bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Nutrition on the Prevention and Treatment of Pressure Injuries in Critically Ill Patients: An Integrative Review
Authors: da Silveira Julia Braga , Teixeira Gabrielle Mello , Baron Miriam Viviane , Caron-Lienert Rafaela Siviero
Published: September 2022

OBJECTIVE

To review the main scientific evidence on nutrition in the prevention and treatment of pressure injuries (PIs) in critically ill adult patients.

DATA SOURCES

The searches were carried out in several scientific databases, namely, Scientific Electronic Library Online (SciELO), Public MEDLINE (PubMed), Latin American and Caribbean Literature in Health Sciences (LILACS), and Web of Science. The MeSH terms used were “pressure injury”, “nutrition”, and “intensive care”.

STUDY SELECTION

Studies published between January 1, 2005, and July 1, 2020, were included. Seven studies met the eligibility criteria and were included in this review. The searches were carried out in August 2020. The authors selected studies available in Portuguese, English, and Spanish.

DATA EXTRACTION

Two independent researchers conducted the searches and read the article titles and abstracts. The studies that met the inclusion criteria were fully evaluated. Disagreements between reviewers were resolved by consensus, and when there was no consensus, a senior researcher was consulted. Data extraction was performed using a standardized form.

DATA SYNTHESIS

Level-of-evidence analysis according to the type of study followed the classification proposed by the Oxford Center Evidence-Based Medicine. The evidence available on the use of standard enteral nutrition therapy and enteral nutrition therapy enriched with hyperprotein and hypercaloric nutrition supplements as well as the addition of zinc, eicosapentaenoic acid, γ-linolenic acid, and vitamins (A, C, D, and E) is limited in terms of supporting a specific nutrition support modality in the prevention and treatment of PI in the intensive care population.

CONCLUSIONS

Malnutrition negatively impacts both the prevention and healing of PIs. The evidence available on the use of standard enteral nutrition therapy versus enrichment with nutrition supplements is too limited to support a specific nutrition modality in the prevention and treatment of PI in the intensive care population.
Quality of life in children with preaxial polydactyly of the foot in comparison to adults, postaxial polydactyly and healthy controls
Authors: Burger Elise , ‘t Hart Judith , Hovius Steven , Van Nieuwenhoven Christianne
Published: September 2022

The effect of preaxial polydactyly of the foot on health-related quality of life (HR-QoL) has not been investigated in current literature. To improve counseling, we investigated HR-QoL in this patient group. A patient-control study was performed with children with preaxial polydactyly (n = 20), adults with preaxial polydactyly (n = 15), children with postaxial polydactyly (n = 15) and healthy controls (n = 62). The primary outcome was the difference in the foot-specific quality of life (FS-QoL) between children with preaxial polydactyly and adults with preaxial polydactyly, children with postaxial polydactyly and controls, using the Oxford Ankle and Foot Questionnaire (OxAFQ-c) and five foot-specific visual analogue scales (VAS). The secondary outcome was the difference in general HR-QoL, using the Pediatric Quality of Life Inventory (PedsQL). Outcomes were compared with the Mann–Whitney-U test. Comparison between children with preaxial polydactyly and healthy controls and postaxial polydactyly showed worse outcomes in all OxAFQ-c domains. The foot-specific VAS score was significantly worse in children with preaxial polydactyly compared to postaxial polydactyly and controls. Only the PedsQL physical domain showed a lower outcome in children with preaxial polydactyly than in postaxial polydactyly and controls. Children and adults with preaxial polydactyly scored the same in all domains. The OxAFQ-c and the PedsQL physical domain showed significantly worse outcomes in children with preaxial polydactyly compared with healthy controls and postaxial polydactyly. However, large variation was observed, suggesting large differences between patients. In children and adults, the foot and scar appearance seems to be the biggest problem, while diminished foot function seems less of an issue.
Analysis of the factors affecting pain level during K-wire removal among pediatric elbow fractures
Authors: Zhamilov Vadym , Turgut Ali , Reisoglu Ali , Basa Can Doruk , Kacmaz İsmail Eralp , Kazimoglu Cemal
Published: September 2022

Our aim was, to analyze the reasons for possible increased pain during the removal of the Kirschner wires from the elbows of children. From February 2021 to December 2021, 573 patients with elbow fractures were treated. In total, 150 patients were analyzed prospectively. No action was taken to reduce pain during the removal of Kirschner wires. The pain status of the patients was evaluated according to the Wong-Baker FACES Pain Rating scoring system (WBAS), the Numeric Rating Scale (NRS) for the pain system and the pulse and oxygen saturation measured by the pulse oximeter on the finger. Measurements were performed before, during, immediately after and 30 min after the procedure. There were 119 patients with a diagnosis of supracondylar humerus fracture and 31 patients with a diagnosis of lateral condyle fracture. The mean age of treated patients was 7.1 years (1–15 years). Of the patients, 93 were boys and 57 were girls. In the measurements made according to the sex difference, it was determined that there was a statistically significant increase in the WBAS scores measured both before the procedure (P = 0.032) and during the removal (P = 0.017), and also in the pulse measurements taken 30 min after the removal in girls (P = 0.034). A statistically significant difference was found in both the WBAS score during removal (P = 0.025) and the NRS scores 30 min later (P = 0.048) in the procedures performed on the right elbow. We found a statistically significant increase in the pain parameters we evaluated in girls, right extremity fractures, the group over 8 years old and when both parents were with the child during the K-wire removal procedure. In light of these findings, physicians should consider the above-mentioned conditions before starting the procedure to ensure a less painful and positive experience.
Ultraviolet A radiation exposure and melanoma: a review
Authors: Fadadu Raj P. , Wei Maria L.
Published: September 2022

