bluuebunny/crossref_metadata_2025 huggingface dataset:
Operative Treatment of Distal Radius Fractures in Patients With Parkinson Disease
Authors: Logli Anthony L. , Rizzo Marco
Published: July 2021

Background:

Owing to the many unique disease characteristics of Parkinson disease (PD)—namely resting tremors, muscular rigidity, and poor bone quality—we hypothesized that this patient population would have inferior outcomes with surgical management of acute distal radius fractures (DRFs) compared with the literature available on the general population.

Methods:

This is a retrospective observational study performed at a single, level 1, academic center from 2001 to 2020 capturing all adult patients with an isolated, acute, and closed DRF that ultimately underwent operative treatment. International Classification of Diseases 10 codes were used to identify 30 patients for manual chart review. Several patient and fracture characteristics were accounted for and complications, reoperations, and failures of surgical intervention were recorded.

Results:

There was a total of 7/30 failures (23%), 6/30 reoperations (20%), and 12 complications in 9/30 wrists (complication rate, 30%) at a mean latest follow-up of 11 months (1.2-158 months). Of the 7 failures, 5 were due to loss of reduction, and 2 of them were deep infections with mean time to failure of 8.3 weeks (range, 11 days-5.2 months).

Conclusions:

This study found a high rate of complications, reoperations, and early failure despite a short follow-up period and a small cohort of patients with PD treated surgically for a DRF. We recommend locked plating if suitable for the fracture type and early involvement of a multidisciplinary team to assist with medical optimization of PD to increase chances of a successful outcome.
Small Effects: The Indispensable Foundation for a Cumulative Psychological Science
Authors: Götz Friedrich M. , Gosling Samuel D. , Rentfrow Peter J.
Published: July 2021

We draw on genetics research to argue that complex psychological phenomena are most likely determined by a multitude of causes and that any individual cause is likely to have only a small effect. Building on this, we highlight the dangers of a publication culture that continues to demand large effects. First, it rewards inflated effects that are unlikely to be real and encourages practices likely to yield such effects. Second, it overlooks the small effects that are most likely to be real, hindering attempts to identify and understand the actual determinants of complex psychological phenomena. We then explain the theoretical and practical relevance of small effects, which can have substantial consequences, especially when considered at scale and over time. Finally, we suggest ways in which scholars can harness these insights to advance research and practices in psychology (i.e., leveraging the power of big data, machine learning, and crowdsourcing science; promoting rigorous preregistration, including prespecifying the smallest effect size of interest; contextualizing effects; changing cultural norms to reward accurate and meaningful effects rather than exaggerated and unreliable effects). Only once small effects are accepted as the norm, rather than the exception, can a reliable and reproducible cumulative psychological science be built.
Yes! I love my mother as much as myself: Self- and mother-association effects in an Indian sample
Authors: Verma Ark , Jain Anuj , Srinivasan Narayanan
Published: July 2021

Information associated with the self is preferentially processed compared to information associated with others. However, cultural differences appear to exist in the way information is processed about those close to us like our mothers. In Eastern compared with Western cultures, information about the mother seems to be processed as well as our self. However, it is not clear whether this lack of difference is due to familiarity or would extend to processing arbitrary perceptual information associated with different categorical labels. The current study employs a perceptual association paradigm in which category labels like self, mother, and none are associated with arbitrary shapes to study self versus mother processing in an Indian sample. We hypothesised that there would be no difference between self and mother processing given the familial and collectivistic tendencies in India. Participants in two experiments performed a matching task between a shape and a pre-assigned category label, with self, mother, and none as categories in Experiment 1A and self, friend, and none as categories in Experiment 1B. As expected, analysis of response times (RT), accuracies, and signal detection theoretic measures showed that information about mother is processed as well as self in Experiment 1A, but this effect is not present with friend in Experiment 1B. Moreover, participants’ processing for the self-associated information gets attenuated depending upon the other close person category used in the task (friend vs. mother) indicating that self-information processing is dynamically dependent on the categorical contexts in which such processing takes place. Our findings have implications for understanding the processing of self-associated information across cultures and contexts.
Perioperative management of open fractures in the lower limb
Authors: Loh Bryan , Lim Jiang An , Seah Matthew , Khan Wasim
Published: July 2021

An open fracture is a fracture which communicates with the external environment through a wound in the skin. Severe open fractures are managed by both orthopaedic and plastic surgeons to address injuries in both the bone and soft tissue. This review outlines the management of open fractures in the lower limb from the initial patient presentation to operative management (including debridement, skeletal fixation, definitive soft tissue coverage) according to the standards jointly published by the British Orthopaedic Association (BOA) and the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS). Additionally, the decision-making between limb salvage or amputation will be explored. Finally, this review will discuss the patient’s postoperative care including wound care and management of potential complications that may arise such as infection, flap failure and fracture non-union.
Managing patients in the community after spinal injury
Authors: Zaver Vasudev
Published: July 2021

Spinal cord injury (SCI) involves damage to any level of the spinal cord and can result in significant disability. It is principally caused by trauma and is treated with long-term rehabilitation, the majority of which takes place in the community. Currently, no comprehensive guidelines exist on the long-term management of SCI in the community. This article, therefore, aims to amalgamate the current literature and provide a guide of how to manage SCI in the community, along with a brief overview of its epidemiology and aetiology.
Use of Cross-sectional and Perspective Mapping to Spatially and Statistically Represent Inpatient Glucose Control
Authors: Saulnier George E. , Castro Janna C. , Mi Lanyu , Cook Curtiss B.
Published: July 2021

Background:

The use of inpatient location for the depiction of glycemic control is an alternative approach to the traditional analysis of hospital-derived glucometric data. Our aim was to develop a method of spatial representation and to test for corresponding statistical variation in inpatient glucose control data.

