bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of radiological and functional results in osteoporotic distal femur fractures operated with single plating, lateral incision, and double plating, anterior paramedial incision: A retrospective study
Authors: Çalbiyik Murat , Zehir Sinan , Demirezen Murat Okan
Published: February 2024

Treatment of osteoporotic distal femur fractures is often complicated by a high rate of nonunion and varus collapse. For such fractures, lateral plating with lateral incision and double plating with anterior paramedial incision have shown promising results in the recent literature. The hypothesis of this study was that bilateral plating of comminuted distal femur fractures in osteoporotic patients would result in higher union rates and lower revision rates compared to an isolated lateral locking plate. The study included 56 patients (23 males, 33 females) with supracondylar femur fracture. According to the OA/OTA classification, 9 were type A3, 8 were A2, 13 were C1, 16 were C2, and 10 were C3. The mean follow-up period was 12 months, with 29 patients treated using lateral mini-incision, lateral locking plate, and 27 patients treated with anterior paramedial incision, dual plating. The clinical and radiological results were evaluated. The mean duration of radiological union in the studied population was 15 ± 2.1 months (range, 11–21 months) in the single plate group (Group A), and 13.5 ± 2.6 months (range, 9–19 months) in the double plate group (Group B). Mean ROM was 112.3° and flexion contracture 4° in Group A, and ROM 108.3° and flexion contracture 6.7° in Group B. (P = .15). The average Western Ontario and McMaster Universities Arthritis Index (WOMAC) score was 85.6 points in Group A and 83.5 points in Group B (P = .2278). The postoperative anteversion measurement in the operated extremity ranged from −15 to 19 in Group A, and from 5 to 18 in Group B. When the anteversion degrees were compared between the injured and uninjured extremities in the postoperative period, a significant difference was observed within Group A (P = .0018), but no significant difference was observed in Group B (P = .2492). Dual plate fixation using the anterior paramedial approach is an effective operative method for osteoporotic distal femur fractures. This has many advantages such as precise exposure, easy manipulation, anatomic reduction, and stable fixation. However, for surgical indications and medial bone defects > 1 cm, grafting should be performed.
Whole-exome sequencing of pathogenic genes in a family with congenital heart disease: A case report
Authors: Chang Li , Ji Renhui , Sa Rina , Huge Jiletu , An Caiyan
Published: February 2024

Rationale:

Congenital heart disease (CHD) is the most common birth defect and an important cause of noninfectious deaths in infants and children. It has high prevalence globally, placing an enormous burden on society and families. Studies of individuals with hereditary or sporadic CHD have provided strong evidence for its genetic basis. The aim of this study was to identify causative gene variants in a Chinese family with congenital heart disease.

Patient concerns and diagnoses:

Three generations of a CHD family were recruited. Proband III.9 was diagnosed with congenital heart disease at age 11 months, and the echocardiogram showed arterial ductus arteriosus, with a left-to-right shunt at the level of the arteries. Precedent III.10 was a twin of Proband III.9 who was diagnosed with congenital heart disease at age 11 months, in whom the echocardiogram revealed an arterial ductus arteriosus, an unenclosed patent ductus arteriosus, and a left to right shunt at the level of the arteries (second figure). III.8 was diagnosed with congenital heart disease at age 15, but echocardiography in this study showed no abnormalities. No cardiac abnormalities were detected in any of his parents, grandparents, or maternal grandparents. We performed whole-exome sequencing on CHD sufferers and their unexpressing family members to investigate the genetic causes of CHD in this family line. Exome sequencing identified 4 mutation sites in this family line. The variant c.3245A>G (p.His1082Arg) of the AMER1 gene was consistent with concomitant X-chromosome recessive inheritance, the variant c.238G>C (p.Val80Leu) of the KCNE1 gene was consistent with autosomal accessory inheritance, and the other 2 variants did not conform to the law of the mode of inheritance of the disease.

Outcomes:

The first identified variant, c.3245A>G (p.His1082Arg) of the AMER1 gene, with X-chromosome recessive inheritance, and the variant c.238G>C (p.Val80Leu) of the KCNE1 gene, which has been reported as autosomal dominant, may be the causative agent of CHD in this family line. These findings broaden the genetic scope of congenital heart disease and could help in the development of targeted drugs for the treatment of congenital heart disease.
Knowledge mapping of prodromal Parkinson’s disease: A bibliometric review and analysis (2000–2023)
Authors: Wang Shun , An Ning , Wang Yulin , Li Yuan , Li Hailong , Bai Yan
Published: February 2024

The prodromal period of Parkinson’s disease (PD) is currently a hot topic in PD research. However, no bibliometric analysis has been conducted in this research field. This study aimed to provide a comprehensive overview of the status, hotspots, and trends in the prodromal period of PD using bibliometrics. CiteSpace and visualization of similarities viewer were used to analyze articles and reviews on the prodromal period of PD in the Web of Science Core Collection (WoSCC) database. We analyzed the data on countries, institutions, journals, authors, keywords, and cited references. In total, 909 articles from 65 countries, including the United States (n = 265, 29.15%) and Germany (n = 174, 19.14%), were included. The number of articles and reviews related to the prodromal period of PD has increased yearly. The University of Tubingen (n = 45, 4.95%), McGill University (n = 33, 3.63%), and University of London (n = 33, 3.63%) were the research institutions with the most published studies. Movement Disorders is the journal with the largest number of published papers (n = 98, 10.8%) and the most cited publications (co-citation = 7035). These publications are from 4681 authors, with Berg (n = 49, 5.39%) and Postuma (n = 40, 4.40%) publishing the most publications, and Postuma’s study (n = 1206) having the most citations. Studying the nonmotor symptoms of PD precursors is a major topic in this research field. This is the first bibliometric study to comprehensively summarize the research trends and developments in the prodromal period of PD. This information identifies recent research frontiers and hotspots and provides a reference for scholars studying the prodromal period of PD.
Mendelian randomization study supports effect of gut microflora on fractures
Authors: Ju Ling-Ling , Wei Yong-Kang , Liu Yanjun
Published: February 2024

