bluuebunny/crossref_metadata_2025 huggingface dataset:
The overview of neutron-induced 56Mn radioactive microparticle effects in experimental animals and related studies
Authors: Hoshi Masaharu
Published: August 2022

Investigation into the risks associated with radiation exposure has been carried out on those exposed to radiation in Hiroshima and Nagasaki, Semipalatinsk and other parts of the world. These risks are used as a guidance standard for the protection for radiation workers and the general public when exposed to radiation, and it sets upper regulatory limits for the amount of radiation exposure. However, the effects of internal exposure to radioactive microparticles have not been considered in these studies. These effects cannot be ignored since the exposure dose increases are inversely proportional to the square of the distance to the vicinity of the particles and can exceed tens of thousands of mGy. So far, only retrospective studies of people who have been exposed to radiation have been conducted, therefore we hypothesized that animal experiments would be necessary to investigate these effects. As a result, we found specific effects of radioactive microparticles. One particularly noteworthy finding was that internal exposure to radioactive microparticles resulted in pathological changes that were more than 20 times greater than those caused by the same level of external exposure. In contrast, there were other results that showed no such effects, and the reasons for this discrepancy need to be clarified. We also conducted RNA expression experiments and found that there was a difference between external exposure to 60Co gamma rays and internal exposure to 56Mn microparticles. In the future, we will need to study the mechanisms behind these findings. If the mechanism can be confirmed, it is expected to lead to the development of protective and therapeutic methods.
Estimation of ‘dose-depth’ profile in the surface layers of a quartz-containing tile from the former Hiroshima University building indicates the possible presence of beta-irradiation from residual radioactivity after A-bombing
Authors: Stepanenko Valeriy , Kaprin Andrey , Ivanov Sergey , Shegay Peter , Sato Hitoshi , Toyoda Shin , Kawano Noriyuki , Fujimoto Nariaki , Endo Satoru , Bogacheva Viktoria , Kolyzhenkov Timofey , Khailov Artem , Zhumadilov Kassym , Zhumalina Aidana , Yerimbetova Dana , Hoshi Masaharu
Published: August 2022

The problem of differentiating between primary irradiation and exposure due to residual radioactivity following A-bombing (including beta-exposure), is the subject of special attention and discussions in order to understand the health effects following the Hiroshima and Nagasaki A-bombings, especially among newcomers to cities soon after the detonations. In this work, the method of single quartz grain luminescence retrospective dosimetry was applied for a retrospective estimation of the ‘dose-depth’ profile in a quartz-containing tile extracted from the building of former Hiroshima University (HU), which was a ‘witness’ of the Hiroshima atomic bombing on the 6 August 1945. It has been shown that results of retrospective estimates of the ‘dose-depth’ profile using the method of optically stimulated luminescence (OSL) from inclusions of quartz grains in very thin layers of the sample, in combination with the calculations of the ‘dose-depth’ profile using the Monte Carlo method, indicates the possible presence of beta irradiation of thin layers of the sample located near the surface of the tile facing the air, where there is no electronic equilibrium from gamma radiation.
Indications for additional volume studies for gland volume estimation in prostate cancer brachytherapy
Authors: Khanolkar Rutvij A , Moore Rosanne , Martell Kevin
Published: August 2022

An estimated gland volume of > 60 cc is a relative contraindication to brachytherapy for prostate cancer. As volume estimation using biopsy ultrasound (Bx-US) alone may be inaccurate, many centers perform additional volume assessments prior to the brachytherapy procedure. At the study institution, computed tomography (CT) based volume assessments were routinely performed on all patients to determine brachytherapy eligibility. This study aimed to determine whether this CT imaging could be omitted for certain Bx-US based gland volume estimates. To investigate this, 1576 consecutive patients that received ultrasound based intraoperatively planned brachytherapy at a single comprehensive cancer center between 2003 and 2021 were reviewed. Gland volume as estimated by Bx-US, CT and magnetic resonance (MR) imaging were compared to intraoperatively contoured gland volume (ICGV) or the larger contoured gland volume on CT for any patients receiving neo-adjuvant androgen deprivation therapy (ADT) for gland downsizing (IM-US-corr). There was a significant difference between IM-US-corr and estimated gland volume for Bx-US (P < 0.001) and MR (P < 0.001), but not CT (P = 0.160). Bx-US and MR tended to underrepresent the IM-US-corr, with a > 20% difference from actual volume in 31% and 59% of cases, respectively. When Bx-US volume was estimated to be < 40 cc, < 50 cc and < 60 cc, an IM-US-corr > 60 cc was encountered in 2%, 5% and 7% of cases, respectively. In contrast, IM-US-corr > 60 cc was encountered in 0.2%, 1% and 2% of cases for CT estimates of < 40 cc, < 50 cc and < 60 cc. In patients with an estimated gland volume of < 50 cc by Bx-US, dedicated pre-operative volume studies are unlikely to alter management. However, patients above this cut-off stand to benefit from the use of additional volume assessment to better delineate gland volume and determine eligibility for brachytherapy.
Technical report: a high-dose-rate interstitial brachytherapy boost for residual sinonasal undifferentiated carcinoma
Authors: Miyata Yusaku , Murakami Naoya , Honma Yoshitaka , Mori Taisuke , Yoshimoto Seiichi , Kashihara Tairo , Takemori Mihiro , Nakayama Yuko , Itami Jun , Ogo Etsuyo , Igaki Hiroshi
Published: August 2022

