bluuebunny/crossref_metadata_2025 huggingface dataset:
Calcium and Bone Metabolism Disorders
Authors: Drake Matthew T.
Published: August 2022

The chapter discusses various calcium and metabolism disorders such as hypercalcemia, hypocalcemia, osteoporosis, osteomalacia, and Paget disease. Definitions, etiologic factors, clinical features, diagnoses, possible prevention, and treatments are covered.
Complementary and Alternative Medicine
Authors: Chon Tony Y. , Bauer Brent A.
Published: August 2022

Traditionally, CAM has encompassed treatments such as acupuncture, herbs and dietary supplements, massage, and chiropractic. Yet, in recent decades, the explosive growth of research in this arena has led to a number of therapies being incorporated increasingly into conventional training and practice. For example, lessons that teach a mind-body practice (eg, meditation) to a patient to help control hypertension are combined with the use of such therapies as medications or lifestyle modifications. This growing integration of evidence-based CAM therapies and conventional medicine is increasingly being referred to as integrative medicine.
Palliative Care
Authors: Lorenz Amanda K. , Strand Jacob J. , Carey Elise C.
Published: August 2022

Cancer-related pain affects up to 50% of patients receiving cancer-directed therapies and between 70% and 90% of patients with advanced-stage cancers. However, pain is a common symptom for many patients with serious illness other than cancer. Patients with chronic obstructive pulmonary disease, heart failure, end-stage renal disease requiring hemodialysis, and various neurodegenerative disorders experience pain from their conditions. In these cases, pain is often underrecognized and undertreated, which can lead to functional impairment and suboptimal quality of life.
Preoperative Evaluation
Authors: Dougan Brian M. , Sundsted Karna K.
Published: August 2022

The mortality rate associated with anesthesia and surgery has decreased markedly in the past several decades. Today, the overall mortality ratio is 1 in 250,000 cases, even though more complex surgical procedures are performed on sicker patients. However, the need for a complete preoperative evaluation remains a mainstay for assessing surgical risks.
Benign Hematologic Disorders
Authors: Gangat Naseema
Published: August 2022

This chapter describes the causes, diagnosis, and treatment of several benign hematologic disorders. The following topics are covered: anemias, sickle cell disorders, hemolytic anemias, transfusion reactions, and porphyria.
Malignant Hematologic Disorders
Authors: Thompson Carrie A.
Published: August 2022

This chapter covers the diagnosis of several malignant hematologic disorders and possible treatments. The main types of hematologic neoplasms are lymphoproliferative disorders, plasma cell disorders, acute leukemias, and chronic myeloid disorders.
Health Care–Associated Infections and Infective Endocarditis
Authors: DeSimone Daniel C. , Sohail M. Rizwan , Tosh Pritish K.
Published: August 2022

This chapter highlights various infections acquired in the hospital, especially hospital-acquired pneumonia and ventilator-acquired pneumonia, which account for 25% of all infections in the intensive care unit and are the basis for 50% of all antimicrobials prescribed in the hospital.
Skin, Soft Tissue, Bone, and Joint Infections
Authors: Urena Eric O. Gomez , Tande Aaron J.
Published: August 2022

Specific skin and soft tissue infections can be characterized by their visual appearance, including vesicles, bullae, folliculitis, crusted lesions, papular lesions, ulcerations, and cellulitis. Cellulitis is most common in tissue damaged by trauma and in extremities with impaired venous or lymphatic drainage (eg, the arm after mastectomy, the leg after saphenous vein harvest for coronary artery bypass grafting). The approach to treatment of cellulitis is guided by the type of skin and soft tissue infection and the severity of clinical presentation.
Electrolyte Disorders
Authors: Qian Qi
Published: August 2022

Disorders of sodium balance, or volume disorders, can lead to volume expansion or volume depletion. Volume expansion can be general (as in patients with congestive heart failure, cirrhosis, or nephrotic syndrome) or regional (as in patients with regional capillary leak, venous insufficiency, or lymphatic obstruction). Volume depletion is associated primarily with gastrointestinal tract (GI) fluid loss, excessive sweating, and renal sodium loss related to diuretic use or, rarely, renal salt loss.
Renal Parenchymal Diseases
Authors: Norby Suzanne M. , Fervenza Fernando C.
Published: August 2022

Acute and chronic interstitial inflammation can result in injury to renal tubules, leading to tubular dysfunction and, chronically, tubular atrophy. Causes of chronic tubulointerstitial damage include autoimmune and hereditary causes, analgesic nephropathy, uric acid, lithium, heavy metals, mercury, lead, and oxalate. Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease. Clinical manifestations of glomerular injury vary. Different types of TMA are characterized by decreased kidney function, along with microangiopathic hemolytic anemia and thrombocytopenia.
Headache, Facial Pain, and “Dizziness”
Authors: Starling Amaal J.
Published: August 2022

Headache is considered to be a nearly universal experience. Approximately 98% of the population experiences some form of headache in a lifetime. Persons with headache disorders also present frequently to outpatient clinics; they are the reason for approximately 1 in every 10 consultations with a primary care physician. Dizziness is a nonspecific term that can describe any one of several subjective experiences, including light-headedness, vertigo, imbalance and unsteadiness, or ataxia.
Oncologic Emergencies and Chemotherapy Complications
Authors: Moynihan Timothy J.
Published: August 2022

Oncologic emergencies occur at any time during the course of cancer, from its initial manifestation to end-stage disease. Prompt recognition and diagnosis of these emergencies improves survival and quality of life for patients. Throughout evaluation and management of the emergency, the patient’s overall condition and prognosis should always be considered, and patients should always be offered relief for pain and other symptoms.
Pulmonary Evaluation
Authors: Iyer Vivek N.
Published: August 2022