The incidence of cutaneous melanoma has been increasing worldwide, and melanoma disproportionately contributes to skin cancer mortality. The pathogenesis of melanoma involves genetic and environmental factors, and while the effects of ultraviolet B radiation on melanoma development are well researched, fewer studies have investigated the role of ultraviolet A (UVA) radiation. We comprehensively reviewed cell, animal and epidemiology studies on the association between UVA exposure and melanomagenesis. UVA radiation has been found to have negative effects on melanocytes due to the induction of oxidative stress, dysregulation of gene transcription and creation of mutagenic photoproducts in DNA. Animal studies demonstrate adverse effects of UVA on melanocytes, including the development of melanoma. Epidemiology studies, of varying quality, that examined participants’ exposure to tanning devices which use UVA radiation primarily found that UVA exposure increased the risk for melanoma. Some studies reported larger associations with increased frequency of device use, suggestive of a dose-response relationship. Overall, we found that many studies supported a positive association between UVA exposure and melanoma on both molecular and population levels. Understanding the role of UVA in the development of melanoma will inform the implementation of preventive health interventions, such as those related to sunscreen development and use and increasing restrictions on indoor tanning.
The impact of foot massage given to postmenopausal women on anxiety, fatigue, and sleep: a randomized-controlled trial
Authors: Gökbulut Nilay , Ibici Akça Emine , Karakayali Ay Çiğdem
Published: September 2022

Objective

This study aims to determine the impact of foot massage given to postmenopausal women on anxiety, fatigue, and sleep.

Methods

This randomized-controlled study was conducted with 70 women (35 experimental, 35 control) who resided in a village located in Northern Turkey. In the study, the women in the experimental group were given foot massage once every day for 7 days. No intervention was applied to the women in the control group. The data were collected using a Personal Information Form, the Fatigue Severity Scale (FSS), and the Beck Anxiety Inventory (BAI) Descriptive statistics (frequency, percentage distribution, median, and Q1-Q3), χ2 test, Mann-Whitney U test, and Wilcoxon test were used in the analysis of the data.

Results

It was found that the women in the control group had lower pretest BAI scores than those in the experimental group (P < 0.05), whereas before the foot massage intervention, the women in the experimental and control groups had similar FSS scores and sleep hours (P > 0.05). After the foot massage, the FSS scores were 2.3 (1.6‐3.4) in the experimental group and 5.5 (4.6‐6.2) in the control group, the BAI scores were 26.0 (23.0‐29.0) in the experimental group and 36.0 (31.0‐43.0) in the control group, the daily sleep hours were 8.0 (8.0‐10.0) in the experimental group and 7.0 (6.0‐8.0) in the control group, and the differences between the groups were statistically significant (P < 0.001).

Conclusions

It was determined that foot massage applied during menopause increases the average daily sleep duration (hours) and reduces women's fatigue and anxiety levels.
Evaluation of Mitral Regurgitation Using Fluid Structure Interaction
Authors: Rajaei Atefe , Hassani Kamran , Golpaygani Ali Tavakoli
Published: September 2022

In this study, mitral regurgitation was investigated using fluid-structure interaction method in 3 dimensions. The fluid-structure interaction modeling technique has been widely used for a wide range of applications in bioengineering sciences. However, despite all these advances, such studies in the field of cardiovascular complications are still limited, and the need for further research and studies seems necessary. Using these methods, the results can be obtained without the need for complex laboratory devices and systems and without spending a lot of time and money and only by modeling the behavior of the mitral valve. In this study, we tried to simulate the hydrodynamics of blood flow and its interaction with the return flow through the mitral valve using numerical solution software and validate it with the available laboratory results. A 3-dimensional numerical simulation was performed for the complete closure of the mitral valve leading to a return flow. Mitral valve, left atrium, and left ventricle were made. These images, consisting of 240 slices, were taken by a multislice computed tomography scan machine, converted to volume in supersonic Geomagic software, and then entered in ANSYS software. Fluid-structure interaction analysis was performed on the project, and the results were reported. Evaluation and comparison of the results show that von Mises stress and shear stress on the valve wall are higher in the normal state than all other conditions, whereas the velocity and pressure of blood flow in the normal state are less than other states. The highest shear stress, von Mises stress, blood flow velocity, and pressure, as well as the greater distance between the 2 leaflets, are the main parameters that affect the abnormities of mitral valve function.
Enteric Permeability, Systemic Inflammation, and Post-Discharge Growth Among a Cohort of Hospitalized Children in Kenya and Pakistan
Authors: Tickell Kirkby D. , Denno Donna M. , Saleem Ali , Ali Asad , Kazi Zaubina , Singa Benson O. , Otieno Catherine , Mutinda Charles , Ochuodho Victor , Richardson Barbra A. , Ásbjörnsdóttir Kristjana H. , Hawes Stephen E. , Berkley James A. , Walson Judd L.
Published: September 2022

Objectives:

To determine whether gut permeability is associated with post-discharge growth and systemic inflammation among hospitalized children in low- and middle-income countries.

