bluuebunny/crossref_metadata_2025 huggingface dataset:
Histopathological Differences in Adult and Elderly Patients With Chronic Rhinosinusitis
Authors: Brown Hannah J. , Baird Ali M. , Khalife Sarah , Escobedo Pedro , Filip Peter , Papagiannopoulos Peter , Gattuso Paolo , Batra Pete , Tajudeen Bobby A.
Published: May 2023

Background

Adult and elderly patients with chronic rhinosinusitis (CRS) undergo similar therapeutic management. Few studies have undertaken sinonasal tissue-level comparisons of these groups. This study examines histopathological differences between adults (>18, <65 years) and the elderly (≥65 years) with CRS, with the goal of optimizing medical management.

Methods

In a retrospective cohort analysis, demographic factors, comorbidities, and a structured histopathological report of 13 variables were compared across adult and elderly patients with CRS who underwent functional endoscopic sinus surgery. These cohorts of adult and elderly patients included patients with and without nasal polyps (NP).

Results

Three hundred adult (158 aCRSsNP, 142 aCRSwNP) and 77 elderly (38 eCRSsNP, 39 eCRSwNP) patients were analyzed. Mean age of the adult cohort was 44.4 ± 12.4 years, while that of the elderly cohort was 71.9 ± 5.9 years ( P  <  .001). Significantly more adults compared to elderly individuals demonstrated a positive atopic status (79.7% vs 64.0%, P  =  .004). Elderly patients exhibited higher rates of comorbid diabetes mellitus than adult patients (21.6% vs 10.3%, P  =  .009). Adults exhibited more tissue eosinophilia (43.4% vs 28.6%, P  =  .012) and presence of eosinophil aggregates (25.0% vs 14.3%, P  =  .029) compared to elderly patients, regardless of NP status. Conversely, the elderly demonstrated significantly more fungal elements (11.7% vs 3.0%, P  =  .004), and trended toward increased overall inflammation (63.6% vs 55.3%, P  =  .118) and tissue neutrophilia (35.1% vs 27.3%, P  =  .117), compared to adults.

Conclusion

Sinonasal tissue of adult and elderly patients with CRS demonstrates clear histopathological differences. Patient comorbidities, in addition to histopathological characterizations, may provide further context for management optimization.

Level of Evidence

2.

Short Summary

Sinonasal tissue samples from adult and elderly patients with CRS demonstrate clear histopathological differences. These patient populations also exhibit unique comorbidities. These distinctions have the potential to inform and optimize management of this condition.
Heidegger as a Colonial Thinker: Puritanism and Germany’s Errand into the Wilderness
Authors: Weidler Markus
Published: May 2023

In the turbulent 1930s, Martin Heidegger gave a lecture on “Logic as the Question Concerning the Essence of Language.” Upon close inspection, this text expounds a form of covenantal thinking guided by the Puritan theme of an errand into the wilderness. The proffered analysis shows how Heidegger invokes a poetic conception of colony to reconfigure Germany’s self-image as a culture nation in search of a “new past.” What can be gleaned from this account is a central but neglected link between Heidegger’s thought and colonial discourse, in uneasy proximity to a special form of eschatological racism which divides humanity into spiritual classes marked by varying degrees of fitness for salvation.
Ophthalmia nodosa secondary to intraocular, white-marked tussock caterpillar setae (Orgyia leucostigma) in a 15-year-old
Authors: Levy Sydney , Posa Molly , Kelly Maria , Samaha J Reeves , Otero Jaclyn
Published: May 2023

A 15-year-old female presented to the emergency department with a 1-day history of pain and swelling of her right eye following ocular contact with a caterpillar. Caterpillars of the white-marked tussock moth and other related species possess hairlike structures called setae, with angled barbs along their length, allowing them to travel linearly upon penetration of an enemy, resisting backward movement and becoming very difficult to extract once imbedded. When these fine, pointed hairs contact the surface of the eye, they can easily migrate in, eliciting movement of the globe, blinking, and rubbing of the eye in an attempt to remove the offending agent, potentially leading to ophthalmia nodosa. One of the most important aspects of ophthalmia nodosa diagnosis is a thorough history and prompt slit-lamp examination to identify the presence of foreign bodies and where they are located; this will help guide clinical management decisions. This case demonstrates that, depending on the number and location, more than one attempt may be required to remove all of the barbed setae. If ophthalmia nodosa is suspected, it is important to promptly refer to ophthalmology for a thorough eye exam, keep the eye clean, prescribe prophylactic topical antibiotics and/or steroids to reduce the potential for infection and inflammation, and emphasize the importance of keeping the eye protected during the healing process with an eye shield.
His-Purkinje conduction system pacing and atrioventricular node ablation in treatment of persistent atrial fibrillation refractory to multiple ablation procedures: A case report
Authors: Qi Peng , An Hui , Lv Yuxuan , Geng Yanping , Chen Shuxia , Li Shuren , Dang Yi
Published: May 2023

In patients with symptomatic atrial fibrillation refractory to optimal medical therapy, atrioventricular node ablation followed by permanent pacemaker implantation is an effective treatment option. A 66-year-old woman with symptomatic persistent atrial fibrillation refractory to multiple ablation procedures was referred to our institution. After optimal drug therapy, the patient still had obvious symptoms. Sequential His-Purkinje conduction system pacing and atrioventricular node ablation were performed. Left bundle branch pacing was used as a backup pacing method if thresholds of His bundle pacing were too high or loss of His bundle capture occurred in the follow-up. At the 6-month follow-up, the European Heart Rhythm Association classification for AF was improved, the score of the Atrial Fibrillation Effect on Quality of Life was enhanced, and the 6-Minute Walk Test was ameliorated. The present case was subjected to His-Purkinje conduction system pacing in combination with atrioventricular node ablation as treatment for a symptomatic persistent atrial fibrillation refractory to multiple ablation procedures, and this procedure alleviated symptoms and improved the quality of life in a short-term follow-up.
Modeling COVID-19 with big mobility data: Surveillance and reaffirming the people in the data
Authors: Walsh Thomas
Published: May 2023

