bluuebunny/crossref_metadata_2025 huggingface dataset:
Intraocular Pressure After Cataract Surgery Combined With Ab Interno Trabeculectomy Versus Trabecular Micro-bypass Stent: An Intrasubject Same-surgeon Comparison
Authors: Weiner Adam J. , Weiner Yotam , Weiner Asher
Published: May 2020

Precis:

Combining Trabectome or iStent with phacoemulsification equally reduces intraocular pressure (IOP) and IOP-lowering medication burden during a 24-month follow-up, with a possible advantage to the Trabectome in the early postoperative period.

Purpose:

Intrasubject same-surgeon comparison between phacoemulsification combined with Trabectome (Phaco/Trabectome) versus one first-generation iStent (Phaco/iStent).

Settings:

Private glaucoma and cataract practice.

Design:

This is a retrospective interventional case series.

Methods:

Data collected at 3 to 4 and 20 to 24 hours and up to 30 months following Phaco/Trabectome in 1 eye and Phaco/iStent in the contralateral eye in patients with bilateral visually-significant cataract and open-angle glaucoma. Evaluations included IOP, intraocular pressure-lowering medications (IOPmeds), visual acuity, and complications.

Results:

Forty-five patients (90 eyes) were identified (age 76.5, 57 to 95 y). At 3 to 4 hours, IOP was above baseline in 12 and 13 eyes following Phaco/Trabectome and Phaco/iStent, respectively, but the degree of IOP elevation was smaller (P=0.048) following Phaco/Trabectome: 4.3 mm Hg, 2.0 to 6.6 mm Hg (95% confidence interval) versus Phaco/iStent: 8.7 mm Hg, 3.8 to 13.6 mm Hg. At 20 to 24 hours, compared with baseline, IOP was significantly lower after Phaco/Trabectome (P=0.004) but not after Phaco/iStent (P=0.14) although the rate of hyphema was higher following Phaco/Trabectome (12/45 vs. 2/45 eyes, P=0.007). IOP reduction from baseline at 3 to 4 hours was significantly larger (P=0.020) in the 21 eyes with hyphema: −3.9, −6.4 to −1.4 versus the 69 eyes without hyphema: −0.3, −2.0 to +1.4. At 1, 6, 12, and 24 months, IOP and number of IOPmeds were similar and significantly lower compared with baseline following either procedure. No complications were encountered in either group.

Conclusions:

Combined phacoemulsification with either Trabectome or first-generation iStent similarly lowers IOP and IOPmeds burden at 1, 6, 12, and 24 months following surgery. The Trabectome may have an advantage in lowering IOP faster and lessening the degree of IOP elevations in the early postoperative period.
Drug Provocation Tests for Assessing Antibiotic Hypersensitivity
Authors: García-Boyano Miguel , Gómez-Traseira Carmen , Umpiérrez Ana María , Quirce Santiago , Boyano-Martínez Teresa
Published: May 2020

Background:

Suspected antibiotic hypersensitivity in children is a frequent reason for consultation. Skin test performance and drug provocation test (DPT) duration are controversial issues. The objective of this study was to assess the effectiveness of diagnostic tests used in the study of antibiotic hypersensitivity and to estimate an optimal duration for DPT.

Methods:

Sixty-two children with a suspected hypersensitivity reaction to antibiotics were studied. Skin tests were performed on all patients. In the case of negative results, DPTs were performed for a duration similar to the time elapsed from the start of treatment until the onset of the reaction.

Results:

The frequency of antibiotic hypersensitivity in the study population was 8.1% (5 of 62). Only 1 patient showed positive skin tests. The other allergic patients were diagnosed by DPT, which reproduced the reaction within the first 6 hours in all but one of them.

Conclusions:

Shortening DPT duration may decrease the sensitivity of the test for the diagnosis of non–IgE-mediated hypersensitivity; however, it should be considered as an opportunity to reduce the resulting microbial resistances.
The Contribution of Physician-System Integrating Structure to Select Health System Outcomes
Authors: Nguyen Ann M. , Johnson Christopher E. , Wood Suzanne J. , Dowling William L.
Published: May 2020

Physician groups are increasingly being vertically integrated with hospitals and health systems; yet, the evidence on the impact of physician-system integration on health system outcomes is mixed. The objective of this study was to examine the impact of increased physician-system integration on select health system outcomes. We used a mixed-methods approach: (1) a fixed-effects multivariate mediation analysis; and (2) a qualitative analysis of interviews with health executives (n = 25). Our findings showed that hospitals spent $633 375.22 to $827 110.24 for each “level” increase in integration. This relationship was attenuated, however, by the presence of care coordination mechanisms.
Nicolau Syndrome Following Metamizole Injection: A Case Report
Authors: Menteşoğlu Dilek , Khurami Hamidullah , Karaduman Ayşen , Gököz Özay
Published: May 2020

Introduction:

Nicolau syndrome is a rare complication following intramuscular injections of various drugs. It is characterized by severe pain, skin and sometimes muscle necrosis after drug injection. However the pathogenesis of Nicolau syndrome remains unclear.

Here, we report a case of Nicolau syndrome following metamizole injection.

Case presentation:

A 35-year-old female presented with an painful necrotic ulcer who developed Nicolau syndrome after an intramuscular injection of metamizole in her right thigh due to reccurent episodes of back pain. This reaction is typical for Nicolau syndrome.

