bluuebunny/crossref_metadata_2025 huggingface dataset:
Pain Catastrophizing and Substance Misuse: A Scoping Review of the Literature
Authors: Bichon Juliette A. , Bailey Allen J. , Ford Stephanie Friree , Lesser Victoria S. , McHugh R. Kathryn
Published: January 2025

Background

Pain catastrophizing, or the interpretation of pain as unbearable or intolerable, can increase pain-related anxiety and severity. High levels of pain catastrophizing have also been linked to substance use, particularly for substances with analgesic properties. Importantly, behavioral treatments can reduce pain catastrophizing, making them promising interventions for mitigating pain-related substance use. The aim of this scoping review is to summarize literature investigating the relationship between pain catastrophizing and substance use in adults.

Methods

We performed a scoping review of peer-reviewed literature. Included articles had both a measurement of pain catastrophizing and substance use, and reported analyses characterizing the relationship between the two.

Results

Of the 341 abstracts identified, 47 articles met eligibility criteria. Most studies focused on people with chronic pain. Some studies also considered samples with substance use disorders (with and without chronic pain) or acute pain, and general population samples. There was generally a positive association between pain catastrophizing and substance misuse; this association was consistent across multiple samples and substances. Most studies were cross-sectional, although associations were also detected in longitudinal studies. The magnitude of associations tended to be stronger for higher severity substance use and more proximal tests of association. More longitudinal and experimental studies are needed, however, to better delineate these effects.

Discussion

Findings indicate a consistent positive association between pain catastrophizing and substance use, highlighting the potential for interventions targeting pain catastrophizing to reduce negative substance-related consequences.
Evaluation of Retinal Capillary Density using OCT Angiography according to Acute Ischemic Stroke Etiologies - A Matched Case –Control Study
Authors: Debourdeau Eloi , Chamard Chloe , Ayrignac Xavier , Varnier Quentin , Crowdy Hannah , Villain Max , Arquizan Caroline , Daien Vincent , Schiphorst Adrien Ter
Published: January 2025

Purpose:

To investigate retinal microvascular changes in ischemic stroke patients using optical coherence tomography angiography (OCT-A) and assess these alterations based on stroke etiology.

Methods:

Case–control study conducted at Montpellier University Hospital from May 2021 to March 2022 (IRB: 202000607). Retinal vascular features were compared between strokes patients and age- and sex- matched controls. OCT-A was performed using RTVue-XR-Avanti with AngioVue (Optovue). Multivariate mixed-effects ANCOVA models adjusted for age, sex, intraocular pressure (IOP), and cardiovascular risk factors were used.

Results:

92 eyes were included: 21 with micro/macro-angiopathy stroke, 12 with etiologically ambiguous stroke, 13 with cardioembolic stroke and 46 eyes from control subjects. After adjusting for age, sex, and IOP, stroke patients had significantly lower parafoveal SCP-VD (p = 0.013) and SCP Flow Index (p = 0.023) compared to controls, especially in the macro/micro-angiopathy subgroup. When cardiovascular risk factors were included, only the SCP Flow Index difference remained significant (p = 0.023). OCT-A’s diagnostic accuracy was validated with an AUROC of 0.83.

Conclusion:

OCT-A effectively detects retinal microvascular alterations in stroke patients, with persistent alterations in macro/micro-angiopathy strokes after adjusting for cardiovascular risk factors. These findings support OCT-A’s role in stroke subtype classification.
Laudable Pus, Cocaine, and the Evolution of Wound Management
Authors: Custer Philip L.
Published: January 2025

Purpose:

To review the long history of wound management, including the methods of skin closure, asepsis, and anesthesia. Periocular techniques will be emphasized.

Methods:

Literature searches and cross-referencing were used to identify historic reports addressing the management of wounds. Foreign language manuscripts were translated using online resources.

Results:

The first written description of suturing dates to around 3000 BC and involved the repair of an eyebrow wound. A wide variety of materials have since been used as ligatures or stitches, including animal intestines, tendons, hair, silk, linen, plant fibers, and metal wire. For much of recorded history, sutures were a primary cause of wound infection and morbidity. There was a time when the resultant drainage was viewed as being beneficial (laudable pus). Many of the discoveries that ultimately led to the practice of asepsis were coincidental. Prior to the development of infiltrative anesthesia in 1894, patients had to endure the discomfort of surgery, occasionally with the sedative effects of wine or cannabis.

Conclusions:

The history of wound closure is a fascinating tale. While there has been a constant evolution, silk and catgut sutures, ligatures, surgical knots, and layered closure have been used for several millennium. Advances in asepsis, in addition to the development of anesthesia, antibiotics, and synthetic sutures, ushered in the modern age of surgery. A knowledge of the past will give us, as oculofacial surgeons, a greater understanding and appreciation of the techniques we use today.
Trends in Demographic, Clinical, Socioeconomic, and Facility-Specific Factors Linked to Eyelid Melanoma Survival: A National Cancer Database Analysis
Authors: Robbins James O. , Huck Nolan A. , Khosravi Pooya , Torabi Sina J. , Woodward Julie A. , Kuan Edward C. , Dermarkarian Christopher R.
Published: January 2025

Purpose:

This study aimed to analyze demographic, clinical, socioeconomic, and facility-specific factors affecting the survival outcomes of patients diagnosed with eyelid melanoma (EM) between 2004 and 2017 using data from the National Cancer Database.

Methods:

Cases of EM diagnosed between 2004 and 2017 were identified using the National Cancer Database. Patient demographic data, tumor stage (American Joint Committee on Cancer TNM classification), treatment modalities, and socioeconomic variables were collected. Facility-specific variables included patient volume and academic status. Kaplan-Meier survival analyses and multivariate Cox regression models were used to assess 10-year survival and identify significant predictors of mortality.

