bluuebunny/crossref_metadata_2025 huggingface dataset:
Which treatment for the French revolutionist Jean-Paul Marat’s dermatitis (1793)? A biomedical analysis of his bathtub deposits
Authors: Charlier Philippe , Bourdin Virginie , Astier Alain , Berecz Véronique , Poupon Joel
Published: January 2023

The history of medicine makes it possible to understand both the evolution of the conceptualization of pathological processes, but also the modification of therapeutic principles and patient management. In the context of dermatology, we are interested here in the case of Jean-Paul Marat, who was murdered in his bathtub at the end of the 18th century in France and had severe dermatosis. Examination of deposits of pharmaceutical products inside the bathtub in which he spent most of his time made it possible to reconstruct the nosological and therapeutic framework of his dermatosis.
Alopecia areata and risk of common infections: a population-based cohort study
Authors: Messenger Andrew G , Harries Matthew , Macbeth Abby E , Chiu Wing Sin , Holmes Susan , Tziotzios Christos , de Lusignan Simon
Published: January 2023

Background

It is not known whether alopecia areata (AA) is associated with a greater or reduced risk for infection.

Aim

We undertook a population-based study exploring associations between AA and common infections.

Methods

We extracted primary care records from the UK Oxford-Royal College of General Practitioners Research and Surveillance Centre database (trial registration: NCT04239521). The incidence of common and viral infection composite outcomes, and individual respiratory, gastrointestinal (GI), skin, urinary tract, genital and herpes infections, were compared in people with AA (AA group, n = 10 391) and a propensity-matched control group (n = 41 564). Adjusted hazard ratios (aHRs), controlling for sociodemographic and clinical covariates, and comorbidities were used to estimate the association between AA and each infection over 5 years.

Results

The incidence (per 100 person-years) of common infections was slightly higher in the AA group [14.2, 95% confidence interval (CI) 13.8–14.6] than the control group (11.7, 95% CI 11.5–11.9). In adjusted analysis, positive associations were observed for composite outcomes (common infections aHR 1.13, 95% CI 1.09–1.17; viral infections aHR 1.11, 95% CI 1.07–1.16) and with respiratory tract, GI, skin and herpes simplex infections (aHR range 1.09–1.32). Excluding people in the control group without a recent consultation with their general practitioner showed no association between AA and infection (common infections aHR 1.01, 95% CI 0.98–1.05, viral infections aHR 0.99, 95% CI 0.95–1.03).

Conclusions

The association between AA and common infection may represent a higher propensity of people with AA to engage with healthcare services (and thereby to have infections recorded), rather than a true association between AA and infection. Overall our findings suggest that AA is not associated with a clinically significantly increased or decreased incidence of common infections.
A papule on the forehead
Authors: Hiranput Siwaporn , Hill Glenda , Raweily Essam , Yesudian Paul D
Published: January 2023

An 85-year-old woman presented with a new painless lesion on the forehead. This case highlights a rare cutaneous tumour that can mimic cutaneous metastasis from nasopharyngeal carcinoma histologically.
Prevalence and risk factors for atopic dermatitis in Greenlandic children
Authors: Andersson Anna M , Kaiser Hannah , Skov Lone , Koch Anders , Thyssen Jacob P
Published: January 2023

Background

The epidemiology of atopic dermatitis (AD) in Greenland has been sparsely investigated.

Aim

To examine the point and overall prevalence, cumulative incidence at different ages, and associated risk factors for AD among children in Greenland.

Methods

Between 2019 and 2020, three towns in Greenland, representing 48% of the total population, were visited. A cross-sectional study was conducted, including children aged 0–7 years attending daycare centres. Parents completed a questionnaire with questions on AD and related risk factors. A diagnosis of AD was based on the UK Working Party’s criteria along with a clinical examination.

Results

In total, 839 children aged 0–7 years were included. The overall prevalence of AD was 35% according to physician’s diagnosis and assessment. The point prevalence was 28% and peaked among 1-year-old children (36%) and declined with age. The cumulative incidence at ages 1–6 years varied between 29% and 41% and was highest in 1-year-old children and showed a slight decline with increasing age. In the fully adjusted multivariate model, AD was associated with being of Inuit descent [odds ratio (OR) 1.7, 95% confidence interval (CI) 1.1–2.8]; food allergy in the child (OR 3.6, 95% CI 2.3–5.6); ear infection in the child (OR 1.4, 95% CI 1.0–1.9); having a mother with a high educational level (OR 1.5, 95% CI 1.0–2.3); maternal atopy (OR 1.4, 95% CI 1.1–2.0); and paternal atopy (OR 2.0, 95% CI 1.5–2.8). No environmental risk factors were identified.

