bluuebunny/crossref_metadata_2025 huggingface dataset:
Transcriptome Analysis and Functional Validation Identify a Putative bZIP Transcription Factor, Fpkapc, that Regulates Development, Stress Responses, and Virulence in Fusarium pseudograminearum
Authors: Zhao Jingya , Peng Mengya , Chen Wenbo , Xing Xiaoping , Shan Yixuan , Fan Zhuo , Shi Yan , Li Haiyang , Yang Xue , Li Honglian , Chen Linlin
Published: January 2022

Fusarium pseudograminearum is a soilborne, hemibiotrophic phytopathogenic fungus that causes Fusarium crown rot and Fusarium head blight in wheat. The basic leucine zipper proteins (bZIPs) are evolutionarily conserved transcription factors that play crucial roles in a range of growth and developmental processes and the responses to biotic and abiotic stresses. However, the roles of bZIP transcription factors remains unknown in F. pseudograminearum. In this study, a bZIP transcription factor Fpkapc was identified to localize to the nucleus in F. pseudograminearum. A mutant strain (Δfpkapc) was constructed to determine the role of Fpkapc in growth and pathogenicity of F. pseudograminearum. Transcriptomic analyses revealed that many genes involved in basic metabolism and oxidation-reduction processes were downregulated, whereas many genes involved in metal iron binding were upregulated in the Δfpkapc strain, compared with the wild type (WT). Correspondingly, the mutant had severe growth defects and displayed abnormal hyphal tips. Conidiation in the Fpkapc mutant was reduced, with more conidia in smaller size and fewer septa than in the WT. Also, relative to WT, the Δfpkapc strain showed greater tolerance to ion stress, but decreased tolerance to H2O2. The mutant caused smaller disease lesions on wheat and barley plants, but significantly increased TRI gene expression, compared with the WT. In summary, Fpkapc plays multiple roles in governing growth, development, stress responses, and virulence in F. pseudograminearum.
Parameter-Specific Morphing Reveals Contributions of Timbre to the Perception of Vocal Emotions in Cochlear Implant Users
Authors: von Eiff Celina I. , Skuk Verena G. , Zäske Romi , Nussbaum Christine , Frühholz Sascha , Feuer Ute , Guntinas-Lichius Orlando , Schweinberger Stefan R.
Published: January 2022

Objectives:

Research on cochlear implants (CIs) has focused on speech comprehension, with little research on perception of vocal emotions. We compared emotion perception in CI users and normal-hearing (NH) individuals, using parameter-specific voice morphing.

Design:

Twenty-five CI users and 25 NH individuals (matched for age and gender) performed fearful-angry discriminations on bisyllabic pseudoword stimuli from morph continua across all acoustic parameters (Full), or across selected parameters (F0, Timbre, or Time information), with other parameters set to a noninformative intermediate level.

Results:

Unsurprisingly, CI users as a group showed lower performance in vocal emotion perception overall. Importantly, while NH individuals used timbre and fundamental frequency (F0) information to equivalent degrees, CI users were far more efficient in using timbre (compared to F0) information for this task. Thus, under the conditions of this task, CIs were inefficient in conveying emotion based on F0 alone. There was enormous variability between CI users, with low performers responding close to guessing level. Echoing previous research, we found that better vocal emotion perception was associated with better quality of life ratings.

Conclusions:

Some CI users can utilize timbre cues remarkably well when perceiving vocal emotions.
The decision in severe upper-limb injuries: amputation or reconstruction? A retrospective case series
Authors: Anter Meselhy Mohammed , Halawa Abdelsamie M.
Published: January 2022

Background:

Large bone defects in the humerus that are associated with severe soft-tissue loss are a challenge. The aim of this study was to share the authors’ experience with the use of an Ilizarov apparatus in treating patients with severe open humeral fractures with large bone defects and soft-tissue compromise. The authors propose important prognostic factors for surgeons to consider when deciding on treating such cases.

Methods:

Sixteen patients with severely injured upper extremities with open humeral fractures associated with bone loss were treated with Ilizarov distraction osteogenesis in an attempt to salvage the limb. Trauma etiology were motor vehicle accidents in 12 patients and machine crushing injuries in four. All patients had open fracture Gustilo-Anderson grade IIIB. The mean bone loss was 10.67 cm (average, 5 cm to 19.5 cm). The radial nerve was completely lost at the site of injury or cut in all patients, the ulnar nerve was found in six patients, and the median nerves and brachial arteries were intact in all patients.

Results:

The mean age of patients was 31.1 yr (range, 21 to 42 yr). Twelve patients were men (75%). The left limb was injured in seven patients (43.75%), and all patients were right-hand dominant Average time of fixator use was 256.87 days, (range, 220 to 355). The mean follow-up period was 4.02 yr (range, 3 to 5 yr). At the end of the follow-up period, all sixteen limbs were salvaged, and bony union was achieved in all patients.

Conclusions:

In severely injured upper limbs, regardless of severity scores, the authors believe that reconstructive vascular impairment is the only reasons to carry out an amputation.

Level of Evidence:

Level IV.
Risk factors of major intraoperative bleeding and postoperative bleeding associated with endoscopic submucosal dissection for gastric neoplasms
Authors: Xu Shanshan , Chai Ningli , Tang Xiaowei , Linghu Enqiang , Wang Shasha
Published: January 2022

Background:

Endoscopic resection bleeding (ERB) classification was proposed by the authors’ team to evaluate the severity of intraoperative bleeding (IB) during endoscopic submucosal dissection (ESD). This study aimed to evaluate the application of ERB classification and to analyze the risk factors of major IB (MIB) and postoperative bleeding (PB) associated with ESD for gastric neoplastic lesions.