Discussion:

The most common finding of Nicolau syndrome in the early period was severe pain at the injection site. Other common findings were skin discoloration, tenderness, and swelling; indurated livedoid plaques; and erythematous, ecchymotic and purpuric patches. The histopathological results of the case with Nicolau syndrome showed formation of ulceration and fat necrosis.

Conclusion:

Although Nicolau syndrome is an uncommon cutaneous adverse reaction, clinicians should be aware of this complication to prevent or minimize the severity of Nicolau syndrome.
Perceived Organizational Support and Psychological Empowerment
Authors: Caesens Gaëtane , Bouchat Pierre , Stinglhamber Florence
Published: May 2020

This research examined the mediating role of employees’ psychological empowerment in the relationship between perceived organizational support and employee psychological well-being. Our hypotheses were tested using three different sets of cross-sectional data (N = 237, N = 334, and N = 182). Results indicated across the three samples that psychological empowerment mediates the positive relationship between perceived organizational support and employee psychological well-being. Implications for organizational support and psychological empowerment literatures are discussed.
Work-to-Family Conflict and its Associations With Workers’ Burnout, Poor Self-Rated Health, and Minor Mental Disorder
Authors: Pien Li-Chung , Chen I-Shin , Cheng Wan-Ju , Cheng Yawen
Published: May 2020

Objectives:

To examine the distribution of work-to-family conflict (W-FC) across socio-demographic groups and a wide spectrum of occupations, and its associations with workers’ burnout, self-rated health, and mental health status by sex.

Methods:

A cross-sectional household survey of representative employees was conducted in 2013. A standardized questionnaire was administered to collect information.

Results:

W-FC was high in employees aged 35 to 44 years old and in certain occupational groups. Long working hours, rotating work shift, high work demands, high job control, low workplace justice, and family care burden were risk factors for W-FC, and high W-FC score was significantly associated with burnout, poor self-rated health, and minor mental disorder.

Conclusions:

To improve workers’ health, it is essential to identify high risk groups and adopt measures to reduce conflicts between work and family life.
Investigating the Factors Influencing the Attitudes of Workplace Employees Toward Paying to Use Technology-Based Health Care Products
Authors: Chen Mei-Ju , Kao Feng-Hsia
Published: May 2020

Objective:

This study explored whether perceived usefulness and perceived ease-of-use generate mediating effects between personal involvement and attitudes toward paying for usage, and further examining the moderating effects of social influence and company type.

Methods:

Questionnaires were used. A total of 365 employees, 218 from the private sector and 147 from the municipal government in Taipei City were collected.

Results:

Perceived ease-of-use mediates between personal involvement and attitude toward paying for usage. The social influences of different types of public and private employment differ significantly in terms of their moderating effects on personal involvement and perceived ease-of-use.

Conclusion:

Due to the different workplace characteristics of private sector and government employees, they have different attitudes toward paying for technology-based health management applications in the future, and social influence is also an important moderating factor.
Relationship Between Faculty Characteristics and Emotional Exhaustion in a Large Academic Medical Center
Authors: Zivin Kara , Brower Kirk J. , Sen Srijan , Brownlee Rebecca M. , Gold Katherine J.
Published: May 2020

Objective:

We evaluated associations between emotional exhaustion (EE), a measure of burnout, among medical school faculty and: demographic and professional characteristics, workplace stressors, coping skills, resilience, sufficient personal time, and depressive symptoms. Respondents completed surveys in November 2017.

Methods:

We conducted bivariate and multivariable logistic regression and recycled predictions models to estimate associations between characteristics and probability of EE.

Results:

Of 1401 respondents, 42% endorsed EE. Faculty with more clinical effort, more workplace stress, less resilience, less personal time, and more depressive symptoms reported statistically significantly higher probabilities of EE compared with their counterparts. Female sex, mid-career stage, and coping skills were no longer associated with EE, after accounting for stress, resilience, personal time, and depressive symptoms.

Conclusions:

Coping skills may not mitigate physician EE when coupled with substantial time and mental health burdens.
Education and Training to Build Capacity in Total Worker Health®
Authors: Newman Lee S. , Scott Joshua G. , Childress Adele , Linnan Laura , Newhall Wilbert J. , McLellan Deborah L. , Campo Shelly , Freewynn Sabrina , Hammer Leslie B. , Leff Maija , Macy Gretchen , Maples Elizabeth H. , Rogers Bonnie , Rohlman Diane S. , Tenney Liliana , Watkins Cecilia
Published: May 2020

Objective:

Establishment of core competencies for education and training of professionals entering the emerging field of Total Worker Health®.

Methods:

Compilation and distillation of information obtained over a 5-year period from Total Worker Health symposia, workshops, and academic offerings, plus contributions from key stakeholders regarding education and training needs.

Results:

A proposed set of Total Worker Health competencies aligns under six broad domains: Subject Matter Expertize; Advocacy and Engagement; Program Planning, Implementation and Evaluation; Communications and Dissemination; Leadership and Management; and Partnership Building and Coordination.

