bluuebunny/crossref_metadata_2025 huggingface dataset:
Erectile dysfunction prevalence in the United States: report from the 2021 National Survey of Sexual Wellbeing
Authors: Mark Kristen P , Arenella Kat , Girard Abby , Herbenick Debby , Fu Jane , Coleman Eli
Published: February 2024

Background

There has been a great deal of public speculation regarding a surge in erectile dysfunction (ED) in younger men despite data consistently indicating that the ED prevalence rates increase with age.

Aim

In this study we sought to assess the prevalence and risk of experiencing ED in a nationally representative sample of men in the United States across various social groups, describe comorbidities, and examine barriers to treatment.

Methods

Data from the 2021 National Survey of Sexual Wellbeing were analyzed by utilizing the Ipsos KnowledgePanel®, a probability-based online panel, for the purpose of obtaining US nationally representative data of adults aged 18 years and older. The analytic sample consisted of 1822 cisgender men ranging in age from 18 to 87 years, with a mean age of 47.5 years.

Outcomes

Study outcomes were ED as measured by the 5-item version of the International Index of Erectile Function (IIEF-5), as well as self-reported diagnosis by a medical professional, comorbidities with other health issues, medications taken for ED, and barriers to treatment.

Results

The ED prevalence rate based on IIEF-5 scores was 24.2%. Prevalence increased with age: 52.2% of the 75+ age group, and 48.0% of the 65-74 age group meeting diagnostic criteria for ED. Diagnostic criteria were met for more participants in the 18-24 age group (17.9%) than the 25-34 (13.3%) or 35-44 (12.7%) age groups, but less than the 45-54 (25.3%) or 55-64 (33.9%) age groups. Only 7.7% (n = 141) of the sample reported having been diagnosed by a provider (n = 4 in 25-34, n = 6 in 35-44, n = 13 in 45-54, n = 39 in 55-64, n = 44 in 65-74, and n = 34 in ≥75–year olds), indicating a gap in access to treatment. The most common reason selected for not accessing care for ED concerns was a lack of need to see a provider in the past year.

Clinical Implications

The discrepancy between ED self-report and medical diagnosis is critical, given that ED can be an indication of underlying health risks.

Strengths and Limitations

This study is the first nationally representative update to information regarding the prevalence of ED in almost 2 decades. Standard administration of the IIEF-5 is limited to participants who have had sex in the last 6 months, so these rates do not include those men with ED who have been avoiding penetrative sex for a significant time.

Conclusion

The results indicate that ED prevalence and severity remain highest in older age groups and that most individuals who meet criteria for ED have not sought medical care related to this concern.
The Liberalism of Fear and Public Health Ethics
Authors: Chen Alvin
Published: February 2024

This article argues that the liberalism of fear provides a useful theoretical framework for public health ethics in two fronts. First, it helps reconcile the tension between public health interventions and liberal politics. Second, it reinforces the existing justifications for public health interventions in liberal political culture. The article discusses this in the context of political emotions in the COVID-19 pandemic. Fear plays a central role in the experiences of pandemic politics, and such fear is extended to the concern that post-pandemic government would normalize emergency politics and threaten the political culture of liberal democracy. The article proposes that the liberalism of fear provides a theoretical solution not only to alleviate such fear, but also to reconcile the long-established tension between liberal politics and public health intervention. This is particularly so if the liberalism of fear’s characteristic of political realism is taken into account. The article makes two points about this, and discusses their pragmatic implications in the case of compulsory vaccination.
On the robustness of detective quantum efficiency within the limits of IEC 61267 RQA standard radiation qualities
Authors: Pojtinger Stefan
Published: February 2024

IEC 61267 allows a certain leeway regarding the establishment of radiation qualities in order to enable the use of X-ray tubes having different anode angles and inherent filtrations. This allowance has a direct impact on the calculation of the detective quantum efficiency and may potentially complicate any comparison of different imaging detectors based on this quantity. This work investigates this effect by applying computational methods. To this end, an algorithm was implemented to calculate the variation of the squared signal-to-noise ratio per air kerma for RQA standard radiation qualities and to deduce corresponding uncertainties based on GUM Supplement 2. For RQA standard radiation qualities, the results show standard uncertainties for the squared signal-to-noise ratio per air kerma of between 0.05 and 2.1%. Comparing imaging detectors based on detective quantum efficiency is associated with substantial uncertainty for some radiation qualities. This is due to the different photon fluences with respect to energy that are allowed by IEC 61267 for identical standard radiation qualities.
A Double-Edged Sword? The Criminalization of False Rape Accusations in Botswana
Authors: Dambe Baboki Jonathan
Published: February 2024

False rape accusations have far reaching consequences in that they may result in the prosecution and conviction of innocent persons so falsely accused. In addition to the possibility of criminal sanctions, persons falsely accused of rape may suffer considerable societal stigma, damage to reputation, and psychological harm. Furthermore, the proliferation of false rape accusations may result in actual victims of rape being treated with mistrust and being disproportionately interrogated before their reports are acted upon. Neither of these consequences bode well for any criminal justice system. For this reason, the parliament of Botswana, through the 2021 amendment to the Penal Code, criminalized false or misleading rape accusations. This paper interrogates the legislative intent behind the criminalization. It discusses the elements of the offence in highlighting what the prosecution needs to prove to secure a conviction. Furthermore, the paper assesses the adequacy of the sentence imposed for the offence. For comparative purposes, I explore how other jurisdictions approach the challenges of false rape accusations and distil the lessons to be learnt from such approaches.
Effects of PM2.5 exposure on clock gene BMAL1 and cell cycle in human umbilical vein endothelial cells
Authors: Shen Haochong , Gong Meidi , Zhang Minghao , Sun Shikun , Zheng Rao , Yan Qing , Hu Juan , Xie Xiaobin , Wu Yan , Yang Junjie , Wu Jing , Yang Jing
Published: February 2024

