bluuebunny/crossref_metadata_2025 huggingface dataset:
Lower Dopamine D2/3 Receptor Availability is Associated With Worse Verbal Learning and Memory in People Who Smoke Cigarettes
Authors: Zakiniaeiz Yasmin , Gueorguieva Ralitza , Peltier MacKenzie R , Roberts Walter , Verplaetse Terril L , Burke Catherine , Morris Evan D , McKee Sherry A , Cosgrove Kelly P
Published: September 2022

Introduction

Tobacco smoking is a major public health burden. The mesocortical dopamine system—including the dorsolateral prefrontal cortex (dlPFC)—plays an important role in cognitive function. Dysregulated dopamine signaling in dlPFC is associated with cognitive deficits such as impairments in attention, learning, working memory, and inhibitory control. We recently showed that dlPFC dopamine D2/3-type receptor (D2R) availability was significantly lower in people who smoke than in healthy-controls and that dlPFC amphetamine-induced dopamine release was lower in females who smoke relative to males who smoke and female healthy-controls. However, we did not examine whether the smoking-related dopamine deficits were related to cognitive deficits.

Aims and Methods

The goal of this study was to relate dopamine metrics to cognitive performance in people who smoke and healthy-controls. In total 24 (12 female) people who smoke cigarettes and 25 sex- and age-matched healthy-controls participated in two same-day [11C]FLB457 positron emission tomography (PET) scans before and after amphetamine administration. Two outcome measures were calculated—D2R availability (non-displaceable binding potential; BPND) and amphetamine-induced dopamine release (%ΔBPND). Cognition (verbal learning and memory) was assessed with a computerized test from the CogState battery (International Shopping List).

Results

People who smoke had significantly worse immediate (p = .04) and delayed (p = .03) recall than healthy-controls. Multiple linear regression revealed that for people who smoke only, lower D2R availability was associated with worse immediate (p = .04) and delayed (p < .001) recall. %ΔBPND was not significantly related to task performance.

Conclusion

This study demonstrated that lower dlPFC D2R availability in people who smoke is associated with disruptions in cognitive function that may underlie difficulty with resisting smoking.

Implications

This is the first study to directly relate dopamine metrics in the prefrontal cortex to cognitive function in people who smoke cigarettes compared to healthy-controls. The current work included a well-characterized subject sample with regards to demographic and smoking variables, as well as a validated neurocognitive test of verbal learning and memory. The findings of this study extend previous literature by relating dopamine metrics to cognition in people who smoke, providing a better understanding of brain-behavior relationships.
Linkage between a plant-based diet and age-related eye diseases: a systematic review and meta-analysis
Authors: Cirone Cristina , Cirone Katrina D , Malvankar-Mehta Monali S
Published: September 2022

Context

An increased risk of age-related eye disease has been observed in individuals lacking a balanced diet. Following a plant-based diet may result in nutritional insufficiencies and negatively affect health if an effort is not made to ensure the consumption of fortified foods or specific supplements.

Objective

The purpose of this article is to characterize the relationship between plant-based diets and age-related ocular outcomes among adults.

Data Sources

A comprehensive literature review was performed using the MEDLINE, Embase, Cochrane, and PubMed databases up until December 19, 2021.

Study Selection

Studies that focused on observed visual changes due to a reduced intake of animal products and that included a minimum of 50 eyes were eligible for inclusion.

Data Extraction

Two levels of screening, quality assessment, and data extraction were conducted by 2 reviewers independently. The 21 studies identified from 814 unique studies progressed to data extraction and 15 were included in the quantitative analysis using STATA 15.0 fixed-effect and random-effect models computed on the basis of heterogeneity.

Results

The 15 (n = 51 695 participants) assessed the impact of fish consumption, 8 studies (n = 28 753 participants) analyzed the effect of red meat intake, and 3 studies (n = 7723 participants) assessed the impact of omission of skim milk, poultry, and non-meat animal products and the presence of disease incidence as indicated by age-related macular degeneration or cataract development. Meta-analysis indicated regular consumption of fish (odds ratio [OR], 0.70; 95%CI, 0.62–0.79) and skim milk, poultry, and non-meat animal products (OR, 0.70; 95%CI, 0.61–0.79) reduced the risk of age-related eye disease development among adults. Consumption of red meat (OR, 1.41; 95%CI, 1.07–1.86) may increase the risk of age-related eye disease development.

Conclusion

A pescatarian diet is associated with the most favorable visual outcomes among adults, whereas consumption of red meat negatively affects ocular health. Results suggest a need for more initiatives promoting a healthy and balanced diet.

Systematic Review Registration

PROSPERO registration no. CRD42021269925
Early Biomarker-Guided Prediction of Bloodstream Infection in Critically Ill Patients: C-Reactive Protein, Procalcitonin, and Leukocytes
Authors: Hertz Frederik Boetius , Ahlström Magnus G , Bestle Morten H , Hein Lars , Mohr Thomas , Lundgren Jens D , Galle Tina , Andersen Mads Holmen , Murray Daniel , Lindhardt Anne , Itenov Theis Skovsgaard , Jensen Jens Ulrik Staehr
Published: September 2022

Background

Bloodstream infections (BSIs) often lead to critical illness and death. The primary aim of this study was to determine the diagnostic accuracy of the biomarkers C-reactive protein (CRP), procalcitonin (PCT), and leukocyte count for the diagnosis of BSI in critically ill patients.

