bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictive value of anti-Mullerian hormone for pregnancy outcomes following assisted reproductive techniques (ART) in Southwest China
Authors: Liu Ling , Sun Xing-Yu , Yang Huan , Feng Xin-Jian , Lan Yun-Zhu
Published: December 2022

Background

Anti-Müllerian hormone (AMH) is secreted by granulosa cells in preantral follicles and small antral follicles. There is limited information about whether serum AMH levels are related to pregnancy outcomes during in vitro fertilization and embryo transfer (IVF-ET). The aim of this study was to provide a theoretical basis for improving pregnancy outcomes.

Methods

A retrospective cohort study was conducted on infertile women who were treated at the Reproductive Centre of the Affiliated Hospital of Southwest Medical University between September 2018 and September 2019. The sample included 518 participants from Southwest China. The participants were divided into 2 groups according to their AMH level. Their data were retrieved from the medical records: days and dosage of gonadotropin (Gn) (one bottle equals 75 IU), the number of oocytes obtained, the number of oocytes in metaphase II (MII) and the number of high-quality embryos. The pregnancy outcomes were followed up and divided into two groups according to whether they were pregnant or not, with statistical analysis of the parameters related to the in vitro fertilization process performed separately.

Results

Compared to a lower AMH level (AMH ≤ 1.1), a higher AMH level (AMH > 1.1) resulted in less total Gn (bottle) (P = 0.00 < 0.05) and a lower starting Gn (IU) (P = 0.00 < 0.05), while the number of oocytes obtained,MII,cleavages and high-quality embryos were higher (P = 0.00 < 0.05). The participants' pregnancy outcomes (ectopic pregnancy, miscarriage, singleton, twin, multiple births) were found to not be predictable by AMH through ROC curves (P = 0.980, 0.093, 0.447, 0.146, 0.526, and 0.868 > 0.05). For participants in the pregnancy group, although AMH was lower in the nonpregnant participants(P = 0.868 > 0.05), the difference was not statistically significant, and the correlation coefficients between the two groups suggested no differences in the IVF process, except for the starting Gn (IU) (P = 0.038 < 0.05).

Conclusion

AMH has clinical application value in predicting ovarian reserve function, providing guidance and suggestions for the specific formulation of ovulation promotion programs with assisted reproductive technology, but it cannot effectively predict the outcome of clinical pregnancy.
Physical activity promotion in chiropractic: a systematic review of clinician-based surveys
Authors: Fernandez Matthew , Young Anika , Milton Karen , Pinhiero Marina , de Luca Katie , Ferreira Paulo , Hebert Jeffrey
Published: December 2022

Background

Physical inactivity is a global health pandemic. Allied healthcare providers, including chiropractors, are well placed to integrate individual physical activity (PA) promotion into routine care. A previous systematic review identified that approximately 90% of chiropractors held a positive opinion towards healthier patient lifestyles; however, the extent to which chiropractors promote PA to their patients within routine care is unclear. This systematic review aimed to describe chiropractors' attitudes towards and current practice in advising, counselling, discussing, supporting, or recommending PA to patients.

Methods

Five databases were searched from inception to December 2021 for cross-sectional surveys that explored PA promotion by chiropractors in practice. We assessed the risk of bias of the included studies with the ‘Risk of Bias in Cross-Sectional Surveys of Attitudes and Practices’ tool. Descriptive data were extracted, grouping similar survey questions and responses into emerging categories. Chiropractors’ views regarding the perceived importance and/or their preparedness to counsel and provide PA or exercise information are reported.

Results

From 661 studies, 15 met the selection criteria. Surveys included 7999 chiropractors primarily from the USA, UK, Australia, and Sweden. All studies were rated as moderate-to-high risk of bias, with methodological weaknesses characterised by inconsistent reporting of missing data, non-representative samples, low response rates (i.e., less than 60%), and unknown validity of survey instruments. Chiropractors frequently recognised the importance of PA promotion, as demonstrated by the proportion of respondents reporting that they: (1) support the importance of providing PA or exercise information and counselling (64% to 100%); (2) are prepared to provide PA or exercise information and/or counselling to patients (91% to 92%,); (3) frequently obtain PA or exercise information from patients (87% to 97%,); 4) frequently discuss PA or exercise and/or provide PA or exercise information to patients (68% to 99%); and 5) frequently provide PA counselling to patients (50% to 81%.).

Conclusion

A large majority of practising chiropractors actively engage with PA promotion. However, the results should be interpreted with caution owing to the moderate-to-high risk of bias of the included studies. Forthcoming research initiatives should explore unbiased surveys, further PA education and training as well as capitalising on chiropractors’ own PA participation.
A rare case of mediastinal mass with massive pleural effusion misdiagnosed as neurogenic tumor
Authors: Zheng Wanyu , Chen Xiaoyang , Shi Liyong
Published: December 2022

Background

Mediastinal cavernous hemangiomas are extremely rare vascular tumors. To the best of our knowledge less than 20 cases of posterior mediastinal hemangioma have been reported in literature, and this is the first case of mediastinal cavernous hemangioma presenting with massive pleural effusion.

