bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediction accuracy of no-history intraocular lens formulas for a diffractive extended depth-of-focus intraocular lens after myopic corneal refractive surgery
Authors: Tan Qian , Wang Yong , Zhao Libei , Peng Manqiang , Zheng Hansong , Lin Ding
Published: December 2021

Purpose:

To compare the accuracy of intraocular lens (IOL) calculation methods for extended depth-of-focus (EDoF) IOLs in eyes with a history of myopic laser-assisted in situ keratomileusis (LASIK)/photorefractive keratectomy (PRK) surgery lacking historical data.

Setting:

Changsha Aier Eye Hospital, Changsha, and Wuhan Aier Eye Hospital, Wuhan, China.

Design:

Retrospective case series.

Methods:

Patients with axial lengths (ALs) ≥25.0 mm and a history of myopic LASIK/PRK surgery who underwent cataract surgery with implantation of EDoF IOLs were enrolled. A comparison was performed of the accuracy of 10 IOL methods lacking historical data, including Barrett True-K no history (Barrett TKNH), Haigis-L, Shammas, and Potvin-Hill formulas and average, minimum, and maximum IOL power on the ASCRS online postrefractive IOL calculator; Seitz/Speicher/Savini (Triple-S) formula; and Schuster/Schanzlin-Thomas-Purcell (SToP) formulas based on Holladay 1 and SRK/T formulas. IOL power was calculated with the abovementioned methods in 2 groups according to AL (Group 1: 25.0 mm ≤ AL < 28.0 mm and Group 2: AL ≥ 28.0 mm).

Results:

64 eyes were included. Excellent outcomes were achieved with the minimum, Barrett TKNH, SToP (SRK/T), and Triple-S formulas in the whole sample and subgroups, which led to similar median absolute error, mean absolute error, and the percentage of eyes with a prediction error within ±0.5 diopters (D). In the whole sample, the Haigis-L and maximum formulas had a significantly higher absolute error than minimum, SToP (SRK/T), and Barrett TKNH formulas. The maximum formula also had a significantly lower percentage of eyes within ±0.5 D than the Barrett TKNH, and SToP (SRK/T) formulas (15.6% vs 50% and 51.5%, all P < .05 with Bonferroni adjustment).

Conclusions:

Predicting the EDoF IOL power in postmyopic refractive eyes by no-history IOL formulas remains challenging. The Barrett TKNH, Triple-S, minimum, and SToP (SRK/T) formulas achieved the best accuracy when AL ≥ 25.0 mm, while the Barrett TKNH and SToP (SRK/T) formulas were recommended when AL ≥ 28.0 mm.
Association Between Work Attendance When Experiencing Fever or Cold Symptoms and Company Characteristics and Socioeconomic Status in the COVID-19 Pandemic in Japanese Workers
Authors: Mizuki Kazuyoshi , Okawara Makoto , Hino Ayako , Ando Hajime , Nagata Tomohisa , Tateishi Seiichiro , Tsuji Mayumi , Matsuda Shinya , Fujino Yoshihisa
Published: December 2021

Objective:

This study investigated the association between attending work while experiencing fever or cold symptoms and workers’ socioeconomic background and company characteristics during the COVID-19 pandemic.

Methods:

A cross-sectional online survey was performed. Of a total of 33,302 participants, 3676 workers who experienced fever or cold symptoms after April 2020 were included. The odds ratios (ORs) of attending work while sick associated with workers’ socioeconomic background and company characteristics were evaluated using a multilevel logistic model.

Results:

The OR of attending work while sick associated with a lack of policy prohibiting workers from working when ill was 2.75 (95% CI: 2.28 to 3.20, P < 0.001).

Conclusion:

This study suggests that clear company policies on work and illness can be effective for preventing employees from attending work while sick.
Association between the rs2106261 polymorphism in the zinc finger homeobox 3 gene and risk of atrial fibrillation
Authors: Wei Yue , Wang Lingjie , Lin Changjian , Xie Yun , Bao Yangyang , Luo Qingzhi , Zhang Ning
Published: December 2021

Introduction:

Previous genome-wide studies have identified an association between the rs2106261 single-nucleotide polymorphism (SNP) in the zinc finger homeobox 3 (ZFHX3) gene and an increased risk of atrial fibrillation (AF). However, this association remains controversial, since conflicting results have been reported in previous studies. We aimed to investigate the association between the ZFHX3 rs2106261 polymorphism and susceptibility to AF.

Methods:

A comprehensive literature search, of articles written in either English or Chinese, was conducted on various databases, including PubMed, Embase, Web of Science, the Cochrane library, Wan Fang, and CNKI, for studies performed up to August 1, 2020. Data were abstracted and pooled using Stata 14.0 software. A meta-analysis was performed on all selected studies based on ZFHX3 rs2106261 polymorphism genotypes.

Results:

Nine studies, including 10,107 cases and 58,663 controls, were analyzed in the meta-analysis. In the overall population, a significant association was found between AF and the T-allelic ZFHX 3 rs2106261 SNP (odds ratio [OR] = 1.32, 95% confidence interval [CI] 1.19–1.46). In subgroup analysis, a significant association between the T-allele of rs7193343 and risk of AF in Caucasian (OR = 1.23, 95% CI 1.10–1.37) and Asian subgroups (OR = 1.58, 95% CI 1.32–1.89) was observed. However, no statistically significant association was found in African populations (OR = 1.06, 95% CI 0.95–1.19).