Methods

This was a nested case–control study based on the Procalcitonin And Survival Study (PASS) trial (n = 1200). Patients who were admitted to the intensive care unit (ICU) <24 hours, and not expected to die within <24 hours, were recruited. For the current study, we included patients with a BSI within ±3 days of ICU admission and matched controls without a BSI in a 1:2 ratio. Diagnostic accuracy for BSI for the biomarkers on days 1, 2, and 3 of ICU admission was assessed. Sensitivity, specificity, and negative and positive predictive values were calculated for prespecified thresholds and for a data-driven cutoff.

Results

In total, there were 525 patients (n = 175 cases, 350 controls). The fixed low threshold for all 3 biomarkers (CRP = 20 mg/L; leucocytes = 10 × 109/L; PCT = 0.4 ng/mL) resulted in negative predictive values on day 1: CRP = 0.91; 95% CI, 0.75–1.00; leukocyte = 0.75; 95% CI, 0.68–0.81; PCT = 0.91; 95% CI, 0.84–0.96). Combining the 3 biomarkers yielded similar results as PCT alone (P = .5).

Conclusions

CRP and PCT could in most cases rule out BSI in critically ill patients. As almost no patients had low CRP and ∼20% had low PCT, a low PCT could be used, along with other information, to guide clinical decisions.
Problem-solving in groups of common marmosets (Callithrix jacchus): more than the sum of its parts
Authors: Sehner Sandro , Willems Erik P , Vinicus Lucio , Migliano Andrea B , van Schaik Carel P , Burkart Judith M
Published: September 2022

Human hypercooperativity and the emergence of division of labor enables us to solve problems not only effectively within a group but also collectively. Collective problem-solving occurs when groups perform better than the additive performance of separate individuals. Currently, it is unknown whether this is unique to humans. To investigate the evolutionary origin of collective problem-solving and potential precursors, we propose a continuum of group effects on problem-solving, from simple to complex ones, eventually culminating in collective problem-solving. We tested captive common marmosets with a series of problem-solving tasks, either alone or in a group. To test whether the performance of a group was more than the sum of its parts, we compared real groups to virtual groups (pooled scores of animals tested alone). Marmosets in real groups were both more likely to solve problems than marmosets within the virtual groups and to do so faster. Although individuals within real groups approached the problem faster, a reduction in neophobia was not sufficient to explain the greater success. Success within real groups arose because animals showed higher perseverance, especially after a fellow group member had found the solution in complex tasks. These results are consistent with the idea that group problem-solving evolved alongside a continuum, with performance improving beyond baseline as societies move from social tolerance to opportunities for diffusion of information to active exchange of information. We suggest that increasing interdependence and the adoption of cooperative breeding pushed our ancestors up this scale.
Cobinamide is a strong and versatile antioxidant that overcomes oxidative stress in cells, flies, and diabetic mice
Authors: Chang Stephen , Tat John , China Shyamsundar Pal , Kalyanaraman Hema , Zhuang Shunhui , Chan Adriano , Lai Cassandra , Radic Zoran , Abdel-Rahman Engy A , Casteel Darren E , Pilz Renate B , Ali Sameh S , Boss Gerry R
Published: September 2022

Increased oxidative stress underlies a variety of diseases, including diabetes. Here, we show that the cobalamin/vitamin B12 analog cobinamide is a strong and multifaceted antioxidant, neutralizing superoxide, hydrogen peroxide, and peroxynitrite, with apparent rate constants of 1.9 × 108, 3.7 × 104, and 6.3 × 106 M−1 s−1, respectively, for cobinamide with the cobalt in the +2 oxidation state. Cobinamide with the cobalt in the +3 oxidation state yielded apparent rate constants of 1.1 × 108 and 8.0 × 102 M−1 s−1 for superoxide and hydrogen peroxide, respectively. In mammalian cells and Drosophila melanogaster, cobinamide outperformed cobalamin and two well-known antioxidants, imisopasem manganese and manganese(III)tetrakis(4-benzoic acid)porphyrin, in reducing oxidative stress as evidenced by: (i) decreased mitochondrial superoxide and return of the mitochondrial membrane potential in rotenone- and antimycin A-exposed H9c2 rat cardiomyocytes; (ii) reduced JNK phosphorylation in hydrogen-peroxide-treated H9c2 cells; (iii) increased growth in paraquat-exposed COS-7 fibroblasts; and (iv) improved survival in paraquat-treated flies. In diabetic mice, cobinamide administered in the animals’ drinking water completely prevented an increase in lipid and protein oxidation, DNA damage, and fibrosis in the heart. Cobinamide is a promising new antioxidant that has potential use in diseases with heightened oxidative stress.
Testing Public Reactions to Mass-Protest Hybrid Media Events
Authors: Jiménez-Sánchez Manuel , Fraile Marta , Lobera Josep
Published: September 2022

