bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmacological treatment in adult patients with CRPS-I: a systematic review and meta-analysis of randomized controlled trials
Authors: Fassio Angelo , Mantovani Alessandro , Gatti Davide , Rossini Maurizio , Viapiana Ombretta  , Gavioli Irene , Benini Camilla , Adami Giovanni
Published: January 2022

Objective

Several pharmacological treatments have been proposed for the treatment of complex regional pain syndrome type-I (CRPS-I) in adults, but data regarding the efficacy of various agents for this disease is scarce. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to analyse the efficacy of the various pharmacological approaches in adults with CRPS-I.

Methods

We systematically searched PubMed, Scopus, and Web of Science databases from the inception date to 30 June 2021 to identify placebo-controlled or active-controlled RCTs using bisphosphonates, ketamine, CSs, anti-epileptics, NSAIDs/COXIBs, opiates, antidepressants, scavengers/magnesium sulphate or IVIGs for the treatment of CRPS-I. The primary outcomes included changes in the visual analogue scale (VAS) or numeric rating scale (NRS) for pain before and after treatment.

Results

We included 20 placebo-controlled or active-controlled RCTs (including a total of 818 adults with CRPS-I) that used bisphosphonates (n = 7), ketamine (n = 2), CSs (n = 2), anti-epileptics (n = 1), NSAIDs/selective inhibitors of cyclooxygenase-2 (COXIBs) (n = 2), scavengers/magnesium sulphate (n = 5), or IVIGs (n = 1) to treat CRPS-I during a median follow-up of 26 weeks. Treatment with bisphosphonates showed a significant reduction in the values of the VAS/NRS pain scale compared with placebo or reference therapy (random effects weighted mean difference [WMD]: −23.8, 95% CI: −28.0 to −19.6; I2 = 36.4%). Treatment with ketamine also documented a reduction in the values of the VAS/NRS for pain (random effects WMD: −8.27, 95% CI: −12.9 to −3.70; I2 = 0%). Treatment with other agents did not reduce the values of the VAS/NRS assessments of pain.

Conclusion

This systematic review and meta-analysis supports the recommendation of parenteral bisphosphonates as the first-line agent in the treatment of CRPS-I.

Trial registration

Open Science Framework registries, https://osf.io/et9gu/, osf.io/et9gu.
Ultrasound findings of calcium pyrophosphate deposition disease at metacarpophalangeal joints
Authors: Cipolletta Edoardo , Di Matteo Andrea , Smerilli Gianluca , Di Carlo Marco , Di Battista Jacopo , Abhishek Abhishek , Grassi Walter , Filippucci Emilio
Published: January 2022

Objective

To explore the spectrum of articular and peri-articular ultrasound (US) findings at metacarpophalangeal (MCP) joints in calcium pyrophosphate (CPP) deposition disease (CPPD).

Methods

Consecutive CPPD patients (chronic CPP crystal inflammatory arthritis or OA with CPPD), and age- and sex-matched controls with RA were prospectively enrolled. Patients underwent bilateral US examination of MCP joints. CPP deposits, synovial inflammation, osteophytes, cartilage damage and bone erosions were recorded.

Results

Sixty CPPD patients (33, 55.0% with OA with CPPD and 27, 45.0% with chronic CPP crystal inflammatory arthritis) and 40 RA patients were enrolled. CPP deposits were detected in 24 (40.0%) CPPD patients and in 3 (7.5%) RA patients (P <0.01). In CPPD patients, different types of CPP deposits were identified at MCP joints: 17 (28.3%) patients had dorsal capsuloligamentous deposits, 14 (23.3%) intra-cartilaginous deposits, 13 (21.7%) lateral capsuloligamentous deposits, 12 (20.0%) intra-articular deposits, eight (13.3%) double contour sign and five (8.3%) flexor digitorum tendons’ deposits. CPPD patients with chronic CPP crystal inflammatory arthritis showed more US findings indicating synovial inflammation and CPP deposits than those with OA with CPPD. Conversely, a higher prevalence of US features indicating structural damage was noted in this latter phenotype. CPP deposits and bone erosions were the US findings with the highest value for diagnosing chronic CPP crystal inflammatory arthritis and RA, respectively.

Conclusion

This study provides pictorial evidence of the broad spectrum of US findings indicating CPP deposits at MCP joints in CPPD. Furthermore, we reported different US patterns in different CPPD phenotypes.
Impaired Membrane Lipid Homeostasis in Schizophrenia
Authors: Li Minghui , Gao Yan , Wang Dandan , Hu Xiaowen , Jiang Jie , Qing Ying , Yang Xuhan , Cui Gaoping , Wang Pengkun , Zhang Juan , Sun Liya , Wan Chunling
Published: January 2022

Background and Hypothesis

Multiple lines of clinical, biochemical, and genetic evidence suggest that disturbances of membrane lipids and their metabolism are probably involved in the etiology of schizophrenia (SCZ). Lipids in the membrane are essential to neural development and brain function, however, their role in SCZ remains largely unexplored.

Study Design

Here we investigated the lipidome of the erythrocyte membrane of 80 patients with SCZ and 40 healthy controls using ultra-performance liquid chromatography-mass spectrometry. Based on the membrane lipids profiling, we explored the potential mechanism of membrane phospholipids metabolism.

