bluuebunny/crossref_metadata_2025 huggingface dataset:
CSF sTREM2 in neurological diseases: a two-sample Mendelian randomization study
Authors: Dong Ming-Hao , Zhou Luo-Qi , Tang Yue , Chen Man , Xiao Jun , Shang Ke , Deng Gang , Qin Chuan , Tian Dai-Shi
Published: April 2022

Background

Soluble triggering receptor expressed on myeloid cells 2 (sTREM2) in cerebrospinal fluid (CSF) has been described as a biomarker for microglial activation, which were observed increased in a variety of neurological disorders.

Objective

Our objective was to explore whether genetically determined CSF sTREM2 levels are causally associated with different neurological diseases by conducting a two-sample Mendelian randomization (MR) study.

Methods

Single nucleotide polymorphisms significantly associated with CSF sTREM2 levels were selected as instrumental variables to estimate the causal effects on clinically common neurological diseases, including stroke, Alzheimer’s diseases, Parkinson’s diseases, amyotrophic lateral sclerosis, multiple sclerosis, and epilepsy and their subtypes. Summary-level statistics of both exposure and outcomes were applied in an MR framework.

Results

Genetically predicted per 1 pg/dL increase of CSF sTREM2 levels was associated with higher risk of multiple sclerosis (OR = 1.038, 95%CI = 1.014–1.064, p = 0.002). Null association was found in risk of other included neurological disorders.

Conclusions

These findings provide support for a potential causal relationship between elevated CSF sTREM2 levels and higher risk of multiple sclerosis.
The effect of Ulinastatin on postoperative course in cardiopulmonary bypass patients in Asia: a meta-analysis of randomized controlled trials
Authors: Zhenyu Hu , Qiaoli Yuan , Guangxiang Chen , Maohua Wang
Published: April 2022

Objectives

To evaluate the effect of urinary trypsin inhibitor (UTI) or Ulinastatin on postoperative course and clinical outcomes in patients with cardiopulmonary bypass.

Methods

We searched PubMed, Embase, Web of Science, and Cochrane Library for the keywords UTI and Cardiopulmonary bypass (CPB). The primary outcome measure was the intensive care unit length of stay (ICU LOS), and results were stratified for relevant subgroups (dosage of UTI). The effects of UTI on mechanical ventilation duration (MVD), hospital LOS, renal failure incidence (RFI), and all-cause mortality were studied as secondary outcomes.

Results

Twelve randomized controlled trials (enrolling 1620 patients) were evaluated. Eleven studies pooled for subgroup analysis showed that using UTI persistently or with a considerable amount would lead to a shorter ICU LOS (95% CI, − 0.69 to − 0.06;P = 0.0001). Ten studies showed that UTI could shorten MVD in patients (95% CI, − 1.505 to − 0.473;P < 0.0001). RFI generally showed a more favourable outcome with UTI treatment (95%CI, 0.18–1.17;P = 0.10). And the current evidence was insufficient to prove that UTI could reduce the hospital LOS (95% CI, − 0.22 to 0.16;P = 0.75) and the all-cause mortality rate (95% CI, 0.24–2.30;P = 0.60).

Conclusions

Various subsets of UTI treatment suggested that UTI could shorten ICU LOS, and it is associated with the dosage of UTI. Considering the substantial heterogeneity and lack of criteria for UTI dosage, more evidence is needed to establish a standard dosing guideline.
PPFIA4 promotes castration-resistant prostate cancer by enhancing mitochondrial metabolism through MTHFD2
Authors: Zhao Ru , Feng Tingting , Gao Lin , Sun Feifei , Zhou Qianqian , Wang Xin , Liu Junmei , Zhang Wenbo , Wang Meng , Xiong Xueting , Jia Wenqiao , Chen Weiwen , Wang Lin , Han Bo
Published: April 2022

Background

The development of castration-resistant prostate cancer (CRPC) remains a major obstacle in the treatment of prostate cancer (PCa). Dysregulated mitochondrial function has been linked to the initiation and progression of diverse human cancers. Deciphering the novel molecular mechanisms underlying mitochondrial function may provide important insights for developing novel therapeutics for CRPC.

Methods

We investigate the expression of the protein tyrosine phosphatase receptor type F polypeptide interacting protein alpha 4 (PPFIA4) using public datasets and tumor specimens from PCa cases by immunohistochemistry. Gain- and loss-of-function studies are performed in PCa cell lines and mouse models of subcutaneous xenograft to characterize the role of PPFIA4 in CRPC. Gene expression regulation is evaluated by a series of molecular and biochemical experiments in PCa cell lines. The therapeutic effects of methylenetetrahydrofolate dehydrogenase 2 (MTHFD2) inhibitor combined enzalutamide are assessed using in vitro functional assays and in vivo mouse models.

Results

We show that the increase of PPFIA4 exacerbates aggressive phenotype resembling CRPC. A fraction of PPFIA4 localizes to mitochondria and interacts with MTHFD2, a key enzyme for one-carbon metabolism. Androgen deprivation increases the translocation of PPFIA4 into mitochondria and increases the interaction between PPFIA4 and MTHFD2, which result in the elevation of tyrosine phosphorylated MTHFD2. Consequently, the levels of NADPH synthesis increase, resulting in protection against androgen deprivation-induced mitochondrial dysfunction, as well as promotion of tumor growth. Clinically, PPFIA4 expression is significantly increased in CRPC tissues compared with localized PCa ones. Importantly, an MTHFD2 inhibitor, DS18561882, combined with enzalutamide can significantly inhibit CRPC cell proliferation in vitro and tumor growth in vivo.

