bluuebunny/crossref_metadata_2025 huggingface dataset:
Taste loss as a distinct symptom of COVID-19: a systematic review and meta-analysis
Authors: Hannum Mackenzie E , Koch Riley J , Ramirez Vicente A , Marks Sarah S , Toskala Aurora K , Herriman Riley D , Lin Cailu , Joseph Paule V , Reed Danielle R
Published: December 2023

Chemosensory scientists have been skeptical that reports of COVID-19 taste loss are genuine, in part because before COVID-19 taste loss was rare and often confused with smell loss. Therefore, to establish the predicted prevalence rate of taste loss in COVID-19 patients, we conducted a systematic review and meta-analysis of 376 papers published in 2020–2021, with 235 meeting all inclusion criteria. Drawing on previous studies and guided by early meta-analyses, we explored how methodological differences (direct vs. self-report measures) may affect these estimates. We hypothesized that direct measures of taste are at least as sensitive as those obtained by self-report and that the preponderance of evidence confirms taste loss is a symptom of COVID-19. The meta-analysis showed that, among 138,015 COVID-19-positive patients, 36.62% reported taste dysfunction (95% confidence interval: 33.02%–40.39%), and the prevalence estimates were slightly but not significantly higher from studies using direct (n = 15) versus self-report (n = 220) methodologies (Q = 1.73, df = 1, P = 0.1889). Generally, males reported lower rates of taste loss than did females, and taste loss was highest among middle-aged adults. Thus, taste loss is likely a bona fide symptom of COVID-19, meriting further research into the most appropriate direct methods to measure it and its underlying mechanisms.
Clinical Impact of Multiplex Molecular Diagnostic Testing in Children With Acute Gastroenteritis Presenting to an Emergency Department: A Multicenter Prospective Study
Authors: Pavia Andrew T , Cohen Daniel M , Leber Amy L , Daly Judy A , Jackson Jami T , Selvarangan Rangaraj , Kanwar Neena , Bender Jeffrey M , Dien Bard Jennifer , Festekjian Ara , Duffy Susan , Larsen Chari , Holmberg Kristen M , Bardsley Tyler , Haaland Benjamin , Bourzac Kevin M , Stockmann Christopher , Chapin Kimberle C , Leung Daniel T
Published: December 2023

Background

Multiplex molecular diagnostic panels have greatly enhanced detection of gastrointestinal pathogens. However, data on the impact of these tests on clinical and patient-centered outcomes are limited.

Methods

We conducted a prospective, multicenter, stepped-wedge trial to determine the impact of multiplex molecular testing at 5 academic children's hospitals on children presenting to the emergency department with acute gastroenteritis. Caregivers were interviewed on enrollment and 7–10 days after enrollment to determine symptoms, risk factors, subsequent medical visits, and impact on family members. During the pre-intervention period, diagnostic testing was performed at the clinician's discretion . During the intervention period, multiplex molecular testing was performed on all children, with results available to clinicians. The primary outcome was return visits to a healthcare provider within 10 days of enrollment.

Results

Potential pathogens were identified by clinician-ordered tests in 19 of 571 (3.3%) in the pre-intervention period compared with 434 of 586 (74%) in the intervention period; clinically relevant pathogens were detected in 2.1% and 15%, respectively. In the multivariate model, the intervention was associated with a 21% reduction in the odds of any return visit (odds ratio, 0.79; 95% confidence interval, .70–.90) after adjusting for potential confounders. Appropriate treatment was prescribed in 11.3% compared with 19.6% during the intervention period (P = .22).

Conclusions

Routine molecular multiplex testing for all children who presented to the ED with acute gastroenteritis detected more clinically relevant pathogens and led to a 21% decrease in return visits. Additional research is needed to define patients most likely to benefit from testing.

Clinical Trials Registration. NCT02248285.
Ticagrelor or prasugrel vs. clopidogrel in patients with atrial fibrillation undergoing percutaneous coronary intervention for myocardial infarction
Authors: Godtfredsen Sissel J , Kragholm Kristian H , Kristensen Anna Meta Dyrvig , Bekfani Tarek , Sørensen Rikke , Sessa Maurizio , Torp-Pedersen Christian , Bhatt Deepak L , Pareek Manan
Published: December 2023

Aims

The efficacy and safety of ticagrelor or prasugrel vs. clopidogrel in patients with atrial fibrillation (AF) on oral anticoagulation (OAC) undergoing percutaneous coronary intervention (PCI) for myocardial infarction (MI) have not been established.

Methods and results

This was a nationwide cohort study of patients on OAC for AF who underwent PCI for MI from 2011 through 2019 and were prescribed a P2Y12 inhibitor at discharge. The primary efficacy outcome was major adverse cardiovascular events (MACE), defined as a composite of death from any cause, stroke, recurrent MI, or repeat revascularization. The primary safety outcome was cerebral, gastrointestinal, or urogenital bleeding requiring hospitalization. Absolute and relative risks for outcomes at 1 year were calculated through multivariable logistic regression with average treatment effect modelling. Outcomes were standardized for the individual components of the CHA2DS2-VASc and HAS-BLED scores as well as type of OAC, aspirin, and proton pump inhibitor use. We included 2259 patients of whom 1918 (84.9%) were prescribed clopidogrel and 341 (15.1%) ticagrelor or prasugrel. The standardized risk of MACE was significantly lower in the ticagrelor or prasugrel group compared with the clopidogrel group (standardized absolute risk, 16.3% vs. 19.4%; relative risk, 0.84, 95% confidence interval, 0.70–0.98; P = 0.02), while the risk of bleeding did not differ (standardized absolute risk, 5.5% vs. 5.1%; relative risk, 1.07, 95% confidence interval, 0.73–1.41; P = 0.69).