Background

Fine particulate matter (PM2.5) exposure has been closely associated with cardiovascular diseases, which are relevant to cell cycle arrest. Brain and muscle aryl-hydrocarbon receptor nuclear translocator-like protein 1 (BMAL1) not only participates in regulating the circadian clock but also plays a role in modulating cell cycle. However, the precise contribution of the circadian clock gene BMAL1 to PM2.5-induced cell cycle change remains unclear. This study aims to explore the impact of PM2.5 exposure on BMAL1 expression and the cell cycle in human umbilical vein endothelial cells (HUVECs).

Methods

HUVECs was exposed to PM2.5 for 24 hours at different concentrations ((0, 12.5, 25, 75 and 100 μg.mL-1) to elucidate the potential toxic mechanism. Following exposure to PM2.5, cell viability, ROS, cell cycle, and the expression of key genes and proteins were detected.

Results

A remarkable decrease in cell viability is observed in the PM2.5-exposed HUVECs, as well as a significant increase in ROS production. In addition, PM2.5-exposed HUVECs have cycle arrest in G0/G1 phase, and the gene expression of p27 is also markedly increased. The protein expression of BMAL1 and the gene expression of BMAL1 are increased significantly. Moreover, the protein expressions of p-p38 MAPK and p-ERK1/2 exhibit a marked increase in the PM2.5-exposed HUVECs. Furthermore, following the transfection of HUVECs with siBMAL1 to suppress BMAL1 expression, we observed a reduction in both the protein and gene expression of the MAPK/ERK pathway in HUVECs exposed to PM2.5.

Conclusions

Overall, our results indicate that PM2.5 exposure significantly upregulates the circadian clock gene expression of BMAL1 and regulates G0/G1 cell cycle arrest in HUVECs through the MAPK/ERK pathway, which may provide new insights into the potential molecular mechanism regarding BMAL1 on PM2.5-induced cardiovascular diseases.
Exploring the latency period in Chagas disease: duration and determinants in a cohort from Colombia
Authors: Olivera Mario Javier , Muñoz Lyda
Published: February 2024

Background

Chagas disease has a varying latency period, the time between infection and onset of cardiac symptoms, due to multiple factors. This study seeks to identify and understand these factors to enhance our knowledge of the disease.

Methods

A retrospective follow-up study was conducted in Colombia on patients with indeterminate chronic Chagas disease. Medical files were examined to evaluate the disease latency time using time ratios (TRs) and the AFT Weibull model.

Results

The study followed 578 patients, of whom 309 (53.5%) developed cardiac disease, with a median latency period of 18.5 (95% CI 16 to 20) y for the cohort. Those with the TcISyl genotype (TR 0.72; 95% CI 0.61 to 0.80), individuals who lived 5–15 y (TR 0.80; 95% CI 0.67 to 0.95), 15–30 y (TR 0.63; 95% CI 0.53 to 0.74) or >30 y (vs 5 y) in areas with high disease prevalence had shorter latency periods. On the other hand, undergoing treatment increased the latency period (TR: 1.74; 95% CI 1.52 to 1.87).

Conclusions

The latency period of Chagas disease was found to be independently related to male gender, receipt of etiological treatment, length of time spent in an endemic area and the TcISyl genotype. The implications of these findings are discussed.
A Semi-Selective Medium to Evaluate Over-Summering Survival of Neopestalotiopsis sp. in Florida Strawberry Fields
Authors: Zuniga Adrian I. , Baggio Juliana S. , Peres Natalia A.
Published: February 2024

Devastating disease outbreaks with leaf spot symptoms and fruit rot caused by a fungus identified as a cryptic species of Neopestalotiopsis have generated concern in the Florida strawberry industry. Some Neopestalotiopsis species are saprobes in soil and plant debris, but the ability of the new Neopestalotiopsis sp. to survive in strawberry debris was unknown. Therefore, the objectives of this study were to develop a semiselective medium for isolation of Neopestalotiopsis spp. and to evaluate Neopestalotiopsis sp. survival in soil and strawberry plant debris over the summer in Florida. The Neopestalotiopsis semiselective medium (NSM) inhibited growth of most fungal species pathogenic to strawberry in Florida, except Neopestalotiopsis rosae, Neopestalotiopsis sp., and Phomopsis obscurans, in addition to Penicillium spp., which are nonpathogenic. However, Neopestalotiopsis species, P. obscurans, and Penicillium spp. could be distinguished in the medium through morphological characteristics. Soil samples arbitrarily collected from six commercial fields toward the end of the season (May) and before (July) and after (September) preplant soil fumigation in the following season were processed with NSM, and Neopestalotiopsis spp. populations were calculated as CFU per gram of soil. CFU ranged from 48.3 to 2,410.8 at the end of the season and from 1.7 to 630.8 before soil fumigation, but Neopestalotiopsis spp. were not recovered after soil treatment. However, 1.7 to 25 CFU were obtained from the nontreated areas in the row middles. Neopestalotiopsis sp. survival was also evaluated on diseased strawberry plants (leaves and crowns) exposed to the environment for 17 months. On leaves, Neopestalotiopsis spp. were recovered for 6 months before leaf decomposition, whereas the number of CFU on crowns declined monthly, but colonies were still recovered during the final evaluation months. A high-resolution melting analysis confirmed most of the colonies from soil and crowns were the new Neopestalotiopsis sp. Our results show Neopestalotiopsis sp. can survive in soil and strawberry debris under Florida summer conditions and may serve as a source of inoculum for the subsequent season.
Management of postinfectious inflammatory arthritis
Authors: Baker Hailey , Amaral J. Kennedy , Schoen Robert T.
Published: February 2024