Conclusion:

The genetic variant rs2106261 SNP is associated with susceptibility to AF in Caucasian and Asian individuals, with Asian samples showing a stronger association. However, based on the current evidence, no association was found in African samples. Future studies, with larger sample sizes and multiple ethnicities, are still necessary.
Long-standing overt ventriculomegaly in adulthood with primary presentation of psychiatric disturbance
Authors: Su Gao-jian , Gao Jie , Wu Chu-wei , Zou Jun-feng , Zhu Dong-liang , Liu Jun , Zhang Jie-hua , Huang Xian-jian
Published: December 2021

Rationale:

Hydrocephalus is a common disease in neurosurgery. The typical symptoms of hydrocephalus include urinary incontinence, gait instability, and cognitive decline. Irritability rarely occurs in patients with hydrocephalus. Irritability rarely occurs in patients with hydrocephalus, especially in long-standing overt ventriculomegaly of adulthood (LOVA).

Patient concerns:

A 30-year-old female was admitted to our hospital because of mental retardation and unstable gait for more than 15 years. She had undergone ventriculoperitoneal shunt 15 years prior due to ventriculomegaly and related symptoms. However, the shunt catheter was removed shortly after surgery because of blockage, with no further postoperative treatment.

Diagnosis:

The patient was diagnosed with long-standing overt ventriculomegaly according to her head circumference and clinical symptoms, including adult hydrocephalus development, overt triventriculomegaly and absence of a secondary cause for aqueductal stenosis in adulthood.

Interventions:

After considerable discussion, she underwent ventriculoperitoneal shunt placement and showed dramatic and sustained improvement.

Outcomes:

The patient has been followed at 3-month intervals for over 2 years since discharge, and both the patient and family have reported a significant change in their daily life. She was able to live independently and control her emotions. Slight epilepsy was noted approximately 5 months after surgery but recovered 2 months later.

Lessons:

It is difficult to decide whether to treat LOVA when the in patients whose symptoms are not significant. We believe that early diagnosis and positive treatment can help improve outcomes and would recommend ventriculoperitoneal (VP) shunting in patients with LOVA.
Imatinib mesylate in combination with pembrolizumab in patients with advanced KIT-mutant melanoma following progression on standard therapy
Authors: Hirai Ikuko , Tanese Keiji , Fukuda Keitaro , Fusumae Takayuki , Nakamura Yoshio , Sato Yasunori , Amagai Masayuki , Funakoshi Takeru
Published: December 2021

Introduction:

Genetic alterations of KIT gene are known to be one of the major causes of melanoma. Those are more common in the mucous and acral subtypes and KIT is regarded as major oncogene in Asian melanomas, where the prevalence of these subtypes is high. Up to date, several clinical trials have been conducted to target KIT gene alterations in melanoma with unsatisfied efficacies. Imatinib mesylate, a small-molecule inhibitor of the KIT tyrosine kinase, provides a rapid but not durable clinical response in KIT-mutant melanoma. Meanwhile, recent basic and clinical evidence have revealed another aspect of KIT-targeted therapy, namely the enhancement of antitumor activity of immune checkpoint inhibitors. Herein, we designed clinical trial of co-administrating imatinib mesylate and pembrolizumab (anti-PD-1 antibody) to evaluate its safety and efficacy.

Methods and analysis:

This is an open-label, single-arm, phase I/II clinical trial involving Japanese patients with metastatic KIT-mutant melanoma that are refractory to standard therapy including anti-PD-1 therapy. Phase I study is a dose-escalation study comprising two dose levels of imatinib mesylate (200 and 400 mg/day, respectively) with fixed dose of pembrolizumab (200 mg every 3 weeks) to evaluate safety and tolerability and determine recommended phase II dose. The primary endpoint of the phase II study is the objective response rate after 4 cycles (3 weeks/cycle) of pembrolizumab and imatinib mesylate at the dose determined in phase I, based on RECIST version 1.1. A Simon's minimax two-stage design is employed to test the null hypothesis of a 5% response rate vs 30% alternative, which will be rejected when a lower confidence limit of two-sided 90% confidence interval of true response rate is over than threshold response rate. The secondary endpoints include progression free survival, overall survival, best overall response and incidence of adverse events. Totally, a target size of 22 patients will be expected.

Discussion:

If this study shows efficacy and acceptable safety profile, it will contribute to the development of novel treatment option for patients with KIT-mutant melanoma that are refractory to standard therapy.

Trial registration:

NCT04546074. Date of Registration: September 11, 2020 (https://clinicaltrials.gov/ct2/show/NCT04546074). Date of First Participant Enrollment: December 23, 2020.
Invaginated duct to mucosa pancreaticojejunostomy reduce postoperative pancreatic leakage
Authors: Yao Guo-Liang , An Meng-Jiao , Fan Yong-Gang
Published: December 2021

Postoperative pancreatic leakage is an obstacle in pancreaticoduodenectomy, which always follows pancreaticojejunostomy (PJ) failure. Dozens of PJ procedures have been reported, and none have shown superiority over others. Therefore, the present study is conducted to assess the potential advantages of invaginated duct-to-mucosa (D-M) PJ.

We retrospectively analyze the related data from patients who underwent pancreaticodedunostomy due to malignant tumors at the First Affiliated Hospital of Henan University of Science and Technology from January 2017 to August 2019. According to the different PJ procedures, the patients are divided into custom D-M group and invaginated D-M group. Matching by sex, age, pancreatic duct size, and pancreatic texture is performed. Pancreatic leakage and other complications are compared, and SPSS 16.0 is employed for analysis.