Methods:

Children aged 2–23 months being discharged from Civil Hospital Karachi (Pakistan) and Migori County Referral Hospital (Kenya) underwent lactulose-rhamnose ratio (LRR) permeability testing and were compared to age-matched children from their home communities. Linear mixed effect models estimated the associations between LRR among discharged children with change in length-for-age (LAZ) and weight-for-age z score (WAZ) at 45, 90, and 180 days after discharge. Linear regression tested if relationships between LRR, systemic inflammation [C-reative protein (CRP), Cluster of Differentiation 14 (CD14), Tumour Necrosis Factor Alpha (TNFα), Interleukin-6 (IL-6)], and enterocyte damage [Intestinal Fatty-Acid Binding protein (I-FABP)] differed between the hospitalized and community groups.

Results:

One hundred thirty-seven hospitalized and 84 community participants were included. The hospitalized group had higher log-LRR [0.43, 95% confidence interval (CI): 0.15–0.71, P = 0.003] than the community children. Adjustment for weight-for-length z score at discharge attenuated this association (0.31, 95% CI: 0.00–0.62, P = 0.049). LRR was not associated with changes in WAZ or LAZ in the post-discharge period. Associations between LRR and CRP (interaction P = 0.036), TNFα (P = 0.017), CD14 (P = 0.078), and IL-6 (P = 0.243) differed between community and hospitalized groups. LRR was associated with TNFα (P = 0.004) and approached significance with CD14 (P = 0.078) and IL-6 (P = 0.062) in community children, but there was no evidence of these associations among hospitalized children.

Conclusions:

Although increased enteric permeability is more prevalent among children being discharged from hospital compared to children in the community, it does not appear to be an important determinant of systemic inflammation or post-discharge growth among hospitalized children.
Measurement of Stricture Dimensions Using a Visual Comparative Estimation Method With Biopsy Forceps During Endoscopy
Authors: Yasuda Jessica L. , Staffa Steven J. , Taslitksy Gabriela , Ngo Peter D. , Manfredi Michael A.
Published: September 2022

Background:

Estimation of the dimensions of endoscopic findings such as stricture diameter is largely subjective. Accurate assessment of stricture dimensions has multiple benefits including facilitating the choice of appropriately sized endoscopic therapies for treating stricture, properly tracking response to endoscopic therapies between procedures, and potentially even predicting outcomes of endoscopic therapy.

Methods:

Endoscopies performed in children with repaired esophageal atresia between August 2019 and August 2021 for which both (1) an endoscopic estimate of esophageal stricture diameter obtained by visual comparison with the known dimensions of the biopsy forceps and (2) an intraoperative esophageal fluoroscopy study were performed were included for analysis. Fluoroscopic stricture diameter measurements were manually obtained using a software ruler tool calibrated to the known dimensions of the intraluminal endoscope. Statistical concordance was calculated between the visual diameter estimates and the standard fluoroscopic stricture measurements.

Results:

One hundred ninety‐one endoscopies were included for analysis. Lin’s concordance correlation coefficient was 0.92 (95% confidence interval: 0.89–0.94) between the visual diameter estimates and the fluoroscopic stricture measurements. Correlation was strongest for smaller to mid‐sized stricture diameters.

Conclusions:

Use of the biopsy forceps as a visual reference of known dimensions enables accurate visual estimation of esophageal stricture diameter during endoscopy using commonly available tools, with high concordance with standard fluoroscopic measurement techniques.
Increased Systemic Immune-Inflammation Index Predicts Disease Severity and Functional Outcome in Acute Ischemic Stroke Patients
Authors: Huang Lu
Published: September 2022

Background:

Systemic immune-inflammation index (SII) and system inflammation response index (SIRI) have been recently investigated as novel inflammatory and prognostic markers. Our study aimed to investigate the relationship between SII and SIRI index and severity of stroke, and to analyze the prognostic value in acute ischemic stroke (AIS) patients.

Methods:

The SII is defined as platelet×(neutrophil count/lymphocyte count), SIRI is defined as neutrophil count×(monocyte count/lymphocyte count). We plotted receiver operating characteristic curves of SII and SIRI for poor outcomes and calculated area under the curve (AUC) values and cutoff values. Multivariate logistic regression analysis was performed to analyze the association between SII/SIRI index and poor functional outcome.

Results:

We included 234 AIS patients [mean age 69 (57-78) years; 50.4% male]. Both SII and SIRI were higher in the moderate-to-severe stroke group than in the mild stroke group [932.73 (569.84-1610.90) vs. 581.21 (386.98-1015.59), P<0.001 and 2.00 (1.24-3.13) vs. 1.35 (0.83-1.92), P <0.001]. The area under the receiver operating characteristic curve (area under the curve) value of SII (0.678, 0.608-0.748, P<0.001) tested a similar discriminatory ability compared with SIRI (0.682, 95% CI (0.612-0.751), P<0.001). Multivariate logistic regression analyses showed that SII was significantly associated with poor prognosis at discharge of AIS patients [adjusted odds ratio (95% confidence interval): 2.350 (1.149-4.803), P=0.019)], conversely, SIRI had no prognostic value.