Conclusion

In patients with AF on OAC who underwent PCI for MI, treatment with ticagrelor or prasugrel vs. clopidogrel was associated with reduced ischaemic risk, without a concomitantly increased bleeding risk.
Hospital use of common Z-codes for Medicare fee-for-service beneficiaries, 2017–2021
Authors: Chang Ji E , Smith Nate , Lindenfeld Zoe , Weeks William B
Published: December 2023

Recognizing the impact of the social determinants of health (SDOH) on health outcomes, in 2016, the Centers for Medicare and Medicaid Services recommended the use of International Classification of Diseases, 10th Revision (ICD-10), Z-codes to capture patients' health-related social needs. We examined changes in Z-code utilization to document health-related social needs for Medicare fee-for-service recipients among US hospitals between 2017 and 2021 across 5 common SDOH domains. We found that, while 56.9% of hospitals had at least 1 Z-code recorded in at least 1 patient per year, apart from those referring to housing needs, rates of Z-code adoption were low. Additionally, hospitals that were general medical, part of a teaching institution, affiliated with larger health systems, and of medium to large size had greater odds of utilizing Z-codes. Findings from this study highlight the need for continued efforts in promoting the consistent use of standardized SDOH capturing methods like Z-code documentation, such as provider training.
Automated informatics may increase the detection rate of suspicious cases of human trafficking—a preliminary study
Authors: Duke David O , Allard Derin , Dysart Suzanne , Hogan Keenan O , Phelan Suzanne , Rawlings Luke , Stoklosa Hanni
Published: December 2023

Objectives

Worldwide, there is an estimated 40.3 million victims trapped in modern day slavery, including 24.9 million in forced labor and 15.4 million in forced marriage. A majority of labor and sex trafficking survivors report at least one healthcare encounter during their victimization. An approach to an informatics technology solution for identifying trafficked persons in real time, in the hospital / emergency department settings is the primary focus of this paper.

Materials and methods

Octavia, a software application implemented in 3 California hospitals, scanned all patient encounters for social and clinical determinants that are consistent predictors of HT. Any encounter that matched these criteria was forwarded to a specially trained High-Risk Navigator who screened the data and when able, made direct contact in an effort to build rapport and possibly provide victim assistance.

Results

During the observation period, the automated scanning of hospital patient encounters resulted in a notable increase in the detection of persons who had a likelihood of being trafficked when compared to a pre-project baseline.

Discussion

Our experience demonstrated that automated technology is useful to assist healthcare providers in identification of potentially trafficked persons, improving the likelihood of care provision.
Patient and Public Involvement in Inflammatory Bowel Disease Research—A Scoping Review
Authors: Elsolh Karam , Li Amy , Hu Malini , Seleq Samir , Neary Emma , Gimpaya Nikko , Scaffidi Michael A , Kishibe Teruko , Khan Rishad , Grover Samir C
Published: December 2023

Background

Interest in patient and public involvement in research has grown. Medical, health, and social care research has demonstrated several benefits of patient and public engagement, such as empowering user input and reducing attrition rates in clinical trials. To date, no study has reviewed patient engagement in inflammatory bowel disease (IBD). We aimed to describe the benefits, challenges, and best practices of patient engagement in IBD research.

Methods

We performed a systematic search on MEDLINE, EMBASE, and Cochrane for all clinical IBD research studies in which patients were involved in the research process (1946- 2023). Patient input was considered in: (1) study design, (2) study execution, (3) research dissemination, and/or (4) other domains not specified here. Two authors independently screened and extracted data on type of engaged person(s), format of engagement, author-reported benefits, recommendations, and challenges. For each study, we reported the level of patient engagement and study adherence to standardized reporting guidelines.

Results

After screening 9,355 articles, we included 51 for final analysis. IBD patients were most frequently engaged in study design. Patient engagement in IBD research improved recruitment rates and promoted the creation of user-friendly quality-of-life tools. Selection bias and recruitment difficulties were common challenges in the application of patient engagement. Authors recommended continuous patient involvement to address emerging priorities and cognitive interviewing to improve questionnaire clarity.

Conclusions

Patient engagement represents an important step in promoting patient-centred care. According to study authors, implementing cognitive interviewing techniques, continuous patient involvement, and standardized reporting guidelines may improve future iterations of engagement in IBD.
Choreographed expansion of services results in decreased patient burden without compromise of outcomes: An assessment of the Ontario experience
Authors: Rzadki Kathryn , Baqri Wafa , Yermakhanova Olga , Habbous Steven , Das Sunit
Published: December 2023

Background

Neuro-oncology care in Ontario, Canada has been historically centralized, at times requiring significant travel on the part of patients. Toward observing the goal of patient-centered care and reducing patient burden, 2 additional regional cancer centres (RCC) capable of neuro-oncology care delivery were introduced in 2016. This study evaluates the impact of increased regionalization of neuro-oncology services, from 11 to 13 oncology centers, on healthcare utilization and travel burden for glioblastoma (GBM) patients in Ontario.

Methods

We present a cohort of GBM patients diagnosed between 2010 and 2019. Incidence of GBM and treatment modalities were identified using provincial health administrative databases. A geographic information system and spatial analysis were used to estimate travel time from patient residences to neuro-oncology RCCs.

