bluuebunny/crossref_metadata_2025 huggingface dataset:
Self-Treatment and Family Treatment
Authors: Bulger Jeffrey W.
Published: September 2024

Treating family members or friends can lead to a compromised patient–practitioner relationship, causing issues with confidentiality, informed consent, and intimate examinations. This practice violates the patient’s positive right to a fair and impartial practitioner and is categorized as unprofessional and a potential form of healthcare misconduct. Exceptions to these practices for healthcare emergencies, minor and commonplace conditions, and situations independent of the necessity of having a patient–practitioner relationship can be made. However, they should be uncommon and not lead to an unacceptable standard of care. The American Medical Association Code of Medical Ethics Opinion 1.2.1 states, “Physicians [practitioners] should not treat themselves or members of their own families.”
Sterilization
Authors: Bulger Jeffrey W.
Published: September 2024

The right to sterilization as a form of birth control has been determined as a fundamental constitutional right under the 14th Amendment’s due process clause. This means that all adults with decisional capacity have the autonomous right to request, access, and consent to sterilization without interference from others. The patient’s autonomy must be respected, and practitioners have a professional obligation to provide patient-centered care that respects the patient’s informed consent and that is in line with the patient’s reasonable goals, values, and priorities. If a practitioner declines to perform the sterilization procedure, they must provide unbiased information and a referral to a qualified practitioner. The concept of reproductive justice, which includes the right to legal sterilization, is an essential public policy and a response to past injustices of forced sterilization programs.
Bullying, cyberbullying, and suicide
Authors: Nadeem Tania , Hamid Sahar N. , Mahr Fauzia , Asad Nargis
Published: September 2024

Bullying is defined as the intent to harm another with repeated aggressive behaviour in the presence of a power imbalance. Bullying is a significant public health issue for adolescents across the world. Bullying in all its forms takes its toll on the mental health of all: the perpetrator, the bystander, and the victim. There is a large amount of research that shows a strong link between increased suicidal ideation for victims and perpetrators of traditional bullying. This chapter will discuss different forms of bullying and its association with suicide, especially focusing on data from low- to middle-income countries and the effect of culture in this paradigm. The importance of preventive programmes focusing on individuals, families, communities, and schools will also be explored.
Relative Effectiveness and Immunogenicity of Quadrivalent Recombinant Influenza Vaccine Versus Egg-Based Inactivated Influenza Vaccine Among Adults Aged 18–64 Years: Results and Experience From a Randomized, Double-Blind Trial
Authors: Grant Lauren , Whitaker Jennifer A , Yoon Sarang K , Lutrick Karen , Bhargava Shivam , Brown C Perry , Zaragoza Emily , Fink Rebecca V , Meece Jennifer , Wielgosz Kristina , El Sahly Hana , Hegmann Kurt T , Lowe Ashley A , Southworth Alia , Tatum Tanya , Ball Sarah W , Levine Min Z , Thiese Matthew S , Battan-Wraith Steph , Barnes John , Phillips Andrew L , Fry Alicia M , Dawood Fatimah S ,   Randomized Assessment of Influenza Vaccine Efficacy Network (RAIVEN), Mayo-Lamberte Julie , Blanton Lenee , Healy Catherine Mary , McKell Jacob , Brown Rachel , Williams Jesse , Campbell Riley , Randal Fornessa T
Published: September 2024

Background

Immunogenicity studies suggest that recombinant influenza vaccine (RIV) may provide better protection against influenza than standard-dose inactivated influenza vaccines (SD IIV). This randomized trial evaluated the relative vaccine effectiveness (VE) and immunogenicity of RIV versus SD IIV in frontline workers and students aged 18–64 years.

Methods

Participants were randomized to receive RIV or SD IIV and followed for reverse-transcription polymerase chain reaction (RT-PCR)–confirmed influenza during the 2022–2023 influenza season. Sera were collected from a subset of participants before and at 1 and 6 months postvaccination and tested by hemagglutination inhibition for A/H1N1, A/H3N2, B/Yamagata, and B/Victoria and against cell-grown vaccine reference viruses for A/H1N1 and A/H3N2.

Results

Overall, 3988 participants were enrolled and vaccinated (25% of the trial sample size goal); RT-PCR–confirmed influenza occurred in 20 of 1963 RIV recipients and 28 of 1964 SD IIV recipients. Relative VE was 29% (95% confidence interval [CI], −26% to 60%). In the immunogenicity substudy (n = 118), the geometric mean titer ratio (GMTR) comparing RIV to SD IIV at 1 month was 2.3 (95% CI, 1.4–3.7) for cell-grown A/H1N1, 2.1 (95% CI, 1.3–3.4) for cell-grown A/H3N2, 1.1 (95% CI, .7–1.6) for B/Victoria, and 1.4 (95% CI, .9–2.0) for B/Yamagata. At 6 months, GMTRs were >1 against A/H1N1, A/H3N2, and B/Yamagata.

Conclusions

Relative VE of RIV compared to SD IIV did not reach statistical significance, but RIV elicited more robust humoral immune responses to 2 of 4 vaccine viruses at 1 month and 3 of 4 viruses at 6 months after vaccination, suggesting possible improved and sustained immune protection from RIV.

