bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of the Environment in Horizontal Gene Transfer
Authors: Acar Kirit Hande , Bollback Jonathan P , Lagator Mato
Published: October 2022

Gene-by-environment interactions play a crucial role in horizontal gene transfer by affecting how the transferred genes alter host fitness. However, how the environment modulates the fitness effect of transferred genes has not been tested systematically in an experimental study. We adapted a high-throughput technique for obtaining very precise estimates of bacterial fitness, in order to measure the fitness effects of 44 orthologs transferred from Salmonella Typhimurium to Escherichia coli in six physiologically relevant environments. We found that the fitness effects of individual genes were highly dependent on the environment, while the distributions of fitness effects across genes were not, with all tested environments resulting in distributions of same shape and spread. Furthermore, the extent to which the fitness effects of a gene varied between environments depended on the average fitness effect of that gene across all environments, with nearly neutral and nearly lethal genes having more consistent fitness effects across all environments compared to deleterious genes. Put together, our results reveal the unpredictable nature of how environmental conditions impact the fitness effects of each individual gene. At the same time, distributions of fitness effects across environments exhibit consistent features, pointing to the generalizability of factors that shape horizontal gene transfer of orthologous genes.
A Case Study of Zoonotic Chlamydia abortus Infection: Diagnostic Challenges From Clinical and Microbiological Perspectives
Authors: Burgener Anne-Valérie , Seth-Smith Helena M B , Kern-Baumann Sina , Durovic Ana , Blaich Anette , Menter Thomas , Bruder Elisabeth , Roloff Tim , Martinez Aurélien , Borel Nicole , Albini Sarah , Hösli Irene , Egli Adrian , Weisser Maja , Hinić Vladimira
Published: October 2022

Chlamydia abortus is the most common causative agent of abortion in small ruminants, but it is poorly recognized as a human pathogen. In most published case studies, diagnosis remained difficult and often resulted in delayed initiation of therapy. In this case study of severe C abortus infection in a pregnant farmer from Switzerland, we highlight the clinical and microbiological diagnostic challenges and provide evidence of a zoonotic epidemiological link.
Relative Effectiveness of Cell-Based Versus Egg-Based Quadrivalent Influenza Vaccines in Adults During the 2019–2020 Influenza Season in the United States
Authors: Imran Mahrukh , Ortiz Justin R , McLean Huong Q , Fisher Lauren , O’Brien Dan , Bonafede Machaon , Mansi James A , Boikos Constantina
Published: October 2022

Background

Mutations occurring during egg-based influenza vaccine production may affect vaccine effectiveness. The mammalian cell-based quadrivalent inactivated influenza vaccine (IIV4c) demonstrated improved protection relative to egg-based vaccines in prior seasons. This study estimated the relative vaccine effectiveness (rVE) of IIV4c versus standard-dose egg-based quadrivalent inactivated influenza vaccine (IIV4e) in preventing influenza-related medical encounters (IRMEs) in the 2019–2020 US influenza season.

Methods

This retrospective cohort study was conducted using a dataset linking electronic medical records with medical and pharmacy claims data among individuals ≥18 years vaccinated with IIV4c or IIV4e during 2019–2020. A doubly robust inverse probability of treatment weighting model was used to obtain odds ratios (ORs) adjusted for age, sex, race, ethnicity, region, vaccination week, health status, frailty, and baseline healthcare resource utilization. rVE was calculated by (1 – OR) × 100. An exploratory analysis evaluated IRMEs in inpatient and outpatient settings separately.

Results

The final study cohort included 1 499 215 IIV4c and 4 126 263 IIV4e recipients ≥18 years of age. Fewer IRMEs were reported in individuals with recorded IIV4c versus IIV4e. The rVE for IIV4c versus IIIV4e for any IRME was 9.5% (95% confidence interval [CI], 7.9%–11.1%). Inpatient and outpatient rVEs were 5.7% (95% CI, 2.1%–9.2%) and 11.4% (95% CI, 9.5%–13.3%), respectively. In age subgroup analyses, rVEs favored IIV4c except in adults aged ≥65 years.

Conclusions

Adults vaccinated with IIV4c had a lower risk of IRMEs versus IIV4e recipients in the 2019–2020 US influenza season. These results support IIV4c as a potentially more effective public health measure against influenza than egg-based vaccines.
Antimicrobials in Animal Agriculture in the United States: A Multidisciplinary Overview of Regulation and Utilization to Foster Collaboration: On Behalf Of the Society of Infectious Diseases Pharmacists
Authors: Gens Krista D , Singer Randall S , Dilworth Thomas J , Heil Emily L , Beaudoin Amanda L
Published: October 2022

Given the complexity of antimicrobial resistance and the dire implications of misusing antimicrobials, it is imperative to identify accurate and meaningful ways to understand and communicate the realities, challenges, and opportunities associated with antimicrobial utilization and measurement in all sectors, including in animal agriculture. The objectives of this article are to (i) describe how antimicrobials are regulated and used in US animal agriculture and (ii) highlight realities, challenges, and opportunities to foster multidisciplinary understanding of the common goal of responsible antimicrobial use. Recognition of the realities of medicine, practice, and policy in the agricultural setting is critical to identify realistic opportunities for improvement and collaboration.
Climate change challenges, plant science solutions
Authors: Eckardt Nancy A , Ainsworth Elizabeth A , Bahuguna Rajeev N , Broadley Martin R , Busch Wolfgang , Carpita Nicholas C , Castrillo Gabriel , Chory Joanne , DeHaan Lee R , Duarte Carlos M , Henry Amelia , Jagadish S V Krishna , Langdale Jane A , Leakey Andrew D B , Liao James C , Lu Kuan-Jen , McCann Maureen C , McKay John K , Odeny Damaris A , Jorge de Oliveira Eder , Platten J Damien , Rabbi Ismail , Rim Ellen Youngsoo , Ronald Pamela C , Salt David E , Shigenaga Alexandra M , Wang Ertao , Wolfe Marnin , Zhang Xiaowei
Published: October 2022

