bluuebunny/crossref_metadata_2025 huggingface dataset:
Antiviral Abidol is Associated with the Reduction of In-Hospital Mortality in COVID-19 Patients
Authors: Zeng Hesong , He Xingwei , Liu Wanjun , Kan Jing , He Liqun , Zhao Jinhe , Chen Cynthia , Zhang Junjie , Chen Shaoliang
Published: October 2021

Objective:

Coronavirus disease 2019 (COVID-19) is a global public health crisis. There are no specific antiviral agents for the treatment of SARS-CoV-2. Information regarding the effect of Abidol on in-hospital mortality is scarce. The present study aimed to evaluate the treatment effect of Abidol for patients with COVID-19 before and after propensity score matching (PSM).

Methods:

This retrospective cohort study analyzed 1019 patients with confirmed COVID-19 in China from December 22, 2019 to March 13, 2020. Patients were divided to Abidol (200 mg, tid, 5–7 days, n = 788, 77.3%) and No-Abidol (n = 231, 22.7%) groups. The primary outcome was the mortality during hospitalization.

Results:

Among 1019 COVID-19 patients, the age was (60.4 ± 14.5) years. Abidol-treated patients, compared with No-Abidol-treated patients, had a shorter duration from onset of symptoms to admission, less frequent renal dysfunction, lower white blood cell counts (lymphocytes <0.8) and erythrocyte sending rate, lower interleukin-6, higher platelet counts and plasma IgG and oxygen saturation, and less frequent myocardial injury. The mortality during hospitalization before PSM was 17.9% in Abidol group and 34.6% in No-Abidol (hazard ratio (HR) = 2.610, 95% confident interval (CI): 1.980–3.440), all seen in severe and critical patients. After PSM, the in-hospital death was 13.6% in Abidol and 28.6% in No-Abidol group (HR = 2.728, 95% CI: 1.598–4.659).

Conclusions:

Abidol-treatment results in less in-hospital death for severe and critical patients with COVID-19. Further randomized study is warranted to confirm the findings from this study.
Upregulation of Cartilage Oligomeric Matrix Protein and Bone Morphogenetic Protein-2 May Associate with Calcific Aortic Valve Disease
Authors: Xu Yueyue , Cao Yide , Liu Yafeng , Wang Jingsong , Chen Ganyi , Tao Zhonghao , Yao Yiwei , Cai Yuchen , Wu Yunzhang , Chen Wen
Published: October 2021

Objective:

Calcific aortic valve disease (CAVD) affects millions of elderly people, and there is currently no effective way to stop or slow down its progression. Therefore, exploring the pathogenesis of CAVD is very important for prevention and treatment. Cartilage oligomeric matrix protein (COMP) have important role in cell phenotype change. This study is aimed to confirm whether COMP participate in CAVD and try to find the possible mechanisms.

Methods:

Human aortic valve tissues from Nanjing First Hospital (CAVD group, n = 20; control group, n = 11) were harvested. The expression level of COMP was tested by western blot and immunohistochemistry. Dual immunofluorescence staining was used for locating COMP. Bone morphogenetic protein-2 (BMP2) signalling were tested by western blot. The animal model was also used to detect COMP level by immunohistochemistry.

Results:

The results showed that the expression level of COMP was significantly increased in the calcific valve samples when compared with that of the control valve (P < 0.05); COMP was expressed near the calcific nodules and co-localized with α-smooth muscle actin (α-SMA). The protein levels of BMP2 and p-Smads 1/5/9 were markedly more highly expressed in the CAVD group than the control group (P < 0.05). Furthermore, immunofluorescence detection showed that COMP and BMP2 were co-located in calcific valves.

Conclusions:

The above results suggested that upregulation of COMP and BMP2 may be associated with aortic valve calcification and that COMP may become a potential therapeutic target in human CAVD.
Bivalirudin in Primary PCI: Can Its Glory Being Restored?
Authors: Li Yang , Li Yi , Stone Gregg W. , Han Yaling
Published: October 2021

Intravenous anticoagulant therapy is critical to prevent ischemic recurrences and complications without increasing the risk of bleeding in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). It includes the indirect thrombin inhibitor heparins and the direct thrombin inhibitor bivalirudin. However, the ideal anticoagulant for patients undergoing PPCI remains controversial. In this review, we provide an overview of currently available anticoagulant therapies used in STEMI patients undergoing PPCI, including describing the rationale for their use, pivotal clinical trial data, and treatment recommendations of guidelines, providing much-needed clarity to guide the selection of the safest and most effective anticoagulant regimens for PPCI.
Surgical Treatment of Left Atrial Dissection and Severe Mitral Valve Obstruction
Authors: Chen Antian , Ma Guotao , Yang Deyan , Wang Chenyu , Liu Yingxian
Published: October 2021

Left atrial dissection is a rare complication of mitral valve replacement surgery. Here, a case of left atrial dissection followed by mitral valvular obstruction was presented. It is suspected that the dissection was caused by trematodiases infection. Cardiac surgery was finally performed, which not only confirmed the diagnosis but also acted as an effective treatment. Especially, surgery is of essential value to confirm the perforation locating at the basal posterior wall of the left ventricle, to repair the atrial dissection, and to relieve the mitral valvular obstruction.
Rationale and Design of a Randomized Controlled Trial on Intensive Management of Blood PRESSure and Cholesterol in Elderly Chinese with Hypertension and Atrial FibrillatION (IMPRESSION)
Authors: Zhang Wei , Chen Yi , Huang Qifang , Wang Ji-Guang
Published: October 2021