Results:

A total of 3,235 patients with EM were eligible for demographic analysis. The majority of patients were over 60 years of age and predominantly male. Kaplan-Meier analysis showed a significant decrease in 10-year overall survival with increasing age at diagnosis (p < 0.001), T clinical stage (p < 0.001), and male sex (p = 0.001). Additionally, patients with higher income (p = 0.01), private insurance (p < 0.001), and those treated at high-volume (p = 0.006) and academic facilities (p = 0.005) had improved 10-year overall survival. Multivariate Cox regression identifying independent predictors of EM mortality corroborated these findings.

Conclusions:

Eyelid melanoma survival outcomes were significantly influenced by age, tumor stage, socioeconomic status, and facility characteristics. Treatment at high-volume centers confers a survival advantage, emphasizing the importance of specialized care. These findings underscore the need for early detection and equitable access to improve EM outcomes.
Eyelid Malpositions as Complication of Pregnancy
Authors: Clabeaux Carson E. , Bates Tyson S. , Yakopson Vladimir S.
Published: January 2025

Eyelid malpositions as a complication of pregnancy, in the absence of associated trauma or injury, are rarely encountered. There are limited published reports on this phenomenon or subsequent surgical repair. We present the case of a 38-year-old female who experienced 3 separate episodes of eyelid malpositions, each occurring independently during 3 otherwise uncomplicated pregnancies, which persisted until surgical correction. Histological analysis of the patient’s conjunctiva and tarsus revealed degeneration and loss of elastic tissue, crucial for eyelid anatomy. Surgical repair was performed in each instance, resulting in excellent cosmetic, anatomic, and visual outcomes.
Progress of Baggy Eyelid: An Anatomical Study
Authors: Kakizaki Hirohiko , Ambat Jose Miguel , Naito Munekazu , Takahashi Yasuhiro
Published: January 2025

Purpose:

To examine microscopically the progress of baggy eyelid formation in the lower eyelid.

Methods:

Histological evaluation of 17 central lower eyelids (11 right and 6 left) from 13 Japanese cadavers (age range: 36–97 years, average: 73.0 years) was performed. The specimens were fixed in 10% formalin and stained with Masson’s Trichrome. The following characteristics were examined: 1) presence of baggy eyelid, 2) thickness of the orbital septum, 3) presence of anterior protrusion of fat and/or orbicularis oculi muscle (OOM), 4) thickness of OOM and subcutaneous tissue at the widest anterior protrusion, and 5) skin thickness.

Results:

The findings were divided into 4 stages: stage 0 (2 eyelids in 1 specimen) absent baggy eyelid, all tissues normal, stage 1 (1 eyelid in 1 specimen) absent baggy eyelid, intermediate orbital septum, anterior dome-like protrusion of fat but minimal OOM projection, thick OOM, subcutaneous tissue, and skin, stage 2 (9 eyelids in 7 specimens) absent or minimal baggy eyelid, intermediate orbital septum, anterior dome like protrusion of fat and OOM, intermediate OOM, with thick subcutaneous tissue and skin, stage 3 (5 eyelids in 4 specimens) with present baggy eyelid, thin orbital septum, severe anterior dome like protrusion of fat and OOM, with thin OOM, subcutaneous tissue and thick skin in mild type, with thin skin in severe type.

Conclusions:

Baggy eyelid appears to be triggered by the anterior protrusion of fat, followed by thinning of the orbital septum, OOM, and subcutaneous tissue in order. Thinner skin may promote severe entity.
Association between diabetes and characteristics of hospitalization in patients with acute pancreatitis
Authors: Kirzhner Alena , Green Hefziba , Lin Guy , Khadija Haitham abu , Cohen Ramon , Mari Andaleeb , Schiller Tal
Published: January 2025

Objective:

Data on the influence of diabetes and the prognosis of acute pancreatitis (AP) remains limited. We aimed to characterize the clinical course and prognosis of patients hospitalized with a principal diagnosis of AP with and without diabetes.

Methods:

This was a single-center hospital-based observational retrospective cohort study of adult patients admitted to the Department of General Surgery at Kaplan Medical Center with AP between 2017 and 2022. Elaborated data were retrieved from the electronic medical records. The main adverse outcomes included infections, necrotizing pancreatitis, surgery due to these complications, organ failure, intensive care unit admission, in-hospital mortality, length of hospitalization, and three months of all-cause readmission after the index hospitalization.

Results:

350 adult patients with AP were included, of which 101 (29%) had diabetes. Diabetic patients were older and had a higher prevalence of comorbidities. Despite these differences, the presence of diabetes did not correlate with any of the adverse hospitalization outcomes except a three-fold higher risk for re-admissions in the three months post-discharge due to AP complications (9% vs 3%, p=0.025). Using logistic regression, the risk factors significantly associated with unfavorable outcomes among diabetic patients included age, background congestive heart failure (OR 5.064, 95% CI 1.036–24.742, p = 0.045), and hyperglycemia during hospitalization (OR 4.382, 95% CI 1.108–17.325, p = 0.035). Patients who used DPP4 inhibitors at admission were 19 times more likely to have an adverse outcome (OR 18.637, 95% CI 2.510–138.374, p = 0.004), while Metformin and unknown etiology of AP had a protective effect.

Conclusion:

Although diabetic patients had less favorable characteristics at baseline most hospitalization outcomes were comparable to patients without diabetes.
Nevus of Hori in African patients: an entity that is most likely underdiagnosed in clinical practice
Authors: Maruma Frans , Dlova Ncoza , Mofokeng Thabiso Rafaki Petrus , Moloabi Boitshoko Claudia
Published: January 2025

Background:

Nevus of Hori (HN) has been primarily reported in patients of Eastern Asian descent, with a paucity of data regarding HN occurring in African patients. In this study, we report on South African patients with HN initially thought to have melasma.