Study Results

By comparing 812 quantified lipids, we found that in SCZ, membrane phosphatidylcholines and phosphatidylethanolamines, especially the plasmalogen, were significantly decreased. In addition, the total polyunsaturated fatty acids (PUFAs) in the membrane of SCZ were significantly reduced, resulting in a decrease in membrane fluidity. The accumulation of membrane oxidized lipids and the level of peripheral lipid peroxides increased, suggesting an elevated level of oxidative stress in SCZ. Further study of membrane-phospholipid-remodeling genes showed that activation of PLA2s and LPCATs expression in patients, supporting the imbalance of unsaturated and saturated fatty acyl remodeling in phospholipids of SCZ patients.

Conclusions

Our results suggest that the mechanism of impaired membrane lipid homeostasis is related to the activated phospholipid remodeling caused by excessive oxidative stress in SCZ. Disordered membrane lipids found in this study may reflect the membrane dysfunction in the central nervous system and impact neurotransmitter transmission in patients with SCZ, providing new evidence for the membrane lipids hypothesis of SCZ.
Discursive multivocality: how the proliferation of economic language can undermine the political influence of economists
Authors: Rilinger Georg
Published: January 2022

This article shows how the proliferation of economic language can undermine the political authority of economists. The argument emerges from a comparative case study of two early experiments with electricity market design. Relying on archival materials and 30 in-depth interviews, I examine why political actors ignored the advice of economists in California, while they deferred to the experts in the Pennsylvania, Jersey, Maryland (PJM) region. The debates were framed in economic language, but stakeholders interpreted central concepts differently without recognizing the resulting ambiguities. This ‘discursive multivocality’ undermined economists’ authority as experts. It challenged economists’ monopoly on the interpretation of economic concepts and undercut rhetorical strategies to reassert the superiority of their understanding. At the PJM Interconnect, the experts overcame this problem by switching to a different conceptual apparatus. Ironically, economists could establish their authoritative understanding of economics by appealing to a shared understanding of engineering problems.
Environmental Inequality in the American Mind: The Problem of Color-Blind Environmental Racism
Authors: Bugden Dylan
Published: January 2022

Despite research showing that public beliefs about the distribution of resources in society is a crucial factor in the reproduction of inequality, we do not know what Americans believe about environmental inequality or what factors structure those beliefs. Results of a novel national survey (n = 1000) show that Americans poorly understand environmental inequality, often view inequalities as fair, and are only marginally supportive of a range of key policy tools. Regression analyses reveal that the dominant factor explaining Americans’ views of environmental inequality is what I term color-blind environmental racism. Color-blind environmental racism refers to a specific manifestation of color-blind racial ideology, wherein belief in a post-racial society obfuscates and justifies environmental racism and reduces support for policy solutions. Given the pervasiveness of color-blind environmental racism in the American mind, it is likely a substantial cultural barrier facing the environmental justice movement, from local siting disputes to the passage of federal policy. Future research should build on this study to further explore the roles of public opinion and color-blind environmental racism as barriers to achieving environmental justice.
Three is Company, Four is a Crowd? Perceptions of Cultural Diversity in the Workplace
Authors: ORSINI Philippe , MAGNIER-WATANABE Remy
Published: January 2022

Cultural diversity has gained increased validation as a source of greater performance in the context of globalization. This paper examines whether there is an optimum number of foreign coworkers in order to maximize the perceived benefits and minimize the perceived threats of cultural diversity at work. Using a questionnaire survey of 572 Japanese, we found that for perceived benefits of cultural diversity at work, there is no difference between having zero or a token foreign coworker, while more foreign coworkers are associated with moderately higher perceived benefits. For perceived threats, there is a U-shaped relationship whereby interacting with zero or more than three foreign coworkers is linked to higher perceived threats compared to that of only a few foreign coworkers. Our findings reveal that in the Japanese context, interacting with about three foreign coworkers can maximize the perceived benefits while minimizing the perceived threats of cultural diversity in the workplace. Considering diversity in absolute rather than relative terms is an important contribution and implication for business and policy, as Japan and Japanese firms are increasingly dependent on globalization.
Ten-Eleven Translocation Ablation Impairs Cardiac Differentiation of Mouse Embryonic Stem Cells
Authors: Fang Shaohai , Cui Dan , Hong Tingting , Guo Lei , Lee Yi-Tsang , Lee Minjung , Isgandarova Sevinj , Martinez-Moczygemba Margarita , Zhou Yubin , Li Jia , Huang Yun
Published: January 2022

Ten-eleven Translocation (TET) dioxygenases mediated DNA methylation oxidation plays an important role in regulating the embryonic stem cells (ESCs) differentiation. Herein, we utilized a CRISPR/Cas9 based genome editing method to generate single, double, and triple Tet-deficient mouse ESCs (mESCs) and differentiated these cells toward cardiac progenitors. By using emerald green fluorescent protein (GFP; emGFP) expression under the control of Nkx2.5 promoter as marker for cardiac progenitor cells, we discovered that Tet1 and Tet2 depletion significantly impaired mESC-to-cardiac progenitor differentiation. Single-cell RNA-seq analysis further revealed that Tet deletion resulted in the accumulation of mesoderm progenitors to hamper cardiac differentiation. Re-expression of the Tet1 catalytic domain (Tet1CD) rescued the differentiation defect in Tet-triple knockout mESCs. Dead Cas9 (dCas9)-Tet1CD mediated loci-specific epigenome editing at the Hand1 loci validated the direct involvement of Tet-mediated epigenetic modifications in transcriptional regulation during cardiac differentiation. Our study establishes that Tet-mediated epigenetic remodeling is essential for maintaining proper transcriptional outputs to safeguard mESC-to-cardiac progenitor differentiation.
Evaluation of Black Soldier Fly larvae (Hermetia illucens) as a protein supplement for beef steers consuming low-quality forage
Authors: Fukuda Emma P , Cox Jodi R , Wickersham Tryon A , Drewery Merritt L
Published: January 2022

