bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic significance of mean platelet volume in patients with lung cancer: a meta-analysis
Authors: Kharel Sanjeev , Shrestha Suraj , Shakya Prafulla , Rawat Rohit , Shilpakar Ramila
Published: March 2022

Objective

The mean platelet volume (MPV) is a measure of platelet size, and it is considered a surrogate marker of platelet activation. Because the correlation between platelet count/size and lung cancer prognosis remains unclear, this meta-analysis comprehensively evaluated the prognostic significance of MPV among patients with lung cancer.

Methods

A systematic search of PubMed, Embase, Google Scholar, and additional sources of relevant studies were conducted with no language restrictions from inception to 7 May 2021. Overall survival (OS) and disease-free survival (DFS)/progression-free survival (PFS), as well as their hazard ratios (HR) and 95% confidence intervals (CIs), were pooled to evaluate the relationship between MPV and survival. The study protocol was registered on PROSPERO.

Results

Eleven studies involving 2421 patients with lung cancer were included in our analysis. Nine studies including only patients with non-small cell lung cancer were included in the meta-analysis. Our analysis revealed no significant associations of MPV with OS (HR = 1.09, 95% CI = 0.84–1.41) and DFS/PFS (HR = 1.13, 95% CI = 0.58–2.20).

Conclusion

Pretreatment MPV levels did not display prognostic significance in patients with NSCLC. Large-scale prospective studies and a validation study considering ethnicity and lung cancer staging are warranted.
High Incidence of Combined and Posterior Labral Tears in Military Patients With Operative Shoulder Instability
Authors: Swan Erin R. , Lynch Thomas B. , Sheean Andrew J. , Schmitz Matthew R. , Dickens Jon F. , Patzkowski Jeanne C.
Published: March 2022

Background:

Anterior shoulder instability is the pattern most commonly reported in the civilian population, but military servicemembers may represent a unique population. At 1.7 per 1000 person-years, servicemembers not only have a higher incidence of instability events compared with civilians (reported rate of 0.2-0.8), but the distribution of labral tears in the military may differ significantly as well.

Hypothesis:

The incidence of combined and posterior labral tears in the military population will be greater than numbers previously reported.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

The Wounded, Ill, and Injured Registry, a Department of Defense patient reported outcomes data collection platform that includes all military branches, was queried retrospectively for all patients who had undergone a primary arthroscopic or open shoulder stabilization procedure (Current Procedural Terminology codes 29806, 23455, 23462) between October 2016 and January 2019. Demographic information was obtained through intake forms completed by patients at the time of enrollment into the Military Orthopaedics Tracking Injuries and Outcomes Network. Tear location was determined arthroscopically and labeled as anterior, inferior, posterior, superior, or any combination thereof. Chi-square analysis was used to compare the percentage of patients with isolated anterior, isolated posterior, isolated inferior, or combined labral tears in the current study cohort with those in a previously reported cohort of patients with operative shoulder instability at a single military treatment facility.

Results:

A total of 311 patients were included who had undergone primary shoulder stabilization during the study period. Of these patients, 94 (30.2%) had isolated anterior tears, 76 (24.4%) had isolated posterior tears, and 136 (43.7%) had combined tears. We observed a higher percentage of combined tears in our data set than in a data set from a single military treatment facility (χ2(2) = 48.2; P < .00001). Chi-square analysis demonstrated that significantly more female patients had an isolated anterior labral tear (51.2%) compared with male patients (27.1%; χ2(2) = 9.4; P = .009).

Conclusion:

The incidence of combined and posterior labral tears in the military population is greater than numbers previously reported in both military and civilian populations.
“Novel Management of Depression Using Ketamine in the Intensive Care Unit”
Authors: Giri Abhishek R. , Kaur Nirmaljot , Yarrarapu Siva Naga S. , Rottman Pietrzak Kathleen A. , Santos Christan , Lowman Philip E. , Niaz Shehzad , Franco Pablo Moreno , Sanghavi Devang K.
Published: March 2022

Background: Ketamine, a dissociative anesthetic, induces improvement in depressive symptoms by antagonizing glutaminergic NMDA receptors. Ketamine has been used previously in outpatient setting for treatment-resistant depression, but we showcase its utility in depression management at the Intensive Care Unit (ICU). Research Question: Can ketamine be used for depression treatment in ICU patients? Study Design and Methods: A retrospective chart review of ICU patients was done at a tertiary center from 2018 to 2021, to assess the ketamine usage. Among the patients reviewed, ketamine was used for depression in 12, and for analgesia & sedation in 2322 patients. Ketamine was administered in doses of 0.5mg/kg & 0.75mg/kg for depression. Each course consisted of 3 doses of ketamine administered over 3 days, and 7 in 12 patients received a single course of ketamine. The rest received 3–4 courses 1 week apart. Results: Ketamine was found to improve mood and affect in most of the patients with depression. 11 in 12 patients had a positive response with better sleep. It has a major advantage over conventional anti-depressants since it takes only a few hours to induce clinical improvement. Patients who were observably withdrawn from care team and family, were administered ketamine. Conclusion: A major drawback of ketamine is that the duration of clinical improvement is short, with the response lasting only up to seven days after a single dose. Hence, all the patients in our study were weaned off ketamine with a supporting antidepressant. Ketamine has been documented to cause cardio-neurotoxicity; however, only one patient had worsening lethargy in our study. To conclude, ketamine has a marked benefit in treating depression in the ICU. Although our study was associated with positive outcomes, there is a need for prospective studies with long-term follow-up assessments.
Correlation of microstructural with corrosion behaviour of Ti-6Al-4V specimens developed through selective laser melting technique
Authors: Jeyaprakash N. , Yang Che-Hua , Karuppasamy Sundara Subramanian , Rajendran Dinesh Kumar
Published: March 2022

