bluuebunny/crossref_metadata_2025 huggingface dataset:
The importance of infectious disease specialists consulting on a weekly basis in a Japanese tertiary care hospital: A retrospective observational study
Authors: Hadano Yoshiro , Suyama Asuka , Hijikata Toshiyuki , Miura Ayako , Fujii Shigeo , Suzuki Yoshiko , Tomoda Yoshitaka , Awaya Yukikazu
Published: January 2023

Limited data are available regarding part-time infectious disease consultations (IDCs) and their importance in tertiary care teaching hospitals in Japan. This is a retrospective review of IDCs from June 2016 to March 2021 and describes IDC services provided by part-time infectious disease specialists once a week for 4 hours, and their impact on the quality of medical care, including antimicrobial stewardship. Data, such as the requesting department, requesting reasons, and final diagnoses, were analyzed. In April 2018, part-time infectious disease specialists launched consultation services and attended an antimicrobial stewardship team conference. Meropenem, tazobactam/piperacillin, and cefepime monthly days of therapy (DOT) were calculated to assess the effect of each intervention; a pre-post analysis was conducted using the Kruskal–Wallis test. Additional quality improvement (QI) projects related to infectious diseases were implemented. There were 237 IDCs during the study period. Consultations were mostly requested by the General Internal Medicine, Emergency Medicine, and Cardiology departments. The most common diagnoses were bone/joint, respiratory, and genitourinary infections. Infectious disease services, even on a part-time basis, achieve good outcomes in patient management, antimicrobial stewardship, and QI projects.

DOT/1000 patient-days were reduced for meropenem and cefepime, while it increased for tazobactam/piperacillin. The DOT/1000 patient-days for the 3-antipseudomonal agents significantly decreased during this period. After implementing the QI tetanus vaccination project in the Emergency Room, the number of tetanus toxoid vaccinations per month increased.
Follicular carcinoma originating from struma ovarii: A case report
Authors: Shou Leyi , Lu Jianfeng , Yang Junjie , Wang Huabing , Sun Lijun , Dong Hao , Jiang Yiqian
Published: January 2023

Introduction:

Follicular carcinoma originating from struma ovarii is a clinically rare low-grade malignant tumor. The pathological diagnosis of ovarian thyroid follicular carcinoma is predominantly based on the infiltrative growth and vascular involvement of tumor cell nests of different sizes in the ovarian parenchyma.

Patient concerns:

Here we present a case of this malignancy in which the bilateral ovaries, right oviduct wall, myometrial surface, omentum, and bladder reflex were extensively involved Microscopically, the thyroid follicles in this case showed infiltrative growth of nodules of different sizes in the ovarian stroma.

Diagnosis:

The epithelial layer of the follicles was atypical, but with no nuclear features of papillary thyroid carcinoma such as nuclear groove and nuclear pseudoinclusions. Immunohistochemistry showed positive expression of thyroglobulin, thyroid transcription factor-1, and cytokeratin19, with a Ki-67 index of 5% +. Immunohistochemical results combined with microscopic morphology allowed a diagnosis of follicular carcinoma originating from struma ovarii.

Interventions:

After exclusion of contraindications to surgery, the patient underwent surgical exploration on July 26, 2022, during which frozen pathological examination was performed.

Outcomes:

The patient recovered well and was discharged. At the first follow-up visit in October 2022, the patient had an excellent survival.

Conclusion:

The analysis of the microscopic morphological characteristics and immunohistochemistry deepened our understanding of the pathological characteristics of ovarian and thyroid follicular carcinoma, and further provides a diagnostic reference for other clinicians who will encounter these conditions in the future.
Improved treatment of vulvovaginal candidiasis with Clotrimazole plus probiotic Lacidophilin Vaginal Capsules: A prospective, real-world study
Authors: Zeng Xianling , An Ruifang , Li Han , Zhang Yafei
Published: January 2023

Background:

Clotrimazole has long been used to treat vulvovaginal candidiasis (VVC), yet the antibiotic resistance, adverse effects and recurrences still bring about a great challenge for the clinicians. To explore the effect of probiotic Lacidophilin Vaginal Capsules plus Clotrimazole Vaginal Tablets (500mg) in the treatment of uncomplicated VVC, a self-controlled real-world study was conducted.

Methods:

Twenty-seven women with a normal vaginal flora and 15 women with uncomplicated VVC were recruited. The patients were treated with the single dose of Clotrimazole Vaginal Tablets (500mg) supplemented with 2 Lacidophilin Vaginal Capsules for the following 7 days. The patients were prospectively examined 4 times and the time points were at m0 (the first visit), m1 (8–10 days after the first visit), m2 (30 days after the second visit) and m3 (30 days after the third visit). However, women in the healthy normal control group were examined just once at the first visit. The obtained vaginal secretions were examined by high-throughput sequencing.

Results:

The mean age in healthy control group and case group was 28.63 ± 5.40y and 27.67 ± 3.33y, respectively. Finally, 46.67% (7/15) of patients were cured at the second visit, 61.54% (8/13) were cured at the third visit and eventually 72.73% (8/11) were cured. A total of 81 samples were sequenced, generating 1668 operation taxonomy units among all the samples. The bacterial composition of women in the healthy control group was exceedingly abundant and dominated by Lactobacillus, especially by Lactobacillus. crispatus, and followed by Lactobacillus. iners, Lactobacillus. jensenii and Gardneralla. On the contrary, the bacterial composition of women with VVC was relatively few and dominated by Lactobacillus. iners. During the process of treatment, the bacterial abundance of VVC patients was increased gradually. At the final visit, the abundance of vaginal flora was augmented further with the dominant bacteria being Lactobacillus. crispatus, followed by Lactobacillus. iners.

