bluuebunny/crossref_metadata_2025 huggingface dataset:
Mass spectrometry‐based cortisol profiling during adrenal venous sampling reveals misdiagnosis for subtyping primary aldosteronism
Authors: Ma Ying , Chen Hong , Chen Fangjun , Jiang Jingjing , Guo Wei , Li Xiaoying , Gao Xin , Lu Zhiqiang , Zhou Bo , Zhao Lin , Li Xiaomu
Published: December 2021

Objective

Primary aldosteronism (PA) is a common form of secondary hypertension. Adrenal venous sampling (AVS) is the gold standard for subtyping PA. This study aimed to determine whether there is a difference between immunoassays and liquid chromatography‐mass spectrometry (LC‐MS/MS) methods for measuring cortisol levels that affect the judgement of AVS.

Design

This was a retrospective study.

Patients

Included 72 patients who were diagnosed with PA and had undergone AVS.

Measurements

Patients were grouped according to whether they received adrenocorticotropic hormone (ACTH) stimulation during AVS, and the cortisol results were measured using immunoassay and LC‐MS/MS.

Results

There were 48 patients in the without ACTH stimulation group and 24 in the post‐ACTH stimulation group during AVS (bilateral adrenal vein cannulation success rate, 56.25% vs. 83.33%). ACTH stimulation was beneficial for increasing the success rate of AVS (p < .001). Immunoassays were linearly correlated with LC‐MS/MS when cortisol concentrations were <1750 nmol/L (r = .959, p < .001). When cortisol concentrations were >17,500 nmol/L, no correlation was found between the two methods (p = .093). The two methods were consistent for the detection of cortisol for evaluating the success of cannulation for AVS. Five percent of patients showed discordant lateralization of aldosterone production according to the cortisol LC‐MS/MS and immunoassay results in the without ACTH group, and 15% showed discordant lateralization in the post‐ACTH group.

Conclusions

The immunoassay method can be used to determine whether cannulation is successful. The final decision for lateralization may be more appropriate based on LC‐MS/MS results.
Traits affecting nutrient recycling by mobile consumers can explain coexistence and spatially heterogeneous trophic regulation across a meta‐ecosystem
Authors: Peller Tianna , Marleau Justin N. , Guichard Frédéric
Published: December 2021

Ecosystems are linked through spatial flows of organisms and nutrients that impact their biodiversity and regulation. Theory has predominantly studied passive nutrient flows that occur independently of organism movement. Mobile organisms, however, commonly drive nutrient flows across ecosystems through nutrient recycling. Using a meta‐ecosystem model where consumers move between ecosystems, we study how consumer recycling and traits related to feeding and sheltering preferences affect species diversity and trophic regulation. We show local effects of recycling can cascade across space, yielding spatially heterogeneous top‐down and bottom‐up effects. Consumer traits impact the direction and magnitude of these effects by enabling recycling to favour a single ecosystem. Recycling further modifies outcomes of competition between consumer species by creating a positive feedback on the production of one competitor. Our findings suggest spatial interactions between feeding and recycling activities of organisms are key to predicting biodiversity and ecosystem functioning across spatial scales.
Impact of HIV impact on outcomes of deep‐brain stimulation of the subthalamic nucleus for Parkinson’s disease
Authors: Garcia Jeanne , Hubsch Cécile , Marques Ana , Gurruchaga Jean‐Marc , Lamirel Cédric , Roze Emmanuel , Moulignier Antoine
Published: December 2021

Background and purpose

Middle‐aged persons living with HIV (PLHIV) have a heightened risk of more concomitant age‐related comorbidities that are acknowledged as signs of poorer prognosis after deep‐brain stimulation of the subthalamic nucleus (STN‐DBS) at younger‐than‐expected ages. To assess the beneficial and adverse effects of STN‐DBS in PLHIV with Parkinson's disease (PD).

Methods

We retrospectively included nine PLHIV with PD who had sustained virological control. Patients were followed up for 7 ± 4 years.

Results

Patients’ mean ages at PD onset and STN‐DBS were 45 ± 15 and 53 ± 16 years, respectively. At STN‐DBS, mean HIV infection and PD durations were 15 ± 12 and 8 ± 4 years, respectively. STN‐DBS significantly improved 1‐year Unified Parkinson's Disease Rating Scale (UPDRS)‐III scores (71%), daily off‐time (63%), motor fluctuations (75%) and daily levodopa‐equivalent dose (68%); mean 5‐year UPDRS‐III score and motor fluctuation improvements remained ~45%. Impulse control disorders (affecting 6/9 patients) fully resolved after STN‐DBS. Postoperative course was uneventful. No serious adverse events occurred during follow‐up.

Conclusion

Our findings indicate that STN‐DBS is a safe and effective treatment for PLHIV with PD.
Longitudinal amyloid cognitive composite in preclinical Alzheimer’s disease
Authors: Kim Young Ju , Hahn Alice , Park Yu Hyun , Na Duk L. , Chin Juhee , Seo Sang Won
Published: December 2021

Background and purpose

Previous studies have developed several cognitive composites in preclinical Alzheimer disease (AD). However, more sensitive measures to track cognitive changes and therapeutic efficacy in preclinical AD are needed considering the diverse sociocultural and linguistic backgrounds. This study developed a composite score that can sensitively detect the amyloid‐β (Aβ)‐related cognitive trajectory of preclinical AD using Korean data.