Methods:

We retrospectively enrolled a total of 1334 patients who underwent ESD between November 2006 and September 2019 at The First Medical Center of Chinese People's Liberation Army General Hospital. All patients were divided into the non-MIB group (including ERB-0, ERB-controlled 1 [ERB-c1], and ERB-c2) and the MIB group (including ERB-c3 and ERB-uncontrolled [ERB-unc]) according to the ERB classification. Risk factors of major MIB and risk factors of PB were analyzed using a logistic regression model.

Results:

Among the 1334 patients, 773 (57.95%) had ERB-0, 477 (35.76%) had ERB-c1, 77 (5.77%) had ERB-c2, 7 (0.52%) had ERB-c3, and no patients had ERB-unc. The rate of PB in patients with IB classifications of ERB-0, ERB-c1, ERB-c2, and ERB-c3 were 2.20% (17/773), 3.35% (16/477), 9.09% (7/77), and 2/7, respectively. In multivariate analysis, proximal location (odds ratio [OR]: 1.488; 95% confidence interval [CI]: 1.045–3.645; P = 0.047) was the only significant risk factor of MIB. Chronic kidney disease (CKD) (OR: 7.844; 95% CI: 1.637–37.583; P = 0.010) and MIB (ERB-c3) (OR: 13.932; 95% CI: 2.585–74.794; P = 0.002) were independent risk factors of PB.

Conclusions:

Proximal location of lesions was a significant risk factor of MIB. Additionally, CKD and MIB (ERB-c3) were independent risk factors of PB. More attention should be paid to these high-risk patients for MIB and PB.
Statins Accelerate Coronary Calcification and Reduce the Risk of Cardiovascular Events
Authors: Xinyu Zhang , Dongxia Miao , Yue Hu , Xiao Jie , Wang Lei , Xiaoping Ji
Published: January 2022

Lipid-lowering therapy with statins is well recognized as an effective therapy in reducing adverse cardiovascular events. However, the relationship between statin therapy and progression of coronary artery calcification (CAC) is unclear. A few of studies suggested that statins fail to slow and even accelerate progression of CAC; meanwhile, some researchers demonstrate opposite results. With the purpose of seeking out the effect of statin therapy on CAC, we summarized the existing evidence on statins and undertook meta-analyses of clinical trials assessing the effect of statin therapy on CAC. Fourteen trials were identified suitable for inclusion in the analysis of the effect of statin treatment on CAC, of which 11 were randomized controlled trails, 1 was case-control study, 1 was cross-sectional study, and 1 was observational study. In the meta-analysis of CAC progression, statin therapy seemed to accelerate the progression of CAC. Meanwhile, the analysis revealed a significant correlation between statin treatment and lower risk of cardiovascular events. In conclusion, meta-analyses of the available trials have shown a significant reduction of risk of cardiovascular events. In contrast, statins accelerated CAC. This suggests that statin-mediated atheroma calcification may enhance plaque stability and reduce the risk of plaque rupture.
Efficacy of Cognitive Behavioral Therapy in Heart Failure Patients: A Systematic Review and Meta-Analysis
Authors: Nso Nso , Emmanuel Kelechi , Nassar Mahmoud , Rezaei Bookani Kaveh , Antwi-Amoabeng Daniel , Alshamam Mohsen , Kondaveeti Ravali , Kompella Ritika , Lakhdar Sofia , Rizzo Vincent , Sorkin Miry , Munira Most Sirajum , Radparvar Farshid
Published: January 2022

Background:

Heart failure (HF) is a global disorder affecting around 6.2 million Americans aged 20 years and above. Neurovegetative disorders are common among such patients, and depression is a major problem that affects 20% to 40% of them. Cognitive behavioral therapy (CBT) is a type of treatment that produces the most favorable results compared to other psychotherapies, especially among patients with depression and anxiety. We aim to summarize and synthesize evidence regarding the efficacy of CBT for patients with HF.

Methods:

We conducted this study by searching PubMed, Scopus, and Web of Science for relevant studies about CBT use in patients with HF. The outcomes were pooled as mean difference (MD) or standard MD with a 95% CI. The analysis was performed using the RevMan software.

Results:

Combined data from 9 randomized controlled trials (1070 patients) revealed that CBT can alleviate both depression symptoms in HF patients when measured using different scales after 3 months of follow-up (standard MD, −0.18 [95% CI, −0.33 to −0.02]; P = 0.03) and the quality of life after 3 and 6 months of follow-up (MD, 4.92 [95% CI, 1.14–8.71]; P = 0.01 and MD, 7.72 [95% CI, 0.77–14.68]; P = 0.03, respectively).

Conclusion:

CBT is an effective type of psychotherapy for dealing with depression, mediocre quality of life, and defective physical functioning; therefore, it should be considered in HF patients’ care.
Painful Purulent Nodules Caused by Mycobacterium at Site of Lipodissolve Injections
Authors: Kaur Harsimran , Reyes-Barron Cynthia , Sipprell William H. , Cameron Andrew , Louie Ted , Tsai Peihsuan R. , Scott Glynis
Published: January 2022