Sinonasal undifferentiated carcinoma (SNUC) is a highly aggressive and uncommon neoplasm that arises from the mucosa of the nasal cavity or paranasal sinuses. The multidisciplinary approach that includes surgery, radiation therapy (RT), and chemotherapy has been proven to improve survival rates. However, there is no established evidence for the efficacy of further (boost) irradiation following definitive RT in SNUC patients with residual primary tumor. We describe a successful case of a patient with SNUC who had an uncontrolled primary tumor following induction chemotherapy and radical concurrent chemoradiotherapy (CCRT) and underwent a high-dose-rate interstitial brachytherapy (HDR-ISBT) boost. A 75-year-old Japanese woman with unresectable locally advanced SNUC (LA-SNUC) received induction chemotherapy followed by radical CCRT. However, because the residual primary tumor was evident after planned external beam RT, she underwent an HDR-ISBT boost, and the tumor decreased significantly. A complete response (the Response Evaluation Criteria in Solid Tumors, ver. 1.1) was achieved 2 months after brachytherapy, and the patient has been disease-free for 2 years following treatment initiation. In conclusion, an HDR-ISBT boost can be a safe and effective treatment option in patients with residual and inoperable LA-SNUC in the maxillary sinus after initial RT.
Malignant inflammatory myofibroblastic tumor: a rare case presentation
Authors: Spafford Megan , Lunn Danley , Graham Peter
Published: August 2022

Malignant inflammatory myofibroblastic tumors (IMT) are extremely rare, aggressive tumors with variable presentation. This is a case of a 29-year-old female presented with severe anemia and a large abdominal mass presumed to be a gastrointestinal stromal tumor (GIST). Severe anemia, leukocytosis and thrombocytosis accompanied the presentation. Final pathological assessment yielded a diagnosis of malignant IMT. Given the rarity of these tumors, no established diagnostic criteria exist aside from histological analysis of the tissue, which may result in delays or inappropriate treatment. As these tumors are aggressive in nature, a high index of suspicion is critical to improve outcomes. Further reports on the presentation, diagnosis and treatment of such rare tumors are important to develop clinical diagnostic guidelines to improve diagnosis and treatment and improve outcomes.
A case of spontaneously ruptured hepatic angiosarcoma resected after transcatheter arterial embolization
Authors: Kashiwadate Toshiaki , Hara Yasuyuki , Hashizume Eiji , Nishida Akiko , Unno Michiaki , Kamei Takashi
Published: August 2022

Hepatic angiosarcoma is a very rare disease, but it has a poor prognosis. Here, we report the case of a 77-year-old man who was referred to our hospital for suspicion of hepatocellular carcinoma and cancerous peritonitis. Based on the imaging findings, a diagnosis of spontaneously ruptured hepatic hemangioma was made. Six days later, the patient was transported to the hospital in a state of shock and an emergency transarterial embolization was performed. He underwent lateral hepatic segmentectomy 7 days later. Histopathologically, he was diagnosed with hepatic angiosarcoma. Fever was observed 21 days after surgery, and computed tomography was performed. Multiple liver masses, which ware increasing rapidly, were found, and hepatic angiosarcoma recurrence was confirmed. He requested home medical care and died at home 36 days after surgery. When a tumor diagnosed as a hepatic hemangioma by imaging has ruptured, the possibility of hepatic angiosarcoma should be considered.
Ursinus, Luciferians, and The Bishops of Rome
Authors: Whiting Colin M
Published: August 2022

Two texts in the Collectio Avellana, a sixth-century collection of documents concerning the relationship between bishops of Rome and emperors, provide us with a unique window into the Christian landscape of Rome in late antiquity. The first is the Quae gesta sunt, a narrative of the contested episcopal election at Rome in 366 between Ursinus and Damasus, written by a supporter of Ursinus. The second is the Libellus precum, a petition from a group of Nicene rigorists called ‘Luciferians’ which details the long persecution they have suffered at the hands of other Nicene Christians in Rome and elsewhere. The relationship between these two documents, and between these two communities, has long been a point of confusion in modern scholarship, but has only rarely been addressed as a question in its own right. This study examines these two documents in their mid-fourth-century context and concludes that they reflect the interests and experiences of separate communities. It concludes with a brief note about how the historical events of the 350s, which compelled these two separate Nicene communities to remain opposed to Damasus in the 360s, caused intractable social ruptures in Rome that Damasus was unable to overcome.
Social networks in the single cell
Authors: Rodriguez Moira , Martinez-Hottovy Ana , Christensen Alan C
Published: August 2022

This article comments on:

Chustecki JM, Etherington RD, Gibbs DJ, Johnston IG. 2022. Altered collective mitochondrial dynamics in the Arabidopsis msh1 mutant compromising organelle DNA maintenance. Journal of Experimental Botany 73,5428–5439.
PagWOX11/12a positively regulates the PagSAUR36 gene that enhances adventitious root development in poplar
Authors: Liu Rui , Wen Shuang-Shuang , Sun Ting-Ting , Wang Rui , Zuo Wen-Teng , Yang Tao , Wang Chao , Hu Jian-Jun , Lu Meng-Zhu , Wang Liu-Qiang
Published: August 2022