Conclusion

Overall, our findings reveal a PPFIA4-MTHFD2 complex in mitochondria that links androgen deprivation to mitochondrial metabolism and mitochondrial dysfunction, which suggest a potential strategy to inhibit CRPC progression.
Evaluation of the protective efficacy of a spatial repellent to reduce malaria incidence in children in western Kenya compared to placebo: study protocol for a cluster-randomized double-blinded control trial (the AEGIS program)
Authors: Ochomo Eric O. , Gimnig John E. , Bhattarai Achuyt , Samuels Aaron M. , Kariuki Simon , Okello George , Abong’o Bernard , Ouma Eunice A. , Kosgei Jackline , Munga Stephen , Njagi Kiambo , Odongo Wycliffe , Liu Fang , Grieco John P. , Achee Nicole L.
Published: April 2022

Background

Spatial repellents are widely used for prevention of mosquito bites and evidence is building on their public health value, but their efficacy against malaria incidence has never been evaluated in Africa. To address this knowledge gap, a trial to evaluate the efficacy of Mosquito Shield™, a spatial repellent incorporating transfluthrin, was developed for implementation in Busia County, western Kenya where long-lasting insecticidal net coverage is high and baseline malaria transmission is moderate to high year-round.

Methods

This trial is designed as a cluster-randomized, placebo-controlled, double-blinded clinical trial. Sixty clusters will be randomly assigned in a 1:1 ratio to receive spatial repellent or placebo. A total of 6120 children aged ≥6 months to 10 years of age will be randomly selected from the study clusters, enrolled into an active cohort (baseline, cohort 1, and cohort 2), and sampled monthly to determine time to first infection by smear microscopy. Each cohort following the implementation of the intervention will be split into two groups, one to estimate direct effect of the spatial repellent and the other to estimate degree of diversion of mosquitoes and malaria transmission to unprotected persons. Malaria incidence in each cohort will be estimated and compared (primary indicator) to determine benefit of using a spatial repellent in a high, year-round malaria transmission setting. Mosquitoes will be collected monthly using CDC light traps to determine if there are entomological correlates of spatial repellent efficacy that may be useful for the evaluation of new spatial repellents. Quarterly human landing catches will assess behavioral effects of the intervention.

Discussion

Findings will serve as the first cluster-randomized controlled trial powered to detect spatial repellent efficacy to reduce malaria in sub-Saharan Africa where transmission rates are high, insecticide-treated nets are widely deployed, and mosquitoes are resistant to insecticides. Results will be submitted to the World Health Organization Vector Control Advisory Group for assessment of public health value towards an endorsement to recommend inclusion of spatial repellents in malaria control programs.

Trial registration

ClinicalTrials.govNCT04766879. Registered February 23, 2021.
Introduction of a Zn-based metal–organic framework @ biomass porous activated carbon as a high-sensitive coating for a stainless steel SPME fiber: application to the simultaneous analysis of nonsteroidal anti-inflammatory drugs
Authors: Pasandideh Yalda , Razmi Habib
Published: April 2022

The present study introduces a high-efficiency nanocomposite material featuring a zinc-based metal–organic framework and a novel porous activated carbon derived from bread waste. The prepared nanocomposite, namely Zn-MOF-5@BHPAC, has been synthesized by a low-temperature hydrothermal process and coated onto the surface of a stainless steel wire with epoxy glue. The fabricated fiber has been employed as an SPME fiber applied in the extraction and pre-concentration of some nonsteroidal anti-inflammatory drugs (NSAIDs) before their high-performance liquid chromatography-ultraviolet (HPLC-UV) studies. The characterization studies were performed utilizing field emission scanning electron microscopy, elemental mapping, energy-dispersive X-ray spectroscopy, elemental analyzer, Fourier-transform infrared spectroscopy, and Brunauer–Emmett–Teller surface area analysis. Under the optimal conditions, the method demonstrated low detection limits (LODs, 0.06–0.15 µg L–1), wide linear ranges (LRs, 0.20–380 µg L–1) with good linearity (R2 > 0.991), good precisions (RSDs < 6.95%), and acceptable relative recoveries (RR > 85%). Using the green and affordable biomass of bread as a novel carbon-rich source is an innovative idea provided in this study. In addition, the hybridization of the obtained carbon-based material with the MOF compound to create a new high-capacity sorbent is another strength of the proposed method. Long service lifetime, economic efficiency, environmental friendliness, and high extraction capability were some of the other advantages of the suggested procedure. Therefore, the method can utilize successfully for the simultaneous determination of NSAIDs (as model analytes) in different matrixes.
Effects of short-term breathing exercises on respiratory recovery in patients with COVID-19: a quasi-experimental study
Authors: Kader Manzur , Hossain Md. Afzal , Reddy Vijayendar , Perera Nirmala K. Panagodage , Rashid Mamunur
Published: April 2022

Background

Coronavirus disease 2019 (COVID-19) is a highly infectious respiratory tract disease. The most common clinical manifestation of severe COVID-19 is acute respiratory failure. Respiratory rehabilitation can be a crucial part of treatment, but data lack for patients with COVID-19. This study investigates the effects of short-term respiratory rehabilitation (i.e., breathing exercises) on respiratory recovery among non-ICU hospitalised patients with COVID-19.