Hypertension significantly increases the risk of embolic stroke and systemic embolism in patients with atrial fibrillation, while statin therapy can improve long-term outcomes in hypertensive patients at high risk. However, it is still unclear whether patients with both hypertension and atrial fibrillation can benefit from intensive management of blood pressure and cholesterol. IMPRESSION is a 3-year prospective, randomized, open-label, blinded-endpoint investigation. A total of 1200 hypertensive patients with atrial fibrillation from about 40 clinical centers nationwide will be included upon confirming the presence of both hypertension and atrial fibrillation and will be randomly assigned to groups for intensive or standard management of blood pressure and cholesterol. Patients in all groups will have office and home blood pressure measured by the end of the first month and every 3 months thereafter. The effects of blood pressure and cholesterol management strategies in patients with hypertension and atrial fibrillation on fatal and non-fatal stroke, acute myocardial infarction, and cardiovascular death at 3 years will be assessed. The IMPRESSION study protocol has received approval from the Ethics Committee of Ruijin Hospital, Shanghai Jiaotong University School of Medicine. The procedures set out in this protocol are in accordance with the principles of the Declaration of Helsinki and Good Clinical Practice guidelines. The results will be published following the CONSORT statement in a peer-reviewed scientific journal (Trial registration number: NCT04111419).
Imaging Findings in Immunotherapy-related Renal Toxicity
Authors: Khauli Mark A. , An Thomas J. , Anderson Mark A.
Published: October 2021

Immunotherapy-related adverse events (irAEs) associated with immune-checkpoint inhibitors can affect nearly any organ system including commonly the luminal gastrointestinal tract, hepatobiliary system, lungs, endocrine glands, and skin, many of which have described imaging manifestations. In patients without clinically suspected irAEs, imaging findings may be the first indication of an abnormality that prompts further workup to facilitate early detection and initiation of appropriate treatment, such as therapy discontinuation or corticosteroid therapy. While some irAEs have well described imaging correlates, such as pneumonitis, hypophysitis, and colitis, others are not well described, such as nephritis. We report 2 cases of irAE nephritis associated with PD-1 inhibitor therapy and their imaging features.
Upregulation of miR-345-5p suppresses cell growth of lung adenocarcinoma by regulating ras homolog family member A (RhoA) and Rho/Rho associated protein kinase (Rho/ROCK) pathway
Authors: Zhou Qiao-Yun , Gui Shu-Yu , Zhang Peng , Wang Mei
Published: October 2021

Background:

Microribose nucleic acids (miRNAs) are implicated in the progression of lung adenocarcinoma. MicroRNA-345-5p (miR-345-5p) is a recently identified anti-oncogene in some human cancers, but its functional role and possible molecular mechanism in lung adenocarcinoma remain unknown. This study aimed to identify the biological function and underlying mechanism of miR-345-5p in lung adenocarcinoma cells.

Methods:

In this study, lung adenocarcinoma tissues and adjacent tissues were collected in the First Affiliated Hospital of Anhui Medical University between April 2016 and February 2017. The expression of miR-345-5p and ras homolog family member A (RhoA) in lung adenocarcinoma tissues and human lung adenocarcinoma cell lines (A549, H1650, PC-9, and H441) was detected by reverse transcription quantitative polymerase chain reaction analysis. Functional assays including colony formation, flow cytometry analysis, wound healing, and transwell assays were performed to assess the proliferation, apoptosis, migration, and invasion of lung adenocarcinoma cells. In addition, RNA pulldown and luciferase reporter assays were conducted to evaluate the relationship between miR-345-5p and RhoA. Difference between the two groups was analyzed with Student's t test, while that among multiple groups was analyzed with one-way analysis of variance.

Results:

MiR-345-5p expression displayed lower level in lung adenocarcinoma tissues (0.241 ± 0.095 vs.1.000 ± 0.233, t = 19.247, P < 0.001) and cell lines (F = 56.992, P < 0.001) than control tissues and cells. Functional experiments demonstrated that upregulation of miR-345-5p inhibited the malignant phenotypes of lung adenocarcinoma cells via suppressing cell proliferation, migration, invasion, and facilitating cell apoptosis. Additionally, RhoA was verified to be the downstream target of miR-345-5p. Expression of RhoA was downregulated by overexpression of miR-345-5p in PC-9 (0.321 ± 0.047 vs. 1.000 ± 0.127, t = 8.536, P < 0.001) and H1650 (0.398 ± 0.054 vs. 1.000 ± 0.156, t = 4.429, P = 0.011) cells. Rescue assays revealed that overexpression of RhoA rescued the suppressive effects of miR-345-5p upregulation on proliferation, migration, and invasion of lung adenocarcinoma cells. Further, miR-345-5p was found to regulate the Rho/Rho-associated protein kinase (ROCK) signaling pathway by downregulation of RhoA in lung adenocarcinoma cells.

Conclusions:

MiR-345-5p plays a tumor suppressor role in lung adenocarcinoma cells by downregulating RhoA to inactivate the Rho/ROCK pathway.
Risk factors associated with osteoporosis and fracture in psoriatic arthritis
Authors: Wang Yu , Song Zhi-Bo , Deng Xue-Rong , Zhang Xiao-Hui , Zhang Zhuo-Li
Published: October 2021

Background:

Although there are few studies mentioned there may be some relationship between psoriatic arthritis (PsA) and osteoporosis, clinical data in real world still need to be clarified in China. The aim of this study was to assess the areal and volumetric bone mineral density (BMD), frequency of fracture, and risk factors in patients with PsA.