To better understand the COVID-19 pandemic, public health researchers turned to “big mobility data”—location data collected from mobile devices by companies engaged in surveillance capitalism. Publishing formerly private big mobility datasets, firms trumpeted their efforts to “fight” COVID-19 and researchers highlighted the potential of big mobility data to improve infectious disease models tracking the pandemic. However, these collaborations are defined by asymmetries in information, access, and power. The release of data is characterized by a lack of obligation on the part of the data provider towards public health goals, particularly those committed to a community-based, participatory model. There is a lack of appropriate reciprocities between data company, data subject, researcher, and community. People are de-centered, surveillance is de-linked from action while the agendas of public health and surveillance capitalism grow closer. This article argues that the current use of big mobility data in the COVID-19 pandemic represents a poor approach with respect to community and person-centered frameworks.
Nothrus mite as a potential cause of exacerbation of pruritus in a cat
Authors: Kifleyohannes Tsegabirhan , Olstad Ingrid , Jiménez-Meléndez Alejandro , Lambert Elliott Brice J , Ingvaldsen Ingrid , Robertson Lucy J
Published: May 2023

Objectives

Morphological and molecular approaches were used to identify arthropods associated with feline pruritus. The literature associated with the arthropod genus identified was reviewed.

Methods

On two occasions (summer 2020 and summer 2021), the owner of a cat with seasonal pruritus (commenced 2020) found the cat’s bed was substantially infested with arthropods suspected of being associated with exacerbated pruritus. The pruritus was largely itching and hair loss, particularly on the abdomen, and flaking skin patches. On the second occasion (2021), examples of the arthropods were sent to the parasitology laboratory at the Norwegian University of Life Sciences for identification. They were examined by stereomicroscopy and tentatively identified based on morphology. DNA was extracted, and identification confirmed by PCR and sequencing. The literature was reviewed to determine whether this arthropod genus has previously been considered to be associated with pruritus or the infestation of mammals.

Results

Based on morphological characteristics, the arthropods were tentatively identified as Nothrus species mites. This was confirmed by PCR. A literature review found no previous reports of pruritus or other clinical signs associated with Nothrus species mites, and mites were not found on the cat. However, this mite has previously been found on small mammals at densities exceeding that expected of incidental stragglers.

Conclusions and relevance

The large number of Nothrus species mites could have exacerbated the cat’s pruritus. By publishing this study, we hope to alert veterinarians to the possibility that Nothrus species mites may cause or exacerbate pruritus in cats.
Machine Learning Prediction Model and Risk Factor Analysis of Reoperation in Recurrent Lumbar Disc Herniation Patients After Percutaneous Endoscopic Lumbar Discectomy
Authors: Shan Zheng-Ming , Ren Xue-Song , Shi Hang , Zheng Shi-Jie , Zhang Cong , Zhuang Su-Yang , Wu Xiao-Tao , Xie Xin-Hui
Published: May 2023

Study Design

Retrospective, matched case-control study.

Objective

To investigate the risk factors of reoperation after percutaneous endoscopic lumbar discectomy (PELD) due to recurrent lumbar disc herniation (rLDH) and to establish a set of individualized prediction models.

Methods

Patients who underwent PELD successfully from January 2016 to February 2022 in a single institution were enrolled in this study. Six methods of machine learning (ML) were used to establish an individualized prediction model for reoperation in rLDH patients after PELD, and these models were compared with logistics regression model to select optimal model.

Results

A total of 2603 patients were enrolled in this study. 57 patients had repeated operation due to rLDH and 114 patients were selected from the remaining 2546 nonrecurrent patients as matched controls. Multivariate logistic regression analysis showed that disc herniation type ( P < .001), Modic changes (type II) ( P = .003), sagittal range of motion (sROM) ( P = .022), facet orientation (FO) ( P = .028) and fat infiltration (FI) ( P = .001) were independent risk factors for reoperation in rLDH patients after PELD. The XGBoost AUC was of 90.71%, accuracy was approximately 88.87%, sensitivity was 70.81%, specificity was 97.19%. The traditional logistic regression AUC was 77.4%, accuracy was about 77.73%, sensitivity was 47.15%, specificity was 92.12%.

Conclusion

This study showed that disc herniation type (extrusion, sequestration), Modic changes (type II), a large sROM, a large FO and high FI were independent risk factors for reoperation in LDH patients after PELD. The prediction efficiency of XGBoost model was higher than traditional Logistic regression analysis model.
A Tourist Attractions Recommendation Model Based on Sequence Interest Extraction and Location Information Fusion
Authors: Zhang Manman , Tong Ruijia , Xia Xiaoling
Published: May 2023

