bluuebunny/crossref_metadata_2025 huggingface dataset:
Whole-organ deceased donor tracheal allograft transplantation for the treatment of refractory tracheal stenosis: a case report
Authors: Dickerson Shane C. , Genden Eric M. , Gross Caroline R. , Florman Sander S. , Franz Eric , Chang Daniel , DeMaria Samuel
Published: January 2022

Tracheal stenosis involving >5 cm of trachea is debilitating for patients, impedes their quality of life and may even become life-threatening. Large, open defects often result in these patients because of multiple failed tracheal resections and endoscopic dilatations. Tracheal transplantation has been proposed as a curative solution, but revascularization of the trachea as an allograft has generally been considered prohibitively challenging due to a tenuous blood supply. We report a multidisciplinary effort resulting in the first vascularized, single-stage, deceased donor tracheal allograft transplantation in a woman with long-segment tracheal stenosis.
METAGENOMIC NEXT-GENERATION SEQUENCING DETECTS PATHOGENS IN ENDOPHTHALMITIS PATIENTS
Authors: Zhu Junfeng , Xia Honghe , Tang Ruqing , Ng Tsz Kin , Yao Fen , Liao Xulong , Zhang Qi , Ke Xixuan , Shi Tingkun , Chen Haoyu
Published: January 2022

Purpose:

To investigate the utility of metagenomic next-generation sequencing (mNGS) in identifying the pathogens in endophthalmitis.

Methods:

In this prospective study, 36 cases of endophthalmitis were recruited. All patients received surgical treatment and intraocular drug lavage. The samples of vitreous or aqueous humor were extracted for mNGS and microbiological culture. The diagnostic performance of pathogens was compared between mNGS and culture.

Results:

The positive rates of mNGS and culture were 88.89% (32/36) and 27.78% (10/36), respectively. There was a statistically significant difference between mNGS and culture (Chi-square = 27.657; P < 0.01). Staphylococcus epidermidis, Streptococcus pneumoniae, and Klebsiella pneumoniae were the most pathogenic bacteria in traumatic, postoperative, and endogenous endophthalmitis, respectively. The concordance of pathogen identified by mNGS and culture was 70% for culture-positive cases. Antibiotic resistance genes were identified in 9 cases. There was a marginal correlation between the final visual acuity and the microbial sequence read (Spearman correlation coefficient = 0.498; P = 0.05).

Conclusion:

Metagenomic next-generation sequencing has a higher positive rate of identifying pathogens in endophthalmitis than in culture. It can also provide information on antibiotic resistance and visual prognosis. However, caution must be taken when interpreting the results of mNGS because they may not be concordant with culture.
Factors Associated With Differences in the Initial Location of Structural Progression in Normal-Tension Glaucoma
Authors: Lee Sang Yeop , Yang Heon , Lee Kwanghyun , Seong Gong Je , Kim Chan Yun , Bae Hyoung Won
Published: January 2022

Précis:

Different clinical factors are associated with the location of the first structural progression in glaucoma.

Purpose:

The aim was to investigate the underlying clinical parameters affecting the location of the initial structural progression of glaucoma in patients with normal-tension glaucoma (NTG).

Methods:

This retrospective study included 228 eyes of 228 patients with NTG. In total, 130 eyes of 130 patients demonstrated structural progression (as determined by event-based guided progression analysis using Cirrus HD-optical coherence tomography) in the peripapillary retinal nerve fiber layer (ppRNFL) or macular ganglion cell inner plexiform layer (mGCIPL). Depending on where the progression occurred first, it was defined as either ppRNFL first progression or mGCIPL first progression. Clinical parameters associated with each first progression were identified using logistic regression.

Results:

In total, 50 eyes showed ppRNFL first progression and 64 eyes showed mGCIPL first progression. ppRNFL first progression was significantly associated with female sex [odds ratio (OR)=5.705, P=0.015], lack of systemic hypertension (OR=0.199, P=0.014), disc hemorrhage (OR=4.188, P=0.029), higher mean intraocular pressure (OR=1.300, P=0.03), and lower pattern SD (OR=0.784, P=0.028). In contrast, male sex (OR=0.450, P=0.043), lower central corneal thickness (OR=0.987, P=0.032), higher intraocular pressure fluctuation (OR=1.753, P=0.047), lower systolic blood pressure fluctuation (OR=0.839, P=0.002), and higher diastolic blood pressure fluctuation (OR=1.208, P=0.015) were significantly associated with mGCIPL first progression.

Conclusions:

Different clinical factors were associated with the initial site of structural glaucoma progression in patients with NTG depending on its peripapillary or macular location, and these findings suggest possible differences in underlying mechanisms of glaucoma damage.
Incidence of Glaucoma Progression and Rate of Visual Field Deterioration in a Cohort of Urban Ghanaians
Authors: Mwanza Jean-Claude , Tulenko Samantha E. , Budenz Donald L. , Herndon Leon W. , Hall Alyson , Hay-Smith Graham , Kim Hanna Y. , Mathenge Elizabeth , Spratt Alexander , Tanna Angelo P. , Barton Keith
Published: January 2022

Précis:

The annual incidence of glaucoma progression (9.7%) and rates of visual field mean deviation (MD) change in progressors (−1.02±0.06 dB/y) are high in a small cohort of urban Ghanaians.

Purpose:

To report the incidence of glaucoma progression and the rate of visual field deterioration in a small cohort of Ghanaians.

Methods:

One hundred ten subjects (204 eyes) diagnosed with glaucoma at a baseline population-based screening examination were re-examined a mean of 8.3±0.8 years later. Eyes were classified as having progressed if the optic disc alone, visual field alone or both showed significant glaucomatous changes on follow-up. Visual field MD was used to calculate the rate of visual field progression.

