bluuebunny/crossref_metadata_2025 huggingface dataset:
High-scale random access on DNA storage systems
Authors: El-Shaikh Alex , Welzel Marius , Heider Dominik , Seeger Bernhard
Published: January 2022

Due to the rapid cost decline of synthesizing and sequencing deoxyribonucleic acid (DNA), high information density, and its durability of up to centuries, utilizing DNA as an information storage medium has received the attention of many scientists. State-of-the-art DNA storage systems exploit the high capacity of DNA and enable random access (predominantly random reads) by primers, which serve as unique identifiers for directly accessing data. However, primers come with a significant limitation regarding the maximum available number per DNA library. The number of different primers within a library is typically very small (e.g. ≈10). We propose a method to overcome this deficiency and present a general-purpose technique for addressing and directly accessing thousands to potentially millions of different data objects within the same DNA pool. Our approach utilizes a fountain code, sophisticated probe design, and microarray technologies. A key component is locality-sensitive hashing, making checks for dissimilarity among such a large number of probes and data objects feasible.
Perceived racial discrimination and eating habits: a systematic review and conceptual models
Authors: Rodrigues Ylana Elias , Fanton Marcos , Novossat Ricardo Suñé , Canuto Raquel
Published: January 2022

Context

There is no systematic review on the relationship between racial discrimination and eating habits.

Objective

A systematic review was conducted to synthesize evidence on the association between perceived racial discrimination (PRD) and eating habits. A conceptual model was developed to depict the most common mechanisms used to explain this association.

Data Sources

Articles were retrieved from the PubMed, Embase, LILACS, and PsycINFO databases from inception to January 2021.

Study Selection

Only observational studies were included, and there were no restrictions on age, racial group, or country. Two reviewers selected the articles independently.

Data Extraction

Data were extracted independently by 2 reviewers. The assessment of methodological quality was conducted using the Newcastle-Ottawa Scale.

Results

All studies retrieved were conducted among the US population. Nineteen studies were included. On average, the studies showed a methodological quality of 66%. Forty-six associations were evaluated: 38 between PRD and negative eating habits, 29 between PRD and eating behavior, and 17 between PRD and food consumption.

Conclusions

PRD negatively affects eating habits. A conceptual framework based on ecosocial theory is suggested as a guide for future research. Further studies in different countries (beyond the United States) should be conducted to understand how racial discrimination affects eating habits within different ethnic, cultural, social, and economic contexts.

Systematic Review Registration

PROSPERO registration no. CRD42019142605
Pathways of parental influence on adolescent diet and obesity: a psychological stress–focused perspective
Authors: Dimitratos Sarah M , Swartz Johnna R , Laugero Kevin D
Published: January 2022

Youth obesity has become increasingly prevalent, with 34.5% of US adolescents 12–19 years old estimated to have overweight or obesity. Disordered eating and weight concern peak in adolescence, and overeating to cope with negative emotions can affect long-term health and obesity risk. Parents significantly influence adolescent diet quality, and parental stress may influence parenting behaviors that increase the risk for stress-motivated eating and obesity in adolescents. Chronic or repeated exposure to parental stress may lead to stress-related neurophysiological changes that promote consumption of palatable foods and obesogenic eating habits in adolescents. Understanding how parental stress influences adolescents’ eating behavior may reveal novel access points for reducing adolescent obesity. Here, we aim to provide a new stress-focused framework for developing intervention strategies targeted at obesity prevention in adolescents.
Western and ketogenic diets in neurological disorders: can you tell the difference?
Authors: Habashy Karl John , Ahmad Fatima , Ibeh Stanley , Mantash Sarah , Kobeissy Fatima , Issa Hawraa , Habis Ralph , Tfaily Ali , Nabha Sanaa , Harati Hayat , Reslan Mohammad Amine , Yehya Yara , Barsa Chloe , Shaito Abdullah , Zibara Kazem , El-Yazbi Ahmed F , Kobeissy Firas H
Published: January 2022

The prevalence of obesity tripled worldwide between 1975 and 2016, and it is projected that half of the US population will be overweight by 2030. The obesity pandemic is attributed, in part, to the increasing consumption of the high-fat, high-carbohydrate Western diet, which predisposes to the development of the metabolic syndrome and correlates with decreased cognitive performance. In contrast, the high-fat, low-carbohydrate ketogenic diet has potential therapeutic roles and has been used to manage intractable seizures since the early 1920s. The brain accounts for 25% of total body glucose metabolism and, as a result, is especially susceptible to changes in the types of nutrients consumed. Here, we discuss the principles of brain metabolism with a focus on the distinct effects of the Western and ketogenic diets on the progression of neurological diseases such as epilepsy, Parkinson’s disease, Alzheimer’s disease, and traumatic brain injury, highlighting the need to further explore the potential therapeutic effects of the ketogenic diet and the importance of standardizing dietary formulations to assure the reproducibility of clinical trials.
Triage by PAX1 and ZNF582 Methylation in Women With Cervical Intraepithelial Neoplasia Grade 3: A Multicenter Case–Control Study
Authors: Fu Kun , Lei Ming , Wu Li-Sha , Shi Jing-Cheng , Yang Si-Yu , Yang Wen-Qing , Xu Jin-Yun , Kang Ya-Nan , Yang Zhen-Ying , Zhang Xuan , Huang Kang-Ni , Han Chi , Tian Yan , Zhang Yu
Published: January 2022

Background

The colposcopy-conization inconsistency is common in women with cervical intraepithelial neoplasia grade 3 (CIN3). No adequate method has been reported to identify the final pathology of conization. In this study, we explored the ability of PAX1 and ZNF582 methylation to predict the pathological outcome of conization in advance.

