bluuebunny/crossref_metadata_2025 huggingface dataset:
Melanoma-related costs by disease stage and phase of management in Ireland
Authors: Crealey Grainne E , Hackett Caitriona , Harkin Katharine , Heckmann Patricia , Kelleher Fergal , Lyng Áine , McCarthy Triona , McEnery Maria , Meaney Clare , Roche Darren , Tobin Anne-Marie
Published: May 2023

Background

Management options for the treatment of melanoma have expanded in recent years. In an era of promising, but expensive novel pharmacological treatments, robust stage-specific melanoma-related cost estimates are necessary to support budgetary planning, evaluation of cost-effectiveness and to contribute to the investment case for prevention.

Methods

A detailed decision model, describing the melanoma care pathway (by disease stage) from diagnosis, through treatment and follow-up was developed over a 5-year time frame from the perspective of the Irish healthcare system. The model was populated with real-world data from the National Cancer Registry Ireland. Uncertainty was explored using one-way and probabilistic sensitivity analysis.

Results

The cost of managing a case of melanoma diagnosed at Stage IV (€122 985) was more than 25 times more expensive than managing a case diagnosed at Stage IA (€4269). Total costs were sensitive to the choice of immunotherapeutic and targeted drug, duration of treatment and proportion of patients receiving immunotherapy agents.

Conclusions

The rising incidence of melanoma and high cost of new novel therapies presents an immediate challenge to cancer control and public health globally. This study highlights the cost differential between early and late detection and the potential return on investment for prevention versus high-cost treatment.
Mortgage Design and Slow Recoveries: The Role of Recourse and Default
Authors: Gete Pedro , Zecchetto Franco
Published: May 2023

We show that mortgage recourse systems, by discouraging default, magnify the impact of nominal rigidities. They cause deeper and more persistent recessions. This mechanism can account for up to 31% of the recovery gap during the Great Recession between the U.S., mostly a non-recourse economy, and Spain, a recourse economy. General equilibrium effects explain most of the differences between mortgage systems. With recourse, highly indebted homeowners dramatically cut consumption in a crisis, and account for a larger share of the aggregate consumption decline. However, without recourse, mortgages would be more expensive for riskier households, and homeownership rates would be lower.
Tannin-based product in feedlot diet as a strategy to reduce enteric methane emissions of Nellore cattle finished under tropical conditions
Authors: Magnani Elaine , Silva Thiago H , Sakamoto Leandro , Manella Marcelo Q , Dias Fabio M G N , Mercadante Maria E , Henry Darren , Marcatto Juliana O S , Paula Eduardo M , Branco Renata H
Published: May 2023

A total of 120 Nellore bulls, [initial body weight (BW) = 307 ± 11.6 kg and 12 mo of age] were allocated into 12 collective pens (10 bulls per pen) in a commercial feedlot to evaluate the effects of a specific blend of tannin and saponins on enteric methane (CH4) emissions. The study was a completely randomized design, in which pens were considered the experimental units (N = 6 pens per treatment) and were randomly allocated into one of two treatments: 1) Control (CON), a basal diet with monensin supplementation (25 mg/kg dry matter [DM]; Rumensin, Elanco Animal Health, Greenfield, IN, USA), or 2) Control + a specific blend of tannin and saponins (TAN; 0.7 g/kg DM; composed of quebracho and chestnut tannin extracts along with carriers from cereals rich in saponins; SilvaFeed BX, Silvateam, San Michele Mondovi, CN, Italy). After the adaptation period (20 d), the experiment was divided into two phases: growing phase (21 to 53 d; total of 33 d) and fattening phase (54 to 139 d; total of 86 d). Enteric methane emissions were estimated using the sulfur hexafluoride (SF6) tracer gas technique. Interactions between treatment and period (growing vs. fattening) were detected for daily CH4 emissions, in which animals fed TAN reduced CH4 emissions by 17.3% during the fattening period compared to bulls fed CON (P = 0.05). In addition, bulls fed TAN had lower CH4 emissions expressed by dry matter intake (DMI) during the fattening period compared to bulls fed CON (P = 0.06). The findings presented herein indicate that a specific blend of tannin and saponins can be used as a strategy to reduce enteric CH4 emissions and its intensity of Nellore bulls finished in feedlot systems under tropical conditions.
Amelioration of cognition impairments in the valproic acid-induced animal model of autism by ciproxifan, a histamine H3-receptor antagonist
Authors: Taheri Farahnaz , Esmaeilpour Khadijeh , Sepehri Gholamreza , Sheibani Vahid , Shekari Majid Asadi
Published: May 2023