This chapter describes the pulmonary evaluation and the various presentations, tests, and possible causes of several pulmonary disorders. Diagnostic imaging is also covered.
HIV Transmission Prevention
Authors: Chu Carolyn , Baumgartner Katrina , Bositis Christopher M.
Published: August 2022

Behavioral factors and opportunities surrounding HIV prevention are discussed in this chapter. These include strategies to reduce HIV exposure risk and considerations for unique circumstances and populations. Structural and systems-level interventions are reviewed as well as medical interventions for HIV transmission prevention. Special attention is paid to prevention of HIV related to substance use, substance use screening, and expanded HIV testing. The chapter includes data from clinical trials detailing eligibility, preexposure prophylaxis (PrEP) prescription, concerns related to PrEP use, and PrEP challenges and disparities. Occupational and nonoccupational postexposure prophylaxis are discussed as well as novel antiretrovirals and delivery methods for PrEP.
Initial Evaluation of the Person Living with HIV
Authors: DelPilar-Morales Esteban A. , Skiest Daniel J.
Published: August 2022

This chapter describes what is essential in the HIV-oriented medical history as well as the HIV-oriented physical examination. Detailed descriptions of what is needed for the medical history, the physical examination, the initial HIV laboratory evaluation, and signs and symptoms of acute retroviral illness are presented to the reader via tables. The chapter also outlines the importance of patient–provider relationships and addresses issues such as cultural competency and language. Telehealth in HIV is briefly touched on.
Complementary and Alternative Medicine/Integrative Medicine Approaches
Authors: Patel Ashka , Shere-Wolfe Kalpana D.
Published: August 2022

A comprehensive explanation of complementary and alternative medicine (CAM) and integrative medicine is provided at the beginning of this chapter. The use of CAM by people with HIV is discussed as well as physicians’ attitudes toward CAM. The chapter covers the benefits of natural health products for use in people with HIV and provides extensive examples of these products. Mind–body approaches to treatment are reviewed in detail in addition to traditional medicine and manual therapies.
Virology and Natural History of HIV
Authors: Mathur Poonam
Published: August 2022

HIV structure and life cycle are highlighted in this chapter. The reader is provided information regarding how virology informs treatment aimed at various stages of the viral life cycle and virology in relation to current and potential drug targets. The chapter goes on to discuss viral classification, viral structure, and viral entry. Reverse transcription and integration are reviewed, and the chapter concludes with an overview of HIV natural history.
The HIV Reservoir and Cure and Remission Strategies
Authors: Gandhi Rajesh T. , Juelg Boris , Jilg Nikolaus , Jakharia Niyati , Talwani Rohit
Published: August 2022

This chapter covers the HIV reservoir and cure and remission strategies. It details the importance of why we should try to cure HIV and includes clinical observations where the concept of a “functional cure” has been introduced. Early establishment and persistence of the latent HIV-1 reservoir are discussed as well as latency reversal approaches and latency silencing. A variety of immune-enhancing and/or immune-modulating strategies and immunomodulatory treatments are reviewed. Special attention is paid to therapeutic and preventive vaccines.
Solid Organ Transplantation in Persons with HIV
Authors: Durand Christine M.
Published: August 2022

The evaluation and management of kidney and liver transplantation candidates with HIV is discussed in this chapter as well as the clinical outcomes for these candidates. Criteria for transplantation, pretransplant infection screening and vaccinations, and posttransplant management and care are highlighted for the reader. Special attention is paid to outcomes and infections after the transplant. The chapter concludes with a review of the HIV Organ Policy Equity Act.
Malignancies in HIV
Authors: Clark Eva H. , Chiao Elizabeth Y.
Published: August 2022

This chapter discusses the role of virally mediated and non-virally mediated AIDS-associated and non–AIDS-associated malignancies. The learner will review the epidemiology and role of antiretroviral therapy on the impact of AIDS-defining malignancies. The chapter covers the role of human herpes virus-8 in the development of Kaposi’s sarcoma, the role of Epstein–Barr virus in primary central nervous system lymphoma, and other HIV-associated lymphomas. It reviews and the role of human papillomavirus vaccination in virally mediated anogenital squamous cell cancer. Non-AIDS-defining malignancies, including lung, prostate, oropharyngeal, liver, breast, and pancreatic cancers, are covered. Lastly, the text emphasizes that antiretroviral initiation is of utmost importance for all AIDS-defining malignancies and non-AIDS-defining malignancies and summarizes the National Cancer Center Network Guidelines for HIV malignancies.
HIV and Hepatitis Coinfection
Authors: Vigil Karen J.
Published: August 2022

This chapter discusses the epidemiology, clinical presentation, diagnosis, treatment, and complications of hepatitis B and hepatitis C in people with HIV. The learner will gain an understanding that all people with HIV should have a complete evaluation for hepatitis B. The chapter covers how to determine which patients are candidates for hepatitis B vaccinations and what treatments are appropriate for hepatitis B among patients living with HIV. The learner will also understand that patients with HIV who develop acute hepatitis C should be treated immediately and rescreened for potential reinfection. The chapter also discusses which direct-acting agents work best for patients with HIV and how antiretroviral therapy can be modified to reduce drug–drug interactions, disease severity, and cost considerations.
Sexually Transmitted Diseases
Authors: Vigil Karen J.
Published: August 2022