Methods

This was a multicenter study and included 277 histologically confirmed CIN3 women who underwent cold knife conization (CKC) from January 2019 to December 2020. The methylation levels of PAX1 (PAX1m) and ZNF582 (ZNF582m) were determined by quantitative methylation-specific polymerase chain reaction (qMSP) and expressed in ΔCp. Receiver operating characteristic curves were used to evaluate predictive accuracy.

Results

The final pathological results in 48 (17.33%) patients were inflammation or low-grade squamous intraepithelial lesion (LSIL), 190 (68.59%) were high-grade squamous intraepithelial lesion (HSIL), and 39 (14.08%) were squamous cervical cancer (SCC). PAX1m and ZNF582m increased as lesions progressed from inflammation/LSIL, HSIL, to SCC. PAX1 and ZNF582 methylation yielded better prediction performance compared with common screening strategies, whether individually or combined. A 4.33-fold increase in the probability of inflammation/LSIL was observed in patients with lower ZNF582 methylation levels (ΔCpZNF582 ≥ 19.18). A 6.53-fold increase in SCC risk was observed in patients with elevated ZNF582 methylation (ΔCpZNF582 < 7.09).

Conclusions

DNA methylation would be an alternative screening method to triage and predict the final outcome of conization in CIN3 cases.
Phase I Study Evaluating Dose De-escalation of Sorafenib with Metformin and Atorvastatin in Hepatocellular Carcinoma (SMASH)
Authors: Ostwal Vikas , Ramaswamy Anant , Gota Vikram , Bhargava Prabhat G , Srinivas Sujay , Shriyan Bharati , Jadhav Shraddha , Goel Mahesh , Patkar Shraddha , Mandavkar Sarika , Naughane Deepali , Daddi Anuprita , Nashikkar Chaitali , Shetty Nitin , Ankathi Suman Kumar , Banavali Shripad D
Published: January 2022

Background

This phase I dose de-escalation study aimed to assess the tolerability, safety, pharmacokinetics (PK), and efficacy of sequentially decreasing doses of sorafenib in combination (SAM) with atorvastatin (A, 10 mg) and metformin (M, 500 mg BD) in patients with advanced hepatocellular carcinoma (HCC).

Methods

Patients were enrolled in 1 of 4 sequential cohorts (10 patients each) of sorafenib doses (800 mg, 600 mg. 400 mg, and 200 mg) with A and M. Progression from one level to the next was based on prespecified minimum disease stabilization (at least 4/10) and upper limits of specific grade 3-5 treatment-related adverse events (TRAE).

Results

The study was able to progress through all 4 dosing levels of sorafenib by the accrual of 40 patients. Thirty-eight (95%) patients had either main portal vein thrombosis or/and extra-hepatic disease. The most common grade 3-5 TRAEs were hand-foot-syndrome (grade 2 and grade 3) in 3 (8%) and transaminitis in 2 (5%) patients, respectively. The plasma concentrations of sorafenib peaked at 600 mg dose, and the concentration threshold of 2400 ng/mL was associated with higher odds of achieving time to exposure (TTE) concentrations >75% centile (odds ratio [OR] = 10.0 [1.67-44.93]; P = .01). The median overall survival for patients without early hepatic decompensation (n = 31) was 8.9 months (95% confidence interval [CI]: 3.2-14.5 months).

Conclusion

The SAM combination in HCC patients with predominantly unfavorable baseline disease characteristics showed a marked reduction in sorafenib-related side effects. Studies using sorafenib 600 mg per day in this combination along with sorafenib drug level monitoring can be evaluated in further trials.

(Trial ID: CTRI/2018/07/014865).
A bipartite chromatophore transit peptide and N-terminal protein processing in the Paulinella chromatophore
Authors: Oberleitner Linda , Perrar Andreas , Macorano Luis , Huesgen Pitter F , Nowack Eva C M
Published: January 2022

The amoeba Paulinella chromatophora contains photosynthetic organelles, termed chromatophores, which evolved independently from plastids in plants and algae. At least one-third of the chromatophore proteome consists of nucleus-encoded (NE) proteins that are imported across the chromatophore double envelope membranes. Chromatophore-targeted proteins exceeding 250 amino acids (aa) carry a conserved N-terminal extension presumably involved in protein targeting, termed the chromatophore transit peptide (crTP). Short imported proteins do not carry discernable targeting signals. To explore whether the import of proteins is accompanied by their N-terminal processing, here we identified N-termini of 208 chromatophore-localized proteins by a mass spectrometry-based approach. Our study revealed extensive N-terminal acetylation and proteolytic processing in both NE and chromatophore-encoded (CE) fractions of the chromatophore proteome. Mature N-termini of 37 crTP-carrying proteins were identified, of which 30 were cleaved in a common processing region. Surprisingly, only the N-terminal ∼50 aa (part 1) become cleaved upon import. This part contains a conserved adaptor protein-1 complex-binding motif known to mediate protein sorting at the trans-Golgi network followed by a predicted transmembrane helix, implying that part 1 anchors the protein co-translationally in the endoplasmic reticulum and mediates trafficking to the chromatophore via the Golgi. The C-terminal part 2 contains conserved secondary structural elements, remains attached to the mature proteins, and might mediate translocation across the chromatophore inner membrane. Short imported proteins remain largely unprocessed. Finally, this work illuminates N-terminal processing of proteins encoded in an evolutionary-early-stage organelle and suggests host-derived posttranslationally acting factors involved in regulation of the CE chromatophore proteome.
The Emerging Digital Twin Bureaucracy in the 21st Century
Authors: Eom Seok-Jin
Published: January 2022

