bluuebunny/crossref_metadata_2025 huggingface dataset:
Liver Involvement in Congenital Disorders of Glycosylation: A Systematic Review
Authors: Colantuono Rossella , D’Acunto Elisa , Melis Daniela , Vajro Pietro , Freeze Hudson H. , Mandato Claudia
Published: June 2021

An ever-increasing number of disturbances in glycosylation have been described to underlie certain unexplained liver diseases presenting either almost isolated or in a multi-organ context. We aimed to update previous literature screenings which had identified up to 23 forms of congenital disorders of glycosylation (CDG) with associated liver disease. We conducted a comprehensive literature search of three scientific electronic databases looking at articles published during the last 20 years (January 2000–October 2020). Eligible studies were case reports/series reporting liver involvement in CDG patients. Our systematic review led us to point out 41 forms of CDG where the liver is primarily affected (n = 7) or variably involved in a multisystem disease with mandatory neurological abnormalities (n = 34). Herein we summarize individual clinical and laboratory presentation characteristics of these 41 CDG and outline their main presentation and diagnostic cornerstones with the aid of two synoptic tables. Dietary supplementation strategies have hitherto been investigated only in seven of these CDG types with liver disease, with a wide range of results. In conclusion, the systematic review recognized a liver involvement in a somewhat larger number of CDG variants corresponding to about 30% of the total of CDG so far reported, and it is likely that the number may increase further. This information could assist in an earlier correct diagnosis and a possibly proper management of these disorders.
High Seroconversion Rate Against Severe Acute Respiratory Syndrome Coronavirus 2 in Symptomatic Pediatric Inflammatory Bowel Disease Patients
Authors: Ruan Wenly , Nguyen Huyen , Wyatt Allyson , Ihekweazu Faith , Vartabedian Bryan S. , Karam Lina , Walsh Seema , Kellermayer Richard
Published: June 2021

Understanding coronavirus disease 2019 (COVID-19) in pediatric inflammatory bowel disease (PIBD) is important. We describe a single-center cohort of COVID-19 PIBD patients where seroconversion against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was examined.

Immunosuppressed PIBD patients at Texas Children's Hospital who tested positive for SARS-CoV-2 by nasopharyngeal reverse transcriptase polymerase chain reaction were included in the study. The clinical course of IBD, concurrent medications, COVID-19 related symptoms, SARS-CoV-2 testing date, and SARS-CoV-2 immunoglobulin G (IgG) antibody testing date and result were examined. Of 14 SARS-CoV-2 positive PIBD patients, 12 were tested for qualitative anti-SARS-CoV-2 IgG (seven with transient COVID-19 symptoms, five asymptomatic). All symptomatic (7/7) and 60% of asymptomatic (3/5) patients seroconverted. No patients required hospitalization attributed to COVID-19.

High rates of COVID-19 seroconversion occurred in immunosuppressed and symptomatic PIBD patients. More research to evaluate the significance of COVID-19 seroconversion is needed.
Racial Discrimination and Stress Across the Life Course
Authors: Gillespie Shannon L. , Bose-Brill Seuli , Giurgescu Carmen , Gondwe Kaboni W. , Nolan Timiya S. , Spurlock Elizabeth J. , Christian Lisa M.
Published: June 2021

Background

Among Black Americans, interpersonal racial discrimination is common. Stress, including following discrimination, contributes to pregnancy complications. In this secondary analysis, we provide data on associations among discrimination, stress, and their interaction across the life course and inflammation, perceived stress, and depressive symptoms during pregnancy.

Methods

During the early third trimester, Black American women (n = 93) completed the Experiences of Discrimination Scale, the Stress and Adversity Inventory, the Perceived Stress Scale, and the Center for Epidemiological Studies Depression Inventory. Plasma interleukin-6 (IL-6), IL-8, tumor necrosis factor-α (TNF-α), and IL-β levels were quantified. Associations were examined by linear regression, controlling for demographic, behavioral, and clinical covariates.

Results

Associations among racial discrimination and plasma IL-8, TNF-α, and IL-β levels depended upon average ratings of life course stress. When stress was low, discrimination in the mid tertile was associated with the highest levels of IL-8, TNF-α, and IL-β. Subscale analyses suggested that findings related to IL-8 were driven by chronic stress whereas findings related to TNF-α and IL-β were driven by acute stress. When examined together, greater discrimination but not greater life course stress was associated with higher prenatal perceived stress. In subscale analyses, the association between discrimination and prenatal perceived stress depended upon average ratings of life course acute stress. When acute stress was low, discrimination in the midtertile was associated with the highest levels of prenatal perceived stress. When acute stress was high, discrimination in the high tertile was associated with the highest levels of prenatal perceived stress. There were also direct associations among greater life course chronic stress, prenatal perceived stress, and prenatal depressive symptoms. Associations were attenuated when discrimination was included as a covariate.