Methods

A total of 196 cognitively normal participants who underwent amyloid positron emission tomography were followed‐up with neuropsychological assessments. We developed the Longitudinal Amyloid Cognitive Composite in Preclinical AD (LACPA) using the linear mixed‐effects model (LMM) and z scores. The LMM was also used to investigate the longitudinal sensitivity of the LACPA and the association between time‐varying brain atrophy and the LACPA.

Results

Considering the group‐time interaction effects of each subtest, the Seoul Verbal Learning Test‐Elderly version immediate recall/delayed recall/recognition, the Korean Trail Making Test B Time, and the Korean Mini‐Mental State Examination were selected as components of the LACPA. The LACPA exhibited a significant group‐time interaction effect between the Aβ+ and Aβ− groups (t = −3.288, p = 0.001). Associations between time‐varying LACPA and brain atrophy were found in the bilateral medial temporal, right lateral parietal, and right lateral frontal regions, and hippocampal volume.

Conclusions

The LACPA may contribute to reduction in time and financial burden when monitoring Aβ‐related cognitive decline and therapeutic efficacy of the disease‐modifying agents specifically targeting Aβ in secondary prevention trials.
Effect of coupling damage on fatigue behavior of 2198‐T8 aluminum‐lithium alloy thin sheet for fuselage
Authors: Chen Yajun , Pan Xuechun , Peng Jianshu , Wang Fusheng
Published: December 2021

Based on fatigue experiment and digital image correlation (DIC) technique, the fatigue damage behavior and the failure mechanism of the 2198 aluminum‐lithium alloy thin sheet used for the fuselage were investigated. Firstly, the influence of hemispherical insert size, impact energy, and rivet hole size Φ on the fatigue performance was explored. Secondly, the axial strain distribution and crack propagation behavior of the coupling damaged specimen under the fatigue cyclic loading were characterized by DIC. The results are as follows: the axial strain along the dent path and the rivet hole section path indicates that there exists a competitive relationship between the discontinuity caused by the rivet hole and the dent damage under the fatigue load. For specimens impacted by the same insert, the critical local plastic strain rate
for the transition point of the fatigue fracture is related to the rivet hole size Φ, and it increases with the rise of Φ. After the dent damage being quantified, the final fracture position could be determined by the numerical comparison method.
Fatigue failure identification using deformation and energy rate for hole‐fissure contained granite under freeze–thaw and variable‐frequency–variable‐amplitude cyclic loads
Authors: Wang Yu , Li Juzhou , Zhu Chun , Mao Tianqiao
Published: December 2021

This work conducted laboratory tests considering the coupled freeze–thaw (FT) and variable‐frequency–variable‐amplitude cyclic loads on granite containing two fissures and a circular hole. The analysis is dedicated to reveal the deformation and energy rate characteristics. Testing results show that increasing FT cycle and loading level both accelerate rock damage. The rock subjecting to high FT cycle behaves much larger damage rate in terms of volumetric strain and dissipated energy. The warning strength is defined according to the volumetric strain rate and dissipated energy rate which can early issue a warning than the crack damage stress point. In addition, the rock instability precursor is proposed by monitoring the incremental rate of the radial strain and volumetric strain; drastic damage occurs when the volumetric rate exceeds the radial rate. Three typical crack coalescence modes of double shear coalescence, single shear coalescence, and single tensile coalescence were revealed.
The National Evaluation of Malawi’s PMTCT Program (NEMAPP) study: 24‐month HIV‐exposed infant outcomes from a prospective cohort study
Authors: van Lettow Monique , Tippett Barr Beth A. , van Oosterhout Joep J. , Schouten Erik , Jahn Andreas , Kalua Thokozani , Auld Andrew , Nyirenda Rose , Wadonda Nellie , Kim Evelyn , Landes Megan
Published: December 2021

Objectives

Data on long‐term HIV‐free survival in breastfeeding, HIV‐exposed infants (HEIs) are limited. The National Evaluation of Malawi’s Prevention of Mother‐to‐Child Transmission (PMTCT) Program (NEMAPP), conducted between 2014 and 2018, evaluated mother‐to‐child transmission (MTCT) and infant outcomes up to 24 months postpartum.

Methods

We enrolled a nationally representative cohort of HEIs at 54 health facilities across four regional strata in Malawi and used multivariable Cox regression analysis to investigate the risk of adverse outcomes (HIV transmission, infant death and loss to follow‐up) to 24 months postpartum. Models, controlling for survey design, were fitted for the total cohort (n = 3462) and for a subcohort that received maternal viral load (VL) monitoring (n = 1282).

Results

By 24 months, in 3462 HEIs, weighted cumulative MTCT was 4.9% [95% confidence interval (CI) 3.7–6.4%], 1.3% (95% CI 0.8–2.2%) of HEIs had died, 26.2% (95% CI 24.0–28.6%) had been lost to follow‐up and 67.5% (95% CI 65.0–70.0%) were alive and HIV‐free. Primiparity [weighted adjusted hazard ratio (aHR) 1.6; 95% CI 1.1–2.2; parity 2–3: weighted aHR 1.5; 95% CI 1.2–1.9], the mother not disclosing her HIV status to her partner (no disclosure: weighted aHR 1.3; 95% CI 1.1–1.6; no partner: weighted aHR 0.7; 95% CI 0.5–0.9), unknown maternal ART start (weighted aHR 2.0; 95% CI 1.0–3.9) and poor adherence (missed ≥ 2 days of ART in the last month: weighted aHR 1.7; 95% CI 1.2–2.2; not on ART: weighted aHR 1.7; 95% CI 1.0–2.7) were associated with adverse outcomes by 24 months. In the subcohort analysis, risk of HIV transmission or infant death was higher among HEIs whose mothers started ART post‐conception (during pregnancy: weighted aHR 3.2; 95% CI 1.3–7.7; postpartum: weighted aHR 12.4; 95% CI 1.5–99.6) or when maternal viral load at enrolment was > 1000 HIV‐1 RNA copies/mL (weighted aHR 15.7; 95% CI 7.8–31.3).