Adventitious root (AR) development is an extremely complex biological process that is affected by many intrinsic factors and extrinsic stimuli. Some WUSCHEL-related homeobox (WOX) transcription factors have been reported to play important roles in AR development, but their functional relationships with auxin signaling are poorly understood, especially the developmental plasticity of roots in response to adversity stress. Here, we identified that the WOX11/12a–SMALL AUXIN UP RNA36 (SAUR36) module mediates AR development through the auxin pathway in poplar, as well as under salt stress. PagWOX11/12a displayed inducible expression during AR development, and overexpression of PagWOX11/12a significantly promoted AR development and increased salt tolerance in poplar, whereas dominant repression of PagWOX11/12a produced the opposite phenotype. PagWOX11/12a proteins directly bind to the SAUR36 promoter to regulate SAUR36 transcription, and this binding was enhanced during salt stress. Genetic modification of PagWOX11/12a–PagSAUR36 expression revealed that the PagWOX11/12a–PagSAUR36 module is crucial for controlling AR development via the auxin pathway. Overall, our results indicate that a novel WOX11–SAUR–auxin signaling regulatory module is required for AR development in poplar. These findings provide key insights and a better understanding of the involvement of WOX11 in root developmental plasticity in saline environments.
Weak relevant justification logics
Authors: Standefer Shawn
Published: August 2022

This paper will develop ideas from [44]. We will generalize their work in two directions. First, we provide axioms for justification logics over the base logic B and show that the logic permits a proof of the internalization theorem. Second, we provide alternative frames that more closely resemble the standard versions of the ternary relational frames, as well as a more general approach to the completeness proof. We prove that soundness and completeness hold for justification logics over a wide variety of base logics. Finally, we will strengthen Belnap’s variable sharing for the justification logic context, demonstrating that the justifications are properly relevant justifications.
Epidemiology
Authors: Albin Roger L.
Published: August 2022

The epidemiology of Parkinson disease (PD) is reviewed. PD was identified as a distinct clinical entity in the 19th century, and its pathology was clarified in the first half of the 20th century, but it is likely that it was during and after the mid-20th century that it emerged as a major medical problem. Studies of incidence, prevalence, mortality, and potential risk factors are reviewed. PD is a common age-related disorder with rising worldwide prevalence accompanying population aging. PD is associated with relatively increased mortality compared with appropriate reference populations. Considerable uncertainty exists about specific incidence rates and whether age-adjusted incidence is changing. A number of potential environmental risk factors were identified, but the causal relationship of many putative risk factors to PD incidence is unclear.
Pathology
Authors: Albin Roger L.
Published: August 2022

In this chapter, the pathology of Parkinson disease (PD) is reviewed. Discussions of PD pathology are dogged by the same problems of definition and metasyndromic heterogeneity that arise in other contexts of PD biology. And although pathologic evaluations are often regarded as “gold standards” for disease definition, the PD pathology literature is characterized by notable ambiguities. The intersection of brain aging and PD-specific pathology is discussed, and the key features of intraneuronal accumulation of α-synuclein–immunoreactive Lewy bodies and related inclusions are identified. The distribution of α-synucleinopathy within the substantia nigra, in other brain regions, and in the peripheral nervous system is discussed. The Braak system for staging PD pathology and its implications for understanding pathogenesis are described.
Pathogenesis
Authors: Albin Roger L.
Published: August 2022

Hypotheses regarding the pathogenesis of Parkinson disease (PD) are reviewed in this chapter. All proposed mechanisms of neurodegeneration involve disruptions of basic cellular processes, with considerable overlap among and interdigitation of these proposed mechanisms and cellular processes, both in terms of normal functions and potential dysfunctions. PD is an age-related syndrome with incidence focused in and generally rising in the later decades of life, and while many brain regions are affected in PD, there is at least relatively selective neuronal vulnerability to the pathogenic processes causing neuronal dysfunction-degeneration. The relative vulnerability of dopaminergic substantia nigra neurons is reviewed. Major hypotheses including the toxic effects of α-synuclein and its possible prion-like spread, mitochondrial dysfunction, oxidative stress, endolysomal dysfunction, and neuroinflammation are discussed. The role of neuroprotection trials in addressing major hypotheses of pathogenesis is discussed.
Who opposes refugees? Swedish demographics and attitudes towards forcibly displaced populations
Authors: Rozo Sandra V , Urbina Maria J
Published: August 2022

We exploit the quasi-random settlement of refugees in Sweden between 1985 and 1994 to examine characteristics of Swedish voters who showed a disproportionately negative response to increased migration inflows, and we assess whether these responses differed according to economic conditions when refugees arrived. We document that, on average, increases in migration inflows translated to lower support for immigration. These responses disproportionately stemmed from attitudinal changes in young males, those with less wealth, and people who worked in blue-collar occupations. Also, we find more support for immigration where employment increased and tax collection was lower when refugees arrived.
Refugees, trade, and FDI
Authors: Bahar Dany , Parsons Christopher , Vézina Pierre-Louis
Published: August 2022