Methods:

Point-of-care blood glucose data from inpatients with diabetes mellitus were extracted. Calculations included patient-day weighted means (PDWMs) and percentage of patient hospital days with hypoglycemia. Results were overlaid onto hospital floor plans, and room numbers were used as geolocators to generate cross-sectional (2-dimensional) and perspective (3-dimensional) views of the data. Linear mixed and mixed-effects logistic regression models were used to compare the location effect and to assess statistical variation in the data after adjusting for age, sex, and severity of illness.

Results:

Visual inspection of cross-sectional and perspective maps demonstrated variation in glucometric outcomes across areas within the hospital. Statistical analysis confirmed significant variation between some hospital wings and floors.

Conclusions:

Spatial depiction of glucometric data within the hospital could yield insights into hot spots of poor glycemic control. Future studies on how to operationalize this approach, and whether this method of analysis can drive changes in glycemic management practices, need to be conducted.
The Contexts of Political Participation: the Communication Mediation Model Under Varying Structural Conditions of the Public Sphere
Authors: Borah Porismita , Barnidge Matthew , Rojas Hernando
Published: July 2021

The communication mediation model asserts that the effects of news use on political participation are mostly indirect, mediated through discussion. Recent research has shown that this mediation process is stronger in countries where freedom of the press and expression are also greater. Relying on data collected during election cycles in seventeen countries between 2013 and 2018, we examine how additional country-level factors, including political freedom and digital infrastructure, moderate the indirect relationship between news use and political participation via political talk. Results provide evidence that these factors condition both outcomes, but in different ways. For protest, two of three country-level indices moderate individual-level variation in the pathway between political talk and protest. For voting, two of three country-level indices moderate aggregate-level variation in the pathway between news use and political talk. Results are discussed in light of their implications for the communication mediation model and comparative political communication research.
Afterthoughts: Transnormal, the “New Normal” and Other Varieties of “Normal” in Postnormal Times
Authors: Sardar Ziauddin
Published: July 2021

What is normal? And what constitutes “the new normal”? This article argues that the much vaunted “new normal” is nothing more than a return to the status quo ante, life before COVID-19, with a few extra appendages. After discussing the notion of the complex normal, the article suggests that what lies at the other end of postnormal times is best seen as the domain of the transnormal: over and beyond capitalism and neoliberalism, modernity, and postmodernism, almost most of what we can possibly conceive as normal or “the new normal.” The route to a transnormal world is a process of systematic movement leading to transposition: acts of changing relationships, structures, and values that interactively and collectively relocate humanity to a trans, or stable, state or realm of existence. The article suggests that we use the concepts of transmodernity and mutually assured diversity as tools to navigate toward the transnormal and our way out of postnormal times.
A rare case of chordoma presenting as a Pancoast tumor
Authors: Sobash Philip T , Vedala Krishna , Alfano Daniel , Pinckard-Dover Heather , Muesse Jason L , Desikan Raman
Published: July 2021

The notochord is the defining structure of all chordate embryos. It is a midline structure ventral to the ectoderm, neural plates, and neural arch. Remnants of the notochord ultimately give rise to the nucleus pulposus. The function of the notochord is to organize the surrounding structures. Chordoma is a rare malignant bone tumor arising from remnants of the notochord. These tumors are indolent and can present as incidental or locally advanced involving adjacent structures. These tumors typically present at the skull base and sacral spine but more rarely can be seen on the cervical and thoracic spine. Rare cases of chordoma invading the brachial plexus have been recorded. Surgical resection is the mainstay of treatment for chordomas. We would like to discuss a novel presentation of a chordoma as a Pancoast tumor, and aim to highlight the clinical importance of accurate diagnosis and planning therapy along with poor prognosis of incomplete surgical resection.
The value of survival gains from therapeutic innovations for US patients with relapsed/refractory multiple myeloma
Authors: MacEwan Joanna P , Majer Istvan , Chou Jacquelyn W , Panjabi Sumeet
Published: July 2021

Aims:

This study quantifies the value of survival gains attributable to novel treatments approved since 2003 for United States (US) patients with relapsed/refractory multiple myeloma (RRMM).

Methods:

We estimated the increase in survival attributable to lenalidomide and bortezomib for multiple myeloma (MM) patients in the 1983–2013 Surveillance, Epidemiology, and End Results (SEER) registry. To estimate the survival benefit of treatments approved since 2015 (carfilzomib, elotuzomab, daratumumab, used in combination with lenalidomide and dexamethasone) we used clinical trial data to calibrate survival estimated using the SEER data. We then conducted an economic valuation of the estimated shift in survival curves for all therapies. Finally, we estimated the share of the value accruing to patients and manufacturers using treatment costs estimated from MarketScan data.

