bluuebunny/crossref_metadata_2025 huggingface dataset:
The association of ambient temperature variability with blood pressure in southern China
Authors: Li Muyun , Luo Jiali , Hu Jianxiong , Meng Ruilin , Xu Xiaojun , He Guanhao , Li Xing , Liu Tao , Xiao Jianpeng , Zeng Weilin , Wang Yuqin , Ma Wenjun
Published: January 2023

Objectives

Numerous studies have shown a positive relationship between temperature variability and mortality, but few studies have investigated the effect of temperature variability on blood pressure (BP). We aimed to estimate the effect of temperature variability on BP in Guangdong Province, southern China.

Methods

Data on meteorological factors were obtained from the Guangdong Meteorological Center, and BP was collected from a series of cross-sectional surveys conducted in Guangdong Province, China, from 2004 to 2015. There were 38 088 participants aged 18 years and over. A generalized additive model was used to estimate the association between temperature variability and BP after adjusting for confounding variables.

Results

Our study found a significant positive association between temperature variability and SBP, and this effect increased with the increment of exposure days in total population. The highest estimate was for temperature variability at 7 days lag (TV0–7) with a 0.497 (95% confidence interval, 0.335–0.660) mmHg rise of SBP for each 1°C increase of TV0–7. The effects of TV0–1 and TV0–2 on SBP were higher for hypertensives than that for normotensives, and in warm season higher than that in cold season. However, we did not observe statistical significance between temperature variability and DBP.

Conclusions

There was a positive association between temperature variability and SBP in Guangdong Province, which should be considered in clinical management and epidemiological survey of hypertension.
Conventional office blood pressure measurements and unattended automated office blood pressure compared with home self-measurement and 24-h ambulatory blood pressure monitoring
Authors: Fonseca-Reyes Salvador , Fonseca-Cortés Karla , Coca Antonio , Romero-Velarde Enrique , Pérez-Molina Jesús
Published: January 2023

Objective

To assess whether automated office blood pressure (BP) (AOBP) measurement is a better method for measuring BP in the office than conventional techniques and an alternative to out-of-office BP measurements: home-self BP (HSBP) or ambulatory BP monitoring (ABPM).

Methods

We conducted a cross-sectional study of 74 patients and compared AOBP with the conventional technique using a mercury sphygmomanometer and with both out-to-office BP measurements: HSBP of 7 days (three measurements in the morning, afternoon, and night) and daytime ABPM. In addition, we compared BP values obtained using HSBP and ABPM to determine their level of agreement. We used ANOVA to compare means, Bland–Altman, and intraclass correlation coefficients (ICC) for concordance.

Results

BP values obtained by the two office methods were similar: conventional 147.2/85.0 mmHg and AOBP 146.0/85.5 mmHg (P > 0.05) with good agreement (ICC 0.85). The mean SBP differences between AOBP and HSBP (P < 0.001) and between AOBP and ABPM (P < 0.001) were 8.6/13.0 mmHg with limits of agreement of −21.2 to 38.5 and −18.4 to 44.3 mmHg, respectively. The average SBP values obtained by HSBP were 4.3 mmHg higher than those obtained by ABPM (P < 0.01).

Conclusion

Our study showed good agreement and concordance between the two office methods as well between the two out-to-office methods, although there was a significant difference in the mean SBP between the HSBP and ABPM. Moreover, AOBP was not comparable to either HSBP or ABPM; therefore, the estimation of out-to-office BP using AOBP is not supported.
Trimethoprim-sulfamethoxazole induced aseptic meningitis case report
Authors: Pata Giulia , Montagna Marco , Bosi Emanuele , Davalli Alberto , Rovere Querini Patrizia
Published: January 2023

Rationale:

Drug-induced aseptic meningitis (DIAM) is an uncommon meningitis and trimethoprim with or without sulfamethoxazole is the most involved antibiotic. Although DIAM is easily treated with the discontinuation of the causative drug, the diagnosis is a big challenge for physicians, as it remains a diagnosis of exclusion. Here, we present a case report of trimethoprim-sulfamethoxazole induced aseptic meningitis in a woman with acute osteomyelitis.

Patient concerns:

A 52-year-old woman was admitted to the hospital for septic shock and acute osteomyelitis of the right homerus. She was started on antibiotic therapy with oxacillin and daptomycin, then oxacillin was replaced with cotrimoxazole, due to its excellent tissue penetration, including bone tissue. During cotrimoxazole therapy, the patient developed a fluent aphasia with ideomotor apraxia and muscle hypertonus.

Diagnosis and interventions:

Having excluded infectious, epileptic and vascular causes of the acute neurologic syndrome of our patient, given the improvement and full recovery after discontinuation of cotrimoxazole, we hypothesized a DIAM.

Outcomes:

After discontinuation of cotrimoxazole, in 48 hours the patient had a full recovery.

Lessons:

Although DIAM can be easily managed with the withdrawal of the causative drug, it can be difficult to recognize if it is not included in the differential diagnosis. An antimicrobial stewardship program with a strict monitoring of patients by infectious disease specialists is essential, not only to optimize the appropriate use of antimicrobials, but also to improve patient outcomes and reduce the likelihood of adverse events.
Combined acupuncture-medicine anesthesia used in thyroid surgery: A systematic review and meta-analysis
Authors: Zhang Wei , Zhang Meng , Han Yanxun , Liu Yuchen , Liu Yehai , Sun Chunping
Published: January 2023

Background:

Combined acupuncture-medicine anesthesia (CAMA) is extensively used in thyroid surgery in China. We conducted a systematic review and meta-analysis to assess the efficacy and safety of CAMA.