Climate change is a defining challenge of the 21st century, and this decade is a critical time for action to mitigate the worst effects on human populations and ecosystems. Plant science can play an important role in developing crops with enhanced resilience to harsh conditions (e.g. heat, drought, salt stress, flooding, disease outbreaks) and engineering efficient carbon-capturing and carbon-sequestering plants. Here, we present examples of research being conducted in these areas and discuss challenges and open questions as a call to action for the plant science community.
Neural correlates of affective task switching and asymmetric affective task switching costs
Authors: Eckart Cindy , Kraft Dominik , Rademacher Lena , Fiebach Christian J
Published: October 2022

The control of emotions is of potentially great clinical relevance. Accordingly, there has been increasing interest in understanding the cognitive mechanisms underlying the ability to switch efficiently between the processing of affective and non-affective information. Reports of asymmetrically increased switch costs when switching toward the more salient emotion task indicate specific demands in the flexible control of emotion. The neural mechanisms underlying affective task switching, however, are so far not fully understood. Using functional Magnetic Resonance Imaging (MRI) (N = 57), we observed that affective task switching was accompanied by increased activity in domain-general fronto-parietal control systems. Blood-oxygen-level-dependent (BOLD) activity in the posterior medial frontal and anterolateral prefrontal cortex was directly related to affective switch costs, indicating that these regions play a particular role in individual differences in (affective) task-switching ability. Asymmetric switch costs were associated with increased activity in the right inferior frontal and dorsal anterior medial prefrontal cortex, two brain regions critical for response inhibition. This suggests that asymmetric switch costs might—to a great extent—reflect higher demands on inhibitory control of the dominant emotion task. These results contribute to a refined understanding of brain systems for the flexible control of emotions and thereby identify valuable target systems for future clinical research.
Large-Scale Surveys of Blackleg of Oilseed Rape (Leptosphaeria biglobosa) Revealed New Insights into Epidemics of This Disease in China
Authors: Deng Y. , Li J. C. , Lyv X. , Xu J. W. , Wu M. D. , Zhang J. , Yang L. , Li G. Q.
Published: October 2022

Blackleg of oilseed rape caused by Leptosphaeria maculans/L. biglobosa is a worldwide important disease. L. maculans is more virulent than L. biglobosa, so it causes a great concern for oilseed rape production. In China, blackleg (L. biglobosa) of oilseed rape was reported in the 2000s, but epidemiological features of blackleg have not been well elucidated. Moreover, whether L. maculans exists in China is still an open question. Therefore, a 5-year survey was done in China to collect blackleg-occurrence data for characterizing the features of blackleg epidemics and to identify the blackleg pathogens for assessing the risk of L. maculans invasion. The results showed that all the 19 surveyed provinces had blackleg on oilseed rape, and the most frequently occurring provinces are Gansu, Qinghai, Shaanxi, and Hubei. Phoma stem canker was the most common symptom, which was associated with stem cracks on winter oilseed rape and with stem-weevil activities on spring oilseed rape. Temperature and rainfall were the main factors for blackleg epidemics on winter oilseed rape, whereas rainfall was the main factor for blackleg epidemics on spring oilseed rape. Brassica campestris and B. juncea oilseed rapes were more susceptible than B. napus to blackleg. Oilseed rapes cultivated under the continuous dry land-cropping pattern were more prone to blackleg than those cultivated under the paddy land/dry land-cropping pattern. All 6,015 fungal isolates from blackleg plant tissues belonged to L. biglobosa. These results are helpful for understanding the blackleg epidemics of oilseed rapes and for management of this disease in China.
Field-Portable, Rapid, and Low-Cost RT-LAMP Assay for the Detection of Tomato Chlorotic Spot Virus
Authors: Yilmaz Salih , Adkins Scott , Batuman Ozgur
Published: October 2022

Tomato chlorotic spot virus (TCSV) is a highly destructive, thrips-transmitted, emerging orthotospovirus in various vegetable and ornamental crops. It is important to reduce the risk of spreading this virus by limiting the movement of infected plant materials to other geographic areas by utilizing point-of-care diagnostics. Current diagnostic assays for TCSV require costly lab equipment, skilled personnel, and electricity. Here, we report the development of a simple rechargeable battery-operated handwarmer-assisted reverse transcription-loop-mediated isothermal amplification (RT-LAMP) assay and demonstrate a step-by-step protocol to achieve in-field detection of TCSV. Under field conditions, handwarmer-assisted RT-LAMP can detect as little as 0.9 pg/μl of total RNA from TCSV-infected tomato plants in <35 min. When fully charged, the field-portable device can be used in six consecutive RT-LAMP detection assays, yielding test results for 96 individual samples. Dye-based colorimetric methods, including pH and metal ion indicators, were evaluated to eliminate laboratory-dependent LAMP visualization. Phenol red combined with hydroxynaphthol blue was adopted in the handwarmer-assisted RT-LAMP detection method to obtain a more robust color difference distinguishable by the naked eye. Overall, handwarmer-assisted RT-LAMP is a rapid, highly sensitive, and cost-effective diagnostic technique that can be used by nonspecialist personnel in the field, particularly in rural production areas lacking access to a diagnostic lab or constant electricity.

[Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Telenursing
Authors: McVey Caitlin
Published: October 2022

The national nursing shortage is affecting hospital leaders in their ability to employ nursing staff. Nursing staffing shortages contribute to extended nurse-to-patient ratios and increased workload for staff. Increased workload contributes to missed nursing care and correlates with increased patient length of stay, readmission rates, patient safety errors, and hospital-acquired infections. Telehealth services have shown initial improvements in care quality outcomes but have not addressed nursing workload or nursing shortages. Telenursing has potential to provide additional nursing support to offset the workloads of bedside nursing staff and break the associated cycle of adverse outcomes. Various definitions of telenursing are present in the literature, but a concept analysis of telenursing has not been published. Understanding the concept of telenursing is necessary to integrate this concept within the context of researching nursing shortages and patient and nurse outcomes in acute care hospitals. The author used Walker and Avant's eight-step procedure to define the concept of telenursing and present a model case, a related case, and a contrary case to describe the telenursing concept. This concept analysis helps to provide clarity around the concept of telenursing and directions for future research. Understanding the concept of telenursing is necessary to integrate this concept within the context of researching nursing shortages, nursing satisfaction, and patient and nurse outcomes in various healthcare settings.
Log-transformation of Independent Variables: Must We?
Authors: Choi Giehae , Buckley Jessie P. , Kuiper Jordan R. , Keil Alexander P.
Published: October 2022

Epidemiologic studies often quantify exposure using biomarkers, which commonly have statistically skewed distributions. Although normality assumption is not required if the biomarker is used as an independent variable in linear regression, it has become common practice to log-transform the biomarker concentrations. This transformation can be motivated by concerns for nonlinear dose-response relationship or outliers; however, such transformation may not always reduce bias. In this study, we evaluated the validity of motivations underlying the decision to log-transform an independent variable using simulations, considering eight scenarios that can give rise to skewed X and normal Y. Our simulation study demonstrates that (1) if the skewness of exposure did not arise from a biasing factor (e.g., measurement error), the analytic approach with the best overall model fit best reflected the underlying outcome generating methods and was least biased, regardless of the skewness of X and (2) all estimates were biased if the skewness of exposure was a consequence of a biasing factor. We additionally illustrate a process to determine whether the transformation of an independent variable is needed using NHANES. Our study and suggestion to divorce the shape of the exposure distribution from the decision to log-transform it may aid researchers in planning for analysis using biomarkers or other skewed independent variables.
Spatial modeling of ambient concentrations of volatile organic compounds in Montreal, Canada
Authors: Zapata-Marin Sara , Schmidt Alexandra M. , Crouse Dan , Ho Vikki , Labrèche France , Lavigne Eric , Parent Marie-Élise , Goldberg Mark S.
Published: October 2022

Background:

Volatile organic compounds (VOCs) are components of the complex mixture of air pollutants within cities and can cause various adverse health effects. Therefore, it is necessary to understand their spatial distribution for exposure assessment in epidemiological studies.

Objectives:

The objective was to model measured concentrations of five VOCs within the city of Montreal, Canada, developing spatial prediction models that can be used in health studies.

Methods:

We measured concentrations using 3M 3500 Organic Vapor Monitors, over 2-week periods, for three monitoring campaigns between 2005 and 2006 in over 130 locations in the city. Using GC/MSD (Gas Chromatography/Mass Selective Detector), we measured concentrations of benzene, n-decane, ethylbenzene, hexane, and trimethylbenzene. We fitted four different models that combine land-use regression and geostatistical methods to account for the potential spatial structure that remains after accounting for the land-use variables. The fitted models also accounted for possible variations in the concentration of air pollutants across campaigns.

Results:

The highest concentrations for all VOCs were found in December with hexane being the most abundant followed by ethylbenzene. We obtained predicted surfaces for the VOCs for the three campaigns and mean surfaces across campaigns. We found higher concentrations of some VOCs along highways and in the Eastern part of Montreal, which is a highly industrialized area.

Conclusions:

Each of the fitted models captured the spatial and across-campaigns variability for each VOC, and we found that different VOCs required different model structures.
Patient-reported Outcomes of Scar Impact: Comparing of Abdominoplasty, Breast Surgery, and Facial Surgery Patients
Authors: Garg Stuti P. , Weissman Joshua P. , Reddy Narainsai K. , Varghese Jeffrey , Ellis Marco F. , Kim John Y. S. , Galiano Robert D.
Published: October 2022

Background:

Scarring negatively impacts patient mental health, causing worsened self-confidence, body image, and social interactions, as well as anxiety and depression. The objective of this study is to evaluate the scarring impact after facial surgery, breast surgery, and full abdominoplasty for symptoms, appearance, psychosocial health, career, and sexual well-being using validated patient-reported outcome measures.

Method:

A total of 901 patients from five providers completed the SCAR-Q (covering symptoms, appearance, and psychosocial) and Career/Sexual Well-being assessments via phone or email where a higher score indicated a more positive scar perception.

Results:

Of the 901 patients, 38.1% had abdominoplasty surgery, 38.1% breast reduction, 15.3% facial surgery, 4.7% breast lift, and 3.9% breast augmentation. The differences in SCAR-Q, appearance, and symptom scores between the five procedures were statistically significant. Breast augmentation SCAR-Q scores (median = 256) and facial surgery (median = 242) were significantly higher than those of abdominoplasty patients (median = 219; P = 0.003 and P = 0.001, respectively). Duration after surgery was positively correlated with improved symptom scale scores for abdominoplasty (r = 0.24, P < 0.001), breast augmentation (r = 0.71, P = 0.015), and facial surgery patients (r = 0.28, P = 0.001), but not for other procedures.

