bluuebunny/crossref_metadata_2025 huggingface dataset:
A randomized, placebo-controlled, trial to assess the photosensitizing, phototoxic and carcinogenic potential of hydrochlorothiazide in healthy volunteers
Authors: Götzinger Felix , Hohl Mathias , Lauder Lucas , Millenaar Dominic , Kunz Michael , Meyer Markus R. , Ukena Christian , Lerche Catharina M. , Philipsen Peter A. , Reichrath Jörg , Böhm Michael , Mahfoud Felix
Published: September 2023

Background and aims:

Pharmacovigilance reports, associating hydrochlorothiazide (HCT) with skin cancer, resulted in a significant decrease of HCT prescriptions for hypertension and heart failure. Whether HCT exhibits phototoxic properties thereby causing skin cancer remains unknown. This study aimed to examine the photosensitizing, phototoxic and carcinogenic potential of HCT in a randomized, placebo-controlled, double-blind trial in vivo and also in vitro.

Methods:

The trial assigned 30 healthy, normotensive adult volunteers in a 2:1 ratio to either HCT 25 mg/day or placebo for 15 days. Photosensitivity of the skin with and without the effect of HCT treatment were assessed. Following whole-body ultraviolet A (UVA) and B (UVB, 311 nm) irradiation, phototoxic and carcinogenic reactions by measuring urinary excretion of pyrimidine dimers were evaluated. For the in-vitro studies, human keratinocytes (HaCaT) were incubated with HCT, irradiated with UVB, and analysed for markers of inflammation, apoptosis and carcinogenesis.

Results:

Skin photosensitivity following exposure to UVA and UVB remained unchanged from baseline to 15-day follow-up in both groups (UVA change HCT 0.0 J/cm2 vs. placebo 0.0 J/cm2; P = 0.99; UVB change HCT 0.0 J/cm2 vs. placebo -0.2 J/cm2; P = 0.06). Pyrimidine dimers were not detected in either group. In vitro, combination of HCT and UVB irradiation did not induce the expression of oxidative stress marker proteins, inflammatory proteins, apoptotic proteins or activation of oncoproteins.

Conclusion:

HCT did not increase photosensitivity for UVA or UVB in healthy volunteers compared with placebo, and was not associated with phototoxic or carcinogenic reactions. In vitro, HCT was also not associated with phototoxicity or carcinogenesis (NCT04654312).
Measurement of Sleep in Chronic Traumatic Brain Injury: Relationship Between Self-report and Actigraphy
Authors: Morrow Emily L. , Mattis-Roesch Hannah , Walsh Kimberly , Duff Melissa C.
Published: September 2023

Objective:

To examine the relationship between self-report and actigraphy measurement of sleep in people with and without traumatic brain injury (TBI) by addressing 2 aims: (1) to assess the relationship between self-report and actigraphy for sleep quantity in people with and without TBI; and (2) to explore how self-report and actigraphy capture sleep quality in TBI.

Setting:

Participants completed the study over 2 weeks in their own homes. They wore activity monitors, day and night, throughout the experiment and completed morning sleep diaries while interacting with an experimenter on videoconference.

Participants:

This project was embedded in a larger study on sleep and word learning in 100 adults: 50 with chronic, moderate-severe TBI and 50 demographically matched noninjured peers. Of the 100 participants who completed the larger study, 92 participants (45 with TBI and 47 noninjured peers) had sufficient actigraphy data for inclusion in the current study.

Design:

We used multilevel linear regression models and correlation analyses to assess how well participants' self-report corresponded to actigraphy measurement of sleep.

Main Measures:

Actigraphy measures included nightly sleep duration and nighttime wakeups. Sleep diary measures included self-reported nightly sleep duration, nighttime wakeups, sleep quality, and morning fatigue.

Results:

People with and without TBI did not differ in the relationship between self-reported and actigraphy measurement of sleep quantity. Performance on a neuropsychological memory assessment did not correlate with the difference in self-reported and actigraphy-measured sleep in the TBI group. Sleep characteristics that were measured by actigraphy did not predict subjective experiences of sleep quality or fatigue.

Conclusions:

Short-term self-report diaries capture accurate information about sleep quantity in individuals with TBI and may support self-report of other daily habits. Future research is needed to identify reliable metrics of sleep quality, and how they relate to other domains such as memory and mood, in the chronic phase of TBI.
Evaluating the safety and operability of asymmetric trapezoid and near-square side-port incision in cataract surgery
Authors: Tu Biyue , Zuo Jidong , Peng Tingting , Guo Huafang , Ortega-Usobiaga Julio , Wang Yong
Published: September 2023

Purpose:

To compare the accuracy, safety, and consistency of asymmetric trapezoid and near-square side-port incision in cataract surgery.

Setting:

Aier Eye Hospital of Wuhan University, Wuhan, Hubei Province, China.

Design:

Prospective pilot study.

Methods:

This study included patients who underwent phacoemulsification between January 2022 and August 2022. They were divided into Group A and Group B using the random number table method. Group A was given a near-square side-port incision and Group B was given an asymmetric trapezoid side-port incision. We contrasted the differences in incision length, width, and shape; surgical time; and postoperative intraocular pressure (IOP) between the 2 groups.

