cells to radiation results in poor survival. The mechanism of radioresistance has not been fully elucidated. This study aimed to screen the differential expressed genes related with radiosensitivity. The differentially expressed genes were screened based on RNA sequencing in 15 pairs of primary and recurrent glioblastoma that have undergone radiotherapy. Candidate genes were validated in 226 primary and 134 recurrent glioblastoma (GBM) obtained from the Chinese Glioma Genome Atlas (CGGA) database. RNA and protein expression were verified by Quantitative Real-time PCR (qPCR) and western blot in irradiated GBM cell lines. The candidate gene was investigated to explore the relationship between mRNA levels and clinical characteristics in the CGGA and The Cancer Genome Atlas dataset. Kaplan–Meier survival analysis and Cox regression analysis were used for survival analysis. Gene ontology and KEGG pathway analysis were used for bioinformatics analysis. Four genes (TMEM59L, Gelsolin, ZBTB7A and ATX) were screened. TMEM59L expression was significantly elevated in recurrent glioblastoma and lower in normal brain tissue. We selected TMEM59L as the target gene for further study. The increasing of TMEM59L expression induced by radiation was confirmed by mRNA and western blot in irradiated GBM cell. Further investigation revealed that high expression of TMEM59L was enriched in IDH mutant and MGMT methylated gliomas and associated with a better prognosis. Gene ontology and KEGG pathway analysis revealed that TMEM59L was closely related to the DNA damage repair and oxidative stress respond process. We speculated that the high expression of TMEM59L might enhance radiotherapy sensitivity by increasing ROS-induced DNA damage and inhibiting DNA damage repair process.
Hydrometrocolpos in an infant with urological complications: a rare case and review of literature
Authors: Ngowi Bartholomeo N , Bright Frank , Lodhia Jay , Kimolo Mathias , Shirima Denis , Mbwambo Jasper S , Mteta Alfred K , Mbwambo Orgeness J
Published: July 2023

Hydrometrocolpos is a rare congenital anomaly characterized by gross distension of the uterus and vagina with fluid, which may result in obstruction to the urine flow. The insertion of Foley catheter into the uterus can relieve the obstruction to the flow of urine and improve renal function. Herein we present a case of infant who was diagnosed with an abdominal mass and renal insufficiency that was managed by the placement of Foley catheter into the dilated uterus and the renal function recovered.
Scar endometriosis: the menace of surgery
Authors: Mittal Ritika , Ashraf Aabid , Gupta Monika , Shah Mausam
Published: July 2023

Caesarean scar endometriosis (CSE) is a rare type of abdominal wall endometriosis and is frequently missed on initial presentation. A case of CSE diagnosed and treated by surgical excision is presented. Although rare, CSE should be considered a possibility in the differential diagnoses of pain and mass at scar site.
Unexpected presentation of ischemic colitis: a case report and review of the literature
Authors: Al-Mohannadi Fatima Saoud , Al Obahi Mohammed , Al-Hashimy Yaseen , Mahdi Hijran , Ahmed Mohamed Badie
Published: July 2023

Ischemic colitis accounts for many cases of bowel infarction. Usually, it has various manifestations, such as vomiting, abdominal pain, hematochezia and many other symptoms. Risk factors might include age, medications, hypercoagulable state and chronic illnesses. However, it can still occur in healthy young patients. This might make it difficult for physicians to establish a correct diagnosis and generate the appropriate treatment plan for patients suffering from ischemic colitis. In this case we report a previously healthy 37-year-old female who had a sudden onset of lower abdominal pain associated with hematochezia. This patient was treated for upper respiratory tract infection by amoxicillin-clavulanate 2 weeks prior to her symptoms. The computed tomography abdomen findings along with the exploratory laparotomy confirmed the diagnosis of ischemic colitis. Ischemic colitis is a serious condition with high mortality and morbidity rate. Therefore, prompt investigation, and if indicated, surgical intervention should be calculated in sick patients complaining of abdominal pain and lower gastrointestinal bleeding.
On the internal structure of relativistic jets with zero velocity along the axis
Authors: Beskin V S , Kniazev F A , Chatterjee K
Published: July 2023

The present work is devoted to the analysis of the internal structure of relativistic jets under the condition that the velocity of the plasma flow at the jet axis vanishes. It is shown that in spite of the seemingly fundamental difference in the formulation of the problem at the axis, the key properties of the internal structure of such relativistic jets remain the same as for non-zero velocity along the axis. In both cases, at a sufficiently low ambient pressure, a dense core appears near the axis, the radius of which is close to the size of the light cylinder.
iSMOD: an integrative browser for image-based single-cell multi-omics data
Authors: Zhang Weihang , Suo Jinli , Yan Yan , Yang Runzhao , Lu Yiming , Jin Yiqi , Gao Shuochen , Li Shao , Gao Juntao , Zhang Michael , Dai Qionghai
Published: July 2023