Travel, as one way to relax oneself, has become the first choice for people to enjoy their body and mind in modern society. However, while facing lots of information, how to help users make better decisions on their next travel goals through their historical interest spots is a direction that needs further research in big data recommendation systems. In this thesis, we proposed the deep convolution and multi-head self-attention position network model. First, it extracts the user’s historical interest point feature information by convolutional neural network method, and then performs horizontal and vertical filtering. Next, it interacts the obtained information with the candidate attraction information, and extracts the location information of the historical interest sequence by the multi-head self-attention mechanism. Finally, the model does the attention mechanism of the candidate attraction by fusing the feature information of the location information. The final model achieves a deep fusion of user sequence interest and location feature information. We conducted detailed comparison experiments with the very popular models in the industry on different public datasets, and the results showed that our deep convolution and multi-head self-attention position network model has good performance.
How Membrane Contact Sites Shape the Phagophore
Authors: Capitanio Cristina , Bieber Anna , Wilfling Florian
Published: May 2023

During macroautophagy, phagophores establish multiple membrane contact sites (MCSs) with other organelles that are pivotal for proper phagophore assembly and growth. In S. cerevisiae, phagophore contacts have been observed with the vacuole, the ER, and lipid droplets. In situ imaging studies have greatly advanced our understanding of the structure and function of these sites. Here, we discuss how in situ structural methods like cryo-CLEM can give unprecedented insights into MCSs, and how they help to elucidate the structural arrangements of MCSs within cells. We further summarize the current knowledge of the contact sites in autophagy, focusing on autophagosome biogenesis in the model organism S. cerevisiae.
Valuing Theory and Practice: Using a Portfolio Lens to Publish Research on Projects
Authors: Davies Andrew , MacAulay Samuel C.
Published: May 2023

This article maps the contributions project scholars can make in management journals. Research on projects cuts across disciplinary boundaries, with scholars working in institutions with different norms, epistemologies, rewards, and selection environments. But this diversity can make it hard to know where to publish. We hope our map of the publication landscape—the “V diagram”—will help project scholars better understand and respect one another’s diverse contributions and make conversations across the field flourish.
Final analysis of carfilzomib, dexamethasone, and daratumumab vs carfilzomib and dexamethasone in the CANDOR study
Authors: Usmani Saad Z. , Quach Hang , Mateos Maria-Victoria , Landgren Ola , Leleu Xavier , Siegel David , Weisel Katja , Shu Xiaomei , Li Chuang , Dimopoulos Meletios
Published: May 2023

CANDOR (NCT03158688) is a phase 3, randomized, open-label trial comparing carfilzomib, daratumumab, and dexamethasone (KdD) vs carfilzomib and dexamethasone (Kd) in adults with relapsed/refectory multiple myeloma (RRMM) with 1 to 3 prior therapies. The CANDOR study met its primary end point of progression-free survival (PFS) in the primary analysis. Here, we report the final analysis of the study, including secondary end points and subgroup analyses thereof. The median follow-up was 50 months. Patients treated with KdD had higher minimal residual disease–negative (MRD−) achievement rates (28% vs 9%; odds ratio [OR], 4.22; 95% confidence interval [95% CI], 2.28-7.83) and MRD– complete response rates (22% vs 8%; OR, 3.55; 95% CI, 1.83-6.88) than those treated with Kd. Median PFS was 28.4 months for KdD vs 15.2 months for Kd (hazard ratio [HR], 0.64; 95% CI, 0.49-0.83). Median overall survival (OS) for KdD was 50.8 months vs 43.6 months for Kd (HR, 0.78 [0.60-1.03]; P = .042). Trends toward improved OS occurred in predefined subgroups, including patients refractory to lenalidomide (KdD, not reached vs Kd, 38.2 months; HR, 0.69 [0.43-1.11]) and refractory to proteasome inhibitor (KdD, 43.2 months vs Kd, 30.0 months; HR, 0.70 [0.45-1.09]), and there was significant improvement in patients with high-risk cytogenetics (KdD, 34.3 months vs Kd: 17.1 months; HR, 0.52 [0.29-0.94]). No new safety signals were identified. In summary, the final analysis of CANDOR confirmed the PFS benefit and showed a trend in OS benefit with KdD vs Kd. These findings reinforce KdD as a standard of care for RRMM, especially in clinically relevant patient subgroups. This trial was registered at www.clinicaltrials.gov as #NCT03158688.
The SALENTO prognostic model for limited-stage peripheral T-cell lymphoma from the International T-Cell Project Network
Authors: Hapgood Greg , Civallero Monica , Stepanishyna Yana , Vose Julie , Cabrera Monica Elena , Advani Ranjana H. , Pileri Stefano A. , Manni Martina , Horwitz Steven M. , Foss Francine M. , Hitz Felicitas , Radford John , Dlouhy Ivan , Chiattone Carlos , Kim Won Seog , Skrypets Tetiana , Nagler Arnon , Trotman Judith , Luminari Stefano , Federico Massimo
Published: May 2023

