bluuebunny/crossref_metadata_2025 huggingface dataset:
Pelvic inflammatory disease is associated with ovarian cancer development in women with endometriosis: A cohort study in Taiwan
Authors: Lo Hui‐Wen , Weng Shih‐Feng , Chen Hung‐Sheng , Tsai Eing‐Mei
Published: September 2021

Objective

Endometriosis and pelvic inflammatory disease are considered to be risk factors for ovarian cancer, as dysbiosis probably contributes to ovarian cancer development via chronic inflammation and immune response alteration. Therefore, we hypothesized that pelvic inflammatory disease predisposes to ovarian cancer development in women with endometriosis.

Methods

We selected patients who were diagnosed with endometriosis or pelvic inflammatory disease between January 1, 2000 and December 31, 2015, in a 2 million longitudinal health and welfare database in Taiwan with cancer and death registries. Patients were divided into five groups: (1) those with endometriosis, (2) those with pelvic inflammatory disease, (3) those with endometriosis diagnosed before pelvic inflammatory disease, (4) those with pelvic inflammatory disease diagnosed before endometriosis, and (5) healthy women. Propensity score matching with inverse probability of treatment weighting was used to adjust for covariates across the study groups.

Results

The risk of ovarian cancer was significantly higher in women with endometriosis and subsequent pelvic inflammatory disease than in those with endometriosis alone (hazard ratio 8.07; 95% confidence interval 4.53–14.37; P < 0.001). The same result was found for ovarian cancer incidence per 1000 person‐years.

Conclusion

Our data show that pelvic inflammatory disease is associated with cancer development in women with pre‐existing endometriosis.
Observations and reports of incidents of how birthing persons are treated during childbirth in two public facilities in Argentina
Authors: Correa Malena , Klein Karen , Vasquez Paula , Williams Caitlin R. , Gibbons Luz , Cormick Gabriela , Belizan María
Published: September 2021

Objective

This study sought to estimate the frequency and types of mistreatment during childbirth and explore health professionals’ opinions on barriers/facilitators to providing respectful childbirth care.

Methods

This prospective mixed‐methods investigation consisted of direct observations of childbirth (n = 250), at‐home surveys with birthing individuals (n = 45), and qualitative in‐depth health staff interviews (n = 6), conducted between January and July 2019, in two public facilities in Argentina. Frequencies of clinical practices and mistreatment and 5% confidence intervals were calculated. A logistic regression analysis was also conducted to examine associations between mistreatment and covariates of interest, with P < 0.05 considered statistically significant.

Results

Overall, 61/250 (24.4%, confidence interval 19.6%–30.6%) observations recorded instances of mistreatment; 20/45 surveyed participants (44.4%) reported at least one episode of mistreatment. The most frequent perpetrators were physicians (35.6%), birth companions (24.4%), midwives (22.2%), and nurses (13.3%). Participants with lower educational attainment and those racialized as non‐white had higher odds of being mistreated. Health providers reported that respectful childbirth is currently widely implemented due to authorities’ and communities’ awareness on respectful birth´s rights.

Conclusion

Almost a quarter of birthing people were observed to suffer mistreatment – primarily verbal abuse – and 44.4% of surveyed individuals reported mistreatment. Future research is needed to determine how to ensure the provision of respectful childbirth care for all.

A quarter of participants experienced mistreatment; mostly those with lower educational attainment and/or racialized as non‐white. Further research on implementation of respectful childbirth is warranted.
A case of pyelocalyceal diverticulum urothelial carcinoma that was difficult to distinguish from cystic renal cell carcinoma preoperatively
Authors: Matsuda Iori , Miyauchi Yasuyuki , Miura Takayoshi , Kato Takuma , Tsunemori Hiroyuki , Kimura Nachino , Miyai Yumi , Haba Reiji , Sugimoto Mikio
Published: September 2021

Introduction

Pyelocalyceal diverticulum is a rare disease sometimes difficult to distinguish from cysts. We report a case of urothelial carcinoma originating from a pyelocalyceal diverticulum, difficult to distinguish from cystic renal cell carcinoma preoperatively.

Case presentation

A 51‐year‐old Japanese man complained of gross hematuria. Computed tomography revealed a solid mass in one of the many cystic lesions in the left kidney. He was diagnosed with left cystic renal cell carcinoma and underwent retroperitoneal laparoscopic nephrectomy. Pathological examination revealed high‐grade invasive urothelial carcinoma arising within the renal pyelocalyceal diverticulum. The definitive diagnosis was high‐grade invasive urothelial carcinoma (pT3). In retrospect, the retrograde pyelography findings indicated the cyst and urinary tract connection. Residual ureterectomy and adjuvant chemotherapy were later performed. The patient has since been recurrence‐free.