Conclusion

The overall prevalence of AD in children in Greenland is high and has likely increased over the past 20 years. The point prevalence was highest in the youngest children indicating early onset of disease. Inuit descent, family atopy predisposition and having a higher socioeconomic status (based on parental educational level and housing) increased the risk of AD. Insight into possible Inuit-specific genetic predisposition is needed.
Athena: Speciality Certificate Examination case for skin oncology
Authors: Bakko Freya , Burton Harry , Daunton Adam , Bodansky David Maxwell Sterling
Published: January 2023

A 33-year-old White pregnant woman (gestational age 20 weeks) presents following an excision biopsy of a hyperpigmented, irregular lesion of the forearm increasing in size over the past 5 months.
NRAP reduction rescues sarcomere defects in nebulin-related nemaline myopathy
Authors: Casey Jennifer G , Kim Euri S , Joseph Remi , Li Frank , Granzier Henk , Gupta Vandana A
Published: January 2023

Nemaline myopathy (NM) is a rare neuromuscular disorder associated with congenital or childhood-onset of skeletal muscle weakness and hypotonia, which results in limited motor function. NM is a genetic disorder and mutations in 12 genes are known to contribute to autosomal dominant or recessive forms of the disease. Recessive mutations in nebulin (NEB) are the most common cause of NM affecting about 50% of patients. Because of the large size of the NEB gene and lack of mutational hot spots, developing therapies that can benefit a wide group of patients is challenging. Although there are several promising therapies under investigation, there is no cure for NM. Therefore, targeting disease modifiers that can stabilize or improve skeletal muscle function may represent alternative therapeutic strategies. Our studies have identified Nrap upregulation in nebulin deficiency that contributes to structural and functional deficits in NM. We show that genetic ablation of nrap in nebulin deficiency restored sarcomeric disorganization, reduced protein aggregates and improved skeletal muscle function in zebrafish. Our findings suggest that Nrap is a disease modifier that affects skeletal muscle structure and function in NM; thus, therapeutic targeting of Nrap in nebulin-related NM and related diseases may be beneficial for patients.
Streptococcus suisprophage lysin as a new strategy for combating streptococci-induced mastitis andStreptococcus suisinfection
Authors: Li Xin-Xin , Zhang Fen-Qiang , Wang Shuang , Duan Xiao-Chao , Hu Da-Yue , Gao Dong-Yang , Tao Pan , Li Xiang-Min , Qian Ping
Published: January 2023

Objectives

The genus Streptococcus contains species of important zoonotic pathogens such as those that cause bovine mastitis. Unfortunately, many Streptococcus species have developed antibiotic resistance. Phage lysins are considered promising alternatives to antibiotics because it is difficult for bacteria to develop lysin resistance. However, there remains a lack of phage lysin resources for the treatment of streptococci-induced mastitis.

Methods

We identified the prophage lysin Lys0859 from the genome of the Streptococcus suis SS0859 strain. Lys0859 was subsequently characterized to determine its host range, MIC, bactericidal activity in milk, and ability to clear biofilms in vitro. Finally, to determine the effects of Lys0859 on the treatment of both bovine mastitis and S. suis infection in vivo, we established models of Streptococcus agalactiae ATCC 13813-induced mastitis and S. suis serotype 2 SC19 systemic infection.

Results

Our results demonstrate that Lys0859 possesses broad-spectrum lytic activity against Streptococcus and Staphylococcus species isolated from animals with bovine mastitis and 15 serotypes of S. suis isolated from swine. Intramammary and intramuscular injection of Lys0859 reduced the number of bacteria in mammary tissue by 3.75 and 1.45 logs compared with the PBS group, respectively. Furthermore, 100 μg/mouse of Lys0859 administered intraperitoneally at 1 h post-infection protected 83.3% (5/6) of mice from a lethal dose of S. suis infection.

Conclusions

Overall, our results enhance the understanding and development of new strategies to combat both streptococci-induced mastitis and S. suis infection.
Multianalytical Approach for the Preservation of Pleistocene Bones: Evaluation of Potential Consolidation Products and Application Methods
Authors: Díaz-Cortés Andrea , Otero Jorge , López-Polín Lucía
Published: January 2023

Bone in archaeological or paleontological sites is often prone to degradation during the taphonomic phases (before and after the burial process until its discovery) which significantly weakens the bone’s mechanical properties. To preserve the material, consolidation treatments are commonly applied during ̶excavations to improve the cohesion of friable material. Studies on the effectiveness of bone consolidation treatments are relatively scarce. This research provides the first comparative analysis of the effectiveness of consolidation among three bone consolidation products (Acril 33®, Paraloid B72®, and Nanorestore®) applied by three different methods (capillary, immersion, and drip). Consolidation effectiveness was analyzed by the characterization of the absorption (water-drop absorption), contact angle measurements, environmental scanning electron microscopy, observation of the ability to penetrate the bone microstructure, by 3D visible light microscopy (HIROX 8700), and Leeb hardness measurements for the determination of mechanical strength improvements. Results show that the aqueous resin Acril 33® tends to provide a low penetration depth, creating a rigid superficial layer over the samples regardless of the application method, which seriously compromises the overall consolidation effectiveness. On the contrary, samples treated with Paraloid B72® present a higher penetration depth and increase the mechanical properties of samples applied by capillarity and immersion. Nanorestore® induced a significant increase in surface hardness regardless of the application method.
Automated Particle Analysis Using Field-Emission Scanning Electron Microscopy (FE-SEM) and Energy Dispersive X-Ray Spectroscopy (EDS) to Characterize Inhaled Particulate Matter (PM) in Biopsied Lung Tissue
Authors: Hayden Leslie , Strausborger Stacy , Lewin-Smith Michael
Published: January 2023