Genomic and transcriptomic image data, represented by DNA and RNA fluorescence in situ hybridization (FISH), respectively, together with proteomic data, particularly that related to nuclear proteins, can help elucidate gene regulation in relation to the spatial positions of chromatins, messenger RNAs, and key proteins. However, methods for image-based multi-omics data collection and analysis are lacking. To this end, we aimed to develop the first integrative browser called iSMOD (image-based Single-cell Multi-omics Database) to collect and browse comprehensive FISH and nucleus proteomics data based on the title, abstract, and related experimental figures, which integrates multi-omics studies focusing on the key players in the cell nucleus from 20 000+ (still growing) published papers. We have also provided several exemplar demonstrations to show iSMOD’s wide applications—profiling multi-omics research to reveal the molecular target for diseases; exploring the working mechanism behind biological phenomena using multi-omics interactions, and integrating the 3D multi-omics data in a virtual cell nucleus. iSMOD is a cornerstone for delineating a global view of relevant research to enable the integration of scattered data and thus provides new insights regarding the missing components of molecular pathway mechanisms and facilitates improved and efficient scientific research.
Characterization of an HNA aptamer suggests a non-canonical G-quadruplex motif
Authors: Schofield Peter , Taylor Alexander I , Rihon Jérôme , Peña Martinez Cristian D , Zinn Sacha , Mattelaer Charles-Alexandre , Jackson Jennifer , Dhaliwal Gurpreet , Schepers Guy , Herdewijn Piet , Lescrinier Eveline , Christ Daniel , Holliger Philipp
Published: July 2023

Nucleic acids not only form the basis of heredity, but are increasingly a source of novel nano-structures, -devices and drugs. This has spurred the development of chemically modified alternatives (xeno nucleic acids (XNAs)) comprising chemical configurations not found in nature to extend their chemical and functional scope. XNAs can be evolved into ligands (XNA aptamers) that bind their targets with high affinity and specificity. However, detailed investigations into structural and functional aspects of XNA aptamers have been limited. Here we describe a detailed structure-function analysis of LYS-S8-19, a 1′,5′-anhydrohexitol nucleic acid (HNA) aptamer to hen egg-white lysozyme (HEL). Mapping of the aptamer interaction interface with its cognate HEL target antigen revealed interaction epitopes, affinities, kinetics and hot-spots of binding energy similar to protein ligands such as anti-HEL-nanobodies. Truncation analysis and molecular dynamics (MD) simulations suggest that the HNA aptamer core motif folds into a novel and not previously observed HNA tertiary structure, comprising non-canonical hT-hA-hT/hT-hT-hT triplet and hG4-quadruplex structures, consistent with its recognition by two different G4-specific antibodies.
Post-COVID-19 Syndrome 2 Years After the First Wave: The Role of Humoral Response, Vaccination and Reinfection
Authors: Peghin Maddalena , De Martino Maria , Palese Alvisa , Chiappinotto Stefania , Fonda Federico , Gerussi Valentina , Sartor Assunta , Curcio Francesco , Grossi Paolo Antonio , Isola Miriam , Tascini Carlo
Published: July 2023

Background

The aim of this study was to describe the long-term evolution of post-COVID-19 syndrome over 2 years after the onset of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) in survivors of the first wave.

Methods

This prospective study was based on interviews and investigated post-COVID-19 syndrome 6, 12, and 24 months after the disease onset in all adult in- and outpatients with COVID-19 followed at Udine Hospital (Italy) during the first wave (March–May 2020). Humoral response, vaccination status, and reinfection were assessed.

Results

Overall, 230 patients (53.5% female; mean age 54.7 years) were interviewed 2.3 years (standard deviation = 0.11) after acute onset. Post-COVID-19 syndrome was observed in 36.1% of patients (n = 83) at 2 years. The most common persistent symptoms were fatigue (14.4%), rheumatological (14.4%), and psychiatric symptoms (9.6%). Overall, 55.4% (46 of 83) of long haulers searched for healthcare system support and 21 (45.7%) were visited by a specialist. Female gender (odds ratio [OR] = 2.50, P = .005), a proportional increase in the number of symptoms during acute COVID-19 (OR = 1.40, P = .001), and the presence of comorbidities (OR = 1.57, P = .004) were all independent risk factors for post-COVID-19 syndrome. Vaccination and reinfection had no impact on post-COVID-19 syndrome dynamics. The presence of receptor-binding domain (RBD) SARS-CoV-2 immunoglobulin G (IgG) and non-RBD SARS-CoV-2 IgG titers were not associated with the occurrence of post-COVID-19 syndrome.

Conclusions

Two years after COVID-19, the burden of persistent symptoms remains high among in- and outpatients’ population infected during the first wave. Post-COVID-19 dynamic does not seem to be influenced by SARS-CoV-2 immunization status and reinfection.
Hepatitis B Virus Prevalence and Mother-to-Child Transmission Risk in an HIV Early Intervention Cohort in KwaZulu-Natal, South Africa
Authors: Millar Jane , Cromhout Gabriela Z L , Mchunu Noxolo , Bengu Nomonde , Ndung’u Thumbi , Goulder Philip J , Matthews Philippa C , McNaughton Anna L
Published: July 2023

Background

HIV and hepatitis B virus (HBV) prevalence are both high in KwaZulu-Natal, South Africa. HIV coinfection negatively affects HBV prognosis and can increase the likelihood of HBV mother-to-child transmission (MTCT). In an early HIV infant treatment intervention cohort of HIV-transmitting mother-child pairs in KwaZulu-Natal, we characterized maternal HBV prevalence and screened infants at risk.

Methods

Infants were treated for HIV MTCT at birth, and combination regimens incidentally active against HBV were initiated within 21 days. Maternal samples (N = 175) were screened at birth for HBV infection (HBV surface antigen [HBsAg]), exposure to HBV (HBV anti-core IgG), and vaccination responses (HBV anti-S positive without other HBV markers). Infants of mothers who were HBV positive were screened for HBsAg at 1 and 12 months.