Conclusions

The current analyses suggest that, among Black Americans, prenatal inflammation, perceived stress, and depressive symptoms may be shaped by racial discrimination and stress across the life course. In many cases, associations among discrimination and prenatal parameters depended upon how stressful exposures to life course stressors had been rated. The data suggest the potential for adaptive plasticity under some stress and highlight the deleterious nature of compounding stress.
Pain and Self-Efficacy Among Patients With Systemic Sclerosis
Authors: Wojeck Robyn K. , Silva Susan G. , Bailey Donald E. , Knisely Mitchell R. , Kwakkenbos Linda , Carrier Marie-Eve , Nielson Warren R. , Bartlett Susan J. , Pope Janet , Thombs Brett D.
Published: June 2021

Background

Pain is one of the most common symptoms affecting patients with systemic sclerosis; however, little is known about the relationship between self-efficacy and pain and changes in pain over time.

Objectives

The purpose of this study was to describe the relationships between self-efficacy and pain in patients with systemic sclerosis, as well as determine whether changes in self-efficacy mediate changes in pain.

Methods

A prospective longitudinal study was conducted using data from the Scleroderma Patient-Centered Intervention Network Cohort. The baseline sample included 1,903 adults, with a trajectory subsample of 427 who completed 3-month assessments across 3 years. Hierarchical (sequential) forward multivariable regression, covarying for participant characteristics, was conducted to determine the association between self-efficacy and patient characteristics on pain outcomes. Trajectory models, covarying for participant characteristics, were used to examine changes in self-efficacy and pain outcomes across time and whether self-efficacy mediated the pain trajectories.

Results

Mean time since diagnosis was 9.5 years, with 39.2% diagnosed with diffuse cutaneous systemic sclerosis. Greater self-efficacy was associated with less pain interference and intensity. Increasing age, female gender, finger ulcers, and small joint contractures were related to greater pain interference and intensity. Esophageal gastrointestinal symptoms were associated with more pain interference. Self-efficacy and pain trajectories remained stable across time, and self-efficacy did not mediate the pain trajectories.

Discussion

This study identified self-efficacy, age, gender, finger ulcers, small joint contractures, and esophageal gastrointestinal symptoms as important correlates associated with pain in patients with systemic sclerosis. In addition, this study found that self-efficacy and pain outcomes remained stable over time, providing important insights into the longitudinal pain experiences of patients with systemic sclerosis.
Maternal Experiences of Racial Discrimination, Child Indicators of Toxic Stress, and the Minding the Baby Early Home Visiting Intervention
Authors: Condon Eileen M. , Londono Tobon Amalia , Jackson Brianna , Holland Margaret L. , Slade Arietta , Mayes Linda , Sadler Lois S.
Published: June 2021

Background

Racism is a significant source of toxic stress and a root cause of health inequities. Emerging evidence suggests that exposure to vicarious racism (i.e., racism experienced by a caregiver) is associated with poor child health and development, but associations with biological indicators of toxic stress have not been well studied. It is also unknown whether two-generation interventions, such as early home visiting programs, may help to mitigate the harmful effects of vicarious racism.

Objective

The purpose of this study was to examine associations between maternal experiences of racial discrimination and child indicators of toxic stress and to test whether relationships are moderated by prior participation in Minding the Baby (MTB), an attachment-based early home visiting intervention.

Methods

Ninety-seven maternal–child dyads (n = 43 intervention dyads, n = 54 control dyads) enrolled in the MTB Early School Age follow-up study. Mothers reported on racial discrimination using the Experiences of Discrimination Scale. Child indicators of toxic stress included salivary biomarkers of inflammation (e.g., C-reactive protein, panel of pro-inflammatory cytokines), body mass index, and maternally reported child behavioral problems. We used linear regression to examine associations between maternal experiences of racial discrimination and child indicators of toxic stress and included an interaction term between experiences of discrimination and MTB group assignment (intervention vs. control) to test moderating effects of the MTB intervention.

Results

Mothers identified as Black/African American (33%) and Hispanic/Latina (64%). In adjusted models, maternal experiences of racial discrimination were associated with elevated salivary interleukin-6 and tumor necrosis factor-α levels in children, but not child body mass index or behavior. Prior participation in the MTB intervention moderated the relationship between maternal experiences of discrimination and child interleukin-6 levels.

Discussion

Results of this study suggest that racism may contribute to the biological embedding of early adversity through influences on inflammation, but additional research with serum markers is needed to better understand this relationship. Improved understanding of the relationships among vicarious racism, protective factors, and childhood toxic stress is necessary to inform family and systemic-level intervention.
Challenges of Cognitive Interviewing in Sensitive Health Topic Research
Authors: Arthur Elizabeth K. , Menon Usha , Browning Kristine , Overcash Janine , Wills Celia E.
Published: June 2021

Background

Cognitive interviewing is a qualitative methodology for generating valid, reliable patient-centered outcome measures. There are challenges inherent in research on sensitive topics that require thoughtful approach by the scientist for data collection methods, analysis, and interpretation.

Objective

The purpose of this article is to provide principles of cognitive interviewing for sensitive health topics.

Methods

We review the challenges inherent in cognitive interviewing for sensitive topics scale development. We illustrate adaptations to general cognitive interviewing for sensitive topics through the presentation and analysis of a research exemplar.

Results

Researchers must consider threats to quality of sensitive topic data collection and potential harms to participants and researchers. We provide specific examples of how these risks were mitigated in a sensitive topic scale development study.

