bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of food on selumetinib pharmacokinetics and gastrointestinal tolerability in adolescents with neurofibromatosis type 1-related plexiform neurofibromas
Authors: Viskochil David , Wysocki Mariusz , Learoyd Maria , Sun Peng , So Karen , Evans Azura , Lai Francis , Hernàndez Héctor Salvador
Published: March 2024

Background

Selumetinib is approved for the treatment of pediatric patients with neurofibromatosis type 1 (NF1) who have symptomatic, inoperable plexiform neurofibromas (PN) in multiple countries, including the USA (≥ 2 years). Until recently, individuals had to take selumetinib twice daily (BID) in a fasted state. This study evaluated the effect of a low-fat meal on selumetinib PK parameters and gastrointestinal (GI) tolerability in adolescent participants with NF1-PN.

Methods

Eligible participants aged ≥ 12 to < 18 years took 25 mg/m2 selumetinib BID with a low-fat meal (T1) for 28 days, followed by a 7-day washout, and then administration in a fasted state (T2) for another 28 days. Primary objectives were to evaluate the effect of a low-fat meal on AUC0−12,ss and GI tolerability after multiple selumetinib doses in T1 versus T2. Key secondary objectives were additional PK parameters and adverse events (AEs).

Results

At primary data cut-off, all 24 participants completed T1, and 23 participants completed T2. There were no significant differences in AUC0−12,ss between T1 and T2. In T1 and T2, 29.2% and 33.3% participants, respectively, reported ≥ 1 GI AE. No GI AEs Grade ≥ 3, or serious AEs, or GI AEs resulting in treatment interruptions, discontinuation, or dose reductions were reported in T1 and T2.

Conclusions

Dosing selumetinib with a low-fat meal had no clinically relevant impact on selumetinib AUC0−12,ss nor GI tolerability in adolescents with NF1-PN.

Trial registration ClinicalTrials.gov ID

NCT05101148.
Study on the underlying molecular mechanism of benzene-induced nervous system damage in mice based on tandem mass tag (TMT) proteomics
Authors: Zheng Zhe , Li Hongwei , Zhang Zhenqian , Zhai Xiandun , Qin Haojie
Published: March 2024

Benzene is known to be a common toxic industrial chemical, and prolonged benzene exposure may cause nervous system damage. At present, there were few studies on benzene-induced neurological damage. This research aimed to identify the protein biomarkers to explore the mechanism of nervous system damage caused by benzene. We established a benzene poisoning model of C57 mice by gavage of benzene-peanut oil suspension and identified differentially expressed proteins (DEPs) in brain tissue using tandem mass tag (TMT) proteomics. The results showed a significant weight loss and decrease in leukocyte and neutrophil counts in benzene poisoning mice compared to the control group. We also observed local cerebral oedema and small vessel occlusion in the cerebral white matter of benzene poisoning mice. TMT proteomic results showed that a total 6,985 proteins were quantified, with a fold change (FC) > 1.2 (or < 1/1.2) and P value <0.05 were considered as DEPs. Compared with the control group, we identified 43 DEPs, comprising 14 upregulated and 29 downregulated proteins. Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis results showed that the candidate proteins were mainly involved in cholesterol metabolism, complement and coagulation cascades, african trypanosomiasis, PPAR signaling pathway, and vitamin digestion and absorption. Three proteins, 2-hydroxyacylsphingosine 1-beta-galactosyltransferase (UGT8), Apolipoprotein A-I (APOA1) and Complement C3 (C3) were validated using immunoblotting and immunohistochemical. In conclusion, our study preliminarily investigated the mechanism of benzene toxicity to the nervous system by analyzing DEPs changes in the brain.
Promotion and Tenure Policies and Practices at U.S. Medical Schools: Is Tenure Irrelevant or More Relevant Than Ever?
Authors: Mallon William T. , Cox Natalya
Published: March 2024

Promotion and tenure (P&T) have been common mechanisms to support and nurture faculty at higher education institutions and, therefore, have been of continual interest to medical school faculty and administrators. In the last decade, significant changes in the academic medicine sector have occurred, including new medical schools, mergers and acquisitions of academic hospitals and health systems, and institutional and societal efforts to address systemic racism and inequality. In addition, societal controversies have revived long-dormant concerns about academic freedom for medical school faculty, a bedrock principle of U.S. higher education for more than a century. These developments raise the question of whether tenure at medical schools is increasingly irrelevant for large numbers of full-time faculty or more relevant than ever.

Using a 2022 survey of 118 medical schools, a review of P&T policies at 37 other medical schools, and an analysis of Association of American Medical Colleges Faculty Roster data, the authors review the prevalence of tenure systems at U.S. MD-granting medical schools; trends in the use of such systems for full-time basic science and clinical faculty; models of including diversity, equity, and inclusion (DEI) criteria in P&T standards; and alterations to introduce greater flexibility into the P&T process.

The authors’ analysis shows that, although tenure systems remain well established at U.S. MD-granting medical schools, the percentage of full-time faculty on tenured or tenure-eligible tracks declined over the last 4 decades. Troubling gaps in tenure-eligible appointments persist between men and women faculty and among faculty by race and ethnicity. Medical schools have begun to deploy a variety of tactics in P&T processes focused on DEI to address these systemic inequities. To adapt the traditional tenure system to meet the needs of academic medicine, medical schools have altered their policies, including tenure financial guarantees, probationary period extensions, and post-tenure review.
Disparities in Medical School Clerkship Grades Associated With Sex, Race, and Ethnicity: A Person-Centered Approach
Authors: Perez Mejias Paulina , Lara Gustavo , Duran Alex , Musci Rashelle , Hueppchen Nancy A. , Ziegelstein Roy C. , Lipsett Pamela A.
Published: March 2024

Purpose

To determine whether students’ self-reported race/ethnicity and sex were associated with grades earned in 7 core clerkships. A person-centered approach was used to group students based on observed clerkship grade patterns. Predictors of group membership and predictive bias by race/ethnicity and sex were investigated.