Results:

The introduction of bortezomib in combination with dexamethasone (Vd) and lenalidomide in combination with dexamethasone (Rd) resulted in substantial survival gains and societal value for multiple myeloma patients, generating 1.7 additional life-years per RRMM patient. More recently, approved novel treatments have improved survival over effective treatments (i.e. Rd/Vd) by an additional 2.5 life-years – the monetary value of this incremental survival benefit far exceeds the incremental cost of treatment. At the patient level, the incremental benefit of Rd/Vd is $335,500 and with novel treatments is $565,000. Applying this benefit to all future cohorts of US RRMM patients translates into a value of at least $75 billion and $130 billion with Rd/Vd and the novel treatments, respectively.

Conclusions:

SEER registry data were only available through 2013. Therefore, survival gains for recently approved treatments were estimated based on clinical trials, rather than observed survival. Our valuation analysis does not capture sources of value aside from survival gains, for example, better quality of life, increased productivity, or the value of surviving until subsequent novel therapies become available. Substantial extensions in life expectancy in RRMM since 2003 translate into real economic value gained by society.
Statin-Induced Autoimmune Necrotizing Myopathy
Authors: Jayatilaka Sahani , Desai Kunal , Rijal Swarup , Zimmerman Debra
Published: July 2021

Statin therapy is a widely prescribed medication class for hypercholesterolemia. In statin-induced autoimmune myopathy, genetically predisposed and at-risk patients can develop antibodies against hydroxy-3-methylglutaryl-CoA reductase (HMGCR), the key enzyme in the production of cholesterol. As a result, an autoimmune reaction causing weakness, myalgia, with possible severe rhabdomyolysis, renal failure, and myonecrosis also can occur. A 73-year-old female presented to clinic with myalgia and fatigue. She was on atorvastatin 20 mg/day for over 1 year, which she stopped 1 week prior to her initial presentation. Patient did experience rhabdomyolysis as well as a transaminitis. She underwent an autoimmune workup which was positive for HMG-CoA reductase antibodies. Patient was initially treated on a prednisone taper, starting dose 50 mg/day. Without remission of symptoms, methotrexate 15 mg/week was initiated.
Resource boom and the politics of accountability at the sub-national level: Insight from Indonesia
Authors: Abdullah Imaduddin , Karim Moch Faisal
Published: July 2021

A growing literature has investigated the relations between accountability and resource boom in developing economies. However, few studies focus on the emergence of political accountability in resource-rich regions at the local level. This article investigates accountability at the sub-national level in Indonesia’s resource-rich areas. While natural resource abundance in developing countries is associated with predatory states, this article aims to show how some sub-national governments have encouraged the responsible management of resources. This article primarily examines the political incentives that influence local elites’ promotion of accountability. Using the Bojonegoro Regency in East Java as a case study, we show that functioning local democracy and the existence of collective actions by local civil societies coupled with promotion from within parties drive politicians to promote accountability.
Barriers for Entering the Digital World: Exploring Customer Value Co-destruction in Self-Service Technologies
Authors: Galdolage Badra Sandamali
Published: July 2021

The value co-creation scholarly work has been criticized for neglecting the possible failures in the collaborative value creation process, which is termed as ‘value co-destruction’. Additionally, both the value co-creation and available limited research work in value co-destruction have overly attended on actor-to-actor interactions taking place in traditional service encounters, disregarding the practical movement towards the provision of services via technological platforms. Though there are ample studies that recognize factors influencing customer acceptance or rejections of technologies, a very limited number of studies have focused on exploring how and why customer collaboration with self-service technologies (SSTs) goes wrong due to the failures in the co-creation process. Therefore, this study attempts to understand how ‘value co-destruction’ takes place in the SSTs. Following a qualitative inquiry, using semi-structured interviews with 25 individuals, 15 reasons for co-destruction that vary among different customer demographics were found and classified into four integrative themes as ‘inabilities in co-learning’, ‘poor co-operation’, ‘problems with connecting’ and ‘poor corrective actions’. The findings fill the gap in the literature by addressing value co-destruction in technological interfaces, particularly in the SST context. Further, it will help practitioners to design and deliver value-enhancing self-service technological interfaces, resulting in none or minimum difficulties for customers.
Isolated Deep MCL tear: an easily missed injury and cause of persistent medial side knee pain
Authors: Gahlot Nitesh
Published: July 2021

Introduction:

The usual treatment of medial collateral ligament (MCL) grades I / II injuries is conservative, with good healing rates reported in the literature. Isolated deep MCL tears are reported rarely in literature, possibly due to under diagnosis. The usual reported mechanism is rapid external rotation of tibia at knee during sports.

