bluuebunny/crossref_metadata_2025 huggingface dataset:
An autopsy case of granulomatous amebic encephalitis caused by Balamuthia mandrillaris involving prior amebic dermatitis
Authors: Maehara Tatsuro , Mizuno Tetsushi , Tokoro Masaharu , Hara Tatsuru , Tomita Yui , Makioka Kouki , Motegi Sei‐Ichiro , Yamazaki Ayako , Matsumura Nozomi , Nobusawa Sumihito , Yokoo Hideaki
Published: February 2022

An 82‐year‐old man, who was healthy and had worked as a farmer, experienced worsening neurological symptoms over a seven‐month period, which eventually caused his death. Multiple fluctuating brain lesions were detected radiographically. Clinically, sarcoidosis was ranked high among the differential diagnoses because of the presence of skin lesions showing granulomatous inflammation, confirmed by biopsy. The patient's cerebrospinal fluid was also examined, but no definitive diagnosis was made while he was alive. An autopsy revealed multiple granulomatous amebic encephalitis lesions in the brain. Genetic and immunohistochemical analyses identified Balamuthia (B.) mandrillaris, a free‐living ameba, which resides in soil and fresh water, as the causative organism. A retrospective examination revealed B. mandrillaris in the biopsied skin as well as cerebrospinal fluid, strongly suggesting that the ameba had spread into the brain percutaneously. Few studies have detailed the cutaneous pathology of B. mandrillaris infections. In general, granulomatous amebic encephalitis is extremely difficult to diagnose without autopsy, but the present case provides a clue that could allow similar cases to be diagnosed earlier; that is, the presence of skin lesions.
UK oral surgeons' early response to the COVID‐19 pandemic and impact on patient care
Authors: Moore Richard , Keshani Divya , Coulthard Paul
Published: February 2022

Introduction

Coronavirus disease (COVID‐19) was declared a global pandemic on 11 March 2020, and all routine dental care in England was suspended on 25 March 2020. Oral surgeons typically continued their roles due to the requirement of surgical expertise in the management of urgent care.

Aims

To survey the British Association of Oral Surgeons' membership of 654 exploring the impact and response of the speciality in the early phase of the pandemic.

Methods

British Association of Oral Surgeons members were invited to participate in a weekly online survey commencing 30th March 2020 for 4 weeks. Themes explored included demographics, Personal Protective Equipment (PPE), clinical role and care provided, and financial impact.

Results

400 responses were received over the 4‐week period. Telephone advice was rapidly introduced ahead of clinical examinations. Few oral surgeons were initially able to provide emergency oral surgery procedures or clinical examinations due to PPE shortage. Only a small proportion of oral surgeons were required themselves to isolate and only a small proportion were redeployed.

Conclusion

The COVID‐19 pandemic severely disrupted UK oral surgery services particularly in the early stage and highlight the lack of preparedness. As availability of PPE and evidence on aerosol‐generating procedures and infection control became more readily accessible, surgeons became more confident to provide emergency surgical treatment rather than just phone consultations. The impact on patients' oral health is likely to have been profound.
Neuropathological investigation of patients with prolonged anorexia nervosa
Authors: Kawakami Ito , Iritani Shuji , Riku Yuichi , Umeda Kentaro , Takase Mina , Ikeda Kenji , Niizato Kazuhiro , Arai Tomio , Yoshida Mari , Oshima Kenichi , Hasegawa Masato
Published: February 2022

Objectives

Recent neuroimaging studies have indicated that the mesolimbic pathway, known to work as reward neuronal circuitry, regulates cognitive–behavioral flexibility in prolonged anorexia nervosa (AN). Although AN is associated with the highest mortality rate among psychiatric disorders, there have been few neuropathological studies on this topic. This study aims to identify alterations of the reward circuitry regions, especially in the nucleus accumbens (NAcc), using AN brain tissues.

Methods

The neuronal networks in AN cases and controls were examined by immunohistochemistry directed at tyrosine hydroxylase (TH; dopaminergic neuron marker) and glial fibrillary acidic protein (GFAP; astrocyte marker). We also immunochemically analyzed frozen samples presenting astrogliosis, especially in the NAcc and striatum.

Results

Histologically, neuronal deformation with cytoplasmic shrinkage was seen in reward‐related brain regions, such as the orbitofrontal cortex/anterior cingulate cortex. The NAcc showed massive GFAP‐positive astrocytes and dot‐like protrusions of astrocytes in the shell compartment. In the shell, TH and GFAP immunoreactivities revealed prominent astrogliosis within striosomes, which receive projection from the ventral tegmental area (VTA). The numbers of GFAP‐positive astrocytes in the NAcc (P = 0.0079) and VTA (P = 0.0025) of AN cases were significantly higher than those of controls. Strongly immunoreactive 18 to 25 kDa bands, which might represent degradation products, were detected only in the NAcc of AN cases. Clinically, all cases presented cognitive rigidity, which might reflect a deficit of the reward pathway.