“Lipodissolve” (LD) is a non–FDA-approved solution of phosphatidylcholine in deoxycholate that was developed around 2004. A study of its safety reported minor and uncommon side effects including pain, tender nodules, pigmentary alterations, and ulceration at the site of injection. We present a 53-year-old woman who received LD injections bilaterally to her proximal arms. One week later, she developed painful nodules at each injection site. She was treated with a 10-day course of trimethoprim/sulfamethoxazole without improvement. An incisional biopsy was performed and showed deep dermal suppurative inflammation with numerous neutrophils and granulomas. Stains for bacteria, fungus, and acid-fast organisms were negative. Cultures for acid-fast bacilli grew Mycobacterium abscessus, sensitive to amikacin and clarithromycin. The patient was subsequently treated with intravenous amikacin, azithromycin, and bedaquiline with symptom resolution. Investigation revealed 3 similar infections linked to LD injections originating from the same physician's office. The most common organism implicated in injection infections is Staphylococcus aureus. Infections at injection sites caused by atypical mycobacteria have been reported to occur after tattooing, other types of injections, and implants. Of atypical mycobacteria, M. abscessus accounts for the greatest number of postinjection or iatrogenic infections. Common antitubercular drugs are not effective for treating atypical mycobacteria, making species identification and sensitivity testing imperative for treatment. This case highlights an unusual infection caused by cosmetic injections of LD, previously reported to be associated with minimal side effects, and the importance of examination for acid-fast bacilli and follow-up with culture, even in the absence of organisms identified on stained sections.
Dermatologists' Impressions of Spontaneously Regressing Verruca Plana Histopathology
Authors: Choi Soo Hyun , Park Sujin , Kim Do-Young
Published: January 2022

Verruca plana in its regressing phase exhibits clinical and histological features distinct from classic verruca plana, but the ways in which these features should inform treatment plans are still under investigation. We conducted a retrospective single-center analysis of 25 patients with features of classic verruca plana, or plane warts, who exhibited self-remission within 4 weeks of skin biopsy. Measures included lesion sites, clinical findings preceding regression, and histological analysis. Histological analysis involved review by 2 dermatologists followed by impressions given by 4 board-certified dermatologists who were blinded to the clinical characteristics of the patients. Histopathological findings of regressing plane warts showed superficial perivascular infiltration (96%), spongiosis and exocytosis (84%), basal vacuolization (64%), parakeratosis (64%), apoptotic keratinocytes (60%), and lichenoid infiltration (44%). These findings were more compatible with the histological patterns of pityriasis lichenoides, lichen planus, and spongiotic eczema, rather than classic verruca plana. This suggests that regressing verruca plana may be included in the differential diagnosis of lesions exhibiting a lichenoid or spongiotic reaction, and observation may be a favorable treatment plan in these patients.
Therapeutic Effects of New Pulsed-Type Microneedling Radiofrequency for Refractory Facial Pigmentary Disorders
Authors: Park Byeong Jin , Jung You Jin , Ro Young Suck , Chang Sung Eun , Kim Jeong Eun
Published: January 2022

BACKGROUND

Numerous treatments for pigmentary disorders have been used with variable outcomes. Recently, a new radiofrequency (RF) device with minimal pulse duration has been introduced.

OBJECTIVE

The aim of this study was to evaluate the efficacy and safety of a pulsed-type microneedling RF device for treatment of facial pigmentary disorders.

METHODS

Forty-four patients diagnosed with facial melasma or Riehl melanosis received 5 treatments with RF at 2-week intervals, and evaluation was performed at each visits, including 4 and 8 weeks after the last treatment. Treatment outcomes were evaluated by investigator global assessment, patient global assessment score, and skin biophysical parameters of erythema index, melanin index (MI), and transepidermal water loss. Gene array and immunohistochemical staining including melan-A, Fontana silver, CD44, basic fibroblast growth factor (bFGF), and periodic acid–Schiff were performed.

RESULTS

Most of the patients showed clinical improvement. Erythema index, MI, and transepidermal water loss decreased after the first treatment. Histopathologic examination showed decrease of melanin pigment, melanophages, and blood vessel proliferation but thickened basement membrane after treatment. Expression of CD44 and b-FGF was decreased after treatment. There were no serious adverse events reported during the study.

CONCLUSION

Pulsed-type microneedling RF could be a treatment option for facial pigmentary disorders.
A Review of the Effect of the Intermediate Frequency Electromagnetic Fields on Female Reproduction
Authors: Mohammed Stephanie
Published: January 2022

The use of intermediate frequency (IF) fields in occupational equipment and domestic appliances is increasing dramatically. The World Health Organization consistently points out that there is a lack of scientific evidence to assess the reproductive risk in female species within the exposure limits as stated by the International Commission on Non-Ionizing Radiation Protection. The purpose of this review paper is to review the available literature on the effects of IF EMR on female reproduction in all species and to fully understand these effects. A literature review of experimental, epidemiological, in vivo, and in vitro literature from the 1800s to the present was conducted. Very few studies have been conducted on the effects of IF on female reproduction. The study of women in their workplace, laboratory rats and mice, and chicken embryos has yielded conflicting results on the dangers of IF. Some reports consider IF harmful during pregnancy, while other results show an insignificant (p < 0.05) correlation between the exposed group and the unexposed groups. The experiments conducted so far restrict several parameters such as field strength, frequency, and modulation to draw definitive conclusions. In two experiments, this frequency range is considered safe for non-invasive treatment of cancerous and noncancerous ovarian cells in the initial phase. Evaluation of the IF range on reproduction should be a priority for research. This review shows that there are few reports in this field, and they all contradict each other on whether the IF field is harmful or not. Nonetheless, IF is used in medicine to treat cancer and is currently being researched for non-cancerous cells. More comprehensive IF studies should be conducted to address the limitations in these summary studies.
Radium-223 Dichloride in Peritoneal Dialysate Following Treatment of Metastatic Castration-resistant Prostate Cancer
Authors: Saganich Christopher , Zgaljardic Michael
Published: January 2022

