bluuebunny/crossref_metadata_2025 huggingface dataset:
Brain radiotoxicity-related 15CAcBRT gene expression signature predicts survival prognosis of glioblastoma patients
Authors: Reyes-González Jesús , Barajas-Olmos Francisco , García-Ortiz Humberto , Magraner-Pardo Lorena , Pons Tirso , Moreno Sergio , Aguirre-Cruz Lucinda , Reyes-Abrahantes Andy , Martínez-Hernández Angélica , Contreras-Cubas Cecilia , Barrios-Payan Jorge , Ruiz-Garcia Henry , Hernandez-Pando Rogelio , Quiñones-Hinojosa Alfredo , Orozco Lorena , Abrahantes-Pérez María del Carmen
Published: July 2022

Background

Glioblastoma is the most common and devastating primary brain cancer. Radiotherapy is standard of care; however, it is associated with brain radiation toxicity (BRT). This study used a multi-omics approach to determine whether BRT-related genes (RGs) harbor survival prognostic value and whether their encoded proteins represent novel therapeutic targets for glioblastoma.

Methods

RGs were identified through analysis of single-nucleotide variants associated with BRT (R-SNVs). Functional relationships between RGs were established using Protein-Protein Interaction networks. The influence of RGs and their functional groups on glioblastoma prognosis was evaluated using clinical samples from the Glioblastoma Bio-Discovery Portal database and validated using the Chinese Glioma Genome Atlas dataset. The identification of clusters of radiotoxic and putative pathogenic variants in proteins encoded by RGs was achieved by computational 3D structural analysis.

Results

We identified the BRT-related 15CAcBRT molecular signature with prognostic value in glioblastoma, by analysis of the COMT and APOE protein functional groups. Its external validation confirmed clinical relevance independent of age, MGMT promoter methylation status, and IDH mutation status. Interestingly, the genes IL6, APOE, and MAOB documented significant gene expression levels alteration, useful for drug repositioning. Biological networks associated with 15CAcBRT signature involved pathways relevant to cancer and neurodegenerative diseases. Analysis of 3D clusters of radiotoxic and putative pathogenic variants in proteins coded by RGs unveiled potential novel therapeutic targets in neuro-oncology.

Conclusions

15CAcBRT is a BRT-related molecular signature with prognostic significance for glioblastoma patients and represents a hub for drug repositioning and development of novel therapies.
Disease-specific expansion of CD29+IL-17RA+ T effector cells possessing multiple signalling pathways in spondyloarthritis
Authors: Akiyama Mitsuhiro , Yoshimoto Keiko , Ishigaki Sho , Suzuki Katsuya , Takeuchi Tsutomu , Kaneko Yuko
Published: July 2022

Objectives

T cells adhere to enthesis fibrocartilage via integrins and intrinsically require IL-17RA-mediated signals to maintain their effector function. We analysed CD29+IL-17RA+ T cells in inflamed lesions and peripheral blood in patients with SpA and investigated their association with disease activity and therapeutic response.

Methods

Transcriptome analysis of synovial fluid T cells from PsA was performed using publicly available bulk cell RNA sequencing data. Blood samples were obtained from healthy controls (n = 37), RA (n = 12), IgG4-related disease (IgG4-RD; n = 12), large vessel vasculitis (LVV; n = 12) and SpA (n = 28) and were analysed by flow cytometry.

Results

T cells in the inflamed joints of PsA showed CD29 and IL-17RA expression. CD29+IL-17RA+ T cells showed enriched CXCR3+CD45RA+ effector cells and activation of spleen tyrosine kinase (Syk), nuclear factor κB (NF-κB) and Janus kinase–signal transducer and activator of transcription (JAK-STAT) pathways. The proportion of peripheral blood CD29+IL-17RA+ T cells was significantly increased in patients with SpA compared with patients with RA, IgG4-RD or LVV and in healthy controls. Based on the ASDAS-CRP scores, the proportion of CD29+IL-17RA+ T cells was positively correlated with disease activity in treatment-naïve patients with active SpA. Anti-IL-17 but not anti-TNF monoclonal antibodies reduced CD29+IL-17RA+ T cells.

Conclusions

CD29+IL-17RA+ T effector cells with enhanced Syk, NF-κB and JAK-STAT pathways were specifically increased in SpA and were correlated with disease activity, implicating a role of this newly identified T cell population in the pathogenesis. Anti-IL-17 monoclonal antibodies may be effective for patients by reducing this pathogenic T cell population.
Neural processes of inhibitory control in American Indian peoples are associated with reduced mental health problems
Authors: White Evan J , Demuth Mara J , Nacke Mariah , Kirlic Namik , Kuplicki Rayus , Spechler Philip A , McDermott Timothy J , DeVille Danielle C , Stewart Jennifer L , Lowe John , Paulus Martin P , Aupperle Robin L
Published: July 2022

