bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of Disease Activity on Sexual and Erectile Dysfunction in Patients With Inflammatory Bowel Disease
Authors: Mules Thomas C , Swaminathan Akhilesh , Hirschfeld Esther , Borichevsky Grace M , Frampton Chris M , Day Andrew S , Gearry Richard B
Published: September 2022

Background

Increased disease activity may be a risk factor for sexual dysfunction (SD) in patients with inflammatory bowel disease (IBD). This study investigated associations between objective measures of disease activity and sexual function.

Methods

Adults with IBD undergoing ileocolonoscopy were prospectively recruited. Demographic, sexual function (Female Sexual Function Index and International Index of Erectile Function), disease activity (endoscopic, biomarker, and symptoms), psychological symptoms, and quality-of-life data were collected. Rates of SD and erectile dysfunction (ED) were compared between patients with active and inactive inflammation and symptoms using the Fisher’s exact test. Logistic regression examined associations between SD and ED, and disease characteristics and psychological symptoms.

Results

A total of 159 participants were included, 97 had Crohn’s disease and 85 were women. SD was reported in 36 of 59 and 13 of 59 sexually active women and men, respectively and ED in 22 of 59 sexually active men. Rates of SD and ED were similar between individuals with active and inactive IBD based on endoscopic indices (P > .05) and biomarkers (P > .05). Women with active IBD symptoms experienced significantly higher rates of SD (P < .05), but men did not (P > .05). Multivariable logistic regression identified that symptoms of severe depression (odds ratio, 5.77; 95% confidence interval, 1.59-20.94) were associated with SD in women, and severe anxiety (odds ratio, 15.62; 95% confidence interval, 1.74-140.23) was associated with ED in men.

Conclusions

Objective measures of disease activity are not associated with SD or ED in patients with IBD. Clinicians should consider concomitant psychological symptoms contributing to the sexual health of patients with IBD.
Those Who Left/Are Left Behind: Schrödinger's Refugee and the Ethics of Complementarity
Authors: Fierke K M , Mackay Nicola
Published: September 2022

“Those left behind” was a recurring emphasis of media depictions of the emotions surrounding the departure of those who left Afghanistan. The relationship between “those who left” and “those left behind,” which is characteristic of any context of forced displacement, relates to potentials, compelled by life and death questions. A decision to leave or stay is on the surface a binary choice, defined by the physical impossibility of doing both. The purpose of this paper is to explore how the ethical questions change when placed in a framework of quantum complementarity, by which phenomena, defined by what they are not, are also, in important respects, that which they are not, that is, the polar opposite. The first section develops Schrodinger's thought experiment and problematizes his focus on life and death as physical states of the cat, and the separateness of the observer, as a misrepresentation of the Copenhagen School arguments from which the thought experiment arose, and complementarity in particular. The second section examines the relationship between “those who left,” “those left behind,” and external observers in terms of a duality of matter and consciousness, which is complementary and mutually constituted. The third section examines the liminality that arises from a series of nested “boxes” and the various positions from which the forcefully displaced are observed within a holographic world. The final section then unpacks the ethical implications of quantum complementarity and ungrieved grief as they relate to forced displacement.
Molecular mechanism of negative cooperativity of ferredoxin-NADP + reductase by ferredoxin and NADP(H): role of the ion pair of ferredoxin Arg40 of and FNR Glu154
Authors: Kimata-Ariga Yoko , Nishimizu Yoshiro , Shinkoda Rina
Published: September 2022

Ferredoxin-NADP+ reductase (FNR) in plants receives electrons from ferredoxin (Fd) and converts NADP+ to NADPH at the end of the photosynthetic electron transfer chain. We previously showed that the interaction between FNR and Fd was weakened by the allosteric binding of NADP(H) on FNR, which was considered as a part of negative cooperativity. In this study, we investigated the molecular mechanism of this phenomenon using maize (Zea mays L.) FNR and Fd, as the 3D structure of this Fd:FNR complex is available. Site-specific mutants of several amino acid residues on the Fd:FNR interface were analysed for the effect on the negative cooperativity, by kinetic analysis of Fd:FNR electron transfer activity and by Fd-affinity chromatography. Mutations of Fd Arg40Gln and FNR Glu154Gln that disrupt one of the salt bridges in the Fd:FNR complex suppressed the negative cooperativity, indicating the involvement of the ion pair of Fd Arg40 and FNR Glu154 in the mechanism of the negative cooperativity. Unexpectedly, either mutation of Fd Arg40Gln or FNR Glu154Gln tends to increase the affinity between Fd and FNR, suggesting the role of this ion pair in the regulation of the Fd:FNR affinity by NADPH, rather than the stabilization of the Fd:FNR complex.
The Right to Water and Vulnerable Populations: Whose Voices are Heard in the UN CESCR Monitoring Mechanism?
Authors: Viveros-Uehara Thalia
Published: September 2022