Autism spectrum disorder is a neurodevelopmental disorder characterized by deficits in social communication and repetitive behavior. Many studies show that the number of cognitive impairmentscan be reduced by antagonists of the histamine H3 receptor (H3R). In this study, the effects of ciproxifan (CPX) (1 and 3 mg/kg, intraperitoneally) on cognitive impairments in rat pups exposed to valproic acid (VPA) (600 mg/kg, intraperitoneally) wereexamined on postnatal day 48–50 (PND 48–50) using marble-burying task (MBT), open field, novel object recognition (NOR), and Passive avoidance tasks. Famotidine (FAM) (10, 20, and 40 mg/kg, intraperitoneally) was also used to determine whether histaminergic neurotransmission exerts its procognitive effects via H2 receptors (H2Rs). Furthermore, a histological investigation was conducted to assess the degree of degeneration of hippocampal neurons. The results revealed that repetitive behaviors increased in VPA-exposed rat offspring in the MBT. In addition, VPA-exposed rat offspring exhibited more anxiety-like behaviors in the open field than saline-treated rats. It was found that VPA-exposed rat offspring showed memory deficits in NOR and Passive avoidance tasks. Our results indicated that 3 mg/kg CPX improved cognitive impairments induced by VPA, while 20 mg/kg FAM attenuated them. We concluded that 3 mg/kg CPX improved VPA-induced cognitive impairments through H3Rs. The histological assessment showed that the number of CA1 neurons decreased in the VPA-exposed rat offspring compared to the saline-exposed rat offspring, but this decrease was not significant. The histological assessment also revealed no significant differences in CA1 neurons in VPA-exposed rat offspring compared to saline-exposed rat offspring. However, CPX3 increased the number of CA1 neurons in the VPA + CPX3 group compared to the VPA + Saline group, but this increase was not significant. This study showed that rats prenatally exposed to VPA exhibit cognitive impairments in the MBT, open field, NOR, and Passive avoidance tests, which are ameliorated by CPX treatment on PND 48–50. In addition, morphological investigations showed that VPA treatment did not lead to neuronal degeneration in the CA1 subfield of the hippocampus in rat pups.
Pharmacological evaluation of lateral habenula and rostromedial tegmental nucleus in the expression of ethanol-induced place preference
Authors: Gakare Sukanya G. , Ugale Rajesh R.
Published: May 2023

Although ethanol administration produces a range of physiological effects, the rewarding aspect associated with its consumption is a major contributory factor to its abuse liability. Recently, lateral habenula (LHb) has been shown to be engaged by both rewarding and aversive stimuli. Its major glutamatergic output, the fasciculus retroflexus, projects to the rostromedial tegmental nucleus (RMTg) and controls the activity of the ventral tegmental area (VTA) dopaminergic system to promote reward circuitry. While several attempts have been made to understand the relationship between LHb and addiction, there is still a lack of knowledge in relation to ethanol addiction. In the present study, by pharmacologically exacerbating or inhibiting the LHb or RMTg neuronal activity during a post-conditioning test, we investigated the role of LHb-RMTg fasciculus retroflexus in ethanol-induced reward behavior using the conditioned place preference (CPP) test. We found that activation of LHb glutamatergic system by intra-LHb administration of l-trans-2,4-pyrrolidine dicarboxylate (PDC) (glutamate transporter inhibitor) significantly decreased CPP score; on the contrary, lamotrigine (inhibits glutamate release) significantly increased CPP score and showed a rewarding effect in CPP. Instead, intra-RMTg administration of muscimol (GABAA receptor agonist) significantly increased CPP score, whereas bicuculline (GABAA antagonist) treatment decreased CPP score. In immunohistochemistry, we found that PDC administration significantly decreased, whereas lamotrigine treatment significantly increased tyrosine hydroxylase immunoreactivity (TH-ir) in VTA and nucleus accumbens (NAc). Furthermore, while intra-RMTg administration of muscimol increased, the bicuculline treatment significantly decreased the TH-ir in VTA and NAc. Together, our behavioral and immunohistochemical results signify the role of LHb and RMTg in the expression of ethanol-conditioned reward behavior.
Understanding the impact of transformational leadership on nurse compassion provision through a time-lagged field study
Authors: Larson Jeffrey D. , Perkins Benjamin G. , Chawla Nitya , Ellis Aleksander P. J.
Published: May 2023

Background

A large volume of literature identifies positive, rejuvenating benefits associated with giving compassion to others. However, the relationship between giving compassion and feelings of exhaustion remains underexplored. Understanding when giving compassion can potentially lead to feelings of emotional exhaustion is particularly important for nurses who are called upon to provide high levels of compassion to suffering patients in their daily work. We suggest that by engaging in transformational leadership behaviors, frontline supervisors can help nurses realize the positive benefits associated with giving compassion.

Purpose

The aim of this study was to examine the impact of nurses’ perceptions of transformational leadership offered by their supervisors on the relationship between the levels of compassionate behaviors nurses report engaging in with patients and feelings of emotional exhaustion and job satisfaction.

Methodology/Approach

A time-lagged field survey was conducted across two waves of 112 full-time employed inpatient nurses within the United States.

Results

Providing high levels of compassionate behavior to patients was associated with reduced (increased) perceptions of emotional exhaustion and increased (decreased) job satisfaction when supervisors engaged in higher (lower) levels of transformational leadership.

Discussion

Transformational leadership serves as an important resource to help caregivers such that nurses feel invigorated and satisfied, as opposed to drained or fatigued, when engaging in high levels of compassionate behaviors toward suffering patients.

Practice Implications

For nurses to fully reap the established positive benefits associated with providing compassion to patients, frontline supervisors should be encouraged to engage in behaviors reflective of transformational leadership.
Closed-Loop Deep Brain Stimulation for Psychiatric Disorders
Authors: Widge Alik S.
Published: May 2023

Deep brain stimulation (DBS) is a well-established approach to treating medication-refractory neurological disorders and holds promise for treating psychiatric disorders. Despite strong open-label results in extremely refractory patients, DBS has struggled to meet endpoints in randomized controlled trials. A major challenge is stimulation “dosing”—DBS systems have many adjustable parameters, and clinicians receive little feedback on whether they have chosen the correct parameters for an individual patient. Multiple groups have proposed closed loop technologies as a solution. These systems sense electrical activity, identify markers of an (un)desired state, then automatically deliver or adjust stimulation to alter that electrical state. Closed loop DBS has been successfully deployed in movement disorders and epilepsy. The availability of that technology, as well as advances in opportunities for invasive research with neurosurgical patients, has yielded multiple pilot demonstrations in psychiatric illness. Those demonstrations split into two schools of thought, one rooted in well-established diagnoses and symptom scales, the other in the more experimental Research Domain Criteria (RDoC) framework. Both are promising, and both are limited by the boundaries of current stimulation technology. They are in turn driving advances in implantable recording hardware, signal processing, and stimulation paradigms. The combination of these advances is likely to change both our understanding of psychiatric neurobiology and our treatment toolbox, though the timeframe may be limited by the realities of implantable device development.
Intraobserver Repeatability Assessment of the S390L Firefly WDR Slitlamp in Patients With Dry Eye Disease: Objective, Automated, and Noninvasive Measures
Authors: Ballesteros-Sánchez Antonio , Gargallo-Martínez Beatriz , Gutiérrez-Ortega Ramón , Sánchez-González José-María
Published: May 2023

Objectives:

To assess the intraobserver repeatability of automated, objective, and noninvasive measures obtained with the S390L Firefly WDR slitlamp.