Radium-223 dichloride was administrated to a patient with castration-resistant metastatic prostate cancer (mCRPC) undergoing in-home peritoneal dialysis. The peritoneal dialysate and tubing sets were collected following four treatment cycles and analyzed for removable contamination, dose rate, and radioactivity. The purpose of the study was to assess radiation safety concerns and compare data with patients having normal renal function. Sixty-two liters of dialysate in 22 samples were collected over 4 mo. The mean surface dose rate of the dialysate bags was 0.16 μSv h−1 (range 0.11–0.23 μSv h−1). The highest measured removable surface activity was 150 dpm per 100 cm2. The mean cumulative percent of administered activity was 1.7% (range 1.4–1.9%). The mean concentration of 223Ra in dialysate was 4.0 kBq L−1 (range 0.56–14.1 kBq L−1). There was no association between the measured 223Ra activity in dialysate with peritoneal dwell time or the number of exchanges following administration. The measurement of the 211Bi and 223Ra ratio in the dialysate compared with a standard showed an increase of 23% by 40 h post administration. The data presented suggest that 223Ra dialysate can be safely managed in the home without risk of radiation dose or contamination if minimal precautions are taken. Patients with normal renal function have been shown to excrete up to six times more 223Ra in urine compared to those undergoing hemodialysis or peritoneal dialysis. A potential consequence may be an increase in 223Ra activity transiting GI tract leading to intestinal effects.
Intermediate Outcomes of Deep Sclerectomy in Juvenile Glaucoma
Authors: Alharbi Shaima S. , Al Obaida Ibrahim , Al Jadaan Ibrahim , Al Owaifeer Adi M.
Published: January 2022

Précis:

In this retrospective study of patients with predominantly severe juvenile open-angle glaucoma, deep sclerectomy (DS) achieved a success rate [defined as intraocular pressure (IOP) between 5 to 18 mm Hg] of 72% at 3 years.

Purpose:

The purpose of this study was to evaluate the safety and efficacy of DS in patients with juvenile open-angle glaucoma (JOAG).

Methods:

A retrospective chart review of all JOAG patients that underwent DS with mitomycin C at a tertiary care eye center during the period from May 2014 to May 2019.

Results:

A total of 50 eyes in 37 patients were included. The mean age at the time of surgery was 27.1±11.3 years and the majority of patients (86%) had a cup-disc ratio of 0.8 to 0.9. The mean duration of follow-up was 26.1±13.4 months (range 12 to 54 mo). Mean IOP was reduced from 26.1±13.4 mm Hg at baseline to 15.2±6.4 mm Hg at the last follow-up visit (P<0.01). Moreover, the mean number of glaucoma medications decreased from 3.8±0.5 at baseline to 0.8±1.2 at the last follow-up visit (P<0.01). The cumulative probabilities of overall success (defined as IOP between 5 and 18 mm Hg) at 12, 24, and 36 months were 94%, 85%, and 72%, respectively. Hypotony occurred in 4 eyes (8%), and in one of these patients, the final visual acuity was >2 lines worse compared with presentation. No other vision-threatening complications were encountered.

Conclusion:

DS in JOAG was safe and successfully controlled IOP in most patients for 3 years.
Comparison of the Structure-Function Relationship in Glaucoma Using Optical Microangiography in the Peripapillary Retinal Nerve Fiber Layer
Authors: Nakatani Yusuke , Sugiyama Kazuhisa
Published: January 2022

Précis:

Optical microangiography measurements correlated with functional parameters in glaucoma patients. Optical coherence tomography angiography–derived vessel perfusion density (VPD) better reflected the structure-function relationship than flux index (FI) and retinal nerve fiber layer thickness.

Purpose:

The purpose of this study was to compare the structure-function relationship between peripapillary optical microangiography (OMAG) measurements and standard automated perimetry (SAP) loss by comparison with peripapillary retinal nerve fiber layer (pRNFL) thickness in primary open-angle glaucoma.

Materials and Methods:

One eye from each of 128 patients with early-to-severe glaucoma (including preperimetric glaucoma) and 23 normal participants underwent optic nerve head scanning of the radial peripapillary capillaries and pRNFL scans with OMAG centered on the optic disc and SAP (mean age: 67.8±12.0 y; SAP mean deviation: −5.84±6.6 dB). Regional relationships between VPD, FI, pRNFL thickness, and corresponding SAP sensitivity were compared using linear and fractional polynomial (FP) models.

Results:

Structure was significantly related to function for all but the nasal pRNFL thickness region. For VPD, the coefficient of determination (R
2) using the FP model was significantly stronger than that of the linear model (FP: 0.25 to 0.67, linear: 0.19 to 0.61), while no difference was found for FI in any region (FP: 0.19 to 0.44, linear: 0.15 to 0.42). R
2 for VPD was stronger than FI and pRNFL (FP: 0.11 to 0.52, linear: 0.01 to 0.44) in inferior and superior regions, while VPD and FI were not different in temporal and nasal regions.

Conclusions:

VPD showed a stronger association with visual field loss than FI or retinal nerve fiber layer thickness except in the temporal region. The FI relationship was weak but more linear around the peripapillary region. The strength of the structure-function relationship may differ depending on the region of OMAG measurements.
Trabeculotomy Versus Combined Trabeculotomy-Trabeculectomy for Management of Primary Congenital Glaucoma
Authors: Yazdani Shahin , Pakravan Mohammad , Gerami Ebrahim , Doozandeh Azadeh , Esfandiari Hamed , Sharifipour Farideh
Published: January 2022

Précis:

Trabeculotomy (T) alone is as safe and effective as combined trabeculotomy-trabeculectomy (TT) in patients with primary congenital glaucoma (PCG) and requires significantly fewer examinations under anesthesia in the postoperative period.