This chapter demonstrates the established and evolving science regarding the diagnosis and treatment of most prevalent sexually diseases in patients with HIV infection, including syphilis, gonorrhea, chlamydia, human papillomavirus, and genital ulcers. The learner will be able to identify the clinical presentation of each sexually transmitted disease, discuss available diagnostic tests and tools, and describe the recommended treatments in order to decrease the spread of sexually transmitted diseases.
Cardiovascular Disease
Authors: Kirchner Jeffrey T.
Published: August 2022

This chapter describes the pathophysiology of cardiovascular disease and myocardial infarction in persons with HIV and the association between HIV infection and the increased risk of cardiovascular disease, myocardial infarction, stroke, peripheral artery disease, and sudden cardiac death. The learner will also understand the association between specific antiretroviral therapies and cardiovascular risk and myocardial infarction, and how to assess risk for cardiovascular disease using the American College of Cardiology/American Heart Association (ACC/AHA)10-year risk calculator for atherosclerotic cardiovascular disease. Lastly, the learner will become familiar with medical therapies such as statins and non-statins and lifestyle interventions such as diet, exercise, weight loss, and smoking cessation to lower the risk of cardiovascular disease and myocardial infarction in persons with HIV.
HIV and Bone Health
Authors: Overton Edgar T.
Published: August 2022

This chapter on HIV and bone health discusses the prevalence of low bone mineral density and fractures in persons with HIV and emphasizes that metabolic bone disease is a common manifestation of HIV infection, with a subsequently increased risk of fracture. The learner will be able to discuss the risk factors associated with diminished bone mineral density and fractures for people with HIV, understand screening indications and diagnostic tests used to identify bone disease among people with HIV, and identify current treatment strategies for people with HIV who have low bone mineral density or who have already sustained bone fractures.
Immune Reconstitution Inflammatory Syndrome (IRIS)
Authors: Coppock Dagan
Published: August 2022

This chapter covers the epidemiology of the immune reconstitution inflammatory syndrome (IRIS) and associated opportunistic infections. IRIS is the inflammatory response that can cause clinical deterioration in patients whose immunologic function has been rapidly restored after starting antiretroviral therapy for HIV. Opportunistic and other infections that were previously unrecognized or that were tolerated by a failing immune system may suddenly become targets of an overzealous restored immune system and patients may become clinically worse, despite an otherwise excellent response to antiretroviral treatment. The learner will also recognize timing considerations regarding opportunistic infection treatment and antiretroviral therapy initiation as well as management approaches to IRIS based on presenting and underlying opportunistic infections.
Benchmarking mesa isochrones against the Hyades single star sequence
Authors: Brandner Wolfgang , Calissendorff Per , Kopytova Taisiya
Published: August 2022

Based on GAIA Early Data Release 3 (EDR3), we revisit and update our sample of bonafide single stars in the Hyades open cluster. The small observational uncertainties in parallax and photometry of EDR3 result in a tightly defined stellar sequence, which is ideal for the testing and calibration of theoretical stellar evolutionary tracks and isochrones. We benchmark the solar-scaled mesa evolutionary models against the single star sequence. We find that the non-rotating mesa models for [Fe/H] = +0.25 provide a good fit for stars with masses above 0.85, and very low mass stars below 0.25 M⊙. For stars with masses between 0.25 and 0.85 M⊙, the models systematically under predict the observed stellar luminosity. One potential limitation of the models for partially convective stars more massive than 0.35 M⊙ is the prescription of (superadiabatic) convection with the mixing-length theory parameter αML tuned to match the Solar model. Below 0.35 M⊙, the increased scatter in the stellar sequence might be a manifestation of the convective kissing instability, which is driven by variations in the 3He nuclear energy production rate due to instabilities at the convective core to envelope boundary. For a Hyades-like stellar population, the application of solar-scaled models to subsolar mass stars could result in a significant underestimate of the age, or an overestimate of the metallicity. We suggest that future grids of solar-scaled evolutionary stellar models could be complemented by Hyades-scaled models in the mass range 0.25 to 0.85 M⊙.
New horizons for building pyrenoid-based CO2-concentrating mechanisms in plants to improve yields
Authors: Adler Liat , Díaz-Ramos Aranzazú , Mao Yuwei , Pukacz Krzysztof Robin , Fei Chenyi , McCormick Alistair J
Published: August 2022

Many photosynthetic species have evolved CO2-concentrating mechanisms (CCMs) to improve the efficiency of CO2 assimilation by Rubisco and reduce the negative impacts of photorespiration. However, the majority of plants (i.e. C3 plants) lack an active CCM. Thus, engineering a functional heterologous CCM into important C3 crops, such as rice (Oryza sativa) and wheat (Triticum aestivum), has become a key strategic ambition to enhance yield potential. Here, we review recent advances in our understanding of the pyrenoid-based CCM in the model green alga Chlamydomonas reinhardtii and engineering progress in C3 plants. We also discuss recent modeling work that has provided insights into the potential advantages of Rubisco condensation within the pyrenoid and the energetic costs of the Chlamydomonas CCM, which, together, will help to better guide future engineering approaches. Key findings include the potential benefits of Rubisco condensation for carboxylation efficiency and the need for a diffusional barrier around the pyrenoid matrix. We discuss a minimal set of components for the CCM to function and that active bicarbonate import into the chloroplast stroma may not be necessary for a functional pyrenoid-based CCM in planta. Thus, the roadmap for building a pyrenoid-based CCM into plant chloroplasts to enhance the efficiency of photosynthesis now appears clearer with new challenges and opportunities.
Understanding the Psychophysiological and Sensitization Mechanisms Behind Fibromyalgia Syndrome: A Network Analysis Approach
Authors: Varol Umut , Úbeda-D’Ocasar Edurne , Cigarán-Méndez Margarita , Arias-Buría José Luis , Fernández-de-las-Peñas César , Gallego-Sendarrubias Gracia María , Valera-Calero Juan Antonio
Published: August 2022

Objective

Current evidence suggests that fibromyalgia syndrome (FMS) involves complex underlying mechanisms. This study aimed to quantify the multivariate relationships between clinical, psychophysical, and psychological outcomes in women with FMS by using network analysis to understand the psychobiological mechanisms driving FMS and generating new research questions for improving treatment strategies.