The natural history of limited-stage peripheral T-cell lymphomas (PTCLs) remains poorly defined. We investigated outcomes and prognostic variables in patients registered in the T-Cell Project (TCP) (#NCT01142674) to develop a model to predict overall survival (OS) for the common nodal PTCL subtypes (PTCL-NOS, AITL, ALCL). The model was validated in an independent data set from Australian and Brazilian registries. 211 patients registered in the TCP between 2006-2018 were studied. The median age was 59 years (range 18-88) and median follow-up was 49 months. One hundred twenty-seven patients (78%) received anthracycline-based regimens, 5 patients (3%) radiotherapy alone (RT), 24 patients (15%) chemotherapy+RT. 5-year OS and PFS were 47% and 37%, respectively. Age >60 years, elevated LDH and low serum albumin were independent prognostic factors. The model identified 3 groups with low- (26%, score 0), intermediate- (41%, score 1), and high-risk (33%, score 2-3) with 5-year OS of 78% (95% confidence interval [95% CI], 29-127), 46% (95% CI, 24-68), and 25% (95% CI, 20-30), respectively (P < 0.001) and 5-year PFS of 66% (95% CI, 33-99), 37% (95% CI, 9-65), and 17% (95% CI, 9-25), respectively (P < 0.001). The model demonstrated greater discriminatory power than established prognostic indices and an analogous distribution and outcomes in the 3 groups in the validation cohort of 103 patients. The SALENTO Model (Limited Stage Peripheral T-Cell Lymphoma Prognostic Model) is an objective, simple and robust prognostic tool. The high-risk group has poor outcomes, comparable to advanced stage disease, and should be considered for innovative first-line approaches.
PTCy, abatacept, and a short course of tacrolimus for GVHD prevention after haploidentical transplantation
Authors: Al-Homsi A. Samer , Cirrone Frank , Wo Stephanie , Cole Kelli , Suarez-Londono J. Andres , Gardner Sharon L. , Hsu Jingmei , Stocker Kelsey , Bruno Benedetto , Goldberg Judith D. , Levinson Benjamin A. , Abdul-Hay Maher
Published: May 2023

Reducing the incidence of graft-versus-host disease (GVHD) after haploidentical hematopoietic stem cell transplantation (HSCT) is warranted. Posttransplant cyclophosphamide (PTCy) is the main agent used for GVHD prevention in this setting. It remains unknown whether costimulation blockade can be safely combined with PTCy and enhance its efficacy. We performed a phase 1b-2 clinical trial to examine the combination of PTCy, abatacept, and a short course of tacrolimus (CAST) after peripheral blood haploidentical HSCT. The primary end point was the incidence of grades 2-4 acute GVHD by day +120. The study enrolled 46 patients with a median age of 60 years (range, 18-74 years). The cumulative incidences of grades 2-4 and 3 or 4 acute GVHD were 17.4% (95% confidence interval [CI], 9.2-32.9) and 4.4% (95% CI, 1.1-17.1), respectively. With a median follow-up of 15.3 months, the cumulative incidence of 1-year treatment-related mortality was 4.4% (95% CI, 1.1-17.1). The estimated 1-year moderate-to-severe chronic GVHD rate, relapse rate, progression-free survival, overall survival, and GVHD- and relapse-free survival were 15.9% (95% CI, 8-31.7), 11.7% (95% CI, 5-27.2), 84.1% (95% CI, 73.8-95.7), 85.9% (95% CI, 75.9-97.2), and 66.1% (95% CI, 53.4-81.8), respectively. Toxicities were similar to those expected in patients receiving haploidentical HSCT. This clinical trial showed that the CAST regimen is safe and effective in reducing the rate of grades 2-4 acute GVHD after haploidentical peripheral blood HSCT. This trial was registered at www.clinicaltrials.gov as #NCT04503616.
The role of noncoding RNAs in metabolic reprogramming of cancer cells
Authors: Safi Amir , Saberiyan Mohammadreza , Sanaei Mohammad-Javad , Adelian Samaneh , Davarani Asl Fateme , Zeinaly Mahsa , Shamsi Mahdi , Ahmadi Reza
Published: May 2023

Metabolic reprogramming is a well-known feature of cancer that allows malignant cells to alter metabolic reactions and nutrient uptake, thereby promoting tumor growth and spread. It has been discovered that noncoding RNAs (ncRNAs), including microRNA (miRNA), long noncoding RNA (lncRNA), and circular RNA (circRNA), have a role in a variety of biological functions, control physiologic and developmental processes, and even influence disease. They have been recognized in numerous cancer types as tumor suppressors and oncogenic agents. The role of ncRNAs in the metabolic reprogramming of cancer cells has recently been noticed. We examine this subject, with an emphasis on the metabolism of glucose, lipids, and amino acids, and highlight the therapeutic use of targeting ncRNAs in cancer treatment.
HLA-Clus: HLA class I clustering based on 3D structure
Authors: Shen Yue , Parks Jerry M. , Smith Jeremy C.
Published: May 2023

Background

In a previous paper, we classified populated HLA class I alleles into supertypes and subtypes based on the similarity of 3D landscape of peptide binding grooves, using newly defined structure distance metric and hierarchical clustering approach. Compared to other approaches, our method achieves higher correlation with peptide binding specificity, intra-cluster similarity (cohesion), and robustness. Here we introduce HLA-Clus, a Python package for clustering HLA Class I alleles using the method we developed recently and describe additional features including a new nearest neighbor clustering method that facilitates clustering based on user-defined criteria.

Results

The HLA-Clus pipeline includes three stages: First, HLA Class I structural models are coarse grained and transformed into clouds of labeled points. Second, similarities between alleles are determined using a newly defined structure distance metric that accounts for spatial and physicochemical similarities. Finally, alleles are clustered via hierarchical or nearest-neighbor approaches. We also interfaced HLA-Clus with the peptide:HLA affinity predictor MHCnuggets. By using the nearest neighbor clustering method to select optimal allele-specific deep learning models in MHCnuggets, the average accuracy of peptide binding prediction of rare alleles was improved.