Conclusions:

This study is the first to show that breast augmentation and facial surgery patients have a more positive perception of their scars in terms of appearance, symptoms, psychosocial, career, and sexual well-being impact than abdominoplasty patients. Furthermore, the data suggest that symptoms may improve over time for abdominoplasty, breast augmentation, and facial surgery patients. This study highlights the need for further follow-up, counseling, or other improvements to postoperative scar care.
Facial Pressure Sores in COVID-19 Patients during Prone Positioning: A Case Series and Literature Review
Authors: Mernier Thibaud , Taveau Corentin , Cetrulo Curtis L. , Goutard Marion , Lellouch Alexandre G.
Published: October 2022

Background:

COVID-19 has been a source of several stays in intensive care units, increasing the number of prone positioning. In parallel, complications increased, such as facial ulcers. Herein, we present a literature review and a case series about facial pressure sores in COVID-19 patients during prone positioning. This study aimed to show that such facial pressure sores may require surgical intervention in specific cases.

Methods:

We performed a search of the literature with the Pubmed database, and we selected 13 articles for review. Therefore, we analyzed the results among the most frequent locations of facial ulcers: cheeks, ears, lips, nose, and chin. We also reported three original clinical scenarios with a gradual surgical approach to address facial pressure sores from less invasive to more invasive surgery (corresponding to the reconstructive ladder strategy) during the COVID-19 period.

Results:

We identified 13 articles related to the topic. Only four clinical cases discussed a surgical treatment but only for complications such as bleeding, infection, and sequelae after long-term management. Faced with a lack of literature about surgical options, we reported our case series showing that surgical treatments could be increasingly complex among the sore grades. The following surgical approach was selected: debridement, skin graft, and local or free flaps.

Conclusions:

Surgical intervention is the last course of treatment for pressure sores. However, the need for later surgical revision cannot be excluded, especially regarding the face, in case of dyschromia or retraction affecting the facial aesthetic subunits.
TRANSPLANTATION OF SUBRETINAL STEM CELL–DERIVED RETINAL PIGMENT EPITHELIUM FOR STARGARDT DISEASE
Authors: Brant Fernandes Rodrigo A. , Lojudice Fernando H. , Zago Ribeiro Lucas , Santos da Cruz Natasha Ferreira , Polizelli Murilo Ubukata , Cristovam Priscila C. , Innocenti Francesco , Morimoto Lisangela , Magalhães Octaviano , Ferraz Sallum Juliana Maria , Penha Fernando Marcondes , Sogayar Mari C. , Belfort Rubens , Maia Mauricio
Published: October 2022

Purpose:

To assess the safety of injecting human embryonic stem cell retinal pigment epithelial cell dose to treat Stargardt disease.

Methods:

In this prospective, Phase I clinical trial, human embryonic stem cell retinal pigment epithelial cells in suspension were injected into the subretinal space in eyes with the worse best-corrected visual acuity (BCVA). After vitrectomy/posterior hyaloid removal, a partial retinal detachment was created and the human embryonic stem cell retinal pigment epithelial cells were administered. Phacoemulsification with intraocular lens implantation was performed in eyes with lens opacity. All procedures were optical coherence tomography–guided. The 12-month follow-up included retinal imaging, optical coherence tomography, visual field/electrophysiologic testing, and systemic evaluation. The main outcome was the absence of ocular/systemic inflammation or rejection, tumor formation, or toxicity during follow-up.

Results:

The mean baseline BCVAs in the phacoemulsification and no phacoemulsification groups were similar (1.950 ± 0.446 and 1.575 ± 0.303, respectively). One year postoperatively, treated eyes showed a nonsignificant increase in BCVA. No adverse effects occurred during follow-up. Intraoperative optical coherence tomography was important for guiding all procedures.

Conclusion:

This surgical procedure was feasible and safe without cellular migration, rejection, inflammation, or development of ocular or systemic tumors during follow-up.
Corneal RGP Contact Lens Fitting Software for Keratoconus Built-In Anterior Segment Optical Coherence Tomography
Authors: Itoi Motohiro , Itoi Motozumi , Harigaya Ayuka , Ishigaki Kaho , Satou Rika , Ueda Eiko
Published: October 2022

Objective:

To assess the performance of the contact lens fitting software built into anterior segment optical coherence tomography (AS-OCT).

Methods:

This retrospective study enrolled patients with keratoconus prescribed with spherical corneal rigid gas-permeable contact lenses based on a contact lens fitting software. Subjects were classified into four subgroups based on corneal morphology: nipple, oval, globus, and marginal type. Software performance was evaluated according to the correlation between the back optical zone radius (BOZR) calculated by the contact lens fitting program and the BOZR of the lens prescribed, and the number of trial lens replacements required.

Results:A total of 340 eyes of 254 patients with a mean age of 40.4 ± 13.6 years were included. The oval type was the most common (61.8%), followed by the nipple type (26.2%). Linear regression analysis revealed a significant correlation between the prescribed and the calculated BOZR in all subgroups (R2 = 0.92, P < 0.01 for the nipple type; R2 = 0.76, P < 0.01 for the oval type; R2 = 0.93, P < 0.01 for the globus type; and R2 = 0.79, P < 0.01 for the marginal type). Furthermore, the globus type had the highest proportion of cases requiring at least one trial lens replacement (36.3%), followed by the nipple group (27.0%). There were no significant differences among the subgroups (P = 0.14).

