bluuebunny/crossref_metadata_2025 huggingface dataset:
Analgesia and spread of erector spinae plane block in breast cancer surgeries: a randomized controlled trial
Authors: Abdella Ahmed Mohamed Mohamed Rabah , Arida Emad Eldin Abd El Monem , Megahed Nagwa Ahmed , El-Amrawy Wessam Zakaria , Mohamed Walid Mohamed Ahmed
Published: October 2022

Background

To evaluate the analgesic efficacy and spread of variable volumes of local anesthetics (LA) in Erector spinae plane block (ESPB).

Methods

Sixty patients aged between 18 and 50 years with an ASA I-II and scheduled for breast cancer surgery were randomized to receive either ESPB with 20 ml 0.25% bupivacaine (Standard volume ESPB), or with 40 ml 0.125% bupivacaine (High volume ESPB), or no ESPB (GA only group). The primary outcome was pain intensity evaluated by the visual analogue scale (VAS), 12 hours after surgery. P-values < 0.05 were considered the cutoff point for statistical significance. The secondary outcomes were pain at rest and pain on movement evaluated by the VAS, craniocaudal injectate spread, to paravertebral (PV) and epidural spaces assessed by CT, clinical dermatomal spread, level of sedation or agitation, and patient satisfaction with anesthesia and analgesia.

Results

VAS at rest 12 h after surgery was less in both intervention groups compared to the control (1.75 ± 0.79 vs. 1.6 ± 0.88 vs. 3.4 ± 1.96, p = 0.001). The LA had extended further in the high volume group than the standard volume group (11.20 ± 3.07 vs. 9.15 ± 2.54 vertebral levels, p = 0.027). No difference of the spread to PV or epidural spaces between the 2 intervention groups. More dermatomes were covered in the high volume group (7.20 ± 2.12 vs. 5.75 ± 1.37 dermatomes, p = 0.014). Agitation was higher in the GA only group than both ESPB groups in the first 8 postoperative hours. Patients were more satisfied in both ESPB groups than the GA only group.

Conclusions

Preoperative ESPB is an excellent analgesic modality and it can also attenuate both postoperative agitation and sedation. Doubling the injectate volume enhances the craniocaudal spreading and may be useful for surgeries requiring multiple dermatomes. However, larger volume has no effect on analgesic efficacy or patient satisfaction as there is no further spread to the PV, epidural spaces or spinal nerve rami.

Trial registration

NCT04796363 (12/3/2021).
Household food insecurity and its association with overweight and obesity in children aged 2 to 14 years
Authors: Ortiz-Marrón Honorato , Ortiz-Pinto Maira Alejandra , Urtasun Lanza María , Cabañas Pujadas Gloria , Valero Del Pino Virginia , Belmonte Cortés Susana , Gómez Gascón Tomás , Ordobás Gavín María
Published: October 2022

Background

The objective was to estimate the prevalence of household food insecurity (HFI) depending on sociodemographic factors and its association with lifestyle habits and childhood overweight and obesity.

Methods

Data was collected from 1,938 children aged 2 to 14 years who participated in the “Study about Malnutrition” of the Community of Madrid. Weight and height were obtained through physical examination. Body mass index was calculated as weight/height2 (kg/m2) and the criteria of the WHO were used for determining conditions of overweight and obesity. The participants’ parents answered a structured questionnaire about their diet, lifestyle (physical activity and screen time), and food insecurity. The diet quality was assessed with the Healthy Eating Index in Spain and food insecurity, defined as the lack of consistent access to sufficient food for a healthy life, was measured via three screening questions and the Household Food Insecurity Access Scale (HFIAS). Odds Ratios (ORs) and Relative Risk Ratios (RRRs) were estimated using logistic regression models and adjusted for confounding variables.

Results

The overall prevalence of HFI was 7.7% (95% CI: 6.6‒9.0), with lower values in children 2 to 4 years old (5.7%, 95% CI: 4.0‒8.1) and significantly higher values in households with low family purchasing power [37.3%; OR: 8.99 (95% CI: 5.5‒14.6)]. A higher prevalence of overweight (33.1%) and obesity (28.4%) was observed in children from families with HFI, who presented a lower quality diet and longer screen time compared to those from food-secure households (21.0% and 11.5%, respectively). The RRR of children in families with HFI relative to those from food-secure households was 2.41 (95% CI: 1.5‒4.0) for overweight and 1.99 (95% CI: 1.2‒3.4) for obesity.

Conclusion

The prevalence of HFI was high in the paediatric population, especially in households with low family purchasing power. HFI was associated with lower diet quality and higher prevalence of childhood overweight and obesity. Our results suggest the need for paediatric services to detect at-risk households at an early stage to avoid this dual burden of child malnutrition.
Evidence of co-creation practices in suicide prevention in government policy: a directed and summative content analysis
Authors: Pearce Tania , Maple Myfanwy , Wayland Sarah , McKay Kathy , Shakeshaft Anthony , Woodward Alan
Published: October 2022

Background

In Australia, the collaborative involvement of stakeholders, especially those with lived experience in mental health and suicide prevention, has become important to government policy and practice at Federal and State levels. However, little is known about how governments translate this intention into frameworks of co-creation for policy, funding programs, service improvement, and research and evaluation. We investigated the extent to which publicly available government policies refer to collaborative practice using an established translation model.

