bluuebunny/crossref_metadata_2025 huggingface dataset:
Introduction
Authors: Hoskin Peter , Goh Vicky
Published: February 2022

Chapter 1 discusses the principles of imaging and the requirements for radiotherapy planning, emphasizing the role of imaging in diagnosis, staging, radiotherapy planning and post treatment follow-up. Imaging is an integral component of patient care throughout the cancer journey, being required for diagnosis and staging, radiotherapy planning, and subsequent response evaluation and follow-up. The evolution of imaging in recent years, with widespread availability of increasingly sophisticated computerized tomography, magnetic resonance, and molecular imaging has driven major changes in radiotherapy practice. The precise requirements for individual tumours and tumour sites vary and a clear appreciation of the relative strengths and weaknesses of different imaging modalities for a given patient is essential. It is critical to bear in mind that increased use of ionizing-radiation based imaging exposes the patient to a higher concomitant radiation dose, the long-term sequelae of which are as yet to be fully evaluated.
Lung and thorax
Authors: Jain Pooja , Clarke Katy , Darby Michael
Published: February 2022

Chapter 5 discusses the malignancies arising in the lung and thorax. It provides background for these diseases, focuses on imaging for diagnosis and staging, and then moves on to discuss the imaging requirements for state-of- the-art radiotherapy planning. This includes principles of advanced radiotherapy planning techniques such as the use of 4D imaging, stereotactic ablative body radiotherapy contouring and planning, volumetric arc therapy, and image guided radiotherapy. We have used non-small cell lung cancers as the main focus as these are the commonest malignancies, but these principles can be applied to all thoracic radiotherapy. Lung cancer screening is also an emerging and important area in improving outcomes for lung cancers. Finally, imaging approaches and protocol for treatment follow-up are covered.
Rectal cancer
Authors: Misra Vivek , Kochhar Rohit
Published: February 2022

Chapter 12 discusses rectal cancer, including its clinical background, diagnosis and staging, radiotherapy planning, therapeutic assessment, and follow-up. Initial imaging is able to accurately stage and restage disease and to guide therapy (total mesorectal excision ± neoadjuvant radiotherapy or chemoradiotherapy) which has contributed to improved rectal cancer outcome. Minimally invasive surgery, sphincter preservation in low rectal cancers rather than abdominoperineal resection, and non-surgical management may be appropriate in selected patients to preserve and improve quality of life following successful treatment. In patients with an initial complete response and on active surveillance, MRI with diffusion imaging has a role in the first two years in extraluminal disease detection.
Anal cancer
Authors: Muirhead Rebecca , Goh Vicky
Published: February 2022

Chapter 13 covers the basics of anal squamous cell carcinoma, including risk factors and presenting symptoms. The natural progression of disease is discussed. Standard treatment is chemoradiotherapy for all but very early cancers. Surgery with abdominoperineal resection is reserved as salvage treatment when chemoradiotherapy fails. Outcomes with this treatment strategy are quoted. Diagnostic investigations include MRI pelvis, CT chest, abdomen, pelvis, and an evolving use of PET/CT. The MRI and PET/CT can be used within the planning system to aid with radiotherapy planning. Details on radical radiotherapy are presented, including doses, volumes, set-up, margins, and verification images. Lastly, we discuss the appropriate imaging to confirm complete response following chemoradiotherapy and any further imaging required preoperatively if salvage surgery is to be considered.
Paediatrics
Authors: Gaze Mark , Shahid Monique , Humphries Paul , Peters Francesca
Published: February 2022

Chapter 21 discusses the role of imaging in paediatric oncology, and covers central nervous system (CNS) and renal tumours, neuroblastoma, lymphoma, primary bone tumours (osteosarcoma and Ewing’s sarcoma), and soft tissue sarcomas, including rhabdomyosarcoma and other types. In the management of children’s cancers, diagnostic imaging and interventional radiology have several roles, which include assessment of suspicious lesions to provide a differential diagnosis and guide a biopsy procedure, determination of the local extent of disease and the presence of nodal or distant metastases for the purposes of staging and risk stratification, response assessment, target volume and organ at risk delineation for radiotherapy, management of complications and late effects, and post-treatment surveillance. Active involvement of paediatric radiologists as full members of the paediatric oncology multidisciplinary team is essential to get the best value for patients from imaging studies.
Imaging for treatment verification
Authors: Dean June
Published: February 2022

Technological advances in radiotherapy delivery have led to increased conformality of dose to the target, with the potential to reduce margin size and dose escalation. Relying on skin marks or tattoos for positioning are no longer sufficient. To have confidence in delivering treatment accurately requires a robust method of verification. Therapeutic radiographers are best placed to make decisions regarding online image matching as part of the treatment delivery process. Geometric verification utilizing 3D volumetric imaging requires agreed local protocols on decision making and specific competencies for therapeutic radiographers to provide them with the knowledge, skill, and confidence in decision making in a pressured online environment.
Radiation protection issues when imaging patients for radiotherapy
Authors: Thomas Simon
Published: February 2022

Chapter 24 discusses radiation protection matters for patients who require imaging with ionizing radiation as part of their radiotherapy management. Although non-ionizing radiation, for example ultrasound and magnetic resonance imaging (MRI) will also be used for these patients, these imaging modalities are not discussed here. This chapter will include some fundamental scientific aspects of radiation and its effect on the human body, guidance on dosimetry, as well as the regulations themselves. The 2017 ionizing radiation (medical exposure) regulations requires diagnostic dose reference levels be set for diagnostic examinations. Examples are given of how to compare the risks from ionizing radiation between different imaging regimes.
Designing long-term incentives that promote innovation instead of value capture
Authors: Souder David , Badwaik Dhvani
Published: February 2022