Ti-6Al-4 V (Ti64) alloy is majorly preferred for fabricating the parts in biomedical, aerospace and automobile industries. Traditional manufacturing techniques are mostly involved in making these parts. This work is focused on evaluating the as-cast and Selective Laser Melting (SLM) printed Ti64 specimens in terms of microstructure, hardness and corrosion resistance. The microstructure and the hardness of as-cast and SLM printed samples were examined using FESEM with EDS followed by Vickers microhardness test The corrosion resistance offered by both samples at different durations was investigated in an electrochemical workstation followed by the examination of the corroded surface roughness. The results showed that the existence of martensite microstructure in the SLM printed Ti64 sample has paved the way for enhancing the hardness property compared with the as-cast specimen. Furthermore, the corrosion analysis revealed that the formation of strong and compact passive film has been observed on the SLM samples which resist corrosion. This is due to the even distribution of stabilizing elements followed by martensite phase formation with subsequent solidification during the SLM process. The electrochemical impedance spectroscopy (EIS) analysis and surface roughness evaluation also confirm that the SLM samples have a better passive film with higher Rp and lower Ra values, thereby providing greater resistance against corrosion.
The effect of electromagnetic load fluctuation on the gas exchange stability of a free-piston hybrid power system
Authors: Li Shilei , Yuan Chenheng
Published: March 2022

The free-piston hybrid power system (FPHS) is affected by the dynamic coupling of combustion drive, power transmission, piston motion, excitation generation and gas exchange, and its operating state is very different from that of traditional engines. In this paper, the influence of the change of electromagnetic load on the ventilation stability of the whole system is studied by combining the method of system simulation and experimental validation. A dynamic-ventilation one-dimensional coupled gas exchange model was established, and the influence of the fluctuation of the electromagnetic load on the gas exchange is simulated by combining the thermodynamic model with the magnetic inductive load model. The results show that the scavenging efficiency is positively correlated with the load fluctuation, while the trapping efficiency changes with the opposite rule. Specifically, increasing the electromagnetic load properly will increase the time of gas exchange and obtain more fresh charge. The reduction of the electromagnetic load will make the compression process have higher gas pressure and temperature, which the mixture of oil and gas is more homogeneous and the combustion rate is faster after ignition. The stability of the ventilation performance of FPHS is very sensitive to electromagnetic fluctuations. The control of FPHS system can be achieved by adjusting the electromagnetic load.
Mobilizing Forward: An Interpretive Description of Supporting Successful Neonatal Intensive Care Unit-To-Home Transitions for Adolescent Parents
Authors: Orr Elizabeth , Ballantyne Marilyn , Gonzalez Andrea , Jack Susan Michelle
Published: March 2022

Pregnancy and parenting in adolescence and the transition home following the hospitalization of an infant in the neonatal intensive care unit (NICU) are two relatively complex phenomena; and whilst each have been consistently explored within the relevant literature, little is understood about the care required when they intersect. Using interpretive description methodology to guide our exploration, we conducted semi-structured interviews with 23 expert providers caring for adolescent parents involved in NICU-to-home transitions to describe this process in their practice. Findings suggest that supporting successful NICU-to-home transitions for adolescent parents relied strongly on understanding the impact of the NICU experience, establishing therapeutic relationships and facilitating supportive partnerships between the NICU and parents as well as the NICU and supportive services post-discharge. Findings highlight the opportunity for more integrated models of care within the NICU and extending into the community to address the complex biopsychosocial care needs of this parent population.
Gender Bias in Policy Representation in Post-Conflict Societies
Authors: Butler Daniel M. , Tavits Margit , Hadzic Dino
Published: March 2022

Do politicians represent the policy preferences of men and women equally post-war? Gender inclusiveness has particularly high stakes in this context: research shows that it can help sustain peace. We use a series of survey experiments with politicians ( N = 1389) and voters ( N = 3049) to study gender bias in policy representation in a post-conflict setting: Bosnia. We find a significant pro-male bias in the policy responsiveness of local politicians (both men and women) to their constituency preferences. We do not find evidence that this is because men are more active and vocal about expressing their policy preferences. Instead, this bias is present in the post-war society more generally: politicians’ attitudes reflect the pro-male bias among voters, both men and women. These results have important implications for the study of gender and post-conflict politics.
Employment Stress and Couple Adjustment among Clients With Disorders of Gambling and Alcohol Use: Themes of Transfers in Congruence Couple Therapy
Authors: Lee Bonnie K , Merali Noor-Khanu
Published: March 2022

Background:

Individuals with problematic gambling, alcohol and substance use commonly report lower employment rates and more employment-related problems such as job loss, work conflicts and poor performance.