Method

Using data from 6 medical student cohorts at Johns Hopkins University School of Medicine (JHUSOM), latent class analysis was used to classify students based on clerkship grades. Multinomial logistic regression was employed to investigate if preclerkship measures and student demographic characteristics predicted clerkship performance-level groups. Marginal effects for United States Medical Licensing Exam (USMLE) Step 1 scores were obtained to assess the predictive validity of the test on group membership by race/ethnicity and sex. Predictive bias was examined by comparing multinomial logistic regression prediction errors across racial/ethnic groups.

Results

Three clerkship performance-level groups emerged from the data: low, middle, and high. Significant predictors of group membership were race/ethnicity, sex, and USMLE Step 1 scores. Black or African American students were more likely (odds ratio [OR] = 4.26) to be low performers than White students. Black or African American (OR = 0.08) and Asian students (OR = 0.41) were less likely to be high performers than White students. Female students (OR = 2.51) were more likely to be high performers than male students. Patterns of prediction errors observed across racial/ethnic groups showed predictive bias when using USMLE Step 1 scores to predict clerkship performance-level groups.

Conclusions

Disparities in clerkship grades associated with race/ethnicity were found among JHUSOM students, which persisted after controlling for USMLE Step 1 scores, sex, and other preclerkship performance measures. Differential predictive validity of USMLE Step 1 exam scores and systematic error predictions by race/ethnicity show predictive bias when using USMLE Step 1 scores to predict clerkship performance across racial/ethnic groups.
A Randomized Trial of Ionic Silver Dressing to Reduce Surgical Site Infection After Gastrointestinal Surgery
Authors: Kosugi Chihiro , Koda Keiji , Shimizu Hiroaki , Yamazaki Masato , Shuto Kiyohiko , Mori Mikito , Usui Akihiro , Nojima Hiroyuki , Endo Satoshi , Yanagibashi Hiroo , Arimitsu Hidehito , Tochigi Toru , Sazuka Tetsutaro , Hirota Mihono , Kuboki Hideyuki
Published: March 2024

Objective:

To determine whether Aquacel Ag Hydrofiber dressings containing ionic silver are superior to film dressings for preventing superficial surgical site infections (SSI) in patients undergoing elective gastrointestinal surgery.

Background:

Multiple clinical trials have assessed the effectiveness of silver-containing wound dressings; however, systematic reviews failed to find any advantages of these dressings and concluded that there was insufficient evidence to indicate that they prevented wound infections. This study aimed to evaluate the efficacy of Aquacel Ag Hydrofiber dressings for preventing superficial SSIs in patients undergoing gastrointestinal surgery.

Methods:

Patients undergoing elective gastrointestinal surgery were randomly assigned to receive either Aquacel Ag Hydrofiber (study group) or film dressings (control group). The primary end point was superficial SSI within 30 days after surgery (UMIN Clinical Trials Registry ID: 000043081).

Results:

A total of 865 patients (427 study group, 438 control group) were qualified for primary end-point analysis. The overall rate of superficial SSIs was significantly lower in the study group than in the control group (6.8% vs 11.4%, P = 0.019). There was no significant difference in superficial SSI rates between the groups in patients undergoing upper gastrointestinal surgery; however, the rate was significantly lower in the study group in patients undergoing lower gastrointestinal surgery (P = 0.042). Multivariate analysis identified Aquacel Ag Hydrofiber dressings as an independent factor for reducing superficial SSIs (odds ratio, 0.602; 95% confidence interval, 0.367–0.986; P = 0.044).

Conclusions:

Aquacel Ag Hydrofiber dressings can reduce superficial SSIs compared to film dressings in patients undergoing elective gastrointestinal surgery, especially lower gastrointestinal surgery.
Effect of Adding a Program of Contextualized, Personalized, Remote Physical Activity Support to Conventional Cardiac Rehabilitation
Authors: Meenamkuzhy-Hariharan Priyanka , Tew Kirstie F. , Cranwell Ewan J. , Birkinshaw Louise M. , Eleuteri Antonio , Fisher Michael
Published: March 2024

Purpose:

The objective of this investigation was to conduct a randomized controlled trial to evaluate whether KiActiv Heart alongside usual care (UC) promotes positive physical activity (PA) change versus UC alone.

Methods:

Patients in cardiac rehabilitation (n = 130) undertook an 8-wk intervention with follow-up at wk 8. Both groups attended UC and wore a PA monitor during the intervention. The intervention group accessed the digital service and received weekly one-to-one remote mentor sessions. The primary outcome was change in PA to achieve the Association of Certified Physiotherapists in Cardiac Rehabilitation (ACPICR) recommendations. The secondary outcome was cardiorespiratory fitness (CRF) change, measured using incremental shuttle walk test (ISWT).

Results:

The probability of meeting ACPICR “Daily Activity” recommendation was statistically significantly greater in the intervention group versus control at wk 8 (P< .05). No statistically significant differences between groups were found for mean ISWT change (intervention 89 ± 116 m; control 44 ± 124 m).