A total of 48 pairs of patients are included. Patients in both groups has almost the same baseline characteristics in terms of sex (P = 1.000), age (P = .897), American Society of Anesthesiologists status (P = .575), body mass index (P = .873), pancreatic duct size (P = .932), pancreatic texture (P = 1.000) and tumor origin (P = .686). No significant difference is observed in operative outcomes, such as operative duration (P = .632), PJ duration (P = .748), blood loss (P = .617) and number of required transfusions (P = .523). Pancreatic leakage is significantly decreased in the invaginated D-M group (P = .005). The differences in other complications, such as bleeding (P = .617), biliary leakage (P = .646), pneumonia (P = .594) and thrombosis (P = .714), do not reach statistical significance. The postoperative hospitalization duration is almost the same for both groups (P = .764).

Invaginated D-M PJ may reduce pancreatic leakage following pancreaticoduodenectomy.
Val158Met polymorphisms of COMT gene and serum concentrations of catecholaminergic neurotransmitters of ADHD in Chinese children and adolescents
Authors: Xiong Zhonggui , Yan Jiong , Shi Shuhua
Published: December 2021

This study analyzed the Val158Met polymorphisms of the catechol-O-methyltransferase (COMT) gene and serum concentrations of catecholaminergic neurotransmitters in attention deficit hyperactivity disorder (ADHD) children and adolescents.

All the subjects (180 paired ADHD and non-ADHD children and adolescents) were genotyped for the Val158Met polymorphisms of the COMT gene, and determined by the difference of dopamine and noradrenalin from a 1:1 paired case–control study.

The frequencies of methionine (A)/A, valine (G)/A, and G/G were 51.67%, 41.11%, and 7.22% in the case group, and 62.22%, 31.11%, and 6.67% in the control group. There was a significant difference in the distribution of all genotypes of the COMT gene between the 2 groups (odds ratio = 1.85, 95% confidence interval: 1.62–2.08; χ2 = 7.80, P < .05). The serum concentrations of dopamine and noradrenalin were 1.42 ± 0.34 ng/mL and 177.70 ± 37.92 pg/mL in the case group, and 1.94 ± 0.42 ng/mL and 206.20 ± 42.45 pg/mL in the control group. There were the significant differences in the levels of dopamine and noradrenalin between the 2 groups (dopamine: t = 4.30, P < .01; noradrenalin: t = 2.24, P < .05).

Our study suggested that the Val158Met polymorphisms of the COMT gene and serum concentrations of catecholaminergic neurotransmitters were associated with ADHD children and adolescents.
Favorable response to multimodal treatment in hepatocellular carcinoma with inferior vena cava and right atrial tumor thrombus and left adrenal gland metastasis
Authors: Sun Ning , Zhang Jialin , Li Baifeng , Li Ailin , Lv Mutian , Zhang Chengshuo
Published: December 2021

Rationale:

Hepatocellular carcinoma (HCC) is the fourth most common cause of cancer-related deaths and the sixth most commonly diagnosed cancer globally. Interdisciplinary and multimodal treatment strategies are essential for a successful therapy in HCC. Established therapies for HCC treatment include surgical resection, liver transplantation, local ablative therapies, transarterial chemoembolization (TACE), tyrosine kinase inhibitors (TKIs), immunotherapy, and radiotherapy (RT).

Patient concerns:

A 52-year-old male patient did an ultrasound scan and found a large mass within the right lobe of the liver and gallstones in December 2018. He had a history of chronic hepatitis C virus infection (30 years) and was treated with sofosbuvir (400 mg, q.d.) for 1 year. The patient never had any symptoms of gallstones. Enhanced abdominal computed tomography of this patient showed a heterogeneous irregular mass with the largest measurement of up to 13.7 × 11.1 cm in size in the right lobe of the liver, meanwhile also had inferior vena cava (IVC) tumor thrombus, right atrial (RA) tumor thrombus, and left adrenal gland metastasis. The laboratory test data revealed that the serum tumor marker α-fetoprotein was 2.63 ng/mL, cancer antigen 19-9 (CA 19-9) was 34.40 U/mL, and protein induced by Vitamin K absence was 391.94 mAU/mL.

Diagnosis:

HCC with IVC tumor thrombus, RA tumor thrombus, and left adrenal gland metastasis, and gallstones.

Interventions:

He was hospitalized and received TACE treatment, oral TKIs, intravenous drip programmed cell death-1 (PD-1) inhibitor and RT.

Outcomes:

The patient showed a favorable response after consecutive treatment with TACE, TKIs, PD-1 inhibitor, and RT. Until now, the patient has survived 34 months since the diagnosis of the disease.

Lessons:

Our case suggests that TACE combined with TKIs, PD-1 inhibitor, and RT may be a suitable treatment option for advanced HCC patients with IVC tumor thrombus and/or RA tumor thrombus, and/or adrenal gland metastasis.
Comparative effectiveness of nonsurgical interventions in the treatment of patients with knee osteoarthritis
Authors: Naja Moustafa , Fernandez De Grado Gabriel , Favreau Henri , Scipioni Dominique , Benkirane-Jessel Nadia , Musset Anne-Marie , Offner Damien
Published: December 2021

Background:

To find out, based on the available recent randomized controlled trials (RCTs), if the nonsurgical interventions commonly used for knee osteoarthritis patients are valid and quantify their efficiency.

Methods:

The database of MEDLINE and EMBASE were searched for RCTs evaluating nonsurgical treatment strategies on patients with mild to moderate knee osteoarthritis. A Bayesian random-effects network meta-analysis was performed. The primary outcome was the mean change from baseline in the Western Ontario and McMaster university (WOMAC) total score at 12 months. Raw mean differences with 95% credibility intervals were calculated. Treatments were ranked by probabilities of each treatment to be the best.