Conclusion:

Clotrimazole Vaginal Tablets plus probiotic Lacidophilin Vaginal Capsules could improve the effect in treating uncomplicated VVC. This improved effect was achieved perhaps through improving the composition of vaginal flora and restoring vaginal microecology.
Residual Disease Threshold After Primary Surgical Treatment for Advanced Epithelial Ovarian Cancer, Part 1: A Systematic Review and Network Meta-Analysis
Authors: Bryant Andrew , Johnson Eugenie , Grayling Michael , Hiu Shaun , Elattar Ahmed , Gajjar Ketankumar , Craig Dawn , Vale Luke , Naik Raj
Published: January 2023

Background:

We present a systematic review and network meta-analysis (NMA) that is the precursor underpinning the Bayesian analyses that adjust for publication bias, presented in the same edition in AJT. The review assesses optimal cytoreduction for women undergoing primary advanced epithelial ovarian cancer (EOC) surgery.

Areas of Uncertainty:

To assess the impact of residual disease (RD) after primary debulking surgery in women with advanced EOC. This review explores the impact of leaving varying levels of primary debulking surgery.

Data Sources:

We conducted a systematic review and random-effects NMA for overall survival (OS) to incorporate direct and indirect estimates of RD thresholds, including concurrent comparative, retrospective studies of ≥100 adult women (18+ years) with surgically staged advanced EOC (FIGO stage III/IV) who had confirmed histological diagnoses of ovarian cancer. Pairwise meta-analyses of all directly compared RD thresholds was previously performed before conducting this NMA, and the statistical heterogeneity of studies within each comparison was evaluated using recommended methods.

Therapeutic Advances:

Twenty-five studies (n = 20,927) were included. Analyses demonstrated the prognostic importance of complete cytoreduction to no macroscopic residual disease (NMRD), with a hazard ratio for OS of 2.0 (95% confidence interval, 1.8–2.2) for <1 cm RD threshold versus NMRD. NMRD was associated with prolonged survival across all RD thresholds. Leaving NMRD was predicted to provide longest survival (probability of being best = 99%). The results were robust to sensitivity analysis including only those studies that adjusted for extent of disease at primary surgery (hazard ratio 2.3, 95% confidence interval, 1.9–2.6). The overall certainty of evidence was moderate and statistical adjustment of effect estimates in included studies minimized bias.

Conclusions:

The results confirm a strong association between complete cytoreduction to NMRD and improved OS. The NMA approach forms part of the methods guidance underpinning policy making in many jurisdictions. Our analyses present an extension to the previous work in this area.
Early Single-Center Experience With Irreversible Electroporation for Stage 2, 3, and 4 Pancreatic Adenocarcinomas
Authors: Wall Chris , Ahmed Shahid , Kabir Rasel , Lim Hyun J. , Iqbal Mussawar , Chalchal Haji , Domes Trustin , Beck Gavin , Luo Yigang , Ogaick Maurice , Shaw John , Moser Michael
Published: January 2023

Objectives

Irreversible electroporation (IRE) is an ablation technology that uses electrical energy delivered between electrodes. If the electrodes are placed atraumatically, there is little to no risk of collateral injury, making IRE appealing for the treatment of pancreatic tumors.

Methods

We report on 20 patients with pancreatic adenocarcinoma (PAC) who underwent 21 IRE in our center. There were 6 IRE for stage 2 PAC, 11 for stage 3 PAC, 1 for stage 4 PAC, and 2 patients treated with IRE for recurrence after pancreaticoduodenectomy. One patient had local progression 18 months after IRE and received a second IRE treatment. Using propensity score matching (age, sex, stage, tumor size, and chemotherapy), cases were matched 2 to 1 with patients from the Surveillance, Epidemiology, and End Results database.

Results

A total of 7 cases experienced 8 complications; 4 complications were mild, and 4 were severe. Significant survival benefit was seen for patients with stage 3 PAC (27.5 vs 14.6 months for the matched group, P = 0.003); for stage 2, median survival was 15 months, and the single stage 4 patient survived 9 months after IRE treatment.

Conclusions

Pancreatic cancers were safely and effectively treated with image-guided IRE in our medium-sized center.
Association of Islet Amyloid Polypeptide to C-Peptide Ratio With Cystic Fibrosis–Related Diabetes
Authors: Thota Rohith N. , Wynne Katie , Pradeepan Shyamala , Wark Peter A.B. , Garg Manohar L.
Published: January 2023

Objectives

Early detection of cystic fibrosis (CF) related diabetes (CFRD) improves health outcomes and reduces CF-related mortality. The study aims to evaluate the ratio of islet amyloid polypeptide (IAPP) to C-peptide in CF patients with diabetes and without diabetes.

Methods

Cross-sectional analysis was carried out in a prospective cohort of 33 participants (CF [n = 16] and CFRD [n = 18]). We examined the association of plasma IAPP:C-peptide ratio with clinical information, including glycated hemoglobin, and lung function markers.

Results

The median (interquartile range) IAPP:C-peptide ratio was significantly (P = 0.004) higher in people with CFRD (4.8 [4.5]) compared with participants without CFRD (12.1 [19.7]). The ratio of IAPP to C-peptide significantly accounted for a 38% variation in the diabetes status in patients with CF (r
2 = 0.399, P < 0.001). Islet amyloid polypeptide is strongly correlated with serum ferritin levels (r = 0.683, P = 0.005) and forced expiratory volume in CFRD, but not in nondiabetic participants with CF.

