bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the presence of markers of decidualization in the fallopian tubes: a systematic review
Authors: Aljassim F , Georgopoulou N , Rigby C H , Powell S G , Wyatt J N R , Hapangama D K , Hill C J
Published: June 2023

The fallopian tubes (FTs) are part of the female upper genital tract. The healthy FT provides the biological environment for successful fertilization and facilitates the subsequent movement of the conceptus to the endometrial cavity. However, when the FT is damaged, as with salpingitis, pyosalpinx, and hydrosalpinx, it may increase the risk of an ectopic pregnancy, a life-threatening condition. Decidualization refers to a multifactorial process by which the endometrium changes to permit blastocyst implantation. The decidualization reaction is vital for endometrial receptivity during the window of implantation. To date, no comprehensive review that collates evidence on decidualization in the human FT has been conducted. Therefore, the aim of this review is to compile the current evidence on cellular decidualization occurring in the healthy and pathological FT in women of reproductive age. A literature search was conducted using five databases and identified 746 articles, 24 of which were analyzed based on inclusion and exclusion criteria. The available evidence indicates that the FT are able to undergo decidual changes under specific circumstances; however, the exact mechanism by which this occurs is poorly understood. Further research is needed to elucidate the mechanism by which decidualization can occur in the FT.
“Morning Glories of the Night”: Angela Carter’s Translational Poetics in Fireworks
Authors: Hennard Dutheil de la Rochère Martine
Published: June 2023

Translation plays a central role as a creative method in Angela Carter’s Fireworks (1974). The collection of stories showcases Carter’s multilingual musings on the word hanabi by opening with “A Souvenir of Japan,” which records a brief moment of bliss during the Japanese summer festival, captured in the image of the “morning glories of the night.” It then builds on its literary and cultural resonances in English, French, and Japanese to form a variegated bouquet of stories linked by the flower motif that gives the collection its aesthetic identity. Infused by Carter’s experience of Japan and memories of Baudelaire, Buñuel, and Bashō, Fireworks exemplifies Carter’s translational poetics as a mode of writing blossoming across intertwined languages, cultures, and art forms.
Implementation Lessons Learned: Distress Behaviors in Dementia Intervention in Veterans Health Administration
Authors: Curyto Kim , Wray Laura O , Sullivan Jennifer L , McConnell Eleanor S , Jedele Jenefer M , Minor Lisa , Karel Michele J
Published: June 2023

Background and Objectives

Evidence-based practices to manage distress behaviors in dementia (DBD) are not consistently implemented despite demonstrated effectiveness. The Veterans Health Administration (VA) trained teams to implement Staff Training in Assisted Living Residences (STAR)-VA, an intervention to manage DBD in VA nursing home settings, or Community Living Centers (CLCs). This paper summarizes multiyear formative evaluation results including challenges, adaptations, and lessons learned to support sustained integration into usual care across CLCs nationwide.

Research Design and Methods

STAR was selected as an evidence-based practice for DBD, adapted for and piloted in VA (STAR-VA), and implemented through a train-the-trainer program from 2013 to 2018. Training and consultation were provided to 92 CLC teams. Evaluation before and after training and consultation included descriptive statistics of measures of clinical impact and survey feedback from site teams regarding self-confidence, engagement, resource quality, and content analysis of implementation facilitators and challenges.

Results

STAR-VA training and consultation increased staff confidence and resulted in significant decreases in DBD, depression, anxiety, and agitation for Veterans engaged in the intervention. Implementation outcomes demonstrated feasibility and identified facilitators and barriers. Key findings were interpreted using implementation frameworks and informed subsequent modifications to sustain implementation.

Discussion and Implications

STAR-VA successfully prepared teams to manage DBD and resulted in improved outcomes. Lessons learned include importance of behavioral health–nursing partnerships, continuous engagement, iterative feedback and adaptations, and sustainment planning. Evaluation of sustainment factors has informed selection of implementation strategies to address sustainment barriers. Lessons learned have implications for integrating team-based practices into system-level practice.
Building a Program Theory of Implementation Using Process Evaluation of a Complex Quality Improvement Trial in Nursing Homes
Authors: Ginsburg Liane R , Easterbrook Adam , Massie Ariane , Berta Whitney , Doupe Malcolm , Hoben Matthias , Norton Peter , Reid Colin , Song Yuting , Wagg Adrian , Estabrooks Carole
Published: June 2023

Background and Objectives

Significant quality problems exist in long-term care (LTC). Interventions to improve care are complex and often have limited success. Implementation remains a black box. We developed a program theory explaining how implementation of a complex intervention occurs in LTC settings—examining mechanisms of impact, effects of context on implementation, and implementation outcomes such as fidelity.

Research Design and Methods

Concurrent process evaluation of Safer Care for Older Persons in residential Environments (SCOPE)—a frontline worker (care aide) led improvement trial in 31 Canadian LTC homes. Using a mixed-methods exploratory sequential design, qualitative data were analyzed using grounded theory to develop a conceptual model illustrating how teams implemented the intervention and how it produced change. Quantitative analyses (mixed-effects regression) tested aspects of the program theory.