American Indians (AI) experience disproportionately high prevalence of suicide and substance use disorders (SUD). However, accounting for risk burden (e.g. historical trauma and discrimination), the likelihood of mental health disorders or SUD is similar or decreased compared with the broader population. Such findings have spurred psychological research examining the protective factors, but no studies have investigated its potential neural mechanisms. Inhibitory control is one of the potential neurobehavioral construct with demonstrated protective effects, but has not been examined in neuroimaging studies with AI populations specifically. We examined the incidence of suicidal thoughts and behaviors (STB) and SUD among AI (n = 76) and propensity matched (sex, age, income, IQ proxy and trauma exposure) non-Hispanic White (NHW) participants (n = 76). Among the AI sample, functional magnetic resonance imaging (fMRI) data recorded during the stop-signal task (SST) was examined in relation to STB and SUDs. AIs relative to NHW subjects displayed lower incidence of STB. AIs with no reported STBs showed greater activity in executive control regions during the SST compared with AI who endorsed STB. AI without SUD demonstrated lower activity relative to those individual reporting SUD. Results are consistent with a growing body of literature demonstrating the high level of risk burden driving disparate prevalence of mental health concerns in AI. Furthermore, differential activation during inhibitory control processing in AI individuals without STB may represent a neural mechanism of protective effects against mental health problems in AI. Future research is needed to elucidate sociocultural factors contributing protection against mental health outcomes in AIs and further delineate neural mechanisms with respect to specific concerns (e.g. SUD vs STB).
Dicey Rule 3(1) for the 21st Century—the revenue rule in a modern setting
Authors: McPherson George
Published: July 2022

This Article considers the conflict of laws principle, which precludes English courts having jurisdiction in respect of any action to enforce penal, revenue or other public laws of a foreign State (Dicey Rule 3(1)). It follows the Court of Appeal’s decision in the SKAT litigation in February 2022, which reinstated claims brought by the Danish tax authority against all but one of more than 100 defendants, to recover refunds of £1.44 billion of withholding tax, on the basis that Dicey Rule 3(1) did not render those claims inadmissible. The Article looks at (1) the rationale, scope and boundaries of the Rule; (2) how the Rule was applied in the SKAT case; and (3) what that case tells us about the likely future of the Rule.
Integration of allocentric and egocentric visual information in a convolutional/multilayer perceptron network model of goal-directed gaze shifts
Authors: Abedi Khoozani Parisa , Bharmauria Vishal , Schütz Adrian , Wildes Richard P , Crawford J Douglas
Published: July 2022

Allocentric (landmark-centered) and egocentric (eye-centered) visual codes are fundamental for spatial cognition, navigation, and goal-directed movement. Neuroimaging and neurophysiology suggest these codes are initially segregated, but then reintegrated in frontal cortex for movement control. We created and validated a theoretical framework for this process using physiologically constrained inputs and outputs. To implement a general framework, we integrated a convolutional neural network (CNN) of the visual system with a multilayer perceptron (MLP) model of the sensorimotor transformation. The network was trained on a task where a landmark shifted relative to the saccade target. These visual parameters were input to the CNN, the CNN output and initial gaze position to the MLP, and a decoder transformed MLP output into saccade vectors. Decoded saccade output replicated idealized training sets with various allocentric weightings and actual monkey data where the landmark shift had a partial influence (R2 = 0.8). Furthermore, MLP output units accurately simulated prefrontal response field shifts recorded from monkeys during the same paradigm. In summary, our model replicated both the general properties of the visuomotor transformations for gaze and specific experimental results obtained during allocentric–egocentric integration, suggesting it can provide a general framework for understanding these and other complex visuomotor behaviors.
Fungicide Resistance and Host Influence on Population Structure in Botrytis spp. from Specialty Crops in California
Authors: Naegele Rachel P. , Abdelsamad Noor , DeLong Jeff A. , Saito Seiya , Xiao Chang-Lin , Miles Timothy D.
Published: July 2022

Botrytis is an important genus of plant pathogens causing pre- and postharvest disease on diverse crops worldwide. This study evaluated Botrytis isolates collected from strawberry, blueberry, and table grape berries in California. Isolates were evaluated for resistance to eight different fungicides, and 60 amplicon markers were sequenced (neutral, species identification, and fungicide resistance associated) distributed across 15 of the 18 B. cinerea chromosomes. Fungicide resistance was common among the populations, with resistance to pyraclostrobin and boscalid being most frequent. Isolates from blueberry had resistance to the least number of fungicides, whereas isolates from strawberry had resistance to the highest number. Host and fungicide resistance-specific population structure explained 12 and 7 to 26%, respectively, of the population variability observed. Fungicide resistance was the major driver for population structure, with select fungicides explaining up to 26% and multiple fungicide resistance explaining 17% of the variability observed. Shared and unique significant single-nucleotide polymorphisms (SNPs) associated with host and fungicide (fluopyram, thiabendazole, pyraclostrobin, and fenhexamid) resistance-associated population structures were identified. Although overlap between host and fungicide resistance SNPs were detected, unique SNPs suggest that both host and fungicide resistance play an important role in Botrytis population structure.
Evaluation of the BEAT Meth Intervention for Emergency Department Patients with Methamphetamine Psychosis
Authors: Simpson Scott A. , Wolf Chelsea , Loh Ryan M. , Camfield Katherine , Rylander Melanie
Published: July 2022

Objectives

Methamphetamine is the second leading cause of overdose death in America and a leading cause of emergency department (ED) visits. Methamphetamine-induced psychosis is a dangerous and difficult-to-treat consequence of methamphetamine use. We describe the pilot implementation and outcomes of a multimodal treatment intervention for ED patients with methamphetamine psychosis, Beginning Early and Assertive Treatment for Methamphetamine Psychosis (BEAT Meth).

Methods

BEAT Meth was implemented in an urban safety net health system. The protocol includes early identification and treatment of methamphetamine psychosis, a protocolized hospitalization, and support for transitioning patients to specialty addiction treatment. Patients receiving BEAT Meth were compared with ED patients with methamphetamine psychosis who were discharged. Implementation fidelity was measured to assess feasibility.