Major projects share at least two common challenges with corporations pursuing innovation: the need to coordinate many complementary constituents and the temporal separation between upfront costs and future benefits. In the corporate context, high-powered incentives such as stock options have been popularized as a way to reward executives for successfully navigating these challenges. However, research shows that these high-powered incentives can have hidden negative effects, such that options have a negligible net impact on promoting innovation. Yet few alternatives for promoting innovation have been designed, allowing stock options and other high-powered incentives to remain common in the belief they are the best available approach. This article uses the parallels between the corporate context and major projects to draw implications for regulatory policy-makers to obtain more favourable outcomes.
Towards the Substantive Representation of Women: A Study of the Indonesian Women’s Parliamentary Caucus
Authors: Maryuni Maryuni
Published: February 2022

A women’s parliamentary caucus works to strengthen the goals of women in a legislative body. It trains female members of the parliament in legislation and facilitates communication among feminists in parliament and civil society in pursuing common goals through collective action to enact feminist legislation. Qualitative research in Indonesia over the parliamentary term 2009–2014 has suggested that active communication is vital for the performance of such functions. Poor communication in the study term resulted in an inability to initiate collective action, a mismatched design of capacity-building activity and diminishment of the relationship between feminists in parliament and civil society. The existence of a caucus alone is insufficient. A functioning caucus is essential for substantive representation of women.
Effector-mediated plant–virus–vector interactions
Authors: Ray Swayamjit , Casteel Clare L
Published: February 2022

Hemipterans (such as aphids, whiteflies, and leafhoppers) are some of the most devastating insect pests due to the numerous plant pathogens they transmit as vectors, which are primarily viral. Over the past decade, tremendous progress has been made in broadening our understanding of plant–virus–vector interactions, yet on the molecular level, viruses and vectors have typically been studied in isolation of each other until recently. From that work, it is clear that both hemipteran vectors and viruses use effectors to manipulate host physiology and successfully colonize a plant and that co-evolutionary dynamics have resulted in effective host immune responses, as well as diverse mechanisms of counterattack by both challengers. In this review, we focus on advances in effector-mediated plant–virus–vector interactions and the underlying mechanisms. We propose that molecular synergisms in vector–virus interactions occur in cases where both the virus and vector benefit from the interaction (mutualism). To support this view, we show that mutualisms are common in virus–vector interactions and that virus and vector effectors target conserved mechanisms of plant immunity, including plant transcription factors, and plant protein degradation pathways. Finally, we outline ways to identify true effector synergisms in the future and propose future research directions concerning the roles effectors play in plant–virus–vector interactions.
Which field of research would Gregor Mendel choose in the 21st century?
Authors: Berger Frédéric
Published: February 2022

Gregor Mendel’s work on segregation of traits in plants established the basic methodology and rules of genetics. The interruption of Mendel’s research activities in 1870 impeded the immediate recognition of the value of his work until the dawn of the 20th century. Only then were his founding laws of genetics validated, propelling the development of biological research toward the birth of molecular biology in the second half of the 20th century. While molecular plant genetics can be viewed as the spiritual heir of Mendel’s research, one might wonder whether in the 21st century Gregor Mendel would prefer to practice scientific approaches other than molecular genetics such as population genetics, comparative genomics, or the emerging field of evo-chromo. In this perspective, I review aspects of these fields that might have attracted or perplexed a 21st century Mendel.
Enforcement of low-level warrants in the City of St. Louis: Officer decision making and implications for policy and practice
Authors: Slocum Lee , Torres Luis C , Huebner Beth M , Larson Eric G , Baumgartner Jerome , Schaefer Sherri , Preiss Erica
Published: February 2022

Warrants are commonplace in the USA, especially bench warrants issued for non-compliance with court orders. Although warrants compel arrest, in practice, officers exercise discretion when enforcing low-level warrants; yet, this discretion goes undocumented and data on warrant enforcement are limited. This collaboration between St. Louis Metropolitan Police Department and the University of Missouri—St. Louis addresses these gaps. Using arrest data, we find that warrant arrests in St. Louis declined from 2002 to 2019. One-third of arrests involve a bench warrant, primarily stemming from traffic violations, and many involve no new charges. Racial disparities in warrant enforcement exist, but data are needed to uncover why. Informal focus groups and meetings with St. Louis Metropolitan Police Department personnel held from 2018 to 2021 provide insight into the role of warrants in officer decision making. We argue that reducing resources devoted to warrant enforcement and racial disparities requires collaboration between police and other stakeholders.
Integrality Properties in the Moduli Space of Elliptic Curves: Isogeny Case
Authors: Schmid Stefan
Published: February 2022

For a fixed j–invariant j0 of an elliptic curve without complex multiplication we bound the number of j–invariants j that are algebraic units and such that elliptic curves corresponding to j and j0 are isogenous. Our bounds are explicit. We also modify the problem slightly by fixing a singular modulus α and looking at all j such that $j-\alpha$ is an algebraic unit and such that elliptic curves corresponding to j and j0 are isogenous. The number of such j can again be bounded explicitly.
Training and assessment of musculoskeletal ultrasound and injection skills—a systematic review
Authors: Carstensen Stine M D , Velander Marie Juul , Konge Lars , Østergaard Mikkel , Pfeiffer Jensen Mogens , Just Søren Andreas , Terslev Lene
Published: February 2022

Objectives

To examine how residents are trained and assessed in musculoskeletal US (MSUS), MSUS-guided and landmark-guided joint aspiration and injection. Additionally, to present the available assessment tools and examine their supporting validity evidence.