Methods

This was a quasi-experimental, pre-and post-test study. The study recruited 173 patients hospitalised with moderate to severe COVID-19. All the patients received standardised care for COVID-19, and 94 patients in the intervention group also received the intervention of breathing exercises, which included breathing control, followed by diaphragmatic breathing, deep breathing, or thoracic expansion exercise, and huffing (forced expiratory technique) and coughing. Data on the mean values of peripheral oxygen saturation (SpO2), need for oxygen therapy (litre/min), respiratory rate (breaths/minute), and heart rate (beats/minute) and were collected at baseline, 4 days, and 7 days after the baseline assessment. Analysis of variance on repeated measures was applied to compare the mean value of outcome measures of all the time points.

Results

The mean (± SD) age of the intervention (69.6% men) and control group (62.1% men) were 50.1 (10.5) and 51.5 (10.4) years, respectively. At 4-day of follow-up, SpO2 (96.6% ± 1.9 vs. 90.7% ± 1.8, P < 0.001), need for oxygen therapy (0.8 ± 2.6 vs. 2.3 ± 2.9, P < 0.001), respiratory rate (20.5 ± 2.3 vs. 22.3 ± 2.5, P < 0.001), and heart rate (81.2 ± 9.5 vs. 89.2 ± 8.9, P < 0.001) improved in the intervention group compared to the control group. At 7-day follow-up, differences remained significant concerning the oxygen saturation and the need for oxygen therapy (P < 0.001) between the groups.

Conclusions

Our results indicate that breathing exercise, even for a short period, effectively improves specific respiratory parameters in moderate to severe COVID-19 patients. As a non-invasive and cost-effective respiratory rehabilitation intervention, breathing exercise can be a valuable tool for a health care system overwhelmed by the COVID-19 pandemic. These results should be considered preliminary until they are replicated in larger samples in different settings.
Associations between bio-motor ability, endocrine markers and hand-specific anthropometrics in elite female futsal players: a pilot study
Authors: Farhani Farid , Arazi Hamid , Mirzaei Mohammad , Nobari Hadi , Mainer-Pardos Elena , Chamari Imen Moussa , Baker Julien S. , Pérez-Gómez Jorge , Chamari Karim
Published: April 2022

Background

The second-to-fourth digit ratio (2D:4D) has been calculated for individual athletes and sports, but it has not been investigated in futsal performance. Therefore, the aim of this study was to investigate any relationships between 2D:4D of the dominant and non-dominant hands and physical capacity performances, selected functional variables and hormone concentrations in elite female futsal players.

Methods

Twenty-four elite female futsal players were measured for 2D:4D in the dominant (2D:4DD) and non-dominant (2D:4DND) hand. The futsal specific performance test (FSPT), hand-grip strength (HGS) and aerobic power were also assessed. In addition, selected circulatory hormones were measured (estradiol, cortisol, growth hormone and insulin like growth factor-1). Pearson’s correlation test was used to identify correlational relationships.

Results

Total test-time and performance time (total time + penalty time) for the FSPT showed a significant correlation with 2D:4DD(r = 0.53,p = 0.005 and r = 0.55,p = 0.003, respectively). HGSNDalso displayed a significant correlation with the 2D:4DD(r = 0.59,p = 0.002). Aerobic power and time spent running on the treadmill also showed a significant relationship with 2D:4DND(both, r = 0.54,p = 0.006). Cortisol showed a significant correlation with 2D:4DD(− 0.58,p = 0.003) and 2D:4DND(− 0.52,p = 0.008).

Conclusions

The measurement of 2D:4D ratio could be an important factor in determining potential performance attributes and talent identification of elite female futsal players. Further studies are needed in this area to further examine the results presented here.
Anatomical study of the sternoclavicular joint using high-frequency ultrasound
Authors: Olivier Timothée , Kasprzak Kevin , Herteleer Matthias , Demondion Xavier , Jacques Thibaut , Cotten Anne
Published: April 2022

Objectives

The purpose of the present study was to determine whether ultrasound enables assessment of sternoclavicular structures.

Methods

A preliminary study in 3 cadavers was followed by an ultrasound study, performed by 2 musculoskeletal radiologists working in consensus, in 59 patients without history of trauma, surgery or pain in the sternoclavicular joint. The visibility, echogenicity and thickness of the sternoclavicular structures were assessed.

Results

The anterior sternoclavicular ligament and the interclavicular ligament could be seen in all patients (mean thickness: 1.4 mm and 1.3 mm, respectively). The articular disc was clearly seen in 66.1% of cases, and shoulder antepulsion enabled analysis in an additional 20.3%. Intra-articular joint gas was frequent (33.89% of cases), preventing analysis of the disc in 2 patients. Only the superficial anterior aspect of the clavicular and sternal articular cartilages could be assessed. Joint effusion was seen in 6.8% of cases. Clavicular osteophytes, sternal osteophytes and bone irregularities at the anterior sternoclavicular ligament insertion were detected in 33.9%, 16.9% and 16.9% of cases, respectively.

Conclusion

The anterior sternoclavicular ligament, interclavicular ligament and anterior intra-articular structures can be visualized by ultrasound. This means of assessment may have clinical applications, particularly in patients with trauma or microtrauma.
Granulomatous mastitis, erythema nodosum, and polyarthritis: a case report
Authors: Laor Leanna , Ganguli Suhas , Fakioglu Esra
Published: April 2022

Background

Granulomatous mastitis is a rare inflammatory disease of the breast, typically seen in woman of child-bearing age. No definitive etiology has been described. In rare instances, this condition has been reported to be associated with extramammary manifestations such as erythema nodosum and arthritis. We describe this rare condition in an adolescent female.