Case presentation

We report a case of a 56-year-old female who presented with cough and chest tightness and was found with a massive pleural effusion in chest CT. It was mistaken for a malignant pleural effusion. A posterior mediastinal lesion was observed after thoracic drainage and misdiagnosed again as neurofibroma. The lesion was resected and post-operative histopathology suggested that it was a cavernous hemangioma. Post-operative recovery was uneventful, and a follow-up examination nearly 14 months later showed the patient had no recurrence.

Conclusions

Due to the lack of diagnostic specificity and variety of clinical manifestations, CHM is often misdiagnosed prior to resection. This is the first description of mediastinal hemangioma presenting with massive pleural effusion. It is very important to consider mediastinal hemangioma before operation to reduce surgical complications, and it should be in the differential diagnosis of posterior mediastinal masses.
Prospective cholestanol screening of cerebrotendinous xanthomatosis among patients with juvenile-onset unexplained bilateral cataracts
Authors: Fernández-Eulate Gorka , Martin Gilles C. , Dureau Pascal , Speeg-Spatz Claude , Brassier Anais , Gillard Perrine , Bremond-Gignac Dominique , Thouvenin Dominique , Pagan Cecile , Lamari Foudil , Nadjar Yann
Published: December 2022

Background

Cerebrotendinous xanthomatosis (CTX) is a rare genetic disorder related to CYP27A1 biallelic mutations, leading to decreased synthesis of bile acids and increased cholestanol. Juvenile bilateral cataracts are one of the most common findings in the disease, frequently occurring before the onset of neurological manifestations. While early treatment with chenodeoxycholic acid can prevent the onset of neurological impairment, poor awareness of CTX accounts for a markedly delayed diagnosis. The objective of this study was to evaluate the utility of plasma cholestanol analysis at the moment of cataract diagnosis and before the onset of neurological impairment in CTX.

Methods

Multicenter prospective cohort study of patients with juvenile-onset unexplained bilateral cataracts recruited from seven French ophthalmology departments. Plasma cholestanol analysis was performed at diagnosis from January 2018 to January 2020. CYP27A1 genetic testing was performed at the ophthalmologist’s discretion. Cholestanol levels were compared with those of a similar population of patients without cataracts (control cohort).

Results

30 patients were finally recruited, with a mean age at cataract diagnosis of 7.1 years (± 4.8 SD, range 1–19 years). One patient had a very high cholestanol level (68 μmol/L, reference < 10) and carried two pathogenic heterozygous mutations in CYP27A1 confirming CTX. This patient was a 19-year-old female, reporting chronic diarrhea only in childhood, and diagnosed with bilateral posterior cataracts with cortical fleck-like opacities. Therefore, the incidence of CTX in our cohort of patients was 3.3%. Five further patients (5/29; 17.2%) had moderate elevations of cholestanol level (between 10.3 and 16.5 μmol/L), compared to 12/286 (4.2%) in the control cohort (p = 0.014) after adjustment for age.

Conclusion

Our study argue for the relevance of plasma cholestanol CTX screening in all patients with juvenile-onset unexplained cataracts, even without other CTX identified manifestations. Whether moderate elevations of plasma cholestanol unrelated to CTX may be a risk factor for bilateral cataracts occurrence needs further examination.
Effects of Internet of Things-based power cycling and neuromuscular training on pain and walking ability in elderly patients with KOA: protocol for a randomized controlled trial
Authors: Zhang Yujia , Xie Suhang , Wang Xiaoyi , Song Kangping , Wang Lin , Zhang Ruishi , Feng Yuan , He Chengqi
Published: December 2022

Background

Osteoarthritis (OA) is a common and highly disabling disease that imposes a heavy burden on individuals and society. Although physical therapy is recommended as an important method to relieve OA symptoms, patients cannot continue treatment after returning home. Research on Internet telerehabilitation for knee osteoarthritis (KOA) can reduce pain and improve patient quality of life, and Internet of Things (IoT)-based telerehabilitation is a new form of delivering rehabilitation. This study will evaluate the effect of telerehabilitation via IoT, as a medium to deliver exercises, on pain and walking in patients with KOA.

Methods

This study is a single-blind randomized controlled trial. We will recruit 42 middle-aged and elderly patients with KOA aged ≥ 50 years and randomly divided into power cycling group, neuromuscular exercise group, and control group, and intervention will last for 12 weeks. Outcome measures will be taken at baseline and 4 weeks, 8 weeks, and 12 weeks post-intervention. The pre- and posttreatment differences in knee pain and physical function between participants undergoing power cycling and neuromuscular training and those in the control group will be determined by each scale. The effectiveness will be assessed by the Western Ontario and McMaster Universities Osteoarthritis Index Score (WOMAC) and an 11-point numerical pain rating scale. Walking function and quality of life will be assessed by the timed up and go and walk test, 6-min walk test, and quality of life health status questionnaires.

Discussion

The findings from this trial will establish the feasibility and effectiveness of IoT-based power cycling and neuromuscular training on elderly patients with KOA in the community. As a result, this trial may help provide experimental evidence for finding a better exercise method suitable for elderly patients with KOA in the community.