Conclusions:

In conclusion, our findings reveal that the contact lens fitting software built into AS-OCT may be useful for accurate contact lens prescription for any corneal shape.
Partial Stenosis and Complete Punctal Closure Following Topical Netarsudil Use for Glaucoma
Authors: Rashad Ramy , Zhu Catherine , Kupcha Anna C. , Distefano Alberto G. , Kefella Haben , Desai Manishi A.
Published: October 2022

Purpose:

To describe patients who developed partial or complete punctal closure after the use of topical netarsudil in the treatment of glaucoma, with documented reversal of symptoms on drug cessation.

Patients and Methods:

This is a retrospective, single-center case series including patients treated with topical netarsudil who were documented to have developed punctal disease ipsilateral to the eye(s) being treated. A literature review was also performed to identify other similar reports.

Results:

A total of 10 patients were included in the study. Six patients developed partial punctal stenosis and 4 patients developed complete closure of the puncta in 1 or both eye(s) ipsilateral to the use of the topical medication. None of the patients developed punctal disease on the non-netarsudil side. The time from initiation of netarsudil to the documentation of punctal disease ranged from 5–32.2 months (18.41±9.94). In the patients with complete punctal closure, discontinuation of the topical medication led to clinical reappearance of the punctal opening, ranging from 31–83 days after drug cessation (45.75±21.57). In 8 cases, discontinuation of netarsudil resulted in improved epiphora and degree of punctal stenosis on clinical examination.

Conclusions:

The use of topical netarsudil for glaucoma may lead to punctal stenosis and complete punctal closure. These side effects of netarsudil are relevant to therapeutic considerations for glaucoma patients.
Performance of a Glaucoma Screening Program Compared With Opportunistic Detection in China
Authors: Xie Yanqian , Jiang Junhong , Liu Chi , Lin Haishuang , Wang Lin , Zhang Cong , Chen Jinyuan , Liang Yuanbo , Congdon Nathan , Zhang Shaodan
Published: October 2022

Précis:

Health examination center-based screening provide a good supplement to clinic-based glaucoma care by detecting early-stage glaucoma, especially those with normal intraocular pressure (IOP) and less visual impairment.

Purpose:

Opportunistic glaucoma screening for early case identification is of great value in the prevention of severe visual impairment, however, novel, low-cost models are needed. We aimed to determine whether health examination center-based glaucoma screening identifies diseases earlier than outpatient cases in China.

Materials and Methods:

In this case-control study, 76 patients with primary glaucoma identified from a health examination center-based glaucoma screening program and 272 consecutive outpatient cases at the same hospital were enrolled from March 21 to September 30, 2016. Demographic characteristics, best-corrected visual acuity, IOP, mean deviation (MD), and pattern standard deviation (PSD) on Humphrey visual field testing in the better-seeing eye were compared between groups.

Results:

Screening-detected glaucoma patients had significantly lower IOP (18.3±4.2 mm Hg) than out-patient cases (26.7±12.6 mm Hg, P<0.001). Most (71.1%) of the screening-detected patients had IOP<21 mm Hg compared with 37.1% in the clinic group (P<0.001). Seventy-five patients (98.7%) in the screening group were diagnosed as primary open angle glaucoma, compared with 44.1% in the clinic group (P<0.001). Screening-detected patients had significantly less visual impairment than the clinic group (6.6% vs. 38.6%, P<0.05). Mean MD (−4.4±5.0 dB) and PSD (4.4±3.6 dB) for the screening group were superior to the clinic group (MD: −16.5±10.5 dB, P<0.001; PSD: 6.5±3.7 dB, P<0.001).

Conclusion:

The glaucoma screening program was effective at detecting early disease, especially normal tension glaucoma and supplemented opportunistic detection of glaucoma.
Trabeculectomy Tenon Advancement Technique May Reduce Bleb-Related Infections
Authors: Mambo Yuki , Higashide Tomomi , Ohkubo Shinji , Udagawa Sachiko , Yamashita Yoko , Tsuchiya Shunsuke , Okayama Masahiko , Wajima Ryotaro , Sugiyama Kazuhisa
Published: October 2022

Précis:

Trabeculectomy using the Tenon advancement technique with a fornix-based (FB) conjunctival flap showed avascular bleb formation less frequently and had a significantly lower risk of developing bleb-related infections than trabeculectomy with a limbus-based conjunctival flap.

Purpose:

To determine whether the Tenon advancement technique for trabeculectomy with a FB conjunctival flap is effective in preventing bleb-related infections.

Materials and Methods:

This was a single-center, nonrandomized retrospective cohort study of 998 eyes from 854 patients with glaucoma who underwent trabeculectomy with mitomycin C. Trabeculectomy procedures were categorized into 3 groups: limbus-based (LB, 296 eyes), FB without Tenon advancement (FBTA-, 167 eyes), and FB with Tenon advancement (FBTA+, 535 eyes). The cumulative incidence of bleb-related infections and the rate of surgical success during the 5-year postoperative follow-up period were analyzed using Kaplan–Meier survival analysis and Cox proportional hazards models. Intraocular pressure (IOP) reduction of <20% from baseline or additional glaucoma surgeries was deemed a surgical failure. Surgical success with or without IOP-lowering medications was evaluated according to different IOP criteria.