Conclusion

Whether cystic renal cell carcinoma is suspected on imaging, pyelocalyceal diverticulum should be considered a differential diagnosis, though unlikely to be encountered in daily practice.
Information‐centric vehicular social network routing scheme in smart city
Authors: Fang Xiaoyi , Shi Junling , Wen Yingyou , Yang Zhaoyu , Zhang Xinran
Published: September 2021

Smart cities call for the smart communication among vehicles, which requests for efficient routing schemes in Vehicle Ad hoc Network (VANET). As a kind of VANET, Vehicle Social Network (VSN) benefits from social attributes among vehicle drivers or passengers to improve the routing performance. However, traditional VSN routing schemes cannot well solve the mobilities of vehicles. Since Information‐Centric Network supports the mobility naturally, in this paper, we propose a information‐centric VSN routing scheme. An Information‐centric Utility‐based Forwarding Scheme is proposed to make optimal message forwarding among vehicle nodes, which the utility is calculated based on the devised message caching priority, the proposed interest similarity and the physical metric. Simulation results have shown that the proposed scheme has a great advantage on delivery rate and network overhead.
Hematopoietic progenitor cell counting can optimize peripheral blood stem cell apheresis process
Authors: Reberšek Katarina , Furlan Tadej , Zver Samo , Podgornik Helena
Published: September 2021

Introduction

Monitoring of stem cell concentration in transplantation settings is crucial to determine the optimal time of apheresis and is currently based on enumeration of CD34+ cells by flow cytometry. No surrogate marker has replaced CD34+ cell enumeration to date. The aim of this study was the evaluation of the hematopoietic progenitor cell (HPC) parameter of the Sysmex XN‐1000 analyzer in terms of optimizing the peripheral blood stem cell apheresis process.

Materials and Methods

Results of flow cytometric CD34+ cell and Sysmex HPC count were compared in 208 preharvest samples and 139 apheresis products.

Results

HPC and CD34+ cell counts showed significant differences in the multiple myeloma (MM) group. The correlation between preharvest HPC and CD34+ cell counts was good in the MM group (rho = .613) and strong in the lymphoma group (rho = .802), allogeneic donors (rho = .923), and other group of samples (rho = .816). The HPC positive cutoff demonstrating 100% specificity and positive predictive value for MM patients was high for ≥20/μL and ≥10/μL CD34+ cell counts, and therefore of limited value. The HPC negative cutoff demonstrating 100% sensitivity and negative predictive value was approximately <4/μL, irrespective of diagnosis.

Conclusions

Based on proposed HPC positive cutoffs (≥31/μL in the lymphoma group and ≥11/μL in the other group of samples), routine HPC enumeration could improve the workflow by replacing CD34+ cell counting in allogeneic donors as well as non‐MM patients. Furthermore, based on proposed HPC negative cutoff (<4/μL), CD34+ cell counting could be fully omitted in donors and patients that are not adequately mobilized.
The relationship between problematic Internet use in adolescents and emotion regulation difficulty and family Internet attitude
Authors: Günaydın Nevin , Kaşko Arıcı Yeliz , Kutlu Fatma Y. , Yancar Demir Esra
Published: September 2021

The study aims to determine the relationship between problematic Internet use in adolescents and emotion regulation difficulty and family Internet attitude. The study used a descriptive and correlational design. The sample of the study consisted of 5916 students. The data were collected using the “Problematic Internet Use Scale,” “Difficulties in Emotion Regulation Scale,” “Internet Parental Style Scale.” The total score on the Problematic Internet Use Scale was 55.41 ± 19.60 while the total score on the Difficulties in Emotion Regulation Scale was 97.51 ± 17.84. Considering the Internet parental styles, it was found that 42.89% of the parents had a negligent attitude. According to the results of the logistic regression analysis performed, grade level was found to affect problematic Internet use. A highly significant correlation was found between problematic Internet use and emotional regulation difficulties and family control of family Internet attitude (p < 0.01). This study determined that adolescents' grade level and excessive Internet use of the father were effective in the problematic Internet use of the adolescents. Adolescents' difficulties in emotion regulation and the type of families' attitudes towards Internet use were associated with problematic Internet use. In accordance with these results, it can be recommended to form programs to decrease problematic Internet use.
Whether Immunostimulants Are Effective in Susceptible Children Suffering From Recurrent Respiratory Tract Infections: A Modeling Analysis Based on Literature Aggregate Data
Authors: Zhang Weilong , Huang Jihan , Liu Hongxia , Wen Xin , Zheng Qingshan , Li Lujin
Published: September 2021

Immunostimulants are gradually being used in the prevention and treatment of recurrent respiratory tract infections in susceptible children, but their drug effects have not been quantified. The purpose of this study was to confirm the efficacy of immunostimulants in the prevention and treatment of recurrent respiratory tract infections in susceptible children. A model‐based meta‐analysis was used to describe the time course of placebo and immunostimulants in the prevention of respiratory tract infections in children. The cumulative number of respiratory tract infections was used as an indicator of efficacy. A meta‐analysis was used to analyze the incidence of drug‐related adverse events. Fourteen articles with 2400 pediatric subjects were finally included in the analysis. The results showed that the cumulative number of respiratory tract infections increased linearly with time, with the incidence of respiratory tract infections in the placebo group being 0.65 (95% confidence interval [CI], 0.55‐0.75) per month. OM‐85 BV and pidotimod reduced the incidence of respiratory tract infections by 0.21 (95%CI, 0.16‐0.26) and 0.19 (95%CI, 0.17‐0.21) compared to placebo per month, respectively. Pidotimod and OM‐85 BV can effectively reduce the incidence of respiratory tract infections in susceptible children, with no significant increase in the incidence of drug‐related adverse events when compared with placebo (risk ratio values were 1.07 [95%CI, 0.66‐1.71] and 1.31 [95%CI, 0.54‐3.19], respectively). This study provides quantitative support for the application of immunostimulants for the prevention of recurrent respiratory tract infections in children.
Gut barrier and microbiota changes with glycine and branched‐chain amino acid supplementation in chronic haemodialysis patients
Authors: Genton Laurence , Pruijm Menno , Teta Daniel , Bassi Isabelle , Cani Patrice D. , Gaïa Nadia , Herrmann François R. , Marangon Nicola , Mareschal Julie , Muccioli Giulio G. , Stoermann Catherine , Suriano Francesco , Wurzner‐Ghajarzadeh Arlene , Lazarevic Vladimir , Schrenzel Jacques
Published: September 2021

Background

We have previously shown that glycine increases fat‐free mass in chronic haemodialysis patients with features of malnutrition as compared with branched‐chain amino acids (BCAAs). This multicentre randomized double‐blind crossover study evaluates the impact of these amino acids on the gut barrier and microbiota.