Results:

Progression was observed in 89 (80.9%, 9.7%/year) subjects (130 eyes). Progression occurred in 32 (31.7%, 3.8%/year) subjects by optic disc alone (46 eyes), 38 (44.7%, 5.4%/year) subjects by visual field alone (58 eyes), and 19 (25.0%, 3.0%/year) subjects by both modalities (26 eyes). The average rate of change in MD differed significantly between progressors (−1.02±1.06 dB/y) and nonprogressors (+0.089±0.49 dB/y), P=0.001. The rate of visual field worsening was greater among those who were classified as having progressed by both structure and function (−1.29±0.68 dB/y) and by function alone (−1.21±1.20 dB/y) than by structure alone (−0.55±0.76 dB/y). Progression was significantly associated with older age [odds ratio (OR), 1.42; P<0.001] and higher baseline intraocular pressure (OR, 1.18; P=0.002). Factors associated with rate of MD change were baseline older age (OR, 1.66; P=0.003), higher intraocular pressure (OR, 2.81; P=0.007), better visual field MD (OR, 1.41; P=0.004), and systemic hypertension (OR, 1.15; P=0.029).

Conclusion:

The incidence and rate of visual field progression are high in this longitudinal study of Ghanaian subjects with glaucoma. The findings may have important clinical and public health policy ramifications.
Patterns of Visual Field Loss in Early, Moderate, and Severe Stages of Open Angle Glaucoma
Authors: Germano Renato A.S. , Germano Caroline S. , Susanna Fernanda N. , Susanna Remo
Published: January 2022

Précis:

Even in the early stages of glaucomatous visual field defects (VFDs), 49% of the defects occurred in both hemifields and 28% involved the central 5 degrees of the visual field (VF), which may have prognostic values.

Purpose:

The aim was to determine the patterns of glaucomatous VFDs in early, moderate and severe stages of primary open angle glaucoma, using the Glaucoma Staging Application.

Methods:

According to the Modified University of Sao Paulo Glaucoma Visual Field Staging System Classification, patients with early, moderate and advanced VFDs were selected by the Glaucoma Staging Application using all databases of the Humphrey Visual Field Analyser of a glaucoma referral practice. We analyzed one VF of the 100 patients included in each group. The analysis consisted of classifying all exams regarding the location of the defects, the hemifields involved, and the connection to the blind spot.

Results:

We analyzed 300 VF. In the Early group, 27% of the VFDs are connected to the physiological blind spot, 64% in the Moderate group, and 95% in the Severe group (P<0.01). In the Early group, 28% of the defects involved the central 5 degrees of the fixation, 59% in the Moderate and 88% in the Severe group. In the Early group, 49% of the defects involved both hemifields, 80% in the Moderate and 80% in the Severe group.

Conclusion:

With increasing glaucoma severity, VFD showed a more central pattern, connected to the blind spot, and involved both hemifields. In early disease, both hemifields were commonly affected and more than a quarter of VFD involved the central 5 degrees close to fixation. Careful monitoring of the central VF in glaucoma is suggested.
Perioperative Considerations for Antithrombotic Therapy in Oculofacial Surgery: A Review of Current Evidence and Practice Guidelines
Authors: Kim Christian , Pfeiffer Margaret L. , Chang Jessica R. , Burnstine Michael A.
Published: January 2022

Purpose:

Recent survey studies have demonstrated wide variability in practice patterns regarding the management of antithrombotic medications in oculofacial plastic surgery. Current evidence and consensus guidelines are reviewed to guide perioperative management of antithrombotic medications.

Methods:

Comprehensive literature review of PubMed database on perioperative use of antithrombotic medication.

Results/Conclusions:

Perioperative antithrombotic management is largely guided by retrospective studies, consensus recommendations, and trials in other surgical fields due to the limited number of studies in oculoplastic surgery. This review summarizes evidence-based recommendations from related medical specialties and provides context for surgeons to tailor antithrombotic medication management based on patient’s individual risk. The decision to continue or cease antithrombotic medications prior to surgery requires a careful understanding of risk: risk of intraoperative or postoperative bleeding versus risk of a perioperative thromboembolic event. Cessation and resumption of antithrombotic medications after surgery should always be individualized based on the patient’s thrombotic risk, surgical and postoperative risk of bleeding, and the particular drugs involved, in conjunction with the prescribing doctors. In general, we recommend that high thromboembolic risk patients undergoing high bleeding risk procedures (orbital or lacrimal surgery) may stop antiplatelet agents, direct oral anticoagulants, and warfarin including bridging warfarin with low-molecular weight heparin. Low-risk patients, regardless of type of procedure performed, may stop all agents. Decision on perioperative management of antithrombotic medications should be made in conjunction with patient’s internist, cardiologist, hematologist, or other involved physicians which may limit the role of guidelines depending on patient risk and should be used on a case-by-case basis. Further studies are needed to provide oculofacial-specific evidence-based guidelines.
Identification of early response to hypertonic dextrose prolotherapy markers in knee osteoarthritis patients by an inflammation-related cytokine array
Authors: Pan Po-Jung , Wang Jia-Chi , Tsai Chih-Chun , Kuo Hsing-Chun
Published: January 2022

Background:

Osteoarthritis (OA) is one of the most common forms of arthritis, and hypertonic dextrose prolotherapy has long been used clinically to treat knee OA. The aim of this study was to investigate the inflammation-related protein-expression profile characterizing the efficacy of the hypertonic dextrose prolotherapy in knee OA as prognostic markers.