Methods:

A total of one hundred PsA patients who visited Peking University First Hospital and one hundred age- and sex-matched healthy controls with DXA data were enrolled in the study. Patients with clinical fractures confirmed by X-ray during follow-up were also recorded. Clinical characteristics of the patients were recorded and compared between the abnormal BMD group and the normal BMD group, as well as between the fracture and non-fracture groups. Risk factors for fracture and low BMD were analyzed.

Results:

Mean BMD at the total hip and femoral neck was significantly lower in PsA patients than that in healthy controls (0.809 ± 0.193 vs. 0.901 ± 0.152 g/cm2, P 
= 0.041; 0.780 ± 0.146 vs. 0.865 ± 0.166 g/cm2, P 
= 0.037, respectively). Moreover, lumbar spine BMD was negatively correlated with psoriasis duration, swollen joint count and DAS28-CRP (r = –0.503, –0.580, –0.438; P < 0.05). Total hip BMD and femoral neck BMD were negatively correlated with HAQ (r = –0.521, –0.335; P < 0.05). Fractures occurred in 29 patients during the follow-up period. Logistic regression analysis showed that older age (OR 1.132 [95%CI: 1.026–1.248), P < 0.05], higher HAQ score (OR 1.493, 95%CI: 1.214–1.836, P < 0.01), higher disease activity index for psoriatic arthritis (OR 1.033, 95% CI: 1.002–1.679, P < 0.05) and hip joint involvement (OR 6.401, 95% CI: 4.012–44.180, P < 0.05) were risk factors for fracture in the multivariate model.

Conclusions:

Increased risks of osteoporosis and fracture were found in PsA patients compared to healthy controls. Besides age, high disease activity and hip joint involvement were risk factors for decreased BMD and fracture.
Role of Pericytes in Diabetic Angiogenesis
Authors: Wang Tianyou , Zang Guangyao , Zhang Lili , Sun Zhen , Liu Jia , Hou Lina , Wang Zhongqun
Published: October 2021

In the context of diabetes mellitus, various pathological changes cause tissue ischemia and hypoxia, which can lead to the compensatory formation of neovascularization. However, disorders of the internal environment and dysfunctions of various cells contribute to the dysfunction of neovascularization. Although the problems of tissue ischemia and hypoxia have been partially solved, neovascularization also causes many negative effects. In the process of small blood vessel renewal, pericytes are extremely important for maintaining the normal growth and maturation of neovascularization. Previously, our understanding of pericytes was very limited, and the function of pericytes was not yet clear. Recently, multiple new functions of pericytes have been identified, affecting various processes in angiogenesis and relating to various diseases. Therefore, the importance of pericytes has gradually become apparent. This article presents the latest research progress on the role of pericytes in diabetic angiogenesis, characterizes pericytes, summarizes various potential therapeutic targets, and highlights research directions for the future treatment of various diabetes-related diseases.
Catalpol Alleviates Ang II-Induced Renal Injury Through NF‐κB Pathway and TGF-β1/Smads Pathway
Authors: Cong Cong , Yuan Xiaohong , Hu Ying , Chen Wenjing , Wang Yong , Tao Lei
Published: October 2021

Catalpol is an iridoid glycoside obtained from Rehmannia glutinosa, which in previous studies showed various pharmacological properties, including anti-inflammatory, antioxidant, antidiabetic, antitumor, and dopaminergic neurons protecting effects. Here, we examined the effect of catalpol on renal injury induced by angiotensin II (Ang II) and further to explore its latent molecular mechanisms. We used an in vivo model of Ang II-induced renal injury mice; catalpol (25, 50, and 100 mg/kg) was administered for 28 days. Mouse glomerular mesangial cells (SV40 MES 13), rat kidney interstitial fibroblasts cells (NRK-49F), and human proximal tubular epithelial cells (HK-2) were induced by Ang II (10 µM) in the presence or absence of catalpol (1, 5, and 10 µM) and incubated for 48 hours in vitro. In our study, periodic acid-Schiff and Masson staining of renal tissue showed that catalpol reduced Ang II-induced renal injury in a concentration-dependent manner. The positive expressions of collagen IV and TGF-β1 were observed to decrease sharply after catalpol treatment. In renal tissue, the levels of pro-inflammatory cytokines tumor necrosis factor α and interleukin 6 were evidently decreased after catalpol intervention. Catalpol can relieve Ang II-induced renal injury by inactivating NF‐κB and TGF-β1/Smads signaling pathways. Therefore, catalpol may act as a potential drug to treat Ang II-induced renal injury.
The menopausal transition in Mongolia
Authors: Bayanjargal Oyuntuya , Namsrai Zolzaya , Sievert Lynnette Leidy
Published: October 2021

Objective:

The purpose of this cross-sectional pilot study was to develop a preliminary understanding of how menopause is experienced by Mongolian women. Our goals were to collect symptoms associated with the end of menstruation and to understand the language used and meaning of menopause in everyday life.

Methods:

We carried out interviews using a semistructured questionnaire with open-ended questions (n = 17). In the capital city of Ulaanbaatar, we carried out two focus groups of five women each in a community center and an artisan factory, along with five separate interviews in a second community center and a coffee shop. We also administered the questionnaire by phone to two women residing in rural villages.

