bluuebunny/crossref_metadata_2025 huggingface dataset:
Glycemic control level alters working memory neural dynamics in adults with type 2 diabetes
Authors: Embury Christine M , Lord Grace H , Drincic Andjela T , Desouza Cyrus V , Wilson Tony W
Published: April 2023

Poor glycemic control in type 2 diabetes has been associated with accentuated age-related cognitive decline, although the underlying neural mechanisms are not well understood. The current study sought to identify the impact of glycemic control on the neural dynamics serving working memory in adults with type 2 diabetes. Participants (n = 34, ages = 55–73) performed a working memory task while undergoing MEG. Significant neural responses were examined relative to poorer (A1c > 7.0%) or tighter glycemic control (A1c < 7.0%). Those with poorer glycemic control showed diminished responses within left temporal and prefrontal regions during encoding and showed diminished responses within right occipital cortex during maintenance but showed an enhanced activity in the left temporal, occipital, and cerebellar regions during maintenance. Notably, left temporal activity in encoding and left lateral occipital activity in maintenance significantly predicted performance on the task such that diminished temporal activity led to longer reaction times, which were driven by the poorer glycemic control group. Greater lateral occipital activity during maintenance was associated with both lower accuracy and longer reaction times across all participants. These findings suggest that glycemic control has a robust impact on the neural dynamics serving working memory, with distinct effects by subprocess (e.g. encoding vs. maintenance) and direct effects on behavior.
A case report of infective endocarditis in a 52-year-old female with unrepaired tricuspid atresia and d-transposition of the great arteries
Authors: Karmali Rehan , Mazumder Samia , Berglund Felix , Fuchs Margaret M
Published: April 2023

Background

d-Transposition of the great arteries (d-TGA) is a congenital cardiac defect that is typically fatal. Those patients who survive without surgical repair and who are rare in number, need adequate intracardiac shunting and will suffer from chronic cyanosis. Here, we present a rare case of an adult with unrepaired cyanotic congenital heart disease (CHD) who developed infective endocarditis (IE) and also our approach to the medical decision-making process in this uncommonly encountered dilemma.

Case summary

A 52-year-old female with unrepaired d-TGA with tricuspid atresia, hypoplastic right ventricle, unrestricted atrial septal defect, ventricular septal defect, and sub-valvular as well as valvular pulmonic stenosis with a hypoplastic, bicuspid pulmonary valve presented with abdominal pain and hypoxia and was found to have an acute renal infarct. Transthoracic echocardiogram (TTE) revealed a large mobile mass on the mitral valve. Blood cultures grew Streptococcus mitis-oralis and she was diagnosed with streptococcal native mitral valve IE complicated by a renal embolus. Her large left-sided vegetation and embolic phenomenon favoured surgery. However, a right heart catheterization showed normal intracardiac pressures, likely a result of multi-level obstruction relating to sub-valvular and valvular pulmonary stenosis protecting the pulmonary vasculature from over-circulation and pulmonary hypertension. Cardiac surgery posed a significant risk of destabilizing her delicately balanced haemodynamics. Hence, she was treated with ceftriaxone for 4 weeks. A repeat TTE 8 weeks later showed a resolution of the vegetation.

Discussion

A decision for surgery vs. medical treatment for IE in adult patients with compensated CHD should be made following a multi-disciplinary assessment of each patient’s unique cardiac haemodynamics and after shared decision-making with the patient.
Peripheral location of lung cancer is associated with higher local disease recurrence
Authors: Fourdrain Alex , Anastay Vassili , Pauly Vanessa , Braggio Cesare , D'Journo Xavier-Benoit , Boulate David , Thomas Pascal-Alexandre
Published: April 2023

OBJECTIVES

Our goal was to evaluate the association between the distance of the tumour to the visceral pleura and the rate of local recurrence in patients surgically treated for stage pI lung cancer.

METHODS

We conducted a single-centre retrospective review of 578 consecutive patients with clinical stage IA lung cancer who underwent a lobectomy or segmentectomy from January 2010 to December 2019. We excluded 107 patients with positive margins, previous lung cancer, neoadjuvant treatment and pathological stage II or higher status or for whom preoperative computed tomography (CT) scans were not available at the time of the study. The distance between the tumour and the closest visceral pleura area (fissure/mediastinum/lateral) was assessed by 2 independent investigators who used preoperative CT scans and multiplanar 3-dimensional reconstructions. An area under the receiver operating characteristic curve analysis was performed to determine the best threshold for the tumour/pleura distance. Then multivariable survival analyses were used to assess the relationship between local recurrence and this threshold in relation to other variables.

RESULTS

Local recurrence occurred in 27/471 patients (5.8%). A cut-off value of 5 mm between the tumour and the pleura was determined statistically. In the multivariable analysis, the local recurrence rate was significantly higher in patients with a tumour-to-pleura distance ≤5 mm compared to patients with a tumour-to-pleura distance >5 mm (8.5% vs 2.7%, hazard ratio 3.36, 95% confidence interval: 1.31–8.59, P = 0.012). Subgroup analyses of patients with pIA and tumour size ≤2 cm identified local recurrences in 4/78 patients treated with segmentectomy (5.1%), with a significantly higher occurrence with tumour-to-pleura distances ≤5 mm (11.4% vs 0%, P = 0.037), and in 16/292 patients treated with lobectomy (5.5%) without significant higher occurrence in tumour-to-pleura distances of ≤5 mm (7.7% vs 3.4%, P = 0.13).