To investigate the possible causal relationship between intestinal microflora and fractures using Mendelian randomization (MR). A 2-sample MR study of gut microbiota and fractures was conducted using a weighted inverse variance analysis with tests for heterogeneity, horizontal pleiotropy, and sensitivity. A causal association between fracture risk and specific bacterial taxa was identified at various taxonomic levels: 2 (Bacteroidia, P = .0304; Deltaproteobacteria P = .0304) at the class level, 3 (Bacteroidales, P = .0428; Desulfovibrionales, P = .0428; Enterobacteriales, P = .0208) at the order level, 2 (FamilyXI, P = .0304; Enterobacteriaceae P = .0332) at the family level, and 1 (Alistipes, P = .0405) at the genus level. This study revealed a causal relationship between gut microflora and fracture risk, demonstrating that the effect of different flora taxa flora abundance on fracture risk differs. It provides a reference for further studies.
PLAU and GREM1 are prognostic biomarkers for predicting immune response in lung adenocarcinoma
Authors: Fu Dongliao , Hu Zhigang , Ma Haodi , Xiong Xin , Chen Xingang , Wang Jingjing , Zheng Xuewei , Yin Qinan
Published: February 2024

Lung adenocarcinoma (LUAD) is a common malignant tumor. Identification of biomarkers and understanding their potential functions will facilitate the treatment and diagnosis in LUAD patients. The yellow module (cor = 0.31, P = 2e-6) was selected as the core module based on weighted gene co-expression network analysis (WGCNA) by integrating RNA-seq data and tumor stage. Two upregulated genes (PLAU and GREM1) in yellow module were identified to be biomarkers. Kaplan–Meier curve analysis displayed that high expression levels of them had a poor overall survival (OS). And, their high expression levels revealed higher tumor stage and relapse possibility in LUAD patients, and could be a prognostic parameter. Both biomarkers showed similar immune cell expression profiles in low- and high-expression groups. Strongly positive correlation between both biomarkers and biomarkers of tumor-infiltrating lymphocytes were also clarified in TCGA-LUAD cohort. Importantly, single gene GSEA showed that transcriptional mis-regulation in cancer and microRNAs in cancer were enriched in LUAD patients. Therefore, a miRNA-mRNA-transcription factors (TFs) co-expression regulatory networks was constructed for each biomarker, various miRNAs and TFs were related to PLAU and GREM1. Among which, 6 downstream TFs were overlapped genes for both biomarkers. Notably, 2 of these TFs (FOXF1 and TFAP2A) exhibited significantly abnormal expression levels. Among which, FOXF1 was downregulated and TFAP2A was upregulated in TCGA-LUAD cohort. Both TFs showed a significantly positive correlation with the expression level of PLAU. In conclusion, we identified 2 biomarkers related to immune response and achieved a good accuracy in predicting OS in patients with LUAD.
Gamma knife radiosurgery as primary management for intracranial meningioma identified as growing on serial imaging
Authors: Kim Yeong Jin , Moon Kyung-Sub , Park Sue Jee , Jung Tae-Young , Kim In-Young , Jung Shin
Published: February 2024

Gamma knife radiosurgery (GKRS) has emerged as a highly effective therapeutic modality for the management of intracranial meningiomas. However, the role of GKRS in treating growing meningiomas detected during active surveillance remains unclear. This study seeks to investigate the long-term outcomes of GKRS treatment for growing meningiomas.

A retrospective analysis was conducted on patients who underwent GKRS as the primary treatment for growing meningiomas between 2004 and 2021. Growing meningiomas were defined as those exhibiting a > 10% increase in tumor volume (TV) compared to the previous imaging. Fifty-nine patients who received GKRS as their initial treatment were included, with a minimum follow-up period of 12 months. Comprehensive clinical, radiological, and procedural data were analyzed. Serial TV assessments were performed for all tumors before and after GKRS. Tumor progression and regression were defined as a > 10% increase or decrease in TV, respectively, compared to the pretreatment image.

At a median follow-up of 41 months (range 15–197 months), TV was unchanged in 16 patients (27.1%), decreased in 41 patients (69.5%), and increased in 2 patients (3.4%). Multivariate analysis revealed that both TV (cm3) (hazard ratio [HR], 1.107; 95% confidence interval [CI], 1.002–1.222; P = .045) and volume growing rate (%/yr) (HR, 1.013; 95% CI, 1.000–1.025; P = .04) significantly correlated with tumor progression. Eleven patients (18.6%) experienced new or worsening symptoms. In multivariate analysis, factor predicting new or worsening neurological function was preexisting calcification (HR, 5.297; 95% CI, 1.328–21.124; P = .018).