Conclusion

Our findings suggest impaired dopaminergic innervation between the NAcc and VTA in AN. Functional dysconnectivity in the reward‐related network might induce neuropsychiatric symptoms associated with AN.
Why Benefitting a Person Cannot Constitute a Form of Discrimination
Authors: Statman Daniel
Published: February 2022

The purpose of this article is to discuss whether a person can be discriminated against by means of an action intended to benefit him or her. The discussion is triggered by a recent court decision according to which women may be entitled to compensation for a policy that made them better off in some respect because of its assumed effect on the perpetuation of harmful stereotypes about women. I reject this view, arguing that such effects are neither necessary nor sufficient for an act to be discriminatory. If people stand to directly benefit from some act, they cannot claim discrimination on the basis of such benefit.
Examining implicit positive affect toward suicide among suicidal and nonsuicidal adults and adolescents
Authors: Jaroszewski Adam C. , Huettig James L. , Kleiman Evan M. , Franz Peter J. , Millner Alexander J. , Joyce Victoria W. , Nash Carol C. , Nock Matthew K.
Published: February 2022

Objective

The purpose of this study was to examine implicit affect toward suicide (i.e., how good/bad suicide is perceived). Some people might be more likely to think about/choose suicide because they perceive it as a good option (to gain relief) relative to available alternatives.

Method

Implicit affect toward suicide among adults (N = 72) and adolescents (N = 174) with and without suicidal thoughts was examined using first‐person (FP) perspective suicide pictures in the affect misattribution procedure (AMP).

Results

Suicidal adults’ implicit positive affect toward suicide was associated with STB variables, such as explicit valence (r = 0.34) and arousal (r = 0.44) ratings of suicide pictures, and implicit affect differentiated groups above and beyond explicit valence ratings. Contrary to our hypothesis, suicidal participants did not display higher implicit positive affect toward suicide than nonsuicidal participants. However, suicidal participants displayed consistent implicit affect toward different suicide pictures, whereas nonsuicidal participants evaluated some pictures as more pleasant than others (ORs = 1.92–2.27).

Conclusions

Implicit affect toward suicide may relate to STB, but stimuli characteristics (e.g., color) likely influence the accuracy of assessment with the AMP and should be a focus of future research involving this and other implicit measures.
Discovery of the novel HLA‐B*40:483N Allele in a Taiwanese individual
Authors: Yang Kuo‐Liang , Li Chi‐Cheng , Lin Py‐Yu
Published: February 2022

Nucleotide mutations in exons 1 and 4 of HLA‐B*40:01:01 result in the novel allele HLA‐B*40:483N.
Non‐tuberculous mycobacteria isolation from presumptive tuberculosis patients in Lambaréné, Gabon
Authors: Epola Dibamba Ndanga Micheska , Achimi Agbo Abdul Jabar Babatundé Pacome , Edoa Jean Ronald , Chester Mevyann Rhett , Adegbite Bayodé Romeo , Mfoumbi Arnault , Mebiame Biyogho Christopher , Beh Mba Romual , Mahoumbou Jocelyn , McCall Matthew B. B. , Grobusch Martin Peter , Adegnika Ayola Akim , Alabi Abraham Sunday
Published: February 2022

Objective

The prevalence of clinical cases of pulmonary non‐tuberculous mycobacteria (NTM) is increasing worldwide. The aim of this study was to determine the proportion and the NTM species isolated from presumptive tuberculosis patients in Lambaréné, Gabon.

Method

From January 2018 to December 2020, sputum samples from presumptive TB patients were analysed at the tuberculosis reference laboratory of the Centre de Recherches Médicales de Lambaréné. Two sputum samples were collected per patient, and culture was performed using Bactec MGIT 960. The GenoType Mycobacterium CM/AS was used for NTM isolates confirmation and species differentiation.

Results

Among 1363 sputum samples analysed, 285 (20.9%) were Auramin acid fast bacilli (AFB) smear‐positive. NTM were isolated in 137/1363 (10%) of the samples. The most prevalent NTM species was Mycobacterium intracellulare (n = 74; 54%).

Conclusion

These results show the presence of NTM among presumptive TB patients in Gabon, which could potentially complicate TB diagnosis. This presents a new public health challenge, and emphasises the need to consider NTM in planning the prevention and management of tuberculosis control.
Comparative results of 3 treatments for medial femoral condyle subchondral cystic lesions in Thoroughbred racehorses
Authors: Klein Chelsea E. , Bramlage Lawrence R. , Stefanovski Darko , Ruggles Alan J. , Embertson Rolf M. , Hopper Scott A.
Published: February 2022

Objectives

To compare 3 different methods for treatment of medial femoral condyle (MFC) subchondral cystic lesions in Thoroughbred horses <24 months old based on the criterion of ability to race post‐treatment.

Study design

Retrospective cohort study.

Animals

Thoroughbreds (n= 107, age < 24 months) diagnosed with MFC subchondral cystic lesions.

Methods

Medical records between January 2004 and December 2017 were reviewed. Three treatment methods were used in these horses during that time frame: arthroscopic debridement, intralesional autologous mesenchymal stem cell (MSC) injection, and intralesional corticosteroid injection. The outcome evaluated was the ability to compete in a pari‐mutuel race.

Results

Seventy‐eight of 107 Thoroughbreds (73%) raced post‐treatment; 41/57 (72%) of horses treated by arthroscopic debridement raced; 16/19 (84%) of horses treated with intralesional MSCs raced; 21/31 (68%) of horses treated with intralesional corticosteroids raced. There was no difference between groups in the ability to start a race. Sex, limb affected, and lesion size also had no effect on the ability to start a race. There was a trend for increasing lesion size reducing the probability of racing.

Conclusions

Seventy‐three percent of the horses raced, but there was no difference in the ability of unraced Thoroughbreds to race after treatment of MFC subchondral cystic lesions with arthroscopic debridement, intralesional mesenchymal stem cells, or intralesional corticosteroids.