Conclusions

Infant positivity and infant mortality at 24 months were low for a breastfeeding population. Starting ART pre‐conception had the greatest impact on HIV‐free survival in HEIs. Further population‐level reduction in MTCT may require additional intervention during breastfeeding for women new to PMTCT programmes. Pre‐partum diagnosis and linkage to ART, followed by continuous engagement in care during breastfeeding can further reduce MTCT but are challenging to implement.
Differential effects of schooling and cognitive and non‐cognitive skills on labour market outcomes: The case of the garment industry in Ethiopia
Authors: Yamada Shoko , Otchia Christian S.
Published: December 2021

The paper contributes to the discussion of the effects of educational attainment and skills on labour market outcomes, especially in a fast‐growing economy. The data are derived through the authors’ unique skills assessment of 591 workers at 19 foreign‐invested garment‐production companies in Ethiopia, which allows for the analysis of the impact of cognitive, non‐cognitive, and practical skills separately from that of years of schooling. Instead of using the total score of a written test as a proxy for skills, we examine the composition of skills more closely. Our findings indicate that the schooling record is a significant determinant of wage, although the level of basic cognitive skills does not necessarily correspond to participants’ educational backgrounds. We also find that the non‐cognitive skills needed to perform tasks accurately and with confidence are important for both written test performance and higher wages. Employers reward people with practical skills and knowledge directly related to work, although our findings suggest that overall cognitive capacities are developed holistically from a combination of different types of skills such as mathematical, reading, and analytical. The study highlights how developing economies face different skills assessment challenges than developed economies.
In situ dynamics of Vibrio parahaemolyticus and Vibrio vulnificus in water, sediment and triploid Crassostrea virginica oysters cultivated in floating gear
Authors: Prescott James , Barkovskii Andrei L.
Published: December 2021

Aims

To understand spatial–temporal distribution of Vibrio parahaemolyticus and Vibrio vulnificus in triploid Crassostrea virginica in off-bottom aquaculture.

Methods and Results

Oysters, sediments and water were seasonally collected in Georgia, USA. V. parahaemolyticus and V. vulnificus were quantified with tlh/tdh/trh and vvhA genes, respectively. No tdh/trh genes were detected. Highest concentrations of tlh gene were observed in summer sediments > oysters > water (105/g, 104/g, 103/ml). VvhA concentrations were similar in sediments and oysters but never exceeded ≥3 × 101/ml in water. Concentrations of tlh and vvhA genes correlated to temperature and turbidity, respectively, which along with their different spatial distribution indicated different environmental drivers. In oysters, ratios of the tlh and vvhA to 16S rRNA gene have increased from 0 to 10−1 and 10−2 in summer, while these ratios in water and sediments were lower by 2–3 orders of magnitude.

Conclusions

Dynamics of tlh and vvhA concentrations and abundances suggested enrichment of V. parahaemolyticus and V. vulnificus by off-bottom triploid oysters in summer resulting in their abundance by far exceeding that in water.

Significance and Impact of the Study

This first report on enrichment of Vibrio pathogens in triploid oysters with no direct contact to sediments reveals a threat to human health suggesting their monitoring in triploid off-bottom C. virginica aquaculture.
Effects of regulatory focus on online learning engagement of high school students: The mediating role of self‐efficacy and academic emotions
Authors: Deng Wenbo , Lei Weina , Guo Xipei , Li Xinyi , Ge Wenshuang , Hu Weiping
Published: December 2021

Background

Since the outbreak of COVID‐19, online courses have been extensively used from K‐12 to higher education. Online learning engagement, an important factor in online learning success, is currently at a low level in high school. Meanwhile, the research on the factors that influence high school students' online learning engagement is still limited.

Objectives

Based on the theories of regulatory focus and value control, this study developed a multi‐mediation model to investigate whether self‐efficacy and academic emotions can mediate the relationship between regulatory focus and online learning engagement.

Methods

A total of 926 high school student (52.16% female, mean age = 16.47 years) were recruited to participate in this study and completed self‐report measures of regulatory focus, online learning engagement, online learning self‐efficacy and academic emotions. And we used SPSS macro PROCESS developed by Hayes to examine the mediating role of online learning self‐efficacy and academic emotions.

Results and Conclusions

The results indicated that promotion focus had a stable positive effect on online learning engagement of high school students, whereas prevention focus had a significant negative effect on the same. Self‐efficacy and positive emotions had a significant positive mediating effect between promotion focus and online learning engagement. Moreover, positive emotions had a significant positive mediating effect between the prevention focus and online learning engagement, while negative emotions had a significant negative mediating effect between them.
Frontline connect: Evaluating a virtual technology program to enhance patient and provider communication during COVID‐19
Authors: Bansal Rishi , Jezrawi Rita , Greenwald Ari , Sandhanwalia Simerpreet , Luo Emmy , Greenwald Ilana , Saeed Humaira , Mondoux Shawn , Chan Teresa , Lokker Cynthia
Published: December 2021

Rationale

Since the beginning of the COVID‐19 pandemic, many hospitals have reduced in‐hospital visitation. In these situations, virtual communication tools have helped maintain interaction between parties. The Frontline Connect program was designed to address communication and patient care challenges by providing data‐enabled devices to clinical staff in hospitals.