Conclusions

The HLA-Clus package offers a solution for characterizing the peptide binding specificities of a large number of HLA alleles. This method can be applied in HLA functional studies, such as the development of peptide affinity predictors, disease association studies, and HLA matching for grafting. HLA-Clus is freely available at our GitHub repository (https://github.com/yshen25/HLA-Clus).
High frequencies (HF) repetitive transcranial magnetic stimulation (rTMS) increase motor coordination performances in volleyball players
Authors: Moscatelli Fiorenzo , Toto Giusi Antonia , Valenzano Anna , Cibelli Giuseppe , Monda Vincenzo , Limone Pierpaolo , Mancini Nicola , Messina Antonietta , Marsala Gabriella , Messina Giovanni , Polito Rita
Published: May 2023

Introduction

It is widely demonstrated that high frequency (HF) repetitive transcranial magnetic stimulation (rTMS) has facilitative effects and is therefore capable to inducing changes in motor responses. One of the most investigated areas is the dorsolateral prefrontal cortex (DLPFC) as it plays a special executive attention role in actively preserving access to stimulus representations and objectives in environments with plenty of distraction such as those of team sports. Volleyball is a team sport in which the attention and coordination components are essential for achieving performance. Thus, the aim of this study was to investigate if HF rTMS at DLPFC in volleyball players can improve homolateral motor coordination and cortical excitability.

Results

This study was a double-blinded (participant and evaluator) matched-pair experimental design. Twenty right-handed female volleyball players were recruited for the study and were randomly assigned either the active rTMS (n = 10) or the sham stimulation group (n = 10). The stimulation was performed in one session with 10 Hz, 80% of the resting motor threshold (RMT) of the right first dorsal interosseous muscle, 5 s of stimulation, and 15 s of rest, for a total of 1500 pulses. Before and after stimulation, the coordination and the cortical excitability were evaluated. The significant finding of this paper was that HF-rTMS of the DLPFC improved performance in terms of the homolateral interlimb coordination, with a significantly decreased in resting motor threshold and MEP latency of the ipsilateral motor cortex. It seem that HF-rTMS could increase coordination performances when the velocity of the execution is higher (120 bpm and 180 bpm).

Conclusion

Moreover, in active rTMS group significant differences emerged after stimulation in RMT and in MEP latency, while no differences emerged after stimulation in MEP amplitude. In conclusion we believe that these results may be of great interest to the scientific community and may also have practical implications in the future.
Emphasis on the clinical relationship between alpha-fetoprotein and hepatoid adenocarcinoma of the stomach: a retrospective study
Authors: Li Lamei , Yang Xinle , Ji Wei , Zhu Qi , Yang Xin , Niu Junqi , Li Wanyu
Published: May 2023

Background

Hepatoid adenocarcinoma of the stomach (HAS) is a highly malignant and rare extrahepatic tumor. The prognosis is controversial because of its rarity and the lack of multi-center cohort studies, especially on the influence of serum Alpha-fetoprotein (AFP) level on prognosis. We aimed to analyze the clinicopathological characteristics and prognosis of HAS, particularly the effect of serum AFP on the prognosis of HAS.

Methods

We retrospectively reviewed clinical data of one HAS patient treated at our institution in 2019 and of 252 patients reported between 1984 and 2020 in research databases.

Results

Among these patients, 60.1% were > 60 years, 51% had lesions in the gastric antrum, and 51.0% (73/143) had the ulcerative lesion type. The preoperative elevated levels of serum alpha-fetoprotein (AFP) were detected in most patients (76.7%). Lymph-node (84.6%) and preoperative liver metastasis (39.1%) were often found. The high-AFP group was characterized by a higher rate of stage IV (P = 0.000682) and liver metastasis (P = 0.000068). The 1-, 3-and 5-year progression-free survival(PFS) rates were 41%, 18%, and 0%, and the 1-, 3-, and 5-year overall survival (OS) rates were 64%, 26%, and 21%, respectively. The survival analysis showed that OS was significantly shorter for HAS with high-AFP (> 300 ng/ml) than with low-AFP (≤ 300 ng/ml) (P = 0.023). The univariate analysis indicated that the OS of HAS was associated with tumor location, pTNM stage, lymph-node metastasis, surgical resection, and serum AFP > 300 ng/ml. However,the prognostic factors for PFS was only pTNM stage and surgical resection. The multivariate analysis confirmed that the independent prognostic factor affecting OS of HAS included pTNM stage and surgical resection.

Conclusions

Liver metastasis was increasingly more likely with increasingly higher serum AFP, but the prognosis of HAS is not necessarily poor. Serum AFP level is an important prognostic indicator in HAS and should be monitored.
Protocol, rationale and design of BE-PEOPLE (Bedaquiline enhanced exposure prophylaxis for LEprosy in the Comoros): a cluster randomized trial on effectiveness of rifampicin and bedaquiline as post-exposure prophylaxis of leprosy contacts
Authors: Younoussa Assoumani , Samidine Said Nourdine , Bergeman Auke T. , Piubello Alberto , Attoumani Nissad , Grillone Silahi Halifa , Braet Sofie Marijke , Tsoumanis Achilleas , Baco Abdallah , Mzembaba Aboubacar , Salim Zahara , Amidy Mohamed , Grillone Saverio , Snijders Rian , Corstjens Paul , Ortuno-Gutierrez Nimer , Hoof Carolien , Geluk Annemieke , de Jong Bouke C. , Hasker Epco
Published: May 2023

Background

Leprosy is an ancient infectious disease with an annual global incidence of around 200,000 over the past decade. Since 2018, the World Health Organization (WHO) recommends single-dose rifampicin as post-exposure prophylaxis (SDR-PEP) for contacts of leprosy patients. The Post ExpOsure Prophylaxis for Leprosy (PEOPLE) trial evaluated PEP with a double dose of rifampicin in Comoros and Madagascar. Preliminary results of this trial show some reduction in leprosy incidence in intervention villages but a stronger regimen may be beneficial. The objective of the current Bedaquiline Enhanced ExpOsure Prophylaxis for LEprosy trial (BE-PEOPLE) is to explore effectiveness of a combination of bedaquiline and rifampicin as PEP.

