bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamic Immune Profile in French Toxoplasmosis Patients
Authors: Denis Julie , Gommenginger Chloé , Strechie Teodora , Filisetti Denis , Beal Laetitia , Pfaff Alexander W , Villard Odile
Published: August 2022

Background

Toxoplasma gondii infection is usually benign in Europe due to the strong predominance of type II strains. Few studies have been conducted to examine the immunological course of infection in humans and have yielded conflicting results, maybe influenced by heterogeneous parasite strains.

Methods

We measured 23 immune mediators in 39, 40, and 29 sera of French noninfected, acutely infected, and chronically infected immunocompetent pregnant women, respectively.

Results

Four different cytokine patterns were identified regarding their dynamics through infection phases. For 11 of the cytokines (IFN-β, IFN-γ, IL-4, IL5, IL-6, IL-10, IL-12, IL-15, CXCL9, CCL2, and CSF2) the serum levels were significantly elevated during acute infection. The inflammatory mediators IL-1β, IL-17A, IL-18, TNF-α, and CSF3 remained unchanged during acute infection, while they were significantly lower in chronically infected compared to noninfected patients. As for the anti-inflammatory cytokines TGF-β and CCL5, their levels remained significantly elevated during chronic infection. We also observed a significant negative correlation of several cytokine concentrations with IgG levels, indicating a rapid decline of serum concentrations during the acute phase.

Conclusions

These results indicate an anti-inflammatory pattern in chronically infected patients in a type II dominated setting and demonstrate the highly dynamic immune situation during acute infection.
Rapid detection of CTX-M-type ESBLs and carbapenemases directly from biological samples using the BL-DetecTool
Authors: Volland Hervé , Ballesté-Delpierre Clara , Szabó Dóra , Gonzalez Camille , Takissian Julie , Aszalos Albert Zoltan , Ostorhazi Eszter , Farkas Szilvia , Kamotsay Katalin , Rosenmoller Magda , Stankov-Pugès Milovan , Francius Laura , Boutigny Laure , Sivan Virginie , Simon Stéphanie , Gelhaye Stéphanie , Bosch Jordi , Vila Jordi , Naas Thierry
Published: August 2022

Background

Lateral flow immunoassays (LFIA) have shown their usefulness for detecting CTX-M- and carbapenemase-producing Enterobacterales (CPEs) in bacterial cultures. Here, we have developed and validated the BL-DetecTool to detect CTX-M enzymes and carbapenemases directly from clinical samples.

Methods

The BL-DetecTool is an LFIA that integrates an easy sample preparation device named SPID (Sampling, Processing, Incubation and Detection). It was evaluated in three University hospitals on urine, blood culture (BC) and rectal swab (RS) specimens either of clinical origin or on spiked samples. RS evaluation was done directly and after a 24 h enrichment step.

Results

The CTX-M BL-DetecTool was tested on 485 samples (154 BC, 150 urines, and 181 RS) and revealed a sensitivity and specificity of 97.04% (95% CI 92.59%–99.19%) and 99.43% (95% CI 97.95%–99.93%), respectively. Similarly, the Carba5 BL-DetecTool was tested on 382 samples (145 BC, 116 urines, and 121 RS) and revealed a sensitivity and specificity of 95.3% (95% CI 89.43%–98.47%) and 100% (95% CI 98.67%–100%), respectively. While with the Carba5 BL-DetecTool five false negatives were observed, mostly in RS samples, with the CTX-M BL-DetecTool, in addition to four false-negatives, two false-positives were also observed. Direct testing of RS samples revealed a sensitivity of 78% and 86% for CTX-M and carbapenemase detection, respectively.

Conclusions

BL-DetecTool showed excellent biological performance, was easy-to-use, rapid, and could be implemented in any microbiology laboratory around the world, without additional equipment, no need for electricity, nor trained personnel. It offers an attractive alternative to costly molecular methods.
Challenges of in vitro propagation and antimicrobial susceptibility testing of Mycoplasma genitalium
Authors: Pitt Rachel , Boampong Dolcibella , Day Michaela , Jensen Jorgen Skov , Cole Michelle
Published: August 2022

The sexually transmitted bacterial pathogen Mycoplasma genitalium has proved a complex organism to work with in the laboratory setting. Exhibiting an extremely fastidious nature, successful in vitro propagation of M. genitalium has remained elusive for many researchers. Antimicrobial resistance to both first- and second-line recommended therapies (macrolides and fluoroquinolones, respectively) is commonly reported. However, phenotypic susceptibility testing is not routinely performed, due to the difficulties of in vitro growth. Instead, molecular detection of known resistance determinants is used to infer susceptibility/resistance. However, associations between determinant detection and clinical treatment failure are not always clear. Furthermore, molecular assays have limited use for detection of emerging resistance mechanisms. The present review collates and discusses the development of successful culture systems for initial isolation of this organism and current methodologies employed for phenotypic susceptibility testing to aid researchers in this field. As with Neisseria gonorrhoeae, future treatment options are extremely limited for M. genitalium and, if this sexually transmitted infection is to remain treatable, phenotypic susceptibility testing will play an invaluable role in evaluation of potential therapeutics. As such, retainment of these techniques is imperative.
A DNA Metabarcoding Workflow to Identify Species in Spices and Herbs
Authors: Cottenet Geoffrey , Cavin Christophe , Blancpain Carine , Chuah Poh Fong , Pellesi Roberta , Suman Michele , Nogueira Sofia , Gadanho Mario
Published: August 2022

Background

Spices and herbs are food categories regularly cited as highly susceptible to be adulterated. To detect potential adulteration with undeclared species, DNA-based methods are considered the most suitable tools.