Conclusion:

Participation in KiActiv Heart alongside UC was associated with statistically significant improvement in probability of meeting ACPICR recommendation and non-statistically significant but potentially clinically important increases in CRF versus UC alone. This builds on existing evidence for effectiveness.
Imaging-based noninvasive liver disease assessment for staging liver fibrosis in chronic liver disease: A systematic review supporting the AASLD Practice Guideline
Authors: Duarte-Rojo Andres , Taouli Bachir , Leung Daniel H. , Levine Deborah , Nayfeh Tarek , Hasan Bashar , Alsawaf Yahya , Saadi Samer , Majzoub Abdul Mounaem , Manolopoulos Apostolos , Haffar Samir , Dundar Ayca , Murad M. Hassan , Rockey Don C. , Alsawas Mouaz , Sterling Richard K.
Published: March 2024

Background and Aims:

Transient elastography (TE), shear wave elastography, and/or magnetic resonance elastography (MRE), each providing liver stiffness measurement (LSM), are the most studied imaging-based noninvasive liver disease assessment (NILDA) techniques. To support the American Association for the Study of Liver Diseases guidelines on NILDA, we summarized the evidence on the accuracy of these LSM methods to stage liver fibrosis (F).

Approach and Results:

A comprehensive search for studies assessing LSM by TE, shear wave elastography, or MRE for the identification of significant fibrosis (F2-4), advanced fibrosis (F3-4), or cirrhosis (F4), using histopathology as the standard of reference by liver disease etiology in adults or children from inception to April 2022 was performed. We excluded studies with <50 patients with a single disease entity and mixed liver disease etiologies (with the exception of HCV/HIV coinfection). Out of 9447 studies, 240 with 61,193 patients were included in this systematic review. In adults, sensitivities for the identification of F2-4 ranged from 51% to 95%, for F3-4 from 70% to 100%, and for F4 from 60% to 100% across all techniques/diseases, whereas specificities ranged from 36% to 100%, 74% to 100%, and 67% to 99%, respectively. The largest body of evidence available was for TE; MRE appeared to be the most accurate method. Imaging-based NILDA outperformed blood-based NILDA in most comparisons, particularly for the identification of F3-4/F4. In the pediatric population, imaging-based NILDA is likely as accurate as in adults.

Conclusions:

LSM from TE, shear wave elastography, and MRE shows acceptable to outstanding accuracy for the detection of liver fibrosis across various liver disease etiologies. Accuracy increased from F2-4 to F3-4 and was the highest for F4. Further research is needed to better standardize the use of imaging-based NILDA, particularly in pediatric liver diseases.
Indocyanine green fluorescence applied to gynecologic oncology: beyond sentinel lymph node
Authors: Loverro Matteo , Bizzarri Nicolò , Capomacchia Filippo M. , Watrowski Rafał , Querleu Denis , Gioè Alessandro , Naldini Angelica , Santullo Francesco , Foschi Nazario , Fagotti Anna , Scambia Giovanni , Fanfani Francesco
Published: March 2024

Indocyanine green (ICG), a well-known molecule employed in medicine for over five decades, has emerged as a versatile dye widely embraced across various surgical disciplines. In gynecologic oncology, its prevalent use revolves around the detection of sentinel lymph nodes. However, the true potential of ICG extends beyond this singular application, owing to its pragmatic utility, cost-effectiveness, and safety profile. Furthermore, ICG has been introduced in the theranostic landscape, marking a significant juncture in the evolution of its clinical utility. This narrative review aims to describe the expanding horizons of ICG fluorescence in gynecologic oncology, beyond the sentinel lymph node biopsy. The manifold applications reported within this manuscript include: 1) lymphography; 2) angiography; 3) nerve visualization; 4) ICG-driven resections; and 5) theranostic. The extensive exploration across these numerous applications, some of which are still in the preclinical phase, serves as a hypothesis generator, aiming to stimulate the development of clinical studies capable of expanding the use of this drug in our field, enhancing the care of gynecological cancer patients.
Effect of COVID-19 infection and vaccination on SARS-CoV-2 antibody titer change following ovarian stimulation: Prospective analysis of IVF outcomes
Authors: Shin So Yeon , Kim Jee Hyun , Kim Ji Hyang , Kwon Hwang , Park Chan , Choi Dong Hee , Cho Sun-mi , Shin Ji Eun
Published: March 2024

The coronavirus disease 2019 (COVID-19) outbreak caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) has affected various medical fields worldwide. However, relatively few studies have examined the impact of COVID-19 infection and vaccination on in vitro fertilization (IVF) outcomes and changes in SARS-CoV-2 antibody concentration in follicular fluid (FF). A total of 45 women were prospectively recruited and assigned to 3 groups: uninfected and non-vaccinated control group (Control group), infected group (COVID + group), and vaccinated group (Vaccination group). Serum and follicular fluid (FF) estradiol, progesterone, and SARS-CoV-2 antibody concentrations were measured. There were no statistical differences in the total number of retrieved oocytes (P = .291), mature oocytes (P = .416), and good-quality embryos (P = .694) among the 3 groups. In the vaccination group, BNT162b2 exhibited a significantly lower trigger-day serum estradiol/MII oocyte level (110.6 pg/mL) than other vaccines (289.5 pg/mL) (P = .006). No statistical differences in serum (P = .687) and FF (P = .108) SARS-CoV-2 antibody changes were noted among the 3 groups. Only FF antibody changes exhibited statistically significant differences between the BNT162b2 and other vaccine subgroups (P = .047). COVID-19 infection and vaccination do not affect IVF outcomes. However, the effect of BNT162b2 on steroidogenesis of the mature oocyte and FF SARS-CoV2 antibody titer should be further investigated.
Development of an immune-related diagnostic predictive model for oral lichen planus
Authors: Bian Jiamin , Yan Jiayu , Chen Chu , Yin Li , Liu Panpan , Zhou Qi , Yu Jianfeng , Liang Qin , He Qingmei
Published: March 2024