Methods

Demographic (age, height, weight), clinical (pain history, pain intensity at rest and during daily living activities), psychophysical (widespread pressure pain thresholds [PPT]), sensory-related (PainDETECT, S-LANSS, Central Sensitization Inventory [CSI]) and psychological (depressive and anxiety levels) variables were collected in 126 women with FMS. Network analysis was conducted to quantify the adjusted correlations between the modeled variables and to assess their centrality indices (i.e., the connectivity with other symptoms in the network and the importance in the system modelled as network).

Results

The network showed several local associations between psychophysical and clinical sensory-related variables. Multiple positive correlations between PPTs were observed, being the strongest weight between PPTs on the knee and tibialis anterior muscle (ρ: 0.33). PainDETECT was associated with LANSS (ρ: 0.45) and CSI (ρ: 0.24), whereas CSI was associated with HADS-A (ρ: 0.28). The most central variables were PPTs over the tibialis anterior (the highest Strength centrality) and CSI (the highest Closeness and Betweenness centrality).

Conclusion

Our findings support a model where clinical sensory-related, psychological, and psycho-physical variables are connected, albeit in separate clusters, reflecting a nociplastic condition with a relevant role of sensitization. Clinical implications of the findings, such as developing treatments targeting these mechanisms, are discussed.
The Life Cycle of Dual-Class Firm Valuation
Authors: Cremers Martijn , Lauterbach Beni , Pajuste Anete
Published: August 2022

We examine U.S. dual- and single-class firms from 1980 to 2019 and document their valuation differences over their corporate life cycle. At the IPO, dual-class firms have higher mean valuations than do single-class firms, and some evidence indicates that this premium may emanate from dual-class firm founders’ unique vision and leadership skills. As firms age, the valuation premium of dual-class firms tends to dissipate, possibly because dual-class agency problems increase due to a gradual widening of the wedge (the difference between insider voting and cash flow rights) in the post-IPO years. (JEL G32, G34)
Time-dependent changes in RPILD and mortality risk in anti-MDA5+ DM patients: a cohort study of 272 cases in China
Authors: You Hanxiao , Wang Lei , Wang Jiajia , Lv Chengyin , Xu Lingxiao , Yuan Fenghong , Li Ju , Wu Min , Zhou Shiliang , Da Zhanyun , Qian Jie , Wei Hua , Yan Wei , Zhou Lei , Wang Yan , Yin Songlou , Zhou Dongmei , Wu Jian , Lu Yan , Su Dinglei , Liu Zhichun , Liu Lin , Ma Longxin , Xu Xiaoyan , Zang Yinshan , Liu Huijie , Ren Tianli , Wang Fang , Zhang Miaojia , Tan Wenfeng
Published: August 2022

Objectives

Anti-melanoma differentiation-associated gene 5 positive (anti-MDA5+) DM has a close relationship with rapidly progressive interstitial lung disease (RPILD) and is associated with high mortality. However, data regarding the time-dependent risk of RPILD and deaths during disease progression are limited. We conducted this study to investigate whether the risk of RPILD and death were time-dependent or not in anti-MDA5+ DM.

Methods

We assessed a cohort of 272 patients with anti-MDA5+ DM. The clinical characteristics of patients with anti-MDA5+ were collected, and COX regression was used to analyse independent risk factors for RPILD and death. We also described changes in risk of RPILD and death over time and their potential clinical implications.

Results

There were 272 anti-MDA5+ DM patients enrolled in this study. According to the multivariate cox regression analysis, short disease course, high CRP level, anti-Ro52 positive and anti-MDA5 titre (++∼+++) were independent risk factors of RPILD. High creatine kinase level, high CRP level and RPILD were independent risk factors for death, and >90% RPILD and 84% mortality occurred in the first 6 months after disease onset. Notably, the first 3 months is a particularly high-risk period, with 50% of RPILD and 46% of deaths occurring. Hazards regarding RPILD and mortality diminished over time during a median follow-up of 12 months.

Conclusion

These results suggest significant, time-dependent changes in RPILD and mortality risk in anti-MDA5+ DM patients, providing a cut-off time window to estimate disease progression and poor prognosis.
Do IPO Firms Become Myopic?
Authors: Maksimovic Vojislav , Phillips Gordon , Yang Liu
Published: August 2022

We compare the growth and responsiveness to demand shocks of post-initial public offering (IPO) firms and their private counterparts. Using multiple measures of myopia and multiple ways to match IPO firms with private firms, we do not find evidence of myopic behavior by public firms. IPO firms respond more to investment opportunities and have higher productivity in their early public years. Our results on public firms’ sensitivity to growth opportunities hold under several robustness tests, including when we consider firms’ total growth including acquisitions. The results show the importance of matching public to private firms early in their life.
Effect of obeticholic acid in non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) patients: a systematic review and meta-analysis
Authors: Aishwarya Thanatharayil Sathian , Mounika Nadella , Vishwakarma Gayatri , Adela Ramu
Published: August 2022

Objectives

Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are the major public health issues. Though the prevalence of the disease is high, there is no approved pharmacological treatment. Obeticholic acid (OCA) has not been well described in terms of its efficacy and safety in NAFLD/NASH patients. Hence, we investigated the efficacy and safety of OCA in NAFLD/NASH patients.