Black Soldier Fly larvae (BSFL; Hermetia illucens) has been the focus of recent feeding trials in poultry, swine, and fish; however, in vivo research has not yet been conducted in cattle. Accordingly, a study was conducted to evaluate the effects of BSFL as a protein supplement in beef steers. Six steers (603 ± 20 kg of BW, n = 3 and 404 ± 17 kg of BW, n = 3) consuming King Ranch bluestem hay (6.55% dry matter [DM] crude protein [CP]) ad libitum were used in two simultaneous 3 × 3 Latin squares. Steers were provided one of three treatments each period: 1) a control with no supplement (CON), 2) a supplement comprised of conventional feed ingredients with whole cottonseed and soybean meal as the main protein sources (CONV), and 3) a supplement with BSFL as the main protein source (BSFL). Three 14-d periods were conducted with 8 d to adapt to treatments, 5 d to measure intake and digestion, and 1 d to complete a ruminal fermentation profile. DM, organic matter (OM), CP, neutral detergent fiber (NDF), and acid detergent insoluble ash were determined in forage, supplement, ort, and fecal samples. Protein supplementation as CONV or BSFL stimulated forage OM intake (P ≤ 0.01) relative to CON with a trend for a difference (P = 0.08) between the supplements such that CONV steers consumed more FOMI than BSFL steers. Treatment affected total digestible OM intake (TDOMI; P ≤ 0.01); TDOMI for CON steers was 47.5 g/kg metabolic body weight (MBW) which was significantly less (P ≤ 0.01) than that of CONV or BSFL steers. Steers supplemented with CONV consumed significantly more TDOMI than BSFL steers (P = 0.05; 62.2 vs. 60.1 g/kg MBW, respectively). Treatment did not significantly affect digestibility of DM, OM, or NDF (P > 0.32). There was also not a significant effect (P ≥ 0.17) of treatment on ruminal ammonia-N, total volatile fatty acids, or ruminal pH. Overall, these data indicate that BSFL may be an effective protein supplement for beef cattle consuming low-quality forage.
Environmental Exposure to Brominated Flame Retardants: Unraveling Endocrine and Mammary Gland Effects That May Increase Disease Risk
Authors: Gouesse Rita-Josiane , Plante Isabelle
Published: January 2022

Brominated flame retardants (BFR) are molecules added to consumer products to reduce fire hazards. They were banned in North America and Europe because of their persistence and biomagnification. However, BFR are still released in the environment due to continued use of products manufactured before restriction, and from waste and recycling processes of those products. As a result, they remain sources of chronic environmental and human exposure worldwide. BFR are well-characterized endocrine disruptors. They have been associated with a wide range of alterations in endocrine and reproductive systems both in humans and experimental models in vivo and in vitro. Paradoxically, the effects of BFR on mammary glands, whose development and carcinogenesis are mainly under hormonal dependency are poorly known. There is increasing weight of evidence that exposure to endocrine disruptors promotes breast cancer, especially if the exposure occurs during sensitivity windows. For the mammary gland, these windows include the perinatal life, puberty, and pregnancy, as important remodeling of the organ happens during those periods. The peak of exposure to BFRs happened during late 1990s and beginning of 2000s in most countries. Women who were pregnant at that time are reaching menopause while their daughters are 20–30 years old. It is thus important to better understand the effects of BFRs on mammary gland development and breast cancer to determine whether these women are more at risk. Thus, this review aims to propose a comprehensive review of data reporting the effects of exposure to BFR on female endocrine and reproductive systems, with a particular focus on mammary gland development and of a potential increased risk of breast cancer.
Diagnosis of Malnutrition in Children and Adolescents with Identified Developmental Disabilities (IDD) Using Subjective Global Nutrition Assessment (SGNA)
Authors: Ong Shu Hwa , Chen Seong Ting
Published: January 2022

Background

Children with identified developmental disabilities (IDD) experience a higher risk of growth retardation. Anthropometric indicator is one common objective measurement used to determine malnutrition in those children. A comprehensive nutritional assessment tool should be introduced to offer a more robust approach in understanding their nutritional problems.

Objective

To determine the use of Subjective Global Nutrition Assessment (SGNA) as a nutrition assessment tool for children with IDD in comparison to the anthropometric indicators.

Methods

This cross-sectional study was conducted in local community settings. IDD included in this study were autism spectrum disorder (ASD), Down syndrome (DS) and cerebral palsy (CP). SGNA and anthropometry measurements including weight, height, mid-upper arm circumference and triceps skinfolds were performed on 93 children with IDD (40 ASD, 26 DS and 27 CP) aged 5–18 years. Cohen’s Kappa, sensitivity, specificity and its 95% confidence interval were calculated between SGNA and anthropometric indicators for the agreement in determining malnutrition status of the children.

Results

SGNA identified a lower prevalence of malnutrition in children with IDD in comparison to the use of anthropometric indicators. SGNA obtained a moderate-to-fair agreement (above 80% agreement, except height-for-age parameter) and sensitivity (25.71–59.09%) against the use of a single anthropometric indicator in identifying the malnutrition status of the children.