Results:

Ten eyes developed bleb-related infections (8 eyes in the LB group and 1 eye in both the FBTA- and FBTA+ groups each). The cumulative probability of bleb-related infections in the LB, FBTA-, and FBTA+ groups was 4.8±1.7% (± standard error), 0.8±0.8%, and 0.3±0.3%, respectively. The FBTA+ group had a significantly lower risk of bleb-related infections than the LB group (hazard ratio, 0.06; 95% confidence interval, 0.01 to 0.39; P=0.009). The FBTA+ group did not have a higher risk of surgical failure.

Conclusion:

The Tenon advancement technique for trabeculectomy using an FB conjunctival flap may be effective in preventing bleb-related infections without compromising surgical success.
Retinal Nerve Fiber Layer and Ganglion Cell Complex Thickness in Adult Children of Patients With Pseudoexfoliation Glaucoma
Authors: Dönmez Gün Raziye , Tutaş Günaydin Nesrin , Penbe Ayşegül , Kivrak Ulviye , Şimşek Şaban
Published: October 2022

Précis:

The adult children of patients with pseudoexfoliation glaucoma (PXG) had universally lower retinal nerve fiber layer (RNFL) thickness and ganglion cell complex (GCC) thickness values compared with individuals with a negative family history of PXG.

Purpose:

This study aimed to evaluate RNFL and GCC thicknesses in the adult children of individuals with PXG compared with people without a parental history of PXG.

Materials and Methods:

This cross-sectional observational study included 40 eyes of 40 adults with confirmed parental history of PXG and 40 eyes of 40 healthy adults with no parental history of PXG. RNFL and macular GCC thicknesses were measured by spectral-domain optical coherence tomography (Nidek RS-3000 Advance) and compared between the groups. All subjects also underwent visual field testing (program 30-2 of the Humphrey Field Analyzer), and their mean deviation and pattern SD values were compared.

Results:

Compared with adults without parental PXG, those with a parental history of PXG had significantly lower RNFL thickness overall (mean 98.2 vs 109.5 µm) and in all quadrants (inferior, superior, nasal, and temporal) (P<0.001 for all). They also had significantly lower GCC thickness overall (mean 97.9 vs 109.4 µm) and in both hemispheres (superior and inferior) (P<0.001 for all). There was no significant difference between the groups in terms of mean deviation or pattern SD values (P>0.05).

Conclusion:

PXG in a parent was associated with significantly thinner RNFL and GCC compared with those with no history of PXG in a parent. Longer follow-up and prospective controlled clinical studies are needed to evaluate whether these findings may serve as an early indicator of glaucoma in the adult children of known PXG patients.
Reduction of Intraocular Pressure and Aqueous Outflow Resistance After Modified 360-degree Suture Trabeculotomy
Authors: Suzuki Kayo , Shinmei Yasuhiro , Hirooka Kiriko , Kanaya Rina , Shinkai Akihiro , Kijima Riki , Chin Shinki , Ito Yoichi M. , Ishida Susumu
Published: October 2022

Précis:

Decreasing aqueous outflow resistance at trabecular meshwork is the main mechanism of modified 360-degree suture trabeculotomy (ST), and the preoperative C-value, which shows aqueous outflow resistance, is likely to be useful for predicting intraocular pressure (IOP) reduction.

Purpose:

To clarify the mechanism of IOP reduction and the preoperative prognostic predictor of modified 360-degree ST.

Materials and Methods:

Forty-three eyes of 32 patients with glaucoma who underwent ST at Hokkaido University Hospital between April 2017 and February 2020 were enrolled. The records of postoperative IOP and coefficient of aqueous outflow (C-value) after ST were reviewed from clinical charts retrospectively. Preoperative IOP and C-values were also reviewed and considered as the baseline.

Results:

Although the differences were not significant, IOP decreased to 15.4±3.3 mm Hg at 3 months (P=0.10) and 16.1±3.8 mm Hg at 6 months (P=0.21). In addition, there were significant decreases in anti-glaucoma medication scores at both 3 and 6 months after surgery (P<0.01). The C-value increased significantly to 0.24±0.11 µL/min/mm Hg at 3 months (P<0.01) and increased significantly to 0.27±0.14 µL/min/mm Hg at 6 months (P<0.01). The rates of change in IOP were negatively correlated with that in the C-value at 3 months (r=−0.49 P<0.01) and 6 months (r=−0.46 P<0.01). The success rate (IOP<21 mm Hg, IOP reduction>20%) was greater in the low baseline C-value group (≤0.17) than high baseline C-value group (>0.17) (P<0.05), and the baseline IOP and C-values were statistically significant in association with the success (P<0.05) at 6 months.

Conclusions:

Increased conventional outflow by the elimination of the aqueous outflow resistance at the trabecular meshwork is the main mechanism of IOP reduction after ST. Preoperative examination of tonographic outflow facility may be useful for predicting the IOP reduction and outcome of ST.
Creeping hair: A case report
Authors: Cao Shan , Lu Xian-Mei , Yang Bao-Qi
Published: October 2022

Introduction:

Creeping hair is a rare condition that presents as a migratory linear cutaneous track and accounts for 1% of all subtypes of creeping eruption.

Herein, we report a case of creeping hair on the neck that was diagnosed by histopathological examination.

Case presentation:

A 32-year-old man presented to our outpatient clinic with a half-day history of a visible black linear lesion in the left neck region without any symptoms. He had no recent travel history and no special personal or family medical histories. Dermatological examination revealed a black, thin, linear, 2-cm-long skin lesion in the left neck region, leaving a pattern similar to wave-like erythema or cutaneous larva migrans. Histopathological examination of a skin biopsy confirmed the diagnosis of creeping hair. The treatment was a shallow incision over the lesion and removal of the hair.

