bluuebunny/crossref_metadata_2025 huggingface dataset:
Current status of cardiopulmonary resuscitation training and automatic external defibrillator availability in high schools in Halifax, Nova Scotia, Canada
Authors: Zamzami Sultan , Hussain Arif , Wong Kenny , Pellerine Kimberley , Dhillon Santokh
Published: January 2023

Background

School-based cardiopulmonary resuscitation (CPR) training and early use of an automated external defibrillator (AED) have proven to increase the survival of victims of sudden cardiac arrest (SCA). This study aimed to determine the status of CPR training, availability of AEDs, and medical emergency response programs (MERPs) in high schools in Halifax Regional Municipality.

Method

High school principals were asked to participate in a voluntary online survey comprising questions about demographics, AEDs availability, CPR training for staff and students, the existence of MERPs, and perceived barriers. Three autogenerated reminders followed the initial invitation.

Results

Out of 51 schools, 21 (41%) responded, only 10% (2/21) and 33% (7/21) reported providing CPR training to students and staff, respectively. About 35% (7/20) of the schools reported having AEDs, but only 10% (2/20) have MERPs for SCA. All respondents reported in favor of AED availability in schools. The reported barriers to CPR training included limited financial resources (54%), perception of low priority (23%), and time constraints (23%). Respondents reported limited financial resources (85%) and the lack of trained staff to use (30%) as the main reasons for the unavailability of AEDs.

Conclusion

This survey showed that all respondents overwhelmingly favour having access to AEDs. However, the availability of CPR and AED training for staff and students in schools remains inadequate. Emergency action plans have not been devised, and few schools have AED devices. More education and awareness are needed to ensure lifesaving equipment and practices in all Halifax Regional Municipality schools.
Mitochondrial gene defects in Arabidopsis can broadly affect mitochondrial gene expression through copy number
Authors: Ayabe Hiroki , Toyoda Atsushi , Iwamoto Akitoshi , Tsutsumi Nobuhiro , Arimura Shin-ichi
Published: January 2023

How mitochondria regulate the expression of their genes is poorly understood, partly because methods have not been developed for stably transforming mitochondrial genomes. In recent years, the disruption of mitochondrial genes has been achieved in several plant species using mitochondria-localized TALEN (mitoTALEN). In this study, we attempted to disrupt the NADH dehydrogenase subunit7 (NAD7) gene, a subunit of respiratory chain complex I, in Arabidopsis (Arabidopsis thaliana) using the mitoTALEN method. In some of the transformants, disruption of NAD7 was accompanied by severe growth inhibition and lethality, suggesting that NAD7 has an essential function in Arabidopsis. In addition, the mitochondrial genome copy number and overall expression of genes encoding mitochondrial proteins were generally increased by nad7 knockout. Similar increases were also observed in mutants with decreased NAD7 transcripts and with dysfunctions of other mitochondrial respiratory complexes. In these mutants, the expression of nuclear genes involved in mitochondrial translation or protein transport was induced in sync with mitochondrial genes. Mitochondrial genome copy number was also partly regulated by the nuclear stress-responsive factors NAC domain containing protein 17 and Radical cell death 1. These findings suggest the existence of overall gene-expression control through mitochondrial genome copy number in Arabidopsis and that disruption of single mitochondrial genes can have additional broad consequences in both the nuclear and mitochondrial genomes.
Anti-SARS-CoV-2 vaccination in adolescent and adult patients with juvenile-onset systemic lupus erythematosus: tolerability and impact on disease activity
Authors: Chighizola Cecilia Beatrice , Suardi Ilaria , Carrea Giulia , Argolini Lorenza , Gattinara Maurizio , Marino Achille , Pontikaki Irene , Caporali Roberto , Gerosa Maria
Published: January 2023

Objectives

JSLE has a severe presentation and a remitting course. Patients with JSLE carry an increased vulnerability to infections, which also act as triggers of disease flare. Thus, vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an important tool in JSLE. The objective of this study is to evaluate the tolerability and the safety of anti-SARS-CoV-2 vaccination, including the booster, in a monocentric cohort of JSLE patients.

Methods

Clinical records of JSLE patients who received at least one dose of any anti-SARS-CoV-2 vaccine were retrospectively reviewed. Data about disease activity, treatment, anti-SARS-CoV-2 vaccination and COVID-19 infection were collected.

Results

Sixty-five JSLE patients received at least one dose of anti-SARS-CoV-2 vaccination, while 46 patients completed the schedule with the booster. The rate of mild–moderate adverse events was 66%, mainly comprising fever, fatigue, arthromyalgias and pain at injection site. The rate of adverse events after the booster was similar to that registered after the first two doses. No significant changes after SARS-CoV-2 vaccination in BILAG and SLEDAI were observed. Disease flare rate (mainly LN) after immunization was 10.8%. Flares occurred predominantly in patients with moderate disease activity before immunization; accordingly, SLEDAI ≥4 identified patients at risk of flare while Lupus Low Disease Activity State (LLDAS) plays a protective role against post-vaccination flare.