Results:

The most common symptoms associated with the end of menstruation were hot flashes (71%), anger (47%), and stress (29%). Other symptoms included shortness of breath, fatigue, crying, and badairakh (tingling) on the face. Women used the words tsevershilt and tsevershikh to describe cleansing. Menstruation was thought to rid the body of “bad” blood, so with menopause the body has been “cleaned.” Conversely, some women attributed a decline in health, including varicose veins, diabetes, and negative psychological changes, to the retention of “bad” blood after menopause.

Conclusions:

The topic of menopause is not taboo, and the prevalence and experience of hot flashes is similar to experiences described across the world. However, there are specific words and concepts, such as tsevershikh and tsevershilt, that are uniquely applied to the menopausal transition in Mongolia.
Do Dedicated Research Years during Medical School Predict Academic Productivity during Residency?
Authors: Applebaum Sarah A. , Stoehr Jenna R. , Bacos Jonathan T. , Vaca Elbert E. , Lopez Joseph , Chu Yuyang , Gosain Arun K.
Published: October 2021

Background:

Evidence regarding whether medical school research portends resident research is limited. This information will provide program directors with data that may be useful for selecting applicants with a commitment to continued academic productivity.

Methods:

A questionnaire distributed via the American Society of Plastic Surgeons Resident Council to residents in 44 plastic surgery training programs in May 2020 assessed participation in dedicated research years during medical school, the number of publications completed before residency, and the total number of publications by each resident at the time of the survey. One-way ANOVA and post hoc analysis determined significant associations between publication count and number of research years.

Results:

Of the 256 included respondents, 203 did not complete a research year during medical school, 44 completed 1 research year, and nine completed 2 research years. Mean publications before residency were higher for participants who took 1 or 2 research years (9.88 and 27.60, respectively) compared with those who did not (4.83, P < 0.001). A comparison of total publications during residency similarly revealed increased productivity by individuals who took 1 or more research years; however, there was no difference between the number of publications completed during residency for individuals who took 1 versus 2 years (P = 0.23).

Conclusions:

Residents with research experience during medical school continue to produce an increased number of publications during residency compared with those without, suggesting dedicated research years taken during medical school serve as a predictor of academic productivity in plastic surgery residents.
A Three-dimensionally Printed Acrylonitrile Butadiene Styrene Model for the Reduction of Nasomaxillary Fracture
Authors: Ikebe Shohei , Niimi Yosuke , Hasegawa Yuki , Kamei Wataru , Hori Keijiro , Masamune Ken , Sakurai Hiroyuki
Published: October 2021

The successful reduction of a nasomaxillary fracture was performed using a three-dimensional printed model. A 16-year-old boy was struck in the left orbit by a baseball; subsequently, he was diagnosed with the nasal bone fracture at a hospital, and was referred to the authors’ department. A left nasomaxillary fracture and nasal bone fracture were diagnosed by computed tomography. Standard triangulated language data for the mirror image of the frontal process of the right maxilla were obtained from digital imaging and communications in medicine data for preparing a three-dimensional printed acrylonitrile butadiene styrene model. On postinjury day 13, the frontal process fracture was reduced via transconjunctival and intraoral approaches. After the reduction of the fracture, an absorbable plate fitting to the shape of three-dimensional printed acrylonitrile butadiene styrene model was molded, and the maxillary frontal process and infraorbital rim were reduced and fixed with an absorbable plate and screws. Postoperative computed tomography demonstrated a favorable reduction. The intraoperative use of the 3D printed acrylonitrile butadiene styrene model was helpful in the nasomaxillary fracture reduction and fixation.
In Utero Fetal Therapy: Stem Cells, Cell Transplantation, Gene Therapy, and CRISPR-Cas9
Authors: Shear Matthew A. , Massa Andrew
Published: October 2021

In utero fetal therapy offers the opportunity to prevent and treat diseases with a cellular or genetic basis. Components of successful fetal treatment include isolation of a replacement cell population, in utero stem cell transplantation, cell engraftment with fetal immune tolerance, and ongoing cell function. Fetal gene therapy with CRISPR-Cas9 represents an exciting potential therapy for genetic diseases not amenable to gene supplementation via adenoviral vector transduction. These fetal therapies have unique ethical and safety considerations. Clinical trials for in utero cell therapy are underway, as additional discoveries in stem cell biology and gene therapy move closer to clinical translation.
Regionalization of congenital cardiac surgical care: what it will take
Authors: Ghandour Hiba Z. , Vervoort Dominique , Welke Karl F. , Karamlou Tara
Published: October 2021

Purpose of review

Decentralized, inconsistent healthcare delivery results in variable outcomes and wastes nearly one trillion dollars annually in the United States (US). Congenital heart surgery (CHS) is not immune due to high, variable costs and inconsistent outcomes across hospitals. Many European countries and Canada have addressed these issues by regionalizing CHS. Centralizing resources lowers costs, reduces in-hospital mortality and improves long-term survival. Although the impact on travel distance for patients is limited, the effect on healthcare disparities requires study. This review summarizes current data and integrates these into paths to regionalization through health policy, research, and academic collaboration.

Recent findings

There are too many CHS programs in the US with unnecessarily high densities of centers in certain regions. This distribution lowers center and surgeon case volumes, creates redundancy, and increases variation in costs and outcomes. Simultaneously, adhering to suboptimal allocation impedes the understanding of optimal regionalization models to optimize congenital cardiac care delivery.