Conclusions:

Higher SII and SIRI indexes were correlated with greater risk of stroke severity, meanwhile SII could be useful for predicting adverse clinical outcomes after AIS.
Chronic Endometritis: Diagnostic Considerations in Patients With Infertility
Authors: Lee Sandra
Published: September 2022

Chronic endometritis (CE) is a controversial clinical and pathological entity. Although the presence of plasma cells (PCs) is the most frequently used diagnostic criterion for CE, the minimal diagnostic criteria remain controversial and undefined. The clinical setting of CE (asymptomatic, pelvic inflammatory disease, infertility) is an important consideration regarding the clinical significance of endometrial PCs. In the setting of infertility, specifically recurrent implantation failure (RIF) and recurrent pregnancy loss (RPL), CE may have a negative impact on endometrial receptivity, resulting in higher rates of implantation failure. The proposed pathophysiology is that a subclinical intrauterine infection alters the local inflammatory milieu resulting in a shift of the normal inflammatory cell profiles toward responses associated with implantation failure and poorer reproductive outcomes. Cure rates following antibiotic treatment are reported to be high (up to 90%). The results of meta-analyses describing the effect of CE on reproductive outcomes are mixed. There is evidence supporting CE as a treatable factor with improved reproductive outcomes following treatment and there are also results showing no differences in reproductive outcomes. Variable diagnostic criteria for CE, inclusion criteria, and treatment regimens between studies are the main limitations, hampering the ability to compare results across studies. Results regarding the optimal diagnostic criteria in the setting of RIF and RPL are also variable, with some authors recommending a cutoff of 1 or more CD138+ PCs per high-power field and some recommending a cutoff of 5 or more CD138+ PCs per high-power field. There are some studies indicating CE as a negative prognostic factor in patients with RIF and RPL, which may be reversible with antibiotic treatment. The optimal diagnostic criteria for CE in this clinical setting are undefined. For the investigation of infertility patients whom clinicians intend to treat, a descriptive diagnosis (indicating the presence/number of PCs and method of identification) is a reasonable approach. Routine use of CD138 immunohistochemistry is of limited value for the diagnosis of CE.
Carcinomas With Concurrent Involvement of the Endometrium and Uterine Adnexa—Implications for Pathological Diagnosis and Clinical Management in Current Practice
Authors: Singh Naveena , Tinker Anna , Gilks C. Blake
Published: September 2022

A proportion of endometrial and adnexal carcinomas have concurrent involvement of the other site. In the case of high-grade serous carcinomas involving the tubal epithelium as well as endometrium, distinction of tubo-ovarian high-grade serous from endometrial serous carcinoma can have implications for surgical as well as nonsurgical treatment approaches, including targeted therapies and referral to clinical genetics services. The other situation is involvement of the endometrium and ovary by low-grade endometrioid carcinoma; here separation of high-stage endometrial carcinoma from 2 low-stage, low-grade tumors determines adjuvant treatment decisions. These challenging scenarios are illustrated with case presentations and criteria for pathological reporting while acknowledging uncertainty where this is warranted. It is accepted that these are areas in transition, and any criteria offered are likely to change in the light of new information.
Mesonephric-Like Adenocarcinoma of the Endometrium: Review of the Literature and Practical Diagnostic Recommendations
Authors: Chapel David B. , Park Kay J.
Published: September 2022

Mesonephric-like adenocarcinomas are endometrial and ovarian neoplasms of müllerian origin with morphologic, immunophenotypic, and molecular evidence of mesonephric-type transdifferentiation, as well as considerable homology with endometrioid tumors. First described in 2016, mesonephric-like adenocarcinomas are morphologically indistinguishable from “true” mesonephric adenocarcinomas of the uterine cervix, but the latter are distinguished by (1) primary localization to the cervical wall, (2) frequent association with mesonephric remnants, and (3) in some cases, lack of mucosal involvement. Despite an overall low-grade morphology, mesonephric-like adenocarcinoma follows an aggressive clinical course, characterized by frequent and early recurrences, most often in the lung. Accordingly, accurate distinction of mesonephric-like adenocarcinoma from morphologic mimics—especially low-grade endometrioid adenocarcinoma—is critical. However, available evidence indicates that endometrial mesonephric-like adenocarcinomas are significantly underdiagnosed, likely due to their relative novelty, rarity, and considerable overlap with endometrioid neoplasia. Prospective recognition of characteristic morphologic features, a low threshold for application of diagnostic immunohistochemistry, and judicious use of molecular studies will permit accurate diagnosis in almost all cases.
The Best of Both Worlds: Combining the Molecular and Traditional (Histotype/Grade) Endometrial Cancer Classification
Authors: Bosse Tjalling
Published: September 2022

The discovery of 4 distinct molecular endometrial cancer subgroups by The Cancer Genome Atlas has fundamentally changed the way we look at endometrial carcinoma today. The proven robustness of surrogate markers in a diagnostic algorithm endorsed by the World Health Organization classification of female genital tumors 2020 has opened the gates for worldwide implementation. This advance delivers a reproducible classification system with improved prognostication and a biological basis for future targeted treatments. Although we all embrace this exciting development, we now struggle how to position the traditional histology-based classification (histotype/International Federation of Gynecology and Obstetrics grade). The author discusses the strengths, weaknesses, opportunities, and threats and deliberates on how we could bring the best of both worlds together.
Counterpoint: Integration of Molecular Subtype and Histotype/Grade Into One Classification System for Endometrial Carcinoma
Authors: Köbel Martin
Published: September 2022