Methods:

OA patients over the age of 65 were recruited for Western Ontario McMaster University Osteoarthritis (WOMAC) index, knee X-ray evaluation and knee joint synovial fluid analysis before and after hypertonic dextrose prolotherapy. The expressions of inflammation-related factors were measured using a novel cytokine antibody array methodology. The cytokine levels were quantified by quantitative protein expression and analyzed by ELISA using the patients’ knee-joint synovial fluid.

Results:

The WOMAC Index and minimum joint space width before receiving the intra-articular injection and at 2-week intervals were compared. Twelve patients who received OA intervention were enrolled and finally a clinical evaluation of 12 knee joints and knee synovial fluid samples were analyzed. In this study, after receiving hypertonic dextrose prolotherapy, the OA patients clearly demonstrated a significant improvement in WOMAC index and increasing tendency in the medial minimum joint space width after intervention. Meanwhile, we observed a significantly associated tendency between hypertonic dextrose treatment of knee OA and the upregulation of MMP2, TIMP-1, EGF, CXCL9 and IL-22.

Conclusion:

The findings provide knee OA patients receiving hypertonic dextrose prolotherapy, which is accompained by the improvemeny of knee symptoms and associated tendency of upregulation of MMP2, EGF, CXCL 9 and IL-22.
Effects of a Job Crafting Intervention Program on Work Performance Among Japanese Employees: An Analysis of Secondary Outcomes of a Randomized Controlled Trial
Authors: Sakuraya Asuka , Shimazu Akihito , Imamura Kotaro , Kawakami Norito
Published: January 2022

Objective:

This study reports a randomized controlled trial of the effect of a job crafting intervention program on work performance and job crafting (as secondary outcomes) among Japanese employees.

Methods:

Participants who satisfied the inclusion criteria were randomly allocated to an intervention (n = 138) or a control group (n = 143). Outcomes were measured at baseline and at 3-month and 6-month follow-up in both groups.

Results:

For the whole sample, the job crafting intervention program showed a nonsignificant effect on work performance and job crafting. However, the program showed a significant effect on these outcomes among younger participants (under 36years old).

Conclusions:

The job crafting intervention program may not be sufficiently effective to improve work performance and job crafting for the whole sample of participants. However, it may be efficacious for younger workers.
Perceptions of Anal Cancer Risk Among HIV-Positive and High-Risk HIV-Negative Women
Authors: Wells Jessica , Chandler Rasheeta , Flowers Lisa , Paul Sudeshna , Sharma Anjali , Kalifa Nia , Holstad Marcia
Published: January 2022

Objectives

Women living with HIV (WLWH) have a greater risk of anal cancer than women without HIV; however, there are limited studies that examine awareness of anal cancer risk among WLWH and “high-risk” HIV-negative women. This study examines risk factors for anal cancer, perceptions of risk for anal cancer, and perceptions of anal cancer screening among a cohort of WLWH and high-risk HIV-negative women.

Materials and Methods

From the Atlanta, GA, and Bronx, NY, sites of the Women's Interagency HIV Study, 155 WLWH and HIV-negative women were enrolled and the Champion Health Belief Model Scale questionnaire measuring risk perceptions to anal cancer was administered to each participant.

Results

The WLWH perceived anal cancer to be less serious and perceived facing fewer barriers to anal cancer screening than HIV-negative women (both p = .01). Older women (≥50 years) felt that they had less barriers to anal cancer screening (p = .047). Moreover, women who had less than a high school education felt more susceptible to anal cancer (p = .001), as did women who reported a history of anal intercourse (p = .017).

Conclusions

Despite being at an increased risk for anal cancer, perceptions of susceptibility to anal cancer and seriousness of anal cancer were low among WLWH. These findings highlight opportunities for provider and patient educational interventions to improve awareness of anal cancer risk among WLWH.
A Subset of Intracanalicular Vestibular Schwannomas Demonstrates Minimal Growth Over a 10-Year Period
Authors: Wu Matthew J. , Knoll Renata M. , Chen Jenny X. , Reinshagen Katherine , Roychowdhury Prithwijit , McKenna Michael J. , Kozin Elliott D. , Remenschneider Aaron K. , Jung David H.
Published: January 2022

Objective:

Vestibular schwannomas (VS) commonly undergo magnetic resonance imaging (MRI) surveillance, but long-term data to support the ideal frequency is limited. Herein, we aim to investigate intracanalicular VS growth predictors and long-term growth rates (GR).

Study Design:

Retrospective chart review.

Setting:

Two tertiary care centers.

Patients:

Sporadic intracanalicular VS with initial conservative management and at least two sequential MRIs.

Intervention:

Serial MRI.

Main Outcome Measure(s):

VS were categorized by baseline internal auditory canal tertile sublocalization (fundus, midpoint, porus) and size (≤100, 100–200, >200 mm3). Throughout follow-up, volumetric GR (mm3/yr) were determined (baseline–3 yrs, 3–5 yrs, 5–10 yrs) and treatment rates were assessed.

Results:

Ninety-nine intracanalicular VS were identified (mean follow-up of 6.1 ± 4.5 yrs). Mean GR before 5-year follow-up were comparable for baseline tertile involvement and size. After 5-year follow-up, mean GR of VS involving the fundus at baseline were lower than those involving the midpoint and fundus (6.17 ± 21.16 and 119.74 ± 117.57 mm3/yr, respectively; p = 0.034). Mean GR of VS with less than or equal to 100 mm3 at baseline (–7.29 ± 25.44 mm3/yr) were lower than those with 100 to 200 mm3 (86.55 ± 103.99 mm3/yr; p = 0.011) and more than 200 mm3 (45.70 ± 35.71 mm3/yr; p = 0.031). Vestibular schwannomas involving the midpoint and fundus had greater treatment rates compared with VS involving only the fundus (p < 0.001).