The role of inhaled particulate matter in the development of chronic lung disease in military veterans remains ill-defined and controversial. Characterizing the nature of such inhaled particulates in surgical lung biopsy tissue is an important step in evaluating the association between exposure and illness. We have developed a protocol for automated in-situ analysis of inorganic inhaled particulate matter using field-emission scanning electron microscopy with energy dispersive X-ray spectroscopy. Over 120,000 particles of both a geological and manufactured nature were analyzed and characterized according to their chemistry and morphology. The most abundant particles were clays, feldspars, silica, titanium dioxides, and metals and were by and large less than 2.5 µm in the greatest dimension. Automating the process allows for efficient in-situ analysis of thousands of particles each day and the development of large datasets.
VecMap: A Python-based Graphic User Interface Tool for Atomic Displacement Mapping in Perovskite Structures
Authors: Ma Tao
Published: January 2023

VecMap, a python-based graphic user interface tool was developed to help analyzing the atomic displacements in perovskite ceramics. With an input of a high-resolution STEM image in which the A-site, B-site, and/or O columns clearly resolved, VecMap outputs the displacement vector maps of either A-site or B-site cations, as well as the oxygen vector map if O columns are visible, in a highly automated fashion. A “Coupled HAADF-ABF” function was specially designed for easy atom finding in ABF images, in case the A-site and B-site atoms are too close in atomic numbers to show enough contrast. VecMap greatly simplifies the analysis of atomic displacement in perovskite structures.
Men who inject opioids exhibit altered tRNA-Gly-GCC isoforms in semen
Authors: Gornalusse Germán , Spengler Ryan M , Sandford Erin , Kim Yeseul , Levy Claire , Tewari Muneesh , Hladik Florian , Vojtech Lucia
Published: January 2023

In addition to their role in protein translation, tRNAs can be cleaved into shorter, biologically active fragments called tRNA fragments (tRFs). Specific tRFs from spermatocytes can propagate metabolic disorders in second generations of mice. Thus, tRFs in germline cells are a mechanism of epigenetic inheritance. It has also been shown that stress and toxins can cause alterations in tRF patterns. We were therefore interested in whether injecting illicit drugs, a major stressor, impacts tRFs in germline cells. We sequenced RNA from spermatocytes and from semen-derived exosomes from people who inject illicit drugs (PWID) and from non-drug using controls, both groups of unknown fertility status. All PWID injected opioids daily, but most also used other illicit drugs. The tRF cleavage products from Gly-GCC tRNA were markedly different between spermatocytes from PWID compared to controls. Over 90% of reads in controls mapped to shorter Gly-GCC tRFs, while in PWID only 45% did. In contrast, only 4.1% of reads in controls mapped to a longer tRFs versus 45.6% in PWID. The long/short tRF ratio was significantly higher in PWID than controls (0.23 versus 0.16, P = 0.0128). We also report differential expression of a group of small nucleolar RNAs (snoRNAs) in semen-derived exosomes, including, among others, ACA14a, U19, and U3-3. Thus, PWID exhibited an altered cleavage pattern of tRNA-Gly-GCC in spermatocytes and an altered cargo of snoRNAs in semen-derived exosomes. Participants were not exclusively using opioids and were not matched with controls in terms of diet, chronic disease, or other stressors, so our finding are not conclusively linked to opioid use. However, all individuals in the PWID group did inject heroin daily. Our study indicates a potential for opioid injection and/or its associated multi-drug use habits and lifestyle changes to influence epigenetic inheritance.
Recommendations for the management of the vascular involvement in Behçet’s disease by the Japanese National Research Committee for Behçet’s disease—secondary publication
Authors: Nagafuchi Hiroko , Kikuchi Hirotoshi , Ishibash Hiroyuki , Maeda Hideaki , Ogino Hitoshi , Kirino Yohei , Sawada Tetsuji , Saito Kazuyoshi , Kuwana Masataka , Hirohata Shunsei , Ishigatsubo Yoshiaki , Niimi Masanori , Okita Yutaka , Miyata Tetsuro , Shigematsu Hiroshi , Takeno Mitsuhiro
Published: January 2023

Objectives

This study aimed to develop clinical guidelines for the management of vascular Behçet’s disease (BD) by the Behçet’s Disease Research Committee of the Ministry of Health, Labour and Welfare of the Japanese Government.

Methods

A task force proposed clinical questions (CQs) concerning vascular BD based on a literature search. After screening, draft recommendations were developed for each CQ and brushed up in three blinded Delphi rounds, leading to the final recommendations.

Results

This study provides recommendations for 17 CQs concerning diagnosis and differential diagnoses, assessment of disease activity, and treatment. The guidelines recommend immunosuppressive treatments, for both arterial and venous involvement with active inflammation. Anticoagulation is also recommended for deep vein thrombosis except in high-risk patients. Surgical and endovascular therapies can be optional, particularly in patients with urgent arterial lesions undergoing immunosuppression. In addition, two sets of algorithms for diagnosis and treatment are shown for arterial and venous involvement.

Conclusions

These recommendations are expected to serve as useful tools in the daily clinical practice of BD. This content has already been published in Japanese in the Guideline for the Management of Behçet’s Disease 2020 and is submitted with permission from both the primary and secondary publishers.
Iron deficiency and cognitive functioning in kidney transplant recipients: findings of the TransplantLines biobank and cohort study
Authors: Vinke Joanna Sophia J , Ziengs Aaltje L , Buunk Anne M , van Sonderen Lisanne , Gomes-Neto Antonio W ,   TransplantLines Investigators, Berger Stefan P , Bakker Stephan J L , Eisenga Michele F , Spikman Jacoba M , De Borst Martin H
Published: January 2023

Background

Neurocognitive impairment is common in kidney transplant recipients (KTRs). Adequate brain functioning requires energy and neurotransmitter activity, for which iron is essential. We aimed to investigate iron deficiency (ID) as a potentially modifiable risk factor for cognitive impairment in KTRs.