Results

Implementation fidelity was moderate. Implementation is facilitated by (a) care aide engagement with core intervention components; (b) supportive leadership (internal facilitation) to create positive team dynamics and help negotiate competing workplace priorities; (c) shifts in care aide role perceptions and power differentials. Mixed-effects model results suggest intervention acceptability, perceived intervention benefits, and leadership support predict implementation fidelity. When leadership support is high, fidelity is high regardless of intervention acceptability or perceived benefits.

Discussion and Implications

Our program theory addresses important knowledge gaps regarding implementation of complex interventions in nursing homes. Results can guide scaling of complex interventions and future research.
Law, film, and trans identity in Hong Kong
Authors: Wan Marco
Published: June 2023

This article examines the construction of trans identity in Hong Kong law and cinema. By juxtaposing the key Hong Kong court cases on trans rights and some recent feature films on trans experience, it argues that film can reproduce and reinforce the understanding of identity in the court cases, and that they can unwittingly perpetuate the dynamic of exclusion enacted in those cases. Law and popular film may seem to be distinct discursive domains, but their constructions of trans identity are in fact intertwined. The article contends that to break out of these limiting identity formulations, we need to move beyond the dominant imaginaries of law and popular culture. It offers one way of doing so by turning to independent queer filmmaking as a forum for articulating and recognizing alternative trans subjectivities.
Combinatorial Influence of Bone Marrow Aspirate Concentrate (BMAC) and Platelet-Rich Plasma (PRP) Treatment on Cutaneous Wound Healing in BALB/c Mice
Authors: Mohammed Rebar N , Aziz Sadat Sadat Abdulla , Hassan Snur M A , Mohammed Hawraz Farhad , Ramzi Derin Omer
Published: June 2023

Bone marrow, a soft spongy tissue, is containing mesenchymal stem cells, that are well-recognized according to their self-renewability and stemness. Therefore, we hypothesized that bone marrow aspirate concentrate (BMAC) could have a pivotal influence on the process of wound healing in particular when it is combined with platelet-rich plasma (PRP). Thirty-six albino mice (BALB/c) were used in the study and they were grouped as negative-control, PRP treated, BMAC treated and BMAC plus PRP treated. An incisional wound (1 cm2) was made at the back of mouse and their wounds were treated according to their treatment plan and group allocations. Later, the skin at the treated wound sites was collected on days 7, 14, and 21 for histopathological investigation. The results showed that there was a statistically significant difference in BMAC+PRP-treated wounds over the rest of the treated groups in the acceleration of wound healing throughout the experiment by increasing the rate of wound contraction, re-epithelization process, and granulation tissue intensity with fluctuated infiltration in the number of the neutrophils, macrophages, and lymphocytes, also restoration of the epidermal and dermal thickness with less scarring and hair follicle regeneration vs to the negative-control, PRP and BMAC only treated groups. Our findings indicated that BMAC containing mesenchymal stem cells is an efficient approach, which can be used to enhance a smooth and physiopathological healing process, especially when it is used in combination with PRP.
Safe insertion of Veress needle for the induction of pneumoperitoneum: a technical note
Authors: Alam Fahreyar , Badminton Rebecca , Tsvetkov Filip , Hanif Zulfiqar , Payne Richard
Published: June 2023

Techniques for the induction of pneumoperitoneum for laparoscopic surgery remain varied as complication risk remains with all techniques. Veress needle is used for the induction of pneumoperitoneum as a technique of preference or when an open technique is considered challenging as in obese patients. We present a novel safe technique for insertion of Veress needle by measuring the depth of the anterior abdominal wall prior to insertion. Accurate measurements help in the safe insertion of the Veress needle for inducing pneumoperitoneum and hence reduce the incidence of intra-abdominal injuries.
Connection Between Sleep and Psychological Well-Being in U.S. Army Soldiers
Authors: Holmes Kristen E , Fox Nadia , King Jemma , Presby David M , Kim Jeongeun
Published: June 2023

Introduction

The goal of this exploratory study was to examine the relationships between sleep consistency and workplace resilience among soldiers stationed in a challenging Arctic environment.

Materials and Methods

A total of 862 soldiers (67 females) on an Army base in Anchorage, AK, were provided WHOOP 3.0, a validated sleep biometric capture device and were surveyed at onboarding and at the conclusion of the study. Soldiers joined the study from early January to early March 2021 and completed the study in July 2021 (650 soldiers completed the onboarding survey and 210 completed the exit survey, with 151 soldiers completing both). Three comparative analyses were conducted. First, soldiers’ sleep and cardiac metrics were compared against the general WHOOP population and a WHOOP sample living in AK. Second, seasonal trends (summer versus winter) in soldiers’ sleep metrics (time in bed, hours of sleep, wake duration during sleep, time of sleep onset/offset, and disturbances) were analyzed, and these seasonal trends were compared with the general WHOOP population and the WHOOP sample living in AK. Third, soldiers’ exertion, sleep duration, and sleep consistency were correlated with their self-reported psychological functioning. All analyses were conducted with parametric and non-parametric statistics. This study was approved by The University of Queensland Human Research Ethics Committee (Brisbane, Australia) Institutional Review Board.

Results

Because of the exploratory nature of the study, the critical significance value was set at P < .001. Results revealed that: (1) Arctic soldiers had poorer sleep consistency and sleep duration than the general WHOOP sample and the Alaskan WHOOP sample, (2) Arctic soldiers showed a decrease in sleep consistency and sleep duration in the summer compared to that in the winter, (3) Arctic soldiers were less able to control their bedroom environment in the summer than in the winter, and (4) sleep consistency but not sleep duration correlated positively with self-report measures of workplace resilience and healthy social networks and negatively with homesickness.