Methods

An exploratory directed and summative content analysis approach was used to analyse the contents of Federal (also known as Commonwealth), State and Territories policy documents on mental health and suicide prevention published in Australia between 2010 and 2021. The data was extracted, compared to an existing translation model, and summated to demonstrate the evidence of co-creation-related concepts between government and stakeholders.

Results

40 policy documents (nine at the Federal and 31 at the State and Territory level) were identified and included in the analysis. Only 63% of policy documents contained references to the concept of co-design. Six of the State policies contained references to the concept of co-production. Across all policy documents, there were no references to other concepts in the model adopted for this study, such as co-creation, co-ideation, co-implementation, and co-evaluation.

Conclusion

Although the government at Federal, State and Territory levels appear to support collaborative practice through partnership and co-design, this study suggests a narrow approach to the theoretical model for co-creation at a policy level. Implications for both research and practice are discussed.
Expert survey on coverage and characteristics of pediatric palliative care in Europe – a focus on home care
Authors: Wager Julia , Kubek Larissa Alice , Brenner Maria , Calmanti Sara , Doyle Carmel , Lövgren Malin , Kreicbergs Ulrika , Kremer Leontien , Le Moine Philippe , Robert Guillaume , Schuiling-Otten Meggi , Schröder-Bäck Peter , Verhagen Eduard , Zernikow Boris
Published: October 2022

Background

For children with life-limiting conditions home care is a key component of pediatric palliative care. However, poor information is available on service coverage and in particular on country-specific pediatric palliative home care characteristics. The aim of the study was therefore to describe the association between pediatric palliative care coverage and national activities and obtain detailed information on the pediatric palliative home care structure in different European countries.

Methods

Online survey with in-country experts from N = 33 European countries.

Results

Pediatric palliative home care (65.6%) represented the most pediatric palliative care units (15.6%) and the least common services. National documents constituted the most widespread national pediatric palliative care activity (59.4%) and were associated with available services. Pediatric palliative home care could be mostly accessed as a service free of charge to families (95.2%) from the time of a child's diagnosis (85.7%). In most countries, oncological and non-oncological patients were cared for in pediatric palliative home care. Only a minority of home care teams covered home-ventilated children. Pediatric palliative home care usually comprised medical care (81.0%), care coordination (71.4%), nursing care (75.0%) and social support (57.1%). Most countries had at least two professional groups working in home care teams (81.0%), mostly physicians and nurses. In many countries, pediatric palliative home care was not available in all regions and did not offer a 24 h-outreach service.

Conclusions

Pediatric palliative care provision in Europe is heterogeneous. Further work on country-specific structures is needed.
Nurse-led telephone follow-up according to the revised nursing outcomes classification for laryngeal carcinoma surgery patients: a randomized controlled trial
Authors: Ding Yongxia , Xu Jinxia , Ning Yan , Wang Qian , Chang Zhaojie
Published: October 2022

Background

This study used the revised nursing outcomes classification (NOC) outlined in our previous study, “Core nursing outcomes for otorhinolaryngology head-neck,” for telephone follow-up of patients who had laryngeal carcinoma surgery in China. This randomized controlled trial aimed to compare nurse-led telephone follow-up according to the revised NOC with traditional telephone follow-up.

Methods

A total of 100 postoperative patients were recruited from March 2018‒March 2020. Patients were randomly assigned to nurse-led telephone follow-up groups as either revised NOC follow-up (n = 51) or traditional follow-up (n = 49). The investigated outcomes included nursing outcomes, quality of life, and self-care abilities.

Results

The baseline characteristics of patients were well balanced. We noted that improvements in nursing outcomes in the intervention group were significantly better than for those in the control group (P = 0.018), primarily regarding psychosocial health (P < 0.001) and health knowledge and behavior (P < 0.001). Moreover, patient outcomes in the intervention group were associated with greater improvements in quality of life than those in the control group (P < 0.001), especially for social conditions (P < 0.001), emotional health (P < 0.001), functional status (P < 0.001), and additional attention (P = 0.001). Finally, compared with the control group, significant improvements were observed in self-care abilities in the intervention group (P = 0.002), mainly regarding general self-care abilities (P = 0.016) and development self-care abilities (P < 0.001).

Conclusion

This study found that nurse-led telephone follow-up according to the revised NOC improved nursing outcomes, quality of life, and self-care abilities.

Trial registration:

ChiCTR2100045941.
Unmet health care needs: factors predicting satisfaction with health care services among community-dwelling Canadians living with neurological conditions
Authors: Chambers-Richards Tamara , Chireh Batholomew , D’Arcy Carl
Published: October 2022

Background

Neurological conditions (NCs) can lead to long-term challenges including functional impairments and limitations to activities of daily living. People with neurological conditions often report unmet health care needs and experience barriers to care. This study aimed to (1) explore the factors predicting patient satisfaction with general health care, hospital, and physician services among Canadians with NCs, (2) examine the association between unmet health care needs and satisfaction with health care services among neurological patients in Canada, and (3) contrast patient satisfaction between physician care and hospital care among Canadians with NCs.