Trail registration

Chinese Clinical Trials Registry ChiCTR2200058924. Prospectively registered on 6 May 2022.
Associations of MRI-visible perivascular spaces with longitudinal cognitive decline across the Alzheimer’s disease spectrum
Authors: Wang Ming-Liang , Zou Qiao-Qiao , Sun Zheng , Wei Xiao-Er , Li Peng-Yang , Wu Xue , Li Yue-Hua ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: December 2022

Objective

To investigate the characteristics and associations of MRI-visible perivascular spaces (PVS) with clinical progression and longitudinal cognitive decline across the Alzheimer’s disease spectrum.

Methods

We included 1429 participants (641 [44.86%] female) from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. PVS number and grade in the centrum semiovale (CSO-PVS), basal ganglia (BG-PVS), and hippocampus (HP-PVS) were compared among the control (CN), mild cognitive impairment (MCI), and Alzheimer’s disease (AD) groups. PVS were tested as predictors of diagnostic progression (i.e., CN to MCI/AD or MCI to AD) and longitudinal changes in the 13-item Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-Cog 13), Mini-Mental State Examination (MMSE), memory (ADNI-MEM), and executive function (ADNI-EF) using multiple linear regression, linear mixed-effects, and Cox proportional hazards modeling.

Results

Compared with CN subjects, MCI and AD subjects had more CSO-PVS, both in number (p< 0.001) and grade (p< 0.001). However, there was no significant difference in BG-PVS and HP-PVS across the AD spectrum (p> 0.05). Individuals with moderate and frequent/severe CSO-PVS had a higher diagnostic conversion risk than individuals with no/mild CSO-PVS (log-rankp< 0.001 for all) in the combined CN and MCI group. Further Cox regression analyses revealed that moderate and frequent/severe CSO-PVS were associated with a higher risk of diagnostic conversion (HR = 2.007, 95% CI = 1.382–2.914,p< 0.001; HR = 2.676, 95% CI = 1.830–3.911,p< 0.001, respectively). A higher CSO-PVS number was associated with baseline cognitive performance and longitudinal cognitive decline in all cognitive tests (p< 0.05 for all).

Conclusions

CSO-PVS were more common in MCI and AD and were associated with cognitive decline across the AD spectrum.
The role of type 2 diabetes in the association between habitual glucosamine use and dementia: a prospective cohort study
Authors: Xu Chenjie , Hou Yabing , Fang Xuexian , Yang Hongxi , Cao Zhi
Published: December 2022

Background

Growing evidence has showed an association between habitual glucosamine use and type 2 diabetes (T2D). However, the effect of habitual glucosamine use on risk of dementia remains poorly understood. Our study aimed to examine the association between glucosamine use and risk of dementia and further to identify the mediating role of T2D in the association.

Methods

A total of 495,942 participants from UK Biobank who completed a questionnaire on habitual glucosamine use were included at baseline (2006–2010) and then followed up for incidence of dementia until 2020. Cox proportional hazard regressions were performed to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident dementia. Markov multi-state models were used to explore the role of incidence of T2D during the follow-up in the association.

Results

Overall, 18.80% of the participants reported habitual use of glucosamine at baseline. A total of 6831 dementia events were recorded during a median follow-up of 11 years. In fully adjusted models, habitual glucosamine use was associated with a significantly lower risk of dementia (HR = 0.87, 95% CI: 0.82–0.93). Multi-state models showed that the association between glucosamine use and dementia was mediated by the incidence of T2D during the follow-up (HR of dementia without T2D: 0.92, 95% CI: 0.86–0.99; HR of post-T2D dementia: 0.79, 95% CI: 0.67–0.93).

Conclusions

Our findings reveal that habitual use of glucosamine supplement is associated with a lower risk of dementia, which might be explained by incidence of T2D.
Microbial active functional modules derived from network analysis and metabolic interactions decipher the complex microbiome assembly in mangrove sediments
Authors: Du Huan , Pan Jie , Zou Dayu , Huang Yuhan , Liu Yang , Li Meng
Published: December 2022

Background

The metabolic interactions of microbes significantly affect the assembly of microbial communities that play important roles in biogeochemical processes. However, most interspecies interactions between microorganisms in natural communities remain unknown, leading to a poor understanding of community assembly mechanisms.

Results

Here, we used a genome-scale metabolic modeling-based approach to explore the potential interactions among bacteria and archaea in mangrove sediments. More than half of the assembled microbial species ($$\backsim 340$$

∽
340

) combined about 3000 pairwise metabolic interaction relationship with high potential. The examples of predicted interactions are consistent with the implications of studies based on microbial enrichment/culture, indicating the feasibility of our strategy for extracting diverse potential interactions from complex interspecies networks. Moreover, a substantial number of previously unknown microbial metabolic interactions were also predicted. We proposed a concept of microbial active functional module (mAFM), defined as a consortium constituted by a group of microbes possessing relatively high metabolic interactions via which they can actively realize certain dominant functions in element transformations. Based on the metabolic interactions and the transcript distribution of microorganisms, five mAFMs distributed in different layers of the sediments were identified. The whole group of mAFMs covered most of the principal pathways in the cycle of carbon, nitrogen, and sulfur, while each module possessed divergently dominant functions. According to this distinction, we inferred that the mAFMs participated in the element cycles via their intra-cycle and the inter-exchange among them and the sediments.