Clinical significance

The 3 reported treatment options may be considered for treatment of MFC subchondral cystic lesions with a good prognosis for racing post‐treatment. Owners should be advised that increasing lesion size decreases the probability of racing.
Wastewater reuse: Perception and social acceptance
Authors: Faria Daniella Costa , Naval Liliana Pena
Published: February 2022

The planned reuse of treated wastewater is the most effective instrument for the sustainability of water resources management. Given the various possibilities and advantages of reusing treated wastewater, sociocultural acceptance can be a limiting factor for the success of this practice. This study analysed the perceptions and social acceptability regarding the reuse of treated water in individuals with a high level of education, as they have a strong influence on the transformations of society. The study was carried out in the city of Palmas (Brazil). The results indicated that the public was receptive to this practice for indirect uses, but had a strong rejection of direct reuse. Schooling was associated with knowledge about sanitation issues. This correlation with the acceptability of reusing treated wastewater for the investigated uses was not observed. Of the total respondents, 96.3% stated that cultural factors can cause people to reject the practice of reuse, resulting from the consequent culture of waste and non‐valorization of water sources.
Putative ITS2 secondary structure model and multi‐gene phylogenies of tetrahymenids (Ciliophora, Hymenostomatia) parasitizing planarians and crayfish worms
Authors: Rataj Matej , Vďačný Peter
Published: February 2022

Tetrahymena comprises over 80 free‐living as well as facultative or obligate histophagous species parasitizing especially invertebrates and fishes. Because of the comparatively high morphological conservativeness of tetrahymenids, their identification is primarily based on the gene coding for cytochrome c oxidase subunit I (COI). In addition to this mitochondrial barcoding marker, we tested here also the species discriminatory power of the highly variable nuclear ITS region, using the secondary structure of the ITS2 molecules and the compensatory base change (CBC) analysis. ITS2 secondary structures were proposed for 25 distinct ribotypes of 13 taxa, including three Tetrahymena species parasitizing planarians and crayfish worms, with the free‐energy minimization approach and the homology modelling. Although the majority of Tetrahymena species pairs can be reliably separated by one to six hemi‐CBCs localized especially in the third and fourth helix of the ITS2 molecules, some ITS region sequences might transcend species boundaries. In other words, intraspecies and interspecies p‐distances of ITS region sequences might overlap. This fact weakens the discriminatory power and the usage of the ITS region in the molecular taxonomy of Tetrahymena. On the other hand, there was always a distinct barcoding gap at about 4% sequence divergence in the case of the COI gene. Despite the slightly lower delimitation power of the ITS region, this molecular marker helped to recognize multiple previous misidentifications that were subsequently verified by comparing COI sequences.
In-depth feasibility study of extreme ultraviolet damascene extension: Patterning, dielectric etch, and metallization
Authors: Sun Xinghua , Mignot Yann , Cole Christopher , Liu Eric , Santos Daniel , Raley Angelique , Church Jennifer , Meli Luciana , Sieg Stuart A. , Biolsi Peter
Published: February 2022

While semiconductor logic device nodes keep moving to N3 and beyond, the backend of line (BEOL) metal pitch is aggressively scaling to improve device performance and density. BEOL damascene extension refers to interconnect with a full metal pitch of 26–21 nm. The challenges of damascene extensions are profoundly critical due to an extreme ultraviolet (EUV) single exposure limit, dielectric etch, and metallization challenges. Multipatterning is required as well as more advanced low K dielectric etch. Severe line wiggling, bad via/contact hole open, and via/trench short issue can easily be observed. Cu resistance also contributes to most of the device’s R/C delay. Before transitioning to subtractive metal integrations, there is no doubt that multipatterning damascene extension plays an important role in bridging the gap between them. In this work, we provide an in-depth feasibility study on damascene extension focusing on EUV self-aligned double patterning with cut and block assembly for 24 nm pitch line and space. EUV double patterned self-aligned via is also validated for the dual damascene test. Both continuous wave and quasiatomic layer etch are developed to achieve a wiggling-free, bridge-free, and high metal hard mask selectivity process in TEL’s new generation capacitively coupled plasma etchers. Copper metallization is demonstrated in both via and trench of a 24 nm pitch. This report provides an important insight into damascene extension feasibility for high volume manufacturing.
Assessing the Relationship Between External and Internal Match Loads in Elite Women’s Rugby Sevens
Authors: Conte Daniele , Arruda Ademir Felipe Schultz , Clemente Filipe M. , Castillo Daniel , Kamarauskas Paulius , Guerriero Aristide
Published: February 2022