Methods

We conducted a secondary analysis on a subsample of the 2010 Canadian Community Health Survey - Annual Component data (N = 6335) of respondents with neurological conditions, who received general health care services, hospital services, and physician services within twelve months. Multivariate logistic regression fitted the models and odds ratios and 95% confidence intervals were reported using STATA version 14.

Results

Excellent quality care predicts higher odds of patient satisfaction with general health care services (OR, 95%CI–237.6, 70.4–801.5), hospital services (OR, 95%CI–166.9, 67.9–410.6), and physician services (OR, 95%CI–176.5, 63.89–487.3). In contrast, self-perceived unmet health care needs negatively predict patient satisfaction across all health care services: general health care services (OR, 95%CI–0.59, 0.37–0.93), hospital services (OR, 95%CI–0.41, 0.21–0.77), and physician services (OR, 95%CI–0.29, 0.13–0.69). Other negative predictors of patient satisfaction include some post-secondary education (OR, 95%CI–0.36, 0.18–0.72) for general health services and (OR, 95%CI–0.26, 0.09–0.80) for physician services. Those with secondary (OR, 95% CI–0.32, 0.13–0.76) and post-secondary graduation (OR, 95%CI– 0.28, 0.11–0.67) negatively predicted patient satisfaction among users of physician services while being an emergency room patient most recently (OR, 95%CI– 0.39, 0.20–0.77) was also negatively associated with patients satisfaction among hospital services users.

Conclusion

This study found self-perceived unmet health care needs as a significant negative predictor of neurological patients’ satisfaction across health care services and emphasizes the importance of ensuring coordinated efforts to provide appropriate and accessible care of the highest quality for Canadians with neurological conditions.
Pathophysiology, clinical manifestations and current management of IL-1 mediated monogenic systemic autoinflammatory diseases, a literature review
Authors: Li Yandie , Yu Meiping , Lu Meiping
Published: October 2022

Background

Systemic autoinflammatory diseases (SAIDs) are hyperinflammatory and immune-dysregulation conditions that present in childhood. This kind of disease is a rare disease with early-onset, severe condition and difficult diagnosis, which seriously affects the growth and development of children. Most children need a genetic diagnosis. However, with the limitation of access to genetic testing and the detection of somatic mutations, the diagnosis of SAIDs remains challenging. IL-1 is one of the important cytokines involved in the pathogenesis of SAIDs. Here we briefly review monogenic SAIDs mediated by aberrant IL-1 production, with the aim to further understand the pathogenesis, clinical manifestations and treatments of IL-1 mediated SAIDs.

Methods

Literature reviews were performed using “PubMed” and “Web of Science” by searching for the terms “autoinflammatory diseases” and “IL-1”.

Results

Monogenic SAIDs mediated by IL-1 include MKD, FMF, TRAPS, PAAND, PAPA, CAPS, DIRA, Majeed syndrome, NAIAD, NLRC4-MAS, PFIT, APLAID. Monogenic SAIDs have early onset, various clinical manifestations and difficult diagnosis, so early recognition and early treatment can reduce the complications and enhance the quality of life.

Conclusions

There are many kinds of IL-1 mediated SAIDs. Pediatricians should be alert to SAIDs in the face of the patients with repeated fever, repeated rash and poor effect of routine treatment. The patients should be carried out with gene testing and treatment in time.
Global prevalence of congenital anencephaly: a comprehensive systematic review and meta-analysis
Authors: Salari Nader , Fatahi Behnaz , Fatahian Reza , Mohammadi Payam , Rahmani Adibeh , Darvishi Niloofar , Keivan Mona , Shohaimi Shamarina , Mohammadi Masoud
Published: October 2022

Background

Anencephaly is a fatal congenital anomaly characterized by the absence of brain hemispheres and cranial arch. Timely preventive measures can be taken by knowing the exact prevalence of this common neural tube defect; thus, carried out through systematic review and meta-analysis, the present study was conducted to determine the worldwide prevalence, incidence and mortality of anencephaly.

Methods

Cochran’s seven-step instructions were used as the guideline. Having determined the research question and inclusion and exclusion criteria, we studied MagIran, SID, Science Direct, WoS, Web of Science, Medline (PubMed), Scopus, and Google Scholar databases. Moreover, the search strategy in each database included using all possible keyword combinations with the help of “AND” and “OR” operators with no time limit to 2021. The I2 test was used to calculate study heterogeneity, and Begg and Mazumdar rank correlation tests were employed to assess the publication bias. Data were analyzed by Comprehensive Meta-Analysis software (Version 2).

Results

In this study, the statements of Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) were used. In the first stage, 1141 articles were found, of which 330 duplicate studies were omitted. 371 articles were deleted based on the inclusion and exclusion criteria by reviewing the title and abstract of the study. 58 articles were removed by reviewing the full text of the article because it was not relevant to the research. 360 studies with a sample size of 207,639,132 people were considered for the meta-analysis. Overall estimate of the prevalence, incidence and attenuation of anencephaly worldwide were 5.1 per ten thousand births (95% confidence interval 4.7–5.5 per ten thousand births), 8.3 per ten thousand births (95% confidence interval 5.5–9.9 per ten thousand births), 5.5 per ten thousand births (95% confidence interval 1.8–15 per ten thousand births) respectively the highest of which according to the subgroup analysis, belonged to the Australian continent with 8.6 per ten thousand births (95% confidence interval 7.7–9.5 per ten thousand births).