Results

Evidence of HBV infection was present in 8.6% (n = 15) of maternal samples. Biomarkers for HBV exposure were present in 31.4% (n = 55). Evidence of HBV vaccination was uncommon in mothers (8.0%; n = 14). Despite prescription of antiretroviral therapy (ART) active against HBV, HBV DNA was detectable in 46.7% (7/15) of mothers who were HBsAg positive. Three mothers had HBV viral loads >5.3 log10 IU/mL, making them high risk for HBV MTCT. Screening of available infant samples at 1 month (n = 14) revealed no cases of HBV MTCT. At 12 months, we identified 1 HBV infection (1/13), and serologic evidence of vaccination was present in 53.8% (7/13) of infants.

Discussion

This vulnerable cohort of HIV-transmitting mothers had a high prevalence of undiagnosed HBV. Early infant ART may have reduced the risk of MTCT in high-risk cases. Current HBV guidelines recommend ART prophylaxis, but these data underline the pressing need to increase availability of birth dose vaccines.
A Green Social Work Study of Environmental and Social Justice in an Australian River Community
Authors: Downey Heather , Spelten Evelien , Holmes Katie , MacDermott Sean , Atkins Prue
Published: July 2023

In Australia the impacts of climate change are resulting in considerable water scarcity, a scenario affecting the green and blue spaces that provide well-recognized individual health benefits. However, far less is known about the social health benefits of these spaces, particularly for those residing in rural Australian river communities. In this geographic context, water issues are compounded by a dominant culture that privileges the commodification of water for agricultural purposes over other interests. Using an environmental justice perspective consistent with a green social work approach, this proof-of-concept study contributes a critical element to water debates by examining the cultural, recreational, and environmental meanings of water for the rural river community of Mildura. Results from an online mixed-methods questionnaire (N = 33) show that people privileged cultural meanings of water as fundamental to life, were concerned for river health, and felt marginalized in water debates. Findings suggest that understanding communities’ hydrosocial relationships is key to environmentally and socially just water management and to individual, community, and environmental health. Social work can contribute to such environmental issues by working collaboratively to enable communities to exercise their voices and to advocate to decision makers to include consideration of environmental, social, and cultural impact.
A comparison of carcass characteristics, carcass cutting yields, and meat quality of barrows and gilts
Authors: Bohrer Benjamin M , Dorleku Justice B , Campbell Cheryl P , Duarte Marcio S , Mandell Ira B
Published: July 2023

Objectives of this research were to compare carcass characteristics, carcass cutting yields, and meat quality for market barrows and market gilts. Commercially-sourced carcasses from 168 market barrows and 175 market gilts weighing an average of 107.44 ± 7.37 kg were selected from 17 different slaughter groups representing approximately 3,950 carcasses. Each group was sorted into percentiles based on hot carcass weight with an equal number of barrows and gilts selected from each quartile so that weight minimally confounded parameters of interest. Carcass lean yield was determined for carcasses following fabrication (i.e. dissection of lean, fat, and bone tissue components) and meat quality measurements were evaluated at the time of fabrication (24 to 72 h postmortem) and following 14-d of postmortem storage. Data were analyzed as a randomized complete block design with carcass serving as the experimental unit, sex (barrow or gilt), the three hot carcass weight quantiles (light [<104 kg]; average [104 to 110 kg]; heavy [>110 kg]), and the interaction between sex and hot carcass weight quantile serving as fixed effects, and producer nested within slaughter event serving as a random effect. Results from the study demonstrated that gilt carcasses were leaner (3 mm less backfat thickness; 3.5 cm2 greater loin muscle area, 1.52% greater merchandized-cut yield, and 2.92% greater dissected carcass lean yield; P < 0.01) than barrow carcasses, while loins from barrows were higher quality (0.43% more intramuscular fat and slightly less shear force; P < 0.01) than loins from gilts. While this study confirms the well-known biological principle that barrow carcasses have greater levels of fat deposition and lower levels of carcass leanness when compared with gilt carcasses, this study provides a much-needed quantification of these differences for the commercial industry that will undoubtedly be useful as new technologies emerge in upcoming years.
Preoperative Predictors of Prolonged Opioid Use in the 6 Months Following Total Knee Arthroplasty
Authors: Larach Daniel B. , Kertai Miklos D. , Billings Frederic T. , Anderson Sara B. , Polkowski Gregory G. , Shinar Andrew A. , Milne Ginger L. , Mishra Puneet , Bruehl Stephen
Published: July 2023

Objectives:

Prolonged postoperative opioid use increases risk for new post-surgical opioid use disorder. We evaluated preoperative phenotypic factors predicting prolonged postoperative opioid use.

Methods:

We performed a secondary analysis of a prospective observational cohort (n=108) undergoing total knee arthroplasty (TKA) for osteoarthritis with 6-week and 6-month follow-up. Current opioid use and psychosocial, pain, and opioid-related characteristics were assessed at preoperative baseline. Primary outcomes were days/week of opioid use at follow-up.