Objective

In this study, the performance of the ready-to-use Thermo Scientific™ NGS Food Authenticity Workflow (Thermo Fisher Scientific)—a commercial DNA metabarcoding approach—is described. The tool was further applied to analyze 272 commercial samples of spices and herbs.

Method

Pure samples of spices and herbs were analyzed with the Thermo Scientific NGS Food Authenticity Workflow to assess its specificity, and spikings down to 1% (w/w) allowed evaluation of its sensitivity. Commercial samples, 62 and 210, were collected in Asian and European markets, respectively.

Results

All tested species were correctly identified often down to the species level, while spikings at 1% (w/w) confirmed a limit of detection at this level, including in complex mixtures composed of five different spices and/or herbs. The analysis of 272 commercial samples showed that 78% were compliant with the declared content, whereas the rest were shown to contain undeclared species that were in a few cases allergenic or potentially toxic.

Conclusions

The Thermo Scientific NGS Food Authenticity Workflow was found to be suitable to identify food plant species in herbs and spices, not only when tested on pure samples, but also in mixtures down to 1% (w/w). The overall workflow is user-friendly and straightforward, which makes it simple to use and facilitates data interpretation.

Highlights

The Thermo Scientific NGS Food Authenticity Workflow was found to be suitable for species identification in herbs and spices, and it allowed the detection of undeclared species in commercial samples. Its ease of use facilitates its implementation in testing laboratories.
Characterization of Feeding Behavior and its Relationship With the Longevity of Wild and Peridomestic Triatoma dimidiata, Latreille 1811 (Hemiptera, Reduviidae) Under Laboratory Conditions
Authors: Marín-Ortiz Juan Carlos , Parra-Henao Gabriel , Altamiranda-Saavedra Mariano , Jaramillo-O Nicolás
Published: August 2022

Triatoma dimidiata (Latreille 1811) is considered the second most important vector of the Trypanosa cruzi etiological agent of Chagas disease in Colombia. It has a life cycle that involves a domiciled, peridomiciled, and wild distribution. The study of feeding behavior and its influence on the survival of sylvatic and peridomestic populations can help identify a possible differential risk in the transmission of Chagas disease to humans, mainly in northwestern and east-central Colombia. We characterize the main parameters of feeding behavior and their influence on the longevity and survival of two rat-fed populations of T. dimidiata from Colombia, one in the north-west (from palms in a tropical dry forest area) and the other in the center-east (peridomiciliated), under controlled environmental conditions. The palm population took considerably longer than the peridomestic population to complete its life cycle under experimental laboratory conditions, being both populations univoltine since they have only one life cycle per year. Statistically significant differences were evidenced using Box-Cox model between the survival rates of T. dimidiata populations when the parameters related to blood intake and behavior were incorporated, in contrast to the survival models in which the origin only was considered as a factor. Our results could be used to generate recommendations to guide prevention strategies in communities near sylvatic and peridomiciliated populations of T. dimidiata.
Social Vulnerability and Risk of Nonrelapse Mortality After Allogeneic Hematopoietic Cell Transplantation
Authors: Bhandari Rusha , Teh Jennifer Berano , He Tianhui , Nakamura Ryotaro , Artz Andrew S , Jankowska Marta M , Forman Stephen J , Wong F Lennie , Armenian Saro H
Published: August 2022

Background

Risk of nonrelapse mortality (NRM) after hematopoietic cell transplantation (HCT) is high. Patient-level clinical prediction models such as the HCT–comorbidity index (HCT-CI) help identify those at increased risk for NRM, but the independent contribution of social determinants of health on HCT outcomes is not well characterized.

Methods

This study included 1602 patients who underwent allogeneic HCT between 2013 and 2019 at City of Hope. Census tract–level social vulnerability was measured using the social vulnerability index (SVI). Fine-Gray multivariable regression evaluated the association between SVI and 1-year NRM. Subgroup analysis examined risk of NRM across combined SVI and HCT-CI categories and by race and ethnicity.

Results

Cumulative incidence of 1-year NRM after HCT was 15.3% (95% confidence interval [CI] = 13.6% to 17.1%). In multivariable analysis, patients in the highest SVI tertile (highest social vulnerability) had a 1.4-fold risk (subdistribution hazard ratio [sHR] = 1.36, 95% CI = 1.04 to 1.78) of NRM compared with individuals in the lower tertiles; patients in the highest SVI tertile who also had elevated (≥3) HCT-CI scores had the highest risk (sHR = 1.81, 95% CI = 1.26 to 2.58) of 1-year NRM (reference: lower SVI tertiles and HCT-CI < 3). High social vulnerability was associated with risk of 1-year NRM in Asian (sHR = 2.03, 95% CI = 1.09 to 3.78) and Hispanic (sHR = 1.63, 95% CI = 1.04 to 2.55) but not non-Hispanic White patients.