Clinical Trials Registration. NCT05514002.
Efficacy, Safety, and Tolerability of Switching From Bictegravir/Emtricitabine/Tenofovir Alafenamide to Dolutegravir/Lamivudine Among Adults With Virologically Suppressed HIV: The DYAD Study
Authors: Rolle Charlotte-Paige , Castano Jamie , Nguyen Vu , Hinestrosa Federico , DeJesus Edwin
Published: September 2024

Background

In TANGO and SALSA, switching to dolutegravir/lamivudine (DTG/3TC) was noninferior to continuing a baseline regimen among adults who were treatment experienced, although few switched from bictegravir (B) / emtricitabine (F) / tenofovir alafenamide (TAF). Here, we present the efficacy and safety of switching to DTG/3TC as compared with continuing with B/F/TAF among adults with virologic suppression.

Methods

DYAD is an open-label clinical trial that randomized adults with HIV-1 RNA <50 copies/mL and no prior virologic failure (2:1) to switch to once-daily fixed-dose DTG/3TC or maintain B/F/TAF. The primary end point is the proportion with HIV-1 RNA ≥50 copies/mL at week 48 (Food and Drug Administration Snapshot algorithm, intention-to-treat exposed population, 6% noninferiority margin).

Results

Overall, 222 adults were randomized (16% women, 51% aged ≥50 years, 28% Black). At week 48, 6 (4%) with DTG/3TC and 5 (7%) with B/F/TAF had HIV-1 RNA ≥50 copies/mL (treatment difference, −2.8%; 95% CI, −11.4% to 3.1%), meeting noninferiority criteria. Through week 48, 18 participants (12 with DTG/3TC, 6 with B/F/TAF) met confirmed virologic withdrawal (CVW) criteria, and 2 of 18 had resistance: 1 with B/F/TAF developed M184M/I and G140G/S at week 12, and 1 with DTG/3TC had M184V at week 12. One participant with DTG/3TC and non-CVW developed M184V and K65R at week 12. Drug-related adverse events (AEs) and withdrawals due to AEs occurred in 31 (21%) and 6 (4%) participants with DTG/3TC and 2 (3%) and 0 participants with B/F/TAF, respectively.

Conclusions

Switching to DTG/3TC was noninferior to continuing B/F/TAF among adults with virologic suppression at week 48. Drug-related AEs and withdrawals were higher in the DTG/3TC arm, which is likely consistent with the open-label nature of this switch study.
The neurophysiological effects of detached and positive reappraisal during the regulation of self-conscious emotions
Authors: Zhu Leling , Fu Tingyu , Yan Xinyu , Yuan Jiajin , Yang Jiemin
Published: September 2024

Background

While cognitive reappraisal represents a promising emotion regulation strategy in regulating basic emotions, little experimental research has investigated its efficacy in reducing self-conscious emotions such as shame and guilt.

Objective

The present study aimed to investigate the effectiveness of detached reappraisal and positive reappraisal in regulating feelings of shame and guilt, and also compared the effectiveness of these two strategies using behavioral and event-related potentials.

Method

Thirty-nine participants grouped either in positive reappraisal or detached reappraisal condition were informed to advise the decider to perform a dot-estimation task. Participants were also informed that the payment of the decider would be reduced if he/she adopted the wrong advice provided by them.

Result

The behavioral results demonstrated that both regulation strategies reduced shame and guilt when compared to the observation stage. We also observed a phenomenon (absent during the regulation of shame) where regulating guilt resulted in a higher parietal P3 amplitude, a component related to negative experiences, compared to the observation phase in the detached reappraisal group.

Conclusion

The results demonstrated that both regulation strategies were able to regulate self-conscious emotions (shame, guilt) effectively. The findings of this study enhance our understanding of the neurophysiological effects of different regulation strategies on self-conscious emotions.
Multifaceted bioactivity of marine fungal derived secondary metabolite, xyloketal B -a review
Authors: Udayan Sreelekshmi Puthuvalnikarthil , Hariharan Sini , Nevin Kottayath Govindan
Published: September 2024

Background

A growing number of findings have focused on the distinctive physiochemical characteristics that marine microorganisms have acquired as a result of their adaptation to the challenging conditions inherent in the marine environment. It has been established that the marine environment is a very rich source of bioactive substances with a variety of biological effects and structural diversity. A major discovery was the extraction of xyloketals from Xylaria sp. Numerous thorough studies have subsequently been carried out to determine the medicinal potential of these bioactive components. Xyloketals are thought to be a very promising and significant class of naturally occurring substances with a wide range of potent biological activities, such as radical scavenging, suppression of cell proliferation, reduction of neonatal hypoxic-ischemic brain injury, antioxidant activity, inhibition of acetylcholine esterase, inhibition of L-calcium channels, and others. Xyloketal B is one of the most potent molecules with significant therapeutic properties among the numerous variants discovered.

Conclusion

This review summarizes the structural characterization of all naturally occurring xyloketal compounds, especially the B derivative with an emphasis on their bioactivity and provides an outline of how xyloketals operate in diverse disease scenarios.
Known Distribution of the Soybean Cyst Nematode, Heterodera glycines, in the United States and Canada Through 2023
Authors: Tylka Gregory L. , Marett Christopher C.
Published: September 2024

The soybean cyst nematode (SCN), Heterodera glycines Ichinohe, is a major yield-reducing pathogen of soybean ( Glycine max [L.] Merrill) in the United States and Canada, causing twice as much yield loss annually as any other pathogen. Reports of new discoveries of SCN in areas of the United States and Canada that grow the crop can lead to greater awareness of the pathogen and increased efforts to scout for the nematode. Beginning in January 2024, university nematologists, plant pathologists, and agronomists as well as government plant health officials in soybean-producing states in the United States and provinces in Canada were queried about the known distribution of the nematode. This publication contains an updated map of the known distribution of SCN in the United States and Canada through 2023 and a listing of counties and rural municipalities where the nematode initially was identified between 2000 and 2023. In total, there were 31 counties in 10 states in the United States plus three counties total in Manitoba and Ontario and 10 rural municipalities in Quebec, Canada, in which SCN was first discovered between 2020 and 2023. The results show that the distribution of SCN in the United States and Canada continues to expand, and sustained scouting for the presence of the pathogen is warranted to facilitate management to reduce soybean yield losses.