Key findings

PubMed, Cochrane CENTRAL and Google Scholar were searched from 2001 to date for identifying randomized controlled trials (RCTs) which examined the OCA effect on liver enzymes, lipoproteins and liver histology in NASH/NAFLD patients. Four relevant RCTs were identified and included for quantitative analysis. OCA exhibited significant reduction in ALT, AST and GGT levels, whereas in case of liver histology, significant improvement in steatosis, hepatocellular ballooning, lobular inflammation and fibrosis was observed in OCA treatment group [RR: 1.25, 95% CI: (1.03 to 1.52); P = 0.02; I2 = 53%], [RR: 1.39, 95% CI: (1.17 to 1.64); P = 0.0001; I2 = 0%], [RR: 1.23, 95% CI: (1.07 to 1.40); P = 0.002; I2 = 29%] and [RR: 1.85, 95% CI: (1.44 to 2.38); P < 0.00001; I2 = 0%], respectively.

Our results indicate that OCA might be used as a potential therapeutic drug candidate in NAFLD/NASH management.
Enhanced development of functional human NK cells in NOD‐scid‐IL2rgnull mice expressing human IL15
Authors: Aryee Ken‐Edwin , Burzenski Lisa M. , Yao Li‐Chin , Keck James G. , Greiner Dale L. , Shultz Leonard D. , Brehm Michael A.
Published: August 2022

Human innate immunity plays a critical role in tumor surveillance and in immunoregulation within the tumor microenvironment. Natural killer (NK) cells are innate lymphoid cells that have opposing roles in the tumor microenvironment, including NK cell subsets that mediate tumor cell cytotoxicity and subsets with regulatory function that contribute to the tumor immune suppressive environment. The balance between effector and regulatory NK cell subsets has been studied extensively in murine models of cancer, but there is a paucity of models to study human NK cell function in tumorigenesis. Humanized mice are a powerful alternative to syngeneic mouse tumor models for the study of human immuno‐oncology and have proven effective tools to test immunotherapies targeting T cells. However, human NK cell development and survival in humanized NOD‐scid‐IL2rgnull (NSG) mice are severely limited. To enhance NK cell development, we have developed NSG mice that constitutively expresses human Interleukin 15 (IL15), NSG‐Tg(Hu‐IL15). Following hematopoietic stem cell engraftment of NSG‐Tg(Hu‐IL15) mice, significantly higher levels of functional human CD56+ NK cells are detectable in blood and spleen, as compared to NSG mice. Hematopoietic stem cell (HSC)‐engrafted NSG‐Tg(Hu‐IL15) mice also supported the development of human CD3+ T cells, CD20+ B cells, and CD33+ myeloid cells. Moreover, the growth kinetics of a patient‐derived xenograft (PDX) melanoma were significantly delayed in HSC‐engrafted NSG‐Tg(Hu‐IL15) mice as compared to HSC‐engrafted NSG mice demonstrating that human NK cells have a key role in limiting the tumor growth. Together, these data demonstrate that HSC‐engrafted NSG‐Tg(Hu‐IL15) mice support enhanced development of functional human NK cells, which limit the growth of PDX tumors.
Early Warning and Monitoring of Coronavirus Disease 2019 Using Baidu Search Index and Baidu Information Index in Guangxi, China
Authors: Xie Yihong , Zhou Wanwan , Zhu Jinhui , Ruan Yuhua , Wang Xiaomin , Huang Tengda
Published: August 2022

Coronavirus disease 2019 (COVID-19) is an emerging infectious disease, and it is important to detect early and monitor the disease trend for policymakers to make informed decisions. We explored the predictive utility of Baidu Search Index and Baidu Information Index for early warning of COVID-19 and identified search keywords for further monitoring of epidemic trends in Guangxi. A time-series analysis and Spearman correlation between the daily number of cases and both the Baidu Search Index and Baidu Information Index were performed for seven keywords related to COVID-19 from January 8 to March 9, 2020. The time series showed that the temporal distributions of the search terms “coronavirus,” “pneumonia” and “mask” in the Baidu Search Index were consistent and had 2 to 3 days' lead time to the reported cases; the correlation coefficients were higher than 0.81. The Baidu Search Index volume in 14 prefectures of Guangxi was closely related with the number of reported cases; it was not associated with the local GDP. The Baidu Information Index search terms “coronavirus” and “pneumonia” were used as frequently as 192,405.0 and 110,488.6 per million population, respectively, and they were also significantly associated with the number of reported cases (r
s > 0.6), but they fluctuated more than for the Baidu Search Index and had 0 to 14 days' lag time to the reported cases. The Baidu Search Index with search terms “coronavirus,” “pneumonia” and “mask” can be used for early warning and monitoring of the epidemic trend of COVID-19 in Guangxi, with 2 to 3 days' lead time.
Low Adaptation to Management Philosophy and Refraining From Seeking Medical Care in Japanese Employees
Authors: Inoue Akiomi , Eguchi Hisashi , Kachi Yuko , Tsutsumi Akizumi
Published: August 2022

Objective

We examined the prospective association of low adaptation to management philosophy with refraining from seeking medical care (RSMC) among Japanese employees in a company with a management philosophy of “pursuing employees’ well-being.”