Conclusions

The study highlights the relationship between seasonality, sleep consistency, and psychological well-being. The results indicate the potential importance of sleep consistency in psychological functioning, suggesting that future work should manipulate factors known to increase sleep consistency to assess whether improved sleep consistency can enhance the well-being of soldiers. Such efforts would be of particular value in an Arctic environment, where seasonality effects are large and sleep consistency is difficult to maintain.
Progress in the Typhoid Conjugate Vaccine Program Rollout Supported by Gavi During the COVID-19 Pandemic and the Path Forward
Authors: Russell Allyson L , Hampton Lee M , Sinha Antara , Luquero Francisco J , Abdelwahab Jalaa’
Published: June 2023

Gavi supports countries to introduce typhoid conjugate vaccine (TCV) with catch-up campaigns. Available TCVs are highly efficacious, equity-focused, and critical to curbing the expansion of antimicrobial resistance. Four Gavi-supported countries have introduced TCVs since 2018. In the wake of the COVID-19 emergency, momentum is building to scale up TCV introduction worldwide, supported by global partners and Gavi’s funding for improved typhoid diagnostics.
Diagnostics for Typhoid Fever: Current Perspectives and Future Outlooks for Product Development and Access
Authors: Sapkota Jyotshna , Roberts Tamalee , Basnyat Buddha , Baker Stephen , Hampton Lee M , Dittrich Sabine
Published: June 2023

Typhoid is an enteric disease caused by Salmonella Typhi. Like many febrile illnesses, typhoid presents with nonspecific symptoms. In routine healthcare settings in low- and middle-income countries, typhoid fever is suspected and treated empirically. Though many diagnostic tests are available for typhoid diagnosis, there are currently no diagnostic tests that meet ideal requirements for sensitivity, specificity, speed, and cost-effectiveness. With introduction of typhoid conjugate vaccine, it is essential to explore the current and future typhoid approach in the context of use case and access to ensure their utilization for disease control.
What Should We Be Recommending for the Treatment of Enteric Fever?
Authors: Parry Christopher M , Qamar Farah N , Rijal Samita , McCann Naina , Baker Stephen , Basnyat Buddha
Published: June 2023

Patients with suspected enteric (typhoid and paratyphoid) fever are predominantly managed as outpatients in endemic regions. Nonspecific clinical presentation, lack of accurate diagnostic tools, and widespread antimicrobial resistance makes management challenging. Resistance has been described for all antimicrobials including chloramphenicol, amoxycillin, trimethoprim-sulfamethoxazole, ciprofloxacin, ceftriaxone, and azithromycin. No significant differences have been demonstrated between these antimicrobials in their ability to treat enteric fever in systematic reviews of randomized controlled trials (RCTs). Antimicrobial choice should be guided by local resistance patterns and national guidance. Extensively drug-resistant typhoid isolates require treatment with azithromycin and/or meropenem. Combining antimicrobials that target intracellular and extracellular typhoid bacteria is a strategy being explored in the Azithromycin and Cefixime in Typhoid Fever (ACT-SA) RCT, in progress in South Asia. Alternative antimicrobials, such as the oral carbapenem, tebipenem, need clinical evaluation. There is a paucity of evidence to guide the antimicrobial management of chronic fecal carriers.
Achieving Impact: Charting the Course to Meet the Challenges Ahead at the 12th International Conference on Typhoid and Other Invasive Salmonelloses
Authors: Greear Jade A , Steele A Duncan , Garrett Denise O
Published: June 2023

Typhoid fever and other invasive salmonelloses remain a major public health concern, primarily in low- and middle-income countries in Asia and Africa, where transmission occurs through contaminated food or water. However, recent developments in research, policy, and implementation offer newfound optimism for prevention and control. Now, more than ever, a coordinated and multisectoral global response is needed. To chart the course to meet the challenges ahead, the Coalition against Typhoid, housed at the Sabin Vaccine Institute, virtually organized the 12th International Conference on Typhoid and Other Invasive Salmonelloses from December 7 to 9, 2021. This commentary provides an overview of the conference's significant findings, highlighting barriers and opportunities for prevention and control. Topics covered include diagnostics advancements, improved data methodologies for a better understanding of the disease burden, the incorporation of environmental surveillance and genomics, the threat of drug resistance, and the use of typhoid conjugate vaccines alongside other integrated solutions.
Currency Risk Premiums Redux
Authors: Nucera Federico , Sarno Lucio , Zinna Gabriele
Published: June 2023

We study a large currency cross-section using asset pricing methods that account for omitted-variable and measurement-error biases. First, we show that the pricing kernel includes at least three latent factors that resemble (but are not identical to) a strong U.S. “dollar” factor and two weak high Sharpe ratio “carry” and “momentum” slope factors. Evidence for an additional “value” factor is weaker. Second, using this pricing kernel, we find that only a small fraction of the over 100 nontradable candidate factors considered have a statistically significant risk premium, mostly relating to volatility, uncertainty, and liquidity conditions, rather than macro variables.

Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Modern Midwifery and Maternal Mortality in Urban China, 1920s–1940s
Authors: Li Minghui
Published: June 2023

This article investigates the history of midwifery from the 1920s to 1940s in China through looking at the linkage between modern midwifery and maternal mortality in urban areas. It first shows that people’s perceptions of maternal mortality and its causes changed from the nineteenth to the twentieth century, and that a modern form of midwifery service took shape in the Republican era (1912–49) in order for reducing maternal mortality rate and building a strong nation. Evidence from urban areas of Beijing and Sichuan between the 1920s and the 1940s demonstrates that the practice of modern midwifery varied with medical infrastructure and personnel in different places, and that modern midwives in small towns may practise against the rules, taking the initiative to use forceps and perform surgery to save mothers’ lives. The relationship between modern midwifery and maternal mortality in the researched period was more complex than medical experts’ anticipation.
Combinatorial islet protective therapeutic approaches in β‐cell transplantation: Rationally designed solutions using a target product profile
Authors: Lu Katie , Brauns Timothy , Sluder Ann E. , Poznansky Mark C. , Dogan Fatma
Published: June 2023

While progress has been made in the development of islet cell transplantation (ICT) as a viable alternative to the use of exogenous insulin therapy in the treatment of type 1 diabetes, it has not yet achieved its full potential in clinical studies. Ideally, ICT would enable lifelong maintenance of euglycemia without the need for exogenous insulin, blood glucose monitoring or systemic immune suppression. To achieve such an optimal result, therapeutic approaches should simultaneously promote long‐term islet viability, functionality, and localized immune protection. In practice, however, these factors are typically tackled individually. Furthermore, while the requirements of optimal ICT are implicitly acknowledged across numerous publications, the literature contains few comprehensive articulations of the target product profile (TPP) for an optimal ICT product, including key characteristics of safety and efficacy. This review aims to provide a novel TPP for ICT and presents promising tried and untried combinatorial approaches that could be used to achieve the target product profile. We also highlight regulatory barriers to the development and adoption of ICT, particularly in the United States, where ICT is only approved for use in academic clinical trials and is not reimbursed by insurance carriers. Overall, this review argues that the clear definition of a TPP in addition to the use of combinatorial approaches could help to overcome the clinical barriers to the widespread adoption of ICT for the treatment of type 1 diabetes.
Increasing Diversity in the Physician Workforce: Pathway Programs and Predictive Analytics
Authors: Mayrath Michael , Fontanez Darah , Abdelbaset Ferrahs , Lenihan Bryan , Lenihan David V.
Published: June 2023

Problem

Lack of diversity in the physician workforce has well-documented negative impacts on health outcomes. Evidence supports the use of pathway or pipeline programs to recruit underrepresented in medicine students. However, data on how a pathway program should deliver instruction are lacking. This report describes a multiyear project to build such a system with the goal of increasing diversity within medical school cohorts and ultimately the physician workforce.

Approach

In the 2015–2016 academic year, the Ponce Health Sciences University started a 3-phase project to create a data-driven medical school feeder system by coupling a pathway program with predictive analytics. Phase 1 launched the pathway program. Phase 2 developed and validated a predictive model that estimates United States Medical Licensing Examination (USMLE) Step 1 performance. Phase 3 is underway and focuses on adoption, implementation, and support.

Outcomes

Data analysis compared 2 groups of students (pathway vs direct) across specific factors, including Medical College Admission Test (MCAT) score, undergraduate grade point average (GPA), first-generation status, and Step 1 exam performance. Statistically significant differences were found between the 2 groups on the MCAT exam and undergraduate GPA; however, no significant differences were found between groups for first-generation status and performance on the Step 1 exam. This finding supports the authors’ hypothesis that although pathway students have significantly lower mean MCAT exam scores compared with direct students, pathway students perform just as well on the USMLE Step 1 exam.

Next Steps

Next steps include expanding the project to another campus, adding more socioeconomic status and first-generation data, and identifying best curricular predictors. The authors recommend that medical school programs use pathway programs and predictive analytics to create a more data-centered approach to accepting students with the goal of increasing physician workforce diversity.
The impact of the Dobbs decision on in-vitro fertilization and fertility care
Authors: Ulker Ashley , Evans M Blake , Craig LaTasha B.
Published: June 2023

Purpose of review

The 2022 Supreme Court ruling in Dobbs vs Jackson marks a frightening new reality in America. Physicians and patients have been left confused and concerned regarding the broader implications of this ruling. Now that the constitutional right to an abortion has been overturned and the power has been relinquished to individual states, there is justifiable concern regarding the impact on in-vitro fertilization (IVF). This review explores the ways IVF and fertility care are at risk in the context of our new reality.

Recent findings

The decision to overturn the right to an abortion without specifying a viability standard opens the door to interpretation of when ‘life’ begins. Laws that do not specifically exempt IVF, or that include language suggesting that ‘life begins at fertilization’ pose a real threat to IVF. The potential for personhood laws poses a threat to embryo freezing and disposition, preimplantation genetic testing and culpability among other concerns.

Limitations to IVF may become an unintended consequence to the Dobbs decision, making IVF less efficient, more costly and unsafe, and inevitably limiting access to care. It is therefore crucial that public health legislation be rooted in science and not dictated by religion or politics. Physicians must act alongside legislators to protect reproductive freedom and access to care.
HBV screening among West Africans living in the US: Influences of stigma, health literacy, and self-efficacy
Authors: Perumalswami Ponni V , Belemkoabga Assita , Joseph Lovely , Erblich Joel , Jandorf Lina
Published: June 2023

Background:

Applying theoretically informed constructs using an adaptation of the “Theory of Planned Behavior,” this study assessed social-cognitive and sociocultural determinants of HBV screening among West Africans living in the US to inform solutions to testing gaps.