Results:

At 6 weeks, preoperative opioid use and greater cumulative opioid exposure, depression, catastrophizing, anxiety, pain interference, sleep disturbance, and central sensitization were significantly associated with more days/week of opioid use after controlling for contemporaneous pain intensity. These predictors, and prior euphoric response to opioids, were also significant predictors at 6 months. All 6-week predictors except anxiety remained significant after controlling for preoperative opioid use; at 6 months, cumulative opioid exposure, catastrophizing, pain interference, and sleep disturbance remained significant after this adjustment (p’s <0.05). In multivariable models, a psychosocial factor reflecting negative affect, sleep, and pain accurately predicted 6-week opioid use (AUC=0.84). A combined model incorporating psychosocial factor scores, opioid-related factor scores, and preoperative opioid use showed near-perfect predictive accuracy at 6 months (AUC=0.97).

Discussion:

Overall, preoperative psychosocial, pain-related, and opioid-related phenotypic characteristics predicted prolonged opioid use following TKA.
Mobile Phone Based Telemonitoring for Improving Adherence to Analgesic Treatment in Trauma Patients After Emergency Department Discharge. Randomized Controlled Trial
Authors: Romdhane Khouloud , Sekma Adel , Sassi Sarra , Yaakoubi Hajer , Youssef Rym , Msolli Mohamed Amine , Beltaief Kaouthar , Grissa Mohamed Habib , Boubaker Hamdi , Ben Soltane Houda , Mezgar Zied , Boukef Riadh , Bouida Wahid , Belghith Asma , Bel Haj Ali Khaoula , Zorgati Asma , Nouira Semir
Published: July 2023

Objective:

To determine the impact of mobile-phone telemonitoring on patients’ adherence and satisfaction to post-trauma pain treatment.

Materials and Methods:

We conducted a prospective randomized clinical trial including patients with minor trauma discharged from the emergency department (ED) with analgesic treatment. Patients were randomized to one of three groups, control group where patients received a phone call on day-7, short message service (SMS) group where patients received a daily text message to remind them to take their treatment during 7 days and mobile-phone based telemonitoring (TLM) group. Patients’ adherence to analgesic treatments using the Morisky Medication Adherence Scale (MMAS-4), current pain by using a visual analogue scale (VAS) and patients’ satisfaction were assessed. For TLM group, assessment was performed at day-2, 4 and 7.

Results:

Good adherence was observed in 418 patients (92.9%) in TLM group versus 398 patients (88.6%) in SMS group and 380 patients (84.8%) in control group (P<0.001). The factor mostly associated with adherence was telemonitoring (OR 2.40 95% CI 1.55 to 3.71). The decrease of pain VAS was highest in TLM group compared to SMS and control groups (P<0.001). Percentage of patients’ satisfaction at 7-day post ED discharge was 93% in TLM group vs 88% in SMS group and 84% in standard group (P=0.02).

Discussion:

Our findings suggest that mobile-phone based telemonitoring is beneficial in the treatment of pain in trauma patients after ED discharge. This approach improved patients’ adherence and satisfaction.
PAI-1 genetic polymorphisms influence septic patients' outcomes by regulating neutrophil activity
Authors: Jiang Shaowei , Wang Yang , Chen Liang , Mu Honghua , Meaney Connor , Fan Yiwen , Pillay Janesh , Wang Hairong , Zhang Jincheng , Pan Shuming , Gao Chengjin
Published: July 2023

Background:

Plasminogen activator inhibitor-1 (PAI-1) plays an important role in the pathophysiology of sepsis, but the exact mechanism remains debatable. In this study, we investigated the associations among the serum levels of PAI-1, the incidence of 4G/5G promoter PAI-1 gene polymorphisms, immunological indicators, and clinical outcomes in septic patients.

Methods:

A total of 181 patients aged 18–80 years with sepsis between November 2016 and August 2018 in the intensive care unit in the Xinhua Hospital were recruited in this retrospective study, with 28-day mortality as the primary outcome. The initial serum level of PAI-1 and the presence of rs1799768 single nucleotide polymorphisms (SNPs) were examined. Univariate logistic regression and multivariate analyses were performed to determine the factors associated with different genotypes of PAI-1, serum level of PAI-1, and 28-day mortality.

Results:

The logistic analysis suggested that a higher serum level of PAI-1 was associated with the rs1799768 SNP of PAI-1 (4G/4G and 4G/5G) (Odds ratio [OR]: 2.49; 95% confidence interval [CI]: 1.09, 5.68). Furthermore, a higher serum level of PAI-1 strongly influenced 28-day mortality (OR 3.36; 95% CI 1.51, 7.49). The expression and activation of neutrophils (OR 0.96; 95% CI 0.93, 0.99), as well as the changes in the expression patterns of cytokines and chemokine-associated neutrophils (OR: 1.00; 95% CI: 1.00, 1.00), were both regulated by the genotype of PAI-1.

Conclusions:

Genetic polymorphisms of PAI-1 can influence the serum levels of PAI-1, which might contribute to mortality by affecting neutrophil activity. Thus, patients with severe sepsis might clinically benefit from enhanced neutrophil clearance and the resolution of inflammation via the regulation of PAI-1 expression and activity.
Does choice of outdoor heat metric affect heat-related epidemiologic analyses in the US Medicare population?
Authors: Spangler Keith R. , Adams Quinn H. , Hu Jie Kate , Braun Danielle , Weinberger Kate R. , Dominici Francesca , Wellenius Gregory A.
Published: July 2023

Background:

Outdoor air temperature is associated with increased morbidity and mortality. Other thermal indices theoretically confer greater physiological relevance by incorporating additional meteorological variables. However, the optimal metric for predicting excess deaths or hospitalizations owing to extreme heat among US Medicare beneficiaries remains unknown.