Purpose of review

Postinfectious inflammatory arthritis can result from various pathogens, including bacteria, viruses, fungi, and parasites. Prompt identification and treatment of acute infection is vital, but some cases progress to chronic arthritis despite successful treatment of infection. Postinfectious inflammatory arthritis varies from mild, self-limited arthralgia to severe, refractory arthritis, necessitating ongoing disease-modifying treatment. This review explores the spectrum of postinfectious inflammatory arthritis to provide insights into effective management.

Recent findings

Research continues regarding the benefit of antimicrobial therapy, beyond treatment of the acute infection, to diminish the severity of postinfectious inflammatory arthritis. Following treatment of acute infection, most cases are self-limited so treatment is symptomatic. However, a difficult-to-predict fraction of cases develop chronic postinfectious inflammatory arthritis that can be challenging to manage. Recently, as more biologic, and targeted synthetic DMARDs have become available, treatment options have expanded.

In this article, we use the term ‘postinfectious inflammatory arthritis’ rather than ‘reactive arthritis’ because it describes a broader spectrum of diseases and emphasizes the common pathogenesis of a postinfectious inflammatory process. We summarize the conventional therapies and recent management developments for the most frequently encountered postinfectious inflammatory arthritides.
T1 Pedicle Subtraction Osteotomy With Subaxial Cervical Pedicle Screw Fixation
Authors: Greenberg Jacob , Patel Arpan A. , Magro Matt , Srivatsa Shaarada , Spiessberger Alexander
Published: February 2024

Patients suffering from ankylosing spondylitis are not only predisposed to the development of rigid cervicothoracic deformities but are also at an increased risk of cervical fractures. Deformity correction and stabilization are particularly challenging in this patient population due to the brittle bone quality and low bone mineral density. Thoracic pedicle subtraction osteotomy is a workhorse approach for the correction of focal severe kyphotic deformity with lower complication rates than 3-column osteotomy. Successful execution of an upper thoracic PSO requires careful presurgical planning as well as anticipation of the patient’s postoperative needs. Here, we describe the use of a T1 PSO in the correction of a rigid cervicothoracic chin-on-chest deformity in a patient with AS. The risk of implant failure was reduced by the use of a multi-rod construct, navigated cervical pedicle screws, and dual-pitched thoracic pedicle screws.
Outcomes Following Pelvic Exenteration for Locally Recurrent Rectal Cancer With and Without En Bloc Sacrectomy
Authors: Waller Jacob H. , Van Kessel Charlotte S. , Solomon Michael J. , Lee Peter J. , Austin Kirk K.S. , Steffens Daniel
Published: February 2024

BACKGROUND:

Extended radical resection is often the only chance of cure for locally recurrent rectal cancer. Recurrence in the posterior compartment often necessitates en bloc sacrectomy as part of pelvic exenteration in order to obtain clear resection margins and provide survival benefit.

OBJECTIVE:

To compare oncological, morbidity and quality of life outcomes, following pelvic exenteration with and without en bloc sacrectomy for recurrent rectal cancer.

DESIGN:

Comparative Cohort study with retrospective analysis of prospectively collected data.

SETTING:

This study was conducted at a high volume pelvic exenteration center.

PATIENTS:

Those who underwent pelvic exenteration for locally recurrent rectal cancer between 1994 and 2022.

MAIN OUTCOME MEASURES:

Overall survival, post-operative morbidity, R0 resection margin and quality of life outcomes.

RESULTS:

A total of 305 (31.6%) of 965 patients underwent pelvic exenteration for locally recurrent rectal cancer. 64.3% of patients were male with a median age of 62 (range, 29-86). 185 patients (60.7%) underwent en bloc sacrectomy, 65 (35.1%) underwent high transection, 119 (64.3%) had sacrectomy below S2. R0 resection was achieved in 80% of patients with sacrectomy and 72.5% without. Sacrectomy patients experienced more postoperative complications without increased mortality. Median overall survival was 52 months, 47 months with sacrectomy and 73 months without (p = 0.059). Quality of life scores were not significantly different across physical component (p = 0.346), mental component (p = 0.787) or Functional assessment of cancer therapy-Colorectal (p = 0.679) scores at 24 month follow up.

LIMITATIONS:

Generalizability of these findings may be limited outside of sub-specialist exenteration units. Selection bias exists in a retrospective analysis.