Results:

220 eyes of 220 patients were included. The mean external width of the incision in Group A was much smaller than that in Group B (P < .01), and the consistency of the incision diameter in Group A was better than that in Group B. There was no statistically significant difference in incision length between the 2 groups (P = .75). 1 day after surgery, there was no statistically significant difference in incision morphology between the 2 groups (P = .72). The operating time for Group A was significantly shorter than that of Group B (P < .01). There was no obvious incision leakage in both groups after surgery, and the IOP was generally elevated after surgery, but there was no significant statistical difference between the 2 groups (P = .98).

Conclusions:

The present study suggests that a near-square side-port results in better consistency of incision width and shorter surgical time.
Multifocal intraocular lens implantation in children with unilateral congenital cataracts
Authors: Jiang Mingming , Zhang Jing , Ding Yichao , Huang Yusen
Published: September 2023

Purpose:

To evaluate the vision recovery, reconstruction of binocular visual function, and influencing factors after multifocal intraocular lens implantation in children with unilateral congenital cataracts.

Setting:

University hospital.

Design:

Prospective clinical study.

Methods:

In the prospective clinical study, 55 children aged 3 to 14 with unilateral congenital cataracts received multifocal intraocular lenses (TECNIS ZMB00) posterior optic capture from 2019 to 2022. Corrected distance visual acuity (CDVA; 5 m), distance-corrected intermediate visual acuity (DCIVA; 66 cm), distance-corrected near visual acuity (DCNVA; 33 cm), stereoscopic vision, visual quality (objective scatter index [OSI] and modulation transfer function [MTF]), axial length (AL), keratometry (K), and contrast sensitivity (CS), as well as postoperative occlusion compliance were evaluated before and after surgery.

Results:

At the final follow-up, 90.91% (50/55) patients showed significant improvement in visual acuity (VA) after surgery. CDVA, DCIVA and DCNVA were 0.23 ± 0.17, 0.39 ± 0.15, and 0.44 ± 0.15 logMAR, respectively. 69.09% (38/55) patients achieved good VA (better than 0.3 logMAR).52.76% (25/48) patients had a positive Titmus test. OSI and MTF were 1.24 ± 0.91 and 42.45 ± 12.30, respectively. 73.68% (28/38) of the patients (better than 0.3 logMAR) underwent strict occlusion therapy. Postoperative VA is correlated with preoperative CDVA (r = −0.829, P < .001), corneal astigmatism (r = 0.384, P = .036), △AL (difference between the cataract eyes and contralateral eyes, r = −0.490, P = .006), and occlusion compliance (r = −0.806, P < .001).

Conclusions:

Multifocal intraocular lens implantation could obtain relatively satisfactory VA (CDVA, DCIVA and DCNVA) and the binocular visual function of children with unilateral congenital cataracts. Postoperative VA is related to preoperative VA, corneal astigmatism, △AL, and occlusion compliance.
Effect of spherical aberration on visual acuity and depth of focus in pseudophakic eyes
Authors: Kozhaya Karim , Kenny Peter I. , Esfandiari Saina , Wang Li , Weikert Mitchell P. , Koch Douglas D.
Published: September 2023

Purpose:

To assess the performance of 4 intraocular lenses (IOLs) in various spherical aberration (SA) conditions, using the VAO adaptive optics simulator.

Setting:

Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.

Design:

Prospective case series.

Methods:

Distance-corrected visual acuities at distance (CDVA), intermediate (DCIVA), and near (DCNVA) were measured in 42 dilated pseudophakic eyes at baseline and with ocular SA ranging from −0.4 to +0.4 μm in increments of 0.2 μm (6.0-mm pupil). 4 IOL types were assessed: monofocal IOLs with zero-SA, enhanced-monofocal, extended depth-of-focus (EDOF), and continuous range-of-vision.

Results:

Compared with SA = 0 μm, significant changes (all P < .05) were: (1) zero-SA monofocal IOLs' DCNVA at high contrast improved by 0.13 logMAR with SA = −0.4 μm and worsened by 0.09 and 0.10 logMAR with SA = +0.2 and +0.4 μm, respectively. DCNVA at low contrast worsened by 0.09 logMAR with SA = +0.4 μm; and (2) with SA = −0.4 μm, the enhanced monofocal IOL lost 0.06 logMAR of CDVA at high contrast and gained 0.09 logMAR of DCNVA at low contrast. There were no significant changes from SA = 0 μm for EDOF and continuous range-of-vision IOLs.

Conclusions:

Zero-SA and EDOF IOLs were the most and least sensitive to SA modulation, respectively. In perfect optical systems where all the optical elements are aligned, induction of targeted amounts of negative SA improved the depth of focus of some IOL types. No benefit was found with positive SA.
Epidemiology and 12-Month Outcomes of Patients Managed in a Thoracolumbosacral Orthosis After Trauma
Authors: Webb Darren Craig , Kimmel Lara Anne , D’Souza Jeff , Liew Susan
Published: September 2023

Introduction

Traumatic fractures of the thoracolumbar junction (T10–L3) are the most common fractures of the spinal column. The management of these injuries can be operative or nonoperative, and braces are often used, including the Boston Overlap Brace (BOB), a type of thoracolumbosacral orthosis (TSLO).

Methods

All patients admitted to the Alfred Hospital in 2015 and managed in a BOB for 2- or 3-column thoracolumbar burst fractures (without neurology) were included in the study. In-hospital and 6- and 12-month patient-reported outcome measures were collected. A random-effects regression model analysis for each outcome (self-reported) pain and functional outcome measures by the Glasgow Outcomes Scale–Extended (GOS-E) was undertaken.