Results

Among the 5242 GBM patients, 79% received radiation as part of treatment. Median travel time to the closest RCC was higher for patients who did not receive radiation as part of treatment than for patients who did (P = .03). After 2016, the volume of patients receiving radiation at their local RCC increased from 62% to 69% and the median travel time to treatment RCCs decreased (P = .0072). The 2 new RCCs treated 35% and 41% of patients within their respective catchment areas. Receipt of standard of care, surgery, and chemoradiation (CRT), increased by 11%.

Conclusions

Regionalization resulted in changes in the healthcare utilization patterns in Ontario consistent with decreased patient travel burden for patients with GBM. Focused regionalization did not come at the cost of decreased quality of care, as determined by the delivery of a standard of care.
Micronutrient status in children aged 6–59 months with severe wasting and/or nutritional edema: implications for nutritional rehabilitation formulations
Authors: Vresk Laura , Flanagan Mary , Daniel Allison I , Potani Isabel , Bourdon Celine , Spiegel-Feld Carolyn , Thind Mehakpreet K , Farooqui Amber , Ling Catriona , Miraglia Emiliano , Hu Guanlan , Wen Bijun , Zlotkin Stanley , James Philip , McGrath Marie , Bandsma Robert H J
Published: December 2023

Undernutrition remains a global struggle and is associated with almost 45% of deaths in children younger than 5 years. Despite advances in management of severe wasting (though less so for nutritional edema), full and sustained recovery remains elusive. Children with severe wasting and/or nutritional edema (also commonly referred to as severe acute malnutrition and part of the umbrella term “severe malnutrition”) continue to have a high mortality rate. This suggests a likely multifactorial etiology that may include micronutrient deficiency. Micronutrients are currently provided in therapeutic foods at levels based on expert opinion, with few supportive studies of high quality having been conducted. This narrative review looks at the knowledge base on micronutrient deficiencies in children aged 6–59 months who have severe wasting and/or nutritional edema, in addition to highlighting areas where further research is warranted (See “Future Directions” section).
Disparities in Hypertension Prevalence, Awareness, Treatment, and Control Among Women Living With and Without HIV in the US South
Authors: Blair Jessica , Kempf Mirjam-Colette , Dionne Jodie A , Causey-Pruitt Zenoria , Wise Jenni M , Jackson Elizabeth A , Muntner Paul , Hanna David B , Kizer Jorge R , Fischl Margaret A , Ofotokun Igho , Adimora Adaora A , Gange Stephen J , Brill Ilene K , Levitan Emily B
Published: December 2023

Background

Hypertension-related diseases are major causes of morbidity among women living with HIV. We evaluated cross-sectional associations of race/ethnicity and HIV infection with hypertension prevalence, awareness, treatment, and control.

Methods

Among women recruited into Southern sites of the Women's Interagency HIV Study (2013–2015), hypertension was defined as (1) systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg according to clinical guidelines when data were collected, (2) self-report of hypertension, or (3) use of antihypertensive medication. Awareness was defined as self-report of hypertension, and treatment was self-report of any antihypertensive medication use. Blood pressure control was defined as <140/90 mm Hg at baseline. Prevalence ratios for each hypertension outcome were estimated through Poisson regression models with robust variance estimators adjusted for sociodemographic, behavioral, and clinical risk factors.

Results

Among 712 women, 56% had hypertension and 83% were aware of their diagnosis. Of those aware, 83% were using antihypertensive medication, and 63% of those treated had controlled hypertension. In adjusted analyses, non-Hispanic White and Hispanic women had 31% and 48% lower prevalence of hypertension than non-Hispanic Black women, respectively. Women living with HIV who had hypertension were 19% (P = .04) more likely to be taking antihypertension medication when compared with women living without HIV.

Conclusions

In this study population of women living with and without HIV in the US South, the prevalence of hypertension was lowest among Hispanic women and highest among non-Hispanic Black women. Despite similar hypertension prevalence, women living with HIV were more likely to be taking antihypertensive medication when compared with women living without HIV.
A statistical mechanics framework for constructing nonequilibrium thermodynamic models
Authors: Leadbetter Travis , Purohit Prashant K , Reina Celia
Published: December 2023

Far-from-equilibrium phenomena are critical to all natural and engineered systems, and essential to biological processes responsible for life. For over a century and a half, since Carnot, Clausius, Maxwell, Boltzmann, and Gibbs, among many others, laid the foundation for our understanding of equilibrium processes, scientists and engineers have dreamed of an analogous treatment of nonequilibrium systems. But despite tremendous efforts, a universal theory of nonequilibrium behavior akin to equilibrium statistical mechanics and thermodynamics has evaded description. Several methodologies have proved their ability to accurately describe complex nonequilibrium systems at the macroscopic scale, but their accuracy and predictive capacity is predicated on either phenomenological kinetic equations fit to microscopic data or on running concurrent simulations at the particle level. Instead, we provide a novel framework for deriving stand-alone macroscopic thermodynamic models directly from microscopic physics without fitting in overdamped Langevin systems. The only necessary ingredient is a functional form for a parameterized, approximate density of states, in analogy to the assumption of a uniform density of states in the equilibrium microcanonical ensemble. We highlight this framework’s effectiveness by deriving analytical approximations for evolving mechanical and thermodynamic quantities in a model of coiled-coil proteins and double-stranded DNA, thus producing, to the authors’ knowledge, the first derivation of the governing equations for a phase propagating system under general loading conditions without appeal to phenomenology. The generality of our treatment allows for application to any system described by Langevin dynamics with arbitrary interaction energies and external driving, including colloidal macromolecules, hydrogels, and biopolymers.
Sudden adiabaticity signals reentrant bulk superconductivity in UTe2
Authors: Schönemann Rico , Rosa Priscila F S , Thomas Sean M , Lai You , Nguyen Doan N , Singleton John , Brosha Eric L , McDonald Ross D , Zapf Vivien , Maiorov Boris , Jaime Marcelo
Published: December 2023