Conclusions

This study confirms that anti-SARS-CoV-2 vaccination in JSLE is well tolerated; a strict clinical monitoring and a thoughtful choice of vaccination timing should be devoted to patients not in LLDAS due to the risk of post-vaccine flare.
Susceptibility of Historically Dominant Runner-Type Peanut Cultivars of the Southeastern United States to Early and Late Leaf Spot
Authors: Fulmer Abraham M. , Kemerait Robert C. , Brenneman Timothy B. , Culbreath Albert K. , Cantonwine Emily G.
Published: January 2023

A greenhouse experiment was conducted to test the hypothesis that cultivar use contributed to historical shifts in disease predominance patterns in the southeastern United States over the past 50 years. Passalora arachidicola, the causal agent of early leaf spot (ELS), and Nothopassalora personata, the causal agent of late leaf spot (LLS), were inoculated separately or together on three historically dominant cultivars, Florunner (1970 to 1996), Georgia Green (1996 to 2008), and Georgia-06G (2008 to present), and on one susceptible cultivar, Georgia Valencia. These results suggest that the transition from Florunner to Georgia Green could have contributed to the historical shift from LLS to ELS predominance observed in the 1990s, with sporulation potential as a possible mechanistic explanation. There was no evidence that Georgia-06G contributed to the resurgence of LLS in recent years. A negative association between ELS and LLS, where LLS is more suppressed in the presence of ELS, demonstrates that the dynamics of the ELS-LLS disease patterns are complex. Understanding factors that contribute to disease predominance will improve predictive abilities and support the development of cultural practices and fungicide programs specific to the pathogen that is expected to dominate.
First Report of Pyricularia oryzae Causing Gray Leaf Spot of Perennial Ryegrass (Lolium perenne) in Oregon
Authors: Braithwaite E. , Wang R. , Kowalewski A. , Tabima J. F. , Temple T. N. , Rivedal H. M.
Published: January 2023

Gray leaf spot of perennial ryegrass ( Lolium perenne), caused by Pyricularia oryzae, is a devastating turfgrass disease in many regions of the United States. In 2021, P. oryzae was detected for the first time in Oregon, causing disease on a perennial ryegrass athletic field. This report describes the occurrence of gray leaf spot and pathogenicity testing on the original infected cultivar mixture. The confirmation of this pathogen in Oregon could have management implications for turfgrass managers of the state.
“Intersections of Social Systems, Race, and Health in America: A Historical Perspective”: A Novel Elective for Medical Students to Increase Antiracism Advocacy
Authors: Lord Victoria , Larsen Alexandra , Rashid Rudmila , Palmer Walter , Mamtani Mira , Aysola Jaya
Published: January 2023

Problem

There are growing calls for medical education to effectively teach about and explicitly name racism as a driver of inequities in social determinants of health and inspire student action to address health inequities.

Approach

Using a novel application of the generative co-design approach, in 2020 Perelman School of Medicine students and faculty implemented a student-led, interdisciplinary elective course for preclerkship medical students. The co-design process allowed for an iterative and conversation-based experience emphasizing how social systems and racist policies shape health care access and outcomes. Active student participation was integral to developing discussion questions to elicit how students’ positions in power structures can uphold inequities. Community members and nonprofit leaders taught about the current realities of discrimination and how students could best advocate for patients in the future. Enrolled students (n = 17) and a control group of nonenrolled classmates (n = 37) completed the Anti-Racism Behavioral Inventory (ARBI) pre- and post-course to compare changes in antiracist behaviors.

Outcomes

Course participants demonstrated a significant increase in ARBI scores (mean = 4.29 (7.30); t(16) = 2.42; P = .01), while students from the control group did not (mean = 1.43 (6.98); t(36) = 1.25; P = .11). The “individual advocacy” subdomain of the ARBI largely drove the change in ARBI scores, suggestive of increased antiracism behavior in the enrolled cohort. Students provided feedback offering praise for course elements and suggestions for improvement.

Next Steps

Early findings suggest that this course, created with a co-design approach, generated new experiences for medical students, increased their understanding of systemic racism, and increased individual antiracist advocacy. Future work, with larger class sizes and longitudinal measurement of behavior change, should further investigate the transformative effects of applying co-design strategies to medical education courses about race and health.
A Comparison of Outcomes between Finger and Pulp Replantation/Revascularization in a Single Center
Authors: Duah-Asante Kwaku , Kadhum Murtaza , Khajuria Ankur , Nduka Charles , Koshima Isao , Kannan Ruben Y.
Published: January 2023

Background:

Supermicrosurgery has allowed the replantation/revascularization of the pulp, but how does this currently compare with more proximal digit replantation/revascularization?

Methods:

In a retrospective case study over a 5-year period at our institute, a total of 21 patients (n = 21) had either finger or pulp replantation-revascularization posttrauma. All pulp replants had a single-vessel anastomosis viz., “artery-to-artery” or “artery-to-vein” only, with venous outflow dependent on the skin-shave technique, while more proximal replants had both arterial and venous anastomoses. Age, sex, ischemic time, handedness, smoker status, and injury-replant interval were compared between the two groups, with all procedures performed by a single surgeon. The outcome parameters studied were length of hospital stay, timeline for wound healing, viability, and functional outcomes.

Results:

Our patients consisted of 18 men and three women, of which 14.3% were smokers and 85.7% were right-handed. There were 11 finger replantation/revascularizations (n = 11) versus 10 pulp replantation/revascularizations (n = 10). The average age of digit replantation/revascularization patients was 44.8 years compared with 26.4 years in pulp replantation/revascularization patients (Student t test, P = 0.04). Mean ischemia time in digital replants was 67 minutes versus 32.3 minutes in pulp replantation/revascularization (Student t test, P = 0.056). Digital replantation/revascularization was viable in 72% of cases versus a 90% viability in the pulp subcohort.