The configuration of protests as hybrid media events not only enables them to reach wider audiences but also favors the transformation of those audiences into active publics. In this increasingly common scenario, our study proposes a set of indicators to scrutinize how the public reacts during such hybrid media events, and to test such reactions in light of the mass protests that took place in Spain to mark the 2019 International Women’s Day (IWD). We analyze a nationally representative survey sample collected through daily tracking over 20 days before and after the 2019 IWD. Findings confirm the ability of hybrid media protests to broaden their audience, generate interest, spark conversations on gender inequality, and contribute to opinion conformation. They also reveal that some of these reactions were conditioned by prior exposure to similar events and by gender. Our study contributes to a recent line of research testing the influence of protests on the public and shows the possibilities of using rolling cross-sectional designs to capture those effects. The study also contributes to the discussion on the political significance of these mass protests as hybrid media events.
RBM46 is essential for gametogenesis and functions in post-transcriptional roles affecting meiotic cohesin subunits
Authors: Lv Yue , Lu Gang , Cai Yuling , Su Ruibao , Liang Liang , Wang Xin , Mu Wenyu , He Xiuqing , Huang Tao , Ma Jinlong , Zhao Yueran , Chen Zi-Jiang , Xue Yuanchao , Liu Hongbin , Chan Wai-Yee
Published: September 2022

RBM46 is a germ cell-specific RNA-binding protein required for gametogenesis, but the targets and molecular functions of RBM46 remain unknown. Here, we demonstrate that RBM46 binds at specific motifs in the 3ʹUTRs of mRNAs encoding multiple meiotic cohesin subunits and show that RBM46 is required for normal synaptonemal complex formation during meiosis initiation. Using a recently reported, high-resolution technique known as LACE-seq and working with low-input cells, we profiled the targets of RBM46 at single-nucleotide resolution in leptotene and zygotene stage gametes. We found that RBM46 preferentially binds target mRNAs containing GCCUAU/GUUCGA motifs in their 3ʹUTRs regions. In Rbm46 knockout mice, the RBM46-target cohesin subunits displayed unaltered mRNA levels but had reduced translation, resulting in the failed assembly of axial elements, synapsis disruption, and meiotic arrest. Our study thus provides mechanistic insights into the molecular functions of RBM46 in gametogenesis and illustrates the power of LACE-seq for investigations of RNA-binding protein functions when working with low-abundance input materials.
Complete mitochondrial genomes from museum specimens clarify millipede evolution in the Eastern Arc Mountains
Authors: Nielsen Martin , Margaryan Ashot , Nielsen Tejs Lind , Enghoff Henrik , Allentoft Morten E
Published: September 2022

The Eastern Arc Mountains in Tanzania represent a hotspot for biological diversity of global importance. The level of endemism is high, and Eastern Arc biodiversity has been studied extensively in vertebrates and invertebrates, including millipedes. However, millipede evolution is vastly understudied at the molecular level. Therefore, we used next-generation ‘shotgun’ sequencing to obtain mitochondrial genome sequences of 26 museum specimens, representing six genera and 12 millipede species found across the Eastern Arc Mountains. Bayesian and maximum likelihood methods yielded consistent topologies with high node support, confirming a high level of congruence between molecular and morphological analyses. The only exception was a Tropostreptus sigmatospinus individual from Zanzibar, which was placed outside an otherwise monophyletic group consisting of mainland individuals of the same assumed species. For two species with a distribution across several mountain blocks (Tropostreptus sigmatospinus and Tropostreptus hamatus), each mountain population represents a distinct monophyletic lineage. In contrast, we also observe that distinct species exist sympatrically in the same montane forests, indicative of older speciation events that are not defined by current forest distribution. Our results are important for understanding speciation mechanisms in montane rain forests and highlight that ethanol-preserved invertebrates exhibit a tremendous potential for genomic analyses.
Cross-cultural Adaptation and Validation of Hindi Version of Roland Morris Disability Questionnaire for Chronic Low Back Pain in Indian Population
Authors: Mohan Anjali , Sharma Rajni , Ghai Babita , Kumar Vishal , Makkar Jeetinder K. , Jain Aditi
Published: September 2022

Study Design.

A cross-cultural adaptation, validation, and psychometric analysis.

Objective.

The main aim was to assess the validity and reliability of the Hindi version of the Roland Morris Disability Questionnaire (Hi-RMDQ) for chronic low back pain.

Summary of Background Data.

Roland Morris Disability Questionnaire is a standardized, self-administered tool for disability assessment in patients with chronic low back pain. However, its Hindi version has not been validated.

Materials and Methods.

Cognitive debriefing was carried out with 10 patients to ensure the comprehensibility of the Hi-RMDQ. Following this, 120 patients were asked to complete the finalized questionnaire along with the modified Oswestry Disability Index Questionnaire, Quebec Back Pain Disability Score, and the Verbal Numeric Rating Scale. The patients were then asked to again fill out the finalized questionnaire after 72 hours. The internal consistency and retest reliability of the Hindi translated version of the questionnaire was tested. Its correlation with the other scores was also analyzed.

Results.

The translated questionnaire showed excellent internal consistency (Cronbach α=0.989) and excellent retest reliability (intraclass correlation coefficient=0.978). There was a positive and statistically significant association between the Hi-RMDQ, modified Oswestry Disability Index Questionnaire (r=0.807; P<0.01), Quebec Back Pain Disability Score (r=0.839; P<0.01), and Verbal Numeric Rating Scale (r=0.713; P<0.01).

Conclusion.

The Hi-RMDQ version is an easy-to-use, acceptable, reliable, and valid tool to measure disability in the Indian population with nonspecific back pain with or without leg pain.

Level of Evidence.