CONCLUSIONS

The peripheral location of a lung tumour is associated with a higher rate of local recurrence and should be taken into account during preoperative planning when considering segmental versus lobar resection.
Off the mark? What we (should) know about the bright and dark sides of corporate trademark practices
Authors: Castaldi Carolina
Published: April 2023

Corporate trademark practices play a key role in the intangible reputation-based economy and are increasingly being scrutinized by societal stakeholders. Yet, research on the effects of trademarks has mostly focused on private returns, while insights on their societal returns are scattered and resting on limited empirical evidence. This study integrates existing research in a framework connecting suggested mechanisms to the available evidence. The integrative framework lays bare clear gaps in our theoretical understanding and the empirical support, with the dark sides of corporate trademark practices being critically under-investigated. Based on this analysis, I propose a research agenda stemming from two broad questions: (i) how do corporate trademark practices deal with societal pressures? and (ii) how do corporate trademark practices enable or hinder competition and innovation? The envisioned research lines bear relevance for organizations, society, and research alike.
Stage identification and strategy optimization of industrial evolution of China’s digital economy supporting low-carbon effect
Authors: Yang Yanping , Wang Bojun
Published: April 2023

Developing low-carbon economy is an inherent requirement for China's sustainable development, and digital economy is an important engine for China's economy to reduce carbon emission intensity in the new development stage. Identifying the industrial evolution law of China's digital economy is helpful to diagnose its development opportunity, tap the ‘green potential’ and provide strategic support for the digital economy to play the low-carbon effect. Based on the data of China's digital industrialization and industry digitization from 2001 to 2020, the development level of China's digital economy industry was analyzed by logistic curve estimation, and the evolution stage of China's digital economy industry was determined by the characteristic points of the curve. The results showed that, before 2008, China's digital economy industry was in the germination period; from 2009 to 2035, China's digital economy industry is in the period of accelerating growth; from 2036 to 2062, China's digital economy industry will be in the mature stage; after 2062, it will enter a period of decline. The above analysis results are basically in line with the requirements of China's ‘strategic plan to become a high-income country by 2035’ and ‘strategic goal of achieving carbon neutrality by 2060’. Finally, according to the carbon emission reduction development demand of China's digital economy in the ‘growth period’, it is pointed out that it is urgent for China to continue to promote the construction of digital infrastructure, achieve green digital technology innovation, improve the social digital literacy level and increase the proportion of renewable energy application.
Community pharmacists’ roles in providing contraceptive services: views and experiences of adolescents in urban Khon Kaen, Northeast Thailand
Authors: Andajani Sari , Chanthasukh Sansanee , Fairbairn-Dunlop Peggy , Smith John F
Published: April 2023

Objectives

Adolescent pregnancy is a national public health priority in Thailand. While contraceptive methods are available to prevent adolescent pregnancy, Thai adolescent contraceptive usage is low. Community pharmacists are likely the first health professionals to contact adolescents engaged in unprotected sex and needing emergency contraception. However, there is limited research on Thai pharmacists’ roles in promoting sexual and reproductive health. This study examines Thai adolescents’ perspectives on community pharmacists’ roles in promoting contraceptives and preventing unwanted pregnancies.

Method

This qualitative study recruited 38 adolescents aged 15–19 from one vocational school and one secondary school in Khon Kaen, Thailand. Data were collected from focus group discussions and in-depth interviews and analysed using thematic analysis.

Key findings

Participants felt community pharmacists had potentially critical roles in promoting adolescent contraceptive use. Community pharmacists had relevant knowledge of effective contraceptive methods, the risks and benefits of each method, and the quality of different condoms available. Community pharmacists, at times, also provided emotional support to distressed adolescents who came to their store. However, participants reported pharmacists’ age, gender, and non-empathetic and judgemental attitudes could be barriers to adolescents’ ease of access to contraceptive services.

Conclusion

This study highlights the potentially crucial role community pharmacists could play in providing contraceptive information for adolescents. It suggests the need for changes in government policies and education and training of community pharmacists to enhance their soft skills – empathetic and non-judgemental attitudes – and their roles in delivering youth-friendly sexual and reproductive health services.
pyPheWAS Explorer: a visualization tool for exploratory analysis of phenome-disease associations
Authors: Kerley Cailey I , Nguyen Tin Q , Ramadass Karthik , Cutting Laurie E , Landman Bennett A , Berger Matthew
Published: April 2023

Objective

To enable interactive visualization of phenome-wide association studies (PheWAS) on electronic health records (EHR).

Materials and Methods

Current PheWAS technologies require familiarity with command-line interfaces and lack end-to-end data visualizations. pyPheWAS Explorer allows users to examine group variables, test assumptions, design PheWAS models, and evaluate results in a streamlined graphical interface.

Results

A cohort of attention deficit hyperactivity disorder (ADHD) subjects and matched non-ADHD controls is examined. pyPheWAS Explorer is used to build a PheWAS model including sex and deprivation index as covariates, and the Explorer’s result visualization for this model reveals known ADHD comorbidities.