Conclusions:

In our patient cohort, pulp replantation/revascularizations produced better postoperative viability. Where supermicrosurgery expertise is available, pulp replantation/revascularization should be considered a worthwhile option when compared with digital replantation/revascularization.
A Novel Otoplasty Technique Using Dermabrader on Prominent Ear Deformity Patients: A Retrospective Study and a Description of Technique
Authors: Gelidan Adnan G. , Mortada Hatan , Alarki Subhi M.K. Zino , Arab Khalid , Kattan Abdullah E.
Published: January 2023

Background:

Approximately 5% of the population has protruding ears. An antihelix deficiency or absence is a common cause of ear protrusion. Although there are over 200 techniques to manage prominent ears, there is no evidence to support using dermabraders in this situation. To the author’s knowledge, this is one of the first articles to assess the clinical outcome of dermabrader use on patients with prominent ear deformities.

Methods:

An analysis of retrospective medical records was conducted by the senior author on patients with prominent ears treated with our novel dermabrasion technique between 2018 and 2021. The demographics, clinical assessment, and outcomes of the patients were assessed. Furthermore, the article provides a detailed description of the technique.

Results:

A total of 18 ears were operated on. Eight of the included patients had bilateral ear deformities, and two had unilateral deformities. The mean distance from the ear to the head at the superior helix was 29 mm (range, 25–35 mm). In our series, no complications were observed. During the most recent clinical evaluation, all patients had achieved acceptable ear positioning and excellent aesthetic results.

Conclusions:

Dermabrasion is a useful technique for otoplasty because no sutures are required and symmetry can be achieved in bilateral ears. Furthermore, this technology is safe, simple, reproducible, reliable, and versatile. We recommend that future studies be conducted in a prospective manner with larger sample sizes and longer follow-up periods to ensure the validity of the findings.
Subjective and objective burden on providers from a multicenter app-based study of patients with cirrhosis and caregivers
Authors: Shaw Jawaid , Acharya Chathur , Albhaisi Somaya , Fagan Andrew , McGeorge Sara , White Melanie B. , Lachar Jatinder , Olson Jessica , Olofson Amy , Bergstrom Lori , Kamath Patrick S. , Bajaj Jasmohan S.
Published: January 2023

Background:

App-based technologies could enhance patient and caregiver communication and provide alerts that potentially reducing readmissions. However, the burden of App alerts needs to be optimized to reduce provider burnout.

Aim:

The purpose of this study was to determine subjective and objective burden of using the Patient Buddy App, a health information technology (HIT) on providers in a randomized multicenter trial, who completed a semi-quantitative Likert scale survey regarding training procedures, data and privacy concerns, follow-up details, and technical support. This randomized multicenter trial recruits cirrhosis inpatients and their caregivers, and randomizes them into standard-of-care, HIT (communication only via App) and HIT+visits (App+phone calls/visits) for 30 days after discharge. The alerts are monitored by providers through a central iPad. The reason(s) and number of alerts were recorded as the objective burden. A total of 1442 messages were sent as alerts from the 103 dyads (patient + caregiver) (n=206) randomized to HIT arms. The most common messages related to Hepatic Encephalopathy (HE) (high or low bowel movement=50% or orientation tests=37%). Twelve providers completed the surveys reflecting the following themes—92% and 100%, felt adequately trained and confident about educating the patients and caregivers before roll out of App and had no concerns related to data and privacy; 70%, felt that appropriate time was spent on pursuing reason for data not being logged; 60% each, had issues with availability of adequate technical support and connectivity.

Conclusion:

The Patient Buddy App randomized multicenter trial till date shows an overall favorable rating regarding training procedures/education, privacy concerns, and ease of message follow-up, from providers. However, it is important to gauge and address subjective and objective burdens of monitoring human resources in current and future HIT studies to avoid burnout and to ensure successful study completion.
Plant adaptive agents: promising therapeutic molecules in the treatment of post-viral fatigue
Authors: Yan Yiqi , Han Rui , Ma Yaolei , Zhang Han , Oduro Patrick Kwabena , Wang Xiaoying , Lei Wei
Published: January 2023

In recent years, the spread of the coronavirus disease 2019 (COVID-19) in China has been effectively controlled by implementing national prevention and control measures. However, a large number of recovered patients are plagued by fatigue, whether acute or chronic, and other fatigue-related syndromes that severely affect their quality of life. Post-viral fatigue syndrome (PVFS) is a widespread chronic neurological disease with no definite etiological factor(s), definitive diagnostic test, or approved pharmacological treatment, therapy, or cure. In this study, we performed a bibliometric analysis and the results suggested that neuroinflammation played a role in the development of PVFS. Therefore, we briefly analyzed the mechanisms underlying the development of neuroinflammation in patients with COVID-19. To identify effective drugs to alleviate PVSF, we summarized four traditional herbal phytoadaptations and discussed their molecular mechanisms in improving neurological fatigue. Our study showed that ginseng, Acanthopanax, Rhodiola, and Schisandra played beneficial roles in alleviating PVSF.

Graphical abstract:

http://links.lww.com/AHM/A45.
QUANTITATIVE ASSESSMENT OF AUTOMATED OPTICAL COHERENCE TOMOGRAPHY IMAGE ANALYSIS USING A HOME-BASED DEVICE FOR SELF-MONITORING NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
Authors: Oakley Jonathan D. , Verdooner Steven , Russakoff Daniel B. , Brucker Alexander J. , Seaman John , Sahni Jayashree , BIANCHI Carlo D. , Cozzi Mariano , Rogers John , Staurenghi Giovanni
Published: January 2023

Purpose:

To evaluate a prototype home optical coherence tomography device and automated analysis software for detection and quantification of retinal fluid relative to manual human grading in a cohort of patients with neovascular age-related macular degeneration.