Purpose:

The purpose of this study was to compare the outcomes of T and combined TT as the initial surgical procedure for patients with PCG.

Methods:

In this retrospective study, medical records of patients who had undergone T or TT as the initial procedure for PCG were reviewed. The primary outcome measure was a surgical success, defined as 5≤ intraocular pressure (IOP) ≤21 mm Hg, IOP reduction of at least 20% with no need for further glaucoma surgery. Secondary outcome measures were the number of glaucoma medications and complications.

Results:

A total of 134 eyes from 134 patients with a mean follow-up of 8±6.6 years were included consisting of 106 and 28 eyes, which had undergone T and TT, respectively. Success rates were comparable with both surgical procedures at 1, 2, 3, 4, and 5 years with no statistically significant difference. IOP was significantly decreased from 27.5±4.2 mm Hg preoperatively to 15.62±3.4 mm Hg at the 5-year follow-up visit in the T group and from 25.3±6.5 to 17.1±3.2 mm Hg in the TT group (P=0.1) there was no significant difference between the 2 groups in the number of glaucoma medications (P=0.2). Patients in the T group required significantly fewer examinations under anesthesia than the TT group (7.3±4.4 vs. 10.1±3.9, P=0.04).

Conclusion:

Trabeculotomy alone seems as effective as combined trabeculotomy-trabeculectomy and may significantly reduce exposure to anesthesia in primary congenital glaucoma patients.
Investigation of Amoxicillin Use in Fever Clinic Patients: Standardized Application of Antibiotics is Still Challenging
Authors: Yu Dong-Shan , Gao Zhen , Ai Mao-Xing , Wu Yu-Chan , Xi Wen-Na
Published: January 2022

Amoxicillin is widely used by the Chinese population and available in pharmacies without prescription. We performed a retrospective study on patients with fever who took amoxicillin before going to the fever clinic of the Second Affiliated Hospital of Nanchang University from March 1, 2020 to March 31, 2021. Among the total of 9093 patients attending the fever clinic, 446 patients had a history of taking amoxicillin, from which 100 cases were randomly selected to evaluate the therapeutic effects of non-prescribed amoxicillin by changes in clinical symptoms, counts of white blood cells, neutrophils, and lymphocytes, and levels of C-reactive protein (CRP). The control group consisted of 100 randomly selected patients for who it was verified that they did not take antibiotics before attending the fever clinic. Our study showed that there were no significant differences between the group of patients taking amoxicillin and the control group in terms of symptom improvement, white blood cell, neutrophil or lymphocyte counts, or the levels of CRP. Therefore, our study indicated that although non-prescribed amoxicillin is widely used among patients with fever, it does not provide significant beneficial therapeutic effects. There is still a long way to go to standardize the application of antibiotics and popularize knowledge on proper antibiotics use among the population.
The Intersectionality of HIV-Related Stigma and Tobacco Smoking Stigma With Depressive and Anxiety Symptoms Among Women Living With HIV in the United States: A Cross-sectional Study
Authors: Kim Sun S. , DeMarco Rosanna F.
Published: January 2022

This study examined the intersectionality of HIV-related stigma, tobacco smoking stigma, and mental health among women living with HIV who were daily smokers. This secondary analysis used baseline data from 2 pilot smoking cessation studies. Participants received either an HIV-tailored or an attention-control intervention focused on smoking cessation as an outcome. There were significant positive relationships between HIV-related stigma and depressive and anxiety symptoms. In contrast, tobacco smoking stigma had no significant relationship with either of the symptoms when HIV-related stigma was controlled. However, there was a significant interaction effect (β = 1.37, p = .02) of tobacco smoking stigma with internalized HIV-related stigma on anxiety symptoms. Tobacco smoking stigma worsened anxiety symptoms for women who had high internalized HIV-related stigma. Health care providers should understand the effect of HIV-related stigma on mental health and address the intersectionality of HIV-related stigma with other socially disapproved behaviors, such as tobacco smoking.
Influence of Clinical Instructor Experience on Assessing Doctor of Physical Therapist Student Clinical Performance: A Mixed-Methods Study
Authors: Rubertone Patricia P. , Nixon-Cave Kim , Wellmon Robert
Published: January 2022

Introduction.

Formative and summative feedback are essential for physical therapist students' professional growth. Achieving objectivity in student clinical assessment has been a longstanding concern for health care educators and ambiguity surrounds what is meant by competent clinical practice. According to a sociocultural perspective, clinical performance is socially constructed and based on an individual's perception of what is taking place, which may explain differences identified in the literature between novice and experienced assessors of student clinical performance. However, it is not known whether novice clinical instructors (CIs) differ from experienced CIs in their assessment practices of student physical therapists. The purposes of this study were to examine whether novice and experienced CIs' assessment practice differ and explore the reasons for these differences (if any).

Methods.

Novice and experienced CIs for physical therapist students' 3 full-time clinical education experiences served as participants for this study. A mixed-methods research design was used. In the quantitative phase, novice and experienced CI-assigned midterm and final student ratings of the Clinical Performance Instrument (CPI) were compared. In the qualitative phase, semi-structured interviews, document review, and participant observation were conducted.

Results.

Experienced CIs awarded higher ratings on the CPI than novice CIs, but ratings on only a few of the performance criteria were significantly different. Qualitatively, both novice and experienced CIs were similar in terms of the importance assigned to professional behavior and safety. However, novice CIs were more literal and concrete and experienced CIs were more flexible and varied. Three CI roles (CI as student, CI as clinician, and CI as assessor), CI self-confidence, reflection, context, assessor approach, and assessor agreement emerged as strong themes throughout.

Discussion and Conclusion.

