bluuebunny/crossref_metadata_2025 huggingface dataset:
Severe hypertriglyceridemia as a cause of necrotizing pancreatitis in a pediatric patient with familial hyperchylomicronemia syndrome: A case report
Authors: Valenzuela-Vallejo Laura , Meléndrez-Vásquez Daniela , Durán-Ventura Paola , Rivera-Nieto Carolina , Lema Adriana , Fernandez Monica
Published: July 2022

Familial hyperchylomicronemia syndrome is a monogenic autosomal recessive disorder that causes severe and refractory hypertriglyceridemia. This uncommon condition is challenging to diagnose and treat and can lead to comorbidities such as acute pancreatitis. Although treatment options are limited in the pediatric population, strict diets and treatments approved for other dyslipidemias may be implemented in familial hyperchylomicronemia syndrome, given the lack of pharmacological interventions available. We report a 14-year-old female presented to the emergency room with abdominal pain suggestive of acute pancreatitis. Biochemical analysis revealed a triglyceride value of 4260 mg/dL. Treatment for triglyceride reduction with a strict CHILD-2 triglyceride-lowering diet, insulin infusion, fibrates, and multiple plasmapheresis were initially insufficient. Primary hypertriglyceridemia was suspected, and genetic testing identified a homozygous pathogenic variant in the lipoprotein lipase gene, diagnosing familial hyperchylomicronemia syndrome. She was discharged with a maximum dose of fibrate, statin, omega-3 fatty acids, and a restrictive diet. At her 1-month and 9-month follow-ups, her triglyceride values were 756 and 495 mg/dL, respectively, without incident complications. Familial hyperchylomicronemia syndrome is an uncommon condition with limited available literature and treatment options, especially in the pediatric population. Acute pancreatitis secondary to severe hypertriglyceridemia is a condition with a high risk of mortality which requires prompt clinical suspicion and treatment.
Learning by Researching: Achievements and Actions of Teacher Learning in a School–University Collaborative Project
Authors: Wei (魏戈) Ge , Chung (钟启旸) Chi-yang
Published: July 2022

Purpose

This study explores the achievements and process of a group of Chinese primary school teachers learning from a research-based school–university collaborative project.

Design/Approach/Methods

We used qualitative methods to construct our research design, collecting data through participatory observations of weekly meetings, teacher interviews, and participants’ reflective journals. Both thematic analysis and discursive analysis were employed as strategies to scrutinize the data.

Findings

We categorize teachers’ learning into five achievements: outcome, processual, democratic, catalytic, and dialogic achievement. A further examination highlights seven successive learning actions composing an implicit mechanism to facilitate these achievements: questioning, analyzing, modeling, examining, implementing, reflecting, and consolidating.

Originality/Value

Through this longitudinal study, we more comprehensively record details about teachers’ learning as they conduct their own research. Although school–university heterogeneous collaboration has potential conflicts, teachers can improve their problem-solving and knowledge creation and sharing abilities, promoting a sense of professional accomplishment. These findings also suggest the need to reconsider the authentic process of teacher research, a task equally significant for international educators.
The Impact of Hydropower Energy in Malaysia Under the EKC Hypothesis: Evidence From Quantile ARDL Approach
Authors: Jahanger Atif , Yu Yang , Awan Ashar , Chishti Muhammad Zubair , Radulescu Magdalena , Balsalobre-Lorente Daniel
Published: July 2022

The present study investigates the impact of economic growth, hydropower generation, and urbanization on Malaysia’s CO2 emissions. This study applies Quantile Autoregressive Lagged (QARDL) technique for the period of 1965Q1 to 2018Q4. The Granger-causality in quantiles is applied to confirm the causal nexus among the modeled variables. The outcomes demonstrate that hydropower generation decreases the detrimental effects of CO2 emissions at the range of high quantile levels. Furthermore, urbanization, except for higher quantiles, exhibits negative impacts on CO2 emissions. Also, the QARDL coefficients confirm the presence of the Environmental Kuznets Curve hypothesis from median to higher quantiles. Besides, the Granger-causality test confirms the two-way causality among CO2 emissions and hydropower generation in Malaysia’s economy and the same for the other series. The policymakers should enhance the market attractiveness of hydropower generation projects through incentives for the investors.
Acute Vertebral Fractures in Skiing and Snowboarding: A 20-Year Sex-Specific Analysis of National Injury Data
Authors: Huffman William H. , Jia Lori , Pirruccio Kevin , Li Xinning , Hecht Andrew C. , Parisien Robert L.
Published: July 2022

Background:

The epidemiology of acute vertebral fractures (AVFs) sustained while skiing and snowboarding remains poorly defined in the United States.

Hypothesis:

It was hypothesized that there would be no significant differences across sex and a greater number of AVFs in younger age groups associated with skiing and snowboarding.

Study Design:

Descriptive epidemiological study.

Methods:

The authors utilized the National Electronic Injury Surveillance System to identify patients who were reported in emergency departments in the United States from 2000 to 2019. All patients were noted to have sustained AVFs during skiing or snowboarding. National estimates and demographic analysis were performed.