Methods:

We calculated daily maximum, minimum, and mean outdoor air temperature (T), heat index (HI), wet-bulb globe temperature (WBGT), and Universal Thermal Climate Index (UTCI) for populous US counties and linked estimates with daily all-cause mortality and heat-related hospitalizations among Medicare beneficiaries (2006–2016). We fit distributed-lag nonlinear models for each metric and compared relative risks (RRs) at the 99th percentile.

Results:

Across all heat metrics, extreme heat was statistically significantly associated with elevated risks of morbidity and mortality. Associations were more pronounced for maximum daily values versus the corresponding minimum for the same metric. The starkest example was between HImax (RR = 1.14; 95% confidence interval [CI] = 1.12, 1.15) and HImin (RR = 1.10; 95% CI = 1.09, 1.11) for hospitalizations. When comparing RRs across heat metrics, we found no statistically significant differences within the minimum and maximum heat values (i.e., no significant differences between Tmax/HImax/WBGTmax/UTCImax or between Tmin/HImin/WBGTmin/UTCImin). We found similar relationships across the National Climate Assessment regions.

Conclusion:

Among Medicare beneficiaries in populous US counties, daily maximum and mean values of outdoor heat are associated with greater RRs of heat-related morbidity and all-cause mortality versus minimum values of the same metric. The choice of heat metric (e.g., temperature versus HI) does not appear to substantively affect risk calculations in this population.
First Trimester Ultrasound and Aneuploidy Screening in Twins
Authors: Hopkins Maeve K. , Neumann Olivia , Kuller Jeffrey A. , Dugoff Lorraine
Published: July 2023

All patients with twin pregnancy should have first trimester ultrasound and be offered screening for chromosomal aneuploidy as well as diagnostic testing. Screening for aneuploidy in twins presents unique challenges compared with singletons. Cell-free DNA screening should be considered first-line; however, this option may not be available or may have limitations in certain clinical scenarios, such as vanishing twins. If cell-free DNA screening is not available, maternal serum marker screening in conjunction with nuchal translucency assessment should be offered. Patients with positive aneuploidy screening tests or fetal structural abnormalities should be offered diagnostic testing.
Comparison of patient experiences and clinical outcomes between an illuminated chopper and a conventional chopper under a surgical microscope
Authors: Eom Youngsub , Koh Eunheh , Lee Do Hyung , Lee Sung Jin , Nam Dong Heun
Published: July 2023

Purpose:

To compare patient experiences and cooperation and the clinical outcomes illuminated chopper vs conventional chopper during cataract surgery.

Setting:

4 tertiary institutions in Korea.

Design:

Prospective, randomized, paired-eye, controlled pilot study.

Methods:

152 eyes of 76 patients who underwent bilateral cataract surgeries were enrolled in this study. The surgical method was randomly assigned to each patient's eye (1 eye using the illuminated chopper with a light source and the other using the conventional chopper under the microscope light). Patient suffering scores (the degree of strong light perception, glare, inability to fixate, anxiety, discomfort, and fear) from 0 to 10 (10 being the most severe level); cooperation score from 0 to 3 (3 being the best cooperation); operating time; and corneal endothelial cell density (ECD) preoperatively and postoperatively were compared between the 2 groups.

Results:

The mean patient suffering score of all 6 parameters in the iChopper group was significantly smaller than those in the control group (all P < .05). The mean patient cooperation score of the iChopper group (2.3 ± 0.8) was significantly greater than that of the control (1.6 ± 0.9; P < .001). There was no significant difference in the mean operating time and corneal ECD at each visit between the groups, albeit the mean corneal ECD was significantly decreased from baseline to 1 month after cataract surgery in both groups.

Conclusions:

Phacoemulsification using the illuminated chopper provides less glare and anxiety and better cooperation during cataract surgery without increasing the operating time and damaging corneal endothelium compared with the conventional chopper.
Therapeutic efficacy and safety results of 177Lu-PSMA therapy in metastatic castration-resistant prostate cancer patients: first experience of a developing South Asian Country
Authors: Parveen Azra , Fatima Arzoo , Fatima Ismat , Khan Irfan U. , Shahid Abubaker
Published: July 2023

Objective

Metastatic castration resistant-prostate cancer (mCRPC) is deadly condition that remains incurable despite various therapies. Initial studies have shown promising results with Lutetium-177 prostate-specific membrane antigen (177Lu-PSMA) therapy for advanced prostate cancer. However, most of the published efficacy and safety data is retrospective. The purpose of the study was to prospectively evaluate the therapeutic efficacy and safety results of 177Lu-PSMA therapy in mCRPC patients after 2 cycles.

Methods

Twenty-five patients of mCRPC, treated with standard care treatment were enrolled for 2 cycles of 177Lu-PSMA therapy. Prostate-specific antigen (PSA), Eastern Cooperative Oncology Group (ECOG) performance status, Visual Analogue Score (VAS) and Analgesic Quantification Scale (AQS) for efficacy and hemoglobin, total leukocyte, platelets and serum creatinine for toxicity were recorded pre and post-therapy. Paired sample t-test was used for statistical analysis.