Discussion

Unique challenges of cognitive interviewing for sensitive health topics can be addressed with a well-planned data collection strategy, anticipating participant safety concerns, and consideration to researcher well-being.
Use of Food to Cope With Culturally Relevant Stressful Life Events Is Associated With Body Mass Index in African American Women
Authors: Woods-Giscombe Cheryl L. , Lobel Marci , Zimmer Catherine , Brooks Jada , Sheffield-Abdullah Karen , Bey Ganga , Bravo Lilian , Lackey Charity , Smith Raven , Frazier Taleah , Muhirwa Amnazo
Published: June 2021

Background

Although stress is an established contributor to obesity (in general population studies), mechanisms to explain this association in African American women that incorporate culturally relevant frameworks have received little attention.

Objective

To investigate how stress is associated with body mass index (BMI) in this population, we examined multivariate models of BMI predicted by race-related, gender-related, and generic stressful life events and by use of food to cope with stress. We hypothesized that the three types of stressful life events would be indirectly associated with BMI through using food to cope with stress.

Methods

Psychometrically robust measures were included in surveys administered to a socioeconomically diverse sample of 189 African American women aged 21–78 years. Hypotheses were tested using structural equation modeling. We examined race-related, gender-related, and generic stressful life events as latent constructs indicated by exposure to and appraisal of potential stressors predicting a mediator, using food to cope, which predicted BMI; this model also included direct paths from the three latent stressful life event constructs to BMI.

Results

Almost every participant reported using food in some way to cope with stress; 33% and 42% met established criteria for overweight and obesity, respectively. The race-related stressful life event construct was the only latent construct predicting using food to cope with stress, and using food to cope with stress predicted BMI. A significance test of indirect effects demonstrated that the race-related stressful life event construct was indirectly associated with BMI through the mediator, using food to cope.

Discussion

Culturally relevant stress exposures and stress-related eating are important areas of foci for tackling overweight, obesity, and related health inequities in African American women. Findings highlight the importance of developing more complex models to understand the stress-related factors that elevate risk for overweight and obesity in this population.
Racialized Experiences Differentiate Food Security Among African American Adults
Authors: Chisolm Deena J. , Bell Bethany A. , Yamoah Owusua , Freedman Darcy A.
Published: June 2021

Background

Patterns of food security persistently vary by race, yet limited research has examined how community-specific experiences of race and racism are associated with nutritional outcomes.

Objectives

This analysis describes a novel approach for classifying experiences of race and racism and explores the relationship between identified classes and measures of food security and diet quality.

Methods

Cross-sectional self-reported survey data from 306 African American adults living in two urban midwestern cities were collected in 2017–2018. Measures of racialized experiences assessed consciousness of race, perceived discrimination, and health effects of perceived discrimination. Food security was measured with a six-item screener and diet quality with the Healthy Eating Index-2010. Latent class analysis was used to generate racialized classes. Bivariate analyses were conducted to examine differences in class membership by sociodemographics and nutrition outcomes.

Results

Participants were majority women who were receiving Supplemental Nutrition Assistance Program benefits. Three racialized classes were identified: Class 1 reported few racialized experiences (42.8% of the sample), Class 2 was racially conscious with few experiences of discrimination (45.1%), and Class 3 was both racially conscious and affected by racialized actions (12.1%). Racialized classes were significantly different in mean household income, level of education, home ownership, and job loss in the past year. Class 3 was the least represented among those that were food secure and the most represented among those that were very low food secure. There were no differences by class in Healthy Eating Index-2010 scores.

Discussion

Findings offer an innovative method for measuring exposures to racism and for assessing its relationship to food security. Findings highlight heterogeneity of racialized experiences in similar contexts as well as potential root cause targets such as wages, education, home ownership, and employment that may be modulated to mitigate the effects of racism on food insecurity.
Observational Studies
Authors: Donzelli Sabrina , Loss Karla Loureiro , Zaina Fabio , Negrini Stefano
Published: June 2021

The development of high-quality research is desired in all healthcare fields. Experimental and nonexperimental designs are used to investigate the effect or association of an intervention and clinical or surrogate outcome. The aims of these methods are to improve knowledge and to develop new strategies to manage a disease or condition. Randomized clinical trials are considered one of the standard methods to test the efficacy of a new drug or intervention; however, they are costly, have reduced generalizability, and cannot be feasible in all scenarios. Well-designed observational studies can provide valuable information regarding exposure factor and the event under investigation. In physical and rehabilitation medicine, where complex procedures and multiple risk factors can be involved in the same disease, the use of observational study must be planned in detail and a priori to avoid overestimations. In this article, we will give an overview of the methods used for observational design studies in physical and rehabilitation medicine using clinical examples to illustrate each method. We will describe when it is appropriate and how to use the observational studies in different scenarios explaining how to deal with potential bias and confounders using the adequate design and statistical plan for the situation.
Prolonged Dysphagia After a COVID-19 Infection in a Patient With Parkinson Disease
Authors: Lee Min-Yong , Oh Byung-Mo , Seo Han Gil
Published: June 2021