Results:

A total of 466 AVFs were identified, or roughly 23.3 AVFs per year. Compared with women, men accounted for the majority of AVFs sustained in both skiing and snowboarding: 67.8% (95% CI, 62.6%-73.0%) during skiing and 82.1% (95% CI, 76.3%-87.8%) during snowboarding. This represented a significantly larger percentage of AVFs while snowboarding compared with skiing ( P = .002). Women accounted for 32.2% (95% CI, 27.0%-37.4%) of AVFs while skiing and 17.9% (95% CI, 12.2%-23.7%) while snowboarding, which indicated a significantly larger percentage of AVFs sustained during skiing compared with snowboarding ( P = .002). Snowboarders were more likely than skiers to sustain an AVF in the region of the coccyx (21.5% [95% CI, 14.3%-28.7%] vs 11.5% [95% CI, 3.5%-16.9%], respectively; P = .003) and as a result of a fall at ground level (69.2% [95% CI, 62.1%-76.4%] vs 52.8% [95% CI, 43.2%-62.4%], respectively; P = .009). A significant decrease in the number of snowboarding-related AVFs was identified over the 20-year study period: 899 in 2000-2003 versus 283 in 2016-2019 ( P < .01). The change in skiing-related AVFs over the study period was not statistically significant (694 vs 462; P = .5).

Conclusion:

This national study of AVFs sustained while skiing and snowboarding identified critical sex- and age-specific differences in the population at risk, anatomic location of injury, and mechanism of injury. The national data generated from this study over a 20-year period may be utilized to better inform public health injury awareness and prevention initiatives in the rapidly growing sports of skiing and snowboarding.
Assessment of Social Trust in Relatives of Discharged Patients With Personal Consent and Other Relatives of Patients
Authors: Bagi Hamid Reza Moretza , Khamnian Zhila , Hatami Forough , Vahdati Samad Shams , Yazdani Reza , Rahnemayan Sama
Published: July 2022

Lack of social trust in the physician–patient relationship will disrupt health. Since social trust has not been sufficiently studied in patients' companions, this study investigates and compares social trust and its dimensions in companions of patients discharged against medical advice with total patients’ companions in the emergency room. In this cross-sectional descriptive-comparative study, 385 patients’ companions were enrolled. This study was done by a questionnaire with five subscales: honesty, frankness, cooperative tendency, confidence, and trust. Data were analyzed using descriptive statistics and analytical statistics methods. In this study, there was no significant difference between the mean score of social trust between companions of patients discharged against medical advice (61.11 ± 9.01) and patients discharged after treatment (62.27 ± 6.97). There was a significant relationship between the mean score of the 2 groups only in the frankness domain ( P-value = .001). The level of social trust in the patients’ companions was moderate in both groups. Companions of discharged patients after completing the treatment process are more explicit than the companions of patients discharged against medical advice.
Changes in ocular pulse amplitude and posterior ocular structure parameters in type 1 diabetic children without diabetic retinopathy
Authors: Asik Abdulvahit , Bolu Semih , Direkci Ilke , Aydemir Emre , Aydemir Gozde Aksoy
Published: July 2022

Background:

It is important to determine changes in posterior ocular structures in the early period before retinopathy develops in pediatric patients with type 1 diabetes mellitus (DM).

Objective:

To evaluate inner plexiform layer (IPL), ganglion cell layer (GCL), and retinal nerve fiber layer (RNFL) thicknesses, as well as the relationship between choroidal thickness (CT) and ocular pulse amplitude (OPA) in type 1 diabetic children without diabetic retinopathy (DR).

Design:

A prospective observational study.

Methods:

Group 1 ( n = 44) consisted of pediatric patients with type 1 DM without DR, and Group 2 ( n = 65) of pediatric control subjects. Both intraocular pressure (IOP) and OPA were measured using a dynamic contour tonometer. CT, IPL, GCL, and RNFL were all measured using spectral domain optical coherence tomography (OCT).

Results:

The mean IOP and OPA values were 16.67 ± 2.34 and 1.85 ± 0.34, respectively, in group 1, and 15.14 ± 2.17 and 1.65 ± 0.25 in Group 2 ( p = 0.001 for both). The mean subfoveal CT value was 294.30 ± 67.61 μm in group 1 and 394.42 ± 69.65 μm in Group 2 ( p < 0.001). The mean GCL and RNFL values were 1.09 ± 0.11 and 96.46 ± 11.69, respectively, in group 1, and 1.14 ± 0.09 and 101.73 ± 9.33 in Group 2 ( p = 0.005 and p = 0.008, respectively).

Conclusions:

IOP and OPA values were higher, and CT, GCL, and RNFL values were lower in children with type 1 DM during the early stages than in the healthy control group. These findings suggest that CT may be a marker of retinal involvement in children with type 1 DM without DR.
“Scopen” Scope to Open Hamstring Repair
Authors: Sivasundaram Lakshmanan , Hevesi Mario , Rice Morgan W. , Paul Katlynn M. , Salata Michael J. , Mather Richard C. , Chahla Jorge , Nho Shane J.
Published: July 2022

Background:

Hamstring injuries at the musculotendinous junction are relatively common. However, injuries to the proximal hamstring account for just 12% of hamstring injuries. Surgical repair of these injuries including both open and endoscopic techniques are becoming increasingly more common.

Indications:

Surgical intervention is generally reserved for cases with 2 or more torn tendons and at least 2 centimeters of retraction.

Technique Description:

The combined open and endoscopic technique utilizes direct posterior and posterolateral portals. After visualizing the posterior femoral cutaneous (PFCN) and sciatic nerves (SN), the proximal hamstring tear is identified, and the shaver is used to remove any surrounding adhesions and aid in clearing any hematoma. The ischial tuberosity is prepared using a shaver, radiofrequency ablation, and a 5.5 mm, round arthroscopic burr. Two, 4.5 mm, doubled-loaded anchors are placed into the ischium. The incision for the open portion of the case is created by incising the skin between the direct posterior and posterolateral portals. A dissection is continued down to the gluteal fascia, and the gluteal fascia is incised in line with the surgical incision. The gluteus maximus is retracted then the hamstring stump is secured with a stay suture and brought outside the surgical incision for inspection. The double-loaded sutures are passed in a running locking technique. The other suture limbs are then passed through the central aspect of the tendon and tensioned to reduce the proximal hamstring onto the prepared tuberosity.