[Formula: see text] Copyright © 2025 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Confronting Adversity
Authors: Machado Kayzuka Giovanna C. , Nascimento Lucila Castanheira , Walsh Susan M. , Jeremiah Rohan D. , Obrecht Jennifer A. , Leite Adriana Moraes
Published: September 2024

Background and Significance:

In neonatal intensive care, the communication of difficult news can have lingering repercussions throughout the lives of those receiving such information. Uncertainty and stress associated with the COVID-19 pandemic may negatively influence this sensitive yet essential communication process.

Purpose:

To analyze the communication of difficult news during the COVID-19 pandemic from the perspective of parents of newborns admitted to a neonatal intensive care unit.

Methods:

A qualitative, descriptive research study was completed in a hospital in Brazil. Individual and semistructured interviews were conducted with 21 parents of newborns hospitalized in an intensive care unit and submitted to thematic analysis.

Results:

Three themes were built: “Tools and strategies to manage difficult news,” “What makes difficult news hard to listen,” and “The importance of being prepared to receive difficult news.” When comparing these findings with prepandemic literature, the COVID-19 period changed communication dynamics, including coping tools and altered family dynamics. Additionally, assessing healthcare providers’ positive and negative behaviors by parents could clarify essential skills to support the family’s hospitalization process during a crisis.

Implications for Practice and Research:

Applying and investing in skills training such as spirituality assessment, providing clear and straightforward information, and empathy can reduce the impact of difficult news and, thus, requires both recognition and action from healthcare professionals. Knowing some of the effects COVID-19 had on the communication process for parents with critically ill infants, healthcare providers can better prepare themselves for communication in several scenarios and establish successful interactions.
Survival After Simple Compared With Radical Hysterectomy for Patients With Early-Stage Cervical Cancer
Authors: Viveros-Carreño David , Agusti Nuria , Wu Chi-Fang , Melamed Alexander , Nitecki Wilke Roni , Kanbergs Alexa , Pareja René , Zamorano Abigail S. , Rauh-Hain J. Alejandro
Published: September 2024

OBJECTIVE:

To assess the effect on overall survival of simple hysterectomy with lymph node staging compared with radical hysterectomy with lymph node staging for patients with early-stage cervical cancer.

METHODS:

We conducted a retrospective cohort study of patients in the National Cancer Database diagnosed with early cervical carcinoma of 2 cm or smaller (stage IA1 with lymphovascular space invasion through IIA1, International Federation of Gynecology and Obstetrics staging) from 2010 to 2019. After 1:1 propensity score matching, we compared patients who underwent simple hysterectomy with lymph node staging and those with radical hysterectomy with lymph node staging. The variables used for matching were age, tumor size, race and ethnicity, lymphovascular space invasion, year of diagnosis, Charlson–Deyo comorbidity score, histology, and surgical approach. The primary outcome was overall survival at the end of follow-up. Secondary outcomes included 30-day readmission rate and 30- and 90-day mortality rates.

RESULTS:

In total, 4,167 patients met the inclusion criteria, of whom 2,637 patients (63.3%) underwent radical hysterectomy and lymph node staging and 1,530 patients (36.7%) underwent simple hysterectomy and lymph node staging. After propensity score matching, 1,529 patients in each group were included. There was no statistically significant difference in overall survival between patients who underwent simple hysterectomy and those who underwent radical hysterectomy (hazard ratio 1.25, 95% CI, 0.91–1.73, P=.17). Subgroup analysis by histology, lymphovascular space invasion, tumor size, and surgical approach did not reveal statistically significant differences in overall survival according to hysterectomy type. The hysterectomy groups also did not significantly differ in 30-day readmission rate (4.6% vs 4.2%, P=.73), 30-day mortality rate (0.1% vs 0%, P=.14), or 90-day mortality rate (0.1% vs 0.1%, P=.93).

CONCLUSION:

Patients with low-risk cervical cancer could undergo less radical surgery without a negative effect on their oncologic outcomes.
Oocyte Cryopreservation in Transgender and Gender-Diverse Individuals With or Without Prior Testosterone Use
Authors: Cromack Sarah Capelouto , Walter Jessica R. , Smith Kristin N. , Elvikis Jennifer , Bazzetta Sarah E. , Goldman Kara N.
Published: September 2024

To evaluate oocyte cryopreservation among transgender and gender-diverse adolescents and young adults with or without prior testosterone exposure, we performed a retrospective cohort study of all patients younger than age 35 years referred for oocyte cryopreservation through our formal fertility-preservation program from 2014 to 2023. The number of patients referred and pursuing fertility preservation increased over time. Among the 93 patients referred, 37 pursued oocyte cryopreservation (31 testosterone-naïve and six testosterone-exposed). Among the latter, neither length of time on testosterone before presentation nor duration off testosterone before retrieval (minimum 2 months) were associated with the number of mature oocytes frozen. When comparing testosterone-naïve with testosterone-exposed individuals, there was no difference in number of oocytes retrieved (median 28 vs 32, P=0.43) or mature oocytes frozen (21 vs 21, P=0.95).
Geographical and Specialty-specific Variation in the Utilization of Laminoplasty for Cervical Myelopathy
Authors: Alqazzaz Aymen , Zhuang Thompson , Dehghani Bijan , Barchick Stephen R. , Ozturk Ali K. , Khalsa Amrit S. , Casper David S.
Published: September 2024

Study Design:

Level IV retrospective cohort study.