Conclusions:

Proposed set of core competencies will help standardize education and training for professionals being trained in Total Worker Health. It serves as an invitation for further input from stakeholders in academia, business, labor, and government.
High Right Ventricular Afterload Is Associated with Impaired Exercise Tolerance in Patients with Left Ventricular Assist Devices
Authors: Ton Van-Khue , Ramani Gautam , Hsu Steven , Hopkins C. Danielle , Kaczorowski David , Madathil Ronson J , Mak Susanna , Tedford Ryan J.
Published: May 2020

Patients with left ventricular assist device (LVAD) have poor exercise tolerance. We aimed to characterize relationship between right ventricular (RV) afterload and exercise capacity, RV reserve, and adaptation to load. Twelve well-compensated LVAD subjects underwent right heart catheterization at rest and during symptom-limited exercise. Cardiopulmonary exercise tests were also performed. Hemodynamics were compared with age- and sex-matched subjects with pulmonary arterial hypertension (PAH) and normal non-athletes. Hemodynamic changes were expressed as Δ(exercise − rest). At rest, LVAD subjects had normal biventricular pressures and cardiac output (CO). On exercise, despite similar increases in pulmonary artery wedge pressure (PAWP) between three groups, RV afterload increased only in LVAD cohort (pulmonary elastance [ΔEa] LVAD: 0.4, PAH: 0.1, normal: 0.1 mmHg/ml, p = 0.0024). This afterload increase coincided with the largest rise in right atrial pressure (RAP), lowest change in RV stroke work index, and smallest CO augmentation (ΔCO LVAD: 1.5, PAH: 4.3, normal: 5.7 L/min, p = 0.0014). Peak VO2 negatively correlated with RV afterload (Ea) (r = −0.8, p = 0.0101), while VE/VCO2 slope had the inverse correlation. During exercise, pulmonary artery pulsatility index worsened while RAP:PAWP ratio was unchanged in LVAD subjects. Well-compensated LVAD patients had poor RV reserve and adaptation to load on exercise compared with PAH and normal subjects.
The efficacy of single-photon emission computed tomography in identifying dystonic muscles in cervical dystonia
Authors: Feng Liang , Zhang Zhuoyu , Malam Djibo Issa , Chen Shuzhen , Li Bing , Pan Yougui , Zhang Xiaolong , Xu Yifei , Su Junhui , Ma Hongxing , Teng Fei , Jin Lingjing
Published: May 2020

Introduction

The key point for botulinum toxin type A injection in treating cervical dystonia is to accurately identify dystonic muscles. This study aimed to evaluate the efficacy of 99mtechnetium-sestamibi single-photon emission computed tomography in identifying target muscles in cervical dystonia.

Methods

In the study group (n = 18), target muscles were selected according to clinical evaluation combined with 99mtechnetium-sestamibi single-photon emission computed tomography, while in the control group (n = 18), target muscles were selected by clinical evaluation alone. All patients were followed-up at 2 weeks, 1, 3 and 6 months after botulinum toxin type A injection. The primary outcomes were the reduction rates in Toronto Western Spasmodic Torticollis Rating Scale and Tsui score at 1 month.

Results

Although the reduction rates in Toronto Western Spasmodic Torticollis Rating Scale and Tsui scores were not different between the two groups at 2 weeks and 1 month, the reduction rates in both scores were significantly higher in the study group at 3 and 6 months. The number of patients receiving re-injection within 6 months was significantly lower in the study group. Also, the re-injection interval was significantly longer in the study group. In the study group, more deep cervical muscles were injected, which concerns especially semispinalis capitis, longissimus capitis, and obliques capitis inferior muscles.

Conclusion

99mtechnetium-sestamibi single-photon emission computed tomography is a useful method for screening target muscles in cervical dystonia. It helps clinicians draw a ‘blueprint’ for the distribution of dystonic muscles before botulinum toxin type A injection.
Bovine Lactoferrin Supplementation Does Not Disrupt Microbiota Development in Preterm Infants Receiving Probiotics
Authors: Grzywacz Kelly , Butcher James , Li Jennifer , Barrington Keith , Mohamed Ibrahim , Stintzi Alain
Published: May 2020

Objective:

The aim of the study was to assess whether bovine lactoferrin (bLf) supplementation disrupts intestinal microbiota development in preterm infants less than 31 weeks gestational age receiving prophylactic probiotic administration.

Methods:

Subjects were recruited from the LACUNA trial (ISRCTN66482337), designed to assess bLf safety. These subjects were randomized to daily receive either probiotic supplements or probiotics supplemented with 100 mg bLf mixed with their feeds (human milk or formula). Stools were collected weekly from enrolled infants for 1 month and the microbiota characterized using V6‐16S rRNA gene amplicon profiling.

Results:

Infants’ microbiomes did not increase in alpha diversity over time in both feeding interventions. Infants receiving bLf supplementation had overall higher species richness as compared with those not receiving these supplements and lactoferrin supplementation had differing effects on infant microbiota species richness depending on the infant's gestational age. Principal co‐ordinate analysis revealed that the infant microbiotas did not separate by intervention group, gestational age bracket at birth or sampling time and the main factor dictating sample clustering was infant identity. There were very few detectable differences in taxa relative abundance or functional gene content between the microbiotas in the 2 study groups.