Methods:

Patients undergoing anti-vascular endothelial growth factor therapy were enrolled in this prospective observational study. In 136 optical coherence tomography scans from 70 patients using the prototype home optical coherence tomography device, fluid segmentation was performed using automated analysis software and compared with manual gradings across all retinal fluid types using receiver-operating characteristic curves. The Dice similarity coefficient was used to assess the accuracy of segmentations, and correlation of fluid areas quantified end point agreement.

Results:

Fluid detection per B-scan had area under the receiver-operating characteristic curves of 0.95, 0.97, and 0.98 for intraretinal fluid, subretinal fluid, and subretinal pigment epithelium fluid, respectively. On a per volume basis, the values for intraretinal fluid, subretinal fluid, and subretinal pigment epithelium fluid were 0.997, 0.998, and 0.998, respectively. The average Dice similarity coefficient values across all B-scans were 0.64, 0.73, and 0.74, and the coefficients of determination were 0.81, 0.93, and 0.97 for intraretinal fluid, subretinal fluid, and subretinal pigment epithelium fluid, respectively.

Conclusion:

Home optical coherence tomography device images assessed using the automated analysis software showed excellent agreement to manual human grading.
Non–Germ Cell Intrascrotal Tumors in Adults: A Retrospective Cohort of Localized and Metastatic Disease From a Tertiary Cancer Center
Authors: Cunha Mateus T. , Cardoso Camila A. , Silva Jamile A. , Freitas Guilherme F. , Muniz David Q. , Guglielmetti Giuliano B. , Cordeiro Mauricio D. , Cardili Leonardo , Nahas William C. , Mota Jose Mauricio
Published: January 2023

Purpose:

Given their rarity, little is known about outcomes and optimal treatment strategies for non–germ cell intrascrotal tumors (NGCITs). Here, we report a retrospective cohort of NGCITs and describe clinicopathological features and treatment patterns and outcomes.

Materials and Methods:

Patients 18 years or older with a histological diagnosis of NGCIT were eligible. Electronic health records were reviewed to assess clinical features, disease characteristics, and outcomes. Radiological responses were determined by RECIST 1.1. Time-to-event outcomes were estimated using the Kaplan-Meier method and compared through the log-rank test and Cox univariate regression.

Results:

From January 2009 to April 2022, 896 patients were reviewed for eligibility, with 36 patients with NGCIT identified. At diagnosis, 29 were nonmetastatic (Leydig tumors, n = 9; sarcomas, n = 8; Sertoli tumors, n = 3; others, n = 9) and 7 were metastatic (sarcomas, n = 5; others, n = 2). Five patients (sarcomas, n = 2; Leydig tumors, n = 2; mesothelioma, n = 1) developed metastatic disease after a median follow-up of 18.6 months. Systemic treatment (n = 10) was given according to primary histology, with partial responses observed in 2 patients with metastatic rhabdomyosarcoma treated with VAC regimen (vincristin, adriamycin, and cyclophosphamide). Overall survival varied according to disease classification (benign vs malignant, hazard ratio [HR] 4.5, confidence interval [CI] 95% 1.0-21.2) or presentation (all patients: metastatic vs localized at diagnosis, HR 7.1, CI 95% 2.0-24.5; patients with malignant disease: metastatic vs localized at diagnosis, HR 5.0, CI 95% 1.1-24.4).

Conclusions:

NGCITs comprise a heterogeneous group of diseases, with a relatively better prognosis at early stages. Most metastatic cases occurred within patients with paratesticular sarcomas and mesotheliomas.
Prevalence and Risk Factors of Functional Gastrointestinal Disorders: A Cross-Sectional Study in Italian Infants and Young Children
Authors: Scarpato Elena , Salvatore Silvia , Romano Claudio , Bruzzese Dario , Ferrara Dante , Inferrera Ramona , Zeevenhooven Judith , Steutel Nina F. , Benninga Marc A. , Staiano Annamaria
Published: January 2023

Objectives:

Reports of prevalence of functional gastrointestinal disorders (FGIDs) in infants/toddlers are widely variable. Reasons for this variability are not yet fully understood. The objective of this study is to estimate the prevalence of FGIDs according to Rome IV criteria and to evaluate associated factors, in Italian infants and toddlers.

Methods:

Subjects aged 0–48 months were enrolled by general pediatricians from 3 Italian regions. Parents or legal guardians were administered questionnaires including information about the child, the family, and GI symptoms according to Rome IV criteria.

Results:

Five hundred eight infants aged 0–12 months [mean age 4.4 ± 3.4 months; females (F) 40.9%], and 268 children aged 13–48 months (mean age 30.8 ± 10.7 months; F 44.4%) were included. In infants, prevalence of FGIDs was 21.1%, and the most prevalent FGID was infant colic (9.3%). In toddlers, prevalence of FGIDs was 19.6%, with functional constipation being the most frequent disorder (16.1%). In infants, multivariable analysis found that being older, being the only child, and living in a rural environment were associated with a lower rate of FGIDs. Prevalence was, in contrast, higher in infants fed with formula.

Conclusions:

One out of 5 Italian infants and young children is affected by at least 1 FGID. The most frequent FGID in infants is infant colic, while in toddlers this is functional constipation. In infants, prevalence of FGIDs is lower if the subject has no siblings, and in children living in a rural environment, while formula feeding represents a risk factor for FGIDs occurrence.
Fish Oil And/Or Probiotics Intervention in Overweight/Obese Pregnant Women and Overweight Risk in 24-Month-Old Children
Authors: Saros Lotta , Vahlberg Tero , Koivuniemi Ella , Houttu Noora , Niinikoski Harri , Tertti Kristiina , Laitinen Kirsi
Published: January 2023

Objectives:

To evaluate whether a fish oil and/or probiotics intervention in pregnant women with overweight or obesity would influence the tendency of their 24-month-old children to become overweight and alter their body fat percentage.