Results

A total of 115 patients (62 male) were included with a median age of 53 years. Using a random-effects model, having a lower-limb fracture or a regional kyphosis angle >8° was associated with not having a good recovery after taking into account all other factors with a univariate relationship with this outcome. In terms of the outcome of self-reported pain, only female sex was associated with reporting pain.

Conclusions

This study included a large cohort of patients with management of a traumatic fracture with a BOB-type TLSO and provided information that should guide a larger study to review whether the factors associated with poorer outcome, including female sex and local kyphotic angle, need to be considered before deciding on the management of these fractures.

Clinical Relevance

The association between degree of deformity of fracture (>8°) and associated lower-limb injury with poorer patient outcomes may need to be taken into account before deciding to manage thoracolumbar fractures with a BOB-type TLSO although further longitudinal studies are required.
Direct to Operating Room for Decompressive Craniotomy/Craniectomy in Patients With Traumatic Brain Injury
Authors: Kelley Jesse K. , Jaje Katie E. , Smitterberg Chase W. , Reed Charles R. , Pounders Steffen J. , Krech Laura A. , Groseclose Ryan S. , Fisk Chelsea S. , Chapman Alistair J. , Yang Amanda Y.
Published: September 2023

BACKGROUND:

Emergent decompressive craniotomy/craniectomy can be a lifesaving surgical intervention for select patients with traumatic brain injury. Prompt management is critical as early decompression can impact traumatic brain injury outcomes.

OBJECTIVE:

This study aims to describe the feasibility and clinical impact of a new pathway for transporting patients with severe traumatic brain injury directly to the operating room from the trauma bay for decompressive craniotomy/craniectomy.

METHODS:

This is a retrospective cohort preintervention and postintervention study of severe traumatic brain injury patients undergoing decompressive craniectomy/craniotomy at a Midwestern U.S. Level I trauma center between 2016 and 2022. In the new pathway, the in-house trauma surgeon takes the patient directly to the operating room with the neurosurgery advanced practice provider to drape and prepare the patient for surgery while the neurosurgeon is en route to the hospital.

RESULTS:

A total of 44 patients were studied, five (5/44, 11.4%) of which were in the preintervention group and 39 (39/44, 88.6%) in the postintervention group. The median arrival-to-operating room time was shorter in the postintervention cohort (1.4 hr) than in the preintervention cohort (1.5 hr). In examining night shifts only, the preintervention cohort had shorter arrival-to-operating room times (1.2 hr) than the postintervention cohort (1.5 hr).

CONCLUSION:

The study demonstrated that the new pathway is feasible and expedites patient transport to the operating room while awaiting the arrival of the on-call neurosurgeon.
Mean arterial pressure and mortality in patients with heart failure: a retrospective analysis of Zigong heart failure database
Authors: Ma Hangkun , Li Haibo , Sheng Song , Quan Longfang , Yang Zhixu , Xu Fengqin , Zeng Wenying
Published: September 2023

Background

It is commonly observed that a higher target of mean arterial pressure (MAP) is in previous studies. This study assessed the association of MAP with short-term mortality in heart failure (HF) patients.

Methods

A retrospective cohort study was conducted by using data from Hospitalized patients with heart failure: integrating electronic healthcare records and external outcome database(v1.2). The characteristic of patients was described by 3 groups of MAP: below 80 mmHg, 80–100 mmHg, and above 100 mmHg. Univariate and multivariate logistic regression analyses were used to assess the relevance between MAP and all-cause mortality within 28 days and 6 months. For assessing the effect of multiple variables on patient survival time, 28-day and 6-month, Kaplan–Meier survival analysis and Forest plot were performed.

Results

The overall cohort comprised 2008 patients divided by MAP into 3 groups, each group had 344 (17.1%), 938 (46.7%), and 726 (36.2%) patients. Patients in MAP < 80 mmHg group had higher mortality than MAP 80-100 mmHg and MAP ≥ 100 mmHg in 28 days(3.8% versus 1.6% versus 1.2%) and in 6 months (4.9% versus 2.5% versus 2.3%). Univariate analysis showed that MAP as a continuous variate was associated with 28-day (OR was 0.98, 95% CIs: 0.96–0.99, P = 0.011) and 6-month mortality (OR was 0.98, 95% CIs: 0.97–1, P = 0.021) in HF patients. Model 4 put into multivariate logistic regression analyses showed MAP 80-100 mmHg (OR was 0.13, 95% CIs: 0.02–0.8, P = 0.027) stably associated with 28-day and 6-month mortality after adjusted covariable. Kaplan–Meier survival curves revealed a higher survival rate in the MAP ≥ 80 mmHg group than in the MAP < 80 mmHg group. The forest plot showed the stable effect of MAP ≥ 80 mmHg compared with MAP < 80 mmHg, the interaction analysis had no statistical significance effect between the two groups of MAP and multi-variable.