Methods

Haemodialysis patients were included if they had plasma albumin <38 g/L or weight loss >5% of dry body weight, and daily dietary intakes <30 kcal/kg and <1 g protein/kg. They consumed glycine or BCAA (7 g twice daily) for 4 months and underwent a 1 month washout period, before crossover of supplementations. Faecal microbiota (16S rRNA gene sequencing) and immunoglobulin A (IgA), serum levels of cytokines, surrogate markers of intestinal permeability, appetite mediators, and endocannabinoids were obtained at the start and end of each supplementation. Supplementations were compared by multiple mixed linear regression models, adjusted for age, sex, month of supplementation (0 and 4 in each period), and period (Period 1: first 4 months; Period 2: last 4 months). Microbiota comparisons were performed using principal coordinate analysis and permutational multivariate analysis of variance, Shannon diversity index estimate and analysis of composition of microbiomes analysis, and Wilcoxon tests.

Results

We analysed 27 patients compliant to the supplementations. Multiple mixed linear regression models were significant only for interleukin‐6 (P = 0.002), glucagon‐like peptide 1 (P = 0.028), cholecystokinin (P = 0.021), and peptide YY (P = 0.002), but not for the other outcomes. The significant models did not show any impact of the type of supplementation (P < 0.05 in all models). Principal coordinate analysis and permutational multivariate analysis of variance (P = 0.0001) showed strong microbiota clustering by subject, but no effect of the amino acids. Bacterial alpha diversity and zero‐radius operational taxonomic unit richness remained stable, whatever the supplementation. Lacticaseibacillus paracasei (0.030; Q1–Q3 0.008–0.078 vs. 0.004; Q1–Q3 0.001–0.070) and Bifidobacterium dentium (0.0247; Q1–Q3 0.002–0.191 vs. 0.003; Q1–Q3 0.001–0.086) significantly decreased with the BCAA supplementation.

Conclusions

The BCAA and glycine supplementations had no impact on the serum levels of cytokines, appetite mediators, intestinal permeability, endocannabinoids, or faecal IgA. Overall faecal microbiota composition and microbial diversity did not change with the glycine or BCAA supplementation but decreased the abundance of L. paracasei and B. dentium.
Longitudinal association of sarcopenia and mild cognitive impairment among older Mexican adults
Authors: Salinas‐Rodríguez Aarón , Palazuelos‐González Rosa , Rivera‐Almaraz Ana , Manrique‐Espinoza Betty
Published: September 2021

Background

Recent evidence from cross‐sectional and longitudinal studies supports the hypothesis that sarcopenia is associated with worsening cognitive function. However, primary evidence largely comes from high‐income countries, whereas in low‐ and middle‐income countries, this association has been underexplored. This study aimed to estimate the longitudinal association between sarcopenia and mild cognitive impairment in a sample of older Mexican adults.

Methods

Data come from the three waves of the World Health Organization (WHO) Study on Global AGEing and Adult Health (SAGE) in Mexico (2009, 2014, 2017). Four hundred ninety‐six older adults, aged ≥50, were included. Sarcopenia was defined as having low muscle quantity and either/both slow gait speed and weak handgrip strength. Mild cognitive impairment was determined based on the recommendations of the National Institute on Aging‐Alzheimer's Association. Cognitive function was evaluated by a composite cognitive score of five different cognitive tests: immediate and delayed recall, forward and backward digit span and semantic verbal fluency. Three‐level mixed‐effects models (logistic and linear) were used to estimate the longitudinal associations between sarcopenia, mild cognitive impairment and cognitive function.

Results

The prevalence of mild cognitive impairment (8.9%, 12.9%, 16.0%) and sarcopenia (10.5%, 20.7%, 23.3%) showed a significant temporal increase for Waves 1, 2 and 3 (P‐value < 0.01, respectively). The presence of sarcopenia was significantly associated with mild cognitive impairment (OR = 1.74; CI95% 1.02, 2.96; P = 0.04) and worse cognitive function (β = −0.57; CI95% ‐0.93, −0.21; P < 0.01). We observed significant associations between sarcopenia and immediate verbal recall (β = −0.14; CI95% −0.28, −0.01; P = 0.04), delayed verbal recall (β = −0.12; CI95% −0.23, −0.01; P = 0.03) and semantic verbal fluency (β = −0.17; CI95% −0.28, −0.05; P = 0.01). The prevalence of mild cognitive impairment increased at an annual rate of 0.8% for non‐sarcopenic older adults, but nearly 1.5% for sarcopenic adults.