Results

BEAT Meth patients were nearly 3 times more likely to attend an outpatient specialty addiction appointment in the 30 days after discharge than comparison patients (32% vs 11%, P < 0.01). Subsequent ED utilization was common among all patients, and there was no significant difference in 30-day ED return rates between BEAT Meth and comparison patients (28% vs 37%, P = 0.10). Exploratory analyses suggested that increased attendance at outpatient treatment reduced ED utilization.

Conclusions

BEAT Meth is an intervention framework to support identification, management, and treatment engagement of ED patients with methamphetamine psychosis. Treatment strategies like BEAT Meth are necessary to manage the unique challenges of methamphetamine addiction. These findings will guide clinical care, program development, and research.
The 13.5-mg, 19.5-mg, and 52-mg Levonorgestrel-Releasing Intrauterine Systems and Risk of Ectopic Pregnancy
Authors: Elgemark Karin , Graner Sofie , McTaggart Julia , Ramirez Löfström Jennie , Sörensen Daniela , Envall Niklas , Kopp Kallner Helena
Published: July 2022

OBJECTIVE:

To assess the Pearl Index for risk of ectopic pregnancy in women using levonorgestrel-releasing intrauterine systems (LNG-IUS) with hormonal reservoirs of 13.5 mg, 19.5 mg, or 52 mg.

METHODS:

This was a retrospective cohort study. Women diagnosed with an ectopic pregnancy in Stockholm County, Sweden, between January 1, 2014, and December 31, 2019, were identified through the electronic medical record system. The final analysis included 2,252 cases of ectopic pregnancy. Information on age, reproductive and medical history, as well as current use of contraception was retrieved. The time of intrauterine device (IUD) insertion before ectopic pregnancy and the numbers of sold LNG-IUS during the study period were used to calculate the incidence rate for ectopic pregnancy during use per 100 woman-years (Pearl Index).

RESULTS:

Among women with an ectopic pregnancy diagnosis, 105 presented with a known type of hormonal IUD in situ, of whom 94 were included in the calculations of the Pearl Index. The estimated Pearl Index for ectopic pregnancy was 0.136 (95% CI 0.106–0.176) for the LNG-IUS 13.5-mg, 0.037 (95% CI 0.021–0.067) for the LNG-IUS 19.5-mg, and 0.009 (95% CI 0.006–0.014) for the LNG-IUS 52-mg. With the 52-mg LNG-IUS as referent, the relative risk (RR) for ectopic pregnancy was higher during the first year for LNG 13.5-mg (RR 20.59, 95% CI 12.04–35.21), and for both 13.5-mg (RR 14.49, 95% CI 9.01–23.3) and 19.5-mg (RR 4.44, 95% CI 1.64–12.00) during the total study period.

CONCLUSION:

The absolute risk of ectopic pregnancy during the use of LNG-IUS at any doses was low. The results show that the lower the dose of the IUD, the higher the risk of an ectopic pregnancy. Higher-dose LNG-IUS should be considered when providing contraceptive counseling to a woman with known risk factors for ectopic pregnancy who are considering a hormonal IUD.
Imiquimod-Associated Localized Skin Ulceration in a Patient With Uncontrolled Diabetes
Authors: McKinzie Alexandra H. , Christman Megan A.
Published: July 2022

BACKGROUND:

Human papillomavirus, one of the most common viral infections worldwide, frequently manifests as condyloma acuminata, or anogenital warts. First-line treatment of this condition includes the use of imiquimod, a topical immunomodulator.

CASE:

We describe a case of a localized skin ulceration necessitating surgical debridement after the use of topical imiquimod for 24 hours in a patient with uncontrolled type 2 diabetes mellitus. After debridement, the patient's wound healed appropriately, with regular wound clinic visits and diabetes education.

CONCLUSION:

Health care professionals should use caution when prescribing imiquimod in patients with uncontrolled type 2 diabetes mellitus.
National Estimates of Labiaplasty Performance in the United States From 2016 to 2019
Authors: Luchristt Douglas , Sheyn David , Bretschneider C. Emi
Published: July 2022

The objective of this analysis was to provide national estimates of rates and patterns of labiaplasty performance among all payers in the ambulatory surgery setting. We used the Nationwide Ambulatory Surgery Sample database from 2016 to 2019 and estimated the annual rate of labiaplasty in the United States, along with the demographic characteristics of patients undergoing the procedure and characteristics of the facilities where the procedure was performed. The highest rate of cases was observed among adolescent and young women in the United States, with nearly 20% of all cases being performed in girls younger than age 18 years. Given the limited outcome data and potential long-term adverse events associated with this procedure, as well as the high rate of minors undergoing this procedure, more dedicated research assessing the prevalence and associated outcomes is warranted.
Commercially Available Home Pelvic Training Devices for the Treatment of Pelvic Floor Disorders
Authors: Pennycuff Jon F. , Borazjani Ali , Wang Haijun , Iglesia Cheryl
Published: July 2022

OBJECTIVE:

To assess the clinical efficacy of commercially available pelvic muscle training devices on the treatment of pelvic floor disorders.

DATA SOURCES:

We searched MEDLINE, Web of Science, and ClinicalTrials.gov through April 2020. We included observational cohort studies and randomized trials. Case reports, case series, and conference poster presentations were excluded. Studies using vaginal weights or cones and those conducted in the peripartum periods were also excluded.