Oral lichen planus (OLP) was a chronic inflammatory disease of unknown etiology with a 1.4% chance of progressing to malignancy. However, it has been suggested in several studies that immune system disorders played a dominant role in the onset and progression of OLP. Therefore, this experiment aimed to develop a diagnostic prediction model for OLP based on immunopathogenesis to achieve early diagnosis and treatment and prevent cancer. In this study, 2 publicly available OLP datasets from the gene expression omnibus database were filtered. In the experimental group (GSE52130), the level of immune cell infiltration was assessed using MCPcounter and ssGSEA algorithms. Subsequently, differential expression analysis and gene set enrichment analysis were performed between the OLP and control groups. The resulting differentially expressed genes were intersected with immunologically relevant genes provided on the immunology database and analysis portal database (ImmPort) website to obtain differentially expressed immunologically relevant genes (DEIRGs). Furthermore, the gene ontology and kyoto encyclopedia of genes and genomes analyses were carried out. Finally, protein–protein interaction network and least absolute shrinkage and selection operator regression analyses constructed a model for OLP. Receiver operating characteristic curves for the experimental and validation datasets (GSE38616) were plotted separately to validate the model’s credibility. In addition, real-time quantitative PCR experiment was performed to verify the expression level of the diagnostic genes. Immune cell infiltration analysis revealed a more significant degree of inflammatory infiltration in the OLP group compared to the control group. In addition, the gene set enrichment analysis results were mainly associated with keratinization, antibacterial and immune responses, etc. A total of 774 differentially expressed genes was obtained according to the screening criteria, of which 65 were differentially expressed immunologically relevant genes. Ultimately, an immune-related diagnostic prediction model for OLP, which was composed of 5 hub genes (BST2, RNASEL, PI3, DEFB4A, CX3CL1), was identified. The verification results showed that the model has good diagnostic ability. There was a significant correlation between the 5 hub diagnostic biomarkers and immune infiltrating cells. The development of this model gave a novel insight into the early diagnosis of OLP.
Effects of high ligation plus endovenous laser therapy in patients with varicosis of great saphenous vein and type 2 diabetes
Authors: Yang Zheng , Zhang Liang , Niu Haiguang , Zhao Lei , Zhang Hongguang , Guo Xin , Suo Qingxia
Published: March 2024

To analyze the effects of high ligation plus endovenous laser therapy on intraoperative blood loss, postoperative visual analogue scale (VAS) score, and complications in patients with varicosis of great saphenous vein and type 2 diabetes. About 61 patients with varicosis of great saphenous vein and type 2 diabetes treated at our hospital were included. About 32 patients (37 affected limbs) receiving conventional surgery were included in control group, while 29 patients (34 affected limbs) receiving high ligation plus endovenous laser therapy were included in study group. The intraoperative blood loss, operation time, length of postoperative hospital stay, postoperative VAS scores, blood glucose levels, Venous Clinical Severity Score (VCSS), and incidence of complications were compared between the two groups. Compared with the control group, there were less intraoperative blood loss (P < .05), shorter operation time (P < .05), and shorter length of postoperative hospital stay in the study group (P < .05). Besides, there was also lower VAS scores at different time points after surgery in the study group than in the control group (P < .05). Blood glucose levels were decreased in both groups after surgery (P < .05). Moreover, VCSS was decreased in either group at 3 months after surgery (P < .05). Blood glucose levels of patients in the study group were lower than those of the control group after surgery (P < .05). The VCSS was also lower in the study group at 3 months after surgery than in the control group (P < .05). High ligation with endovenous laser therapy for varicosis of great saphenous vein in patients with type 2 diabetes was safe and feasible.
Under-reporting by surgical pathologists in tissue removed during revision surgery for metal-on-metal arthroplasties
Authors: Velleca Anthony , Pournaras Stephen , Bryk Eli , Vigorita Vincent
Published: March 2024

Although adverse local tissue reactions (ALTR) have been reported for metal-on-metal implants (MoM) requiring early revision surgery, no study has looked at the accuracy of surgical pathologists in diagnosing ALTR. This study aims to investigate the accuracy of reporting adverse local tissue reactions in tissue samples following revision surgery from metal-on-metal implants. The authors reviewed histology glass slides as well as the original pathology reports of tissue processed in revision arthroplasties in 23 cases. These samples were microscopically analyzed for tissue necrosis and cystic degeneration, the presence of metal particles, corrosion byproducts, membrane formation, histiocytic cells, lymphocytic cells, and vascular pathology. The authors’ findings were then compared to their corresponding original pathology reports. The authors found consistent under-reporting of the tissue findings. Most importantly, 18 samples showed evidence of metal present compared to 2 samples on original pathology reporting. The authors found that 15 samples showed evidence of pathological membranous tissue compared to just 6 on original pathology reporting. While just 3 of the original pathology reports indicated the presence of areas of predominantly lymphocytic inflammatory cells, the authors found 13 examples of such areas. Although ALTR reactions have been described as a sequala of failed MoM, the authors’ data suggest that ALTR may occur more frequently than previously described. Under-reported findings of ALTR deprive both the patient and orthopaedic surgeon of important information that can help guide further follow-up.
Comparative efficacy of acupuncture, venesection, and physical therapy on chronic low back pain outcomes: a randomized clinical trial
Authors: Jamali Dastjerdi Moein , Azadvari Mohaddeseh , Kordafshari Gholamreza , Zhao Bai-Xiao , Adel-Mehraban Mohammad Sadegh , Alipour Reihane , Karimi Mehrdad , Kazemi Amir Hooman , Sourani Arman , Vafaie Sefti Ali
Published: March 2024

Objective:

Chronic low back pain (CLBP) imposes considerable financial and social burden with poor response to medical and surgical treatments. Alternatively, acupuncture and venesection(Fasd) are traditionally used to alleviate nociceptive and musculoskeletal pains. This study aimed to evaluate the effectiveness and the safety of acupuncture and venesection on CLBP and patient functionality.