3.
Reconstructive Surgery in a Patient with High Radial Nerve Palsy Using the WALANT Technique
Authors: Fahandezh-Saddi Díaz Homid , Bebea Zamorano Fátima , Ruiz Zafra Jorge Enrique , Ríos Luna Antonio , Cantero Yubero María Elena , Lalonde Donald H.
Published: September 2022

Tendon transfers can be tied too tight or too loose. Both impede good function after surgery. Performing tendon transfers without sedation and pain during the surgery and then watching the patient move the transfer have helped us adjust the tension more accurately. This method can be applied to complex transfers such as radial nerve palsy triple tendon transfers. We describe the technique and results of a triple tendon transfer using wide-awake local anesthesia no tourniquet in a patient with a high radial nerve palsy. This was a complex case of reconstruction after five operations at the level of the humerus. This left him with a pseudoarthrosis of the humerus and a complete radial nerve palsy. We performed tendon transfers of pronator teres to extensor carpi radialis brevis, flexor carpi ulnaris to extensor digitorum communis, and palmaris longus to extensor pollicis longus tendons. Eighteen months after the triple tendon transfer surgery for the radial nerve palsy, the patient has good extension of the fingers, wrist, and thumb. He can open and close the hand properly. He has excellent function and mobility allowing him to perform most activities in a manner that is practically normal. Wide-awake local anesthesia no tourniquet can be used safely and successfully in complex cases requiring triple radial nerve tendon transfers of pronator teres to extensor carpi radialis brevis, flexor carpi ulnaris to extensor digitorum communis, and palmaris longus to extensor pollicis longus tendons.
Norovirus-associated White Matter Injury in a Term Newborn With Seizures
Authors: Gutiérrez-Camus Andrea , Valverde Eva , del Rosal Teresa , Utrilla Cristina , Ruiz-Carrascoso Guillermo , Falces-Romero Iker , Calvo Cristina , Sáenz de Pipaón Miguel
Published: September 2022

Neonatal seizures with white matter injury have been associated with rotavirus, enterovirus and parechovirus. Neurological symptoms caused by norovirus have been occasionally reported in older children. We describe a case of a neonate with seizures and white matter lesions, with detection of human norovirus in stool samples from the patient and her mother.
Investigating Health Disparities Associated With Multisystem Inflammatory Syndrome in Children After SARS-CoV-2 Infection
Authors: Zambrano Laura D. , Ly Kathleen N. , Link-Gelles Ruth , Newhams Margaret M. , Akande Manzilat , Wu Michael J. , Feldstein Leora R. , Tarquinio Keiko M. , Sahni Leila C. , Riggs Becky J. , Singh Aalok R. , Fitzgerald Julie C. , Schuster Jennifer E. , Giuliano John S. , Englund Janet A. , Hume Janet R. , Hall Mark W. , Osborne Christina M. , Doymaz Sule , Rowan Courtney M. , Babbitt Christopher J. , Clouser Katharine N. , Horwitz Steven M. , Chou Janet , Patel Manish M. , Hobbs Charlotte , Randolph Adrienne G. , Campbell Angela P. ,   for the Overcoming COVID-19 Investigators
Published: September 2022

Background:

Multisystem inflammatory syndrome in children (MIS-C) is a postinfectious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–related complication that has disproportionately affected racial/ethnic minority children. We conducted a pilot study to investigate risk factors for MIS-C aiming to understand MIS-C disparities.

Methods:

This case-control study included MIS-C cases and SARS-CoV-2-positive outpatient controls less than 18 years old frequency-matched 4:1 to cases by age group and site. Patients hospitalized with MIS-C were admitted between March 16 and October 2, 2020, across 17 pediatric hospitals. We evaluated race, ethnicity, social vulnerability index (SVI), insurance status, weight-for-age and underlying medical conditions as risk factors using mixed effects multivariable logistic regression.

Results:

We compared 241 MIS-C cases with 817 outpatient SARS-CoV-2-positive at-risk controls. Cases and controls had similar sex, age and U.S. census region distribution. MIS-C patients were more frequently previously healthy, non-Hispanic Black, residing in higher SVI areas, and in the 95th percentile or higher for weight-for-age. In the multivariable analysis, the likelihood of MIS-C was higher among non-Hispanic Black children [adjusted odds ratio (aOR): 2.07; 95% CI: 1.23–3.48]. Additionally, SVI in the 2nd and 3rd tertiles (aOR: 1.88; 95% CI: 1.18–2.97 and aOR: 2.03; 95% CI: 1.19–3.47, respectively) were independent factors along with being previously healthy (aOR: 1.64; 95% CI: 1.18–2.28).

Conclusions:

In this study, non-Hispanic Black children were more likely to develop MIS-C after adjustment for sociodemographic factors, underlying medical conditions, and weight-for-age. Investigation of the potential contribution of immunologic, environmental, and other factors is warranted.
High Rates of Viral Suppression and Care Retention Among Youth Born Outside of the United States with Perinatally Acquired HIV
Authors: Desai Neerav , Jenkins Cathy A. , Zanoni Brian , Nmoh Ashley , Patel Nehali , Shepherd Bryan E. , Hussen Sophia , Doraivelu Kamini , Pierce Leslie , Carlucci James G , Ahonkhai Aima A.
Published: September 2022

Background:

Youth born outside of the US with perinatally acquired HIV infection (YBoUS-PHIV) account for most children living with HIV in the US, but there are few data characterizing their care outcomes.