Methods:

This cross-sectional study included 50 eyes of patients with dry eye disease with a mean age of 55.06±12.96 years. Three consecutively repeated measures of the following variables were obtained: first noninvasive break-up time (F-NIBUT), average noninvasive break-up time (A-NIBUT), tear meniscus height, tear meniscus area (TMA), nasal ciliary hyperemia (NCIH), temporal ciliary hyperemia (TCIH), nasal conjunctival hyperemia (NCOH), temporal conjunctival hyperemia (TCOH), upper loss area meibomian gland (U-LAMG), lower loss area meibomian gland (L-LAMG), upper meibomian gland dysfunction grade (U-MGD grade), and lower meibomian gland dysfunction grade (L-MGD grade). Intraobserver repeatability was estimated with coefficient of variation (CoV), intrasubject standard deviation (SD) (Sw), and Bland–Altman plots.

Results:

All variables showed no statistically significant differences in the repeated-measures analysis except for L-MGD grade (P=0.045). F-NIBUT and A-NIBUT obtained the highest CoV with an average value of 0.48±0.41 [0.02–1.00] and 0.34±0.25 [0.02–1.00], respectively. The remaining variables showed CoVs between 0.04±0.11 [0.00–0.43] and 0.18±0.16 [0.00–0.75]. A-NIBUT, TMA, NCOH, and L-LAMG obtained an Sw of 2.78s, 0.21 mm2, <0.001, and 4.11%, respectively. Bland–Altman plots showed a high level of agreement between pairs of repeated measures.

Conclusion:

The S390L Firefly WDR slitlamp has moderate intraobserver repeatability for F-NIBUT and A-NIBUT, which suggests that F-NIBUT and A-NIBUT are tests with high variability. The remaining variables show satisfactory intraobserver repeatability.
Association Between Longitudinal 10-2 Central Visual Field Change and the Risk of Visual Acuity Loss in Mild-to-Moderate Glaucoma
Authors: Wu Jo-Hsuan , Moghimi Sasan , Nishida Takashi , Kamalipour Alireza , Liebmann Jeffrey M. , Fazio Massimo , Girkin Christopher A. , Zangwill Linda M. , Weinreb Robert N.
Published: May 2023

Précis:

Faster worsening of 10-2 visual field (VF) was associated with the development of visual acuity (VA) loss in mild-to-moderate glaucoma, suggesting longitudinal 10-2 VF change is associated with the risk of VA impairment.

Purpose:

To examine whether longitudinal 10-2 central VF change is associated with the risk of VA loss in glaucoma.

Patients and Methods:

Primary open angle glaucoma and glaucoma suspect eyes with ≥3 years and 5 visits of 10-2 VF examinations were included. Cox proportional hazard modeling with shared frailty was used to evaluate the hazard ratio (HR) of 10-2 VF mean deviation (MD), superior hemifield mean sensitivity (hemi-MS), and inferior hemi-MS worsening rates for developing VA loss, defined as a change in logMAR VA ≥95% test-retest variability.

Results:

Among the 252 eyes (148 participants, mean follow-up = 5.8 y), 30 eyes (21 participants, mean follow-up = 4.9 y) developed VA loss. There was no difference in baseline VF between eyes with and without VA loss (P > 0.05). Eyes with VA loss showed faster 10-2 VF MD worsening [−0.39 (95% CI: −0.60, −0.18) dB/y] and hemi-MS decrease (range: −0.42~−0.38 dB/y), as compared with no-VA loss eyes [10-2 VF MD change = −0.11 (−0.16, −0.07) dB/y; hemi-MS change: −0.12~−0.07 dB/y; P < 0.05]. In the multivariable model, faster 10-2 VF MD worsening [HR (95% CI) = 4.05 (1.61, 10.22), per 1 dB/y faster], superior hemi-MS decrease [HR (95% CI) = 7.07 (2.48, 20.14), per 1 dB/y faster], and inferior hemi-MS decrease [HR (95% CI) = 8.32 (1.99, 34.91), per 1 dB/y faster] were all associated with increased risk of developing VA loss (P < 0.05).

Conclusions:

Faster 10-2 VF MD and hemifield MS worsening are associated with the development of VA loss. Monitoring the longitudinal central 10-degree VF change may suggest that there is impending VA impairment in glaucoma.
Slow-Coagulation Transscleral Cyclophotocoagulation Laser Treatment for Medically Uncontrolled Secondary Aphakic Adult Glaucoma
Authors: Elhusseiny Abdelrahman M. , Khodeiry Mohamed M. , Liu Xiangxiang , Sayed Mohamed S. , Lee Richard K.
Published: May 2023

Précis:

Slow-coagulation CW-TSCPC is an efficacious, relatively safe, and non-incisional laser treatment option as an initial surgical glaucoma management choice, in secondary aphakic adult glaucoma that is medically uncontrolled.