Objective:

To characterize the histopathological and clinical phenotypes of HN in African patients.

Methods:

Retrospective data were collected from patients who met the inclusion criteria. These data entailed the clinical distribution, demographic data, Fitzpatrick skin phototype, and histopathologic features of African patients diagnosed with HN from a single private aesthetic center in Bloemfontein, South Africa.

Results:

Thirty patients with an average age of 49 ± 7.37 were included in this analysis. The majority of patients were female (n = 29; 96.67%), and most patients were of Fitzpatrick skin phototype V (n = 22; 73.3%). The most common clinical distribution pattern was bitemporal (76.7%), followed by the zygomatic pattern (20%), mixed type (16.7%), and finally the central forehead pattern (3.3%). Histopathologically, the dendritic cell type of melanocytes was observed in the majority of patients (n = 25; 83.3%), while spindle-shaped cells were observed in few patients (n = 7; 23.33%), and none of the patients had bipolar-type melanocytes.

Limitations:

This study has limitations inherent to small sample size and its inability to accurately generalize the findings.

Conclusion:

HN can clinically mimic melasma in African patients. The most common clinical presentation was bitemporal. To our knowledge, this study is the largest regarding the clinicopathological profile of HN in African patients and it is likely to be the first to report these compelling findings.
Comparison of Clinical and Pathologic Features of Antimitochondrial Antibodies-negative Primary Biliary Cirrhosis and Cholestatic Type Drug-induced Liver Injury
Authors: Xiaohan Ma , Lixia Yang , Xiangyu Zeng , Wanting Liu
Published: January 2025

Aim:

To compare the respective clinical and pathologic features of antimitochondrial antibodies-negative (AMA-negative) primary biliary cirrhosis (PBC) and cholestatic type drug-induced liver injury (DILI) for clinical differential diagnosis.

Patients and Methods:

Clinical data from 23 patients with AMA-negative PBC and 39 patients with cholestatic type DILI, treated at our hospital between January 2013 and January 2024, were collected and retrospectively analyzed.

Results:

The cholestatic type DILI group exhibited a higher incidence of malaise and abdominal pain compared with the AMA-negative PBC group. Alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, alkaline phosphatase, low-density lipoprotein cholesterol, globulin, immunoglobulin G, immunoglobulin M, and anti-gp210/anti-Sp100 antibodies were higher in the AMA-negative PBC group compared with the cholestatic type DILI group. There were differences in the stages of inflammation and fibrosis between the cholestatic type DILI group and the AMA-negative PBC group. Lymphocyte and plasma cell infiltration in the confluent areas was more pronounced in the AMA-negative PBC group, while monocyte infiltration was greater in the cholestatic type DILI group. In the small bile duct reaction, the positive rate was higher in the AMA-negative PBC group compared with the cholestatic DILI group. Conversely, the positive rate of D-PAS staining was greater in the cholestatic type DILI group than in the AMA-negative PBC group. All of these differences were statistically significant (P < 0.05).

Conclusions:

Comparing the AMA-negative PBC with the cholestatic type DILI revealed differences in liver function, lipid profiles, immunoglobulins, autoantibodies, and hepatic histopathologic features. These distinctions facilitate the clinical differentiation between the 2 conditions.
West Nile Neuroinvasive Disease: Case Series and Review of the Literature
Authors: Alter Rachel , Juretschko Stefan , Smith Miriam A.
Published: January 2025

Background:

West Nile virus (WNV), although underdiagnosed, is the most common mosquito-borne disease and the second most common cause of viral encephalitis in the United States. Fewer than 1% of those infected develop neuroinvasive disease.

Methods:

We present a cluster of 3 cases of neuroinvasive WNV that occurred between August and September 2023 and a review of the literature for neurologic involvement with this virus.

Data Sources:

Sunrise Electronic Health Record; PubMed; Google; Division of Infectious Disease Diagnostics, Northwell Health Laboratories, Little Neck, NY.

Results:

The patients in all 3 cases were admitted with acute encephalopathy and other neurologic impairment. All 3 patients had a serum serologic diagnosis consistent with WNV. However, only one of 3 of the patients underwent a lumbar puncture with cerebrospinal fluid confirmation of WNV.

Areas of Uncertainty:

Clinical and laboratory guidelines have been described for the diagnosis of neuroinvasive WNV infection. This is especially important in patients who do not have cerebrospinal fluid confirmation.

Conclusions:

WNV is underdiagnosed. Furthermore, although neuroinvasive WNV infection is uncommon, this diagnosis should be considered in patients presenting with abnormal neurologic signs and symptoms during the summer months in geographic areas where potential transmission is of concern.
Characteristics of Peripheral Intravenous Catheter Cannulation in Older Japanese Inpatients
Authors: Kitada Motoko , Yamamura Shigeo , Ninomiya Ayako , Kabashima Minoru , Tateno Kazuko , Hori Etsuro
Published: January 2025