TABULATION, INTEGRATION, AND RESULTS:

A total of 294 studies were screened. Twenty-six studies were included in the qualitative analysis, and 15 studies were eligible for meta-analyses. Study characteristics and quality were recorded for each study. Meta-analysis showed a large positive effect of commercially available pelvic floor training devices on pelvic floor muscle strength by both objective and subjective measures. Meta-analysis of objective measures showed a reduction of 1.2 pads per day (P<.01), 1.3 incontinence episodes per day, (P<.01) and 11 g on 24-hour pad test (P<.01). Meta-analysis of subjective measures showed a reduction in UDI-6 (Urogenital Distress Inventory, Short Form) scores by 25.1 points (P<.01) and in IIQ-7 scores (Incontinence Impact Questionnaire, Short Form) by 14.1 points (P=.01). There was an increase in I-QOL (Incontinence Quality of Life) scores by 16.8 points (P<.01). The minimal important difference was met for the UDI-6 and I-QOL but not for the IIQ-7. We were unable to perform meta-analysis to evaluate whether pelvic floor training devices are as effective as traditional supervised pelvic floor physical therapy.

CONCLUSION:

Commercially available home pelvic floor training devices are effective in increasing strength of pelvic floor muscles and in the treatment of pelvic floor disorders.
Suture Compared With Staples for Skin Closure After Cesarean Delivery
Authors: Mackeen A. Dhanya , Sullivan Maranda V. , Schuster Meike , Berghella Vincenzo
Published: July 2022

OBJECTIVE:

Absorbable suture is the preferred method of cesarean skin closure compared with metal staples, because it decreases wound complications. Two recently published trials in patients with obesity contradict this evidence. The goal of this meta-analysis was to assess whether suture remains the recommended method of cesarean skin closure, regardless of obesity status.

DATA SOURCES:

MEDLINE through OVID, PubMed, Cochrane Database, and ClinicalTrials.gov were searched from inception until September 24, 2021.

METHOD OF STUDY SELECTION:

Published randomized controlled trials (RCTs) comparing subcuticular absorbable suture with nonabsorbable metal staples for cesarean skin closure were included. Non-RCTs, RCTs that did not compare staples with suture, and ongoing trials were excluded. Fourteen studies met inclusion criteria.

TABULATION, INTEGRATION AND RESULTS:

Data were individually abstracted and entered into RevMan. Fixed and random effects models were used. The Cochrane risk-of-bias tool was used to assess each study. The primary outcome, a sensitivity analysis of wound complications (excluding studies at high risk of bias), showed a significant decrease in wound complications when the cesarean skin incision was closed with suture compared with staples (10 studies; 71/1,497 vs 194/1,465; risk ratio [RR] 0.47, 95% CI 0.25–0.87). When all studies were analyzed, there remained a significant decrease in wound complications when the skin was closed with suture (14 studies; 121/1,780 vs 242/1,750; RR 0.59, 95% CI 0.36–0.97). Of the individual wound complications, wound separation was significantly decreased with suture closure compared with staples (11 studies; 55/1,319 vs 129/1,273; RR 0.43, 95% CI 0.32–0.58). In patients with obesity, there remained a significant decrease in wound complications with suture closure of the skin incision compared with staples (five studies; 34/507 vs 67/522; RR 0.51, 95% CI 0.34–0.75).

CONCLUSION:

Closure of the cesarean skin incision with suture decreased composite wound complications by 50% as compared with closure with staples; a significant decrease persisted regardless of obesity status.

SYSTEMATIC REVIEW REGISTRATION:

PROSPERO, CRD42021270378.
Hip Fracture With Elevated Troponin: Harbinger of Mortality or Need for Accelerated Surgery?
Authors: O'Hara Nathan N. , Wu Jocelyn , Rolle Nicholas , Sprague Sheila , Devereaux P. J. , Borges Flavia K. , Slobogean Gerard P.
Published: July 2022

Objective:

To determine the association of elevated troponin levels with time to surgery and the risk of mortality and other key clinical outcomes among elderly patients with hip fracture who had measured troponin levels at hospital admission.

Design:

Retrospective cohort study.

Setting:

Single academic trauma center.

Patients:

We included 299 consecutive patients 60 years of age or older with a hip fracture and cardiac troponin levels measured at the time of hospital admission.

Intervention:

Patients with elevated cardiac troponin levels at hospital admission (n = 43) compared with patients with normal troponin levels at admission (n = 256).

Main Outcome Measures:

Time to surgery, 90-day mortality, and major complications within 90 days of injury.

Results:

The median age of the cohort was 80 years (interquartile range, 70–87 years), 59% were female, and 86% were living independently before their injury. Elevated troponin levels were associated with a 21-hour [95% confidence interval (CI), 12 to 32, P < 0.001] increase in the median time from admission to surgery (43 vs. 22 hours). Elevated troponin levels were also associated with a 14% (95% CI, 0% to 29%, P = 0.01) absolute increase in 90-day mortality (28% vs. 14%). Patients with elevated troponins were 15% (95% CI, −1% to 30%, P = 0.06) more likely to have a major complication (37% vs. 23%); however, the difference did not reach statistical significance.