Methods

We analyzed stable KTRs participating in the TransplantLines Biobank and Cohort study. Participants underwent neuropsychological tests for memory, mental speed, and attention and executive functioning. ID was defined as ferritin <100 µg/mL or 100–299 µg/mL with transferrin saturation (TSAT) ≤20%. Associations between iron status and norm scores of neurocognitive outcomes, corrected for age, sex and education, were assessed using multivariable linear regression analyses adjusted for potential confounders including hemoglobin.

Results

We included 166 KTRs [median (IQR) age 57 (45–65) years, 59% male, estimated glomerular filtration rate 51±18 mL/min/1.73 m2]. Time since transplantation was 5.8 (1.0–12.0) years. Prevalence of ID was 65%. ID was independently associated with lower scores for mental speed (std.β = –0.19, P = .02) and attention and executive functioning (std.β = –0.19, P = .02), and tended to be associated with worse memory (std.β = –0.16, P = .07). Lower plasma ferritin levels were associated with worse memory (std.β = 0.23, P = .007), mental speed (std.β = 0.34, P < .001), and attention and executive functioning (std.β = 0.30, P = .001). Lower TSAT was associated with worse memory (std.β = 0.19, P = .04) and mental speed (std.β = 0.27, P = .003), and tended to be associated with worse attention and executive functioning (std.β = 0.16, P = .08).

Conclusions

Iron-deficient KTRs performed worse on neurocognitive tasks measuring memory, mental speed, and attention and executive functioning. These findings set the stage for prospective studies addressing whether ID correction restores cognitive function after kidney transplantation.
The flowering time regulator FLK controls pathogen defense inArabidopsis thaliana
Authors: Fabian Matthew , Gao Min , Zhang Xiao-Ning , Shi Jiangli , Vrydagh Leah , Kim Sung-Ha , Patel Priyank , Hu Anna R , Lu Hua
Published: January 2023

Plant disease resistance is a complex process that is maintained in an intricate balance with development. Increasing evidence indicates the importance of posttranscriptional regulation of plant defense by RNA binding proteins. In a genetic screen for suppressors of Arabidopsis (Arabidopsis thaliana) accelerated cell death 6-1 (acd6-1), a small constitutive defense mutant whose defense level is grossly in a reverse proportion to plant size, we identified an allele of the canonical flowering regulatory gene FLOWERING LOCUS K HOMOLOGY DOMAIN (FLK) encoding a putative protein with triple K homology (KH) repeats. The KH repeat is an ancient RNA binding motif found in proteins from diverse organisms. The relevance of KH-domain proteins in pathogen resistance is largely unexplored. In addition to late flowering, the flk mutants exhibited decreased resistance to the bacterial pathogen Pseudomonas syringae and increased resistance to the necrotrophic fungal pathogen Botrytis cinerea. We further found that the flk mutations compromised basal defense and defense signaling mediated by salicylic acid (SA). Mutant analysis revealed complex genetic interactions between FLK and several major SA pathway genes. RNA-seq data showed that FLK regulates expression abundance of some major defense- and development-related genes as well as alternative splicing of a number of genes. Among the genes affected by FLK is ACD6, whose transcripts had increased intron retentions influenced by the flk mutations. Thus, this study provides mechanistic support for flk suppression of acd6-1 and establishes that FLK is a multifunctional gene involved in regulating pathogen defense and development of plants.
Clinical value of penile sympathetic skin response to assess the efficacy of sertraline in the treatment of patients with sympathetic hyperexcitability in primary premature ejaculation
Authors: Li Jiacheng , Liao Zedong , Xu Zilei , Huang Xiaojun
Published: January 2023

Background

The pathogenesis of primary premature ejaculation (PPE) is complex, and the pathologic basis may be an overactive sympathetic nervous system.

Aim

To investigate sertraline efficacy in patients with sympathetic hyperexcitability in PPE and clarify the value of penile sympathetic skin response (PSSR) in assessing the efficacy of sertraline for PPE treatment.

Methods

Sixty-three patients with PPE were recruited in the outpatient clinic and asked to take 50 mg of oral sertraline daily for a 4-week treatment period. Changes in intravaginal ejaculation latency time (IELT), Premature Ejaculation Diagnostic Tool, International Index of Erectile Function (IIEF-5), and PSSR latency and wave amplitude were compared before and after treatment.

Outcomes

The principal aim was to determine the relationships among sertraline efficacy, IELT, and PSSR latency and amplitude.

Results

After sertraline treatment, patients with PPE demonstrated a significant decrease in Premature Ejaculation Diagnostic Tool scores (P < .001); a significant increase in IELT, PSSR latency, and wave amplitude (P < .001); and no significant change in International Index of Erectile Function scores (P > .05). Moreover, the latency changes of PSSR were positively correlated with the increment of IELT (r = 0.550, P < .001). In addition, there was some degree of improvement vs pretreatment, although IELT and PSSR latencies were significantly shorter after drug discontinuation when compared with posttreatment (both P < .001).