Objectives:

Despite the positive outcomes associated with laminoplasty, there is significant surgeon variability in the use of laminoplasty for cervical myelopathy in the United States. In this study, we explored how geographic and specialty-specific differences may influence the utilization of laminoplasty to treat cervical myelopathy.

Background:

We queried the Mariner 157 database (PearlDiver, Inc.), a national administrative claims database containing diagnostic, procedural, and demographic records from over 157 million patients from 2010 to 2021.

Patients and Methods:

Using the International Classification of Diseases 10th Revision/International Classification of Diseases Ninth Revision and Current Procedural Terminology codes, we identified all patients with a diagnosis of cervical myelopathy who had undergone multilevel posterior cervical decompression and fusion (PCDF) or laminoplasty. We further analyzed patients’ demographics, comorbidities, geographical location, and specialty of the surgeon (neurosurgery or orthopedic spine surgery).

Results:

There were 34,432 patients with a diagnosis of cervical myelopathy, of which 4,033 (11.7%) underwent laminoplasty and 30,399 (88.3%) underwent multilevel PCDF. Northeast, South, and West regions had lower percentages of laminoplasty utilization compared with the Midwest in terms of total case mix between laminoplasty and PCDF. In addition, 2,300 (57.0%) of the laminoplasty cases were performed by orthopedic spine surgeons compared with 1,733 (43.0%) by neurosurgeons. Temporal trends in laminoplasty utilization were stable for orthopedic surgeons, whereas laminoplasty utilization decreased over time between 2010 and 2021 for neurosurgeons (P < 0.001).

Conclusions:

Utilization of laminoplasty in the United States is not well defined. Our results suggest a geographical and training-specific variation in the utilization of laminoplasty. Surgeons with orthopedic training were more likely to perform laminoplasty compared with surgeons with a neurosurgery training background. In addition, we found greater utilization of laminoplasty in the Midwest compared with other regions.
Antiseizure Medications in Adult Patients With Traumatic Brain Injury: A Systematic Review and Bayesian Network Meta-Analysis
Authors: Angriman Federico , Taran Shaurya , Angeloni Natalia , Devion Catherine , Lee Jong Woo , Adhikari Neill K. J.
Published: September 2024

OBJECTIVES:

We sought to evaluate the effectiveness of any antiseizure medication on the incidence of early post-traumatic seizures among adult patients with traumatic brain injury.

DATA SOURCES:

MEDLINE, Embase, PubMed, Cochrane Central Register of Controlled Trials, and LILACS were searched from inception to October 2023.

STUDY SELECTION:

We included randomized trials of adult patients with traumatic brain injury evaluating any antiseizure medication compared with either placebo or another agent.

DATA EXTRACTION:

Two reviewers independently extracted individual study data and evaluated studies for risk of bias using the Cochrane Risk of Bias tool. Our main outcome of interest was the occurrence of early seizures (i.e., within 7 d); secondary outcomes included late-seizures and all-cause mortality.

DATA SYNTHESIS:

Bayesian network meta-analyses were used to derive risk ratios (RRs) alongside 95% credible intervals (CrIs). We used Grading of Recommendations Assessment, Development, and Evaluation methodology to rate the certainty in our findings. Overall, ten individual randomized controlled trials (1851 participants) were included. Compared with placebo, phenytoin (RR, 0.28; 95% CrI, 0.13–0.57; moderate certainty) and levetiracetam (RR, 0.20; 95% CrI, 0.07–0.60; moderate certainty) were associated with a reduction in the risk of early seizures. Carbamazepine may be associated with a reduced risk of early seizures, but the evidence is very uncertain (RR, 0.41; 95% CrI, 0.12–1.27; very low certainty). Valproic acid may result in little to no difference in the risk of early seizures, but the evidence is very uncertain (RR, 0.97; 95% CrI, 0.16–9.00; very low certainty). The evidence is very uncertain about the impact of any antiseizure medication on the risk of late seizures or all-cause mortality at longest reported follow-up time.

CONCLUSIONS:

Phenytoin or levetiracetam reduce the risk of early seizures among adult patients with traumatic brain injury. Further research is needed to evaluate required duration of therapy and long-term safety profiles.
Lycopene exerts cytotoxic effects by mitochondrial reactive oxygen species–induced apoptosis in glioblastoma multiforme
Authors: Ko Huey-Jiun , Su Yu-Feng , Loh Joon-Khim , Tsai Cheng Yu
Published: September 2024

Background

Glioblastoma multiforme (GBM) faces challenges with standard treatments, prompting exploration into alternative approaches. Reactive oxygen species (ROS) are implicated in cancer development, making antioxidants from natural sources, such as lycopene in tomatoes, promising candidates. This study aimed to assess the effectiveness of lycopene in GBM.