Conclusions

Significant longitudinal associations were observed between sarcopenia, mild cognitive impairment and cognitive function among older Mexican adults. Public health strategies, including policy research and clinical interventions, must be implemented in low‐ and middle‐income countries in order to reduce or delay the onset of sarcopenia and thus improve population‐level cognitive health among older adults.
Ultrasound of the symptomatic shoulder arthroplasty: Spectrum and prevalence of periarticular soft tissue pathology
Authors: Goldman Lauren , Walter William , Adler Ronald S. , Kaplan Daniel , Burke Christopher J.
Published: September 2021

Purpose

To describe our experience using ultrasound (US) to evaluate postoperative complications in the presence of in situ shoulder arthroplasty.

Methods

Review of patients who underwent US evaluation following total shoulder arthroplasty (TSA), reverse total shoulder arthroplasty (RTSA) or hemiarthroplasty from 2007 to 2020. All studies were reviewed independently by two musculoskeletal radiologists to assess for joint effusion, periarticular collection, and characterization of associated rotator cuff tears. Tendon tears were assessed with respect to (1) thickness: low grade (<50% thickness), high grade (>50% thickness), full thickness; (2) morphology (focal vs. diffuse) and location (insertion vs. critical zone). Inter‐reader agreements were determined using Cohen's kappa test.

Results

Ninety‐seven studies were performed in 72 patients following TSA, RTSA, or hemiarthroplasty. Thirty‐seven exams were solely for diagnostic purposes, and 59 were for guiding joint or periarticular collection aspiration. Twenty‐eight studies assessed the cuff tendons post TSA. The mean time between surgery and US examination was 29.2 months. Complete or high‐grade tears were identified in 8/28 (28.6%) diagnostic exams. The most commonly torn tendon among TSA patients was the subscapularis, with 13/28 (46.4%) demonstrating at least partial tearing. Inter‐reader agreement was excellent for presence of effusion (k = 0.79, p < .001) and periarticular collection (k = 0.87, p < .001), and excellent agreement for presence of subscapularis tear (k = 0.78, p < .001), with fair agreement for assessment of supraspinatus (k = 0.66, p < .001) and infraspinatus (k = 0.60, p < .001) tears.

Conclusion

The most commonly torn tendon following anatomic TSA identified by US was the subscapularis, which was torn or deficient in 46.4% of cases. The majority of studies were performed for the guidance of percutaneous aspiration.
Exercise interventions in child and adolescent mental health care: An overview of the evidence and recommendations for implementation
Authors: Carney Rebekah , Firth Joseph
Published: September 2021

Background

The use of physical activity interventions in mental health care for adults has a large academic evidence base and numerous examples of real‐world implementation. However, the use of physical activity within mental health care for children and young people (CYP) has received less attention to date.

Methods

A narrative review was conducted to summarize the relevant literature in the area. Online databases were searched using terms synonymous with CYP, exercise, physical health, and mental health. Findings from existing systematic reviews, meta‐analyses, meta‐syntheses, and consensus statements were reviewed, and used alongside the authors' experience to inform clinical recommendations.

Results

We first discuss the importance of applying physical health interventions in early stages of mental illness for CYP to prevent physical comorbidities and premature mortality in the long term. We then provide a brief summary of the current evidence of the benefits of exercise interventions in CYP with mental illness. We then present our top five recommendations on the implementation of exercise interventions within CYP mental health care.

Conclusion

The key conclusions from this suggest there is an increasingly strong evidence base for the benefits of using physical activity interventions to improve, prevent, and manage physical and mental health outcomes in CYP with mental illness. However, more work needs to be done to improve the evidence base, refine its implementation into standard mental health care, and develop strategies for large‐scale dissemination of such interventions across various care and cultural contexts.
Rethinking genetic counseling clinical skills training in the time of COVID‐19
Authors: Stallman Chris , Kieran Shannon , Quinn Dorothy , Schaibley Valerie M.
Published: September 2021

The COVID‐19 pandemic has had a significant impact on clinical training programs, including genetic counseling graduate programs. The University of Arizona Genetic Counseling Graduate Program responded to limited clinical training opportunities by designing a virtual Clinical Skills Workshop for incoming genetic counseling students. During the workshop, students were introduced to psychosocial and clinical genetics skills through virtual lectures, role‐play, and practice sessions, as well as assignments. Program evaluation of the Clinical Skills Workshop demonstrated better preparation of key clinical skills prior to starting clinical rotations and highlighted areas for improvement in future iterations. Although this workshop was developed in response to clinical restrictions due to COVID‐19, this approach to providing incoming students with basic clinical skills has been a valuable addition to the UAGCGP curriculum.
Prostate Cancer Diffusion‐Weighted Magnetic Resonance Imaging: Does the Choice of Diffusion‐Weighting Level Matter?
Authors: Maier Stephan E. , Wallström Jonas , Langkilde Fredrik , Johansson Jens , Kuczera Stefan , Hugosson Jonas , Hellström Mikael
Published: September 2021

Background

Diffusion‐weighted magnetic resonance imaging plays an important role in multiparametric assessment of prostate lesions. The derived apparent diffusion coefficient (ADC) could be a useful quantitative biomarker for malignant growth, but lacks acceptance because of low reproducibility.

Purpose

To investigate the impact of the choice of diffusion‐weighting levels (b‐values) on contrast‐to‐noise ratio and quantitative measures in prostate diffusion‐weighted MRI.

Study Type

Retrospective and simulation based on published data.