GKRS demonstrates a promising level of tumor control with minimal risk of neurological deterioration when applied to growing meningiomas. These findings provide compelling support for considering GKRS as a valuable therapeutic option following an initial period of active surveillance for these tumors.
Can we predict overall survival using machine learning algorithms at 3-months for brain metastases from non-small cell lung cancer after gamma knife radiosurgery?
Authors: Moon Hyeong Cheol , Min Byung Jun , Park Young Seok
Published: February 2024

Gamma knife radiosurgery (GRKS) is widely used for patients with brain metastases; however, predictions of overall survival (OS) within 3-months post-GKRS remain imprecise. Specifically, more than 10% of non-small cell lung cancer (NSCLC) patients died within 8 weeks of post-GKRS, indicating potential overtreatment. This study aims to predict OS within 3-months post-GKRS using machine learning algorithms, and to identify prognostic features in NSCLC patients. We selected 120 NSCLC patients who underwent GKRS at Chungbuk National University Hospital. They were randomly assigned to training group (n = 80) and testing group (n = 40) with 14 features considered. We used 3 machine learning (ML) algorithms (Decision tree, Random forest, and Boosted tree classifier) to predict OS within 3-months for NSCLC patients. And we extracted important features and permutation features. Data validation was verified by physician and medical physicist. The accuracy of the ML algorithms for predicting OS within 3-months was 77.5% for the decision tree, 72.5% for the random forest, and 70% for the boosted tree classifier. The important features commonly showed age, receiving chemotherapy, and pretreatment each algorithm. Additionally, the permutation features commonly showed tumor volume (>10 cc) and age as critical factors each algorithm. The decision tree algorithm exhibited the highest accuracy. Analysis of the decision tree visualized data revealed that patients aged (>71 years) with tumor volume (>10 cc) were increased risk of mortality within 3-months. The findings suggest that ML algorithms can effectively predict OS within 3-months and identify crucial features in NSCLC patients. For NSCLC patients with poor prognoses, old age, and large tumor volumes, GKRS may not be a desirable treatment.
One-stage reconstruction of extensive exposed tibia on malnourished patient using single-layer Integra and amino acid supplements: A case report and literature review
Authors: Lee Kuan-I , Lin Yun-Nan
Published: February 2024

Rationale:

Extremity injuries resulting from motor vehicle collisions, especially those leading to bone-exposed wounds, present challenges for achieving effective wound coverage. Such injuries are susceptible to complications including infections, osteomyelitis, and unexpected amputations due to inadequate blood supply. Severe traumatic degloving injuries often entail damage to the surrounding blood vessels, making local or free flaps impractical choices in many cases. Consequently, treatment options may vary based on distinct clinical scenarios, with no standardized guidelines available. Our study introduces an integrated approach utilizing dermal substitutes and skin grafts as a safer treatment modality for managing large-area tibial exposure resulting from traffic accidents.

Patient concerns:

A 66-year-old male with a compromised nutritional status was struck by a car while riding a motorcycle. Previous attempts using double-layer Integra and negative pressure wound therapy (NPWT) for two-stage reconstruction have been unsuccessful.

Diagnoses:

Computed tomography imaging studies revealed multiple comminuted and displaced fractures involving the left femoral shaft, left proximal tibia, left patella, and proximal fibula, as well as a fracture of the right fibular shaft and an avulsion fracture of the right distal medial femur. The patient’s condition corresponded to Type 3B in the Gustilo classification for open fractures, and the patient had an Injury Severity Score of 25.

Interventions:

We applied a one-stage reconstruction involving single-layer Integra, split-thickness skin grafts, NPWT, and nutritional supplements containing various amino acids.

Outcomes:

By implementing an integrated treatment approach and providing diligent wound care over a total of 2 months, the patient achieved successful healing and expressed satisfaction with the postoperative results.

Lessons:

This study offers insights into the effectiveness of employing one-stage reconstruction for traumatic injuries with extensive exposed tibias. In addition, it underscores the impact of a patient’s nutritional status on wound healing and introduces a potential solution for similar challenging cases.
Bilateral thalamic and brainstem anaplastic astrocytoma: A case report
Authors: Zhang Hong , Zhang Ping , Nie Hongbing , Zhang Ji , Li Jie , Lu Xiaoqing , Shen Yaoyao
Published: February 2024

Rationale:

Bilateral thalamic glioma is extremely rare and characterized by strictly limited involvement of bilateral thalami. To investigate its clinical and neuroimaging features, we herein reported a rare case of anaplastic astrocytoma (AA) involving both thalami and the brainstem and reviewed the literature.

Patient concerns:

A-33-year-old Chinese woman was referred to our department owing to persistent headache and nausea and vomiting. Neurological examination showed mild cognitive impairment and positive Kernig sign.

Diagnosis:

Brain magnetic resonance imaging (MRI) demonstrated asymmetrical and swollen lesions involving both thalami, midbrain and pontine tegmentum, without restricted diffusion or enhancement. On day 7 after admission, she was transferred to the department of neurosurgery and underwent a stereotactic brain biopsy of the right thalamic lesion. Histopathological features and immunohistochemistry were consistent with AA, IDH wild-type, World Health Organization grade III.

Interventions:

She was administrated with mannitol and glycerin fructose for decreasing intracranial pressure.

Outcomes:

In spite of receiving chemotherapy, she died on 2-month after her initial diagnosis.