Discussion

pyPheWAS Explorer may be used to rapidly investigate potentially novel EHR associations. Broader applications include deployment for clinical experts and preliminary exploration tools for institutional EHR repositories.

Conclusion

pyPheWAS Explorer provides a seamless graphical interface for designing, executing, and analyzing PheWAS experiments, emphasizing exploratory analysis of regression types and covariate selection.
Clinical and serological correlation of systemic sclerosis in Moroccan patients
Authors: Ouazahrou Kaoutar , El Bakkouri Jalila , Souali Manal , Jeddane Leila , Mokhantar Khaoula , Errami Abderrahmane , El Kabli Hassan , Bousfiha Ahmed Aziz , Echchilali Khadija
Published: April 2023

Objective

SSc is a CTD characterized by excessive fibrosis of the skin and internal organs, along with microvascular damage, and is often associated with typical autoantibodies. The aim of this study was to analyse the correlation between specific autoantibody profiles, clinical and paraclinical features in Moroccan patients with SSc.

Methods

We analysed the presence of specific autoantibodies in 46 SSc patients using IIF on HEp-2 cells and immunodot. We then correlated the types of autoantibodies with clinical and laboratory manifestations.

Results

Among our patients, 86.9% were females. The mean age of patients at diagnosis was 50.21 years, with an average delay to diagnosis of 5 years. The main clinical manifestations found were RP (89.2%), sclerodactyly (84.8%), proximal scleroderma (67.4%), gastrointestinal involvement (50%) and interstitial lung disease (30.4%). According to the specific autoantibody profile, 14 patients were anti-topo I positive (30.4%), 8 anti-RNP (68 kDa/A/C) positive (17.4%) and 6 anti-RNA polymerase III positive (13%). We found a significant association of anti-RNA polymerase III with sclerodactyly and pulmonary arterial hypertension (P < 0.05). We also found an association between anti-topo I and interstitial lung disease in 30.4% of patients. There was no significant association between the positivity for the autoantibodies and other diagnosed clinical manifestations.

Conclusion

Some clinical manifestations of SSc might be positively correlated with the presence of specific autoantibodies. Environmental factors, ethnicity and gene interaction might also influence this correlation.
Idiosyncratic Volatility, Growth Options, and the Cross-Section of Returns
Authors: Barinov Alexander , Chabakauri Georgy
Published: April 2023

The value effect and the idiosyncratic volatility (IVol) discount arise because growth firms and high IVol firms beat the CAPM during periods of increasing aggregate volatility (market volatility and average IVol), that makes their risk low. All else equal, growth options’ value increases with volatility, an effect that is stronger for high IVol firms, for which growth options take a larger fraction of the firm value and firm volatility responds more to aggregate volatility changes. The factor model with the market factor, the market volatility risk factor, and the average IVol factor explains the value effect and the IVol discount.

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.
Recombinant humanized collagen remodels endometrial immune microenvironment of chronic endometritis through macrophage immunomodulation
Authors: You Shuang , Zhu Yun , Li Hu , He Fan , Liu Shuaibin , Yang Xia , Wang Li , Zeng Hui , Dai Jingcong , Hu Lina
Published: April 2023

Recently, evidence has suggested that chronic endometritis (CE) is a crucial factor associated with infertility and failure of assisted reproductive techniques, prompting concern in the reproductive field. Studies have shown that persistent infiltered immune cells stimulation result in the disturbance of endometrial immune microenvironment could lead to the infertility of CE patients finally. Conventional treatments are limited because they lack immune regulation, so it is urgent to develop a novel approach to treat CE and promote embryo implantation in patients with CE. Herein, we prepared recombinant humanized type III collagen (rhCol III) with high cell adhesion activity to regulate macrophages and repair the endometrium. In this study, M1 macrophages and M1 macrophages cultured medium and lipopolysaccharide (LPS) co-stimulated inflammatory endometrium stromal cells (ESCs) were established in vitro to mimic CE condition. rhCol III promoted M1 macrophages toward M2 phenotype, improved cell migration, viability and collagen components of inflammatory ESCs. Also, the inflammatory response of inflammatory ESCs was downregulated after rhCol III treatment. Subsequently, LPS was used for CE rat model and a 28-day observation was performed; inflammatory cells’ infiltration, endometrium repair, extracellular matrix (ECM) remodeling and pregnancy outcomes were promoted after rhCol III endometrial infusion. In conclusion, rhCol III promoted (i) macrophage polarization toward M2 macrophages, (ii) pro-inflammatory cytokine production and anti-inflammatory cytokine reduction, (iii) ECM remodeling and (iv) fertility restoration. Meanwhile, rhCol III enhanced cell biological functions by interacting with discoidin domain receptors, regulated cell metabolism and reduced the inflammatory response through the inhibition of the NF-κB/YAP signaling pathway. Overall, the results illustrated the potential therapeutic prospects of rhCol III for CE treatment.
Process evaluation of Dulce Digital-Me: an adaptive mobile health (mHealth) intervention for underserved Hispanics with diabetes
Authors: Spierling Bagsic Samantha R , Savin Kimberly L , Soriano Emily C , San Diego Emily Rose N , Orendain Natalia , Clark Taylor , Sandoval Haley , Chichmarenko Mariya , Perez-Ramirez Perla , Farcas Emilia , Godino Job , Gallo Linda C , Philis-Tsimikas Athena , Fortmann Addie L
Published: April 2023