Subjects

Patient cohort (21 men with Prostate Imaging‐Reporting and Data System (PI‐RADS) version 2 score ≥3) from a single‐center study.

Field Strength/Sequence

3 T/diffusion‐weighted imaging with single‐shot echo‐planar imaging.

Assessment

Both clinical data and simulations based on previously acquired data were used to quantify the influence of b‐value choice in normal peripheral zone (PZ) and PZ tumor lesions. For clinical data, ADC was determined for different combinations of b‐values. Contrast‐to‐noise ratio and quantitative diffusion measures were simulated for a wide range of b‐values.

Statistical Tests

Tissue ADC and the lesion‐to‐normal tissue ADC ratios of different b‐value combinations were compared with paired two‐tailed Student's t‐tests. A P‐value <0.05 was considered statistically significant.

Results

Findings about b‐value dependence derived from clinical data and from simulations agreed with each other. Provided measurement was limited to two b‐values, simulation‐derived optimal b‐value choices coincided with PI‐RADSv2 recommendations. For two‐point measurements, ADC decreased by 15% when the maximum b‐value increased from 1000 to 1500 seconds/mm2, but corresponding lesion‐to‐normal tissue ADC ratio showed no significant change (P = 0.86 for acquired data). Simulations with three or more measurement points produced ADCs that declined by only 8% over this range of maximum b‐value. Corresponding ADC ratios declined between 2.6% (three points) and 3.8% (21 points). Simulations also revealed an ADC reduction of about 19% with the shorter echo and diffusion time evaluated.

Data Conclusion

The comprehensive assessment of b‐value dependence permits better formulation of protocol and analysis recommendations for obtaining reproducible results in prostate cancer diffusion‐weighted MRI.

Level of Evidence

4

Technical Efficacy

Stage 2
Collaborative learning in the professional development of medical radiation practitioners
Authors: Turner Michelle , Morasi Sanya , Mrsnik‐Hamdi Monica , Shanahan Madeleine
Published: September 2021

Introduction

Medical radiation practitioners (MRPs) participate in continuous professional development (CPD) to update their knowledge, skills, safety standards and patient care. The Medical Radiation Practice Board of Australia (MRPBA) recommends that practitioners participate in a variety of activities and to incorporate the use of collaborative learning tools. The aim of this research was to investigate the value, use and workplace supports for online and face‐to‐face collaborative learning for CPD.

Methods

A cross‐sectional online survey of Australian MRPs was conducted. The questionnaire was distributed via e‐blast from the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT) to members.

Results

A total of 115 completed questionnaires were received. Seminars, workshops and conferences were the most valued collaborative learning tools, with no significant difference in ranking observed (P > 0.05). The majority of MRPs regularly attend conferences (64%, n = 73) with those working in a metropolitan location more likely to attend. MRPs are supported by their workplace to attend conferences through the provision of paid leave (61%, n = 63), funding (50%, n = 52) and to a lesser extent travel expense (38%, n = 39). More than half (60%, n = 69) of the participants use social media for CPD with Facebook being the most frequently used and most useful online platform. The most common reasons for using social media for CPD were accessibility to information (85%, n = 56), little geographical limitations (77%, n = 51) and ease of use (74%, n = 49).

Conclusion

Medical radiation practitioners currently utilise both face‐to‐face and online collaborative learning tools to meet their CPD needs. Face‐to‐face tools are more frequently utilised and highly valued by MRPs.
Exact inference for fixed‐effects meta‐analysis of proportions
Authors: Hansen Spencer , Rice Kenneth
Published: September 2021

Meta‐analysis of proportions is conceptually simple: Faced with a binary outcome in multiple studies, we seek inference on some overall proportion of successes/failures. Under common effect models, exact inference has long been available, but is not when we more realistically allow for heterogeneity of the proportions. Instead a wide range of nonexact fixed‐effects methods are used, the interpretation of some of which is challenging. In this paper, we present methods for exact statistical tests and confidence intervals for fixed‐effects meta‐analysis of proportions. These methods retain the interpretability of the underlying parameter of interest, and can be implemented in straightforward software. We also show how our inference on the overall proportion is compatible with exact inference on heterogeneity of proportions. An illustrative example from a recent kidney disease study shows how the method's performance can be assessed in practice.
Regression in melanoma is significantly associated with a lower regional recurrence rate and better recurrence‐free survival
Authors: Subramanian Sarayu , Han Gang , Olson Natalie , Leong Stanley P. , Kashani‐Sabet Mohammed , White Richard L. , Zager Jonathan S. , Sondak Vernon K. , Messina Jane L. , Pockaj Barbara , Kosiorek Heidi E. , Vetto John , Fowler Graham , Schneebaum Schlomo , Han Dale
Published: September 2021

Background and Objectives

The prognostic significance of regression in predicting melanoma recurrences is unknown. We present a large multicenter study correlating regression with recurrence.

Methods

The Sentinel Lymph Node Working Group database was queried from 1993 to 2018 for cases with regression data. Clinicopathologic factors were correlated with overall and first‐site of recurrence and with recurrence‐free survival (RFS).