Conclusions

High social vulnerability independently associated with 1-year NRM after HCT, specifically among minority populations and those with a high comorbidity burden at HCT. These findings may inform targeted approaches for needs assessment during and after HCT, allowing for timely interventions to improve health outcomes in at-risk patients.
Internalizing Symptoms in Adolescents With Sickle Cell Disease
Authors: Heitzer Andrew M , Longoria Jennifer , Porter Jerlym S , MacArthur Erin , Potter Brian , Ding Juan , Gossett Jeffrey , Kang Guolian , Hankins Jane S
Published: August 2022

Objective

Sickle cell disease (SCD) is a genetic blood disorder that may affect patients’ mood and behavior. However, measuring the prevalence of internalizing symptoms (anxiety and depression) in patients with SCD has been elusive. We assessed internalizing symptoms in adolescents with SCD to evaluate prevalence and to test whether neurocognitive performance and frequency of pain-related episodes were associated with internalizing concerns.

Methods

One hundred eighty-five patients (57% HbSS/HbSß0-thalassemia, 43% HbSC/HbSß+-thalassemia), ages 12–18 years, received a neuropsychological evaluation as a part of a larger cohort study. Internalizing symptoms were measured using the Behavior Assessment System for Children, Second or Third Edition. Scores on the depression and anxiety scales were compared to normative values using Wilcoxon signed rank test. Spearman correlations examined associations between neurocognitive performances and internalizing symptoms. Robust multivariable regression models measured associations between internalizing symptoms and age, sex, sickle genotype, total hemoglobin, fetal hemoglobin, socioeconomic status, and frequency of pain episodes.

Results

Parent- and self-reported ratings of internalizing symptoms were not elevated compared to normative expectations. Overall, 1.8% and 6.3% of the sample displayed clinically elevated symptoms of anxiety and depression based on self-report, respectively. There were no associations between internalizing symptoms and neurocognitive performance (all p > .05). In multivariable analyses, the frequency of pain episodes was positively associated with self-reported anxiety (p = .006) and parent-reported depressive symptoms (p = .017).

Conclusions

Adolescents with SCD do not report elevated internalizing symptoms compared to normative expectations. Further research is needed to examine the trajectory of internalizing symptoms and the bidirectional relationship between pain and psychosocial functioning in SCD.
Modelling the persistent low-state γ-ray emission of the PKS 1510−089 blazar with electromagnetic cascades initiated in hadronuclear interactions
Authors: Dzhatdoev T A , Khalikov E V , Latypova V S , Podlesnyi E I , Vaiman I A
Published: August 2022

Blazars may accelerate protons and/or nuclei as well as electrons. The hadronic component of accelerated particles in blazars may constitute the bulk of their high-energy budget; nevertheless, this component is elusive because of the high value of the energy threshold of proton interactions with photon fields inside the source. However, the broad line regions (BLRs) of some flat spectrum radio quasars (FSRQs) may contain a sufficient amount of matter to render primary protons ‘visible’ in γ-rays via hadronuclear interactions. In this paper, we study the persistent γ-ray emission of the FSRQ PKS 1510−089 in its low state, utilizing the publicly available Fermi-LAT data, as well as using the spectrum measured with the Major Atmospheric Gamma Imaging Cherenkov (MAGIC) telescopes. We find an indication that there is an excess of γ-rays at the energy range ≳ 20 GeV with respect to a simple baseline log-parabolic intrinsic spectral model. This excess could be explained in a scenario invoking hadronuclear interactions of primary protons on the BLR material with the subsequent development of electromagnetic cascades in photon fields. We present a Monte Carlo calculation of the spectrum of this cascade component, taking as input the BLR photon field spectrum calculated with the cloudy code. To our knowledge, this is the first calculation of an electromagnetic cascade spectrum inside a blazar based on a direct calculation of the photon field spectrum with a spectral synthesis code.
Dust grain size evolution in local galaxies: a comparison between observations and simulations
Authors: Relaño M , De Looze I , Saintonge A , Hou K-C , Romano L E C , Nagamine K , Hirashita H , Aoyama S , Lamperti I , Lisenfeld U , Smith M W L , Chastenet J , Xiao T , Gao Y , Sargent M , van der Giessen S A
Published: August 2022

The evolution of the dust grain size distribution has been studied in recent years with great detail in cosmological hydrodynamical simulations taking into account all the channels under which dust evolves in the interstellar medium. We present a systematic analysis of the observed spectral energy distribution of a large sample of galaxies in the local Universe in order to derive not only the total dust masses but also the relative mass fraction between small and large dust grains (DS/DL). Simulations reproduce fairly well the observations except for the high-stellar mass regime where dust masses tend to be overestimated. We find that ∼45 per cent of galaxies exhibit DS/DL consistent with the expectations of simulations, while there is a subsample of massive galaxies presenting high DS/DL (log (DS/DL) ∼ −0.5), and deviating from the prediction in simulations. For these galaxies which also have high-molecular gas mass fractions and metallicities, coagulation is not an important mechanism affecting the dust evolution. Including diffusion, transporting large grains from dense regions to a more diffuse medium where they can be easily shattered, would explain the observed high DS/DL values in these galaxies. With this study, we reinforce the use of the small-to-large grain mass ratio to study the relative importance of the different mechanisms in the dust life cycle. Multiphase hydrodynamical simulations with detailed feedback prescriptions and more realistic subgrid models for the dense phase could help to reproduce the evolution of the dust grain size distribution traced by observations.
The Neurodevelopmental Gene MSANTD2 Belongs to a Gene Family Formed by Recurrent Molecular Domestication of Harbinger Transposons at the Base of Vertebrates
Authors: Etchegaray Ema , Baas Dominique , Naville Magali , Haftek-Terreau Zofia , Volff Jean Nicolas
Published: August 2022