Method:

A thematic qualitative analysis was conducted to extract employment-related themes from 21 sets of addiction counselors’ case notes of couple therapy sessions (average 10 sessions per case) from a randomized controlled trial of Congruence Couple Therapy (CCT). Case notes were examined for the types of employment issues to answer the research question: What are the interconnections of employment, couple adjustment and addictive behaviors as revealed in the CCT counselors’ case notes?

Results:

Five key areas of employment-related stress were identified: (1) unemployment, (2) financial concerns, (3) history of crime, (4) overworking and workaholism, and (5) workplace conflict. These themes interacted negatively with couple adjustment and addictive behaviors. Using CCT as an intervention, clients gained skills in 4 areas transferred to employment: (1) awareness of self, other and family of origin, (2) congruent communication, (3) work-family balance, and (4) enlisting spousal support. These themes intersected with enhanced work functioning and reduced stress, alcohol use and gambling.

Conclusion:

Employment problems negatively impacted addictive behaviors, couple adjustment and well-being of partners and addicted clients. Skills and awareness gained in CCT promoted changes in addicted clients’ employment functioning and coping with employment stress. The domains of work and couple adjustment are mutually influential in increasing or reducing stress with implications for addiction recovery. CCT as a viable intervention for enhancing employment function should be further studied.
Overview of MicroRNA Expression in Predicting Response to Neoadjuvant Therapies in Human Epidermal Growth Receptor-2 Enriched Breast Cancer – A Systematic Review
Authors: Davey Matthew G , Davey Martin S , Richard Vinitha , Wyns William , Soliman Osama , Miller Nicola , Lowery Aoife J , Kerin Michael J
Published: March 2022

Purpose:

Increased appreciation of the human epidermal growth factor receptor-2 (HER2/neu) signalling pathway has led to the development of targeted therapeutic agents used in conjunction with chemotherapy to improve outcomes for HER2 overexpressing (HER2+) breast cancer. For neoadjuvant therapy, response rates can be unpredictable – novel biomarkers predicting effectiveness are required to enhance oncological outcomes for these patients, and microRNA may prove effective. Our objective was to identify microRNA (miRNA) expression patterns predictive of response to neoadjuvant chemotherapy (NAC) and/or anti-HER2 targeted therapies in patients being treated for early-stage HER2+ breast cancer.

Methods:

A search was performed of the PUBMED, SCOPUS, Web of Science, and EMBASE in accordance to Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines.

Results:

Overall, 15 studies including 1335 patients were included. These studies highlighted an expression profile of 73 miRNA and their ability to predict tumour response to neoadjuvant therapies was correlated. Results from 11 studies were in relation to circulatory miRNA and 4 studies included data from tumour tissue. Overall, upregulation and downregulation of 41 miRNA and 29 miRNA, respectively, predicted differential response to neoadjuvant therapy. Expression levels of 3 miRNA (miR-21, miR-210, and miR-376c-3p) were inconclusive in predicting therapeutic response, while ‘aberrant’ expression of circulating miR-199a predicted pathological complete response (pCR) to NAC.

Conclusions:

This systematic review outlines expression patterns of a number of miRNA which correlate with response to NAC and/or anti-HER2 therapies. Future translational research evaluating predictive biomarkers of primary response to neoadjuvant therapy in HER2+ breast cancer may consider these results.
Properties of Bi2O3/epoxy resin–coated composites for protection against gamma rays
Authors: Li Weibin , Peng Min , Zhao Xiaoming , Chen Shuai
Published: March 2022

In this paper, bismuth oxide (Bi2O3) as the main functional powder, lead (Pb) and tantalum (Ta) as the metal additives, epoxy resin as the matrix and polyester–cotton blended woven fabric as the substrate, Bi2O3 coating nuclear radiation protection composite, Bi2O3/Pb coating nuclear radiation protection composite, and Bi2O3/Ta coating nuclear radiation protection composite with different process parameters were prepared. The cross-section scanning analysis and the influence factor analysis of γ-ray protection performance were carried out, and the mechanical properties of the composites were discussed. The results show that an increase in Bi2O3 content (mass fraction) and an increase in coating thickness can improve the shielding rate of the composite materials to γ-rays. When the thickness of the coating is 1.6 mm and the content of Bi2O3 is 50%, the shielding rate of the composite to γ-rays (at 59.5 keV) reaches 46.1%. The shielding rate of the composite can be increased by adding appropriate metal additives, and the effect of adding Ta is better than that of Pb. The shielding rate of the composite to γ-rays (59.5 keV) can be increased from 28.4% to 31.5% by adding 5% Ta. An increase in Bi2O3 content (mass fraction) and an increase in the coating thickness can aggravate the agglomeration of functional particles in the material. The addition of metal additives can reduce agglomeration to a certain extent. Bi2O3 content, coating thickness, and metal additives all have an effect on the mechanical properties of the composite. If the coating is too thick or the functional particle content is too high, the tensile strength and elongation at break of the composite will be reduced.
CT-Guided Percutaneous Core Needle Biopsy in Typing and Subtyping Lung Cancer: A Comparison to Surgery
Authors: Zhang Hanfei , Tian Sufang , Wang Shan , Liu Songmei , Liao Meiyan
Published: March 2022