With the expansion of digital transformation based on new technologies, the digital twin bureaucracy (DTB) emerges as a distinct type of 21st-century bureaucracy. The digital twin bureaucracy is defined as a digital replica of the bureaucracy in the physical world. Although the digital twin is formed based on new information and communication technology and physical bureaucracy data, it will control the physical bureaucracy through autonomous decision-making on matters of public affairs. Feedback from the physical world serve as input and update to the digital twin in this cyclical course of interactions. This study explores the technological figures and benefits of the digital twin bureaucracy based on a case analysis of the Sejong City Digital Twin Project in South Korea. It also compares the characteristics of the DTB and those of Max Weber’s “ideal-type” bureaucracy. Based on this theoretical and empirical analysis, the paper presents the challenges and concerns of building the DTB.
IMPACT OF RADIATION FIELD SIZE ON ABSORBED ORGAN DOSES IN NEONATES UNDERGOING CHEST RADIOGRAPHY IN AN ANTERIOR–POSTERIOR PROJECTION: A MONTE CARLO SIMULATION STUDY
Authors: Elshami Wiam , Tekin H O , Abuzaid Mohamed M , Issa Bashar
Published: January 2022

Electronic image cropping and poor collimation practices are used by some radiographers during paediatric radiography. Advantages of collimation should be investigated to disseminate convenient use among radiographers and create awareness. The aim of this study was to use Monte Carlo simulation to investigate the extent of the effect of collimation on the absorbed organ dose in neonates undergoing anterior–posterior chest examination. The minimum field size recommended by the European guidelines was calculated experimentally using a neonate phantom. A PCXMC version 2.0 simulation calculated the organ and effective doses at the minimum field size and at different field sizes. Increasing the field size by 1 cm in the head-to-feet direction increases the dose to the urinary bladder and prostate, whereas increasing the field size by 1 cm on all sides increases the dose to the upper limbs, ovaries, testicles and prostate. The use of an optimal field size reduces organ doses for neonates undergoing chest X-ray. Cropping X-ray images to reduce unnecessarily large field sizes results in unnecessary patient dosages and should be avoided. The primary beam should be restricted to expose only the area of interest, and image cropping should be discouraged.
Exposure to aristolochic acid I is associated with poor prognosis of liver cancer patients
Authors: Wang Lan , Bai Shi-Hao , Song Shu-Jin , Lu Zhao-Ning , Huang Jian , Han Ze-Guang
Published: January 2022

The aristolochic acids (AAs), derived from Aristolochia and Asarum species used widely in herbal medicines, are closely associated with liver cancer. The major AA derivatives are aristolochic acid I (AAI) and II (AAII), which can bind DNA covalently to form AA-DNA adducts after metabolic activation in vivo. Among all these AA-DNA adducts, 7-(deoxyadenosine-N6-yl) aristolactam I (dA-AL-I) is the most abundant and persistent DNA lesion in patients. However, the direct evidence indicating AA exposure in human liver cancer is still missing. Here, we analyzed dA-AL-I adduct, the direct biomarker of AAI exposure, by ultra-performance liquid chromatography coupled with triple quadrupole mass spectrometry (UPLC-TQ/MS) in 209 liver cancer patients. Also, DNA samples from mice treated with/without AAI were used as positive and negative controls. dA-AL-I adduct was present in 110 of 209 (52.6%) patients, indicating that these patients were exposed to AAI prior to their clinical investigations and also had a worse prognosis. The relative high AA exposure rate and worse prognosis in our cohort of patients emphasize the significance to increase public awareness to avoid the use of herbal medicine containing AAs or their derivatives.
Diagnostic and Prognostic Biomarkers of Coronavirus Disease 2019 in Children
Authors: Önal Pınar , Kılınç Ayşe Ayzıt , Aygün Fatma Deniz , Aygün Fatih , Durak Cansu , Akkoç Gülşen , Ağbaş Ayşe , Elevli Murat , Çokuğraş Haluk
Published: January 2022

Predictors of early diagnosis and severe infection in children with coronavirus disease 2019 (COVID-19), which has killed more than 4 million people worldwide, have not been identified. However, some biomarkers, including cytokines and chemokines, are associated with the diagnosis, pathogenesis and severity of COVID-19 in adults. We examined whether such biomarkers can be used to predict the diagnosis and prognosis of COVID-19 in pediatric patients. Eighty-nine children were included in the study, comprising three patient groups of 69 patients (6 severe, 36 moderate and 27 mild) diagnosed with COVID-19 by real-time polymerase chain reaction observed for 2–216 months and clinical findings and 20 healthy children in the same age group. Hemogram, coagulation, inflammatory parameters and serum levels of 16 cytokines and chemokines were measured in blood samples and were analyzed and compared with clinical data. Interleukin 1-beta (IL-1β), interleukin-12 (IL-12) and interferon gamma-induced protein 10 (IP-10) levels were significantly higher in the COVID-19 patients (p = 0.035, p = 0.006 and p < 0.001). Additionally, D-dimer and IP-10 levels were higher in the severe group (p = 0.043 for D-dimer, area under the curve = 0.743, p = 0.027 for IP-10). Lymphocytes, C-reactive protein and procalcitonin levels were not diagnostic or prognostic factors in pediatric patients (p = 0.304, p = 0.144 and p = 0.67). Increased IL-1β, IL-12 and IP-10 levels in children with COVID-19 are indicators for early diagnosis, and D-dimer and IP-10 levels are predictive of disease severity. In children with COVID-19, these biomarkers can provide information on prognosis and enable early treatment.
Clinical Profile and Outcome Following Exchange Transfusion for Neonatal Jaundice in a Tertiary Care Centre
Authors: Ramachandran Rajashree M , Srinivasan Ramesh
Published: January 2022