Case presentation

A 16-year-old, Hispanic female presented with right-sided painful breast swelling, polyarthritis, and erythema nodosum on bilateral shins and lower thighs. Physical examination was negative for lymphadenopathy and pulmonary, gastrointestinal, and cardiovascular findings. Ophthalmologic examination for uveitis and serologic tests for autoimmune diseases were negative. Diagnosis of idiopathic granulomatous mastitis was made by exclusion of other etiologies and conditions. Confirmation was made by histopathologic examination demonstrating noncaseating granuloma within breast lobules with neutrophils and microabscess formation. After wide local excision and a short course of trimethoprim–sulfamethoxazole, our patient was placed on naproxen and prednisone, the latter being tapered off over 3 months, with steady and complete resolution of all symptoms.

Conclusion

This is the first reported case of idiopathic granulomatous mastitis in a pediatric patient who also had extramammary manifestations, including erythema nodosum and polyarthritis. In this case-based review, we summarize the phenotype, risk factors, prognosis, and treatment options of this rare condition, chiefly to make the readers cognizant of such a diagnostic possibility in similar clinical presentation in the future.
Systematic review and meta-analysis of candidate gene association studies of benign prostate hyperplasia
Authors: Lin Lin , Li Pugui , Liu Xin , Xie Xiuyuan , Liu Liping , Singh Anjani Kumar , Singh Himanshu Narayan
Published: April 2022

Background

Benign prostate hyperplasia (BPH) is the most common urological problem in elderly males. Recent studies have reported polymorphism in various metabolic genes in BPH. However, their association with the susceptibility of BPH is still inconsistent. Here, we systematically reviewed and performed a meta-analysis of CYP17, VDR, and ACE genes to determine their precise association with the risk of BPH.

Methods

A comprehensive literature search for published studies on candidate gene associations involving vitamin D receptor (VDR), angiotensin-converting enzyme (ACE), and CYP17 genes with the risk of BPH was done up to April 2020 in PubMed, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar databases. Fixed/random effects models were used to estimate the odd’s ratio (OR) and 95% confidence intervals (CIs). Begg’s funnel plot was used to assess the potential for publication bias.

Results

We found a total of 23 studies containing 3461 cases and 3833 controls for these gene polymorphisms. A significant association of ACE gene polymorphism was observed under the recessive (II vs. ID + DD) model for BPH susceptibility compared to control subjects (overall OR = 1.67, 95% CI = 1.03–2.73). Similar trends were observed for ACE gene polymorphism in Caucasian (OR = 6.18, 95% CI = 1.38–27.68) and Asian (OR = 1.42, 95% CI = 0.99–2.03) populations under study. No significant association was observed in VDR and CYP17 gene polymorphisms in any dominant or recessive models.

Conclusion

Significant OR demonstrated the implication of ACE gene polymorphism in the proliferation of prostate tissue, which in turn is associated with BPH susceptibility. However, prospective studies at large scale and sample size are needed to confirm the current findings.
Case report: acute care management of severe opioid withdrawal with IV fentanyl
Authors: Azar Pouya , Westenberg Jean N. , Ignaszewski Martha J. , Wong James S. H. , Isac George , Mathew Nickie , Krausz R. Michael
Published: April 2022

Background

An increasing number of individuals who use drugs in North America are preferentially consuming fentanyl over other opioids. This has significant consequences on the treatment and management of opioid use disorder (OUD) and its concurrent disorders, especially in acute care if opioid requirements are not met.

Case presentation

We present a patient with severe OUD and daily injection of fentanyl, admitted to hospital for management of acute physical health issues. Due to high opioid requirements and history of patient-initiated discharge, intravenous fentanyl was administered for treatment of opioid withdrawal, and management of pain, which supported continued hospitalization for acute care treatment and aligned with substance use treatment goals.

Conclusion

This case demonstrates that intravenous fentanyl for management of OUD in hospital can be a feasible approach to meet opioid requirements and avoid fentanyl withdrawal among patients with severe OUD and daily fentanyl use, thereby promoting adherence to medical treatment and reducing the risk of patient-initiated discharge. There is an urgent need to tailor current treatment strategies for individuals who primarily use fentanyl. Carefully designed research is needed to further explore the use of IV fentanyl for acute care management of severe opioid withdrawal in a hospital setting.
m6A binding protein YTHDF2 in cancer
Authors: Chen Xiaomin , Zhou Xiangxiang , Wang Xin
Published: April 2022

YT521-B homology domain family member 2 (YTHDF2) is an N6-methyladenosine (m6A)-binding protein that was originally found to regulate the stability of mRNA. Growing evidence has shown that YTHDF2 can participate in multifarious bioprocesses, including embryonic development, immune response, and tumor progression. Furthermore, YTHDF2 is closely associated with the proliferation, apoptosis, invasion, and migration of tumor cells, suggesting its significant role in cancers. YTHDF2 primarily relies on m6A modification to modulate signaling pathways in cancer cells. However, the expression and function of YTHDF2 in human malignancies remain controversial. Meanwhile, the underlying molecular mechanisms of YTHDF2 have not been elucidated. In this review, we principally summarized the biological functions and molecular mechanisms of YTHDF2 in tumors and discussed its prognostic and therapeutic values.
Reaching the malaria elimination goal in Brazil: a spatial analysis and time-series study
Authors: Laporta Gabriel Zorello , Grillet Maria Eugenia , Rodovalho Sheila Rodrigues , Massad Eduardo , Sallum Maria Anice Mureb
Published: April 2022

Background

Since 2015, the Global Technical Strategy (GTS) for Malaria 2016–2030 has been adopted by the World Health Organization (WHO) as a comprehensive framework to accelerate progress for malaria elimination in endemic countries. This strategy sets the target of reducing global malaria incidence and mortality rates by 90% in 2030. Here it is sought to evaluate Brazil’s achievements towards reaching the WHO GTS milestone in 2030. Considering the total number of new malaria cases in 2015, the main research question is: will Brazil reach the malaria elimination goal in 2030?