Background: Lung cancer histologic types and subtypes are closely associated with treatment selection and prognosis prediction. In this study, we aim to evaluate the suitability of computed tomography-guided percutaneous core needle biopsy (CT-guided PCNB) in typing and subtyping lung cancer. Methods: From August 2007 to December 2015, the patients who underwent CT-guided PCNB and lung lesion resection were retrospectively collected and analyzed. All pathological sections were reassessed in consensus by 2 junior pathologists (group A) and 2 senior pathologists (group B), respectively. All cases were diagnosed on 3 levels: first, malignant and benign diagnosis; second, histologic types diagnosis; and third, histologic subtypes diagnosis and compared with surgery results. Pearson chi-square test was used to compare the differences of diagnostic accuracy between pathologists in group A and group B. Results: A cohort of 160 patients was included in this study. On the first level, the diagnostic accuracy was 90.63% (group A) and 94.38% (group B), ( P = .20). On the second level, the diagnostic accuracy for malignant lesions, adenocarcinoma (ADC), and squamous cell carcinoma (SQC) were, respectively, 72.66%, 84.72%, and 69.05% (group A) and 76.98%, 90.28%, and 71.43% (group B) ( P > .05). On the third level, the diagnostic accuracy for ADC subtypes were 26.39% (group A) and 55.56% (group B) ( P < 0.01); for SQC subtypes were 28.57% (group A) and 38.10% (group B) ( P = 0.36). Conclusion: Small specimens obtained by CT-guided PCNB were suitable for the diagnosis of lung cancer histologic types, which may contribute to the selection of a suitable treatment strategy for the unresectable lung cancers. While for the diagnosis of subtypes, discussion with experienced pathologists was recommended.
A Single-Arm Phase II Study to Evaluate Efficacy and Safety of First-Line Treatment With DCVAC/LuCa, Standard of Care Chemotherapy and Shenqi Fuzheng Injection in Advanced (Stage IIIB/IV) Non-Small Cell Lung Cancer Patients
Authors: Liu Qing , Lou Yanni , Li Liya , Yang Guowang , Cui Huijuan , Cheng Zhiqiang , Li Yuan , Liu Meng , Deng Chao , Wan Donggui , Yan Yongxia , Jia Liqun
Published: March 2022

Objectives:

To evaluate the efficacy and safety of first-line treatment with a dendritic cell vaccination for lung cancer (DCVAC/LuCa), standard of care chemotherapy and Shenqi Fuzheng injection in patients with advanced (stage IIIB/IV) non-small cell lung cancer.

Patients and Methods:

Patients with histologically or cytologically confirmed recurrent metastatic or advanced NSCLC (stage IIIB/IV) with wild-type epidermal growth factor receptor (EGFR) or EGFR mutation which does not confer increased tumor susceptibility to EGFR-interacting drugs were recruited. For the treatment period, the first cycle of standard of care therapy (SoC) started 2 to 14 days after the leukapheresis procedure. SoC continued 4 to 6 cycles. DCVAC/LuCa was administered from the second cycle of SoC. DCVAC/LuCa was administered in a 3-week cycle schedule (5 doses) and then in a 6-week cycle schedule. Shenqi Fuzheng injection was administered 3 days before each DCVAC/LuCa administration for a total of 14 daily doses. Patients would undergo disease evaluation by computed tomography (CT) scan every 3 months. The primary and secondary endpoint was efficacy with regard to objective response rate (ORR) and progression free survival (PFS). The safety profile was measured by: incidence, type, and severity of all adverse events (AEs), laboratory abnormalities (blood routine test, urine test, and chemical test), physical status, and vital signs. Qi insufficiency was evaluated by tongue diagnosis and questionnaire survey with “Classification and Determination of constitution in TCM.”

Results:

Twenty-three patients from 3 hospitals who received combination therapy were included. ORR was 34.8% (95% CI:16.4%-57.3%). Median duration of response was 5.51 m (95% CI:2.70-8.32). Median PFS was 10.72 m (95% CI:4.52-16.93), 1-year survival was 77.8%. mOS was 21.97 m (95% CI:13.68-30.25). There was 1 severe AE related to a history of heart disease and there were no adverse events related to DCVAC/LuCa treatment. Qi insufficiency was improved significantly ( P < .0001) from 41.19 ± 14.58 before treatment to 10.52 ± 16.58 after treatment.

Conclusion:

DCVAC/LuCa, combined with standard of care chemotherapy and Shenqi Fuzheng injection exhibited good benefit in Chinese patients with recurrent metastatic or advanced (stage IIIB/IV) NSCLC, and also significantly improved Qi insufficiency constitution. There were no related adverse events with DCVAC/LuCa treatment.
‘We Learned the Language of the Tree’ Ecovillages as Spaces of Place-Based Transformative Learning
Authors: Pisters Siri R. , Vihinen Hilkka , Figueiredo Elisabete , Wals Arjen E. J.
Published: March 2022

This article explores learning processes that underpin ecovillages as place based ‘sustainability initiatives’. Through the theoretical lens of place- based transformative learning (PBTL), developed in earlier work ( Pisters et al., 2019 , 2020 ), empirical data from life-story interviews and photovoice sessions from three ecovillages is analysed and discussed. The results support, illustrate and deepen the meaning of the four dimensions of the theoretical framework: connection to place, compassionate connection, creativity and transgression. They show how the co-existence of ‘community’ and ‘disruption’ is essential in PBTL where community brings connection, cohesion and stability to a change process whereas disruption paves the way for disrupting old structures and experiment with new ones. This article shows how a change in inner consciousness is related to alternative practices and structures that re-define relationships with ourselves, other humans and the material, more-than-human world.
Diagnosis and Management of Primary Prostatic Signet Ring Cell Carcinoma: Single-Center Experience
Authors: Li Pu , Zhou Zihan , Bao Meiling , Li Jie , Meng Xiaoxin , Liu Bianjiang , Tang Min
Published: March 2022