Coronavirus disease 2019 might have an impact on patients with Parkinson disease because of the neuroinvasive potential. Herein, we report the case of a patient with Parkinson disease who developed severe and prolonged oropharyngeal dysphagia after a coronavirus disease 2019 infection. A 73-yr-old male patient with Parkinson disease was diagnosed with coronavirus disease 2019 and admitted to a tertiary care hospital. Before hospitalization, he was assessed at Hoehn and Yahr stage 4 and showed no symptoms of dysphagia. After admission, the patient gradually recovered; however, he was fed through a nasogastric tube. A videofluoroscopic swallowing study revealed a severe oropharyngeal dysphagia with a severely delayed oral phase. Therefore, he underwent percutaneous gastrostomy tube insertion. After discharge, although he received swallowing therapy for 4 mos, he still had severe dysphagia, which made him dependent on enteral feeding. We speculate that the impact of coronavirus disease 2019 on dopaminergic and nondopaminergic mechanisms could lead to the development of dysphagia in this patient. The present case suggests that clinicians must have a high index of suspicion without dismissing the possibility of dysphagia and subsequent aspiration pneumonia in coronavirus disease 2019 patients with Parkinson disease.
A qualitative study examining prosthesis use in everyday life in individuals with lower limb amputations
Authors: Roberts Evan , Burhani Lamya , Lankester Ryan , Mobbs Alexander , Tigert Carly , Vanvelzen Troy , Campbell Janet , Devlin Michael , Dilkas Steven , MacKay Crystal
Published: June 2021

Background:

Lower limb amputation (LLA) is a life-changing event that affects functional mobility and participation in everyday life. Prostheses provide individuals with LLA the opportunity to improve mobility and quality of life; however, existing literature suggests that there is underuse of prostheses.

Objectives:

The purpose of this study is to describe how individuals with major LLA use their prosthesis in everyday life and describe barriers and facilitators that influence prosthesis use.

Study Design:

A qualitative descriptive methodology was used.

Methods:

Ten community dwelling adults (>18 years) with unilateral major LLAs (transtibial, transfemoral, and knee disarticulation) attending outpatient follow-up at a specialized rehabilitation center were recruited. Participants were purposively sampled for variation in prosthesis use and level of amputation. One-on-one semistructured in-depth interviews were conducted in person or by telephone. The interviews were audio recorded, transcribed verbatim, and analyzed inductively using thematic analysis.

Results:

The experiences of individuals with major LLA were organized into three overarching themes: everyday experiences using a prosthesis, extrinsic factors influencing prosthesis use, and intrinsic factors influencing prosthesis use. These themes, and their associated subthemes, highlight how individuals use their prosthesis and the various factors perceived to act as barriers and facilitators to prosthesis use in everyday life.

Conclusions:

These findings provide valuable insight into the everyday experiences of individuals with LLA and can be used to implement strategies to optimize prosthesis use.
Incidence of HIV-positive admission and inpatient mortality in Malawi (2012–2019)
Authors: Burke Rachael M. , Henrion Marc Y.R. , Mallewa Jane , Masamba Leo , Kalua Thokozani , Khundi McEwen , Gupta-Wright Ankur , Rylance Jamie , Gordon Stephen B. , Masesa Clemens , Corbett Elizabeth L. , Mwandumba Henry C. , Macpherson Peter
Published: June 2021

Objective:

To investigate trends in population incidence of HIV-positive hospital admission and risk of in-hospital death among adults living with HIV between 2012 and 2019 in Blantyre, Malawi.

Design:

Population cohort study using an existing electronic health information system (‘SPINE’) at Queen Elizabeth Central Hospital and Blantyre census data.

Methods:

We used multiple imputation and negative binomial regression to estimate population age-specific and sex-specific admission rates over time. We used a log-binomial model to investigate trends in risk of in-hospital death.

Results:

Of 32 814 adult medical admissions during Q4 2012--Q3 2019, HIV status was recorded for 75.6%. HIV-positive admissions decreased substantially between 2012 and 2019. After imputation for missing data, HIV-positive admissions were highest in Q3 2013 (173 per 100 000 adult Blantyre residents) and lowest in Q3 2019 (53 per 100 000 residents). An estimated 10 818 fewer than expected people with HIV (PWH) [95% confidence interval (CI) 10 068–11 568] were admitted during 2012–2019 compared with the counterfactual situation where admission rates stayed the same throughout this period. Absolute reductions were greatest for women aged 25–34 years (2264 fewer HIV-positive admissions, 95% CI 2002–2526). In-hospital mortality for PWH was 23.5%, with no significant change over time in any age-sex group, and no association with antiretroviral therapy (ART) use at admission.

Conclusion:

Rates of admission for adult PWH decreased substantially, likely because of large increases in community provision of HIV diagnosis, treatment and care. However, HIV-positive in-hospital deaths remain unacceptably high, despite improvements in ART coverage. A concerted research and implementation agenda is urgently needed to reduce inpatient deaths among PWH.
Estimated time from HIV infection to diagnosis and diagnosis to first viral suppression during 2014–2018
Authors: Crepaz Nicole , Song Ruiguang , Lyss Sheryl B. , Hall H. Irene
Published: June 2021

Objective:

To examine changes in the lengths of time from HIV infection to diagnosis (Infx-to-Dx) and from diagnosis to first viral suppression (Dx-to-VS), two periods during which HIV can be transmitted.

Design:

Data from the National HIV Surveillance System (NHSS) for persons who were aged at least 13 years at the time of HIV diagnosis during 2014–2018 and resided in one of 33 United States jurisdictions with complete laboratory reporting.