There has been a recent surge of interest in UTe2 due to its unconventional magnetic field (H)-reinforced spin-triplet superconducting phases persisting at fields far above the simple Pauli limit for H∥[010]. Magnetic fields in excess of 35 T then induce a field-polarized magnetic state via a first-order-like phase transition. More controversially, for field orientations close to H∥[011] and above 40 T, electrical resistivity measurements suggest that a further superconducting state may exist. However, no Meissner effect or thermodynamic evidence exists to date for this phase making it difficult to exclude alternative scenarios. In this paper, we describe a study using thermal, electrical, and magnetic probes in magnetic fields of up to 55 T applied between the [010] (b) and [001] (c) directions. Our MHz conductivity data reveal the field-induced state of low or vanishing electrical resistance; our simultaneous magnetocaloric effect measurements (i.e. changes in sample temperature due to changing magnetic field) show the first definitive evidence for adiabaticity and thermal behavior characteristic of bulk field-induced superconductivity.
The Bone Marrow Microenvironment in Immune-Mediated Inflammatory Diseases: Implications for Mesenchymal Stromal Cell-Based Therapies
Authors: Redondo Juliana , Bailey Steven , Kemp Kevin C , Scolding Neil J , Rice Claire M
Published: December 2023

Bone marrow (BM)-derived mesenchymal stromal cells (MSCs) are promising candidates for cell-based therapy for several immune-mediated inflammatory diseases (IMIDs) due to their multiplicity of immunomodulatory and reparative properties and favorable safety profile. However, although preclinical data were encouraging, the clinical benefit demonstrated in clinical trials of autologous MSC transplantation in a number of conditions has been less robust. This may be explained by the growing body of evidence pointing to abnormalities of the bone marrow microenvironment in IMIDs, including impaired MSC function. However, it is not currently known whether these abnormalities arise as a cause or consequence of disease, the role they play in disease initiation and/or progression, or whether they themselves are targets for disease modification. Here, we review current knowledge about the function of the BM microenvironment in IMIDs including multiple sclerosis, systemic lupus erythematosus, rheumatoid arthritis, and type I diabetes, focusing on MSCs in particular. We predict that an improved understanding of disease-related changes in the bone marrow microenvironment including the role of MSCs in vivo, will yield new insights into pathophysiology and aid identification of new drug targets and optimization of cell-based therapy in IMIDs.
Determining the phosphorus release curve for Sunphase HT phytase in nursery pig diets
Authors: Kim Ty H , Gaffield Katelyn N , Tokach Mike D , DeRouchey Joel M , Woodworth Jason C , Goodband Robert D , Gebhardt Jordan T , Zhou Ying , Song Xuerong , Wu Xiuyi
Published: December 2023

A total of 280 pigs (DNA 241 × 600, initially 10.4 ± 0.24 kg) were used in a 21-d study to determine the available P (aP) release curve for Sunphase HT phytase (Wuhan Sunhy Biology Co., Ltd., Wuhan, P.R. China) when fed diets with a high phytate concentration. On day 21 post-weaning, considered day 0 of the study, pigs were blocked by average pen body weight (BW) and randomly allotted to 1 of 7 dietary treatments with 5 pigs per pen and 8 pens per treatment. Dietary treatments were derived from a single basal diet, and ingredients including phytase, monocalcium P, limestone, and sand were added to create the treatment diets. Treatments included three diets with increasing (0.11%, 0.19%, and 0.27%) aP from monocalcium P, or four diets with increasing phytase (250, 500, 1,000, or 2,000 phytase unit (FTU)/kg) added to the diet formulated to 0.11% aP. All diets were corn–soybean meal–canola meal-based and were formulated to contain 1.24% SID Lys, a 1.10:1 total calcium-to-phosphorus ratio, and a calculated 0.32% phytate P. Prior to the beginning of the study, all pigs were fed a diet containing 0.11% aP from days 18 to 21 post-weaning. At the conclusion of the study, 1 pig, closest to the mean weight of each pen, was euthanized, and the right fibula, 10th rib, and metacarpal were collected to determine bone ash and density. After cleaning, bones were submerged in ultra-purified water under a vacuum for 4 h and then weighed to calculate the density (Archimedes principle). For bone ash, bones were processed using the non-defatted method. From days 0 to 21, increasing aP from monocalcium P increased (linear, P ≤ 0.014) average daily gain (ADG), gain-to-feed (G:F), and final BW. Pigs fed increasing phytase had increased (linear, P ≤ 0.045) ADG, final BW, and plasma inositol concentration as well as improved (quadratic, P = 0.023) G:F. For bone characteristics, pigs fed increasing aP from inorganic P had a linear improvement (P ≤ 0.019) in fibula bone ash weight and percentage bone ash, rib bone ash weight and bone density, and all metacarpal bone properties, with a quadratic response (P ≤ 0.030) for fibula bone density and rib percentage ash. Additionally, pigs fed increasing phytase had increased (P < 0.05) bone ash weight, percentage bone ash, and bone density in either a linear or quadratic fashion depending on the bone analyzed. The available P release curve generated for Sunphase HT phytase for percentage bone ash combining values from the right fibula, 10th rib, and metacarpal is aP release, % = (0.360 × FTU) ÷ (2,330.250 + FTU).
Import Uncertainty and Export Dynamics
Authors: Vijil Mariana , Wagner Laurent , Woldemichael Martha Tesfaye
Published: December 2023

