bluuebunny/crossref_metadata_2025 huggingface dataset:
Walking Meeting Effects on Productivity and Mood Among White-Collar Workers
Authors: Kling Hannah E. , Moore Kevin J. , Brannan Debi , Caban-Martinez Alberto J.
Published: November 2020

Objective:

Walking Meetings (WaM) have shown to be acceptable, feasible, and implementable among white-collar workers. This pilot study examines the effects of WaM on worker mood, productivity, and physical activity.

Methods:

Eighteen white-collar workers were recruited from a university in Florida. Participants wore accelerometers for 3 consecutive weeks. During baseline week, participants continued their normal seated meetings. In weeks 2 and 3, participants conducted one walking meeting in groups of two to three people.

Results:

Increased moderate occupational physical activity was correlated with increased productivity measured by decreased work time missed due to health reasons (r = –0.59; P = 0.03) and decreased impairment while working due to health reasons (r = –0.61; P = 0.02). In week 3, very vigorous physical activity was significantly correlated with negative mood (r = 0.69, P = 0.01).

Conclusion:

WaM affected worker mood and productivity and increased occupational physical activity-levels.
Before They Get to You for Gender-Related Surgery
Authors: Borek Lorraine , Selekman Janice
Published: November 2020

The acronym LGBT (lesbian, gay, bisexual, and transgender) has expanded to LGBTQIA (lesbian, gay, bisexual, transgender, queer or questioning, intersex, and asexual or allies). The health needs of this community are often grouped together, yet each of these letters represents a distinct population with its own health concerns. Youth who identify as transgender usually experience multiple physical, psychological, and social challenges from childhood through adolescence. Gender-affirming surgical interventions improve both one's mental health and one's quality of life for those who are transgender but often occur later in the transgender journey. This article will focus on the healthcare needs and experiences of transgender youth in the school setting before coming to the attention of the surgical team.
Professional Athletes Have Poorer Sleep Quality and Sleep Hygiene Compared With an Age-Matched Cohort
Authors: Cameron Alyse F. M. , Perera Nirmala , Fulcher Mark
Published: November 2020

Objective:

To study sleep quality and sleep hygiene in professional athletes and an age-matched cohort.

Design:

Cross-sectional study.

Setting:

Professional athletes and a sport medicine center.

Participants:

Professional rugby, netball and football athletes (n = 184) and attendees to a sport medicine center (n = 101).

Interventions:

Participants completed an online survey.

Main Outcome Measures:

Sleep Hygiene Index (SHI) and Pittsburgh Sleep Quality Index (PSQI).

Results:

Forty-five percent (n = 128) of respondents were aged between 18 and 24 years, 54% (n = 154) were men and 65% (n = 184) were professional athletes. The sleep duration of the professional athletes (mean rank 134.3, n = 181) was greater than the age-matched cohort (mean rank = 154.4, n = 101), U = 7835.0, z = −2.3, P = 0.02; however, they reported more sleep disturbance (mean ranking = 148.0, n = 181) than the age-matched cohort (mean rank = 129.8, n = 101), U = 7960.5 z = −2.5, P = 0.01, 2–tailed. Professional athletes had worse sleep regularity (mean rank = 152.3, n = 183) compared with the age-matched cohort (mean rank = 124.6, n = 101), U = 7448.5, z = −2.7, P = 0.006, 2-tailed, had an inferior sleep environment (mean rank = 149.5, n = 183) compared with the age-matched cohort (mean rank = 129.8, n = 101), U = 7959.5, z = −2.0, P = 0.047, and had more naps (mean rank = 156.2, n = 183) compared with the age-matched cohort (mean rank = 117.6, n = 101), U = 6729.0, z = −4.2, P = 0.00 0, 2-tailed.

Conclusions:

Professional athletes reported poorer sleep quality and sleep hygiene compared with an age-matched cohort, and difficulty falling asleep following competition. It is likely this is due to the stress of competition, training, and traveling. Because sleep plays an important role in postexercise recovery and has an impact on injury and athletic performance, it is important to have strategies to support better sleep quality and sleep hygiene in athletes.
Safety and efficacy of switching from infliximab biosimilar CT-P13 to infliximab biosimilar SB2 in patients with inflammatory bowel disease
Authors: Lovero Rosa , Losurdo Giuseppe , La Fortezza Rosa Federica , Terracciano Fulvia , Biscaglia Giuseppe , Martino Giuseppina , Nardella Marianna , Di Leo Alfredo , Principi Mariabeatrice , Andriulli Angelo , Bossa Fabrizio
Published: November 2020

Introduction

For patients with inflammatory bowel diseases, switching from infliximab originator to biosimilars is effective and safe. Few data on single switch have been published, and data on multiple switches of different infliximab are unavailable.

Methods

A retrospective analysis of patients who switched from CT-P13 to SB2, and of those with multiple switches among different infliximab compounds was conducted. Clinical activity, C reactive protein (CRP), adverse events (AE) and loss of response (LOR) were recorded.

Results

Thirty-six patients (26 males, 14 Crohn’s disease and 22 ulcerative colitis) were enrolled and followed up for >6 months. All patients switched from CT-P13 to SB2; 12 of them (33.3%) had already switched from reference Infliximab to CT-P13, and for the remaining patients CT-P13 was the first infliximab. The clinical remission rate six months before and three months after SB2-switch was the same (58.3%) and the rate of mild activity varied from 27.8 to 33.3% (P = 0.68); the percentage of patients with normal CRP values passed from 94.4 to 91.7% (P = 1). Two patients (5.5%) had AE and 11 (30.5%) a LOR. At univariate analysis, patients with a single switch had a non-significant risk of LOR during SB2 [odds ratio (OR) = 7.86; 95% confidence interval (CI) 0.87–71, P = 0.06]. SB2-LOR was associated with previous AE under CT-P13 (OR = 9.1, 95% CI 0.82–100, P = 0.07). None of such factors was significant at multivariate analysis.