Methods

We surveyed 2791 employees (2059 men and 732 women) from 2 factories of a Japanese manufacturing company following the management philosophy of “pursuing employees’ well-being.” Using a self-administered questionnaire, we measured adaptation to management philosophy at baseline and RSMC at a 1-year follow-up. We conducted robust Poisson regression analysis.

Results

Low adaptation to management philosophy was significantly associated with RSMC (incidence rate ratio, 1.17; 95% confidence interval, 1.03–1.35).

Conclusions

Adaptation to management philosophy may be an important factor associated with the decision of employees working at a company following the “pursuing employees’ well-being” management philosophy to seek medical care for their perceived health issues.
Locations and Predictive Factors of Hypertrophic Pachymeningitis in Otitis Media With Antineutrophil Cytoplasmic Antigen-Associated Vasculitis
Authors: Morita Yuka , Kitazawa Meiko , Yagi Chihiro , Takahashi Kuniyuki , Ohshima Shinsuke , Yamagishi Tatsuya , Izumi Shuji , Horii Arata
Published: August 2022

Objective

To determine the locations and predictive factors of hypertrophic pachymeningitis (HP), a serious central complication of otitis media with antineutrophil cytoplasmic antigen-associated vasculitis (OMAAV).

Study Design

Retrospective study.

Setting

University hospital.

Patients

Thirty-six patients with OMAAV underwent contrast-enhanced magnetic resonance imaging (CE-MRI) of the brain, of whom 18 and 18 had or did not have HP, respectively.

Main Outcome Measures

The location of HP lesions, which were detected as dural thickening on CE-MRI, was reviewed. Clinical characteristics, laboratory data, and audiometric data before treatment were correlated with the occurrence of HP.

Results

HP lesions were most frequently observed in the middle cranial fossa, followed by the internal auditory meatus, tentorium cerebelli, and posterior cranial fossa, which were adjacent to the middle ear primary lesion. Headache was more frequently observed in patients with HP than without HP. The neutrophil-to-lymphocyte ratio (NLR) of the HP (+) group (median, 3.91; interquartile range, 2.50–6.06) was higher than that of the HP (−) group (median, 2.40; interquartile range, 2.01–3.03). The area under the receiver operating characteristic curve for the NLR was 0.741. An NLR of 3.46 had the highest sensitivity (61.1%) and specificity (94.4%) for predicting HP. Other markers of systemic inflammation and comorbidities of systemic diseases were not different between the groups.

Conclusions

HP may not be a systemic manifestation of OMAAV but may be related to local lesions in the adjacent brain. A high NLR may be a predictive factor for comorbid HP. Therefore, CE-MRI should be considered for patients with a high NLR.
Outcomes of Nonvariceal Upper Gastrointestinal Bleeding in Patients With Cirrhosis
Authors: Kruger Andrew J. , Abougergi Marwan S. , Jalil Sajid , Sobotka Lindsay A. , Wellner Michael R. , Porter Kyle M. , Conteh Lanla F. , Kelly Sean G. , Mumtaz Khalid
Published: August 2022

Goals:

We sought to evaluate hospital outcomes of cirrhosis patients with nonvariceal upper gastrointestinal bleeding (NVUGIB).

Background:

NVUGIB is common in patients with cirrhosis. However, national outcome studies of these patients are lacking.

Study:

We utilized the 2014 Nationwide Readmission Database to evaluate NVUGIB in patients with cirrhosis, further stratified as no cirrhosis (NC), compensated cirrhosis (CC), or decompensated cirrhosis (DC). Validated International Classification of Diseases, Ninth Revision, Clinical Modification codes captured diagnoses and interventions. Outcomes included 30-day readmission rates, index admission mortality rates, health care utilization, and predictors of readmission and mortality using multivariable regression analysis.

Results:

Overall, 13,701 patients with cirrhosis were admitted with NVUGIB. The 30-day readmission rate was 20.8%. Patients with CC were more likely to undergo an esophagogastroduodenoscopy (EGD) within 1 calendar day of admission (74.1%) than patients with DC (67.9%) or NC (69.4%). Patients with DC had longer hospitalizations (4.1 d) and higher costs of care ($11,834). The index admission mortality rate was higher in patients with DC (6.2%) than in patients with CC (1.7%, P<0.001) or NC (1.4%, P<0.001). Predictors of 30-day readmission included performing an EGD >1 calendar day from admission (OR: 1.21; 95% CI, 1.00 to 1.46) and DC (OR: 1.78; 95% CI, 1.54 to 2.06). DC was a predictor of index admission mortality (OR: 3.68; 95% CI, 2.67 to 5.05).

Conclusions:

NVUGIB among patients with DC is associated with higher readmission rates, mortality rates, and health care utilization compared with patients with CC and NC. Early EGD is a modifiable variable associated with reduced readmission rates. Early identification of high-risk patients and adherence to guidelines may improve clinical outcomes.
Effects of tranexamic acid on coagulofibrinolytic markers during the early stage of severe trauma: A propensity score–matched analysis
Authors: Gando Satoshi , Shiraishi Atsushi , Wada Takeshi , Yamakawa Kazuma , Fujishima Seitaro , Saitoh Daizoh , Kushimoto Shigeki , Ogura Hiroshi , Abe Toshikazu , Mayumi Toshihiko , Sasaki Junichi , Kotani Joji , Takeyama Naoshi , Tsuruta Ryosuke , Takuma Kiyotsugu , Shiraishi Shin-ichiro , Shiino Yasukazu , Nakada Taka-aki , Okamoto Kohji , Sakamoto Yuichiro , Hagiwara Akiyoshi , Fujimi Satoshi , Umemura Yutaka , Otomo Yasuhiro ,   for the JAAM FORECAST TRAUMA Study Group
Published: August 2022