Introduction

Phototherapy has reduced the need for exchange transfusion (ET) to manage jaundiced neonates. Hence there are concerns about increased risk of complication due to lack of opportunity to sustain skills in performing ET. We studied the complications and treatment outcomes of neonates treated for jaundice with ET.

Methodology

A retrospective observational study was conducted from June 2013 to June 2020 in a tertiary care hospital in India. All neonates treated with ET for jaundice were included.

Results

Twenty-eight neonates underwent 31 ET during the study period. Their mean gestational age and birth weight were 37 weeks and 3200 g, respectively. Predisposing factor for jaundice observed were Coomb’s positive status (11), hepatosplenomegaly suggesting hemolysis (3), cephalhematoma (2) and birth asphyxia (1). Abnormal neurological status before ET was seen in seven neonates. Adverse clinical events that happened during or within 8 h after ET were desaturation (4), tachycardia (3), tachypnea (2), bradycardia (2), shock (2) and temperature instability (2). One neonate developed acute kidney injury after ET and required peritoneal dialysis. Abnormal lab parameters observed during or within 8 h after ET were hypocalcemia (20), anemia (8), hypokalemia (7), hypernatremia (3), thrombocytopenia (3) and hyperkalemia (2). Post ET sepsis was seen in five neonates: two had only blood culture positive sepsis, two had bone and joint infection and one had liver abscess.

Conclusion

The neonates undergoing ET are at high risk of developing complications which may be life threatening. Hence careful monitoring during the procedure is needed.
A Surgical Alternative in the Treatment of Hypopharyngeal Perforation
Authors: Abboud Nicolas M. , Dziubek Melvin , Bogaert Svetlana , Ennaji Meriem , Spitaels Julien , Marron Mendes Vanessa , Fouarge Alessandro , Vander Kuylen Maarten , Cuylits Nicolas
Published: January 2022

Pharyngo-esophageal perforation is a rare, life-threatening complication of anterior cervical discectomy and fusion surgery with an incidence estimated to be between 0.2 and 1.51%. Early diagnosis and appropriate treatment of this complication is the key to reduce morbidity and mortality, as the main prognostic factor is the interval between the onset of the fistula, diagnosis and treatment. Conservative management has shown encouraging results in small and localized defects, whereas surgical approaches using flaps are to be considered for most of the cases. However, there is no clear consensus on the first choice of treatment in esophageal perforation. This case report presents the use of a supra-clavicular fascio-cutaneous pedicled propeller flap as a patch combined to primary repair of a hypopharyngeal perforation, 10 years after anterior cervical spine arthrodesis.
Trigger points and sensitized acupoints: same book, different covers?
Authors: Sun Mingsheng , Yang Mingxiao , Rong Jing , Ma Xingsha , Zheng Hui , Cai Dingjun , Zhao Ling , Liang Fanrong
Published: January 2022

Acupoints and trigger points in traditional Chinese medicine represent two different minimally invasive therapy systems-based, respectively, on traditional acupuncture and dry needles. Many studies argue that trigger points and traditional acupoints are conceptually similar because they generally have identical locations on the human body. However, whether trigger points contribute to the formation of the traditional acupuncture technique is controversial. Although many relevant studies have been conducted, this controversy continues to hinder the development of both disciplines. Recently, researchers of Chinese acupuncture have proposed the “acupoint sensitization” theory, which postulates that traditional acupoints may be sensitized by diseases, environments, and therapies. This turns them into a “sensitized state.” Recent studies suggest that trigger points and sensitized acupoints share similar biological properties. To clarify the above-mentioned confusion, we reviewed relevant studies on these two concepts and attempted to analyze their relationship. In this paper, we provide a general summary of acupoint sensitization theory and sensitized acupoints. We then compare trigger points with sensitized acupoints by categorizing their similarities and differences, including location and range, pathological morphology, pain perception, surface temperature effects, and bioelectrical properties. We believe that, because trigger points and sensitized acupoints have many shared properties, they might constitute “the same book with different covers.”
OPTICAL COHERENCE TOMOGRAPHY IMAGING OF RETINAL MACROPHAGE-LIKE CELLS IN PATIENTS WITH MULTIPLE EVANESCENT WHITE DOT SYNDROME
Authors: Maltsev Dmitrii S. , Kulikov Alexei N. , Vasiliev Alexander S.
Published: January 2022

Purpose:

To analyze the changes of macrophage-like cells (MLCs) on the inner retinal surface associated with multiple evanescent white dot syndrome using optical coherence tomography.

Methods:

Four eyes of four patients with multiple evanescent white dot syndrome were examined and followed with multimodal imaging, including optical coherence tomography angiography, to visualize MLC on en face structural projections.