Methods

BE-PEOPLE is a cluster-randomized trial in which 44 clusters in Comoros will be randomized to two study arms. Door-to-door screening will be conducted annually during four years, leprosy patients identified will be offered standard of care treatment. Based on study arm, contacts aged five years and above and living within a 100-meter radius of an index case will either receive bedaquiline (400-800 mg) and rifampicin (150-600 mg) or only rifampicin (150–600 mg). Contacts aged two to four years will receive rifampicin only. Household contacts randomized to the bedaquiline plus rifampicin arm will receive a second dose four weeks later. Incidence rate ratios of leprosy comparing contacts who received either of the PEP regimens will be the primary outcome. We will monitor resistance to rifampicin and/or bedaquiline through molecular surveillance in all incident tuberculosis and leprosy patients nationwide. At the end of the study, we will assess anti-M. leprae PGL-I IgM seropositivity as a proxy for the population burden of M. leprae infection in 8 villages (17,000 individuals) that were surveyed earlier as part of the PEOPLE trial.

Discussion

The COLEP trial on PEP in Bangladesh documented a reduction of 57% in incidence of leprosy among contacts treated with SDR-PEP after two years, which led to the WHO recommendation of SDR-PEP. Preliminary results of the PEOPLE trial show a lesser reduction in incidence. The BE-PEOPLE trial will explore whether reinforcing SDR-PEP with bedaquiline increases effectiveness and more rapidly reduces the incidence of leprosy, compared to SDR-PEP alone.

Trial registration

NCT05597280. Protocol version 5.0 on 28 October 2022.
Clinicians’ experiences in signposting an online mental health resource to expectant mothers: a qualitative study
Authors: Saxild Sofie , Wilson Philip , de Voss Sarah , Overbeck Gritt
Published: May 2023

Background

Poor maternal mental well-being and a lack of secure parent-infant attachment, have been identified as important factors associated with adverse mental health outcomes later in a child’s life. Interventions designed to care for maternal mental well-being during pregnancy and early parenthood, are therefore likely to support healthy child development. Mentalization is a skill parents can practice, improving the emotional bond to the child, offering insights into their own and the child’s mental states and potentially improving parental mental well-being. Most pregnant women in Denmark schedule antenatal consultations in general practice, potentially offering a solid platform to promote web-based interventions aiming to enhance mentalization skills. Signposting towards online resources has several advantages including high accessibility, ease of distribution and cost-effectiveness. We aimed to explore the attitudes and experiences of clinicians in general practice in signposting women towards a web-intervention to increase parental mentalization skills.

Methods

The intervention was offered to pregnant women at their primary preventive antenatal consultation in Danish general practice around week eight of pregnancy, and was designed to be incorporated into the following antenatal- and pediatric consultations until the child’s second birthday. Semi-structured interviews about clinicians’ experiences with signposting the intervention were conducted with 11 general practitioners (GP), three practice midwives (MW) and one practice nurse (NR).

Results

Clinicians wanted to enhance the focus on mental well-being in pregnancy and early childhood during preventive consultations. The main barriers to signposting the web-program were decreasing motivation over time, lack of financial viability and time limitations. Utilizing a psychoeducational web-intervention was generally accepted by clinicians, but ideally not carried out solely in general practice.

Conclusion

Signposting web-programs to improve parental mentalization skills can be welcomed by clinicians in general practice but need to be more tailored to suit the everyday workflow of the clinics. Addressing parental mentalization remains largely unchartered territory for pregnant women and clinicians alike, therefore training clinicians on the subject and its presentation should be offered.

Trial registration

The study is part of a larger project that has been approved by the Research Ethics Committee at the University of Copenhagen, Nov. 2019 (reference number 504–0111/19–5000).
Unravelling the genetic basis of retinal dystrophies in Pakistani consanguineous families
Authors: Marwan Muhammad , Dawood Muhammad , Ullah Mukhtar , Shah Irfan Ullah , Khan Niamat , Hassan Muhammad Taimur , Karam Muhammad , Rawlins Lettie E. , Baple Emma L , Crosby Andrew H. , Saleha Shamim
Published: May 2023

Background

Retinitis Pigmentosa (RP) is a clinically and genetically progressive retinal dystrophy associated with severe visual impairments and sometimes blindness, the most common syndromic form of which is Usher syndrome (USH). This study aimed to further increase understanding of the spectrum of RP in the Khyber Pakhtunkhwa region of Pakistan.

Methodology

Four consanguineous families of Pashtun ethnic group were investigated which were referred by the local collaborating ophthalmologists. In total 42 individuals in four families were recruited and investigated using whole exome and dideoxy sequencing. Among them, 20 were affected individuals including 6 in both family 1 and 2, 5 in family 3 and 3 in family 4.

Result

Pathogenic gene variants were identified in all four families, including two in cone dystrophy and RP genes in the same family (PDE6C; c.480delG, p.Asn161ThrfsTer33 and TULP1; c.238 C > T, p.Gln80Ter) with double-homozygous individuals presenting with more severe disease. Other pathogenic variants were identified in MERTK (c.2194C > T, p.Arg732Ter), RHO (c.448G > A, p.Glu150Lys) associated with non-syndromic RP, and MYO7A (c.487G > A, p.Gly163Arg) associated with USH. In addition, the reported variants were of clinical significance as the PDE6C variant was detected novel, whereas TULP1, MERTK, and MYO7A variants were detected rare and first time found segregating with retinal dystrophies in Pakistani consanguineous families.