Methods

A systematic search of PubMed, Cochrane Library and Embase was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and studies published from 1 January 2000 to 31 May 2021 were included. Two independent reviewers performed the search and data extraction. The studies were evaluated using the Medical Education Research Quality Instrument (MERSQI).

Results

A total of 9884 articles were screened, and 43 were included; 3 were randomized studies, 21 pre- and post-test studies, 16 descriptive studies and 3 studies developing assessment tools. The studies used various theoretical training modalities, e.g. lectures, anatomical quizzes and e-learning. The practical training models varied from mannequins and cadavers to healthy volunteers and patients. The majority of studies used subjective ‘comfort level’ as assessment, others used practical examination and/or theoretical examination. All training programs increased trainees’ self-confidence, theoretical knowledge, and/or practical performance, however few used validated assessment tools to measure the effect. Only one study met the MERSQI high methodical quality cut-off score of 14.

Conclusion

The included studies were heterogeneous, and most were of poor methodological quality and not based on contemporary educational theories. This review highlights the need for educational studies using validated theoretical and practical assessment tools to ensure optimal MSUS training and assessment in rheumatology.
Subjective Well-Being Scarring Through Unemployment: New Evidence from a Long-Running Panel
Authors: Eberl Andreas , Collischon Matthias , Wolbring Tobias
Published: February 2022

Scarring effects of unemployment on subjective well-being (SWB), i.e., negative effects that remain even after workers reenter employment, are well documented in the literature. Nevertheless, the theoretical mechanisms by which unemployment leads to long-lasting negative consequences for SWB are still under debate. Thus, we theorize that unemployment can have an enduring impact mainly through (1) the experience of unemployment as an incisive life event and (2) unemployment as a driver of future unemployment. In the empirical part, we focus on one important dimension of SWB: overall life satisfaction. Based on advanced longitudinal modeling that controls for group-specific trends, we estimate scarring through unemployment using the German Socio-Economic Panel (SOEP). Our results consistently show a large negative effect of unemployment on life satisfaction as well as significant scarring effects that last at least 5 years after reemployment for both men and women as well as for short- and long-term unemployment spells. Further analyses reveal that repeated periods of unemployment drive these effects and cause even longer lasting scarring, implying that there are hardly any adaptations to unemployment that buffer its effect on life satisfaction. We conclude that scarring effects mainly work through repeated episodes of unemployment. Regarding policy implications, our findings suggest that preventing unemployment, regardless of its duration, is beneficial for individual well-being not only in the short term.
DAPK1 Interacts with the p38 Isoform MAPK14, Preventing Its Nuclear Translocation and Stimulation of Bone Marrow Adipogenesis
Authors: Wang Shan , Mi Rujia , Cai Zhaopeng , Wang Ziming , Zeng Chenying , Xie Zhongyu , Li Jinteng , Ma Mengjun , Liu Wenjie , Su Hongjun , Cen Shuizhong , Wu Yanfeng , Shen Huiyong
Published: February 2022

Bone marrow (BM) adipose tissue (BMAT), a unique adipose depot, plays an important role in diseases such as osteoporosis and bone metastasis. Precise control of mesenchymal stem cell (MSC) differentiation is critical for BMAT formation and regeneration. Here, we show that death associated protein kinase 1 (DAPK1) negatively regulates BM adipogenesis in vitro and in vivo. Prx1creDapk1loxp/loxp mice showed more adipocytes in the femur than Dapk1loxp/loxp mice. Further mechanistic analyses revealed that DAPK1 inhibits p38 mitogen-activated protein kinase (MAPK) signaling in the nucleus by binding the p38 isoform MAPK14, decreasing p38 nuclear activity, which subsequently inhibits BM adipogenesis. The inhibitory effect of DAPK1 against MAPK14 was independent of its kinase activity. In addition, the decreased DAPK1 was observed in the BM-MSCs of ageing mice. Our results reveal a previously undescribed function for DAPK1 in the regulation of adipogenesis and may also reveal the underlying mechanism of BMAT formation in ageing.
Tumor mutational burden and somatic mutation status to predict disease recurrence in advanced melanoma
Authors: Hotz Meghan J. , O’Halloran Eileen A. , Hill Maureen V. , Hayden Kelly , Zaladonis Angela G. , Deng Mengying , Olszanski Anthony J. , Reddy Sanjay S. , Wu Hong , Luo Biao , Farma Jeffrey M.
Published: February 2022