Clinical Implications

We aimed to find an objective test that accurately reflects the efficacy of treatment for sympathetic hyperexcitability in PPE.

Strengths and Limitations

The strengths include a well-powered study, use of validated instruments, and self-assessment of treatment benefit. The limitations include the single-center design, relatively short-term follow-up, and lack of more comprehensive monitoring between treatment and drug discontinuation.

Conclusion

These findings suggest that sertraline is effective for PPE treatment, that its efficacy can be partially maintained even after drug discontinuation, and that PSSR may be reliable for evaluating treatment success in patients with PPE.
From Colorblindness to Critical Investigations: Examining Structural Racism in Social Work Research
Authors: Lauve-Moon Katie R , Enman Shelby , Hentz Vanessa
Published: January 2023

Current and persistent racialized inequalities in the United States raise important research questions investigating the social structures and systems that underlie racist outcomes. Consequently, social workers are called to centralize race and racism in their research agendas and utilize critical race theories and methodologies to examine institutional racism. This study investigates the extent to which critical race frameworks are utilized in mainstream social work research. The researchers conducted a content analysis of three top-ranked mainstream social work research journals (N = 407) to determine the extent to which critical race theories and methodologies are utilized for the investigation of institutional racism. Findings demonstrate a dearth of critical investigation into issues of race and racism in mainstream social work research as well as the underutilization of critical race frameworks. In conclusion, researchers argue for a critical shift in mainstream social work research through utilizing critical race theoretical frameworks and methodologies.
What We Lose When We “Don’t Say Gay”: Generational Shifts in Sexual Identity and Gender
Authors: Bochicchio Lauren , Carmichael Avery Jane , Veldhuis Cindy , Stefancic Ana
Published: January 2023

At a time when anti-LGBTQ+ legislation is on the rise in more than a dozen states across the United States, social work providers and researchers must be acutely aware of the ways in which their practice may unintentionally invalidate the identities of LGBTQ+ youth. Concurrently, language used in the LGBTQ+ youth community to describe both sexual identity and gender has moved away from monosexual and binary labels toward nonmonosexual and nonbinary descriptions. The adoption of such language, in practice and in research, is a simple step toward combatting invalidation in the social work field. This commentary explores the expansion of identity labels through the lens of a study conducted across four leading LGBTQ+ agencies in New York and New Jersey with youth and staff. Authors review data that demonstrate the evolution of labels and argue that adopting these terms in practice and research will have fruitful and affirming effects on access to care, treatment attrition, and the design and quality of research in and for the LGBTQ+ community. This shift in language must be comprehensively addressed to ensure that practice and research continue to adopt and advocate for ways to affirm LGBTQ+ people, particularly given the recent onslaught of anti-LGBTQ+ legislation.
Racial Disparities and Pressure Injuries Among Hospitalized Patients
Authors: Cox Jill , Thomas Hawkins Charlotte
Published: January 2023

OBJECTIVE

To describe the demographic factors, hospitalization-related factors, comorbid states, and social determinants of health among racial groups in a sample of patients with a primary or secondary diagnosis of pressure injury (PI) admitted to New Jersey hospitals during the year 2018.

METHODS

Researchers conducted a retrospective analysis of the Health Care Utilization Project’s 2018 New Jersey State Inpatient Database. Patients with a primary or secondary diagnosis of PI (sacrum, buttocks, or heels; N = 17,781) were included in the analytic sample. Analysis compared patients who identified as Black (n = 3,515) with all other racial groups combined (n = 14,266).

RESULTS

A higher proportion of Black patients were admitted for a PI (P < .001) and had higher proportions of stage 4 PIs (P < .001) but a lower proportion of stage 1 PIs (P < .001). Higher proportions of Black patients were younger, resided in lower income communities, and identified Medicaid as their primary payor source.

CONCLUSIONS

Results highlight the racial disparities that exist among patients with PIs in this diverse state and may represent a much larger problem. Clinical research examining the impact of skin tone rather than by racial group is needed. The impact of racial disparities on social determinants of health with regard to PIs remains largely unknown, but its importance cannot be underestimated.
Factors Associated with Leg Ulcers in Adults with Sickle Cell Disease in Brazil
Authors: Reis de Souza Valquíria , Kelly Shannon , Cerdeira Sabino Ester , Mendes de Oliveira Franciane , Silva Tassila , Miranda Teixeira Carolina , Máximo Claudia , Loureiro Paula , Barbara de Freitas Carneiro-Proietti Anna , Gomes Isabel , Custer Brian , de Almeida-Neto Cesar
Published: January 2023

OBJECTIVE

To define the prevalence of leg ulcers and identify the clinical and laboratory factors associated with leg ulcers in adult participants.

METHODS

The authors conducted a cross-sectional study of 1,109 patients who were 18 years or older with SS or Sβ0-thalassemia genotypes from a Brazilian cohort. Investigators assessed the prevalence of factors associated with leg ulcers from 2013 to 2017.

RESULTS

The prevalence of leg ulcers was 21%. Increasing age (odds ratio [OR], 1.07; range, 1.06–1.09), male sex (OR, 2.03; range, 1.44–2.87), treatment with chronic transfusion therapy (OR, 1.88; range, 1.15–3.03), higher indirect bilirubin levels (OR, 1.48; range, 1.02–2.16), and low hemoglobin levels (OR, 2.17; range, 1.52–3.11) were associated with leg ulcers. Participants who self-reported as Black (OR, 6.75; range, 2.63–21.32), mixed (OR, 3.91; range, 1.55–12.20), and other/unknown (OR, 3.84; range, 1.04–15.24) were more likely to have leg ulcers compared with those who self-reported as White.