Type 2 diabetes disproportionately impacts ethnic minorities and individuals from low socioeconomic status. Diabetes self-management education and support has been shown to improve clinical outcomes in these populations, and mobile health (mHealth) interventions can reduce barriers to access. Dulce Digital-Me (DD-Me) was developed to integrate adaptive mHealth technologies to enhance self-management and reduce disparities in the high-risk, underserved Hispanic population. The objective of the present study was to evaluate reach, adoption, and implementation of an mHealth diabetes self-management education and support intervention in this underrepresented population. The present analysis is a multimethod process evaluation using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. The study was effective in reaching a sample that was representative of the intended population; only modest but significant differences were observed in sex and age. The DD-Me health coach (HC) cited several important facilitators of intervention adoption, including outreach frequency and personalization, and the automated HC report. Implementation fidelity was high, with participants receiving >90% of intended interventions. Participants who received DD-Me with support from a HC were most engaged, suggesting utility and acceptability of integrating HCs with mHealth interventions. Perceptions of implementation among study participants were positive and consistent across study arms. This evaluation revealed the target population was successfully reached and engaged in the digital health interventions, which was implemented with high fidelity. Further studies should evaluate the efficacy and maintenance of the study following the RE-AIM model to determine whether this intervention warrants expansion to additional settings and populations.
Flavonoid brachydin B decreases viability, proliferation, and migration in human metastatic prostate (DU145) cells grown in 2D and 3D culture models
Authors: Serpeloni Juliana Mara , Ribeiro Diego Luis , Weiss Gabriela Fátima , de Oliveira Larissa Cristina Bastos , Fujiike Andressa Yuri , Nunes Higor Lopes , da Rocha Claudia Quintino , Guembarovski Roberta Losi , Cólus Ilce Mara de Syllos
Published: April 2023

Brachydin B (BrB) is a unique dimeric flavonoid extracted from Fridericia platyphylla (Cham.) LG Lohmann with different biological activities. However, the antitumoral potential of this flavonoid is unclear. In our study, we evaluated the effects of the BrB flavonoid on cell viability (MTT, resazurin, and lactate dehydrogenase assays), proliferation (protein dosage and clonogenic assay), and migration/invasion (3D ECM gel, wound-healing, and transwell assays) of metastatic prostate (DU145) cells cultured both as traditional 2D monolayers and 3D tumor spheroids in vitro. The results showed that the BrB flavonoid promotes cytotoxic effects from ≥1.50 μM after 24 h of treatment in DU145 cells in monolayers. In 3D prostate tumor spheroids, BrB also induced cytotoxic effects at higher concentrations after longer treatment (48, 72, and 168 h). Furthermore, BrB treatment is associated with reduced DU145 clonogenicity in 2D cultures, as well as decreased area/volume of 3D tumor spheroids. Finally, BrB (6 μM) reduced cell migration/invasion in 2D monolayers and promoted antimigratory effects in DU145 tumor spheroids (≥30 μM). In conclusion, the antitumoral and antimigratory effects observed in DU145 cells cultured in 2D and 3D models are promising results for future studies with BrB using in vivo models and confirm this molecule as a candidate for metastatic prostate cancer therapy.
Host Invasion Type Is a Phylogenetically Conserved Characteristic of Cephaleuros
Authors: Huang Yu-Cheng , Tsai Cheng-Yu , Wang Chih-Li
Published: April 2023

Cephaleuros species cause algal spot diseases, also known as red rust diseases, on many plants, including fruit crops. Most algal species are defined based on their morphological characteristics. Recent phylogenetic studies of Cephaleuros species showed that morphological determination was not congruent with phylogeny. Our study examined the phylogenetic congruence of the host invasion types (or growth habits), which are the most critical characteristics in the taxonomy of Cephaleuros. To ensure that host invasion types and phylogenetic characteristics could be inferred from the same isolate, host invasion types were assessed using microanatomical observation, and rRNA sequences from the same algal spot and/or the derived algal cultures were compared. Host invasion types were found to be conserved classification traits and were congruent with Cephaleuros phylogeny. The results also indicated that more than one Cephaleuros species commonly grew on the same leaf or, in a few cases, the same algal spot, suggesting that identification using different algal spots could result in misidentification. The Cephaleuros isolates were separated into two species complexes by host invasion types: the C. virescens species complex (CVSC) with subcuticular host invasion type and the C. parasiticus species complex (CPSC) with intercellular host invasion type. Molecular phylogenetic analysis indicated that Cephaleuros isolates clustered into 14 clades of CVSC and three clades of CPSC. This study also identified 16 and eight new hosts of CVSC and CPSC in Taiwan, respectively.
Verbal Behavior of Mothers With Opioid Use Disorder While Feeding Infants With Neonatal Opioid Withdrawal Syndrome
Authors: Rinaldi Kailey , Maguire Denise
Published: April 2023

Background:

An infant's cognitive development is highly dependent on early interactions with its primary caregiver, often its mother. Feeding, a frequent and early exchange between mothers and infants, is an important time for maternal–infant bonding. Mothers with opioid use disorder have been found to be more physically and verbally stimulating and more active during feeds than mothers with no opioid use.