CONCLUSIONS:

Patients undergoing pelvic exenteration with and without en bloc sacrectomy for locally recurrent rectal cancer experience similar rates of R0 resection, survival and quality of life outcomes. As R0 remains the most important predictor of survival the requirement of sacral resection should prompt referral to a subspecialist center which performs sacrectomy routinely. See Video Abstract.
Laparoscopic partial splenectomy for sclerosing angiomatoid nodular transformation: A case report and literature review
Authors: Lin Yu-Ning , Tsai Chun-Yi , Yeh Ta-Sen
Published: February 2024

Laparoscopic partial splenectomy has become the preferred method for benign disease or low-grade malignancy with advantages of organ preservation and avoidance of potential postsplenectomy fulminant infection. We herein presented a presumed diagnosis of sclerosing angiomatoid nodular transformation subjected to laparoscopic partial splenectomy. The patient underwent the surgical procedure uneventfully and was discharged at day 4 postoperatively. The diagnosis was confirmed by the pathological examination.
Association between lumbar muscle size and bone mineral density in nonfractured postmenopausal women with and without osteoporosis
Authors: Hou Chun-Han , Hsieh Tsyh-Jyi , Chou Ming-Chung
Published: February 2024

Objective

Estrogen deficiency in postmenopausal women is associated with bone loss and a decline in muscle mass. However, the associations between lumbar muscle size and bone mineral density (BMD) in postmenopausal women with and without osteoporosis remain unclear. The aim of this study was to investigate the associations between lumbar muscle size and BMD in nonfractured postmenopausal women with osteoporosis and those with osteopenia.

Methods

A total of 89 postmenopausal women with osteopenia (n = 53) and osteoporosis (n = 36) were retrospectively enrolled in this study from 2014 to 2022. All participants underwent lumbar magnetic resonance imaging and dual-energy absorptiometry within a month. The lean lumbar muscle sizes at different lumbar levels were quantitatively evaluated on axial T1-weighted images. The associations between lumbar muscle size and BMD were analyzed using Pearson's correlation analysis.

Results

The osteoporosis group had significantly smaller lean psoas muscle sizes than the osteopenia group. Based on the correlation analysis, the erector spinae and multifidus muscle sizes were significantly associated with lumbar and femoral neck BMDs in the osteoporosis group. However, no significant association was found between lean psoas muscle size and BMDs in the osteopenia group. Thus, the associations between lumbar muscle decline and bone loss differed between postmenopausal women with osteoporosis and those with osteopenia.

Conclusions

The study findings suggest differences in the associations between BMD and lumbar muscle size between postmenopausal women with osteoporosis and those with osteopenia.
Osteoarthritis Increases the Frequency and Duration of Postoperative Hand Clinic Visits after Carpal Tunnel Release
Authors: George Robert E. , Seitz Allison J. , Moura Steven P. , Mclaughlin Matthew T. , Crawford Serra B. , Attaluri Pradeep K. , Edalatpour Armin , Michelotti Brett F.
Published: February 2024

Background:

Carpal tunnel syndrome affects up to 6% of the general population, and surgical intervention is often required to ameliorate symptoms. Osteoarthritis (OA) is a common condition that often coexists with carpal tunnel syndrome. We hypothesized that patients with preexisting OA use more healthcare resources after carpal tunnel release (CTR) than patients without arthritis.

Methods:

This was a retrospective cohort study at a single academic center between January 1, 2018 and November 1, 2021. Patients who underwent CTR were included. Preoperative carpal tunnel symptoms, diagnostic tests, medications, and concomitant OA were abstracted. Hand, wrist, and basal joint arthritis were specified. The primary outcome was healthcare utilization represented by duration and frequency of hand clinic and occupational therapy (OT) follow-up. In total, 312 hands were included. Multivariable analysis was performed.

Results:

The average duration of hand clinic follow-up among patients without arthritis was 25.3 days compared with 87.1 days for patients with any arthritis (P = 0.0375) and 172 days for patients with wrist arthritis (P = 0.012). The average number of postoperative surgeon visits was increased in patients with hand arthritis, with an average of 2.3 visits versus 1.34 visits for patients without arthritis (P = 0.003). Both the number of OT visits and the duration of OT follow-up did not differ between cohorts.

Conclusion:

After CTR, patients with preexisting OA use more healthcare resources than patients without OA.
Early Return to Work after Carpal Tunnel Release with Ultrasound Guidance
Authors: Paterson Paul D. , Kirsch Matthew J. , Miller Larry E. , Aguila Demetrio J.
Published: February 2024

Background:

The duration of postoperative leave varies by the carpal tunnel release (CTR) technique. This study aimed to determine the time to return to work (RTW) after CTR with ultrasound (CTR-US) guidance and identify factors contributing to this duration.

Methods:

This was a multicenter postmarket registry of patients treated with CTR-US. Time to RTW was analyzed with Kaplan–Meier methods. Logistic regression identified the association of patient, work, and procedural factors with the probability of RTW within 5 days (a standard work week) after CTR-US.