Conclusions

The use of SGNA as an adjunct to body mass index-for-age as an anthropometric measurement for diagnosing malnutrition in children and adolescents with IDD is recommended.
Silent circulation of Zika and dengue virus in Aedes aegypti (Diptera: Culicidae) during a non-epidemic year in the state of Sergipe, northeastern Brazil
Authors: Jesus Myrela C S , Chagas Rynat D O , Santos Matheus L J , Santos Rafaela W F , La Corte Roseli , Storti-Melo Luciane M
Published: January 2022

Background

Dengue virus (DENV) and Zika virus (ZIKV) have a severe impact on human health worldwide. To understand the dynamics of these viruses in mosquito populations, it is necessary to maintain surveillance during non-epidemic years.

Methods

We aimed to assess the presence of DENV and ZIKV in Aedes aegypti females in the state of Sergipe, northeastern Brazil, during a non-epidemic year. The Ae. aegypti females collected were sectioned, and the heads and thorax were used to analyze the infection rate. Each female was first analyzed to detect Flavivirus using RT-PCR. Flavivirus-positive samples were further screened to detect ZIKV and DENV types 1, 2, 3 and 4.

Results

A total of 184 females were collected. ZIKV was identified in 5.4% of the sample and DENV in 7.1%, with the DENV-positive samples belonging to subtypes 2, 3 and 4. The presence of coinfected vectors was also observed. Of the four cities tested, only one was negative for all viruses.

Conclusions

These results show that the maintenance of vigilance during non-epidemic years can provide data on viruses circulating before the onset of outbreaks. This can enable the planning and implementation of local control measures to prevent the appearance of new outbreaks.
Supervisor Age and Embeddedness, Employee Embeddedness, and Job Performance
Authors: Ng Thomas W H , Koopmann Jaclyn , Lucianetti Lorenzo
Published: January 2022

Guided by social information processing theory and regulatory focus theory, this study examines embeddedness contagion related to supervisors’ age. Older (vs. younger) supervisors are more likely to become embedded in their organizations, and when employees see these older supervisors as more embedded, they are likely to take this as a positive cue signaling them to become embedded in the organization, too. This tendency is an important topic within employee age research because it can strengthen employees’ regulatory focus, which in turn affects their job performance. Analysis of matched data collected from 406 employees and their supervisors showed that supervisors’ age was positively related to supervisors’ perceptions of their own organizational embeddedness, which then positively affected employees’ perceptions of supervisors’ and their own embeddedness. Employee embeddedness perceptions, in turn, were positively related to their promotion and prevention focus. Crucially, promotion focus, but not prevention focus, predicted a variety of performance outcomes. Thus, this study explains why employees are more likely to become organizationally embedded in the presence of older supervisors and shows that such embeddedness contagion enhances their work productivity.
Shedding light on species boundaries in small endogeic animals through an integrative approach: species delimitation in the centipedeClinopodes carinthiacus(Chilopoda: Geophilidae) in the south-eastern Alps
Authors: Peretti Emiliano , Cecchin Chiara , Fusco Giuseppe , Gregnanin Luca , Kos Ivan , Bonato Lucio
Published: January 2022

The investigation of species boundaries in strictly endogeic animals is challenging because they are prone to fine-scale genetic and phenotypic geographical differentiation owing to low dispersal ability. An integrative approach exploiting different sources of information has seldom been adopted in these animals and even more rarely by treating all data sources equally. We investigated species boundaries in the endogeic centipede Clinopodes carinthiacus across the south-eastern Alps by studying genetic and morphological differentiation in a sample of 66 specimens from 27 sites, complemented by the morphological examination of more than 1100 specimens from other sites. Hypotheses of species delimitation were obtained independently from the molecular sequences of three markers (mitochondrial 16S and COI and nuclear 28S) by means of different species discovery methods (automatic barcode gap discovery, assemble species by automatic partitioning, general mixed Yule coalescent and the Poisson tree process) and from ten morphological characters by means of a model-based cluster analysis and Bayesian model selection. We found strong support for the existence of at least two species: C. carinthiacus s.s. and Clinopodes strasseri, which was formerly described as a subspecies of another species, and later placed in synonymy with C. carinthiacus. The two species coexist in syntopy in at least one site.
SdhC-I86F Mutation in Phakopsora pachyrhizi Is Stable and Can Be Related to Fitness Penalties
Authors: Claus Alexandre , Simões Kelly , De Mio Louise L. May
Published: January 2022

Succinate dehydrogenase inhibitors (SDHIs) fungicides are used to control Asian soybean rust (Phakopsora pachyrhizi), and the SdhC-I86F mutation is related to pathogen resistance. The objective of this study was to determine whether fitness penalties are associated with SDHI resistance (SdhC-I86F mutation) in P. pachyrhizi populations. Moreover, the study investigated whether the SdhC-I86F mutation remained stable after the fungus propagation both in the absence and presence of fungicide. The populations used in this study presented mutations for all genes analyzed (Cyp51, Cytb, and SdhC), except for a wild-type population (WTSdhC) found with no SdhC-I86F mutation. The frequencies of the SdhC-I86F mutant populations were stable after 36 generations in the absence of fungicide. However, in the case of the WTSdhC population, the SdhC-I86F mutation was further detected after one generation of the fungus in the presence of the SDHI fungicide, according to the results of a detached leaf assay. Three tests were performed to evaluate fitness components and sensitivity to fungicides (half maximal effective concentration). SdhC-I86F mutant populations were more sensitive to osmotic and oxidative stress than the WTSdhC population; however, the sensitivity to ultraviolet radiation was similar for both populations. All mutated populations were less sensitive than the WTSdhC when using SDHI (azoxystrobin + benzovindiflupyr), but more sensitive to mancozeb. The presence of fitness penalties, the mutation stability, and the sensitivity to mancozeb presented by the SdhC-I86F mutant populations can be relevant to the management of the disease in the field.
How E-cigarettes and vaping can affect asthma in children and adolescents
Authors: Di Cicco Maria , Sepich Margherita , Beni Alessandra , Comberiati Pasquale , Peroni Diego G.
Published: January 2022