Conclusions:

Baseline tertile involvement and size may predict long-term intracanalicular VS growth where fundal tumors or those less than or equal to 100 mm3 exhibit little long-term growth. Extending surveillance after 5-year follow-up may be reasonable for fundal VS.
Psychopathology and Poor Clinical Insight in Psychotic Patients
Authors: Habibi Asgarabad Mojtaba , Ruhollah Hosseini Seyed , Salehi Yegaei Pardis , Moradi Shahram , Lysaker Paul H.
Published: January 2022

Poor clinical insight is one of the most common features of schizophrenia spectrum disorders and plays a critical role in prognosis and treatment. Considering the biological and phenomenological overlap between schizophrenia and bipolar I disorder with psychotic features (BID) and increasing incidents of methamphetamine-induced psychotic disorder (MIPD) patients in Iran, it is necessary to have a clear picture of insight among these three groups. The aim of the present study was to compare clinical insight and other aspects of illness among three different disorders: schizophrenia, BID, and MIPD. In addition, we sought to examine the relationship of the severity of psychotic symptoms with clinical insight in each group. A total of 115 male inpatients, including 48 persons diagnosed with schizophrenia, 35 persons diagnosed with BID, and 32 persons diagnosed with MIPD, were selected. All participants completed the Scale to Assess Unawareness of Mental Disorder and the Positive and Negative Syndrome Scale. The results of analysis of variance indicated that schizophrenia patients reported higher rates of illness duration and number of hospital admissions in comparison to the MIPD and BID groups. In addition, persons diagnosed with BID reported more of these outcomes than MIPD groups. However, the three groups showed similar patterns in terms of age of onset and educational, marital, and occupational statuses. The results also revealed that awareness of the disorder was more impaired in schizophrenia patients compared with BID and MIPD patients and in MIPD compared with BID groups. However, the level of awareness of the effect of medication, the awareness of social consequences, and the total score of clinical insight were similar across the three diagnostic groups. As expected, poor clinical insight was correlated with high levels of positive, negative, and cognitive symptoms in the schizophrenia group; with high levels of positive, cognitive, and depressive symptoms in the BID group; and with high levels of positive and excitement symptoms in MIPD. In addition, hierarchical linear regression analyses revealed that only cognitive symptoms in the schizophrenia group and excitement symptoms in the MIPD group significantly predicted the overall score of clinical insight. In the BID group, both cognitive and depressive symptoms significantly predicted clinical insight. These findings suggest that there are differing levels of poor clinical insight in schizophrenia, MIPD, and BID and that poor clinical insight found within each group may have different antecedents.
Relationship of Psychiatric Disorders and Sleep Quality to Physical Symptoms in Coronary Artery Disease
Authors: Peng Anshu , Lin Ze , Zhu Chunying
Published: January 2022

Psychiatric disorders (depression/anxiety) and sleep quality are linked to coronary artery disease (CAD). CAD patients often complain of various physical symptoms (PSs), which are not only organic changes of biological origin, but also somatization of mental illness. PSs also affect CAD progression. However, the relationship between psychiatric disorders/sleep quality and PS in CAD is less studied, which this study aims to clarify. This cross-sectional observational study was conducted on the first 305 CAD patients diagnosed with PS by Patient Health Questionnaire-15. They were compared with 521 other CAD patients showing no PS. On multivariate analysis, sex, age, family history, psychiatric disorders, and sleep quality were the significant independent predictors of PS. A significant correlation was found between PS severity and the severity of both psychiatric disorders and sleep quality. Further studies are warranted to explore the impact of psychological and sleep intervention on PS and long-term outcomes.
Assessment of Iron Status in Adolescents Presenting to the Emergency Department With Heavy Menstrual Bleeding
Authors: Stoffers Victoria L. , Weyand Angela C. , Quint Elisabeth H. , Rosen Monica W.
Published: January 2022

Objective

Iron deficiency is extremely common in adolescents with heavy menstrual bleeding (HMB) presenting to the emergency department; however, patients are rarely screened for this. The objective of this study was to evaluate screening for iron deficiency in adolescents presenting to the emergency department for HMB.

Methods

This is a secondary analysis of a single-center, cross-sectional observational study using retrospective chart review. The study subjects are adolescents ages 11 to 19 years with International Classification of Diseases, Ninth Revision, Clinical Modification/International Classification of Diseases, Tenth Revision, Clinical Modification, codes for HMB who presented to the emergency department at a national tertiary care hospital from 2006 to 2018. Pregnant adolescents with HMB were excluded. Chart abstraction for demographic data, symptoms, laboratory tests, treatments, and outcomes was performed. The main outcome measure was the number of adolescents who had an iron evaluation in the emergency department and were discharged on oral iron.

Results

Of the 258 nonpregnant adolescents who sought care for HMB in the emergency department, 225 (87.2%) were evaluated with serum hemoglobin testing. Ninety-four (41.7%) of those tested were anemic. Only 23 of the 258 patients (8.9%) had iron studies (serum ferritin) performed; 18 of 23 (78.3%) had iron deficiency and 21 of 23 (92.3%) were anemic. Subjects presenting with fatigue, headache, or palpitations were more likely to have iron studies performed than those without these symptoms (all P < 0.01). Thirty-two of the 258 subjects (12.4%) were discharged on oral iron therapy, which included only 15 of the 18 subjects (83.3%) with iron deficiency determined by ferritin testing.