Tumor mutational burden (TMB) has recently been identified as a biomarker of response to immune checkpoint inhibitors in many cancers, including melanoma. Co-assessment of TMB with inflammatory markers and genetic mutations may better predict disease outcomes. The goal of this study was to evaluate the potential for TMB and somatic mutations in combination to predict the recurrence of disease in advanced melanoma. A retrospective review of 85 patients with stage III or IV melanoma whose tumors were analyzed by next-generation sequencing was conducted. Fisher’s exact test was used to assess differences in TMB category by somatic mutation status as well as recurrence locations. Kaplan–Meier estimates and Cox-proportional regression model were used for survival analyses. The most frequently detected mutations were TERT (32.9%), CDKN2A (28.2%), KMT2 (25.9%), BRAF V600E (24.7%), and NRAS (24.7%). Patients with TMB-L + BRAFWT status were more likely to have a recurrence [hazard ratio (HR), 3.43; confidence interval (CI), 1.29–9.15; P = 0.01] compared to TMB-H + BRAF WT. Patients with TMB-L + NRASmut were more likely to have a recurrence (HR, 5.29; 95% CI, 1.44–19.45; P = 0.01) compared to TMB-H + NRAS WT. TMB-L tumors were associated with local (P = 0.029) and in-transit (P = 0.004) recurrences. Analysis of TMB alone may be insufficient in understanding the relationship between melanoma’s molecular profile and the body’s immune system. Classification into BRAFmut, NRASmut, and tumor mutational load groups may aid in identifying patients who are more likely to have disease recurrence in advanced melanoma.
Anticoagulation Considerations in Liver Disease
Authors: Stone Andrew C. , Gaborcik Joshua W. , Smetana Megan E.
Published: February 2022

Coagulopathy of liver disease is a complex pathology that may result in thrombosis and/or bleeding complications. Routine laboratory values are not always reflective of the degree of these risks. Additionally, prophylaxis and treatment of venous thromboembolism in patients with cirrhosis require careful evaluation when selecting and monitoring drug therapy for these indications. Therefore, this article aims to provide insight regarding coagulopathy of liver disease, influence on laboratory values, and anticoagulant therapy considerations for critical care nurses assuming care for patients with cirrhosis.
SGLT-2 Inhibitor Use in Heart Failure
Authors: March Katherine L. , Lukas Jack G. , Berei Theodore J. , Shah Samarth P. , Cave Brandon E.
Published: February 2022

Sodium-glucose cotransporter-2 (SGLT-2) inhibitors (empagliflozin, canagliflozin, dapagliflozin, and ertugliflozin) are a new class of heart failure medications that have previously been exclusively utilized in the management of type 2 diabetes mellitus (T2DM). The rationale for using SGLT-2 inhibitors in patients with heart failure has stemmed from recent landmark clinical trials in T2DM in which reductions in mortality and hospitalization for heart failure were first observed. On the basis of these robust outcomes, empagliflozin has further been evaluated in heart failure with reduced ejection fraction (HFrEF) and preserved ejection fraction and dapagliflozin solely in the management of HFrEF. While cardiovascular outcomes among each agent vary depending on the patient population, updates among both the American and European guidelines have included SGLT-2 inhibitors as pillars of therapy. The exact mechanisms for how SGLT-2 inhibitors are beneficial in heart failure are unknown, but current hypotheses include multiple metabolic and hemodynamic mechanisms. The purpose of this review is to summarize available literature focusing on the use of the SGLT-2 inhibitors as adjunctive therapy in heart failure, as well as evaluate mechanisms for heart failure benefit, adverse effects, and practical considerations for using these agents in the clinical setting.
Upregulation of Periostin Through CREB Participates in Myocardial Infarction-induced Myocardial Fibrosis
Authors: Xue Ke , Chen Shuai , Chai Jiayin , Yan Wenjing , Zhu Xinyu , Dai Hongyan , Wang Wen
Published: February 2022

Myocardial fibrosis after myocardial infarction (MI) leads to heart failure, which has become an important global public health issue. One of the most important features of myocardial fibrosis is the abnormal deposition of extracellular matrix (ECM) proteins. Periostin is one of the ECM proteins. Cyclic AMP response element-binding protein 1 (CREB) is well known for its involvement in multiple signaling in myocardial fibrosis. It has been confirmed that CREB could regulate ECM proteins deposition. However, little is known about the relationship between CREB and periostin post-MI. This study aims to verify the hypothesis that CREB promotes the expression of periostin in MI-induced myocardial fibrosis. To test this hypothesis, primary rat cardiac fibroblasts were cultured and rat model of MI was established. The level of myocardial fibrosis post-MI was identified by histological staining. The expressions of CREB and periostin were detected through western blot and reverse transcription quantity polymerase chain reaction. The upregulation and downregulation of CREB and periostin were established by plasmid, small interfere RNA (siRNA), and lentivirus, respectively. High levels of CREB and periostin were found post-MI in our study. Meanwhile, the expression of periostin was decreased after CREB downregulation both in vivo and in vitro. Finally, with the treatment of pAV-CREB and si-periostin, the expressions of collagen Ⅰ and Ⅲ were attenuated. The expression of periostin was elevated post-MI and participated in MI-induced myocardial fibrosis, which was regulated through CREB. This study provides a novel idea and potential intervention target for MI-induced myocardial fibrosis.
Role of Bone Morphogenetic Protein 4 in the Inflammation of the Myocardium and Vascular Tissue of Obese Mice
Authors: Wu Ting , Chen Liang , Shen Qin , Wang Li , Zong Gang-Jun
Published: February 2022