CONCLUSIONS

The prevalence of leg ulcers in this Brazilian cohort was higher than the prevalence reported in developed countries. Known factors such as age and male sex were corroborated. The increased bilirubin level and decreased hemoglobin levels among participants with leg ulcers support the hypothesis that hemolysis is correlated with leg ulcer pathogenesis. Self-reported black skin color was an independent predictor of leg ulcers and warrants further study to understand the etiology and implications of this finding.
Methodological and Clinimetric Evaluation of Inspiratory Respiratory Muscle Ultrasound in the Critical Care Setting: A Systematic Review and Meta-Analysis
Authors: Truong Dominic , Abo Shaza , Whish-Wilson Georgina A. , D’Souza Aruska N. , Beach Lisa J. , Mathur Sunita , Mayer Kirby P. , Ntoumenopoulos George , Baldwin Claire , El-Ansary Doa , Paris Michael T. , Mourtzakis Marina , Morris Peter E. , Pastva Amy M. , Granger Catherine L. , Parry Selina M. , Sarwal Aarti
Published: January 2023

OBJECTIVE:

Significant variations exist in the use of respiratory muscle ultrasound in intensive care with no society-level consensus on the optimal methodology. This systematic review aims to evaluate, synthesize, and compare the clinimetric properties of different image acquisition and analysis methodologies.

DATA SOURCES:

Systematic search of five databases up to November 24, 2021.

STUDY SELECTION:

Studies were included if they enrolled at least 50 adult ICU patients, reported respiratory muscle (diaphragm or intercostal) ultrasound measuring either echotexture, muscle thickness, thickening fraction, or excursion, and evaluated at least one clinimetric property. Two independent reviewers assessed titles, abstracts, and full text against eligibility.

DATA EXTRACTION:

Study demographics, ultrasound methodologies, and clinimetric data.

DATA SYNTHESIS:

Sixty studies, including 5,025 patients, were included with 39 studies contributing to meta-analyses. Most commonly measured was diaphragm thickness (DT) or diaphragm thickening fraction (DTF) using a linear transducer in B-mode, or diaphragm excursion (DE) using a curvilinear transducer in M-mode. There are significant variations in imaging methodology and acquisition across all studies. Inter- and intrarater measurement reliabilities were generally excellent, with the highest reliability reported for DT (ICC, 0.98; 95% CI, 0.94–0.99). Pooled data demonstrated acceptable to excellent accuracy for DT, DTF, and DE to predicting weaning outcome after 48 to 72 hours postextubation (DTF AUC, 0.79; 95% CI, 0.73–0.85). DT imaging was responsive to change over time. Only three eligible studies were available for intercostal muscles. Intercostal thickening fraction was shown to have excellent accuracy of predicting weaning outcome after 48-hour postextubation (AUC, 0.84; 95% CI, 0.78–0.91).

CONCLUSIONS:

Diaphragm muscle ultrasound is reliable, valid, and responsive in ICU patients, but significant variation exists in the imaging acquisition and analysis methodologies. Future work should focus on developing standardized protocols for ultrasound imaging and consider further research into the role of intercostal muscle imaging.
The human and animals’ malignant melanoma: comparative tumor models and the role of microbiome in dogs and humans
Authors: Pinto Catarina , Aluai-Cunha Catarina , Santos Andreia
Published: January 2023

Currently, the most progressively occurring incident cancer is melanoma. The mouse is the most popular model in human melanoma research given its various benefits as a laboratory animal. Nevertheless, unlike humans, mice do not develop melanoma spontaneously, so they need to be genetically manipulated. In opposition, there are several reports of other animals, ranging from wild to domesticated animals, that spontaneously develop melanoma and that have cancer pathways that are similar to those of humans. The influence of the gut microbiome on health and disease is being the aim of many recent studies. It has been proven that the microbiome is a determinant of the host’s immune status and disease prevention. In human medicine, there is increasing evidence that changes in the microbiome influences malignant melanoma progression and response to therapy. There are several similarities between some animals and human melanoma, especially between canine and human oral malignant melanoma as well as between the gut microbiome of both species. However, microbiome studies are scarce in veterinary medicine, especially in the oncology field. Future studies need to address the relevance of gut and tissue microbiome for canine malignant melanoma development, which results will certainly benefit both species in the context of translational medicine.
Evaluation of Coenzyme Q10 (CoQ10) Deficiency and Therapy in Mouse Models of Cardiomyopathy
Authors: Pu Tian-Tian , Wu Wei , Liang Pei-Da , Du Jin-Chan , Han Sheng-Li , Deng Xiu-Ling , Du Xiao-Jun
Published: January 2023