The formation of new genes is a major source of organism evolutionary innovation. Beyond their mutational effects, transposable elements can be co-opted by host genomes to form different types of sequences including novel genes, through a mechanism named molecular domestication. We report the formation of four genes through molecular domestication of Harbinger transposons, three in a common ancestor of jawed vertebrates about 500 million years ago and one in sarcopterygians approx. 430 million years ago. Additionally, one processed pseudogene arose approx. 60 million years ago in simians. In zebrafish, Harbinger-derived genes are expressed during early development but also in adult tissues, and predominantly co-expressed in male brain. In human, expression was detected in multiple organs, with major expression in the brain particularly during fetal development. We used CRISPR/Cas9 with direct gene knock-out in the F0 generation and the morpholino antisense oligonucleotide knock-down technique to study in zebrafish the function of one of these genes called MSANTD2, which has been suggested to be associated to neuro-developmental diseases such as autism spectrum disorders and schizophrenia in human. MSANTD2 inactivation led to developmental delays including tail and nervous system malformation at one day post fertilization. Affected embryos showed dead cell accumulation, major anatomical defects characterized by impaired brain ventricle formation and alterations in expression of some characteristic genes involved in vertebrate nervous system development. Hence, the characterization of MSANTD2 and other Harbinger-derived genes might contribute to a better understanding of the genetic innovations having driven the early evolution of the vertebrate nervous system.
Metagenomics versus total RNA sequencing: most accurate data-processing tools, microbial identification accuracy and perspectives for ecological assessments
Authors: Hempel Christopher A , Wright Natalie , Harvie Julia , Hleap Jose S , Adamowicz Sarah J , Steinke Dirk
Published: August 2022

Metagenomics and total RNA sequencing (total RNA-Seq) have the potential to improve the taxonomic identification of diverse microbial communities, which could allow for the incorporation of microbes into routine ecological assessments. However, these target-PCR-free techniques require more testing and optimization. In this study, we processed metagenomics and total RNA-Seq data from a commercially available microbial mock community using 672 data-processing workflows, identified the most accurate data-processing tools, and compared their microbial identification accuracy at equal and increasing sequencing depths. The accuracy of data-processing tools substantially varied among replicates. Total RNA-Seq was more accurate than metagenomics at equal sequencing depths and even at sequencing depths almost one order of magnitude lower than those of metagenomics. We show that while data-processing tools require further exploration, total RNA-Seq might be a favorable alternative to metagenomics for target-PCR-free taxonomic identifications of microbial communities and might enable a substantial reduction in sequencing costs while maintaining accuracy. This could be particularly an advantage for routine ecological assessments, which require cost-effective yet accurate methods, and might allow for the incorporation of microbes into ecological assessments.
In-Person Versus Tele-Infectious Disease (Tele-ID) Care: Is One Better?
Authors: Gupta Nupur , Bariola J Ryan , Mellors John W , Abdel-Massih Rima C
Published: August 2022

We compared outcomes at 3 community hospitals before and after switching from in-person to a Tele-ID group from an academic medical center. Compared to in-person, Tele-ID received significantly more consultations with similar outcomes for length of hospital stay, transfers, readmission, and mortality. Tele-ID is a suitable alternative for community settings.
Insurers as Asset Managers and Systemic Risk
Authors: Ellul Andrew , Jotikasthira Chotibhak , Kartasheva Anastasia , Lundblad Christian T , Wagner Wolf
Published: August 2022

Financial intermediaries often provide guarantees resembling out-of-the-money put options, exposing them to undiversifiable tail risk. We present a model in the context of the U.S. life insurance industry in which the regulatory framework incentivizes value-maximizing insurers to hedge variable annuity (VA) guarantees, though imperfectly, and shifts risks into high-risk and illiquid bonds. We calibrate the model to insurer-level data and identify the VA-induced changes in insurers’ risk exposures. In the event of major asset and guarantee shocks and absent regulatory intervention, these shared exposures exacerbate system-wide fire sales to maintain capital ratios, plausibly erasing over half of insurers’ equity capital.

Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Estimating General Equilibrium Spillovers of Large-Scale Shocks
Authors: Huber Kilian
Published: August 2022

Large-scale shocks directly affect some firms and households and indirectly affect others through general equilibrium spillovers. In this paper, I describe how researchers can directly estimate spillovers using quasi-experimental or experimental variation. I then argue that spillover estimates suffer from distinct sources of mechanical bias that standard empirical tools cannot resolve. These biases are particularly relevant in finance and macroeconomics, where multiple spillover channels and nonlinear effects are common. I offer guidance on how to detect and overcome mechanical biases. An application and several examples highlight that the suggested methods are broadly relevant and can inform policy and multiplier calculations.

Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Corneal complications of rheumatoid arthritis
Authors: Wajnsztajn Denise , Nche Eleanor , Solomon Abraham
Published: August 2022

Purpose of review

Rheumatoid arthritis (RA) is an autoimmune disease that primarily affects the joints. Extra-articular manifestations (EAMs) are common and may affect up to 40.6% of patients. Ocular EAM can occur in 39% of the patients. The cornea is involved by different pathogenic mechanisms and corneal disease varies from mild symptoms to severe corneal ulceration and melting with visual loss. Severe corneal involvement is associated with increased mortality in RA patients. We aimed to review the prevalence, mechanisms, management and overall impact of corneal involvement in RA patients.

Recent findings

Corneal involvement is frequent among RA patients. With the wider use of systemic immunosuppression, in particular the disease-modifying antirheumatic drugs (DMARDs), and with improvement of surgical techniques, spontaneous and surgery-related corneal ulceration and melting is becoming less common. However, RA patients are still at risk and should be carefully managed.

RA-related corneal complications are associated with a decreased quality of life and poor ocular and systemic prognosis. Prompt recognition and a multidisciplinary approach involving topical ophthalmic management and systemic immunosuppression are the key factors to maintain ocular integrity and avoid a lethal outcome.
Is allergy immunotherapy-induced anaphylaxis still a real problem?
Authors: Bernstein David I. , Berendts Karen
Published: August 2022

Purpose of review

The current review describes the incidence and risk for anaphylaxis due to allergy injections.

Recent findings

The incidence of fatal anaphylaxis occurs with approximately one in 7.2 million injection visits. Severe anaphylaxis may occur once in every 160 000 visits. The major risk for fatal anaphylaxis is severe and uncontrolled asthma.

Understanding risk factors for anaphylaxis to allergy injections has led to clinic protocols aimed at preventing such events. The efficacy of these preventive measures remains to be determined in future studies.
Development and Usability Testing of a System to Detect Adverse Events and Medical Mistakes
Authors: Blakeney Erin Abu-Rish , Dardas Todd , Zierler Brenda K. , Wolpin Seth
Published: August 2022

Many inpatient hospital visits result in adverse events, and a disproportionate number of adverse events are thought to occur among vulnerable populations. The personal and financial costs of these events are significant at the individual, care team, and system levels. Existing methods for identifying adverse events, such as the Institute for Healthcare Improvement Global Trigger Tool, typically involve retroactive chart review to identify risks or triggers and then detailed review to determine whether and what type of harm occurred. These methods are limited in scalability and ability to prospectively identify triggers to enable intervention before an adverse event occurs. The purpose of this study was to gather usability feedback on a prototype of an informatics intervention based on the IHI method. The prototype electronic Global Trigger Tool collects and presents risk factors for adverse events. Six health professionals identified as potential users in clinical, quality improvement, and research roles were interviewed. Interviewees universally described insufficiencies of current methods for tracking adverse events and offered important information on desired future user interface features. A key next step will be to refine and integrate an electronic Global Trigger Tool system into standards-compliant electronic health record systems as a patient safety module.
Evidence-Based Approach to Decrease Incidence of Hospital-Acquired Pressure Injuries
Authors: Bartolowits Kim , Morran Lacee , Eisenhooth Alaina , Criste Taylor
Published: August 2022

Hospital-acquired pressure injuries (HAPIs) are a painful and unwanted experience for the patient and cause unwanted additional costs to hospitals. Because HAPIs are a preventable occurrence, they are a nurse-sensitive indictor for national benchmarking when looking at quality and safety. Controlling the occurrence of HAPI in the hospital setting can be challenging for any nurse, but the difficulty is enhanced in the intensive care unit. This article discusses how a group of nurses from various areas of the hospital came together to heighten awareness of skin care and provided frontline education to peers. Through the use of structured programs using both a nationally known Wound Associate treatment program and Lean methodology, the nurses were able to work through processes and barriers and successfully decrease the incidence of HAPI in this academic medical center.
Myopericytoma: A Review of Twenty-Three Cases Over Twelve Years and a Case Report of a Rare Neoplasm
Authors: Tan Marcus Wei Ping , Wei Tay Adriel You , Tang Po Yin , Chew Khong Yik , Nicholas Yeo Eng Meng
Published: August 2022

Myopericytoma is a rare soft tissue tumor with a predilection for the distal extremities. It is commonly found in the skin and subcutaneous tissues and usually takes a benign course. Current knowledge is limited to isolated case series and reports; hence, this study aims to report our tertiary institution's experience with this uncommon entity. A review of our institution's pathology records for cases of myopericytoma was performed. From January 2009 to September 2020, 23 cases of myopericytoma were identified and their clinicopathologic features were reported. A unique case of myopericytoma of the ankle from the series was also highlighted as a case report. Among the 22 cutaneous cases, 18 were in the extremities and 4 in the head and neck. One patient had an intracranial lesion. Most patients developed asymptomatic nodules (72.2%), but 1 patient had a locally aggressive tumor on presentation. None recurred despite marginal excision in some patients (80.0%). In conclusion, pathologists and surgeons who encounter this rare neoplasm can reassure patients of its benign tendency.
Ocular neuromyotonia: a review of diagnosis and treatment
Authors: Lee Samuel K. , Lee Michael S.
Published: August 2022

Purpose of review

The current review will cover the clinical presentation, causes, epidemiology, differential diagnoses, workup, and treatment of ocular neuromyotonia (ONM) in detail.