Purpose:

The purpose of this study was to describe the characteristics of verbal interactions mothers with opioid use disorder expressed while engaged in a feeding encounter with their infant undergoing treatment for neonatal opioid withdrawal syndrome to offer insight into maternal experiences and potential challenges of feeding infants experiencing withdrawal.

Methods:

A qualitative descriptive analysis of maternal verbalizations during the feeding was used in a secondary analysis using the Barnard Model as the theoretical framework for maternal–infant interaction.

Results:

A theory-driven deductive approach was assumed to organize the identified subthemes within the concepts of the Barnard Model. Mothers frequently commented on hunger, satiation, and stress cues, while providing consolation, praise, and encouragement. Mothers expressed concerns regarding feeding volume and pace, and consequences related to feeding.

Implications for Practice and Research:

It is crucial that clinicians remember that feeding is an important time for maternal–infant bonding. Further research into the feeding interactions of mother–infant dyads with opioid exposure is warranted. As infants may present with subacute signs of withdrawal, including persistent feeding difficulties for months, further investigation into feeding challenges dyads experience after discharge from the hospital is needed.
Practice Changes Among Patients Without COVID-19 Receiving Mechanical Ventilation During the Early COVID-19 Pandemic
Authors: Shankar Divya A. , Bosch Nicholas A. , Walkey Allan J. , Law Anica C.
Published: April 2023

OBJECTIVES:

The COVID-19 pandemic led to rapid changes in care delivery for critically ill patients, due to factors including increased numbers of ICU patients, shifting staff roles, and changed care locations. As these changes may have impacted the care of patients without COVID-19, we assessed changes in common ICU practices for mechanically ventilated patients with non-COVID acute respiratory failure at the onset of and during the COVID-19 pandemic.

DESIGN:

Interrupted time series analysis, adjusted for seasonality and autocorrelation where present, evaluating trends in common ICU practices prior to the pandemic (March 2016 to February 2020), at the onset of the pandemic (April 2020) and intra-pandemic (April 2020 to December 2020).

SETTING:

Premier Healthcare Database, containing data from 25% of U.S. discharges from January 1, 2016, to December 31, 2020.

PATIENTS:

Patients without COVID-19 receiving mechanical ventilation for acute respiratory failure.

INTERVENTIONS:

We assessed monthly rates of chest radiograph (CXR), chest CT scans, lower extremity noninvasive vascular testing (LENI), bronchoscopy, arterial catheters, and central venous catheters.

MEASUREMENTS AND MAIN RESULTS:

We identified 742,096 mechanically ventilated patients without COVID-19 at 545 hospitals. At the onset of the pandemic, CXR (–0.5% [–0.9% to –0.2%; p = 0.001]), LENI (LENI: –2.1% [–3.3% to –0.9%; p = 0.001]), and bronchoscopy rates (–1.0% [–1.5% to –0.6%; p < 0.001]) decreased; use of chest CT increased (1.5% [0.5–2.5%; p = 0.006]). Use of arterial lines and central venous catheters did not change significantly. Intra-pandemic, LENI (0.5% [0.3–0.7%; p < 0.001]/mo) and bronchoscopy (0.1% [0.05–0.2%; p < 0.001]/mo) trends increased relative to pre-pandemic trends, while the remainder of practices did not change significantly.

CONCLUSIONS:

We observed several statistically significant changes to practice patterns among patients without COVID-19 early during the pandemic. However, most of the changes were small or temporary, suggesting that routine practices in the care of mechanically ventilated patients in the ICU was not drastically affected by the pandemic.
Cytoplasmic poly(A)-binding protein 1 as a biomarker to assist early diagnosis and prognosis of esophageal squamous cell carcinoma in endoscopic biopsy fragments
Authors: Li Xiaochen , Xu Shengen , Sun Xingwang , Long Wenbo
Published: April 2023

Objective

Esophageal squamous cell carcinoma (ESCC) has high mortality worldwide, but its early diagnosis and prognosis are very difficult. Cytoplasmic poly(A)-binding protein 1 (PABPC1) plays an important role in regulating most cellular processes, resulting in a close relationship to tumor genesis and malignant development. Therefore, this work aimed to evaluate the clinical value of PABPC1 as a biomarker for the early diagnosis and prognosis of ESCC in endoscopic patients.

Methods

A total of 185 patients with lesions found by endoscopy were involved in this study, including 116 finally diagnosed with ESCCs and 69 with nonmalignant lesions. Biopsy fragments and surgical specimens were collected to assess PABPC1 expression by immunohistochemistry, and the association between the expression and survival was analyzed and compared in both samples.