Methods:

We developed and administered a theory-based survey in both English (41%) and French (59%) from September 2021 to April 2022 to a sample of West African-born individuals (n = 162). Predictors of HBV screening included: attitudes, perceived behavioral control or self-efficacy, and subjective norms along with health literacy (HL), language proficiency, and stigma of HBV infection. We hypothesized that these constructs would predict HBV testing. We also conducted path analytic modeling to better understand both direct and indirect effects of key factors on HBV screening status.

Results:

West Africans who completed the survey in English were younger with less education and lower income, whereas those who completed the survey in French reported higher HBV-related stigma. In a bivariate analysis of factors associated with HBV screening by language, less education was associated with lower HBV screening in English speakers. Adequate HL, higher self-efficacy, and higher English language proficiency were independently associated with HBV screening. Path analysis to better understand the interplay between social-cognitive and sociocultural factors revealed HL and stigma both had indirect effects on screening, mediated by differences in self-efficacy.

Conclusions:

This study identified HL and stigma as key indirect factors that influence HBV screening by way of self-efficacy in West Africans in the US. This work is a first step to identifying barriers that can lead to the development of an evidence-based intervention aimed at increasing HBV screening of West Africans to address health disparities.
Primary biliary cholangitis: Epidemiology, prognosis, and treatment
Authors: Trivella Juan , John Binu V. , Levy Cynthia
Published: June 2023

Primary biliary cholangitis (PBC) is a chronic cholestatic autoimmune liver disease characterized by a destructive, small duct, and lymphocytic cholangitis, and marked by the presence of antimitochondrial antibodies. The incidence and prevalence of PBC vary widely in different regions and time periods, and although disproportionally more common among White non-Hispanic females, contemporary data show a higher prevalence in males and racial minorities than previously described. Outcomes largely depend on early recognition of the disease and prompt institution of treatment, which, in turn, are directly influenced by provider bias and socioeconomic factors. Ursodeoxycholic acid remains the initial treatment of choice for PBC, with obeticholic acid and fibrates (off-label therapy) reserved as add-on therapy for the management of inadequate responders or those with ursodeoxycholic acid intolerance. Novel and repurposed drugs are currently at different stages of clinical development not only for the treatment of PBC but also for its symptomatic management. Here, we summarize the most up-to-date data regarding the epidemiology, prognosis, and treatment of PBC, providing clinically useful information for its holistic management.
Scleral thickness in the fellow eyes of patients with unilateral central serous chorioretinopathy
Authors: Aichi Takaaki , Terao Nobuhiro , Imanaga Naoya , Sawaguchi Shota , Wakugawa Sorako , Miyara Yasunori , Oshiro Ayano , Yamauchi Yukihide , Koizumi Hideki
Published: June 2023

Purpose:

The sclera is reportedly thicker in eyes with central serous chorioretinopathy (CSC) than in healthy control eyes. We compared the scleral thicknesses of the affected and unaffected fellow eyes of patients with unilateral CSC.

Methods:

We retrospectively examined the findings of 115 patients with unilateral CSC. Comparisons of the spherical equivalent (SE), axial length, anterior chamber depth (ACD), subfoveal choroidal thickness (SCT), scleral thickness, and presence of peripheral ciliochoroidal effusion (CE) of the affected and fellow eyes were made. Using anterior segment optical coherence tomography, scleral thickness was measured vertically, 6 mm posterior to the scleral spur in the superior, temporal, inferior, and nasal directions.

Results:

No significant differences in scleral thickness in all four directions, SE, axial length, ACD, and frequency of CE were found between the affected and unaffected fellow eyes. The only significant difference between the affected and fellow eyes was observed in the SCT (398.8 µm vs. 346.6 µm, P < 0.001).

Conclusion:

A thickened choroid seems to have a direct effect on CSC development. In contrast, the affected and fellow eyes showed no significant difference in scleral thickness, indicating that scleral thickening may be a predisposing factor for the development of CSC.
Presentation of a Smooth Muscle Hamartoma in the Bulbar Conjunctiva of an Adolescent Boy: A Case Report and Review of Literature
Authors: Sayegh Yoseph , Tang Vincent , Khzam Rayan Abou , Rosenberg Andrew E. , Blessing Nathan , Dubovy Sander
Published: June 2023

Purpose:

The aim of this study was to describe a novel presentation of conjunctival smooth muscle hamartoma and review the histopathologic findings of this entity.

Methods:

A 17-year-old African American adolescent boy presented with a pink, nontender lesion of the right bulbar conjunctiva that did not improve with medical management. He had no previous medical or ocular history. The lesion was excised.

Results:

Histopathologic examination disclosed morphologically benign smooth muscle bundles within the substantia propria that stained positively for smooth muscle actin, vimentin, and desmin consistent with the diagnosis of a smooth muscle hamartoma.