Purpose:

This study evaluates the outcomes of slow-coagulation continuous wave transscleral cyclophotocoagulation (CW-TSCPC) laser for treating secondary aphakic adult glaucoma after complicated cataract surgery as a primary surgical intervention.

Materials and Methods:

A retrospective chart review of adult aphakic eyes with medically uncontrolled glaucoma underwent slow-coagulation CW-TSCPC as a primary surgical glaucoma intervention was performed. Surgical success was the primary outcome measure. Success was defined as postoperative intraocular pressure (IOP) between 6 and 21 mm Hg with ≥20% reduction compared with baseline and no need for further glaucoma surgeries or development of vision-threatening complications. The secondary outcomes included changes in IOP, glaucoma medication numbers, visual acuity, and postoperative complications during the first year after laser treatment after laser treatment.

Results:

This study included 41 eyes of 41 patients. The mean age of study participants was 66.7±13.1 years, with a mean follow-up duration of 19±3.5 months. At one year, the success rate was 63.4%. A statistically significant reduction of the IOP was observed, with the mean IOP decreasing from 29.6±5.8 mm Hg with a mean of 3.9±1.0 medications at baseline to a mean of 19.0±6.4 mm Hg with a mean of 2.5±1.2 medications at 12 months (P<0.001). Four eyes received CW-TSCPC retreatment, and 2 eyes required incisional glaucoma surgeries. Reported postoperative complications included: visual acuity decline ≥2 lines in 7 eyes, iritis in 6 eyes, hyphema in 5 eyes, cystoid macular edema in 2 eyes, and transient hypotony in 1 eye.

Conclusion:

Slow-coagulation CW-TSCPC is an efficacious, relatively safe, and non-incisional laser treatment option as an initial surgical glaucoma management choice, in secondary aphakic adult glaucoma that is medically uncontrolled.
Mediastinitis After Congenital Heart Surgery: Epidemiology, Clinical Features and Outcomes
Authors: Villaverde Serena , Carbonell-Sahuquillo Silvia , López Fernández Eduardo , Belda Hofheinz Sylvia , Ramos Casado Victoria , García-Torres Enrique , Montañés Elena , Prieto Luis Manuel
Published: May 2023

Mediastinitis after surgery for congenital heart disease has a great impact on morbidity and mortality. However, there are scarce studies focused on the epidemiology of postsurgical mediastinitis in pediatric patients. In this 18-year period retrospective study, the cumulative incidence of mediastinitis was low: 0.64%, (95% confidence interval: 0.36–1.1). Gram-negative bacilli were common (35%). The mortality rate was 7.1%, associated with fungal infection.
High-throughput Sequencing to Identify Bacteremia in Children with Cancer
Authors: McLaren Son H. , Mishra Nischay , Hijiya Nobuko , Ng James , Guo Cheng , Whittier Susan , Mariani Erica , Glaser Laura , Frantzis Irene , Vindas Marc T. , Leu Cheng-Shiun , Dayan Peter S.
Published: May 2023

Current methods to diagnose bacteremia are limited. In this pilot study of children with cancer presenting with fever, we determined the concordance between a novel high-throughput sequencing platform called BacCapSeq and blood culture. High-throughput sequencing had modest concordance with blood culture. Discordant organisms included those with both unlikely or potential clinical relevance.
Bacterial Colonization of the Lower Airways in Children With Esophageal Atresia
Authors: van Tuyll van Serooskerken Eleonora Sofie , Duhoky Rauand , Verweij Johannes W. , Bont Louis , Arets Hubertus G.M. , Bittermann Arnold J.N. , van der Zee David C. , Tytgat Stefaan H.A.J. , Lindeboom Maud Y.A.
Published: May 2023

Background:

Esophageal atresia (EA) is most often accompanied by some degree of tracheomalacia (TM), which negatively influences the airway by ineffective clearance of secretions. This can lead to lower airway bacterial colonization (LABC), which may cause recurrent respiratory tract infections (RTIs). This study aims to evaluate the prevalence and specific pathogens of LABC in EA patients.

Methods:

A 5-year retrospective single-site cohort study was conducted including all EA patients that had undergone an intraoperative bronchoalveolar lavage (BAL) during various routine surgical interventions. Concentrations of greater than 10 cfu were considered evidence of LABC.

Results:

We recruited 68 EA patients, of which 12 were excluded based on the exclusion criteria. In the remaining 56 patients, a total of 90 BAL samples were obtained. In 57% of the patients, at least 1 BAL sample was positive for LABC. Respiratory symptoms were reported in 21 patients at the time of the BAL, of which 10 (48%) had LABC. Haemophilus influenzae (14%) and Staphylococcus aureus (16%) were most frequently found in the BAL samples. The number of respiratory tract infections and the existence of a recurrent fistula were significantly associated with LABC (P = 0.008 and P = 0.04, respectively).

Conclusions:

This is the first study showing that patients with EA have a high prevalence of bacterial colonization of the lower airways which may be a leading mechanism of severe and recurrent respiratory complications.
Early Childhood COVID-19: A Comparative Report of 20,506 Cases
Authors: Zamani Raha , Zare Amir , Davoodi Seyedeh Zahra , Shati Mohsen , Eshaghi Hamid , Faramarzinia Arian , Mirjamali Nima , Barekati Seyed Hamed , Lornejad Hamidreza
Published: May 2023

This report includes a retrospective analysis of 20506 children aged under 6 years old admitted with Coronavirus Disease of 2019 in Iranian hospitals. The total mortality rate was 2.9%, and 5.7% required mechanical ventilation. We demonstrate a higher mortality rate in comparison with existing studies as well as identifying clinical predictors of survival.
Bacteremia in Pediatric Liver Transplant Recipients
Authors: Lubell Tamar R. , Cruz Andrea T. , Tanverdi Melisa S. , Ochs Julie B. , Lobritto Steven , Saini Sukhpreet , Mavrogiorgos Evangelia , Dayan Peter S.
Published: May 2023

Background:

We aimed to determine the frequency of bacteremia, septic shock and bacterial meningitis in pediatric liver transplant recipients (pLTRs) in the outpatient setting and to identify clinical factors associated with bacteremia.