Methods:

We searched the China National Knowledge Infrastructure (CNKI), VIP database, WanFang database, PubMed, EMBASE, and the Cochrane Library for relevant literature. The term of literature was published before April 18, 2020, and there were no restrictions on publication language, region, or publication year. The inclusion criteria included a randomized controlled trial (RCT) of acupuncture combined with cervical plexus anesthesia. We used RevMan5.3 software for data analysis. If the chi-square test showed no significant heterogeneity (P > .10, I
2 < 50%), we used the fixed-effect model to calculate risk ratio (RR) and mean difference. Otherwise, the random-effects model was used.

Results:

Overall, 18 RCTs involving 1211 patients were included in the study. The anesthesia significant rate (ASR) in the transcutaneous electrical acupoint stimulation (TEAS) plus cervical plexus block anesthesia (CPBA) and electroacupuncture (EA) plus CPBA groups was significantly higher compared with the CPBA group (TEAS + CPBA: P < .001; EA + CPBA: P < .001). The pooled effect values of the intraoperative heart rate (HR) and mean arterial pressure (MAP) were significantly lower in both the TEAS + CPBA and EA + CPBA groups relative to the control group (HR: P = .05, P < .001; the MAP: P = .002, P < .001; respectively). Moreover, the postoperative adverse reaction was markedly lower in the experimental group than in the control group (RR = 0.30, P < .001), and there was no heterogeneity between the two groups (P = .71, I
2 = 0%).

Conclusion:

Combined acupuncture-medicine anesthesia significantly increases the anesthesia significance rate, reduces the intraoperative heart rate, and blood pressure, and reduces the incidence of postoperative adverse reactions. However, more high-quality future studies should be conducted to validate the efficacy and safety of acupuncture combined anesthesia further.
Factor structure of the patient health questionnaire-9 and measurement invariance across gender and age among Chinese university students
Authors: Wang Yang , Liang Lijuan , Sun Zhenyuan , Liu Rongxun , Wei Yange , Qi Shisan , Ke Qiao , Wang Fei
Published: January 2023

The Patient Health Questionnaire-9 (PHQ-9) has been widely used to screen depression symptoms. The present research aimed to assess the reliability and validity of PHQ-9, besides measurement invariance of the PHQ-9 across gender and age among Chinese university students. A total of 12,957 Chinese college students from 2 universities in Henan and Hainan provinces (China) completed the questionnaires via WeChat. This research reported the psychometric properties of PHQ-9 and measurement invariance of the PHQ-9 across gender and age among Chinese university students. Compared with 1-factor model, the 2-factor (affective factor and somatic factor) model of PHQ-9 showed a better fit index in Chinese university students. Without the last 2 items, the 2-factor model of the PHQ-9 showed satisfactory reliability, validity, and good fit index (e.g., Root mean square error of approximation = 0.060, Goodness-of-fit index = 0.982, Comparative fit index = 0.986, and Tucker-Lewis index = 0.974). The Cronbach’s alpha of PHQ-9 was 0.874. Multi-group analysis across gender and age demonstrated that measurement equivalency for the 2-factor model of the PHQ-9 was established (e.g., Root mean square error of approximation < 0.08, Comparative fit index > 0.90 and Tucker-Lewis index > 0.90). The 2-factor model of the PHQ-9 without the items of “movement” and “desire to die” showed a better fit index in Chinese university students. The measurement equivalence across gender and age for the 2-factor model of the PHQ-9 can be established among Chinese university students.
Safety and efficacy of etomidate in combination with oxycodone in painless gastroscopic procedures in the elderly: A prospective randomized controlled trial study
Authors: Zhou Ying , Li Yan-Ping
Published: January 2023

Objective:

Etomidate is often combined in rapid succession during induction of anesthesia. However, the effect of pretreatment with oxycodone on recovery of cognitive function and adverse effects has rarely been studied. We conducted a prospective randomized controlled trial to compare etomidate alone with etomidate combined with oxycodone in elderly patients undergoing painless gastroscopy.

Methods:

Hundred elderly patients undergoing painless gastroscopy were divided into a control and an observation group, with 50 cases in each group. The age, gender, height, weight, body mass index and American Society of Anesthesiologists physical status (I/II) of patients in both groups were recorded. The recovery of cognitive function was compared in both groups using the Neurobehavioral Cognitive Status Examination. Adverse events, including somatic motor reactions, hypotension, bradycardia, myocardial tremor, nausea and vomiting, and injection pain, were also recorded in both groups. Moreover, heart rate, peripheral capillary oxygen saturation, systolic blood pressure, and diastolic blood pressure were evaluated in the 2 groups at different time points.

Results:

A total of 100 patients were enrolled in this study. The demographic characteristics in the 2 groups were not significantly different (P > .05). Regarding the recovery of cognitive functions, more subjects in the observation group passed the memory, arithmetic and orientation test than in the control group (P < .05). Fewer adverse events such as dynamic body reactions, cardiac tremor, nausea and vomiting, and injection pain occurred in the observation group than in the control group (P < .05). During anesthesia and after awakening, the results of peripheral capillary oxygen saturation, systolic blood pressure and diastolic blood pressure were better in the observation group than in the control group (P < .05).