Civil society has long demanded that human rights monitoring mechanisms be accessible not only for big international NGOs, but also for grassroots and domestic civil society organizations. Ensuring equal participation in these procedures has never been timelier as increasing socioeconomic inequalities widen the barriers for vulnerable populations to engage in transnational advocacy strategies. By using the right to water in the reviews that the UN Committee on Economic, Social and Cultural Rights has conducted to Argentina, Ecuador, and Uruguay as case studies, this article examines how receptive the monitoring mechanism has been to the voices of—and concerns related to—the most vulnerable sectors of society. Through a multi-methods research approach, the study first traces matches in language between alternative reports and the Committee’s lists of issues and concluding observations to identify which voices and claims the CESCR has effectively ‘heard’. It further draws on semi-structured interviews involving civil society actors and former and current members of the Committee. While the findings suggest that efforts for assuring equal weight to all voices are taking place at the CESCR monitoring mechanism, they also unveil how the Committee has overlooked claims when raised by only one alternative report—which have voiced the challenges experienced by groups with intersectional identities. Hence, this article’s contribution rests on the light it sheds on the opportunities and challenges that the Committee confronts to ensure equal participation and make the most vulnerable voices and concerns heard in its monitoring procedure.
First Detection of the Invasive Asian Longhorned Tick (Acari: Ixodidae) on Migratory Passerines in the Americas
Authors: Pandey Medha , Piedmonte Nicholas P , Vinci Vanessa C , Falco Richard C , Daniels Thomas J , Clark J Alan
Published: September 2022

The Asian longhorned tick (Haemaphysalis longicornis Neumann), native to East Asia, was first reported in the United States in 2017 and is now established in at least 17 states. Haemaphysalis longicornis feeds on birds in its range outside of the United States, and migratory birds disperse this tick and tick-borne pathogens. However, early studies in the United States did not find H. longicornis on migrating passerine birds. The transport of the parthenogenetic H. longicornis on birds has the potential to greatly expand its range. We report the first discovery of H. longicornis on migratory passerine birds in the Americas.
Risk assessment of the continuity of essential medications for low socioeconomic patients in Syria: a case study of diabetes mellitus
Authors: Sahloul Lujain , Bouri Feras , Bsso Eman , Saleh Aya , Darwish Ebaa , Yaseen Lamiaa , Mustafa Ammar Muhamed , Hatahet Taher
Published: September 2022

Objectives

During the past decade, the health system in Syria has been devastated due to the ongoing conflict which affected the production of pharmaceuticals as well. Patients of chronic diseases, such as diabetes mellitus, were significantly affected by the shortages of oral anti-diabetic medications, especially those of lower socioeconomic status. The objective of this paper is to study the causes and effects of the shortage of oral anti-diabetic agents in the Syrian market on patients with low socioeconomic status who find difficulties in accessing these medications.

Methods

The methodology of the study includes determining the availability of nationally produced oral anti-diabetic agents in different local pharmacies. Then, it studied the effects of this availability on low socioeconomic status patients whose prescriptions were registered in a local NGO and analysed using Microsoft Excel (Microsoft, USA).

Key findings

The study shows that many of the anti-diabetic medications included in the study have less than 50% availability in the pharmacies. Metformin, which is considered as a first-line treatment in diabetes has 40% availability. In addition, metformin was the most prescribed medication with about 57% frequency followed by gliclazide with 37% prescription frequency.

Conclusion

This study raises concerns about the continuity of supply of some of the oral anti-diabetic agents in the Syrian market. This can impact patient commitment to treatment, where patients from low socioeconomic status can be most affected by medication unavailability in nearby pharmacies or increased pricing due to high demand with low supply.
The role of biodegradable temporizing matrix in the management of a patient with major burns and anorexia nervosa
Authors: Tan Poh , Shah Rushabh , Hassouna Tarek , Murphy Ralph , McNally Samantha
Published: September 2022

Severe malnutrition secondary to anorexia nervosa results in deeper burns and significantly impacts wound healing, which represents a major challenge to burn management. The use of acellular dermal matrices, such as biodegradable temporizing matrix (BTM), is a valuable tool to overcome the surgical limitations. We describe a case of a 36-year-old female with a background of anorexia nervosa (body mass index of 12.3) presenting with a 30% total burns surface area (TBSA) burn. All of her burns were excised down to fascia due to the absence of subcutaneous fat. Her thin skin and depleted nutritional status significantly impacted reconstructive options. BTM was utilized to create a neodermis and provide adequate time to optimize the nutritional status before autologous skin resurfacing 3 weeks later, which yielded robust coverage with minimal donor site morbidity. Despite initial surgical and nutritional challenges, excellent outcomes were achieved in terms of wound healing, scar contractures and mobility.
The impact of the Mexico–San Diego border wall extension on spine injuries: a retrospective cohort review
Authors: Tenorio Alexander , Brandel Michael G , Produturi Gautam R , McCann Carson P , Doucet Jay J , Costantini Todd W , Ciacci Joseph D
Published: September 2022

Background

The recent San Diego–Mexico border wall height extension has resulted in an increased injury risk for unauthorized immigrants falling from greater heights. However, the effects of the border wall extension on frequency and morbidity of spinal injuries and related economic costs have yet to be highlighted.