The establishment of 4 endometrial carcinoma molecular subtypes by The Cancer Genome Atlas project and their surrogates (POLE mutated, mismatch repair–deficient, p53 abnormal, and no specific molecular profile) invigorated a debate on how to integrate these within the traditional histotype/grade classification. Specific issues of contradicting histotype/grade and molecular subtype diagnoses will be discussed with illustrated examples. The hierarchy of histotype/grade and molecular subtype is interdependent. Pathologists should aim to integrate histotypes/grades and molecular subtypes to provide one consistent and clinically relevant diagnosis.
Longitudinal outpatient and school-based service utilization among children with nonsyndromic craniosynostosis
Authors: Peck Connor J. , Junn Alexandra , Park Kitae E. , Khetpal Sumun , Cabrejo Raysa , Singh Anusha , Mayes Linda , Alperovich Michael , Persing John
Published: September 2022

Purpose:

While non-syndromic craniosynostosis (NSC) has been associated with neurodevelopmental sequalae, a lesser amount of emphasis has been placed on the need for related supportive services. This study assessed the prevalence of such services among children surgically treated for NSC, and identified predictors of service use.

Methods:

Parents of children with NSC were recruited from an online craniosynostosis support network and surveyed regarding their child’s use of various outpatient and school-based services. Multiple stepwise regression was performed to identify predictive variables for each type of intervention.

Results:

A total of 100 surveys were completed. Of these, 45% of parents reported use of one or more outpatient support services for their children. The most commonly utilized services were speech therapy (26.0%) and physical therapy (22.0%), although the use of services such as psychology/psychiatry increased among older children (18.2% in children ages 6-10). Among school-age children (n=49), the majority of parents (65.3%) reported school-based assistance for their children, most commonly for academic (46.9%) or behavioral (42.9%) difficulties. Significant predictive variables (p<0.05 following stepwise regression) for increases in various outpatient and school-based services included male sex, African-American race/ethnicity, higher parental income, the presence of siblings in the household, increased age at time of surgery, and sagittal synostosis.

Conclusions:

Parents of children with NSC reported frequent utilization of outpatient and school-based supportive services throughout childhood. These services may incur a significant burden of care families. The multifactorial nature of predictive models highlights the importance of cross-disciplinary collaboration to address each child’s longitudinal needs.
A Randomized Trial to Assess Effectiveness and Safety of a Hyaluronic Acid Filler for Chin Augmentation and Correction of Chin Retrusion
Authors: Marcus Keith , Moradi Amir , Kaufman-Janette Joely , Ablon Glynis , Donofrio Lisa , Chapas Anne , Kazin Rebecca , Rivkin Alexander , Rohrich Rod , Weiss Robert , George Rosalyn
Published: September 2022

Background:

The chin is important for facial appearance, affecting overall balance and harmony of the face.

Objective:

To evaluate effectiveness of hyaluronic acid filler Restylane Defyne (HARD) for chin augmentation and correction of chin retrusion versus a no-treatment control.

Methods & Materials:

Male and female subjects, ≥22 years, with mild to moderate chin retrusion, were randomized 3:1 to HARD (n=107) or no treatment (n=33). Assessments included live, blinded evaluations on a validated chin retrusion scale, GCRS, aesthetic improvement (Global Aesthetic Improvement Scale), subject-reported FACE-Q© Satisfaction with Chin, and safety follow-up.

Results:

GCRS responder rate (≥1 grade improvement) was higher for HARD (81%) than control (6%) (p<0.001) at Week 12, and remained higher at Week 48 (74% vs. 11%; p<0.001). Aesthetic improvement rates were high throughout the study as reported by investigators (≥96%) and subjects (≥85%). Subject satisfaction was higher in HARD than control at Week 12 (p<0.001). In the individual FACE-Q© scale items, 87%-98% of subjects were satisfied at Week 12. Treatment-related adverse events were mild to moderate.

Conclusion:

HARD was safe and effective for augmentation of the chin region to improve the chin profile and associated with high aesthetic improvement and subject satisfaction. Effectiveness was sustained throughout 48 weeks.
The Usefullness of Subclavian Artery Ultrasound Assessment in Giant Cell Arteritis Evaluation
Authors: Oshinsky Charles , Bays Alison M. , Sacksen Ingeborg , Jernberg Elizabeth , Zierler R. Eugene , Pollock P. Scott
Published: September 2022

Objective

Vascular ultrasound has been increasingly used to diagnose giant cell arteritis (GCA). The temporal and axillary arteries are commonly evaluated. However, the usefulness of including the subclavian artery remains unclear. This study investigated whether inclusion of the subclavian artery in addition to the temporal and axillary arteries in the ultrasound evaluation of GCA improves the accuracy of the examination beyond ultrasonography of the temporal and axillary arteries alone.

Methods

We formed a fast-track clinic to use ultrasound to rapidly evaluate patients with suspected GCA. In this cohort study, patients referred for new concern for GCA received a vascular ultrasound for GCA. Subclavian intima-media thickness (IMT) cutoffs of 1.0 and 1.5 mm were retrospectively assessed.