Results:

On en face structural optical coherence tomography angiography projection at presentation, all multiple evanescent white dot syndrome eyes showed a decrease of the nearest neighbor distance of MLC within the region of interest and an increase of MLC density in the perifovea compared with the fellow unaffected eye. Three eyes demonstrated protrusion of MLC into the vitreous. At 1 to 3 months of follow-up, nearest neighbor distance increased, and MLC density decreased to the level of the fellow unaffected eye along with regression of multiple evanescent white dot syndrome symptoms.

Conclusion:

Multiple evanescent white dot syndrome may be associated with increase of MLC population on the inner retinal surface, which can be tracked with clinical optical coherence tomography imaging.
RETINAL CHANGES IN PORETTI–BOLTSHAUSER SYNDROME: RETINA AS A WINDOW TO THE BRAIN
Authors: Parameswarappa Deepika C. , Sheth Jenil , Agarwal Komal
Published: January 2022

Purpose:

LAMA 1 gene as a pathologic variant leading to cerebellar dysplasia and cysts, nonprogressive ataxia, language, and motor developmental delay without any muscular involvement was recently described as Poretti–Boltshauser syndrome (PBS). Ocular involvement is a common associated feature in this neurodegenerative disorder. In this case report, we describe the retinal changes associated with Poretti–Boltshauser syndrome.

Methods, Patient, and Results:

A 4-year-old female child presented with the progressive decreased vision for the past 6 to 8 months. Ophthalmic examination revealed mild myopia and ocular motor apraxia with retinal disruptions appearing as holes that were confined only to inner retinal layers. The child also had motor and speech developmental delays. Magnetic resonance imaging of the brain showed vermis hypoplasia with cerebellar dysgenesis and multiple cystic spaces in both cerebellar hemispheres. Whole exome sequencing revealed a homozygous pathogenic variant of exon 2-63 deletion in the LAMA 1 gene, which was confirmatory for Poretti–Boltshauser syndrome.

Conclusion:

Oculomotor apraxia and retinal changes can lead to visual disturbances in Poretti–Boltshauser syndrome. Identification of these features and prompt rehabilitative measures can improve the quality of life of these children.
Campylobacter jejuni Bacteremia in the Term Infant A Rare Cause of Neonatal Hematochezia
Authors: Mizuno Shinsuke , Yokoyama Koji , Nukada Takayuki , Ikeda Yuka , Hara Shigeto
Published: January 2022

Early-onset sepsis caused by Gram-negative spiral organisms is rarely reported, with Campylobacter fetus being a better known causative agent than other Campylobacter species. We report the case of a 2-day-old girl who presented with hematochezia and bacteremia caused by Campylobacter jejuni. She was born full-term. Her family ate undercooked chicken, and Campylobacter enteritis was diagnosed before her birth.
Determinants of Disclosure, Adherence and Viral Suppression in Children and Adolescents Living With HIV in Ecuador
Authors: García-Boyano Miguel , Chávez-Solórzano Nelly , Layana-Coronel Marianella , Soffe-Pazmiño Judith , Sarcos-Lindao Héctor , Solís-Montiel Dalton , Miño-León Greta
Published: January 2022

Background:

Studies on HIV disclosure and adherence among children performed in Latin America are anecdotal. We aimed to assess the factors associated with HIV disclosure, adherence and viral suppression among Ecuadorian children and compare the psychologic consequences and the impact on adherence and viral suppression of early against late disclosure age.

Methods:

Cross-sectional study using a questionnaire and collected data on medical records of HIV-infected children between 6 and 21 years of age in Ecuador.

Results:

In 250 children included, HIV diagnosis was revealed at a median age of 11 years (p25-p75 9-12). Children 12 years old or older (P < 0.0001), 10 or more years since HIV diagnosis (P = 0.001), antiretroviral initiation above 3 years of age (P = 0.018) and decease of the mother (P = 0.048) were significantly associated with total disclosure in multivariate analysis. Profound sadness or anxiety was significantly more common when diagnosis was disclosed after 12 years of age (28.4%) than before (15.4%, P = 0.047). According to the simplified medication adherence questionnaire, 194 children (78.2%) were adherent to antiretroviral therapy and HIV-RNA viral load was undetectable in 168 (67.7%). In multivariate analysis, variables associated with nonadherence were age ≥14 years (P < 0.001), taking ≥3 daily antiretroviral pills (P = 0.013) and the presence of adverse effects (P < 0.001), whereas nonadherence (P = 0.001) was the only variable significantly associated with an unsuppressed HIV-RNA viral load.

Conclusions:

Although we failed to show that an earlier disclosure age is followed by better adherence outcomes, psychological outcomes did seem to improve, supporting disclosure before 12 years of age.
Multiple Cranial Neuropathies as the Initial Presentation of Primary Ductal Adenocarcinoma of the Lacrimal Gland
Authors: Kim Jane S. , Proia Alan D. , Liss Jason , Morgenlander Joel , Meekins Landon C.
Published: January 2022

Primary ductal adenocarcinoma of the lacrimal gland is a rare, aggressive malignancy that clinically and histologically resembles salivary duct carcinoma. Similar to other malignant epithelial lacrimal gland tumors, ductal adenocarcinoma typically presents with unilateral proptosis, pain, upper eyelid swelling, palpable mass, diplopia, ptosis, and blurred or decreased vision. Rarely, primary malignant epithelial lacrimal gland tumors may first present with multiple cranial neuropathies due to occult spread to the cavernous sinus, as in this case. With such a vast differential diagnosis, a practical yet systematic approach to multiple cranial neuropathies, as guided by clinical history, exam, and neuroimaging, allows for a more targeted diagnostic evaluation, especially when multiple diagnostic tests and interventions return unrevealing. A repeat biopsy or complete excision of the lacrimal gland may be necessary to yield the correct diagnosis.
Exploring Health Literacy Categories in Patients With Heart Failure
Authors: Jiang SiXuan , Zhang Xiaonan , Li Xuedong , Li Yanting , Yang Weiling , Yao Ying , Fu Li , Zhao Man , Zang Xiaoying
Published: January 2022

Background

Although a growing number of studies have demonstrated that patients' health literacy is associated with health outcomes, the exact relationship between them is not clear.