The purpose of the study was to retrospectively summarize the diagnosis and management of 10 primary prostatic signet ring cell carcinoma (PPSRCC) cases in our center. Ten PPSRCC patients diagnosed at the First Affiliated Hospital of Nanjing Medical University from November 2014 to December 2020 were included. Clinical characteristics, image features, therapeutic procedures, histological diagnosis, and outcomes were retrospectively analyzed. All patients received prostate-specific antigen (PSA) examination preoperatively. Nine of them accepted multiparametric magnetic resonance imaging (mpMRI) due to elevated PSA value, and further biopsied. Among them, five patients were diagnosed as prostatic adenocarcinoma and the other four cases were found a mixture of signet ring cell carcinoma (SRCC) and adenocarcinoma. Furthermore, gastrointestinal endoscope and abdominal computed tomography (CT) did not find SRCC originating in gastrointestinal tract. Therefore, these cases were considered to be PPSRCC. Nine patients accepted laparoscopic or robot-assisted RP. Only one patient with normal PSA adopted transurethral resection of the prostate. Postoperative pathological results confirmed SRCC mixed with prostatic adenocarcinoma in nine cases, and only one patient with pure SRCC. After surgery, nine patients received adjuvant hormone therapy, one of which accepted radiotherapy simultaneously. The patient with pure SRCC did not accept any adjuvant therapy postoperatively. During a mean follow-up of 31.9 months, only four patients were alive without disease progression. In summary, PPSRCC is a rare malignant tumor with few specific symptoms, rapid disease progression, and poor prognosis and is frequently accompanied by high-grade prostate adenocarcinoma patterns. There is still no clear and effective strategy to improve the prognosis.
Ulnar variance and triangular fibrocartilage thickness in adolescents: a cross-sectional MRI study of healthy participants
Authors: van der Post Anne-Sophie , Jens Sjoerd , Jacobs Karl , Smithuis Frank F. , Obdeijn Miryam C. , Maas Mario
Published: March 2022

Skeletally immature wrists are considered at risk of injury due to increased axial loading through a relatively shorter ulna. The aim of this study was to determine whether triangular fibrocartilage thickness relates to ulnar variance and age in adolescents. The radiographs and MRIs of 24 healthy adolescents were retrospectively assessed. Four observers assessed bone age and ulnar variance on radiographs and measured triangular fibrocartilage thickness on MRIs. Median calendar and bone age was 13 years and ulnar variance was −0.7 mm. Median triangular fibrocartilage thickness was 1.4 mm, with excellent inter-observer agreement (r = 0.86). It was moderately correlated with ulnar variance (ρ = −0.46) as well as with bone age (ρ = −0.49). Both variables were statistically significant predictors in a multivariate analysis. This suggests that triangular fibrocartilage thickness changes during skeletal maturation, which might influence axial load distribution in skeletally immature wrists.
Investigations into flexor tendon repair: a research journey over three decades
Authors: Tang Jin Bo
Published: March 2022

In this article, I review how my team and I addressed clinical concerns in Zone 2 flexor tendon repair, and how major findings in each step of our research were translated into clinical practice. The focus of the article is on the thought processes behind each new investigation, the interpretation of research findings and conclusions drawn from the basic and clinical studies.
Antiviral Potential of Indian Medicinal Plants Against Influenza and SARS-CoV: A Systematic Review
Authors: Khuntia Bharat Krushna , Sharma Vandna , Wadhawan Mohit , Chhabra Varun , Kidambi Bharatraj , Rathore Shubhangi , Agarwal Aman , Ram Amirtha , Qazi Sahar , Ahmad Shaban , Raza Khalid , Sharma Gautam
Published: March 2022

The COVID-19 pandemic has posed a significant threat to human health due to the lack of drugs that can potentially act against SARS-CoV -2. Also, even after the emergency approval of WHO, the vaccines’ efficacy is still a question, and people are getting reinfections. Previous studies have demonstrated the efficacy of traditional medicinal plants against influenza and SARS coronavirus. The present article aims to review potential phytochemicals from Indian medicinal plants that may be used against SARS-CoV-2. Articles published in the English language between 1992 and 2021 were retrieved from Embase, PubMed, and Google scholar using relevant keywords, and the scientific literature on efficacies of Indian medicinal plants against SARS-CoV and influenza virus were analyzed. The initial search revealed 1304 studies, but, on subsequent screening, 115 eligible studies were reported. Twenty research articles investigating traditional medicinal plant extracts and metabolites against SARS-CoV and influenza A virus in in vitro and in vivo systems satisfied the search criteria. The studies reported that plant extracts and active compounds such as glycyrrhizin, 14-α-lipoyl andrographolide, and curcumin from medicinal plants such as Yashtimadhu ( Glycyrrhiza glabra), Bhunimba ( Andrographis paniculata), and Haridra ( Curcuma longa) are effective against the various phases of the virus life cycle, viz., virus-host cell attachment, viral replication, 3CL protease activity, neuraminidase activity, adsorption and penetration of the virus. As per ancient Indian literature, plants in Ayurveda possess Rasayana (revitalizing) and Jwara hara (antipyretic, anti-inflammatory) properties. This evidence may be used to conduct experimental and clinical trials to study the underlying mechanisms and efficacy of antiviral properties of Indian medicinal plants against SARS-CoV-2.
Altered Expression of the Hedgehog Pathway Proteins BMP2, BMP4, SHH, and IHH Involved in Knee Cartilage Damage of Patients With Osteoarthritis and Kashin-Beck Disease
Authors: Deng Huan , Xiao Xiang , Chilufya Mumba Mulutula , Qiao Lichun , Lv Yizhen , Guo Ziwei , Lei Jian , Liu Jiaxin , Zhao Yan , Zhang Jiaheng , Wang Wenyue , Han Jing , Qu Chengjuan
Published: March 2022