Methods:

The current study was a single-blinded, randomized clinical trial with balanced allocation, conducted in the Department of Physical Medicine & Rehabilitation Medicine, in 2022. One hundred five CLBP patients who had no back pain-attributable structural or major diseases were randomly allocated into three parallel arms and received either physical therapy (PTG), acupuncture (APG), or venesection (VSG). Pain severity and functional aspects were evaluated using the visual analogue scale (VAS) and Oswestry disability index (ODI) during the study. VAS and ODI scores were defined as the primary outcomes.

Results:

Ninety-five patients were reviewed in the final analysis (PTG=33, APG=30, VSG=31). Demographic data showed equal group distribution. Statistical analysis showed all procedures had reduced VAS score immediately after the first session, after the last session, and after follow-up; however, APG and VSG values were significantly lower (P<0.05). Pain reduction results in follow-up period were more sustainable in APG and VSG as compared to PTG (P<0.01). ODI results revealed global improvement after the last session of the treatment in all groups, while APG had more significant results (P<0.05). During the follow-up period, ODI still tended to decrease in VSG, non-significantly increased in APG, and significantly increased in PTG. Only two patients reported fainting after receiving venesection.

Conclusion:

Considering the pain and functional scores, both acupuncture and venesection can reproduce reliable results. Acupuncture and venesection both have sustained effects on pain and daily function of the patients even after treatment termination, while physical therapy had more relapse in pain and functional limitations.
Recurrent paratesticular liposarcoma: a case report
Authors: Blaiech Walid , Ben Othmen Mouna , Ouahchi Ines , Alaya Meriam , Belkacem Oussama , Hmida Wissem , Jaidane Mehdi
Published: March 2024

Introduction and importance:

Paratesticular liposarcoma (PTL) is a rare condition, with fewer than 200 cases reported worldwide. It is a malignant tumor that originates from fat tissue with high risk of recurrence. Herein, the authors present a contralateral recurrence of a treated PTL. To the best of the authors’ knowledge, in the current literature, there are few cases reported with recurrent PTL.

Case presentation:

The authors report the case of a 62-year-old man who presented with a rapidly growing painless right hemiscrotal swelling. Clinical and radiographic evidence suggested the presence of two paratesticular tumors. The patient underwent a radical orchidectomy with resection of the two tumors through an inguinal approach. The histologic examination revealed a sclerosing, well-differentiated liposarcoma. The decision of the multidisciplinary consultation meeting was not to do adjuvant treatment. A follow-up of 12 months showed recurrence of the contralateral scrotum revealed by an FDG-PET/scan.

Clinical discussion:

PTL, a rare spermatic cord tumor, affects adults aged 50–60, often presenting with scrotal swelling. Diagnosis involves ultrasound, computed tomography, and magnetic resonance imaging. Surgical intervention, including radical orchiectomy and adjuvant radiotherapy, is common for management, while the role of chemotherapy is inconclusive. High-grade subtypes carry a higher recurrence risk.

Conclusion:

PTL is often misdiagnosed preoperatively. It is typically managed through radical orchidectomy, which includes wide excision and high ligation to ensure free surgical margins and avoid recurrence. The role of adjuvant therapy remains debatable. Despite a generally favorable prognosis, long-term follow-up is crucial because of the elevated risk of recurrence.
Aetiology, clinical profile, management and outcome of acute pancreatitis at public hospitals in Addis Ababa, Ethiopia: a prospective observational study
Authors: Hussen Mohammed Seid , Ibrahim Amelmasin Faris , Tekle Yared , Gebremariam Shimelis , Feto Amana Deko , Nida Tamrat , Mohammed Hussen
Published: March 2024

Background:

Acute pancreatitis (AP) is a rare gastrointestinal pathology that has recently become increasingly common owing to lifestyle changes. Its clinical presentation ranges from mild discomfort to organ failure and death. Previous studies in Ethiopia reported that AP is rare. However, lifestyle changes have recently increased. Therefore, this study aimed to assess the aetiology, clinical profile, management, and outcomes of AP.

Methods:

This prospective observational study included 59 adults diagnosed with AP using the Revised Atlanta Classification between November 2021 and August 2022 at five public hospitals in Addis Ababa. The data were analyzed using SPSS 25. The mean ± standard deviation and adjusted odds ratio (AOR) at 95% CI were used.

Results:

The mean age was 38.2 (SD±11.5 years), mostly aged 30–44, with 67% males and 89.8% patients presenting with new-onset AP. Abdominal pain and nausea were the most common presentations in 93.2% of patients. More than 52.5% of AP cases were caused by alcohol, followed by gallstones (28.8%), and gallstones (47.1%) underwent cholecystectomy during the index admission. One patient (1.7%) died. The length of hospital stay ranges from 1–47 days and increases with the severity of AP. Patients with recurrent AP had a 2.4 folds increase in complications compared to new-onset AP (AOR=2.4, 95% CI=1.38, 15.71).