Results

Treated patients with mean PSA level of 157 ng/ml received mean dose of 6.84 GBq of 177Lu-PSMA. For PSA, partial response (PR) was seen in 11/25 (44%), stable disease (SD) in 8/25 (32%) and progressive disease (PD) in 6/25 (24%) patients. Grade 1 and 2 hemoglobin toxicity was seen in 5/25 (20%) and 6/25 (24%) patients respectively. No patient developed grade 3 or 4 bone marrow toxicities. Grade 1 and 2 nephrotoxicity was seen in 1 patient each. Statistically significant difference was seen in ECOG, VAS and AQS scores (P < 0.001). No significant nephrotoxicity was observed (P = 0.558).

Conclusion

Efficacy and safety of 177Lu-PSMA therapy after 2 cycles have shown significant PSA response and pain palliation in heavily pretreated mCRPC patients.
Pediatric Aerodigestive Medicine: Advancing Collaborative Care for Children With Oropharyngeal Dysphagia
Authors: Krasaelap Amornluck , Duncan Daniel R. , Sabe Ramy M. M. , Bhardwaj Vrinda , Lerner Diana G. , Gold Benjamin D. , Boesch Richard Paul , Faure Christophe , von Allmen Daniel , Williams Dana , Chiou Eric , DeBoer Emily , Hysinger Erik , Maybee Jennifer , Khlevner Julie , Larson Kara , Morris Kimberly , Jalali Lauren , McSweeney Maireade , Brigger Matthew T. , Greifer Melanie , Rutter Michael , Williams Nina , Subramanyan Ram Kumar , Ryan Matthew J. , Acra Sari , Pentiuk Scott , Friedlander Joel , Sobol Steven E. , Kaul Ajay , Dorfman Lev , Darbari Anil , Prager Jeremy D. , Rosen Rachel , Cocjin Jose T. , Mousa Hayat
Published: July 2023

Objectives:

Aerodigestive disorders encompass various pathological conditions affecting the lungs, upper airway, and gastrointestinal tract in children. While advanced care has primarily occurred in specialty centers, many children first present to general pediatric gastroenterologists with aerodigestive symptoms necessitating awareness of these conditions. At the 2021 Annual North American Society for Pediatric Gastroenterology, Hepatology and Nutrition meeting, the aerodigestive Special Interest Group held a full-day symposium entitled, Pediatric Aerodigestive Medicine: Advancing Collaborative Care of Children with Aerodigestive Disorders. The symposium aimed to underline the significance of a multidisciplinary approach to achieve better outcomes for these complex patients.

Methods:

The symposium brought together leading experts to highlight the growing aerodigestive field, promote new scientific and therapeutic strategies, share the structure and benefits of a multidisciplinary approach in diagnosing common and rare aerodigestive disorders, and foster multidisciplinary discussion of complex cases while highlighting the range of therapeutic and diagnostic options. In this article, we showcase the diagnostic and therapeutic approach to oropharyngeal dysphagia (OPD), one of the most common aerodigestive conditions, emphasizing the role of a collaborative model.

Conclusions:

The aerodigestive field has made significant progress and continues to grow due to a unique multidisciplinary, collaborative model of care for these conditions. Despite diagnostic and therapeutic challenges, the multidisciplinary approach has enabled and greatly improved efficient, high-quality, and evidence-based care for patients, including those with OPD.
Medication Adherence Rates in Adolescents With Eosinophilic Esophagitis Are Low and Are Associated With Health Habits
Authors: Mehta Pooja , Pan Zhaoxing , Zhou Wenru , Kwan Bethany M. , Furuta Glenn T.
Published: July 2023

Although swallowed topical steroids are effective in inducing histological remission in eosinophilic esophagitis (EoE), their efficacy is limited by treatment nonadherence. In this study, we objectively measured adherence rates to swallowed topical steroids in adolescents with EoE over the course of 8 weeks and analyzed the association between adherence rate, disease and demographic features, symptom severity, and medication-taking habit strength. We found that approximately 20% of adolescents with EoE were over-dosing on their medications. After excluding these patients, mean adherence rate was 67.0% (±19.4%) and median adherence rate was 63% (interquartile range 53%–88%). Adherence was not associated with demographic features, disease history, symptom severity, or quality of life but was associated with habit strength (Pearson r = 0.48, P = 0.04). These findings suggest that habit strength may serve as a potential target for interventions aimed at improving adherence in adolescents with EoE.
Place of Death for Young Adults With Chronic Illness
Authors: Gustafson Carolina M. , Higgins Melinda , Wood Kathryn A. , Song Mi-Kyung
Published: July 2023

Background

Little is known about where young adults with chronic illness die in the United States and factors associated with place of death.

Objectives

This study aimed to examine place of death and factors associated with place of death for young adults with chronic illness using the most recent national data.

Methods

Our sample (N = 405,535) from the National Center for Health Statistics Division of Vital Statistics death certificate data (2003–2018) included young adults (age 18–39 years) who died from chronic conditions common in childhood or young adulthood. Conditions were grouped by underlying pathophysiology (oncological, cardiovascular, neuromuscular, metabolic, hematological/immunological, renal, chromosomal/congenital, gastrointestinal, and respiratory). Place of death was dichotomized into acute care (inpatient, outpatient/emergency room, and dead on arrival) or nonacute care (home, hospice, nursing home/long-term care, other, and unknown). Examined factors were gender, year of death, age, race (White, Black, Asian/Pacific Islander, American Indian/Alaskan Native), cause of death, and city of residence population (100,000 or greater and under 100,000). Descriptive statistics and logistic regression were used to examine factors related to place of death.