A supply chain is only as strong as its weakest link. Firms are constantly managing uncertainties, including unexpected delays in the provision of a critical input that can slow down or halt the production process, possibly making the manufacturer miss a delivery deadline. As most exporters are also importers of intermediate goods, supply chain unreliability related to import processing times at the border could impact downstream export dynamics. The role of unpredictability in border-clearance times for imports in manufacturing firms’ entry, exit, and survival in export markets is investigated using the PPML estimator on a rich dataset built on firm-level information for 48 developing countries over 2006–2014. Uncertainty in the time to clear imported inputs impacts neither the entry nor the exit rate, but translates into lower survival rates for new exporters, reducing the number of firms that continue serving the foreign market beyond their first year of entry. This effect grows larger over time, owing to rising reputational costs to input-importing exporters and is mainly driven by South-North trade, possibly reflecting the time-sensitivity of buyers in developed countries. Results also reveal heterogeneous effects across export industries, and the mediating role of sunk costs of entry in foreign markets, which attenuate the negative effect of uncertainty on survival rates as firms delay exiting the export market.
The Role and Mechanism of Spinal NF-κB-CXCL1/CXCR2 in Rats with Nucleus Pulposus–induced Radicular Pain
Authors: Gao Fengjiao , Wei Ming , Wang Meiyue , Yang Yongting , Duan Xuan , Yang Lin , Sun Laibao
Published: December 2023

Study Design.

Experimental study of the role and mechanism of spinal NFκB-CXCL1/CXCR2 in rats with nucleus pulposus-induced radicular pain.

Objective.

This study investigated the role and mechanism of spinal NFκB-CXCL1/CXCR2 in autologous nucleus pulposus-induced pain behavior in rats and to clarify the involvement and regulation of spinal NFκB as an upstream molecule of CXCL1 in autologous nucleus pulposus-induced radicular pain in rats.

Summary of Background Data.

The inflammatory response of nerve roots is an important mechanism for the occurrence of chronic pain. NFκB-CXCL1/CXCR2 pathway plays an important role in the development of radicular pain, but its regulatory mechanism in the model of radicular pain induced by autologous nucleus pulposus is still unclear.

Materials and Methods.

We established a rat model of autologous medullary nucleus transplantation. We observed and recorded the changes in 50% mechanical withdrawal threshold and thermal withdrawal latency before and after the administration of CXCL1-neutralizing antibodies, CXCR2 inhibitor, and NFκB inhibitor in each group of rats and evaluated the expression of NFκB, CXCL1, and CXCR2 in the spinal dorsal horn using immunofluorescence and Western blot. To compare differences between groups in behavioral testing, analysis of variance was employed. Dunnett’s method was used to compare differences at different time points within a group and between different groups at the same time point. A comparison of the relative concentration of protein, relative concentration of mRNA, and semiquantitative data from immunofluorescence staining was conducted utilizing one-way ANOVA and Dunnett’s pairwise comparison.

Results.

Autologous nucleus pulposus transplantation can induce radicular pain in rats and upregulate the expression of CXCL1, CXCR2, and NFκB in the spinal cord. CXCL1 is co-expressed with astrocytes, CXCR2 with neurons, and NFκB with both astrocytes and neurons. The application of CXCL1 neutralizing antibodies, CXCR2 inhibitors, and NFκB inhibitors can alleviate pain hypersensitivity induced by autologous nucleus pulposus transplantation in rats. Inhibitors of NFκB could downregulate the expression of CXCL1 and CXCR2.

Conclusions.

We found that spinal NFκB is involved in NP-induced radicular pain in rats through the activation of CXCL1/CXCR2, enriching the mechanism of medullary-derived radicular pain and providing a possible new target and theoretical basis for the development of more effective anti-inflammatory and analgesic drugs for patients with chronic pain following LDH.
Aggressive Angiomyxoma of the Pelvis: 35-year Experience
Authors: Cardenas Lara Francisco J. , Bauzon Justin , Perry William R.G. , Kelley Scott R
Published: December 2023

BACKGROUND:

Aggressive angiomyxoma is a very rare mesenchymal tumor most commonly found in the pelvic and perineal regions. Although many are estrogen and progesterone hormone receptor positive, the pathogenesis is unknown. Due to the rarity, there is a paucity of literature relating to this pathology. This paper presents a case-series on the management of aggressive angiomyxoma of the pelvis.

OBJECTIVE:

To present a 35-year experience managing aggressive angiomyxoma of the pelvis.

DESIGN:

This was a retrospective single system analysis.

SETTINGS:

This study was conducted at a quaternary referral academic healthcare system.

PATIENTS:

All patients treated for aggressive angiomyxoma of the pelvis.

INTERVENTIONS:

All patients underwent surgical and/or medical management of their disease.

MAIN OUTCOME MEASURES:

The primary outcomes were disease recurrence and mortality. Secondary outcomes included risk factors for recurrence.

RESULTS:

A total of 32 patients (94% female) were identified with a median follow-up of 65 months. Thirty (94%) underwent operative resection and 2 were treated solely with medical management. Fifteen achieved an R0 resection (negative microscopic margins) at the index operation, of which 4 (27%) experienced tumor recurrence. There were no mortalities. No risk factors for disease recurrence were identified.