Results:

Thirteen trials assessed 7 strategies with WOMAC at 12 months: injection of platelet rich plasma (PRP), corticosteroids, mesenchymal stem cells (MSCs), hyaluronic acid, ozone, administration of nonsteroidal anti-inflammatory drugs with or without the association of physiotherapy. For treatment-specific effect size, a greater association with WOMAC decrease was found significantly for MSCs (mean difference, −28.0 [95% CrI, −32.9 to −22.4]) and PRP (mean difference, −19.9 [95% CrI, −24.1 to −15.8]). Rank probabilities among the treatments indicated that MSCs had a much higher probability (P = .91) of being the best treatment compared with other treatments, while PRP ranked as the second-best treatment (P = .89).

Conclusion:

In this systematic review and network meta-analysis, the outcomes of treatments using MSCs and PRP for the management of knee osteoarthritis were associated with long-term improvements in pain and function. More high quality RCTs would be needed to confirm the efficiency of MSCs and PRP for the treatment of patients with knee osteoarthritis.
Autologous or allogeneic hematopoietic stem cells transplantation combined with high-dose chemotherapy for refractory neuroblastoma
Authors: Zhao Zhang-Shuai , Shao Wei , Liu Ji-Ke
Published: December 2021

Background:

Neuroblastoma is a common solid malignant tumor in children. Despite the development of new treatment options, the prognosis of high-risk neuroblastoma patients is still poor. High-dose chemotherapy and hematopoietic stem cell (HSC) transplantation might improve survival of patients with refractory neuroblastoma. In this study, we aimed to summarize the efficacy of autologous or allogeneic HSC transplantation combined with high-dose chemotherapy for patients with refractory neuroblastoma through the meta-analysis.

Methods and analysis:

Relevant clinical trials of autologous or allogeneic HSC transplantation for the treatment refractory neuroblastoma patients will be searched in Web of Science, Cochrane Library, PubMed, Google Scholar, Embase, Medline, China National Knowledge Infrastructure, China Scientific Journal Database, Chinese Biomedical Literature Database and Wanfang Database from their inception to December 2020. Two researchers will perform data extraction and risk of bias assessment independently. The clinical outcomes including tumor response, overall survival, event-free survival (EFS), quality of life (QoL) and adverse events, were systematically evaluated by using Review Manager 5.3 and Stata 14.0 statistical software.

Results:

The results of this study will provide high-quality evidence for the effect of autologous or allogeneic HSC transplantation combined with high-dose chemotherapy on tumor response, survival, and QoL in patients with refractory neuroblastoma.

Conclusions:

The conclusions of this meta-analysis will be published in a peer-reviewed journal, and provide more evidence-based guidance in clinical practice.
High-flow nasal cannula application in an infant patient with laryngomalacia during general anesthesia
Authors: Kim Ji-Yoon , Bae Jieun , Lee Kwang Hyun , Kang Leekyeong , Kim Kyu Nam , Jeong Mi Ae
Published: December 2021

Rationale:

Laryngomalacia is defined as the collapse of supraglottic structures and can cause not only strider but also trigger difficulties with ventilation and endotracheal intubation during anesthesia management. High-flow nasal cannula (HFNC) has been used to manage patients at high risk of hypoxemia in the intensive care unit; however, limited literature information is available for the application of HFNC to infant patients with laryngomalacia during anesthesia practice.

Patient concerns:

A 2-month-old male infant was scheduled to undergo surgery for inguinal hernia and undescended testis with general anesthesia.

Diagnosis:

The patient had subcostal retraction while breathing and frequent oxygen desaturation events and was diagnosed laryngomalacia.

Interventions:

After the patient was supplied oxygen via HFNC and then given general anesthesia, the initial 2 attempts of endotracheal intubation with a rigid laryngoscope were unsuccessful because the vocal cords were obscured by the epiglottis. A third intubation attempt was performed and successful with a 3.0-sized, uncuffed endotracheal tube within 20 minutes of the initial attempt.

Outcomes:

No airway complications emerged and oxygen saturation remained at greater than 98% during general anesthesia. The patient was discharged 5 days after surgery without any adverse side effects.

Lessons:

Continuous oxygenation via HFNC is a good choice to prevent desaturation during difficult tracheal intubations in infant patients with laryngomalacia. This device is expected to be useful for intubation not only in patients with laryngomalacia, but also in infant patients with a predicted high risk of oxygen desaturation events during general anesthesia.
Complex regional pain syndrome type II caused by iatrogenic lateral dorsal cutaneous nerve injury
Authors: Kim Tae-Hoon , Jo Geun-Yeol , Kim Wanil , Do Hwan-Kwon
Published: December 2021

Rationale:

Complex regional pain syndrome (CRPS) is a painful condition classified as type I or II depending on the absence or presence of nerve injury, respectively. Injury to the lateral dorsal cutaneous nerve (LDCN), a branch of the sural nerve, is a rare occurrence observed after a sprain or procedures conducted on the lateral side of the ankle.

Patient concerns:

A 38-year-old female, who had undergone prolotherapy for a sprain in the lateral side of the left ankle 3 months ago, presented with persistent causalgia and dysesthesia around the injection site.

Diagnosis:

An electrodiagnostic study was conducted, which confirmed that the patient had peripheral neuropathy of the left LDCN. Considering the digital infrared thermal imaging and three-phase bone scan findings and the clinical presentation, the condition was diagnosed as CRPS type II due to iatrogenic LDCN injury according to the Budapest diagnostic criteria for CRPS.