Conclusions

The results of this study greatly expanded interaction potential of microbes in mangrove sediments, which could provide supports for prospective mutualistic system construction and microbial enrichment culture. Furthermore, the mAFMs can help to extract valuable microbial metabolic interactions from the whole community and to profile the functioning of the microbial community that promote biogeochemical cycling in mangrove sediments.
What about males? Exploring sex differences in the relationship between emotion difficulties and eating disorders
Authors: Vuillier L. , Joseph J. , Greville-Harris M. , May L. , Somerville M. P. , Harrison A. , Moseley R. L.
Published: December 2022

Objective

While eating disorders (EDs) are more commonly diagnosed in females, there is growing awareness that men also experience EDs and may do so in a different way. Difficulties with emotion processing and emotion regulation are believed to be important in EDs, but as studies have involved predominantly female samples, it is unclear whether this is also true for males.

Methods

In a sample of 1604 participants (n = 631 males), we assessed emotion processing and emotion regulation in males with EDs (n = 109) and compared results to both females with EDs (n = 220) and males from the general population (n = 522). We also looked at whether emotion processing and emotion regulation difficulties predicted various aspects of eating psychopathology and whether this was moderated by sex. We assessed emotion processing with the Toronto Alexithymia Scale, emotion regulation with the Difficulties in Emotion Regulation Scale and the Emotion Regulation Questionnaire, and eating psychopathology with the Eating Disorder Examination Questionnaire.

Results

We found that males with ED, like their female counterparts, suffered from emotion processing and emotion regulation deficits. We did find some sex differences, in that males with EDs tended to report more difficulties with their emotions as well as a more externally oriented thinking style compared to females with EDs. Difficulties with emotion processing and emotion regulation were strongly predictive of various aspects of eating psychopathology in both sexes. Importantly, we found that sex moderated the relationship between cognitive reappraisal and eating restraint. As such, low use of reappraisal was found to be associated with higher levels of restraint in females but not in males.

Discussion

Difficulties with emotion processing and emotion regulation are associated with eating psychopathology in both males and females. Reappraisal was not found to be associated with reduced eating psychopathology in males, suggesting a cautious approach to interventions targeting this strategy. Research around explanatory mechanisms and interventions must adopt a broader viewpoint including those that are traditionally overlooked in EDs.
Comparison of the accuracy of immediate implant placement using static and dynamic computer-assisted implant system in the esthetic zone of the maxilla: a prospective study
Authors: Feng Yuzhang , Su Zhenya , Mo Anchun , Yang Xingmei
Published: December 2022

Purpose

This study aimed to compare the accuracy of fully guided between dynamic and static computer-assisted implant surgery (CAIS) systems for immediate implant placement in the esthetic zone.

Methods

A total of 40 qualified patients requiring immediate implant placement in the esthetic zone were randomly and equally assigned to either static CAIS group (n = 20) or dynamic CAIS groups (n = 20). Global deviations at entry, apex, and angular deviation between placed and planned implant position were measured and compared as primary outcomes. Secondary outcomes were the deviation of implant placement at mesial–distal, labial–palatal, and coronal–apical directions.

Results

For the immediate implant placement, the mean global entry deviations in static and dynamic CAIS groups were 0.99 ± 0.63 mm and 1.06 ± 0.55 mm (p = 0.659), while the mean global apex deviations were 1.50 ± 0.75 mm and 1.18 ± 0.53 mm (p = 0.231), respectively. The angular deviation in the static and dynamic CAIS group was 3.07 ± 2.18 degrees and 3.23 ± 1.67 degrees (p = 0.547). No significant differences were observed for the accuracy parameters of immediate implant placement between static and dynamic CAIS systems, except the deviation of the implant at entry in the labial–palatal direction in the dynamic CAIS group was significantly more labial than of the static CAIS (p = 0.005).

Conclusions

This study demonstrated that clinically acceptable accuracy of immediate implant placement could be achieved using static and dynamic CAIS systems.

Trial registration ChiCTR, ChiCTR2200056321. Registered 3 February 2022,http://www.chictr.org.cn/showproj.aspx?proj=151348
Stem cell laden nano and micro collagen/PLGA bimodal fibrous patches for myocardial regeneration
Authors: Wee Jung Hee , Yoo Ki-Dong , Sim Sung Bo , Kim Hyun Joo , Kim Han Joon , Park Kyu Nam , Kim Gee-Hee , Moon Mi Hyoung , You Su Jung , Ha Mi Yeon , Yang Dae Hyeok , Chun Heung Jae , Ko Jae Hoon , Kim Chun Ho
Published: December 2022

Background

Although the use of cardiac patches is still controversial, cardiac patch has the significance in the field of the tissue engineered cardiac regeneration because it overcomes several shortcomings of intra-myocardial injection by providing a template for cells to form a cohesive sheet. So far, fibrous scaffolds fabricated using electrospinning technique have been increasingly explored for preparation of cardiac patches. One of the problems with the use of electrospinning is that nanofibrous structures hardly allow the infiltration of cells for development of 3D tissue construct. In this respect, we have prepared novel bi-modal electrospun scaffolds as a feasible strategy to address the challenges in cardiac tissue engineering .

Methods

Nano/micro bimodal composite fibrous patch composed of collagen and poly (D, L-lactic-co-glycolic acid) (Col/PLGA) was fabricated using an independent nozzle control multi-electrospinning apparatus, and its feasibility as the stem cell laden cardiac patch was systemically investigated.