Objective

This study aimed to identify areas of improvement for the Frontline Connect program by: (a) evaluating communication needs, user experience, and program satisfaction; and (b) identifying potential barriers to device access or use.

Methods

We administered pre‐implementation needs assessment, post‐use, and exit surveys to healthcare staff at a pilot hospital site in Ontario. Recruitment was through email lists and site champions using convenience sampling. We descriptively analysed survey responses and compared the initial need statements to post‐implementation use‐cases identified by users.

Results

We received 139 needs assessments, 31 user experience assessments, and 47 exit survey responses. Most device use occurred in the emergency department and intensive care units and was facilitated by social workers, nurses, and physicians to connect patients, families, and care providers. Pre‐implementation concerns were related to infection control, data security, and device privacy. In the exit survey, these were replaced by other concerns including Internet connectivity and time‐intensiveness. Device utility and ease‐of‐use were rated 9.7/10 and 9.6/10 respectively in the user experience survey, though overall experience was rated 7.2/10 in the exit survey. Overall, respondents viewed the devices as useful and we agree with participants who suggested increased program promotion and training would likely improve adoption.

Conclusions

We found that our virtual technology program for facilitating communication was positively perceived. Survey feedback indicates that a rapid rollout in response to urgent pandemic‐related needs was feasible, though program logistics could be improved. The current work supports the need to improve, standardize, and sustain virtual communication programs in hospitals.
Association of daily sleep duration with the incident dementia by serum soluble TREM2 in a community
Authors: Ohara Tomoyuki , Hata Jun , Tanaka Masashi , Honda Takanori , Yamakage Hajime , Inoue Takayuki , Hirakawa Yoichiro , Kusakabe Toru , Shibata Mao , Kitazono Takanari , Nakao Tomohiro , Satoh‐Asahara Noriko , Ninomiya Toshiharu
Published: December 2021

Background

Little is known about the influence of serum level of soluble triggering receptor expressed on myeloid cells 2 (sTREM2), which is a soluble type of an innate immune receptor expressed on the microglia, on the association of the daily sleep duration with the risk of dementia.

Methods

A total of 1230 Japanese community‐residents aged 60 and older without dementia were followed prospectively for 10 years (2002–2012). Serum sTREM2 levels were divided into two groups using the median value (334.8 pg/ml). Self‐reported daily sleep duration was grouped into three categories of <5.0, 5.0–7.9, and ≥8.0 h. A Cox proportional hazards model was used to estimate the hazard ratios (HRs) and their 95% confidence intervals (CIs) of daily sleep duration on the risk of dementia according to serum sTREM2 levels.

Results

During the follow‐up, 262 subjects developed dementia. In subjects with low serum sTREM2 levels, subjects with ≥8.0 h of daily sleep had a significantly greater risk of dementia (multivariable‐adjusted HR 2.05 [95% CI 1.32–3.19]) than those with 5.0–7.9 h of daily sleep, but those with <5.0 h did not. In contrast, the risk of dementia increased significantly in subjects with both <5.0 (1.95 [1.03–3.68]) and ≥8.0 h of daily sleep (1.48 [1.06–2.07]) in the subjects with high serum sTREM2 levels.

Conclusions

The influence of daily sleep duration on risk of dementia differed according to serum sTREM2 levels in the older Japanese population. Short daily sleep may be associated with greater risk of dementia only in subjects with a high serum sTREM2 level.
Treatment of acanthosis nigricans with sequential salicylic acid‐mandelic acid combination peel and maintenance with glycolic acid‐urea combination cream: A retrospective pilot study
Authors: Zeeshan Md , Arfeen Noorussaba , Sonthalia Sidharth , Singh Anupama , Roy Prasoon Kumar
Published: December 2021

Background

Acanthosis nigricans (AN) is a common dermatosis that presents with hyperpigmented, velvety thick plaques over intertriginous areas. Though a number of treatment modalities including chemical peels have been used, none provide long‐term and sustained improvement.

Aim and objectives

Our study evaluated the efficacy and safety of regular sessions of salicylic acid‐mandelic acid peeling over axillary AN lesions, which was followed by daily application of a topical combination of glycolic acid, urea, and cetylated fat esters for maintenance of effect for 9 months.

Methodology

A retrospective pilot study was conducted in Indian patients (Fitzpatrick skin type 4 or 5), aged 18–50 with benign hereditary AN involving the underarms, with or without affection of other typical sites. Data were retrieved of seventeen patients with AN involving the axillae. Patients were started on combination salicylic‐mandelic acid peel given every 2 weeks for a total of 6 sessions. Maintenance was done by night application of combination cream of glycolic acid, urea, and cetylated fat esters, which was continued for 9 months after completion of peeling sessions. Lesions were evaluated every 3 months of 9 months for improvement in pigmentation and skin thickening.

Results

All the patients (100%) showed significant improvement in both pigmentation and thickening of lesions. In terms of improvement in skin thickening, very good improvement was seen in 41%, while 29% patients had moderate improvement. In terms of improvement in pigmentation, 35% each had very good and moderate improvement. Post peel erythema (100%) and burning sensation (90%) were the most common encountered adverse effects which lasted for only 1–2 days. Patients were followed up for another 9 months during which no relapses were seen.