Results

Over half of young adults died in acute care settings. Young adults who were Asian/Pacific Islander or Black or who died from a respiratory or renal cause of death were most likely to die in an acute care setting. Rates of acute care death decreased over the studied years.

Discussion

Many young adults died in an acute care setting. Race and cause of death were the most influential factors associated with place of death. Young adults with an oncological cause of death were less likely to die in an acute care setting than patients with other underlying causes. This may indicate that specific care needs or preferences at the end of life may differ in certain disease populations and may affect place of death. Previous research has shown similar results in other developmental populations; however, given the complex psychosocial concerns that often arise during young adulthood, further research is needed to describe how the young adult status may specifically affect place of death.
The Association of Pediatric Emergency Medicine Physicians' Self-Identified Skills in Suicide Risk Assessment and Management With Training in Mental Health
Authors: Cervantes Paige E. , Tay Ee Tein , Knapp Katrina , Wiener Ethan , Seag Dana E. M. , Richards-Rachlin Shira , Baroni Argelinda , Horwitz Sarah M.
Published: July 2023

Objective

Because changes to pediatric emergency medicine (PEM) education may help address barriers to youth suicide risk screening programs, this study aimed to understand the impact of formal training in areas that likely include suicide-related practices, developmental-behavioral pediatrics (DBP) and adolescent medicine (AM), on PEM physician-perceived level of training, attitudes, and confidence assessing and managing youth suicide risk.

Methods

Twenty-seven PEM attendings and trainees completed an online survey and were divided into 2 groups: those who had completed DBP and AM rotations (DBP/AM+; n = 20) and those who had not completed either rotation (DBP/AM−; n = 7). We compared perceived level of training, attitudes, and confidence in assessing and managing suicide risk across groups. We also examined the relationship between perceived level of training and confidence. Finally, we conducted exploratory analyses to evaluate the effect of an additional formal rotation in child psychiatry.

Results

The DBP/AM+ and DBP/AM− groups did not differ on perceived level of training or on attitudes and confidence in suicide risk assessment or management. Perceived level of training in assessment and management predicted confidence in both assessing and managing suicide risk. Additional training in child psychiatry was not associated with increased perceived level of training or confidence.

Conclusions

The DBP and AM rotations were not associated with higher perceived levels of suicide risk training or greater confidence; however, perceived level of training predicted physician confidence, suggesting continued efforts to enhance formal PEM education in mental health would be beneficial.
Maxillary Reconstruction With a Rib-attached Free Latissimus Dorsi Muscle Flap
Authors: Katayama Riku , Yazawa Masaki , Kishi Kazuo
Published: July 2023

In defect reconstruction after maxillary tumor resection, filling the dead space created by resection and reconstruction of surrounding areas are crucial for good cosmetic outcomes. Although various procedures have been described in the literature, most are complex and require advanced surgical skills. Therefore, in this study, the authors aimed to identify a simple procedure for successful reconstruction with minimal bone fixation. Three patients who underwent total maxillectomy and reconstruction using the rib-attached free latissimus dorsi flap at Keio University Hospital between 2012 and 2014 were included and followed up with for a minimum of 5 years. After total maxillectomy, the authors used a free latissimus dorsi flap with a portion of the rib to fill the dead space and reconstructed the orbit, nasal cavity, and oral cavity.The authors performed a rigid reconstruction of the zygomatic ridge using only 2-point plate fixations of the ribs at the outer orbit and anterior nasal spine. Patients were followed up for ≥5 years, and the flap successfully survived in all cases. There was an issue with rib fixation in 1 case; however, all patients were highly satisfied with the procedure’s cosmetic results.
Binding of respiratory syncytial virus particles to platelets does not result in their degranulation in vitro
Authors: Lakerveld Anke J. , van Erp Elisabeth A. , van Kasteren Puck B.
Published: July 2023

Respiratory syncytial virus (RSV) is a major cause of severe respiratory infection in infants and the elderly. The mechanisms behind severe RSV disease are incompletely understood, but a dysregulated immune response probably plays an important role. Platelets are increasingly being recognized as immune cells and are involved in the pathology of several viruses. The release of chemokines from platelets upon activation may attract, for example, neutrophils to the site of infection, which is a hallmark of RSV pathology. In addition, since RSV infections are sometimes associated with cardiovascular events and platelets express several known RSV receptors, we investigated the effect of RSV exposure on platelet degranulation. Washed human platelets were incubated with sucrose-purified RSV particles. P-selectin and CD63 surface expression and CCL5 secretion were measured to assess platelet degranulation. We found that platelets bind and internalize RSV particles, but this does not result in degranulation. Our results suggest that platelets do not play a direct role in RSV pathology by releasing chemokines to attract inflammatory cells.
Perceived and Enacted HIV-Related Stigma in Eastern and Southern Sierra Leone: A Psychometric Study of an HIV Stigma Scale
Authors: Yendewa George A. , Kpaka Rashid A. , Sellu Edmond , Yendewa Sahr A. , Massaquoi Samuel P.E. , Cummings Peterlyn E. , Ghazzawi Manal , Barrie Umaru , Dubé Karine , Lakoh Sulaiman , James Peter B. , Salata Robert A. , Babawo Lawrence S.
Published: July 2023

Background

HIV stigma continues to hinder the care of people with HIV (PWH), especially in low-resource settings. We aimed to adapt and validate a concise HIV stigma scale for perceived HIV stigma in Sierra Leone.