Conclusion

Switching from CT-P13 to SB2 seems to be safe and effective either in patients with a single than in those with multiple switches.
Endoscopic submucosal dissection in tumors extending to the dentate line compared to proximal rectal tumors: a systematic review with meta-analysis
Authors: Pérez-Cuadrado-Robles Enrique , Chupin Antoine , Perrod Guillaume , Severyns Thomas , Cellier Christophe , Rahmi Gabriel
Published: November 2020

Endoscopic submucosal dissection (ESD) is a validated treatment for early rectal tumors, but whether this therapy is efficient or not for rectal tumors extending to the dentate line (RTDL) remains unclear. We performed a systematic review and meta-analysis to assess the effectiveness and safety of ESD in RTDL compared to non-RTDL. A search in PubMed, Scopus and the Cochrane library up to April 2020 was conducted to identify studies that compared ESD in both localizations (RTDL and non-RTDL), reporting at least one main outcome (en bloc, complete resection, recurrence). Secondary outcomes were adverse event occurrence. Five observational studies including 739 patients with a total of 201 RTDL and 538 non-RTDL were considered. The proportion of female sex (66% vs. 36.9%, P < 0.001) and tumor size [mean difference = 7.75, 95% confidence interval (CI): 3.01–12.49, P = 0.001] were higher in the RTDL group. There were no differences in en bloc resection rates between RTDL and non-RTDL groups [odds ratio (OR): 0.95, 95% CI: 0.50–1.79, P = 0.087]. The complete resection rate was significantly higher in the non-RTDL group (OR: 1.72, 95% CI: 1.18–2.53, P = 0.005, I
2 = 0%). However, recurrence rates were comparable (RD: –0.04, 95% CI: –0.07 to 0.00, P = 0.06, I
2 = 0%). Concerning adverse events, there were no differences in terms of perforation (OR: 0.9, 95% CI: 0.26–3.08, P = 0.86, I
2 = 0%) or delayed bleeding (OR: 0.64, 95% CI: 0.17–2.42, P = 0.51, I
2 = 35%). Anal pain rate was 28% (95% CI: 21.4–35.8%). ESD is an effective and safe therapeutic approach for RTDL with comparable recurrence rate to non-RTDL. The lower complete resection rate in RTDL needs to be clarified in studies.
Montreal Cognitive Assessment and Frontal Assessment Battery test as a predictor of performance of unaffected hand function after subcortical stroke
Authors: Kang Ji Hye , Kim Yeo Hyung , Choi Young-Ah
Published: November 2020

The objective of this study was to elucidate the association between unaffected hand function and cognitive impairment and to determine whether the cognitive screening test can be a predictor of unaffected upper limb function in patients with unilateral subcortical strokes. A retrospective study of 37 patients with unilateral first-ever subcortical stroke was conducted through a review of medical records. The unaffected hand function and cognitive screening tests were measured upon admission to the neurorehabilitation unit and then 4 weeks later at discharge. The relationship between unaffected hand function and cognitive function was investigated with multiple linear regression analysis. Comparing the initial evaluation of unaffected hand function and cognitive function with the evaluation at discharge, cognitive function improved significantly at discharge; however, grip strength and dexterity of the unaffected hand were stationary except for three-point pinch strength, tip pinch strength, and finger tapping speed. The Montreal cognitive assessment (MoCA) score was found to be a significant predictor of unaffected grip strength (R
2 = 0.33, P = 0.004) and three-point pinch strength (R
2 = 0.16, P = 0.04) at discharge and the Frontal Assessment Battery (FAB) score to be a predictive value of the unaffected finger tapping test (R
2 = 0.46, P < 0.001) at discharge. In subcortical stroke patients with low MoCA and FAB scores, clinicians must ensure that patients participate in rehabilitation therapy including bimanual activity with careful attention to the patient’s unaffected hand function.
Effect of constraint-induced movement therapy on persons-reported outcomes of health status after stroke: a systematic review and meta-analysis
Authors: Abdullahi Auwal , Van Criekinge Tamaya , Umar Naima A. , Zakari Usman U. , Truijen Steven , Saeys Wim
Published: November 2020

Constraint-induced movement therapy (CIMT) is used for the rehabilitation of motor function after stroke. The aim of this review was to investigate its effect on persons-reported outcomes of health status (PROsHS) compared with conventional therapy. The study was a systematic review and meta-analysis registered in PROSPERO (CRD42019142279). Five databases PubMED, PEDro, OTSeeker, CENTRAL and Web of Science were searched. Randomized controlled trials were included if they assessed PROsHS. Mean scores of PROsHS, sample size and dose of CIMT and control groups interventions were extracted. The result was analyzed using qualitative and quantitative syntheses. Nine studies (n = 558) were included in the review. From the result, CIMT significantly improved PROsHS postintervention. However, postintervention, there was no statistically significant difference between groups for the upper limb [Mean difference (MD) = 6.67, 95% confidence interval (CI) = –2.09 to 15.44, P = 0.14] and the lower limb (MD = –1.86, 95% CI = –16.29 to 12.57, P = 0.80). Similarly, there was no statistically significant percentage of variation across studies, upper limb (I
2 = 0%, P = 0.92) and lower limb (I
2 = 0%, P = 0.86). For the lower limb at follow-up, there was no statistically significant difference between groups (MD = 0.97, 95% CI = –13.59 to 15.53, P = 0.90). When upper and lower limbs studies were pooled, there was no statistically significant difference between groups postintervention (MD = 0.22, 95% CI = –0.15 to 0.58, P = 0.24) and at follow-up (MD = 0.03, 95% CI = –0.43 to 0.49, P = 0.90). CIMT improves PROsHS after stroke. However, it is not superior to conventional therapy based on the current literature.
The Costs of Breast Reconstruction and Implications for Episode-Based Bundled Payment Models
Authors: Berlin Nicholas L. , Chung Kevin C. , Matros Evan , Chen Jung-Sheng , Momoh Adeyiza O.
Published: November 2020