LIMITATIONS:

Limitations to our study include its nonrandomized retrospective nature, single healthcare system experience, and small patient sample size.

CONCLUSIONS:

Aggressive angiomyxoma is a rare, slow-growing tumor with locally invasive features and high potential for recurrence even after resection with negative margins. Imaging modalities such as CT and/or MRI should be obtained to aid in diagnosis and surgical planning. Workup should be paired with preoperative biopsy and testing for hormone receptor status, which can increase diagnostic accuracy and guide medical treatment. Close post-treatment surveillance is imperative to detect recurrence. See Video Abstract.
THE ROLE OF OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN DOME-SHAPED MACULOPATHY
Authors: Milad Daniel , Antaki Fares , Dahoud Andrea , Farah Andrew , Hammamji Karim , Saab Marc
Published: December 2023

Purpose:

The aim of this study was to demonstrate the role of optical coherence tomography angiography in the management of dome-shaped maculopathy.

Methods:

This was a retrospective case review.

Results:

A 52-year-old woman was referred to the authors’ retinal service for potential bilateral choroidal neovascular membrane (CNVM) and blurry vision bilaterally. Initial spectacle-corrected visual acuity was 20/30-2 in the right eye and 20/30 + 2 in the left eye. Dome-shaped maculopathy was diagnosed on optical coherence tomography. In both eyes, optical coherence tomography B-scan passing through the fovea showed shallow irregular retinal pigment epithelium elevation suspicious of occult (type 1) CNVM. The outer retinal and choriocapillaris angiograms showed a zone of nonexudative CNVM in the right eye and exudative CNVM in the left eye. Given the persistent subretinal fluid with CNVM in the left eye, the authors elected to perform intravitreal injections of ranibizumab 0.5 mg on a treat and extend regimen. On the most recent follow-up, the best-corrected visual acuity improved to 20/20 in the left eye with no persisting subretinal fluid.

Conclusion:

The authors present a case where assessing disease progression and the development of CNVM and evaluating the efficiency of therapies were realized through the application of novel optical coherence tomography angiography technology. This diagnostic tool may be used to guide clinicians in their management of dome-shaped maculopathy, as demonstrated through the authors’ experience. Optical coherence tomography angiography can also make it possible to visualize nonexudative CNVM lesions that may be missed on traditional imaging assessments.
DELAYED SPONTANEOUS CLOSURE OF A FULL-THICKNESS MYOPIC MACULAR HOLE WITH GOOD VISUAL RECOVERY
Authors: Oh Jin Kyun , Chang Stanley
Published: December 2023

Purpose:

The aim of this study was to present the longitudinal progression of a myopic macular hole with eventual closure and excellent visual recovery over a decade after initial full-thickness hole formation.

Methods:

The patient was monitored using time domain and spectral domain optical coherence tomography images over 16 years.

Results:

A 68-year-old man with high myopia was referred for surgical evaluation of a full-thickness macular hole and retinal detachment of his left eye, which were repaired. At the initial presentation, the fellow eye demonstrated a lamellar hole, which eventually also progressed to become a full-thickness macular hole. The patient subsequently declined surgery and was observed semiannually over the course of 16 years. At 10 years after the initial injury, the full-thickness macular hole closed spontaneously. The visual recovery was excellent with an acuity of 20/25.

Conclusion:

Although surgical intervention remains the mainstay of treatment for macular holes, patients who are not surgical candidates may still have good visual and anatomic outcomes even long after initial hole formation. Lamellar hole epiretinal proliferation material is frequently seen in myopic full-thickness macular holes and may be associated with eventually delayed hole closure because of their slow progression.
Incidence of Acanthamoeba Keratitis in the United Kingdom in 2015: A Prospective National Survey
Authors: Jasim Haneen , Grzeda Mariusz , Foot Barny , Tole Derek , Hoffman Jeremy J.
Published: December 2023

Purpose:

The aims of this study were to quantify the incidence of Acanthamoeba keratitis (AK) in the United Kingdom and investigate risk factors and management parameters.

Methods:

This was a prospective population-based study from January to December 2015 through the British Ophthalmic Surveillance Unit. Data were collected on demographics, clinical features, and management. Incidence rates were calculated from estimates of population and contact lens (CL) user numbers. Statistical analysis compared annualized incidences per million and altered risk ratios for AK with the England and Wales 24 months 1997/1998 to 1998/1999 study.

Results:

The study identified 124 AK cases, an overall incidence of 2.35 per million. CL wearers accounted for 108 of 124 cases (87%), in whom the AK incidence was 26.94 per million. Herpes keratitis was initially misdiagnosed in 25 of 124 cases (20.2%). The highest incidence of AK was among planned replacement soft CL (PRSCL) wearers (50.65 per million), 7-fold greater than for daily disposable CL (DDSCL) users (7.24 per million). There was a significant increase in AK incidence (P < 0.001) compared with both 1997/1998 [risk ratio 1.92, 95% confidence interval (CI) 1.38–2.66] and 1998/1999 (risk ratio 2.13, 95% CI 1.52–2.98) together with a higher incidence per million CL users of 26.94 versus 21.14 (1997/1998) and 17.53 (1998/1999).