Methods:

We conducted a retrospective study of YBoUS-PHIV receiving care across 3 HIV clinics in the Southeastern US between October 2018 and 2019. Primary outcomes were retention in care and viral suppression defined as (1) proportion of suppressed viral loads (VLs) and (2) having all VLs suppressed (definition 1 presented in the abstract). Primary predictors were age, adoption and disclosure status (full, partial and none/unknown). Multivariable logistic regression and χ2 tests were used to test for associations with care outcomes. Analysis of disclosure status was restricted to youth greater than or equal to 12 years.

Results:

The cohort included 111 YBoUS-PHIV. Median age was 14 years (interquartile range, 12–18), 59% were female, and 79% were international adoptees. Overall, 84% of patients were retained in care, and 88% were virally suppressed at each VL measurement. Adopted youth were more likely to be virally suppressed than nonadopted youth [odds ratio (OR), 7.08; P < 0.01] although the association was not statistically significant in adjusted analysis (adjusted OR, 4.26; P = 0.07). Neither age nor adoption status was significantly associated with retention. Among 89 patients greater than or equal to 12 years, 74% were fully disclosed of their HIV status, 12% were partially disclosed, and 13% had not started the disclosure process. There was no significant difference in retention or viral suppression by disclosure status.

Conclusions:

YBoUS-PHIV achieved high rates of retention and viral suppression. Adopted youth may be more likely to achieve viral suppression which may reflect the need for tailored interventions for nonadopted youth.
Infection control in cystic fibrosis: evolving perspectives and challenges
Authors: Jones Andrew M.
Published: September 2022

Purpose of review

This article reviews the impact of some of the most recent changes in clinical care management in cystic fibrosis on infection prevention practice and advice for people with cystic fibrosis.

Recent findings

People with cystic fibrosis (CF) consistently highlight infection control as one of their major concerns. Infection prevention guidance and practice has facilitated successful decreases in rates of many transmissible CF pathogens. The coronavirus disease 2019 pandemic highlighted the clinical significance of respiratory viral infections and has accelerated the implementation of remote monitoring and telemedicine consultations as standard practice in CF. The continued improvement in health of the CF population is being further augmented by the introduction of new therapies, in particular cystic fibrosis transmembrane conductance regulator modulators. Infection prevention will remain pertinent to CF care, but these recent changes in clinical practice will have ongoing implications for infection prevention guidance in CF.

Recent changes in CF clinical care have implications that will lead to further evolution of infection control practice and advice.
Impact of coronavirus disease 2019 on food security in early childhood
Authors: He Yuan
Published: September 2022

Purpose of review

To summarize the impact of the COVID-19 pandemic on food insecurity during early childhood, with a focus on challenges and strategies to improve access to and consumption of nutritious food in early childcare and education settings.

Recent findings

The COVID-19 pandemic exacerbated existing gaps and inequities in the early childcare and education system, resulting in closures and decreased access to healthy foods that disproportionately impacted black, indigenous, and people of color, as well as rural and low-income communities.

Closures and changes in operational capacity not only stressed the early childcare and education system and its workforce but also contributed to financial strain and food insecurity among families with young children. Increased public investment and cross-sector partnerships can support and strengthen both early childcare and education and food systems, increasing equitable access to quality care and reducing food insecurity in early childhood.
Social support and transplantation
Authors: Bruschwein Heather , Chen Gloria , Yost Joanna
Published: September 2022

Purpose of review

Social support has many benefits for patients undergoing organ transplantation, though inclusion of it as criteria for transplant listing has been debated. This review highlights recent developments in the research regarding social support and organ transplantation, including the impact of social support on transplantation and caregivers, interventions, COVID-19, and ethical perspectives.

Recent findings

Social support and perceived social support have benefits for transplant patients, including increased quality of life and adherence. The providers of social support may also be impacted and the impact may vary based on patient and caregiver characteristics, including organ group and caregiver ethnicity. Debates regarding COVID-19 vaccine requirements for caregivers and ethical concerns about the inclusion of social support as criteria for transplant listing are also explored.

Transplant patients benefit from social support, though additional research is needed on the impact of social support on transplant outcomes and the utility of the use of social support as criteria for transplant listing. There is also a need for more robust research on diverse caregiver populations, including the identification and use of supportive interventions for caregivers.
Extent of lymph node dissection and impact on survival in radical cystectomy for advanced bladder cancer
Authors: Crocerossa Fabio , Autorino Riccardo , Carbonara Umberto , Cantiello Francesco , Damiano Rocco , Mir M. Carmen
Published: September 2022

Purpose of review

In patients with muscle invasive bladder cancer (MIBC) or unresectable non-MIBC, radical cystectomy is routinely combined with bilateral pelvic lymph node dissection (LND) owing to the oncological benefits found in recurrence-free survival (RFS), overall survival (OS) and cancer-specific survival (CSS) compared with radical cystectomy alone. However, the optimal anatomic extent of LND is still unclear.

Recent findings

Retrospective studies were consistent in reporting oncological benefits of extended LND over nonextended LND. A recent RCT (the LEA trial) failed to demonstrate any benefit in terms of RFS, CSS and OS of super-extended LND over standard LND. Several confounding factors hindered the interpretation of the results, leaving the question of the right extent for LND still open. Results of a similar study, the SWOG S1011 are, therefore, highly anticipated. This study differed from the LEA study in several aspects but might also turn out to be a negative study.