Results

There were 4790 patients and the median follow‐up was 39.6 months. Regression and recurrences were seen in 1081 (22.6%) and 773 (16.1%) cases, respectively. First‐site locoregional and distant recurrences were seen in 412 (8.6%) and 352 (7.3%) patients, respectively. Regression was seen in 15.8% and 24.7% of all cases with and without recurrences (p < 0.0001), respectively, while regression was seen in 14.3% and 17.9% of first‐site locoregional and distant recurrent cases, respectively, compared with 23.3% and 22.9% of patients with regression and without first‐site locoregional and distant recurrences, respectively (p = 0.29). On multivariable analysis, after controlling for age, gender, thickness, ulceration, lymphovascular invasion, and sentinel lymph node status, regression significantly predicted improved RFS (p = 0.004) and fewer first‐site regional recurrences (p = 0.017).

Conclusion

Our data suggest that regression is a favorable prognostic marker in melanoma and predicts significantly better RFS and decreased first‐site regional recurrences.
Fast liquid chromatography method for separation of peptides using a sub‐2 μm ground silica monolith packed column
Authors: Lu Yao , Yan Zhihong , Sun Genlin
Published: September 2021

A stationary phase based on sub‐2 μm ground silica monolith particles was fabricated by in situ polymerization and applied in micro‐column for separation of peptides. The sub‐2 μm silica particles were obtained from monolith using sol‐gel process followed by grinding and sedimentation to remove the fines. Initially, the silica monolith particles were pretreated with 3‐trimethoxysilyl propyl methacrylate to attach double‐bonded ligands onto the surface, then a network structure was formed onto the surface of the particle using styrene, N‐isopropylacrylamide, and ethylene glycoldimethacrylate. The effect of the flow rate of the mobile phase on the separation performance was investigated. The stationary phase was characterized by field emission scanning electron microscopy, thermogravimetry, particle size distribution, and element analysis. The resultant phase was packed in glass‐lined stainless steel micro‐columns (2.1 mm × 50 mm) and evaluated for fast separation. An average number of theoretical plates as high as 9800 plates/column (5.10 μm plate height) was achieved for five synthetic peptides under the optimized flow rate of 0.15 mL/min. The repeatabilities of column‐to‐column, intraday, and interday through relative standard deviation were found better than 4%, exhibiting satisfactory repeatability of the developed micro‐column for fast separation of peptides.
Recent forensic applications of enhanced chromatographic separation methods
Authors: Young Genetta M. , Lurie Ira S.
Published: September 2021

This study reviews the recent applications of enhanced separation methods employed in forensic analysis utilizing gas chromatography, liquid chromatography, and supercritical fluid chromatography published between 2015 to 2020, except papers previously covered in relevant review articles. Applications of enhanced chromatographic separation methods to arson investigations, environmental forensics, sexual assault investigations, drug analysis, and toxicology are discussed. Future directions for enhanced chromatographic separation methods in forensic science are also explored.
Lesser Known Uses of γ‐Aminobutyric Acid Analogue Medications in Otolaryngology
Authors: Miller Nathaniel , Noller Michael , Yang Alex , McCoul Edward D. , Tolisano Anthony M. , Riley Charles A.
Published: September 2021

Objectives/Hypothesis

In otolaryngology, γ‐aminobutyric acid (GABA) analogues have been previously analyzed for their roles in neuropathic pain, chronic cough, tinnitus, and perioperative analgesia. The primary aim of this study is to comprehensively summarize and synthesize the existing evidence for lesser known uses of gabapentin and pregabalin in otolaryngology.

Study Design

A scoping review conducted of the available English‐language literature was performed by two authors through April 1, 2021.

Methods

The Preferred Reporting Items for Systematic Review and Meta‐Analysis criteria were followed, and a quality assessment of included studies was performed using the Methodological Index for Non‐Randomized Studies.

Results

Ten studies met inclusion criteria. Three studies found that gabapentin may reduce gastrostomy tube usage and improve swallowing function in head and neck cancer patients undergoing radiation therapy (RT). Three studies suggested that gabapentin may help reduce opiate use when used as a primary analgesic in patients with radiation‐induced mucositis. One study demonstrated that pregabalin‐reduced trismus severity in patients with radiotherapy‐induced trismus. One study demonstrated gabapentin may be useful in patients with phonasthenia. Two studies demonstrated that GABA analogues may be a useful adjunct in patients with globus pharyngeus in the context of likely laryngeal sensory neuropathy.

Conclusions

The most promising potential uses for GABA analogues identified in this review are for improving swallowing, trismus, and narcotic overuse after RT. The benefit of GABA analogues for improving nonorganic voice disorders is also promising while the benefit for globus pharyngeus when possibly related to laryngeal sensory neuropathy is inconclusive. Laryngoscope, 132:954–964, 2022
Reduced interactivity during microbial community degradation leads to the extinction of Tricholomas matsutake
Authors: Zhou Hanchang , Ma Anzhou , Liu Guohua , Zhou Xiaorong , Yin Jun , Liang Yu , Wang Feng , Zhuang Guoqiang
Published: September 2021