Recent findings

While ONM largely remains a unilateral eye movement disease affecting adults with a history of sellar radiation, recent case reports highlight an expansion of this presentation to include bilateral, pediatric, and congenital cases.

ONM is a rare but recognizable ocular motility disorder involving sustained contraction of the extraocular muscle, commonly resulting in intermittent diplopia. Diagnosis of ONM relies upon a thorough history and clinical exam, with particular attention to history of radiotherapy and eccentric gaze testing. Treatment with carbamazepine remains first-line therapy, although other membrane stabilizing agents and surgical interventions can be effective.
Systemic Barriers in Receiving Electronically Prescribed Glaucoma Medications
Authors: Oke Isdin , Badami Avni , Kosteva Kathryn L. , Wu Kevin , Desai Manishi A.
Published: August 2022

Précis:

Over a third of electronically prescribed glaucoma medications were not picked up within 1 month of patient request. Feedback-driven protocols may help minimize treatment interruptions attributed to electronic prescribing.

Purpose:

Glaucoma treatment relies on long-term medication compliance and many socioeconomic factors impact the ability of patients to receive their medications. This study aims to quantify treatment interruptions attributable to electronically prescribed medications and propose interventions to minimize this barrier.

Methods:

This is a cross-sectional study of the electronic prescribing patterns at a tertiary care hospital serving a socioeconomically diverse patient population. Glaucoma medication refill requests received over a 6-week interval were reviewed and patient pharmacies were contacted 1 month after the request date to determine whether the medication was received by the patient. Patients who did not pick up the prescriptions were contacted and consented to participate in a survey to identify the barriers to acquiring the medications.

Results:

Refill requests of 198 glaucoma medications met the inclusion criteria and the most common classes were prostaglandin analogs (44%) and alpha-2-agonists (21%). Medications were not obtained within 1 month in 71 (35.9%) cases. Prior authorization requirement was significantly associated with patients not obtaining their medication (odds ratio, 0.07; 95% confidence interval, 0.03–0.45). Patient reported challenges to successful receipt electronically prescribed medications included insurance coverage (32.2%) and pharmacy availability (22.6%).

Conclusions:

Approximately a third of electronically prescribed glaucoma medications were not received by patients within a month of refill request due to the need for prior authorization, insurance coverage, and pharmacy availability. A mechanism to alert providers and to address these barriers to medication access may minimize treatment interruption and disease progression.
Diurnal Variation of Corneal Hysteresis in Patients With Untreated Primary Open Angle Glaucoma and Normal Individuals
Authors: Okayama Masahiko , Tsuchiya Shunsuke , Higashide Tomomi , Udagawa Sachiko , Yamashita Yoko , Shioya Satomi , Takemori Hayato , Nakazawa Kazuki , Manbo Yuki , Sugiyama Kazuhisa
Published: August 2022

Précis:

Corneal hysteresis in both patients with untreated open angle glaucoma and normal individuals demonstrated significant diurnal variation independent of confounding factors and was higher in the nighttime than in the daytime.

Purpose:

To investigate diurnal variations in corneal hysteresis (CH) in patients with untreated primary open angle glaucoma (POAG) and normal individuals by using an ocular response analyzer.

Materials and Methods:

This prospective study included 72 eyes of 53 patients with untreated POAG and 53 eyes of 47 normal individuals. Intraocular pressure (IOP) and CH were measured using Goldmann applanation tonometry (GAT) and ocular response analyzer, respectively, every 3 hours from 9:00 to 24:00. Mixed-effects models were used to determine factors associated with CH values and CH amplitude (maximum values minus minimum values) and to examine the diurnal variations in GAT IOP and CH in each group. Significant differences between time points were defined as significant variations.

Results:

The diurnal average GAT IOP and CH in patients with POAG were significantly higher and lower than those in normal individuals (P=0.001, 0.002). In the multivariate analysis, the larger central corneal thickness was associated with larger CH values in POAG and normal eyes (both P<0.001). A larger amplitude of GAT IOP was significantly associated with a larger CH amplitude in POAG and normal eyes (P=0.010, 0.013). CH, in both groups, showed similar significant diurnal variation and was higher in the nighttime than in the daytime, even after adjusting for confounding factors, while IOP showed an antiphase pattern.

Conclusion:

CH in both untreated POAG patients and normal participants demonstrated similar diurnal variations, that is, higher at night, independent of confounding factors. These findings suggest that viscoelastic properties of the cornea may fluctuate diurnally independent of IOP.
Parent-Mediated Targeted Intervention for Young Children at Risk for Autism Spectrum Disorder
Authors: Azzano Alicia , Ward Rebecca , Vause Tricia , Feldman Maurice
Published: August 2022