Materials and Methods

The PAMPA-BBB assay predicted lycopene penetration. After treating GBM8401 and T98G GBM cells with lycopene, flow cytometry assessed cell cycle and apoptosis, while the CCK-8 assay measured antiproliferative efficacy. Colony formation assay examined cell growth, and intracellular and mitochondrial ROS levels were quantified. Western blot analyzed protein levels of p-ERK/ERK, p53, and cyclin-related proteins.

Results

Our results demonstrated lycopene penetration across the blood-brain barrier and its induction of apoptosis, inhibiting proliferation in GBM8401 and T98G GBM cells. In addition, lycopene promoted p53 upregulation and suppressed cyclins B and cyclin D, leading to cell cycle arrest through ROS-activated ERK pathways.

Conclusions

In conclusion, our study focused on lycopene’s potential in GBM treatment, revealing its ability to induce apoptosis, inhibit proliferation, and regulate the cell cycle through ROS-activated ERK pathways. These findings suggest lycopene as a promising candidate for preventing and treating GBM by targeting ROS-induced cell proliferation, paving the way for future research.
Impact of expected blood pressure reduction on patient preferences for pharmaceutical and renal denervation treatment
Authors: Pathak Atul , Weber Michael A. , Poulos Christine , Cohen Sidney A. , DeBruin Vanessa , Kandzari David E.
Published: September 2024

Background:

Effective patient-centered care requires an adequate understanding of patient preferences for different therapeutic options. We modelled patient preference for blood pressure (BP) management by pharmaceutical or interventional treatments such as renal denervation in patients with different profiles of uncontrolled hypertension.

Methods:

Modeling was based on the findings from a previously conducted quantitative discrete choice experiment (DCE). The likelihood of selecting either an interventional treatment option or additional antihypertensive medication option was calculated for three patient profiles that represent the range of patients with hypertension commonly encountered in clinical practice: treatment-naive, patients with uncontrolled BP while on one to three antihypertensive medications, and patients with drug-resistant hypertension. Variables in the preference model were treatment attributes from the DCE study: expected reduction in office SBP with each treatment, duration of treatment effect, risk of reversible drug side effects from drugs, and risk of temporary pain and/or bruising or vascular injury from interventions. Values of the variables were derived from published clinical studies or expert opinion.

Results:

The model predicted that the likelihood of choosing an intervention over initiating pharmacotherapy was 17.2% for previously untreated patients, 23.7% for patients with moderate hypertension currently on pharmacotherapy, and 41.8% for patients with drug-resistant hypertension. The dominant variable driving preference in these models was the expected BP reduction. Patient preferences for intervention are greater when drug nonadherence or increased SBP reduction at 3 vs. 1 year are included in the model. Baseline BP, drug side effects, or risks of the procedure had little influence on decisions.

Conclusion:

Modeling using patient preference weights predicts that a substantial minority of patients favor an interventional treatment such as renal denervation over initiation or escalation of medications. Awareness of a patient's interest in device-based versus pharmaceutical strategies should inform the shared decision-making process for hypertension treatment.
Investigation of Oral Candida Colonization in COVID-19 Patients With Dysgeusia
Authors: Oz Ali , Oz Yasemin , Demir Betul , Hamarat Hatice , Ermis Sevilay Sureyya , Alkan Tali Ozge , Fidan Vural , Metintas Selma
Published: September 2024

Background

The mechanism of dysgeusia in coronavirus disease (COVID-19) is also still debated. Although excess of Candida in the oral cavity can cause changes in the sense of taste, it is not known whether there is a relationship between Candida colonization on the surface of the tongue and dysgeusia occurred in COVID-19. We aimed to evaluate the frequency and species distribution of Candida colonization on dorsum the tongue in patients with dysgeusia after COVID-19, in addition various factors that may be associated with dysgeusia and colonization.

Methods

This case-control study was conducted in a tertiary care hospital for 3 months. Participants were divided into the following 3 groups: patients with dysgeusia who have had COVID-19 confirmed with PCR; patients with no dysgeusia who have had COVID-19 in the last 3 months; and healthy volunteers. Scraping samples from the surface of dorsum the tongue were obtained from all participants and used for direct microscopic examination and fungal culture.

Results

A total of 201 participants were analyzed. Any association between dysgeusia and the frequency of Candida colonization or species distribution did not observe. However, the vaccination with mRNA vaccine and tooth brushing habits reduced the frequency of dysgeusia. The frequency of Candida colonization on dorsum the tongue was significantly higher in the participants who smoke or have dentures (P < 0.05), independently COVID-19.

Conclusions

The results of this study may be useful to explain of the factors affecting dysgeusia or Candida colonization.
Assessing the Disruption of Health Services During the COVID-19 Pandemic Among Adults Living With HIV by Age in Essex County, NJ: A Cross-Sectional Study
Authors: Krause Kristen D. , Karr Anita G. , Aggarwal Juhi , Subramhanya Sanjana , DallaPiazza Michelle , Swaminathan Shobha , Valera Pamela , Halkitis Perry N. , Shiau Stephanie
Published: September 2024

At the onset of the COVID-19 pandemic, clinicians and researchers were concerned about its impact on the health of people living with HIV (PLWH). Although mitigation measures during the early part of the pandemic used telehealth, it was uncertain whether PLWH would be amenable to this type of care and whether health outcomes would be affected. PLWH actively seeking treatment at a large urban outpatient practice in Essex County, New Jersey, were interviewed from October 2020 to June 2021 about their health-related experiences during COVID-19. The sample was dichotomized by age (< 55 and ≥ 55). In all, participants (69.2%, n = 92) used telehealth during this period, 85.0% (n = 113) actively tested for COVID-19, with only 7% (n = 8) testing positive at the time of interview. Our findings demonstrate that PLWH who engaged with health care before the COVID-19 pandemic continued doing that and had relatively favorable health outcomes with few differences by age.
Acceptable outcomes of liver transplantation in uninsured patients under the coverage of a state assistance program
Authors: Paterno Flavio , Lee-Riddle Grace S. , Olivo Raquel , Amin Arpit N. , Koneru Baburao , Pyrsopoulos Nikolaos T. , Lunsford Keri E. , Guarrera James V.
Published: September 2024