Results

Nano/micro bimodal distributions of Col/PLGA patches without beaded fibers were obtained in the range of the 4-6% collagen concentration. The poor mechanical properties of collagen and the hydrophobic property of PLGA were improved by co-electrospinning.
In vitro
experiments using bone marrow-derived mesenchymal stem cells (BMSCs) revealed that Col/PLGA showed improved cyto-compatibility and proliferation capacity compared to PLGA, and their extent increased with increase in collagen content. The results of tracing nanoparticle-labeled as well as GFP transfected BMSCs strongly support that Col/PLGA possesses the long-term stem cells retention capability, thereby allowing stem cells to directly function as myocardial and vascular endothelial cells or to secrete the recovery factors, which in turn leads to improved heart function proved by histological and echocardiographic findings.

Conclusion

Col/PLGA bimodal cardiac patch could significantly attenuate cardiac remodeling and fully recover the cardiac function, as a consequence of their potent long term stem cell engraftment capability.
Autoimmune polyendocrine syndrome II presenting paradoxically as Takotsubo cardiomyopathy: a case report and reappraisal of pathophysiology
Authors: Batta Akash , Gupta Amit Kumar , Singal Gautam , Mohan Bishav , Kumar Sushil , Jaiswal Bhavuk , Hatwal Juniali , Tandon Rohit , Singh Gurbhej , Goyal Abhishek , Singh Bhupinder , Mittal Naveen , Chhabra Shibba Takkar , Aslam Naved , Wander Gurpreet Singh
Published: December 2022

Background

Takotsubo cardiomyopathy (TCM) is a rare disease entity characterized by acute, non-ischemic, reversible myocardial dysfunction that mimics acute myocardial infarction. Activation and excessive outflow of sympathetic nervous system are believed to be central to the figure in the disease pathogenesis. Adrenocortical hormones potentiate the systemic actions of sympathetic nervous system and accordingly are essential for regulation of myocardial function. We present an unusual case of a middle-aged woman with primary adrenal insufficiency who presented paradoxically with TCM.

Case presentation

A 50-year-old woman with past history of hypothyroidism presented to emergency department with history of acute chest pain and syncope. There was no significant drug history or history of an emotional or physical stimulus prior to admission. Prominent pigmentation over the tongue and skin creases of hands were noted. On presentation, she was in shock and had ventricular tachycardia which required electrical cardioversion. The subsequent electrocardiogram demonstrated diffuse T-wave inversions with prolonged QTC. There was apical hypokinesia on echocardiogram, and cardiac biomarkers were elevated. There was persistent inotropic requirement. She had marked postural symptoms, and a postural blood pressure drop of 50 mm Hg was present. Initial laboratory parameters were significant for hyperkalemia (7.8 mEq/L) and hyponatremia (128 mEq/L). These findings prompted evaluation for adrenal insufficiency which was confirmed with appropriate tests. Autoimmune polyendocrine syndrome II was thus diagnosed based on the above findings. Coronary angiography revealed normal coronaries. The diagnoses of TCM was established in accordance with the International Takotsubo Diagnostic Criteria. She was started on stress dose steroid replacement therapy and improved dramatically. At one month of follow-up, the patient is asymptomatic, and there was normalization of her left ventricular function.

Conclusions

Intricate relationship and interplay exist between the steroid hormones and catecholamines in the pathogenesis of TCM. Steroid hormones not only potentiate the actions of catecholamines, but they also regulate and channelize catecholaminergic actions preventing their deleterious effects on the cardiac tissue. Hence, both steroid deficiency and exogenous steroid replacement may precipitate TCM. Evidence from more such cases and larger perspective studies in future will further improve our understanding of this complex disease process and its myriad associations.
Health care personnel’s perspectives on human papillomavirus (HPV) self-sampling for cervical cancer screening: a pre-implementation, qualitative study
Authors: Xiong Serena , Lazovich De Ann , Hassan Faiza , Ambo Nafisa , Ghebre Rahel , Kulasingam Shalini , Mason Susan M. , Pratt Rebekah J.
Published: December 2022

Background

Persistent infection with high-risk human papillomavirus (hrHPV) types is a well-documented cause of cervical cancer. Since the implementation of cervical cancer screening methods (e.g., Pap tests), cervical cancer rates have declined. However, Pap tests are still unacceptable to many women and require complex infrastructure and training. Self-sampling techniques for collecting HPV specimens (or “HPV self-sampling”) have been proposed as a possible alternative to overcome these barriers. The objective of this study was to capture perspectives from health care personnel (providers, leaders, and clinic staff) across primary care systems on the potential implementation of an HPV self-sampling practice.

Methods

Between May and July 2021, a study invitation was emailed to various health care professional networks across the Midwest, including a snowball sampling of these networks. Eligible participants were invited to a 45–60-min Zoom-recorded interview session and asked to complete a pre-interview survey. The survey collected sociodemographics on age, occupation, level of educational attainment, race/ethnicity, gender, and awareness of HPV self-sampling. The semi-structured interview was guided by the Consolidated Framework for Implementation Research and asked participants about their views on HPV self-sampling and its potential implementation. All interviews were audio-recorded, transcribed, and analyzed using NVivo 12.