Interventions:

The patient was treated with steroid pulse therapy, physical therapy, and transcutaneous electrical nerve stimulation, as well as nonsteroidal anti-inflammatory drugs, pregabalin, and tricyclic antidepressants.

Outcomes:

After 1 month of treatment, allodynia of the left foot persisted, but the pain reduced from 6 points to 3 points on the numeric rating scale. Partial recovery of amplitude and conduction velocity was confirmed in the follow-up electrodiagnostic study.

Lessons:

LDCN injury should be considered in patients who complain of persistent lateral ankle and foot paresthesia or pain after sprain or procedures performed on the lateral side of the ankle. Early diagnosis and treatment can lead to a good prognosis when the LDCN injury has progressed to CRPS.
The relationship between radiologic parameters and transverse atlantal ligament injury obtained from MRI scans in patients with an isolated atlas burst fracture
Authors: Eun Jongpil , Oh Youngmin
Published: December 2021

The treatment of an atlas burst fracture depends on whether transverse atlantal ligament (TAL) injury is present. We compared the radiologic parameters associated with the presence of a TAL injury as detected using magnetic resonance imaging (MRI), and verified whether the lateral mass displacement (LMD) criteria currently used to diagnose TAL injuries in atlas burst fractures are reliable or need revision.

Thirty patients who presented with isolated atlas burst fractures were included in this retrospective observational study. We measured radiologic parameters, including LMD, atlanto-dental interval, basion-dens interval, internal lateral mass displacement, and external lateral mass displacement, in each patient at the time of initial presentation. The presence of TAL injury was evaluated using MRI. We compared the radiologic parameters and characteristics of patients who presented with TAL injury. We also determined the sensitivity and specificity of an LMD test to accurately diagnose TAL injury based on MRI. Finally, we compared the radiologic parameters according to the presence of surgical treatment and patient union status.

Twenty patients presented with an intact TAL, while 10 patients had a TAL injury on MRI. LMD was significantly higher in patients with TAL injury (9.61 vs 3.73 mm, P < .001). In multivariable logistic regression analysis, LMD was also significantly higher in patients with TAL injury. The sensitivity and specificity of LMD for diagnosing TAL injury based on MRI in patients with isolated C1 fractures were 90% and 100%, respectively. The incidence of an LMD greater than 8.1 mm was statistically higher in patients than in those without TAL injury (90% vs 0%, P < .001).

Nine patients underwent surgery for isolated atlas burst fractures, and 21 did not. LMD (9.56 vs 4.03 mm, P < .001) and fracture gap (7.96 vs 4.01 mm, P < .001) were significantly higher in patients who underwent surgery.

Among the various radiologic parameters, LMD closely correlated with the presence of TAL injury, as patients with an LMD greater than 8.1 mm were more likely to have a TAL injury in the case of atlas burst fractures. LMD is a good method for predicting the presence of TAL injury if MRI is not available.
Factors influencing the clinical outcomes of intense pulsed light for meibomian gland dysfunction
Authors: Chen Chen , Chen Di , Chou Yu-yu , Long Qin
Published: December 2021

To observe the clinical outcomes of intense pulsed light (IPL) for meibomian gland dysfunction (MGD) and identify its influencing factors.

Forty-eight eyes of 48 patients with MGD were included. Subjects were followed up 5 times on day 1, day 15, day 30, day 45, and day 120, and underwent 3 sessions of the IPL treatment on day 1, day 15 and day 30. Gender, age, duration of MGD, time of video display terminal usage, and severity of MGD were recorded at baseline. At every visit, Ocular Surface Disease Index (OSDI), eyelid margin abnormality score, tear film breakup time, Schirmer I test (S ɪ t) and corneal fluorescein staining were recorded. The clinical parameters before and after 3 IPL treatments were compared. Univariate and multivariable logistic regression analyses were performed to explore influencing factors.

Compared with baseline, the tear film breakup time was increased and the corneal fluorescein staining score and OSDI were significantly decreased on day 45 and day 120 (all P < .001). In univariate analysis, among the patients with a younger age (18–39 years), moderate MGD, higher baseline S ɪ t and higher baseline OSDI, the IPL treatment had a higher effective rate (P = .032, .004, .024, and .014 respectively). The MGD severity was strongly associated with effective IPL, and patients with moderate MGD had an OR of 22.454 compared with the severe MGD patients (OR = 22.454, 95% CI: 2.890-174.436, P = .003).

IPL effectively improves clinical symptoms and some signs in MGD patients. Age, MGD severity, baseline S ɪ t and baseline OSDI are potential factors that may influence the clinical outcomes of IPL. MGD severity is an independent influencing factor.
Risk factors for bile duct injury after laparoscopic cholecystectomy
Authors: Dong Chang-Cheng , Jiang Xue-Jun , Shi Xue-Ying , Li Bing , Chen Liang
Published: December 2021

Background:

Bile duct injury (BDI) is one of the serious complications in laparoscopic cholecystectomy (LC), but there is currently a lack of systematic review of risk factors related to BDI after LC. This study conducts meta-analysis on the risk factors related to bile duct injury after LC, the purpose is to provide reference basis for preventing and reducing BDI after LC.