Conclusion:

Etomidate in combination with oxycodone for painless gastroscopic operation in the elderly is a safe and effective anesthetic strategy.
Change in left ventricular diastolic function after pioglitazone treatment in patients with type 2 diabetes mellitus: A protocol for systematic review and meta-analysis
Authors: Song Han , Li Yunye , Yu Ruiming , Meng Xiangbin , Bi Yanwen
Published: January 2023

Background:

Pioglitazone is currently used as an anti-diabetic agent and can reduce cardiovascular events in in patients with type 2 diabetes mellitus (T2DM). Left ventricular diastolic dysfunction has been recognized as an early manifestation of myocardial dysfunction in T2DM patients. This systematic review and meta-analysis aimed to investigate changes in the left ventricular diastolic function after the treatment of pioglitazone.

Methods:

A systematic literature search of PubMed, Embase, and the Cochrane Library until May 2021 with keywords pioglitazone and left ventricular diastolic function was performed in accordance with the meta-analysis of observational studies in epidemiology guidelines and preferred reporting items for systematic reviews and meta-analyses statement. Three reviewers independently selected the studies and extracted data. Quality assessment of the included studies was undergone. A fixed effects model was used to calculate overall effect sizes. Subgroup analyses were subsequently performed. A fixed effects model was used to calculate the overall effect size. Subgroup analyses were then performed.

Results:

Seven studies with 233 patients were investigated. We found pioglitazone significantly improved hemoglobin A1c (%) in patients with T2DM and left ventricular diastolic function had an improvement tendency (weighted mean difference [WMD], 0.03; 95% confidence interval [CI], 0.01–0.05, P < .01) despite moderate heterogeneity (I
2 = 66%). Subsequent subgroup analysis indicated that left ventricular diastolic function were significantly improved (WMD, 0.20; 95% CI, 0.12–0.29, P < .001) in T2DM patients whose average age < 55 after receiving pioglitazone treatment. However, in T2DM patients with mean age ≥ 55 years, there was no significant improvement of left ventricular diastolic function (WMD, 0.02; 95% CI, 0–0.04, P = .04).

Conclusion:

Pioglitazone treatment significantly improved left ventricular diastolic function in type 2 diabetic patients with a mean age of < 55 years, but did not improve left ventricular diastolic function in patients with a mean age of ≥ 55 years.
Glioblastoma in the contralateral cerebral hemisphere with previous surgery for meningioma: A case report
Authors: Wang Zhe , Sun Shushu , Xie Kunming , Miao Junjie
Published: January 2023

Rationale:

Meningioma and glioblastoma (GBM) are 2 common intracranial tumors with different pathophysiologies and prognoses. It is rare for these 2 kinds of tumors to occur in the same patient. Most of the similar cases reported in the literature have been treated with radiotherapy, while cases without radiotherapy are rare. In particular, GBM in the contralateral cerebral hemisphere after resection of meningioma has not been reported.

Patient concerns:

We present a case of a 66-years-old man with GBM in the right temporal lobe after previous resection of a benign meningioma of the left frontal lobe without radiotherapy.

Diagnoses:

The patient was admitted to our hospital for the first time because of right upper limb weakness. Brain magnetic resonance imaging indicated a space-occupying lesion in the left frontal area. Surgical treatment was performed, and postoperative pathology confirmed a meningioma. The patient was readmitted to the hospital 3 years after surgery of the meningioma due to a new lesion of the right temporal lobe and underwent reoperation. The postoperative pathological results showed GBM.

Interventions:

The patient underwent 2 operations, and the postoperative pathologies were meningioma and GBM. In addition, the patient received concurrent chemoradiotherapy and 2 cycles of temozolomide adjuvant chemotherapy.

Outcomes:

During the last 4 months of follow-up, the patient was in good condition with no recurrence of the tumor.

Lessons:

The development of GBM without radiotherapy after meningioma surgery is very rare, especially at different sites, and it is necessary to accumulate relevant cases to reveal the causes of the disease and provide more evidence for the treatment of similar patients in the future.
Clinical Significance of Pancreatic Fat in Children
Authors: Cho Jin Young , You Sun Kyoung , Lim Han Hyuk , Kim Hyun Jin
Published: January 2023

Objectives

Recently, interest in pancreatic fat has increased, and fatty pancreas is considered to be related to nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome. We aimed to evaluate the prevalence of echogenic pancreas in children and its related factors.

Methods

We retrospectively analyzed the data of patients aged 5 to 18 years who had undergone abdominal sonography between January 2020 and December 2020. Patients with chronic or pancreatic diseases were excluded.

Results

Of 102 patients, 27 (26.5%) had echogenic pancreas and 55 (53.9%) had NAFLD. Among the 55 patients with NAFLD, 18 (32.7%) had an echogenic pancreas. Patients with echogenic pancreas had significantly higher fasting glucose, low-density lipoprotein cholesterol, and triglyceride levels than those without echogenic pancreas. The proportion of NAFLD and obesity was higher in the echogenic group; however, only the proportion of obese subjects showed a significant difference. In multivariate analysis, family history of diabetes mellitus (DM) and/or dyslipidemia and presence of DM and/or dyslipidemia were factors related to the presence of echogenic pancreas.