Purpose: To assess the relationship between external and internal load during official women’s rugby seven matches. Methods: Six backs (age = 24.2 [3.2] y; height = 161.5 [7.3] cm; body mass = 59.5 [5.0] kg; playing experience = 5.3 [1.5] y) and 8 forwards (age = 22.4 [2.7] y; height = 167.0 [4.8] cm; body mass = 70.6 [5.6] kg; playing experience = 5.0 [1.5] y) belonging to the women’s rugby seven Brazilian national team were monitored across 3 international tournaments during the 2019–20 season, with 2 players excluded from the analysis since they did not participate in any investigated match. Total distance (TD), distance during high-intensity running 18.1 to 20.0 km·h−1 and >20 km·h−1 (sprinting), number of accelerations >1.8 m·s−2 (ACC), and of decelerations <1.8 m·s−2 were used as match load volume measures, while their relative values (TD per minute, high-intensity running per minute, sprinting per minute, ACC per minute, and decelerations per minute) were used as external load match intensity measures. Internal load intensity and volume were assessed using the session rating of perceived exertion (sRPE) and its value multiplied by match duration (sRPE-ML), respectively. Spearman correlations and linear mixed models were used to assess the relationships between internal and external load measures. Results: A very large relationship (ρ = .830, P < .001) was found between sRPE-ML and TD, with linear mixed models showing that TD statistically affected sRPE-ML (P < .001). Linear mixed models analysis showed that ACC per minute was also affecting the sRPE-ML (P = .017), while sprinting (P = .007) and ACC per minute (P = .005) were the only 2 measures statistically affecting sRPE. However, weak relationships (trivial to large) were found for these and all other measures. Conclusions: These results highlight that TD is the main external load measure able to anticipate the internal load responses measured via sRPE-ML in elite women’s rugby sevens.
Replicative Aging Remodels the Cell Wall and Is Associated with Increased Intracellular Trafficking in Human Pathogenic Yeasts
Authors: Silva Vanessa K. A. , Bhattacharya Somanon , Oliveira Natalia Kronbauer , Savitt Anne G. , Zamith-Miranda Daniel , Nosanchuk Joshua D. , Fries Bettina C.
Published: February 2022

Cryptococcus neoformans
and
Candida glabrata
are two opportunistic human fungal pathogens that cause life-threatening diseases. During infection, both microorganisms have the ability to persist for long periods, and treatment failure can occur even if standard testing identifies the yeasts to be sensitive to antifungals.
Roles of Ferredoxin-Dependent Proteins in the Apicoplast of Plasmodium falciparum Parasites
Authors: Swift Russell P. , Rajaram Krithika , Elahi Rubayet , Liu Hans B. , Prigge Sean T.
Published: February 2022

Ferredoxin (Fd) and ferredoxin-NADP+ reductase (FNR) form one of the few known redox systems in the apicoplast of malaria parasites and provide reducing power to iron-sulfur (FeS) cluster proteins within the organelle. While the Fd/FNR system has been explored as a drug target, the essentiality and roles of this system and the identity of its downstream FeS proteins have not been determined.
Pervasive RNA Regulation of Metabolism Enhances the Root Colonization Ability of Nitrogen-Fixing Symbiotic α-Rhizobia
Authors: García-Tomsig Natalia I. , Robledo Marta , diCenzo George C. , Mengoni Alessio , Millán Vicenta , Peregrina Alexandra , Uceta Alejandro , Jiménez-Zurdo José I.
Published: February 2022

Nitrogen-fixing root nodule symbioses between rhizobia and legume plants provide more than half of the combined nitrogen incorporated annually into terrestrial ecosystems, rendering plant growth independent of environmentally unfriendly chemical fertilizers. The success of symbiosis depends primarily on the capacity of rhizobia to establish competitive populations in soil and rhizosphere environments.
Structural Basis for the Peptidoglycan-Editing Activity of YfiH
Authors: Lee Meng-Sheng , Hsieh Kan-Yen , Kuo Chiao-I , Lee Szu-Hui , Garde Shambhavi , Reddy Manjula , Chang Chung-I
Published: February 2022

YfiH is a peptidoglycan (PG)-editing factor required for the maintenance of specific amino acid compositions of the stem peptides. However, the activity of YfiH has not been deciphered, and the editing mechanism involving YfiH has remained a mystery.
Dissecting the Structural and Conductive Functions of Nanowires in
Geobacter sulfurreducens
Electroactive Biofilms
Authors: Ye Yin , Liu Xing , Nealson Kenneth H. , Rensing Christopher , Qin Shuping , Zhou Shungui
Published: February 2022

The low power generation of microbial fuel cells limits their utility. Many factors can affect power generation, including inefficient electron transfer in the anode biofilm.
Modeling Infection and Tropism of Human Parainfluenza Virus Type 3 in Ferrets
Authors: Rijsbergen Laurine C. , Schmitz Katharina S. , Begeman Lineke , Drew-Bear Jennifer , Gommers Lennert , Lamers Mart M. , Greninger Alexander L. , Haagmans Bart L. , Porotto Matteo , de Swart Rik L. , Moscona Anne , de Vries Rory D.
Published: February 2022

HPIV-3 is an important cause of pediatric disease and significantly impacts the elderly. Increasing numbers of immunocompromised patients suffer from HPIV-3 infections, often related to problems with viral clearance.
Challenges in the management of extensive aplasia cutis congenita
Authors: Ngeow Alvin , Hui Cheryl , Chua Alvin Wen Choong , Koh Mark , Ong Yee Siang , Poon Woei Bing
Published: February 2022

Aplasia cutis congenita (ACC) is a rare group of congenital disorders characterised by focal or widespread absence of skin, predominantly affecting the scalp. A Malay female infant was born at 37 weeks with extensive ACC, affecting 37% of total body surface area, including her scalp and trunk. There is no consensus on the management of ACC given the rarity and variable presentation. A multi-disciplinary team comprising neonatologists, paediatric dermatologists, plastic surgeons and medical laboratory scientists at the skin bank, employed a more aggressive surgical approach with the aim of avoiding potentially catastrophic morbidity, including sagittal sinus haemorrhage and brain herniation. Out of several surgical options, the team used a staged artificial dermal matrix (Integra) and cultured epithelial autograft application, followed by regular wound dressing, and eventually allowed the child to achieve complete epithelialisation of her trunk, and most of scalp before she was discharged from hospital.
Intrapancreatic accessory spleen with an epidermoid cyst: a malignant mimicry
Authors: Wee Jia Jia , Vu Charles K F , Ding Cristine Szu Lyn , Shelat Vishal G
Published: February 2022

With the liberal use of CT scan for clinical diagnosis, clinicians are faced with an increasing number of pancreatic incidentalomas. Compared with other incidentalomas, pancreatic incidentalomas have higher chances of future malignant transformation. There are many differential diagnoses, and epidermoid cyst in an intrapancreatic accessory spleen (ECIPAS) is extremely rare, with only a handful of reports. Preoperative diagnosis is often complicated, and the final diagnosis is usually only made after surgical resection.