Methods:

Using the Computer to retrieve of Chinese and English databases such as CNKI, WANFANG Data, the VIP Network, PubMed, Embase, the Cochrane Library, etc. The time is from the establishment of each database until August 2021. A case–control study is selected that is related to the risk factors of BDI after LC. This meta-analysis using RevMan 5.4 and State 12.0 software is performed after two researchers independently sift through the literature, extract the data, and evaluate the bias risk included in the study.

Results:

The risk factors related to BDI after LC will be analyzed by systematic review.

Conclusion:

The conclusion of this study will play an important role in reducing BDI after LC.

OSF Registration:

DOI 10.17605/OSF.IO/2B3K9, the registration URL is https://osf.io/2b3k9.
Anesthetic management with remimazolam for a pediatric patient with Duchenne muscular dystrophy
Authors: Horikoshi Yuta , Kuratani Norifumi , Tateno Ken , Hoshijima Hiroshi , Nakamura Tina , Mieda Tsutomu , Doi Katsushi , Nagasaka Hiroshi
Published: December 2021

Rationale:

With Duchenne muscular dystrophy (DMD) being the most common and most severe type of muscular dystrophy, DMD patients are at risk for complications from general anesthesia due to impaired cardiac and respiratory functions as the pathological condition progresses. In recent years, advances in multidisciplinary treatment have improved the prognosis of DMD patients, and the number of patients requiring surgery has increased. Remimazolam is a benzodiazepine derivative similar to midazolam. Its circulatory stability and the fact that it has an antagonist make it superior to propofol.

There are no reports of pediatric patients with DMD undergoing total intravenous anesthesia with remimazolam.

Patient concerns:

A 4-year boy was scheduled for single-incision laparoscopic percutaneous extraperitoneal closure for inguinal hernia under general anesthesia, but the surgery was postponed because his serum creatine phosphokinase level was extremely high.

Diagnosis:

He was diagnosed with DMD. According to the results of the genetic test, exon deletion of the DMD gene was detected using multiplex ligation-dependent probe amplification, although he had no symptoms of DMD except for elevated serum levels of creatine phosphokinase, etc.

Intervention:

He was admitted for the same surgical purpose. Anesthesia was induced with 3 mg of intravenously administered remimazolam. He lost the ability to respond to verbal commands. After the intravenous administration of 100 μg of fentanyl, a continuous infusion of remifentanil (1.0 μg/kg/min) and remimazolam (15 mg/h) was started, and the endotracheal tube was inserted smoothly after the administration of 10 mg of rocuronium with which the muscle twitches disappeared in train-of-four monitoring. At the end of the surgery, 15 mg of flurbiprofen was administered intravenously. After surgery, we injected 40 mg of sugammadex to confirm a train-of-four count of 100%.

Outcomes:

Although the dose of remimazolam was reduced to 5 mg/h 30 minutes before the end of the surgery, it took 20 minutes after the discontinuation of remimazolam for the patient to open his eyes upon verbal command. On postoperative Day 2, he was discharged from the hospital without any complications.

Lessons:

Remimazolam was shown to be safe to use for general anesthesia in a pediatric patient with DMD.
Early anthropometric indicators of type 2 diabetes mellitus
Authors: Bakhtiani Priyanka , Geffner Mitchell E.
Published: December 2021

Purpose of review

With the rapidly increasing incidence of type 2 diabetes mellitus (T2DM) in youth (as in adults), it is critical to recognize phenotypic markers that can help predict and potentially prevent its onset, and reduce the associated burden of the disease for patients, families, and society. In this review, we summarize the most recent literature characterizing growth, puberty, and body composition in youth at risk for or who have T2DM.

Recent findings

There is an inverse, nonlinear relationship between birth weight and future risk of developing T2DM. Height seems to have an inverse correlation with risk for diabetes. Earlier onset of puberty in males and females is associated with the T2DM phenotype. While adiposity is a known correlate of T2DM, visceral adiposity as represented by waist circumference has emerged as one of the key determinants of T2DM in population-based studies globally. Thresholds for body mass index vary across ethnicities in predicting risk for T2DM, depending on genetic factors and fat-distribution profiles.

Emerging links between T2DM and dysregulated parameters of growth and development highlight the importance of early recognition of modifiable risk factors and the creation of individualized screening protocols.

Video abstract

http://links.lww.com/COE/A31.
Superficial Angiomyxomas Frequently Demonstrate Loss of Protein Kinase A Regulatory Subunit 1 Alpha Expression
Authors: Neumann Neil M. , LeBoit Philip E. , Cohen Jarish N.
Published: December 2021