Methods:

Multicenter retrospective study of pLTRs evaluated in the emergency department or outpatient clinic between 2010 and 2018 for suspected infection, defined as fever ≥38 °C or a blood culture obtained. We excluded patients with nontransplant immunodeficiency, multiorgan transplants or intestinal failure. The primary outcome was bacteremia; secondary outcomes included fluid-refractory septic shock, bacterial meningitis and antibiotic resistance. The unit of analysis was the encounter.

Results:

A total of 151 children had 336 encounters for infection evaluation within 2 years of transplant. Of 307 (91.4%) encounters with blood cultures, 17 (5.5%) had bacteremia, with 10 (58.8%) occurring within 3 months of transplant. Fluid-refractory septic shock and bacterial meningitis occurred in 7 of 307 (2.8%) and 0 of 307 encounters, respectively. Factors associated with bacteremia included closer proximity to transplant (<3 months) [odds ratio (OR): 3.6; 95% confidence interval (CI): 1.3–9.8; P = 0.01], shorter duration of illness (OR: 4.3; 95% CI: 1.5–12.0; P < 0.01) and the presence of a central venous catheter (CVC) (OR: 12.7; 95% CI: 4.4–36.6; P < 0.01). However, 5 (29.4%) encounters with bacteremia had none of these factors. Among Gram-positive pathogens, 1 of 7 (14.2%) isolates were resistant to vancomycin. Among Gram-negative pathogens, 3 of 13 (23.1%) isolates were resistant to 3rd generation cephalosporins.

Conclusions:

Bacteremia was an important cause of infection within 2 years of pLTR. Clinical factors increased the risk of bacteremia. Further, large sample studies should derive multivariable models to identify those at high and low risk of bacteremia to optimize antibiotic use.
Neonatal Parotitis: A Case Report and Review of the Literature
Authors: Pollenus Julie , Van Lierde Stefaan
Published: May 2023

Background:

Neonatal parotitis is a rare disease. Between 1970 and 2011 only 44 cases have been reported in the English literature.

Methods:

In this case report, we describe a case of neonatal parotitis caused by Group B streptococcus (GBS). Additionally, we performed a review of the recent literature. We found 18 new cases published between 2011 and 2020. These cases were analyzed together with the 44 cases published before 2011.

Results:

All patients presented with swelling over the parotid area, with varying degrees of local inflammation and general symptoms. Purulent discharge from the Stensen’s duct was present in 85% of the patients. The swelling was usually unilateral (84%). In total 70% of the patients were male. Prematurity was reported in 29% of the cases. The most common isolated pathogen wasStaphylococcus aureus(68%). Only 5 cases were found describing GBS as the causative pathogen in neonatal parotitis. In most of the cases treatment with intravenous antibiotics was successful, 27% of the patients needed surgical drainage. The reported outcomes were good.

Conclusions:

When comparing GBS cases and non-GBS cases there seems to be a difference in presenting symptoms and pathophysiology, with GBS patients presenting without purulent discharge form the Stensen’s duct and with more severe generalized symptoms. Additionally, all GBS patients had a positive blood culture, compared to 27% of the non-GBS patients, which indicates that in GBS cases the major route of parotid infection is hematogenous, compared to a retrograde flow from the oral cavity to the parotid gland in non-GBS cases.
Early-life adversity increases morphine tolerance and persistent inflammatory hypersensitivity through upregulation of δ opioid receptors in mice
Authors: Singleton Sam , Sneddon Claire , Bakina Alice , Lambert Jeremy J. , Hales Tim G.
Published: May 2023

Exposure to severely stressful events during childhood is associated with poor health outcomes in later life, including chronic pain and substance use disorder. However, the mediators and mechanisms are unclear. We investigated the impact of a well-characterized mouse model of early-life adversity, fragmented maternal care (FC) between postnatal day 2 and 9, on nociception, inflammatory hypersensitivity, and responses to morphine. Male and female mice exposed to FC exhibited prolonged basal thermal withdrawal latencies and decreased mechanical sensitivity. In addition, morphine had reduced potency in mice exposed to FC and their development of tolerance to morphine was accelerated. Quantitative PCR analysis in several brain regions and the spinal cords of juvenile and adult mice revealed an impact of FC on the expression of genes encoding opioid peptide precursors and their receptors. These changes included enhanced abundance of δ opioid receptor transcript in the spinal cord. Acute inflammatory hypersensitivity (induced by hind paw administration of complete Freund's adjuvant) was unaffected by exposure to FC. However, after an initial recovery of mechanical hypersensitivity, there was a reappearance in mice exposed to FC by day 15, which was not seen in control mice. Changes in nociception, morphine responses, and hypersensitivity associated with FC were apparent in males and females but were absent from mice lacking δ receptors or β-arrestin2. These findings suggest that exposure to early-life adversity in mice enhances δ receptor expression leading to decreased basal sensitivity to noxious stimuli coupled with accelerated morphine tolerance and enhanced vulnerability to persistent inflammatory hypersensitivity.
Impact of Occupations and Hobbies on the Severity of Carpal Tunnel Syndrome
Authors: Shields Lisa B.E. , Iyer Vasudeva G. , Daniels Michael W. , Zhang Yi Ping , Shields Christopher B.
Published: May 2023

Objective

This study describes the clinical and electrodiagnostic (EDX) findings as well as occupations and hobbies in 613 patients diagnosed with carpal tunnel syndrome (CTS).