Purpose of review

Electronic nicotine delivery systems such as e-cigarettes are commonly felt to be harmless devices when compared to traditional cigarettes. However, an increasing number of studies support the biological plausibility for the potential detrimental effects of vaping on the respiratory mucosa. To date, few human studies have been carried out on adult vapers showing a reduction in lung function testing, especially in those with asthma, whereas the effects of vaping on children and adolescents have not been elucidated so far.

Recent findings

Several cross-sectional, national, population-based studies on large groups of adolescents have been carried out showing an association between vape exposure and self-reported asthma diagnosis and/or respiratory symptoms in this age group. The effects of second and third-hand exposure together with those of active and passive exposure in pregnancy, are almost completely unknown.

This review outlines recent data on the potential effects of vaping on asthma, focusing on vape composition, reported effects on the respiratory mucosa, available data in adolescents, and reasons behind the current vaping epidemic. The evidence so far available both in animals and humans suggests that vaping is not harmless, and its exposure should be limited in children and adolescents, especially when affected by asthma.
Advances in hemorrhage control resuscitation
Authors: Muldowney Maeve , Aichholz Pudkrong , Nathwani Rajen , Stansbury Lynn G. , Hess John R. , Vavilala Monica S.
Published: January 2022

Purpose of review

Despite significant advances in trauma management over the last twenty years, uncontrolled hemorrhage remains the leading cause of preventable death in trauma. We review recent changes affecting hemorrhage control resuscitation.

Recent findings

Early blood product usage has become well established as a standard of care in trauma hemorrhage control. To enable this, low titer group A liquid plasma and group O whole blood are increasingly utilized. Single donor apheresis platelets have now replaced pooled donor platelets in the USA and are often pathogen reduced, which has implications for trauma resuscitation. Further work is examining timing and dosing of tranexamic acid and the debate in factor concentrate usage in trauma induced coagulopathy continues to evolve. The ‘Stop the bleed’ campaign has highlighted how important the use of hemostatic dressings are in hemorrhage control, as too is the expanded use of endovascular aortic occlusion. We highlight the ongoing research into desmopressin use and the undetermined significance of ionized calcium levels in trauma. Finally, we discuss our own hospital experience with coagulation testing and the paucity of evidence of improved outcomes with viscoelastic testing.

Improving trauma coagulopathy diagnostics and hemorrhage control are vital if we are to decrease the mortality associated with trauma.
In Vitro Fertilization and Early Pregnancy Outcomes After Coronavirus Disease 2019 (COVID-19) Vaccination
Authors: Aharon Devora , Lederman Matthew , Ghofranian Atoosa , Hernandez-Nieto Carlos , Canon Chelsea , Hanley William , Gounko Dmitry , Lee Joseph A. , Stein Daniel , Buyuk Erkan , Copperman Alan B.
Published: January 2022

OBJECTIVE:

To assess whether coronavirus disease 2019 (COVID-19) mRNA vaccination is associated with controlled ovarian hyperstimulation or early pregnancy outcomes.

METHODS:

This retrospective cohort study included patients who underwent controlled ovarian hyperstimulation or single euploid frozen-thawed embryo transfer at a single academic center. Patients fully vaccinated with a COVID-19 mRNA vaccine were compared with unvaccinated patients who cycled during the same time period. The primary outcome was the fertilization rate for controlled ovarian hyperstimulation and the clinical pregnancy rate for frozen-thawed embryo transfer. Secondary outcomes for controlled ovarian hyperstimulation included eggs retrieved, mature oocytes retrieved, mature oocytes ratio, blastulation rate, and euploid rate. Secondary outcomes for frozen-thawed embryo transfer included pregnancy rate, ongoing pregnancy rate, biochemical pregnancy loss rate, and clinical pregnancy loss rate.

RESULTS:

Among 222 vaccinated patients and 983 unvaccinated patients who underwent controlled ovarian hyperstimulation cycles between February and September 2021, there was no association on adjusted analysis between COVID-19 vaccination and fertilization rate (β=0.02±0.02, P=.20) or any of the secondary outcomes assessed: eggs retrieved (β=0.01±0.57, P=.99), mature oocytes retrieved (β=0.26±0.47, P=.58), mature oocytes ratio (β=0.02±0.01, P=.12), blastulation rate (β=0.02±0.02, P=.27), or euploid rate (β=0.05±0.03, P=.08). Among 214 vaccinated patients and 733 unvaccinated patients undergoing single euploid frozen-thawed embryo transfer, adjusted analysis demonstrated no significant association between vaccination and clinical pregnancy (adjusted odds ratio [aOR] 0.79, 95% CI 0.54–1.16) or any of the secondary outcomes: pregnancy (aOR 0.88, 95% CI 0.58–1.33), ongoing pregnancy (aOR 0.90, 95% CI 0.61–1.31), biochemical pregnancy loss (aOR 1.21, 95% CI 0.69–2.14), or clinical pregnancy loss (aOR 1.02, 95% CI 0.51–2.06).