We report a 34-year-old man who had an incidentally noted 2.8 cm pancreatic tail cystic lesion on a CT scan done for urinary symptoms. The lesion had a solid nodular component that was worrisome for malignancy, and the patient underwent further evaluation with an MRI scan and endoscopic ultrasound of the pancreas. The differential diagnoses of cystic degeneration of neuroendocrine tumour, branch-duct intraductal papillary mucinous neoplasm with worrisome features or ectopic intrapancreatic spleen were made. A multidisciplinary tumour board recommended surgical resection given risk features of malignancy. The patient subsequently underwent a laparoscopic distal pancreatectomy with splenectomy, and histology confirmed the diagnosis of ECIPAS.

Imaging characteristics of ECIPAS are non-specific, and most patients have a diagnosis made only after surgery. Therefore, more evidence is warranted for accurate preoperative imaging diagnosis to avoid unnecessary pancreatic surgery, which is not without its risks.
No association found between body checking experience and injury or concussion rates in adolescent ice hockey players
Authors: Eliason Paul , Hagel Brent E , Palacios-Derflingher Luz , Galarneau Jean-Michel , Warriyar K V Vineetha , Bonfield Stephan , Black Amanda Marie , Babul Shelina , Mrazik Martin , Lebrun Constance , Emery Carolyn
Published: February 2022

Objectives

To compare rates of injury and concussion among U-15 (ages 13–14 years) ice hockey players playing in leagues allowing body checking, but who have a varying number of years of body checking experience.

Methods

This 5-year longitudinal cohort included U-15 ice hockey players playing in leagues where policy allowed body checking. Years of body checking experience were classified based on national/local body checking policy. All ice hockey game-related injuries were identified using a validated injury surveillance methodology. Players with a suspected concussion were referred to a study sport medicine physician. Multiple multilevel Poisson regression analysis was performed, adjusting for important covariates and a random effect at a team level (offset by game exposure hours), to estimate injury and concussion incidence rate ratios (IRRs).

Results

In total, 1647 players participated, contributing 1842 player-seasons (195 players participating in two seasons). Relative to no body checking experience, no significant differences were found in the adjusted IRRs for game-related injury for players with 1 year (IRR=0.94; 95% CI: 0.69 to 1.28) or 2+ years (IRR=0.89; 95% CI: 0.56 to 1.40) body checking experience. No differences were found in the rates of concussion for players with 1 year (IRR=0.79; 95% CI: 0.51 to 1.22) but was significantly lower for players with 2+ years (IRR=0.51; 95% CI: 0.28 to 0.94) compared with no body checking experience.

Conclusions

Among ice hockey players aged 13–14 years participating in leagues permitting body checking, the adjusted rates of all injury were not significantly different between those that had body checking experience and those that did not. While the rates of concussion were significantly lower among those with 2+ years of body checking experience, the number of concussions potentially prevented in U-15 does not offset the number of concussions prevented through policy disallowing body checking at U-13.
Breast and ovarian surgery reduces cancer risk in women at high risk
Authors: Saul Helen , Gursul Deniz , Cassidy Samantha , Evans Gareth
Published: February 2022

The study

Marcinkute R, Woodward ER, Gandhi A, et al. Uptake and efficacy of bilateral risk reducing surgery in unaffected female
BRCA1
and
BRCA2
carriers.
J Med Genet
2021;0:1-8.

To read the full NIHR Alert, go to:
https://evidence.nihr.ac.uk/alert/earlier-decisions-breast-ovarian-surgery-reduce-risk-cancer/
Modelling the benefits of an optimised treatment strategy for 5-ASA in mild-to-moderate ulcerative colitis
Authors: Louis Edouard , Paridaens Kristine , Al Awadhi Sameer , Begun Jakob , Cheon Jae Hee , Dignass Axel U , Magro Fernando , Márquez Juan Ricardo , Moschen Alexander R , Narula Neeraj , Rydzewska Grazyna , Freddi Matthew J , Travis Simon PL
Published: February 2022

Objectives

5-aminosalicylate (mesalazine; 5-ASA) is an established first-line treatment for mild-to-moderate ulcerative colitis (UC). This study aimed to model the benefits of optimising 5-ASA therapy.

Methods

A decision tree model followed 10 000 newly diagnosed patients with mild-to-moderately active UC through induction and 1 year of maintenance treatment. Optimised treatment (maximising dose of 5-ASA and use of combined oral and rectal therapy before treatment escalation) was compared with standard treatment (standard doses of 5-ASA without optimisation). Modelled data were derived from published meta-analyses. The primary outcomes were patient numbers achieving and maintaining remission, with an analysis of treatment costs for each strategy conducted as a secondary outcome (using UK reference costs).