Conclusion

Combination of keratolytic chemical peels and topical mild keratolytic application ensures better therapeutic outcome in patients of AN with long lasting effect.
Decade of the dangers of multiple magnet ingestion in children: A retrospective review
Authors: Chang Annette , Yeap Evie , Lee Eloise , Bortagaray Juan , Giles Edward , Pacilli Maurizio , Nataraja Ramesh M
Published: December 2021

Aim

Magnet ingestion has become more frequent in children as magnetic toys and jewellery have been popularised, with the potential to cause significant morbidity. Our aim was to describe our experience at a tertiary paediatric surgical centre.

Methods

Retrospective review of patients admitted with multiple magnet ingestion (January 2011‐December 2020). Division into an intervention group and conservative group. Comparisons included demographics, number of magnets and clinical outcomes. Data analysis with a Student's t‐test and ROC Curve, P value of <0.05 was significant.

Results

A total of 23 patients were identified with a total of 150 magnets ingested. The majority required an intervention for magnets retrieval (15/23, 65.2%), 11/15 (73.3%) surgical and 4/15 (26.7%) endoscopic. In the surgery group, 6/11 (54%) presented with an initial perforation and 1/11 (9.1%) an entero‐enteric fistula. One patient (9.1%) had a multi‐site anastomotic leak post‐operatively. The conservative group had a significantly lower median number of ingested magnets (2 (2–6) vs. 7 (2–40), P = 0.03) and median length of stay (1 (1–4) vs. 7 (1–24), P = 0.03). ROC curve analysis revealed ingestion of >3 magnets had a sensitivity of 86.7% (95% CI: 62.1–97.6%) and specificity of 87.5% (95% CI: 53.0–99.4%) for requiring an intervention.

Conclusion

This series highlights a significant morbidity in children with a higher incidence of intervention following ingestion of more than three magnets. There is a strong requirement for the creation and adherence to new legislature involving industry standards.
Evaluation of temporary palatopexy to manage brachycephalic obstructive airway syndrome in dogs in respiratory distress
Authors: Sun J. A. , Johnson J. A. , Hallowell T. C.
Published: December 2021

Objective

To describe the use of temporary palatopexy procedure as a treatment for brachycephalic dogs in severe respiratory distress.

Materials and Methods

In this prospective pilot study, seven client‐owned brachycephalic dogs in severe respiratory distress, requiring emergent intubation or failing extubation, had a temporary palatopexy placed using a novel suture pattern.

Results

Six out of seven dogs were successfully extubated less than 2 hours post palatopexy and survived to discharge. One dog failed extubation secondary to worsening lower airway disease and laryngeal collapse. That patient was euthanased. The only noted complication was regurgitation in two dogs; however, one had pre‐existing gastrointestinal signs.

Clinical Significance

Temporary palatopexy is a relatively simple procedure that may be a useful method for managing brachycephalic dogs in an upper airway crisis. This could avoid the need for prolonged intubation, emergency tracheostomy, re‐intubation or euthanasia in dogs where costs, access to specialists and availability of referral centres are limited.
Organisation, technological change and skills use over time: A longitudinal study on linked employee surveys
Authors: Dhondt Steven , Kraan Karolus O. , Bal Michiel
Published: December 2021

The impact of technological change on the content of jobs and accompanying skills is a central topic across disciplines. To date, ample research has directly linked the technological change to shifts in skills use; however, organisational change is rarely considered as an influencing factor. Based on a panel survey, this paper uses a Luhmannian approach to understand the relationship between technological change and organisational context. This theory is tested quantitatively and shows the importance of considering the working environment's nature when studying skills changes. The results show small effects by the technological change on changing skills use but larger effects by changes in the working environment. Recommendations for future research and practical implications are discussed.
Financial Cycles in Euro Area Economies: A Cross‐Country Perspective Using Wavelet Analysis*
Authors: Mandler Martin , Scharnagl Michael
Published: December 2021

We study the cross‐country dimension of financial cycles for six euro area countries using wavelet analysis. Estimated wavelet cohesions show that cycles in equity prices and interest rates display stronger synchronization across countries than real output cycles, whereas credit variables and house prices show lower cross‐country synchronization. We propose a wavelet‐based extension to the spectral envelope that is similar to a frequency‐based time‐varying principal component analysis. The country loadings show that, contrary to all other variables, cycles in loans to households and house prices in Germany and the Netherlands are negatively or less strongly correlated with the common cycles.
Pediatric patch testing in a multi‐ethnic Asian population: A retrospective review
Authors: Lee Elis Yuexian , Wee Charlene Li Ping , Tan Chee Hian , Wee Lynette Wei Yi , Lim Charmaine En‐En , Zhao Xiahong , Koh Mark Jean Aan , Yew Yik Weng , Goon Anthony Teik Jin
Published: December 2021

Background

Pediatric allergic contact dermatitis (ACD) is increasingly prevalent. Patch testing is the gold‐standard diagnostic investigation. The aims of our study were to describe the clinical profile of pediatric patients with ACD in a multi‐ethnic Asian population and identify the common contact allergens.

Methods

This was a retrospective study involving children and adolescents aged 16 years or younger with clinically suspected ACD who underwent patch testing between January 2007 and March 2020 at two institutions in Singapore. Information pertaining to their demographics, atopy history, clinical presentation, and patch test results was analyzed.