The low number of statistically significant differences between novice and experienced CIs' awarding CPI ratings suggests that there were few true quantitative disparities between the assessors. Both study cohorts' backgrounds as former students and as current clinicians as well as their stage of CI professional development seem to have influenced their approach to clinical assessment.
Analysis of Hearing Preservation in Middle Cranial Fossa Resection of Vestibular Schwannoma
Authors: La Monte Olivia A. , Tawfik Kareem O. , Khan Usman , Schwartz Marc , Friedman Rick
Published: January 2022

Objective:

Describe the effect of preoperative hearing on the likelihood of hearing preservation after middle cranial fossa (MCF) approach for resection of vestibular schwannoma (VS) and the effect of hearing preservation on disease-specific quality of life (QOL).

Study design:

Retrospective chart review.

Setting:

Academic tertiary care skull base surgery program.

Patients:

Sixty three adult patients with preoperative word recognition score (WRS) ≥50% who underwent MCF resection of VS between 2017 and 2020.

Interventions:

All patients underwent MCF VS resection with attempted hearing preservation.

Main outcome measures:

Hearing preservation (postoperative WRS ≥50%), hearing-related Penn Acoustic Neuroma Quality of Life (PANQOL) score.

Results:

Sixty three patients with mean age 47.4 (±9.6) years and tumor size 11.5 (±0.5) mm were analyzed. Hearing was preserved (+HP) and lost (−HP) in 37 (58.7%) and 26 (41.3%) patients, respectively. Preoperatively, pure tone average audiometry was significantly lower among the +HP group (20.0 dB) versus −HP (31.0 dB, p < 0.003). WRS was higher among +HP versus −HP (94% vs. 84%, respectively; p < 0.002). Linear regression showed that intra- versus extra-canalicular tumor location, sudden hearing loss history, fundal fluid cap thickness, and tumor size had no relationship to hearing preservation outcomes. When evaluating postoperative QOL data (n = 37) hearing-related PANQOL score differed between +HP and −HP (t
35 = 2.458, p = 0.0191) groups.

Conclusions:

In this cohort of patients undergoing MCF resection of VS, rates of HP were higher for patients with excellent preoperative hearing. Postoperatively, +HP patients reported improved hearing-related PANQOL scores compared to −HP patients.
How Face Masks Interfere With Speech Understanding of Normal-Hearing Individuals: Vision Makes the Difference
Authors: Sönnichsen Rasmus , Llorach Tó Gerard , Hochmuth Sabine , Hohmann Volker , Radeloff Andreas
Published: January 2022

Objective:

To investigate the effects of wearing a simulated mask on speech perception of normal-hearing subjects.

Study Design:

Prospective cohort study.

Setting:

University hospital.

Patients:

Fifteen normal-hearing, native German speakers (8 female, 7 male).

Intervention:

Different experimental conditions with and without simulated face masks using the audiovisual version of the female German Matrix test (Oldenburger Satztest, OLSA).

Main Outcome Measure(s):

Signal-to-noise ratio (SNR) at speech intelligibility of 80%.

Results:

The SNR at which 80% speech intelligibility was achieved deteriorated by a mean of 4.1 dB SNR when simulating a medical mask and by 5.1 dB SNR when simulating a cloth mask in comparison to the audiovisual condition without mask. Interestingly, the contribution of the visual component alone was 2.6 dB SNR and thus had a larger effect than the acoustic component in the medical mask condition.

Conclusions:

As expected, speech understanding with face masks was significantly worse than under control conditions. Thus, the speaker's use of face masks leads to a significant deterioration of speech understanding by the normal-hearing listener. The data suggest that these effects may play a role in many everyday situations that typically involve noise.
Long-term Prognosis of Vertigo Attacks and Health-related Quality of Life Limitations in Patients With Vestibular Paroxysmia
Authors: Hanskamp Lise A. J. , Schermer Tjard R. , van Leeuwen Roeland B.
Published: January 2022

Objective:

To explore the long-term course of outcomes in vestibular paroxysmia (VP).

Study design:

Cross-sectional observational study with a retrospective collection of baseline data.

Setting:

Tertiary referral center.

Patients:

Adult patients who visited the Apeldoorn Dizziness Center between 2010 and 2020 and were diagnosed with definite or probable VP according to the Bárány Society criteria were contacted by telephone to complete a study-specific questionnaire. Baseline data were retrospectively collected from patients electronic medical records to allow comparison between baseline and follow-up data.

Main outcome measures:

Vertigo attack frequency, use of carbamazepine and health-related quality of life (HRQoL) limitations were the primary outcomes. Secondary outcomes were the number of attack-free years and perceived effect of medication for VP.

Results:

Seventy three patients were included, 61 (84%) of whom agreed to participate in the follow-up study. Mean age was 55.0 (SD 13.1) years, 49.2% were females. Mean follow-up was 3.4 years (range 0.4–11.3). At follow-up, 44 responders (72%) still experienced vertigo attacks. Average attack frequency in the past 6 months was 307 (SD 451) at baseline and 153 (SD 279) at follow-up (p = 0.050). At follow-up, 19.7% (n = 12) of the responders reported to use or have used carbamazepine, 58% of patients who (had) used this medication reported a positive perceived effect. Overall, 71% (n = 31) of the responders reported to have limitations in one or more HRQoL items due to their VP.

Conclusion:

Our study shows a rather unfavorable prognosis in patients with VP in terms of vertigo attacks and HRQoL limitations. After the initial diagnosis follow-up is warranted to monitor clinical outcomes in these patients.
Clinical Factors Associated With Positive Stool PCR for Gastrointestinal Pathogens in Celiac and Inflammatory Bowel Disease
Authors: Varma Sanskriti , Green Peter H. , Krishnareddy Suneeta
Published: January 2022

Goals:

We aimed to identify the clinical factors of celiac disease (CeD) and inflammatory bowel disease (IBD) associated with positive stool gastrointestinal (GI) polymerase chain reaction (PCR) test.