Conclusion

The overall prevalence of anencephaly in the world is significant, indicating the urgent need for preventive and treating measures.
Identification of a novel interaction site between the large hepatitis delta antigen and clathrin that regulates the assembly of genotype III hepatitis delta virus
Authors: Chiou Wei-Chung , Lu Hsu-Feng , Chen Jui-Chieh , Lai Yu-Heng , Chang Ming-Fu , Huang Yuan-Li , Tien Ni , Huang Cheng
Published: October 2022

Background

Hepatitis delta virus (HDV), a satellite virus of hepatitis B virus (HBV), is a small, defective RNA virus strongly associated with the most severe form of hepatitis and progressive chronic liver disease and cirrhosis. Chronic hepatitis D, resulting from HBV/HDV coinfection, is considered to be the most severe form of viral hepatitis and affects 12–20 million people worldwide. Involved in the endocytosis and exocytosis of cellular and viral proteins, clathrin contributes to the pathogenesis and morphogenesis of HDV. Previously, we demonstrated that HDV-I and -II large hepatitis delta antigens (HDAg-L) possess a putative clathrin box that interacts with clathrin heavy chain (CHC) and supports HDV assembly.

Methods

Virus assembly and vesicular trafficking of HDV virus-like particles (VLPs) were evaluated in Huh7 cells expressing HDV-I, -II and -III HDAg-L and hepatitis B surface antigen (HBsAg). To elucidate the interaction motif between HDAg-L and CHC, site-directed mutagenesis was performed to introduce mutations into HDAg-L and CHC and analyzed using coimmunoprecipitation or pull-down assays.

Results

Comparable to HDV-I virus-like particles (VLPs), HDV-III VLPs were produced at a similar level and secreted into the medium via clathrin-mediated post-Golgi vesicular trafficking. Mutation at F27 or E33 of CHC abolished the binding of CHC to the C-terminus of HDV-III HDAg-L. Mutation at W207 of HDV-III HDAg-L inhibited its association with CHC and interfered with HDV-III VLP formation. We elucidated mechanism of the binding of HDV-III HDAg-L to CHC and confirmed the pivotal role of clathrin binding in the assembly of genotype III HDV.

Conclusions

A novel W box which was identified at the C terminus of HDV-III HDAg-L is known to differ from the conventional clathrin box but also interacts with CHC. The novel W box of HDAg-L constitutes a new molecular target for anti-HDV-III therapeutics.
Ischial osteochondroma as an unusual source of pregnancy-related sciatic pain: a case report
Authors: Trager Robert J. , Prosak Sarah E. , Getty Patrick J. , Barger Richard L. , Saab Shahrazad T. , Dusek Jeffery A.
Published: October 2022

Background

While most cases of sciatica result from degenerative conditions of the low back, some cases result from conditions of the hip and pelvic region. Sciatica developing in relation to pregnancy or labor also presents unique considerations.

Case presentation

A 37-year-old African American woman with a history of hypertension and polycystic ovary syndrome presented to a chiropractor at a hospital-based outpatient clinic with a seven-week history of low back pain with radiation into the right lower extremity which began during labor. The chiropractor performed a brief trial of care, yet when the patient’s symptoms worsened, ordered lumbar spine radiographs, followed by lumbar magnetic resonance imaging (MRI), which were both normal. The chiropractor then ordered hip radiographs, which were suggestive of ischial osteochondroma, and referred the patient to an orthopedic oncologist. MRI findings were compatible with an osteochondroma with associated adventitial bursitis and mass effect on the sciatic nerve. The patient initially chose conservative management with bursa aspiration and therapeutic injection. Despite initial relief, there was eventual return of symptoms. The patient elected to undergo surgical removal, with a positive outcome.

Conclusion

The key distinguishing features that led to a diagnosis of osteochondroma in this case included attention to the patient-reported symptoms and history, worsening of symptoms despite conservative care, and lack of explanatory findings on lumbar imaging. This case highlights the benefit of evaluating the hip and pelvis when the clinical features of sciatica cannot be ascribed to a lumbar etiology. This case also illustrates the role of a chiropractor working in an integrative health system to facilitate timely imaging and referrals to resolve a challenging diagnosis.
Systematic review: preoperative psychological factors and total hip arthroplasty outcomes
Authors: O’Connor John P. , Holden Paige , Gagnier Joel J.
Published: October 2022

Background

Total hip arthroplasties (THA) are cost-effective interventions for patients with osteoarthritis refractory to physical therapy or medical management. Most individuals report positive surgical outcomes with reduction in pain and improved joint function. Multiple recent studies demonstrated the influence of patient mental health on surgical success. We sought to determine the relationship between patient preoperative psychological factors and postoperative THA outcomes, specifically pain and function.

Methods

PubMed, EMBASE and Cochrane Reviews databases were queried using terms “(mental OR psychological OR psychiatric) AND (function OR trait OR state OR predictor OR health) AND (outcome OR success OR recovery OR response) AND total joint arthroplasty).” A total of 21 of 1,286 studies fulfilled inclusion criteria and were included in the review. All studies were analyzed using GRADE and Risk of Bias criteria.