CONCLUSION:

Administration of COVID-19 mRNA vaccines was not associated with an adverse effect on stimulation or early pregnancy outcomes after IVF. Our findings contribute to the growing body of evidence regarding the safety of COVID-19 vaccination in women who are trying to conceive.
Effects of Whole Pelvic Radiotherapy on the Distribution of Lymphocyte Subpopulations in Prostate Cancer Patients
Authors: Roviello Giandomenico , Nardone Valerio , Bonetta Alberto , Correale Pierpaolo , Molteni Alfredo , Lazzari Maria C. , Generali Daniele
Published: January 2022

Introduction:

In the current study, we have investigated the effects of the different modalities of treatment (volume of radiotherapy [RT], previous surgery) as well as the Gleason score of prostate cancer (PC) on the lymphocyte composition of PC patients undergoing RT.

Methods:

This is a monoinstitutional study that prospectively included PC patients that underwent RT from January 2016 until December 2017. To compare the different evaluations, the Wilcoxon signed-rank test was used among 2 times (Timepoint 0 to Timepoint 1). Percentage variation was calculated for all the lymphocyte subpopulation and was correlated with clinical parameters (previous surgery, Gleason score, and pelvic irradiation) with the χ2 test. The statistical analysis was repeated also on the stratified dataset according to the above parameters (previous surgery, Gleason score, and whole pelvic radiotherapy [WPRT]).

Results:

One hundred and eleven patients were included in the present analysis. All the lymphocyte subpopulations resulted significantly lower after RT. The modifications of several lymphocyte subpopulations correlated with previous surgery, Gleason score, and WPRT, although stratified analysis demonstrated that WPRT showed the greatest correlation.

Conclusion:

Our results could be used to design a prospective trial in order to study the use of WPRT on the lymphocyte subpopulations.
The Role of Plastic Surgery in the Treatment of Recurrent and Large Penile Keloid
Authors: Alzeerelhouseini Hussam I.A. , Alzaro Rashad M.
Published: January 2022

Penile keloid is an extremely rare condition that most commonly occurs as a complication of circumcision. In this article, we describe a unique case of recurrent, large penile keloid formation after circumcision in an 11-year-old White boy. This was treated by surgical excision and reconstruction of penile shaft by skin graft followed by serial intradermal steroid injections. A good aesthetic outcome was achieved with no keloid recurrence during a 1-year follow-up. In addition, we extensively reviewed all available literature studies of penile keloid from 1966 to 2021 with their treatments and outcomes. We summarized all reported cases and presented them in a comprehensive table.
A Fourteen-year Review of Practice Patterns and Evidence-based Medicine in Operative Metacarpal Fracture Repair
Authors: Sasson Daniel C. , Shah Nikhil D. , Yuksel Selcen S. , Kearney Aaron M. , Brandt Keith , Gosain Arun K.
Published: January 2022

Background:

The American Board of Plastic Surgery has been collecting practice data on metacarpal fracture operative repair since 2006 as part of its Continuous Certification process. These data allow plastic surgeons to compare their surgical experience to national trends. Additionally, these data present the opportunity to analyze those trends in relation to evidence-based medicine.

Methods:

Data on metacarpal fracture operative repair from May 2006 to December 2014 were reviewed and compared with those from January 2015 to March 2020. National practice trends observed in these data were evaluated and reviewed alongside published literature and evidence-based medicine.

Results:

In total, 1160 metacarpal fracture repair cases were included. Outpatient (as opposed to inpatient) operative repairs have been trending upward, from 50% to 61% (P < 0.001). Most repairs were performed under general anesthesia (68%), and there was a decrease in the use of regional anesthesia between our two cohorts (14%–9%; P = 0.01). An open reduction with internal fixation was the most popular technique (51%), and a decrease in the use of closed reduction with splinting was observed (16%–10%; P = 0.001). Stiffness was the most commonly reported adverse event. Topics addressed in evidence-based medicine articles but not tracer data included interosseous wiring, which has shown success in spiral shaft fracture treatment with minimal complications, and nonoperative management.

Conclusion:

As evidence-based recommendations continue to change with additional research inquiry, tracer data can provide an excellent overview of the current practice of metacarpal fracture repair and how effectively physicians adapt to remain aligned with best practices.
The Plastic Surgery Common Application: Improving Efficiency and Reducing Inequity in the Application Process
Authors: Jackson Kianna R. , Makhoul Alan T. , Janis Jeffrey E. , Drolet Brian C.
Published: January 2022