Results

Key informant interviews were conducted with thirty health care personnel—13 health care providers, 6 clinic staff, and 11 health care leaders—from various health care systems. Most participants had not heard of HPV self-sampling but reported a general enthusiasm for wanting to implement it as an alternative cervical cancer screening tool. Possible barriers to implementation were knowledge of clinical evidence and ease of integration into existing clinic workflows. Potential facilitators included the previous adoption of similar self-sampling tools (e.g., stool-based testing kits) and key decision-makers.

Conclusion

Although support for HPV self-sampling is growing, its intervention’s characteristics (e.g., advantages, adaptability) and the evidence of its clinical efficacy and feasibility need to be better disseminated across US primary care settings and its potential adopters. Future research is also needed to support the integration of HPV self-sampling within various delivery modalities (mail-based vs. clinic-based).
Anomalous left coronary artery presenting with out-of-hospital cardiac arrest: a malignant outcome for a ‘benign’ variant
Authors: Ali Umar Syed , Geldenhuys Agneta , Otto Jacobus , Samie Rafeeq , Dwivedi Girish , Andrews David , Ihdayhid Abdul Rahman
Published: December 2022

Background

Anomalous left coronary arteries are rare congenital defects. These are often detected incidentally unless they have a malignant course whereby patients present with acute coronary syndromes. We describe a rare presentation of a benign variant of this pathology and a proposed diagnostic and management plan.

Case presentation

A 41-year-old female was admitted following an out-of-hospital cardiac arrest. Cardiac imaging demonstrated an anomalous left main coronary artery arising from a single right coronary ostium with a trans-septal course and associated ischaemic changes on functional testing. Given her clinical presentation, she underwent successful left coronary reimplantation surgery.

Conclusions

This case highlights that even supposedly ‘benign’ variants can have malignant outcomes and that functional testing can be useful in further risk-stratifying anomalous coronary anatomy. Surgical reimplantation is a feasible and effective treatment for achieving optimal long-term results
Bone mineral density changes in osteoporotic and osteopenic patients after COVID-19 infection
Authors: Elmedany Samah Hamdy , Badr Omaima Ibrahim , Abu-Zaid Mohammed Hassan , Tabra Samar Abd Alhamed
Published: December 2022

Background

Coronavirus disease 2019 (COVID-19) infection is linked to high levels of inflammatory cytokines and prolonged immobilization; furthermore, corticosteroid treatment leads to increased bone loss and resorption. We aimed to study the change in bone mineral density (BMD) after COVID-19 infection in osteoporotic and osteopenic patients. One hundred osteoporotic or osteopenic patients were selected in this single-center retrospective study; the patients were divided into two groups. Group 1 included 56 patients who got COVID-19 infection. Group 2 included 44 patients who did not get COVID-19 infection. BMD was assessed at baseline, after 9 months of COVID infection, and then after 1 year follow-up using dual energy x-ray absorptiometry (DXA) scan.

Results

There was no significant difference between two groups regarding demographic data (p > 0.05); there was a significant decrease in BMD of the lumbar region and femur at 9 months as compared to baseline in group1 (p < 0.001), while there was a significant increase in the lumbar BMD of osteoporotic patients who did not get COVID infection after 21 months. Concerning activity of COVID infection, there was a significant difference between the three subgroups of COVID patients regarding percentage of change in BMD after 9 months, the severe group having the highest decrease in BMD (p < 0.001).

Conclusions

COVID-19 may have deleterious effect on BMD in osteoporotic patients. It is recommended to assess BMD in osteoporotic/osteopenic patients who got COVID infection to detect if there is an increased risk of fracture which may necessitate post-COVID change in the therapeutic intervention plan.
Challenges and Strategies for Solubility Measurements and Dissolution Method Development for Amorphous Solid Dispersion Formulations
Authors: Hermans Andre , Milsmann Johanna , Li Hanlin , Jede Christian , Moir Andrea , Hens Bart , Morgado James , Wu Tian , Cohen Michael
Published: December 2022

This manuscript represents the view of the Dissolution Working Group of the IQ Consortium on the challenges of and recommendations on solubility measurements and development of dissolution methods for immediate release (IR) solid oral dosage forms formulated with amorphous solid dispersions. Nowadays, numerous compounds populate the industrial pipeline as promising drug candidates yet suffer from low aqueous solubility. In the oral drug product development process, solubility along with permeability is a key determinant to assure sufficient drug absorption along the intestinal tract. Formulating the drug candidate as an amorphous solid dispersion (ASD) is one potential option to address this issue. These formulations demonstrate the rapid onset of drug dissolution and can achieve supersaturated concentrations, which poses significant challenges to appropriately characterize solubility and develop quality control dissolution methods. This review strives to categorize the different dissolution and solubility challenges for ASD associated with 3 different topics: (i) definition of solubility and sink conditions for ASD dissolution, (ii) applications and development of non-sink dissolution (according to conventional definition) for ASD formulation screening and QC method development, and (iii) the advantages and disadvantages of using dissolution in detecting crystallinity in ASD formulations. Related to these challenges, successful examples of dissolution experiments in the context of control strategies are shared and may lead as an example for scientific consensus concerning dissolution testing of ASD.
Disrupted Circadian Rhythm of Epinephrine in Males With Youth-Onset Type 2 Diabetes
Authors: Giessner Stephanie , Ramaker Megan E , Blew Kathryn , Crawford Matthew L , Grant Russell P , Bain James R , Muehlbauer Michael , Jain Nina , Hsia Daniel S , Armstrong Sarah , Freemark Michael , Gumus Balikcioglu Pinar
Published: December 2022

Context

Blood pressure and plasma catecholamines normally decline during sleep and rapidly increase in early morning. This is blunted in adults with type 2 diabetes (T2D).