Superficial angiomyxomas (SAMs) are benign cutaneous tumors that arise de novo and in the setting of the Carney complex (CC), an autosomal dominant disease with several cutaneous manifestations including lentigines and pigmented epithelioid melanocytomas. Although most SAM do not pose a diagnostic challenge, a subset can demonstrate histopathologic overlap with other myxoid tumors that arise in the skin and subcutis. Traditional immunohistochemical markers are of limited utility when discriminating SAM from histopathologic mimics. Since protein kinase A regulatory subunit 1 alpha (PRKAR1A) genetic alterations underlie most CC cases, we investigated whether SAM demonstrate loss of PRKAR1A protein expression by immunohistochemistry. In our series, 29 SAM, 26 myxofibrosarcoma, 5 myxoid dermatofibrosarcoma protuberans, 11 superficial acral fibromyxomas, and 18 digital mucous cysts were characterized. Of the 29 SAM examined in this study, 1 was associated with documented CC in a 5-year-old girl. SAM tended to arise in adults (mean 49.7 y; range: 5 to 87 y). Loss of PRKAR1A was seen in 55.2% of cases (16/29) and had a male predilection (87.5%, 12/16). PRKAR1A-inactivated SAM demonstrated significant nuclear enlargement (100%, 16/16 vs. 23.1%, 3/13), multinucleation (81.3%, 13/16 vs. 23.1%, 3/13), and presence of neutrophils (43.8%, 7/16 vs. 0%, 0/13). In contrast, PRKAR1A was retained in all cases of myxofibrosarcoma (100%, 26/26), myxoid dermatofibrosarcoma protuberans (100%, 5/5), superficial acral fibromyxomas (100%, 11/11), and digital mucous cyst (100%, 18/18). Taken together, PRKAR1A loss by immunohistochemistry can be used as an adjunctive assay to support the diagnosis of SAM given the high specificity of this staining pattern compared with histopathologic mimics.
Pathologic Examination of Pancreatic Specimens Resected for Treated Pancreatic Ductal Adenocarcinoma
Authors: Wang Huamin , Chetty Runjan , Hosseini Mojgan , Allende Daniela S. , Esposito Irene , Matsuda Yoko , Deshpande Vikram , Shi Jiaqi , Dhall Deepti , Jang Kee-Taek , Kim Grace E. , Luchini Claudio , Graham Rondell P. , Reid Michelle D. , Basturk Olca , Hruban Ralph H. , Krasinskas Alyssa , Klimstra David S. , Adsay Volkan ,   for the Pancreatobiliary Pathology Society
Published: December 2021

Currently, there are no internationally accepted consensus guidelines for pathologic evaluation of posttherapy pancreatectomy specimens. The Neoadjuvant Therapy Working Group of Pancreatobiliary Pathology Society was formed in 2018 to review grossing protocols, literature, and major issues and to develop recommendations for pathologic evaluation of posttherapy pancreatectomy specimens. The working group generated the following recommendations: (1) Systematic and standardized grossing and sampling protocols should be adopted for pancreatectomy specimens for treated pancreatic ductal adenocarcinoma (PDAC). (2) Consecutive mapping sections along the largest gross tumor dimension are recommended to validate tumor size by histology as required by the College of American Pathologists (CAP) cancer protocol. (3) Tumor size of treated PDACs should be measured microscopically as the largest dimension of tumor outer limits that is bound by viable tumor cells, including intervening stroma. (4) The MD Anderson grading system for tumor response has a better correlation with prognosis and better interobserver concordance among pathologists than does the CAP system. (5) A case should not be classified as a complete response unless the entire pancreas, peripancreatic tissues, ampulla of Vater, common bile duct, and duodenum adjacent to the pancreas are submitted for microscopic examination. (6) Future studies on tumor response of lymph node metastases, molecular and/or immunohistochemical markers, as well as application of artificial intelligence in grading tumor response of treated PDAC are needed. In summary, systematic, standardized pathologic evaluation, accurate tumor size measurement, and reproducible tumor response grading to neoadjuvant therapy are needed for optimal patient care. The criteria and discussions provided here may provide guidance towards these goals.
Contact transmission of SARS-CoV-2 on fomite surfaces: surface survival and risk reduction
Authors: Tharayil Abhimanyu , Rajakumari R. , Mozetic Miran , Primc Gregor , Thomas Sabu
Published: December 2021

There is an unprecedented concern regarding the viral strain SARS-CoV-2 and especially its respiratory disease more commonly known as COVID-19. SARS-CoV-2 virus has the ability to survive on different surfaces for extended periods, ranging from days up to months. The new infectious properties of SARS-CoV-2 vary depending on the properties of fomite surfaces. In this review, we summarize the risk factors involved in the indirect transmission pathways of SARS-CoV-2 strains on fomite surfaces. The main mode of indirect transmission is the contamination of porous and non-porous inanimate surfaces such as textile surfaces that include clothes and most importantly personal protective equipment like personal protective equipment kits, masks, etc. In the second part of the review, we highlight materials and processes that can actively reduce the SARS-CoV-2 surface contamination pattern and the associated transmission routes. The review also focuses on some general methodologies for designing advanced and effective antiviral surfaces by physical and chemical modifications, viral inhibitors, etc.
The Role of Mentoring in Promoting Diversity, Equity, and Inclusion in STEM Education and Research
Authors: Marshall Andrea G. , Vue Zer , Palavicino-Maggio Caroline B. , Spencer Elsie C. , Beasley Heather K. , Garza-Lopez Edgar , Conley Zachary , Neikirk Kit , Murray Sandra A. , Martinez Denise , Davis Jamaine , Brady Lillian , Shuler Haysetta D. , Morton Derrick , Hinton Antentor
Published: December 2021

Mentoring success is derived from active and respectful listening and the willingness to learn and accept opportunities for personal growth. Mentoring shapes every trainee and their career path in science, technology, engineering, and mathematics (STEM). Productive mentoring relationships cultivate rapport, stimulate moments of introspection, and provide constructive feedback. Effective mentoring in STEM allows trainees, especially underrepresented minorities (URMs), to flourish in welcoming and supportive environments. However, URM trainees often experience inadequate mentoring due to their mentor’s inexperience with URM groups, poor mentorship training, or a lack of understanding of their mentee’s journey. To promote diversity, equity, and inclusion in STEM education and research, it is essential for mentors and mentees to work together with creativity, authenticity, and networking. In this workshop, we will focus on mentees’ perspective on how mentors can enhance their training, professional and career development, and improve their focus. We analyzed data on feedback obtained from students interested in pursuing graduate education who attended a recent workshop. Our results show that despite low initial expectations for the workshop, many students were satisfied with the knowledge they learned. The future of increasing the URM representation in STEM lies in providing adequate community support and mentorship throughout the careers of URM professionals.
Polynomial Mendelian Randomization reveals widespread non-linear causal effects in the UK Biobank
Authors: Sulc Jonathan , Sjaarda Jennifer , Kutalik Zoltán
Published: December 2021