Lessons:

AA involving in both thalami and brainstem is a rare entity with poor prognosis. The clinicians and radiologists should deepen their awareness of the specific MRI feature of bilateral thalamic involvement. When MRI alone is insufficient, the utility of stereotactic biopsy is essential for making a definitive diagnosis.
Concordance of esophageal and tracheal temperatures in patients using breathing circuit with heated wire humidifier: A prospective observational study
Authors: Yoon Ji-Uk , Byeon Gyeong-Jo , Kim Hee Young , Kim Hye-Jin , Yoo Yeong Min , Bae Jaesang , Lee Jimin
Published: February 2024

No study has compared tracheal and esophageal temperatures when a breathing circuit with a heated wire humidifier was used. This study aimed to investigate the correlation between tracheal and esophageal temperatures in patients using a breathing circuit with heated wire humidifiers. Tracheal temperatures measured by the cuff sensor correlated well with esophageal temperatures while using a heated wire humidifier breathing circuit in patients with anesthesia duration of > 2 hours. Thirty-eight patients who underwent general anesthesia for > 2 hours were enrolled. Tracheal and esophageal temperatures were recorded at 5-minute intervals, starting from the insertion of the esophageal temperature probe to the end of anesthesia. The temperatures were compared by Bland-Altman analysis, calculating the proportion of tracheal temperature measurements within ± 0.25°C of esophageal temperatures, and linear mixed-effects model. Univariate analysis was performed to assess whether any variables influenced the proportion of differences within ± 0.25°C.

Results:

After excluding 4 patients with an anesthesia duration of < 2 hours, data from 34 patients (1163 sets of tracheal and esophageal temperatures) were analyzed. Concordance correlation coefficient was 0.78. The overall mean bias (95% limits of agreement) between the tracheal and esophageal temperatures was −0.16°C (−0.65°C to 0.34°C). The percentage of temperature differences within ± 0.25°C was 73.5% ± 32.3, with a median of 89.4% [0,100]. The linear mixed-effects model revealed that the estimated intercept was 0.17°C with a 95% confidence interval (CI) of 0.13°C to 0.22°C. The duration of anesthesia and the number of temperature measurements were associated with higher concordance between the tracheal and esophageal temperatures in univariate analysis.
SARS-CoV-2 may play a direct role in the pathogenesis of posterior reversible encephalopathy syndrome (PRES) associated with COVID-19: A CARE-compliant case report and literature review
Authors: Wang Lishen , Wang Zhihan , Huang Rui , Li Weishuai , Zheng Dongming
Published: February 2024

Rationale:

During the past 3 years of the corona virus disease 2019 (COVID-19) pandemic, COVID-19 has been recognized to cause various neurological complications, including rare posterior reversible encephalopathy syndrome (PRES). In previously reported cases of PRES associated with COVID-19, the majority of patients had severe COVID-19 infection and known predisposing factors for PRES, such as uncontrolled hypertension, renal dysfunction, and use of immunosuppressants. It remains unclear whether these risk factors or infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contributes to the development of PRES in these patients. Here we report a special case of PRES associated with COVID-19 without any known risk factors for PRES, indicating the SARS-CoV-2’s direct role in the pathogenesis of PRES associated with COVID-19.

Patient concerns:

An 18-year-old female patient presented to the emergency department with abdominal pain. Preliminary investigations showed no abnormalities, except for positive results in novel coronavirus nucleic acid tests using oropharyngeal swabs. However, the patient subsequently developed tonic–clonic seizures, headaches, and vomiting on the second day. Extensive investigations have been performed, including brain MRI and lumbar puncture. Brain MRI showed hypointense T1-weighted and hyperintense T2-weighted lesions in the bilateral occipital, frontal, and parietal cortices without enhancement effect. Blood and cerebrospinal fluid analyses yielded negative results. The patient had no hypertension, renal insufficiency, autoimmune disease, or the use of immunosuppressants or cytotoxic drugs.

Diagnoses:

PRES was diagnosed based on the clinical features and typical MRI findings of PRES.

Interventions:

Symptomatic treatments such as anticonvulsants were administered to the patients.

Outcomes:

The patient fully recovered within 1 week. The initial MRI abnormalities also disappeared completely on a second MR examination performed 11 days later, supporting the diagnosis of PRES. The patient was followed up for 6 months and remained in a normal state.

Lessons:

The current case had no classical risk factors for PRES, indicating that although the cause of PRES in COVID-19 patients may be multifactorial, the infection of SARS-CoV-2 may play a direct role in the pathogenesis of PRES associated with COVID-19.
Preimplantation genetic testing for X-linked chronic granulomatous disease induced by a CYBB gene variant: A case report
Authors: Chen Xinlian , Peng Cuiting , Chen Han , Zhou Fan , Keqie Yuezhi , Li Yutong , Liu Shanling , Ren Jun
Published: February 2024

Introduction:

X-linked recessive chronic granulomatous disease (XR-CGD) is a severe primary immunodeficiency principally caused by a CYBB (OMIM: 300481) gene variant. Recurrent fatal bacterial or fungal infections are the main clinical manifestations of XR-CGD.

Patient concerns:

In the current case, in vitro fertilization (IVF) associated with preimplantation genetic testing for monogenic disorder (PGT-M) was applied for a Chinese couple who had given birth to a boy with XR-CGD.

Diagnosis:

Next-generation sequencing-based SNP haplotyping and Sanger-sequencing were used to detect the CYBB gene variant (c.804 + 2T>C, splicing) in this family.