CHS regionalization models developed for the US increase surgeon and center volume, decrease healthcare spending, and improve patient outcomes without substantially increasing travel distance. Regionalization in countries with few or no existing CHS programs is yet to be explored, but may be associated with more efficient spending and procedural complexity expansion.
Secular trends in blood pressure trajectories in Chinese children and adolescents: the impact of changing physical growth
Authors: Gao Mingyue , Wells Jonathan C.K. , Li Leah
Published: October 2021

Background:

Globally, 80% of cardiovascular disease (CVD) occur in low-income /middle-income countries. High blood pressure (BP), a major risk factor for CVD, has its origins in early-life. We investigated how age trajectories of BP (childhood to late-adolescence) have changed recently in China and the mediating roles of physical growth.

Methods:

Using the longitudinal data on 3785 children from the China Health and Nutrition Survey 1991–2015, we estimated mean BP trajectories (7–18 years) for cohorts born in 1981–1985, 1986–1990, 1991–1995 and 1996–2000 using random effect models. Models were adjusted for BMI and/or height growth to assess their impact on BP trends.

Results:

BP trajectories shifted upwards across cohorts. Compared with the earliest cohort, mean BP was higher in the latest cohort throughout childhood to late adolescence. For example, the increment in SBP was 4.4 mmHg (95% confidence interval: 2.9–5.8) in boys and 4.0 mmHg (2.6–5.5) in girls at 9 years, narrowed slightly during adolescence, and was 3.0 mmHg (0.7–5.4) and 2.6 mmHg (0.4–4.8) respectively at 17 years. BMI and height trajectories also shifted upwards. The overall increment was greater for height than BMI. When adjusting for physical growth, the increment in BP trajectories reduced (more for height than BMI), but remained in childhood (P < 0.05).

Conclusion:

The upward shift of BP trajectories among Chinese youths was largely explained by trends in physical growth, especially increasing height. Other early-life factors might have also contributed to the BP trends. Substantial increases in mean BP in children within a short time frame is a public health concern and will affect future CVD, especially in the developing world.
Characterization of Specific Humoral Immunity in Asymptomatic SARS-CoV-2 Infection
Authors: Deng Yingying , Zheng Jiaxin , Lin Yong , Huang Ailong
Published: October 2021

The outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in December 2019 caused a huge blow to both global public health and global economy. At the early stage of the coronavirus disease 2019 (COVID-19) epidemic, asymptomatic individuals with SARS-CoV-2 infection were ignored, without appropriate identification and isolation. However, asymptomatic individuals proved to comprise a high proportion of all SARS-CoV-2-infected individuals, which greatly contributed to the rapid and wide spread of this disease. In this review, we summarize the latest advances in epidemiological characteristics, diagnostic assessment methods, factors related to the establishment of SARS-CoV-2 asymptomatic infection, as well as humoral immune features after SARS-CoV-2 infection or vaccination in asymptomatic individuals, which would contribute to effective control of ongoing COVID-19 epidemic.
Potential role of blood biomarkers in patients with fibromyalgia: a systematic review with meta-analysis
Authors: Kumbhare Dinesh , Hassan Samah , Diep Dion , Duarte Felipe C. K. , Hung Jasper , Damodara Sreekant , West Daniel W.D. , Selvaganapathy P. Ravi
Published: October 2021

Fibromyalgia (FM) is a complex chronic pain condition. Its symptoms are nonspecific, and to date, no objective test exists to confirm FM diagnosis. Potential objective measures include the circulating levels of blood biomarkers. This systematic review and meta-analysis aim to review studies assessing blood biomarkers' levels in patients with FM compared with healthy controls. We systematically searched the PubMed, MEDLINE, EMBASE, and PsycINFO databases. Fifty-four studies reporting the levels of biomarkers in blood in patients with FM were included. Data were extracted, and the methodological quality was assessed independently by 2 authors. The methodological quality of 9 studies (17%) was low. The results of most studies were not directly comparable given differences in methods and investigated target immune mediators. Thus, data from 40 studies only were meta-analyzed using a random-effects model. The meta-analysis showed that patients with FM had significantly lower levels of interleukin-1 β and higher levels of IL-6, IL-8, tumor necrosis factor-alpha, interferon gamma, C-reactive protein, and brain-derived neurotrophic factor compared with healthy controls. Nevertheless, this systematic literature review and meta-analysis could not support the notion that these blood biomarkers are specific biomarkers of FM. Our literature review, however, revealed that these same individual biomarkers may have the potential role of identifying underlying pathologies or other conditions that often coexist with FM. Future research is needed to evaluate the potential clinical value for these biomarkers while controlling for the various confounding variables.
Decrease in pain perception during acute SARS-CoV-2 infection: a case series
Authors: Hentsch Lisa , Stancu Patrick , Allali Gilles , Lövblad Karl-Olof , Lobrinus Johannes A. , Cocetta Sara , Pautex Sophie , Uginet Marjolaine , Serratrice Jacques , Coen Matteo
Published: October 2021

Many reports have described pain appearance or an increase of chronic pain concomitant to severe acute respiratory syndrome coronavirus 2 infection. Here, we describe the cases of 3 patients with chronic cancer pain, in which COVID-19 was associated with a dramatic reduction or disappearance of pain. Pain reappeared after recovery from COVID-19. Neurological imaging and pathological findings, when available, were inconclusive. To the best of our knowledge, this is the first case series reporting an acute reduction in pain perception in COVID-19. We believe further investigation is mandatory because it could shed new light on the mechanisms of pain perception and modulation.
Observing treatment outcomes in other patients can elicit augmented placebo effects on pain treatment: a double-blinded randomized clinical trial with patients with chronic low back pain
Authors: Schwartz Marie , Fischer Laura-Marie , Bläute Corinna , Stork Jan , Colloca Luana , Zöllner Christian , Klinger Regine
Published: October 2021