Results

During induction, there was a 39% increase in patients achieving remission through the optimised pathway without requiring systemic steroids and/or biologics (6565 vs 4725 for standard). Potential steroidal/biological adverse events avoided included: seven venous thromboembolisms and eight serious infections. Out of the 6565 patients entering maintenance following successful induction on 5-ASA, there was a 21% reduction in relapses when optimised (1830 vs 2311 for standard). This translated into 297 patients avoiding further systemic steroids and 214 biologics. Optimisation led to an average net saving of £272 per patient entering the model for the induction and maintenance of remission over 1 year.

Conclusion

Modelling suggests that optimising 5-ASA therapy (both the inclusion of rectal 5-ASA into a combined oral and rectal regimen and maximisation of 5-ASA dose) has clinical and cost benefits that supports wider adoption in clinical practice.
Outcomes of upper gastrointestinal cancer screening in high-risk individuals: a population-based prospective study in Northeast China
Authors: Yu Zhifu , Zuo Tingting , Yu Huihui , Zhao Ying , Zhang Yong , Liu Jinghua , Dong Shoulan , Wu Ying , Liu Yunyong
Published: February 2022

Objectives

The strategy for upper gastrointestinal cancer (UGC) screening has not yet been determined, especially in northeast China.

Design

The sample was from an ongoing prospective population-based cohort for cancer screening.

Participants

This study belonged to the Chinese Urban Cancer Screening Program. The analysis was based on the recruitment of participants aged 40–74 in Northeast China from 2016 to 2017. Totally, 39 369 eligible participants were recruited, 8772 were evaluated to be at high risk for UGC, 1957 underwent endoscopy.

Outcomes

χ2 test and multifactor logistic regression model was performed to analyse influencing factors of participation rate. Receiver operating characteristic curve analysis was applied to evaluate the diagnostic power of the high-risk assessment. The Cox regression model was used to estimate hazard ratio (HR) for the potential value.

Results

The high-risk rate was 22.28% and the participation rate of endoscopy screening was 22.31%. Factors such as age at 45–59 years, female sex, high level of education, occupation for professional and technical personnel, former drinking, secondary smoking, less physical activity, history of trauma or mental depression, history of upper gastrointestinal system disease and family history of UGC were associated with increased participation in endoscopy screening (all the p<0.05). There were five UGCs, 86 oesophageal precancerous lesions and 145 gastric precancerous lesions, and the detection rates were 0.26%, 4.39% and 7.41%, respectively. The detection rate for both oesophageal and gastric lesions increased with age and was higher for men than for women (all the p<0.05). After a 3-year follow-up, 30 UGCs had been diagnosed and the high risk of UGC increased the mortality risk ratio (HR: 1.90, 95% confidence interval (CI) 1.41 to 2.56).

Conclusion

The participation rate and outcomes of UGC screening were promising in our study and will provide important reference for evaluating value of UGC screening in China.
Primary care clinical management following self-harm during the first wave of COVID-19 in the UK: population-based cohort study
Authors: Steeg Sarah , Carr Matthew , Trefan Laszlo , Ashcroft Darren , Kapur Navneet , Nielsen Emma , McMillan Brian , Webb Roger
Published: February 2022

Objectives

A substantial reduction in self-harm recorded in primary care occurred during the first wave of COVID-19 but effects on primary care management of self-harm are unknown. Our objectives were to examine the impact of COVID-19 on clinical management within 3 months of an episode of self-harm.

Design

Retrospective cohort study.

Setting

UK primary care.

Participants

4238 patients with an index episode of self-harm recorded in UK primary care during the COVID-19 first-wave period (10 March 2020–10 June 2020) compared with 48 739 patients in a prepandemic comparison period (10 March-10 June, 2010-2019).

Outcome measures

Using data from the UK Clinical Practice Research Datalink, we compared cohorts of patients with an index self-harm episode recorded during the prepandemic period versus the COVID-19 first-wave period. Patients were followed up for 3 months to capture subsequent general practitioner (GP)/practice nurse consultation, referral to mental health services and psychotropic medication prescribing. We examined differences by gender, age group and Index of Multiple Deprivation quintile.

Results

Likelihood of having at least one GP/practice nurse consultation was broadly similar (83.2% vs 80.3% in the COVID-19 cohort). The proportion of patients referred to mental health services in the COVID-19 cohort (4.2%) was around two-thirds of that in the prepandemic cohort (6.1%). Similar proportions were prescribed psychotropic medication within 3 months in the prepandemic (54.0%) and COVID-19 first-wave (54.9%) cohorts.

Conclusions

Despite the challenges experienced by primary healthcare teams during the initial COVID-19 wave, prescribing and consultation patterns following self-harm were broadly similar to prepandemic levels. We found no evidence of widening of digital exclusion in terms of access to remote consultations. However, the reduced likelihood of referral to mental health services warrants attention. Accessible outpatient and community services for people who have self-harmed are required as the COVID-19 crisis recedes and the population faces new challenges to mental health.
Risk of psychosis in illicit amphetamine users: a 10 year retrospective cohort study
Authors: Huang Chieh-Liang , Tsai I-Ju , Lee Cynthia Wei-Sheng
Published: February 2022

Question

Amphetamine use is a risk factor for psychosis, which imposes a substantial burden on society. We aimed to investigate the incidence of psychosis associated with illicit amphetamine use and whether rehabilitation treatments could influence the psychosis risk.

Study selection and analysis

A retrospective cohort study was conducted using the population based Taiwan Illicit Drug Issue Database (TIDID) and the National Health Insurance Research Database (NHIRD), from 2007 to 2016. We identified 74 601 illicit amphetamine users as the amphetamine cohort and 2 98 404 subjects as the non-amphetamine cohort. The incidence rate of newly diagnosed psychosis was the main outcome. Cox proportional hazards models were applied to assess the effects of amphetamine, and the Kaplan–Meier method was used to estimate the cumulative psychosis incidence curves.