Methods

We retrospectively compared two cohorts who presented to the UC San Diego Health Trauma Center for border wall falls: pre-height extension (12 patients; January 2016–May 2018), and post-height extension (102 patients; January 2020–December 2021). Patients presented during border wall construction (June 2018–December 2019) were excluded. Demographics, clinical data and hospital costs were collected. Spinal injuries were normalized using Customs and Border Protection apprehensions. Costs were adjusted for inflation using the 2021 medical care price index.

Results

The increase in spine injuries per month (0.8–4.25) and operative spine injuries per month (0.3– 1.7) was statistically significant (P < 0.001). Increase in median length of stay from 6 [interquartile range (IQR) 2–7] to 9 days (IQR 6–13) was statistically significant (P = 0.006). Median total hospital charges increased from $174 660 to $294 421 and was also significant (P < 0.001).

Conclusion

The data support that the recent San Diego–Mexico border wall extension is correlated with more frequent, severe and costly spinal injuries. This current infrastructure should be re-evaluated as border-related injuries represent a humanitarian and public health crisis.
Turbulence, coherence, and collapse: Three phases for core evolution
Authors: Offner Stella S R , Taylor Josh , Markey Carleen , Chen Hope How-Huan , Pineda Jaime E , Goodman Alyssa A , Burkert Andreas , Ginsburg Adam , Choudhury Spandan
Published: September 2022

We study the formation, evolution, and collapse of dense cores by tracking structures in a magnetohydrodynamic simulation of a star-forming cloud. We identify cores using the dendrogram algorithm and utilize machine learning techniques, including Neural Gas prototype learning and Fuzzy c-means clustering to analyse the density and velocity dispersion profiles of cores together with six bulk properties. We produce a 2-d visualization using a Uniform Manifold Approximation and Projection (UMAP), which facilitates the connection between physical properties and three partially-overlapping phases: i) unbound turbulent structures (Phase I), ii) coherent cores that have low turbulence (Phase II), and iii) bound cores, many of which become protostellar (Phase III). Within Phase II, we identify a population of long-lived coherent cores that reach a quasi-equilibrium state. Most prestellar cores form in Phase II and become protostellar after evolving into Phase III. Due to the turbulent cloud environment, the initial core properties do not uniquely predict the eventual evolution, i.e. core evolution is stochastic, and cores follow no one evolutionary path. The phase lifetimes are 1.0 ± 0.1 × 105 yr, 1.3 ± 0.2 × 105 yr, and 1.8 ± 0.3 × 105 yr for Phase I, II, and III, respectively. We compare our results to NH3 observations of dense cores. Known coherent cores predominantly map into Phase II, while most turbulent pressure-confined cores map to Phase I or III. We predict that a significant fraction of observed starless cores have unresolved coherent regions and that ≳20 per cent of observed starless cores will not form stars. Measurements of core radial profiles in addition to the usual bulk properties will enable more accurate predictions of core evolution.
Demographic and Selection Histories of Populations Across the Sahel/Savannah Belt
Authors: Fortes-Lima Cesar , Tříska Petr , Čížková Martina , Podgorná Eliška , Diallo Mame Yoro , Schlebusch Carina M , Černý Viktor
Published: September 2022

The Sahel/Savannah belt harbors diverse populations with different demographic histories and different subsistence patterns. However, populations from this large African region are notably under-represented in genomic research. To investigate the population structure and adaptation history of populations from the Sahel/Savannah space, we generated dense genome-wide genotype data of 327 individuals—comprising 14 ethnolinguistic groups, including 10 previously unsampled populations. Our results highlight fine-scale population structure and complex patterns of admixture, particularly in Fulani groups and Arabic-speaking populations. Among all studied Sahelian populations, only the Rashaayda Arabic-speaking population from eastern Sudan shows a lack of gene flow from African groups, which is consistent with the short history of this population in the African continent. They are recent migrants from Saudi Arabia with evidence of strong genetic isolation during the last few generations and a strong demographic bottleneck. This population also presents a strong selection signal in a genomic region around the CNR1 gene associated with substance dependence and chronic stress. In Western Sahelian populations, signatures of selection were detected in several other genetic regions, including pathways associated with lactase persistence, immune response, and malaria resistance. Taken together, these findings refine our current knowledge of genetic diversity, population structure, migration, admixture and adaptation of human populations in the Sahel/Savannah belt and contribute to our understanding of human history and health.
Kagome superconductors AV3Sb5 (A = K, Rb, Cs)
Authors: Jiang Kun , Wu Tao , Yin Jia-Xin , Wang Zhenyu , Hasan M Zahid , Wilson Stephen D , Chen Xianhui , Hu Jiangping
Published: September 2022