Discussion:

There are few reports of creeping hair, and the pathogenesis remains unknown. The lack of a hair follicle in the dermis on histopathological examination suggests that the creeping hair in the present case was an outgrown hair that penetrated the dermis under constant friction and extrusion.

Conclusion:

Fragile skin and constant friction are common reasons for creeping hair. The creeping hair in this case was classified as an outgrown hair.
Recalcitrant pediatric pyoderma gangrenosum controlled with adalimumab
Authors: Wu Zhe , Xu Qian-Yue , Yao Zhi-Rong
Published: October 2022

Introduction:

Pyoderma gangrenosum (PG) refers to an autoinflammatory cutaneous disorder characterized by bizarre painful ulcerations. Clinical data of pediatric PG are rare in China. We herein present the first report of adalimumab in the treatment of pediatric PG in China.

Case presentation:

An 8-year-old boy presented with multiple painful ulcerations on both lower legs. He was diagnosed with PG according to his clinical manifestations and results of a histological examination. His condition showed resistance to corticosteroids, immunosuppressants, and even intravenous immunoglobulin. We then treated him with adalimumab, which induced remission of the disease.

Discussion:

PG poses both diagnostic and therapeutic challenges. Increased levels of inflammatory mediators, including interleukins 1β, 8, and 17 and tumor necrosis factor-α, induce development of the disease. Despite the availability of traditional treatments, new therapeutic regimens should be taken into consideration.

Conclusion:

No previous data regarding adalimumab for the treatment of pediatric PG have been reported in China. Our case demonstrates that adalimumab has a beneficial effect on pediatric patients with recalcitrant PG. However, further evaluation and long-term follow-up of this treatment are required. Because infliximab has been studied in a randomized, double blind, placebo-controlled trial, we anticipate forthcoming multicenter randomized trials and research of adalimumab.
Colposcopy Standards: Guidelines for Endocervical Curettage at Colposcopy
Authors: Massad L. Stewart , Perkins Rebecca B. , Naresh Amber , Nelson Erin L. , Spiryda Lisa , Gecsi Kimberly S. , Mulhem Elie , Kostas-Polston Elizabeth , Zou Tianle , Giles Tashima Lambert , Wentzensen Nicolas
Published: October 2022

Objective

The most recent guidelines for colposcopy practice in the United States, the 2017 Colposcopy Standards Consensus Guidelines, did not include recommendations for endocervical curettage (ECC). This document provides updated guidelines for use of ECC among patients referred for colposcopy.

Methods

Consensus guidelines for the use of ECC were developed in 2012. To update these guidelines in concordance with the 2017 Colposcopy Standards process, an expert workgroup was convened in 2021. Literature had been previously reviewed through 2011, before the 2012 guideline. Literature from the years 2012–2021 and data from the NCI Biopsy study were reviewed, focusing on the additional yield of ECC.

Results

Endocervical curettage is recommended for patients with high-grade cytology, human papillomavirus 16/18 infection, positive results on dual staining for p16/Ki67, for those previously treated for known or suspected cervical precancer or considering observation of cervical intraepithelial neoplasia grade 2, and when the squamocolumnar junction is not fully visualized at colposcopy. Endocervical curettage is preferred for all patients aged older than 40 years. Endocervical curettage is acceptable for all nonpregnant patients undergoing colposcopy but may be omitted when a subsequent excisional procedure is planned, the endocervical canal does not admit a sampling device, or in nulliparous patients aged younger than 30 years, with cytology reported as atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion regardless of whether the squamocolumnar junction is fully visualized. Endocervical curettage is unacceptable in pregnancy.

Conclusions

These guidelines for ECC add to the 2017 consensus recommendations for colposcopy practice in the United States.
Role of bacteriophage therapy for resistant infections in transplant recipients
Authors: Nicholls Paul , Aslam Saima
Published: October 2022

Purpose of review

Multidrug-resistant organisms (MDROs) are prevalent in transplant recipients and associated with poor outcomes. We review recent cases of phage therapy used to treat recalcitrant infections in transplant recipients and explore the future role of such therapy in this setting.

Recent findings

Individual case reports and small case series suggest possible efficacy of phage therapy for the treatment of MDRO infections in pre and posttransplant patients. Importantly, there have been no serious safety concerns in the reported cases that we reviewed. There are no applicable randomized controlled trials (RCTs) to better guide phage therapy at this time.

Given the safety and possibility of successful salvage therapy of MDRO infections using bacteriophages, it is reasonable to pursue phage therapy for difficult-to-treat infections on a compassionate use basis, but RCT data are critically needed to better inform management.
The Clinical Academic Partnership for Excellence
Authors: Luckenbach Alyson , L'Ecuyer Kristi
Published: October 2022

Background:

The Clinical Academic Partnership for Excellence (CAPE) is an innovative program designed to provide ongoing education, mentorship, and support for novice clinical faculty.

Purpose:

The aims of this study were to (1) understand the competency of clinical faculty in their teaching, (2) discover the usefulness of CAPE modules, and (3) explore the benefits of the CAPE program.

Methods:

An electronic survey using Likert-style and open-ended questions was administered to clinical faculty who participated in CAPE over 2 years.

Results:

Participants were able to operationalize the curriculum, objectively evaluate students, and communicate effectively using CAPE content. Benefits included collaboration with faculty, evidence-based teaching, and debriefing. Eighty-eight percent of participants planned to teach for the program again.