Methods:

The date of HIV infection was estimated based on a CD4+-depletion model. Date of HIV diagnosis, and dates and results of first CD4+ test and first viral suppression (<200 copies/ml) after diagnosis were reported to NHSS through December 2019. Trends for Infx-to-Dx and Dx-to-VS intervals were examined using estimated annual percentage change.

Results:

During 2014–2018, among persons aged at least 13 years, 133 413 HIV diagnoses occurred. The median length of infx-to-Dx interval shortened from 43 months (2014) to 40 months (2018), a 1.5% annual decrease (7% relative change over the 5-year period). The median length of Dx-to-VS interval shortened from 7 months (2014) to 4 months (2018), an 11.4% annual decrease (42.9% relative change over the 5-year period). Infx-to-Dx intervals shortened in only some subgroups, whereas Dx-to-VS intervals shortened in all groups by sex, transmission category, race/ethnicity, age, and CD4+ count at diagnosis.

Conclusion:

The shortened Infx-to-Dx and Dx-to-VS intervals suggest progress in promoting HIV testing and earlier treatment; however, diagnosis delays continue to be substantial. Further shortening both intervals and eliminating disparities are needed to achieve Ending the HIV Epidemic goals.
Adverse Event Trends Within a Large-Scale, Routine, Voluntary Medical Male Circumcision Program in Zimbabwe, 2014–2019
Authors: Victor Omollo , Phiona Marongwe , Vernon Murenje , Thoko Madoda , Paidamoyo Gonouya , Farai Gwenzi , Joseph Hove , Munyaradzi Tinashe , Olbarn Rutsito , Pesanai Chatikobo , Mufuta Tshimanga , Vuyelwa Sidile-Chitimbire , Sinokuthemba Xaba , Batsirai Makunike-Chikwinya , Marrianne Holec , Scott Barnhart , Feldacker Caryl
Published: June 2021

Background:

Between 2008 and 2020, over 22.6 million male circumcisions (MCs) were performed among men ≥10 years in 15 priority countries of East and Southern Africa. Few studies from routine MC programs operating at scale describe trends of adverse events (AEs) or AE rates over time.

Setting:

Routine program data from a large MC program in Zimbabwe.

Methods:

χ2 compared characteristics of patients with AEs. Univariable and multivariable logistic models examined factors associated with AE severity. Cochran–Armitage trend tests compared AE rate trends by year (2014–2019), age, and MC method (2017–2019).

Results:

From 2014 to 2019, 469,000 men were circumcised; of the total men circumcised, 38%, 27%, and 35% were conducted among individuals aged 10–14; 15–19; and ≥20 years, respectively. Most MCs (95%) used surgical (dorsal slit or forceps-guided) methods; 5% were device based (PrePex). AEs were reported among 632 (0.13%) MCs; 0.05% were severe. From 2015 to 2019, overall AE rates declined from 34/10,000 to 5/10,000 (P-value <0.001). Severe AE rates also decreased over this period from 12/10,000 to 2/10,000 (P-value <0.001). AE rates among younger clients, aged 10–14 (18/10,000) were higher than among older age men (9/10,000) aged ≥20 years (P < 0.001); however, there was no significant association between age and AE severity.

Conclusion:

AE rates each year and over time were lower than the World Health Organization acceptable maximum (2% AEs). ZAZIC quality assurance activities ensured guideline adherence, mentored clinicians to MC competency, promoted quality client education and counseling, and improved AE reporting over time. Decreases in AE rates are likely attributed to safety gains and increasing provider experience.
Chemokine Receptor 4–Targeted 68Ga-Pentixafor PET/CT in Response Assessment of Waldenström Macroglobulinemia/Lymphoplasmacytic Lymphoma
Authors: Pan Qingqing , Cao Xinxin , Luo Yaping , Li Jian , Li Fang
Published: June 2021

Purpose

68Ga-pentixafor PET/CT was reported to have a high sensitivity in detecting tumor involvement of Waldenström macroglobulinemia/lymphoplasmacytic lymphoma (WM/LPL) in our previous study. We aimed to further investigate its value in response assessment in WM/LPL.

Patients and Methods

Fifteen patients with WM/LPL were recruited in a prospective cohort study and underwent both 68Ga-pentixafor and 18F-FDG PET/CT at baseline and posttreatment. PET/CT-based responses were analyzed with visual assessments and compared with clinical response.

Results

At baseline, all of the 15 patients had a positive 68Ga-pentixafor PET/CT scan, whereas 18F-FDG PET/CT was positive in 11/15 patients. After chemotherapy, the overall response rate was 86.7% (13/15), and 68Ga-pentixafor PET/CT showed different degree of tumor response from baseline in these patients. In the 2 patients with progressive disease, 68Ga-pentixafor PET/CT detected new lesions or remarkable increase of 68Ga-pentixafor uptake in tumor involvements. However, 18F-FDG PET/CT failed to detect the improvement of disease in 6/13 patients and missed disease progression in 1 of the 2 patients.