Results:

Significant postoperative improvements in patient-reported outcomes have been reported for open and endoscopic repairs in isolation, but to date there are no outcomes studies on the combined “Scopen” technique. Postoperative complications may include numbness or neuropraxia, re-rupture, infection, and deep vein thrombosis (DVT).

Discussion:

The endoscopic portion allows an improved view and preservation of the SN and PFCN, as well as a detailed view of the ischial tuberosity for decortication and anchor placement in comparison with a purely open approach. In comparison with a purely endoscopic approach, this combined approach can be used in patients with retraction >4 cm, and can also be utilized for chronic, retracted tears as well.
A Retrospective Case-Series of Patient-Reported Response to Ultrasound-Guided Corticosteroid Injection of the Long Head of Biceps Tendon in Orthopedic Surgery
Authors: Quintero Daniel , Singer Adam , Greif Dylan N. , Baraga Michael , Perez Jose , Jose Jean
Published: July 2022

Objective:

Identify factors predictive of therapeutic success following ultrasound-guided sheath injection of the long head of the biceps tendon.

Materials and Methods:

A total of 162 cases were divided into three groups based on clinical responses: complete, partial, or no relief. The presence or absence of clinical symptoms, glenohumeral joint structural pathology, and treatment method was compared.

Results:

Of the 115 injections with follow-up, 19.1% reported no clinical response while 53.0% had a complete response. Patients with fibromyalgia or chronic spine pain were strongly associated with a poor outcome (odds ratio [OR] = 5.7, P < .001).

Conclusion:

Ultrasound-guided intra-sheath injection is an effective method of non-surgical management for biceps tendinopathy.
Longer-term benefit of luspatercept in transfusion-dependent lower-risk myelodysplastic syndromes with ring sideroblasts
Authors: Zeidan Amer M. , Platzbecker Uwe , Garcia-Manero Guillermo , Sekeres Mikkael A. , Fenaux Pierre , DeZern Amy E. , Greenberg Peter L. , Savona Michael R. , Jurcic Joseph G. , Verma Amit K. , Mufti Ghulam J. , Buckstein Rena , Santini Valeria , Shetty Jeevan K. , Ito Rodrigo , Zhang Jennie , Zhang George , Ha Xianwei , Backstrom Jay T. , Komrokji Rami S.
Published: July 2022

Luspatercept is an approved therapy for selected patients with lower risk myelodysplasia requiring transfusion despite erythropoiesis-stimulating agents, based on the early results of a randomized trial against placebo. Zeidan and colleagues report that after a median of 26 months follow-up, 27% of patients commencing luspatercept were continuing therapy. Their updated analyses confirm that a significant minority (45%) of eligible patients can achieve transfusion independence, with a median durability of 30 weeks. These longer follow-up data better quantify the incremental benefit of luspatercept over placebo.
Screening of xylose utilizing and high lipid producing yeast strains as a potential candidate for industrial application
Authors: Qvirist Linnea , Mierke Friederike , Vazquez Juarez Ricardo , Andlid Thomas
Published: July 2022

Background

Sustainable production of oil for food, feed, fuels and other lipid-based chemicals is essential to meet the demand of the increasing human population. Consequently, novel and sustainable resources such as lignocellulosic hydrolysates and processes involving these must be explored. In this paper we screened for naturally-occurring xylose utilizing oleaginous yeasts as cell factories for lipid production, since pentose sugar catabolism plays a major role in efficient utilization of lignocellulosic feedstocks. Glycerol utilization, which is also beneficial in yeast-based oil production as glycerol is a common by-product of biodiesel production, was investigated as well. Natural yeast isolates were studied for lipid accumulation on a variety of substrates, and the highest lipid accumulating strains were further investigated in shake flask cultivations and fermenter studies on xylose and hydrolysate.

Results

By collecting leaves from exotic plants in greenhouses and selective cultivation on xylose, a high frequency of oleaginous yeasts was obtained (> 40%). Different cultivation conditions lead to differences in fatty acid contents and compositions, resulting in a set of strains that can be used to select candidate production strains for different purposes. In this study, the most prominent strains were identified as Pseudozyma hubeiensis BOT-O and Rhodosporidium toruloides BOT-A2. The fatty acid levels per cell dry weight after cultivation in a nitrogen limited medium with either glucose, xylose or glycerol as carbon source, respectively, were 46.8, 43.2 and 38.9% for P. hubeiensis BOT-O, and 40.4, 27.3 and 42.1% for BOT-A2. Furthermore, BOT-A2 accumulated 45.1% fatty acids per cell dry weight in a natural plant hydrolysate, and P. hubeiensis BOT-O showed simultaneous glucose and xylose consumption with similar growth rates on both carbon sources. The fatty acid analysis demonstrated both long chain and poly-unsaturated fatty acids, depending on strain and medium.