Background:

Understanding the pattern of enteric infections in CeD and IBD may allow further insight into microbiome-mediated pathogeneses.

Study:

This was a retrospective study of adult patients (age 18 y or above) with CeD and IBD at a large quaternary care institution. We identified patients with CeD or IBD who underwent stool GIPCR evaluation as outpatients (office visit or at endoscopy) between March 2015 and March 2019. Patients with a negative GIPCR test within the study time frame were randomly chosen as controls (1 : 1). The independent relationship between clinical characteristics and positive GIPCR was evaluated using multivariable logistic regression.

Results:

A total of 266 patients met criteria for the study, including 92 (35%) with CeD and 174 (65%) with IBD. On multivariable analysis of factors associated with positive GIPCR test, CeD patients were more likely to have diarrheal presentation of illness [odds ratio (OR): 2.61, 95% confidence interval (CI) 1.05-6.72], experience extraintestinal manifestations (OR: 2.49, 95% CI: 1.01-6.31), and practice a gluten-free diet for at least 5 years (OR: 4.00, 95% CI: 1.36-11.67), relative to those with a negative GIPCR test. IBD patients with positive GIPCR were more likely to be on corticosteroids (OR: 2.23, 95% CI: 1.02-5.4.84), experience extraintestinal manifestations (OR: 2.60, 95% CI: 1.22-5.53), and use proton-pump inhibitors (OR: 4.07, 95% CI: 1.69-9.77).

Conclusions:

Intestinal infections in CeD and IBD are associated with important disease-specific characteristics.
Association of Bolus Transit Time on Barium Esophagram With Esophageal Peristalsis on High-resolution Manometry and Nonobstructive Dysphagia
Authors: Razia Deepika , Trahan Amy , Hu Chengcheng , Giulini Luca , Bremner Ross M. , Mittal Sumeet K.
Published: January 2022

Goal:

The goal of this study was to correlate upright and prone bolus transit time (BTT) on barium esophagography (BE) with esophageal peristalsis on high-resolution manometry (HRM) and self-reported dysphagia in patients with normal lower esophageal sphincter parameters on HRM.

Background:

BTT on BE could be the gold standard for assessing the effectiveness of esophageal peristalsis if it can be quantified.

Materials and Methods:

Patients with normal lower esophageal sphincter parameters and standard-protocol BE from 2017 to 2020 were included. Patients were divided, based on the number of normal swallows (distal contractile integral >450 mm Hg-s-cm), into 11 groups (10 normal swallows to 0 normal swallows). Liquid barium swallows in prone position were objectively evaluated for prone BTT. Patients reported difficulty in swallowing on a scale from 0 (none) to 4 (very severe). Fractional polynomial and logistic regression analysis were used to study the association (along with the rate of change) between BTT, peristalsis, and dysphagia.

Results:

A total of 146 patients were included. Prone BTT increased as the number of normal swallows decreased (P<0.001). Two deflection points were noted on the association between peristalsis and prone BTT at 50% normal swallows, 40 seconds and 30% normal swallows, 80 seconds, after which peristaltic function declined independently of prone BTT. Patients with prone BTT>40 seconds had nearly 6-fold higher odds of 0% normal swallows on HRM than patients with prone BTT<40 seconds (P=0.002). Increasing prone BTT was associated with increasing dysphagia grades 1 and 2 (P≤0.036).

Conclusions:

Esophageal motility can be quantified by BE. Prone BTT correlates with the proportion of normal esophageal swallows and dysphagia.
Derivation and Validation of a Model to Predict Clinically Significant Portal Hypertension Using Transient Elastography and FIB-4
Authors: Banini Bubu A. , Patel Samarth , Yu Jonathan W. , Kang Le , Bailey Christopher , Strife Brian J. , Siddiqui Mohammad S. , Patel Vaishali , Matherly Scott C. , Lee Hannah , Lewis Shawn , Cherian Reena , Stravitz Richard T. , Luketic Velimir , Sanyal Arun J. , Sterling Richard K.
Published: January 2022

Background:

Liver biopsy and hepatic venous pressure gradient (HVPG), the gold standard for assessing advanced fibrosis (AF) and clinically significant portal hypertension (CSPH), are invasive, costly, and time-consuming.

Goal:

We investigated if the combination of fibrosis index based on 4 factors (FIB-4) and liver stiffness measure (LSM) can identify AF and more importantly, CSPH.

Patients and Methods:

Patients with chronic liver disease referred for transjugular liver biopsy were analyzed retrospectively. FIB-4 and LSM were compared with liver histology for diagnosing AF. FIB-4, LSM, and platelet count were compared with HVPG for diagnosing CSPH. Optimal cutoffs for predicting CSPH were determined by grid search. A composite log-odds to predict CSPH was derived from logistic regression using LSM, FIB-4, and gender. Internal bootstrap validation and external validation were performed.

Results:

A total of 142 patients were included in the derivation; 42.3% had AF, and 11.3% had CSPH using the current gold standards. The area under the receiver operating characteristic curve (AUROC) for LSM, FIB-4, and their combination to predict AF were 0.7550, 0.7049, and 0.7768, respectively. LSM, FIB-4, and platelet count predicted CSPH with AUROC 0.6818, 0.7532, and 0.7240, respectively. LSM plus FIB-4 showed the best performance in predicting CSPH with AUROC 0.8155. Based on LSM, FIB-4, and gender, a novel model—the Portal Hypertension Assessment Tool (PHAT)—was developed to predict CSPH. PHAT score ≥−2.76 predicted CSPH with sensitivity 94%, specificity 67%, positive predictive value 27%, negative predictive value 99%, and accuracy 70%. In internal and external validation, AUROCs for the model were 0.8293 and 0.7899, respectively.