Interventions:

The patient was treated with IVF and PGT-M successively.

Outcomes:

In this IVF cycle, 7 embryos were obtained, and 2 of them were euploid and lacked the CYBB gene variant (c.804 + 2T>C). The PGT results were verified by prenatal diagnosis after successful pregnancy, and a healthy girl was eventually born.

Conclusion:

PGT-M is an effective method for helping families with these fatal and rare inherited diseases to have healthy offspring. It can availably block the transmission of disease-causing loci to descendant.
Intestinal barrier biomarkers in clinical evaluation of patients with inflammatory bowel disease
Authors: Mogilevski Tamara , Nguyen Anke L. , Ajamian Mary , Smith Rebecca , Rosella Sam , Sparrow Miles P. , Moore Gregory T. , Gibson Peter R.
Published: February 2024

Background

Inflammatory bowel disease (IBD) is associated with chronic intestinal barrier dysfunction, though its non-invasive assessment remains challenging. This study aimed to determine how four putative circulating markers vary across differing states of intestinal inflammation and with therapy in patients with IBD.

Methods

Plasma samples from one prospective cross-sectional and four longitudinal studies, including healthy controls, were analysed for markers of lipopolysaccharide translocation, lipopolysaccharide-binding protein (LBP) and soluble-CD14 (sCD14), and markers of epithelial injury, syndecan-1 and intestinal-type fatty acid-binding protein (IFABP). Inflammatory activity was determined using objective measures.

Results

Compared with healthy subjects, concentrations of LBP and sCD14 were higher in patients with active (P < 0.001) and severe ulcerative colitis (UC) (P < 0.0001) and active Crohn’s disease (CD) (P < 0.001). In UC in remission, LBP was less than in active disease (P = 0.011) LBP levels decreased longitudinally before and after induction of medical therapy in patients with IBD (P = 0.030) and as severe UC was brought into remission at weeks 2 and 12 (P ≤ 0.022). Response to treatment was associated with higher baseline levels of LBP (P = 0.019) and soluble-CD14 (P = 0.014). Concentrations of syndecan-1 and IFABP were or tended to be lower in UC and CD in active disease and did not change with successful therapy.

Conclusion

While markers of epithelial injury were subnormal with active disease and did not change with therapy, markers of lipopolysaccharide translocation directly reflected intestinal inflammation, reduced with successful therapy and predicted treatment response.
Negative pressure plmonary oedema after adenotonsillectom: a case report and litrature review
Authors: Befikadu Aynalem , Timerga Sara , Mihretu Fasil , Wonte Mesay Milkias
Published: February 2024

Background:

Negative pressure pulmonary is a non-cardiogenic pulmonary oedema that can occur after reliving of upper airway obstruction. It is life threatening clinical scenario developed due to increase intrathoracic pressure during marked inspiratory effort against a closed glottis.

Case presentation:

A successful adenotonsillectomy was done for a healthy 12-year-old, 33 kg male patient and transferred to post-anaesthesia care unit. In the unit the patient developed signs and symptoms of negative pressure pulmonary oedema so he was treated with diuretics and oxygen while restricting fluid. However, the dyspnoea was persisted so he was transferred to ICU.

Clinical discussion:

This case report shows the development of negative pressure pulmonary oedema after adenotonsillectomy. In this report the clinical presentation, diagnosis, treatment, prevention and prognosis of negative pressure pulmonary oedema after adenotonsillectomy was discussed in detail with citing updated evidences.

Conclusions:

Post-extubation pulmonary oedema can occur after reliving of chronic air obstruction. Usually it occur within 5 min after reliving the obstruction but it can occur at any time. All healthcare professionals must be knowledgeable about clinical presentation and managements of negative pressure pulmonary oedema.
Treatment Rates for Chlamydia trachomatis and Neisseria gonorrhoeae in a Metropolitan Area: Observational Cohort Analysis
Authors: Dixon Brian E. , Price John , Valvi Nimish R. , Allen Katie S. , Heumann Christine L. , Titus Melissa K. , Duszynski Thomas J. , Wiensch Ashley , Tao Guoyu
Published: February 2024

Background

Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) are the 2 most common sexually transmitted infections (STIs) in the United States. The Centers for Disease Control and Prevention regularly publishes and updates STI Treatment Guidelines. The purpose of this study was to measure and compare treatment rates for CT and GC among public and private providers.

Methods

Data from multiple sources, including electronic health records and Medicaid claims, were linked and integrated. Cases observed during 2016–2020 were defined based on positive laboratory results. We calculated descriptive statistics and odd ratios based on characteristics of providers and patients, stratifying by public versus private providers. Univariate logistic regression models were used to examine the factors associated with recommended treatment.

Results

Overall, we found that 82.2% and 63.0% of initial CT and GC episodes, respectively, received Centers for Disease Control and Prevention–recommended treatment. The public STI clinic treated more than 90% of CT and GC cases consistently across the 5-year period. Private providers were significantly less likely to treat first episodes for CT (79.6%) and GC (53.3%; P < 0.01). Other factors associated with a higher likelihood of recommended treatment included being male, being HIV positive, and identifying as Black or multiracial. Among GC cases, 10.8% received nonrecommended treatment; all CT cases with treatment occurred per guidelines.