Findings

Illicit amphetamine users were 5.28 times more likely to experience psychosis than those without illicit drug use records. The risk was higher for subjects with multiple arrests for amphetamine use. A greater hazard ratio (HR) magnitude was observed in female patients. We also observed a significant decrease in the risk of psychosis in patients receiving rehabilitation treatments during deferred prosecution (adjusted HR 0.74, 95% CI 0.61 to 0.89).

Conclusions

Illicit amphetamine use was associated with an increased incidence of psychosis. The risk was identified across all age groups, particularly in women and in those arrested multiple times, and was inversely correlated with rehabilitation treatments for amphetamine misuse.
EASL clinical practice guidelines: non-invasive liver tests for evaluation of liver disease severity and prognosis
Authors: Archer Ann J , Belfield Katherine J , Orr James G , Gordon Fiona H , Abeysekera Kushala WM
Published: February 2022

The European Association for the Study of the Liver has recently published updated guidelines on the use of non-invasive tests to identify and stratify chronic liver disease. Here, we provide a summary of the key recommendations from the guideline.
Metabolic Derangement in Patients with Vitiligo: A Cross-Sectional Study
Authors: Aryanian Zeinab , Shirzadian Azar , Farzaneh Sepideh , Goodarzi Azadeh , Azizpour Arghavan , Hatami Parvaneh
Published: February 2022

Vitiligo is a pigmentary disorder resulting from progressive destruction of melanocytes in the skin. There is a growing body of evidence about higher risk of metabolic syndrome and dyslipidemia in some dermatoses including vitiligo. We aimed to evaluate lipid profile, leptin and C reactive protein (CRP) status among Iranian patients with vitiligo, compared with healthy controls and perused the relationship between abnormal values of these parameters with disease duration and physical characteristics of patients. 40 patients with vitiligo and 40 age-matched and sex-matched healthy controls were enrolled in the study. Data on weight, height, lipid profile, leptin and CRP values were recorded and compared. The mean values for nearly all study parameters (except for high-density lipoprotein) were significantly higher in patients with vitiligo, compared with healthy controls, irrespective of age and sex. We could not find any correlation between vitiligo and study parameters, regarding disease severity and extension of lesions; but in patients who have been suffering from vitiligo for more than 5 years, systolic blood pressure, diastolic blood pressure and CRP values were noted to be significantly higher (p<0.001, p=0.003 and p=0.03, respectively). In conclusion, screening of patients with vitiligo in regard to their lipid profile as well as blood pressure should be considered, especially in patients with longer disease duration or those who have other cardiovascular risk factors to prevent morbidity and mortality as a result of developing cardiovascular events.
Effect of CYB2B6 (c.516G>T), CYP2C9 (c.1075A>C) and UGT1A9 (c.98T>C) polymorphisms on propofol pharmacokinetics in patients submitted to colonoscopy: a cohort study
Authors: Poma Mara Aparecida Maricato , Ribeiro Junior Howard Lopes , Costa Eugênio Araújo , Paier Carlos Roberto Koscky , Brasil Laís Lacerda , Lima Luína Benevides , Nobre Livia Maria Soares , Leite Tayales Tavares , Lima-Júnior Roberto César Pereira , Quidute Ana Rosa Pinto , de Moraes Maria Elisabete Amaral , de Moraes Filho Manoel Odorico
Published: February 2022

Background

The aim of this study was to investigate the effect of CYB2B6 (c.516G>T, rs3745274), CYP2C9 (c.1075A>C, rs1057910) and UGT1A9 (c.98T>C, rs72551330) polymorphisms on the pharmacokinetics of single-drug propofol in adult patients undergoing intravenous sedation.

Methods

In this prospective clinical study, a total of 124 patients undergoing anaesthesia with propofol, as a single drug, were evaluated when undergoing colonoscopy procedure. Clinical variables were obtained from the patient’s anamnesis prior to performing the anaesthetic procedure, in the moment of the patient’s loss of consciousness, during the colonoscopy exam (recorded every 5 min) and in the awakening time.

Results

Polymorphic genotypes for the rs3745274 and rs1057910 polymorphisms were associated with bispectral index, target-controlled infusion (TCI)/effector concentration of propofol and TCI/plasma concentration of propofol values. Based on multivariate analysis, it was observed that weight, age, surgery time, systolic blood pressure and the rs1057910 polymorphism corresponded to predictive values for the dose of propofol used. Weight (B = 4.807±0.897), age (B = 1.834±0.834) and duration of surgery (B = 8.164±1.624) corresponded to factors associated with increased propofol dose, while systolic blood pressure (B = −1.892±0.679) and the genotypes (AA vs CA) of the single nucleotide polymorphism (SNP) rs1057910 CYPP2C9 gene (B = −74.161±26.820) decreased the total dose of propofol used.

Conclusion

We concluded that the rs1057910 and rs3745274 polymorphisms affect the metabolism of propofol in patients exclusively submitted to this drug. Thus, the knowledge of the polymorphic genotypes of the CYPP2C9 and CYB2B6 genes may be predictive of different metabolising phenotypes, suggesting expected behaviours of BIS parameter in the anaesthetic procedure, which contributes to safer monitoring by anaesthesiologists during the clinical intervention.
Allergic conditions and risk of rheumatoid arthritis: a Swedish case–control study
Authors: Kronzer Vanessa L , Westerlind Helga , Alfredsson Lars , Crowson Cynthia S , Klareskog Lars , Holmqvist Marie , Askling Johan
Published: February 2022

Objective

To determine the association of allergic conditions with incident rheumatoid arthritis (RA), especially in relation to smoking history and anti-citrullinated peptide antibody (ACPA) status.