The quasi-two-dimensional kagome materials AV3Sb5 (A = K, Rb, Cs) were found to be a prime example of kagome superconductors, a new quantum platform to investigate the interplay between electron correlation effects, topology and geometric frustration. In this review, we report recent progress on the experimental and theoretical studies of AV3Sb5 and provide a broad picture of this fast-developing field in order to stimulate an expanded search for unconventional kagome superconductors. We review the electronic properties of AV3Sb5, the experimental measurements of the charge density wave state, evidence of time-reversal symmetry breaking and other potential hidden symmetry breaking in these materials. A variety of theoretical proposals and models that address the nature of the time-reversal symmetry breaking are discussed. Finally, we review the superconducting properties of AV3Sb5, especially the potential pairing symmetries and the interplay between superconductivity and the charge density wave state.
Management of Crohn’s disease relapse during neoadjuvant chemotherapy for bilateral breast cancer: a case report
Authors: Yamada Miki , Jinno Hiromitsu , Maeda Yuka , Sato Ayana , Matsumoto Akiko , Ikeda Tatsuhiko , Sasajima Yuko
Published: September 2022

Diagnosis of breast cancer in a patient with Crohn’s disease (CD) is uncommon. However, cytotoxic chemotherapy might help control CD during the treatment period. Here, we report a case of CD relapse during treatment with neoadjuvant chemotherapy (NAC) for bilateral breast cancer. A 39-year-old woman with CD controlled by infliximab and mesalazine was diagnosed with bilateral breast cancer. Infliximab treatment was discontinued temporarily so that the patient could receive NAC. However, her CD symptoms intensified during chemotherapy, and after her symptoms improved after a one-time administration of infliximab, the remainder of NAC was completed with a corticosteroid. Bilateral breast conservation surgery was performed. Histopathological examination revealed partial response of the left breast cancer and no residual cancer in the right breast. Breast irradiation and hormone therapy were added and no signs of recurrence have been observed for 5 years. CD has been well controlled with adalimumab and mesalazine.
Successful management of generalized tetanus in a 12-year old girl without anti-tetanus immunoglobulins: a case report
Authors: Muhelo Arlindo , Zita Ahivaldino , Seni Amir , Arzuaga Danys Alvarez , Smith Lee , Pizzol Damiano , Naber Yasmin Al
Published: September 2022

In low-income countries tetanus is a major public health concern owing to a low immunization coverage and unclean birth practices. Although it is a vaccine-preventable disease, tetanus can be contracted across the life course. The disease is prevalent and harmful in newborn babies and their mothers when the mothers` are unvaccinated against tetanus. We report on a case of a 12-year-old girl who presented with general malaise, anorexia, dysphagia, trismus and dehydration, which rapidly developed into severe generalized tetanus and was successfully managed in a low-resource setting without the availability of human anti-tetanus immunoglobulins.
Macroprudential Policy with Liquidity Panics
Authors: Garcia-Macia Daniel , Villacorta Alonso
Published: September 2022

We study the optimality of macroprudential policies in an environment where banks provide liquidity to firms. Informational frictions between banks can cause interbank market freezes, prompting firms to accumulate their own liquid assets. Liquidity hoarding by firms in turn reduces the demand for bank loans and bank profitability, makes interbank market freezes even more likely, and may ultimately trigger a self-fulfilling bad equilibrium. Such “liquidity panics” provide an additional rationale for liquidity requirements on banks, which alleviate frictions in the banking sector and, paradoxically, can increase aggregate investment. Instead, policies encouraging bank lending can have the opposite effect.
Perspective on honest brokers in science: Broadening conflicts of interest and role academies could play
Authors: Baveye Philippe C
Published: September 2022

Over the last two decades, there has been a documented decline in public trust toward science. This evolution has often been attributed to the fast expansion of Internet, making it very easy to spread alternate viewpoints. In the present perspective piece, it is argued that the unethical behavior of some researchers also has fueled the public distrust toward science. In this context, a solution could come from creating publicly accessible registries that would provide all the information needed by the public to determine whether a given researcher could safely be presumed to be an ‘honest broker’, i.e. to act in a disinterested manner about particular issues being debated. In the development of such registries, academies would be particularly suited to provide oversight, since some of their senior members, by virtue of their retirement from active duty, meet many of the conditions to effectively be honest brokers.
Risk dynamics for marine systems: towards a bio-inspired framework for dynamic risk assessment
Authors: Ventikos Nikolaos P , Louzis Konstantinos
Published: September 2022

The development of innovative, complex marine systems, such as autonomous ship concepts, has led to risk-based approaches in design and operation that provide safety level quantification and continuous risk assessment. The existing approaches to dynamic risk assessment mainly aim at updating accident probabilities for specific risk scenarios, based on knowledge of system operation and failure, as well as on past accident and failure information. However, for innovative marine systems that include complex interactions, our ability to identify anything that might go wrong is very limited, which may lead to unidentified risks, and failure data may not be available. This paper presents the foundations of a framework for dynamic risk assessment, which is equally applicable to manned and autonomous ships and mainly relies on information about the safe operational envelope and real-time information regarding deviations from safety. Inspiration is drawn from how the biological immune system identifies the risk of infection in a dynamic environment. The objective is to show the feasibility and benefits of our approach for quantifying the operational risk of marine systems. This paper provides the conceptual basis for developing ship specific applications and describes a process for dynamic risk assessment that is methodologically based on artificial immune systems. To demonstrate the implementation of our framework, we described, an illustrative example that involves a ship in a grounding scenario. The results show that the bio-inspired assessment process and risk description can reflect the changes of the risk level of a marine system.
Multisystem inflammatory syndrome in children
Authors: Porta Kelly R. , Zammit Christine
Published: September 2022