Conclusions

Although these treatment rates are higher than previous studies, there remain significant gaps in STI treatment that require intervention from public health.
Partying in Thailand: Never Testing Among Men Who Have Sex With Men Who Attend Sexualized (Drug) Parties
Authors: Cheung Doug H. , Samoh Nattharat , Jonas Kai , Lim Sin How , Kongjareon Yamol , Guadamuz Thomas E.
Published: February 2024

Background

Human immunodeficiency virus (HIV) testing for Thai men who have sex with men (MSM) is suboptimal, which undermines their linkage to care and subsequent HIV preexposure prophylaxis (PrEP) uptake.

Methods

We analyzed a cross-sectional survey conducted in 2021 among Thai MSM who attended any private sex parties or circuit parties in the past 3 years (“sexualized parties”).

Results

Of the 424 men included in our analysis, 47.6% had been recently tested for HIV in the past 1 year, 30.2% had not recently been tested, and 22.2% had never been tested. In our multivariable analysis, relative to participants who had recently tested for HIV, those who have never tested were more likely to have lower education or to live outside of Bangkok, and to have attended both circuit and private sex parties (vs. private sex party only) but were less likely to report any sexually transmitted infection diagnosis or to have heard of PrEP. Participants who had an HIV test more than a year ago were more likely to have attended both circuit and private sex parties (vs. private sex parties only) but were less likely to have any sexually transmitted infection diagnosis, meet sexual partners online, or have heard of PrEP. Rates of condomless anal sex and willingness to use PrEP were similar across groups.

Conclusions

Despite the high rates of sexual risk-taking, sexualized party attendees reported suboptimal HIV testing uptake. The joint promotion of HIV testing and PrEP is warranted—especially on-premise HIV testing at circuit parties and outreach at online platforms to reach sexualized party attendees.
Asymptomatic and Subclinical Mpox: An Association With Modified Vaccinia Ankara Vaccine
Authors: Golden Matthew R. , Soge Olusegun O. , Mills Margaret , Berzkalns Anna , Cannon Chase , Ramchandani Meena , Dombrowski Julia C. , Karmarkar Ellora N. , Chow Eric J. , Gov Jolene P. , Swenson Paul , Greninger Alexander L.
Published: February 2024

Background

How often mpox causes asymptomatic infections, particularly among persons who have received the Modified Vaccinia Ankara (MVA) vaccine, is unknown.

Methods

We performed mpox polymerase chain reaction testing on rectal and pharyngeal specimens collected from symptomatic and asymptomatic patients at a sexual health clinic in Seattle, WA, between May 2022 and May 2023. Analyses evaluated the prevalence of asymptomatic or subclinical infection and, among persons with polymerase chain reaction–positive tests, the association of MVA vaccination status with the symptomatic infection.

Results

The study population included 1663 persons tested for mpox during 2353 clinic visits. Ninety-three percent of study participants were cisgender men and 96% were men who have sex with men. A total of 198 symptomatic patients (30%) had a first mpox-positive test during 664 visits. Eighteen patients (1.1%) tested during 1689 visits had asymptomatic or subclinical mpox based on a positive rectal or pharyngeal test done in the absence of testing done because of clinical suspicion for mpox. Fourteen (78%) of 18 persons with asymptomatic/subclinical mpox and 53 (26%) of 198 persons with symptomatic mpox had received at least 1 dose of the MVA vaccine (P < 0.0001). Controlling for calendar month, study subjects who received 1 and 2 doses of MVA vaccine were 4.4 (95% confidence interval, 1.3–15) and 11.9 (3.6–40) times more likely to have asymptomatic versus symptomatic mpox, respectively, than persons who were unvaccinated.

Conclusions

Asymptomatic mpox is uncommon. Modified Vaccinia Ankara vaccination is associated with an asymptomatic/subclinical infection among persons with mpox.
Trends in Chlamydia trachomatis Treatment Prescribing Practices in King County, Washington, 2010–2018
Authors: Brase Piper R. , Dombrowski Julia C. , Berzkalns Anna , Manhart Lisa E. , Golden Matthew R. , Khosropour Christine M.
Published: February 2024

Background

In 2021, national Chlamydia trachomatis (CT) treatment guidelines changed from recommending either azithromycin (1 g; single dose) or doxycycline (100 mg twice daily for 7 days) to recommending only doxycycline as first-line treatment. The distribution and trends in CT prescribing practices before the guidelines change is largely unknown.

Methods

We conducted a trends analysis using Washington STD surveillance data. We included all female cases of urogenital CT 15 years or older who resided in King County and were diagnosed between 2010 and 2018. Surveillance data included information on demographics, sexual history, clinical features, diagnosing facility (eg, emergency department, family planning), and treatment regimen. We conducted descriptive analyses to examine trends in prescribing practices over time and by facility type. We used Poisson regression to examine the association between CT case characteristics and receipt of receipt of azithromycin.

Results

There were 36,830 cases of female urogenital CT during the study period. The percent of cases receiving azithromycin increased significantly from 86% in 2010 to 94% in 2018; the percent receiving doxycycline decreased from 13% to 5%. Five of the 8 facility types prescribed azithromycin to >95% of CT cases by 2018. Cases who were younger or cases of color were more likely to receive azithromycin (versus doxycycline) compared with older and White cases, respectively.