Age-related physiological changes affect various aspects of peripheral intravenous catheter (PIVC) cannulation. However, the characteristics of PIVCs, especially in older patients, have been poorly investigated. In the current cross-sectional observational study, PIVC sizes, PIVC sites, the number of attempts until successful insertion, and the degree of venodilation upon insertion among hospital inpatients aged ≥65 years were investigated, along with measurements of the vessel diameter and depth using ultrasound. In total, 91 PIVC insertions were analyzed. The vessel diameter was estimated to be smaller than that in domestic adult inpatients. Most of the catheters were placed at the ideal site on the first attempt. However, considering the optimal vein-to-catheter ratio, most of the cannulations were oversized and would be oversized even when using a 24-gauge catheter. In addition, obvious differences were found in the vessel diameter, catheter size, and catheter site compared with previous studies conducted outside of Asia. The current study indicates the need for further research on the identification of appropriate veins, and the definition of “appropriate” approaches might vary among countries.
Pediatric Myeloid Neoplasms With UBTF Tandem Duplications
Authors: Khanlari Mahsa , Wang Wei , Ni Yonghui , Mead Paul E. , Umeda Masayuki , Westover Tami , Ma Jing , Rubnitz Jeffrey E. , Barajas Juan M. , Pounds Stanley , Klco Jeffery M.
Published: January 2025

Tandem duplications (TDs) in exons of upstream binding transcription factor (UBTF-TD) are a rare recurrent alteration in pediatric and adult acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS)/neoplasm. Although recently identified, AML with UBTF-TD is now considered a distinct subtype of AML. To further our understanding of myeloid neoplasms with UBTF-TD, we analyzed clinical, morphologic, and immunophenotypic characteristics of 27 pediatric patients with UBTF-TD-positive myeloid neoplasm, including 21 diagnosed as AML and 6 as MDS. Our data demonstrated that UBTF-TD is frequently associated with cytopenia, hypercellular marrow with erythroid hyperplasia, and trilineage dysplasia. Blasts and maturing myeloid cells show a characteristic dysplastic feature with condensed eosinophilic cytoplasm. Blasts have a myeloid or myelomonocytic immunophenotype with a variably dim expression of CD34 and/or CD117, and except for CD7 expression lack a consistent pattern of aberrant lineage-specific antigen expression. Patients with MDS had a lower blast count in the peripheral blood (P = 0.03) and bone marrow (P <0.001) but otherwise had no significant differences in other hematological parameters. Three patients with MDS rapidly progressed to AML in 33, 39, and 210 days from the initial diagnosis and there was no difference in overall survival between patients with MDS and AML (P = 0.18). Our data suggest that MDS with UBTF-TD is prognostically equivalent to AML with UBTF-TD and thus should be considered as a continuum of the same molecularly defined myeloid neoplasm. These collective data also provide morphologic and immunophenotypic clues that can prompt screening for UBTF-TD in patients with MDS or AML.
A Conservative Crease-Height-Adjustable Asian Double Eyelid Surgery Technique Based on Live Anatomical Studies
Authors: Yu Arthur Y. , Yu Abigail A. , Boonipat Thanapoon , Pu Lee L.Q.
Published: January 2025

Background:

Ideal methods for double eyelid crease creation in Asian upper eyelids remain controversial due to the complexity of Asian upper eyelid anatomies. Key confusions include the underestimation of tarsal height and the septum/aponeurosis fusion point height (FPH), which may underlie the unnaturally high creases in many classic double eyelid procedures.

Methods:

A total of 1272 patients had tarsal heights measured. Among 386 patients with orbital septa opened, FPHs and other anatomic findings were also documented. Based on the anatomical findings, a novel method for double eyelid crease formation was designed. This method involves preserving the pretarsal fibrofatty tissue and using horizontal mattress sutures to connect the orbicularis oculi muscle (OOM), through the pretarsal fibrofatty tissue and levator aponeurosis, to the pretarsal membrane (MAP method) as the linkage mechanism.

Results:

Tarsal height levels were higher than reported in many previous studies. In the supine position, all FPHs were higher than the tarsi. Eyelid creases using the MAP method are created below the superior tarsal edges at varying heights, accommodating individual patient requests while achieving well-formed creases and improved eyelid mechanics. The recovery was brief, and the results were long-lasting with a minimal failure rate.

Conclusions:

Tarsal heights and FPHs are not as low as previously thought, which could explain why many ‘classic’ surgeries encounter various issues. Our proposed MAP method for Asian double eyelid blepharoplasty allows conservative crease-height-adjustability with results that are dynamic, natural, and durable.
Differences in Clinical Profiles and Biologic Treatment Approaches for Autoimmune Rheumatic Diseases Across Regions in Mexico
Authors: Rivera Terán Vijaya , Saavedra Miguel Ángel , Colunga Pedraza Iris Jazmín , Vega Morales David , Irazoque Palazuelos Fedra , Carrillo Vázquez Sandra , Xibillé Friedmann Daniel , Castillo Ortiz Angel Alejandro , Torres Valdez Estefanía , Sicsik Ayala Sandra , Miranda Hernández Dafhne , Casasola Vargas Julio César , Muñoz Monroy Omar , Valdés Corona Luis Francisco , Mendieta Zerón Samara , Merayo Chalico Javier , Durán Barragán Sergio , Ramos Sánchez Azucena , Paz Viscarra Aleni , Zamora Tehozol Erick , Torres Jiménez Alfonso , Torres-Ruiz Jiram , Alpízar Rodríguez Deshiré
Published: January 2025

Objective

Being Mexico a very diverse developing country, the access to health care varies among geographical regions. We aimed to assess the differences in clinical features and treatment prescription in 3 regions of Mexico using data from the Mexican Adverse Events Registry (BIOBADAMEX).

Methods

We included all BIOBADAMEX patients from 2016 to 2023, compared the prescription patterns, the sociodemographic, clinical, and treatment characteristics between the northern (NR), central (CR), and southern regions (SR), and addressed the treatment survival by calculating hazards ratios (HRs).