Background:

Implementation of payment reform for breast reconstruction following mastectomy demands a comprehensive understanding of costs related to the complex process of reconstruction. Bundled payments for services to women with breast cancer may profoundly impact reimbursement and access to breast reconstruction. The authors’ objectives were to determine the contribution of cancer therapies, comorbidities, revisions, and complications to costs following immediate reconstruction and the optimal duration of episodes to incentivize cost containment for bundled payment models.

Methods:

The cohort was composed of women who underwent immediate breast reconstruction between 2009 and 2016 from the MarketScan Commercial Claims and Encounters database. Continuous enrollment for 3 months before and 24 months after reconstruction was required. Total costs were calculated within predefined episodes (30 days, 90 days, 1 year, and 2 years). Multivariable models assessed predictors of costs.

Results:

Among 15,377 women in the analytic cohort, 11,592 (75 percent) underwent tissue expander, 1279 (8 percent) underwent direct-to-implant, and 2506 (16 percent) underwent autologous reconstruction. Adjuvant therapies increased costs at 1 year [tissue expander, $39,978 (p < 0.001); direct-to-implant, $34,365 (p < 0.001); and autologous, $29,226 (p < 0.001)]. At 1 year, most patients had undergone tissue expander exchange (76 percent) and revisions (81 percent), and a majority of complications had occurred (87 percent). Comorbidities, revisions, and complications increased costs for all episode scenarios.

Conclusions:

Episode-based bundling should consider separate bundles for medical and surgical care with adjustment for procedure type, cancer therapies, and comorbidities to limit the adverse impact on access to reconstruction. The authors’ findings suggest that a 1-year time horizon may optimally capture reconstruction events and complications.
Best New Flaps and Tips for Success in Microsurgery
Authors: Brown Erin , Suh Hyunsuk Peter , Han Hyun Ho , Pak Changsik John , Hong Joon Pio
Published: November 2020

Learning Objectives:

After reviewing this article, the participant should be able to: 1. Understand the trends in reconstruction using flaps. 2. Understand the surgical anatomy and elevation of the three best flaps: superficial circumflex iliac artery perforator, profunda artery perforator, and thin anterolateral thigh perforator. 3. Understand the core principle and the modern evolution of microsurgery. 4. Be acquainted with new microsurgical tips to maximize outcomes.

Plastic surgery has a long history of innovation expanding the conditions we can treat, and microsurgical reconstruction has played a pivotal role. Freestyle free flaps now create another paradigm shift in reconstructive surgery, relying on a better understanding of anatomy and physiology, opening the door to patient-specific customized reconstruction. This article aims to provide information regarding useful and practical new advances in the field of microsurgery.
Psychological Characteristics, Female Sex, and Opioid Use Predict Acute Postoperative Pain in Patients Surgically Treated for Thumb Base Osteoarthritis: A Cohort Study
Authors: Wouters Robbert M. , Porsius Jarry T. , van der Oest Mark J. W. , Slijper Harm P. , Souer J. Sebastiaan , Selles Ruud W. , MacDermid Joy C.
Published: November 2020

Background:

It is unclear which factors predict acute postoperative pain in patients surgically treated for thumb base osteoarthritis. The authors investigated the influence of type of surgery, preoperative sociodemographics, preoperative patient-reported outcome measures, psychological characteristics, and postoperative opioid use on acute postoperative pain 24 hours postoperatively following surgery for thumb carpometacarpal osteoarthritis. In addition, preoperative and acute postoperative pain were compared.

Methods:

In this prospective cohort study, 215 patients surgically treated for thumb carpometacarpal osteoarthritis were included. Data were collected in 16 clinics for hand surgery and therapy in The Netherlands. Hierarchical regression was used to identify whether type of surgery, preoperative sociodemographics, preoperative patient-reported outcome measures, psychological characteristics (including treatment credibility and expectations, illness perception, pain catastrophizing, anxiety, and depression), and postoperative opioid use predicted acute postoperative pain 24 hours postoperatively, measured using the Numeric Pain Rating Scale (range, 0 to 10).

Results:

Female sex, opioid use, higher preoperative satisfaction with hand, and higher self-reported consequences and coherence predicted greater postoperative pain, with 31 percent explained variance in the final model including psychological factors. Mean postoperative Numeric Pain Rating Scale score was lower (5.1 ± 2.4) than preoperative pain, measured using visual analogue scales (during the past week, 6.7 ± 1.7; physical load, 7.5 ± 1.7) and the Michigan Hand Outcomes Questionnaire (6.4 ± 1.4; p < 0.001).