Conclusions

A substantial shift in CT prescribing practices will be needed to adhere to new CT treatment guidelines. Our findings highlight the need for targeted provider education and training to encourage the transition to doxycycline use.
Assessing the Validity of the Social Impact Scale Among a Longitudinal Cohort of Adolescents and Young Adults Living With Perinatally Acquired HIV
Authors: Poku Ohemaa , Attoh-Okine Naa-Djama , Corbeil Thomas , Chen Ying , Kluisza Luke , Ahmed Afifa , Liotta Lucy , Morrison Corey , Dolezal Curtis , Robbins Reuben N. , Mellins Claude A.
Published: February 2024

Background:

With few psychometrically evaluated HIV-related stigma measures for adolescents and young adults living with HIV, we examined the developmental applicability (ie, validity) of 2 subscales of the commonly used stigma measure, the Social Impact Scale, among a cohort of adolescents and young adults with perinatally acquired HIV.

Setting:

Data were obtained from a New York City longitudinal study (N = 340). This study primarily comprised Black and Latinx adolescents and young adults with either perinatally acquired HIV or those with perinatal exposure but who are uninfected. Data for this analysis were obtained from the population with perinatally acquired HIV and spanned approximately a 15-year survey period (2003–2018).

Methods:

A confirmatory factor analysis was used at 7 time points to assess whether the Social Rejection and Internalized Shame subscales were consistent in this cohort over time. Overall and individual Cronbach alphas were reported to show the strength of the internal consistency.

Results:

The mean age from baseline to follow-up 6 ranged from 12 to 23 years over the study period. The Social Rejection subscale was acceptably valid across follow-up periods with strong factor loadings and Cronbach alphas higher than 0.70. However, the Internalized Shame subscale was less valid among younger adolescents. Starting at follow-up 2, we observed better validity with the Internalized Shame subscale performance.

Conclusion:

Future research must consider mechanisms for developing and adapting measures from a developmental perspective to best measure the experiences of HIV-related stigma among younger populations.
FDG PET/CT Imaging of Liver and Spleen Histiocytic Sarcoma
Authors: Gan Meifu , He Xiaoxiao , Zheng Xiaohe
Published: February 2024

Histiocytic sarcoma is a tumor of the lymphohematopoietic system characterized by macrophage morphology and immunophenotype. Here, we report FDG PET/CT images of a 50-year-old man with coexisting histiocytic sarcoma of the liver and spleen. Images showed multiple enhanced uptake lesions of FDG in both the liver and spleen. Ultimately, histiocytic sarcoma was confirmed by the biopsy histopathology.
Intraoperative Neurophysiologic Monitoring and Mapping During Surgery on Intramedullary Spinal Cord Tumors in Children and Adolescents
Authors: Seidel Kathleen , Deletis Vedran , Raabe Andreas , Lutz Katharina , Schucht Philippe
Published: February 2024

Surgical resection of intramedullary spinal cord tumors carries significant risks of neurologic deficits, especially in cases of infiltrative tumors. In pediatric patients, this type of surgery may be associated with a high risk of poor neurologic outcome. Intraoperative neurophysiologic monitoring has been adopted as part of the clinical routine by many centers as a useful adjunct for intraoperative assessment of neurologic integrity. To what extent intraoperative neurophysiologic mapping strategies may further support intraoperative decision-making is still a matter of debate. Here, we report on a small cohort of five pediatric patients in whom mapping with the double-train paradigm was used to identify the dorsal column and corticospinal tract and to guide the surgical resection. We also discuss the possible benefits and challenges regarding the available literature.
Electroacupuncture alleviates streptozotocin-induced diabetic neuropathic pain via suppressing phosphorylated CaMKIIα in rats
Authors: Li Siyi , Zheng Yinmu , Kang Yurong , He Xiaofen , Zheng Yu , Jiang Minjian , Xu Xinnan , Ma Liqian , Wang Xiaoxiang , Zhang Kunlong , Shao Xiaomei , Fang Jianqiao , Jiang Yongliang
Published: February 2024

Diabetic neuropathic pain (DNP) is a frequent complication of diabetes. Calcium/calmodulin-dependent protein kinase II α (CaMKIIα), a multi-functional serine/threonine kinase subunit, is mainly located in the surface layer of the spinal cord dorsal horn (SCDH) and the primary sensory neurons in dorsal root ganglion (DRG). Numerous studies have indicated electroacupuncture (EA) takes effect in various kinds of pain. In this research, we explored whether CaMKIIα on rats’ SCDH and DRG participated in DNP and further explored the mechanisms underlying the analgesic effects of EA. The DNP model in rats was successfully established by intraperitoneal injection of streptozotocin. Certain DNP rats were treated with intrathecal injections of KN93, a CaMKII antagonist, and some of the DNP rats received EA intervention. The general conditions, behaviors, the expressions of CaMKIIα and phosphorylated CaMKIIα (p-CaMKIIα) were evaluated. DNP rats’ paw withdrawal threshold was reduced and the expressions of p-CaMKIIα in SCDH and DRG were upregulated compared with the Normal group, while the level of CaMKIIα showed no significance. KN93 attenuated DNP rats’ hyperalgesia and reduced the expressions of p-CaMKIIα. We also found EA attenuated the hyperalgesia of DNP rats and reduced the expressions of p-CaMKIIα. The above findings suggest that p-CaMKIIα in SCDH and DRG is involved in DNP. The analgesic effect of EA in DNP might be related to the downregulation of p-CaMKIIα expression level. Our study further supports that EA can be an effective clinical treatment for DNP.
Sf3b4mutation inXenopus tropicaliscauses RNA splicing defects followed by massive gene dysregulation that disrupt cranial neural crest development
Authors: Griffin Casey , Coppenrath Kelsey , Khan Doha , Lin Ziyan , Horb Marko , Saint-Jeannet Jean-Pierre
Published: February 2024