Conclusions:

Bovine lactoferrin supplementation has minimal impact on microbiota composition/function in preterm infants receiving probiotics, and therefore, is unlikely to disrupt microbiota development.
Human and Doll's Hair in a Gastric Trichobezoar, Endoscopic Retrieval Hazards
Authors: Niţă Andreia F. , Hill Chris J. , Lindley Richard M. , Marven Sean S. , Thomson Mike A.
Published: May 2020

Trichobezoars are masses of ingested hair, usually the individual's own hair, that accumulate in the gastrointestinal tract, most commonly in the stomach. When extending into the small intestine, this is termed “Rapunzel syndrome.” Removal has traditionally been by laparotomy; however, successful endoscopic removal has also been described. We report the case of a 9‐year‐old‐girl with undiagnosed coeliac disease and Rapunzel syndrome who underwent endoscopic removal of a large trichobezoar, which was followed by unexpected multiple perforations of the small bowel and stomach. Argon plasma coagulation (APC) and snare electrocautery were employed during endoscopy to remove the trichobezoar piecemeal, and approximately 70% was removed without any clear signs of damage to the mucosa. It was discovered subsequently that about 20 of her dolls were found without hair. On investigating the composition of a specific doll hair from the manufacturer, it was discovered that it could be hazardous if burned. It was, therefore, hypothesized that a constellation of factors had conspired to lead to perforation, that is, the potentially hazardous gas produced from the electrical energy applied to the synthetic hair and possible mucosal damage by the physical abrasion of this hair. A review of the literature on endoscopic attempts to remove trichobezoars irrespective of the result reveals a success rate of 30.7%.
Impact of Transanal Irrigation Device in the Management of Children With Fecal Incontinence and Constipation
Authors: Patel Samit , Hopson Puanani , Bornstein Jeffrey , Safder Shaista
Published: May 2020

Objectives:

Children with fecal incontinence and constipation can be classified into 3 groups: neurogenic bowel dysfunction (NBD) related to spinal cord defects (NBD), refractory constipation (RC), or anorectal malformations (ARMs). The transanal irrigation (TAI) device (Peristeen) was approved in 2012 by the Food and Drug Administration. This system uses a pump rather than gravity to instill water as a colonic irrigant and uses balloon occlusion of the rectum. Our aim was to evaluate the effectiveness of TAI (Peristeen) in children who failed to respond to conservative measures for stool incontinence and constipation.

Methods:

Retrospective study of 147 patients prescribed TAI between January 2014 and January 2020. Data collected included demographics, prior bowel regimen, symptoms before and after, patient satisfaction scores, and NBD scores.

Results:

Of the 147 patients initiated, 114 remain active users (13 lost to follow‐up and 20 discontinued use). Multiple bowel regimens including laxatives (n = 139), cone enema (n = 40), and cecostomy (n = 7) were tried previously. The majority of our patients (n = 85) have NBD, primarily spina bifida, followed by RC (n = 43), and ARM (n = 19). For all patient groups, there was significant improvement in symptoms of fecal incontinence and constipation (P ≤ 0.001). Abdominal pain was improved in the NBD and RC group, but not significantly in the ARM group.

Conclusions:

We provide a single‐center review of a large pediatric cohort using TAI (Peristeen) for management of fecal incontinence and constipation. Peristeen offered significant improvement in patients with NBD, RC, and ARM.
Recurrent Intracranial Bleed in 3 Siblings: Short of a Shot of Vitamin K!
Authors: Mahajan Vidushi , Tahlan Anita , Azad Chandrika , Ahluwalia Jasmina , Watzka Matthias , Oldenburg Johannes
Published: May 2020

We present a family who suffered recurrent sibling losses due to vitamin K deficiency bleed. The index child was asymptomatic at presentation, had normal clinical examination, and was investigated for coagulation disorders in view of previous 3 sibling losses as a result of intracranial hemorrhage. His investigations showed deranged coagulogram and clotting factors’ assay. The baby was given vitamin K1 1 mg intramuscularly following which his coagulogram and clotting factors’ assay returned to normal. The genetic analysis did not identify any inherited cause of bleeding tendency. The significant family history, exclusive breastfeeding, no diarrhea, failure to thrive or drug use, no prophylaxis with vitamin K at birth, recovery of clotting factors on vitamin K administration, and a corroborative molecular analysis confirmed diagnosis of vitamin K deficiency in the index child. This case gives a strong reminder not to miss birth dose of vitamin K in any neonate.
The Correlation of Symptom Clusters and Functional Performance in Adult Acute Leukemia Patients Under Chemotherapy
Authors: Chen Fengjiao , Leng Yamei , Zhang Li , Xu Juan , Zhang Dan , Qin Yu , Li Jiping , Zheng Yuhuan
Published: May 2020

Background

Adult acute leukemia (AL) patients who receive chemotherapy usually experience multiple symptoms during the treatment course. The symptom clusters (SCs) as well as subsets of concurrent symptoms in AL patients have not yet been demonstrated.

Objective

To investigate the SCs of adult AL patients who were receiving chemotherapy and to determine their correlations with functional performance.

Methods

A total of 132 hospitalized adult AL patients were included in this study. A cross-sectional survey aimed to examine symptoms and functional performance was conducted. The patients’ symptoms were assessed using the Chinese version of the Condensed Memorial Symptom Assessment Scale, and functional performance was evaluated through activities of daily living and quality of life.

Results

We identified 4 SCs in adult AL patients: psychological SC, pain-fatigue-sleep SC, dry mouth–constipation SC, and nutrition-impaired SC. The psychological SC was the most common and most distressing SC. The different SCs were each differentially correlated with patient characteristics. The distress of the psychological SC, pain-fatigue-sleep SC, and nutrition-impaired SC was adversely correlated with functional performance.