Results

Two hundred thirty-seven patients were referred to the fast-track clinic from November 2017 to August 2021. One hundred sixty-eight patients received an ultrasound for concern for new GCA. With a subclavian IMT cutoff of 1.5 mm, inclusion of the subclavian artery did not identify any patients with GCA who were not otherwise found to have positive temporal and/or axillary artery examinations, and at this cutoff, there was 1 false-positive result. A subclavian IMT cutoff of 1.0 mm identified several subjects diagnosed with GCA who had otherwise negative ultrasounds, but most subjects with an isolated subclavian IMT greater than 1.0 mm had false-positive results, and the specificity of this cutoff was poor.

Conclusion

Inclusion of the subclavian artery in the ultrasound assessment of GCA at 2 different cutoffs rarely contributed to the accurate diagnosis of GCA and increased the rate of false-positive results.
Astragaloside IV ameliorates cerebral ischemia-reperfusion injury via upregulation of PKA and Cx36
Authors: Yu Li , Wang Yuting , Tang Jingxue , Shu Zhaorui , Han Xian
Published: September 2022

Objectives

To determine the effects of astragaloside IV on cerebral ischemic-reperfusion injury in rats and to explore underlying mechanisms of brain protection.

Methods

Sixty Sprague–Dawley rats were randomized into four groups: Sham, cerebral ischemia-reperfusion (I/R group), I/R+astragaloside IV (I/R+AST-IV group) and I/R+astragaloside IV+PKA kinase inhibitor H-89 (I/R+AST-IV+H-89 group). All I/R rats were subjected to 2 h cerebral ischemia, followed by 24 h reperfusion and scored for neurobehavior. Cerebral infarct volume, pathomorphological changes and brain apoptosis, in addition to changes in expression of Cx36, PKA, Bax and Bcl-2 proteins, were assessed.

Results

Astragaloside IV treatment reduced neurobehavioral score and percentage volume of cerebral infarct, reducing pathomorphological injury and brain apoptosis. Expressions of Cx36 and PKA protein were increased and the Bax/Bcl-2 ratio decreased. All astragaloside IV effects were reversed by the PKA inhibitor and H-89.

Conclusions

Astragaloside IV attenuated cerebral I/R injury in rats by increasing Cx36 and PKA protein expression and reducing the Bax/Bcl-2 ratio.
Multiple needs and multiple treatments. What's a clinician to do? Update on the psychosocial treatment of disruptive behaviours in childhood
Authors: Andrade Brendan F. , Aitken Madison , Brodkin Sabrina , Sawrikar Vilas
Published: September 2022

Purpose of review

There are a wide range of psychosocial treatment options, delivered in different modalities, for children with disruptive behaviour. However, clinicians face many challenges in ensuring the empirically supported treatments (ESTs) they select will be effective for their patient. This has prompted studies to generate knowledge on how to improve treatment outcomes for children with disruptive behaviour. This review identifies the major challenges in treatment selection as well as emerging research seeking to improve outcomes.

Recent findings

This review emphasizes the salience of the research-practice gap associated with establishing ESTs using narrow definitions of clinical problems. Recent research is reviewed considering the complex determinants of disruptive behaviours, including parent and family factors that influence outcomes. The review subsequently outlines recent advances in research and clinical practice guidelines aiming to surmount these challenges. Key advances discussed include examining the most impactful components of ESTs, personalizing interventions by targeting core dysfunction underlying behaviour, and addressing parent factors including mental health and cultural relevance to improve outcomes.

Thorough assessment of patients’ needs, combined with knowledge of treatment response predictors, are recommended to determine the most suitable treatment plan. Recent advances have focused on developing and designing interventions that meet needs in a way that is flexible and tailored.
A possible home for a bizarre Carboniferous animal: is
Typhloesus
a pelagic gastropod?
Authors: Conway Morris Simon , Caron Jean-Bernard
Published: September 2022

By contrast to many previously enigmatic Palaeozoic fossils, the Carboniferous metazoan
Typhloesus
has defied phylogenetic placement. Here, we document new features, including possible phosphatized muscle tissues and a hitherto unrecognized feeding apparatus with two sets of
ca
20 spinose teeth whose closest similarities appear to lie with the molluscan radula. The ribbon-like structure, located well behind the mouth area and deep into the anterior part of the body, is interpreted as being in an inverted proboscis configuration. Gut contents, mostly conodonts, in the midgut area demonstrate that
Typhloesus
was an active predator. This animal was capable of propelling itself in the water column using its flexible body and a prominent posterior fin. The affinity of
Typhloesus
as a pelagic mollusc remains problematic but may lie more closely with the gastropods. Heteropod gastropods share with
Typhloesus
an active predatory lifestyle and have a comparable general body organization, albeit they possess characteristic aragonitic shells and their origins in the Jurassic post-date
Typhloesus
.
Typhloesus
may represent an independent radiation of Mid-Palaeozoic pelagic gastropods.
Potential origins of fish toti-like viruses in invertebrates
Authors: Tighe Andrew J. , Ruane Neil M. , Carlsson Jens
Published: September 2022