Causal inference is a critical step in improving our understanding of biological processes and Mendelian randomisation (MR) has emerged as one of the foremost methods to efficiently interrogate diverse hypotheses using large-scale, observational data from biobanks. Although many extensions have been developed to address the three core assumptions of MR-based causal inference (relevance, exclusion restriction, and exchangeability), most approaches implicitly assume that any putative causal effect is linear. Here we propose PolyMR, an MR-based method which provides a polynomial approximation of an (arbitrary) causal function between an exposure and an outcome. We show that this method provides accurate inference of the shape and magnitude of causal functions with greater accuracy than existing methods. We applied this method to data from the UK Biobank, testing for effects between anthropometric traits and continuous health-related phenotypes and found most of these (84%) to have causal effects which deviate significantly from linear. These deviations ranged from slight attenuation at the extremes of the exposure distribution, to large changes in the magnitude of the effect across the range of the exposure (e.g. a 1 kg/m2 change in BMI having stronger effects on glucose levels if the initial BMI was higher), to non-monotonic causal relationships (e.g. the effects of BMI on cholesterol forming an inverted U shape). Finally, we show that the linearity assumption of the causal effect may lead to the misinterpretation of health risks at the individual level or heterogeneous effect estimates when using cohorts with differing average exposure levels.
BrnQ-type Branched-chain Amino Acid Transporters Influence Bacillus anthracis Growth and Virulence
Authors: Dutta Soumita , Corsi Ileana D. , Bier Naomi , Koehler Theresa M.
Published: December 2021

Bacillus anthracis, the anthrax agent, exhibits robust proliferation in diverse niches of mammalian hosts. Metabolic attributes of B. anthracis that permit rapid growth in multiple mammalian tissues have not been established. We posit that branched-chain amino acid (BCAA: Isoleucine, leucine and valine) metabolism is key to B. anthracis pathogenesis. Increasing evidence indicates relationships between B. anthracis virulence and expression of BCAA-related genes. Expression of some BCAA-related genes is altered during culture in bovine blood in vitro and the bacterium exhibits valine auxotrophy in a blood serum mimic medium. Transcriptome analyses have revealed that the virulence regulator AtxA, that positively affects expression of the anthrax toxin and capsule genes, negatively regulates genes predicted to be associated with BCAA biosynthesis and transport. Here, we show that B. anthracis growth in defined media is severely restricted in the absence of exogenous BCAAs, indicating that BCAA transport is required for optimal growth in vitro. We demonstrate functional redundancy among multiple BrnQ-type BCAA transporters. Three transporters are associated with isoleucine and valine transport, and deletion of one, BrnQ3, attenuates virulence in a murine model for anthrax. Interestingly, an ilvD-null mutant lacking dihydroxy-acid dehydratase, an enzyme essential for BCAAs synthesis, exhibits unperturbed growth when cultured in media containing BCAAs, but is highly attenuated in the murine model. Finally, our data show that BCAAs enhance AtxA activity in a dose-dependent manner, suggesting a model in which BCAAs serve as a signal for virulence gene expression.

IMPORTANCE

Infection with B. anthracis can result in systemic disease with large numbers of the bacterium in multiple tissues. We found that BCAA synthesis is insufficient for robust growth of B. anthracis; access to branched-chain amino acids (BCAAs) is necessary for proliferation of the pathogen during culture and during infection in a murine model for anthrax. B. anthracis produces an unusually large repertoire of BCAA-related transporters. We identified three isoleucine/valine transporters with partial functional redundancy during culture. Deletion of one of these transporters, BrnQ3, resulted in attenuated virulence. Interestingly, a BCAA biosynthesis mutant grew well in medium containing BCAAs, but like BrnQ3, was attenuated for virulence. These results suggest that BCAAs are limiting in multiple niches during infection and furthers understanding of nutritional requirements of this important pathogen.
Impact of corruption on Chinese investment in African countries
Authors: Yuan Shilin , Chen Haiyang , Zhang Wei
Published: December 2021

Purpose

This paper aims to examine the impact of host country corruption on foreign direct investment (FDI) from China to developing countries in Africa. With the opposing arguments that corruption is detrimental to or instrumental in FDI and mixed empirical evidence, this paper contributes to the literature by providing new evidence on the issue. Additionally, little research has been done on the impact of corruption on FDI made by developing country multinationals to developing countries. This paper fills a void in this area.

Design/methodology/approach

Based on the published literature, as well as China and Africa contexts, the authors develop hypotheses that host countries with low corruption receive more FDI and resource-seeking investments weaken the relationship. The annual stock of Chinese FDI in 35 African countries, host country corruption data and other control variables from 2007 to 2015 are collected. Feasible generalized least squares models are used to test the hypotheses. Additional robustness tests are also conducted.

Findings

The findings support the hypotheses. Specifically, Chinese investors make more investments in host countries with low corruption except for resource-seeking investments in resource-rich host counties. The results are statistically significant accounting for various control variables. The results of the robustness tests show that the main findings are robust.

Originality/value

First, this study provides new evidence on the impact of corruption on FDI. Second, this study also fills a void by examining FDI from a developing country, China to other developing countries in Africa. Finally, this study also has a practical implication for Chinese multinationals investing in Africa.