Bone morphogenetic protein 4 (BMP4) is a proinflammatory factor. The expression of BMP4 is reduced in the adipose and enhanced in the myocardium and vascular during obesity. It is possibly involved in the process of inflammatory response of the myocardium and vascular. Obesity, often regarded as a risk factor for cardiovascular diseases, is a kind of inflammatory response. This study aimed to investigate the relationship of BMP4 with obesity and cardiovascular disease. Ob/ob mice were used as the experimental group, and C57BL/6 mice were used as the control group. The two groups were further divided into 2 subgroups based on the mice carrying adenovirus-encoding shRNA for BMP4 or Lac Z genes. The messenger RNA and protein levels of BMP4, interleukin-1β, and interleukin-9 were significantly higher in the myocardial tissue and aorta of ob/ob+ Lac Z shRNA than those in the other 3 groups, whereas the levels in the ob/ob+ BMP4 shRNA group were significantly decreased and comparable with those in the control groups. BMP4 is significantly upregulated in the myocardial tissue and aorta of obese mice, and this suggests that BMP4 is an risk factor involved in the local inflammatory response.
Propofol Causes Sustained Ca2+ Elevation in Endothelial Cells by Stimulating Ryanodine Receptor and Suppressing Plasmalemmal Ca2+ Pump
Authors: Chuang Chin-Min , Chen Cing-Yu , Yen Pao-Sheng , Wu Cheng-Hsun , Shiao Lian-Ru , Wong Kar-Lok , Chan Paul , Leung Yuk-Man
Published: February 2022

Propofol, a general anesthetic administered intravenously, may cause pain at the injection site. The pain is in part due to irritation of vascular endothelial cells. We here investigated the effects of propofol on Ca2+ transport and pain mediator release in human umbilical vein endothelial cells (EA.hy926). Propofol mobilized Ca2+ from cyclopiazonic acid (CPA)-dischargeable pool but did not cause Ca2+ release from the lysosomal Ca2+ stores. Propofol-elicited Ca2+ release was suppressed by 100 μM ryanodine, suggesting the participation of ryanodine receptor channels. Propofol did not affect ATP-triggered Ca2+ release but abolished the Ca2+ influx triggered by ATP; in addition, propofol also suppressed store-operated Ca2+ entry elicited by CPA. Ca2+ clearance during CPA-induced Ca2+ discharge was unaffected by a low Na+ (50 mM) extracellular solution, but strongly suppressed by 5 mM La3+ (an inhibitor of plasmalemmal Ca2+ pump), suggesting Ca2+ extrusion was predominantly through the plasmalemmal Ca2+ pump. Propofol mimicked the effect of La3+ in suppressing Ca2+ clearance. Propofol also stimulated release of pain mediators, namely, reactive oxygen species and bradykinin. Our data suggest propofol elicited Ca2+ release and repressed Ca2+ clearance, causing a sustained cytosolic [Ca2+]i elevation. The latter may cause reactive oxygen species and bradykinin release, resulting in pain.
Mitochondrial Transplantation: A Unique Treatment Strategy
Authors: Zhou Manli , Yu Yunfeng , Luo Ying , Luo Xiaoxin , Zhang Yifan , Zhou Xiahui , Hu Yilei , Jian Weixiong
Published: February 2022

Mitochondrial transplantation (MT) refers to the process of introducing isolated mitochondria into a damaged area of the heart or other organs. In the past decade, this technique has been continuously updated as the fundamental research on the repair of damaged cells or tissues. In particular, in the field of heart protection from ischemia–reperfusion injury, the MT therapy has been developed to the clinical trial stage. Generally speaking, the goal of therapeutic intervention is to replace damaged mitochondria or increase the transfer of mitochondria between cells so as to improve mitochondrial dysfunction. In this review, we summarized the studies on MT conducted at different time nodes and outlined a range of different methods for delivering mitochondria into the target site. Finally, we described the applications of MT in different diseases and discussed the clinical studies of human MT currently in progress and the problems that need to be overcome. We hope to provide new ideas for the treatment of mitochondrial defect–related diseases.
Classification for Staging and Managing Patients with Biopolymer-induced Human Adjuvant Disease
Authors: Pachón Suárez Jaime Eduardo , Salazar Marcela C. , Rizo Victor Z.
Published: February 2022

Background:

Biopolymer-induced human adjuvant disease (BHAD) is a chronic clinical condition that requires surgical intervention, regardless of the presence of symptoms, to minimize the risk of functional, aesthetic, and systemic sequelae and the development of conditions simulating autoimmune disease. We propose a classification for BHAD on the basis of course of the disease, which will make it possible to assess the damage and difficulty in patients, leading to a more appropriate therapeutic approach.

Methods:

A protocol study was implemented. A casuistry of patients with a diagnosis of autoimmune/inflammatory syndrome induced by adjuvants was taken into account according to the Shoenfeld criteria. Qualitative variables were analyzed through frequencies and percentages, and quantitative variables were analyzed with measures of central tendency and dispersion. The diagnostic validity of the signs and symptoms was analyzed using some paraclinical tests.

Results:

A total of 190 patients diagnosed with autoimmune/inflammatory syndrome induced by adjuvants with biopolymers in the buttocks and who underwent a surgical procedure by the open, masked technique between January 2017 and December 2020 were selected. Considering each sign and symptom, the location of the biopolymers in different planes, and pathophysiology of the clinical course of the disease, a classification was proposed that takes into account diagnostic imaging findings, local clinical signs, systemic symptoms, systemic clinical signs, and autoimmune markers.