Conclusion

It is indicated that MAP was independently associated with 28-day, 6-month all-cause mortality of HF patients, and compared with MAP < 80 mmHg, MAP ≥ 80 mmHg had a lower risk of 28-day, 6-month all-cause mortality of patients with HF.
Positive blood pressure response may predict the recovery of renal function after transcatheter aortic valve implantation
Authors: Ince Orhan , Gulsen Kamil , Ozcan Sevgi , Tugrul Sevil , Katkat Fahrettin , Karahan Serkan , Donmez Esra , Kepez Alper , Sahin Irfan , Okuyan Ertugrul
Published: September 2023

Objective

Transcatheter aortic valve implantation (TAVI) may ameliorate renal function and increase blood pressure (BP). We aimed to investigate the association between increased BP and improved renal function (IRF) after TAVI.

Methods

A total of 176 patients who had undergone TAVI were evaluated retrospectively. BP records that were taken 24 h before and 72 h after TAVI were reviewed. Pre-procedural, post-procedural 48 h, and the first month estimated glomerular filtration rate (eGFR) levels were noted. IRF was accepted as a ≥ 10% increase in eGFR. The predictors of acute kidney injury (AKI) development at 48 h and IRF at 1 month were investigated. The association between mortality and BP response was assessed.

Results

A total of 157 patients were included in this study after exclusion as defined in the methodology. Mean age was 78.1 ± 7,1 and 51.6% were female. AKI occurred in 25.5% of patients and baseline eGFR and male gender were found as independent predictors for AKI development. IRF was observed in 16% at 48 h and 31.8% of patients at 1-month follow-up. Positive BP response was seen in 42% of patients. Pre-procedural chronic kidney disease, positive BP response, and an early increase in eGFR emerged as independent predictors of IRF at the first month. The patients with positive BP response were found to have decreased mortality at 710 days follow-up.

Conclusion

Positive BP response after TAVI is related to improved survival and renal functions. The beneficial effect of TAVI on renal function may be precisely evaluated at 1st month rather than 48 h.
Validation of the iHealth Track upper-arm blood pressure monitor KN-550BT in general population according to the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018+AMD1:2020)
Authors: Shi Lei , Zhang Xin-Yi , Sun Jia-Yi , Chen Jin-Feng , Ma Yi-Fei , Zhou Kai-Yuan
Published: September 2023

Objective

To validate the iHealth Track KN-550BT oscillometric upper-arm blood pressure monitor in general population according to the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018+AMD1:2020).

Methods

Participants were recruited and the same left-arm sequential method was used for blood pressure measurement according to the ISO 81060-2:2018+AMD1:2020. The validation results were assessed following the protocol and the Bland–Altman scatterplot was used to show the difference between the test device and reference results.

Results

A total of 89 qualified participants were included in the final analysis. For the validation Criterion 1, the mean ± SD of the differences between the test device and reference readings was −1.22 ± 5.76 mmHg and −0.08 ± 4.40 mmHg for systolic and diastolic blood pressure, respectively. For Criterion 2, the mean ± SD of the differences between the test device and reference readings per participant was −1.22 ± 5.06 mmHg and −0.08 ± 3.84 mmHg for systolic and diastolic blood pressure, respectively.

Conclusion

The iHealth Track KN-550BT upper-arm blood pressure monitor passed all the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018+AMD1:2020) and can be recommended for clinical use and self-measurement in general population.
Fibroblast Activation Protein–Targeted PET/CT Imaging in a Treatment-Naive Prostate Cancer Patient With Low PSMA Expression
Authors: Mu Xingyu , Li Meng , Huang Jingquan , Wang Zhenzhen , Fu Wei
Published: September 2023

Prostate-specific membrane antigen (PSMA) PET/CT has become increasingly accepted for imaging prostate cancer (PCa), including its recent use in primary staging. In this case report, we present the case of a 76-year-old man with newly diagnosed PCa. 18F-PSMA-1007 PET/CT showed minimal PSMA activity in the primary tumor and metastases. However, 18F-FAPI-04 PET/CT revealed more avid lesions in primary tumor, metastatic lymph nodes, and bones. Subsequent histopathologic examination confirmed the diagnosis of PCa. These findings suggest that 18F-FAPI-04 may have a potential role in the evaluation of PCa with low PSMA expression in treatment-naive patients.
18F-FDG PET/CT Imaging of Pulmonary Hamartomas
Authors: Usmani Sharjeel , Jain Anjali , Akhter Syed M. J. , Al Riyami Khulood , Abubakar Sofiullah , Al Busaidi Asiya
Published: September 2023

Pulmonary hamartoma is the most common benign tumor of the lung and often discovered incidentally on imaging. We report the case of a 49-year-old woman recently diagnosed with left breast cancer with suspicious left axillary lymph nodes. 18F-FDG PET/CT showed well-circumscribed, lobulated, low-attenuation soft tissue mass in the right lower lobe lung with mild to no significant metabolic activity. CT-guided biopsy showed the lesion composed of fat, cartilage, and smooth muscle, admixed with fibroconnective tissue. The findings are consistent with pulmonary hamartoma. The presence of fat in a well-circumscribed solitary pulmonary nodule along with low metabolic activity helps in the characterization of the lesion, which can alter patient management.
Anti-LGI1 Autoimmune Epilepsy
Authors: Burkett Brian J. , Johnson Derek R. , Hunt Christopher H. , Messina Steven A. , Broski Stephen M.
Published: September 2023