Methods:

Women (n = 439) were double-blindly randomized into 4 intervention groups: fish oil+placebo, probiotics+placebo, probiotics+fish oil, and placebo+placebo (fish oil: 1.9 g docosahexaenoic acid and 0.22 g eicosapentaenoic acid, probiotics: Lacticaseibacillus rhamnosus HN001 and Bifidobacterium animalis ssp. lactis 420, 1010 colony-forming units each). The intervention lasted from early pregnancy until 6 months postpartum. Children’s (n = 330) growth data (height, weight, head circumference), a secondary outcome of the trial, were evaluated at birth, 3, 6, 12, and 24 months of age and compared to Finnish growth charts. Body fat percentage was measured with air displacement plethysmography (24 months). Logistic regression and general linear models were used to analyze the data.

Results:

Probiotics+placebo [weight-for-height% adj. Odds ratio (OR) = 0.36, 95% confidence interval (CI) = 0.14–0.95] and probiotics+fish oil [weight-for-age standard deviation score (SD-score) adj. OR = 0.22, 95% CI = 0.07–0.71] associated with lower overweight odds in 24-month-old children compared to placebo+placebo. Results remained essentially the same, when probiotics’ main effect (combined probiotics+placebo and probiotics+fish oil) was estimated; that is, lower overweight odds (weight-for-height% adj. OR = 0.48, 95% CI = 0.25–0.95 and weight-for-age SD-score adj. OR = 0.42, 95% CI = 0.20–0.88) compared to non-probiotics. No fish oil main effect (combined fish oil+placebo and probiotics+fish oil) was seen. The intervention did not influence body fat percentage.

Conclusions:

The administration of probiotics solely and in combination with fish oil during pregnancy to women with overweight or obesity lowered the overweight odds of their 24-month-old children.
Disturbed Pediatric Gut Microbiome Maturation in the Developmental Origins of Subsequent Chronic Disease
Authors: Simon David Aaron , Kellermayer Richard
Published: January 2023

The microbiome is known to play an important role in the development and maintenance of human health. During early childhood the gut microbiome undergoes a rapid evolution, making this developmental window most susceptible to microbial manipulation and, therefore, most vulnerable to environmental stimuli. Such stimuli may induce persistent alterations (or dysbiosis) in microbiome and/or host physiology, thereby resulting in susceptibility to subsequent disease development. This phenomenon is frequently described as “the microbial developmental origins of disease.” In this topic of the month, we call attention to the microbial developmental origins of disease by examining the potential for childhood antibiotic exposures and appendectomy (ie, inducers of dysbiosis) to influence the pathogenesis of certain multifactorial, common diseases (eg, celiac disease, inflammatory bowel disease, obesity), especially those with increasing incidence worldwide. We conclude that fully appreciating the critical components in the microbial developmental origins of common chronic disorders is a major task ahead of pediatric gastroenterologists in the 21st century. Such information will be key in working to prevent numerous common and emerging disorders.
Ethnic Disparities in Risk Factors for Myopia among Han and Minority Schoolchildren in Shawan, Xinjiang, China
Authors: Shi Yumeng , Ma Dongmei , Li Xuemei , He Xiaolan , Cui Hanwen , Li Guoqing , Wang Jingjing , Luo Jianfeng , Yang Jin
Published: January 2023

SIGNIFICANCE

The ethnic differences in myopia rates, ocular dimensions, and risk factors between Han and non-Han schoolchildren observed in this study may help fill the knowledge gap about ethnic minorities and are important for China and other countries to address vision-related health inequalities among different ethnic groups.

PURPOSE

This study aimed to investigate the risk factors of juvenile myopia and elucidate the disparities of risk factors among Han and non-Han school students in Xinjiang, China.

METHODS

A population-based cross-sectional study of 876 schoolchildren from grades 1 to 9 was conducted in the Anjihai Middle School in Shawan, Xinjiang Uygur Autonomous Region, China. Visual acuity and ocular biometry were assessed, and personal information, including behavior, birth status, and familial factors, was collected using self-made standardized questionnaires.

RESULTS

The myopia rate among students of Han ethnicity (50.5%) was the highest, followed by Hui (41.3%) and Uygur et al. (32.0%, P < .001). Similar patterns were observed for mean axial length. The mean axial lengths are 23.7, 23.4, and 23.3 mm, respectively (P = .01). Overall, performing high-quality eye exercises, longer sleep duration, being born in summer, parental smoking, and consuming more food containing anthocyanins were all associated with a lower incidence of myopia. Meanwhile, Han ethnicity, intensive near task, bad eye habits, and myopic mothers were associated with higher odds of myopia. After adjusting for environmental influences pertaining to myopia, the variation in myopia prevalence between Han and Uygur et al. remained significant, whereas it changed to not significant between Han and Hui ethnicities.

CONCLUSIONS

Significant disparities were found in the prevalence of myopia among various ethnic groups in Shawan, Xinjiang. Life habits, birth status, and familial factors may contribute to such variance and play different roles in the occurrence of juvenile myopia among various ethnicities.
Association between Refractive Errors and Ocular Biometry in an Elderly Population
Authors: Hashemi Hassan , Bouyeh Aria , Khabazkhoob Mehdi
Published: January 2023

SIGNIFICANCE

The anterior chamber depth in hyperopic eyes is significantly deeper than that in myopic eyes, and this finding is independent of the axial length.