Conclusions

Islet amyloid polypeptide:C-peptide ratio could be a potential marker of CFRD in adults with CF. Further research requires validation of this marker in longitudinal cohort studies to confirm the capability of IAPP:C-peptide to predict CFRD.
Long Noncoding RNA PSMA3 Antisense RNA 1 Promotes Cell Proliferation, Migration, and Invasion in Pancreatic Ductal Adenocarcinoma Via Targeting MicroRNA-154-5p to Positively Modulate Karyopherin Subunit Alpha 4
Authors: Bi Jiancheng , Liang Wenjie , Wang Yaqi , Tian Wei , Cao Shuang , Liu Ping
Published: January 2023

Objectives

Pancreatic ductal adenocarcinoma (PDAC), as the most frequent pancreatic tumor, featuring high death rate. The current study intends to explore the biological role of PSMA3 antisense RNA 1 (PSMA3-AS1) and its mechanism underlying PDAC progression.

Methods

Expression analyses were conducted using quantitative reverse transcription–polymerase chain reaction. Proliferative, apoptotic, migratory, and invasive capacities were determined by functional assays, encompassing 5-ethynyl-2′-deoxyuridine, colony formation, JC-1, terminal deoxynucleotidyl transferase dUTP nick-end labeling, and transwell assays in PDAC cells. The RNA-binding protein immunoprecipitation, RNA pulldown, and luciferase reporter assays uncovered the biological and regulatory role of PSMA3-AS1 in PDAC.

Results

Long noncoding RNA PSMA3-AS1 was aberrantly overexpressed in PDAC cells. Downregulated PSMA3-AS1 repressed cell proliferative, migratory, and invasive capacities and propelled cell apoptosis of PDAC. MicroRNA-154-5p (miR-154-5p) was proved to be targeted by PSMA3-AS1 in PDAC cells. Karyopherin subunit alpha 4 (KPNA4) was the downstream target messenger RNA of miR-154-5p. Karyopherin subunit alpha 4 knockdown hindered cell proliferation, migration, and invasion in PDAC. In rescue assays, KPNA4 overexpression or miR-154-5p interference counteracted the inhibitory influence of PSMA3-AS1 ablation on the progression of PDAC cells.

Conclusions

Our results suggested that PSMA3-AS1 enhances PDAC cell proliferative, migratory, and invasive capacities via modulating miR-154-5p/KPNA4 axis.
Emerging Trends in Intestinal Knowledge Structure Associated With Acute Pancreatitis From 1981 to 2021
Authors: Liu Yang , Zhou Xiaojiang , Xiong Huifang , Song Conghua , Xie Yong
Published: January 2023

Objectives

Bibliometric analysis has not comprehensively summarized studies of acute pancreatitis (AP)–associated intestinal diseases. This work aimed to evaluate cooperative networks of authors, countries, and institutions and explore the field's developing trends and hot topics.

Methods

Original articles and reviews of AP-associated intestinal diseases were obtained from the Web of Science Core Collection on October 11, 2021. VOSviewer and CiteSpace software were used to perform co-occurrence analyses for authors, countries, and institutions and detect the highest citation burst.

Results

A total of 1634 articles on the intestine associated with AP were identified. The United States, the University of Auckland, and Roland Andersson are the most influential country, research institute, and scholar, respectively. The World Journal of Gastroenterology (73 articles) has the highest number of publications, and Gastroenterology was the most co-cited journal. The top 5 key words are “acute pancreatitis,” “bacterial translocation,” “management,” “gut,” and “inflammatory bowel disease.” We find that several emergent key words like “gut microbiota,” “pathway,” “gut barrier,” “risk,” and “oxidative stress” experienced a continuous and rapid development as new research directions.

Conclusions

This bibliometric study summarizes current important perspectives and offers comprehensive guidance on the AP-associated intestinal diseases, which may help researchers choose the most appropriate research directions.
Evaluation of Third Molar Maturity Index by Cone Beam Computed Tomography in Legal Age Estimation
Authors: Yurdabakan Zeliha Zuhal , Karadayı Beytullah , Yetimoğlu Nihal
Published: January 2023

This retrospective study aimed to evaluate the accuracy and applicability of the third molar maturity index (I3M) for discriminating Turkish minors from adults, and its relationship with chronological age using cone beam computed tomography (CBCT). A total of 122 CBCT scans of Turkish individuals (55 boys and 67 girls) aged 13 to 23 years were evaluated using the I3M cutoff value. Chronological age gradually decreased as the I3M value increased. The overall accuracy was 95.9%. The sensitivity and specificity of this test were 93.5% and 97.4%, respectively. Positive predictive value was 95.6%. The intraclass correlation coefficient values of the I3M for the intraobserver and interobserver agreements were 0.998 and 0.996, respectively. This study showed relatively higher reproducibility of measurements on CBCT scans than on panoramic radiographs in the literature. Cone beam computed tomography may be advantageous and preferred over panoramic radiographs in distinguishing the legal age threshold of 18 years according to Cameriere's method when a more extensive investigation is needed to support the solution of challenging and uncertain cases in forensic medicine.
Angiomyxoma of the Breast
Authors: Baranov Esther , Alston Erin L.J. , Lester Susan C. , Fletcher Christopher D.M. , Doyle Leona A.
Published: January 2023