Conclusions

68Ga-pentixafor PET/CT outperformed 18F-FDG PET/CT in response assessment of WM/LPL.
The Role of Imaging Studies in Favor of Possible Cerebellar Multiple System Atrophy
Authors: Utrera-Costero Ana , Martinez-Sanchis Begoña , Sopena-Novales Pablo , Bello-Arques Pilar
Published: June 2021

We report a 64-year-old woman whose history started with urinary incontinence and neurological symptoms (cognitive impairment, dysarthria, and gait difficulties). The 18F-FDG PET/CT showed hypometabolism of the whole cerebellum. Then 6 months later, she developed tremor, postural instability, and ataxia, so she was hospitalized to complete study. Blood tests (antibodies, vitamin B12, copper, genetic test of spinocerebellar ataxia) did not have alterations, but imaging studies, along with clinical symptoms, provide the diagnosis of possible multiple system atrophy.
Increased 68Ga-FAPI Uptake in Intramuscular Gluteal Hematoma in a Patient With Hemophagocytic Syndrome
Authors: Yang Xiao , Liu Huipan , You Zhouxiang , Gong Weidong , Chen Yue
Published: June 2021

A 39-year-old man was diagnosed clinically with hemophagocytic syndrome, which was suspected to be secondary to a malignancy. Therefore, the patient underwent a 68Ga-FAPI PET/CT scan as part of an ongoing clinical trial (ChiCTR2100044131). Increased tracer uptake was noted the gluteal region. Medical history revealed recent iliac bone marrow aspiration on the same side. On further examination, the lesion was confirmed to be a hematoma. The present case highlights that puncture operations may result in intramuscular hematomas, which might potentially malignancy on a 68Ga-FAPI PET/CT.
Prognostic Impact of Metabolic Heterogeneity in Patients With Newly Diagnosed Multiple Myeloma Using 18F-FDG PET/CT
Authors: Terao Toshiki , Machida Youichi , Hirata Kenji , Kuzume Ayumi , Tabata Rikako , Tsushima Takafumi , Miura Daisuke , Narita Kentaro , Takeuchi Masami , Tateishi Ukihide , Matsue Kosei
Published: June 2021

Purpose

This study aimed to investigate the prognostic impact of metabolic heterogeneity (MH) in patients with multiple myeloma (MM).

Patients and Methods

We retrospectively analyzed MH with 18F-FDG PET/CT in 203 patients with newly diagnosed MM. Metabolic heterogeneity was estimated using the area under the curve of the cumulative SUV volume histogram. To evaluate MH, we selected 2 lesions: “MH-SUVmax,” a lesion with SUVmax, and “MH–metabolic tumor volume (MTV),” a lesion with the largest MTV.

Results

Metabolic heterogeneity from an MH-SUVmax lesion showed more prognostic relevance than that from a lesion with the largest MTV. The progression-free survival (PFS) and overall survival (OS) rates were significantly lower in the high-MH-SUVmax group than in the low-MH-SUVmax group (median PFS: 25.2 vs 33.9 months; median OS: 41.6 vs 112.0 months; P = 0.004 and 0.046, respectively), whereas high MH-SUVmax retained independent prognostic power on multivariate analysis. Even among patients with high whole-body MTV, those with high MH-SUVmax tended to show poorer prognosis than those without (median PFS, 23.8 vs 30.2 months; P = 0.085). Moreover, patients with high MH-SUVmax and high-risk cytogenetic abnormalities showed dismal outcomes even with standard treatment (median PFS and OS, 10.0 and 33.3 months, respectively).

Conclusions

Our results suggested that high MH-SUVmax based on pretreatment with 18F-FDG PET/CT is a novel prognostic factor for cases of MM.
FDG PET/CT in a Case of Lynch Syndrome With Synchronous Inverted Urothelial Papilloma of the Bladder, Urothelial Carcinoma of the Ureter, and Jejunal Adenocarcinoma
Authors: Zhao Qian , Dong Aisheng , Wang Yang
Published: June 2021

A 64-year-old man was referred because of the right ureteral obstruction. CT urography showed an intraluminal enhancing mass in the right midureter and an enhancing nodule in the bladder wall. FDG PET/CT showed increased FDG uptake of the ureteral mass and an unexpected hypermetabolic lesion in the jejunum. The patient underwent transurethral resection of the bladder tumor, right laparoscopic nephroureterectomy, and partial enterectomy. Inverted urothelial papilloma of the bladder, high-grade urothelial carcinoma of the right ureter, and jejunal adenocarcinoma were confirmed by histopathology. Genetic testing of the jejunal adenocarcinoma revealed MSH2 germline mutation, confirming the diagnosis of Lynch syndrome.
Three-Dimensional Osteosynthesis Plates for the Surgical Treatment of Mandibular Fractures
Authors: Khalil Sherin , Khamis Hamza , Kauke Martin , Iizuka Tateyuki , Safi Ali-Farid
Published: June 2021

Objectives:

Mandible fractures can be treated with different plate systems, that is, miniplates or three-dimensional (3D) plates. This systematic review describes the effectiveness and clinical outcomes of 3D plates used in fractures of the mandible and aims to critically evaluate its risks and benefits.

Materials and Methods:

A comprehensive electronic search was conducted without date but with restriction to articles written in English. Studies in humans, including randomized or quasi-randomized controlled trials and retrospective studies, were included. The outcome parameters measured were number of patients, fracture classification, results, follow-up period, postoperative complications, and mean age of patients. Major complications were defined as those needing additional surgical intervention, for example, malocclusion, infection or plate fracture. Accordingly, complications not needing additional surgical intervention were defined as minor (ie, dehiscence, trismus).