PURPOSE

This study aimed to determine the relationship between and refractive errors and ocular biometric components in a geriatric population 60 years and older.

METHODS

The present population-based cross-sectional study was performed using a multistage random cluster sampling method in Tehran, Iran. After selecting the samples, visual acuity measurement, autorefraction, subjective refraction, and slit-lamp examination were performed for all participants. Ocular biometric indices were measured with Pentacam AXL (Oculus, Wetzlar, Germany).

RESULTS

The correlation coefficients of spherical equivalent with axial length, corneal radius of curvature, axial length/corneal radius of curvature ratio, and anterior chamber depth were −0.40, 0.14, −0.63, and −0.18, respectively, after controlling the effects of age, sex, and nuclear cataract. The axial length (24.84 vs. 21.21 mm), the anterior chamber depth (2.74 vs. 2.34 mm), the ratio of the axial length to the corneal radius of curvature (3.35 vs. 2.71), and the anterior chamber volume (138.59 and 105.54 mm3) were the highest and lowest in myopic and hyperopic individuals, respectively (all P < .001). In the first model, axial length and nuclear cataract were significantly inversely related to the spherical equivalent. However, corneal radius of curvature, anterior chamber depth, central corneal thickness, and corneal diameter had a significant direct relationship with the spherical equivalent. In the second model, the axial length/corneal radius of curvature ratio and cataract showed an inverse relationship with the spherical equivalent, whereas anterior chamber depth and corneal diameter had a direct relationship with the spherical equivalent.

CONCLUSIONS

Among the biometric components, the axial length/corneal radius of curvature ratio has the strongest relationship with refractive errors. The anterior chamber depth is lower in myopes compared with hyperopes after controlling the effect of axial length.
Myopia and Its Association with Near Work, Outdoor Time, and Housing Type among Schoolchildren in South India
Authors: Gopalakrishnan Aparna , Hussaindeen Jameel Rizwana , Sivaraman Viswanathan , Swaminathan Meenakshi , Wong Yee Ling , Armitage James A. , Gentle Alex , Backhouse Simon
Published: January 2023

SIGNIFICANCE

In this comprehensive assessment of environmental associations with refractive status among schoolchildren in India, outdoor time was the key modifiable risk factor associated with myopia rather than time spent on near work.

PURPOSE

This study aimed to investigate the environmental risk factors associated with myopia among adolescent schoolchildren in South India.

METHODS

Children in grades 8 to 10 from 11 schools in Tamil Nadu, South India, underwent eye examination and risk factor assessments through a modified version of the Sydney myopia questionnaire. Time spent on near work and outdoors was analyzed after division into three groups based on tertiles. Mixed-effects logistic regression was performed to assess the factors associated with myopia.

RESULTS

A total of 3429 children (response rate, 78.4%) provided both questionnaire and refraction data. The mean (standard deviation) age was 14 (0.93) years with an equal distribution of sexes. Myopia was present among 867 children (noncycloplegic spherical equivalent refraction, ≤−0.75 D). Refraction was not associated with near work tertiles (P = .22), whereas less time outdoors was associated with higher myopic refractions (P = .01). Refraction shifted toward increased myopia with an increase in the near-work/outdoor time ratio (P = .005). Children living in apartment housing had a higher prevalence of myopia compared with other types of housing (P < .001). In multivariate analysis, increased time outdoors was a protective factor against myopia (odds ratio, 0.79; 95% confidence interval, 0.63 to 0.99; P = .04), whereas living in apartment housing (odds ratio, 1.27; 95% confidence interval, 1.04 to 1.55; P = .02) was a significant risk factor.

CONCLUSIONS

In this cohort of Indian children, outdoor time, increased near-work/outdoor time ratio, and type of housing were the factors associated with myopia. Policies should target implementing a balance between near-work and outdoor time among children.
Feasibility, Acceptability, and Preliminary HIV Care and Psychological Health Effects of iTHRIVE 365 for Black Same Gender Loving Men
Authors: English Devin , Smith Justin C. , Scott-Walker Larry , Lopez Felix Gabriel , Morris Michael , Reid Malcolm , Lashay Crystal , Bridges Dwain , McNeish Daniel
Published: January 2023

Objectives:

This uncontrolled pilot study examined the feasibility, acceptability, and preliminary HIV and psychological health effects of iTHRIVE 365, a multicomponent intervention designed by and for Black same gender loving men (SGLM) to promote: health knowledge and motivation, Black SGLM social support, affirming health care, and housing and other economic resources.

Design: & Methods:

We conducted a 14-day daily diary study with 32 Black SGLM living with HIV connected to THRIVE SS in Atlanta, GA. Daily surveys assessed intervention engagement, antiretroviral medication (ART) use, depressive symptoms, anxiety symptoms, and emotion regulation difficulties. App paradata (ie, process data detailing app usage) assessed amount of intervention engagement via page access. Participants began receiving access to the intervention on day 7. After the 14-day daily diary period, participants responded to follow-up items on the user-friendliness, usefulness, helpfulness, and whether they would recommend iTHRIVE 365 to others. Chi-square analyses examined associations between intervention engagement and ART use, and dynamic structural equation modelling assessed longitudinal associations from intervention engagement to next-day psychological health. This intervention trial is registered on ClinicalTrials.gov (NCT05376397).