Humanitarian policies aimed at welcoming forced migrants may yield unexpected economic dividends. This article focuses on the trade and investment links forged by refugees between their countries of resettlement and the origins they fled. We document how such immigrant-links differ in the case of refugees, focusing on why their opportunity sets might differ and the difficulties in establishing economic connections against a backdrop of civil conflict and political unrest. We conclude by discussing a range of policies aimed at engaging refugee diasporas to foster development at refugees’ origins.
Covid in the nursing homes: the US experience
Authors: Bjoerkheim Markus B , Tabarrok Alex
Published: August 2022

The death toll in nursing homes accounted for almost 30 per cent of total Covid-19 deaths in the US during 2020. We examine the course of the pandemic in nursing homes focusing especially on whether nursing homes could have been better shielded. Across all nursing homes the key predictor of infections and deaths was community spread, i.e. a factor outside of the control of nursing homes. We find that higher-quality nursing homes, as measured by the CMS Five-Star Rating system, were not better able to protect their residents. Policy failures from the CDC and FDA, especially in the early stages of the pandemic, created extended waiting times for Covid-19 tests and slowed attempts to isolate infectious residents. But once infections were widespread, testing would have had to have been much greater to have had an appreciable effect on nursing home deaths. We find, however, that starting vaccinations just 5 weeks earlier could have saved in the order of 14,000 lives and starting them ten weeks earlier could have saved 40,000 lives.
The Metric Used in the Global Health Impact Project: Implicit Values and Unanswered Questions
Authors: Asada Yukiko
Published: August 2022

The core aims of the Global Health Impact Project include incentivizing pharmaceutical companies for socially conscious production and promoting socially conscious consumption among consumers. Its backbone is a metric that computes the amount of illness burden alleviated by a pharmaceutical drug. This essay aims to assess the connection between values and numbers in the Global Health Impact Project. Specifically, I concentrate on two issues, the anonymity of illness burden and the distribution of health benefits. The former issue asks whether we should treat the illness burden of every person the same. The latter issue asks among whom health benefits should be fairly distributed. Examination of these issues begs for clarification of some of the key concepts of the Global Health Impact Project, such as the definition of essential medicines and the significance of national borders. Although this essay focuses on the two particular metric issues in the Global Health Impact Project, its core argument is applicable to other metrics for ethically motivated initiatives—to construct a metric for an ethically motivated initiative, it is not only important to articulate underlying concepts and values, but it is also important to operationalize them, so they are consistently reflected in the metric.
How Gene–Culture Coevolution can—but Probably did not—Track Mind-Independent Moral Truth
Authors: Cofnas Nathan
Published: August 2022

I argue that our general disposition to make moral judgments and our core moral intuitions are likely the product of social selection—a kind of gene–culture coevolution driven by the enforcement of collectively agreed-upon rules. Social selection could potentially track mind-independent moral truth by a process that I term realist social selection: our ancestors could have acquired moral knowledge via reason and enforced rules based on that knowledge, thereby creating selection pressures that drove the evolution of our moral psychology. Given anthropological evidence that early humans designed rules with the conscious aim of preserving individual autonomy and advancing their collective interests, the theory of realist social selection appears to be attractive for moral realists. The goal of evolutionary debunking arguments should be to show not that our moral beliefs are the product of natural selection, but that realist social selection did not occur.
Innovation: It’s in Our DNA
Authors: Kigin Colleen M
Published: August 2022

Colleen M. Kigin, PT, DPT, MS, MPA, FAPTA, the 52nd Mary McMillan Lecturer, is a consultant focused on innovation. She is a visiting clinical professor at the University of Colorado physical therapy program, University of Colorado School of Medicine, and an adjunct associate professor at the MGH Institute of Health Professions (MGH IHP). From 1998–2014, she held the positions of chief of staff and program manager for the Center of Integration of Medicine and Innovative Technology, a 12-institution consortium based in Boston, Massachusetts, developing innovative solutions to health care problems. She subsequently has served as a consultant to such efforts as the University of Manchester, Manchester Academic Health Science Centre, United Kingdom, to develop an innovation culture. In 1994, she joined the newly formed Partners HealthCare System in Boston, coordinating the system's cost reduction efforts through 1998. Kigin previously served as director of physical therapy services at Massachusetts General Hospital (MGH) (1977–1984) and as assistant professor at MGH IHP (1980–1994). While at MGH, she was responsible for the merger of 2 separate physical therapy departments, the establishment of the first nonphysician specialist position, and practice without referral for the physical therapy services. Kigin has held numerous positions within the American Physical Therapy Association (APTA), serving on the Board of Directors from 1988–1997, including as vice president; co-chair of The Physical Therapy Summit in 2007; and co-chair of FiRST, the Frontiers in Rehabilitation, Science and Technology Council. She also served as prior chair of the APTA Committee on Clinical Residencies and served on the American Board of Physical Therapy Specialties. Kigin earned a bachelor of science degree in physical therapy at the University of Colorado, a master of science degree at Boston University, a master's degree in public administration from the Harvard Kennedy School of Government, and a doctor in physical therapy degree from the MGH IHP.
Conflicting Interests and the Effect of Fiduciary Duty: Evidence from Variable Annuities
Authors: Egan Mark , Ge Shan , Tang Johnny
Published: August 2022

We examine the variable annuity market to study conflicts of interest and the effect of fiduciary duty in brokerage markets. Insurers typically pay brokers higher commissions for selling more expensive annuities. Our results indicate that sales are four times as sensitive to brokers’ interests as to investors’. To limit conflicts of interest, the Department of Labor proposed a rule in 2016 holding brokers to a fiduciary standard. We find that after the proposal, sales of high-expense products fell by 52$\%$ as sales became more sensitive to expenses. Based on our structural estimates, investor welfare improved overall.

Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Impact of COVID-19 on the Italian Mental Health System: A Narrative Review
Authors: Carpiniello Bernardo , Vita Antonio
Published: August 2022

Italy has been severely affected by the COVID-19 pandemic, consequently producing a heavy burden on the Italian National Health Service. From February 2020 until the end of the same year, the Italian Mental Health System (MHS), comprising an extensive network of community services, was subjected to a significant decrease in standards of care followed at the beginning of 2021 by a slow return to usual levels of activity. Data reported in the present article highlight how the Italian MHS – as was the case in the majority of countries—was largely unprepared for this emergency, suggesting an impelling need to develop appropriate supplementary national plans with the aim of preventing similar situations from developing in the future. The upheaval caused by the pandemic has highlighted the need to reinforce, both at a local and national level, the organization and standards of care of the Italian MHS in order to protect and support the mental health of patients with severe mental disorders, health workers, and the general population, thus preventing a potential “pandemic” of mental disorders.
Red propolis exhibits chemopreventive effect associated with antiproliferative and anti-inflammatory activities
Authors: de Freitas Karoline Soares , da Silva Lucas Henrique Domingos , Squarisi Iara Silva , de Souza Oliveira Lucas Teixeira , Ribeiro Arthur Barcelos , Alves Bianca Silva , Esperandim Tábata Rodrigues , de Melo Matheus Reis Santos , Ozelin Saulo Duarte , Lemes Danieli Cristina , Bastos Jairo Kenupp , Veneziani Rodrigo Cassio Sola , Tavares Denise Crispim
Published: August 2022

INTRODUCTION: Red propolis is synthetized from exudates of Dalbergia ecastophyllum (L) Taub. and Symphonia globulifera L.f., presents isoflavones, guttiferone E, xanthochymol, and oblongifolin B and has anti-inflammatory, antioxidant, and antiproliferative activities. OBJECTIVES: This study aimed to evaluate the antigenotoxic and anticarcinogenic potential of red propolis hydroalcoholic extract (RPHE) in rodents. METHODS: The influence of RPHE in doxorubicin (DXR)-induced genotoxicity was investigated through the micronucleus test in Swiss mice. Blood samples were also collected to investigate oxidative stress, hepatotoxicity, and nephrotoxicity. Was investigated the influence of RPHE in 1,2-dimethylhydrazine (DMH)-induced aberrant crypt foci, as well as its influence in proliferating cell nuclear antigen (PCNA) and the cyclooxygenase-2 (COX-2) expression in colon of rats, by immunohistochemistry. RESULTS: The results showed that RPHE (48 mg/kg) reduced DXR-induced genotoxicity. Animals treated with DXR showed significantly lower GSH serum levels in comparison to the negative control. RPHE treatments did not attenuated significantly the DXR-induced GSH depletion. No difference was observed in cytotoxicity parameters of mice hematopoietic tissues between the treatment groups, as well as the biochemical parameters of hepatotoxicity and nephrotoxicity. RPHE (12 mg/kg) reduced the DMH-induced carcinogenicity and toxicity, as well as DMH-induced PCNA and COX-2 expression in colon tissue. CONCLUSION: Therefore, was observed that the RPHE has chemopreventive effect, associated to antiproliferative and anti-inflammatory activities.
Novel Vertical Cup-to-Disc Classification to Identify Normal Eyes That Maintain Non-Glaucoma Status: A 10-Year Longitudinal Study
Authors: Ikeda Yoko , Mori Kazuhiko , Maruyama Yuko , Ueno Morio , Yoshii Kengo , Yamamoto Yuji , Imai Kojiro , Omi Natsue , Sato Ryuichi , Sato Fumiko , Nakano Masakazu , Hamuro Junji , Tashiro Kei , Sotozono Chie , Kinoshita Shigeru
Published: August 2022

Précis:

We propose a new classification model to serve as a control for future genomic studies of glaucoma by distinguishing normal subjects maintaining non-glaucoma status for 10 years using the vertical cup-to-disc ratio (VCDR).

Purpose:

This study aimed to develop a classification for distinguishing subjects maintaining non-glaucoma status for 10 years using the VCDR.

Participants and Methods:

Among 842 volunteers 40 years and older, 421 volunteers participated in the second ophthalmic examination 10 years after their first examination. Each volunteer was diagnosed either as healthy normal or glaucoma suspect (GS) in the first glaucoma screening examinations. The former was further classified into the 3 grades of N1, N2, and N3. Specifically, N1 represented (1) VCDR <0.3; (2) no notching or nerve fiber layer defect; and (3) no undermining, N2 indicated 0.3≤VCDR<0.6 and conditions (2) and (3) of N1; and N3 represented 0.3≤VCDR<0.6 with undermining and condition (2), or 0.6≤VCDR<0.7 and condition (2) of N1. Glaucoma transition rates (GTRs) were evaluated in 421 volunteers who returned to participate after a 10-year period.