Results

A total of 1084 patients were included: 389 (35.9%) from the NR, 569 (52.5%) from the CR, and 126 (11.6%) from the SR. The most common diagnosis was rheumatoid arthritis (61.0%). Patients from NR had longer disease duration (p = 0.03); those from SR had higher BMI (p < 0.001), DAS28 (p < 0.001), BASDAI scores (p = 0.02), and used more frequently glucocorticoids (p < 0.001). Patients from CR had more comorbidities (p = 0.001) and more regularly used conventional DMARDs (p = 0.007). Among patients with at least 2 assessments (n = 441), treatment with bDMARDs and tsDMARDs was discontinued in 247 (56%), 53% due to lack of efficacy. There was no association between the country region and treatment survival, but the main factors related to treatment discontinuation were disease duration (HR, 0.9; 95% confidence interval, 0.6–0.9) and lack of response (HR, 1.4; 95% confidence interval, 1.2–1.7).

Conclusions

In Mexico, patients with rheumatic diseases show regional differences in their clinical features and prescription patterns, which may be related to regional disparities in health care access and sociodemographic characteristics.
Prevalence and Associated Factors of Sarcopenia in Thai Rheumatoid Arthritis Patients
Authors: Gumtorntip Wanitcha , Phinyo Phichayut , Kasitanon Nuntana , Louthrenoo Worawit
Published: January 2025

Background/Objectives

Sarcopenia associates with poor health-related quality of life (HRQoL). This study aimed to determine prevalence and factors associated with sarcopenia in rheumatoid arthritis (RA) patients. The HRQoL between RA patients with and without sarcopenia also was compared.

Methods

This cross-sectional study recruited RA patients, aged ≥20 years, at Chiang Mai University Hospital between May and November 2023. Their skeletal muscle mass (bioelectrical impedance analysis), grip strength (hand dynamometer), and physical performance (gait speed test) were evaluated. Sarcopenia was defined according to the Asian Working Group for Sarcopenia. Patient characteristics, disease activity, physical disability (HAQ-DI), HRQoL (SF-36), nutrition (mini nutrition assessment), and medications were recorded.

Results

Of 299 patients (89.0% female; age 61.3 ± 11.6 years; disease duration 13.9 ± 8.6 years), 37.5% had sarcopenia (27.4% severe sarcopenia). In multivariable analysis, body mass index (odds ratio [95% confidence interval] 1.46/1 unit decrease [1.27, 1.68], p < 0.001), disease duration (1.89/10 years increase [1.27, 2.83], p = 0.002), deformity of hands/feet (3.80 [1.50, 9.61], p = 0.005), mini nutritional assessment score (1.21/1 score decrease [1.04, 1.40], p = 0.012), and high C-reactive protein (CRP) (1.94 [1.02, 3.69], p = 0.044) were independent factors associated with sarcopenia. There was no relationship between sarcopenia and disease activity (DAS-28-ESR or CRP) or medication use. RA patients with sarcopenia had higher HAQ score than those without, but potentially lower scores in physical function domain of SF-36 with adjusted mean difference of 0.2 (95% confidence interval 0.03, 0.32, p = 0.022) and −5.9 (−12.24, 0.38, p = 0.066), respectively.

Conclusions

About one third of the Thai RA patients in this center had sarcopenia. Low body mass index, long disease duration, joint deformity, malnutrition, and high CRP were independent factors associated with sarcopenia. Sarcopenia affects physical capabilities and the physical function domain of the HRQoL.
Salivary β2-Microglobulin, Na+, and Cortisol Levels, and Salivary Glands' Uptakes in Sialoscintigraphy in Sjögren Disease
Authors: Inokuma Shigeko , Ishida Makoto , Uchida Yoshitaka
Published: January 2025

Objective

For early diagnosis and inquiry into the pathophysiology of Sjögren disease (SjD), salivary secretion and component levels, and salivary glands' uptakes in sialoscintigraphy were examined, in this cross-sectional study.

Methods

Patients who visited our hospital with suspected SjD between April 2016 and March 2020 were checked for unstimulated salivary secretion and β2-microglobulin, Na+, and cortisol levels in saliva. The patients who showed any abnormal salivary test results underwent sialoscintigraphy; the uptakes in the parotid, submandibular, and thyroid glands were compared using paired t test.

Results

Sixty-five patients (female/male 51/14, 64.5 ± 13.7 years) were checked for saliva. The secretion was 0.39 ± 0.43 mL/min. The component levels were 1.98 ± 1.45 mg/dL for β2-microglobulin (n = 61), 15.9 ± 15.3 mEq/L for Na+ (n = 61), and 0.20 ± 0.18 μg/dL for cortisol (n = 56). A significant negative correlation was observed between the secretion and each component level. A significant positive correlation was found between the 2 out of the 3 component levels. Sialoscintigraphy of 52 patients showed significantly lower uptake in the submandibular glands than in the parotid glands (submandibular/parotid ratio: 0.51 ± 0.36, left; 0.54 ± 0.39, right). The total uptake in the 4 salivary glands was lower, but not significantly, than that in the thyroid gland.

Conclusions

In patients with suspected SjD, a decreased salivary secretion correlated with a high level of any of β2-microglobulin, Na+, and cortisol; the 2 of the 3 levels correlated positively. Sialoscintigraphy showed that the submandibular glands were involved to a greater extent than the parotid glands were. The total salivary gland uptake may be lower than that in thyroid.
High-Resolution Free-Breathing Chemical-Shift-Encoded MRI for Characterizing Lymph Nodes in the Upper Abdomen
Authors: Maatman Ivo T. , Maas Marnix C. , Ypma Sjoerd , Block Tobias K. , van den Elshout Rik , Veltien Andor , Smit Ewoud J. , Hermans John J. , Scheenen Tom W.J.
Published: January 2025

Objectives

Accurate lymph node (LN) staging is crucial for managing upper abdominal cancers. Ultrasmall superparamagnetic iron oxide (USPIO)–enhanced magnetic resonance imaging effectively distinguishes healthy and metastatic LNs through fat/water and

-weighted imaging. However, respiratory motion artifacts complicate detection of abdominal LNs. This study evaluates if a free-breathing radial stack-of-stars acquisition can match or outperform Cartesian reference scans to visualize LNs and depict uptake of USPIO nanoparticles.