Conclusions:

Although congenital smooth muscle hamartomas of the conjunctiva have been rarely reported in the literature, this is the first described case of a smooth muscle hamartoma presenting in adolescence in the bulbar conjunctiva. This lesion should be considered in the differential diagnosis for adolescents with similar appearing lesions.
Fusarium Keratitis From a Comprehensive Eye Health Care Facility in South India: Molecular Characterization by MALDI-TOF Versus Polymerase Chain Reaction Sequencing, Species Complex Distribution, and Clinical Correlation
Authors: Bagga Bhupesh , Das Sourav , Tawde Yamini , Singh Shreya , Shaw Tushar , Sharma Savitri , Ghosh Anup
Published: June 2023

Purpose:

Fusarium keratitis possesses significant diagnostic and therapeutic challenges. Medically relevant Fusaria belong to various species complexes and show prominent differences in their antifungal susceptibility profile which may influence the clinical outcome. Rapid diagnostic methods are warranted for precise identification of species complexes for prompt initiation of correct antifungals. The aim of the study was to compare between matrix-assisted laser desorption/ionization–time of flight (MALDI-TOF) and polymerase chain reaction sequencing for correct species-level identification and to analyze the clinical outcome among different Fusarium species complexes.

Methods:

Twenty-nine culture-proven Fusarium keratitis cases were included in this study. A phylogenetic tree was constructed after TEF1α gene sequencing and isolates were subjected to MALDI-TOF MS, followed by database expansion and identification. Clinical outcome and risk association among species complexes were analyzed retrospectively.

Results:

Maximum likelihood phylogeny categorized 68.9% isolates as Fusarium solani species complex (FSSC), 17.2% as Fusarium dimerum species complex (FDSC), followed by 13.7% as Fusarium fujikuroi species complex (FFSC). With extended database, MALDI-TOF MS could correctly speciate 96.5% (28/29) isolates. Previous antibiotic usage (P = 0.034) and preoperative antifungal treatment with natamycin, voriconazole, or ketoconazole (P = 0.025) were significantly higher in the FSSC group. The patients in the FFSC group had a significantly longer duration of symptoms at the time of clinical presentation to the clinic (15 days vs. 5 days, P = 0.030). Among 11 patients with a clinically poor outcome, 9 (31%) had FSSC infection.

Conclusions:

Patients infected with the FSSC had more aggressive infection with poor prognosis. MALDI-TOF MS can serve as the best alternative method to conventional molecular identification with reduced turnaround time, which may help the ophthalmologists to consider the appropriate antifungals or early surgical intervention for improved outcome.
Hypervirulent Strains of Neisseria meningitidis and Clinical Manifestations in Children With Invasive Meningococcal Disease
Authors: Rivacoba María Carolina , Villena Rodolfo , Hormazabal Juan Carlos , Benadof Dona , Payá Ernesto , Valdivieso Francisca , Canals Andrea , Arteta-Acosta Cindy , Santolaya María Elena
Published: June 2023

Background:

Hypervirulent clonal complex (cc) have been associated with higher incidence and case fatality rate of invasive meningococcal disease (IMD). The aim of this study was to describe the clinical manifestations of the hypervirulent cc of meningococcus in children.

Methods:

Retrospective study in patients hospitalized by IMD microbiologically confirmed at three children’s tertiary health care centers in Santiago, Chile, between 2010 and 2018. Demographic, clinical information and determination of the cc and factor H binding protein (fHbp) alleles were performed.

Results:

In total 93 cases were evaluated, sequence typing was available for 91 cases, and 87 (95.6%) had a cc assigned; 63.7% were MenW and 31.8% MenB. The median age was 9 months, 67% were male and 18.7% had any comorbidity. A 26.4% presented neurological deficit, 25.3% petechiae and 20% diarrhea. Sixty-seven percent were admitted to the pediatric intensive care unit (PICU) and the case fatality rate was 9.9%. Regarding cc and fHbp alleles, ST11, ST41/44 and allele 22 were the most frequently identified, with 63.7%, 19.8% and 72.5%, respectively. We found statistically significant differences between the cc and presence of petechiae, diagnosis of meningococcemia plus meningitis, admission and days in PICU and advanced support. Allele 22 for fHbp was associated with the absence of petechiae, low suspicion of IMD, less diagnosis of meningitis+meningococcemia, PICU admission, advanced support and adrenal insufficiency.

Conclusion:

Epidemiological and microbiological surveillance of IMD should integrate clinical and laboratory components, including molecular and genetic characterization, to enrich the dynamic understanding of the clinical evolution of IMD.
Early Abortions and Congenital Malformations
Authors: de Fátima Alvim Braga Isabel , Cozendey-Silva Eliana Napoleão , Ertler Laila Zelkcovicz , dos Santos Martins Thiago Gonçalves , da Silva Santos Sabrina , Silva Bruno de Avilla da Fonseca e , Assumpção Lia Roque , Waissmann William
Published: June 2023

Introduction

Areas with higher agricultural production have higher rates of abortion and malformation, probable related to pesticides.

Objective

To compare the rates of early abortion and fetal malformation in agricultural and nonagricultural areas.

Method

A survey was carried out on fetal deaths in children weighing less than 500 g or gestational age less than 22 weeks and fetal malformations in live births.

Results

From 1996 to 2018, there was an increase in the rates of abortion and, albeit to a lesser extent, malformation. The areas of greater agricultural production have higher rates of fetal mortality and malformation than the others.