The lack of health insurance is a major barrier to access to health care, even in the case of life-saving procedures such as liver transplantation (LT). Concerns about worse outcomes in uninsured patients have also discouraged the evaluation and transplantation of patients without adequate health insurance coverage. The aim of this study is to evaluate outcomes from the largest cohort of uninsured patients who underwent LT with the support of a state payment assistance program (also called charity care). This study included all consecutive patients who underwent LT at a single center from 2002 to 2020. Demographic, clinical, and social variables and outcome metrics were collected and compared between insured and uninsured patients. Among a total of 978 LT recipients, 594 had private insurance, 324 government insurance (Medicare/Medicaid), and 60 were uninsured and covered under a state charity care program. In the charity care group, there was a higher proportion of Hispanic subjects, single marital status, younger age, and high-MELD score patients. The 1- and 3-year patient survival rates were 89.0% and 81.8% in private insurance patients, 88.8% and 80.1% in government insurance recipients, and 93.3% and 79.6% in those with charity care (p=0.49). There was no difference in graft survival between insured and uninsured patients (p=0.62). The 3 insurance groups presented similar hospital length-of-stay and 30-day readmission rates. In both univariate and multivariate analysis, uninsured status (charity care) was not associated with worse patient survival (HR: 1.23, 95% CI: 0.84–1.80, p=0.29) or graft survival (HR: 1.22, 95% CI: 0.84–1.78, p=0.29). In conclusion, there was no difference in outcomes after LT between insured and uninsured patients. A charity care program may be an effective tool to mitigate socioeconomic disparities in both outcomes and access to LT.
Risk factors for unclear margin in cold snare polypectomy for colorectal polyp
Authors: Ikeda Ryosuke , Kaneko Hiroaki , Sato Hiroki , Anan Hideyuki , Suzuki Yuichi , Ikeda Aya , Goda Yoshihiro , Sue Soichiro , Irie Kuniyasu , Maeda Shin
Published: September 2024

Objectives

Cold snare polypectomy (CSP) is a common, simple, and safe procedure; however, it has a high rate of unclear margins. We analyzed the risk factors for unclear margins of colorectal polyp.

Methods

We retrospectively investigated colorectal polyps treated with CSP between July 2021 and July 2022, excluding those that could not be retrieved or pathologically nonneoplastic and hyperplastic polyps without margin evaluation. The clinicopathological features and risk factors for unclear margins were analyzed. Furthermore, the polyps were divided into two groups: those resected by experts and those resected by trainees. A 1 : 1 propensity score matching was performed. After matching, the risk factors for unclear margins in each group were analyzed as secondary outcomes.

Results

We analyzed 237 patients with 572 polyps; the margins were negative in 58.6% (negative group) and unclear in 41.4% (unclear group). The unclear margin was significantly higher at straddling folds (P = 0.0001), flexure points (P = 0.005), and in the procedures performed by trainees (P < 0.0001). Altogether, 198 propensity score matched pairs were explored for secondary outcomes. There were no significant differences in risk factors for unclear margins in the expert group, while in the trainee group, the unclear margin was significantly higher at the straddling folds (P = 0.0004) and flexure points (P = 0.005).

Conclusions

We demonstrated that straddling folds, flexure points, and procedures performed by the trainees were significant risk factors for unclear margins, and we hypothesized that the rate of unclear margins will reduce as the trainees accumulate experience at difficult sites.
Hyperthyroidism and hypothyroidism in patients with autoimmune pancreatitis
Authors: Hirano Kenji , Sanga Katsuyuki , Natomi Hisayoshi , Niwa Kazuhiro
Published: September 2024

Objective

The objective of this study is to clarify the clinical features of thyroid dysfunction observed in patients with autoimmune pancreatitis (AIP).

Methods

We repeatedly examined thyroid function in 74 patients with type 1 AIP (58 males, 16 females; average onset age of AIP 67 years). Clinical and serological findings in patients with thyroid dysfunction were analyzed.

Results

During follow-up, clinical and subclinical hypothyroidism were observed in 3 and 17 patients, respectively. Clinical and subclinical hyperthyroidism were observed in 5 and 1 patients, respectively. One patient showed clinical hyperthyroidism followed by subclinical hypothyroidism. All patients with clinical and subclinical hypothyroidism were asymptomatic and required no medical treatment, whereas four patients with clinical hyperthyroidism were symptomatic and received treatment with thiamazole.

Conclusion

Frequent hypothyroidism in AIP, which was previously reported, was confirmed. Moreover, in this study, the association between hyperthyroidism and AIP was demonstrated. Hyperthyroidism in AIP may be more clinically significant than hypothyroidism because patients frequently require medical treatment.
Long-term real-world data of ustekinumab in ulcerative colitis: the Stockholm Ustekinumab Study (STOCUSTE)
Authors: Sabhan Haider , Bello Francesca , Muhsen Samer , Borin Alexandra , Johansson Fredrik , Höög Charlotte , Forsberg Ole , Wennerström Christina , Lördal Mikael , Almer Sven , Söderman Charlotte
Published: September 2024

Background

Ustekinumab (UST) is an anti-interleukin-12/23 antibody used in the treatment of inflammatory bowel disease. This study includes patients treated at four hospitals in Stockholm to provide long-term real-world data.