Results:

On average, participants engaged with iTHRIVE 365 over once every other day and accessed intervention pages 4.65 times per day. Among participants who engaged with the intervention, 78% reported it was helpful to extremely helpful, 83% reported it was moderately to extremely useful, and 88% reported it was user-friendly and they would recommend it to others. On intervention engagement days, participants had higher odds of ART use, χ2(1) = 4.09, P = 0.04, than intervention nonengagement days. On days after intervention engagement, participants showed non-null decreases in depressive symptoms (τ = −0.14; 95% CI: = [−0.23, −0.05]) and emotion regulation difficulties (τ = −0.16; 95% CI: = [−0.24, −0.02]).

Conclusions:

Findings suggest iTHRIVE 365 is feasible, acceptable, and positively affects daily ART use, depressive symptoms, and emotion regulation difficulties.
An Educational Intervention to Improve Patient Outcomes for Colonoscopy
Authors: Janik Mary , Heitschmidt Mary , Gascon Maria , Robertson Lauren
Published: January 2023

Bowel prep for inpatient cases are for the most part inadequate. Gastroenterology nurses are ideally situated to recognize the importance of bowel preparation for patients who require a colonoscopy. Unique challenges exist for inpatients who require a colonoscopy preparation as part of their hospitalization. We identified that inpatients scheduled for colonoscopies during their hospitalization were not appropriately prepped, leading to unsuccessful and repeat procedures. We conducted this research study to determine whether an educational intervention would optimize inpatients, bowel preparation and improve the quality of bowel preparation, patient satisfaction, and understanding of bowel preparation. Three months prior to an educational intervention, inpatients who required a colonoscopy completed surveys about their colonoscopy preparation. Then, educational in-services on how to administer bowel preparation were presented to multidisciplinary staff, which included 70% of all registered nurses (RNs). Following the education phase, 40 inpatients were surveyed. We found that patients' perception of education differed if they verbalized a past experience and the highest prep scores were obtained in patients educated by a physician and RN. Our results indicated that an educational intervention targeting inpatient staff improved patient satisfaction, decreased aborted colonoscopies by 22%, and increased Boston Bowel Preparation Scale utilization in 100% of cases. Educating inpatient providers on the necessary preparation protocol improved inpatient care outcomes by decreasing the amount of incomplete and repeat inpatient colonoscopies and therefore may reduce healthcare costs.
PROGRESSION OF VASCULAR FUNCTION AND BLOOD PRESSURE IN A MOUSE MODEL OF KAWASAKI DISEASE
Authors: DelVechio Mia , Alves Juliano V. , Saiyid Alina Z. , Singh Shubhnita , Galley Joseph , Awata Wanessa M. C. , Costa Rafael M. , Bruder-Nascimento Ariane , Bruder-Nascimento Thiago
Published: January 2023

Kawasaki disease (KD) is a systemic vasculitis of childhood characterized by vascular damage in the acute stage, which can persist into the late stage. The vascular mechanisms in the cardiovascular risk of KD are not fully studied. We investigated the vascular function and blood pressure in a murine model of KD. We used the Candida albicans water-soluble (CAWS) fraction model. Mice were injected with 4 mg CAWS for 5 consecutive days and separated into three groups. Control, CAWS 7 days (C7), and CAWS 28 days (C28). Hearts and arteries were harvested for vascular characterization. Rat aortic smooth muscle cells were used to studies in vitro. C7 presented elevated inflammatory markers in the coronary area and abdominal aortas, whereas C28 showed severe vasculitis. No difference was found in blood pressure parameters. Vascular dysfunction characterized by higher contractility to norepinephrine in C7 and C28 in aortic rings was abolished by blocking nitric oxide (NO), reactive oxygen species, and cyclooxygenase (COX)–derived products. The CAWS complex increased COX2 expression in rat aortic smooth muscle cells, which was prevented by Toll-like receptor 4 antagonist. Our data indicate that the murine model of KD is associated with vascular dysfunction likely dependent on COX-derived products, oxidant properties, and NO bioavailability. Furthermore, vascular smooth muscle cell may present an important role in the genesis of vascular dysfunction and vasculitis via the Toll-like receptor 4 pathway. Finally, the CAWS model seems not to be appropriate to study KD-associated shock. More studies are necessary to understand whether vascular dysfunction and COXs are triggers for vasculitis.
GENETIC DELETION OF TRANSLOCATOR PROTEIN EXACERBATES POST-SEPSIS SYNDROME WITH ACTIVATION OF THE C1Q PATHWAY IN SEPTIC MOUSE MODEL
Authors: Kikutani Kazuya , Hosokawa Koji , Giga Hiroshi , Ota Kohei , Matsumata Miho , Zhu Meina , Takemoto Hidenori , Ji Bin , Ohshimo Shinichiro , Shime Nobuaki , Aizawa Hidenori
Published: January 2023