Superficial angiomyxoma is an uncommon benign mesenchymal neoplasm that usually arises in dermis/subcutis of the extremities or trunk. Some tumors are associated with Carney complex. When arising in breast, these tumors are not well-recognized, mainly due to a lack of uniform nomenclature in the literature. This study therefore aims to improve recognition of angiomyxomas of the breast region. Forty cases were identified: demographics, presence of Carney complex, imaging and histologic features, PRKAR1A expression, and outcomes were evaluated. There were 22 female and 18 male patients (median age 40 years, range: 14 to 72). Most tumors presented as slowly-growing masses (77%). All but one were solitary, and median size was 1.5 cm. Tumors were superficial (dermal/subcutaneous) in 52.5% and deep/parenchymal in 47.5%. Nine involved the nipple-areola complex. All showed characteristic features of superficial angiomyxoma: poorly circumscribed, hypocellular, myxoid neoplasms with lobulated (55%) or infiltrative (45%) architecture, bland spindled fibroblasts, prominent thin-walled vessels, and admixed neutrophils. Tumors involving the nipple-areola complex infiltrated through areolar smooth muscle, and deep/parenchymal tumors showed entrapment of lobules mimicking myxoid fibroadenoma. Mitoses were typically absent, as was significant atypia. Cystic change was common. Two-thirds showed loss of PRKAR1A expression by immunohistochemistry. Two patients had Carney complex (7%). Recurrence after incomplete excision occurred in 1 patient. Angiomyxoma of breast may arise at superficial, nipple-areola or deep/parenchymal locations, where it can be difficult to recognize classic histologic features. Loss of expression of PRKAR1A is not invariable, but may be a helpful diagnostic clue. Recognizing angiomyxoma is important for 2 reasons: first, the recurrence rate is low and therefore wide excision is not essential, and second, it may allow detection of Carney complex in some patients.
Control Charts Usage for Monitoring Performance in Surgery: A Systematic Review
Authors: Le Thien My-Anh , Cordier Quentin , Lifante Jean-Christophe , Carty Matthew J. , Duclos Antoine
Published: January 2023

Objectives

The control chart is a graphical tool for data interpretation that detects aberrant variations in specific metrics, ideally leading to the identification of special causes that can be resolved. A clear assessment of control chart utilization and its potential impact in surgery is required to justify recommendations for its dissemination. This review aims to describe how performance monitoring using control charts was used over time in surgery.

Methods

A systematic search of PubMed regarding statistical process control in surgery from its inception until December 2019 was performed using Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Information extracted from selected publications included study aim and population setting, monitored indicators, control charts methodological parameters, and implementation strategy.

Results

One hundred thirteen studies met the selection criteria with a median of 1916 monitored patients. Overall, 57.5% of studies focused on control chart methodology, 24.8% aimed at evaluating performance changes using control charts retrospectively, and 17.7% implemented control charts for continuous quality improvement prospectively. Although there was a great diversity of used indicators and charting tools, the evaluation of patient safety (72.6%) or efficiency (15.9%) metrics based on Shewhart control chart (33.6%) or cumulative sum chart (54.9%) were common. To foster control charts implementation, 14 studies promoted their periodic review, but only three assessed their impact on patient outcomes.

Conclusions

The scientific literature supports the feasibility and utility of control chart to improve patient safety in multiple surgical settings. Additional studies are necessary to reveal the optimal manner in which to implement this affordable tool in surgical practice.
18F-FDG PET/CT Imaging of G-CSF–Producing Inflammatory Myofibroblastic Tumor of the Pleura
Authors: Tokunaga Koji , Maeda Chikara , Horikawa Sadao , Nakayama Ryuko , Umeoka Shigeaki
Published: January 2023

We report a case of granulocyte colony-stimulating factor (G-CSF)–producing inflammatory myofibroblastic tumor of the pleura in a 71-year-old man. Contrast-enhanced CT demonstrated multiple pleural masses with pulmonary hilar lymph nodes swelling. 18F-FDG PET/CT demonstrated marked focal FDG uptake in the thoracic masses with diffuse uptake in the bone marrow. Based on the pathological findings and elevated serum G-CSF level, the patient was diagnosed as G-CSF–producing inflammatory myofibroblastic tumor. Because G-CSF–producing tumors demonstrate aggressive clinical course, early and accurate diagnosis is important.
Exceptional Response of Rare Plasmacytoid Variant Prostate Cancer Post 177Lu-PSMA Therapy Seen on 68Ga-PSMA PET/CT
Authors: Maharaj Masha , Heslop Lucille , Govender Trisha , Korowlay Nisaar
Published: January 2023

Plasmacytoid is a rare variant of acinar prostatic adenocarcinoma. The aggressive type is characterized by an aggressive clinical course, lack of responsiveness to hormonal therapies, and an overall poor prognosis. Here we present pretherapy and posttherapy 68Ga-PSMA PET/CT images showing an exceptional response to 177Lu-PSMA therapy. This case demonstrates the usefulness of both 68Ga-PSMA PET/CT in assessing the tumor PSMA avidity and the potential of 177Lu-PSMA therapy in these patients.
68Ga-DOTATOC PET in Extracranial Hepatic and Bone Metastasis of Atypical Refractory Meningioma
Authors: Ghomari Cherifa Fazila , Bender Laura , Lhermitte Benoît , Noël Georges , Namer Izzie Jacques , Bund Caroline
Published: January 2023

A falcine meningioma was diagnosed in a 66-year-old woman and was treated by surgery and 2 times by radiotherapy during 9 years of follow-up with the diagnosis of atypical meningioma. Three months after the last radiotherapy, incidental liver lesions were detected on chest CT realized for suspected pneumonia. In view of the predisposing factors for meningioma metastases, 68Ga-DOTATOC hepatic and cerebral PET/MRI was performed and completed by total body PET/CT demonstrating a somatostatin receptor 2 overexpression of the multiple liver lesions and several bone lesions. Biopsies from the liver and iliac bone confirmed the metastatic origin of meningioma.
18F-FDG and 68Ga-FAPI-04 PET/CT in Evaluating Clear-Cell Endometrial Cancer
Authors: Kiran Murat Yilmaz , Has Simsek Duygu , Sanli Yasemin , Kuyumcu Serkan
Published: January 2023