Objective

To investigate the expression of Hedgehog (HH) signaling pathway proteins in knee articular cartilage from Kashin-Beck disease (KBD) and osteoarthritis (OA) patients.

Methods

Knee articular cartilage samples were collected from normal (N), OA, and KBD adults (aged 38-60 years) and divided into 3 groups with 6 subjects in each group. The localization of the HH pathway proteins bone morphogenetic protein 2 (BMP2), bone morphogenetic protein 4 (BMP4), Sonic hedgehog (SHH), and Indian hedgehog (IHH) was observed with the microscope after immunohistochemical (IHC) staining. Positive staining cell rates of each proteins were compared.

Results

The strongest stainings of all proteins were observed in the middle zones of all 3 groups. The positive staining rates of BMP4 and IHH were significantly lower in the OA and KBD groups than those in the N group in all 3 zones. The positive staining rates of BMP2 and SHH tend to be lower in the OA and KBD groups than those in the N group in the deep zone, while higher in the OA and KBD groups than those in the N group in superficial and middle zones.

Conclusions

Altered expression of the HH pathway proteins BMP2, BMP4, SHH, and IHH was found in OA and KBD articular cartilage. There seemed to be a compensatory effect between SHH and IHH in cartilage damage. Further studies on the pathogenesis of OA and KBD may be carried out from these aspects in the future.
Audiologic and patient perceived benefit in cochlear implantation for single-sided deafness
Authors: YJ Tan Vanessa , Zhang Edward ZY , Leem PS , D'Souza Deepak , Li Huihua , Teng SW , Krishna S Gopal , Ong Bennett , Tan Barrie YB
Published: March 2022

Background

CI in SSD strives to restore binaural hearing. With normal acoustic hearing on one ear, the benefits of rehabilitating the deaf ear with an implant are not well established.

Objectives

We investigate audiologic and quality-of-life measures, and long-term usage patterns of cochlear implantation (CI) in patients with single-sided deafness (SSD)

Methods

Eight patients with idiopathic sudden sensorineural hearing loss of less than 5-year duration were recruited. Pure tone average (PTA), speech discrimination score (SDS), hearing-in-noise test (HINT), tinnitus handicap inventory (THI), quality-of-life speech spatial qualities (SSQ) scale tests were performed before, and one-year after CI. Long-term usage of CI four-years post-operatively was determined.

Results

The median PTA of the deaf ear was 96 dBHL (IQR = 90–120) before, and 30 dBHL (IQR = 27–33) after CI ( p = 0.0156). SDS improved from median of 0% (IQR = 0–3) to 33% (IQR = 24–58) ( p = 0.0360). Median signal-to-noise ratio (SNR), particularly of the S0Nbetter setting of HINT showed improvement from 6.4 dB (IQR = 5.7–7) to 0.9 dB (IQR = −2.25–6.2) ( p = 0.1094). Despite median THI improving from 24 (IQR = 6–47) to 4 (IQR = 2–7) ( p = 0.1563), two patients experienced worsening of tinnitus. SSQ scores in all subscales showed modest improvement not approaching significance. 5 of 8 (62%) patients stopped using their implant four years after surgery.

Conclusion

Despite improved audiologic and tinnitus outcome measures, our patients’ SDS remained in non-serviceable range, while quality-of-life measures showed only modest improvement. Majority of our patients stopped using their implant four years post-surgery. Our study suggests that objective measurable benefits of CI in SSD may not translate to actual patient perceived benefits.
Loncastuximab tesirine in relapsed or refractory diffuse large B-cell lymphoma: a review of clinical data
Authors: Furqan Fateeha , Hamadani Mehdi
Published: March 2022

Loncastuximab tesirine-lpyl (ADC Therapeutics) is an anti-CD19 antibody-drug conjugate which consists of anti-CD19 antibody and cytotoxic alkylating agent, SG3199. Data from preclinical in vitro and animal studies demonstrated its selectivity and efficacy. The phase I LOTIS-1 study for relapsed, refractory B-cell non-Hodgkin lymphoma (NHL) demonstrated efficacy and a tolerable safety profile, with major adverse effects being neutropenia, thrombocytopenia, elevated liver enzymes, and fluid accumulation. Based on pharmacokinetics analysis in this study, a dose of 150 μg/kg every 3 weeks for cycles 1 and 2 followed by 75 μg/kg every 3 weeks until disease progression or intolerability was chosen for the phase II LOTIS-2 study. This study recruited relapsed, refractory diffuse large B-cell lymphoma and confirmed similar safety profile. Overall response rate was 48.6% (24.1% complete response), and overall survival was 9.9 months. Due to its safety and efficacy reported in the above trials, loncastuximab tesirine was recently approved by the US Food and Drug Administration for the treatment of relapsed, refractory diffuse large B-cell lymphoma. Several clinical trials are ongoing to assess its safety and efficacy in NHL in various clinical settings.
Pattern of semen analysis in male partners of infertile couples in Western Ethiopia: Retrospective cross-sectional study
Authors: Tilahun Temesgen , Oljira Rut , Getahun Ayantu
Published: March 2022

Objectives:

This study assesses the pattern of semen analysis results in male partners of infertile couples at Gimbie Adventist Hospital, Western Ethiopia, 2021.