Conclusions

Echogenic pancreas is relatively common in children. Echogenic pancreas, typically observed in patients with a family history of DM and/or dyslipidemia, was strongly associated with metabolic syndrome, even in the absence of fatty liver.
Familial Duodenal Somatostatinomatosis Not Associated With a Known Genetic Syndrome
Authors: Yu Run , Rao Jianyu , Zhai Jing , Hecht J. Randolph , Pisegna Joseph R.
Published: January 2023

We report a father and his daughter who both had multiple somatostatinomas in the duodenal bulb without a known syndrome. The father, at age 68 years, was incidentally found to harbor 4 approximately 1.5-cm well-differentiated neuroendocrine tumors in the duodenal bulb. His preoperative somatostatin level was elevated. He underwent partial duodenectomy and regional lymph node dissection; one lymph node was positive for metastasis. One year postoperatively, a recurrence was found in the surgical bed; he was treated with octreotide for 2 years, which stabilized the recurrent tumor. Ten years postoperatively, the mucosa of his remaining duodenum was normal. His daughter, at age 53 years, was found to harbor multiple small neuroendocrine tumors in the duodenal bulb. Immunostaining of available specimens showed that the neuroendocrine tumors from the father and daughter both were strongly positive for somatostatin. Micronodules of somatostatin-expressing neuroendocrine cells were found in the parts of the specimens uninvolved with the tumors. Both patients exhibited no evidence of known syndromes associated with somatostatinoma. The daughter did not harbor mutations in 93 genes commonly found in genetic tumor syndromes. The 2 cases thus suggest a novel, autosomal dominant, genetic syndrome of familial duodenal somatostatinomatosis.
Fat-Soluble Vitamin Deficiencies and Disruption of the Immune System in Pancreatic Cancer
Authors: Aziz Mohammad Hosein , van der Meulen Jan , Mustafa Dana A.M. , van Eijck Casper H. J.
Published: January 2023

Pancreatic ductal adenocarcinoma (PDAC) is currently an increasing contributor to cancer-related mortality. Despite advances in cancer treatment, PDAC survival rates have remained roughly unchanged over the years. Specifically, late diagnosis and insensitivity to currently available therapeutic regimens have been identified as the main causes for its poor survival. Pancreatic exocrine insufficiency (PEI) is a typical complication associated with PDAC diagnosis and pancreatic surgery. Pancreatic exocrine insufficiency, a major contributor to maldigestion in PDAC, is often not treated because it remains undetected because of lack of overt signs and symptoms. In this review, we will focus on the major consequences of PEI, including the inadequacy of lipase excretion, which results in deficiency of fat-soluble vitamins. Because PDAC is known for its immune-high jacking mechanisms, we describe key features in which deficiencies of fat-soluble vitamins may contribute to the aggressive biological behavior and immune evasion in PDAC. Because PEI has been shown to worsen survival rates in patients with PDAC, detecting PEI and the related fat-soluble vitamin deficits at the time of PDAC diagnosis is critical. Moreover, timely supplementation of pancreatic enzymes and fat-soluble vitamins may improve outcomes for PDAC patients.
Angiotensin-(1–7) Restores Microcirculation Profiles in Acute Pancreatitis
Authors: Wang Xueyan , Cui Tianyu , Zhang Tingting , Hu Weikai , Liu Ruixia , Yin Chenghong
Published: January 2023

Objectives

The aim of this study was to investigate whether angiotensin (Ang)-(1–7)–mediated restoration of pancreatic microcirculation profiles and endothelial injury is associated with the expression of telomerase reverse transcriptase (TERT).

Methods

Wild-type, TERT transgene, and TERT knockdown mice were used in this study, and acute pancreatitis model was induced by intraperitoneal injection of cerulein and lipopolysaccharide (LPS). Pancreatitis was confirmed by histopathology and serum amylase levels. Pancreatic microcirculation function was assessed by laser Doppler. Endothelial injury model was established by exposing endothelial cells to LPS. Proinflammatory cytokines were detected using enzyme-linked immunosorbent assay, endothelial permeability was detected using transwell assay, and mitochondrial dysfunction and mitochondrial reactive oxygen species (mtROS) were determined by performing confocal microscopy.

Results

The effects of Ang-(1–7) in the treatment of pancreatic microcirculation dysfunction were associated with TERT expression. In addition, Ang-(1–7) protected against endothelial cell lesions via inhibiting the increase in endothelial cell permeability and release of proinflammatory cytokines in a TERT-dependent manner. Furthermore, TERT was involved in Ang-(1–7)–mediated attenuation of mitochondrial dysfunction and mtROS in LPS-induced endothelial cells.

Conclusions

Angiotensin-(1–7) restores pancreatic microcirculation profiles and reverses endothelial injury by inhibiting mtROS production and mitochondrial dysfunction in a TERT-dependent manner.
Clinical Characteristics of Patients With Chronic Pancreatitis With or Without Prior Acute Pancreatitis Are Different
Authors: Tao Heqing , Chang Hong , Li Nan , Zhu Shiwei , Duan Liping
Published: January 2023

Objective

The aim of the study is to clarify the clinical characteristics of patients with chronic pancreatitis (CP) who had no prior acute pancreatitis (AP) attack.

Methods

We retrospectively analyzed patients with CP who were admitted to our center between January 2012 and January 2020.

Results

A total of 274 patients were divided into the following 3 groups: group A: CP without prior AP (n = 103 [37.6%]), group B: CP preceded by a single episode of AP (n = 39 [14.23%]), and group C: CP preceded by recurrent AP (n = 132 [48.18%]). At the diagnosis, patients in group A had a higher incidence of pancreatic duct stones (41.7% vs 25.8%, P = 0.012), higher proportion of idiopathic CP (68.9% vs 48.5%, P = 0.001), and higher mean pancreatic volume change rate (37.61% vs 10.48%, P = 0.007) compared with Group C. Patients in group A underwent the most episodes of extracorporeal shockwave lithotripsy therapy among the 3 groups (P < 0.001).