The residency application process is expensive, costing an average of $2149 in application fees per applicant during the 2020–2021 cycle. Additionally, the number of applications per applicant continues to rise annually across all specialties. This considerable cost creates a financial barrier for students, particularly those from first-generation and underrepresented backgrounds. Moreover, the Electronic Residency Application Service (ERAS) application generates a lengthy, diluted output that hinders a holistic review. We developed the Plastic Surgery Common Application (PSCA), a focused, specialty-specific application external to ERAS with the goal of lessening the financial barrier for students and improving reviewer satisfaction. The PSCA was revised over a 5-month period after prepiloting with stakeholders. All integrated plastic surgery programs were invited to participate. Of the 86 plastic surgery programs, 20 agreed to participate in the pilot, accepting both ERAS and PSCA for direct comparison. A total of 181 completed applications were received through the PSCA. In a postparticipation survey, most applicants and reviewers felt that the PSCA offered a reasonable alternative to ERAS, despite minor technical difficulties. The PSCA pilot demonstrates that there is a reasonable alternative to applying to residency through ERAS and offers a template for developing a system that is not cost-prohibitive to applicants. The PSCA also demonstrates the benefit of a specialty-specific, customizable application for reviewer efficiency and satisfaction.
Early Clinical Outcomes of Polydioxanone Mesh for Prepectoral Prosthetic Breast Reconstruction
Authors: Qiu Cecil S. , Seth Akhil K.
Published: January 2022

Background:

Many biologic matrices and synthetic meshes are available as adjuncts for prosthetic and autologous breast reconstructions to help control implant position and to reinforce abdominal flap donor sites. Absorbable synthetic meshes may have advantages over biologic matrices and permanent meshes, such as lower cost and better long-term biocompatibility. We present a prospective case series of patients undergoing two-stage, prepectoral breast reconstruction with polydioxanone (PDO) mesh.

Methods:

This prospective, consecutive single-surgeon series of patients who received PDO mesh during two-stage, prepectoral breast reconstruction involved incorporation of the PDO mesh at stage 1 as an anterior tarp over the tissue expander. A detailed description of surgical technique is provided herein. Surgical complications monitored included surgical site infection, wound dehiscence, mastectomy skin flap necrosis, hematoma or seroma requiring operative intervention, and reconstructive failure.

Results:

Seven patients with fourteen breast reconstructions were included in the study. All patients had unilateral cancer and underwent bilateral mastectomies with immediate reconstruction. The average age of patient was 50.0 (SD 7.4) and BMI was 29.3 (SD 2.7). Patients were followed for a median of 274 days, during which only one late infection (7.1%) occurred requiring expander removal.

Conclusions:

PDO mesh has an acceptable short-term complication rate in two-stage prepectoral prosthetic breast reconstruction. Future investigations should elucidate its comparative efficacy and safety against alternative products with respect to long-term outcomes.
Corneal Pigment Opacity From Face-Down Positioning After Pars Plana Vitrectomy, Treated With Descemet Stripping Only Technique
Authors: Yung Madeline , Lee Edward H. , Chow Jason , Kim Esther , Park Susanna , Tu Lien , Mannis Mark J.
Published: January 2022

Purpose:

The purpose of this study was to report a case of corneal opacity resulting from pigment deposition after face-down positioning, which was treated with Descemet stripping only (DSO) to enable concurrent pars plana vitrectomy (PPV) for retinal detachment repair.

Methods:

A 79-year-old man with a history of Fuchs endothelial dystrophy and retinal detachment presented for the repair of recurrent retinal detachment and evaluation of a central corneal opacity.

Results:

The patient was found to have significant corneal endothelial pigment deposition obscuring the view to the fundus. A repeat macula-involving retinal detachment was visualized on limited fundoscopic examination and confirmed using ultrasonography. The patient subsequently underwent combination scleral buckle, DSO, and PPV. DSO achieved corneal clarity for the entire duration of the PPV and allowed for the necessary postoperative face-down positioning. Immunohistochemistry of the corneal specimen revealed deposition of retinal pigment epithelium as the origin of the pigment opacity. The corneal edema cleared at postoperative month 4, and the retina remained attached, resulting in an improvement of visual acuity from counting fingers preoperatively to 20/70.

Discussion:

This is, to the best of our knowledge, the first case describing the formation of a corneal endothelial opacity because of retinal pigment epithelium deposition associated with face-down positioning after PPV for retinal detachment. DSO is a minimally invasive, viable alternative to endothelial keratoplasty or temporary keratoprosthesis placement for the clearance of focal corneal endothelial opacities for PPV.
Use of a Single Radial Incision to Improve Curvature Matching and Graft Adhesion in Descemet Membrane Endothelial Keratoplasty in a Patient With Keratoconus
Authors: García-Onrubia Luis , Stanojcic Nick , Bhogal Maninder
Published: January 2022

Purpose:

The purpose of this study was to report a novel surgical technique for altering donor Descemet membrane endothelial keratoplasty (DMEK) curvature to match host posterior stroma in a patient with advanced keratoconus (KC) and endothelial decompensation.

Methods:

We report a 56-year-old man with Fuch endothelial dystrophy and KC, who underwent DMEK due to endothelial decompensation. A triangular area of graft detachment centered on the apex of cones persisted after repeat gas tamponade. A radial incision from the graft edge to the apex was used to allow overlapping of the graft, thereby increasing the grafts curvature.

Results:

The use of a radial incision in the Descemet membrane (DM) graft was made to allow the graft overlap and adapt to the new shape. By matching the donor curvature to that of the hosts posterior curvature, full adhesion of the graft was achieved with the use of a short-acting air bubble by 1 week after the procedure.