The virus family Totiviridae had originally been considered to include only viruses which infected fungal and protist hosts, but since 2006 a growing number of viruses found in invertebrates and fish have been shown to cluster phylogenetically within this family. These Totiviridae-like, or toti-like, viruses do not appear to belong within any existing genera of Totiviridae, and whilst a number of new genus names have been suggested, none has yet been universally accepted. Within this growing number of toti-like viruses from animal hosts, there exists emerging viral threats particularly to aquaculture, namely Infectious myonecrosis virus in whiteleg shrimp and Piscine myocarditis virus (PMCV) in Atlantic salmon (Salmo salar). PMCV in particular continues to be an issue in salmon aquaculture as a number of questions remain unanswered about how the virus is transmitted and the route of entry into host fish. Using a phylogenetic approach, this study shows how PMCV and the other fish toti-like viruses probably have deeper origins in an arthropod host. Based on this, it is hypothesized that sea lice could be acting as a vector for PMCV, as seen with other RNA viruses in Atlantic salmon aquaculture and in the toti-like Cucurbit yellows-associated virus which is spread by the greenhouse whitefly Trialeurodes vaporariorum.
Sibling Variation in Phenotype and Genotype: Polygenic Trait Distributions and DNA Recombination Mapping with UK Biobank and IVF Family Data
Authors: Lello Louis , Hsu Maximus , Widen Erik , Raben Timothy G.
Published: September 2022

We use UK Biobank and a unique IVF family dataset (including genotyped embryos) to investigate sibling variation in both phenotype and genotype. We compare phenotype (disease status, height, blood biomarkers) and genotype (polygenic scores, polygenic health index) distributions among siblings to those in the general population. As expected, the between-siblings standard deviation in polygenic scores is times smaller than in the general population, but variation is still significant. As previously demonstrated, this allows for substantial benefit from polygenic screening in IVF. Differences in sibling genotypes result from distinct recombination patterns in sexual reproduction. We develop a novel sibling-pair method for detection of recombination breaks via statistical discontinuities. The new method is used to construct a dataset of 1.44 million recombination events which may be useful in further study of meiosis.
A leap to non-communicable diseases epidemic in Burundi: overall trends of the disproportionate burden
Authors: Niyukuri David , Nyandwi Joseph , Kamatari Olivier , Uwizeyimana Canesius , Mikaza Chamy , Barengayabo Mediatrice
Published: September 2022

In developing countries, Noncommunicable diseases (NCDs) are increasing relentlessly. A recent review in East African Community countries showed that much need to be done to improve in prevention of risk factors, monitoring, surveillance, governance, and evaluation of health systems to tackle NCDs. In Burundi, there is no study which has been conducted to give an overview on status of NCDs and their risks factors. We conducted a review on estimations of some NCDs statistics and pooled the data of NCDs and associated risk factors, together with data available on cancer for Burundi. A descriptive analysis was performed, and statistical test was conducted to check distribution differences of the NCDs burden between male and female populations. We built linear model for diabetes and hypertension with same predictors (blood pressure, body-mass index, and cholesterol). Overall, data pooled in different studies showed that almost all the NCDs and associated risk factors have an increasing trend in Burundi among male and female populations. Adult men and women are at high risk of developing diabetes and hypertension. Although both female and male populations have an increasing trend of obesity, women, girls between 5 and 10 years, and adolescent girls are carrying the highest burden compared to their male counterpart with same age categories. The data showed that obesity has been sharply increasing among children and adolescents in the last two decades. Cancer is also increasing with a lot of new types being diagnosed. We conclude that, NCDs are of a lot of concerns in male and female populations in Burundi. The prevalence of obesity among younger children and adolescent is alarming. There is a need of actions to be done in order to be able to prevent and manage NCDs, but interventions targeting children, adolescents, and women should be put in place urgently.
Use of nudge techniques in General practice (GP) to promote HPV vaccination among parents of boys aged 11-14 years: effectiveness and acceptability
Authors: Barbaroux Adriaan , Chanzy Morgane
Published: September 2022

Background

A nudge is any procedure that modifies and/or influences the architecture of a choice, without using persuasion or financial incentives. It is commonly referred to as a “psychological nudge”. Nudges are effective in promoting public health issues such as HPV vaccination. Several systematic reviews of the literature place nudges among the most promising interventions for increasing vaccination coverage.

Objective

The objective of this study is to evaluate the effectiveness and acceptability of a nudge towards HPV vaccination based on the proposal of a consultation appointment to the parents of boys aged 11 to 14 years in the patient base of two general practitioners. The secondary objective is to evaluate the role of the feeling of control in this acceptability.

Methods

Participants were divided into two parallel experimental arms: a nudge group and a non-nudge group. The procedure used was a simple randomization of the parents of boys aged 11-14 years into two groups in the general practitioner’s practice. The study was conducted in two phases and took the form of a proposed appointment at the private practice of the participants in the nudged group. A questionnaire was administered to the participants in both groups one month after these appointments, asking them about their vaccination status regarding HPV vaccination, their acceptability of the nudge and their feeling of control in this procedure.

Results

The analysis was carried out on 32 participants in each of the two groups. The nudge was significantly effective in terms of vaccination coverage. Similar acceptability was found in both groups. The absence of a feeling of control was noted.