A 60-year-old woman diagnosed with clear cell endometrial carcinoma received neoadjuvant chemotherapy. However, the patient was inoperable and referred to our clinic to evaluate the extent of the disease. The patient underwent 18FDG PET/CT and 68Ga-FAPI (fibroblast activated protein inhibitor)-04 PET/CT scans. 68Ga-FAPI-04 PET/CT outperformed 18FDG PET/CT demonstrating higher uptake in the metastatic lesions.
From Alpha to Zeta: A Systematic Review of Zeta Waves
Authors: Freund Brin E. , Brigham Tara , Salman Saif , Kaplan Peter W. , Tatum William O.
Published: January 2023

Purpose:

Electroencephalogram is used for prognostication and diagnosis in critically ill patients and is vital in developing clinical management algorithms. Unique waveforms on EEG may distinguish neurological disorders and define a potential for seizures. To better characterize zeta waves, we sought to define their electroclinical spectrum.

Methods:

We performed a systematic review using MEDLINE, Embase, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Review [through Ovid], Scopus, Science Citation Index Expanded and Emerging Sources Citation Index [through the Web of Science], and Epistemonikos. Grey literature resources were searched.

Results:

Five hundred thirty-seven articles were identified. After excluding duplicates and reviewing titles, abstracts, and bodies and bibliographies of articles, four studies reported 64 cases describing data from patients with zeta waves, with a prevalence of 3 to 4%. Various and often incomplete clinical, neuroimaging, and EEG data were available. 57 patients (89.1%) had a focal cerebral lesion concordant with the location of zeta waves on EEG. 26 patients (40.6%) had clinical seizures, all but one being focal onset. Thirteen patients (20%) had epileptiform activity on EEG. Typically, zeta waves were located in the frontal head regions, often with generalized, frontal, predominant, rhythmic delta activity and associated with focal EEG suppression.

Conclusions:

Zeta waves frequently represent an underlying focal structural lesion. Their presence suggests a heightened risk for seizures. The small number of retrospective cases series in the literature reporting zeta waves might be an underrepresentation. We suggest a need for prospective studies of cEEG in critically ill patients to determine their clinical significance.
Altered cortical gyrification, sulcal depth, and fractal dimension in the autism spectrum disorder comorbid attention-deficit/hyperactivity disorder than the autism spectrum disorder
Authors: Chen Yajue , Luo Jiawen , Chen Songjian , Lin Qiwen , Kuang Changyi , Rao Yuyang , Zhang Xuebiao , Huang Yanping , Ma Lijun , Lin Jiabao
Published: January 2023

Autism spectrum disorder (ASD) frequently occurs accompanied by attention-deficit/hyperactivity disorder (ADHD), which catches increasing attention. The comorbid diagnosis of ASD with ADHD (ASD + ADHD) is permitted in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). However, compared to autism spectrum disorder without other symptoms (ASD-only), the special neural underpinnings in ASD+ADHD remain unclear. Therefore, this study aimed to uncover the differences in cortical complexity between ASD + ADHD and ASD-only patients. A total of 114 ASD participants (i.e. containing 40 ASD + ADHD and 74 ASD-only participants) with T1-weighted magnetic resonance images were collected from the Autism Brain Imaging Data Exchange II. Afterward, a surface-based morphometry method was carried out to compare the cortical complexity (i.e. gyrification index, fractal dimension, and sulcal depth) between the ASD + ADHD and ASD-only cohorts. Results showed the increased fractal dimension in the right fusiform gyrus of the ASD + ADHD cohort in comparison to the ASD-only cohort. Moreover, the ASD + ADHD cohort exhibited increased sulcal depth in the left middle temporal gyrus/inferior temporal gyrus and right middle temporal gyrus compared to the ASD-only cohort. Last but not least, the increased gyrification index in the insula/postcentral gyrus was observed in the ASD + ADHD cohort in comparison to the ASD-only cohort. Overall, the present study contributes to the delineation of particular structural abnormalities in ASD + ADHD than ASD-only, enriching the evidence of the combined phenotype of ASD + ADHD.
Increased GABAergic projections in the paraventricular nucleus regulate colonic hypersensitivity via oxytocin in a rat model of irritable bowel syndrome
Authors: Li Junshu , Liu Hua , Guo Feifei , Guo Ruixiao , Zhang Hui , He Xiaoman , Ming Xing , Ma Xinqi , Shang Gaohao , Ji Pengfei , Song Longchang , Gao Shengli
Published: January 2023

Irritable bowel syndrome (IBS) is characterized by gastrointestinal dysmotility and visceral hyperalgesia, and the impaired brain–gut axis is accepted as a crucial cause for the onset of IBS. The objective of this study is to investigate the effects of the adaptive changes in the central neural system induced by stress on IBS-like syndromes in rats. Long-term water avoidance stress (WAS) was used to prepare IBS animals. The changes in neuronal excitation and GABA expression were shown by immunohistochemistry. The mRNA and protein expressions of neurotransmitters were detected with Quantitative reverse-transcription PCR (qRT-PCR) and Enzyme-linked immunosorbent assay (ELISA). The intestinal transit time, fecal moisture content, and abdominal withdrawal reflex scores of rats were recorded to monitor intestinal motility and visceral hyperalgesia. In the WAS-treated rats with enhanced intestinal motility and visceral hypersensitivity, more GABAergic projections were found in the paraventricular nucleus (PVN) of the hypothalamus, which inhibited the firing rate of neurons and decreased the expression of oxytocin. Exogenous oxytocin improved gut motility and decreased AWR scores. The inhibition of oxytocin by the adaptive GABAergic projection in the PVN might be an important mediator of IBS, which indicates a potential novel therapeutic target.
Effects of a Brief Mindfulness-Based Intervention on Pavlovian-To-Instrumental Transfer in Alcohol Use Disorder
Authors: Rosenthal Annika , Garbusow Maria , Romanczuk-Seiferth Nina , Beck Anne
Published: January 2023