Conclusions

Adult AL patients undergoing chemotherapy experience multiple symptoms that can be further categorized into 4 SCs. The distress from some SCs is negatively associated with patients’ functional performance.

Implications for Practice

Symptom burden remains a major problem for adult AL patients undergoing chemotherapy. Identifying SCs of AL patients should be the basis for accurate and cost-effective interventions. Personalized SC management may improve the functional performance and healthcare quality of adult AL patients.
Toward an Understanding of the Factors Associated With Reproductive Concerns in Younger Female Cancer Patients
Authors: Bártolo Ana , Santos Isabel M. , Monteiro Sara
Published: May 2020

Background

Cancer treatments may compromise fertility and family building in reproductive-age women. Previous research has shown that younger women with cancer experienced several reproductive health concerns.

Objective

The aim of this study was to conduct a focused review of existing research about the subjective perceptions of reproductive concerns among young women with cancer (aged 15-49 years) and identify their potential predictors and outcomes.

Methods

A systematic synthesis of mixed-methods research was conducted including peer-reviewed articles in English. Relevant studies were identified through the electronic databases Scopus, Web of Science, PubMed, ProQuest, and Psychology & Behavioral Sciences Collection (through EBSCOhost).

Results

A total of 22 reports met the eligibility criteria (8 qualitative and 14 quantitative). Research showed that younger women reported concerns related to their fertility status and/or own health after conception, their children’s health, and their dyadic relationships. Redefinition of the motherhood role and the family future were also a source of concern. However, there is variance among women in concerns and experiences based on life stages and expectations.

Conclusions

Reproductive concerns seem to be affected by personal circumstances and previous therapeutics. These concerns constitute a potential risk factor, simultaneously, for psychosocial maladjustment and adherence to endocrine therapy and fertility care.

Implications for Practice

This article proposes a conceptual framework to understand the dimensions and potential predictors and outcomes of perceived concerns among reproductive-age cancer patients. Our data allow us to look at these concerns from a multifactorial perspective, identifying areas to be addressed in providing clinical care, namely, by nurses accompanying patients over an extended period.
Patient Activation Among Community-Dwelling Persons Living With Chronic Obstructive Pulmonary Disease
Authors: Wetzstein Marnie M. , Shanta Linda L. , Chlan Linda L.
Published: May 2020

Background

Vigilant self-management is associated with positive health outcomes in people living with chronic obstructive pulmonary disease (COPD), yet the predictors of activated self-managers are not well understood.

Objectives

The aims of the study were to identify and describe the predictors of patient activation among a sample of community-dwelling adults with COPD in the United States.

Methods

A postal survey of demographic, mood, symptom, function, health perception, life quality measures, and the patient activation measure was completed by 64 participants. Descriptive and inferential statistics were used to examine and describe associations between personal characteristics, health outcomes, and patient activation measure scores (0–100). Multivariate, linear regression analysis was conducted to identify predictors of patient activation score.

Results

Patient activation was high among the sample. Multivariate analysis revealed positive affect, smoking pack-years, overall quality of life, and female gender collectively explained 45.4% of the variance in patient activation.

Discussion

Positive life view, gender, and lifestyle factors present novel predictors of high activation in self-managers of COPD that warrant explication through future research.
Evaluation of an Emergency Department and Hospital-Based Data Exchange to Improve HIV Care Engagement and Viral Suppression
Authors: Avoundjian Tigran , Golden Matthew R. , Ramchandani Meena S. , Guthrie Brandon L. , Hughes James P. , Baseman Janet G. , Dombrowski Julia C.
Published: May 2020

Background

Emergency department (ED) visits and inpatient (IP) admissions may provide an opportunity to reengage poorly engaged people living with HIV and facilitate viral suppression. In 2015, Public Health Seattle and King County partnered with the University of Washington Medicine to implement a real-time data exchange to identify virally unsuppressed people living with HIV seen at the ED/IP hospital and reengage them in HIV care. We evaluated the impact of the data exchange on care engagement and viral suppression.

Methods

Public Health Seattle and King County received a text alert on weekdays 8 am to 6 pm for ED/IP patients previously diagnosed with HIV with a most recent viral load ≥200 copies/mL. We compared viral load testing <3 months and viral suppression <6 months after an alert-eligible visit in the 2 years after intervention and the 7 to 30 months before intervention. To account for secular trends, we used difference-in-differences models to compare patients with alert-window visits to patients with visits outside the alert window before and after intervention.

Results

Patients with visits within the alert window in the postintervention period were 1.08 (95% confidence interval [CI], 0.97–1.20) times more likely to have a viral load test within 3 months after an ED visit/IP admission and 1.50 (95% CI, 1.27–1.76) times more likely to achieve viral suppression within 6 months than patients in the preintervention period. However, care engagement (difference-in-differences relative risk, 1.00; 95% CI, 0.84–1.18) and viral suppression (difference-in-differences relative risk, 1.01; 95% CI, 0.84–1.20) trends were similar among patients with visits outside the alert window.