Conclusion:

Most AP cases were caused by alcohol consumption, followed by gallstones, smoking, and hypertriglyceridemia. One death in a 60-year-old male with an alcohol and smoking history was diagnosed and triaged as severe AP with persistent multiple organ failure; BISAP score 4, his Creatinine=2.55 mg/dl, haematocrit 72.6%; and left shift of WBC, was associated.
Leadership: Bright Spots of Governmental Public Health Employee Reflections on the COVID-19 Response
Authors: Madsen Emilie R. , Schaffer Kay , Hare Bork Rachel , Yeager Valerie A.
Published: March 2024

The protracted nature of the COVID-19 pandemic demanded extraordinary efforts and innovation from public health agencies and their leaders. This is the first of 3 research briefs that highlight valuable experiences and opportunities that can be thought of as “bright spots” of the public health workforce's pandemic response. Using Public Health Workforce Interests and Needs Survey 2021 data, we qualitatively examined responses to an open-ended question about pandemic workforce experiences. Leadership was emphasized as a critical component of employees' experiences during the response, and 7 “leadership” subthemes were identified among 157 responses. Findings illustrate the importance of leaders prioritizing safe and supportive environments for employees. Respondents also highlighted the importance of leaders fostering teamwork alongside employees and advocating for and demonstrating appreciation for employees. In addition, effective leadership communication was reported to be motivational and alleviate uncertainty during crisis situations. Focusing on these leadership skills and competencies may aid the workforce during future emergency response events.
Integration of HIV Testing in a Community Intervention for Tuberculosis Screening Among Household Contacts of Patients with Tuberculosis in Cameroon and Uganda
Authors: Tchakounte Youngui Boris , Atwine Daniel , Otai David , Vasiliu Anca , Ssekyanzi Bob , Sih Colette , Kana Rogacien , Arinaitwe Rinah , Cuer Benjamin , Simo Leonie , Okello Richard , Tchendjou Patrice , Casenghi Martina , Kuate Albert Kuate , Turyahabwe Stavia , Cohn Jennifer , Bonnet Maryline , Tchounga Boris Kevin ,   on behalf of the CONTACT Study Group
Published: March 2024

Introduction:

People living with HIV are considered at higher risk of developing severe forms of tuberculosis (TB) disease. Providing HIV testing to TB-exposed people is therefore critical. We present the results of integrating HIV testing into a community-based intervention for household TB contact management in Cameroon and Uganda.

Methods:

Trained community health workers visited the households of index patients with TB identified in 3 urban/semiurban and 6 rural districts or subdistricts as part of a cluster-randomized trial and provided TB screening to all household contacts. Voluntary HIV counseling and testing were offered to contacts aged 5 years or older with unknown HIV status. We describe the cascade of care for HIV testing and the factors associated with the acceptance of HIV testing.

Results:

Overall, 1983 household contacts aged 5 years or older were screened for TB. Of these contacts, 1652 (83.3%) did not know their HIV status, 1457 (88.2%) accepted HIV testing, and 1439 (98.8%) received testing. HIV testing acceptance was lower among adults than children [adjusted odds ratio (aOR) = 0.35, 95% confidence interval (CI): 0.22 to 0.55], those living in household of an HIV-positive vs HIV-negative index case (aOR = 0.56, 95% CI: 0.38 to 0.83), and contacts requiring a reassessment visit after the initial TB screening visit vs asymptomatic contacts (aOR = 0.20, 95% CI: 0.06 to 0.67) and was higher if living in Uganda vs Cameroon (aOR = 4.54, 95% CI: 1.17 to 17.62) or if another contact of the same index case was tested for HIV (aOR = 9.22, 95% CI: 5.25 to 16.18).

Conclusion:

HIV testing can be integrated into community-based household TB contact screening and is well-accepted.
Risk Factors for Oronasal Fistula in Primary Palatoplasty: A Case-Control Study From a Reference Center in Medellín, Colombia
Authors: Correa Acebedo Esteban , Gallego Gónima Sabrina , Vásquez Sañudo Vanesa , Vélez Toro Juan Sebastián , Salinas Ana María
Published: March 2024

Background:

Oronasal fistula is one of the most critical complications in primary palatoplasty, with a reported incidence between 5% and 46% with multiple associated risk factors described previously. In addition, in more than half of the patients, it implies additional surgeries, increasing risks for the patient and health care costs. In this case-control study, the authors aim to determine the specific risk factors for oronasal fistula after primary palatoplasty in the study population.

Methods:

A retrospective review was undertaken to identify all patients undergoing primary palatoplasty between 2017 and 2019. Patients who developed oronasal fistula were included (cases) and compared with patients from the same cohort without fistula (controls). Demographic, clinical, and perioperative variables and their association with postoperative fistula presentation were explored through crude and adjusted analysis.

Results:

One hundred thirty-nine patients with a median age of 6 years (5–6) who underwent primary palatoplasty were found. Forty-five presented an oronasal fistula, corresponding to 32% of the population, and 64% required subsequent repair of an oronasal fistula. In the crude analysis, the surgeon’s experience (OR: 0.44) was associated significantly with the outcome. Adjusted analysis showed an association between surgical site infection and syndromic presentation.