Clinical research on social observational learning (SoL) as an underlying mechanism for inducing expectancy and eliciting analgesic placebo effects is lacking. This double-blinded randomized controlled clinical trial investigated the influence of SoL on medication-augmenting placebo effects in 44 patients with chronic low back pain. Our hypothesis was that observing positive drug effects on pain and mobility in another patient could increase pain reduction and functional capacity. To test this, we compared the effects of observing positive treatment outcomes in a sham patient (the social learning group [SoLG]) vs hearing the same sham patient report neutral effects (the control group). In the SoLG, the sham patient told peers about pain reduction due to amitriptyline and demonstrated his improved mobility by bending forwards and sideways while he told the control group only that he was taking amitriptyline. The primary outcome was a reduction in clinical low back pain self-ratings. The secondary outcome was perceptions of pain-related disability. The exploratory outcome was mood and coping statements. Data collection occurred before and after the intervention and 2 weeks later. After the intervention, pain decreased in both groups (F [1, 41] = 7.16, P < 0.05, d = 0.83), with no difference between groups. However, the SoLG showed a significantly larger decrease in perceived disability (F [1, 41] = 5, P < 0.05, d = 0.63). The direct observation of patient with chronic low back pain of positive treatment outcomes in the sham patient seems to have enhanced the treatment effects while indirect verbal reports of reduced pain did not.
Olanzapine-Related Somnambulism
Authors: de Filippis Renato , Guinart Daniel , Rania Marianna , Carbone Elvira Anna , Gaetano Raffaele , Segura-Garcia Cristina
Published: October 2021

Background

Somnambulism, or sleepwalking (SW), is one of the most common forms of arousal parasomnias. It is characterized by different complex motor behaviors leading to unwanted movements in bed or walking during sleep. It can be the consequence of psychological stress, abnormal breathing during sleep, high fever, or drug adverse effects. There is evidence of an association between antipsychotic treatment, including olanzapine, and SW.

Methods

We present the case of a patient experiencing treatment-resistant anorexia nervosa whose somnambulism re-exacerbated after the addition of a low dose of olanzapine, following the CARE (CAse REport) Statement and Checklist. We also conducted a systematic review of the literature on olanzapine-induced somnambulism following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, PsychINFO, and the Cochrane Library databases were independently reviewed up to January 2021 for articles reporting olanzapine-related somnambulism cases, without language or time restriction.

Results

We describe a case of somnambulism in a patient initially admitted to our hospital for anorexia nervosa and treated with a low dose of olanzapine. This is the first case of SW induced by olanzapine in eating disorders to be reported. Up-to-date olanzapine-related somnambulism was described in 8 patients experiencing psychiatric disorders (ie, schizophrenia and bipolar disorder).

Conclusions

To provide a reliable estimate of incidence and prevalence for olanzapine-related somnambulism, large-scale, pharmacovigilance studies are required, to allow for comparisons of overall clinical characteristics, outcomes, including time to recovery, between different treatment options. Clinician awareness should be enhanced, and attention should be given to such infrequent adverse effects associated with antipsychotics.
A Cross-Sectional Study of Psychosocial Factors and Sickness Presenteeism in Japanese Workers During the COVID-19 Pandemic
Authors: Masuda Masashi , Ishimaru Tomohiro , Hino Ayako , Ando Hajime , Tateishi Seiichiro , Nagata Tomohisa , Tsuji Mayumi , Matsuda Shinya , Fujino Yoshihisa
Published: October 2021

Background:

We examined the association between socioeconomic and health status, and lifestyle and sickness presenteeism among Japanese workers during the COVID-19 epidemic.

Methods:

A cross-sectional study using an Internet-monitor survey was conducted in December, 2020 in Japan. Of 33,302 survey participants, we analyzed 27,036 participants (13,814 men and 13,222 women) who reported experience with sickness presenteeism.

Results:

The odds ratio (OR) of sickness presenteeism associated with unmarried versus married status was 1.15. Respective figures for other variables were 1.11 for manual laboring work compared to desk work; 1.79 and 2.29 for loss of employment at the time the pandemic began and continuation of unemployment compared with maintaining employment during the pandemic; and 3.34 for a feeling of financial instability compared with stability.

Conclusion:

The issue of sickness presenteeism has become more prominent under the COVID-19 epidemic.
The Impact of Age on Noise Sensitivity in Cochlear Implant Recipients
Authors: Shew Matthew A. , Herzog Jacques A. , Kallogjeri Dorina , Chen Stephanie , Wick Cameron , Durakovic Nedim , McJunkin Jonathan , Buchman Craig A.
Published: October 2021

Objective:

To evaluate the impact of different open set sentence recognition tests in quiet, +10 dB signal to noise ratio (SNR), and +5 dB SNR in adult cochlear implant (CI) recipients above and below 65 years of age.

Study Design and Setting:

Multi-institution, prospective, non-randomized, single-subject repeated measures design.

Patients:

Ninety six adults more than or equal to 18 years old with postlingual bilateral sensorineural hearing loss.

Interventions:

Participants received a CI532 in one ear. Speech perception measures were evaluated before and 6-months after activation.