Results

A total of 252 patients were included. The mean age was 10.9 years (1.0–16.7 years). The majority were Chinese (79.8%) and girls (57.5%). Many (66.3%) had atopic dermatitis (AD), which was mild. The most common presentation was an acral eczematous rash. The sensitization rate was 50.0%. The most frequent reactions were to nickel sulfate (49.2%) and fragrance mix (19.1%). The overall rate of relevant positive patch tests was 72.5%. Patients with AD were less likely to have a reaction to fragrance mix (p = .019) and more likely to have a reaction to disperse blue (p = .041). Compared to younger children, adolescents were less likely to have a positive patch test (p = .008). Indians were also less likely to have a positive reaction (p = .004).

Conclusion

Metals and fragrances were the most common allergens causing childhood ACD in Singapore. Patients with AD were less likely to be sensitized to fragrances and more likely to be sensitized to disperse blue dye.
Effects of Photobiomodulation Therapy with Various Laser Wavelengths on Proliferation of Human Periodontal Ligament Mesenchymal Stem Cells
Authors: Etemadi Ardavan , Faghih Aramdokht , Chiniforush Nasim
Published: December 2021

Several methods have been proposed to enhance the regeneration and healing time in periodontal therapy. Photobiomodulation therapy (PBMT) is a recently suggested novel technique for this purpose. This study aimed to compare the efficacy of PBMT with various laser wavelengths and energy densities on proliferation of human periodontal ligament mesenchymal stem cells (PDLMSCs). The wells containing PDLMSCs were subjected to laser irradiation at 635, 660, 808 and 980 nm wavelengths with 1, 1.5, 2.5 and 4 J cm−2 energy densities. Cell proliferation and viability were evaluated after 1, 3 and 5 days with the methyl thiazolyl tetrazolium (MTT) assay and 4,6‐diamidino‐2‐phenylindole (DAPI) staining. No significant difference was observed among the experimental and the control groups on day 1 (P > 0.05). On day 3, 808 nm laser at 4 J cm−2 energy density and 980 nm laser at all densities had significant differences with control group. On day 5, the control group had significant differences in cell proliferation with 808 nm laser at 2.5 and 4 J cm−2 energy densities, and 980 nm laser at all densities. PBMT with 635, 660, 808 and 980 nm wavelengths increased the proliferation of PDLMSCs but the maximum cell viability was prominent after irradiation by 980 nm laser with energy density of 4 J cm−2 on day 3.
Singlet Oxygen Activatable Prodrugs of Paclitaxel, SN‐38, MMC and CA4: Nonmitochondria‐Targeted Prodrugs†
Authors: Rahman Kazi Md Mahabubur , Thapa Pritam , Hurst Robert , Woo Sukyung , You Youngjae
Published: December 2021

We established a light‐activatable prodrug strategy that produces the combination effect of photodynamic therapy (PDT) and site‐specific chemotherapy. Prodrugs are activated by singlet oxygen (SO), generated from PS and visible or near IR light, in either intra‐ or inter‐molecular manner. The goal of this study is to evaluate cytotoxic effects of nonmitochondria‐targeted prodrugs of a number of anticancer drugs with different mechanisms of action. They were tested in both 2D and 3D in vitro conditions via inter‐molecular activation of prodrugs by SO generated in mitochondria by protoporphyrin IX‐PDT (PpIX‐PDT). Prodrugs of anticancer drugs (paclitaxel, SN‐38, combretastatin A4 and mitomycin C) were synthesized using facile and high‐yielding reactions. Nonmitochondria‐targeted prodrugs showed limited dark toxicity while all of them showed greatly enhanced phototoxicity compared to PpIX‐PDT in the 2D culture model. Prodrugs generated up to about 95% cell killing at 2.5 μM when administered with hexyl‐aminolevulinate (HAL) to produce Protoporphyrin IX in cancer cells in both 2D monolayer and 3D spheroids model. The data demonstrate that mitochondria‐targeting of prodrugs is not fully essential for our inter‐molecular activation prodrug strategy. The prodrug strategy also worked for anticancer drugs with diverse MOAs.
Preconception exposures and adverse pregnancy, birth and postpartum outcomes: Umbrella review of systematic reviews
Authors: Daly Michael , Kipping Ruth R. , Tinner Laura E. , Sanders Julia , White James W.
Published: December 2021

Background

Preconception exposures have been associated with adverse pregnancy, birth and postpartum outcomes. However, the reports, statements and guidelines of national and international health organisations vary in what they recommend individuals should monitor, avoid, reduce or practise in the preconception period.

Objectives

To synthesise and evaluate the evidence across systematic reviews for associations between exposures before conception and adverse pregnancy, birth and postpartum outcomes.

Data sources

MEDLINE, Embase, Epistemonikos (to May 2020) and reference lists of included reviews, without language or date restrictions.

Study selection, data extraction and synthesis

Systematic literature reviews of observational and/or interventional studies reporting associations between preconception exposures in women and/or men of reproductive age and pregnancy, birth or postpartum health outcomes were included. The methodological quality of reviews and the certainty of the evidence underlying each exposure‐outcome association were assessed using AMSTAR 2 and the GRADE approach.

Results

We identified 53 eligible reviews reporting 205 unique exposure‐outcome associations. Methodological quality was generally low with only two reviews rated as ‘high’ quality and two as ‘moderate’. We found high‐certainty, randomised trial evidence that maternal folate supplementation reduces the risk of neural tube defects and anomaly‐related terminations. Moderate‐certainty, observational evidence was found that maternal physical activity is associated with reduced risk of pre‐eclampsia and gestational diabetes, and that paternal age of ≥40 years and maternal body mass index (BMI) and interpregnancy weight gain are associated with increased risk of various adverse pregnancy and birth outcomes. Low‐ and very low‐certainty evidence was found for other associations.