Conclusions

Adolescents presenting to the emergency department with HMB are at significant risk of iron deficiency but are not being screened or treated, which may have significant consequences.
Variations in 2-Minute Walk Test outcomes for people with lower limb amputation in the outpatient clinic and research settings
Authors: Shank Christopher , Kristal Anat , Van Veld Renee , Applegate Brooks , Gaunaurd Ignacio , Gailey Robert
Published: January 2022

Background:

This study determined the differences in 2-Minute Walk Test (2MWT) distances between people with lower limb amputations in clinical and research settings and described variations in test administration in various clinical settings.

Study Design:

Retrospective Cross-sectional design.

Methods:

The 2MWT for 290 patients with lower limb amputations were obtained from a medium-sized prosthetic company with locations within the central United States. Data on 12 prosthetists’ 2MWT administration decisions were obtained from the results of an administrative questionnaire. Patient 2MWT distances were compared with published distances. Multiple regression was used to examine the impact of test settings on 2MWT outcomes. Descriptive statistics were used to present prosthetists’ variations in test administration.

Results:

Clinical 2MWT distances were significantly less than distances obtained in a research setting. Clinical facilities reported inconsistent path dimensions and potential obstacles in proximity to the test area. Variations in test administration by prosthetists with respect to path length, instructions, turn marker, and overage measurement may contribute to the differences.

Conclusions:

Prosthetists should be aware that comparisons of patients’ 2MWT distance in a clinical environment may differ from published results. Although variations in clinical environments are usually nonmodifiable characteristics of the clinical facility, test administration and scoring could be modified.
IgA Nephropathy in a Patient With Metastatic Carcinoma of Unknown Primary
Authors: Huang Shuhui , Qi Zhibing , Huang Rui , Su Minggang
Published: January 2022

A 35-year-old man with mesenteric metastases of unknown primary was referred for 18F-FDG PET/MRI. The images demonstrated that FDG accumulated in the chest, abdomen, bilateral kidneys, and external genitalia. Renal and testicular metastases were suspected. The primary tumor was still not found. In addition, kidney biopsy findings indicated a diagnosis of IgA nephropathy.
68Ga-Pentixafor PET/CT Improves the Detection of Recurrent Myeloma in the Temporal Bone Masked by the Physiological 18F-FDG Uptake of the Brain and Extraocular Muscles
Authors: Pan Qingqing , Luo Yaping , Cao Xinxin , Li Jian
Published: January 2022

A 71-year-old woman was recently diagnosed with multiple myeloma. Baseline 18F-FDG and 68Ga-pentixafor PET/CT showed diffusely increased uptake in bone marrow, consistent with infiltrated myeloma. She had very good partial response after 9 cycles of chemotherapy. However, during the maintenance with ixazomib, she experienced progressed disease. In the follow-up PET/CT, except for diffusely infiltrated disease in bone marrow, 68Ga-pentixafor PET/CT additionally detected a new emerging lesion in the right temporal bone with lytic bone destruction, which was initially missed in 18F-FDG PET/CT due to the intense physiological uptake of the brain and extraocular muscles.
Anastomosing Hemangioma on 68Ga-DOTATATE PET/CT
Authors: Chua Wei Ming , Hoe Kian Ming Jeremy , Dalan Rinkoo , Too Chow Wei , Ong Simon Yew Kuang , Tay Timothy Kwang Yong , Loke Kelvin Siu Hoong
Published: January 2022

Anastomosing hemangioma (AH) is a rare benign vascular lesion that primarily involves the genitourinary tract. Cases have also rarely been reported in other organs. AH is often discovered incidentally and resembles angiosarcoma histologically. On imaging, it may mimic other vascular lesions such as renal cell carcinoma and neuroendocrine tumors. We present a case of a 32-year-old woman with incidentally detected AH involving the kidneys, adrenal glands, liver, and retroperitoneum, initially presumed to be neuroendocrine tumors based on imaging findings on CT and 68Ga-DOTATATE PET scans.
Incidental Intrahepatic Hepatocellular Cholangiocarcinoma Detected on 68Ga-PSMA PET/CT
Authors: Kang Christine , Jiang James Yuheng , Lee Marco Enoch , Shen Lily , Mansberg Robert
Published: January 2022

A 69-year-old man with intermediate-risk prostate cancer and a mildly elevated prostate-specific antigen of 8.2 μg/L was referred for 68Ga–prostate-specific membrane antigen (68Ga-PSMA) PET/CT for primary staging. An incidental intensely 68Ga-PSMA–avid hepatic focus was seen on PSMA PET and subsequent FDG PET/CT and MRI cholangiogram. This was confirmed to be hepatocellular cholangiocarcinoma on subsequent histopathological examination.
Assessment of Patient Satisfaction in Digestive Endoscopy
Authors: Minciullo Andrea , Filomeno Lucia
Published: January 2022

Endoscopic examinations are often perceived as invasive, annoying, and painful procedures. For this reason, it is essential to know the patient's opinion to improve service quality and adherence to screening programs. The European Society of Gastrointestinal Endoscopy (ESGE) and the American Society for Gastrointestinal Endoscopy (ASGE) recommend the identification of quality indicators, including patient satisfaction. The aim of this narrative review of the literature is to investigate the tools available to evaluate customer satisfaction in digestive endoscopy, highlighting which sections and items should be present in a questionnaire for complete evaluation. A narrative review of the literature was performed through five biomedical databases. A total of 125 studies were selected. The review process resulted in a total of 12 scientific papers meeting the inclusion criteria. This review suggests which items and sections should be present in a questionnaire that evaluates customer satisfaction in digestive endoscopy. Customer satisfaction verification programs in the normal routine of a digestive endoscopy service are essential to allow continuous improvement of the offered services.
Development and Validation of the Gastrointestinal Unhelpful Thinking Scale (GUTs)
Authors: Knowles Simon R. , Apputhurai Pragalathan , Burgell Rebecca E. , Keefer Laurie
Published: January 2022