Conclusions

Real-time data exchange with ED/IP hospitals was associated with improved viral suppression, but not increased care engagement. However, our results may reflect secular trends resulting from diverse interventions, of which ours was only one. More efforts are needed to improve the effectiveness of relinkage interventions guided by real-time data exchange.
Monitoring and Handing of 89Sr Injection Site Extravasation in a Patient With Breast Cancer
Authors: Tang Jiali , Fu Xiaolin , Hu Yishu , Zhang Yiyuan , Shao Fuqiang
Published: May 2020

Extravasation of various imaging tracers during administration was not a rare complication during nuclear medicine practice. However, the occurrence of extravasation of therapeutic radiopharmaceutical was rarely reported. Here we reported a 60-year-old woman with breast cancer and diffuse painful bone metastases who received strontium chloride (89SrCl2) therapy to palliate her bone pain. Accidental subcutaneous extravasation in the injection site occurred. The extravasated 89Sr was absorbed rapidly by arm elevation, squeezing a stress ball, local warming, and gently massaging. Follow-up results showed the patient's bone pain significantly relieved and her right arm remained normal.
68Ga-PSMA PET/CT and 18F-FDG PET/CT in Renal Cell Carcinoma
Authors: Chen Ew-Jun , Tan Teik Hin , Chew Ming Tsuey , Chye Ping Ching
Published: May 2020

Recent case reports and series have demonstrated the usefulness of 68Ga/18F-PSMA PET/CT in restaging recurrent renal cancer after nephrectomy. We presented a case of a patient with renal mass who had undergone both 18F-FDG and 68Ga-PSMA PET/CT for diagnosis and staging. Concordant tracer uptake in the primary tumor and metastatic lesions was demonstrated by both radiotracers. Final histopathological reports revealed clear cell renal cell carcinoma. Furthermore, unusual left metacarpal bone metastasis was also detected.
Decreased Vision and Headache as the Initial Symptoms of Hepatocellular Carcinoma
Authors: Xu Tingting , Zhang Xinyi , Cao Jianpeng , Chen Yue
Published: May 2020

Sphenoid sinus metastasis is extremely rare. Herein, we report a case of occult hepatocellular carcinoma with initial symptoms of decreased vision and headache, which were caused by sphenoid sinus metastasis. A 44-year-old man recently complained of bilateral decreased vision and headache. Head MRI showed a soft tissue mass in the sphenoid sinus. Pathological examination of the resected sphenoid sinus mass indicated metastatic carcinoma. Subsequently, 18F-FDG PET/CT and immunohistochemical analysis of the sphenoid sinus mass confirmed the hepatic origin of the primary lesion.
18F-FDG PET/CT of a Rare Case of an Adenomatoid Tumor of the Adrenal Gland
Authors: Dietz Matthieu , Neyrand Sophie , Dhomps Anthony , Decaussin-Petrucci Myriam , Tordo Jeremie
Published: May 2020

A 28-year old man, with previous history of chronic abdominal pain, was referred to our nuclear medicine center for an 18F-FDG PET/CT following the fortuitous discovery of a 48-mm right adrenal gland lesion of heterogeneous density at the CT scan. The PET/CT showed an isolated heterogeneous significant uptake evocative of neoplasia. Surprisingly, the anatomopathological analysis after surgery revealed an adenoid tumor of the adrenal gland. This case of a rare benign tumor can be a source of false-positive and mimicking malignancies in the exploration of adrenal lesions.
Hemizygous mutations in L1CAM in two unrelated male probands with childhood onset psychosis
Authors: Sato Mitra S. , Kyriakopoulos Marinos , James Anthony , Marwedel Susanne , Borsay Clare , Gutierrez Armandina Almanza , Blakemore Alexandra I. , Need Anna C.
Published: May 2020

Objective

To identify genes underlying childhood onset psychosis.

Methods

Patients with onset of psychosis at age 13 or younger were identified from clinics across England, and they and their parents were exome sequenced and analysed for possible highly penetrant genetic contributors.

Results

We report two male childhood onset psychosis patients of different ancestries carrying hemizygous very rare possibly damaging missense variants (p.Arg846His and p.Pro145Ser) in theL1CAMgene.L1CAMis an X-linked Mendelian disease gene in which both missense and loss of function variants are associated with syndromic forms of intellectual disability and developmental disorder.

Conclusions

This is the first study reporting a possible extension of the phenotype ofL1CAMvariant carriers to childhood onset psychosis. The family history and presence of other significant rare genetic variants in the patients suggest that there may be genetic interactions modulating the presentation.
Preparation and antimicrobial activity of ‘Yuja’
nanoemulsion using ultrasonic homogenization treated ‘Yuja’
juice
Authors: Jung Seo A , Hong Su Jung , Kim Jun Tae , Kim Su-Hyeon , Park Mi-Kyung , Lee Dong Hee , Shin Gye Hwa
Published: May 2020