Results

The average ratio of positive tumor cells to total tumor cells in the biopsy fragments was lower than that in surgical specimens, leading to a cutoff value of only 10% for the former in ROC analysis (AOC = 0.808, P < 0.001). However, PABPC1 high expression (PABPC1-HE) in both biopsy fragments and surgical specimens was associated with poor survival. When PABPC1 expression was used as a biomarker to diagnose ESCC in biopsy fragments, sensitivity, specificity, positive predictive value, and negative predictive value reached 44.8, 100.0, 100.0, and 51.9%, respectively. Among the 116 ESCC patients, 32 received postoperative concurrent chemoradiotherapy. Postoperative treatment increased the overall survival (OS) but not disease-free survival in lymph node-positive patients (P = 0.007 and 0.957, respectively). Nevertheless, PABPC1-HE predicted shorter OS regardless of the postoperative treatment in both endoscopic biopsy samples and surgical specimens.

Conclusion

PABPC1 expression can be used as a biomarker to detect ESCC from endoscopic lesions. At the same time, PABPC1-HE is a predictor of poor survival regardless of postoperative chemoradiotherapy in endoscopic biopsy samples of ESCC.
It’s electric! An environmental equity perspective on the lifecycle of our energy sources
Authors: Willis Mary D. , Cushing Lara J. , Buonocore Jonathan J. , Deziel Nicole C. , Casey Joan A.
Published: April 2023

Energy policy decisions are driven primarily by economic and reliability considerations, with limited consideration given to public health, environmental justice, and climate change. Moreover, epidemiologic studies relevant for public policy typically focus on immediate public health implications of activities related to energy procurement and generation, considering less so health equity or the longer-term health consequences of climate change attributable to an energy source. A more integrated, collective consideration of these three domains can provide more robust guidance to policymakers, communities, and individuals. Here, we illustrate how these domains can be evaluated with respect to natural gas as an energy source. Our process began with a detailed overview of all relevant steps in the process of extracting, producing, and consuming natural gas. We synthesized existing epidemiologic and complementary evidence of how these processes impact public health, environmental justice, and climate change. We conclude that, in certain domains, natural gas looks beneficial (e.g., economically for some), but when considered more expansively, through the life cycle of natural gas and joint lenses of public health, environmental justice, and climate change, natural gas is rendered an undesirable energy source in the United States. A holistic climate health equity framework can inform how we value and deploy different energy sources in the service of public health.
Patterns of Opioid Demand after Operative Treatment of Distal Radius Fractures
Authors: Lee Nayun , Le Elliot L.H. , Constantine Ryan , Iorio Matthew L.
Published: April 2023

Background:

The purpose of this study was to evaluate opioid demand after open reduction and internal fixation of distal radius fractures in patients with and without a diagnosis of cannabis use.

Methods:

The PearlDiver database was queried for all patients who underwent open reduction and internal fixation of distal radius fractures between 2010 and 2020. Patients were categorized into two groups: (1) those with an active diagnosis of cannabis use (case) and (2) those without (control). The primary outcome measure was morphine milligram equivalents per prescription filled within 30 days after surgery. A logistic regression was used to determine potential risk factors associated with increased opioid filling patterns.

Results:

The rates of prescription refills before and after surgery were congruent in both the case and control populations and did not show significant differences (P > 0.05). The average morphine milligram equivalents of patients’ first opioid prescription was significantly reduced in the case population compared with the control (352.26 versus 480.61 morphine milligram equivalents/prescription, P = 0.005). A history of chronic opioid use was the strongest predictor of prolonged opioid prescription refills after surgery.

Conclusions:

This study found a significant reduction in opioid volume in patients with a diagnosis of cannabis use who filled an opioid prescription after open reduction and internal fixation of distal radius fractures. Mental health diagnoses, specifically depression, showed an increased risk of multiple opioid prescription refills in patients without a diagnosis of cannabis use.
Thread Lifting of the Nose: Fully Comprehensive Approach to the Technique
Authors: Sulamanidze Constantin , Lanfranchi Luciano , Diaspro Alberto
Published: April 2023

Background:

Nose thread lifting is a relatively recent technique. It offers a chance to approach nose morphology defects without turning to surgery to obtain a temporary improvement. Nevertheless, it lacks standardization and it can therefore offer quite variable results and short durability. The authors’ experience is presented here along with a recommended methodological approach to deliver reliable techniques for predictable results. Thread lifting techniques for nose reshaping by means of insertion of poly-L-lactic/poly-caprolactone threads are presented, based on principles of graft-based techniques, to obtain temporary morphological correction of selected nose deformities.

Methods:

A total of 553 patients underwent nose reshaping using poly-L-lactic/poly-caprolactone threads. Of the procedures, 471 were primary treatment, and 82 were secondary treatment after a previous rhinoplasty. The mean follow-up period was carried out through patient photographs and lasted 33.4 months (range 2–60 months). Clinical examinations and patient satisfaction surveys were done at 6 months and 1 year from thread lifting.

Results:

The Freiburg questionnaire survey (subjective Global Aesthetic Improvement Scale) allowed the authors to confirm a 95% satisfaction rate after 6 months, and 62% at 1 year after treatment. A flow chart based on the recorded results is presented to support operators in selecting the proper correction method to adopt, based on the different listed indications.