This article describes the development and validation of the Gastrointestinal Unhelpful Thinking scale. The purpose of the research was to develop the Gastrointestinal Unhelpful Thinking scale to assess in tandem the primary cognitive–affective drivers of brain–gut dysregulation, gastrointestinal-specific visceral anxiety, and pain catastrophizing. The research involved 3 phases which included undergraduate and community samples. In the first phase, an exploratory factor analysis revealed a 15-item 2-factor (visceral sensitivity and pain catastrophizing) scale (N= 323), which then was confirmed in the second phase: N = 399, χ2(26) = 2.08, p = .001, Tucker–Lewis Index = 0.94, comparative fit index = 0.96, standardized root mean square residual = 0.05, and root mean square error of approximation = 0.07. Demonstrating convergent validity, Gastrointestinal Unhelpful Thinking scale total and subscales were strongly correlated with the modified Manitoba Index, Irritable Bowel Syndrome Symptom Severity Scale scores, Visceral Sensitivity Index, and the Pain Catastrophizing Scale. A third phase (N = 16) established test–retest reliability for the Gastrointestinal Unhelpful Thinking scale (total and subscales). The test–retest reliability correlation coefficient for the Gastrointestinal Unhelpful Thinking scale total score was .93 (p < .001) and for the subscales was .86 (p < .001) and .94 (p < .001), respectively. The Gastrointestinal Unhelpful Thinking scale is a brief psychometrically valid measure of visceral anxiety and pain catastrophizing that can be useful for both clinicians and researchers who wish to measure these thinking patterns and relate them to changes in gastrointestinal and psychological symptoms.
Modelling the direct virus exposure risk associated with respiratory events
Authors: Wang Jietuo , Dalla Barba Federico , Roccon Alessio , Sardina Gaetano , Soldati Alfredo , Picano Francesco
Published: January 2022

The outbreak of the COVID-19 pandemic highlighted the importance of accurately modelling the pathogen transmission via droplets and aerosols emitted while speaking, coughing and sneezing. In this work, we present an effective model for assessing the direct contagion risk associated with these pathogen-laden droplets. In particular, using the most recent studies on multi-phase flow physics, we develop an effective yet simple framework capable of predicting the infection risk associated with different respiratory activities in different ambient conditions. We start by describing the mathematical framework and benchmarking the model predictions against well-assessed literature results. Then, we provide a systematic assessment of the effects of physical distancing and face coverings on the direct infection risk. The present results indicate that the risk of infection is vastly impacted by the ambient conditions and the type of respiratory activity, suggesting the non-existence of a universal safe distance. Meanwhile, wearing face masks provides excellent protection, effectively limiting the transmission of pathogens even at short physical distances, i.e. 1 m.
Fast priming of grammatical decisions: repetition and transposed-word priming effects
Authors: Mirault Jonathan , Declerck Mathieu , Grainger Jonathan
Published: January 2022

We used the grammatical decision task to investigate fast priming of written sentence processing. Targets were sequences of 5 words that either formed a grammatically correct sentence or were ungrammatical. Primes were sequences of 5 words and could be the same word sequence as targets, a different sequence of words with a similar syntactic structure, the same sequence with two inner words transposed or the same sequence with two inner words substituted by different words. Prime-word sequences were presented in a larger font size than targets for 200 ms and followed by the target sequence after a 100 ms delay. We found robust repetition priming in grammatical decisions, with same sequence primes leading to faster responses compared with prime sequences containing different words. We also found transposed-word priming effects, with faster responses following a transposed-word prime compared with substituted-word primes. We conclude that fast primed grammatical decisions might offer investigations of written sentence processing what fast primed lexical decisions have offered studies of visual word recognition.
Quantifying transmissibility of SARS-CoV-2 and impact of intervention within long-term healthcare facilities
Authors: Stockdale Jessica E. , Anderson Sean C. , Edwards Andrew M. , Iyaniwura Sarafa A. , Mulberry Nicola , Otterstatter Michael C. , Janjua Naveed Z. , Coombs Daniel , Colijn Caroline , Irvine Michael A.
Published: January 2022

Estimates of the basic reproduction number (
R
0
) for COVID-19 are particularly variable in the context of transmission within locations such as long-term healthcare (LTHC) facilities. We sought to characterize the heterogeneity of
R
0
across known outbreaks within these facilities. We used a unique comprehensive dataset of all outbreaks that occurred within LTHC facilities in British Columbia, Canada as of 21 September 2020. We estimated
R
0
in 18 LTHC outbreaks with a novel Bayesian hierarchical dynamic model of susceptible, exposed, infected and recovered individuals, incorporating heterogeneity of
R
0
between facilities. We further compared these estimates to those obtained with standard methods that use the exponential growth rate and maximum likelihood. The total size of outbreaks varied dramatically, with range of attack rates 2%–86%. The Bayesian analysis provided an overall estimate of
R
0
= 2.51 (90% credible interval 0.47–9.0), with individual facility estimates ranging between 0.56 and 9.17. Uncertainty in these estimates was more constrained than standard methods, particularly for smaller outbreaks informed by the population-level model. We further estimated that intervention led to 61% (52%–69%) of all potential cases being averted within the LTHC facilities, or 75% (68%–79%) when using a model with multi-level intervention effect. Understanding of transmission risks and impact of intervention are essential in planning during the ongoing global pandemic, particularly in high-risk environments such as LTHC facilities.
Case Report: Vibrio fluvialis isolated from a wound infection after a piercing trauma in the Baltic Sea
Authors: Hecht Juliane , Borowiak Maria , Fortmeier Bernhard , Dikou Salah , Gierer Wolfgang , Klempien Ingo , Nekat Jonas , Schaefer Stephan , Strauch Eckhard
Published: January 2022

Vibrio

spp. are Gram-negative bacteria found in marine ecosystems. Non-cholera

Vibrio

spp. can cause gastrointestinal infections and can also lead to wound infections through exposure to contaminated seawater.