Methods

Patients with moderate, moderately severe, or severe CTS based on EDX criteria were included.

Results

The most common occupations included workers in offices, construction/maintenance, and assembly lines. The occupation severity scores were greatest in garment workers, musicians, and landscapers. Regardless of occupation, patient age and occupation duration were significantly correlated (P < 0.001). Gardeners had the highest average severity score of the hobbies, followed by painters, those who sew, and individuals who perform house chores.

Conclusions

Physicians should be aware of particular occupations and hobbies associated with a greater risk of severe CTS and offer modifications to their patients’ work duties and hobbies to minimize the likelihood of developing severe CTS.
Iranian traditional medicinal plants for management of chronic heart failure: A review
Authors: Keihanian Faeze , Moohebati Mohsen , Saeidinia Amin , Mohajeri Seyed Ahmad
Published: May 2023

Chronic heart failure is a public health problem with a high prevalence worldwide and an important topic in clinical cardiology. Despite of advances in the drug treatment strategy for heart failure, the number of deaths from this condition continues to rise. It will be a renewed focus on preventing heart failure using proven and perhaps novel drugs. Management will also focus on comorbid conditions that may influence the progression of the disease. Traditional medicine has a potential to introduce different approaches for treatment of some disorders. We here reviewed top medicinal plants, according to traditional medicine to experimental studies, and their potency for the treatment of chronic heart failure based on the evidence of their functions.
Analysis of immune subtypes in non-small-cell lung cancer based on TCGA database
Authors: Xie Xuexue , Chen Gonghai , Song Wei
Published: May 2023

Immunotherapy is one of the main therapeutic approaches for non-small-cell lung cancer (NSCLC). Based on the poor response of immunotherapy, it is crucial to determine the most accurate and widespread predictive characteristics of NSCLC. We retrieved lung squamous cell carcinoma and lung adenocarcinoma gene expression profiles and clinical data from the cancer genome atlas database and classified them into 3 subtypes based on 29 immune gene sets. Combined with previous studies, the expression differences of related pathways and genes in different subtypes were analyzed. We classified them into 3 subtypes: Immunity High, Immunity Medium, and Immunity Low. Immunity High had the strongest immune cell infiltration and antitumor immune activity. Gene ontology enrichment analyses revealed enriched immune-related signaling pathways in lung squamous cell carcinoma. The hyperactivation of cancer-related pathways did not occur in any NSCLC. In addition, the Hippo signaling pathway was negatively correlated with immune signature, whereas epithelial-to-mesenchymal transition was positively correlated. In addition, we found significant differences in immune signatures between males and females; however, no correlation was observed with other clinical data. The identification of NSCLC subtypes based on immune signatures has potential clinical implications for NSCLC treatment.
A network pharmacological-based study of the mechanism of Liuwei Dihuang pill in the treatment of chronic kidney disease
Authors: Xie Xi , Lou Hongjun , Shi Ye , Gan Guang , Deng Hanqing , Ma Xinwei , Meng Mingfang , Gao Xi
Published: May 2023

Background:

Chronic kidney disease (CKD) is a progressive disease that poses a huge economic burden to society. Liuwei Dihuanng pill is an effective treatment for chronic kidney disease, but its treatment mechanism is unclear. The rapid development of network pharmacology has provided new strategies for studying Chinese medicine.

Method:

The traditional Chinese medicine systems pharmacology database and analysis platform was used to obtain the bioactive components and targets of Liuwei Dihuanng pill. The sources for the CKD-related targets were then obtained from the Genecards, OMIM, TTD, and DisGeNET databases. R was used to identify the intersecting genes for Liuwei Dihuang pill and CKD-related targets. Analysis of protein-protein interactions (PPI) was performed using STRING, and PPI networks and drug-component-target networks were constructed using Cytoscape software. Kyoto encyclopedia of genes and genomes pathway and gene ontology enrichment analyses were performed using R. Finally, molecular docking was performed to determine the binding activity between bioactive components and the targets.

Result:

After screening and data de-duplication of 74 active components, 209 drug targets, and 14,794 disease targets, a total of 204 drug-disease targets were acquired. Subsequently, a drug-component-target network and PPI network were established. The primary components of Liuwei Dihuang pill included quercetin, stigmasterol, kaempferol, beta-sitosterol, tetrahydroalstonine, kadsurenone, hederagenin, hancinone C, diosgenin, and sitosterol. In addition, JUN, AKT1, TP53, RELA, MAPK1, FOS, TNF, IL6, ESR1, and RXRA were identified as the main targets. Gene ontology function enrichment analysis revealed that these targets were involved in reactive oxygen species metabolic processes, responses to metal ions and to chemical stimuli, G protein-coupled amine receptor activity, and nuclear factor receptor activity. Kyoto encyclopedia of genes and genomes enrichment analysis showed that these targets were involved in the AGE-RAGE signaling pathway, IL-17 signaling pathway, TNF signaling pathway, and so on. Molecular docking results indicated good binding activity between the core targets and core components.