Methods

Retrospective study including patients diagnosed with ulcerative colitis and treated with UST between the years 2019 and 2021. Patients were followed until withdrawal of treatment, or until a predefined end of study, 31 July 2021. Disease activity was assessed with Physician Global Assessment (PGA); Ulcerative Colitis Endoscopic Index of Severity (UCEIS), laboratory parameters, and drug persistence. The primary outcome was steroid-free remission (PGA = 0) and response (decrease PGA ≥ 1 from baseline) at 3 and 12 months, respectively.

Results

A total of 96 patients, 44 women and 52 men were included. The patients had either extensive colitis (69%), left-sided colitis (29%), or proctitis (3%). All but two patients were anti-TNF-experienced; 94 (98%) had failed ≥1, 59 (61%) ≥ 2, and 34 (35%) had failed ≥ 3 anti-TNF drugs. In addition, 28 (29%) had failed vedolizumab. At inclusion, 92/96 patients (96%) had active disease and four patients were in remission. Among patients who were treated with UST, 9/71 (13%) were in steroid-free remission at 3 months, and 26/33 (78%) were at 12 months. Withdrawal rates at 3 and 12 months, were 12 and 26%, respectively, mainly due to persisting disease activity (20%).

Conclusion

In this group of patients with difficult-to-treat ulcerative colitis, UST was shown to be effective in the majority, with high drug persistence at 12 months in combination with a favorable safety profile.
Expanding the Molecular Spectrum of Carcinoma Ex Pleomorphic Adenoma
Authors: de Lima-Souza Reydson Alcides , Altemani Albina , Michal Michal , Mariano Fernanda Viviane , Leivo Ilmo , Skálová Alena
Published: September 2024

Carcinoma ex pleomorphic adenoma (CXPA) is an aggressive epithelial and/or myoepithelial neoplasm that arises in association with a pleomorphic adenoma (PA). Its etiopathogenesis remains poorly understood, but it is believed that the development of this tumor is due to the accumulation of genetic, protein, metabolic, and epigenetic alterations in a PA. A retrospective review of the Salivary Gland Tumor Registry in Pilsen yielded 84 CXPA, namely 25/84 salivary duct carcinoma (SDC), 15/84 myoepithelial carcinoma (MC), 1/84 epithelial-myoepithelial carcinoma (EMC), and 1/84 adenoid cystic carcinoma (AdCC). All 84 CXPA cases were analyzed by next-generation sequencing (NGS) and/or fluorescence in situ hybridization (FISH). Forty-three tumors originally diagnosed as CXPA (43/84, 51.2%) showed some molecular alteration. Fusion transcripts were identified in 12/16 (75%) CXPA, including LIFR::PLAG1, CTNNB1::PLAG1, FGFR1::PLAG1, and a novel fusion, HMGA2::LINC02389. Most of the fusions were confirmed by FISH using PLAG1 (6/11) and HMGA2 (1/1) gene break probes. Split signals indicating gene break were identified by FISH for PLAG1 (12/17), HMGA2 (3/4), EWSR1 (7/22), and MYB (2/7). Concerning pathogenic mutations, only CXPA with epithelial differentiation (SDC) presented these alterations, including HRAS mutation (2/4), TP53 (1/4), PTEN (1/4), and ATK1 (1/4). In addition, amplifications in ERBB2 (17/35), MDM2 (1/4), and EWSR1 (1/7) were detected. A novel finding was the discovery of an HMGA2::LINC02389 fusion in 1 patient with EMC ex-PA. The present results indicate that molecular profiling of CXPA with myoepithelial differentiation (MC) tends to reveal chromosomal fusion events, whereas CXPA with epithelial differentiation (SDC) tends to have a higher frequency of pathogenic mutations and gene amplifications.
Preserving Fertility in People With Rheumatic Diseases
Authors: Leavitt Molly , Adeleye Amanda , Edens Cuoghi
Published: September 2024

Rheumatology patients historically were told they “can't” or “shouldn't” become pregnant. Improved rheumatic diagnostics and treatments have led to decreased morbidity and mortality and increased quality of life resulting in an opportunity to focus on fertility and its preservation. In the same vein as rheumatic disease care, assisted reproductive technology (ART), which includes freezing of egg and sperm as well as in vitro fertilization, has made considerable strides in the recent past. ART is safe for those with rheumatic diseases and has comparable outcomes to the general public, but may take additional effort due to optimal timing, rheumatic medications, and other nuances. In a specialty that treats chronic inflammatory diagnoses using teratogens and gonadotoxins, it is important to address family building desires with patients so their goals can be met.