Conclusions

The study suggests that areas with higher use of pesticides have higher rates of abortion and fetal malformations than the others, requiring further observational studies, reducing confounders inherent to the ecological study.
Preoperative C-reactive protein-to-albumin ratio as a prognostic factor in biliary tract cancer: A systematic review and meta-analysis
Authors: Utsumi Masashi , Inagaki Masaru , Kitada Koji , Tokunaga Naoyuki , Kondo Midori , Yunoki Kosuke , Sakurai Yuya , Hamano Ryosuke , Miyasou Hideaki , Tsunemitsu Yousuke , Otsuka Shinya
Published: June 2023

Background:

The preoperative C-reactive protein-to-albumin ratio is a novel inflammation-based prognostic marker in various cancers. However, its prognostic role in biliary tract cancer is unknown. We conducted a systematic review and meta-analysis to evaluate the prognostic value of preoperative C-reactive protein-to-albumin ratio in biliary tract cancer.

Methods:

A systematic search of the literature for studies evaluating the prognostic value of C-reactive protein-to-albumin ratio in patients undergoing surgery for biliary tract cancer was conducted, and a random effects meta-analysis of overall survival and recurrence-free survival was performed.

Results:

Nine studies with 1292 participants were included. The preoperative C-reactive protein-to-albumin ratio negatively correlated with overall survival (hazard ratio, 2.44 [95% confidence interval: 1.98–2.90]; P < .001) and recurrence-free survival (hazard ratio, 2.73 [95% confidence interval: 2.01–3.70]; P < .001). Subgroup analysis showed that an elevated preoperative C-reactive protein-to-albumin ratio predicted poor overall survival, regardless of the cutoff value, sample size, histological type, and treatment.

Conclusion:

An elevated preoperative C-reactive protein-to-albumin ratio is significantly associated with poor prognosis in patients undergoing surgery for biliary tract cancer. The C-reactive protein-to-albumin ratio may be an independent prognostic biomarker for overall survival and recurrence-free survival in patients undergoing surgery for biliary tract cancer.
Multiple surgical treatment comparisons for irreparable rotator cuff tears: A network meta-analysis
Authors: Zhou Xin , Zhang Xiaohua , Jin Xianrong , Deng Jialin , Zhang Zhongzu , Yu Yating
Published: June 2023

Background:

To evaluate the effect of different surgical methods in the treatment of patients with irreparable rotator cuff tears (IRCTs) using a network meta-analysis.

Methods:

A search of the PubMed, EMbase, The Cochrane Library, VIP, WanFang Data, and CNKI databases was performed in January 2023 to search for randomized controlled trials and cohort studies of different surgical methods in the treatment of IRCTs. Risk assessment of the included randomized controlled trials was conducted using the risk of bias assessment tool recommended by the Cochrane Manual, and the Newcastle-Ottawa Scale was used for the risk assessment of cohort studies. Data were analyzed and plotted using Stata 15.0 software.

Results:

A total of 17 studies involving 2123 patients and 10 surgical methods were included in this study. According to the surface under the cumulative ranking curve, the probability ranking in descending order is latissimus dorsi transfer (LDT) + partial repair > LDT > reverse total shoulder arthroplasty > superior capsular reconstruction > patch > partial repair > debridement + tenotomy of the long head of the biceps > debridement > in space subacromial balloon spacer + tenotomy of the long head of the biceps > in space subacromial balloon spacer.

Conclusion:

Among the multiple surgical treatments for patients with IRCTs, LDT + partial repair may have the best effect, and more randomized controlled trials with larger sample sizes are needed for further verification.
Involvement of NY-ESO-1 and MAGE-A4 in the pathogenesis of desmoid tumors
Authors: Hashimoto Kazuhiko , Nishimura Shunji , Shinyashiki Yu , Ito Tomohiko , Kakinoki Ryosuke , Akagi Masao
Published: June 2023

The involvement of New York esophageal squamous cell carcinoma-1 (NY-ESO-1) and melanoma-associated antigen A4 (MAGE-A4) in soft-tissue sarcoma pathogenesis has recently been reported; however, their involvement in desmoid tumors (DTs) remains unknown. This study aimed to determine the involvement of NY-ESO-1 and MAGE-A4 in DTs. Immunostaining for β-catenin, NY-ESO-1, and MAGE-A4 was performed on DT biopsy specimens harvested at our institution. The positivity rate for each immune component was calculated. In addition, the correlations between the positivity rates for the immune molecules were investigated. The correlation between the positivity rate and age or longest diameter of each immune molecule was also investigated. β-catenin showed staining mainly in the tumor cell nuclei of DTs. Both NY-ESO-1 and MAGE-A4 showed staining in the nucleus, cytoplasm, and infiltrating lymphocytes of DT cells. The mean positive cell rates for β-catenin, NY-ESO-1, and MAGE-A4 were 43.9 ± 21.7, 30 ± 21.6, and 68.9 ± 20.8, respectively. A strong negative correlation was observed between β-catenin and MAGE-A4 positivity rates (r = −0.64). The positivity rates for NY-ESO-1 and MAGE-A4 showed a moderate positive correlation (r = −0.42). A very strong negative correlation was observed between age and the NY-ESO-1 positivity rate (r = −0.72). A weak negative correlation was observed between age and the MAGE-A4 positivity rate (r = −0.28). A medium negative correlation was observed between the longest tumor diameter and NY-ESO-1 positivity (r = −0.37). NY-ESO-1 and MAGE-A4 may be involved in the DT microenvironment. Thus, NY-ESO-1 and MAGE-A4 may be useful in the diagnosis of DT.
Thermal stimulation with meridian points for enhanced recovery after spine surgery: A PRISMA-compliant protocol for network meta-analysis of randomized controlled trials
Authors: Kim Jung-Hyun , Goo Bonhyuk , Seo Byung-Kwan
Published: June 2023