There are still no firm data on the oncological benefit brought by more extended LND in patients with MIBC. Survival benefits seem limited, at least in the general population. Other factors could influence the impact of LND on survival, including the administration of adjuvant and neoadjuvant chemotherapies.
Breastfeeding Symptoms with Tongue- and Lip-Tie
Authors: Hill Rebecca R. , Richard Melissa A. , Pados Britt F.
Published: September 2022

Purpose:

The aims of this study were to describe maternal and infant symptoms relative to tongue- and lip-tie severity and describe changes in symptoms and feeding efficiency from pre- to post-frenotomy.

Study Design and Methods:

A one-group pre- and post-intervention study design was used. Data from a dental practice were collected from medical records of infants less than 1 year old who underwent a frenotomy procedure for tongue- and/or lip-tie. Infant and maternal symptoms were compared with severity of tongue- and lip-tie using binary logistic regression. Wilcoxon Signed Rank test compared pain scores and feeding duration pre- and post-frenotomy. Linear regression compared total number of symptoms reported pre-frenotomy with tongue- and lip-tie severity.

Results:

N = 121 dyads were included. More severe classifications of tongue- and lip-tie were significantly associated with certain infant and maternal symptoms pre-frenotomy. Improvements were noted in all reported infant symptoms post-frenotomy. Feeding duration times significantly decreased post-frenotomy.

Clinical Implications:

Infants and mothers experience problematic symptoms with feeding associated with tongue- and lip-tie. Nurses are the primary care providers during postpartum and should be alert to signs and symptoms that may suggest oral restrictions. Early evaluation and involvement of feeding experts may improve the breastfeeding experience of the dyad.
Follicular Neoplasm of Thyroid Revisited: Current Differential Diagnosis and the Impact of Molecular Testing
Authors: Ohori N. Paul , Nishino Michiya
Published: September 2022

The diagnosis of “follicular neoplasm” (FN) in thyroid cytopathology has a long history that originated not long after the practice of fine-needle aspiration (FNA) of thyroid nodules. From the outset, this interpretive category was intended to convey a set of differential diagnoses rather than a precise diagnosis, as key diagnostic features, such as capsular and vascular invasion, were not detectable on cytology preparations. Cytologic-histologic correlation studies over the past several decades have shown that FN interpretation can be applied to the spectrum of nonneoplastic tumors to carcinomas. Most tumors classified as FN include follicular adenoma, follicular carcinoma, noninvasive follicular thyroid tumor with papillary-like nuclear features, and follicular variant of papillary thyroid carcinoma. Less common entities that may be classified as FN on FNA include hyalinizing trabecular tumor (HTT), poorly differentiated thyroid carcinoma, medullary carcinoma, and nonthyroidal lesions such as parathyroid tissue, paraganglioma, and metastatic tumors. Advances in our ability to detect characteristic molecular alterations (eg, GLIS gene rearrangements for hyalinizing trabecular tumor) in FNA samples may assist in the identification of some of these entities. In this review, we summarize the pathophysiology, history, and evolution of the terminology and the current differential diagnosis according to the recently published 2022 World Health Organization classification, molecular testing, and management of nodules classified as FN.
“Exploring the Patient Narrative for Breast Implant Illness: A 10-Year Review of the FDA MAUDE Database”
Authors: Taskindoust Mahsa , Bowman Trevor , Thomas Samantha M. , Levites Heather , Wickenheisser Victoria , Hollenbeck Scott T.
Published: September 2022

Introduction:

There is growing recognition of a condition known as Breast Implant Illness (BII). Very little information exists about the diagnosis and natural history of BII. To better understand the patient experience, we surveyed the FDA’s MAUDE database for narratives describing symptoms of BII.

Methods:

The Manufacturer and User Facility Device Experience Database (MAUDE) was queried for all reports that included Breast Implant Illness within the patient narrative between 2010 and 2020. A review of narratives was used to identify and summarize 36 symptoms over 9 symptom classes. Event year and reporting year were summarized. Hierarchical clustering analysis using centroid components was conducted on all reported BII symptoms and a dendrogram was created to visualize clustering.

Results:

During the study period from 2010 to 2020, there were 751 captured adverse event reports in the FDA’s MAUDE database that referenced Breast Implant Illness with the first report submission in 2014. Of those reports, 60.6% were for silicone implants and 39.4% were for saline implants. The three most commonly reported symptom categories were neurological (N=544, 72.4%), followed by musculoskeletal (N=418, 55.7%), and dermatological (N=273, 36.4%). The top ten symptoms, irrespective of category, include fatigue/weakness, numbness/tingling, brain fog, depression/anxiety, arthralgia, myalgia, headache, hair loss, gastrointestinal issues, and weight change. A hierarchical clustering analysis demonstrated that symptoms reported by patients clustered into 2 major groups.