Methods:

We report here 14 cases (all males, age range 21 - 35 years) of deep MCL tears with intact superficial MCL. All Patients were level 6 (recreational sports) on the Tegner- Lysholm activity scale. Diagnosis was done by grade 1 valgus stress test at 30-degree flexion, normal on 0 degrees. Confirmation was done by MRI imaging showing deep MCL fibers rupture on coronal T2 images. All of these patients had medial sided knee pain. Ten had associated knee injuries (10 had ACL tears, 5 had medial meniscus tears, 3 had lateral meniscus tears). Nine patients were diagnosed retrospectively on MRI due to symptom persistence; five were diagnosed preoperatively. Deep MCL repair was done in five patients. The dMCL was found to be avulsed from the femoral origin underneath an intact sMCL in all the cases. The repair was done over a suture anchor and was checked with intraoperative correction of the valgus stress test to normal. The Average follow-up duration was 10 months.

Results:

Five patients, diagnosed preoperatively, had medial sided knee pain resolution and no laxity complaints. The other nine patients reported slight pain on medial knee side at follow-up, for which local depomedrol and lignocaine injections were given under ultrasound guidance. The pain was resolved immediately and remains reduced at the time of last follow-up. The patient with repaired dMCL had better symptom resolution as compared to the patients managed with local steroid injections. Although there were no symptoms of laxity in any of the patients, even though the conservatively managed patients had valgus stress test grade 1 positive in 30 degree flexion, at the time of last follow-up.

Conclusion:

Isolated deep MCL tears are reported sparsely in literature. They can be a cause of persistent medial sided knee pain at follow-up, compromising the result of associated ligament reconstructions. The long-term outcomes of such injuries in terms of media laxity are not known, but a timely diagnosis can allow repair of the dMCL and better patient satisfaction.
The Effect of Bone Marrow Aspirate Concentrate on Clinical Results Used with Open Wedge High Tibial Osteotomy
Authors: Kaya Özgür , Uysal Özgür Selim , Emre Fahri , Kılıç Erden , Bozkurt Murat
Published: July 2021

Objectives:

Medial open wedge high tibial osteotomy is a widely used treatment method for early stages of medial compartment osteoarthritis, particularly in the middle aged patients. Correction of the malalignment of the knee and even distribution of the body weight through knee joint is considered to facilitate the regeneration of the damaged cartilage. Addition of a regenerative procedure to tibial osteotomies may enhance its potential effects. In this study we analyzed the effect of, if any, simultaneous use of BMAC with high tibial osteotomy.

Methods:

We have evaluated the clinical results of 46 knees of 38 patients that underwent open wedge high tibial osteotomy for early stage medial compartment arthrosis between 2017-2020. Patients were recruited into two groups as HTO only group (Group 1) and HTO+BMAC group (Group 2). Mean follow up time was 12.6 months. Preoperative International Knee Documentation Committee (IKDC) subjective score and Knee Society Score (KSS) of the patients were compared with those at the 1st, 3rd, 6th and 12th post-operative months. Wilcoxon Ranked Signed test was used to detect the significant difference.

Results:

Group 1 consisted of 18 female and 4 male patients, Group 2 consisted of 14 female and 2 male patients. Two patients in Group 1 received bilateral HTO and 6 patients in Group 2 received bilateral HTO+BMAC. Twenty four knees in Group 1 and 22 knees in Group 2 were included for evaluation. There was no significant improvement in the KSS and IKDC scores of the patients in Group 1 at the first follow-up, however at the 3rd month follow-up, KSS scores showed significant improvement (p<0,001) whereas IKDC scores did not show any improvement (p>0,005). Both KSS and IKDC scores showed significant improvement at the 6th and 12th months. (p<0,001). In Group 2, only KSS scores showed improvement at the 1st month follow-up (p<0,001). Both KSS and IKDC scores showed significant improvement at the 3rd, 6th and 12th month follow-up compared to preoperative scores.

Conclusion:

We believe that simultaneous use of BMAC with open wedge high tibial osteotomy for early stage medial compartment arthrosis may relieve pain at the early period and improve patient compliance to rehabilitation. Increase in range of motion promote the recovery period and provide rapid return to daily activities, thereby positively affecting cartilage regeneration.
Does measuring the medial gap before bone resection in total knee arthroplasty provide optimum gap adjustment and prevent bone recutting?
Authors: TİFtİkÇİ Uğur , Serbest Sancar , Tosun Hacı Bayram , Keskinkılıç Seyyid İsa , Kılınç Cem Yalın , Firat Ahmet
Published: July 2021

Objectives:

The aim of this study was to demonstrate that measuring the medial gap before bone resection during total knee arthroplasty (TKA) provides an optimum gap adjustment in varus knees.

Methods:

Patients were separated into two groups, Group 1 being those whose medial joint gap was measured prior to bone resection and Group 2 comprising those who underwent conventional measured resection technique without measuring. The medial joint gap was measured with a custom-made gap measuring device up to the point that the knee was corrected and aligned along its mechanical axis. Medial joint gap distances, distal medial femoral bone cut thicknesses, amounts of tibial resection calculated, gap internal distances measured after cutting, and the thicknesses of the trial inserts were recorded. A comparison was made between the groups in terms of the number of patients requiring an additional tibial bone cut and the distribution of insert thicknesses.