Conclusions:

Nose reshaping techniques with poly-L-lactic/poly-caprolactone threads are presented together with patients’ treatment satisfaction. Standardization is based upon the authors’ experience. Contraindications and encountered complications are discussed, so as to provide the readers with a complete “state-of-the art” presentation of these techniques. In the authors’ experience, this is a reliable and safe approach to obtain temporary amelioration of selected nose defects via a nonsurgical and minimally invasive method.
NovoSorb Biodegradable Temporizing Matrix for Reconstruction of Multiplanar Degloving Injury of the Upper Limb
Authors: Knightly Nauar , de Blacam Catherine
Published: April 2023

Originally described as “wringer injuries” by MacCollum in 1938,
1
traumatic multiplanar degloving injuries that occur as the result of the hand, forearm or arm being drawn between the rollers of a machine are functionally devastating and present a significant reconstructive challenge. Revascularization and comprehensive excision of devitalized bone and soft tissue, followed by appropriate skeletal fixation and vascularized soft tissue cover are the mainstays of management. To date, published case series have described local flaps and free tissue transfer for coverage of wounds that involve exposed vital structures such as nerves, vessels, and tendons.
2
NovoSorb biodegradable temporizing matrix (BTM; PolyNovo Biomaterials Pty Ltd, Melbourne, Australia) is a bilayer bioabsorbable synthetic polymer dermal substitute, which has the ability to integrate into large wound beds and is resistant to infection.
3
BTM comprises a bioabsorbable, polyurethane matrix that allows for cellular infiltration and a temporary nonbiodegradable, nonporous polyurethane layer, which limits moisture loss and provides a barrier to bacteria. Here we describe the successful use of BTM in the staged reconstruction of a high-energy industrial roller injury in an adolescent patient.
Exogenous Ochronosis With Ocular Involvement From Chronic Use of Teavigo
Authors: Vempuluru Vijitha S. , Laiton Andrea , Milman Tatyana , Lee Jason B. , Eagle Ralph C. , Shields Carol L.
Published: April 2023

Exogenous ochronosis refers to accumulation of homogentisic acid metabolites in tissues, manifesting as pigmentation of affected tissues. Phenolic compounds are most commonly implicated, including hydroquinone, quinine, phenol, resorcinol, mercury, and picric acid. The affected connective tissues exhibit brownish discoloration when heavily pigmented and the histopathological appearance is characteristic with “banana-shaped” ochre-colored pigment deposits. Herein, the authors describe a rare case of exogenous ochronosis involving the conjunctiva, sclera and skin, as a result of chronic use of Teavigo (94% epigallocatechin gallate), a polyphenol compound with postulated antioxidant and antiapoptotic activity.
Congenital Orbital Fibrosis With Spontaneous Regression of Orbital Tumor
Authors: Yu Sarah N. , Shteyman Amy R. , Garcia Maria D. , Kazim Michael
Published: April 2023

Congenital orbital fibrosis (COF) is a rare disorder characterized by an infiltrating orbital mass with secondary involvement of the extraocular muscles that may present with extraocular muscle dysfunction, and globe and eyelid abnormalities in infancy. This condition is thought to be a nonprogressive process and literature on longitudinal assessment of COF is limited. The authors describe a case of COF which was followed for 15 years. The patient had stable symptoms of ocular dysmotility and ptosis but was noted to have spontaneous regression of the orbital mass on serial MRI.
Association Between Caregiver Burden and Patient Recovery After Left Ventricular Assist Device Implantation
Authors: Thomas Merrill , Spertus John A. , Andrei Adin-Cristian , Wu Tingqing , Farr Stacy L. , Warzecha Anna , Grady Kathleen L.
Published: April 2023

Introduction

After left ventricular assist device (LVAD) implantation, caregivers may experience increasing burden because of new roles and responsibilities. We examined the association between caregiver burden at baseline and patient recovery after long-term LVAD implantation in patients ineligible for heart transplantation.

Methods

Between October 1, 2015, and December 31, 2018, data from 60 patients with a long-term LVAD (age, 60–80 years) and caregivers through 1 postoperative year were analyzed. Caregiver burden was measured using the Oberst Caregiving Burden Scale, a validated instrument used for measuring caregiver burden. Patient recovery post–LVAD implantation was defined by change in Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12) overall summary score and rehospitalizations over 1 year. Multivariable regression models (least-squares for change in KCCQ-12 and Fine-Gray cumulative incidence for rehospitalizations) were used to assess for association with caregiver burden.

Results

Patients were 69.4 ± 5.5 years old, 85% men, and 90% White. Over the first year post–LVAD implantation, there was a 32% cumulative probability of rehospitalization; 72% (43/60) of patients had an improvement of ≥5 points in KCCQ-12 scores. Caregivers were 61.2 ± 11.5 years old, 93% women, 81% White, and 85% married. Median Oberst Caregiving Burden Scale Difficulty and Time scores at baseline were 1.13 and 2.27, respectively. Higher caregiver burden was not significantly associated with hospitalizations or change in patient health-related quality of life during the first year post–LVAD implantation.

Conclusions

Higher caregiver burden at baseline was not associated with patient recovery in the first year after LVAD implantation. Understanding the associations between caregiver burden and patient outcomes after LVAD implantation is important as excessive caregiver burden is a relative contraindication for LVAD implantation.
Provider and Patient Experiences of Delays in Primary Care During the Early COVID-19 Pandemic
Authors: Muellers Kimberly A. , Andreadis Katerina , Ancker Jessica S. , Horowitz Carol R. , Kaushal Rainu , Lin Jenny J.
Published: April 2023

Background:

The necessary suspension of nonacute services by healthcare systems early in the COVID-19 pandemic was predicted to cause delays in routine care in the United States, with potentially serious consequences for chronic disease management. However, limited work has examined provider or patient perspectives about care delays and their implications for care quality in future healthcare emergencies.