Methods

Analytical strategies were undertaken using the SIVEP-malaria official databases of the Brazilian Malaria Control Programme for the Brazilian Amazon region from 2009 to 2020. Spatial and time-series analyses were applied for identifying municipalities that support the highest numbers of malaria cases over the years. Forecast analysis was used for predicting the estimated number of new cases in Brazil in 2025–2050.

Results

Brazil has significantly reduced the number of new malaria cases in 2020 in comparison with 2015 in the states of Acre (− 56%), Amapá (− 75%), and Amazonas (− 21%); however, they increased in the states of Pará (156%), Rondônia (74%), and Roraima (362%). Forecast of the predicted number of new malaria cases in 2030 is 74,764 (95% CI: 41,116–141,160) in the Brazilian Amazon.

Conclusions

It is likely that Brazil will reduce the number of new malaria cases in the Brazilian Amazon in 2030 in relation to that in 2015. Herein forecast shows a reduction by 46% (74,754 in 2030 forecast/137,982 in 2015), but this reduction is yet far from the proposed reduction under the WHO GTS 2030 milestone (90%). Stable and unbeatable transmission in the Juruá River Valley, Manaus, and Lábrea still support endemic malaria in the Brazilian Amazon. Today’s cross-border malaria is impacting the state of Roraima unprecedently. If this situation is maintained, the malaria elimination goal (zero cases) may not be reached before 2050. An enhanced political commitment is vital to ensure optimal public health intervention designs in the post-2030 milestones for malaria elimination.

Graphical Abstract
Injection laryngoplasty of human adipose-derived stem cell spheroids with hyaluronic acid-based hydrogel improves the morphological and functional characteristics of geriatric larynx
Authors: Lee Doh Young , Choi Young Hwan , Choi Ji Suk , Eom Min Rye , Kwon Seong Keun
Published: April 2022

Aim

As the geriatric population increased, the need of treatment for laryngeal atrophy and dysfunction increased. This study was performed to evaluate the effects of injection of human adipose-derived stem cell (hASC) spheroid-loaded catechol-conjugated hyaluronic acid (HA-CA) hydrogel on therapeutic rejuvenation of the geriatric larynx.

Methods

Stem cell spheroids with hyaluronic acid-based hydrogel were injected into the laryngeal muscles of 18-month-old Sprague–Dawley rats. The effects of hASC spheroids were examined in the following four groups: SHAM, injected with PBS; GEL, injected with HA-CA hydrogel; MONO, injected with single hASCs in HA-CA hydrogel; and SP, injected with hASCs spheroids in HA-CA hydrogel. The rejuvenation efficacy in geriatric laryngeal muscle tissues at 12 weeks postinjection was evaluated and compared by histology, immunofluorescence staining, and functionality analysis.

Results

Total myofiber cross-sectional area and myofiber number/density, evaluated by detection of myosin heavy chain with antibodies against laminin and fast myosin heavy chain, were significantly higher in the SP group than in the other groups. The lamina propria of the larynx was evaluated by alcian blue staining, which showed that the HA was increased significantly in the SP group compared to the other groups. In functional analysis, the glottal gap area was significantly reduced in the SP group compared to the other groups. The phase difference in the vocal fold during vibration was also smaller in the SP group than in the other groups, but the difference did not reach statistical significance.

Conclusion

Injection of hASC spheroids with hyaluronic acid-based hydrogel improves the morphological and functional characteristics of geriatric larynx.

Graphical abstract
White dot syndrome in a patient with presumed ocular tuberculosis: a case report
Authors: Nicolau Zaira Fernanda Martinho , Araújo Diego Lisboa , Nakayama Luis Filipe , Bergamo Vinicius Campos , Meirelles Rodrigo Luz , Júnior Octaviano Magalhães
Published: April 2022

Background

This manuscript describes a case of a patient with presumed ocular tuberculosis masquerading as multiple evanescent white dot syndrome.

Case presentation

A 32-year-old male patient presented with a complaint of reduced visual acuity in the left eye. Retinal fundus exam of the left eye revealed gray-whitish deep lesions predominantly nasal to the optic disc. The lesions were more clearly identifiable on fundus autofluorescence (FAF) imaging, fluorescein angiography (FA) and en face optical coherence tomography (OCT). FA also indicated retinal vasculitis and papillitis. Swept-source OCT B-scan demonstrated loss of the ellipsoid layer in the regions corresponding to the lesions detected by FAF. A positive tuberculin skin test (TST) confirmed presumed tuberculosis, and a related WDS diagnosis was made. Specific antituberculosis therapy was instituted with favorable anatomical recovery and visual outcome.