Results:

Extra tibial bone resections performed in two (5.7%) patients in Group 1 and in 10 (28.6%) patients in Group 2. In Group 1, where the medial joint gap was measured, the need for an additional bone resection was statistically less. (p=0.018). In the comparison of distribution of insert size by group, the number of patients on whom an 8 mm insert had been used was significantly greater in Group 1 (p=0.024).

Conclusion:

Measuring the medial joint gap prior to bone resection in total knee arthroplasty may prevent repeated bone recutting and additional bone resections. Furthermore, we can use this method to avoid the disadvantages of the measured resection technique.
All-inside reconstruction of anterior cruciate ligament with single-bundle autogenous peroneal longus tendon
Authors: Lanbo Yang , Chunyu Zou , Yufei Mi , Zhanchao Wang
Published: July 2021

Objectives:

To evaluate the curative effect of all-inside reconstruction of anterior cruciate ligament with single-bundle autogenous peroneal longus tendon.

Methods:

A total of 21 people who met the including criteria were enrolled into this study. The autogenous peroneal longus tendon were got to all-inside anterior cruciate ligament reconstruction. The complications were documented, while the clinical consequences was evaluated by Lachman test, KOOS, SF - 36 and AOFAS.

Results:

There were no serious complications after operation. Lachman test showed that the stability of knee joint after operation was significantly improved (P < 0.05). The KOOS score significantly improved at 12 months postoperatively, including pain, symptoms, activity of daily living, sport and recreation function and knee related quality of life, compared with those before operation (P<0.05). In addition, the SF-36 score also significantly improved at 12 months postoperatively compared with those preoperatively, with statistically significant differences in physical functioning, physical role functioning, bodily pain, general health perceptions, emotional role functioning and social role functioning (P<0.05), whereas no statistically significant differences in vitality and mental health (P>0.05).

Conclusion:

The all-inside reconstruction of anterior cruciate ligament with single-bundle peroneal longus tendon can effectively restore the stability of knee joint, reduce postoperative pain, improve the function of knee joint, and provide high satisfaction.
Patient-Centered Identification of Meaningful Regulatory Endpoints for Medical Devices to Treat Parkinson’s Disease
Authors: Benz Heather L. , Caldwell Brittany , Ruiz John P. , Saha Anindita , Ho Martin , Christopher Stephanie , Bardot Dawn , Sheehan Margaret , Donnelly Anne , McLaughlin Lauren , Mange Brennan , Hauber A. Brett , Gwinn Katrina , Heetderks William J. , Sheldon Murray
Published: July 2021

Introduction. A growing literature has developed on identifying outcomes that matter to patients. This study demonstrates an approach involving patient and regulatory perspectives to identify outcomes that are meaningful in the context of medical devices for Parkinson’s disease (PD). Methods. A systematic process was used for specifying relevant regulatory endpoints by synthesizing inputs of various sources and stakeholders. First, a literature review was conducted to identify important benefits, risks, and other considerations for medical devices to treat PD; patient discussion groups ( n = 6) were conducted to refine the list of considerations, followed by a survey ( n = 29) to prioritize them; and patient and Food and Drug Administration (FDA) reviewers informed specification of the final endpoints. Two FDA clinicians gave clinical and regulatory perspectives at each step. Results. Movement symptoms were ranked as most important (ranked 1 or 2 by 72% of participants) and psychological and cognitive symptoms as the next most important (ranked 1 or 2 by 52% of participants). Within movement symptoms, falls, impaired movement, bradykinesia, resting tremor, stiffness, and rigidity were ranked highly. Overall, nine attributes were identified and prioritized as patient-centric for use in clinical trial design and quantitative patient preference studies. These attributes were benefits and risks related to therapeutics for PD as well as other considerations, including time until a medical device is available for patient use. Discussion. This prospective approach identified meaningful and relevant benefits, risks, and other considerations that may be used for clinical trial design and quantitative patient preference studies. Although PD was the focus of this study, the approach can be used to study patient perspectives about other disease or treatment areas.
MasterplanGAN: Facilitating the smart rendering of urban master plans via generative adversarial networks
Authors: Ye Xinyue , Du Jiaxin , Ye Yu
Published: July 2021

This study proposes a prototype for the smart rendering of urban master plans via artificial intelligence algorithms, a process which is time-consuming and relies on professionals’ experience. With the help of crowdsourced data and generative adversarial networks (GAN), a generation model was trained to provide colorful rendering of master plans similar to those produced by experienced urban designers. Approximately 5000 master plans from Pinterest were processed and CycleGAN was applied as the core algorithm to build this model, the so-called MasterplanGAN. Using the uncolored input design files in an AutoCAD format, the MasterplanGAN can provide master plan renderings within a few seconds. The validation of the generated results was achieved using quantitative and qualitative judgments. The achievements of this study contribute to the development of automatic generation of previously subjective and experience-oriented processes, which can serve as a useful tool for urban designers and planners to save time in real projects. It also contributes to push the methodological boundaries of urban design by addressing urban design requirements with new urban data and new techniques. This initial exploration indicates that a large but clear picture of computational urban design can be presented, integrating scientific thinking, design, and computer techniques.
Remission of Recalcitrant Psoriasis on Combined Biologic Therapy With Infliximab and Ustekinumab
Authors: Taylor Kayla H. , Feldman Steven R.
Published: July 2021

Introduction:

Anti-TNF treatment is effective for inflammatory bowel disease (IBD), however it also has the potential to cause paradoxical psoriasis which can be challenging to manage. Discontinuation of anti-TNF agents may improve psoriatic lesions but may worsen IBD. Combining biologic therapies, though not yet commonly practiced, may be a useful approach to the treatment of both conditions.