Pavlovian conditioned contextual cues have been suggested to modulate instrumental action and might explain maladaptive behavior such as relapse in patients suffering from alcohol use disorder (AUD). Pavlovian-to Instrumental transfer (PIT) experimentally assesses the magnitude of this context-dependent effect and studies have shown a larger PIT effect in AUD populations. Taken this into account, a reduction of the influence of cues on behavior seems warranted and one approach that could alter such cue reactivity is mindfulness. Mindfulness-based interventions have been shown to be efficient in the treatment of AUD, but underlying mechanisms are yet to be elucidated. Therefore, we aim at investigating the effect of a brief mindful body scan meditation on the magnitude of the PIT effect in AUD subjects and matched controls. Using a randomized within-subjects design, we compared the effect of a short audio guided body scan meditation against a control condition (audio of nature sounds) on PIT in healthy (n = 35) and AUD (n = 27) participants. We found no differences in PIT effect between healthy and AUD participants as well as between conditions. However, a significant interaction effect points to a decreased PIT effect after body scan meditation in AUD subjects only. These results suggest that AUD might be susceptible to mindfulness-induced changes in PIT, with these findings contributing to entangling the underlying mechanisms of the efficacy of mindfulness-based interventions in AUD.
Neurophysiological Changes Associated with Vibroacoustically-augmented Breath-focused Mindfulness for Dissociation: Targeting Interoception and Attention
Authors: Fani Negar , Guelfo Alfonsina , La Barrie Dominique L. , Teer Andrew P. , Clendinen Cherita , Karimzadeh Leyla , Jain Jahnvi , Ely Timothy D. , Powers Abigail , Kaslow Nadine , Bradley Bekh , Siegle Greg J.
Published: January 2023

Background

Dissociative symptoms can emerge after trauma and interfere with attentional control and interoception, both of which are barriers to mind-body interventions such as breath-focused mindfulness (BFM). To overcome these barriers, we tested the use of an exteroceptive augmentation to BFM, using vibrations equivalent to the amplitude of the auditory waveform of the actual breath, delivered via a wearable subwoofer in real time (VBFM). We tested whether this device enhanced interoceptive processes, attentional control and autonomic regulation in trauma-exposed women with dissociative symptoms.

Method

65 women, majority (82%) Black American, aged 18-65 completed self-report measures of interoception and 6 BFM sessions, during which electrocardiographic recordings were taken to derive high-frequency heart rate variability (HRV) estimates. A subset (n=31) of participants completed functional MRI at pre- and post-intervention, during which they were administered an affective attentional control task.

Results

Compared to those who received BFM only, women who received VBFM demonstrated greater increases in interoception, particularly their ability to trust body signals, increased sustained attention, and as well as increased connectivity between nodes of emotion processing and interoceptive networks. Intervention condition moderated the relationship between interoception change and dissociation change, as well as the relationship between dissociation and HRV change.

Conclusions

Vibration feedback during breath focus yielded greater improvements in interoception, sustained attention and increased connectivity of emotion processing and interoceptive networks. Augmenting BFM with vibration appears to have considerable effects on interoception, attention and autonomic regulation; it could be used as a monotherapy or to address trauma treatment barriers.
A Convolutional Autoencoder-based Explainable Clustering Approach for Resting-State EEG Analysis
Authors: Ellis Charles A. , Miller Robyn L. , Calhoun Vince D.
Published: January 2023

Machine learning methods have frequently been applied to electroencephalography (EEG) data. However, while supervised EEG classification is well-developed, relatively few studies have clustered EEG, which is problematic given the potential for clustering EEG to identify novel subtypes or patterns of dynamics that could improve our understanding of neuropsychiatric disorders. There are established methods for clustering EEG using manually extracted features that reduce the richness of the feature space for clustering, but only a couple studies have sought to use deep learning-based approaches with automated feature learning to cluster EEG. Those studies involve separately training an autoencoder and then performing clustering on the extracted features, and the separation of those steps can lead to poor quality clustering. In this study, we propose an explainable convolutional autoencoder-based approach that combines model training with clustering to yield high quality clusters. We apply the approach within the context of schizophrenia (SZ), identifying 8 EEG states characterized by varying levels of δ activity. We also find that individuals who spend more time outside of the dominant state tend to have increased negative symptom severity. Our approach represents a significant step forward for clustering resting-state EEG data and has the potential to lead to novel findings across a variety of neurological and neuropsychological disorders in future years.
Distinct prefrontal projections conversely orchestrate social competition and hierarchy
Authors: Choi Tae-Yong , Jeon Hyoungseok , Jeong Sejin , Kim Eum Ji , Kim Jeongseop , Jeong Yun Ha , Kang Byungsoo , Choi Murim , Koo Ja Wook
Published: January 2023