Conclusions:

Psychological factors, female sex, and opioid use enhance the prediction of acute postoperative pain beyond surgery type, preoperative sociodemographics, and patient-reported outcome measures. Female sex and opioid use were the strongest predictors, even after controlling for psychological factors. Future studies may investigate sex-based approaches and patient education for reducing acute postoperative pain.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Risk, II.
Shear Force Processing of Lipoaspirates for Stem Cell Enrichment Does Not Affect Secretome of Human Cells Detected by Mass Spectrometry In Vitro
Authors: Prantl Lukas , Eigenberger Andreas , Klein Silvan , Limm Katharina , Oefner Peter J. , Schratzenstaller Thomas , Felthaus Oliver
Published: November 2020

Background:

Lipofilling is one of the most often performed surgical procedures in plastic and reconstructive surgery. Lipoaspirates provide a ready source of stem cells and secreted factors that contribute to neoangiogenesis and fat graft survival. However, the regulations about the enrichment of these beneficial cells and factors are ambiguous. In this study, the authors tested whether a combination of centrifugation and homogenization allowed the enrichment of viable stem cells in lipoaspirates through the selective removal of tumescent solution, blood, and released lipids without significantly affecting the cell secretome.

Methods:

Human lipoaspirate was harvested from six different patients using water jet–assisted liposuction. Lipoaspirate was homogenized by first centrifugation (3584 rpm for 2 minutes), shear strain (10 times intersyringe processing), and second centrifugation (3584 rpm for 2 minutes). Stem cell enrichment was shown by cell counting after stem cell isolation. Lipoaspirate from different processing steps (unprocessed, after first centrifugation, after homogenization, after second centrifugation) was incubated in serum-free cell culture medium for mass spectrometric analysis of secreted proteins.

Results:

Lipoaspirate homogenization leads to a significant 2.6 ± 1.75-fold enrichment attributable to volume reduction without reducing the viability of the stem cells. Protein composition of the secretome did not change significantly after tissue homogenization. Considering the enrichment effects, there were no significant differences in the protein concentration of the 83 proteins found in all processing steps.

Conclusions:

Stem cells can be enriched mechanically without significantly affecting the composition of secreted proteins. Shear-assisted enrichment of lipoaspirate constitutes no substantial manipulation of the cells’ secretome.
Examining the Correlation between Altmetric Score and Citations in the Plastic Surgery Literature
Authors: Boyd Carter J. , Ananthasekar Shivani , Kurapati Srikanth , King Timothy W.
Published: November 2020

Background:

Social media are transforming the dissemination of published research. This influence brought the advent of a new metric, altmetrics, which seeks to quantify the influence of research in real time based on an article’s attention online. This study aims to determine the correlation between altmetrics ratings for articles with traditional bibliometrics of impact factor and citation rate.

Methods:

The 10 most cited articles in the top 15 plastic surgery journals were determined for 2013 and 2016. The 2013 articles allow for a 5-year lag time, whereas 2016 data provide another timepoint for comparison. Altmetric scores and citation count were collected for each article. Impact factor and Twitter account age were determined for each journal. Statistical analysis was completed using descriptive statistics, and Pearson and Spearman correlation coefficients.

Results:

In both 2013 and 2016, there was a weak positive correlation between citations and Altmetric score (r = 0.2620, p = 0.0012; r = 0.3564, p < 0.0001, respectively) and between impact factor and the Altmetric score (r = 0.2419, p = 0.0040; r = 0.3887, p = < 0.0001, respectively). Twitter was the main contributor to the Altmetric score in both 2013 and 2016.

Conclusions:

Altmetric scores and traditional bibliometrics are not strongly correlated with one another in the plastic surgery literature at this point in time. Still, the short- and long-term impact of a publication might be determined through the combined analysis of citation count, impact factor, and Altmetric scores.
Upper Eyelid Ptosis Correction with Levator Advancement in Asian Patients using the Musculoaponeurotic Junction of the Levator as the Key Reference Point
Authors: Wong Chin-Ho , Hsieh Michael Ku Hung , Mendelson Bryan
Published: November 2020

Upper eyelid ptosis correction is a complex procedure. The ethnic differences in the Asian upper eyelid anatomy are compounded by the technical challenges of primary and revision ptosis correction. The authors present a technique of upper eyelid ptosis correction that estimates the exact location of suture fixation that uses the musculoaponeurotic junction of the levator as the reference point. The preoperative considerations in determining the fixation point relative to the musculoaponeurotic junction include the following: A, the extent of ptosis correction needed; B, the degree of compensatory brow elevation with eye opening; and C, eye dominance. The benefits of this approach are the shortened operative time because of more precise preoperative planning and greater predictability and reproducibility of the results. The authors have found that this technique produced consistent and superior results for ptosis correction in Asian patients.
Task Shifting for Initiation and Monitoring of Antiretroviral Therapy for HIV-Infected Adults in Uganda: The SHARE Trial
Authors: Sekiziyivu Brian Arthur , Bancroft Elizabeth , Rodriguez Evelyn M. , Sendagala Samuel , Nasirumbi Muniina Pamela , Najjengo Marjorie Sserunga , Kiragga Agnes N. , Musaazi Joseph , Musinguzi Joshua , Sande Enos , Brad Bartholow , Dalal Shona , Byakika-Jayne Tusiime , Kambugu Andrew
Published: November 2020

Background:

With countries moving toward the World Health Organization's “Treat All” recommendation, there is a need to initiate more HIV-infected persons into antiretroviral therapy (ART). In resource-limited settings, task shifting is 1 approach that can address clinician shortages.

Setting:

Uganda.

Methods:

We conducted a randomized controlled trial to test if nurse-initiated and monitored ART (NIMART) is noninferior to clinician-initiated and monitored ART in HIV-infected adults in Uganda. Study participants were HIV-infected, ART-naive, and clinically stable adults. The primary outcome was a composite end point of any of the following: all-cause mortality, virological failure, toxicity, and loss to follow-up at 12 months post-ART initiation.