Case Presentation:

We describe a case of paradoxical palmoplantar psoriasis in a 48-year-old woman with ulcerative colitis (UC). Her UC was well-managed on infliximab. Following trials of several other topical and systemic therapies for her psoriatic lesions, she ultimately received relief on combined ustekinumab and infliximab therapy without flare of her IBD.

Discussion:

While other publications report success using ustekinumab for paradoxical psoriasis following cessation of infliximab, this case report highlights successful treatment using a combination of ustekinumab and infliximab with no reported adverse effects at 3 months.

Conclusion:

Discontinuation of the anti-TNF agent and use of a single biologic that may treat both IBD and psoriasis is a treatment option. Additionally, combining biologic therapies, though not yet commonly practiced, may be a useful, albeit costly, approach to prevent potential flares of IBD that may accompany cessation of some biologics. Further studies may be beneficial to assess for long term adverse effects.
The MIPAM trial – motivational interviewing and physical activity monitoring to enhance the daily level of physical activity among older adults – a randomized controlled trial
Authors: Larsen Rasmus Tolstrup , Korfitsen Christoffer Bruun , Keller Camilla , Christensen Jan , Andersen Henning Boje , Juhl Carsten , Langberg Henning
Published: July 2021

Background

One in four older adults in Denmark and almost half of the very old above 75 do not meet the World Health Organization’s recommendations for a minimum of physical activity (PA). A cost-efficient and effective way to increase focus on and motivation for daily walking might be to use Physical Activity Monitors (PAMs) in combination with behavioural change intervention. Thus, the objective of this randomized controlled study was to investigate the effect of Motivational Interviewing (MI) as an add-on intervention to a PAM-based intervention measured in community-dwelling older adults.

Methods

This two-arm parallel group randomized controlled effectiveness trial compared a 12-weeks PAM-based intervention with additional MI (PAM+MI group) with a PAM-based intervention alone (PAM group). The primary outcome, average daily step count, was analysed with a linear regression model, adjusted for sex and baseline daily step count. Following the intention-to-treat principle, multiple imputation based on baseline step count, sex and age was performed.

Results

In total, 38 participants were randomized to the PAM intervention and 32 to the PAM+MI intervention arm. During the intervention period, PAM+MI participants walked on average 909 more steps per day than PAM participants, however insignificant (95%CI: − 71; 1889) and reported 2.3 points less on the UCLA Loneliness Scale (95%CI: − 4.5; − 1.24).

Conclusion

The use of MI, in addition to a PAM-based intervention among older adults in PA promoting interventions hold a potential clinically relevant effect on physical activity and should thus be investigated further with adequately powered RCTs.

Trial registration

This study was pre-registered in the clinicaltrials.gov database with identifier: NCT03906162.
RETRACTED ARTICLE: Bone Marrow Mesenchymal Stem Cell-Derived Exosomal MicroRNA-133a Restrains Myocardial Fibrosis and Epithelial–Mesenchymal Transition in Viral Myocarditis Rats Through Suppressing MAML1
Authors: Li Qiming , Jin Yunpeng , Ye Xiaoqi , Wang Wei , Deng Gang , Zhang Xiaojian
Published: July 2021

Myocarditis is a disease characterized by localized or diffuse inflammation of the myocardium without efficient treatment. This study explored the regulatory mechanism of microRNA-133 (miR-133) secreted from bone marrow mesenchymal stem cell-derived exosome (BMSC-Exo) on myocardial fibrosis and epithelial–mesenchymal transition (EMT) in viral myocarditis (VMC) rats through regulating mastermind-like 1 (MAML1). BMSCs in rats were isolated and cultured to identify their immune phenotype and osteogenic and adipogenic ability, and BMSC-Exo were extracted and identified. Exosomes were obtained through ultracentrifugation, which were identified by transmission electron microscope and western blot analysis. The rats were injected with Coxsackie B3 virus for preparation of VMC model, and cardiomyocytes were isolated, cultured and grouped in the same way as animal experiments (NCExo, Ad-miR-133aExo, Adas-miR-133aExo). In vivo and in vitro experiments were conducted to figure out the roles of exosomal miR-133a and MAML1 in inflammation, apoptosis, EMT, fibrosis, and cell viability. The targeting relationship between miR-133a and MAML1 was verified by dual luciferase reporter gene assay. BMSC-Exo raised miR-133a expression in VMC rats and effectively improved the VMC rat cardiac function and myocardial fibrosis, increased cardiomyocyte viability and inhibited the EMT process. Elevated miR-133a in exosomes strengthened the improvements. Silenced miR-133a effectively reversed the effects of BMSC-Exo on VMC rats. miR-133a targeted MAML1. Inhibition of MAML1 improved cardiac function and myocardial fibrosis in VMC rats and could reverse the effect of miR-133a-silenced exosomes on VMC rats. Our study suggests that elevated exosomal miR-133a suppresses myocardial fibrosis and EMT in rats with VMC via down-regulating MAML1, thereby inhibiting the progression of myocarditis.
Seasonality of mortality under a changing climate: a time-series analysis of mortality in Japan between 1972 and 2015
Authors: Madaniyazi Lina , Chung Yeonseung , Kim Yoonhee , Tobias Aurelio , Ng Chris Fook Sheng , Seposo Xerxes , Guo Yuming , Honda Yasushi , Gasparrini Antonio , Armstrong Ben , Hashizume Masahiro
Published: July 2021