Methods

This case–control study included 3515 incident RA cases and 5429 matched controls from the Epidemiological Investigation of Rheumatoid Arthritis study 1995 to 2016, including questionnaire-based information on eight allergic conditions composed from a list of 59 unique allergies. We used logistic regression and adjusted ORs (aOR) to assess the association between allergic conditions and risk of RA, adjusting for age, sex, residential area, body mass index, education, and smoking, and stratified by smoking and ACPA.

Results

A history of any reported allergy was equally common in RA (n=1047, 30%) as among population controls (n=1540, 29%), aOR 1.04, 95% CI 0.95 to 1.15. Metal, respiratory, food, plant/pollen and chemical allergies were not associated with risk of RA. By contrast, statistically significant associations were observed for animal dander allergy (6% vs 5%, aOR 1.37, 95% CI 1.03 to 1.82), especially in ACPA-positive RA (aOR 1.46 95% CI 1.06 to 2.01) and for atopic dermatitis, in particular for older and ACPA-negative RA (aOR 2.33, 95% CI 1.37 to 3.96 at age 80). Never smokers with allergic rhinitis also had increased risk of developing RA (aOR 1.30, 95% CI 1.00 to 1.68).

Conclusion

Most common allergies do not increase risk of RA, nor do they protect against RA. However, some allergic conditions, notably animal dander allergy, atopic dermatitis and allergic rhinitis, were associated with an increased risk for RA.
Interplay between stress and immunity triggers herpes zoster infection in COVID-19 patients: a review
Authors: Rahangdale Rakesh Ravishankar , Tender Tenzin , Balireddy Sridevi , Pasupuleti Mukesh , Hariharapura Raghu Chandrashekar
Published: February 2022

Coronavirus disease 2019 (COVID-19) is a potential health threat in the highly mobile society of the world. There are also concerns regarding the occurrence of co-infections occurring in COVID-19 patients. Herpes zoster (HZ) is currently being reported as a co-infection in COVID-19 patients. It is a varicella-zoster virus induced viral infection affecting older and immunocompromised individuals. Reactivation of HZ infection in COVID-19 patients are emerging and the mechanism of reactivation is still unknown. The most convincing argument is that increased psychological and immunological stress leads to HZ in COVID-19 patients; this review justifies this argument.
Special relativity optical cavity experiments explained from the perspective of the rotating frame
Authors: Sfarti A.
Published: February 2022

In this paper, we present an explanation of a fundamental test of special relativity from the perspective of the frame co-moving with a rotating observer. The test in cause is based on the frequency comparison between two optical resonating cavities. The solution is of great interest for real-time applications because certain experiments, such as the optical resonator tests of Lorentz invariance, rely on rotating setups. We present the derivation of the optical resonator experiments from the perspective of the rotating device as compared to the inertial device. We explain the improved tests that use two rotating resonators mounted on the same substrate.
A systematics for negative pion induced nuclear fission cross-sections: Experimental data fitting and cascade exciton model validation
Authors: Rana Mukhtar Ahmed , Parveen Bushra
Published: February 2022

The developed fission systematics depicts the projectile energy and the target mass dependence of fission cross-sections of heavy nuclei. The developed model is fitted using experimental fission cross-section data of 500–1665 MeV negative pion induced fission in [Formula: see text]Sn, [Formula: see text]Au and [Formula: see text]Bi. The same systematics is further fitted using the cascade exciton model (CEM) calculations of the above-mentioned fission reactions. Parameterization of the model is performed by calculating its parameters and uncertainties in them. A comparison of the systematics predictions with experimental data and CEM calculations is made. Validation of the systematics using new target nuclei [Formula: see text]Eu, [Formula: see text]Ta, [Formula: see text]Hg and [Formula: see text]At (not included in the systematics development) over an extended range of pion energies, from 80 MeV to 2500 MeV, builds trust in it. The systematics is not valid for [Formula: see text]Th and [Formula: see text]U. The systematics is found to be valid for target nuclei from [Formula: see text]Sn to [Formula: see text]At and for incident negative pion energies from 80 MeV to 2500 MeV. Results are discussed in detail. Merits and demerits of the developed systematics have been concisely described. Valid conclusions and future perspectives are also given.
Improving Energy Efficiency Using Optimized Energy Model Virtual Machine Algorithm in Cloud Computing
Authors: Manjunatha S. , Suresh L.
Published: February 2022

Cloud computing is the emerging trend that provides a variety of applications to promote corporate business across the globe over the internet. Cloud computing offers services to deploy the infrastructure in the specified environment. Different computing techniques are used to manipulate the cloud services. One of the most eminent techniques is Virtual Machine (VM) Migration which enables to set up the compute resources and storages from one to another host without detaching the application or client. Virtual Machine Migration helpful in minimizing energy dissipation, load balancing, and fault management. It is based on the migration and down time with live and non-live categorization. Live VM Migration in data hubs has potential to minimize energy consumption. The proposed Optimized Energy Model Virtual Machine Algorithm is used to calculate each host in the data hub, while the energy consumed by the system in each hour is increasing exponentially then the proposed algorithm is also responsible for reorders the node and the minimizing the energy after reordering.