Conclusions

Approximately 37.6% of patients had no prior AP attack before CP diagnosis. Patients with CP without prior AP had higher incidence of pancreatic duct stones and pancreas volume shrank faster.
Walking into a COVID Petri Dish
Authors: Elliott Brenda , Burt Sue , Lahr Jessica
Published: January 2023

As we approach the third anniversary of the COVID-19 pandemic, the long-term effects on the health and well-being of those caring for patients in their homes, where less control of the environment can be maintained, remain a concern. The purposes of this study were to describe home care providers' experiences caring for patients during the pandemic, barriers and facilitators to the provision of care, and lessons learned for practice during future healthcare crises. A qualitative descriptive study using semistructured interviews was conducted with 13 home care providers. Four themes emerged from the data: Riding an emotional roller coaster, Putting a fire out with a garden hose, Walking into a COVID petri dish, and I'm just trying to do my job. Support for frontline staff should be initiated early in a healthcare crisis or pandemic. Communication needs to be clear, consistent, and made available at regular intervals. Home care leaders need to be visible and transparent to reduce emotional uncertainties that can negatively influence staff and patient outcomes. Education and planning around emergency preparedness are essential in future crises to mitigate the negative consequences on staff and patients.
Lhermitte-Duclos Disease Related With Cowden Syndrome Mimicking Metastatic Lung Cancer on FDG PET/CT
Authors: Kesim Selin , Ozguven Salih , Oksuzoglu Kevser , Erdil Tanju Yusuf
Published: January 2023

Cowden syndrome is characterized by multiple hamartomatous and neoplastic lesions including Lhermitte-Duclos disease, which is the main criterion for the diagnosis. Herein, we presented a patient with suspected metastatic disease referred to PET/CT, which showed mildly hypermetabolic multinodular thyroid goiter, multiple hamartomatous pulmonary, and breast nodules. Also, intense hypermetabolism was noted on the cerebellar tumor lesion. Lhermitte-Duclos disease was diagnosed based on the characteristic MRI findings, and she was followed up with a diagnosis of Cowden syndrome. Our case indicates that Cowden syndrome should be included as a differential diagnosis of abnormal FDG uptake in the multiple systemic hamartomatous tumors.
Heterotopic Pancreas Mimicking Metastases From Renal Carcinoma
Authors: Datta Deepanksha , Kumar Rajesh , Varshney Peeyush , Khera Sudeep , Gupta Tanisha
Published: January 2023

Heterotopic pancreas, also known as ectopic or aberrant pancreas, is described as the deposits of normal pancreatic tissue “dropped” into the developing gastrointestinal system. Here we present an operated case of renal clear cell carcinoma, which on 6-month follow-up presented with eccentric mass in the gastric body suspicious for malignancy. Endoscopic biopsy was inconclusive and showed isometabolism on 18F-FDG PET/CT. It was subsequently resected laparoscopically, and final histopathology revealed heterotopic pancreas.
Normalization of Liver Physiological Uptake as a Response Marker to Treatment in Prostate Cancer Liver Metastases Appearing as Photopenic on Baseline 18F-Fluorocholine PET/CT
Authors: Faudemer Julie , Meriaux Emeline , Tillou Xavier , Aide Nicolas
Published: January 2023

In a 54-year-old patient referred for 18F-fluorocholine (FCH) baseline PET/CT before chemotherapy for biopsy-proven liver metastases, FCH PET/CT demonstrated multiple hypodense hepatic lesions with no FCH uptake and 2 positive bone metastases. FCH PET/CT performed after 6 cycles of docetaxel demonstrated a near normalization of the physiological uptake in the area of the sterilized liver metastases, which was confirmed by a drop in prostate-specific antigen and a complete metabolic response in the bone metastases. The present case demonstrates a new pattern of response defined by a reverse phenomenon from photopenic to normal uptake in responding liver metastases.
Head-to-Head Comparison Between Rabbit Sign and EANM/SNMMI Criteria for the 18F-DOPA Visual Assessment of Parkinsonian Syndromes in PET/MRI
Authors: Goldfarb Lucas , Iep Alex , Chawki Mohammad Bilal , Nguyen Loc , Lun François , Carpentier Amer-Adam Al Najjar , de Recondo Anne , Blin Jérôme , Bourdinaud Valérie , Morin Ludovic , Andriatsiferana Harisoa , Ferreira André , Deschiens Anne Marie , Brulon Vincent , Comtat Claude , Lebon Vincent , Besson Florent L.
Published: January 2023

Purpose

The aim of this study was to compare the diagnostic performance of the rabbit visual pattern versus the one endorsed by the EANM/SNMMI for the diagnosis of parkinsonian syndromes in PET/MRI.

Patients and Methods

The 18F-DOPA PET images of 129 consecutive patients (65 Park+ and 64 controls) with 1 year of clinical follow-up were reviewed independently by 5 experienced readers on the same imaging workstation, blinded to the final clinical diagnosis. Two visual methods were assessed independently, with several days to months of interval: the criteria endorsed by EANM/SNMMI and the “rabbit” shape of the striate assessed on 3D MIP images. The sensitivities, specificities, likelihood ratios, and predictive values of the 2 diagnostic tests were estimated simultaneously by using the “comparison of 2 binary diagnostic tests to a paired design” method.

Results

The estimated 95% confidence interval (CI) of sensitivities and specificities ranged from 49.4% to 76.5% and from 83.2% to 97.7%, respectively. The 95% CI estimates of positive and negative likelihood ratios ranged from 3.8 to 26.7 and from 0.26 to 0.56, respectively. The 95% CI estimates of the positive and negative predictive values ranged from 78.1% to 96.7% and from 60.3% to 81.4%, respectively. For all the parameters, no statistical difference was observed between the 2 methods (P > 0.05). The rabbit sign reduced the readers’ discrepancies by 25%, while maintaining the same performance.