Results

Overall, compared to cohorts with a normal psychological status, patients with higher objective measures of preoperative depression and anxiety reported increased postoperative pain, decreased functionality and greater complications following THA. Additionally, participants with lower self-efficacy or somatization were found to have worse functional outcomes.

Conclusions

Preoperative depression, anxiety and somatization may negatively impact patient reported postoperative pain, functionality and complications following THA. Surgeons should consider preoperative psychological status when counseling patients regarding expected surgical outcomes.

Level of evidence

3.
Immunological consequences of compromised ocular immune privilege accelerate retinal degeneration in retinitis pigmentosa
Authors: Mohan K. Varsha , Mishra Alaknanda , Muniyasamy Abaranjitha , Sinha Prakriti , Sahu Parul , Kesarwani Ashwani , Jain Kshama , Nagarajan Perumal , Scaria Vinod , Agarwal Manisha , Akhter Naseem S. , Gupta Chanda , Upadhyay Pramod
Published: October 2022

Background

Retinitis pigmentosa (RP) is a hereditary retinal disease which leads to visual impairment. The onset and progression of RP has physiological consequences that affects the ocular environment. Some of the key non-genetic factors which hasten the retinal degeneration in RP include oxidative stress, hypoxia and ocular inflammation. In this study, we investigated the status of the ocular immune privilege during retinal degeneration and the effect of ocular immune changes on the peripheral immune system in RP. We assessed the peripheral blood mononuclear cell stimulation by retinal antigens and their immune response status in RP patients. Subsequently, we examined alterations in ocular immune privilege machineries which may contribute to ocular inflammation and disease progression in rd1 mouse model.

Results

In RP patients, we observed a suppressed anti-inflammatory response to self-retinal antigens, thereby indicating a deviated response to self-antigens. The ocular milieu in rd1 mouse model indicated a significant decrease in immune suppressive ligands and cytokine TGF-B1, and higher pro-inflammatory ocular protein levels. Further, blood–retinal-barrier breakdown due to decrease in the expression of tight junction proteins was observed. The retinal breach potentiated pro-inflammatory peripheral immune activation against retinal antigens and caused infiltration of the peripheral immune cells into the ocular tissue.

Conclusions

Our studies with RP patients and rd1 mouse model suggest that immunological consequences in RP is a contributing factor in the progression of retinal degeneration. The ocular inflammation in the RP alters the ocular immune privilege mechanisms and peripheral immune response. These aberrations in turn create an auto-reactive immune environment and accelerate retinal degeneration.
Orthodontic and dentofacial orthopedic treatments in patients with ectodermal dysplasia: a systematic review
Authors: Cerezo-Cayuelas Marina , Pérez-Silva Amparo , Serna-Muñoz Clara , Vicente Ascensión , Martínez-Beneyto Yolanda , Cabello-Malagón Inmaculada , Ortiz-Ruiz Antonio José
Published: October 2022

Objective

The objective of this systematic review was to determine the orthodontic and dentofacial orthopedic treatments carried out in patients with ectodermal dysplasia to facilitate functional and aesthetic rehabilitation.

Methods

The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. We systematically searched PubMed, Web of Science, Scopus, Scielo, LILACS, EBSCOhost and Embase databases up to 6 January 2022. We included articles describing patients with any type of ectodermal dysplasia who received orthodontic or dentofacial orthopedic treatment to facilitate functional and aesthetic oral rehabilitation. The search was not restricted by language or year of publication. The quality of the studies was assessed using the Joanna Briggs Institute Quality Assessment Scale of the University of Adelaide for case series and case reports. The review was registered at the University of York Centre for reviews (CRD42021288030).

Results

Of the initial 403 studies found, 29 met the inclusion criteria. After applying the quality scale, 23 were left for review—21 case reports and 2 case series. The initial age of patients ranged from 34 months to 24 years. Thirteen studies were on hypohidrotic and/or anhidrotic ectodermal dysplasia, of which two were X-chromosome linked. In one study, the patient had Wiktop syndrome, and in nine the type of ectodermal dysplasia was not specified. The duration of treatment was 7 weeks to 10 years. The treatments described were: fixed orthodontic appliances or simple acrylic plates designed for tooth movement, including leveling and aligning, closing of diastemata, retraction of impacted teeth in the dental arch; clear aligners; fixed and/or removable appliances for the correction of skeletal and/or dentoalveolar relationships; palatal expanders in combination with face masks for orthopedic traction of the maxilla; and orthognathic surgery. Only three studies provided cephalometric data.

Conclusion

The level of evidence of the articles reviewed was low and most orthopedic and dentofacial orthodontic treatments described were focused on correcting dental malpositioning and jaw asymmetries and not on stimulating growth from an early age. Studies with greater scientific evidence are needed to determine the best treatment for these patients.
Tau interactome and RNA binding proteins in neurodegenerative diseases
Authors: Kavanagh Tomas , Halder Aditi , Drummond Eleanor
Published: October 2022