Conclusion:

Some signs associated with biomarkers with sensitivity and specificity values can influence the pretest decision to request paraclinicals, improving the diagnostic probability and cost effectiveness in these patients.
Successful Treatment Outcomes for Partial Thickness Burns by Innovative Bovine Peritoneum Dressing
Authors: Tuleubayev Berik E. , Anapiya Baurzhan B. , Kurmangaliyev Yerkin-Dauir T. , Abugaliyev Kabylbek R.
Published: February 2022

In the world practice of treating burns, acellular matrices have been used for quite a long time. However, the budget for treating one burn patient in Kazakhstan does not exceed $1000. This amount does not cover the costs for procurement of foreign-made xenograft dressings. Because the cattle breeding sector is very well-developed in the country, a domestic xenograft is produced by decellularization and sterilization of the cattle peritoneum, which costs only $10. This case report outlines how we used this matrix in a patient with partial thickness burns. A 45-year-old woman was admitted to the burn department with second stage burns on her back and right shoulder. The burn area comprised 10%, according to the Lund Browder chart. Once formal consent was obtained from the patient, an occlusive dressing was applied from the decellularized cattle peritoneum. Good adhesion of the dressing to the wound bed was noted. The patient was discharged from the hospital on the tenth day. It took 23 days to reach complete epithelialization. No adverse effects were noted. We believe that further studies conducted by our research team will allow this innovative, low-cost, easy-to-apply biologic dressing to be widely used in the therapeutic treatment of burns.
EVIDENCE AGAINST A CONTRALATERAL COATS PHENOTYPE BY OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY
Authors: Daruich Alejandra , Zola Marta , Elalouf Martine , Munier Francis L.
Published: February 2022

Purpose:

To evaluate the laterality of Coats disease by analyzing optical coherence tomography angiography features in affected, fellow, and control eyes.

Methods:

Patients with Coats disease who underwent optical coherence tomography angiography were retrospectively reviewed. Healthy eyes of age-matched patients served as controls. Automated optical coherence tomography angiography determination of foveal avascular zone size and vascular density of superficial capillary plexus and deep capillary plexus was recorded.

Results:

Thirty-four patients with Coats disease (13 with bilateral optical coherence tomography angiography) and 24 controls were included. The foveal avascular zone was larger in affected eyes compared with fellow eyes (P = 0.004). Vascular density was decreased in affected eyes compared with fellow eyes in the superficial capillary plexus and deep capillary plexus whole images (P = 0.047 and P = 0.007) and in the deep capillary plexus at the fovea (P = 0.001). Vascular density was significantly reduced only in the deep capillary plexus in Stage 1 or 2A patients but in both plexuses in patients with Stage 2B1. No differences were shown on foveal avascular zone and vascular density values between fellow eyes of patients with Coats disease and controls.

Conclusion:

The foveal avascular zone is enlarged, and vascular density is decreased in affected eyes with Coats disease, but no differences are seen between fellow and control eyes, confirming the unilateral nature of the disease.
PNEUMATIC VITREOLYSIS VERSUS PARS PLANA VITRECTOMY IN FOCAL SYMPTOMATIC VITREOMACULAR TRACTION SYNDROME
Authors: Kumar Vinod , Sonkar Ragini , Verma Saurabh , Azad Shorya Vardhan , Chawla Rohan , Venkatesh Pradeep , Vohra Rajpal , Kumar Atul
Published: February 2022

Purpose:

To compare pneumatic vitreolysis and pars plana vitrectomy in the management of focal symptomatic vitreomacular traction (VMT).

Method:

Patients aged 18 years or older, with idiopathic focal symptomatic VMT and best-corrected visual acuity <20/40, without any other retinal pathology were randomized to undergo pneumatic vitreolysis (Group 1) or pars plana vitrectomy (Group 2). The primary outcome measure was resolution of traction confirmed with optical coherence tomography at 3 months. Secondary outcome measures were to compare changes in best-corrected visual acuity, central foveal thickness, and complications if any.

Results:

A total of 30 eyes of 30 patients were included with 15 eyes in each group. Vitreomacular traction resolved successfully in 12 of 15 (80%) eyes in Group 1 and in all (100%) eyes in Group 2 (P = 0.224). The mean visual acuity improved from 0.80 ± 0.26 (20/126 Snellen's equivalent) to 0.70 ± 0.46 logMAR (20/100 Snellen's equivalent) in Group 1 (P = 0.71) and from 0.904 ± 0.44 (20/160 Snellen's equivalent) to 0.47 ± 0.26 logMAR (20/59 Snellen's equivalent) in Group 2 (P = 0.0016). Although 4 of 15 (26.66%) eyes in Group 1 had formation of full-thickness macular hole and 7 eyes required resurgery (4 for full-thickness macular hole and 3 for unresolved VMT), none in the pars plana vitrectomy group had any complications requiring resurgery (P = 0.0063). Two eyes in the pars plana vitrectomy group had intraoperative deroofing of the fovea leading to full-thickness macular hole.

Conclusion:

Pars plana vitrectomy is better than pneumatic vitreolysis as a single intervention in the management of focal symptomatic VMT.
SUBRETINAL DRUSENOID DEPOSITS AND SOFT DRUSEN
Authors: Thomson Robert J. , Chazaro Joshua , Otero-Marquez Oscar , Ledesma-Gil Gerardo , Tong Yuehong , Coughlin Arielle C. , Teibel Zachary R. , Alauddin Sharmina , Tai Katy , Lloyd Harriet , Scolaro Maria , Govindaiah Arun , Bhuiyan Alauddin , Dhamoon Mandip S. , Deobhakta Avnish , Narula Jagat , Rosen Richard B. , Yannuzzi Lawrence A. , Freund K. Bailey , Smith R. Theodore
Published: February 2022

Purpose:

Soft drusen and subretinal drusenoid deposits (SDDs) characterize two pathways to advanced age-related macular degeneration (AMD), with distinct genetic risks, serum risks, and associated systemic diseases.