Conclusions:

The mismatch in the curvature of the DM graft and the host posterior corneal surface, in cases with KC or very steep corneas, should be taken into consideration because it can lead to redundancy folds. These can result in atypical, conical detachments, distinct from the typical peripheral detachments seem commonly in DMEK. A single radial incision in the DM graft combined with air tamponade is a feasible treatment option in cases where DMEK fails to attach because of apparent curvature mismatch between the donor and host.
Meningococcal Vaccination and Risk of Serious Adverse Events
Authors: Fontalvo-Mendoza María Fernanda , Pérez-Romero Diana Marcela , Quintana-Pájaro Loraine , Ramos-Villegas Yan Carlos , Ballestas Ezequiel García , Florez-Perdomo William A. , Ghosh Amrita , Pal Ranabir , Moscote-Salazar Luis Rafael , Agrawal Amit
Published: January 2022

Background

Adverse events after immunization are an integral part of meningococcal polysaccharide vaccine that need to be minimized by a holistic approach from production to administration. This study aimed to characterize serious adverse events in meningococcal vaccine recipients.

Methods

A search was carried out following a strategy Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines using PubMed, EMBASE, EBSCO, and SCOPUS databases till May 2020. A series of cases, observational prospective and retrospective cohort, case and control, randomized control trials, and patients of any age vaccinated against meningococcus were included.

Results

A total of 8 selected studies included 7,213,663 children and adults, immunized with meningococcal vaccines. Adverse events in the neurological system are shown (4 studies); the most important are seizures, respiratory system (dyspnea and bronchospasm) and dermatological reactions (angioedema), anaphylaxis, and infectious processes.

Conclusions

Vaccination is adequate protection against meningococcal infections, with reported minimal adverse effects after immunization that do not constitute absolute contraindications to vaccination except allergic or anaphylactic reaction that needs further evaluation.
Anti–SARS-CoV-2 Monoclonal Antibodies for Early COVID-19
Authors: Belden Katherine A. , Hess Bryan , Brugger Caroline , Carr Rachel , Braun Todd , DeRose Joseph , Zurlo John
Published: January 2022

Background

Anti–SARS-CoV-2 monoclonal antibodies have been shown to reduce severe COVID-19 in high-risk ambulatory patients.

Methods

This operations study at 3 affiliated centers conducted from November 23, 2020, to April 30, 2021, identified and treated patients meeting criteria for anti–SARS-CoV-2 monoclonal antibody therapy. The primary study outcome was treatment of qualifying patients. Secondary outcomes included infusion complications, hospitalization/death, and symptom resolution.

Results

Three hundred sixty-seven patients were treated during the study period. The mean patient age was 63 years (SD, 13.47 years). A total of 201 patients (55%) were male, 276 patients (75%) were White, 54 patients (15%) were African American, 10 patients (2.7%) were Asian, and 9 patients (2.4%) identified as Latino or Hispanic. Patients had a first positive direct SARS-CoV-2 test within 10 days of infusion and met high-risk criteria with 232 patients (63%) having more than 1 risk factor. Thirty-two patients (9%) had received at least 1 dose of SARS-CoV-2 vaccination. Four patients experienced an infusion reaction. Of 236 patients reporting time to symptom resolution, 172 patients (73%) were symptom free within 5 days of infusion. Twenty patients (5%) treated were hospitalized for COVID-19 within 30 days of infusion including 1 patient death from COVID-19.

Conclusions

Our study demonstrates that treatment with anti–SARS-CoV-2 neutralizing monoclonal antibodies is feasible in a high-resource health care setting. Infusion was well tolerated by the majority of patients, and there were no known infusion center SARS-CoV-2 exposures.
Bilateral corneal opacities and surface irregularity: role of contact lenses in a case of paraproteinemic keratopathy and multiple myeloma
Authors: Nguyen Lily T. , Smith Ronald J. , Yu Xiao X. , Ilsen Pauline F.
Published: January 2022

Introduction:

This report features an interdisciplinary approach to diagnose and manage a case of paraproteinemic keratopathy and multiple myeloma. In addition, it suggests that rigid gas-permeable contact lenses (RGP CLs) may be a viable alternative to corneal surgery to reduce visual symptoms.

Patient and clinical findings:

A 57-year-old man symptomatic for progressive blur and glare over 2 years presented with an outside diagnosis of corneal dystrophy. An examination revealed bilateral diffuse subepithelial corneal crystals in conjunction with peripheral annular deposits with demarcated ridges. Corneal topography revealed central irregular astigmatism induced by these peripheral corneal opacities.

Diagnosis, intervention, and outcomes:

A hematological workup confirmed IgG Kappa monoclonal gammopathy and multiple myeloma. Visual rehabilitation for paraproteinemic keratopathy was achieved with RGP CLs, which are expected to maintain stable visual acuity while the patient undergoes systemic chemotherapy.

Conclusions:

This report emphasizes the value of thoroughly investigating dystrophy-like corneal deposits of unknown etiology as monoclonal gammopathy can have adverse or even fatal systemic implications. To the authors’ knowledge, this is the first study to directly suggest RGP CL as an adaptable and economical means to improve acuity in certain cases of paraproteinemic keratopathy without resorting to surgical intervention.
Building an Advising Model for Physician Assistant Education
Authors: Fleming Shani , Gordes Karen L. , Kulo Violet , Cawley James F.
Published: January 2022

Physician assistant education is balancing an explosion of new programs, an increase in novice faculty, and expectations from accreditation standards to track student progress longitudinally. The traditional “one-size fits all” model of advising will not meet the demands of this changing educational environment. This article introduces a longitudinal advising model that integrates various strategies from existing models such as proactive, appreciative advising, and the GROW (Goal, Reality, Options, Will) coaching model with a focus on the goal of achieving the new Physician Assistant Education Association (PAEA) Competencies for the New Graduate.