Conclusions:

Among patients with a hip fracture and measured troponin levels, elevated troponin levels were associated with significant delays in surgery and increased 90-day mortality.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
A Prospective Randomized Controlled Trial Comparing Enoxaparin & Rivaroxaban for Venous Thromboembolism Prophylaxis in Orthopaedic Trauma
Authors: John Mitchell P. , Streufert Benjamin D. , Downes Katheryne , Chase Collin B. , Mir Hassan R.
Published: July 2022

Objectives:

To determine whether there is a difference in orthopaedic trauma patient medication satisfaction and adherence using an oral versus subcutaneous injectable anticoagulant for venous thromboembolism chemoprophylaxis.

Design:

Randomized controlled trial.

Setting:

Single academic Level 1 trauma center.

Participants:

One hundred twenty adult orthopaedic trauma patients with operative pelvic or lower extremity fractures were randomized and completed the study.

Intervention:

Three weeks of either the service standard 40 mg once daily enoxaparin versus trial medication 10 mg once daily rivaroxaban postoperatively.

Main Outcome Measures:

Patient satisfaction as measured by the Treatment Satisfaction Questionnaire for Medication (TSQM-9). Medication adherence as measured by the Morisky Medication Adherence Scale (MMAS-8).

Results:

Medication adherence was similar in both groups. Medication satisfaction was significantly higher in the oral rivaroxaban group based on the TSQM-9 and patient-reported data. Secondary outcomes found no significant difference in the incidence of bleeding events or clinically relevant venous thromboembolism. The enoxaparin group experienced more adverse medication-related events. The rivaroxaban medication regimen costs 7.5–10× less out of pocket for uninsured patients.

Conclusion:

The results of this randomized controlled trial demonstrate that patients with surgical orthopaedic trauma prefer an oral anticoagulant for postoperative venous thromboembolism chemoprophylaxis and suggest that rivaroxaban may be a viable option. Furthermore, large-scale studies are needed to confirm safety and efficacy for rivaroxaban in this population as a potential alternative to enoxaparin and aspirin.

Level of Evidence:

Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
Acupuncture and moxibustion treating lower urinary tract symptoms due to benign prostatic hyperplasia: a systematic review and network meta-analysis
Authors: Chen Zhe , Jiang Tao , Peng Yingying , Qiang Xiaoyu , Yang Fengwen , Hu Haiyin , Liu Chunxiang , Lee Myeong Soo
Published: July 2022

Objective:

Lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) affect the quality of life of elderly individuals. Acupuncture and moxibustion are used in the clinic in China for improving LUTS symptoms due to BPH. However, there is no evidence to suggest which is the best option. We compared the efficacy of acupuncture and moxibustion to provide evidence for clinical decision-making.

Methods:

PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wan Fang Data, and VIP databases were searched from inception to July 2020 to identify the randomized controlled trials (RCTs) of acupuncture and moxibustion for LUTS due to BPH. Two researchers filtered studies and extracted the information independently. This study conducted a network meta-analysis using the Bayesian random method. The interventions ranking was evaluated using the surface under the cumulative ranking curve (SUCRA).

Results:

We finally included 40 studies comprising 10 treating therapies and 3655 patients with LUTS caused by BPH. In terms of the International Prostate Symptom Score, maximum urinary flow rate, and quality of life, electroacupuncture (EA) (MD = −3.6, 95% credible interval [CrI] [−5.5, −1.8], very low certainty of evidence; MD = 2.2, 95% CrI [1.1, 3.3], low certainty of evidence; MD = −1.3, 95% CrI [−2.2, −0.43], very low certainty of evidence) may be consistently the optimal treatment compared with other interventions, with SUCRA values of 84%, 81%, and 89%, respectively.

Conclusions:

Of all treatments, EA may have the best efficacy with fewer adverse events for LUTS due to BPH. The quality of evidence supporting this result is low to very low certainty of the evidence due to limitations of primary studies; thus, more high-quality RCTs are needed for further evidence.
Chondrogenic differentiation of rat bone marrow mesenchymal stem cells induced by puerarin and tetrandrine
Authors: Dong Xin-Ran , Hu Meng-Jiao , Pan Hui-Xin , Li Ke-Feng , Cui Yuan-Lu
Published: July 2022

Objective:

This study aims to clarify the effect of the active components puerarin and tetrandrine on the chondrogenic differentiation of bone marrow mesenchymal stem cells (BMSCs).

Methods:

Using network pharmacology, protein targets of puerarin and tetrandrine were predicted, and a database of cartilage formation targets was established. The protein target information related to disease was then collected, and the drug-targeting network was constructed by analyzing the protein–protein interactions. Genes related to chondrogenesis induced by puerarin and tetrandrine and chondroblast differentiation signaling pathways were searched. Finally, potential drug- and disease-related genes, as well as proteins, were screened and verified using real-time RT-PCR and western blotting.

Results:

Network pharmacological studies have shown that puerarin and tetrandrine are involved in BMSCs cartilage differentiation. The experimental results showed that puerarin and tetrandrine could regulate the expression of cartilage differentiation-related genes and proteins. Puerarin increased the protein expression of COL2A1, COL10A1, MMP13, and SOX-9, as well as the gene expression of Col2a1, Mmp13, Tgfb1, and Sox-9. Tetrandrine increased the protein expression of COL2A1, COL10A1, MMP13, and SOX-9, as well as the gene expression of Col10a1, Tgfb1, Sox-9, and Acan. The combination of puerarin and tetrandrine increased the protein expression of COL2A1, COL10A1, MMP13, and SOX-9 and the gene expression of Col2a1, Col10a1, Sox-9, and Acan.