Background:

Enhanced recovery after surgery programs are widely known as a far-reaching approach to help patients with surgeries recover rapidly by giving optimized care. However, especially in the spine medicinal domain, relevant studies are scarce. In order to manage proper recovery after surgery, practitioners need to take a comprehensive look at the suppression of pain, strategies for improving the results of surgery, improving the quality of life, and mental support of patients. To this end, a recovery-enhancing program through integrated medical technology which covers both conventional and Korean medicine is highly required. We want to develop an integrated medical program that covers a wide range of medicinal domains for the early recovery of patients after spinal surgery. The aim of the present study is to check out which thermal stimulation with meridian points are more effective than others to enhance recovery after spinal surgery.

Methods:

The following online databases will be retrieved in the present study: PubMed; Scopus; the Cochrane Central Register of Controlled Trials; Ovid MEDLINE; Ovid EMBASE; Chinese Biomedical Literature Database; China National Knowledge Infrastructure; and Chinese Scientific Journal Database (VIP database). We will independently classify articles and will encapsulate characteristics of the study components. Primary outcomes will be categorized into visual analog scale, Tolerance to liquid and solid diet, postoperative hospitalization period, and quality of life. Secondary outcomes will be analyzed based on the study findings.

Results and Conclusion:

The results of this study will be submitted to a peer-reviewed journal for publication. Furthermore, the outcomes of this study would afford the documentation of whether thermal stimulation on meridian points can be effective for enhanced recovery after spine surgery.
Sudden unilateral corneal clouding in diabetic patient: A case report and literature review
Authors: Xu Man , Wu Shujuan , Niu Xiaoguang
Published: June 2023

Rationale:

Corneal opacity can be caused by various disease. Generally, the opacity gradually increases as the disease progresses. Sudden corneal opacity is mainly caused by corneal trauma, toxic drugs entering the cornea, or acute edema of the keratoconus. However, sudden corneal opacity caused by diabetes has not been reported.

Patient concerns:

A 60-year-old man reported blurred vision and the black eye became white in appearance in the left eye for 5 days. The patient had a history of diabetes which had not been treated.

Diagnoses:

He underwent slit-lamp examination, anterior segment optical coherence tomography, ultrasound bio microscopy, B-mode ultrasound, corneal endothelial examination, random blood glucose testing, and other examinations. The diagnosis of Diabetic Keratopathy was made.

Interventions:

Topical glucocorticoids and dilating eye drops were administered and undergo blood sugar control treatment.

Outcomes:

The corneal of the patient was completely transparent in a few days, and the flocculent exudation in the anterior chamber disappeared.

Lessons:

Although diabetes generally causes chronic corneal edema, acute corneal edema may also occur when blood sugar is poorly controlled. Therefore, when we see sudden corneal opacity without obvious incentives, we must consider systemic diseases, especially diabetes.
Sleep quality and related influencing factors in adult hypertensive patients in Shandong Province, China
Authors: Gou Fuyue , Zhong Xia , Jiao Huachen
Published: June 2023

Hypertension is a leading cause of death worldwide. Hypertension is associated with poor sleep quality, which adversely affects physical and mental health, and can increase the incidence rate and mortality of cardiovascular disease, cancer, and depression. This study aimed to investigate the prevalence of the factors related to poor sleep quality in hypertensive patients in Shandong Province, China. This cross-sectional study of adult patients with hypertension from August 2020 to February 2021was conducted in 10 cooperative hospitals in Shandong Province, China. Information was collected in the form of a questionnaire. In this study, Pittsburgh sleep quality index was used to evaluate sleep quality. A multivariate logistic regression model was used to analyze the risk of poor sleep quality. Variables with a P value < 0.05 and a 95% confidence interval (CI) were considered statistically significant. A total of 528 patients with hypertension were included, ranging in age from 31 to 90 years old. The prevalence of poor sleep quality among study participants with hypertension was 319 (60.4%) (95% CI: 0.562–0.646). Female gender (adjusted odds ratios [AOR] = 3.231; 95% CI: 2.194–4.757), stage III blood pressure (AOR = 2.142; 95% CI: 1.108–4.141), mental labor, and labor both physical and mental (AOR = 1.639; 95% CI:1.03–2.611 and AOR = 1.632; 95% CI: 1.030–2.584), unstable marriage (AOR = 3.203; 95% CI: 1.026–9.997) and the very Low-density Lipoprotein (odds ratios = 0.776; 95% CI: 0.649–0.928) were significantly associated with poor sleep quality. This study preliminarily showed that poor sleep quality was a common problem in hypertensive patients, and more than half of the hypertensive patients had poor sleep quality. Poor sleep quality was significantly correlated with gender, hypertension level, occupation, marital status, and the very Low-density Lipoprotein. Considering the negative impact of sleep quality, appropriate strategies should be developed to prevent and treat poor sleep quality in hypertensive patients.