Conclusions

We found various natural yeast isolates with high lipid production capabilities and the ability to grow not only on glucose, but also xylose, glycerol and natural plant hydrolysate. R. toruloides BOT-A2 and P. hubeiensis BOT-O specifically showed great potential as production strains with high levels of storage lipids and comparable growth to that on glucose on various other substrates, especially compared to currently used lipid production strains. In BOT-O, glucose repression was not detected, making it particularly desirable for utilization of plant waste hydrolysates. Furthermore, the isolated strains were shown to produce oils with fatty acid profiles similar to that of various plant oils, making them interesting for future applications in fuel, food or feed production.
HCV spread among female incarcerated population and treatment pathways to viral elimination in Italian prison settings: clinical perspectives and medico legal aspects
Authors: Fiore Vito , Rastrelli Elena , Madeddu Giordano , Ranieri Roberto , De Vito Andrea , Giuliani Ruggero , Di Mizio Giulio , Bolcato Matteo , De Matteis Giuseppe , Ialungo Anna Maria , Dell’Isola Serena , Starnini Giulio , Babudieri Sergio
Published: July 2022

Background

Hepatitis C virus (HCV) infection is more frequent among incarcerated people than in general population. In the DAAs era, the short schedules and the low risk of adverse reactions, increased the number of HCV treatments. However, the most part of literature reports lack of incarcerated women inclusion in studies on field. Our aim is to assess the screening execution, HCV prevalence, and DAAs treatment among incarcerated women. A focused insight on quick vs standard diagnosis and staging approach will be also provided.

Methods

Incarcerated women from 4 Italian regions’ penitentiary institutes were included. HCV screening was executed with HCV saliva test (QuickOral Test®) or phlebotomy. Stage of liver fibrosis was evaluated with FIB-4 value or fibroscan®, based on physicians’ decision. Treatment prescription followed national protocols.

Results

We included 156 women, 89 (57%) were Italian, mean age was 41 ± 10 years, and 28 (17.9%) were people who inject drugs (PWIDs). Overall, the HCV seroprevalence was 20.5%. Being PWID and on opioid substitution therapy (OST) were significantly associated with serological status (p-value < 0.001). Of them, the 75.5% of patients had active infection, the most frequent genotype was 3a (50%). Among them, 4 (16.6%) and 6 (25%) had psychosis or alcohol abuse history. The 62.5%, 25% and 12.5% had low, intermediate, and advanced fibrosis, respectively. Out of the 24 HCV-RNA positive patients, the 75% underwent to DAAs treatment. The sustained virological response (SVR12) was achieved in 88.8% of cases. When evaluating the influence of quick diagnosis and staging methods vs standard phlebotomy and fibroscan® on SVR12, FIB-4 use showed higher performance for retainment in treatment during prison staying (p = 0.015), while the use of quick saliva test had no influence on the outcome (p = 0.22).

Conclusion

HCV seroprevalence and active infections are very high among incarcerated women. More tailored interventions should be focused on HCV diagnosis and treatment in female prison population. The use of quick staging methods (FIB-4) is useful to increase SVR12 achievement without delays caused by the fibroscan® awaiting.
Can inverse probability treatment weighting (IPTW) be used to assess differences of CRBSI rates between non-tunneled femoral and jugular CVCs in PICU patients?
Authors: Al-Sofyani Khouloud Abdulrhman , Uddin Mohammed Shahab
Published: July 2022

Background

In children in the ICU, catheter-related bloodstream infections (CRBSI) have also been linked to mortality, morbidity, and healthcare costs. Although CRBSI poses many potential risks, including the need to avoid femoral access, there is debate regarding whether jugular access is preferable to femoral access in adults. Study reports support both perspectives. There is no consensus in meta-analyses. Children have yet to be examined in depth. Based on compliance with the central line bundle check lists, we aim to determine CRBSI risk in pediatric intensive care units for patients with non-tunneled femoral and internal jugular venous access.

Methods

A retrospective cohort study was conducted on patients with central venous catheters in the pediatric ICU of King Abdulaziz University Hospital between January 1st, 2017 and January 30th, 2018. For the post-match balance, we use a standardized mean difference of less than 0.1 after inverse probability treatment weighting for all baseline covariates, and then we draw causal conclusions. As a final step, the Rosenbaum sensitivity test was applied to see if any bias influenced the results.

Results

We recorded 145 central lines and 1463 central line days with 49 femoral accesses (33.79%) and 96 internal jugular accesses (66.21%). CRBSI per 1000 central line days are 4.10, along with standardized infections of 3.16. CRBSI risk differed between non-tunneled femoral vein access and internal jugular vein access by 0.074 (− 0.021, 0.167), P-value 0.06, and relative risk was 4.67 (0.87–25.05). Using our model, the actual probability was 4.14% (0.01–0.074) and the counterfactual probability was 2.79% (− 0.006, 0.062). An unobserved confounding factor was not identified in the sensitivity analysis.

Conclusions

So long as the central line bundle is maintained, a femoral line does not increase the risk of CRBSI. Causation can be determined through propensity score weighting, as this is a trustworthy method of estimating causality. There is no better way to gain further insight in this regard than through the use of randomized, double-blinded, multicenter studies.
Carriage prevalence of Neisseria meningitidis in China, 2005–2022: a systematic review and meta-analysis
Authors: Yue Mengmeng , Xu Juan , Yu Jianxing , Shao Zhujun
Published: July 2022

Introduction

Neisseria meningitidis (Nm) is a major cause of meningitis and septicemia. Most people are infected with latent infections or are carriers. We aimed to estimate the carriage prevalence of Nm in China.