Nager syndrome is a rare craniofacial and limb disorder characterized by midface retrusion, micrognathia, absent thumbs, and radial hypoplasia. This disorder results from haploinsufficiency of SF3B4 (splicing factor 3b, subunit 4) a component of the pre-mRNA spliceosomal machinery. The spliceosome is a complex of RNA and proteins that function together to remove introns and join exons from transcribed pre-mRNA. While the spliceosome is present and functions in all cells of the body, most spliceosomopathies – including Nager syndrome – are cell/tissue-specific in their pathology. In Nager syndrome patients, it is the neural crest (NC)-derived craniofacial skeletal structures that are primarily affected. To understand the pathomechanism underlying this condition, we generated aXenopus tropicalis sf3b4mutant line using the CRISPR/Cas9 gene editing technology. Here we describe thesf3b4mutant phenotype at neurula, tail bud, and tadpole stages, and performed temporal RNA-sequencing analysis to characterize the splicing events and transcriptional changes underlying this phenotype. Our data show that while loss of one copy ofsf3b4is largely inconsequential inXenopus tropicalis, homozygous deletion ofsf3b4causes major splicing defects and massive gene dysregulation, which disrupt cranial NC cell migration and survival, thereby pointing at an essential role of Sf3b4 in craniofacial development.
Generation and analysis of a mouse multi-tissue genome annotation atlas
Authors: Adams Matthew , Vollmers Christopher
Published: February 2024

Generating an accurate and complete genome annotation for an organism is complex because the cells within each tissue can express a unique set of transcript isoforms from a unique set of genes. A comprehensive genome annotation should contain information on what tissues express what transcript isoforms at what level. This tissue-level isoform information can then inform a wide range of research questions as well as experiment designs. Long-read sequencing technology combined with advanced full-length cDNA library preparation methods has now achieved throughput and accuracy where generating these types of annotations is achievable.

Here, we show this by generating a genome annotation of the mouse (Mus musculus). We used the nanopore-based R2C2 long-read sequencing method to generate 64 million highly accurate full length cDNA consensus reads - averaging 5.4 million reads per tissue for a dozen tissues. Using the Mandalorion tool we processed these reads to generate theTissue-levelAtlas ofMouseIsoforms (TAMI - available athttps://genome.ucsc.edu/s/vollmers/TAMI) which we believe will be a valuable complement to conventional, manually curated reference genome annotations.
Task Activation Results in Regional13C-Lactate Signal Increase in the Human Brain
Authors: Uthayakumar Biranavan , Cappelletto Nicole I.C. , Bragagnolo Nadia D. , Chen Albert P. , Ma Nathan , Perks William J. , Endre Ruby , Tam Fred , Graham Simon J. , Heyn Chris , Keshari Kayvan R. , Soliman Hany , Cunningham Charles H.
Published: February 2024

Hyperpolarized-13C magnetic resonance imaging (HP-13C MRI) was used to image changes in13C-lactate signal during a visual stimulus condition in comparison to an eyes-closed control condition. Whole-brain13C-pyruvate,13C-lactate and13C-bicarbonate production was imaged in healthy volunteers (N=6, ages 24-33) for the two conditions using two separate hyperpolarized13C-pyruvate injections. BOLD-fMRI scans were used to delineate regions of functional activation.13C-metabolite signal was normalized by13C-metabolite signal from the brainstem and the percentage change in13C-metabolite signal conditions was calculated. A one-way Wilcoxon signed-rank test showed a significant increase in13C-lactate in regions of activation when compared to the remainder of the brain (p= 0.02, V = 21). No significant increase was observed in13C-pyruvate (p= 0.11, V = 17) or13C-bicarbonate (p= 0.95, V = 3) signal. The results show an increase in13C-lactate production in the activated region that is measurable with HP-13C MRI.
Curing of a field strain ofSalmonella entericaserovar Infantis isolated from poultry from its highly stable pESI like plasmid
Authors: Gruzdev Nadia , Katz Chen , Yadid Itamar
Published: February 2024

Salmonella entericaserovar Infantis (S. Infantis) is an important emerging pathogen, associated with poultry and poultry products and related to an increasing number of human infections in many countries. A concerning trend amongS. Infantis isolates is the presence of plasmid-mediated multi-drug resistance. In many instances, the genes responsible for this resistance are carried on a megaplasmid known as the plasmid of emergingS. Infantis (pESI) or pESI like plasmids. Plasmids can be remarkably stable due to the presence of multiple replicons and post-segregational killing systems (PSKs), which contribute to their maintenance within bacterial populations. To enhance our understanding ofS. Infantis and its multidrug resistance determinants toward the development of new vaccination strategies, we have devised a method for targeted plasmid curing. This approach effectively overcomes plasmid addiction by leveraging the temporal overproduction of specific antitoxins coupled with the deletion of the partition region. By employing this strategy, we successfully generated a plasmid-free strain from a field isolate derived fromS. Infantis 119944.

This method provides valuable tools for studyingS. Infantis and its plasmid-borne multidrug resistance mechanisms.