Methods:

One hundred and twenty-six subjects with AMD were classified as SDD (with or without soft drusen) or non-SDD (drusen only) by retinal imaging, with serum risks, genetic testing, and histories of cardiovascular disease (CVD) and stroke.

Results:

There were 62 subjects with SDD and 64 non-SDD subjects, of whom 51 had CVD or stroke. SDD correlated significantly with lower mean serum high-density lipoprotein (61 ± 18 vs. 69 ± 22 mg/dL, P = 0.038, t-test), CVD and stroke (34 of 51 SDD, P = 0.001, chi square), ARMS2 risk allele (P = 0.019, chi square), but not with CFH risk allele (P = 0.66). Non-SDD (drusen only) correlated/trended with APOE2 (P = 0.032) and CETP (P = 0.072) risk alleles (chi square). Multivariate independent risks for SDD were CVD and stroke (P = 0.008) and ARMS2 homozygous risk (P = 0.038).

Conclusion:

Subjects with subretinal drusenoid deposits and non-SDD subjects have distinct systemic associations and serum and genetic risks. Subretinal drusenoid deposits are associated with CVD and stroke, ARMS2 risk, and lower high-density lipoprotein; non-SDDs are associated with higher high-density lipoprotein, CFH risk, and two lipid risk genes. These and other distinct associations suggest that these lesions are markers for distinct diseases.
Transitions Out of Early Intervention
Authors: Mahurin-Smith Jamie
Published: February 2022

This study was designed to describe the experience of families exiting the early intervention (EI) system and transitioning into early childhood special education (ECSE) programs. Eight mothers of children preparing to exit EI services completed semistructured interviews, which were transcribed and analyzed using interpretative phenomenological analysis. Four mothers answered additional post-transition interview questions. Interview participants experienced anxiety about the transition process but reported that they found EI personnel to be knowledgeable and supportive allies. Participants also described favorable outcomes related to a structured transition class. These findings indicate that the transition out of EI is associated with parental anxiety and uncertainty, which can be allayed through strong relationships with EI service providers.
Early Elevation and Normalization of Electrode Impedance in Patients With Enlarged Vestibular Aqueduct Undergoing Cochlear Implantation
Authors: Li Lieber Po-Hung , Wei Jeff Jia-Fu , Chen Joshua K. , Wu David Chen-Yin , Coelho Daniel H.
Published: February 2022

Objective:

To characterize early changes in impedance in patients undergoing cochlear implantation with and without enlarged vestibular aqueducts (EVA).

Methods:

Case-control retrospective study of patients undergoing cochlear implantation with and without EVA. Impedance was measured across all channels intraoperatively and within 24 hours of surgery. All patients received the same electrode array.

Results:

Ten patients with EVA (and matched controls were identified). The average intraoperative impedance across all electrodes was significantly higher in patients with EVA (13.1 ± 1.4 kΩ) than in controls (9.6 ± 2.5 kΩ, p 
< 0.001). At 24-hour activation, the average impedance across all electrodes was roughly equal in both groups (6.8 ± 2.7 kΩ versus 6.5 ± 2.1 kΩ, p 
= 0.72)

Conclusions:

This study is the first identify differences in intraoperative impedance between patients with and without EVA. In addition, these data demonstrate rapid normalization within 24 hours of surgery. Such findings can give a window of insight into both the intracochlear microenvironment of patients with EVA and the important early electrode-fluid-tissue interface changes that occur within hours of surgery for all patients.
A Systematic Review of the Effectiveness of Bisphosphonates for Otosclerosis
Authors: Patel Sanjay , Walters Ben , Eastwood Michael , Abou-Foul Ahmad Kamal , Bhimrao Sanjeev
Published: February 2022

Objective:

To systematically review the evidence for the use of bisphosphonate therapy in otosclerosis through clinically relevant outcomes.

Databases Reviewed:

MEDLINE, EMBASE, PubMed, and CINAHL databases were searched up to July 12, 2021.

Methods:

RCTs and cohort studies investigating the effect of bisphosphate therapy on adults or children diagnosed with otosclerosis were included. The risk of bias within trials was examined using the ROB2 tool for RCTs, and the ROBINS-I for non-RCTs.

Results:

Three studies reported over five publications were included in the systematic review. Data from one RCT at 6 months did not demonstrate any improvement nor deterioration in audiological outcomes in participants treated with Sodium Alendronate. Data from MRI in this group demonstrated improvements in the SI of the otosclerotic foci at the RAOW compared to participants taking placebo. In another RCT, improvements in audiological outcomes were seen at 12 and 24 months in individuals treated with Etidronate Sodium. Long-term data from a retrospective cohort study demonstrated stabilisation of hearing in individuals with otosclerosis and progressive SNHL.