Conclusion

Multiple evanescent white dot syndrome (MEWDS) may be manifestation of presumed ocular tuberculosis, and multimodal retinal exams can provide a better understanding of atypical diseases and their follow-up.
Effect of cryoprecipitate on an increase in fibrinogen level in patients with excessive intraoperative blood loss: a single-center retrospective study
Authors: Kouroki Satoshi , Maruta Toyoaki , Tsuneyoshi Isao
Published: April 2022

Background

Cryoprecipitate, which contains fibrinogen and factor VIII in large quantities, is concentrated from fresh frozen plasma, and it has hemostatic effects in severe bleeding. We retrospectively examined the effects of cryoprecipitate on the increase in fibrinogen levels in patients with excessive intraoperative blood loss.

Methods

Ninety-seven patients who were administered cryoprecipitate during surgery between June 2014 and May 2019 were enrolled in our study and categorized according to the volume of intraoperative blood loss as follows: group A, 2000–5000 mL; group B, 5000–10,000 mL; group C, > 10,000 mL. Data were extracted from electronic medical records and electronic anesthesia records. The primary endpoint was an increase in the fibrinogen level after the administration of cryoprecipitate.

Results

Nine patients with no fibrinogen data and four patients with a bleeding volume of less than 2000 mL were excluded; thus, 84 patients (A: n = 36, B: n = 37, C: n = 11) were evaluated. The mean intraoperative blood loss (mL) in groups A, B, and C were 3348 ± 791, 6688 ± 1225, and 14,281 ± 5142, respectively. The fibrinogen levels (mg/dL) before cryoprecipitate administration in groups A, B, and C were 189 ± 94, 113 ± 42, and 83 ± 29, respectively (p < 0.05 among the groups). The increase in fibrinogen level (mg/dL) after cryoprecipitate administration in group C was significantly greater than that in group A (84 ± 34 versus 50 ± 36, p < 0.01).

Conclusions

The results of this study indicate that the effect of cryoprecipitate on the increase in fibrinogen level was most apparent in patients with excessive intraoperative blood loss ≥ 10,000 mL. In addition, most patients with intraoperative blood loss ≥ 5000 mL had fibrinogen levels < 150 mg/dL which improved to ≥ 150 mg/dL after cryoprecipitate administration in approximately 70% of patients. Therefore, cryoprecipitate administration should be considered for patients with hypofibrinogenemia (≤ 150 mg/dL) experiencing severe bleeding (e.g., ≥ 5000 mL) and rapid administration of cryoprecipitate is necessary to maximize the hemostatic effect, especially when the bleeding volume exceeds 10,000 ml.
Impact of clinical symptoms and diagnosis: the electronic Person-Specific Outcome Measure (ePSOM) development programme
Authors: Saunders S. , Sheehan S. , Muniz-Terrera G. , Luz S. , Ritchie C. W.
Published: April 2022

Introduction

Regulatory bodies recommend that outcome measures used in Alzheimer’s disease (AD) clinical trials capture clinically meaningful changes for the trial participant. However, commonly used outcome measures do not reflect the individual’s views on what matters to them individually. The aim of the electronic Person-Specific Outcome Measure (ePSOM) programme is to better understand what outcomes matter to patients in early Alzheimer’s disease.

Methods

As part of the ePSOM programme, we designed and ran an online study to understand what matters to individuals when developing new treatments for AD. The ePSOM survey ran Aug 2019–Dec 2019 (UK) and collected primarily free text responses which were analysed using Natural Language Processing (NLP) techniques. In this paper, we focus our analyses on individuals who reported having a neurodegenerative disease diagnosis (primarily Mild Cognitive Impairment (MCI) or AD), reporting the most frequent and most important brain health priorities for this group. Due to a small sample size, the Diagnosis group was analysed as a whole. Finally, we compared the Diagnosis group to an age and gender matched control group using chi-squared tests to look for any differences between the Diagnosis and control groups’ priorities.

Results

The survey was completed by 5808 respondents, of whom 167 (2.9%) (women n = 91, men n = 69, other n = 7) had received one of our pre-defined neurodegenerative disease diagnosis: most commonly MCI n = 52, 1.1% (mean age 69.42, SD = 10.8); or Alzheimer’s disease n = 48, 1.0% (mean age 71.24, SD = 9.79). Several thematic clusters were significantly more important for the target diagnostic group, e.g.: Expressing opinions; and less important, e.g., Cognitive Games.

Conclusion

We conclude there are a range of outcomes which individuals consider important and what potential new treatments should help maintain or improve, suggesting that outcomes that matter shift along the preclinical, prodromal and overt dementia continuum. This has important implications for the development of outcome measures in long term prevention studies that last several years where participants may pass through different stages of disease. In the final stage of our project, we will design an electronic outcomes app which will employ the methodology tested in the large-scale survey to capture what matters to individuals about their brain health at an individual level.
Association between patient factors and hospital completeness of a patient-reported outcome measures program in joint arthroplasty, a cohort study
Authors: Harris Ian A. , Peng Yi , Cashman Kara , Ackerman Ilana , Heath Emma , Rowden Neville , Graves Stephen E.
Published: April 2022

Background

The collection of patient-reported outcome measures (PROMs) following arthroplasty is common. PROMs data collection programs seek to maximise completeness in order to minimise selection bias and optimise representativeness of the sample attained. We aimed to determine if patient factors influence variation in PROMs program completeness between-hospitals.

Methods

Using data from a national arthroplasty registry PROMs program, we tested for associations between patient characteristics (age, sex, body mass index [BMI] and American Society of Anaesthesiologists [ASA] class) and both potential completeness (registration completeness: the proportion of arthroplasty patients that were registered in the PROMs electronic system) and actual completeness (response completeness: the proportion of arthroplasty patients who provided PROMs data) using linear regression.