Conclusions

The rabbit visual pattern appears at least comparable to the current EANM/SNMMI reference procedure for the assessment of parkinsonian syndromes in daily clinical practice, without the need of any image postprocessing. Further multicenter prospective studies would be of relevance to validate these findings.
Routine Use of Lateral Vertebral Assessment With DXA Scan for Detection of Silent But Debilitating Vertebral Fractures
Authors: Gill Sana Munir , Hassan Aamna
Published: January 2023

Purpose of the Report

Reduced bone mineral density is a major public health dilemma with high prevalence. Vertebral fracture (VF) is an independent risk factor for fragility fracture. Lateral vertebral assessment (LVA) in dual-energy x-ray absorptiometry is a reliable, low-radiation, accurate, and cost-effective method for VF assessment.

Patients and Methods

Five hundred seventy-five scans of oncologic and nononcologic patients were retrospectively reviewed irrespective of age or sex. Patients’ symptoms, bone mineral density, and risk factors were also evaluated. Scans in which LVA was not acquired or had previously known VFs were excluded.

Results

The mean age of patients was 66 ± 11.5 years. Eleven percent of patients had VFs on LVA, of which 7 were excluded due to known VFs. Ten percent had new VFs, most of whom were women (n = 42). The most common risk factor was secondary osteoporosis in women and rheumatoid arthritis in men. Sixty-eight percent of the patients had solitary fractures, whereas 32% had multiple fractures. Most of these patients had underlying osteopenia (n = 19). FRAX was calculated twice: once with the history of personal fracture marked and the other time unmarked as these would not have been discovered if LVA was not acquired. Statistically significant mean percent difference of 5.4% was found in probability of major osteoporotic fracture and 2.1% in the mean risk of hip fracture.

Conclusions

In our population, 10% patients had unsuspected VFs on LVA in dual-energy x-ray absorptiometry scan. Most of these were nononcologic patients with associated risk factors. Based on the FRAX tool, there is a significant difference in the 10-year risk of fracture when unsuspected fractures discovered on LVA are marked.
Increased FAPI Activity in Pulmonary Tuberculosis
Authors: Liu Wei , Gong Weidong , Yang Xiao , Xu Tingting , Chen Yue
Published: January 2023

A 50-year-old man presented with cough and hemoptysis for 1 month. Chest CT showed an irregular mass in the right lung, with enlarged lymph nodes in the mediastinum and right hilum. These findings were suggestive of lung cancer with lymph node metastases. The patient was subsequently enrolled in a 68Ga-DOTA-FAPI-04 PET/CT clinical trial. 68Ga-DOTA-FAPI-04 PET/CT revealed a mass in the upper lobe of right lung, with intense tracer uptake. Meanwhile, PET/CT showed enlarged lymph nodes in the mediastinum and right hilum, with mild FAPI uptake. However, pathological examination confirmed the mass was tuberculous granuloma.
Striatal Dopaminergic Loss and Dysphagia in Parkinson Disease
Authors: Kim Ji Hwan , Jeon Jonghu , Lee Young , Kim Seung Min , Cheon Miju , Kim Jun Yup
Published: January 2023

Purpose

To better understand the development of dysphagia in patients with Parkinson disease (PD) and to identify possible neuromodulatory target regions of dysphagia, we studied the striatal dopamine transporter (DAT) availability distribution by subtype of dysphagia.

Methods

In this retrospective cross-sectional study, patients with PD who underwent videofluoroscopic swallowing study and N-(3-[18F]fluoropropyl)-2β-carbon ethoxy-3β-(4-iodophenyl) nortropane (18F-FP-CIT) PET at intervals of less than 1 month were analyzed. The 14 binarized subitem scores of the Videofluoroscopic Dysphagia Scale were analyzed using a voxel-wise Firth’s penalized binary logistic regression model, adjusting for age and disease duration at videofluoroscopic swallowing study.

Results

Sixty-five patients with PD were finally included. Striatal mapping showed association of decreased DAT availability with 5 subitems with 1 or more clusters surviving the statistical threshold: 1 oral phase and 4 pharyngeal phase subitems. The overlap maps created by superimposing clusters for all 5 statistically significant subitems revealed associations of dysphagia in PD with decreased DAT availability in the bilateral ventral striatum. Of these, 4 subitems belonging to the pharyngeal phase-specific dysphagia were additionally found to be related to dopaminergic degeneration of the bilateral anterior-to-posterior caudate and ventral striatum.

Conclusions

These findings suggest that subitem/phase-specific striatal subregional dopaminergic depletion may explain the dysphagia of PD. This dopaminergic degeneration of striatal subregions specific to the phases of dysphagia may serve as a potential target for neuromodulatory brain stimulation through stimulation of cortices functionally connected.
Effect of Leflunomide Use on 68Ga-DOTATATE Biodistribution in a Case With Neuroendocrine Tumor
Authors: Tatar Gamze , Beyhan Ediz , Arslan Esra , Ergül Nurhan , Çermik Tevfik Fikret
Published: January 2023

A 58-year-old man who underwent surgery for a well-differentiated neuroendocrine tumor of pancreatic origin was evaluated with 68Ga-DOTATATE PET/CT imaging in the follow-up period. After PET/CT findings consistent with disease remission, the patient was started on leflunomide treatment with the diagnosis of rheumatoid arthritis. The patient received leflunomide for 6 months. Then, 68Ga-DOTATATE PET/CT scan was repeated to evaluate the primary disease outcome. Besides the disease remission, we also observed alterations in DOTATATE uptakes of some tissues and organs. In this case, we present the changes in 68Ga-DOTATATE PET/CT scan findings after leflunomide use.
Higher betweenness and degree centrality in the frontal and cerebellum cortex of Meige’s syndrome patients than hemifacial spasm patients
Authors: Chen Hao , Deng Kexue , Zhang Yingxing , Jiang Xiaofeng , Wang Ying
Published: January 2023