Significant numbers of patients who survive sepsis exhibit psychiatric and cognitive impairments, termed post-sepsis syndrome. Understanding the underlying pathophysiology is essential to develop effective therapies. Translocator protein 18 kDa (TSPO) is a multifaceted mitochondrial protein implicated in inflammation, oxidative stress, and steroidogenesis in the central nervous system. Despite accumulated evidence demonstrating TSPO is a biomarker in psychiatric and neurodegenerative disorders, the role of this protein in post-sepsis syndrome remains elusive. The aim of this study was to investigate the role of TSPO in the long-term impairment of mouse behavior associated with psychiatric and cognitive impairments following sepsis induced by cecal ligation and puncture (CLP) surgery. Animals were divided into three groups: (i) wild type (WT) + sham, (ii) WT + CLP, and (iii) TSPO knock out + CLP. Survival rate and body weight change were assessed up to 17 days after surgeries. Then, we also assessed anxiety-like behavior, depression-like behavior, cognitive function, locomotor activity, and forelimb muscle strength in surviving mice by elevated plus maze, tail suspension test, y-maze, open field test, and grip strength test, respectively. Deletion of the TSPO gene led to high mortality and prolonged weight loss and exacerbated anxiety-like and depressive-like behavior with cognitive impairment 17 days after, but not before, CLP surgery. RNA-seq analysis of the hippocampus revealed the upregulation of genes (C1qb, C1qc, and Tyrobp) in C1q complement pathways correlated significantly with anxiety-like behavior that appeared long after CLP surgery. The expressions of these genes predicted other behavioral traits, including depressive-like behavior in the tail suspension test and grip power impairment, supporting the role of the C1q pathway in post-sepsis syndrome. Because the C1q pathway has recently attracted interest as a tag for pathological synaptic elimination, the current study suggests the C1q pathway is involved in the psychiatric and cognitive impairments observed in post-sepsis syndrome.
PREHOSPITAL CRYSTALLOID RESUSCITATION: PRACTICE VARIATION AND ASSOCIATIONS WITH CLINICAL OUTCOMES
Authors: Weykamp Michael B. , Stern Katherine E. , Brakenridge Scott C. , Robinson Bryce R.H. , Wade Charles E. , Fox Erin E. , Holcomb John B. , O’Keefe Grant E.
Published: January 2023

Introduction: Although resuscitation guidelines for injured patients favor blood products, crystalloid resuscitation remains a mainstay in prehospital care. Our understanding of contemporary prehospital crystalloid (PHC) practices and their relationship with clinical outcomes is limited. Methods: The Pragmatic, Randomized Optimal Platelet and Plasma Ratios trial data set was used for this investigation. We sought to identify factors associated with PHC volume variation and hypothesized that higher PHC volume is associated with worse coagulopathy and a higher risk of acute respiratory distress syndrome (ARDS) but a lower risk of acute kidney injury (AKI). Subjects were divided into groups that received <1,000 mL PHC (PHC<1,000) and ≥1,000 mL PHC (PHC≥1,000); initial laboratory values and outcomes (ARDS and AKI risk) were summarized with medians and interquartile ranges or percentages and compared using Wilcoxon rank-sum tests and chi-square tests. The primary outcome was ARDS risk. Multivariable regression was used to characterize the association of each 500 mL aliquot of PHC with initial laboratory values and clinical outcomes. Results: PHC volume among study subjects (n = 680) varied (median, 0.3 L; interquartile range, 0–0.9 L) with weak associations demonstrated among prehospital hemodynamics, intubation, Glasgow Coma Score, and Injury Severity Score (0.008 ≤ R
2 ≤ 0.09); prehospital time and enrollment site explained more variation in PHC volume with R
2 values of 0.2 and 0.54, respectively. Compared with PHC<1,000, PHC≥1,000 had higher INR, PT, PTT, and base deficit and lower hematocrit and platelets. The proportion of ARDS in the PHC≥1,000 group was higher than PHC<1,000 (21% vs. 12%, P < 0.01), whereas the rate of AKI was similar between groups (23% vs. 23%, P = 0.9). In regression analyses, each 500 mL of PHC was associated with increased INR and PTT, and decreased hematocrit and platelet count (P < 0.05). Each 500 mL of PHC was associated with increased ARDS risk and decreased AKI risk (P < 0.05). Conclusion: PHC administration correlates poorly with prehospital hemodynamics and injury characteristics. Increased PHC volume is associated with greater anemia, coagulopathy, and increased risk of ARDS, although it may be protective against AKI.
Imaging Amyloid and Tau in the Retina: Current Research and Future Directions
Authors: Tang Mira Y. , Blazes Marian S. , Lee Cecilia S.
Published: January 2023

Background:

The retina is a key focus in the search for biomarkers of Alzheimer's disease (AD) because of its accessibility and shared development with the brain. The pathological hallmarks of AD, amyloid beta (Aβ), and hyperphosphorylated tau (pTau) have been identified in the retina, although histopathologic findings have been mixed. Several imaging-based approaches have been developed to detect retinal AD pathology in vivo. Here, we review the research related to imaging AD-related pathology in the retina and implications for future biomarker research.

Evidence Acquisition:

Electronic searches of published literature were conducted using PubMed and Google Scholar.

Results:

Curcumin fluorescence and hyperspectral imaging are both promising methods for detecting retinal Aβ, although both require validation in larger cohorts. Challenges remain in distinguishing curcumin-labeled Aβ from background fluorescence and standardization of dosing and quantification methods. Hyperspectral imaging is limited by confounding signals from other retinal features and variability in reflectance spectra between individuals. To date, evidence of tau aggregation in the retina is limited to histopathologic studies. New avenues of research are on the horizon, including near-infrared fluorescence imaging, novel Aβ labeling techniques, and small molecule retinal tau tracers. Artificial intelligence (AI) approaches, including machine learning models and deep learning-based image analysis, are active areas of investigation.

Conclusions:

Although the histopathological evidence seems promising, methods for imaging retinal Aβ require further validation, and in vivo imaging of retinal tau remains elusive. AI approaches may hold the greatest promise for the discovery of a characteristic retinal imaging profile of AD. Elucidating the role of Aβ and pTau in the retina will provide key insights into the complex processes involved in aging and in neurodegenerative disease.