Pathological tau aggregation is a primary neuropathological feature of many neurodegenerative diseases. Intriguingly, despite the common presence of tau aggregates in these diseases the affected brain regions, clinical symptoms, and morphology, conformation, and isoform ratio present in tau aggregates varies widely. The tau-mediated disease mechanisms that drive neurodegenerative disease are still unknown. Tau interactome studies are critically important for understanding tauopathy. They reveal the interacting partners that define disease pathways, and the tau interactions present in neuropathological aggregates provide potential insight into the cellular environment and protein interactions present during pathological tau aggregation. Here we provide a combined analysis of 12 tau interactome studies of human brain tissue, human cell culture models and rodent models of disease. Together, these studies identified 2084 proteins that interact with tau in human tissue and 1152 proteins that interact with tau in rodent models of disease. Our combined analysis of the tau interactome revealed consistent enrichment of interactions between tau and proteins involved in RNA binding, ribosome, and proteasome function. Comparison of human and rodent tau interactome studies revealed substantial differences between the two species. We also performed a second analysis to identify the tau interacting proteins that are enriched in neurons containing granulovacuolar degeneration or neurofibrillary tangle pathology. These results revealed a timed dysregulation of tau interactions as pathology develops. RNA binding proteins, particularly HNRNPs, emerged as early disease-associated tau interactors and therefore may have an important role in driving tau pathology.
Exploratory study to assess feasibility of intracerebral hemorrhage detection by point of care cranial ultrasound
Authors: Sarwal Aarti , Patel Yash , D’Agostino Ralph , Brown Patrick , Wolfe Stacey Q. , Bushnell Cheryl , Glass Casey , Duncan Pamela
Published: October 2022

Background

Limited studies have evaluated the use of ultrasound for detection of intracerebral hemorrhage (ICH) using diagnostic ultrasound Transcranial Doppler machines in adults. The feasibility of ICH detection using Point of care Ultrasound (POCUS) machines has not been explored. We evaluated the feasibility of using cranial POCUS B mode imaging performed using intensive care unit (ICU) POCUS device for ICH detection with a secondary goal of mapping optimal imaging technique and brain topography likely to affect sensitivity and specificity of ICH detection with POCUS.

Materials and methods

After obtaining IRB approval, a blinded investigator performed cranial ultrasound (Fujifilm, Sonosite® Xporte, transcranial and abdominal presets) through temporal windows on 11 patients with intracerebral pathology within 72 h of last CT/MRI (computed tomography scan/magnetic resonance imaging) brain after being admitted to a neurocritical care unit in Aug 2020 and Nov 2020–Mar 2021. Images were then compared to patient’s CT/MRI to inform topography. Inferential statistics were reported.

Results

Mean age was 57 (28–77 years) and 6/11 were female. Six patients were diagnosed with ICH, 3 with ischemic stroke, 1 subarachnoid hemorrhage, and 1 brain tumor. The sensitivity and specificity of point of care diagnosis of ICH compared to CT/MRI brain was 100% and 50%, respectively. Mean time between ultrasound scan and CT/MRI was 13.3 h (21 min–39 h). Falx cerebri, choroid calcification and midbrain-related artifacts were the most reproducible hyperechoic signals. Abdominal preset on high gain yielded less artifact than Transcranial Doppler preset for cranial B mode imaging. False positive ICH diagnosis was attributed to intracerebral tumor and midbrain-related artifact.

Conclusions

Our exploratory analysis yielded preliminary data on use of point of care cranial ultrasound for ICH diagnosis to inform imaging techniques, cranial topography on B mode and sample size estimation for future studies to evaluate sensitivity and specificity of cranial POCUS in adult patients. This pilot study is limited by small sample size and over representation of ICH in the study. Cranial POCUS is feasible using POCUS machines and may have potential as a screening tool if validated in adequately powered studies.
Intravenous fluid therapy in patients with severe acute pancreatitis admitted to the intensive care unit: a narrative review
Authors: Crosignani Andrea , Spina Stefano , Marrazzo Francesco , Cimbanassi Stefania , Malbrain Manu L. N. G. , Van Regenmortel Niels , Fumagalli Roberto , Langer Thomas
Published: October 2022

Patients with acute pancreatitis (AP) often require ICU admission, especially when signs of multiorgan failure are present, a condition that defines AP assevere. This disease is characterized by a massive pancreatic release of pro-inflammatory cytokines that causes a systemic inflammatory response syndrome and a profound intravascular fluid loss. This leads to a mixed hypovolemic and distributive shock and ultimately to multiorgan failure. Aggressive fluid resuscitation is traditionally considered the mainstay treatment of AP. In fact, all available guidelines underline the importance of fluid therapy, particularly in the first 24–48 h after disease onset. However, there is currently no consensus neither about the type, nor about the optimal fluid rate, total volume, or goal of fluid administration. In general, a starting fluid rate of 5–10 ml/kg/h of Ringer’s lactate solution for the first 24 h has been recommended. Fluid administration should be aggressive in the first hours, and continued only for the appropriate time frame, being usually discontinued, or significantly reduced after the first 24–48 h after admission. Close clinical and hemodynamic monitoring along with the definition of clear resuscitation goals are fundamental. Generally accepted targets are urinary output, reversal of tachycardia and hypotension, and improvement of laboratory markers. However, the usefulness of different endpoints to guide fluid therapy is highly debated. The importance of close monitoring of fluid infusion and balance is acknowledged by most available guidelines to avoid the deleterious effect of fluid overload. Fluid therapy should be carefully tailored in patients with severe AP, as for other conditions frequently managed in the ICU requiring large fluid amounts, such as septic shock and burn injury. A combination of both noninvasive clinical and invasive hemodynamic parameters, and laboratory markers should guide clinicians in the early phase of severe AP to meet organ perfusion requirements with the proper administration of fluids while avoiding fluid overload. In this narrative review the most recent evidence about fluid therapy in severe AP is discussed and an operative algorithm for fluid administration based on an individualized approach is proposed.
Autologous stem cell transplantation in tandem with Anti-CD30 CAR T-cell infusion in relapsed/refractory CD30+ lymphoma
Authors: Zhang Peiling , Yang Xiuxiu , Cao Yang , Wang Jue , Zhou Mi , Chen Liting , Wei Jia , Mao Zekai , Wang Di , Xiao Yi , Zhu Haichuan , Zhang Shangkun , Zhang Tongcun , Zhang Yicheng , Zhou Jianfeng , Huang Liang
Published: October 2022