Conclusion:

This study demonstrates the utility of public facing databases like MAUDE in understanding the patient experience as it relates to the term Breast Implant Illness.
“Animation Deformity: Evaluating the Role of Morpho-Topological Features in Suggesting Preventive Surgical Procedures.”
Authors: Onishi Fumio , Suzuki Ayumi , Yamakawa Tomomi , Makino Jun , Minabe Toshiharu
Published: September 2022

Background:

Animation deformity (AD) is an undesirable complication after subpectoral implant reconstruction, and is defined as skin distortion during activation of the pectoralis major muscle. However, detailed anatomical features of deformities have yet to be clarified. This study aimed to elucidate how (morphology) and where (topology) AD occurs in reconstructed breasts, and assess causes and prevention of AD.

Methods:

This study included 100 consecutive patients with breast cancer, who underwent unilateral subpectoral implant reconstruction. AD was evaluated and the patients were grouped according to both, morphological and topological features. Univariate and multivariate analyses were performed to identify independent factors associated with deformities.

Results:

The patients were divided into three groups based on skin distortions with or without implant movement: Group I, 60 patients with upper-medial dimpling; Group II, 41 patients with upper-lateral folding; and Group III, 52 patients with mid-lower lines. Overall, 86 patients (86%) showed one or more types of deformity. Among the patients with AD, 24 (28%) had implant movement. Our study identified axillary dissection as an independent factor for the upper-lateral folding group (OR, 0.30), implant volume for the mid-lower lines group (OR, 1.01), and age for implant movement (OR, 1.06).

Conclusions:

AD was commonly observed in our cohort of patients who underwent subpectoral implant reconstruction, and exhibited three morpho-topological patterns of deformity. The current study demonstrated that the morpho-topological grouping of AD may assist in suggesting possible causes and preventive surgical procedures for these deformities.
Translabial Ultrasound
Authors: Clark Ellen , Wermuth Daniela Escobar , Oliver Janine , Sheridan Alison
Published: September 2022

Midurethral sling (MUS) surgical procedures, in which a polypropylene synthetic mesh graft is transvaginally placed to support the urethra and manage stress urinary incontinence (SUI), is commonly performed (Urology. 2013;82(1):38-41; Radiology. 2018;289(3):728-729). Within 10 years of sling placement, about 1 in 20 women undergo subsequent surgery to revise their mesh, in which the mesh is cut or partially excised (Obstet Gynecol. 2019;133:1099-1108). Translabial ultrasound (TLUS) has been described as a sensitive technique for viewing MUS, although few studies have evaluated its ability to view surgically revised MUS (Radiology. 2018;289(3):721-727). Understanding the anatomy of the MUS is critical to urologists and urogynecologists striving to optimize management of patients presenting with lower urinary tract symptoms and history of MUS. To assess the clinical utility and reliability of TLUS as a diagnostic tool in its detection of MUS discontinuity, we conducted a retrospective analysis on patients who underwent TLUS at a tertiary care center between September 2017 and May 2020 for indication of lower urinary tract symptoms and history of MUS placement. Performance of TLUS was evaluated by comparing findings with operative or clinical records. Among the 81 women included, detection of MUS revision, which was defined as a discontinuity in sling material, had a sensitivity of 84.6% and specificity of 97.1%. Translabial ultrasound is an inexpensive, nonirradiating, and noninvasive modality that is effective at visualizing MUSs. It is a reliable identifier of previous MUS revision, in which it detects a midline discontinuity of the hyperechoic mesh with an average 10 mm gap.
Machine Learning Algorithm Improves the Prediction of Transplant Hepatic Artery Stenosis or Occlusion
Authors: Feldman Keith , Baraboo Justin , Dinakarpandian Deeyendal , Chan Sherwin S.
Published: September 2022

The aim of this study was to determine if machine learning can improve the specificity of detecting transplant hepatic artery pathology over conventional quantitative measures while maintaining a high sensitivity.

This study presents a retrospective review of 129 patients with transplanted hepatic arteries. We illustrate how beyond common clinical metrics such as stenosis and resistive index, a more comprehensive set of waveform data (including flow half-lives and Fourier transformed waveforms) can be integrated into machine learning models to obtain more accurate screening of stenosis and occlusion. We present a novel framework of Extremely Randomized Trees and Shapley values, we allow for explainability at the individual level.

The proposed framework identified cases of clinically significant stenosis and occlusion in hepatic arteries with a state-of-the-art specificity of 65%, while maintaining sensitivity at the current standard of 94%. Moreover, through 3 case studies of correct and mispredictions, we demonstrate examples of how specific features can be elucidated to aid in interpreting driving factors in a prediction.

This work demonstrated that by utilizing a more complete set of waveform data and machine learning methodologies, it is possible to reduce the rate of false-positive results in using ultrasounds to screen for transplant hepatic artery pathology compared with conventional quantitative measures. An advantage of such techniques is explainability measures at the patient level, which allow for increased radiologists' confidence in the predictions.
Multiprocedural Facial Feminization Surgery: A Review of Complications in a Cohort of 31 Patients
Authors: Hazkour Nissim , Palacios Jose , Lu Weiying , Goote Paige , Rivera Robin , Bastidas Nicholas
Published: September 2022

Objective:

Facial feminization surgery (FFS) is instrumental in gender affirmation for transgender patients. Multiprocedural FFS, the combination of multiple facial feminization procedures across multiple depths and planes during one surgery, crosses sterile and nonsterile planes in the oropharynx, nose, and frontal sinus. A closer look at the prevention and management of resulting complications of such reconstruction is necessary.