Leucine-rich glioma inactivated 1 autoimmune encephalitis is a treatable cause of autoimmune epilepsy associated with faciobrachial dystonic seizures—a rare form of epilepsy with frequent brief seizures primarily affecting the arm and face. We report a case with characteristic imaging findings. 18F-FDG PET/CT demonstrated severe hypometabolism in the left basal ganglia, a regional abnormality associated with leucine-rich glioma inactivated 1 encephalitis.
177Lu-FAP-2286 Therapy in a Case of Recurrent Bladder Cancer With Multiple Metastatic Lesions
Authors: Li Linwei , Yang Jian , Peng Dengsai , Zhang Yu , Chen Yue
Published: September 2023

We reported a 73-year-old man who was diagnosed with the recurrence of bladder tumor received 177Lu-FAP-2286 treatment. Encouragingly, radiological remission and alleviation of his symptom were noted. In addition, the patient did not have any adverse effects.
Papillary Thyroid Cancer in Thyroglossal Duct Cysts
Authors: Bishop Grace L. , Jasim Sina , Strnad Benjamin S. , Itani Malak
Published: September 2023

Thyroglossal duct cyst is the most common congenital neck mass, but the incidence of malignancy within a thyroglossal duct cyst is rare, estimated at 1%. Most cancers arising within thyroglossal duct cysts are incidentally detected after surgical excision. We present the preoperative radiologic findings of 8 patients with papillary thyroid cancer arising within a thyroglossal duct cyst, as evaluated on ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography scan.
Handheld Doppler Detection and Light Illumination for Vascular Mapping in Nasal Reconstruction
Authors: Zhang Xulong , Song Zhen , Xu Yihao , Zheng Ruobing , Guo Junsheng , Tian Le , Wang Huan , You Jianjun , Fan Fei
Published: September 2023

Background:

The application of the expanded forehead flap in nasal reconstruction has the advantage of being able to provide a sufficient amount of flap and can provide good aesthetic results. For an expanded forehead flap to survive, there must be adequate arterial supply and venous return. Despite this, limited studies have been conducted on preoperative vascular mapping and the design of the expanded forehead flap for nasal reconstruction. In this article, the authors present a technique of hand-held Doppler detection with light illumination for vascular mapping.

Patients and Methods:

The study included patients who underwent total nasal reconstruction with expanded forehead flaps between May 2016 and April 2021. The design of the flap was based on the result of preoperative vascular detection by hand-held Doppler detection assisted by light illumination.

Results:

A total of 32 patients underwent total nasal reconstruction with an expanded forehead flap. The distal part of the flap became necrotic 1 week after the surgery in 2 patients. Following dressing changes and the administration of antibiotics, the distal flap in these patients survived well. No complications were reported in the long term.

Conclusions:

Hand-held Doppler detection combined with light illumination is a convenient and effective preoperative design method for nasal reconstruction with an expanded forehead flap. All flaps survived well in the long term.

Level of Evidence:

Level IV.
Meta-Analysis of Validated Quality of Life Outcomes Following Voice Feminization in Transwomen
Authors: Hao Yvonne , Trilles Jorge , Brydges Hilliard T. , Boczar Daniel , Kurian Keerthi K. , Chaya Bachar F. , Colon Ricardo Rodriguez , Parker Augustus , Kwak Paul E. , Rodriguez Eduardo D.
Published: September 2023

Objectives:

For transwomen undergoing voice feminization interventions, fundamental frequency (F0; vocal pitch) is a commonly reported functional outcome measure in the literature. However, F0 may not correlate well with improvement in quality of life (QoL). Several validated voice-related QoL instruments have been used to assess QoL improvement in these patients, yet there is no consensus on the most appropriate instrument. This systematic review and meta-analysis aimed to assess the relationship between change in F0 and QoL improvement following voice feminization, and to compare validated QoL instruments commonly used in this population.

Data Sources:

PubMed, Cochrane, and Embase.

Review Methods:

A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Primary studies of transwomen undergoing voice feminization, reporting validated QoL outcomes were included. Meta-analyses for associations between mean change in QoL score and mean change in F0, as well as variations in mean change in QoL score by QoL instrument, were performed using a multilevel mixed effects model.

Results:

No statistically significant correlation was found between change in F0 and QoL score improvement post-intervention. Different validated instruments showed statistically significant variation in QoL score change, with the Trans Women Voice Questionnaire (TWVQ) capturing a greater improvement in QoL score relative to other instruments.

Conclusions:

Lack of correlation between changes in F0 and QoL improvement further supports that F0 alone is insufficient to assess the efficacy of voice feminizing interventions. Validated QoL measures are useful adjuncts. Of these, the TWVQ appears to be the most sensitive for measurement of QoL improvement following voice feminization.
Evaluation of Quality of Life and Self-reported Complications in Patients With Clean Intermittent Catheterization
Authors: Santos-Pérez de la Blanca Rocío , Medina-Polo José , González-Padilla Daniel , Cano-Galán María Mercedes , Arrébola-Pajares Ana , Hernández-Arroyo Mario , Rodríguez-Antolín Alfredo
Published: September 2023

PURPOSE:

This study sought to determine health-related quality of life and self-reported complications associated with clean intermittent catheterization (CIC).

DESIGN:

Observational, cross-sectional study.

SUBJECTS AND SETTING:

The target population was patients cared for by the urology department at Hospital 12 de Octubre in Madrid, Spain, undergoing CIC for chronic urinary retention of any etiology (neurogenic bladder dysfunction, neobladder, and other). The sample comprised 50 respondents with a mean age of 49 years; a majority (66%, n = 33) were female. Participants performed an average of 4 CICs.