Background

Ambient temperature may contribute to seasonality of mortality; in particular, a warming climate is likely to influence the seasonality of mortality. However, few studies have investigated seasonality of mortality under a warming climate.

Methods

Daily mean temperature, daily counts for all-cause, circulatory, and respiratory mortality, and annual data on prefecture-specific characteristics were collected for 47 prefectures in Japan between 1972 and 2015. A quasi-Poisson regression model was used to assess the seasonal variation of mortality with a focus on its amplitude, which was quantified as the ratio of mortality estimates between the peak and trough days (peak-to-trough ratio (PTR)). We quantified the contribution of temperature to seasonality by comparing PTR before and after temperature adjustment. Associations between annual mean temperature and annual estimates of the temperature-unadjusted PTR were examined using multilevel multivariate meta-regression models controlling for prefecture-specific characteristics.

Results

The temperature-unadjusted PTRs for all-cause, circulatory, and respiratory mortality were 1.28 (95% confidence interval (CI): 1.27–1.30), 1.53 (95% CI: 1.50–1.55), and 1.46 (95% CI: 1.44–1.48), respectively; adjusting for temperature reduced these PTRs to 1.08 (95% CI: 1.08–1.10), 1.10 (95% CI: 1.08–1.11), and 1.35 (95% CI: 1.32–1.39), respectively. During the period of rising temperature (1.3 °C on average), decreases in the temperature-unadjusted PTRs were observed for all mortality causes except circulatory mortality. For each 1 °C increase in annual mean temperature, the temperature-unadjusted PTR for all-cause, circulatory, and respiratory mortality decreased by 0.98% (95% CI: 0.54–1.42), 1.39% (95% CI: 0.82–1.97), and 0.13% (95% CI: − 1.24 to 1.48), respectively.

Conclusion

Seasonality of mortality is driven partly by temperature, and its amplitude may be decreasing under a warming climate.
Correlation of fasting blood sugar at the time of penile prosthesis surgery with the level of glycated hemoglobin and the outcome of surgery
Authors: Haobus Mohamad , Almannie Raed , Aziz Mohammed , Farag Mohammed , Ralph David , Mulhall John , Binsaleh Saleh
Published: July 2021

Background

The role of glycemic control in predicting implant infection and other surgical complications is debatable. This study aimed to assess the potential correlation between fasting blood sugar (FBS) levels prior to penile prosthesis surgery (PPS) and the surgical outcomes.

Methods

A retrospective study from data collected prospectively in 2015 in a single center. Patients who underwent penile implant procedures were included. Exclusion criteria were if surgery done by low-volume implanter, patients who required revision surgery or not diagnosed with diabetes mellitus. Management was standardized to all patients.

Results

All complications whether minor or major were documented up to three years. One year after the surgery a Likert scale questionnaire was completed by the patients. In total, 218 patients completed the study at last follow-up. Complications rate was 6.25%. The rate of infection requiring explantation was 3.8%. 0.9% of patients had a superficial infection managed successfully with conservative management. 0.9% had erosion and 0.9% had mechanical failure. There was no statistically significant difference in FBS or glycated hemoglobin (HbA1c) levels in patients with postoperative complications compared to patients with satisfactory postoperative course. FBS level on the day of surgery was within 20 mg/dL (1.11 mmol/L) of the expected range based on HbA1c measurement in 62 patients (28.44%), while in 146 patients (66.98%) the FBS was not within 20 mg/dl (1.11 mmol/L) of the expected range based on preoperative HbA1c level.

Conclusion

FBS levels on the day of surgery are not correlated with HbA1c levels and PPS outcomes.
Changes in handwashing and hygiene product usage patterns in Korea before and after the outbreak of COVID-19
Authors: Choi KeunOh , Sim Seunghye , Choi Junyeong , Park Choa , Uhm Yoonhee , Lim Eunkyung , Kim Augustine Yonghwi , Yoo Seong Joon , Lee YoungJoo
Published: July 2021

Background

The World Health Organization declared COVID-19, the disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a global pandemic on March 11, 2020. Non-pharmaceutical interventions such as social distancing, handwashing, using hand sanitizer, and wearing facial masks are recommended as the first line of protection against COVID-19. Encouraging hand hygiene may be one of the most cost-effective means of reducing the global burden of disease.