Conclusions

This study increases knowledge of the genetic basis of retinal dystrophies in families from Pakistan providing information important for genetic testing and diagnostic provision particularly from the Khyber Pakhtunkhwa region.
A case of two connected stents deployed during iStent inject W surgery
Authors: Shimada Ayaka , Ichioka Sho , Ishida Akiko , Kaidzu Sachiko , Tanito Masaki
Published: May 2023

Background

We report a case with two connected stents ejected simultaneously during an iStent inject W surgery, a modified second-generation iStent Trabecular Micro-Bypass System.

Case presentation

A 57-year-old woman with primary open-angle glaucoma underwent a combined cataract and iStent inject W surgery in her left eye. After the trabecular meshwork/Schlemm’s canal was pierced by the trocar of injector, the delivery button was pressed a first time, but the stent was not ejected. After the button was pressed a second time, connected two stents were ejected. After removing the dislocated stents from the anterior chamber, two stents were implanted into the desired places using another injector. Except for mild hyphema, no postoperative complication occurred. Stereomicroscopic observation showed that the two stents were connected by a broken trocar shaft. An X-ray showed that the trocar shaft was broken at the part referred to as the “sprayed trocar”. Scanning electron microscopy showed that the surface features of the broken trocar and trocar tip represented tensile failure.

Conclusions

Although rare, considering that the damage was seen at the structurally weak part (i.e., sprayed trocar), the same phenomenon can happen. For patient safety, surgeons are recommended to inspect the device when the deployment of either the first or second stent is unsuccessful during the iStent inject surgery.
Association between dating app use and unhealthy weight control behaviors and muscle enhancing behaviors in sexual minority men: a cross-sectional study
Authors: Tran Alvin , Darboe Mabintou , Goyal Anirudh , Birk Nick
Published: May 2023

Background

Body image concerns are prevalent and are viewed as risk factors for engaging in unhealthy weight control behaviors (UWCBs), such as purging, fasting, and the misuse of laxatives and diet pills. Studies have also linked UWCBs to the development of eating disorders. In the United States (U.S.), sexual minority men (e.g., bisexual, gay, and men who have sex with men) are prone to UWCBs often as a result of societal pressures to achieve certain standards of appearance – of which are often perpetuated through various media platforms. A growing number of studies have explored the possible role mobile dating applications (“dating apps”) play in contributing to UWCBs. To our knowledge, such studies have not explored this possible relationship between dating apps and UWCBs in sexual minority men (SMM). To fill this gap in the scientific literature, the present study assessed the association between dating app use and UWCBs and muscle enhancing behaviors among a sample of adult SMM in the U.S.

Method

549 SMM participated in an anonymous survey from Qualtrics Survey Panels. UWCBs and muscle enhancing behaviors were assessed through items adapted from national surveys. Body image dissatisfaction was assessed using the Male Body Attitudes Scales. Participants also reported their history of dating app use. We performed descriptive statistics, chi-square tests, and student’s t-tests. Multivariable logistic regression models assessed the relationship between dating app use and UWCBs and muscle enhancing behaviors.

Results

Dating app users had significantly higher body image dissatisfaction scores than non-users. Dating app users also demonstrated significantly elevated odds of engaging in four UWCBs and muscle enhancing behaviors: laxatives, diet pills, muscle-building supplements, and protein powders.

Conclusions

This is one of the first studies to assess dating app use and its association with UWCBs and muscle enhancing behaviors in SMM. Increased surveillance and detection for such behaviors among SMM, particularly those using dating apps, are needed.
Disease perception, impacts and coping strategies for onchocerciasis in Southeast Nigeria: a qualitative study among patients and program managers
Authors: Otache Adah E. , Ezenwosu Ifeyinwa L. , Ossai Edmund N. , Nwobi Emmanuel A. , Abah Stephen O. , Uzochukwu Benjamin SC.
Published: May 2023

Background

Onchocerciasis is a disease of public health concern due to the devastating consequences of the disease which impacts negatively on the lives of the people. The negative impact of the disease may affect its perception and lead to the adoption of some coping strategies. Therefore, understanding the disease perception, impacts and coping strategies used by onchocerciasis patients will help plan health interventions aimed at improving their general well-being.

Methods

This was a community-based study that employed a qualitative method through Key informant interviews (KII) with program managers and focus group discussions (FGD) among people who had Onchocerciasis. Four sessions of FGDs with a total of thirty-two (32) participants and eleven KIIs were conducted to ascertain their in-depth experience in five thematic areas.

Results

In these communities, onchocerciasis is perceived to have been caused mainly by the bite of blackflies. Other presumed causes by the patients included drinking polluted water, poor environmental sanitation and witchcraft. The disease had a significant detrimental influence on both the physical and financial aspects of life with limited emotional and social impacts. The long-term clinical manifestations of onchocerciasis triggered pain and insufficient mobility. Thus, onchocerciasis patients experienced impairment in normal daily life activities (farming, etc.), dependency, depression and inability to participate in social events. These manifestations stimulated various coping strategies, mainly, nodulectomy by traditional healers. Others included self-medication, taking an overdose of ivermectin, and the use of alcohol.

Conclusion

Misconceptions about the cause of onchocerciasis still exist among people with the disease. The consequences of the disease impact negatively on various aspects of their lives and stimulate various coping strategies. Therefore, health promotion messages to the public should aim at dispelling misconceptions about the disease and promote healthy coping strategies.
Platelet-rich plasma treatment for talar cartilage repair: a systematic review and meta-analysis
Authors: Peng Jialei , Wang Qian , Xu Yang , He Hongchen
Published: May 2023

Purpose

To systematically review the studies regarding to the safety, efficacy and application methods of PRP in promoting the talar cartilage repair.