Objective:

This study explores primary care provider (PCP) and patient experiences with healthcare delays during the COVID-19 pandemic.

Methods:

PCPs and patients were recruited from four large healthcare systems in three states. Participants underwent semistructured interviews asking about their experiences with primary care and telemedicine. Data were analyzed using interpretive description.

Results:

Twenty-one PCPs and 65 patients participated in interviews. Four main topics were identified: (1) types of care delayed, (2) causes for delays, (3) miscommunication contributing to delays, and (4) patient solutions to unmet care needs.

Conclusions:

Both patients and providers reported delays in preventive and routine care early in the pandemic, driven by healthcare system changes and patient concerns about infection risk. Primary care practices should develop plans for care continuity and consider new strategies for assessing care quality for effective chronic disease management in future healthcare system disruptions.
Weight loss during neoadjuvant therapy and short-term outcomes after esophagectomy: a retrospective cohort study
Authors: Hirano Yuki , Konishi Takaaki , Kaneko Hidehiro , Itoh Hidetaka , Matsuda Satoru , Kawakubo Hirofumi , Uda Kazuaki , Matsui Hiroki , Fushimi Kiyohide , Daiko Hiroyuki , Itano Osamu , Yasunaga Hideo , Kitagawa Yuko
Published: April 2023

Background:

Neoadjuvant therapy (NAT) has become common worldwide for resectable advanced esophageal cancer and frequently involves weight loss. Although failure to rescue (death after major complications) is known as an emerging surgical quality measure, little is known about the impact of weight loss during NAT on failure to rescue. This retrospective study aimed to investigate the association of weight loss during NAT and short-term outcomes, including failure to rescue after esophagectomy.

Materials and methods:

Patients who underwent esophagectomy after NAT between July 2010 and March 2019 were identified from a Japanese nationwide inpatient database. Based on quartiles of percent weight change during NAT, patients were grouped into four categories of gain, stable, small loss, and loss (>4.5%). The primary outcomes were failure to rescue and in-hospital mortality. The secondary outcomes were major complications, respiratory complications, anastomotic leakage, and total hospitalization costs. Multivariable regression analyses were used to compare outcomes between the groups, adjusting for potential confounders, including baseline BMI.

Results:

Among 15 159 eligible patients, in-hospital mortality and failure to rescue occurred in 302 (2.0%) and 302/5698 (5.3%) patients, respectively. Weight loss (>4.5%) compared to gain was associated with increased failure to rescue and in-hospital mortality [odds ratios 1.55 (95% CI: 1.10–2.20) and 1.53 (1.10–2.12), respectively]. Weight loss was also associated with increased total hospitalizations costs, but not with major complications, respiratory complications, and anastomotic leakage. In subgroup analyses, regardless of baseline BMI, weight loss (>4.8% in nonunderweight or >3.1% in underweight) was a risk factor for failure to rescue and in-hospital mortality.

Conclusion:

Weight loss during NAT was associated with failure to rescue and in-hospital mortality after esophagectomy, independent of baseline BMI. This emphasizes the importance of weight loss measurement during NAT to assess the risk for a subsequent esophagectomy.
A case series of pediatric neurobrucellosis: a rare complication to a common disease
Authors: Osman Mohammed Rayan Abdelwahab , Ayesh Ezzatly Ahmed Mohamed , Banaga Siddiq Neema Siddiq , Alagraa Thnaa , Yahia Elhassan Maha Abdalla , Hussain Idres Roua Mohammedali , Salaheldin Mohamed Elhassan Baraa Mohamed , Hussien Mohamed Ahmed Khabab Abbasher , Mahmmoud Fadelallah Eljack Mohammed
Published: April 2023

Introduction and importance:

Neurobrucellosis (NB) is a rare complication of the most common zoonotic infection worldwide. Meningitis and encephalitis are the most common manifestations. While it is endemic in many countries, it is frequently misdiagnosed due to its nonspecific presentations, and it requires a high index of suspicion and special care to be cured.

Case presentation:

The first case is from a rural area and presented with a prolonged fever associated with profuse sweating, which was complicated later by headache and sudden left-sided weakness associated with urine incontinence without signs of meningeal irritation. Laboratory and radiological tests confirmed the diagnosis of NB after other cerebral infections were ruled out, and the patient received the full brucella regimen and recovered well. The second patient presented with a gradual onset of fever that did not respond to conventional treatment. Days later, his condition was complicated by a convulsion that was not preceded by an aura and was not accompanied by symptoms of weakness, increased intracranial pressure, or sphincteric disturbances. He has a history of drinking raw milk, and tests for brucella were positive, ruling out other intracranial infections and masses. He received full brucella treatment and showed good recovery.

Conclusion:

A patient from an endemic area who has a prolonged fever and neurological symptoms should be considered positive for NB until it is ruled out.