Methods:

A retrospective cross-sectional study on 131 semen samples of male partners of infertile couples was conducted at Gimbie Adventist Hospital from 5 September 2021 to 5 October 2021. All semen samples were processed and analyzed according to methods and standards outlined by the World Health Organization laboratory manual for the examination and processing of human semen 2010. The data were coded and entered into EpiData version 3.1, and then cleaned and exported to Statistical Package for Social Sciences (SPSS for Windows version 25) for analysis. The results were presented in tables, figures, and charts.

Results:

The age of study participants ranges from 20 to 65 years with a mean age of 30.2 ± 8.1 years. Sperm cell count, morphology, total motility, and vitality below the World Health Organization reference level were found in 48.9%, 27.5%, 43.5%, and 67.2% of the analyzed samples, respectively. Low power of hydrogen and high viscosity were observed in 31.3% and 16.8% of the semen samples, respectively. The majority, 84%, had one or more abnormal semen analysis parameters. Asthenozoospermia (43.5%), necrozoospermia (25.2%), oligozoospermia (24%), azoospermia (24%), and oligoasthenoteratozoospermia (25.2%) were the severe forms of abnormal semen analysis findings detected in this study. The decline in sperm cell morphology and motility were noticed after the age of 31–34 years.

Conclusion:

In this study, both sperm quantity and quality were more affected when compared to similar studies. Only 16% of analyzed samples had normal semen parameters. Given this finding, identifying risk factors and introducing advanced diagnostic modalities for the workup of male infertility in the study area are highly recommended.
Physical evidence of rape against children and adolescents in Brazil: Analysis of 13,870 reports of sexual assault in 2017
Authors: Miziara Ivan Dieb , Miziara Carmen Silvia Molleis Galego , Salguero Aguiar Luan , Alvez Beatriz
Published: March 2022

Introduction:

The medical literature reports child and adolescent maltreatment since the 8th century. Unfortunately, even today, the incomplete knowledge of this event persists. Several forms of violence are applied to children and adolescents, mainly sexual violence including rape and sexual assault. Forensic medical examinations routinely include the genital area, anus, and the body of the victims for signs of a recent or old injury. The main goal of this study is to show the results of physical and sexual examinations regarding confirmation of rape in children and adolescents, based on the medicolegal reports.

Methods:

We made a descriptive cross-sectional study conducted by collecting data from Medicolegal Institute (IML-São Paulo, Brazil) in 2017. We examined 13,870 reports of sexological examinations of victims of the alleged rape. The variables analyzed were age; sex; physical examination; sexological examination; and direct search for sperm in the vaginal, anal, or oral cavity. We selected 11,725 reports from victims under 18 years.

Results:

As for the medical-legal findings, only 1735 reports (14.8%) confirmed sexual abuse. The most affected ages were between 3 and 5 years in the male group and 11 to 14 years in the female group. The most frequent injuries were bruises and abrasions, fissures in the anal region. In 96.2% of the examined males and 85.8% of the females under 14 years old, the examination was inconclusive, and somebody cannot prove the alleged rape. Only 1735 reports (113 from men and 1622 from women) concluded beyond any doubt the alleged rape (14.8%). The search for sperm was positive in only 1582 cases (13.5%).

Conclusion:

This study shows that the results of the medicolegal examinations were quite limited in recording evidence. Sexual violence against children and adolescents reaches mostly females under 13 years of age. Besides, it is a complicated crime to prove, as 85.8% of female examinations and 96.2% of male exams revealed: “no supporting elements” or “undetermined” to characterize the felony. Therefore, to prevent it, the communication of the alleged rape must be made as quickly as possible.
Obstetric analgesia utilization in labor pain management and associated factors among obstetric care providers in the West Shewa Zone, Central Ethiopia
Authors: Terfasa Eba Abera , Bulto Gizachew Abdissa , Irenso Dereje Yadesa
Published: March 2022

Objectives:

Labor pain is the worst pain that almost every woman experiences during childbirth. Labor pain management plays a crucial role in promoting maternal-wellbeing, contributing enormously to maternal satisfaction with the childbirth experience and the high quality of services. Although there have been previous studies, they have primarily been conducted at referral or general hospitals located in urban settings. Thus, this study aimed to assess the utilization of labor pain analgesia and associated factors among obstetric care providers at all levels of health facilities in central Ethiopia.

Methods:

A multicenter institution-based cross-sectional study design was employed from 1 July to 30 September 2020. Simple random sampling using the lottery method was employed to select 399 obstetric care providers. The data were entered into Epi-data version 4.2 and analyzed using SPSS version 26. Bivariate and multivariable logistic regression analysis were used to identify the associated factors. The adjusted odds ratio with its 95% confidence interval and p value ⩽ 0.05 were used to identify associated factors.