Aims and objectives

The aim of this study was to explore latent classes of health literacy in patients with heart failure and analyze the differences among different groups.

Design and Methods

This is a cross-sectional survey. Patients diagnosed with heart failure were selected from 3 tertiary hospitals in Tianjin, China, from March 2019 to November 2019. We measured patients' health literacy using the Health Literacy Scale for Chronic Patients. Latent class analysis was carried out based on the patients' Health Literacy Scale for Chronic Patients scores. Multinomial logistic regression was used to identify the predictive indicators of the latent classes.

Results

The health literacy of patients with heart failure was divided into 3 different latent classes, named “high health literacy group,” “low literacy high dependence group,” and “moderate literacy high willingness group.” There were statistically significant differences in gender, age, smoking history, marital status, education level, household income level, and quality of life among different health literacy classes. Low education level and household income level predicted poor health literacy.

Conclusion

There were 3 latent classes for the health literacy of patients with heart failure. Different health literacy classes exhibited their own distinctive characteristics. Patients in the “moderate literacy high willingness group” had the worst quality of life. Understanding the specific types of health literacy in patients with heart failure facilitates targeted nursing interventions to improve their quality of life.
Case report of the rare Peters’ anomaly complicated with Axenfeld-Rieger syndrome
Authors: Meng Yong , Lu Guohua , Xie Yang , Sun Xincheng , Huang Liqin
Published: January 2022

Introduction:

Peters’ anomaly (PA) and Axenfeld-Rieger syndrome (ARS) are typical classifications of anterior segment dysgenesis (ASD) and ascribed to congenital eye diseases that encompass developmental defects in anterior segment structures. The aim of this study is to discuss the unusual association between PA and ARS and to determine the results of penetrating keratoplasty combined with extracapsular cataract extraction and anterior vitrectomy for this unusual ophthalmic phenotype.

Patient concerns:

A 72-year-old female was referred to Changzhou No. 2 People's Hospital for a progressive decrease in visual acuity in both eyes in the past few decades.

Diagnoses:

The patient was diagnosed with PA with cone-shaped polar cataracts in the left eye based on a series of ophthalmic examinations. ARS with retinal detachment was diagnosed in the right eye 2 years prior.

Interventions:

Penetrating keratoplasty combined with extracapsular cataract extraction and anterior vitrectomy were performed to manage PA with cataracts in the left eye.

Outcomes:

Her best corrected visual acuity did not improve significantly after the operation. Patients with ARS and PA should be treated cautiously because of fundus lesions.

Conclusion:

This study revealed that cases with PA accompanied by iridocorneal adhesions, or other ocular anomalies, need to be treated cautiously for a very low success rate. It is of reference value for the evaluation of treatment prognosis for this joint occurrence of ophthalmic phenotypes.
Sex disparities in the effect of statins on lipid parameters
Authors: Hunt Nicholas B. , Emmens Johanna E. , Irawati Sylvi , de Vos Stijn , Bos Jens H.J. , Wilffert Bob , Hak Eelko , de Boer Rudolf A.
Published: January 2022

Real-world evidence on a potential statin effect modification by sex is inconclusive, especially for the primary prevention of cardiovascular disease (CVD). We aimed to quantify the differences in the effect of statins on lipid parameters between men and women.

The PharmLines Initiative linked the Lifelines Cohort Study and the IADB.nl prescription database. This database covers a representative population from the Netherlands. We selected participants aged ≥40 years at the index date: the date of the first prescription of any statin monotherapy in the study period 2006 to 2017. Multivariate regression modeling was used to compare the difference of the mean percentage change of lipid parameters (% mean difference [MD]) from baseline to follow-up measurement between the sexes.

Out of 5366 statin users from approximately 50,000 participants available in the final linked database, 685 were statin initiators. At baseline, women had significantly higher levels of mean total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) than men (all P values <.01). At follow-up, women had a significantly higher mean percentage change of HDL-C compared to men (adjusted % MD 5.59, 95% confidence interval [CI] 2.42-8.75, P < .01). There was no significant sex difference in other parameters, nor in the proportion of men and women who achieved LDL-C ≤2.5 mmol/L.

Statins appear to have a greater effect on increasing HDL-C levels in women than men while showing similar effect on other lipid parameters in both sexes. Men should not be treated differently than women.
Klebsiella pneumoniae-related brain abscess and meningitis in adults
Authors: Zhao Jingru , Huo Tiantian , Luo Xintong , Lu Fan , Hui Shuo , Yang Baoming
Published: January 2022

Introduction:

Klebsiella pneumoniae is once thought to be a less common cause of brain abscess in adults and is mainly hospital-acquired. Community-acquired CNS infection (brain abscess and meningitis) caused by K pneumoniae without other metastatic septic abscesses is exceedingly rare. Therefore, we present a rare adult patient with invasive cerebral abscess and meningitis without other invasive abscesses related to K pneumoniae.