Results:

A total of 544 employed patients (655 hands) from 24 centers were treated with CTR-US between November 2019 and August 2022. The mean patient age was 50 years, 62% were women, and most (76%) were full-time employees, where work activities were desk-based (49%), light manual (28%), or heavy manual (23%). The complication rate was 0.8%. After CTR-US, the median RTW was 3 days (interquartile range: 1–6 days), with 74.6% returning by 5 days, 87.8% by 10 days, and 97.1% by 30 days. Work activity (desk-based versus heavy manual: odds ratio = 2.93, 95% confidence interval: 1.70–5.04, P < 0.001) and sex (man versus woman: odds ratio = 1.85, 95% confidence interval: 1.15–2.98, P = 0.01) were associated with higher probability of RTW within 5 days. The median RTW ranged from 2 to 4 days in all patient subgroups, including heavy manual laborers (median 4 days) and women (median 3 days).

Conclusions:

CTR-US offers an efficient approach to treating CTS, enabling most patients to RTW with minimal delay. The short recovery periods observed across diverse patient and work characteristic subgroups compare favorably to other CTR techniques.
Problematic Sexualized Behavior in Children: Essentials for the Pediatric Forensic Nurse
Authors: Hornor Gail
Published: February 2024

Problematic sexual behavior (PSB) in children and adolescents is a significant public health problem. PSB is defined as harmful or developmentally inappropriate behaviors involving sexual organs or regions of the body exhibited by children or adolescents. PSB may be harmful to self or others or be abusive toward another child, adolescent, or adult. Adolescents, typically defined as children 12 years old or older, engaging in PSB can be vulnerable to formal court adjudication as their behaviors may be considered a sexual offense. PSB can result in significant negative consequences for all children and adolescents involved as well as their families. This article will describe sexual behavior in children, normative and problematic, and explore implications for forensic nursing practice.
Associations of Chronotype, Work Schedule, and Sleep Problems With Work Engagement Experiences in Middle Age—The Northern Finland Birth Cohort 1966
Authors: Kiema-Junes Heli , Saarinen Aino , Ala-Mursula Leena , Hintsanen Mirka
Published: February 2024

Objective

The aim of the study is to investigate the role of chronotype for work engagement in middle age.

Methods

We used data from the Northern Finland Birth Cohort 1966 study (N = 5341) to analyze associations of self-reported chronotype (morning, intermediate, and evening type) with work engagement and its dimensions (vigor, dedication, absorption). We conducted multivariate analyses of variance to examine whether work schedule or sleep problems moderate these associations.

Results

Evening types showed lower scores in work engagement and its dimensions than intermediate and morning types, even when work schedule and sleep problems were controlled. Sleep problems emphasized the chronotype-work engagement and chronotype-dedication linkages.

Conclusions

Chronotype may play a role in employees’ work engagement. In addition, sleep problems seem relevant in terms of chronotype-work engagement linkage.
Efficacy of nicorandil and ranolazine in prevention of contrast-induced nephropathy in patients with mild-to-moderate renal dysfunction: a randomized controlled trial
Authors: Yusuf Jamal , Prakash Gyan , Safal Safal , Mehta Vimal , Mukhopadhyay Saibal
Published: February 2024

Introduction

Contrast-induced nephropathy (CIN) is a common complication after percutaneous coronary intervention (PCI). There is conflicting evidence regarding efficacy of nicorandil in CIN prevention. With respect to ranolazine, there is physiological possibility as well as data in animal study regarding its protective effect against CIN; there is, however, no human data till date.

Aim and objectives

To assess the efficacy of nicorandil and ranolazine in preventing CIN. The secondary endpoint was to measure difference in postprocedure acute kidney injury (AKI) incidence across groups. Also, patients were followed up till 6 months for major adverse events.

Material and methods

This single-center randomized controlled study included 315 patients of coronary artery disease with mild-to-moderate renal dysfunction undergoing elective PCI. Eligible patients were assigned to either nicorandil (n = 105), ranolazine (n = 105) or control group (n = 105) in 1 : 1 : 1 ratio by block randomization. All enrolled patients were given intravenous sodium chloride at rate of 1.0 mL/kg/h (0.5 mL/kg/h for patients with left ventricular ejection fraction <45%) from 6 h before procedure till 12 h after procedure. Iso-osmolar contrast agent (iodixanol) was used for all patients. In addition to hydration, patients in nicorandil group received oral nicorandil (10 mg, 3 times/d) and those in ranolazine group received oral ranolazine (1000 mg, 2 times/d) 1 day before procedure and for 2 days after PCI. Patients in control group received only hydration.

Results

Total number of CIN was 34 (10.7%), which included 19 (18.1%) in control, 8 (7.6%) in nicorandil and 7 (6.6%) in ranolazine group. There was significant association of CIN reduction across groups (P = 0.012). On pairwise comparison also, there was significant benefit across control and ranolazine as well as control and nicorandil (P < 0.025). There was numerically higher incidence of AKI in controls; the difference, however, did not reach statistical significance after applying Bonferroni correction (P = 0.044). Over 6-month follow-up, adverse events were similar across groups.

Conclusion

While this study adds to existing literature that supports role for nicorandil in CIN prevention, the efficacy of ranolazine in protecting against CIN has been demonstrated in humans for the first time.
Examining the impact of air pollution, climate change, and social determinants of health on asthma and environmental justice
Authors: Canaday Felicia T. , Georas Steve N. , Croft Daniel P.
Published: February 2024

Purpose of review

In this review, we discuss the current literature examining the impact air pollution and climate change has on asthma onset, control, and exacerbation. This review also addresses the risk of exposure to specific disproportionately affected communities, highlighting health disparities in exposure and asthma outcomes.