Multisystem inflammatory syndrome in children (MIS-C) is a potentially life-threatening syndrome that emerged soon after the start of the COVID-19 pandemic. This case report focuses on the general overview, case definition, epidemiology, pathogenesis, clinical findings, and management of MIS-C.
Legionella
Authors: Barimani Mark J.
Published: September 2022

Legionnaires disease is an important, relatively uncommon, yet well known form of atypical community-acquired pneumonia (CAP). If not appropriately treated in the early stage of infection, it can be fatal. Several factors increase the risk of contracting Legionnaires disease, including age over 50 years, chronic cardiovascular disease, underlying respiratory disease, chronic renal disease, diabetes, smoking, any immunosuppressing condition, travel history, and certain types of employment. Legionnaires disease can present without the usual symptoms associated with pneumonia. The incidence of Legionnaires disease is increasing, and because of its morbidity and mortality, clinicians should consider it in the differential when treating patients with CAP. This article reviews the pathophysiology and treatment of Legionnaires disease and when to refer patients to tertiary centers for higher levels of care, including extracorporeal membrane oxygenation.
Genetic testing for patients at risk of hereditary breast and ovarian cancer
Authors: DeTroye Alisha , Gabbett Kayla , Yi Cheryl , Judice Melanie , Luu Victor , Nelson Brittany , Gregory Tanya
Published: September 2022

The field of cancer genetic testing has made great advances in correctly identifying patients at risk for hereditary cancer syndromes. These tests, used during a genetic consultation, promote earlier detection of cancer and potentially increase survival. Despite these advancements, a large number of persons at risk for BRCA1/2 mutations remain untested due to a shortage of genetic counselors and lack of clinician knowledge on how to properly screen, identify, and refer patients to genetic counseling. We suggest team-based practices that physician associates/assistants (PAs) and NPs can use in collaboration with genetic counselors. We also explore how PAs and NPs can alleviate the burden on genetic counselors by taking a comprehensive family history, providing elements of counseling, and ordering appropriate genetic tests. This approach maximizes the amount of time the patient spends receiving actual genetic counseling. By creating this collaborative relationship, PAs and NPs can help increase the number of qualifying patients who receive genetic testing and counseling for hereditary breast and ovarian cancer syndromes.
Noninvasive diagnostic modalities for the diagnosis of coronary artery disease
Authors: El Hussein Mohamed Toufic , Fibich Elio
Published: September 2022

Selecting noninvasive diagnostic tests for coronary artery disease can be a daunting task to acute care NPs. This article provides an overview of the pathophysiology of coronary artery disease, relevant noninvasive diagnostic imaging modalities, and an evidence-based approach to guide subsequent diagnostic and therapeutic interventions.
Mycoplasma genitalium
Authors: Bach Susan
Published: September 2022

Many APRNs are not familiar with Mycoplasma genitalium, even if it is included on a sexually transmitted infection screening panel. This article briefly outlines prevalence, asymptomatic infection, clinical manifestations, diagnostics, and treatment.
Bronchiectasis and obstructive lung diseases in primary antibody deficiencies and beyond: update on management and pathomechanisms
Authors: Hanitsch Leif G.
Published: September 2022

Purpose of review

Pulmonary complications are among the most frequent manifestations in patients with primary antibody deficiency (PAD), contributing significantly to morbidity and mortality. Here, we focus on recent findings in obstructive pulmonary disease and bronchiectasis in PAD. Since specific data on patients with PAD is limited and management mostly follows general recommendations, this review also aims to summarize data from the immunocompetent population.

Recent findings

Potential risk factors for the development and progression of bronchiectasis include reduced immunoglobulins and lower CD4 cells. In addition, Pseudomonas aeruginosa and an altered microbiome might contribute to local inflammation and disease progression. Findings on the contribution of neutrophils and eosinophils in the affected immunocompetent population require confirmation in PAD. Despite its high global burden, there is an extreme paucity of data on chronic obstructive pulmonary disease in PAD. Lower IgA and IgM are associated with asthma in PAD, but the heterogeneity of prevalence among PAD groups is poorly understood. Recent observations of non-IgE-mediated pathomechanisms in asthma may be of particular interest in PAD patients.

Management of PAD patients with chronic lung disease requires a multidisciplinary team approach including immunology, pulmonology, infectious disease and physiotherapy. Diagnostic processes should be harmonized to ensure a more precise perspective on prevalence and disease courses.
Trends and determinants of epinephrine prescriptions: a proxy of anaphylaxis epidemiology?
Authors: Costa Enrico , Tanno Luciana Kase , Salazzari Damiano , Tedeschi Federico , Andretta Margherita , Caminati Marco
Published: September 2022

Purpose of review

Epinephrine autoinjectors (EAIs) are recommended to all patients previously experiencing anaphylaxis reaction in order to prevent further reactions and fatalities. Under that perspective, EAI prescription could be considered as a proxy of anaphylaxis epidemiology. Nevertheless EAI prescription rates are still unacceptably low.