Results:

Over half of the study cohort (1,760) was women (54.9%). The mean age was 35.1 years (SD 9.51). Five hundred thirty-three (31.6%) participants experienced the composite end point. At 12 months post-ART initiation, nurse-initiated and monitored ART was noninferior to clinician-initiated and monitored ART. The intention-to-treat site-adjusted risk differences for the composite end point were −4.1 [97.5% confidence interval (CI): = −9.8 to 0.2] with complete case analysis and −3.4 (97.5% CI: = −9.1 to 2.5) with multiple imputation analysis. Per-protocol site-adjusted risk differences were −3.6 (97.5% CI: = −10.5 to 0.6) for complete case analysis and −3.1 (−8.8 to 2.8) for multiple imputation analysis. This difference was within hypothesized margins (6%) for noninferiority.

Conclusions:

Nurses were noninferior to clinicians for initiation and monitoring of ART. Task shifting to trained nurses is a viable means to increase access to ART. Future studies should evaluate NIMART for other groups (e.g., children, adolescents, and unstable patients).
Effect of Statin Therapy on Age-Associated Changes in Physical Function Among Men With and Without HIV in the Multicenter AIDS Cohort Study
Authors: Abdo Mona , Langan Susan J. , MaWhinney Samantha , Sun Jing , Lake Jordan E. , Palella Frank J. , Kingsley Lawrence , Brown Todd T. , Erlandson Kristine M.
Published: November 2020

Background:

The longer-term risks of statins on physical function among people with HIV are unclear.

Methods:

Longitudinal analysis of Multicenter AIDS Cohort Study men between 40 and 75 years of age with ≥2 measures of gait speed or grip strength. Generalized estimating equations with interaction terms between (1) statin use and age and (2) HIV serostatus, age, and statin use were considered to evaluate associations between statin use and physical function. Models were adjusted for demographics and cardiovascular risk factors.

Results:

Among 2021 men (1048 with HIV), baseline median age was 52 (interquartile range 46–58) years; 636 were consistent, 398 intermittent, and 987 never statin users. There was a significant interaction between age, statin, and HIV serostatus for gait speed. Among people with HIV, for every 5-year age increase, gait speed (m/s) decline was marginally greater among consistent versus never statin users {−0.008 [95% confidence interval (CI) −0.017 to −0.00007]; P = 0.048}, with more notable differences between intermittent and never users [−0.017 (95% CI −0.027 to −0.008); P < 0.001]. Similar results were observed among men without HIV. Significant differences in grip strength (kg) decline were seen between intermittent and never users [−0.53 (95% CI −0.98 to −0.07); P = 0.024] and differences between consistent and never users [−0.28 (95% CI −0.63 to 0.06); P = 0.11] were not statistically significant.

Conclusions:

Among men with and without HIV, intermittent statin users had more pronounced declines in physical function compared with consistent and never users. Consistent statin use does not seem to have a major impact on physical function in men with or without HIV.
Quantitative CT Detects Undiagnosed Low Bone Mineral Density in Oncologic Patients Imaged With 18F-FDG PET/CT
Authors: Kay Fernando U. , Ho Vinh , Dosunmu Edmund B. , Chhabra Avneesh , Brown Keenan , Duan Xinhui , Öz Orhan K.
Published: November 2020

Purpose

We assessed the prevalence of low bone mineral density (BMD) in oncologic patients undergoing 18F-FDG PET/CT.

Patients and Methods

This is a retrospective analysis of 100 patients who underwent 18F-FDG PET/CT at a single center from October 2015 till May 2016. Quantitative CT (QCT) was used to assess BMD at the lumbar spine (BMDQCT) and femoral necks (BMDCTXA). SUVmax was used to evaluate metabolic activity of the bone marrow. Risk of osteoporosis-related fractures was calculated with femoral neck BMDCTXA and the FRAX algorithm, which was compared against measurements of CT attenuation of the trabecular bone at L1 (L1HU).

Results

Osteoporosis and osteopenia were respectively present in 16% and 46% of patients 50 years and older. Bone marrow SUVmax was correlated with BMD at the lumbar spine (ρ = 0.36, P < 0.001). Increased age and low marrow SUVmax were associated with low BMDQCT at the lumbar spine (both P < 0.001), whereas increased age, female sex, and low marrow SUVmax were associated with low BMDCTXA at the femoral necks (P < 0.001, P < 0.001, P = 0.01, respectively). L1HU had an area under the curve of 0.95 (95% confidence interval [CI], 0.90–0.99) for detecting increased risk for osteoporosis-related fracture, with best threshold of 125.8 HU (95% CI, 115.7–144.9) yielding sensitivity of 100% (95% CI, 0.92–1.00), specificity of 0.90 (95% CI, 0.76–0.97), and accuracy of 0.91 (95% CI, 0.79–0.97).

Conclusions

Low BMD is frequent in oncologic patients undergoing 18F-FDG PET/CT. Decreased 18F-FDG avidity of the bone marrow correlates with decreased BMD, validating the link between osteoporosis and bone marrow fat. L1HU could be a simple and accurate approach for detecting patients at risk for osteoporosis-related fractures using PET/CTdata.
False-Positive 18F–Prostate-Specific Membrane Antigen–1007 PET/CT Caused by Hepatic Multifocal Inflammatory Foci
Authors: Ladrón-de-Guevara David , Canelo Alejando , Piottante Antonio , Regonesi Carlos
Published: November 2020