Main Outcome Measure(s):

Subjects completed consonant-nucleus-constant (CNC) words in quiet and AzBio sentences in noise using +10 and +5 dB SNR, and Montreal Cognitive Assessment (MOCA).

Results:

Ninety six adult patients were enrolled (n = 70 older [≥65 yr], n = 26 younger [<65 yr]). There was no difference in CNC scores (CI alone 58.4% versus 67.5%, p = 0.0857; best aided 66.7% versus 76.1%, p = 0.3357). Older adults performed worse on AzBio +10 dB SNR compared with younger patients (CI alone 37.4% versus 56.9%, p = 0.0006; best aided 51.4% versus 68.2%; p = 0.01), and in AzBio +5 dB SNR (CI alone 7.7% versus 11.2%, p = 0.0002; best aided 15.3% versus 22.3%, p = 0.0005). The magnitude of change in AzBio +10 dB SNR was significantly less in older adults in CI alone (15.3% versus 22.3%; p = 0.0493) but not best aided (21.5% versus 31.3%; p = 0.105). The magnitude of change was drastically worse in AzBio +5 dB SNR for older adults (CI alone 6.7% versus 22.1%, p = 0.0014; best aided 9.5% versus 21.5%; p = 0.0142). There was no significant difference in MOCA between the two age groups.

Conclusions:

While both older and younger patients have similar outcomes with respect to CNC word scores in quiet, the addition of noise disproportionally impacts older patients. Caution should be exercised testing the elderly in noise; testing in noise may disproportionally impact performance expectations and should be more carefully considered when used for candidacy criteria and counseling. Future studies need to further investigate the disproportionate effect of noise on candidacy testing and its impact on how elderly patients are qualified.
Neutrophil-to-Lymphocyte Ratio and Ferritin as Measurable Tools for Disease Burden and B Symptoms in Pediatric Patients With Hodgkin Lymphoma
Authors: Jan Saja , Mustafa Omima , Elgaml Amal , Ahmad Nehal , Abbas Adil , Althubaiti Sami
Published: October 2021

Background:

Pediatric Hodgkin lymphoma (HL) has been treated successfully with risk-adapted and response-adapted therapy. While risk factors like Ann Arbor staging system, B symptoms, bulky disease, and erythrocyte sedimentation rate were measured objectively, B symptoms are subjective tools. We evaluated whether the neutrophil-to-lymphocyte ratio (NLR) and inflammatory marker levels correlated with B symptoms and disease burden.

Materials and Methods:

We conducted a retrospective chart review of all children ≤14 years old with pathology-confirmed HL treated at our institution. Data included clinical and pathologic features, pretreatment erythrocyte sedimentation rate, ferritin levels; monocyte, neutrophil, and lymphocyte counts; and NLR. Optimum cutoffs of variables significantly associated with B symptoms were determined based on receiver operating characteristic curves.

Results:

Sixty-four patients were included in the analysis. Sixteen patients (25%) had B symptoms. Patients with B symptoms had higher ferritin levels (P<0.0001), monocyte counts (P=0.0060), neutrophil counts (P=0.0003) and NLR (P<0.0001), and lower lymphocyte counts (P=0.0017). Multiple receiver operating characteristic curves were generated to identify the optimum cutoff. Sensitivities and specificities of NLR (cutoff, 3.5) and ferritin (cutoff, 173 ng/mL) were the highest (81.25% and 81.25% [P<0.0001] and 89.36% and 75% [P<0.0001], respectively). Patients with NLR >3.5 and ferritin >173 (ng/mL) had significantly higher stage, bulky disease, and B symptoms. NLR and ferritin are not predictive of worst outcome in the cohort analyzed.

Conclusions:

NLR and ferritin levels were associated with high disease burden and B symptoms. Therefore, these variables can be used as measurable tools for B symptoms that can help stratify patients with HL. Larger and prospective studies are needed to validate these findings.
Hemolysis After Medication Exposure in Pediatric Patients With G6PD Deficiency
Authors: Doshi Bhavya S. , Kamdar Aditi , Lambert Michele P. , Obstfeld Amrom E.
Published: October 2021

Hemolysis in glucose-6-phosphate dehydrogenase (G6PD) deficiency varies by mutation status and the oxidative stressor. Although classified by percent of enzymatic deficiency, variability in normal G6PD values clouds assessment of hemolysis risk by level. This was a retrospective, single institution, cohort study assessing risk of postexposure medication-induced hemolysis in G6PD deficient patients. Exposures occurred in 87 of 1415 deficient patients. Only 2 of 87 medication-exposed patients had hemolytic episodes and both had very low enzymatic activity. No hemolytic events occurred with G6PD levels >7 units/g hemoglobin. Correlation of levels with mutation may improve predictive capacity for hemolysis in G6PD deficiency.
Participants and Victims of Armed Conflicts and Hostilities Rehabilitation
Authors: Myronets Oksana M. , Dei Maryna О. , Korolchuk Olena L. , Butenko Oleksii V. , Slabetskyi Oleksandr N.
Published: October 2021

The research purpose of the article is to determine current issues and prospects of rehabilitation of participants and victims of armed conflicts and hostilities in pandemic, postpandemic, and new world's order conditions. By using the dialectical method, theoretical background and current issues of rehabilitation of participants and victims of armed conflicts and hostilities have been investigated, and the modern challenges concerning this issue have been outlined. The article concluded that only a complex repair of health of participants and victims of armed conflicts and hostilities, which, on the one hand, includes medical, physical, psychical practices, and experience for bodily intact ones, and, on the other hand, obligatorily involves the possibility of cyber technology use to be integrated physically into bodily injured ones, may lead to desirable results of their rehabilitation in pandemic and postpandemic conditions of new world's order.
Strategies to Move Entry-Level Nurse Practitioner Education to the Doctor of Nursing Practice Degree by 2025
Authors: Idzik Shannon , Buchholz Susan W. , Kelly-Weeder Susan , Finnegan Lorna , Bigley Mary Beth
Published: October 2021

Background

The National Organization of Nurse Practitioner Faculties (NONPF) has made the commitment to move all entry-level nurse practitioner (NP) education to the Doctor of Nursing Practice (DNP) degree by 2025.