Recent findings

Recent studies have shifted from highlighting the associations between asthma exacerbations and indoor and outdoor air pollution. Studies are now focused on confirming the association of asthma incidence from these same exposures. Many studies have linked particulate matter to adverse asthma outcomes, however, the pollutant exposures that pose the greatest risk and the effect of natural disasters fueled by climate change are under current study. Some studies have observed that the true burden that pollutant exposures have on asthma outcomes occurs at the intersection of exposure and vulnerability. Future studies in this area will address social determinants of health, societal factors such as redlining and other systemic racism practices.

Although decades of research support the causal link between gaseous and particulate air pollution and the exacerbation of preexisting asthma, recent studies suggest air pollution can cause incident (new onset) asthma. Studies have started to focus on the underlying drivers of poor outcomes in asthma. Many of the structural impediments to high quality asthma care at the society level (e.g. poverty, redlining, systemic racism) also are risk factors for worsened climate events and air pollution exposure. The individuals in these disproportionately affected groups are doubly affected by worsened exposure and worsened access to care for the resultant asthma exacerbations or incident asthma. More research is needed to understand the specific climate and air pollution mitigation efforts where disproportionately affected communities would derive the most benefit.
The histomorphology of the senescent kidney – the clinical relevance of specimen and biopsy findings in the elderly native kidneys
Authors: Kozakowski Nicolas
Published: February 2024

Purpose of review

Renal pathology is crucial in diagnosing the ageing kidney. Recent technological advances enabled high-resolution molecular investigations into the complex mechanisms of ageing and senescence.

Recent findings

The pathological analysis of large kidney tissue collections coupled with computer-assisted morphometry contributed to the establishment of age-related reference values for glomerular or vascular sclerosis, interstitial fibrosis, and tubular atrophy. Furthermore, new high-throughput proteomic and transcriptomic platforms have entered the field of pathology. When coupled with morphology information, these techniques facilitated the study of extracellular matrix modifications and the senescent immune system in the ageing kidney. Finally, iatrogenic complications are now frequent indications for diagnostic kidney biopsies in older patients, potentially accelerating kidney senescence.

Recent pathology literature supports identifying and prognosticating sclerosing processes in ageing kidneys.
Juvenile sialidosis: a rare case and review of the literature
Authors: Pokharel Pashupati , Dawadi Aakriti , Baral Biraj , Dhungana Sunil , Baskota Arati , Poudel Daman Raj
Published: February 2024

Background:

Sialidosis is a rare variety of lysosomal storage disease that results in intracellular accumulation of sialic acid containing compounds. The authors report the first case of type II sialidosis, juvenile subtype in a 30-month-old male child from Nepal.

Case presentation:

Progressive hearing loss with coarse facies, hepatomegaly, kyphoscoliosis, dysostosis multiplex were the major features in a 30-month-old child born to healthy non-consanguineous parents. With the suspicion of lysosomal storage disease, urinary oligosaccharides were tested and were positive. Whole-exome sequencing revealed a mutation in the neuraminidase gene (NEU1) and established the diagnosis of sialidosis.

Clinical discussion:

Sialidosis is a rare autosomal recessive type of lysosomal storage disease resulting due to mutation of the neuraminidase gene leading to intracellular accumulation of sialic acid compounds. Based on the presence of visual symptoms, sialidosis is classified into type I and II varieties. Our case is of type II juvenile sialidosis.

Conclusion:

Despite rare, sialidosis is a life-threatening, and disabling disease. Exploring targeted therapy is the utmost to treat this condition.
Parthenolide induces gallbladder cancer cell apoptosis via MAPK signaling
Authors: Obulkasim Halmurat , Aji Gulibositan , Abudoula Abudoukaher , Liu Yu , Duan Shaobin
Published: February 2024

Objective

Parthenolide (PTL) has a wide range of clinical applications owing to its anti-inflammatory and antitumor effects. To date, the antitumor effect of PTL on gallbladder cancer (GBC) remains largely unknown. Therefore, we aimed to investigate the biological effects of PTL on GBC.

Methods:

The cellular viability and proliferation of GBC-SD and NOZ cell lines after treatment with different concentrations of PTL were analyzed using the Cell Counting Kit-8( CCK8 )assay and colony formation assay. Apoptosis analysis was performed using flow cytometry. Hoechst staining was performed. RNA sequencing (RNA-seq) was performed to identify PTL-related genes and signaling pathways. Furthermore, we confirmed the involvement of these signaling pathways by qRT-PCR and western blotting. For the in vivo experiments, a xenograft model was used to evaluate the effects of PTL on the proliferation of NOZ cells.

Results:

PTL significantly inhibited GBC cell growth in vitro and induced apoptosis in the GBC-SD and NOZ cell lines in a dose-dependent manner. RNA sequencing data showed that the immune response and mitogen-activated protein kinase (MAPK) signaling pathways are closely associated with PTL-induced gallbladder cancer cell apoptosis. PTL upregulated BAX, Cleaved PARP-1, Cleaved Caspase-3, Cleaved Caspase-9, P53 and decreased the expression of BCL-2, phosphorylated ERK, and phosphorylated MEK in vitro. Tumor volume and weight were also suppressed by PTL in vivo. Moreover, the effects of PTL on GBC cells might be mediated by the MAPK pathway.