Social animals compete for limited resources, resulting in a social hierarchy. Although different neuronal subpopulations in the medial prefrontal cortex (mPFC), a hub brain region of social hierarchy, encode distinct social competition behaviors, their identities and associated molecular underpinnings have not yet been identified. In this study, we found that mPFC neurons projecting to the nucleus accumbens (mPFC-NAc) encode social winning behavior, whereas mPFC neurons projecting to the ventral tegmental area (mPFC-VTA) encode social losing behavior by monitoring and manipulating neural circuit activity. High-throughput single-cell transcriptomic analysis and projection-specific genetic manipulation revealed that the expression level of POU domain, class 3, transcription factor 1 (Pou3f1) in mPFC-VTA neurons controls social hierarchy. Optogenetic activation of mPFC-VTA neurons increasesPou3f1expression and lowers social rank. Together, these data demonstrate that discrete activity and gene expression in separate mPFC projections oppositely orchestrate social competition and hierarchy.
Clinical Characteristics and Outcomes of Laboratory-Confirmed SARS-CoV-2 Cases Infected with Omicron subvariants and XBB recombinant variant
Authors: Karyakarte Rajesh , Das Rashmita , Dudhate Sonali , Agarasen Jeanne , Pillai Praveena , Chandankhede Priyanka , Labshetwar Rutika , Gadiyal Yogita , Rajmane Mansi , Kulkarni Preeti , Nizarudeen Safanah , Joshi Suvarna , Potdar Varsha , Karmodiya Krishanpal
Published: January 2023

Background

SARS-CoV-2 has evolved to produce new variants causing successive waves of infection. Currently, six variants are being monitored by the World Health Organization that are replacing BA.5. These include BF.7 (BA.5 + R346T in spike), BQ.1 (and BQ.1.1, with BA.5 + R346T, K444T, N460K mutations in spike), BA.2.75 (including BA.2.75.2 and CH.1.1), and XBB (including XBB.1.5). BQ.1 and XBB variants are more immune evasive and have spread quickly throughout the world. With the concern of the potential severity of infections caused by these variants, the present study describes the clinical characteristics and outcomes of these major variants in Maharashtra.

Material and Methods

A total of 1141 Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) positive SARS-CoV-2 samples, with a cycle threshold value (Ct) less than 25, were processed for SARS-CoV-2 whole genome sequencing between 10th July 2022 and 12th January 2023. All corresponding demographic and clinical data were recorded and analysed using Microsoft® Excel and Epi Info™.

Results

Out of 1141 samples sequenced, BA.2.75* (63.78%) was the predominant Omicron variant, followed by the XBB* (18.88%), BA.2.38* (4.94%), BA.5* (4.06%), BA.2.10* (3.51%) and BQ.1* (1.65%). A total of 540 cases were contacted telephonically, of which 494 (91.48%) were symptomatic with mild symptoms. Fever (77.73%) was the most common symptom, followed by cold (47.98%), cough (42.31%), myalgia and fatigue (18.83%). Of the 540 cases, 414 (76.67%) cases recovered at home, and 126 (23.33%) were institutionally quarantined/hospitalised. Among the home-isolated and hospitalised cases, 416 (99.76%) and 108 (87.80%), respectively, recovered with symptomatic treatment, while one (0.24%) and 15 (12.20%), respectively, succumbed to the disease. In all, 491 (90.93%) cases were vaccinated with at least one dose of the COVID-19 vaccine, 41 (7.59%) were unvaccinated, and for 08 (1.48%), vaccine data was not available.

Conclusion

The current study indicates that the XBB* variant is causing mild disease in India. However, as XBB* possess both immune-escape and infectivity-enhancing mutations, it has the potential to spread to other parts of the world rapidly.
Primary Blastic Plasmacytoid Dendritic Cell Neoplasm: a US Population-Based Study
Authors: Wang Fan
Published: January 2023

Background

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and poorly understood hematopoietic malignancy. This study aimed to investigate the clinical characteristics and prognostic factors in patients with primary BPDCN.

Methods

Patients diagnosed with primary BPDCN from 2000 to 2019 were extracted from the Surveillance, Epidemiology and End Results (SEER) database. Independent prognostic factors were evaluated based on the univariate and multivariate Cox regression analysis. The nomogram was then constructed to predict the overall survival of primary BPDCN patients at 3, 5 and 10 years after diagnosis.

Results

A total of 668 primary BPDCN patients were included in this study. The average age was 35.7 ± 25.4 years, with 68.7% being male. The mostly affected sites were lymph nodes (59.9%). Most patients (69.9%) received chemotherapy or radiation therapy. For all the patients, the 1-year, 3-year, 5-year, and 10-year overall survival (OS) were 78.0%, 62.6%, 59.0%, and 56.3%, respectively, and the corresponding disease-specific survival (DSS) were 80.6%, 66.8%, 63.5, and 61.8%, respectively. Multivariate cox analysis indicated that age and marital status of other (divorced, widowed and separated) at diagnosis were independent prognostic factors for DSS, but only age was for OS. The 5-year OS rate significantly declined with increasing age: age <15, 89.3%; age 15-39, 57.9%; age 40-64, 51.2%; age ≥65, 26.1%. Nomograms were further constructed to predict the possibility of OS and DSS with good performances.

Conclusions

Primary BPDCN is a rare disease, age and marital status were associated with survival of primary BPDCN patients, and age was an independent prognostic factor for OS.
Direct comparison of clinical diagnostic sensitivity of saliva from buccal swabs versus combined oro-/nasopharyngeal swabs in the detection of SARS-CoV-2 B.1.1.529 Omicron
Authors: Puyskens Andreas , Michel Janine , Stoliaroff-Pépin Anna , Bayram Fatimanur , Sesver Akin , Wichmann Ole , Harder Thomas , Schaade Lars , Nitsche Andreas , Peine Caroline
Published: January 2023