Conclusion

This study shows that the prevalence of a vaccination can be significantly modified by a nudge. This study did not show a significant difference in the acceptability of the nudge in the two groups. However, the acceptability of the nudge is significant in both groups. The literature shows good external consistency across different populations in France. This could mean that the French population is predominantly pro-nudge. Thus, a nudge deemed acceptable by the participants is not necessarily ethical, and may insidiously implant an idea. The ethical approach to nudges before their implementation is therefore essential.
Antibody avidity maturation favors SARS-CoV-2 convalescents over vaccinated individuals granting breadth in neutralizability and tolerance against variants
Authors: Nakagama Yu , Candray Katherine , Kaku Natsuko , Komase Yuko , Rodriguez-Funes Maria-Virginia , Dominguez Rhina , Tsuchida Tomoya , Kunishima Hiroyuki , Nagai Etsuko , Adachi Eisuke , Mumba Ngoyi Dieudonné , Yamasue Mari , Komiya Kosaku , Hiramatsu Kazufumi , Uemura Naoto , Sugiura Yuki , Yasugi Mayo , Yamagishi Yuka , Mikamo Hiroshige , Shiraishi Satoshi , Izumo Takehiro , Nakagama Sachie , Watanabe Chihiro , Nitahara Yuko , Tshibangu-Kabamba Evariste , Kakeya Hiroshi , Kido Yasutoshi
Published: September 2022

Background

The durability and cross-neutralizability of protective antibodies against evolving SARS-CoV-2 variants are primary concerns in mitigating (re-)exposures. The role of antibody maturation, the process whereby selection of higher avidity antibodies augments host immunity, to determine SARS-CoV-2 neutralizability was investigated.

Methods

Sera collected from SARS-CoV-2 convalescent individuals at 2- or 10-months after recovery, and BNT162b2 vaccine recipients at 3 or 25 weeks post-vaccination, were analyzed. Anti-spike IgG avidity was measured on a urea-treated ELISA platform. Neutralizing ability of antibodies was assessed by surrogate virus neutralization. Fold change between variant and wild-type antigen neutralizability was calculated to infer breadth of neutralizability.

Results

Compared with early-convalescence, the avidity index of late-convalescent sera was significantly higher (median 37.7 (interquartile range 28.4–45.1) vs. 64.9 (57.5–71.5), p < 0.0001), indicative of progressive antibody maturation extending months beyond acute-phase illness. The urea-resistant, high-avidity fraction of IgG was best predictive of neutralizability (Spearman’s r = 0.49 vs. 0.67 for wild-type; 0.18–0.52 vs. 0.48–0.83 for variants). Higher-avidity convalescent sera showed greater cross-neutralizability against SARS-CoV-2 variants (p < 0.001 for Alpha; p < 0.01 for Delta and Omicron). Vaccinees experienced delayed maturation kinetics, translating to limited breadth of neutralizability at week-25 post-vaccination which was only comparable to that of early-convalescence.

Conclusions

Avidity maturation grants broader neutralizability that is resilient against emerging SARS-CoV-2 variants. With immunopotentiation through repeat vaccinations becoming a pivotal strategy to accomplish herd immunity, understanding the variable longitudinal evolutions of the two building blocks of ‘hybrid immunity’ is crucial.
Multi-lingual multi-platform investigations of online trade in jaguar parts
Authors: Polisar John , Davies Charlotte , Morcatty Thais , da Silva Mariana , Zhang Song , Duchez Kurt , Madrid Julio , Lambert Ana Elisa , Gallegos Ana , Delgado Marcela , Nguyen Ha , Wallace Robert , Arias Melissa , Nijman Vincent , Ramnarace Jon , Pennell Roberta , Novelo Yamira , Rumiz Damian , Rivero Kathia , Murillo Yovana , Salas Monica Nunez , Kretser Heidi , Reuter Adrian
Published: September 2022

We conducted research to understand online trade in jaguar parts and develop tools of utility for jaguars and other species. Our research took place to identify potential trade across 31 online platforms in Spanish, Portuguese, English, Dutch, French, Chinese, and Vietnamese. We identified 230 posts from between 2009 and 2019. We screened the images of animal parts shown in search results to verify if from jaguar; 71 posts on 12 different platforms in four languages were accompanied by images identified as definitely jaguar, including a total of 125 jaguar parts (50.7% posts in Spanish, 25.4% Portuguese, 22.5% Chinese and 1.4% French). Search effort varied among languages due to staff availability. Standardizing for effort across languages by dividing number of posts advertising jaguars by search time and number individual searches completed via term/platform combinations, the adjusted rankings of posts were: Portuguese #1, Chinese 2 (time) & 3 (searches), Spanish 3 & 4; French 5 & 4; English 5 & 2, and Dutch 6. Teeth were most common; 156 posts offered at least 367 apparent teeth. From these, 95 teeth were assessed as definitely jaguar; 71 jaguar teeth could be linked to a location, with the majority of the 71 offered for sale from Mexico, China, Bolivia, and Brazil (26.8, 25.4, 16.9, and 12.7% respectively). Ranking of number of teeth was Mexico (19), China (18), Bolivia (12), Brazil (9), Peru/Ecuador (most accurate probable location) (8), Venezuela (3), Guadeloupe (1), and Uruguay (1). The second most traded item, skins and derivative items were only identified from Latin America: Brazil (7), was followed by Peru (6), Bolivia (3), Mexico (2 and 1 skin piece), and Nicaragua and Venezuela (1 each). Whether by number of posts or pieces, the ranking of parts was teeth, skins/pieces of skins, heads, and bodies. Our research presents a snapshot of online jaguar trade and methods that may have utility for many species now traded online. Our research took place within a longer-term project to assist law enforcement in host countries to better identify potential illegal trade online, with research findings informing hubs in Latin America for building such capacity.