Results:

Guided by the PRISMA statement and the Cochrane Handbook for Systematic Reviews of Interventions, the authors identified 44 publications with a total of 1790 patients. Among the articles selected for the final review, there were 32 reported prospective studies, 12 reported retrospective studies. Regarding the evaluation of quality, 8 studies showed a low value of the risk of bias, 17 a moderate risk, and 19 a high risk. There were statistically significant advantages for 3D plates in mandibular fractures in terms of postoperative complications, for example, wound dehiscences or plate fracture.

Conclusions:

The 3D plate is an effective treatment modality for mandibular fractures, with low incidence of major complications, decreased length of operation time, and increased stability of osteosynthesis.
Quality of Life After Class III Repair Orthognathic Surgery: Five-Year Retrospective Study
Authors: Joachim Michael V. , Richter Din Emm , Mohana Aladdin , Labeeb Musa , Abdelraziq Murad , Abu El-Naaj Imad
Published: June 2021

Objective:

To evaluate the effect of orthognathic surgery on the long-term quality of life of patients with presurgical skeletal Class III and to identify its strongest effect—whether esthetic, social, or functional.

Materials and Methods:

In this retrospective cohort study, the subjects were patients after orthognathic surgery for repairing skeletal Class III. Fifty-five patients who had undergone orthognathic surgery from 2013 to 2018 in the oral and maxillofacial surgery department participated in this study. Each participant completed a modified questionnaire used to assess the patient's esthetic, social, and functional abilities after orthognathic surgery.

Results:

The rate of esthetic improvement in orthognathic surgery patients was 88%. More than four-fifths (81.8%) of the patients reported improvement in their personal and social self-esteem and confidence. Finally, 40.7% of the patients reported functional improvement. No significant differences between male and female patients were found. All but one of the patients recommended orthognathic surgery for patients with similar problems. One in six (17.3%) patients was dissatisfied with the nasal appearance after the surgical procedure, while almost a quarter (21.8%) reported worsening of their mouth opening, and 25.4% reported worsening of TMJ (Temporo-Mandibular Joint) symptoms. Analysis of the results revealed no statistically significant pattern connecting preoperative overjet or overbite measures with satisfaction rates.

Conclusions:

In this study, patient satisfaction with the orthognathic surgical procedure was mostly a result of improvements in facial esthetics, followed by psychological well-being and functional abilities. Most dissatisfaction after the orthognathic surgical procedure was related to nasal appearance, mouth opening, and TMJ complaints.
Extensive Convexity Flattening of a Synthetic Skull Implant the Overcome Major Scalp Deficiency After Multiple Craniotomies
Authors: Andereggen Lukas , Marbacher Serge , Dolp Armando , Gruber Philipp , Remonda Luca , Meuli-Simmen Claudia , Eyer David
Published: June 2021

Multiple craniofacial surgeries and postoperative recalcitrant infections frequently can lead to secondary scalp tissue scarring and skin retraction. Although there are different methods of reducing and optimizing scalp skin tension, the authors describe a last resort treatment method of cranioplastic procedure, which despite of its unfavorable cosmetic outcome, relieves the skin tension through extensive flattening of the polyetheretherketone curvature. Thereby, a custom-made cranioplastic bone flap was extensively flattened in the curvature of the fronto-parietal area with consideration of the related brain hemisphere extension. The extent of bone curvature flatting reduced the skin tension significantly and allowed for plain and simple tension-free wound closure in a chronic smoker patient with poor skin quality and brain atrophy. Although brain extension was sufficient, the cosmetic outcome was unfavorable with regard to skull symmetry, but well accepted and satisfactory for the patient due to preoperative discussion outcome expectation from surgery. Thus, extensive polyetheretherketone curvature flattening is a straightforward and simple last resort treatment option for tension-free skin closure in high-risk patients with extensive skin scarring and retraction and previous reconstructive plastic skin relief procedures. However, this method is limited in patients with normal brain hemisphere extension.
Transcriptomic Changes Within Human Bone Marrow After Severe Trauma
Authors: Kelly Lauren S. , Apple Camille G. , Darden Dijoia B. , Kannan Kolenkode B. , Pons Erick E. , Fenner Brittany P. , Parvataneni Hari K. , Hagen Jennifer E. , Brakenridge Scott C. , Efron Philip A. , Mohr Alicia M.
Published: June 2021

Background:

Severe trauma is associated with severe systemic inflammation and neuroendocrine activation that is associated with erythroid progenitor growth suppression and refractory anemia. Although distinct transcriptional profiles have been detected in numerous tissue types after trauma, no study has yet characterized this within the bone marrow. This study sought to identify a unique bone marrow transcriptomic response following trauma.

Methods:

In a prospective observational cohort study, bone marrow was obtained from severely injured trauma patients with a hip or femur fracture (n = 52), elective hip replacement patients (n = 33), and healthy controls (n = 11). RNA was isolated from bone marrow using a Purelink RNA mini kit. Direct quantification of mRNA copies was performed by NanoString Technologies on a custom gene panel.

Results:

Trauma patients displayed an upregulation of genes encoding receptors known to have inhibitory downstream effects on erythropoiesis, including ferroportin, interleukin-6 (IL-6) receptor, transforming growth factor-beta (TGF-β) receptor, and IL-10, as well as genes involved in innate immunity including toll-like receptor 4 (TLR4)-mediated signaling factors. In contrast, hip replacement patients had downregulated transcription of IL-1β, IL-6, TGF-β, tumor necrosis factor alpha, and the HAMP gene with no change in TLR4-mediated signaling factors.