Objective

We hypothesize that increased sympatho-adrenal activity during sleep differentiates youth with T2D from nondiabetic obese youth and lean youth.

Methods

Fasting spot morning and 24-hour urines were collected in obese adolescents with and without T2D, and normal-weight controls. Fractionated free urine catecholamines (epinephrine, norepinephrine, and dopamine) were measured, and the ratio of fasting spot morning to 24-hour catecholamines was calculated.

Results

Urinary 24-hour catecholamine levels were comparable across the 3 groups. Fasting morning epinephrine and the ratio of fasting morning/24-hour epinephrine were higher in youth with T2D (P = 0.004 and P = 0.035, respectively). In males, the ratio of fasting morning/24-hour epinephrine was also higher in youth with T2D (P = 0.005). In females, fasting morning norepinephrine and the ratio of fasting morning/24-hour dopamine were lower in obese youth with and without T2D (P = 0.013 and P = 0.005, respectively) compared with lean youth. Systolic blood pressure was higher in diabetic participants than other groups; males trended higher than females.

Conclusion

Circadian rhythm in catecholamines is disrupted in youth-onset T2D, with a blunted overnight fall in urinary epinephrine in males. Conversely, fasting morning norepinephrine and dopamine levels were lower in obese females with or without T2D. Higher nocturnal catecholamines in males with T2D might associate with, or predispose to, hypertension and cardiovascular complications. Lower catecholamine excretion in females with obesity might serve an adaptive, protective role.
Sodium-Glucose Cotransporter-2 Inhibition Benefits in Cardiorenal Risk in Men and Women
Authors: Pruett Jacob E , Lirette Seth T , Romero Damian G , Yanes Cardozo Licy L
Published: December 2022

Introduction

In addition to their antihyperglycemic action, sodium-glucose cotransporter-2 (SGLT2) inhibitors are used in patients with type 2 diabetes due to their cardioprotective effects. Meta-analyses of large clinical trials have reported mixed results when examining sex differences in their cardioprotective effects. For example, some studies reported that, compared to women, men had a greater reduction in cardiovascular risk with SGLT2 inhibition. Taking advantage of several recently completed large-scale randomized controlled clinical trials, we tested the hypothesis that women have an attenuated response in primary cardiorenal outcomes to SGLT2 inhibition compared to men.

Methods

We performed a systematic search using PubMed and the Cochrane Library to find completed large-scale, prospective, randomized controlled Phase III clinical trials with primary outcomes testing cardiovascular or renal benefit. Studies had to include at least 1000 participants and report data about sex differences in their primary cardiovascular or renal outcomes.

Results

The present meta-analysis confirmed that SGLT2 inhibition decreased adverse cardiorenal outcomes in a pooled sex analysis using 13 large-scale clinical trials. SGLT2 inhibition exhibited similar reduction in hazard ratios for both men (0.79, 95% CI, 0.73-0.85) and women (0.78, 95% CI, 0.72-0.84) for adverse cardiorenal outcomes.

Conclusion

In contrast to previous findings, our updated meta-analysis suggests that women and men experience similar cardiorenal benefit in response to SGLT2 inhibition. These findings strongly suggest that SGLT2 inhibition therapy should be considered in patients with high risk for cardiovascular disease irrespective of the patient sex.
Comparison of Neuroform Atlas Stent-Assisted Coiling and Coiling Alone in Ruptured Intracranial Aneurysms: A Propensity Score Matching Analysis
Authors: Yi Ho Jun , Shin Dong-Seong , Kim Bum-Tae , Lee Dong Hoon , Sung Jae Hoon
Published: December 2022

BACKGROUND:

Although Neuroform Atlas stent is commonly used in stent-assisted coiling (SAC) to treat ruptured intracranial aneurysms (RIA), its safety and efficacy remain controversial.

OBJECTIVE:

To assess the safety and efficacy of SAC using Neuroform Atlas for treating RIA compared with coiling alone by performing a propensity score matching analysis.

METHODS:

RIA treated with coiling alone and SAC between January 2017 and May 2021 were retrospectively reviewed. Demographics, periprocedural complication rates, angiographic outcomes, and clinical outcomes of the SAC using Neuroform Atlas group and the coiling-alone group were analyzed with 1:1 propensity score matching.

RESULTS:

A total of 375 aneurysms were enrolled, and 274 (63.1%) aneurysms were treated with coiling alone. In total, 101 (26.9%) aneurysms were treated with SAC, and Neuroform Atlas stent was used in 71 aneurysms. In propensity score matching, the SAC using Neuroform Atlas group showed higher incidence of complete occlusion (69.0% vs 56.3%, P = .029), lower rate of recanalization (11.3% vs 25.4%, P = .011), and lesser need for retreatment (7.0% vs 16.9%, P = .016) compared with the coiling-alone group. However, there were no significant differences in periprocedural complications such as intraprocedural thrombosis or postprocedural cerebral infarct between the 2 groups.