While current guidelines recommend the use of respiratory tract specimens for the direct detection of SARS-CoV-2 infection, saliva has recently been suggested as preferred sample type for the sensitive detection of SARS-CoV-2 B.1.1.529 (Omicron). Here, we compare the clinical diagnostic sensitivity of paired buccal saliva swabs and combined oro-/nasopharyngeal swabs from hospitalized, symptomatic COVID-19 patients collected at median six days after symptom onset by real-time polymerase chain reaction (PCR) and antigen test. Of the tested SARS-CoV-2 positive sample pairs, 55.8% were identified as Omicron BA.1 and 44.2% as Omicron BA.2. Real-time PCR from buccal swabs generated significantly higher quantification cycle (Cq) values compared to those from matched combined oro-/nasopharyngeal swabs and resulted in an increased number of false-negative PCR results. Reduced diagnostic sensitivity of buccal swabs by real-time PCR was observed already at day one after symptom onset. Similarly, detection rates using the Abbott COVID-19 Ag Rapid Test Device were reduced in buccal swabs compared to those using combined oro-/nasopharyngeal swabs. Our results suggest reduced clinical diagnostic sensitivity of saliva from buccal swabs in comparison to combined oro-/nasopharyngeal swabs in the detection of Omicron in symptomatic individuals.
Malaria diagnosis in rural healthcare facilities and treatment-seeking behavior in malaria endemic settings in western Kenya
Authors: Omondi Collince J. , Odongo David , Otambo Wilfred O. , Ochwedo Kevin O. , Otieno Antony , Lee Ming-Chieh , Kazura James W. , Githeko Andrew K. , Yan Guiyun
Published: January 2023

Accurate diagnosis and timely treatment are central requirements for effective malaria management in communities. However, in resource-constrained settings, healthcare facilities are likely to be few, inaccessible, and ill-equipped with frequent drug or rapid diagnostic test kit (RDT) shortages. This may jeopardize much-needed quality care for patients and may have an impact on treatment-seeking behavior among the local population. The study’s goal is to determine treatment-seeking behavior, malaria diagnosis and treatment, and likely treatment-seeking determinants in the local population. Passive case detection, which targeted all patients with suspected malaria cases, was conducted in ten public healthcare facilities over a three-month period. Monthly malaria cases, methods of diagnosis and antimalarial drug availability were assessed. A household-based survey was also carried out. Structured questionnaires were used to collect data from household heads. Malaria knowledge, treatment seeking behavior, and predictors of malaria treatment-seeking were all determined. Three of the seven dispensaries lacked a laboratory to conduct microscopy-based diagnosis. These three dispensaries also experienced frequent RDT stock-outs, which resulted in a clinical diagnosis of malaria. The majority of local residents with fever (50.3%) purchased antimalarial drugs from a chemist. About 37% of fever patients sought treatment at healthcare facility while the remaining 12.7% did nothing. In irrigated areas, 45.5% (46/64) of fever patients sought treatment at healthcare facilities, compared to 25% (18/64) in non-irrigated areas (p = 0.009). Most children aged below 5 who had fever (77.7%) were taken to healthcare facility for treatment compared to 31.4% of older children or 20.9% of adults (0.0001). Predictors of treatment seeking included access to healthcare facility (OR = 16.23, 95% CI: 2.74-96.12), and ability to pay hospital bill (OR = 10.6, 95% CI: 1.97-57). Other factors that influenced health-seeking behavior included the severity of symptoms, the age of the fever patient and knowledge of malaria symptoms.
Evaluating Evasion Strategies in Zebrafish Larvae
Authors: Jiao Yusheng , Colvert Brendan , Man Yi , McHenry Matthew J. , Kanso Eva
Published: January 2023

An effective evasion strategy allows prey to survive encounters with predators. Prey are generally thought to escape in a direction that is either random or serves to maximize the minimum distance from the predator. Here we introduce a comprehensive approach to determine the most likely evasion strategy among multiple hypotheses and the role of biomechanical constraints on the escape response of prey fish. Through a consideration of six strategies with sensorimotor noise and previous kinematic measurements, our analysis shows that zebrafish larvae generally escape in a direction orthogonal to the predator’s heading. By sensing only the predator’s heading, this orthogonal strategy maximizes the distance from fast-moving predators, and, when operating within the biomechanical constraints of the escape response, it provides the best predictions of prey behavior among all alternatives. This work demonstrates a framework for resolving the strategic basis of evastion in predator-prey interactions, which could be applied to a broad diversity of animals.
Microbial strong organic ligand production is tightly coupled to iron in hydrothermal plumes
Authors: Hoffman Colleen L. , Monreal Patrick J. , Albers Justine B. , Lough Alastair J.M. , Santoro Alyson E. , Mellett Travis , Buck Kristen N. , Tagliabue Alessandro , Lohan Maeve C. , Resing Joseph A. , Bundy Randelle M.
Published: January 2023

Hydrothermal vents have emerged as an important source of iron to seawater, yet only a subset of iron is soluble and persists long enough to be available for surface biological uptake. The longevity and solubility of iron in seawater is governed by strong organic ligands, like siderophores, that are produced by marine microorganisms and are a part of the ocean’s dissolved iron-binding ligand pool. These ligands have been hypothesized to aid in the persistence of dissolved iron in hydrothermal environments. To explore this hypothesis, we measured iron, iron-binding ligands, and siderophores from 11 geochemically distinct sites along a 1,700 km section of the Mid-Atlantic Ridge. Siderophores were found in hydrothermal plumes at all sites, with proximity to the vent playing an important role in dictating siderophore types and diversity. The notable presence of amphiphilic siderophores may point to microbial utilization of siderophores to access particulate hydrothermal iron, and the exchange of dissolved and particulate iron. The tight coupling between strong ligands and dissolved iron within neutrally buoyant plumes across six distinct hydrothermal environments, and the presence of dissolved siderophores with siderophore-producing microbial genera, suggests that biological production of siderophores exerts a key control on hydrothermal dissolved iron concentrations.