Recent findings

The review focuses on potential determinants, in addition to clinical indications, which might impact EAI prescription rates by exploring the scientific literature published within the past 18 months, wherever available. Although some controversial results, age, sex, ethnicity, geographical setting and socioeconomic conditions might influence both physician prescription behaviour and EAIs’ accessibility from the patient's side, which hampers the accuracy of EAI prescription as a proxy of anaphylaxis. Low EAI prescription and refill rates have been recorded even in the absence of significant socioeconomic barriers, suggesting that economical limitations only partially account for the issue, and cultural restrictions have also to be considered and addressed.

In addition to providing the same opportunities in terms of EAI availability in all countries worldwide, implementing the resources for anaphylaxis management in terms of practical knowledge, education, and allergy specialist networks is an urgent need, even in the absence of socioeconomic barriers.
The new indications for biologicals in type 2 diseases: perspectives
Authors: Bagnasco Diego , Canevari Rikki Frank , Passalacqua Giovanni , Caminati Marco
Published: September 2022

Purpose of review

To provide a literature review of what is on the market and under study for some diseases treated with drugs targeting type 2 (T2) inflammation.

Recent findings

Literature data have shown that drugs targeting type 2 inflammation are effective in asthma and nasal polyposis, conditions for which they are on the market, and have promising expectations in the case of eosinophilic esophagitis, especially using anti-IL-5/IL-5 receptor and IL-4 receptor antibodies, while concerning eosinophilic granulomatosis with polyangitis (EGPA), mepolizumab (MEP) was approved by FDA and EMA as a drug for the treatment of this condition because of the promising results obtained in trials and in real life.

The use of these drugs is certainly an important achievement in the treatment of complex diseases such as those mentioned above, which are too often orphaned from innovative treatments and limited to the use of immunosuppressants and systemic corticosteroid for their control.
Hospital-initiated Extended-release Injectable Buprenorphine Using a Novel Reallocation Initiative From an Outpatient Addiction Medicine Clinic
Authors: Ganetsky Valerie S. , Salzman Matthew , Carroll Gerard , Heil Jessica , Sutton Jacqueline , Visioli Vincent M. , Currie Samuel , Schmidt Ryan , Baston Kaitlan E. , Haroz Rachel
Published: September 2022

Objectives

Novel strategies for initiation and continuation of buprenorphine are critical, especially during a pandemic when traditional opioid use disorder treatment pathways may be disrupted. We describe an innovative outpatient to inpatient reallocation initiative for extended-release buprenorphine (XR-BUP) designed to repurpose an expensive medication for use in hospitalized patients facing treatment barriers upon discharge and pilot the feasibility of XR-BUP use in the inpatient setting.

Methods

We collaborated with our institution's inpatient pharmacy and a New Jersey Medicaid managed care organization to create an alternate pathway to make XR-BUP available to hospitalized patients insured by the same payor. In this process, XR-BUP doses were deidentified and transferred to the inpatient controlled substance inventory for administration to hospitalized patients at no charge by our Addiction Medicine Consult Service after a period of sublingual buprenorphine stabilization. Our reallocation pathway bypassed several existing XR-BUP regulatory barriers to allow for inpatient administration.

Results

To date, we have transferred approximately 85 XR-BUP 300 mg doses to the inpatient controlled substance inventory. This equates to a cost savings of nearly $145,000.

Conclusions

Reallocation of XR-BUP from an outpatient to inpatient setting increased postdischarge buprenorphine treatment access while also reducing health care costs by repurposing an expensive medication that would otherwise go to waste. Use of reallocated XR-BUP in the inpatient setting may pave the way for addition of XR-BUP to the hospital's formulary to minimize treatment gaps after discharge.
Measuring Attitudes About Alcohol Misuse and Dependence Among Alaska Native People Within a Tribal Health Care System
Authors: Dillard Denise A. , Hebert Luciana E. , Shaw Jennifer L. , Trinidad Susan B. , Dirks Lisa G. , Lillie Kate , Ludman Evette J. , Donovan Dennis , Burke Wylie
Published: September 2022

Objectives

Attitudes about alcohol misuse and dependence influence alcohol use and help-seeking behavior. Alaska Native and American Indian (AN/AI) people have higher rates of alcohol-related morbidity and mortality but engage in treatment at lower rates than the general population. No validated instruments exist to assess attitudes of AN/AI people about alcohol misuse and dependence to inform treatment and prevention efforts. This study aimed to develop an instrument to assess public attitudes among AN/AI people of alcohol misuse and dependence.

Methods

This multiphase, mixed-methods study was conducted at Southcentral Foundation, a tribally owned health system serving 65,000 AN/AI people in Alaska. We conducted focus groups and interviews with health system users, providers, and leaders to adapt the Public Attitudes About Addiction Survey. The adapted instrument was piloted with 200 people. Cognitive interviews and exploratory and confirmatory factor analyses were used to refine the instrument, which were then administered to 777 AN/AI people.