Results:

GTRs were calculated as 1.3% in both N1 and N2, 3.9% in N3, and 18.2% in GS. The ratio of volunteers in the same category maintenance rate increased from N1 to N3.

Conclusion:

GTRs were lower in N1 and N2 than in N3 or GS during the 10-year study period. This novel classification of healthy non-glaucoma subjects may help identify those, especially Japanese males, who maintain a non-glaucoma status for an extended period of 10 years.
Evaluation of a polymer-coated nanoparticle cream formulation of resiniferatoxin for the treatment of painful diabetic peripheral neuropathy
Authors: Baskaran Padmamalini , Mohandass Adithya , Gustafson Noah , Bennis Jane , Louis Somaja , Alexander Brenda , Nemenov Mikhail I. , Thyagarajan Baskaran , Premkumar Louis S.
Published: August 2022

Painful diabetic peripheral neuropathy (PDPN) is one of the major complications of diabetes. Currently, centrally acting drugs and topical analgesics are used for treating PDPN. These drugs have adverse effects; some are ineffective, and treatment with opioids is associated with use dependence and addiction. Recent research indicates that transient receptor potential vanilloid 1 (TRPV1) expressed in the peripheral sensory nerve terminals is an emerging target to treat pain associated with PDPN. Block of TRPV1 ion channel with specific antagonists, although effective as an analgesic, induced hyperthermia in clinical trials. However, TRPV1 agonists are useful to treat pain by virtue of their ability to cause Ca2+ influx and subsequently leading to nerve terminal desensitization. Here, we report the effectiveness of an ultrapotent TRPV1 agonist, resiniferatoxin (RTX) nanoparticle, in a topical formulation (RTX-cream; RESINIZIN) that alleviates pain associated with DPN in animal models of diabetes. Resiniferatoxin causes nerve terminal depolarization block in the short term, which prevents pain during application and leading to nerve terminal desensitization/depletion in the long term resulting in long-lasting pain relief. Application of RTX cream to the hind limbs suppresses thermal hyperalgesia in streptozotocin-induced diabetic rats and mini pigs without any adverse effects as compared with capsaicin at therapeutic doses, which induces intense pain during application. Resiniferatoxin cream also decreases the expression of TRPV1 in the peripheral nerve endings and suppresses TRPV1-mediated calcitonin gene–related peptide release in the skin samples of diabetic rats and mini pigs. Our preclinical data confirm that RTX topical formulation is an effective treatment option for PDPN.
Increased nasality of connected speech in patients underwent modified Lothrop procedure for refractory chronic rhinosinusitis: Cross-sectional and prospective study
Authors: Pan Yi-An , Wang Ying-Piao , Lee Guo-She , Hsieh Li-Chun , Chen Yi-Chen
Published: August 2022

Background:

The endoscopic modified Lothrop procedure (EMLP) is performed to create a large frontal neostium in patients who had failed previous frontal sinus surgeries. EMLP causes obvious changes in the volume and anatomy of the sinuses, which may cause a more significant change in nasality. This study aimed to evaluate the changes in nasalance in patients who underwent EMLP by comparing their preoperative nasalance to the established normative values and postoperative nasalance.

Methods:

This was a prospective study. Twenty-one patients diagnosed with refractory frontal sinusitis who were indicated to undergo EMLP were enrolled. One hundred one healthy participants were enrolled as norm references. The Nasometer II Model 6400 (KayPENTAX) was used to analyze the nasalance scores. Nasalance scores were tested before surgery and 1 and 3 months after the surgery.

Results:

The normative references of nasalance were (mean ± SD) 14.6% ± 6.7%, 39.4% ± 8.4%, and 55.8% ± 8.3% for the oral passage, oral-nasal passage, and nasal sentences, respectively. The mean nasalance scores pre-EMLP and 1 and 3 months post-EMLP were 23.2% ± 9.6%, 29.0% ± 9.3%, and 29.9% ± 0.4% for the oral passage; 48.7% ± 10.7%, 54.7% ± 7.7%, and 56.4% ± 7.2% for the oral-nasal passage; and 62.7% ± 10.9%, 69.8% ± 6.7%, and 70.7% ± 6.4% for the nasal sentences, respectively. Compared with the normative references, pre-EMLP nasalance was higher for all the three speech stimuli (t-test, p < 0.05). Post-EMLP nasalance also significantly increased for all the three stimuli at the 1- and 3-month follow-up visits (Paired t-test, p < 0.05).