Vibrio

infections are increasingly documented from the Baltic Sea due to extended warm weather periods. We describe the first isolation of

Vibrio fluvialis

from a wound infection acquired by an impalement injury in the shallow waters of the Baltic Sea. The severe infection required amputation of the third toe. Whole genome sequencing of the isolate was performed and revealed a genome consisting of two circular chromosomes with a size of 1.57 and 3.24 Mb.
A case report of Salmonella enterica serovar Corvallis from environmental isolates from Cambodia and clinical isolates in the UK
Authors: Schwan Carla L. , Dallman Timothy J. , Cook Peter W. , Vipham Jessie
Published: January 2022

Salmonella enterica

subspecies

enterica

serovar Corvallis (S. Corvallis) has been identified as a human pathogen and as a food contaminant. Diarrhoeal disease is a common diagnosis in tourists visiting Southeast Asia, often with unknown aetiology. However, numerous public health institutes have identified

Salmonella

as a common causative agent when consuming contaminated food and water. Genomic data from environmental isolates from a Cambodian informal market were uploaded to the National Center for Biotechnology Information (NCBI) platform, allowing the novel sequences to be compared to global whole-genome sequence archives. The comparison revealed that two human clinical isolates from England and four of the environmental isolates were closely related, with an average single nucleotide polymorphism (SNP) difference of 1 (0–3 SNPs). A maximum-likelihood tree based on core SNPs was generated comparing the 4 isolates recovered from a Cambodian informal market with 239 isolates of S. Corvallis received from routine surveillance of human salmonellosis in England and confirmed the close relationship. In addition, the environmental isolates clustered into a broader phylogenetic group within the S. Corvallis population containing 68 additional human isolates, of which 42 were from patients who reported recent international travel, almost exclusively to Southeast Asia. The environmental isolates of S. Corvallis isolated from an informal market in Cambodia are concerning for public health due to their genetic similarity to isolates (e.g. clinical isolates from the UK) with known human virulence and pathogenicity. This study emphasizes the benefits of global and public data sharing of pathogen genomes.
Evaluation of the virucidal efficacy of Klaran UVC LEDs against surface-dried norovirus
Authors: Mariita Richard M. , Wilson Miller Amy C. , Randive Rajul V.
Published: January 2022

Human norovirus (HuNoV) is a highly contagious pathogenic virus that is transmitted through contaminated food, water, high-touch surfaces and aerosols. Globally, there are an estimated 685 million infections annually due to norovirus, including 200 million affecting children under the age of 5. HuNoV causes approximately 50, 000 child deaths per year and costs an estimated USD $60 billion annually in healthcare. This study sought to determine the inactivation profile of ultraviolet subtype C (UVC) against norovirus using a UVC light-emitting diode (LED) array, KL265-50V-SM-WD. The array emitted radiation at 269 nm peak wavelength and a measured fluence of 1.25 mW cm−2 at a 7 cm source–surface distance. Since the HuNoV is not cultivable, the study utilized feline calicivirus (FCV) ATCC VR-782, a recommended surrogate as challenge organism. The test followed modified ASTM E2197. Assessment of virus inactivation was performed using a plaque assay method. With irradiance at a UVC dose of 22.5 mJ cm−2, the study obtained 99.9 % virus reduction (3 log reduction). The results demonstrate that the UVC LED array can provide effective inactivation of HuNoV.
Genomic evolution of the globally disseminated multidrug-resistant Klebsiella pneumoniae clonal group 147
Authors: Rodrigues Carla , Desai Siddhi , Passet Virginie , Gajjar Devarshi , Brisse Sylvain
Published: January 2022

The rapid emergence of multidrug-resistant

Klebsiella pneumoniae

is being driven largely by the spread of specific clonal groups (CGs). Of these, CG147 includes 7-gene multilocus sequence typing (MLST) sequence types (STs) ST147, ST273 and ST392. CG147 has caused nosocomial outbreaks across the world, but its global population dynamics remain unknown. Here, we report a pandrug-resistant ST147 clinical isolate from India (strain DJ) and define the evolution and global emergence of CG147. Antimicrobial-susceptibility testing following European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines and genome sequencing (Illumina and Oxford Nanopore Technologies, Unicycler assembly) were performed on strain DJ. Additionally, we collated 217 publicly available CG147 genomes [National Center for Biotechnology Information (NCBI), May 2019]. CG147 evolution was inferred within a temporal phylogenetic framework (beast) based on a recombination-free sequence alignment (Roary/Gubbins). Comparative genomic analyses focused on resistance and virulence genes and other genetic elements (BIGSdb, Kleborate, PlasmidFinder, phaster, ICEfinder and CRISPRCasFinder). Strain DJ had a pandrug-resistance phenotype. Its genome comprised the chromosome, seven plasmids and one linear phage-plasmid. Four carbapenemase genes were detected: bla
NDM-5 and two copies of bla
OXA-181 in the chromosome, and a second copy of bla
NDM-5 on an 84 kb IncFII plasmid. CG147 genomes carried a mean of 13 acquired resistance genes or mutations; 63 % carried a carbapenemase gene and 83 % harboured bla
CTX-M. All CG147 genomes presented GyrA and ParC mutations and a common subtype I-E CRISPR-Cas system. ST392 and ST273 emerged in 2005 and 1995, respectively. ST147, the most represented phylogenetic branch, was itself divided into two main clades with distinct capsular loci: KL64 (74 %, DJ included, emerged in 1994 and disseminated worldwide, with carbapenemases varying among world regions) and KL10 (20 %, emerged in 2002, predominantly found in Asian countries, associated with carbapenemases NDM and OXA-48-like). Furthermore, subclades within ST147-KL64 differed at the yersiniabactin locus, OmpK35/K36 mutations, plasmid replicons and prophages. The absence of IncF plasmids in some subclades was associated with a possible activity of a CRISPR-Cas system.