Conclusion:

There is insufficient evidence to recommend the routine use of bisphosphonates in otosclerosis patients at present. Long-term retrospective data has suggested a role for bisphosphonates in the subset of patients with deteriorating sensorineural hearing loss with the aim of hearing stabilisation. Adequately powered RCTs with long term follow up will be required to evaluate this further.
Rosai-Dorfman disease with spine involvement
Authors: Jiang Haoran , Song Jipeng , Lin Wancheng , Yi Meng , Yao Mingtao , Ding Lixiang
Published: February 2022

Rationale:

Rosai-Dorfman disease (RDD) is a rare, benign, self-limiting disease, also known as sinus histiocytosis with giant lymphadenopathy. Skeletal involvement is rare, and this isolated bone lesion usually occurs in adults with no other symptoms. It is estimated that 0.6% to 1% of RDD cases have isolated or complicated spinal lesions, which may occur in the bone, dura, and spinal parenchyma, but spinal RDD has no pathologic clinical or imaging features.

Patient concerns:

A 25-year-old woman presented with complaints of low back pain without obvious causes for a month.

Diagnosis:

RDD with spinal involvement.

Interventions:

Resection of the spinous process of the third lumbar spine was performed under epidural anesthesia.

Outcomes:

At the time of discharge, the patient had no problems with autonomous activities and reported no discomfort. We also followed up the patient at 12 and 36 months after surgery, and the patient reported no discomfort, inconvenience, and no recurrence of symptoms. Imaging examination 1 year after surgery showed no recurrence.

Lesson:

This case suggests that surgery for RDD with spinal involvement may not require internal fixation.
A metabolomics strategy to identify potential biomarkers associated with human laryngeal cancer based on dried blood spot mass spectrometry approach
Authors: Wu Xue , Liu Yongting , Ao Huaixuan , Yang Peng , Zhu Zhitu
Published: February 2022

Laryngeal cancer (LC) as one of common malignant tumors in the head and neck region accounted for 1% to 5% of new cancer cases and was ranked as the third otolaryngology cancer. However, some patients with LC were diagnosed at the advanced stage, which can cause delayed diagnosis and treatment. It is an urgent task to seek effective biomarkers for the early diagnosis of LC aimed at alleviating suffering.

A combination of dried blood spot sampling and direct infusion mass spectrometry technology was applied to 39 patients with LC and 53 healthy individuals. Multiple algorithms towards 93 metabolites including amino acids and carnitine/acylcarnitines were run for selecting differential metabolites. Furthermore, leave-one-out cross-validation method was used to evaluate diagnostic performance of selected metabolite biomarkers.

A biomarker panel consisting of arginine, proline, hexacosanoic carnitine, ornithine /citrulline, and 3-hydroxy-octadecenoylcarnitine exhibited potential to distinguish patients with LC from healthy individuals, with a sensitivity of 0.8974 and a specificity of 0.8302 in leave-one-out cross-validation model.

The metabolomic analysis of LC patients is beneficial to screen disease-associated biomarkers and develop new diagnostic approaches.
The effect of ultrasound therapy on lateral epicondylitis
Authors: Luo Dongni , Liu Bingyan , Gao Lini , Fu Shengxin
Published: February 2022

Objective:

Lateral epicondylitis is a common musculoskeletal disorder, and ultrasound therapy is one of the most used treatments in the clinic. The effect remains uncertain, and the present paper aims to figure it out with a meta-analysis.

Methods:

The Pubmed, Cochrane library, and Embase databases were searched for relevant studies published before Jure 1, 2021. Continuous variables were compared by calculating the standard difference of the means, whereas categorical dichotomous variables were assessed using relative risks. A random-effects model was used if the heterogeneity statistic was significant; otherwise, a fixed-effects model was used.

Results:

Thirteen studies were included in the quantitative analysis, including 442 participants (287 ultrasonic treated patients and 155 controls). The VAS scale decreased markedly after ultrasound therapy (P = .027). However, no statistically significant difference could be found between ultrasound therapy and the control groups at all post-treatment time points. Similarly, no benefits could be found when comparing the pre- and post-treatment grip strength with ultrasonic therapy (P = .324). Moreover, though ultrasound treatment always continues for a long time, the present study demonstrated there were no additional benefits when comparing short- and long-term outcomes.

Conclusions:

The ultrasound therapy is helpful to relieve pain for LE patients, but no such benefit could be found for grip strength. However, it has no significant advantage against other conservative treatments like rest and brace.
Risk factors for surgical site infection following spinal surgery
Authors: Zhang Xinxin , Liu Peng , You Jipeng
Published: February 2022

Study design:

A meta-analysis.

Background:

We performed a meta-analysis to explore risk factors of surgical site infection (SSI) following spinal surgery.

Methods:

An extensive search of literature was performed in English database of PubMed, Embase, and Cochrane Library and Chinese database of CNKI and WANFANG (up to October 2020). We collected factors including demographic data and surgical factor. Data analysis was conducted with RevMan 5.3 and STATA 12.0.

Results:

Totally, 26 studies were included in the final analysis. In our study, the rate of SSI after spinal surgery was 2.9% (1222 of 41,624). Our data also showed that fusion approach (anterior vs posterior; anterior vs combined), osteotomy, transfusion, a history of diabetes and surgery, hypertension, surgical location (cervical vs thoracic; lumbar vs thoracic), osteoporosis and the number of fusion levels were associated with SSI after spinal surgery. However, age, sex, a history of smoking, body mass index, fusion approach (posterior vs combined), surgical location (cervical vs lumbar), duration of surgery, blood loss, using steroid, dural tear and albumin were not associated with development of SSI.

Conclusions:

In our study, many factors were associated with increased risk of SSI after spinal surgery. We hope this article can provide a reference for spinal surgeons to prevent SSI after spinal surgery.