METHODS:

All participants completed the ISC-Q (Intermittent Self-Catheterization Questionnaire) and a questionnaire about CIC-associated complications. Data were collected in February 2019.

RESULTS:

A vast majority of respondents (98%, n = 49) indicated preparation for catheterization was simple, and 76% (n = 38) indicated the catheter was easy to insert. One in 5 (20%, n = 10) considered carrying catheters and supplies inconvenient, though 58% (n = 29) indicated it was easy to dispose of the catheters outside the home. Most respondents (98%, n = 49) indicated they felt self-conscious about their need to self-catheterize, and 16% (n = 8) felt that CIC created limitations when visiting friends and family. The most frequent complication was symptomatic urinary tract infections (UTIs); participants reported an average of 1.7 UTIs in the last year. Additional complications, such as epididymo-orchitis, urethral stenosis, and urethral bleeding, were reported by less than 5% (n = 2) of participants.

CONCLUSIONS:

Participants managed by CIC for chronic urinary retention of any cause reported acceptable levels of satisfaction with the procedure. The reported incidence of complications was low, except for UTIs.
Does Resilience Predict Ostomy Adjustment in Patients With Permanent Ostomy?
Authors: Tirgari Batool , Azizzadeh Forouzi Mansooreh , Heidarzadeh Azam , Khalilzadeh Ganjalikhani Mahboobeh
Published: September 2023

PURPOSE:

This study aimed to evaluate associations between resilience and ostomy adjustment in a group of patients with a permanent ostomy.

DESIGN:

Descriptive, correlational study.

SUBJECTS AND SETTING:

One hundred participants were interviewed; most were male (N = 56; 56%), married (N = 77; 77%), illiterate (N = 46; 46%), and self-employed (N = 35; 35%). The most frequent condition leading to ostomy surgery was colorectal cancer (N = 24; 24%). A majority (N = 43; 43%) had been diagnosed with cancer 1 to 5 years before data collection, and 35 (35%) had lived with an ostomy for 1 to 5 years. Participants were recruited from an ostomy clinic of in Kerman, located in southeastern Iran. Data were collected from August to October 2019.

METHODS:

Data were collected via interviews. A questionnaire, developed for purposes of this study, was developed that included items querying demographic and pertinent clinical characteristics and 2 validated instruments, the Resilience Scale and the Ostomy Adjustment Inventory-23 (OAI-23). Data were analyzed usingttests, analysis of variance, Pearson correlation coefficient, and linear regression.

RESULTS:

The mean score for ostomy adjustment was 43.37 (SD = 11.57) indicating less than optimal adjustment to life with an ostomy. The mean score of the Resilience Scale was 104.56 (SD = 25.98); most participants (n = 67, 67%) had very low and low resilience. Resilience was weakly associated with ostomy adjustment; specifically, participants who scored higher on the Resilience Scale tended to score higher on the OAI-23 (r= 0.32,P= .006). Linear regression indicated that resilience had the greatest predictive effect on ostomy adjustment (P= .004).

CONCLUSIONS:

Results suggest that higher levels of resilience may facilitate adjustment to a permanent ostomy. Findings indicate that nurses should design and implement programs to aid ostomy adjustment via resilience assessment.
Health Belief Scale for Urinary Incontinence and Kegel Exercise
Authors: Aydin Avci I˙lknur , Öz Yildirim Özge
Published: September 2023

PURPOSE:

The aim of this study was to develop an instrument based on the Health Belief Model that measures urinary incontinence awareness and beliefs regarding pelvic floor muscle (Kegel) exercises.

DESIGN:

Evaluation of validity and reliability of the novel instrument and analysis of sociodemographic variables based on responses to this 49-item scale.

SUBJECTS AND SETTING:

The sample used to validate the instrument (n = 527) was drawn from patients cared for at the gynecology and obstetrics and urology polyclinic at Ondokuz Mayıs University Hospital. A majority of participants were female (n = 431, 81.8%) and their average age was 33.8 years (SD 12.3). The university is located in Samsun, a city located in northern Turkey. Data were collected between October 2019 and December 2020.

METHODS:

The Health Belief Scale for Urinary Incontinence and Kegel Exercise's validity was analyzed using a content validity index approach with 8 experts. Psychometric measurements were obtained using exploratory factor analysis and Cronbach's α reliability analysis. Exploratory factor analysis incorporated principal component analysis and varimax rotation. t Tests and 1-way analysis of variance were used to compare subdimensions of the Health Belief Scale for Urinary Incontinence and Kegel Exercise with some variables (sex, education status, marital status, make Kegel exercises regularly, etc).

RESULTS:

Results supported a scale having 49 items and 6 subscales per factor analysis explaining 59.8% of total variance. With exploratory factor analysis, the Kaiser-Meyer-Olkin coefficient was 0.899 and Barlett test result was χ² = 18389.424 (P = .001). Cronbach's α coefficients for the scale varied between 0.79 and 0.94. Factor loadings per underlying dimensions ranged from 0.42 to 0.84.