Results

When using all elective primary total hip, knee or shoulder arthroplasty procedures (N = 31,801) from 43 hospitals as the denominator, overall registration completeness was 52%, varying from 5 to 87% between hospitals. Overall pre-operative response completeness was 46%, varying from 5 to 82% between hospitals. There were no significant associations between hospital-level registration completeness or response completeness and age, sex, BMI or ASA score.

Conclusion

Completeness rates of a PROMs program in arthroplasty varied widely between hospitals but in the absence of a relationship between measured patient factors and completeness rates, the observed variation likely relates to local site factors such as access to patients, local resources and clinician engagement with the program. Efforts to improve the rates of completeness of arthroplasty PROMs programs at individual hospitals may not improve the representativeness of the sample.
COVID-19 and myocarditis: a review of literature
Authors: Ali Mohammed , Shiwani Haaris A. , Elfaki Mohammed Y. , Hamid Moaz , Pharithi Rebabonye , Kamgang Rene , Egom Christian BinounA , Oyono Jean Louis Essame , Egom Emmanuel Eroume-A
Published: April 2022

Myocarditis has been discovered to be a significant complication of coronavirus disease 2019 (COVID-19), a condition caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. COVID-19 myocarditis seems to have distinct inflammatory characteristics, which make it unique to other viral etiologies. The incidence of COVID-19 myocarditis is still not clear as a wide range of figures have been quoted in the literature; however, it seems that the risk of developing myocarditis increases with more severe infection. Furthermore, the administration of the mRNA COVID-19 vaccine has been associated with the development of myocarditis, particularly after the second dose. COVID-19 myocarditis has a wide variety of presentations, ranging from dyspnea and chest pain to acute heart failure and possibly death. It is important to catch any cases of myocarditis, particularly those presenting with fulminant myocarditis which can be characterized by signs of heart failure and arrythmias. Initial work up for suspected myocarditis should include serial troponins and electrocardiograms. If myocardial damage is detected in these tests, further screening should be carried out. Cardiac magnetic resonance imagining and endomyocardial biopsy are the most useful tests for myocarditis. Treatment for COVID-19 myocarditis is still controversial; however, the use of intravenous immunoglobulins and corticosteroids in combination may be effective, particularly in cases of fulminant myocarditis. Overall, the incidence of COVID-19 myocarditis requires further research, while the use of intravenous immunoglobulins and corticosteroids in conjunction requires large randomized controlled trials to determine their efficacy.
The false alarm: Rosai–Dorfman disease of breast: case report
Authors: Ingole Sanjivanee , Pavithra V. , Sundaram Sandhya , Dennis Joseph Leena , Hussain Syed Altaf , Dev Bhawna
Published: April 2022

Introduction

Rosai–Dorfman disease is a rare disorder caused by benign proliferation of histiocytes and thus also called sinus histiocytosis with massive lymphadenopathy. It is typically known to involve lymph nodes but can also affect extra nodal sites with breast involvement being extremely rare. This disease is known to mimic malignancy clinically and on imaging. The final verdict is through histopathological evaluation.

Case presentation

We present a case of a 21-year-old female who presented with a palpable suspicious lump in right breast. Ultrasound, mammogram and MRI breast were done followed by fine needle aspiration, which showed lymphocytes and occasional histiocytes, which is suggestive of a lymphoid process. Surgical excision was done due to high suspicion of low-grade angiosarcoma in spite of a negative cytology. Diagnosis of Rosai–Dorfman disease was concluded after histopathological evaluation and was further confirmed by immunohistochemical staining by immunohistochemical markers S-100 and CD68.

Conclusion

Rosai–Dorfman disease can present as low-grade angiosarcoma clinically as well as on imaging. There is a need for high level of suspicion to rule out benign mimics of malignancy to avoid radical surgery. Final diagnosis is by histopathology along with immunohistochemical staining.
Understanding implementation costs of a pediatric weight management intervention: an economic evaluation protocol
Authors: Michaud Tzeyu L. , Hill Jennie L. , Heelan Kate A. , Bartee R. T. , Abbey Bryce M. , Malmkar Ali , Masker John , Golden Caitlin , Porter Gwenndolyn , Glasgow Russell E. , Estabrooks Paul A.
Published: April 2022

Background

Understanding the cost and/or cost-effectiveness of implementation strategies is crucial for organizations to make informed decisions about the resources needed to implement and sustain evidence-based interventions (EBIs). This economic evaluation protocol describes the methods and processes that will be used to assess costs and cost-effectiveness across implementation strategies used to improve the reach, adoption, implementation, and organizational maintenance of an evidence-based pediatric weight management intervention- Building Health Families (BHF).

Methods

A within-trial cost and cost-effectiveness analysis (CEA) will be completed as part of a hybrid type III effectiveness-implementation trial (HEI) designed to examine the impact of an action Learning Collaborative (LC) strategy consisting of network weaving, consultee-centered training, goal-setting and feedback, and sustainability action planning to improve the adoption, implementation, organizational maintenance, and program reach of BHF in micropolitan and surrounding rural communities in the USA, over a 12-month period. We discuss key features of implementation strategy components and the associated cost collection and outcome measures and present brief examples on what will be included in the CEA for each discrete implementation strategy and how the results will be interpreted. The cost data will be collected by identifying implementation activities associated with each strategy and using a digital-based time tracking tool to capture the time associated with each activity. Costs will be assessed relative to the BHF program implementation and the multicomponent implementation strategy, included within and external to a LC designed to improve reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) of BHF. The CEA results will be reported by RE-AIM outcomes, using the average cost-effectiveness ratio or incremental cost-effectiveness ratio. All the CEAs will be performed from the community perspective.