Interventions for young children at risk for autism spectrum disorder (ASD) may improve key developmental skills and remediate early ASD signs. Parents of 3 children (19, 23, and 26 months old) showing possible early signs of ASD participated. The Parent Observation of Early Markers Scale (POEMS) identified specific child concerns confirmed in baseline observations. Multiple baseline designs across parent and child behaviors evaluated a parent-mediated behavioral intervention, called Parent Intervention for Children At-Risk for Autism (PICARA), to increase targeted developmental skills (e.g., responding to name, imitation, requesting). Parents received individual behavioral skills training in their home 1 hr per week over 12, 18, and 29 sessions, respectively, based on the number of child skills trained and child performance. All parent and child skills improved and were maintained at the 46-, 12-, and 6-week follow-up periods, respectively. With training, parents of young children at risk for ASD may be able to improve child skills deficits often seen in children with ASD.
A Review of Early Motor Issues in Young Children With Autism Spectrum Disorder
Authors: Hebert Elizabeth Baltus , Nolan Karen W. , Smith Katie Nicole
Published: August 2022

The cardinal features of autism spectrum disorder (ASD) are recognized to include impairments in communication, social interactions, and restricted, repetitive behaviors and stereotyped interests. However, many children with ASD also have motor activity limitations that are often overlooked. The purpose of this review is to summarize the literature on neuromotor impairment and motor activity limitation in children with ASD. A literature search was conducted of citations from 1998 through 2021 using PubMed, EMBASE, and PsycINFO. Twenty-three search terms were used to encompass diverse articles focused on children with autism and motor activity. The search resulted in 78 articles that included the search terms and were also consistent with the aims of this literature review. The potential significance of motor activity limitations on development from an early age is explored and recommendations are offered for more holistic surveillance in children with ASD, which can facilitate early access to services when indicated.
A Literature Review of the Causes of Congenital Limb Deficiencies Over the Last 20 Years
Authors: Shivers Emma , Day Sarah
Published: August 2022

Introduction

Despite the prevalence of congenital limb deficiencies (CLDs) occurring in around 7.9/10,000 births (Am J Med Genet A. 2011;155A:1225–1235), there is still a gap in the knowledge regarding the etiology of a large proportion of cases, and literature addressing this topic is sparser compared with other conditions.

Objective

The aim of this study is to assess the literature surrounding the causes of CLDs and use this to suggest the area in which a potential gap in the information on the causes of CLDs lies.

Study Design

This study is a literature review on articles published from the year 2000 onward.

Methods

A search was conducted on five databases (CINAHL, Scopus, PubMed, Embase, Cochrane Library) and the ProQuest platform resulting in 18 articles to be discussed, after inclusion and exclusion criteria were applied and critical appraisals were completed.

Results and Discussion

The main findings could be separated into four themes including genetics, environment, drugs, and vascular. Comparisons were made among similar literature, although within some topics, this was less effective, given the specificity and reduced volume of research. Positive correlations were seen in all studies; however, the biggest underlying factor for most causes seemed to originate from a vascular disruption.

Conclusions

Future studies should focus on an underlying vascular disruption as a base for further research to attempt to find reasoning for the proportion of CLDs with an unknown cause. Further attempts should be made into creating a consensus on classifying and recording CLDs to ensure a more uniform approach to this topic worldwide, allowing comparisons to be drawn more easily.

Clinical Relevance

Understanding relevant terminology is vital to ensure that families experiencing CLD receive accurate information about their child's condition. This understanding will also lead to improvements in the quality of recorded data, such as clinical notes and registry inputs.
Regulation of cardiovascular calcification by lipids and lipoproteins
Authors: Hsu Jeffrey J. , Tintut Yin , Demer Linda L.
Published: August 2022

Purpose of review

Lipids and lipoproteins have long been known to contribute to atherosclerosis and cardiovascular calcification. One theme of recent work is the study of lipoprotein (a) [Lp(a)], a lipoprotein particle similar to LDL-cholesterol that carries a long apoprotein tail and most of the circulating oxidized phospholipids.

Recent findings

In-vitro studies show that Lp(a) stimulates osteoblastic differentiation and mineralization of vascular smooth muscle cells, while the association of Lp(a) with coronary artery calcification continues to have varying results, possibly because of the widely varying threshold levels of Lp(a) chosen for association analyses. Another emerging area in the field of cardiovascular calcification is pathological endothelial-to-mesenchymal transition (EndMT), the process whereby endothelial cell transition into multipotent mesenchymal cells, some of which differentiate into osteochondrogenic cells and mineralize. The effects of lipids and lipoproteins on EndMT suggest that they modulate cardiovascular calcification through multiple mechanisms. There are also emerging trends in imaging of calcific vasculopathy, including: intravascular optical coherence tomography for quantifying plaque characteristics, PET with a radiolabeled NaF tracer, with either CT or MRI to detect coronary plaque vulnerability.

Recent work in this field includes studies of Lp(a), EndMT, and new imaging techniques.
A Comparison of Temperature Thresholds to Begin Laboratory Evaluation of Well-Appearing Febrile Infants
Authors: Lam Sophia , Chamdawala Haamid , Friedman Jonathan , Meltzer James A.
Published: August 2022

Objective

Young infants who develop fever are at an increased risk for serious infection. It is unclear, however, what temperature cutoff would be optimal to begin evaluating these infants because some criteria use different thresholds. We sought to determine the percentage of infants presenting to the Emergency Department (ED) with a temperature less than 38.2°C who develop serious infection compared with those with higher temperatures.