Methods

We enrolled participants in two HIV clinics in Eastern and Southern Sierra Leone in 2022. We assessed perceived stigma using a 12-item adaptation of Berger’s HIV Stigma Scale and enacted stigma using select USAID indicators. We used ordinal logistic regression to identify predictors of perceived stigma and Pearson’s correlation to examine associations between perceived and enacted stigma.

Results

624 PWH were enrolled. The final adapted 6-item HIV stigma scale demonstrated acceptable internal consistency (Cronbach’s α = 0.72) and a four-factor solution accounting for 84.8% of variance: concern about public attitude (2 items), personalized stigma (2 items), negative self-image (1 item), and disclosure concerns (1 item). The prevalence of perceived HIV stigma was 68.6%, with disclosure concerns as the most prominent contributor. Enacted HIV stigma was reported by only 6.7% of participants, with partner/spousal abandonment and workplace stigma being the most common discriminatory experiences. Employment (β = 0.525, p <0.001), residence in Eastern Sierra Leone (β = 3.215, p < 0.001), and experiencing enacted stigma (β = 0.804, p < 0.001) were significantly associated with perceived stigma. Having a family member or friend with HIV (β = -0.499, p < 0.001), and HIV disclosure (β = -0.710, p < 0.001) were protective against perceived stigma. Enacted stigma strongly correlated with partner abandonment and family isolation (r = 0.223, p < 0.001).

Conclusion

We found high levels of perceived HIV stigma, underscoring the need for targeted interventions to combat stigma and promote inclusivity for PWH in Sierra Leone.
Knowledge of Female Genital Cutting among health and social care professionals in Francophone Belgium: A cross-sectional survey
Authors: O’Neill Sarah , Richard Fabienne , Alexander Sophie , Godin Isabelle
Published: July 2023

Background

The provision of optimal, equitable and gender-sensitive health care to women and girls with FGM/C is challenging. Research indicates that health professionals in receiving countries lack knowledge, confidence and competence in managing FGM/C. In order to develop policies that are suitable to the wide heterogeneity of women from FGM/C practising groups, it is paramount to identify what appropriate care might consist of and what are the knowledge gaps of health and social-care providers. No previous research has specifically addressed the knowledge and practices of health professionals in Francophone Belgium and the bi-lingual Brussels region.

Methods

An anonymous questionnaire with 24 questions was developed targeting healthcare and social-care professionals. The questionnaire was distributed between 6 May and 30 August 2021via professional organisations for midwifery, social work, GPs, infectious disease specialists, internal medicine, paediatricians and gynaecologists. The results are presented as frequencies, differences in proportions between groups were tested with Pearson’s Chi-square, when applicable. Correlations were tested by the Pearson correlation coefficient. The threshold of statistical significance is 5%.

Results

460 individuals filled in the questionnaire of which 42% were medical doctors, 6% nurses, 27% midwives and 25% non-medical professionals (social workers and psychologists). 55% of non-medical professionals had provided support for women with FGM/C. Almost 40% of health professionals knew that there were 4 types of FGM and were able to correctly describe them, 15% were unable to correctly describe any of the 4 types. Those who had already provided care for FGM/C were more numerous to know that there were 4 types (52%). Two health professionals had received requests to perform FGM/C. Twenty-seven midwives and medical doctors had received requests for re-infibulation.

Conclusion

Growing numbers of health and social care professionals are providing care for women with FGM/C. However, knowledge of FGM/C is suboptimal. Continuous professional training is crucial.
Modeling the impact of Malakit intervention: one more step towards malaria elimination in the Guiana Shield?
Authors: Lambert Yann , Métras Raphaëlle , Sanna Alice , Galindo Muriel , Hiwat Helene , Marchesini Paola , Vreden Stephen , Suárez-Mutis Martha Cecilia , Mesones Lapouble Oscar , Adenis Antoine , Nacher Mathieu , Boëlle Pierre-Yves , Poletto Chiara , Douine Maylis
Published: July 2023

Background

Malaria elimination in mobile and hard-to-reach populations calls for new, tailored interventions. In the Guiana Shield countries, the malaria burden is high in the population working in illegal gold mining. Between April 2018 and March 2020, we implemented Malakit, a new intervention targeting gold miners, and relying on the distribution of kits for self-diagnosis and self-treatment. In this study, we evaluate the impact of Malakit on malaria transmission.

Methods

We fitted a mathematical model of malaria transmission to surveillance data from Brazil and Suriname, and to prevalence data from cross-sectional surveys, to estimate the change in treatment coverage and reproduction number between the pre-intervention (2014-2018) and intervention (2018-2020) periods.

Results

Model results show that treatment coverage of symptomatic all-species malaria infections increased from 26.4% (95%CrI 22.8, 30.3) prior intervention to 55.1% (95%CrI 49.9, 60.8) during the intervention, leading to a decrease of the reproduction number from 1.19 to 0.86. We estimate that on average 6943 all-species malaria infections were averted during the intervention, corresponding to a 48.7% reduction in incidence and 43.9% reduction in total infection prevalence.

Discussion

Malakit had a significant impact on malaria transmission by improving the access to treatment of the population working in illegal gold mining in French Guiana. Building on the regional efforts of the past twenty years, Malakit contributed to another step towards malaria elimination in the Guiana Shield.