Results

Initial exploratory factor analysis identified 5 factors, including 3 from the original Public Attitudes About Addiction Survey (moral, disease, nature), a combined psychology and sociology factor (psychosocial), and a new factor (environment). A final 4-factor model (psychosocial, moral, disease, nature) with 14 items had good fit with root mean square error of approximation (0.035; comparative fit index = 0.977; Tucker-Lewis index = 0.970; standardized root mean residual = 0.040) and loadings ranging from 0.41 to 0.80.

Conclusions

This study developed the first instrument to assess AN/AI attitudes about alcohol misuse and dependence. This instrument has potential to inform alcohol-related treatment in AN/AI communities. Future research is warranted to adequately measure place-based contributors salient to AN/AI people.
Intralesional Versus Intramuscular Hepatitis B Virus Vaccine in the Treatment of Multiple Common Warts
Authors: Nofal Ahmad , Elaraby Aya , Elkholy Basma M.
Published: September 2022

BACKGROUND

Hepatitis B virus (HBV) vaccination is associated with stimulation of humoral and cell-mediated immunity. Intralesional HBV vaccine has been recently used as an immunotherapy of common warts with relatively low success rate.

AIM

To assess the efficacy and safety of intralesional versus intramuscular (IM) HBV vaccine in the treatment of multiple common warts.

PATIENTS AND METHODS

The study included 60 patients with multiple common warts who were randomly assigned to 2 groups: intralesional HBV vaccine or IM HBV vaccine. In the intralesional HBV vaccine group, the vaccine was injected into the largest wart at 2-week intervals until complete clearance or for a maximum of 5 sessions. Intramuscular HBV vaccine group received 3 injections in the deltoid muscle at 0, 1, and 6 months.

RESULTS

Complete wart clearance was reported in 7 patients (23.3%) of the intralesional HBV vaccine group and 15 patients (50%) of the IM HBV vaccine group. The difference was statistically significant in favor of the IM group (p = .0479). Adverse effects were mild and insignificant in the 2 groups.

CONCLUSION

HBV vaccine, particularly the IM form seems to be a promising, well-tolerated therapeutic option for the treatment of warts.

LIMITATIONS

Short follow-up period and small sample size.
The Growth Factors of Subcutaneous Benign Lipoma: Consideration from Anatomical Position of Occurrence
Authors: Nakao Ko , Onishi Fumio , Kiyama Maiko , Minabe Toshiharu
Published: September 2022

Background:

Subcutaneous lipomas are the most common benign soft-tissue tumors. Theoretically, adipocyte sites could be the primary foci; however, lipomas are likely located in the occipital, neck, shoulder, torso, and thigh areas. To date, no study has reported the anatomical relationship between these subcutaneous structures and lipomas. Therefore, we aimed to investigate the anatomical locations of lipomas and considered their growth factors. In addition, we discussed the mechanism of fat amplification to improve the success of fat grafting.

Methods:

In the present study, lipomas measuring more than 5 cm in diameter from patients hospitalized between 2017 and 2021 were retrospectively examined using preoperative computed tomography and magnetic resonance imaging as well as clinical records with intraoperative pictures.

Results:

In total, 22 lipomas of 22 patients were examined. All lesions (100%) were accompanied by neurovascular perforators. Nineteen lesions (86%) were located deep in the superficial fascia, where it was clearly defined. Moreover, all lesions were located at the mobile adipofascial layer adjacent to an anchored fixed or less mobile structure.

Conclusions:

Lipoma growth might require neurovascular perforators that supply both blood flow and continuous stretching stimuli. The mobile adipofascial layer with bones adjacent to a fixed or less mobile area might also be necessary to grow lipomas. If these findings can be used as clues to elucidate the mechanism of fat amplification in the future, it may lead to an improvement in the survival rate of fat grafts.
Retinal vasculopathy following varicella zoster virus infection
Authors: Sutra Plern , Pokawattana Itsara
Published: September 2022

Purpose of review

Varicella zoster virus (VZV) ocular infection can manifest purely as a vasculopathy that leads to retinal arteriole occlusion, without any retinitis or vasculitis. This review summarizes our current knowledge of such VZV ocular infection phenotype, incorporating initial descriptions from 1988. We describe the pathogenesis and VZV's manifestations in the retina using fundus photography, fundus fluorescein angiography, optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Laboratory investigations, diagnostic procedures, prognoses, and treatment options are also being reviewed.

Recent findings

Ten case reports where VZV retinal vasculopathy was the primary feature observed after varicella or zoster rash are described. The retinal arteriole, cilioretinal artery, branches of retinal artery, central retinal artery and ophthalmic artery were found to be areas of more rarely affected, neither in the form of vasculitis nor retinitis. Diagnosis is typically made from positive polymerase chain reaction (PCR) for VZV from extracted intraocular fluid or positive serum or cerebrospinal fluid (CSF) anti-VZV immunoglobulin G antibody in the context of compatible ocular findings. In addition, retinal vasculopathy occurring in the setting of confirmed varicella or zoster rashes could be considered potentially pathognomonic. Pathological concepts, including direct VZV infection of affected tissue, persistent inflammation, and/or virus-induced hypercoagulability are also discussed.