Conclusions:

A unique transcriptomic response within the bone marrow was identified following severe trauma compared to elective hip replacement. These transcriptomic differences were related to the innate immune response as well as known inhibitors of erythropoiesis. Although confined to just one time point, this differential transcriptional response may be linked to refractory anemia and inflammation after injury.
Controlled Oxygenated Rewarming Compensates for Cold Storage–induced Dysfunction in Kidney Grafts
Authors: von Horn Charlotte , Zlatev Hristo , Kaths Moritz , Paul Andreas , Minor Thomas
Published: June 2021

Background.

Normothermic machine perfusion (NMP) provides a promising strategy for preservation and conditioning of marginal organ grafts. However, at present, high logistic effort limits normothermic renal perfusion to a short, postponed machine perfusion at site of the recipient transplant center. Thus, organ preservation during transportation still takes place under hypothermic conditions, leading to significantly reduced efficacy of NMP. Recently, it was shown that gentle and controlled warming up of cold stored kidneys compensates for hypothermic induced damage in comparison to end ischemic NMP. This study aims to compare controlled oxygenated rewarming (COR) with continuous upfront normothermic perfusion in a porcine model of transplantation.

Methods.

Following exposure to 30 min of warm ischemia, kidneys (n = 6/group) were removed and either cold stored for 8 h (cold storage [CS]), cold stored for 6 h with subsequent controlled rewarming up to 35 °C for 2 h (COR), or directly subjected to 8 h of continuous NMP. Kidney function was evaluated using a preclinical autotransplant model with follow-up for 7 d.

Results.

NMP and COR both improved renal function in comparison to CS and displayed similar serum creatinine and urea levels during follow-up. COR resulted in less tenascin C expression in the tissue compared with CS, indicating reduced proinflammatory upregulation in the graft by gentle rewarming.

Conclusions.

COR seems to be a potential alternative in clinical application of NMP, thereby providing logistic ease and usability.
Comparative study of the reorganization in bilateral motor and sensory cortices after spinal cord hemisection in mice
Authors: Deng Junhao , Xie Huimin , Chen Youbai , Peng Zhan , Zhao Jiajia , Zhou Yanmei , Chen Chao , Zhang Kexue
Published: June 2021

Objective

The effects of spinal cord injury (SCI) on sensorimotor cortex plasticity have not been well studied. Therefore, to explore the reorganization after SCI, we dynamically monitored postsynaptic dendritic spines of pyramidal neurons in vivo.

Methods

Thy1-YFP transgenic mice were randomly divided into two groups: the control and SCI group. We then opened the spinal vertebral plates of all mice and sectioned one-half of the spinal cord in SCI group. The relevant areas were imaged bilaterally at 0, 3, 14 and 28 days post-SCI. The rates of elimination, formation and stable spines were evaluated.

Results

At the early stage, the rate of stable and elimination spines experienced a similar change trend. But the rate of formation spines in the contralateral sensory cortex was significantly increased after SCI compared with those in the control group. At the late stage, spines of three types remodeled very differently between the sensory and motor cortex. Compared with those in the control group, spines in the bilateral sensory cortex demonstrated obvious differences in the rate of stable and elimination spines but not formation spines, while spines in the motor cortex, especially in the contralateral cortex increased significantly in the rate of formation after SCI. As for survival rate, differences mainly appeared in time frame instead of cortex type or region.

Conclusions

The dendritic spines in hindlimb representation area of the sensorimotor cortex experienced bilaterally remodeling after SCI. And those spines in the sensory and motor cortex experienced great but different change trends after SCI.
SLIMP: Supervised learning of metabolite-protein interactions from co-fractionation mass spectrometry data
Authors: Zühlke Boris M. , Sokolowska Ewelina M. , Luzarowski Marcin , Schlossarek Dennis , Chodasiewicz Monika , Leniak Ewa , Skirycz Aleksandra , Nikoloski Zoran
Published: June 2021

Metabolite-protein interactions affect and shape diverse cellular processes. Yet, despite advances, approaches for identifying metabolite-protein interactions at a genome-wide scale are lacking. Here we present an approach termed SLIMP that predicts metabolite-protein interactions using supervised machine learning on features engineered from metabolic and proteomic profiles from a co-fractionation mass spectrometry-based technique. By applying SLIMP with gold standards, assembled from public databases, along with metabolic and proteomic data sets from multiple conditions and growth stages we predicted over 9,000 and 20,000 metabolite-protein interactions forSaccharomyces cerevisiaeandArabidopsis thaliana, respectively. Extensive comparative analyses corroborated the quality of the predictions from SLIMP with respect to widely-used performance measures (e.g. F1-score exceeding 0.8). SLIMP predicted novel targets of 2’, 3’ cyclic nucleotides and dipeptides, which we analysed comparatively between the two organisms. Finally, predicted interactions for the dipeptide Tyr-Asp in Arabidopsis and the dipeptide Ser-Leu in yeast were independently validated, opening the possibility for future applications of supervised machine learning approaches in this area of systems biology.