Ecosystem degradation is a process during which different ecosystem components interact and affect each other. The microbial community, as a component of the ecosystem whose members often display high reproduction rates, is more readily able to respond to environmental stress at the compositional and functional levels, thus potentially threatening other ecosystem components. However, very little research has been carried out on how microbial community degradation affects other ecosystem components, which hampers the comprehensive understanding of ecosystems as a whole. In this study, we investigated the variation in a soil microbial community through the extinction gradient of an ectomycorrhizal species (Tricholomas matsutake) and explored the relationship between microbial community degradation and ectomycorrhizal species extinction. The result showed that during degradation, the microbial community switched from an interactive state to a stress tolerance state. During degradation, the interactivity of the microbial community decreased from average degree (avgK) 3.54 of undegraded state to 1.63 of degraded state, and the interactivity parameter was significantly related to T. matsutake dominance (R2 = 0.953, p < 0.05). The reduced community interactions with T. matsutake marginalized it from a large central interactive module (67 nodes with 399 intra‐module links and 86 inter‐module links) to a small peripheral module (four nodes with three intra‐module links and no inter‐module links), eventually leading to its extinction. This study highlights the mechanisms of T. matsutake extinction due to the loss of soil microbial community interactivity, offering valuable information about soil microbial community degradation and the plant ectomycorrhizal species conservation.
Development of a physiological model of human middle ear epithelium
Authors: Mather Michael William , Verdon Bernard , Botting Rachel Anne , Engelbert Justin , Delpiano Livia , Xu Xin , Hatton Catherine , Davey Tracey , Lisgo Steven , Yates Philip , Dawe Nicholas , Bingle Colin D. , Haniffa Muzlifah , Powell Jason , Ward Chris
Published: September 2021

Introduction

Otitis media is an umbrella term for middle ear inflammation; ranging from acute infection to chronic mucosal disease. It is a leading cause of antimicrobial therapy prescriptions and surgery in children. Despite this, treatments have changed little in over 50 years. Research has been limited by the lack of physiological models of middle ear epithelium.

Methods

We develop a novel human middle ear epithelial culture using an air‐liquid interface (ALI) system; akin to the healthy ventilated middle ear in vivo. We validate this using immunohistochemistry, immunofluorescence, scanning and transmission electron microscopy, and membrane conductance studies. We also utilize this model to perform a pilot challenge of middle ear epithelial cells with SARS‐CoV‐2.

Results

We demonstrate that human middle ear epithelial cells cultured at an ALI undergo mucociliary differentiation to produce diverse epithelial subtypes including basal (p63+), goblet (MUC5AC+, MUC5B+), and ciliated (FOXJ1+) cells. Mature ciliagenesis is visualized and tight junction formation is shown with electron microscopy, and confirmed by membrane conductance. Together, these demonstrate this model reflects the complex epithelial cell types which exist in vivo. Following SARS‐CoV‐2 challenge, human middle ear epithelium shows positive viral uptake, as measured by polymerase chain reaction and immunohistochemistry.

Conclusion

We describe a novel physiological system to study the human middle ear. This can be utilized for translational research into middle ear diseases. We also demonstrate, for the first time under controlled conditions, that human middle ear epithelium is susceptible to SARS‐CoV‐2 infection, which has important clinical implications for safe otological surgery.

Level of Evidence

NA.
Radiographic disease severity in chronic rhinosinusitis patients and health care utilization
Authors: Mehta Mitesh P. , Hur Kevin , Price Caroline P. E. , Shintani‐Smith Stephanie , Welch Kevin C. , Conley David B. , Kern Robert C. , Tan Bruce K.
Published: September 2021

Objectives

Chronic rhinosinusitis (CRS) affects approximately 12% of the population and leads to increased health care utilization and indirect costs exceeding $20 billion annually in the United States. The Lund‐Mackay score (LMS) measures radiographic disease severity for CRS but poorly correlates with symptom scores. The association between LMS and health care utilization in CRS patients has not yet been investigated. The study aimed to assess the association between health care utilization and CRS radiographic severity using LMS.

Methods

CRS patients enrolled in a clinical registry were evaluated. Nasal endoscopy findings and LMS were recorded for patients with sinus CT imaging. Patient symptom scores, demographic characteristics, and health care utilization measures were collected. The relationship between these factors and LMS was examined.

Results

A total of 556 patients met inclusion criteria. Mean age was 45.3 years, 53.4% were male, and 41.7% had nasal polyps. There was no difference in sex, smoking history, 22‐item Sino‐nasal Outcome Test scores, or past medical history factors between patients with high (≥8, n = 410) and low (<8, n = 146) LMS. Among high LMS patients, 73.7% underwent endoscopic sinus surgery (ESS) compared to 55.5% with low LMS (P < .01), and a greater percentage of patients had nasal polyps (49.3% vs 20.5%, P < .01). On multivariable logistic regression, high LMS patients used fewer antibiotic courses (OR: 0.68 [0.51‐0.91]), but were more likely to be managed with ESS (OR: 2.28 [1.41‐3.73]), and have nasal polyps (OR: 2.11 [1.16‐3.93]) compared to low LMS patients. There was no significant difference in the number of steroid courses, over the counter pill use, provider visits, work/school days missed, or symptom duration between the two LMS groups.

Conclusion

CRS patients with severe radiographic disease are more likely to have nasal polyps, undergo ESS, and take fewer antibiotic courses. However, there is no association between radiographic disease severity and other measures of health care utilization.