Conclusions:

The experience of the surgeon is a protective factor for the oronasal fistula presentation; in addition, the presentation of infection of the operative site, the syndromic presentation, and the clinical follow-up at 1 year were also relevant; the latter, possibly due to the social context of our patients.
The Severity of Initial Unilateral Cleft Lip and Nasal Deformity Predicts Long-Term Postoperative Esthetic Outcome
Authors: Lo Alexis L. , Haley Christopher T. , Jones Christine M. , Brooke Sebastian M. , Long Ross E. , Samson Thomas D. , Mackay Donald R.
Published: March 2024

Background:

Infantile cleft lip and nasal severity influence the final esthetic result of the repair. Although various authors have described methods of cleft lip and nasal repair, there is a paucity of data that correlates cleft severity with esthetic outcomes. The aim of this study was to examine the correlation between presurgical severity of unilateral cleft deformity and long-term postoperative esthetic outcomes.

Methods:

This retrospective study, based at a single institution, investigated patients with complete unilateral cleft lip, with or without cleft palate, who underwent repair by a single surgeon, had preoperative infantile facial casts, and had postoperative facial photographs at 6 to 11 years of age (N=31). Preoperative nostril width ratio and columellar angle measurements were taken from facial casts. Postoperative, long-term nasolabial appearance was rated by 5 blinded observers used a modified Kuijpers-Jagtman scale. Linear regression was used to determine the relationship between preoperative cleft severity and postoperative ratings.

Results:

Preoperative nostril width ratio directly correlated with postoperative nasal form score (r=0.40; P=0.026); likewise, preoperative columellar angle predicted postoperative nasal form score (r=0.37; P=0.040). Preoperative cleft severity was not significantly correlated with vermillion border appearance. Cronbach α values of 0.91 (nasal form) and 0.79 (vermillion border) indicated good inter-rater reliability. Kappa values of 0.87 (nasal form) and 0.70 (vermillion border) indicated good intrarater reliability.

Conclusions:

Preoperative unilateral cleft nose severity directly correlates with long-term postoperative nasal appearance in childhood. Outcome studies should present and control for preoperative severity to allow more accurate assessment of repair techniques.
Effects of Danggui Wuji granules on 16S rDNA, metagenome, and metabolome in BDS mice
Authors: Huang Hanhui , Deng Yurong , Chen Shisheng , Li Zongyuan , Li Xiaomin , Sun Jianhui , Hao Liyu , Yu Zeyue , Wang Aoao , Li Jianliang , Huo Hairu , Liu Guimin , Li Hongmei
Published: March 2024

Blood deficiency syndrome (BDS) refers to a pathological state with blood dysfunction and organ dystrophy in traditional Chinese medicine. Danggui Wuji granules (DWG) was developed from a formula containing Angelicae Sinensis Radix and Musculus et Os Galli Domestici. Herein, we investigated the mechanism of DWG in treating BDS by modulating gut microbiota. We found that DWG protected mice from BDS by elevating the levels of red blood cell count, hemoglobin, and hematocrit in peripheral blood and increasing the erythrocyte membrane Na+-K+-ATPase activity. Danggui Wuji granules changed the composition and metabolites of colonic flora. Notably, Lactobacillus, Muribaculaceae, and Alistipes were the main genera showing changes after DWG treatment. Our findings revealed that DWG presented a positive therapeutic effect on BDS in mice by regulating the gut microbiota and metabolites. The protective mechanism of DWG was associated with pathways such as metabolic pathways, biosynthesis of secondary metabolites, ABC transporters, ribosome, thyroid hormone synthesis, lysine degradation, galactose metabolism, tyrosine metabolism, etc.
Methods to assess porous and non-porous antibacterial, antifungal and antiviral surfaces in relation to touch and droplet transfer in medical and transport applications: a gap analysis and suggested approaches.
Authors: Cunliffe Alexander J , Askew Peter , Iredale Gillian , Marchant Abby , Redfern James
Published: March 2024

To help assess whether a potentially antimicrobial material, surface, or coating provides antimicrobial efficacy, a number of standardised test methods have been developed internationally. Ideally, these methods should generate data that supports the materials efficacy when deployed in the intended end-use application. These methods can be categorised based on their methodological approach such as suspension tests, agar plate/zone diffusion tests, surface inoculation tests, surface growth tests or surface adhesion tests. To further support those interested in antimicrobial coatings to make appropriate decisions on their method selection, this paper brings together an exhaustive list of methods (for porous and non-porous materials), exploring the methodological (e.g. microorganism) and environmental (e.g. temperature and relative humidity) parameters to test bacteria, fungi, and viruses. This analysis demonstrates that methods that test either fungi or viruses are generally lacking, whilst methods that test bacteria, fungi and viruses are not designed to simulate end-use/lack realistic conditions. As such, a number of applications for antimicrobial activity across medical touch screens, medical textiles and gloves and transport seat textiles are explored, providing guidance on modifications to existing methods that may better simulate the intended end-use of antimicrobial materials.
Correlation between phytochemical contents in peel and flesh of cold-stored Fuji apple
Authors: Kim Jang-Soo , Kang Sang-Jae
Published: March 2024