Conclusion:

The potential mechanism of Liuwei Dihuanng pill in the treatment of CKD was preliminarily discussed in this study, providing a theoretical basis and evidence for further experimental research.
Identification of immune cell infiltration profiles in renal cell carcinoma and their clinical significance
Authors: Wang Le , Song Lei
Published: May 2023

Renal cell carcinoma (RCC) is the most common malignancy of the urinary system, accounting for 3.7% of all new malignancies. The prognosis of RCC patients is still poor, especially patients in advanced stage. Limited studies have fully clarified the role of immune cell infiltration profiles in the prognosis and immunotherapy of RCC. In current study, we evaluated the abundance of the 22 tumor-infiltrating immune cells (TIICs) with CIBERSORT methods. The correlation between TIICs and clinicopathological parameters, tumor immune dysfunction and exclusion (TIDE) score and immunophenoscore (IPS) of RCC patients were also explored. Significant correlations were obtained between TIICs subpopulation and specific clinicopathologic parameters of RCC, including age, gender, tumor grade, clinical stage, T stage and distant metastasis. Moreover, RCC patients with high level of memory activated CD4 T cells, follicular helper T cells and regulatory T cells had a worse overall survival (OS) rate. RCC patients with high level of CD 8 + T cells and M1 macrophages had a lower TIDE score and higher anti-CTLA IPS, higher anti-PD1 IPS as well as higher anti-PD1/CTLA4 IPS. Our results clarified the immune cell infiltration profiles of RCC. RCC patients with high level of CD 8 + T cell and M1 macrophages had a lower TIDE score and higher IPS, suggesting that RCC patients with high level of CD 8 + T cell and M1 macrophages may benefit from immunotherapy.
The impact of laparoscopic, open, extended right, and left colectomy on clinical outcomes of splenic flexure colon cancer: A meta-analysis
Authors: Cheng Hefei , Zhou Minjian , Yang Lianlei , Sui Ziqi
Published: May 2023

Background:

Surgical intervention is the recommended line for the management of colon cancer. The aim of this study was to evaluate the impact of different surgical techniques (laparoscopic, open, extended right, and left colectomy) on clinical outcomes such as mortality, postoperative complications, operation and hospitalization time, and oncological factors.

Methods:

A total of 15 studies have been included in the current study. The outcomes of these studies were analyzed using a random-effect model and it was used to calculate the mean difference with 95% confidence intervals to quantify the impact of open, laparoscopic, extended right, and left colectomy. Inclusion criteria included studies in which subjects undergo splenic flexure colon cancer surgery with 2 comparable different surgical techniques.

Results:

Laparoscopic splenic flexure colon cancer surgery showed a significant beneficial impact on the length of hospital stay (P < .001), the volume of blood loss during surgery (P < .001), postoperative complications (P < .001), and time to an oral diet (P < .001). On the other hand, there was no significance regarding anastomotic leakage, infection of the surgical site, and operation time. Regarding the comparison between extended right colectomy (ERC) and lift colectomy (LC), analysis findings showed a significant (P = .001) higher efficacy of ERC in harvested number of lymph nodes compared with LC. On the other hand, there was no significant difference for the rest of the parameters. The neoadjuvant therapy as an influencing factor on postoperative outcome showed a beneficial impact regarding the overall survival rate.

Conclusion:

Laparoscopic splenic flexure colon cancer surgery showed a significant beneficial impact compared with open surgery as proved by clinical outcomes. On the other hand, ERC and LC resulted in similar findings except for harvested lymph nodes, results were in favor of ERC.
Treating open tibular fracture (Type gustillo IIIA) with medullary nail assisted by cortex screws: A case report
Authors: Jiang Yuchen , Zhou Jiaqian , Tang Bingwang , Zhu Xingfei
Published: May 2023

Background:

Open fractures of the tibia are mostly caused by high-energy injuries, accompanied by severe soft tissue injuries. Staged operations are reported performing better prognosis in these cases.

Case summary:

The author reports a case of open comminuted fracture of the left tibia (GustilloIIIA) and discusses its clinical features and treatment experience with the literature. The patient was admitted to our hospital by an ambulance for half an hour due to pain in her left leg caused by a car collision on an electric bike. During hospitalization, external fixation and an intramedullary nail were sequential used.

Conclusion:

The case report suggests that cortex screws are likely benefit the prognosis of severe open tibial fracture.
Multicenter randomized control study of the efficacy of SO clip in colorectal endoscopic submucosal dissection (ESD). (SO clip study in colorectal ESD): Randomized controlled trial
Authors: Taki Shinya , Iguchi Mikitaka , Fukatsu Kazuhiro , Shimokawa Toshio , Kinoshita Ikuharu , Syunsuke Ogata , Maekita Takao , Kinoshita Jun , Takao Masaki , Kitano Masayuki
Published: May 2023

Introduction:

Endoscopic submucosal dissection (ESD) allows the en bloc resection of colorectal epithelial tumors regardless of size. Although ESD is minimally invasive and yields favorable outcomes, it is technically difficult and requires a long procedure time. In addition, colorectal ESD is associated with a particularly high risk of complications, due to the thin bowel wall, bowel flexion, and peristalsis.

Direct visualization of the submucosal layer by traction of the lesion after mucosal dissection would make ESD performance easier. S-O clips traction lesions toward the lumen, facilitating direct visualization of the submucosal layer, resulting in efficient dissection due to the traction effect and adequate dissection depth. Use of this traction device can contribute to shortening the procedure time and reducing the risk of complications. This multicenter randomized controlled trial will evaluate the usefulness of the S-O clip in colorectal ESD and assess the procedure time and frequency of complications associated with the procedure.

Methods/design:

This multicenter, randomized control trial will enroll 200 patients at 4 hospitals in Japan undergoing ESD for colorectal epithelial tumors. Patients who meet the inclusion and exclusion criteria will be randomized to undergo ESD using S-O clips or conventional ESD. Patients will be randomized by a computer-generated random sequence with stratification by operator experience (trainee or expert), tumor location (colon/rectum), and institution. The primary endpoint will be ESD procedure time, defined as the time from the start of the local injection into the submucosal layer to the end of dissection. Other outcomes will include the rates of procedural complications, en bloc resection and cure.