CONCLUSION:

The Health Belief Scale for Urinary Incontinence and Kegel Exercise is a valid and reliable instrument.
Enhancing Self-Management Skills of Patients With Existing Diabetic Foot Ulcerations
Authors: Zima Janice , Jairath Nalini
Published: September 2023

PURPOSE:

The purpose of this quality improvement initiative was to determine the impact of a nurse-administered foot care intervention bundle (NA-FCIB) upon self-management knowledge, skills, and outcomes in patients with diabetic foot ulcerations.

PARTICIPANTS AND SETTING:

The sample comprised 39 patients being treated for diabetic foot ulceration at a wound care clinic in a tertiary care hospital in Arlington, Virginia. The project was conducted from August 2017 to February 2018.

APPROACH:

This quality improvement project used the Johns Hopkins Plan-Do-Study-Act Method supplemented by self-regulation theory for diabetic patient education and evidence in clinical literature. The 12-week-long intervention included one-on-one teaching in the prevention of ulcerations and optimal care of the diabetic foot, blood glucose level tracking logs, patient “teach-back” and skills demonstration, and free foot care tools.

OUTCOMES:

From baseline to post-NA-FCIB, the number of participants knowing the reasons for temperature foot protection increased by 92%, those knowing major factors leading to diabetic foot ulceration by 85%, those knowing what to look for in the foot self-exam by 85%, and those able to demonstrate correct foot self-exam by 84%. The number of participants understanding proper footwear increased by 74%, and those identifying ways to avoid/decrease the likelihood of diabetic foot ulcers by 72%. Mean serum hemoglobin A1c (HgbA1c) levels decreased from baseline to postintervention (8.27%; SD 2.05% vs 7.46%; SD 1.58%; P = .002).

IMPLICATIONS FOR PRACTICE:

The NA-FCIB intervention was successfully incorporated into routine clinic care as the standard of care. Our experience suggests that the NA-FCIB may be feasible and effective for use at comparable wound care clinics and may have secondary benefits for HgbA1c regulation.
Preliminary evidence of an increased susceptibility to face pareidolia in postpartum women
Authors: Taubert Jessica , Wally Samantha , Dixson Barnaby J.
Published: September 2023

As primates, we are hypersensitive to faces and face-like patterns in the visual environment, hence we often perceive illusory faces in otherwise inanimate objects, such as burnt pieces of toast and the surface of the moon. Although this phenomenon, known as face pareidolia, is a common experience, it is unknown whether our susceptibility to face pareidolia is static across our lifespan or what factors would cause it to change. Given the evidence that behaviour towards face stimuli is modulated by the neuropeptide oxytocin (OT), we reasoned that participants in stages of life associated with high levels of endogenous OT might be more susceptible to face pareidolia than participants in other stages of life. We tested this hypothesis by assessing pareidolia susceptibility in two groups of women; pregnant women (low endogenous OT) and postpartum women (high endogenous OT). We found evidence that postpartum women report seeing face pareidolia more easily than women who are currently pregnant. These data, collected online, suggest that our sensitivity to face-like patterns is not fixed and may change throughout adulthood, providing a crucial proof of concept that requires further research.
Off-label drug use during the COVID-19 pandemic in Africa: topic modelling and sentiment analysis of ivermectin in South Africa and Nigeria as a case study
Authors: Movahedi Nia Z. , Bragazzi N. L. , Ahamadi A. , Asgary A. , Mellado B. , Orbinski J. , Seyyed-Kalantari L. , Woldegerima W. A. , Wu J. , Kong J. D.
Published: September 2023

Although rejected by the World Health Organization, the human and even veterinary formulation of ivermectin has widely been used for prevention and treatment of COVID-19. In this work we leverage Twitter to understand the reasons for the drug use from ivermectin supporters, their source of information, their emotions, their gender demographics, and location information, in Nigeria and South Africa. Topic modelling is performed on a Twitter dataset gathered using keywords ‘ivermectin’ and ‘ivm’. A model is fine-tuned on RoBERTa to find the stance of the tweets. Statistical analysis is performed to compare the stance and emotions. Most ivermectin supporters either redistribute conspiracy theories posted by influencers, or refer to flawed studies confirming ivermectin efficacy
in vitro
. Three emotions have the highest intensity, optimism, joy and disgust. The number of anti-ivermectin tweets has a significant positive correlation with vaccination rate. All the provinces in South Africa and most of the provinces of Nigeria are pro-ivermectin and have higher disgust polarity. This work makes the effort to understand public discussions regarding ivermectin during the COVID-19 pandemic to help policy-makers understand the rationale behind its popularity, and inform more targeted policies to discourage self-administration of ivermectin. Moreover, it is a lesson to future outbreaks.
Deconstructing the effects of stochasticity on transmission of hospital-acquired infections in ICUs
Authors: Haghpanah Fardad , Lin Gary , Klein Eili ,   for the CDC MInD-Healthcare Program
Published: September 2023