Methods

We used a publicly available dataset from the Pediatric Emergency Care Applied Research Network. Patients were included if they were aged 60 days or younger, had a documented rectal temperature of 38.0°C or higher in the ED or a history of fever within 24 hours before presentation to the ED, and were being evaluated for serious infection. We used the same exclusion criteria as the original Pediatric Emergency Care Applied Research Network study but further excluded those who were ill-appearing (Yale Observation Score > 10). Serious infections included any of the following: urinary tract infection, bacteremia, bacterial or herpes meningitis, bacterial pneumonia, or bacterial enteritis. Data were described using frequencies (percentages) and compared between groups using χ2 test.

Results

Of the 4619 eligible infants, 1311 (28.4%) had a temperature lower than 38.2°C. Infants with temperatures lower than 38.2°C were significantly less likely to have a serious infection compared with those with higher temperatures (97 [7.5%] vs 365 [11.2%], P < 0.001). Of the infants with temperatures lower than 38.2°C who were tested, 67 (5.8%) had a urinary tract infection, 10 (0.8%) had bacteremia, 3 (0.4%) had bacterial meningitis, 3 (2.9%) had herpes meningitis, 17 (4.5%) had bacterial pneumonia, and 2 (4.8%) had bacterial enteritis.

Conclusions

In this study, we found that infants with temperatures lower than 38.2°C were significantly less likely to have a serious infection than those with higher temperatures. Using an evaluation cutoff of 38.2°C, however, would likely miss a clinically important number of well-appearing infants with serious infections.
Cognitive Task Performance and Subjective Cognitive Symptoms in Individuals With Chronic Fatigue Syndrome or Fibromyalgia: A Cross-Sectional Analysis of the Lifelines Cohort Study
Authors: Joustra Monica L. , Hartman Catharina A. , Bakker Stephan J.L. , Rosmalen Judith G.M.
Published: August 2022

Objective

This study examined cognitive task performance and self-reported cognitive functioning in individuals with chronic fatigue syndrome (CFS) and fibromyalgia (FM) in a population-based sample and investigated the role of mood and anxiety disorders as well as severity of the physical symptoms.

Methods

This study was performed in 79,966 participants (mean [standard deviation] age = 52.9 [12.6] years, 59.2% women) from the Lifelines general population. Symptoms consistent with the diagnostic criteria for CFS and FM were assessed using questionnaires. Two comparison groups were used: participants with self-reported medical disorders with well-defined pathophysiology (i.e., multiple sclerosis and rheumatic arthritis) and controls without these diseases. Objective task performance was based on the computerized CogState cognitive battery and subjective cognitive symptoms using the concentration subscale of the Checklist Individual Strength.

Results

Cognitive task performance was poorer in individuals with CFS versus controls without disease and controls with a medical disorder, although the severity of cognitive dysfunction was mild. Participants meeting the criteria for CFS (n = 2461) or FM (n = 4295) reported more subjective cognitive symptoms compared with controls without a medical disorder (d = 1.53, 95% confidence interval [CI] = 1.49–1.57 for CFS; d = 1.25, 95% CI = 1.22–1.29 for FM) and participants with a medical disease (d = 0.62, 95% CI = 0.46–0.79 for CFS; d = 0.75, 95% CI = 0.70–0.80 for FM). These differences remained essentially the same when excluding participants with comorbid mood or anxiety disorders or adjusting for physical symptom severity.

Conclusions

Subjective cognitive symptoms and, to a lesser extent, suboptimal cognitive task performance are more prevalent in individuals with CFS or FM compared with controls without these conditions.
The Association Between Peripheral Oxytocin Levels and Depressive Symptoms in People With HIV
Authors: Shortell Destin D. , Rubin Leah H. , Murphy Aidan J. , Cohen Ronald A. , Porges Eric C.
Published: August 2022

Objective

Depression is common in people with HIV (PWH), yet little is known about the mechanisms contributing to depressive symptoms in PWH. Previous research across a range of populations has suggested a relationship between the neuropeptide oxytocin and depressive symptoms, with variable directionality. This article investigated the association between peripheral oxytocin levels and depressive symptoms in PWH.

Methods

Unextracted oxytocin serum concentrations were assayed in 79 PWH (44% female, mean age = 34.35 [8.5], mean body mass index = 25.69 [5.46], mean CD4 = 516.60 [271.15]) who also completed the Center for Epidemiologic Studies Depression Scale (CES-D). CES-D items were evaluated in an exploratory factor analysis (EFA), and the relationships between oxytocin, total CES-D score, and the resulting EFA factors were analyzed with multivariate linear regressions conducted in R. Multiple regression models were used to adjust for age, sex, body mass index, CD4, and education.

Results

Contrary to hypothesized, higher peripheral oxytocin levels were associated with higher CES-D total scores with a small-to-moderate effect size (β = 0.26, p = .009). Following Bonferroni correction, oxytocin was not significantly associated with any of the five factors identified from the EFA: depressed affect, positive affect, appetite, cognitive symptoms, or perceived failure (p values > .042). Small effect sizes were found for the depressed affect (β = 0.22) and perceived failure (β = 0.21) factors (p values > .042).

Conclusions

In a sample of predominately Black or African American individuals with HIV, higher oxytocin was associated with higher total depressive symptoms. In addition, this relationship was slightly stronger than those of specific depressive symptoms. These findings warrant further study into the role of oxytocin in mood symptoms within PWH.