Conclusions:

This study provides the first published data on the nationwide incidence of AK in the United Kingdom. The findings confirm an increasing incidence of AK, particularly among contact lens wearers since 1997/1998 to 1998/1999. PRSCLs were identified as a significant risk factor compared with DDSCLs. Misdiagnosis and treatment delays remain an ongoing problem for patients with AK.
Boosting weight loss after conversional Roux-en-Y Gastric Bypass with liraglutide and placebo use. A double-blind-randomized controlled trial
Authors: Hany Mohamed , Torensma Bart , Ibrahim Mohamed , Zidan Ahmed , Agayby Ann S.S. , Abdelkhalek Mohamed H. , El Sayed Iman
Published: December 2023

Background:

Conversional bariatric surgery inherently has less weight loss (WL) compared to primary procedures. Adjunctive use of the GLP-1 analog, liraglutide with conversional Roux-en-Y Gastric Bypass (cRYGB) may maximize the WL benefits of surgery.

Material and methods:

This single-center randomized double-blind placebo-controlled trial included 80 patients randomized into two groups; the liraglutide group (40 patients) who received daily injections of liraglutide, and the placebo group (40 patients) who received normal saline starting at 6 weeks from cRYGB and continued for 6 months. After discontinuing the drugs at 6 months and unblinding, the patient were followed up to 12 months. The endpoints were percentage of total weight loss (%TWL) and percentage of excess weight loss (%EWL), and changes in the metabolic biomarkers, and complications within 30 and 90 days according to the global outcome benchmark (GOB) stratification.

Results:

In total, 38 patients in the liraglutide group and 31 in the placebo group completed the 24 weeks. Liraglutide group experienced better WL with a significantly higher mean %TWL at 1 month (10.27±1.39 vs. 8.41±2.08), at 6 weeks (12.65±1.77 vs. 10.47±2.23), at 6 months (18.29 ±1.74 vs. 15.58 ±1.65), and at 12 months 24.15±2.35 versus 22.70±2.13 (all P<0.001). For %EWL, this was also significantly higher in the liraglutide group at all time points. A %TWL of greater than 20% at 6 months of treatment was recorded in six (15.8%) patients in the liraglutide group and none in the placebo group (P=0.029). Both groups had comparable changes in metabolic biomarkers. Adverse events were recorded in 11 (27.5%) patients in the liraglutide, with no adverse events in the placebo group (P<0.001). Both groups had Clavien–Dindo scores I and II (5.0 and 2.5%), and GOB values indicated that 90.0 and 97.5% were low-risk patients.

Conclusion:

Adjunctive use of liraglutide with cRYGB gives significantly higher WL and resolution of associated medical problems.
Neighborhood-level social determinants of health measures independently predict receipt of living donor liver transplantation in the United States
Authors: Kanneganti Mounika , Byhoff Elena , Serper Marina , Olthoff Kim M. , Bittermann Therese
Published: December 2023

Disparities exist in the access to living donor liver transplantation (LDLT) in the United States. However, the association of neighborhood-level social determinants of health (SDoH) on the receipt of LDLT is not well-established. This was a retrospective cohort study of adult liver transplant recipients between January 1, 2005 and December 31, 2021 at centers performing LDLT using the United Network for Organ Sharing database, which was linked through patients’ ZIP code to a set of 24 neighborhood-level SDoH measures from different data sources. Temporal trends and center differences in neighborhood Social Deprivation Index (SDI), a validated scale of socioeconomic deprivation ranging from 0 to 100 (0=least disadvantaged), were assessed by transplant type. Multivariable logistic regression evaluated the association of increasing SDI on receipt of LDLT [vs. deceased donor liver transplantation (DDLT)]. There were 51,721 DDLT and 4026 LDLT recipients at 59 LDLT-performing centers during the study period. Of the 24 neighborhood-level SDoH measures studied, the SDI was most different between the 2 transplant types, with LDLT recipients having lower SDI (ie, less socioeconomic disadvantage) than DDLT recipients (median SDI 37 vs. 47; p < 0.001). The median difference in SDI between the LDLT and DDLT groups significantly decreased from 13 in 2005 to 3 in 2021 (p = 0.003). In the final model, the SDI quintile was independently associated with transplant type (p < 0.001) with a threshold SDI of ~40, above which increasing SDI was significantly associated with reduced odds of LDLT (vs. reference SDI 1–20). As a neighborhood-level SDoH measure, SDI is useful for evaluating disparities in the context of LDLT. Center outreach efforts that aim to reduce disparities in LDLT could preferentially target US ZIP codes with SDI > 40.
Comparative efficacy and safety of Faricimab and other anti-VEGF therapy for age-related macular degeneration and diabetic macular edema: A systematic review and meta-analysis of randomized clinical trials
Authors: Li Guoxian , Zhu Ning , Ji Aimin
Published: December 2023

Introduction:

A systematic review and meta-analysis were conducted to evaluate the efficacy and the overall safety of Faricimab compared with other anti-vascular endothelial growth factors (VEGF) therapy for neovascular age-related macular degeneration (AMD) and diabetic macular edema (DME).

Materials and methods:

A systematic literature search of a comprehensive electronic database was performed to identify randomized clinical trials published from January 2013 to January 2023 for Faricimab in AMD and DME. Weighted mean differences and risk ratios were used to integrate the different studies.

Results:

A total of 4 randomized controlled trials (RCTs) with 1678 AMD patients and 3 RCTs with 20 DME patients were included in the meta-analysis.

In patients with AMD, a significant difference was found in the number of injections between Faricimab and other anti-VEGF therapy (MD = −2.42, 95% CI [−3.93 to −0.90], P = .002).No significant difference was found for the change in best corrected visual acuity (BVCA), central subfoveal thickness (CST), and gaining 15 or more letters. Similarly, no significant difference was found for adverse events.