Conclusions

Clinicians and policymakers can be confident that maternal folate supplementation should be encouraged during the preconception period. There is moderate certainty in the evidence base that maternal physical activity, BMI and interpregnancy weight gain and advanced paternal age are important preconception considerations. High‐quality research is required to better understand other exposure‐outcome associations.
Older adults’ provision of informal care and support to their peers – A cornerstone of swedish society: Demographic characteristics and experiences of social isolation
Authors: Siira Elin , Olaya‐Contreras Patricia , Yndigegn Signe , Wijk Helle , Rolandsson Bertil , Wolf Axel
Published: December 2021

Background

Family members provide the majority of informal care for older adults in Sweden. Nevertheless, by providing a range of assistance, peers often emerge as a central to counter social isolation among older adults. Therefore, there is a need to know more about what informal care provision by older adults to their peers means for different groups of older adults.

Aim

This study investigated the types of informal care and support that older adults provide to their peers in Sweden, and how these types of care and support are associated with demographic characteristics and social isolation. We also compared older adults who provide informal care and support with those who do not.

Method

For this purpose, we used a national online survey named “Involuntary loneliness among senior citizens” answered by 10,044 older adults enrolled in the Swedish Citizen Panel. We adopted a mixed‐method design to analyse the survey data, including free‐text options (n = 2155) and numerical data. Social isolation was assessed using a score built from the social loneliness items of the UCLA Loneliness Scale.

Results

In our population, 21.5% of the older adults were providing informal care and support to their peers. Practical/instrumental help was frequently offered by younger participants (<75 years), men and respondents who were less socially isolated. On a general level, the factors that were positively associated with giving informal care and support to peers were older age, being male, retired, married/living in a relationship, living in an urban area/big city and exhibiting greater isolation. Focusing specifically on social support shows that older participants (>80) and those experiencing less social isolation (score < 24) were more engaged in social activities. 

Conclusion

This paper is unique in exploring the informal peer‐caregiver's perceptions of isolation. Data were collected during the COVID‐19 pandemic; this highlights the need to recognise informal care and support between older adults and to acknowledge their contributions as an essential component of Swedish civil society, especially during a societal crisis.
Lung nodules due toCandida parapsilosisin a person with cystic fibrosis
Authors: Piechowiak Mary Bryson , Brown Anne Whitney , Aryal Shambhu , Katugaha Shalika Basnayake
Published: December 2021

We present the first reported case ofCandida parapsilosispulmonary infection presenting as lung nodules. The patient is a 31-year-old man with cystic fibrosis (CF) colonised with multidrug-resistantEscherichia coliand increased frequency of pulmonary exacerbations in the preceding months. While on intravenous antibiotics for a pulmonary exacerbation, he developed bilateral pulmonary nodules. Bronchoalveolar lavage cultures grewC. parapsilosis. He was initially treated with dual antifungal therapy, voriconazole and micafungin. Discontinuation of voriconazole due to transaminitis resulted in the development of new nodules, and isavuconazonium was added. Repeat imaging revealed no progression of disease. Micafungin was eventually discontinued. Monotherapy with isavuconazonium is planned for 1 year post lung transplant. In the CF population,C. parapsilosismay be an opportunistic pathogen. The case highlights that frequent CF exacerbations and antibiotic exposure increase the risk for opportunistic infections includingCandidaspecies and the implications for lung transplantation in this setting.
Proton pump inhibitors associated with rapid eye movement sleep behaviour disorder
Authors: Jayasekara Ruwanthi , Smith Ian
Published: December 2021

We present the case of a 65-year-old woman diagnosed with rapid eye movement sleep behaviour disorder (REMBD) based on typical symptoms and confirmed with an inpatient polysomnogram. She was prescribed clonazepam and later temazepam but continued to have intrusive symptoms. She subsequently recalled that the onset of dream enactment coincided with starting high-dose omeprazole for acid reflux. With this insight, she stopped the omeprazole. Within days, the dream enactment and nocturnal movements subsided. She stopped taking the temazepam and was symptom free for a few months. However, she was started on lansoprazole for recurrent dyspepsia. Once again she experienced violent movements in sleep. This is the first time an association between proton pump inhibitors (PPIs) and REMBD has been reported. PPIs have many effects on the central nervous system and should be considered as a possible provoking factor in people presenting with REMBD.
Lymphoma presented as dysphagia: a diagnosis hard to swallow
Authors: João Mafalda , Bento-Miranda Mário , Gravito-Soares Elisa , Gravito-Soares Marta , Figueiredo Pedro
Published: December 2021