A 68-year-old man with history of treated prostate cancer was referred to 68Ga–prostate-specific membrane antigen (PSMA)–11 PET/CT imaging. Moderate bone involvement was observed, with a normal liver tracer uptake. Bone biopsy confirmed metastases of prostate cancer. After therapy adjustment, a follow-up 18F-PSMA-1007 PET/CT revealed good response in bone lesions, although it showed 3 new rounded liver intense uptake foci. Concurrent PSA was 0.6 ng/mL. Liver function tests were normal. PET/CT-guided hepatic biopsy demonstrated no malignant cells, focal inflammation, and steatosis, being possibly the inflammation the cause of false-positive multifocal uptake of 18F-PSMA-1007. Following PET/CT, controls showed a normal liver.
Intracystic Papillary Neoplasm of Gallbladder Mimicking Metastatic Malignancy on PET/CT
Authors: Ismail Rasha , Saeed Bamashmos Anas , Cohen Paul J. , Pucar Darko
Published: November 2020

Intracystic papillary neoplasm of the gallbladder is a rare preinvasive neoplastic lesion with similar characteristics as intraductal papillary mucinous neoplasm and other papillary neoplasms of pancreaticobiliary system. We report a case of 48-year-old woman with a history of recurrent right flank chondrosarcoma and gallbladder lesion on MRI and PET/CT interpreted as indeterminate for metastatic disease. Subsequent cholecystectomy showed intracystic papillary neoplasm. With gallbladder lesions being rare on PET/CT, this case illustrates the importance of considering both primary and secondary tumors in the differential diagnosis.
Comparision of Mechanical Thrombectomy With Contact Aspiration or Stent Retriever in Patients With Large-vessel Occlusion in Acute Ischemic Stroke
Authors: Xia Lei , Zhao Piao-Ping , Sun He-Xiang , Jing Chao-Hui , Zhong Jun , Hua Xu-Ming , Wan Liang
Published: November 2020

Objectives:

Whether the direct aspiration approach of thrombectomy for recanalization in patients with acute ischemic stroke has a similar efficacy and safety compared to the stent-retriever still remains uncertain.

Methods:

A retrospective data analysis was performed to identify patients with large cerebral artery acute ischemic stroke treated with endovascular thrombectomy. The study was conducted between January 2018 and December 2019 in a single stroke center.

Results:

Twenty patients met inclusion criteria for this study with a mean age 66.64 ± 17.92 years’ old. The symptom occurred on the left side were in 13, and the right side in 7. The location of occlusion was 8 in M1 of the middle cerebral artery of M2, and 6 in internal carotid artery. Nine patients were randomized to first-line treatment with contact aspiration and eleven to first-line treatment with a stent retriever. The mean time from admission time to groin puncture was 55.51 ± 31.03 minutes. The average time from groin puncture to maximal revascularizion after mechanical thrombectomy was 50.9 ± 22.5 minutes in contact aspiration group, but this time was 71.37 ± 25.45 minutes in the group of stent retriever. The overall successful revascularization rate (TICI 2b-3) was 88.9% in contact aspiration (TICI2a = 1, TICI 2b = 4 patients, TICI 3 = 4 patients), and 90.1% in stent retriever (TICI2a = 1, TICI 2b = 6 patients, TICI 3 = 4 patients).

Discussion:

First-line thrombectomy with contact aspiration did not result in a higher successful revascularization rate at the end of the procedure but had a short time from groin puncture to maximal revascularizion.
Tongue Reduction for Macroglossia
Authors: McCrossan Susan , Martin Serena , Hill Christopher
Published: November 2020

Introduction:

Macroglossia is a term used to describe a large tongue which protrudes outside of the mouth while in a resting position (Balaji, 2013). It is a cardinal sign in children with Beckwith-Wiedemann syndrome and can also be found in children with Down syndrome and Klippel-Trenaunay-Weber syndrome. Macroglossia can lead to airway and feeding difficulties, as well as problems with speech, drooling, and cosmesis. We present a review of tongue reduction operations performed for macroglossia over a 10-year period in Northern Ireland.

Methods:

We performed a retrospective review of the medical notes of those children identified to have undergone a tongue reduction procedure in the regional pediatric hospital. We reviewed the presenting symptoms and concerns, the operative technique used, postoperative outcomes, and follow up. Outcomes data included improvements in symptoms, complications, and the need for revision procedures.

Results:

Six children underwent tongue reduction procedures over a 10-year period. Age range at time of surgery was between 4 months to 10 years 3 months. Five children had an underlying diagnosis of Beckwith-Wiedemann syndrome and 1 child had Down syndrome. One child underwent a second tongue reduction for mild tongue protrusion at the 5-year follow up. There were no complications in relation to tongue reduction surgery for any of the children and importantly, there were no airway complications in our series. All patients were found to have improved feeding, better tongue position in the oral cavity, reduced drooling, and better speech development following surgery.

Conclusion:

Symptomatic macroglossia requiring a tongue reduction procedure is relatively rare and these procedures are, therefore, uncommonly performed. Despite the rarity of this procedure, when it is required, it can be life saving for some infants and children, and life altering for the remainder. Improvements in airway, feeding, speech, and psychosocial wellbeing are the desired outcomes with this procedure. Throughout our 10-year series we have found it to be a relatively safe procedure but potentially anesthetically challenging. We have demonstrated both good short and long-term outcomes for these children.
Evaluation of the efficacy of commercial and noncommercial tourniquets for extremity hemorrhage control in a perfused cadaver model
Authors: Cremonini Camilla , Nee Nadya , Demarest Matthew , Piccinini Alice , Minneti Michael , Canamar Catherine P. , Benjami Elizabeth R. , Demetriades Demetrios , Inaba Kenji
Published: November 2020

BACKGROUND

Tourniquets are a critical tool in the immediate response to life-threatening extremity hemorrhage; however, the optimal tourniquet type and effectiveness of noncommercial devices remain unclear. Our aim was to evaluate the efficacy of five tourniquets in a perfused-cadaver model.