Methods

We did a systematic review of published work to assess the prevalence of meningococcal carriage in China. The quality assessment was conducted by the risk of bias tool according to Damian Hoy’s study. We estimated pooled proportions of carriage and its 95% confidence interval (95% CI) using fixed effect model for studies with low heterogeneity and random effect model for studies with moderate or high heterogeneity. Subgroup analyses were also conducted by region and age group.

Results

In total, 115 studies were included. The quality evaluation grades of all included documents were medium or high grade. The weighted proportion of carriage was 2.86% (95% CI: 2.25–3.47%, I2: 97.7%, p = 0). The carriage prevalence of Nm varied between provinces, ranged from 0.00% (95% CI: 0.00–0.66%) to 15.50% (95% CI: 14.01–16.99%). Persons aged 15 years and older had the highest carriage 4.38% (95% CI: 3.15–5.62%, I2: 95.4%, p < 0.0001), and children under 6 years of age had the lowest carriage 1.01% (95% CI: 0.59–1.43%, I2: 74.4%, p < 0.0001). In positive carriers, serogroup B (41.62%, 95% CI: 35.25–48.00%, I2: 98.6%, p = 0) took up the highest proportion, and serogroup X (0.02%, 95% CI: 0.00–0.09%, I2: 0.00%, p = 1) accounted for the lowest proportion.

Conclusion

The meningococcal carriage in China was estimated low and varied by region and age group. Understanding the epidemiology and transmission dynamics of meningococcal infection in insidious spreaders is essential for optimizing the meningococcal immunization strategies of the country.
Saturation-pulse prepared heart-rate independent inversion-recovery (SAPPHIRE) biventricular T1 mapping: inter-field strength, head-to-head comparison of diastolic, systolic and dark-blood measurements
Authors: Alfarih Mashael , Augusto João B. , Knott Kristopher D. , Fatih Nasri , Kumar M. Praveen , Boubertakh Redha , Hughes Alun D. , Moon James C. , Weingärtner Sebastian , Captur Gabriella
Published: July 2022

Background

To assess the feasibility of biventricular SAPPHIRE T1 mapping in vivo across field strengths using diastolic, systolic and dark-blood (DB) approaches.

Methods

10 healthy volunteers underwent same-day non-contrast cardiovascular magnetic resonance at 1.5 Tesla (T) and 3 T. Left and right ventricular (LV, RV) T1 mapping was performed in the basal, mid and apical short axis using 4-variants of SAPPHIRE: diastolic, systolic, 0th and 2nd order motion-sensitized DB and conventional modified Look-Locker inversion recovery (MOLLI).

Results

LV global myocardial T1 times (1.5 T then 3 T results) were significantly longer by diastolic SAPPHIRE (1283 ± 11|1600 ± 17 ms) than any of the other SAPPHIRE variants: systolic (1239 ± 9|1595 ± 13 ms), 0th order DB (1241 ± 10|1596 ± 12) and 2nd order DB (1251 ± 11|1560 ± 20 ms, all p < 0.05). In the mid septum MOLLI and diastolic SAPPHIRE exhibited significant T1 signal contamination (longer T1) at the blood-myocardial interface not seen with the other 3 SAPPHIRE variants (all p < 0.025). Additionally, systolic, 0th order and 2nd order DB SAPPHIRE showed narrower dispersion of myocardial T1 times across the mid septum when compared to diastolic SAPPHIRE (interquartile ranges respectively: 25 ms, 71 ms, 73 ms vs 143 ms, all p < 0.05). RV T1 mapping was achievable using systolic, 0th and 2nd order DB SAPPHIRE but not with MOLLI or diastolic SAPPHIRE. All 4 SAPPHIRE variants showed excellent re-read reproducibility (intraclass correlation coefficients 0.953 to 0.996).

Conclusion

These small-scale preliminary healthy volunteer data suggest that DB SAPPHIRE has the potential to reduce partial volume effects at the blood-myocardial interface, and that systolic SAPPHIRE could be a feasible solution for right ventricular T1 mapping. Further work is needed to understand the robustness of these sequences and their potential clinical utility.
High prevalence of chronic kidney disease of unknown etiology among workers in the Mesoamerican Nephropathy Occupational Study
Authors: Keogh Sinead A. , Leibler Jessica H. , Sennett Decker Caryn M. , Amador Velázquez Juan Jose , Jarquin Emmanuel R. , Lopez-Pilarte Damaris , Garcia-Trabanino Ramon , Delgado Iris S. , Petropoulos Zoe E. , Friedman David J. , Amador Sánchez Magaly Rosario , Guevara Raul , McClean Michael D. , Brooks Daniel R. , Scammell Madeleine K.
Published: July 2022

Background

Mortality from chronic kidney disease of unknown etiology (CKDu) is extremely high along the Pacific coast of Central America, particularly among sugarcane workers. The Mesoamerican Nephropathy Occupational Study (MANOS) is a prospective cohort study of CKDu among agricultural and non-agricultural workers in El Salvador and Nicaragua. The objective of this manuscript is to describe the MANOS cohort recruitment, baseline data collection, and CKDu prevalence after two rounds.

Methods

Workers with no known diabetes, hypertension, or CKD were recruited from sugarcane, corn, plantain, brickmaking, and road construction industries (n = 569). Investigators administered questionnaires, collected biological samples, and observed workers for three consecutive workdays at the worksite. Serum specimens were analyzed for kidney function parameters, and used to calculate estimated glomerular filtration rate (eGFR). At six months, serum was collected again prior to the work shift. CKD at baseline is defined as eGFR ≤ 60 ml/min/1.73m2 at both timepoints. Age-standardized prevalence was calculated by industry, country, and demographic measures. Kidney function parameters were compared by CKD status.