Conclusions:

Puerarin, tetrandrine, and their combination can promote the proliferation of BMSCs and induce their differentiation into chondrocytes, and they are thus expected to be inducers of chondrogenic differentiation. These results suggest that puerarin and tetrandrine have potential therapeutic effects on osteoarthritis.
Dry Eye–Related Risk Factors for Digital Eye Strain
Authors: Talens-Estarelles Cristian , García-Marqués José Vicente , Cerviño Alejandro , García-Lázaro Santiago
Published: July 2022

Objectives:

To evaluate dry eye–related lifestyle and demographic factors associated with digital eye strain (DES).

Methods:

An anonymous online survey was conducted in 851 university students. Participants were classified into DES (computer vision syndrome questionnaire [CVS-Q]≥6) or non-DES (CVS-Q<6). Respondents completed three dry eye questionnaires (Ocular Surface Disease Index [OSDI]; 5-item Dry Eye Questionnaire [DEQ-5]; 8-item Contact Lens Dry Eye Questionnaire) and were surveyed on dry eye risk factors contemplated by the Tear Film and Ocular Surface Society Dry Eye Workshop II.

Results:

Six hundred twenty-eight participants were classified into the group with DES and 222 into the group without DES. Participants with DES slept fewer hours, spent more hours indoors with air conditioning, drank more caffeinated beverages, used the computer for longer periods, reported poorer health quality, and obtained a higher score in all questionnaires (P<0.025). A higher proportion of the participants were female, had several health disorders, and took several medications associated with dry eye (P<0.029). Multivariate logistic regression analysis revealed that stress (P=0.035), contact lens wear (P=0.011), hours of computer use per day (P=0.010), migraine headaches (P=0.013), and a higher OSDI (P<0.001) and DEQ-5 score (P<0.001) were associated with DES.

Conclusions:

Several dry eye–related risk factors and health conditions are associated with suffering from DES. Clinicians should acknowledge the relevance of triaging questions and dry eye disease risk factors when dealing with patients who view screens for extended periods.
Addressing Compassion Fatigue in Trauma Emergency and Intensive Care Settings: A Pilot Study
Authors: Beres Katherine E. , Zajac Lisa M. , Mason Heidi , Krenke Karen , Costa Deena Kelly
Published: July 2022

BACKGROUND:

Emergency and intensive care health care professionals are experiencing exhaustion and helplessness, which may cause compassion fatigue. Unaddressed compassion fatigue impacts staff morale and patient safety. Structured debriefing sessions may reduce compassion fatigue by providing social support and increasing job satisfaction.

OBJECTIVE:

To investigate the feasibility of a 12-week pilot of structured debriefing sessions and its impact on compassion fatigue experienced by emergency and intensive care health care professionals after patient death.

METHODS:

In this 12-week pilot study (March 2021 to May 2021), we used a preintervention/postintervention design to determine the feasibility of structured debriefing among trauma health care professionals experiencing patient death in an urban, academic, 300-bed, Midwest, Level II trauma center. Compassion fatigue was measured using the Professional Quality of Life Measure survey. Univariate descriptive statistics, independent unpaired t tests, and χ2 tests examined the intervention impact.

RESULTS:

Fifty-six health care professionals participated in 20 debriefing sessions during the 12-week intervention: 37 (80%) registered nurses, 10 (5.6%) respiratory therapists, and 5 (11.2%) nursing assistants or emergency medical technicians. The debriefings covered nearly half of all patient deaths (38%). No significant differences were seen in burnout (M = 25.5, SD = 5.4, p = .47), secondary traumatic stress (M = 23.9, SD = 5.6, p = .99), or compassion satisfaction (M = 36.8, SD = 6.4, p = .61).

CONCLUSIONS:

Structured debriefings to address compassion fatigue among trauma health care professionals are feasible, but further research on effectiveness is needed. Administration-provided emotional support strategies may assist health care professionals in processing work-related stress.
Management of delusions of parasitosis: an interview with experts in psychodermatology
Authors: Brownstone Nicholas , Howard Josie , Koo John
Published: July 2022

Delusions of parasitosis (DOP), which is also called Morgellons disease or delusional infestation, can be one of the most challenging clinical encounters in a dermatologist’s practice. One reason for this is lack of education during dermatology residency and a paucity of resources for the practicing dermatologist such as specialized psychodermatology clinics for these patients. To help close this knowledge gap, an interview was conducted with 3 experts in the field of psychodermatology and their responses were recorded and edited with goal of improving care for patients suffering from DOP by educating the busy, practicing dermatologist. The experts discussed many topics regarding DOP including the difference between primary and secondary DOP, how to build a good rapport with DOP patients, why the condition is seen mostly in older woman, and which medications are effective for treatment. The interview ends with a few high-yield practical treatment tips.
Characterization of zebrafish gp1ba mutant and modelling Bernard Soulier syndrome
Authors: Dhinoja Sanchi , Al Qaryoute Ayah , Fallatah Weam , DeMaria Anthony , Jagadeeswaran Pudur
Published: July 2022