Meige’s syndrome and hemifacial spasm (HFS) are two different forms of dystonic movement disorder, but their difference in terms of resting state functional connectivity (rsFC) remains unclear. The present study applied resting state fMRI on the patients and quantified their functional connectivity with graph theoretical measures, including the degree centrality and the betweenness centrality. Fifteen Meige’s syndrome patients and 19 HFS patients matched in age and gender were recruited and their MRI data were collected. To analyze the rsFC, we adopted the Anatomical Automatic Labeling (AAL) template, a brain atlas system including 90 regions of interest (ROIs) covering all the brain regions of cerebral cortex. For each participant, the time-course of each ROI was extracted, and the corresponding degree centrality and betweenness centrality of each ROI were computed. These measures were then compared between the Meige’s syndrome patients and the HFS patients. Meige’s syndrome patients showed higher betweenness centrality and degree centrality of bilateral superior medial frontal cortex, the left cerebellum cortex, etc. than the HFS patients. Our results suggest that the rsFC pattern in Meige’s syndrome patients might become more centralized toward the prefrontal and vestibular cerebellar systems, indicating less flexibility in their functional connections. These results preliminarily revealed the characteristic abnormality in the functional connection of Meige’s patients and may help to explore better treatment.
Two Novel, Nonoperative Methods of Stoma Prolapse in Newborns
Authors: Zhou Jialiang , Huang Rong , Zhang Ying , Ge Wuping , Fang Yuanlong , Zhu Xiaochun
Published: January 2023

BACKGROUND:

Prolapse is a common complication following enterostomy; the defect and consequences of a prolapse significantly affect health-related quality of life. Creative techniques must be employed to manage the prolapse.

CASES:

This article describes management of 3 neonates with stoma prolapse.

CONCLUSION:

Management of stoma prolapse should be individualized, employing successful nonoperative techniques rather than more difficult operative procedures to prevent recurrent prolapse.
Multiplex MinION sequencing suggests enteric adenovirus F41 genetic diversity comparable to pre-COVID-19 era
Authors: Maes Mailis , Khokhar Fahad , Wilkinson Sam A. J. , Smith Andrew D. , Kovalenko Ganna , Dougan Gordon , Quick Joshua , Loman Nicholas J. , Baker Stephen , Curran Martin D. , Skittrall Jordan P. , Houldcroft Charlotte J.
Published: January 2023

Human adenovirus F41 causes acute gastroenteritis in children, and has recently been associated with an apparent increase in paediatric hepatitis of unknown aetiology in the UK, with further cases reported in multiple countries. Relatively little is known about the genetic diversity of adenovirus F41 in UK children; and it is unclear what, if any, impact the COVID-19 pandemic has had on viral diversity in the UK. Methods that allow F41 to be sequenced from clinical samples without the need for viral culture are required to provide the genomic data to address these questions. Therefore, we evaluated an overlapping-amplicon method of sequencing adenovirus genomes from clinical samples using Oxford Nanopore technology. We applied this method to a small sample of adenovirus-species-F-positive extracts collected as part of standard care in the East of England region in January–May 2022. This method produced genomes with >75 % coverage in 13/22 samples and >50 % coverage in 19/22 samples. We identified two F41 lineages present in paediatric patients in the East of England in 2022. Where F41 genomes from paediatric hepatitis cases were available (n=2), these genomes fell within the diversity of F41 from the UK and continental Europe sequenced before and after the 2020–2021 phase of the COVID-19 pandemic. Our analyses suggest that overlapping amplicon sequencing is an appropriate method for generating F41 genomic data from high-virus-load clinical samples, and currently circulating F41 viral lineages were present in the UK and Europe before the COVID-19 pandemic.
Maternal diesel exposure and maternal choline supplementation interactions in fetal and placental immune factors
Authors: Maurer Sara V , Bolton Jessica L , Bilbo Staci D , Williams Christina L
Published: January 2023

Air pollution causes widespread inflammatory changes in the body and brain. When exposure to air pollution occurs early in development, children exhibit impaired working memory ability (Sunyer et al., 2015). In addition, prenatal exposure to diesel particulate matter (DEP) increases inflammatory cytokine expression in the whole brain of embryonic day 18 (E18) males and leads to adverse long-term negative outcomes (Bolton et al., 2012). In contrast, dietary choline supplementation is negatively correlated with inflammatory cytokine production in adult rats and cultured human cells (Zhang et al., 2018; Jiang et al., 2014). When administered as a supplement to pregnant rats, choline also improves working memory in adulthood (Meck et al., 2008; Meck & Williams, 1999; 1997). The current study sought to determine if prenatal dietary choline supplementation protects against the effects of air pollution in the developing brain and in the placenta and fetal liver. These data revealed region-specific microglial morphology alterations in fetal brain and in inflammatory gene expression in the placenta and fetal liver (specifically,Tnf, Tlr2, Tlr4, andItgam) due to maternal choline supplementation and/or maternal air pollution exposure. We found that DEP led to changes in microglial morphology in the fetal dentate gyrus of E18 male, but not female, fetuses. In the placenta and fetal liver of males, inflammatory gene expression was affected by both DEP and maternal choline supplementation. However, maternal choline supplementation alone upregulated inflammatory gene expression in females, which may indicate an alteration in maturation rate. These data further contribute to the growing literature indicating region- and tissue-specificity in the developmental immune system in the context of maternal exposures.
The Preprint Club - A cross-institutional, community-based approach to peer reviewing
Authors: Richter Felix Clemens , Gea-Mallorquí Ester , Ruffin Nicolas , Vabret Nicolas
Published: January 2023