Conclusion

PTL significantly inhibits gallbladder cancer cell proliferation and induces apoptosis through the MAPK pathway, which is a potential molecular reagent for treating GBC. However, further exploration is needed to verify the antitumor effects of PTL and its intracellular signaling mechanism.
Noninvasive diagnostic biomarkers, genomic profiling, and advanced microscopic imaging in the early detection and characterization of Naegleria fowleri infections leading to primary amebic meningoencephalitis (PAM)
Authors: Shaukat Ayesha , Khaliq Nawal , Riaz Rumaisa , Munsab Rabbia , Ashraf Tayyaba , Raufi Nahid , Shah Hafsa
Published: February 2024

This review delves into the strategies for early detection and characterization of Naegleria fowleri infections leading to primary amoebic meningoencephalitis (PAM). The study provides an in-depth analysis of current diagnostic approaches, including cerebrospinal fluid analysis, brain tissue examination, immunostaining techniques, and culture methods, elucidating their strengths and limitations. It explores the geographical distribution of N. fowleri, with a focus on regions near the equator, and environmental factors contributing to its prevalence. The review emphasizes the crucial role of early detection in PAM management, discussing the benefits of timely identification in treatment, personalized care, and prevention strategies. Genomic profiling techniques, such as conventional PCR, nested PCR, multiplex PCR, and real-time PCR, are thoroughly examined as essential tools for accurate and prompt diagnosis. Additionally, the study explores advanced microscopic imaging techniques to characterize N. fowleri’s morphology and behavior at different infection stages, enhancing our understanding of its life cycle and pathogenic mechanisms. In conclusion, this review underscores the potential of these strategies to improve our ability to detect, understand, and combat N. fowleri infections, ultimately leading to better patient outcomes and enhanced public health protection.
Prevalence of Fetomaternal Rhesus incompatibility at the tertiary care hospital; a cross-sectional study
Authors: Nyakio Olivier , Kibukila Fabrice , Suvvari Tarun Kumar , Bhattacharjee Priyadarshini , Akilimali Aymar , Mukwege Denis
Published: February 2024

Background:

Fetomaternal Rhesus Incompatibility is a medical condition that affects the pregnant woman (of blood group (A, B, AB, O) and a negative Rhesus) and the foetus (of positive Rhesus). The objective of this study is to determine the prevalence and to present the clinical characteristics of Fetomaternal Rhesus incompatibility in a tertiary care hospital.

Methods:

We conducted a retrospective cross-sectional study and 37 participants were recorded during the study period of 4 years.

Results:

A total of 11898 pregnant women admitted to the maternity and 37 of them (women with blood groups A, B, AB or O and with a negative Rhesus) participated in our study, including a frequency of 0.31%. 30 cases of Fetomaternal Rhesus Incompatibility were recorded in new-borns. 27 (73%) of the women are from the urban region and the age group between 21 and 25 is the most affected with 37.8%. 22 (59.5%) of pregnant women have blood group O (and negative Rhesus) and primiparous women are the most affected with 64.9%. For the discovery of allo immunization, 43.2% of women discovered it during the second pregnancy and 48.7% women received a single infusion of Anti-D serum during the first pregnancy. 12 (40%) new-borns developed jaundice as a perinatal prognosis.

Conclusion:

Fetomaternal Rhesus incompatibility remains a major problem of maternal health because it is likely to lead to the formation of antibodies in women, which by crossing the placental barrier, they destroy red blood cells and thus cause serious complications.
Intracranial osteochondroma arising from the posterior clinoid process: a rare case report with diagnostic challenges and comprehensive literature review
Authors: Thapa Bikash Raj , katwal Shailendra
Published: February 2024

Introduction and importance:

Intracranial osteochondroma is rare, presenting diagnostic challenges due to overlapping imaging findings with other pathologies. This case report highlights the significance of considering osteochondroma in calcified tumour differentials near bone.

Case presentation:

A 34-year-old man with vision deterioration and headaches had an MRI revealing a suprasellar lesion. Intraoperatively, a bony hard tumour was partially resected. Subsequent computed tomography (CT) confirmed a calcified mass contiguous with the posterior clinoid.

Clinical discussion:

Reviewing 28 cases, skull base osteochondromas were common, with differential diagnoses including craniopharyngioma and meningioma. Surgical decision-making involved balancing complete resection for convexity and falx cases versus partial resection for skull base tumours due to proximity to critical structures.

Conclusion:

Intracranial osteochondroma poses diagnostic challenges, especially near bone. Tailored surgical approaches are vital, with complete resection yielding good outcomes for convexity and falx cases. Close follow-up is crucial for monitoring recurrences and complications.
Central retinal artery occlusion in a child with ADA2 deficiency: A case report
Authors: Sharabati Israa , Ayesh Baraa , Qafesha Ruaa Mustafa , Rasras Heba , Abunejma Fawzy M. , Abdulrazzak Mohammed , Jobran Afnan W.M.
Published: February 2024

Introduction and Importance:

Deficiency of ADA2 (DADA2) is the first molecularly described monogenic vasculitis syndrome. During the past decade, DADA2’s clinical spectrum has expanded significantly as the number of reported cases has increased.