Oil-in-water (O/W) ‘Yuja’ nanoemulsion was successfully prepared
using ‘Yuja’ juice as an aqueous phase and ‘Yuja’
seed oil as an oil phase. ‘Yuja’ nanoemulsion was further coated
using chitosan solution to improve its stability. Firstly, ‘Yuja’
oils were extracted from traditionally wasted ‘Yuja’ seeds by
using supercritical carbon dioxide extraction technique. The mean particle
diameter of ‘Yuja’ nanoemulsion was 145.6 nm and significantly
(p<0.05) decreased to 79.5 nm after chitosan coating. The shape of
‘Yuja’ nanoemulsion droplets was heterogeneous with some round and
rod shapes whereas chitosan-coated ‘Yuja’ nanoemulsion showed
homogenous droplets with spherical shape and uniform distributions.
Antimicrobial activity of ultrasonic homogenized ‘Yuja’ juice
(UH-‘Yuja’ juice), ‘Yuja’ nanoemulsion
(‘Yuja’ NE) and chitosan-coated ‘Yuja’ nanoemulsion
(CS-‘Yuja’ NE) was evaluated against Staphylococcus
aureus and Escherichia coli at 25°C and
10°C in every 2 h up to 12 h. Antimicrobial activity of
UH-‘Yuja’ juice, ‘Yuja’ NE, and
CS-‘Yuja’ NE was significantly (p<0.05) different compared
to the negative control (PBS) both at 25°C and 10°C and similar to
the positive control (Ampicillin) at 10°C. These results showed that
CS-‘Yuja’ NE had higher antimicrobial activity than
UH-‘Yuja’ juice and ‘Yuja’-NE against
Staphylococcus aureus and Escherichia
coli.
COVID-19: Easing the coronavirus lockdowns with caution
Authors: Alabi Rasheed Omobolaji , Siemuri Akpojoto , Elmusrati Mohammed
Published: May 2020

Background: The spread of the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) has reached a global level, creating a pandemic. The government of various countries, their citizens, politicians, and business owners are worried about the unavoidable economic impacts of this pandemic. Therefore, there is an eagerness for the pandemic peaking. Objectives: This study uses an objective approach to emphasize the need to be pragmatic with easing of lockdowns measures worldwide through the forecast of the possible trend of COVID-19. This is necessary to ensure that the enthusiasm about SARS-CoV-2 peaking is properly examined, easing of lockdown is done systematically to avoid second-wave of the pandemic. Methods: We used the Facebook prophet on the World Health Organization data for COVID-19 to forecast the spread of SARS-CoV-2 for the 7th April until 3rd May 2020. The forecast model was further used to forecast the trend of the virus for the 8th until 14th May 2020. We presented the forecast of the confirmed and death cases. Results: Our findings from the forecast showed an increase in the number of new cases for this period. Therefore, the need for easing the lockdown with caution becomes imperative. Our model showed good performance when compared to the official report from the World Health Organization. The average forecasting accuracy of our model was 79.6%. Conclusion: Although, the global and economic impact of COVID-19 is daunting. However, excessive optimism about easing the lockdown should be appropriately weighed against the risk of underestimating its spread. As seen globally, the risks appeared far from being symmetric. Therefore, the forecasting provided in this study offers an insight into the spread of the virus for effective planning and decision-making in terms of easing the lockdowns in various countries.
Low doses of radiation increase the immunosuppressive profile of lung macrophages during viral infection and pneumonia
Authors: Meziani Lydia , Robert Charlotte , Classe Marion , Da Costa Bruno , Mondini Michele , Clemenson Céline , Mordant Pierre , Ammari Samy , Le Goffic Ronan , Deutsch Eric
Published: May 2020

Severe pneumonia and acute respiratory distress syndrome (ARDS) have been described in patients with severe COVID-19. Recently, early clinical data reported the efficacy of low doses of radiation therapy (RT) in the treatment of ARDS in patients with severe COVID-19. However, the involved mechanisms remained unknown. Here, we used airways-instilled lipopolysaccharide (LPS) and influenza virus (H1N1) as murine models of pneumonia, and Tolllike receptor (TLR)-3 stimulation in human lung macrophages. Low doses RT (0.5-1 Gy) decreased LPS induced pneumonia, and increased the percentage of Nerve- and Airway-associated Macrophages (NAMs) producing IL-10. During H1N1 viral infection, we observed decreased lung tissue damage and immune cell infiltration in irradiated animals. Low doses RT increased IL-10 production by infiltrating immune cells into the lung. Irradiation of TLR-3 ligand-stimulated human lung macrophagesex vivoincreased IL-10 secretion and decreased IFNγ production in the culture supernatant. The percentage of human lung macrophages producing IL-6 was also decreased. Our data highlight one of the mechanisms by which low doses RT regulate lung inflammation and skew lung macrophages towards an anti-inflammatory profile. These data provide the preclinical rationale for the use and for the optimization of low doses RT in situations such as COVID-19-induced ARDS.
Gaining Accuracy for Gene Expression Data by Parsimonious Models
Authors: Gauch Hugh G. , Zhang Yehao , Chen Chang
Published: May 2020

Gene expression data must be accurate in order to promote extensive, reliable, and repeatable results and to compare treatments with few false positives and false negatives. One way to gain accuracy is by advanced experimental techniques, and another is by good experimental design, including replication. But these may not be enough to achieve even one significant digit, as shown by an example using oat data. This article introduces an additional opportunity to increase accuracy that involves parsimonious models, which has not yet been implemented in the gene expression literature to the best of our knowledge. Basically, a parsimonious model gains accuracy by selectively recovering signal in its model while selectively relegating noise to a discarded residual. Typically, this accuracy gain is equivalent to averaging over several times as many replications, but its cost is trivial, merely some computation. Consequently, this neglected way to gain accuracy is quite cost effective. For gene expression research, accuracy gain by parsimonious models should be a standard component of best practices.
Transcriptional regulation of genes involved in Zn transport after foliar Zn application toMedicago sativa
Authors: Cardini Alessio , Pellegrino Elisa , White Philip J. , Mazzolai Barbara , Mascherpa Marco C. , Ercoli Laura
Published: May 2020