The academic community has been increasingly using preprints to disseminate their latest research findings quickly and openly. This early and open access of non-peer reviewed research warrants new means from the scientific community to efficiently assess and provide feedback to preprints. Yet, most peer review of scientific studies performed today are still managed by journals, each having their own peer review policy and transparency. However, approaches to uncouple the peer review process from journal publication are emerging. Additionally, formal education of early career researchers (ECRs) in peer reviewing is rarely available, hampering the quality of peer review feedback. Here, we introduce the Preprint Club, a cross-institutional, community-based approach to peer reviewing, founded by ECRs from the University of Oxford, Karolinska Institutet and Icahn School of Medicine at Mount Sinai. Over the past two years and using the collaborative setting of the Preprint Club, we have been discussing, assessing, and providing feedback on recent preprints in the field of immunology. In this article, we provide a blueprint of the Preprint Club basic structure, demonstrate its effectiveness, and detail the lessons we learned on its impact on peer review training and preprint author’s perception.
CAT PETR: A Graphical User Interface for Differential Analysis of Phosphorylation and Expression Data
Authors: Flanagan Keegan , Pelech Steven , Av-Gay Yossef , Duc Khanh Dao
Published: January 2023

Antibody microarray data provides a powerful and high-throughput tool to monitor global changes in cellular response to perturbation or genetic manipulation. However, while collecting such data has become increasingly accessible, a lack of specific computational tools has made their analysis limited. Here we present CAT PETR, a user friendly web application for the differential analysis of expression and phosphorylation data collected via antibody microarrays. Our application addresses the limitations of other GUI based tools by providing various data input options and visualizations. To illustrate its capabilities on real data, we show that CAT PETR both replicates previous findings, and reveals additional insights, using its advanced visualization and statistical options.
DNA supercoiling-induced shapes alter minicircle hydrodynamic properties
Authors: Waszkiewicz Radost , Ranasinghe Maduni , Fogg Jonathan M. , Catanese Daniel J. , Ekiel-Jeżewska Maria L. , Lisicki Maciej , Demeler Borries , Zechiedrich Lynn , Szymczak Piotr
Published: January 2023

DNA in cells is organized in negatively supercoiled loops. The resulting torsional and bending strain allows DNA to adopt a surprisingly wide variety of 3-D shapes. This interplay between negative supercoiling, looping, and shape influences how DNA is stored, replicated, transcribed, repaired, and likely every other aspect of DNA activity. To understand the consequences of negative supercoiling and curvature on the hydrodynamic properties of DNA, we submitted 336 bp and 672 bp DNA minicircles to analytical ultracentrifugation (AUC). We found that the diffusion coefficient, sedimentation coefficient, and the DNA hydrodynamic radius strongly depended on circularity, loop length, and degree of negative supercoiling. Because AUC cannot ascertain shape beyond degree of non-globularity, we applied linear elasticity theory to predict DNA shapes, and combined these with hydrodynamic calculations to interpret the AUC data, with reasonable agreement between theory and experiment. These complementary approaches, together with earlier electron cryotomography data, provide a framework for understanding and predicting the effects of supercoiling on the shape and hydrodynamic properties of DNA.
Comment on “Connexins evolved after early chordates lost innexin diversity”
Authors: Kelmanson Ilya V. , Bakin Evgeny A. , Karbat Izhar , Slivko-Koltchik Georgy A. , Reuveny Eitan , Panchin Yuri V.
Published: January 2023

Gap junctional (GJ) intercellular channels are an important way of intercellular communication. Currently, two unrelated families of GJ proteins, innexins/pannexins, and connexins, are known, either or both of which are present in most multicellular animals. A striking exception is the echinoderms which have functional GJs but until recently were believed to be lacking both innexins and connexins, which suggests the presence of the third, yet the unknown family of GJ proteins. In the recent work Welzel and Schuster (Welzel and Schuster, 2022) have reported several putative innexins and one connexin from echinoderms, therefore undermining such a hypothesis. Here we provide evidence showing that all reported connexin and innexin sequences from echinoderms are cross-species contaminations, indicating that a search for a third GJ protein family is still a subject of immediate scientific research interest.
Segmenting functional tissue units across human organs using community-driven development of generalizable machine learning algorithms
Authors: Jain Yashvardhan , Godwin Leah L. , Joshi Sripad , Mandarapu Shriya , Le Trang , Lindskog Cecilia , Lundberg Emma , Börner Katy
Published: January 2023

The development of a reference atlas of the healthy human body requires automated image segmentation of major anatomical structures across multiple organs based on spatial bioimages generated from various sources with differences in sample preparation. We present the setup and results of the “Hacking the Human Body” machine learning algorithm development competition hosted by the Human Biomolecular Atlas (HuBMAP) and the Human Protein Atlas (HPA) teams on the Kaggle platform. We showcase how 1,175 teams from 78 countries engaged in community- driven, open-science code development that resulted in machine learning models which successfully segment anatomical structures across five organs using histology images from two consortia and that will be productized in the HuBMAP data portal to process large datasets at scale in support of Human Reference Atlas construction. We discuss the benchmark data created for the competition, major challenges faced by the participants, and the winning models and strategies.