Materials and Methods

Five volunteers with USPIO and 20 patients without USPIO were scanned using radial stack-of-stars, Cartesian dual-echo, and fat-saturated Cartesian multiecho sequences for fat/water imaging and

estimation. Reconstructed images from radial and Cartesian patient data underwent qualitative comparison by 2 radiologists. LNs were identified in all fat/water images, LN short-axis sizes were measured, and relaxation rates were analyzed using linear correlations and Bland-Altman plots.

Results

Radial imaging provided better image quality than the Cartesian reference standard, according to both readers. Substantially, more LNs were identified in radial compared with Cartesian datasets (349 vs 202). Median short-axis diameters showed a significant difference, measuring 2.7 mm (interquartile range [IQR]: 2.7–4.6 mm) for radial images and 4.5 mm (IQR: 3.7–5.6 mm) for Cartesian images (P < 0.0001). Relaxation rates measured in radial data showed a significant linear correlation with the Cartesian reference (Pearson correlation coefficient: 0.90 with P < 0.0001). Bland-Altman plots indicated a slight bias with a mean difference (MD) of 3.9 s−1 and limits of agreement at MD ± 16.4 s−1.

Conclusions

This work presents a promising magnetic resonance imaging method to depict upper abdominal LNs and to visualize their USPIO uptake. Instead of multiple Cartesian breath-hold scans, all relevant contrasts and parameters are obtained from a single free-breathing radial acquisition. The proposed method yielded higher image quality and more sensitive detection of small LNs.

value analysis showed a strong linear correlation with the reference, albeit with minimal biases.
Genomic analysis of surgical patients to identify patients at risk for postoperative sepsis and surgical site infection
Authors: Ahmed Kaleem S. , Christensen Mathias A. , Bonde Alexander , Wei Wei-Qi , Khan Atlas , Pacheco Jennifer , Roy-Puckelwartz Megan , McCarthy Robert J. , Alam Hasan B. , Sillesen Martin
Published: January 2025

BACKGROUND

Early and accurate diagnosis of sepsis and the ensuing organ dysfunction remain a challenge in the postoperative setting. Susceptibility to infections, as well as the subsequent immunological response, are driven to some extent by the genetic predisposition of the patient. The purpose of this study was to identify novel genetic variants associated with postoperative sepsis (POS) and surgical site infections (SSIs).

METHODS

We conducted genome-wide association studies for POS and SSIs in the Electronic Medical Records and Genomics Network database. All patients with surgical and genomic information in Electronic Medical Records and Genomics were identified. Patients with a new diagnosis of sepsis/SSIs after surgery were classified as cases, and those without as controls. Analyses were performed using PLINK 2.0's logistic regression function. A p value of <5 × 10−8 was considered statistically significant.

RESULTS

A total of 59,755 participants were included in the analysis. Genetic regions on chromosomes 9 and 14 reached statistical significance for POS (p < 5 × 10−8). The most significant single-nucleotide polymorphisms (SNPs) were rs9413988 (p = 5.59 × 10−12) on chromosome 9 and rs35407594 (p = 1.43 × 10−10) on chromosome 14. The rs9413988 region is downstream to the phosphoglucomutase 5 pseudogene (PGM5P2) and Zn-regulated GTPase metalloprotein activator 1F (ZNGF1) and likely plays a role in transcription regulation, while rs35407594 corresponds to the olfactory receptor gene family, OR11. Similar SNPs were also associated with SSIs.

CONCLUSION

We have identified two genetic regions containing SNPs associated with POS and SSIs. These findings provide new avenues for investigation, which may help identify and guide point-of-care management for at-risk patients.

LEVEL OF EVIDENCE

Prognostic and Epidemiological; Level III.
Automating excellence: A breakthrough in emergency general surgery quality benchmarking
Authors: Perkins Louis A. , Mou Zongyang , Masch Jessica , Harris Brandon , Liepert Amy E. , Costantini Todd W. , Haines Laura N. , Berndtson Allison , Adams Laura , Doucet Jay J. , Santorelli Jarrett E.
Published: January 2025

BACKGROUND

Given the high mortality and morbidity of emergency general surgery (EGS), designing and implementing effective quality assessment tools is imperative. Currently accepted EGS risk scores are limited by the need for manual extraction, which is time-intensive and costly. We developed an automated institutional electronic health record (EHR)–linked EGS registry that calculates a modified Emergency Surgery Score (mESS) and a modified Predictive OpTimal Trees in Emergency Surgery Risk (POTTER) score and demonstrated their use in benchmarking outcomes.

METHODS

The EHR-linked EGS registry was queried for patients undergoing emergent laparotomies from 2018 to 2023. Data captured included demographics, admission and discharge data, diagnoses, procedures, vitals, and laboratories. The mESS and modified POTTER (mPOTTER) were calculated based off previously defined variables, with estimation of subjective variables using diagnosis codes and other abstracted treatment variables. This was validated against ESS and the POTTER risk calculators by chart review. Observed versus expected (O:E) 30-day mortality and complication ratios were generated.