Zinc (Zn) is an essential micronutrient for both plants and animals, and Zn deficiency is one of the most widespread problems for agricultural production. Although many studies have been performed on the biofortification of staple crops with Zn, few studies have focused on forage crops. In this study the molecular mechanisms of Zn transport-related inMedicago sativaL. were investigated following foliar Zn applications aimed at increasing the accumulation of Zn in edible tissues. Zinc uptake and redistribution between shoot and root were determined following the application of six Zn doses to leaves (0, 0.01, 0.1, 0.5, 1, 10 mg Zn plant-1). Twelve putative genes encoding proteins involved in Zn transport (MsZIP1-7, MsZIF1, MsMTP1, MsYSL1, MsHMA4andMsNAS1) were identified and the changes in their expression following foliar Zn application were quantified using newly designed RT-qPCR assays. Shoot and root Zn concentration was increased following foliar Zn applications ≥ 0.1 mg plant-1. Increased expression ofMsZIP2, MsHMA4andMsNAS1in shoots, and ofMsZIP2andMsHMA4in roots, was observed with the largest Zn dose. By contrast,MsZIP3was downregulated in shoots at Zn doses ≥ 0.1 mg plant-1. Three functional modules were identified in theM. sativaresponse to foliar Zn application: genes involved in Zn uptake by cells, genes involved in vacuolar Zn sequestration and genes involved in Zn redistribution within the plant. These results will inform genetic engineering strategies aimed at increasing the efficiency of crop Zn biofortification.

One-sentence summary

Upregulation ofZIP2, NASIandHMA4and downregulation ofZIP3are associated with Zn sequestration and shoot-to-root translocation inMedicago sativafollowing foliar Zn biofortification
Gene functional networks and autism spectrum characteristics in young people with intellectual disability
Authors: Brkić Diandra , Ng-Cordell Elise , O’Brien Sinéad , Scerif Gaia , Astle Duncan , Baker Kate
Published: May 2020

Background

Genes associated with Intellectual disability (ID) can be grouped into networks according to gene function. This study asked whether individuals with ID show differences in autism spectrum characteristics (ASC), depending on the functional network membership of their rare, pathogenicde novogenetic variants.

Methods

Children and young people with ID of known genetic origin were allocated to two broad functional network groups: synaptic physiology (n=29) or chromatin regulation (n=23). We applied principle components analysis to the Social Responsiveness Scale to map the structure of ASC in this population, and identified three components – Inflexibility, Social Understanding and Social Motivation. We then used Akaike Information Criterion (AIC) to test the best fitting models for predicting ASC components, including demographic factors (age, gender), non-ASC behavioural factors (global adaptive function, anxiety, hyperactivity, inattention) and gene functional networks.

Results

We found that, when other factors are accounted for, the chromatin regulation group showed higher levels of Inflexibility. We also observed contrasting predictors of ASC within each network group. Within the chromatin regulation group, Social Understanding was associated with inattention, and Social Motivation was predicted by hyperactivity. Within the synaptic group, Social Understanding was associated with hyperactivity, and Social Motivation was linked to anxiety.

Conclusion

We report that gene functional networks can predict Inflexibility, but not other ASC dimensions. Contrasting behavioural associations within each group suggests network-specific developmental pathways from genomic variation to autism. Simple classification of neurodevelopmental disorder genes as high risk or low risk for autism is unlikely to be valid or useful.
SIFNet: Electromagnetic Source Imaging Framework Using Deep Neural Networks
Authors: Sun Rui , Sohrabpour Abbas , Ye Shuai , He Bin
Published: May 2020

Electroencephalography (EEG) and magnetoencephalography (MEG) are used to measure brain activity, noninvasively, and are useful tools for brain research and clinical management of brain disorders. Tremendous effort has been made in solving the inverse source imaging problem from EEG/MEG measurements. This is a challenging ill-posed problem, since the number of measurements is much smaller than the number of possible sources in the brain. Various methods have been developed to estimate underlying brain sources from noninvasive EEG/MEG as this can offer insight about the underlying brain electrical activity with significantly improved spatial resolution. In this work, we propose a novel data-drivenSource Imaging Frameworkusing deep learning neural networks (SIFNet), where (1) a simulation pipeline is designed to model realistic brain activation and EEG/MEG signals to train generalizable neural networks, (2) and a residual convolutional neural network is trained using the simulated data, capable of estimating source distributions from EEG/MEG recordings. The performance of our proposed SIFNet approach is evaluated in a series of computer simulations, which indicates the excellent performance of SIFNet outperforming conventional weighted minimum norm algorithms that were tested in this work. The SIFNet is further tested by analyzing interictal EEG data recorded in a clinical setting from a focal epilepsy patient. The results of this clinical data analysis indicate accurate localization of epileptogenic activity as validated by the epileptogenic zone clinically determined in this patient. In sum, the proposed SIFNet approach promises to offer an alternative solution to the EEG/MEG inverse source imaging problem, shows promising signs of being robust against measurement noise, and is easy to implement, therefore, being translatable to clinical practice.