Rheumatologists have little knowledge of ART and how it impacts or applies to their patients; however, patients want their rheumatologist to be the source of knowledge for this information (Arthritis Rheumatol. 2022;74:suppl 9). Many barriers to ART exist and will be explored, with the financial burden being paramount (Glob J Health Sci. 6;1:181–191). Future efforts to examine the future fertility of rheumatology patients in an era of biologics and “treat-to-target” are needed to better understand who would most benefit from this costly and not without risk medical treatment. Given the changing landscape of financial support for ART due to insurance mandates, rheumatologists should not modify counseling based on the anticipated ability of patients to afford care. Preservation should also be broached with patients without partners and those from the LGBTQAI+ community. In addition to expanding the education of rheumatologists regarding this topic and its incorporation into clinical care, advocacy for ART access and insurance coverage is a much-needed future direction.
18F-FDG PET/CT Imaging Findings in Adult-Onset Rasmussen Encephalitis
Authors: Tosunoğlu Zehranur , Alçın Göksel , Arslan Esra , Ergül Nurhan , Çermik Tevfik Fikret
Published: September 2024

Rasmussen encephalitis is a rare condition characterized by chronic, progressive encephalitis. Typically, it involves one cerebral hemisphere and manifests through intractable epileptic seizures. Its occurrence in adults is notably infrequent. In this case, we presented the observations from an 18F-FDG PET/CT scan of a 70-year-old man diagnosed with Rasmussen encephalitis, where MRI displayed nonspecific findings.
Cross-Modality Image Translation From Brain 18F-FDG PET/CT Images to Fluid-Attenuated Inversion Recovery Images Using the CypixGAN Framework
Authors: Lee Sangwon , Jung Jin Ho , Choi Yong , Seok Eunyeong , Jung Jiwoong , Lim Hyunkeong , Kim Dongwoo , Yun Mijin
Published: September 2024

Purpose

PET/CT and MRI can accurately diagnose dementia but are expensive and inconvenient for patients. Therefore, we aimed to generate synthetic fluid-attenuated inversion recovery (FLAIR) images from 18F-FDG PET and CT images of the human brain using a generative adversarial network (GAN)–based deep learning framework called the CypixGAN, which combined the CycleGAN framework with the L1 loss function of the pix2pix.

Patients and Methods

Data from 143 patients who underwent PET/CT and MRI were used for training (n = 79), validation (n = 20), and testing (n = 44) the deep learning frameworks. Synthetic FLAIR images were generated using the pix2pix, CycleGAN, and CypixGAN, and white matter hyperintensities (WMHs) were then segmented. The performance of CypixGAN was compared with that of the other frameworks.

Results

The CypixGAN outperformed the pix2pix and CycleGAN in generating synthetic FLAIR images with superior visual quality. Peak signal-to-noise ratio and structural similarity index (mean ± standard deviation) estimated using the CypixGAN (20.23 ± 1.31 and 0.80 ± 0.02, respectively) were significantly higher than those estimated using the pix2pix (19.35 ± 1.43 and 0.79 ± 0.02, respectively) and CycleGAN (18.74 ± 1.49 and 0.78 ± 0.02, respectively) (P < 0.001). WMHs in synthetic FLAIR images generated using the CypixGAN closely resembled those in ground-truth images, as indicated by the low absolute percentage volume differences and high dice similarity coefficients.

Conclusions

The CypixGAN generated high-quality FLAIR images owing to the preservation of spatial information despite using unpaired images. This framework may help improve diagnostic performance and cost-effectiveness of PET/CT when MRI scan is unavailable.
Peritoneal Actinomycosis After Bariatric Surgery Mimicking a Peritoneal Carcinomatosis on 18F-FDG PET/CT
Authors: Fevrier Agathe , Bailly Matthieu , Delalande Flore , Metrard Gilles
Published: September 2024

A 54-year-old man with a history of bypass surgery 3 years ago presented with ascites, abdominal pain, and a decline in general health. CT and 18F-FDG PET/CT suggested peritoneal carcinomatosis, but histology revealed peritoneal actinomycosis. This rare peritoneal infection can occur after digestive surgeries, such as bariatric procedures, due to disruption of the digestive barrier, allowing actinomycosis to spread outside its typical anatomical location. Clinicians should consider this diagnosis after bariatric surgery, even years later, especially in the absence of neoplastic disease.
Simultaneous Metastatic Involvement of Bilateral Testes and Left Spermatic Cord in Prostate Cancer Detected on 68Ga-PSMA-11 PET/CT
Authors: Aggarwal Piyush , Gupta Kirti , Sood Ashwani , Bora Girdhar Singh , Goyal Shikha , Singh Harmandeep , Mittal Bhagwant Rai
Published: September 2024

Bilateral testicular involvement in prostate cancer is quite rare. It is often associated with widespread systemic disease and inadequate response to systemic therapy. We present a case of metastatic prostate cancer with bilateral testicular metastases and simultaneous involvement of the left spermatic cord detected on 68Ga-PSMA-11 PET/CT and confirmed on the histopathology of bilateral orchiectomy done for achieving the androgen deprivation status. Early detection of such unusual sites of metastases has poorer prognostic outcome and management implications.
Incidental Detection of Brain Metastases From a Pulmonary Large Cell Neuroendocrine Carcinoma at 18F-Fluorocholine PET/CT in a Context of Primary Hyperparathyroidism
Authors: Didier Mathilde , Godard François , Fraisse Cléa , Morin Léo , Drouet Clément
Published: September 2024

This 65-year-old man suffering from hypercalcemia in a context of hyperparathyroidism treated by calcimimetics was referred to our institution to perform an 18F-fluorocholine PET/CT in order to localize the pathological parathyroid gland(s). We incidentally discovered a brain metastatic pulmonary large cell neuroendocrine carcinoma in addition to a parathyroid adenoma. This case illustrates the value of FCH PET/CT in hyperparathyroidism workup event under calcimimetic treatment, as well as the potential of FCH PET/CT to reveal occult malignancies.