In patients with DME, a significant difference was observed for CST (MD = −22.41, 95% CI [−29.95 to −14.86], P < .00001) and the number of injections(MD = −0.93, 95% CI [−1.33 to −0.54], P < .00001). No significant difference was found for BVCA and gaining 15 or more letters, and no significant difference was found for adverse events.

Conclusions:

Comprehensive evidence confirms that Faricimab achieves non-inferior or even better CST improvement than other anti-VEGF therapies with extended dosing intervals, but more long-term follow-up studies are needed to support our conclusions.
Correlations between activation, family adaptation, and self-perceived burden in breast cancer patients with an implanted venous access port: A cross-sectional study
Authors: Li Kun , Zhu Lan , Zhang Liu-Yi
Published: December 2023

We found that activation and family adaptation on the self-perceived burden of breast cancer patients with an implanted venous access port (IVAP), and to analyze the correlations among these scores. A total of 256 patients completed a general data questionnaire, the Patient Activation Measure (PAM), the Family adaptation and Cohesion Scale II-Chinese version (FACES-II-CV), and the Self-perceived Burden Scale (SPBS). The total scores for activation, family adaptation, and self-perceived burden were 63.31 ± 18.92, 42.72 ± 7.937, and 28.55 ± 7.89, respectively. We analyzed activation and family adaptation were associated with self-perceived burden (P < .05) the patients’ self-perceived burden main factors is included Main caregiver, disease stage, complications, Type of health insurance, activation, and family adaptation. The activation, family adaptation, and self-perceived burden of breast cancer patients with an IVAP are closely related, which suggests that clinical workers should consider the patient family to formulate an intervention plan to improve patient activation, and thus reduce the self-perceived burden. For example, hospitals regularly conduct breast cancer health education activities, or invite psychological counselors to provide services to patients.
Glenohumeral internal rotation deficit in general population with shoulder pain: A descriptive observational study
Authors: Jácome-López Rafael , Tejada-Gallego Javier , Silberberg José María , García-Sanz Fernando , García-Muro-San José Francisco
Published: December 2023

Glenohumeral internal rotation deficit (GIRD) is one of the most important factors influencing injury risk in the arm of overhead athletes. Some studies have shown that the GIRD of athletes with shoulder pain was higher than those without shoulder pain, establishing a relation between shoulder pain and GIRD. However, there are no studies that relate to GIRD and shoulder pain or the risk factors that affect GIRD in the population with this ailment. This study aimed to: determine if GIRD could be found clinically and between which values it oscillates in patients with shoulder pain, and explore if there are any potential associations between GIRD and some sociodemographic data, and orthopedic or radiological findings. A descriptive observational study design was adopted to determine if GIRD could be found clinically in patients with shoulder pain and to gain further evidence in the potential associations between GIRD and sociodemographic data, and orthopedic or radiological findings. All those patients without exclusion criteria between October 1,2020 and March 31,2021 were included. Exclusion criteria consisted of being under 18 years old but younger than 80 years old, showing shoulder pain in both shoulders and having a joint prosthesis in at least one of the 2 shoulders, tumor, or infection. A total of 67 patients aged between 25 and 75 years (52.7 ± 11.8 years, 36 male and 31 female). More than 82% of patients with shoulder pain showed a GIRD higher than 20º. The mean GIRD was 37.6 ± 17.09º. The 95th percentile was 66.22º. From sociodemographic data could be extracted that: patients who have children showed a lower GIRD, patients with right shoulder pain, or whose dominance coincided with a painful shoulder showed a higher GIRD. The orthopedic findings revealed that patients with a positive Jobe test showed a lower GIRD. The linear model considering both sociodemographic and orthopedic findings showed that GIRD was reduced by having children and by BMI. GIRD shows a high incidence in patients with shoulder pain. The descendant, BMI, and positive Jobe test were negatively associated with the GIRD.
Examining the effect of COVID-19 vaccines on the menstrual cycle: A study from Turkey
Authors: Toktaş İzzettin , Akelma Hakan , Araç Eşref
Published: December 2023

Concerns about a possible relationship between vaccination against Coronavirus Disease 2019 (COVID-19) and menstrual disorders have been raised in the media. In addition, different studies have shown that the COVID-19 vaccine may be associated with menstrual changes. This study was conducted to investigate the effects of COVID-19 vaccines on the menstrual cycle in women. This cross-sectional descriptive study was conducted between August 16 and September 17, 2021. Data were collected through a self-administered questionnaire via an online form sent to the participants through social media. Data of 586 women were included in this study. A total of 82.4% (n = 483) of the participants were aged between 31 and 50 years. The BioNTech vaccine (2 doses) was administered to 75.8% (n = 444), Sinovac (3 doses) to 9.0% (n = 53) of the participants. 53.1% (n = 311) of the women experienced changes in their menstrual cycles. The most common menstrual changes after vaccination were delayed menstruation (n = 176; 30.0%) and prolonged menstrual duration (n = 132; 22.5%). Menstrual delay, prolonged menstrual duration, heavy bleeding, and early menstruation were more common in women than prior to receiving the vaccine (P < .05). More than half of the women experienced menstrual cycle changes after receiving the COVID-19 vaccine. Women experienced significantly higher rates of menstruation delay, prolonged menstrual duration, heavy bleeding, and early bleeding compared to before vaccination.