RESULTS

The EGS registry captured 177 emergent laparotomies. There were 32 deaths (18%) and 79 complications (45%) within 30 days of surgery. For mortality, the mean difference between the mESS and ESS risk predictions for mortality was 3% (SD, 10%) with 86% of mESS predictions within 10% of ESS. The mean difference between the mPOTTER and POTTER was −2% (SD, 11%) with 76% of mPOTTER predictions within 10% of POTTER. Observed versus expected ratios by mESS and ESS were 1.45 and 1.86, respectively, and for mPOTTER and POTTER, they were 1.45 and 1.30, respectively. There was similarly good agreement between automated and manual risk scores in predicting complications.

CONCLUSION

Our study highlights the effective implementation of an institutional EHR-linked EGS registry equipped to generate automated quality metrics. This demonstrates potential in enhancing the standardization and assessment of EGS care while mitigating the need for extensive human resources investment.

LEVEL OF EVIDENCE

Prognostic and Epidemiologic Study; Level IV.
“Investigating Colistin Resistance in Carbapenem Resistant Acinetobacter baumanii Isolates during a Neonatal Intensive Care Unit outbreak "
Authors: Raza Mubashir , Khan Saadullah Jan , Masood. Muhammad Faisal , Jafri Laila , Rani Rehana , Ali Roomana , Sadiq Sara , Aakhtar Nosheen , Jamil Bushra
Published: January 2025

Purpose: Colistin resistant Acinetobacter baumannii poses a growing challenge in neonatal intensive care units (NICUs) due to the emergence of plasmid-mediated Mobile Colistin Resistance (mcr) genes that can rapidly spread among neonates. This pioneering study conducted a comprehensive analysis of mcr-1, mcr-2, mcr-3, mcr-4, and mcr-5 genes in A. baumannii strains isolated from NICU. Notably, this investigation marks the first of its kind in this setting.
In addition to genotypic analyses, the study incorporated phenotypic assays to identify the most effective method for detecting colistin resistance in these A. baumannii strains.
Methods: In the genotypic investigation, DNA was extracted from strains of colistin-resistant A. baumannii, collected from the NICU of a local hospital of Islamabad, Pakistan. The specific set of primers for each mcr gene was used to detect their presence. Various phenotypic methods such as, disc diffusion, broth macro dilution, Minimum Inhibitory Concentration (MIC), disc elusion and colistin agar methods were performed using predetermined calculations for phenotypic studies.
Results:The study confirms the distribution of the mcr-1 gene among the eight strains, which contributes 62% of the total number, whereas mcr-2, 3, 4 and 5 genes were not detected in all strains. Based on phenotypic analysis, A. baumannii had shown resistance against colistin at < 2µg/mL. In contrast, MIC varies from strain to strain.
Conclusions: The horizontal transfer of the mcr-1 gene is responsible for developing resistance against colistin among A. baumannii in neonates. All phenotypic methods adopted in this study generated the same results, so the method selection depends upon individual comfort. However, we propose that the colistin agar method offers multiple advantages over other methods as it is more economical, easy to perform, multiple samples can be assessed simultaneously, and fewer calculations are involved for colistin resistance determination and finding out clinical breakpoints.
Validation of an improved reference freeze-dried direct agglutination test for detecting leishmaniasis in the canine reservoir
Authors: el Harith Abdallah , Abass Elfadil , Martinkovic Franjo , Mansour Durria , Osman Hussam Ali
Published: January 2025

Introduction. Proper identification and management of post-kala-azar dermal leishmaniasis (PKDL) and canine leishmaniasis (CanL) cases are among the prerequisites to the effective control of visceral leishmaniasis worldwide. Unlike PKDL, CanL still awaits effective improvement because of its cryptic nature, absence of Leishmania parasites in lesions or lymph nodes and not complete sensitivity of some diagnostic tools in use. Because of the need for certain skills and equipment, both the liquid direct agglutination test and freeze-dried direct agglutination test (FD-DAT) versions are, in comparison with the indirect immunofluorescence antibody test (IFAT) or enzyme-linked immunosorbent assay (ELISA), practical and feasible diagnostic alternatives.

Aim. Validate the performance of an improved FD-DAT to suit routine and large-scale applications in CanL endemic areas.

Methodology. Introducing citrate-saline formaldehyde (CSF) as an anti-clumping agent to replace normal saline for antigen reconstitution and drastically, however, eligibly lower the concentration of promastigotes (1.4×107) in comparison with the original FD-DAT reference (>5×107 ml−1). To ensure optimal safety, β-mercaptoethanol was replaced by urea or SDS as a serum-reducing agent.

Results. By improving the procedure for reconstitution of FD-DAT antigen with CSF, a 150% reduction in the test application cost was achieved. Expired test batches (±4 years earlier) were successfully revitalized to full validity. As compared to the 48 h shelf-life time for the original, an FD-DAT batch reconstituted here with CSF maintained stability for ±12 months.

Conclusions. The highly concordant results with IFAT and ELISA (one-way ANOVA test, P=0.142, homogeneity of variances P=0.009) as routine CanL diagnostics further motivate the application of the improved FD-DAT for the detection of the disease in endemic areas.
Phytochemical screening and in vitro antibacterial evaluation of Plectranthus amboinicus (Lour) spreng against selected four pathogenic bacteria
Authors: Adame Abdisha Abrahim , Desta Mulugeta Desta , Yus Zekariya Yusuf , Ume Yusuf Umer , Chavula Petros Chavula
Published: January 2025

Background

Traditional medicine is still utilized around the globe, particularly in developing countries such as Ethiopia, where the majority of people maintain their health through the use of plant medicines. The primary challenges that needed to be addressed were the requirement for scientific backing for adequate documentation and drug development. The current study intended to screen phytochemical and antibacterial activities of Plectranthus amboinicus crude extracts, against selected pathogenic bacteria.