Patient concerns:

A 64-year-old woman experienced a sudden onset of severe continuous headache accompanied by intermittent nausea, vomiting, and fever. Meanwhile, she experienced tinnitus and had a feeling of swelling in the right ear.

Diagnosis:

Cranial magnetic resonance imaging revealed abnormal hyperintensity signals in the left head of the caudate nucleus. The next generation sequencing of cerebral spinal fluid showed infection with K pneumoniae. The patient was diagnosed with K pneumoniae-related brain abscesses and meningitis.

Interventions:

Antibacterial treatment was carried out for 2 months.

Outcomes:

The patient recovered well.

Conclusion:

Despite the progress of modern neurosurgical techniques, new antibiotics, and modern imaging techniques, brain abscesses are still a potentially fatal infection. Streptococci are common organisms that result in brain abscesses. Nevertheless, Klebsiella species, once thought to be a less common cause of brain abscess in adults, has become an increasingly important cause of brain abscess, especially in Asia.
Acupuncture combined tuina for oculomotor paralysis
Authors: Huang Yan , Miao Zuoxiong , Lai Chunbai , Zeng Fanhua , Guo Qin , Zhang Tonghai , Li Mingheng , Xu Zhenhua
Published: January 2022

Background:

Oculomotor paralysis (OP) is a neurologic syndrome with multiple causes of oculomotor nerve and its dominant tissue and muscle dysfunction. Acupuncture combined with tuina is a wide-ranging used rehabilitation therapy, although there is short of supporting evidence for its efficacy and safety in patients with OP. The purpose of this systematic review was to estimate and synthesize evidence of the efficacy and safety of acupuncture combined with tuina in the treatment of OP.

Methods:

Electronic databases, including PubMed, Web of Science, Cochrane Library, EMBASE, Technology Journal and China Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wanfang,

adopt an appropriate search strategy. RevMan V.5.3.5 software will be used for data synthesis, bias risk, and subgroup analyses.

Results:

This study provides high-quality evidence to assess the effectiveness and safety of acupuncture combined with tuina for OP.

Conclusion:

This systematic review explores whether acupuncture combined with tuina is an effective and safe intervention for OP.

Ethics and dissemination:

Private information from individuals will not publish. This systematic review does not involve endangering participant rights. Ethical approval was not obtained. The results may be published in a peer-reviewed journal or disseminated at relevant conferences.

PROSPERO registration number:

PROSPERO CRD42021266447
Current state and future direction of task shifting in obstetric and gynecological care
Authors: Ishikawa Masatoshi
Published: January 2022

To conduct a survey about task shifting in obstetric and gynecological care.

A multivariate logistic regression analysis was conducted in Japanese hospitals using obstetrician–gynecologists (OB/GYNs) who answered that task shifting was rarely used at their working environment as the outcome variable and using their personal attributes (sex, age, type of medical institution employed at, and regional characteristics) as predictor variables. Opinions were gathered regarding promoting task shifting impact on individual work duties.

Responses were collected from 919 OB/GYNs (49.9% women, 50.8% <40 years). Characteristics’ analysis of 34.6% of OB/GYNs who thought that task shifting was hardly used indicated that it was used significantly more at private university hospitals (odds ratio 5.33, 95% confidence interval: 2.33–12.18) than at national university hospitals (odds ratio 3.54, 95% confidence interval: 1.67–7.51). “Transfer of patients (from operating rooms to the ward)” and “securing the contrast agent line” were the only items related to the task shifting status for individual work duties that were identified by most respondents, revealing that task shifting is not progressing. More than half and 9% of the OB/GYNs said that task shifting progression would improve and decline medical care quality, respectively. Overall, 46% and 24% of the respondents thought that task shifting could reduce working hours by “>1 hour, but <2 hours”/day and “<1 hour”/day, respectively.

The current study confirmed that OB/GYNs working at university hospitals believe that task shifting is not progressing in university hospitals and that the working environment is poor. Even if task shifting reduces the number of working hours per day by 2 hours, the working hours of these physicians still exceed the criteria for death by overwork. Thus, further working hour reduction measures are needed in addition to task shifting, such as consolidation of medical institutions dealing with deliveries.

To promote task shifting in obstetrical and gynecological care in Japan, it is necessary to continue promoting policy-based, institutional, and educational guidance.
Comparative effects of 6-weeks progressive resistance exercise and moderate intensity aerobic exercise on CD4 count and weights of people living with HIV/AIDS in Alex-Ekwueme Federal University Teaching Hospital Ebonyi State
Authors: Asogwa Eucharia Ijego , Abonyi Okechukwu Sunday , Elom Chinyere Ori , Oduma Christian A. , Umoke Chukwudum Collins , Ogai Nwele Anamelechi , Uwaleke Chidebe Chijioke , Nwimo Ignatius Obilom
Published: January 2022

Introduction:

The most significant clinical challenges in people living with HIV/AIDS (PLWHA) are decline in CD4+ T helper cells and abnormal weight reduction. Consequently, PLWHA who are on Anti-Retroviral Therapy (ART) or Highly Active Anti-Retroviral Therapy (HAART) are usually predisposed to coronary artery diseases due to abnormal weight gain (lipohypertrophy), though with improved and unstable Cluster of Differentiation 4 (CD4) counts.

The main aim of this study was to compare the effects of 6 weeks progressive resistance exercise (PRE) and moderate intensity aerobic exercise (MIAE) on CD4 count, and weight of PLWHA in Alex-Ekwueme Federal University Teaching Hospital Ebonyi State.