METHODS

This prospective study used a perfused-cadaver model with standardized superficial femoral artery injury bleeding at 700 mL/min. Five tourniquets were tested: combat application tourniquet; rapid application tourniquet system; Stretch, Wrap, And Tuck Tourniquet; an improvised triangle bandage windlass; and a leather belt. Forty-eight medical students underwent a practical hands-on demonstration of each tourniquet. Using a random number generator, they placed the tourniquets on the bleeding cadaver in random order. Time to hemostasis, time to secure devices, estimated blood loss, and difficulty rating were assessed. A one-way repeated measures analysis of variance was used to compare efficacy between the tourniquets in achieving the outcomes.

RESULTS

The mean ± SD participant age was 25 ± 2.6 years, and 29 (60%) were male. All but one tourniquet was able to stop bleeding, but the rapid application tourniquet system had a 4% failure rate. Time to hemostasis and estimated blood loss did not differ significantly (p > 0.05). Stretch, Wrap, And Tuck Tourniquet required the longest time to be secured (47.8 ± 17.0 seconds), whereas the belt was the fastest (15.2 ± 6.5 seconds; p < 0.001). The improvised windlass was rated easiest to learn and apply, with 22 participants (46%) assigning a score of 1.

CONCLUSION

Four of five tourniquets evaluated, including both noncommercial devices, effectively achieved hemostasis. A standard leather belt was the fastest to place and was able to stop the bleeding. However, it required continuous pressure to maintain hemostasis. The improvised windlass was as effective as the commercial devices and was the easiest to apply. In an emergency setting where commercial devices are not available, improvised tourniquets may be an effective bridge to definitive care.
Development of Rift valley fever encephalitis in rats is mediated by early infection of olfactory epithelium and neuroinvasion across the cribriform plate
Authors: Boyles Devin A. , Schwarz Madeline M. , Albe Joseph R. , McMillen Cynthia M. , O'Malley Katherine J. , Reed Douglas S. , Hartman Amy L.
Published: November 2020

The zoonotic emerging Rift Valley fever virus (RVFV) causes sporadic disease in livestock and humans throughout Africa and the Saudi Arabian peninsula. Infection of people with RVFV can occur through mosquito bite or mucosal exposure during butchering or milking of infected livestock. Disease typically presents as a self-limiting fever; however, in rare cases, hepatitis, encephalitis and ocular disease may occur. Recent studies have illuminated the neuropathogenic mechanisms of RVFV in a rat aerosol infection model. Neurological disease in rats is characterized by breakdown of the blood–brain barrier late in infection, infiltration of leukocytes to the central nervous system (CNS) and massive viral replication in the brain. However, the route of RVFV entry into the CNS after inhalational exposure remains unknown. Here, we visualized the entire nasal olfactory route from snout to brain after RVFV infection using RNA in situ hybridization and immunofluorescence microscopy. We found widespread RVFV-infected cells within the olfactory epithelium, across the cribriform plate, and in the glomerular region of the olfactory bulb within 2 days of infection. These results indicate that the olfactory tract is a major route of infection of the brain after inhalational exposure. A better understanding of potential neuroinvasion pathways can support the design of more effective therapeutic regiments for the treatment of neurological disease caused by RVFV.
Covid-19 pandemic lessons: Uncritical communication of test results can induce more harm than benefit and raises questions on standardized quality criteria for communication and liability
Authors: Porzsolt Franz , Pfuhl Gerit , Kaplan Robert M , Eisemann Martin
Published: November 2020

Background

The COVID-19 pandemic is characterized by both health and economic risks. A ‘safety loop’ model postulates risk-related decisions are not based on objective and measurable risks but on the subjective perception of those risks. We here illustrate a quantification of the difference between objective and subjective risks.

Method

The objective risks (or chances) can be obtained from traditional 2 × 2 tables by calculating the positive (+LR) and negative (-LR) likelihood ratios. The subjective perception of objective risks is calculated from the same 2 × 2 tables by exchanging the X- and Y-axes. The traditional 2 × 2 table starts with the hypothesis, uses a test and a gold standard to confirm or exclude the investigated condition. The 2 × 2 table with inverted axes starts with the communication of a test result and presumes that the communication of bad news (whether right or false) will induce ‘perceived anxiety’ while good news will induce ‘perceived safety’. Two different functions (confirmation and exclusion) of both perceptions (perceived anxiety and safety) can be quantified with those calculations.

Results

The analysis of six published tests and of one incompletely reported test on COVID-19 polymerase chain reactions (completed by four assumptions on high and low sensitivities and specificities) demonstrated that none of these tests induces ‘perceived safety’. Eight of the ten tests confirmed the induction of perceived anxiety with +LRs (range 3.1 – 5900). In two of these eight tests a -LR (0.25 and 0.004) excluded the induction of perceived safety.

Conclusions

Communication of test results caused perceived anxiety but not perceived safety in 80% of the investigated tests. Medical tests – whether right or false – generate strong psychological messages. In the case of COVID-19 tests may induce more perceived anxiety than safety.
Estimating E-Cigarette Use Prevalence Among US Adolescents Using Vaping-Related Online Search Trends
Authors: Foxon Floe
Published: November 2020

Introduction

Adolescent e-cigarette use is a developing phenomenon. Greater surveillance of underage use is necessary to inform e-cigarette policy and mitigate adolescent e-cigarette use. Accurate prevalence estimates for adolescent e-cigarette use are provided by large national surveys. However, these surveys are costly and provide only annual estimates. To obtain more affordable estimates faster and more frequently, novel methods are required.