Conclusion:

A model consisting of FIB-4, LSM, and gender can identify CSPH among patients with chronic liver disease.
Increasing Prevalence and Racial Disparity of Alcohol-Related Gastrointestinal and Liver Disease During the COVID-19 Pandemic
Authors: Damjanovska Sofi , Karb Daniel B. , Cohen Stanley M.
Published: January 2022

Objectives:

One consequence of social distancing during the coronavirus disease 2019 (COVID-19) pandemic was an increase in alcohol use disorders. We postulated that this would be associated with a rise in alcohol-related gastrointestinal and liver disease.

Methods:

Using Explorys Inc., an aggregate of electronic health records from US health care systems from 1999 to June 2021, we identified patients with “alcoholic hepatitis,” “inflammation of pancreas caused by alcohol,” and “alcoholic gastritis,” based on Systematized Nomenclature of Medicine—Clinical Terms (SNOMED-CT). We compared patients utilizing health care during the pandemic to those before it.

Results:

We identified 8,445,720 patients treated from June 21, 2020 to June 20, 2021 (“COVID cohort”) and 65,587,860 patients treated before this (“pre-COVID cohort”). African American patients were more likely to be treated for all causes during COVID-19 [odds ratio (OR): 1.65; P<0.0001]. Alcoholic hepatitis (OR: 2.77), alcoholic pancreatitis (OR: 3.67), and alcoholic gastritis (OR: 1.70) (for each, P<0.0001) were more likely in all patients in the COVID cohort. African Americans in the COVID cohort were more likely to be diagnosed with alcoholic hepatitis (OR: 2.63), alcoholic pancreatitis (OR: 2.17), and alcoholic gastritis (OR: 3.09) [for each, P<0.0001].

Conclusions:

The prevalence of alcohol-related liver and gastrointestinal disease increased during COVID-19. We suspect these increases are associated with increased alcohol use disorder resulting from the stress of social isolation. These data suggest COVID-19 disproportionately affected African Americans in overall health care utilization and increased burden of alcoholic gastrointestinal and liver disease.
A Radio-Odontometric Analysis of Sexual Dimorphism in First Molars Using Cone-Beam Computed Tomography
Authors: Paknahad Maryam , Dokohaki Sonia , Khojastepour Leila , Shahidi Shoaleh , Haghnegahdar Abdolaziz
Published: January 2022

Objective

Different techniques for sex prediction are developed and used in the forensic medicine field. One of these methods is based on the teeth morphometry. The aim of the present study was to evaluate the degree of sex determination of the maxillary and mandibular first molar teeth in cone beam computed tomography images.

Method and Materials

This study was carried out on cone beam computed tomography images of 100 men and 100 women with a mean age of 21.28 ± 2.47 years. The roof, floor and height of pulp chamber, as well as marginal enamel thickness and dentin thickness at the height of contour, tooth width, and crown length were measured. Student t test and discriminant analysis were applied to assess the differences in the measured parameters between men and women.

Results

According to the present study, the maxillary first molar was more dimorphic than the mandibular teeth. The accuracy of sex identification of mandibular and maxillary first molar tooth was 84% and 77%, respectively. The mesiodistal measured variables were more accurate in sexual differentiation than the buccolingual ones. For sex differentiation, the most dominant variables for maxillary and mandibular first molar teeth were crown height and dentin thickness, respectively.

Conclusions

The first molar tooth showed an acceptable level of sex determination accuracy based on the odontometric measurements.
Fatigue is associated with worse cognitive and everyday functioning in older persons with HIV
Authors: Campbell Laura M. , Sun-Suslow Ni , Heaton Anne , Heaton Robert K. , Ellis Ronald J. , Moore David J. , Moore Raeanne C.
Published: January 2022

Objective:

The aim of this study was to determine whether there are relationships between fatigue, cognition, and everyday functioning in older persons with and without HIV and to examine if associations remain after accounting for depression, anxiety, and sleep quality.

Methods:

Sixty-nine persons with HIV (PWH) and 36 persons without HIV, aged 50–74 years, were recruited from ongoing studies at UC San Diego's HIV Neurobehavioral Research Program and from the community. Participants completed neuropsychological testing, a performance-based measure of everyday functioning, and self-report questionnaires of fatigue, depression, anxiety, sleep quality, and everyday functioning. Multivariable linear regressions and logistic regressions stratified by HIV serostatus were used to examine relationships between fatigue, cognition, and everyday functioning. Psychiatric symptoms and sleep quality were examined as covariates.

Results:

In this cross-sectional study, PWH had significantly greater fatigue than the HIV-negative group (g 
= 0.83; P < 0.01). When stratifying by HIV serostatus, greater fatigue was significantly associated with worse global cognition (β = −0.56;P < 0.01) in PWH even when controlling for covariates;however, fatigue was not significantly associated with global cognition in persons without HIV. In PWH and when accounting for covariates, fatigue was also associated with greater risk of self-reported everyday functioning impairment [odds ratio (OR) = 1.66 for 10-point increase in fatigue, P 
= 0.04] but not performance-based everyday functioning (P = 0.95).

Conclusion:

Fatigue is associated with cognition, particularly measures with a speeded component, and self-reported everyday functioning in older PWH. Findings suggest that fatigue is important to assess and consider in the context of aging with HIV.