Methods

This study uses a web-based questionnaire to evaluate the usage patterns and consumer perceptions of the effectiveness and health safety of bar soap, liquid hand soap, and hand sanitizer products before and after the spread of COVID-19.

Results

The results show that since the outbreak of COVID-19, the number of consumers who primarily use bar soap has decreased from 71.8 to 51.4%, the number of those who primarily use liquid hand soap has increased from 23.5 to 41.3%, and the number of those who use and carry hand sanitizer has increased. The frequency of use, duration of use, and amount used of all three products have increased significantly since the COVID-19 outbreak. Finally, consumer perception of the products’ preventive effect against COVID-19 is higher for liquid hand soap and hand sanitizer than it is for bar soap.

Conclusions

Because use of hand sanitizers has increased, public health guidelines must address the potential risks associated them. Our data also show that the public is abiding by the recommendations of the regulatory authorities. As handwashing has become important in preventing COVID-19 infections, the results of our study will support the development of better handwashing guidelines and a public health campaign.
Pre-processing tissue specimens with a tissue homogenizer: clinical and microbiological evaluation
Authors: Yusuf Erlangga , Pronk Marieke , van Westreenen Mireille
Published: July 2021

Background

Tissues are valuable specimens in diagnostic microbiology because they are often obtained by invasive methods, and effort should thus be taken to maximize microbiological yield. The objective of this study was to evaluate the added value of using tissue pre-processing (tissue homogenizer instrument gentleMACS Dissociator) in detecting microorganisms responsible for infections.

Methods

We included 104 randomly collected tissue samples, 41 (39.4 %) bones and 63 (60.6 %) soft tissues, many of those (42/104 (40.4 %)) were of periprosthetic origins. We compared the agreement between pre-processing tissues using tissue homogenizer with routine microbiology diagnostic procedure, and we calculated the performance of these methods when clinical infections were used as reference standard.

Results

There was no significant difference between the two methods (McNemar test, p = 0.3). Among the positive culture using both methods (n = 62), 61 (98.4 %) showed at least one similar microorganism. Exactly similar microorganisms were found in 42/62 (67.7 %) of the samples. From the included tissues, 55/ 104 (52.9 %) were deemed as infected. We found that the sensitivity of homogenized tissue procedure was lower (83.6 %) than when tissue was processed using tissue homogenizer (89.1 %). Sub-analysis on periprosthetic tissues and soft or bone tissues showed comparable results.

Conclusions

The added value of GentleMACS Dissociator tissue homogenizer is limited in comparison to routine tissue processing.
Emergence of a mupirocin-resistant, methicillin-susceptible Staphylococcus aureus clone associated with skin and soft tissue infections in Greece
Authors: Giormezis Nikolaos , Doudoulakakis Anastassios , Tsilipounidaki Katerina , Militsopoulou Maria , Kalogeras George , Stamouli Vasiliki , Kolonitsiou Fevronia , Petinaki Efthimia , Lebessi Evangelia , Spiliopoulou Iris
Published: July 2021

Background

Staphylococcus aureus causes various infections, including skin and soft tissue infections (SSTIs). In this study, methicillin-susceptible S. aureus (MSSA) from SSTIs among patients in three tertiary-care hospitals in Greece were studied in terms of antimicrobial resistance, clonal distribution, toxin and adhesin genes carriage.

Results

During a five-year period (2014–2018), 6145 S. aureus were recovered from 13,244 patients with SSTIs and tested for antimicrobial susceptibility. MSSA were 4806 (78.21 %) including 1484 isolates with mupirocin minimum inhibitory concentration (MIC) > 64 mg/L (30.88 %). Two hundred and sixty representative mupirocin-resistant MSSA were analyzed for genes encoding Panton-Valentine leukocidin (PVL, lukS/lukF-PV), exfoliative toxins (eta, etb), adhesin FnbA (fnbA) and resistance genes mupA (high-level resistance to mupirocin), fusB (fusidic acid), aminoglycosides’ modifying enzymes, ermA, ermC and msrA (macrolides/lincosamides) by PCRs. Strains were classified into clones by PFGE and MLST.

All mupirocin-resistant MSSA were penicillin-resistant; 92.7 % expressed resistance to fusidic acid and 88.9 % to tobramycin. All 260 molecularly analyzed isolates were mupA-positive; all fusidic acid-resistant (241/260) carried fusB whereas, the tobramycin-resistant ones (230), ant(4′)-Ia. The majority carried eta (93.85 %), etb (98.08 %) and fnbA (88.85 %). PFGE typing revealed a mostly unvarying population; 260 MSSA were grouped into three types. One major eta/etb-positive clone comprising of 258/260 strains (99.2 %), PFGE type 1, was classified as ST121, including nine strains co-carrying PVL. Another PVL-positive strain was identified as ST1, and one toxins-negative as ST21.

Conclusions

A mupirocin-resistant MSSA clone, ST121, carrying resistance, exfoliative toxins and adhesin genes, was spread and predominated in SSTIs from patients in Greece during the five-year studied period.