K. pneumoniae

CG147 comprises pandrug-resistant or extensively resistant isolates, and carries multiple and diverse resistance genes and mobile genetic elements, including chromosomal bla
NDM-5. Its emergence is being driven by the spread of several phylogenetic clades marked by their own genomic features and specific temporo–spatial dynamics. These findings highlight the need for precision surveillance strategies to limit the spread of particularly concerning CG147 subsets.
Low and high frequency intracranial neural signals match in the human associative cortex
Authors: Jacques Corentin , Jonas Jacques , Colnat-Coulbois Sophie , Maillard Louis , Rossion Bruno
Published: January 2022

In vivo intracranial recordings of neural activity offer a unique opportunity to understand human brain function. Intracranial electrophysiological (iEEG) activity related to sensory, cognitive or motor events manifests mostly in two types of signals: event-related local field potentials in lower frequency bands (<30 Hz, LF) and broadband activity in the higher end of the frequency spectrum (>30 Hz, High frequency, HF). While most current studies rely exclusively on HF, thought to be more focal and closely related to spiking activity, the relationship between HF and LF signals is unclear, especially in human associative cortex. Here we provide a large-scale in-depth investigation of the spatial and functional relationship between these 2 signals based on intracranial recordings from 121 individual brains (8000 recording sites). We measure selective responses to complex ecologically salient visual stimuli – human faces - across a wide cortical territory in the ventral occipito-temporal cortex (VOTC), with a frequency-tagging method providing high signal-to-noise ratio (SNR) and the same objective quantification of signal and noise for the two frequency ranges. While LF face-selective activity has higher SNR across the VOTC, leading to a larger number of significant electrode contacts especially in the anterior temporal lobe, LF and HF display highly similar spatial, functional, and timing properties. Specifically, and contrary to a widespread assumption, our results point to nearly identical spatial distribution and local spatial extent of LF and HF activity at equal SNR. These observations go a long way towards clarifying the relationship between the two main iEEG signals and reestablish the informative value of LF iEEG to understand human brain function.
Collagen XVIII promotes breast cancer through EGFR/ErbB signaling and its ablation improves the efficacy of ErbB-targeting inhibitors
Authors: Devarajan Raman , Peltoketo Hellevi , Izzi Valerio , Ruotsalainen Heli , Kauppila Saila , Väisänen Marja-Riitta , Rask Gunilla , Martínez-Nieto Guillermo , Karppinen Sanna-Maria , Väisänen Timo , Kaur Inderjeet , Koivunen Jussi , Sasaki Takako , Winqvist Robert , Wärnberg Fredrik , Sund Malin , Pihlajaniemi Taina , Heljasvaara Ritva
Published: January 2022

The tumor extracellular matrix (ECM) is a critical regulator of cancer progression and metastasis, significantly affecting the treatment response. Expression of collagen XVIII (ColXVIII), a ubiquitous component of basement membranes, is induced in many solid tumors, but its involvement in tumorigenesis has remained elusive. We show here that ColXVIII is markedly upregulated in human breast cancer (BC) cells and is closely associated with a poor prognosis in high-grade BC, especially in human epidermal growth factor receptor 2 (HER2)-positive and basal/triple-negative cases. We identified a novel mechanism of action for ColXVIII as a modulator of epidermal growth factor receptor (EGFR/ErbB) signaling and show that it forms a complex with EGFR, HER2 and α6 integrin to promote cancer cell proliferation in a pathway involving its N-terminal portion and the MAPK/ERK1/2 and PI3K/Akt cascades. In vivo studies with Col18a1 mouse models crossed with the MMTV-PyMT mammary carcinogenesis model showed that the short ColXVIII isoform promotes BC growth and metastasis in a tumor cell-autonomous manner. Moreover, the number of mammary cancer stem cells was significantly reduced in both mouse and human cell models upon ColXVIII inhibition. Finally, ablation of ColXVIII in human BC cells and the MMTV-PyMT model substantially improved the efficacy of certain EGFR/ERbB-targeting therapies, even abolishing resistance to EGFR/ErbB inhibitors in some cell lines. In summary, a new function is revealed for ColXVIII in sustaining the stemness properties of BC cells, and tumor progression and metastasis through EGFR/ErbB signaling, suggesting that targeting ColXVIII in the tumor milieu may have significant therapeutic potential.

One Sentence Summary

Collagen XVIII is upregulated in breast cancer and promotes mammary carcinogenesis through EGFR/ErbB signaling and by sustaining cancer stem cells, so that its targeting improves the efficacy of ErbB-targeted therapies.