Methods

The study were designed in Complete Randomized Design based on laboratory bioassay with three replications involves a 2x2x3x4x3 (2 sources i.e. leaf and stem; 2 solvent, i.e. Ethanol, and aqueous water; 3 concentration levels, i.e. 100mg/ml, 120 mg/ml and 150mg/ml; 4 bacterial species; and 3 replications). Qualitative analysis or susceptibility was carried out using standard protocol and phytochemical and antimicrobial activities were determined by disc diffusion and broth dilution method.

Result

According of study indicated the presence of six phytochemical compounds among the tested compounds, while, Saponin and Terpenoid were absent in ethanol extract and present in water extract. Phlobotanin possess negative at all in both ethanol and water extract. Based on observed susceptibility test the highest inhibition zone 14.6mm was recorded against S. Pyogenes at a concentration of 150 mg/ml, while 9.1 mm inhibition zone was observed against E. coli in concentration of 100 mg/ml. Minimum inhibitory concentration values, in the range 25 mg/mL to 100 mg /ml gram positive and gram negative, minimum bactericidal concentration values ranged 50 mg/ml to 100 mg/ml respectively recorded.

Conclusion

Plectranthus amboincus plant showed presence of secondary metabolites, possesses bio-active compounds against selected human pathogenic bacterial species, thereby justifying the application of their crude extracts as medicinal plants. Further studies are required against more bacteria and fungus pathogens.
Tistrella arctica sp. nov., isolated from the surface seawater of the Bering Sea and Chukchi Sea and emended description of the genus Tistrella
Authors: Zhang Jinzhu , Wang Jianning , Lai Qiliang , Liu Xiupian , Li Guangyu , Pan Panyi , He Ziyuan , Shao Zongze , Dong Chunming
Published: January 2025

Two Gram-stain-negative, motile, non-spore-forming, aerobic or facultative anaerobic and short rod-shaped bacterial strains, 25B02-3T and BH-R2-4, were isolated from surface seawater collected from the Bering Sea and Chukchi Sea, respectively. The 16S rRNA gene sequences of the two strains were identical. The phylogenetic analysis of the 16S rRNA gene sequences indicated that they were related to the genus Tistrella and shared 99.6 and 98.2% sequence similarity with T. bauzanensis BZ78T and T. mobilis IAM 14872T, respectively. Both 16S rRNA gene and genome sequence-based phylogenetic analyses showed that the two strains formed a monophyletic clade within the genus Tistrella, indicating that they may represent a novel species. The digital DNA‒DNA hybridization (dDDH) values and average nucleotide identities (ANI) between the two strains were 93 and 99%, respectively, indicating that they are different strains. The dDDH and ANI values between the two strains and the type strains of the genus Tistrella were 22.4–58.3% and 81.0–95.0%, respectively. These data clearly demonstrated that the two strains represent a separate genomic species of the genus Tistrella. The principal fatty acids were Sum In Feature 8 (C18 : 1
ω7c or C18 : 1
ω6c), C19 : 0 cyclo ω8c, Sum In Feature 2 (C12 : 0 aldehyde or unknown 10.928) and C16 : 0. The predominant respiratory quinone was Q-10, with a minor Q-9. The polar lipids included phosphatidylethanolamine, aminolipids and phospholipids. The genomic DNA G+C contents of strains 25B02-3T and BH-R2-4 were 67.3 mol% and 67.4 mol%, respectively. On the basis of the polyphasic evidence presented in this study, the two strains represent a novel species within the genus Tistrella, for which the name Tistrella arctica sp. nov. is proposed. The type strain is 25B02-3T (=MCCC 1A07333T=KCTC 8340T).
Luteimonas salinilitoris sp. nov., isolated from the shore soil of saline lake in Tibet of China
Authors: Zhang Xuan , Liao You-Jun , Liu Zi-Xuan , Wang Rui , Liu Hong-Can , Zheng Yan-Yan , Zhou Yu-Guang , Yu Ya-Jing , Xue Lu , Li Ai-Hua
Published: January 2025

Five aerobic, Gram-stain-negative bacterial strains, designated as C3-2-a3T, B3-2-R+30, C3-2-a4, C3-2-M3 and C3-2-M8, were isolated from the coastal soil of LungmuCo Lake in the Tibet Autonomous Region, PR China. Phylogenetic analyses based on 16S rRNA genes and genomes indicated that these isolates belonged to the genus Luteimonas and showed a high similarity to Luteimonas suaedae LNNU 24178T (99.01%), Luteimonas endophytica RD2P54T (98.80%) and Luteimonas salinisoli SJ-92T (97.67%). The average nucleotide identity (ANI) and digital DNA–DNA hybridization (dDDH) values between strain C3-2-a3T and related reference strains Luteimonas suaedae LNNU 24178T, Luteimonas endophytica RD2P54T and Luteimonas salinisoli SJ-92T were 91.89, 83.11 and 83.86% and 46.90, 26.90 and 28.20%, respectively. All values were below the thresholds for delineating species, supporting their classification as novel species of the genus Luteimonas. The genomic DNA G+C content of strains C3-2-a3T was 68.39%. The major polar lipids were diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine and two unidentified phospholipids. The predominant respiratory quinone was ubiquinone-8 (Q-8), aligning with the characteristics of members of the genus Luteimonas. The major fatty acids (>10.0%) of strain C3-2-a3T were identified as iso-C11 :  0, iso-C15 :  0, iso-C16 : 0 and iso-C17 : 1
 ω9c. Based on the results of phenotypic, physiological, chemotaxonomic and genotypic characterizations, we propose that the isolates represent a novel species of genus Luteimonas, for which the name Luteimonas salinilitoris sp. nov is proposed. The type strain is C3-2-a3T (=CGMCC 1.14507T=KCTC 8642T).