Methods

A systematic review was performed by searching PubMed, Web of Science, OVID and EMBASE to identify studies that compared the clinical efficacy of PRP for talar cartilage repair. Main outcome was the American Orthopedic Foot and Ankle Society (AOFAS) score for function and Visual Analog Scale (VAS) for pain was the second outcome.

Results

A total of 10 studies were included in this systematic review, including 4 randomized controlled trials, 1 controlled trial, 3 case series and 2 cohort studies. Four RCTs were analyzed using meta-analysis. For all outcomes, statistical results favored PRP group (AOFAS: MD = 7.84; 95% CI= [-0.13, 15.80], I2 = 83%, P < 0.01; VAS: MD = 1.86; 95% CI= [0.68, 3.04], I2 = 85%, P < 0.01). There were almost no reports of adverse events related to PRP intervention. Subgroup analysis showed that whether PRP was used alone or combined with other treatments could result in high heterogeneity but no more specific factors were identified to contribute to this.

Conclusion

PRP is safe and effective for talar cartilage repair. In addition to the standardization of PRP preparation and application, it is necessary to distinguish the effects of PRP used alone or in combination with other treatments. In PRP studies, surgical treatment of talar cartilage repair remains the mainstream. The regulation of PRP in surgical applications are worth exploring. The most relative component is the mesenchymal stem cell because it is the only exposed chondrocyte precursor in the articular cavity whether it is microfracture or cell transplantation.

Trial registration

The study was registered in the PROSPERO International prospective register of systematic reviews (CRD42022360183).
Silicone ring tourniquet could be a substitute for a conventional tourniquet in total knee arthroplasty with a longer surgical field: a prospective comparative study in simultaneous total knee arthroplasty
Authors: Lee Tae sung , Park Kwan Kyu , Cho Byung Woo , Lee Woo-Suk , Kwon Hyuck Min
Published: May 2023

Introduction

This study aimed to compare the clinical outcomes of silicon ring tourniquets and conventional pneumatic tourniquets in total knee arthroplasty (TKA). The study compared the operation time, total bleeding amount, length from the tourniquet distal end to the patella superior pole (L_TP), and complications related to the two tourniquet application methods and attempted to determine whether the silicon ring tourniquet has advantages over conventional pneumatic tourniquets.

Materials and methods

This prospective comparative study included 30 patients who underwent bilateral simultaneous TKA for degenerative osteoarthritis in August to December 2021. All patients underwent TKA on one side with a conventional pneumatic tourniquet, while TKA on the other side with a silicon ring tourniquet. The primary outcomes were the L_TP, operation time, tourniquet time, total bleeding amount, total drainage amount, and postoperative visual analog scale (VAS) score of the tourniquet applied site at 6, 24, and 48 h postoperatively. The secondary outcome was tourniquet-related complications in both groups.

Results

L_TP was significantly longer in the silicon ring tourniquet group compared with that in the pneumatic tourniquet group (20.22 ± 2.74 cm versus 15.12 ± 2.40, p < 0.001). No significant difference was found in other results. The tourniquet applied site pain was less in the silicon ring tourniquet group (p = 0.037).

Conclusions

Silicon ring tourniquet application resulted in better clinical outcomes than conventional pneumatic tourniquets in TKA. Because we can obtain a wider surgical field using silicon ring tourniquets without complications, silicon ring tourniquets could be a substitute for conventional pneumatic tourniquets in total knee arthroplasty or distal femoral surgeries.
Comparison of the ALPS and PHILOS plating systems in proximal humeral fracture fixation – a retrospective study
Authors: Dewarrat Antoine , Terrier Alexandre , Barimani Bardia , Vauclair Frédéric
Published: May 2023

Background

Open reduction and plate osteosynthesis are considered as a successful technique for the treatment of proximal humerus fracture (PHF) despite high complication rates. The objective of our study was to review the clinical outcome and complications of the Anatomic Locking Plate System (ALPS) and compare it to the Proximal Humeral Internal Locking System (PHILOS). Our hypothesis was that ranges of motion (ROM) were superior and complication rates were lower with ALPS.

Methods

Twenty patients treated with ALPS for PHF were retrospectively compared to 27 patients treated with PHILOS. Union, ROM and complications were clinically and radiologically assessed at 6 weeks, 3, 6, 12 and 18–24 months post-operatively.

Results

Mean age was 52 ± 14 in the ALPS group and 58 ± 13 in the PHILOS group. Last follow-ups were conducted at a mean of 20.6 ± 4.8 months. Mean shoulder abduction was superior with ALPS by 14° (p-value = 0.036), 15° (p-value = 0.049), and 15° (p-value = 0.049) at 3, 6, and 12 months respectively. Mean shoulder external rotation was superior with ALPS by 11° (p-value = 0.032), 15° (p-value = 0.010) and 12° (p-value = 0.016) at 6 weeks, 3 and 6 months respectively. At the end of the follow-up, ROM remained better with ALPS, but not significantly. Complication rates over 21 months reached 20% with ALPS and 48% with PHILOS (p-value = 0.045). Implant removal rates reached 10% with ALPS and 37% with PHILOS (p-value = 0.036). Avascular necrosis was the only cause for hardware removal in the ALPS group.

Conclusion

The ALPS group showed better clinical outcomes with faster recovery in abduction and external rotation, although no difference in ROM remained after 21 months. Additionally, the complications rate was lower at last follow up. In our experience, the ALPS plating system is an effective management option in some PHF.