Background

Long-term outcome is unfavourable for relapsed/refractory (r/r) lymphoma patients who are resistant to salvage chemotherapy, even after subsequent autologous stem-cell transplantation (ASCT). Although anti-CD30 chimeric antigen receptor (CAR30) T-cell therapy induces high response rates in these patients, the duration of response is relatively limited.

Methods

This open-label, single-center and single-arm pilot study investigated the safety and efficacy of ASCT in tandem with CAR30 T-cell infusion in r/r CD30+ lymphoma. The primary endpoint was safety and key secondary endpoint was overall response rate, overall survival, progression-free survival, and duration of response.

Results

Five classical Hodgkin lymphoma (cHL) patients and 1 anaplastic lymphoma kinase (ALK)-negative anaplastic large cell lymphoma (ALCL) patient were enrolled. The median age was 24 years. No patient had prior ASCT. Three patients (50.0%) relapsed for ≥ 2 times and 3 patients (50.0%) had primary refractory diseases. All had a Deauville score of 4 or 5, and 5 patients (83.3%) had a stable or progressive disease (SD/PD) at enrollment. All patients received myeloablative chemotherapy and infused CD34-positive hematopoietic stem cells (HSCs) and CAR30 T cells in tandem, with a median dose of 3.9 × 106/kg and 7.6 × 106/kg, respectively. Five paitents presented with cytokine release syndrome (CRS), all of which were grade 1. No neurotoxicity was observed. All patients had successful HSCs engraftment and reached an objective response, including 5 (4 cHL and 1 ALCL, 83.3%) with a complete response (CR) and 1 with a partial response (PR). With a median follow-up of 20.4 (range, 12.1–34.4) months, all remained alive and maintained their responses.

Conclusion

Our work demonstrates the combined administration of ASCT and CAR30 T-cell therapy is well-tolerate and highly effective in r/r cHL and ALCL, even in PET-positive or chemorefractory patients who are expected to have inferior outcome after ASCT, although further large-scaled validation in prospective clinical trial is warranted.

Trial registration The trial was registered with the Chinese Clinical Trial Registry (ChiCTR, number ChiCTR2100053662).
Particle size distributions inside and around the artificial crater produced by the Hayabusa2 impact experiment on Ryugu
Authors: Ogawa K. , Sakatani N. , Kadono T. , Arakawa M. , Honda R. , Wada K. , Shirai K. , Shimaki Y. , Ishibashi K. , Yokota Y. , Saiki T. , Imamura H. , Tsuda Y. , Nakazawa S. , Takagi Y. , Hayakawa M. , Yano H. , Okamoto C. , Iijima Y. , Morota T. , Kameda S. , Tatsumi E. , Cho Y. , Yoshioka K. , Sawada H. , Matsuoka M. , Yamada M. , Kouyama T. , Suzuki H. , Honda C. , Sugita S.
Published: October 2022

Japanese Hayabusa2 spacecraft has successfully carried out an impact experiment using a small carry-on impactor (SCI) on an asteroid (162173) Ryugu. We examine the size distribution of particles inside and outside an artificial impact crater (the SCI crater) based on the images taken by the optical navigation camera onboard the Hayabusa2 spacecraft. The circumferential variation in particle size distribution inside the SCI crater is recognized and we interpret that major circumferential variation is caused by the large boulders inside the SCI crater that existed prior to the impact. The size distribution inside the SCI crater also shows that the subsurface layer beneath the SCI impact site had a large number of particles with a characteristic size of – 9 cm, which is consistent with the previous evaluations. On the other hand, the size distribution outside the SCI crater exhibits the radial variation, implying that the deposition of ejecta from the SCI crater is involved. The slope of the size distribution outside the crater at small sizes differs from the slope of the size distribution on the surface of Ryugu by approximately 1 or slightly less. This is consistent with the claim that some particles are buried in fine particles of the subsurface origin included in ejecta from the SCI crater. Thus, the particle size distributions inside and outside the SCI crater reveal that the subsurface layer beneath the SCI impact site is rich in fine particles with – 9 cm in size while the particles on the surface have a size distribution of a power-law form with shallower slopes at small sizes due to the deposition of fine ejecta from the subsurface layer. Finally, we discuss a process responsible for this difference in particle size distribution between the surface and the subsurface layers. The occurrence of segregation in the gravitational flow of particles on the surface of Ryugu is plausible.