CONCLUSION:

The use of Neuroform Atlas is safe and effective for SAC in RIA with comparable procedure-related complication rates but better angiographic outcome in comparison with coiling alone.
Favorable Long-Term Outcomes of Chordoid Meningioma Compared With the Other WHO Grade 2 Meningioma Subtypes
Authors: Ren Leihao , Hua Lingyang , Deng Jiaojiao , Cheng Haixia , Wang Daijun , Chen Jiawei , Xie Qing , Wakimoto Hiroaki , Gong Ye
Published: December 2022

BACKGROUND:

WHO grade 2 meningiomas, including atypical, chordoid, and clear cell subtypes, form a heterogenous group of meningiomas with varying aggressiveness and clinical behavior.

OBJECTIVE:

To demonstrate the differences of clinical-histopathological characteristics and long-term outcomes among these 3 subtypes.

METHODS:

A total of 609 consecutive patients diagnosed with WHO grade 2 meningiomas (543 atypical meningiomas [AMs], 36 chordoid meningiomas [CMs], and 30 clear cell meningiomas [CCMs]) from 2010 to 2018 were enrolled in this study. We compared the clinical-histopathological characteristics and long-term outcomes in these 3 subtypes and assessed survival differences among the subtypes. Targeted panel sequencing of meningioma-relevant genes was performed in the cases of CM.

RESULTS:

The patients with CCM were significantly younger than those with AM (P < .001) and CM (P = .016). CMs were more likely to receive gross total resection than AMs and CCMs (P = .033). The Ki-67 index was lower (P < .001) while the progesterone receptors-positive rate was higher (P = .034) in CM than in AM and CCM. Importantly, survival analysis demonstrated that CM had better progression-free survival (P = .022) and overall survival (P = .0056) than non-CM tumors. However, the PFS of CM was still worse than WHO grade 1 meningiomas (P < .001). Alterations in NF2 (20.6%) and KMT2C (26.5%) were associated with poorer PFS in CM (P = .013 for NF2; P = .021 for KMT2C).

CONCLUSION:

Patients with CM had better long-term postoperative outcomes than the other WHO grade 2 subtypes. A lower Ki-67 index, higher PR status, higher extent of resection, and lower frequency of NF2 alteration might contribute to favorable clinical outcomes of CM.
Psychedelic-Assisted Therapy and Psychedelic Science: A Review and Perspective on Opportunities in Neurosurgery and Neuro-Oncology
Authors: Kelly Daniel F. , Heinzerling Keith , Sharma Akanksha , Gowrinathan Shanthi , Sergi Karina , Mallari Regin Jay
Published: December 2022

After a decades-long pause, psychedelics are again being intensely investigated for treating a wide range of neuropsychiatric ailments including depression, anxiety, addiction, post-traumatic stress disorder, anorexia, and chronic pain syndromes. The classic serotonergic psychedelics psilocybin and lysergic acid diethylamide and nonclassic psychedelics 3,4-methylenedioxymethamphetamine and ketamine are increasingly appreciated as neuroplastogens given their potential to fundamentally alter mood and behavior well beyond the time window of measurable exposure. Imaging studies with psychedelics are also helping advance our understanding of neural networks and connectomics. This resurgence in psychedelic science and psychedelic-assisted therapy has potential significance for the fields of neurosurgery and neuro-oncology and their diverse and challenging patients, many of whom continue to have mental health issues and poor quality of life despite receiving state-of-the-art care. In this study, we review recent and ongoing clinical trials, the set and setting model of psychedelic-assisted therapy, potential risks and adverse events, proposed mechanisms of action, and provide a perspective on how the safe and evidence-based use of psychedelics could potentially benefit many patients, including those with brain tumors, pain syndromes, ruminative disorders, stroke, SAH, TBI, and movement disorders. By leveraging psychedelics' neuroplastic potential to rehabilitate the mind and brain, novel treatments may be possible for many of these patient populations, in some instances working synergistically with current treatments and in some using subpsychedelic doses that do not require mind-altering effects for efficacy. This review aims to encourage broader multidisciplinary collaboration across the neurosciences to explore and help realize the transdiagnostic healing potential of psychedelics.
Função estimulante da publicidade governamental
Authors: Piccelli Roberto Ricomini
Published: December 2022

Este trabalho procura apresentar a publicidade governamental como uma ferramenta de fomento público. Para tanto, são examinadas as características típicas dos contratos mantidos por órgãos e entidades estatais brasileiras com empresas de mídia e confrontadas com os elementos definidores dessa forma de intervenção estatal. A partir do reconhecimento de que a compra de espaço na imprensa caracteriza, de fato, uma forma de apoio aos veículos contratados, o trabalho engaja-se no esmiuçamento, à luz da Constituição Federal, de algumas diretrizes objetivas a serem obrigatoriamente seguidas pelos administradores públicos na definição dos critérios de escolha dos veículos contratados, como a desconcentração, em homenagem ao pluralismo político, e a credibilidade do veículo, em respeito à moralidade administrativa.