Tranexamic acid (TXA) reduces the risk of bleeding trauma death without altering the need for blood transfusion. We examined the effects of TXA on coagulation and fibrinolysis dynamics and the volume of transfusion during the early stage of trauma. This subanalysis of a prospective multicenter study of severe trauma included 276 patients divided into propensity score–matched groups with and without TXA administration. The effects of TXA on coagulation and fibrinolysis markers immediately at (time point 0) and 3 hours after (time point 3) arrival at the emergency department were investigated. The transfusion volume was determined at 24 hours after admission. TXA was administered to the patients within 3 hours (median, 64 minutes) after injury. Significant reductions in fibrin/fibrinogen degradation products and D-dimer levels from time points 0 to 3 in the TXA group compared with the non-TXA group were confirmed, with no marked differences noted in the 24-hour transfusion volumes between the 2 groups. Continuously increased levels of soluble fibrin, a marker of thrombin generation, from time points 0 to 3 and high levels of plasminogen activator inhibitor-1, a marker of inhibition of fibrinolysis, at time point 3 were observed in both groups. TXA inhibited fibrin(ogen)olysis during the early stage of severe trauma, although this was not associated with a reduction in the transfusion volume. Other confounders affecting the dynamics of fibrinolysis and transfusion requirement need to be clarified.
Diagnostic value of HA, PC-III, IV-C, and LN in infants with congenital biliary atresia
Authors: Bai Yukun , Wang Ping , Qi Yanwei , Li Yang , Liu Weidong , Gao Lei , Jiao Hanliang , An Yanxiao , Gong Yingxin
Published: August 2022

Hyaluronic acid (HA), type III procollagen III (PC-III), type IV collagen IV (IV-C), and laminin (LN) have certain diagnostic value for hepatobiliary diseases. No published studies have compared the diagnostic accuracy of these 4 indicators for the diagnosis of congenital biliary atresia (CBA) in infants. This study aimed to investigate the diagnostic value of HA, PC-III, IV-C, and LN in infants with CBA.

From January 2017 to December 2020, 185 infants with nonphysiological jaundice in the Second Department of General Surgery at the Children’s Hospital of Hebei were enrolled in this study. Forty-six infants with CBA (CBA group) and 139 infants without CBA (noncongenital biliary atresia group) were diagnosed using ultrasonography, magnetic resonance imaging, intraoperative exploration, and intraoperative cholangiography. The levels of HA, PC-III, IV-C, and LN in the 2 groups were statistically analyzed. The diagnostic accuracy was determined using receiver operating characteristic curves and by calculating the area under the curve. Univariate and multivariate logistic regression analyses were performed to identify the independent risk factors.

Compared to the noncongenital biliary atresia group, the levels of HA, PC-III, IV-C, and LN were significantly increased in the CBA group (P <.05). The receiver operating characteristic analysis showed the optimal cutoff values for HA, PC-III, IV-C, and LN were 162.7, 42.5, 199.7, and 101.2 ng/mL, and the area under the curves were 0.892, 0.762, 0.804, and 0.768, respectively. The sensitivity values for the diagnosis of CBA were 76.82%, 71.61%, 70.32%, and 72.28%, and the specificity values for the diagnosis of biliary atresia were 70.22%, 70.44%, 66.34%, and 68.71%, respectively. In the multivariate model, HA ≥162.7 ng/mL (odds ratio [OR] = 5.28, 95% confidence interval [CI]: 3.15–8.37), PC-III ≥42.5 ng/mL (OR = 4.61, 95% CI: 2.54–7.16), IV-C ≥199.7 ng/mL (OR = 5.02, 95% CI: 2.98–7.64), and LN ≥101.2 ng/mL (OR = 6.25, 95% CI: 2.41–10.07) remained associated with the occurrence of CBA.

HA, PC-III, IV-C, and LN have high accuracy for the diagnosis of CBA in infants, and these factors are potential diagnostic biomarkers for CBA.
Metabolic syndrome in patients with schizophrenia: Why should we care
Authors: Liu Jichao , Fu Lijuan
Published: August 2022

Metabolic syndrome (MS) is a serious disease in patients with schizophrenia; it is necessary to evaluate the characteristics and influencing factors of MS to provide reliable evidence for the management of schizophrenia.

Patients with schizophrenia treated in our hospital from January 1, 2018, to March 31, 2021, were selected. The characteristics and treatment details of MS and no-MS patients were evaluated. Pearson correlation analyses were applied for analyzing MS and related characteristics. Logistic regression analyses were conducted to evaluate the risk factors of MS in patients with schizophrenia.

A total of 465 patients with schizophrenia were included, the incidence of MS in patients with schizophrenia was 18.06%. Pearson correlation analyses had found that age (r = 0.621), waist circumference (r = 0.744), body mass index (r = 0.691), diabetes (r = 0.598), course of disease (r = 0.504), triglyceride (r = 0.532), high-density lipoprotein cholesterol (r = –0.518), low-density lipoprotein cholesterol (r = 0.447), and total cholesterol (r = 0.523) were correlated with MS (all P < .05). Logistic regression analyses showed that age ≥55 years (odds ratio [OR]: 2.012, 95% confidence interval [CI]: 1.425–3.196), waist circumference ≥80 cm (OR: 1.944, 95% CI: 1.081–3.172), body mass index ≥24.5 kg/m2 (OR: 2.451, 95% CI: 1.825–3.108), diabetes (OR: 2.301, 95% CI: 1.944–2.881), course of disease ≥15 years (OR: 1.804, 95% CI: 1.236–2.845), triglyceride ≥1.5 mmol/L (OR: 2.032, 95% CI: 1.614–3.079), high-density lipoprotein cholesterol ≤0.8 mmol/L (OR: 1.226, 95% CI: 1.102–1.845), low-density lipoprotein cholesterol ≥2 mmol/L (OR: 1.759, 95% CI: 1.236–1.987), and total cholesterol ≥4.5 mmol/L (OR: 1.664, 95% CI: 1.422–1.852) were the risk factors of MS in patients with schizophrenia (all P < .05).