Conclusions:

The CAPE program is an innovative approach to bridging the gap between clinical practice and academia. It may be a sustainable solution for faculty retention, satisfaction, and quality education.
Histopathology of Prostate Cancer and its Precursors
Authors: Montironi Rodolfo , Cimadamore Alessia , Mazzucchelli Roberta , Lopez-Beltran Antonio , Scarpelli Marina , Cheng Liang
Published: October 2022

Starting in the mid-1970s, we formed a group of pathologists with a major interest in uropathology. Originally, it included 2 (R.M. and M.S.). In the years the followed, the group was enlarged to include 4 more people, 2 in the mid- and late-1980s (A.L.B. and L.C.) and another in the mid-1990s (R.Ma.); a sixth (A.C.) joined the group ∼5 years ago. Two have reached the retirement age (R.M. and M.S.), while others are in the process of joining the group to replace them. A fruitful collaboration spanned for ∼45 years. This contribution is based on a series of personal recollections of the successive changes in the interpretation of prostate cancer and its precursors, starting in the mid-1970s. Here we have retraced our involvement steps, sharing issues related to them with a junior uropathologist (A.C.).
Loss of Major Histocompatibility Complex Class I, CD8+ Tumor-infiltrating Lymphocytes, and PD-L1 Expression in Ovarian Clear Cell Carcinoma
Authors: Lin Shih-Yao , Hang Jen-Fan , Lai Chiung-Ru , Chan I-San , Shih Ying-Chu , Jiang Ling-Yu , Chang Yen-Hou , Chen Yi-Jen
Published: October 2022

Ovarian clear cell carcinoma (OCCC), a chemoresistant ovarian cancer, shows a modest response to anti–programmed death-1/programmed death ligand-1 (PD-1/PD-L1) therapies. The effects of anti-PD-1/PD-L1 therapies rely on cytotoxic T-cell response, which is triggered by antigen presentation mediated by major histocompatibility complex (MHC) class I. The loss of MHC class I with simultaneous PD-L1 expression has been noted in several cancer types; however, these findings and their prognostic value have rarely been evaluated in OCCC. We collected data from 76 patients with OCCC for clinicopathologic analysis. Loss of MHC class I expression was seen in 44.7% of the cases including 39.3% to 47.4% of the PD-L1+ cases and was associated with fewer CD8+ tumor-infiltrating lymphocytes (TILs). PD-L1 positivity was associated with a higher number of CD8+ TILs. Cox proportional hazard models showed that high (≥50/mm2) CD8+ TILs was associated with shorter disease-specific survival (hazard ratio [HR]=3.447, 95% confidence interval [CI]: 1.222-9.720, P=0.019) and overall survival (HR=3.053, 95% CI: 1.105-8.43, P=0.031). PD-L1 positivity using Combined Positive Score was associated with shorter progression-free survival (HR=3.246, 95% CI: 1.435-7.339, P=0.005), disease-specific survival (HR=4.124, 95% CI: 1.403-12.116, P=0.010), and overall survival (HR=4.489, 95% CI: 1.553-12.972, P=0.006). Loss of MHC class I may contribute to immune evasion and resistance to anti-PD-1/PD-L1 therapies in OCCC, and CD8+ TILs and PD-L1 positivity using Combined Positive Score may have a negative prognostic value.
Laparoscopic Cholecystectomy in Acute Cholecystitis: Refining the Best Surgical Timing Through Network Meta-Analysis of Randomized Trials
Authors: Coccolini Federico , Solaini Leonardo , Binda Cecilia , Catena Fausto , Chiarugi Massimo , Fabbri Carlo , Ercolani Giorgio , Cucchetti Alessandro
Published: October 2022

Background:

Acute cholecystitis (AC) is largely diffused among population worldwide. Laparoscopic cholecystectomy is the treatment of choice. Current evidence suggests a clinical benefit of early cholecystectomy. The aim of the present study was to evaluate the different “timing” (“early” vs. “delayed” cholecystectomy), through the application of network meta-analyses, to define the most adequate interval associated with the best outcomes.

Materials and methods:

A network meta-analysis of randomized controlled trials was conducted.

Results:

Early cholecystectomy ≤72 hours from symptoms reduced conversion rate in comparison to: cholecystectomy ≤7 days from symptoms (P=0.044), delayed cholecystectomy within 1 to 5 weeks from first admission (P=0.010) and 6 to 12 weeks from symptoms resolutions (P=0.009). Delaying cholecystectomy to 6 to 12 weeks reduces operating time in respect to early cholecystectomy ≤72 hours from symptoms (P=0.001), within 24 hours from admission (P=0.001), ≤72 hours from admission (P=0.001) and ≤7 days from symptoms (P=0.001). Cholecystectomy ≤24 hours from admission was the best strategy to reduce total in-hospital stay, whereas delaying cholecystectomy to 6 to 12 weeks was the worst strategy. The same applied when cholecystectomy was performed ≤72 hours from symptoms in respect to both delayed strategies (P=0.001 for both comparisons) or when it was performed ≤72 hours from admission (P=0.001 for both comparisons). Cholecystectomy ≤72 hours from symptoms onset was the best strategy to reduce postoperative complications, the worst was represented by delayed cholecystectomy at 1 to 5 weeks from first admission.

Conclusion:

AC should be operated as soon as possible. AC surgical management should be considered in a dynamic time conception to optimize clinical, organizational, and economical outcomes.