Results

Prevalence of CKD at baseline was 7.4% (n = 42). Age-standardized prevalence was highest in Salvadoran sugarcane (14.1%), followed by Salvadoran corn (11.6%), and Nicaraguan brickmaking (8.1%). Nicaraguan sugarcane had the lowest prevalence, likely due to kidney function screenings prior to employment.

Conclusion

Despite efforts to enroll participants without CKD, our identification of prevalent CKD among agricultural and non-agricultural workers in the MANOS cohort indicates notable kidney disease in the region, particularly among sugarcane workers.
The value of repeat kidney biopsy during an atypical course of membranous nephropathy
Authors: Ahmed Sumaiya , Massicotte-Azarniouch David , Canney Mark , Booth Clare , Blanco Paula , Hundemer Gregory L.
Published: July 2022

Background

The clinical trajectory for patients with primary membranous nephropathy ranges widely from spontaneous remission to a rapid decline in kidney function. Etiologies for rapid progression with membranous nephropathy include concurrent bilateral renal vein thrombosis, malignant hypertension, and crescentic membranous nephropathy. Given the wide heterogeneity in prognosis, timing of immunosuppressive therapy is often challenging and centers around an individual patient’s perceived risk for rapidly progressive disease.

Case presentation

Herein, we describe the clinical course of a young patient who initially developed a typical presentation of membranous nephropathy with consistent kidney biopsy findings. Given clinical stability, a six month observation period was undertaken prior to initiating immunosuppression. Within this observation window, the patient developed community acquired pneumonia followed several weeks later by a sudden, rapid decline in kidney function requiring dialysis. Repeat kidney biopsy revealed post-infectious glomerulonephritis superimposed upon a background of membranous nephropathy. Immunosuppressive therapy resulted in a favorable long-term outcome with normalization of kidney function and remission of nephrotic syndrome. To our knowledge, this is the first report of the simultaneous occurrence of these two glomerular disease processes.

Conclusion

This case illustrates the value of repeat kidney biopsy during an atypical course of membranous nephropathy. Superimposed glomerular disease processes should be considered during a course of rapidly progressive membranous nephropathy.
Relationship between serum alkaline phosphatase and poor 3-month prognosis in acute ischemic stroke patients with preserved renal function: results from Xi’an Stroke Registry Study of China
Authors: Liu Zhongzhong , Lin Xuemei , Zeng Lingxia , Lu Qingli , Liu Pei , Wang Jing , Liu Yan , Chang Qiaoqiao , Wang Yan , Song Chensheng , Wang Fang , Shi Yaling , Liu Guozheng , Wang Qing , Wu Songdi
Published: July 2022

Background

In recent years, alkaline phosphatase (ALP) has been considered as one of the independent risk factors of acute ischemic stroke (AIS) and leads to worse clinical outcomes in patients with renal failure. In this study, we aim to investigate whether serum ALP level is associated with poor early-term prognosis in relationship of AIS patients with preserved renal function.

Methods

A prospectively collected database of AIS patients hospitalized in the Xi’an district of China from January to December, 2015 was analyzed. The demographics, serum ALP levels and stroke outcomes of all patients at 3 months were reviewed. Patients were routinely followed-up for 3 months. Serum ALP level was analyzed as a continuous variable and quintiles (Q1-Q5). Multivariate logistic regression model and a two-piecewise linear regression model were used to investigate the relationship and to determine the threshold effect regarding serum ALP levels and poor 3-month prognosis of AIS patients with preserved renal function.

Results

Overall, 1922 AIS patients were enrolled with 62.3% of them being men. The risk of having a poor 3-month prognosis was significantly increased in Q1, Q2, Q3 and Q5, when compared to that in Q4 being as the reference. The highest risk was noted in Q5 (odds ratio 2.21, 95% confidence interval: 1.32–3.73, P = 0.003) after being adjusted for confounders. Further analysis revealed a J-shaped curvilinear relationship between ALP levels and a poor 3-month prognosis of strokes (optimal threshold ALP level = 90 U/L). The relationship between both parameters was not significantly affected by age, sex, drinking, hypertension and leukocyte count (stratified by 10 × 109/L) (P for interaction > 0.05).

Conclusions

Serum ALP was noted as an independent risk factor for a poor 3-month prognosis of AIS patients with preserved renal function. ALP levels higher than 90 U/L could cause an increased risk of a poor 3-month prognosis.
Low expression of PRDM5 predicts poor prognosis of esophageal squamous cell carcinoma
Authors: Guo Jing , Yang Qiuxing , Wei Sheng , Shao Jingjing , Zhao Tianye , Guo Liyuan , Liu Jia , Chen Jia , Wang Gaoren
Published: July 2022

Background

The role of the PRDM5 in esophageal squamous cell carcinoma (ESCC) has not been revealed. This study investigated the relationship between PRDM5 expression and survival outcome in esophageal squamous cell carcinoma and explored the mechanism in tumor development.

Methods

In present study, expression of PRDM5 mRNA in esophageal squamous cell carcinoma patients was conducted using the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) database. The expression of PRDM5 was assessed by immunohistochemical staining. Kaplan-Meier curve and Cox regression analysis was performed to analyze the survival outcome and independent predictive factors. qRT-PCR and Methylation-specific PCR were performed to identify the mRNA level of PRDM5 and Methylation rate. Cibersort algorithm to analyze the relationship between PRDM5 expression and immune cell invasion. Western-blot was performed to confirm the expression of esophageal tumor tissues and adjacent tissues.