MS is very common in patients with schizophrenia, which may be associated with many possible risk factors, and early interventions and nursing care targeted at those influencing factors are needed to improve the prognosis of schizophrenia.
Effects of resveratrol therapy on glucose metabolism, insulin resistance, inflammation, and renal function in the elderly patients with type 2 diabetes mellitus: A randomized controlled clinical trial protocol
Authors: Ma Nan , Zhang Youzhi
Published: August 2022

Background:

Diabetes mellitus is a spectrum of metabolic disorders characterized by hyperglycemia and shows a growing global public health problem in the elderly. Resveratrol presents antiaging, anti-inflammatory, antitumor antioxidant, and cardioprotective activities. The purpose of this study was to investigate the ameliorative effects of resveratrol on blood glucose, insulin metabolism, lipid profile, renal function, inflammation, and nutrient sensing systems in the elderly patients with type 2 diabetes mellitus.

Methods:

The study is a single-blind, parallel-group, randomized controlled clinical trial consisting of a 6-month treatment period. A total of 472 elderly patients with type 2 diabetes mellitus were enrolled, and included participants will be randomized into 2 groups: resveratrol (n = 242) and placebo (n = 230). The clinical efficacy and changes in clinical parameters in each group will be measured at the indicated time. Clinical parameters included blood glucose, insulin resistance index, blood lipid index, proinflammatory cytokines, renal function, and nutrient sensing systems.

Results:

Resveratrol treatment greatly improved glucose metabolism, insulin tolerance, and insulin metabolism compared to placebo. Resveratrol relieved symptoms through enhancing nutrient sensing systems, which in turn reduced production and activity of glucose-6-phosphatase. Compared with placebo, resveratrol treatment significantly decreased proinflammatory cytokines glycated hemoglobin/hemoglobin A1c, interleukin-6, tumor necrosis factor-alpha, and interleukin-1beta in the elderly diabetes. Resveratrol treatment decreased blood glucose parameters, improved the lipid profile (total cholesterol, low-density lipoprotein, high-density lipoprotein, and triglycerides), and renal function compared to placebo.

Conclusion:

In conclusion, resveratrol treatment improves inflammation, renal function, blood glucose parameters, inflammation, insulin resistance, and nutrient sensing systems in the elderly patients with type 2 diabetes mellitus, indicating resveratrol may be a potential therapeutic drug for the treatment of the elderly patients with type 2 diabetes mellitus.
Hyponatremia and SARS-CoV-2 infection: A narrative review
Authors: Habas Elmukhtar , Ali Elrazi , Habas Aml , Rayani Amnna , Ghazouani Hafedh , Khan Fahmi , Farfar Khalifa , Elzouki Abdel-Nasser
Published: August 2022

A novel rapid spreading and changing virus called SARS-CoV-2 appeared in Wuhan city in December 2019. It was announced by the World Health Organization (WHO) as a pandemic disease in March 2020. It commonly presents with respiratory symptoms; however, it may be asymptomatic. Electrolyte abnormalities are not uncommon features of SARS-CoV-2 infection. Hyponatremia is one of these electrolyte disturbances among SARS-CoV-2 patients, and it may produce symptoms such as weakness and seizure as the initial presenting symptoms. The underlying mechanism(s) of hyponatremia due to SARS-CoV-2 infection is (are) not established.

The aim of this review is to evaluate the possible mechanism of hyponatremia in patients with COVID-19. Understanding and categorizing the hyponatremia in these patients will lead to better treatment and correction of the hyponatremia.

A review of the literature between December 2019 and March 2022 was conducted searching for the possible reported mechanism(s) of hyponatremia in SARS-CoV-2.

Although SIADH is the commonly reported cause of hyponatremia in SARS-CoV-2 infection, other causes such as diarrhea, vomiting, and kidney salt loss must be considered before SIADH.
Parent Risk Perceptions, Physical Literacy, and Fundamental Movement Skills in Children With Juvenile Idiopathic Arthritis
Authors: Brandelli Yvonne N. , Stone Michelle , Westheuser Victoria , Huber Adam M. , Joshi Nila , Reid Allison , Stringer Elizabeth , Stevens Daniel
Published: August 2022

Purpose:

This pilot study sought to examine the fundamental movement skills (FMS) and physical literacy (PL) of children with juvenile idiopathic arthritis (JIA) and to explore their relationship with physical activity (PA) and parent perceptions of PA-related risks.

Methods:

Twenty-five children with JIA and their parents completed questionnaires. Fundamental movement skills were assessed in the laboratory and PA through accelerometry data.

Results:

Children spent a median of 39.4%, 40.9%, and 18.2% of their day sedentary, in light, and in moderate to vigorous PA, respectively. Fundamental movement skills and PL scores were within the average range, although were related to which joints (upper/lower body) were affected by JIA. Parents who viewed activities such as biking and climbing as risky tended to have children with weaker locomotor skills and lower PL.

Conclusion:

Children with JIA had age-appropriate PA, FMS, and PL; however, parent perceptions of PA-related risks are related to their child's FMS and PL.