Discussion

The proposed costing approach and economic evaluation framework for dissemination and implementation strategies and EBI implementation will contribute to the evolving but still scant literature on economic evaluation of implementation and strategies used and facilitate the comparative economic analysis.

Trial registration

ClinicalTrials.govNCT04719442. Registered on January 22, 2021.
Hearing disorders in lupus patients: correlation with duration and severity of the disease
Authors: Alzokm Saad Mahmoud , Ghanem Soliman S.
Published: April 2022

Background

Hearing loss can greatly affect the overall quality of life. Several studies have reported that patients with SLE may suffer from audio-vestibular manifestations. The aim of this study is to evaluate the influence of systemic lupus erythematosus (SLE) on hearing and association of hearing impairment with severity and duration of SLE.

Results

Pure-tone audiometry (PTA) (air conduction and bone conduction) thresholds showed significant elevation in SLE group than controls (P ≤ 0.05). It was observed also that there is a significant association between SLE severity and duration with sensorineural hearing loss (SNHL) and its degree.

Conclusion

SLE can lead to hearing loss, and there is a positive association of SLE severity and duration with degree of hearing loss.
Effectiveness of ultrasound-guided local steroid injection to the wrist for the treatment of carpal tunnel syndrome: Is it worth it?
Authors: Goru Poornanand , Butaliu George C. , Verma Gopalkrishna G. , Haque Syed , Mustafa Abubakar , Paul Ashok
Published: April 2022

Background

Carpal tunnel syndrome (CTS) is caused by compression of the median nerve at the wrist level and the most frequent entrapment neuropathy in the upper limb. It can be treated with surgical or non-surgical methods. When nonsurgical treatment is indicated, a local corticosteroid injection into the carpal tunnel can be used to reduce pain and tingling sensation. To assess the clinical outcomes and effectiveness of patient satisfaction following ultrasound-guided steroid injection for the treatment of carpal tunnel syndrome.

Results

The study comprises 44 female (73%) and 16 (27%) male patients, with a mean age of 57 (27–84) years. Thirty-one patients were left-handed and 29 right-handed. Twenty-six (43%) injections were performed on the right side, 8 (13%) on the left, and 26 were bilateral. Fifty-six hands of thirty-seven (70%) patients reported significant improvement symptoms, five (8%) had temporary improvement with recurrence, seventeen patients (28%) failed to improve, and one patient’s symptoms have resolved before intervention. Among temporary responders and nonresponders, two were referred to the neurologist for further evaluation. Out of twenty patients, fourteen patients (23%) had surgical decompression of carpal tunnel with complete resolution of symptoms, four patients had opted for repeat injections, and two patients refused any further intervention.

Conclusions

The use of ultrasound-guided injection for the treatment of mild to moderate carpal tunnel syndrome is a practical procedure before offering surgical treatment. It is also appropriate for the patient with significant medical problems or not willing to undergo surgical intervention. Its ultrasound guide reduces injection-related complications, improves patient satisfaction, is cost-effective, and improves patient compliance.
Mortality and Second Cancer Incidence After Treatment for Testicular Cancer: Psychosocial Health and Lifestyle Are Modifiable Prognostic Factors
Authors: Fosså Sophie D. , Dahl Alv A. , Thorsen Lene , Hellesnes Ragnhild , Kiserud Cecilie E. , Tandstad Torgrim , Brydøy Marianne , Haugnes Hege S. , Myklebust Tor Å.
Published: April 2022

PURPOSE

To evaluate whether selected modifiable patient-reported adverse health outcomes (AHOs) in testicular cancer survivors (TCSs) represent prognostic factors of overall mortality, cancer mortality, and first-time non–germ cell second cancer (SecCa) incidence.

PATIENTS AND METHODS

In 775 long-term TCSs (diagnosis: 1980-1994) who previously participated in a quality-of-life survey, 20-year mortality and SecCa incidence were compared between the surgery group (n = 272) and TCSs after platinum-based chemotherapy (PBCT; n = 503). A PBCT standard group (total cisplatin: ≤ 630 mg: n = 124) was separated from a PBCT high subgroup (total cisplatin: > 630 mg; n = 379). Univariate and multivariate analyses (Kaplan-Meier; Cox proportional hazard analyses) included age, treatment, and prior major physical comorbidity as nonmodifiable factors, whereas low socioeconomic status, unhealthy lifestyle, probable depression disorder, and neurotoxicity were modifiable AHOs.

RESULTS

For all TCSs, the cumulative overall 20-year mortality was 14% (95% CI, 11.8 to 16.8). Rising age, PBCT high, and comorbidity significantly increased the risk of overall mortality rate. Compared with a low-risk group (no AHO; n = 446) and with exception of neurotoxicity, this risk was further significantly enhanced by 80% in TCSs of a medium-risk group (one or two AHOs; n = 278). In men of a high-risk group (three AHOs; n = 47), the probability of overall mortality and of cancer mortality was eight-fold and five-fold increased, respectively. Risk grouping did not influence on SecCa incidence.

CONCLUSION

Self-reported unfavorable modifiable AHO concerning lifestyle and psychosocial health are in TCSs independently and significantly associated with increased overall mortality and cancer mortality. Health professionals and the TCSs themselves, particularly those after PBCT high, should continuously be aware of these risk factors attempting maximal reduction of these AHOs and thereby supporting long-term survival.