Case Presentation:

A five-year-old boy with DADA2 who experienced sudden onset left-sided vision loss due to unilateral central retinal artery occlusion. The patient had a history of recurrent fever and arthralgia with high inflammatory markers (CRP and ESR). Brain MRI showed mild limbic encephalitis, and MRA was normal. His gene sequencing results demonstrated substitutions mutation in ADA2, and the diagnosis of DADA2 was eventually confirmed.

Clinical Discussion:

Central retinal artery occlusion (CRAO) in pediatrics is a very rare condition. Typically, DADA2 presents in childhood as systemic inflammation, vasculitis, humoral immunodeficiency, and/or hematologic abnormalities. The most common phenotype described in the literature is vasculitis, which typically affects the skin and central nervous system, but other systems can also be affected. Ophthalmic manifestations are less common and highly variable.

Conclusion:

DADA2 manifests rarely with central retinal artery occlusion; therefore, physicians should be aware of this manifestation.
Unusual location of subungual amelanotic melanoma in 39-year-old patient: a rare case report
Authors: Karaja Saja Ahmad , Halloum Mai Abdulsalam , Mansour Sanaa Yasser , Almasri Alae Aldin
Published: February 2024

Introduction and importance:

Melanoma represents only 1% of all skin cancers. Acral lentigious melanoma (ALM) which usually arises from feet, is the rarest main subtype of melanoma. Subungual melanoma (SUM) is a rare variant of ALM. Amelanotic melanoma (AM) is found only in 4–27.5% of melanomas, and the mean age for patients affected by AM exceeds 50 years. Late diagnosing leads to unfavourable prognosis.

Case presentation:

The authors present a case of subungual amelanotic melanoma that affected the nail unit of the right thumb which is a rare case, especially when the patient is only 39 years old. The lesion enlarged over a year and was misdiagnosed many times and treated with no response. Sentinel node biopsy was positive and the patient was moved to a specialized hospital for treatment.

Clinical discussion:

Diagnosing subungual amelanotic melanoma is challenging, not only because it is the rarest, but also it mimics many benign and malignant neoplasms due to the lack of pigmentation, in addition to the absence of clinical diagnostic features. AM exhibits a high growth rate helping in limiting the window for early detection.

Conclusions:

Lately diagnosed subungual amelanotic melanoma usually associates with an increased risk of metastases, So it should be considered as a cause of any non-healing lesion. Early diagnosing gives patients the best chance for survival.
Impact of the Pandemic on Newly Licensed Nurses’ Role Transition Experiences
Authors: Casey Kathy , Loresto Figaro , Lundy Kary , Humphrey Kale , Oja Kenneth J.
Published: February 2024

This study examined differences in newly licensed nurses’ role transition experiences while enrolled in a nurse residency program before and during the pandemic. The Casey–Fink Graduate Nurse Experience Survey measured baseline, 6-month, and 12-month program outcomes. The prepandemic cohort had higher subscale scores at baseline. Both cohort groups showed significant increases in role confidence, patient safety, communication/leadership, and job satisfaction. Despite the pandemic, nurse residency program completion rates remained stable. Implications for nursing professional development practitioners are presented.
Access to Benzathine Penicillin G Treatment for Persons With Syphilis, Maricopa County, Arizona, 2021
Authors: Mangone Elizabeth , Bell Jonathan , Devlin Stephanie , Khurana Renuka , Taylor Melanie M.
Published: February 2024

Background

As the incidence of syphilis continues to increase, examining benzathine penicillin G (BPG) treatment data provides valuable insight for public health strategies. This study analyzed the trends of where BPG is administered relative to the initial clinical site of syphilis diagnosis. Our findings are timely in the context of recent national BPG shortages.

Methods

The analysis included persons diagnosed with any syphilis stage in Maricopa County, Arizona, from January 1, 2021, to December 31, 2021. The Arizona surveillance database (PRISM) was the source of demographic, testing, and treatment data.

Results

Of a total of 4028 persons with syphilis, 3038 (75.4%) received at least 1 injection of BPG. Among persons who received an initial BPG injection, only 1719 (56.6%) were diagnosed and treated at the same clinical site type. The Maricopa County Sexually Transmitted Disease Clinic administered BPG to 48.8% (n = 1483) of persons with syphilis who received an initial injection.

Conclusions

Our findings analyze trends in BPG administration that are likely due to treatment referral practices and medication cost. Administration of BPG is not guaranteed at the clinical site of diagnosis, highlighting concerns regarding access to BPG. A burden is placed on patients who are required to leave their diagnosing provider to seek syphilis treatment at other health facilities that administer BPG.
An Autopsy Case of Saphenous Vein Graft Rupture
Authors: Auen Thomas , Linde Erin
Published: February 2024

Saphenous vein graft aneurysms are rare complications after coronary artery bypass grafting that carry serious complications. Less than 10 case reports of autopsy findings consistent with ruptured saphenous vein grafts exist in the literature. We report a case of a female presenting at autopsy who, after coronary artery bypass grafting 20 years prior, demonstrated findings of a saphenous vein graft aneurysm and rupture. With limited evidence from medical records, this case highlights a need for patients with previous coronary artery bypass grafting to be properly monitored to detect minute graft changes before aneurysm formation and rupture as seen in our decedent.