Problem

Although there are more than 250 DNP NP programs throughout the United States, many other NP programs have yet to transition to the doctoral level.

Approach

Leaders representing licensure, accreditation, certification, education, and practice organizations attended a NONPF 2017 Summit to discuss the DNP degree as entry into NP practice. Summit participants strategized on building collective strengths and addressed barriers to implementation. A solution-oriented discussion with action items has been operationalized for the last 4 years.

Outcomes

Four workgroups were created to address education, outcomes, capacity, and messaging related to moving all entry-level NP education to the DNP degree.

Conclusion

Ongoing collaborative efforts are critical to facilitate advancing all NP education programs to the DNP degree by 2025.
Incentive-Based Human Immunodeficiency Virus Screening in Low- and Middle-Income Countries: A Systematic Review
Authors: Finlay Jenise , Lambert Teresa , Krahn Jessica , Meyer Garret , Singh Ameeta E. , Caine Vera
Published: October 2021

Background

The majority of new human immunodeficiency virus (HIV) infections that occur worldwide are in sub-Saharan Africa. While recent gains have been made in many low- and middle-income countries (LMICs), substantial disparities in sexually transmitted and blood-borne infections (STBBI) screening and treatment still exist between LMIC and high-income countries. In addition to increasing STBBI screening uptake, providing incentives for STBBI screening may decrease perceived stigma associated with STBBI screening.

Methods

Our review was conducted as part of a larger systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and guidance from the Cochrane Handbook for Systematic Reviews of Interventions. This review focuses on incentivized STBBI screening in LMIC; high-income countries were excluded. Articles were excluded if their primary focus was on children and youth (younger than 16 years), results retrieval, treatment, behavioral change only, behavior intention, treatment adherence, or provider incentive.

Results

The search yielded 6219 abstracts. The search and selection criteria included all STBBI; however, only articles examining incentivized HIV screening met our inclusion criteria. Five articles representing 4 distinct studies from South Africa, Uganda, and Zimbabwe were included, all of which focused on incentivized HIV screening. Populations screened included the following: men, first-time testers, population-based surveillance program families, and insurance health plan members. Incentive structures varied widely and incentives were mainly food vouchers, lottery prizes, or household items.

Conclusions

Our review was conducted to determine if patient incentives increase STBBI test uptake in LMIC. Overall, incentives were associated with an increase in HIV screening uptake. Most studies included focused solely on men. There is a significant void in understanding STBBI incentive-based screening outside of this context and in complex populations who should be targeted in incentivized HIV screening. Incentives appear most effective when developed specific to context and target population. Further research is needed to analyze incentivized screening across similar study designs, to evaluate long-term effectiveness, and to explore the ethical implications of incentivized care.
Examining the Relative Contributions of Methamphetamine Use, Depression, and Sexual Risk Behavior on Rectal Gonorrhea/Chlamydia Among a Cohort of Men Who Have Sex With Men in Los Angeles, California
Authors: Blair Cheríe S. , Needleman Jack , Javanbakht Marjan , Comulada W. Scott , Ragsdale Amy , Bolan Robert , Shoptaw Steven , Gorbach Pamina M.
Published: October 2021

Background

Methamphetamine use, sexual risk behaviors, and depression contribute to ongoing human immunodeficiency virus (HIV) and sexually transmitted infection (STI) disparities among men who have sex with men (MSM). The relative contributions of these effects longitudinally are not well understood.

Methods

This analysis used visit-level data from a longitudinal cohort of MSM, half with HIV, in Los Angeles, CA. From August 2014 to March 2020, participants completed follow-up visits every 6 months and underwent testing for rectal gonorrhea/chlamydia (GC/CT) and completed questionnaires including depressive symptoms, number of receptive anal intercourse (RAI) partners, and methamphetamine use. Path analysis with structural equation modeling using concurrent and lagged covariates was used to identify relative contributions of methamphetamine use and depression on number of RAI partners and rectal GC/CT across time.

Results

Five hundred fifty-seven MSM with up to 6 visits (3 years) were included for a total of 2437 observations. Methamphetamine use and depressive symptoms were positively associated with number of RAI partners (β = 0.28, P < 0.001; β = 0.33, P = 0.018, respectively), which was positively associated with rectal GC/CT (β = 0.02, P < 0.001). When stratified by HIV status, depressive symptoms were positively associated with RAI partners for HIV-negative MSM (β = 0.50, P = 0.007) but were not associated for MSM living with HIV (β = 0.12, P = 0.57). Methamphetamine use was positively associated with RAI partners in both strata.

Conclusions

Factors and patterns, which contribute to risk behaviors associated with rectal GC/CT, may differ by HIV status. Our findings demonstrate the importance of combined treatment and prevention efforts that link screening and treatment of stimulant use and depression with STI prevention and treatment.