Mitochondrial dysfunction plays a key role in the development of heart failure, but targeted therapeutic interventions remain elusive. Previous studies have shown coenzyme Q10 (CoQ10) insufficiency in patients with heart disease with undefined mechanism and modest effectiveness of CoQ10 supplement therapy. Using 2 transgenic mouse models of cardiomyopathy owing to cardiac overexpression of Mst1 (Mst1-TG) or β2-adrenoceptor (β2AR-TG), we studied changes in cardiac CoQ10 content and alterations in CoQ10 biosynthesis genes. We also studied in Mst1-TG mice effects of CoQ10, delivered by oral or injection regimens, on both cardiac CoQ10 content and cardiomyopathy phenotypes. High performance liquid chromatography and RNA sequencing revealed in both models significant reduction in cardiac content of CoQ10 and downregulation of most genes encoding CoQ10 biosynthesis enzymes. Mst1-TG mice with 70% reduction in cardiac CoQ10 were treated with CoQ10 either by oral gavage or i.p. injection for 4–8 weeks. Oral regimens failed in increasing cardiac CoQ10 content, whereas injection regimen effectively restored the cardiac CoQ10 level in a time-dependent manner. However, CoQ10 restoration in Mst1-TG mice did not correct mitochondrial dysfunction measured by energy metabolism, downregulated expression of marker proteins, and oxidative stress nor to preserve cardiac contractile function. In conclusion, mouse models of cardiomyopathy exhibited myocardial CoQ10 deficiency likely due to suppressed endogenous synthesis of CoQ10. In contrast to ineffectiveness of oral administration, CoQ10 administration by injection regimen in cardiomyopathy mice restored cardiac CoQ10 content, which, however, failed in achieving detectable efficacy at molecular and global functional levels.
Outcomes of Nipple-sparing Mastectomy with Reconstruction after Recent Oncoplastic Wise-pattern Reduction
Authors: Choudhry Salman , Martin Tasha A. , Holton Tripp , Jackson Rubie S.
Published: January 2023

Background:

For patients with large and/or ptotic breasts, a planned staged approach to nipple-sparing mastectomy (NSM) has been described. Less is known about surgical outcomes of unplanned staged NSM for management of positive margins after partial mastectomy with oncoplastic reduction. It is not clear from earlier studies whether an interval of less than 10 weeks between oncoplastic reduction and NSM is feasible, when a shorter interval is important for oncologic reasons.

Methods:

This is a single institution analysis of patients from 2018 to 2021 with a diagnosis of invasive cancer or ductal carcinoma in situ who underwent NSM after oncoplastic breast reduction for positive margins or nodes. The primary endpoint measured was nipple loss. Secondary outcomes were need for operative re-intervention and wound complications.

Results:

Nine patients (14 breasts) underwent partial mastectomy with oncoplastic Wise-pattern breast reduction, followed by NSM. Three patients underwent intersurgery chemotherapy. The average interval between oncoplastic reduction and NSM was 11.3 weeks when excluding patients undergoing chemotherapy (range 8–13 weeks). Thirteen breasts (93%) underwent pre-pectoral direct-to-implant reconstruction. One breast (7%) received autologous reconstruction. One breast required reoperation for seroma. The rate of partial or total nipple loss was 0%, with an average follow-up of 1.6 years.

Conclusions:

Our experience demonstrates excellent outcomes from NSM after oncoplastic breast reduction, with the majority of patients undergoing single-stage pectoral direct-to-implant breast reconstruction. Overall, patients had a shorter intersurgery interval, compared with prior studies, with no cases of nipple loss. An intersurgery interval of 8 weeks may be feasible when avoiding delays is important for oncologic reasons.
Triad multisystem phenotype with high risk for developing temporomandibular disorders—characteristics and potential pathophysiology results from the Orofacial Pain: Prospective Evaluation and Risk Assessment dataset
Authors: Chen Hong , Comnick Carissa , Norman Greg J. , Caplan Daniel J. , Xie Xian Jin , Fillingim Roger B.
Published: January 2023

A multisystem phenotype with the Triad of bodily pain, psychological distress, and sleep disturbance was found to have high risk for developing initial onset of painful temporomandibular disorders (TMDs) in the multicenter Orofacial Pain: Prospective Evaluation and Risk Assessment dataset. In this study, we systemically examined phenotypic characteristics and explored potential pathophysiology in quantitative sensory testing and autonomic nervous system domains in this multisystem Triad phenotype. Secondary analysis was performed on 1199 non-Triad and 154 Triad TMD-free Orofacial Pain: Prospective Evaluation and Risk Assessment enrollees at baseline. Results indicated that before developing TMDs, the Triad phenotype demonstrated both orofacial and systemic signs and symptoms that can only be captured through multisystem assessment. In addition, we found significantly lower resting heart rate variability and higher resting heart rate in the Triad phenotype as compared with the non-Triad group. However, pain sensitivity measured by quantitative sensory testing was not different between groups. These findings highlight the importance of whole-person multisystem assessment at the stage before developing complex pain conditions, such as TMDs, and suggest that, in addition to a “tissue damage monitor,” pain should be considered in a broader context, such as a component within a “distress monitoring system” at the whole-person level when multisystem issues copresent. Therefore, the presence or absence of multisystem issues may carry critical information when searching for disease mechanisms and developing mechanism-based intervention and prevention strategies for TMDs and related pain conditions. Cardiovascular autonomic function should be further researched when multisystem issues copresent before developing TMDs.
The burden of preoperative fear-avoidance beliefs in workers after thoracic and lumbar spine surgery: a 2-year follow-up study
Authors: Bellosta-López Pablo , Langella Francesco , Ponzo Matteo , Bassani Roberto , Brayda-Bruno Marco , Damilano Marco , Giudici Fabrizio , Lovi Alessio , Morselli Carlotta , Redaelli Andrea , Scaramuzzo Laura , Lamartina Claudio , Berjano Pedro
Published: January 2023