The aim of this study is to model classical Bernard Soulier Syndrome in the zebrafish by targeting Gp1ba. We obtained gp1ba mutant embryos from Zebrafish International Resource Center and grew them to adulthood. The tail clips from these fish were used to prepare DNA and sequenced to identify heterozygotes. They were then bred to obtain homozygotes. The mutation was confirmed by DNA sequencing as a termination codon UAA in place of AAA codon at position 886 in the gp1ba transcript. Thus, at the Pro-295, the Gp1ba protein could be terminated. The blood from gp1ba homozygous and heterozygous mutants showed decreased ristocetin-mediated agglutination in the whole blood agglutination assay. The gp1ba heterozygous and homozygous larvae were subjected to a laser-assisted arterial thrombosis assay, and the results showed the prolonged occlusion in the caudal artery. These results suggested that the gp1ba mutant had a bleeding phenotype. The blood smears from the adult gp1ba, heterozygous and homozygous mutants, showed macrothrombocytes, similar to the human GP1BA deficiency that showed giant platelets. The bleeding assay on these heterozygous and homozygous mutants showed greater bleeding than wildtype, confirming the above findings. Taken together, the characterization of gp1ba zebrafish mutant suggested an autosomal dominant mode of inheritance. The zebrafish gp1ba mutant models classical Bernard Soulier Syndrome and could be used for reversing this phenotype to identify novel factors by the genome-wide piggyback knockdown method.
Tributary Medicine System of the Qing Dynasty: A Preliminary Study
Authors: Zhang Zi-Long , Xian Yi-Sha , Shi Xiao-Jie , Wang Xue-Qi , Sun Ling-Yi
Published: July 2022

Medicine was one of the articles of tribute paid by other countries and kingdoms to the imperial court of the Qing dynasty (1644–1912). The act of paying tributes and the rituals associated with it enhanced communication and helped establish relationships between ancient China and other nations or territories. The imperial court was generous in return, which attracted many countries to pay tributes. This paper analyzes how medicines as tributes played an important role in consolidating the dominant status of ancient China, and in promoting the exchange of knowledge between Chinese and Western medicine.
Use of Non-Verbal Representations to Define Concept of Pulse Conditions in Traditional Chinese Medicine Standards
Authors: Zhang Chun-Ke , Wang Yi-Qin , Guo Rui , Yan Hai-Xia , Yan Jian-Jun , Wu Wen-Jie , Li Jing
Published: July 2022

The standardization of terms and definitions is fundamental to all activities in the domain of traditional Chinese medicine (TCM). For decades, definitions of TCM terminology relied on conventional verbal representations to differentiate between related concepts. However, the ancient Chinese is obscure and comprises a massive volume of information, making it difficult to convey the definition accurately in other languages. This article proposes a potential solution that the definition for pulse terminology can be supplemented by modern means of non-verbal representation, i.e., using pulse waveform graphs and parameters to complete the definition of each pulse. A discussion of the challenges of obtaining reliable data is also included.
Art of Nourishing Life According to the Kidney Meridian in Zhenjiu Dacheng (The Great Compendium of Acupuncture and Moxibustion)
Authors: Bui Anita
Published: July 2022

“Daoyin Benjing” (Art of Nourishing Life) discusses the kidney meridian in depth. It is a dense and heterogeneous text that is heavily influenced by Daoism. The text proposes rules for the maintenance of life using language that is often cryptic and understandable only to the initiated. This language is closely interwoven with the classical terms of traditional Chinese medicine. The kidney is the home of vital energy, which is a type of sexual energy and the root of life. Engagement in moderate sexual activity nourishes life and leads to a long life. This is the goal of every Daoist follower and the goal of every doctor.
Role of pilocarpine use following laser peripheral iridotomy in eyes with refractory acute angle closure glaucoma: A case report and literature review
Authors: Yen Chu-Yu , Chen Chun-Chen , Tseng Po-Chen
Published: July 2022

Rationale:

Angle closure glaucoma (ACG) is one of the most emergent types of glaucoma in clinical practice. Laser peripheral iridotomy (LPI) could minimize pupillary block and prevent ACG from an acute attack. However, recurrent increase in intraocular pressure (IOP) may still occur despite successful LPI. The aim of this study is to highlight the importance of postLPI pilocarpine use and larger LPI size as well as to share some experiences of cataract surgery in patients with ACG.

Patient concerns:

A 63-year-old female was referred to our hospital for headache, and poor control of IOP in the right eye for 3 hours.

Diagnoses:

The patient was diagnosed ACG in the right eye. Recurrence of ACG in the right eye and new-onset and recurrent ACG in the left eye were noted during follow-up, despite successful LPI. The diagnosis was confirmed through slit lamp and gonioscope examination.

Interventions:

The LPI size was enlarged and pilocarpine use was maintained at 2% (1 drop 4 times a day) in both the eyes. Finally, cataract surgery was performed in both the eyes.

Outcomes:

No recurrence of ACG was noted during postLPI pilocarpine use in both the eyes. The postoperative IOP was stable for >6 months after cataract surgery without any surgical intervention or antiglaucoma medication use. No discomfort or major complication was observed.

Conclusion:

This report highlights the importance of postLPI pilocarpine use and larger LPI size in patients with refractory ACG.
Sex-related differences in postoperative complications following elective craniotomy for intracranial lesions: An observational study
Authors: Brandi Giovanna , Stumpo Vittorio , Gilone Marco , Tosic Lazar , Sarnthein Johannes , Staartjes Victor E. , Wang Sophie Shih-Yüng , Van Niftrik Bas , Regli Luca , Keller Emanuela , Serra Carlo
Published: July 2022

Introduction:

The integration of sex-related differences in neurosurgery is crucial for new, possible sex-specific, therapeutic approaches. In neurosurgical emergencies, such as traumatic brain injury and aneurysmal subarachnoid hemorrhage, these differences have been investigated. So far, little is known concerning the impact of sex on frequency of postoperative complications after elective craniotomy. This study investigates whether sex-related differences exist in frequency of postoperative complications in patients who underwent elective craniotomy for intracranial lesion.