VZV may produce a wide spectrum of ocular manifestations with isolated VZV retinal vasculopathy being a rarer presentation. A prompt diagnosis followed by an early treatment of systemic acyclovir with or without corticosteroids is the mainstay of treatment.
Implementation of Early Rehabilitation in Severe COVID-19 Respiratory Failure
Authors: Miner Daniel , Smith Kellen , Foroozesh Mahtab , Price Justin H.
Published: September 2022

Purpose:

The purpose of this scoping review is to describe current clinical practice guidelines (CPGs) for early rehabilitation for individuals hospitalized in an intensive care unit with COVID-19 and examine practice patterns for implementation of mobility-related interventions.

Methods:

PubMed, EMBASE, and CINAHL databases were searched from January 1, 2020, through April 1, 2022. Selected studies included individuals hospitalized with severe COVID-19 and provided objective criteria for clinical decision making for mobility interventions. A total of 1464 publications were assessed for eligibility and data extraction. The PRISMA-ScR Checklist and established guidelines for reporting for scoping reviews were followed.

Results:

Twelve articles met inclusion criteria: 5 CPGs and 7 implementation articles. Objective clinical criteria and guidelines for implementation of early rehabilitation demonstrated variable agreement across systems. No significant adverse events were reported.

Conclusions:

Sixty percent (3/5) of CPGs restrict mobility for individuals requiring ventilatory support of more than 60% Fio
2 (fraction of inspired oxygen) and/or positive end-expiratory pressure (PEEP) greater than 10-cm H2O (positive end-expiratory pressure). Preliminary evidence from implementation studies may suggest that some individuals with COVID-19 requiring enhanced ventilatory support outside of established parameters may be able to safely participate in mobility-related interventions, though further research is needed to determine safety and feasibility to guide clinical decision making.
Proteomics analysis of the phytopathogenic fungus
Sclerotinia sclerotiorum
: a narrative review
Authors: Otun Oluwatobi Sarah , Achilonu Ikechukwu , Ntushelo Khayalethu
Published: September 2022

Sclerotinia sclerotiorum
(Lib.) de Bary is a necrotrophic plant pathogen that causes cottony rot, watery soft rot, stem rot, white mold, and other disease symptoms in over 700 plant hosts around the world. Destruction of economically important crops, the lack of resistant cultivars, and the general challenge of controlling diseases caused by this broad-based pathogen call for continued research. However, in recent years, mass spectrometry-based proteomics analyses have been used to acquire a fundamental and in-depth molecular understanding of this fungal pathogen. In this review, we describe the characteristics of the
Sclerotinia sclerotiorum
pathogen and examine its virulence factors, secreted proteins, and host suppression mechanisms. Furthermore, we review recent proteomics studies and extrapolate their primary findings for the identification and functional characterization of
Sclerotinia sclerotiorum
proteins. Finally, we discuss key findings that shape the understanding of the virulent factors and pathogenesis of
Sclerotinia sclerotiorum
and outline directions for future proteomic investigations of plant pathogens.
The Effects of Work Satisfaction and Work Flexibility on Burnout in Nurses
Authors: LEE Huan-Fang , CHANG Ying-Ju
Published: September 2022

Background

The World Health Organization has encouraged improving working conditions for nurses to decrease turnover and increase nurse staffing and nursing capacity. The International Council of Nurses has pointed out that a positive work environment can improve satisfaction and decrease burnout in nurses. However, the effects of working conditions and work satisfaction on burnout in nurses remain unclear.

Purpose

The purpose of this study was to explore the effects of working-condition-related flexibility and work satisfaction on burnout in nurses.

Methods

A cross-sectional design was employed, and 450 nurses from a single medical center participated in this study. In addition to demographic information, three survey instruments, including the Taiwanese Hospital Nurses' Job Satisfaction Scale, the Working Conditions and Flexible System Scale, and the Maslach Burnout Inventory-Chinese Version, were used to measure working condition flexibility, work satisfaction, and burnout. Descriptive statistics, the Pearson correlation coefficient, and hierarchical linear regression were used to analyze the data.

Results

Four hundred thirty-five nurses were enrolled as participants. Most were female, with a mean age of 29 years. Over four fifths (83.1%) were unmarried, and 65.5% had at least 2 years of prior experience working at other hospitals. Although the participants reported experiencing burnout several times per month, they reported feeling satisfied with their work. They noted flexibility related to working conditions, especially task-related flexibility, as important. Four variables (satisfaction/professional autonomy, interpersonal interaction, workload, and working condition flexibility/task flexibility) were found to be significant predictors of emotional exhaustion (adjusted R
2 = 0.212). However, only professional autonomy was found to significantly predict a sense of low personal accomplishment (adjusted R
2 = .077), whereas nursing competence significantly predicted depersonalization (adjusted R
2 = .086).

Conclusions

Work satisfaction and flexibility related to working conditions were shown to relate negatively to burnout. Nursing managers should improve the level of satisfaction related to professional autonomy, interpersonal interaction, and workload as well as task flexibility for nurses.