Conclusion:

EMLP has a short-term impact on resonance; however, long-term follow-up is required for further study.
Patient Characteristics and Positive Outcomes Associated With a Novel Youth Inpatient Program for Concurrent Disorders
Authors: Saulnier Luc , Keramatian Kamyar , Cohen Jordan
Published: August 2022

Concurrent substance use and mental health disorders in youth are a major public health concern and require specialized and comprehensive services. In this paper, a novel inpatient tertiary care facility serving youth aged 13 to 18 with significant concurrent substance use and mental health issues is introduced. The development of this unit was prompted by the opioid overdose crisis in British Columbia and serves as the third concurrent disorders unit in Canada catered specifically to an adolescent population. From its opening in 2017, preadmission and postadmission data from each patient was gathered with the aim of providing a robust image of the serviced patient population as well as the efficacy of this service model. Patients admitted to this program had significantly higher quality of life (d = 0.65) and significantly lower suicidality (d = 0.86) at discharge, compared with at admission. Patients identifying as female had significantly lower quality of life, higher suicidality, and higher prevalence of adverse childhood events compared with patients identifying as male. Results from this program evaluation outline the efficacy of a novel concurrent disorders program for youth while further providing an overview of clinical and relevant demographic characteristics from an underanalyzed patient population.
The history of cardiac pacing in the young and a look to the future
Authors: Cohen Mitchell I. , Thurber Cristina
Published: August 2022

Purpose of review

The purpose of this review is to explore the historical and serendipitous events that led to the creation of modern-day pacemakers. In addition, this review will explore how contemporary conduction site-specific pacing has overcome some of the deleterious effects from historical chronic right ventricular apical pacing.

Recent findings

Recently, there have been tremendous advances in not just the lead design but the tools required to promote more physiologic pacing. Although cardiac resynchronization pacing has been around for nearly 2 decades, this review also introduces and discusses the early results of His-bundle pacing and left bundle branch pacing and some of the potential applicability of this technology for our children.

Pacemakers have evolved significantly in the last 30 years through collaborative partnerships between physicians and engineers. The future of cardiac pacing is bright compared to the field of electrotherapy 50 years ago. Future iterations of pacemakers must consider unusual anatomy and growing children. Pediatric patients contribute to a small percentage of the overall device volume, but the majority of these patients will have a pacemaker for life. We need to be proactive and consider what are the best short and long-term solutions for this cohort.
Extracorporeal Membrane Oxygenation Outcomes in Children With Preexisting Neurologic Disorders or Neurofunctional Disability*
Authors: Dante Siddhartha A. , Carroll Megan K. , Ng Derek K. , Patel Ankur , Spinella Philip C. , Steiner Marie E. , Loftis Laura L. , Bembea Melania M. ,   for the Pediatric ECMO (PediECMO) subgroup of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network and the Extracorporeal Life Support Organization (ELSO)
Published: August 2022

Objective:

Patient selection for pediatric extracorporeal membrane oxygenation (ECMO) support has broadened over the years to include children with pre-existing neurologic morbidities. We aimed to determine the prevalence and nature of pre-ECMO neurologic disorders or disability and investigate the association between pre-ECMO neurologic disorders or disability and mortality and unfavorable neurologic outcome.

Design:

Multicenter retrospective observational cohort study.

Setting:

Eight hospitals reporting to the Pediatric ECMO Outcomes Registry between October 2011 and June 2019.

Patients:

Children younger than 18 years supported with venoarterial or venovenous ECMO.

Interventions:

The primary exposure was presence of pre-ECMO neurologic disorders or moderate-to-severe disability, defined as Pediatric Cerebral Performance Category (PCPC) or Pediatric Overall Performance Category (POPC) 3–5. The primary outcome was unfavorable outcome at hospital discharge, defined as in-hospital mortality or survival with moderate-to-severe disability (discharge PCPC 3–5 with deterioration from baseline).

Measurements and Main Results:

Of 598 children included in the final cohort, 68 of 598 (11%) had a pre-ECMO neurologic disorder, 70 of 595 (12%) had a baseline PCPC 3–5, and 189 of 592 (32%) had a baseline POPC 3–5. The primary outcome of in-hospital mortality (n = 267) or survival with PCPC 3–5 with deterioration from baseline (n = 39) was observed in 306 of 598 (51%). Overall, one or more pre-ECMO neurologic disorders or disability were present in 226 of 598 children (38%) but, after adjustment for age, sex, diagnostic category, pre-ECMO cardiac arrest, and ECMO mode, were not independently associated with increased odds of unfavorable outcome (unadjusted odds ratio [OR], 1.34; 95% CI, 1.07–1.69; multivariable adjusted OR, 1.30; 95% CI, 0.92–1.82).

Conclusions:

In this exploratory study using a multicenter pediatric ECMO registry, more than one third of children requiring ECMO support had pre-ECMO neurologic disorders or disability. However, pre-existing morbidities were not independently associated with mortality or unfavorable neurologic outcomes at hospital discharge after adjustment for diagnostic category and other covariates.
Pregnancy in Women With HIV in a Tuberculosis Preventive Therapy Trial
Authors: Singh Priya , Moulton Lawrence H. , Barnes Grace L. , Gupta Amita , Msandiwa Reginah , Chaisson Richard E. , Martinson Neil A.
Published: August 2022

Background:

Tuberculosis preventive therapy (TPT) is recommended for people with HIV infection, including during pregnancy. The effect of TPT exposure at conception and during pregnancy is poorly documented.

Methods:

We report pregnancy outcomes among South African women with HIV enrolled in a randomized trial of 4 TPT regimens (two 3-month regimens, rifapentine/isoniazid [3HP] or rifampin/isoniazid [3HR], isoniazid for 6 months, or isoniazid continuously). Descriptive statistics and risk ratios were assessed to examine relationships between study regimens and outcomes.