Spinal disorders are the main reasons for sick leave and early retirement among the working population in industrialized countries. When “red flags” are present, spine surgery is the treatment of choice. However, the role of psychosocial factors such as fear-avoidance beliefs in spine surgery outcomes is still debated. The study aims to investigate whether patients presenting high or low levels of fear-avoidance thoughts before the spine surgery reported different surgical results and return-to-work rates over 2 years. From an institutional spine surgery registry, workers surgically treated with a preoperative score in the Oswestry Disability Index (ODI) higher than 20/100 and provided ODI questionnaires, return-to-work status at 3-, 6-, 12-, and 24-month follow-ups were analyzed. A total of 1769 patients were stratified according to the work subscale of the Fear-Avoidance Beliefs Questionnaire (FABQ-W) in high fear (FABQ-W ≥ 34/42) or low fear (FABQ-W < 34/42). Multivariate regression was used to search for preoperative factors, which might interact with FABQ-W. The higher-fear group showed a different recovery pattern, with higher levels of disability according to the ODI (total score, absolute change, frequency of clinically relevant change, and disability categories) and lower return-to-work ratios over the 24-month follow-up. High fear, high disability, greater age, female gender, smoking, and worse physical status at baseline were associated with worse ODI outcomes 2 years after the surgery. In summary, fear-avoidance beliefs significantly influence the speed and the entity of surgical outcomes in the working population. However, the contribution of FABQ-W in predicting long-term disability levels was limited.
The impact of ageism in the care of older adults with cancer
Authors: Krasovitsky Michael , Porter Isobel , Tuch Gina
Published: January 2023

Purpose of review

This review summarizes recent research on the impact of ageism in older adults with cancer and how society can best address the issue. Despite older individuals representing the vast majority of those with cancer, with a dramatic increase in incidence anticipated in the coming decades, ageism remains an under-recognized and extremely detrimental phenomenon in cancer care.

Recent findings

We examine the associations between ageism and health, and highlight the consequences of higher mortality, a deterioration in mental and physical health, worse functional status and increased comorbidity burden. We then discuss the oncologic-specific impacts of ageism, including lower rates of cancer screening, decreased histological confirmation of cancer, decreased surgical intervention and systemic therapy prescription and poorer survivorship experience. To conclude, we illustrate the opportunities within oncologic systems of care to engage with, and dismantle, the damaging effects of ageism, namely policy and legislation, education and intergenerational contact.

Despite recognition of the numerous negative sequelae of ageism, there remains a paucity of literature regarding the intersection between ageism and cancer. Our piece summarizes the key developments in this field, but further evaluation is desperately required.
The Effect of Chair-Based Exercises on Exercise Perception and Risk of Falling in Inactive Older Adults Who Live at Nursing Home
Authors: Arslan Tuğba , Aslan Telci Emine , Arslan Serdar
Published: January 2023

The purpose of this study was to investigate the effect of chair-based exercises on exercise perception, fall risk, and health-related quality of life in inactive older adults. The study was carried out on nursing home residents older than 65 years with an inactive lifestyle. The Exercise Benefits/Barriers Scale, Tinetti Assessment Battery, and Nottingham Health Profile were used in the assessments. The Exercise Benefits/Barriers Scale score and Tinetti Balance and Gait Test scores of the participants in the exercise group were higher than those of the control group. The study concluded that chair-based exercises are beneficial for sedentary older adults in respect of the perception of exercise and risk of falling.
Glioblastoma Combined With an Extracranial Bone Tumor in the Femur—A Case Report
Authors: Lee Yeon Soo , Lee Sook Joung , Choi Eunseok , Lee Il Woo , Yi Jinseok , Lee Sangjee , Chang So-Youn
Published: January 2023

Glioblastoma multiforme (GBM) is one of the most aggressive malignancies and primarily arises intracranially. It rarely coexists with other tumors. Here, we report an anomalous case of a patient who had GBM combined with a bone tumor of the femur. As new treatment options have been developed, the survival rate of patients with GBM has increased incrementally; thus, clinicians will encounter patients with extracranial metastases or combined with other diseases. Although extracranial GBM metastases and GBM combined with other tumors are rare, comprehensive whole-body evaluations are needed for proper management and therapeutic strategies.
Immediate Effects of the Honda Walking Assist on Spatiotemporal Gait Characteristics in Older Adults
Authors: Firouzi Mahyar , De Keersmaec Emma , Lefeber Nina , Roggeman Stijn , Joos Erika , Kerckhofs Eric , Beckwée David , Swinnen Eva
Published: January 2023

We compared changes in spatiotemporal gait parameters of 11 healthy older adults (mean age: 88.6 years) over 3 conditions of walking with the Honda Walking Assist (HWA), a hip-assistive exoskeleton. Differences in 14 gait parameters between (1) normal overground walking, (2) walking with a nonassisting HWA, and (3) optimally assisting HWA were analyzed using Friedman and Wilcoxon signed rank tests. Significant differences depending on type of assistance were found for 9 parameters. None persisted following Bonferroni corrections. Single-session individualized HWA assistance does not induce immediate changes in gait parameters. This does not contradict the potential of multiple training sessions with the HWA.