Material and Methods:

All consecutive patients who underwent an elective intracranial procedure over a 2-year period at our center were eligible for inclusion in this retrospective study. Demographic data, comorbidities, frequency of postoperative complications at 24 hours following surgery and at discharge, and hospital length of stay were compared among females and males.

Results:

Overall, 664 patients were considered for the analysis. Of those, 339 (50.2%) were females. Demographic data were comparable among females and males. More females than males suffered from allergic, muscular, and rheumatic disorders. No differences in frequency of postoperative complications at 24 hours after surgery and at discharge were observed among females and males. Similarly, the hospital length of stay was comparable.

Conclusions:

In the present study, no sex-related differences in frequency of early postoperative complications and at discharge following elective craniotomy for intracranial lesions were observed.
A sewing needle in the liver in children: A case report and literature review
Authors: Xing Huiwu , Tan Bingqian , Yang Chenyu , Zhang Mingman
Published: July 2022

Rationale:

In clinical practice, foreign bodies (FBs) in the digestive tract are more common in children, but intrahepatic FBs are rare, especially those that can cause infection, bleeding, bile leakage, and other complications. However, there is no consensus on its diagnosis and treatment due to the lack of large-scale cohort studies.

Patient concerns:

Case 1 is a 4-years 8-months-old girl, who at the age of 10 months, showed an X-ray finding of a striped FB in her liver, with no symptoms. However, the patient’s parents refused surgery. After nearly 4 years of active surveillance, the patient visited our hospital for surgery. Case 2, a 2-year-old male, reported a sewing needle that completely pierced into the right upper abdomen due to an accidental fall that took place half-a-day before admission. He only had right upper abdominal pain. CT showed a striped FB in the liver.

Diagnosis:

FB in the liver (sewing needle).

Interventions:

Both the patients were injected with human tetanus immunoglobulin and underwent surgical removal.

Outcomes:

Both patients recovered smoothly and had no complications during follow-up.

Lessons:

Active surveillance might be considered for cases with no symptoms or complications and no displacement of the FB, but surgery should be the first choice. If the patient’s condition is complicated, it is recommended to use ultrasound or X-ray to help decision-making during the operation. Additionally, tetanus, child safety, and family education are important supportive measures.
Comparison of nighttime and daytime operation on outcomes of supracondylar humeral fractures: A prospective observational study
Authors: Buget Mehmet I. , Canbolat Nur , Chousein Chasan M. , Kizilkurt Taha , Ersen Ali , Koltka Kemalettin
Published: July 2022

Supracondylar humeral fractures are seen in children and treatment is usually closed reduction and percutaneous pinning (CRPP). This surgery can be performed at night, depending on its urgency. Fatigue and sleep deprivation can impact performance of doctors during night shifts. The purpose of this study is to investigate the association between night shifts postoperative morbidity and mortality of supracondylar fracture operations compared to daytime procedures.

This prospective observational study included 94 patients who were aged 5 to 12 years with ASA I to III who had supracondylar humeral fractures, underwent CRPP under general anesthesia. Patients were stratified by the time of surgery using time of induction of anesthesia as the starting time of the procedure, into 2 groups: day (07:30 am–06:29 pm) and night (06:30 pm–07:29 am). In total, 82 patients completed the study: 43 in Group Day and 39 in Group Night.

The operation duration in Group Night (114.66 ± 29.46 minutes) was significantly longer than in Group Day (84.32 ± 25.9 minutes) (P = .0001). Operation duration (OR: 0.007; P = .0001) and morbidities (OR: 0.417; P = .035) were independent risk factors in Group Night.

Children who had supracondylar humeral fractures, undergoing urgent CRPP surgery, in-hospital mortality was associated with the time of day at which the procedure was performed. Patient safety is critically important for pediatric traumatic patient population. Therefore, we suggested to increase the number of healthcare workers and improve the education and experience of young doctors during night shifts.
Advanced gallbladder cancer accompanied with cancer-associated dermatomyositis: A case report and literature review
Authors: Kuroda Haruka , Yamaguchi Atsushi , Sugata Shuhei , Hamada Takuro , Moriuchi Riho , Wada Kaoru , Tamaru Yuzuru , Kusunoki Ryusaku , Kuwai Toshio , Kouno Hirotaka , Kurashige Takashi , Torii Tsuyoshi , Saito Akihisa , Kuraoka Kazuya , Kohno Hiroshi
Published: July 2022

Rationale:

Muscle weakness due to cancer-associated dermatomyositis (CADM) can be misdiagnosed as cancer cachexia and disuse atrophy.

Patient concerns:

A 75-year-old female was admitted to our institute with muscle weakness, dysphagia, and suspected gallbladder cancer. Computed tomography and cytopathological examinations of the liver biopsy and fine-needle aspiration from swollen lymph nodes using endoscopic ultrasonography revealed cancer in the gallbladder body and metastasis to the lymph nodes around the abdominal aorta. We avoided the administration of anticancer drugs due to her poor general condition.

Diagnosis:

Subsequently, we diagnosed her with muscle weakness and dysphagia as a result of CADM using species from muscle and skin biopsy.

Interventions and Outcomes:

Prednisolone therapy and anticancer agents partially improved the patient symptoms.

Lessons:

CADM is reported to be associated with a high incidence of dysphagia, which may aid in the diagnosis of this disease.