Method:

The study adopted quasi experimental research design. The population of the study was 60 Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome patients that attended HIV clinics at Alex-Ekwueme Federal University Teaching Hospital Abakaliki (AE-FUTHA) which formed 58 sample sizes for this study.

Simple random sampling technique was adopted for the study and flow cytometry, Heel Densitometer (X-rite 331C), and Omron BF 400 were the instrument used for data collection of CD4 counts and weight respectively; and they are standardized hence not validated. Mean, standard deviation and Analysis of Co-variance (ANCOVA) were used to analyze the data obtained. The reliability coefficient obtained from the pilot study was 0.848 and 0.994 for CD4 and WEIGHT respectively.

Results:

The major findings revealed a significant difference after 6 weeks’ PRE and MIAE on CD4 and Weight of PLWHA.

Conclusion:

Health promotion policy maker's arm of the government and Healthcare givers should integrate and enforce the use of exercises either as a single regimen or combined exercises into the management plan of PLWHA for greater boost in absolute CD4 count bearing in mind that both have positive effects. Physiotherapist should be integrated in the managements of PLWHA for appropriate prescription and education of therapeutic exercises for body weight.
Acute pancreatitis soon after COVID-19 vaccination
Authors: Ozaka Sotaro , Kodera Takamoto , Ariki Shimpei , Kobayashi Takashi , Murakami Kazunari
Published: January 2022

Rationale:

In response to the global coronavirus infectious disease 2019 (COVID-19) pandemic, several vaccines against severe acute respiratory syndrome coronavirus 2 have been developed. Although many infrequent side effects of COVID-19 mRNA vaccine have been reported, only a few cases of pancreatitis have been reported.

Patient concerns:

A 71-year-old woman was presented to the hospital with upper abdominal pain and vomiting. She had no history of alcohol consumption, pancreatitis, or allergic reactions to vaccines. She had received the first dose of the Pfizer/BioNTech COVID-19 mRNA vaccine 2 days prior to her current presentation. Laboratory tests revealed elevated serum pancreatic enzymes. An abdominal computed tomography scan showed diffuse enlargement of the pancreas with fat stranding extending to below the kidneys bilaterally.

Diagnosis:

The patient was diagnosed with acute pancreatitis.

Interventions:

The patient was treated with the administration of intravenous antimicrobials, proteolytic enzyme inhibitors, and proton pump inhibitors.

Outcomes:

The patient had an uneventful recovery with no complications.

Lessons:

Acute pancreatitis can develop shortly after COVID-19 mRNA vaccination. Therefore, of great importance to differentiate acute pancreatitis when abdominal pain occurs after COVID-19 mRNA vaccination.
A case report of primary myxoid liposarcoma mimicking as a parotid cystic lesion
Authors: Hong Yong Tae , Yang Yunna , Lee Hyunjun
Published: January 2022

Rationale:

Myxoid liposarcoma (MLS) is an extremely rare tumor of the salivary gland and it arises from undifferentiated pluripotent mesenchymal cells. We report a rare case of a primary MLS in the parotid gland.

Patient concerns:

The patient was a 49-year-old female who presented with a hard fixed mass in the left parotid region.

Diagnosis:

On computed tomography and MR images, this tumor has a low attenuation center with a thick enhancing wall and ill-defined margins. The absence of high-signal-intensity foci on T1-weighted images makes a MLS indistinguishable from most other soft-tissue masses. Pathologically, the tumor was diagnosed as MLS.

Interventions:

The patient received total parotidectomy with facial nerve preservation and selective neck dissection.

Outcomes:

Immediate facial nerve function was House Brackmann Grade III and recovered within 3 months after the surgery. Follow-up period is 57 months and there was no recurrence until now.

Lessons:

In this report, we report a rare case of primary MLS mimicking a cystic lesion of the parotid gland.
Effectiveness and safety of Tai Chi for chronic pain of knee osteoarthritis
Authors: Guo Guangxin , Wu Boyi , Xie Shengji , Xu Jianghan , Zhou Xu , Wu Guanghui , Lu Ping
Published: January 2022

Background:

Chronic pain (CP) has been a major area of interest in the field of knee osteoarthritis (KOA), further aggravating the dysthymia, stiffness, and dysfunction of KOA patients. As an important part of complementary and alternative medicine, Tai Chi has a positive effect on KOA patients. The systematic review is to evaluate the effectiveness and safety of Tai Chi for KOA patients with CP.

Methods:

A systematic search will be performed in the following electronic databases for randomized controlled trials to evaluate the effectiveness and safety of Tai Chi in treating chronic pain of knee osteoarthritis: the Cochrane Library, PubMed, EMBASE, OVID-MEDLINE, and four Chinese databases (Wan Fang, CNKI, CBMdisc and VIP). Each database will be searched from inception to Dec. 2021. The process will include study selection, data extraction, risk of bias assessment and meta-analysis.

Results:

This proposed study will evaluate the effectiveness and safety of Tai Chi for KOA patients with CP. Improvement in pain and adverse effects of KOA will be included in our measure.

Conclusions:

This proposed systematic review and meta-analysis will evaluate the existing evidence on the effectiveness and safety of Tai Chi for KOA patients with CP.

Dissemination and ethics:

The results of this review will be disseminated through peer-reviewed publication. This review does not require ethical approval because all of the data used in this systematic review and meta-analysis have already been published. Furthermore, all of these data will be analyzed anonymously during the review process.

INPLASY registration number:

INPLASY2021120020.