The inherent stochasticity in transmission of hospital-acquired infections (HAIs) has complicated our understanding of transmission pathways. It is particularly difficult to detect the impact of changes in the environment on acquisition rate due to stochasticity. In this study, we investigated the impact of uncertainty (epistemic and aleatory) on nosocomial transmission of HAIs by evaluating the effects of stochasticity on the detectability of seasonality of admission prevalence. For doing so, we developed an agent-based model of an ICU and simulated the acquisition of HAIs considering the uncertainties in the behaviour of the healthcare workers (HCWs) and transmission of pathogens between patients, HCWs, and the environment. Our results show that stochasticity in HAI transmission weakens our ability to detect the effects of a change, such as seasonality patterns, on acquisition rate, particularly when transmission is a low-probability event. In addition, our findings demonstrate that data compilation can address this issue, while the amount of required data depends on the size of the said change and the degree of uncertainty. Our methodology can be used as a framework to assess the impact of interventions and provide decision-makers with insight about the minimum required size and target of interventions in a healthcare facility.
The 2013 Chikungunya outbreak in the Caribbean was structured by the network of cultural relationships among islands
Authors: Dommar Carlos J. , López Leonardo , Paul Richard , Rodó Xavier
Published: September 2023

In 2013, the Caribbean underwent an unprecedented epidemic of Chikungunya that affected 29 islands and mainland territories throughout the Caribbean in the first six months. Analysing the spread of the epidemic among the Caribbean islands, we show that the initial patterns of the epidemic can be explained by a network model based on the flight connections among islands. The network does not follow a random graph model and its topology is likely the product of geo-political relationships that generate increased connectedness among locations sharing the same language. Therefore, the infection propagated preferentially among islands that belong to the same cultural domain, irrespective of their human and vector population densities. Importantly, the flight network topology was also a more important determinant of the disease dynamics than the actual volume of traffic. Finally, the severity of the epidemic was found to depend, in the first instance, on which island was initially infected. This investigation shows how a simple epidemic model coupled with an appropriate human mobility model can reproduce the observed epidemiological dynamics. Also, it sheds light on the design of interventions in the face of the emergence of infections in similar settings of naive subpopulations loosely interconnected by host movement. This study delves into the feasibility of developing models to anticipate the emergence of vector-borne infections, showing the importance of network topology, bringing valuable methods for public health officials when planning control policies. Significance statement: The study shows how a simple epidemic model associated with an appropriate human mobility model can reproduce the observed epidemiological dynamics of the 2014 Chikungunya epidemic in the Caribbean region. This model sheds light on the design of interventions in the face of the emergence of infections in similar settings of naive subpopulations loosely interconnected by the host.
Haemophagocytic lymphohistiocytosis due to Burkholderia pseudomallei in a primigravida
Authors: al Waseem Shaikh Mohammed Haroon , Antony Tessa , Suresh Suchitra , Gopalan Sowmya
Published: September 2023

Introduction. Melioidosis is caused by Burkholderia pseudomallei, a Gram-negative, saprophytic bacillus, commonly found in soil or contaminated water. As infection with this bacterium produces a wide variety of clinical manifestations the organism is aptly called the ‘great mimicker’. Even though it is non-fastidious and an easily cultivable organism, it can be misidentified in automated identification systems.

Case report. A 24-year-old primigravida presented with complaints of fever and myalgia of 45 days’ duration. She was diagnosed to have haemophagocytic lymphohistiocytosis (HLH) based on clinical and laboratory parameters. Blood and bone marrow culture sent to the microbiology laboratory grew non-fermenting Gram-negative bacilli which were misidentified as

Burkholderia cepacia

by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) technology. It was subsequently identified as

B. pseudomallei

by 16S rRNA gene sequencing. The patient was commenced on intensive phase therapy with intravenous ceftazidime for 2 weeks, followed by maintenance therapy with oral trimethoprim and sulfamethoxazole for 3 months. In view of HLH, she was treated with intravenous dexamethasone for 2 weeks which was later switched to oral dexamethasone for a period of 6 weeks. She responded well to the treatment, but had to undergo medical termination of her pregnancy as there was severe intrauterine growth restriction of the fetus.

Conclusion. Prognosis of melioidosis is excellent if early diagnosis and appropriate antibiotic treatment is provided. In this era of automation, it is important to determine if the suspected pathogen is listed in the database of the automated identification system.
Prevalence and epidemiological characteristics of methicillin-resistant Staphylococcus aureus isolated from cattle in Bangalore India as a part of the One Health approach
Authors: Venugopal Nimita , Tewari Rituparna , Ganaie Feroze A. , Mitra Susweta , Shome Rajeswari , Shome Bibek R.
Published: September 2023

In India, limited studies are available on the epidemiological aspects of methicillin-resistant

Staphylococcus aureus

(MRSA) infections in both animal and human settings. Herein, we investigated the prevalence, antimicrobial resistance profile and molecular characteristics of MRSA isolates recovered from cattle using the One Health approach. Out of 66 mecA-positive staphylococci, species-specific multiplex PCR detected 24 % (n=16) of isolates as MRSA. Maximum antibiotic resistance was seen against cloxacillin (94 %, n=15) and least for enrofloxacin and cephalothin (each 13 %, n=2). Overall, 13 % (n=2) of MRSA isolates were multidrug-resistant. Molecular characterization by SCCmec typing identified 88 % (n=14) of MRSA isolates as type V. Twelve isolates (75 %) belonged to novel spa-type t17242, of which 67 % (n=8) belonged to agr type I. MLST analysis revealed ST 1687 (50 %, n=8) as the most predominant sequence type. Circulation of different MRSA clones among the cattle populace offers a risk of transmission to humans through direct contact, food chain or environmental contamination. Thus, continuous monitoring of MRSA strains is imperative for early diagnosis and for establishing effective treatment strategies to restrain the disease burden caused by MRSA infections.