Discussion:

ESD using the S-O clip is expected to shorten procedure time, reduce the incidence of adverse events, and standardize the procedure. This study may resolve clinical questions about whether ESD using the S-O clip traction device is more effective and safer than conventional ESD.
Performance of a simplified nutrition screening tool for outpatient radiotherapy cancer patients
Authors: Wongdama Supisara , Lertsiripatarajit Piyawat , Wongdama Supasuta , Virojanapa Kris , Chuthapisith Suebwong , Siriussawakul Arunotai , Dankulchai Pittaya , Thanakiattiwibun Chayanan , Pramyothin Pornpoj
Published: May 2023

Public hospitals in Thailand recently adopted a new nutrition screening tool to satisfy documentation requirements for reimbursements through the diagnosis-related group system. However, data on the performance of this instrument remains limited. This study was designed to assess the validity and cutoff points of the Society of Parenteral and Enteral Nutrition of Thailand (SPENT) nutrition screening tool against the patient-generated subjective global assessment (PG-SGA) and malnutrition diagnostic criteria proposed by the global leadership initiative on malnutrition (GLIM) in cancer patients receiving outpatient radiation therapy. A cross-sectional study of 350 patients was conducted from August 2018 to September 2020. All patients were screened for malnutrition using the SPENT nutrition screening tool. The instrument’s sensitivity, specificity, positive predictive value, negative predictive value, and agreement were calculated using either the PG-SGA or GLIM malnutrition diagnosis as benchmarks. The cutoff that gave the highest sensitivity and specificity of the SPENT nutrition screening tool was selected. The mean age standard deviation of the 350 cancer patients was 59.9 (13.9) years, and 191 (54.6%) were men. Head and neck cancers were the most common type (35.7%). Against PG-SGA and GLIM malnutrition diagnosis, the SPENT nutrition screening tool demonstrated good sensitivity (85.3% and 82.8%), specificity (84.1% and 59.4%), positive predictive value (90.5% and 64.0%), negative predictive value (76.3% and 79.9%), with moderate strength of agreement (Cohen kappa 0.678, P < .001 and 0.414, P < .001). Using only the first 2 out of 4 questions revealed an acceptable sensitivity and specificity. The SPENT nutrition screening tool is an accurate, sensitive, and specific tool for malnutrition screening in cancer patients receiving outpatient radiotherapy.
NOTCH2NLC mutation-positive neuronal intranuclear inclusion disease with retinal dystrophy: A case report and literature review
Authors: Katayama Takayuki , Takahashi Kae , Yahara Osamu , Sawada Jun , Ishida Ken-ichi , Asanome Asuka , Endo Hisako , Saito Tsukasa , Hasebe Naoyuki , Kishibe Mari , Kanno Harumi , Ishiko Satoshi , Sone Jun
Published: May 2023

Introduction:

Neuronal intranuclear inclusion disease (NIID) is a neurodegenerative disorder that produces a broad spectrum of clinical conditions such as dementia, upper motor neuron involvement, extrapyramidal symptoms, and neuropathy. Some studies have reported ophthalmological conditions associated with the disease; however, the details of these conditions remain unclear.

Patient concerns:

We report a 63-year-old Japanese female with cognitive decline, blurred vision, photophobia, and color blindness at 52 years of age who was diagnosed with cone dystrophy. She also had anxiety, insomnia, depression, delusions, hallucinations, a wide-based gait with short steps, and urinary incontinence.

Diagnoses, interventions, and outcomes:

Magnetic resonance imaging revealed diffuse cerebral white matter changes and subcortical hyperintensity on diffusion-weighted imaging. Skin biopsy showed p62-positive intranuclear inclusions in sweat glands. NOTCH2NLC gene analysis revealed abnormal GGC expansion; therefore, NIID was diagnosed.

Conclusion:

NOTCH2NLC mutation-positive NIID may be associated with retinal dystrophy. Brain magnetic resonance imaging and skin biopsy are helpful diagnostic clues, and gene analysis is crucial for accurate diagnosis and appropriate management.
Charlson comorbidity index and 1-year poor outcomes in elderly patients undergoing successful percutaneous coronary intervention: A retrospective study
Authors: Balun Ahmet , Akgümüş Alkame
Published: May 2023

Elderly patients with acute syndrome are frailer due to the burden of comorbidity. Comorbidities that increase with age result in an increased risk of mortality in patients with acute coronary syndrome (ACS). Many scales have been developed to assess the burden of comorbidity, including the Charlson Comorbidity Index (CCI). The aim of our study is to show the effect of the CCI on 1-year mortality and poor clinical outcomes in elderly patients who underwent percutaneous coronary intervention due to ACS. This single-center retrospective study included 704 patients aged 75 years and older. The study population consisted of patients who were admitted to the hospital with ACS between April 2017 and September 2021 and underwent successful percutaneous intervention. The patients were divided into 3 groups according to their CCI scores as CCI 0 (n:156), 1 (n:266), and ≥2 (n:282). Stroke development was significantly higher in patients with CCI scores ≥ 2 compared to the other 2 groups (P = .005). Mortality rates were found to be 28.4%, 7.5%, and 2.6% in patients with CCI ≥ 2, CCI 1, and CCI 0, respectively. The mortality rate of the CCI ≥ 2 group was significantly higher than those of the other 2 groups (P < .001). The multivariate Cox proportional hazard regression model showed that CCI was an independent predictor for 1-year all-cause mortality (hazard ratio: 1.632; 95% confidence interval: 1.403–1.898; P < .001). CCI may contribute to treatment and follow-up management, as it indicates a poor prognosis in elderly patients who have undergone percutaneous coronary intervention.