This study determined the relationships between the total anthocyanin content in apple skin and the total polyphenols, flavonoids, proanthocyanidins, and soluble solids contents in the flesh of cold-stored Fuji apples. Total anthocyanin content in apple skin ranged from 0.130±0.005 mg CE/g fw to 0.262±0.028 mg CE/g fw, and the overall average was 0.200±0.008 mg CE/g fw. The total polyphenolic compounds in the flesh was ranged from a 4.283±0.141 mM GAE/g fw to 8.207±0.234 mM GAE/g fw, and the average content was 6.275±0.177 mM GAE/g fw. The total flavonoid content ranged from 4.510±0.080 mM QE/g fw to 2.467±0.458 mM QE/g fw, and the average total flavonoid content was about 3.586 mM QE/g fw. The total proanthocyanidin content was relatively high, ranging from 3.475±0.577 mM EE/g fw to 6.816±0.277 mM EE/g fw, and the soluble solid in the flesh was about 12 °Brix to 14 °Brix. The DPPH radical scavenging activity of extracts from apple flesh ranged from 66.36% to 94.99%, and the ascorbate equivalent concentration was 0.482 mM. The ABTS radical scavenging activity was 99.12% to 99.9%, indicating a higher inhibitory activity than the DPPH inhibitory activity, and the ascorbate equivalent concentration was 0.486 mM. The correlation between the total anthocyanin and total polyphenolic compounds was y = 15.192x + 3.2169 (R2=0.2748), but the concentration of total polyphenolic compounds increased when the total anthocyanin content was increased. The correlation equation of total anthocyanin with total flavonoids was y = 15.18x + 0.5555 (R2=0.6226), with total proanthocyanin was y = 14.918x + 2.3422 (R2=0.3372), and with soluble solid was y = 10.558x + 11.126 (R2=0.1925), indicating that the correlation of total anthocyanin with total flavonoid was higher than that with soluble solid.
Production of Dendropanax morbiferus extract containing multi-functional ingredients by serial fermentation using Bacillus subtilis HA and Lactobacillus plantarum KS2020
Authors: Son Su-Jin , Kang Hye-Mi , Park Yun-Ho , Hwangbo Mi-Hyang , Lee Sam-Pin
Published: March 2024

The production of poly-γ-glutamic acid (γ-PGA) and γ-aminobutyric acid (GABA) was optimized by serial fermentation of Dendropanax morbiferus extract (DME) using Bacillus subtilis HA and Lactobacillus plantarum KS2020. The 1st alkaline fermentation was performed on 60% DME including 2% glucose and 10% monosodium ʟ-glutamate (MSG) as a precursor. The 1st fermented DME had 57 mg% tyrosine. Consequently, the 2nd lactic acid fermentation for 5 days increased the tyrosine content of 106 mg%. The mucilage containing γ-PGA showed a high content of 3.50% on the first day of alkaline fermentation and then increased to 4.10% after 2 days. The precursor (MSG) remaining in the 1st fermented DME was efficiently converted to GABA by the 2nd lactic acid fermentation in the presence of 5% skim milk, 1.5% glucose and 0.5% yeast extract, resulting in the production of 18.29 mg/mL GABA. The viable cells of lactic acid bacteria increased and indicated 9.49 log CFU/mL on the fermentation for 5 days, and the acidity of co-fermented DME indicated the highest value of 1.55%. Conclusively, the serial fermented DME has multi-functional ingredients containing γ-PGA, GABA, peptides and probiotics.
The synthesis of dextran from rice hydrolysates using Gluconobacter oxydans KACC 19357 bioconversion
Authors: Baek Seung-Min , Lee Hyun Ji , Chewaka Legesse Shiferaw , Park Chan Soon , Park Bo-Ram
Published: March 2024

Dextran is a glucose homo-polysaccharide with a predominantly α-1,6 glycosidic linkage of microbial source and is known to be produced primarily by lactic acid bacteria. However, it can also be obtained through the dextran dextrinase of acetic acid bacteria (Gluconobacter oxydans). The dextrin-based dextran was obtained from rice starch using G. oxydans fermentation of rice hydrolysate, and its properties were studied. Both dextrin- and rice hydrolysate-added media maintained the OD value of 6 after 20 h of incubation with acetic acid bacteria, and the gel permeation chromatography (GPC) analysis of the supernatant after 72 h of incubation confirmed that a polymeric material with DP of 480 and 405, which was different from the composition of the substrate in the medium, was produced. The glucose linkage pattern of the polysaccharide was confirmed using the proton nuclear magnetic resonance (1H-NMR) and the increased α-1,4:α-1,6 bond ratio from 0.23 and 0.13 to 1:2.37 and 1:4.4, respectively, indicating that the main bonds were converted to α-1,6 bonds. The treatment of dextrin with a rat-derived alpha-glucosidase digestive enzyme resulted in a slow release of glucose, suggesting that rice hydrolysate can be converted to dextran using acetic acid bacteria with glycosyltransferase activity to produce high-value bio-materials with slowly digestible properties.
Effects of cold and room temperature storage on the sprouting and marketability of early-grown spring potatoes
Authors: Won Heon-Seop , Han Kyusuk , Lee Young Hun
Published: March 2024

Three spring potato varieties (Atlantic, Chubaek, and Superior) were cultivated for 80, 90, and 100 days and compared in terms of their total and marketable yields and specific gravities. Subsequently, changes in the quality parameters (weight loss, sprouting rate, disease incidence, dry weight, and specific gravity) of potatoes cultivated for 100 days were monitored during two-month storage in improved and semi-underground warehouses at 4°C and room temterature. The productivities of Atlantic, Superior, and Chubaek were maximized at cultivation periods of 100, 100, and >90 days, respectively. In all cases, cold storage resulted in <5.3% weight loss and no marketability loss. However, two-month room temperature storage resulted in pronounced marketability loss due to weight loss (6.2, 7.3% and 10.9% for Atlantic, Superior, and Chubaek, respectively) and sprouting (in ~13%, >75%, and 99% of Atlantic, Superior, and Chubaek tubers, respectively). The marketability of Atlantic, Superior, and Chubaek during cold storage was maintained for >2, ~2, and <2 months, respectively. All varieties were characterized by rapid sprouting, low dry weight and specific gravity, and rapid marketability loss during storage.