Methods:

We performed a retrospective review of patient demographics, operative variables, and postoperative complications on 31 FFS patients. Patients who underwent FFS between January 2020 and June 2021 were eligible for inclusion. Associations between prevention methods, procedure type, and complications were assessed by the Fisher exact test. The main effect of patient age and number of procedures on complication rate was assessed via the nonparametric Kruskal-Wallis test.

Results:

A total of 31 patients, with a mean age of 37 years (range: 19–65 y, SD: 13.3 y), underwent 257 procedures. Patients underwent a mean of 8 procedures (SD: 2.2) lasting 3.5 to 6 hours (mean: 5.0 h, SD: 0.9 h). Overall, 68% of patients experienced no complications. Six patients experienced a postoperative infection; 4 of these patients required return for a washout. Preventative measures implemented include: preoperative dental check, intraoperative antibiotic irrigation, locking sutures, and postoperative antibiotics. After measures were implemented, there were no further procedure-related infections recorded.

Conclusions:

Patients do not suffer from major complications after multiprocedural FFS. Factors such as age, irrigation method, and dental history may be important variables affecting FFS outcomes.
Modified Le Fort I Arc Osteotomy Combined With Autologous Bone Grafts to Improve Midface Hypoplasia Combined With Skeletal Class III Malocclusion: A Technical Note
Authors: Chen Kai , Sun Xiumei , Lin Yuhui , Wu Guomin
Published: September 2022

Midface hypoplasia sometimes appears in patients with skeletal class III malocclusion in the Asian population, often requires additional surgical treatments. The technical note is intended to introduce a modified Le Fort I arc osteotomy combined with autologous bone grafts harvested from proximal segments after bilateral sagittal split ramus osteotomy to improve the profile for skeletal class III malocclusion patients with midface hypoplasia. The benefit of the modified technology is that the size and position of the arc can be adjusted according to the severity of the deformity to suit different patients. In addition, the application of autologous bone grafts increased the extra height of osteotomy line and enhanced the surgical effect, and maintained bone consolidation. More importantly, the osteotomy line of the modified Le Fort I arc osteotomy can be easily designed and this modification will not cause additional injuries. Therefore, we believe that for skeletal class III malocclusion patients with midface hypoplasia in Asia modified Le Fort I arc osteotomy combined with autologous bone grafts will be an efficient surgical method to improve midface hypoplasia.
Auricular Framework Construction Using Cadaveric Costal Cartilage in Type III Microtia: Preliminary Results
Authors: Bastidas Nicholas , Hazkour Nissim , Palacios Jose , Raza Syed A. , Atamian Elisa , Pessino Kenneth
Published: September 2022

Purpose:

Non/minimally irradiated Cadaveric Costal Cartilage (NCCC) is commonly used for grafts in nasal reconstruction; however, no information exists on its use in total ear reconstruction for type III microtia. In this case series we describe preliminary results from the novel use of NCCC for auricular framework construction in 7 ear reconstructions.

Methods:

Patients requiring total ear reconstruction from August 2020 to October 2021 were eligible and underwent ear reconstruction using NCCC from MTF Biologics (Edison, NJ). Patients were evaluated for surgical site infection, skin necrosis, cartilage exposure, warping, and resorption during regular follow up visits.

Results:

Seven ears were reconstructed using NCCC across 5 patients with type III microtia. Patients ranged from 5 to 51 years old at the time of surgery. Follow up time ranged from 12 to 78 weeks (mean: 46 wk). No patients experienced surgical site infections or significant cartilage resorption. All procedures were done outpatient, total time under anesthesia was <90 minutes in 5/7 cases and postoperative narcotics for pain management were not needed in 5/7 cases. Complications included minor skin necrosis that was repaired via primary closure, construct exposure in the immediate postoperative period, which was successfully salvaged with a local flap, and explantation of one construct after reconstruction for a complicated revision surgery involving a previous temporoparietal fascial flap.

Conclusion:

NCCC serves as an immediately available alternative to alloplastic and autologous materials for construction of auricular frameworks during ear reconstruction. Longer follow up times and a larger sample size will further elucidate long-term efficacy.
Burden of respiratory problems in low-income and middle-income countries
Authors: Clark Joseph , Kochovska Slavica , Currow David C.
Published: September 2022

Purpose of review

Chronic respiratory diseases are a leading cause of morbidity and mortality in low-income and middle-income countries (LMICs). We aim to review prevalence of respiratory diseases and related symptoms, which contribute significantly to burden of disease in LMICs. We report global estimates of respiratory problems amongst adults in LMICs and recent findings relating to community prevalence and impact of respiratory problems. We conclude by identifying research priorities for improved recognition and palliation of respiratory problems.

Recent findings

We report findings from 16 studies, highlighting key issues relevant to burden of respiratory problems in LMICs. COPD and associated symptoms are identified as important drivers of increasing respiratory problems in LMICs, with an estimated prevalence of 7.2%. Negative impacts of respiratory diseases include: reduced physical function (capacity to work), quality of life (depression; anxiety) and socioeconomic wellbeing (healthcare costs; earning potential). Locally appropriate palliative care interventions may improve quality of life without increasing costs.

Prevention and treatment of respiratory diseases is essential for improved wellbeing. We identify missed opportunities for measurement and understanding of burden caused by respiratory problems within efforts to measure illness prevalence. We highlight need for symptom management interventions, developed in context of local cultural beliefs and behaviours.