Results:

216/896 women (24%) conceived during the study. Women who conceived were younger (27.9 vs 31.3 years) and had higher mean CD4 counts (589.1 vs 536.7). The odds of pregnancy were higher in women in the rifamycin-isoniazid arms than those in the isoniazid arms (3HP: relative risk [RR] 1.73, P = 0.001; 3HR:RR 1.55, P = 0.017) despite increased contraceptive use compared with the standard 6H therapy. Thirty-four women became pregnant while taking preventive treatment (8 rifamycin and 26 isoniazid monotherapy). Pregnancy outcomes in these women were as follows: 17 (50%) mother/baby healthy, 3 (9%) spontaneous abortions, 6 (18%) elective abortions, 1 (3%) premature delivery, 2 (6%) neonatal deaths [1 rifamycin-isoniazid and 1 isoniazid], and 5 (15%) unknown.

Conclusions:

Pregnancy was common in women who had received TPT and more frequent in women who had received rifamycin-isoniazid–based regimens.
Clinical Results Evaluation of Patients With Submental Mass Through Endoscopy-Assisted Transoral Surgery
Authors: Zhu Chuandong , Liu Deyu , Liu Zhixin , Rui Tao , Zhou Bin , Wang Youyuan
Published: August 2022

Background:

Surgical resection through extraoral approach is the first choice for submental mass but leaves a visible scar. This study introduces an endoscopy-assisted transoral approach to resect submental mass and evaluates the clinical results.

Patients and Methods:

From September 2018 to December 2019, 5 patients with submental mass underwent surgical resection through endoscopy-assisted transoral approach. The swallowing, speech, and appearance domains of the University of Washington Quality of Life questionnaire were assessed preoperatively and at 3 months postoperatively.

Results:

Each mass was completely removed without rupture. No patient developed any permanent postoperative complications. The function and aesthetic outcomes were excellent without recurrence.

Conclusions:

Endoscopy-assisted transoral approach for resection of submental mass is a reliable technique that achieves excellent postoperative aesthetics and functional results.
Midface Rejuvenation With Autologous Fat Grafting
Authors: Sheng Lingling , Yu Ziyou , Li Shengli , Jiang Zhaohua , Cao Weigang
Published: August 2022

Background:

Midface rejuvenation is important to restore a youthful and appealing appearance. However, there are several problems existed in the treatment of fat grafting, including low fat retention and undesired aesthetic outcomes.

Objective:

To objectively evaluate the efficacy of midface fat grafting, and analyze the problems encountered in this process to increase patient satisfaction.

Methods:

Thirty-two patients who underwent autologous fat grafting for midface augmentation were included. Facial analysis was performed based on preoperative and postoperative photographs. Satisfaction outcome was assessed by the patient, the surgeon, and a layperson postoperatively.

Results:

After treatment, 87.5% of the patients were assessed as satisfactory and mostly satisfactory based on facial proportion and complications. The postoperative medial cheek projection was 1.92±0.26 times the height of the preoperative one (P<0.01). A smooth lid-cheek junction, a single convex, and ameliorated nasolabial groove were obtained. The dark coloration and wrinkles in lower eyelid were improved. The most common complication was overcorrection, which could be resolved with further treatments.

Conclusions:

Autologous fat grafting remains an optimal option for midface rejuvenation with satisfactory results. Most of the complications are preventable and optimal outcomes can be obtained through correct comprehension of aesthetic features and proper operations.
Natural History of Traumatic Encephaloceles: A Systematic Literature Review
Authors: Langman Maya , Stopa Brittany M. , Cuoco Joshua A. , Patel Vaibhav M. , Rogers Cara M. , Marvin Eric A.
Published: August 2022

Encephaloceles rarely develop following traumatic skull fractures. Given their low incidence, the clinical presentations and management strategies of these lesions are confined to case reports and limited case series. A systematic literature review was performed using PubMed, Ovid, and Web of Science databases to identify relevant articles using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 37 articles met inclusion criteria, including the case presented herein. These articles reported 52 traumatic encephaloceles. Mean patient age was 25.3 years (range 6 mo–66 y) with a male predominance (63%, 33/52). The most common bony defects resulting in encephalocele formation were the orbital roof (52%, 27/52), ethmoid (35%, 18/52), and sphenoid (10%, 5/52). Mean time from traumatic injury to initial presentation was 21.3 months (range 0 d–36 y) with a bimodal distribution split between immediately following the traumatic injury (57%, 26/46) or in a delayed manner (43%, 20/46). Common presentations of orbital roof, frontonasal, and temporal bone encephaloceles were exophthalmos (85%, 23/27), cerebrospinal fluid rhinorrhea (71%, 17/24), and hearing loss (100%, 4/4), respectively. Operative approach, repair technique, and materials used for encephalocele reduction were highly variable. Surgical intervention afforded definitive symptomatic improvement or resolution in the majority of cases (89%, 42/47). Clinical outcomes did not differ between orbital, frontonasal, or temporal bone encephaloceles (P=0.438). Traumatic encephaloceles are a rare entity with diverse presenting symptomatology dependent upon the location of fracture dehiscence. Surgical intervention affords symptomatic improvement in the majority of cases irrespective of encephalocele location, time to presentation, or operative approach.