Methods

Online search term popularity data were taken from Google Trends. Interest in the search terms ‘vapes’, ‘vape’, and ‘vape pen’ were followed monthly from January 2011 to November 2020. Time-lagged zero-normalized cross-correlations were performed between the Google data and current (past 30 day) high-school e-cigarette use prevalence estimates from the National Youth Tobacco Survey (NYTS). The search interest data were then calibrated to the NYTS data to estimate adolescent e-cigarette use prevalence using online searches.

Results

Maximum correlation coefficients of 0.979 for ‘vapes’ and 0.938 for ‘vape’ were obtained when search interest lagged use prevalence by one month, and 0.970 for ‘vape pen’ when the lag was two months (p < 0.0001 for all). Calibrating the search term data to NYTS provided a high-school current e-cigarette use prevalence estimate of 11.3–16.5% for November 2020, suggesting adolescent use of e-cigarettes has continued to decline since the NYTS estimate of 19.6% for January–March 2020.

Conclusion

Online search trend data may provide reasonably reliable and more frequent estimates of adolescent e-cigarette use prevalence at substantially lower costs than traditional surveys. Such additional data may help in developing adolescent e-cigarette use prevention efforts.
Cocaine receptor identified as BASP1
Authors: Harraz Maged M. , Malla Adarsha P. , Semenza Evan R , Shishikura Maria , Hwang Yun , Kang In Guk , Song Young Jun , Snowman Adele M. , Cortes Pedro , Snyder Solomon H.
Published: November 2020

Cocaine is a behavioral stimulant with substantial abuse potential related to its positively rewarding actions1,2. Cocaine inhibits the reuptake inactivation of neurotransmitters such as dopamine, serotonin, and norepinephrine at high nanomolar to low micromolar concentrations2. There is evidence for substantially more potent influences of cocaine. For instance, Calligaro and Eldefrawi reported binding of [3H]cocaine to brain membranes with a dissociation constant of about 16 nM3. At 10 nM concentration, cocaine elicits environmental place conditioning in planarians4. Furthermore, 1nM cocaine enhances dopamine D2 receptor agonist-mediated signaling5. Inhibition of amine reuptake by cocaine is substantially less potent than some of these high affinity actions. Thus, evidence for a specific, high affinity receptor for cocaine that mediates its behavioral actions has been lacking. We now report high affinity binding of cocaine to the membrane-associated brain acid soluble protein-1 (BASP1) with a Kd of 7 nM. Knocking down BASP1 in the striatum inhibits [3H]cocaine binding to striatal synaptosomes. Depletion of BASP1 in the nucleus accumbens diminishes locomotor stimulation, acquisition, and expression of locomotor sensitization to cocaine. Our findings indicate that BASP1 is a pharmacologically relevant receptor for cocaine and a putative therapeutic target for psychostimulant addiction.
Effects of probiotics on loperamide-induced constipation in rats
Authors: Inatomi Takio
Published: November 2020

Constipation, a common health problem, causes discomfort and affects quality of life. This study aimed to evaluate the potential effect of probiotics on loperamide (LP)-induced constipation in Sprague-Dawley (SD) rats, a well-established animal model of spastic constipation. In total, 100 male SD rats (age, 8 weeks; Japan SLC, Inc., Hamamatsu, Japan) were used in the experiments following a 12-day acclimatisation period. They were randomly divided into two treatment groups (groups 1 and 2) of 50 rats each. Spastic constipation was induced via oral administration of LP (3 mg/kg) for 6 days 1 hour before the administration of each test compound. Similarly, a probiotics solution (4 ml/kg body weight) was orally administered to the rats once a day for 6 days in group 2. In group 1, phosphate buffer solution was orally administered once a day for 6 days 1 hour after each LP administration. The changes in body weight, faecal parameters, short-chain fatty acid concentration in faeces, and faecal immunoglobulin (Ig)-A concentration were recorded. In the present study, the oral administration of probiotics improved faecal parameters, short-chain fatty acid concentration in faeces, and faecal IgA concentration. Our results indicate that probiotics increase the levels of intestinal short-chain fatty acids, especially butyric acid, thereby improving constipation and intestinal immunity.
Low-resolution structures of modular nanotransporters shed light on their functional activity
Authors: Khramtsov Yuri V. , Vlasova Anastasiia D. , Vlasov Alexey V. , Rosenkranz Andrey A. , Ulasov Alexey V. , Ryzhykau Yury L. , Kuklin Alexander I. , Orekhov Anton S. , Eydlin Ilia B. , Georgiev Georgii P. , Gordeliy Valentin I. , Sobolev Alexander S.
Published: November 2020

Modular nanotransporters (MNTs) are multifunctional chimeric polypeptides for the multistep transport of locally acting cytotoxic agents into the nuclei of cancer target cells. MNTs consist of several polypeptide domains (functional modules) for the recognition of a cell-surface internalizable receptor, pH-dependent endosomal escape and subsequent transport into the nucleus through the nuclear pores. MNTs are a promising means for cancer treatment. As has been shown previously, all of the modules of MNTs retain their functionalities. Despite their importance, there is no structural information available about these chimeric polypeptides, which hampers the creation of new MNT variants. Here, a low-resolution 3D structure of an MNT is presented which was obtained by atomic force microscopy, transmission electron microscopy and small-angle X-ray scattering coupled to size-exclusion chromatography. The data suggest that the MNT can adopt two main conformations, but in both conformations the protein N- and C-termini are distanced and do not influence each other. The change in the MNT conformation during acidification of the medium was also studied. It was shown that the fraction of the elongated conformation increases upon acidification. The results of this work will be useful for the development of MNTs that are suitable for clinical trials and possible therapeutic applications.