Results

The TCGA database and GEO database show that PRDM5 mRNA level in esophageal squamous cell carcinoma adjacent tissues was higher than that of cancer tissues, and ESCC patients with high expression of PRDM5 mRNA had better overall survival. Tissue microarray showed that the protein level of PRDM5 in the adjacent tissues of patients with ESCC was higher than that in cancer tissues, and the expression level of PRDM5 was significantly correlated with the grade of clinicopathological characteristics (P < 0.001). Patients with high expression of PRDM5 displayed a better OS and DFS. Cox regression analysis showed that PRDM5 was an independent risk factor and prognostic factor for ESCC patients (HR: 2.626, 95%CI: 1.824–3.781; P < 0.001). The protein level of PRDM5 matched with the transcriptional level, whereas the DNA methylation affected the transcriptional level. Cibersort showed that T cells CD4 memory resting, mast cells resting, eosinophils, M2 macrophages and mast cells activated were significantly positively correlated with PRDM5 expression (P < 0.05), while regulatory T cells, monocytes and dendritic cells negatively correlated with PRDM5 expression (P < 0.05).

Conclusion

PRDM5 can be used as a biomarker to predict the survival of ESCC patients. Furthermore, PRDM5 expression in ESCC cells may affect WNT/β-catenin signaling pathways, thus further affect the ESCC cell proliferation, migration, and invasion capacity.
Efficacy of donepezil for the treatment of oxaliplatin-induced peripheral neuropathy: DONEPEZOX, a protocol of a proof of concept, randomised, triple-blinded and multicentre trial
Authors: Kerckhove Nicolas , Tougeron David , Lepage Côme , Pezet Denis , Le Malicot Karine , Pelkowski Manon , Pereira Bruno , Balayssac David
Published: July 2022

Background

The use of oxaliplatin in digestive tract cancers could induce severe peripheral neuropathy (OIPN) decreasing the quality of life of patients and survivors. There is currently, no univocal treatment for these peripheral neuropathies. Donepezil, a reversible inhibitor of cholinesterase, used to treat Alzheimer’s disease and dementia, is reported to have a good safety profile in humans, and preclinical data have provided initial evidence of its effectiveness in diminishing neuropathic symptoms and related comorbidities in OIPN animal models.

Methods

The DONEPEZOX trial will be a proof-of-concept, randomised, triple-blinded, and multicentre study. It will be the first clinical trial evaluating the efficacy and safety of donepezil for the management of OIPN. Adult cancer survivors with OIPN that report sensory neuropathy according to QLQ-CIPN20 sensory score (equivalence of a grade ≥ 2), at least 6 months after the end of an oxaliplatin-based chemotherapy will be included. Eighty patients will be randomly assigned to receive either donepezil or placebo over 16 weeks of treatment. The primary endpoint will be the rate of responders (neuropathic grade decreases according to the QLQ-CIPN20 sensory score) in the donepezil arm. The severity of OIPN will be assessed by the QLQ-CIPN20 sensory scale before and after 16 weeks of treatment. The comparison versus the placebo arm will be a secondary objective. The other secondary endpoints will be tolerance to donepezil, the severity and features of OIPN in each arm before and after treatment, related-comorbidities and quality of life. Fleming’s one-stage design will be used for sample size estimation. This design yields a type I error rate of 0.0417 and power of 91% for a responder rate of at least 30% in donepezil arm. A total of 80 randomized patients is planned.

Discussion

This study will allow, in the case of positive results, to initiate a phase 3 randomized and placebo-controlled (primary endpoint) clinical study to assess the therapeutic interest of donepezil to treat OIPN.

Trial registration

NCT05254639, clincialtrials.gov, Registered 24 February 2022.
Comparative evaluation of somatostatin and CXCR4 receptor expression in different types of thyroid carcinoma using well-characterised monoclonal antibodies
Authors: Czajkowski Max , Kaemmerer Daniel , Sänger Jörg , Sauter Guido , Wirtz Ralph M. , Schulz Stefan , Lupp Amelie
Published: July 2022

Background

Papillary and follicular thyroid carcinomas can be treated surgically and with radioiodine therapy, whereas therapeutic options for advanced stage IV medullary and for anaplastic tumours are limited. Recently, somatostatin receptors (SSTs) and the chemokine receptor CXCR4 have been evaluated for the treatment of thyroid carcinomas, however, with contradictory results.

Methods

The expression of the five SSTs and of CXCR4 was assessed in 90 samples from 56 patients with follicular, papillary, medullary, or anaplastic thyroid carcinoma by means of immunohistochemistry using well-characterised monoclonal antibodies. The stainings were evaluated using the Immunoreactivity Score (IRS) and correlated to clinical data. In order to further substantiate the immunohistochemistry results, in serial sections of a subset of the samples receptor expression was additionally examined at the mRNA level using qRT-PCR.

Results

Overall, SST and CXCR4 protein expression was low in all four entities. In single cases, however, very high IRS values for SST2 and CXCR4 were observed. SST2 was the most frequently expressed receptor, found in 38% of cases, followed by SST5 and SST4, found in 14 and 9% of tumours, respectively. SST1 and SST3 could not be detected to any significant extent. CXCR4 was present in 12.5% of medullary and 25% of anaplastic carcinomas. Expression SST3, SST4, SST5 and CXCR4 was positively correlated with expression of the proliferation marker Ki-67. Additionally, a negative interrelationship between SST4 or SST5 expression and patient survival and a positive association between SST3 expression and tumour diameter were observed. qRT-PCR revealed a similar receptor expression pattern to that seen at the protein level. However, probably due to the low overall expression, no correlation was found for the SSTs or the CXCR4 between the IRS and the mRNA values.