An 18-year-old woman presented with progressive oesophageal dysphagia, weight loss and night sweats over a 6-month period. Oesophagogastroduodenoscopy revealed a diffuse luminal narrowing with normal mucosa, whose biopsies were inconclusive. A cervical and thoracic CT scan showed a thickening of the upper oesophagus, densification of the mediastinal fat, several adenopathies and a 4.3×2.4 cm mass with infiltrative appearance and heterogeneous enhancement in right cervical paravertebral location. Positron emission tomography-CT showed marked increased fluorodeoxyglucose uptake in supradiaphragmatic lymph nodes, pleuropulmonary tissue, paraspinal musculature and bone marrow. Imaging-guided and surgical incisional biopsies of the paravertebral mass were inconclusive. During hospitalisation, she developed right cervicobrachial paraesthesia. Only excisional biopsy of the mass allowed the diagnosis of high-grade B-cell lymphoma not otherwise specified, Ann Arbor stage IV-B. The patient underwent chemotherapy with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone), followed by R-EPOCH (rituximab, etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin hydrochloride). Follow-up at 12 months revealed complete response.
Vulvar herpes zoster infection: a rare and challenging diagnosis
Authors: Martins Matilde Matos , Ferreira Patrícia , Maciel Raquel , Costa Cristina
Published: December 2021

A 26-year-old woman under immunosuppression with infliximab due to Crohn’s disease was referred to the gynaecology emergency room with dispersed and coalescing vesicular lesions on the vulvar region extending to the right lower limb involving S2–S3 dermatome, associated with severe pain. Clinical history, physical examination and serological testing was consistent with herpes zoster infection. The patient was treated with valaciclovir for 14 days and cefradine for 7 days (due to the possibility of secondary bacterial infection). Significant symptomatic improvement was noted after 1 week. The 1-year follow-up was unremarkable. According to our knowledge and review of the literature, this is one of the few cases reported of vulvar herpes zoster, especially related to infliximab.
Infantile mediastinal neuroblastoma presenting as an oncologic emergency: usefulness of serum-basedMYCNgene amplification analysis for risk stratification
Authors: Suematsu Masaya , Yagyu Shigeki , Hosoi Hajime , Iehara Tomoko
Published: December 2021

We reported two infantile cases of mediastinal neuroblastoma with life-threatening tracheal obstructions presenting as oncologic emergencies that were successfully treated per tentative risk classification using serum-basedMYCNgene amplification (MNA) analysis. Tentative risk stratification based on age, tumour location and serum-based MNA status may be useful in patients with neuroblastoma presenting as oncologic emergencies who require urgent therapy stratification but for whom tumor-based molecular diagnoses cannot be established.
Adenoid cystic carcinoma with a leptomeningeal dissemination in a ‘wash’ pattern
Authors: Prieto Cuadra Juan Daniel , Dawid de Vera Maria Teresa , García Carrasco Eva , Hierro Martín M Isabel
Published: December 2021

A 39-year-old woman was referred to the neurology department due to headache, instability and difficulty walking for 5 months. Several ancillary tests were performed. The blood test showed leucocytosis and the cerebrospinal fluid revealed an increased total protein and glucose consumption. Other infections or autoimmune causes were excluded. The MRI showed non-specific brain and spinal cord lesions. Given the findings described, a differential diagnosis between granulomatous meningoencephalitis and primary tumour or metastasis was proposed. Empirical treatment with tuberculostatic agents and corticosteroids was started. The neurological state of the patient worsened, she fell into a non-responsive coma and died in few days. The clinical autopsy performed revealed an adenoid cystic carcinoma with involvement of the central nervous system that developed leptomeningeal dissemination along the spinal cord in a fluid ‘wash’ pattern.
High grade non-germinal centre-like diffuse large B-cell lymphoma double expressor presenting as a hydrocoele
Authors: Hogan Donnacha , Hayes Brian , Keohane Clodagh , Hennessey Derek Barrry
Published: December 2021

A 72-year-old man was referred to our urology outpatient department with a left hemi-scrotal swelling increasing in size over a matter of weeks, initially suspicious for a left hydrocoele. Initial investigation with ultrasound (US) identified a heterogenous enlargement of the left testis and epididymis with a soft tissue mass extending through the inguinal canal. Subsequent CT detected this soft tissue mass to extend along the left gonadal vein to the level of the left renal vein. A biopsy of the retroperitoneal mass confirmed a diagnosis of diffuse large B-cell lymphoma. Immunohistochemical staining further categorised this lymphoma as double expressor but not double hit.

Through multidisciplinary team involvement the patient was treated with combination steroids and chemotherapy. Given the scrotal involvement this was considered a sanctuary site for chemotherapy therefore the patient also received radiotherapy to the scrotum. He recovered well following his treatment. This case highlights how early specialist referral can identify rare variants of disease. Essential preoperative imaging with US prior to treating a presumed hydrocoele prevented inappropriate surgical excision. A multidisciplinary team approach improved the patient’s outcome and is hoped to have improved his chances of recurrence-free survival.
Pseudochoreoathetosis secondary to progressive spondylotic cervical myelopathy
Authors: Brooks Christopher Alan , Phua Chun Seng , Dower Ashraf , Bazina Renata
Published: December 2021

Pseudochoreoathetosis is a rare movement disorder associated with loss of proprioception. Culprit lesions may occur at any point between the cerebral cortex and the peripheral nerve. Seldom is the underlying cause reversible or prone to improvement. An elderly man presented to our tertiary centre with choreoathetoid movements secondary to spondylotic subaxial cervical myelopathy. His myelopathy fulminated and he was emergently treated with posterior decompressive neurosurgery. Unexpectedly, his choreoathetoid movements improved significantly post-operatively. There are a multitude of reports of pseudochoreoathetosis secondary to lesions of various aetiologies; however, few have reported this disorder secondary to cervical spondylosis. To our knowledge, there is only one other report in the medical literature. Herein, we report a second case, for the purposes of raising awareness of this disorder, and to highlight relevant clinical pearls for clinicians who encounter this rare pathology.