Results:

The overall utilization of obstetric analgesia was 46% (95% confidence interval: 41.2%–50.8%). Being a Midwife (adjusted odds ratio: 2.10, 95% confidence interval: 1.27–3.47), having heard of the World Health Organization pain ladder (adjusted odds ratio: 2.95, 95% confidence interval: 1.73–5.01), having favorable attitude (adjusted odds ratio: 1.89, 95% confidence interval: 1.17–3.05), the expectation of obstetric care providers about labor pain (adjusted odds ratio: 3.26, 95% confidence interval: 1.27–8.36), having training on labor pain management (adjusted odds ratio: 2.51, 95% confidence interval: 1.03–6.07), and presence of chance for preference of obstetric analgesia for mothers in the facility (adjusted odds ratio = 2.30, 95% confidence interval: 1.33–3.98) were identified as factors significantly associated with the practice of obstetric analgesia among obstetric care providers.

Conclusion:

The overall use of labor pain management methods among obstetric care providers is low. Professional category, provider attitude, labor pain severity expectations, and having training were found to be factors associated with the use of obstetric analgesia. Therefore, working on adapting and disseminating the harmonized guideline and protocols on labor pain management and provision of training for obstetric care providers on labor pain management techniques were recommended.
Rare case of obturator hernia: Surgical anatomy, planning, and considerations
Authors: Delgado Adam , Bhuller Sidra B , Phan Peter , Weaver John
Published: March 2022

Obturator hernia is a rare variation of abdominal hernias that cause significant morbidity and mortality, especially in the elderly population. Incidence rates vary but account for approximately 0.07%–1.0% of all hernias. Literature on laparoscopic versus laparotomy, as well as types of closure (primary vs mesh) have not been well described in the literature. Obturator hernias, although rare, require a high index of suspicion and care in surgical management as many of these patients will be elderly with a multitude of comorbid conditions. Further research and reporting on technique and type of closures utilized when these rare hernias are encountered by surgeons would benefit the surgical community on practices and management of obturator hernias. Here, we present a case of an elderly female who presented with complaints of obstructive symptoms and abdominal pain secondary to an obturator hernia.
Clinical and dermoscopic overlap of genital molluscum contagiosum with condyloma acuminate
Authors: Wang Bin , Guo Shujing , Yao Yue , Zhang Guoqiang
Published: March 2022

A 24-year-old male presented with asymptomatic penile papules for 1 month. Dermatology examination showed pink, soft papules on the ventral side of the penis, with a clear boundary and rough surface, and papillary hyperplasia could be seen. Dermoscopy revealed multiple finger-like projections without vessels in the center of the lesion under polarized light, and linear and crown-like vessels could be seen at the edge of the lesion. Histopathological examination revealed endophytic infundibular hyperplasia with keratinocytes containing Henderson–Patterson bodies. A diagnosis of molluscum contagiosum was made. Molluscum contagiosum can present with several atypical presentations including giant, cystic, ulcerated, or condyloma acuminatum-like, especially in immunosuppressed patients. Here, we report a case of atypical genital molluscum contagiosum with novel dermoscopic findings in an otherwise-healthy adult.
Blue-grey hyperpigmentation in acne after vandetanib therapy and doxycycline use: A case report
Authors: Perlmutter Jonah W , Cogan Rachel C , Wiseman Marni C
Published: March 2022

Vandetanib is an oral tyrosine kinase inhibitor with cutaneous adverse effects that include the development of acne. We present a patient who underwent vandetanib therapy for stage IV medullary thyroid cancer in conjunction with the use of doxycycline for acne that developed. After vandetanib use, blue-grey pigmentation developed in the acne on his face, chest, back, and arms, which darkened after the use of doxycycline. We review the literature to report that this blue-grey hyperpigmentation was likely vandetanib-induced but may have been the result of both drugs being used in combination.
Surgically treated congenital cleft palate in a 4-month-old kitten: medium-term clinical and CT assessment
Authors: Garnier Paul , Viateau Véronique , Manassero Mathieu , Maurice Emeline
Published: March 2022

Case summary

A 4-month-old female domestic shorthair kitten was presented for a congenital cleft palate causing nasal discharge and sneezing episodes. CT revealed a palatal bone defect involving 20% of the palatal area. Surgical correction of both the hard and soft palate defects was performed using the overlapping and medially positioned flap techniques, respectively. Complete healing of the wound and full resolution of the clinical signs occurred within a 1-month period. At 2 months postoperatively, two punctiform oronasal fistulae were observed rostrally without associated clinical signs. Control CT, performed 6 months postoperatively, revealed a 50% enlargement of the palatal bone defect. At 12 months postoperatively, the cat was still in good general condition without any clinical signs.

Relevance and novel information

To the best of our knowledge, this is the first report to describe the treatment of a congenital cleft palate in a kitten using the overlapping flap technique with a successful medium-term clinical outcome, despite the formation of two oronasal fistulae. This suggests that, as in dogs, full restoration of oronasal compartmentation is not mandatory to achieve functional outcome. The increase of the palatal bone defect over time may play a role in late oronasal fistulae formation and should be considered for surgical planning.