Conclusions

SST- or CXCR4-based diagnostics or therapy in thyroid carcinomas should not be considered in general but may be feasible in single cases with high levels of expression of these receptors.
Occurrence and outcome of firework-related ocular injuries in Switzerland: A descriptive retrospective study
Authors: Turgut Ferhat , Bograd Alexandra , Jeltsch Brida , Weber Adrian , Schwarzer Petra , Ciotu Iulia M , Amaral Joao , Menke Marcel N , Thommen François , Tandogan Tamer , Tappeiner Christoph
Published: July 2022

Background

Firework-related ocular injuries (FWROI) are a major cause of preventable visual impairment. This study aimed to analyze the occurrence and outcome of FWROI in Switzerland.

Methods

This retrospective multicenter study included patients with FWROI from seven centers in Switzerland from January 2009 to August 2020. Demographic information, type of injuries, medical and surgical treatments, the best corrected visual acuity (BCVA) at baseline and end of follow-up, occurrence and type of secondary complications, and duration of hospitalization were analyzed.

Results

A total of 105 patients (119 eyes) with a mean age of 27.1 ± 15.9 years were included in the study (71.4% male patients; 29.5% underage). Most injuries occurred around New Year’s Eve (32.4%) and the Swiss national holiday on 1 August (60.9%). The most common anterior segment findings were conjunctival or corneal foreign bodies (58%), whereas Berlin’s edema was the most common posterior segment finding (11.4%). Globe ruptures were found in four patients. The mean BCVA in all patients at first presentation was 0.4 ± 0.8 logMAR and improved to 0.3 ± 0.8 logMAR at last follow-up. A primary surgical intervention was performed in 48 eyes (40.3%). Hospitalization directly after the trauma was necessary for 18 patients for a mean of 5.8 ± 4.1 days, and a total of 4.9 ± 7.6 follow-up visits were needed.

Conclusion

This study provides the first data on FWROI in Switzerland, which are helpful for further preventive and educational programs and comparisons with other countries.
Punctate inner choroidopathy immediately after COVID-19 infection: a case report
Authors: Miyata Manabu , Ooto Sotaro , Muraoka Yuki
Published: July 2022

Background

Punctate inner choroidopathy (PIC) is a rare idiopathic inflammatory multifocal chorioretinopathy. Although the etiology of PIC is unknown, it is proposed to be an autoimmune disease that arises in the context of polygenic susceptibility triggered by an environmental stimulus, such as infection. We reported a case of PIC immediately after COVID-19 infection.

Case presentation

A 25-year-old woman complained of blurred vision in the right eye six days after the symptoms of COVID-19 infection first appeared. The patient visited our hospital and underwent comprehensive ophthalmological examination 18 days after the initial COVID-19 symptoms. Based on the characteristic fundus features observed with multimodal imaging, retinal specialists made a diagnosis of PIC. The patient was affected with high myopia. As her general COVID-19 symptoms disappeared, the patient was prescribed oral prednisolone 30 mg/day for 14 days to treat PIC. Fundus abnormality decreased and her ocular symptoms improved. No side effects were observed, including the recurrence of general COVID-19 symptoms.

Conclusion

We experienced an extremely rare case of PIC immediately after COVID-19 infection and showed the potential safety and effectiveness of oral prednisolone in treating PIC in the active phase after the disappearance of the general COVID-19 infection symptoms.
Clinically assessed and perceived unmet mental health needs, health care use and barriers to care for mental health problems in a Belgian general population sample
Authors: Rens Eva , Michielsen Joris , Dom Geert , Remmen Roy , Van den Broeck Kris
Published: July 2022

Background

Mental health problems often remain undetected and untreated. Prior research suggests that this is mainly due to a lack of need-perception and attitudinal barriers. The aim of this study is to examine unmet mental health needs using both a clinically assessed and a self-perceived approach in a Belgian province.

Methods

A cross-sectional survey study with a weighted representative sample of 1208 individuals aged 15 – 80 years old was carried out in 2021 in the province of Antwerp (Belgium). Mental health needs were defined as a positive symptom screening for depression (PHQ-9), anxiety (GAD-7) or alcohol abuse (AUDIT-C and CAGE), combined with experiencing significant dysfunction in daily life. Also 12-month health care use for mental health problems, self-perceived unmet mental health needs and reasons for not seeking (extra) help were assessed. Logistic regression analyses were used to explore the predictors of mental health problems, health care use, and objective and subjective unmet mental health needs.

Results

One in five participants had a positive screening on one of the scales, of whom half experienced dysfunction, leading to a prevalence of 10.4% mental health needs. Among those, only half used health care for their mental health, resulting in a population prevalence of 5.5% clinically assessed unmet mental health needs. Fourteen percent of the total sample perceived an unmet mental health need. However, more women and younger people perceived unmet needs, while clinically assessed unmet needs were higher among men and older people. One in six of the total sample used health care for their mental health, most of whom did not have a clinically assessed mental health need. Motivational reasons were most often endorsed for not seeking any help, while a financial barrier was the most important reason for not seeking extra help.

Conclusions

The prevalence of unmet mental health needs is high. Assessed and perceived (unmet) mental health needs are both relevant and complementary, but are predicted by different factors. More research is needed on this discrepancy.