Level of Evidence

2b, individual retrospective cohort study.
Hydraulic and biological controls of biofilm nitrogen uptake in gravel‐bed streams
Authors: Anlanger Christine , Risse‐Buhl Ute , von Schiller Daniel , Noss Christian , Weitere Markus , Lorke Andreas
Published: September 2021

Epibenthic biofilms are important in regulating nitrogen (N) fluxes in stream ecosystems. The efficiency of the regulation is controlled by hydraulic and biological processes and their interactions. However, knowledge on the underlying physical and biological processes, their controlling parameters, and interactions in stream ecosystems is still limited. To analyze the relative importance of hydraulic and biological controls on biofilm N uptake, we measured turbulence, biofilm N uptake using a stable isotope tracer, and biofilm biomass in two gravel‐bed streams with contrasting nutrient concentrations for two seasons. We found high within‐stream variability in biofilm areal N uptake and uptake velocity, which exceeded variability between streams and seasons by 60% and 30%, respectively. Sixty‐four percent of the within‐stream variability in uptake velocity was explained by hydraulic mass transfer and biofilm characteristics, which were described in terms of the turbulent dissipation rate and the biofilm biomass, respectively. We show that surface renewal theory based on scales of the smallest turbulent eddies can be used to estimate transfer velocities at the sediment–water interface and can be extrapolated to larger scales by spatial averaging. Our results improved the mechanistic understanding of the processes regulating biofilm N uptake at small scale which contributes to the understanding of ecosystem functioning in low‐order streams and supports upscaling to larger spatiotemporal scales along stream networks.
Recent Improvement in Survival Outcomes and Reappraisal of Prognostic Factors in Pediatric Living Donor Liver Transplantation
Authors: Oh Seak Hee , Jeong In Sook , Kim Dae Yeon , Namgoong Jung‐Man , Jhang Won Kyoung , Park Seong Jong , Jung Dong‐Hwan , Moon Deok Bog , Song Gi‐Won , Park Gil‐Chun , Ha Tae‐Yong , Ahn Chul‐Soo , Kim Ki‐Hun , Hwang Shin , Lee Sung Gyu , Kim Kyung Mo
Published: September 2021

Living donor liver transplantation (LDLT) is a significant advancement for the treatment of children with end‐stage liver disease given the shortage of deceased donors. The ultimate goal of pediatric LDLT is to achieve complete donor safety and zero recipient mortality. We conducted a retrospective, single‐center assessment of the outcomes as well as the clinical factors that may influence graft and patient survival after primary LDLTs performed between 1994 and 2020. A Cox proportional hazards model was used for multivariate analyses. The trends for independent prognostic factors were analyzed according to the following treatment eras: 1, 1994 to 2002; 2, 2003 to 2011; and 3, 2012 to 2020. Primary LDLTs were performed on 287 children during the study period. Biliary atresia (BA; 52%), acute liver failure (ALF; 26%), and monogenic liver disease (11%) were the leading indications. There were 45 graft losses (16%) and 27 patient deaths (7%) in this population during the study period. During era 1 (n = 81), the cumulative survival rates at 1 and 5 years after LDLT were 90.1% and 81.5% for patients and 86.4% and 77.8% for grafts, respectively. During era 2 (n = 113), the corresponding rates were 92.9% and 92% for patients and 89.4% and 86.7% for grafts, respectively. During era 3 (n = 93), the corresponding rates were 100% and 98.6% for patients and 98.9% and 95.4% for grafts, respectively. In the multivariate analyses, primary diagnosis ALF, bloodstream infection, posttransplant lymphoproliferative disease, and chronic rejection were found to be negative prognostic indicators for patient survival. Based on generalized care guidelines and center‐oriented experiences, comprehensive advances in appropriate donor selection, refinement of surgical techniques, and meticulous medical management may eventually realize a zero‐mortality rate in pediatric LDLT.
Designing Tunable Omniphobic Surfaces by Controlling the Electropolymerization Sites of Carbazole‐Based Monomers
Authors: Fradin Caroline , Guittard Frédéric , Darmanin Thierry
Published: September 2021

Carbazole‐based monomers are electrodeposited in dichloromethane with different water content and water pH in order to control the surface micro‐ and nanostructures. The presence of water makes the depositions more porous by the formation of a micellar soft template. Due to the presence of the free amine groups, the water acidity plays a role on the structure of the monomers by protonation, limiting their polymerization ways and thus controlling the morphology of the structures. The wetting properties are tuned either by deprotonation of the depositions, or fluorinated postgrafting. Surfaces reach superhydrophobic and oleophobic properties.
Age of Onset of Huntington's Disease in Carriers of Reduced Penetrance Alleles
Authors: McDonnell Erin I. , Wang Yuanjia , Goldman Jill , Marder Karen
Published: September 2021

Background

Age of manifest Huntington's disease (HD) onset correlates with number of CAG repeats in the huntingtin gene. Little is known about onset with 36 to 39 repeats, the “reduced penetrance” (RP) range.

Objectives

We provide allele‐specific estimates of HD penetrance (diagnostic confidence level of 4) for RP allele carriers.

Methods

We analyzed 431 pre‐manifest RP allele carriers from Enroll‐HD, the largest prospective observational HD study. Cumulative penetrance (CP) was estimated from Kaplan–Meier curves.

Results

No one with 36 repeats (n = 25) phenoconverted. CP for 38 repeats (n = 120) was 32% (95% confidence interval [CI] 0%–55%) and 51% (CI, 10%–73%) by ages 70 and 75, respectively, and 68% (CI, 46%–81%) and 81% (CI, 58%–92%) by ages 70 and 75 for 39 repeats (n = 253). CP was not estimable at those ages for 37 repeats (n = 33).

Conclusions

Differences by RP‐range repeat length did not reach significance with a 3‐year median follow‐up duration among censored individuals. © 2021 International Parkinson and Movement Disorder Society