Graphical Abstract
Multimodality treatment for brain arteriovenous malformation in Mainland China: design, rationale, and baseline patient characteristics of a nationwide multicenter prospective registry
Authors: Chen Yu , Han Heze , Ma Li , Li Ruinan , Li Zhipeng , Yan Debin , Zhang Haibin , Yuan Kexin , Wang Ke , Zhao Yang , Zhang Yukun , Jin Weitao , Li Runting , Lin Fa , Meng Xiangyu , Hao Qiang , Wang Hao , Ye Xun , Kang Shuai , Jin Hengwei , Li Youxiang , Gao Dezhi , Sun Shibin , Liu Ali , Wang Shuo , Chen Xiaolin , Zhao Yuanli
Published: October 2022

Background

Brain arteriovenous malformation (AVM) is an important cause of hemorrhagic stroke in young adults, which can lead to severe neurological impairment. The registry of Multimodality treatment for brain ArTeriovenous malformation in mainland CHina (MATCH) is a national prospective registry to identify the natural history of AVMs in Asian population; to investigate traditional and emerging hemorrhagic predictors; and to explore the superiority of the multidisciplinary assessment in improving the long-term outcomes. 

Methods

Consecutive AVM patients will be enrolled from 52 participating hospitals in mainland China. Baseline demographic, clinical and imaging data will be collected prospectively. Conservation, microsurgery, embolization, stereotactic radiosurgery (SRS), and multimodal strategies are all included in this study. Patients will be divided into experimental and control group according to whether the treatment protocols are formulated by multidisciplinary team. Neurofunctional status, subsequent hemorrhage, seizure, and novel neurofunctional deficit will be queried at 3 months, annually (1 and 2 years), 3 years, and 10 years follow-up.

Results

Between August 2011 and April 2021, 3241 AVMs were enrolled in 11 participating sites. Among them, 59.0% were male with an average age of 28.4 ± 14.6 years, 61.2% had rupture history and 2268 hemorrhagic events occurred before admission. The median Spetzler-Martin grade and Lawton-Young grade was 3 and 5, respectively. Microsurgery is the dominant strategy (35.7%), with a similar proportion of embolization, SRS, and a combination of both (12.7%; 14.8%; 11.8%; respectively). Among them, 15.43% underwent multidisciplinary assessment and received standardized treatment. At the most recent follow-up, 7.8% were lost and the median follow-up duration was 5.6 years.

Conclusions

The MATCH study is a large-sample nationwide prospective registry to investigate multimodality management strategy for AVMs. Data from this registry may also provide the opportunity for individualized risk assessment and the development of optimal individual management strategies.

Trial registration

ClinicalTrials.gov Registry (NCT04572568).
Role of magnetic resonance imaging in evaluation of ejaculatory duct in Zinner’s syndrome: case series of five patients and review of the literature
Authors: Elsorougy Ali , Farg Hashim , Badawy Mohamed , Shebel Haytham , El-Ghar Mohamed Abou , Abdelhamid Abdalla
Published: October 2022

Background

Zinner's syndrome is a mesonephric duct anomaly characterized by unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ipsilateral ejaculatory duct obstruction due to insult occurred at urogenital tract embryogenesis during the first trimester. In the third and fourth decades of life, it is frequently diagnosed when patients begin to be symptomatic, such as lower urinary tract symptoms, infertility and painful ejaculation.

Case presentation

Herein we illustrate case review including five patients diagnosed as Zinner’s syndrome, three of them complaining from infertility; however, the remaining two cases were fertile and incidentally diagnosed.

Conclusions

Radiological investigations play significant role in the diagnostic and management processes including US, CT and MRI for detecting ipsilateral renal agenesis and unilateral seminal vesicles dilatation, but evaluation of ejaculatory duct can be done only by MRI and transrectal ultrasound; however, the latter may be sometimes nonconclusive or intolerable by patients, so MRI is considered the golden modality with its high capability to assess the lower male genital tract which played a significant role in our case series starting with detection of the presence or absence of the ejaculatory duct obstruction as well as the high delineation of the origin and nature the seminal vesicle cyst including also its size and content and finally by detection of the communication between ureteral bud and the seminal vesicles cystic dilatation.
Revealing the output power potential of bifacial monolithic all-perovskite tandem solar cells
Authors: Li Hongjiang , Wang Yurui , Gao Han , Zhang Mei , Lin Renxing , Wu Pu , Xiao Ke , Tan Hairen
Published: October 2022

Bifacial monolithic all-perovskite tandem solar cells have the promise of delivering higher output power density by inheriting the advantages of both tandem and bifacial architectures simultaneously. Herein, we demonstrate, for the first time, the bifacial monolithic all-perovskite tandem solar cells and reveal their output power potential. The bifacial tandems are realized by replacing the rear metal electrodes of monofacial tandems with transparent conduction oxide electrodes. Bandgap engineering is deployed to achieve current matching under various rear illumination conditions. The bifacial tandems show a high output power density of 28.51 mW cm−2 under a realistic rear illumination (30 mW cm− 2). Further energy yield calculation shows substantial energy yield gain for bifacial tandems compared with the monofacial tandems under various ground albedo for different climatic conditions. This work provides a new device architecture for higher output power for all-perovskite tandem solar cells under real-world conditions.